Association between standard clinical and pathological breast cancer characteristics and the 21-gene recurrence score: A population-based study

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 11002-11002
Author(s):  
I. Wolf ◽  
N. Ben-Baruch ◽  
R. Shapira-Frommer ◽  
S. Rizel ◽  
H. Goldberg ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Validation Study ◽  
Tumor Size ◽  
Ductal Carcinoma ◽  
Age Distribution ◽  
Recurrence Score ◽  
Population Based ◽  
Her2 Expression ◽  
Study Population ◽  
Risk Categories

11002 Background: The 21-gene recurrence score (RS) aims to quantify chemotherapy benefit in lymph node-negative, estrogen receptor (ER)-positive breast cancer (BC) patients. We aimed to elucidate the association between the RS and clinical-pathological features in a population-based Israeli cohort. Methods: Study population included all Israeli BC female patients referred to the RS assay from October 2004 until October 2006. Clinical and pathology data were collected upon referral, RS risk was categorized as previously defined (low < 18, intermediate 18–30, high = 31) and chemotherapy benefit was also assessed for each patient using NCCN guidelines, St. Gallen recommendations and Adjuvant! Online. Results: 300 patients were referred to the assay by 70 physicians from 16 institutions. Low, intermediate and high RS were noted in 109 (36 %), 134 (45 %) and 57 (19%) of the patients respectively, compared to 54%, 21% and 25% respectively, in the validation study (JCO;24:3726). Median age was 54 and median tumor size was 1.6 cm. Similar age distribution, tumor size and ER staining intensity were noted in all risk categories. Interestingly, no association has been identified between the RS and the presence of lymph nodes micrometastases. High tumor grade was noted in 15%, 20% and 56%; progesterone expression in 88% 72% 43%; non-infiltrative ductal carcinoma (IDC) 24%, 12% and 6%; and Her2 expression in 2%, 3% and 19% of the low, intermediate and high risk categories respectively (p<0.0001 for all variables). Risk assessment according to clinical guidelines or Adjuvant! Online correlated poorly with the RS. Conclusions: Risk stratification of referred Israeli patients differs from that of the validation study population. Moreover, the RS did not correlate with age, tumor size and ER intensity. The RS correlated with histology, grade, PR and Her2 expression and may be predicted, in specific subsets of patients, using these features. However, RS categorization cannot be predicted by commonly-used clinical predicting tools. No significant financial relationships to disclose.

scholarly journals Breast-cancer-specific mortality in patients treated based on the 21-gene assay: a SEER population-based study

2016 ◽  
Vol 2 (1) ◽  
Author(s):  
Valentina I Petkov ◽  
Dave P Miller ◽  
Nadia Howlader ◽  
Nathan Gliner ◽  
Will Howe ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Tumor Size ◽  
Recurrence Score ◽  
Population Based ◽  
Node Negative ◽  
Node Positive ◽  
Breast Cancer Specific Mortality ◽  
Specific Mortality ◽  
Size Grade ◽  
Cancer Specific Mortality

Abstract The 21-gene Recurrence Score assay is validated to predict recurrence risk and chemotherapy benefit in hormone-receptor-positive (HR+) invasive breast cancer. To determine prospective breast-cancer-specific mortality (BCSM) outcomes by baseline Recurrence Score results and clinical covariates, the National Cancer Institute collaborated with Genomic Health and 14 population-based registries in the the Surveillance, Epidemiology, and End Results (SEER) Program to electronically supplement cancer surveillance data with Recurrence Score results. The prespecified primary analysis cohort was 40–84 years of age, and had node-negative, HR+, HER2-negative, nonmetastatic disease diagnosed between January 2004 and December 2011 in the entire SEER population, and Recurrence Score results (N=38,568). Unadjusted 5-year BCSM were 0.4% (n=21,023; 95% confidence interval (CI), 0.3–0.6%), 1.4% (n=14,494; 95% CI, 1.1–1.7%), and 4.4% (n=3,051; 95% CI, 3.4–5.6%) for Recurrence Score <18, 18–30, and ⩾31 groups, respectively (P<0.001). In multivariable analysis adjusted for age, tumor size, grade, and race, the Recurrence Score result predicted BCSM (P<0.001). Among patients with node-positive disease (micrometastases and up to three positive nodes; N=4,691), 5-year BCSM (unadjusted) was 1.0% (n=2,694; 95% CI, 0.5–2.0%), 2.3% (n=1,669; 95% CI, 1.3–4.1%), and 14.3% (n=328; 95% CI, 8.4–23.8%) for Recurrence Score <18, 18–30, ⩾31 groups, respectively (P<0.001). Five-year BCSM by Recurrence Score group are reported for important patient subgroups, including age, race, tumor size, grade, and socioeconomic status. This SEER study represents the largest report of prospective BCSM outcomes based on Recurrence Score results for patients with HR+, HER2-negative, node-negative, or node-positive breast cancer, including subgroups often under-represented in clinical trials.

