Electrochemotherapy for cutaneous metastases in breast cancer: Experience from a designated treatment centre.

2015 ◽  
Vol 33 (28_suppl) ◽  
pp. 48-48
Author(s):  
Shramana Mitul Banerjee ◽  
Jackie Newby ◽  
Shahab Khan ◽  
Virginia Homfray ◽  
Diane Whittaker ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Disease Progression ◽  
Cancer Patients ◽  
Chest Wall ◽  
Chemotherapeutic Agents ◽  
Post Treatment ◽  
Breast Cancer Patients ◽  
Cutaneous Metastases ◽  
Treatment Centre

48 Background: Electrochemotherapy (ECT) combines the administration of poorly permeable chemotherapeutic agents with electroporation. It has been shown to be effective when compared with other treatments. This study assessed how breast cancer patients were benefited and identified potential problems at a designated treatment centre. Methods: This was a single centre prospective study of patients with cutaneous metastases from breast cancer. Patients who fulfilled NICE UK (National Institute Of Clinical Excellence) and local guidelines were treated. Gabapentin was given prior to general anaesthesia. Intravenous Bleomycin 15,000IU/m2 was given as a bolus. Treatment was commenced 8 minutes later with Cliniporator. Electrical pulses were delivered via an electrode inserted through the skin surface. Treatment response, disease progression free duration, post-operative pain and length of in-patient stay (LOS) were recorded. Patients recorded a symptom diary post treatment. Results: 20 treatments were performed in 16 patients from 2011-2015 with 53 separate areas treated. 8 patients had diffuse lesions, 5 had discrete lesions and 3 had both diffuse and discrete areas. 16 patients were being treated with ECT for the first time and 4 patients required 2 treatments. Median LOS was 3 days. Median follow up was 6 months (range 3-12).12 patients had complete response (75%) and 4 patients partial response. There was no disease progression for 6 months or more in 9 patients (56%) and 2 further patients had disease stabilised for 3 months with systemic or cutaneous progression in the remaining patients in 3 months or less. There were no deaths or immediate adverse events from ECT. 5 Patients (31%) with extensive diffuse chest wall disease reported persistent discomfort post treatment requiring extended period of post treatment analgesia. Conclusions: Electrochemotherapy is safe and effective treatment for cutaneous metastases. Appropriate patient selection for treatment, pre-emptive analgesia, post treatment support and follow up is essential in order to maximise the benefits and minimise potential side-effects particularly in extensive chest wall disease.

Using Canadian administrative data to evaluate primary and oncology care of breast cancer patients post-treatment: Subset of the CanIMPACT Study.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 5-5 ◽  
Author(s):  
Mary L McBride ◽  
Patti Groome ◽  
Donna Turner ◽  
Margaret Jorgensen ◽  
Cynthia Kendell ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Primary Care ◽  
Cancer Patients ◽  
Administrative Data ◽  
Cancer Care ◽  
Data Access ◽  
Post Treatment ◽  
Breast Cancer Patients ◽  
Oncology Care

5 Background: CanIMPACT is a multi-provincial Canadian research team funded to identify and address key issues faced by cancer patients and providers at the intersection of primary and specialist oncology care. Canada has national healthcare standards, but provincial/territorial healthcare delivery systems. One facet will use administrative data from the population-based, publicly-funded healthcare system to evaluate issues during pre-diagnosis, treatment, and post-treatment survivorship for breast cancer patients. For the survivorship phase, we aim to conduct the following analyses and compare across provinces: 1) Utilization of physician services overall and by specialty, including oncologists, non-oncology specialists, and primary care; 2) Assessment of adherence to ASCO and Canadian follow-up guideline for breast cancer care, use of surveillance breast imaging, and metastatic investigations; 3) Assessment of adherence to recommended care of chronic illness and preventive care; 4) Quantification of the cost of follow-up overall and by specialty; 5) Comparison of inter- and intra-provincial variation for all outcomes by health administrative region and for vulnerable groups (age ≥ 75 at diagnosis, northern/rural/remote, low income, immigrants), and examine the effect of continuity of primary care and chronic disease on post-treatment care. Methods: Patients will be identified from provincial cancer registries and linked to data extracted from: outpatient physician service claims, hospital inpatient and outpatient data, and cancer facility medical records. Results: Participating provinces have finalized the core questions and detailed protocols, and assessed data comparability. They are in the process of obtaining the required ethics and data access approvals, and data acquisition for processing and analysis. Conclusions: Results will address existing information gaps that can be used to improve transition and care across the cancer care trajectory. Importantly, results will be combined with those of a CanIMPACT qualitative study to inform design of a pragmatic randomized trial focused on improving coordination and quality of care.

