scholarly journals Understanding risk factors in grade 3 breast cancer in NZ

2020 ◽  
Author(s):  
Sharita Meharry ◽  
Reena Ramsaroop ◽  
Robert Borotkanics ◽  
Fabrice Merien
Keyword(s):  
Breast Cancer ◽  
Prognostic Factors ◽  
New Zealand ◽  
Survival Rates ◽  
Elevated Risk ◽  
Pacific Islanders ◽  
High Grade ◽  
Grade 3 ◽  
Nottingham Grade ◽  
Survival Differences

Abstract Background Breast cancer is the most common cancer in New Zealand women, accounting for approximately 3000 new registrations per year, affecting one in nine women and resulting in more than 600 deaths annually. This study analysed data of patients selected with prognostic factor of Nottingham grade 3 tumours over a specified five- year period. These represent a heterogeneous group of cancers with variable survival rates. Method All women diagnosed with Nottingham grade 3 invasive breast cancer between 1 st January 2011 to 31 st December 2015, from four Breast Cancer Registries in New Zealand (Auckland, Waikato, Christchurch, and Wellington) were studied. Results Applying Fine-Gray analyses, the study of 2,493 women found that subjects in the older age group (>70 years) had a higher five-year mortality risk (SHR: 1.74 to 2.25, p: 0.053 to <0.001). Analysis of hormonal receptors showed that tumours with hormonal profile ER-positive, PR negative and ER-negative, PR negative subjects were at increased mortality risk (SHR: 3.56, p: <0.001) and (SHR: 2.67, p: <0.001) respectively. Molecular subtypes TNBC and Luminal B subjects were at increased risk of five-year mortality (SHR: 3.01 and 3.35 respectively, both p: <0.001). HER2 enriched subjects, were at elevated risk (SHR: 1.66, p: 0.11). Women identifying as NZ European ethnicity were at elevated risk of mortality overall (SHR: 1.70, p: 0.11), and they presented with the highest CIF across ethnicities. The NZ Europeans represented the largest proportion of HER2 enriched and TNBC subjects; however, Pacific Islanders experienced the highest HER2 CIF. Conclusion The survival rates for grade 3 breast cancer vary across the selected prognostic factors and ethnicity. Although grade 3 breast cancer is considered as high grade heterogeneous cancer, this study showed that not every patient has a poor outcome. NZ Europeans are worst affected followed by Pacific Islanders. Biology of the cancer and ethnicity needs to be looked at as a possible factor associated with this disease for survival differences. The results of this study make an initial contribution to the understanding of high-grade malignancy and other prognostic factors must be included in order to get a better understanding of survival differences.

scholarly journals Risk factors at five-year survival in grade 3 breast cancer: a retrospective observational study of the New Zealand population

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sharita Meharry ◽  
Robert Borotkanics ◽  
Reena Ramsaroop ◽  
Fabrice Merien
Keyword(s):  
Breast Cancer ◽  
Prognostic Factors ◽  
New Zealand ◽  
Significant Risk ◽  
Luminal A ◽  
Differential Survival ◽  
Luminal B ◽  
Zealand Population ◽  
Increased Risk ◽  
Grade 3

Abstract Background Breast cancer is the most common cancer in New Zealand, with approximately 3000 new registrations annually, affecting one in nine women and resulting in more than 600 deaths. This study analyzed data of patients with selected prognostic factors of Nottingham grade 3 tumors over a specified five-year period. The study aimed to identify factors that result in differential survival in the female, New Zealand population. Method This is an observational, retrospective cohort study of prospectively collected data from New Zealand Breast Cancer Register. The selected period of 1st January 2011 to 31st, December 2015 allowed a consistent overlap for a national five-year data of grade 3 breast cancer in New Zealand. Mortality was carried out using univariate Fine-Gray competing risk statistical models. Results This study showed that women in the older age group (> 70 years) had higher five-year mortality risk (HR: 1.7, 95% CI: 0.9–3.0, p = 0.053). Hormonal receptor analysis showed that ER positive, PR negative, and ER negative, PR negative subjects were at increased risk (HR = 3.5, 95% CI 2.3–5.4, p < 0.001) and (HR = 2.6, 95% CI, 1.8–3.9, p < 0.001) respectively. Molecular subtypes Triple Negative Breast Cancer and Luminal B subjects were at increased risk (HR = 3.0, 95% CI, 1.8–4.7, p < 0.001 and (HR = 3.3, 95% CI, 1.7–6.3, p < 0.001) respectively. HER2 enriched subjects were at a higher, but not significant, risk of five-year mortality compared to luminal A (HR = 1.6, 95% CI, 0.8–3.0, p = 0.10). NZ Europeans were at increased risk (HR = 1.7, 95% CI, 0.8–3.2, p = 0.11), with the highest Cumulative Incidence Function CIF, the largest proportion of HER2 enriched and TNBC across ethnicities.; however, Pacific Islanders experienced the highest HER2 CIF. Conclusion The survival rates for grade 3 breast cancer vary across the selected prognostic factors and ethnicity. The results of this study make an initial contribution to the understanding of grade 3 breast cancer in the New Zealand population.

