scholarly journals Survival Outcomes After Breast-Conserving Therapy Compared With Mastectomy for Patients With Early-Stage Invasive Micropapillary Carcinoma of the Breast: A SEER Population-Based Study

2021 ◽  
Vol 11 ◽  
Author(s):  
Song Wang ◽  
Yiyuan Zhang ◽  
Fangxu Yin ◽  
Xiaohong Wang ◽  
Zhenlin Yang
Keyword(s):  
Breast Cancer ◽  
Multivariate Analysis ◽  
Breast Carcinoma ◽  
Early Stage ◽  
Survival Outcomes ◽  
Invasive Micropapillary Carcinoma ◽  
Seer Database ◽  
Kaplan Meier ◽  
The Impact ◽  
Mastectomy Group

BackgroundInvasive micropapillary breast carcinoma (IMPC) is a relatively rare pathological type of invasive breast cancer. Little is currently known on the efficacy and safety of breast-conserving treatment (BCT, lumpectomy plus postsurgical radiation) compared with mastectomy in women diagnosed with early-stage IMPC. Accordingly, we sought to investigate the long-term prognostic differences between BCT and mastectomy in patients with T1-3N0-3M0 invasive micropapillary breast carcinoma using data from the Surveillance, Epidemiology, and End Results (SEER) database.Materials and MethodsWe retrospectively analyzed 1,203 female patients diagnosed with early-stage IMPC between 2004 and 2015 from the SEER database. The impact of different surgical approaches on patient prognosis was assessed by the Kaplan-Meier method and Cox proportional risk models.ResultsA total of 609 and 594 patients underwent mastectomy and BCT, respectively. Compared with patients who underwent a mastectomy, patients in the BCT group were older and had lower tumor diameters, lower rates of lymph nodes metastasis, and higher rates of ER receptor positivity and PR receptor positivity (p < 0.05). Kaplan-Meier plots showed that the overall survival (OS) and breast cancer-specific survival (BCSS) were higher in the BCT group than in the mastectomy group. In subgroup analysis, patients with T2 stage in the BCT group had better OS than the mastectomy group. Multivariate analysis showed no statistical difference in OS and BCSS for patients in the mastectomy group compared with the BCT group (hazard ratio (HR) = 0.727; 95% confidence interval (95% CI) 0.369–1.432, p = 0.357; HR = 0.762; 95% CI 0.302–1.923, p = 0.565; respectively). During the multivariate analysis and stratifying for the T stage, a better OS was found for patients with T2 stage in the BCT group than the mastectomy group (HR = 0.333, 95% CI: 0.149–0.741, p = 0.007). There was no significant difference in OS for patients with T1 and T3 stages between the BCT and mastectomy groups (p > 0.05).ConclusionIn women with early-stage IMPC, BCT was at least equivalent to mastectomy in terms of survival outcomes. When both procedures are feasible, BCT should be recommended as the standard surgical treatment, especially for patients with T2 disease.

How radiation oncologist accessibility influences treatment choice and quality in early-stage breast cancer: A SEER database analysis.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 6031-6031
Author(s):  
Thomas M. Churilla ◽  
Patrick E. Donnelly ◽  
Christopher A. Peters
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Early Stage ◽  
Early Stage Breast Cancer ◽  
Partial Mastectomy ◽  
Adjuvant Radiation ◽  
Seer Database ◽  
Radiation Oncologist ◽  
Radiation Oncologists ◽  
The Impact

6031 Background: Mastectomy and breast conserving therapy (BCT, partial mastectomy and adjuvant radiotherapy) are equivalent in survival for treatment of early stage breast cancer. This study evaluated the impact of radiation oncologist accessibility on choice of mastectomy versus BCT, and the receipt of radiotherapy after BCT. Methods: In the NCI SEER database, breast cancer cases from 2004-2008 were selected with the following criteria: T2N1M0 or less, lobular or ductal histology, and treatment with simple mastectomy or partial mastectomy (+/-) adjuvant radiation. The HRSA Area Resource File was combined to define average radiation oncologist density (ROD, number of radiation oncologists/100K people) by county over the same time period. Tumor characteristics, demographic information, and ROD were evaluated with respect to mastectomy rates and receipt of radiation therapy after BCT in univariate and multivariate analyses. Results: In the 118,961 cases analyzed, mastectomy was performed 33.3% of the time relative to BCT. After adjustment for demographic and tumor variables, the odds of having mastectomy versus BCT were inversely associated with ROD (OR [95% CI] = 0.94 [0.93-0.96]; p<0.001). Adjuvant radiation therapy was not administered in 23.4% of BCT cases. Likewise, the odds of having BCT without adjuvant radiation were inversely associated with ROD (0.96 [0.95-0.98]; p<0.001, table). Conclusions: There was a significant, inverse and linear relationship between ROD and mastectomy rates independent of demographic and tumor variables. An inverse trend was also observed for the omission of radiotherapy after BCT. Access to radiation oncologists was a factor in surgical choice and receiving appropriate BCT in early stage breast cancer. [Table: see text]

