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Sefidbakht S, Beizavi Z, Kanaani Nejad F, Pishdad P, Sadighi N, Ghoddusi Johari M, Bijan B, Tahmasebi S. Association of imaging and pathological findings of breast cancer in very young women: Report of a twenty-year retrospective study. Clin Imaging 2024; 110:110094. [PMID: 38599926 DOI: 10.1016/j.clinimag.2024.110094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 01/14/2024] [Accepted: 01/20/2024] [Indexed: 04/12/2024]
Abstract
PURPOSE In this study, we aimed to assess the new trends in characteristics, molecular subtypes, and imaging findings of breast cancer in very young women. METHODS We retrospectively reviewed the database of a primary breast cancer referral center in southern Iran in 342 cases of 30-year-old or younger women from 2001 to 2020. Pathologic data, including nuclear subtype and grade, tumor stage, presence of in situ cancer, imaging data including lesion type in mammogram and ultrasound, and treatment data were recorded. Descriptive statistics were applied. Differences between categorical values between groups were compared using Pearson's Chi-square test. RESULTS The mean age was 27.89 years. The tumor type was invasive ductal carcinoma in 82 % of cases. Fourteen patients (4.4 %) had only in situ cancer, and 170 patients had in situ components (49.7 %). Molecular subtypes were available in 278 patients, including 117 (42.1 %) Luminal A, 64 (23.0 %) Luminal B, 58 (20.9 %) triple negative, and 39 (14 %) HER2 Enriched. In those with mammograms available, 63 (30.1 %) had no findings, 53 (25.3 %) had mass, 27 (12.9 %) had asymmetry, whether focal or global, 21 (10 %) had microcalcifications solely, and 45 (21.5 %) had more than one finding. Microcalcifications were significantly more common in Luminal cancers than HER2 and triple-negative cancers (p = 0.041). CONCLUSION Our study shows the most common subtype to be Luminal A cancer, with 74 % of the tumors being larger than 2 cm at the time of diagnosis. Irregular masses with non-circumscribed margins were the most common imaging findings.
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Affiliation(s)
- Sepideh Sefidbakht
- Medical Imaging Research Center, Department of Radiology, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Zahra Beizavi
- Department of Radiology, Mayo Clinic, Phoenix, AZ, USA
| | - Fatemeh Kanaani Nejad
- Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Parisa Pishdad
- Medical Imaging Research Center, Department of Radiology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nahid Sadighi
- Radiology Department, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Bijan Bijan
- Sutter Imaging (SMG) - Sacramento, Professor of Nuclear Medicine & Radiology (W.O.S.), University of California Davis Medical Center, Sacramento, CA, USA
| | - Sedigheh Tahmasebi
- Breast Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; Surgical Oncology Division, General Surgery Department, Shiraz University of Medical Sciences, Shiraz, Iran
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Takehara Y, Matsuda N, Kobayashi D, Yoshida A, Takei J, Kanomata N, Tsunoda H, Yamauchi H, Hayashi N. Radiation-induced angiosarcoma of the breast: individual participant meta-analysis of Japanese population. Breast Cancer 2023; 30:739-747. [PMID: 37261705 DOI: 10.1007/s12282-023-01466-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 04/29/2023] [Indexed: 06/02/2023]
Abstract
BACKGROUND Radiation-induced angiosarcoma (RIAS) of the breast is a very rare and poor prognostic disease. According to previous studies, the efficacy of chemotherapy for RIAS is still controversial. However, no study has assessed the prognosis of RIAS and the prognostic impact of preoperative or postoperative chemotherapy in Japanese patients. Our study aimed to assess them in Japanese people using publication data with our three patients. METHODS Thirty-nine patients diagnosed with RIAS, including 36 patients from 34 published case series, and three patients from our hospital were used for analysis. Disease-free survival (DFS), distant disease-free survival (DDFS), and overall survival (OS) were assessed. RESULTS Among the 39 patients, 36 patients (92.3%) underwent surgery. The median DFS and OS periods were 14 months (range 1-75 months) and 23 months (range 4-84 months), respectively. Chemotherapy with taxane-based regimen was administered in 13 cases (33.2%) pre- or post-operatively. DFS was significantly improved with chemotherapy in addition to surgery (p = 0.037). However, addition of chemotherapy to surgery did not improve DDFS (p = 0.09) and OS (p = 0.878). In multivariate analysis, age ≥ 70 years was an independent but poor prognostic factor of DFS. Additionally, a lack of chemotherapy showed a trend to be associated with worse DFS. There was no independent variable contributing to DDFS and OS. CONCLUSIONS Chemotherapy may have reduced the recurrence rate of RIAS in Japanese patients but did not improve OS. Further data are needed to confirm the efficacy and proper regimen of chemotherapy.
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Affiliation(s)
- Yuri Takehara
- Department of Breast Surgical Oncology, St. Luke's International Hospital, Tokyo, Japan
| | - Naoko Matsuda
- Department of Breast Surgical Oncology, St. Luke's International Hospital, Tokyo, Japan
| | - Daiki Kobayashi
- Graduate School of Public Health, St. Luke's International University, Tokyo, Japan
| | - Atsushi Yoshida
- Department of Breast Surgical Oncology, St. Luke's International Hospital, Tokyo, Japan
| | - Junko Takei
- Department of Breast Surgical Oncology, St. Luke's International Hospital, Tokyo, Japan
| | - Naoki Kanomata
- Department of Pathology, St. Luke's International Hospital, Tokyo, Japan
| | - Hiroko Tsunoda
- Department of Radiology, St. Luke's International Hospital, Tokyo, Japan
| | - Hideko Yamauchi
- Department of Breast Surgical Oncology, St. Luke's International Hospital, Tokyo, Japan
| | - Naoki Hayashi
- Department of Breast Surgical Oncology, St. Luke's International Hospital, Tokyo, Japan.
- Division of Breast Surgical Oncology, Department of Surgery, Showa University School of Medicine, Tokyo, Japan.
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Lee PJ, Jhuang JR, Chen YC, Su SY, Chiang CJ, Yang YW, Hsieh PC, Chen MJ, Lee WC. Urban-Rural Disparity in Birth Cohort Effects on Breast Cancer Incidence. J Urban Health 2023; 100:341-354. [PMID: 36781812 PMCID: PMC10160333 DOI: 10.1007/s11524-023-00718-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/18/2023] [Indexed: 02/15/2023]
Abstract
Breast cancer is the most commonly diagnosed cancer among women worldwide. Studies have reported minimal birth cohort effects on the incidence rates of breast cancer in Western countries but have reported notable birth cohort effects in some Asian countries. The risks of breast cancer may also vary within a country. In the present study, we abstracted female invasive breast cancer data from the Taiwan Cancer Registry for the period 1997-2016. We used the age-period-cohort model to compare birth cohort effects on breast cancer incidence rates between urban and rural regions in Taiwan. We identified a notable urban-rural disparity in birth cohort effects on breast cancer incidence rates in women in Taiwan. The incidence rates in the urban regions were higher than those in the rural regions across all cohorts. However, the incidence rates rose faster in the rural regions than in the urban regions across the cohorts. The risks of breast cancer observed for women born in 1992 were approximately 22 and 11 times than those observed for women born in 1917 in rural and urban regions, respectively. The observed gap in breast cancer incidence rates between the urban and rural regions gradually disappeared across the cohorts. Accordingly, we speculate that urbanization and westernization in Taiwan may be the drivers of female breast cancer incidence rates across birth cohorts.
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Affiliation(s)
- Peng-Jhen Lee
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Xuzhou Rd, Rm. 536, No. 17, Taipei, 100, Taiwan
| | - Jing-Rong Jhuang
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Xuzhou Rd, Rm. 536, No. 17, Taipei, 100, Taiwan
- Taiwan Cancer Registry, Taipei, Taiwan
| | - Yi-Chu Chen
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Xuzhou Rd, Rm. 536, No. 17, Taipei, 100, Taiwan
| | - Shih-Yung Su
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Xuzhou Rd, Rm. 536, No. 17, Taipei, 100, Taiwan
- Master Program in Statistics, National Taiwan University, Taipei, Taiwan
| | - Chun-Ju Chiang
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Xuzhou Rd, Rm. 536, No. 17, Taipei, 100, Taiwan
- Taiwan Cancer Registry, Taipei, Taiwan
| | - Ya-Wen Yang
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Xuzhou Rd, Rm. 536, No. 17, Taipei, 100, Taiwan
- Taiwan Cancer Registry, Taipei, Taiwan
| | - Pei-Chun Hsieh
- Health Promotion Administration, Ministry of Health and Welfare, Taipei, Taiwan
| | - Mei-Ju Chen
- Health Promotion Administration, Ministry of Health and Welfare, Taipei, Taiwan
| | - Wen-Chung Lee
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Xuzhou Rd, Rm. 536, No. 17, Taipei, 100, Taiwan.
- Taiwan Cancer Registry, Taipei, Taiwan.
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Lin CH, Zahid M, Kuo WH, Hu FC, Wang MY, Chen IC, Beseler CL, Mondal B, Lu YS, Rogan EG, Cheng AL. Estrogen-DNA Adducts and Breast Cancer Risk in Premenopausal Asian Women. Cancer Prev Res (Phila) 2023; 16:153-161. [PMID: 36517463 DOI: 10.1158/1940-6207.capr-22-0415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 11/23/2022] [Accepted: 12/12/2022] [Indexed: 12/16/2022]
Abstract
The incidence of breast cancer among premenopausal women has been increasing rapidly in recent decades in East Asia. This case-control study investigated whether estrogen-DNA adducts were associated with breast cancer risk in Taiwan. The control group (n = 146) comprised healthy female volunteers and women with non-proliferative breast disease. The case group (n = 221) comprised women either with proliferative benign breast disease or breast cancer. The ratios of estrogen-DNA adducts to their respective metabolites and conjugates in plasma were analyzed using ultraperformance LC/MS-MS. The SNPs of CYP1A1, CYP1B1, and COMT were genotyped. Logistic regression model was used to compare the estrogen-DNA adduct ratios between the two groups. The estrogen-DNA adduct ratio in the case group was significantly higher than that in the control group (median ratio: 58.52 vs. 29.36, P = 0.004). A multiple logistic regression model demonstrated that a unit increase in the natural log of the estrogen-DNA adduct ratio in premenopausal women was a significant predictor of breast cancer risk, with an estimated hazard ratio of 1.718 (1.444-2.046, P < 0.001). However, the CYP1A1, CYP1B1, and COMT SNPs were not associated with the estrogen-DNA adduct ratios. In conclusion, plasma estrogen-DNA adduct ratio was associated with the presence of breast cancer or proliferating benign breast disease in premenopausal women in Taiwan. PREVENTION RELEVANCE This study provides evidence that endogenous estrogen-induced genotoxicity may contribute to the carcinogenesis of breast cancer in premenopausal Asian women. This work could have important preventive implication for the emerging disease in East Asia.
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Affiliation(s)
- Ching-Hung Lin
- Department of Medical Oncology, National Taiwan University Hospital, Cancer Center Branch, Taipei, Taiwan
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Muhammad Zahid
- Department of Environmental, Agricultural and Occupational Health, University of Nebraska Medical Center, Omaha, Nebraska
| | - Wen-Hung Kuo
- Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - Fu-Chang Hu
- Graduate Institute of Clinical Medicine and School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
- Statistical Consulting Clinic, International-Harvard Statistical Consulting Company, Taipei, Taiwan
| | - Ming-Yang Wang
- Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - I-Chun Chen
- Department of Medical Oncology, National Taiwan University Hospital, Cancer Center Branch, Taipei, Taiwan
- Graduate Institute of Oncology, National Taiwan University, Taipei, Taiwan
| | - Cheryl L Beseler
- Department of Environmental, Agricultural and Occupational Health, University of Nebraska Medical Center, Omaha, Nebraska
| | | | - Yen-Shen Lu
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Eleanor G Rogan
- Department of Environmental, Agricultural and Occupational Health, University of Nebraska Medical Center, Omaha, Nebraska
| | - Ann-Lii Cheng
- Department of Medical Oncology, National Taiwan University Hospital, Cancer Center Branch, Taipei, Taiwan
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
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Chen YC, Lien WC, Su SY, Jhuang JR, Chiang CJ, Yang YW, Lee WC. Birth Cohort Effects in Breast Cancer Incidence: Global Patterns and Trends. Am J Epidemiol 2022; 191:1990-2001. [PMID: 35774004 DOI: 10.1093/aje/kwac116] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 04/18/2022] [Accepted: 06/28/2022] [Indexed: 02/01/2023] Open
Abstract
Breast cancer is the most common neoplasm in the world among women. The age-specific incidences and onset ages vary widely between Asian and Western countries/regions. Invasive breast cancer cases among women from 1997 to 2011 were abstracted from the International Agency for Research on Cancer and the Taiwan Cancer Registry. Age-period-cohort analysis was performed to examine the trends. The cohort effect was prominent in South Korea, Taiwan, Japan, and Thailand, possibly related to the timing of westernization. The risk of breast cancer initially rose with the birth cohorts in Hong Kong and India (both former British colonies), peaked, and then declined in recent birth cohorts. Unlike other Asian countries/regions, virtually no birth cohort effect was identified in the Philippines (a Spanish colony in 1565 and the first Asian country to adopt Western cultural aspects). Moreover, an at-most negligible birth cohort effect was identified for all ethnic groups (including Asian immigrants) in the United States. This global study identified birth cohort effects in most Asian countries/regions but virtually no impact in Western countries/regions. The timing of westernization was associated with the birth cohort effect.
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Breast Cancer Epidemiology and Survival Analysis of Shenyang in Northeast China: A Population-Based Study from 2008 to 2017. Breast J 2022; 2022:6168832. [PMID: 36320435 PMCID: PMC9596254 DOI: 10.1155/2022/6168832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 07/28/2022] [Accepted: 09/21/2022] [Indexed: 12/24/2022]
Abstract
Background To investigate the status of breast cancer incidence, trends, and survival in women in urban Shenyang from 2008–2017 using large Cancer Registry data. Methods Breast cancer incidence and mortality data were abstracted from the Shenyang Cancer Registry between 2008 and 2017. The crude and age-standardized incidence and mortality rates were calculated for each year. Average annual percentage changes (AAPC) were used to describe the change over time. Results A total of 14,255 out of 18,782,956 women were diagnosed with breast cancer between 2008 and 2017 in urban Shenyang. The overall crude and age-standardized incidences were 75.89 and 43.42 per 100,000, respectively. The crude incidence increased from 61.93 per 100,000 in 2008 to 90.07 per 100,000 in 2017, with an AAPC of 5.10%. The crude mortality increased from 11.41 per 100,000 in 2008 to 17.29 per 100,000 in 2017, with an AAPC of 4.60. The highest age-specific incidence occurs in the 55–59 year age group at a rate of 140.67 per 100,000. During the study period, 2,710 women died from breast cancer. The overall crude and age-standardized mortality rates were 14.43 and 7.43 per 100,000, respectively. The highest age-specific mortality occurs at 80–84 years old at a rate of 57.57 per 100,000. The 3-year and 5-year survival rates for female breast cancer in urban Shenyang from 2008 to 2013 were 85.61% and 77.39%, respectively, and both declined with age. Conclusion The incidence and mortality rates of breast cancer in Shenyang increased over time. Screening and control strategies should be enhanced, especially for perimenopausal females.
