Brachial plexopathy in breast cancer

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 10601-10601 ◽  
Author(s):  
S. Terstriep ◽  
K. Amrami ◽  
R. Spinner ◽  
T. Moynihan
Keyword(s):  
Breast Cancer ◽  
Brachial Plexus ◽  
Median Time ◽  
Breast Cancer Diagnosis ◽  
Recurrent Breast Cancer ◽  
Pet Scan ◽  
Brachial Plexopathy ◽  
Mri Findings ◽  
Primary Tumors ◽  
Recurrent Breast

10601 Background: Brachial plexopathy is a well-recognized complication of breast cancer, most attributed to late effects of radiation. However, direct involvement of brachial plexus by recurrent breast cancer occurs. Misdiagnoses may lead to inappropriate attribution of the plexopathy to radiation, and therefore inappropriate therapy. Methods: We report fourteen cases of brachial plexopathy secondary to breast cancer diagnosed at the Mayo Clinic-Rochester from 2003 to 2005. Results: Thirteen of fourteen primary tumors and 12/14 recurrences were ER/PR positive. Only 1/14 patient had Her 2 neu overexpression. The median time from the original breast cancer diagnosis to first brachial plexus symptom was 14 years. The median time from the development of symptoms to diagnosis was 8 months with the range being 1 month to 8 years. MRI revealed a distinct mass in 3/13 patients, plexus thickening in 5/13, and was normal in 5/13. Only 5/13 original MRI interpretations suggested tumor. In four patients that the 1.5 T MRI was either interpreted as normal or unlikely cancer the 3 Tesla MRI revealed abnormal uptake suggestive of malignancy. PET scan suggested malignancy in 3/6 patients. Two of these cases had other metastatic disease. In the other three cases that PET scans were done the uptake was mild, suggesting inflammation rather than malignancy. Reinterpretations of the PET scan and MRI in combination by an experienced musculoskeletal radiologist was highly suggestive of malignancy in all cases. Definitive diagnosis was eventually obtained by biopsy of the brachial plexus (7/14) or another site of metastasis in (4/14). Conclusions: The often slowly progressive nature of hormonally driven breast cancer can mimic radiation induced brachial plexopathy. In the cases reviewed, PET was not reliable in differentiating inflammation from tumor. MRI findings are nonspecific and higher resolution 3T MRI may be needed to detect an abnormality. Interpretation of MRI and PET together is useful. Patients with a history of breast cancer, and brachial plexus symptoms should be carefully evaluated with consideration for recurrent disease as a cause. Biopsy of the brachial plexus can be done safely and has an important role in diagnosis. No significant financial relationships to disclose.

Changing ER, PgR, and HER2 status between primary and recurrent breast cancer.

2012 ◽  
Vol 30 (27_suppl) ◽  
pp. 92-92 ◽  
Author(s):  
Akiko Matsumoto ◽  
Maiko Takahashi ◽  
Tetsu Hayashida ◽  
Shigemichi Hirose ◽  
Hiromitsu Jinno ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Biological Markers ◽  
Distant Metastases ◽  
Recurrent Breast Cancer ◽  
University Hospital ◽  
Her2 Status ◽  
Fish Analysis ◽  
Breast Cancer Patients ◽  
Primary Tumors ◽  
Recurrent Breast

92 Background: Estrogen receptor (ER), progesterone receptor (PgR), and HER2 status are important biological markers for making decisions about breast cancer treatments. Although changes of hormone receptor (HR) and HER2 status with recurrence of breast cancer are clinically experienced, the frequency of discordance and clinical significance are still unknown. Thus, we investigated ER, PgR, and HER2 status with primary tumors and recurrent lesions, and assessed discordance rates and prognosis. Methods: We retrospectively identified recurrent breast cancer patients who had biopsies or resections of recurrent lesions between January 2007 to April 2012 at Keio University Hospital. HR status was assessed by immunohistochemistry (IHC) and determined using the Allred score. HR status was defined as positive when score was 3 and more. HER2 status was assessed by IHC and fluorescence in situ hybridization (FISH) analysis. We defined HER2 positivity as 3+ staining intensity by IHC or the presence of HER2 gene amplification by FISH. Results: Among 32 recurrences, 40% (13) were loco-regional recurrences (LLR) and 60% (19) were distant metastases (DM) (lung 14; liver 3; brain 1; pleura 1). Discordance rates in ER, PgR and HER2 status between the primary tumors and the recurrence lesions were 12.5%, 31.3%, and 13.8%, respectively. The most common change was loss of PgR. Changings from negative to positive in ER, PgR and HER2 status were found in 6.3%, 3.1%, and 3.4% of the patients, respectively. All gains were found in distant metastases. Discordance in ER and HER2 were more common in DM (15.8% and 17.6%) comparing with LRR (7.7% and 8.3%). Loss of HR status was not associated with a shorter time to progression (TTP) (ER: 19.3 vs. 8.5 months, p=0.185; PgR: 4.4 vs. 11.5 months, p=0.907). Patients with discordant HER2 status had significantly shorter TTP than with concordant status (0.9 vs. 11.5 months, p=0.012). Conclusions: Discordance of biological markers between primary and recurrent breast cancers were seen in 10-30%. Although HR discordance was not associated with prognosis, patients with HER2 discordance had poorer TTP. Tissue confirmation should be considered for making effective treatment decisions in recurrent breast cancer.

