Pattern of breast cancer presentation during the coronavirus disease pandemic: results from a cohort study in the UK

Background: This study aimed to explore the hypothesis that the stage of breast cancer at initial diagnosis in 2020 is more advanced compared with 2019. Methods: Tumor, node, metastasis and Union for International Cancer Control (UICC) stages of new breast cancer diagnoses at the Bucks Breast Unit from May to October 2019 and 2020 were reviewed. A p < 0.05 was considered significant. Results: Average UICC stage increased from 1a in 2019 to 2a in 2020 (p < 0.01). Excluding cancers detected through screening, UICC stage still increased from 1b in 2019 to 2a in 2020 (p = 0.0184). There was a significant increase in the percentage of node-positive patients (p = 0.0063) and patients with metastatic disease (p = 0.0295) on initial presentation. Conclusion: Overall, patients presented with higher UICC stages and more node-positive and metastatic disease on initial diagnosis in 2020 compared with 2019.

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Tumor Characteristics and Treatment Outcomes of Older Women with Breast Cancer in Jordan

10.21203/rs.2.16951/v2 ◽

2019 ◽

Author(s):

Hikmat Abdel-Razeq ◽

Fadwa Abdel Rahman ◽

Hanan Al-Masri ◽

Hazem Abdulelah ◽

Mahmoud Abu Nasser ◽

...

Keyword(s):

Breast Cancer ◽

Treatment Outcomes ◽

Metastatic Disease ◽

Cox Regression ◽

Early Stage ◽

Poor Performance Status ◽

Tumor Characteristics ◽

Early Stage Disease ◽

Node Positive ◽

Stage Disease

Abstract Background : Less than 10% of newly diagnosed breast cancer in our region are diagnosed in women 70 years or older. Treatment plans of such patients is less clear and have poor outcomes. In this paper, we describe clinical presentation, tumor characteristics and treatment outcomes in such patients. Methods : Consecutive patients aged 65 years or older with pathologically-confirmed diagnosis of breast cancer were included. Medical records and hospital databases were searched for patients’ characteristics and treatment outcomes. Results : A total of 553 patients, median age 70 (range: 65-91) years, were included. On presentation, 114 (20.6%) patients had metastatic disease and was mostly visceral (81; 71.1%). Patients with non-metastatic disease had poor pathological features including node-positive in 244 (55.6%), GIII in 170 (38.7%) and lymphovascular invasion in 173 (39.4%). Patients were treated less aggressively; 144 (32.8%) patients with early-stage disease and 98 (86.0%) with metastatic disease never had chemotherapy. After a median follow up of 45 months, 5-year overall survival for the whole group was 67.6%. Survival was better for patients with non-metastatic disease (78.8% vs. 25.4%, P<0.001) and for those with node-negative compared to node-positive disease (85.4% vs. 74.1%, P=0.002). On Cox regression, only positive lymph nodes were associated with poor outcome in patients with non-metastatic disease (Hazard Ratio [HR], 1.75; 95% CI: 1.006-3.034, P=0.048). Conclusions : Older Jordanian women with breast cancer present with more aggressive features and advanced-stage disease that reflect poorly on treatment outcomes. Because of comorbidities and poor performance status, some patients were not aggressively treated.

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The lingering mysteries of metastatic recurrence in breast cancer

British Journal of Cancer ◽

10.1038/s41416-020-01161-4 ◽

2020 ◽

Vol 124 (1) ◽

pp. 13-26

Author(s):

Alessandra I. Riggio ◽

Katherine E. Varley ◽

Alana L. Welm

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Metastatic Disease ◽

Systemic Therapy ◽

Initial Diagnosis ◽

Diagnosis And Treatment ◽

Breast Cancer Patients ◽

Key Factors ◽

Metastatic Recurrence ◽

Metastatic Relapse

AbstractDespite being the hallmark of cancer that is responsible for the highest number of deaths, very little is known about the biology of metastasis. Metastatic disease typically manifests after a protracted period of undetectable disease following surgery or systemic therapy, owing to relapse or recurrence. In the case of breast cancer, metastatic relapse can occur months to decades after initial diagnosis and treatment. In this review, we provide an overview of the known key factors that influence metastatic recurrence, with the goal of highlighting the critical unanswered questions that still need to be addressed to make a difference in the mortality of breast cancer patients.

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Abstract P3-01-03: The loss of lymph node metastasis after neoadjuvant chemotherapy in patients with cytologically proven node-positive primary breast cancer

10.1158/1538-7445.sabcs17-p3-01-03 ◽

2018 ◽

Author(s):

M Namura ◽

N Hayashi ◽

H Tsunoda ◽

A Yoshida ◽

J Takei ◽

...

Keyword(s):

Breast Cancer ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Neoadjuvant Chemotherapy ◽

Primary Breast Cancer ◽

Node Metastasis ◽

Node Positive

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Circulating miR-200c-3p as a marker of metastatic disease at diagnosis in breast cancer patients.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.e12559 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. e12559-e12559

Author(s):

Esther Navarro Manzano ◽

Gines Luengo-Gil ◽

Elisa Garcia-Garre ◽

Maria Piedad Fernandez Perez ◽

Ana Fernandez Sanchez ◽

...

Keyword(s):

Breast Cancer ◽

Metastatic Disease ◽

Predictive Value ◽

Plasma Levels ◽

Cancer Biology ◽

Statistical Tests ◽

Locally Advanced ◽

Initial Diagnosis ◽

Plasma Samples ◽

Mesenchymal Transition

e12559 Background: MicroRNAs are involved in cancer biology through their role in regulation of protein expression. The miR-200 family plays a dual role in breast cancer (BC), both regulating epithelial to mesenchymal transition and promoting metastatic colonization. Plasma levels of miR-200 have been previously evaluated as prognostic factors in early and metastatic BC (MBC) but its role as a potential diagnostic marker is less well established. The aim of this study was to determine the potential diagnostic value of miR-200c-3p plasmatic levels in women with locally advanced and metastatic BC. Methods: We included 73 BC patients and 14 controls. Plasma samples were obtained at diagnosis, before treatment. RNA from plasma samples was extracted with NucleoSpin miRNA plasma (Macherey-Nagel). We analyzed expression levels of miR-200c-3p, which were relativized (2-ΔΔCT method) to miR-16. Non-parametric statistical tests were used to determine the association of miR-200c levels with clinical variables. Receiver-operating curves (ROC) were constructed and diagnostic ability evaluated. Kaplan-Meier curves and Cox models were used for survival analyses. Results: 73 BC patients were included: 36 locally advanced BC (LABC) and 37 MBC (7 recurrences and 30 MBC at initial diagnosis [MBCID]). Plasma miR-200c levels were significantly higher in MBC than in controls (p = 0.001) and in LABC (p = 0.001). We found differences neither for age nor for estrogen receptors, HER2, tumor subtype or histology. Overall and disease free survival did not differ by miR-200c levels in any of the groups. Among MBC patients, higher levels were observed in MBCID (p = 0.023). In the group of women with an initial diagnosis of BC (n = 65), high miR-200c levels (over 1st tertile) identified metastatic disease with a sensitivity of 90.0% (95%CI: 72.3-97.4%) and a specificity of 51.4% (95%CI: 34.3-68.3%); negative predictive value: 85.7%; positive predictive value: 61.4%; ROC AUC: 0.79. Conclusions: MiR-200c plasma levels are higher in BC patients with metastatic disease at diagnosis, and might be clinically useful to identify them. Further research on miR200c biological role in MBC and validation in larger populations with sequential samples are warranted.

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