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Wang H, Tsai YH, Dong YH, Liu JJ. Young adult cancer incidence trends in Taiwan and the U.S. from 2002 to 2016. Cancer Epidemiol 2022; 78:102144. [PMID: 35334356 DOI: 10.1016/j.canep.2022.102144] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 02/17/2022] [Accepted: 03/11/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Previous studies have not examined young adult cancer incidence trends in Taiwan, or comprehensively compared these trends at two nations with different population genetics, environmental exposures, and health care. Therefore, we compared the incidence rates and trends of the most common young adult cancers diagnosed at 20-39 years of age in Taiwan and the U.S. METHODS Incidence rates from 2002 to 2016 were calculated from the Taiwan National Health Insurance Research Datasets and the U.S. Surveillance, Epidemiology, and End Results Program. For trend assessment, average annual percent change (AAPC) values were calculated from 15 years of data using Joinpoint Regression Program. We also obtained sex or age of diagnosis stratified estimates. RESULTS The age-standardized overall young adult cancer incidence rate significantly increased from 2002 to 2016 in both Taiwan (AAPC=1.1%, 95% CI: 0.8-1.5%) and the U.S. (AAPC=1.8%, 95% CI: 1.1-2.4%). Cancers with significantly decreasing trends in Taiwan included cancers of the nasopharynx, liver, and tongue, which were not among the most common young adult cancers in the U.S. Cancers with significantly increasing trends in both Taiwan and the U.S. included colorectal, thyroid, and female breast cancers. Lymphoma, ovarian cancer, and lung and bronchus cancer had significantly increasing trends in Taiwan but not in the U.S. Although cervical cancer had significantly decreasing trends in both nations among those 30-39 years of age, its trend was significantly increasing in Taiwan but decreasing in the U.S. among those 20-29 years of age. CONCLUSION The types of common young adult cancers as well as their incidence rates and trends differed in Taiwan and the U.S. Future studies should further understand the etiological factors driving these trends.
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Affiliation(s)
- Hsin Wang
- Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yu-Han Tsai
- Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yaa-Hui Dong
- Department of Pharmacy, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Jason J Liu
- Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan.
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Risk Factors for Female Breast Cancer: A Population Cohort Study. Cancers (Basel) 2022; 14:cancers14030788. [PMID: 35159055 PMCID: PMC8834157 DOI: 10.3390/cancers14030788] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 01/22/2022] [Accepted: 02/01/2022] [Indexed: 02/04/2023] Open
Abstract
Simple Summary In recent years, it has been emphasized that the development of a healthy lifestyle can prevent the incidence of cancer, and several recent studies on female breast cancer (BC) have also become interested in sedentary behavioral issues. Our prospective cohort study found that, in addition to the currently known risk factors (RFs) such as parity and body mass index (BMI), which affect the probability of developing BC in women, a sedentary lifestyle and drinking sugar-sweetened beverages (SSB) can cause BC. Therefore, we propose that the modifiable risk profiles of sedentary behavior and sugary beverage consumption may also be associated with increased incidence of female BC in the Taiwanese population. Abstract Background: The incidence of female BC among the Eastern and Southeastern Asian populations has gradually increased in recent years. However, epidemiological studies on the relationship between a sedentary lifestyle and female BC are insufficient. In order to determine the association between this lifestyle and the incidence of female BC, we conducted a population-based cohort study on women in Taiwan. Methods: We followed a prospective cohort of 5879 women aged 30 years and over enrolled in the 2001 National Health Interview Survey (NHIS), who developed female BC over a period of 72,453 person years, and we estimated the hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) using the Cox proportional hazards model. Results: RFs associated with female BC incidence included parity (adjusted HR = 0.63; 95% CI: 0.44–0.91), body mass index (adjusted HR = 1.34; 95% CI: 1.04–1.71), and ≥3 h/day spent sitting (adjusted HR = 1.89; 95% CI: 1.08–3.32). The incidence of female BC in participants who sat for ≥3 h/day and consumed sugary drinks was 2.5 times greater than that in those who sat for <3 h/day and did not consume sugary drinks (adjusted HR = 2.51; 95% CI: 1.01–6.23). Conclusions: The findings of this study indicate that sedentary behavior and sugary drink intake may increase the risk of developing female BC. These are modifiable RFs; therefore, a healthy lifestyle and diet can reduce the incidence of female BC.
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Sharma JD, Khanna S, Ramchandani S, Kakoti LM, Baruah A, Mamidala V. Prevalence of Molecular Subtypes of Breast Carcinoma and Its Comparison between Two Different Age Groups: A Retrospective Study from a Tertiary Care Center of Northeast India. South Asian J Cancer 2022; 10:220-224. [PMID: 34984199 PMCID: PMC8719960 DOI: 10.1055/s-0041-1731905] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
Objective The aim of the study is to see the prevalence of different molecular subtypes in breast cancer patients among two different age groups: ≤40 years and >40 years. Materials and Methods Retrospective study was conducted from January 2019 to December 2019. We studied 568 cases of breast carcinoma and classified them into four molecular subtypes-luminal A, luminal B, human epidermal growth factor-2 (HER 2), and triple negative. Cases were divided into two different groups: (1) ≤40 years and (2) >40 years. Statistical Analysis was done by using SPSS software version 20.0. Results Out of 568 cases, 151 (26.6%) were ≤40 years of age and 417 (73.4%) were >40 years of age. The most common histological subtype of breast cancer was ductal carcinoma in 548 cases and the most common grade was grade III. Immunohistochemistry was done in 432 patients. In younger age group, the most common molecular subtype was luminal B (31%) followed by triple negative (20%), luminal A (14%), and then HER 2 (5.3%), while in the older age group most common molecular subtype was luminal B (27.8%) followed by triple negative (14%), HER 2 (12.2%), and then luminal A (12%). Conclusion Luminal B is found to be the most common subtype in Northeast Indian women with breast cancer, as compared with other studies in which luminal A was the most common subtype. This could be due to the reason that K i -67 was not done in most of the other studies.
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Affiliation(s)
| | - Sachin Khanna
- Department of Surgical Oncology, BBCI, Guwahati, India
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Chen SH, Chung WP, Huang YC, Kuo YL, Lee KT, Hsu HP, Loh ZJ, Tsai JH, Yang SR, Lee CH. Real-world utilization of the 21-gene assay in taiwanese female patients with early-stage breast cancer: Experience from a single institute. JOURNAL OF CANCER RESEARCH AND PRACTICE 2022. [DOI: 10.4103/2311-3006.355306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Qian B, Yang J, Zhou J, Hu L, Zhang S, Ren M, Qu X. Individualized model for predicting pathological complete response to neoadjuvant chemotherapy in patients with breast cancer: A multicenter study. Front Endocrinol (Lausanne) 2022; 13:955250. [PMID: 36060977 PMCID: PMC9428399 DOI: 10.3389/fendo.2022.955250] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 07/26/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Pathological complete response (pCR) is considered a surrogate for favorable survival in breast cancer (BC) patients treated with neoadjuvant chemotherapy (NACT), which is the goal of NACT. This study aimed to develop and validate a nomogram for predicting the pCR probability of BC patients after NACT based on the clinicopathological features. METHODS A retrospective analysis of 527 BC patients treated with NACT between January 2018 and December 2021 from two institutions was conducted. Univariate and multivariate logistic regression analyses were performed to select the most useful predictors from the training cohort (n = 225), and then a nomogram model was developed. The performance of the nomogram was evaluated with respect to its discrimination, calibration, and clinical usefulness. Internal validation and external validation were performed in an independent validation cohort of 96 and 205 consecutive BC patients, respectively. RESULTS Among the 18 clinicopathological features, five variables were selected to develop the prediction model, including age, American Joint Committee on Cancer (AJCC) T stage, Ki67 index before NACT, human epidermal growth factor receptor 2 (HER2), and hormone receptor (HR) status. The model showed good discrimination with an area under the receiver operating characteristic curve (AUC) of 0.825 (95% CI, 0.772 to 0.878) in the training cohort, and 0.755 (95% CI, 0.658 to 0.851) and 0.79 (95% CI, 0.724 to 0.856) in the internal and external validation cohorts, respectively. The calibration curve presented good agreement between prediction by nomogram and actual observation, and decision curve analysis (DCA) indicated that the nomogram had good net benefits in clinical scenarios. CONCLUSION This study constructed a validated nomogram based on age, AJCC T stage, Ki67 index before NACT, HER2, and HR status, which could be non-invasively applied to personalize the prediction of pCR in BC patients treated with NACT.
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Affiliation(s)
- Bei Qian
- Department of Thyroid and Breast Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jing Yang
- Department of Breast Surgery, Department of General Surgery, First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Jun Zhou
- Department of Thyroid and Breast Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Longqing Hu
- Department of Thyroid and Breast Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shoupeng Zhang
- Department of Thyroid and Breast Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- *Correspondence: Xincai Qu, ; Min Ren, ; Shoupeng Zhang,
| | - Min Ren
- Department of Breast Surgery, Department of General Surgery, First Affiliated Hospital of Anhui Medical University, Hefei, China
- *Correspondence: Xincai Qu, ; Min Ren, ; Shoupeng Zhang,
| | - Xincai Qu
- Department of Thyroid and Breast Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- *Correspondence: Xincai Qu, ; Min Ren, ; Shoupeng Zhang,
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Lu YS, Yeo W, Yap YS, Park YH, Tamura K, Li H, Cheng R. An Overview of the Treatment Efficacy and Side Effect Profile of Pharmacological Therapies in Asian Patients with Breast Cancer. Target Oncol 2021; 16:701-741. [PMID: 34582007 PMCID: PMC8613101 DOI: 10.1007/s11523-021-00838-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2021] [Indexed: 11/05/2022]
Abstract
Breast cancer (BC) among Asians accounts for ~ 40% of the global BC burden. Differences in BC risk, presentation, tumor biology, and response to treatment exist between Asian and non-Asian patients; however, Asian patients are often under-represented in clinical trials. This narrative review summarizes the efficacy and safety of pharmacological therapies for BC in Asian populations, with a focus on outcomes in Asian versus non-Asian patients treated with chemotherapy, hormone therapy, anti-human epidermal growth factor receptor-2 targeted therapies, cyclin-dependent kinase 4/6 (CDK4/6) inhibitors, mammalian target of rapamycin inhibitors, bone-targeted therapies, poly-ADP ribose polymerase, phosphoinositide 3-kinase, and checkpoint inhibitors. While most therapies have demonstrated comparable efficacy and safety in Asian and non-Asian patients with BC, differences that are largely attributed to pharmacogenetic variations between populations exist. Pharmacogenetic differences may contribute to a reduced clinical benefit of tamoxifen, whereas improved clinical outcomes have been reported with tyrosine kinase inhibitors and CDK4/6 inhibitors in Asian versus non-Asian patients with BC. In particular, Asian patients have an increased incidence of hematological toxicities, including neutropenia, although adverse events can be effectively managed using dose adjustments. Recent trials with CDK4/6 inhibitors have increased efforts to include Asians within study subsets. Future clinical trials enrolling higher numbers of Asian patients, and an increased understanding of differences in patient and tumor genetics between Asians and non-Asians, have the potential to incrementally improve the management of BC in Asian patients.
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Affiliation(s)
- Yen-Shen Lu
- Department of Oncology, National Taiwan University Hospital, No. 7, Chung Shan South Road, Taipei, 100, Taiwan.
| | - Winnie Yeo
- Department of Clinical Oncology, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Yoon-Sim Yap
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Yeon Hee Park
- Sungkyunkwan University, SKKU-Samsung Medical Centre, Seoul, South Korea
| | - Kenji Tamura
- Department of Breast and Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Huiping Li
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Breast Oncology, Peking University Cancer Hospital and Institute, Beijing, China
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13
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Yang JJ, Chen CW, Fourman MS, Bongers MER, Karhade AV, Groot OQ, Lin WH, Yen HK, Huang PH, Yang SH, Schwab JH, Hu MH. International external validation of the SORG machine learning algorithms for predicting 90-day and one-year survival of patients with spine metastases using a Taiwanese cohort. Spine J 2021; 21:1670-1678. [PMID: 33545371 DOI: 10.1016/j.spinee.2021.01.027] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 01/26/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Accurately predicting the survival of patients with spinal metastases is important for guiding surgical intervention. The SORG machine-learning (ML) algorithm for the 90-day and one-year mortality of patients with metastatic cancer to the spine has been multiply validated, with a high degree of accuracy in both internal and external validation studies. However, prior external validations were conducted using patient groups located on the east coast of the United States, representing a generally homogeneous population. The aim of this study was to externally validate the SORG algorithms with a Taiwanese population. STUDY DESIGN/SETTING Retrospective study at a single tertiary care center in Taiwan PATIENT SAMPLE: Four hundred and twenty-seven patients who underwent surgery for metastatic spine disease from November 1, 2010 to December 31, 2018 OUTCOME MEASURES: 90-day and one-year mortality METHODS: The baseline characteristics of our validation cohort were compared with those of the previously published developmental and external validation cohorts. Discrimination (c-statistic and receiver operating curve), calibration (calibration plot, intercept, and slope), overall performance (Brier score), and decision curve analysis were used to assess the performance of the SORG ML algorithms in this cohort. RESULTS Ninety-day and one-year mortality rates were 110 of 427 (26%) and 256 of 427 (60%), respectively. The external validation cohort and the developmental cohort differed in body mass index (BMI), preoperative performance status, American Spinal Injury Association impairment scale, primary tumor histology and in several laboratory measurements. The SORG ML algorithm for 90-day and 1-year mortality demonstrated a high level of discriminative ability (c-statistics of 0.73 [95% confidence interval [CI], 0.67-0.78] and 0.74 [95% CI, 0.69-0.79]), overall performance, and had a positive net benefit throughout the range of threshold probabilities in decision curve analysis. The algorithm for 1-year mortality had a calibration intercept of 0.08, representing a good calibration. However, the 90-day mortality algorithm underestimated mortality for the lowest predicted probabilities, with an overall intercept of 0.81. CONCLUSIONS The SORG algorithms for predicting 90-day and 1-year mortality in patients with spinal metastatic disease generally performed well on international external validation in a predominately Taiwanese population. However, 90-day mortality was underestimated in this group. Whether this inconsistency was due to different primary tumor characteristics, body mass index, selection bias or other factors remains unclear, and may be better understood with further validative works that utilize international and/or diverse populations.
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Affiliation(s)
- Jiun-Jen Yang
- Department of Orthopedics, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan; School of Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Chih-Wei Chen
- Department of Orthopedics, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan
| | - Mitchell S Fourman
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA, USA
| | - Michiel E R Bongers
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA, USA
| | - Aditya V Karhade
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA, USA
| | - Olivier Q Groot
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA, USA
| | - Wei-Hsin Lin
- Department of Orthopedics, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan
| | - Hung-Kuan Yen
- School of Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Po-Hao Huang
- Department of Orthopedics, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan
| | - Shu-Hua Yang
- Department of Orthopedics, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan
| | - Joseph H Schwab
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA, USA
| | - Ming-Hsiao Hu
- Department of Orthopedics, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan.
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14
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Hou MF, Ou-Yang F, Li CL, Chen FM, Chuang CH, Kan JY, Wu CC, Shih SL, Shiau JP, Kao LC, Kao CN, Lee YC, Moi SH, Yeh YT, Cheng CJ, Chiang CP. Comprehensive profiles and diagnostic value of menopausal-specific gut microbiota in premenopausal breast cancer. Exp Mol Med 2021; 53:1636-1646. [PMID: 34707191 PMCID: PMC8569190 DOI: 10.1038/s12276-021-00686-9] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 09/01/2021] [Accepted: 09/08/2021] [Indexed: 12/19/2022] Open
Abstract
In Western countries, breast cancer tends to occur in older postmenopausal women. However, in Asian countries, the proportion of younger premenopausal breast cancer patients is increasing. Increasing evidence suggests that the gut microbiota plays a critical role in breast cancer. However, studies on the gut microbiota in the context of breast cancer have mainly focused on postmenopausal breast cancer. Little is known about the gut microbiota in the context of premenopausal breast cancer. This study aimed to comprehensively explore the gut microbial profiles, diagnostic value, and functional pathways in premenopausal breast cancer patients. Here, we analyzed 267 breast cancer patients with different menopausal statuses and age-matched female controls. The α-diversity was significantly reduced in premenopausal breast cancer patients, and the β-diversity differed significantly between breast cancer patients and controls. By performing multiple analyses and classification, 14 microbial markers were identified in the different menopausal statuses of breast cancer. Bacteroides fragilis was specifically found in young women of premenopausal statuses and Klebsiella pneumoniae in older women of postmenopausal statuses. In addition, menopausal-specific microbial markers could exhibit excellent discriminatory ability in distinguishing breast cancer patients from controls. Finally, the functional pathways differed between breast cancer patients and controls. Our findings provide the first evidence that the gut microbiota in premenopausal breast cancer patients differs from that in postmenopausal breast cancer patients and shed light on menopausal-specific microbial markers for diagnosis and investigation, ultimately providing a noninvasive approach for breast cancer detection and a novel strategy for preventing premenopausal breast cancer.
