scholarly journals Preoperative Systemic Inflammatory Biomarkers Are Independent Predictors of Disease Recurrence in ER+ HER2- Early Breast Cancer

2021 ◽  
Vol 11 ◽  
Author(s):  
Marta Truffi ◽  
Francesca Piccotti ◽  
Sara Albasini ◽  
Valentina Tibollo ◽  
Carlo Francesco Morasso ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Stratification ◽  
Early Breast Cancer ◽  
Distant Metastases ◽  
Disease Recurrence ◽  
Inflammatory Biomarkers ◽  
Breast Cancers ◽  
Breast Cancer Patients ◽  
Distant Relapse ◽  
Blood Neutrophils

The host’s immune system plays a crucial role in determining the clinical outcome of many cancers, including breast cancer. Peripheral blood neutrophils and lymphocytes counts may be surrogate markers of systemic inflammation and potentially reflect survival outcomes. The aim of the present study is to assess the role of preoperative systemic inflammatory biomarkers to predict local or distant relapse in breast cancer. In particular we investigated ER+ HER2- early breast cancer, considering its challenging risk stratification. A total of 1,763 breast cancer patients treated at tertiary referral Breast Unit were reviewed. Neutrophil-to-lymphocyte (NLR), platelet-to-lymphocyte (PLR) and lymphocyte-to-monocyte (LMR) ratios were assessed from the preoperative blood counts. Multivariate analyses for 5-years locoregional recurrence-free (LRRFS), distant metastases-free (DMFS) and disease-free survivals (DFS) were performed, taking into account both blood inflammatory biomarkers and clinical-pathological variables. Low NLR and high LMR were independent predictors of longer LRRFS, DMFS and DFS, and low PLR was predictive of better LRRFS and DMFS in the study population. In 999 ER+ HER2- early breast cancers, high PLR was predictive of worse LRRFS (HR 0.42, p=0.009), while high LMR was predictive of improved LRRFS (HR 2.20, p=0.02) and DFS (HR 2.10, p=0.01). NLR was not an independent factor of 5-years survival in this patients’ subset. Inflammatory blood biomarkers and current clinical assessment of the disease were not in agreement in terms of estimate of relapse risk (K-Cohen from -0.03 to 0.02). In conclusion, preoperative lymphocyte ratios, in particular PLR and LMR, showed prognostic relevance in ER+ HER2- early breast cancer. Therefore, they may be used in risk stratification and therapy escalation/de-escalation in patients with this type of tumor.

Early breast cancer: evaluation of the prognostic role of the site of the primary tumor.

1998 ◽  
Vol 16 (4) ◽  
pp. 1363-1366 ◽  
Author(s):  
R Zucali ◽  
L Mariani ◽  
E Marubini ◽  
R Kenda ◽  
L Lozza ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Early Breast Cancer ◽  
Distant Metastases ◽  
Breast Cancers ◽  
Prognostic Role ◽  
Long Term Follow Up ◽  
Internal Mammary

PURPOSE The prognostic role of the site of the primary breast cancer has not been clarified. This study aimed to gather more information about this issue from a large series of patients with long-term follow-up data. PATIENTS AND METHODS Data from 2,396 patients treated for early breast cancer with a conservative approach were reviewed (1973 to 1989). In 1,619 patients, the tumor had a lateral site, while in 777 cases, it was situated in the internal/central quadrants. The characteristics of the two groups were well balanced, apart from axillary nodal metastases, which were more frequent for lateral tumors (38.1% v 26.3%). RESULTS Analysis of distant metastases indicated that the regression coefficient associated with tumor site was significant and the hazards ratio estimate was 1.291, which indicates the risk of distant metastases was increased by approximately 30% for internal/central tumors. The analysis of overall survival yielded a significant coefficient and a hazards ratio of 1.192, which indicates an approximately 20% increase of mortality for internal/central tumors. CONCLUSION Early breast cancers situated in central/ internal quadrants have a worse prognosis compared with those in lateral quadrants, in terms of distant metastases and survival. Irradiation of the internal mammary chain for internal/medial tumors could be suggested, but, to date, the therapeutic strategy is still controversial.

Bone recurrence in early breast cancer patients: The paradox of aromatase inhibitors induced bone resorption

2021 ◽  
pp. 1-6
Author(s):  
Francesco Pavese ◽  
Alessandro Parisi ◽  
Silvia Rotondaro ◽  
Valentina Cocciolone ◽  
Giovanni Pierorazio ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Bone Resorption ◽  
Bone Metastases ◽  
Early Breast Cancer ◽  
Aromatase Inhibitors ◽  
Underlying Mechanism ◽  
Recurrence Risk ◽  
Disease Recurrence ◽  
Breast Cancer Patients ◽  
Mineral Density

