scholarly journals Clinical Impact of Delaying Surgery in Patients Undergoing Neoadjuvant Chemotherapy on Breast Cancer Recurrence and Survival

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 70s-70s
Author(s):  
J. Lin ◽  
L. Anna
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Neoadjuvant Chemotherapy ◽  
Cancer Recurrence ◽  
Disease Free Survival ◽  
Optimal Time ◽  
Study Cohort ◽  
Free Survival ◽  
Time To Surgery ◽  
Kaplan Meier

Background: For patients with breast cancer, the optimal time of surgery after completion of neoadjuvant chemotherapy (NAC) is unknown. Aim: We evaluated the association between time to surgery after NAC completion and disease free survival (DFS) and overall survival (OS). Methods: Women diagnosed with breast cancer stages I to III between 2013-2016 who received NAC at our institution were included. Patients were categorized into two groups according to time to surgery after completion of NAC ≤ 60 days, and > 60 days. Survival outcomes were estimated and compared according to time to surgery after NAC completion. Statistical analysis was done using the Kaplan-Meier estimate. Groups were then compared by log rank. Results: In total, 58 patients treated with NAC were included in the study. The median interval to surgery after completion of NAC was 29 days. Five-year DFS was 82% for patients with surgery < 60 days and 63% for patients with surgery > 60 days after NAC completion (log rank z=2.32, P = 0.02). A surgery date of > 60 days after NAC completion was associated with shorter DFS. Five-year OS was 89% for patients with surgery < 60 days and 90% for patients > 60 days after NAC completion (log rank z=0.14, P = 0.89). A surgery date of > 60 days after NAC completion was not associated with a poorer overall survival. Conclusion: Time to surgery after completion of NAC influenced recurrence outcomes but not overall survival in our study cohort. Our findings suggest that the timing of surgery after completion of NAC is crucial for recurrence, but not survival, for patients undergoing NAC.

scholarly journals Association between the Dietary Inflammatory Index and Risk for Cancer Recurrence and Mortality among Patients with Breast Cancer

Nutrients ◽  
2018 ◽  
Vol 10 (8) ◽  
pp. 1095 ◽  
Author(s):  
Hyeonjeong Jang ◽  
Min Chung ◽  
Shin Kang ◽  
Yongsoon Park
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Cancer Recurrence ◽  
Disease Free Survival ◽  
Dietary Inflammatory Index ◽  
Free Survival ◽  
Inflammatory Index ◽  
Node Metastasis ◽  
Disease Free ◽  
Overall Mortality

The dietary inflammatory index (DII) has been associated with breast cancer incidence and survival. However, the association between DII and cancer recurrence and mortality among patients with breast cancer has not been investigated. Therefore, the present study aimed to investigate whether DII was positively associated with risk for cancer recurrence and overall mortality among patients with breast cancer. Among 511 women (51.9 ± 10.7 years; stage 0–3) who underwent breast cancer surgery, 88 had cancer recurrence, and 44 died during follow–up until 213 months (average disease free survival of 84.3 ± 42.4 months and overall survival of 69.3 ± 38.9 months). The DII assessed after surgery (5.4 ± 5.2 months after diagnosis) was significantly higher in patients with recurrence than those without recurrence, and Cox proportional hazards regression analysis showed that it was positively associated with the risk for cancer recurrence (hazard ratio (HR) 2.347, confidence interval (CI) 1.17–4.71) and overall mortality (HR 3.049, CI 1.08–8.83) after adjusting for confounding factors. Disease-free survival and overall survival rates were significantly lower in patients with higher DII scores. In addition, the DII was positively associated with the risk for cancer recurrence according to prognostic factors, such as age (<50 years), premenopausal status, body mass index (≥25 kg/m2), HR+, tumor size (>2 cm), and presence of lymph node metastasis. The present study showed that anti-inflammatory diets may decrease the risk of cancer recurrence and overall mortality in patients with breast cancer, particularly those with prognostic factors, such as younger age, premenopausal status, obesity, HR+ breast cancer, tumor size >2 cm, and presence of lymph node metastasis.

