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Leemans M, Cuzuel V, Bauër P, Baba Aissa H, Cournelle G, Baelde A, Thuleau A, Cognon G, Pouget N, Guillot E, Fromantin I, Audureau E. Screening of Breast Cancer from Sweat Samples Analyzed by 2-Dimensional Gas Chromatography-Mass Spectrometry: A Preliminary Study. Cancers (Basel) 2023; 15:cancers15112939. [PMID: 37296901 DOI: 10.3390/cancers15112939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 05/11/2023] [Accepted: 05/12/2023] [Indexed: 06/12/2023] Open
Abstract
Breast cancer (BC) remains one of the most commonly diagnosed malignancies in women. There is increasing interest in the development of non-invasive screening methods. Volatile organic compounds (VOCs) emitted through the metabolism of cancer cells are possible novel cancer biomarkers. This study aims to identify the existence of BC-specific VOCs in the sweat of BC patients. Sweat samples from the breast and hand area were collected from 21 BC participants before and after breast tumor ablation. Thermal desorption coupled with two-dimensional gas chromatography and mass spectrometry was used to analyze VOCs. A total of 761 volatiles from a homemade human odor library were screened on each chromatogram. From those 761 VOCs, a minimum of 77 VOCs were detected within the BC samples. Principal component analysis showed that VOCs differ between the pre- and post-surgery status of the BC patients. The Tree-based Pipeline Optimization Tool identified logistic regression as the best-performing machine learning model. Logistic regression modeling identified VOCs that distinguish the pre-and post-surgery state in BC patients on both the breast and hand area with sensitivities close to 1. Further, Shapley additive explanations and the probe variable method identified the most important and pertinent VOCs distinguishing pre- and post-operative status which are mostly of distinct origin for the hand and breast region. Results suggest the possibility to identify endogenous metabolites linked to BC, hence proposing this innovative pipeline as a stepstone to discovering potential BC biomarkers. Large-scale studies in a multi-centered VOC analysis setting must be carried out to validate obtained findings.
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Affiliation(s)
- Michelle Leemans
- Clinical Epidemiology and Ageing Unit, Institut Mondor de Recherche Biomédicale, Paris-Est University, 94010 Créteil, France
| | - Vincent Cuzuel
- Forensic Institute of the French Gendarmerie, Caserne Lange, 5 Boulevard de l'Hautil, Cedex, 95001 Cergy-Pontoise, France
| | - Pierre Bauër
- Wound Care and Research Unit 26, Curie Institute, Rue d'Ulm, 75005 Paris, France
| | - Hind Baba Aissa
- Wound Care and Research Unit 26, Curie Institute, Rue d'Ulm, 75005 Paris, France
| | - Gabriel Cournelle
- Baelde & Cournelle Analytics, 130 Allée Reysa Bernson, 59800 Lille, France
| | - Aurélien Baelde
- Baelde & Cournelle Analytics, 130 Allée Reysa Bernson, 59800 Lille, France
| | - Aurélie Thuleau
- Wound Care and Research Unit 26, Curie Institute, Rue d'Ulm, 75005 Paris, France
| | - Guillaume Cognon
- Forensic Institute of the French Gendarmerie, Caserne Lange, 5 Boulevard de l'Hautil, Cedex, 95001 Cergy-Pontoise, France
| | - Nicolas Pouget
- Department of Surgical Oncology, Curie Institute, 35 Rue Dailly, 92210 Saint-Cloud, France
| | - Eugénie Guillot
- Department of Surgical Oncology, Curie Institute, 35 Rue Dailly, 92210 Saint-Cloud, France
| | - Isabelle Fromantin
- Wound Care and Research Unit 26, Curie Institute, Rue d'Ulm, 75005 Paris, France
| | - Etienne Audureau
- Clinical Epidemiology and Ageing Unit, Institut Mondor de Recherche Biomédicale, Paris-Est University, 94010 Créteil, France
- Public Health Department, Henri-Mondor Hospital, Assistance Publique des Hôpitaux de Paris, 94010 Créteil, France
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Fernandes U, Guidi G, Martins D, Vieira B, Leal C, Marques C, Freitas F, Dupont M, Ribeiro J, Gomes C, Marques R, Avelar P, Esteves AS, Pinto-de-Sousa J. Breast cancer in young women: a rising threat: A 5-year follow-up comparative study. Porto Biomed J 2023; 8:e213. [PMID: 37362019 PMCID: PMC10289488 DOI: 10.1097/j.pbj.0000000000000213] [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: 01/07/2023] [Accepted: 04/03/2023] [Indexed: 06/28/2023] Open
Abstract
Introduction Breast cancer in young women is usually considered as breast cancer occurring in women younger than 40 years and is the most frequent cancer-related cause of death in these patients. In the past few years, there seems to be an increasing trend in the prevalence of breast cancer in young women, which, associated with poorer prognosis, more aggressive histologic features, and more frequent recurrence rates, makes it a rising threat to young women. This study aimed to evaluate the biological behavior of breast cancer in young women in our institution. Material and methods A retrospective, unicentric, cohort study was conducted between 2012 and 2016. All consecutive patients with breast cancer were enrolled in the study. Cases were divided into two groups: case group, those younger than 40 years, and control group, those 40 years or older. The exclusion criterion was nonoperative treatment. Several clinical and pathologic parameters were evaluated, as well as were overall survival time and disease-free survival time. Results The incidence of breast cancer in young women presented a rising tendency over the study period. Significant differences were observed in the comparison of the groups according to body mass index, age at menarche, age at birth of the first child, and proliferation rate. There were no differences in overall survival and disease-free survival rates between the groups. Conclusions Young women had a more symptomatic presentation, a greater tumor proliferation rate, but similar outcomes compared with older patients. Greater multicentric studies are needed to confirm or refute these results.
