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Fentaw S, Godana AA, Abathun D, Chekole DM. Comparative Analysis of Women's Breast Cancer Survival Time at Three Selected Government Referral Hospitals in Ethiopia's Amhara Region Using Parametric Shared Frailty Models. BREAST CANCER (DOVE MEDICAL PRESS) 2024; 16:269-287. [PMID: 38832124 PMCID: PMC11144655 DOI: 10.2147/bctt.s447684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 05/18/2024] [Indexed: 06/05/2024]
Abstract
Background One in five people will eventually develop cancer, and one in eleven women will lose their lives to the disease. The main aim of this study is to determinants of survival time of women with breast cancer using appropriate Frailty models. Methods A study involving 632 Ethiopian women with breast cancer was conducted between 2018 and 2020, utilizing medical records from Felege-Hiwot Referral Hospital, the University of Gondar, and Dessie Referral Hospital. To compare survival, the Kaplan-Meier plot (s) and Log rank test were employed; to assess mean survival, one-way analysis of variance and the t test were utilized. The factors influencing women's survival times from breast cancer were identified using the parametric shared frailty model and the accelerated failure time model. Results The median time to die for breast cancer patients treated at FHRH, UoGCSH, and DRH was 14.91 months, 11.14 months, and 12.32 months, respectively. The parametric model of shared frailty fit those who were statistically significant in univariate analysis. The results showed that survival of women with breast cancer was significantly influenced by age, tumor size, comorbidity, nodal status, stage, histologic grade, and type of primary treatment initiated. When comparing mean survival times between hospitals, the results showed a significant difference; patients who were treated in FHRH live significantly longer than patients treated in UoGCSH and DRH, whereas patients treated in UoGCSH have comparatively lower survival. Women with stage IV and comorbidities have 22.4% and 27.1% shorter expected survival, respectively. Conclusion This finding suggests that improving the availability and accessibility of radiation therapy and surgery, eliminating disparities between hospitals, raising awareness of early signs and symptoms of breast cancer and encouraging women to seek clinical help, and highlighting women with comorbidities at diagnosis are important ways to increase survival time.
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Affiliation(s)
- Seid Fentaw
- Department of Statistics, College of Natural and Computational Sciences, Wollo University, Dessie, Ethiopia
| | - Anteneh Asmare Godana
- Department of Statistics, College of Natural and Computational Sciences, University of Gondar, Gondar, Ethiopia
| | - Dawit Abathun
- Department of Statistics, College of Natural and Computational Sciences, University of Gondar, Gondar, Ethiopia
| | - Dessie Melese Chekole
- Department of Statistics, College of Natural and Computational Sciences, University of Gondar, Gondar, Ethiopia
- Management and Healthcare Laboratory, Institute of Management and Department EMbeDS, Sant’Anna School of Advanced Studies, Piazza Martiri della Libertà 33, Pisa, 56127Italy
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James J, Law M, Sengupta S, Saunders C. Assessment of the axilla in women with early-stage breast cancer undergoing primary surgery: a review. World J Surg Oncol 2024; 22:127. [PMID: 38725006 PMCID: PMC11084006 DOI: 10.1186/s12957-024-03394-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 04/28/2024] [Indexed: 05/12/2024] Open
Abstract
Sentinel node biopsy (SNB) is routinely performed in people with node-negative early breast cancer to assess the axilla. SNB has no proven therapeutic benefit. Nodal status information obtained from SNB helps in prognostication and can influence adjuvant systemic and locoregional treatment choices. However, the redundancy of the nodal status information is becoming increasingly apparent. The accuracy of radiological assessment of the axilla, combined with the strong influence of tumour biology on systemic and locoregional therapy requirements, has prompted many to consider alternative options for SNB. SNB contributes significantly to decreased quality of life in early breast cancer patients. Substantial improvements in workflow and cost could accrue by removing SNB from early breast cancer treatment. We review the current viewpoints and ideas for alternative options for assessing and managing a clinically negative axilla in patients with early breast cancer (EBC). Omitting SNB in selected cases or replacing SNB with a non-invasive predictive model appear to be viable options based on current literature.
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Affiliation(s)
- Justin James
- Eastern Health, Melbourne, Australia.
- Monash University, Melbourne, Australia.
- Department of Breast and Endocrine Surgery, Maroondah Hospital, Davey Drive, Ringwood East, Melbourne, VIC, 3135, Australia.
| | - Michael Law
- Eastern Health, Melbourne, Australia
- Monash University, Melbourne, Australia
| | - Shomik Sengupta
- Eastern Health, Melbourne, Australia
- Monash University, Melbourne, Australia
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Sindhura N, Kaumudi K. Vascular Endothelial Growth Factor Expression by Immunohistochemistry as a Possible Indicator of Prognosis in Invasive Breast Carcinoma of No Special Type. Int J Appl Basic Med Res 2024; 14:124-130. [PMID: 38912361 PMCID: PMC11189271 DOI: 10.4103/ijabmr.ijabmr_17_24] [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: 01/10/2024] [Revised: 03/20/2024] [Accepted: 03/22/2024] [Indexed: 06/25/2024] Open
Abstract
Context Angiogenesis, the formation of new blood vessels from preexisting vascular network, is essential for tumor growth and spread. Vascular endothelial growth factor (VEGF) is a potent angiogenic growth factor. Aims To assess the expression of VEGF in invasive carcinoma of no special type and its correlation with all the known prognostic factors of breast carcinoma. Settings and Design Descriptive. Materials and Methods Mastectomy specimens were studied noting the clinical details. The formalin-fixed tissues were subjected to routine processing and hematoxylin and eosin sections and studied extensively for all the histological prognostic factors. Representative sections from each case with the tumor were subjected to immunohistochemistry (IHC) staining with VEGF, estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2/neu) antibodies. Statistical Analysis Used Descriptive statistics, Chi-square tests, contingency table analysis using SPSS for Windows. Results One hundred and twelve cases of invasive carcinoma of special type were studied to evaluate various clinicopathological parameters. The association of VEGF with clinicopathological parameters and all the known prognostic factors was studied to note its significance. VEGF overexpression was observed in 69% of the cases. It was noted that larger tumor size, higher histological grade, lymphovascular invasion, nodal involvement, tumor necrosis, high microvessel density, ER negativity, PR negativity, and HER2/neu positivity had a significant statistical association with VEGF overexpression. Conclusions We conclude that incorporating VEGF as a biomarker along with the known factors into a prognostic index will not only help predict clinical outcome more accurately, but also determines the patient who can be benefited with combinational therapy including anti-VEGF factors.
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Affiliation(s)
- Nugala Sindhura
- Department of Pathology, Guntur Medical College, Guntur, Andhra Pradesh, India
| | - Konkay Kaumudi
- Department of Pathology, Siddhartha Medical College, Vijayawada, Andhra Pradesh, India
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Ntostoglou K, Theodorou SDP, Proctor T, Nikas IP, Awounvo S, Sepsa A, Georgoulias V, Ryu HS, Pateras IS, Kittas C. Distinct profiles of proliferating CD8+/TCF1+ T cells and CD163+/PD-L1+ macrophages predict risk of relapse differently among treatment-naïve breast cancer subtypes. Cancer Immunol Immunother 2024; 73:46. [PMID: 38349444 PMCID: PMC10864422 DOI: 10.1007/s00262-024-03630-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 01/07/2024] [Indexed: 02/15/2024]
Abstract
Immunophenotypic analysis of breast cancer microenvironment is gaining attraction as a clinical tool improving breast cancer patient stratification. The aim of this study is to evaluate proliferating CD8 + including CD8 + TCF1 + Τ cells along with PD-L1 expressing tissue-associated macrophages among different breast cancer subtypes. A well-characterized cohort of 791 treatment-naïve breast cancer patients was included. The analysis demonstrated a distinct expression pattern among breast cancer subtypes characterized by increased CD8 + , CD163 + and CD163 + PD-L1 + cells along with high PD-L1 status and decreased fraction of CD8 + Ki67 + T cells in triple negative (TNBC) and HER2 + compared to luminal tumors. Kaplan-Meier and Cox univariate survival analysis revealed that breast cancer patients with high CD8 + , CD8 + Ki67 + , CD8 + TCF1 + cells, PD-L1 score and CD163 + PD-L1 + cells are likely to have a prolonged relapse free survival, while patients with high CD163 + cells have a worse prognosis. A differential impact of high CD8 + , CD8 + Ki67 + , CD8 + TCF1 + T cells, CD163 + PD-L1 + macrophages and PD-L1 status on prognosis was identified among the various breast cancer subtypes since only TNBC patients experience an improved prognosis compared to patients with luminal A tumors. Conversely, high infiltration by CD163 + cells is associated with worse prognosis only in patients with luminal A but not in TNBC tumors. Multivariate Cox regression analysis in TNBC patients revealed that increased CD8 + [hazard ratio (HR) = 0.542; 95% confidence interval (CI) 0.309-0.950; p = 0.032), CD8 + TCF1 + (HR = 0.280; 95% CI 0.101-0.779; p = 0.015), CD163 + PD-L1 + (HR: 0.312; 95% CI 0.112-0.870; p = 0.026) cells along with PD-L1 status employing two different scoring methods (HR: 0.362; 95% CI 0.162-0.812; p = 0.014 and HR: 0.395; 95% CI 0.176-0.884; p = 0.024) were independently linked with a lower relapse rate. Multivariate analysis in Luminal type A patients revealed that increased CD163 + was independently associated with a higher relapse rate (HR = 2.360; 95% CI 1.077-5.170; p = 0.032). This study demonstrates that the evaluation of the functional status of CD8 + T cells in combination with the analysis of immunosuppressive elements could provide clinically relevant information in different breast cancer subtypes.
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Affiliation(s)
- Konstantinos Ntostoglou
- Department of Histopathology, Biomedicine Group of Health Company, 15626, Athens, Greece
- Medical School, National and Kapodistrian University of Athens, 11527, Goudi, Athens, Greece
| | - Sofia D P Theodorou
- Medical School, National and Kapodistrian University of Athens, 11527, Goudi, Athens, Greece
| | - Tanja Proctor
- Institute of Medical Biometry, University of Heidelberg, 69120, Heidelberg, Germany
| | - Ilias P Nikas
- Medical School, University of Cyprus, 2029, Nicosia, Cyprus
| | - Sinclair Awounvo
- Institute of Medical Biometry, University of Heidelberg, 69120, Heidelberg, Germany
| | - Athanasia Sepsa
- Department of Anatomic Pathology, Metropolitan Hospital, 9 Ethnarchou Makariou & 1 E. Venizelou Street, Neo Faliro, 18547, Piraeus, Greece
| | | | - Han Suk Ryu
- Department of Pathology, College of Medicine, Seoul National University Hospital, 03080, Seoul, Republic of Korea
| | - Ioannis S Pateras
- 2nd Department of Pathology, Medical School, "Attikon" University Hospital, National and Kapodistrian University of Athens, 124 62, Athens, Greece.
| | - Christos Kittas
- Department of Histopathology, Biomedicine Group of Health Company, 15626, Athens, Greece
- Medical School, National and Kapodistrian University of Athens, 11527, Goudi, Athens, Greece
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Gaffoor N, Krishnamurthy J. Stromal Expression of CD10 in Breast Carcinoma and Its Association with Known Prognostic Factors-A Tissue Microarray-Based Study. J Lab Physicians 2023; 15:354-360. [PMID: 37564218 PMCID: PMC10411238 DOI: 10.1055/s-0043-1761925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023] Open
Abstract
Background Breast cancer is an epithelial malignancy; however, stroma plays a key role with its stimulatory and inhibitory factors in modulating tumor invasion and metastasis. CD10, a matrix metalloproteinase, is known to regulate cell adhesion, migration and helps in determining the progression of tumor. This knowledge helps to identify specific signals that promote growth, dedifferentiation, invasion, metastasis and serve as target for better therapeutic management. Objectives The aim of this study was to estimate frequency of expression of stromal CD10 and assess its prognostic significance in breast carcinomas by correlating with known prognostic factors. Materials and Methods Morphological parameters of 62 cases of carcinoma breast were studied on H&E (hematoxylin and eosin) stained sections and expressions of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2/neu), and CD10 on manually constructed tissue microarray sections by immunohistochemistry (IHC). Staining pattern, percentage of stained cells, and intensity of stains were evaluated and IHC scoring of all markers was done. CD10 scores were correlated with the known prognostic factors (ER, PR, and HER2/neu). A p -value less than 0.05 was considered as significant. Results Stromal expression of CD10 was found in 82.3% of cases and it was significantly associated with increasing tumor size ( p = 0.012), increasing tumor grade ( p = 0.001), lymph node metastasis ( p = 0.018), necrosis ( p = 0.008), lymphovascular invasion ( p = 0.008), ER negativity ( p = 0.001), PR negativity( p = 0.007), HER 2 positivity ( p = 0.012), triple-negative molecular subtypes ( p = 0.001), and poor prognostic groups ( p = 0.01). Conclusion CD10 can be used as an independent prognostic stromal marker and this will help to envisage new therapeutic strategies.
