scholarly journals Prognostic Implication of Isolated Pulmonary Nodules in Patients with a History of Breast Cancer

2021 ◽  
Author(s):  
Weigang Zhao ◽  
Shu Zhu ◽  
Zuodong Song
Keyword(s):  
Breast Cancer ◽  
Lung Cancer ◽  
Cancer Patients ◽  
Surgical Outcomes ◽  
Primary Lung Cancer ◽  
Disease Free Survival ◽  
Metastatic Breast ◽  
Pulmonary Nodules ◽  
Limited Resection ◽  
Breast Cancer Patients

Abstract Background: Isolated malignant pulmonary nodules were frequently seen in patients with breast cancer. These were metastasis from the breast cancer or new primary lung cancer. The role of surgery for such pulmonary nodules remains unclear.Methods: A total of 90 patients who underwent surgery for solitary malignant pulmonary nodules between January 2010 and April 2018 after curative operation for breast cancer were reviewed.Results: The pathologic diagnoses revealed 63 patients with primary lung cancer (PLC) and 27 patients with pulmonary metastatic breast cancer (MBC), which were divided into two groups. All patients were female with a mean age of 55.08±9.84 years (range 31-75). Age differences between the two groups were insignificant. Of the 63 patients with PLC, 55(87%) had a lobectomy with lymphadenctomy and 8(13%) had a limited resection, while the majority of patients (78%) with MBC had a limited resection. All nodules were adenocarcinomas and their mean diameter was 1.63±0.57cm. 7/55 of patients with PLC had N1 disease while 3/6 of those with MBC had involvement of N1 nodes. For all patients, the overall survival (OS) was 86.1% at 5 years and the disease free survival (DFS) was 86.0% at 5 years. Patients with PLC had the better surgical outcomes including OS and DFS than those with MBC did (94.2% versus 72.8%, p=0.017; 93.6% versus 63.9%, p=0.002).Conclusions: Surgical outcomes of isolated malignant pulmonary nodules in breast cancer patients were favorable. Surgery should be considered as an option for breast cancer patients with isolated pulmonary nodules.

scholarly journals Radiomics Methods to Differentiate Metastasis and Primary Lung Cancer of Breast Cancer Patients in PET/CT

2021 ◽  
Author(s):  
Xinglu Zhou ◽  
Yunsong Peng ◽  
Yingci Li ◽  
Jiarui Zhang ◽  
Tianyi Liu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lung Cancer ◽  
Cancer Patients ◽  
Roc Curve ◽  
Primary Lung Cancer ◽  
Whole Body ◽  
Imaging Method ◽  
Pathological Features ◽  
Breast Cancer Patients ◽  
Pet Ct

Abstract Purpose：Positron emission tomography (PET) with integrated computed tomography (PET/CT) is a whole-body imaging method providing information the entire body. When it was used in staging breast cancer patients, quite a few patients were found to have a second primary lung cancer(PLC), which was has few distinguishing features from breast cancer metastasis(MBC). Therefore, based on CT, LDCT and PET images, combined with pathological features, we established radiomics models to distinguish between MBC and PLC.Methods：We retrospectively collected CT, LDCT, and PET images, and pathology features of 100 breast cancer patients, including 60 metastases of breast cancer(MBC) and 40 primary lung cancers(PLC). The two radiologists manually drew a region of interest around the whole visible tumor in consensus. Python 3.8 and Pyradiomics toolkit are used to extract features from CT, LDCT, and PET. The linear discriminant analysis (LDA) classifier was used to build the radiomics model. The receiver operating characteristic (ROC) curve and area under the ROC curve (AUC) were used to evaluate the classification performance.Results：Total 12, 13, and 9 features were selected from the CT, LDCT, and PET respectively. The model based on the LDCT and PET obtained the same highest AUC (0.9479). The combination with CT and pathology features showed a highest AUC of 0.9583 with a sensitivity of 1.000 and a specificity of 0.8333. Conclusion：Overall, the results are encouraging that radiomics models based on CT, LDCT and PET can differentiate between MBC and PLC pathological features could significantly improve the AUC and ACC of CT model.

