scholarly journals Chemotherapy for T1 pN0M0 Breast Cancer Patients: A Propensity Score Matching Study Based on SEER Database and External Data

2021 ◽  
Author(s):  
Kaiwen Shen ◽  
Longdi Yao ◽  
Huihua Cao ◽  
Ximing Gu ◽  
Jie Wang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Cancer Patients ◽  
Molecular Subtypes ◽  
External Validation ◽  
Tumor Grade ◽  
Seer Database ◽  
Breast Cancer Patients ◽  
Grade Ii ◽  
Grade Iii

Abstract Background There is no definitive, unified view on chemotherapy for T1 pN0M0 breast cancer. Our study explored the effects of chemotherapy on T1 pN0M0 breast cancer. Methods 75,139 patients diagnosed with T1 pN0M0 breast cancer were selected from the Surveillance, Epidemiology, and End Results (SEER) database. Multivariate Cox analyses were performed to investigate the effects of chemotherapy on T1a, T1b, and T1c pN0M0 breast cancer, various tumor grades, and four molecular subtypes. Propensity score matching (PSM) was used to eliminate confounding factors and further verify the results between chemotherapy and no chemotherapy. Finally, 545 T1pN0M0 breast cancer patients treated at the Northern Jiangsu People’s Hospital were included for external validation. Univariate and multivariate Cox analyses were used to confirm the role of chemotherapy in T1a, T1b, and T1c pN0M0 breast cancer. Survival curves were plotted using the Kaplan–Meier method for tumor grades and molecular subtypes. Results Chemotherapy demonstrated a statistically significant improvement in T1b and T1c breast cancer, not in T1a breast cancer. With T1b breast cancer, chemotherapy had effects on grade III and molecular subtypes hormone receptor+ [HR+]/human epidermal growth factor receptor 2+ [HER2+], HR-/HER2+, and HR-/HER2-. Chemotherapy was beneficial to overall survival for grade II/III and T1c breast cancer. After PSM, identical results were obtained. We also obtained similar results with external validation, except that chemotherapy made a difference in grade II and T1b breast cancer of external validation. Conclusion Partial T1 pN0M0 breast cancer patients with tumor grade III T1b pN0M0 except HR+/HER2-, those with tumor grade II and III T1c pN0M0 can obtain overall survival benefits from chemotherapy.

Predictors of adjuvant chemotherapy for breast cancer patients with an intermediate Oncotype-DX score: A SEER-based population study.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e12014-e12014
Author(s):  
Sowmya Goranta ◽  
Tarek Haykal ◽  
Areeg Bala ◽  
Ragheed Al-Dulaimi ◽  
Ghassan Bachuwa ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Multivariate Analysis ◽  
Adjuvant Chemotherapy ◽  
Cancer Patients ◽  
Recurrence Score ◽  
Oncotype Dx ◽  
Breast Cancer Patients ◽  
T Stage ◽  
Grade Iii

e12014 Background: Oncotype-DX Assay is a 21-gene based recurrence score (RS) that helps stratify breast cancer patients based on their risk of recurrence. It is often used to help identify patients that may benefit from adjuvant chemotherapy (AC). Prior to the TAILORx Trial results, there were no guidelines for AC in patients with an intermediate score (18-30). Management of these patients was often at the clinical judgement of the provider. We sought to determine predictors of AC among these patients, and measure treatment effect on survival. Methods: We queried the Surveillance, Epidemiology, and End-Results database for breast cancer patients newly diagnosed between 2010-2015. We included patients with T1-T3, hormone receptor positive, HER2-negative, and lymph node-negative breast cancer with an intermediate RS. Male patients, those younger than 40 years, tumors 5 mm or less, and incomplete records were excluded. Univariate and multivariate analysis was performed to derive independent predictors of AC. Cox Proportional-Hazards Model was done to examine the effect of AC on survival. Results: We included 14,710 patients of whom 4,508 (30.6%) received AC. Patients that received AC were younger (55.4 years [8.8] vs 60.0 [9.7], p < 0.001), grade III or higher (29.8% vs 16.4%, p < 0.001), and had a higher RS (23.9 [3.6] vs 21.5 [3.1], p < 0.001). Higher T stage was associated with a higher rate of patients receiving AC (p < 0.001). Marital status was also associated with AC; a higher proportion of patients who received AC were married (67.9% vs 64.4%, p < 0.001). There was no significant association between race/ethnicity or insurance type with AC. Multivariate analysis showed that RS (OR: 1.24 [1.23-1.26], p < 0.001), T stage (OR: 1.67 [1.21-2.30], p < 0.001), and a grade III tumor (OR: 1.85 [1.64-2.09], p < 0.001) were the strongest predictors of AC. The age decile 80-89 years (OR: 0.05 [0.02-0.10], p < 0.001) was the most negative predictor of AC. AC did not have an effect on 5 year overall survival (97.6% vs 96.0%, p = 0.28). Conclusions: Between 2010-2015, our study shows 30.6% of breast cancers patients with an intermediate Oncotype-DX score were given AC. The decision to treat was largely based on tumor size, grade and age. AC had no effect on overall survival.

