Breast cancer in the young (≤35 years): A single center study from the All India Institute of Medical Sciences.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e12539-e12539
Author(s):  
Vinod Raina ◽  
Ajay Gogia ◽  
B. K. Mohanti ◽  
S. V. S. Deo ◽  
N. K. Shukla ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Young Women ◽  
Triple Negative ◽  
Tumour Size ◽  
Breast Cancer Patients ◽  
Visceral Metastasis ◽  
Nodal Stage ◽  
Her 2 ◽  
Young Breast Cancer

e12539 Background: Breast cancer in young women (</= 35 years) is uncommon and accounts for 1-2 % of all breast cancer in the West. There is limited data on breast cancer in the young from India. The aim of our study was to assess clinical, pathological parameters and outcome in young breast cancer patients. Methods: We carried out an analysis of 271 patients of young breast cancer patients (</=35 years) registered between 2000 to 2012 at I.R.C.H, AIIMS, New Delhi, India. Results: The median age was 31 years (range 18-35). The median duration of symptoms was 10 months (range 0.25-60). Breast lump was the commonest (93%) presenting symptom (left >right side). Ninety percent of patients were married and median age at first child birth was 23 years. Positive family history was elicited in only 15 patients. The TNM stage distribution was: stage I was 3 %, stage II- 20%, stage III- 55%, and stage IV- 22%. The median clinical tumour size was 5.1 cm. Modified radical mastectomy was the commonest surgical procedure and this was done in 80 % of cases. The histopathological analysis showed 93% had infiltrating ductal carcinoma. Thirty percent of tumours were high grade and 55% had pathological node positive disease. ER/PR and her-2neu positivity was 33% and 30% respectively. Triple negative breast cancer (TNBC) constituted 33%. Fifty five patients presented with metastasis. A combination of anthracycline and taxanes were used in the majority of patients and Trastuzumab could be used only in 6 cases out of 72 patients who were Her-2 neu positive. With a median follow up of 30 months (non metastatic group), three years disease free survival (DFS) and overall survival (OS) was 50% and 60%. Higher nodal stage, tumour size (>5 cm), negative hormonal status (triple negative) and visceral metastasis at baseline predicted poor outcome. Conclusions: Young women constituted 8 % of breast cancer cases, this proportion is much higher than the published Western figures of 1-2 % and reflects younger age of our population. Even in this young group ER/ PR positivity was 33% and almost a third were her-2 neu positive. Higher nodal stage, tumour size (>5 cm), triple negativity and visceral metastasis at baseline predicted poor outcome.

Translational cell study exploring the role of estrogen receptor β expression as a predictive and/or prognostic factor in breast cancer patients

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e22185-e22185
Author(s):  
S. Saji ◽  
N. Honma ◽  
M. Hirose ◽  
S. Hayashi ◽  
K. Kuroi
Keyword(s):  
Breast Cancer ◽  
Estrogen Receptor ◽  
Cell Line ◽  
Cancer Patients ◽  
Triple Negative ◽  
Breast Cancer Patients ◽  
Her 2 ◽  
Mcf 7 ◽  
Cell Study ◽  
Positive Breast Cancer

