scholarly journals PROGNOSIS OF BREAST CANCER IN VERY YOUNG AGE (LESS THAN 30 YEARS)

2016 ◽  
Vol 2 (1) ◽  
Author(s):  
Razia Bano ◽  
Mariam Salim ◽  
Amina Iqbal Khan ◽  
Akif Zaidi
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Local Recurrence ◽  
Triple Negative ◽  
Locally Advanced ◽  
Breast Conservation ◽  
Radical Mastectomy ◽  
Histopathological Diagnosis ◽  
Single Patient ◽  
Tumour Biology

Purpose: Breast cancer diagnosed at a younger age has aggressive biology being triple negative and high grade and is associated with poor prognosis.Materials and Methods: Retrospectively data of 121 patients age 30 years or younger registered during the year 2008 were reviewed. Data were extracted from the cancer registry department of the institute. Demographics studied were the age at diagnosis, gender, pregnancy or lactation association, family history of breast cancer, histopathological diagnosis, and stage of the disease, receptors, type of treatment, response, local recurrence, distant relapse, and survival. Results: A total of 121 patients with age 30 years or less were included. An only a single patient was male. The age range was from 20 to 30 years; bilateral involvement was seen in a single patient. Almost half 50.4% (n = 61) patients had locally advanced disease at presentation. Pregnancy/lactation-associated breast cancer was seen in 29.8% (n = 36). The most common stage was Stage III (52.1%) and Stage II (33.9%). Invasive ductal carcinoma was the most common histology 94.2% (n = 114) of patients; triple negative was the most common molecular subtype present in 46.3% (n = 56). Chemotherapy was received by 92.6% (n = 112), 88.4% (n = 107) patients received radiation therapy. Modi ed radical mastectomy was performed in 57% (n = 69), breast conservation surgery in 35.5% (n = 43), follow- up period was 5 years, local recurrence was observed in 12.4% (n = 15) and cancer related deaths were 42.1% (n = 51). Conclusions: Breast cancer in very young has very aggressive tumour biology, needs aggressive treatment with surgery, chemotherapy, radiation therapy and hormonal therapy. Key words: Breast cancer, pregnancy-associated aggressive tumour biology, triplenegative, young 

scholarly journals 210 Prognosis of Breast Cancer in Very Young Age (Less Than 30 Years)

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
M Abid ◽  
R Bano ◽  
M Salim ◽  
A I Khan ◽  
M Z Chaudhry ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Local Recurrence ◽  
Triple Negative ◽  
Molecular Subtype ◽  
Locally Advanced ◽  
Tumor Biology ◽  
Histopathological Diagnosis ◽  
Distant Relapse ◽  
Associated Family ◽  
Age Range

Abstract Background Breast cancer diagnosed at younger age has aggressive biology being triple negative and high grade and associated with poor prognosis. Method Retrospectively data of 121 patients age 30 years or younger registered during the year 2008 was reviewed. Demographics studied were age at diagnosis, gender, pregnancy, or lactation associated, family history, histopathological diagnosis, stage of the disease, receptors, type of treatment, response, local recurrence, distant relapse, survival. Results One patient was male. Age range 20 -30 years, single patient had bilateral involvement. half 50.4%(n = 61) patients had locally advanced disease at presentation. Pregnancy/ lactation associated breast cancer was seen in 29.8%(n = 36). Most common stage was stage III (52.1%) & stage II (33.9%). IDC was the most common histology 94.2% (n = 114) Triple negative was most common molecular subtype present in 46.3%(56). After 5 years follow up, local recurrence was observed in 12.4%(n = 15), cancer related deaths were 42.1%(n = 51). Conclusions Breast cancer in very young has very aggressive tumor biology, needs aggressive treatment with surgery, chemotherapy, radiation therapy and hormonal therapy, furthermore there is need to identify possible environmental factors which may contribute in the rising incidence in this age group.

