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Stanton S, Schmitz F, Copeland W, DellAringa J, Newhall K, Disis M. Populations of triple negative and hormone receptor positive HER2 negative breast tumors share immune gene profiles. RESEARCH SQUARE 2024:rs.3.rs-4542494. [PMID: 39149486 PMCID: PMC11326399 DOI: 10.21203/rs.3.rs-4542494/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/17/2024]
Abstract
In breast cancer, triple negative (TN) breast cancer has most responses to immune checkpoint inhibitor (ICI) therapy. Lymphocyte infiltrate does not impact prognosis in Hormone receptor positive HER2 negative (HR + HER2-) breast tumors and few HR + HER2- tumors respond to ICI. We contrasted immune-associated gene expression between 119 TN and 475 HR + HER2- breast tumors from The Cancer Genome Atlas (TCGA) and confirmed our findings in 299 TN and 1369 HR + HER2- breast tumors in the METABRIC database. TN and HR + HER2- tumors grouped into immune-high or -low tumors, both subtypes were represented in the immune-high group. The largest difference between the immune-high TN and HR + HER2- tumors was TN tumors had more abundant T h1 and T h2 CD4 + T cells while HR + HER2- tumors had more abundant fibroblasts (log 2 FC > 0.3; p < 10X10 - 10 ). This suggests an immune-high signature is not dictated by breast cancer subtype, but fibroblast subsets associated with worse outcome were higher in the immune-high HR + HER2- tumors.
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Tittmann J, Ágh T, Erdősi D, Csanády B, Kövér E, Zemplényi A, Kovács S, Vokó Z. Breast cancer stage and molecular subtype distribution: real-world insights from a regional oncological center in Hungary. Discov Oncol 2024; 15:240. [PMID: 38907840 PMCID: PMC11193705 DOI: 10.1007/s12672-024-01096-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Accepted: 06/12/2024] [Indexed: 06/24/2024] Open
Abstract
OBJECTIVE Examining the distribution of breast cancer (BC) stage and molecular subtype among women aged below (< 45 years), within (45-65 years), and above (> 65 years) the recommended screening age range helps to understand the screening program's characteristics and contributes to enhancing the effectiveness of BC screening programs. METHODS In this retrospective study, female patients with newly diagnosed BC from 2010 to 2020 were identified. The distribution of cases in terms of TNM stages, severity classes, and subtypes was analysed according to age groups. RESULTS A total of 3282 women diagnosed with BC were included in the analysis. Among these cases 51.4% were detected outside the screening age group, and these were characterized by a higher TNM stage compared to those diagnosed within the screening age band. We observed significantly higher relative frequency of advanced BC in the older age group compared to both the screening age population and women younger than 45 years (14.9% vs. 8.7% and 7.7%, P < 0.001). HR-/HER2- and HER+ tumours were relatively more frequent among women under age 45 years (HR-/HER2-: 23.6%, HER2+: 20.5%) compared to those within the screening age range (HR-/HER2-: 13.4%, HER2+: 13.9%) and the older age group (HR-/HER2-: 10.4%, HER2+: 11.5%). CONCLUSIONS The findings of our study shed light on potential areas for the improvement of BC screening programs (e.g., extending screening age group, adjusting screening frequency based on molecular subtype risk status) in Hungary and internationally, as well.
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Affiliation(s)
- Judit Tittmann
- Center for Health Technology Assessment, Semmelweis University, Üllői Str 25, Budapest, 1091, Hungary.
- Center for Health Technology Assessment and Pharmacoeconomic Research, University of Pécs, Pécs, Hungary.
| | - Tamás Ágh
- Center for Health Technology Assessment and Pharmacoeconomic Research, University of Pécs, Pécs, Hungary
- Syreon Research Institute, Budapest, Hungary
| | - Dalma Erdősi
- Center for Health Technology Assessment, Semmelweis University, Üllői Str 25, Budapest, 1091, Hungary
- Center for Health Technology Assessment and Pharmacoeconomic Research, University of Pécs, Pécs, Hungary
| | - Bettina Csanády
- Center for Health Technology Assessment and Pharmacoeconomic Research, University of Pécs, Pécs, Hungary
| | - Erika Kövér
- Department of Oncotherapy, Medical School and Clinical Center, University of Pécs, Pécs, Hungary
| | - Antal Zemplényi
- Center for Health Technology Assessment and Pharmacoeconomic Research, University of Pécs, Pécs, Hungary
- Syreon Research Institute, Budapest, Hungary
| | - Sándor Kovács
- Center for Health Technology Assessment and Pharmacoeconomic Research, University of Pécs, Pécs, Hungary
- Syreon Research Institute, Budapest, Hungary
| | - Zoltán Vokó
- Center for Health Technology Assessment, Semmelweis University, Üllői Str 25, Budapest, 1091, Hungary
- Syreon Research Institute, Budapest, Hungary
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Teng YT, Wang YA, Dong YH, Liu JJ. Five-year survival prognosis of young, middle-aged, and elderly adult female invasive breast cancer patients by clinical and lifestyle characteristics. Breast Cancer Res Treat 2024; 205:619-631. [PMID: 38526687 PMCID: PMC11101574 DOI: 10.1007/s10549-024-07280-3] [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: 12/12/2023] [Accepted: 02/07/2024] [Indexed: 03/27/2024]
Abstract
PURPOSE Early-onset breast cancer incidence has been increasing globally and in Taiwan. However, previous studies have not comprehensively examined how clinical and lifestyle characteristics influence the 5-year survival of breast cancer diagnosed at different stages of adulthood. METHODS We analyzed the Taiwan National Cancer Registry and Cause of Death datasets to understand how clinical factors (including tumor and treatment characteristics) and lifestyle factors (including body mass index, cigarette smoking, and alcohol consumption) were associated with the 5-year survival of 8471 young, 57,695 middle-aged, and 14,074 elderly female adult invasive breast cancer patients respectively diagnosed at age 20-39, 40-64, and ≥ 65 years between 2002 and 2015, with mortality follow-up to 2020. Poisson regression was used for obtaining the crude and adjusted 5-year survival risk ratios. RESULTS Clinical and lifestyle characteristics were distributed differently but had mostly similar direction of association with 5-year survival for the three age groups. Receiving any treatment was associated with better survival, especially for elderly patients. Being underweight at initial cancer treatment was associated with worse survival than having normal weight, especially for elderly patients. Current smokers had worse survival than never smokers for middle-aged and elderly patients. The 5-year breast cancer-specific survival was not significantly higher for those of age 45-49 years than 40-44 years, despite the recommended starting screening age is 45 years in Taiwan. CONCLUSION Our findings contribute to the understanding of early-onset and later-onset female breast cancer characteristics and prognosis, which may inform surveillance and treatment strategies to achieve better breast cancer prognosis.
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Affiliation(s)
- Yu-Tung Teng
- Institute of Public Health, National Yang Ming Chiao Tung University, No.155, Sec. 2, Linong St., Beitou District, Taipei, 112, Taiwan
| | - Yong Alison Wang
- Koo Foundation Sun-Yat Sen Cancer Center, Taipei, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yaa-Hui Dong
- Institute of Public Health, National Yang Ming Chiao Tung University, No.155, Sec. 2, Linong St., Beitou District, Taipei, 112, Taiwan
- Department of Pharmacy, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Jason J Liu
- Institute of Public Health, National Yang Ming Chiao Tung University, No.155, Sec. 2, Linong St., Beitou District, Taipei, 112, Taiwan.
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Kang D, Park S, Kim HJ, Lee J, Han J, Kim SW, Lee JE, Yu J, Lee SK, Kim JY, Nam SJ, Cho J, Park YH. Comprehensive Young Age Breast Cancer registry from clinical, genomics, and patient-reported outcomes measured with 15 years follow-up: the CHARM cohort profile. Breast Cancer 2024; 31:467-475. [PMID: 38472736 DOI: 10.1007/s12282-024-01559-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 02/20/2024] [Indexed: 03/14/2024]
Abstract
BACKGROUND In recognition of the distinct clinical challenges and research gaps in young breast cancer (YBC) patients, we established the Comprehensive Young Age Breast Cancer (CHARM) registry to collect prospective data. METHODS This prospective cohort included patients who were newly diagnosed with histologically confirmed breast cancer without prior treatment at the Samsung Medical Center (SMC) in April 2013. We included patients who were either 40 years old or younger at the time of diagnosis, pregnant at breast cancer diagnosis or diagnosed with breast cancer within 1 year of delivery. All data were collected using Medidata's Rave Electronic Data. Clinical data were obtained from electronic medical records. Two experienced pathologists reviewed the pathologic data. Bone mineral densitometry tests have been conducted annually. To obtain multi-omics data, tumor tissues and blood samples were prospectively collected from consenting patients in the registry during surgery. The fertility-related factor also collected collaborated with the Department of Obstetrics and Gynecology. Anti-Müllerian hormone, estradiol, follicle-stimulating hormone, and luteinizing hormone levels were measured using an additional blood sample from baseline to last follow-up. Patient-reported outcomes were assessed using mobile questionnaires. RESULTS A total of 1868 participants were included in the SMC YBC study. The average (standard deviation) age was 35.57 (3.79) and 99.8% of the participants were premenopausal. Among them, 1062 participants completed the PRO questionnaires. CONCLUSIONS The SMC YBC cohort serves as a comprehensive registry for YBC to optimize care and improve knowledge regarding the management of YBC.
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Affiliation(s)
- Danbee Kang
- Department of Clinical Research Design and Evaluation SAIHST, Sungkyunkwan University, 115 Irwon-ro, Gangnam, Seoul, 06335, South Korea
- Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06351, South Korea
| | - Seri Park
- Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, 06351, South Korea
| | - Hyo Jung Kim
- Department of Digital Health, SAIHST, Sungkyunkwan University, Seoul, 06351, South Korea
- Research Institution for Future Medicine, Samsung Medical Center, Seoul, 06351, South Korea
| | - Jiseon Lee
- Department of Clinical Research Design and Evaluation SAIHST, Sungkyunkwan University, 115 Irwon-ro, Gangnam, Seoul, 06335, South Korea
- Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06351, South Korea
| | - Jiyoon Han
- Department of Clinical Research Design and Evaluation SAIHST, Sungkyunkwan University, 115 Irwon-ro, Gangnam, Seoul, 06335, South Korea
- Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06351, South Korea
| | - Seok Won Kim
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06351, South Korea
| | - Jeong Eon Lee
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06351, South Korea
| | - Jonghan Yu
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06351, South Korea
| | - Se Kyung Lee
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06351, South Korea
| | - Ji-Yeon Kim
- Division of Hematology-Oncology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong Kangnam-gu, Seoul, 135-710, South Korea
| | - Seok Jin Nam
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06351, South Korea
| | - Juhee Cho
- Department of Clinical Research Design and Evaluation SAIHST, Sungkyunkwan University, 115 Irwon-ro, Gangnam, Seoul, 06335, South Korea.
- Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06351, South Korea.
| | - Yeon Hee Park
- Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, 06351, South Korea.
- Division of Hematology-Oncology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong Kangnam-gu, Seoul, 135-710, South Korea.
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Aurell C, Haidar A, Giglio D. Follow-up Routines Matter for Adherence to Endocrine Therapy in the Adjuvant Setting of Breast Cancer. Breast Cancer (Auckl) 2024; 18:11782234241240171. [PMID: 38628960 PMCID: PMC11020713 DOI: 10.1177/11782234241240171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 02/29/2024] [Indexed: 04/19/2024] Open
Abstract
Background Endocrine therapy (ET) adherence leads to increased survival in breast cancer (BC). How follow-up should be done to maximize adherence is not known. Objectives To assess adherence to ET, factors favouring adherence to ET and effects on survival in a population-based cohort of BC patients in western Sweden. Design This is a retrospective study. Methods We included 358 patients operated for oestrogen receptor-positive BC and recommended 5 years of ET, in Region Halland, Sweden, year 2015 to 2016. Demographical, clinical and pathological data and use of ET were retrieved from the electronic medical records. Patients were considered adherent if taking ET for 5 years or during the full extent of the follow-up, until termination of ET due to BC relapse or death and where renewals of prescriptions of ET covered ⩾80% of the ordinated dose. Two follow-up routines were employed, ie, routine A where patients were contacted annually by nurses and a more passive follow-up routine B where patients were only contacted by nurses at 2 years and 5 years following start of ET. Results Medication persistence for 4 years and more was good and similar between patients initiating aromatase inhibitor (AI) and tamoxifen (75.7% and 72.0%, respectively, P = .43). More patients initiating AIs changed ET due to side effects compared with patients initiating tamoxifen (24.3% vs 9.9%, respectively, P < .0001). Endocrine therapy adherence was better for follow-up routine B than for follow-up routine A (hazard ratio [HR] = 2.71 [1.44-5.09], P = .0027). Conclusions Adherence to ET in BC is high in Western Sweden. Less regular nurse-initiated contacts between BC patients and nursesled surprisingly to a better adherence than a more regular nurse-initiated contact.
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Affiliation(s)
- Carolina Aurell
- Department of Surgery, Halland Hospital Varberg, Region Halland, Varberg, Sweden
| | - Alaa Haidar
- Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Oncology, Halland Hospital Halmstad, Region Halland, Halmstad, Sweden
| | - Daniel Giglio
- Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Oncology, Sahlgrenska University Hospital, Gothenburg, Sweden
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Yan Z, Chang C, Kang Z, Chen C, Lv X, Chen C. Application of one-dimensional hierarchical network assisted screening for cervical cancer based on Raman spectroscopy combined with attention mechanism. Photodiagnosis Photodyn Ther 2024; 46:104086. [PMID: 38608802 DOI: 10.1016/j.pdpdt.2024.104086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 04/07/2024] [Accepted: 04/10/2024] [Indexed: 04/14/2024]
Abstract
Cervical cancer is one of the most common malignant tumors among women, and its pathological change is a relatively slow process. If it can be detected in time and treated properly, it can effectively reduce the incidence rate and mortality rate of cervical cancer, so the early screening of cervical cancer is particularly critical and significant. In this paper, we used Raman spectroscopy technology to collect the tissue sample data of patients with cervicitis, Low-grade Squamous Intraepithelial Lesion, High-grade Squamous Intraepithelial Lesion, Well differentiated squamous cell carcinoma, Moderately differentiated squamous cell carcinoma, Poorly differentiated squamous cell carcinoma and cervical adenocarcinoma. A one-dimensional hierarchical convolutional neural network based on attention mechanism was constructed to classify and identify seven types of tissue samples. The attention mechanism Efficient Channel Attention Networks module and Squeeze-and-Excitation Networks module were combined with the established one-dimensional convolutional hierarchical network model, and the results showed that the combined model had better diagnostic performance. The average accuracy, F1, and AUC of the Principal Component Analysis-Squeeze and Excitation-hierarchical network model after 5-fold cross validations could reach 96.49%±2.12%, 0.97±0.03, and 0.98±0.02, respectively, which were 1.58%, 0.0140, and 0.008 higher than those of hierarchical network. The recall rate of the Principal Component Analysis-Efficient Channel Attention-hierarchical network model was as high as 96.78%±2.85%, which is 1.47% higher than hierarchical network. Compared with the classification results of traditional CNN and ResNet for seven types of cervical cancer staging, the accuracy of the Principal Component Analysis-Squeeze and Excitation-hierarchical network model is 3.33% and 11.05% higher, respectively. The experimental results indicate that the model established in this study is easy to operate and has high accuracy. It has good reference value for rapid screening of cervical cancer, laying a foundation for further research on Raman spectroscopy as a clinical diagnostic method for cervical cancer.
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Affiliation(s)
- Ziwei Yan
- College of Software, Xinjiang University, Urumqi, China
| | - Chenjie Chang
- School of Computer Science and Technology, Xinjiang University, Urumqi, China
| | - Zhenping Kang
- School of Computer Science and Technology, Xinjiang University, Urumqi, China
| | - Chen Chen
- College of Software, Xinjiang University, Urumqi, China
| | - Xiaoyi Lv
- School of Computer Science and Technology, Xinjiang University, Urumqi, China
| | - Cheng Chen
- College of Software, Xinjiang University, Urumqi, China.
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Shitrit IB, Wang A, Ilan K, Agassi R, Freih SA, Vaynshtein J. Epidemiological, clinical, and pathological characteristics of invasive breast cancer in Bedouin and Jewish women in southern Israel: a retrospective comparative study. BMC Cancer 2024; 24:310. [PMID: 38448861 PMCID: PMC10916252 DOI: 10.1186/s12885-024-12051-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 02/25/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND Invasive breast cancer (IBC) is a leading cause of cancer-related death among women in Israel, regardless of ethnicity. This study compared IBC epidemiological, clinical, and pathological characteristics in Bedouin and Jewish patients in southern Israel. METHODS Medical records of 1514 Jewish and 191 Bedouin women with IBC treated at Soroka University Medical Center between 2014 and 2021 were analyzed retrospectively. Baseline measures and tumor characteristics were compared between groups. Overall survival (OS) and disease-free survival (DFS) were analyzed using log-rank test. Multivariate analysis was performed using the Cox proportional hazard model. RESULTS Bedouin patients exhibited a significantly younger age at diagnosis (median 48 vs. 62 years, p < 0.001), larger tumor size (median 2.5 vs. 2.13 cm, p < 0.001), and higher metastasis rate (18.8% vs. 12.7%, p = 0.03) compared to Jewish patients. In early-stage (non-metastatic) disease, Jewish and Bedouin patients had comparable overall survival (OS) rates (127 vs. 126 months, p = 0.2), consistent across stages 1 to 3. However, among patients with metastatic disease, Bedouins exhibited significantly longer OS (76.6 vs. 37.8 months, p = 0.006). Disease-free survival (DFS) showed no ethnic differences (not reached vs. 122 months, p = 0.31). There were no significant differences in OS between Bedouin and Jewish patients undergoing various treatment modalities for early-stage disease: surgery, adjuvant radiotherapy, chemotherapy, and systemic neoadjuvant therapy. CONCLUSION Breast cancer among Bedouin women in southern Israel manifests at a younger age, with larger tumors and more advanced stages than in Jewish women. However, recent data indicate no differences in OS and DFS between the ethnic groups despite past disparities in prognosis.
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Affiliation(s)
- Itamar Ben Shitrit
- Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer- Sheva, Israel.
