Phase II study of  a novel neoadjuvant chemotherapy (NAC) for breast cancer (BC).

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 1060-1060
Author(s):  
Miguel E. Albino ◽  
Fernando Cabanillas ◽  
Orestes Antonio Pavia ◽  
Margarita Bruno ◽  
Miguel M. Echenique ◽  
...  
Keyword(s):  
Triple Negative ◽  
Ductal Carcinoma ◽  
Pathologic Response ◽  
Pet Scan ◽  
Ki 67 ◽  
Receptor Status ◽  
Residual Cancer Burden ◽  
Response To Chemotherapy ◽  
Her 2 ◽  
Md Anderson

1060 Background: The goal of this NAC study was to improve the pathologic response of pts with localized BC. Methods: 51 pts with localized BC >1 cm were treated with this novel regimen consisting first of docetaxel 75 mg/m2, epirubicin 80 mg/m2, and cyclophosphamide 500 mg/m2 (TEC) and PEG Filgrastim for 4 cycles. Pretreament PET scan was done and repeated after course 1. Following the 4th course, ER+/HER2- patients received 4 additional TEC cycles if they achieved CR by MRI, or were switched to a non cross-resistant regimen (vinorelbine, bevacizumab, capecitabine) if they had < CR. HER2+ pts were given docetaxel + trastuzumab for 4 additional cycles, or were switched to a different regimen if < PR. MD Anderson residual cancer burden (MDARCB) score was used to measure pathologic response and correlation with several prognostic factors was studied. Results: Median age = 53; 27 were postmenopausal; 42 had invasive ductal carcinoma, 5 invasive lobular; 12 triple negative, 11 HER2+, and 28 ER+ or PR+/HER2-. MDARCB was significantly better in HER-2+ and triple negative tumors (table). ER+ or PR+/Her2- pts had the least favorable MDARCB with none achieving 0 and only 21% attaining MDARCB=1. 59% of pts with > 5% SUV drop attained MDARCB score 0-1 vs 13% with ≤ 5% drop. %Ki-67 correlated well with MDARCB (table). Ki-67 correlated well with receptor status: 85% of Triple Neg or Her2+ pts had Ki-67 >17 vs only 29% of ER+ or PR+/Her2-. Conclusions: a) This novel NAC regimen leads to markedly favorable MDARCB scores in triple negative and Her-2+ cases. b) Several factors may be useful in predicting response to chemotherapy, including receptor status, Ki-67, and PET scan response after 1st chemotherapy course. c) Ki-67 proliferative rate is closely correlated with receptor status. d) Early PET could be used to predict MDARCB. The challenge now is to improve response in ER+ or PR+/Her2- pts. [Table: see text]

scholarly journals Correlation of DCE-MRI Perfusion Parameters and Molecular Biology of Breast Infiltrating Ductal Carcinoma

2021 ◽  
Vol 11 ◽  
Author(s):  
Li Liu ◽  
Nan Mei ◽  
Bo Yin ◽  
Weijun Peng
Keyword(s):  
Triple Negative ◽  
Ductal Carcinoma ◽  
Growth Factor Receptor ◽  
Luminal A ◽  
Ki 67 ◽  
Dce Mri ◽  
Infiltrating Ductal Carcinoma ◽  
Breast Infiltrating Ductal Carcinoma ◽  
Her 2 ◽  
Epidermal Growth