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Affiliation(s)
- Nidha Gaffoor
- Department of Pathology, Dr. Chandramma Dayananda Sagar Institution of Medical Education and Research, Ramanagara, Karnataka, India
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Chen Q, Duan CB, Huang Y, Liu K. Clinicopathological characteristics and features of molecular subtypes of breast cancer at high altitudes. Front Oncol 2023; 12:1050481. [PMID: 36713537 PMCID: PMC9880539 DOI: 10.3389/fonc.2022.1050481] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 12/29/2022] [Indexed: 01/15/2023] Open
Abstract
Background Breast cancer is one of the major malignancies threatening women's health worldwide. The incidence of breast cancer at high altitudes increased over the years. But few studies focused on the characteristics of clinicopathology and molecular subtypes among breast cancer at high altitudes, which are still unknown. Tibet, with an average altitude over 4000 meters, is a representative city at high altitudes, lying in the Qinghai-Tibetan Plateau in southwestern China. This study aimed to identify the clinicopathological characteristics and features of molecular subtypes among Tibetan women with breast cancer, and provide evidence for cancer prevention and personalized therapeutics in high-altitude regions. Methods Between May 2013 and March 2022, 104 Tibetan women from high-altitude regions (Tibetan-group) and 34 Han Chinese women from low-altitude regions (Han-group), consecutively diagnosed with breast cancer in the Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region, were included in the study. We retrospectively reviewed the clinical character, altitudes of residence, tumor size, lymph nodes metastasis, distant metastasis, pathological type, immunohistochemical index, and molecular subtype. Results In the study, we calculated the patient delay, equal to the period from symptoms onset to hospital visits. The patient delay of Tibetan-group was 7.47 ± 11.53 months, which was significantly longer than that of Han-group, 7.22 ± 22.96 months (p<0.05). Body Mass Index (BMI) was significantly different (p<0.05). Tumors in Tibetan-group were significantly larger than those in Han-group, 4.13 ± 2.98cm and 2.51 ± 0.82cm in diameter, respectively (p<0.05). According to ordinal logistic regression analysis, exposure to high altitudes might result in more advanced T stage (OR=2.45 95%CI 1.10-5.44). 41.3% (43/104) of cases in Tibetan-group had lymph node positive disease, whereas the percentage was found in 38.26% (13/34) in Han-group(p<0.05). The distribution of molecular subtypes was quite significantly different between two groups (p<0.05), according to the comparison of constituent ratios. Conclusion Our study verified that breast cancer at high altitudes possessed its own unique clinicopathological characteristics and distinct features of molecular subtypes. It broadened the understanding of this heterogenous disease and also provided valuable evidence for cancer prevention and personalized therapeutics of breast cancer at high altitudes.
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Wetzl M, Dietzel M, Ohlmeyer S, Uder M, Wenkel E. Spiral breast computed tomography with a photon-counting detector (SBCT): the future of breast imaging? Eur J Radiol 2022; 157:110605. [DOI: 10.1016/j.ejrad.2022.110605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 11/04/2022] [Accepted: 11/08/2022] [Indexed: 11/15/2022]
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Coillard L, Guaddachi F, Ralu M, Brabencova E, Garbar C, Bensussan A, Le Bras M, Lehmann-Che J, Jauliac S. The NFAT3/RERG Complex in Luminal Breast Cancers Is Required to Inhibit Cell Invasion and May Be Correlated With an Absence of Axillary Lymph Nodes Colonization. Front Oncol 2022; 12:804868. [PMID: 35847954 PMCID: PMC9280138 DOI: 10.3389/fonc.2022.804868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 05/25/2022] [Indexed: 11/18/2022] Open
Abstract
Luminal breast cancers represent 70% of newly diagnosed breast cancers per annum and have a relatively good prognosis compared with triple-negative breast cancers. Luminal tumors that are responsive to hormonal therapy are particularly associated with a favorable prognosis. Nonetheless, the absolute number of metastatic relapses in luminal cancers is larger than in triple-negative breast cancers. A better understanding of the biology of luminal cancers, control of metastases formation, and identification of predictive markers of their evolution are therefore still necessary. In this context, we previously disclosed the key role of NFAT3 in regulating luminal breast cancer invasion. We have now identified a specific inhibitory region, in the C-terminal part of NFAT3, required for the inhibition of invasion of the human luminal breast cancer cell line T-47D. Indeed, we showed that this 85 amino acid C-terminal region acts as a dominant negative form of NFAT3 and that its overexpression in the T-47D cell line led to increased cell invasion. Mechanistically, we have revealed that this region of NFAT3 interacts with the small Ras GTPase RERG (RAS like estrogen regulated growth inhibitor) and shown that RERG expression is required for NFAT3 to impede T-47D cell invasion. We have validated the association of NFAT3 with RERG in human luminal breast cancer tissues. We have shown an increase of the quantity of the NFAT3/RERG complexes in patients without axillary lymph node colonization and therefore proposed that the detection of this complex may be a non-invasive marker of axillary lymph node colonization.
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Affiliation(s)
- Lucie Coillard
- Université de Paris, Research Saint Louis Institute (IRSL), Institut National de la Santé et de la Recherche Médicale, Human Immunology Pathophysiology Immunotherapy (INSERM HIPI) U976, Paris, France
| | - Frédéric Guaddachi
- Université de Paris, Research Saint Louis Institute (IRSL), Institut National de la Santé et de la Recherche Médicale, Human Immunology Pathophysiology Immunotherapy (INSERM HIPI) U976, Paris, France
| | - Maëlle Ralu
- Université de Paris, Research Saint Louis Institute (IRSL), Institut National de la Santé et de la Recherche Médicale, Human Immunology Pathophysiology Immunotherapy (INSERM HIPI) U976, Paris, France
| | - Eva Brabencova
- Department of Biopathology, Centre Régional de Lutte Contre le Cancer, Institut Godinot, Reims, France
| | - Christian Garbar
- Department of Biopathology, Centre Régional de Lutte Contre le Cancer, Institut Godinot, Reims, France
| | - Armand Bensussan
- Université de Paris, Research Saint Louis Institute (IRSL), Institut National de la Santé et de la Recherche Médicale, Human Immunology Pathophysiology Immunotherapy (INSERM HIPI) U976, Paris, France
| | - Morgane Le Bras
- Université de Paris, Research Saint Louis Institute (IRSL), Institut National de la Santé et de la Recherche Médicale, Human Immunology Pathophysiology Immunotherapy (INSERM HIPI) U976, Paris, France
| | - Jacqueline Lehmann-Che
- Université de Paris, Research Saint Louis Institute (IRSL), Institut National de la Santé et de la Recherche Médicale, Human Immunology Pathophysiology Immunotherapy (INSERM HIPI) U976, Paris, France
- Molecular Oncology Unit, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Saint Louis, Paris, France
| | - Sébastien Jauliac
- Université de Paris, Research Saint Louis Institute (IRSL), Institut National de la Santé et de la Recherche Médicale, Human Immunology Pathophysiology Immunotherapy (INSERM HIPI) U976, Paris, France
- *Correspondence: Sébastien Jauliac,
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Balla A, Weaver DL. Pathologic Evaluation of Lymph Nodes in Breast Cancer: Contemporary Approaches and Clinical Implications. Surg Pathol Clin 2022; 15:15-27. [PMID: 35236631 DOI: 10.1016/j.path.2021.11.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The presence of detected metastases in locoregional lymph nodes of women with breast cancer is an important prognostic variable for cancer staging, prognosis, and treatment planning. Systematic and standardized lymph node evaluation with gross and microscopic protocols designed to detect all macrometastases larger than 2.0 mm is the appropriate objective based on clinical outcomes evidence. Pathologists will detect smaller micrometastases and isolated tumor cell clusters (ITCs) by random chance but will also leave similar sized metastases undetected in paraffin blocks. Although these smaller metastases have prognostic significance, they are not predictive of recurrence for chemotherapy naïve patients. Thus, protocols to reliably detect metastases smaller than 2.0 mm are not required or recommended by guidelines. Women with T1-T2 breast cancer with a clinically negative axilla but with 1 or 2 pathologically positive sentinel nodes now have alternative options including observation and axillary irradiation and do not require completion axillary dissection.
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Affiliation(s)
- Agnes Balla
- Department of Pathology and Laboratory Medicine, Larner College of Medicine, University of Vermont and UVM Medical Center, 111 Colchester Avenue, Burlington, VT 05401, USA.
| | - Donald L Weaver
- Department of Pathology and Laboratory Medicine, Larner College of Medicine, University of Vermont, UVM Cancer Center, UVM Medical Center, Given Courtyard South, 89 Beaumont Avenue, Burlington, VT 05405-0068, USA
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Wetzl M, Wenkel E, Dietzel M, Siegler L, Emons J, Dethlefsen E, Heindl F, Kuhl C, Uder M, Ohlmeyer S. Potential of spiral breast computed tomography to increase patient comfort compared to DM. Eur J Radiol 2021; 145:110038. [PMID: 34818609 DOI: 10.1016/j.ejrad.2021.110038] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 11/02/2021] [Accepted: 11/12/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE To intra-individually compare patient comfort of spiral breast computed tomography (SBCT) versus digital mammography (DM). METHOD This prospective IRB approved study included 79 patients undergoing both SBCT and DM for the assessment of BI-RADS 4 - 6 lesions. Following SBCT and DM patients answered a standardized questionnaire regarding "Overall patient comfort" and "Pain" on a 5-point Likert Scale. On the same Likert Scale, experienced radiologic technicians rated the workflow of the SBCT regarding patients' "Mobility", ease of patient "Positioning", patients' adherence to the examination ("Compliance") and expected image quality. Visibility of fibroglandular tissue in SBCT was independently rated by two breast radiologists on a 10-point Likert Scale. Subgroups stratified by menopausal status and body mass index (BMI) were analyzed. RESULTS Patients reported significantly lower pain during SBCT (4.73 ± 0.57) compared to DM (4.09 ± 0.90; P < 0.01). This effect was independent from BMI. However, pain reduction by SBCT was most pronounced in premenopausal (SBCT vs. DM: 4.79 ± 0.50 vs. 3.89 ± 0.99) compared to postmenopausal patients (4.71 ± 0.77 vs. 4.20 ± 0.89). Overall patient comfort in premenopausal patients tended to be higher in SBCT compared to DM (P = 0.08). Radiologic technicians rated the SBCT procedure generally as positive (average: 4.62 ± 0.56). Coverage of fibroglandular tissue in SBCT was generally high (9.82 ± 0.43) and interrater agreement was good (κ = 0.77). CONCLUSIONS Patients experience less pain during spiral breast computed tomography compared to DM, especially in premenopausal women. Imaging is feasible at a high level of anatomical breast coverage and without problems with the clinical workflow.
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Affiliation(s)
- Matthias Wetzl
- Department of Radiology, University Hospital Erlangen, Maximiliansplatz 3, 91054 Erlangen, Germany.
| | - Evelyn Wenkel
- Department of Radiology, University Hospital Erlangen, Maximiliansplatz 3, 91054 Erlangen, Germany.
| | - Matthias Dietzel
- Department of Radiology, University Hospital Erlangen, Maximiliansplatz 3, 91054 Erlangen, Germany.
| | - Lisa Siegler
- Department of Radiology, University Hospital Erlangen, Maximiliansplatz 3, 91054 Erlangen, Germany.
| | - Julius Emons
- Department of Gynecology and Obstetrics, University Hospital Erlangen, Universitätsstraße 21/23, 91054 Erlangen, Germany.
| | - Ebba Dethlefsen
- Department of Diagnostic and Interventional Radiology, University Hospital Aachen, Pauwelsstraße 30, 52074 Aachen, Germany.
| | - Felix Heindl
- Department of Gynecology and Obstetrics, University Hospital Erlangen, Universitätsstraße 21/23, 91054 Erlangen, Germany.
| | - Christiane Kuhl
- Department of Diagnostic and Interventional Radiology, University Hospital Aachen, Pauwelsstraße 30, 52074 Aachen, Germany.
| | - Michael Uder
- Department of Radiology, University Hospital Erlangen, Maximiliansplatz 3, 91054 Erlangen, Germany.
| | - Sabine Ohlmeyer
- Department of Radiology, University Hospital Erlangen, Maximiliansplatz 3, 91054 Erlangen, Germany.
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diFlorio-Alexander RM, Song Q, Dwan D, Austin-Strohbehn JA, Muller KE, Kinlaw WB, MacKenzie TA, Karagas MR, Hassanpour S. Fat-enlarged axillary lymph nodes are associated with node-positive breast cancer in obese patients. Breast Cancer Res Treat 2021; 189:257-267. [PMID: 34081259 PMCID: PMC8302552 DOI: 10.1007/s10549-021-06262-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 05/12/2021] [Indexed: 12/11/2022]
Abstract
PURPOSE Obesity associated fat infiltration of organ systems is accompanied by organ dysfunction and poor cancer outcomes. Obese women demonstrate variable degrees of fat infiltration of axillary lymph nodes (LNs), and they are at increased risk for node-positive breast cancer. However, the relationship between enlarged axillary nodes and axillary metastases has not been investigated. The purpose of this study is to evaluate the association between axillary metastases and fat-enlarged axillary nodes visualized on mammograms and breast MRI in obese women with a diagnosis of invasive breast cancer. METHODS This retrospective case-control study included 431 patients with histologically confirmed invasive breast cancer. The primary analysis of this study included 306 patients with pre-treatment and pre-operative breast MRI and body mass index (BMI) > 30 (201 node-positive cases and 105 randomly selected node-negative controls) diagnosed with invasive breast cancer between April 1, 2011, and March 1, 2020. The largest visible LN was measured in the axilla contralateral to the known breast cancer on breast MRI. Multivariate logistic regression models were used to assess the association between node-positive status and LN size adjusting for age, BMI, tumor size, tumor grade, tumor subtype, and lymphovascular invasion. RESULTS A strong likelihood of node-positive breast cancer was observed among obese women with fat-expanded lymph nodes (adjusted OR for the 4th vs. 1st quartile for contralateral LN size on MRI: 9.70; 95% CI 4.26, 23.50; p < 0.001). The receiver operating characteristic curve for size of fat-enlarged nodes in the contralateral axilla identified on breast MRI had an area under the curve of 0.72 for predicting axillary metastasis, and this increased to 0.77 when combined with patient and tumor characteristics. CONCLUSION Fat expansion of axillary lymph nodes was associated with a high likelihood of axillary metastases in obese women with invasive breast cancer independent of BMI and tumor characteristics.
