scholarly journals Comparison between the american joint committee on cancer (ajcc) anatomic and prognostic stages for breast cancer

Mastology ◽  
2020 ◽  
Vol 30 (Suppl 1) ◽  
Author(s):  
Mariana Soares Cardoso ◽  
Marcelo Antonini Matheus de Paula Solino
Keyword(s):  
Breast Cancer ◽  
Surgical Treatment ◽  
Hormone Receptors ◽  
Histological Grade ◽  
Menopausal Status ◽  
Recurrence Score ◽  
Clinical Staging ◽  
Molecular Profile ◽  
Breast Cancer Patients ◽  
Genomic Test

Introduction: The knowledge regarding the biology of breast cancer has grown substantially and resulted in the identification of different breast cancer subtypes based on their molecular profile, which led to an important change in treatment, from a standardized therapy to a personalized one. A panel of experts and AJCC representatives were responsible for preparing the most recent Cancer Staging Manual. The panel recognized the clinical usefulness of biological factors such as histological grade, expression of hormone receptors (HR; estrogen and progesterone) and overexpression and/or amplification of the human epidermal growth factor receptor 2 (HER2) in predicting patient survival7 and incorporated data regarding these biomarkers in the new staging system. In addition, for eligible cases, the ‘Recurrence score’ was also incorporated, generated by the analysis of OncotypeDx (genomic test). The new manual, therefore, started to use 3 stagings. Anatomical staging – based on the classic TNM; clinical prognostic staging and pathological prognosis – association of TNM with prognostic biomarkers (using clinical data in the first and data after surgical treatment in the second). Objective: To verify the agreement between anatomical staging from the 7th edition of the AJCC manual and the prognosis from its 8th edition in a cohort of breast cancer patients at the Hospital do Servidor Público Estadual de São Paulo. Methodology: Observational and cross-sectional study, which evaluated patients undergoing surgical treatment at Hospital do Servidor Público Estadual from March, 2014 to March, 2019. Information was collected regarding age, menopausal status, tumor characteristics, anatomical and clinical staging, neoadjuvant chemotherapy, adjuvant chemotherapy and radiotherapy, and type of surgery performed. Patients were staged using the digital platform “TNM8 Breast Cancer Calculator”. Results: 805 patients were included in the analysis. All patients were females aged between 29 and 97 years, mostly in the post-menopausal period (78.88%). 74.04% of cases were positive for ER, 66.21% PR-positive, and 88.07% HER2-negative. Prognostic staging downgraded a total of 285 out of 805 patients (35.4%). Almost all of the cases that decreased in staging were ER and/or PR+ (283 of 285). Most of those who went up were Triple Negatives (100 out of 111). Conclusion: Prognostic Staging changes the staging in almost half of the cases and there was a greater number of decreased staging in total and an association of increased staging with tumors considered to have a worse prognosis, which is in agreement with several studies already carried out since the new manual came out.

Patient-reported cognitive impairments among women with breast cancer randomly assigned to hormonal therapy (HT) alone versus chemotherapy followed by hormonal therapy (C+HT): Results from the Trial Assigning Individualized Options for Treatment (TAILORx).

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 9020-9020
Author(s):  
Lynne I. Wagner ◽  
Robert James Gray ◽  
George W. Sledge ◽  
Timothy Joseph Whelan ◽  
Daniel F. Hayes ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Hormonal Therapy ◽  
Cognitive Impairments ◽  
Menopausal Status ◽  
Recurrence Score ◽  
Well Being ◽  
Control Group ◽  
Breast Cancer Patients ◽  
Change Scores ◽  
Patient Reported

