Persistence of disseminated tumor cells (DTC) in bone marrow (BM) of breast cancer patients predicts increased risk for relapse—Results of pooled European data

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 10083-10083 ◽  
Author(s):  
W. J. Janni ◽  
G. Wiedswang ◽  
T. Fehm ◽  
J. Jueckstock ◽  
E. Borgen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Bone Marrow ◽  
Adjuvant Therapy ◽  
Cancer Patients ◽  
Adjuvant Treatment ◽  
Prognostic Significance ◽  
Primary Diagnosis ◽  
Nodal Status ◽  
Breast Cancer Patients ◽  
Increased Risk

10083 Background: The prognostic significance of DTC in the BM of breast cancer patients at the time of primary diagnosis has recently been confirmed by a large pooled analysis. If the persistence of DTC after adjuvant therapy confers a similar risk for relapse, there might be an indication for secondary adjuvant treatment. Methods: We analyzed BM aspirates of 697 patients from academic breast cancer units in Oslo (n=356), Munich (n=228) and Tuebingen (n=113) during recurrence-free follow-up at a median interval of 32.4 months (standard deviation [std] 19.4 mon) after primary diagnosis of breast cancer pT1–4, pN0–3 pM0. Carcinoma cells were detected using a standardized immunoassay with the monoclonal antibodies A45-B/B3 (Munich, Tuebingen), or AE1 and AE3 (Oslo), directed against cytokeratin (CK). Patients were followed for a median of 54.2 months (std 24.5 mon) after primary diagnosis. Results: Persistent DTC in the BM were detected in 15.6% of the patients (n=109). The Kaplan-Meier estimate for mean distant relapse-free survival estimate was 155.6 mon (142.4 - 168.9 95%CI) in patients with negative and 102.3 mon (93.6 - 111.0, 95% CI, p< .0001, log rank test) in patients with positive BM status. Patients without evidence of persistent DTC had a significantly longer overall survival (164.4 [155.6 - 173.3]), than patients with positive BM status (101.7 mon [89.4 - 113.9], p< .0001). In multivariate Cox regression analysis, allowing for bone marrow status, tumor size, nodal status, histopathological grading and hormone receptor status, DTC was of higher independent prognostic significance for subsequent reduced breast cancer specific survival (RR 5.9, 2.8 - 12.8, 95% CI, p< .0001), than nodal status at time of primary diagnosis (RR 1.2, 1.0 - 1.3, 95% CI, p=.014). Conclusion: Evidence of persistent DTC in breast cancer patients indicates an increased risk for subsequent relapse, and may serve for monitoring in future clinical trials. Such trials might investigate the benefit of individualized secondary adjuvant treatment or extended adjuvant therapy of patients with DTC. No significant financial relationships to disclose.

scholarly journals Prognostic Significance of Abdominal-to-Gluteofemoral Adipose Tissue Distribution in Patients with Breast Cancer

2019 ◽  
Vol 8 (9) ◽  
pp. 1358 ◽  
Author(s):  
Lee ◽  
Kim ◽  
Lee ◽  
Han ◽  
Lee ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adipose Tissue ◽  
Cancer Patients ◽  
Univariate Analysis ◽  
Prognostic Significance ◽  
Volume Ratio ◽  
Ct Images ◽  
Breast Cancer Patients ◽  
Risk Of Recurrence ◽  
Increased Risk

This study aimed to evaluate the association between abdominal-to-gluteofemoral adipose tissue (AT) distribution and recurrence-free survival (RFS) in breast cancer patients. Staging F-18 fluorodexoyglucose (FDG) positron emission tomography/computed tomography (PET/CT) images of 336 women with breast cancer were retrospectively analyzed. From CT images, the volume and CT-attenuation of visceral adipose tissue (VAT), abdominal subcutaneous adipose tissue (SAT), and gluteofemoral AT were measured and the ratio of abdomen-to-gluteofemoral AT volume (AG volume ratio) was calculated. The relationships between adipose tissue parameters and RFS were assessed. Through univariate analysis, abdominal SAT volume, gluteofemoral AT volume, and AG volume ratio were significantly associated with RFS. An increase in abdominal SAT volume and AG volume ratio were associated with an increased risk of recurrence, whereas increased gluteofemoral AT volume was associated with a decreased risk of recurrence. On multivariate analysis, abdominal SAT volume, gluteofemoral AT volume, and AG volume ratio were found to be significant predictors of RFS after adjusting for clinic-histological factors. Irrespective of obesity, patients with a high AG volume ratio showed a higher recurrence rate than those with a low AG volume ratio. Increased abdominal SAT volume and decreased gluteofemoral AT volume were related to poor RFS in breast cancer patients.