ObjectiveWe aimed to investigate the correlation of the perfusion parameters of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) with the molecular biological expression of breast infiltrating ductal carcinoma (IDC) in order to guide appropriate therapeutic advice and clinical outcome prediction.Materials and MethodsIn a prospective analysis of 67 patients with breast IDC, preoperative DCE-MRI and routine MRI images were obtained. The double-chamber model (extended Tofts model) was employed to calculate the perfusion parameters. Postoperative pathological immunohistochemistry was examined, including human epidermal growth factor receptor 2 (HER-2), estrogen receptor (ER), progesterone receptor (PR), cell nuclear-associated antigen (Ki-67), cytokeratin 5/6 (CK5/6), and epidermal growth factor receptor (EGFR). Statistical analysis was applied to explore the relationship between the perfusion parameters and the molecular biomarkers of breast cancer.ResultsA total of 67 lesions were included in our study. The mean maximum diameter of lesions was 4.48 ± 1.73 cm. Perfusion parameters had no correlation with tumor diameters (p &gt; 0.05). The volume transfer constant (Ktrans) and the rate constant (kep) had positive correlations with Ki-67 (p &lt; 0.05). The plasma volume ratio (vp) had a statistical difference between CK5/6 positivity and CK5/6 negativity. The maximum rising slope (MAX Slope) was higher in HER-2-enriched tumors than that in luminal A or B tumors (p &lt; 0.05). kep was higher in HER-2-enriched tumors than that in luminal A tumors (p &lt; 0.05). The extravascular extracellular space volume fraction (ve) was higher in triple-negative tumors than that in HER-2-enriched and in luminal A and B tumors (p &lt; 0.05). The time to peak enhancement (TTP) was lower in HER-2-enriched tumors than that in luminal A and B tumors (p &lt; 0.05). Maximum concentration (MAX Conc) was higher in triple-negative tumors than that in luminal B tumors (p &lt; 0.05).ConclusionDCE-MRI perfusion parameters can behave as a noninvasive tool to assess the molecular biological expression and the molecular subtypes of breast IDC. They may aid in predicting breast IDC invasiveness, metastasis, and prognosis.

scholarly journals Apparent diffusion coefficient cannot predict molecular subtype and lymph node metastases in invasive breast cancer: a multicenter analysis

BMC Cancer ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Alexey Surov ◽  
Yun-Woo Chang ◽  
Lihua Li ◽  
Laura Martincich ◽  
Savannah C. Partridge ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Diffusion Coefficient ◽  
Triple Negative ◽  
Molecular Subtype ◽  
Luminal A ◽  
Ki 67 ◽  
Luminal B ◽  
Apparent Diffusion ◽  
Adc Values ◽  
Her 2

Abstract Background Radiological imaging plays a central role in the diagnosis of breast cancer (BC). Some studies suggest MRI techniques like diffusion weighted imaging (DWI) may provide further prognostic value by discriminating between tumors with different biologic characteristics including receptor status and molecular subtype. However, there is much contradictory reported data regarding such associations in the literature. The purpose of the present study was to provide evident data regarding relationships between quantitative apparent diffusion coefficient (ADC) values on DWI and pathologic prognostic factors in BC. Methods Data from 5 centers (661 female patients, mean age, 51.4 ± 10.5 years) were acquired. Invasive ductal carcinoma (IDC) was diagnosed in 625 patients (94.6%) and invasive lobular carcinoma in 36 cases (5.4%). Luminal A carcinomas were diagnosed in 177 patients (28.0%), luminal B carcinomas in 279 patients (44.1%), HER 2+ carcinomas in 66 cases (10.4%), and triple negative carcinomas in 111 patients (17.5%). The identified lesions were staged as T1 in 51.3%, T2 in 43.0%, T3 in 4.2%, and as T4 in 1.5% of the cases. N0 was found in 61.3%, N1 in 33.1%, N2 in 2.9%, and N3 in 2.7%. ADC values between different groups were compared using the Mann–Whitney U test and by the Kruskal-Wallis H test. The association between ADC and Ki 67 values was calculated by Spearman’s rank correlation coefficient. Results ADC values of different tumor subtypes overlapped significantly. Luminal B carcinomas had statistically significant lower ADC values compared with luminal A (p = 0.003) and HER 2+ (p = 0.007) lesions. No significant differences of ADC values were observed between luminal A, HER 2+ and triple negative tumors. There were no statistically significant differences of ADC values between different T or N stages of the tumors. Weak statistically significant correlation between ADC and Ki 67 was observed in luminal B carcinoma (r = − 0.130, p = 0.03). In luminal A, HER 2+ and triple negative tumors there were no significant correlations between ADC and Ki 67. Conclusion ADC was not able to discriminate molecular subtypes of BC, and cannot be used as a surrogate marker for disease stage or proliferation activity.

