Gemcitabine and concurrent radiation as a salvage treatment of chest wall recurrence in breast cancer

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 11027-11027
Author(s):  
A. Shaharyar ◽  
Z. Alauddin ◽  
K. Shabbir ◽  
M. Hafeez ◽  
E. U. Rehman ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Chest Wall ◽  
Low Dose ◽  
Radical Mastectomy ◽  
Complete Response ◽  
Salvage Treatment ◽  
Breast Cancer Patients ◽  
Cytological Evidence ◽  
Chest Wall Recurrence

11027 Background: Chest wall recurrences are seen despite postoperative chemotherapy and radiotherapy. For patients with unresectable lesions who have previously received radiotherapy no standard treatment is available. We devised a protocol of low dose gemcitabine as radiosensitizer concurrent with low dose of radiation and conducted this study with the objectives to document the efficacy and toxicity of this protocol. Methods: From January 2003 to August 2005, 48 patients were included in this study. A histopthological or cytological evidence of chest wall recurrence was required. Females between 18–70 years, with previous modified radical mastectomy, post operative radiation and adjuvant chemotherapy were included. Patients with metastatic disease were excluded. Written informed consent was obtained. A dose of 150 mg / m2 of gemcitabine in 200 ml of normal saline was infused in 2 hour on day 1, 8, 15 and 22 of radiation. Radiation was delivered 2 hours after the completion of infusion. Conventional fractionation was used to deliver a total dose of 36 Gy given in 3.5 weeks. RECIST and RTOG criteria were used. Results: Twenty recurrences were related to the scar, 10 to the involved internal mammary lymph node region invading sternum and ribs and 18 were associated with the soft tissue masses outside the scar area. All patients were evaluable for response and toxicity. Complete response was seen in 6 (12.5 %) patients, (95 % CI, 13.87_37.16), partial response was seen in 30 (62.5 %) (95 % CI, 44.92 -71.40) with an over all response rate of 75 % (95 % CI, 70.57—91.40) Stable disease was seen in 9 (18.8 %) patients and disease progression in 3 (6.3 %) patients. Grade I skin reaction was seen in 15 (31.2 % ) patients grade II in 11 ( 22.9 % ) and grade III in 3 ( 6.3 % ) patients. No systemic toxicity was seen. Conclusions: Low dose gemcitabine and concurrent radiotherapy is a reasonable salvage treatment in chest wall recurrence in breast cancer patients who have previously received adjuvant chemotherapy and full dose of radiotherapy. This approach has acceptable toxicity. No significant financial relationships to disclose.

Radiomodification with fluor-pyrimidines in radiation therapy of breast cancer

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 11073-11073
Author(s):  
N. V. Malyshev ◽  
E. V. Kostrova ◽  
N. V. Bochkova ◽  
A. H. Dosakhanov ◽  
V. B. Sirota
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Clinical Effect ◽  
Radical Mastectomy ◽  
Complete Response ◽  
Pathological Response ◽  
Breast Cancer Patients ◽  
Beam Radiation ◽  
The Third ◽  
Level 3

11073 Background: to assess the effectiveness of fluor-pyrimidines used in altered fractionated radiation therapy (RT) of breast cancer. Methods: 122 breast cancer patients (stage II) were included in this trial. Mean age - 51.3 years. All of them were randomly assigned to three groups. The first group - 41 patients treated by preoperative course of extra-beam radiation therapy, with double daily fractionation by 2 Gy (time between fractions - 4.5 hours, 4 Gy per day, 8 days), total dose - 32 Gy. The second group - 39 patients treated by the same regimen of radiation therapy, but with the concurrent application of the factory-made papers, sodden with 5-fluorouracil, on the irradiated breast. Papers covered the breast for 8 days, and were removing only during irradiation (2 times a day). The third group - 42 patients treated by the same regimen of radiation therapy, but with the concurrent radiomodification by capecitabine (1000mg/sq.m. per os twice daily before each irradiation, 8 days). In all three groups the radiation therapy was always followed by radical mastectomy in 1–2 days. The endpoints were: frequency of clinical effect and of level 3–4 pathological response. Results: positive clinical effect (complete response and partial response) and stabilization of disease were observed in the first group in 34.1% and 65.9% of patients, in the second group in 33.3% and 66.7% and in the third group in 42.9% and 57.1%. Progression was never observed. There were no signs of pathological response in 17% of patients of the first group, in 5.1% of patients of the second group and in 16.7% of patients of the third group. Level 1–2 and level 3–4 pathological response were observed in the first group in 63.4% and accordingly in 19.6% of patients, in the second group in 12.8% and 46.2% of patients and in the third group in 57.2% and 23.8% of patients. Conclusions: Therefore, using of papers with 5-fluorouracil in preoperational RT of breast cancer demonstrated more frequent level 3–4 pathological response. Using of capecitabine, on the contrary, demonstrated the highest clinical effect, but lower rate of level 3–4 pathological response. No significant financial relationships to disclose.

