scholarly journals Peritoneal Metastasis After Treated With Abemaciclib Plus Fulvestrant for Metastatic Invasive Lobular Breast Cancer: A Case Report and Review of the Literature

2021 ◽  
Vol 12 ◽  
Author(s):  
Hong-Fei Gao ◽  
Jun-Sheng Zhang ◽  
Qiang-Zu Zhang ◽  
Teng Zhu ◽  
Ci-Qiu Yang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Drug Resistance ◽  
Peritoneal Metastasis ◽  
Lobular Carcinoma ◽  
Palliative Therapy ◽  
Metastatic Breast ◽  
Peritoneal Metastases ◽  
Breast Cancer Patients ◽  
Adequate Treatment ◽  
Metastatic Lesions

Peritoneal metastases from invasive lobular carcinoma (ILC) of breast are uncommon and usually related to poor prognosis due to difficulty of detection in clinical practice and drug resistance. Therefore, recognizing the entities of peritoneal metastases of ILC and the potential mechanism of drug resistance is of great significance for early detection and providing accurate management. We herein report a case of a 60-year-old female who presented with nausea and vomiting as the first manifestation after treated with abemaciclib (a CDK4/6 inhibitor) plus fulvestrant for 23 months due to bone metastasis of ILC. Exploratory laparotomy found multiple nodules in the peritoneum and omentum, and immunohistochemistry confirmed that the peritoneal metastatic lesions were consistent with ILC. Palliative therapy was initiated, but the patient died two months later due to disease progression with malignant ascites. Whole exome sequencing (WES) was used to detect the tumor samples and showed the peritoneal metastatic lesions had acquired ESR1 and PI3KCA mutations, potentially explaining the mechanism of endocrine therapy resistance. We argue that early diagnosis of peritoneal metastasis from breast cancer is crucial for prompt and adequate treatment and WES might be an effective supplementary technique for detection of potential gene mutations and providing accurate treatment for metastatic breast cancer patients.

scholarly journals Quercetin Inhibits Lef1 and Resensitizes Docetaxel-Resistant Breast Cancer Cells

Molecules ◽  
2020 ◽  
Vol 25 (11) ◽  
pp. 2576 ◽  
Author(s):  
Marta Prieto-Vila ◽  
Iwao Shimomura ◽  
Akiko Kogure ◽  
Wataru Usuba ◽  
Ryou-u Takahashi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Drug Resistance ◽  
Metastatic Breast ◽  
Drug Resistant ◽  
Breast Cancer Patients ◽  
Phase I Clinical Trials ◽  
Pathway Activation ◽  
Promising Therapeutic Approach ◽  
Cav1 Expression ◽  
Resistant Cells

Drug resistance is a major problem for breast cancer patients. Docetaxel is an anti-mitotic agent that serves as first line of treatment in metastatic breast cancer, however it is susceptible to cellular drug resistance. Drug-resistant cells are able to spread during treatment, leading to treatment failure and eventually metastasis, which remains the main cause for cancer-associated death. In previous studies, we used single-cell technologies and identified a set of genes that exhibit increased expression in drug-resistant cells, and they are mainly regulated by Lef1. Furthermore, upregulating Lef1 in parental cells caused them to become drug resistant. Therefore, we hypothesized that inhibiting Lef1 could resensitize cells to docetaxel. Here, we confirmed that Lef1 inhibition, especially on treatment with the small molecule quercetin, decreased the expression of Lef1 and resensitized cells to docetaxel. Our results demonstrate that Lef1 inhibition also downregulated ABCG2, Vim, and Cav1 expression and equally decreased Smad-dependent TGF-β signaling pathway activation. Likewise, these two molecules worked in a synergetic manner, greatly reducing the viability of drug-resistant cells. Prior studies in phase I clinical trials have already shown that quercetin can be safely administered to patients. Therefore, the use of quercetin as an adjuvant treatment in addition to docetaxel for the treatment of breast cancer may be a promising therapeutic approach.

scholarly journals Non-Palpable Invasive Lobular Carcinoma Initially Diagnosed by Inguinal Lymph Node Biopsy

2020 ◽  
Vol 17 (2) ◽  
pp. 88-92
Author(s):  
Mohammad Zuhdy ◽  
Mona Zaky ◽  
Reham Alghandour ◽  
Gena Abdelazeem ◽  
Omar Hamdy ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Invasive Lobular Carcinoma ◽  
Inguinal Lymph Node ◽  
Lobular Carcinoma ◽  
Rare Event ◽  
Metastatic Breast ◽  
Lymph Node Biopsy ◽  
Breast Cancer Patients ◽  
Core Needle

