Redox chemistry of nickel(II) complexes supported by a series of noninnocent β-diketiminate ligands

Nickel complexes of a series of β-diketiminate ligands ((R)L(-), deprotonated form of 2-substituted N-[3-(phenylamino)allylidene]aniline derivatives (R)LH, R = Me, H, Br, CN, and NO2) have been synthesized and structurally characterized. One-electron oxidation of the neutral complexes [Ni(II)((R)L(-))2] by AgSbF6 or [Ru(III)(bpy)3](PF6)3 (bpy = 2,2'-bipyridine) gave the corresponding metastable cationic complexes, which exhibit an EPR spectrum due to a doublet species (S = 1/2) and a characteristic absorption band in near IR region ascribable to a ligand-to-ligand intervalence charge-transfer (LLIVCT) transition. DFT calculations have indicated that the divalent oxidation state of nickel ion (Ni(II)) is retained, whereas one of the β-diketiminate ligands is oxidized to give formally a mixed-valence complex, [Ni(II)((R)L(-))((R)L(•))](+). Thus, the doublet spin state of the oxidized cationic complex can be explained by taking account of the antiferromagnetic interaction between the high-spin nickel(II) ion (S = 1) and the organic radical (S = 1/2) of supporting ligand. A single-crystal structure of one of the cationic complexes (R = H) has been successfully determined to show that both ligands in the cationic complex are structurally equivalent. On the basis of theoretical analysis of the LLIVCT band and DFT calculations as well as the crystal structure, the mixed-valence complexes have been assigned to Robin-Day class III species, where the radical spin is equally delocalized between the two ligands to give the cationic complex, which is best described as [Ni(II)((R)L(0.5•-))2](+). One-electron reduction of the neutral complexes with decamethylcobaltocene gave the anionic complexes when the ligand has the electron-withdrawing substituent (R = CN, NO2, Br). The generated anionic complexes exhibited EPR spectra due to a doublet species (S = 1/2) but showed no LLIVCT band in the near-IR region. Thus, the reduced complexes are best described as the d(9) nickel(I) complexes supported by two anionic β-diketiminate ligands, [Ni(I)((R)L(-))2](-). This conclusion was also supported by DFT calculations. Substituent effects on the electronic structures of the three oxidation states (neutral, cationic, and anionic) of the complexes are systematically evaluated on the basis of DFT calculations.

Abstract P3-02-06: Survival impact of early detection of recurrence after surgery in early breast cancer patients

Background and Object: Annual mammography and physical examination as the follow-up tests after surgery were recommended to early breast cancer patients based on the two randomized clinical trials (GIVIO and Rosselli Del Turco) which were reported in 1990s. Whereas, radiological imaging and blood test (serum tumor marker) for early detection of recurrence are not recommended due to the lack of evidence from clinical trial. However, the imaging techniques (helical CT, bone scan, PET/CT. MRI et al) to detect minute lesions and therapeutic options for metastatic breast cancer have been remarkably advanced since then. In fact, routine radiological examinations after surgery were performed in several Japanese hospitals for aiming early detection of recurrence as the clinical practice.

We here evaluate the possible benefit of early detection of recurrence by radiological and laboratory examinations during post-operative follow-up period.

Methods: Clinical information of breast cancer patients who were diagnosed as recurrence after surgery during 2005–2006 was collected from 30 hospitals in Japan. Clinical and pathological characteristics such as molecular subtype of breast cancer, survival time from initial therapy or 1st recurrence, detection methods and symptomatic information when they diagnosed as metastasis were analyzed retrospectively.