Male Versus Female Breast Cancers

2003 ◽  
Vol 127 (1) ◽  
pp. 36-41 ◽  
Author(s):  
D. Muir ◽  
R. Kanthan ◽  
S. C. Kanthan
Keyword(s):  
Breast Cancer ◽  
Estrogen Receptor ◽  
Progesterone Receptor ◽  
Male Breast Cancer ◽  
Male Breast ◽  
High Grade ◽  
Breast Cancers ◽  
Receptor Status ◽  
Female Breast ◽  
Grade 3

Abstract Context.—The rate of male breast cancer is a small fraction of that observed in females, thus severely limiting our understanding of the pathogenesis of this condition. It remains unclear whether the biological behavior and tumor progression associated with male breast cancer parallel that of the female form. Objectives.—To evaluate the immunohistochemical profile of male breast carcinomas and to compare this profile with that of stage-matched female breast cancers. Design.—Seventy-five cases of primary male breast cancer were identified using the records of the Saskatchewan Cancer Foundation over a period of 26 years (1970–1996). Fifty-nine of these cases had formalin-fixed, paraffin-embedded tissue blocks available for the purposes of this study. All cases were reviewed and a standardized modified Bloom-Richardson grading criterion was applied. Estrogen receptor status, progesterone receptor status, c-Erb-B2 expression, p53 expression, and Bcl-2 expression were evaluated by immunohistochemistry. Results from 240 consecutive cases of stage-matched female breast cancers analyzed in the same laboratory were used as a standard set for comparison. Results.—Male breast cancers tended to be high grade (85% grade 3) in comparison with the female breast cancers (50% grade 3). In descriptive analysis across all stages of disease, male carcinomas were more frequently estrogen receptor positive (81% vs 69%) than their female counterparts. Despite their high grade, they were less likely to overexpress p53 (9% vs 28%) and Erb-B2 (5% vs 17%) than the female counterparts. There was no significant difference in either progesterone receptor (63% vs 56%) or Bcl-2 (79% vs 76%) overexpression. Stratified analysis by stage-matched controls showed no statistically significant differences among the men and women with stage I disease. However, in stage II–matched samples, statistically significant differences were observed between the 2 groups. The male cancers were more likely to overexpress estrogen receptor (81.6% vs 64.4%, P = .04), progesterone receptor (71.1% vs 47.5%, P = .01), and Bcl-2 (78.9% vs 69.4%, P = .20). They also showed statistically significant lower expression of p53 (7.9% vs 36.3%, P = .001) and Erb-B2 (5.3% vs 23.8% P = .01). Conclusion.—Male breast cancers display distinct immunophenotypic differences from those occurring in women, implying a different pathogenesis in the evolution and progression of this disease. Such differences may play key roles in therapeutic management, warranting different treatment strategies in comparison to female breast cancers.

scholarly journals Breast Cancer Survival Defined by Biological Receptor and Menopausal Status in Vietnamese Women

2019 ◽  
Vol 26 (1) ◽  
pp. 107327481986527 ◽  
Author(s):  
Thang Vu Hong ◽  
Duc Nguyen Ba ◽  
Lambert Skoog ◽  
Van Ta Thanh ◽  
Edneia Tani
Keyword(s):  
Breast Cancer ◽  
Prognostic Factors ◽  
Survival Rate ◽  
Progesterone Receptor ◽  
Cox Model ◽  
Menopausal Status ◽  
Survival Rates ◽  
Factors Associated ◽  
Vietnamese Women ◽  
Significant Difference

