Determinants of adjuvant chemotherapy use in small luminal-like breast cancer.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e12010-e12010
Author(s):  
Marta Bonotto ◽  
Lorenzo Gerratana ◽  
Alessandro Bettini ◽  
Marika Cinausero ◽  
Debora Basile ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Adjuvant Chemotherapy ◽  
Tumor Size ◽  
Cox Regression ◽  
Disease Free Survival ◽  
Lymph Node Involvement ◽  
Lymph Node Status ◽  
Related Factors ◽  
Luminal B

e12010 Background: The use of adjuvant chemotherapy (CT) in small luminal-like breast cancer (BC) is still heavily debated. International guidelines identify endocrine therapy as the backbone of adjuvant treatment for these patients (pts), while the addition of CT should be limited to high risk cases. The aim of this study was to evaluate the association between patient- or disease-related factors with the prescription of adjuvant CT. Methods: This retrospective study reviewed data from 559 consecutive pts with pT1 ( < 2 cm) luminal-like BC treated between 2004 and 2015 at the Department of Oncology of Udine (Italy). No restrictions were applied regarding lymph node status. The cut-off point of 1% was used to define ER and/or PgR positivity. Factors influencing the prescription of CT were investigated through uni- and multivariate logistic regression with odds ratio (OR) calculation. Prognosis was explored through Cox regression. Results: About thirty percent (173/559) of pts received adjuvant CT. By multivariate analysis, lymph node involvement was highly associated with CT prescription (OR 16.94, 95% CI 7.86-36.50, P < 0.001 for pN1; OR 3.92, 95% CI 1.45-10.58, P = 0.007 for pNmi). Tumor size drove towards the use of CT among pts with pT1c tumors (OR 12.87, 95% CI 1.49-110.88, P = 0.020) but not in pts with pT1b BC (OR 2.38, 95% CI 0.26-21.38, P = 0.437). In addition, a higher CT use was observed in pts with luminal B-like disease (OR 3.79, 95% CI 2.16-6.65, P < 0.001) or in presence of a Ki67 > 14% (OR 1.05, 95% CI 1.03-1.07, P < 0.001). On the contrary, pts with age > 60 years had a very low chance of receiving adjuvant CT (OR 0.09, 95% CI 0.04-0.20, P < 0.001). Notably, the use of CT was not associated with Disease Free Survival or Overall Survival (HR 1.3, 95% CI 0.77-2.17, P = 0.320; HR 1.05, 95% CI 0.56-2, P = 0.866; respectively). Conclusions: Nodal status, tumor size, disease sub-type, Ki67 expression and age are determinants of adjuvant CT prescription in pts with small luminal-like BC. Prospective studies are needed to identify which pts could safely avoid CT without influencing prognosis.

scholarly journals Comparison of ER, PR, Ki67 and HER-2/neu Reactivity Pattern with Patients’ Age, Histologic Grade, Tumor Size and Lymph Node Status in Invasive Ductal Breast Cancer

2020 ◽  
Vol 13 (6) ◽  
Author(s):  
Mahsa Ahadi ◽  
Motahareh Heibatollahi ◽  
Sara Zahedifard
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Tumor Size ◽  
Histological Grade ◽  
Lymph Node Involvement ◽  
Lymph Node Status ◽  
Invasive Ductal Breast Cancer ◽  
Ductal Breast Cancer ◽  
Node Involvement ◽  
Her 2

