scholarly journals Molecular Subtypes, Metastatic Pattern and Patient Age in Breast Cancer: An Analysis of Italian Network of Cancer Registries (AIRTUM) Data

2021 ◽  
Vol 10 (24) ◽  
pp. 5873
Author(s):  
Giovanna Tagliabue ◽  
Sabrina Fabiano ◽  
Paolo Contiero ◽  
Giulio Barigelletti ◽  
Maurizio Castelli ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Molecular Subtypes ◽  
Age Groups ◽  
Cancer Registries ◽  
Receptor Expression ◽  
National Database ◽  
Italian Population ◽  
Patient Age ◽  
Primary Tumors ◽  
Patient Âgé

Breast cancer stage at diagnosis, patient age and molecular tumor subtype influence disease progression. The aim of this study was to analyze the relationships between these factors and survival in breast cancer patients among the Italian population using data from the AIRTUM national database. We enrolled women with primary breast cancer from 17 population-based cancer registries. Patients were subdivided into older (>69 years), middle (50–69 years) and younger age groups (<50 years) and their primary tumors categorized into four molecular subtypes based on hormone receptor (HR) and human epidermal growth factor receptor 2 (HER2) status. There were 8831 patients diagnosed between 2010 and 2012 included. The most represented age group was 50–69 years (41.7%). In 5735 cases the molecular subtype was identified: HER2–/HR+ was the most frequent (66.2%) and HER2+/HR− the least (6.2%). Of the 390 women with metastases at diagnosis, 38% had simultaneous involvement of multiple sites, independent of age and molecular profile. In women with a single metastatic site, bone (20% of cases), liver (11%), lung (7%) and brain (3%) were the most frequent. In the studied age groups with different receptor expression profiles, the tumor metastasized to target organs with differing frequencies, affecting survival. Five-year survival was lowest in women with triple-negative (HER2−/HR–) tumors and women with brain metastases at diagnosis.

scholarly journals Glucocorticoid receptor expression in breast cancer associates with older patient age

2008 ◽  
Vol 116 (3) ◽  
pp. 441-447 ◽  
Author(s):  
Larissa Belova ◽  
Bertha Delgado ◽  
Masha Kocherginsky ◽  
Amal Melhem ◽  
Olufunmilayo I. Olopade ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Glucocorticoid Receptor ◽  
Receptor Expression ◽  
Older Patient ◽  
Patient Age ◽  
Patient Âgé

scholarly journals Survival Associations between Patient Age and Treatment Modality in Olfactory Neuroblastoma: A Retrospective Population-Based Study

2021 ◽  
Vol 10 (12) ◽  
pp. 2685
Author(s):  
Andre J. Burnham ◽  
Phillip A. Burnham ◽  
Edwin M. Horwitz
Keyword(s):  
Treatment Modality ◽  
Age Groups ◽  
Olfactory Neuroblastoma ◽  
Population Based ◽  
Treatment Modalities ◽  
Long Term Outcomes ◽  
Patient Age ◽  
Population Based Study ◽  
Patient Âgé

Olfactory neuroblastoma (ONB) is a rare neuroepithelial-derived malignancy that usually presents in the nasal cavity. The rarity of ONB has led to conflicting reports regarding associations of patient age and ONB survival and outcome. Moreover, long-term outcomes of chemotherapy and other treatment modalities are speculated. Here, we aimed to compare survival outcomes across age groups through time and determine associations between treatment modality and survival. In this retrospective population-based study, we analyzed the SEER 2000–2016 Database for patients with ONB tumors. Using Kaplan–Meier survival analysis, a significant effect of age and cancer-specific survival (CSS) was observed; geriatric ONB patients had the lowest CSS overall. Generalized linear models and survival analyses demonstrated that CSS of the pediatric patient population was similar to the geriatric group through 100 months but plateaued thereafter and was the highest of all age groups. Radiation and surgery were associated with increased CSS, while chemotherapy was associated with decreased CSS. GLM results showed that tumor grade, stage and lymph node involvement had no CSS associations with age or treatment modality. Our results provide insight for future investigations of long-term outcomes associated with ONB patient age and treatment modality, and we conclude that survival statistics of ONB patients should be analyzed in terms of trends through time rather than fixed in time.

An assessment of fertility preservation practices among oncology providers.