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Affiliation(s)
- Ming-Feng Hou
- Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 80756, Taiwan
- Division of Breast Oncology and Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 80756, Taiwan
- Department of Biomedical Science and Environmental Biology, College of Life Science, Kaohsiung Medical University, Kaohsiung, 80756, Taiwan
| | - Fu Ou-Yang
- Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 80756, Taiwan
- Division of Breast Oncology and Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 80756, Taiwan
| | - Chung-Liang Li
- Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 80756, Taiwan
- Division of Breast Oncology and Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 80756, Taiwan
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, 80756, Taiwan
| | - Fang-Ming Chen
- Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 80756, Taiwan
- Division of Breast Oncology and Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 80756, Taiwan
| | - Chieh-Han Chuang
- Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 80756, Taiwan
- Division of Breast Oncology and Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 80756, Taiwan
| | - Jung-Yu Kan
- Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 80756, Taiwan
- Division of Breast Oncology and Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 80756, Taiwan
| | - Cheng-Che Wu
- Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 80756, Taiwan
- Division of Breast Oncology and Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 80756, Taiwan
| | - Shen-Liang Shih
- Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 80756, Taiwan
- Division of Breast Oncology and Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 80756, Taiwan
| | - Jun-Ping Shiau
- Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 80756, Taiwan
- Division of Breast Oncology and Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 80756, Taiwan
| | - Li-Chun Kao
- Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 80756, Taiwan
- Division of Breast Oncology and Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 80756, Taiwan
| | - Chieh-Ni Kao
- Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 80756, Taiwan
- Division of Breast Oncology and Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 80756, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, 80756, Taiwan
| | - Yi-Chen Lee
- Department of Anatomy, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, 80756, Taiwan
| | - Sin-Hua Moi
- Center of Cancer Program Development, E-Da Cancer Hospital, I-Shou University, Kaohsiung, 82445, Taiwan
| | - Yao-Tsung Yeh
- Aging and Disease Prevention Research Center, Fooyin University, Kaohsiung, 83102, Taiwan
- Department of Medical Laboratory Sciences and Biotechnology, Fooyin University, Kaohsiung, 83102, Taiwan
| | - Chien-Ju Cheng
- Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 80756, Taiwan
- Division of Breast Oncology and Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 80756, Taiwan
| | - Chih-Po Chiang
- Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 80756, Taiwan.
- Division of Breast Oncology and Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 80756, Taiwan.
- Department of Medical Laboratory Sciences and Biotechnology, Fooyin University, Kaohsiung, 83102, Taiwan.
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15
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Wu HC, Yang HI, Lin PH, Chen CJ, Santella RM, Terry MB. Reproductive and environmental exposures and the breast cancer risk in Taiwanese women. Sci Rep 2021; 11:15656. [PMID: 34341437 PMCID: PMC8329069 DOI: 10.1038/s41598-021-95290-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 07/15/2021] [Indexed: 02/07/2023] Open
Abstract
Breast cancer (BC) incidence is increasing around the globe, including in Taiwan, though the cause of the increasing incidence is less clear. We followed up 11,296 Taiwanese females who did not have BC at baseline, and ascertained new invasive BC (N = 351) through data linkage to the National Cancer Registry from 1991 to 2018 to examine whether reproductive, lifestyle and environmental risk factors including polycyclic aromatic hydrocarbons (PAH) were associated with BC risk. We conducted a nested case-control study using baseline blood available from a total of 305 women with BC and 598 women without BC matched on time in cohort. We examined the association of PAH-albumin adducts and BC risk using conditional logistic regression models. Age at menarche (HR 0.6 (95% CI 0.5-0.9) for ≥ 15 vs. < 13 years) and multiparity were associated with BC risk (HR 2.0 (95% CI 1.4-2.8), 2.8 (1.9-4.2), and 2.4 (1.0-5.0) for 3-4, 1-2 and 0 live birth, compared with women ≥ 5 births). PAH-albumin adducts were not associated with BC risk. Given the increasing BC incidence in Taiwan, there is a need to identify environmental factors that are important to this population.
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Affiliation(s)
- Hui-Chen Wu
- Department of Environmental Health Sciences, Mailman School of Public Health of Columbia University, New York, NY, 10032, USA.
- Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY, USA.
| | - Hwai-I Yang
- Genomics Research Center, Academia Sinica, Taipei, Taiwan
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
- Graduate Institue of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Biomedical Translation Research Center, Academia Sinica, Taipei, Taiwan
| | - Po-Han Lin
- Department of Medical Genetics, National Taiwan University, Taipei, Taiwan
| | - Chien-Jen Chen
- Genomics Research Center, Academia Sinica, Taipei, Taiwan
- Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Regina M Santella
- Department of Environmental Health Sciences, Mailman School of Public Health of Columbia University, New York, NY, 10032, USA
- Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY, USA
| | - Mary Beth Terry
- Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY, USA
- Department of Epidemiology, Mailman School of Public Health of Columbia University, New York, NY, USA
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16
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Lin CH, Huang RYJ, Lu TP, Kuo KT, Lo KY, Chen CH, Chen IC, Lu YS, Chuang EY, Thiery JP, Huang CS, Cheng AL. High prevalence of APOA1/C3/A4/A5 alterations in luminal breast cancers among young women in East Asia. NPJ Breast Cancer 2021; 7:88. [PMID: 34226567 PMCID: PMC8257799 DOI: 10.1038/s41523-021-00299-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 06/09/2021] [Indexed: 02/08/2023] Open
Abstract
In East Asia, the breast cancer incidence rate among women aged <50 years has rapidly increased. Emerging tumors are distinctly characterized by a high prevalence of estrogen receptor (ER)-positive/human epidermal growth factor receptor (HER2)-negative cancer. In the present study, we identified unique genetic alterations in these emerging tumors. We analyzed gene copy number variations (CNVs) in breast tumors from 120 Taiwanese patients, and obtained public datasets of CNV and gene expression (GE). The data regarding CNV and GE were separately compared between East Asian and Western patients, and the overlapping genes identified in the comparisons were explored to identify the gene-gene interaction networks. In the age <50 years/ER + /HER2- subgroup, tumors of East Asian patients exhibited a higher frequency of copy number loss in APOA1/C3/A4/A5, a lipid-metabolizing gene cluster (33 vs. 10%, P < .001) and lower APOA1/C3/A4/A5 expressions than tumors of Western patients. These copy number loss related- and GE-related results were validated in another Taiwanese cohort and in two GE datasets, respectively. The copy number loss was significantly associated with poor survival among Western patients, but not among East Asian patients. Lower APOA1, APOC3, and APOA5 expressions were associated with higher ESTIMATE immune scores, indicating an abundance of tumor-infiltrating immune cells. In conclusion, APOA1/C3/A4/A5 copy number loss was more prevalent in luminal breast tumors among East Asian women aged <50 years, and its immunomodulatory effect on the tumor microenvironment possibly plays various roles in the tumor biology of East Asian patients.
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Affiliation(s)
- Ching-Hung Lin
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
- Department of Medical Oncology, National Taiwan University Cancer Center Hospital, Taipei, Taiwan
| | - Ruby Yun-Ju Huang
- School of Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
- Graduate Institute of Oncology, College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Tzu-Pin Lu
- Institute of Epidemiology and Preventive Medicine, Department of Public Health, National Taiwan University, Taipei, Taiwan
| | - Kuan-Ting Kuo
- Department of Pathology, National Taiwan University Hospital, Taipei, Taiwan
| | - Ko-Yun Lo
- Genomics Research Center, Academia Sinica, Taipei, Taiwan
| | - Ching-Hsuan Chen
- Institute of Epidemiology and Preventive Medicine, Department of Public Health, National Taiwan University, Taipei, Taiwan
- Department of Obstetrics and Gynecology, Taipei City Hospital Heping Fuyou Branch, Taipei, Taiwan
| | - I-Chun Chen
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
| | - Yen-Shen Lu
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
- Department of Medical Oncology, National Taiwan University Cancer Center Hospital, Taipei, Taiwan
| | - Eric Y Chuang
- Graduate Institute of Biomedical Electronics and Bioinformatics and Department of Electrical Engineering, National Taiwan University, Taipei, Taiwan
- Bioinformatics and Biostatistics Core, Center of Genomic Medicine, National Taiwan University, Taipei, Taiwan
| | - Jean Paul Thiery
- Institute of Molecular and Cell Biology, A*STAR, Singapore, Singapore
- Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Chiun-Sheng Huang
- Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan.
| | - Ann-Lii Cheng
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
- Department of Medical Oncology, National Taiwan University Cancer Center Hospital, Taipei, Taiwan
- Graduate Institute of Oncology and Cancer Research Centre, College of Medicine, National Taiwan University, Taipei, Taiwan
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17
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Huang X, Lin S, Rao X, Zeng D, Wang H, Weng X, Huang P. First-line Treatment with Ribociclib plus Endocrine Therapy for Premenopausal Women with Hormone-receptor-positive Advanced Breast Cancer: A Cost-effectiveness Analysis. Clin Breast Cancer 2021; 21:e479-e488. [PMID: 33676870 DOI: 10.1016/j.clbc.2021.01.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Revised: 01/29/2021] [Accepted: 01/31/2021] [Indexed: 12/09/2022]
Abstract
BACKGROUND We conducted a cost-effectiveness analysis incorporating recent phase III clinical trial (MONALEESA-7) data to evaluate the cost-effectiveness of ribociclib (RIB) as a first-line treatment for premenopausal women with hormone receptor (HR)-positive and human epidermal growth factor receptor 2 (HER2)-negative advanced breast cancer (ABC) from the United States healthcare payer perspective. In addition, because RIB has not been marketed in China, we identified the range of drug costs for which RIB could be considered cost effective from a Chinese healthcare system perspective. PATIENTS AND METHODS A Markov model was developed to evaluate the cost-effectiveness of adding RIB to endocrine therapy over a lifetime. The clinical outcomes and utility data were obtained from published literature. Costs data were obtained from United States and Chinese official websites, and we determined the potential price for RIB in China based on its price in the United States. The main outcomes of this study were the incremental cost-effectiveness ratio (ICER) and quality-adjusted life-years (QALYs). RESULTS The model projected that mean outcome was better with RIB and endocrine combined (3.83366 QALYs) than with endocrine therapy alone (2.71203 QALYs). In the United States, RIB and endocrine therapy cost an additional $604,960.06, resulting in an ICER of $539,357.95/QALY compared with endocrine monotherapy. Subgroup analyses indicated that, in China, the projected mean outcomes were better for RIB and endocrine therapy (6.37 QALYs) than for endocrine monotherapy (2.71 QALYs). The corresponding incremental costs were $224,731.88943. Thus, the ICER comparing RIB and endocrine therapy with endocrine therapy alone represented a $61,454.96/QALY gain. CONCLUSION Additional use of RIB is estimated to not be cost effective as a first-line treatment for premenopausal women with HR-positive, HER2-negative ABC in the United States. A value-based price for the cost of RIB is less than $31.74/200 mg for China.
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Affiliation(s)
- Xiaoting Huang
- Department of Pharmacy, The First Affiliated Hospital of Fujian Medical University, 20 Cha Zhong Road, Taijiang, Fuzhou 350005, People's Republic of China
| | - Shen Lin
- Department of Pharmacy, The First Affiliated Hospital of Fujian Medical University, 20 Cha Zhong Road, Taijiang, Fuzhou 350005, People's Republic of China
| | - Xin Rao
- Department of Pharmacy, The First Affiliated Hospital of Fujian Medical University, 20 Cha Zhong Road, Taijiang, Fuzhou 350005, People's Republic of China
| | - Dayong Zeng
- Department of Pharmacy, The First Affiliated Hospital of Fujian Medical University, 20 Cha Zhong Road, Taijiang, Fuzhou 350005, People's Republic of China
| | - Hang Wang
- Department of Pharmacy, The First Affiliated Hospital of Fujian Medical University, 20 Cha Zhong Road, Taijiang, Fuzhou 350005, People's Republic of China
| | - Xiuhua Weng
- Department of Pharmacy, The First Affiliated Hospital of Fujian Medical University, 20 Cha Zhong Road, Taijiang, Fuzhou 350005, People's Republic of China.
| | - Pinfang Huang
- Department of Pharmacy, The First Affiliated Hospital of Fujian Medical University, 20 Cha Zhong Road, Taijiang, Fuzhou 350005, People's Republic of China.
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18
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Chen TWW, Pang A, Puhaindran ME, Maw MM, Loong HH, Sriuranpong V, Chang CC, Mingmalairak S, Hirose T, Endo M, Kawai A, Farid M, Tan SH, Goh WL, Quek R, Chan JCH, Leung AKC, Ngan RKC. The treatment landscape of advanced angiosarcoma in Asia-A multi-national collaboration from the Asian Sarcoma Consortium. Cancer Sci 2021; 112:1095-1104. [PMID: 33393133 PMCID: PMC7935784 DOI: 10.1111/cas.14793] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 12/29/2020] [Accepted: 12/30/2020] [Indexed: 01/05/2023] Open
Abstract
Angiosarcoma (AS) is a rare disease with a dismal prognosis. The treatment landscape and prognostic factors for advanced AS, including locally advanced, unresectable, and metastatic disease remain elusive. The Asian Sarcoma Consortium is an international collaborative effort to understand the sarcoma treatment landscape in Asia. We undertook a retrospective chart review of AS patients seen in 8 sarcoma academic centers across Asia. Patients with complete clinical, treatment, and follow-up data were enrolled. Overall, 276 advanced AS patients were included into this study; 84 (30%) of the patients had metachronous metastatic AS. The median age was 67 y; primary sites of AS was cutaneous in 55% and visceral in 45% of patients. In total, 143 (52%) patients received at least 1 line of systemic chemotherapy. The most common first-line chemotherapy regimen used was paclitaxel (47.6%) followed by liposomal doxorubicin (19.6%). The median overall survival (OS) was 7.8 mo. Significant prognostic factors for OS included age > 65 (hazard ratio (HR) 1.54, P = .006), male gender (HR 1.39, P = .02), and a cutaneous primary AS site (HR 0.63, P = .004). The median progression-free survival (PFS) for first-line chemotherapy was 3.4 mo. PFS for single vs combination or paclitaxel vs liposomal doxorubicin chemotherapy regimens were comparable. This study provides an insight into the treatment patterns and prognostic factors of advanced AS patients in Asia. Prognosis of advanced AS remains poor. Data from this study serve as a benchmark for future clinical study design.
