scholarly journals STUDY OF CORRELATION OF INFLAMMATORY CELL INFILTERATION SCORE WITH TUMOR GRADE, NODAL STATUS, ER, PR, HER-2 NEU STATUS IN PATIENTS OF STAGE 2 AND 3 BREAST CANCER IN A TERTIARY CENTER, KOLKATA

2021 ◽  
Vol 5 (12) ◽  
Author(s):  
Deepika Pandey ◽  
Mohit Pradhan ◽  
Gautam Mandal
Keyword(s):  
Breast Cancer ◽  
Breast Carcinoma ◽  
Inflammatory Response ◽  
Inflammatory Cell ◽  
Nodal Status ◽  
Group Score ◽  
Common Cancer ◽  
Tertiary Center ◽  
Her 2 ◽  
Risk Of Cancer

Breast Cancer is the most common cancer in women in India and constitute one–third of women’s cancers and is second reason of mortality after lung carcinoma.[1] It is the most commonly diagnosed malignancy in most cities in India, and 2nd most common cancer in females in the rural areas. As the disease burden and mortality rate is very high, evaluation of several parameters that influence survival rates among women with breast cancer may help design early detection, predict the prognosis and frame a suitable line of treatment.[2] The link between inflammation and cancer was first suggested in 1863.[3] Chronic inflammation is known to increase the risk of cancer development, such as colon cancer in inflammatory bowel diseases.[4] There is good evidence that the development of cancer and its progression are dependent on a complex interaction of the tumour and the host inflammatory response.[5] Aim: This study aims to correlate the relation of inflammatory cell infilteration with tumour staging, nodal status, ER, PR, HER-2 NEU status of breast cancer. Material and Method: The proposed study was a cross sectional study with mostly prospective observation and with some retrospective observation, included 74 patients of stage II and stage III breast carcinoma who underwent MRM in Cancer Institute from 2017-2018. The various clinical and histopathological prognostic parameters along with inflammatory cell infilterate score in invasive breast carcinoma patients were studied and correlated. The inflammatory cell infilterates was assessed according to Klintrup-Makinen (K-M) criteria. It is scored on 4 point scale where score 0 defined no increase in inflammatory cell infilterate, score 1 defined as mild or patchy increase ,score 2 denoted as prominent inflammatory response with some cancer cell destruction and score 3 as florid cup like response. Further it is classified as low group score (score 0-1)and high group score (score 2-3) .[6] Result: There was significant association between inflammatory cell infiltrate score and grade of tumor (p=0.0005) (TABLE 1) .58.1% ,54.1% and 37.8% of the cases were ER, PR and Her-2/neu positive respectively. ER negative tumors (74.19%) were showing statistically significant (p= 0.01) association with high inflammatory cell infilterate score (ie. Score 2 and 3). Similarly PR negative tumors (64.7%) were showing statistically significant association (p= 0.04) with high inflammatory cell infilterate score. No such correlation was found between between HER-2 /NEU status and nodal involvement with inflammatory cell infilterate score (TABLE 3). Keywords: Breast cancer, Invasive ductal carcinoma, ER , PR , HER-2/Neu ,grade of tumor, Nodal status, inflammatory cell infilterate score.

HER-2 status of the primary breast cancer in patients with relapse at least five years after the initial diagnose

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 10631-10631
Author(s):  
Z. I. Tomasevic ◽  
D. Jovanovic ◽  
L. Radosevic-Jelic ◽  
Z. Tomasevic ◽  
S. Vasovic ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Carcinoma ◽  
Contralateral Breast ◽  
Late Relapse ◽  
Primary Breast Carcinoma ◽  
Disease Free Interval ◽  
Free Interval ◽  
Her 2 ◽  
Time To Relapse ◽  
Disease Free