scholarly journals The Effectiveness of Lapatinib in HER2-Positive Metastatic Breast Cancer Patients Pretreated With Multiline Anti-HER2 Treatment: A Retrospective Study in China

2021 ◽  
Vol 20 ◽  
pp. 153303382110378
Author(s):  
Xinzhao Wang ◽  
Lin Wang ◽  
Qian Yu ◽  
Zhaoyun Liu ◽  
Chao Li ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Cancer Patients ◽  
Disease Free Survival ◽  
Metastatic Breast ◽  
Second Line ◽  
Breast Cancer Patients ◽  
Her2 Positive ◽  
Free Survival ◽  
Line Setting

Background: The aim of this study was to evaluate the effectiveness of lapatinib in human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer. Methods: We retrospectively reviewed the medical records of patients who received lapatinib for salvage treatment at any line setting from January 1, 2007 to August 31, 2019 at Shandong Cancer Hospital and Institute. Results: A total of 115 (89.1%) patients were included in the study. In the overall cohort, the median disease-free survival (DFS) was 19.0 months; the median progression-free survival (PFS), 6.3 months; and median overall survival (OS), 88.0 months, with 32.2% of patients alive at 5 years. In the second line setting, the median PFS among trastuzumab, lapatinib, and trastuzumab plus lapatinib were 4.2 months, 5.2 months, and 7.3 months, respectively ( P = 0.004). No significant differences between the median PFSs and OSs of the different line salvage treatments with lapatinib was observed (all P > 0.05). For brain metastasis patients, the median PFSs in first line, second line, and more than 3 lines were 7.2 months, 4.5 months, and 6.3 months, respectively. Conclusions: Our findings suggest that patients would benefit more from trastuzumab plus lapatinib than from lapatinib or trastuzumab alone for second line treatment in the advanced stages of the disease. Lapatinib could be used as an alternative selection for HER2-positive metastasic breast cancer patients when there is disease progression after trastuzumab or pyrotinib treatment, which is used as part of China’s national health insurance.

scholarly journals Assessment of Survival and Cardiotoxicity of Adjuvant Trastuzumab among HER2 Breast Cancer Patients in an Oncology Centre in Malaysia

2018 ◽  
Vol 3 (1) ◽  
pp. 33
Author(s):  
Harissa Husainy Hasbullah ◽  
Anita Bustamam ◽  
Tho Lye Munn ◽  
Vincent Phua
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Cancer Patients ◽  
Disease Free Survival ◽  
Metastatic Breast ◽  
Left Ventricular ◽  
Rank Test ◽  
Breast Cancer Patients ◽  
Adjuvant Trastuzumab ◽  
Her2 Breast Cancer

Introduction: Adjuvant trastuzumab has been used in human epidermal growth factor-2 (HER2) breast cancer to improve survival but with concern of cardiotoxicity. Our study is the first to review efficacy and toxicity of adjuvant trastuzumab in Malaysia. Methods: This is a retrospective cohort study on HER2 non metastatic breast cancer patients in University Malaya Medical Centre diagnosed between October 2006 and May 2011. Two cohorts were created based on whether or not they received adjuvant trastuzumab. Disease free survival (DFS) and overall survival (OS) for both groups were estimated using Kaplan Meier method and compared using Log rank test. Cox proportional hazards regression models analysed for potential covariates of age, tumour size and grade, node and estrogen receptor (ER) status. Trastuzumab cardiotoxicity was defined as left ventricular systolic dysfunction or heart failure with or without symptoms and graded using Common Terminology Criteria for Adverse Events (CTCAE 4.0). Results: 170 HER2 non metastatic breast cancer patients were identified. Thirty-three received trastuzumab and 136 did not. Median age was 53.4 ± 10.3 years old. Significantly more ER negative patients received trastuzumab. Four years DFS in ‘trastuzumab’ versus ‘no trastuzumab’ cohort was 90.9% vs 74.5% (p = 0.027). Four years OS was 91% vs 84.7% (p = 0.30) respectively. Majority tolerated trastuzumab with no toxicity. Five patients (15.2%) experienced cardiotoxicity (all grade I).Conclusions: Adjuvant trastuzumab significantly improved DFS in HER2 breast cancer. Treatment was well tolerated. With this we propose the justification for adjuvant trastuzumab in HER2 breast cancer in our population.