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Affiliation(s)
- Tom Wei-Wu Chen
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan.,Graduate Institute of Oncology, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Angela Pang
- National University Cancer Institute, Singapore, National University Health System, Singapore City, Singapore
| | - Mark E Puhaindran
- Department of Hand and Reconstructive Microsurgery, National University Hospital, Singapore City, Singapore
| | - Myo Myint Maw
- Medical Oncology Unit, University of Medicine 1, Yangon, Myanmar
| | - Herbert H Loong
- Department of Clinical Oncology, The Chinese University of Hong Kong, Hong Kong, China
| | - Virote Sriuranpong
- Division of Medical Oncology, Department of Medicine, Chulalongkorn University and the King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Chih-Chi Chang
- Department of Cancer Administration and Coordination Center, National Taiwan University Hospital, Taipei, Taiwan
| | - Siyamol Mingmalairak
- Division of Medical Oncology, Department of Medicine, Chulalongkorn University and the King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Takeshi Hirose
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Makoto Endo
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Akira Kawai
- Division of Musculoskeletal Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Mohamad Farid
- Division of Medical Oncology, National Cancer Center, Singapore City, Singapore
| | - Sze Huey Tan
- Division of Clinical Trials and Epidemiological Sciences, National Cancer Center, Singapore City, Singapore.,Oncology Academic Clinical Programme, Duke-NUS Medical School, Singapore City, Singapore
| | - Wei Lin Goh
- Division of Medical Oncology, National Cancer Center, Singapore City, Singapore
| | - Richard Quek
- Parkway Cancer Centre Singapore, Singapore City, Singapore
| | - Jeffrey C H Chan
- Department of Clinical Oncology, Queen Elizabeth Hospital, Hong Kong, China
| | - Alex K C Leung
- Department of Clinical Oncology, Queen Elizabeth Hospital, Hong Kong, China
| | - Roger K C Ngan
- Department of Clinical Oncology, Queen Elizabeth Hospital, Hong Kong, China.,Department of Clinical Oncology, Queen Mary Hospital, Hong Kong, China
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19
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Breath biopsy of breast cancer using sensor array signals and machine learning analysis. Sci Rep 2021; 11:103. [PMID: 33420275 PMCID: PMC7794369 DOI: 10.1038/s41598-020-80570-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 12/16/2020] [Indexed: 12/16/2022] Open
Abstract
Breast cancer causes metabolic alteration, and volatile metabolites in the breath of patients may be used to diagnose breast cancer. The objective of this study was to develop a new breath test for breast cancer by analyzing volatile metabolites in the exhaled breath. We collected alveolar air from breast cancer patients and non-cancer controls and analyzed the volatile metabolites with an electronic nose composed of 32 carbon nanotubes sensors. We used machine learning techniques to build prediction models for breast cancer and its molecular phenotyping. Between July 2016 and June 2018, we enrolled a total of 899 subjects. Using the random forest model, the prediction accuracy of breast cancer in the test set was 91% (95% CI: 0.85–0.95), sensitivity was 86%, specificity was 97%, positive predictive value was 97%, negative predictive value was 97%, the area under the receiver operating curve was 0.99 (95% CI: 0.99–1.00), and the kappa value was 0.83. The leave-one-out cross-validated discrimination accuracy and reliability of molecular phenotyping of breast cancer were 88.5 ± 12.1% and 0.77 ± 0.23, respectively. Breath tests with electronic noses can be applied intraoperatively to discriminate breast cancer and molecular subtype and support the medical staff to choose the best therapeutic decision.
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Chan PW, Chiu JH, Huang N, Chen CM, Yu H, Liu CY, Hsu CH. Influence of Traditional Chinese Medicine on Medical Adherence and Outcome in Estrogen Receptor (+) Breast Cancer Patients in Taiwan: A Real-World Population-Based Cohort Study. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2021; 80:153365. [PMID: 33126168 DOI: 10.1016/j.phymed.2020.153365] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 09/24/2020] [Accepted: 10/01/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Medical adherence is often higher in clinical trials than in real world practice. The aim of this study was to investigate the effects of traditional Chinese medicine (TCM) on medical adherence to hormonal therapy (HT) and survival outcome in ER (+) breast cancer patients in Taiwan. SUBJECTS AND METHODS Using a nationwide longitudinal population-based database, we enrolled patients with newly diagnosed ER-positive breast cancer who had received HT, and followed for up to 5 years (N = 872). Medication adherence in terms of medication possession ratios (MPR) and patient outcome were evaluated with or without TCM exposure. We applied logistic regression and Cox proportional hazards (PH) analysis to identify factors, including TCM exposure, associated with adherence to HT and mortality. RESULTS MPR to HT in general decreased over the 5-year period post breast cancer diagnosis. Both TCM and MPR to HT ≥ 80% were significantly associated with reduced risk of breast cancer-associated mortality. Subgroup analysis revealed that TCM annual visits ≥ 3 times with CHP prescription 1~90 days per year affected mortality reduction most significantly (HR: 0.26; 95% CI = 0.08-0.83; p < 0.05) compared to other TCM use. In contrast, using TCM (either short-term or long-term) was not associated with MPR in HT. CONCLUSIONS Our results supported the potential advantage of TCM on breast cancer-associated mortality, whereas TCM use does not compromise medical adherence to HT. This study offers important insights in integrative therapy for HT in patients with estrogen receptor (+) breast cancer.
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Affiliation(s)
- Pi-Wei Chan
- Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Jen-Hwey Chiu
- Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan; Comprehensive Breast Health Center & Division of General Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan; Division of General Surgery, Department of Surgery, Cheng-Hsin General Hospital, Taiwan
| | - Nicole Huang
- Institute of Hospital and Health Care Administration, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Chyong-Mei Chen
- Institute of Public Health, National Yang-Ming University, Taipei 11221, Taiwan
| | - Hung Yu
- Department of Pharmacy, MacKay Memorial Hospital, Taipei, Taiwan
| | - Chun-Yu Liu
- Division of Medical Oncology, Department of Oncology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Taipei 112, Taiwan; School of Medicine, National Yang-Ming University, No. 155, Sec. 2, Li-Nong Street, Taipei 112, Taiwan; Comprehensive Breast Health Center, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Taipei 112, Taiwan.
| | - Chung-Hua Hsu
- Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan; Branch of Linsen, Chinese Medicine, and Kunming, Taipei City Hospital, No. 530, Linsen North Road, Zhongshan District, Taipei City 104, Taiwan.
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Abstract
ABSTRACT Obesity is an increasingly prevalent state of energy imbalance that contributes to breast cancer risk and outcomes. The effects of obesity differ by breast cancer subtype and menopause. While most studies have focused on postmenopausal hormone receptor-positive disease, less is known about the relationship between obesity and triple-negative breast cancer (TNBC). Here we will review the observations linking obesity to TNBC, the socioeconomic disparities that contribute to obesity-related TNBC, and putative biologic mechanisms. Finally, we will consider the impact of obesity on surgical and medical treatment of TNBC and novel strategies to improve energy balance after cancer diagnosis.
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Combinatorial Epigenetic and Immunotherapy in Breast Cancer Management: A Literature Review. EPIGENOMES 2020; 4:epigenomes4040027. [PMID: 34968306 PMCID: PMC8594694 DOI: 10.3390/epigenomes4040027] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 11/25/2020] [Accepted: 11/30/2020] [Indexed: 12/27/2022] Open
Abstract
Breast cancer is one of the leading causes of death among cancer patients worldwide. To date, there are several drugs that have been developed for breast cancer therapy. In the 21st century, immunotherapy is considered a pioneering method for improving the management of malignancies; however, breast cancer is an exception. According to the immunoediting model, many immunosuppressive cells contribute to immunological quiescence. Therefore, there is an urgent need to enhance the therapeutic efficacy of breast cancer treatments. In the last few years, numerous combinatorial therapies involving immune checkpoint blockade have been demonstrated that effectively improve clinical outcomes in breast cancer and combining these with methods of targeting epigenetic regulators is also an innovative strategy. Nevertheless, few studies have discussed the benefits of epi-drugs in non-cancerous cells. In this review, we give a brief overview of ongoing clinical trials involving combinatorial immunotherapy with epi-drugs in breast cancer and discuss the role of epi-drugs in the tumor microenvironment, including the results of recent research.
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Tsai MS, Chang SH, Kuo WH, Kuo CH, Li SY, Wang MY, Chang DY, Lu YS, Huang CS, Cheng AL, Lin CH, Chen PC. A case-control study of perfluoroalkyl substances and the risk of breast cancer in Taiwanese women. ENVIRONMENT INTERNATIONAL 2020; 142:105850. [PMID: 32580117 DOI: 10.1016/j.envint.2020.105850] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 05/18/2020] [Accepted: 05/19/2020] [Indexed: 05/09/2023]
Abstract
Breast cancer (BC) is a common cancer in women worldwide; however, the incidence of BC is increasing in younger women, possibly associated with the environment. Perfluoroalkyl substances (PFAS) are one of endocrine disruptors that accumulate in environment and impact human health. This study aimed to investigate whether the PFAS and BC are associated. We enrolled 120 BCE patients and 119 controls at National Taiwan University Hospital (NTUH) and also collected bio-specimen and questionnaire from 2013 to 2015. All subjects' plasma PFAS levels were analyzed by ultra-performance liquid chromatography tandem mass spectrometry method with electrospray ionization (UHPLC-ESI-MS/MS). A logistic regression model was used to estimate the association between PFAS and BC. In the ≤50 years age group, the adjusted odds ratio (OR) was 2.34 (95% CI = 1.02, 5.38) for perfluorooctane sulfonate (PFOS) exposure per natural log unit increase. After stratifying the estrogen receptor (ER) status and age group, we obtained a positive association for PFHxS and PFOS concentrations with respect to the risk of ER positive tumors for ≤50 years age group. In conclusion, we found that PFAS were associated with the BC risk of ER positive tumors in young Taiwanese women. Further studies are needed to follow and explore whether these associations are causal.
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Affiliation(s)
- Meng-Shan Tsai
- Institute of Environmental and Occupational Health Sciences, College of Public Health, National Taiwan University, Taipei 100, Taiwan
| | - Shu-Han Chang
- School of Pharmacy, College of Medicine, National Taiwan University, Taipei 100, Taiwan
| | - Wen-Hung Kuo
- Departments of Surgery, National Taiwan University Hospital, Taipei 100, Taiwan
| | - Ching-Hua Kuo
- School of Pharmacy, College of Medicine, National Taiwan University, Taipei 100, Taiwan; The Metabolomics Core Laboratory, Centers of Genomic Medicine and Precision Medicine, National Taiwan University, Taipei 100, Taiwan; Department of Pharmacy, National Taiwan University Hospital, Taipei 100, Taiwan
| | - Szu-Yi Li
- Department of Oncology, National Taiwan University Hospital, Taipei 100, Taiwan
| | - Ming-Yang Wang
- Departments of Surgery, National Taiwan University Hospital, Taipei 100, Taiwan
| | - Dwan-Ying Chang
- Department of Oncology, National Taiwan University Hospital, Taipei 100, Taiwan
| | - Yen-Shen Lu
- Department of Oncology, National Taiwan University Hospital, Taipei 100, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, Taipei 100, Taiwan
| | - Chiun-Sheng Huang
- Departments of Surgery, National Taiwan University Hospital, Taipei 100, Taiwan
| | - Ann-Lii Cheng
- Department of Oncology, National Taiwan University Hospital, Taipei 100, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, Taipei 100, Taiwan; Graduate Institute of Oncology and Cancer Research Centre, College of Medicine, National Taiwan University, Taipei 100, Taiwan
| | - Ching-Hung Lin
- Department of Oncology, National Taiwan University Hospital, Taipei 100, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, Taipei 100, Taiwan.
| | - Pau-Chung Chen
- Institute of Environmental and Occupational Health Sciences, College of Public Health, National Taiwan University, Taipei 100, Taiwan; Department of Public Health, National Taiwan University College of Public Health, Taipei 100, Taiwan; Department of Environmental and Occupational Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei 100, Taiwan; Office of Occupational Safety and Health, National Taiwan University College of Medicine and Hospital, Taipei 100, Taiwan; Innovation and Policy Center for Population Health and Sustainable Environment, National Taiwan University College of Public Health, Taipei 100, Taiwan.
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Correlation between imaging features and molecular subtypes of breast cancer in young women (≤30 years old). Jpn J Radiol 2020; 38:1062-1074. [PMID: 32562180 DOI: 10.1007/s11604-020-01001-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 06/08/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To analyze the features of digital mammography (DM) plus digital breast tomosynthesis (DBT), ultrasonography (US) and magnetic resonance imaging (MRI) of breast cancer in young women (≤30 years old) and the correlation with molecular subtypes. MATERIALS AND METHODS We performed a retrospective study of imaging features of consecutive young women aged ≤30 years who were treated and surgically confirmed with breast cancer between January 2013 and December 2019 in our institution. All patients were Chinese women. DM + DBT and US were available for 170 lesions, MRI for 41 lesions. The imaging features were analysed by univariate and multivariate logistic regression analyses to find the predictive factors of the molecular subtypes. RESULTS The predictive factors of the luminal B(HER2-) subtype (n = 51) were the mass with microcalcifications, irregular shape, spiculated margins, and shadowing posterior features (all P < 0.01). The predictive factors of the luminal B(HER2+) subtype (n = 26) were the spiculated margins (DBT + DM), angular margins (US), shadowing posterior features, and high vascularity (all P < 0.05). The predictive factors of the luminal A subtype (n = 37) were the mass without microcalcifications, spiculated margins, shadowing posterior features, and low vascularity (all P < 0.05). The predictive factors of the triple-negative subtype (n = 31) were the mass without microcalcifications, oval/round shape, circumscribed margins, enhancement of posterior features, and rim enhancement (MRI) (all P < 0.005). The predictive factors of the human-epidermal-growth-factor-receptor-2-enriched subtype (n = 26) were the only microcalcifications, microlobulated margins, and combined posterior feature (all P < 0.05). CONCLUSION Compared with the general population of breast cancer, this young female population presents a different molecular phenotype distribution. Some imaging features of breast cancer in young women ≤30 years old can be used to predict certain tumor molecular subtypes.
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Lin CH, Yap YS, Lee KH, Im SA, Naito Y, Yeo W, Ueno T, Kwong A, Li H, Huang SM, Leung R, Han W, Tan B, Hu FC, Huang CS, Cheng AL, Lu YS. Contrasting Epidemiology and Clinicopathology of Female Breast Cancer in Asians vs the US Population. J Natl Cancer Inst 2020; 111:1298-1306. [PMID: 31093668 DOI: 10.1093/jnci/djz090] [Citation(s) in RCA: 77] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 01/29/2019] [Accepted: 05/06/2019] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND The incidence of breast cancer among younger East Asian women has been increasing rapidly over recent decades. This international collaborative study systemically compared the differences in age-specific incidences and pathological characteristics of breast cancer in East Asian women and women of predominantly European ancestry. METHODS We excerpted analytic data from six national cancer registries (979 675 cases) and eight hospitals (18 008 cases) in East Asian countries and/or regions and, for comparisons, from the US Surveillance, Epidemiology, and End Results program database. Linear regression analyses of age-specific incidences of female breast cancer and logistic regression analyses of age-specific pathological characteristics of breast cancer were performed. All statistical tests were two-sided. RESULTS Unlike female colorectal cancer, the age-specific incidences of breast cancer among East Asian women aged 59 years and younger increased disproportionally over recent decades relative to rates in US contemporaries. For years 2010-2014, the estimated age-specific probability of estrogen receptor positivity increased with age in American patients, whereas that of triple-negative breast cancer (TNBC) declined with age. No similar trends were evident in East Asian patients; their probability of estrogen receptor positivity at age 40-49 years was statistically significantly higher (odd ratio [OR] = 1.50, 95% confidence interval [CI] = 1.36 to 1.67, P < .001) and of TNBC was statistically significantly lower (OR = 0.79, 95% CI = 0.71 to 0.88, P < .001), whereas the probability of ER positivity at age 50-59 years was statistically significantly lower (OR = 0.88, 95% CI = 0.828 to 0.95, P < .001). Subgroup analyses of US Surveillance, Epidemiology, and End Results data showed similarly distinct patterns between East Asian American and white American patients. CONCLUSIONS Contrasting age-specific incidences and pathological characteristics of breast cancer between East Asian and American women, as well as between East Asian Americans and white Americans, suggests racial differences in the biology.
