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Iwamoto T, Kumamaru H, Niikura N, Sagara Y, Miyashita M, Konishi T, Sanuki N, Tanakura K, Nagahashi M, Hayashi N, Yoshida M, Watanabe C, Kinukawa N, Toi M, Saji S. Survival trends and patient characteristics between 2004 and 2016 for breast cancer in Japan based on the National Clinical Database-Breast Cancer Registry. Breast Cancer 2024; 31:185-194. [PMID: 38319565 DOI: 10.1007/s12282-024-01545-x] [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: 11/20/2023] [Accepted: 01/07/2024] [Indexed: 02/07/2024]
Abstract
This is a prognostic report by the Japanese Breast Cancer Society on breast cancer extracted from the National Clinical Database-Breast Cancer Registry of Japan. Here, we present a summary of 457,878 breast cancer cases registered between 2004 and 2016. The median follow-up duration was 5.6 years. The median age at the start of treatment was 59 years (5-95%: 38-82 years) and increased from 57 years between 2004 and 2008 to 60 years between 2013 and 2016. The proportion of patients with Stage 0-II disease increased from 74.5% to 78.3%. The number of cases with estrogen and progesterone receptor positivity increased from 74.8% to 77.9% and 60.5% to 68.1%, respectively. Regarding (neo-)adjuvant chemotherapy, the taxane (T) or taxane-cyclophosphamide (C) regimen increased by 2.4% to 8.2%, but the (fluorouracil (F)) adriamycin (A)-C-T/(F) epirubicin (E)C-T and (F)AC/(F)EC regimens decreased by 18.6% to 15.2% and 13.5% to 5.0%, respectively. Regarding (neo-)adjuvant anti-human epidermal growth factor-2 (HER2)-targeted therapy, the use of trastuzumab increased from 4.6% to 10.5%. The rate of sentinel lymph node biopsy increased from 37.1% to 60.7%, while that of axillary dissection decreased from 54.5% to 22.6%. Improvements in disease-free and overall survival were observed in patients with HER2-positive breast cancer, but there was no apparent trend in patients with hormone receptor-positive, HER2-negative, or triple-negative breast cancers.
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Affiliation(s)
- Takayuki Iwamoto
- Breast and Thyroid Surgery, Kawasaki Medical School Hospital, Okayama, Japan.
| | - Hiraku Kumamaru
- Department of Healthcare Quality Assessment, University of Tokyo, Tokyo, Japan
| | - Naoki Niikura
- Department of Breast Oncology, Tokai University School of Medicine, Kanagawa, Japan
| | - Yasuaki Sagara
- Department of Breast Surgical Oncology, Social Medical Corporation Hakuaikai, Sagara Hospital, Kagoshima, Japan
| | - Minoru Miyashita
- Department of Breast and Endocrine Surgical Oncology, Tohoku University School of Medicine, Miyagi, Japan
| | - Takaaki Konishi
- Department of Breast and Endocrine Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Naoko Sanuki
- Radiation Therapy Department, Yokkaichi Municipal Hospital, Mie, Japan
| | - Kenta Tanakura
- Plastic and Reconstructive Surgery, Mitsui Memorial Hospital, Tokyo, Japan
| | - Masayuki Nagahashi
- Department of Surgery, Division of Breast and Endocrine Surgery, School of Medicine, Hyogo Medical University, Hyogo, Japan
| | - Naoki Hayashi
- Department of Surgery, Division of Breast Surgical Oncology, Showa University, Tokyo, Japan
| | - Masayuki Yoshida
- Department of Diagnostic Pathology, National Cancer Center Hospital, Tokyo, Japan
| | - Chie Watanabe
- School of Nursing and Rehabilitation Sciences, Showa University, Tokyo, Japan
| | - Naoko Kinukawa
- Department of Healthcare Quality Assessment, University of Tokyo, Tokyo, Japan
| | - Masakazu Toi
- Tokyo Metropolitan Cancer and Infectious Disease Center, Komagome Hospital, Tokyo, Japan
| | - Shigehira Saji
- Department of Medical Oncology, Fukushima Medical University, Fukushima, Japan
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Sagara Y, Kumamaru H, Niikura N, Miyashita M, Konishi T, Iwamoto T, Sanuki N, Tanakura K, Nagahashi M, Hayashi N, Yoshida M, Kinukawa N, Watanabe C, Toi M, Saji S. 2020 Annual Report of National Clinical Database-Breast Cancer Registry: 10-year mortality of elderly breast cancer patients in Japan. Breast Cancer 2024; 31:179-184. [PMID: 38180641 DOI: 10.1007/s12282-023-01532-8] [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: 10/26/2023] [Accepted: 11/27/2023] [Indexed: 01/06/2024]
Abstract