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Affiliation(s)
| | - Qingyuan Song
- Department of Biomedical Data Science, Dartmouth College, 1 Medical Center Drive, HB 7261, Lebanon, NH, 03756, USA
| | - Dennis Dwan
- Department of Internal Medicine, Carney Hospital, 2100 Dorchester Ave, Dorchester, MA, 02124, USA
| | - Judith A Austin-Strohbehn
- Department of Radiology, Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH, 03756, USA
| | - Kristen E Muller
- Department of Pathology, Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH, 03756, USA
| | - William B Kinlaw
- Department of Medicine, Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH, 03756, USA
| | - Todd A MacKenzie
- Department of Biomedical Data Science, Dartmouth College, 1 Medical Center Drive, HB 7261, Lebanon, NH, 03756, USA
| | - Margaret R Karagas
- Department of Epidemiology, Dartmouth College, 1 Medical Center Drive, Lebanon, NH, 03756, USA
| | - Saeed Hassanpour
- Department of Biomedical Data Science, Dartmouth College, 1 Medical Center Drive, HB 7261, Lebanon, NH, 03756, USA.
- Department of Epidemiology, Dartmouth College, 1 Medical Center Drive, Lebanon, NH, 03756, USA.
- Department of Computer Science, Dartmouth College, Hanover, NH, 03755, USA.
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13
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Relationship Between 18F-FDG Uptake with Clinicopathological Prognostic Factors and Biological Subtypes in Breast Cancer. Indian J Surg 2021. [DOI: 10.1007/s12262-020-02706-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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14
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Modeling breast cancer survival and metastasis rates from moderate-sized clinical data. Clin Exp Metastasis 2021; 38:77-87. [PMID: 33389336 DOI: 10.1007/s10585-020-10066-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 11/20/2020] [Indexed: 10/22/2022]
Abstract
Predicting time-dependent survival probability of a breast cancer patient using information such as primary tumor size, grade, node spread status, and patient age at the time of surgery can be of immense help in managing life expectations and strategizing postoperative treatment. However, for moderate-sized clinical datasets the application of standard Kaplan-Meier theory to determine survival probability as a function of multiple cofactors can become challenging when continuous variables like tumor diameter and survival time are segmented into a large number of narrow intervals, a problem commonly termed the curse of dimensionality. We circumvent this problem by modeling the patient-to-patient distribution of primary tumor diameter with a realistic, right-skewed function, and then matching the diameter-marginalized survival with the mean Kaplan-Meier survival for the data. We apply this procedure on a recent clinical data from 1875 breast cancer patients and develop parameters that can be readily used to estimate post-surgery survival for an arbitrary time length. Finally, we show that the observed fraction of node-positive patients can be quantitatively explained within a simple tumor growth and metastasis framework. Employing two different tumor growth models from the literature (i.e., Gompertz and logistic growth models), we utilize the observed fraction-node-positive data to determine metastasis rates from the surface of a primary tumor and its patient-to-patient distribution.
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15
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Huh S, Suh HJ, Kim EK, Kim MJ, Yoon JH, Park VY, Moon HJ. Follow-Up Intervals for Breast Imaging Reporting and Data System Category 3 Lesions on Screening Ultrasound in Screening and Tertiary Referral Centers. Korean J Radiol 2020; 21:1027-1035. [PMID: 32691538 PMCID: PMC7371624 DOI: 10.3348/kjr.2019.0747] [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: 10/08/2019] [Revised: 03/10/2020] [Accepted: 03/12/2020] [Indexed: 11/30/2022] Open
Abstract
Objective To assess the appropriate follow-up interval, and rate and timepoint of cancer detection in women with Breast Imaging Reporting and Data System (BI-RADS) 3 lesions on screening ultrasonography (US) according to the type of institution. Materials and Methods A total of 1451 asymptomatic women who had negative or benign findings on screening mammogram, BI-RADS 3 assessment on screening US, and at least 6 months of follow-up were included. The median follow-up interval was 30.8 months (range, 6.8–52.9 months). The cancer detection rate, cancer detection timepoint, risk factors, and clinicopathological characteristics were compared between the screening and tertiary centers. Nominal variables were compared using the chi-square or Fisher's exact test and continuous variables were compared using the independent t test or Mann-Whitney U test. Results In 1451 women, 19 cancers (1.3%) were detected; two (0.1%) were diagnosed at 6 months and 17 (1.2%) were diagnosed after 12.3 months. The malignancy rates were both 1.3% in the screening (9 of 699) and tertiary (10 of 752) centers. In the screening center, all nine cancers were invasive cancers and diagnosed after 12.3 months. In the tertiary center, two were ductal carcinomas in situ and eight were invasive cancers. Two of the invasive cancers were diagnosed at 6 months and the remaining eight cancers newly developed after 13.1 months. Conclusion One-year follow-up rather than 6-month follow-up may be suitable for BI-RADS 3 lesions on screening US found in screening centers. However, more caution is needed regarding similar findings in tertiary centers where 6-month follow-up may be more appropriate.
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Affiliation(s)
- Sun Huh
- Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hee Jung Suh
- Department of Radiology, Severance Check-Up, Seoul, Korea
| | - Eun Kyung Kim
- Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Min Jung Kim
- Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jung Hyun Yoon
- Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Vivian Youngjean Park
- Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hee Jung Moon
- Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
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16
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Dynamic and subtype-specific interactions between tumour burden and prognosis in breast cancer. Sci Rep 2020; 10:15445. [PMID: 32963275 PMCID: PMC7508816 DOI: 10.1038/s41598-020-72033-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Accepted: 08/17/2020] [Indexed: 12/31/2022] Open
Abstract
We investigated the relationship between the prognostic importance of anatomic tumour burden and subtypes of breast cancer using data from the Korean Breast Cancer Registry Database. In HR+/HER2+ and HR−/HER2−tumours, an increase in T stage profoundly increased the hazard of death, while the presence of lymph node metastasis was more important in HR+/HER2+ and HR−/HER2+ tumours among 131,178 patients with stage I–III breast cancer. The patterns of increasing mortality risk and tumour growth (per centimetre) and metastatic nodes (per node) were examined in 67,038 patients with a tumour diameter ≤ 7 cm and < 8 metastatic nodes. HR+/HER2− and HR−/HER2− tumours showed a persistent increase in mortality risk with an increase in tumour diameter, while the effect was modest in HER2+ tumours. Conversely, an increased number of metastatic nodes was accompanied by a persistently increased risk in HR−/HER2+ tumours, while the effect was minimal for HR−/HER2− tumours with > 3 or 4 nodes. The interactions between the prognostic significance of anatomic tumour burden and subtypes were significant. The prognostic relevance of the anatomic tumour burden was non-linear and highly dependent on the subtypes of breast cancer.
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17
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Tyuryumina EY, Neznanov AA, Turumin JL. A Mathematical Model to Predict Diagnostic Periods for Secondary Distant Metastases in Patients with ER/PR/HER2/Ki-67 Subtypes of Breast Cancer. Cancers (Basel) 2020; 12:cancers12092344. [PMID: 32825078 PMCID: PMC7563940 DOI: 10.3390/cancers12092344] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 08/13/2020] [Accepted: 08/17/2020] [Indexed: 02/07/2023] Open
Abstract
Previously, a consolidated mathematical model of primary tumor (PT) growth and secondary distant metastasis (sdMTS) growth in breast cancer (BC) (CoMPaS) was presented. The aim was to detect the diagnostic periods for visible sdMTS via CoMPaS in patients with different subtypes ER/PR/HER2/Ki-67 (Estrogen Receptor/Progesterone Receptor/Human Epidermal growth factor Receptor 2/Ki-67 marker) of breast cancer. CoMPaS is based on an exponential growth model and complementing formulas, and the model corresponds to the tumor-node-metastasis (TNM) staging system and BC subtypes (ER/PR/HER2/Ki-67). The CoMPaS model reflects (1) the subtypes of BC, such as ER/PR/HER2/Ki-67, and (2) the growth processes of the PT and sdMTSs in BC patients without or with lymph node metastases (MTSs) in accordance with the eighth edition American Joint Committee on Cancer prognostic staging system for breast cancer. CoMPaS correctly describes the growth of the PT in the ER/PR/HER2/Ki-67 subtypes of BC patients and helps to calculate the different diagnostic periods, depending on the tumor volume doubling time of sdMTS, when sdMTSs might appear. CoMPaS and the corresponding software tool can help (1) to start the early treatment of small sdMTSs in BC patients with different tumor subtypes (ER/PR/HER2/Ki-67), and (2) to consider the patient almost healthy if sdMTSs do not appear during the different diagnostic periods.
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Affiliation(s)
- Ella Ya. Tyuryumina
- International Laboratory for Intelligent Systems and Structural Analysis, Faculty of Computer Science, National Research University Higher School of Economics, 109028 Moscow, Russia;
- Correspondence:
| | - Alexey A. Neznanov
- International Laboratory for Intelligent Systems and Structural Analysis, Faculty of Computer Science, National Research University Higher School of Economics, 109028 Moscow, Russia;
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18
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Ultrasound-Guided Core-Needle Biopsy of Suspicious Breast Lesions. JOURNAL OF INTERDISCIPLINARY MEDICINE 2020. [DOI: 10.2478/jim-2020-0010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Background: Breast cancer is the female cancer with the highest mortality. While early detection is a public health priority in Western European countries, a screening program in our country has yet to be implemented. The best diagnostic accuracy is achieved through the use of triple assessment: clinical examination, imaging, and core-needle biopsy where indicated. Prognosis is influenced by clinical, histological, and biological factors, and therapy is most effective when individually tailored.
Aim of the study: To analyze the clinical, histological, and immunohistochemical characteristics of the biopsied nodules and summarize our experience from the last three years.
Material and Methods: We retrospectively analyzed data from 137 patients who underwent core-needle biopsy between 2017 and 2019. Imaging score was assigned based on ultrasound examination or mammography. Clinical and pathological parameters were recorded, followed by statistical processing of the data.
Results: The mean age of the patients was 58 ± 14 years, lesions had a mean size of 22.83 ± 14.10 mm. Most nodules (n = 63, 47.01%) were located in the upper-outer quadrant, and bilateral presence was found in 4 (3.08%) cases. We found a significant positive correlation between lesion size and the patients’ age (Spearman r = 0.356; 95% CI 0.186, 0.506; p = 0.000). The malignancy rates within the Breast Imaging Reporting and Data System (BI-RADS) categories were as follows: 0% for „4a”, 31.58% for „4b”, 71.42% for „4c”, and 97.72% for „5”. Most malignancies (n = 73, 78.35%) were represented by invasive ductal carcinoma of no special type, 58.43% (n = 52) were grade 2, 89.13% (n = 82) were estrogen receptor positive, and Luminal B-like type was the most common (n = 63, 78.75%).
Conclusions: The mean size of tumors was larger than the average size at discovery described in the literature. In our region, age and tumor size are positively correlated. Preoperative histological results may indicate the reliability of the imaging risk stratification system. Most cases can benefit from adjuvant endocrine therapy.
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19
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Shea EKH, Koh VCY, Tan PH. Invasive breast cancer: Current perspectives and emerging views. Pathol Int 2020; 70:242-252. [PMID: 32039524 DOI: 10.1111/pin.12910] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Accepted: 01/21/2020] [Indexed: 12/18/2022]
Abstract
Invasive breast cancer constitutes a heterogeneous group of tumors. They comprise various histological types that differ in clinical presentation, imaging features, histopathological characteristics, biomarker profiles, prognostic and predictive parameters. The current classification of invasive breast cancer is based primarily on histopathological features. Invasive carcinoma of no special type accounts for the majority, with some rare entities also being described. With recent research and advances, there are emerging concepts, including new genetic insights of invasive breast cancer and the role of the stromal microenvironment. With greater understanding of the pathogenesis of invasive breast cancer, changes based on the correlation of histologic and genetic findings have been incorporated in the latest World Health Organization classification of breast tumors. Medullary carcinomas are subsumed as invasive carcinoma of no special type with basal-like and medullary features, regarded as part of the spectrum of tumor infiltrating lymphocyte-rich breast cancers. Tall cell carcinoma with reversed polarity is proposed as a distinct entity in recognition of unique IDH2 mutations. This article reviews conventional prognostic parameters, new histological entities, and updates on breast cancer classification, with inclusion of some genetic insights into breast cancer and the role of tumor infiltrating lymphocytes.