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Affiliation(s)
- Urânia Fernandes
- General Surgery Department, Hospital Centre Hospitalar de Trás-os-Montes e Alto Douro (CHTMAD), Clinical Academic Centre Trás-os-Montes e Alto Douro (CACTMAD), Vila Real, Portugal
| | - Gonçalo Guidi
- General Surgery Department, Hospital Centre Hospitalar de Trás-os-Montes e Alto Douro (CHTMAD), Clinical Academic Centre Trás-os-Montes e Alto Douro (CACTMAD), Vila Real, Portugal
| | - Daniela Martins
- General Surgery Department, Hospital Centre Hospitalar de Trás-os-Montes e Alto Douro (CHTMAD), Clinical Academic Centre Trás-os-Montes e Alto Douro (CACTMAD), Vila Real, Portugal
| | - Bruno Vieira
- General Surgery Department, Hospital Centre Hospitalar de Trás-os-Montes e Alto Douro (CHTMAD), Clinical Academic Centre Trás-os-Montes e Alto Douro (CACTMAD), Vila Real, Portugal
| | - Clara Leal
- General Surgery Department, Hospital Centre Hospitalar de Trás-os-Montes e Alto Douro (CHTMAD), Clinical Academic Centre Trás-os-Montes e Alto Douro (CACTMAD), Vila Real, Portugal
| | - Carolina Marques
- General Surgery Department, Hospital Centre Hospitalar de Trás-os-Montes e Alto Douro (CHTMAD), Clinical Academic Centre Trás-os-Montes e Alto Douro (CACTMAD), Vila Real, Portugal
| | - Francisca Freitas
- General Surgery Department, Hospital Centre Hospitalar de Trás-os-Montes e Alto Douro (CHTMAD), Clinical Academic Centre Trás-os-Montes e Alto Douro (CACTMAD), Vila Real, Portugal
| | - Margarida Dupont
- General Surgery Department, Hospital Centre Hospitalar de Trás-os-Montes e Alto Douro (CHTMAD), Clinical Academic Centre Trás-os-Montes e Alto Douro (CACTMAD), Vila Real, Portugal
| | - Juliana Ribeiro
- General Surgery Department, Hospital Centre Hospitalar de Trás-os-Montes e Alto Douro (CHTMAD), Clinical Academic Centre Trás-os-Montes e Alto Douro (CACTMAD), Vila Real, Portugal
| | - Carina Gomes
- General Surgery Department, Hospital Centre Hospitalar de Trás-os-Montes e Alto Douro (CHTMAD), Clinical Academic Centre Trás-os-Montes e Alto Douro (CACTMAD), Vila Real, Portugal
| | - Rita Marques
- General Surgery Department, Hospital Centre Hospitalar de Trás-os-Montes e Alto Douro (CHTMAD), Clinical Academic Centre Trás-os-Montes e Alto Douro (CACTMAD), Vila Real, Portugal
| | - Paulo Avelar
- General Surgery Department, Hospital Centre Hospitalar de Trás-os-Montes e Alto Douro (CHTMAD), Clinical Academic Centre Trás-os-Montes e Alto Douro (CACTMAD), Vila Real, Portugal
| | - Ana Sofia Esteves
- General Surgery Department, Hospital Centre Hospitalar de Trás-os-Montes e Alto Douro (CHTMAD), Clinical Academic Centre Trás-os-Montes e Alto Douro (CACTMAD), Vila Real, Portugal
| | - João Pinto-de-Sousa
- General Surgery Department, Hospital Centre Hospitalar de Trás-os-Montes e Alto Douro (CHTMAD), Clinical Academic Centre Trás-os-Montes e Alto Douro (CACTMAD), Vila Real, Portugal
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Leemans M, Bauër P, Cuzuel V, Audureau E, Fromantin I. Volatile Organic Compounds Analysis as a Potential Novel Screening Tool for Breast Cancer: A Systematic Review. Biomark Insights 2022; 17:11772719221100709. [PMID: 35645556 PMCID: PMC9134002 DOI: 10.1177/11772719221100709] [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: 12/16/2021] [Accepted: 04/19/2022] [Indexed: 11/17/2022] Open
Abstract
Introduction An early diagnosis is crucial in reducing mortality among people who have breast cancer (BC). There is a shortfall of characteristic early clinical symptoms in BC patients, highlighting the importance of investigating new methods for its early detection. A promising novel approach is the analysis of volatile organic compounds (VOCs) produced and emitted through the metabolism of cancer cells. Methods The purpose of this systematic review is to outline the published research regarding BC-associated VOCs. For this, headspace analysis of VOCs was explored in patient-derived body fluids, animal model-derived fluids, and BC cell lines to identify BC-specific VOCs. A systematic search in PubMed and Web of Science databases was conducted according to the PRISMA guidelines. Results Thirty-two studies met the criteria for inclusion in this review. Results highlight that VOC analysis can be promising as a potential novel screening tool. However, results of in vivo, in vitro and case-control studies have delivered inconsistent results leading to a lack of inter-matrix consensus between different VOC sampling methods. Discussion Discrepant VOC results among BC studies have been obtained, highly due to methodological discrepancies. Therefore, methodological issues leading to disparities have been reviewed and recommendations have been made on the standardisation of VOC collection and analysis methods for BC screening, thereby improving future VOC clinical validation studies.
