Tubular carcinomas of the breast: A comparison of features and survival outcomes versus low grade ductal and lobular carcinomas in the SEER database.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e11596-e11596
Author(s):  
Andrew Michael Romano ◽  
Mark E Smolkin ◽  
Patrick Michael Dillon
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Early Stage ◽  
Age At Diagnosis ◽  
Low Grade ◽  
Early Stage Disease ◽  
Stage Disease ◽  
Significant Difference ◽  
Er Positive ◽  
Stage 1

e11596 Background: Tubular carcinoma of the breast (TC) is a rare histologic subtype of breast cancer considered to have a favorable prognosis relative to other histologies. TC is by definition low grade. TC is described to have clinical behavior similar to low grade ductal and lobular breast cancers, but due to its infrequent presentation, long-term follow-up studies of TC are lacking. Methods: The Surveillance, Epidemiology and End Results database was queried to include the years 1988-2009, selecting for patients with either grade 1 TC or grade 1 ductal and lobular breast cancer (G1BC). Data collected included age at diagnosis, race, stage, receptor status, overall survival, and surgery type. Two Cox proportional hazard models were assessed for differences between TC and G1BC, adjusting for age at diagnosis. Results: In SEER 18, 115,945 cases of TC+G1BC breast cancer are found, with 6.1% classified as TC. Of TC cases, 91% are stage 1, while 71% of GIBC are stage 1. Presenting stage 3 or 4 disease occurred in only 4.7% of G1BC versus 0.68% of TC cases. Due to the rarity of advanced disease, we analyzed early stage disease. For early Stage (1-2) breast cancer, mean age was 61.5 years for TC and 63.5 years for G1BC. The TC cases were 92% white, 4% black, 97% Estrogen Receptor (ER) positive, 82% Progesterone Receptor (PR) positive. Of G1BC cases, 88% were white, 5% black, 96% ER positive, 84% PR positive. Treatment differed with 76% of TC patients receiving lumpectomy versus G1BC where 65% received lumpectomy (p<0.001). There was no significant difference in overall survival between Stage I TC and G1BC (p=0.98), or between Stage II TC and G1BC (p=0.075), with the survival estimate higher for TC. Conclusions: In this large-scale analysis, TC was limited to early stage disease and there was no difference in overall survival between patients with early stage TC and early stage GIBC. There were similar receptor statuses and baseline characteristics, but more conservative surgical treatment in TC. Because no survival difference exists for early stage disease, the finding of tubular histology to guide treatment decisions may not be warranted.

scholarly journals Overall Survival and Adjuvant Therapy in Women with Ovarian Carcinosarcoma: A Single-Institution Experience

Diagnostics ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. 200 ◽  
Author(s):  
Aaron Nizam ◽  
Bethany Bustamante ◽  
Weiwei Shan ◽  
Karin K. Shih ◽  
Jill S. Whyte ◽  
...  
Keyword(s):  
Overall Survival ◽  
Median Overall Survival ◽  
Early Stage ◽  
Age At Diagnosis ◽  
Disease Stage ◽  
Tumor Board ◽  
Single Institution ◽  
Early Stage Disease ◽  
Stage Disease ◽  
Platinum Based Chemotherapy

Background: Carcinosarcoma of the ovary (CSO) is a rare and aggressive variant of ovarian cancer. Due to the rare nature of the disease there is insufficient evidence to make recommendations regarding standard management and overall prognosis. Methods: An Institutional Review Board-approved study identified all our patients with CSO between January 2011 and May 2018. Demographic and outcome measures were abstracted from the medical records and tumor board files. Cox proportional hazard models, log rank tests, and comparisons of means were used to calculate significance (p < 0.05). Results: 27 women with CSO were identified. The median age at diagnosis was 65 years (range 48–91). Five women (18%) presented with early stage disease (Stage I or II) and 22 patients (82%) presented with late stage III or IV disease. Twenty patients (74%) received intravenous platinum-based combination chemotherapy. Seven patients did not receive chemotherapy during their treatment course. The median overall survival was 23 months (range 2–68 months). Overall survival was not significantly worsened by the stage of disease at diagnosis. There was no difference in survival based on the age at diagnosis, tobacco status or ethnicity (p > 0.05). Conclusion: This is one of the largest single institution experiences with CSO. The majority of our patients presented with advanced stage disease and received adjuvant platinum-based chemotherapy after cytoreductive surgery. The median overall survival of 23 months was not affected by the stage of the disease. The optimal management of this rare disease needs further study with collaborative, prospective multi-institutional trials.