Image-guided biopsy in women with breast cancer presenting with peritoneal carcinomatosis

2006 ◽  
Vol 16 (Suppl 1) ◽  
pp. 108-110 ◽  
Author(s):  
M. J. Hewitt ◽  
G. D. Hall ◽  
N. Wilkinson ◽  
T. J. Perren ◽  
G. Lane ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Peritoneal Carcinomatosis ◽  
Exploratory Laparotomy ◽  
Recurrent Breast Cancer ◽  
Second Primary ◽  
Primary Tumors ◽  
Image Guided ◽  
History Of ◽  
Clinical Dilemma ◽  
Recurrent Breast

When women with a history of breast cancer present with peritoneal carcinomatosis, the differential diagnosis lies between recurrent breast cancer or a new primary tumor. This scenario is of particular relevance to women with a BRCA gene mutation, who have a genetic predisposition to develop second primary tumors of the ovary, fallopian tube, and peritoneum. We describe the use of image-guided core biopsy as an alternative to laparoscopy or exploratory laparotomy in providing minimally invasive diagnosis in this increasingly common clinical dilemma.

Estrogen Replacement Therapy After Localized Breast Cancer: Clinical Outcome of 319 Women Followed Prospectively

1999 ◽  
Vol 17 (5) ◽  
pp. 1482-1482 ◽  
Author(s):  
Rena Vassilopoulou-Sellin ◽  
Lina Asmar ◽  
Gabriel N. Hortobagyi ◽  
Mary Jean Klein ◽  
Marsha McNeese ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Estrogen Receptor ◽  
Replacement Therapy ◽  
Median Time ◽  
Estrogen Replacement Therapy ◽  
Recurrent Breast Cancer ◽  
Estrogen Replacement ◽  
Previously Treated ◽  
Recurrent Breast ◽  
Trial Participants

PURPOSE: To determine whether estrogen replacement therapy (ERT) alters the development of new or recurrent breast cancer in women previously treated for localized breast cancer. PATIENTS AND METHODS: Potential participants (n = 319) in a trial of ERT after breast cancer were observed prospectively for at least 2 years whether they enrolled onto the randomized trial or not. Of 319 women, 39 were given estrogen and 280 were not given hormones. Tumor size, number of lymph nodes, estrogen receptors, menopausal status at diagnosis, and disease-free interval at the initiation of the observation period were comparable for the trial participants (n = 62) versus nonparticipants (n = 257) and for women on ERT (n = 39) versus controls (n = 280). Cancer events were ascertained for both groups. RESULTS: Patient and disease characteristics were comparable for the trial participants versus nonparticipants, as well as for the women on ERT versus the controls. One patient in the ERT group developed a new lobular estrogen receptor–positive breast cancer 72 months after the diagnosis of a ductal estrogen receptor–negative breast cancer and 27 months after initiation of ERT. In the control group, there were 20 cancer events: 14 patients developed new or recurrent breast cancer at a median time of 139.5 months after diagnosis and six patients developed other cancers at a median time of 122 months. CONCLUSION: ERT does not seem to increase breast cancer events in this subset of patients previously treated for localized breast cancer. Results of randomized trials are needed before any changes in current standards of care can be proposed.

Brachial plexus syndrome (BPS) due to primary or locally recurrent breast cancer (BC)

2005 ◽  
Vol 23 (16_suppl) ◽  
pp. 748-748
Author(s):  
A. S. Braverman ◽  
B. S. Kamenova ◽  
D. Efiom-Ekaha ◽  
C. Sohn
Keyword(s):  
Breast Cancer ◽  
Brachial Plexus ◽  
Recurrent Breast Cancer ◽  
Locally Recurrent ◽  
Recurrent Breast

scholarly journals Recurrent Breast Cancer with Metastatic Brachial Plexopathy

2010 ◽  
Vol 49 (12) ◽  
pp. 1257-1257 ◽  
Author(s):  
Takashi Irioka ◽  
Hidehiro Mizusawa
Keyword(s):  
Breast Cancer ◽  
Recurrent Breast Cancer ◽  
Brachial Plexopathy ◽  
Recurrent Breast

Loss of estrogen receptor in recurrent breast cancer is associated with poor response to endocrine therapy.

