scholarly journals Prognosis and Prophylactic Regional Nodal Irradiation in Breast Cancer Patients With the First Isolated Chest Wall Recurrence After Mastectomy

2021 ◽  
Vol 10 ◽  
Author(s):  
Xu-Ran Zhao ◽  
Liang Xuan ◽  
Jun Yin ◽  
Yu Tang ◽  
Hui-Ru Sun ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Chest Wall ◽  
Risk Model ◽  
Rank Test ◽  
Breast Cancer Patients ◽  
Regional Nodal Irradiation ◽  
Failure Patterns ◽  
Chest Wall Recurrence ◽  
Supraclavicular Fossa

Background and PurposeOptimal radiation target volumes for breast cancer patients with their first isolated chest wall recurrence (ICWR) after mastectomy are controversial. We aimed to analyze the regional failure patterns and to investigate the role of prophylactic regional nodal irradiation (RNI) for ICWR.Materials and MethodsAltogether 205 patients with ICWR after mastectomy were retrospectively analyzed. Post-recurrence progression-free survival (PFS) and overall survival (OS) rates were calculated by Kaplan-Meier method and the differences were compared with Log-rank test. Competing risk model was used to estimate the subsequent regional recurrence (sRR) and locoregional recurrence (sLRR) rates, and the differences were compared with Gray test.ResultsThe 5-year sRR rate was 25.2% with median follow-up of 88.6 months. Of the 52 patients with sRR, 30 (57.7%) recurred in the axilla, 29 (55.8%) in supraclavicular fossa (SC), and five (9.6%) in internal mammary nodes. Surgery plus radiotherapy was independently associated with better sLRR and PFS rates (p<0.001). The ICWR interval of ≤ 4 years was associated with unfavorable sRR (p=0.062), sLRR (p=0.014), PFS (p=0.001), and OS (p=0.005). Among the 157 patients who received radiotherapy after ICWR, chest wall plus RNI significantly improved PFS (p=0.004) and OS (p=0.021) compared with chest wall irradiation alone. In the 166 patients whose ICWR interval was ≤ 4 years, chest wall plus RNI provided the best PFS (p<0.001) and OS (p=0.022) compared with chest wall irradiation alone or no radiotherapy.ConclusionPatients with ICWR have a high-risk of sRR in SC and axilla. Chest wall plus RNI is recommended.

scholarly journals The Prognostic Value of Skin Involvement in Breast Cancer Patients With Chest Wall Recurrence

2021 ◽  
Author(s):  
Danyang Zhou ◽  
Mei Li ◽  
Fei Xu ◽  
Qiufan Zheng ◽  
Qianyi Lu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Disease Progression ◽  
Cancer Patients ◽  
Chest Wall ◽  
Female Breast Cancer ◽  
Nodal Status ◽  
Skin Involvement ◽  
Breast Cancer Patients ◽  
Female Breast ◽  
Chest Wall Recurrence

Abstract Background: To assess the prognosis of skin involvement in female breast cancer patients with chest wall recurrence (CWR).Methods: We retrospectively analyzed the clinical-pathological data of breast cancer patients with CWR who were diagnosed pathologically between January 2000 and April 2020. Progression free survival (PFS) was defined as time from diagnosis of CWR to the first disease progression. Persistent chest wall progression was three consecutive chest wall progression without distant organ involvement.Results: A total of 476 patients with CWR were included in this study. Among them, skin involvement or not was queried and confirmed in 345 patients. Skin involvement was significantly correlated to tumor size (P=0.003) and initial nodal status (P<0.001). By Kaplan-Meier analysis, skin involvement predicted a shorter PFS (P<0.001), especially local disease progression (P<0.001). Skin involvement was an independent biomarker for PFS by the multivariate analysis (P=0.034). Patients with skin involvement were more likely to experience persistent chest wall progression (P=0.040). After eliminating the potential deviation caused by insufficient follow-up time, persistent chest wall progression was more likely to be associated with positive lymph nodal status (P=0.046), negative PR (P=0.001) and positive HER2 (P=0.046) of the primary site, negative ER (P=0.027) and PR (P=0.013) of chest wall lesion and skin involvement (P=0.020).Conclusion: Skin involvement predicted poor local disease control in female breast cancer patients with CWR and it was more likely to be related to persistent chest wall progression. We improved the stratification of prognosis and provided new insights for biological behaviors of the disease and further individualized treatment in breast cancer patients with CWR.

