scholarly journals The frequency of demand and options for surgical treatment of breast cancer metastases in long and flat bones, depending on the histological subtype of the tumor

2021 ◽  
Vol 13 (3) ◽  
pp. 49-62
Author(s):  
A. A. Shaposhnikov ◽  
A. V. Lazukin ◽  
A. P. Ukhvarkin ◽  
V. V. Teplyakov
Keyword(s):  
Breast Cancer ◽  
Internal Fixation ◽  
Survival Rates ◽  
Pathologic Fracture ◽  
Luminal A ◽  
Her2 Positive ◽  
Breast Cancer Metastases ◽  
Metastatic Lesions ◽  
Cancer Metastases ◽  
Pathologic Fractures

Introduction. Bone metastases increase the risk of developing a pathological fracture, spinal cord compression, pain syndrome and require palliative, radiation therapy and oncoortopedic operations. The appearance of these metastases and the above complications is associated with an unfavorable prognosis and negatively affects the quality of life of patients.Objective – to analyze the outcomes of surgical treatment in patients with breast cancer metastases to long and flat bones and to identify an optimal surgical tactics depending on the morphological subtype of the tumor.Materials and methods. Between April 2015 and April 2021, a total of 731 patients with breast cancer and bone metastases were consulted in the departments of the Russian Research Center of Radiology, Ministry of Health of Russia. Two hundred and thirty patients (31.5 %) had indications for orthopedic surgery. This study included 78 patients with breast cancer metastases to long or flat bones. Of them, 50 individuals had metastases to bones only, whereas 28 participants additionally had metastases to other organs. Luminal A and B breast cancer was diagnosed in 27 patients (34.6 %) and 40 patients (51.2 %), respectively. Ten participants (12.8 %) were found to have HER2-positive tumors, whereas one patient (1.3 %) had triplenegative cancer.Results. Eighteen patients with metastatic lesions in long bones have undergone bone grafting; 17 patients had intramedullary internal fixation with osteoplasty; and 1 patient had extramedullary internal fixation with osteoplasty. Forty two patients with metastatic lesions in the flat bones have undergone 39 osteoplasty surgeries of the iliac bone, while 3 patients had osteoplasty surgeries of the sternum. The survival rates of patients with luminal A, luminal B, HER2- positive, and triple-negative breast cancer were as follows: 1-year survival – 95, 84, 87 and 100 %, respectively; 3-year survival – 83, 64, 23 and 0 %, respectively; 5-year survival – 66, 32, 23 and 0 %, respectively. Thirty-one patients were lost to follow-up between month 0 and month 46. Eighteen patients died between month 1 and month 58.Conclusion. Patients with luminal A and B breast cancer and threatened pathologic fracture should undergo intramedullary/extramedullary internal fixation, while for patients who already developed pathologic fracture and their estimated life expectancy does not exceed 1 months, it is recommended to perform bone grafting regardless of the tumor immunohistochemical type. Patients with threatened pathologic fractures demonstrated a more favorable prognosis, better functional status, and higher survival rates than patients with pathologic fractures: 1-year survival was 90 and 87 %, respectively; 3-year survival was 67 and 58 %, respectively, and 5-year survival was 54 and 0 %, respectively. Radiation therapy increases the risk of pathological fractures, but is not a contraindication for orthopedic surgery.

scholarly journals Evaluation of the HER2 and Hormone Receptor Status in Metastatic Breast Cancer Using Cell Blocks: A Multi-Institutional Study

2018 ◽  
Vol 62 (4) ◽  
pp. 288-294 ◽  
Author(s):  
Rieko Nishimura ◽  
Yuya Murata ◽  
Kiyoshi Mori ◽  
Katsushige Yamashiro ◽  
Kazuya Kuraoka ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Hormone Receptors ◽  
Growth Factor Receptor ◽  
Metastatic Breast ◽  
Routine Practice ◽  
Her2 Positive ◽  
Her2 Protein ◽  
Breast Cancer Metastases ◽  
Cancer Metastases ◽  
Epidermal Growth

Objective: We explore the problems associated with the cell block (CB) method for receptor analysis in breast cancer metastases and propose a method for reporting the results. Study Design: Nine institutions used the CB method for the analysis of hormone receptors (HRs) and HER2 (human epidermal growth factor receptor 2) protein in cytological specimens of breast cancer metastases in routine practice. The stained slides were independently evaluated by 8 pathologists. Dual in situ hybridization assay was performed in cases of discordant results for HER2 protein. Based on the results, we propose a method for receptor scoring in the CB method. Results: Of 61 specimens, 57 contained tumor cells. Two or more pathologists disagreed on the results for the estrogen receptor, progesterone receptor, and HER2 protein in 3 (5.3%), 13 (22.8%), and 19 (33.3%) cases, respectively. The discrepant results for the HRs were attributed to the presence of a few positive cells or faintly stained cells. The high interobserver discordance rate for HER2 protein was explained by interobserver differences in the scoring criteria. Conclusion: The use of categorical scoring into positive and negative is recommended for evaluating the HR expressions. Use of strict criteria for HER2 protein 2+ and 3+ cases is recommended, as HER2-positive cases should not be missed.