Effect of treatment of patients with early-stage uterine carcinosarcoma

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 5516-5516
Author(s):  
L. A. Cantrell ◽  
L. Havrilesky ◽  
D. O'Malley ◽  
M. Liotta ◽  
A. A. Secord ◽  
...  
Keyword(s):  
Overall Survival ◽  
Combination Chemotherapy ◽  
Early Stage ◽  
Progression Free Survival ◽  
Postoperative Treatment ◽  
Uterine Carcinosarcoma ◽  
Early Stage Disease ◽  
Time To Recurrence ◽  
Stage Disease ◽  
Significant Difference

5516 Background: The treatment of early stage uterine carcinosarcoma is controversial. We sought to retrospectively review factors that influence progression and survival. Methods: A retrospective, multi-institution study of women diagnosed from 1997–2007 was performed. Postoperative treatment included either observation (OBS), RT (brachytherapy, whole pelvic, or combination), chemotherapy (CT) alone or with RT (CT+RT). Data collected included time to recurrence, overall survival, and sites of recurrence. Statistics included ANOVA and Kaplan Meier. Results: One hundred and forty-six patients were diagnosed with early stage (stages 1 and 2) uterine carcinocarcoma. The median age at diagnosis was 68 years (range:40–91). The majority (62%) were Caucasian, 49 (34%) were African-American and the remainder were other ethnicities. One hundred and seventeen had stage 1 disease and 29 had stage 2. The majority of patients (N = 54, 37 %) were observed, 36 (25%) were treated with CT, 31 (21%) were treated with RT and 17 (12%) were treated with CT + RT. The median progression free survival (PFS) for patients diagnosed with early stage disease was 16.7 months for the OBS cohort and 38.2 months for the CT cohort (p < 0.01). Median overall survival was 23 months for the OBS cohort and 39.3 months for the CT cohort (p = 0.02). The cohorts that underwent RT or CT+RT had improved median progression free (29.9, 20 months) and overall survival (31.7, 20.8 months) as compared to the OBS cohort, however this was not a statistically significant difference. Conclusions: We report on the largest experience in the literature on early stage uterine carcinosarcoma and the first to show that women with early stage disease may benefit from adjuvant chemotherapy. The role of radiation therapy or combination chemotherapy and radiation could not be adequately assessed from this retrospective analysis, but a trend toward improved survival was present. Prospective trials evaluating the best treatment for patients with early stage carcinosarcoma of the uterus should be undertaken to better answer this question. No significant financial relationships to disclose.

scholarly journals Female Breast Cancer in Suriname: Pathways to Treatment—A Patient’s Perception

2020 ◽  
Vol 6 (Supplement_1) ◽  
pp. 49-49
Author(s):  
Euridice R. Irving ◽  
Dennis R. A. Mans ◽  
Els Th. M. Dams ◽  
Maureen Y. Lichtveld
Keyword(s):  
Breast Cancer ◽  
Health Care ◽  
Access To Health Care ◽  
Early Stage ◽  
Diagnosis And Treatment ◽  
Related Factors ◽  
Entire Interval ◽  
Early Stage Disease ◽  
Resource Setting ◽  
Stage Disease

PURPOSE Delays across the entire cancer care continuum are not uncommon. This cross-sectional study explored the health care trajectories of Surinamese women with breast cancer and identified predictors of timely diagnosis and treatment initiation. METHODS One hundred women age 30 years or older who were newly diagnosed with breast cancer in 2017 to 2018 were recruited from all 4 hospitals in Paramaribo. Data on their demographics, lifestyle, reproductive and medical history, health status, and family history of breast cancer and other malignancies were collected using a validated semistructured questionnaire. Using Anderson’s Model of Pathways to Treatment, we defined a patient interval (from detection to first consultation), diagnostic interval (from consultation to histopathologic diagnosis), and treatment interval (from diagnosis to first treatment). Log-transformed data were analyzed using linear regression, and variables with P ≤ .05 were considered statistically significant predictors of intervals. RESULTS All participants had health insurance and access to health care. Eighty-five percent of patients presented with early-stage disease. Ninety percent of patients had self-detected their disease, with 70% finding a lump. Average age was 55.6 years (± 11.8 years). Median durations of patient, diagnostic, and treatment intervals were 13 days (interquartile, range, 4-63 days), 40 days (IQR, 21-57 days), and 18 days (IQR, 8-38 days), respectively. Median duration of the entire interval was 95 days (IQR, 59-272 days). Patient-related factors associated with the intervals were religion (β = −530; P = .003), being employed (β = 149.4; P = .007), and age 50 years and older (β = −195.8; P = .037). Disease-related factors were lump as first symptom (β = −175.6; P = .038) and late-stage disease at diagnosis (β = 213.5; P = .004). CONCLUSION Given the limited-resource setting, delays in Suriname’s health care can be minimized by programs aimed at increasing breast cancer awareness and education; however, delays may have been underestimated as a result of the over-representation of early-stage disease and recall bias regarding the first symptom detected.