scholarly journals Prospective observational study in early breast cancer at University Hospital of Tlemcen

2017 ◽  
Vol 1 (2) ◽  
pp. 37-38
Author(s):  
I Lahfa- Merad ◽  
H Aris ◽  
S Chaibdraa Tani ◽  
N Hammou-Tani ◽  
S Saidi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Early Breast Cancer ◽  
Tumor Size ◽  
Ductal Carcinoma ◽  
Significant Proportion ◽  
Stage I ◽  
University Hospital ◽  
Stage Iii ◽  
Her2 Status ◽  
Study Population

Background: Breast cancer is the first cancer in women in Algeria. It affects a significant proportion of young women. Stage at diagnosis is made with a positive, massive, and often lymph node involvement. The objective of this study is to determine the clinicopathological and histological features of patients treated for invasive breast carcinoma. Methods: This is an observational prospective study from January 2006 to December 2011 done at the medical oncology department at the University Hospital Center of Tlemcen: 103 patients with early breast cancer were included. Results: Extreme age is between 29 and 70 years; 50% of patients are under 47 years. The average age at diagnosis of 46.45 ± 0.90 years; 54% are stage T2; 17% are stage T3 and 4% stage T4; stage III is the most frequent with 50.4%. Half of patients have four to nine nodes with relatively wide tumor size, and only one patient was stage I; 10% had more than 10 positive nodes. The infiltrating ductal carcinoma is the most common histological types (83.5%), followed by atypical carcinoma (5.82%). Note the predominance of grade II of Scarf Bloom and Richardson (58.25%), followed by grade III (36.89%) and grade I (1.91%). Over 50% of patients had a tumor size of 35.41 ± 1.82 mm. Hormone receptors were positive in 65% of patients (ER + PR +) and negative in 35%. HER2 status was determined in 82 patients, 12% expressed a positive score, and 67% of were negative. The luminal profile is the most common in our study population with 57.3%, followed by triple negative tumors or basal-like with 26.8%. Conservative surgical treatment was realized in 2.9% and an astectomy in most patients at 97%. Radiotherapy was performed in 83.5% of patients, and 65% of patients received hormone therapy according to hormone positivity. Conclusion: The clinical and histological profiles of the patients in our study population are different from Western populations by the average age of diagnosis of 46 years, 10 years higher for Western women, and the stage is more advanced for our population. The majority are at stage III, while Western women are diagnosed at stage I or II through screening. Given the Algerian profile, women should be offered screening at aged 40 years for earlier diagnosis and improved survival rate.

Comparison of Mammography and Ultrasonography for Tumor Size of DCIS of Breast Cancer

2019 ◽  
Vol 15 (2) ◽  
pp. 209-213
Author(s):  
Yu Wang ◽  
Jiantao Wang ◽  
Haiping Wang ◽  
Xinyu Yang ◽  
Liming Chang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Correlation Coefficient ◽  
Tumor Size ◽  
Ductal Carcinoma ◽  
Pearson Correlation ◽  
Dense Breast ◽  
Pathological Examination ◽  
Negative Group ◽  
The Difference