Background: Breast cancer is the most prevalent neoplasm diagnosed in Iranian women. Objectives: The current study was performed to measure the hormone receptor status and its possible connection with the patient’s age, tumor size, histological grade, and lymph node status and involvement in patients with invasive ductal breast cancer (IDBC) Methods: A total of 103 women with IDBC recently diagnosed at the Department of Pathology of Shohada-E-Tajrish Hospital were entered into this study. The mean age of the patients was 48.4 years, and 59.2% of cases were 50 years old or less. Results: Most lesions (78.6%) were more than 2 cm at their greatest dimension. Grade-II lesions were observed in a large number of patients and 59.8% of cases had lymph node involvement. Positive ER, PR, and HER-2/neu were detected in 59%, 57%, and 29% of patients, respectively. A significant correlation was found between patients’ age and histologic score, tumor dimension and both histologic score and nuclear grade, and, finally, between lymph node involvement and nuclear grade. Conclusions: According to previous studies, the evaluation of hormone receptor status in patients with breast cancer is strongly recommended. Here, by studying its possible connection with the patient’s age, tumor size, histological grade, and lymph node metastasis, we detected some biomarkers, which could be used as prognostic indices in these patients. These biomarkers could help us in the clinical management of patients with IDBC by providing the best therapeutic options.

Luminal A and Luminal B subtypes in patients with breast cancer 65 years of age and older.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 549-549
Author(s):  
Robert Konigsberg ◽  
Georg Pfeiler ◽  
Nicole Hammerschmid ◽  
Tatjana Klement ◽  
Christian Dittrich
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Endocrine Therapy ◽  
Tumor Size ◽  
Lymph Node Status ◽  
Primary Therapy ◽  
Luminal A ◽  
Ki 67 ◽  
Luminal B ◽  
Significant Difference

549 Background: In 2011, the St. Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer (bc) suggested the distinction between Luminal A and Luminal B subtypes. In Luminal A patients (pts) endocrine therapy seems to be sufficiently effective, whereas in Luminal B pts the additional application of chemotherapy should be considered. It is currently unknown, whether the risk stratification into Luminal A and B is comparably or more discriminatory than the established pathologic tumor size (pT) and lymph node (pN) status in pts ≥ 65 years. This analysis evaluates the discriminatory capacity of the new distinction between Luminal A and B and the established prognostic factors in bc pts ≥ 65 years treated with endocrine therapy only. Methods: Clinico-pathological data of 190 bc pts ≥ 65 years diagnosed between 1998 and 2004 were retrospectively analyzed. Pts were classified as Luminal A [ER (+) and/ or PR (+) and Her/2neu (-) and Ki-67 < 14%] or Luminal B [ER (+) and/ or PR (+) and Her2 (-) and Ki-67 ≥ 14%]. The Kaplan-Meier method was used to assess the progression-free survival (PFS) and overall survival (OS) estimates. Differences in survival between groups were tested for significance by the log-rank test. Results: Median age was 74 years (65–92 years) and median time of follow-up was 69 months (0–134 months). 68.9% and 31.1% pts had Luminal A and B subtypes, respectively. 73.3% and 26.7% of pts had pT1 and pT2 tumors, respectively. 79.7% and 20.3% of pts had pN0 and pN1 status, respectively. Overall, median PFS was 33 months. No significant difference regarding PFS could be detected between Luminal A and B pts, between pT1 and pT2 tumors and between pN0 and pN1 status (p=0.458; 0.172; 0.156), respectively. Overall, median OS was not reached. No significant difference regarding OS could be detected between Luminal A and B pts, between pT1 and pT2 tumors and between pN0 and pN1 status (p=0.328; 0.951; 0.976), respectively. Conclusions: In bc pts ≥ 65 years treated with endocrine therapy only, neither the recently consented dichotomization into Luminal A and B subtypes nor pathologic tumor size and lymph node status could be confirmed to be discriminative as propagated in the 2011 St. Gallen Consensus for the overall bc population.

scholarly journals A Study on the Relationship Between Tumor Size, Tumor Grade and Lymph Node Involvement in Canine Mammary Cancer: Simulation of Tumor Behavior in Human Breast Cancer

2021 ◽  
Author(s):  
Sanaz Rismanchi ◽  
Pejman Mortazavi ◽  
Samad Muhammadnejad
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Tumor Size ◽  
Mammary Cancer ◽  
Tumor Grade ◽  
Lymph Node Involvement ◽  
Lymph Node Status ◽  
Comparative Oncology ◽  
Canine Mammary Cancer ◽  
Node Involvement