scholarly journals Mitochondrial DNA alterations correlate with the pathological status and the immunological ER, PR, HER-2/neu, p53 and Ki-67 expression in breast invasive ductal carcinoma

2015 ◽  
Vol 33 (6) ◽  
pp. 2924-2934 ◽  
Author(s):  
CHEN-SUNG LIN ◽  
SHI-CHUAN CHANG ◽  
LIANG-HUNG OU ◽  
CHIEN-MING CHEN ◽  
SOPHIE SWEN-WAN HSIEH ◽  
...  
Keyword(s):  
Mitochondrial Dna ◽  
Invasive Ductal Carcinoma ◽  
Ductal Carcinoma ◽  
Ki 67 ◽  
Breast Invasive Ductal Carcinoma ◽  
Dna Alterations ◽  
Her 2

scholarly journals STUDY ON TWO YEAR SURVIVAL OF STAGE II AND STAGE III BREAST CARCINOMA IN EASTERN INDIA WITH SPECIAL REFERANCE TO PROGNOSTIC MARKERS HER-2/NEU, ER, PR AND Ki-67.

2020 ◽  
Vol 4 (4) ◽  
Author(s):  
Deepika Pandey ◽  
Rajesh kumar Sinha ◽  
Gautam Mandal
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Breast Carcinoma ◽  
Triple Negative ◽  
Disease Free Survival ◽  
Stage Ii ◽  
Stage Iii ◽  
Ki 67 ◽  
Important Indicator ◽  
Her 2

Breast cancer is one of the most commonly diagnosed malignancies and leading cause of cancer death in women over the world and the second most common cancer in females in India. Length of survival of cancer patients is an important indicator for knowing the outcome of treatment in any study. As the disease burden and mortality rate is very high, knowing the factors that influence survival rates among women with breast cancer may help design early detection and improve treatment. The immunohistochemistry plays a very important role in prognostication and treatment determination. Aim:  This study aims to correlate the various relevant prognostic pattern like reactivity pattern of ER,PR,Her-2/Neu ,ki-67 and 2-yr overall survival. Material and method: The proposed study was a cross sectional study with mostly prospective observation and with some retrospective observation, included 74 patients of stage II and stage III breast carcinoma who underwent MRM in Chittaranjan National Cancer Institute from 2017-2018. The various clinical and histopathological prognostic parameters with Estrogen/ Progesterone hormone receptors and Human epidermal growth factor receptor (Her-2/Neu) status in invasive breast carcinoma patients were studied and correlated. Result: 58.1%, 54.1% and 35.1% of the cases were ER, PR and Her-2/neu positive respectively. 89.2% of cases had Ki-67 level >20%. Her-2 neu negative, ER negative and KI-67>20% were found to be significant factors for mortality. Maximum (66.7%) of patients with recurrence and maximum (53.8%) patients who died in study period had triple negative breast cancer. Triple negative tumours have poor survival as compared to ER + PR + and HER-2/Neu +ve tumours. Disease free survival and overall survival of the patients with Ki-67< 20% was better than that of patients with Ki-67>20% (100%). Keywords: Breast cancer, Invasive ductal carcinoma, ER,PR,HER-2/Neu , Ki-67 , Two year survival.

scholarly journals Long-term Outcomes of Pregnancy-Associated Breast Cancer: A Single Institution Experience

2021 ◽  
Keyword(s):  
Breast Cancer ◽  
Triple Negative ◽  
Long Term Outcomes ◽  
Single Institution ◽  
Term Survival ◽  
Long Term Survival ◽  
Response To Chemotherapy ◽  
Her 2

