scholarly journals Variability in Breast Cancer Biomarker Assessment and the Effect on Oncological Treatment Decisions: A Nationwide 5-Year Population-Based Study

Cancers ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1166
Author(s):  
Balazs Acs ◽  
Irma Fredriksson ◽  
Caroline Rönnlund ◽  
Catharina Hagerling ◽  
Anna Ehinger ◽  
...  
Keyword(s):  
Breast Cancer ◽  
New Technologies ◽  
Growth Factor Receptor ◽  
Patient Characteristics ◽  
Population Based ◽  
Breast Cancer Patients ◽  
Oncological Treatment ◽  
Quality Register ◽  
National Quality ◽  
Her2 Positivity

We compared estrogen receptor (ER), progesterone receptor (PR), human epidermal growth-factor receptor 2 (HER2), Ki67, and grade scores among the pathology departments in Sweden. We investigated how ER and HER2 positivity rates affect the distribution of endocrine and HER2-targeted treatments among oncology departments. All breast cancer patients diagnosed between 2013 and 2018 in Sweden were identified in the National Quality Register for Breast Cancer. Cases with data on ER, PR, HER2, Ki67, grade, and treatment were selected (43,261 cases from 29 departments following the guidelines for biomarker testing). The ER positivity rates ranged from 84.2% to 97.6% with 6/29 labs out of the overall confidence intervals (CIs), while PR rates varied between 64.8% and 86.6% with 7/29 labs out of the CIs. HER2 positivity rates ranged from 9.4% to 16.3%, with 3/29 labs out of the overall CIs. Median Ki67 varied between 15% and 30%, where 19/29 labs showed significant intra-laboratory variability. The proportion of grade-II cases varied between 42.9% and 57.1%, and 13/29 labs were outside of the CI. Adjusting for patient characteristics, the proportion of endocrine and anti-HER2 treatments followed the rate of ER and HER2 positivity, illustrating the clinical effect of inter- and intra-laboratory variability. There was limited variability among departments in ER, PR, and HER2 testing. However, even a few outlier pathology labs affected endocrine and HER2-targeted treatment rates in a clinically relevant proportion, suggesting the need for improvement. High variability was found in grading and Ki67 assessment, illustrating the need for the adoption of new technologies in practice.

scholarly journals Improvements in esophageal and gastric cancer care in Sweden-population-based results 2007–2016 from a national quality register

2019 ◽  
Vol 33 (3) ◽  
Author(s):  
M Jeremiasen ◽  
G Linder ◽  
J Hedberg ◽  
L Lundell ◽  
O Björ ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Cancer Care ◽  
Gastroesophageal Junction ◽  
Population Based ◽  
National Register ◽  
Clinical Registry ◽  
Oncological Treatment ◽  
Gastric Cancers ◽  
Quality Register ◽  
National Quality

SUMMARY The Swedish National Register for Esophageal and Gastric cancer was launched in 2006 and contains data with adequate national coverage and of high internal validity on patients diagnosed with these tumors. The aim of this study was to describe the evolution of esophageal and gastric cancer care as reflected in a population-based clinical registry. The study population was 12,242 patients (6,926 with esophageal and gastroesophageal junction (GEJ) cancers and 5,316 with gastric cancers) diagnosed between 2007 and 2016. Treatment strategies, short- and long-term mortality, gender aspects, and centralization were investigated. Neoadjuvant oncological treatment became increasingly prevalent during the study period. Resection rates for both esophageal/GEJ and gastric cancers decreased from 29.4% to 26.0% (P = 0.022) and from 38.8% to 33.3% (P = 0.002), respectively. A marked reduction in the number of hospitals performing esophageal and gastric cancer surgery was noted. In gastric cancer patients, an improvement in 30-day mortality from 4.2% to 1.6% (P = 0.005) was evident. Overall 5-year survival after esophageal resection was 38.9%, being higher among women compared to men (47.5 vs. 36.6%; P < 0.001), whereas no gender difference was seen in gastric cancer. During the recent decade, the analyses based on the Swedish National Register for Esophageal and Gastric cancer database demonstrated significant improvements in several important quality indicators of care for patients with esophagogastric cancers. The Swedish National Register for Esophageal and Gastric cancer offers an instrument not only for the control and endorsement of quality of care but also a unique tool for population-based clinical research.