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Affiliation(s)
- Eric Ka Ho Shea
- Department of Clinical Pathology, Tuen Mun Hospital, Tuen Mun, Hong Kong.,Department of Anatomical Pathology, Singapore General Hospital, Singapore, Singapore
| | - Valerie Cui Yun Koh
- Department of Anatomical Pathology, Singapore General Hospital, Singapore, Singapore
| | - Puay Hoon Tan
- Division of Pathology, Singapore General Hospital, Singapore, Singapore
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20
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Overexpression of PURPL and downregulation of NONHSAT062994 as potential biomarkers in gastric cancer. Life Sci 2019; 237:116904. [PMID: 31606380 DOI: 10.1016/j.lfs.2019.116904] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 09/18/2019] [Accepted: 09/22/2019] [Indexed: 02/07/2023]
Abstract
AIMS Long non-coding RNAs (LncRNAs) play central roles in the formation and development of gastric cancer (GC). The aim of this study was to evaluate the expression of PURPL and NONHSAT062994 and the relationship between their expressions with clinical characteristics in GC. MAIN METHODS PURPL and NONHSAT062994 LncRNAs and p53 gene expression levels were analyzed both in 50 pairs of cancerous and adjacent noncancerous tissue samples in GC patients using qRT-PCR and in four sets of data obtained from Gene Expression Omnibus (GEO) database. Chi-square (χ2) test was used to determine the relationship between PURPL, NONHSAT062994 RNA levels and the clinicopathological characteristics of GC. Receiver operating characteristic (ROC) curves were drawn to represent sensitivity and specificity of PURPL and NONHSAT062994 expression as markers of GC. KEY FINDINGS Expression of PURPL was significantly upregulated in 50 GC samples as well as in GC tissues from GSE13911 and GSE27342 datasets. Our results demonstrated that PURPL RNA level in GC was significantly related to tumor size and histopathological grade. p53 expression at both protein and mRNA levels were significantly decreased in GC tissues compared to adjacent control samples. NONHSAT062994 expression was downregulated in 50-pair GC and GC tissues from GSE13915 dataset. However, NONHSAT062994 showed no consistently differential expression in GSE2637dataset. NONHSAT062994 was significantly associated with histological grade and tumor size. SIGNIFICANCE Overall, these results suggest that PURPL and NONHSAT062994 may play critical roles in the progression of GC and therefore might be considered as candidate tumor markers for therapeutic goals.
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21
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Wienbeck S, Uhlig J, Fischer U, Hellriegel M, von Fintel E, Kulenkampff D, Surov A, Lotz J, Perske C. Breast lesion size assessment in mastectomy specimens: Correlation of cone-beam breast-CT, digital breast tomosynthesis and full-field digital mammography with histopathology. Medicine (Baltimore) 2019; 98:e17082. [PMID: 31517829 PMCID: PMC6750260 DOI: 10.1097/md.0000000000017082] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022] Open
Abstract
To compare the accuracy of breast lesion size measurement of cone-beam breast-CT (CBBCT), digital breast tomosynthesis (DBT) and full-field digital mammography (FFDM).Patients scheduled for mastectomy due to at least 1 malignant breast lesion were included. Mastectomy specimens were examined by CBBCT, DBT, FFDM, and histopathology.A total of 94 lesions (40 patients) were included. Histopathological analyses revealed 47 malignant, 6 high-risk, and 41 benign lesions. Mean histopathological lesion size was 20.8 mm (range 2-100). Mean absolute size deviation from histopathology was largest for FFDM (5.3 ± 6.7 mm) and smallest for CBBCT 50 mA, high-resolution mode (4.3 ± 6.7 mm). Differences between imaging modalities did not reach statistical significance (P = .85).All imaging methods tend to overestimate breast lesion size compared to histopathological gold standard. No significant differences were found regarding size measurements, although in tendency CBBCT showed better lesion detection and cT classification over FFDM.
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Affiliation(s)
- Susanne Wienbeck
- Institute of Diagnostic and Interventional Radiology, University Medical Center Goettingen
| | - Johannes Uhlig
- Institute of Diagnostic and Interventional Radiology, University Medical Center Goettingen
| | | | - Martin Hellriegel
- Department of Gynecology and Obstetrics, University Medical Center Goettingen
| | - Eva von Fintel
- Institute of Diagnostic and Interventional Radiology, University Medical Center Goettingen
| | - Dietrich Kulenkampff
- Department of Gynecology and Obstetrics, Agaplesion Hospital Neu Bethlehem Goettingen
| | - Alexey Surov
- University of Leipzig, Department of Diagnostic and Interventional Radiology
| | - Joachim Lotz
- Institute of Diagnostic and Interventional Radiology, University Medical Center Goettingen
| | - Christina Perske
- Institute for Pathology, University Medical Center Goettingen, Germany
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22
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Schwingel D, Andreolla AP, Erpen LMS, Frandoloso R, Kreutz LC. Bovine leukemia virus DNA associated with breast cancer in women from South Brazil. Sci Rep 2019; 9:2949. [PMID: 30814631 PMCID: PMC6393560 DOI: 10.1038/s41598-019-39834-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2018] [Accepted: 01/23/2019] [Indexed: 01/23/2023] Open
Abstract
Breast cancer is a neoplastic condition with a high morbidity and mortality amongst women worldwide. Recent data linking bovine leukemia virus (BLV) with breast cancer has been contested already. Our study investigated the presence of BLV genome in healthy (n = 72) and cancerous (n = 72) paraffin-embedded samples of breast tissues from women in south Brazil. BLV DNA was found most frequently (30.5%) in breast cancer tissue than in healthy breast (13.9%) (Odds ratio = 2.73; confidence interval = 1.18-6.29; p = 0.027). In contrast, antibodies to BLV were found in a very small percentage of healthy blood donors. There was no association between BLV DNA and other tumor prognostic biological markers such as hormonal receptors, HER2 oncoprotein, proliferation index, metastasis in sentinels lymph nodes, and tumor grade and size. Our findings suggest that BLV should be considered a potential predisposing factor to breast cancer in women.
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Affiliation(s)
- Daniela Schwingel
- Universidade de Passo Fundo, Laboratório de Microbiologia e Imunologia Avançada, Prédio G3. Campus I, Bairro São José, BR 285, Km 292, 99052-900, Passo Fundo, RS, Brazil
| | - Ana P Andreolla
- Universidade de Passo Fundo, Laboratório de Microbiologia e Imunologia Avançada, Prédio G3. Campus I, Bairro São José, BR 285, Km 292, 99052-900, Passo Fundo, RS, Brazil
| | - Luana M S Erpen
- Universidade de Passo Fundo, Laboratório de Microbiologia e Imunologia Avançada, Prédio G3. Campus I, Bairro São José, BR 285, Km 292, 99052-900, Passo Fundo, RS, Brazil
| | - Rafael Frandoloso
- Universidade de Passo Fundo, Laboratório de Microbiologia e Imunologia Avançada, Prédio G3. Campus I, Bairro São José, BR 285, Km 292, 99052-900, Passo Fundo, RS, Brazil
| | - Luiz C Kreutz
- Universidade de Passo Fundo, Laboratório de Microbiologia e Imunologia Avançada, Prédio G3. Campus I, Bairro São José, BR 285, Km 292, 99052-900, Passo Fundo, RS, Brazil.
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Tirada N, Aujero M, Khorjekar G, Richards S, Chopra J, Dromi S, Ioffe O. Breast Cancer Tissue Markers, Genomic Profiling, and Other Prognostic Factors: A Primer for Radiologists. Radiographics 2018; 38:1902-1920. [PMID: 30312139 DOI: 10.1148/rg.2018180047] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
An understanding of prognostic factors in breast cancer is imperative for guiding patient care. Increased tumor size and more advanced nodal status are established independent prognostic factors of poor outcomes and are incorporated into the American Joint Committee on Cancer (AJCC) TNM (primary tumor, regional lymph node, distant metastasis) staging system. However, other factors including imaging findings, histologic evaluation results, and molecular findings can have a direct effect on a patient's prognosis, including risk of recurrence and relative survival. Several microarray panels for gene profiling of tumors are approved by the U.S. Food and Drug Administration and endorsed by the American Society of Clinical Oncology. This article highlights prognostic factors currently in use for individualizing and guiding breast cancer therapy and is divided into four sections. The first section addresses patient considerations, in which modifiable and nonmodifiable prognostic factors including age, race and ethnicity, and lifestyle factors are discussed. The second part is focused on imaging considerations such as multicentric and/or multifocal disease, an extensive intraductal component, and skin or chest wall involvement and their effect on treatment and prognosis. The third section is about histopathologic findings such as the grade and presence of lymphovascular invasion. Last, tumor biomarkers and tumor biology are discussed, namely hormone receptors, proliferative markers, and categorization of tumors into four recognized molecular subtypes including luminal A, luminal B, human epidermal growth factor receptor 2-enriched, and triple-negative tumors. By understanding the clinical effect of these prognostic factors, radiologists, along with a multidisciplinary team, can use these tools to achieve individualized patient care and to improve patient outcomes. ©RSNA, 2018.
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Affiliation(s)
- Nikki Tirada
- From the Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, 22 S Greene St, Baltimore, MD 21201
| | - Mireille Aujero
- From the Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, 22 S Greene St, Baltimore, MD 21201
| | - Gauri Khorjekar
- From the Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, 22 S Greene St, Baltimore, MD 21201
| | - Stephanie Richards
- From the Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, 22 S Greene St, Baltimore, MD 21201
| | - Jasleen Chopra
- From the Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, 22 S Greene St, Baltimore, MD 21201
| | - Sergio Dromi
- From the Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, 22 S Greene St, Baltimore, MD 21201
| | - Olga Ioffe
- From the Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, 22 S Greene St, Baltimore, MD 21201
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24
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Tyuryumina EY, Neznanov AA. Consolidated mathematical growth model of the primary tumor and secondary distant metastases of breast cancer (CoMPaS). PLoS One 2018; 13:e0200148. [PMID: 29979733 PMCID: PMC6034839 DOI: 10.1371/journal.pone.0200148] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2018] [Accepted: 06/20/2018] [Indexed: 11/28/2022] Open
Abstract
The goal of this research is to improve the accuracy of predicting the breast cancer (BC) process using the original mathematical model referred to as CoMPaS. The CoMPaS is the original mathematical model and the corresponding software built by modelling the natural history of the primary tumor (PT) and secondary distant metastases (MTS), it reflects the relations between the PT and MTS. The CoMPaS is based on an exponential growth model and consists of a system of determinate nonlinear and linear equations and corresponds to the TNM classification. It allows us to calculate the different growth periods of PT and MTS: 1) a non-visible period for PT, 2) a non-visible period for MTS, and 3) a visible period for MTS. The CoMPaS has been validated using 10-year and 15-year survival clinical data considering tumor stage and PT diameter. The following are calculated by CoMPaS: 1) the number of doublings for the non-visible and visible growth periods of MTS and 2) the tumor volume doubling time (days) for the non-visible and visible growth periods of MTS. The diameters of the PT and secondary distant MTS increased simultaneously. In other words, the non-visible growth period of the secondary distant MTS shrinks, leading to a decrease of the survival of patients with breast cancer. The CoMPaS correctly describes the growth of the PT for patients at the T1aN0M0, T1bN0M0, T1cN0M0, T2N0M0 and T3N0M0 stages, who does not have MTS in the lymph nodes (N0). Additionally, the CoMPaS helps to consider the appearance and evolution period of secondary distant MTS (M1). The CoMPaS correctly describes the growth period of PT corresponding to BC classification (parameter T), the growth period of secondary distant MTS and the 10-15-year survival of BC patients considering the BC stage (parameter M).
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Affiliation(s)
- Ella Ya. Tyuryumina
- International Laboratory for Intelligent Systems and Structural Analysis, Faculty of Computer science, National Research University Higher School of Economics, Moscow, Russia
- * E-mail:
| | - Alexey A. Neznanov
- International Laboratory for Intelligent Systems and Structural Analysis, Faculty of Computer science, National Research University Higher School of Economics, Moscow, Russia
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25
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Kong AL, Nattinger AB, McGinley E, Pezzin LE. The relationship between patient and tumor characteristics, patterns of breast cancer care, and 5-year survival among elderly women with incident breast cancer. Breast Cancer Res Treat 2018; 171:477-488. [DOI: 10.1007/s10549-018-4837-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 05/25/2018] [Indexed: 11/29/2022]
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26
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Vallacha A, Haider G, Raja W, Kumar D. Quality of Breast Cancer Surgical Pathology Reports. Asian Pac J Cancer Prev 2018; 19:853-858. [PMID: 29582645 PMCID: PMC5980866 DOI: 10.22034/apjcp.2018.19.3.853] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background: Surgical pathology reporting of breast cancer is needed for appropriate staging and treatment decisions.
We here checked the quality of surgical pathology reports of breast cancer from different laboratories of Karachi,
Pakistan. Methods: One hundred surgical pathology reports from ten different laboratories of Karachi were assessed
for documentation of elements against a checklist adopted from the CAP guideline over a period of six months from
January, 2017 to June, 2017 in the Oncology Department, Jinnah Postgraduate Medical Centre, Karachi. Results: Out
of 100 reports, clinical information was documented in 68%, type of procedure and lymph node sampling in 84%
and 34% respectively. Specimen laterality was mentioned in 90%, tumor site in 44%, tumor size in 92%, focality in
40%, histological type in 96%, grade in 87%, LCIS in 19%, DCIS in 83%, size of DCIS in 19%, architectural pattern
in 26% , nuclear grade in 17%, necrosis in 14%, excision margin status in 91%, invasive component in 83%, DCIS in
16%, lymph node status in 91% with positive nodes in 56%, size of macro met in 54%, extranodal involvement in 48%,
lymph vascular invasion in 86%, treatment effects in 31%, and pathology reporting with TNM in 57%. Conclusion:
This study shows that the quality of surgical pathology reports for breast cancer in Karachi is not satisfactory. Therefore,
there is great need to create awareness among histopathologists regarding the importance of accurate breast cancer
surgical pathology reporting and to introduce a standardized checklist according to international guidelines for better
treatment planning.
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Affiliation(s)
- Anita Vallacha
- Department of Oncology, Jinnah Postgraduate Medical Center, Karachi, Sindh, Pakistan.