10631 Background: HER-2 status of the primary breast carcinoma in the subgroup of patients who relapsed after many years is not well known. The aim of this paper is to determine the HER-2 status of the primary breast cancer in patients with late relapse, defined as local recurrence, distant metastases or carcinoma in the contralateral breast, at least five years after the initial diagnosis Methods: During six month period (June-November 2005) 1256 patients were diagnosed with primary or relapsed breast cancer at the IORS. HER-2 (HercepTest, DAKO) status was determined on the archived pathological specimens of patients with late relapse. Results: One hundred eleven patients (111/1256; 8,8%) were diagnosed with late relapse. At the time of the initial diagnose, majority of patients have been treated for early breast carcinoma. Median age at the initial diagnose was 50 years (33–74). Initial tumor characteristic were: ductal carcinoma 49%; lobular carcinoma 41%;cancer mastitis 6,5%;not reported 3,5%; T1 34%; T2 52%; T3 4,5%; T4 6%;unknown 3,5%; Nodal status: positive 73,5%; negative 23%;not reported 3,5% Steroid receptor status: ER and/or PR positive 59%; both negative 14%; unknown 27%. Median time to relapse is 7 years, (range 5–29), the most frequent first relapse sites were: local recurrence (22%); carcinoma of the contralateral breast (18%); bone metastases (18%). Archived pathological specimens are identified for 63/111 (56,7%) patients and HER-2 status of the those primary breast carcinoma is: 0+ 36,5%; 1+ 34,9%; 2+ 9,5%; 3+ 14,2%; Thirty four patients (30,6%) had disease free interval 10 or more years, and HER-2 3+ in this subgroup is 17,6% (6/34). Conclusions: Long disease free interval in breast cancer patients is usually explained by initial more favorable cancer characteristics. Still, a significant percentage (14,2%) of our patients with median time to relapse of 7 years, initially had breast cancers with HER-2 3+. No significant financial relationships to disclose.

scholarly journals STUDY ON TWO YEAR SURVIVAL OF STAGE II AND STAGE III BREAST CARCINOMA IN EASTERN INDIA WITH SPECIAL REFERANCE TO PROGNOSTIC MARKERS HER-2/NEU, ER, PR AND Ki-67.

2020 ◽  
Vol 4 (4) ◽  
Author(s):  
Deepika Pandey ◽  
Rajesh kumar Sinha ◽  
Gautam Mandal
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Breast Carcinoma ◽  
Triple Negative ◽  
Disease Free Survival ◽  
Stage Ii ◽  
Stage Iii ◽  
Ki 67 ◽  
Important Indicator ◽  
Her 2

Breast cancer is one of the most commonly diagnosed malignancies and leading cause of cancer death in women over the world and the second most common cancer in females in India. Length of survival of cancer patients is an important indicator for knowing the outcome of treatment in any study. As the disease burden and mortality rate is very high, knowing the factors that influence survival rates among women with breast cancer may help design early detection and improve treatment. The immunohistochemistry plays a very important role in prognostication and treatment determination. Aim:  This study aims to correlate the various relevant prognostic pattern like reactivity pattern of ER,PR,Her-2/Neu ,ki-67 and 2-yr overall survival. Material and method: The proposed study was a cross sectional study with mostly prospective observation and with some retrospective observation, included 74 patients of stage II and stage III breast carcinoma who underwent MRM in Chittaranjan National Cancer Institute from 2017-2018. The various clinical and histopathological prognostic parameters with Estrogen/ Progesterone hormone receptors and Human epidermal growth factor receptor (Her-2/Neu) status in invasive breast carcinoma patients were studied and correlated. Result: 58.1%, 54.1% and 35.1% of the cases were ER, PR and Her-2/neu positive respectively. 89.2% of cases had Ki-67 level >20%. Her-2 neu negative, ER negative and KI-67>20% were found to be significant factors for mortality. Maximum (66.7%) of patients with recurrence and maximum (53.8%) patients who died in study period had triple negative breast cancer. Triple negative tumours have poor survival as compared to ER + PR + and HER-2/Neu +ve tumours. Disease free survival and overall survival of the patients with Ki-67< 20% was better than that of patients with Ki-67>20% (100%). Keywords: Breast cancer, Invasive ductal carcinoma, ER,PR,HER-2/Neu , Ki-67 , Two year survival.

