Assessing the impact of CMF/FEC/FEC-DOC/ETC (dose-dense) adjuvant chemotherapy in dependency of positive axillary lymph nodes on survival: A retrospective multicenter cohort study of 4,526 breast cancer patients receiving adjuvant chemotherapy.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 1074-1074
Author(s):  
Lukas Schwentner ◽  
Reyn Van Ewijk ◽  
Isabell Hoffmann ◽  
Rolf Kreienberg ◽  
Maria Blettner ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cohort Study ◽  
Adjuvant Chemotherapy ◽  
Lymph Nodes ◽  
Significant Benefit ◽  
Axillary Lymph ◽  
Dose Dense ◽  
The Impact ◽  
Positive Lymph Nodes ◽  
Positive Breast Cancer

1074 Background: Adjuvant chemotherapy has changed dramatically in the last decades. Anthracycline-/taxane-based and dose-dense chemotherapy regimens improved survival in node positive breast cancer. This study tries to answer the following questions: (1) Are there differences in survival dependent on chemotherapy regimens in 0/0-3/4-10/<10 positive lymph nodes? (2) Is it possible to define a cut-off of positive lymph nodes for the use of Taxane-based and dose dense chemotherapy? Methods: This German is a multi-center [17 participating hospitals all are certified as breast cancer centers] retrospective cohort study. We included CMF (1.385), FEC (1.170), FEC-DOC (1.723), and dose-dense ETC (248) into the analysis. Results: In case of 0 LN CMF/FEC/FEC-DOC did not show significant differences in DFS, but OAS was significantly impaired by the use of FEC-DOC in 0 LN [p=0.024; HR=2.02 (95% CI: 1.10-3.73)] (no ETC use in 0 LN). In case of 1-3 positive LN CMF/FEC/FEC-DOC/ETC did not differ significantly in survival parameters. But in 4-10 LN FEC-DOC [p=0.049; HR=0.67 (95% CI: 0.44-0.99)] and ETC [p=0.024; HR=0.56 (95% CI: 0.34-0.93)] demonstrated a significant benefit in DFS and a strong trend in OAS. Dose-dense ETC showed a significant improvement in DFS [p=0.003; HR=0.35 (95% CI: 0.17-0.69)] and OAS [p=0.009; HR=0.35 (95% CI: 0.16-0.77)] in patients with >10 positive LN. Conclusions: Our data confirms that Taxane-based chemotherapy does not improve DFS in LN negative breast cancer, but rather demonstrated an inferior OAS. But in LN positive breast cancer we can demonstrate a benefit by the use of Taxane-based chemotherapy regimens. Furthermore, dose-dense ETC demonstrated a significant benefit in survival in >10 positive LN.

The prognostic value of nodal ratios in node-positive breast cancer: AUBMC experience

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 21072-21072
Author(s):  
A. Shamseddine ◽  
H. Hatoum ◽  
Z. Salem ◽  
Z. Abdel Khalek ◽  
N. El Saghir ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Axillary Lymph Node ◽  
Disease Free Survival ◽  
Axillary Lymph ◽  
Node Positive ◽  
The Impact ◽  
Positive Breast Cancer

21072 Background: Axillary lymph node metastasis has proven to be the most important factor affecting overall survival (OS) and disease free survival (DFS) in patients with breast cancer. Recent evidence suggests that axillary lymph node ratio (LNR) may be at least as important as absolute number of involved lymph nodes in predicting OS and DFS. The aim of this retrospective study is to evaluate the impact of axillary nodal ratios in node-positive breast cancer as a prognostic factor for survival. Methods: Data from 1181 patients with stage I, II and III breast cancer diagnosed at AUBMC between 1990 and 2001 were studied. The median age at diagnosis was 50 years (23 - 88); the median number of lymph nodes dissected was 17 (0 - 49). Survival was compared in 737 patients with node-positive disease according to a LNR below or more than 0.25 (defined as number of involved lymph nodes divided by total dissected axillary lymph nodes). Results: Patients with LNR = 0.25 had a median follow-up of 30 months (1.2–156) and a median DFS of 26 months (1–156). The 5-year survival was 26.2% (94/358) and the 5-year DFS was 22.9% (82/358). Patients with LNR <0.25 had a median follow-up of 36 months (1.2–157) and a median DFS of 36 months (1–157). The 5-year survival of 33.2% (245/737) and the 5-year DFS was 29.8 % (220/737). LNR showed significance as a continuous variable and a categorical variable (0, < 0.25, and = 0.25) with a p < 0.001 Conclusions: LNR significantly predicts OS and DFS in node-positive primary breast cancer. No significant financial relationships to disclose.

scholarly journals Clinical and pathological characteristics of patients with overexpressed her 2 breast cancer in the national cohort study – Amazona III