The Japanese Breast Cancer Society initiated the breast cancer registry in 1975, which transitioned to the National Clinical Database-Breast Cancer Registry in 2012. This annual report presents data from 2020 and analyzes the ten-year mortality rates for those aged 65 and older. We analyzed data from 93,784 breast cancer (BC) cases registered in 2020 and assessed 10-year mortality rates for 36,279 elderly patients diagnosed between 2008 and 2012. In 2020, 99.4% of BC cases were females with a median age of 61. Most (65%) were diagnosed at early stages (Stage 0 or I). Breast-conserving surgery rates varied with stages: 58.5% at cStage I, 30.8% at cStage II, and 13.1% at cStage III. Sentinel lymph node biopsy was done in 73.6% of cases, followed by radiotherapy in 70% of those post-conserving surgery and chemotherapy in 21.1% post-surgery. Pathology showed that 63.4% had tumors under 2.0 cm, 11.7% had pTis tumors, and 77.3% had no axillary lymph node metastasis. ER positivity was seen in 75.1%, HER2 in 14.3%, and 30% had a Ki67 positivity rate above 30%. Across all stages and subtypes, there was a trend where the 10-year mortality rates increased for individuals older than 65 years. In Stage I, many deaths were not directly linked to BC and, for those with HER2-type and triple-negative BC, breast cancer-related deaths increased with age. Within Stage II, patients older than 70 years with luminal-type BC often experienced deaths not directly linked to BC, whereas patients below 80 years with HER2-type and triple-negative BC, likely had breast cancer-related deaths. In Stage III, breast cancer-related deaths were more common, particularly in HER2 and triple-negative BC. Our prognostic analysis underscores distinct mortality patterns by stage, subtype, and age in elderly BC patients. It highlights the importance of personalized treatment strategies, considering subtype-specific aggressiveness, age-related factors, and comorbidities.
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Affiliation(s)
- Yasuaki Sagara
- Department of Breast and Thyroid Surgical Oncology, Hakuaikai Medical Corporation, Sagara Hospital, 3-28 Matsubara, Kagoshima, 892-0833, Japan.
- Department of Breast Oncology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, Japan.
| | - Hiraku Kumamaru
- Department of Healthcare Quality Assessment, University of Tokyo, 7‑3‑1 Hongo, Bunkyo‑Ku, Tokyo, 113‑8655, Japan
| | - Naoki Niikura
- Department of Breast Oncology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, Japan
| | - Minoru Miyashita
- Department of Breast and Endocrine Surgical Oncology, Tohoku University School of Medicine, Seiryo‑Machi, Aoba‑Ku, Sendai, 980‑8574, Japan
| | - Takaaki Konishi
- Department of Breast and Endocrine Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Takayuki Iwamoto
- Breast and Thyroid Surgery, Kawasaki Medical School Hospital, Kurashiki, Japan
| | - Naoko Sanuki
- Radiation Therapy Department, Yokkaichi Municipal Hospital, Yokkaichi, Japan
| | - Kenta Tanakura
- Plastic and Reconstructive Surgery, Mitsui Memorial Hospital, 1 Kanda‑Izumicho, Chiyoda‑Ku, Tokyo, 101‑8643, Japan
| | - Masayuki Nagahashi
- Division of Breast and Endocrine Surgery, Department of Surgery, School of Medicine, Hyogo Medical University, 1‑1 Mukogawa, Nishinomiya, Hyogo, Japan
| | - Naoki Hayashi
- Department of Breast Surgical Oncology, St. Luke's International Hospital, 9‑1 Akashicho, Chuo‑Ku, Tokyo, 104‑8560, Japan
| | - Masayuki Yoshida
- Department of Diagnostic Pathology, National Cancer Center Hospital, 5‑1‑1 Tsukiji, Chuo‑Ku, Tokyo, 104‑0045, Japan
| | - Naoko Kinukawa
- Department of Healthcare Quality Assessment, University of Tokyo, 7‑3‑1 Hongo, Bunkyo‑Ku, Tokyo, 113‑8655, Japan
| | - Chie Watanabe
- School of Nursing and Rehabilitation Sciences, Showa University, Tokyo, Japan
| | - Masakazu Toi
- Tokyo Metropolitan Komagome Hospital, 3 Chome-18 Honkomagome, Bunkyo City, Tokyo, Japan
| | - Shigehira Saji
- Department of Medical Oncology, Fukushima Medical University, 1 Hikarigaoka, Fukushima, 960-1295, Japan
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Li M, Wang H, Qu N, Piao H, Zhu B. Breast cancer screening and early diagnosis in China: a systematic review and meta-analysis on 10.72 million women. BMC Womens Health 2024; 24:97. [PMID: 38321439 PMCID: PMC10848517 DOI: 10.1186/s12905-024-02924-4] [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: 09/28/2023] [Accepted: 01/22/2024] [Indexed: 02/08/2024] Open
Abstract