- Clinical Research Center, Faculty of Health Sciences, Soroka University Medical Center, Ben- Gurion University of the Negev, Beer-Sheva, Israel.
| | - Ao Wang
- Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer- Sheva, Israel
| | - Karny Ilan
- Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer- Sheva, Israel
| | - Ravit Agassi
- Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer- Sheva, Israel
| | - Sofyan Abu Freih
- Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer- Sheva, Israel
| | - Julie Vaynshtein
- Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer- Sheva, Israel
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Tang Z, Li L, Huang X, Zhao Y, Huang L. Association of molecular subtypes and treatment with survival in invasive micropapillary breast cancer: an analysis of the Surveillance, Epidemiology, and End Results database. Breast Cancer 2024; 31:205-216. [PMID: 38043116 DOI: 10.1007/s12282-023-01523-9] [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: 07/26/2023] [Accepted: 11/06/2023] [Indexed: 12/05/2023]
Abstract
BACKGROUND This study aims to examine the features, treatments, and survival of invasive micropapillary carcinoma (IMPC) according to different molecular subtypes. METHODS In this cohort study, data between 2010 and 2018 were retrospectively reviewed from the Surveillance, Epidemiology, and End Results database. Molecular subtypes were categorized into four varieties: hormone receptor (HR)+/HER2- (Luminal A), HR+/HER2+ (Luminal B), HR-/HER2- [triple-negative (TN)], and HR-/HER2+ (HER2 enriched). RESULTS In this study, 1,180 IMPC patients were included, with 99 patients (8.39%) of the 1,180 patients having an overall mortality, and 53 patients (53.54%) of the 99 patients having a breast cancer-specific mortality. The follow-up duration was 40.00 (18.50, 61.00) months. TN molecular subtype was associated with worse OS and BCSS in IMPC patients. Treatment of chemotherapy, radiation, and combination therapy were associated with better survival in HR+/HER2+ molecular subtype and HR+/HER2- molecular subtype. However, in HR-/HER2- molecular subtype, treatment of chemotherapy was associated with a poor BCSS, and treatment of radiation was not associated with OS and BCSS. Surgery treatment was not associated with survival in HR+/HER2+ molecular subtype and HR+/HER2- molecular subtype. However, surgery treatment of mastectomy was associated with better OS in HR-/HER2- molecular subtype (P < 0.05). CONCLUSION The prognosis of IMPC was significantly influenced by different molecular subtypes. Chemotherapy and radiotherapy are beneficial in HR+/HER2+ and HR+/HER2- patients. However, they should be used with caution in HR-/HER2- (TN) patients.
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Affiliation(s)
- Zhenning Tang
- Department of Surgical Oncology, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, 750004, People's Republic of China
| | - Ling Li
- Department of Neurology, The First People's Hospital of Yinchuan, Yinchuan, Ningxia, 750001, People's Republic of China
| | - Xiaoying Huang
- Ningxia Medical University, Yinchuan, Ningxia, 750004, People's Republic of China
| | - Yinbing Zhao
- Ningxia Medical University, Yinchuan, Ningxia, 750004, People's Republic of China
| | - Lingyan Huang
- Department of Pathology, General Hospital of Ningxia Medical University, No. 804 Shengli Street, Xingqing District, Yinchuan, Ningxia, 750004, People's Republic of China.
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Carbajal-Ochoa W, Bravo-Solarte DC, Bernal AM, Anampa JD. Benefit of adjuvant chemotherapy in lymph node-negative, T1b and T1c triple-negative breast cancer. Breast Cancer Res Treat 2024; 203:257-269. [PMID: 37833449 DOI: 10.1007/s10549-023-07132-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 09/22/2023] [Indexed: 10/15/2023]
Abstract
INTRODUCTION Current guidelines recommendations regarding chemotherapy in small (T1b and T1c), node-negative triple-negative breast cancer (TNBC) differ due to lack of high-quality data. Our study aimed to assess the benefit of adjuvant chemotherapy in patients with T1bN0M0 and T1cN0M0 TNBC. METHODS We obtained data from the Surveillance, Epidemiology, and End Results database for patients with node-negative, T1b/T1c TNBC diagnosed between 2010 and 2020. Logistic regresion models assessed variables associated with chemotherapy administration. We evaluated the effect of chemotherapy on overall survival (OS) and breast cancer specific survival (BCSS) with Kaplan-Meier methods and Cox proportional hazards methods. RESULTS We included 11,510 patients: 3,388 with T1b and 8,122 with T1c TNBC. During a median follow-up of 66 months, 305 patients with T1b and 995 with T1c died. After adjusting for clinicopathological, demographic and treatment factors, adjuvant chemotherapy improved OS in T1b TNBC (HR, 0.52; 95% CI, 0.41-0.68 p < 0.001) but did not improve BCSS (HR, 0.70; 95% CI, 0.45-1.07; p = 0.10); the association between chemotherapy and BCSS was not statistically significant in any subgroup. In T1c TNBC, adjuvant chemotherapy improved OS (HR, 0.54; 95% CI, 0.47-0.62; p < 0.001) and BCSS (HR, 0.79; 95% CI, 0.63-0.99; p = 0.043); the benefit of chemotherapy in OS varied by age (Pinteraction=0.024); moreover, the benefit in BCSS was similar in all subgroups. CONCLUSIONS Our study results support the use of adjuvant chemotherapy in patients with node-negative, T1c TNBC. Patients with node-negative, T1b TNBC had excellent long-term outcomes; furthermore, chemotherapy was not associated with improved BCSS in these patients.
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Affiliation(s)
- Walter Carbajal-Ochoa
- Department of Medical Oncology, Catalan Institute of Oncology/Josep Trueta Hospital, Girona, Spain
| | | | - Ana M Bernal
- Department of Medical Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, 1695 Eastchester Rd, Bronx, NY, 10461, USA
| | - Jesus D Anampa
- Department of Medical Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, 1695 Eastchester Rd, Bronx, NY, 10461, USA.
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Chen X, Chen C, Tian X, He L, Zuo E, Liu P, Xue Y, Yang J, Chen C, Lv X. DBAN: An improved dual branch attention network combined with serum Raman spectroscopy for diagnosis of diabetic kidney disease. Talanta 2024; 266:125052. [PMID: 37574605 DOI: 10.1016/j.talanta.2023.125052] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 08/02/2023] [Accepted: 08/05/2023] [Indexed: 08/15/2023]
Abstract
Diabetic kidney disease (DKD) is one of the most common kidney diseases worldwide. It is estimated that approximately 537 million adults worldwide have diabetes, and up to 30%-40% of diabetic patients are at risk of developing nephropathy. The pathogenesis of DKD is complex, and its onset is insidious. Currently, the clinical diagnosis of DKD primarily relies on the increase of urinary albumin and the decrease in glomerular filtration rate in diabetic patients. However, the excretion of urinary albumin is influenced by various factors, such as physical activity, infections, fever, and high blood glucose, making it challenging to achieve an objective and accurate diagnosis. Therefore, there is an urgent need to develop an efficient, fast, and low-cost auxiliary diagnostic technology for DKD. In this study, an improved Dual Branch Attention Network (DBAN) was developed to quickly identify DKD. Serum Raman spectroscopy samples were collected from 32 DKD patients and 32 healthy volunteers. The collected data were preprocessed using the adaptive iteratively reweighted penalized least squares (airPLS) algorithm, and the DBAN was used to classify the serum Raman spectroscopy data of DKD. The model consists of a dual branch structure that extracts features using Convolutional Neural Network (CNN) and bottleneck layer modules. The attention module allows the model to learn features specifically, and lateral connections are added between the dual branches to achieve multi-level and multi-scale fusion of shallow and deep features, as well as local and global features, improving the classification accuracy of the experiment. The results of the study showed that compared to traditional deep learning algorithms such as Artificial Neural Network (ANN), CNN, GoogleNet, ResNet, and AlexNet, our proposed DBAN classification model achieved 95.4% accuracy, 98.0% precision, 96.5% sensitivity, and 97.2% specificity, demonstrating the best classification performance. This is the best method for identifying DKD, and has important reference value for the diagnosis of DKD patients, as well as improving the accuracy of medical auxiliary diagnosis.
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Affiliation(s)
- Xinya Chen
- College of Information Science and Engineering, Xinjiang University, Urumqi, 830046, China
| | - Chen Chen
- College of Information Science and Engineering, Xinjiang University, Urumqi, 830046, China
| | - Xuecong Tian
- College of Information Science and Engineering, Xinjiang University, Urumqi, 830046, China
| | - Liang He
- College of Information Science and Engineering, Xinjiang University, Urumqi, 830046, China; Xinjiang Key Laboratory of Signal Detection and Processing, Urumqi, 830017,China; Department of Electronic Engineering, and Beijing National Research Center for Information Science and Technology, Tsinghua University, Beijing, 100084, China
| | - Enguang Zuo
- College of Information Science and Engineering, Xinjiang University, Urumqi, 830046, China
| | - Pei Liu
- College of Information Science and Engineering, Xinjiang University, Urumqi, 830046, China
| | - You Xue
- College of Information Science and Engineering, Xinjiang University, Urumqi, 830046, China
| | - Jie Yang
- College of Information Science and Engineering, Xinjiang University, Urumqi, 830046, China
| | - Cheng Chen
- College of Software, Xinjiang University, Urumqi, 830046, China.
| | - Xiaoyi Lv
- College of Software, Xinjiang University, Urumqi, 830046, China; The Key Laboratory of Signal Detection and Processing, Xinjiang Uygur Autonomous Region, Xinjiang University, Urumqi, 840046, China.
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11
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Sebastian D, Joseph J, Mathews E. The prevalence and correlates of comorbidities among patients with cancer attending a tertiary care cancer center in South India: An analytical cross-sectional study. CANCER RESEARCH, STATISTICS, AND TREATMENT 2023; 6:526-533. [PMID: 38826774 PMCID: PMC7616054 DOI: 10.4103/crst.crst_93_23] [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] [Indexed: 06/04/2024] Open
Abstract
Background Comorbidities in patients with cancer can affect treatment, and should, therefore, be prioritized and managed. Objectives Our primary aim was to assess the prevalence of comorbidities among patients with cancer. The secondary objective was to identify the association of comorbidities with various sociodemographic and clinical variables. Materials and Methods This was a cross-sectional study conducted between December 2019 and March 2020 among patients with cancer, seeking treatment at Malabar Cancer Center, in Kannur District of northern Kerala in South India. Semi-structured interviews were conducted, and comorbidities were assessed using the Charlson Comorbidity Index. The anthropometric measurements were recorded using a standardized instrument and protocol. Results We enrolled 242 patients in this study. There were 148 (61.2%) female patients; 106 (43.8%) were aged between 41 and 50 years. Cancers of the head-and-neck and breast accounted for the majority of cases (23.1% each, n = 56), followed by the digestive system (18.6%, n = 45) and female reproductive system (11.2%, n = 27). The most common primary cancers in the head-and-neck, digestive, and female reproductive systems were oral, colorectal, and cervical, respectively. The prevalence of comorbidities among patients with cancer was 70.2% (n = 170). Common comorbidities were hypertension (n = 82 ; 33.9%), arthritis (n = 57; 23.6%), and diabetes (n = 53; 21.6%). After controlling for potential confounders, the factors noted to be independently associated with the presence of comorbidities were advanced age, family history of comorbidity, normal weight or underweight, and cancer treatment for more than 6 months' duration. Conclusions The high prevalence of comorbidities among patients with cancer suggests the need for an integrated system of care and management as the comorbidities affect the overall management of cancer treatment and care.
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Affiliation(s)
- Divya Sebastian
- Department of Public Health and Community Medicine, Central University of Kerala, Kasaragod
| | | | - Elezebeth Mathews
- Department of Public Health and Community Medicine, Central University of Kerala, Kasaragod
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12
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Vidarsdottir L, Olafsdottir EJ, Barkardottir RB, Bjarnadottir O, Jonasson JG, Sigurdsson S, Tryggvadottir L. Estrogen receptor-positive breast cancer and adverse outcome in BRCA2 mutation carriers and young non-carrier patients. NPJ Breast Cancer 2023; 9:95. [PMID: 38036573 PMCID: PMC10689749 DOI: 10.1038/s41523-023-00600-8] [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: 05/26/2023] [Accepted: 11/09/2023] [Indexed: 12/02/2023] Open
Abstract
Estrogen receptor-positive (ER+) breast cancer generally confers a more favorable prognosis than ER-negative cancer, however, a different picture is emerging for BRCA2 mutation carriers and young patients. We used nationwide data from population-based registries to study prognostic effects in those two groups. Of all 2817 eligible women diagnosed with breast cancer in Iceland during 1980-2004, 85% had been tested for the Icelandic 999del5 BRCA2 (c.771_775delTCAAA) founder pathogenic variant. We compared breast cancer-specific survival, effects of ER status, other clinical parameters, and treatment, between three mutually exclusive groups: BRCA2-carriers, non-carriers diagnosed 40 years or younger, and older non-carriers. Prevalence of the BRCA2 mutation among tested patients <=40 years of age was 21.0%, but it was 5.4% among women diagnosed >40 years of age. For ER+ cancer, breast cancer-specific 15-year survival was 49.7%, 55.2%, and 74.7%, among BRCA2-carriers, young and older non-carriers, respectively, whereas for ER-negative cancer, survival was similar (64.0-69.3%) for all three groups. Neither BRCA2 carriers nor young non-carriers did tumor grade 3 predict worse survival than did tumor grade 1. The adverse outcome for the young cases cannot be explained by BRCA2 mutations, as carriers were excluded from the group. Those two clinically important patient groups need special attention with respect to treatment choices, in particular, if diagnosed with ER+ tumors. It is thus advisable to have knowledge of BRCA2 status when treatment decisions are made. Finally, it is important to understand the biological basis for the specific nature of ER+ tumors in young women and BRCA2 carriers.
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Affiliation(s)
- Linda Vidarsdottir
- Faculty of Medicine, University of Iceland, Sturlugata 8, Reykjavik, Iceland
- BioMedical Center, University of Iceland, Sturlugata 8, Reykjavik, Iceland
| | | | - Rosa B Barkardottir
- BioMedical Center, University of Iceland, Sturlugata 8, Reykjavik, Iceland
- Department of Pathology, Landspitali-University Hospital, Reykjavik, Iceland
| | - Olöf Bjarnadottir
- Department of Oncology, Landspitali-University Hospital, Reykjavik, Iceland
| | - Jon G Jonasson
- Faculty of Medicine, University of Iceland, Sturlugata 8, Reykjavik, Iceland
- Department of Pathology, Landspitali-University Hospital, Reykjavik, Iceland
| | - Stefan Sigurdsson
- Faculty of Medicine, University of Iceland, Sturlugata 8, Reykjavik, Iceland
- BioMedical Center, University of Iceland, Sturlugata 8, Reykjavik, Iceland
| | - Laufey Tryggvadottir
- Faculty of Medicine, University of Iceland, Sturlugata 8, Reykjavik, Iceland.
- BioMedical Center, University of Iceland, Sturlugata 8, Reykjavik, Iceland.
- Icelandic Cancer Registry, Icelandic Cancer Society, Reykjavik, Iceland.
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13
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Ohashi A, Kataoka M, Iima M, Honda M, Ota R, Urushibata Y, Dominik Nickel M, Toi M, Zackrisson S, Nakamoto Y. A multiparametric approach to predict triple-negative breast cancer including parameters derived from ultrafast dynamic contrast-enhanced MRI. Eur Radiol 2023; 33:8132-8141. [PMID: 37286791 DOI: 10.1007/s00330-023-09730-w] [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: 07/03/2022] [Revised: 03/12/2023] [Accepted: 03/21/2023] [Indexed: 06/09/2023]
Abstract
OBJECTIVE Triple-negative breast cancer (TNBC) is a highly proliferative breast cancer subtype. We aimed to identify TNBC among invasive cancers presenting as masses using maximum slope (MS) and time to enhancement (TTE) measured on ultrafast (UF) DCE-MRI, ADC measured on DWI, and rim enhancement on UF DCE-MRI and early-phase DCE-MRI. METHODS This retrospective single-center study, between December 2015 and May 2020, included patients with breast cancer presenting as masses. Early-phase DCE-MRI was performed immediately after UF DCE-MRI. Interrater agreements were evaluated using the intraclass correlation coefficient (ICC) and Cohen's kappa. Univariate and multivariate logistic regression analyses of the MRI parameters, lesion size, and patient age were performed to predict TNBC and create a prediction model. The programmed death-ligand 1 (PD-L1) expression statuses of the patients with TNBCs were also evaluated. RESULTS In total, 187 women (mean age, 58 years ± 12.9 [standard deviation]) with 191 lesions (33 TNBCs) were evaluated. The ICC for MS, TTE, ADC, and lesion size were 0.95, 0.97, 0.83, and 0.99, respectively. The kappa values of rim enhancements on UF and early-phase DCE-MRI were 0.88 and 0.84, respectively. MS on UF DCE-MRI and rim enhancement on early-phase DCE-MRI remained significant parameters after multivariate analyses. The prediction model created using these significant parameters yielded an area under the curve of 0.74 (95% CI, 0.65, 0.84). The PD-L1-expressing TNBCs tended to have higher rim enhancement rates than the non-PD-L1-expressing TNBCs. CONCLUSION A multiparametric model using UF and early-phase DCE-MRI parameters may be a potential imaging biomarker to identify TNBCs. CLINICAL RELEVANCE STATEMENT Prediction of TNBC or non-TNBC at an early point of diagnosis is crucial for appropriate management. This study offers the potential of UF and early-phase DCE-MRI to offer a solution to this clinical issue. KEY POINTS • It is crucial to predict TNBC at an early clinical period. • Parameters on UF DCE-MRI and early-phase conventional DCE-MRI help in predicting TNBC. • Prediction of TNBC by MRI may be useful in determining appropriate clinical management.
