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 Breast Subtypes and Prognosis of Breast Cancer Patients With Initial Bone Metastasis: A Population-Based Study

2020 ◽  
Vol 10 ◽  
Author(s):  
Deyue Liu ◽  
Jiayi Wu ◽  
Caijin Lin ◽  
Lisa Andriani ◽  
Shuning Ding ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Prognostic Factors ◽  
Metastatic Breast Cancer ◽  
Bone Metastasis ◽  
Cancer Patients ◽  
Metastatic Breast ◽  
Risk Groups ◽  
Population Based ◽  
Breast Cancer Patients

BackgroundMetastatic breast cancer (MBC) is a highly heterogeneous disease and bone is one of the most common metastatic sites. This retrospective study was conducted to investigate the clinical features, prognostic factors and benefits of surgery of breast cancer patients with initial bone metastases.MethodsFrom 2010 to 2015, 6,860 breast cancer patients diagnosed with initial bone metastasis were analyzed from Surveillance, Epidemiology, and End Results (SEER) database. Univariate and Multivariable analysis were used to identify prognostic factors. A nomogram was performed based on the factors selected from cox regression result. Survival curves were plotted according to different subtypes, metastatic burdens and risk groups differentiated by nomogram.ResultsHormone receptor (HR) positive/human epidermal growth factor receptor 2 (HER2) positive patients showed the best outcome compared to other subtypes. Patients of younger age (<60 years old), white race, lower grade, lower T stage (<=T2), not combining visceral metastasis tended to have better outcome. About 37% (2,249) patients received surgery of primary tumor. Patients of all subtypes could benefit from surgery. Patients of bone-only metastases (BOM), bone and liver metastases, bone and lung metastases also showed superior survival time if surgery was performed. However, patients of bone and brain metastasis could not benefit from surgery (p = 0.05). The C-index of nomogram was 0.66. Cutoff values of nomogram point were identified as 87 and 157 points, which divided all patients into low-, intermediate- and high-risk groups. Patients of all groups showed better overall survival when receiving surgery.ConclusionOur study has provided population-based prognostic analysis in patients with initial bone metastatic breast cancer and constructed a predicting nomogram with good accuracy. The finding of potential benefit of surgery to overall survival will cast some lights on the treatment tactics of this group of patients.

Prognosis of breast cancer patients with initial bone metastasis: A population-based study.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e13081-e13081
Author(s):  
Deyue LIU ◽  
Jiayi Wu ◽  
Li Zhu
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Prognostic Factors ◽  
Metastatic Breast Cancer ◽  
Bone Metastasis ◽  
Cancer Patients ◽  
Risk Group ◽  
Metastatic Breast ◽  
Population Based ◽  
Breast Cancer Patients

e13081 Background: Metastatic breast cancer (MBC) is a highly heterogeneous disease and bone is one of the most common metastatic sites. This retrospective study was conducted to investigate the clinical features, prognostic factors and benefits of surgery of breast cancer patients with initial bone metastases. Methods: From 2010 to 2015, 6860 breast cancer patients diagnosed with initial bone metastasis were analysed from Surveillance, Epidemiology, and End Results (SEER) database. Univariate and Multivariable analysis were used to identify prognostic factors. A nomogram was performed based on the factors selected from cox regression result. Survival curves were plotted according to different subtypes, metastatic burdens and risk group differentiated by nomogram. Results: Hormone receptor (HR) positive/human epidermal growth factor receptor 2 (HER2) positive patients showed the best outcome compared to other subtypes. Patients of younger age ( < 60 years old), white race, lower grade, lower T stage ( < = T2), not combining organ metastasistend to have better outcome. About 37% (2249) patients received surgery of primary tumor. Patients of all subtypes can benefit from surgery. Patients of bone-only metastases (BOM), bone and liver metastases, bone and lung metastases also showed superior survival time if surgery is performed. While patients of bone and brain patients cannot benefit from surgery (p = 0.05). The C-index of nomogram is 0.68. A cutoff value of nomogram point was identified by ROC curve as 93 points, which divided all patients into low-risk group and high-risk group. Patients of both groups showed better overall survival when receiving surgery. Conclusions: Our study has provided population-based nomogram in patients with initial bone metastatic breast cancer. The finding of potential benefit of surgery to overall survival will cast some light on the treatment tactics of this group of patients.

Prognosis of BRCA1/2-negative breast cancer patients with HBOC risk factors compared with sporadic breast cancer patients without HBOC risk factors

2020 ◽  
Vol 50 (2) ◽  
pp. 104-113
Author(s):  
Jai Min Ryu ◽  
Seok Jin Nam ◽  
Seok Won Kim ◽  
Jeong Eon Lee ◽  
Byung Joo Chae ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Ovarian Cancer ◽  
Overall Survival ◽  
Cancer Patients ◽  
Disease Free Survival ◽  
Breast Cancer Specific Survival ◽  
Breast Cancer Patients ◽  
Cancer Specific Survival ◽  
Free Survival

