Impact of timeliness of breast radiotherapy on health outcomes in early breast cancer

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 6591-6591
Author(s):  
H. T. Gold ◽  
H. T. Do
Keyword(s):  
Breast Cancer ◽  
Health Outcomes ◽  
Cancer Patients ◽  
Early Breast Cancer ◽  
White Women ◽  
Disease Free Survival ◽  
Breast Cancer Patients ◽  
Post Surgery ◽  
Stage 1 ◽  
The Impact

6591 Background: The objective of this study is to understand the impact of timely radiotherapy on disease-free survival (DFS) in early breast cancer patients ages 65 and above. Methods: The study population is women diagnosed from 1991–1999 in the linked SEER-Medicare database who underwent breast-conserving surgery and radiotherapy within 6 months of diagnosis. Median followup varies from 4 years for ductal carcinoma in situ (DCIS)(n=1,185) to 5 years for Stage 1 disease (n=7,481), and ranges from 0–11 years. Descriptive and proportional hazards analysis of this longitudinal cohort were conducted. Covariates include age, race, poverty, marital status, comorbidity, rurality, radiation completion and delay, elapsed time since diagnosis, comedo necrosis histology (DCIS only), and chemotherapy receipt (Stage 1 only). Subjects were censored at end of followup (including enrolling in Medicare managed care from Medicare fee-for-service) or death. Treatment delay is defined as radiotherapy beginning 8+ weeks post-surgery without chemotherapy or 4+ weeks after chemotherapy ends; other definitions also were explored. Radiotherapy is considered complete if the patient received greater than 16/22 of expected treatments, based on scientific literature. Results: DFS is negatively associated with radiation delay (OR=1.24, p=0.003 for Stage 1; OR=1.40, p=0.054 for DCIS) and Klabunde's inpatient comorbidity index (OR=1.32, p=0.004 for Stage 1; OR=1.66, p=0.065 for DCIS). Additional analyses suggest that a longer delay of 12+ weeks post-surgery (16+ weeks post-chemotherapy) further reduces DFS (OR=4.66, p<0.0001 for Stage 1; OR=12.4, p<0.0001 for DCIS). Non-white women with Stage 1 disease are more likely to delay radiotherapy (p<0.0001), but are not more likely to have worse outcomes (p>0.3). Conclusions: Delayed initiation of radiation therapy is associated with decreased DFS following radiotherapy for early breast cancer and DCIS. Non-white race is associated with delay, but not reduced DFS. Programs targeting referring physicians and patients should be developed to promote timely receipt of radiotherapy by early breast cancer patients, thereby reducing the risk of adverse health outcomes. No significant financial relationships to disclose.

scholarly journals SULT1A1,CYP2C19and disease-free survival in early breast cancer patients receiving tamoxifen

2011 ◽  
Vol 12 (11) ◽  
pp. 1535-1543 ◽  
Author(s):  
Ann M Moyer ◽  
Vera J Suman ◽  
Richard M Weinshilboum ◽  
Rajeswari Avula ◽  
John L Black ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Early Breast Cancer ◽  
Disease Free Survival ◽  
Breast Cancer Patients ◽  
Free Survival ◽  
Disease Free

scholarly journals The Effect of Intraoperative Radiotherapy on Breast Cancer: Focus on the Levels of Angiogenic Factors

2021 ◽  
Author(s):  
Nahid Nafisi ◽  
Maryam Mohammadlou ◽  
Mohammad Esmaeil Akbari ◽  
Seyed Rabie Mahdavi ◽  
Maryam Sheikh ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Linear Regression Analysis ◽  
Intraoperative Radiotherapy ◽  
Angiogenic Factors ◽  
Breast Cancer Patients ◽  
Risk Of Death ◽  
Post Surgery ◽  
Before And After ◽  
The Impact

Abstract Objective: Angiogenesis is one of the hallmarks of cancers that is involved in tumor progression. Angiogenic factors induce the formation of new blood vessels and tumor extension, and finally reduce the survival of patients. Intraoperative radiotherapy (IORT), in which radiation is delivered to the tumor bed can kill cells and change tumor microenvironment. Here, we compared the impact of IORT on the levels of angiogenic factors in the blood and surgical wound fluids (SWF) of the breast cancer patients. Patients and Methods: Blood and drained wound fluid (WF) samples were collected from the breast cancer patients before and after surgery, followed by quantification of the amounts of TGF-β, EGF, FGF, VEGF and DLL4 in the patients using ELISA.Results: Our results were indicative of significant differences between the pre-surgery and post-surgery serum levels of EGF, DLL4 and VEGF. In addition, linear regression analysis showed the significant impact of IORT, vascular invasion and lymph node (LN) involvement on the difference between TGF-β levels in the blood before and after surgery-IORT. According to the outcomes of multivariate analysis, IORT changed the levels of EGF and FGF in the blood and WF. Furthermore, logistic regression analyses showed that TGF-β and EGF can be used as predictor markers of the late-stage and LN involvement of the disease. Interestingly, IORT was able to reduce the risk of death and the recurrence rate of disease. Conclusions: In summary, IORT is a safe and effective treatment that can affect angiogenesis and improve the survival of breast cancer patients.

scholarly journals Metformin intervention against ovarian toxicity during chemotherapy for early breast cancer: study protocol for a randomized double-blind placebo-controlled trial

2020 ◽  
Author(s):  
Jinjin Zhang ◽  
Xiangyi Ma ◽  
Ya Li ◽  
Ronghua Liu ◽  
Yan Li ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Cancer Patients ◽  
Early Breast Cancer ◽  
Ovarian Function ◽  
Objective Response ◽  
Disease Free Survival ◽  
Breast Cancer Patients ◽  
Double Blind