Efficacy and safety of neoadjuvant docetaxel, carboplatin, trastuzumab, and pertuzumab (TCH-P) in HER2-positive breast cancer: An Indian experience.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e12619-e12619
Author(s):  
Ajay Gogia ◽  
Shalabh Arora ◽  
SVS Deo ◽  
Sandeep Mathur ◽  
Dayanand Sharma
Keyword(s):  
Breast Cancer ◽  
Locally Advanced ◽  
Neoadjuvant Treatment ◽  
Breast Conservation ◽  
Radical Mastectomy ◽  
Stage Ii ◽  
Breast Conservation Surgery ◽  
Secondary Outcome ◽  
Her2 Positive ◽  
Positive Breast Cancer

e12619 Background: Dual targeted therapy with chemotherapy is one of the therapeutic approaches as neoadjuvant treatment in HER2/neu positive breast cancer (BC). However the safety and efficacy data of dual-targeted, chemotherapy regimen (docetaxel, carboplatin, trastuzumab, & pertuzumab [TCH-P] is limited from the Indian subcontinent. Methods: This retrospective study aims to evaluate the efficacy and toxicity of neoadjuvant TCH-P regimen in early, locally advanced, and oligometastatic (OM) HER2-positive BC, at All India Institute of Medical Sciences, New Delhi, India, in between the period 2015-2020. Total 6 cycles of 3-weekly neoadjuvant chemotherapy (NACT) protocol containing docetaxel (75 mg/m2), carboplatin (AUC = 6), trastuzumab (8 mg/kg loading followed by 6 mg/kg) and pertuzumab ( 840 mg loading followed by 420 mg) were planned. Subcutaneous peg-filgrastim was prophylactically administered on day 2 of each cycle. The primary outcome was the pathological complete response (pCR), which was defined as an absence of invasive and noninvasive cancer in breast or lymph node and secondary outcome were clinical overall response rate (ORR), rate of breast conservation surgery( BCS) for patients for whom modified radical mastectomy( MRM)was planned and toxicity. Results: Forty-five patients with a median age of 48 years (31-65) were included in this study. The TNM (AJCC-7th edition) stage distribution was stage II, 14 (31.1%); stage III, 29 (64.5%); and stage IV (OM), 2 (4.4%). Clinical node positivity disease was found in 26 (57.8%) cases. Nineteen (42.2%) patients had hormone-positive and 26(57.8%) cases were premenopausal. The clinically ORR and CR were seen in 100% and 60% respectively. Overall pCR rate was observed in 25 (55.6%) patients (70% in stage II). BCS was performed in 23(51.1%) cases. In 12(26.6%) cases, planned MRM was changed to BCS following NACT. Grade 3 and 4 toxicities were diarrhea 7 cases, thrombocytopenia in 6, neutropenia in 4, febrile neutropenia in 1, and anemia in 2 cases. Ten patients required dose modification and interruption. No patient had congestive heart failure or induction death. Conclusions: This is the first study of the non-anthracycline-based neoadjuvant protocol in HER2 positive BC from India. The TCH-P is an effective, safe, and well-tolerated, protocol with a path CR rate of 55.6% and 26.6% BCS conversion rate from planned MRM.

scholarly journals Immunohistochemistry profile and its relation with prognosis in locally advanced breast cancer

2019 ◽  
Vol 6 (12) ◽  
pp. 4507
Author(s):  
Naseef Kannanavil ◽  
Nabeel Thommil Padinjarenalakath ◽  
Ahsan Vilayapoyilil ◽  
Abidali Karatparambil
Keyword(s):  
Breast Cancer ◽  
Triple Negative ◽  
Locally Advanced ◽  
Radical Mastectomy ◽  
Response To Therapy ◽  
Advanced Breast ◽  
Age Group ◽  
Modified Radical Mastectomy ◽  
Number Of Patients ◽  
Related Mortality

