scholarly journals Imaging Surveillance of the Reconstructed Breast in a Subset of Patients May Aid in Early Detection of Breast Cancer Recurrence

2021 ◽  
Vol 11 ◽  
pp. 58
Author(s):  
Beatriz Elena Adrada ◽  
Niloofar Karbasian ◽  
Monica Huang ◽  
Gaiane Maia Rauch ◽  
Piyanoot Woodtichartpreecha ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Primary Breast Cancer ◽  
Detection Method ◽  
Cancer Recurrence ◽  
Recurrent Breast Cancer ◽  
Breast Cancer Recurrence ◽  
Imaging Features ◽  
Imaging Surveillance ◽  
Recurrent Breast ◽  
Reconstructed Breast

Objectives: The purpose of this study is to determine the biological markers more frequently associated with recurrence in the reconstructed breast, to evaluate the detection method, and to correlate recurrent breast cancers with the detection method. Material and Methods: An institutional review board-approved retrospective study was conducted at a single institution on 131 patients treated with mastectomy for primary breast cancer followed by breast reconstruction between 2005 and 2012. Imaging features were correlated with clinical and pathologic findings. Results: Of the 131 patients who met our inclusion criteria, 40 patients presented with breast cancer recurrence. The most common histopathologic type of primary breast cancer was invasive ductal carcinoma in 82.5% (33/40) of patients. Triple-negative breast cancer was the most common biological marker with 42.1% (16/38) of cases. Clinically, 70% (28/40) of the recurrences presented as palpable abnormalities. Of nine patients who underwent mammography, a mass was seen in eight patients. Of the 35 patients who underwent ultrasound evaluation, an irregular mass was found in 48.6% (17/35) of patients. Nine patients with recurrent breast cancer underwent breast MRI, and MRI showed an irregular enhancing mass in four patients, an oval mass in four patients, and skin and trabecular thickening in one patient. About 55% of patients with recurrent breast cancer were found to have distant metastases. Conclusion: Patients at higher risk for locoregional recurrence may benefit from imaging surveillance in order to detect early local recurrences.

scholarly journals Proteomic Analysis of Inflammatory Biomarkers Associated With Breast Cancer Recurrence

2020 ◽  
Vol 185 (Supplement_1) ◽  
pp. 669-675 ◽  
Author(s):  
Alakesh Bera ◽  
Eric Russ ◽  
Muthu Srinivasan ◽  
Ofer Eidelman ◽  
Michael Eklund ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Breast Imaging ◽  
Critical Role ◽  
Embryonic Stem ◽  
Cancer Recurrence ◽  
Recurrent Breast Cancer ◽  
Breast Cancer Recurrence ◽  
Breast Cancer Patients ◽  
Recurrent Breast

ABSTRACT Introduction Breast cancer is the most frequent cancer detected for women, and while our ability to treat breast cancer has improved substantially over the years, recurrence remains a major obstacle. Standard screening for new and recurrent breast cancer involves clinical breast imaging. However, there is no clinically approved noninvasive body fluid test for the early detection of recurrent breast cancer. Materials and Method: In this study, we analyzed serum samples from both recurrent and nonrecurrent breast cancer patients by different proteomics methods to identify biomarkers in patients with recurrence of disease. Results Comparative data analysis identified several histone deacetylase (HDAC) proteins, which were found at significantly higher levels in the serum of recurrent breast cancer patients: HDAC9 (C-term) (P = 0.0035), HDAC5 (C-term) (P = 0.013), small ubiquitin-like modifier 1 (N-term) (P = 0.017), embryonic stem cell-expressed Ras (inter) (P = 0.018), and HDAC7 (C-term) (P = 0.020). Chronic inflammation plays a critical role in the development of the breast cancer recurrence, and we identified several proinflammatory cytokines that were present at elevated levels only in recurrent breast cancer patient serum. Conclusions Our data indicated that the epigenetic regulation of inflammatory processes plays a critical role in breast cancer recurrence. The identified proteins could lay the groundwork for the development of a serum-based breast cancer recurrence assay.

scholarly journals Debulking mastectomy with electrochemotherapy: a case report of no surgery approach to recurrent breast cancer.

