Epidemiology and clinical profile of breast cancer in central Nepal: A single institutional experience.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e12008-e12008
Author(s):  
Sachin Shakya
Keyword(s):  
Breast Cancer ◽  
Strong Correlation ◽  
Triple Negative ◽  
Clinical Profile ◽  
Age At Diagnosis ◽  
Research Centre ◽  
Age Group ◽  
Receptor Status ◽  
Younger Women ◽  
Her 2

e12008 Background: In this study, our objective was to determine the epidemiological and clinical profile of Breast Cancers. Different Literatures have highlighted the correlation between stage and age at diagnosis, size and age at diagnosis, correlations of different hormone receptor status with different age group etc. But precise documentation is lacking in Nepal. Methods: The study was conducted at department of Medical Oncology, Nepal Cancer Hospital and Research Centre from Dec 2014 to June 2016 and 183 patients diagnosed with breast cancer were enrolled. A retrospective cross-sectional study was conducted. Results: Prevalence of Breast Cancer was 5.59 %. Newar was the most affected ethnic group. The most frequent age group was 40 to 49. The most common symptom was mass in 80 % of patients. Stage II (49.1 %) was the most common stage at diagnosis. 83% patients had a tumour size of 2-5 cm with average size of 3.25 cm at presentation. Younger women with cancer had a strong correlation with ER-ve/PR-ve and Her-2/Neu +ve receptor status with P<.005. Triple Negative receptor status was 32.87%. Her2/neu +ve receptor status cancer was 39.72%. Conclusions: Majority of patients presented with Stage IIa and IIIa disease breast cancer. Disease is more aggressive and diagnosed at a more advanced stage in younger women. Younger women had a strong correlation with ER-ve/PR-ve and her-2/neu +ve receptor. Recommendation for the Her-2/Neu receptor test should be done in every case of breast cancer. Triple negative status was lower in comparison to the previous studies which is favourable for hormonal antibody treatment implementation.

scholarly journals Clinical Profile of Patients Presenting with Breast Cancer in Nepal

2013 ◽  
Vol 10 (3) ◽  
pp. 3-7 ◽  
Author(s):  
Sandhya Chapagain Acharya ◽  
AK Jha ◽  
T Manandhar
Keyword(s):  
Breast Cancer ◽  
Locally Advanced ◽  
Tnm Staging ◽  
Clinical Profile ◽  
Stage Iii ◽  
Disease Stage ◽  
Case Report Form ◽  
South Asian Population ◽  
Receptor Status ◽  
Her 2

Background Breast cancer is the second most common cancer in women in Nepal. Even though the evaluation and treatment of patients is done as per western guidelines, there are considerable variations in risk factors, presenting stage and prognostic factors such as receptor status. Objective To evaluate the clinical profile of patients presenting with breast cancer in Nepal. Method The study was conducted at Department of Radiotherapy and Oncology, Bir Hospital and Department of Radiation Oncology, BP Koirala Memorial Cancer Hospital, Bharatpur from 16th July 2007 to 15th June 2008 for a period of one year and 114 patients were enrolled. Detailed history, clinical examination and necessary investigations performed. Histological features including receptor status were recorded. Tumor Node Metastasis (TNM) staging system was as per American Joint Committee on Cancer (AJCC), fifth edition. Data was collected in preformed case report form and was managed using SPSS version 13. Results The incidence was high (34.2%) among perimenopausal women age ranging from 41 to 50. The majority of women presented with lump (98.2%) and others with pain (21.9%), nipple retraction (16.7%), ulceration (7.9%), discharge (7%), or symptoms of metastasis (6.1%). Regarding receptor status, the majority (64.0%) were Estrogen receptor (ER) and Progesterone receptor (PR) negative with 21.9 percent. ER+PR+, Younger women were more likely to be both ER and PR negative. Where available, Her-2 immunohistochemistry showed that 45.0 % of post menopausal women were Her-2 neative, compared to 64.0 % of premenopausal women. Incidence of Triple negative disease was 41.3 %. The most common stage at presentation was stage III (26.3%). Conclusion Majority of patients were perimenopausal, presenting with locally advanced disease (Stage III and Stage II) and with average tumor size two to five cm and were hormonal receptor negative. These findings are similar to other South Asian population but is inverse than profile reported in Western populations.Kathmandu University Medical Journal | VOL.10 | NO. 3 | ISSUE 39 | JUL- SEP 2012  | Page 3-7 DOI: http://dx.doi.org/10.3126/kumj.v10i3.8009

scholarly journals Incidence of triple negative breast cancer at Rajendra Institute of Medical Sciences, Ranchi

