Type of surgery for early breast cancer and predictive factors an institutional review: A regression model.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e12016-e12016
Author(s):  
Mahvish Muzaffar ◽  
Iman Mohamed ◽  
Colette Gaba ◽  
Sadik Khuder
Keyword(s):  
Breast Cancer ◽  
Early Breast Cancer ◽  
Cancer Registry ◽  
Academic Institution ◽  
Stage I ◽  
Stage Ii ◽  
Bilateral Mastectomy ◽  
Tumor Characteristics ◽  
Local Surgery ◽  
Type Of Surgery

e12016 Background: Breast conserving surgery (BCS) is the preferred surgical management for most early-stage breast cancer, given the equivalent survival after BCS plus radiation and mastectomy (M). Clinical reports of an increasing trend in mastectomy from some institutional reviews have been published. The aim of this study was to assess correlation of type of surgery with different factors in our cancer registry database. Methods: We retrospectively reviewed the cancer registry data at UTMC for early breast cancer stage I/II from 2006-2010. Patient demographics, tumor characteristics, institution of surgery, academic versus private surgeon were identified and compared. We used univariate analysis to select factors for entry into a multivariate analysis. Multinomial logistic regression analysis was performed to predict the type of surgery (cancer side mastectomy (CSM) versus BCS, bilateral mastectomy (BM) versus BCS based on the above variables. A p-value of < 0.05 was significant and comparisons were two tailed. Results: We identified 506 eligible patients with stage I/II breast cancer. 306(60.5%) had undergone breast conservative surgery (BCS), 91 (18%) patients had cancer side mastectomy (CSM) and 109 (21.5%) patients had bilateral mastectomy (BM). 298 (59%) patients were stage I and 208 (41%) had stage II, 218 (42%) had undergone surgery at academic center versus 298 (58%) at nonacademic institution. Predictors o CSM were stage II (p =0.0193), high-grade tumor (p=0.015), surgeon from academic institution (p=0.64), age (p=0.61). Predictors of BM were surgeon from academic institution (p=0.060), age (p=0.07). Conclusions: This study confirms some known factors like stage, surgeon expertise, as influencing factors in type of local surgery, while at the same time did not show impact of race and other tumor characteristics. Further research of these factors need to confirm the influence on decision making prospectively.

Four versus six cycles of docetaxel and cyclophosphamide in early breast cancer.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e12047-e12047
Author(s):  
Aparna Basu ◽  
Vrushali S. Dabak ◽  
Randa Loutfi ◽  
Haythem Y. Ali ◽  
Hadi Mohammed ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adjuvant Therapy ◽  
Adverse Events ◽  
Early Breast Cancer ◽  
Tnm Staging ◽  
Stage I ◽  
Stage Ii ◽  
Limited Series ◽  
Grade 3 ◽  
Number Of Cycles

e12047 Background: ABC trials established the use of non-anthracycline containing regimen, docetaxel and cyclophosphamide (TC) as adjuvant therapy in early breast cancer. In clinical practice, TC is commonly used in Stage I Triple Negative (TN) and Stage I,II Hormone positive breast cancer. However, no specific recommendations exist in literature, regarding the number of cycles that can be used. i.e. TC4 vs TC6. Our aim, was to determine if TC4 is non-inferior to TC6 when used as adjuvant therapy in early breast cancer. Methods: We retrospectively reviewed 143 patients who were diagnosed with early breast cancer, between 2007 to 2017, at our institution who had received either TC4 or TC6 as adjuvant therapy. The number of cycles the patients received were based on provider preference. The two groups (TC4, TC6) were compared in regard to stage of cancer at diagnosis based on AJCC 7th edition-stratified by TNM staging for hormone positive and T staging only for TN, grade of adverse events, recurrence and death from breast cancer. Median follow up was 5 years. Results: Out of the 143, 102(71.3%) received TC4 and 41(28.7%) received TC6. Among the hormone positive, 42 were stage I and out of which 32(76.2%) received TC4 and 10(23.8%) received TC6 and there were 24 stage II patients, out of which 17(70.8%) received TC4 and 7(29.2%) received TC6. Among the TN group, there were 64 who were T1, out of which 45(70.3%) received TC4 and 19(29.7%) received TC6, while there were 12 T2 patients, out of which 7(58.3%) received TC4 and 5(41.7%) received TC6. Recurrence of breast cancer was seen in 5(4.9%) in TC4 and 3(7.3%) in TC6, p=0.569. Death due to breast cancer was seen in 2(1.9%) in TC4 and 1(2.4%) in TC6, p=0.856. Adverse events were seen in 86(84.3%) in TC4 and 39(95.1%) in TC6,p=0.078. Adverse events of Grade 3 or higher were seen in 10(9.8%) in TC4 and 11(26.8%) in TC6, p=0.09. Conclusions: In this limited series, TC4 appears to be equally effective to TC6, with fewer adverse events of any grade and lower incidence of Grade 3 or higher side effects which was statistically significant. Although the proportion of patients who received TC 4 were higher in our series, the percentage of patients who received TC6 was higher in stage II for hormone positive and T2 for TN when compared to Stage 1 and T1 respectively. We also found a higher percentage of recurrence and death due to breast cancer in TC6 which was not statistically significant and this likely a reflection of the fact that as mentioned above patient with a higher stage at diagnosis tended to receive 6 cycles as compared to 4 cycles and therefore had a higher chance of recurrence in the future.