Background: Breast cancer is one of the most common malignancy and leading cause of cancer related deaths in women worldwide. Immunohistochemistry (IHC) is done to characterize intracellular proteins or cell-surface antigens and is used to assess tumour subtypes, confirm diagnosis, predict prognosis and response to therapy. The aim of the present study was to evaluate the relationship of IHC profile- ER, PR and HER2 neu and prognosis of patients who underwent modified radical mastectomy for locally advanced breast cancer.Methods: A retrospective cohort study was conducted at MES Medical College Hospital from October 2015 to November 2017 in patients who underwent modified radical mastectomy for locally advanced breast carcinoma. A total of 65 women were enrolled in the study. 5 years survival was taken as the prognostic indicator.Results: Majority of the patients belong to the age group of 40-49 years with 40% patients followed by 33.84% patients in the age group of 50-59 years. Maximum number of patients was found in 2B stage of tumour. Maximum patients belonged to the ER/PR+, HER2- subgroup (27), followed by triple negative (ER/PR-, HER2) subgroup (16). There was no disease related mortality in ER/PR+, HER2+ and ER/PR+, HER2- subgroups. There were 1 and 2 disease related mortality in ER/PR-, HER2+ and triple negative subgroups respectively.Conclusions: In the present study the worst prognosis was observed in triple negative (ER/PR-,HER2-) IHC subgroup followed by the HER2 enriched (ER/PR-, HER2+) subgroup. 

Influence of radiation therapy on the outcome of T1-2N0M0 triple-negative breast cancer: A SEER population-based retrospective analysis.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e12073-e12073
Author(s):  
Xiaoxiang Guan ◽  
Huan Li ◽  
Yajuan Chen ◽  
Xin Wang ◽  
Lin Tang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Retrospective Analysis ◽  
Triple Negative Breast Cancer ◽  
Survival Benefit ◽  
Triple Negative ◽  
Breast Conservation ◽  
Population Based ◽  
Axillary Staging ◽  
Cancer Specific Survival

e12073 Background: For T1-2N0M0 breast cancer after surgery and axillary staging, the current NCCN guideline recommends radiation therapy (RT) after lumpectomy but not total mastectomy unless there is a positive or less than 1 mm negative margin. This recommendation is regardless of hormonal status. Triple-negative breast cancer is a generally considered more aggressive compared with hormone positive breast cancer. We sought to investigate whether there is a survival benefit of RT in T1-2N0M0 TNBC. Methods: A Population-based retrospective analysis was performed using the Surveillance, Epidemiology, and End Results (SEER) database. Patients included in the analysis were divided into three groups according to surgery modality and RT: breast conservation therapy (BCT, i.e., lumpectomy + RT), mastectomy alone, and mastectomy + RT. The survival endpoints were breast cancer-specific survival (BCSS) and overall survival (OS), and survival analysis was performed using the Kaplan-Meier method. Results: A total of 22473 female with T1-2N0M0 TNBC diagnosed between 2010 and 2015 were included, with 13395 (60%) T1 and 9078 (40%) T2 cases. Surgery, RT and chemotherapy was done in 21674 (96%), 9633 (43%) and 14651 (65%) patients, respectively. Patients who underwent RT were older ( > 50 years, 78% vs 72%, P< 0.001), had fewer T2 (35% vs 44%, P< 0.001) tumor, and had more chemotherapy utilization (72% vs 60%, P< 0.001). 8807 patients had BCT; 8329 had mastectomy alone and 635 had mastectomy + RT. The 5-year BCSS rate was 94.3% for BCT, 93.3% for mastectomy alone ( P= 0.009 vs BCT), and 83.7% for mastectomy + RT ( P< 0.001 vs BCT and P< 0.001 vs mastectomy alone), respectively. The 5-year OS rate was 88.6% for BCT, 83.0 % for mastectomy alone ( P< 0.001 vs BCT), and 79.6% for mastectomy + RT ( P< 0.001 vs BCT and P= 0.190 vs mastectomy alone), respectively. Conclusions: In patients with T1-2N0M0 TNBC, BCT was associated with superior BCSS and OS compared to mastectomy with or without RT. After mastectomy, there was no evidence of survival benefit of RT, with worse BCSS and similar OS.

scholarly journals Is Surgery Justifiable in Residual Locally Advance Breast Cancer After Neo-Adjuvant Systemic Treatment?