scholarly journals Nomogram for Predicting the Overall Survival and Cancer-Specific Survival of Patients with Occult Breast Cancer: A Population-Based Study

2021 ◽  
Author(s):  
Yang-Yu Huang ◽  
Guowei Ma ◽  
Shen-Hua Liang ◽  
Lei-Lei Wu ◽  
Xuan Liu
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Prognostic Factors ◽  
Cancer Patients ◽  
Subgroup Analysis ◽  
External Validation ◽  
Breast Cancer Patients ◽  
Cancer Specific Survival ◽  
Occult Breast Cancer ◽  
Training Cohort

Abstract Background: Occult breast cancer is a rare breast tumor, whose prognostic nomogram model has not been established. Thus, we aim to develop and validate a nomogram for evaluating the overall survival (OS) and cancer-specific survival (CSS) of patients with occult breast cancer. Methods: Between 2004 and 2015, 704 eligible occult breast cancer patients were screened from the Surveillance, Epidemiology, and End Results (SEER) database using specific inclusion and exclusion criteria and then included in the surveillance. They were randomly divided into a training cohort (n = 494) and a validation cohort (N = 210). Univariate and multivariate Cox analyses were performed to explore independent prognostic factors and establish two survival-related nomograms. Area under the curve (AUC), consistency index (C index), internal and external validation calibration curve, decision curve analysis (DCA), Kaplan-Meier analysis, and subgroup analysis were used to evaluate the nomogram. Results: A total of seven variables were considered to be independent prognostic factors for overall survival (OS) and cancer-specific survival (CSS): age, chemotherapy, radiotherapy, Progesterone receptor (PR) status, N stage, number of lymph node examinations, and number of positive lymph nodes. In the training cohort, the OS nomogram-predicted AUC for three, five, and ten years were 0.792, 0.775, and 0.783, respectively, while those of the CSS nomogram were 0.807, 0.817, and 0.812, respectively. The calibration chart showed excellent agreement between the actual and the nomogram-predicted survival rates in both the training and validation cohorts. The C-index values ​​of the OS nomogram in the training and validation cohorts were 0.762 and 0.782, respectively, while those ​​of the CSS nomogram were 0.786 and 0.816, respectively. DCA and subgroup analysis proved the usefulness of nomograms. Conclusion: The developed nomogram provided a comprehensive visual model of the risk of each prognostic factor. It can be conveniently used as a personalized prediction tool for the prognosis of occult breast cancer patients.

scholarly journals BRENDA-Score, a Highly Significant, Internally and Externally Validated Prognostic Marker for Metastatic Recurrence: Analysis of 10,449 Primary Breast Cancer Patients

Cancers ◽  
2021 ◽  
Vol 13 (13) ◽  
pp. 3121
Author(s):  
Manfred Wischnewsky ◽  
Lukas Schwentner ◽  
Joachim Diessner Diessner ◽  
Amelie De Gregorio ◽  
Ralf Joukhadar ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Cancer Patients ◽  
Prognostic Marker ◽  
Cox Regression ◽  
External Validation ◽  
Breast Cancer Patients ◽  
Predictive Tool ◽  
Metastatic Recurrence ◽  
Very High

