Microcalcification-associated breast cancer: HER2-enriched molecular subtype is associated with mammographic features

2018 ◽  
pp. 20170942 ◽  
Author(s):  
Zhong Nie ◽  
Jian Wang ◽  
Xiao-chun Ji
Keyword(s):  
Breast Cancer ◽  
Tumor Size ◽  
Breast Tumor ◽  
Molecular Subtype ◽  
Univariate Analysis ◽  
Breast Cancers ◽  
Tumor Mass ◽  
Tumor Phenotype ◽  
Mass Lesions ◽  
Small Tumor Size

Purpose: To investigate whether the mammographic features were different between breast cancer HER2-enriched molecular subtype and non-HER2-enriched molecular subtype. Methods: 283 microcalcification-associated breast cancers were identified (HER2-enriched: n = 57; non-HER2-enriched: n = 226). Mammographic tumor mass and calcification features in relation to HER2 molecular subtype were analyzed. Results: On univariate analysis, HER2-enriched molecular subtype rates were significantly higher (a) in tumor size <= 2 cm 33 of 57 [57.9%]) than in tumor size >2 cm lesions (22 of 226 [9.7%]) (p = 0.007), (b) in non-spiculated mass 39 of 57 [68.4%]) than in spiculated mass lesions (18 of 226 [7.9%]) (p = 0.034)，(c) in calcifications extent >2 cm (41of 57 [71.9%]) lesions than in calcifications extent <= 2 cm lesions (16 of 226 [7.1%]) (p < 0.001)and (d) in calcification density ＞20/cm2 (44 of 57 [71.2%]) lesions than in calcification density <= 20/cm2 lesions (13 of 226 [5.8%]) (p = 0.034).On multivariate analysis, three mammographic features (tumor size >2 cm vs size⩽2 cm OR: 0.415 95% CI: 0.215 to 0.802, p = 0.009, spiculated mass vs non-spiculated mass OR: 0.226 95% CI: 0.114 to 0.446, p < 0.001 and calcifications extent >2 cm vs calcifications extent <= 2 cm OR: 7.754, 95% CI: 3.100 to 19.339P < 0.001) were independent predictors. Our results indicated that small tumor size, non-spiculated mass and calcification extent >2 cm are more likely to be HER2 molecular subtype. The discrimination of this model, as quantified by the AUC, was 0.751 (95%CI: 0.701 to 0.854). Conclusion: Our study presents a prediction model that incorporates the mammographic features of tumor size, non-spiculated mass and calcification extent, which can potentially be used to preoperative predict breast cancer HER2-enriched subtype. Advancesinknowledge: Mammographic features can noninvasively visualize breast tumor phenotype characteristics.

scholarly journals Study characteristics affecting the responses to neoadjuvant chemotherapy and the prognosis of patients with bilateral breast cancer: A retrospective analysis

2019 ◽  
Author(s):  
Zhenrong Tang ◽  
Yihua Wang ◽  
Luo Yang ◽  
Ling Chen ◽  
Yingzi Zhang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Survival Time ◽  
Tumor Size ◽  
Breast Tumor ◽  
Molecular Subtype ◽  
Clinical Stage ◽  
Axillary Lymph ◽  
Tumor Type ◽  
Survival Times ◽  
The Right

Abstract BackgroundBilateral breast cancer (BBC) is defined as breast cancer diagnosed in both breasts in the same patient. Neoadjuvant chemotherapy (NAC) is a well-established approach to evaluate the tumor response to chemotherapeutic agents. The consensus is that different responses in characteristics after NAC can affect prognosis in unilateral breast cancer (UBC), but little is known about the responses of the BBC to NAC. This analysis explored the characteristics that can affect the prognosis of patients with BBC.MethodsThe characteristics of patients diagnosed with BBC (n = 126) was collected and the immunohistochemistry staining was used to detect expression levels of estrogen receptor (ER), progesterone receptor (PR), Ki67, and HER2. A statistical analysis of the differences was performed to identify the factors that affect survival times in all patients with BBC.ResultsA logistic regression indicated that the status of sentinel and axillary lymph node, expression of PR of the right breast tumor, and molecular subtype of the right breast tumor might relate to survival times. Tumor size, status of axillary lymph node, clinical stage, tumor type, histological grade, and molecular subtype of the left breast tumor might have a more profound effect on the survival time than the right breast tumor in the synchronous breast cancer (SBBC) patients. A multivariate analysis of overall survival times in patients with metachronous breast cancer (MBBC) showed that age was the only factor affecting survival time. After NAC treatment in SBBC patients, the Kaplan-Meier survival estimate showed that a decrease in tumor size, clinical stage, Ki67 and P53 levels were positive for a prolonged life span. However, a decrease in ER, PR, and HER2 were negative for prolonged life span. Changes in tumor type and molecular subtype also influenced the survival time.ConclusionCharacteristic changes in the left breast tumor were significant factors affecting survival times in patients with SBBC. After NAC treatment, changes in tumor size, Ki67, P53, ER, PR, and HER2 might affect the prognosis of patients with SBBC. For MBBC, only age was a factor affecting survival time. These findings provide clinical insight for the treatment of patients with BBC.