2020 ◽  
Author(s):  
Emanuela Esposito ◽  
Claudio Siani ◽  
Ugo Pace ◽  
Raffaele Costanzo ◽  
Raimondo di Giacomo
Keyword(s):  
Breast Cancer ◽  
Chest Wall ◽  
New Technologies ◽  
Cancer Recurrence ◽  
Recurrent Breast Cancer ◽  
Breast Conserving Surgery ◽  
Breast Cancer Recurrence ◽  
Multi Drug Resistance ◽  
Patient Will ◽  
Recurrent Breast

Abstract Background Electrochemotherapy has been shown to be safe, effective and non-invasive loco-regional treatment for chest wall breast cancer recurrence. Electrochemotherapy is the gold standard treatment of patients with cutaneous metastases from breast cancer who due to the extent of those lesions are not eligible for resection or radiotherapy has already been used, and systemic therapy is ineffective or contraindicated. Case presentation Here we present the case of a women affected by multiple metastatic cancers with multi-drug resistance who refused mastectomy after being diagnosed with recurrent ulcerated right breast cancer. We first describe an extended indication to electrochemotherapy to treat breast cancer recurrence after breast conserving surgery. Electroporation-induced necrosis through electrochemotherapy replaced surgery and was delivered in 30 minutes at 5000 Hz frequencies at 730 V by hexagonal needle under general anesthesia. The necrosis of the remaining breast resulted in a voluminous eschar that was easily removed few months after leaving the chest wall free from macroscopic disease turning in a non-surgical mastectomy. Conclusions. This kind of breakthrough application of electrochemotherapy might be considered to avoid palliative mastectomy in very selected patients. New technologies may help clinicians to find agreement between patient’ will and the burden of treatment and might contribute in selected cases to give options to patients not keen on having surgery.

Postchemotherapy rheumatism.

1993 ◽  
Vol 11 (4) ◽  
pp. 768-770 ◽  
Author(s):  
C L Loprinzi ◽  
J Duffy ◽  
J N Ingle
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Combination Chemotherapy ◽  
Case Reports ◽  
Cancer Recurrence ◽  
Recurrent Breast Cancer ◽  
Rheumatologic Diseases ◽  
Clinical Phenomenon ◽  
Recurrent Breast

PURPOSE This report describes a previously unreported clinical phenomenon that occurs in some patients after completion of combination chemotherapy. METHODS AND RESULTS Eight case reports are presented. Affected patients developed a syndrome of myalgias/arthralgias within several months of completing cyclophosphamide/fluorouracil (5FU)-containing adjuvant combination chemotherapy for breast cancer. These symptoms did not appear to be related to cancer recurrence or any common rheumatologic disorder. The syndrome generally resolved over several months. CONCLUSION Postchemotherapy rheumatism is a syndrome of myalgias/arthralgias that usually develops 1 to 3 months after completion of adjuvant chemotherapy. Recognition of this syndrome can limit the need for extensive work-ups to exclude recurrent breast cancer or inflammatory rheumatologic diseases.

scholarly journals RIPK3 upregulation confers robust proliferation and collateral cystine-dependence on breast cancer recurrence

2019 ◽  
Author(s):  
Chao-Chieh Lin ◽  
Nathaniel Mabe ◽  
Yi-Tzu Lin ◽  
Wen-Hsuan Yang ◽  
Xiaohu Tang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Tumor Cells ◽  
Breast Tumor ◽  
Tumor Recurrence ◽  
Cancer Recurrence ◽  
Breast Cancer Recurrence ◽  
Recurrent Tumor ◽  
Breast Tumor Cells ◽  
Recurrent Tumors ◽  
Recurrent Breast

AbstractThe molecular and genetic basis of tumor recurrence is complex and poorly understood. RIPK3 is a key effector in programmed necrotic cell death and, therefore, its expression is frequently suppressed in primary tumors. In a transcriptome profiling between primary and recurrent breast tumor cells from a murine model of breast cancer recurrence, we found that RIPK3, while absent in primary tumor cells, is dramatically re-expressed in recurrent breast tumor cells by an epigenetic mechanism. Unexpectedly, we found that RIPK3 knockdown in recurrent tumor cells reduced clonogenic growth, causing cytokinesis failure, p53 stabilization, and repressed the activities of YAP/TAZ. These data uncover a surprising role of the pro-necroptotic RIPK3 kinase in enabling productive cell cycle during tumor recurrence. Remarkably, high RIPK3 expression also rendered recurrent tumor cells exquisitely dependent on extracellular cystine and undergo programmed necrosis upon cystine deprivation. The induction of RIPK3 in recurrent tumors unravels an unexpected mechanism that paradoxically confers on tumors both growth advantage and necrotic vulnerability, providing potential strategies to eradicate recurrent tumors.

Asymptomatic versus symptomatic metastatic breast cancer: Potential effects on prognosis and quality adjusted life years (QALYs).