Background: In the last two decades, canine mammary cancer has played an essential role in human breast cancer research. There are various similarities between biological and clinical features of canine breast cancer and female breast cancer in many cases. Clinical studies and evaluation of prognostic factors in canine mammary cancer can increase reliability in generalizing results to human cancers. This study was performed in the direction of comparative oncology. Methods: We collected clinicopathological data of an invasive type of canine mammary carcinoma from clinical records and pathology reports. Age, tumor laterality, tumor size, lymph node status, and tumor grade were recorded, and the relationships between the parameters were evaluated using linear regression analysis. Results: Ninety-seven patients were included in the study, and the mean age was 10.06 ± 2.73 years. The left mammary gland was involved in 51% of cases, and pT2 was the most common tumor size. Lymph nodes were involved in 27% of patients, and 43% of tumors were grade I. Statistical analysis showed no relationship between tumor size and laterality with other clinicopathological features. However, there was a statistically significant relationship between tumor size and tumor grade, and lymph node status. As the tumor size increased, tumor grade and the risk of lymph node involvement raised. Conclusion: Similar results of this study to breast cancer in women show that canine mammary carcinoma is a suitable model in comparative oncology research. Dogs live shorter than humans so that researchers can get the results of treatment and perform survival rate assessments faster in clinical trials. By considering ethical principles, dogs with breast cancer may replace phases I and II of human clinical trials in some cancer types soon.

scholarly journals Four Cycles of Docetaxel-Cyclophosphamide versus Anthracycline-Taxane as Adjuvant Chemotherapy for HER2-Negative, Axillary Lymph Node Negative Breast Cancer: A Real-World Comparison of Alberta Patients Treated 2008–2012

2021 ◽  
Vol 28 (2) ◽  
pp. 1137-1142
Author(s):  
Malek Hannouf ◽  
Atul Batra ◽  
Sasha Lupichuk
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Adjuvant Chemotherapy ◽  
Axillary Lymph Node ◽  
Cox Regression ◽  
Disease Free Survival ◽  
Axillary Lymph ◽  
Cancer Specific Survival ◽  
Node Negative ◽  
Significant Difference

Uncertainty exists around the need to include an anthracycline if taxane-based adjuvant chemotherapy is being used for human epidermal growth factor receptor-2 (HER2) negative and axillary lymph node negative (LNN) breast cancer. We identified all patients who were diagnosed with HER2-negative, LNN breast cancer treated with docetaxel-cyclophosphamide for four cycles (DC4) or an anthracycline-taxane (AT) regimen following surgical resection in Alberta from 2008 through 2012. We used propensity score methods to match each patient treated with AT to up to four patients treated with DC4 on potentially confounding clinicopathologic and treatment variables. We compared the 10-year invasive disease free survival (iDFS), breast cancer specific-survival (BCSS) and overall survival (OS) and assessed the effect of the type of adjuvant chemotherapy on these outcomes using Cox regression. Of the 726 eligible patients, 657 (90.5%) were treated with DC4 and 69 (9.5%) were treated with AT. Matching created a group of 202 women treated with DC4 and eliminated differences in clinicopathologic and treatment factors. There was no statistically significant difference for the treatment effects of matched DC4 patients compared to the AT patients on iDFS (75.7% vs. 76.8%, p = 0.75; hazard ratio (HR) = 1.05, 95% CI = 0.65 to 1.8), BCSS (88.1% vs. 87%, p = 0.8; HR = 0.91, 95% CI = 0.42 to 1.9), or OS (87.1% vs. 86.9%, p= 0.96; HR = 0.98, 95% CI = 0.46 to 2.1). Four cycles of DC as compared with an AT regimen yielded similar 10-year iDFS, BCSS and OS amongst patients with HER2-negative, LNN breast cancer.

