Is obesity associated with increased recurrence risk in estrogen receptor (ER)-positive breast cancer?

2011 ◽  
Vol 29 (27_suppl) ◽  
pp. 171-171 ◽  
Author(s):  
K. K. L. Yap ◽  
D. N. Efiom-Ekaha
Keyword(s):  
Breast Cancer ◽  
Weight Gain ◽  
Pearson Correlation ◽  
Cancer Recurrence ◽  
Oncotype Dx ◽  
Breast Cancer Recurrence ◽  
Breast Cancers ◽  
Obese Women ◽  
Er Positive ◽  
Positive Breast Cancer

171 Background: Oncotype DX Score is a 21-gene expression analysis that has been validated clinically as a reliable predictor of breast cancer recurrence for ER-positive, node-negative breast cancers. Obesity is recognized as a risk factor for many cancers, including breast cancer. Additionally obesity has been shown to be an independent prognostic factor in breast cancer. The primary objective of this study is to determine the correlation between obesity and Oncotype DX score, hence the relationship between obesity and breast cancer recurrence in ER-positive breast cancer. The secondary objective is to investigate the association between weight gain after diagnosis and breast cancer recurrence. Methods: An IRB-exempted retrospective chart review of female patients at Wellspan Group with ER-positive breast cancer who had Oncotype DX analysis in 2008 and 2009. Data collected included Oncotype DX score and BMI (at diagnosis, 6 months and 12 months). Data were analyzed to determine the correlation between Oncotype DX score and BMI at diagnosis, at 6 months and at 12 months. The correlation between Oncotype DX score and BMI changes at 12 months also was determined. Results: A total of 125 patients were identified; 103 had BMI recorded at diagnosis, 88 had BMI recorded at 6 months and 87 had BMI recorded at 12 months. Of these, we were able to determine the BMI changes at 12 months for 82 patients. The Pearson correlation scores were 0.091 (p = 0.361), 0.074 (p = 0.492), and 0.047 (p = 0.669) for BMI at diagnosis, at 6 months and at 12 months respectively. The Pearson correlation score was 0.007 (p = 0.948) for BMI changes at 12 months. Conclusions: Obesity and weight gain are not independent predictors of recurrence in patients with ER-positive breast cancer. The reported adverse prognostic associations may be more prominent in ER-negative breast cancers. This is consistent with the reports suggesting a higher rate of ER-negative, high-grade cancers in obese women as well as a greater magnitude of benefit from dietary and weight reduction interventions seen in women with ER-negative cancers.

Do younger women with early breast cancer have a higher recurrence risk?

2011 ◽  
Vol 29 (27_suppl) ◽  
pp. 178-178
Author(s):  
K. K. L. Yap ◽  
D. N. Efiom-Ekaha
Keyword(s):  
Breast Cancer ◽  
Pearson Correlation ◽  
Age Groups ◽  
Cancer Recurrence ◽  
Recurrence Risk ◽  
Oncotype Dx ◽  
Age At Diagnosis ◽  
Breast Cancer Recurrence ◽  
Cancer Center ◽  
Younger Women

178 Background: There has been conflicting evidence in the literature regarding the association between age and breast cancer recurrence risk. Cancer Research UK reported a better survival among patients aged 50 to 69 compared to younger women. The National Cancer Institute had reported the same, but only in women with stage 1 cancer. Fox Chase Cancer Center and Lyman et al had however suggested that there is no association between breast cancer recurrence and age at diagnosis. Our objective is to investigate the association between breast cancer recurrence and age at diagnosis. Methods: An IRB-exempted restrospective chart review of female patients at Wellspan Group who had Oncotype DX analysis in 2008 and 2009. Data collected included Oncotype DX score and age at diagnosis. Data was analyzed to determine the correlation between Oncotype DX score and age at diagnosis. The patients were divided into three groups: age less than 45 years, age 45 to 59 years, and age 60 or more. Oncotype DX score was used because it has been clinically validated as a reliable predictor of breast cancer recurrence for node-negative breast cancer. Results: A total of 125 patients were identified. The Pearson Correlation score for Oncotype DX score and age at diagnosis was -0.064 (p = 0.478). The mean score was 18.36 for those aged less than 45 years, 22.04 for those aged 45 to 59 years, and 19.16 for those age 60 or more. The difference between these groups was not significant (p = 0.340). Conclusions: There was neither significant correlation between breast recurrence and age, nor difference between the three age groups. Our study shows that age at diagnosis is not an independent predictor of breast cancer recurrence risk.