9020 Background: Cognitive impairment is a complication of chemotherapy. Perceived cognitive impairments (PCI) were prospectively assessed among TAILORx participants randomized to HT alone versus chemotherapy followed by HT (C+HT). Methods: TAILORx participants with an OncoType DX Recurrence Score 11-25 were randomly assigned to HT or C+HT. PCI, fatigue, endocrine symptoms and health-related quality of life (HRQL) were assessed at baseline, 3, 6, 12, 24, and 36 months, using the Functional Assessment of Cancer Therapy (FACT) in 455 patients enrolled after 1/15/10. PCI change scores > 4.5 from baseline were defined a priori as clinically meaningful. Linear regression (LR) was used to model PCI scores on baseline PCI, treatment and other factors. Results: PCI scores were significantly worse at 3, 6, and 12 months compared to baseline for both groups (Table). The decline was greater for C+HT than HT at 3 months, but scores were similar at 12 months. Tests of an interaction between menopausal status and treatment were non-significant. PCI correlated with fatigue (r = 0.57-0.64) but not FACT Emotional well-being (EWB; r = 0.28-0.38); controlling for EWB did not account for differences in PCI change scores between treatment arms. Conclusions: Our study is the first to examine PCI among breast cancer patients randomized to receive C+HT vs. HT alone. C+HT was associated with greater declines in PCI at 3 months, but at 12 months PCI was similar in the C+HT and HT groups. PCI was associated with fatigue but not EWB. Pre- and post-menopausal groups demonstrated the same pattern of change. Since this study did not include a control group of patients not treated with HT, further study is required to determine if and to what extent HT contributes to PCI. [Table: see text]

scholarly journals Comprehensive Association Analysis of 21-Gene Recurrence Score and Obesity in Chinese Breast Cancer Patients

2021 ◽  
Vol 11 ◽  
Author(s):  
Yiwei Tong ◽  
Weiqi Gao ◽  
Jiayi Wu ◽  
Siji Zhu ◽  
Ou Huang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Gene Expression ◽  
Cancer Patients ◽  
Prognostic Value ◽  
Single Gene ◽  
Menopausal Status ◽  
Recurrence Score ◽  
Risk Category ◽  
Obese Patients ◽  
Breast Cancer Patients

PurposeA center-specific 21-gene recurrence score (RS) assay has been validated in Luminal-like, HER2-, pN0-1 Chinese breast cancer patients with both predictive and prognostic value. The association between RS and host factors such as obesity remains unclear. The objectives of the current study are to comprehensively analyze the distribution, single gene expression, and prognostic value of RS among non-overweight, overweight and obese patients.Patients and methodsLuminal-like patients between January 2009 and December 2018 were retrospectively reviewed. Association and subgroup analysis between BMI and RS were conducted. Single-gene expression in RS panel was compared according to BMI status. Disease-free survival (DFS) and overall survival (OS) were calculated according to risk category and BMI status.ResultsAmong 1876 patients included, 124 (6.6%), 896 (47.8%) and 856 (45.6%) had RS < 11, RS 11-25, and RS ≥ 26, respectively. Risk category was significantly differently distributed by BMI status (P=0.033). Obese patients were more likely to have RS < 11 (OR 2.45, 95% CI 1.38-4.35, P=0.002) compared with non-overweight patients. The effect of BMI on RS significantly varied according to menstruation (P<0.05). Compared to non-overweight patients, obese ones presented significantly higher ER, PR, CEGP1, Ki67, CCNB1 and GSTM1 (all P<0.05) mRNA expression, and such difference was mainly observed in postmenopausal population. After a median follow-up of 39.40 months (range 1.67-119.53), RS could significantly predict DFS in whole population (P=0.001). RS was associated with DFS in non-overweight (P=0.046), but not in overweight (P=0.558) or obese (P=0.114) population.ConclusionsRS was differently distributed among different BMI status, which interacted with menopausal status. Estrogen receptor and proliferation group genes were more expressed in obese patients, especially in postmenopausal population.

scholarly journals Adenosquamous carcinoma of the breast: a population-based study