The role of adjuvant chemotherapy in luminal B breast cancer.

2014 ◽  
Vol 32 (26_suppl) ◽  
pp. 156-156
Author(s):  
Meng Zhao ◽  
Jianying Zhang ◽  
Janette S Laubacher ◽  
Maria-Teresa Ramirez ◽  
Charles L. Shapiro
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Cox Regression ◽  
Histological Grade ◽  
Disease Free Survival ◽  
Her2 Overexpression ◽  
Nuclear Staining ◽  
Adjuvant Trastuzumab ◽  
Poor Prognostic Factor ◽  
Luminal B

156 Background: Luminal B breast cancer is a heterogeneous subtype characterized by higher grade, increased proliferation rates and overall poorer prognosis. We conducted a retrospective study on the associations between adjuvant chemotherapy, HER2 overexpression, progesterone receptor (PR) and treatment outcomes. Methods: The characteristics of 1,372 patients (pts) with ER positive (ER+) breast cancer (stages 1-3) diagnosed between 1998 and 2005 were reviewed. 432 (31%) were phenotypically defined as luminal B: (2011 St. Gallen’s consensus criteria): ER+, HER2-negative (HER2-) and histological grade 3, or ER+ and HER2-positive (HER2+). ER and PR was positive if nuclear staining was > 1%. HER2 was positive if IHC = 3+ or gene amplification was confirmed by FISH. Statistical analyses were performed using Kaplan-Meier estimate and multivariable cox regression. Results: Among the 432 luminal B pts, 179 cases (41%) were HER2+ and 93 (22%) were PR negative (PR-). Tumor characteristics were similar (see Table). With a median follow-up of 105 months the overall recurrence rate was 56/432 (13%) pts and the median disease-free survival (DFS) and overall survival (OS) have not been reached. No differences were observed in DFS or OS between HER2+ and HER2- groups or between PR+ and PR- groups. In multivariate analysis, Pts who received adjuvant chemotherapy had better DFS (HR = 0.3, p = 0.034) and OS (HR = 0.2, p = 0.013) and the benefit of adjuvant chemotherapy was not dependent on HER2 overexpression (DFS: HR = 1.65, p = 0.37; OS: HR = 1.65, p = 0.39) or PR status (DFS: HR = 1.8, p = 0.37; OS: HR = 2.3, p = 0.25). HER2+ in pts ≥ age of 60 (presumed postmenopausal) was associated with worse DFS (HR = 3.23, p = 0.017) and OS (HR = 3.06, p = 0.027). Conclusions: In patients with luminal B subtype adjuvant chemotherapy significantly improved OS and DFS irrelevant of HER2 or PR status. HER2+ was a poor prognostic factor in postmenopausal pts, however, the vast majority of them did not receive adjuvant trastuzumab. [Table: see text]

scholarly journals Breast Cancer Subtypes Based on ER, PR and HER2/neu Expression and Its Clinico-pathological Correlation

2020 ◽  
Vol 7 (1) ◽  
pp. 30-35
Author(s):  
Nur E Jannatul Ferdous ◽  
Dabashish Patowary ◽  
Yeasmin Nahar ◽  
Mohammad Shafiul Islam ◽  
Suporna Saleh ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Tumor Size ◽  
Reactivity Pattern ◽  
Cancer Subtypes ◽  
Luminal B ◽  
Therapeutic Implications ◽  
North East ◽  
The North ◽  
Her 2