scholarly journals Arterial Stiffness in Breast Cancer Patients Treated with Anthracycline and Trastuzumab-Based Regimens

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Özlem Yersal ◽  
Ufuk Eryilmaz ◽  
Hakan Akdam ◽  
Nezih Meydan ◽  
Sabri Barutca
Keyword(s):  
Breast Cancer ◽  
Cardiovascular Diseases ◽  
Arterial Stiffness ◽  
Pulse Wave Velocity ◽  
Cancer Patients ◽  
Wave Velocity ◽  
Pulse Wave ◽  
Chemotherapeutic Agents ◽  
Breast Cancer Patients

Aims. Cardiovascular diseases are the primary cause of premature morbidity and mortality in early breast cancer patients after treatment with cardiotoxic chemotherapeutic agents. Arterial stiffness is an independent risk factor for future cardiovascular diseases and can be used as a predictive marker of subclinical cardiac damage. The aim of this study is to analyze the arterial stiffness in breast cancer patients who are in the follow-up period after receiving anthracycline-based chemotherapy regimens with trastuzumab. Methods and Material. We enrolled 45 HER2-positive breast cancer patients who are on follow-up at least for six months after completion of adjuvant chemotherapy with trastuzumab, and cardiovascular risk matched 30 control volunteers. The measurements were done with pulse wave analyzing machine. Results. Mean pulse wave velocity was higher in breast cancer patients compared to controls. The pulse wave velocity was significantly higher in patients receiving aromatase inhibitors compared to patients under tamoxifen. It was also significantly higher in postmenopausal breast cancer patients than postmenopausal controls. Conclusions. Arterial stiffness measurements may predict the breast cancer survivors with higher risk for cardiovascular events earlier in the follow-up period, and necessary preventive approaches and/or treatments can be applied.

scholarly journals The Prognostic Value of Skin Involvement in Breast Cancer Patients With Chest Wall Recurrence

2021 ◽  
Author(s):  
Danyang Zhou ◽  
Mei Li ◽  
Fei Xu ◽  
Qiufan Zheng ◽  
Qianyi Lu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Disease Progression ◽  
Cancer Patients ◽  
Chest Wall ◽  
Female Breast Cancer ◽  
Nodal Status ◽  
Skin Involvement ◽  
Breast Cancer Patients ◽  
Female Breast ◽  
Chest Wall Recurrence

Abstract Background: To assess the prognosis of skin involvement in female breast cancer patients with chest wall recurrence (CWR).Methods: We retrospectively analyzed the clinical-pathological data of breast cancer patients with CWR who were diagnosed pathologically between January 2000 and April 2020. Progression free survival (PFS) was defined as time from diagnosis of CWR to the first disease progression. Persistent chest wall progression was three consecutive chest wall progression without distant organ involvement.Results: A total of 476 patients with CWR were included in this study. Among them, skin involvement or not was queried and confirmed in 345 patients. Skin involvement was significantly correlated to tumor size (P=0.003) and initial nodal status (P<0.001). By Kaplan-Meier analysis, skin involvement predicted a shorter PFS (P<0.001), especially local disease progression (P<0.001). Skin involvement was an independent biomarker for PFS by the multivariate analysis (P=0.034). Patients with skin involvement were more likely to experience persistent chest wall progression (P=0.040). After eliminating the potential deviation caused by insufficient follow-up time, persistent chest wall progression was more likely to be associated with positive lymph nodal status (P=0.046), negative PR (P=0.001) and positive HER2 (P=0.046) of the primary site, negative ER (P=0.027) and PR (P=0.013) of chest wall lesion and skin involvement (P=0.020).Conclusion: Skin involvement predicted poor local disease control in female breast cancer patients with CWR and it was more likely to be related to persistent chest wall progression. We improved the stratification of prognosis and provided new insights for biological behaviors of the disease and further individualized treatment in breast cancer patients with CWR.