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26
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Gomez SL, Yao S, Kushi LH, Kurian AW. Is Breast Cancer in Asian and Asian American Women a Different Disease? J Natl Cancer Inst 2020; 111:1243-1244. [PMID: 31093671 DOI: 10.1093/jnci/djz091] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 05/06/2019] [Indexed: 12/28/2022] Open
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Guo JY, Wang MZ, Wang MS, Sun T, Wei FH, Yu XT, Wang C, Xu YY, Wang L. The Undervalued Effects of Polychlorinated Biphenyl Exposure on Breast Cancer. Clin Breast Cancer 2020; 20:12-18. [DOI: 10.1016/j.clbc.2019.07.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Accepted: 07/07/2019] [Indexed: 12/26/2022]
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28
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Chen C, Lu Y, Cheng A, Huang C, Kuo W, Wang M, Chao M, Chen I, Kuo C, Lu T, Lin C. Disparity in Tumor Immune Microenvironment of Breast Cancer and Prognostic Impact: Asian Versus Western Populations. Oncologist 2020; 25:e16-e23. [PMID: 31371522 PMCID: PMC6964121 DOI: 10.1634/theoncologist.2019-0123] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 07/11/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The clinicopathological features and prognosis of breast cancer in Asia are different from those in the Western countries. Tumor-infiltrating immune cells can influence the outcome of patients with breast cancer, but they have not been systemically evaluated in Asian patients with breast cancer. METHODS We compared the immune score, composition, and prognostic impact of infiltrating immune cells between Asian and Western patients with breast cancer by analyzing gene expression profiles from eight Gene Expression Omnibus data sets and The Cancer Genome Atlas data set. The Estimation of Stromal and Immune Cells in Malignant Tumours Using Expression Data (ESTIMATE) and Cell Type Identification by Estimating Relative Subsets of Known RNA Transcripts (CIBERSORT) algorithms were used to determine the immune score and composition of tumor-infiltrating immune cells, respectively. FINDINGS This study included 462 Asian patients and 2,186 Western patients. Tumors of Asian patients had significantly higher immune score, particularly in the luminal B and HER2-enriched subtypes. High immune score was associated with favorable prognosis in both Asian and Western patients, and Asian race with a high ESTIMATE immune score provided additional power to predict longer disease-free survival. Activated CD4 T cells and M2 macrophages were the most strongly associated with survival in both Asian and Western patients. INTERPRETATION Our study highlights the difference in tumor immune microenvironments between Asian and Western patients. The higher ESTIMATE immune score, which represents more abundant tumor-infiltrating immune cells, in tumors of Asian patients partly explains their favorable prognosis. IMPLICATIONS FOR PRACTICE The tumor microenvironment serves as an interface that affects the human body's reaction to cancer cells. Evidence has revealed that tumor-infiltrating immune cells were associated with patient prognosis. This study demonstrated the disparity of tumor microenvironments and their prognostic impact between Asian and Western patients with breast cancer. The differences in immune score partially explained the racial survival differences noted in recent studies. Integrated analysis of tumor cells, tumor microenvironment, and racial effect may significantly improve recurrence risk prediction for patients with stage I-III breast cancer. Because the effect of tumor microenvironment varies across different populations, a model of interaction between immune score and race/ethnicity is recommended in accessing the risk of patients with cancer.
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Affiliation(s)
- Ching‐Hsuan Chen
- Institute of Epidemiology and Preventive Medicine, Department of Public Health, National Taiwan UniversityTaipeiTaiwan
- Department of Obstetrics and Gynecology, Taipei City Hospital Heping Fuyou BranchTaipeiTaiwan
| | - Yen‐Shen Lu
- Department of Oncology, National Taiwan University HospitalTaipeiTaiwan
- Department of Internal Medicine, National Taiwan University HospitalTaipeiTaiwan
| | - Ann‐Lii Cheng
- Department of Oncology, National Taiwan University HospitalTaipeiTaiwan
- Department of Internal Medicine, National Taiwan University HospitalTaipeiTaiwan
- National Taiwan University Cancer CenterTaipeiTaiwan
| | - Chiun‐Sheng Huang
- Department of Surgery, National Taiwan University HospitalTaipeiTaiwan
| | - Wen‐Hung Kuo
- Department of Surgery, National Taiwan University HospitalTaipeiTaiwan
| | - Ming‐Yang Wang
- Department of Surgery, National Taiwan University HospitalTaipeiTaiwan
| | - Ming Chao
- Department of Surgery, National Taiwan University Hospital Hsin‐Chu BranchHsin‐ChuTaiwan
| | - I‐Chun Chen
- Department of Oncology, National Taiwan University HospitalTaipeiTaiwan
- Department of Internal Medicine, National Taiwan University HospitalTaipeiTaiwan
- National Taiwan University Cancer CenterTaipeiTaiwan
| | - Chun‐Wei Kuo
- Department of Pathology, National Taiwan University Hospital Hsin‐Chu BranchHsin‐ChuTaiwan
| | - Tzu‐Pin Lu
- Institute of Epidemiology and Preventive Medicine, Department of Public Health, National Taiwan UniversityTaipeiTaiwan
| | - Ching‐Hung Lin
- Department of Oncology, National Taiwan University HospitalTaipeiTaiwan
- Department of Internal Medicine, National Taiwan University HospitalTaipeiTaiwan
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Lin EPY, Lin CH, Yang CY, Lu TP, Chang SN, Hsiao TH, Huang BT, Yu CJ, Chan KA, Yang PC. Population-Based Cohort Study Reveals Distinct Associations Between Female Lung Cancer and Breast Cancer in Taiwan. JCO Clin Cancer Inform 2019; 2:1-14. [PMID: 30652619 DOI: 10.1200/cci.18.00065] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Associations between Asian lung cancer (LC) and breast cancer (BC) are unknown. This study evaluates associations between LC and BC in the Taiwan population. METHODS This study was based on the Taiwan National Health Insurance data and Taiwan Cancer Registry. The cohorts included women with newly diagnosed LC or BC between 2000 and 2011 and an age- and sex-stratified random sample as a noncancer comparison cohort during the same period. Cox proportional hazards regression analysis was used to determine the risks. The National Taiwan University Hospital (NTUH) cohort, which comprised patients with confirmed pathology diagnoses of double BC/LC, was reviewed. RESULTS In 32,824 women with LC, there were increased risks for synchronous BC in patients younger than age 50 years (hazard ratio, 5.80; 95% CI, 1.83 to 18.73), age 50 to 59 years (HR, 2.37; 95% CI, 1.02 to 5.54), and age 60 to 69 years (HR, 4.42; 95% CI, 1.91 to 10.2). In the 88,446 women with BC, there were increased risks for synchronous LC in patients age 40 to 59 years (HR, 5.86; 95% CI, 3.05 to 11.3) and older than 60 years (HR, 1.98; 95% CI, 1.04 to 3.77). In the 128-patient NTUH double LC/BC cohort, 77 (60%) had both cancers diagnosed within 5 years of each other. CONCLUSION LC is associated with an increased risk for synchronous BC in Taiwan and vice versa. Radiotherapy might not be a major risk factor for LC in BC survivors. Etiology for double LC/BC deserves additional exploration and cross-racial genomic studies.
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Affiliation(s)
- Emily Pei-Ying Lin
- Emily Pei-Ying Lin and Ching-Yao Yang, National Taiwan University Hospital; Chong-Jen Yu, K. Arnold Chan, and Pan-Chyr Yang, National Taiwan University Hospital and College of Medicine; Tzu-Pin Lu, National Taiwan University; Bo-Tsang Huang and Pan-Chyr Yang, Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan; Ching-Heng Lin, Shih-Ni Chang, and Tzu-Hung Hsiao, Taichung Veterans General Hospital; and Shih-Ni Chang, China Medical University Hospital, Taichung, Taiwan
| | - Ching-Heng Lin
- Emily Pei-Ying Lin and Ching-Yao Yang, National Taiwan University Hospital; Chong-Jen Yu, K. Arnold Chan, and Pan-Chyr Yang, National Taiwan University Hospital and College of Medicine; Tzu-Pin Lu, National Taiwan University; Bo-Tsang Huang and Pan-Chyr Yang, Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan; Ching-Heng Lin, Shih-Ni Chang, and Tzu-Hung Hsiao, Taichung Veterans General Hospital; and Shih-Ni Chang, China Medical University Hospital, Taichung, Taiwan
| | - Ching-Yao Yang
- Emily Pei-Ying Lin and Ching-Yao Yang, National Taiwan University Hospital; Chong-Jen Yu, K. Arnold Chan, and Pan-Chyr Yang, National Taiwan University Hospital and College of Medicine; Tzu-Pin Lu, National Taiwan University; Bo-Tsang Huang and Pan-Chyr Yang, Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan; Ching-Heng Lin, Shih-Ni Chang, and Tzu-Hung Hsiao, Taichung Veterans General Hospital; and Shih-Ni Chang, China Medical University Hospital, Taichung, Taiwan
| | - Tzu-Pin Lu
- Emily Pei-Ying Lin and Ching-Yao Yang, National Taiwan University Hospital; Chong-Jen Yu, K. Arnold Chan, and Pan-Chyr Yang, National Taiwan University Hospital and College of Medicine; Tzu-Pin Lu, National Taiwan University; Bo-Tsang Huang and Pan-Chyr Yang, Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan; Ching-Heng Lin, Shih-Ni Chang, and Tzu-Hung Hsiao, Taichung Veterans General Hospital; and Shih-Ni Chang, China Medical University Hospital, Taichung, Taiwan
| | - Shih-Ni Chang
- Emily Pei-Ying Lin and Ching-Yao Yang, National Taiwan University Hospital; Chong-Jen Yu, K. Arnold Chan, and Pan-Chyr Yang, National Taiwan University Hospital and College of Medicine; Tzu-Pin Lu, National Taiwan University; Bo-Tsang Huang and Pan-Chyr Yang, Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan; Ching-Heng Lin, Shih-Ni Chang, and Tzu-Hung Hsiao, Taichung Veterans General Hospital; and Shih-Ni Chang, China Medical University Hospital, Taichung, Taiwan
| | - Tzu-Hung Hsiao
- Emily Pei-Ying Lin and Ching-Yao Yang, National Taiwan University Hospital; Chong-Jen Yu, K. Arnold Chan, and Pan-Chyr Yang, National Taiwan University Hospital and College of Medicine; Tzu-Pin Lu, National Taiwan University; Bo-Tsang Huang and Pan-Chyr Yang, Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan; Ching-Heng Lin, Shih-Ni Chang, and Tzu-Hung Hsiao, Taichung Veterans General Hospital; and Shih-Ni Chang, China Medical University Hospital, Taichung, Taiwan
| | - Bo-Tsang Huang
- Emily Pei-Ying Lin and Ching-Yao Yang, National Taiwan University Hospital; Chong-Jen Yu, K. Arnold Chan, and Pan-Chyr Yang, National Taiwan University Hospital and College of Medicine; Tzu-Pin Lu, National Taiwan University; Bo-Tsang Huang and Pan-Chyr Yang, Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan; Ching-Heng Lin, Shih-Ni Chang, and Tzu-Hung Hsiao, Taichung Veterans General Hospital; and Shih-Ni Chang, China Medical University Hospital, Taichung, Taiwan
| | - Chong-Jen Yu
- Emily Pei-Ying Lin and Ching-Yao Yang, National Taiwan University Hospital; Chong-Jen Yu, K. Arnold Chan, and Pan-Chyr Yang, National Taiwan University Hospital and College of Medicine; Tzu-Pin Lu, National Taiwan University; Bo-Tsang Huang and Pan-Chyr Yang, Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan; Ching-Heng Lin, Shih-Ni Chang, and Tzu-Hung Hsiao, Taichung Veterans General Hospital; and Shih-Ni Chang, China Medical University Hospital, Taichung, Taiwan
| | - K Arnold Chan
- Emily Pei-Ying Lin and Ching-Yao Yang, National Taiwan University Hospital; Chong-Jen Yu, K. Arnold Chan, and Pan-Chyr Yang, National Taiwan University Hospital and College of Medicine; Tzu-Pin Lu, National Taiwan University; Bo-Tsang Huang and Pan-Chyr Yang, Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan; Ching-Heng Lin, Shih-Ni Chang, and Tzu-Hung Hsiao, Taichung Veterans General Hospital; and Shih-Ni Chang, China Medical University Hospital, Taichung, Taiwan
| | - Pan-Chyr Yang
- Emily Pei-Ying Lin and Ching-Yao Yang, National Taiwan University Hospital; Chong-Jen Yu, K. Arnold Chan, and Pan-Chyr Yang, National Taiwan University Hospital and College of Medicine; Tzu-Pin Lu, National Taiwan University; Bo-Tsang Huang and Pan-Chyr Yang, Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan; Ching-Heng Lin, Shih-Ni Chang, and Tzu-Hung Hsiao, Taichung Veterans General Hospital; and Shih-Ni Chang, China Medical University Hospital, Taichung, Taiwan
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Yap YS, Lu YS, Tamura K, Lee JE, Ko EY, Park YH, Cao AY, Lin CH, Toi M, Wu J, Lee SC. Insights Into Breast Cancer in the East vs the West: A Review. JAMA Oncol 2019; 5:1489-1496. [PMID: 31095268 DOI: 10.1001/jamaoncol.2019.0620] [Citation(s) in RCA: 89] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Importance During the past few decades, the incidence of breast cancer (BC) has been increasing rapidly in East Asia, and BC is currently the most common cancer in several countries. The rising incidence is likely related to changing lifestyle and environmental factors in addition to the increase in early diagnosis with BC awareness and screening. The understanding and management of BC are generally based on research and data from the West. However, emerging differences in BC epidemiology and tumor and host biology in Asian populations may be clinically relevant. Observations A higher proportion of premenopausal BCs occur in Asia, although this factor is possibly an age-cohort effect. Although the relative frequencies of different immunohistochemical subtypes of BC may be similar between the East and West, the higher prevalence of luminal B subtypes with more frequent mutations in TP53 may be confounded by disparities in early detection. In addition, Asian BCs appear to harbor a more immune-active microenvironment than BCs in the West. The spectra of germline mutations in BC predisposition genes and single-nucleotide polymorphisms contributing to BC risk vary with ethnicity as well. Differences in tolerability of certain cytotoxic and targeted agents used in BC treatment may be associated with pharmacogenomic factors, whereas the lower body mass of the average woman in East Asia may contribute to higher toxicities from drugs administered at fixed doses. Phenotypic characteristics, such as lower breast volume, may influence the type of surgery performed in East Asian women. On the other hand, increased breast density may affect the sensitivity of mammography in detecting BCs, limiting the benefits of screening mammography. Conclusions and Relevance Breast cancer has become a major health problem in Asia. The inclusion of more women from Asia in clinical trials and epidemiologic and translational studies may help unravel the interethnic heterogeneity of BCs and elucidate the complex interplay between environmental and intrinsic factors in its pathogenesis. These insights may help to refine prevention, diagnosis, and management strategies for BC in the setting of ethnic diversity.