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Affiliation(s)
- Akane Ohashi
- Department of Translational Medicine, Diagnostic Radiology, Lund University, Malmö, Sweden
- Department of Imaging and Functional Medicine, Skåne University Hospital, Malmö, Sweden
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Kawahara-Cho Shogoin Sakyo-Ku, Kyoto-Shi, Kyoto, Japan
| | - Masako Kataoka
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Kawahara-Cho Shogoin Sakyo-Ku, Kyoto-Shi, Kyoto, Japan.
| | - Mami Iima
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Kawahara-Cho Shogoin Sakyo-Ku, Kyoto-Shi, Kyoto, Japan
- Institute of Advancement of Clinical and Translational Science (iACT), Kyoto University Hospital, Kyoto, Japan
| | - Maya Honda
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Kawahara-Cho Shogoin Sakyo-Ku, Kyoto-Shi, Kyoto, Japan
- Department of Diagnostic Radiology, Kansai Electric Power Hospital, Osaka, Japan
| | - Rie Ota
- Department of Radiology, Tenri Hospital, Nara, Japan
| | | | | | - Masakazu Toi
- Department of Breast Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Sophia Zackrisson
- Department of Translational Medicine, Diagnostic Radiology, Lund University, Malmö, Sweden
- Department of Imaging and Functional Medicine, Skåne University Hospital, Malmö, Sweden
| | - Yuji Nakamoto
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Kawahara-Cho Shogoin Sakyo-Ku, Kyoto-Shi, Kyoto, Japan
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14
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Jung HH, Kim JY, Cho EY, Lee JE, Kim SW, Nam SJ, Park YH, Ahn JS, Im YH. A Retrospective Exploratory Analysis for Serum Extracellular Vesicles Reveals APRIL (TNFSF13), CXCL13, and VEGF-A as Prognostic Biomarkers for Neoadjuvant Chemotherapy in Triple-Negative Breast Cancer. Int J Mol Sci 2023; 24:15576. [PMID: 37958571 PMCID: PMC10647725 DOI: 10.3390/ijms242115576] [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: 09/13/2023] [Revised: 10/18/2023] [Accepted: 10/23/2023] [Indexed: 11/15/2023] Open
Abstract
Neoadjuvant chemotherapy (NAC) is widely used as a standard treatment for early-stage triple-negative breast cancer (TNBC). While patients who achieve pathologic complete response (pCR) have a highly favorable outcome, patients who do not achieve pCR have variable prognoses. It is important to identify patients who are most likely to have poor survival outcomes to identify candidates for more aggressive therapeutic approaches after NAC. Many studies have demonstrated that cytokines and growth factors packaged into extracellular vesicles (EVs) have an essential role in tumor progression and drug resistance. In this study, we examined the role of serum-derived EV-associated cytokines as prognostic biomarkers for long-term outcomes in patients who underwent anthracycline-taxane-based NAC. We isolated extracellular vesicles from the serum of 190 TNBC patients who underwent NAC between 2015 and 2018 at Samsung Medical Center. EV-associated cytokine concentrations were measured with ProcartaPlex Immune Monitoring 65-plex panels. The prognostic value of EV-associated cytokines was studied. We found that patients with high EV_APRIL, EV_CXCL13, and EV_VEGF-A levels had shorter overall survival (OS). We further evaluated the role of these selected biomarkers as prognostic factors in patients with residual disease (RD) after NAC. Even in patients with RD, high levels of EV_APRIL, EV_CXCL13, and EV_VEGF-A were correlated with poor OS. In all subgroup analyses, EV_CXCL13 overexpression was significantly associated with poor overall survival. Moreover, multivariate analysis indicated that a high level of EV_CXCL13 was an independent predictor of poor OS. Correlation analysis between biomarker levels in EVs and serum showed that EV_VEGF-A positively correlated with soluble VEGF-A but not CXCL13. An elevated level of soluble VEGF-A was also associated with poor OS. These findings suggest that EV_APRIL, EV_CXCL13, and EV_VEGF-A may be useful in identifying TNBC patients at risk of poor survival outcomes after NAC.
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Affiliation(s)
- Hae Hyun Jung
- Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul 06351, Republic of Korea; (H.H.J.); (J.-Y.K.); (Y.H.P.)
- Biomedical Research Institute, Samsung Medical Center, Seoul 06351, Republic of Korea
| | - Ji-Yeon Kim
- Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul 06351, Republic of Korea; (H.H.J.); (J.-Y.K.); (Y.H.P.)
- Biomedical Research Institute, Samsung Medical Center, Seoul 06351, Republic of Korea
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Seoul 06351, Republic of Korea;
- School of Medicine, Sungkyunkwan University, Suwon 16419, Republic of Korea; (E.Y.C.); (J.E.L.); (S.W.K.); (S.J.N.)
| | - Eun Yoon Cho
- School of Medicine, Sungkyunkwan University, Suwon 16419, Republic of Korea; (E.Y.C.); (J.E.L.); (S.W.K.); (S.J.N.)
- Department of Pathology, Samsung Medical Center, Seoul 06351, Republic of Korea
| | - Jeong Eon Lee
- School of Medicine, Sungkyunkwan University, Suwon 16419, Republic of Korea; (E.Y.C.); (J.E.L.); (S.W.K.); (S.J.N.)
- Department of Surgery, Samsung Medical Center, Seoul 06351, Republic of Korea
| | - Seok Won Kim
- School of Medicine, Sungkyunkwan University, Suwon 16419, Republic of Korea; (E.Y.C.); (J.E.L.); (S.W.K.); (S.J.N.)
- Department of Surgery, Samsung Medical Center, Seoul 06351, Republic of Korea
| | - Seok Jin Nam
- School of Medicine, Sungkyunkwan University, Suwon 16419, Republic of Korea; (E.Y.C.); (J.E.L.); (S.W.K.); (S.J.N.)
- Department of Surgery, Samsung Medical Center, Seoul 06351, Republic of Korea
| | - Yeon Hee Park
- Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul 06351, Republic of Korea; (H.H.J.); (J.-Y.K.); (Y.H.P.)
- Biomedical Research Institute, Samsung Medical Center, Seoul 06351, Republic of Korea
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Seoul 06351, Republic of Korea;
- School of Medicine, Sungkyunkwan University, Suwon 16419, Republic of Korea; (E.Y.C.); (J.E.L.); (S.W.K.); (S.J.N.)
| | - Jin Seok Ahn
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Seoul 06351, Republic of Korea;
- School of Medicine, Sungkyunkwan University, Suwon 16419, Republic of Korea; (E.Y.C.); (J.E.L.); (S.W.K.); (S.J.N.)
| | - Young-Hyuck Im
- Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul 06351, Republic of Korea; (H.H.J.); (J.-Y.K.); (Y.H.P.)
- Biomedical Research Institute, Samsung Medical Center, Seoul 06351, Republic of Korea
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Seoul 06351, Republic of Korea;
- School of Medicine, Sungkyunkwan University, Suwon 16419, Republic of Korea; (E.Y.C.); (J.E.L.); (S.W.K.); (S.J.N.)
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15
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Dunlop HM, Williams LJ, Hall PS, Barber M, Dodds C, Figueroa JD. Evaluation of the association of area-level socioeconomic deprivation and breast cancer recurrence by oestrogen receptor subtypes in Scotland. Breast Cancer Res 2023; 25:106. [PMID: 37784154 PMCID: PMC10546786 DOI: 10.1186/s13058-023-01704-6] [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: 03/23/2023] [Accepted: 08/30/2023] [Indexed: 10/04/2023] Open
Abstract
BACKGROUND Women from socioeconomically deprived areas have lower breast cancer (BC) incidence rates for screen-detected oestrogen receptor (ER) + tumours and higher mortality for select tumour subtypes. We aimed to determine if ipsilateral breast cancer recurrence (IBR) differs by Scottish Index of Multiple Deprivation (SIMD) quintile and tumour subtype in Scotland. METHODS Patient data for primary invasive BC diagnosed in 2007-2008 in Scotland was analysed. Manual case-note review for 3495 patients from 10 years post-diagnosis was used. To determine the probability of IBR while accounting for the competing risk of death from any cause, cumulative incidence functions stratified by ER subtype and surgery were plotted. Multivariable Cox Proportional Hazards models were used to estimate the association of SIMD accounting for other predictors of IBR. RESULTS Among 2819 ER + tumours, 423 patients had a recurrence and 438 died. SIMD was related to death (p = 0.018) with the most deprived more likely to have died in the 10-year period (17.7% vs. 12.9%). We found no significant differences by SIMD in prognostic tumour characteristics (grade, TNM stage, treatment, screen-detection) or risk of IBR. Among 676 patients diagnosed with ER- tumours, 105 died and 185 had a recurrence. We found no significant differences in prognostic tumour characteristics by SIMD except screen detection with the most deprived more likely than the least to have their tumours detected from screening (46.9% vs. 28%, p = 0.03). Among patients with ER- tumours, 50% had mastectomy and the most deprived had increased 5-year IBR risk compared to the least deprived (HR 3.03 [1.41-6.53]). CONCLUSIONS IBR is not a major contributor to mortality differences by SIMD for the majority of BC patients in our study. The lack of inequities in IBR are likely due to standardised treatment protocols and access to healthcare. The association with socioeconomic deprivation and recurrence for ER- tumours requires further study.
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Affiliation(s)
- Hayley M Dunlop
- The Ohio State University College of Medicine, Columbus, OH, USA
| | - Linda J Williams
- Edinburgh Clinical Trials Unit, The Usher Institute, The University of Edinburgh, Edinburgh, EH16 4UX, UK
| | - Peter S Hall
- Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, UK
| | - Matthew Barber
- Edinburgh Breast Unit, NHS Lothian, Western General Hospital, Edinburgh, UK
| | | | - Jonine D Figueroa
- Centre for Global Health, The Usher Institute, The University of Edinburgh, Edinburgh, EH8 9AG, UK.
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
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16
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Blanch S, Gil-Gil JM, Arumí M, Aguirre E, Seguí MÁ, Atienza M, Díaz-Cerezo S, Molero A, Cervera JM, Gavilá J. Observational study of HR+/HER2- metastatic breast cancer patients treated with abemaciclib in Spain in the Named Patient Use Program (AbemusS). Clin Transl Oncol 2023; 25:2950-2959. [PMID: 37029241 PMCID: PMC10462534 DOI: 10.1007/s12094-023-03159-9] [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: 12/27/2022] [Accepted: 03/18/2023] [Indexed: 04/09/2023]
Abstract
INTRODUCTION/OBJECTIVES To describe abemaciclib use in patients with hormone receptor-positive, human epidermal growth factor receptor-negative (HR+/HER2-) metastatic breast cancer (mBC) who participated in the Named Patient Use program (NPU) in Spain. MATERIAL AND METHODS This retrospective study was based on medical record review of patients across 20 centers during 2018/2019. Patients were followed up until death, enrolment in a clinical trial, loss of follow-up or study end. Clinical and demographic characteristics, treatment patterns and abemaciclib effectiveness were analyzed; time-to-event and median times were estimated using the Kaplan-Meier (KM) method. RESULTS The study included 69 female patients with mBC (mean age 60.4 ± 12.4 years), 86% of whom had an initial diagnosis of early BC and 20% had an ECOG ≥ 2. Median follow-up was 23 months (range 16-28). Metastases were frequently observed in bone (79%) and visceral tissue (65%), with 47% having metastases in > 2 sites. Median number of treatment lines before abemaciclib was 6 (range 1-10). Abemaciclib monotherapy was received by 72% of patients and combination therapy with endocrine therapy by 28% of patients; 54% of patients required dose adjustments, with a median time to first adjustment of 1.8 months. Abemaciclib was discontinued in 86% of patients after a median of 7.7 months (13.2 months for combination therapy and 7.0 months for monotherapy) mainly due to disease progression (69%). CONCLUSION These results suggest that abemaciclib is effective, as monotherapy and in combination, for patients with heavily pretreated mBC, consistent with clinical trial results.
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Affiliation(s)
- Salvador Blanch
- Instituto Valenciano de Oncología (IVO), Carrer del Professor Beltrán Báguena, 8, 46009 Valencia, Valencia Spain
| | - Juan Miguel Gil-Gil
- Institut Català d’Oncologia (ICO), Gran Via 199-201, Hospitalet, 08908 Barcelona, Spain
| | - Miriam Arumí
- Department of Medical Oncology, Vall d’Hebron University Hospital and Vall d’Hebron Institute of Oncology, Passeig de la Vall d’Hebron, 119, 08035 Barcelona, Spain
| | - Elena Aguirre
- Hospital Universitario Miguel Servet, Paseo Isabel la Católica, 1-3, 50009 Zaragoza, Spain
| | - Miguel Ángel Seguí
- Hospital Parc Taulí de Sabadell, Parc Taulí, 1, 08208 Sabadell, Barcelona Spain
| | - Manuel Atienza
- Medical Department, Lilly Spain, Av. de la Industria 30, 28108 Madrid, Spain
| | - Silvia Díaz-Cerezo
- Medical Department, Lilly Spain, Av. de la Industria 30, 28108 Madrid, Spain
| | - Alberto Molero
- Medical Department, Lilly Spain, Av. de la Industria 30, 28108 Madrid, Spain
| | - José Manuel Cervera
- Medical Department, Lilly Spain, Av. de la Industria 30, 28108 Madrid, Spain
| | - Joaquín Gavilá
- Instituto Valenciano de Oncología (IVO), Carrer del Professor Beltrán Báguena, 8, 46009 Valencia, Valencia Spain
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17
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Bravo-Solarte DC, Zhang F, Anampa JD. Assessment of Use and Impact of Chemotherapy in Lymph Node-Negative, T1a Triple-Negative Breast Cancer. Clin Breast Cancer 2023; 23:763-773.e6. [PMID: 37648557 DOI: 10.1016/j.clbc.2023.08.002] [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: 06/30/2023] [Revised: 08/03/2023] [Accepted: 08/05/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND Current treatment guidelines suggest considering adjuvant chemotherapy in high-risk patients with T1a, node-negative triple-negative breast cancer (TNBC); however, limited quality data support this statement. Our population-based study assessed the efficacy of adjuvant chemotherapy and factors associated with its administration in node-negative, T1a TNBC. MATERIALS AND METHODS We obtained data from the Surveillance, Epidemiology, and End Results database for patients with T1aN0 TNBC diagnosed between 2010 and 2019. We utilized the Kaplan-Meier method and Cox regression model to analyze the overall survival (OS) and breast cancer-specific survival (BCSS) in chemotherapy benefit. We performed stratified models to identify differences in OS and BCSS between those who received chemotherapy and those who did not across subgroups. Competing risk analysis was conducted to assess differences in risk of breast cancer death in patients with chemotherapy administration versus no chemotherapy. Additionally, propensity score matching was executed to assess survival analysis in a matched cohort. RESULTS We included 1739 patients with T1a TNBC. Patients who received chemotherapy were younger, had higher histological grade and ductal histology subtype, were more likely to be married and undergo mastectomy. Our study did not show improvement in OS (HR, 0.63; 95% CI, 0.35-1.13; P = .122) or BCSS (HR, 0.95; 95% CI, 0.37-2.43; P = .908) after chemotherapy use. We did not identify any subgroup of patients that may benefit from chemotherapy. Without chemotherapy, 8-year risk of breast cancer death is 2.75% for these patients. CONCLUSION Adjuvant chemotherapy is not associated with benefit on OS or BCSS in node-negative, T1a TNBC.
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Affiliation(s)
| | - Frank Zhang
- Department of Internal Medicine, Montefiore Medical Center, Bronx, NY
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18
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Löfling LL, Støer NC, Andreassen BK, Ursin G, Botteri E. Low-dose aspirin, statins, and metformin and survival in patients with breast cancers: a Norwegian population-based cohort study. Breast Cancer Res 2023; 25:101. [PMID: 37649039 PMCID: PMC10466817 DOI: 10.1186/s13058-023-01697-2] [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: 06/15/2023] [Accepted: 08/14/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND Previous studies assessed the prognostic effect of aspirin, statins, and metformin in breast cancer (BC) patients, with inconclusive results. METHODS We performed a nationwide population-based cohort study to evaluate if post-diagnostic use of low-dose aspirin, statins, and metformin was associated with BC-specific survival. Women aged ≥ 50 years and diagnosed with BC in 2004-2017, who survived ≥ 12 months after diagnosis (follow-up started 12 months after diagnosis), were identified in the Cancer Registry of Norway. The Norwegian Prescription Database provided information on prescriptions. Multivariable Cox proportional hazard models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the association between post-diagnostic use and BC-specific survival, overall and by oestrogen receptor (ER) status. RESULTS A total of 26,190 patients were included. Of these, 5324 (20%), 7591 (29%), and 1495 (6%) were post-diagnostic users of low-dose aspirin, statins, and metformin, respectively. The median follow-up was 6.1 years, and 2169 (8%) patients died from BC. HRs for use, compared to no use, were estimated at 0.96 (95% CI 0.85-1.08) for low-dose aspirin (ER+: HR = 0.97, 95% CI 0.83-1.13; ER-: HR = 0.97, 95% CI 0.73-1.29, p value for interaction = 0.562), 0.84 (95% CI 0.75-0.94) for statins (ER+: HR = 0.95, 95% CI 0.82-1.09; ER-: HR = 0.77, 95% CI 0.60-1.00, p value for interaction = 0.259), and 0.70 (95% CI 0.51-0.96) for metformin (compared to use of non-metformin antidiabetics) (ER+: HR = 0.67, 95% CI 0.45-1.01; ER-: HR = 1.62, 95% CI 0.72-3.62, p value for interaction = 0.077). CONCLUSION We found evidence supporting an association between post-diagnostic use of statins and metformin and survival, in patients with BC. Our findings indicate potential differences according to ER status.
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Affiliation(s)
- L Lukas Löfling
- Department of Research, Cancer Registry of Norway, Postboks 5313 Majorstuen, 0304, Oslo, Norway
| | - Nathalie C Støer
- Department of Research, Cancer Registry of Norway, Postboks 5313 Majorstuen, 0304, Oslo, Norway
| | | | - Giske Ursin
- Cancer Registry of Norway, Oslo, Norway
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
- Department of Preventive Medicine, University of Southern California, Los Angeles, USA
| | - Edoardo Botteri
- Department of Research, Cancer Registry of Norway, Postboks 5313 Majorstuen, 0304, Oslo, Norway.
- Section for Colorectal Cancer Screening, Cancer Registry of Norway, Oslo, Norway.
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19
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Rocha AFBM, Freitas-Junior R, Soares LR, Ferreira GLR. Breast cancer screening and diagnosis in older adults women in Brazil: why it is time to reconsider the recommendations. Front Public Health 2023; 11:1232668. [PMID: 37601214 PMCID: PMC10433194 DOI: 10.3389/fpubh.2023.1232668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 07/19/2023] [Indexed: 08/22/2023] Open
Abstract
Introduction Breast cancer screening in women of 70 years of age or older remains controversial due to a lack of studies that include women of this age. Methods This ecological study evaluated data from the Brazilian National Health Service (SUS) on breast cancer screening and staging in this age group compared to 50-69-year olds, for Brazil as a whole and for its geographical regions, between 2013 and 2019. A secondary database was obtained from the outpatient data system of the SUS's Informatics Department, the Brazil Oncology Panel, the Brazilian Institute of Geography and Statistics, the Supplementary Health Agency and the Online Mortality Atlas. Results There was a marked reduction in screening in women ≥70 years of age (annual percent change [APC] -3.5; p < 0.001) compared to those of 50-69 years of age (APC-2.2; p = 0.010). There was a trend towards an increase in clinical staging, with a greater occurrence of stages III and IV in the ≥70 group (44.3%) compared to the women of 50-69 years of age (40.8%; p < 0.001). Conclusion Considering the increasing age of the Brazilian population and the heterogeneity among older adults women, screening for the over-70s within the SUS merits greater debate insofar as the implementation of public policies is concerned.