2020 ◽  
Keyword(s):  
Breast Cancer ◽  
Recurrence Rate ◽  
Triple Negative ◽  
Residual Disease ◽  
Locally Advanced ◽  
Tumor Biology ◽  
Radical Mastectomy ◽  
Her2 Status ◽  
Systemic Recurrence ◽  
Time To Recurrence

Background: Management of locally advanced disease is a challenge. In women with significant residual disease after neoadjuvant therapy when subjected to surgery wounds cannot be closed primarily and require myo-cutaneous flap, Latismus dorsi being the easiest one. The purpose of this study is to look at the recurrence rate, time to recurrence and is surgery needed in this group of patients. Material and Methods: This is a hospital-based retrospective study conducted at Liaquat National Hospital and Medical College, Karachi. Pakistan. From 2006 to 2015, 15 patients with locally advanced breast cancer, who still had significant residual disease after adequate neo-adjuvant therapy that after Modified radical mastectomy wound could not be closed and latismus dorsi flap was used to close the defect. The age, histopathology report, margin of clearance, ER, PR, Her2 status and ki67 was noted. These patients were followed up to look for any local or systemic recurrence and time to recurrence and local or site of any systemic recurrence was recorded. Results: A total of 15 female patients with a mean age of 42.73±9.66 years with a mean follow up of 33.93±26.78 months were seen. In all patients, margins were histologically negative. Mean nodes removed and involved were 12.53±8.04 and 5.46±7.15 respectively. Meantime to recurrence was 16.00±14.92 months. In our study, recurrence was observed in 11 (73.3%) patients with 7(64 %) local and 4(36%) systemic recurrence. All 5 triple-negative and 4 patients stage IV 4 had local recurrence. Patients with poor prognostic markers like higher residual nodal involvement, large tumor size, higher Ki 67, aggressive tumor biology (triple-negative and HER2 Positive tumors) had a high and early recurrence. Conclusion: In patients with high residual tumor burden and aggressive biology has high chances of disease recurrence. Surgery in these patients should be offered to keep quality of life, disease biology and recurrence rate in mind.

Omission of radiation therapy following breast conservation in older (≥70 years) women with T1‐2N0 triple‐negative breast cancer

2019 ◽  
Vol 25 (6) ◽  
pp. 1126-1133 ◽  
Author(s):  
Waqar Haque ◽  
Vivek Verma ◽  
Kuan‐Yin Hsiao ◽  
Sandra Hatch ◽  
Candy Arentz ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Triple Negative Breast Cancer ◽  
Triple Negative ◽  
Breast Conservation

Trends in rates of modified radical mastectomies and bilateral mastectomies in unilateral breast cancer.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 569-569
Author(s):  
Ajaz Bulbul ◽  
Tareq Braik ◽  
Sadaf Rashad ◽  
Emilio Araujo Mino ◽  
Adrianna Bautista ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Local Recurrence ◽  
Clinical Outcomes ◽  
Recurrence Rate ◽  
Early Stage ◽  
Breast Conservation ◽  
Radical Mastectomy ◽  
Breast Conservation Surgery ◽  
Bilateral Mastectomy ◽  
Unilateral Breast Cancer