2019 ◽  
Vol 6 (9) ◽  
pp. 3134
Author(s):  
Priyanka Kumari ◽  
Sumit Bhaskar ◽  
Rajiv Ranjan ◽  
Dipendra Kumar Sinha
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Triple Negative Breast Cancer ◽  
Triple Negative ◽  
Tumour Size ◽  
Progesterone Receptors ◽  
Prognostic Index ◽  
Axillary Lymph ◽  
Receptor Status ◽  
Her 2

Background: Breast carcinoma is the second most common carcinoma in women and accounts for 22% of all female cancer, which is more than twice the prevalence of cancer in women at any other site. Triple negative breast cancer, i.e., negative expression of oestrogen and progesterone receptors and HER2/neu receptors and accounts for approximately 10-17% of all breast carcinomas, is biologically aggressive, resistant to conventional cytotoxic chemotherapy treatment, and is associated with reduced survival compared to other subtypes of breast cancer.Methods: History, local examination, Various investigations like: FNAC of breast lump and axillary lymph node, USG of breasts and axilla, USG of whole abdomen and pelvis, Chest X-ray PA View etc, ER/PR and HER-2/neu status on the specimen sent for HPE were done. The prognostic implications on ER, PR and HER-2/neu receptors were assessed indirectly with the help of Nottingham prognostic index (NPI)).Results: A statistically significant correlation of ER/PR receptor status was found with tumour size, no. of lymph nodes, tumour grade and NPI, whereas HER2/neu receptor status had a statistically significant correlation with tumour size and no. of lymph node involved. Incidence of triple negative breast cancer in this Institute is 20%.Conclusions: ER, PR and HER2/neu receptor status is highly important predictor in cases of carcinoma breast which necessitates routine evaluation of these receptor statuses for better management of disease.

scholarly journals Prevalence of Molecular Subtypes of Breast Carcinoma and Its Comparison between Two Different Age Groups: A Retrospective Study from a Tertiary Care Center of Northeast India

2021 ◽  
Vol 10 (04) ◽  
pp. 220-224
Author(s):  
Jagannath Dev Sharma ◽  
Sachin Khanna ◽  
Shubhra Ramchandani ◽  
Lopa Mudra Kakoti ◽  
Argha Baruah ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Retrospective Study ◽  
Triple Negative ◽  
Molecular Subtypes ◽  
Molecular Subtype ◽  
Age Groups ◽  
Age Group ◽  
Luminal A ◽  
Luminal B ◽  
Her 2

Abstract Objective The aim of the study is to see the prevalence of different molecular subtypes in breast cancer patients among two different age groups: ≤40 years and >40 years. Materials and Methods Retrospective study was conducted from January 2019 to December 2019. We studied 568 cases of breast carcinoma and classified them into four molecular subtypes—luminal A, luminal B, human epidermal growth factor-2 (HER 2), and triple negative. Cases were divided into two different groups: (1) ≤40 years and (2) >40 years. Statistical Analysis was done by using SPSS software version 20.0. Results Out of 568 cases, 151 (26.6%) were ≤40 years of age and 417 (73.4%) were >40 years of age. The most common histological subtype of breast cancer was ductal carcinoma in 548 cases and the most common grade was grade III. Immunohistochemistry was done in 432 patients. In younger age group, the most common molecular subtype was luminal B (31%) followed by triple negative (20%), luminal A (14%), and then HER 2 (5.3%), while in the older age group most common molecular subtype was luminal B (27.8%) followed by triple negative (14%), HER 2 (12.2%), and then luminal A (12%). Conclusion Luminal B is found to be the most common subtype in Northeast Indian women with breast cancer, as compared with other studies in which luminal A was the most common subtype. This could be due to the reason that Ki-67 was not done in most of the other studies.