Mastology ◽  
2020 ◽  
Vol 30 (Suppl 1) ◽  
Author(s):  
Alessandra Borba Anton de Souza ◽  
Gustavo Werutsky ◽  
Daniela Dornelles Rosa ◽  
Rafaela Gomes ◽  
Sergio Simon
Keyword(s):  
Breast Cancer ◽  
Cohort Study ◽  
Lymph Nodes ◽  
Neoadjuvant Therapy ◽  
Surgical Morbidity ◽  
Multicenter Cohort Study ◽  
Pathology Laboratory ◽  
Her 2 ◽  
The Impact ◽  
Positive Lymph Nodes

Introduction: HER2 overexpressed breast cancer (+) is observed at around 15-20%. The introduction of target therapies in this subtype changed the prognosis of these patients, improving mortality and reducing surgical morbidity when neoadjuvant therapy allows downstaging of breast and axillary surgery. A recent publication with 1,310 samples from Brazilian patients described 20% of HER-2 + tumors. There are few epidemiological studies evaluating patients in our population. The Amazona III study evaluated the epidemiology of breast cancer in a sample of the Brazilian population including 2,950 patients from 23 Brazilian hospitals, completed in 2018. Objective: To characterize the frequency of positive HER-2 breast cancer in patients in the Amazona III study and its clinical characteristics. Method: Prospective, multicenter cohort study. All female patients with invasive breast cancer over 18 years of age included in the Amazona III Project were considered eligible. Immunohistochemical determination was made according to the pathology laboratory of each center. Results: Of the 2,950 study participants, 643 (21%) were HER2 +, 71% from the Unified Health System (SUS) and 28.9% from the complementary system. Most had grade 2 (52.6%) or 3 (36.4%), were post-menopausal (53%), positive estrogen receptor (71.9%), and did not undergo neoadjuvant therapy (52%). As for the number of lymph nodes, 45% were positive lymph nodes, with cN1 (27%), cN2 (12%), and cN3 (5%). 49% had positive lymph nodes in SUS and 37% in the private system. The rate of conservative breast surgery was similar in both groups, being around 46%. Conclusion: The prevalence of HER-2 + in patients included in the Amazona Study III (current epidemiological study of breast cancer in Brazil) is compatible with data from the literature. The prevalence of positive lymph node at diagnosis is high, especially in SUS (49%), therefore the impact of access to therapies that increase the chance of increasing overall survival, decreasing invasive recurrence, and decreasing surgical morbidity must be evaluated.

Dose-Dense Adjuvant Chemotherapy with Epirubicin Monotherapy in Patients with Operable Breast Cancer and ≥10 Positive Axillary Lymph Nodes

Oncology ◽  
1998 ◽  
Vol 55 (6) ◽  
pp. 508-512 ◽  
Author(s):  
George Fountzilas ◽  
Costas Nicolaides ◽  
Gerasimos Aravantinos ◽  
Dimosthenis Skarlos ◽  
Paris Kosmidis ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Lymph Nodes ◽  
Operable Breast Cancer ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Dose Dense

scholarly journals Dose-Dense Docetaxel versus Weekly Paclitaxel following Dose-Dense Epirubicin and Cyclophosphamide as Adjuvant Chemotherapy in Node-Positive Breast Cancer Patients: A Retrospective Cohort Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Sara Khoshroo ◽  
Saleh Sandoughdaran ◽  
Parisa Sabetrasekh ◽  
Parastoo Hajian ◽  
Pegah Bikdeli ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Cancer Patients ◽  
Adjuvant Treatment ◽  
Weekly Paclitaxel ◽  
Axillary Lymph ◽  
Breast Cancer Patients ◽  
Node Positive ◽  
Dose Dense ◽  
Positive Breast Cancer

Background/Aims. The anthracycline and taxane-based chemotherapy regimens are the standard adjuvant treatment of node-positive breast cancer patients. Although it was believed that docetaxel and paclitaxel are similarly effective as adjuvant treatment in node-positive breast cancer, recent studies report that weekly paclitaxel is superior to weekly and triweekly docetaxel schedules in terms of overall survival (OS) and disease-free survival (DFS). However, to the best of our knowledge, no study has compared weekly paclitaxel with a dose-dense regimen of docetaxel. The current study is aimed at evaluating the outcome of women with node-positive breast cancer who had received weekly paclitaxel compared with those treated with dose-dense docetaxel. Methods. This study included patients from two prospective studies conducted in our institute from April 2007 to March 2009. Ninety-one women with axillary lymph node-positive breast cancer who had received four cycles of dose-dense epirubicin and cyclophosphamide were treated with either weekly paclitaxel (80 mg/m2) for 12 doses or biweekly docetaxel (75 mg/m2) for four cycles. Results. After a median follow-up of 88 and 109 months, 11 (23.4%) and 10 (22.7%) patients had experienced disease recurrence ( p = 0.16 ), while 10 (21.3%) and 5 (11.4%) patients had died in the paclitaxel and docetaxel arm, respectively ( p = 0.56 ). No significant difference could be seen in 5-year DFS or OS among groups (HR: 0.58; 95% CI: 0.19–1.81, p = 0.35 ; HR: 0.58; 95% CI: 0.19–1.81, p = 0.35 , respectively). Conclusion. In conclusion, both evaluated adjuvant chemotherapy regimens have comparable effectiveness regarding DFS and OS.

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