scholarly journals Ethnicity-Related Survival Analysis of Patients with Triple-Negative Breast Cancer

10.29007/f7fq ◽  
2019 ◽  
Author(s):  
Mohammad Owrang Ojaboni ◽  
Yasmine Kanaan ◽  
Robert Dewitty Jr
Keyword(s):  
Breast Cancer ◽  
Triple Negative Breast Cancer ◽  
Triple Negative ◽  
Prognostic Significance ◽  
Growth Factor Receptor ◽  
Population Based ◽  
Lymph Node Status ◽  
Breast Cancer Patients ◽  
The Poor ◽  
Clinical Difference

Breast cancer prognostication is a vital element for providing effective treatment for breast cancer patients. Different types of breast cancer can be identified based on the existence or lack of certain receptors (i.e., estrogen, progesterone, her2 receptors). Triple-negative breast cancer (TNBC) is characterized by a lack of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2) expression. Existing studies suggest that TNBC patients tend to have worse prognosis compared to non-TNBC counterparts. The incidence of breast cancer and prognosis in women differ according to ethnicity. Given the poor prognosis of TNBC, cancer-related outcomes must be estimated accurately. Several factors responsible for the poor clinical outcomes observed in TNBC, including age, race/ethnicity, grade, tumor size, lymph node status among others, have been studied extensively. Available research data are not conclusive enough to make a convincing argument for or against a biological or clinical difference in TNBC patients based on these factors. This study was designed to investigate the effects of the ethnicity on breast cancer survivability among TNBC patients utilizing population-based Surveillance, Epidemiology, and End Results (SEER) data to confirm whether ethnicity factor has prognostic significance.

Prognostic significance of tumor subtypes in women with breast cancer according to stage: A population-based study.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 1070-1070
Author(s):  
Jose Pablo Leone ◽  
Julieta Leone ◽  
Ariel Osvaldo Zwenger ◽  
Carlos Teodoro Vallejo ◽  
Bernardo Amadeo Leone
Keyword(s):  
Breast Cancer ◽  
Prognostic Significance ◽  
Growth Factor Receptor ◽  
Population Based ◽  
Her2 Status ◽  
Lower Grade ◽  
Breast Cancer Patients ◽  
Tumor Subtypes ◽  
Epidermal Growth ◽  
Stage 1

1070 Background: Tumor subtypes (TS) are an important prognostic tool in breast cancer patients (pts). However, with contemporary therapies the prognosis of different subtypes is unclear. Recently, the AJCC proposed to incorporate TS among other variables in the 8th edition of the staging manual. The aim of this study was to analyze differences in overall survival (OS) by TS according to stage compared with other factors. Methods: We evaluated women with microscopically confirmed invasive breast cancer between 2010 and 2013 with known estrogen receptor (ER) and progesterone receptor (PR) (together hormone receptor [HR]) status and human epidermal growth factor receptor 2 (HER2) status reported to the SEER program. Pts with other primary either before or after breast cancer were excluded. Pt characteristics were compared between TS. Univariate and multivariate analyses were performed to determine the effect of each variable on OS. Results: We included 166,054 pts. Median age was 60 years (range 18-108). Median follow-up was 21 months (range 1-48). TS distribution was: 72.5% HR+/HER2-, 10.8% HR+/HER2+, 4.8% HR-/HER2+ and 12% triple negative (TN). Pts with HR+/HER2- tumors were older, had lower grade and presented with earlier stage (all p < 0.0001). OS at 3 years for each subtype according to stage is shown in the table (p for interaction < 0.0001). These differences in OS by TS continued to be significant for each stage in multivariate analysis adjusted for age, race, grade, histology and marital status. Conclusions: In this cohort, we observed significant differences in pt characteristics according to TS. Although HR+/HER2- tumors had better clinicopathologic features, the HR+/HER2+ group had the best OS in most stages. OS was significantly different by TS in each of the 4 stages and these results remained significant in the multivariate model. Pts with TN stage 1 tumors had similar OS as pts with HR+/HER2+ stage 2 tumors. Our results support the incorporation of TS as part of the staging variables in breast cancer. [Table: see text]