Identification of biomarkers and functional modules from genomic data in stage-wise breast cancer

2020 ◽  
Vol 15 ◽  
Author(s):  
Athira K ◽  
Vrinda C ◽  
Sunil Kumar P V ◽  
Gopakumar G
Keyword(s):  
Breast Cancer ◽  
Expression Patterns ◽  
Differential Expression Analysis ◽  
Predictive Biomarkers ◽  
Stage I ◽  
Stage Ii ◽  
Stage Iii ◽  
Functional Modules ◽  
Incidence And Mortality ◽  
Multiple Stages

Background: Breast cancer is the most common cancer in women across the world, with high incidence and mortality rates. Being a heterogeneous disease, gene expression profiling based analysis plays a significant role in understanding breast cancer. Since expression patterns of patients belonging to the same stage of breast cancer vary considerably, an integrated stage-wise analysis involving multiple samples is expected to give more comprehensive results and understanding of breast cancer. Objective: The objective of this study is to detect functionally significant modules from gene co-expression network of cancerous tissues and to extract prognostic genes related to multiple stages of breast cancer. Methods: To achieve this, a multiplex framework is modelled to map the multiple stages of breast cancer, which is followed by a modularity optimization method to identify functional modules from it. These functional modules are found to enrich many Gene Ontology terms significantly that are associated with cancer. Result and Discussion: predictive biomarkers are identified based on differential expression analysis of multiple stages of breast cancer. Conclusion: Our analysis identified 13 stage-I specific genes, 12 stage-II specific genes, and 42 stage-III specific genes that are significantly regulated and could be promising targets of breast cancer therapy. That apart, we could identify 29, 18 and 26 lncRNAs specific to stage I, stage II and stage III respectively.

scholarly journals The impact of sociodemographic factors on the utilization of radiation therapy in breast cancer patients in Estonia: a register-based study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Fereshteh Shahrabi Farahani ◽  
Keiu Paapsi ◽  
Kaire Innos
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Cancer Registry ◽  
Psychosocial Support ◽  
Sociodemographic Factors ◽  
Stage I ◽  
Equal Access ◽  
Administrative Databases ◽  
The Impact ◽  
Over Time

