Relationship between survival to breast cancer and level of HER2 expression by immunohistochemistry.

e13078 Background: Central review of NSABP B-31 showed that some central-review HER2-negative patients benefited from trastuzumab, but survival according to different levels of HER2 expression by immunohistochemistry (IHC) is unknown. The aim of the present study was to examine the survival of trastuzumab-naïve patients with breast cancer according to the level of HER2 expression by IHC. Methods: This was a retrospective study of all women who were treated for an invasive breast cancer at the Centre des maladies du Sein Deschênes-Fabia (Quebec City, Province of Quebec, Canada) between July 1999 and December 2010. Patients were grouped according to the HER2 status by IHC of their primary cancer (0 vs. 1+ vs. 2+ vs. 3+). Survival was obtained from the death registry of the Ministry of Health. Follow-up was censored on December 31st, 2012. Results: During the study period, 2571 patients with invasive breast cancer, with available HER2 status by IHC and survival data, and naïve to anti-HER2 therapy were treated at our center. Both 5- and 9-year overall survival (OS) decreased with increasing HER2 expression by IHC (9-year OS: 0: 86.2% vs. 1+: 71.3% vs. 2+: 73.9% vs. 3+: 69.3%; unadjusted log-rank test: P < 0.0001; adjusted P = 0.04 for 3+). Both 5- and 9-year breast cancer-specific survival (BCSS) decreased with increasing HER2 expression by IHC (9-year BCSS: 0: 90.7% vs. 1+: 81.8% vs. 2+: 77.0% vs. 3+: 75.4%; unadjusted log-rank test: P < 0.0001; adjusted P = 0.04 for 3+). Conclusions: Survival among trastuzumab-naïve breast cancer patients seems to follow a continuum across HER2 expression by IHC.

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Adjuvant treatment delay in breast cancer patients

Revista da Associação Médica Brasileira ◽

10.1590/1806-9282.61.05.411 ◽

2015 ◽

Vol 61 (5) ◽

pp. 411-416 ◽

Cited By ~ 6

Author(s):

Damila Cristina Trufelli ◽

Leandro Luongo de Matos ◽

Patricia Xavier Santi ◽

Auro Del Giglio

Keyword(s):

Breast Cancer ◽

Overall Survival ◽

Risk Factor ◽

Adjuvant Treatment ◽

Invasive Breast Cancer ◽

Rank Test ◽

Breast Cancer Patients ◽

Risk Of Death ◽

Log Rank Test ◽

Public Strategies

Summary Background: to evaluate if time between surgery and the first adjuvant treatment (chemotherapy, radiotherapy or hormone therapy) in patients with breast cancer is a risk factor for lower overall survival (OS). Method: data from a five-year retrospective cohort study of all women diagnosed with invasive breast cancer at an academic oncology service were collected and analyzed. Results: three hundred forty-eight consecutive women were included. Time between surgery and the first adjuvant treatment was a risk factor for shorter overall survival (HR=1.3, 95CI 1.06-1.71, p=0.015), along with negative estrogen receptor, the presence of lymphovascular invasion and greater tumor size. A delay longer than 4 months between surgery and the first adjuvant treatment was also associated with shorter overall survival (cumulative survival of 80.9% for delays ≤ 4 months vs. 72.6% for delays > 4 months; p=0.041, log rank test). Conclusion: each month of delay between surgery and the first adjuvant treatment in women with invasive breast cancer increases the risk of death in 1.3-fold, and this effect is independent of all other well-established risk factors. Based on these results, we recommend further public strategies to decrease this interval.

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Clinical presentation and outcomes of 2,924 early breast cancer patients (br.ca. pts) treated in a single institution in a 10-year period with a long follow up

Journal of Clinical Oncology ◽

10.1200/jco.2006.24.18_suppl.10669 ◽

2006 ◽

Vol 24 (18_suppl) ◽

pp. 10669-10669

Author(s):

E. Galligioni ◽

R. Triolo ◽

A. Lucenti ◽

A. Ferro ◽

M. Frisinghelli ◽

...