Abstract Background With the significant improvement of the cure rate and survival rate of cancer patients, the survivors need to face quality of life problems, such as significant decline in reproductive system development, ovarian reserves and function, and even fertility loss and early menopause. These problems are often highly associated with chemotherapy-induced ovarian damage in the course of cancer treatment. However, there are no ideal treatment strategies at present. In our attempt to develop reagents and approaches for delaying ovarian aging and protecting chemotherapy-induced ovarian injury, we recently found that metformin may be the most potential drug to protect female malignant tumor patients from chemotherapy-induced ovarian injury. The optional trial is aimed to test whether administration of metformin during chemotherapy could protect normal ovarian function of early breast cancer patients. Methods This study is prospective, randomized, double-blind and placebo-controlled. Female early breast cancer patients (N=314), were randomly assigned to two groups (placebo, metformin 2000 mg). Metformin was administered during and after chemotherapy for patients with stage I-IIIa breast cancer. The primary outcome was the menstruation recovery rate 12 months after chemotherapy, defined as recovery of menstruation twice in a row within 1 year. Patients were followed up for 5 years to observe long-term ovarian function and prognosis of tumor, such as overall survival (OS), objective response rate (ORR), disease-free survival (DFS). Quality of life and safety will also be assessed. Discussion Our research will provide new treatment strategy of fertility protection, and clinical treatment guidance for cancer patients.

scholarly journals Impact of BMI for clinical outcomes in Japanese breast cancer patients

2020 ◽  
Vol 50 (3) ◽  
pp. 230-240
Author(s):  
Naomi Gondo ◽  
Masataka Sawaki ◽  
Masaya Hattori ◽  
Akiyo Yoshimura ◽  
Haruru Kotani ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Clinical Outcomes ◽  
Disease Free Survival ◽  
Overweight And Obesity ◽  
The Body ◽  
Breast Cancer Patients ◽  
Cancer Specific Survival ◽  
Er Positive ◽  
The Impact

Abstract Objective The relationship between the body mass index (BMI) at the time of breast cancer diagnosis and the prognosis of breast cancer patients has not yet been clarified. We investigated the impact of obesity for clinical outcomes in Japanese breast cancer patients. Methods Women with primary breast cancer operated between 2002 and 2014 were identified. All patients are categorized into four groups according to BMI. The range of BMI is &lt;18.5 kg/m2, from 18.5 to 24.9 kg/m2, 25 to 29.9 kg/m2, &gt;30 kg/m2 in underweight, normal, overweight and obesity groups, respectively. The correlation between BMI and overall survival (OS), breast cancer-specific survival (BCSS) and disease-free survival (DFS) were statistically analyzed. Results From the database of our institution, we identified 3223 patients. The median follow-up period was 57 months (1–149). We categorized 2257 (70.0%), 318 (9.9%), 545 (16.9%) and 103 (3.2%) patients into normal, underweight, overweight obesity groups respectively. There were189 patients (5.9%) deaths due to breast cancer recurrence (137 patients) and other disease (52 patients). Obesity groups was significantly high compared with normal groups for OS (adjusted HR, 2.43; 95% CI, 1.38–4.28; P &lt; 0.001), BCSS (adjusted HR, 2.73; 95% CI, 1.15–6.44; P = 0.02) and DFS (adjusted HR, 1.83; 95% CI, 1.11–3.02; P = 0.017) by multivariate analysis. Especially, OS (adjusted HR, 4.87; 95% CI, 2.15–11.04; P &lt; 0.001), BCSS (adjusted HR, 4.51; 95% CI, 1.52–13.34; P &lt; 0.001) and DFS (adjusted HR, 4.87; 95% CI, 1.02–4.89; P = 0.04) were statistically insignificant in postmenopausal ER-positive breast cancer patients. Conclusion Obesity might be risk factor for OS, BCSS and DFS, especially postmenopausal ER-positive women.

scholarly journals Age of 40 Years or Younger Is an Independent Risk Factor for Locoregional Failure in Early Breast Cancer: A Single-Institutional Analysis in Saudi Arabia

2012 ◽  
Vol 2012 ◽  
pp. 1-10 ◽  
Author(s):  
Volker Rudat ◽  
Hamdan El-Sweilmeen ◽  
Elias Fadel ◽  
Iris Brune-Erber ◽  
Alaa Ahmad Nour ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Early Breast Cancer ◽  
Univariate Analysis ◽  
Tumor Type ◽  
Breast Cancer Patients ◽  
Free Survival ◽  
Locoregional Failure ◽  
T Stage ◽  
The Impact

Background. This study was undertaken to evaluate the impact of prognostic factors on the locoregional failure-free survival of early breast cancer patients.Methods. In this single-institutional study, 213 breast cancer patients were retrospectively analysed. Fifty-five of 213 patients were ≤40 years of age at diagnosis. The impact of patient- or treatment-related factors on the locoregional failure-free survival was assessed using the Kaplan-Meier method. The simultaneous impact of factors on the locoregional failure-free survival was assessed using the Cox proportional hazards regression analysis.Results. The median follow-up time of the censored patients was 22 months (mean 28 months, range 3–92 months). On univariate analysis, statistically significant factors for the locoregional failure-free survival were the age (≤40 versus >40 years), T stage (Tis, T0–2 versus T3-4), molecular tumor type (luminal A versus luminal B, Her2neu overexpression, or triple negative), and lymphovascular status (LV0 versus LV1). On multivariate analysis, age and T stage remained statistically significant.Conclusions. Being 40 years or younger has a statistically significant independent adverse impact on the locoregional failure-free survival of patients with early breast cancer.

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