Abstract Background Radiation therapy is an important part of multimodal breast cancer treatment. The aim was to examine the impact of sociodemographic factors on radiation therapy use in breast cancer (BC) patients in Estonia, linking cancer registry data to administrative databases. Methods Estonian Cancer Registry provided data on women diagnosed with BC in Estonia in 2007–2018, including TNM stage at diagnosis. Use of radiation therapy within 12 months of diagnosis was determined from Estonian Health Insurance Funds claims, and sociodemographic characteristics from population registry. Receipt of radiation therapy was evaluated over time and by clinical and sociodemographic factors. Poisson regression with robust variance was used to calculate univariate and multivariate prevalence rate ratios (PRR) with 95 % confidence intervals (CI) for receipt of radiation therapy among stage I–III BC patients age < 70 years who underwent primary surgery. Results Overall, of 8637 women included in the study, 4310 (50 %) received radiation therapy within 12 months of diagnosis. This proportion increased from 39 to 58 % from 2007 to 2009 to 2016–2018 (p < 0.001). Multivariate regression analysis showed that compared to women with stage I BC, those with more advanced stage were less likely to receive radiation therapy. Receipt of radiation therapy increased significantly over time and was nearly 40 % higher in 2016–2018 than in 2007–2009. Use of radiation therapy was significantly lower for women with the lowest level of education compared to those with a university degree (PRR 0.88, 95 % CI 0.80–0.97), and for divorced/widowed women (PRR 0.95, 95 % CI 0.91–0.99) and single women (PRR 0.92, 95 % CI 0.86–0.99), compared to married women. Age at diagnosis, nationality and place of residence were not associated with receipt of radiation therapy. Conclusions The study showed considerable increase in the use of radiation therapy in Estonia over the study period, which is in line with increases in available equipment. The lack of geographic variations suggests equal access to therapy for patients living in remote regions. However, educational level and marital status were significantly associated with receipt of radiation therapy, highlighting the importance of psychosocial support in ensuring equal access to care.

Differing from diseased stage in melanoma, the olfactory receptor gene OR56A4 is expressed

2021 ◽  
Author(s):  
Bronte Morse ◽  
Kobi Decker
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Olfactory Receptor ◽  
Receptor Gene ◽  
Stage I ◽  
Stage Ii ◽  
Stage Iii ◽  
Olfactory Receptor Gene ◽  
Breast Cancer Patients ◽  
Receptor Family

We have compared the global profiles of 100 tumors in Stage I, II and III with two independently releasedmicroarray datasets in order to understand their transcriptional behaviors accompanying a progression in breastcancer (1, 2). The olfactive receptor, family 56, subfamily A, member 4 OR56A4, was discovered to have beenone of the genes with the most varied expression when comparing initial tumors in stage I, stage II, and stageIII of breast cancer patients. In the stage III tumors, OR56A4 expression in comparison to the stage I tumorswas lower.

Inflammatory cytokines and distant recurrence in HER2-negative early breast cancer in the ECOG-ACRIN 5103 trial.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 520-520
Author(s):  
Joseph A. Sparano ◽  
Anne M. O'Neill ◽  
Noah Graham ◽  
Donald W. Northfelt ◽  
Chau T. Dang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Early Breast Cancer ◽  
Inflammatory Cytokines ◽  
Multiple Testing ◽  
Distant Recurrence ◽  
Stage Ii ◽  
P Value

