Abstract Submission

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 526-526 ◽  
Author(s):  
L. J. Goldstein ◽  
R. Gray ◽  
B. H. Childs ◽  
D. Watson ◽  
S. G. Rowley ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Disease Free Survival ◽  
Recurrence Score ◽  
Recurrence Risk ◽  
Oncotype Dx ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Breast Cancers ◽  
Free Survival ◽  
Increased Risk

526 Background: Evidence suggests modern chemotherapy (CT) regimens are only marginally more effective in HR-pos breast cancer (Berry et al. JAMA 2006: 295: 1658). Genomic classifiers may be useful for selection of high-risk subjects for more aggressive CHT. Methods: A case-cohort sample of 776 patients enrolled on E2197 who did (N=179) or did not have a recurrence after CT (if HR-neg) or CHT (if HR-pos) and had available tissue were evaluated for Oncotype DX™ Recurrence Score (RS). E2197 included 2885 evaluable patients with 0–3 positive nodes treated with four 3-week cycles of doxorubicin (60 mg/m2) plus cyclophosphamide 600 mg/m2 (AC) or docetaxel 60 mg/m2 (AT) and hormonal therapy (if HR-pos). Median follow-up was 76 months. Results: There was no difference in DFS between treatment arms. In multivariate analysis, RS was a significant predictor of recurrence in HR-pos disease (p=0.0007, recurrence risk 21% lower for each 10 point drop in RS, 95% confidence intervals 9% to 31%). Recurrence risk was significantly elevated for an intermediate RS 18–30 (n=138, hazard ratio [HR] 2.96 [p=0.0002]) or a high RS ≥ 31 (n=108, HR 4.00, p=0.0001) compared with low RS < 18(n=196), but not for high compared with intermediate RS (HR 1.34, [p=0.32]); results were similar if only HER2-neg disease was included. The 5-year relapse free interval(RFI), breast cancer free survival (BCFS), disease-free survival (DFS), and overall survival (OS) for patients with HR-pos, HER2-neg disease are shown below (%); patients with both node-neg or node-pos breast cancers whose RS was < 18 had excellent outcomes. Conclusions: Oncotype DX™ RS identifies individuals with HR-pos, HER2-neg breast cancer with 0–3 positive axillary lymph nodes at 3–4-fold increased risk of relapse despite standard CHT, and may serve as a means to distinguish between those who do well with standard CHT (RS <18) from those who may be suitable candidates for clinical trials evaluating alternative CT regimens or other strategies (RS ≥ 18). [Table: see text] [Table: see text]

scholarly journals Exemestane in the Adjuvant Treatment of Breast Cancer in Postmenopausal Women

2011 ◽  
Vol 5 ◽  
pp. BCBCR.S6234
Author(s):  
Muaiad Kittaneh ◽  
Stefan Glück
Keyword(s):  
Breast Cancer ◽  
Postmenopausal Women ◽  
Adjuvant Treatment ◽  
Hot Flashes ◽  
Disease Free Survival ◽  
Breast Cancers ◽  
Irreversible Inhibitor ◽  
Free Survival ◽  
Increased Risk ◽  
Clinical Benefits

Exemestane is an irreversible inhibitor of the aromatase enzyme, which is a key component in the production of estrogen. The majority of breast cancers are sensitive to the proliferative effects of estrogen. Exemestane is approved for the adjuvant treatment of postmenopausal women with breast cancer after 2 to 3 years of tamoxifen therapy, based on a 32% improvement in disease-free survival compared with 5 years of tamoxifen alone ( P < 0.001). Exemestane has also shown clinical benefits as an upfront therapy. The safety profile of exemestane shares some side effects with tamoxifen (hot flashes and arthralgia), but is not associated with an increased risk of endometrial cancer or thromboembolic events. This review will discuss in detail the efficacy and safety of exemestane in early breast cancer.

scholarly journals Is adjuvant chemotherapy necessary in older patients with breast cancer?