scholarly journals Human epidermal growth factor receptor 2/neu and the clinico-pathological profile in breast cancer: an observational study at a tertiary care hospital in Central India

2021 ◽  
Vol 8 (12) ◽  
pp. 3649
Author(s):  
Shikha Shukla ◽  
Fahad Ansari
Keyword(s):  
Breast Cancer ◽  
Epidermal Growth Factor Receptor ◽  
Growth Factor ◽  
Breast Carcinoma ◽  
Epidermal Growth Factor ◽  
Cancer Patients ◽  
Growth Factor Receptor ◽  
Breast Cancer Patients ◽  
Her 2 ◽  
Epidermal Growth

Background: Breast cancer is the most commonly occurring cancer in women and the second most common cancer overall. Owing to a unique pattern of presentation in terms of clinical and biological features, finding their mutual association may be important and may help predict prognosis. HER2 (human epidermal growth factor receptor 2)/neu is one such important immunohistochemical factor that is considered to be more prevalent amongst Indians and therefore makes up for an emerging area for studies. The study aimed to assess the patients of breast carcinoma in terms of their HER2/neu statuses and find out their association with clinical parameters.Methods: This was a prospective comparative study conducted in department of surgery, Hamidia hospital, Bhopal, India, with a total duration of 1 year between November 2018 to September 2019 including a total of 98 consecutive in house breast carcinoma patients.Results: A total of 98 breast cancer patients were tested for HER-2/neu gene presence. Of these 25 (25.5%) samples tested positive and 73 (7.48%) tested negative. A comparison of the two groups revealed that none of the clinic-pathological factors tested were found to have a statistically significant association with the HER2/neu status.Conclusions: It appeared that there is no defining factor in terms of clinic-pathological presentation that helps to separate significantly HER-2/neu positive with HER-2/neu negative cases with breast cancer. Still, immune-histochemical marker analysis should be an integral part of the overall work up of the breast cancer patients because of its both prognostic and therapeutic application and significance.

scholarly journals Does trastuzumab-related cardiotoxicity influence long-term outcome in patients with HER-2 positive breast cancer? A prospective study

2021 ◽  
Author(s):  
Grzegorz Piotrowski ◽  
Maciej Kulig ◽  
Arkadiusz Stasiak ◽  
Joanna Stasiak ◽  
Maciej Banach
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Treatment Discontinuation ◽  
Cardiac Complications ◽  
Adjuvant Setting ◽  
Long Term Outcome ◽  
Trastuzumab Treatment ◽  
Her 2 ◽  
Risk Of Cancer ◽  
Positive Breast Cancer

IntroductionTrastuzumab is a monoclonal antibody directed against the HER-2 receptor that has led, in an adjuvant setting, to higher disease-free (DFS) and overall survival (OS) in HER-2 positive breast cancer (BC) compared with chemotherapy alone. Cardiotoxicity often results in early discontinuation of trastuzumab, which may elevate the risk of cancer recurrence or mortality. Our study aimed to assess how early interruption or early permanent termination of adjuvant trastuzumab treatment influences DFS and OS of patients with HER-2 positive BC.Material and methodsThis is a prospective observation of 253 women (55 ±10 years of age) with HER-2 positive unilateral, non-metastatic BC treated with trastuzumab in an adjuvant setting. To monitor the safety of the treatment echocardiography was performed at baseline and every 3 months up to 12 months after the end of therapy. If cardiotoxicity developed, trastuzumab was stopped early. Overall survival and DFS were assessed.ResultsTrastuzumab-associated cardiac complications resulting in treatment discontinuation developed in 52 (20.55%) patients. Median DFS time was 21.1 months in the group with interruption compared with 25.7 months in the group with full trastuzumab treatment, being significantly shorter (HR = 2.32, 95% CI: 1.15–4.71, p = 0.0106). Two year OS in the interruption and no-interruption groups were 80.8% and 88.5%, respectively, which were not statistically significantly different (p = 0.268). In a multivariate regression analysis the cumulative dose of anthracycline (OR = 1.01, 95% CI: 1.00–1.01, p = 0.002) and LVEF at baseline (OR = 0.83, 95% CI: 0.70–0.99, p = 0.0344) were independent predictors of a cardiotoxic effect.ConclusionsTrastuzumab-related cardiotoxicity resulting in early treatment discontinuation negatively influences DFS, but does not seem to influence OS.