Metastasis from breast cancer to the inguinal lymph nodes or the vulva is a rare event with very few cases reported in literature. A 38-year-old lady presented complaining of progressive abdominal enlargement. Physical examination was unremarkable apart from abdominal enlargement and enlarged right inguinal lymph node. Radiology showed marked ascites, omental thickening, bilateral small ovarian masses, suspicious right inguinal lymph node (LN) as well as breast fibrocystic disease. Cytological examination of the ascitic fluid revealed malignant cells. Core needle biopsy from the inguinal LN suggested metastatic breast carcinoma. Breast MRI showed heterogeneous fibro-glandular tissue and moderate parenchymal enhancement. Random core needle biopsies from the breast led to the diagnosis of invasive lobular carcinoma. The patient received 8 cycles of docetaxel/carboplatin protocol, with partial response. Next, she was maintained on hormonal treatment (Anastrazole) till the ascites re- accumulated. Vulvar nodules appeared whose biopsy revealed infiltration by the same tumoral tissue. She received 6 cycles of Endoxan and Pharmarubicin till regression was achieved, and then she was subjected to Exemestane. Thorough clinical assessment including of all lymph node basins and gynecological assessment are crucial in all breast cancer patients, particularly those with invasive lobular subtypes. Keywords: Breast neoplasms, Lobular, Vulva, Vulvar metastasis, Neoplasm metastasis

Prognosis of breast cancer in patients with peritoneal metastasis.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e11509-e11509
Author(s):  
Ibrahim Petekkaya ◽  
Veysel Ayyildiz ◽  
Cemal Kizilarslanoglu ◽  
Ugur Sahin ◽  
Gamze Gezgen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Survival Time ◽  
Cancer Patients ◽  
Survival Data ◽  
Peritoneal Metastasis ◽  
Survival Rates ◽  
Peritoneal Metastases ◽  
Breast Cancer Patients ◽  
Er Positive

e11509 Background: Distant spread from breast cancer is commonly found in bones, lungs, liver, and central nervous system. However, peritoneal involvement is unusual and unexpected. The aim of the study was to perform a comprehensive analysis of breast cancer patients with peritoneal metastases. Methods: Twenty-one (0.9% of the cohort) breast cancer patients with peritoneal metastases were detected out of a database of 2,219 breast cancer patients treated in Hacettepe University Medical Oncology Department. Clinical characteristics, follow up times and survival rates were analyzed. Results: The mean age of the 21 patients at the time of peritoneal metastasis was 56 years (38-71). 12 (57.1%) patients were post-menopausal, 6 (28.6%) patients were pre-menopausal. Numbers of deceased patients were 7 (33.3%). Seven (33.3%) patients’ histological subtypes were invasive ductal carcinoma (IDC), five (23.8%) patients’ were invasive lobular carcinoma (ILC) and three (14.3%) patients’ were mixed (IDC and ILC). Numbers of luminal A patients were 8 (38.1%), luminal B were 5 (23.8%), triple negative were 2 (9.5%). There was no Her-2 overexpressing patient and numbers of unknown molecular subtype patients were 6 (28.6%). The median follow up times after peritoneal disease in patients deceased and living were 9.3 (range: 0.4-23.3) months and 15.6 (range: 0.3-40.4) months, respectively. Median follow up time after peritoneal metastasis of ER positive patients was 13.7 months, and it was longer than ER negative patients (4.4 months). Six months and one year survival rates after peritoneal metastasis were 83.3% and 73.3%, respectively. Disease free, progression free and overall survival data could not be obtained due to inadequate number of events. Conclusions: Peritoneal metastasis of breast cancer is very rare and median survival time is controversial in literature. Despite of a small cohort, we found the patients’ follow up times longer than reported before. Especially, ER positive patients have longer survival time than ER negative, and this result highlights the importance of hormonotherapies.

scholarly journals Prognostic Value and Influence of Receptor Conversion on Treatment Regimen in Metastatic Breast Cancer at the First Time of Recurrence

2020 ◽  
Vol 43 (11) ◽  
pp. 620-627
Author(s):  
Jiming Shen ◽  
Lu Xu ◽  
Jing Shi ◽  
Lei Zhao ◽  
Sha Shi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Treatment Regimen ◽  
Growth Factor Receptor ◽  
Metastatic Breast ◽  
Breast Cancer Patients ◽  
Receptor Status ◽  
Metastatic Lesions ◽  
Receptor Conversion ◽  
First Time

<b><i>Purpose:</i></b> At the first time of metastatic breast cancer recurrence, conversion of the receptors status may occur between primary lesions and metastatic lesions, including the estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2). Whether the decision of the treatment regimen is based on the primary receptor status or that of metastatic lesions is still unclear. <b><i>Methods:</i></b> This study enrolled 411 female patients with a diagnosis of metastatic breast cancer at the first time of recurrence to explore the influence of receptor conversion on prognosis prediction and treatment regimen of patients with metastatic breast cancer. <b><i>Results:</i></b> ER and PR changes from negative to positive are both prognostic factors for patients with breast cancer. Patients receiving endocrine therapy showed a better survival after recurrence than those using chemotherapy alone in the ER or PR Prim– Met+ subgroup. Patients in the HER2 Prim– Met+ subgroup using HER2-targeted therapy in multilines showed a post-recurrence survival advantage. In the bone re-biopsy subgroup, the PR change from positive to negative appeared to be more frequent than at other re-biopsy sites. <b><i>Conclusions:</i></b> Patients with metastatic breast cancer should perform re-biopsy to clarify the receptor status of the first metastatic lesions, which may provide clinicians valuable evidence to conduct treatments with higher precision.