Results: As the routine examination of post-operative follow-up, serum tumor maker, chest x-ray/CT, abdominal US/CT and bone scan were done in 95%, 57%, 38%, 24% of 30 hospitals, respectively. Of the 698 patients individually evaluated in this analysis, 248 had loco-regional recurrences and 450 had distant metastases. The first distant metastatic site were 35% in bone, 30% in lung, 17% in liver and 11% in lymph node, respectively. All individual patients are divided into symptomatic (45.7%) or asymptomatic groups (54.3%) at the detection of metastases. Asymptomatic metastases were detected by serum tumor marker (26%), bone scan (18%), chest x-ray (17%), chest CT (17%), abdominal US (11%) and abdominal CT (5%), respectively. The median disease-free interval (DFI) was 3.0 years in both groups, but the median survival time after the diagnosis of recurrence to death were 3.7 years in asymptomatic patients and 3.0 years in symptomatic patients, respectively. In addition, asymptomatic group had significantly superior overall survival (from primary surgery to death) than symptomatic group with oligo-metastases such as limited organ disease (P < 0.001).

Conclusions: Our data may support the hypothesis that early detection of breast cancer recurrences has beneficial impact on survival. Randomized clinical trial would be warranted to prove this hypothesis, and we are currently planning this.

Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P3-02-06.

P2-12-21: Impact of Recent Parity on Histopathological Tumor Features and Outcome of Young Women with Breast Cancer

Background

Younger age has been associated with worse outcome in breast cancer patients (pts) and recent parity has been epidemiologically identified as worse prognostic factor among women with breast cancer. The objective of this study was to explore potential factors associated with worse prognosis in young breast cancer pts, and to demonstrate the impact of parity on the histopathological tumor feature and patient outcome.

Materials and Methods: We retrospectively analyzed 634 early breast cancer pts younger than 45 years old who underwent surgery between 2000 and 2009. For statistical analysis, Pearson's and Fisher's exact test were used. Survival analysis was performed only for pts diagnosed before 2006 in order to obtain a minimum follow up 5 years.

Results: 108 women were diagnosed within 5 years since last parity (Group A), 216 were diagnosed > 5 years since last parity (Group B) and 310 were nulliparous (Group C). Median age at diagnosis was 37 (range 26–44), 41 (range 32–44), and 38.5 (range 22–44) and family history (FH) of breast and/or ***ovarian cancer within second degree was found in 23, 22, and 23% of the pts in Groups A, B, and C, respectively. In Groups A, B and C, clinical stage was III in 22, 10 and 12% (p= .025), ER was positive in 65, 69 and 70% (p= .650), PgR was positive in 64, 75 and 74% (p= .057), and HER2 was positive in 25, 14 and 14% (p=.017), respectively. Tumors in Group A had higher histological grade (grade 3: 60/44/47%, p=.019), higher nuclear grade (grade 3: 61/47/48%, p=.036) and more lymph vessel invasion (61/52/45%, p=.015) compared to those in Groups B and C, respectively. Median follow up time was 85.1 months (range 1.8−137.1 months) during which there were 61 deaths. In univariate analysis, age and FH were not correlated with overall survival (OS). OS in Group A was significantly lower than in Group B (hazard ratio (HR) 3.51, 95% confidential interval (CI) 1.80−6.84, p<.001) and in Group C (HR 2.42, 95%CI 1.36−4.29, p=.002), while OS did not differ significantly between Groups B and C. In the pts without FH, the HR of cancer death was more pronounced in Group A than in Group B (HR 4.25, 95%CI 1.97−9.14, p<.001) or Group C (HR 2.67, 95%CI 1.43−5.01, p=.002), while there was no significant difference among the groups in pts with FH. In multivariate analysis among the pts without FH, lymph vessel invasion (HR 4.51, 95%CI 1.89−10.76, p=.001), Group A women (HR 2.28, 95%CI 1.25−4.17, p=.007), histological grade 3 (HR 2.72, 95%CI 1.28−5.77, p=.009), PgR negativity (HR 2.23, 95%CI 1.19−4.18, p=.013) and clinical stage II and III (HR 2.92, 95%CI 1.04−8.21, p=.04) were significantly associated with poor prognosis, adjusting for age.

Conclusion: Recent parity was associated with worse histopathological features in breast cancer of women younger than 45. It was also associated with worse outcome, especially among pts without FH. Recent parity seems to be a confounding factor for the worse outcome in young breast cancer patients, which justifies further studies to elucidate underlying biology.

Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P2-12-21.

Risk of breast cancer among Japanese women with a positive family history

191

Background: Most breast cancer cases are sporadic, rather than associated with inherited gene mutations, such as BRCA1 and BRCA2. However, women with a family history of breast cancer are at increased risk of developing breast cancer compared to those women without any family history, even if they lack these gene mutations.

Methods: We analyzed 10892 patients including bilateral breast cancer cases (total of 11398 breast cancers) who underwent surgery at our hospital between 1962 and 2009. We excluded 295 cases whose family history data were not available. Clinical and pathological differences between following patient groups were tested; 9528 patients or 9955 cancers (88%) with negative family history (FH-), 896 patients or 951 cancers (8%) who had at least one first-degree relative with breast cancer (1FH+), 468 patients or 492 cancers (4%) who had second-degree relative with breast cancer (2FH+), and 1364 patients or 1443 cancers (12%) with family history regardless of first- or second-degree relative (FH+). Significance was established at a p-value of < 0.05.

Results: Among the family members, sisters were more likely to have treated for breast cancer (38% in FH+ group), followed by mothers (27%), aunts (26%), grandmothers (7%), and daughters (2%). The incidence of developing contralateral breast cancer was significantly higher in 1FH+ group, compared to patients in FH- and 2FH+ groups. No other factors showed any significant difference, including the incidence of cancer in other organs, pathological characteristics, and age of onset, although BRCA1 and BRCA2 mutation may be associated with increased risk of developing breast cancer at younger age. Outcome studies with available data did not show any significant difference in overall survival between FH+ and FH- patients.

Conclusions: A Japanese woman with a positive family history has a higher risk of developing breast cancer than women without any close relatives with breast cancer, similar to the results reported in Western countries where prevalence of breast cancer is higher. Regular checkup of contralateral breast is important for those patients whose first-degree relatives have also been diagnosed with breast cancer.

Study of sentinel lymph node biopsy after preoperative chemotherapy in patients with breast cancer

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Background: Despite the increasing use of both sentinel lymph node biopsy (SLNB) and preoperative chemotherapy (PST) in patients with operable breast cancer, there is still limited information on the feasibility and accuracy of SLNB following PST. In this study, the feasibility and accuracy of SLNB for breast cancer patients with clinically negative lymph nodes after PST were investigated. In addition, conditions that may affect SLN biopsy detection and false-negative rates with respect to clinical tumor response and clinical tumor/nodal status before PST were analyzed.

Methods: Between 2003 and 2008, 200 patients with stage II and III breast cancer previously treated with PST were enrolled in this study. The eligible criteria for PST were (a) primary tumor > 3cm or (b) positive axillary lymph node status on initial examination. FNA biopsy was performed for clinically or ultrasonographically suspicious axillary lymph nodes. The patients then underwent SLNB, which involved a combination of intradermal injection over the tumor of radiocolloid and subareolar injection of blue dye. This was followed by Level I/II axillary lymph node dissection (ALND).

Results: The median patient age was 49 years, and the median primary tumor size was 4.9 cm. The overall SLN identification rate was 94.5% (189 of 200). In 178/189 patients (94%) the SLN accurately predicted the axillary status. Eleven patients had a false-negative SLN biopsies, yielding a false-negative rate of 12.9%. There were no significant differences in the SLN identification rate according to tumor classifications before PST, the clinical nodal status before PST, the clinical tumor response after PST, or pathological response of the tumor after PST, although the SLN identification rate tended to be lower in patients with a T4 primary tumor.

Conclusions: Our data and some reports suggested that SLNB was feasible method for axillary staging in breast cancer patients who received PST even in patients who initially with lymph node positive disease. However, false-negative rate of SLNB in patients with clinical and pathological complete tumor response tended to be higher than other group.