Little is known about breast cancer in Vietnamese women. Previous studies have reported the frequencies of prognostic factors of breast cancer in this population. The aim of this study was to examine the prognostic factors associated with the survival rates of patients with breast cancer treated at the National Cancer Hospital, Hanoi, Vietnam. We recruited 248 women with operable breast cancer treated with surgery and adjuvant therapy. Tumor tissue samples were stained by many immunohistochemical approaches and analyzed for estrogen receptor, progesterone receptor, and HER2 gene amplification status. A Cox model was used to determine the relationship between survival and the prognostic factors. The disease-free survival rate, overall survival rate, and cancer-specific survival rate were 75.8%, 80.6%, and 86.4%, respectively, at 5 years and 62.3%, 68.1%, and 78.9%, respectively, at 10 years. The lung was the most common metastatic site. Women with factors associated with a poor prognosis (eg, advanced clinical stage, high tumor grade, progesterone receptor [PR] negativity, HER2 amplification) had significantly lower survival rates. Patients with PR-negative breast cancer had significantly worse survival rates compared to those who were PR positive, according to multivariate analysis (hazard ratio = 1.77, 95% confidence interval: 1.01-3.11, P = .045); however, there was only a statistically significant difference in postmenopausal patients. The PR was a prognostic factor in postmenopausal women with breast cancer, but not in premenopausal women.

Tumor biologic characteristics and clinical outcomes in geriatric patients with breast cancer.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e21526-e21526
Author(s):  
Sukesh Manthri ◽  
Muhammad Iqbal ◽  
Kathy Robinson ◽  
Robert S. Mocharnuk ◽  
Meghna R. Desai
Keyword(s):  
Breast Cancer ◽  
Clinical Outcomes ◽  
Clinical Stage ◽  
Cox Proportional Hazards ◽  
Nodal Involvement ◽  
Tumor Histology ◽  
Age Related ◽  
Grade 3 ◽  
Nottingham Grade ◽  
The Impact

e21526 Background: The probability of dying from breast cancer increases from 0.2% to 2% annually for women once they reach 70 years of age. However there is limited age-related information available about tumor biologic characteristics (TBCs) and clinical outcomes among elderly patients (pts). The purpose of this study was to analyze the impact of TBCs on clinical outcomes in a single institution's geriatric breast cancer pts. Methods: An institutional database of a total of 269 patients with histologically confirmed invasive or in-situ breast cancer with age 65 years or older at the time of diagnosis was reviewed in an IRB approved fashion. Tumors were assessed for Nottingham grade, stage, ER/PR status, HER-2 status, tumor histology, lymphovascular invasion and nodal status. Kaplan-Meyer and Cox proportional hazards methods were used to calculate overall survival (OS). Results: Breast cancer was seen equally in both breasts: left n = 130 (48.3%), right n = 132 (49.1%). Most tumors were located in the upper outer quadrant (n = 122, 45.35%). TNM clinical stage Tlc was identified in 79 pts (29.36%), Tlb in 55 pts (20.44%), T2 in 54 pts (20.07%) and no nodal involvement in 146 pts (54.27%). Nottingham Grade 2 (n = 120, 44.60%) and invasive ductal carcinomas (n = 152, 56.50%) were diagnosed most often. Tumors were more frequently ER+ (n = 237, 88.10%), PR+ (n = 210, 78.06%), and HER2-negative (n = 219, 81.41%). There was no statistically significant increase in OS based on location of tumor (P = 0.9796) and tumor histology (invasive ductal vs invasive lobular cancers, P = 0.1143). Node negative breast cancers were associated with increased OS (P = 0.0014). Grade 2 tumors were associated with increased OS compared to Grade 3 tumors (P = 0.0112). ER+ and PR-negative tumors were associated with decreased OS in both short term and long term follow up (P = 0.0083 & P = 0.0254). Conclusions: In pts 65 years of age or older with newly diagnosed breast cancer, lack of nodal involvement is associated with increased OS. Prognosis for ER+ and PR-negative tumors is worse compared to ER+ and PR+ tumors. Nottingham Grade 2 tumors have better OS compared to Grade 3 tumors. Location of tumor and tumor histology are not associated with increased OS.