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Affiliation(s)
- Yoon-Sim Yap
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore
| | - Yen-Shen Lu
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
| | - Kenji Tamura
- Department of Breast and Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Jeong Eon Lee
- Breast Division, Department of Surgery, Samsung Medical Center, Seoul, South Korea
| | - Eun Young Ko
- Department of Radiology, Samsung Medical Center, Seoul, South Korea
| | - Yeon Hee Park
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Seoul, South Korea
| | - A-Yong Cao
- Department of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Ching-Hung Lin
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
| | - Masakazu Toi
- Breast Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Jiong Wu
- Department of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Soo-Chin Lee
- Department of Haematology-Oncology, National University Cancer Institute, Singapore.,Cancer Science Institute, National University of Singapore, Singapore
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31
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Kuo CN, Liao YM, Kuo LN, Tsai HJ, Chang WC, Yen Y. Cancers in Taiwan: Practical insight from epidemiology, treatments, biomarkers, and cost. J Formos Med Assoc 2019; 119:1731-1741. [PMID: 31522970 DOI: 10.1016/j.jfma.2019.08.023] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 07/25/2019] [Accepted: 08/23/2019] [Indexed: 12/20/2022] Open
Abstract
Cancer is the leading cause of death in Taiwan, and the overall incidence rate has gradually increased. The four most common cancers in Taiwan are colorectal, lung, breast and liver cancers. With the rise in incidence, the clinical use and costs of all anticancer drugs have steadily increased. The costs of novel therapeutics, such as targeted therapies and immunotherapy were accounted almost two-third of all antineoplastic agents in Taiwan. Moving forward, it will be necessary to discuss the economic impacts to clinical use of new therapeutics, while continuing to monitor and improve the quality of cancer therapy. In this review, we describe the epidemiology, disease screening policies and medication treatment policies for colorectal, lung, breast and liver cancer. We focus on the recent developments in cancer therapeutics, discuss the use of biomarkers, and finally consider the costs and the recent advances of anticancer medications in Taiwan.
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Affiliation(s)
- Chun-Nan Kuo
- Department of Clinical Pharmacy, School of Pharmacy, Taipei Medical University, Taipei, Taiwan; Department of Pharmacy, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Yu-Ming Liao
- Division of Hematology and Oncology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Li-Na Kuo
- Department of Clinical Pharmacy, School of Pharmacy, Taipei Medical University, Taipei, Taiwan; Department of Pharmacy, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Hui-Ju Tsai
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan; Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Wei-Chiao Chang
- Department of Clinical Pharmacy, School of Pharmacy, Taipei Medical University, Taipei, Taiwan; Department of Pharmacy, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; The PhD Program for Translational Medicine, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan; Master Program for Clinical Pharmacogenomics and Pharmacoproteomics, School of Pharmacy, Taipei Medical University, Taipei, Taiwan; Integrative Research Center for Critical Care, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
| | - Yun Yen
- The PhD Program for Translational Medicine, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan.
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32
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Yeo W, Ueno T, Lin CH, Liu Q, Lee KH, Leung R, Naito Y, Park YH, Im SA, Li H, Yap YS, Lu YS. Treating HR+/HER2− breast cancer in premenopausal Asian women: Asian Breast Cancer Cooperative Group 2019 Consensus and position on ovarian suppression. Breast Cancer Res Treat 2019; 177:549-559. [DOI: 10.1007/s10549-019-05318-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 06/08/2019] [Indexed: 12/19/2022]
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33
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Chou HH, Kuo WL, Yu CC, Tsai HP, Shen SC, Chu CH, Yu MC, Lo YF, Dabora MA, Chang HK, Lin YC, Ueng SH, Chen SC. Impact of age on pathological complete response and locoregional recurrence in locally advanced breast cancer after neoadjuvant chemotherapy. Biomed J 2019; 42:66-74. [PMID: 30987708 PMCID: PMC6468039 DOI: 10.1016/j.bj.2018.10.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Revised: 10/05/2018] [Accepted: 10/23/2018] [Indexed: 12/31/2022] Open
Abstract
Background Neoadjuvant chemotherapy (NAC) is the standard approach for downstaging of locally advanced breast cancer and can improve breast conservation rates. A pathological complete response (pCR) after NAC associated with favorable long-term outcomes has been described. There is still a high locoregional recurrence (LRR) rate after NAC and the influence of age on LRR after NAC is unclear. This study analyzed the relationship between age and LRR after NAC. Methods Two hundred and sixty-three patients with invasive breast cancer who received NAC followed by mastectomy or breast conserving surgery (BCS) were enrolled. Concurrent weekly epirubicin and docetaxel was the NAC regimen. Results Twenty-nine patients (11%) achieved a pCR after NAC. In univariate analysis, age <50 years, luminal B (HER2 positive) subtype, HER2 overexpression subtype, and triple-negative subtype were factors to predict a pCR. In multivariate analysis, age <50 years, luminal B (HER2 positive) type, HER2 overexpression, and triple-negative subtype were the independent factors to predict a pCR. No patients in the pCR group developed LRR compared with 31 patients in the non-pCR group. Eleven patients (6.9%) in the younger group (age <50 years) developed LRR compared with 20 patients (19.4%) in the older group (age ≥50 years). In multivariate analysis, younger age (<50 years) was the only independent prognostic factor for a LRR-free survival. Conclusion Younger age can predict a pCR and is an independent prognostic factor for LRR in locally advanced breast cancer patients after NAC as concurrent epirubicin and docetaxel.
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Affiliation(s)
- Hsu-Huan Chou
- Department of General Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Wen-Ling Kuo
- Department of General Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Chi-Chang Yu
- Department of General Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Hsiu-Pei Tsai
- Department of General Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Shih-Cheh Shen
- Department of General Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Chia-Hui Chu
- Department of General Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Ming-Chin Yu
- Department of General Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Yung-Feng Lo
- Department of General Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | | | - Hsien-Kun Chang
- Department of Medical Oncology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Yung-Chang Lin
- Department of Medical Oncology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Shir-Hwa Ueng
- Department of Pathology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Shin-Cheh Chen
- Department of General Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.
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34
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Luangxay T, Virachith S, Hando K, Vilayvong S, Xaysomphet P, Arounlangsy P, Phongsavan K, Mieno MN, Honma N, Kitagawa M, Sawabe M. Subtypes of Breast Cancer in Lao P.D.R.: A Study in a Limited-Resource Setting. Asian Pac J Cancer Prev 2019; 20:589-594. [PMID: 30806064 PMCID: PMC6897003 DOI: 10.31557/apjcp.2019.20.2.589] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Aim: The purpose of this study is to evaluate the prevalence of the immunohistochemical subtypes of breast cancer among Lao women by using immunohistochemistry (according to the St. Gallen 2017 guidelines) and to study their correlation to clinicopathological features in order to help guide better treatment plans for patients. Materials and methods: Formalin-fixed and paraffin embedded tissue blocks of 76 cases of primary invasive breast cancer were retrieved from the University of Health Sciences, Vientiane, Lao PDR, from 2013 to 2016. Patients’ information and previous histological reports were reviewed. Immunohistochemistry was done using antibodies against estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2/neu) and Ki-67 (MIB-1). Results: The mean age of the patients was 49 years, and the major histologic type was invasive ductal carcinoma, NOS (90.7%). The proportion of each subtype was hormone receptor-positive and HER2-negative, 44.7%; hormone receptor-positive and HER2-positive, 3.9%; hormone receptor-negative and HER2-positive, 13.2%; and triple-negative, 38.2%. ER was positive in 40.8% of the cases, while PR was positive in 47.4%. More than half of the cases were poorly differentiated cancer (65.8%), followed by moderately differentiated (34.2%). Tumors presented with pT2 (60.5%), followed by pT3 (25.0%) and pT4 (7.9%). Conclusion: Breast cancer among Lao women is characterized by a large percentage of the triple-negative subtype that is less susceptible to hormonal treatments. The empirical treatment with tamoxifen should be reconsidered since it would be less effective to these patients. More importantly, basic pathology services should be the first requirement in Lao PDR in order to provide adequate care.
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Affiliation(s)
- Thitsamay Luangxay
- Department of Comprehensive Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan.,Cancer Center, Mittaphab Hospital, Vientiane, Laos.
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35
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Ayadi EZ, Cherif B, Ben Hamed Y, Mokni M, Rebai A, Ayadi H, Jlidi R. Prognostic Value of BCL2 in Women Patients with Invasive Breast Cancer. Asian Pac J Cancer Prev 2018; 19:3557-3564. [PMID: 30583683 PMCID: PMC6428546 DOI: 10.31557/apjcp.2018.19.12.3557] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background: Breast cancers are heterogeneous, making it essential to recognize several biomarkers for cancer
outcome predictions especially in young women where the classical prediction parameters are not suitable. The goal
from this study is to evaluate the impact of B cell lymphoma 2 (BCL2), P53 and Ki-67 proteins expression on survival
in young women patients with invasive ductal carcinoma. Patients and methods: Samples and clinical data from 238
patients were collected between 2003 and 2017. They were selected according to 2 criteria: age ≤40 years old and most of
them are affected by an Invasive Ductal Carcinoma. We evaluated BCL2, P53 and ki-67 expression by immunochemistry
test, and then we assessed correlations of these biomarkers expression with patient’s clinicopathological characteristics
and survival. Results: Triple negative breast cancer group showed a high frequency among our cohort but we emphasize
an almost equitable distribution among all molecular groups. Contrary to other studies which reported that luminal A
was correlated with better prognosis, our analysis demonstrated that luminal A is correlated with the Scarff, Bloom
and Richardson (SBR) grading 2 or SBR grading 3. To better investigate the prognosis, we analyze three biomarkers
known by their impact on physiopathology behavior on breast cancer BCL2, ki-67and P53. BCL2 is the more relevant
one, it was correlated with molecular subtypes (p=0.0012) and SBR grading (p=0.0016). BCL2 seems to be the good
prognostic biomarker related to survival (p=0.004) with a protective role among patients when endocrine therapy
is not provided and Lymph Node (LN) involvement is positive (p=0.021, p=0.000 respectively). Conclusions: The
classical prognostic parameters based mainly on the molecular classification in breast cancer seem insufficient in the
case of young women. BCL2 protein expression analysis provides a better prognostic value. BCL2 should be clinically
associated in current practice when young women specimens are diagnosticated.
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Affiliation(s)
- E-Z Ayadi
- Procédés de criblage moléculaire et cellulaire, Centre of Biotechnology of Sfax B.P K.3038 Sfax, Tunisia.,Patholab Private CytoPathology Laboratory R. du Caire, Cité Jardin Sfax,Tunisia.,Patholab Private Cytopathology Laboratory A. Ibn Khaldoun Sfax, Tunisia.
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Hironaka-Mitsuhashi A, Tsuda H, Yoshida M, Shimizu C, Asaga S, Hojo T, Tamura K, Kinoshita T, Ushijima T, Hiraoka N, Fujiwara Y. Invasive breast cancers in adolescent and young adult women show more aggressive immunohistochemical and clinical features than those in women aged 40-44 years. Breast Cancer 2018; 26:386-396. [PMID: 30539373 DOI: 10.1007/s12282-018-00937-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 11/30/2018] [Indexed: 01/14/2023]
Abstract
BACKGROUND Limited knowledge exists concerning the clinicopathological features of breast cancers (BCs) occurring in adolescent and young adult (AYA) women. We evaluated tumor characteristics in AYA women in comparison with those in middle-aged premenopausal women. METHODS From consecutive AYA patients (< 35-year-old) with invasive BC in a single institute, 82 patients first treated with surgery were examined. As the control group, 82 tumors from middle-aged premenopausal patients (40-44 years) were selected by matching pathological T and N factors. We compared habitual factors, immunohistochemical parameters, and patient outcome between the two groups. RESULTS Most of the study population (148 of 164, 90.2%) were in the early clinical stages (stage I or II). In the AYA group, the number of childbirths was smaller (p < 0.0001), while the volume of alcohol consumption was larger (p < 0.0001), and palpable primary tumors were more frequent (p < 0.01) than in the control group. The positivities of estrogen receptor, progesterone receptor, and androgen receptor were lower (p < 0.001, p = 0.03, and p < 0.001, respectively), and the triple-negative (TN) BCs rates were higher (p < 0.01) in the AYA group. Distant recurrence-free survival (DRFS) curves were different in the whole population (p = 0.02) and in hormone receptor-positive cases (p = 0.01). CONCLUSIONS We confirmed that BCs occurring in AYA women had more aggressive features than those of the older premenopausal women in terms of a high proportion of TN subtypes and a lower DRFS.
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Affiliation(s)
- Ai Hironaka-Mitsuhashi
- Department of Pathology, National Cancer Center Hospital, Tokyo 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.,Division of Molecular and Cellular Medicine, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.,Course of Advanced Clinical Research of Cancer, Juntendo Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Hitoshi Tsuda
- Department of Basic Pathology, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan.
| | - Masayuki Yoshida
- Department of Pathology, National Cancer Center Hospital, Tokyo 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Chikako Shimizu
- Department of Breast and Medical Oncology, National Cancer Center Hospital, Tokyo 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.,National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan
| | - Sota Asaga
- Department of Breast Surgery, National Cancer Center Hospital, Tokyo 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.,Department of Breast Surgery, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan
| | - Takashi Hojo
- Department of Breast Surgery, National Cancer Center Hospital, Tokyo 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.,Department of Breast Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
| | - Kenji Tamura
- Department of Breast and Medical Oncology, National Cancer Center Hospital, Tokyo 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Takayuki Kinoshita
- Department of Breast Surgery, National Cancer Center Hospital, Tokyo 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Toshikazu Ushijima
- Course of Advanced Clinical Research of Cancer, Juntendo Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.,Division of Epigenomics, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Nobuyoshi Hiraoka
- Department of Pathology, National Cancer Center Hospital, Tokyo 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Yasuhiro Fujiwara
- Department of Breast and Medical Oncology, National Cancer Center Hospital, Tokyo 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
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37
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Is the high proportion of young age at breast cancer onset a unique feature of Asian breast cancer? Breast Cancer Res Treat 2018; 173:189-199. [DOI: 10.1007/s10549-018-4947-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Accepted: 08/27/2018] [Indexed: 11/26/2022]
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38
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Gupta P, Rai NN, Agarwal L, Namdev S. Comparison of Molecular Subtypes of Carcinoma of the Breast in Two Different Age Groups: A Single Institution Experience. Cureus 2018; 10:e2834. [PMID: 30131927 PMCID: PMC6101449 DOI: 10.7759/cureus.2834] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Hormonal analysis and molecular subtyping are used as an important predictive and prognostic factors in women with carcinoma of the breast. The aim of this study was to analyze and compare the hormonal (estrogen receptor (ER) and progesterone receptor (PR)) and human epidermal growth factor (HER2) status among women with carcinoma breast belonging to two different age groups and classify them in molecular subtypes (luminal A, luminal B, triple negative, and HER2). Materials and Methods This was an analytical cross-sectional study performed at a tertiary care center in Northern India. Breast carcinoma cases treated over a period of two years were stratified into two groups (≤ 40 years: younger group, n = 27 and > 40 years: older group, n = 33). Their hormonal (ER, PR) and HER2 status were studied using immunohistochemistry (IHC) and classified according to the molecular classification of the breast carcinoma. Results A total of 60 cases of breast carcinoma were treated for hormonal and HER2 status during our study period and were classified into four subtypes. In the younger group (n = 27), luminal A (n = 16, 59.2%) was the most common molecular subtype, followed by triple negative (n = 6, 22.2%), HER2 (n = 4, 14.8%), and luminal B (n = 1, 3.7%). Similarly, in the older group luminal A (n = 20, 60.6%) ranked first, followed by triple negative (n = 10, 30.3%), HER2 (n = 2, 6.0%), and luminal B (n = 1, 3.0%). Conclusion Carcinoma of the breast in young women shows variation in the prevalence of molecular subtypes in different regions of the world. The results of our study are in accordance with the Asian literature, showing no significant difference in molecular subtyping of carcinoma breast in younger versus older women. More molecular research is needed to clearly understand the pathophysiology associated with carcinoma of the breast in young women.