Locoregional recurrence risk factor and indications for postmastectomy radiotherapy in Japanese patients with tumors 5 cm or larger

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Background: Locoregional recurrence (LRR) after mastectomy reduces the patient’s quality of life and survival. There is a consensus that postmastectomy radiotherapy (PMRT) helps achieve locoregional control and reduces LRR. However, in patients with large tumors, the question of which variables affect the likelihood of LRR and the role of PMRT has been the subject of substantial controversy. This study investigated what are risk factors for LRR and the efficacy of PMRT in this Japanese patient population.

Methods: This study examined 589 cases of invasive breast carcinoma with tumors 5 cm or larger from 1998 to 2008. We divided the study population into 3 groups: patients with negative nodes, 1-3 positive nodes, and ≥4 positive nodes. The relationship between various clinicopathological variables and LRR was examined and the relationship between LRR and PMRT was estimated.

Results: During the median follow-up was 44.2 months, 38 (6.5%) patients experienced LRR. In the multivariate analysis, independent predictors of LRR include pectoral invasion in patients with 1-3 positive nodes, and severity lymphatic invasion, estrogen receptor-negative status, and nodal ratio of positive/excised nodes ≥ 0.50 in patients with ≥4 positive nodes. In patients without positive nodes, none of the examined variables were significantly associated with LRR. PMRT did not improve the outcome of the patients at highest risk who had these variables.

Conclusions: The efficacy of PMRT in patients with large tumors was not shown. In the context of systemic therapy and adequate lymph node dissection, PMRT by itself had a limited role in providing locoregional control. Due to the very low incidence of LRR observed, PMRT was not necessary for patients with large tumors without lymph node metastasis. The indication for PMRT in patients with metastatic nodes remains controversial.

Modified primary tumour/vessel tumour/nodal tumour classification for patients with invasive ductal carcinoma of the breast

Background:

We previously reported that the primary tumour/vessel tumour/nodal tumour (PVN) classification is significantly superior to the UICC pTNM classification and the Nottingham Prognostic Index for accurately predicting the outcome of patients with invasive ductal carcinoma of the breast in a manner that is independent of the nodal status and the hormone receptor status.

Methods:

The purpose of the present study was to compare the outcome predictive power of a modified PVN classification to that of the newly devised pathological UICC pTNM classification and the reclassified Nottingham Prognostic Index in a different group of patients with invasive ductal carcinoma (n=1042) using multivariate analyses by the Cox proportional hazard regression model.

Results:

The modified PVN classification clearly exhibited a superior significant power, compared with the other classifications, for the accurate prediction of tumour recurrence and tumour-related death among patients with invasive ductal carcinoma in a manner that was independent of the nodal status, the hormone receptor status, and adjuvant therapy status.

Conclusion:

The modified PVN classification is a useful classification system for predicting the outcome of invasive ductal carcinoma of the breast.

Abstract P1-12-07: Neo-Adjuvant Exemestane in Post Menopausal Estrogen and/or Progesterone Receptor Positive Breast Cancer: A Randomized Phase II Trial To Investigate Optimal Duration (4 Month Versus 6 Month) of Preoperative Endocrine Therapy (PTEX46 Trial)

Background: Since the 1990s, primary endocrine therapy has been considered the gold standard in the adjuvant and metastatic treatment settings for estrogen and/or progesterone receptor (ER and/or PgR) positive breast cancer. This therapy has also been shown to be effective as neo-adjuvant endocrine therapy in these indications. In recent years, the focus of clinical interest has shifted to the third-generation aromatase inhibitors from tamoxifen. The optimal treatment duration time and causal relationship between neo-adjuvant endocrine therapy and survival, however, are not clear. We therefore conducted the present study to investigate the potential benefits of neo-adjuvant exemestane (E) therapy with the goal of identifying the optimal treatment duration (4 months versus 6 months).

Methods: Conducted at three hospitals in Japan, this study was a multicenter, randomized phase II trial of pre-operative E treatment in postmenopausal women with untreated primary breast cancer. Fifty postmenopausal women with ER positive and/or PgR positive invasive breast cancer were randomly assigned to E (25 mg/day) for 4 months (4 mo) or E (25 mg/day) for 6 months (6 mo). All patient data were collected by UMIN and were analyzed by the National Cancer Center in Japan. Tumor regression (by clinical examination, ultrasound, and MRI), pathological response, shift towards breast-conserving surgery, and safety assessments were the main outcome measures.