Outcomes of HER2-positive nonmetastatic breast cancer patients with or without deleterious BRCA mutations after trastuzumab treatment.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e12550-e12550
Author(s):  
Aimaz Afrough ◽  
Heather Lin ◽  
Angelica M. Gutierrez-Barrera ◽  
Jennifer Keating Litton ◽  
Vicente Valero ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Brca Mutation ◽  
Disease Free Survival ◽  
Metastatic Breast ◽  
Her2 Overexpression ◽  
Breast Cancer Patients ◽  
Her2 Positive ◽  
Brca Mutations ◽  
Her2 Breast Cancer

e12550 Background: Human epidermal growth factor receptor (HER2) overexpression or amplification occurs in 20–25% of all breast cancers and is associated with an aggressive form of the disease with reduced disease-free survival (DFS) and overall survival (OS). However, the outcome of patients with HER2+ tumor and BRCA mutation is poorly described. The purpose of this analysis was to analyze the clinical and pathological features and outcomes of patients with HER2+ breast cancer regards to their BRCA status. Methods: Patients who were referred for genetic counseling between 2004-2012 and who had a HER2+ breast cancer treated with trastuzumab were included in our analysis. Patients were considered Her2+ if immunohistochemistry was 3+ or had a ratio of ≥2 by FISH. Patients with metastatic breast cancer at diagnosis were excluded. Clinical and pathological and outcome data was extracted from a prospectively maintained research data base after IRB approval was obtained. Results: Ninety-four patients were identified. The median age at diagnosis was 39 years (range 21 – 58). The majority of the patients were White (76%). Tumors were invasive ductal carcinoma in 89% and had nuclear grading of 3 in 76% of patients. Hormone receptors were positive in 66% and BRCA 1 or 2 mutations were positive in 16% (N=15). The majority of the patients were treated with a combination of Anthracyclines plus Taxanes (76%). All patients received trastuzumab in the neoadjuvant or adjuvant setting. After a median follow-up of 4.4 years, OS and DFS in all patients were 97% and 88%, respectively. Three HER2-positive breast cancer patients had died (3.2 %). Recurrence had occurred in 11 patients; all of these patients were BRCA negative. OS and DFS of patients with BRCA mutations were then compared with OS and DFS of patients without BRCA mutation (both 100% vs. 96% and 81.9%, respectively). There was no statistically significant survival difference in BRCA mutation carriers compared with non-carriers (p=0.362). Conclusions: The presence of a BRCA mutation does not seem to offer prognostic information in this population. Further investigation with larger cohort are needed for confirmation.

scholarly journals MA03.03 High Risk for Second Primary Lung Cancer in Taiwanese Early-Onset Female Breast Cancer Patients

2017 ◽  
Vol 12 (1) ◽  
pp. S353-S354
Author(s):  
Pei-Ying Lin ◽  
Ching-Yao Yang ◽  
Ching-Heng Lin ◽  
Tzu-Pin Lu ◽  
James Chih-Hsin Yang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lung Cancer ◽  
High Risk ◽  
Cancer Patients ◽  
Primary Lung Cancer ◽  
Female Breast Cancer ◽  
Second Primary ◽  
Breast Cancer Patients ◽  
Female Breast ◽  
Second Primary Lung Cancer

scholarly journals Impact of Post-diagnosis Weight Change on Survival Outcomes in a Multiethnic Cohort of Breast Cancer Patients

