Impact of the 21-gene Recurrence Score assay on the adjuvant treatment of breast cancer patients with 1-3 positive lymph nodes in an academic centre in Ontario.

2016 ◽  
Vol 34 (15_suppl) ◽  
pp. e12026-e12026 ◽  
Author(s):  
Sofia Torres ◽  
Maureen E. Trudeau ◽  
Sonal Gandhi ◽  
Ellen Warner ◽  
Sunil Verma ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Nodes ◽  
Cancer Patients ◽  
Adjuvant Treatment ◽  
Recurrence Score ◽  
Breast Cancer Patients ◽  
Positive Lymph Nodes

Randomized phase II trial evaluating the efficacy of adding sequential half body irradiation (SHBI) to adjuvant chemotherapy in high-risk breast cancer patients with >10 positive lymph nodes

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 627-627
Author(s):  
M. S. Barsoum ◽  
R. M. Gafar ◽  
M. M. Nazmy ◽  
A. Niazy
Keyword(s):  
Breast Cancer ◽  
Lymph Nodes ◽  
Cancer Patients ◽  
Phase Ii ◽  
Adjuvant Treatment ◽  
Phase Ii Trial ◽  
Phase Iii ◽  
Breast Cancer Patients ◽  
Er Positive ◽  
Positive Lymph Nodes

627 Background: Adjuvant sequential half body irradiation (SHBI) is both interesting as well as scientifically sound approach with proven efficacy in many tumors. Methods: Patients with node positive (≥10) breast cancer were randomized in this phase II trial to receive either 6 cycles of adjuvant cyclophosphamide 500 mg/m2, 5FU 500 mg/m2 and epirubicin 100 mg/m2 followed by postoperative local irradiation (Arm A) versus the same adjuvant treatment plus consolidation SHBI staring 3 weeks after end of adjuvant treatment with upper half 750cGy /5 fractions /1week then one month gap followed by the lower half for the same dose (Arm B) Results: Between November 1999 and November 2000 a total of 70 patients who met the eligibility criteria were enrolled. Arm A (n=35) and arm B (n=35) were almost comparable with the respect to different prognostic factors. There was significant improvement in the disease free survival (DFS) at 5 years in arm B. The DFS was 65±8% in arm B while it was 33±8% in arm A (log-rank test: P =0.0036). In subset analysis the difference is apparent in subgroups of patients with less potential metastatic burden, which are T2 cases and ER positive cases. The DFS at 5 years was 83% in arm B and it was 35% in arm A (P=0.0008) in T2 cases. In the subgroup of patients with ER positive tumors (n=51), the DFS at 4 years was 58% in arm B and it was 25% in arm A (P=0.0072). The complications of the addition of SHBI were mild (grades 2 and 3) and mainly gastrointestinal (vomiting, diarrhea and colic). In both arms of the study there were no life-threatening complications or treatment-related mortality. Conclusions: SHBI was found to be a well-tolerated consolidation regimen with acceptable side effects and it showed significant improvement of the DFS in breast cancer patients with ≥ 10 positive lymph nodes especially in the relative cases with good prognosis (T2-ER positive). This makes it worthy of testing in a phase III trial. No significant financial relationships to disclose.

A retrospective study in the Spanish population with Oncotype dx recurrence score (RS) in breast cancer patients with positive and negative-lymph nodes.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e11531-e11531 ◽  
Author(s):  
Laura G Estevez ◽  
Isabel Calvo ◽  
Maria Fernandez Abad ◽  
Juan Jose Cruz ◽  
Sofia Perea ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Nodes ◽  
Cancer Patients ◽  
Case Series ◽  
Recurrence Score ◽  
Oncotype Dx ◽  
Nuclear Staining ◽  
Breast Cancer Patients ◽  
Wide Range ◽  
Positive Lymph Nodes

e11531 Background: The international guidelines include the use of Oncotype DX as a predictor of chemotherapy (CT) benefit in hormonal sensitive breast cancer patients (pts) with node negative and node positive (1-3 positive nodes) disease.The aim of this study was to assess the distribution of the RS in breast cancer pts regardless lymph nodes status, and the association with treatment recommendations. Methods: Retrospectivedata from 131 pts with invasive breast cancer for which the OncotypeDX Assay had been ordered, and pathology data were available. Estrogen (ER) and progesterone (PR) receptor was assessed by IHC (cut-off 10% nuclear staining). Ki67 by IHC [high (≥14%) and low (< 14%)]. Positive-lymph nodes pts was classified as isolated tumoral cells (ITC), micrometastasis (MIC) and macrometasis (MAC). Results: Median age: 51 (range: 35-78); premenopausal status: 74 pts (56%). Median tumor size: 1.5 cm (0.3- 6); Median Ki 67 index: 15 (3-63); Median ER: 93 (35-100) and PR: 85(0-100). 42 pts (32%) had positive-lymph nodes: 6 ITC (14%), 14 MIC (33%) and 22 MAC (52%). RS was low in 82 (63%) cases, intermediate 39 (30%), and high 10 (7%). RS according to nodal status was: positive nodes, 31 pts (74%) low RS, 10 pts (24%) intermediate and 1 pts (2%) high; negative nodes: 50 pts (57%) low RS, 26 (29%) intermediate and 12 pts (14%) high RS. ER and Ki67 was similar between both lymph-nodes groups whereas a higher PR expression (median 90) was seen in positive-lymph nodes vs 76 in negative nodes. First recommendation in positive-lymph nodes: hormonotherapy (HT) 33%, CT 55% and 12% no defined (ND); after RS, HT 83% and CT 17% (p=0.021). Negative nodes first recommendation: HT 68%, CT 23% and ND 14%; after RS, HT 68% and CT 32%. Conclusions: Although based on a small case series, the results show that a substantial number (73%) pts with positive-lymph nodes have low RS, indicating minimal if any benefit from adjuvant CT. The proportion of patients with low scores is higher than in the validation studies and selection bias can’t be excluded. The wide range of RS in both negative and positive-lymph nodes breast cancer confirm the important role of Oncotype DX in treatment decision- making.