scholarly journals Tumor Characteristics and Treatment Outcomes of Older Women with Breast Cancer in Jordan

2019 ◽  
Author(s):  
Hikmat Abdel-Razeq ◽  
Fadwa Abdel Rahman ◽  
Hanan Al-Masri ◽  
Hazem Abdulelah ◽  
Mahmoud Abu Nasser ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Treatment Outcomes ◽  
Metastatic Disease ◽  
Cox Regression ◽  
Early Stage ◽  
Poor Performance Status ◽  
Tumor Characteristics ◽  
Early Stage Disease ◽  
Node Positive ◽  
Stage Disease

Abstract Background : Less than 10% of newly diagnosed breast cancer in our region are diagnosed in women 70 years or older. Treatment plans of such patients is less clear and have poor outcomes. In this paper, we describe clinical presentation, tumor characteristics and treatment outcomes in such patients. Methods : Consecutive patients aged 65 years or older with pathologically-confirmed diagnosis of breast cancer were included. Medical records and hospital databases were searched for patients’ characteristics and treatment outcomes. Results : A total of 553 patients, median age 70 (range: 65-91) years, were included. On presentation, 114 (20.6%) patients had metastatic disease and was mostly visceral (81; 71.1%). Patients with non-metastatic disease had poor pathological features including node-positive in 244 (55.6%), GIII in 170 (38.7%) and lymphovascular invasion in 173 (39.4%). Patients were treated less aggressively; 144 (32.8%) patients with early-stage disease and 98 (86.0%) with metastatic disease never had chemotherapy. After a median follow up of 45 months, 5-year overall survival for the whole group was 67.6%. Survival was better for patients with non-metastatic disease (78.8% vs. 25.4%, P<0.001) and for those with node-negative compared to node-positive disease (85.4% vs. 74.1%, P=0.002). On Cox regression, only positive lymph nodes were associated with poor outcome in patients with non-metastatic disease (Hazard Ratio [HR], 1.75; 95% CI: 1.006-3.034, P=0.048). Conclusions : Older Jordanian women with breast cancer present with more aggressive features and advanced-stage disease that reflect poorly on treatment outcomes. Because of comorbidities and poor performance status, some patients were not aggressively treated.

scholarly journals BRAF Mutation is associated with early stage disease and improved outcome in patients with low-grade serous ovarian cancer

Cancer ◽  
2012 ◽  
Vol 119 (3) ◽  
pp. 548-554 ◽  
Author(s):  
Rachel N. Grisham ◽  
Gopa Iyer ◽  
Karuna Garg ◽  
Deborah DeLair ◽  
David M. Hyman ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Braf Mutation ◽  
Early Stage ◽  
Low Grade ◽  
Serous Ovarian Cancer ◽  
Early Stage Disease ◽  
Stage Disease ◽  
Improved Outcome

The role of radiotherapy in elderly women with early-stage breast cancer treated with breast conserving surgery

2018 ◽  
Vol 104 (6) ◽  
pp. 429-433 ◽  
Author(s):  
Mariacarla Valli ◽  
Simona Cima ◽  
Paola Fanti ◽  
Barbara Muoio ◽  
Alessandra Vanetti ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Elderly Women ◽  
Early Stage ◽  
Conservative Surgery ◽  
Early Stage Breast Cancer ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Significant Difference ◽  
The Impact

Objective: To analyze the impact of adjuvant radiotherapy (RT) on ipsilateral breast recurrence (IBR) and overall survival (OS) in patients older than 69 years with early-stage breast cancer. Methods: From January 2007 to June 2015, we analyzed retrospectively 137 women with estrogen receptor–positive T1–2 invasive breast cancer, with negative axillary lymph nodes, dividing them into 2 subgroups: 70 to 79 years and older than 79 years. Results: After a median follow-up of 43.2 months, the 3-year IBR-free survival in patients treated with surgery plus RT was 98.8% and 92.1% in patients treated with surgery alone, with a significant difference ( p = .01). Radiotherapy did not impact overall survival ( p = .10). A higher percentage of patients aged between 70 and 79 years received RT after conservative surgery if compared with the older subgroup ( p < .01). Conclusions: In elderly women, adjuvant RT reduced the IBR, but did not improve OS.

Low-grade astrocytoma: a decade of experience at St. Jude Children's Research Hospital.