ER-/PgR+ breast cancer is a separate entity characterized by distinct phenotype: Comprehensive reevaluation of cases from Polish and Hungarian centers.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e12554-e12554 ◽  
Author(s):  
Elzbieta Senkus-Konefka ◽  
Michał Kunc ◽  
Rafał Pęksa ◽  
Aleksandra Łacko ◽  
Barbara Radecka ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lower Percentage ◽  
Proliferation Index ◽  
High Grade ◽  
Apocrine Carcinoma ◽  
Ki67 Expression ◽  
Tissue Block ◽  
Insufficient Amount ◽  
Grade 3 ◽  
Positive Breast Cancer

e12554 Background: ER negative (-)/PgR positive (+) breast cancer (BC) is very uncommon and questioned by many experts. We comprehensively reevaluated ER-/PgR+ BCs in the large cohort from Polish and Hungarian centers. Methods: FFPE blocks from 105 ER-/PgR+ tumors (45 breast biopsies and 64 post-operative samples from tumors not exposed to systemic therapy) were collected from 10 Polish and 3 Hungarian centers. In 60 cases available original slides with ER/PgR staining underwent reevaluation by 3 pathologists (MK, RP, WB) for ER and PgR expression by ASCO/CAP criteria. Subsequently, all samples were stained with 3 antibodies against ER (Dako monoclonal (MC) mouse anti-ERα, clone 1D5; Dako MC rabbit anti-ERα, clone EP1; VENTANA Roche MC rabbit anti-ERα, clone SP1), and PgR (Dako MC mouse anti-PgR, clone 636). If available, > 1 tissue block was used (av. 2.04 blocks/case, range 1-6). In 5 cases ESR1/PGR/ERBB2/MKi67 mRNA was measured by the Xpert® Breast Cancer STRAT4 (Cepheid, Sunnyvale, CA, USA). Results: 13 cases were excluded from immunohistochemical steps of the study due to insufficient amount of tissue and 8 - due to misdiagnosis after ER/PgR reevaluation of original slides. After re-staining, 42 cases (41.5%) retained the original phenotype, in 34 (33.67%) the ER status was corrected to ER+, and 16 (15.84%) tumors were ER/PgR-double-negative. The general agreement between anti-ER clones was moderate (Fleiss’ κ = 0.54). There were 56 ER- and 16 ER+ cases across all three assays. Five cases showed ER positivity with 2 antibodies (either SP1/EP1 or SP1/1D5), 5 tumors reacted exclusively with SP1 clone, and 2 - with 1D5 clone. Xpert Breast Cancer STRAT4 confirmed the ER-/PgR+ phenotype in 4 of 5 analyzed cases. The confirmed ER-/PgR+ BCs were characterized by lower percentage of PgR+ cells (median 5%) than BCs reclassified to ER+ (median 70%) (p = 0.022) and higher Ki67 expression than ER+ cases (median 54.5% vs 25%, respectively; p = 0.003). 39 (92.85%) ER-/PgR+ BCs presented with grade 3. Besides “conventional” high-grade cancers, we identified two distinct morphologies of ER-/PgR+ BC: resembling apocrine carcinoma (n = 5, 11.9%) and carcinoma with central acellular zone (n = 4, 9.5%). Conclusions: ER-/PgR+ BCs confirmed in the current study were defined by high-grade histology, high proliferation index and low percentage of PgR+ cells. We postulate ER-/PgR+ BC is a real albeit rare entity, and its diagnosis should be made cautiously, utilizing retesting with an alternative tissue block and anti-ER antibody.

scholarly journals The Identification of Prognostic Factors and Survival Statistics of Conventional Central Chondrosarcoma

Sarcoma ◽  
2015 ◽  
Vol 2015 ◽  
pp. 1-11 ◽  
Author(s):  
Sjoerd P. F. T. Nota ◽  
Yvonne Braun ◽  
Joseph H. Schwab ◽  
C. Niek van Dijk ◽  
Jos A. M. Bramer
Keyword(s):  
Prognostic Factors ◽  
Survival Rates ◽  
Disease Free Survival ◽  
Selection Procedure ◽  
Tumor Location ◽  
Low Grade ◽  
High Grade ◽  
Dedifferentiated Chondrosarcoma ◽  
Free Survival ◽  
Disease Free