Background: The incidence of pregnancy-associated breast cancer (PABC) is increasing, especially in the developed countries. Herein, we report the long-term outcomes of PABC from a single institution in an Arab country. Methods: Consecutive patients diagnosed to have PABC between 2005 and 2012 at a tertiary referral hospital from a Gulf cooperation council country were the subjects of the study. Long-term outcomes are reported, with a minimum follow-up of 8 years. Results: A total of 16 patients were evaluable for long-term survival analysis. The median age at the time of diagnosis was 31.5 (26-40) years. Nine (56%) patients were multiparous (> 5 previous pregnancies). The mean gestational age at diagnosis was 19.7±7.4 weeks. Immunohistochemistry revealed the following phenotypes: Luminal A 3 (18.8%); HER-2 enriched 8 (50%); triple-negative 5 (31.2%). Three patients underwent modified radical mastectomy as the initial treatment, of which 2 received adjuvant chemotherapy during pregnancy. For patients who received neoadjuvant or palliative chemotherapy, the response rate was 75% (pCR 2; CR 1; PR 6). After a median follow-up of 60 months, median progression-free survival was 36 months (95%CI 24.2 to 47.8), while the overall survival was 59 months (95%CI 31.6 – 86.4). Age, marker status, Ki-67 score, clinical stage and differentiation grade did not affect the PFS or OS on univariate analysis. Conclusions: Fifty percent of the patient with PABC expressed HER-2/neu protein, and 1/3rd had triple-negative disease. The rate of response to chemotherapy, and long-term survival may help to set a benchmark for studies from the region. Larger cohort studies may help to draw firm conclusions.

Epidemiology and clinical profile of breast cancer in central Nepal: A single institutional experience.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e12008-e12008
Author(s):  
Sachin Shakya
Keyword(s):  
Breast Cancer ◽  
Strong Correlation ◽  
Triple Negative ◽  
Clinical Profile ◽  
Age At Diagnosis ◽  
Research Centre ◽  
Age Group ◽  
Receptor Status ◽  
Younger Women ◽  
Her 2

e12008 Background: In this study, our objective was to determine the epidemiological and clinical profile of Breast Cancers. Different Literatures have highlighted the correlation between stage and age at diagnosis, size and age at diagnosis, correlations of different hormone receptor status with different age group etc. But precise documentation is lacking in Nepal. Methods: The study was conducted at department of Medical Oncology, Nepal Cancer Hospital and Research Centre from Dec 2014 to June 2016 and 183 patients diagnosed with breast cancer were enrolled. A retrospective cross-sectional study was conducted. Results: Prevalence of Breast Cancer was 5.59 %. Newar was the most affected ethnic group. The most frequent age group was 40 to 49. The most common symptom was mass in 80 % of patients. Stage II (49.1 %) was the most common stage at diagnosis. 83% patients had a tumour size of 2-5 cm with average size of 3.25 cm at presentation. Younger women with cancer had a strong correlation with ER-ve/PR-ve and Her-2/Neu +ve receptor status with P<.005. Triple Negative receptor status was 32.87%. Her2/neu +ve receptor status cancer was 39.72%. Conclusions: Majority of patients presented with Stage IIa and IIIa disease breast cancer. Disease is more aggressive and diagnosed at a more advanced stage in younger women. Younger women had a strong correlation with ER-ve/PR-ve and her-2/neu +ve receptor. Recommendation for the Her-2/Neu receptor test should be done in every case of breast cancer. Triple negative status was lower in comparison to the previous studies which is favourable for hormonal antibody treatment implementation.

scholarly journals Clinical pathological and epidemiological study of triple negative breast cancer

2017 ◽  
Vol 5 (6) ◽  
pp. 2657
Author(s):  
Arun Ajay ◽  
Priya Radhakrishnan
Keyword(s):  
Breast Cancer ◽  
Triple Negative ◽  
Ductal Carcinoma ◽  
Tertiary Care ◽  
High Rate ◽  
Care Hospital ◽  
Breast Carcinomas ◽  
Significant Difference ◽  
Her 2 ◽  
Epidemiological Characteristics

