Lobular invasive pleomorphic breast cancer (BC) should be isolated from the classic type

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 17024-17024 ◽  
Author(s):  
E. Gil Deza ◽  
H. Japaze ◽  
C. García Gerardi ◽  
C. Diaz ◽  
N. Gercovich ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Ductal Carcinoma ◽  
Histological Grade ◽  
Lobular Carcinoma ◽  
Stage I ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Entire Cohort ◽  
Worse Prognosis

17024 Background: Lobular invasive BC represents between 5 and 10% of all breast tumors. The MD Anderson Hospital has published a study of 122 pt with lobular invasive carcinoma classic type (LIC) with a better long-term outcome than pt with invasive ductal carcinoma (JCO 23:41, 2005). In most papers, the lobular invasive pleomorphic type (LIP) represents a small number of cases and can be easily confused with the NOS carcinoma. The aim of this study is to compare the onset and prognosis of patients (pt) with LIP vs LIC breast cancer. Methods: A search in the IOHM database of 1169 BC was carried out. All of them had been reviewed by two pathologists and classified according the USA Association of Directors of Anatomic and Surgical Pathology's recommendations. The entire cohort was diagnosed and treated at the IOHM. Only those with lobular invasive BC were included in this paper. Results: Between Oct 97 and Nov 06, 116/1169 pt (10%) were diagnosed with invasive lobular carcinoma. Seventy pt (60%) were LIC, and 46 pt (40%) were LIP. Characteristics of the Population: All pt were females. Both groups were comparable in terms of age (median age for both groups = 60 yo) Staging: LIP presented in more advanced stages: A) LIP group: Stage I: 14 pt; II: 22 pt; III: 8 pt; IV: 2 pt B) LIC group: Stage I: 42 pt ; II:13 pt; III: 15 pt; (p:0,001). The LIP group had a higher histological grade (p:0,0001), and more multifocality (p: 0.023), and vascular invasion (p:0,0001) than the LIC group. There were no differences in hormonal receptors status or the ductal extensive component. The retrospective determination of the Her2/neu status is underway. Treatment: Both groups were treated similarly according to the different stages of the illness. Follow-Up: The average follow up time was 23 months (range 4–102) and the LIP group showed a worse prognosis than the LIC group as measured by a higher rate of metastasis (LIP: 12 pt - LIC: 4 pt) (p:0,002) and a higher mortality rate (LIP: 6 pt - LIC: 0) (p:0,003). Conclusions: 1- The LIP carcinoma is a more aggressive variant and has a worse prognosis than the LIC. 2- The incidence for LIP is higher than expected, as it stands for 40% of the total cases in our study. 3- The results justify the establishment of a clear cut differentiation between the classical and pleomorphic types. No significant financial relationships to disclose.

scholarly journals Long-term outcome with lenalidomide and dexamethasone therapy for newly diagnosed multiple myeloma.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 8096-8096 ◽  
Author(s):  
Geetika Srivastava ◽  
Vishal Rana ◽  
Martha Lacy ◽  
Morie A. Gertz ◽  
Angela Dispenzieri ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Initial Therapy ◽  
Cell Transplant ◽  
Newly Diagnosed ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Entire Cohort ◽  
Dexamethasone Therapy

8096 Background: The combination of lenalidomide and dexamethasone (Len-Dex) is a commonly used initial therapy for newly diagnosed multiple myeloma. While the short-term outcomes with respect to response and toxicity is well-known, long-term outcome with this combination as initial therapy is not well described. Methods: We studied 286 consecutive patients with newly diagnosed MM seen at our institution, who received initial therapy with Len-Dex, and who had complete follow up records. Data regarding the clinical course was obtained from medical records. Results: The median (range) age at diagnosis was 63 (28-92) yrs; 166 (58% were ≤ 65 yrs and175 (61%) were male. The median estimated follow-up was 3.9 yrs (95% CI, 3.4, 4.2) and 203 (71%) pts were alive at the time of last follow up. The median estimated duration on Len-Dex was 5.3 mos (95% CI, 4.6, 6.4). The best overall response (≥PR) was 72%, including 26% with VGPR or better and 14 (5%) not being evaluable for a response. At last follow up, 41 (14%) patients were continuing on therapy. There were 93 pts (32%) who stayed on therapy for 12 months or more. Among these patients, the ORR was 86%, including 45% with VGPR or better. The median overall survival (OS) for the entire cohort from diagnosis was 7.4 yrs (95% CI; 5.8, NR) and the estimated 5-yr survival was 67%. There were 16 (5.5%) pts who died within a year of diagnosis. The median time to first disease progression, irrespective of transplant status, was 30.2 mos (95% CI, 25, 42). Overall, 143 (50%) of the patients have gone to stem cell transplant. Censoring those patients who proceeded to SCT prior to relapse at the time of BMT, the median TTP was 25.5 mos (95% CI, 22, 29). The median OS was 7.4 yrs for those ≤65 yrs, compared with 6.2 yrs for the older patients (P=0.01). The 5-yr OS estimate for patients in ISS stage 1, 2 and 3 were 82, 65, and 44 months respectively. Conclusions: The current study provides long-term estimates of responses and survival in a series of patients treated initially with lenalidomide and dexamethasone. The median survival of nearly 8 years reflects the efficacy of the novel agents both at diagnosis and at relapse and confirms the survival improvements seen in MM in the last decade.

