scholarly journals Impact of Pre-Operative Breast Magnetic Resonance Imaging (MRI) on Contralateral Synchronous and Metachronous Breast Cancer Detection- A Case Control Comparison Study With Mean Follow-Up of 102 Months.

2021 ◽  
Author(s):  
Wen-Pei Wu ◽  
Chih-Yu Chen ◽  
Chih-Wei Lee ◽  
Hwa-Koon Wu ◽  
Shou-Tung Chen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Detection ◽  
Contralateral Breast Cancer ◽  
Breast Mri ◽  
Contralateral Breast ◽  
Conventional Imaging ◽  
Metachronous Breast Cancer ◽  
Group B ◽  
Synchronous Breast Cancer

Abstract Background: Women with unilateral breast cancer are at an increased risk for the development of contralateral breast cancers. We hypothesis that combined breast MRI would detect more contralateral synchronous breast cancer than conventional imaging alone, and resulted in less contralateral metachronous breast cancer during follow-up. Methods: In this case control analysis, we retrospectively collected two groups of patients for evaluating the effectiveness and value of adding pre-operative breast MRI to conventional breast images (mammography and sonography) for detection of contralateral synchronous breast cancer. The new metachronous contralateral breast cancer diagnosed during follow-up was prospectively evaluated and compared. Results: Group A (n=733) comprised patients who underwent conventional preoperative imaging and group B (n=735) combined with MRI were enrolled and compared. Seventy (9.5%) of the group B patients were found to have contralateral lesions detected by breast MRI, and 65.7% of these lesions only visible with MRI. The positive predictive value of breast MRI detected contralateral lesions was 48.8%. With the addition of breast MRI to conventional imaging studies, more surgical excisions were performed in contralateral breasts (6% (44/735) versus 1.4% (10/733), P< 0.01), more synchronous contralateral breast cancer detected (2.9% (21/735) versus 1.1% (8/733), P=0.02), and resulted in numerical less (2.2% (16/714) versus 3% (22/725), p=0.3) metachronous contralateral breast cancer during a mean follow-up of 102 months. Conclusions: Combining pre-operative breast MRI evaluation resulted in an increase of contralateral synchronous breast cancer detection, and a numerical less subsequent contralateral metachronous breast cancer occurrence compared to conventional imaging alone.

scholarly journals Impact of pre-operative breast magnetic resonance imaging on contralateral synchronous and metachronous breast cancer detection—A case control comparison study with 1468 primary operable breast cancer patients with mean follow-up of 102 months

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0260093
Author(s):  
Wen-Pei Wu ◽  
Chih-Yu Chen ◽  
Chih-Wei Lee ◽  
Hwa-Koon Wu ◽  
Shou-Tung Chen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Contralateral Breast Cancer ◽  
Breast Mri ◽  
Contralateral Breast ◽  
Conventional Imaging ◽  
Breast Cancer Patients ◽  
Metachronous Breast Cancer ◽  
Group B ◽  
Synchronous Breast Cancer

Background Women with unilateral breast cancer are at an increased risk for the development of contralateral breast cancers. We hypothesis that combined breast MRI would detect more contralateral synchronous breast cancer than conventional imaging alone, and resulted in less contralateral metachronous breast cancer during follow-up. Methods We retrospectively collected two groups of breast cancer patients diagnosed from 2009 to 2013 for evaluating the effectiveness and value of adding pre-operative breast MRI to conventional breast images (mammography and sonography) for detection of contralateral synchronous breast cancer. The new metachronous contralateral breast cancer diagnosed during follow-up was prospectively evaluated and compared. Results Group A (n = 733) comprised patients who underwent conventional preoperative imaging and group B (n = 735) combined with MRI were enrolled and compared. Seventy (9.5%) of the group B patients were found to have contralateral lesions detected by breast MRI, and 65.7% of these lesions only visible with MRI. The positive predictive value of breast MRI detected contralateral lesions was 48.8%. With the addition of breast MRI to conventional imaging studies, more surgical excisions were performed in contralateral breasts (6% (44/735) versus 1.4% (10/733), P< 0.01), more synchronous contralateral breast cancer detected (2.9% (21/735) versus 1.1% (8/733), P = 0.02), and resulted in numerical less (2.2% (16/714) versus 3% (22/725), p = 0.3) metachronous contralateral breast cancer during a mean follow-up of 102 months. Conclusions Our study provides useful estimates of the pre-operative breast MRI for the increased detection of contralateral synchronous breast cancer and less subsequent contralateral metachronous breast cancer.