Results: Of the 50 patients that enrolled, 28 patients had undergone surgery. The mean ages in the 4 mo and 6 mo treatment groups were 66.7 years and 66.8 years, respectively. No significant differences in the patient characteristics were found in the two groups. The response rates (partial or complete responses) by clinical examination in the 4 mo and 6 mo groups were 37.5% and 50%, respectively. Pathological responses (minimal response or better) were found in 13.3% and 41.7% of patients and a partial mastectomy was performed in 50.0% and 58.3% of patients after 4 mo and 6 mo, respectively.

Conclusion: To date, the results of this study demonstrate that treatment with E for 6 mo was more efficacious than treatment with E for 4 mo. Further work is in progress to obtain data from additional patients and to identify the optimal duration of neo-adjuvant E.

Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P1-12-07.

FcγR2A and 3A polymorphisms predict clinical outcome of trastuzumab in both neoadjuvant and metastatic settings in patients with HER2-positive breast cancer

BACKGROUND

Antibody-dependent-mediated cytotoxicity (ADCC) is one of the modes of action for trastuzumab. Recent data have suggested that fragment C γ receptor (FcγR) polymorphisms have an effect on ADCC. This prospective phase II trial aimed to evaluate whether these polymorphisms are associated with clinical efficacies in patients who received trastuzumab.

PATIENTS AND METHODS

Patients in a neoadjuvant (N) setting received Adriamycin and cyclophosphamide followed by weekly paclitaxel/trastuzumab. Patients in a metastatic (M) setting received single trastuzumab until progression. In total, 384 distinct single nucleotide polymorphisms of different FcγR, HER2, and fucosyltransferase loci were assessed.

RESULTS

Fifteen operable and 35 metastatic HER2-positive breast cancer patients were enrolled in each of the N and M settings, respectively. The FcγR2A-131 H/H genotype was significantly correlated with the pathologically documented response (pathological response) (P = 0.015) and the objective response (P = 0.043). The FcγR3A-158 V/V genotype was not correlated with the pathological response, but exhibited a tendency to be correlated with the objective response. Patients with the FcγR2A-131 H/H genotype had significantly longer progression-free survival in the M setting (P = 0.034).

CONCLUSION

The FcγR2A-131 H/H polymorphism predicted the pathological response to trastuzumab-based neoadjuvant chemotherapy in early-stage breast cancer, and the objective response to trastuzumab in metastatic breast cancer.

Expression of Tn and sialyl Tn antigens in synovial tissues in rheumatoid arthritis

OBJECTIVES

The carbohydrate chains represented by mucins (MUCs) are expressed by a variety of normal and malignant secretory epithelial cells and induce a variety of immunoreactions. Tn and sialyl Tn antigens are tumour-associated carbohydrate antigens which are borne on the core proteins of mucins. The purpose of this study is to investigate the existence of tumour-associated carbohydrate antigens in rheumatoid arthritis (RA).

METHODS

. We examined the expression of Tn and sialyl Tn antigens in synovial tissues from RA and osteoarthritis (OA) patients by immunohistochemistry. In addition, mucins from synovial fluid (SF) from RA patients are purified by gel filtration and density gradient ultracentrifugation and the existence of these antigens examined by dot and Western blotting.

RESULTS

We found that Tn and sialyl Tn antigens were strongly expressed in synovial cells and infiltrating mononuclear cells on the sublining layer and lymphoid follicles in synovial tissues in RA compared with those in osteoarthritis. Tn and sialyl Tn antigens were detected in purified mucins of SF from RA patients.

CONCLUSIONS

Tumour-like synovial hyperplasia cells expressed Tn and sialyl Tn antigens. This finding suggests that the mucins exhibiting with abnormal glycosylation may be in part responsible for synovial hyperplasia, leading to the joint destruction in the pathogenesis of RA.

