Genomics of HER2+ breast cancer in young women before and after exposure to chemotherapy (chemo) plus trastuzumab (H).

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 554-554
Author(s):  
Adrienne Gropper Waks ◽  
Esha Jain ◽  
Laura C. Collins ◽  
Shoshana M. Rosenberg ◽  
Kathryn Jean Ruddy ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Young Women ◽  
Evolutionary Analysis ◽  
Mechanisms Of Resistance ◽  
Her2 Breast Cancer ◽  
Whole Exome ◽  
Activating Mutation ◽  
Before And After ◽  
Myc Gene ◽  
Large Prospective Cohort

554 Background: HER2+ breast cancer (BC) is particularly common in young women. Genomic features of HER2+ tumors before and after H-based therapy have not been described in a population of young women and may point to clinically targetable mechanisms of resistance. Methods: From a large prospective cohort of women diagnosed with BC age ≤40 years, we identified those with HER2+ BC and tumor tissue available for sequencing before and after chemo+H. Whole exome sequencing (WES) was performed on each tumor and on germline DNA from blood. Tumor-normal pairs were analyzed for mutations and copy number (CN) changes. Evolutionary analysis was performed for patients with both pre- and post-treatment (tx) samples. Results: 22 women had successful WES samples from at least one timepoint; 13 of these had paired sequencing results both before and after chemo+H. For the majority of women, post-tx sample was following neoadjuvant chemo + H, though post-tx timepoint for other women represented locoregional or distant metastasis (Table). TP53 was the only gene that was significantly recurrently mutated in both pre- and post-tx samples. Comparison of matched pre-tx and post-tx samples demonstrated that large changes in HER2 CN over the course of tx were uncommon, only 2/13 pts had > 2-fold change in HER2 CN. Other clonal and subclonal genomic alterations were found to be acquired in the post-tx sample compared to the pre-tx sample. One patient acquired a putative activating mutation in ERBB2. Another patient acquired a clonal hotpsot mutation in TP53. MYC gene amplification was observed in 4 post-tx tumors. NOTCH2 alterations were found in post-tx biopsies from 2 different patients, and mutations in STIL were also found in post-tx biopsies from 2 patients, though the function of these mutations is not known. Conclusions: HER2+ breast tumors in young women display genomic evolution following tx with chemo+H. HER2 CN changes are uncommon, but we identified several genes that warrant exploration as potential mechanisms of resistance to therapy in this population.[Table: see text]

Modern chemotherapy use among young women with early-stage ER+/HER2- breast cancer

The Breast ◽  
2018 ◽  
Vol 41 ◽  
pp. S18
Author(s):  
Philip Poorvu ◽  
Shari Gelber ◽  
Shoshana Rosenberg ◽  
Kathryn Ruddy ◽  
Rulla Tamimi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Young Women ◽  
Early Stage ◽  
Her2 Breast Cancer

scholarly journals Mechanisms of resistance and sensitivity to anti-HER2 therapies in HER2+ breast cancer

Oncotarget ◽  
2016 ◽  
Vol 7 (39) ◽  
pp. 64431-64446 ◽  
Author(s):  
Debora de Melo Gagliato ◽  
Denis Leonardo Fontes Jardim ◽  
Mario Sergio Pereira Marchesi ◽  
Gabriel N. Hortobagyi
Keyword(s):  
Breast Cancer ◽  
Mechanisms Of Resistance ◽  
Her2 Breast Cancer

The experience of young women diagnosed with breast cancer who undergo fertility preservation (FP) consultation.

2011 ◽  
Vol 29 (27_suppl) ◽  
pp. 249-249
Author(s):  
K. A. Hill ◽  
T. Nadler ◽  
R. Mandel ◽  
S. Burlein-Hall ◽  
C. Librach ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Cancer Patients ◽  
Young Women ◽  
Systemic Therapy ◽  
Her2 Status ◽  
Breast Cancer Patients ◽  
Additional Time ◽  
Before And After ◽  
Young Breast Cancer

