scholarly journals Adjuvant chemotherapy may improve survival of patients with luminal A breast cancer and positive lymph nodes

2015 ◽  
Vol 14 (3) ◽  
pp. 8563-8573 ◽  
Author(s):  
Y. Han ◽  
Q. Li ◽  
B.H. Xu ◽  
P. Zhang ◽  
P. Yuan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Lymph Nodes ◽  
Luminal A ◽  
Positive Lymph Nodes

scholarly journals Breast Cancer Care in South India: Is Practice Concordant With National Guidelines?

2019 ◽  
pp. 1-7 ◽  
Author(s):  
D.K. Vijaykumar ◽  
Sujana Arun ◽  
Aswin G. Abraham ◽  
Wilma Hopman ◽  
Andrew G. Robinson ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Adjuvant Chemotherapy ◽  
Lymph Nodes ◽  
Cancer Care ◽  
Adjuvant Radiotherapy ◽  
South India ◽  
Breast Cancer Care ◽  
Adjuvant Trastuzumab ◽  
Positive Lymph Nodes

PURPOSE The National Cancer Grid (NCG) of India has recently published clinical practice guidelines that are relevant in the Indian context. We evaluated the extent to which breast cancer care at a teaching hospital in South India was concordant with NCG guidelines. METHODS All patients who had surgery for breast cancer at a single center from January 2014 to December 2015 were included. Demographic, pathologic, and treatment characteristics were extracted from the electronic medical record. Patients were classified as being concordant with six elements selected from the NCG guideline. The indicators related to appropriate use of sentinel lymph node (SLN) biopsy, lymph node harvest, adjuvant radiotherapy, adjuvant chemotherapy, human epidermal growth factor receptor 2 (HER2) testing, and delivery of adjuvant trastuzumab. RESULTS A total of 401 women underwent surgery for breast cancer; mean age (standard deviation) was 57 (12) years. Lymph node involvement was present in 47% (188 of 401) of the cohort; 23% (94 of 401) had T1 disease. Ninety-two percent (368 of 401) underwent radical modified mastectomy. SLN biopsy was performed in 75% (167 of 222) of eligible patients. Eighty percent (208 of 261) of patients with a positive SLN biopsy or no SLN biopsy had a lymph node harvest of more than 10. Adjuvant chemotherapy with an anthracycline and a taxane was delivered to 67% of patients (118 of 177) with node-positive disease. Adjuvant radiotherapy was delivered to 84% (180 of 213) of patients with breast-conserving surgery, T4 tumors, or 3+ positive lymph nodes. Fluorescent in situ hybridization testing was performed in 59% of patients (43 of 73) with 2+ HER2-positive lymph nodes on immunohistochemistry. Among patients with HER2 overexpression, 40% (36 of 91) received adjuvant trastuzumab. CONCLUSION Concordance with NCG guidelines for breast cancer care ranged from 40% to 84%. Guideline concordance was lowest for those elements of care associated with the highest direct costs to patients.

Intermittent adjuvant chemotherapy as an alternative to improve survival in breast cancer patients with ten or more positive lymph nodes

2005 ◽  
Vol 23 (16_suppl) ◽  
pp. 906-906
Author(s):  
F. U. Lara medina ◽  
T. Ramirez-Ugalde ◽  
D. Flores-Estrada ◽  
A. Alvarado-Miranda ◽  
N. Castaneda soto ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Lymph Nodes ◽  
Cancer Patients ◽  
Breast Cancer Patients ◽  
Positive Lymph Nodes

Assessing the impact of CMF/FEC/FEC-DOC/ETC (dose-dense) adjuvant chemotherapy in dependency of positive axillary lymph nodes on survival: A retrospective multicenter cohort study of 4,526 breast cancer patients receiving adjuvant chemotherapy.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 1074-1074
Author(s):  
Lukas Schwentner ◽  
Reyn Van Ewijk ◽  
Isabell Hoffmann ◽  
Rolf Kreienberg ◽  
Maria Blettner ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cohort Study ◽  
Adjuvant Chemotherapy ◽  
Lymph Nodes ◽  
Significant Benefit ◽  
Axillary Lymph ◽  
Dose Dense ◽  
The Impact ◽  
Positive Lymph Nodes ◽  
Positive Breast Cancer

1074 Background: Adjuvant chemotherapy has changed dramatically in the last decades. Anthracycline-/taxane-based and dose-dense chemotherapy regimens improved survival in node positive breast cancer. This study tries to answer the following questions: (1) Are there differences in survival dependent on chemotherapy regimens in 0/0-3/4-10/<10 positive lymph nodes? (2) Is it possible to define a cut-off of positive lymph nodes for the use of Taxane-based and dose dense chemotherapy? Methods: This German is a multi-center [17 participating hospitals all are certified as breast cancer centers] retrospective cohort study. We included CMF (1.385), FEC (1.170), FEC-DOC (1.723), and dose-dense ETC (248) into the analysis. Results: In case of 0 LN CMF/FEC/FEC-DOC did not show significant differences in DFS, but OAS was significantly impaired by the use of FEC-DOC in 0 LN [p=0.024; HR=2.02 (95% CI: 1.10-3.73)] (no ETC use in 0 LN). In case of 1-3 positive LN CMF/FEC/FEC-DOC/ETC did not differ significantly in survival parameters. But in 4-10 LN FEC-DOC [p=0.049; HR=0.67 (95% CI: 0.44-0.99)] and ETC [p=0.024; HR=0.56 (95% CI: 0.34-0.93)] demonstrated a significant benefit in DFS and a strong trend in OAS. Dose-dense ETC showed a significant improvement in DFS [p=0.003; HR=0.35 (95% CI: 0.17-0.69)] and OAS [p=0.009; HR=0.35 (95% CI: 0.16-0.77)] in patients with >10 positive LN. Conclusions: Our data confirms that Taxane-based chemotherapy does not improve DFS in LN negative breast cancer, but rather demonstrated an inferior OAS. But in LN positive breast cancer we can demonstrate a benefit by the use of Taxane-based chemotherapy regimens. Furthermore, dose-dense ETC demonstrated a significant benefit in survival in >10 positive LN.

