scholarly journals Treatment after breast cancer recurrence: Conserving surgery or adenomastectomy?

Mastology ◽  
2020 ◽  
Vol 30 (Suppl 1) ◽  
Author(s):  
Antonio Luiz Frasson ◽  
Martina Lichtenfels ◽  
Betina Vollbrecht ◽  
Ana Beatriz Falcone ◽  
Fernanda Barbosa
Keyword(s):  
Breast Cancer ◽  
Local Recurrence ◽  
Cancer Recurrence ◽  
Radical Mastectomy ◽  
Breast Cancer Recurrence ◽  
Luminal A ◽  
Recurrence Rates ◽  
Oncological Safety ◽  
Aesthetic Result ◽  
Increased Risk

Introduction: Different factors are related with the increased risk of local recurrence, such as tumor grade, surgical margins and age. The recurrence of a tumor shows the aggressiveness of the disease and can be related with progression and worse prognosis. Radical mastectomy is the standard treatment for patients who present local recurrence after conserving surgery (CS); however, different studies have shown oncological safety using a new conserving surgery as an alternative to treat recurrence in selected patients. In the past few years, due to an increasing concern of mastologists with oncological safety, besides the aesthetic result, adenomastectomy (nipple-sparing mastectomy, NSM) became a good therapeutic choice for patients with breast cancer. Several authors have demonstrated similar recurrence and survival rates when compared to NSM techniques and total mastectomy. This study aims at assessing the local recurrence rates and the distance of NSM versus CS for the treatment of breast cancer recurrence. Methods: We assessed data from patients with breast cancer recurrence after conserving surgery who were treated with NSM, 24 patients, or new CS, 22 patients. All surgeries to treat the recurrence were carried out between 2001 and 2017. Results: The mean age of patients submitted to NSM was 52.7 years, and 61.3 years in the CS group. Patients submitted to a new conserving surgery presented 81.8% of tumors smaller than 2 cm; 81.3% grade 1 and 2 tumors; and 43.9% of luminal A tumors. In comparison to these characteristics, the patients who underwent NSM demonstrated lower rates (66.7%) of tumors smaller than 2 cm, higher rates of grade 2 (63.2%) and 3 (36.8%) tumors, and only 26.4% presented luminal A tumors, being the highest percentage (52.6%) of luminal B tumors. After a mean follow-up period of 140 months, the local recurrences were similar for both groups: 20.9% in NSM, and 22.7% in CS. Only 1 (4.2%) patient submitted to NSM presented metastasis, and in the CS group, no patient presented metastasis. Conclusions: By assessing the characteristics of patients submitted to NSM or CS for the treatment of breast cancer recurrence after previous CS, we observed younger patients and more aggressive tumors in the group that underwent NSM. Despite these characteristics, the local recurrence rates were similar in both surgeries. The presented local recurrence rates are high, and show the difficulty to treat the recurrence of previous tumors. No patient in the CS group presented with metastasis, and only one was shown in the group of patients submitted to NSM. These results suggest that NSM can be a surgical option to treat breast cancer recurrence when CS is not possible; however, further studies need to be carried out to elucidate these findings.

Influence of complications following immediate breast reconstruction on breast cancer recurrence rates

2016 ◽  
Vol 103 (4) ◽  
pp. 391-398 ◽  
Author(s):  
S. M. Beecher ◽  
D. P. O'Leary ◽  
R. McLaughlin ◽  
K. J. Sweeney ◽  
M. J. Kerin
Keyword(s):  
Breast Cancer ◽  
Breast Reconstruction ◽  
Cancer Recurrence ◽  
Immediate Breast Reconstruction ◽  
Breast Cancer Recurrence ◽  
Recurrence Rates

Effect of Concomitant CYP2D6 Inhibitor Use and Tamoxifen Adherence on Breast Cancer Recurrence in Early-Stage Breast Cancer

2010 ◽  
Vol 28 (14) ◽  
pp. 2423-2429 ◽  
Author(s):  
Vincent O. Dezentjé ◽  
Nico J.C. van Blijderveen ◽  
Hans Gelderblom ◽  
Hein Putter ◽  
Myrthe P.P. van Herk-Sukel ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Early Stage ◽  
Cancer Recurrence ◽  
Cox Proportional Hazards Model ◽  
Breast Cancer Recurrence ◽  
Tamoxifen Treatment ◽  
Adjuvant Tamoxifen ◽  
Increased Risk ◽  
Cyp2d6 Inhibitors