Background Current research in breast cancer focuses on individualization of local and systemic therapies with adequate escalation or de-escalation strategies. As a result, about two-thirds of breast cancer patients can be cured, but up to one-third eventually develop metastatic disease, which is considered incurable with currently available treatment options. This underscores the importance to develop a metastatic recurrence score to escalate or de-escalate treatment strategies. Patients and methods Data from 10,499 patients were available from 17 clinical cancer registries (BRENDA-project [1]. In total, 8566 were used to develop the BRENDA-Index. This index was calculated from the regression coefficients of a Cox regression model for metastasis-free survival (MFS). Based on this index, patients were categorized into very high, high, intermediate, low, and very low risk groups forming the BRENDA-Score. Bootstrapping was used for internal validation and an independent dataset of 1883 patients for external validation. The predictive accuracy was checked by Harrell’s c-index. In addition, the BRENDA-Score was analyzed as a marker for overall survival (OS) and compared to the Nottingham prognostic score (NPS). Results: Intrinsic subtypes, tumour size, grading, and nodal status were identified as statistically significant prognostic factors in the multivariate analysis. The five prognostic groups of the BRENDA-Score showed highly significant (p < 0.001) differences regarding MFS:low risk: hazard ratio (HR) = 2.4, 95%CI (1.7–3.3); intermediate risk: HR = 5.0, 95%CI.(3.6–6.9); high risk: HR = 10.3, 95%CI (7.4–14.3) and very high risk: HR = 18.1, 95%CI (13.2–24.9). The external validation showed congruent results. A multivariate Cox regression model for OS with BRENDA-Score and NPS as covariates showed that of these two scores only the BRENDA-Score is significant (BRENDA-Score p < 0.001; NPS p = 0.447). Therefore, the BRENDA-Score is also a good prognostic marker for OS. Conclusion: The BRENDA-Score is an internally and externally validated robust predictive tool for metastatic recurrence in breast cancer patients. It is based on routine parameters easily accessible in daily clinical care. In addition, the BRENDA-Score is a good prognostic marker for overall survival. Highlights: The BRENDA-Score is a highly significant predictive tool for metastatic recurrence of breast cancer patients. The BRENDA-Score is stable for at least the first five years after primary diagnosis, i.e., the sensitivities and specificities of this predicting system is rather similar to the NPI with AUCs between 0.76 and 0.81 the BRENDA-Score is a good prognostic marker for overall survival.

scholarly journals Activated Leukocyte Cell Adhesion Molecule (ALCAM) in Saudi Breast Cancer Patients as Prognostic and Predictive Indicator

2015 ◽  
Vol 9 ◽  
pp. BCBCR.S25563 ◽  
Author(s):  
Fawziah S. Al-Shehri ◽  
Eman M. Abd EL Azeem
Keyword(s):  
Breast Cancer ◽  
Cell Adhesion ◽  
Cancer Patients ◽  
Area Under The Curve ◽  
High Sensitivity ◽  
Roc Curves ◽  
Breast Cancer Patients ◽  
Grade Group ◽  
Grade Ii ◽  
Grade Iii

Background Activated leukocyte cell adhesion molecules (ALCAMs) play an essential role in tumor metastasis and are higher in some patients with breast cancer. AIM This study aimed to evaluate ALCAM as an early diagnostic biomarker for breast cancer and how it compares with other markers. Subjects and Methods One-hundred and sixty-one women were selected for this study. They were divided into three groups: Group 1 consisted of 42 healthy individuals (control) while a patients groups divided into two groups according to tumour grade, Group II, Include 58 breast cancer patient's grade II and Group III, Include 61 patients with grade III of breast cancer. Tumour markers CEA, CA 15–3 and s ALCAM levels were determined and Group 2 consisted of breast cancer patients. Results A highly significant elevation was recorded in s ALCAM, CA 15–3 and CEA. Percent change for grade II and grade III were [sALCAM (90, 127)], [CA15–3 (40, 72)] and [CEA (33, 156)]. Operating characteristic (ROC) curves were used to evaluate the diagnostic performance of the biomarkers ALCAM, CA15–3 and CEA with area under the curve (AUC) of (0.99 & 1.0) (AUC 0.947 & 0.99) and (AUC 0.88 & 0.94) for grade II and grade III respectively the incremental values of AUC were statistically highly significant (p < 0.001). Conclusion It could be concluded that serum ALCAM concentration represents a suitable biomarker for Saudi arabian breast carcinoma with high sensitivity and has the potential to be used as a diagnostic tool comparable to CA15–3 and CEA.