Keyword(s):

Breast Cancer ◽

Rank Test ◽

Consecutive Series ◽

Breast Cancer Patients ◽

Log Rank Test ◽

Product Limit ◽

Probability Of Death ◽

Clinical Records ◽

Hormonal Receptor Status

10669 Background: A consecutive series of br.ca. pts, treated between Jan 1st 1990 to Dec 31st 1999 in our Department, is the basis of our retrospective study, aimed to create a data base on routinary clinical management of early br.ca. pts, to which compare similar series and literature data. Methods: All Clinical Records were reviewed and computerized. Disease free and overall survival were estimated using the product-limit method of Kaplan and Meier. The log-rank test was used to compare prognosis between different subgroups. Results: Among 2924 consecutive br.ca. pts, 836 were younger than 50 years (med. age 44) and 2088 older (med. age 63). Regional nodes were negative (N−) in 1754, positive (N+) in 1027 and unknown in the remaining pts. So, 2593 pts were stage I-II and 301 stage IIIA-B. Hormonal Receptor status (available on 2560 pts) was positive for Estrogen (ER+) in 2021 pts and for Progesterone (PgR+) in 1649 pts. Moreover, 1571 pts were ER+Pgr+, 539 ER-PgR−, 78 ER-PgR+ and 461 ER+PgR−. HER2 was overexpressed in 262/1426 (18%) pts. Tumor grading (available on 2176 cases) was G1–2 in 1411 and G3–4 in 765 cases. After surgery, 731 pts received adjuvant Tamoxifen, 507 pts CMF ± Antracyclines chemotherapy, 434 pts both chemotherapy and Tamoxifen and 958 pts none. (no therapy data are available for the remaining 334 pts). At a median f.up of 9.8 years, 993/2924 pts (33.9%) have recurred, (med. DFS 137 mos) with a 5, 10 and 15 y probability of recurrence of 26, 44 and 63% respectively. Corresponding figures of recurrence for N− pts were 14, 30 and 50% (med. DFS 168 mos), while for N+ pts were 41, 61 and 77% (med DFS 81 mos). For younger N+ pts treated with chemotherapy, the 5 years probability of recurrence was 34% while it was 24% for older ER+ pts treated with hormonal therapy. So far, 794/2924 (27.5%) pts have died, with a 5, 10 and 15 y probability of death of 13, 27 and 41%. This was 5, 16 and 28% for N- pts and 22, 41 and 56% for N+ pts. For younger N+ pts treated with chemotherapy, the 5 y probability of death was 14%, as it was for older ER+ pts treated with Tamoxifen. Conclusions: Although this data are not yet conclusive, it appears that large part of the clinical improvements reported in clinical trials may be achieved in the routine management of breast cancer pts. No significant financial relationships to disclose.

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The Difference in Clinical and Prognostic Features Between De Novo and Recurrent Her2-Positive Metastatic Breast Cancer Patients

Acta Medica ◽

10.32552/2019.actamedica.395 ◽

2019 ◽

Vol 50 (4) ◽

pp. 14-19

Author(s):

Yusuf Acikgoz ◽

Yakup Ergun ◽

Gokhan Ucar ◽

Merve Dirikoc ◽

Dogan Uncu

Keyword(s):

Breast Cancer ◽

Metastatic Breast Cancer ◽

Survival Data ◽

De Novo ◽

Metastatic Breast ◽

Rank Test ◽

Breast Cancer Patients ◽

Her2 Positive ◽

Prognostic Features ◽

Her 2

Abstract BACKGROUND: There are different data in the literature about the consequences of the development of metastasis as de novo or recurrent. In this study, we retrospectively investigated the clinicopathologic and prognostic characteristics of HER-2 positive de novo and recurrent metastatic breast cancer (MBC) patients. PATIENTS AND METHODS: The data of patients admitted to our clinic between 1996-2017 were analyzed retrospectively. The baseline features, treatments and survival data were recorded. Recurrent metastatic patients were further categorized as disease free interval (DFI) <24 months and DFI >24 months. The features of two groups were analyzed by pearson chi-square test. Survival were calculated by using the Kaplan-Meier method with the Long-rank test. p <0.05 was considered statistically significant. RESULTS: A total of 44 patients were included to study in which 20 patients in de novo HER-2 positive MBC group and 24 patients in recurrent HER-2 MBC group. There was no difference in baseline features between groups. The median OS in de novo and recurrent MBC group was 60.3 months and 43.9 months respectively (HR: 0.87, 95% CI 0.37-2.05, p=0.76). OS was not different between de novo MBC group and patients with DFI <24 months and with DFI > 24 months (p=0.135). CONCLUSION: Our study showed that baseline features of patients with de novo HER-2 positive MBC and recurrent HER-2 positive MBC did not differ from each other. The presence of metastasis at the time of diagnosis or during follow-up did not change response to treatments.