Prediction of late metastasis in node-negative breast cancer.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 10551-10551
Author(s):  
Marcus Schmidt ◽  
Birte Hellwig ◽  
Mathias Gehrmann ◽  
Heinz Koelbl ◽  
Daniel Boehm ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Cox Regression ◽  
Prognostic Significance ◽  
Gene Array ◽  
Breast Cancer Patients ◽  
Node Negative ◽  
Node Negative Breast Cancer ◽  
Increased Risk ◽  
Late Metastasis

10551 Background: Prediction of late metastasis is of clinical relevance in breast cancer. However, systematic genome-wide studies to identify genes associated with increased risk of metastasis 5 or more years after surgery are scarce. Methods: We examined the natural course of disease in three previously published cohorts (Mainz, Rotterdam, Transbig) including 766 node-negative breast cancer patients with gene array data who did not receive systemic chemotherapy in the adjuvant setting. We established a Cox regression based method adjusted for multiple testing that identified genes predicting late metastasis (5 or more years after surgery). Only those genes were accepted that showed similar results in all three cohorts. Metastasis-free survival (MFS) was analyzed with univariate and multivariate Cox regression. Results: We identified 9 genes [ABCC5 (Hazard Ratio (HR) 2.19, p=0.003), EDDM3B (HR 3.58, p=0.044), RAD23B (HR 0.37, p<0.001), XYLT2 (HR 2.19, p=0.027), DDX18 (HR 0.35, p=0.006), GPBP1L1 (HR 0.20, p=0.018), UBB (HR 9.73, p=0.025), RPS24 (HR 0.20, p=0.050), GPC1 (HR 2.36, p=0.013)] predicting late metastasis. These genes retained their independent prognostic significance after adjustment for established clinical factors (age, tumor size, grade, hormone receptor status, HER2) and biological motives like estrogen receptor, proliferation, B or T cells. These late-type genes are largely associated with resistance to hypoxia, apoptosis and DNA damage, suggesting that they might contribute to persistence of disseminated tumor cells. Conclusions: Genes associated with late metastasis offer a perspective to identify breast cancer patients suitable for additional and prolonged therapies.

Efficacy of zoledronic acid for the reduction of bone marrow tumor cells in breast cancer patients receiving adjuvant therapy

Bone ◽  
2006 ◽  
Vol 38 (3) ◽  
pp. 84
Author(s):  
E.-F. Solomayer ◽  
T. Fehm ◽  
G. Gebauer ◽  
W. Janni ◽  
H.-J. Lück ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Bone Marrow ◽  
Zoledronic Acid ◽  
Adjuvant Therapy ◽  
Cancer Patients ◽  
Tumor Cells ◽  
Breast Cancer Patients

Prognostic Value of p53 for Local Failure in Mastectomy-Treated Breast Cancer Patients

2000 ◽  
Vol 18 (9) ◽  
pp. 1906-1913 ◽  
Author(s):  
R.C. Zellars ◽  
S.G. Hilsenbeck ◽  
G.M. Clark ◽  
D.C. Allred ◽  
T.S. Herman ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
P53 Protein ◽  
Local Relapse ◽  
Nodal Status ◽  
Local Failure ◽  
Nuclear Accumulation ◽  
Protein Accumulation ◽  
Breast Cancer Patients ◽  
Increased Risk

PURPOSE: The loss of p53 function is a recognized adverse prognostic factor in invasive breast cancer. Several studies have shown a relationship between the nuclear accumulation of p53 protein (a surrogate marker of p53 inactivation) and poor disease-free and overall survival. In general, however, these studies did not report the prognostic value of p53 for local failure, which we have therefore assessed retrospectively here. MATERIALS AND METHODS: Accumulation of p53 protein was evaluated by immunohistochemistry in 1,530 mastectomy-treated breast cancer patients (259 radiation therapy [RT]– and 1,271 mastectomy only [No RT]–treated patients). Statistical comparisons were made between p53 protein accumulation, estrogen/progesterone receptors, nodal status, tumor size, and local failure rate (LFR). Local failure was defined as tumor recurrence involving the chest wall and/or the ipsilateral supraclavicular/axillary lymph nodes. The median follow-up period was 62 months. RESULTS: In the No RT group, the LFR was 9.1% and 16.5% in p53-negative and p53-positive patients, respectively (P < .001). Multivariate analysis revealed that p53 protein accumulation was significantly associated with an increased risk of local relapse (relative risk [RR], 1.7; 95% confidence interval [CI], 1.2 to 2.4). Nodal status and tumor size were also significant factors. In the RT group, the LFR was 9.3% and 21.5% in p53-negative and p53-positive patients, respectively (P = .009). Multivariate analysis revealed that p53 protein accumulation was significantly associated with an increased risk of local relapse (RR, 2.5; 95% CI, 1.1 to 5.7), as was nodal status. CONCLUSION: Nuclear accumulation of p53 protein is independently associated with a significantly increased local failure rate in breast cancer patients treated with mastectomy, with or without radiation.