BACKGROUND The incidence of breast cancer among Chinese women has gradually increased in recent years. This study aims to analyze the situation of breast cancer screening programs in China and compare the cancer detection rates (CDRs), early-stage cancer detection rates (ECDRs), and the proportions of early-stage cancer among different programs. METHODS We conducted a systematic review and meta-analysis of studies in multiple literature databases. Studies that were published between January 1, 2010 and June 30, 2023 were retrieved. A random effects model was employed to pool the single group rate, and subgroup analyses were carried out based on screening model, time, process, age, population, and follow-up method. RESULTS A total of 35 studies, including 47 databases, satisfied the inclusion criteria. Compared with opportunistic screening, the CDR (1.32‰, 95% CI: 1.10‰-1.56‰) and the ECDR (0.82‰, 95% CI: 0.66‰-0.99‰) were lower for population screening, but the proportion of early-stage breast cancer (80.17%, 95% CI: 71.40%-87.83%) was higher. In subgroup analysis, the CDR of population screening was higher in the urban group (2.28‰, 95% CI: 1.70‰-2.94‰), in the breast ultrasonography (BUS) in parallel with mammography (MAM) group (3.29‰, 95% CI: 2.48‰-4.21‰), and in the second screening follow-up group (2.47‰, 95% CI: 1.64‰-3.47‰), and the proportion of early-stage breast cancer was 85.70% (95% CI: 68.73%-97.29%), 88.18% (95% CI: 84.53%-91.46%), and 90.05% (95% CI: 84.07%-94.95%), respectively. CONCLUSION There were significant differences between opportunistic and population screening programs. The results of these population screening studies were influenced by the screening process, age, population, and follow-up method. In the future, China should carry out more high-quality and systematic population-based screening programs to improve screening coverage and service.
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Affiliation(s)
- Mengdan Li
- Department of Liaoning Office for Cancer Prevention and Control, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, No.44 Xiaoheyan Road, Dadong District, Shenyang, Liaoning, 110042, China
| | - Hongying Wang
- Department of School of Public Health, China Medical University, Shenyang, Liaoning, 110122, China
| | - Ning Qu
- Department of Radiology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Shenyang, Liaoning, 110042, China
| | - Haozhe Piao
- Department of Neurosurgery, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, No.44 Xiaoheyan Road, Dadong District, Shenyang, Liaoning, 110042, China.
| | - Bo Zhu
- Department of Liaoning Office for Cancer Prevention and Control, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, No.44 Xiaoheyan Road, Dadong District, Shenyang, Liaoning, 110042, China.
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Miyashita M, Kumamaru H, Niikura N, Sagara Y, Konishi T, Iwamoto T, Sanuki N, Tanakura K, Nagahashi M, Hayashi N, Yoshida M, Watanabe C, Kinukawa N, Toi M, Saji S. Annual report of the Japanese Breast Cancer Registry for 2019. Breast Cancer 2024; 31:16-23. [PMID: 38044372 DOI: 10.1007/s12282-023-01526-6] [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: 09/15/2023] [Accepted: 11/06/2023] [Indexed: 12/05/2023]
Abstract
This is an annual report by the Japanese Breast Cancer Society regarding the clinical data on breast cancer extracted from the National Clinical Database-Breast Cancer Registry (NCD-BCR) of Japan. Here, we present an updated summary of 98,300 breast cancer cases registered in 2019. The median age at cancer diagnosis was 61 years (interquartile range 49-72 years), and 30.6% of the breast cancer patients were premenopausal. Of the 93,840 patients without distant metastases, 14,118 (15.0%) and 42,047 (44.8%) were diagnosed with stage 0 and I disease, respectively. Breast-conserving surgery was performed in 42,080 (44.8%) patients. Regarding axillary procedures, 62,677 (66.8%) and 7371 (7.9%) patients underwent sentinel node biopsy and axillary node dissection after biopsy, respectively. Whole breast irradiation was administered to 29,795 (70.8%) of the 42,080 patients undergoing breast-conserving surgery. Chest wall irradiation was administered to 5524 (11.1%) of the 49,637 patients who underwent mastectomy. Of the 6912 clinically lymph node-negative patients who received preoperative therapy, 5250 (76.0%) and 427 (6.2%) underwent sentinel node biopsy and axillary node dissection after biopsy, respectively; however, 602 (8.7%) patients initially underwent axillary node dissection without biopsy.