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Affiliation(s)
| | - Ruffo Freitas-Junior
- Advanced Center for Breast Diagnosis (CORA), Federal University of Goiás, Goiânia, Goiás, Brazil
| | - Leonardo Ribeiro Soares
- Advanced Center for Breast Diagnosis (CORA), Federal University of Goiás, Goiânia, Goiás, Brazil
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20
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Crocetti E, Ravaioli A, Giuliani O, Bucchi L, Vattiato R, Mancini S, Zamagni F, Vitali B, Balducci C, Baldacchini F, Falcini F. Female breast cancer subtypes in the Romagna Unit of the Emilia-Romagna cancer registry, and estimated incident cases by subtypes and age in Italy in 2020. J Cancer Res Clin Oncol 2023; 149:7299-7304. [PMID: 36922443 PMCID: PMC10374783 DOI: 10.1007/s00432-023-04593-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 01/18/2023] [Indexed: 03/17/2023]
Abstract
PURPOSE The aim of this study was to estimate the Italian burden of incident breast cancer (BC) by subtypes, according to the distribution of hormonal receptor (HR) status and expression of human epidermal growth factor 2 (HER2). METHODS Female breast cancers incidence in the Romagna Unit of the Emilia-Romagna registry (n. 10,711) were grouped into: HR+ /HER2-, HR+ /HER2+ , HR-/HER2+ , HR-/HER2- and missing, and by age: < 50, 50-69 and 70+ years. Data were compared with other published Italian population-bases series before using them for national estimates. We used national and regional numbers of expected breast cancers published by the Italian network of cancer registries considering the age- and geographic-specific variation of the Italian population. RESULTS Overall, 70.7% of incident BC cases are expected to be HR+ /HER2-, 8.5% HR+ /HER2+ , 7.5% HR-/HER2-, 4.1% HR-/HER2+ and 9.3% missing. The global ranking is similar across age-groups but with age-specific differences. The proportion of missing was around 3-times lower than in the other Italian published population-based series and similar to the SEER one. In Italy, are estimated 38,841 HR+ /HER2- breast cancer cases, 4665 HR+ /HER2+ , 4098 HR-/HER2-, 2281 HR-/HER2+ , and 5092 not specified. Numbers by age-group were provided. CONCLUSIONS The present estimates relied on high-quality population-based data and provide a clinically relevant information on the burden of breast cancer subtypes. These data will support the planning of therapy needs for oncologists, decision-makers, and all other stakeholders.
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Affiliation(s)
- Emanuele Crocetti
- Romagna Unit of the Emilia-Romagna Cancer Registry, Romagna Cancer Institute, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Forlì, Meldola, Italy.
| | - Alessandra Ravaioli
- Romagna Unit of the Emilia-Romagna Cancer Registry, Romagna Cancer Institute, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Forlì, Meldola, Italy.
| | - Orietta Giuliani
- Romagna Unit of the Emilia-Romagna Cancer Registry, Romagna Cancer Institute, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Forlì, Meldola, Italy
| | - Lauro Bucchi
- Romagna Unit of the Emilia-Romagna Cancer Registry, Romagna Cancer Institute, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Forlì, Meldola, Italy
| | - Rosa Vattiato
- Romagna Unit of the Emilia-Romagna Cancer Registry, Romagna Cancer Institute, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Forlì, Meldola, Italy
| | - Silvia Mancini
- Romagna Unit of the Emilia-Romagna Cancer Registry, Romagna Cancer Institute, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Forlì, Meldola, Italy
| | - Federica Zamagni
- Romagna Unit of the Emilia-Romagna Cancer Registry, Romagna Cancer Institute, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Forlì, Meldola, Italy
| | - Benedetta Vitali
- Romagna Unit of the Emilia-Romagna Cancer Registry, Romagna Cancer Institute, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Forlì, Meldola, Italy
| | - Chiara Balducci
- Romagna Unit of the Emilia-Romagna Cancer Registry, Romagna Cancer Institute, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Forlì, Meldola, Italy
| | - Flavia Baldacchini
- Romagna Unit of the Emilia-Romagna Cancer Registry, Romagna Cancer Institute, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Forlì, Meldola, Italy
| | - Fabio Falcini
- Romagna Unit of the Emilia-Romagna Cancer Registry, Romagna Cancer Institute, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Forlì, Meldola, Italy
- Local Health Authority, Cancer Prevention Unit, Forlì, Italy
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21
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Heeling E, van de Kamer JB, Methorst M, Bruining A, van de Meent M, Vrancken Peeters MJTFD, Lok CAR, van der Ploeg IMC. The Safe Use of 125I-Seeds as a Localization Technique in Breast Cancer during Pregnancy. Cancers (Basel) 2023; 15:3229. [PMID: 37370839 DOI: 10.3390/cancers15123229] [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: 05/19/2023] [Revised: 06/12/2023] [Accepted: 06/15/2023] [Indexed: 06/29/2023] Open
Abstract
INTRODUCTION Some aspects of the treatment protocol for breast cancer during pregnancy (PrBC) have not been thoroughly studied. This study provides clarity regarding the safety of the use of 125I-seeds as a localization technique for breast-conserving surgery in patients with PrBC. METHODS To calculate the exposure to the fetus of one 125I-seed implanted in a breast tumor, we developed a model accounting for the decaying 125I-source, time to surgery, and the declining distance between the 125I-seed and the fetus. The primary outcome was the maximum cumulative fetal dose of radiation at consecutive gestational ages (GA). RESULTS The cumulative fetal dose remains below 1 mSv if a single 125I-seed is implanted at a GA of 26 weeks. After a GA of 26 weeks, the fetal dose can be at a maximum of 11.6 mSv. If surgery takes place within two weeks of implantation from a GA of 26 weeks, and one week above a GA of 32 weeks, the dose remains below 1 mSv. CONCLUSION The use of 125I-seeds is safe in PrBC. The maximum fetal exposure remains well below the threshold of 100 mSv, and therefore, does not lead to an increased risk of fetal tissue damage. Still, we propose keeping the fetal dose as low as possible, preferably below 1 mSv.
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Affiliation(s)
- Eva Heeling
- Department of Surgical Oncology, Netherlands Cancer Institute Antoni van Leeuwenhoek, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
| | - Jeroen B van de Kamer
- Department of Radiation Oncology, Netherlands Cancer Institute Antoni van Leeuwenhoek, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
| | - Michelle Methorst
- Department of Gynaecologic Oncology, Netherlands Cancer Institute Antoni van Leeuwenhoek, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
| | - Annemarie Bruining
- Department of Radiology, Netherlands Cancer Institute Antoni van Leeuwenhoek, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
| | - Mette van de Meent
- Department of Obstetrics, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | | | - Christianne A R Lok
- Department of Gynaecologic Oncology, Netherlands Cancer Institute Antoni van Leeuwenhoek, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
| | - Iris M C van der Ploeg
- Department of Surgical Oncology, Netherlands Cancer Institute Antoni van Leeuwenhoek, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
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Phakathi B, Dix-Peek T, Van Den Berg E, Dickens C, Nietz S, Cubasch H, Joffe M, Neugut AI, Jacobson JS, Ruff P, Duarte R. PAM50 intrinsic subtypes, risk of recurrence score and breast cancer survival in HIV-positive and HIV-negative patients-a South African cohort study. Breast Cancer Res Treat 2023:10.1007/s10549-023-06969-1. [PMID: 37266756 DOI: 10.1007/s10549-023-06969-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 05/03/2023] [Indexed: 06/03/2023]
Abstract
PURPOSE Treatment decision making for patients with breast cancer increasingly depends on analysis of markers or systems for estimating risk of breast cancer recurrence. Breast cancer intrinsic subtypes and risk of recurrence (ROR) scores have been found to be valuable in predicting survival and determining optimal treatment for individual patients. We studied the association of breast cancer survival with the PAM50 gene expression assay in HIV-positive and HIV-negative patients. METHOD RNA was extracted from formalin-fixed paraffin-embedded specimens of histologically confirmed invasive carcinoma and was purified using the AllPrep® DNA/RNA FFPE kit, Qiagen (Hilden, Germany). The NanoString RUO PAM50 algorithm was used to determine the molecular subtype and the risk of recurrence score of each sample. The overall and disease-free survival were determined with comparison made among HIV-positive and -negative patients. We then generated Kaplan-Meier survival curves, calculated p-values and estimated hazard ratios and their 95% confidence intervals using Cox regression models. RESULTS Of the 384 RNA samples analysed, 98.4% met the required RNA quality standard and the specified QC threshold for the test. Luminal B was the most common PAM50 intrinsic subtype and 82.1% of patients were at high risk for disease recurrence based on ROR score. HIV infection, PAM50-based HER2-enriched and basal-like intrinsic subtypes, and high ROR were associated with poor overall and disease-free survival. HIV-positive patients with luminal A & B subtypes had significantly worse survival outcomes than HIV-negative luminal patents. CONCLUSION Aggressive tumour biology was common in our cohort. HIV infection, PAM50 HER2-enriched,basal-like intrinsic subtypes and high ROR score were associated with poor overall and disease-free survival. HIV infection impacted survival in patients with luminal subtypes only.
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Affiliation(s)
- Boitumelo Phakathi
- Department of Surgery, Nelson R Mandela School of Medicine, University of Kwa-Zulu Natal, 719 Umbilo Road, Durban, 4001, South Africa.
| | - Therese Dix-Peek
- Department of Internal Medicine, University of Witwatersrand Faculty of Health Sciences, 7 York Road, Parktown, Johannesburg, South Africa
| | - Eunice Van Den Berg
- Department of Anatomical Pathology, University of Witwatersrand Faculty of Health Sciences, 7 York Road, Parktown, Johannesburg, South Africa
| | - Caroline Dickens
- Department of Internal Medicine, University of Witwatersrand Faculty of Health Sciences, 7 York Road, Parktown, Johannesburg, South Africa
| | - Sarah Nietz
- Department of Surgery, University of the Witwatersrand Faculty of Health Sciences, 7 York Road, Parktown, Johannesburg, 2193, South Africa
- Strengthening Oncology Services Research Unit, University of the Witwatersrand Faculty of Health Sciences, Johannesburg, South Africa
| | - Herbert Cubasch
- Department of Surgery, University of the Witwatersrand Faculty of Health Sciences, 7 York Road, Parktown, Johannesburg, 2193, South Africa
- Strengthening Oncology Services Research Unit, University of the Witwatersrand Faculty of Health Sciences, Johannesburg, South Africa
- Batho Pele Breast Unit, Chris Hani Baragwanath Academic Hospital, 26 Chris Hani Road, Diepkloof, Soweto, 1860, South Africa
- WITS/SAMRC Common Epithelial Cancers Research Centre (CECRC, Cape Town, South Africa
| | - Maureen Joffe
- Strengthening Oncology Services Research Unit, University of the Witwatersrand Faculty of Health Sciences, Johannesburg, South Africa
- WITS/SAMRC Common Epithelial Cancers Research Centre (CECRC, Cape Town, South Africa
| | - Alfred I Neugut
- Herbert Irving Comprehensive Cancer Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, USA
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, USA
| | - Judith S Jacobson
- Herbert Irving Comprehensive Cancer Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, USA
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, USA
| | - Paul Ruff
- Department of Internal Medicine, University of Witwatersrand Faculty of Health Sciences, 7 York Road, Parktown, Johannesburg, South Africa
- Strengthening Oncology Services Research Unit, University of the Witwatersrand Faculty of Health Sciences, Johannesburg, South Africa
- WITS/SAMRC Common Epithelial Cancers Research Centre (CECRC, Cape Town, South Africa
- Division of Medical Oncology, University of the Witwatersrand Faculty of Health Sciences, 7 York Road, Parktown, Johannesburg, South Africa
| | - Raquel Duarte
- Department of Internal Medicine, University of Witwatersrand Faculty of Health Sciences, 7 York Road, Parktown, Johannesburg, South Africa
- WITS/SAMRC Common Epithelial Cancers Research Centre (CECRC, Cape Town, South Africa
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Kang Z, Li Y, Liu J, Chen C, Wu W, Chen C, Lv X, Liang F. H-CNN combined with tissue Raman spectroscopy for cervical cancer detection. SPECTROCHIMICA ACTA. PART A, MOLECULAR AND BIOMOLECULAR SPECTROSCOPY 2023; 291:122339. [PMID: 36641920 DOI: 10.1016/j.saa.2023.122339] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 12/24/2022] [Accepted: 01/06/2023] [Indexed: 06/17/2023]
Abstract
Cervical cancer is one of the most common cancers with a long latent period and slow onset process. Early and accurate identification of the stage of cervical cancer can significantly improve the cure rate and patient survival time. In this study, we collected 699 Raman spectral data of tissue sections from 233 different patients. We analyzed and compared the characteristics and differences of the mean Raman spectra of the seven tissues and pointed out the main differences in the biochemical composition of the seven tissues. In this study, 1D hierarchical convolutional neural network (H-CNN) is proposed by integrating the prior knowledge of hierarchical classification relations with the research of deep learning in Raman spectroscopy. H-CNN is based on CNN and is added with three network branches. Hierarchical classification is performed from coarse to fine for tissue samples of cervicitis, Low-grade Squamous Cell Carcinoma, High-grade Squamous Cell Carcinoma, Well Differentiated Squamous Cell Carcinoma, Moderately Differentiated Squamous Cell Carcinoma, Poorly Differentiated Squamous Cell Carcinoma and cervical adenocarcinoma. To evaluate the recognition performance of H-CNN, we compared it with traditional methods such as Bayesian classifier (NB), decision tree classifier (DT), support vector machine classifier (SVM) and CNN. The experimental results show that H-CNN can accurately identify different classes of tissue sections and has apparent advantages in several aspects such as recognition accuracy, stability and sensitivity compared with the other four traditional recognition methods. The classification Macro-Accuracy of H-CNN can reach 94.91%, Macro-Recall can reach 95.31%, Macro-F1 can reach 95.23%, and Macro-AUC can reach 97.35%. The hierarchical classification method proposed in this study can diagnose patients more accurately. This could lay the foundation for further research on Raman spectroscopy as a clinical diagnostic method for cervical cancer.
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Affiliation(s)
- Zhenping Kang
- College of Information Science and Engineering, Xinjiang University, Urumqi 830046, China
| | - Yizhe Li
- College of Information Science and Engineering, Xinjiang University, Urumqi 830046, China
| | - Jie Liu
- Department of Gynecology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, China; State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Urumqi, 830054, China.; Xinjiang Key Laboratory of Medical Animal Model Research, Urumqi, 830054, China
| | - Cheng Chen
- College of Software, Xinjiang University, Urumqi 830046, China; Key Laboratory of signal detection and processing, Xinjiang University, Urumqi 830046, China.
| | - Wei Wu
- College of Software, Xinjiang University, Urumqi 830046, China
| | - Chen Chen
- College of Information Science and Engineering, Xinjiang University, Urumqi 830046, China; Xinjiang Cloud Computing Application Laboratory, Karamay 834099, China
| | - Xiaoyi Lv
- College of Information Science and Engineering, Xinjiang University, Urumqi 830046, China; Department of Gynecology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, China; Key Laboratory of signal detection and processing, Xinjiang University, Urumqi 830046, China
| | - Fei Liang
- Xinjiang Karamay Central Hospital, Karamay 834099, China
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24
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Korbecki J, Bosiacki M, Barczak K, Łagocka R, Brodowska A, Chlubek D, Baranowska-Bosiacka I. Involvement in Tumorigenesis and Clinical Significance of CXCL1 in Reproductive Cancers: Breast Cancer, Cervical Cancer, Endometrial Cancer, Ovarian Cancer and Prostate Cancer. Int J Mol Sci 2023; 24:ijms24087262. [PMID: 37108425 PMCID: PMC10139049 DOI: 10.3390/ijms24087262] [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: 03/18/2023] [Revised: 04/11/2023] [Accepted: 04/13/2023] [Indexed: 04/29/2023] Open
Abstract
C-X-C motif chemokine ligand 1 (CXCL1) is a member of the CXC chemokine subfamily and a ligand for CXCR2. Its main function in the immune system is the chemoattraction of neutrophils. However, there is a lack of comprehensive reviews summarizing the significance of CXCL1 in cancer processes. To fill this gap, this work describes the clinical significance and participation of CXCL1 in cancer processes in the most important reproductive cancers: breast cancer, cervical cancer, endometrial cancer, ovarian cancer, and prostate cancer. The focus is on both clinical aspects and the significance of CXCL1 in molecular cancer processes. We describe the association of CXCL1 with clinical features of tumors, including prognosis, ER, PR and HER2 status, and TNM stage. We present the molecular contribution of CXCL1 to chemoresistance and radioresistance in selected tumors and its influence on the proliferation, migration, and invasion of tumor cells. Additionally, we present the impact of CXCL1 on the microenvironment of reproductive cancers, including its effect on angiogenesis, recruitment, and function of cancer-associated cells (macrophages, neutrophils, MDSC, and Treg). The article concludes by summarizing the significance of introducing drugs targeting CXCL1. This paper also discusses the significance of ACKR1/DARC in reproductive cancers.
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Affiliation(s)
- Jan Korbecki
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University in Szczecin, Powstańców Wlkp. 72, 70-111 Szczecin, Poland
- Department of Anatomy and Histology, Collegium Medicum, University of Zielona Góra, Zyty 28 Str., 65-046 Zielona Góra, Poland
| | - Mateusz Bosiacki
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University in Szczecin, Powstańców Wlkp. 72, 70-111 Szczecin, Poland
- Department of Functional Diagnostics and Physical Medicine, Faculty of Health Sciences Pomeranian Medical University in Szczecin, Żołnierska 54 Str., 71-210 Szczecin, Poland
| | - Katarzyna Barczak
- Department of Conservative Dentistry and Endodontics, Pomeranian Medical University, Powstańców Wlkp. 72, 70-111 Szczecin, Poland
| | - Ryta Łagocka
- Department of Conservative Dentistry and Endodontics, Pomeranian Medical University, Powstańców Wlkp. 72, 70-111 Szczecin, Poland
| | - Agnieszka Brodowska
- Department of Gynecology, Endocrinology and Gynecological Oncology, Pomeranian Medical University in Szczecin, Unii Lubelskiej 1, 71-252 Szczecin, Poland
| | - Dariusz Chlubek
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University in Szczecin, Powstańców Wlkp. 72, 70-111 Szczecin, Poland
| | - Irena Baranowska-Bosiacka
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University in Szczecin, Powstańców Wlkp. 72, 70-111 Szczecin, Poland
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Løfling L, Støer NC, Nafisi S, Ursin G, Hofvind S, Botteri E. Low-dose aspirin and risk of breast cancer: a Norwegian population-based cohort study of one million women. Eur J Epidemiol 2023; 38:413-426. [PMID: 36877278 PMCID: PMC10082109 DOI: 10.1007/s10654-023-00976-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 02/03/2023] [Indexed: 03/07/2023]
Abstract
Several studies evaluated the association between aspirin use and risk of breast cancer (BC), with inconsistent results. We identified women aged ≥ 50 years residing in Norway between 2004 and 2018, and linked data from nationwide registries; including the Cancer Registry of Norway, the Norwegian Prescription Database, and national health surveys. We used Cox regression models to estimate the association between low-dose aspirin use and BC risk, overall and by BC characteristics, women's age and body mass index (BMI), adjusting for sociodemographic factors and use of other medications. We included 1,083,629 women. During a median follow-up of 11.6 years, 257,442 (24%) women used aspirin, and 29,533 (3%) BCs occurred. For current use of aspirin, compared to never use, we found an indication of a reduced risk of oestrogen receptor-positive (ER +) BC (hazard ratio [HR] = 0.96, 95% confidence interval [CI]: 0.92-1.00), but not ER-negative BC (HR = 1.01, 95%CI: 0.90-1.13). The association with ER + BC was only found in women aged ≥ 65 years (HR = 0.95, 95%CI: 0.90-0.99), and became stronger as the duration of use increased (use of ≥ 4 years HR = 0.91, 95%CI: 0.85-0.98). BMI was available for 450,080 (42%) women. Current use of aspirin was associated with a reduced risk of ER + BC in women with BMI ≥ 25 (HR = 0.91, 95%CI: 0.83-0.99; HR = 0.86, 95%CI: 0.75-0.97 for use of ≥ 4 years), but not in women with BMI < 25.Use of low-dose aspirin was associated with reduced risk of ER + BC, in particular in women aged ≥ 65 years and overweight women.