Single-center experiences of neoadjuvant systemic therapy in breast cancer: Individualization of the treatment

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e11628-e11628
Author(s):  
M. Gumus ◽  
B. O. Ustaalioglu ◽  
M. Seker ◽  
A. Bilici ◽  
T. Salman ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Survival Rate ◽  
Neoadjuvant Chemotherapy ◽  
Distant Metastasis ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
Disease Free Survival ◽  
Free Survival ◽  
Disease Free

e11628 Background: Neoadjuvant chemotherapy is one of the standard treatment options for patients with locally advanced breast cancer for twenty five years. In this study, we evaluate results of neoadjuvant chemotherapy in breast cancer patients. Methods: We retrospectively analyzed 68 patients with locally advanced breast cancer. Anthracycline/taxane-based chemotherapy regimens were prescribed mostly for neoadjuvant chemotherapy. Before chemotherapy was given, patients were examined for distant metastasis by radiologic methods thereafter if patient had distant metastasis, they were excluded. Patients with breast cancer received neoadjuvant chemotherapy were analyzed according to age, menopausal status, type of surgery, response to the treatment, histopathological properties and survival. After 3 to 6 cycle of chemotherapy patients were reevaluated by clinically and radiologically for response. Surgery was performed for appropriate patient thereafter adjuvant locoregional and systemic chemotherapy were continued. Results: Median age was 47 (29–43) years. 17,6 % of them were younger than 35 years and 42,6 % were premenopausal. Median follow-up time was 19 month. After 3 to 6 cycle of neoadjuvant chemotherapy 64 of patients responded to therapy (94,1 %). Breast conserving surgery was performed for 15,6 % patients. In histopathologic analysis most of patients were invasive ductal carcinoma and there was lymph node invasion for 84,9 %. Estrogen and progesterone receptor status were negative for 18,6 % of patients and cerbB2 was positive for 14,8 % of patients. Median disease free survival time was 44 month (SE: 9; 95% CI: 25–62) but median overall survival time could not be reached. Three years disease free survival rate and overall survival rate were 55,3% and 90,1% respectively. According to Cox regression analyses; we did not find any demographic and pathologic characteristic of breast cancer that is related to prognosis. Conclusions: In recent years neoadjuvant chemotherapy in breast cancer is increasingly being used for early stage disease. Further study will be facilitated establishment of guidelines for preselecting patients for neoadjuvant chemotherapy and will provide beneficial effect on treatment option and survival. No significant financial relationships to disclose.

Locoregional Control of Clinically Diagnosed Multifocal or Multicentric Breast Cancer After Neoadjuvant Chemotherapy and Locoregional Therapy

2006 ◽  
Vol 24 (31) ◽  
pp. 4971-4975 ◽  
Author(s):  
Julia L. Oh ◽  
Mark J. Dryden ◽  
Wendy A. Woodward ◽  
Tse-Kuan Yu ◽  
Welela Tereffe ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Neoadjuvant Chemotherapy ◽  
Breast Conservation ◽  
Disease Free Survival ◽  
Locoregional Control ◽  
Locoregional Therapy ◽  
Cancer Center ◽  
Free Survival ◽  
Disease Free

Purpose The purpose was to assess whether patients with clinical multifocal or multicentric (MFMC) breast cancer determined by mammogram, ultrasound, or physical examination have inferior outcome compared with patients with clinical unicentric lesions. Patients and Methods We retrospectively analyzed 706 consecutive patients with stages I-III breast cancer treated at the M.D. Anderson Cancer Center (Houston, TX) from 1976 to 2003 who received neoadjuvant anthracycline-based chemotherapy followed by breast conservation therapy (BCT), mastectomy alone, or mastectomy plus postmastectomy radiation therapy. Results The mean follow-up was 66 months. At presentation, 97 of 706 patients had clinically MFMC disease (13.7%). The 5-year rate of locoregional failure was 10% for unicentric disease compared with 7% for MFMC disease (P = .78). Subset analyses of patients by treatment groups confirmed no statistical difference in locoregional control regardless of the type of locoregional treatment. Among patients with multifocal disease treated with BCT, there were no in-breast recurrences and one supraclavicular recurrence. Five-year disease-free survival and overall survival was equivalent between patients with MFMC and unicentric breast cancers. Conclusion Patients with clinical MFMC breast cancer at the time of diagnosis treated with neoadjuvant chemotherapy followed by locoregional therapy have similar 5-year rates of locoregional control, disease-free survival, and overall survival as those with unicentric disease. Clinically detected MFMC disease did not predict for inferior outcome.

Is Surgery Necessary After Complete Clinical Remission Following Neoadjuvant Chemotherapy for Early Breast Cancer?