scholarly journals Factors that influence ultrasound evaluation of breast tumor size

2019 ◽  
Vol 21 (2) ◽  
pp. 144 ◽  
Author(s):  
Jin Xu ◽  
Ge Ma ◽  
Mengdi Liang ◽  
Yue Wang ◽  
Hong Pan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Tumor Size ◽  
Breast Tumor ◽  
Core Biopsy ◽  
Molecular Subtype ◽  
Histological Grade ◽  
Breast Ultrasound ◽  
Tumor Type ◽  
Her2 Breast Cancer ◽  
Ultrasound Evaluation

Aims: To determine the factors influencing ultrasound breast tumor size assessment accuracy.Material and methods: Five factors (tumor type, molecular subtype, histological size, histological grade, and breast density) were used to assess the measurement accuracy of breast ultrasound in tumor size. Size underestimation was defined as ultrasound index lesion diameter < histological size by at least 5 mm.Results: Breast ultrasound underestimated tumor size significantly, especially in cases with intraductal components (p=0.002). There was a tendency for higher size underestimation in breast cancer tumors with high–histological grade (p=0.03), human epidermal growth factor receptor type 2 (HER2)-overexpressing breast cancer tumors (p=0.02) and hormone receptor (HR)−/HER2+ breast cancer tumors (p=0.008). Furthermore, core biopsy revealedhigher probability of size underestimation with intraductal components (p=0.002). Size underestimation was more frequent with larger histological size (p<0.001). Masses in non-dense breasts were significantly underestimated (p=0.036) compared to dense breasts.Conclusions: The size underestimation was influenced by pathological type, molecular subtype, and histological size. The pathological results of core biopsy were conducive for predicting tumor size pre-surgery in precise breast cancer diagnosis.

Clinicopathologic characteristics and survival outcomes in multifocal and multicentric breast cancer.

2013 ◽  
Vol 31 (26_suppl) ◽  
pp. 41-41
Author(s):  
Atsushi Fushimi ◽  
Atsushi Yoshida ◽  
Osamu Takahashi ◽  
Naoki Hayashi ◽  
Hiroshi Yagata ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Multivariate Analysis ◽  
Tumor Size ◽  
Univariate Analysis ◽  
Disease Free Survival ◽  
Survival Outcomes ◽  
Breast Cancers ◽  
Free Survival ◽  
The Impact ◽  
Disease Free

41 Background: Although multifocal and multicentric (MF/MC) breast cancers are a common entity, their clinical behaviors are not well characterized. We evaluated the impact of MF/MC on the disease-free survival (DFS) and distant disease free survival (DDFS) of breast cancer patients and compared clinicopathological characteristics between MF/MC breast cancers and breast cancers with single lesion. Methods: We retrospectively analyzed 734 consecutive patients who had invasive breast carcinoma and underwent definitive surgery at the St Luke’s International Hospital from January 2004 to December 2006. MF or MC ware defined as more than one lesion in the same quadrant or in separate quadrants, respectively. DDFS and DFS ware calculated by The Kaplan–Meier method. Univariate analysis was performed using the log rank test and multivariate analysis by Cox proportional hazards models. Results: Of 734 patients, 136 (18.5%) had MF/MC disease. MF/MC disease was associated with smaller tumor size (P <0.001). Multivariate analysis shows that MF/MC disease did not have an independent impact on DDFS or DFS adjusting by age, ER status, tumor size, lymphovascular invasion, lymph node metastases and nuclear grade. Conclusions: MF/MC breast cancers were not associated with poor prognostic factors, and were not independent predictors of worse survival outcomes. Our findings support the current TNM staging system of using the diameter of the largest lesion to assign T stage.

scholarly journals Evaluation of multiple transcriptomic gene risk signatures in male breast cancer

