Estrogen receptor alpha (ESR1) gene amplification status and clinical outcome in tamoxifen-treated postmenopausal patients with endocrine-responsive early breast cancer: An analysis of the prospective ABCSG-6 trial.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 10501-10501 ◽  
Author(s):  
Christian F. Singer ◽  
Frederik Holst ◽  
Stefan Steurer ◽  
E C Burandt ◽  
Hellmut Samonigg ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Estrogen Receptor ◽  
Clinical Outcome ◽  
Copy Number ◽  
Estrogen Receptor Alpha ◽  
Distant Recurrence ◽  
Breast Cancer Specific Survival ◽  
Cancer Specific Survival ◽  
Esr1 Gene

10501 Background: Estrogen receptor alpha (ERα) expression is a prognostic parameter in breast cancer and predicts response to endocrine therapy. One of the factors important for protein expression is amplification of its encoding gene ESR1. We have investigated the value of ESR1 amplification in predicting the long-term clinical outcome in tamoxifen-treated postmenopausal women with endocrine-responsive breast cancer. Methods: 394 patients who had been randomized into the tamoxifen-only arm of the prospectively designed endocrine ABCSG-06 trial and in whom FFPE tumor tissue was available were included in this analysis. Immunohistochemical ERα expression was evaluated both locally and centrally using the Allred score, while ESR1 gene amplification status was evaluated by FISH analysis using the ESR1/CEN6 ratio. Results: ESR1 copy number gains were detected in 187 of 394 (47%) tumor specimen and was associated with favorable clinical outcome. At a median follow-up of 10 years, women with intratumoral ESR1 copy number gains had a significantly longer distant recurrence-free survival (adjusted HR for relapse 0.48; 95% CI 0.28-0.83; p=0.009) and breast cancer-specific survival (adjusted HR for death 0.46; CI 0.46-0.71; p=0.006) when compared to women with normal ESR1 copy numbers. Immunohistochemical ERα protein expression, evaluated by Allred score, was significantly correlated with ESR1 copy number alterations (p<0.0001; Chi-Square test), but did itself not allow to discriminate between patients with poor and good prognosis. Conclusions: ESR1 amplification status is an independent and powerful predictor for long-term distant recurrence-free and breast cancer-specific survival in postmenopausal women with endocrine-responsive early-stage breast cancer who received 5 years of tamoxifen.

scholarly journals Lumpectomy Plus Tamoxifen With or Without Irradiation in Women Age 70 Years or Older With Early Breast Cancer: Long-Term Follow-Up of CALGB 9343

2013 ◽  
Vol 31 (19) ◽  
pp. 2382-2387 ◽  
Author(s):  
Kevin S. Hughes ◽  
Lauren A. Schnaper ◽  
Jennifer R. Bellon ◽  
Constance T. Cirrincione ◽  
Donald A. Berry ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Distant Metastasis ◽  
Early Stage ◽  
Breast Cancer Specific Survival ◽  
Cancer Specific Survival ◽  
Er Positive ◽  
Long Term Follow Up

Purpose To determine whether there is a benefit to adjuvant radiation therapy after breast-conserving surgery and tamoxifen in women age ≥ 70 years with early-stage breast cancer. Patients and Methods Between July 1994 and February 1999, 636 women (age ≥ 70 years) who had clinical stage I (T1N0M0 according to TNM classification) estrogen receptor (ER) –positive breast carcinoma treated by lumpectomy were randomly assigned to receive tamoxifen plus radiation therapy (TamRT; 317 women) or tamoxifen alone (Tam; 319 women). Primary end points were time to local or regional recurrence, frequency of mastectomy, breast cancer–specific survival, time to distant metastasis, and overall survival (OS). Results Median follow-up for treated patients is now 12.6 years. At 10 years, 98% of patients receiving TamRT (95% CI, 96% to 99%) compared with 90% of those receiving Tam (95% CI, 85% to 93%) were free from local and regional recurrences. There were no significant differences in time to mastectomy, time to distant metastasis, breast cancer–specific survival, or OS between the two groups. Ten-year OS was 67% (95% CI, 62% to 72%) and 66% (95% CI, 61% to 71%) in the TamRT and Tam groups, respectively. Conclusion With long-term follow-up, the previously observed small improvement in locoregional recurrence with the addition of radiation therapy remains. However, this does not translate into an advantage in OS, distant disease-free survival, or breast preservation. Depending on the value placed on local recurrence, Tam remains a reasonable option for women age ≥ 70 years with ER-positive early-stage breast cancer.