Breast Cancer ◽  
2022 ◽  
Author(s):  
Midori Morita ◽  
Akihiko Shimomura ◽  
Emi Tokuda ◽  
Yoshiya Horimoto ◽  
Yukino Kawamura ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Older Patients ◽  
Disease Free Survival ◽  
Breast Cancer Surgery ◽  
Axillary Lymph Nodes ◽  
Control Group ◽  
Axillary Lymph ◽  
Free Survival

Abstract Background Due to the lack of clinical trials on the efficacy of chemotherapy in older patients, an optimal treatment strategy has not been developed. We investigated whether adjuvant chemotherapy could improve the survival of older patients with breast cancer in Japan. Methods We retrospectively analyzed data of patients with breast cancer aged ≥ 70 years who underwent breast cancer surgery in eight hospitals between 2008 and 2013. Clinical treatment and follow-up data were obtained from the patients’ medical electric records. Results A total of 1095 patients were enrolled, of which 905 were included in the initial non-matched analysis. The median age and follow-up period were 75 (range 70–93) and 6.3 years, respectively. Of these patients, 127 (14%) received adjuvant chemotherapy (Chemo group) while the remaining 778 (86%) did not (Control group). The Chemo group was younger (mean age in years 73 vs 76; P < 0.0001), had a larger pathological tumor size (mean mm 25.9 vs 19.9; P < 0.0001), and more metastatic axillary lymph nodes (mean numbers 2.7 vs 0.7; P < 0.0001) than the Control group. The disease-free survival (DFS) and overall survival (OS) did not differ significantly between the two groups (P = 0.783 and P = 0.558). After matched analyses, DFS was found to be significantly prolonged with adjuvant chemotherapy (P = 0.037); however, OS difference in the matched cohort was not statistically significant (P = 0.333). Conclusion The results showed that adjuvant chemotherapy was associated with a reduced risk of recurrence, but survival benefits were limited.

scholarly journals MicroRNAs Regulating Tumor Immune Response in the Prediction of the Outcome in Patients With Breast Cancer

2021 ◽  
Vol 8 ◽  
Author(s):  
Konstantina Thomopoulou ◽  
Chara Papadaki ◽  
Alexia Monastirioti ◽  
George Koronakis ◽  
Anastasia Mala ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Cancer Patients ◽  
Disease Free Survival ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Breast Cancer Patients ◽  
Free Survival ◽  
Disease Free ◽  
Line Chemotherapy

MicroRNAs (miRNAs) are key regulators in immune surveillance and immune escape as well as modulators in the metastatic process of breast cancer cells. We evaluated the differential expression of plasma miR-10b, miR-19a, miR-20a, miR-126 and miR-155, which regulate immune response in breast cancer progression and we investigated their clinical relevance in the outcomes of breast cancer patients. Plasma samples were obtained from early (eBC; n = 140) and metastatic (mBC; n = 64) breast cancer patients before adjuvant or first-line chemotherapy, respectively. Plasma miRNA expression levels were assessed by qRT-PCR. We revealed a 4-miRNA panel consisted of miR-19a, miR-20a, miR-126, and miR-155 able to discriminate eBC from mBC patients with an AUC of 0.802 (p &lt; 0.001). Survival analysis in eBC patients revealed that low miR-10b and miR-155 expression was associated with shorter disease free survival (disease free survival; p = 0.012 and p = 0.04, respectively) compared to high expression. Furthermore, miR-126 expression was associated with shorter overall survival (overall survival; p = 0.045). In multivariate analysis the number of infiltrated axillary lymph nodes and low miR-10b expression independently predicted for shorter DFS (HR: 2.538; p = 0.002 and HR: 1.943; p = 0.033, respectively) and axillary lymph nodes and low miR-126 for shorter OS (HR: 3.537; p = 0.001 and HR: 2.558; p = 0.018). In the subgroup of triple negative breast cancer (TNBC) patients, low miR-155 expression independently predicted for shorter DFS (HR: 5.056; p = 0.037). Accordingly in mBC, patients with low miR-10b expression had shorter progression free survival and OS compared to patients with high expression (p = 0.0017 and p = 0.042, respectively). In multivariate analysis, recurrent disease and low miR-10b expression independently predicted for shorter PFS (HR: 2.657; p = 0.001 and HR: 1.920; p = 0.017, respectively), whereas performance status two independently predicted for shorter OS (HR: 2.031; p = 0.03). In summary, deregulated expression of circulating miRNAs involved in tumor and immune cell interactions evaluated before adjuvant and 1st-line chemotherapy can distinguish disease status and emerge as independent predictors for outcomes of breast cancer patients.