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Yoo TK, Chang JM, Shin HC, Han W, Noh DY, Moon HG. An objective nodal staging system for breast cancer patients undergoing neoadjuvant systemic treatment. BMC Cancer 2017; 17:389. [PMID: 28569197 PMCID: PMC5452603 DOI: 10.1186/s12885-017-3380-8] [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] [Received: 12/28/2016] [Accepted: 05/22/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In this study, we aimed to develop an objective staging system to determine the degree of nodal metastasis in breast cancer patients undergoing neoadjuvant systemic treatment (NST). METHODS We reviewed the pretreatment computed tomography (CT) images of 392 breast cancer patients who received NST. The association between the patterns of the enlarged regional lymph nodes and treatment outcome was analyzed. RESULTS In the development cohort of 260 patients, 88 (33.8%) patients experienced tumor recurrence and had a significantly higher number of enlarged lymph nodes on the pretreatment CT compared to patients with no recurrence. When patients were classified according to the numbers and locations of enlarged lymph nodes on pretreatment CT, the number of lymph nodes larger than 1 cm was most significantly associated with tumor recurrence. The accuracy of the CT-based nodal staging system was validated in an independent cohort of 132 patients. The presence of the enlarged supraclavicular nodes was associated with worse outcome, but the effect seemed to originate from the accompanied extensive axillary nodal burden. The prognostic effect of the objectively measured axillary nodal metastasis was more pronounced in hormone receptor-negative tumors. CONCLUSIONS We have developed and validated an objective method of nodal staging in breast cancer patients who undergo NST based on the number of enlarged axillary lymph nodes. Our system can improve the current subjective approach, which uses physical examination alone.
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Affiliation(s)
- Tae-Kyung Yoo
- Department of Surgery, Seoul National University College of Medicine, 03080, 101 Daehak-ro, Jongno-gu, Seoul, Republic of Korea.,Laboratory of Breast Cancer Biology, Cancer Research Institute, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, Republic of Korea.,Present address: Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, Republic of Korea
| | - Jung Min Chang
- Department of Radiology, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, Republic of Korea
| | - Hee-Chul Shin
- Department of Surgery, Chung-Ang University College of Medicine, 84 Heukseouk-ro, Dongjak-gu, Seoul, Republic of Korea
| | - Wonshik Han
- Department of Surgery, Seoul National University College of Medicine, 03080, 101 Daehak-ro, Jongno-gu, Seoul, Republic of Korea.,Laboratory of Breast Cancer Biology, Cancer Research Institute, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, Republic of Korea
| | - Dong-Young Noh
- Department of Surgery, Seoul National University College of Medicine, 03080, 101 Daehak-ro, Jongno-gu, Seoul, Republic of Korea.,Laboratory of Breast Cancer Biology, Cancer Research Institute, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, Republic of Korea
| | - Hyeong-Gon Moon
- Department of Surgery, Seoul National University College of Medicine, 03080, 101 Daehak-ro, Jongno-gu, Seoul, Republic of Korea. .,Laboratory of Breast Cancer Biology, Cancer Research Institute, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, Republic of Korea.
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Rößler AC, Kalender W, Kolditz D, Steiding C, Ruth V, Preuss C, Peter SC, Brehm B, Hammon M, Schulz-Wendtland R, Wenkel E. Performance of Photon-Counting Breast Computed Tomography, Digital Mammography, and Digital Breast Tomosynthesis in Evaluating Breast Specimens. Acad Radiol 2017; 24:184-190. [PMID: 27888024 DOI: 10.1016/j.acra.2016.09.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 09/21/2016] [Accepted: 09/25/2016] [Indexed: 10/20/2022]
Abstract
RATIONALE AND OBJECTIVES This study compared a novel photon-counting breast computed tomography (pcBCT) system with digital mammography (DM) and digital breast tomosynthesis (DBT) systems. For this reason, surgical specimens were examined with all three techniques and rated by three observers. MATERIALS AND METHODS A total of 30 surgical specimens were investigated with DM, DBT, and pcBCT; the associated images were shown to three experienced radiologists. Findings (22 microcalcifications and 23 mass lesions) were recorded and compared to the results of the pathological examination. Sensitivity and specificity for detection of microcalcifications and lesions were calculated and displayed using receiver operating characteristic curves. RESULTS Sensitivity for microcalcifications was 82% for DM, 70% for DBT, and 85% for pcBCT. Specificity for microcalcifications was 71% for DM, 75% for DBT, and 83% for pcBCT. Sensitivity for lesions was 45% for DM, 62% for DBT, and 65% for pcBCT. Specificity for lesions was 76% for DM, 62% for DBT, and 76% for pcBCT. CONCLUSIONS pcBCT showed a comparable or superior performance compared to the clinically approved DM and DBT systems. Mass lesion detectability can be increased further by the use of contrast media.
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Paula LM, De Moraes LHF, Do Canto AL, Dos Santos L, Martin AA, Rogatto SR, De Azevedo Canevari R. Analysis of molecular markers as predictive factors of lymph node involvement in breast carcinoma. Oncol Lett 2017; 13:488-496. [PMID: 28123587 DOI: 10.3892/ol.2016.5438] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 09/15/2016] [Indexed: 11/06/2022] Open
Abstract
Nodal status is the most significant independent prognostic factor in breast cancer. Identification of molecular markers would allow stratification of patients who require surgical assessment of lymph nodes from the large numbers of patients for whom this surgical procedure is unnecessary, thus leading to a more accurate prognosis. However, up to now, the reported studies are preliminary and controversial, and although hundreds of markers have been assessed, few of them have been used in clinical practice for treatment or prognosis in breast cancer. The purpose of the present study was to determine whether protein phosphatase Mg2+/Mn2+ dependent 1D, β-1,3-N-acetylglucosaminyltransferase, neural precursor cell expressed, developmentally down-regulated 9, prohibitin, phosphoinositide-3-kinase regulatory subunit 5 (PIK3R5), phosphatidylinositol-5-phosphate 4-kinase type IIα, TRF1-interacting ankyrin-related ADP-ribose polymerase 2, BCL2 associated agonist of cell death, G2 and S-phase expressed 1 and PAX interacting protein 1 genes, described as prognostic markers in breast cancer in a previous microarray study, are also predictors of lymph node involvement in breast carcinoma Reverse transcription-quantitative polymerase chain reaction analysis was performed on primary breast tumor tissues from women with negative lymph node involvement (n=27) compared with primary tumor tissues from women with positive lymph node involvement (n=23), and was also performed on primary tumors and paired lymph node metastases (n=11). For all genes analyzed, only the PIK3R5 gene exhibited differential expression in samples of primary tumors with positive lymph node involvement compared with primary tumors with negative lymph node involvement (P=0.0347). These results demonstrate that the PIK3R5 gene may be considered predictive of lymph node involvement in breast carcinoma. Although the other genes evaluated in the present study have been previously characterized to be involved with the development of distant metastases, they did not have predictive potential.
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Affiliation(s)
- Luciana Marques Paula
- Laboratory of Molecular Biology of Cancer, Institute of Research and Development (IP&D), University of Vale do Paraíba, São José dos Campos, 12244-000 São Paulo, Brazil
| | | | - Abaeté Leite Do Canto
- Center for Diagnostic Medicine, Pathology and Cytology (CIPAX), São José dos Campos, 12243-000 São Paulo, Brazil
| | - Laurita Dos Santos
- Laboratory of Biomedical Vibrational Spectroscopy, Institute of Research and Development (IP&D), University of Vale do Paraíba, São José dos Campos, 12244-000 São Paulo, Brazil
| | - Airton Abrahão Martin
- Laboratory of Biomedical Vibrational Spectroscopy, Institute of Research and Development (IP&D), University of Vale do Paraíba, São José dos Campos, 12244-000 São Paulo, Brazil
| | - Silvia Regina Rogatto
- NeoGene Laboratory, Urology Department, Sao Paulo State University, Botucatu, 18618-000 São Paulo, Brazil
| | - Renata De Azevedo Canevari
- Laboratory of Molecular Biology of Cancer, Institute of Research and Development (IP&D), University of Vale do Paraíba, São José dos Campos, 12244-000 São Paulo, Brazil
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Rahimi F, Karimi J, Goodarzi MT, Saidijam M, Khodadadi I, Razavi ANE, Nankali M. Overexpression of receptor for advanced glycation end products (RAGE) in ovarian cancer. Cancer Biomark 2017; 18:61-68. [DOI: 10.3233/cbm-160674] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Farzaneh Rahimi
- Department of Biochemistry, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Jamshid Karimi
- Department of Biochemistry, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mohammad Taghi Goodarzi
- Department of Biochemistry, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Massoud Saidijam
- Research Center for Molecular Medicine, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Iraj Khodadadi
- Department of Biochemistry, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Amir Nader Emami Razavi
- Iran National Tumor Bank, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Nankali
- Department of Biochemistry, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
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Mir MA, Manzoor F, Singh B, Raja W, Jeelani S, Zargar WA, Ahmad FF, Ko AZ, Sofi IA. Clinicopathological Profile of Breast Cancer Patients at a Tertiary Care Hospital in Kashmir Valley. ACTA ACUST UNITED AC 2017. [DOI: 10.4236/ss.2017.83018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Ivanović V, Dedović-Tanić N, Milovanović Z, Lukić S, Nikolić S, Baltić V, Stojiljković B, Demajo M, Mandušić V, Dimitrijević B. Case with triple-negative breast cancer shows overexpression of both cFOS and TGF-β1 in node-positive tissue. Per Med 2016; 13:523-530. [PMID: 29754549 DOI: 10.2217/pme-2016-0032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
We present herein a case report style article on a rare advanced triple-negative breast cancer (TNBC) patient with 6-month disease-free interval, and 10-month overall survival. Our results demonstrate that the poor clinical outcome of this patient was associated with pronounced, more than fivefold higher, overexpression of both cFOS and TGF-β1 proteins in its metastatic nodal tissue extracts, when compared with the values of the two non-TNBC controls (with 'zero' disease-free interval and overall survival). This original observation suggests, for the first time, that both the cFOS and TGF-β1 may be considered as a pair of biomarkers for an early assessment of poor prognosis for TNBC patients. The possible clinical implication of this observation is discussed.
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Affiliation(s)
- Vesna Ivanović
- Department for Radiobiology & Molecular Genetics, Institute of Nuclear Sciences 'Vinča', University of Belgrade, Belgrade, Serbia
| | - Nasta Dedović-Tanić
- Department for Radiobiology & Molecular Genetics, Institute of Nuclear Sciences 'Vinča', University of Belgrade, Belgrade, Serbia
| | | | - Silvana Lukić
- Institute of Oncology & Radiology of Serbia, Belgrade, Serbia
| | - Srdjan Nikolić
- Institute of Oncology & Radiology of Serbia, Belgrade, Serbia
| | | | | | - Miroslav Demajo
- Department for Radiobiology & Molecular Genetics, Institute of Nuclear Sciences 'Vinča', University of Belgrade, Belgrade, Serbia
| | - Vesna Mandušić
- Department for Radiobiology & Molecular Genetics, Institute of Nuclear Sciences 'Vinča', University of Belgrade, Belgrade, Serbia
| | - Bogomir Dimitrijević
- Department for Radiobiology & Molecular Genetics, Institute of Nuclear Sciences 'Vinča', University of Belgrade, Belgrade, Serbia
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Nankali M, Karimi J, Goodarzi MT, Saidijam M, Khodadadi I, Razavi ANE, Rahimi F. Increased Expression of the Receptor for Advanced Glycation End-Products (RAGE) Is Associated with Advanced Breast Cancer Stage. Oncol Res Treat 2016; 39:622-628. [PMID: 27710974 DOI: 10.1159/000449326] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 08/17/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND The receptor for advanced glycation end-products (RAGE) is a multiligand transmembrane receptor that is overexpressed in various pathological conditions including cancers. However, the expression pattern of RAGE in breast cancer tumors is still not completely clear. METHODS In this study, we investigated the expression levels of RAGE in 25 fresh-frozen breast cancer samples and corresponding noncancerous tissue samples collected from breast cancer patients, by real-time polymerase chain reaction (PCR). Additionally, we performed immunohistochemistry on breast cancer specimens. RESULTS The results indicate a high expression of the RAGE-encoding gene in the cancerous tissues. RAGE expression at the mRNA and protein levels was statistically significantly up-regulated in advanced-stage and triple-negative breast tumors and node-positive tissues compared with other tissues (p < 0.001). A significant association between RAGE expression and tumor size was observed (p = 0.029). CONCLUSIONS Overexpression of RAGE in advanced-stage tumors may be a useful biomarker for diagnosis and the prediction of breast cancer progression.