scholarly journals OR15-4 Long-Term Follow-Up of a Female with a Mutation in the Estrogen Receptor Alpha (ESR1) Gene

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Soumia Brakta ◽  
Lynn Chorich ◽  
Hyung-Goo Kim ◽  
Laurel Coons ◽  
Janet Hall ◽  
...  
Keyword(s):  
Estrogen Receptor ◽  
Estrogen Receptor Alpha ◽  
Receptor Alpha ◽  
Esr1 Gene ◽  
Long Term Follow Up

Outcome of patients with an ultralow risk 70-gene signature in the MINDACT trial.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 500-500
Author(s):  
Josephine Lopes Cardozo ◽  
Caroline Drukker ◽  
Marjanka Schmidt ◽  
Laura van 't Veer ◽  
Annuska Glas ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cox Regression ◽  
Gene Signature ◽  
Distant Recurrence ◽  
Low Risk ◽  
Risk Category ◽  
Breast Cancer Specific Survival ◽  
Cancer Specific Survival ◽  
Clinical Risk ◽  
Risk Patients

500 Background: Gene signatures have proven successful in identifying patients with a low risk of distant recurrence who could forego chemotherapy (CT) and are currently included in international treatment guidelines for breast cancer. For the 70-gene signature (MammaPrint) an additional threshold was established within the low risk category to identify patients with an ultralow risk of distant recurrence. In independent cohorts, these patients had excellent breast cancer specific survival at 15 years, suggesting that ultralow risk cancers represent indolent disease (Esserman, JAMA Oncol 2017, Delahaye, BC Res Treat 2017). Here we evaluate survival of patients with an ultralow risk 70-gene signature who participated in the randomized phase 3 MINDACT trial (Piccart, Lancet Oncol 2021). Methods: Of the 6,693 patients enrolled in the MINDACT trial (EORTC 10041/BIG 3-04) between 2007-2011, profiling revealed an ultralow risk 70-gene signature in 1,000 patients (15%). We assessed 5- and 8-year distant metastasis free interval (DMFI) and breast cancer specific survival (BCSS) in patients stratified by 70-gene signature result (high, low, ultralow), and within the ultralow risk group stratified by clinical risk. For these exploratory analyses, we used Kaplan-Meier estimates for time to event endpoints and Cox-regression models to calculate hazard ratio’s (HR). Results: Median follow-up was 8.7 years. Among the ultralow risk patients (n = 1,000), 67% were ≥50 years, 81% had tumors < 2cm, 80% were lymph node negative, 96% had grade 1 or 2 tumors and 99% were ER-positive. Systemic therapy was received by 83% of patients (69% endocrine therapy (ET), 14% ET + CT) and 16% received no adjuvant systemic treatment (AST). Survival estimates for all endpoints are shown in the table; 8-year DMFI was 97.0% (95% CI 95.8-98.1) for ultralow risk. The 8-year DMFI in ultralow risk patients who received no AST or ET only was 97.8% (95% CI 95.3-100) and 97.4% (95% CI 96.1-98.7), respectively. The HR for DMFI was 0.66 (95% CI 0.46-0.95) for ultralow vs low risk, after adjusting for tumor and treatment characteristics (preliminary results). Conclusions: In this prospective study, patients with an ultralow risk 70-gene signature have an excellent prognosis with 8-year BCSS above 99% regardless of clinical risk status, and with an 8-year DMFI of 95-98%.[Table: see text]

scholarly journals Circulating sphingomyelins on estrogen receptor-positive and estrogen receptor-negative breast cancer-specific survival