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Jane Bayani ◽  
Coralie Poncet ◽  
Cheryl Crozier ◽  
Anouk Neven ◽  
Tammy Piper ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Male Breast Cancer ◽  
Univariate Analysis ◽  
Gene Signature ◽  
Male Breast ◽  
Risk Scores ◽  
Breast Cancers ◽  
Academic Risk ◽  
Genomic Grade Index ◽  
Prognostic Utility

AbstractMale breast cancer (BCa) is a rare disease accounting for less than 1% of all breast cancers and 1% of all cancers in males. The clinical management is largely extrapolated from female BCa. Several multigene assays are increasingly used to guide clinical treatment decisions in female BCa, however, there are limited data on the utility of these tests in male BCa. Here we present the gene expression results of 381 M0, ER+ve, HER2-ve male BCa patients enrolled in the Part 1 (retrospective analysis) of the International Male Breast Cancer Program. Using a custom NanoString™ panel comprised of the genes from the commercial risk tests Prosigna®, OncotypeDX®, and MammaPrint®, risk scores and intrinsic subtyping data were generated to recapitulate the commercial tests as described by us previously. We also examined the prognostic value of other risk scores such as the Genomic Grade Index (GGI), IHC4-mRNA and our prognostic 95-gene signature. In this sample set of male BCa, we demonstrated prognostic utility on univariate analysis. Across all signatures, patients whose samples were identified as low-risk experienced better outcomes than intermediate-risk, with those classed as high risk experiencing the poorest outcomes. As seen with female BCa, the concordance between tests was poor, with C-index values ranging from 40.3% to 78.2% and Kappa values ranging from 0.17 to 0.58. To our knowledge, this is the largest study of male breast cancers assayed to generate risk scores of the current commercial and academic risk tests demonstrating comparable clinical utility to female BCa.

scholarly journals Outcome of multidisciplinary treatment of peripheral primitive neuroectodermal tumor

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Yidi Liu ◽  
Yan Yuan ◽  
Fuquan Zhang ◽  
Ke Hu ◽  
Jie Qiu ◽  
...  
Keyword(s):  
Overall Survival ◽  
Tumor Size ◽  
Therapeutic Approach ◽  
Univariate Analysis ◽  
Multidisciplinary Treatment ◽  
College Hospital ◽  
Small Tumor ◽  
Medical College ◽  
Treatment Plans ◽  
Small Tumor Size

Abstract Peripheral primitive neuroectodermal tumors (PNETs) constitute very rare and aggressive malignancies. To date, there are no standard guidelines for management of peripheral PNETs due to the paucity of cases arising in various body sites. Therapeutic approach is derived from Ewing sarcoma family, which currently remains multimodal. Our study retrospectively analyzed 86 PNET patients from February 1, 1998 to February 1, 2018 at Peking Union Medical College Hospital with an additional 75 patients from review of literature. The clinicopathologic and treatment plans associated with survival was investigated. Surgery, chemotherapy, female sex, small tumor size, no lymph node metastasis, R0 surgical resection, (vincristine + doxorubicin + cyclophosphamide)/(isophosphamide + etoposide) regimen, and more than 10 cycles of chemotherapy were associated with improved overall survival in univariate analysis. Surgery, more than 10 cycles of chemotherapy, and small tumor size were independent prognostic factors for higher overall survival. Our data indicates that multimodal therapy is the mainstay therapeutic approach for peripheral PNET.

Mammography and Morphobiologic Characteristics of Human Breast Cancer

1993 ◽  
Vol 79 (6) ◽  
pp. 422-426 ◽  
Author(s):  
Angelo Paradiso ◽  
Annita Mangia ◽  
Anna Barletta ◽  
Francesco Marzullo ◽  
Vincenzo Ventrella ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Proliferative Activity ◽  
Menopausal Status ◽  
Tumor Grade ◽  
Breast Cancers ◽  
Breast Cancer Patients ◽  
Tumor Mass ◽  
Premenopausal Patients ◽  
Clinical Interest ◽  
Mammographic Abnormality

Aims A comparative analysis was performed to verify a possible correlation between mammographic features and morphobiologic characteristics of the tumor in a series of 176 invasive primary breast cancer patients. Methods Breast cancers were grouped according to mammographic features as follows: tumor mass with spiculated borders; tumor mass with well-circumscribed borders; tumor with density alteration of parenchyma with no clear borders; a cluster of micro-calcifications as the only sign of tumor presence; tumor without mammographic abnormality. The tumor tissue biologic characteristics investigated were: hormone receptor content, tumor proliferative activity, DNA content and cytohlstologic tumor-grade differentiation. Results Spiculated tumors showed a significantly higher percentage of estrogen-receptorpositive cases with respect to circumscribed tumors, independently of the patient's menopausal status. Tumors with only microcalcifications were all from premenopausal patients and showed a significantly higher percentage of progesterone-receptor-positive cases (83 %). Tumor proliferative activity did not significantly differ in the 5 mammographic breast cancer groups; aneuploidy was less frequent in tumors with spiculated borders than in mammographic types (39 % vs 57 %; p = 0.05); percentages of G1-G2-G3 tumors did not differ significantly among the mammographic groups considered. Conclusions Certain relationships between mammographic features and biologic characteristics could be of potential clinical interest and stimulate more detailed studies on this issue.

