Frequency and predictors of insufficient chemotherapy use among stage I-III breast cancer patients by molecular subtype.

2015 ◽  
Vol 33 (28_suppl) ◽  
pp. 154-154
Author(s):  
Lu Zhang ◽  
Tekeda Freeman Ferguson ◽  
Xiao-cheng Wu ◽  
Mei-Chin Hsieh ◽  
Elizabeth Fontham ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Cancer Patients ◽  
Tumor Size ◽  
Older Age ◽  
Stage I ◽  
Lymph Node Status ◽  
Breast Cancer Patients ◽  
High Poverty ◽  
Luminal A

154 Background: Identification of distinct molecular subtypes has expanded the treatment options for breast cancer, however, chemotherapy remains the common and effective treatment for each subtype. The objective is to compare the frequency and predictors of insufficient chemotherapy use among two subtypes of stage I-III breast cancer patients: luminal A and triple negative breast cancer (TNBC). Methods: We analyzed data from a CDC funded project - Enhancing Cancer Registry Data for Comparative Effectiveness Research (CER) collected by Louisiana Tumor Registry. Women aged < = 70 years, diagnosed in 2011 with stage I-III luminal A or TNBC breast cancer, tumor size > 1cm, were included (N = 1,189). Insufficient chemotherapy (i.e. no chemotherapy use, nonstandard regimen use, and low relative dose intensity (RDI < 85%)) was evaluated respectively. Potential predictors included age, race, insurance, marital status, census tract-poverty, AJCC stage, grade, tumor size, lymph node status, and Charlson comorbidity. Stepwise model selection with p-value for entry at 0.2 and for stay at 0.25 was used to select the most relevant predictors. Results: The frequencies of no chemotherapy use were significantly different (p < .0001) between luminal A (42%, N = 913) and TNBC patients (9%, N = 241). Older age, white race, no insurance, lower stage or grade, and without lymph node involvement were related with no chemotherapy for luminal A patients; older age, not married, and high poverty for TNBC. There were 36% of luminal A and 40% of TNBC patients receiving nonstandard regimen (p = 0.27). Predictors of nonstandard regimen use were increased age, insurance, stage, and grade for luminal A and high poverty level and stage for TNBC. Reduced RDI occurred in 9% luminal A and 10% TNBC patients (p = 0.61). Small cases precluded the prediction model for low RDI. Conclusions: Luminal A patients are less likely to receive chemotherapy than TNBC patients. Low social economic status factors are associated with no chemotherapy use and nonstandard regimens use, especially for TNBC patients.

scholarly journals Changes of breast cancer staging when AJCC prognostic staging manual is used: a retrospective analysis of a Chinese cohort

2017 ◽  
Vol 33 (2) ◽  
pp. 168-173 ◽  
Author(s):  
Jinhua Ding ◽  
Weizhu Wu ◽  
Jianjiang Fang ◽  
Yudong Chu ◽  
Siming Zheng ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Cancer Patients ◽  
Tumor Size ◽  
Medical Center ◽  
Univariate Analysis ◽  
Lymph Node Status ◽  
Axillary Lymph ◽  
Breast Cancer Patients ◽  
Ajcc Staging

Background: This study aimed to investigate staging changes for Chinese breast cancer patients assessed by the 7th (anatomic) and 8th (prognostic) editions of the AJCC staging manual, and to explore the predictive factors for these changes. Methods: Data of patients who received curative surgery for stage I-III breast cancer at Ningbo Medical Center Lihuili Eastern Hospital were retrospectively reviewed. The assessment of staging was according to the criteria of the 7th and 8th editions of the AJCC staging manual. Univariate and multivariate logistic regression analyses were performed to analyze the associations between staging changes and clinicopathological characteristics. Results: Staging changes were found in 59.37% of patients and were more likely to be seen in stage IIIA (96.10%) and IIA (85.94%), then IIB (70.33%), IB (68.75%), followed by IA (36.17%) and IIIC (30.08%). In univariate analysis, staging changes were associated with tumor location, clinical tumor size, clinical axillary lymph node status and Ki67 index. However, multivariate analysis found that staging changes were significantly associated with tumor size >2 cm (odds ratio [OR] = 3.263, 95% confidence interval [95% CI], 2.638-4.036), lymph node involvement (OR = 2.261, 95% CI, 1.830-2.794) and high Ki-67 index (OR = 1.661, 95% CI 1.343-2.054). Conclusions: Our study demonstrated that there were marked staging changes when 2 different editions of the AJCC staging manual were used. Since prognostic biomarkers are available in routine clinical practice, the more recent staging manual should be followed to select better systemic therapy and give better outcomes for Chinese breast cancer patients.