Breast Cancer ◽  
2021 ◽  
Author(s):  
Cheng Xu ◽  
Zhangyuan Gu ◽  
Juan Liu ◽  
Xiaoyan Lin ◽  
Cheng Wang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Hormone Receptors ◽  
Adenosquamous Carcinoma ◽  
Histological Grade ◽  
Population Based ◽  
Clinicopathological Characteristics ◽  
Breast Cancer Patients ◽  
Duct Carcinoma ◽  
Population Based Study ◽  
Significant Difference

Abstract Background To summarize the clinicopathological characteristics, prognosis, and management of breast adenosquamous carcinoma (ASC). Methods A population-based study was performed using retrospectively extracted data from the Surveillance, Epidemiology, and End Results database for breast cancer patients with histological diagnoses of ASC, infiltrating duct carcinoma (IDC) and squamous cell carcinoma (SCC) from 2004 to 2016. Results ASC presented similar tumor size but low histological grade and less lymph node metastasis compared to IDC. ASC expressed less positive rate of hormone receptors and barely HER2, which was similar with SCC. ASC patients underwent the similar surgical and systematic treatment as IDC, only with less radiotherapy. Median follow-up data of 78 months showed that the prognosis of IDC patients was better than that of ASC patients (all p < 0.05 for BCSM and OS). ASC was not an independent prognosis factor of breast cancer. After propensity score matching (PSM), no significant difference in BCSM nor OS was observed between ASC and IDC groups. In HR-negative patients, the prognosis of ASC was similar with that of IDC, and both were superior to SCC. In HR-positive patients, the 5-year survival rate of ASC was 63.5%, which was far less than that in ASC of HR-negative (81.0%). Multivariate analysis showed that older age (age > 60) and advanced AJCC-stage were independent factors of poor prognosis in ASC, breast-conserving surgery was also ideally suited for ASC. Conclusions ASC has unique clinicopathological characteristics and prognosis. It is imperative to focus on a more precise and personalized treatment management of ASC patients.

scholarly journals Annexin A3 as a Prognostic Biomarker for Breast Cancer: A Retrospective Study

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Tao Zhou ◽  
Yong Li ◽  
Li Yang ◽  
Tiantian Tang ◽  
Lina Zhang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Retrospective Study ◽  
Tumor Size ◽  
Histological Grade ◽  
Clinical Stage ◽  
Menopausal Status ◽  
Disease Free Survival ◽  
Breast Cancer Patients ◽  
Lymphatic Metastases ◽  
Tumor Node Metastasis Stage

To validate the correlation between ANXA3 expression and prognosis in breast cancer, a retrospective study encompassing 309 breast cancer patients was performed. The expression of ANXA3 was determined by the immunohistochemical examination of tissue sections by the Max Vision™ method. The ANXA3 levels in the patient samples were validated for the prognosis based on age, menopause status, tumor size, tumor node, metastasis stage, the number of lymphatic metastases, oncology grade, and molecular subtyping. An elevated expression of ANXA3 was detected in breast cancer samples, compared to adjacent tissue samples, and significant correlation depending on the number of lymphatic metastases (P=0.001) and histological grade (P=0.004) was observed. The number of lymphatic metastases and ANXA3 expression were identified as independent risk factors affecting the disease-free survival and overall survival. Significantly (P<0.002) higher level of ANXA3 was detected in triple-negative breast cancer compared to other subtypes. There was no significant (P>0.05) change in the expression of ANXA3 with respect to age, menopausal status, tumor size, and clinical stage. The findings implicate the expression of ANXA3 with the natural progression of breast cancer and associate it with increased lymphatic metastasis. The study validates the use of ANXA3 as a potential prognosis biomarker for breast cancer.

Obesity at diagnosis and breast cancer (BC) recurrence risk based on the 21-gene assay recurrence score (RS).