Analysis of weight trends over time in female survivors with triple negative breast cancer.

2018 ◽  
Vol 36 (7_suppl) ◽  
pp. 28-28 ◽  
Author(s):  
Damien Mikael Hansra ◽  
Rebecca Rollins ◽  
Karen Rados ◽  
Anita Johnson ◽  
Johnathan Ramey ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factor ◽  
Weight Gain ◽  
Triple Negative Breast Cancer ◽  
Triple Negative ◽  
Stage I ◽  
Definitive Treatment ◽  
Female Survivors ◽  
Worse Prognosis

28 Background: Triple-negative breast cancer (TNBC) is a subtype of breast cancer (BC) with unique clinical-pathological & prognostic characteristics. Studies have shown obesity to be risk factor for TNBC. Furthermore, patients (pts) with BC and overweight/obesity have a worse prognosis. Here we investigate body mass index (BMI) & weight trends among BC survivors. Methods: A retrospective review BC pts at Cancer Treatment Centers of America Atlanta from 2012-10/27/17. Definition of a survivor: pts who have completed definitive therapy with no evidence of disease. Survivor BMI & weight gain (kg) calculated from chart review. Weight gain in kg was recorded post chemotherapy, at 3, 6, 9, 12 month follow up. Inclusion: Pts with ER-PR-HER2- (TNBC), adults > 18 yo, pts who completed chemo (neoadjuvant or adjuvant) & surgery +/- radiation. Exclusion: Pts who died, had relapsed local disease or metastatic disease; missing BMI data; currently on chemotherapy; who did not receive chemotherapy; missing continuous BMI data or pathology report; lost to follow up. Results: 1756 BC pts with stage IA-IIIC identified, 300 pts identified as TNBC. A total of 134 patients met full inclusion/exclusion survivorship criteria. Average age of survivors = 52 (range 25-76). Stage: I = 38%; II = 50%, III = 12%. BMI categories: 0% underweight (BMI < 18.5 kg/m2), 15% normal weight (BMI 18.5 to < 25 kg/m2), 18% overweight (BMI 25 to < 30 kg/m2), 55% obese (BMI ≤30 kg/m2), 12% morbid obesity (BMI ≤ 40 kg/m2). Average BMI for all survivors = 32.23 +/-0.59 kg/m2 (range 19-52 kg/m2); post chemotherapy weight change = 0.53 +/-0.41 kg; at 3 month follow up = -0.16 +/-0.51 kg; at 6 month = -0.02 +/-0.54 kg; at 9 month follow up 1.20 +/-0.59 kg; at 12 month follow up = 2.25 +/-0.61 kg. BMI by stage: I = 32.81 +/- 1.00 kg/m2; II = 32.12 +/- 0.91 kg/m2; III = 32.44 +/- 1.27 kg/m2. Conclusions: In our study, female survivors with TNBC present with obesity and gain weight after chemotherapy. Also, weight gain continues at 9 & 12 months post definitive treatment. Survivors with TNBC should be treated with intensive weight loss interventions given that overweight/obesity is a risk factor for recurrence, worse prognosis, & cardiovascular events.

scholarly journals Current Concepts in Diagnosis, Molecular Features, and Management of Lobular Carcinoma In Situ of the Breast With a Discussion of Morphologic Variants

2017 ◽  
Vol 141 (12) ◽  
pp. 1668-1678 ◽  
Author(s):  
Paula S. Ginter ◽  
Timothy M. D'Alfonso
Keyword(s):  
Breast Cancer ◽  
Carcinoma In Situ ◽  
Invasive Carcinoma ◽  
Lobular Carcinoma ◽  
Lobular Carcinoma In Situ ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Molecular Features ◽  
Increased Risk