scholarly journals Biologic Roles of Estrogen Receptor-βand Insulin-Like Growth Factor-2 in Triple-Negative Breast Cancer

2015 ◽  
Vol 2015 ◽  
pp. 1-15 ◽  
Author(s):  
Nalo Hamilton ◽  
Diana Márquez-Garbán ◽  
Vei Mah ◽  
Gowry Fernando ◽  
Yahya Elshimali ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Growth Factor ◽  
Triple Negative Breast Cancer ◽  
Triple Negative ◽  
Progesterone Receptors ◽  
Insulin Like Growth Factor ◽  
Younger Women ◽  
Tnbc Cell ◽  
Her 2

Triple-negative breast cancer (TNBC) occurs in 10–15% of patients yet accounts for almost half of all breast cancer deaths. TNBCs lack expression of estrogen and progesterone receptors and HER-2 overexpression and cannot be treated with current targeted therapies. TNBCs often occur in African American and younger women. Although initially responsive to some chemotherapies, TNBCs tend to relapse and metastasize. Thus, it is critical to find new therapeutic targets. A second ER gene product, termed ERβ, in the absence of ERαmay be such a target. Using human TNBC specimens with known clinical outcomes to assess ERβexpression, we find that ERβ1 associates with significantly worse 5-year overall survival. Further, a panel of TNBC cell lines exhibit significant levels of ERβprotein. To assess ERβeffects on proliferation, ERβexpression in TNBC cells was silenced using shRNA, resulting in a significant reduction in TNBC proliferation. ERβ-specific antagonists similarly suppressed TNBC growth. Growth-stimulating effects of ERβmay be due in part to downstream actions that promote VEGF, amphiregulin, and Wnt-10b secretion, other factors associated with tumor promotion.In vivo, insulin-like growth factor-2 (IGF-2), along with ERβ1, is significantly expressed in TNBC and stimulates high ERβmRNA in TNBC cells. This work may help elucidate the interplay of metabolic and growth factors in TNBC.

scholarly journals Estrogens and Progestogens in Triple Negative Breast Cancer: Do They Harm?

Cancers ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 2506
Author(s):  
Mark van Barele ◽  
Bernadette A. M. Heemskerk-Gerritsen ◽  
Yvonne V. Louwers ◽  
Mijntje B. Vastbinder ◽  
John W. M. Martens ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Triple Negative ◽  
Hormone Replacement ◽  
Breast Cancers ◽  
Younger Women ◽  
Alternative Pathways ◽  
Increased Risk ◽  
History Of ◽  
Hormone Sensitive

Triple-negative breast cancers (TNBC) occur more frequently in younger women and do not express estrogen receptor (ER) nor progesterone receptor (PR), and are therefore often considered hormone-insensitive. Treatment of premenopausal TNBC patients almost always includes chemotherapy, which may lead to premature ovarian insufficiency (POI) and can severely impact quality of life. Hormone replacement therapy (HRT) is contraindicated for patients with a history of hormone-sensitive breast cancer, but the data on safety for TNBC patients is inconclusive, with a few randomized trials showing increased risk-ratios with wide confidence intervals for recurrence after HRT. Here, we review the literature on alternative pathways from the classical ER/PR. We find that for both estrogens and progestogens, potential alternatives exist for exerting their effects on TNBC, ranging from receptor conversion, to alternative receptors capable of binding estrogens, as well as paracrine pathways, such as RANK/RANKL, which can cause progestogens to indirectly stimulate growth and metastasis of TNBC. Finally, HRT may also influence other hormones, such as androgens, and their effects on TNBCs expressing androgen receptors (AR). Concluding, the assumption that TNBC is completely hormone-insensitive is incorrect. However, the direction of the effects of the alternative pathways is not always clear, and will need to be investigated further.

scholarly journals Staging Investigations in Asymptomatic Early Breast Cancer Patients at the Cancer Centre of Southeastern Ontario

2021 ◽  
Vol 28 (3) ◽  
pp. 2190-2198
Author(s):  
Dalia Kamel ◽  
Veronica Youssef ◽  
Wilma M. Hopman ◽  
Mihaela Mates
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Early Breast Cancer ◽  
Triple Negative ◽  
Metastatic Breast ◽  
Receptor Status ◽  
Cancer Centre ◽  
Radiological Staging

