Cardiac Surgery is Safe in Female Patients with a History of Breast Cancer

Background: Assessment of predictors and prognostic factors of locoregional recurrent breast cancer will help in management of those patients. The aim of this study was to assess and identify the predictors and prognostic factors for locoregional current breast cancer.Methods: This prospective study will be carried out on 50 female patients with history of breast cancer underwent surgical procedures either modified radical mastectomy (MRM) or conservative breast surgery (CBS) and adjuvant therapy (chemotherapy, radiotherapy, hormonal therapy).Results: Significant relationship between recurrence of breast cancer and Oral contraceptive pills of the studied female patients with history of breast cancer underwent surgery.Conclusions: Number of positive lymph nodes, lympho-vascular invasion, positive safety margin and presence of extensive intra-ductal component all these factors increase risk of recurrent breast cancer.

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Breast cancer patients have lower in-hospital mortality after acute coronary syndrome, a 5 year nationwide analysis

European Heart Journal ◽

10.1093/ehjci/ehaa946.1743 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

C Huang Lucas ◽

B Yue ◽

X Wei ◽

L Wu ◽

R Abed ◽

...

Keyword(s):

Breast Cancer ◽

Acute Coronary Syndrome ◽

Hospital Mortality ◽

Cancer Patients ◽

Breast Cancer Patients ◽

Female Population ◽

Female Patients ◽

Coronary Syndrome ◽

History Of ◽

St Elevation

Abstract Background Breast cancer and cardiovascular disease (CVD) share common risk factors, and breast cancer therapies are well known to cause cardiotoxicity. Prior studies highlighted the higher burden coronary artery disease and the importance to further assess its consequences on breast cancer patients. Purpose We sought to evaluate the revascularization rate and in-hospital short-term outcomes of breast cancer patients following acute coronary syndrome (ACS) compared to the general female population. Methods We reviewed the Nationwide Inpatient Sample from 2010 to 2014 to identify female patients with principal diagnosis of ACS (ST-elevation and non ST-elevation myocardial infarction, and unstable angina). Two subgroups were identified, women with a history of breast cancer and women without, and were propensity matched. Multivariate regression analyses were performed to evaluate the impact of breast cancer on primary outcome (in-hospital mortality) and secondary outcomes: occurrence of shock, acute kidney injury (AKI), mechanical ventilation (MV), and length of stay (LOS). We also compared the rate of cardiac procedures. Statistical significance of odd ratios (OR) is defined with p-value<0.05 and reported 95% confidence intervals (CI). Results We identified a total of 245,563 female patients with primary diagnosis of ACS, among them 10,625 (4.3%) had a history of breast cancer. The comorbidity of breast cancer was associated with statistically significant lower rates of mortality (OR 0.83, CI 0.74–0.94), shock (OR 0.87, CI 0.77–0.99), AKI (OR 0.90, CI 0.82–0.98), MV (OR 0.81, CI 0.71–0.92) and relative 5.4% decrease in LOS (CI: −7.8%, −3.0%). The cardiac procedural rates were similar for left heart catheterization (OR 0.96, CI 0.90–1.02), for percutaneous coronary intervention (OR 0.95, CI 0.89–1.02) and for CABG (OR 0.88, CI 0.78–1.00) compared to control group. Conclusion Breast cancer patients received a comparable catheterization and revascularization procedure rate and exhibited a statistically significant lower morbidity and mortality rates during hospitalization after an ACS event compared to the general female population. Funding Acknowledgement Type of funding source: None

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Covid-19 infection in patients with a history of everolimus use.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.e18744 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. e18744-e18744

Author(s):

Metin Pehlivan ◽

Adnan Aydiner

Keyword(s):