Purpose The use of cytochrome P450 2D6–inhibiting drugs (CYP2D6 inhibitors) during tamoxifen treatment leads to a decrease in plasma concentration of endoxifen, the major active tamoxifen metabolite. Concomitant use of CYP2D6 inhibitors, such as selective serotonin reuptake inhibitors, as well as low tamoxifen adherence may negatively impact tamoxifen efficacy in patients with breast cancer. The objectives of this study were to relate concomitant CYP2D6 inhibitor use and tamoxifen adherence to breast cancer event-free time (EFT). Patients and Methods Data were from PHARMO and included a community pharmacy dispensing database; PALGA, a nationwide pathology database; and the Dutch Medical Register in the Netherlands. Patients with breast cancer treated with adjuvant tamoxifen between 1994 and 2006 were included. A Cox proportional hazards model with a time-dependent definition for concomitant CYP2D6 inhibitor exposure was used. Adherence calculated over the first year after tamoxifen initiation was related to breast cancer events in the following period. Results In total, 1,962 patients with breast cancer using tamoxifen were included, among whom 150 (7.6%) frequently used a CYP2D6 inhibitor during tamoxifen treatment. No association between concomitant CYP2D6 inhibitor use and breast cancer recurrence was observed (adjusted hazard ratio [HR], 0.87; 95% CI, 0.42 to 1.79; P = .69). Poor tamoxifen adherence was associated with lower EFT (adjusted HR, 0.987; 95% CI, 0.975 to 0.999; P = .029). Conclusion This observational study did not show an association between concomitant CYP2D6 inhibitor use and breast cancer recurrence among patients treated with adjuvant tamoxifen despite the strong biologic rationale. This study shows, to the best of our knowledge for the first time, that poor tamoxifen adherence is associated with an increased risk of breast cancer events.

scholarly journals A Case Report of Local Recurrence Developing 24 Years After Mastectomy for Breast Cancer Recurrence From Breast Cancer After 24 Years

Medicine ◽  
2016 ◽  
Vol 95 (22) ◽  
pp. e3807 ◽  
Author(s):  
Linlin Xiao ◽  
Xudong Hu ◽  
Suzhen Wang ◽  
Gao Yong-Sheng ◽  
Qingxi Yu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Case Report ◽  
Local Recurrence ◽  
Cancer Recurrence ◽  
Breast Cancer Recurrence

Association between Breast Cancer Recurrence and Cellular Dissociation Assessed Using Fine-Needle Aspiration

2016 ◽  
Vol 60 (5) ◽  
pp. 413-420
Author(s):  
Etsuko Koike ◽  
Keiichi Iwaya ◽  
Akinori Watanabe ◽  
Shinji Miyake ◽  
Eiichi Sato ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Fine Needle Aspiration ◽  
Ductal Carcinoma ◽  
Prognostic Significance ◽  
Cancer Recurrence ◽  
Radical Mastectomy ◽  
Needle Aspiration ◽  
Nuclear Size ◽  
Breast Cancer Recurrence ◽  
Fine Needle

Objective: To determine the associations between breast cancer recurrence and cytological findings of fine-needle aspiration cytology (FNAC). Study Design: The study included 117 women who had undergone a modified radical mastectomy for invasive ductal carcinoma of the breast. FNAC samples of these patients were reexamined, and cytological findings, such as cellular dissociation, nuclear pleomorphism, nuclear atypia, chromatin pattern, and nuclear size, were scored. Uni- and multivariate analyses were performed to determine the prognostic significance of the cytological findings. Corresponding cancer tissues were immunostained for estrogen receptor, progesterone receptor, human epidermal growth factor 2 (HER2), p53, and E-cadherin to determine their associations with cytological findings. Coexpression of Arp2 and WAVE2 was also examined immunohistochemically as a cell locomotion signal. Results: Cellular dissociation (p = 0.0259) and nuclear size (p = 0.0417) were significantly associated with cancer recurrence. Multivariate analysis showed that cellular dissociation and histological grade were significant independent predictors of cancer recurrence. Cellular dissociation was found to be associated with coexpression of Arp2 and WAVE2 (p = 0.0356) and HER2 (p = 0.0469). Conclusion: The cytological finding of cell dissociation was associated with the activation of Arp2 and WAVE2 signals and was an independent predictor of recurrence.

Complications following immediate breast reconstruction and influence on breast cancer recurrence rates.