Lymphatic/vascular invasion has a negative impact on overall survival and disease‐free survival in patients with breast cancer and positive axillary lymph nodes

2020 ◽  
Vol 26 (9) ◽  
pp. 1867-1868
Author(s):  
Fabiana Tonellotto ◽  
Anke Bergmann ◽  
Karen de Souza Abrahão ◽  
Suzana Sales Aguiar ◽  
Marcelo Adeodato Bello ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Lymph Nodes ◽  
Vascular Invasion ◽  
Negative Impact ◽  
Disease Free Survival ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Free Survival ◽  
Disease Free

scholarly journals Profile of Immune Cells in Axillary Lymph Nodes Predicts Disease-Free Survival in Breast Cancer

PLoS Medicine ◽  
2005 ◽  
Vol 2 (9) ◽  
pp. e284 ◽  
Author(s):  
Holbrook E Kohrt ◽  
Navid Nouri ◽  
Kent Nowels ◽  
Denise Johnson ◽  
Susan Holmes ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Nodes ◽  
Immune Cells ◽  
Disease Free Survival ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Free Survival ◽  
Disease Free

scholarly journals False-negative frozen section of sentinel nodes in early breast cancer (cT1-2N0) patients

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Zhu-Jun Loh ◽  
Kuo-Ting Lee ◽  
Ya-Ping Chen ◽  
Yao-Lung Kuo ◽  
Wei-Pang Chung ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Early Breast Cancer ◽  
False Negative ◽  
Disease Free Survival ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Frozen Sections ◽  
Sentinel Nodes ◽  
Tumor Emboli

Abstract Background Sentinel lymph node biopsy (SLNB) is the standard approach for the axillary region in early breast cancer patients with clinically negative nodes. The present study investigated patients with false-negative sentinel nodes in intraoperative frozen sections (FNSN) using real-world data. Methods A case–control study with a 1:3 ratio was conducted. FNSN was determined when sentinel nodes (SNs) were negative in frozen sections but positive for metastasis in formalin-fixed paraffin-embedded (FFPE) sections. The control was defined as having no metastasis of SNs in both frozen and FFPE sections. Results A total of 20 FNSN cases and 60 matched controls from 333 SLNB patients were enrolled between April 1, 2005, and November 31, 2009. The demographics and intrinsic subtypes of breast cancer were similar between the FNSN and control groups. The FNSN patients had larger tumor sizes on preoperative mammography (P = 0.033) and more lymphatic tumor emboli on core biopsy (P < 0.001). Four FNSN patients had metastasis in nonrelevant SNs. Another 16 FNSN patients had benign lymphoid hyperplasia of SNs in frozen sections and metastasis in the same SNs from FFPE sections. Micrometastasis was detected in seven of 16 patients, and metastases in nonrelevant SNs were recognized in two patients. All FNSN patients underwent a second operation with axillary lymph node dissection (ALND). After a median follow-up of 143 months, no FNSN patients developed breast cancer recurrence. The disease-free survival, breast cancer-specific survival, and overall survival in FNSN were not inferior to those in controls. Conclusions Patients with a larger tumor size and more lymphatic tumor emboli have a higher incidence of FNSN. However, the outcomes of FNSN patients after completing ALND were noninferior to those without SN metastasis. ALND provides a correct staging for patients with metastasis in nonsentinel axillary lymph nodes.

