Impact of mammographic screening in staging, treatment and prognosis of breast cancer: Early assessment

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 10537-10537
Author(s):  
A. Lluch ◽  
I. Chirivella ◽  
A. Insa ◽  
F. Martinez-Ruiz ◽  
A. Santaballa ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Carcinoma ◽  
Cancer Patients ◽  
Breast Conserving Surgery ◽  
Tumor Stage ◽  
Mammographic Screening ◽  
Invasive Breast Carcinoma ◽  
Breast Cancer Patients ◽  
Early Assessment ◽  
The Impact

10537 Background: The use of breast cancer mammographic screening (MS) leads to early detection and has been shown to reduce the mortality rate and to increase the proportion of breast-conserving surgery. The aim of this study is to analyze the impact of mammography in the staging, treatment and prognosis of breast carcinoma. Methods: In 1993, a population-based mammographic screening among women aged from 45 to 70 years was introduced in the community of Valencia. We examined the effects of this MS program by the comparison of two populations. The first one included all the women with screen-detected invasive breast carcinoma between 1993 and 2002 in the community of Valencia. The second one was comprised of all the women with invasive breast carcinoma, diagnosed in the same period, aged 45–70, not attending the MS and treated at H. Clinico of Valencia. Results: Between January, 1993 and December, 2002, 2313 new invasive breast cancer patients were detected by the MS program in the community of Valencia, and 1349 women aged 45–70, not attending de MS were diagnosed with invasive breast carcinoma in H.Clinico of Valencia. The median follow-up period was 45.5 months for the screen-detected breast cancer and 51.9 months for not screen-detected patients. The screen-detected tumors had smaller pathological size (pT1 tumors 70.2% vs 40.5%, p < 0.0001), were more likely to have pathologically confirmed negative nodal status (66.4% vs 52.2%, p < 0.0001) and stage I disease (55.3% vs 26.1%, p < 0.0001). Breast-conserving surgery was performed in 50.4% of patients with screen-detected tumors and in 31.9% of women who had not undergone MS (p < 0.0001). The 5-year estimated survival was 95.5% (SE 0.57) for women with screen-detected breast cancer and 85.5% (SE 1.17) for those with not screen-detected tumors (p < 0.0001). Conclusions: Our data demonstrate a better prognosis in terms of 5-year survival in screen-detected breast cancer patients that may explain why breast carcinoma mortality rates have decreased in recent decades. These patients have also been found to have smaller tumors, a more favorable tumor stage and a higher proportion of breast-conserving surgery. No significant financial relationships to disclose.

scholarly journals The impact of COVID-19 pandemic on the rate of newly diagnosed gynecological and breast cancers: a tertiary center perspective

2021 ◽  
Author(s):  
Katharina Knoll ◽  
Elisabeth Reiser ◽  
Katharina Leitner ◽  
Johanna Kögl ◽  
Christoph Ebner ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Gynecological Cancer ◽  
Performance Status ◽  
Tumor Stage ◽  
Breast Cancers ◽  
Newly Diagnosed ◽  
Breast Cancer Patients ◽  
Tertiary Center ◽  
The Impact

Abstract Purpose The aim of the present study was to assess the impact of postponed screening examinations and lockdown measures on gynecological and breast cancer diagnoses throughout the year 2020 in a gynecological oncological center in Austria. Methods Data of 889 patients with either newly diagnosed gynecological or breast cancer between January 2019 and December 2020 were collected. Clinical parameters including symptoms, performance status, comorbidities and referral status were compared in patients, who were newly diagnosed with cancer in the period of the first lockdown from March 2020 to April 2020 and the second lockdown from November 2020 to December 2020 and compared to the same period in 2019. Results Our results showed a strong decline in newly diagnosed cancers during the lockdown periods: −45% in gynecological cancer and -52% in breast cancer compared to the same period in 2019. Compared to the analogue period of 2019, breast cancer patients reported significantly more tumor-associated symptoms (55% vs. 31%, p = 0.013) during and in between (48% vs. 32%, p = 0.022) the lockdowns. During the lockdown, periods in the group of breast cancer patients’ tumor stage varied significantly compared to 2019 (T2–T4; p = 0.047). Conclusion Both lockdowns led to a strong decrease in newly diagnosed gynecological and breast cancers. Treatment delays in potentially curable disease could lead to inferior clinical outcomes, with the risk of missing the optimal treatment window. As the COVID-19 pandemic will be a challenge for some time to come, new strategies in patient care are needed to optimize cancer screening and management during the pandemic.