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Affiliation(s)
| | - Pierre Bauër
- Institut Curie, Ensemble hospitalier, Unité Plaies et Cicatrisation, Paris, France
| | - Vincent Cuzuel
- Institut de Recherche Criminelle de la Gendarmerie Nationale, Caserne Lange, Cergy Pontoise Cedex, France
| | - Etienne Audureau
- Univ Paris Est Créteil, INSERM, IMRB, Créteil, France
- Assistance Publique – Hôpitaux de Paris, Hôpital Henri Mondor, Service de Santé Publique, Créteil, France
| | - Isabelle Fromantin
- Univ Paris Est Créteil, INSERM, IMRB, Créteil, France
- Institut Curie, Ensemble hospitalier, Unité Plaies et Cicatrisation, Paris, France
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Nguyen Thanh T, Nguyen Tran BS, Hoang Thi AP, Tran Binh T, Ba Nguyen T, Le Minh T, Nguyen Vu QH, Dang Cong T. HER2Ile655Val Single Nucleotide Polymorphism Associated with Early-Onset Breast Cancer Susceptibility: A Systematic Review and Meta-Analysis. Asian Pac J Cancer Prev 2021; 22:11-18. [PMID: 33507673 PMCID: PMC8184204 DOI: 10.31557/apjcp.2021.22.1.11] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Indexed: 01/21/2023] Open
Abstract
Background: Human epidermal growth factor receptor 2 (HER2) plays an important role in the development and progression of breast cancer. To understand the precise association, this meta-analysis was conducted to estimate the association between HER2Ile655Val single nucleotide polymorphism (SNP) and susceptibility to early-onset breast cancer. Methods: A comprehensive database retrieval from PubMed, Embase, Web of Science and Google Scholar was pooled to investigate links between the HER2Ile655Val SNP and risk of breast cancer. Adjusted odds ratios (ORs) with 95% confidence intervals (CIs) were estimated to appraise the association under the additive model (Ile vs. Val), dominant model (Val/Val + Ile/Val vs. Ile/Ile), and recessive model (Val/Val vs. Ile/Val + Ile/Ile). Results: Seventeen relevant studies with 11,749 cases and 8,105 controls were finally included. We found that HER2Ile655Val SNP is associated with an increased risk of breast cancer in an additive and dominant model. In the subgroup analysis with age stratification, a significant association between the HER2 codon 655 SNP and the risk of breast cancer was found in young women in an additive, dominant, and recessive model; conversely, no significant associations were indicated in older women. In the breast cancer subgroup, HER2Ile655Val SNP was significantly associated with younger age women with breast cancer in the dominant model. In contrast, no association between the HER2 codon 655 SNP and age was found in control populations. Conclusion: Our findings suggest that the Val allele in HER2 codon 655 SNP is strongly associated with breast cancer susceptibility in the young female population and is also significantly associated with younger age in women with breast cancer. HER2Ile655Val SNP might be a susceptibility factor that favours early-onset breast cancer.