Does Concomitant Chemoradiotherapy Influence Cosmetic Outcome in Conservative Treatment of Breast Cancer?

1997 ◽  
Vol 83 (4) ◽  
pp. 743-747 ◽  
Author(s):  
Gregorio Moro ◽  
Michele Stasi ◽  
Valeria Casanova Borca
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Conservative Treatment ◽  
Univariate Analysis ◽  
Conservative Surgery ◽  
Negative Influence ◽  
Cosmetic Outcome ◽  
Breast Cancers ◽  
Aesthetic Outcome ◽  
The Aesthetic

Purpose To evaluate retrospectively factors influencing the cosmetic outcome after conservative treatment for breast cancer. Material and methods From 1988 until 1992, 164 patients were treated with conservative surgery (quadrantectomy) and radiotherapy with 60Co (50 Gy on the whole breast) plus 10 Gy on the surgical bed (300 kV photons) for T1–T2 breast cancers; 46 patients (28%) received concomitant adjuvant chemotherapy (CMF schedule). Cosmesis evaluation was carried out after 24 to 108 months (median, 38 months). A logistic regression analysis was performed to identify independent variables influencing the aesthetic outcome. P values of 0.05 or less were considered significant. Results Univariate analysis showed that T2 versus T1 (P = 0.0102), lower quadrants site (P = 0.0002) and concomitant adjuvant chemotherapy (P = 0.0009) produced a worse aesthetic outcome. Multivariate analysis confirmed the same factors: tumor size (P = 0.0020), tumor site (P = 0.0150) and concomitant chemotherapy (P = 0.0024). Conclusions The significant negative influence on the cosmetic outcome of concomitant adjuvant chemotherapy implies questions about the timing of radiotherapy and chemotherapy in breast cancer conservative treatment.

scholarly journals Prognostic Impact of Stromal Immune Infiltration before and after Neoadjuvant Chemotherapy (NAC) in Triple Negative Inflammatory Breast Cancers (TNIBC) Treated with Dose-Dense Dose-Intense NAC

Cancers ◽  
2020 ◽  
Vol 12 (9) ◽  
pp. 2657
Author(s):  
Luca Campedel ◽  
Paul Blanc-Durand ◽  
Asker Bin Asker ◽  
Jacqueline Lehmann-Che ◽  
Caroline Cuvier ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Triple Negative ◽  
Univariate Analysis ◽  
Tumor Infiltrating Lymphocytes ◽  
Complete Response ◽  
Prognostic Impact ◽  
Breast Cancers ◽  
Dose Dense ◽  
The Impact

Inflammatory breast cancers are very aggressive, and among them, triple negative breast cancer (TNBC) has the worst prognosis. While many studies have investigated the association between tumor-infiltrating lymphocytes (TIL) before neoadjuvant chemotherapy (NAC) and outcome in TNBC, the impact of post-NAC TIL and TIL variation in triple negative inflammatory breast cancer (TNIBC) outcome is unknown. Between January 2010 to December 2018, all patients with TNIBC seen at the breast disease unit (Saint-Louis Hospital) were treated with dose-dense dose-intense NAC. The main objective of the study was to determine factors associated with event-free survival (EFS), particularly pathological complete response (pCR), pre- and post-NAC TIL, delta TIL and post-NAC lymphovascular invasion (LVI). After univariate analysis, post-NAC LVI (HR 2.06; CI 1.13–3.74; p = 0.02), high post-NAC TIL (HR 1.81; CI 1.07–3.06; p = 0.03) and positive delta TIL (HR 2.20; CI 1.36–3.52; p = 0.001) were significantly associated with impaired EFS. After multivariate analysis, only a positive TIL variation remained negatively associated with EFS (HR 1.88; CI 1.05–3.35; p = 0.01). TNIBC patients treated with intensive NAC who present TIL enrichment after NAC have a high risk of relapse, which could be used as a prognostic marker in TNIBC and could help to choose adjuvant post-NAC treatment.

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