scholarly journals The Prognostic Value of Retraction Clefts in Chinese Invasive Breast Cancer Patients

2021 ◽  
Vol 27 ◽  
Author(s):  
Liangliang Huang ◽  
Yujie Li ◽  
Jun Du ◽  
Heng Li ◽  
Mengmeng Lu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Carcinoma ◽  
Cancer Patients ◽  
Estrogen Receptor Status ◽  
Cox Proportional Hazards ◽  
Clinicopathological Features ◽  
Invasive Breast Carcinoma ◽  
Central China ◽  
Occurrence Rate ◽  
Breast Cancer Patients

Some studies reported the correlation between retraction clefts (RCs) and the clinicopathological features as well as prognosis in invasive breast carcinoma. However, limited number of investigations have been done and controversial results were reported. Larger population studies around the world might help to provide more accurate and comprehensive information. Thus, we examined the correlation between the extent of RCs and the clinicopathological features as well as the prognosis in 541 invasive breast carcinoma samples from Central China in this study. The statistical analyses were performed with the Pearson χ2 tests and univariate Cox proportional hazards regression assays. Compared with other studies, lower RCs occurrence rate (15.5%) was observed in Chinese breast cancer patients and opposite association between the presence of RCs and lymph nodes metastasis was identified, in which both progression free survival (PFS) and overall survival (OS) were improved with the presence of RCs in our study. Besides, despite some statistically significant associations between RCs and molecular subtypes, RCs and estrogen receptor status, the results were largely depending on the stratification methods. Generally, no convincing association was detected between the extent of RCs and the clinicopathological features or prognosis. In sum, the extent of RCs showed limited value as a prognostic predictor in invasive breast carcinoma patients from Central China.

Re-excision rates among older breast cancer patients undergoing breast-conserving surgery (BCS): Impact of the SSO-ASTRO consensus guideline on margins.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 576-576
Author(s):  
Mariana Chavez-MacGregor ◽  
Xiudong Lei ◽  
Nina Tamirisa ◽  
Abigail Suzanne Caudle ◽  
Sharon H. Giordano
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Large Population ◽  
Breast Conserving Surgery ◽  
Consensus Guideline ◽  
Breast Cancer Patients ◽  
Time Periods ◽  
Relative Change ◽  
The Impact ◽  
Excision Rate

576 Background: BCS has been historically associated with a high re-excision rate, driven in part by the need of obtaining negative margins. The SSO-ASTRO consensus guideline on invasive margins, defined a negative margin as no ink on tumor. In this large population-based study of older breast cancer patients undergoing BCS for invasive breast cancer we evaluate the guideline impact on re-excision rates. Methods: Female patients diagnosed with stage I-II breast cancer between 2012-2015 were identified in the SEER-Medicare database. Patients were >66 years and underwent BCS. Patients treated with neoadjuvant chemotherapy were excluded. We defined the following time periods: pre-guideline (January 2012-September 2013); peri-guideline (October 2013-March 2014) and post-guideline (April 2014-December 2016). Re-excision was defined as a resection, BCS or mastectomy identified using ICD-9 or CPT codes between 4 and 90 days after initial BCS. Overall re-excision rates and 95%CI were calculated and groups compared using X2test. Within subgroups we calculated re-excision rates for the pre and post-guideline periods and report the relative percent change. Regression model evaluated the association between time periods and re-excision while adjusting for important covariates, risk ratios (RRs) and 95%CI are presented. Results: 17001 patients were included. 6762 of them had BCS in the pre, 1786 in the peri, and 8453 in the post-guideline periods. Overall 22.6% of the patients had a re-excision. The rate decreased from 24.8% pre-guideline to 20.3% post-guideline (P < 0.001). The relative change in re-excision varied according to region (Midwest 3-7.3%, Northeast -20%, West -16.5% and South -13.5%) Differences in the relative change according to race/ethnicity were also seen (Whites -19.2, Blacks -15.3% and Hispanics -9.9%). In the multivariable model, BCS in the post-guideline period was associated with a decreased risk of re-excision (RR = 0.83; 95%CI 0.79-0.88). Lobular histology was associated with a higher risk of re-excision (RR = 1.31; 95%CI 1.21-1.42); greater surgeon volume was associated with lower risk of re-excision (RR = 0.89; 95%CI 0.82-0.95). Conclusions: There has been a statistically significant decrease in the re-excision rate after BCS associated with the dissemination of the SSO-ASTRO consensus guideline on invasive margins. Our study confirms the impact that guidelines have modifying patterns or practice, reducing the frequency of unnecessary interventions.

scholarly journals Germline TP53 Testing in Breast Cancers: Why, When and How?