What do adjuvant and metastatic breast cancer patients (BC) expect from their doctors? Final results of a german survey in 617 patients:

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 6085-6085
Author(s):  
G. Oskay-Oezcelik ◽  
W. Lehmacher ◽  
R. Mirz ◽  
H. Christ ◽  
M. Kaufmann ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Information Needs ◽  
Medical Information ◽  
Treatment Options ◽  
Metastatic Breast ◽  
Special Focus ◽  
Breast Cancer Patients ◽  
Adequate Treatment ◽  
Online Group

6085 Background: An increasing number of breast cancer patients in western countries are accessing the Internet for medical information. The following study was condcuted to explore the information needs and preferences with special focus on doctor-patient communication. Methods: A questionnaire was developed and validated in a phase-I study and was than administered to breast cancer patients both via internet (online) or via a print-version consisting of 62 questions. Results: A total of 617 patients were interviewed, 552 by online version (online group) and 65 by printed questionnaire (print group). The median age of the online group was 47 years (21–85), for the print group 53 years (40–92). 65% of the patients were treated with the intention of cure, 35% of the patients had a metastatic disease. The median time of consultation communicating the information “You have breast cancer”, was 15 minutes (0–300). The most effective and “patient-relevant source of information and explanations of treatment options was the consultation with their physician (84%). When asked to suggest areas for improvement, most frequent answers were: more alternative therapies should be offered by physician (54%); physicians should have more time for explanations (51%); cooperation between involved physicians should be optimized (39%). Most relevant questions for patients are: “Do I receive the adequate treatment?” (89%); “How many patients with my disease does my physician treat?” (46%); “Can I be enrolled into a trial?” (46%). An independent second opinion centre was desired by 94% of the patients, but only 20% know such an institution. Conclusions: This study underlines the need to give patients with breast cancer all details on treatment options and cancer managements. No significant financial relationships to disclose.

scholarly journals Fine analysis of atypical circulating tumor cells in metastatic breast cancer patients reveals subsets with different prognostic values

2020 ◽  
Author(s):  
Alexia Lopresti ◽  
Laurys Boudin ◽  
Pascal Finetti ◽  
Séverine Garnier ◽  
Anaïs Aulas ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Drug Resistance ◽  
Metastatic Breast Cancer ◽  
Cancer Patients ◽  
Tumor Cells ◽  
Epithelial To Mesenchymal Transition ◽  
Metastatic Breast ◽  
Breast Cancer Patients ◽  
Mesenchymal Transition ◽  
Circulating Cells

Purpose: Circulating tumor cells (CTCs) have a tremendous potential for diagnosis and treatment of breast cancer patients. Here, we performed a unique analysis of all atypical circulating cells isolated with a filtration-based technology from metastatic breast cancer (mBC) patients. Patients and methods: The PERMED-01 study enrolled patients with mBC, refractory to systemic therapy, and with an accessible lesion to biopsy. We analyzed atypical circulating cells isolated from patients' blood at the time of inclusion using Screencell® Cyto device. For 23 out of 91 analyzed patients, this was completed by advanced immunofluorescence staining of atypical circulating cells. Subsets cut-offs were established using a two-component Gaussian finite Mixture Model, and evaluated for correlation with clinico-pathological data, including progression-free survival (PFS) and overall survival (OS). Results: Three subsets of atypical circulating cells, absent from controls (n=7), were observed in cancer patients (n=91): isolated (iCTCs), Clusters (CTM), and Giant CTCs (gCTCs). CTCs' median number was 8.33 per mL. Co-expression of stem and drug resistance markers was associated with intermediate epithelial to mesenchymal transition phenotype in CTM and gCTCs, but not in iCTCs. Presence of gCTC was associated with shorter PFS and OS. Concerning PFS, assigning an immunofluorescence-based Epithelial to Mesenchymal status improved their prognostic value. Conclusion: This study brings to light the diversity of CTCs in mBC patients and their specific molecular profiles regarding epithelial to mesenchymal transition, stemness and drug resistance status. It also highlights the involvement of an atypical circulating cell subset, the gCTCs, as a prognostic factor for PFS and OS.

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