CHANGES IN THE NIPPLE-AREOLA COMPLEX IN PATIENTS WITH BREAST CANCER

2017 ◽  
Vol 63 (4) ◽  
pp. 593-597
Author(s):  
Aziz Zikiryakhodzhaev ◽  
Nadezhda Volchenko ◽  
Erik Saribekyan ◽  
Yelena Rasskazova
Keyword(s):  
Breast Cancer ◽  
Surgical Treatment ◽  
Cancer Patients ◽  
Molecular Subtypes ◽  
Breast Cancer Patients ◽  
Nipple Areola Complex ◽  
Histological Types ◽  
Areola Complex

The article presents data about the lesion of the nipple-areola complex in breast cancer. In 2015-2016 surgical treatment was performed in 101 breast cancer patients, different in size but with the mandatory removal of the nipple-areola complex. There are analyzed the dependence of the lesion of the nipple-areola complex from histological types of breast cancer, molecular subtypes, multicentricity, the location of tumor in the breast. The most significant criterion was the dependence of the lesion of the nipple-areola complex from the distance between tumor node and the nipple.

Overexpression of microRNA-21 in the Serum of Breast Cancer Patients

MicroRNA ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. 58-63
Author(s):  
Batool Savari ◽  
Sohrab Boozarpour ◽  
Maryam Tahmasebi-Birgani ◽  
Hossein Sabouri ◽  
Seyed Mohammad Hosseini
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Cancer Progression ◽  
Tumor Resection ◽  
Tumor Grade ◽  
Healthy Controls ◽  
Breast Cancer Patients ◽  
Serum Samples ◽  
Post Surgery ◽  
Polymerase Chain

Background: Breast cancer is the most common cancer diagnosed in women worldwide. So it seems that there's a good chance of recovery if it's detected in its early stages even before the appearances of symptoms. Recent studies have shown that miRNAs play an important role during cancer progression. These transcripts can be tracked in liquid samples to reveal if cancer exists, for earlier treatment. MicroRNA-21 (miR-21) has been shown to be a key regulator of carcinogenesis, and breast tumor is no exception. Objective: The present study was aimed to track the miR-21 expression level in serum of the breast cancer patients in comparison with that of normal counterparts. Methods: Comparative real-time polymerase chain reaction was applied to determine the levels of expression of miR-21 in the serum samples of 57 participants from which, 42 were the patients with breast cancer including pre-surgery patients (n = 30) and post-surgery patients (n = 12), and the others were the healthy controls (n = 15). Results: MiR-21 was significantly over expressed in the serum of breast cancer patients as compared with healthy controls (P = 0.002). A significant decrease was also observed following tumor resection (P < 0.0001). Moreover, it was found that miR-21 overexpression level was significantly associated with tumor grade (P = 0.004). Conclusion: These findings suggest that miR-21 has the potential to be used as a novel breast cancer biomarker for early detection and prognosis, although further experiments are needed.

scholarly journals Human Plasma Metabolomics for Biomarker Discovery: Targeting the Molecular Subtypes in Breast Cancer

Cancers ◽  
2021 ◽  
Vol 13 (1) ◽  
pp. 147
Author(s):  
Leticia Díaz-Beltrán ◽  
Carmen González-Olmedo ◽  
Natalia Luque-Caro ◽  
Caridad Díaz ◽  
Ariadna Martín-Blázquez ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Biomarker Discovery ◽  
Molecular Subtypes ◽  
Breast Cancer Subtype ◽  
P Value ◽  
Plasma Samples ◽  
Breast Cancer Patients ◽  
Clinical Value ◽  
Molecular Phenotypes

Purpose: The aim of this study is to identify differential metabolomic signatures in plasma samples of distinct subtypes of breast cancer patients that could be used in clinical practice as diagnostic biomarkers for these molecular phenotypes and to provide a more individualized and accurate therapeutic procedure. Methods: Untargeted LC-HRMS metabolomics approach in positive and negative electrospray ionization mode was used to analyze plasma samples from LA, LB, HER2+ and TN breast cancer patients and healthy controls in order to determine specific metabolomic profiles through univariate and multivariate statistical data analysis. Results: We tentatively identified altered metabolites displaying concentration variations among the four breast cancer molecular subtypes. We found a biomarker panel of 5 candidates in LA, 7 in LB, 5 in HER2 and 3 in TN that were able to discriminate each breast cancer subtype with a false discovery range corrected p-value < 0.05 and a fold-change cutoff value > 1.3. The model clinical value was evaluated with the AUROC, providing diagnostic capacities above 0.85. Conclusion: Our study identifies metabolic profiling differences in molecular phenotypes of breast cancer. This may represent a key step towards therapy improvement in personalized medicine and prioritization of tailored therapeutic intervention strategies.

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