2020 ◽  
pp. BMT42
Author(s):  
Charleen D Adams
Keyword(s):  
Breast Cancer ◽  
Estrogen Receptor ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Low Density ◽  
Breast Cancer Specific Survival ◽  
Low Density Lipoprotein Cholesterol ◽  
Cancer Specific Survival ◽  
Estrogen Receptor Positive ◽  
Estrogen Receptor Negative

Aim: This study aims to determine whether a causal relationship exists between circulating sphingomyelins and breast cancer-specific survival, since, if one does, sphingomyelins could be studied as a therapeutic target in the management of breast cancer. Patients/materials & methods: Mendelian randomization is used here to investigate whether higher levels of circulating sphingomyelins impact breast cancer-specific survival for estrogen receptor-negative (ER–) and estrogen receptor-positive (ER+) patients. Results: The results suggest a null effect of sphingomyelins for ER– breast cancer-specific survival and a protective effect for ER+ breast cancer-specific survival. Sensitivity analyses implicate low-density lipoprotein cholesterol as a potential confounder. Conclusion: Future studies should replicate and triangulate the present findings with other methods and tease out the roles of sphingomyelins and low-density lipoprotein cholesterol on breast cancer-specific survival.

Long-Term Survival of Patients With Supraclavicular Metastases at Diagnosis of Breast Cancer

2003 ◽  
Vol 21 (5) ◽  
pp. 851-854 ◽  
Author(s):  
Ivo A. Olivotto ◽  
Boon Chua ◽  
Sharon J. Allan ◽  
Caroline H. Speers ◽  
Stephen Chia ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Tnm Staging ◽  
Breast Cancer Specific Survival ◽  
Stage Iiic ◽  
Cancer Specific Survival ◽  
Term Survival ◽  
Long Term Survival ◽  
Tnm System

Background: Patients with supraclavicular metastases at diagnosis of breast cancer were classified between 1987 and 2002 as having stage M1 breast cancer according to the tumor-node-metastasis (TNM) system. The 2003 edition of the TNM staging guidelines has classified such patients as having stage IIIC disease. To determine relative prognosis, we compared long-term survival in a population-based cohort of patients with isolated supraclavicular metastases (nodal-M1) to outcomes of patients with stage IIIB or M1 (other) disease at presentation. Materials and Methods: Among patients with breast cancer and known tumor stage referred to the British Columbia Cancer Agency from 1976 to 1985, 336 IIIB, 233 M1, and 51 nodal-M1 patients were identified. Actuarial overall and breast cancer–specific survival rates were determined to 20 years. Results: Overall survival at 20 years was 13.2% for nodal-M1 cases (95% confidence interval [CI], 5% to 26%), 9.4% for IIIB cases (95% CI, 6% to 14%), and 1.3% for M1 (other) cases (95% CI, 0.4% to 3.5%; log-rank P < .0005). Overall survival was similar between nodal-M1 and IIIB cases (P = .27). Breast cancer–specific survival at 20 years was 24.1% for nodal-M1 cases (95% CI, 13% to 37%), 30.2% for IIIB cases (95% CI, 23% to 38%), and 3.9% for M1 (other) cases (95% CI, 2% to 8%; log-rank P < .0005). Breast cancer–specific survival was significantly different for nodal-M1 cases compared with either IIIB or M1 (other) cases (P = .008 for both). Conclusion: Patients with supraclavicular metastases at diagnosis have significantly better outcomes than patients with M1 (other) disease and overall survival similar to patients with IIIB disease. Reclassification as stage IIIC is appropriate for patients with breast cancer who present with supraclavicular nodal metastases alone.

HER2gene copy number and breast cancer-specific survival

2016 ◽  
Vol 69 (5) ◽  
pp. 871-879 ◽  
Author(s):  
Giovanni B Biserni ◽  
Monica J Engstrøm ◽  
Anna M Bofin
Keyword(s):  
Breast Cancer ◽  
Copy Number ◽  
Breast Cancer Specific Survival ◽  
Cancer Specific Survival
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