scholarly journals MRI Evaluation of the Contralateral Breast in Women with Recently Diagnosed Breast Cancer: 2-Year Follow-up

2019 ◽  
Vol 2 (1) ◽  
pp. 50-55
Author(s):  
Nanette D Debruhl ◽  
Su-Ju Lee ◽  
Mary C Mahoney ◽  
Lucy Hanna ◽  
Catherine Tuite ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Contralateral Breast Cancer ◽  
Diagnostic Yield ◽  
Study Participant ◽  
Breast Mri ◽  
Contralateral Breast ◽  
Unilateral Breast Cancer

Abstract Objective The American College of Radiology Imaging Network Trial 6667 showed that MRI can detect cancer in the contralateral breast that is missed by mammography and clinical examination at the time of the initial breast cancer diagnosis, based on 1-year follow-up. This study is a continuation of the trial that evaluates the diagnostic accuracy of MRI for contralateral breast cancer after 2 years of follow-up. Methods In total, 969 women with a diagnosis of unilateral breast cancer and no clinical or imaging abnormalities in the contralateral breast underwent breast MRI. The cancer status of all participants was monitored for 2 years after the initial MRI. Follow-up included documentation of any clinical, imaging, or interventional procedures performed. A study participant was considered positive for cancer if she had a tissue diagnosis of in situ or invasive breast cancer in the contralateral breast within 730 days of her initial MRI. Results Three additional cancers were diagnosed in the study population in the second year of the trial. The diagnostic yield for MRI for the 2-year period was 3% (31/969). After 2 years of follow-up, breast MRI has a sensitivity of 86% and specificity of 88% for detection of contralateral breast cancer. Its negative predictive value was 99%, and its positive predictive value was 22%. These values did not change significantly from the 1-year data. Conclusion A negative contralateral breast MRI has a very high and reliable negative predictive value over 2 years, and, therefore, is helpful in managing and counseling patients during the period of initial diagnosis and early treatment.

scholarly journals Risk of contralateral breast cancer according to first breast cancer characteristics among women in the USA, 1992–2016

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Cody Ramin ◽  
Diana R. Withrow ◽  
Brittny C. Davis Lynn ◽  
Gretchen L. Gierach ◽  
Amy Berrington de González
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Cumulative Incidence ◽  
Contralateral Breast Cancer ◽  
Breast Cancer Treatment ◽  
Contralateral Breast ◽  
Breast Cancer Patients ◽  
Younger Women ◽  
Er Positive

Abstract Background Estimates of contralateral breast cancer (CBC) risk in the modern treatment era by year of diagnosis and characteristics of the first breast cancer are needed to assess the impact of recent advances in breast cancer treatment and inform clinical decision making. Methods We examined CBC risk among 419,818 women (age 30–84 years) who were diagnosed with a first unilateral invasive breast cancer and survived ≥ 1 year in the US Surveillance, Epidemiology, and End Results program cancer registries from 1992 to 2015 (follow-up through 2016). CBC was defined as a second invasive breast cancer in the contralateral breast ≥ 12 months after the first breast cancer. We estimated standardized incidence ratios (SIRs) of CBC by year of diagnosis, age at diagnosis, and tumor characteristics for the first breast cancer. Cumulative incidence of CBC was calculated for women diagnosed with a first breast cancer in the recent treatment era (2004–2015, follow-up through 2016). Results Over a median follow-up of 8 years (range 1–25 years), 12,986 breast cancer patients developed CBC. Overall, breast cancer patients had approximately twice the risk of developing cancer in the contralateral breast when compared to that expected in the general population (SIR = 2.21, 95% CI = 2.17–2.25). SIRs for CBC declined by year of first diagnosis, irrespective of age at diagnosis and estrogen receptor (ER) status (p-trends < 0.001), but the strongest decline was after an ER-positive tumor. The 5-year cumulative incidence of CBC ranged from 1.01% (95% CI = 0.90–1.14%) in younger women (age < 50 years) with a first ER-positive tumor to 1.89% (95% CI = 1.61–2.21%) in younger women with a first ER-negative tumor. Conclusion Declines in CBC risk are consistent with continued advances in breast cancer treatment. The updated estimates of cumulative incidence inform breast cancer patients and clinicians on the risk of CBC and may help guide treatment decisions.