Abstract Objective Demands for genetic counseling with BRCA1/2 examination have markedly increased. Accordingly, the incidence of uninformative results on BRCA1/2 mutation status has also increased. Because most patients examined for BRCA1/2 mutation have a high risk of hereditary breast and/or ovarian cancer, many patients suffer psychological distress even when the BRCA1/2 result is negative. We compared oncological outcomes between BRCA1/2-negative breast cancer with high risk of hereditary breast and/or ovarian cancer and sporadic breast cancer without risk of hereditary breast and/or ovarian cancer. Methods The criteria for high risk for hereditary breast and/or ovarian cancer were defined as family history of breast and/or ovarian cancer in first- or second-degree relative, early onset breast cancer at &lt;35 years old and bilateral breast cancer. Patients were matched maximally 1:3 into those who identified as negative for BRCA1/2 mutation with risk of hereditary breast and/or ovarian cancer (study group) and those who were not examined for BRCA1/2 mutation without risk for hereditary breast and/or ovarian cancer (control group). Matched variables were pathologic stage, estrogen receptor, progesterone receptor and human epidermal growth factor receptor-2 status. Results All matching variables were successfully matched. Median follow-up duration was 57.8 months. There was no significant difference between the groups in disease-free survival (log-rank P = 0.197); however, the study group showed significantly better overall survival and breast cancer-specific survival (both P &lt; 0.0001). We conducted subgroup analysis in the middle-aged group (36–54) and showed no significant difference for disease-free survival (P = 0.072) but significantly better overall survival and breast cancer-specific survival in the study group (P = 0.002 and P &lt; 0.0001). Conclusions BRCA1/2-negative breast cancer patients who had hereditary breast and/or ovarian cancer risk factors showed similar disease-free survival and better overall survival and breast cancer-specific survival compared with those with sporadic breast cancer without hereditary breast and/or ovarian cancer risk factors.

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 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.

Sequential Tamoxifen and Aminoglutethimide Versus Tamoxifen Alone in the Adjuvant Treatment of Postmenopausal Breast Cancer Patients: Results of an Italian Cooperative Study

2001 ◽  
Vol 19 (22) ◽  
pp. 4209-4215 ◽  
Author(s):  
F. Boccardo ◽  
A. Rubagotti ◽  
D. Amoroso ◽  
M. Mesiti ◽  
D. Romeo ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Cancer Patients ◽  
Disease Free Survival ◽  
Postmenopausal Breast Cancer ◽  
Tamoxifen Treatment ◽  
Breast Cancer Patients ◽  
Cancer Specific Survival ◽  
Free Survival ◽  
Tamoxifen Group

PURPOSE: To determine whether switching patients from tamoxifen to antiaromatase treatment would prevent some of the relapses or deaths that we assume would occur if tamoxifen were continued. PATIENTS AND METHODS: Three hundred eighty postmenopausal breast cancer patients receiving adjuvant tamoxifen treatment for 3 years were randomized to either continue tamoxifen for 2 more years or to switch to low-dose aminoglutethimide (250 mg daily) for 2 years. RESULTS: At a median follow-up of 61 months (range, 5 to 94 months), 59 events occurred in the tamoxifen group, and 55 occurred in the aminoglutethimide group. More treatment failures at distant sites, such as viscera (P = .02), were observed in the tamoxifen group. Although no differences in disease-free survival between the two groups have emerged so far, a significant trend favors aminoglutethimide in overall survival (P = .005) and breast cancer–specific survival (P = .06). Even if more patients in the antiaromatase group complained of drug-related side effects and more of them discontinued treatment (P = .0001), the number of cardiovascular events and, in general, of life-threatening adverse events was higher in the tamoxifen arm. CONCLUSION: Switching patients from tamoxifen to aminoglutethimide treatment resulted in comparable event-free survival, but longer overall survival was achieved in patients who were switched to aminoglutethimide as compared with those who continued to receive tamoxifen. Should these preliminary results be confirmed by larger studies with a similar design, which are now testing the effectiveness of the new, more active, and tolerable aromatase inhibitors, sequencing tamoxifen with an aromatase inhibitor could become a preferable alternative to tamoxifen alone in early breast cancer patients.

scholarly journals Expression of FGD3 gene as prognostic factor in young breast cancer patients

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Irene Renda ◽  
Simonetta Bianchi ◽  
Vania Vezzosi ◽  
Jacopo Nori ◽  
Ermanno Vanzi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Prognostic Factors ◽  
Lymph Node ◽  
Cancer Patients ◽  
Disease Free Survival ◽  
Breast Cancer Patients ◽  
Free Survival ◽  
Young Breast Cancer ◽  
Disease Free

Abstract The FGD3 gene works as a cell migration inhibitor and seems to be a promising indicator of outcome in some human cancers including breast. In this study, we analysed for the first time the prognostic role of FGD3 in young breast cancer patients. We studied the relationship between traditional prognostic factors, FGD3 expression and outcome in ≤40 years breast cancer patients. We found that lower FGD3 expression decreased the probability of disease-free survival (p = 0.042) and overall survival (p = 0.007). In a multivariate analysis for overall survival AJCC stage (p = 0.005) and FGD3 expression (p = 0.03) resulted independent prognostic factors. Low FGD3 expression increased the risk of death from disease (HR 5.73, p = 0.03). Moreover, low FGD3 expression was associated with more widespread lymph node involvement (p = 0.04) and a lower FGD3 staining intensity was found in positive-lymph-node patients vs negative (p = 0.003) and in patients with ≥10 involved lymph nodes vs <10 (p = 0.05). Our results suggest FGD3 to be a significant independent prognostic factor in young breast cancer patients in terms of disease-free survival and overall survival. A lower expression increased the risk of recurrence and death from disease and was associated with widespread lymph node metastases.

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