BACKGROUND: Despite the increase in chances of cure for early breast cancer (EBC) patients, approximately 20–45% of them will experience a disease recurrence, particularly bone metastases in 60–80% of cases, which occur more frequently in luminal subtypes. Endocrine therapy (ET) has always been the milestone of adjuvant treatment for hormone receptor-positive EBC patients, leading to indubitable reduction of disease recurrence risk. However, adjuvant aromatase inhibitors (AIs) therapy may promote a progressive decrease in bone mineral density (BMD), which can lead to osteoporosis. The increased bone resorption associated with osteoporosis may provide fertile soil for cancer growth and accelerate the development of bone metastases. PATIENTS AND METHODS: In this single-institution cohort study, we performed a retrospective analysis of “luminal-like” EBC patients who experienced bone recurrence after a subsequent disease free interval. The aim of the study was to evaluate the median time to skeletal recurrence (TSkR). RESULTS: 143 patients experienced bone recurrence. Median TSkR was 54 months (95%CI: 45–65). Among patients who received adjuvant AIs median TSkR was 35 months (95%CI: 25–54), while among patients who did not was 61 months (95%CI: 50–80) (HR = 1.45 [95%CI: 0.97–2.17], p = 0.0644). After adjusting for TNM stage (AJCC 8th edition), adjuvant AIs treatment was significantly related to a shorter TSkR (HR = 1.60 [95%CI: 1.06–2.42], p = 0.0244). Adjuvant Tamoxifen, adjuvant AIs/Tamoxifen and no-treatment did not revealed to be associated to TSkR. CONCLUSIONS: In this cohort of EBC patients with bone recurrence, AIs treatment seems to be related to a shorter TSkR. AIs-induced bone resorption might represent the underlying mechanism.

scholarly journals Serum Metabolomic Profiles Identify ER-Positive Early Breast Cancer Patients at Increased Risk of Disease Recurrence in a Multicenter Population

2017 ◽  
Vol 23 (6) ◽  
pp. 1422-1431 ◽  
Author(s):  
Christopher D. Hart ◽  
Alessia Vignoli ◽  
Leonardo Tenori ◽  
Gemma Leonora Uy ◽  
Ta Van To ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Early Breast Cancer ◽  
Disease Recurrence ◽  
Breast Cancer Patients ◽  
Increased Risk ◽  
Er Positive ◽  
Risk Of Disease

Prevalence of androgen receptors expression in triple negative breast cancer patients and its correlation with clinicopathological criteria: Our institutes experience.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e12584-e12584 ◽  
Author(s):  
Kamel Farag ◽  
Ola Elfarargy ◽  
Shereen El Shorbagy ◽  
Safa Ahmed ◽  
Ola Harb ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Triple Negative Breast Cancer ◽  
Triple Negative ◽  
Androgen Receptors ◽  
Distant Metastases ◽  
Clinicopathological Parameters ◽  
P Value ◽  
Breast Cancers ◽  
Breast Cancer Patients ◽  
Positive Expression

e12584 Background: Triple negative breast cancer (TNBC) is a term that has been applied to breast cancers which lack expression of three receptors: estrogen receptor (ER), progesterone receptor (PR), and the human epidermal growth factor receptor 2 (HER2). It represents about 20% of breast cancers diagnosed worldwide. TNBC is a challenging type by its presentation criteria and limited options of treatment. Continuous research for finding specific target is the aim of scientists. Androgen receptors (AR) expression take special attention in this type of breast cancer as its expression can help for finding special targeted treatment as antiandrogen therapy.Purpose:is to assess the AR expression in TNBC patients and to correlate its expression with clinicopathological parameters and disease outcome of patients in study populations. Methods: This prospective study included 90 female patients confirmed as TNBC patients in medical oncology and clinical oncology departments, in Mansoura University and Zagazig University, Egypt, between December, 2013 to May, 2016. AR positive expression was defined as ≥10% nuclear immunostaining. Results: AR expression was positive in twenty seven (27/90) patients (30% ), and lack of its expression was significantly associated with younger age group(p < 0.001), higher grade(p = 0.017)& higher tumor stage(p < 0.001), presence of lymph node metastasis(p < 0.001) & distant metastases(p = 0.032), vascular(p = 0.044)& perineural invasion and high baseline CA 15-3 level (p < 0.001).Median follow up duration was 17.5months (range 6-40), 32/90 died (35.6%).Mean OS was 28months for AR negative TNBC patients versus 32months for AR positive patients. Twenty four of died patients (24/32) were AR negative. Three years OS was 50.8% and 44.1% for AR positive and AR negative respectively, but with nonsignificant P-value. Conclusions: Our study confirmed that AR positive expression in TNBC is a good prognostic feature and it can be sued as target for antiandrogen therapy in this group who is lacking any targettreatment.

Time course and prognosis of local recurrence following primary radiation therapy for early breast cancer.