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Affiliation(s)
- Maryam Nankali
- Department of Biochemistry, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
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Ibrahim SA, El-Ghonaimy EA, Hassan H, Mahana N, Mahmoud MA, El-Mamlouk T, El-Shinawi M, Mohamed MM. Hormonal-receptor positive breast cancer: IL-6 augments invasion and lymph node metastasis via stimulating cathepsin B expression. J Adv Res 2016; 7:661-70. [PMID: 27482469 PMCID: PMC4957008 DOI: 10.1016/j.jare.2016.06.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2016] [Revised: 06/18/2016] [Accepted: 06/24/2016] [Indexed: 01/17/2023] Open
Abstract
Hormonal-receptor positive (HRP) breast cancer patients with positive metastatic axillary lymph nodes are characterized by poor prognosis and increased mortality rate. The mechanisms by which cancer cells invade lymph nodes have not yet been fully explored. Several studies have shown that expression of IL-6 and the proteolytic enzyme cathepsin B (CTSB) was associated with breast cancer poor prognosis. In the present study, the effect of different concentrations of recombinant human IL-6 on the invasiveness capacity of HRP breast cancer cell line MCF-7 was tested using an in vitro invasion chamber assay. The impact of IL-6 on expression and activity of CTSB was also investigated. IL-6 treatment promoted the invasiveness potential of MCF-7 cells in a dose-dependent manner. Furthermore, MCF-7 cells displayed elevated CTSB expression and activity associated with loss of E-cadherin and upregulation of vimentin protein levels upon IL-6 stimulation. To validate these results in vivo, the level of expression of IL-6 and CTSB in the carcinoma tissues of HRP-breast cancer patients with positive and negative axillary metastatic lymph nodes (pLNs and nLNs) was assessed. Western blot and immunohistochemical staining data showed that expression of IL-6 and CTSB was higher in carcinoma tissues in HRP-breast cancer with pLNs than those with nLNs patients. ELISA results showed carcinoma tissues of HRP-breast cancer with pLNs exhibited significantly elevated IL-6 protein levels by approximately 2.8-fold compared with those with nLNs patients (P < 0.05). Interestingly, a significantly positive correlation between IL-6 and CTSB expression was detected in clinical samples of HRP-breast cancer patients with pLNs (r = 0.78, P < 0.01). Collectively, this study suggests that IL-6-induced CTSB may play a role in lymph node metastasis, and that may possess future therapeutic implications for HRP-breast cancer patients with pLNs. Further studies are necessary to fully identify IL-6/CTSB axis in different molecular subtypes of breast cancer.
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Affiliation(s)
- Sherif A Ibrahim
- Department of Zoology, Faculty of Science, Cairo University, Giza 12613, Egypt
| | - Eslam A El-Ghonaimy
- Department of Zoology, Faculty of Science, Cairo University, Giza 12613, Egypt
| | - Hebatallah Hassan
- Department of Zoology, Faculty of Science, Cairo University, Giza 12613, Egypt
| | - Noha Mahana
- Department of Zoology, Faculty of Science, Cairo University, Giza 12613, Egypt
| | | | - Tahani El-Mamlouk
- Department of Zoology, Faculty of Science, Cairo University, Giza 12613, Egypt
| | - Mohamed El-Shinawi
- Department of General Surgery, Faculty of Medicine, Ain Shams University, Cairo 11566, Egypt
| | - Mona M Mohamed
- Department of Zoology, Faculty of Science, Cairo University, Giza 12613, Egypt
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Rafia R, Brennan A, Madan J, Collins K, Reed MWR, Lawrence G, Robinson T, Greenberg D, Wyld L. Modeling the Cost-Effectiveness of Alternative Upper Age Limits for Breast Cancer Screening in England and Wales. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2016; 19:404-12. [PMID: 27325332 DOI: 10.1016/j.jval.2015.06.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Revised: 06/02/2015] [Accepted: 06/10/2015] [Indexed: 06/06/2023]
Abstract
BACKGROUND Currently in the United Kingdom, the National Health Service (NHS) Breast Screening Programme invites all women for triennial mammography between the ages of 47 and 73 years (the extension to 47-50 and 70-73 years is currently examined as part of a randomized controlled trial). The benefits and harms of screening in women 70 years and older, however, are less well documented. OBJECTIVES The aim of this study was to examine whether extending screening to women older than 70 years would represent a cost-effective use of NHS resources and to identify the upper age limit at which screening mammography should be extended in England and Wales. METHODS A mathematical model that allows the impact of screening policies on cancer diagnosis and subsequent management to be assessed was built. The model has two parts: a natural history model of the progression of breast cancer up to discovery and a postdiagnosis model of treatment, recurrence, and survival. The natural history model was calibrated to available data and compared against published literature. The management of breast cancer at diagnosis was taken from registry data and valued using official UK tariffs. RESULTS The model estimated that screening would lead to overdiagnosis in 6.2% of screen-detected women at the age of 72 years, increasing up to 37.9% at the age of 90 years. Under commonly quoted willingness-to-pay thresholds in the United Kingdom, our study suggests that an extension to screening up to the age of 78 years represents a cost-effective strategy. CONCLUSIONS This study provides encouraging findings to support the extension of the screening program to older ages and suggests that further extension of the UK NHS Breast Screening Programme up to age 78 years beyond the current upper age limit of 73 years could be potentially cost-effective according to current NHS willingness-to-pay thresholds.
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Affiliation(s)
- Rachid Rafia
- School of Health and Related Research, Health Economics and Decision Science, University of Sheffield, Sheffield, UK.
| | - Alan Brennan
- School of Health and Related Research, Health Economics and Decision Science, University of Sheffield, Sheffield, UK
| | - Jason Madan
- Division of Health Sciences, Warwick Medical School, Coventry, UK
| | - Karen Collins
- Faculty of Health and Wellbeing, Sheffield Hallam University, Sheffield, UK
| | - Malcolm W R Reed
- Brighton and Sussex Medical School, University of Sussex, Brighton, UK
| | - Gill Lawrence
- Breast Screening QA Reference Centre, West Midlands Cancer Intelligence Unit, Public Health Building, The University of Birmingham, Birmingham, UK
| | - Thompson Robinson
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
| | - David Greenberg
- Eastern Cancer Registration and Information Centre (ECRIC), Unit C, Cambridge, UK
| | - Lynda Wyld
- Academic Unit of Surgical Oncology, Royal Hallamshire Hospital, University of Sheffield, Sheffield, UK
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Zhu Y, Bai K, Yu J, Guo M. Association Between Histone Methyltransferase hSETD1A and Prognosis in Patients With Triple-Negative Breast Cancer After Surgery: A Retrospective Study in the Chinese Female Population. Medicine (Baltimore) 2016; 95:e3783. [PMID: 27227949 PMCID: PMC4902373 DOI: 10.1097/md.0000000000003783] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Breast cancer, the most common cancer in women, is a serious public health issue. Triple-negative breast cancer (TNBC), which lacks expression of the estrogen receptor (ER), progesterone receptor, and human epidermal growth factor receptor 2, accounts for ∼15% of breast cancer cases. Treatment of TNBC patients has proven difficult because of the lack of expression of hormone receptors. We conducted a retrospective study to investigate the prognostic impact of histone methyltransferase, hSETD1A, on overall survival in TNBC cases after surgery. In total, 159 TNBC cases were enrolled and clinicopathological characteristics were obtained from medical records. hSETD1A status of each subject was determined using immunohistochemistry. The chi-squared test was used to compare 5-year overall survival rates of all subjects according to clinical characteristics, and both univariate and multivariate analyses were conducted to calculate the hazard ratios and 95% confidence intervals. Advanced tumor-node-metastasis stage stage, larger tumor size, vascular invasion, metastasis in the initial diagnosis, and hSETD1A expression were correlated with worse outcome. Among all factors identified, metastasis in the initial diagnosis had the greatest impact on survival. The results indicated that hSETD1A positivity was correlated with shorter survival among TNBC cases, suggesting it may serve as a prognostic biomarker for patients with TNBC.
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Affiliation(s)
- YanYan Zhu
- From the Department of General Surgery (YZ, JY), Jinshan Hospital, Fudan University, Shanghai, China; Department of Hepatobiliary Surgery (KB), Fuzong Clinical College, Fujian Medical University, Fuzhou City, Fujian Province, China; and Department of Breast Surgery (MG), Affiliated Hospital of Hebei University of Engineering, Handan, Hebei Province, China
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Massat NJ, Sasieni PD, Tataru D, Parmar D, Cuzick J, Duffy SW. Explaining the Better Prognosis of Screening-Exposed Breast Cancers: Influence of Tumor Characteristics and Treatment. Cancer Epidemiol Biomarkers Prev 2016; 25:479-87. [PMID: 26646361 DOI: 10.1158/1055-9965.epi-15-0804] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Accepted: 11/01/2015] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND In England, population mammographic screening has been offered to women for over 20 years. Overall decrease in breast cancer mortality rates and improvements in cancer awareness and organization of medical care over this period call for a more current evaluation of the mediators behind the better prognosis of screening-exposed breast cancers. METHODS A case-control study was conducted within the English National Breast Screening Program. Women who died from primary breast cancer in 2008 to 2009 were matched (by year of birth, screening invitation, and area) to controls that received a diagnosis of invasive breast cancer at the time of the case diagnosis but survived the case death. Data were analyzed by unconditional logistic regression with adjustment for matching factors. RESULTS The unadjusted OR for dying from breast cancer associated with ever having attended breast screening was 0.44 [95% confidence interval (CI), 0.33-0.58]. After adjustment for lead time, overdiagnosis, and self-selection, the OR increased to 0.69 (95% CI, 0.50-0.94). Adjusting for tumor size, lymph node status, stage, grade, histopathology, and laterality accounted for all the screening effect (OR, 1.00; 95% CI, 0.71-1.40). Further adjustment for treatment factors only had a minimal impact on the OR (OR, 1.02; 95% CI, 0.72-1.45). CONCLUSIONS Our results suggest that earlier diagnosis, as reflected by tumor characteristics, remains the major mediator of the improvement in breast cancer survival due to participation in mammographic screening. IMPACT Mammographic screening continues to prevent breast cancer-related deaths in the epoch of adjuvant systemic therapy.
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Affiliation(s)
- Nathalie J Massat
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, United Kingdom
| | - Peter D Sasieni
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, United Kingdom
| | - Daniela Tataru
- National Cancer Intelligence Network (NCIN), Public Health England, London, United Kingdom
| | - Dharmishta Parmar
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, United Kingdom
| | - Jack Cuzick
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, United Kingdom
| | - Stephen W Duffy
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, United Kingdom.
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Barrdahl M, Canzian F, Lindström S, Shui I, Black A, Hoover RN, Ziegler RG, Buring JE, Chanock SJ, Diver WR, Gapstur SM, Gaudet MM, Giles GG, Haiman C, Henderson BE, Hankinson S, Hunter DJ, Joshi AD, Kraft P, Lee IM, Le Marchand L, Milne RL, Southey MC, Willett W, Gunter M, Panico S, Sund M, Weiderpass E, Sánchez MJ, Overvad K, Dossus L, Peeters PH, Khaw KT, Trichopoulos D, Kaaks R, Campa D. Association of breast cancer risk loci with breast cancer survival. Int J Cancer 2015; 137:2837-45. [PMID: 25611573 DOI: 10.1002/ijc.29446] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Revised: 11/27/2014] [Accepted: 12/04/2014] [Indexed: 01/23/2023]
Abstract
The survival of breast cancer patients is largely influenced by tumor characteristics, such as TNM stage, tumor grade and hormone receptor status. However, there is growing evidence that inherited genetic variation might affect the disease prognosis and response to treatment. Several lines of evidence suggest that alleles influencing breast cancer risk might also be associated with breast cancer survival. We examined the associations between 35 breast cancer susceptibility loci and the disease over-all survival (OS) in 10,255 breast cancer patients from the National Cancer Institute Breast and Prostate Cancer Cohort Consortium (BPC3) of which 1,379 died, including 754 of breast cancer. We also conducted a meta-analysis of almost 35,000 patients and 5,000 deaths, combining results from BPC3 and the Breast Cancer Association Consortium (BCAC) and performed in silico analyses of SNPs with significant associations. In BPC3, the C allele of LSP1-rs3817198 was significantly associated with improved OS (HRper-allele =0.70; 95% CI: 0.58-0.85; ptrend = 2.84 × 10(-4) ; HRheterozygotes = 0.71; 95% CI: 0.55-0.92; HRhomozygotes = 0.48; 95% CI: 0.31-0.76; p2DF = 1.45 × 10(-3) ). In silico, the C allele of LSP1-rs3817198 was predicted to increase expression of the tumor suppressor cyclin-dependent kinase inhibitor 1C (CDKN1C). In the meta-analysis, TNRC9-rs3803662 was significantly associated with increased death hazard (HRMETA =1.09; 95% CI: 1.04-1.15; ptrend = 6.6 × 10(-4) ; HRheterozygotes = 0.96 95% CI: 0.90-1.03; HRhomozygotes = 1.21; 95% CI: 1.09-1.35; p2DF =1.25 × 10(-4) ). In conclusion, we show that there is little overlap between the breast cancer risk single nucleotide polymorphisms (SNPs) identified so far and the SNPs associated with breast cancer prognosis, with the possible exceptions of LSP1-rs3817198 and TNRC9-rs3803662.