2020 ◽  
Author(s):  
Lihua Shang ◽  
Masaya Hattori ◽  
Gini Fleming ◽  
Nora Jaskowiak ◽  
Donald Hedeker ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Cancer Patients ◽  
Weight Change ◽  
Repeated Measures ◽  
Disease Free Survival ◽  
Metastatic Breast ◽  
Survival Outcomes ◽  
Breast Cancer Patients ◽  
Increased Risk

Abstract Purpose: To evaluate weight change patterns over time following the diagnosis of breast cancer, and to examine the association of post-diagnosis weight change and survival outcomes in Black and White patients.Methods: The study included 2,888 women diagnosed with non-metastatic breast cancer in 2000-2017 in Chicago. Longitudinal repeated measures of weight and height were collected, along with a questionnaire survey including questions on body size. Multilevel mixed-effects models were used to examine changes in body mass index (BMI). Delayed entry Cox proportional hazards models were used to investigate the impacts of changing slope of BMI on survival outcomes. Results: At diagnosis, most patients were overweight or obese with a mean BMI of 27.5 kg/m2 and 31.5 kg/m2 for Blacks and Whites, respectively. Notably, about 45% of the patients had cachexia before death and substantial weight loss started about 30 months before death. In multivariable-adjusted analyses, compared to stable weight, BMI loss (>0.5 kg/m2/year) showed greater than 2-fold increased risk in overall survival (hazard ratio [HR]=2.68, 95%CI 1.95-3.66), breast cancer specific survival (HR=2.93, 95%CI 1.86-4.62), and disease-free survival (HR=2.25, 95%CI 1.63-3.11). The associations were not modified by race, age at diagnosis, and pre-diagnostic weight. BMI gain (>0.5 kg/m2/year) was also related to worse survival, but the effect was weak (HR=1.53, 95%CI 1.06-2.22 for overall survival).Conclusion: BMI loss is a strong predictor of worse breast cancer outcomes. Growing prevalence of obesity may hide diagnosis of cancer cachexia, which can occur in a large proportion of breast cancer patients long before death.

scholarly journals Plasma Proteome Signature to Predict the Outcome of Breast Cancer Patients Receiving Neoadjuvant Chemotherapy

Cancers ◽  
2021 ◽  
Vol 13 (24) ◽  
pp. 6267
Author(s):  
Sungchan Gwark ◽  
Hee-Sung Ahn ◽  
Jeonghun Yeom ◽  
Jiyoung Yu ◽  
Yumi Oh ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Cancer Patients ◽  
Plasma Concentrations ◽  
Disease Free Survival ◽  
Metastatic Breast ◽  
Plasma Proteome ◽  
Breast Cancer Patients ◽  
Free Survival ◽  
Potential Biomarkers

The plasma proteome of 51 non-metastatic breast cancer patients receiving neoadjuvant chemotherapy (NCT) was prospectively analyzed by high-resolution mass spectrometry coupled with nano-flow liquid chromatography using blood drawn at the time of diagnosis. Plasma proteins were identified as potential biomarkers, and their correlation with clinicopathological variables and survival outcomes was analyzed. Of 51 patients, 20 (39.2%) were HR+/HER2-, five (9.8%) were HR+/HER2+, five (9.8%) were HER2+, and 21 (41.2%) were triple-negative subtype. During a median follow-up of 52.0 months, there were 15 relapses (29.4%) and eight deaths (15.7%). Four potential biomarkers were identified among differentially expressed proteins: APOC3 had higher plasma concentrations in the pathological complete response (pCR) group, whereas MBL2, ENG, and P4HB were higher in the non-pCR group. Proteins statistically significantly associated with survival and capable of differentiating low- and high-risk groups were MBL2 and P4HB for disease-free survival, P4HB for overall survival, and MBL2 for distant metastasis-free survival (DMFS). In the multivariate analysis, only MBL2 was a consistent risk factor for DMFS (HR: 9.65, 95% CI 2.10–44.31). The results demonstrate that the proteomes from non-invasive sampling correlate with pCR and survival in breast cancer patients receiving NCT. Further investigation may clarify the role of these proteins in predicting prognosis and thus their therapeutic potential for the prevention of recurrence.

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