Utility of Intraoperative Frozen-Section Examinations of Surgical Margins: With Special Reference to the Implication of Features of Margin-Exposed Tumor Components on Further Surgical Treatment

Purpose: The assessment of surgical margins is important in breast conserving surgery (BCS). In BCS, we usually resect additional specimens after the diagnosis of positive margin by intraoperative frozen-section examinations (IFE). However, we often experience the patients who received additional resections after positive results by IFE but no tumors were detected in the permanent sections. If we can predict the absence of residual tumor components from IFE, it may be possible to avoid additional mastectomy. In the present study, we tried to identify histological characteristics of margin-exposed tumor components on IFE as predictive factors for the residual tumor components in the additionally resected specimens. Methods: 1,835 cases underwent BCS between October 1999 and July 2008 at the National Cancer Center Hospital, Tokyo, Japan. By the review of the pathological database, we chose patients who had positive surgical margins determined by IFE and had undergone immediate additional resection. Two observers (MK, HT) reviewed the slides of frozen sections and confirmed the presence of tumor components. Results: 220 cases (12%) were eligible for this study. Within the specimens of additional resection, residual tumors existed in 114 cases (51.8%) and no tumors existed in 106 cases (48.2%). As characteristics of the primary tumors, invasive lobular carcinoma, pT3, EIC(+) and lymphatic invasion were significantly associated with the residual tumor components. As characteristics of margin-exposed tumor components on IFE, the number of positive margins, their maximum diameter and histological type were correlated with the residual tumors. The rate of detection of the residual tumors was significantly higher in the group with multiple positive margins (50/72, 69%) than in the group with a single positive margin (64/148, 43%) (p=0.0003). The residual tumors were detected in 36.5% (38/104), 60.8% (62/102), and 100% (14/14) of the groups with &lt;6 mm, ≥6 to &lt;20 mm, and ≥20 mm of the maximum diameter of the exposed tumor components, respectively (p=0.0005). Although there was no significant relationship in the rate between the group with exposed noninvasive components and that with exposed invasive components, the residual tumor components were detected more frequently in the group with exposed lobular carcinoma components (20/29, 69%) than in the group with exposed ductal carcinoma components (94/191, 49%) (p=0.047). By a multivariate analysis, the number of positive margins and the maximum diameter were independent risk factors of the residual tumors. Conclusion: The diagnosis of positive margins by IFE was useful for the prediction of residual tumors, and three histological properties of margin-exposed tumor components were correlated with the absence of residual tumor components. It may be possible to consider stratification of additional surgical therapy according to the characteristics of margin-exposed tumor components on IFE.

Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 4118.

A phase II trial of image-guided radiofrequency ablation of small breast carcinomas: Results of a multicenter study in Japan

e11535

Background: Locally ablative therapy of early breast cancer represents the next frontier in the evolution of minimally invasive breast conservative therapy. We performed this Phase II trial to determine the efficacy and safety of Radiofrequency (RF) ablation of small localized invasive breast carcinomas as a multicenter study in Japan. Methods: Thirty-nine patients with core-biopsy proven invasive breast cancer, T<2 cm in diameter on ultrasound and MRI were enrolled in this trial. Under ultrasound guidance, the tumor and at least a 5mm margin of surrounding breast tissue were ablated with saline- cooled RF electrode followed by surgical resection. Pathologic and immunohistochemical stains were preformed to assess tumor viability. Results: Thirty-seven patients completed the treatment. The mean tumor size on ultrasound was 1.50 cm. The mean ablation time was 12 minutes using mean power of 80.0 watts. During ablation, the tumor became progressively echogenic that correspond with the region of sever electrocautery injury at pathologic examination. Of the 37 treated patients, H&E and NADPH viability staining was available for 27 patients and in 25 (92.5%), there was no evidence of viable cancer cells. H&E and or ssDNA staining were available for another 10 patients. In total, complete thermal injury to the target lesions was recognized in 33 of 37 treated patients (89.2%). No sever adverse effect on the skin and chest wall were noted. Conclusions: RF ablation is a promising minimally invasive treatment of small breast carcinomas, as it can achieve effective cell killing with a low complication rate. We are planning a multicenter observation study for RF ablation of small breast carcinomas.