Objective: Accurate assessment of breast tumor size preoperatively is important for the initial decision-making in surgical approach. Therefore, we aimed to compare efficacy of mammography and ultrasonography in ductal carcinoma in situ (DCIS) of breast cancer. Methods: Preoperative mammography and ultrasonography were performed on 104 women with DCIS of breast cancer. We compared the accuracy of each of the imaging modalities with pathological size by Pearson correlation. For each modality, it was considered concordant if the difference between imaging assessment and pathological measurement is less than 0.5cm. Results: At pathological examination tumor size ranged from 0.4cm to 7.2cm in largest diameter. For mammographically determined size versus pathological size, correlation coefficient of r was 0.786 and for ultrasonography it was 0.651. Grouped by breast composition, in almost entirely fatty and scattered areas of fibroglandular dense breast, correlation coefficient of r was 0.790 for mammography and 0.678 for ultrasonography; in heterogeneously dense and extremely dense breast, correlation coefficient of r was 0.770 for mammography and 0.548 for ultrasonography. In microcalcification positive group, coeffient of r was 0.772 for mammography and 0.570 for ultrasonography. In microcalcification negative group, coeffient of r was 0.806 for mammography and 0.783 for ultrasonography. Conclusion: Mammography was more accurate than ultrasonography in measuring the largest cancer diameter in DCIS of breast cancer. The correlation coefficient improved in the group of almost entirely fatty/ scattered areas of fibroglandular dense breast or in microcalcification negative group.

Impact of TAILORx on chemotherapy prescribing and 21‐gene recurrence score–guided treatment costs in a population‐based cohort of patients with breast cancer

Cancer ◽  
2021 ◽  
Author(s):  
Megan E. Tesch ◽  
Caroline Speers ◽  
Rekha M. Diocee ◽  
Lovedeep Gondara ◽  
Stuart J. Peacock ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Recurrence Score ◽  
Population Based ◽  
Treatment Costs

scholarly journals Intraoperative radiation therapy for early stage breast cancer: experiences from Iran

2020 ◽  
Author(s):  
Vahid Zangouri ◽  
Hamid Nasrollahi ◽  
Ali Taheri ◽  
Majid Akrami ◽  
Peyman Arasteh ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Patient Selection ◽  
Tumor Size ◽  
Ductal Carcinoma ◽  
Early Stage ◽  
Intraoperative Radiation Therapy ◽  
Study Patient ◽  
Intraoperative Radiation

Abstract Background and objective Currently no definite guideline exists on the use of intraoperative radiation therapy (IORT) among patients with early stage BC. We report our experiences with IORT among breast cancer (BC) patients in our region.Methods All patient who received radical IORT from April 2014 on to March 2020 were included in the study. Patient selection criteria were as followed: age equal or older than 45 years old; all cases of invasive carcinomas, moreover in lobular carcinomas only after MRI and confirmation, and in cases with ductal carcinoma in-situ (DCIS) only those with low, intermediate grade, tumor size of equal or less than 2.5cm and a margin of 2-3mm; those between 45 and 50 years old with a tumor size of 0-2cm, those between 50 and 55 years old with a tumor size of 2-2.5cm, and those ≥55 years old with a tumor size of 2.5-3cm; those with invasive tumors a negative margin and in cases of DCIS a margin of 3mm; a negative nodal status (exception in patients with micrometastasis); and a positive estrogen receptor status. Results Overall, 252 patients entered the study. Mean (SD) age of patients was 56.43±7.79 years. In total, 32.9% of patients had a family history of BC. Mean tumor size was 1.56±0.55 cm. Median (IQR) follow-up of patients was 24 (13, 36) months. Overall, 6 patients (2.4%) experienced recurrence in follow-up visits, among which three (1.2%) were local recurrence, two (0.8%) were regional recurrence and one patients (0.4%) had metastasis.Median (IQR) time to recurrence was 23 (13, 36) among the six patient who had recurrence. Overall, 11 patients (4.3%) with DCIS in our study received IORT. All these patients had free margins in histopathology examination. None of these patients experience recurrence.Conclusion For the first time, we categorized patients according to age and tumor size and older patients with larger tumor sizes were considered appropriate candidates for IORT. Our series showed a successful experience with the use of IORT in a region where facilities for IORT are limited using our modified criteria for patient selection.

scholarly journals Invasive breast cancer and breast cancer mortality after ductal carcinoma in situ in women attending for breast screening in England, 1988-2014: population based observational cohort study

BMJ ◽  
2020 ◽  
pp. m1570 ◽  
Author(s):  
Gurdeep S Mannu ◽  
Zhe Wang ◽  
John Broggio ◽  
Jackie Charman ◽  
Shan Cheung ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Invasive Breast Cancer ◽  
Breast Screening ◽  
Ductal Carcinoma ◽  
Breast Cancer Mortality ◽  
Population Based ◽  
Breast Screening Programme ◽  
Observational Cohort