Background: Worldwide breast cancer is the most frequently diagnosed life threatening cancer in women and a leading cause of cancer death among women. In Kerala, India around 30% of cancer-affected women have carcinoma breast. Breast carcinomas which do not express estrogen (ER), progesterone (PR), and human epidermal growth factor receptor 2 (HER-2/neu) receptors are known as triple negative breast carcinomas (TNBC). They are extremely aggressive with poor prognosis. Here the authors described the clinical pathological and epidemiological characters of triple negative breast carcinomas in a tertiary care hospital in Kerala, India and compare with non-TNBC.Methods: It was a cross sectional comparative study. Clinical, pathological and epidemiological characteristics of 75 cases of TNBC were compared with that of 225 cases of non-TNBC presented in Department of General Surgery, Government medical college, Kozhikode, Kerala, India between a period from March 2014 to October 2015 (20 months). Patients were recruited after obtaining an informed consent. ER, PR, HER-2/neu status were determined by immunohistochemical staining. Data obtained were statistically analyzed using SPSS software.Results: Triple negative breast carcinoma was significantly associated with a younger age (mean age 43.67 years), early age of menarche. Commonly seen in premenopausal age group (78.7%). Patients with the triple-negative carcinoma had relatively large tumors (mean size 4.45cm compared to 3.14cm) and a high rate of node positivity (86.67%). More advanced stage at diagnosis with high grade tumor characteristics. Most common histopathology was invasive ductal carcinoma (98.7%) but no statistical difference was noted with non-TNBC.Conclusions: No significant difference was noted between TNBC and non TNBC on comparing family history, parity, age at 1st child birth, OCP use. The outcome of the disease following treatment was unable to study due to short time frame of the study.

scholarly journals Influence of Age, Estrogen receptor (ER),Progesterone receptor (PR) and Epidermal growth factor -2 (HER-2) in Breast Carcinoma Patient in correlation with Radionuclide Bone Scan – Single Institute Based Experience

2021 ◽  
Vol 22 (2) ◽  
pp. 114-118
Author(s):  
Samira Sharmin ◽  
Farida Yasmin ◽  
Debabrata Ghosh ◽  
Afroza Naznin ◽  
Azmal Kabir Sarker ◽  
...  
Keyword(s):  
Breast Carcinoma ◽  
Bone Metastases ◽  
Bone Scan ◽  
Triple Negative ◽  
Receptor Status ◽  
Visceral Involvement ◽  
Multiple Metastases ◽  
Visceral Metastases ◽  
Her 2 ◽  
Solitary Metastases

Background: Breast carcinoma is a common type of malignancy in women worldwide. Radionuclide bone scintigraphy is recognized choice of investigation for the detection of bone metastases both in asymptomatic and symptomatic patients. Biomarkers like Estrogen Receptor (ER), Progesterone Receptor (PR), Human Epidermal growth factor -2 (HER-2) also play important role in the management and prognosis of breast cancer. The study was aimed to find out the relationship between the MDP bone scan findingsand hormone receptor and HER-2 status of breast carcinoma patients referred to the Institute of Nuclear Medicine and Allied Sciences (INMAS), Mitford, Dhaka. Patients and Methods: This cross sectional study was conducted among 301 breast carcinoma patients between January 2018 and December 2019. Planar bone scan and SPECT (if needed) was done to all the patients after intravenous injection of 99mTc-MDP. Receptor status (ER, PR and HER-2) were documented from the patient’s medical records. Breast tumors were classified as (a) Triple positive- HER2-, ER-, and PR-positive) (b) Triple negative- HER2-, ER-, and PR-negative (c) Hormonereceptor (HR) positive (ER+/PR+) with HER-2 negative and d) HR negative (ER-/PR-) with HER-2 positive.Patients were broadly grouped according to age as A. less than 50 years (n = 59) and B. more than 50 (n = 260 ) years. Results: The mean age of the patients enrolled for this study was 59.02±9.3 with range of 32 to 81 years. Out of the 301 patients, positive bone scans were found in 105 (34.8%) and negative bone scan were found 196 (66.2%). Patients of group A (<50years) with triple negative and HR+/HER-status had no bone or bone with visceral metastases. Triple positive subtype had 2 bone metastases, and HR-/HER-2+ subtype had 2 bone metastases and 1 had bone with visceral metastases. Group B (> 50years) patients having HR+/HER2- receptor status showed 16% solitary metastases, 53.2% multiple metastases, 33.3% extensive bony metastases, 13.6% bone with visceral metastases. Triple negative subtype showed 36.0 % solitary metastases, 19.1% bone with visceral metastases. Triple positive subtype group had 40.0% solitary metastases, 34.0 % multiple metastases, 66.7% extensive bony metastases, and 13.6% bone with visceral metastases. HR-/HER-2+ subtype group had 8% solitary metastases, 12.8% multiple metastases, and 18.2 % bone metastases with visceral involvement Overall relationship between bone scan and hormone receptor subtype, showed that most of the patients had HR+/ HER-2-(35.2%) subtype and 25.6% patient had triple positive, 23.3% patient had triple negative and 15.9% patient had HR-/HER-2 – receptor subtype. This study showed the visceral involvement with bone metastases (13 % in HR+/HER-2- 52.2 % in triple negative, 13 % in triple positive, 21.7 % in HR-/HER-2+subtype). Highest bone only metastases (35) in triple positive and HR+/HER-2-(31) subtype. Most of the patiens who had bone metastases with visceral involvement belong to triple negative (52.2%) and HER-2 subtypes -HR-/HER-2+ (21.7%). The result was significant (P<0.001). Conclusion: It is observed from this study that triple positive and HR+/HER-2- were more likely to develop bone metastases than triple negative and HR-/HER-2-. Patients with bone scan negative and HR-/HER-2- or triple negative receptor status most likely develop visceral metastases Bangladesh J. Nuclear Med. 22(2): 114-118, Jul 2019