Cost-effective treatment with half year of trastuzumab and chemotherapy as adjuvant treatment for overexpression of Her2/neu breast cancer patients: Two institutional experiences in Taiwan

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 10765-10765
Author(s):  
C. J. Tai ◽  
C. K. Pan ◽  
C. H. Wu ◽  
C. S. Chen
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Adjuvant Therapy ◽  
Cancer Patients ◽  
Adjuvant Treatment ◽  
Stage Ii ◽  
Stage Iii ◽  
Breast Cancer Patients ◽  
Alternative Treatment Option ◽  
Cost Effective Treatment

10765 Background: In this study, we are evaluating the utilizing trastuzumab as an adjuvant combination with chemotherapy in an half year interval for breast cancer (1–3). Methods: Patients after October 2000 with HER2-positive (3+ by immunohistochemistry; if 2+, should fit over expression by FISH) stage II/III breast cancer who received adjuvant trastuzumab (4mg/kg ×1, then 2mg/kg/wk ×22, equals 6 bottles of trastuzumab) in combination with chemotherapy. The chemotherapy utilized for stage II breast cancer patients received CEF only and for those patients with LN(+) but ER/PR(−/−) also added paclitaxel for another 4 cycles besides CEF with interval of 3 weeks, and for those with stage III breast cancer patient with ER or PR(+), the docetaxel was given with CEF for 6 cycles). Clinical response rates were followed by using imaging studies with chest films, CT scanning, bone scan and sonography. Results: Overall, there were 37 patients enrolled in this study. The median age was 43 years old (22–74 y/o). Two patients (including the youngest one) were found to have bilateral breast cancer on diagnosis but both were still alive without disease so far. There were 3 patients developed disease progression after adjuvant chemotherapy with trastuzumab and 2 of them died thereafter and all these 3 patients were stage III disease. The oldest patient was one of the exception without receiving adjuvant chemotherapy and received monotherapy of trastuzumab only and so far, she was still alive without disease. The side effect including chills (24.32%), dizziness (8.10%), cough (2.10%), cold sweating (2.10%). Conclusions: For her2/neu overexpression patients, trastuzumabwith chemotherapy may have positive role in adjuvant therapy. In this study, our main goal is to achieve patient’s treatment outcome in disease free status. Nonetheless, the cost was high if we applied trastuzumab as adjuvant therapy with 1- or 2-year interval (4–6). Even if this required further time to demonstrate this study’s final outcome, I suppose that utilization of trastuzumab as adjuvant treatment plus chemotherapy in a half interval will be a good alternative treatment option. No significant financial relationships to disclose.

Adjuvant chemotherapy for breast cancer patients: Patients’ expectations and physicians’ attitudes

2012 ◽  
Vol 10 (2) ◽  
pp. 107-114 ◽  
Author(s):  
Frida Barak ◽  
Lev A. Ostrowsky ◽  
Shulamith Kreitler
Keyword(s):  
Breast Cancer ◽  
Side Effects ◽  
Adjuvant Chemotherapy ◽  
Adjuvant Therapy ◽  
Cancer Patients ◽  
Adjuvant Treatment ◽  
Breast Cancer Patients ◽  
Sources Of Information

AbstractObjective:Findings show that there is a certain degree of refusal on the part of breast cancer patients to undergo adjuvant therapy. Accordingly, the major goals of the study were, first, to learn more about the beliefs of breast cancer patients in regard to adjuvant therapy; second, to find out about the sources of the patients’ beliefs; and third, to learn about the attitudes of oncologists concerning the same aspects of adjuvant therapy to which the patients’ beliefs referred.Method:The participants were 92 breast cancer patients (mean age 61.2) and 57 doctors of both genders specialized in oncology or affiliated domains. Both groups were administered questionnaires referring to goals of adjuvant treatment, the chances of attaining these goals, side effects, and difficulty of the treatment. Doctors were specifically asked about the views they thought proper to communicate to patients in regard to the mentioned issues. Patients were also asked about whether they had doubts about the treatment and sources of information.Results:The findings showed disparities between the views of patients and doctors in regard to goals, chances of attainment, side effects, and difficulty of treatment. Patients endorsed more goals than doctors and tended to assign to them lower chances of attainment. Doctors were divided in their views about whether to communicate the side effects and difficulties.Significance of results:The results reveal the importance of outlining goals for patients undergoing adjuvant treatment and the disagreements between doctors about what should be communicated to patients, and highlight the complexity of providing to patients information that is both scientifically correct and emotionally helpful.

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