AbstractObjectiveTo evaluate the long term risks of invasive breast cancer and death from breast cancer after ductal carcinoma in situ (DCIS) diagnosed through breast screening.DesignPopulation based observational cohort study.SettingData from the NHS Breast Screening Programme and the National Cancer Registration and Analysis Service.ParticipantsAll 35 024 women in England diagnosed as having DCIS by the NHS Breast Screening Programme from its start in 1988 until March 2014.Main outcome measuresIncident invasive breast cancer and death from breast cancer.ResultsBy December 2014, 13 606 women had been followed for up to five years, 10 998 for five to nine years, 6861 for 10-14 years, 2620 for 15-19 years, and 939 for at least 20 years. Among these women, 2076 developed invasive breast cancer, corresponding to an incidence rate of 8.82 (95% confidence interval 8.45 to 9.21) per 1000 women per year and more than double that expected from national cancer incidence rates (ratio of observed rate to expected rate 2.52, 95% confidence interval 2.41 to 2.63). The increase started in the second year after diagnosis of DCIS and continued until the end of follow-up. In the same group of women, 310 died from breast cancer, corresponding to a death rate of 1.26 (1.13 to 1.41) per 1000 women per year and 70% higher than that expected from national breast cancer mortality rates (observed:expected ratio 1.70, 1.52 to 1.90). During the first five years after diagnosis of DCIS, the breast cancer death rate was similar to that expected from national mortality rates (observed:expected ratio 0.87, 0.69 to 1.10), but it then increased, with values of 1.98 (1.65 to 2.37), 2.99 (2.41 to 3.70), and 2.77 (2.01 to 3.80) in years five to nine, 10-14, and 15 or more after DCIS diagnosis. Among 29 044 women with unilateral DCIS undergoing surgery, those who had more intensive treatment (mastectomy, radiotherapy for women who had breast conserving surgery, and endocrine treatment in oestrogen receptor positive disease) and those with larger final surgical margins had lower rates of invasive breast cancer.ConclusionsTo date, women with DCIS detected by screening have, on average, experienced higher long term risks of invasive breast cancer and death from breast cancer than women in the general population during a period of at least two decades after their diagnosis. More intensive treatment and larger final surgical margins were associated with lower risks of invasive breast cancer.

Male Breast Cancer: 13-Year Single Institution Experience

2020 ◽  
Vol 86 (10) ◽  
pp. 1345-1350
Author(s):  
Marissa K. Srour ◽  
Farin Amersi ◽  
James Mirocha ◽  
Armando E. Giuliano ◽  
Alice Chung
Keyword(s):  
Breast Cancer ◽  
Male Breast Cancer ◽  
Ductal Carcinoma ◽  
Disease Free Survival ◽  
Recurrence Score ◽  
Breast Conserving Surgery ◽  
Male Breast ◽  
Brca Mutations ◽  
Estrogen Receptor Positive ◽  
Stage 1

Due to the low incidence of male breast cancer (BC), there are few studies evaluating outcomes. We evaluated the clinicopathologic features and outcomes of male BC. Male patients with BC from January 2006 to December 2018 were identified. Of 49 patients, mean age was 64 (range 33-94) years. Of the 27 (55.1%) patients who had genetic testing, 9 (33.3%) had a Breast Cancer gene (BRCA) 1 or 2 mutation. The majority of patients had a mastectomy (n = 43/49, 87.8%) and had invasive ductal carcinoma (n = 47/49, 95.9%). 20 patients (n = 20/43, 46.5%) had positive lymph nodes. 41 (n = 41/47, 87.2%) patients had estrogen receptor positive disease. The majority of patients were pathologic stage 2 (n = 21/46, 45.7%), followed by stage 1 (n = 15/46, 32.6%), stage 3 (n = 6/46, 13.0%), and stage 4 (n = 4/46, 8.7%). Eight patients had the 21-gene recurrence score performed. Of patients with stage 1-3 BC, 10 (n = 10/43, 23.3%) patients had recurrence. With median follow-up of 4.1 (range .6-10.6) years, 5-year overall survival was 82.9% and 5-year disease-free survival was 65.9%. In conclusion, our cohort of patients with male BC had a high incidence of BRCA mutations and most commonly had high-grade estrogen positive stage 2 tumors. Breast conserving surgery was utilized in 4% of patients and genomic testing utilized in 55% of patients.