e22185 Background: We have reported that positive expression of Estrogen receptor β (ERβ) was associated with better prognosis in the early breast cancer patients treated with adjuvant tamoxifen monotherapy (J Clin Oncol. 2008). In addition, this was also true in the ERα-negative/PR-negative/Her-2 negative patients. We explored the biological impact of ERβ in breast cancer cell lines to determine whether these observations were due to its prognostic power or predictive power of response to the therapy. Methods: Since MCF-7 cell was ERβ-negative ERα-positive cell line, we established two stable clones of MCF-7 by introducing ERβ expression vector (β-clone 1, β-clone 2) as the model of ERβ-positive ERα-positive breast cancer. MDA-MB 231 cell was used as ERβ-positive triple-negative cell line. These cells were subjected to proliferation, expression and functional analysis. Results: In western blotting, both β-clone 1 and clone 2 showed decreased expression of PR and Her-2 than parent MCF-7, although there were no differences in ERα expression. Expression of ERβ decreased estradiol (E2) induced proliferation ability and rate of cells in S-phase cycle. PPT (ERα-specific agonist) and DPN (ERβ-specific agonist) did not show any difference in response, and IC 50 for 4 OH-tamoxifen and fulvestrant did not differ among MCF-7, β-clone 1 and clone 2 (0.05–0.1 μM). Whereas, cell death due to deprivation of E2 from 1nM to 1pM was more frequently observed in ERβ-expressing clones than in parent MCF-7 cell. These cell deaths did not involve standard apoptosis pathway with caspase-3/7 activation and PARP cleavage. E2, DPN and PPT did not affect the proliferation of ERβ-positive triple negative MDA-MB 231 cell, and IC 50 for 4-OH tamoxifen was too high (8 μM) to be achieved in clinical pharmacological dose. Conclusions: From our cell study, better prognosis of ERβ-positive breast cancer patient who treated with adjuvant tamoxifen is mainly due to its own favorable biological behavior. However, this prognostic impact may include the favorable response to the treatment, when we use estrogen-deprivation therapy such as aromatase inhibitors (AIs). Additional clinical study in AI users would be required to address this issue. No significant financial relationships to disclose.

A retrospective study of inflammatory breast cancer patients from seven hospitals in the United Kingdom.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e11062-e11062
Author(s):  
Saeed Rafii ◽  
Christopher John Poole ◽  
Adele Francis ◽  
Shalini Chaudhri ◽  
Daniel Rea
Keyword(s):  
Breast Cancer ◽  
United Kingdom ◽  
Neoadjuvant Chemotherapy ◽  
Cancer Patients ◽  
Inflammatory Breast Cancer ◽  
Triple Negative ◽  
Breast Cancer Patients ◽  
The United Kingdom ◽  
Her 2 ◽  
Clinical Records

e11062 Background: Inflammatory breast cancer (IBC) is an aggressive form of locally advanced breast cancer characterised by rapidly progressive breast erythema, pain and tenderness, oedema and paeu d’orange. It is estimated that between 1-4 % of all newly diagnosed breast cancer patients in the United Kingdom have IBC. Methods: We retrospectively identified 51 patients who were treated for IBC at 7 hospitals in the West midlands area of the United Kingdom between 1997 and 2011. Data including patients’ demographics, clinical, radiological and histopathological characteristics were collected from electronic clinical records. The test for HER-2 over-expression was not carried out routinely before 2002, therefore HER-2 status of such patients were assessed retrospectively on the archived tissues. A cox regression analysis was used for statistical assessment of survival and prognostic factors. Results: Median age at diagnosis was 55 years (range 34-83 yrs). Median overall (OS) and progression free survival (PFS) were 32 months (range 7-97 months) and 27 months (range 2-53 months) respectively. The 3–year survival rate for the entire cohort was 32%. Majority of patients were ER and HER-2 positive (49% and 52% respectively). The rate of complete pathological response (pCR) after neoadjuvant chemotherapy was 14%. All cases who had achieved pCR were HER-2 positive who had received anti HER-2 treatment during the neoadjuvant chemotherapy. The OS for the HER-2 positive patients with pCR was not statistically different from the whole cohort (49 vs 32 months, p=0.09) or from the patients with residual disease (49 vs 26 months, p=0.13). Although the triple negative IBC patients consisted 20% of the cohort, no patients in this group had achieved pCR. The OS and PFS for the triple negative patients were 20 and 14 months respectively. Although the rate of pCR was higher in patients treated with taxane compared to those treated with anthracycline containing chemotherapy (35% vs 7%), there was no significant difference in OS between either of these regimens (29 vs 27 months). Conclusions: HER-2 positive IBC patients had higher rate of achieving pCR after neo-adjuvant anti HER-2 therapy. However higher rate of pCR did not improve the OS.