scholarly journals HER2-Low Status and Response to Neoadjuvant Chemotherapy in HER2 Negative Early Breast Cancer

2021 ◽  
Author(s):  
Luciana de Moura Leite ◽  
Marcelle Goldner Cesca ◽  
Monique Celeste Tavares ◽  
Debora Maciel Santana ◽  
Erick Figueiredo Saldanha ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Prognostic Value ◽  
Early Stage ◽  
Pathologic Complete Response ◽  
Cancer Center ◽  
Survival Outcomes ◽  
Early Stage Disease ◽  
The Impact ◽  
Response To Neoadjuvant Chemotherapy

Abstract Purpose: Recently, phase I studies with novel antibody drug conjugates targeting HER2 suggested benefit in HER2-low patients – defined as immunohistochemistry(IHC) +1 or +2 FISH/ISH non-amplified, with advanced breast cancer(BC). Data on the prognostic value of HER2-low in early stage disease is scarce. The purpose of this study was to evaluate the impact of HER2-low status on response to neoadjuvant chemotherapy(NACT) and survival outcomes in early stage HER2- negative BC. Methods: Records from all BC patients treated with NACT from January 2007 to December 2018 in a single cancer center were retrospectively reviewed. Primary objective was to compare differences between pathologic complete response(pCR) and relapse free survival(RFS) in luminal HER2-low/HER2-0 and triple negative(TNBC) HER2-low/HER2-0. Results: 855 non-HER2-positive patients were identified. Median follow-up was 59 months. 542 had luminal BC (63.4%) and 313 TNBC (36.6%). 285 (33.3%) were HER2-low. Among luminal tumors, 145 had HER2 IHC+1 (26.8%) and 91 IHC+2/ISH non-amplified (16.8%). In TNBC, only 36 had HER2 IHC+1 (11.5%) and 13 IHC+2/ISH non-amplified (4.2%). Among luminal/HER2-low and luminal/HER2-0 population, there was a high proportion of clinical T3/4 (61.5% vs 69.2%, p=0.053), node positive (74.2% vs 66.3%, p=0.27) and stage III tumors (63.1% vs 65%, p=0.51). The same was true TNBC/HER-low as compared to TNBC/HER2-0, despite a non-statistically significant higher cT4 among TNBC/HER-low (32.7% vs. 19.3%, p=0.17). pCR was 13% in luminal/HER2-low versus 9.5% in luminal/HER2-0 (p=0.27), and 51% in TNBC/HER2-low versus 47% in TNBC/HER2-0 (p=0.64). 5y RFS was 72.1% in luminal/HER2-low and 71.7% in luminal/HER2-0 (p=0.47), and 75.6% in TNBC/HER2-low versus 70.8% in TNBC/HER2-0 (p=0.23). HER2-low status was not associated with RFS in multivariate analysis (HR 0.83, 95%CI 0.6–1.11, p=0.21). Conclusion: Our data does not support HER2-low as a biologically distinct BC subtype, with no predictive effect on pCR after NACT nor prognostic value on survival outcomes.

scholarly journals Breast – conserving Surgery in Early – Stage Triple – Negative Breast Cancer: Is There a Higher Risk of Locoregional Recurrence?