249 Background: In recent years FP has been a growing concern for young women diagnosed with breast cancer. ASCO has recommended that such women be referred to a reproductive specialist as early as possible before beginning systemic adjuvant therapy. Aim: To gather information about young breast cancer patients’ experiences with FP referral, consultation, and decision making. Methods: Anonymous questionnaires were mailed to consecutive breast cancer patients referred January 2005 through January 2010 from our center to the CReATe clinic in Toronto. Topics included information about demographics, cancer stage and treatment, previous fertility problems, referral source and timing, options presented and chosen, and satisfaction with the referral, consultation and decision making processes. Results: Of the 50 women identified 26 (52%) participated. Average age of respondents was 31 (range 24-41). 17 (65%) were married or in a long-term relationship, and 9 (35%) already had 1 child. Seven (27%) were referred before surgery, 16 (62%) after surgery but before systemic therapy, 2 (8%) after starting hormone therapy, and 1 after completing chemotherapy. Only 54% opted for FP. Of the 17 (66%) who reported plans to start/add to their family prior to diagnosis of breast cancer, 53% proceeded with FP and of the 9 who did not have plans to start/add to their family 5 (55%) pursued FP. 41% had difficulty with decision making and 50% found cost to be a significant barrier. A common theme among respondents was inadequate time for decision making. Several complained about the lack of written material before and/or after their consultation. 85% felt that access to a psychosocial counselor would have been beneficial to the decision making process. 57% were satisfied or extremely satisfied overall. Conclusions: (1) If appropriate, FP referral should be initiated by the surgeon as soon as a diagnosis of invasive cancer is made. Obtaining receptor and HER2 status on core biopsy samples may identify women who will require systemic therapy and may benefit from early FP referral. (2) Women need written materials before and after FP consultation. (3) There is a major role for a FP counselor who is able to spend additional time helping with decision making.

scholarly journals Microenvironment-Mediated Mechanisms of Resistance to HER2 Inhibitors Differ between HER2+ Breast Cancer Subtypes

Cell Systems ◽  
2018 ◽  
Vol 6 (3) ◽  
pp. 329-342.e6 ◽  
Author(s):  
Spencer S. Watson ◽  
Mark Dane ◽  
Koei Chin ◽  
Zuzana Tatarova ◽  
Moqing Liu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Cancer Subtypes ◽  
Mechanisms Of Resistance ◽  
Cancer Subtypes ◽  
Her2 Breast Cancer

scholarly journals Ovarian Reserve after Chemotherapy in Breast Cancer: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 11 (8) ◽  
pp. 704
Author(s):  
Alessia Romito ◽  
Sonia Bove ◽  
Ilaria Romito ◽  
Drieda Zace ◽  
Ivano Raimondo ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Publication Bias ◽  
Young Women ◽  
Ovarian Reserve ◽  
Case Reports ◽  
Meta Analysis ◽  
Case Series ◽  
Female Population ◽  
Before And After

Background: Worldwide, breast cancer (BC) is the most common malignancy in the female population. In recent years, its diagnosis in young women has increased, together with a growing desire to become pregnant later in life. Although there is evidence about the detrimental effect of chemotherapy (CT) on the menses cycle, a practical tool to measure ovarian reserve is still missing. Recently, anti-Mullerian hormone (AMH) has been considered a good surrogate for ovarian reserve. The main objective of this paper is to evaluate the effect of CT on AMH value. Methods: A systematic review and meta-analysis were conducted on the PubMed and Scopus electronic databases on articles retrieved from inception until February 2021. Trials evaluating ovarian reserves before and after CT in BC were included. We excluded case reports, case-series with fewer than ten patients, reviews (narrative or systematic), communications and perspectives. Studies in languages other than English or with polycystic ovarian syndrome (PCOS) patients were also excluded. AMH reduction was the main endpoint. Egger’s and Begg’s tests were used to assess the risk of publication bias. Results: Eighteen trials were included from the 833 examined. A statistically significant decline in serum AMH concentration was found after CT, persisting even after years, with an overall reduction of −1.97 (95% CI: −3.12, −0.82). No significant differences in ovarian reserve loss were found in the BRCA1/2 mutation carriers compared to wild-type patients. Conclusions: Although this study has some limitations, including publication bias, failure to stratify the results by some important factors and low to medium quality of the studies included, this metanalysis demonstrates that the level of AMH markedly falls after CT in BC patients, corresponding to a reduction in ovarian reserve. These findings should be routinely discussed during oncofertility counseling and used to guide fertility preservation choices in young women before starting treatment.