Postmastectomy Radiotherapy in T1–2 Female Breast Cancer Patients with 1–3 Positive Axillary Lymph Nodes: A Propensity Score Matched SEER Analysis

2021 ◽  
Author(s):  
Gang Xu ◽  
Shanshan Bu ◽  
Xiushen Wang ◽  
Hong Ge
Keyword(s):  
Breast Cancer ◽  
Propensity Score ◽  
Lymph Nodes ◽  
Cancer Patients ◽  
Female Breast Cancer ◽  
Axillary Lymph ◽  
Breast Cancer Patients ◽  
Postmastectomy Radiotherapy ◽  
Female Breast ◽  
Positive Lymph Nodes

Abstract Purpose The application of postmastectomy radiotherapy (PMRT) in T1–2 female breast cancer patients with 1–3 positive lymph nodes has been controversial. We sought to determine the survival benefits of PMRT in the patients with T1–2 and 1–3 positive nodes. Methods A retrospective study using the Surveillance, Epidemiology, and End Results (SEER) Regs Custom Data (with additional treatment fields) from 2001 to 2011 was performed. Patients who received PMRT were matched by the propensity score with patients who did not receive PMRT. The Overall survival (OS) and breast cancer-specific survival (BCSS) were analyzed. Results We identified 56,725 female breast cancer patients with T1–2 and 1–3 positive nodes, and 18,646 patients were included in the analysis. After propensity score matching (1:1), with a median follow-up of 116 months, PMRT showed an increase in the OS (P = 0.018) but had no effect on the BCSS. The 10-year OS rates were 76.8% and 74.4%, and the 10-year BCSS rates were 82.8% and 82.2% for the patients who received and who did not receive PMRT, respectively. Only patients with 3 positive nodes could gain the benefit of PMRT for BCSS. Conclusion PMRT for patients with T1–2 and 1–3 positive lymph nodes could increase the 10-year OS, and had no effect on the 10-year BCSS. Subgroup analysis indicated that only patients with 3 positive lymph nodes could benefit from PMRT for both the OS and BCSS.

Postmastectomy Radiotherapy in T1–2 Women Breast Cancer Patients with 1–3 Positive Axillary Lymph Nodes: A Propensity Score Matched SEER Analysis

2020 ◽  
Author(s):  
Gang Xu ◽  
Shanshan Bu ◽  
Xiushen Wang ◽  
Hong Ge
Keyword(s):  
Breast Cancer ◽  
Propensity Score ◽  
Lymph Nodes ◽  
Cancer Patients ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Breast Cancer Patients ◽  
Cancer Specific Survival ◽  
Postmastectomy Radiotherapy ◽  
Positive Lymph Nodes

Abstract Purpose: The application of postmastectomy radiotherapy (PMRT) in T1–2 women breast cancer patients with 1–3 positive lymph nodes has been controversial. We sought to determine the survival benefits of PMRT in the patients with T1–2 and 1–3 positive nodes.Methods: A retrospective study using the Surveillance, Epidemiology, and End Results (SEER) Regs Custom Data (with additional treatment fields) from 2001 to 2011 was performed. Patients who received PMRT were matched by the propensity score with patients who did not receive PMRT. The Overall survival (OS) and breast cancer-specific survival (BCSS) were analyzed. Results: We identified 56,725 women breast cancer patients with T1–2 and 1–3 positive nodes, and 18,646 patients were included in the analysis. After propensity score matching (1:1), with a median follow-up of 116 months, PMRT showed an increase in the OS (P = 0.018) but had no effect on the BCSS. The 10-year OS rates were 76.8% and 74.4%, and the 10-year BCSS rates were 82.8% and 82.2% for the patients who received and who did not receive PMRT, respectively. Only patients with 3 positive nodes could gain the benefit of PMRT for BCSS.Conclusion: PMRT for patients with T1–2 and 1–3 positive lymph nodes could increase the 10-year OS, and had no effect on the 10-year BCSS. Subgroup analysis indicated that only patients with 3 positive lymph nodes could benefit from PMRT for both the OS and BCSS.

Post-mastectomy radiation therapy in breast cancer patients with 1–3 positive lymph nodes: No one size fits all

2020 ◽  
Vol 147 ◽  
pp. 102880
Author(s):  
Majd Kayali ◽  
Joseph Abi Jaoude ◽  
Arafat Tfayli ◽  
Nagi El Saghir ◽  
Philip Poortmans ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Lymph Nodes ◽  
Cancer Patients ◽  
Breast Cancer Patients ◽  
Positive Lymph Nodes
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