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Affiliation(s)
- Myrto Barrdahl
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Federico Canzian
- Genomic Epidemiology Group, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Sara Lindström
- Program in Genetic Epidemiology and Statistical Genetics, Department of Epidemiology, Harvard School of Public Health, Boston, MA
| | - Irene Shui
- Department of Epidemiology, Harvard School of Public Health, Boston, MA
| | - Amanda Black
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Robert N Hoover
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Regina G Ziegler
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Julie E Buring
- Department of Ambulatory Care and Prevention, Harvard Medical School, Boston, MA.,Divisions of Preventive Medicine and Aging, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.,Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Stephen J Chanock
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD.,Core Genotyping Facility Frederick National Laboratory for Cancer Research, Gaithersburg, MD
| | - W Ryan Diver
- Epidemiology Research Program, American Cancer Society, NW Atlanta, GA
| | - Susan M Gapstur
- Epidemiology Research Program, American Cancer Society, NW Atlanta, GA
| | - Mia M Gaudet
- Epidemiology Research Program, American Cancer Society, NW Atlanta, GA
| | - Graham G Giles
- Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, VIC, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, VIC, Australia
| | - Christopher Haiman
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Brian E Henderson
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Susan Hankinson
- Department of Epidemiology, Harvard School of Public Health, Boston, MA.,Department of Epidemiology, University of Massachusetts-Amherst School of Public Health and Health Sciences, Amherst, MA.,Cancer Research Center, Brigham and Women's Hospital, Boston, MA
| | - David J Hunter
- Program in Genetic Epidemiology and Statistical Genetics, Department of Epidemiology, Harvard School of Public Health, Boston, MA
| | - Amit D Joshi
- Department of Epidemiology, Harvard School of Public Health, Boston, MA
| | - Peter Kraft
- Department of Epidemiology, Harvard School of Public Health, Boston, MA
| | - I-Min Lee
- Department of Epidemiology, Harvard School of Public Health, Boston, MA.,Department of Medicine, Harvard Medical School, Boston, MA
| | - Loic Le Marchand
- Cancer Research Center of Hawaii, University of Hawaii, Honolulu, HI
| | - Roger L Milne
- Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, VIC, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, VIC, Australia
| | | | - Walter Willett
- Department of Nutrition, Harvard School of Public Health, Boston, MA
| | - Marc Gunter
- Department of Epidemiology Biostatistics, School of Public Health, Imperial College, South Kensington Campus, London, United Kingdom
| | | | - Malin Sund
- Department of Surgical and Perioperative Sciences, Surgery, Umeå University, Sweden
| | - Elisabete Weiderpass
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, Norway.,Department of Research, Cancer Registry of Norway, Oslo, Norway.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden.,Samfundet Folkhälsan, Helsinki, Finland
| | - María-José Sánchez
- Escuela Andaluza De Salud Pública, Instituto De Investigación Biosanitaria Ibs, Granada, Hospitales Universitarios De Granada/Universidad De Granada, Spain.,CIBER De Epidemiología Y Salud Pública (CIBERESP), Barcelona, Spain
| | - Kim Overvad
- Department of Public Health, Section for Epidemiology, Aarhus University, Denmark
| | - Laure Dossus
- INSERM, Centre for Research in Epidemiology and Population Health (CESP), U1018, Nutrition, Hormones and Women's Health Team, Villejuif, France.,University of Paris Sud, UMRS 1018, Villejuif, France.,IGR, Villejuif, France
| | - Petra H Peeters
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands.,MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom
| | - Kay-Tee Khaw
- Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, United Kingdom
| | - Dimitrios Trichopoulos
- Department of Epidemiology, Harvard School of Public Health, Boston, MA.,Bureau of Epidemiologic Research, Academy of Athens, Greece.,Hellenic Health Foundation, Athens, Greece
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Daniele Campa
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
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Rummel S, Hueman MT, Costantino N, Shriver CD, Ellsworth RE. Tumour location within the breast: Does tumour site have prognostic ability? Ecancermedicalscience 2015; 9:552. [PMID: 26284116 PMCID: PMC4531129 DOI: 10.3332/ecancer.2015.552] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Indexed: 11/06/2022] Open
Abstract
Introduction Tumour location within the breast varies with the highest frequency in the upper outer quadrant (UOQ) and lowest frequency in the lower inner quadrant (LIQ). Whether tumour location is prognostic is unclear. To determine whether tumour location is prognostic, associations between tumour site and clinicopathological characteristics were evaluated. Materials and Methods All patients enrolled in the Clinical Breast Care Project whose tumour site—UOQ, upper inner quadrant (UIQ), central, LIQ, lower outer quadrant (LOQ)—was determined by a single, dedicated breast pathologist were included in this study. Patients with multicentric disease (n = 122) or tumours spanning multiple quadrants (n = 381) were excluded from further analysis. Clinicopathological characteristics were analysed using chi-square tests for univariate analysis with multivariate analysis performed using principal components analysis (PCA) and multiple logistic regression. Significance was defined as P < 0.05. Results Of the 980 patients with defined tumour location, 30 had bilateral disease. Tumour location in the UOQ (51.5%) was significantly higher than in the UIQ (15.6%), LOQ (14.2%), central (10.6%), or LIQ (8.1%). Tumours in the central quadrant were significantly more likely to have higher tumour stage (P = 0.003) and size (P < 0.001), metastatic lymph nodes (P < 0.001), and mortality (P = 0.011). After multivariate analysis, only tumour size and lymph node status remained significantly associated with survival. Conclusions Evaluation of tumour location as a prognostic factor revealed that although tumours in the central region are associated with less favourable outcome, these associations are not independent of location but rather driven by larger tumour size. Tumours in the central region are more difficult to detect mammographically, resulting in larger tumour size at diagnosis and thus less favourable prognosis. Together, these data demonstrate that tumour location is not an independent prognostic factor.
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Affiliation(s)
- Seth Rummel
- Clinical Breast Care Project, Windber Research Institute, Windber, Pennsylvania 15963, USA
| | - Matthew T Hueman
- Clinical Breast Care Project, Murtha Cancer Centre, Walter Reed National Military Medical Centre, Bethesda, Maryland 20889, USA
| | - Nick Costantino
- Clinical Breast Care Project, Windber Research Institute, Windber, Pennsylvania 15963, USA
| | - Craig D Shriver
- Clinical Breast Care Project, Murtha Cancer Centre, Walter Reed National Military Medical Centre, Bethesda, Maryland 20889, USA
| | - Rachel E Ellsworth
- Clinical Breast Care Project, Murtha Cancer Centre, Walter Reed National Military Medical Centre, Bethesda, Maryland 20889, USA
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Shen S, Zhou Y, Xu Y, Zhang B, Duan X, Huang R, Li B, Shi Y, Shao Z, Liao H, Jiang J, Shen N, Zhang J, Yu C, Jiang H, Li S, Han S, Ma J, Sun Q. A multi-centre randomised trial comparing ultrasound vs mammography for screening breast cancer in high-risk Chinese women. Br J Cancer 2015; 112:998-1004. [PMID: 25668012 PMCID: PMC4366890 DOI: 10.1038/bjc.2015.33] [Citation(s) in RCA: 107] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Revised: 01/09/2015] [Accepted: 01/12/2015] [Indexed: 11/24/2022] Open
Abstract
Background: Chinese women tend to have small and dense breasts and ultrasound is a common method for breast cancer screening in China. However, its efficacy and cost comparing with mammography has not been evaluated in randomised trials. Methods: At 14 breast centres across China during 2008–2010, 13 339 high-risk women aged 30–65 years were randomised to be screened by mammography alone, ultrasound alone, or by both methods at enrolment and 1-year follow-up. Results: A total of 12 519 and 8692 women underwent the initial and second screenings, respectively. Among the 30 cancers (of which 15 were stage 0/I) detected, 5 (0.72/1000) were in the mammography group, 11 (1.51/1000) in the ultrasound group, and 14 (2.02/1000) in the combined group (P=0.12). In the combined group, ultrasound detected all the 14 cancers, whereas mammography detected 8, making ultrasound more sensitive (100 vs 57.1%, P=0.04) with a better diagnostic accuracy (0.999 vs 0.766, P=0.01). There was no difference between mammography and ultrasound in specificity (100 vs 99.9%, P=0.51) and positive predictive value (72.7 vs 70.0% P=0.87). To detect one cancer, the costs of ultrasound, mammography, and combined modality were $7876, $45 253, and $21 599, respectively. Conclusions: Ultrasound is superior to mammography for breast cancer screening in high-risk Chinese women.
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Affiliation(s)
- S Shen
- Department of Breast Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, 1 Shuaifuyuan, Dongcheng District, Beijing 100730, China
| | - Y Zhou
- Department of Breast Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, 1 Shuaifuyuan, Dongcheng District, Beijing 100730, China
| | - Y Xu
- Department of Breast Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, 1 Shuaifuyuan, Dongcheng District, Beijing 100730, China
| | - B Zhang
- Department of Breast Surgery, Cancer Institute & Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, 17 Panjiayuan Nanli, Chaoyang District, Beijing 100021, China
| | - X Duan
- Department of Breast Surgery, First Hospital affiliated to Peking University, 7 Xishenku, Xicheng District, Beijing 100034, China
| | - R Huang
- Department of Breast Surgery, Maternity & Child Care Center of Qinhuangdao, 452 Hongqi Road, Qinhuangdao, Hebei 066000, China
| | - B Li
- Department of Breast Surgery, Beijing Hospital affiliated to Ministry of Health, 1 Dahua Road, Dongcheng District, Beijing 100005, China
| | - Y Shi
- Department of Breast Surgery, ShanXi Traditional Medicine Hospital, 46 Bingzhouxi Street, Taiyuan, Shanxi 030012, China
| | - Z Shao
- Department of Breast Surgery, Cancer Hospital affiliated to Fudan University, 270 Dong'an Road, Xuhui District, Shanghai 200032, China
| | - H Liao
- Department of Breast Surgery, Yingbin Hospital of Yancheng, Yingbinnan Road, Yancheng, Jiangsu 224005, China
| | - J Jiang
- Department of Breast Surgery, Southwest Hospital affiliated to the Third Military Medical University, 30 Tanyanzheng Street, Chongqing, 400038, China
| | - N Shen
- Department of Women Health, Population and Family Planning Service Center of Zhuhai, 2 Jilian Road, Zhuhai, Guangdong 519000, China
| | - J Zhang
- Department of Breast Surgery, Cancer Hospital affiliated to Tianjin Medical University, Huanhuxi Road, Hexi District, Tianjin 300060, China
| | - C Yu
- Department of Breast Surgery, Chinese 307 Hospital affiliated to the People's Liberation Army, 8 Dongda Street, Fengtai District, Beijing 100071, China
| | - H Jiang
- Department of Breast Surgery, Beijing Chaoyang Hospital affiliated to the Capital Medical University, 8 Gongtinan Road, Chaoyang District, Beijing 100043, China
| | - S Li
- Department of Breast Surgery, General Hospital affiliated to Beijing Military Area Command, 5 Nanmencang, Dongcheng District, Beijing 100700, China
| | - S Han
- Department of Epidemiology and Medical Statistics, Institute of Basic Medical Science, Peking Union Medical College, Chinese Academy of Medical Sciences, 1 Shuaifuyuan, Dongcheng District, Beijing 100730, China
| | - J Ma
- Channing Division of Network Medicine, Brigham & Women's Hospital, Harvard Medical School; Department of Epidemiology, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA
| | - Q Sun
- Department of Breast Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, 1 Shuaifuyuan, Dongcheng District, Beijing 100730, China
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Pederson HJ, O'Rourke C, Lyons J, Patrick RJ, Crowe JP, Grobmyer SR. Time-Related Changes in Yield and Harms of Screening Breast Magnetic Resonance Imaging. Clin Breast Cancer 2015; 15:348-52. [PMID: 25749071 DOI: 10.1016/j.clbc.2015.01.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2014] [Accepted: 01/14/2015] [Indexed: 01/16/2023]
Abstract
PURPOSE Breast magnetic resonance imaging (MRI) is accepted as a useful adjunct to screening mammography for women at high risk for breast cancer. Nevertheless, concerns about false-positive findings remain, and data about MRI harms and yields are limited. The aim of this study was to quantify harms and yields of breast MRI over time in a large series of patients. METHODS A retrospective review was performed of patients at increased risk for breast cancer who underwent annual screening digital mammography and MRI from 2007 to 2013. Harms were defined as events not producing a breast cancer diagnosis (ultrasonography [US], imaging-guided core or surgical biopsy procedure, recommendation for short-term follow-up, or a combination). RESULTS Of 350 high-risk patients offered MRI screening, 320 underwent 757 screening MRI procedures over time. The median age at the first MRI was 48 years. All patients met American Cancer Society criteria for annual screening breast MRI. Total harms were highest with the first MRI procedure and decreased with subsequent MRI screening. Of 75 biopsy procedures performed, including 58 US- or MRI-guided core biopsy procedures and 17 surgical biopsy procedures, 6 specimens were found to be malignant, including 2 resulting from biopsy procedures performed based on findings from the first MRI scan, 0 from the second MRI scan, 3 from the third MRI scan, and 1 from the fourth MRI scan. CONCLUSION Among women followed with screening MRI, the number of harms was shown to decrease over time. Breast cancer continued to be detected in MRI studies performed over time. This study demonstrates the utility of MRI screening performed over time in high-risk women.