scholarly journals Prognostic Factors and Surgery for Breast Cancer Patients With Locoregional Recurrence: An Analysis of 5,202 Consecutive Patients

2021 ◽  
Vol 11 ◽  
Author(s):  
Jiahui Huang ◽  
Yiwei Tong ◽  
Xiaosong Chen ◽  
Kunwei Shen
Keyword(s):  
Breast Cancer ◽  
Prognostic Factors ◽  
Lymph Node ◽  
Cancer Patients ◽  
Tumor Size ◽  
Locoregional Recurrence ◽  
Salvage Surgery ◽  
Breast Cancer Treatment ◽  
Lymph Node Status ◽  
Breast Cancer Patients

PurposeWith the application of “less extensive surgery” in breast cancer treatment, the pattern of locoregional recurrence (LRR) has significantly changed. This study aims to evaluate the risk and prognostic factors of LRR in a recent large breast cancer cohort.MethodsConsecutive early breast cancer patients who received surgery from January 2009 to March 2018 in Shanghai Ruijin Hospital were retrospectively analyzed. LRR was defined as recurrence at the ipsilateral breast (IBTR), chest wall, or regional lymph nodes and without concurrent distant metastasis (DM). Patients’ characteristics and survival were compared among these groups.ResultsAmong 5,202 patients included, 87 (1.7%) and 265 (5.1%) experienced LRR and DM as first event after a median 47.0 (3.0–122.5) months’ follow-up. LRR was significantly associated with large tumor size and positive lymph node status (p &lt; 0.05). Forty (46.0%) patients received further salvage surgery after LRR and had a significantly better 3-year post-recurrence overall survival than those who did not (94.7% vs. 60.7%, p = 0.012). Multivariate analysis showed that salvage surgery for LRR was independently associated with better survival (HR = 0.12, 95% CI 0.02–0.93, p = 0.043) along with estrogen receptor (ER) positivity (HR = 0.33, 95% CI 0.12–0.91, p = 0.033).ConclusionLRR rate was relatively low in recent era of breast cancer treatment. Tumor size and lymph node status were associated with risk of LRR, and salvage surgery for selected LRR patients achieved an excellent outcome.

scholarly journals The role of adjuvant chemotherapy in stage I–III male breast cancer: a SEER-based analysis

2020 ◽  
Vol 12 ◽  
pp. 175883592095835
Author(s):  
Wei-Ping Li ◽  
Hong-Fei Gao ◽  
Fei Ji ◽  
Teng Zhu ◽  
Min-Yi Cheng ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Adjuvant Chemotherapy ◽  
Cancer Patients ◽  
Male Breast Cancer ◽  
Tumour Size ◽  
Male Breast ◽  
Stage I ◽  
Breast Cancer Patients ◽  
Chemotherapy Group

Background and aims: Male breast cancer is an uncommon disease. The benefit of adjuvant chemotherapy in the treatment of male breast cancer patients has not been determined. The aim of this study was to explore the value of adjuvant chemotherapy in men with stage I–III breast cancer, and we hypothesized that some male patients may safely skip adjuvant chemotherapy. Methods: Male breast cancer patients between 2010 and 2015 from the Surveillance Epidemiology and End Results database were included. Univariate and multivariate Cox analyses were used to analyse the factors associated with survival. The propensity score matching method was adopted to balance baseline characteristics. Kaplan–Meier curves were used to evaluate the impacts of adjuvant chemotherapy on survival. The primary endpoint was survival. Results: We enrolled 514 patients for this study, including 257 patients treated with chemotherapy and 257 patients without. There was a significant difference in overall survival (OS) but not in breast cancer-specific survival (BCSS) between the two groups ( p < 0.001 for OS and p = 0.128 for BCSS, respectively). Compared with the non-chemotherapy group, the chemotherapy group had a higher 4-year OS rate (97.5% versus 95.2%, p < 0.001), while 4-year BCSS was similar (98% versus 98.8%, p = 0.128). The chemotherapy group had longer OS than the non-chemotherapy group among HR+, HER2–, tumour size >2 cm, lymph node-positive male breast cancer patients ( p < 0.05). Regardless of tumour size, there were no differences in OS or BCSS between the chemotherapy and non-chemotherapy cohorts for lymph node-negative patients (OS: p > 0.05, BCSS: p > 0.05). Adjuvant chemotherapy showed no significant effects on both OS and BCSS in patients with stage I (OS: p = 0.100, BCSS: p = 0.858) and stage IIA breast cancer (OS: p > 0.05, BCSS: p > 0.05). Conclusion: For stage I and stage IIA patients, adjuvant chemotherapy could not improve OS and BCSS. Therefore, adjuvant chemotherapy might be skipped for stage I and stage IIA male breast cancer patients.