520 Background: Systemic inflammation may contribute to cancer progression (PMC2803035), including recurrence of early breast cancer (PMC4828958). We hypothesized that inflammatory cytokines and/or chemokines may be associated with distant recurrence (DR). Methods: We performed a case:control study in women with stage II-III Her2-negative breast cancer, all of whom had surgery and adjuvant chemotherapy (doxorubicin/cyclophosphamide, then weekly paclitaxel) with/without bevacizumab, plus endocrine therapy if ER-positive (PMC6118403). Propensity score matching was used to identify approximately 250 case:control pairs (with/without DR). Serum samples obtained before adjuvant chemotherapy were analyzed using the MSD V-Plex Human Cytokine 36-Plex Kit for detection of human cytokines and chemokines involved in the Th1/Th2 pathway, chemotaxis, the Th17 pathway, angiogenesis, and immune system regulation. Conditional logistic regression analysis, with models fit via maximum likelihood, were used to estimate hazard ratios (HRs) and test for associations. Due to skewed nature of cytokines, HRs are reported on log base 2 scale. If adjusted for multiple testing including 36 markers, a p value of < 0.0014 would be required for statistical significance. Results: A total 249 matched pairs (498 patients) were identified. Covariates used for propensity score matching included age, menopausal status (post 54% vs. pre/peri 46%), ER/PR status (one/both pos 64% vs. both neg 36%) tumor size ( < = 2cm 17%, > 2-5cm 67%, > 5cm 16%) nodal status (neg 15%,1-3+ 32%, 4+ 53%), and grade (low 3%, int. 31%, high 66%). The only biomarker associated with a significantly increased DR risk when adjusted for multiple testing was the proinflammatory cytokine IL-6 (HR 1.37, 95% confidence intervals [CI] 1.15, 1.65, p = 0.0006). Others associated with a 2-sided p value < 0.05 included the chemokine MDC(macrophage-derived chemokine/CCL22) (1.90, 95% CI 1.17, 3.1, p = 0.0098), the T helper cell inflammatory cytokine IL-17A (HR 1.36, 95% CI 1.10, 1.67, p = 0.0052), and the cytokine VEGF-A (HR 1.13 for, 95% CI 1.01, 1.27, p = 0.037). There was no statistical interaction between VEGF-A and bevacizumab benefit. The median and mean value for IL-6 was 0.95 and 7.5 pg/ml (range 0.04-2761.24 pg/ml). Conclusions: This analysis provides level 1B evidence indicating that higher levels of the cytokine IL-6 at diagnosis are associated with a significantly higher DR risk in high-risk stage II-III breast cancer despite optimal adjuvant systemic therapy. This provides a foundation for confirmatory validation of IL-6 as a prognostic biomarker, and potentially as a predictive biomarker for testing therapeutic interventions targeting the IL-6/JAK/STAT3 pathway. Supported by NCI U10CA180820,180794,180821; UG1CA189859,232760,233290, 233196; Komen Foundation; Breast Cancer Research Foundation. Clinical trial information: NCT00433511.

Early Breast Cancer (Stage I and II): Tailored Radiotherapy for Very Young Women

2006 ◽  
pp. 279-289
Author(s):  
Alain Fourquet ◽  
Brigitte Sigal-Zafrani ◽  
Anne de la Rochefordière
Keyword(s):  
Breast Cancer ◽  
Early Breast Cancer ◽  
Young Women ◽  
Stage I ◽  
Cancer Stage

scholarly journals Sentinel Lymph Node Biopsy Pathology and 2-Year Postsurgical Recurrence of Breast Cancer in Kenyan Women

2018 ◽  
pp. 1-7
Author(s):  
Nathan R. Brand ◽  
Ronald Wasike ◽  
Khalid Makhdomi ◽  
Rajendra Chauhan ◽  
Zahir Moloo ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Estrogen Receptor ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Lymph Node Biopsy ◽  
Stage I ◽  
Stage Ii ◽  
Node Biopsy

Purpose The goal of this study was to describe the pathologic findings and early follow-up experience of patients who underwent a sentinel lymph node biopsy (SLNB) at Aga Khan University Hospital (AKUH) between 2008 and 2017. Patients and Methods We performed a retrospective analysis of women with breast cancer who underwent an SLNB at AKUH between 2008 and 2017. The SLNB was performed on patients with stage I and stage II breast cancer, and identification of the sentinel lymph node was made by radioactive tracer, blue dye, or both, per availability and surgeon preference. Demographic, surgical, and pathologic data, including immunohistochemistry of the surgical sample for estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2, were abstracted from the patient records. Follow-up data were available for a subset of patients. Results Between 2008 and 2017, six surgeons performed SLNBs on 138 women, 129 of whom had complete records and were included in the study. Thirty-one of 129 (24%) had a positive SLNB, including 10 of 73 (14%) with stage I and 21 of 56 (38%) with stage II disease. Seventy-eight patients (60%) received systemic adjuvant chemotherapy and 79 (62%) received radiation therapy, and of the 102 patients who were estrogen receptor positive, 86 (85%) received endocrine therapy. Seventy-nine patients were observed for > 2 years, and, of these, four (5.1%) had a regional recurrence. Conclusion The SLNB positivity rates were similar to those of high-income country (HIC) cohorts. However, preliminary data suggest that recurrence rates are elevated at AKUH as compared with those of HIC cohorts, perhaps because of a lower use of radiotherapy and chemotherapy at AKUH compared with HIC cohorts or because of differences in the characteristics of the primary tumor in patients at AKUH as compared with those in HICs.

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