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Affiliation(s)
- Lukas Løfling
- Department of Research, Cancer Registry of Norway, Postboks 5313 Majorstuen, 0304, Oslo, Norway
| | - Nathalie C Støer
- Department of Research, Cancer Registry of Norway, Postboks 5313 Majorstuen, 0304, Oslo, Norway
- Norwegian Research Centre for Women's Health, Women's Clinic, Oslo University Hospital, Oslo, Norway
| | - Sara Nafisi
- Department of Research, Cancer Registry of Norway, Postboks 5313 Majorstuen, 0304, Oslo, Norway
- Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Giske Ursin
- Cancer Registry of Norway, Oslo, Norway
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
- Department of Preventive Medicine, University of Southern California, Los Angeles, USA
| | - Solveig Hofvind
- Section for Breast Cancer Screening, Cancer Registry of Norway, Oslo, Norway
- Department of Health and Care Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Edoardo Botteri
- Department of Research, Cancer Registry of Norway, Postboks 5313 Majorstuen, 0304, Oslo, Norway.
- Section for Colorectal Cancer Screening, Cancer Registry of Norway, Postboks 5313 Majorstuen, 0304, Oslo, Norway.
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Chasimpha S, dos Santos Silva I, Martei YM, Grover S, Cubasch H, McCormack V. Survival Disparities Between Patients with Breast Cancer With and Without HIV: A Research Framework. JCO Glob Oncol 2023; 9:e2200330. [PMID: 37075268 PMCID: PMC10281420 DOI: 10.1200/go.22.00330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 01/17/2023] [Accepted: 02/07/2023] [Indexed: 04/21/2023] Open
Affiliation(s)
- Steady Chasimpha
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Isabel dos Santos Silva
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Yehoda M. Martei
- Department of Medicine (Hematology-Oncology), University of Pennsylvania, Philadelphia, PA
| | - Surbhi Grover
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA
| | - Herbert Cubasch
- Department of Surgery, University of Witwatersrand, Johannesburg, South Africa
- Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa
| | - Valerie McCormack
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer, Lyon, France
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27
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Basmadjian RB, Chow K, Kim D, Kenney M, Lukmanji A, O'Sullivan DE, Xu Y, Quan ML, Cheung WY, Lupichuk S, Brenner DR. The Association between Early-Onset Diagnosis and Clinical Outcomes in Triple-Negative Breast Cancer: A Systematic Review and Meta-Analysis. Cancers (Basel) 2023; 15:cancers15071923. [PMID: 37046584 PMCID: PMC10093252 DOI: 10.3390/cancers15071923] [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: 03/06/2023] [Revised: 03/16/2023] [Accepted: 03/21/2023] [Indexed: 04/14/2023] Open
Abstract
Early-onset diagnosis, defined by age <40 years, has historically been associated with inferior outcomes in breast cancer. Recent evidence suggests that this association is modified by molecular subtype. We performed a systematic review and meta-analysis of the literature to synthesize evidence on the association between early-onset diagnosis and clinical outcomes in triple-negative breast cancer (TNBC). Studies comparing the risk of clinical outcomes in non-metastatic TNBC between early-onset patients and later-onset patients (≥40 years) were queried in Medline and EMBASE from inception to February 2023. Separate meta-analyses were performed for breast cancer specific survival (BCSS), overall survival (OS), and disease-free survival (DFS), locoregional recurrence-free survival (LRRFS), distant recurrence-free survival (DRFS), and pathological complete response (pCR). In total, 7581 unique records were identified, and 36 studies satisfied inclusion criteria. The pooled risk of any recurrence was significantly greater in early-onset patients compared to later-onset patients. Better BCSS and OS were observed in early-onset patients relative to later-onset patients aged >60 years. The pooled odds of achieving pCR were significantly higher in early-onset patients. Future studies should evaluate the role of locoregional management of TNBC and the implementation of novel therapies such as PARP inhibitors in real-world settings, and whether they improve outcomes.
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Affiliation(s)
- Robert B Basmadjian
- Department of Community Health Sciences, Foothills Medical Centre, University of Calgary, Calgary, AB T2N 2T9, Canada
| | - Kristian Chow
- Department of Oncology, Tom Baker Cancer Centre, University of Calgary, Calgary, AB T2N 4N2, Canada
| | - Dayoung Kim
- Department of Oncology, Tom Baker Cancer Centre, University of Calgary, Calgary, AB T2N 4N2, Canada
| | - Matthew Kenney
- Department of Oncology, Tom Baker Cancer Centre, University of Calgary, Calgary, AB T2N 4N2, Canada
| | - Aysha Lukmanji
- Department of Community Health Sciences, Foothills Medical Centre, University of Calgary, Calgary, AB T2N 2T9, Canada
| | - Dylan E O'Sullivan
- Department of Community Health Sciences, Foothills Medical Centre, University of Calgary, Calgary, AB T2N 2T9, Canada
- Department of Oncology, Tom Baker Cancer Centre, University of Calgary, Calgary, AB T2N 4N2, Canada
- Department of Cancer Epidemiology and Prevention Research, Cancer Research & Analytics, Cancer Care Alberta, Alberta Health Services, Calgary, AB T2S 3C3, Canada
| | - Yuan Xu
- Department of Community Health Sciences, Foothills Medical Centre, University of Calgary, Calgary, AB T2N 2T9, Canada
- Department of Oncology, Tom Baker Cancer Centre, University of Calgary, Calgary, AB T2N 4N2, Canada
- Department of Surgery, Foothills Medical Centre, University of Calgary, Calgary, AB T2N 2T9, Canada
| | - May Lynn Quan
- Department of Community Health Sciences, Foothills Medical Centre, University of Calgary, Calgary, AB T2N 2T9, Canada
- Department of Oncology, Tom Baker Cancer Centre, University of Calgary, Calgary, AB T2N 4N2, Canada
- Department of Surgery, Foothills Medical Centre, University of Calgary, Calgary, AB T2N 2T9, Canada
| | - Winson Y Cheung
- Department of Community Health Sciences, Foothills Medical Centre, University of Calgary, Calgary, AB T2N 2T9, Canada
- Department of Oncology, Tom Baker Cancer Centre, University of Calgary, Calgary, AB T2N 4N2, Canada
| | - Sasha Lupichuk
- Department of Community Health Sciences, Foothills Medical Centre, University of Calgary, Calgary, AB T2N 2T9, Canada
- Department of Oncology, Tom Baker Cancer Centre, University of Calgary, Calgary, AB T2N 4N2, Canada
| | - Darren R Brenner
- Department of Community Health Sciences, Foothills Medical Centre, University of Calgary, Calgary, AB T2N 2T9, Canada
- Department of Oncology, Tom Baker Cancer Centre, University of Calgary, Calgary, AB T2N 4N2, Canada
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Sokolov P, Nifontova G, Samokhvalov P, Karaulov A, Sukhanova A, Nabiev I. Nontoxic Fluorescent Nanoprobes for Multiplexed Detection and 3D Imaging of Tumor Markers in Breast Cancer. Pharmaceutics 2023; 15:pharmaceutics15030946. [PMID: 36986807 PMCID: PMC10052755 DOI: 10.3390/pharmaceutics15030946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 03/02/2023] [Accepted: 03/13/2023] [Indexed: 03/17/2023] Open
Abstract
Multiplexed fluorescent immunohistochemical analysis of breast cancer (BC) markers and high-resolution 3D immunofluorescence imaging of the tumor and its microenvironment not only facilitate making the disease prognosis and selecting effective anticancer therapy (including photodynamic therapy), but also provides information on signaling and metabolic mechanisms of carcinogenesis and helps in the search for new therapeutic targets and drugs. The characteristics of imaging nanoprobe efficiency, such as sensitivity, target affinity, depth of tissue penetration, and photostability, are determined by the properties of their components, fluorophores and capture molecules, and by the method of their conjugation. Regarding individual nanoprobe components, fluorescent nanocrystals (NCs) are widely used for optical imaging in vitro and in vivo, and single-domain antibodies (sdAbs) are well established as highly specific capture molecules in diagnostic and therapeutic applications. Moreover, the technologies of obtaining functionally active sdAb–NC conjugates with the highest possible avidity, with all sdAb molecules bound to the NC in a strictly oriented manner, provide 3D-imaging nanoprobes with strong comparative advantages. This review is aimed at highlighting the importance of an integrated approach to BC diagnosis, including the detection of biomarkers of the tumor and its microenvironment, as well as the need for their quantitative profiling and imaging of their mutual location, using advanced approaches to 3D detection in thick tissue sections. The existing approaches to 3D imaging of tumors and their microenvironment using fluorescent NCs are described, and the main comparative advantages and disadvantages of nontoxic fluorescent sdAb–NC conjugates as nanoprobes for multiplexed detection and 3D imaging of BC markers are discussed.
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Affiliation(s)
- Pavel Sokolov
- Laboratory of Nano-Bioengineering, National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), 115522 Moscow, Russia
| | - Galina Nifontova
- Laboratoire de Recherche en Nanosciences, LRN-EA4682, Université de Reims Champagne-Ardenne, 51100 Reims, France
| | - Pavel Samokhvalov
- Laboratory of Nano-Bioengineering, National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), 115522 Moscow, Russia
| | - Alexander Karaulov
- Department of Clinical Immunology and Allergology, Institute of Molecular Medicine, Sechenov First Moscow State Medical University (Sechenov University), 119146 Moscow, Russia
| | - Alyona Sukhanova
- Laboratoire de Recherche en Nanosciences, LRN-EA4682, Université de Reims Champagne-Ardenne, 51100 Reims, France
| | - Igor Nabiev
- Laboratory of Nano-Bioengineering, National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), 115522 Moscow, Russia
- Laboratoire de Recherche en Nanosciences, LRN-EA4682, Université de Reims Champagne-Ardenne, 51100 Reims, France
- Department of Clinical Immunology and Allergology, Institute of Molecular Medicine, Sechenov First Moscow State Medical University (Sechenov University), 119146 Moscow, Russia
- Correspondence:
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Targeting KK-LC-1 inhibits malignant biological behaviors of triple-negative breast cancer. J Transl Med 2023; 21:184. [PMID: 36895039 PMCID: PMC9996895 DOI: 10.1186/s12967-023-04030-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 03/01/2023] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND Cancer/testis antigens (CTAs) participate in the regulation of malignant biological behaviors in breast cancer. However, the function and mechanism of KK-LC-1, a member of the CTA family, in breast cancer are still unclear. METHODS Bioinformatic tools, immunohistochemistry, and western blotting were utilized to detect the expression of KK-LC-1 in breast cancer and to explore the prognostic effect of KK-LC-1 expression in breast cancer patients. Cell function assays, animal assays, and next-generation sequencing were utilized to explore the function and mechanism of KK-LC-1 in the malignant biological behaviors of triple-negative breast cancer. Small molecular compounds targeting KK-LC-1 were also screened and drug susceptibility testing was performed. RESULTS KK-LC-1 was significantly highly expressed in triple-negative breast cancer tissues than in normal breast tissues. KK-LC-1 high expression was related to poor survival outcomes in patients with breast cancer. In vitro studies suggested that KK-LC-1 silencing can inhibit triple-negative breast cancer cell proliferation, invasion, migration, and scratch healing ability, increase cell apoptosis ratio, and arrest the cell cycle in the G0-G1 phase. In vivo studies have suggested that KK-LC-1 silencing decreases tumor weight and volume in nude mice. Results showed that KK-CL-1 can regulate the malignant biological behaviors of triple-negative breast cancer via the MAL2/MUC1-C/PI3K/AKT/mTOR pathway. The small-molecule compound Z839878730 had excellent KK-LC-1 targeting ability and cancer cell killing ability. The EC50 value was 9.7 μM for MDA-MB-231 cells and 13.67 µM for MDA-MB-468 cells. Besides, Z839878730 has little tumor-killing effect on human normal mammary epithelial cells MCF10A and can inhibit the malignant biological behaviors of triple-negative breast cancer cells by MAL2/MUC1-C/PI3K/AKT/mTOR pathway. CONCLUSIONS Our findings suggest that KK-LC-1 may serve as a novel therapeutic target for triple-negative breast cancer. Z839878730, which targets KK-LC-1, presents a new path for breast cancer clinical treatment.
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Clauser P. Clinical value of contralateral breast cancers detected by pre-operative MRI in patients diagnosed with DCIS: a population-based cohort study-commentary. Eur Radiol 2023; 33:2207-2208. [PMID: 36692600 DOI: 10.1007/s00330-023-09396-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 10/30/2022] [Accepted: 11/22/2022] [Indexed: 01/25/2023]
Affiliation(s)
- Paola Clauser
- Deparment of Biomedical Imaging and Image-Guided Therapy, Division of General and Pediatric Radiology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
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Quality Indicators Compliance and Survival Outcomes in Breast Cancer according to Age in a Certified Center. Cancers (Basel) 2023; 15:cancers15051446. [PMID: 36900236 PMCID: PMC10000816 DOI: 10.3390/cancers15051446] [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: 01/27/2023] [Revised: 02/19/2023] [Accepted: 02/23/2023] [Indexed: 03/02/2023] Open
Abstract
Age as a breast cancer (BC) prognostic factor remains debatable. Several studies have investigated clinicopathological features at different ages, but few make an age group direct comparison. The European Society of Breast Cancer Specialists quality indicators (EUSOMA-QIs) allow a standardized quality assurance of BC diagnosis, treatment, and follow-up. Our objective was to compare clinicopathological features, compliance to EUSOMA-QIs and BC outcomes in three age groups (≤45 years, 46-69 years, and ≥70 years). Data from 1580 patients with staged 0-IV BC from 2015 to 2019 were analyzed. The minimum standard and desirable target on 19 mandatory and 7 recommended QIs were studied. The 5-year relapse rate, overall survival (OS), and BC-specific survival (BCSS) were also evaluated. No meaningful differences in TNM staging and molecular subtyping classification between age groups were found. On the contrary, disparities in QIs compliance were observed: 73.1% in ≤45 years and 46-69 years women vs. 54% in older patients. No differences in loco-regional or distant progression were observed between age groups. Nevertheless, lower OS was found in older patients due to concurrent non-oncological causes. After survival curves adjustment, we underscored evidence of undertreatment impacting BCSS in ≥70 years women. Despite a unique exception-more invasive G3 tumors in younger patients-no age-specific differences in BC biology impacting outcome were found. Although increased noncompliance in older women, no outcome correlation was observed with QIs noncompliance in any age group. Clinicopathological features and differences in multimodal treatment (not the chronological age) are predictors of lower BCSS.
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Ramírez-Torres N, Reyes-López A, Hernández-Valencia M. [Associating prognostic factors with clinical results in locally advanced breast cancer]. REVISTA MEDICA DEL INSTITUTO MEXICANO DEL SEGURO SOCIAL 2023; 61:88-98. [PMID: 36542781 PMCID: PMC10395981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 08/23/2022] [Indexed: 12/24/2022]
Abstract
Background Breast cancer is the most frequent malignant tumor in women. Objective To identify clinico-pathological and molecular markers as predictors of survival in patients with locally advanced breast cancer (LABC). Methods Retrospective and observational study. The clinical factors of clinico-pathological and molecular predictors in relation with overall survival (OS) were assessed by the survival function, baseline hazard with smoothing and Cox regression. Results 126 patients were assessed. OS at five years was significantly superior in patients with clinical stage IIIA (87%; p < 0.001), grade 2 tumor (81%; p < 0.001), pathological node stage (ypN0: 90%; p < .001), low-risk Nottingham prognostic index (86%; p < 0.001) and luminal A subtype (88%; p = 0.022). Baseline hazard with smoothing exhibited an increase in the mortality rate at 50 months for the luminal B/ HER2+ subtype compared with other subtypes. The multivariate analysis ascertained that the stage ypN2-3 (hazard ratio [HR] = 7.3; 95% confidence interval [95% CI]: 2.2 to 23.9) and the HER2+ nonluminal (HR = 7.8; 95% CI: 2 to 29.6) and triple negative (HR = 5.4; 95% CI: 1.7 to 17.2) subtypes were associated with a poor OS. Conclusions The comprehensive evaluation of the molecular marker and clinico-pathological factors provides more accurate predictive and prognostic information. The nodal stage and molecular subtype are suitable clinical parameters on survival for LABC patients.