Background: Carcinoma of the breast is one of the most common cancer in women and it is the second cause of cancer deaths only to lung cancer. Recent attention has been directed singularly at molecular classifications of breast cancer. Molecular subtypes have different prognostic and therapeutic implications. Objective: The aim of this study was to assess the ER, PR, and HER-2/neu reactivity pattern in breast carcinomas and to correlate this reactivity pattern with stage tumor size and lymph node metastasis. Methodology: This is a prospective analytical observational study was conducted in the North East Cancer Hospital and Department of Pathology of North East Medical College, Sylhet, Bangladesh during a 42 months period from July 2015 to December 2018. Result: Among 67 Cases of primary invasive breast carcinoma only one case was male and 66 were female. In aspect of tumor size most of the patient presented with 2 to 5cm tumor, 47(70.2%) cases and (80.6%) presented with more than 2cm tumor size. In our study 38(56.7%) cases of breast cancer found ER positive, 38.8%(26 cases) PR positive and 22.4% (15 cases) HER2/neu positive, most common presentation of the disease was at stage llB(29 cases,45%), lymph node positivity 46(68.7%) cases and lymph node negative 21(31.3%) cases, 5(7.5%)cases. In aspect of molecular subtyping we found luminl A 29 (43.3%) cases Luminal B 11.9% (8 cases) basal like 22(32.8%) cases and HER-2/neu over expressed 8(11.9%) cases. Conclusion: Cancer screening and early detection program can improve our scenario. Journal of Current and Advance Medical Research 2020;7(1): 30-35

scholarly journals Efficacy and Safety of Albumin-Bound Paclitaxel Compared to Docetaxel as Neoadjuvant Chemotherapy for HER2-Negative Breast Cancer

2022 ◽  
Vol 11 ◽  
Author(s):  
Zhi-Dong Lv ◽  
Hong-Ming Song ◽  
Zhao-He Niu ◽  
Gang Nie ◽  
Shuai Zheng ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Neoadjuvant Chemotherapy ◽  
Neoadjuvant Treatment ◽  
Disease Free Survival ◽  
Lymph Node Status ◽  
Efficacy And Safety ◽  
Significant Difference ◽  
Paclitaxel Group ◽  
Docetaxel Group

BackgroundNanoparticle albumin-bound paclitaxel (nab-paclitaxel) as neoadjuvant chemotherapy (NAC) for breast cancer remains controversial. We conducted a retrospective study to compare the efficacy and safety of nab-paclitaxel with those of docetaxel as neoadjuvant regimens for HER2-negative breast cancer.MethodsIn this retrospective analysis, a total of 159 HER2-negative breast cancer patients who had undergone operation after NAC were consecutively analyzed from May 2016 to April 2018. Patients were classified into the nab-paclitaxel group (n = 79, nab-paclitaxel 260 mg/m2, epirubicin 75 mg/m2, and cyclophosphamide 500 mg/m2) and the docetaxel group (n = 80, docetaxel 75 mg/m2, epirubicin 75 mg/m2, and cyclophosphamide 500 mg/m2) according to the drug they received for neoadjuvant treatment. The efficacy and adverse events were evaluated in the two groups.ResultsThe pathological complete response (pCR)(ypT0/isN0) rate was significantly higher in the nab-paclitaxel group than in the docetaxel group (36.71% vs 20.00%; P = 0.031). The multivariate analysis revealed that therapeutic drugs, lymph node status, and tumor subtype were the most significant factor influencing treatment outcome. At a median follow-up of 47 months, disease-free survival (DFS) was not significantly different in those assigned to nab-paclitaxel compared with docetaxel (82.28% vs 76.25%; P = 0.331). The incidence of peripheral sensory neuropathy in the nab-paclitaxel group was higher than that in the docetaxel group (60.76% vs 36.25%; P = 0.008), while the incidence of arthralgia was observed more frequently in the docetaxel group (57.50% vs 39.97%; P = 0.047).ConclusionsCompared with docetaxel, nab-paclitaxel achieved a higher pCR rate, especially those patients with triple-negative breast cancer or lymph node negative breast cancer. However, there was no significant difference in DFS between the two groups. This study provides a valuable reference for the management of patients with HER2-negative breast cancer.