1984 ◽  
Vol 2 (1) ◽  
pp. 37-41 ◽  
Author(s):  
J R Harris ◽  
A Recht ◽  
R Amalric ◽  
R Calle ◽  
R M Clark ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Local Recurrence ◽  
Early Breast Cancer ◽  
Time Course ◽  
Primary Radiation ◽  
Breast Cancer Patients ◽  
Distant Relapse ◽  
Long Term Follow Up ◽  
Isolated Local Recurrence

The frequency, time course, and prognosis of local recurrence following primary radiation therapy in 152 patients with early breast cancer treated before 1967 were examined. Local recurrence occurred at a constant rate over the first 14 years after treatment. The crude 15-year local recurrence rate was 22%. Of the 30 patients who developed an isolated local recurrence and underwent definitive secondary surgery, the 10-year freedom from distant relapse rate was 50%. These results indicate that breast cancer patients treated by primary radiation therapy require long-term follow-up to detect curable local recurrences.

A Risk Stratification Model for Predicting Survival in Breast Cancer Patients With Lung Metastasis: A Study of the SEER Database and A Chinese Cohort

2021 ◽  
Author(s):  
Xiang-Chen Han ◽  
Yu-Chen Pei ◽  
Yun-Jin Wang ◽  
Xiao-Guang Li ◽  
Xun-Xi Lu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Stratification ◽  
Lung Metastases ◽  
Distant Metastases ◽  
Risk Groups ◽  
Seer Database ◽  
Breast Cancer Patients ◽  
Cancer Specific Survival ◽  
Risk Stratification Model ◽  
Chinese Cohort

Abstract Background Distant metastases are the leading cause of death among breast cancer (BC) patients, and lung is the second preferential colonized sits. However, there has been no prognostic evaluation of BC patients with lung metastases so far. This research aimed to predict the overall survival (OS) and breast cancer-specific survival (BCSS) for BC patients with lung metastases and stratify them into different risk groups.Result A total of 3888 patients from the SEER database were eligible for the subsequent analyses, with the training cohort of 1944 patients and the validation cohort I of 1944 patients. In addition, 374 patients from the Chinese XXX database were assigned as the validation II. Race, age, grade, subtype, number of metastatic sites, surgery, and chemotherapy were identified as determinant prognostic variables and integrated to construct the nomogram. Ultimately, a risk stratification model was established, and all patients were classified as three risk groups. Conclusion We constructed prognostic prediction and risk stratification models for BC patients with lung metastases and validated it in both the SEER cohort and the Chinese cohort; these could assist clinicians in risk prediction, prognosis evaluation, and decision making on an individualized basis.

scholarly journals The Role of Trastuzumab in Patients with HER2 Positive Small (pT1mi/a) Breast Cancers, a Multicenter Retrospective Study

Cancers ◽  
2021 ◽  
Vol 13 (22) ◽  
pp. 5836
Author(s):  
Andrea Villasco ◽  
Silvia Actis ◽  
Valentina Elisabetta Bounous ◽  
Fulvio Borella ◽  
Marta D’Alonzo ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Recurrence Rate ◽  
Disease Free Survival ◽  
Disease Recurrence ◽  
Breast Cancers ◽  
Breast Cancer Patients ◽  
Her2 Positive ◽  
Adjuvant Trastuzumab ◽  
Small Breast ◽  
Increased Risk

The treatment with adjuvant Trastuzumab in patients diagnosed with HER2+ small breast cancers is controversial: limited prospective data from randomized trials is available. This study aims to measure the effect of Trastuzumab in the early stages of breast cancer (pT1mic/a pN0/1mi) in terms of disease recurrence and to identify which are the factors that most affect the prognosis of small HER2+ tumors. One hundred HER2+ pT1mic-pT1a breast cancer patients who were treated in three Turin Breast Units between January 1998 and December 2018 were retrospectively selected and reviewed. Trastuzumab was administered to 23 patients. Clinicopathological features and disease-free survival (DFS) were compared between different subgroups. The primary outcome was the disease recurrence rate. Median follow-up time was 86 months. Compared to pT1a tumors, pT1mic lesions had a higher tumor grade (84% of pT1mic vs. 55% of pT1a; p = 0.003), a higher Ki-67 index (81% vs. 46%; p = 0.007) and were more frequently hormone receptor (HR) negative (69% vs. 36%, p = 0.001). Disease recurrence rate was significantly lower among patients who received adjuvant Trastuzumab (p = 0.02), with this therapy conferring an 85% reduction in the risk of relapse (HR 0.15; p = 0.02). Among the patients who did not receive adjuvant Trastuzumab, the only factor significantly associated with an increased risk of developing a recurrence was the immunohistochemical (IHC) subtype: in fact, HR− HER2+ tumors showed a risk seven times higher of relapsing (HR 7.29; p = 0.003). Adjuvant Trastuzumab appears to reduce the risk of disease recurrence even in small HER2+ tumors. The adjuvant targeted therapy should be considered in patients with HR− HER2+ tumors since they have the highest risk of recurrence, independently from size and grade.

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