Co-expression of ER-beta and HER2 associated with poorer prognosis in primary breast cancer

2009 ◽  
Vol 32 (3) ◽  
pp. 250 ◽  
Author(s):  
Wen-sheng Qui ◽  
Lu Yue ◽  
Ai-ping Ding ◽  
Jian Sun ◽  
Yang Yao ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cell Differentiation ◽  
Primary Breast Cancer ◽  
Tumour Size ◽  
Univariate Analysis ◽  
Growth Factor Receptor ◽  
Disease Free Survival ◽  
Breast Cancer Patients ◽  
Her2 Positive ◽  
Er Alpha

Purpose: To assess the prognostic value of co-expression of estrogen receptor (ER)-beta and human epidermal growth factor receptor 2 (HER2) in primary breast cancer patients in China. Methods: Tumour specimens from 308 patients undergoing surgery for primary breast cancer were evaluated. Expression of ER-beta and HER-2 was investigated by the immunohistochemistry. Results: 123 patients (40%) were ER-beta positive and 58 (18.5 %) were HER2 positive. Among the 58 HER2 positive patients, 44 were ER-beta positive and 14 were ER-beta negative. ER-beta positive was associated with HER2 positive (75.9%, P=0.018) as well as ER-alpha positive (79.7%, P=0.023), poor cell differentiation (77.2% grade 2 or 3, P=0.010) and menopause age < 45 yr (55.3%, P=0.031). HER2 positive was associated with poor cell differentiation (93.1%, P=0.001), ?3cm tumour size (67.2%, P=0.011). Conclusion: Both ER-beta positive and HER2 positive status was associated with poorer overall survival (OS) by univariate analysis. In both HER2 positive and HER2 negative subgroups, ER-beta positive was associated with poorer distant disease free survival (DDFS) but not OS, which implied that ER-beta might relate to metastasis in breast cancer.

Antiestrogen use in breast cancer patients reduces the risk of subsequent lung cancer: A population-based study

2017 ◽  
Vol 48 ◽  
pp. 22-28 ◽  
Author(s):  
Sung-Chao Chu ◽  
Chia-Jung Hsieh ◽  
Tso-Fu Wang ◽  
Mun-Kun Hong ◽  
Tang-Yuan Chu
Keyword(s):  
Breast Cancer ◽  
Lung Cancer ◽  
Cancer Patients ◽  
Population Based ◽  
Breast Cancer Patients ◽  
Population Based Study

scholarly journals MEDALT: single-cell copy number lineage tracing enabling gene discovery

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Fang Wang ◽  
Qihan Wang ◽  
Vakul Mohanty ◽  
Shaoheng Liang ◽  
Jinzhuang Dou ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Single Cell ◽  
Copy Number ◽  
Speciation Analysis ◽  
Population Based ◽  
Lineage Tracing ◽  
Breast Cancer Patients ◽  
Lineage Tree ◽  
History Of ◽  
A Cell

AbstractWe present a Minimal Event Distance Aneuploidy Lineage Tree (MEDALT) algorithm that infers the evolution history of a cell population based on single-cell copy number (SCCN) profiles, and a statistical routine named lineage speciation analysis (LSA), whichty facilitates discovery of fitness-associated alterations and genes from SCCN lineage trees. MEDALT appears more accurate than phylogenetics approaches in reconstructing copy number lineage. From data from 20 triple-negative breast cancer patients, our approaches effectively prioritize genes that are essential for breast cancer cell fitness and predict patient survival, including those implicating convergent evolution.The source code of our study is available at https://github.com/KChen-lab/MEDALT.

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