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 555-555 ◽  
Author(s):  
Kimberly Ridolfi ◽  
Chong Zhang ◽  
Adedayo A. Onitilo ◽  
Wendy M. Ledesma ◽  
Molly Andreason ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Univariate Analysis ◽  
Menopausal Status ◽  
Tumor Biology ◽  
Recurrence Score ◽  
Her2 Status ◽  
Breast Cancer Patients ◽  
Significance Level ◽  
Wilcoxon Rank Sum Test ◽  
Gene Assay

555 Background: Obesity at diagnosis has been associated with poorer overall survival in BC patients. The Oncotype Dx 21-gene assay RS has been shown to predict the risk of distant recurrence in estrogen receptor (ER) positive BC. This study aimed to evaluate if an association exists between body mass index (BMI) and RS. Methods: Retrospective chart review of patients (pts) with BC diagnosed 2005-2010 and a 21-gene assay was performed. Risk factors including BMI, hormone use, and menopausal status were collected as well as tumor characteristics such as ER/PR/HER2 status, stage, and grade. Univariate analysis of the association between BMI level (<30 vs ≥30), and RS (≤18 vs >18), stage (I vs II), and grade (1 vs 2 vs 3) was conducted using Chi square test. Correlation of BMI with RS (0-100) was also assessed via Spearman’s correlation. All tests were at a two sided significance level of 0.05. Results: Of 495 pts with a RS value, 482 had a BMI within 6 months of diagnosis. Median BMI was 27.7 kg/m2 (range 17-63). BMI for pts presenting with stage 2 disease is significantly higher (30±6.9) than those with stage 1 (29±7.8), p=0.04 (Wilcoxon rank sum test). No association was found between BMI level and stage, grade or RS. See Table. Mean RS was 18.8 vs 18.2 (BMI <30 vs ≥30), p=0.79 (Wilcoxon rank sum test). Conclusions: This is the largest study of the association between BMI and the RS. Obesity (BMI≥30) has been associated with increased recurrence and death from BC. However, we found no association between BMI and RS. This suggests that poorer outcomes among obese ER+ breast cancer patients may not be due to intrinsic tumor biology (as reflected in the RS), but to other non-tumor factors, whether higher circulating estrogen levels, reduced efficacy of aromatase inhibitors, other comorbidities, difficulty with chemotherapy or other unidentified factors. Further study is warranted. [Table: see text]

CHANGES IN THE NIPPLE-AREOLA COMPLEX IN PATIENTS WITH BREAST CANCER

2017 ◽  
Vol 63 (4) ◽  
pp. 593-597
Author(s):  
Aziz Zikiryakhodzhaev ◽  
Nadezhda Volchenko ◽  
Erik Saribekyan ◽  
Yelena Rasskazova
Keyword(s):  
Breast Cancer ◽  
Surgical Treatment ◽  
Cancer Patients ◽  
Molecular Subtypes ◽  
Breast Cancer Patients ◽  
Nipple Areola Complex ◽  
Histological Types ◽  
Areola Complex

The article presents data about the lesion of the nipple-areola complex in breast cancer. In 2015-2016 surgical treatment was performed in 101 breast cancer patients, different in size but with the mandatory removal of the nipple-areola complex. There are analyzed the dependence of the lesion of the nipple-areola complex from histological types of breast cancer, molecular subtypes, multicentricity, the location of tumor in the breast. The most significant criterion was the dependence of the lesion of the nipple-areola complex from the distance between tumor node and the nipple.

scholarly journals Treatment Choices Based on OncotypeDx in the Breast Oncology Care Setting

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Teri L. Malo ◽  
Isaac Lipkus ◽  
Tobi Wilson ◽  
Hyo S. Han ◽  
Geza Acs ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Cancer Patients ◽  
Multivariable Analysis ◽  
Recurrence Score ◽  
Treatment Decision ◽  
Breast Cancer Patients ◽  
Multivariable Logistic Regression Model ◽  
Treatment Decision Making ◽  
Inform Treatment Decision