69 Intensified adjuvant chemotherapy for patients with breast cancer and > 10 positive lymph nodes. A phase II study

1995 ◽  
Vol 31 ◽  
pp. S16
Author(s):  
G. Fountzilas ◽  
D. Skarlos ◽  
A. Athanassiadis ◽  
C. Nikolaides ◽  
T. Giannakakis ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Lymph Nodes ◽  
Phase Ii ◽  
Phase Ii Study ◽  
Positive Lymph Nodes

Significant Changes in Circulating Plasma Levels of IGF1 and IGFBP3 after Conventional or Dose-Intensified Adjuvant Treatment of Breast Cancer Patients with one to three Positive Lymph Nodes

2007 ◽  
Vol 22 (3) ◽  
pp. 186-193 ◽  
Author(s):  
S. Kümmel ◽  
H. Eggemann ◽  
D. Lüftner ◽  
N. Gebauer ◽  
H. Bühler ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Growth Factor ◽  
Adjuvant Chemotherapy ◽  
Lymph Nodes ◽  
Cancer Patients ◽  
Plasma Levels ◽  
Binding Protein ◽  
Insulin Like Growth Factor ◽  
Breast Cancer Patients ◽  
Positive Lymph Nodes

The insulin-like growth factor 1 (IGF1) and its binding protein IGFBP3 (insulin-like growth factor binding protein 3) play a pivotal role during the growth and development of tissues. The purpose of this study was to evaluate the influence of anthracycline- and taxane-containing adjuvant chemotherapy in breast cancer patients on the circulating plasma levels of IGF1 and its main binding protein, IGFBP3. This investigation was part of a prospective randomized phase III study in which breast cancer patients were treated with either conventional or dose-intensified adjuvant chemotherapy. The factors were quantified in the plasma of 151 patients with a commercially available sandwich enzyme immunoassay. Before therapy, both parameters were within the normal range in most patients (n=145 and n=144). After therapy, both factors had increased significantly by 29% (IGF1) and 19% (IGFBP3), with the highest increase being observed in the dose-intensified group. Correlations with patient and tumor characteristics revealed a relatively higher increase in both parameters in premenopausal patients, patients with lower-grade tumors, more positive lymph nodes, larger tumor volume, and positive hormone receptor status. No correlation was found with the HER2 expression of the tumors.

Should palpable DCIS be treated as IDC? A retrospective audit.

2011 ◽  
Vol 29 (27_suppl) ◽  
pp. 146-146
Author(s):  
N. S. Nair ◽  
N. Pandey ◽  
V. Vanmali ◽  
T. Shet ◽  
R. Hawaldar ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Lymph Nodes ◽  
Treatment Guidelines ◽  
Ductal Carcinoma ◽  
Screening Mammography ◽  
Retrospective Audit ◽  
Breast Lumps ◽  
Clinical Dilemma ◽  
Positive Lymph Nodes

146 Background: Ductal carcinoma in situ (DCIS) identified by screening mammography accounts for 20% of breast cancer diagnoses, and microinvasion (DCIS-M) is found in 5%-10%. There are no defined treatment guidelines for palpable DCIS or DCIS-M. In the developing world wherein screening mammography is controversial due to a predominantly premenopausal population, most women with DCIS present with a palpable lump in the breast. The objective of this study was to evaluate whether disease in these patients with palpable DCIS have been treated differently from screen detected DCIS. Methods: Annually we register 3,000 new cases of breast cancer of which DCIS constitute a small fraction. Over a period of 12 years (1998-2010) we registered 71 cases of DCIS for treatment. A retrospective analysis of these was performed. Results: Of the 71 patients reviewed, 35 (49.2%) had foci of microinvasion. The median age of presentation was 49 years and mean tumor size was 2.3 cm; all presented with palpable breast lumps. Of the 36 women with DCIS alone Tsize was > 2 cm in 26 (72.2%), 14 (38.9%) had presence of comedo necrosis and 1 (2.7%) had positive lymph nodes on histopathology. Adjuvant chemotherapy was given to 4 (11.11%). Of the 35 women with DCIS-M Tsize was > 2 cm in 23 (66%), 10 (29%) had comedo necrosis (compared to 38.9% in pure DCIS p=0.45), 3 (8.5%) had positive lymph nodes, and 17 (48.6%) received chemotherapy. We compared this data to that of women treated for invasive ductal carcinoma with pTsize <2cm, at a median follow-up of 60 months, DFS for the women with DCIS was 82% (95% CI 0. 67- 0.98), for DCIS-M was 78% (95% CI 0. 59 -0.98), and that for IDC < 2cm was 83% (95% CI 0.70-0.95). Conclusions: DCIS presenting in these palpable lesions poses a clinical dilemma for the use of adjuvant therapy. Over 49.2% of the palpable DCIS showed evidence of microinvasion. We thus need to consider the role of adjuvant chemotherapy when treating women with palpable DCIS.

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