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Affiliation(s)
- Tung Nguyen Thanh
- Institute of Biomedicine, Hue University of Medicine and Pharmacy, Hue University, 6 Ngo Quyen Street, Hue, Vietnam.,Faculty of Basic Science, Hue University of Medicine and Pharmacy, Hue University, 6 Ngo Quyen Street, Hue, Vietnam
| | - Bao Song Nguyen Tran
- Department of Histology, Embryology, Pathology and Forensic, Hue University of Medicine and Pharmacy, Hue University, 6 Ngo Quyen Street, Hue, Vietnam
| | - Ai Phuong Hoang Thi
- Faculty of Basic Science, Hue University of Medicine and Pharmacy, Hue University, 6 Ngo Quyen Street, Hue, Vietnam
| | - Thang Tran Binh
- Faculty of Public Health, Hue University of Medicince and Pharmacy, Hue university, 6 Ngo Quyen Street, Hue, Vietnam
| | - Thong Ba Nguyen
- Department of Medical Bioscience, Soonchunhyang University Hospital Bucheon, Bucheon 14584, Republic of Korea
| | - Tam Le Minh
- Department of Obstetrics and Gynecology, Hue University of Medicine and Pharmacy, Hue University, 6 Ngo Quyen Street, Hue, Vietnam
| | - Quoc Huy Nguyen Vu
- Department of Obstetrics and Gynecology, Hue University of Medicine and Pharmacy, Hue University, 6 Ngo Quyen Street, Hue, Vietnam
| | - Thuan Dang Cong
- Department of Histology, Embryology, Pathology and Forensic, Hue University of Medicine and Pharmacy, Hue University, 6 Ngo Quyen Street, Hue, Vietnam
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Paluch-Shimon S, Cardoso F, Partridge AH, Abulkhair O, Azim HA, Bianchi-Micheli G, Cardoso MJ, Curigliano G, Gelmon KA, Harbeck N, Merschdorf J, Poortmans P, Pruneri G, Senkus E, Spanic T, Stearns V, Wengström Y, Peccatori F, Pagani O. ESO-ESMO 4th International Consensus Guidelines for Breast Cancer in Young Women (BCY4). Ann Oncol 2020; 31:674-696. [PMID: 32199930 DOI: 10.1016/j.annonc.2020.03.284] [Citation(s) in RCA: 158] [Impact Index Per Article: 39.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 03/07/2020] [Indexed: 12/16/2022] Open
Abstract
The 4th International Consensus Conference for Breast Cancer in Young Women (BCY4) took place in October 2018, in Lugano, Switzerland, organized by the European School of Oncology (ESO) and the European Society of Medical Oncology (ESMO). Consensus recommendations for the management of breast cancer in young women were updated from BCY3 with incorporation of new evidence to inform the guidelines. Areas of research priorities were also identified. This article summarizes the ESO-ESMO international consensus recommendations, which are also endorsed by the European Society of Breast Specialists (EUSOMA).
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Affiliation(s)
| | - F Cardoso
- Breast Unit Champalimaud Clinical Centre/Champalimaud Foundation, Lisbon, Portugal
| | - A H Partridge
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, USA
| | - O Abulkhair
- King Abdulaziz Medical City for National Guard, Riyadh, Saudi Arabia
| | - H A Azim
- School of Medicine, Monterrey Institute of Technology, Monterrey, MX
| | | | - M-J Cardoso
- Breast Unit Champalimaud Clinical Centre/Champalimaud Foundation, Lisbon, Portugal; Nova Medical School Lisbon, Portugal
| | - G Curigliano
- European Institute of Oncology IRCCS, Milan, Italy; Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - K A Gelmon
- British Columbia Cancer, Vancouver, Canada
| | - N Harbeck
- Breast Center, Dept. OB&GYN, University of Munich (LMU), Munich, Germany
| | | | - P Poortmans
- Institut Curie, Department of Radiation Oncology & Paris Sciences & Lettres - PSL University, Paris, France
| | - G Pruneri
- National Cancer Institute, IRCCS Foundation, Milan, Italy
| | - E Senkus
- Medical University of Gdansk, Gdansk, Poland
| | - T Spanic
- Europa Donna Slovenia, Ljubljana, Slovenia
| | - V Stearns
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, USA
| | - Y Wengström
- Department of Neurobiology Cancer Science and Society, Karolinska Institute and Theme Cancer Karolinska University Hospital, Sweden
| | - F Peccatori
- European Institute of Oncology IRCCS & European School of Oncology, Milan, Italy
| | - O Pagani
- Oncology Institute of Southern Switzerland and Breast Unit of Southern Switzerland, Geneva University Hospitals, Swiss Group for Clinical Cancer Research (SAKK), Bellinzona, Switzerland
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Liu KH, Zhang L, Chen JX, Lian CL, Wang J, He ZY, Wu SG. Should women with early breast cancer under 40 years of age have a routine 21-gene recurrence score testing: A SEER database study. Breast 2019; 49:233-241. [PMID: 31918322 PMCID: PMC7375685 DOI: 10.1016/j.breast.2019.12.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 12/16/2019] [Accepted: 12/18/2019] [Indexed: 11/16/2022] Open
Abstract
PURPOSE To investigate the effect of 21-gene recurrence score (RS) on chemotherapy-decision making and prognosis in breast cancer patients aged <40 years. METHODS Using the Surveillance, Epidemiology, and End Results program, we included patients aged <40 years with tumor size ≤5 cm, node negative, and estrogen receptor-positive breast cancer between 2004 and 2015. Correlations among the 21-gene RS, chemotherapy decision-making and prognosis were analyzed. RESULTS We included 2721 patients in this study. According to TAILORx cutoffs, 352 (12.9%), 1814 (66.7%), and 555 (20.4%) patients were classified as low-, intermediate-, and high-risk cohorts, respectively. The 21-gene RS categories were associated with the probability of receiving chemotherapy, with 7.1%, 33.4%, and 77.1% of patients in low-, intermediate-, and high-risk cohorts treated with chemotherapy, respectively (P < 0.001). Those in the intermediate-risk cohort were significantly less likely to receive chemotherapy over time (P = 0.008), and the trends of chemotherapy receipt were stable in the low-risk and high-risk cohorts over time. Multivariate analysis showed that the 21-gene RS was an independent prognostic indicator for breast cancer specific survival. In the stratified analysis, the receipt of chemotherapy was associated with better breast cancer specific survival in the high-risk cohort (P = 0.028), but not in the intermediate-risk cohort (P = 0.223). CONCLUSIONS 21-gene RS has clinical implications for young breast cancer patients with respect to optimizing chemotherapy-decisions. Despite increasing rates of chemotherapy receipt in young patients, more studies are needed to determine the definitive effect of chemotherapy in young patients with three RS categories.