Mammography-based radiomics for predicting the risk of breast cancer recurrence: a multicenter study

2021 ◽  
pp. 20210348
Author(s):  
Ning Mao ◽  
Ping Yin ◽  
Haicheng Zhang ◽  
Kun Zhang ◽  
Xicheng Song ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Invasive Breast Cancer ◽  
Cancer Recurrence ◽  
Oncotype Dx ◽  
Breast Cancer Recurrence ◽  
Training Set ◽  
Er Positive ◽  
Test Sets ◽  
External Test ◽  
Radiomics Signature

Objective: This study aimed to establish a mammography-based radiomics model for predicting the risk of estrogen receptor (ER)-positive, lymph node (LN)-negative invasive breast cancer recurrence based on Oncotype DX and validated it by using multicenter data. Methods: A total of 304 potentially eligible patients with pre-operative mammography images and available Oncotype DX score were retrospectively enrolled from two hospitals. The patients were grouped as training set (168 patients), internal test set (72 patients), and external test set (64 patients). Radiomics features were extracted from the mammography images of each patient. Spearman correlation analysis, analysis of variance, and least absolute shrinkage and selection operator regression were performed to reduce the redundant features in the training set, and the least absolute shrinkage and selection operator algorithm was used to construct the radiomics signature based on selected features. Multivariate logistic regression was utilized to construct classification models that included radiomics signature and clinical risk factors to predict low vs intermediate and high recurrence risk of ER-positive, LN-negative invasive breast cancer in the training set. The models were evaluated with the receiver operating characteristic curve in the training set. The internal and external test sets were used to confirm the discriminatory power of the models. The clinical usefulness was evaluated by using decision curve analysis. Results: The radiomics signature consisting of three radiomics features achieved favorable prediction performance. The multivariate logistic regression model including radiomics signature and clinical risk factors (tumor grade and HER 2) showed good performance with areas under the curve of 0.92 (95% confidence interval [CI] 0.86 to 0.97), 0.88 (95% CI 0.75 to 1.00), and 0.84 (95% CI 0.69 to 0.99) in the training, internal and external test sets, respectively. The DCA indicated that when the threshold probability is ranges from 0.1 to 1.0, the radiomics model adds more net benefit than the “treat all” or “treat none” scheme in internal and external test sets. Conclusion: As a non-invasive pre-operative prediction tool, the mammography-based radiomics model incorporating radiomics and clinical factors show favorable predictive performance for predicting the risk of ER-positive, LN-negative invasive breast cancer recurrence based on Oncotype DX. Advances in knowledge: The mammography-based radiomics model incorporating radiomics and clinical factors shows favorable predictive performance for predicting the risk of ER-positive, LN-negative invasive breast cancer recurrence.

scholarly journals Relationship Between Plasma Estradiol Levels and Estrogen-Responsive Gene Expression in Estrogen Receptor–Positive Breast Cancer in Postmenopausal Women

2010 ◽  
Vol 28 (7) ◽  
pp. 1161-1167 ◽  
Author(s):  
Anita K. Dunbier ◽  
Helen Anderson ◽  
Zara Ghazoui ◽  
Elizabeth J. Folkerd ◽  
Roger A'Hern ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Gene Expression ◽  
Estrogen Receptor ◽  
Postmenopausal Women ◽  
Multivariable Analysis ◽  
Independent Set ◽  
Breast Cancers ◽  
Plasma Estradiol ◽  
Er Positive ◽  
Positive Breast Cancer