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Affiliation(s)
- Nicolás Ramírez-Torres
- Instituto Mexicano del Seguro Social, Centro Médico Nacional La Raza, Hospital de Ginecoobstetricia No. 3, Servicio de Ginecología Oncológica. Ciudad de México, MéxicoInstituto Mexicano del Seguro SocialMéxico
| | - Alfonso Reyes-López
- Secretaría de Salud, Hospital Infantil de México “Federico Gómez”, Centro de Estudios Económicos y Sociales en Salud. Ciudad de México, MéxicoSecretaría de SaludMéxico
| | - Marcelino Hernández-Valencia
- Instituto Mexicano del Seguro Social, Centro Médico Nacional Siglo XXI, Hospital de Especialidades “Dr Bernardo Sepúlveda Gutiérrez”, Unidad de Investigación Médica en Enfermedades Endocrinas. Ciudad de México, MéxicoInstituto Mexicano del Seguro SocialMéxico
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Shen Y, Xue J, Yu J, Jiang Y, Bu J, Zhu T, Gu X, Zhu X. Comprehensive analysis of the expression, prognostic significance, and regulation pathway of G2E3 in breast cancer. World J Surg Oncol 2022; 20:398. [PMID: 36517818 PMCID: PMC9753372 DOI: 10.1186/s12957-022-02871-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 12/04/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Loss of G2-specific E3-like (G2E3) protein sensitizes tumor cells to chemotherapy. However, the role of G2E3 in breast cancer development and patient's prognosis is unclear. Here, we explored the expression, prognostic significance, and regulatory pathway of G2E3 in breast cancer. METHODS TCGA and UALCAN database were utilized to explore G2E3 expression in breast cancer and normal tissues and its expression in breast cancer based on clinicopathological characteristics, respectively. The Kaplan-Meier plotter database was utilized to determine the effect of G2E3 on the prognosis of breast cancer patients. RT-PCR was utilized to validate the G2E3 expression in cancerous and normal breast tissues. Immunohistochemistry analysis was utilized to validate the prognostic effect of G2E3 expression in breast cancer patients and the relationship between G2E3 expression and lymphocyte infiltration levels. Receiver operating characteristic (ROC) curves were also generated to validate the diagnostic value of G2E3 expression in recurrence/distant organ metastasis and death. The STRING database, DAVID database, and Sanger-box tools were utilized to perform GO functional, KEGG pathway enrichment, and GSEA analysis. The TISIDB database was utilized to determine the relationship between G2E3 expression and tumor immunity. Finally, CTD database was utilized to screen for potential therapeutic compounds that could reduce the G2E3 mRNA expression. RESULTS TCGA data presented that G2E3 expression was higher in breast cancer tissues than in normal breast tissues. This result was further validated by RT-PCR (P = 0.003). The Kaplan-Meier plotter database suggested that patients with high G2E3 mRNA expression had significantly shorter RFS and OS than patients with low G2E3 mRNA expression. Immunohistochemistry analysis of 156 breast cancer clinical specimens also validated patients with G2E3-positive expression had a significantly shorter DFS and OS than patients with G2E3-negative expression. Thus, G2E3 expression was an independent prognostic predictor of DFS and OS. The G2E3-positive expression also has a high diagnostic value for recurrence/distant organ metastasis and death. GSEA analysis revealed that G2E3 might be enriched in the E2F, PI3K/AKT/mTOR signaling, DNA repair pathways, and other cancer-related signaling pathways. The TISIDB database showed that G2E3 expression was significantly negatively associated with lymphocyte infiltration. This result was further validated in clinical breast cancer samples (P = 0.048; R = -0.158). Using the CTD database, we found that (+)-JQ1 compound, 1,2-dimethylhydrazine, and other compounds may decrease the G2E3 mRNA expression. These compounds could serve as potential therapeutic compounds for the clinical treatment of breast cancer. CONCLUSIONS G2E3 expression was higher in breast cancer tissues than in normal tissues. G2E3-positive expression was related to a worse survival outcome in patients with breast cancer. Genes co-expressed with G2E3 may be enriched in the breast cancer-related signaling pathways. The G2E3 expression was significantly negatively associated with lymphocyte infiltration. G2E3 may serve as a novel prognostic biomarker and therapeutic target for breast cancer.
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Affiliation(s)
- Yanyan Shen
- grid.412467.20000 0004 1806 3501Department of Neurosurgery, Shengjing Hospital of China Medical University, Shenyang, 110004 Liaoning China
| | - Jinqi Xue
- grid.412467.20000 0004 1806 3501Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, 110004 Liaoning China
| | - Jiahui Yu
- grid.412467.20000 0004 1806 3501Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, 110004 Liaoning China
| | - Yi Jiang
- grid.412467.20000 0004 1806 3501Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, 110004 Liaoning China
| | - Jiawen Bu
- grid.412467.20000 0004 1806 3501Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, 110004 Liaoning China
| | - Tong Zhu
- grid.412467.20000 0004 1806 3501Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, 110004 Liaoning China
| | - Xi Gu
- grid.412467.20000 0004 1806 3501Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, 110004 Liaoning China
| | - Xudong Zhu
- grid.412467.20000 0004 1806 3501Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, 110004 Liaoning China ,grid.459742.90000 0004 1798 5889Department of General Surgery, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, 110042 Liaoning China
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Fan Y, Pan X, Yang F, Liu S, Wang Z, Sun J, Chen J. Preoperative Computed Tomography Radiomics Analysis for Predicting Receptors Status and Ki-67 Levels in Breast Cancer. Am J Clin Oncol 2022; 45:526-533. [PMID: 36413682 PMCID: PMC9698095 DOI: 10.1097/coc.0000000000000951] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND To assess the prediction performance of preoperative chest computed tomography (CT) based radiomics features for estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor-2 (HER2+), and Ki-67 status of breast cancer. MATERIALS AND METHODS This study enrolled 108 breast cancer patients who received preoperative chest CT examinations in our institution from July 2018 to January 2020. Radiomics features were separately extracted from nonenhanced, arterial, and portal-venous phases CT images. The least absolute shrinkage and selection operator logistic regression was used for feature selection. Then the radiomics signatures for each phase and a combined model of 3 phases were built. Finally, the receiver operating characteristic curves and calibration curves were used to confirm the performance of the radiomics signatures and combined model. In addition, the decision curves were performed to estimate the clinical usefulness of the combined model. RESULTS The 20 most predictive features were finally selected to build radiomics signatures for each phase. The combined model achieved the overall best performance than using either of the nonenhanced, arterial and portal-venous phases alone, achieving an area under the receiver operating characteristic curve of 0.870 for ER+ versus ER-, 0.797 for PR+ versus PR-, 0.881 for HER2+ versus HER2-, and 0.726 for Ki-67. The decision curve demonstrated that the CT-based radiomics features were clinically useful. CONCLUSION This study indicated preopreative chest CT radiomics analysis might be able to assess ER, PR, HER2+, and Ki-67 status of breast cancer. The findings need further to be verified in future larger studies.
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Affiliation(s)
- Yuan Fan
- General Surgery Department, Qujing City First People’s Hospital, Qujing Yunnan
| | | | | | - Siyun Liu
- GE Healthcare life science, Shanghai, People’s Republic of China
| | - Zhu Wang
- Laboratory of Molecular Diagnosis of Cancer, Cancer Center
| | | | - Jie Chen
- Department of Breast Surgery, West China Hospital of Sichuan University, Chengdu Sichuan
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Curtaz CJ, Kiesel L, Meybohm P, Wöckel A, Burek M. Anti-Hormonal Therapy in Breast Cancer and Its Effect on the Blood-Brain Barrier. Cancers (Basel) 2022; 14:cancers14205132. [PMID: 36291916 PMCID: PMC9599962 DOI: 10.3390/cancers14205132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 10/17/2022] [Accepted: 10/18/2022] [Indexed: 11/16/2022] Open
Abstract
The molecular receptor status of breast cancer has implications for prognosis and long-term metastasis. Although metastatic luminal B-like, hormone-receptor-positive, HER2−negative, breast cancer causes brain metastases less frequently than other subtypes, though tumor metastases in the brain are increasingly being detected of this patient group. Despite the many years of tried and tested use of a wide variety of anti-hormonal therapeutic agents, there is insufficient data on their intracerebral effectiveness and their ability to cross the blood-brain barrier. In this review, we therefore summarize the current state of knowledge on anti-hormonal therapy and its intracerebral impact and effects on the blood-brain barrier in breast cancer.
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Affiliation(s)
- Carolin J. Curtaz
- Department of Gynecology and Obstetrics, University Hospital Würzburg, 97080 Würzburg, Germany
- Correspondence:
| | - Ludwig Kiesel
- Department of Gynecology and Obstetrics, University Hospital of Münster, 48143 Münster, Germany
| | - Patrick Meybohm
- Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, University Hospital Würzburg, 97080 Würzburg, Germany
| | - Achim Wöckel
- Department of Gynecology and Obstetrics, University Hospital Würzburg, 97080 Würzburg, Germany
| | - Malgorzata Burek
- Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, University Hospital Würzburg, 97080 Würzburg, Germany
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Bai X, Zhang X, Xiang W, Wang Y, Cao Y, Geng G, Wu B, Lai Y, Li Y, Shi B. Time tracking and multidimensional influencing factors analysis on female breast cancer mortality: Evidence from urban and rural China between 1994 to 2019. Front Public Health 2022; 10:1000892. [PMID: 36225788 PMCID: PMC9549912 DOI: 10.3389/fpubh.2022.1000892] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 09/05/2022] [Indexed: 01/26/2023] Open
Abstract
Background There are huge differences in female breast cancer mortality between urban and rural China. In order to better prevent breast cancer equally in urban and rural areas, it is critical to trace the root causes of past inequities and predict how future differences will change. Moreover, carcinogenic factors from micro-individual to macro-environment also need to be analyzed in detail. However, there is no systematic research covering these two aspects in the current literature. Methods Breast cancer mortality data in urban and rural China from 1994 to 2019 are collected, which from China Health Statistical Yearbook. The Age-Period-Cohort model is used to examine the effects of different age groups, periods, and birth cohorts on breast cancer mortality. Nordpred project is used to predict breast cancer mortality from 2020 to 2039. Results The age effect gradually increases and changes from negative to positive at the age of 40-44. The period effect fluctuates very little and shows the largest difference between urban and rural areas in 2019. The birth cohort effect gradually decreases with urban-rural effects alternating between strong and weak. In the predicted results, the urban-rural mortality gap becomes first narrow and then wide and shows a trend of younger death. Conclusions From the perspective of a temporal system, the changing trend of breast cancer mortality is highly consistent with the history of social and economic structural changes in China. From the perspective of the theory of social determinants of health, individuals, families, institutions and governments need to participate in the prevention of breast cancer.
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Affiliation(s)
- Xiaodan Bai
- Department of Economics, School of Economics, Minzu University of China, Beijing, China
| | - Xiyu Zhang
- Research Center of Health Policy and Management, School of Health Management, Harbin Medical University, Harbin, China
| | - Wenjing Xiang
- Department of Economics, School of Economics, Minzu University of China, Beijing, China
| | - Yanjie Wang
- Department of Economics, School of Economics, Minzu University of China, Beijing, China
| | - Yu Cao
- Department of Economics, School of Economics, Minzu University of China, Beijing, China
| | - Guihong Geng
- Department of Economics, School of Economics, Minzu University of China, Beijing, China
| | - Bing Wu
- Research Center of Health Policy and Management, School of Health Management, Harbin Medical University, Harbin, China
| | - Yongqiang Lai
- Research Center of Health Policy and Management, School of Health Management, Harbin Medical University, Harbin, China
| | - Ye Li
- Research Center of Health Policy and Management, School of Health Management, Harbin Medical University, Harbin, China,*Correspondence: Ye Li
| | - Baoguo Shi
- Department of Economics, School of Economics, Minzu University of China, Beijing, China,Baoguo Shi
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Intrieri T, Manneschi G, Caldarella A. 10-year survival in female breast cancer patients according to ER, PR and HER2 expression: a cancer registry population-based analysis. J Cancer Res Clin Oncol 2022:10.1007/s00432-022-04245-1. [PMID: 36129548 DOI: 10.1007/s00432-022-04245-1] [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: 06/08/2022] [Accepted: 08/01/2022] [Indexed: 10/14/2022]
Abstract
INTRODUCTION Invasive breast cancer prognosis has significantly improved over time; however, there are few data about the long-term survival. MATERIALS AND METHODS We analysed the data on female breast cancer incident during 2004-2005 in the area of the Tuscan Cancer Registry, distinguishing them in five subtypes, according to ER, PgR, HER2, and Ki67 expression: luminal A, luminal B, luminal B/HER2 + , triple-negative, and HER2 + . Effects of subtypes and age on 10 years breast cancer specific survival were analysed by Kaplan-Meier and multivariate Cox analysis. RESULTS The majority of breast cancer were luminal B (57%), and 45% of them were diagnosed at pathological stage I. The 10-year survival rates (p < 0.001) were higher among luminal A (90.2%) and lower among HER-2 + patients (70.3%). Prognostic effect of age was statistically significant (p < 0.0004): the 10-year cancer specific survival rates were higher among 40-59 years of age patients (88.5%), lower among 0-39 (75.8%). Luminal A breast cancer patients had a constant low risk throughout 10 years of follow up, while luminal B/HER2 + and triple negative tumours showed a peak 5 years after the diagnosis and then declined. DISCUSSION Our study confirmed the prognostic effect of biological subtype also in a long term follow up study; moreover, age at diagnosis showed to influence the outcome, other than stage at diagnosis and treatment. The long term follow up showed a constant risk of death for luminal A and B tumours, whereas for non-luminal cancer a peak 5 years after the diagnosis was found.
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Affiliation(s)
- Teresa Intrieri
- Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Villa delle Rose Via Cosimo il Vecchio, 2- 50139, Florence, Italy
| | - Gianfranco Manneschi
- Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Villa delle Rose Via Cosimo il Vecchio, 2- 50139, Florence, Italy
| | - Adele Caldarella
- Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Villa delle Rose Via Cosimo il Vecchio, 2- 50139, Florence, Italy.
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Lin W, Chen Y, Ji Z, Chen L, Wu J, Chen Y, Li Z. Effect of Previous Cancer History on Survival of Patients with Different Subtypes of Breast Cancer. BIOMED RESEARCH INTERNATIONAL 2022; 2022:6116658. [PMID: 36093405 PMCID: PMC9462974 DOI: 10.1155/2022/6116658] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 08/18/2022] [Indexed: 02/05/2023]
Abstract
Patients with a previous cancer history (PCA) are routinely excluded from most clinical trials, which may limit the accuracy and universality of clinical trials. We aimed to explore the association between PCA and survival of patients with different molecular subtypes of breast cancer. Patients diagnosed with breast cancer from the Surveillance, Epidemiology, and End Results (SEER) database between 2010 and 2015 were included in this retrospective cohort study. The primary outcome was overall survival (OS), which was calculated from date of diagnosis to date of death or censor date during this period. The relationship between PCA and OS of patients with different molecular subtypes of breast cancer was analyzed by the Kaplan-Meier curves and multivariate Cox proportional-hazards model. A total of 35,640 primary breast cancer patients were included, and 2,038 (5.72%) patients had a PCA. Female genital system cancer (491 cases, 24.09%) was the largest proportion type of previous cancer, and HER2-positive (24,754 cases, 69.46%) breast cancer was the most common subtype. Patients with previous female genital/endocrine system cancer history and other cancers history were associated with a poorer OS in overall patients, and in patients with triple-negative and HER2-positive subtypes (P < 0.05). In patients with Luminal A and Luminal B subtypes, previous other cancers history was related to poor OS (P < 0.05), while female genital/endocrine system cancer history may not influence the OS (P > 0.05). Subgroup analyses presented that PCA was related to poor OS in patients aged 40-64 years and ≥65 years (P <0.05), while prognosis in patients aged 18-40 years may not be influenced by PCA (P > 0.05). The impact of PCA on the prognosis of breast cancer patients was related to molecular type, patient age, and type of PCA. In clinical trials of breast cancer, the exclusion criteria for PCA patients may be modified according to the above variables.
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Affiliation(s)
- Weixun Lin
- Department of Thyroid, Breast and Hernia Surgery, The Second Affiliated Hospital of Shantou University Medical College, Shantou, 515041 Guangdong, China
| | - Yaokun Chen
- Department of Thyroid, Breast and Hernia Surgery, The Second Affiliated Hospital of Shantou University Medical College, Shantou, 515041 Guangdong, China
| | - Zeqi Ji
- Department of Thyroid, Breast and Hernia Surgery, The Second Affiliated Hospital of Shantou University Medical College, Shantou, 515041 Guangdong, China
| | - Lingzhi Chen
- Department of Thyroid, Breast and Hernia Surgery, The Second Affiliated Hospital of Shantou University Medical College, Shantou, 515041 Guangdong, China
| | - Jinyao Wu
- Department of Thyroid, Breast and Hernia Surgery, The Second Affiliated Hospital of Shantou University Medical College, Shantou, 515041 Guangdong, China
| | - Yexi Chen
- Department of Thyroid, Breast and Hernia Surgery, The Second Affiliated Hospital of Shantou University Medical College, Shantou, 515041 Guangdong, China
| | - Zhiyang Li
- Department of Thyroid, Breast and Hernia Surgery, The Second Affiliated Hospital of Shantou University Medical College, Shantou, 515041 Guangdong, China
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A prognostic survival model for women diagnosed with invasive breast cancer in Queensland, Australia. Breast Cancer Res Treat 2022; 195:191-200. [PMID: 35896851 PMCID: PMC9374611 DOI: 10.1007/s10549-022-06682-5] [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: 03/09/2022] [Accepted: 07/06/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE Prognostic models can help inform patients on the future course of their cancer and assist the decision making of clinicians and patients in respect to management and treatment of the cancer. In contrast to previous studies considering survival following treatment, this study aimed to develop a prognostic model to quantify breast cancer-specific survival at the time of diagnosis. METHODS A large (n = 3323), population-based prospective cohort of women were diagnosed with invasive breast cancer in Queensland, Australia between 2010 and 2013, and followed up to December 2018. Data were collected through a validated semi-structured telephone interview and a self-administered questionnaire, along with data linkage to the Queensland Cancer Register and additional extraction from medical records. Flexible parametric survival models, with multiple imputation to deal with missing data, were used. RESULTS Key factors identified as being predictive of poorer survival included more advanced stage at diagnosis, higher tumour grade, "triple negative" breast cancers, and being symptom-detected rather than screen detected. The Harrell's C-statistic for the final predictive model was 0.84 (95% CI 0.82, 0.87), while the area under the ROC curve for 5-year mortality was 0.87. The final model explained about 36% of the variation in survival, with stage at diagnosis alone explaining 26% of the variation. CONCLUSIONS In addition to confirming the prognostic importance of stage, grade and clinical subtype, these results highlighted the independent survival benefit of breast cancers diagnosed through screening, although lead and length time bias should be considered. Understanding what additional factors contribute to the substantial unexplained variation in survival outcomes remains an important objective.
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40
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Ayeni OA, O’Neil DS, Pumpalova YS, Chen WC, Nietz S, Phakathi B, Buccimazza I, Čačala S, Stopforth LW, Farrow HA, Mapanga W, Joffe M, Chirwa T, McCormack V, Jacobson JS, Crew KD, Neugut AI, Ruff P, Cubasch H. Impact of HIV infection on survival among women with stage I-III breast cancer: Results from the South African breast cancer and HIV outcomes study. Int J Cancer 2022; 151:209-221. [PMID: 35218568 PMCID: PMC9133061 DOI: 10.1002/ijc.33981] [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: 10/01/2021] [Revised: 02/01/2022] [Accepted: 02/08/2022] [Indexed: 11/10/2022]
Abstract
In some countries of sub-Saharan Africa, the prevalence of HIV exceeds 20%; in South Africa, 20.4% of people are living with HIV. We examined the impact of HIV infection on the overall survival (OS) of women with nonmetastatic breast cancer (BC) enrolled in the South African Breast Cancer and HIV Outcomes (SABCHO) study. We recruited women with newly diagnosed BC at six public hospitals from 1 July 2015 to 30 June 2019. Among women with stages I-III BC, we compared those with and without HIV infection on sociodemographic, clinical, and treatment factors. We analyzed the impact of HIV on OS using multivariable Cox proportional hazard models. Of 2367 women with stages I-III BC, 499 (21.1%) had HIV and 1868 (78.9%) did not. With a median follow-up of 29 months, 2-year OS was poorer among women living with HIV (WLWH) than among HIV-uninfected women (72.4% vs 80.1%, P < .001; adjusted hazard ratio (aHR) 1.49, 95% confidence interval (CI) = 1.22-1.83). This finding was consistent across age groups ≥45 years and <45 years, stage I-II BC and stage III BC, and ER/PR status (all P < .03). Both WLWH with <50 viral load copies/mL and WLWH with ≥50 viral load copies/mL had poorer survival than HIV-uninfected BC patients [aHR: 1.35 (1.09-1.66) and 1.54 (1.20-2.00), respectively], as did WLWH who had ≥200 CD4+ cells/mL at diagnosis [aHR: 1.39 (1.15-1.67)]. Because receipt of antiretroviral therapy has become widespread, WLWH is surviving long enough to develop BC; more research is needed on the causes of their poor survival.