Introduction. This study aimed to evaluate whether OncotypeDx test results predict receipt of adjuvant chemotherapy in breast cancer patients who received an OncotypeDx recurrence score (RS).Materials and Methods. Pathology records were used to identify breast cancer patients who had OncotypeDx testing between December 2004 and January 2009 (n=118). Patient sociodemographic information, tumor characteristics, RS, and treatment-specific data were collected via chart review. RS was classified as follows: low (RS≤17), intermediate (RS = 18–30), or high (RS≥31). Bivariate analyses were conducted to investigate the relationship between adjuvant chemotherapy receipt and each sociodemographic and clinical characteristic; significant sociodemographic and clinical variables were included in a multivariable logistic regression model.Results. In multivariable analysis controlling for tumor size, histologic grade, and nuclear grade, only RS remained significantly associated with chemotherapy uptake. Relative to low RS, an intermediate (adjusted odds ratio [AOR], 21.24; 95% confidence interval [CI], 3.62–237.52) or high (AOR, 15.07; 95% CI, 1.28–288.21) RS was associated with a greater odds of chemotherapy uptake.Discussion. Results indicate that RS was significantly associated with adjuvant chemotherapy uptake, suggesting that OncotypeDx results were used to inform treatment decision making, although it is unclear if and how the information was conveyed to patients.

OncotypeDX Recurrence Score Does Not Predict Nodal Burden in Clinically Node Negative Breast Cancer Patients

2018 ◽  
Vol 26 (3) ◽  
pp. 815-820 ◽  
Author(s):  
S. E. Tevis ◽  
R. Bassett ◽  
I. Bedrosian ◽  
C. H. Barcenas ◽  
D. M. Black ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Recurrence Score ◽  
Breast Cancer Patients ◽  
Node Negative ◽  
Node Negative Breast Cancer ◽  
Nodal Burden

scholarly journals Serum levels of oxidative stress marker malondialdehyde in breast cancer patients in relation to pathohistological factors, estrogen receptors, menopausal status, and age

2018 ◽  
Vol 8 (3) ◽  
pp. 154-161
Author(s):  
Jasmina Gubaljevic ◽  
Nahida Srabović ◽  
Adlija Jevrić-Čaušević ◽  
Adaleta Softić ◽  
Adi Rifatbegović ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Cancer Patients ◽  
Benign Breast Disease ◽  
Menopausal Status ◽  
Serum Levels ◽  
Breast Disease ◽  
Breast Cancer Patients ◽  
Node Metastases

Introduction: The aim of this study was to determine the serum levels of malondialdehyde (MDA) in patients with invasive breast cancer in relation to its serum levels in patients with benign breast disease, and to investigate correlation between MDA serum levels with pathohistological prognostic factors (tumor size, lymph node involvement, and histologic grade [HG]), estrogen receptor (ER) status, and with breast cancer patient’s age and menopausal status. Methods: A total of 43 with well-documented invasive breast cancer were included in this study: 27 with positive axillary’s lymph nodes, and 16 with negative axillary’s lymph nodes, and 39 patients with findings of benign breast diseases. MDA determination in serum of breast cancer and benign breast disease patients was performed by the fluorimetric method, immunohistochemical staining was performed for ER, and routine pathohistological examination was conducted for pathohistological factors. Results: MDA serum levels in breast cancer patients were significantly higher than MDA serum levels in benign breast disease patients (p = 0.042). No statistically significant difference between MDA serum levels in breast cancer patients with and without lymph node metastases was found (p = 0.238). No statistically significant correlations between MDA serum levels and tumor size (p = 0.256), HG (p = 0.124), or number of positive lymph nodes (0.113) were found. A statistically significant correlation between serum MDA levels and ages of breast cancer patients with lymph node metastases was found (p = 0.006). Conclusion: Obtained results support the importance of MDA in the carcinogenesis of breast cancer. According to our findings, serum level of MDA could not be a useful prognostic factor in breast cancer.

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