Context.—Lobular carcinoma in situ (LCIS) refers to a neoplastic proliferation of cells that characteristically shows loss of E-cadherin expression and has long been regarded as a risk factor for invasive breast cancer. Long-term outcome studies and molecular data have also implicated LCIS as a nonobligate precursor to invasive carcinoma. In the past few decades, pleomorphic and florid LCIS have been recognized as morphologic variants of LCIS with more-aggressive histopathologic features, less-favorable biomarker profiles, and more-complex molecular features compared with classic LCIS. There is still a lack of consensus regarding certain aspects of managing patients with LCIS.Objectives.—To review recently published literature on LCIS and to provide an overview of the current morphologic classification of LCIS, recent molecular advances, and trends in patient management.Data Sources.—Sources included peer-reviewed, published journal articles in PubMed (US National Library of Medicine, Bethesda, Maryland) and published guidelines from the National Comprehensive Cancer Network (Fort Washington, Pennsylvania).Conclusions.—Lobular carcinoma in situ represents a marker for increased risk of breast cancer, as well as a nonobligate precursor to invasive carcinoma. Morphologic variants of LCIS—florid and pleomorphic LCIS—are genetically more-complex lesions and are more likely to be associated with invasive carcinoma. Further investigation into which molecular alterations in LCIS are associated with progression to invasive carcinoma is needed to help guide medical and surgical management.

scholarly journals Takotsubo Cardiomyopathy in Patients Suffering From Acute Non-traumatic Subarachnoid Hemorrhage - A Single Center Follow-up Study

2021 ◽  
Author(s):  
Csilla Molnár ◽  
Judit Gál ◽  
Dorottya Szántó ◽  
László Fülöp ◽  
Andrea Szegedi ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Takotsubo Cardiomyopathy ◽  
Troponin T ◽  
Disease Onset ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Entire Cohort ◽  
Follow Up Study ◽  
Transcranial Duplex Sonography

Abstract Background: Takotsubo cardiomyopathy (TTC) is an important complication of subarachnoid hemorrhage (SAH), that may delay surgical or endovascular treatment and may influence patient outcome. This prospective follow-up study intended to collect data on the prevalence, severity, influencing factors and long-term outcome of TTC in patients suffering from non-traumatic SAH. Methods: Consecutive patients admitted with the diagnosis of non-traumatic SAH were included. Intitial assessment consisted of cranial CT, Hunt-Hess, Fisher and WFNS scoring, 12-lead ECG, transthoracic echocardiography (TTE), transcranial duplex sonography and collecting laboratory parameters (CK, CK-MB, cardiac troponin T, NT-proBNP and urine metanephrine and normetanephrine). Diagnosis of TTC was based on modified Mayo criteria. TTC patients were dichotomized to mild and severe forms. Follow-up of TTE, Glasgow Outcome Scale assessment, Barthel’s and Karnofsky scoring occurred on days 30 and 180.Results: One hundred thirty six patients were included. The incidence of TTC in the entire cohort was 28.7 %; of them, 20.6% and 8.1% were mild and severe, respectively. TTC was more frequent in females (30/39; 77%) than in males (9/39; 23%) and was more severe. The occurrence of TTC was related to mFisher scores and WFNS scores. Although the severity of TTC was related to mFisher score, Hunt-Hess score, WFNS score and GCS, multivariate analysis showed the strongest relationship with mFisher scores. Ejection fraction differences between groups were present on day 30, but disappeared by day 180, whereas wall motion score index was still higher in the severe TTC group at day 180. By the end of the follow-up period (180 days), 70 (74.5%) patients survived in the non-TTC, 22 (81.5%) in the mild TTC and 3 (27%) in the severe TTC group (n = 11) (p = 0.002). At day 180, GOS, Barthel, and Karnofsky outcome scores were higher in patients in the control (non-TTC) and the mild TTC groups than in the severe TTC group. Conclusions: Takotsubo cardiomyopathy is a frequent finding in patients with SAH, and severe TTC may be present in 8% of SAH cases. The severity of TTC may be an independent predictor of mortality and outcome at 6 months after disease onset. Therefore, a regular follow-up of ECG and TTE abnormalities is warranted in patients with subrachnoid hemorrhage for early detection of TTC. Trial registration: The study was registered at the Clinical Trials Register under the registration number of NCT02659878 (date of registration: January 21, 2016)

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