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Affiliation(s)
- Kai-Hua Liu
- Department of Gastrointestinal Surgery, Cancer Hospital, The First Affiliated Hospital of Xiamen University, Teaching Hospital of Fujian Medical University, Xiamen, 361003, People's Republic of China
| | - Lei Zhang
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China
| | - Jian-Xian Chen
- Department of Medical Oncology, People's Hospital of Baise, Baise, 533000, People's Republic of China
| | - Chen-Lu Lian
- Department of Radiation Oncology, Cancer Hospital, The First Affiliated Hospital of Xiamen University, Teaching Hospital of Fujian Medical University, Xiamen, 361003, People's Republic of China
| | - Jun Wang
- Department of Radiation Oncology, Cancer Hospital, The First Affiliated Hospital of Xiamen University, Teaching Hospital of Fujian Medical University, Xiamen, 361003, People's Republic of China
| | - Zhen-Yu He
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China.
| | - San-Gang Wu
- Department of Radiation Oncology, Cancer Hospital, The First Affiliated Hospital of Xiamen University, Teaching Hospital of Fujian Medical University, Xiamen, 361003, People's Republic of China.
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Sun S, Yu X, Li J, Li Z, Zhu S, Wang L, Wu J, Li K, Wu Q, Sun S. Risk of breast cancer based on thermal tomography characteristics. Transl Cancer Res 2019; 8:1148-1157. [PMID: 35116857 PMCID: PMC8797328 DOI: 10.21037/tcr.2019.06.29] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 05/30/2019] [Indexed: 11/09/2022]
Abstract
Background There is no uniform standard for the diagnosis of breast lesions by thermal tomography (TT). This study aimed to widely analyse the predictive value of TT in patients with breast cancer and establish a uniform standard for the diagnosis of breast lesions. Methods We retrospectively analysed data from women who suffered from non-inflammatory unilateral single breast lesion and underwent TT from January 2014 to July 2016. Changes in TT parameters were correlated with the pathologic diagnosis, and its predictive value was assessed. Results A total of 407 patients underwent TT examinations during the study period, including 196 subsequently diagnosed with breast cancer. Several characteristics were found to be significantly correlated with breast cancer: age ≥60 years [odds ratio (OR) =109.296, P<0.001], age ≥35 and <60 years (OR =25.720, P<0.001), q-r curve as an angle of 30°–45° (OR =14.895, P<0.001), ΔTs (surface temperature difference between the neoplastic side and the healthy side) ≥0.65 °C (OR =4.129, P<0.001), ΔTn (nipple temperature difference between the neoplastic side and the healthy side) ≥0.45 °C (OR =2.683, P=0.006), isotherm asymmetry (OR =2.297, P=0.035), and vascular plentiful (OR =3.333, P=0.004). Q value as a novel predictive indicator based on the multiple predictor modelling improved the diagnostic rate for breast cancer, and the accuracy in this study was up to 86.7%. Conclusions Age, q-r curve, ΔTs, ΔTn, isotherm, and vascular features were independent predictors of breast cancer. Q value could be used to assess the risk of breast cancer as an additional diagnostic tool for breast cancer screening and diagnosis.