scholarly journals Prognosis and Prophylactic Regional Nodal Irradiation in Breast Cancer Patients With the First Isolated Chest Wall Recurrence After Mastectomy

2021 ◽  
Vol 10 ◽  
Author(s):  
Xu-Ran Zhao ◽  
Liang Xuan ◽  
Jun Yin ◽  
Yu Tang ◽  
Hui-Ru Sun ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Chest Wall ◽  
Risk Model ◽  
Rank Test ◽  
Breast Cancer Patients ◽  
Regional Nodal Irradiation ◽  
Failure Patterns ◽  
Chest Wall Recurrence ◽  
Supraclavicular Fossa

Background and PurposeOptimal radiation target volumes for breast cancer patients with their first isolated chest wall recurrence (ICWR) after mastectomy are controversial. We aimed to analyze the regional failure patterns and to investigate the role of prophylactic regional nodal irradiation (RNI) for ICWR.Materials and MethodsAltogether 205 patients with ICWR after mastectomy were retrospectively analyzed. Post-recurrence progression-free survival (PFS) and overall survival (OS) rates were calculated by Kaplan-Meier method and the differences were compared with Log-rank test. Competing risk model was used to estimate the subsequent regional recurrence (sRR) and locoregional recurrence (sLRR) rates, and the differences were compared with Gray test.ResultsThe 5-year sRR rate was 25.2% with median follow-up of 88.6 months. Of the 52 patients with sRR, 30 (57.7%) recurred in the axilla, 29 (55.8%) in supraclavicular fossa (SC), and five (9.6%) in internal mammary nodes. Surgery plus radiotherapy was independently associated with better sLRR and PFS rates (p<0.001). The ICWR interval of ≤ 4 years was associated with unfavorable sRR (p=0.062), sLRR (p=0.014), PFS (p=0.001), and OS (p=0.005). Among the 157 patients who received radiotherapy after ICWR, chest wall plus RNI significantly improved PFS (p=0.004) and OS (p=0.021) compared with chest wall irradiation alone. In the 166 patients whose ICWR interval was ≤ 4 years, chest wall plus RNI provided the best PFS (p<0.001) and OS (p=0.022) compared with chest wall irradiation alone or no radiotherapy.ConclusionPatients with ICWR have a high-risk of sRR in SC and axilla. Chest wall plus RNI is recommended.

Relationship between the pre-operative background enhancement coefficient under MRI of breast cancer and recurrence of postoperative chest wall.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e12091-e12091
Author(s):  
Ruimei Ren ◽  
Haimin Lin ◽  
Tianshu Zhao
Keyword(s):  
Breast Cancer ◽  
Chest Wall ◽  
Molecular Subtype ◽  
Rapid Development ◽  
Wall Material ◽  
Breast Cancer Patients ◽  
Ki 67 ◽  
Chest Wall Recurrence ◽  
The Relationship ◽  
Background Enhancement

e12091 Background: With the rapid development of MRI scanning technology , DCE-MRI in breast cancer has been one of the most sensitive examinations for the reason of allowing precise imaging, which can be helpful to demonstrate and evaluate the anatomical structures of breast cancer and its surrounding. What is more,through application of postprocessing technique of MRI,quantitative and half-qualitative data can be obtained for the diagnosis and the differential diagnosis of breast cancer. It is reported that the recurrence of breast cancer after breast conserving surgery is related with elevated BEC of MRI before operation as the result of the difficulty to find the micro-lesions and the margin of infiltrative lesions. Objective: Study on the relationship between the background enhancement coefficient of breast cancer under MRI before operation and recurrence of postoperative chest wall. Material and Methods: 194 cases of breast cancer patients undergoing radical surgery were retrospectively analyzed, all of which were confirmed by pathology and molecular classification.Before surgery all the patients did MRI and the BEC was measured.Aim for study on the relevance of the elevated BEC and chest wall recurrence,we investigate the relationship between the stage, grade,molecular subtype of breast cancer and the elevated BEC statistically. Results: The elevated BEC of the breast before operation is associated with chest wall recurrence after operation (P=0.045), and high expression of HER-2 (P=0.07). Multiple lesions of breast cancer and Ki-67>14% also appeared to be associated with the elevated BEC (P=0.08).While there seem to be no correlation between the size of tumor ,LN metastases, nuclear and pathological grade,molecular typing, PR expression,ER expression, status of the LN capsule and the elevated BEC. Conclusions: The elevated BEC of breast before operation is an independent prognostic factor for chest wall recurrence after operation.Given BEC get a potential to make a brand new biomarker for breast cancer,further relevant research is needed.