scholarly journals Expression and Prognostic Significance of Mesothelin in Her-2-Positive and Triple-Negative Breast Cancer Patients

2014 ◽  
Vol 25 ◽  
pp. iv572
Author(s):  
I.V. Bayoglu ◽  
B. Kucukzeybek ◽  
Y. Küçükzeybek ◽  
I. Yildiz ◽  
M. Akyol ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Triple Negative Breast Cancer ◽  
Triple Negative ◽  
Prognostic Significance ◽  
Breast Cancer Patients ◽  
Her 2

The experience of young women diagnosed with breast cancer who undergo fertility preservation (FP) consultation.

2011 ◽  
Vol 29 (27_suppl) ◽  
pp. 249-249
Author(s):  
K. A. Hill ◽  
T. Nadler ◽  
R. Mandel ◽  
S. Burlein-Hall ◽  
C. Librach ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Cancer Patients ◽  
Young Women ◽  
Systemic Therapy ◽  
Her2 Status ◽  
Breast Cancer Patients ◽  
Additional Time ◽  
Before And After ◽  
Young Breast Cancer

249 Background: In recent years FP has been a growing concern for young women diagnosed with breast cancer. ASCO has recommended that such women be referred to a reproductive specialist as early as possible before beginning systemic adjuvant therapy. Aim: To gather information about young breast cancer patients’ experiences with FP referral, consultation, and decision making. Methods: Anonymous questionnaires were mailed to consecutive breast cancer patients referred January 2005 through January 2010 from our center to the CReATe clinic in Toronto. Topics included information about demographics, cancer stage and treatment, previous fertility problems, referral source and timing, options presented and chosen, and satisfaction with the referral, consultation and decision making processes. Results: Of the 50 women identified 26 (52%) participated. Average age of respondents was 31 (range 24-41). 17 (65%) were married or in a long-term relationship, and 9 (35%) already had 1 child. Seven (27%) were referred before surgery, 16 (62%) after surgery but before systemic therapy, 2 (8%) after starting hormone therapy, and 1 after completing chemotherapy. Only 54% opted for FP. Of the 17 (66%) who reported plans to start/add to their family prior to diagnosis of breast cancer, 53% proceeded with FP and of the 9 who did not have plans to start/add to their family 5 (55%) pursued FP. 41% had difficulty with decision making and 50% found cost to be a significant barrier. A common theme among respondents was inadequate time for decision making. Several complained about the lack of written material before and/or after their consultation. 85% felt that access to a psychosocial counselor would have been beneficial to the decision making process. 57% were satisfied or extremely satisfied overall. Conclusions: (1) If appropriate, FP referral should be initiated by the surgeon as soon as a diagnosis of invasive cancer is made. Obtaining receptor and HER2 status on core biopsy samples may identify women who will require systemic therapy and may benefit from early FP referral. (2) Women need written materials before and after FP consultation. (3) There is a major role for a FP counselor who is able to spend additional time helping with decision making.

Efficacy and safety of metronomic capecitabine and gefitinib in heavily pretreated metastatic triple-negative breast cancer.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 1071-1071
Author(s):  
Anantbhushan Ranade ◽  
Kanaka Govind Babu ◽  
Purvish M. Parikh ◽  
Jk Singh ◽  
Manisha Singh ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Cancer Patients ◽  
Triple Negative Breast Cancer ◽  
Triple Negative ◽  
Metastatic Breast ◽  
Breast Cancer Patients ◽  
Visceral Metastasis ◽  
Egfr Expression ◽  
Heavily Pretreated