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Affiliation(s)
- Minoru Miyashita
- Department of Breast and Endocrine Surgical Oncology, Tohoku University School of Medicine, 1-1 Seiryo-Machi, Aoba-Ku, Sendai, 980-8574, Japan.
| | - Hiraku Kumamaru
- Department of Healthcare Quality Assessment, University of Tokyo, 7‑3‑1 Hongo, Bunkyo‑Ku, Tokyo, 113‑8655, Japan
| | - Naoki Niikura
- Department of Breast Oncology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259‑1193, Japan
| | - Yasuaki Sagara
- Department of Breast Surgical Oncology, Social Medical Corporation Hakuaikai, Sagara Hospital, 3-28 Matsubara, Kagoshima, 892-833, Japan
| | - Takaaki Konishi
- Department of Breast and Endocrine Surgery, Graduate School of Medicine, The University of Tokyo, 7‑3‑1 Hongo, Bunkyo‑Ku, Tokyo, 113-8655, Japan
| | - Takayuki Iwamoto
- Breast and Thyroid Surgery, Kawasaki Medical School Hospital, 577 Matsushima, Kurashiki City, Okayama, 701-0192, Japan
| | - Naoko Sanuki
- Radiation Therapy Department, Yokkaichi Municipal Hospital, Yokkaichi, Japan
| | - Kenta Tanakura
- Plastic and Reconstructive Surgery, Mitsui Memorial Hospital, 1 Kanda‑Izumicho, Chiyoda‑Ku, Tokyo, 101‑8643, Japan
| | - Masayuki Nagahashi
- Department of Surgery, Division of Breast and Endocrine Surgery, School of Medicine, Hyogo Medical University, 1‑1 Mukogawa, Nishinomiya, Hyogo, 663‑8501, Japan
| | - Naoki Hayashi
- Division of Breast Surgical Oncology, Department of Surgery, Showa University School of Medicine, Tokyo, Japan
| | - Masayuki Yoshida
- Department of Diagnostic Pathology, National Cancer Center Hospital, 5‑1‑1 Tsukiji, Chuo‑Ku, Tokyo, 104‑0045, Japan
| | - Chie Watanabe
- School of Nursing and Rehabilitation Sciences, Showa University, 1865 Tokaichibacho, Midori-Ku, Yokohama-Shi, Kanagawa, 226-8555, Japan
| | - Naoko Kinukawa
- Department of Healthcare Quality Assessment, University of Tokyo, 7‑3‑1 Hongo, Bunkyo‑Ku, Tokyo, 113‑8655, Japan
| | - Masakazu Toi
- Tokyo Metropolitan Komagome Hospital, 3 Chome-18 Honkomagome, Bunkyo City, Tokyo, Japan
| | - Shigehira Saji
- Department of Medical Oncology, Fukushima Medical University, Fukushima, Japan
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Adachi Y, Asaga S, Kumamaru H, Kinugawa N, Sagara Y, Niikura N, Jinno H, Saji S, Toi M. Analysis of prognosis in different subtypes of invasive lobular carcinoma using the Japanese National Cancer Database-Breast Cancer Registry. Breast Cancer Res Treat 2023; 201:397-408. [PMID: 37479943 DOI: 10.1007/s10549-023-07022-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 06/22/2023] [Indexed: 07/23/2023]
Abstract
PURPOSE Many studies have shown that the prognosis of invasive lobular carcinoma (ILC) is better than that of invasive ductal carcinoma (IDC). However, both disorders exhibit different prognoses according to molecular subtype, and the prognosis of ILC subtypes might depend on their hormone receptor positivity rate. This study clarified the prognosis of ILC and IDC in each subtype and examined the effectiveness of adjuvant chemotherapy (CT) in luminal ILC. METHODS We planned the analysis using data from the Breast Cancer Registry in Japan. Because it was presumed that there are differences in characteristics between ILC and IDC, we created matched cohorts using exact matching to compare their prognoses. We compared the prognosis of ILC and IDC for each subtype. We also compared the prognosis of luminal ILC between the CT and non-CT groups. RESULTS For all subtypes, the disease-free survival (DFS) and overall survival (OS) of ILC were poorer than those of IDC. In the analysis by each subtype, no statistically significant difference was found in DFS and OS in luminal human epidermal growth factor 2 (HER2), HER2, and triple-negative cohorts; however, luminal ILC had significantly poorer DFS and OS than luminal IDC. The CT effects on the prognosis of luminal ILC were greater in more advanced cases. CONCLUSION Luminal ILC had a poorer prognosis than luminal IDC, contributing to the worse prognosis of ILC than that of IDC in the overall cohort. Different therapeutic approaches from luminal IDC are essential for a better prognosis of luminal ILC.