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Prognostic Nutritional Index (PNI) in Patients With Breast Cancer Treated With Neoadjuvant Chemotherapy as a Useful Prognostic Indicator

Frontiers in Cell and Developmental Biology ◽

10.3389/fcell.2021.656741 ◽

2021 ◽

Vol 9 ◽

Author(s):

Li Chen ◽

Ping Bai ◽

Xiangyi Kong ◽

Shaolong Huang ◽

Zhongzhao Wang ◽

...

Keyword(s):

Breast Cancer ◽

Neoadjuvant Chemotherapy ◽

Cancer Patients ◽

Prognostic Significance ◽

Prognostic Nutritional Index ◽

Prognostic Indicator ◽

Rank Test ◽

Breast Cancer Patients ◽

Log Rank Test ◽

The Mean

ObjectivePrognostic nutritional index (PNI), calculated as serum albumin (ALB) (g/L) + 5 × total lymphocyte count (109/L), is initially used to evaluate nutritional status in patients undergoing surgery and may evaluate the therapeutic effects and predict the survival of various solid tumors. The present study aimed to evaluate the potential prognostic significance of PNI in breast cancer patients receiving neoadjuvant chemotherapy (NACT).MethodsA total of 785 breast cancer patients treated with neoadjuvant chemotherapy were enrolled in this retrospective study. The optimal cutoff value of PNI by receiver operating characteristic curve stratified patients into a low-PNI group (<51) and a high PNI group (≥51). The associations between breast cancer and clinicopathological variables by PNI were determined by chi-square test or Fisher’s exact test. Kaplan–Meier plots and log-rank test were used to evaluate the clinical outcomes of disease-free survival (DFS) and overall survival (OS). The prognostic value of PNI was analyzed by univariate and multivariate Cox proportional hazards regression models. The toxicity of NACT was accessed by the National Cancer Institute Common Toxicity Criteria (NCI-CTC).ResultsThe results indicated that PNI had prognostic significance by an optimal cutoff value of 51 on DFS and OS in univariate and multivariate Cox regression survival analyses. Breast cancer patients with a high PNI value had longer DFS and OS than those with a low PNI value [47.64 vs. 36.60 months, P < 0.0001, hazard ratio (HR) = 0.264, 95%CI = 0.160–0.435; 73.61 vs. 64.97 months, P < 0.0001, HR = 0.319, 95%CI = 0.207–0.491, respectively]. Furthermore, the results indicated that patients with high PNI had longer DFS and OS than those with low PNI in early stage and advanced breast cancer, especially in advanced breast cancer. The mean DFS and OS times for breast cancer patients with high PNI by the log-rank test were longer than in those with low PNI in different molecular subtypes. Moreover, the mean DFS and OS times in patients with high PNI by the log-rank test were longer than in those patients with low PNI without or with lymph vessel invasion. The common toxicities after neoadjuvant chemotherapy were hematologic and gastrointestinal reaction, and the PNI had no significance on the toxicities of all enrolled patients, except in anemia, leukopenia, and myelosuppression.ConclusionPretreatment PNI with the advantages of being convenient, noninvasive, and reproducible was a useful prognostic indicator for breast cancer patients receiving neoadjuvant chemotherapy and is a promising biomarker for breast cancer on treatment strategy decisions.

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Influence of pregnancy on breast cancer tumor characteristics and mortality in Iowa women

Journal of Clinical Oncology ◽

10.1200/jco.2006.24.18_suppl.584 ◽

2006 ◽

Vol 24 (18_suppl) ◽

pp. 584-584 ◽

Cited By ~ 1

Author(s):

C. E. Scott-Conner ◽

P. A. Romitti ◽

C. F. Lynch ◽

N. Wilkinson ◽

G. Lal ◽

...