2015 ◽  
Vol 33 (15_suppl) ◽  
pp. 11022-11022 ◽  
Author(s):  
Suzanne M Beecher ◽  
Donal Peter O'leary ◽  
Carmel Malone ◽  
Ray McLaughlin ◽  
Karl Sweeney ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Reconstruction ◽  
Cancer Recurrence ◽  
Immediate Breast Reconstruction ◽  
Breast Cancer Recurrence ◽  
Recurrence Rates

Impact of fertility preservation by ovarian stimulation on breast cancer outcomes.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e21588-e21588
Author(s):  
Ying Wang ◽  
Shaina Lee ◽  
Pierre Camateros ◽  
Kirstin Ann Perdrizet ◽  
Daniel Yokom ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Fertility Preservation ◽  
Ovarian Stimulation ◽  
Cancer Recurrence ◽  
Small Sample ◽  
Reproductive Age ◽  
Breast Cancer Recurrence ◽  
Short Term ◽  
Recurrence Rates

e21588 Background: Chemotherapy and hormone therapy results in potential ovarian toxicity and delay in child-bearing among women of reproductive age with breast cancer. Whether short term ovarian stimulation is safe is not well studied. We examined the effects of short-term ovarian stimulation on patients’ breast cancer recurrence rates. Methods: Women diagnosed with localized breast cancer between 2005 and 2011 at any one of five cancer centres and referred to a reproductive endocrinologist in British Columbia, Canada, were identified from a central database. Clinical, pathological, treatment, and outcome characteristics were compared for patients who did and did not undergo ovarian stimulation prior to systemic cancer treatment. Results: Seventy-seven patients were included: median age was 33, all were ECOG 0/1, 31 (40%) had lymph node involvement, 62 (81%) had estrogen receptor (ER) positive disease, and 18 (23%) had HER2 positive disease. Thirty-four (44%) women underwent ovarian stimulation: they were more likely to receive chemotherapy than patients who declined ovarian stimulation (p = 0.001). Age, number of existing children, radiation, and hormonal treatments were not significantly associated with decision to undergo ovarian stimulation (p > 0.05). After a median follow-up of 3.7 years, 7 (21%) patients who pursued ovarian stimulation and 9 (21%) patients who did not experienced disease recurrence. There was no association between ovarian stimulation and rate of local or distant breast cancer recurrence (p = 0.658). Conclusions: We did not find a harmful effect of short term ovarian stimulation on breast cancer recurrence rates. Limitations include short follow-up, a small sample size, and few relapses. Patients who received chemotherapy were more likely to pursue ovarian stimulation, suggesting that patients were well informed about the negative impact on fertility of chemotherapy and of the importance of fertility preservation prior to potentially gonado-toxic treatments.

scholarly journals Breast Cancer Recurrence Risk Assessment: Is Non-Invasive Monitoring an Option?

2018 ◽  
Vol 3 (3) ◽  
pp. 1-17 ◽  
Author(s):  
Elisa M. Schunkert ◽  
Wanzhou  Zhao ◽  
Kurt Zänker
Keyword(s):  
Breast Cancer ◽  
Risk Assessment ◽  
Locally Advanced ◽  
Cancer Recurrence ◽  
Recurrence Risk ◽  
Breast Cancer Recurrence ◽  
Invasive Monitoring ◽  
Non Invasive ◽  
Increased Risk

Background: Metastatic breast cancer (MBC) represents a life-threatening disease with a median survival time of 18–24 months that often can only be treated palliatively. The majority of women suffering from MBC are those who had been previously diagnosed with locally advanced disease and subsequently experienced cancer recurrence in the form of metastasis. However, according to guidelines, no systemic follow-up for monitoring purposes is recommended for these women. The purpose of this article is to review current methods of recurrent risk assessment as well as non-invasive monitoring options for women at risk for distant disease relapse and metastasis formation. Methods: We used PubMed and national guidelines, such as the National Comprehensive Cancer Network (NCCN), to find recently published studies on breast cancer recurrence risk assessment and systemic monitoring of breast cancer patients through non-invasive means. Results: The options for recurrence risk assessment of locally invasive breast cancer has improved due to diverse genetic tests, such as Oncotype DX, MammaPrint, the PAM50 (now known as the “Prosigna Test”) assay, EndoPredict (EP), and the Breast Cancer Index (BCI), which evaluate a women’s risk of relapse according to certain cancer-gene expression patterns. Different promising non-invasive urinary protein-based biomarkers with metastasis surveillance potential that have been identified are MMP-2, MMP-9, NGAL, and ADAM12. In particular, ααCTX, ββCTX, and NTX could help to monitor bone metastasis. Conclusion: In times of improved recurrence risk assessment of women with breast cancer, non-invasive biomarkers are urgently needed as potential monitoring options for women who have an increased risk of recurrence. Urine as a bioliquid of choice provides several advantages – it is non-invasive, can be obtained easily and frequently, and is economical. Promising biomarkers that could help to follow up women with increased recurrence risk have been identified. In order for them to be implemented in clinical usage and national guideline recommendations, further validation in larger independent cohorts will be needed.

Sign in / Sign up

Export Citation Format

Share Document