A Multi- institutional Prospective Analysis of Impact of CanAssist Breast (Morphometric Immunohistochemistry Based Test) on Adjuvant Chemotherapy Decisions in Early Breast Cancer

2021 ◽  
Author(s):  
Somashekhar SP ◽  
Shekhar Patil ◽  
Ravi Thippeswamy ◽  
Rajeevkumar Rajeevkumar ◽  
Chaturbhuj R Agrawal ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Stratification ◽  
Treatment Plan ◽  
Treatment Decision ◽  
Clinicopathological Features ◽  
Treatment Recommendation ◽  
Her2 Breast Cancer ◽  
Before And After ◽  
Clinical Risk Assessment ◽  
Chemoendocrine Therapy

Abstract Purpose: CanAssist Breast (CAB) has been validated retrospectively for assessing risk of recurrence and thereby usefulness of chemotherapy in HR+/HER2- breast cancer. The objective of this study is to assess the agreement between physician’s treatment plan and CAB risk stratification and evaluate whether CAB results aid in the physician’s treatment decision.Methods: The data on the physician’s treatment plan before and after the CAB test was collected prospectively between 2016 and 2021 in 249 patients. Changes in treatment recommendations and compliance with CAB reports were analyzed. Results: Based on conventional clinicopathological features physicians planned to treat 46% of patients with endocrine therapy (ET) (low-risk-LR)), 24% with chemoendocrine therapy (CET) (high-risk-HR)) and in 30% physicians were uncertain of prescribing chemotherapy (intermediate-risk-IR)) before CAB testing. The correlation between clinical risk assessment and CAB risk stratification (k=0.2 (0.05-0.35) was nonsignificant. CAB classified 64% as LR, which was 18% (9.3-25, P=0.0001) higher compared to clinical LR. In the clinical IR category, CAB risk proportions were 55:45 (LR: HR). We observed a substantial shift in treatment recommendation from CET to ET in 54% (40.75- 66.84, P<0.0001) of clinical HR and ET to CET in 26% (18.27- 35.01, P<0.0001) of clinical LR patients. Overall CAB lead to change in treatment recommendation in 42% of the cohort.Conclusions: There was a significant impact of CAB on the physician’s treatment decision. CAB provided definite treatment recommendation to IR patients where the physician had dilemma on prescribing chemotherapy and provided precise treatment plan to clinical LR and HR patients.

scholarly journals Implementation of SADARI in the Early Detection of Breast Cancer in Young Women High School of West Aceh Regency

2020 ◽  
Vol 7 (1) ◽  
pp. 51
Author(s):  
Arfah Husna ◽  
Muhammad Iqbal Fahlevi
Keyword(s):  
Breast Cancer ◽  
Early Detection ◽  
Young Women ◽  
Early Stage ◽  
Breast Self Examination ◽  
Abnormal Growth ◽  
Younger Age ◽  
Before And After ◽  
Quasi Experimental ◽  
Self Examination

Breast cancer (carcinoma mammae) is a condition where cells have lost control and normal mechanisms, resulting in abnormal growth, rapid and uncontrolled which occurs in breast tissue.. Early detection of breast cancer aims to find cancer in the early stage so that the treatment is better. The detection is done by doing SADARI, SADARI is an easy examination to find a lump or agility others. The case of cancer of West Aceh Regency in 2015 S/d 2017 recorded the number of cases of breast cancer at most 24.43% compared with other cancers. Women aged 50 years more who have breast cancer reaches 52%, 35% at the age of less than 40 years, 22% of women aged 30 years and the younger age exposed to breast cancer is the age of 15 and 18 years. The study aims to determine the influence of breast cancer counseling and breast-check training (SADARI) in an effort to improve the knowledge and skills of young women in the Act of SADARI for prevention and decrease in cases of breast cancer. This research uses Quasi-Experimental design. The research plan is one group before and after intervention design, or one group pre and posttest design. The population in this study is young women SMAN District ACEH Barat with samples amounting to 30 young women. The results of the study concluded that there was an effect of BSE Implementation (counseling about breast cancer and breast self-examination training) in an effort to increase the knowledge of young women about breast cancer and the skills of young women in breast self-examination.

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