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Affiliation(s)
- Yayoi Adachi
- Department of Breast Oncology, Aichi Cancer Center, 1-1 Kanokoden, Chikusa-ku, 464-8681, Nagoya, Aichi, Japan.
- Department of Pathology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, 75206, Dallas, TX, USA.
| | - Sota Asaga
- Department of Surgery, Keiyu Hospital, 3-7-3 Minatomirai, 220-8521, Yokohama, Kanagawa, Japan
| | - Hiraku Kumamaru
- Department of Healthcare Quality Assessment, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, 113-8655, Tokyo, Japan
| | - Naoko Kinugawa
- Department of Healthcare Quality Assessment, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, 113-8655, Tokyo, Japan
| | - Yasuaki Sagara
- Department of Breast Surgical Oncology, Social Medical Cooperation Hakuaikai, 3-31 Matsubara-cho, 892-0833, Kagoshima, Japan
| | - Naoki Niikura
- Department of Breast and Endocrine Surgery, Tokai University School of Medicine, 143, Shimokasuya, 259-1193, Isehara, Kanagawa, Japan
| | - Hiromitsu Jinno
- Department of Surgery, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, 173-8606, Tokyo, Japan
| | - Shigehira Saji
- Department of Medical Oncology, Fukushima Medical University, 1 Hikariga-oka, 960-1295, Fukushima, Fukushima, Japan
| | - Masakazu Toi
- Department of Breast Surgery, Kyoto University Graduate School of Medicine, 54 Kawaracho, Shogoin, Sakyo-ku, 606-8507, Kyoto, Japan
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Hu Q, Ye D, Xudong Z, Wang Q, Gou H, Luo T. Optimum duration of extended adjuvant endocrine therapy in patients with hormone receptor-positive breast cancer: protocol for a network meta-analysis of randomised controlled trials. BMJ Open 2023; 13:e070972. [PMID: 37080619 PMCID: PMC10124296 DOI: 10.1136/bmjopen-2022-070972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/22/2023] Open
Abstract
INTRODUCTION The type of extended adjuvant endocrine therapy is not clear, nor is the optimum duration of extended adjuvant endocrine therapy for patients with early breast cancer. Our study aims to satisfy the requirements for systematically identifying and synthesising the available evidence on the clinical safety and efficacy of extended adjuvant endocrine therapy for patients with hormone receptor-positive early breast cancer. METHODS AND ANALYSIS A comprehensive electronic literature database search will be performed using three electronic databases: PubMed, Cochrane Library and Embase (Ovid interface). Our main outcomes of interest were overall survival, disease-free survival, relapse-free survival, invasive contralateral breast cancer, acceptability and grades 3 and 4 non-haematological toxicities in this study. We will assess the risk of bias and overall quality of evidence using the Cochrane Collaboration's tool and Grades of Recommendation, Assessment, Development and Evaluation, respectively. We will perform subgroup and sensitivity analyses in the selected trials. We will assess the three key assumptions of network meta-analysis: transitivity, consistency and homogeneity. ETHICS AND DISSEMINATION The protocol was preregistered in the International Prospective Register of Systematic Reviews (PROSPERO) database. Ethics approval and patient consent are not required for the network meta-analysis. The final results of this network meta-analysis will be disseminated through national and international conferences and published in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER CRD42021278271.