Breast Cancer ◽

Neuroendocrine Tumor ◽

Mtor Inhibitor ◽

Thymic Carcinoma ◽

Additional Risk ◽

Female Patients ◽

The Past ◽

The World ◽

History Of ◽

Male Patients

e18744 Background: The COVID-19 infection, declared as a pandemic by WHO in March 2020, continues its effects all over the world. Cancer patients also get COVID infection and in some patients this infection is mortal. In our study, we examined the course of COVID-19 infection in patients who actively or in the past used Everolimus. Methods: Patients who used everolimus actively or in the past were examined in our study. Patients who survive after the first cases seen in Turkey March 11, 2020 ; were evaluated in terms of whether they had COVID-19. Demographic characteristics and primary malignancies of the patients were examined. Patients who had COVID-19 infection and died were identified. Results: Our study consists of 50 patients in total. 14 (28%) of the patients were male and 36 (72%) were female. The average age of the patients is 56.72 (28-82), the average age of the male patients is 52.8 (28-80) and the average age of the female patients is 57.58 (36-82). 17 of the patients were treated for breast cancer, 11 for neuroendocrine tumor, 7 for tuberous sclerosis, 5 for renal cell carcinoma, 4 for thymic carcinoma, 2 for thymoma, 2 for ovarian ca, 2 for perivascular ecrine tumor. While it is the most common breast cancer in women (47.2% of female patients), neuroendocrine tumor is the most common in male patients (35.7% of male patients). While 13 patients were actively using everolimus (26%), 37 patients (74%) had discontinued everolimus treatment for 1 year or more.5 of our patients were diagnosed with COVID-19 infection (10% of all patients). 2 of these five patients are actively using everolimus. Of those diagnosed with COVID-19, 3 are women and 2 are men.The average age of the patients is 50.08 (43-66). While 3 patients had mild illness (60%), 2 patients (40%) died. One of the deceased patients is female and one is male. The female patient had a history of using everolimus for breast cancer, while the male patient died at the age of 52 while actively using everolimus for thymoma. Conclusions: Everolimus is a MTOR inhibitor used in many malignancy treatments. In our study, we found that 10% of our patients had COVID infection and 2 of our patients died due to COVID-19. In the group that discontinued everolimus treatment for a year or more, 1 patient died due to COVID-19, and 1 patient in the group still receiving everolimus treatment. Studies with larger patient populations are needed to determine whether everolimus carries an additional risk of COVID-19 infection.

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Treatment Options and Follow-Up among Iraqi Patients with Breast Carcinoma

European Journal of Medical and Health Sciences ◽

10.24018/ejmed.2020.2.2.171 ◽

2020 ◽

Vol 2 (2) ◽

Author(s):

Nada Alwan ◽

Mena M. Shawkat

Keyword(s):

Breast Cancer ◽

Breast Carcinoma ◽

Early Detection ◽

Treatment Options ◽

Radical Mastectomy ◽

Histological Type ◽

Female Patients ◽

Pathological Characteristics ◽

History Of

Breast cancer ranks the first among the Iraqi population and the leading cause of cancer related female mortality. In addition to the barriers that impede early detection of that cancer other major challenges include the capacity for effective multimodality treatment. Aim: To review and follow up a sample of Iraqi female patients diagnosed with breast cancer in a main referral center; recording their clinico-pathological characteristics, the offered treatment options and the rate of recurrence. Material and Methods: This retrospective study analyzed the clinical and pathological characteristics of 230 Iraqi female patients histologically diagnosed with breast carcinoma who had reliable valid data related to their demographic, clinical and tumor pathological status. The studied parameters included the age of the patient, marital status, parity, age at first delivery, occupation, history of lactation and hormonal intake, family history of breast and any other cancer, histological type, tumor grade and clinical stage. Hormone receptors (Estrogen and Progesterone) and HER2 over expression contents of the primary tumors were evaluated immunohistochemically. The offered treatment options included surgery, chemotherapy, radiotherapy, hormonal and biological targeted therapy. The rate of recurrence was evaluated after a follow-up period of three years. Results: Only 3.5% of the patients were under the age of 30 years while 39.1% were aged 50 years and over. About 84% were married, 11.3% were nulliparous, 24.9% had their first delivery before the age of 20 years and 56.9% were housewives. History of lactation was reported in 60.4%, whereas history of breast cancer was registered in 17.4%. The most common histological type of breast carcinoma was the infiltrative ductal (86.5%), well differentiated carcinomas were diagnosed in only 5.2%. The rates of positive ER, PR and HER2 tumor contents were 68.3%, 65.7% and 29.6% respectively. Overall 8.3%, 4.3%, 39.6% and 7.8% of the patients were diagnosed at stages I, II, III and IV respectively. Surgery was the primary treatment modality prescribed to the vast majority (96.1%) of the patients; 88.2% of those underwent modified radical mastectomy and only 3.6% had breast conservative surgery. Whereas 91.7% received chemotherapy, radiotherapy, hormonal and biological therapy were applied on 65.7%, 63.5% and 27.4% respectively. Recurrence of breast carcinoma three years following treatment was displayed among 9.7%; displaying significant direct association with the clinical stages of the disease (p<.05). Conclusions: Breast cancer is still diagnosed at relatively advanced stages at the time of first presentation in Iraq; requesting radical mastectomy. Early detection represents the principal approach to control breast cancer in the near future. Regular long-term follow up through multidisciplinary tumor boards is mandatory to monitor response to therapy and recurrence.