1996 ◽  
Vol 14 (9) ◽  
pp. 2584-2589 ◽  
Author(s):  
T Kuukasjärvi ◽  
J Kononen ◽  
H Helin ◽  
K Holli ◽  
J Isola
Keyword(s):  
Breast Cancer ◽  
Endocrine Therapy ◽  
Hormone Receptor ◽  
Poor Response ◽  
Recurrent Breast Cancer ◽  
Hormone Receptor Status ◽  
Primary Tumors ◽  
Er Positive ◽  
Recurrent Breast ◽  
Er Expression

PURPOSE Up to 30% to 40% of metastases from hormone receptor-positive primary breast cancer do not respond to endocrine therapy. We studied how often hormone receptor status changes between primary and recurrent tumors and whether such a change might explain unresponsiveness to endocrine therapy. PATIENTS AND METHODS Primary breast cancer samples and matched asynchronous recurrences were studied from 50 patients who had not received any adjuvant therapy. Estrogen receptor (ER) and progesterone receptor (PR) status was determined immunohistochemically from histologically representative formalin-fixed paraffin-embedded tumor samples. ER status was ascertained by mRNA in situ hybridization. RESULTS Thirty-five (70%) of 50 primary tumors were positive for ER and 30 (60%) for PR. Hormone receptor status of the recurrent tumor differed from that of the primary tumor in 18 cases (36%). Discordant cases were due to the loss of ER (n = 6), loss of PR (n = 6), or loss of both receptors (n = 6). Receptor-negative primary tumors were always accompanied by receptor-negative recurrences. Among 27 patients with ER-positive primary tumors, loss of ER was a significant predictor (P = .0085) of poor response to subsequent endocrine therapy. Only one of eight patients (12.5%) with lost ER expression responded to tamoxifen therapy, whereas the response rate was 74% (14 of 19) for patients whose recurrent tumors retained ER expression. CONCLUSION Loss of ER expression in recurrent breast cancer should be considered as a cause for poor response to endocrine therapy in primarily ER-positive patients. We conclude that analysis of recurrent tumor samples may improve the predictive value of ER and PR assays.

ER, PR & HER2 Receptor status in recurrent breast cancer: Its relation to age & time of recurrence

2020 ◽  
Vol 22 (1) ◽  
pp. 16-20
Author(s):  
Abu Khaled Muhammad Iqbal ◽  
Nasima Akhter ◽  
Hasan Shahrear Ahmed ◽  
Md Rassell ◽  
AMM Yahia ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Treatment Approach ◽  
Recurrent Breast Cancer ◽  
Breast Cancer Patients ◽  
Her2 Receptor ◽  
Younger Patients ◽  
Receptor Status ◽  
Increased Risk ◽  
Neoplastic Lesions ◽  
Recurrent Breast

Background: Malignant neoplastic lesions of the breast are one of the main causes of cancer death among women. In tumor cells the expression status of Estrogen receptor (ER), progesterone receptor (PR), and c-ERBB2 (HER2/neu) are therapeutically and prognostically important markers affecting the treatment approach, management and prognosis of breast carcinoma. Objective: To explore the relation of receptor status in recurrent breast cancer to age and time of recurrence. Methods: This study was conducted in National Institute of Cancer Research and Hospital (NICRH) and included 81 female patients between 20 to 75 years with recurrent breast cancer. Detection of receptor status of ER +ve/-ve, PR +ve/-ve, Her-2+ve/-ve was based on the immunohistochemistry staining of tissue samples of malignant neoplastic lesions prepared from tissue biopsies of patients with recurrent breast cancer. All the information were recorded through the pre-structured data collection sheet and analyzed. Results: This study showed that most of the recurrent breast cancer patients were Triple negative breast cancer (TNBC) (39.5%) and among them most of them were younger patients. Younger patients with TNBC had increased risk of recurrence. Most of the recurrence occurred within 1-2 years. Conclusion: It can be concluded that the assessment of the expression of these biornarkers in recurrent tumors provides reliable information for the treatment approach of locoregional tumors. Journal of Surgical Sciences (2018) Vol. 22 (1): 16-20

Sign in / Sign up

Export Citation Format

Share Document