Keyword(s):

Breast Cancer ◽

Survival Data ◽

Locally Advanced ◽

Rank Test ◽

High Grade ◽

Tumor Characteristics ◽

Preclinical Phase ◽

Log Rank Test ◽

Before And After ◽

Cancer Tumor

584 Background: Hormonal factors such as pregnancy influence development and course of breast cancer. We identified women who became pregnant during the preclinical phase or shortly after diagnosis of breast cancer, compared them with similar women who had not been pregnant in that time period, and studied tumor characteristics and mortality. Methods: Birth and fetal death certificates were linked with Iowa Cancer Registry information for 10,624 women ≤50 years of age diagnosed with breast cancer as a first invasive primary between January 1, 1975 and December 31, 2002. Women who were pregnant two years before (n=160) or after diagnosis of breast cancer (n=53)and those who had not been pregnant (NP) (n=5008) were identified using probabilistic computer matching with manual review confirmation. Clinical, pathological and 10-year survival data were compared between these groups. Preliminary analysis revealed similarities between women who were pregnant before and after diagnosis. These were combined for analysis (P). Results: The study subjects distributed themselves across two SEER stages of disease: 1) localized, and 2) locally advanced or regional nodal disease (LABC). SEER stage (50% LABC vs. 39% LABC) and grade (75% high grade vs. 56% high grade) were higher in P than in NP cases. Ten-year survival for localized disease was 0.766 (95% CI 0.649–0.848) for P and 0.874 (95% CI 0.858–0.888) for NP (log rank test p= 0.0178). Ten-year survival for LABC was 0.520 (95% CI 0.373–0.649) for P and 0.629 (95% CI 0.601–0.655) for NP (log rank test p= 0.0234). Multivariate analysis ( table below) showed an adverse effect of pregnancy status on survival, independent of stage, grade, age or progesterone receptor (PR) status. Conclusions: Women who are pregnant within two years of diagnosis of breast cancer have higher grade, more locally-advanced tumors and experience a higher mortality than similar women who are never pregnant. Pregnancy persists as a significant adverse survival variable after adjustment for age, grade, stage, and PR status. [Table: see text] No significant financial relationships to disclose.

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HER2 expression and efficacy of preoperative paclitaxel and 5-fluorouracil, cyclophosphamide, doxorubicin chemotherapy in breast cancer

Journal of Clinical Oncology ◽

10.1200/jco.2007.25.18_suppl.548 ◽

2007 ◽

Vol 25 (18_suppl) ◽

pp. 548-548

Author(s):

L. Pusztai ◽

F. Andre ◽

C. Mazouni ◽

C. Liedtke ◽

S. Kau ◽

...

Keyword(s):