scholarly journals The Influence of Adjuvant Systemic Regimens on Contralateral Breast Cancer Risk and Receptor Subtype

2019 ◽  
Vol 111 (7) ◽  
pp. 709-718 ◽  
Author(s):  
Iris Kramer ◽  
Michael Schaapveld ◽  
Hester S A Oldenburg ◽  
Gabe S Sonke ◽  
Danielle McCool ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Reduction ◽  
Endocrine Therapy ◽  
Aromatase Inhibitors ◽  
Contralateral Breast Cancer ◽  
Contralateral Breast ◽  
Receptor Subtype ◽  
Therapy Regimen ◽  
Netherlands Cancer Registry

Abstract Background An increasing number of breast cancer (BC) survivors are at risk of developing contralateral breast cancer (CBC). We aimed to investigate the influence of various adjuvant systemic regimens on, subtype-specific, risk of CBC. Methods This population-based cohort study included female patients diagnosed with first invasive BC between 2003 and 2010; follow-up was complete until 2016. Clinico-pathological data were obtained from the Netherlands Cancer Registry and additional data on receptor status through linkage with PALGA: the Dutch Pathology Registry. Cumulative incidences (death and distant metastases as competing risk) and hazard ratios (HRs) were estimated for all invasive metachronous CBC and CBC subtypes. Results Of 83 144 BC patients, 2816 developed a CBC; the 10-year cumulative incidence was 3.8% (95% confidence interval [CI] = 3.7% to 4.0%). Overall, adjuvant chemotherapy (HR = 0.70, 95% CI = 0.62 to 0.80), endocrine therapy (HR = 0.46, 95% CI = 0.41 to 0.52), and trastuzumab with chemotherapy (HR = 0.57, 95% CI = 0.45 to 0.73) were strongly associated with a reduced CBC risk. Specifically, taxane-containing chemotherapy (HR = 0.48, 95% CI = 0.36 to 0.62) and aromatase inhibitors (HR = 0.32, 95% CI = 0.23 to 0.44) were associated with a large CBC risk reduction. More detailed analyses showed that endocrine therapy statistically significantly decreased the risk of estrogen receptor (ER)-positive CBC (HR = 0.41, 95% CI = 0.36 to 0.47) but not ER-negative CBC (HR = 1.32, 95% CI = 0.90 to 1.93) compared with no endocrine therapy. Patients receiving chemotherapy for ER-negative first BC had a higher risk of ER-negative CBC from 5 years of follow-up (HR = 2.84, 95% CI = 1.62 to 4.99) compared with patients not receiving chemotherapy for ER-negative first BC. Conclusion Endocrine therapy, chemotherapy, as well as trastuzumab with chemotherapy reduce CBC risk. However, each adjuvant therapy regimen had a different impact on the CBC subtype distribution. Taxane-containing chemotherapy and aromatase inhibitors were associated with the largest CBC risk reduction.

scholarly journals A Rare Case of Triple Positive Metachronous Breast Cancer

2019 ◽  
Vol 7 ◽  
pp. 232470961989210
Author(s):  
Hardik S. Chhatrala ◽  
John Khuu ◽  
Lara Zuberi
Keyword(s):  
Breast Cancer ◽  
Estrogen Receptor ◽  
Brain Metastasis ◽  
Progesterone Receptor ◽  
Rare Case ◽  
Contralateral Breast Cancer ◽  
Contralateral Breast ◽  
Her 2 ◽  
Metachronous Breast Cancer ◽  
Aggressive Clinical Course

Metachronous contralateral breast cancer (MCBC) is defined as contralateral breast cancer (BC) diagnosed more than 1 year after previous BC diagnosis. More BC survivors are at risk of MCBC given improved life expectancy with the availability of advanced cancer care. Estrogen receptor/progesterone receptor negative and HER-2-positive status of first BC are independent risk factors for the development of MCBC. We present a rare case of triple positive (estrogen receptor, progesterone receptor, HER-2 positive) MCBC patient who eventually developed brain metastasis within 15 months despite a near complete pathologic response of primary tumor. This case highlights that even in this era of antiestrogen and anti-HER-2 therapies, triple positive MCBC can have an aggressive clinical course, especially with brain metastasis as the first sign of metastasis.