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Affiliation(s)
- Qiancheng Hu
- Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
- Gastric Cancer Center and Laboratory of Gastric Cancer, West China Hospital, Sichuan University, Chengdu, China
| | - Daoli Ye
- Gastric Cancer Center, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Zhao Xudong
- Laboratory of Animal Tumor Models, Frontiers Science Center for Disease-Related Molecular Network, State Key Laboratory of Biotherapy and Cancer Center, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Qingfeng Wang
- Division of Abdominal Tumor Multimodality Treatment, Cancer Center, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Hongfeng Gou
- Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
- Gastric Cancer Center and Laboratory of Gastric Cancer, West China Hospital, Sichuan University, Chengdu, China
| | - Ting Luo
- Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
- Breast Center, West China Hospital, Sichuan University, Chengdu, China
- Multi-omics Laboratory of Breast Diseases, State Key Laboratory of Biotherapy, National Collaborative, Innovation Center for Biotherapy, West China Hospital, Sichuan University, Chengdu, China
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Azim HA, Elghazawy H, Ghazy RM, Abdelaziz AH, Abdelsalam M, Elzorkany A, Kassem L. Clinicopathologic Features of Breast Cancer in Egypt-Contemporary Profile and Future Needs: A Systematic Review and Meta-Analysis. JCO Glob Oncol 2023; 9:e2200387. [PMID: 36888929 PMCID: PMC10497263 DOI: 10.1200/go.22.00387] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 01/06/2023] [Accepted: 01/24/2023] [Indexed: 03/10/2023] Open
Abstract
PURPOSE Breast cancer (BC) is the most common cancer among Egyptian females. No current national cancer database is available in Egypt to provide reliable data on the specific clinicopathologic features of BC in this population. Herein, we investigated the clinical profile of BC among Egyptian women. METHODS A systematic review of studies on BC published from inception until December 2021 was performed. We explored pooled estimated proportions of different stages of BC at presentation in Egypt and other clinicopathologic features including age, menopausal status, tumor (T) and lymph node (N) stages, and biological subtypes. Data analysis was performed using meta package (R). RESULTS Twenty-six studies were eligible for our systematic review and meta-analysis, including 31,172 BC cases. In 12 studies, including 15,067 patients with BC, the estimated mean age was 50.46 years (95% CI, 48.7 to 52.1; I2, 99%), with a pooled proportion of premenopausal/perimenopausal women of 57% (95% CI, 50 to 63; I2, 98%). Among 9,738 patients with BC, pooled proportions of stage I, II, III, and IV were 6% (95% CI, 4 to 8; I2, 90%), 37% (95% CI, 31 to 43; I2, 93%), 45% (95% CI, 42 to 49; I2, 78%), and 11% (95% CI, 9 to 15; I2, 87%), respectively. The pooled proportions of patients with T3 and T4 tumors were 21% (95% CI, 14 to 31; I2, 99%) and 8% (95% CI, 5 to 12; I2, 96%), respectively, while those with positive lymph nodes were 70% (95% CI, 59 to 79; I2, 99%). CONCLUSION Dominance of advanced stage and young age at diagnosis represented the two main features of BC among Egyptian women. Our data may serve to guide the policymakers in Egypt as well as other countries with lower resources to prioritize the diagnostic and therapeutic needs in this context.
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Affiliation(s)
- Hamdy A. Azim
- Clinical Oncology Department, Kasr Alainy School of Medicine, Cairo University, Giza, Egypt
- Cairo Oncology Center, Cairo, Egypt
| | - Hagar Elghazawy
- Cairo Oncology Center, Cairo, Egypt
- Clinical Oncology Department, Ain Shams University, Cairo, Egypt
| | - Ramy M. Ghazy
- Tropical Health Department, High Institute of Public Health, Alexandria University, Alexandria, Egypt
| | | | | | - Amira Elzorkany
- Training and Biostatistics Administration, Ministry of Health and Population, Alexandria, Egypt
| | - Loay Kassem
- Clinical Oncology Department, Kasr Alainy School of Medicine, Cairo University, Giza, Egypt
- Cairo Oncology Center, Cairo, Egypt
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Tada K, Kumamaru H, Miyata H, Asaga S, Iijima K, Ogo E, Kadoya T, Kubo M, Kojima Y, Tanakura K, Tamura K, Nagahashi M, Niikura N, Hayashi N, Miyashita M, Yoshida M, Ohno S, Imoto S, Jinno H. Characteristics of female breast cancer in japan: annual report of the National Clinical Database in 2018. Breast Cancer 2023; 30:157-166. [PMID: 36547868 PMCID: PMC9950166 DOI: 10.1007/s12282-022-01423-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 12/09/2022] [Indexed: 12/24/2022]
Abstract
Information regarding patients who were treated for breast cancer in 2018 was extracted from the National Clinical Database (NCD), which is run by Japanese physicians. This database continues from 1975, created by the Japanese Breast Cancer Society (JBCS). A total of 95,620 breast cancer cases were registered. The demographics, clinical characteristics, pathology, surgical treatment, adjuvant chemotherapy, adjuvant endocrine therapy, and radiation therapy of Japanese breast cancer patients were summarized. We made comparisons with other reports to reveal the characteristics of our database. We also described some features in Japanese breast cancer that changed over time. The unique characteristics of breast cancer patients in Japan may provide guidance for future research and improvement in healthcare services.