Breast Cancer ◽

Gene Expression ◽

Survival Rates ◽

Pathologic Complete Response ◽

Her2 Status ◽

Her2 Overexpression ◽

Her2 Expression ◽

Breast Cancer Patients ◽

Her2 Breast Cancer ◽

Tau Expression

548 Purpose: We examined the correlation between HER2 expression and pathologic complete response (pCR) to paclitaxel/FAC (T/FAC) preoperative chemotherapy in stage II-III breast cancer. Patients and Methods: Retrospective analysis of data including 534 patients treated with preoperative T/FAC was performed. Gene expression results were available from a subset of 132 patients and were used to examine the co-expression of HER2 and topoisomerase II a (TOP2A) and microtubule associated protein tau (MAP-Tau). Results: Of the 534 patients, 105 (20%) had HER2 overexpressing (HER2+) breast cancer. The pCR rates were 33% and 15% for patients with HER2+ and HER2- tumors (P<0.001). The 5-year relapse-free survival rates were 94% and 70% in HER2+ tumors with and without pCR (P=0.009). In multivariate analysis ER-negative status (OR 3.1, 95% CI 1.7–5.5, P < 0.001), high nuclear grade (OR 6.7, 95% CI 3.1–14.2, P < 0.001), weekly paclitaxel regimen (OR 2.6, 95% CI 1.5–4.5, P <0.001), and HER2 overexpression (OR 2.4, 95% CI 1.3–4.2, P = 0.003) were significant predictors of pCR. Among ER- cancers, the pCR rates were 50% (95%CI: 36–64%) in HER2+ (n=24/48) and 30% (95%CI: 23–37%) in HER2- disease (n=48/159), P = 0.02. Among ER+ cancers, the pCR rate was 19% (95% CI: 9–29%) in HER2+ (n=11/57) and 6% (95% CI: 3–9%) in HER2- disease (n=17/270), P = 0.003. In the gene expression data, HER2 overexpression was associated with lower expression of MAP-tau (mean 303 vs 500, p=0.001) and higher expression of TOP2A mRNAs (mean 398 vs 274, p=0.048) in patients with ER+ disease. All ER- cancers had low MAP-Tau expression (compared to ER+ cancers) regardless of HER2 status. Conclusion: HER2 overexpression is associated with higher rate of pCR to preoperative T/FAC chemotherapy in both ER- and ER+ cancers. HER2 overexpression correlates with increased TOP2A and decreased MAP-Tau expression in ER+ cancers which could explain increased anthracycline and taxane sensitivity of these tumors. No significant financial relationships to disclose.

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Hubungan Penyakit Diabetes Melitus dan Penggunaan Antidiabetes terhadap Rekurensi pada Pasien Kanker Payudara

JURNAL MANAJEMEN DAN PELAYANAN FARMASI (Journal of Management and Pharmacy Practice) ◽

10.22146/jmpf.48069 ◽

2019 ◽

Vol 9 (4) ◽

pp. 294

Author(s):

Fitri Wulandari ◽

Kartika Widayati ◽

Fita Rahmawati

Keyword(s):

Breast Cancer ◽

Diabetes Mellitus ◽

Cancer Patients ◽

Cox Regression ◽

Metastatic Breast ◽

Rank Test ◽

Breast Cancer Patients ◽

Risk Of Recurrence ◽

Antidiabetic Therapy ◽

Log Rank Test

Breast cancer is the cancer with the most prevalence of 43.3% and the mortality rate that reaches 12.9%. The prognosis of breast cancer can be affected by diabetes mellitus (DM), so that efforts to control DM through antidiabetic therapy are very necessary, but antidiabetic therapy is also reported to be associated with the prognosis of breast cancer. The purpose of this study was to determine the relationship of diabetes and antidiabetic use to recurrence in breast cancer patients. This study used a retrospective cohort design, involving 176 female non-metastatic breast cancer patients who received chemotherapy, consisting of 88 patients with DM and 88 non-DM patients. The exposures in the study were diabetes mellitus and the types of antidiabetic drugs (metformin and non metformin based therapy), while the study output was the recurrence of breast cancer. The research data was obtained from the patient’s medical records at RSUP Dr. Sardjito Yogyakarta. Research analysis used Chi-square, Kaplan Meier method and Cox-regression to estimate Hazard Ratio with 95% confidence interval. The results showed DM in breast cancer patients was associated with increased the risk of recurrence (HR 2,458; 95% CI 1,571-3,846, log rank test P=0,000), while the use of antidiabetic types (metformin and nonmetformin) to control DM in breast cancer patients was not associated with the risk of recurrence (HR 1.391; 95% CI 0.816 - 2.370, log rank test P=0.210). Further research is warranted by monitoring blood glucose levels regularly.

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NKX6.1 Expression is Associated With The Prognosis in Breast Cancer.

10.21203/rs.3.rs-47888/v1 ◽

2020 ◽

Author(s):

Jie Zhang ◽

Sujie Zhang ◽

Xiaoyan Li ◽

Fan Zhang ◽

Lei Zhao

Keyword(s):