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Affiliation(s)
- Si Sun
- Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Xin Yu
- Department of Breast and Thyroid Surgery, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Juanjuan Li
- Department of Breast and Thyroid Surgery, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Zhiyu Li
- Department of Breast and Thyroid Surgery, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Shan Zhu
- Department of Breast and Thyroid Surgery, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Lijun Wang
- Department of Breast and Thyroid Surgery, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Juan Wu
- Department of Pathology, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Kaiyang Li
- Department of Electronic Science and Technology, School of Physics and Technology, Wuhan University, Wuhan 430072, China
| | - Qi Wu
- Department of Breast and Thyroid Surgery, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Shengrong Sun
- Department of Breast and Thyroid Surgery, Renmin Hospital of Wuhan University, Wuhan 430060, China
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Early Diagnosis of Breast Cancer: Public Health and Mammographic Screening. BIONANOSCIENCE 2018. [DOI: 10.1007/s12668-018-0504-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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9
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Candido dos Reis FJ, Wishart GC, Dicks EM, Greenberg D, Rashbass J, Schmidt MK, van den Broek AJ, Ellis IO, Green A, Rakha E, Maishman T, Eccles DM, Pharoah PDP. An updated PREDICT breast cancer prognostication and treatment benefit prediction model with independent validation. Breast Cancer Res 2017; 19:58. [PMID: 28532503 PMCID: PMC5440946 DOI: 10.1186/s13058-017-0852-3] [Citation(s) in RCA: 146] [Impact Index Per Article: 20.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 05/04/2017] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND PREDICT is a breast cancer prognostic and treatment benefit model implemented online. The overall fit of the model has been good in multiple independent case series, but PREDICT has been shown to underestimate breast cancer specific mortality in women diagnosed under the age of 40. Another limitation is the use of discrete categories for tumour size and node status resulting in 'step' changes in risk estimates on moving between categories. We have refitted the PREDICT prognostic model using the original cohort of cases from East Anglia with updated survival time in order to take into account age at diagnosis and to smooth out the survival function for tumour size and node status. METHODS Multivariable Cox regression models were used to fit separate models for ER negative and ER positive disease. Continuous variables were fitted using fractional polynomials and a smoothed baseline hazard was obtained by regressing the baseline cumulative hazard for each patients against time using fractional polynomials. The fit of the prognostic models were then tested in three independent data sets that had also been used to validate the original version of PREDICT. RESULTS In the model fitting data, after adjusting for other prognostic variables, there is an increase in risk of breast cancer specific mortality in younger and older patients with ER positive disease, with a substantial increase in risk for women diagnosed before the age of 35. In ER negative disease the risk increases slightly with age. The association between breast cancer specific mortality and both tumour size and number of positive nodes was non-linear with a more marked increase in risk with increasing size and increasing number of nodes in ER positive disease. The overall calibration and discrimination of the new version of PREDICT (v2) was good and comparable to that of the previous version in both model development and validation data sets. However, the calibration of v2 improved over v1 in patients diagnosed under the age of 40. CONCLUSIONS The PREDICT v2 is an improved prognostication and treatment benefit model compared with v1. The online version should continue to aid clinical decision making in women with early breast cancer.
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Affiliation(s)
| | | | - Ed M. Dicks
- Department of Oncology, University of Cambridge, Cambridge, UK
| | - David Greenberg
- National Cancer Registration and Analysis Service, Public Health England, London, UK
| | - Jem Rashbass
- National Cancer Registration and Analysis Service, Public Health England, London, UK
| | - Marjanka K. Schmidt
- Division of Molecular Pathology, Netherlands Cancer Institute, Amsterdam, The Netherlands
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Alexandra J. van den Broek
- Division of Molecular Pathology, Netherlands Cancer Institute, Amsterdam, The Netherlands
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Ian O. Ellis
- Division of Cancer and Stem Cells, School of Medicine, University of Nottingham and Nottingham University Hospitals NHS Trust, City Hospital, Nottingham, UK
| | - Andrew Green
- Division of Cancer and Stem Cells, School of Medicine, University of Nottingham and Nottingham University Hospitals NHS Trust, City Hospital, Nottingham, UK
| | - Emad Rakha
- Division of Cancer and Stem Cells, School of Medicine, University of Nottingham and Nottingham University Hospitals NHS Trust, City Hospital, Nottingham, UK
| | - Tom Maishman
- Cancer Sciences Academic Unit and Southampton Clinical Trials Unit, Faculty of Medicine, University of Southampton and University Hospital Southampton Foundation Trust, Southampton, UK
| | - Diana M. Eccles
- Cancer Sciences Academic Unit and Southampton Clinical Trials Unit, Faculty of Medicine, University of Southampton and University Hospital Southampton Foundation Trust, Southampton, UK
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10
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Peritumoral lymphatic vessel density and invasion detected with immunohistochemical marker D240 is strongly associated with distant metastasis in breast carcinoma. BMC Clin Pathol 2017; 17:2. [PMID: 28203117 PMCID: PMC5301373 DOI: 10.1186/s12907-017-0041-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Accepted: 01/30/2017] [Indexed: 12/25/2022] Open
Abstract
Background Detection of vascular invasion by hematoxylin and eosin staining is the current pathological assessment practice to diagnose breast carcinoma. However, conventional hematoxylin and eosin staining failed to distinguish between blood vessel invasion and lymphatic vessel invasion. Both are important prognostic criteria however with different outcomes. The aim of this study is to distinguish between blood vessel invasion and lymphatic vessel invasion using conventional assessment and immunohistochemical markers. The prognostic significance of both circulatory invasions in invasive breast carcinoma was also investigated. Methods Consecutive sections of breast carcinoma samples from 58 patients were stained with CD34 and D240 to stain blood and lymphatic vessels respectively. Hematoxylin and eosin staining was carried out on another consecutive section as conventional staining. Results Although blood vessel density is higher in the sections (median = 10.3 vessels) compared to lymphatic vessel density (median = 0.13), vessel invasion is predominantly lymphatic invasion (69.8 and 55.2% respectively). Interestingly, peritumoral lymphatic vessel density and peritumoral lymphatic invasion was significantly associated with distant metastasis (p = 0.049 and p = 0.05 respectively). The rate of false positive and false negative interpretation by hematoxylin and eosin was 46.7 and 53.3% respectively. Conclusions Lymphatic vessel invasion is a strong prognostic markers of breast carcinoma invasion and the use of immunohistochemical markers increase the rate and accuracy of detection.