Background: In 2012, the American Society for Clinical Oncology (ASCO) identified five key opportunities in oncology to improve patient care, recommending against imaging tests for the staging of patients with early breast cancer (EBC) at low risk for metastases. Similarly, the European Society of Medical Oncology (ESMO) guideline does not support radiological staging in asymptomatic EBC (aEBC). The purpose of this study was to assess local practice and outcomes of staging investigations (SIs) in aEBC at the Cancer Centre of Southeastern Ontario (CCSEO). Methods: A retrospective electronic and paper chart review was undertaken to identify all aEBC patients treated at our institution between January 2012 and December 2014. Patients with pathological staging of T1-T2 and N0-1 with any receptor status were included. We collected patient demographics, treatment and pathologic tumor characteristics. The use and outcomes of initial and follow-up SIs were recorded. Data were analyzed to determine associations between the use of SIs and clinical characteristics (chi-square tests, independent samples t-tests and Mann–Whitney U tests). Results: From 2012 to 2014, 295 asymptomatic EBC patients were identified. The mean age was 64, 81% were postmenopausal and 76% had breast conserving surgery. Stage distribution was as follows: stage I 42%, stage IIA 37% and stage IIB 21%. Receptor status was as follows: ER+ 84%, HER2+ 13% and triple negative 12%. Adjuvant chemotherapy was received by 36%, Trastuzumab by 10% and endocrine therapy by 76% of patients. Baseline SIs were performed in 168 patients (57%) for a total of 332 tests. Overt metastatic disease was found in five patients (one bone scan and four CT scans). Seventy-one out of the 168 patients (42%) who received initial staging imaging underwent 138 follow-up imaging tests, none of which were diagnostic for metastases. Nine patients with suspicious CT findings underwent biopsies, of which four were malignant (one metastatic breast cancer and three new primaries). Factors significantly associated with SI were as follows: younger age (p = 0.001), premenopausal status (p = 0.01), T2 stage (p < 0.001), N1 stage (p < 0.001), HER2 positive (p < 0.001), triple negative status (p = 0.007) and use of adjuvant chemotherapy (p < 0.001). Conclusions: Over a 3-year period at our institution, more than 50% of aEBC patients underwent a total of 470 initial and follow-up staging tests, yielding a cancer diagnosis (metastatic breast cancer or second primary cancer) in four patients. We, therefore, conclude that routine-staging investigations in aEBC patients have low diagnostic value, supporting current guidelines that recommend against the routine use of SI in this population.

scholarly journals Reproductive and hormonal risk factors for postmenopausal luminal, HER-2-overexpressing, and triple-negative breast cancer

Cancer ◽  
2008 ◽  
Vol 113 (7) ◽  
pp. 1521-1526 ◽  
Author(s):  
Amanda I. Phipps ◽  
Kathleen E. Malone ◽  
Peggy L. Porter ◽  
Janet R. Daling ◽  
Christopher I. Li
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Triple Negative Breast Cancer ◽  
Triple Negative ◽  
Her 2

scholarly journals Immunohistochemistry profile and its relation with prognosis in locally advanced breast cancer

2019 ◽  
Vol 6 (12) ◽  
pp. 4507
Author(s):  
Naseef Kannanavil ◽  
Nabeel Thommil Padinjarenalakath ◽  
Ahsan Vilayapoyilil ◽  
Abidali Karatparambil
Keyword(s):  
Breast Cancer ◽  
Triple Negative ◽  
Locally Advanced ◽  
Radical Mastectomy ◽  
Response To Therapy ◽  
Advanced Breast ◽  
Age Group ◽  
Modified Radical Mastectomy ◽  
Number Of Patients ◽  
Related Mortality