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Female patients with soft tissue sarcoma are at a higher risk for developing breast cancer

Journal of Clinical Oncology ◽

10.1200/jco.2007.25.18_suppl.10071 ◽

2007 ◽

Vol 25 (18_suppl) ◽

pp. 10071-10071

Author(s):

I. Jiveliouk ◽

R. Geva ◽

M. Inbar ◽

O. Merimsky

Keyword(s):

Breast Cancer ◽

Family History ◽

General Population ◽

Median Survival ◽

Second Primary ◽

Female Patients ◽

History Of ◽

Therapeutic Radiation ◽

Breast Cancer Family History

10071 Background: An increased incidence of MPM has been reported in association with STS. In a series of 1350 adults with STS almost 10% were diagnosed with additional primaries. The incidence of breast cancer (BC) in the general population is 97/105,(Israel-Cancer-Registry) and the incidence of STS is 1.5/105 (Enzinger&Weiss). It is expected that approx. 1.5/105 × 97/105 of the general population will have both BC and STS. Methods: A retrospective search of the database of approx. 1,350 adult STS patients, who were referred, diagnosed, or treated at our center between 1995- 2005. Results: A group of 132 patients (F=62) with STS had at least one additional malignancy. Twenty-five (25/62=40%) had BC, before or after STS. A family history of malignancy was reported by 8/25 patients (32%), 3 with a specific breast cancer family history. STS types varied. Sixteen (16/25) patients had breast cancer as their first primary, 9 as their second or third. Of 17 patients with first primary BC, the sarcoma appeared in the RT field in 2, and in 1 it appeared in a lymphedematous ipsilateral arm. Of eight patients with first primary sarcoma, only one got chemotherapy prior to the diagnosis of BC. Median interval between 1st to 2nd malignancy was 6.9 years (0.7–31y) when the BC was diagnosed first, and 3.8y (0–47y) when the BC was the second. Exposure to carcinogens, or therapeutic radiation and cytotoxics, given for the 1st tumor prior to the 2nd tumor, was recorded in 58%. The incidence of BC among all patients (females + males) with STS-first (in our database) followed by a second malignancy is 8/58 (14%), or 7/23 (30%) female patients with STS-first, or 25/890 (3%) of all female patients with STS in the registry of STS. The incidence of STS among the BC patients is rather low, and most of the cases in this series are not therapy related (14/17). The median survival of patients with BC-first was 312 months, versus 383 months for STS-first (p=NS). Among patients with BC-first, the median survival of patients with RT related sarcoma was 265 months, versus 312 months for RT unrelated STS (p= 0.6). Conclusions: Second primary BC in patients with STS-first is higher than the expected incidence of BC for this population. Screening for BC should be incorporated into the regular follow-up of patients with STS. No significant financial relationships to disclose.

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Vascular inflammation and cardiovascular burden in metastatic breast cancer female patients receiving hormonal treatment and CDK 4/6 inhibitors or everolimus

European Heart Journal ◽

10.1093/ehjci/ehaa946.3270 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

C Papageorgiou ◽

F Zagouri ◽

M Dimopoulos ◽

E Manios ◽

P Kafouris ◽

...