1071 Background: Metronomic chemotherapy regimens have shown efficacy in patients with metastatic breast cancer by antiangiogenic mechanisms. When used metronomically the toxicity profile of capecitabine is low. Triple negative breast cancer is a common problem in India and developing countries. Approximately 30% of triple negative breast cancer express EGFR and its mutation. Methods: Since October 2003 to December 2011 we objectively tested response rates, clinical benefit, and safety of gefitinib and capecitabine administered with a metronomic schedule of 500 mg thrice daily in heavily pretreated metastatic breast cancer patients with gefitinib 250 mg once daily. 300 patients were screened for EGFR expression. Among 85 enrolled patients with EGFR positivity, 76 were evaluable. ECOG performance status (PS) was 0-2, median age 52 years (range 36-65), bone plus visceral metastasis in 40% of patients. Rest had only visceral metastasis. All the patients were pretreated with anthracyclines and taxanes. The combination was administered for a median duration of 32 weeks (range 12-166). Results: We observed 18 partial responses (PR: 24%), 42 (55%) stable disease (SD). Median time to progression was 53 weeks, (95% CI, range 12-166 weeks). Safety of metronomic capecitabine with gefitinib was excellent. Neither grade 2-4 haematological or clinical side effects were recorded. Only 12 patients experienced grade I (WHO) hand-foot syndrome. Conclusions: Treatment with metronomic capecitabine and gefitinib was effective and minimally toxic in heavily pretreated breast cancer patients.

scholarly journals Clinical utility of genomic signatures in young breast cancer patients: a systematic review

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Cynthia Villarreal-Garza ◽  
Ana S. Ferrigno ◽  
Cynthia De la Garza-Ramos ◽  
Regina Barragan-Carrillo ◽  
Matteo Lambertini ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Young Women ◽  
Young Patients ◽  
Distant Recurrence ◽  
Similar Rate ◽  
Breast Cancer Patients ◽  
Genomic Signatures ◽  
Hormone Sensitive ◽  
Young Breast Cancer

Abstract Risk stratification by genomic signatures has been shown to improve prognostication and guide treatment decisions among patients with hormone-sensitive breast cancer. However, their role in young women has not been fully elucidated. In this review, a systematic search was conducted for published articles and abstracts from major congresses that evaluated the use of genomic signatures in young breast cancer patients. A total of 71 studies were analyzed, including 561,188 patients of whom 27,748 (4.9%) were young. Women aged ≤40 years were subjected to genomic testing at a similar rate to older women but had a higher proportion of intermediate- to high-risk tumors when classified by EndoPredict (p = 0.04), MammaPrint (p < 0.01), and Oncotype DX (p < 0.01). In young women with low genomic risk, 6-year distant recurrence-free survival was 94%, while 5-year overall survival was nearly 100%. Nonetheless, young patients classified as low-risk had a higher tendency to receive chemotherapy compared to their older counterparts. In conclusion, genomic tests are useful tools for identifying young patients in whom chemotherapy omission is appropriate.

scholarly journals Clinical and Pathological Characteristics of Young Female Breast Cancer

2021 ◽  
Author(s):  
Dan Zheng ◽  
Ting Luo ◽  
Xiaorong Zhong ◽  
Chengshi Wang ◽  
Ping He ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Propensity Score ◽  
Cancer Patients ◽  
Young Women ◽  
Hormone Receptor ◽  
Adjuvant Radiotherapy ◽  
Survival Outcomes ◽  
Breast Cancer Patients ◽  
Young Breast Cancer