2012 ◽  
Vol 12 (1) ◽  
pp. 11-14
Author(s):  
Jelena Maksimenko ◽  
Arvids Irmejs ◽  
Genadijs Trofimovics ◽  
Edvins Miklasevics
Keyword(s):  
Breast Cancer ◽  
Triple Negative Breast Cancer ◽  
Locoregional Recurrence ◽  
Triple Negative ◽  
Early Stage ◽  
Statistical Significance ◽  
Group Versus ◽  
Significant Difference ◽  
The Impact ◽  
Mastectomy Group

SummaryIntroduction.Triple- negative breast cancer (TNBC) is an aggressive disease with poor prognosis and high risk of locoregional recurrence (LRR).Aim of the Study.Is to examine the impact of type of surgery on locoregional recurrence in women with early- stage invasive triplenegative breast cancer (TNBC).Materials and Methods.A total of 68 women with stage I- II (T1N0M0, T2N0M0, T1N1M0, or T2N1M0) invasive, unifocal TNBC with hitologically tumor- free surgical margins were included. Patients were stratified into two groups according to surgical treatment, breast- conserving therapy (BCT) in 36 of 68 patients versus mastectomy in 32 of 68 patients. The two common founder mutations in BRCA1 (4153delA and 5382insC) in Latvia were tested using a multiplex- specific polymerase chain reaction(PCR) assay. Clinicopathological data and survival outcomes were analyzed.Results.There were no statistically significant differences in relation to age, stage, tumor size, histological type, tumor grade and nodal status between two groups. 24 patients (77.4%) in the mastectomy group and 27(75%) patients in the BCT group received chemotherapy, these difference was not statistically significant. 10(32.2%) of 32 patients in the mastectomy group and 34(94%) of 36 patients in the BCT group received postoperative radiation (P< 0.0001). There was no statistically significant difference noted in rates of distant metastases (5 cases (16.1%) in the mastectomy group versus 4 cases (11.1%) in the BCT group; P < 0.725)). A higher proportion of patients in the BCT group experienced locoregional recurrence compared with patients in the mastectomy group (3 cases (8.3%) versus 0 case (0%), respectively), but this did not reach statistical significance (P< 0.241). It was found that the tumor histology, grade, age at presentation and BRCA1 mutation status were not significant predictors of local recurrence. There was no significant difference in 5- year breast cancer- related survival between two groups (P>0.05).Conclusions.Patients after BCT have a higher locoregional recurrence rates compared to mastectomy, but this did not reach statistical significance. According to our study data BCT is not a contraindication in the TNBC.

scholarly journals Return to Work in the Gastric Cancer Survivors

2021 ◽  
Author(s):  
Yuan-Yuei Chen ◽  
Wei-Liang Chen ◽  
Wei-Te Wu ◽  
Ching-Liang Ho ◽  
Chung-Ching Wang
Keyword(s):  
Gastric Cancer ◽  
Return To Work ◽  
Cancer Survivors ◽  
Cox Regression ◽  
Early Stage ◽  
Survival Outcomes ◽  
Kaplan Meier ◽  
Returning To Work ◽  
The Impact

Abstract Returning to work (RTW) is an often used outcome in work research to describe employee fully recovering from disease. Several factors are suggested as barriers for workers returning to work. The goal of this study was to investigate the role of RTW in workers with gastric cancer and identify its impact on their survival outcomes during 11 years of follow-up. A total of 4467 workers who with newly diagnosis of gastric cancer were included in this retrospective cohort study with a follow-up period ranging from 2004 to 2015. Relationships between work, treatment, and disease-related variables and RTW were analyzed by Cox regression. The impact of RTW on survival outcomes was analyzed by Kaplan-Meier survival curves. Old age, males, comorbidities, chemotherapy, radiotherapy, and manual jobs were inversely associated with RTW. Operation and early stage of gastric cancer were associated with increased likelihood of RTW. After adjusting for variables, workers with stage 1 gastric cancer were more likely return to work than other stages with HR of 4.67 (95%CI: 2.99~7.31) and 7.44 (95%CI: 4.12~13.43) in the 2nd and 5th year. In terms of effect of RTW on survival rate, reemployed workers had better survival than those without employment in all gastric cancer survivors. Furthermore, RTW had significant association with reduced risk of all-cause mortality (HR: 0.49, 95%CI: 0.38~0.65). Improving these identified barriers and strengthening facilitators of RTW can provide employers and government to conduct comprehensive employment plans for increasing the percentage of RTW in the gastric cancer survivors.