Purpose To determine whether plasma estradiol (E2) levels are related to gene expression in estrogen receptor (ER)–positive breast cancers in postmenopausal women. Materials and Methods Genome-wide RNA profiles were obtained from pretreatment core-cut tumor biopsies from 104 postmenopausal patients with primary ER-positive breast cancer treated with neoadjuvant anastrozole. Pretreatment plasma E2 levels were determined by highly sensitive radioimmunoassay. Genes were identified for which expression was correlated with pretreatment plasma E2 levels. Validation was performed in an independent set of 73 ER-positive breast cancers. Results The expression of many known estrogen-responsive genes and gene sets was highly significantly associated with plasma E2 levels (eg, TFF1/pS2, GREB1, PDZK1 and PGR; P < .005). Plasma E2 explained 27% of the average expression of these four average estrogen-responsive genes (ie, AvERG; r = 0.51; P < .0001), and a standardized mean of plasma E2 levels and ER transcript levels explained 37% (r, 0.61). These observations were validated in an independent set of 73 ER-positive tumors. Exploratory analysis suggested that addition of the nuclear coregulators in a multivariable analysis with ER and E2 levels might additionally improve the relationship with the AvERG. Plasma E2 and the standardized mean of E2 and ER were both significantly correlated with 2-week Ki67, a surrogate marker of clinical outcome (r = −0.179; P = .05; and r = −0.389; P = .0005, respectively). Conclusion Plasma E2 levels are significantly associated with gene expression of ER-positive breast cancers and should be considered in future genomic studies of ER-positive breast cancer. The AvERG is a new experimental tool for the study of putative estrogenic stimuli of breast cancer.

scholarly journals Post-diagnosis weight gain and breast cancer recurrence in women with early stage breast cancer

2006 ◽  
Vol 99 (1) ◽  
pp. 47-57 ◽  
Author(s):  
Bette J. Caan ◽  
Jennifer A. Emond ◽  
Loki Natarajan ◽  
Adrienne Castillo ◽  
Erica P. Gunderson ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Weight Gain ◽  
Early Stage ◽  
Cancer Recurrence ◽  
Early Stage Breast Cancer ◽  
Breast Cancer Recurrence

Safety and Efficacy Results of a Randomized Trial Comparing Adjuvant Toremifene and Tamoxifen in Postmenopausal Patients With Node-Positive Breast Cancer

2000 ◽  
Vol 18 (20) ◽  
pp. 3487-3494 ◽  
Author(s):  
Kaija Holli ◽  
Ritva Valavaara ◽  
Guillermo Blanco ◽  
Vesa Kataja ◽  
Päivi Hietanen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Side Effect ◽  
Cancer Recurrence ◽  
Breast Cancer Recurrence ◽  
Side Effect Profile ◽  
Treatment Groups ◽  
Node Positive ◽  
Er Positive ◽  
The Mean

PURPOSE: In this multicenter trial, toremifene 40 mg/d was compared with tamoxifen 20 mg/d, both given orally for 3 years to postmenopausal, axillary node–positive women after breast surgery. PATIENTS AND METHODS: The first 899 patients (toremifene, n = 459; tamoxifen, n = 440) of the total of 1,480 patients accrued to the trial were included in this scheduled safety analysis. The mean follow-up time was 3.4 years. RESULTS: The two treatment groups were well balanced with respect to patient and disease characteristics. The subjective side-effect profile was similar in both treatment groups. Slightly more vascular complications (deep vein thromboses, cerebrovascular events, and pulmonary embolisms) were seen among tamoxifen-treated patients (5.9%) as compared with toremifene-treated patients (3.5%) (P = .11), whereas bone fractures (P = .09) and vaginal leukorrhea (P = .05) were more common in the toremifene group. The number of subsequent second cancers was similar. The breast cancer recurrence rate was 23.1% (n = 106) in the toremifene group and 26.1% (n = 115) in the tamoxifen group (P = .31). When only patients with estrogen receptor (ER)–positive cancer were considered (n = 556), the risk for breast cancer recurrence was nonsignificantly lower among the toremifene-treated women, with a hazards ratio of 0.74 (90% confidence interval, 0.52 to 1.04; P = .14). The mean time to breast cancer recurrence and overall survival were similar in both groups. CONCLUSION: The side-effect profile of toremifene resembles that of tamoxifen. The efficacy of toremifene seems to be no less than that of tamoxifen. The trend for fewer breast cancer recurrences in the ER-positive subgroup is encouraging, but a longer follow-up is needed to confirm this.