Introduction. Chondrosarcomas are malignant bone tumors that are characterized by the production of chondroid tissue. Since radiation therapy and chemotherapy have limited effect on chondrosarcoma, treatment of most patients depends on surgical resection. We conducted this study to identify independent predictive factors and survival characteristics for conventional central chondrosarcoma and dedifferentiated central chondrosarcoma.Methods. A systematic literature review was performed in September 2014 using the Pubmed, Embase, and Cochrane databases. Subsequent to a beforehand-composed selection procedure we included 13 studies, comprising a total of 1114 patients.Results. The prognosis of central chondrosarcoma is generally good for the histologically low-grade tumors. Prognosis for the high-grade chondrosarcoma and the dedifferentiated chondrosarcoma is poor with lower survival rates. Poor prognostic factors in conventional chondrosarcoma for overall survival are high-grade tumors and axial/pelvic tumor location. In dedifferentiated chondrosarcoma the percentage of dedifferentiated component has significant influence on disease-free survival.Conclusion. Despite the fact that there are multiple prognostic factors identified, as shown in this study, there is a need for prospective and comparative studies. The resulting knowledge about prognostic factors and survival can give direction in the development of better therapies. This could eventually lead to an evidence-based foundation for treating chondrosarcoma patients.

scholarly journals Impact of Technique and Schedule of Reirradiation Plus Hyperthermia on Outcome after Surgery for Patients with Recurrent Breast Cancer

Cancers ◽  
2019 ◽  
Vol 11 (6) ◽  
pp. 782 ◽  
Author(s):  
Sabine Oldenborg ◽  
Rob van Os ◽  
Bing Oei ◽  
Philip Poortmans
Keyword(s):  
Breast Cancer ◽  
Local Control ◽  
Survival Rates ◽  
Recurrent Breast Cancer ◽  
Complete Excision ◽  
Patients At Risk ◽  
The Difference ◽  
Grade 3 ◽  
Recurrent Breast ◽  
Locoregional Recurrent Breast Cancer

Purpose: Combining reirradiation (reRT) with hyperthermia (HT) has shown to be of high therapeutic value for patients with loco-regionally recurrent breast cancer. The purpose of this study was to compare the long-term therapeutic effect and toxicity of reRT + HT following surgery of loco-regionally recurrent breast cancer using two different reRT regimens. Methods: The reRT regimen of the 78 patients treated in Institute A consisted of 8 × 4 Gy twice a week using mostly abutted photon-electron fields. The 78 patients treated in Institute B received a reRT regimen of 12 × 3 Gy, four times a week with single or multiple electron fields. Superficial hyperthermia was applied once a week in Institute A and twice a week in Institute B. Both institutes started HT treatment within 1 hour after reRT and used the same 434-MHz systems to heat the tumor area to 41–43 °C. Results: The 5-year-infield local control (LC) rates were similar; however, the 5-year-survival rates were 13% lower in Institute A. Most remarkable was the difference in risk with respect to 5-year ≥ grade 3 toxicity, which was more than twice as high in Institute A. Conclusion: The combination of reirradiation and hyperthermia after macroscopically complete excision of loco-regional breast cancer recurrences provides durable local control in patients at risk for locoregional recurrent breast cancer. Treatment is well tolerated with the 12 × 3 Gy schedule with limited-sized electron fields.