Chest wall recurrence in pT1-2N0-1 breast cancer patients after mastectomy without radiotherapy

2018 ◽  
Vol 169 (3) ◽  
pp. 507-512 ◽  
Author(s):  
Ji Hyun Chang ◽  
Kyung Hwan Shin ◽  
Seung Do Ahn ◽  
Hae Jin Park ◽  
Eui Kyu Chie ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Chest Wall ◽  
Breast Cancer Patients ◽  
Chest Wall Recurrence

Continuous low-irradiance photodynamic therapy (CLIPT) as a novel treatment for cutaneous recurrences of breast cancer.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e11548-e11548
Author(s):  
Justin Persico ◽  
David E. Wazer ◽  
Anne Marie Melanson ◽  
Gary S Rogers ◽  
Roger Graham
Keyword(s):  
Breast Cancer ◽  
Photodynamic Therapy ◽  
Cancer Patients ◽  
Chest Wall ◽  
Light Exposure ◽  
Tunel Assay ◽  
Post Treatment ◽  
Breast Cancer Patients ◽  
Biopsy Specimens ◽  
Chest Wall Recurrence

e11548 Background: Photodynamic therapy (PDT) has been used for the treatment of many malignancies. This binary therapy involves the administration of a photosensitizer followed by exposure to light. Treatment toxicity has historically limited the use of PDT. Our study aimed to assess whether a novel approach, termed continuous low irradiance photodynamic therapy (CLIPT), would result in enhanced efficacy with reduced toxicity. Preclinical data suggest decreased toxicity and increased cell death by apoptosis with CLIPT. Methods: Breast cancer patients with chest wall progression were eligible for our study. No systemic anti-cancer therapy within 30 days and no radiation to the target site within 60 days of enrollment was allowed. All patients received porfirmer sodium intravenous 0.8mg/kg at time 0 and returned at time 48 hours for light exposure. A wavelength of 630nm was delivered continuously over 24 hours by a Diomed laser via a flexible light patch. An area of uninvolved normal skin was used as a control. Post-treatment biopsy was performed to assess for apoptosis by TUNEL assay. Results: Eight breast cancer patients were enrolled in our study. The initial dose of light was 100J/cm2 and was given to subjects 1 and 2 but resulted in partial-thickness ulceration of the epidermis. Subjects 3-8 received light at 50J/cm2 and experienced erythema at the intervention site, with no ulceration observed. All patients reported mild pain at the treatment site and 6 required short-term narcotic analgesia. Five of the 8 patients showed evidence of response, and no patients had progression of treated lesions. Four of 7 biopsy specimens showed evidence of apoptosis on TUNEL assay. Conclusions: CLIPT may prove to be a valuable option for treatment of breast cancer chest wall recurrence. The dose-limiting toxicity was skin ulceration and the maximum tolerated dose (MTD) was determined to be 50J/cm2/24h. A 50% response rate was seen in patients treated at the MTD, with apoptosis seen on post-treatment biopsy specimens. Further investigation of CLIPT as a therapeutic modality is warranted.

Outcome of Breast Cancer Patients with Chest Wall Recurrence

2003 ◽  
Vol 9 (6) ◽  
pp. 507
Author(s):  
Anees B. Chagpar ◽  
Henry M. Kuerer ◽  
Kelly K. Hunt ◽  
Eric A. Strom ◽  
Thomas A. Buchholz
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Chest Wall ◽  
Breast Cancer Patients ◽  
Chest Wall Recurrence

Outcome of surgical resection for chest wall recurrence in breast cancer patients

1997 ◽  
Vol 64 (1) ◽  
pp. 23-26 ◽  
Author(s):  
Masakazu Toi ◽  
Soichi Tanaka ◽  
Masashi Bando ◽  
Kazuo Hayashi ◽  
Takeshi Tominaga
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Chest Wall ◽  
Surgical Resection ◽  
Breast Cancer Patients ◽  
Chest Wall Recurrence