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Chen HL, Zhou MQ, Tian W, Meng KX, He HF. Effect of Age on Breast Cancer Patient Prognoses: A Population-Based Study Using the SEER 18 Database. PLoS One 2016; 11:e0165409. [PMID: 27798652 PMCID: PMC5087840 DOI: 10.1371/journal.pone.0165409] [Citation(s) in RCA: 99] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Accepted: 09/13/2016] [Indexed: 01/04/2023] Open
Abstract
Background Age is an important risk factor for breast cancer, but data regarding whether patient age at diagnosis is related to breast cancer survival are conflicting. This population-based study evaluated the effect of age on breast cancer prognosis and identified outcome-related factors. Patients and Methods We searched the Surveillance, Epidemiology, and End Results (SEER) database and enrolled female primary non-metastatic cases. Patients were subdivided into seven groups, and analyses of the associations between age and overall survival (OS) and breast cancer-specific survival (BCSS) were carried out using the Kaplan-Meier method and Cox regression model, respectively. We also assessed differences in survival among three specific age groups, using the ages of 30 and 50 years as cut-offs. Stratified analyses regarding race, histology, grade, stage and hormone receptor status were also carried out. Results A total of 133,057 female patients diagnosed with breast cancer from 2004 to 2008 were included in the current study (6.4% <40 years), Women aged 40 to 49 years and 60 to 69 years exhibited significantly better OS and BCSS, respectively (log-rank, p<0.001), than their counterparts in other groups. Middle-aged women exhibited distinctly better OS (log-rank, p<0.001) and BCSS (log-rank, p<0.001) than their counterparts in the other two age groups. Following adjustments for potential confounding factors, middle-age at breast cancer diagnosis was shown to be an independent predictor of favourable outcomes in terms of OS, but not BCSS (for OS, HR, 0.92; 95%CI, 0.87–0.98; p = 0.007; for BCSS, HR, 0.94; 95%CI, 0.80–1.01; p = 0.075, using the young group as reference). Stratified analysis showed that middle-age was significantly associated with increased survival, except among patients with stage III disease, and that elderly women faced worse prognoses than younger patients. Conclusion Our results indicate that younger breast cancer patients exhibit more aggressive disease than older patients. Middle-aged patients exhibit better OS and BCSS than young and elderly patients but exhibit BCSS rates similar to those of young patients after adjustments for confounders. Stratified analysis demonstrated that middle-aged patients exhibited better survival than young patients, with the exception of patients with stage III disease. An age of 60 years or more was a significant independent predictor of a poor prognosis.
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Affiliation(s)
- Hai-long Chen
- Department of General Surgery, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang Province, China
- * E-mail:
| | - Mei-qi Zhou
- Department of Surgical Oncology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Wei Tian
- Department of Surgical Oncology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Ke-xin Meng
- Department of General Surgery, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang Province, China
| | - Hai-fei He
- Department of Surgical Oncology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
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12
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Diagnostic performance of the automated breast volume scanner: a systematic review of inter-rater reliability/agreement and meta-analysis of diagnostic accuracy for differentiating benign and malignant breast lesions. Eur Radiol 2015; 25:3638-47. [DOI: 10.1007/s00330-015-3759-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Revised: 02/15/2015] [Accepted: 04/01/2015] [Indexed: 11/26/2022]
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13
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Rambau PF, Chalya PL, Manyama MM, Jackson KJ. Pathological features of Breast Cancer seen in Northwestern Tanzania: a nine years retrospective study. BMC Res Notes 2011; 4:214. [PMID: 21696617 PMCID: PMC3155835 DOI: 10.1186/1756-0500-4-214] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2011] [Accepted: 06/22/2011] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Breast cancer is more common in Western Countries compared to African populations. However in African population, it appears that the disease tends to be more aggressive and occurring at a relatively young age at the time of presentation. The aim of this study was to describe the trend of Breast Cancer in Northwestern Tanzania. METHODS This was a retrospective study which involved all cases of breast cancer diagnosed histologically at Bugando Medical Center from 2002 to 2010. Histological results and slides were retrieved from the records in the Pathology department, clinical information and demographic data for patients were retrieved from surgical wards and department of medical records. Histology slides were re-evaluated for the histological type, grade (By modified Bloom-Richardson score), and presence of necrosis and skin involvement. Data was entered and analyzed by SPSS computer software version 15. FINDINGS There were 328 patients histologically confirmed to have breast cancer, the mean age at diagnosis was 48.7 years (+/- 13.1). About half of the patients (52.4%) were below 46 years of age, and this group of patients had significantly higher tendency for lymph node metastasis (p = 0.012). The tumor size ranged from 1 cm to 18 cm in diameter with average (mean) of 5.5 cm (+/- 2.5), and median size of 6 cm. Size of the tumor (above 6 cm in diameter) and presence of necrosis within the tumor was significantly associated with high rate of lymph node metastasis (p = 0.000). Of all patients, 64% were at clinical stage III (specifically IIIB) and 70.4% had lymph node metastasis at the time of diagnosis. Only 4.3% of the patients were in clinical stage I at the time of diagnosis. Majority of the patients had invasive ductal carcinoma (91.5%) followed by mucinous carcinoma (5.2%), Invasive lobular carcinoma (3%) and in situ ductal carcinoma (0.3%). In all patients, 185 (56.4%) had tumor with histological grade 3. CONCLUSION Breast cancer in this region show a trend towards relative young age at diagnosis with advanced stage at diagnosis and high rate of lymph node metastasis. Poor Referral system, lack of screening programs and natural aggressive biological behavior of tumor may contribute to advanced disease at the time of diagnosis.