Prognostic Factors in High-Grade Osteosarcoma of the Extremities or Trunk: An Analysis of 1,702 Patients Treated on Neoadjuvant Cooperative Osteosarcoma Study Group Protocols

2002 ◽  
Vol 20 (3) ◽  
pp. 776-790 ◽  
Author(s):  
Stefan S. Bielack ◽  
Beate Kempf-Bielack ◽  
Günter Delling ◽  
G. Ulrich Exner ◽  
Silke Flege ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Wide Spectrum ◽  
Survival Rates ◽  
Study Group ◽  
High Grade ◽  
Tumor Site ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Response To Chemotherapy ◽  
High Grade Osteosarcoma

PURPOSE: To define prognostic factors for response and long-term outcome for a wide spectrum of osteosarcomas, extending well beyond those of the typical young patient with seemingly localized extremity disease. PATIENTS AND METHODS: A total of 1,702 consecutive newly diagnosed patients with high-grade osteosarcoma of the trunk or limbs registered into the neoadjuvant studies of the Cooperative Osteosarcoma Study Group before July 1998 were entered into an analysis of demographic, tumor-related, and treatment-related variables, response, and survival. The intended therapeutic strategy included preoperative and postoperative chemotherapy with multiple agents as well as surgery of all operable lesions. RESULTS: Axial tumor site, male sex, and a long history of symptoms were associated with poor response to chemotherapy in univariate and multivariate analysis. Actuarial 10-year overall and event-free survival rates were 59.8% and 48.9%. Among the variables assessable at diagnosis, patient age (actuarial 10-year survival ≥ 40, 41.6%; < 40, 60.2%; P = .012), tumor site (axial, 29.2%; limb, 61.7%; P < .0001), and primary metastases (yes, 26.7%; no, 64.4%; P < .0001), and for extremity osteosarcomas, also size (≥ one third, 52.5%; < one third, 66.7%; P < .0001) and location within the limb (proximal, 49.3%; other, 63.9%; P < .0001), had significant influence on outcome. Two additional important prognostic factors were treatment related: response to chemotherapy (poor, 47.2%; good, 73.4%; P < .0001) and the extent of surgery (incomplete, 14.6%; macroscopically complete, 64.8%; P < .0001). All factors except age maintained their significance in multivariate testing, with surgical remission and histologic response emerging as the key prognostic factors. CONCLUSION: Tumor site and size, primary metastases, response to chemotherapy, and surgical remission are of independent prognostic value in osteosarcoma.

Can imaging kinetic parameters of dynamic contrast-enhanced magnetic resonance imaging be valuable in predicting clinicopathological prognostic factors of invasive breast cancer?

2017 ◽  
Vol 59 (7) ◽  
pp. 813-821 ◽  
Author(s):  
Cuiyan Wang ◽  
Wei Wei ◽  
Lumarie Santiago ◽  
Gary Whitman ◽  
Basak Dogan
Keyword(s):  
Breast Cancer ◽  
Prognostic Factors ◽  
Kinetic Parameters ◽  
Invasive Breast Cancer ◽  
Imaging Biomarkers ◽  
High Grade ◽  
Maximum Slope ◽  
Dce Mri ◽  
Dynamic Contrast Enhanced ◽  
Contrast Enhanced

Background Intrinsic molecular profiling of breast cancer provides clinically relevant information that helps tailor therapy directed to the specific tumor subtype. We hypothesized that dynamic contrast-enhanced MRI (DCE-MRI) derived quantitative kinetic parameters (CD-QKPs) may help predict molecular tumor profiles non-invasively. Purpose To determine the association between DCE-MRI (CD-QKPs) and breast cancer clinicopathological prognostic factors. Material and Methods Clinicopathological factors in consecutive women with biopsy-confirmed invasive breast cancer who underwent breast DCE-MRI were retrospectively reviewed. Analysis of variance was used to examine associations between prognostic factors and CD-QKPs. Fisher’s exact test was used to investigate the relationship between kinetic curve type and prognostic factors. Results A total of 198 women with invasive breast cancer were included. High-grade and HER2+ tumors were more likely to have a washout type curve while luminal A tumors were less likely. High-grade was significantly associated with increased peak enhancement (PE; P = 0.01), enhancement maximum slope (MS; P = 0.03), and mean enhancement ( ME, P = 0.03), while high clinical lymph node stage (cN3) was significantly associated with increased MS and time to peak (tP; P = 0.01). HER2+ tumors were associated with a higher PE ( P = 0.03) and ME ( P = 0.06) than HER2- counterparts, and ER-/HER2+ tumors showed higher PE and ME values than ER+/HER2- tumors ( P = 0.06). Conclusion DCE-MRI time-intensity CD-QKPs are associated with high tumor grade, advanced nodal stage, and HER2+ status, indicating their utility as imaging biomarkers.

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