Cancers ◽  
2020 ◽  
Vol 12 (12) ◽  
pp. 3762
Author(s):  
D. Gareth Evans ◽  
Emma R. Woodward ◽  
Svetlana Bajalica-Lagercrantz ◽  
Carla Oliveira ◽  
Thierry Frebourg
Keyword(s):  
Breast Cancer ◽  
Breast Carcinoma ◽  
Cancer Patients ◽  
Ductal Carcinoma ◽  
Invasive Breast Carcinoma ◽  
Whole Body ◽  
Breast Cancers ◽  
Breast Cancer Patients ◽  
Degree Relative ◽  
Phyllode Tumour

Germline TP53 variants represent a main genetic cause of breast cancers before 31 years of age. Development of cancer multi-gene panels has resulted in an exponential increase of germline TP53 testing in breast cancer patients. Interpretation of TP53 variants, which are mostly missense, is complex and requires excluding clonal haematopoiesis and circulating tumour DNA. In breast cancer patients harbouring germline disease-causing TP53 variants, radiotherapy contributing to the development of subsequent tumours should be, if possible, avoided and, within families, annual follow-up including whole-body MRI should be offered to carriers. We consider that, in breast cancer patients, germline TP53 testing should be performed before treatment and offered systematically only to patients with: (i) invasive breast carcinoma or ductal carcinoma in situ (DCIS) before 31; or (ii) bilateral or multifocal or HER2+ invasive breast carcinoma/DCIS or phyllode tumour before 36; or (iii) invasive breast carcinoma before 46 and another TP53 core tumour (breast cancer, soft-tissue sarcoma, osteosarcoma, central nervous system tumour, adrenocortical carcinoma); or (iv) invasive breast carcinoma before 46 and one first- or second-degree relative with a TP53 core tumour before 56. In contrast, women presenting with breast cancer after 46, without suggestive personal or familial history, should not be tested for TP53.

scholarly journals CBR3 V244M is associated with LVEF reduction in breast cancer patients treated with doxorubicin

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Jennifer K. Lang ◽  
Badri Karthikeyan ◽  
Adolfo Quiñones-Lombraña ◽  
Rachael Hageman Blair ◽  
Amy P. Early ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Care Center ◽  
Left Ventricular ◽  
The Body ◽  
Left Ventricular Ejection ◽  
Breast Cancer Patients ◽  
Ventricular Ejection Fraction ◽  
Echocardiographic Parameters ◽  
The Impact

Abstract Background The CBR3 V244M single nucleotide polymorphism has been linked to the risk of anthracycline-related cardiomyopathy in survivors of childhood cancer. There have been limited prospective studies examining the impact of CBR3 V244M on the risk for anthracycline-related cardiotoxicity in adult cohorts. Objectives This study evaluated the presence of associations between CBR3 V244M genotype status and changes in echocardiographic parameters in breast cancer patients undergoing doxorubicin treatment. Methods We recruited 155 patients with breast cancer receiving treatment with doxorubicin (DOX) at Roswell Park Comprehensive Care Center (Buffalo, NY) to a prospective single arm observational pharmacogenetic study. Patients were genotyped for the CBR3 V244M variant. 92 patients received an echocardiogram at baseline (t0 month) and at 6 months (t6 months) of follow up after DOX treatment. Apical two-chamber and four-chamber echocardiographic images were used to calculate volumes and left ventricular ejection fraction (LVEF) using Simpson’s biplane rule by investigators blinded to all patient data. Volumetric indices were evaluated by normalizing the cardiac volumes to the body surface area (BSA). Results Breast cancer patients with CBR3 GG and AG genotypes both experienced a statistically significant reduction in LVEF at 6 months following initiation of DOX treatment for breast cancer compared with their pre-DOX baseline study. Patients homozygous for the CBR3 V244M G allele (CBR3 V244) exhibited a further statistically significant decrease in LVEF at 6 months following DOX therapy in comparison with patients with heterozygous AG genotype. We found no differences in age, pre-existing cardiac diseases associated with myocardial injury, cumulative DOX dose, or concurrent use of cardioprotective medication between CBR3 genotype groups. Conclusions CBR3 V244M genotype status is associated with changes in echocardiographic parameters suggestive of early anthracycline-related cardiomyopathy in subjects undergoing chemotherapy for breast cancer.