Correlation of AGR2 expression with the incidence of metastasis in luminal breast cancer

2021 ◽  
pp. 1-5
Author(s):  
David Samuel Kereh ◽  
John Pieter ◽  
William Hamdani ◽  
Haryasena Haryasena ◽  
Daniel Sampepajung ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Mean Value ◽  
Rank Test ◽  
Luminal Breast Cancer ◽  
P Value ◽  
Strong Positive Correlation ◽  
Breast Cancer Patients ◽  
The Mean ◽  
Spearman Test

BACKGROUND: AGR2 expression is associated with luminal breast cancer. Overexpression of AGR2 is a predictor of poor prognosis. Several studies have found correlations between AGR2 in disseminated tumor cells (DTCs) in breast cancer patients. OBJECTIVE: This study aims to determine the correlation between anterior Gradient2 (AGR2) expression with the incidence of distant metastases in luminal breast cancer. METHODS: This study was an observational study using a cross-sectional method and was conducted at Wahidin Sudirohusodo Hospital and the network. ELISA methods examine AGR2 expression from blood serum of breast cancer patients. To compare the AGR2 expression in metastatic patients and the non-metastatic patient was tested with Mann Whitney test. The correlation of AGR2 expression and metastasis was tested with the Rank Spearman test. RESULTS: The mean value of AGR2 antibody expression on ELISA in this study was 2.90 ± 1.82 ng/dl, and its cut-off point was 2.1 ng/dl. Based on this cut-off point value, 14 subjects (66.7%) had overexpression of AGR2 serum ELISA, and 7 subjects (33.3%) had not. The mean value AGR2 was significantly higher in metastatic than not metastatic, 3.77 versus 1.76 (p < 0.01). The Spearman rank test obtained a p-value for the 2 tail test of 0.003 (p < 0.05), which showed a significant correlation of both, while the correlation coefficient of 0.612 showed a strong positive correlation of AGR2 overexpression and metastasis. CONCLUSIONS: AGR2 expression is correlated with metastasis in Luminal breast cancer.

scholarly journals Surgery for primary tumor benefits survival for breast cancer patients with bone metastases: a large cohort retrospective study

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhangheng Huang ◽  
Xin Zhou ◽  
Yuexin Tong ◽  
Lujian Zhu ◽  
Ruhan Zhao ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Prognostic Factors ◽  
Bone Metastases ◽  
Cancer Patients ◽  
Primary Tumor ◽  
Predictive Accuracy ◽  
Rank Test ◽  
Breast Cancer Patients ◽  
Risk Of Death ◽  
The Impact

Abstract Background The role of surgery for the primary tumor in breast cancer patients with bone metastases (BM) remains unclear. The purpose of this study was to determine the impact of surgery for the primary tumor in breast cancer patients with BM and to develop prognostic nomograms to predict the overall survival (OS) of breast cancer patients with BM. Methods A total of 3956 breast cancer patients with BM from the Surveillance, Epidemiology, and End Results database between 2010 and 2016 were included. Propensity score matching (PSM) was used to eliminate the bias between the surgery and non-surgery groups. The Kaplan-Meier analysis and the log-rank test were performed to compare the OS between two groups. Cox proportional risk regression models were used to identify independent prognostic factors. Two nomograms were constructed for predicting the OS of patients in the surgery and non-surgery groups, respectively. In addition, calibration curve, receiver operating characteristic (ROC) curve, and decision curve analysis (DCA) were used to evaluate the performance of nomograms. Result The survival analysis showed that the surgery of the primary tumor significantly improved the OS for breast cancer patients with BM. Based on independent prognostic factors, separate nomograms were constructed for the surgery and non-surgery groups. The calibration and ROC curves of these nomograms indicated that both two models have high predictive accuracy, with the area under the curve values ≥0.700 on both the training and validation cohorts. Moreover, DCA showed that nomograms have strong clinical utility. Based on the results of the X-tile analysis, all patients were classified in the low-risk-of-death subgroup had a better prognosis. Conclusion The surgery of the primary tumor may provide survival benefits for breast cancer patients with BM. Furthermore, these prognostic nomograms we constructed may be used as a tool to accurately assess the long-term prognosis of patients and help clinicians to develop individualized treatment strategies.

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