Continuous low-irradiance photodynamic therapy (CLIPT) as a novel treatment for cutaneous recurrences of breast cancer.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e11548-e11548
Author(s):  
Justin Persico ◽  
David E. Wazer ◽  
Anne Marie Melanson ◽  
Gary S Rogers ◽  
Roger Graham
Keyword(s):  
Breast Cancer ◽  
Photodynamic Therapy ◽  
Cancer Patients ◽  
Chest Wall ◽  
Light Exposure ◽  
Tunel Assay ◽  
Post Treatment ◽  
Breast Cancer Patients ◽  
Biopsy Specimens ◽  
Chest Wall Recurrence

e11548 Background: Photodynamic therapy (PDT) has been used for the treatment of many malignancies. This binary therapy involves the administration of a photosensitizer followed by exposure to light. Treatment toxicity has historically limited the use of PDT. Our study aimed to assess whether a novel approach, termed continuous low irradiance photodynamic therapy (CLIPT), would result in enhanced efficacy with reduced toxicity. Preclinical data suggest decreased toxicity and increased cell death by apoptosis with CLIPT. Methods: Breast cancer patients with chest wall progression were eligible for our study. No systemic anti-cancer therapy within 30 days and no radiation to the target site within 60 days of enrollment was allowed. All patients received porfirmer sodium intravenous 0.8mg/kg at time 0 and returned at time 48 hours for light exposure. A wavelength of 630nm was delivered continuously over 24 hours by a Diomed laser via a flexible light patch. An area of uninvolved normal skin was used as a control. Post-treatment biopsy was performed to assess for apoptosis by TUNEL assay. Results: Eight breast cancer patients were enrolled in our study. The initial dose of light was 100J/cm2 and was given to subjects 1 and 2 but resulted in partial-thickness ulceration of the epidermis. Subjects 3-8 received light at 50J/cm2 and experienced erythema at the intervention site, with no ulceration observed. All patients reported mild pain at the treatment site and 6 required short-term narcotic analgesia. Five of the 8 patients showed evidence of response, and no patients had progression of treated lesions. Four of 7 biopsy specimens showed evidence of apoptosis on TUNEL assay. Conclusions: CLIPT may prove to be a valuable option for treatment of breast cancer chest wall recurrence. The dose-limiting toxicity was skin ulceration and the maximum tolerated dose (MTD) was determined to be 50J/cm2/24h. A 50% response rate was seen in patients treated at the MTD, with apoptosis seen on post-treatment biopsy specimens. Further investigation of CLIPT as a therapeutic modality is warranted.

Outcome analysis of breast cancer patients treated with cardiotoxic agents in the community setting: A single-institution experience.

2016 ◽  
Vol 34 (7_suppl) ◽  
pp. 213-213
Author(s):  
Yousef Khelfa ◽  
Munthir Mansour ◽  
Todd W. Gress ◽  
Maria R. B. Tria Tirona
Keyword(s):  
Breast Cancer ◽  
Targeted Therapy ◽  
Cancer Patients ◽  
Post Treatment ◽  
Mean Difference ◽  
Left Ventricular Ejection ◽  
Breast Cancer Patients ◽  
Her 2 ◽  
Cardiac Outcome

213 Background: Anthracyclines and anti-Her-2 targeted therapy are commonly used effective breast cancer treatments. They are known to decrease Left Ventricular Ejection Fraction (LVEF), which may increase patients’ morbidity and mortality. There is currently no consensus on post treatment cardiac follow-up. Recent observations suggested that ACEI and B blocker drugs could have cardioprotective effects. We conducted a retrospective study to assess patients’ cardiac outcome using post-treatment LVEF follow-up and effect of ACEI and B blocker on cardiac outcome for breast cancer patients who received cardiotoxic agents in our institution. Methods: We reviewed 155 charts of non-metastatic breast cancer patients between 2000-2008, who received anthracyclines and/or anti-Her-2 targeted therapy. Patients were stratified into groups A (anthracycline), B (trastuzumab) and C (anthracycline+trastuzumab). Results: Patients’ median age was 52.5 years. Six patients had coronary artery disease and 45 received radiation to the left breast. After a median follow-up of 93 months, only 3 of 155 (2%) patients developed symptoms of congestive heart failure. One hundred twenty patients had pre-treatment LVEF evaluation, while only 31 patients had pre and post LVEF evaluation. Mean LVEF difference was -7.89, - 9.01, -9 and -6.08 for all patients, group A, group B and group C, respectively. Thirty patients were on ACEI, 7 of them had LVEF follow-up with mean difference of -6.86. Thirty patients were on B blocker, 7 of them had LVEF follow-up with mean difference of -15. Because of the small size of the groups who had LVEF follow-up, no statistical difference can be detected. Conclusions: Our patient population showed very low incidence of clinically significant cardiac events in relation to anthracycline and anti-her-2 directed therapy after a median follow-up of 93 months. However, further follow is required to assess cardiac outcome that may affect quality of life and survival later in life. In this regard, our institution is establishing a dedicated cardio-oncology service to closely monitor patients who have been treated with cardiotoxic agents and provide early cardiac management if needed.