Molecular profiling of circulating tumor cells in the peripheral blood of patients with primary and metastatic breast cancer

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 20033-20033
Author(s):  
N. Fersis ◽  
V. Deckwart ◽  
A. Leitz ◽  
M. Weber ◽  
J. Rom ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Breast Carcinoma ◽  
Tumor Cell ◽  
Cancer Patients ◽  
Tumor Cells ◽  
Metastatic Breast ◽  
Breast Cancer Patients ◽  
Rt Pcr ◽  
Her 2

20033 Background: The purpose of this study was detection and expression profiling of circulating tumor cells (CTC) in breast cancer patients. Methods: Two separate probes of 5 mL peripheral EDTA-blood from patients with primary breast cancer (n=167) and metastatic disease (n=111) were used for immunomagnetic tumor cell selection. Targets for preanalytical enrichment were the antigens EpCAM and MUC-1. Separated cells were lysed and used for mRNA isolation and c-DNA synthesis. The breast carcinoma-associated transcripts EpCAM, MUC-1, HER-2, claudin7, cytokeratin 19, mammaglobin 1, prostate-specific ets factor (PSE) and survivin were amplified by three separate multiplex RT-PCR reactions. Amplicons were analysed by capillary electrophoresis with the Agilent Bioanalyzer 2100. Specificity of the RT-PCR was confirmed by examination of blood of healthy donors. Results: Sensitivity for every single transcript was adjusted to 2 tumor cells per 5 ml blood. Tumor-associated transcripts were detected in 31 of of 167 (18.5%) patients with primary breast cancer and in 46 of 111 (41%) patients with metastatic disease. The marker with the highest incidence in both groups was MUC-1, with a positivity rate of 81%. Tumor-associated transcripts were heterogenouosly expressed, however multiple markers were identified in more than 50% of the positive samples. Conclusion: Using a combination of preanalytical immunomagnetic tumor cell enrichment followed by a multigen RT-PCR approach we describe a sensitive detection system for breast carcinoma cells. In this study a panel of 8 genes overexpressed at high levels in metastatic breast cancer was selected for the identification of disseminated tumor cells in the peripheral blood of breast cancer patients. HER-2, survivin as a unique member of the inhibitor of apotosis protein family, as well as PSE identified in circulating breast cancer cells may serve as prognostic indicators of tumor progression and could represent valid targets for new individualized therapeutic interventions. No significant financial relationships to disclose.

Identification of risk factors in mammographically occult contralateral breast carcinoma detected by magnetic resonance imaging (MRI)

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 614-614
Author(s):  
J. R. Bernard ◽  
L. A. Vallow ◽  
S. Packianathan ◽  
D. G. Feigel ◽  
E. R. DePeri ◽  
...  
Keyword(s):  
Risk Factors ◽  
Breast Carcinoma ◽  
Tumor Size ◽  
Menopausal Status ◽  
Contralateral Breast ◽  
Nodal Status ◽  
Newly Diagnosed ◽  
Receptor Status ◽  
Her 2 ◽  
Contralateral Carcinoma