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Affiliation(s)
- Oluwatosin A. Ayeni
- Noncommunicable Diseases Research Division, Wits Health Consortium (PTY) Ltd, Johannesburg, South Africa
- Division of Medical Oncology, Department of Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Daniel S. O’Neil
- Sylvester Comprehensive Cancer Center and Department of Medicine, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Yoanna S. Pumpalova
- Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Wenlong Carl Chen
- Noncommunicable Diseases Research Division, Wits Health Consortium (PTY) Ltd, Johannesburg, South Africa
- National Cancer Registry, National Health Laboratory Service, Johannesburg, South Africa
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Sarah Nietz
- Noncommunicable Diseases Research Division, Wits Health Consortium (PTY) Ltd, Johannesburg, South Africa
- Department of Surgery, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Boitumelo Phakathi
- Noncommunicable Diseases Research Division, Wits Health Consortium (PTY) Ltd, Johannesburg, South Africa
- Department of Surgery, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Ines Buccimazza
- Department of Specialized Surgery, Inkosi Albert Luthuli Central Hospital, Durban and Ngwelezana Hospital, University of KwaZulu-Natal, Empangeni, KwaZulu-Natal, South Africa
| | - Sharon Čačala
- Departments of Surgery and Radiation Oncology, Grey’s Hospital, University of KwaZulu-Natal, Pietermaritzburg, KwaZulu-Natal, South Africa
- Department of Surgery, Ngwelezana Hospital, Empangeni and University of KwaZulu-Natal, KwaZulu-Natal, South Africa
| | - Laura W. Stopforth
- Departments of Surgery and Radiation Oncology, Grey’s Hospital, University of KwaZulu-Natal, Pietermaritzburg, KwaZulu-Natal, South Africa
| | - Hayley A Farrow
- Noncommunicable Diseases Research Division, Wits Health Consortium (PTY) Ltd, Johannesburg, South Africa
- Departments of Surgery and Radiation Oncology, Grey’s Hospital, University of KwaZulu-Natal, Pietermaritzburg, KwaZulu-Natal, South Africa
| | - Witness Mapanga
- Noncommunicable Diseases Research Division, Wits Health Consortium (PTY) Ltd, Johannesburg, South Africa
- Division of Medical Oncology, Department of Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Maureen Joffe
- Noncommunicable Diseases Research Division, Wits Health Consortium (PTY) Ltd, Johannesburg, South Africa
- South Africa Medical Research Council Common Epithelial Cancers Research Center, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- SAMRC/Wits Developmental Pathways to Health Research Unit, Department of Pediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Tobias Chirwa
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, 27 St Andrews Road, Parktown, Johannesburg, 2193, South Africa
| | - Valerie McCormack
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer, (IARC/WHO), Lyon, France
| | - Judith S. Jacobson
- Herbert Irving Comprehensive Cancer Center, Vagelos College of Physicians and Surgeons, Columbia University, New York NY, USA
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Katherine D. Crew
- Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
- Herbert Irving Comprehensive Cancer Center, Vagelos College of Physicians and Surgeons, Columbia University, New York NY, USA
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Alfred I. Neugut
- Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
- Herbert Irving Comprehensive Cancer Center, Vagelos College of Physicians and Surgeons, Columbia University, New York NY, USA
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Paul Ruff
- Noncommunicable Diseases Research Division, Wits Health Consortium (PTY) Ltd, Johannesburg, South Africa
- Division of Medical Oncology, Department of Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- South Africa Medical Research Council Common Epithelial Cancers Research Center, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Herbert Cubasch
- Noncommunicable Diseases Research Division, Wits Health Consortium (PTY) Ltd, Johannesburg, South Africa
- Department of Surgery, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- South Africa Medical Research Council Common Epithelial Cancers Research Center, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Løfling LL, Støer NC, Sloan EK, Chang A, Gandini S, Ursin G, Botteri E. β-blockers and breast cancer survival by molecular subtypes: a population-based cohort study and meta-analysis. Br J Cancer 2022; 127:1086-1096. [PMID: 35725814 PMCID: PMC9470740 DOI: 10.1038/s41416-022-01891-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 06/07/2022] [Accepted: 06/08/2022] [Indexed: 01/17/2023] Open
Abstract
Background The association between use of β-blockers and breast cancer (BC) prognosis has been investigated in several observational studies, with conflicting results. We performed a nationwide cohort study and a meta-analysis to investigate the association, and assess if it varied between molecular subtypes of BC. Methods We identified women aged ≥50 years with BC diagnosed between 2004 and 2018 in Norway. We used Cox regression models to estimate the association between β-blocker use at diagnosis and BC-specific survival, overall and by molecular subtype. We performed a meta-analysis of observational studies that reported molecular subtype-specific estimates of this association. Results We included 30,060 women, of which 4461 (15%) used β-blockers. After a median follow-up of 5.1 years, 2826 (9%) died of BC. Overall, β-blocker use was not associated with BC-specific survival (hazard ratio [HR] = 1.07; 95% confidence interval [CI]: 0.97–1.19). We found an association only in triple-negative BC (TNBC) patients (HR = 0.66; 95% CI: 0.47–0.91). This was confirmed in the meta-analysis: β-blocker use was associated with progression/recurrence-free (HR = 0.58; 95% CI: 0.38–0.89) and BC-specific survival (HR = 0.74; 95% CI: 0.55–1.00) in TNBC patients only. Conclusion In our cohort of BC patients and in the meta-analysis, β-blocker use was associated with prolonged BC-specific survival only in TNBC patients.
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Affiliation(s)
- L Lukas Løfling
- Department of Research, Cancer Registry of Norway, Oslo, Norway
| | - Nathalie C Støer
- Department of Research, Cancer Registry of Norway, Oslo, Norway.,Norwegian Research Centre for Women's Health, Women's Clinic, Oslo University Hospital, Oslo, Norway
| | - Erica K Sloan
- Drug Discovery Biology Theme, Monash Institute of Pharmaceutical Science, Monash University, Parkville, VIC, Australia
| | - Aeson Chang
- Drug Discovery Biology Theme, Monash Institute of Pharmaceutical Science, Monash University, Parkville, VIC, Australia
| | - Sara Gandini
- Department of Experimental Oncology, European Institute of Oncology IRCCS, Milan, Italy
| | - Giske Ursin
- Cancer Registry of Norway, Oslo, Norway.,Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.,Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA
| | - Edoardo Botteri
- Department of Research, Cancer Registry of Norway, Oslo, Norway. .,Section for Colorectal Cancer Screening, Cancer Registry of Norway, Oslo, Norway.
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42
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Mesa-Eguiagaray I, Wild SH, Bird SM, Williams LJ, Brewster DH, Hall PS, Figueroa JD. Breast cancer incidence and survival in Scotland by socio-economic deprivation and tumour subtype. Breast Cancer Res Treat 2022; 194:463-473. [PMID: 35648299 PMCID: PMC9239954 DOI: 10.1007/s10549-022-06632-1] [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: 01/25/2022] [Accepted: 05/09/2022] [Indexed: 11/04/2022]
Abstract
Background Women from socio-economically deprived areas are less likely to develop and then to survive breast cancer (BC). Whether associations between deprivation and BC incidence and survival differ by tumour molecular subtypes and mode of detection in Scotland are unknown. Methods Data consisted of 62,378 women diagnosed with invasive BC between 2000 and 2016 in Scotland. Incidence rates and time trends were calculated for oestrogen receptor positive (ER+) and negative (ER−) tumours and stratified by the Scottish Index of Multiple Deprivation (SIMD) quintiles and screening status. SIMD is an area-based measure derived across seven domains: income, employment, education, health, access to services, crime and housing. We calculated adjusted hazard ratios (aHR [95% confidence intervals]) for BC death by immunohistochemical surrogates of molecular subtypes for the most versus the least deprived quintile. We adjusted for mode of detection and other confounders. Results In Scotland, screen-detected ER+tumour incidence increased over time, particularly in the least deprived quintile [Average Annual Percentage Change (AAPC) = 2.9% with 95% CI from 1.2 to 4.7]. No marked differences were observed for non-screen-detected ER+tumours or ER− tumours by deprivation. BC mortality was higher in the most compared to the least deprived quintile irrespective of ER status (aHR = 1.29 [1.18, 1.41] for ER+ and 1.27 [1.09, 1.47] for ER− tumours). However, deprivation was associated with significantly higher mortality for luminal A and HER2−enriched tumours (aHR = 1.46 [1.13, 1.88] and 2.10 [1.23, 3.59] respectively) but weaker associations for luminal B and TNBC tumours that were not statistically significant. Conclusions Deprivation is associated with differential BC incidence trends for screen-detected ER+tumours and with higher mortality for select tumour subtypes. Future efforts should evaluate factors that might be associated with reduced survival in deprived populations and monitor progress stratified by tumour subtypes and mode of detection. Supplementary Information The online version contains supplementary material available at 10.1007/s10549-022-06632-1.
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Affiliation(s)
- Ines Mesa-Eguiagaray
- Usher Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK.
| | - Sarah H Wild
- Usher Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK
| | - Sheila M Bird
- Usher Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK.,Cambridge University's MRC Biostatistics Unit, Cambridge, UK
| | - Linda J Williams
- Usher Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK
| | - David H Brewster
- Usher Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK
| | - Peter S Hall
- Usher Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK.,Cancer Research UK Edinburgh Centre, Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, UK
| | - Jonine D Figueroa
- Usher Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK. .,Cancer Research UK Edinburgh Centre, Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, UK.
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43
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Waks AG, Kim D, Jain E, Snow C, Kirkner GJ, Rosenberg SM, Oh C, Poorvu PD, Ruddy KJ, Tamimi RM, Peppercorn J, Schapira L, Borges VF, Come SE, Brachtel EF, Warner E, Collins LC, Partridge AH, Wagle N. Somatic and Germline Genomic Alterations in Very Young Women with Breast Cancer. Clin Cancer Res 2022; 28:2339-2348. [PMID: 35101884 PMCID: PMC9359721 DOI: 10.1158/1078-0432.ccr-21-2572] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 11/17/2021] [Accepted: 01/26/2022] [Indexed: 01/07/2023]
Abstract
PURPOSE Young age at breast cancer diagnosis correlates with unfavorable clinicopathologic features and worse outcomes compared with older women. Understanding biological differences between breast tumors in young versus older women may lead to better therapeutic approaches for younger patients. EXPERIMENTAL DESIGN We identified 100 patients ≤35 years old at nonmetastatic breast cancer diagnosis who participated in the prospective Young Women's Breast Cancer Study cohort. Tumors were assigned a surrogate intrinsic subtype based on receptor status and grade. Whole-exome sequencing of tumor and germline samples was performed. Genomic alterations were compared with older women (≥45 years old) in The Cancer Genome Atlas, according to intrinsic subtype. RESULTS Ninety-three tumors from 92 patients were successfully sequenced. Median age was 32.5 years; 52.7% of tumors were hormone receptor-positive/HER2-negative, 28.0% HER2-positive, and 16.1% triple-negative. Comparison of young to older women (median age 61 years) with luminal A tumors (N = 28 young women) revealed three significant differences: PIK3CA alterations were more common in older patients, whereas GATA3 and ARID1A alterations were more common in young patients. No significant genomic differences were found comparing age groups in other intrinsic subtypes. Twenty-two patients (23.9%) in the Young Women's Study cohort carried a pathogenic germline variant, most commonly (13 patients, 14.1%) in BRCA1/2. CONCLUSIONS Somatic alterations in three genes (PIK3CA, GATA3, and ARID1A) occur at different frequencies in young versus older women with luminal A breast cancer. Additional investigation of these genes and associated pathways could delineate biological susceptibilities and improve treatment options for young patients with breast cancer. See related commentary by Yehia and Eng, p. 2209.
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Affiliation(s)
- Adrienne G. Waks
- Dana-Farber Cancer Institute, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Dewey Kim
- Dana-Farber Cancer Institute, Boston, Massachusetts.,The Broad Institute of MIT and Harvard, Cambridge, Massachusetts
| | - Esha Jain
- Dana-Farber Cancer Institute, Boston, Massachusetts.,The Broad Institute of MIT and Harvard, Cambridge, Massachusetts
| | - Craig Snow
- Dana-Farber Cancer Institute, Boston, Massachusetts
| | | | - Shoshana M. Rosenberg
- Dana-Farber Cancer Institute, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Coyin Oh
- Harvard Medical School, Boston, Massachusetts
| | - Philip D. Poorvu
- Dana-Farber Cancer Institute, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | | | | | - Jeffrey Peppercorn
- Harvard Medical School, Boston, Massachusetts.,Massachusetts General Hospital, Boston, Massachusetts
| | - Lidia Schapira
- Stanford Cancer Institute, Stanford University, Palo Alto, California
| | | | - Steven E. Come
- Harvard Medical School, Boston, Massachusetts.,Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Elena F. Brachtel
- Massachusetts General Hospital, Boston, Massachusetts.,Maastricht University Medical Center, Maastricht, the Netherlands
| | - Ellen Warner
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Laura C. Collins
- Harvard Medical School, Boston, Massachusetts.,Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Ann H. Partridge
- Dana-Farber Cancer Institute, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Nikhil Wagle
- Dana-Farber Cancer Institute, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts.,The Broad Institute of MIT and Harvard, Cambridge, Massachusetts.,Corresponding Author: Nikhil Wagle, Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA 02115. E-mail:
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44
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Font R, Buxó M, Ameijide A, Martínez JM, Marcos-Gragera R, Carulla M, Puigdemont M, Vilardell M, Civit S, Viñas G, Espinàs JA, Galceran J, Izquierdo Á, Borràs JM, Clèries R. Using population-based data to evaluate the impact of adherence to endocrine therapy on survival in breast cancer through the web-application BreCanSurvPred. Sci Rep 2022; 12:8097. [PMID: 35577853 PMCID: PMC9110408 DOI: 10.1038/s41598-022-12228-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 04/22/2022] [Indexed: 11/26/2022] Open
Abstract
We show how the use and interpretation of population-based cancer survival indicators can help oncologists talk with breast cancer (BC) patients about the relationship between their prognosis and their adherence to endocrine therapy (ET). The study population comprised a population-based cohort of estrogen receptor positive BC patients (N = 1268) diagnosed in Girona and Tarragona (Northeastern Spain) and classified according to HER2 status (+ / −), stage at diagnosis (I/II/III) and five-year cumulative adherence rate (adherent > 80%; non-adherent ≤ 80%). Cox regression analysis was performed to identify significant prognostic factors for overall survival, whereas relative survival (RS) was used to estimate the crude probability of death due to BC (PBC). Stage and adherence to ET were the significant factors for predicting all-cause mortality. Compared to stage I, risk of death increased in stage II (hazard ratio [HR] 2.24, 95% confidence interval [CI]: 1.51–3.30) and stage III (HR 5.11, 95% CI 3.46–7.51), and it decreased with adherence to ET (HR 0.57, 95% CI 0.41–0.59). PBC differences were higher in non-adherent patients compared to adherent ones and increased across stages: stage I: 6.61% (95% CI 0.05–13.20); stage II: 9.77% (95% CI 0.59–19.01), and stage III: 22.31% (95% CI 6.34–38.45). The age-adjusted survival curves derived from this modeling were implemented in the web application BreCanSurvPred (https://pdocomputation.snpstats.net/BreCanSurvPred). Web applications like BreCanSurvPred can help oncologists discuss the consequences of non-adherence to prescribed ET with patients.
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Affiliation(s)
- Rebeca Font
- Pla Director d'Oncología, IDIBELL, Av. Gran Vía 199-203, 08908, Hospitalet de Llobregat, Barcelona, Spain.,Institut d'Investigació Biomèdica de Bellvitge, IDIBELL, Av. Gran Via de L'Hospitalet, 199-203 - 1a planta, 08908, Hospitalet de Llobregat, Barcelona, Spain
| | - Maria Buxó
- Institut d'Investigació Biomèdica de Girona, IDIBGI, C/Dr.Castany S/N. Edifici M2. Parc Hospitalari Martí I Julià, 17190, Salt, Spain
| | - Alberto Ameijide
- Registre de Càncer de Tarragona, Servei d'Epidemiologia i Prevenció del Càncer, Hospital Universitari Sant Joan de Reus, IISPV, Reus, Spain
| | - José Miguel Martínez
- Department de Estadística I Investigació Operativa de La Universitat Politècnica de Catalunya. EDIFICI H, Diagonal 647, 08028, Barcelona, Spain.,Grupo de Investigación en Salud Pública, Universidad de Alicante, 03690, Alicante, Spain
| | - Rafael Marcos-Gragera
- Registre de Cáncer de Girona - Unitat d'Epidemiologia. Pla Director d'Oncologia. Institut Català d'Oncología. Grup d'Epidemiologia Descriptiva, Genètica I Prevenció del Càncer de Girona-IDIBGI, 17005, Girona, Spain.,Facultat de Medicina, Universitat de Girona (UdG), Girona, Spain.,Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Marià Carulla
- Registre de Càncer de Tarragona, Servei d'Epidemiologia i Prevenció del Càncer, Hospital Universitari Sant Joan de Reus, IISPV, Reus, Spain
| | - Montse Puigdemont
- Registre de Cáncer de Girona - Unitat d'Epidemiologia. Pla Director d'Oncologia. Institut Català d'Oncología. Grup d'Epidemiologia Descriptiva, Genètica I Prevenció del Càncer de Girona-IDIBGI, 17005, Girona, Spain
| | | | - Sergi Civit
- Secció de Estadística del Departament de Genètica, Microbiología i Estadística de La Facultat de Biologia. Universitat de Barcelona, 08028, Barcelona, Spain
| | - Gema Viñas
- Servei d'Oncología Médica, Institut Català d'Oncología. Hospital Universitari de Girona Doctor Josep Trueta, 17005, Girona, Spain
| | - Josep A Espinàs
- Pla Director d'Oncología, IDIBELL, Av. Gran Vía 199-203, 08908, Hospitalet de Llobregat, Barcelona, Spain.,Institut d'Investigació Biomèdica de Bellvitge, IDIBELL, Av. Gran Via de L'Hospitalet, 199-203 - 1a planta, 08908, Hospitalet de Llobregat, Barcelona, Spain
| | - Jaume Galceran
- Registre de Càncer de Tarragona, Servei d'Epidemiologia i Prevenció del Càncer, Hospital Universitari Sant Joan de Reus, IISPV, Reus, Spain
| | - Ángel Izquierdo
- Registre de Cáncer de Girona - Unitat d'Epidemiologia. Pla Director d'Oncologia. Institut Català d'Oncología. Grup d'Epidemiologia Descriptiva, Genètica I Prevenció del Càncer de Girona-IDIBGI, 17005, Girona, Spain.,Servei d'Oncología Médica, Institut Català d'Oncología. Hospital Universitari de Girona Doctor Josep Trueta, 17005, Girona, Spain
| | - Josep M Borràs
- Pla Director d'Oncología, IDIBELL, Av. Gran Vía 199-203, 08908, Hospitalet de Llobregat, Barcelona, Spain.,Institut d'Investigació Biomèdica de Bellvitge, IDIBELL, Av. Gran Via de L'Hospitalet, 199-203 - 1a planta, 08908, Hospitalet de Llobregat, Barcelona, Spain.,Department de Ciències Clíniques de La Universitat de Barcelona, 08907, Barcelona, Spain
| | - Ramon Clèries
- Pla Director d'Oncología, IDIBELL, Av. Gran Vía 199-203, 08908, Hospitalet de Llobregat, Barcelona, Spain. .,Institut d'Investigació Biomèdica de Bellvitge, IDIBELL, Av. Gran Via de L'Hospitalet, 199-203 - 1a planta, 08908, Hospitalet de Llobregat, Barcelona, Spain. .,Department de Ciències Clíniques de La Universitat de Barcelona, 08907, Barcelona, Spain.