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Affiliation(s)
- Pooja Gupta
- Pathology, National Institute of Pathology, New Delhi, IND
| | - Naresh N Rai
- Pathology, Government Medical College, Kota, IND
| | | | - Swati Namdev
- Pathology, Government Medical College, Kota, IND
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39
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Huang TT, Pennarun N, Cheng YH, Horng CF, Lei J, Hung-Chun Cheng S. Gene expression profiling in prognosis of distant recurrence in HR-positive and HER2-negative breast cancer patients. Oncotarget 2018; 9:23173-23182. [PMID: 29796180 PMCID: PMC5955427 DOI: 10.18632/oncotarget.25258] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 04/06/2018] [Indexed: 12/13/2022] Open
Abstract
There had been several studies using gene-expression profiling in predicting distant recurrence in breast cancer. In this study, we developed an 18-gene classifier (18-GC) to predict distant recurrence of breast cancer and compared it with the 21-gene panel (Oncotype DX®, ODx) in performance. Included were 224 breast cancer patients with positive hormonal receptor (HR+) and negative human epidermal growth factor receptor 2 (HER2-). We compared the demographic, clinical, and survival information of the patients, and further compared the prediction of recurrence risk obtained by using the 18-GC with that by ODx. To have the best combined sensitivity and specificity, receiver operating characteristics (ROC) curve analysis was performed to determine the cutoff values for several breakpoint scores. For the new 18-GC, a breakpoint score of 21 was adopted to produce a combined highest sensitivity (95%) and specificity (39%) in detecting distant recurrence. At this breakpoint score, 164 of the 224 patients were classified by the 18-GC in the same risk level as by ODx, giving a concordance rate of 73%. Along with patient age and tumor stage, this 18-GC was found to be an independent significant prognostic factor of distant metastasis of breast cancer. We have thus created a new gene panel assay for prediction of distant recurrence in HR+ and HER2- breast cancer patients. With a high concordance rate with ODx, this new assay may serve as a good tool for individual breast cancer patients to make an informed decision on whether adjuvant chemotherapy should be performed post-surgery.
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Affiliation(s)
- Tzu-Ting Huang
- Department of Medical Research, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan
| | - Nicolas Pennarun
- Department of Medical Research, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan
| | - Yu-Hao Cheng
- Department of Medicine, Cathy General Hospital, Taipei, Taiwan
| | - Cheng-Fang Horng
- Department of Medical Research, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan
| | - Jason Lei
- Department of Product Development, Amwise Diagnostics Pte Ltd, Taipei, Taiwan
| | - Skye Hung-Chun Cheng
- Department of Medical Research, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan.,Department of Radiation Oncology, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan
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40
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Iyengar NM, Chen IC, Zhou XK, Giri DD, Falcone DJ, Winston LA, Wang H, Williams S, Lu YS, Hsueh TH, Cheng AL, Hudis CA, Lin CH, Dannenberg AJ. Adiposity, Inflammation, and Breast Cancer Pathogenesis in Asian Women. Cancer Prev Res (Phila) 2018; 11:227-236. [PMID: 29222346 PMCID: PMC5882588 DOI: 10.1158/1940-6207.capr-17-0283] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 10/27/2017] [Accepted: 11/29/2017] [Indexed: 12/18/2022]
Abstract
Obesity is associated with white adipose tissue (WAT) inflammation in the breast, elevated levels of the estrogen biosynthetic enzyme, aromatase, and systemic changes that predispose to breast cancer development. We examined whether WAT inflammation and its associated systemic effects correlate with body fat levels in an Asian population where body mass index (BMI) is not an accurate assessment of obesity and cancer risk. We also investigated whether biologic differences could account for the greater proportion of premenopausal estrogen receptor (ER)-positive breast cancer in Asian versus Western countries. Breast WAT and fasting blood were prospectively collected from Taiwanese women undergoing mastectomy for breast cancer treatment. Body composition was measured in a subgroup using bioelectrical impedance analysis. WAT inflammation was defined by the presence of crown-like structures of the breast, which are composed of dead or dying adipocytes surrounded by macrophages. Findings were compared with U.S. Caucasian women. In the Taiwanese cohort (n = 72), breast WAT inflammation was present in 31 (43%) women and was associated with elevated BMI (P < 0.01) and increased levels of body fat (P < 0.01), C-reactive protein (P = 0.02), triglycerides (P < 0.01), insulin resistance scores (P = 0.04), and lower HDL cholesterol (P < 0.01). ER+ tumors were associated with greater body fat versus other subtypes (P = 0.03). Compared with U.S. Caucasians (n = 267), Taiwanese women had larger breast adipocytes despite lower BMI after adjusting for BMI and menopausal status (P = 0.01). A subclinical inflammatory state associated with increased adiposity and metabolic dysfunction could contribute to breast cancer pathogenesis in Asian women. Cancer Prev Res; 11(4); 227-36. ©2017 AACR.
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Affiliation(s)
- Neil M Iyengar
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
- Department of Medicine, Weill Cornell Medical College, New York, New York
| | - I-Chun Chen
- Department of Medicine, Weill Cornell Medical College, New York, New York
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
- National Taiwan University Cancer Center, Taipei, Taiwan
- Graduate Institute of Oncology, National Taiwan University, Taipei, Taiwan
| | - Xi K Zhou
- Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, New York
| | - Dilip D Giri
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Domenick J Falcone
- Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, New York
| | - Lisle A Winston
- Department of Medicine, Weill Cornell Medical College, New York, New York
| | - Hanhan Wang
- Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, New York
| | - Samantha Williams
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Yen-Shen Lu
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
- National Taiwan University Cancer Center, Taipei, Taiwan
| | - Tsu-Hsin Hsueh
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
| | - Ann-Lii Cheng
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
- National Taiwan University Cancer Center, Taipei, Taiwan
- Graduate Institute of Oncology, National Taiwan University, Taipei, Taiwan
| | - Clifford A Hudis
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Ching-Hung Lin
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan.
- National Taiwan University Cancer Center, Taipei, Taiwan
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Kuo WL, Ueng SH, Wu CH, Lee LY, Lee YS, Yu MC, Chen SC, Yu CC, Tsai CN. Establishment of two basal-like breast cancer cell lines with extremely low tumorigenicity from Taiwanese premenopausal women. Hum Cell 2018; 31:154-166. [PMID: 29484537 PMCID: PMC5852199 DOI: 10.1007/s13577-017-0197-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2017] [Accepted: 12/24/2017] [Indexed: 11/19/2022]
Abstract
The research of carcinogenetic mechanisms of breast cancer in different ethnic backgrounds is an interesting field, as clinical features of breast cancers vary among races. High premenopausal incidence is distinctive in East-Asian breast cancer. However, human cell lines derived from Asian primary breast tumor are rare. To provide alternative cell line models with a relevant genetic background, we aimed to establish breast cancer cell lines from Taiwanese patients of Han-Chinese ethnicity. Fresh tissue from mammary tumors were digested into organoids, plated and grown in basal serum-free medium of human mammary epithelial cells (HuMEC) with supplements. Cells were further enriched by positive selection with CD326 (epithelial cell adhesion molecule; EpCAM)-coated micro-magnetic beads. Two breast cancer cell lines derived from premenopausal women were successfully established by this method, and named Chang-Gung Breast Cancer 01 (CGBC 01) and 02 (CGBC 02). These two cell lines had a similar phenotype with weak expression of estrogen receptor (ER), progesterone receptor (PR), and without amplification of receptor tyrosine protein kinase erbB-2 (HER2/neu). Genome-wide Single Nucleotide Polymorphism (SNP) array showed multiple copy number alterations in both cell lines. Based on gene expression profiles, CGBC 01 and 02 were clustered into basal-like subtype with reference to the breast cancer cell line gene expression database. The tumorigenicity of both cell lines was extremely low in both anchorage-independence assay and transplantation into the mammary fat pads of nude mice. CGBC 01 and CGBC 02 are low tumorigenic breast cancer cell lines, established from Han-Chinese premenopausal breast cancer patients, which serve as in vitro models in studying the biological features of Asian breast cancer.
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Affiliation(s)
- Wen-Ling Kuo
- Division of Breast Surgery and General Surgery, Department of Surgery, Chang Gung Memorial Hospital, Linkou, Guishan Dist., Taoyuan, 33305, Taiwan.,Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, 33302, Taiwan
| | - Shir-Hwa Ueng
- Department of Pathology, Chang Gung Memorial Hospital, Chang Gung University, Guishan Dist., Taoyuan, 33305, Taiwan
| | - Chun-Hsing Wu
- Division of Breast Surgery and General Surgery, Department of Surgery, Chang Gung Memorial Hospital, Linkou, Guishan Dist., Taoyuan, 33305, Taiwan
| | - Li-Yu Lee
- Department of Pathology, Chang Gung Memorial Hospital, Chang Gung University, Guishan Dist., Taoyuan, 33305, Taiwan
| | - Yun-Shien Lee
- Department of Biotechnology, Ming Chuan University, Guishan Dist., Taoyuan, 33348, Taiwan.,Genomic Medicine Research Core Laboratory, Chang Gung Memorial Hospital, Linkou, Guishan Dist., Taoyuan, 33305, Taiwan
| | - Ming-Chin Yu
- Division of Breast Surgery and General Surgery, Department of Surgery, Chang Gung Memorial Hospital, Linkou, Guishan Dist., Taoyuan, 33305, Taiwan
| | - Shin-Cheh Chen
- Division of Breast Surgery and General Surgery, Department of Surgery, Chang Gung Memorial Hospital, Linkou, Guishan Dist., Taoyuan, 33305, Taiwan
| | - Chi-Chang Yu
- Division of Breast Surgery and General Surgery, Department of Surgery, Chang Gung Memorial Hospital, Linkou, Guishan Dist., Taoyuan, 33305, Taiwan
| | - Chi-Neu Tsai
- Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, 33302, Taiwan. .,Department of Pediatric, Chang-Gung Memorial Hospital, LinKou, Guishan Dist., Taoyuan, 33305, Taiwan.
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Differential microRNA expression in breast cancer with different onset age. PLoS One 2018; 13:e0191195. [PMID: 29324832 PMCID: PMC5764434 DOI: 10.1371/journal.pone.0191195] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 12/29/2017] [Indexed: 11/28/2022] Open
Abstract
Purpose The lower breast cancer incidence in Asian populations compared with Western populations has been speculated to be caused by environmental and genetic variation. Early-onset breast cancer occupies a considerable proportion of breast cancers in Asian populations, but the reason for this is unclear. We aimed to examine miRNA expression profiles in different age-onset groups and pathological subtypes in Asian breast cancer. Methods At the first stage, 10 samples (tumor: n = 6, normal tissue: n = 4) were analyzed with an Agilent microRNA 470 probe microarray. Candidate miRNAs with expression levels that were significantly altered in breast cancer samples or selected from a literature review were further validated by quantitative real-time PCR (qPCR) of 145 breast cancer samples at the second stage of the process. Correlations between clinicopathological parameters of breast cancer patients from different age groups and candidate miRNA expression were elucidated. Results In the present study, the tumor subtypes were significantly different in each age group, and an onset age below 40 had poor disease-free and overall survival rates. For all breast cancer patients, miR-335 and miR-145 were down-regulated, and miR-21, miR-200a, miR-200c, and miR-141 were up-regulated. In very young patients (age < 35 y/o), the expression of 3 and 8 specific miRNAs were up- and down-regulated, respectively. In young patients (36–40 y/o), 3 and 3 specific miRNAs were up- and down-regulated, respectively. miR-532-5p was up-regulated in triple-negative breast cancer. Conclusions Differential miRNA expressions between normal and tumor tissues were observed in different age groups and tumor subtypes. Evolutionarily conserved miRNA clusters, which initiate malignancy transformation, were up-regulated in the breast cancers of very young patients. None of the significantly altered miRNAs were observed in postmenopausal patients.
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Chien L, Tseng T, Chen C, Jiang H, Tsai F, Liu T, Hsiung CA, Chang I. Comparison of annual percentage change in breast cancer incidence rate between Taiwan and the United States-A smoothed Lexis diagram approach. Cancer Med 2017; 6:1762-1775. [PMID: 28560749 PMCID: PMC5504335 DOI: 10.1002/cam4.1102] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 03/07/2017] [Accepted: 04/25/2017] [Indexed: 11/29/2022] Open
Abstract
Recent studies compared the age effects and birth cohort effects on female invasive breast cancer (FIBC) incidence in Asian populations with those in the US white population. They were based on age-period-cohort model extrapolation and estimated annual percentage change (EAPC) in the age-standardized incidence rates (ASR). It is of interest to examine these results based on cohort-specific annual percentage change in rate (APCR) by age and without age-period-cohort model extrapolation. FIBC data (1991-2010) were obtained from the Taiwan Cancer Registry and the U.S. SEER 9 registries. APCR based on smoothed Lexis diagrams were constructed to study the age, period, and cohort effects on FIBC incidence. The patterns of age-specific rates by birth cohort are similar between Taiwan and the US. Given any age-at-diagnosis group, cohort-specific rates increased overtime in Taiwan but not in the US; cohort-specific APCR by age decreased with birth year in both Taiwan and the US but was always positive and large in Taiwan. Given a diagnosis year, APCR decreased as birth year increased in Taiwan but not in the US. In Taiwan, the proportion of APCR attributable to cohort effect was substantial and that due to case ascertainment was becoming smaller. Although our study shows that incidence rates of FIBC have increased rapidly in Taiwan, thereby confirming previous results, the rate of increase over time is slowing. Continued monitoring of APCR and further investigation of the cause of the APCR decrease in Taiwan are warranted.
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Affiliation(s)
- Li‐Hsin Chien
- Division of Biostatistics and BioinformaticsInstitute of Population Health SciencesNational Health Research InstitutesTaiwan
| | - Tzu‐Jui Tseng
- Center of Biomedical ResourcesNational Health Research InstitutesTaiwan
| | - Chung‐Hsing Chen
- National Institute of Cancer ResearchNational Health Research InstitutesTaiwan
| | - Hsin‐Fang Jiang
- National Institute of Cancer ResearchNational Health Research InstitutesTaiwan
| | - Fang‐Yu Tsai
- National Institute of Cancer ResearchNational Health Research InstitutesTaiwan
| | - Tsang‐Wu Liu
- National Institute of Cancer ResearchNational Health Research InstitutesTaiwan
| | - Chao A. Hsiung
- Division of Biostatistics and BioinformaticsInstitute of Population Health SciencesNational Health Research InstitutesTaiwan
| | - I‐Shou Chang
- Division of Biostatistics and BioinformaticsInstitute of Population Health SciencesNational Health Research InstitutesTaiwan
- Center of Biomedical ResourcesNational Health Research InstitutesTaiwan
- National Institute of Cancer ResearchNational Health Research InstitutesTaiwan
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Effi AB, Aman NA, Koui BS, Koffi KD, Traore ZC, Kouyate M. Breast Cancer Molecular Subtypes Defined by ER/PR and HER2 Status: Association with Clinicopathologic Parameters in Ivorian Patients. Asian Pac J Cancer Prev 2017; 17:1973-8. [PMID: 27221883 DOI: 10.7314/apjcp.2016.17.4.1973] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Breast cancer is a heterogeneous disease that represents a major public health problem. The immunohistochemical determination of breast cancer subtypes with regard to estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor (HER2) status can contribute to improved selection of therapy and patientcare. The purpose of this study was to determine the prevalence of the molecular breast cancer subtypes and to assess their associations with classical clinicopathologic parameters for better therapeutic decisions in women with breast cancer in the Ivory Coast. MATERIALS AND METHODS Formalin- fixed and paraffin-embedded blocks of patients diagnosed with primary breast carcinoma were subjected to immunohistochemical assay for the assessment of ER/RP and HER2 expression. The one-way analysis of variance evaluated the difference between breast cancer subtypes and mean age of patients. The Chi-square Test was used to compare standard clinicopathologic prognostic parameters with tumor subtypes. RESULTS Among 302 patients, 57% were premenopausal and 43% were postmenopausal. The invasive ductal carcinoma not otherwise specified (IDC NOS) (82.8%) was the most frequent histological type, and the tumor grade 2 (56%) was predominant followed by grade 3 (20.9%). The proportion of positivity of ER, PR, and HER2 was 56%, 49%, and 15.6%, respectively. Half of patients of this study (51.6%) had luminal A breast tumor type followed by TN (32.1%). Other subtypes were luminal B (10.1% ) and non-luminal HER2+ (6.3%). CONCLUSIONS The findings of the present study are in line with the literature and should assist in management of breast cancer in our country.
