scholarly journals Development of the predictive model for I stage breast cancer

2021 ◽  
Vol 17 (2) ◽  
pp. 14-22
Author(s):  
A. Kh. Ismagilov ◽  
A. S. Vanesyan ◽  
D. R. Khuzina

Objective: development of a predictive model based on binary regression to determine the likelihood of progression of I stage breast cancer.Materials and methods. A retrospective analysis of data of 385 patients with T1N0M0 stage breast cancer was performed. The minimum follow-up period was 120 months and the maximum made 256 months, with an average follow-up of 191 ± 36 months (16 ± 3 years). Using a forward stepwise selection (binary regression), the most important prognostic factors were selected, on the basis of which the predictive model “Risk Assessment Algorithm for Recurrence of Breast Carcinoma” was constructed.Results. During the study period, recurrence of stage I breast cancer was reported in 67 patients, representing 17.4 % of the total cohort. Five prognostic factors were selected by binary regression: grade, histological type, estrogen receptor expression, HER2 / neu overexpression and Ki-67 amplification. Kaplan–Meier analysis and Cox proportional hazards method demonstrated the influence of each of the selected factors on disease-free survival. Comparative analysis with other existing models showed that our prognostic model is inferior to Adjuvant! Online in terms of sensitivity (85 % ver- sus 95 %). However, it is superior in specificity (58 % versus 38 %), PPV (69 % versus 63 %) and AUC (84 % versus 70 %).Conclusions. In I stage breast cancer, factors such as grade, histological type, estrogen receptor expression, HER2 / neu overexpression and Ki-67 amplification are the most significant predictive factors influencing recurrence rates. The algorithm for assessing the risk of recurrence of stage I breast cancer can predict the risk of tumour progression with a sensitivity of 84 % and a specificity of 58 % (p <0.05).

2015 ◽  
Vol 68 (10) ◽  
pp. 839-843 ◽  
Author(s):  
Francisco E Vera-Badillo ◽  
Martin C Chang ◽  
Gordana Kuruzar ◽  
Alberto Ocana ◽  
Arnoud J Templeton ◽  
...  

BackgroundThe mechanisms underlying the favourable prognosis of androgen receptor (AR) expression in breast cancer are unknown.MethodsThe associations between the 21-gene recurrence score (RS), AR, grade, mitotic score, Ki-67 and estrogen receptor (ER) and progesterone receptor (PgR) expression were explored in sequential women with lymph node-negative, ER-positive and HER2-negative breast cancer. Statistical significance of this exploratory study was defined as p<0.10.ResultsAnalysis comprised 70 women. Most tumours had high AR expression (97% had scores >3). Median RS was 15 (range 1–53). AR expression showed a minimally significant positive correlation with ER (R=0.37), but no correlation with Ki-67 (R=−0.18). In univariable analysis, AR (p=0.01), ER (p<0.001) and PgR (p<0.001) had significant negative associations with RS. Ki-67 (p=0.16), grade (p=0.40) and mitotic score (p=0.23) showed no association with RS. Multivariable analysis showed similar associations.ConclusionsAR is associated with lower RS, but not with Ki-67.


2000 ◽  
Vol 196 (11) ◽  
pp. 753-759 ◽  
Author(s):  
Georg Wolf ◽  
Ralf Hildenbrand ◽  
Christian Schwar ◽  
Rainer Grobholz ◽  
Manfred Kaufmann ◽  
...  

2018 ◽  
pp. 1-7
Author(s):  
Nathan R. Brand ◽  
Ronald Wasike ◽  
Khalid Makhdomi ◽  
Rajendra Chauhan ◽  
Zahir Moloo ◽  
...  

Purpose The goal of this study was to describe the pathologic findings and early follow-up experience of patients who underwent a sentinel lymph node biopsy (SLNB) at Aga Khan University Hospital (AKUH) between 2008 and 2017. Patients and Methods We performed a retrospective analysis of women with breast cancer who underwent an SLNB at AKUH between 2008 and 2017. The SLNB was performed on patients with stage I and stage II breast cancer, and identification of the sentinel lymph node was made by radioactive tracer, blue dye, or both, per availability and surgeon preference. Demographic, surgical, and pathologic data, including immunohistochemistry of the surgical sample for estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2, were abstracted from the patient records. Follow-up data were available for a subset of patients. Results Between 2008 and 2017, six surgeons performed SLNBs on 138 women, 129 of whom had complete records and were included in the study. Thirty-one of 129 (24%) had a positive SLNB, including 10 of 73 (14%) with stage I and 21 of 56 (38%) with stage II disease. Seventy-eight patients (60%) received systemic adjuvant chemotherapy and 79 (62%) received radiation therapy, and of the 102 patients who were estrogen receptor positive, 86 (85%) received endocrine therapy. Seventy-nine patients were observed for > 2 years, and, of these, four (5.1%) had a regional recurrence. Conclusion The SLNB positivity rates were similar to those of high-income country (HIC) cohorts. However, preliminary data suggest that recurrence rates are elevated at AKUH as compared with those of HIC cohorts, perhaps because of a lower use of radiotherapy and chemotherapy at AKUH compared with HIC cohorts or because of differences in the characteristics of the primary tumor in patients at AKUH as compared with those in HICs.


2019 ◽  
Vol 2019 ◽  
pp. 1-8
Author(s):  
Young-Joon Kang ◽  
Han-Byoel Lee ◽  
Yun Gyoung Kim ◽  
JaiHong Han ◽  
Yumi Kim ◽  
...  

Objective. While the value of Ki-67 has been recognized in breast cancer, controversy also exists. The goal of this study is to show the prognostic value of Ki-67 according to progesterone receptor (PgR) expression in patients who have estrogen receptor- (ER-) positive, human epidermal growth factor receptor 2- (HER2-) negative early breast cancer. Methods. The records of nonmetastatic invasive breast cancer patients who underwent surgery at a single institution between 2009 and 2012 were reviewed. Primary end point was recurrence-free survival (RFS), and secondary end point was overall survival (OS). Ki-67 and PgR were assessed with immunohistochemistry for the tumor after surgery. Results. A total of 1848 patients were enrolled in this study. 223 (12%) patients had high (≥10%) Ki-67, and 1625 (88%) had low Ki-67 expression. Significantly worse RFS and OS were observed in the high vs. low Ki-67 expression only when the PgR was low (<20%) (p<0.001 and 0.005, respectively, for RFS and OS). There was no significant difference in RFS and OS according to Ki-67 when the PgR was high (p=0.120 and 0.076). RFS of four groups according to high/low Ki-67 and PgR expression was compared. The low PgR and high Ki-67 expression group showed worst outcome among them (p<0.001). In a multivariate analysis, high Ki-67 was an independent prognostic factor when the PgR was low (HR 3.05; 95% CI 1.50–6.19; p=0.002). Conclusions. Ki-67 had a value as a prognostic factor only under low PgR expression level in early breast cancer. PgR should be considered in evaluating the prognosis of breast cancer patients using Ki-67.


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