Very low-dose adjuvant chemotherapy in steroid receptor negative stage I breast cancer patients

1998 ◽  
Vol 34 (1) ◽  
pp. 66-70 ◽  
Author(s):  
R. Jakesz ◽  
H. Samonigg ◽  
M. Gnant ◽  
E. Kubista ◽  
P. Steindorfer ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Cancer Patients ◽  
Low Dose ◽  
Steroid Receptor ◽  
Stage I ◽  
Breast Cancer Patients

scholarly journals Impact of estrogen receptor levels on outcome in non-metastatic triple negative breast cancer patients treated with neoadjuvant/adjuvant chemotherapy

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Maria Vittoria Dieci ◽  
Gaia Griguolo ◽  
Michele Bottosso ◽  
Vassilena Tsvetkova ◽  
Carlo Alberto Giorgi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Estrogen Receptor ◽  
Adjuvant Chemotherapy ◽  
Triple Negative Breast Cancer ◽  
Triple Negative ◽  
Complete Response ◽  
Breast Cancer Patients ◽  
Significant Difference ◽  
Neo Adjuvant Chemotherapy

AbstractAlthough 1% is the recommended cut-off to define estrogen receptor (ER) positivity, a 10% cut-off is often used in clinical practice for therapeutic purposes. We here evaluate clinical outcomes according to ER levels in a monoinstitutional cohort of non-metastatic triple-negative breast cancer (BC) patients undergoing (neo)adjuvant chemotherapy. Clinicopathological data of 406 patients with ER < 10% HER2-negative BC treated with (neo)adjuvant chemotherapy between 01/2000 and 04/2019 were collected. Patients were categorized in ER-negative (ER < 1%; N = 364) and ER-low positive (1–9%, N = 42). At a median follow-up of 54 months, 88 patients had relapsed and 64 died. No significant difference was observed in invasive relapse-free survival (iRFS) and overall survival (OS) according to ER expression levels, both at univariate and multivariate analysis (5-years iRFS 74.0% versus 73.1% for ER-negative and ER-low positive BC, respectively, p = 0.6; 5-years OS 82.3% versus 76.7% for ER-negative and ER-low positive BC, respectively, p = 0.8). Among the 165 patients that received neoadjuvant chemotherapy, pathological complete response rate was similar in the two cohorts (38% in ER-negative, 44% in ER-low positive, p = 0.498). In conclusion, primary BC with ER1–9% shows similar clinical behavior to ER 1% BC. Our results suggest the use of a 10% cut-off, rather than <1%, to define triple-negative BC.

scholarly journals The Prognostic Value of Skin Involvement in Breast Cancer Patients With Chest Wall Recurrence

2021 ◽  
Author(s):  
Danyang Zhou ◽  
Mei Li ◽  
Fei Xu ◽  
Qiufan Zheng ◽  
Qianyi Lu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Disease Progression ◽  
Cancer Patients ◽  
Chest Wall ◽  
Female Breast Cancer ◽  
Nodal Status ◽  
Skin Involvement ◽  
Breast Cancer Patients ◽  
Female Breast ◽  
Chest Wall Recurrence

Abstract Background: To assess the prognosis of skin involvement in female breast cancer patients with chest wall recurrence (CWR).Methods: We retrospectively analyzed the clinical-pathological data of breast cancer patients with CWR who were diagnosed pathologically between January 2000 and April 2020. Progression free survival (PFS) was defined as time from diagnosis of CWR to the first disease progression. Persistent chest wall progression was three consecutive chest wall progression without distant organ involvement.Results: A total of 476 patients with CWR were included in this study. Among them, skin involvement or not was queried and confirmed in 345 patients. Skin involvement was significantly correlated to tumor size (P=0.003) and initial nodal status (P<0.001). By Kaplan-Meier analysis, skin involvement predicted a shorter PFS (P<0.001), especially local disease progression (P<0.001). Skin involvement was an independent biomarker for PFS by the multivariate analysis (P=0.034). Patients with skin involvement were more likely to experience persistent chest wall progression (P=0.040). After eliminating the potential deviation caused by insufficient follow-up time, persistent chest wall progression was more likely to be associated with positive lymph nodal status (P=0.046), negative PR (P=0.001) and positive HER2 (P=0.046) of the primary site, negative ER (P=0.027) and PR (P=0.013) of chest wall lesion and skin involvement (P=0.020).Conclusion: Skin involvement predicted poor local disease control in female breast cancer patients with CWR and it was more likely to be related to persistent chest wall progression. We improved the stratification of prognosis and provided new insights for biological behaviors of the disease and further individualized treatment in breast cancer patients with CWR.

Chest wall recurrence in pT1-2N0-1 breast cancer patients after mastectomy without radiotherapy

2018 ◽  
Vol 169 (3) ◽  
pp. 507-512 ◽  
Author(s):  
Ji Hyun Chang ◽  
Kyung Hwan Shin ◽  
Seung Do Ahn ◽  
Hae Jin Park ◽  
Eui Kyu Chie ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Chest Wall ◽  
Breast Cancer Patients ◽  
Chest Wall Recurrence
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