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 267-267
Author(s):  
Kathryn DeCarli ◽  
Joshua Ray Tanzer ◽  
Amelia Tajik ◽  
Camille Higel-Mcgovern ◽  
Christine Mary Duffy ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Fertility Preservation ◽  
Negative Binomial ◽  
Psychosocial Distress ◽  
Cancer Type ◽  
Eligibility Criteria ◽  
Patient Age ◽  
Cancer Subtypes ◽  
Mixed Effects Modeling ◽  
Patient Âgé

267 Background: Chemotherapy accelerates the natural decline of ovarian reserve. Women with a new cancer diagnosis commonly experience psychosocial distress around anticipated fertility loss. Fertility preservation via oocyte cryopreservation or temporary ovarian suppression with GnRH agonists may address this concern. ASCO guidelines recommend early discussion of fertility, preservation methods, psychosocial distress counseling, and referral to a fertility specialist. Disparities have been shown in fertility counseling rates based on patient age, race and cancer type. We sought to identify patterns in fertility preservation practices at Lifespan Cancer Institute. Methods: We retrospectively reviewed the medical record of female patients aged 18-45 years at time of solid tumor or lymphoma diagnosis in the years 2014-2019 who received chemotherapy. We compared documented fertility discussions and referrals across patient demographics and provider characteristics. Generalized mixed effects modeling was used with a logit link or a log link (negative binomial or zero inflated truncated Poisson distribution). Results: Among 181 patients who met eligibility criteria, the median age was 38 years with 140 (77.3%) White and 23 (12.7%) Hispanic. Only 112 patients (61.9%) had a conversation about fertility documented by a medical oncologist. Overall, 42 (23.2%) were referred to a fertility specialist and 28 (15.5%) received fertility preservation. Older patients and patients with higher parity were less likely to have a conversation about fertility with their oncologist (parity: OR = 0.33, p = 0.0020; age: OR = 0.64, p = 0.0439) or to be referred to a fertility specialist (parity: OR = 0.87, p = < 0.0001; age: OR = 0.97, p < 0.0001). Male providers were less likely to refer patients to a specialist (OR = 0.85, p = 0.0155) or discuss fertility (OR = 0.02, p = 0.0164). On average, male providers had much shorter conversations about fertility (Cohen’s d = 1.01, p = 0.0007). Male providers were slightly more likely to refer patients of color to a fertility specialist than White patients (OR = 1.26, p = 0.0684). Patients with breast cancer were more likely to have discussions about fertility than patients with other cancers ( p < 0.0001). Conclusions: We found disparities among patient age, parity, cancer type and provider sex in fertility preservation practices at our institution. Though not statistically significant, we also found disparities among patient race. Nearly all breast cancer providers at our institution are female and use a note template that includes fertility preservation. Providers in other cancer subtypes may be less accustomed to addressing fertility based on their patient populations. A major limitation is that we were only able to capture explicitly documented conversations. This needs assessment supports implementation of a systematic approach to promote fertility preservation as a quality measure across all cancer types.

scholarly journals 33. SYSTEMATIC REVIEW AND META-ANALYSIS OF BREAST CANCER BRAIN METASTASIS AND PRIMARY TUMOR RECEPTOR EXPRESSION DISCORDANCE

2020 ◽  
Vol 2 (Supplement_2) ◽  
pp. ii6-ii6
Author(s):  
Rupesh Kotecha ◽  
Raees Tonse ◽  
Muni Rubens ◽  
Michael McDermott ◽  
Yazmin Odia ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Brain Metastasis ◽  
Primary Tumor ◽  
Expression Profiles ◽  
Receptor Expression ◽  
Her2 Status ◽  
Tumor Subtype ◽  
Primary Tumors ◽  
Breast Cancer Brain Metastasis

Abstract BACKGROUND Discordance in hormone receptor (estrogen [ER] and progesterone [PR]) and human epidermal growth factor receptor2 (HER2) status between the primary tumor and brain metastases and its effect on tumor classification subtype switching has been described but remains understudied. METHODS Using the PRISMA guidelines, a systematic review was performed of series published prior to April 2020 of biopsied or resected breast cancer brain metastasis (BCBM) from the Medline database using the keywords “breast cancer” and “brain metastasis” combined with “estrogen receptor/ER,” “progesterone receptor/PR,” “HER2/neu,” and “receptor conversion/dis- or concordance.” Weighted random effects models were used to calculate pooled estimates. RESULTS Fifteen full-text articles met inclusion criteria and cumulatively reported on 1373 patients who underwent biopsy or resection of at least one BCBM to compare to their primary tumor. At initial diagnosis, receptor expression profiles were 45.0% ER+, 41.0% ER-, 31.0% PR+, 51.0% PR-, 35% HER2+, and 47.0% HER2-. Corresponding receptor expression profiles from the BCBM were 19.0% ER+, 31.0% ER-, 13.0% PR+, 40.0% PR-, 21.0% HER2+, and 26.0% HER2-. Intra-patient receptor discordance comparisons revealed that 540 patients (42.6%) exhibited discordance in any receptor with 17.0% (95% CI: 13.0%-23.0%) discordance for ER status, 23.0% (95% CI: 18.0%-30.0%) for PR status, and 12.0% (95% CI: 8.0%-16.0%) for HER2 status. The most common receptor discordance events found in BCBM compared to primary tumors were ER loss 11.0% (95% CI: 8.0%-16.0%), PR loss 15.0% (95% CI: 11.0%-21.0%), and HER2 gain 9.0% (95% CI: 7.0%-11.0%). CONCLUSIONS BCBM commonly exhibit receptor expression changes on comparison to primary tumors including a 10% HER2 gain rate, a potential actionable target. Classification patterns need to be updated to reflect changes in overall tumor subtype grouping and which factors predict for BCBM/primary tumor discordance. Overall, tumor subtype switching and its effect on clinical management remains underappreciated.