Abstract BackgroundWith the increase in socioeconomic status and development of early screening technologies, the proportion of young breast cancer has gradually increased. However, epidemiological research on breast cancer in young women is lagging. There is a lack of diagnosis and treatment guidelines specifically for young breast cancer patients. MethodsThis is an single-center, retrospective cohort study which adopted 2,142 women ≤ 41 years who were diagnosed with stage I-III invasive breast cancer. Patients were grouped into hormone receptor-positive and -negative groups. Variance of common characteristics between the two groups were compared using Chi-square test, Fisher-exact test and Wilcoxon rank sum test. Cox proportional hazards regression was employed for survival estimation and Kaplan–Meier curves were used to graphically present the survival data. Propensity score matching was used to balanced covariates between patients who received or not received the same treatment. ResultsThe median age of the whole cohort was 37 (16-40), and 75.0% suffered from hormone receptor (HR) positive tumors. Modified radical mastectomy was the most frequent surgery (77.7%), and 78.7% women received adjuvant chemotherapy. Adjuvant radiotherapy was implemented in 39.0% of patients, and 58.3% women did not receive radiotherapy. The HR-positive status independently predicted unfavorable overall survival (OS, HR = 1.50, 95% CI 1.03-2.21, P = 0.04) and invasive disease-free survival (iDFS, HR = 1.47, 95% CI 1.05-2.05, P = 0.02). After propensity score matching (PSM), adjuvant chemotherapy (HR = 0.47, 95% CI 0.26-0.87, P = 0.02), and adjuvant radiotherapy (HR = 0.54, 95% CI 0.37-0.78, P = 0.001) improved OS significantly. Adjuvant chemotherapy predicted favorable iDFS (HR = 0.60, 95% CI 0.38-0.94, P = 0.03). Endocrine therapy improved both OS and iDFS in patients with HR-positive disease. ConclusionThe number of young women with breast cancer is gradually increasing, and these women have worse survival outcomes than their elder counterparts. HR-positive disease predicted worse long-term survival outcomes. Adjuvant chemotherapy and adjuvant radiotherapy were required for all of the young patients. Young women with HR-positive disease can benefit from endocrine therapy. No clear benefit was seen from neoadjuvant chemotherapy in young women with early-stage breast cancer.

scholarly journals The AMAZONA Project: Retrospective Cohort Study Describing Breast Cancer Patients' Characteristics and Survival in Brazil

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 219s-219s
Author(s):  
M. Caleffi ◽  
S. Simon ◽  
J. Bines ◽  
G. Werutsky ◽  
J. Soares Nunes ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Retrospective Cohort ◽  
Triple Negative ◽  
Molecular Subtypes ◽  
The United States ◽  
Breast Cancer Patients ◽  
Luminal A ◽  
Pathologic Stage ◽  
Her 2

Background: Breast cancer is the most common cancer in women in Brazil and worldwide. There is large variation in survival among patients and molecular subtypes are important prognostic factors. However, most of the data comes from developed countries such as the United States and in Europe. Aim: Our goal was to describe breast cancer patients' demographic and pathologic characteristics, as well as their survival according to estimated molecular subtypes, assessed by common immunohistochemistry stains. Methods: AMAZONA study is a retrospective cohort conducted from June 2008 to January 2009 including women of at least 18 years old, with histologically proven breast cancer diagnosed in the period between 1 January 2001 and 31 December 2001 and between 1 January 2006 and 31 December. Estimated molecular subtypes by local immunohistochemical stains were luminal A, luminal B, HER-2 positive and triple-negative. Data were obtained from medical records and public databases. Kaplan-Meier method was used for data description and log-rank test for comparison between the subgroups. Results: 2296 patients were included in this analysis. Mean age was 54 years. Most subjects included came from hospitals located in the southeast region of the country, treated in the public health system and had stage II invasive ductal carcinoma of breast. Regarding subtype, 71.3% had hormonal receptor positive disease, 15.7% were HER-2 positive and 21.1% had triple-negative breast cancer. Overall survival (OS) was significantly different among molecular subtypes and was independent of pathologic stage for stages II and III patients. For stage III patients 5-years OS for luminal A subtype was 75.8% and for triple-negative was 56.1% ( P .0002). Conclusion: Classification of breast cancer patients in predicted molecular subtypes using immunohistochemistry is currently available in most underdeveloped countries and is a useful prognostic tool that goes beyond clinical or pathologic stage.

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