scholarly journals Readmissions and complications in breast ductal carcinoma in situ: A retrospective study comparing screen- and non-screen-detected patients

2020 ◽  
Vol 16 ◽  
pp. 174550652096589
Author(s):  
Julieta Politi ◽  
María Sala ◽  
Laia Domingo ◽  
María Vernet-Tomas ◽  
Marta Román ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Confidence Interval ◽  
Ductal Carcinoma In Situ ◽  
Odds Ratio ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Screening Program ◽  
Population Based ◽  
Mammographic Screening

Objective: Population-wide mammographic screening programs aim to reduce breast cancer mortality. However, a broad view of the harms and benefits of these programs is necessary to favor informed decisions, especially in the earliest stages of the disease. Here, we compare the outcomes of patients diagnosed with breast ductal carcinoma in situ in participants and non-participants of a population-based mammographic screening program. Methods: A retrospective cohort study of all patients diagnosed with breast ductal carcinoma in situ between 2000 and 2010 within a single hospital. A total of 211 patients were included, and the median follow-up was 8.4 years. The effect of detection mode (screen-detected and non-screen-detected) on breast cancer recurrences, readmissions, and complications was evaluated through multivariate logistic regression analysis. Results: In the majority of women, breast ductal carcinoma in situ was screen-detected (63.5%). Screen-detected breast ductal carcinoma in situ was smaller in size compared to those non-screen-detected (57.53% < 20 mm versus 78.03%, p = 0.002). Overall, breast-conserving surgery was the most frequent surgery (86.26%); however, mastectomy was higher in non-screen-detected breast ductal carcinoma in situ (20.78% versus 9.7%, p = 0.024). Readmissions for mastectomy were more frequent in non-screen-detected breast ductal carcinoma in situ. Psychological complications, such as fatigue, anxiety, and depression, had a prevalence of 15% within our cohort. Risk of readmissions and complications was higher within the non-screen-detected group, as evidenced by an odds ratio = 6.25 (95% confidence interval = 1.95–19.99) for readmissions and an odds ratio = 2.41 (95% confidence interval = 1.95–4.86) for complications. Conclusions: Our findings indicate that women with breast ductal carcinoma in situ breast cancer diagnosed through population-based breast cancer screening program experience a lower risk of readmissions and complications than those diagnosed outside these programs. These findings can help aid women and health professionals make informed decisions regarding screening.

Incidence of Involvement of Nipple Areola Complex in Breast Cancer

2015 ◽  
Vol 24 (Number 1) ◽  
pp. 33-38
Author(s):  
Md. R Hoq ◽  
A Sayeed ◽  
B Khan ◽  
R Parvin ◽  
S I Khan
Keyword(s):  
Breast Cancer ◽  
Care Center ◽  
Tertiary Care ◽  
Age Distribution ◽  
Oncologic Outcome ◽  
Breast Cancer Surgery ◽  
Breast Cancer Patients ◽  
Areola Complex ◽  
Areolar Complex ◽  
Study Population

In this prospective study, fifty cases of breast cancer were studied in a tertiary care center & different hospitals of Dhaka city for one year, aimed to determine the incidence of malignant involvement of NAC in breast cancer patients of our country with clinically uninvolved nipples from history and postoperative histopathological reports of mastectomy specimens. The age distribution of Breast cancer varied from 25 to 75 years. Highest incidence was in 5th and 6th decades numbering 30 (60%) cases. Incidence of 3rd decades was 8 (16%) cases and in 7th decades was 12 (24%) casesin relation to menstrual cycle Breast Ca incidence is more in post-menopausal women numbering 28 (56%).Lump size of most of the study population found within 2-Scm (T2 stage). Incidence of axillaty lymph node metastasis found positive in 28 patients (56%) and no metastasis in 22 patients (44%). Of 50 patients maximum no 22 (44%) found with moderately differentiated tumour, 16 (32%) patients found poorly differentiated, differentiation could not be assessed in 12 (24%) patient and well differentiated tumour found in only 2 (4%) patients. The most common histological type found in the study population is IDCC 44 (88%). Skin involvement was 0% and only 2% patients have malignant involvement of NAC from underling breast cancer. The conclusion in respect to this study is, Nipple areolar complex can be preserved with breast reconstruction in carefully selected patients going for breast cancer surgery with safe oncologic outcome.

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