614 Background: An analysis of preoperative bilateral breast MRI at our institution suggests that approximately 1/3 of patients with newly diagnosed breast cancer may have a mammographically occult, but MRI-evident, contralateral breast abnormality. A number of these patients will have pathologic confirmation of carcinoma in the contralateral breast. Identification of risk factors to predict which patients are at high risk for having a mammographically occult contralateral carcinoma was performed. Methods: MRI results of 401 women with newly diagnosed breast carcinoma who underwent MRI were reviewed (overall group; OG). Patients with a contralateral abnormality identified only by MRI were analyzed to determine the incidence of contralateral carcinoma. In addition, the following risk factors were evaluated: Age at diagnosis, menopausal status, tumor size, nodal status, ipsilateral tumor histology, tumor grade, hormone receptor status, Her-2/neu receptor status, and whether the patient had a palpable vs. mammographically detected abnormality. Results: Pathologically confirmed contralateral carcinoma (CC) was found in 13 patients (3.2%). Similar percentages of patients in both groups (OG and CC) were noted in regard to tumor size, histology, grade, nodal status, Her-2/neu receptor status, and method of detection (palpable vs. mammographic). However, median patient age was 71 (CC) vs. 62(OG); 92% (12/13) were postmenopausal (CC) compared to 75% (OG); and 100% were ER positive (CC) vs. 81% percent (OG). Conclusions: Older, postmenopausal women who have ER + tumors may have a higher likelihood of having synchronous, contralateral, mammographically occult, MRI-detected breast carcinoma. Preoperative MRI may be beneficial in patients with similar risk factors; however, further follow up and additional experience is needed for confirmation of these findings. No significant financial relationships to disclose.

Survival outcomes of metaplastic breast carcinoma: An Indian tertiary care center data.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e12579-e12579
Author(s):  
Lalnun Puii ◽  
Vinu Sarathy ◽  
Lalram Sangi ◽  
Beulah Elsa Thomas ◽  
Samuel Luke Koramati ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Carcinoma ◽  
Triple Negative ◽  
Locally Advanced ◽  
Clinicopathological Features ◽  
Survival Outcomes ◽  
Metaplastic Breast Cancer ◽  
Her 2 ◽  
Clinical Records ◽  
Metaplastic Breast Carcinoma

e12579 Background: Metaplastic breast carcinoma is a rare histological subtype that has basal like characteristics and is reported to have a poorer prognosis than no specific type/ductal carcinoma (ductal/NST). We aimed to investigate clinicopathological features and outcome from a single institution based registry. Methods: Clinical records of breast cancer patients treated during 2012-2019 were screened and 31 cases of metaplastic breast carcinoma were found. Descriptive analysis was done for patients’ demographics and clinicopathological features. Kaplan Meier method was used to assess survival outcomes. Results: The incidence of metaplastic breast cancer was 0.5% (31/6180) in our study out of which the most common histopathological differentiation was squamous (45.16%). The second most common was sarcomatoid histology (32.25%), followed by chondroid (9.68%) and mixed histology (12.9%). The median age at diagnosis was 60 years ranging from 28 to 82 years. 64.15% of patients were post-menopausal. At presentation, three (9.67%) patients had metastatic disease while the rest were diagnosed with early (51.61%) and locally advanced cancers (38.72%). Triple negative cancers (ER/PR/Her2 negative) constituted the vast majority with 22 cases (80.6%) while hormone receptor positive (ER/PR positive, Her-2 negative) and Her-2 neu positive (ER/PR negative) made up the rest with three patients (9.67%) each group respectively. The median overall survival was found to be 39 months (95% CI 25.46 - 52.53). Conclusions: After a thorough search in PubMed and Google Scholar, we could not find a larger case series from India with clinical outcomes for metaplastic breast carcinoma. Our results suggest that metaplastic breast carcinoma is a heterogenous disease. Outcomes of metaplastic breast carcinoma are relatively worse when compared with literature for triple negative breast cancer and breast cancer in general. Further biological understanding may offer valuable insights for newer targets and therapeutic approaches to metaplastic breast cancer.