scholarly journals Usefulness of 3D-surgical guides in breast conserving surgery after neoadjuvant treatment

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Han Shin Lee ◽  
Hee Jeong Kim ◽  
Il Yong Chung ◽  
Jisun Kim ◽  
Sae Byul Lee ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Neoadjuvant Treatment ◽  
Breast Conserving Surgery ◽  
Resection Margins ◽  
Breast Cancer Patients ◽  
Original Tumor ◽  
Surgical Guides ◽  
Neoadjuvant Systemic Therapy ◽  
Tumor Area

AbstractWe used 3D printed-breast surgical guides (3DP-BSG) to designate the original tumor area from the pre-treatment magnetic resonance imaging (MRI) during breast-conserving surgery (BCS) in breast cancer patients who received neoadjuvant systemic therapy (NST). Targeting the original tumor area in such patients using conventional localization techniques is difficult. For precise BCS, a method that marks the tumor area found on MRI directly to the breast is needed. In this prospective study, patients were enrolled for BCS after receiving NST. Partial resection was performed using a prone/supine MRI-based 3DP-BSG. Frozen biopsies were analyzed to confirm clear tumor margins. The tumor characteristics, pathologic results, resection margins, and the distance between the tumor and margin were analyzed. Thirty-nine patients were enrolled with 3DP-BSG for BCS. The median nearest distance between the tumor and the resection margin was 3.9 cm (range 1.2–7.8 cm). Frozen sections showed positive margins in 4/39 (10.3%) patients. Three had invasive cancers, and one had carcinoma in situ; all underwent additional resection. Final pathology revealed clear margins. After 3-year surveillance, 3/39 patients had recurrent breast cancer. With 3DP-BSG for BCS in breast cancer patients receiving NST, the original tumor area can be identified and marked directly on the breast, which is useful for surgery. Trial Registration: Clinical Research Information Service (CRIS) Identifier Number: KCT0002272. First registration number and date: No. 1 (27/04/2016).

scholarly journals PITX2 DNA-Methylation: Predictive versus Prognostic Value for Anthracycline-Based Chemotherapy in Triple-Negative Breast Cancer Patients

Breast Care ◽  
2020 ◽  
pp. 1-9
Author(s):  
Rudolf Napieralski ◽  
Gabriele Schricker ◽  
Gert Auer ◽  
Michaela Aubele ◽  
Jonathan Perkins ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Dna Methylation ◽  
Cancer Patients ◽  
Triple Negative Breast Cancer ◽  
Predictive Value ◽  
Untreated Patient ◽  
Triple Negative ◽  
Statistical Significance ◽  
Breast Cancer Patients ◽  
The Impact

<b><i>Background:</i></b> PITX2 DNA methylation has been shown to predict outcomes in high-risk breast cancer patients after anthracycline-based chemotherapy. To determine its prognostic versus predictive value, the impact of PITX2 DNA methylation on outcomes was studied in an untreated cohort vs. an anthracycline-treated triple-negative breast cancer (TNBC) cohort. <b><i>Material and Methods:</i></b> The percent DNA methylation ratio (PMR) of paired-like homeodomain transcription factor 2 (PITX2) was determined by a validated methylation-specific real-time PCR test. Patient samples of routinely collected archived formalin-fixed paraffin-embedded (FFPE) tissue and clinical data from 144 TNBC patients of 2 independent cohorts (i.e., 66 untreated patients and 78 patients treated with anthracycline-based chemotherapy) were analyzed. <b><i>Results:</i></b> The risk of 5- and 10-year overall survival (OS) increased continuously with rising PITX2 DNA methylation in the anthracycline-treated population, but it increased only slightly during 10-year follow-up time in the untreated patient population. PITX2 DNA methylation with a PMR cutoff of 2 did not show significance for poor vs. good outcomes (OS) in the untreated patient cohort (HR = 1.55; <i>p</i> = 0.259). In contrast, the PITX2 PMR cutoff of 2 identified patients with poor (PMR &#x3e;2) vs. good (PMR ≤2) outcomes (OS) with statistical significance in the anthracycline-treated cohort (HR = 3.96; <i>p</i> = 0.011). The results in the subgroup of patients who did receive anthracyclines only (no taxanes) confirmed this finding (HR = 5.71; <i>p</i> = 0.014). <b><i>Conclusion:</i></b> In this hypothesis-generating study PITX2 DNA methylation demonstrated predominantly predictive value in anthracycline treatment in TNBC patients. The risk of poor outcome (OS) correlates with increasing PITX2 DNA methylation.

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