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45
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Liao M, Qin R, Huang W, Zhu HP, Peng F, Han B, Liu B. Targeting regulated cell death (RCD) with small-molecule compounds in triple-negative breast cancer: a revisited perspective from molecular mechanisms to targeted therapies. J Hematol Oncol 2022; 15:44. [PMID: 35414025 PMCID: PMC9006445 DOI: 10.1186/s13045-022-01260-0] [Citation(s) in RCA: 57] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 03/28/2022] [Indexed: 02/08/2023] Open
Abstract
Triple-negative breast cancer (TNBC) is a subtype of human breast cancer with one of the worst prognoses, with no targeted therapeutic strategies currently available. Regulated cell death (RCD), also known as programmed cell death (PCD), has been widely reported to have numerous links to the progression and therapy of many types of human cancer. Of note, RCD can be divided into numerous different subroutines, including autophagy-dependent cell death, apoptosis, mitotic catastrophe, necroptosis, ferroptosis, pyroptosis and anoikis. More recently, targeting the subroutines of RCD with small-molecule compounds has been emerging as a promising therapeutic strategy, which has rapidly progressed in the treatment of TNBC. Therefore, in this review, we focus on summarizing the molecular mechanisms of the above-mentioned seven major RCD subroutines related to TNBC and the latest progress of small-molecule compounds targeting different RCD subroutines. Moreover, we further discuss the combined strategies of one drug (e.g., narciclasine) or more drugs (e.g., torin-1 combined with chloroquine) to achieve the therapeutic potential on TNBC by regulating RCD subroutines. More importantly, we demonstrate several small-molecule compounds (e.g., ONC201 and NCT03733119) by targeting the subroutines of RCD in TNBC clinical trials. Taken together, these findings will provide a clue on illuminating more actionable low-hanging-fruit druggable targets and candidate small-molecule drugs for potential RCD-related TNBC therapies.
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Affiliation(s)
- Minru Liao
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, and West China School of Pharmacy, Sichuan University, Chengdu, 610041, China
| | - Rui Qin
- State Key Laboratory of Southwestern Chinese Medicine Resources, Hospital of Chengdu University of Traditional Chinese Medicine, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, China
| | - Wei Huang
- State Key Laboratory of Southwestern Chinese Medicine Resources, Hospital of Chengdu University of Traditional Chinese Medicine, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, China
| | - Hong-Ping Zhu
- State Key Laboratory of Southwestern Chinese Medicine Resources, Hospital of Chengdu University of Traditional Chinese Medicine, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, China.,Antibiotics Research and Re-Evaluation Key Laboratory of Sichuan Province, Sichuan Industrial Institute of Antibiotics, Chengdu University, Chengdu, China
| | - Fu Peng
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, and West China School of Pharmacy, Sichuan University, Chengdu, 610041, China.
| | - Bo Han
- State Key Laboratory of Southwestern Chinese Medicine Resources, Hospital of Chengdu University of Traditional Chinese Medicine, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, China.
| | - Bo Liu
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, and West China School of Pharmacy, Sichuan University, Chengdu, 610041, China.
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46
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Nissan N, Bauer E, Moss Massasa EE, Sklair-Levy M. Breast MRI during pregnancy and lactation: clinical challenges and technical advances. Insights Imaging 2022; 13:71. [PMID: 35397082 PMCID: PMC8994812 DOI: 10.1186/s13244-022-01214-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 03/21/2022] [Indexed: 12/12/2022] Open
Abstract
The breast experiences substantial changes in morphology and function during pregnancy and lactation which affects its imaging properties and may reduce the visibility of a concurrent pathological process. The high incidence of benign gestational-related entities may further add complexity to the clinical and radiological evaluation of the breast during the period. Consequently, pregnancy-associated breast cancer (PABC) is often a delayed diagnosis and carries a poor prognosis. This state-of-the-art pictorial review illustrates how despite currently being underutilized, technical advances and new clinical evidence support the use of unenhanced breast MRI during pregnancy and both unenhanced and dynamic-contrast enhanced (DCE) during lactation, to serve as effective supplementary modalities in the diagnostic work-up of PABC.
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Affiliation(s)
- Noam Nissan
- Radiology Department, Sheba Medical Center, 5265601, Tel Hashomer, Israel. .,Sackler Medicine School, Tel Aviv University, Tel Aviv, Israel.
| | - Ethan Bauer
- Sackler Medicine School, New-York Program, Tel Aviv University, Tel Aviv, Israel
| | - Efi Efraim Moss Massasa
- Joint Medicine School Program of Sheba Medical Center, St. George's, University of London and the University of Nicosia, Sheba Medical Center, Tel Hashomer, Israel
| | - Miri Sklair-Levy
- Radiology Department, Sheba Medical Center, 5265601, Tel Hashomer, Israel.,Sackler Medicine School, Tel Aviv University, Tel Aviv, Israel
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Xie Y, Gou Q, Zhang Y, Xie K, Zheng D, Luo C, Suo J, Zhong X, Luo T. Association between age at initial diagnosis and post-metastasis mortality among women with recurrent metastatic breast cancer in China. BMC Cancer 2022; 22:385. [PMID: 35397518 PMCID: PMC8994897 DOI: 10.1186/s12885-022-09454-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 03/15/2022] [Indexed: 12/13/2022] Open
Abstract
Background Little is known about whether age at initial diagnosis influences the prognosis of recurrent metastatic breast cancer (rMBC). Here, we analyzed the association between age at initial diagnosis and rMBC mortality in China. Methods A total of 1636 women diagnosed with rMBC between 1989 and 2020 at West China Hospital, Sichuan University were included in this study. The age at initial diagnosis was categorized as young (≤ 40 years), middle-aged (41–64 years) and elderly (≥ 65 years). Post-metastasis mortality was the primary outcome and its associated factors were analyzed by Cox proportional hazards models. Results During a median follow-up of 5.2 years after initial diagnosis of breast cancer, 620 deaths were identified. Compared with middle-aged patients, elderly patients had a 70% increased risk of post-metastasis mortality (95%CI, 1.24–2.33) after adjusting for demographics, tumor characteristics and treatment modes. Similarly, elderly patients were associated with a 75% increased risk of post-metastasis mortality (95%CI, 1.19–2.59) compared with young patients. Subgroup analyses also showed similar trends. Conclusion Our findings suggest that in breast cancer, elderly patients at initial diagnosis face a higher risk of post-metastasis mortality. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-022-09454-y.
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Clèries R, Buxó M, Vilardell M, Ameijide A, Martínez JM, Font R, Marcos-Gragera R, Puigdemont M, Viñas G, Carulla M, Espinàs JA, Galceran J, Izquierdo Á, Borràs JM. No Excess Mortality up to 10 Years in Early Stages of Breast Cancer in Women Adherent to Oral Endocrine Therapy: A Probabilistic Graphical Modeling Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063605. [PMID: 35329292 PMCID: PMC8950380 DOI: 10.3390/ijerph19063605] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/15/2022] [Accepted: 03/16/2022] [Indexed: 02/04/2023]
Abstract
Breast cancer (BC) is globally the most frequent cancer in women. Adherence to endocrine therapy (ET) in hormone-receptor-positive BC patients is active and voluntary for the first five years after diagnosis. This study examines the impact of adherence to ET on 10-year excess mortality (EM) in patients diagnosed with Stages I to III BC (N = 2297). Since sample size is an issue for estimating age- and stage-specific survival indicators, we developed a method, ComSynSurData, for generating a large synthetic dataset (SynD) through probabilistic graphical modeling of the original cohort. We derived population-based survival indicators using a Bayesian relative survival model fitted to the SynD. Our modeling showed that hormone-receptor-positive BC patients diagnosed beyond 49 years of age at Stage I or beyond 59 years at Stage II do not have 10-year EM if they follow the prescribed ET regimen. This result calls for developing interventions to promote adherence to ET in patients with hormone receptor-positive BC and in turn improving cancer survival. The presented methodology here demonstrates the potential use of probabilistic graphical modeling for generating reliable synthetic datasets for validating population-based survival indicators when sample size is an issue.
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Affiliation(s)
- Ramon Clèries
- Hospitalet de Llobregat Avenue Gran Vía 199-203, 08908 Barcelona, Spain; (R.F.); (J.A.E.); (J.M.B.)
- Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), Hospitalet de Llobregat, Avenue Gran Via de l’Hospitalet, 199-203-1a Planta, 08908 Barcelona, Spain
- Department de Ciències Clíniques, Universitat de Barcelona, 08907 Barcelona, Spain
- Correspondence: ; Tel.: +34-93-260-74-17
| | - Maria Buxó
- Institut d’Investigació Biomèdica de Girona (IDIBGI), C/Dr. Castany s/n, Edifici M2, Parc Hospitalari Martí i Julià, 17190 Girona, Spain; (M.B.); (R.M.-G.)
| | | | - Alberto Ameijide
- Registre de Càncer de Tarragona, Servei d’Epidemiologia i Prevenció del Càncer, Hospital Universitari Sant Joan de Reus (IISPV), 43204 Reus, Spain; (A.A.); (M.C.); (J.G.)
| | - José Miguel Martínez
- Department de Estadística i Investigació Operativa, Universitat Politècnica de Catalunya (EDIFICI H), Diagonal 647, 08028 Barcelona, Spain;
- Grupo de Investigación en Salud Pública, Universidad de Alicante, 03690 Alicante, Spain
| | - Rebeca Font
- Hospitalet de Llobregat Avenue Gran Vía 199-203, 08908 Barcelona, Spain; (R.F.); (J.A.E.); (J.M.B.)
- Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), Hospitalet de Llobregat, Avenue Gran Via de l’Hospitalet, 199-203-1a Planta, 08908 Barcelona, Spain
| | - Rafael Marcos-Gragera
- Institut d’Investigació Biomèdica de Girona (IDIBGI), C/Dr. Castany s/n, Edifici M2, Parc Hospitalari Martí i Julià, 17190 Girona, Spain; (M.B.); (R.M.-G.)
- Registre de Cáncer de Girona-Unitat d’Epidemiologia, Institut Català d’Oncología, 17005 Girona, Spain; (M.P.); (Á.I.)
- Grup d’Epidemiologia Descriptiva, Genètica i Prevenció del Càncer de Girona-IDIBGI, 17005 Girona, Spain
- Facultat de Medicina, Universitat de Girona (UdG), 17071 Girona, Spain
- Centro de Investigación Biomédica en Red, Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
| | - Montse Puigdemont
- Registre de Cáncer de Girona-Unitat d’Epidemiologia, Institut Català d’Oncología, 17005 Girona, Spain; (M.P.); (Á.I.)
- Grup d’Epidemiologia Descriptiva, Genètica i Prevenció del Càncer de Girona-IDIBGI, 17005 Girona, Spain
| | - Gemma Viñas
- Servei d’Oncología Médica, Institut Català d’Oncología, Hospital Universitari de Girona “Doctor Josep Trueta”, 17005 Girona, Spain;
| | - Marià Carulla
- Registre de Càncer de Tarragona, Servei d’Epidemiologia i Prevenció del Càncer, Hospital Universitari Sant Joan de Reus (IISPV), 43204 Reus, Spain; (A.A.); (M.C.); (J.G.)
| | - Josep Alfons Espinàs
- Hospitalet de Llobregat Avenue Gran Vía 199-203, 08908 Barcelona, Spain; (R.F.); (J.A.E.); (J.M.B.)
- Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), Hospitalet de Llobregat, Avenue Gran Via de l’Hospitalet, 199-203-1a Planta, 08908 Barcelona, Spain
| | - Jaume Galceran
- Registre de Càncer de Tarragona, Servei d’Epidemiologia i Prevenció del Càncer, Hospital Universitari Sant Joan de Reus (IISPV), 43204 Reus, Spain; (A.A.); (M.C.); (J.G.)
| | - Ángel Izquierdo
- Registre de Cáncer de Girona-Unitat d’Epidemiologia, Institut Català d’Oncología, 17005 Girona, Spain; (M.P.); (Á.I.)
- Grup d’Epidemiologia Descriptiva, Genètica i Prevenció del Càncer de Girona-IDIBGI, 17005 Girona, Spain
- Servei d’Oncología Médica, Institut Català d’Oncología, Hospital Universitari de Girona “Doctor Josep Trueta”, 17005 Girona, Spain;
| | - Josep Maria Borràs
- Hospitalet de Llobregat Avenue Gran Vía 199-203, 08908 Barcelona, Spain; (R.F.); (J.A.E.); (J.M.B.)
- Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), Hospitalet de Llobregat, Avenue Gran Via de l’Hospitalet, 199-203-1a Planta, 08908 Barcelona, Spain
- Department de Ciències Clíniques, Universitat de Barcelona, 08907 Barcelona, Spain
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Luo C, Lu L, Zhang W, Li X, Zhou P, Ran Z. The Value of Shear Wave Elastography in the Diagnosis of Breast Cancer Axillary Lymph Node Metastasis and Its Correlation With Molecular Classification of Breast Masses. Front Oncol 2022; 12:846568. [PMID: 35372023 PMCID: PMC8968036 DOI: 10.3389/fonc.2022.846568] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 02/11/2022] [Indexed: 11/17/2022] Open
Abstract
Objective To explore the diagnostic value of shear wave elastography examination (SWE) on axillary node metastasis (ANM) in breast cancer, this study aimed to evaluate the correlation between the SWE features and different molecular types of breast cancer, and to check the elastic modulus differences among the molecular types. Methods Breast cancer patients from November 2020 to December 2021 were subjected to both conventional ultrasonic examination (CUE) and SWE before ultrasound-guided percutaneous biopsy or axillary lymph node dissection (ALND). We used the pathological results as the gold standard to draw the receiver operating characteristic (ROC) curve. Results SWE outperforms CUE, but their conjunctive use is the best option. No significant correlation was found between the elastic modulus values and the molecular types of breast cancer. Conclusion SWE can be used as an routine auxiliary method of CUE for ANM.
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Affiliation(s)
- Changyun Luo
- Regular Physical Examination Centre, The Second Affiliated Hospital of Shandong First Medical University, Taian, China
| | - Li Lu
- Ultrasonography Department, The Second Affiliated Hospital of Shandong First Medical University, Taian, China
| | - Weifu Zhang
- Public Health Section, The Second Affiliated Hospital of Shandong First Medical University, Taian, China
| | - Xiangqi Li
- Breast Surgery, The Second Affiliated Hospital of Shandong First Medical University, Taian, China
| | - Ping Zhou
- Liyang People’s Hospital, Liyang, China
| | - Zhangshen Ran
- Regular Physical Examination Centre, The Second Affiliated Hospital of Shandong First Medical University, Taian, China
- *Correspondence: Zhangshen Ran,
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50
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Nasrazadani A, Marti JLG, Kip KE, Marroquin OC, Lemon L, Shapiro SD, Brufsky AM. Breast cancer mortality as a function of age. Aging (Albany NY) 2022; 14:1186-1199. [PMID: 35134749 PMCID: PMC8876898 DOI: 10.18632/aging.203881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 01/28/2022] [Indexed: 11/25/2022]
Abstract
Background: Incidence of breast cancer (BC) in US women continues to increase with age as the strongest risk factor. We aimed to compare clinical, pathological and sociological variables associated to BC diagnosis, as well as the relative mortality rates of BC patients compared to the general US population. Methods: We performed a retrospective, single-institution study evaluating 52,509 patients diagnosed with unilateral BC at the University of Pittsburgh Medical Center (UPMC) between 1990–2020. Primary outcome was death from any cause with cancer recurrence as a secondary outcome, evaluated for 4 age groups: 20–44, 45–55, 56–69, and 70–90. A dataset of expected mortality for women in the general population over a 10-year period was constructed using the Surveillance, Epidemiology, and End Results (SEER) Program. Observed vs. expected mortality and standardized mortality ratios (SMR) for each age group were calculated. Results: Youngest patients with BC demonstrated the highest SMR at 10-year follow-up from time of diagnosis compared to the general US population (SMR 9.68, 95% CI: 8.99to 10.42), and remained highest compared to other age groups when analysis was limited to Stage 0/1 disease (10-year SMR 3.11, 95% CI: 2.54 to 3.76). SMRs decreased with increasing age at diagnosis with an SMR <1.0 in patients diagnosed with stage 0/1 at ages 70–90 at 5-year follow-up. Conclusions: Younger BC patients have the highest SMR which declines gradually with age. In the elderly, lower stage 0/1 SMR’s are found compared to the general population, suggesting the possibility of an associated protective effect.
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Affiliation(s)
- Azadeh Nasrazadani
- Division of Medical Oncology, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
| | - Juan Luis Gomez Marti
- Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
| | - Kevin E. Kip
- Clinical Analytics, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA
| | - Oscar C. Marroquin
- Clinical Analytics, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA
| | - Lara Lemon
- Clinical Analytics, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA
| | - Steve D. Shapiro
- Keck Medicine of USC, University of Southern California, Los Angeles, CA 90007, USA
| | - Adam M. Brufsky
- Division of Medical Oncology, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
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