Analysis of Demographic and Tumor Characteristics of an Inner City Breast Cancer Patient Population Compared with Patients Treated in National Surgical Adjuvant Breast and Bowel Project Trials

2010 ◽  
Vol 76 (6) ◽  
pp. 640-643
Author(s):  
Alfred J. Colfry ◽  
Timothy Humphries ◽  
George M. Fuhrman
Keyword(s):  
Breast Cancer ◽  
Cancer Patient ◽  
Inner City ◽  
Breast Cancer Patient ◽  
Tumor Size ◽  
Patient Population ◽  
Nodal Status ◽  
Tumor Characteristics ◽  
Receptor Status ◽  
Her 2

In June of 2008 we initiated a breast clinic designed to serve patients regardless of funding status. We analyzed age, race, tumor size, nodal status, estrogen, progesterone, and her-2-neu status. We compared our results to NSABP B-06 (nodal status), B-15 (estrogen, progesterone, and Her-2-neu receptor status), B-18, and B-27 (age, race, and tumor size) to determine whether our patient population was similar to patients included in these trials. Forty-nine patients with newly diagnosed breast cancer were treated during our first year (53 total cancers). Eight patients had noninvasive cancer; 45 had invasive disease. The mean age was 52.2 ± 12.2 years compared to a mean age of 48.4 ± 9.8 years in the B-06 trial ( P = 0.005). Thirty six patients were African American (74%) compared to 10% and 12% in the NSABP B-18 and B-27 trials ( P < 0.00001). A total of 23 of our patients with invasive cancer had involved axillary lymph nodes which was statistically more common than the 35.3% of node positive patients in the B-06 trial ( P = 0.03). Tumor size (3.6 ± 3.3 cm), estrogen (54.4%), and progesterone (52.8%) receptor status were similar to NSABP trials. Only 6 (13.3%) of our patients were considered Her-2-neu positive compared to 29.4 % in the B-15 trial which was significantly less prevalent ( P = 0.02). Significantly different demographic and tumor characteristics were identified in our inner city breast cancer patient population compared to NSABP patients. These results question the validity of using recommendations from large cooperative group trials in the development of treatment plans for our inner city patient population.

AUTOMATIC BREAST CANCER ASSESSMENT IN HER-2/neu IMMUNOHISTOCHEMISTRY

2014 ◽  
Vol 26 (04) ◽  
pp. 1440002
Author(s):  
Chuan-Yu Chang ◽  
Chuan-Wang Chang ◽  
Ya-Chi Huang ◽  
Chien-Chuan Ko
Keyword(s):  
Breast Cancer ◽  
Svm Classifier ◽  
Computer Assisted ◽  
Common Cancer ◽  
Roi Extraction ◽  
Her 2 ◽  
Strong Staining ◽  
Processing Techniques ◽  
Assisted Technologies ◽  
Treat Breast Cancer

Breast cancer is the second most common cancer in females, after lung cancer in the world. In Taiwan, there are about 8500 female suffering from breast cancer every year. The incidence of breast cancer has exceeded cervical cancer and has become the most common female cancer. Immunohistochemistry (IHC) image is widely applied to the diagnosis of breast cancer, but it requires a great deal of manpower and time. The IHC images are scoring as {0+, 1+, 2+ and 3+} corresponding to no staining, weak, moderate and strong staining, respectively. With the growing of image processing techniques, computer-assisted technologies are the best solution to reduce the variability of pathologists evaluation and provide highly specific per-cell information. Therefore, in this paper, we proposed an automatic method to assess the grade of breast cancer in IHC images. The proposed method consists of four steps, including ROI extraction, feature extraction, feature selection and a hierarchical SVM classifier. The hierarchical SVM classifier is utilized to score the IHC images into 0+ (no staining), 1+ (weak), 2+ (moderate) and 3+ (strong staining). According to the experimental results, the proposed method can automatically and effectively asses the score of IHC images; it provides important information to help physicians treat breast cancer.

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