Keyword(s):

Breast Cancer ◽

Blood Pressure ◽

Metastatic Breast Cancer ◽

Interaction Effect ◽

Vascular Inflammation ◽

Metastatic Breast ◽

Hormonal Treatment ◽

Night Time ◽

Female Patients ◽

History Of

Abstract Background Chemotherapy regimens for breast cancer treatment can promote vascular dysfunction and lead to high cardiovascular risk. Purpose The aim of this study was to investigate the cardiovascular burden and vascular inflammation in metastatic breast cancer patients receiving either CDK 4/6 inhibitors and hormonal treatment or standard everolimus and hormonal treatment. Methods 22 consecutive female patients with metastatic breast cancer that expressed estrogen and /or progesteron receptor and were HER2-negative were enrolled. Patients with active infection, chronic autoimmune disease and history of chemotherapy for the metastatic disease and/or adjuvant chemotherapy during the past 3 years were excluded. All subjects received hormonal treatment and of those, 10 received everolimus and 12 received therapy with CDK 4/6 inhibitors. The two groups were matched for age, history of hypertension, diabetes, dyslipidemia, smoking and all were free of major cardiovascular events for the past 6 months. Regional wall thickness (RWT) and left ventricle mass (LVM) measurements by transthoracic echocardiographic study were obtained followed by 24 hour ambulatory blood pressure monitoring, and 18F-fluorodeoxyglucose positron-emission tomography/computed tomography imaging. Radiotracer uptake in the aortic wall (ascending, arch, descending, abdominal), was quantified as tissue-to-background ratio (TBR).Each patient was assessed for the aforementioned parameters before the initiation and after 6 months of treatment. Results At follow up, patients assigned to CDK4/6 treatment demonstrated increased measurements of 24 hour systolic blood pressure (SBP) (p=0.004), daytime SBP(p=0.004) and night time SBP (p=0.012) (Group effect). The 24 hour mean arterial pressure measurements were also higher in CDK 4/6 population, in comparison to everolimus that displayed firm values. (Group effect- p=0.035, Interaction effect-p=0.023).Additionally, 24 hour diastolic blood pressure recordings in CDK 4/6 therapy were higher opposed to everolimus that remained consistent (Interaction effect- p=0.010). In CDK 4/6 group, TBR aorta measurements also increased significantly, whereas TBR values in everolimus remained stable. (Interaction effect-p=0.049). Both therapeutic regimens displayed statistically significant damaging effect with regards to the following variables: Night-time SBP (p=0.032), RWT (p<0.001), and LVM (p<0.001). Conclusion Chemotherapy with novel CDK 4/6 inhibitors and hormonal treatment can lead to increased vascular inflammation, and higher blood pressure values compared to the combination of everolimus and hormonal treatment in female patients with HR-positive HER2-negative metastatic breast cancer. Moreover, both treatment strategies promote remodelling of the left ventricle by means of increased RWT and mass. Further research and longitudinal studies in this field are required to validate the above findings. Funding Acknowledgement Type of funding source: None

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The Association between Soy Food and Breast Cancer; a Multicenter Cross-Sectional Study at Taif City, Saudi Arabia

International Journal of Innovative Research in Medical Science ◽

10.23958/ijirms/vol06-i12/1279 ◽

2021 ◽

Vol 6 (12) ◽

pp. 854-861

Author(s):

Alnefaie S., M.D ◽

Alqashqari K. ◽

Almalki A. ◽

Baabbad A. ◽

Alrabie A. ◽

...

Keyword(s):

Breast Cancer ◽

Saudi Arabia ◽

Food Intake ◽

Cross Sectional Study ◽

Chemical Components ◽

Sectional Study ◽

Cross Sectional ◽

Female Patients ◽

Common Causes ◽

History Of

Background: Breast cancer (BC) has a high incidence rate among females (3 to 8 per 1000) and is one of the most common causes of cancer-related death. Diet is considered one of the risk factors in BC. Phytoestrogens are chemical components similar to estrogen in structure. An isoflavone is a major group of phytoestrogens, and it is found in food like soy products. Aim: Our study investigates the association between soy food intake, BC development and mammogram density among women in Taif City, Saudi Arabia. Methods: A descriptive cross-sectional study was conducted in three hospitals in Taif City, Saudi Arabia. The data was gathered using a questionnaire created by the authors. Phone interviews were conducted with female patients who visited breast/general surgery clinics from January to July 2020. Results: A total of 194 patients participated in this study. We observed that only two female patients (1.03%) had a history of high soya intake, and both developed BC (p = 0.011). One-third (33.5%) showed scattered areas of fibro-glandular densities in a mammogram. Conclusion: We found that a large amount of soy food intake was significantly associated with a higher risk of BC. There is no relationship between mammogram density and age based on soya intake. More prospective studies with larger sample sizes in different cities of Saudi Arabia are needed to confirm this association.

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