2003 ◽  
Vol 21 (24) ◽  
pp. 4540-4545 ◽  
Author(s):  
A. Ring ◽  
A. Webb ◽  
S. Ashley ◽  
W.H. Allum ◽  
S. Ebbs ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Local Recurrence ◽  
Neoadjuvant Chemotherapy ◽  
Disease Free Survival ◽  
Free Survival ◽  
Surgery Group ◽  
Complete Clinical Remission ◽  
Radiotherapy Alone ◽  
Disease Free

Purpose: This retrospective analysis aimed to identify whether breast cancer patients receiving radiotherapy alone following a complete clinical remission (cCR) to neoadjuvant chemotherapy had a worse outcome than those treated with surgery. Patients and Methods: One hundred thirty-six patients who had achieved a cCR to neoadjuvant chemotherapy for early breast cancer were identified from a prospectively maintained database of 453 patients. Of these, 67 patients had undergone surgery as their primary locoregional therapy, and 69 patients had radiotherapy alone. Outcome was assessed in relation to local recurrence-free survival, disease-free survival, and overall survival. Results: Median follow-up was 63 months in the surgery group and 87 months in the no surgery group. Prognostic characteristics were well balanced between the two groups. For surgery and no surgery, respectively, there were no significant differences in disease-free survival or overall survival (5-year, 74% v 76%; 10-year, 60% v 70%, P = .9) between the two groups. There was a nonsignificant trend toward increased locoregional-only recurrence for the no surgery group (21% v 10% at 5 years; P = .09), but no long-term failures of local control. Patients in the no surgery group who also achieved an ultrasound complete remission had a 5-year local recurrence rate of only 8%. Conclusion: In patients achieving a cCR to neoadjuvant chemotherapy, radiotherapy alone achieve survival rates as good as with surgery, but with higher local recurrence rates. Ultrasound may identify a low recurrence rate subgroup for assessing no surgery in a prospective trial.

scholarly journals Analisis Survival Pasien Kanker Payudara Usia Muda di RSUP DR. M. Djamil Padang Tahun 2008-2017

2018 ◽  
Vol 7 ◽  
pp. 25
Author(s):  
M. Al Farisyi ◽  
Daan Khambri
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Triple Negative Breast Cancer ◽  
Triple Negative ◽  
Disease Free Survival ◽  
Free Survival ◽  
Kaplan Meier ◽  
Disease Free

semua wanita yang didiagnosa kanker payudara. KPD usia muda berhubungan dengan progresifitas yang tinggi, kecenderungan untuk rekurensi dan prognosis yang lebih buruk dibandingkan KPD usia tua. Penelitian ini bertujuan untuk menilai outcome dari pasien KPD usia muda yang mendapatkan pengobatan di RSUP Dr. M. Djamil Padang dari tahun 2008-2017. Desain penelitian ini adalah kohort retrospektif dengan analisis data menggunakan Kaplan Meier dengan Log Rank, pada 71 pasien yang telah didiagnosis KPD secara histopatologi dan mendapatkan terapi (bedah, kemoterapi, radioterapi, hormonal terapi ataupun targetting terapi). Hasil penelitian menunjukkan insiden KPD terbanyak pada range usia 35-40 tahun, dengan ukuran tumor T3, diferensiasi derajat sedang, histopatologi tipe duktal karsinoma dengan Triple Negative Breast Cancer (TNBC) sebagai subtipe yang terbanyak. Disease Free Survival (DFS) didapatkan rata-rata 87.48 bulan dan Overall Survival (OS) sebesar 79.13 bulan. Ukuran tumor didapatkan sebagai faktor yang berhubungan terhadap DFS (p = 0.00).

Neoadjuvant Chemotherapy with Taxotere-Epirubicin-5-Fluorouracil (TEF) in Local-Regionally Advanced Breast Cancer: A Preliminary Report

2002 ◽  
Vol 88 (6) ◽  
pp. 474-477 ◽  
Author(s):  
Eşmen Baltali ◽  
M Kadri Altundağ ◽  
Demir Ali Onat ◽  
Osman Abbasoğlu ◽  
Yavuz Özişik ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Neoadjuvant Chemotherapy ◽  
Advanced Breast Cancer ◽  
Chemotherapy Regimen ◽  
Disease Free Survival ◽  
Advanced Breast ◽  
Free Survival ◽  
The Mean ◽  
Disease Free

Aims and background Sixty-three patients with local-regionally advanced breast cancer were treated with neoadjuvant chemotherapy consisting of docetaxel (Taxotere), epirubicin, and 5-fluorouracil (TEF). Methods and study design Preoperatively, patients received four cycles of Taxotere (80 mg/m2), epirubicin (60 mg/m2), and 5-fluorouracil (500 mg/m2), repeated every 21 days. Following completion of four cycles of chemotherapy, appropriate surgery was performed. After the surgery, patients received one cycle of the TEF chemotherapy regimen; following chemotherapy, radiotherapy was applied, and at the end two more cycles of TEF chemotherapy regimen were given. Results Sixty-three patients with locally advanced breast cancer were treated. Three patients were excluded from the study before the evaluation of response. Median age of the patients was 50 years (range, 25–77). Twenty-seven and 33 patients were premenopausal and postmenopausal, respectively. Thirty-nine patients were in stage IIIA and 21 in stage IIIB. Complete and partial responses were observed in 15 (25%) and 42 (70%) of the patients following four cycles of preoperative TEF chemotherapy regimen, respectively. Overall response was 95%, and primary lesion progressed only in 3 (5%) patients. The mean disease-free survival was 15.9 ± 6.8 (range, 3.5–28) months and the mean overall survival was 18.6 ± 7.2 (range, 5–30) months. The most frequent side effects were nausea-vomiting, mucositis, alopecia and leukopenia. Conclusions TEF therapy is a treatment with a high overall response rate and toxicities similar to other taxotere combinations. A longer follow-up of patients is necessary for the determination of disease-free survival and overall survival.