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Affiliation(s)
- Keiichiro Tada
- Department of Breast and Endocrine Surgery, Nihon University School of Medicine, 30-1 Oyaguchikamicho, Itabashi-Ku, Tokyo, 173-8610, Japan.
| | - Hiraku Kumamaru
- Department of Healthcare Quality Assessment, University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Hiroaki Miyata
- Department of Healthcare Quality Assessment, University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Sota Asaga
- Department of Breast Surgery, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan
| | - Kotaro Iijima
- Department of Breast Oncology, Juntendo University, 3-1-3 Hongo, Bunkyo-Ku, Tokyo, 113-8431, Japan
| | - Etsuyo Ogo
- Department of Radiology, Kurume University School of Medicine, 67 Asahi-Machi, Kurume, Fukuoka, 830-0011, Japan
| | - Takayuki Kadoya
- Department of Surgical Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8553, Japan
| | - Makoto Kubo
- Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-Ku, Fukuoka, 812-8582, Japan
| | - Yasuyuki Kojima
- Division of Breast and Endocrine Surgery, Department of Surgery, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-Ku, Kawasaki, 216-8511, Japan
| | - Kenta Tanakura
- Plastic and Reconstructive Surgery, Mitsui Memorial Hospital, 1 Kanda-Izumicho, Chiyoda-Ku, Tokyo, 101-8643, Japan
| | - Kenji Tamura
- Department of Medical Oncology, Shimane University Hospital, 89-1 Enya-Cho, Izumo-Shi, Shimane, 693-8501, Japan
| | - Masayuki Nagahashi
- Department of Surgery, Division of Breast and Endocrine Surgery, School of Medicine, Hyogo Medical University, 1-1 Mukogawa, Nishinomiya, Hyogo, 663-8501, Japan
| | - Naoki Niikura
- Department of Breast Oncology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan
| | - Naoki Hayashi
- Department of Breast Surgical Oncology, St. Luke's International Hospital, 9-1 Akashicho, Chuo-Ku, Tokyo, 104-8560, Japan
| | - Minoru Miyashita
- Department of Breast and Endocrine Surgical Oncology, Tohoku University School of Medicine, Seiryo-Machi, Aoba-Ku, Sendai, 980-8574, Japan
| | - Masayuki Yoshida
- Department of Diagnostic Pathology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-Ku, Tokyo, 104-0045, Japan
| | - Shinji Ohno
- Breast Oncology Center, Cancer Institute Hospital, 3-8-31 Ariake, Koutou-Ku, Tokyo, 135-8550, Japan
| | - Shigeru Imoto
- Department of Breast Surgery, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan
| | - Hiromitsu Jinno
- Department of Surgery, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-Ku, Tokyo, 173-8606, Japan
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9
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Prognosis and effectiveness of chemotherapy for medullary breast carcinoma. Breast Cancer Res Treat 2022; 196:635-645. [DOI: 10.1007/s10549-022-06749-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 09/15/2022] [Indexed: 11/26/2022]
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10
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Breast Cancer in Asia: Incidence, Mortality, Early Detection, Mammography Programs, and Risk-Based Screening Initiatives. Cancers (Basel) 2022; 14:cancers14174218. [PMID: 36077752 PMCID: PMC9454998 DOI: 10.3390/cancers14174218] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 08/24/2022] [Accepted: 08/26/2022] [Indexed: 12/09/2022] Open
Abstract
Simple Summary Nearly all breast cancer patients survive for more than five years when the tumor is found early and in the localized stage. Regular clinical breast examinations, mammograms, and monthly self-exams of the breasts all contribute to early detection. However, late-stage breast cancers are common in many Asian countries. Low-income countries suffer from a lack of resources for breast cancer screening. High-income countries, on the other hand, are not benefiting fully from national breast screening programs due to an underutilization of the preventive healthcare services available. Existing reviews on Asian breast cancers are heavily focused on risk factors. The question of whether we should adopt or adapt the knowledge generated from non-Asian breast cancers would benefit from an extension into screening guidelines. In addition, several Asian countries are piloting studies that move away from the age-based screening paradigm. Abstract Close to half (45.4%) of the 2.3 million breast cancers (BC) diagnosed in 2020 were from Asia. While the burden of breast cancer has been examined at the level of broad geographic regions, literature on more in-depth coverage of the individual countries and subregions of the Asian continent is lacking. This narrative review examines the breast cancer burden in 47 Asian countries. Breast cancer screening guidelines and risk-based screening initiatives are discussed.