Relationship between tumor size and metastatic site in patients with stage IV breast cancer: A large SEER-based study.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e13065-e13065
Author(s):  
Qian Dong ◽  
Mi Zhang ◽  
Da Jiang
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Tumor Size ◽  
Stage Iv ◽  
Breast Cancer Patients ◽  
Luminal A ◽  
Chi Square ◽  
Metastatic Site ◽  
Luminal B ◽  
Stage Iv Breast Cancer

e13065 Background: To analyze the correlation between tumor size and metastatic site in first-diagnosed stage IV breast cancer patients. Methods: Stage IV breast cancer patients diagnosed from 2010 to 2015 were screened by the Surveillance, Epidemiology, and End Results (SEER) database. The characteristics of clinical variables were represented by a frequency table, and the Chi-square test was used for comparison. At the same time, the Chi-square test was used to analyze the relationship between tumor size and organ metastasis. Correlation between tumor size and the prognosis of patients was contributed by KM curve and Log-rank test. Results: Regardless of tumor size, the proportion of bone metastasis was higher and brain metastasis was lower in breast cancer patients. There were significant differences in the site of metastases based on different subtype. Luminal A and Luminal B breast cancer had the highest proportion of bone metastases; brain metastasis accounted for the highest proportion in triple-negative breast cancer (TNBC); while the incidence of liver metastasis was the highest in Her-2(+) breast cancer. At the same time, the results indicated that Luminal A breast cancer with a tumor size > 5 cm was more likely to develop multi-site metastasis and lung metastasis, while Luminal B breast cancer with a tumor size ≤ 5 cm was more likely to develop liver metastasis. The results also revealed that TNBC patients with a tumor size of 0 - 2cm were more likely to develop bone metastasis than those with a tumor size > 5 cm, and the incidence of lung metastasis in triple-negative patients showed an increasing trend with the increase of tumor size. Conclusions: Based on subtype, we found that there was a significant difference between tumor size and metastatic site in patients with stage IV breast cancer, and the difference was statistically significant. This study provided evidence-based basis for decision-making of stage IV breast cancer treatment.

Role of Ultrasound in the Diagnosis of Lymph Node Status in Axillary Lymph Node Metastases in Breast Cancer undergoing Neoadjuvant Chemotherapy

2020 ◽  
Author(s):  
Yizhen Zhou ◽  
Lei Zhang ◽  
Zining Jin ◽  
Hailan Yu ◽  
Siyu Ren ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Neoadjuvant Chemotherapy ◽  
Cancer Patients ◽  
Axillary Lymph Node ◽  
Lymph Node Status ◽  
Axillary Lymph ◽  
Short Axis ◽  
Breast Cancer Patients ◽  
Axillary Ultrasound

Abstract Background:Axillary ultrasound (AUS) is one of the important bases for evaluating the axillary status of breast cancer patients. And it would be helpful for the reassessment of axillary lymph node status in these patients after neoadjuvant chemotherapy(NAC) and guide the selection of their axillary surgical options.The purpose of this study was to evaluate the diagnostic performance of ultrasound,and to find out the factors related to the outcome of ultrasound.Methods:In this retrospective analysis, 172 patients (one bilateral breast cancer) with breast cancer and clinical positive axillary nodes, were enrolled. After NAC, all patients received mastectomy and axillary lymph node dissection (ALND). AUS was used before and after NAC to assess the axilla status. Results:Of the 173 axillae, 137 (79.19%) had pathological metastasis after NAC. The accuracy, sensitivity, specificity, positive predictive value and negative predictive value of axillary ultrasound in this cohort were 68.21%, 69.34%, 63.89%, 87.96% and 35.38% respectively. Univariate analysis showed that primary axillary lymph node(ALN) short axis, progesterone receptors, hormone receptors, the tumor status after NAC, tumor reduction rate, ALN short axis after NAC, physical examination of axilla after NAC and pN impacted the results of AUS(P = 0.000 ~ 0.040). Multivariate analysis of the above indicators showed that ALN short axis after NAC and pN associated with AUS results independently. Conclusion:AUS can accurately assess axilla status after NAC in most breast cancer patients. If the short axis of ALN≥10mm and AUS negative, SLNB could be chosen. However, AUS cannot detect residual lymph node disease after NAC in a short axis of the ALN <10mm.

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