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Affiliation(s)
- Ahoua B Effi
- Department of Anatomic Pathology, School of Medicine, Alassane Ouattara University, Bouake, Ivory Coast E-mail :
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Elidrissi Errahhali M, Elidrissi Errahhali M, Ouarzane M, El Harroudi T, Afqir S, Bellaoui M. First report on molecular breast cancer subtypes and their clinico-pathological characteristics in Eastern Morocco: series of 2260 cases. BMC WOMENS HEALTH 2017; 17:3. [PMID: 28068979 PMCID: PMC5223366 DOI: 10.1186/s12905-016-0361-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 12/29/2016] [Indexed: 12/15/2022]
Abstract
BACKGROUND Breast cancer is the most frequent malignancy among women in Eastern Morocco. In this paper, we provide the first report on molecular breast cancer subtypes in this region. This is the largest population-based study on breast cancer among Moroccan women. METHODS We analyzed 2260 breast cancer cases diagnosed at the Hassan II Regional Oncology Center between October 2005 and December 2012. Clinico-pathological and therapeutic features were studied. Molecular subtypes were determined and their associations with the clinico-pathological characteristics of the tumors were examined. RESULTS The mean age at diagnosis was 48.7 years ±11.4. Invasive ductal carcinoma was the predominant histological type (77.1%), followed by lobular invasive carcinoma (15.3%). The mean size of breast tumors was 3.5 cm ± 1.96, and 84% of our patients are diagnosed with tumors of more than 2 cm. Histological grade II tumors were the most frequent (70.4%), followed by advanced histological grade (18%). Lymph node positive tumors were observed in 64.8% of cases and 29.3% of patients had distant metastasis. Most tumors were hormone receptor-positive (73%) and 28.6% were HER2 positive. 86.1% of patients with hormone receptor-positive breast cancer were given hormone therapy, while 68.9% of patients with HER2+ breast cancer received targeted therapy with Herceptin. Luminal A was the commonest molecular subtype, followed by Luminal B, Triple Negative and HER2. The highest prevalence of premenopausal patients was observed in Triple Negative subtype (72.2%), followed by HER2 (64.1%), Luminal B (62.2%), and Luminal A (55.1%). Luminal B subtype had a poorer prognosis than Luminal A. Compared with Triple Negative, HER2 subtype tend to spread more aggressively and is associated with poorer prognosis. CONCLUSIONS Unlike Western countries, breast cancer occurs at an earlier age and is diagnosed at a more advanced stage in Eastern Morocco. In this region, hormone receptor-positive tumors are predominant and so the majority of breast cancer patients should benefit from hormone therapy. HER2 subtype presents an aggressive tendency, suggesting the importance of anti-HER2 therapy. This study will contribute in developing appropriate screening and cancer management strategies in Eastern Morocco.
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Affiliation(s)
- Manal Elidrissi Errahhali
- Medical Biology Unit, Faculty of Medicine and Pharmacy of Oujda, University Mohammed the First, Oujda, Morocco
| | - Mounia Elidrissi Errahhali
- Medical Biology Unit, Faculty of Medicine and Pharmacy of Oujda, University Mohammed the First, Oujda, Morocco
| | - Meryem Ouarzane
- Medical Biology Unit, Faculty of Medicine and Pharmacy of Oujda, University Mohammed the First, Oujda, Morocco
| | | | - Said Afqir
- Medical Biology Unit, Faculty of Medicine and Pharmacy of Oujda, University Mohammed the First, Oujda, Morocco.,Hassan II Regional Oncology Center, Oujda, Morocco
| | - Mohammed Bellaoui
- Medical Biology Unit, Faculty of Medicine and Pharmacy of Oujda, University Mohammed the First, Oujda, Morocco.
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Huang YS, Chen JLY, Huang CS, Kuo SH, Jaw FS, Tseng YH, Ko WC, Chang YC. High mammographic breast density predicts locoregional recurrence after modified radical mastectomy for invasive breast cancer: a case-control study. Breast Cancer Res 2016; 18:120. [PMID: 27906044 PMCID: PMC5134100 DOI: 10.1186/s13058-016-0784-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 11/22/2016] [Indexed: 12/14/2022] Open
Abstract
Background We aimed to evaluate the influence of mammographic breast density at diagnosis on the risk of cancer recurrence and survival outcomes in patients with invasive breast cancer after modified radical mastectomy. Methods This case-control study included 121 case-control pairs of women diagnosed with invasive breast cancer between 2004 and 2009, and who had undergone modified radical mastectomy and had mammographic breast density measured before or at diagnosis. Women with known locoregional recurrence or distant metastasis were matched by pathological disease stage, age, and year of diagnosis to women without recurrence. Locoregional recurrence was defined as recurrence in the ipsilateral chest wall, or axillary, internal mammary, or supraclavicular nodes. The median follow-up duration was 84.0 months for case patients and 92.9 months for control patients. Results Patients with heterogeneously dense (50–75% density) and extremely dense (>75% density) breasts had an increased risk of locoregional recurrence (hazard ratios 3.1 and 5.7, 95% confidence intervals 1.1–9.8 and 1.2–34.9, p = 0.043 and 0.048, respectively) than did women with less dense breasts. Positive margins after surgery also increased the risk of locoregional recurrence (hazard ratio 3.3, 95% confidence interval 1.3–8.3, p = 0.010). Multivariate analysis that included dense breasts (>50% density), positive margin, no adjuvant radiotherapy, and no adjuvant chemotherapy revealed that dense breasts were significant factors for predicting locoregional recurrence risk (hazard ratio 3.6, 95% confidence interval 1.2–11.1, p = 0.025). Conclusions Our results demonstrate that dense breast tissue (>50% density) increased the risk of locoregional recurrence after modified radical mastectomy in patients with invasive breast cancer. Additional prospective studies are necessary to validate these findings. Trial registration The study is retrospectively registered with ClinicalTrials.gov, number NCT02771665, on May 11, 2016.
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Affiliation(s)
- Yu-Sen Huang
- Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei, Taiwan.,Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, No. 7, Chung-Shan S. Rd., Taipei, 100, Taiwan.,Department of Medical Imaging, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin, Taiwan
| | - Jenny Ling-Yu Chen
- Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei, Taiwan.,Department of Oncology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.,Department of Radiation Oncology, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan
| | - Chiun-Sheng Huang
- Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Sung-Hsin Kuo
- Department of Oncology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Fu-Shan Jaw
- Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei, Taiwan
| | - Yao-Hui Tseng
- Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, No. 7, Chung-Shan S. Rd., Taipei, 100, Taiwan
| | - Wei-Chun Ko
- Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, No. 7, Chung-Shan S. Rd., Taipei, 100, Taiwan
| | - Yeun-Chung Chang
- Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, No. 7, Chung-Shan S. Rd., Taipei, 100, Taiwan.
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Darwish AD, Helal AM, Aly El-Din NH, Solaiman LL, Amin A. Breast cancer in women aging 35 years old and younger: The Egyptian National Cancer Institute (NCI) experience. Breast 2016; 31:1-8. [PMID: 27771499 DOI: 10.1016/j.breast.2016.09.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2016] [Revised: 09/24/2016] [Accepted: 09/27/2016] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE The aim is to identify the epidemiological and clinicopathological features associated with young breast cancer (BC) patients and to discuss factors affecting tumor recurrence and DFS. PATIENTS & METHODS A retrospective analysis was conducted based on medical records from young females patients aged ≤35 years with pathologically confirmed primary breast cancer treated during 2008-2010 at NCI. Cases with non invasive cancer and non carcinoma histology are excluded. RESULTS Of the 5408 cases diagnosed with breast cancer, 554 were young. Four hundred & fifty eight patients representing 9.2% were within our inclusion criteria. Almost half of the patients (45.9%) presented with stage III. Axillary nodes involvement was in 63.9%, 83.3% were grade 2. More than one quarter of tumors was hormone receptors negative (28.8%) & Her2 was over-expressed in 30%. Mastectomy was offered in 72% while conservative breast surgery in 26%, 69.2% received chemotherapy either adjuvant, neoadjuvant or both, 82.5% received adjuvant radiotherapy, 68.6% received hormonal therapy. Metastatic disease developed in 51.3%, with 31% having more than one site of metastases. After a median follow up period of 66 months, the median DFS of patients was 60 months. The median DFS was significantly shorter among patients with positive lymph nodes (P < 0.0001), ER negative disease (P = 0.045) and stage III disease (P < 0.0001). CONCLUSION Breast cancer in young women is aggressive from the time of diagnosis. Our results provide baseline data of young BC in the Middle East & North Africa region; thus, contributing to future epidemiological and hospital-based researches.
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Affiliation(s)
- A D Darwish
- Medical Oncology, National Cancer Institute, Cairo University, Cairo, Egypt.
| | - A M Helal
- Medical Oncology, National Cancer Institute, Cairo University, Cairo, Egypt
| | - N H Aly El-Din
- Biostatistics & Epidemiology, National Cancer Institute, Cairo University, Cairo, Egypt
| | | | - A Amin
- Radiation Oncology and Nuclear Medicine, National Cancer Institute, Cairo University, Cairo, Egypt
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Sarkar S, Kanoi A, Bain J, Gayen R, Das KN. Correlation between cyclin D1 expression and standard clinicopathological variables in invasive breast cancer in Eastern India. South Asian J Cancer 2016; 4:155-9. [PMID: 26981504 PMCID: PMC4772390 DOI: 10.4103/2278-330x.175950] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Introduction: Breast cancer is the leading oncogenic threat in South-East Asian women showing an inexplicable biological aggressiveness. High expression of cyclin D1, a key molecule in breast cancer pathogenesis, has been shown by previous studies in the Western world to be associated with favorable tumoral characteristics. Apart from determining the correlation between cyclin D1 expression and standard clinicopathological variables in invasive breast cancer in Eastern India, questions that we aimed to answer through this study included: Is there a significant regional difference in expression patterns of this protein? And if yes, can it possibly account for the epidemiological differences in breast cancer occurrence and biological behavior? Finally, is testing for overexpression of this protein in regions with limited resources beneficial? Materials and Methods: The present study was carried out on 110 previously untreated, female patients with primary breast carcinoma. Cyclin D1 expression was determined by immunohistochemistry using specific anti-cyclin D1 monoclonal antibodies. Results: Overexpression of cyclin Dl was found in 78 of 110 cases (70.9%). High expression of cyclin D1 showed a significant negative correlation with tumor size (P = 0.023) and tumor grade (P = 0.045). Estrogen receptor and progesterone receptor positive cases showed a significantly positive correlation with cyclin D1 overexpression (P = 0.026 and 0.046, respectively). Interestingly, cyclin D1 positivity showed a strong correlation with the type of surgical procedure performed (P = 0.002). Conclusion: Cyclin D1 overexpression in breast cancer is associated with less aggressive tumoral characteristics. Furthermore, its potential epidemiological role and utility as a prognostic marker have been discussed.
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Affiliation(s)
- Santanu Sarkar
- Department of General Surgery, Burdwan Medical College, Burdwan, West Bengal, India
| | - Aditya Kanoi
- Department of Plastic Surgery, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Jayanta Bain
- Department of Plastic Surgery, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Rajarshi Gayen
- Department of General Surgery, Calcutta Medical College, Kolkata, West Bengal, India
| | - Kashi Nath Das
- Department of General Surgery, Calcutta Medical College, Kolkata, West Bengal, India
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Hsieh YC, Cho EC, Tu SH, Wu CH, Hung CS, Hsieh MC, Su CT, Liu YR, Lee CH, Ho YS, Chiou HY. MSH2 rs2303425 Polymorphism is Associated with Early-Onset Breast Cancer in Taiwan. Ann Surg Oncol 2016; 24:603-610. [DOI: 10.1245/s10434-016-5168-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2015] [Indexed: 11/18/2022]
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50
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Lin CH, Chen IC, Huang CS, Hu FC, Kuo WH, Kuo KT, Wang CC, Wu PF, Chang DY, Wang MY, Chang CH, Chen WW, Lu YS, Cheng AL. TP53 Mutational Analysis Enhances the Prognostic Accuracy of IHC4 and PAM50 Assays. Sci Rep 2015; 5:17879. [PMID: 26671300 PMCID: PMC4680865 DOI: 10.1038/srep17879] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Accepted: 11/06/2015] [Indexed: 02/04/2023] Open
Abstract
IHC4 and PAM50 assays have been shown to provide additional prognostic information for patients with early breast cancer. We evaluated whether incorporating TP53 mutation analysis can further enhance their prognostic accuracy. We examined TP53 mutation and the IHC4 score in tumors of 605 patients diagnosed with stage I-III breast cancer at National Taiwan University Hospital (the NTUH cohort). We obtained information regarding TP53 mutation and PAM50 subtypes in 699 tumors from the Molecular Taxonomy of Breast Cancer International Consortium (METABRIC) cohort. We found that TP53 mutation was significantly associated with high-risk IHC4 group and with luminal B, HER2-enriched, and basal-like subtypes. Despite the strong associations, TP53 mutation independently predicted shorter relapse-free survival (hazard ratio [HR] = 1.63, P = 0.007) in the NTUH cohort and shorter breast cancer-specific survival (HR = 2.35, P = <0.001) in the METABRIC cohort. TP53 mutational analysis added significant prognostic information in addition to the IHC4 score (∆ LR-χ(2) = 8.61, P = 0.002) in the NTUH cohort and the PAM50 subtypes (∆ LR-χ(2) = 18.9, P = <0.001) in the METABRIC cohort. We conclude that incorporating TP53 mutation analysis can enhance the prognostic accuracy of the IHC4 and PAM50 assays.
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Affiliation(s)
- Ching-Hung Lin
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan.,Department of Internal Medicine; National Taiwan University Hospital, Taipei, Taiwan.,Oncology Center, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan
| | - I-Chiun Chen
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
| | - Chiun-Sheng Huang
- Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - Fu-Chang Hu
- Graduate Institute of Clinical Medicine and School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan.,International-Harvard Statistical Consulting Company, Taipei, Taiwan
| | - Wen-Hung Kuo
- Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - Kuan-Ting Kuo
- Department of Pathology, National Taiwan University Hospital, Taipei, Taiwan
| | - Chung-Chieh Wang
- Department of Pathology, National Taiwan University Hospital, Taipei, Taiwan
| | - Pei-Fang Wu
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
| | - Dwan-Ying Chang
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
| | - Ming-Yang Wang
- Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - Chin-Hao Chang
- Department of Medical Research, National Taiwan University Hospital, Taipei, Taiwan
| | - Wei-Wu Chen
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
| | - Yen-Shen Lu
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan.,Department of Internal Medicine; National Taiwan University Hospital, Taipei, Taiwan
| | - Ann-Lii Cheng
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan.,Department of Internal Medicine; National Taiwan University Hospital, Taipei, Taiwan.,Graduate Institute of Oncology and Cancer Research Centre, College of Medicine, National Taiwan University, Taipei, Taiwan
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