Clinicopathologic characteristics and survival outcomes in multifocal and multicentric breast cancer.

2013 ◽  
Vol 31 (26_suppl) ◽  
pp. 41-41
Author(s):  
Atsushi Fushimi ◽  
Atsushi Yoshida ◽  
Osamu Takahashi ◽  
Naoki Hayashi ◽  
Hiroshi Yagata ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Multivariate Analysis ◽  
Tumor Size ◽  
Univariate Analysis ◽  
Disease Free Survival ◽  
Survival Outcomes ◽  
Breast Cancers ◽  
Free Survival ◽  
The Impact ◽  
Disease Free

41 Background: Although multifocal and multicentric (MF/MC) breast cancers are a common entity, their clinical behaviors are not well characterized. We evaluated the impact of MF/MC on the disease-free survival (DFS) and distant disease free survival (DDFS) of breast cancer patients and compared clinicopathological characteristics between MF/MC breast cancers and breast cancers with single lesion. Methods: We retrospectively analyzed 734 consecutive patients who had invasive breast carcinoma and underwent definitive surgery at the St Luke’s International Hospital from January 2004 to December 2006. MF or MC ware defined as more than one lesion in the same quadrant or in separate quadrants, respectively. DDFS and DFS ware calculated by The Kaplan–Meier method. Univariate analysis was performed using the log rank test and multivariate analysis by Cox proportional hazards models. Results: Of 734 patients, 136 (18.5%) had MF/MC disease. MF/MC disease was associated with smaller tumor size (P <0.001). Multivariate analysis shows that MF/MC disease did not have an independent impact on DDFS or DFS adjusting by age, ER status, tumor size, lymphovascular invasion, lymph node metastases and nuclear grade. Conclusions: MF/MC breast cancers were not associated with poor prognostic factors, and were not independent predictors of worse survival outcomes. Our findings support the current TNM staging system of using the diameter of the largest lesion to assign T stage.

Radiation therapy following breast conserving surgery (BCS) in women with early-stage breast cancer and low oncotype scores.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e12547-e12547
Author(s):  
Nicholas Damico ◽  
Michael Kharouta ◽  
Janice A. Lyons ◽  
Eleanor Elizabeth Harris
Keyword(s):  
Breast Cancer ◽  
Multivariate Analysis ◽  
Radiation Therapy ◽  
Tumor Size ◽  
Early Stage ◽  
Low Risk ◽  
Oncotype Dx ◽  
Her2 Breast Cancer ◽  
Propensity Matching ◽  
The Impact

e12547 Background: Clinical trials have demonstrated radiation therapy (RT) significantly reduces local recurrence following BCS, but that omission of RT does not compromise survival in the majority of women with early stage, low risk breast cancer. Criteria for omission of RT have been based on clinical factors such as age, stage, tumor size, surgical margins and estrogen receptor (ER) status. The utility of Oncotype DX RS in determining benefit of RT is not well defined. Methods: The National Cancer Database (NCDB) was queried for women ages 50-69 with T1N0M0, grade 1-2, ER+, Her2- breast cancer who underwent BCS with negative margins and had Oncotype DX RS of 0-18. Overall survival (OS) was estimated using the Kaplan-Meier method and compared between patients who received RT and endocrine therapy (ET) versus ET alone using logrank analysis. Propensity matching was performed to reduce the impact of potential confounders and balance sample bias. Cox proportional hazards regression was used to identify predictors of OS. Results: A total of 13,648 women met inclusion criteria. The median age was 60 years. 13,389 women had adjuvant RT+ET, while 259 women had ET alone. Five year OS was 98.6% in patients who underwent RT+ET compared to 95.5% in those that had ET alone (p = 0.0012). Propensity-matching by age, Charlson Deyo Comorbid Condition score, tumor size, Oncotype RS, and race. Five year OS in the propensity matched cohort was 99.6% for women receiving RT+ET, and 98.3% for ET alone, which was not significantly different (p = 0.095). On multivariate analysis receipt of radiotherapy was not predictive of survival. Age and comorbidity score were the only significant predictors of survival. Conclusions: Patients who receive adjuvant RT with low risk, early stage ER+/Her2- breast cancer had higher OS than women who received ET alone on univariate analysis. However, results from both multivariate analysis and propensity score matching suggest no survival benefit to the addition of RT. Prospective studies are underway assessing omission of RT on the basis of multigene assays rather than clinical features alone. [Table: see text]

scholarly journals The Different Outcomes Between Breast-Conserving Surgery plus Radiotherapy and Mastectomy in Metaplastic Breast Cancer: A Population-Based Study