A new endpoint for the assessment of adjuvant therapy in postmenopausal women with operable breast cancer.

1986 ◽  
Vol 4 (12) ◽  
pp. 1772-1779 ◽  
Author(s):  
R D Gelber ◽  
A Goldhirsch
Keyword(s):  
Breast Cancer ◽  
Postmenopausal Women ◽  
Adjuvant Treatment ◽  
Disease Free Survival ◽  
Operable Breast Cancer ◽  
Treatment Programs ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Breast Cancer Study ◽  
Chemoendocrine Therapy

Between 1978 and 1981, 463 evaluable postmenopausal patients 65 years of age or younger with operable breast cancer and metastases in axillary lymph nodes were entered in Ludwig Breast Cancer Study III (Ludwig III) and randomly allocated to receive chemoendocrine therapy with cyclophosphamide, methotrexate, 5-fluorouracil, low-dose continuous prednisone, and tamoxifen (CMFp + T) for 12 monthly cycles, or endocrine therapy alone with prednisone and tamoxifen (p + T) for 1 year, or no adjuvant treatment after mastectomy (observation). At 60 months' median follow-up, the 5-year disease-free survival (DFS) rates were 59% for CMFp + T, 41% for p + T, and 31% for observation (P less than .0001), and the 5-year overall survival (OS) rates were 71% for CMFp + T, 64% for p + T, and 59% for observation (P = .16; CMFp + T v observation, P = .07). A new quality of life-oriented endpoint was defined to assist in the selection of therapeutic approach after surgery for postmenopausal patients: the time without symptoms of disease and subjective toxic effects of treatment (TWiST). Despite the larger initial discount due to subjective toxicity with chemoendocrine therapy, by 5 years postmastectomy the net difference in average TWiST for treated patients compared with the observation group was positive and approximately equal for both adjuvant treatment programs. Adjuvant chemoendocrine therapy for postmenopausal women appears to be justified due to an emerging OS advantage and increasing TWiST gained for the treated patients.

Massive inflammatory reaction following the removal of a ruptured silicone implant masking the invasive breast cancer – case report and literature review

2016 ◽  
Vol 88 (1) ◽  
Author(s):  
Piotr Nowaczyk ◽  
Aleksandra Budnicka ◽  
Mateusz Wichtowski ◽  
Paweł Kurzawa ◽  
Dawid Murawa
Keyword(s):  
Breast Cancer ◽  
Histopathological Examination ◽  
Breast Implants ◽  
Breast Cancer Case ◽  
Left Breast ◽  
Cancer Case ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Breast Cancers ◽  
Inflammatory Infiltration

AbstractThis paper presents a case of a patient with invasive ductal breast cancer following breast augmentation. Following breast implants rupture in March 2013 the breast implants have been removed – histopathological examination revealed leaked silicone with inflammatory infiltration, without evidence of cancerous lesions. Diagnostic imaging revealed multiple encapsulated silicone particles and clusters of post-inflammatory macrocalcifications in both breasts. In January 2014 the patient presented with symptoms of massive inflammation of the left breast. Following surgical consultation the patient had undergone radical left-sided mastectomy with lymphadenectomy. Postoperative histopathological examination revealed a multifocal advanced invasive ductal cancer G3 pT3pN3a (vascular invasion, metastases in 11 of 12 examined axillary lymph nodes). Following surgery the patient was qualified for further treatment – chemotherapy, radiotherapy, hormone therapy. The discussion includes a review of literature on the risk evaluation of co-occurrence of breast cancers in women with silicone breast implants and presents diagnostic challenges of breast cancer in this patient group.

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