Post-Treatment Follow-Up of Screen-Detected Breast Cancer Patients: A National Survey from Italy

2016 ◽  
Vol 23 (3) ◽  
pp. 370-372
Author(s):  
Doralba Morrone ◽  
Gianni Saguatti ◽  
Eva Benelli ◽  
Chiara Fedato ◽  
Alfonso Frigerio ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
National Survey ◽  
Post Treatment ◽  
Breast Cancer Patients

scholarly journals Impact of Histopathological Profile on Disease Progression of Breast Cancer Patients during the 1st 1-2 Years follow-up: Evidence from the Philippine DOH-Breast Cancer Medicine Access Program

2015 ◽  
Vol 49 (2) ◽  
Author(s):  
Marie Christine G. Semira ◽  
Joanne Marie L. Balbuena ◽  
Vanina Htun-Javier ◽  
Jennifer Sandoval-Tan ◽  
Corazon A. Ngelangel ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Disease Progression ◽  
Cancer Patients ◽  
Breast Cancer Patients ◽  
Cancer Medicine ◽  
Access Program

...

scholarly journals NCOG-08. A COMPARISON OF RESPONSE-ASSESSMENT AND DATA VISUALIZATION METHODS FOR CHARACTERIZATION OF TIME-DEPENDENT OUTCOMES FOLLOWING RADIOSURGERY (SRS) FOR BRAIN METASTASES

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii130-ii131
Author(s):  
Tatiana Kashtanova ◽  
Andrew Keller ◽  
Naren Ramakrishna
Keyword(s):  
Breast Cancer ◽  
Brain Metastases ◽  
Cancer Patients ◽  
Response Assessment ◽  
Post Treatment ◽  
Breast Cancer Patients ◽  
The Impact ◽  
Average State

Abstract PURPOSE We compared multiple response assessment and visualization techniques for characterization of post-SRS treatment outcomes in a cohort of breast cancer patients with long median follow-up. METHODS A retrospective IRB-approved review was completed of 75 breast cancer patients treated with SRS for 271 brain metastases with median follow up of 40 months. Tumor dimensions, brain failure events, corticosteroid use, and clinical status were analyzed utilizing RANO-BM, bidimensional product (BDP), and bidimensional sum (BDS) techniques. 46/75 patients were eligible for RANO-BM assessment. Response at each post-treatment assessment were scored as PD, SD, PR, or CR, and the concordance between techniques was determined. A scoring system-based outcome metric labelled ‘average state’ was derived to estimate fractional time/response state by each assessment method. Interactive timeline displays of outcome states were generated. RESULTS The concordance of patient response states was determined using either RANO-BM, BDP or BDS among the 46 eligible patients. The overall mean and median concordance between techniques were 0.82 and 0.83, (range 0.52 – 1). The average state for the patient population post-treatment was 1.98 by RANO-BM, 2.29 by BDP, and 2.19 by BDS. For patients excluded from RANO-BM secondary to lack of measurable disease, the average state was determined to be 2.44 by BDP and 2.35 by BDS. The average state for HER2+ vs. HER2- patients was 2.21 vs. 1.75 by RANO-BM, 2.58 vs. 2 by BDP, and 2.39 vs. 1.99 by BDS. An interactive timeline view was generated to display outcome states utilizing the 3 response assessment techniques, and the impact of inclusion of non-target lesions and variable response parameters was assessed graphically. CONCLUSIONS These results characterize the concordance and the limitations of multiple outcome assessment methodologies in a post-SRS cohort with long median follow-up. The utility of a novel ‘average state’ outcome metric is demonstrated in this cohort.

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