scholarly journals Disease-free and overall survival after neoadjuvant chemotherapy in breast cancer: breast-conserving surgery compared to mastectomy in a large single-centre cohort study

2020 ◽  
Author(s):  
Janine M. Simons ◽  
Julien G. Jacobs ◽  
Joost P. Roijers ◽  
Maarten A. Beek ◽  
Leandra J. M. Boonman-de Winter ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Neoadjuvant Chemotherapy ◽  
Pathologic Complete Response ◽  
Multivariable Analysis ◽  
Disease Free Survival ◽  
Breast Conserving Surgery ◽  
Prognostic Indicators ◽  
Free Survival ◽  
Disease Free

Abstract Purpose The extended role of breast-conserving surgery (BCS) in the neoadjuvant setting may raise concerns on the oncologic safety of BCS compared to mastectomy. This study compared long-term outcomes after neoadjuvant chemotherapy (NAC) between patients treated with BCS and mastectomy. Methods All breast cancer patients treated with NAC from 2008 until 2017 at the Amphia Hospital (the Netherlands) were included. Disease-free and overall survival were compared between BCS and mastectomy with survival functions. Multivariable Cox proportional hazard regression was performed to determine prognostic variables for disease-free survival. Results 561 of 612 patients treated with NAC were eligible: 362 (64.5%) with BCS and 199 (35.5%) with mastectomy. Median follow-up was 6.8 years (0.9–11.9). Mastectomy patients had larger tumours and more frequently node-positive or lobular cancer. Unadjusted five-year disease-free survival was 90.9% for BCS versus 82.9% for mastectomy (p = .004). Unadjusted five-year overall survival was 95.3% and 85.9% (p < .001), respectively. In multivariable analysis, clinical T4 (cT4) (HR 3.336, 95% CI 1.214–9.165, p = .019) and triple negative disease (HR 5.946, 95% CI 2.703–13.081, p < .001) were negative predictors and pathologic complete response of the breast (HR 0.467, 95% CI 0.238–0.918, p = .027) and axilla (HR 0.332, 95% CI 0.193–0.572, p = .001) were positive predictors for disease-free survival. Mastectomy versus BCS was not a significant predictor for disease-free survival when adjusted for the former variables (unadjusted HR 2.13 (95%CI: 1.4–3.24), adjusted HR 1.31 (95%CI: 0.81–2.13)). In the BCS group, disease-free and overall survival did not differ significantly between cT1, cT2 or cT3 tumours. Conclusion BCS does not impair disease-free and overall survival in patients treated with NAC. Tumour biology and treatment response are significant prognostic indicators.

Greater negative lymph node count predicts favorable survival of patients with breast cancer in the setting of neoadjuvant chemotherapy and mastectomy

2019 ◽  
Vol 15 (32) ◽  
pp. 3701-3709 ◽  
Author(s):  
Xin Wang ◽  
Zhenzhen Yin ◽  
Daquan Wang ◽  
Jiaqi Zhang ◽  
Shuai Wang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Lymph Node ◽  
Neoadjuvant Chemotherapy ◽  
Malignant Tumors ◽  
Survival Rates ◽  
Disease Free Survival ◽  
Free Survival ◽  
Lymph Node Count ◽  
Disease Free

Aim: Adequate lymph node evaluation is recommended in patients with malignant tumors. However, the role of negative lymph nodes (NLNs) remains unclear in breast cancer (BC), especially in patients who have received neoadjuvant chemotherapy and mastectomy. Materials & methods: A total of 435 patients were included in the analysis. On multivariate analysis, NLN count was an independent predictor of 5 year disease-free survival and 5 year overall survival. Results: Patients with NLN count <10 showed significantly worse 5 year disease-free survival than those with NLN count ≥10 (34.8 and 78.2%; p = 0.000); the corresponding 5 year overall survival rates were also significantly different (52.0 and 82.7%; p = 0.000). Conclusion: This is the first study that confirms the relationship between NLN count and prognosis of patients in the setting of neoadjuvant chemotherapy and mastectomy. More NLNs imply better prognosis.

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