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Affiliation(s)
- Holly J Pederson
- Section of Surgical Oncology and Breast Services, Department of General Surgery, Cleveland Clinic, Cleveland, OH.
| | - Colin O'Rourke
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH
| | - Joanne Lyons
- Section of Surgical Oncology and Breast Services, Department of General Surgery, Cleveland Clinic, Cleveland, OH
| | - Rebecca J Patrick
- Section of Surgical Oncology and Breast Services, Department of General Surgery, Cleveland Clinic, Cleveland, OH
| | - Joseph P Crowe
- Section of Surgical Oncology and Breast Services, Department of General Surgery, Cleveland Clinic, Cleveland, OH
| | - Stephen R Grobmyer
- Section of Surgical Oncology and Breast Services, Department of General Surgery, Cleveland Clinic, Cleveland, OH
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Mahmood H, Faheem M, Mahmood S, Sadiq M, Irfan J. Impact of Age, Tumor Size, Lymph Node Metastasis, Stage, Receptor Status and Menopausal Status on Overall Survival of Breast Cancer Patients in Pakistan. Asian Pac J Cancer Prev 2015; 16:1019-24. [DOI: 10.7314/apjcp.2015.16.3.1019] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Rhodes DJ, Hruska CB, Conners AL, Tortorelli CL, Maxwell RW, Jones KN, Toledano AY, O'Connor MK. Journal club: molecular breast imaging at reduced radiation dose for supplemental screening in mammographically dense breasts. AJR Am J Roentgenol 2015; 204:241-51. [PMID: 25615744 PMCID: PMC4423604 DOI: 10.2214/ajr.14.13357] [Citation(s) in RCA: 116] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE. The purpose of this study was to assess the diagnostic performance of supplemental screening molecular breast imaging (MBI) in women with mammographically dense breasts after system modifications to permit radiation dose reduction. SUBJECTS AND METHODS. A total of 1651 asymptomatic women with mammographically dense breasts on prior mammography underwent screening mammography and adjunct MBI performed with 300-MBq (99m)Tc-sestamibi and a direct-conversion (cadmium zinc telluride) gamma camera, both interpreted independently. The cancer detection rate, sensitivity, specificity, and positive predictive value of biopsies performed (PPV3) were determined. RESULTS. In 1585 participants with a complete reference standard, 21 were diagnosed with cancer: two detected by mammography only, 14 by MBI only, three by both modalities, and two by neither. Of 14 participants with cancers detected only by MBI, 11 had invasive disease (median size, 0.9 cm; range, 0.5-4.1 cm). Nine of 11 (82%) were node negative, and two had bilateral cancers. With the addition of MBI to mammography, the overall cancer detection rate (per 1000 screened) increased from 3.2 to 12.0 (p < 0.001) (supplemental yield 8.8). The invasive cancer detection rate increased from 1.9 to 8.8 (p < 0.001) (supplemental yield 6.9), a relative increase of 363%, while the change in DCIS detection was not statistically significant (from 1.3 to 3.2, p =0.250). For mammography alone, sensitivity was 24%; specificity, 89%; and PPV3, 25%. For the combination, sensitivity was 91% (p < 0.001); specificity, 83% (p < 0.001); and PPV3, 28% (p = 0.70). The recall rate increased from 11.0% with mammography alone to 17.6% (p < 0.001) for the combination; the biopsy rate increased from 1.3% for mammography alone to 4.2% (p < 0.001). CONCLUSION. When added to screening mammography, MBI performed using a radiopharmaceutical activity acceptable for screening (effective dose 2.4 mSv) yielded a supplemental cancer detection rate of 8.8 per 1000 women with mammographically dense breasts.
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Affiliation(s)
- Deborah J Rhodes
- 1 Department of Medicine, Mayo Clinic, 200 First St SW, Rochester, MN 55955
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Jacke CO, Albert US, Reinhard I, Kalder M. Convergence with SEER database achieved by a breast cancer network: a longitudinal benchmark of 5-year relative survival. J Cancer Res Clin Oncol 2014; 141:1109-18. [PMID: 25512079 DOI: 10.1007/s00432-014-1879-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Accepted: 11/18/2014] [Indexed: 01/02/2023]
Abstract
PURPOSE To benchmark outcomes of a German breast cancer network with the Surveillance Epidemiology and End Results programme (SEER) of the USA from a longitudinal point of view. METHODS All women receiving primary breast cancer therapy of three hospitals in a rural district of Marburg-Biedenkopf (Germany) of time intervals 1996-1997 and 2003-2004 were used to define local benchmark objects. Data from SEER-programme contributed longitudinal benchmark objects from national level (1988-2004). All benchmark objects were compared with the time-fixed benchmark reference of SEER (2004). Stage distributions and 5-year relative survival ratios were combined to estimate standardized screening-, case-mix-, work-up-, treatment- and relative overall performance index. RESULTS From the entry cohort of 877 German women, 97.7 % of the patients accounted for the institutional sample (N = 857) and 65.8 % accounted for the regional sample (N = 577). Stage distributions, relative survival ratios and indices of the German breast cancer network improved over time. Developed indices converged with SEER (2004). CONCLUSIONS Effectiveness gap between one exemplary German breast cancer network and international benchmark defined by SEER has been closed. Reasons are manifold, and further research is recommended.
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Affiliation(s)
- Christian O Jacke
- Central Institute of Mental Health, Medical Faculty Mannheim, University Heidelberg, Square J5, 68159, Mannheim, Germany,
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45
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de Gelder R, Heijnsdijk EAM, Fracheboud J, Draisma G, de Koning HJ. The effects of population-based mammography screening starting between age 40 and 50 in the presence of adjuvant systemic therapy. Int J Cancer 2014; 137:165-72. [PMID: 25430053 DOI: 10.1002/ijc.29364] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Accepted: 11/13/2014] [Indexed: 01/26/2023]
Abstract
Adjuvant systemic therapy has been shown to be effective in reducing breast cancer mortality. The additional effect of mammography screening remains uncertain, in particular for women aged 40-49 years. We therefore assessed the effects of screening starting between age 40 and 50, as compared to the effects of adjuvant systemic therapy. The use of adjuvant endocrine therapy, chemotherapy and the combination of endocrine- and chemotherapy, as well as the uptake of mammography screening in the Netherlands was modeled using micro-simulation. The effects of screening and treatment were modeled based on randomized controlled trials. The effects of adjuvant therapy, biennial screening between age 50 and 74 in the presence of adjuvant therapy, and extending the screening programme by starting at age 40 were assessed by comparing breast cancer mortality in women aged 0-100 years in scenarios with and without these interventions. In 2008, adjuvant treatment was estimated to have reduced the breast cancer mortality rate in the simulated population by 13.9%, compared to a situation without treatment. Biennial screening between age 50 and 74 further reduced the mortality rate by 15.7%. Extending screening to age 48 would lower the mortality rate by 1.0% compared to screening from age 50; 10 additional screening rounds between age 40 and 49 would reduce this rate by 5.1%. Adjuvant systemic therapy and screening reduced breast cancer mortality in similar amounts. Expanding the lower age limit of screening would further reduce breast cancer mortality.
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Affiliation(s)
- Rianne de Gelder
- Department of Public Health, Erasmus Medical Center, Rotterdam, The Netherlands
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Mittal S, Sharma A, Balaji SA, Gowda MC, Dighe RR, Kumar RV, Rangarajan A. Coordinate hyperactivation of Notch1 and Ras/MAPK pathways correlates with poor patient survival: novel therapeutic strategy for aggressive breast cancers. Mol Cancer Ther 2014; 13:3198-3209. [PMID: 25253780 PMCID: PMC4258404 DOI: 10.1158/1535-7163.mct-14-0280] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Aberrant activation of Notch and Ras pathways has been detected in breast cancers. A synergy between these two pathways has also been shown in breast cell transformation in culture. Yet, the clinical relevance of Notch-Ras cooperation in breast cancer progression remains unexplored. In this study, we show that coordinate hyperactivation of Notch1 and Ras/MAPK pathways in breast cancer patient specimens, as assessed by IHC for cleaved Notch1 and pErk1/2, respectively, correlated with early relapse to vital organs and poor overall survival. Interestingly, majority of such Notch1(high)Erk(high) cases encompassed the highly aggressive triple-negative breast cancers (TNBC), and were enriched in stem cell markers. We further show that combinatorial inhibition of Notch1 and Ras/MAPK pathways, using a novel mAb against Notch1 and a MEK inhibitor, respectively, led to a significant reduction in proliferation and survival of breast cancer cells compared with individual inhibition. Combined inhibition also abrogated sphere-forming potential, and depleted the putative cancer stem-like cell subpopulation. Most importantly, combinatorial inhibition of Notch1 and Ras/MAPK pathways completely blocked tumor growth in a panel of breast cancer xenografts, including the TNBCs. Thus, our study identifies coordinate hyperactivation of Notch1 and Ras/MAPK pathways as novel biomarkers for poor breast cancer outcome. Furthermore, based on our preclinical data, we propose combinatorial targeting of these two pathways as a treatment strategy for highly aggressive breast cancers, particularly the TNBCs that currently lack any targeted therapeutic module.
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Affiliation(s)
- Suruchi Mittal
- Department of Molecular Reproduction, Development and Genetics, Indian Institute of Science, Bangalore, Karnataka, India
- Department of Pathology, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India
| | - Ankur Sharma
- Department of Molecular Reproduction, Development and Genetics, Indian Institute of Science, Bangalore, Karnataka, India
| | - Sai A. Balaji
- Department of Molecular Reproduction, Development and Genetics, Indian Institute of Science, Bangalore, Karnataka, India
| | - Manju C Gowda
- Department of Pathology, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India
| | - Rajan R. Dighe
- Department of Molecular Reproduction, Development and Genetics, Indian Institute of Science, Bangalore, Karnataka, India
| | - Rekha V. Kumar
- Department of Pathology, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India
| | - Annapoorni Rangarajan
- Department of Molecular Reproduction, Development and Genetics, Indian Institute of Science, Bangalore, Karnataka, India
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Zeng XH, Ou ZL, Yu KD, Feng LY, Yin WJ, Li J, Shen ZZ, Shao ZM. Absence of multiple atypical chemokine binders (ACBs) and the presence of VEGF and MMP-9 predict axillary lymph node metastasis in early breast carcinomas. Med Oncol 2014; 31:145. [PMID: 25097078 DOI: 10.1007/s12032-014-0145-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2014] [Accepted: 07/26/2014] [Indexed: 12/30/2022]
Abstract
The aim of this study was to determine the frequency of axillary lymph node (ALN) metastasis of early breast cancers by evaluating the status of DARC, D6 and CCX-CKR and the levels of VEGF and MMP-9. The status of DARC, D6 and CCX-CKR and the levels VEGF and MMP-9 were evaluated in ALN- (n = 130) and ALN + (n = 88) patients with T1 breast cancer by immunohistochemical staining. For ALN, likelihood ratio χ (2)-tests were used for univariate analysis and logistic regression for multivariate analysis. Univariate analysis identified the nuclear grade, VEGF and MMP-9 expression and absence of DARC, D6 and CCX-CKR as predictors of ALN involvement. When combining the three receptors (DARC, D6 and CCX-CKR) together, tumors with multiple absence (multi-absence, any two or three loss) had a higher likelihood of being ALN positive than non-multi-absence (coexpression of any two or three) tumors (56.2 vs. 27.9 %, P < 0.001). The final multivariate logistic regression revealed nuclear grade, VEGF, MMP-9 and non-multi-absence versus multi-absence to be independent predictors of ALN involvement; the odds ratio (OR) and 95 % CI for non-multi-absence tumors versus multi-absence were 0.469 (0.233-0.943). Multi-absence was also associated with the involvement of four or more lymph nodes among ALN + tumors. Moreover, tumors with multi-absence had higher VEGF (78.1 vs. 50.0 %, P < 0.001) and MMP-9 (81.3 vs. 36.1 %, P < 0.001) expression than non-multi-absence tumors. Our data highlight that the absence of DARC, D6 and CCX-CKR in combination, which is associated with higher VEGF and MMP-9 expression, predicts the presence and extent of ALN metastasis in breast cancer.
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Affiliation(s)
- Xiao-Hua Zeng
- Department of Breast Surgery, Chongqing Cancer Institute/Hospital, 181 Hanyu Road, Shapingba District, Chongqing, 400030, China
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Pang H, Lu H, Song H, Meng Q, Zhao Y, Liu N, Lan F, Liu Y, Yan S, Dong X, Cai L. Prognostic values of osteopontin-c, E-cadherin and β-catenin in breast cancer. Cancer Epidemiol 2013; 37:985-92. [DOI: 10.1016/j.canep.2013.08.005] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2013] [Revised: 07/31/2013] [Accepted: 08/07/2013] [Indexed: 12/25/2022]
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49
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Olmez OF, Evrensel T, Cubukcu E, Ugras N, Avci N, Canhoroz M, Deligonul A, Hartavi M, Olmez F, Cubukcu S, Tolunay S, Kurt E, Kanat O, Manavoglu O. Prognostic significance of human epidermal receptor (HER)- 3 immunohistochemical expression in patients with metastatic breast cancer. Asian Pac J Cancer Prev 2013; 14:4115-9. [PMID: 23991962 DOI: 10.7314/apjcp.2013.14.7.4115] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Previous reports have shown that human epidermal receptor (HER)-3 overexpression may be associated with poor prognosis in patients with breast cancer, but results have been conflicting. In this study, we sought to investigate the prognostic significance of HER-3 immunohistochemical expression in patients with metastatic breast cancer. METHODS We retrospectively analyzed HER-3 immunohistochemical expression profiles in 45 paraffin-embedded specimens from patients who had been treated between 1996 and 2006 in the Department of Oncology of the Uludag University School of Medicine, Bursa, Turkey. Membranous or cytoplasmic dominant expression patterns of HER-3 were analyzed using the Rajkumar score and a cytoplasmic 4-point scoring system, respectively. Progression-free survival (PFS) and overall survival (OS) served as the main outcome measures. RESULTS The median PFS in the study participants was 9 months (interquartile range: 4.5-13 months), whereas the median OS was 20 months (interquartile range: 7.5-28 months). Categorization of the patient population according to HER-3 positive immunohistochemical expression did not reveal any statistically significant difference in terms of both PFS (p=0.70) and OS (p=0.81). The results of multivariable Cox regression analysis indicated that tumor size was the only independent predictor of PFS, whereas estrogen and progesterone receptor status was independently associated with OS. CONCLUSIONS HER-3 immunohistochemical expression did not correlate with outcomes in Turkish patients with metastatic breast cancer. Although our results suggest that HER-3 expression in cancer specimens is not of prognostic significance, further prospective studies are warranted to confirm these results.
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Affiliation(s)
- Omer Fatih Olmez
- Department of Medical Oncology, Uludag University Medical School, Bursa, Turkey.
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Labib NA, Ghobashi MM, Moneer MM, Helal MH, Abdalgaleel SA. Evaluation of BreastLight as a Tool for Early Detection of Breast Lesions among Females Attending National Cancer Institute, Cairo University. Asian Pac J Cancer Prev 2013; 14:4647-50. [DOI: 10.7314/apjcp.2013.14.8.4647] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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