scholarly journals Evaluation of the association between HIF-1α and HER-2 expression, hormone receptor status, Ki-67 expression, histology and tumor FDG uptake in breast cancer

2016 ◽  
Vol 12 (5) ◽  
pp. 3889-3895 ◽  
Author(s):  
Sevi̇m Sureyya Cerci ◽  
Kemal Kursat Bozkurt ◽  
Hasan Erol Eroglu ◽  
Celal Cerci ◽  
Evrim Erdemoglu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Hormone Receptor ◽  
Hormone Receptor Status ◽  
Ki 67 ◽  
Receptor Status ◽  
Fdg Uptake ◽  
Her 2

Gata-3 and KI-67 expression in correlation with molecular subtypes of breast cancer

2021 ◽  
pp. 1-5
Author(s):  
M. Husni Cangara ◽  
Upik A. Miskad ◽  
Rina Masadah ◽  
Berti J. Nelwan ◽  
Syarifuddin Wahid
Keyword(s):  
Breast Cancer ◽  
Hormone Receptor ◽  
Triple Negative ◽  
Molecular Subtypes ◽  
Molecular Subtype ◽  
Receptor Expression ◽  
Luminal A ◽  
Ki 67 ◽  
Her 2 ◽  
Hormone Receptor Expression

OBJECTIVES: This study aims to evaluate and compare four breast cancer subtypes defined by immunohistochemistry expression of ER, PR, and HER-2 in correlation with Ki-67 and GATA-3 expression. METHODS: Slides from 89 paraffin blocks of invasive breast cancer patients with four molecular subtypes based on HER-2, ER, and PR expression were then stained with Ki-67 and GATA-3 antibodies to evaluate their expression in correlation with molecular subtype and metastases to lymph nodes. RESULTS: This study was a retrospective study of 89 invasive breast cancers. Luminal A; Luminal B; HER2+; and triple-negative types were 35 (39.3%), 10 (11.2%), 27 (30.3%), and 17 (19.1%) samples. Expression of Ki-67 was increased in triple-negative (TN) tumor compared to non-triple-negative (non-TN) tumor subtypes (p < 0.05). This Ki-67 expression was inversely correlated with the positivity of hormone receptor expression related to lymph-node metastases in TN-type tumors. Sixty-two (57%) samples were immunohistochemically positive for GATA-3. GATA-3 positive samples were significantly more likely to be ER and PR-positive, Ki-67 negative, and luminal A tumors. CONCLUSIONS: Subtype triple-negative breast cancer correlates with high expression of Ki-67 that contributes to poor prognosis of this subtype. The higher Ki-67 expression was correlated with the absence of hormone receptor expression compared with the negativity of Her-2 expression, downplay a role in nodal metastases in a triple-negative tumor. GATA-3 positive breast cancer showed luminal differentiation characterized by high ER expression and mainly was classified as luminal A type tumor with a better prognosis.

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