Breast Cancer ◽

Overall Survival ◽

Cancer Patients ◽

Cox Regression ◽

Expression Level ◽

Rank Test ◽

Breast Cancer Patients ◽

Cox Regression Analysis ◽

Log Rank Test ◽

Cancer Tissues

Abstract Background: Breast cancer is the most common cancer among women in the world. NKX6.1 is proved to be involved in several human cancers, but fewer researches have reported the functional roles of NKX6.1 in breast cancer. In this study, we investigated the clinical significance of NKX6.1 expression in breast cancer prognosis.Methods: The expression level of NKX6.1 in breast cancer tissues and paired non-cancerous tissues were detected by quantitative real-time polymerase chain reaction (qRT-PCR). Chi-square test was applied to evaluate the relationship between NKX6.1 expression and clinicopathologic parameters. The overall survival of breast cancer patients were analyzed by Kaplan-Meier method with log rank test. Additionally, cox regression analysis was used for prognosis analysis.Results: NKX6.1 expression level is increased in breast cancer tissues (P<0.001). Moreover, the elevated levels were significantly correlated with tumor size (P=0.002), TNM stage (P=0.018) and lymph node metastasis (P=0.007). In addition, breast cancer patients with high NKX6.1 level had a poorer overall survival than those with low level (log rank test, P=0.001). NKX6.1 was an independent prognostic factor for breast cancer (HR=2.961, 95%CI=1.368-6.411, P=0.006).Conclusions: NKX6.1 is up-regulated in breast cancer, which may be a potential prognostic biomarker for the cancer.

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The prognostic value of cytoskeletal regulation and vesicle trafficking signaling pathway mutation in breast cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.e13068 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. e13068-e13068

Author(s):

Haiyan Liu ◽

Guanqun Huang ◽

Tanxiao Huang ◽

Ming Liu ◽

Wenting Liao ◽

...

Keyword(s):

Breast Cancer ◽

Signaling Pathway ◽

Prognostic Value ◽

Rank Test ◽

Breast Cancer Patients ◽

Relapse Free Survival ◽

Free Survival ◽

Insertion And Deletion ◽

Log Rank Test ◽

Cytoskeletal Regulation

e13068 Background: Breast cancer (BC) is the most commonly diagnosed cancer in 2020, with an estimated 2.3 million new cases and the leading cause of cancer death in women. The cytoskeleton is a dynamic system of protein filaments that is regulated by dozens of proteins which are, in turn, regulated by phosphoinositides. Cytoskeletal regulation and vesicle trafficking (CRVT) signaling pathway is associated with many changes in the structure and movements of cells. Few studies addressing the association between genetic mutation of the CRVT pathway and the disease prognosis have been reported up to now. Here we investigate the genetic status of CRVT pathway as a biomarker for predicting overall survival (OS) and relapse-free survival (RFS) for breast cancer patients. Methods: We used cBioPortal platform to analyze a cohort of 10646 breast cancer samples. Mutations in 7 genes ( APC, BAP1, KEAP1, PAK1, PTEN, SRC, STAT3 ) are the most common indication in the CRVT signaling pathway. We define overall survival (OS) as the time between the procedure date when the tumor specimen was collected and the date of death or last follow-up visit. And we define relapse-free survival (RFS) as the time from surgical resection to relapse of disease. We estimated and compared the survival curves of these two groups using Kaplan-Meier method and log-rank tests. The statistical significance level was set to 5% ( p < 0.05). Results: Genomic alterations of the CRVT-indicator genes were found in 2582 (n = 2582/10646, 24.25%) samples with sorts of alterations identified including variants of non-synonymous mutations, splicing mutations, short in-frame insertion and deletion, short frame shift insertion and deletion, and copy number gain and loss. PTEN was most commonly altered (n = 2329), followed by PAK1 (n = 863), APC (n = 718), STAT3 (n = 341), KEAP1 (n = 317), BAP1(n = 292), and SRC (n = 278). Based on the result, patients were divided into the CRVT and non-CRVT group. The median OS of the CRVT group was 141.57 moth, which was significantly shorter than the OS of the non-CRVT group (log-rank test p= 0.000662). The median RFS of the CRVT group was 167.76 moth, which was also significantly shorter than the RFS of the non-CRVT group (log-rank test p= 0.0169). Conclusions: To the best of our knowledge, this study is the first investigation to evaluate the prognostic value of CRVT pathway mutation in patients with breast cancer. Our investigation shows that CRVT pathway mutation could significantly predict poor prognosis in breast cancer patients. The result of our analysis should be better confirmed with additional relevant research in the future using updated analyses.

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