Background: Breast cancer is one of the most common malignancy and leading cause of cancer related deaths in women worldwide. Immunohistochemistry (IHC) is done to characterize intracellular proteins or cell-surface antigens and is used to assess tumour subtypes, confirm diagnosis, predict prognosis and response to therapy. The aim of the present study was to evaluate the relationship of IHC profile- ER, PR and HER2 neu and prognosis of patients who underwent modified radical mastectomy for locally advanced breast cancer.Methods: A retrospective cohort study was conducted at MES Medical College Hospital from October 2015 to November 2017 in patients who underwent modified radical mastectomy for locally advanced breast carcinoma. A total of 65 women were enrolled in the study. 5 years survival was taken as the prognostic indicator.Results: Majority of the patients belong to the age group of 40-49 years with 40% patients followed by 33.84% patients in the age group of 50-59 years. Maximum number of patients was found in 2B stage of tumour. Maximum patients belonged to the ER/PR+, HER2- subgroup (27), followed by triple negative (ER/PR-, HER2) subgroup (16). There was no disease related mortality in ER/PR+, HER2+ and ER/PR+, HER2- subgroups. There were 1 and 2 disease related mortality in ER/PR-, HER2+ and triple negative subgroups respectively.Conclusions: In the present study the worst prognosis was observed in triple negative (ER/PR-,HER2-) IHC subgroup followed by the HER2 enriched (ER/PR-, HER2+) subgroup. 

scholarly journals How shall we treat locally advanced triple negative breast cancer?

F1000Research ◽  
2020 ◽  
Vol 8 ◽  
pp. 1649
Author(s):  
Paulo Luz ◽  
David Dias ◽  
Ana Fortuna ◽  
Luis Bretes ◽  
Beatriz Gosalbez
Keyword(s):  
Breast Cancer ◽  
Triple Negative Breast Cancer ◽  
Triple Negative ◽  
Locally Advanced ◽  
Surrogate Marker ◽  
Metastatic Breast ◽  
Complete Response ◽  
Number Of Patients ◽  
Her 2 ◽  
Near Future

Triple negative breast cancer (TNBC) has been shown to respond to neoadjuvant chemotherapy (NACT). It has been established that achieving pathological complete response (pCR) for certain aggressive subtypes of breast cancer, including HER-2 (over-expressed) and TNBC, provides an important surrogate marker for predicting long-term clinical response and survival outcomes. How to increase the number of patients that achieve pCR remains challenging. Platinum-based NACT seems to be part of the solution and capecitabine, an active drug in metastatic breast cancer, but not a standard one in earlier stages may have found its place in the adjuvant setting. In the near future immunotherapy can play a role in early TNBC

scholarly journals Antiangiogenic therapy for breast cancer with triple negative phenotype

2021 ◽  
Vol 23 (1) ◽  
pp. 88-92
Author(s):  
Inna P. Ganshina ◽  
Kristina A. Ivanova ◽  
Olga O. Gordeeva ◽  
Aleksandr V. Arkhipov ◽  
Liudmila G. Zhukova
Keyword(s):  
Breast Cancer ◽  
Triple Negative Breast Cancer ◽  
Triple Negative ◽  
Malignant Tumors ◽  
Antiangiogenic Therapy ◽  
Treatment Strategies ◽  
Her 2 ◽  
Triple Negative Phenotype ◽  
The Impact ◽  
Negative Phenotype

Triple-negative breast cancer is 1024% of all cases of breast cancer and is characterized by the absence of estrogen, progesterone, and HER-2 receptors in the tumor. The therapy of this illness is a difficult clinical case. In contrast to hormone-positive and HER-2-positive phenotypes, in which we successfully use targeted drugs (antiestrogens and anti-HER-2 drugs), for triple-negative breast cancer we have not had such targets for a long time. Thus, despite the impressive results of immunotherapy of triple-negative breast cancer, there remains a fairly large group of patients with negative PD-L1 status, for whom it is necessary to develop other treatment strategies. One of the approaches in the treatment of malignant tumors includes not the impact on tumor cells, but the process of angiogenesis. Antiangiogenic drugs have positively proven themselves in the treatment of a large number of malignant tumors but are underestimated for breast cancer (including triple-negative phenotype). The use of bevacizumab in combinations with cytostatic drugs in breast cancer therapy (including triple-negative breast cancer) has been studied in a large number of clinical trials but was undeservedly forgotten in some countries due to the revoked FDA registration. This review presents the role of bevacizumab in the treatment of patients with triple-negative breast cancer and suggests the conditions when the administration of this drug is justified and leads to better results.

Sign in / Sign up

Export Citation Format

Share Document