scholarly journals SAT-168 Adrenal Incidentalomas: Impact of Patient Age on Referral Rates for Endocrine Evaluation

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Anthony Fryer ◽  
Sarah Hancock ◽  
Cherian George ◽  
Basil George Issa ◽  
Simon Lea ◽  
...  
Keyword(s):  
Age Groups ◽  
Adrenal Incidentaloma ◽  
Older Age ◽  
Age Group ◽  
Adrenal Incidentalomas ◽  
Patient Age ◽  
Radiology Reports ◽  
Patient Âgé ◽  
Mri Scans ◽  
Ct And Mri

Abstract It is estimated that the prevalence of adrenal incidentaloma increases with age: ~3% of those aged 50 years, rising to 10% in those &gt;70 years (1). Given the aging population together with increased utilisation of cross-sectional imaging in the UK (eg CT urogram, MR angiogram), we explored the proportion of patients with adrenal incidentaloma by age based on current imaging trends. Furthermore, there is no information currently available on the relationship between age and pattern of endocrine referrals. We extracted data for all CT and MRI scans from Jan 2018-Oct 2019 and used key phrases in radiology reports (eg adrenal adenoma/lesion/mass/nodule/incidentaloma, incidental adrenal, indeterminate adrenal) to identify potential lesions. We also extracted data on patient age and referral patterns as identified by a logged referral or an attendance (new or follow-up) to endocrine clinic 3 months post index scan, stratified by 10 year age groups. Where possible, we excluded false hits (eg no adrenal lesion). Preliminary data showed that, of the 2604 potential lesions identified by CT and MRI scans, 78.7% were on patients aged over 60 years. The numbers of identified lesions gradually increased with age to a peak in the 71-80 year age group after which these declined. Whilst patients younger that 60 years had fewer potential lesions identified, they were more likely to be referred to endocrine services (73 out of 55 patients; 13.2%) than those in the older age group (168 out of 2049; 8.2%; p&lt;0.001). Indeed there was a statistically significant trend towards decreasing referral with age group (Chi-squared test for trend; p&lt;0.001). In conclusion, patients over 60 years have a higher number of potential adrenal incidentalomas. However, this group is less likely to be referred for endocrine evaluation. This is particularly concerning given the large number of scans requested and the higher prevalence of incidentalomas in this age group. This study represents preparatory work on innovations to enhance case detection, particularly in the older age groups (2). 1. Fassnacht M, Arlt W, Bancos I, et al. Management of adrenal incidentalomas: European Society of Endocrinology Clinical Practice Guideline. Eur J Endocrinol. 2016;175:G1-G34 2. Hanna FWF, Issa BG, Lea SC, George C, Golash A, Firn M, Ogunmekan S, Maddock E, Sim J, Xydopoulos G, Fordham R, Fryer AA. Adrenal lesions found incidentally: how to improve clinical and cost-effectiveness. BMJ Open Quality. 2019;In press.

scholarly journals Initial Experience with Digital Patient Briefing in Computed Tomography

2018 ◽  
Vol 191 (06) ◽  
pp. 540-546
Author(s):  
Babak Alikhani ◽  
Bennet Hensen ◽  
Arne Grosser ◽  
Maria Inés Cartes Febrero ◽  
Markus von Bestenbostel ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Statistical Significance ◽  
Age Groups ◽  
Patient Age ◽  
Open Questions ◽  
Patient Âgé ◽  
Significant Difference ◽  
Student’S T ◽  
The Individual ◽  
Time Required