No relationship is indicated between FHIT expression and clinicopathologic prognostic parameters in early stage cervical carcinoma

2003 ◽  
Vol 13 (2) ◽  
pp. 192-196
Author(s):  
C. Baykal ◽  
A. Ayhan ◽  
A. Al ◽  
K. YÜCE ◽  
A. Ayhan
Keyword(s):  
Overall Survival ◽  
Prognostic Factors ◽  
Lymph Node ◽  
Cox Regression ◽  
Disease Free Survival ◽  
Lymph Node Involvement ◽  
Depth Of Invasion ◽  
Prognostic Parameters ◽  
Node Involvement ◽  
Disease Free

In this study we investigated FHIT (Fragile Histidine Triad) protein alterations in cervical carcinomas to assess the relation of this gene with cervical cancer. Eighty-eight patients with surgically treated FIGO (International Federation of Gynecology and Obstetrics) stage IB carcinomas of the cervix were included in this study. Clinicopathologic prognostic factors were compared with FHIT expression status. Disease-free and overall survival was evaluated according to prognostic factors and FHIT expression. The FHIT gene was found to be depressed in 53% (47/88) of the tumors. None of the clinicopathologic prognostic parameters showed a correlation with FHIT expression. Univariate survival analysis with the Kaplan-Meier method showed that only the age of the patient is significantly correlated with disease-free survival. Interestingly, when the same analysis was done for 5-year overall survival; diameter of the primary tumor, depth of invasion, occurrence of lymph node involvement, and number of metastatic lymph nodes were found to be statistically significant. Furthermore, multivariate analysis with Cox regression revealed that lymph node involvement was the only independent variable for 5-year overall survival. In the present study there was no statistical correlation between FHIT expression and clinicopathologic prognostic factors or survival figures of the patients. These findings may be explained with the carcinogenic role of FHIT in tumoral progression but not in the tumoral development that takes place after the carcinogenetic period.

scholarly journals Association between Lymph Node Status and Expression Levels of Androgen Receptor, miR-185, miR-205, and miR-21 in Breast Cancer Subtypes

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Tatiana S. Kalinina ◽  
Vladislav V. Kononchuk ◽  
Alisa K. Yakovleva ◽  
Efim Y. Alekseenok ◽  
Sergey V. Sidorov ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Androgen Receptor ◽  
Expression Profiles ◽  
Lymph Node Status ◽  
Her2 Positive ◽  
Expression Levels ◽  
Cancer Subtypes ◽  
Luminal B ◽  
Cancer Spread

Breast cancer is the most commonly diagnosed cancer among women. Difficulties in treating breast cancer are associated with the occurrence of metastases at early stages of disease, leading to its further progression. Recent studies have shown that changes in androgen receptor (AR) and microRNAs’ expressions are associated with mammary gland carcinogenesis, in particular, with the formation of metastases. Thus, to identify novel metastatic markers, we evaluated the expression levels of AR; miR-185 and miR-205, both of which have been confirmed to target AR; and miR-21, transcription of which is regulated by AR, in breast cancer samples (n=89). Here, we show that the molecular subtypes of breast cancer differ in the expression profiles of AR and AR-associated microRNAs. In addition, the expression of AR and these microRNAs may depend on the expression of PR, ER, and HER2 receptors. Our results show that the possibility of using AR and microRNAs as markers depends on the tumor subtype: a decrease in AR expression may be the marker for the presence of lymph node metastases in patients with HER2-positive subtypes of breast cancer, and disturbance of miR-205, miR-185, and miR-21 expressions may be the marker in patients with a luminal B HER2-positive subtype. Cases with metastases in this type of breast cancer are characterized by a higher level of miR-205 and a lower level of miR-185 and miR-21 in tumor tissues compared to nonmetastatic cases. A decrease in the miR-185 level is also associated with lymph node metastasis in luminal B HER2-negative breast cancer. Thus, the expression levels of AR, miR-185, miR-205, and miR-21 can serve as markers to predict cancer spread to the lymph node in luminal B- and HER2-positive subtypes of breast cancer.

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