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Affiliation(s)
- Peter F Rambau
- Department of Pathology Weill Bugando University College of Health Sciences, Box 1464 Mwanza, (Bugando Street) Postal code +255, Tanzania
| | - Philipo L Chalya
- Department of Surgery Weill Bugando University College of Health Sciences, Box 1464 Mwanza, (Bugando Street) Postal code +255, Tanzania
| | - Mange M Manyama
- Department of Anatomy Weill Bugando University College of Health Sciences, Box 1464 Mwanza, (Bugando Street) Postal code +255, Tanzania
| | - Kahima J Jackson
- Department of Pathology Bugando Medical Center, Box 1370 Mwanza, (Bugando Street) Postal code +255, Tanzania
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Moelans CB, Milne AN, Morsink FH, Offerhaus GJA, van Diest PJ. Low frequency of HER2 amplification and overexpression in early onset gastric cancer. Cell Oncol (Dordr) 2011; 34:89-95. [PMID: 21394646 PMCID: PMC3063579 DOI: 10.1007/s13402-011-0021-0] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2011] [Indexed: 12/14/2022] Open
Abstract
Background The recent ToGA trial results indicated that trastuzumab is a new, effective, and well-tolerated treatment for HER2-positive gastric cancer (GC). Although GC mainly affects older patients, fewer than 10% of GC patients are considered early-onset (EOGC) (presenting at the age of 45 years or younger). These EOGC show different clinicopathological and molecular profiles compared to late onset GC suggesting that they represent a separate entity within gastric carcinogenesis. In light of potential trastuzumab benefit, subpopulations of GC such as EOGC (versus late onset) should be evaluated for their frequency of amplification and overexpression using currently available techniques. Methods Tissue microarray (TMA) blocks of 108 early onset GC and 91 late onset GC were stained by immunohistochemistry (IHC, Hercep test, DAKO) and chromogenic in situ hybridization (CISH, SPoT-Light, Invitrogen). Results Overall, we found only 5% HER2 high level amplification and 3% HER2 3+ overexpression (6/199). In addition, 8 patients (4%) showed a low level CISH amplification and 9 patients (4.5%) showed a 2+ IHC score. IHC and CISH showed 92% concordance and CISH showed less heterogeneity than IHC. In 2/199 cases (1%), IHC showed clinically relevant heterogeneity between TMA cores, but all cases with focal IHC 3+ expression were uniformly CISH high level amplified. Early onset GCs showed a significantly lower frequency of HER2 amplification (2%) and overexpression (0%) than late onset GCs (8% and 7% respectively) (p = 0.085 and p = 0.008 respectively). Proximal GC had more HER2 amplification (9% versus 3%) and overexpression (7% versus 2%) than distal tumours although this difference was not significant (p = 0.181 and p = 0.182 respectively). HER2 CISH showed more high level amplification in the intestinal type (7%, 16% if low-level included) compared to the mixed (5%, 5% if low-level included) and diffuse type (3%, 4% if low-level included) GCs (p = 0.029). A similar association was seen for HER2 IHC and histologic type (p = 0.008). Logistic regression indicated a significant association between HER2 expression and age, which remained significant when adjusted for both location and histological type. Conclusions Even focal HER2 overexpression in GC points to uniform HER2 amplification by CISH. We show for the first time that early onset GC has a lower frequency of HER2 amplification and overexpression than late onset GC, and confirm that intestinal type GC shows the highest rate of HER2 amplification and overexpression.
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Affiliation(s)
- Cathy B Moelans
- Department of Pathology, University Medical Center Utrecht, Heidelberglaan 100, PO Box 85500, 3508GA, Utrecht, The Netherlands.
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