2021 ◽  
Author(s):  
Lin-Yu Xia ◽  
Wei-Yun Xu ◽  
Qing-Lin Hu
Keyword(s):  
Breast Cancer ◽  
Multivariate Analysis ◽  
Therapeutic Option ◽  
Breast Conserving Surgery ◽  
Population Based ◽  
Survival Outcomes ◽  
Metaplastic Breast Cancer ◽  
Cancer Specific Survival ◽  
Kaplan Meier ◽  
Surgical Methods

Abstract Background: Metaplastic breast cancer (MBC) are rare. The survival outcomes of MBC patients after breast conserving surgery plus radiotherapy (BCS+RT) or mastectomy have not been established. The aim of this study was to compare survival outcomes of MBC patients subjected to BCS+RT or mastectomy therapeutic options.Methods: Patients who were subjected to BCS+RT or mastectomy between 2004 and 2014 were enrolled in this study through the Surveillance, Epidemiology and End Results (SEER) database. Breast cancer-specific survival (BCSS) and the overall survival (OS) of the participants were determined. Cox proportional hazard model and Kaplan Meier method were used to determine the correlation between the two surgical methods and survival outcomes. Results: A total of 1197 patients were enrolled in this study. Among them, 439 patients were subjected to BCS+RT, while 758 patients were subjected to mastectomy. Multivariate analysis showed a significantly high OS for MBC patients who were subjected to BCS+RT compared to those subjected to mastectomy (HR = 0.697, 95% CI = 0.527- 0.922, P=0.012). However, the BCSS for the two groups were statistically comparable (HR = 0.806,95% CI = 0.561-1.158, P= 0.244). After PSM, the BCS+RT and mastectomy groups consisted of 321 patients, respectively. The univariate and multivariate analysis with a 6-month landmark all indicate that patients receiving BCS+RT has higher OS than patients receiving mastectomy (HR = 0.701,95% CI = 0.496-0.990, P=0.044; HR = 0.684,95% CI = 0.479-0.977, P=0.037) while the BCSS was no difference between the two groups(HR = 0.739,95% CI = 0.474-1.153, P = 0.183; HR = 0.741,95% CI = 0.468-1.173, P = 0.200). Conclusion: The BCS+RT therapeutic option exhibits a high OS in MBC patients compared to the mastectomy approach.

scholarly journals The Effect of Marital Status on Survival of Patients with Gastrointestinal Stromal Tumors: A SEER Database Analysis

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Wei Song ◽  
Chuan Tian
Keyword(s):  
Prognostic Factor ◽  
Marital Status ◽  
Gastrointestinal Stromal Tumors ◽  
Cox Regression ◽  
Seer Database ◽  
Cancer Specific Survival ◽  
Stromal Tumors ◽  
Kaplan Meier ◽  
Risk Of Cancer ◽  
The Impact

Background. Marital status has been reported to be a prognostic factor in multiple malignancies. However, its prognostic value on gastrointestinal stromal tumors (GISTs) have not yet been determined. The objective of the present analysis was to assess the effects of marital status on survival in patients with GISTs. Methods. The Surveillance, Epidemiology, and End Results (SEER) database was used to analyze 6195 patients who were diagnosed with GISTs from 2001 to 2014. We also use Kaplan-Meier analysis and Cox regression to analyze the impact of marital status on cancer-specific survival (CSS). Results. Patients in the married group had more frequency in white people, more high/moderate grade tumors, and were more likely to receive surgery. Widowed patients had a higher proportion of women, a greater proportion of older patients (>60 years), and more common site of the stomach. Multivariate analysis demonstrated that marital status was an independent prognostic factor for GISTs (P<0.001). Married patients had better CSS than unmarried patients (P<0.001). Subgroup analysis suggested that widowed patients had the lowest CSS compared with all other patients. Conclusions. Marital status is a prognostic factor for survival in patients with GISTs, and widowed patients are at greater risk of cancer-specific mortality.

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