scholarly journals Breast cancer chemoprevention

2011 ◽  
Vol 2 (4) ◽  
pp. 223
Author(s):  
Ivana Sestak ◽  
Jack Cuzick
Keyword(s):  
Breast Cancer ◽  
Cancer Chemoprevention ◽  
Similar Efficacy ◽  
Breast Cancers ◽  
New Agents ◽  
Breast Cancer Chemoprevention ◽  
Er Positive ◽  
Prevention Trials ◽  
Endometrial Cancers ◽  
Positive Breast Cancer

Trials with tamoxifen have clearly shown that the risk of developing oestrogen receptor positive breast cancer can be reduced by at least 50% with prophylactic agents. The current challenge is to find new agents which achieve this or better efficacy, but with fewer side effects. Recent results indicate that the SERM raloxifene has similar efficacy to tamoxifen, but leads to fewer endometrial cancers, gynecological symptoms, and thromboembolic events. Results for contralateral tumors in adjuvant trials suggest that aromatase inhibitors may be able to prevent up to 70%–80% of ER-positive breast cancers, and this is currently being investigated in two large prevention trials, one using anastrozole (IBIS-II) and the other exemestane (MAP.3). New agents are needed for receptor negative breast cancer and several possibilities are currently under investigation.

scholarly journals Immune Checkpoint Profiles in Luminal B Breast Cancer (Alliance)

2019 ◽  
Vol 112 (7) ◽  
pp. 737-746 ◽  
Author(s):  
Meenakshi Anurag ◽  
Mayanne Zhu ◽  
Chen Huang ◽  
Suhas Vasaikar ◽  
Junkai Wang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Tissue Microarray ◽  
Microarray Analysis ◽  
Immune Tolerance ◽  
Immune Checkpoint ◽  
Mrna Levels ◽  
Breast Cancers ◽  
Er Positive ◽  
Tissue Microarray Analysis ◽  
Positive Breast Cancer

Abstract Background Unlike estrogen receptor (ER)-negative breast cancer, ER-positive breast cancer outcome is less influenced by lymphocyte content, indicating the presence of immune tolerance mechanisms that may be specific to this disease subset. Methods A supervised analysis of microarray data from the ACOSOG Z1031 (Alliance) neoadjuvant aromatase inhibitor (AI) trial identified upregulated genes in Luminal (Lum) B breast cancers that correlated with AI-resistant tumor proliferation (percentage of Ki67-positive cancer nuclei, Pearson r &gt; 0.4) (33 cases Ki67 &gt; 10% on AI) vs LumB breast cancers that were more AI sensitive (33 cases Ki67 &lt; 10% on AI). Overrepresentation analysis was performed using WebGestalt. All statistical tests were two-sided. Results Thirty candidate genes positively correlated (r ≥ 0.4) with AI-resistant proliferation in LumB and were upregulated greater than twofold. Gene ontologies identified that the targetable immune checkpoint (IC) components IDO1, LAG3, and PD1 were overrepresented resistance candidates (P ≤ .001). High IDO1 mRNA was associated with poor prognosis in LumB disease (Molecular Taxonomy of Breast Cancer International Consortium, hazard ratio = 1.43, 95% confidence interval = 1.04 to 1.98, P = .03). IDO1 also statistically significantly correlated with STAT1 at protein level in LumB disease (Pearson r = 0.74). As a composite immune tolerance signature, expression of IFN-γ/STAT1 pathway components was associated with higher baseline Ki67, lower estrogen, and progesterone receptor mRNA levels and worse disease-specific survival (P = .002). In a tissue microarray analysis, IDO1 was observed in stromal cells and tumor-associated macrophages, with a higher incidence in LumB cases. Furthermore, IDO1 expression was associated with a macrophage mRNA signature (M1 by CIBERSORT Pearson r = 0.62 ) and by tissue microarray analysis. Conclusions Targetable IC components are upregulated in the majority of endocrine therapy–resistant LumB cases. Our findings provide rationale for IC inhibition in poor-outcome ER-positive breast cancer.

Sign in / Sign up

Export Citation Format

Share Document