Purpose To assess digital patient briefing as an alternative to conventional paper documentation. Materials and Methods 502 patients with a planned computed tomography (CT) examination were selected for digital patient briefing using the E-ConsentPro software from Thieme Compliance on an iPad by Apple (Cupertino, California, USA). For the analysis, three age groups were formed. The time required for the patient briefing, the number of open questions as well as the time needed for discussion with physicians were determined. Student’s t-test was performed to assess statistical significance. Results There was no significant difference between patient age and briefing time which was about 20 minutes on average. The number of open or unclear questions increased with patient age. While patients younger than 30 years of age had about 2 open questions, patients over 30 and 60 years had about 4 and 5 questions, respectively. The total time needed for discussion with physicians was less than 2 minutes on average. A significant difference in the time required for discussion with physicians could not be observed between the individual age groups. Conclusion Tablet-based digital briefing allows the storage of patient documents with reasonable time and effort. Furthermore, it minimizes the risk of data loss. Key Points  Citation Format

scholarly journals Tumor Autonomous Effects of Vitamin D Deficiency Promote Breast Cancer Metastasis

Endocrinology ◽  
2016 ◽  
Vol 157 (4) ◽  
pp. 1341-1347 ◽  
Author(s):  
Jasmaine D. Williams ◽  
Abhishek Aggarwal ◽  
Srilatha Swami ◽  
Aruna V. Krishnan ◽  
Lijuan Ji ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Cancer Metastasis ◽  
Receptor Expression ◽  
Inverse Association ◽  
Primary Tumors ◽  
Hydroxyvitamin D ◽  
25 Hydroxyvitamin D ◽  
Vitamin D Signaling

Abstract Patients with breast cancer (BCa) frequently have preexisting vitamin D deficiency (low serum 25-hydroxyvitamin D) when their cancer develops. A number of epidemiological studies show an inverse association between BCa risk and vitamin D status in humans, although some studies have failed to find an association. In addition, several studies have reported that BCa patients with vitamin D deficiency have a more aggressive molecular phenotype and worse prognostic indicators. However, it is unknown whether this association is mechanistically causative and, if so, whether it results from systemic or tumor autonomous effects of vitamin D signaling. We found that ablation of vitamin D receptor expression within BCa cells accelerates primary tumor growth and enables the development of metastases, demonstrating a tumor autonomous effect of vitamin D signaling to suppress BCa metastases. We show that vitamin D signaling inhibits the expression of the tumor progression gene Id1, and this pathway is abrogated in vitamin D deficiency in vivo in 2 murine models of BCa. These findings are relevant to humans, because we discovered that the mechanism of VDR regulation of Inhibitor of differentiation 1 (ID1) is conserved in human BCa cells, and there is a negative correlation between serum 25-hydroxyvitamin D levels and the level of ID1 in primary tumors from patients with BCa.

Patterns of HER2/neu, hormonal receptor expression, and proliferative activity in primary and metastatic breast cancer

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 1071-1071
Author(s):  
F. Giotta ◽  
G. Simone ◽  
V. Fazio ◽  
S. Longo ◽  
S. Petroni ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Predictive Factors ◽  
Proliferative Activity ◽  
Metastatic Breast ◽  
Receptor Expression ◽  
Breast Cancer Patients ◽  
Primary Tumors ◽  
Prognostic And Predictive Factors ◽  
Mib 1

1071 Background: The modification of biological features of metastatic sites (MS) in breast cancer patients arise some debatable questions regarding clinically usefull information and safe/efficient methods to detect them. Fine needle aspiration (FNA) of visceral MS is an available tool to characterize tumoral lesion and liquid based citology technique provides usefull cell samples for immunocytochemical and/or molecular assays. Methods: The aim of this study was to compare prognostic and predictive factors obtained from primary tumors (PT) and corresponding MS. Fluorescent in situ hybridization (FISH) was performed for HER2/Neu determination, while ER, PgR, and MIB-1 were detected by immunochemistry using specific monoclonal antibodies on monolayered cell sample and in the corresponding cytoinclusion. FNA with a 21–23 G needle was performed in 20 consecutive breast cancer patients with distant metacronous MS. Results: In 8/20 patients, both ER and PgR were absent in PT and in MS, in 7 were both present, in 4 cases only ER was detected, and only 1 case was ER negative with a low PgR. About the proliferative activity (MIB-1 index: cut off value >20%) only 3 MS presented an higher value. With regard to HER2/Neu, 4/20 cases were amplified and no discrepancies were found between cytological and cytoinclusion specimens. No substantial changes were found about kinetic activity. HER2/Neu status as assessed in PT was confirmed in MS in 10/12 cases; a lung mestastasis showed amplification while primary was not amplified and a liver lesion lost the amplification which was detected in the PT. Conclusions: Our study strongly suggest the opportunity in using FNA for detection of prognostic and predictive factors in MS. Pectasides et al. (Anticancer Res. 2006) found in patients with altered or conserved HER2/Neu in PT and in MS different response rates between the two groups and a significant poorer prognosis in patients with altered Neu. We think that liquid-based cytology applied on FNA of distant metastases could help us to understand some more in this issue. No significant financial relationships to disclose.

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