Long-Term Benefits of 5 Years of Tamoxifen: 10-Year Follow-Up of a Large Randomized Trial in Women at Least 50 Years of Age With Early Breast Cancer

2011 ◽  
Vol 29 (13) ◽  
pp. 1657-1663 ◽  
Author(s):  
Allan Hackshaw ◽  
Michael Roughton ◽  
Sharon Forsyth ◽  
Kathryn Monson ◽  
Krystyna Reczko ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Early Breast Cancer ◽  
Contralateral Breast Cancer ◽  
Disease Free Survival ◽  
Contralateral Breast ◽  
Free Survival ◽  
Free Data ◽  
Cv Disease

Purpose The Cancer Research UK “Over 50s” trial compared 5 and 2 years of tamoxifen in women with early breast cancer. Results are reported after median follow-up of 10 years. Patients and Methods Between 1987 and 1997, 3,449 patients age 50 to 81 years with operable breast cancer who had been taking 20 mg of tamoxifen for 2 years were randomly assigned to either stop or continue for an additional 3 years, if they were alive and recurrence free. Data on recurrences, new tumors, deaths, and cardiovascular events were obtained (April 2010). Results There were 1,103 recurrences, 755 deaths as a result of breast cancer, 621 cardiovascular (CV) events, and 236 deaths as a result of CV events. Fifteen years after starting treatment, for every 100 women who received tamoxifen for 5 years, 5.8 fewer experienced recurrence, compared with those who received tamoxifen for 2 years. The risk of contralateral breast cancer was significantly reduced (hazard ratio, 0.70; 95% CI, 0.48 to 1.00). Among women age 50 to 59 years, there was a 35% reduction in CV events (P = .005) and 59% reduction in death as a result of a CV event (P = .02); in older women, the effect was much smaller and not statistically significant. Conclusion Taking tamoxifen for the recommended 5 years reduces the risk of recurrence or contralateral breast cancer 15 years after starting treatment. It also lowers the risk of CV disease and death as a result of a CV event, particularly among those age 50 to 59 years. Women should therefore be encouraged to complete the full course. Although aromatase inhibitors improve disease-free survival, tamoxifen remains a cheap and highly effective alternative, particularly in developing countries.

scholarly journals Impact of preoperative breast MRI on 10-year survival of patients included in the Swedish randomized multicentre POMB trial

BJS Open ◽  
2021 ◽  
Vol 5 (5) ◽  
Author(s):  
V Gonzalez ◽  
B Arver ◽  
L Löfgren ◽  
L Bergkvist ◽  
K Sandelin ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Mri ◽  
Control Group ◽  
Conventional Imaging ◽  
Newly Diagnosed ◽  
Control Groups ◽  
Risk Of Death ◽  
Preoperative Breast Mri ◽  
And Control

Abstract Background The value of preoperative breast MRI as an adjunct technique regarding its effect on re-excision rates has been a subject of discussion. No survival data regarding preoperative breast MRI are available from randomized studies. Methods Ten-year follow-up of the POMB randomized multicentre study was analysed, evaluating MRI and its effect on disease-free survival (DFS) and overall survival (OS). Patients with newly diagnosed breast cancer were randomized to either preoperative MRI or conventional imaging. Kaplan–Meier plots were used to analyse DFS and OS, and Cox regression to estimate hazard ratios (HRs). Results A total of 440 patients, aged 56 years or less, with newly diagnosed breast cancer were randomized to either preoperative MRI (220) or conventional imaging (220; control). Median follow-up for each group was 10 years. DFS rates were 85.5 and 80.0 per cent for the MRI and control groups respectively (P = 0.099). The risk of relapse or death was 46 per cent higher in the control group (HR 1.46, 95 per cent c.i. 0.93 to 2.29). OS rates after 10 years were 90.9 and 88.6 per cent in the MRI and control groups respectively (P = 0.427). The risk of death was 27 per cent higher in the control group (HR 1.27, 0.71 to 2.29). Locoregional, distant, and contralateral recurrence outcomes combined were increased in the control group (P = 0.048). A subgroup analysis of patients with breast cancer stages I–III showed that preoperative MRI improved DFS compared with conventional imaging, but this did not reach statistical significance (P = 0.057). Conclusion After 10 years of follow-up, preoperative breast MRI as an adjunct to conventional imaging resulted in slightly, but non-significantly, improved DFS and OS. Registration number: NCT01859936 (http://www.clinicaltrials.gov).

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