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e13073-e13073
Author(s):  
Kosho Yamanouchi ◽  
Shigeto Maeda ◽  
Tamotsu Kuroki
Keyword(s):  
Breast Cancer ◽  
Primary Breast Cancer ◽  
Recurrent Breast Cancer ◽  
Quality Adjusted Life Years ◽  
Asymptomatic Group ◽  
Symptomatic Group ◽  
Life Years ◽  
Recurrent Breast ◽  
Quality Adjusted Life

e13073 Background: After radical surgery for breast cancer, routine laboratory or imaging studies for metastases screening are not indicated in the absence of clinical signs and symptoms suggestive of recurrence. While the goal of therapy is the extension of survival and maintenance of quality of life (QOL), therapies themselves could induce adverse events, resulting in deterioration of QOL. We evaluated quality adjusted life years (QALYs), which is survival adjusted by QOL, of the patients with recurrent breast cancer retrospectively and adequate follow-up measures. Methods: Fifty seven patients with recurrent breast cancer who died already were included. Survival curves were partitioned into two health states: time with ≥ grade 2 chemotherapy-related toxicity (TOX) and time without toxicity (TWiST). QALYs were acquired as follows: QALYs = TWiST + 0.7 * TOX. We compared clinical factors in the patients between with (symptomatic group, n = 32) and without symptoms (asymptomatic group, n = 25). Results: The median age of the patient at diagnosis of recurrence was 57 years. Luminal (hormone receptors (HR) - and human epidermal growth factor receptor-2 (HER2) -), HER2 (HER2 +), triple negative (TN) (HR - and HER2 -), and unknown were 29, 7, 15, and 6 cases, respectively. The proportion of HER2 and TN was significantly higher in the symptomatic group than that in the asymptomatic group (58.6, 21.7 %, p < 0.05). 44.6 % of the patients had visceral metastases at diagnosis of recurrence and the proportions were not different between the groups. Although post recurrent survival (PRS) was shorter significantly in the symptomatic group (22.5, 42,0 months, p < 0.01), overall survival from diagnosis of primary breast cancer (OS) was identical (60.5, 91.0 months). Additionally, QALYs after recurrence was shorter in the symptomatic group (23.0, 41.1 months, p < 0.01) and QALYs from diagnosis of primary breast cancer was identical (58.7, 91.0 months). Conclusions: Although there was no significant difference in OS between the both groups, the duration of therapy received was longer in the symptomatic group. In the present study, we acquired limited information due to retrospective manner. Prospective evaluation of QALYs, including patient reported outcome and symptoms derived from cancer itself, would turn out adequate measures of follow-up after radical surgery for primary breast cancer.

FDG-PET/CT in the diagnosis of recurrent breast cancer

2012 ◽  
Vol 53 (1) ◽  
pp. 12-16 ◽  
Author(s):  
Ryusuke Murakami ◽  
Shin-ichiro Kumita ◽  
Tamiko Yoshida ◽  
Keiichi Ishihara ◽  
Tomonari Kiriyama ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Predictive Value ◽  
Cancer Recurrence ◽  
Final Diagnosis ◽  
Recurrent Breast Cancer ◽  
Whole Body ◽  
Positron Emission ◽  
Pet Ct ◽  
The Difference ◽  
Recurrent Breast

Background An advantage of PET/CT has been demonstrated for diagnosis of several tumor entities. In patients with breast cancer, early diagnosis and accurate restaging of recurrence after surgery is important for selection of the most appropriate therapeutic strategy. Purpose To evaluate the accuracy of integrated positron emission tomography and computed tomography (PET/CT) using 18F-fluorodeoxyglucose (FDG), for follow-up of patients with suspected recurrent breast cancer. Material and Methods Forty-seven patients with suspected recurrent breast cancer underwent PET/CT. The PET and PET/CT images were interpreted without knowledge of the results of other diagnostic modalities, and compared with each other with reference to the final diagnosis. Results Twenty-five (53%) patients suffered tumor recurrence. The overall sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of PET/CT were 96%, 91%, 92%, 95%, and 94%, respectively. In comparison with PET, PET/CT had a higher sensitivity and accuracy (96% vs. 80% and 94% vs. 81%, respectively). The difference in diagnostic accuracy between PET/CT and PET was significant ( P < 0.05). Conclusion The present findings indicate that PET/CT is an accurate, sensitive and reliable modality for screening and detection of breast cancer recurrence. PET/CT appears to be an effective surveillance tool, as it is able to cover the whole body in a single procedure and shows good performance.

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