scholarly journals Stereotactic radiotherapy of breast cancer liver metastases

2021 ◽  
Vol 67 (3) ◽  
pp. 382-390
Author(s):  
Sergei Tkachev ◽  
Sevil Alieva ◽  
Sergey Medvedev ◽  
Aleksei Nazarenko ◽  
Denis Romanov ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Liver Metastases ◽  
Cancer Patients ◽  
Stereotactic Radiotherapy ◽  
Survival Rates ◽  
Breast Cancer Patients ◽  
Breast Cancer Metastases ◽  
Cancer Metastases ◽  
Breast Cancer Liver Metastases

Stereotactic body radiation therapy currently occupies its place in the complex treatment of cancer patients with liver metastases. It is assumed that certain groups of patients with breast cancer can benefit from the use of this method, which can be converted into improved overall survival and survival rates without signs of progression of the process. Purpose of the study was to evaluate the efficacy and tolerability of stereotactic radiotherapy in patients with breast cancer metastases in the liver. We have analyzed the results of using stereotactic radiotherapy in 25 breast cancer patients with 43 liver metastases. The treatment was carried out in 3 fractions with a fraction dose of 10-15 Gy and a total dose of 30-45 Gy. Growth of the irradiated lesions was recorded only in 1 case out of 43 metastases (2,3%) and 25 (4%) patients. 1-, 3- and 5-year overall survival rates from the moment of stereotactic radiotherapy were 82,9%, 62% and 38,7%, respectively. Long-term post-radiation adverse events were observed in 8% of cases and did not have a significant effect on the quality of life and the possibility of antitumor treatment. So stereotactic radiotherapy can be recommended as a relatively safe and highly effective method of elimination of breast cancer liver metastases. Taking into account the high achieved local control, further studies on dose escalation in this group of patients are not required.  

scholarly journals Real-world, single-centre prospective data of age at breast cancer onset: focus on survival and reproductive history

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e041706
Author(s):  
Peeter Karihtala ◽  
Anniina Jääskeläinen ◽  
Nelli Roininen ◽  
Arja Jukkola
Keyword(s):  
Breast Cancer ◽  
Cancer Diagnosis ◽  
Survival Rates ◽  
Age Groups ◽  
Metastatic Breast ◽  
Breast Cancer Diagnosis ◽  
University Hospital ◽  
Luminal A ◽  
Her2 Positive ◽  
Luminal B

ObjectivesBeing either young or old at the time of breast cancer diagnosis has been suggested as an indicator of a poor prognosis. We studied the effect of age at breast cancer onset in relation to survival, focusing in particular on biological subtypes and reproductive anamnesis.Design, setting and participantsPatients with early breast cancer (n=594) treated in a Finnish University Hospital during 2003–2013 were prospectively collected and followed in median 102 months.ResultsPatients with luminal A-like breast cancer were older than the patients with luminal B-like (HER2-positive) (p=0.045) or patients with the HER2-positive (non-luminal) subtype (p=0.029). Patients ≥70 years received substantially less adjuvant chemotherapy (p=1.5×10−9) and radiotherapy (p=5.9×10−7) than younger women. Nevertheless, the estimated 10-year breast cancer-specific rates of survival were 84.2%, 92.9% and 87.0% in age groups <41 years, 41–69 years and ≥70 years, respectively, with no statistical difference (p=0.115). Survival rates were also comparable between the three age groups when assessed separately in different biological subtypes, and for patients with metastatic breast cancer there was similarly no difference between the age groups. Later menarche (p=5.7×10−8) and high parity (p=0.000078) correlated with increased age at breast cancer diagnosis, but, according to the patients’ oestrogen receptor (ER) status, only among ER-positive patients.ConclusionsDespite the suggested undertreatment of older patients, we report excellent long-term outcomes in all age groups in this prospective cohort. Later endogenous endocrine exposure may cause delay in breast cancer onset, but the exact biology behind this phenomenon is so far unclear.

Liver Surgery for Breast Cancer Metastases

2009 ◽  
Vol 69 (05) ◽  
Author(s):  
EC Schest ◽  
H Cerwenka ◽  
A El-Shabrawi ◽  
H Bacher ◽  
HJ Mischinger
Keyword(s):  
Breast Cancer ◽  
Liver Surgery ◽  
Breast Cancer Metastases ◽  
Cancer Metastases

Deprivation of the vitamin D receptor (VDR) fuels breast cancer metastases to bone

2019 ◽  
Author(s):  
K Horas ◽  
M Abraham ◽  
F Jakob ◽  
R Ebert ◽  
G Maier ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Vitamin D ◽  
Vitamin D Receptor ◽  
Breast Cancer Metastases ◽  
Cancer Metastases

Olfactomedin-like 2A, 2B and 3 are differentially expressed in breast cancer metastases.

2019 ◽  
Author(s):  
Shahan Mamoor
Keyword(s):  
Breast Cancer ◽  
Genetically Engineered ◽  
Differentially Expressed ◽  
Genetically Engineered Mouse Models ◽  
Breast Cancer Metastases ◽  
Multiple Datasets ◽  
Cancer Metastases ◽  
Distant Organ ◽  
Metastatic Process ◽  
Differential Gene

Differential gene expression analysis of multiple datasets, in mice and in men revealed that transcripts of the olfactomedin-like family are differentially expressed in metastases, both in patients with breast cancer and in genetically engineered mouse models of breast cancer. The expression of olfactomedin-like genes was perturbed in metastases to the bone, brain and the lung, suggesting that these molecules function in the metastatic process rather than having tissue-specific associations with the site of dissemination. The olfactomedin-like family may play a role in the progression of breast cancer from frank tumor to colonization of distant organ sites.

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