1997 ◽  
Vol 15 (8) ◽  
pp. 2792-2799 ◽  
Author(s):  
A Gajjar ◽  
R A Sanford ◽  
R Heideman ◽  
J J Jenkins ◽  
A Walter ◽  
...  
Keyword(s):  
Overall Survival ◽  
Cerebral Hemisphere ◽  
Young Patients ◽  
Age At Diagnosis ◽  
Cerebellar Hemisphere ◽  
Low Grade ◽  
Tumor Site ◽  
Primary Tumor Site ◽  
Significant Difference ◽  
The Impact

PURPOSE To evaluate the impact of primary tumor site, age at diagnosis, extent of resection, and histology on progression-free survival (PFS) in pediatric low-grade astrocytoma. PATIENTS AND METHODS Medical, pathologic, and imaging information were reviewed for 142 children (ages 2 months to 19 years) with low-grade astrocytoma treated between January 1984 and July 1994. Gross total resection (GTR) was attempted for cerebellar and cerebral hemisphere tumors, with biopsy or less aggressive resection used predominantly for tumors in other sites. Surgery was followed by observation in 107 cases, radiation therapy in 31, and chemotherapy in four. RESULTS The overall survival rate was 90% +/- 3% (SE) at 4 years. PFS was significantly better for patients with cerebellar and cerebral hemisphere tumors (n = 75) than those with tumors in all other sites (P = .0006). Within the former group, there was no significant difference in PFS for patients in whom GTR was achieved versus those with incomplete resections (4-year estimates, 89% and 77%, respectively). Histology (juvenile pilocytic v astrocytoma not otherwise specified [NOS]) was not related to PFS in an analysis that controlled for tumor site and patient age. Patients younger than 5 years at diagnosis had a significantly poorer PFS than older children, regardless of histology (P < .03) or tumor site (P < .002). Treatment for progressive/recurrent disease was effective in a majority of patients, but appeared more successful in patients with hemispheric than thalamic or hypothalamic tumors. CONCLUSION The overall survival in this series of pediatric low-grade astrocytomas is excellent. Age at diagnosis and tumor location, but not histology, had a significant impact on PFS. Efforts to improve treatment outcome should focus on young patients (< 5 years) and on those with central midline tumors. The majority of patients with completely resected hemispheric tumors were monitored without further therapy, which supports attempted GTR of cerebral and cerebellar hemisphere low-grade astrocytoma.

Clinical outcomes in very early breast cancer (≤ 1cm): A national population based analysis.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e12034-e12034
Author(s):  
Mahvish Muzaffar ◽  
Abdul Rafeh Naqash ◽  
Nasreen A. Vohra ◽  
Darla K. Liles ◽  
Jan H. Wong
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Early Breast Cancer ◽  
Older Age ◽  
National Database ◽  
Disease Specific Survival ◽  
Excellent Outcome ◽  
Significant Difference ◽  
Er Positive ◽  
Disease Specific

e12034 Background: The utilization of screening mammogram has resulted in increased diagnosis of very small breast cancers including T1a (≤5 mm), T1b ( > 0.5 but ≤1 cm). These small tumors have excellent prognosis with cancer-specific survival rates as high as 90% to 95%.This study evaluates outcomes in very early breast cancer in a national database. Methods: Patients with stage I breast cancer, tumor ≤ 1cm (T1aN0, T1bN0) diagnosed between 2006 and 2011 were selected from the SEER database. We excluded patients with missing biomarker information. Treatment outcome and prognostic factors for disease-specific survival (DSS) and overall survival (OS) were evaluated. Results: We identified 70,543 cases and included 54,796 patients with stageT1aN0M0 and T1bN0M0 in the final analysis.The mean age was 62.09 yrs(CI 95% 62.2-61.99),84% are white,7% black and 7% Other.89% were ER positive,11% ER negative and 3% had Her 2 positive tumors.71% of patients had T1b. ≤ 1cm breast cancer cases increased from 15% in 2006 to 18% in 2011.The 5-year disease specific survival (DSS) and overall survival (OS) for patients with stage T1aN0T1b N0 was 98.7% and 93.7%, respectively. Estrogen receptor(ER) positive tumors were associated with improved 5-yr DSS 99% vs 96% in ER negative (p < 0.0001) and OS in ER positive 94% vs 92%( p < 0.0001).Among white patients 5-yr DSS was 98.8% and OS was 93.7% while 5yr-DSS was 94%,OS 91.5% among black vs 5-yr DSS 99% and OS 96.3% in others( Asian or Pacific Islanders,AI), (p < 0.0001).Tumor subtype was not associated with significant difference in outcome but T1a tumor was associated with OS 94.5% vs 93.4% with T1b tumors(p < 0.0001) On cox model analysis factors which correlated with prolonged DSS and OS are race (p < 0.0001),older age (p < 0.0001), ER positivity (p < 0.0001) and tumor less than 5mm (p = 0.0006). Conclusions: Very early breast cancer is associated with excellent outcome but has some heterogeneity. Nonwhite/Non Black race was associated with better survival compared to white and black patients.ER positive tumors, older age were also associated with better outcome. This data while reassuring also brings into question of overtreatment of this disease subset.

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