No significant financial relationships to disclose.

A clinico-pathological analysis of breast cancer patients with a family history

Abstract #6090

Background: It has been said that the high incidence of breast cancer within family lines could be investigated efficiently from genetic and environmental aspects. There could be a strong enough relationship between various carcinogenic factors and these family members. In this study, we examined the clinical and pathological characteristics of breast cancer among patients with a family history.&#x2028; Patients and Methods: We put the definition of 'Positive for a family history (FH+)' for patients who had one or more members within three generations apart from the proband. Patients with family history of breast cancer were selected out of 10506 patients who were treated in our hospital between 1962 and 2007.&#x2028; Results: There were 1272 cases in FH+ and 9234 cases in 'Negative for a family history (FH-)' group. Distribution within the family line showed the highest percentage for sisters at 37%, aunts at 25% and a mother at 25%. The family history positive breast cancer patients were around 5% in 1960-1970 although the number increased up to 18% in 2007. There was similar increasing pattern in Europe and America. The survival rate had no significant difference between FH+ and FH- statistically, but the trend was toward a better prognosis in FH+ cases. There was no relationship between family history and body mass index (BMI). The outbreak of contralateral breast cancer of FH+ was significantly higher than FH-. FH+ patients had significantly higher prevalence of a mastopathy compare to FH- patients. As for the history of other cancer species, the FH+ breast cancer patients within first generation apart from the proband had significantly higher chances compared to FH- patients.Conclusion: The breast cancer patients with family history require more detail examinations especially for the development of contralateral breast cancer. Also carcinomatous examinations are important other than breast cancer to those patients who are in the first generation apart from the proband.

Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 6090.

The response to neoadjuvant chemotherapy and prognosis of triple-negative breast cancer patients

Abstract #5121

Purpose: It is said that triple negative breast cancer (TNBC) has poor prognosis. However, many study shows TNBC has better response to chemotherapy. Since neoadjuvant chemotherapy plays an important role to TNBC, we compared clinical and pathological response rate and prognosis between TNBC and non-TNBC.&#x2028; Patients and methods: This analysis retrospectively collected 2563 breast cancer patients for StageI-III who underwent surgery between January 2000 and September 2004 (median: 3.9 years) at National Cancer Center, Tokyo, Japan. We defined TNBC as Estorpgen and progesterone receptor negative and HER2 score 0-2+ by immnohistological report. There were 91 TNBC patients (23.1%) out of 400 patients (15.6%) who underwent neoadjuvant chemotherapy. Clinical and pathological response rate and Four-year progression free survival were compared between TNBC and non-TNBC.&#x2028; Results: There were 91 TNBC patients (23.1%). TNBC patients compared with non-TNBC had tendency to achieve cCR (91% vs 78%; p=.058) although TNBC had higher rate for cPD (6.6% vs 1.7%; p &lt;.0001). Also TNBC tended to have higher pathological CR rate of which we classified pCR only for grade 3 cases, compared to non-TNBC (13.1% vs 7.2%; p= .042 ). Interestingly HER2 overexpression type also had higher rate for pCR. As for pPD rate, TNBC had similar rate compared to non-TNBC (5.5% v 4.3%). Four-year progression free- survival rate was higher for non-TNBC. However, TNBC had higher Four-year survival free rate only when pCR were achieved after neoadjuvant chemotherapy (99% vs 82%; p=.02).&#x2028; Conclusion: Patients with TNBC tend to have clinical and pathological response of either CR or PD. Although non-TNBC had better prognosis by four-year survival free rate, TNBC could have better prognosis if neoadjuvant chemotherapy resulted in pCR. There may be some way to predict the efficacy of neoadjuvant chemotherapy and prognosis by analyzing the shrink pattern.

Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 5121.