569 Background: Women with unilateral breast cancer (BC) without genetic predisposition have a low risk for local and contralateral recurrence with breast conservation surgery (BCS) and adjuvant treatment. We aimed to study the pattern of surgical care across centers in rural New Mexico and its correlation to clinical outcomes. Methods: We retrospectively evaluated 533 patients with Stage 1-3 BC diagnosed between January 1989 to October 2015. Clinical Outcomes with BCS, sentinel lymph node dissection (SLND), simple mastectomy (SM), modified radical mastectomy (MRM) and Bilateral Mastectomy (BM) were studied. Descriptive statistics were performed to describe the proportion of surgery types. Predictors of clinical outcomes were evaluated by multivariate logistic regression. Results: Out of 533 patients, 510 (82%) had early stage (0-3) resectable BC. Among these, 48% (246/510) had either MRM (209/510) or BM (37/510). MRM was performed in 3% of stage 0 (6/209), 23% (49/209) stage I, 46%(97/209) of stage II and 27% (57/209) of Stage III patients. Overall, the rate of SLND was 42% among Early stage Breast cancer. Of 41 patients treated with bilateral mastectomy, 10 were positive for BRCA mutation, 6 for family history and 3 for contralateral disease. Median age of BM was 53 +12 y. The local recurrence rate was 8.8% (45/510), and metastatic recurrence rate was 15.5% (79/510). Lymphedema rate was 9.2% (47/510). Using MRM as reference, the Odds Ratio (OR) for lymphedema after BM and BCT were 2.15 (95% CI, 0.84-5.50) and 0.58 (0.28-1.22), respectively. With 9.6 years of median follow up, the predictive probabilities of lymphedema after BCT, SM, MRM and BM were 1%, 4%, 9% and 18%. The OR for local recurrence in women with BCT were 1.46 (95th C/I: 0.72-2.95), SM 0.27 (0.03-2.13), BM 2.06 (95th C/I:0.70-6.06). Conclusions: Less BCT and more aggressive procedures are being performed, and the latter is associated with more lymphedema. No significant differences were noted in local recurrences. Presence of a genetic mutation was not the sole indicator of BM’s in our patient population. There is a need for evidence-based shared decision-making and surgical management of breast cancer, especially in a rural community setting.

Clinical significance following breast conservation surgery with or without postoperative irradiation in Japanese women with breast cancer.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e11530-e11530
Author(s):  
Kentaro Tamaki ◽  
Nobumitsu Tamaki ◽  
Yoshihiko Kamada ◽  
Kanou Uehara ◽  
Minoru Miyashita ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Local Recurrence ◽  
Cancer Patients ◽  
Triple Negative ◽  
Breast Conservation ◽  
Surgical Margin ◽  
Breast Conservation Surgery ◽  
Breast Cancer Patients ◽  
Conservation Surgery ◽  
Postoperative Irradiation

e11530 Background: Postoperative irradiation or radiotherapy following breast conservation surgery has been reported to be clinically effective in terms of prevention of local breast cancer recurrences. However, it is also true that its local recurrence rate was only 5% to 10%, suggestive of the lack of its clinical benefits in the great majority of the cases. The purpose of this study was to investigate the significance of post-operative radiotherapy in breast conservation surgery by comparing the groups with or without irradiation. Methods: We retrospectively evaluated 1197 Japanese female breast cancer patients (598 irradiation cases and 599 non-irradiation cases). Radiation was administered in a dose of 50 Gy for all conserved breast and additional 10 Gy in those with positive margins or carcinoma within 5mm from surgical margin. We examined the local recurrence rates in those with or without post-operative irradiation according to the status of surgical margin, ER and HER2 in breast cancer tissues. Results: RFS in the irradiated groups were significantly higher than non-irradiated ones in surgical margin positive (P=0.001, HR: 0.334, 95%CI: 0.14-0.79), negative (P=0.015, 0.362, 95%CI: 0.15-0.82), ER positive (P<0.001, HR: 0.249, 95%CI: 0.11-0.54), HER2 negative (P=0.002, HR: 0.316, 95%CI: 0.15-0.65) and non-triple negative patients (P=0.001, HR: 0.382, 95%CI: 0.21-0.69). However, no significant differences were detected between these two groups in ER negative (P=0.288, HR: 0.586, 95%CI: 0.22-1.57), HER2 positive (P=0.969, HR: 0.971, 95%CI: 0.22-4.24) and triple negative (P=0.336, HR: 0.282, 95%CI: 0.02-3.72) patients. Conclusions: Results of our present study could provide clinically inert information as to the selection of the breast cancer patients following conserve surgery.

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