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11
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Older patients’ experience of living with cognitive impairment related to hormone therapy for breast cancer: A qualitative study. Eur J Oncol Nurs 2022; 57:102115. [DOI: 10.1016/j.ejon.2022.102115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 01/22/2022] [Accepted: 02/17/2022] [Indexed: 11/21/2022]
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12
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Yotsumoto D, Sagara Y, Kumamaru H, Niikura N, Miyata H, Kanbayashi C, Tsuda H, Yamamoto Y, Aogi K, Kubo M, Tamura K, Hayashi N, Miyashita M, Kadoya T, Saji S, Toi M, Imoto S, Jinno H. Trends in adjuvant therapy after breast-conserving surgery for ductal carcinoma in situ of breast: a retrospective cohort study using the National Breast Cancer Registry of Japan. Breast Cancer 2021; 29:1-8. [PMID: 34665435 DOI: 10.1007/s12282-021-01307-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 10/10/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE Radiotherapy (RT) and endocrine therapy (ET) are standard treatment options after breast-conserving surgery (BCS) for ductal carcinoma in situ (DCIS). We investigated the national patterns of adjuvant therapy use after BCS for DCIS in Japan. METHODS We obtained relevant data of patients diagnosed with DCIS undergoing surgery and treated with BCS between 2014 and 2016 from the Japanese Breast Cancer Registry database. The relationship between the clinicopathologic, institutional, and regional factors, and adjuvant treatment was examined using multivariable analyses. RESULTS We identified 9516 patients who underwent BCS for DCIS. Overall, 23% received no adjuvant treatment, 71% received RT, 32% received ET, and 26% received combination therapy. The percentages of patients who received ET and combination therapy in 2016 were significantly lower [odds ratio (OR): 0.71, 0.77, respectively] than in 2014. The proportion of RT was low among young or elderly patients (OR: 0.75, 0.44, respectively) and in non-certified facilities (OR: 0.56). The proportion of ET was high in non-certified facilities (OR: 1.58) and among patients with positive margins (OR: 1.62). Combination therapy was higher among patients with positive margins (OR: 1.53). CONCLUSIONS Our study found a distinct adjuvant treatment pattern after BCS for DCIS depending on clinicopathologic factors, year, age, which indicate that physicians provide individualized treatment according to the background of the patients and the biology of DCIS. The facilities and regions remain significant factors of influencing adjuvant treatment pattern.
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Affiliation(s)
- Daisuke Yotsumoto
- Department of Breast Surgery, Sagara Hospital Miyazaki, Miyazaki Hakuaikai Medical Corporation, Miyazaki, Japan
| | - Yasuaki Sagara
- Department of Breast Surgery, Sagara Hospital, Hakuaikai Medical Corporation, 3-28 Matsubara Kagoshima City, Kagoshima, 892-0833, Japan.
| | - Hiraku Kumamaru
- Department of Healthcare Quality Assessment, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Naoki Niikura
- Department of Breast and Endocrine Surgery, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Hiroaki Miyata
- Department of Healthcare Quality Assessment, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Chizuko Kanbayashi
- Department of Breast Oncology, Niigata Cancer Center Hospital, Niigata, Japan
| | - Hitoshi Tsuda
- Department of Basic Pathology, National Defense Medical College, Saitama, Japan
| | - Yutaka Yamamoto
- Department of Breast and Endocrine Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Kenjiro Aogi
- Department of Breast Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Ehime, Japan
| | - Makoto Kubo
- Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kenji Tamura
- Department of Medical Oncology, Shimane University Hospital, Izumo, Shimane, Japan
| | - Naoki Hayashi
- Department of Breast Surgical Oncology, St. Luke's International Hospital, Tokyo, Japan
| | - Minoru Miyashita
- Department of Breast and Endocrine Surgical Oncology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Takayuki Kadoya
- Department of Surgical Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Shigehira Saji
- Department of Medical Oncology, Fukushima Medical University, Fukushima, Japan
| | - Masakazu Toi
- Breast Cancer Unit, Graduate School of Medicine, Kyoto University Hospital Breast Surgery, Kyoto University, Kyoto, Japan
| | - Shigeru Imoto
- Department of Breast Surgery, Kyorin University School of Medicine, Tokyo, Japan
| | - Hiromitsu Jinno
- Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan
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13
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Yamada A, Kumamaru H, Shimizu C, Taira N, Nakayama K, Miyashita M, Honma N, Miyata H, Endo I, Saji S, Sawaki M. Systemic therapy and prognosis of older patients with stage II/III breast cancer: A large-scale analysis of the Japanese Breast Cancer Registry. Eur J Cancer 2021; 154:157-166. [PMID: 34293663 DOI: 10.1016/j.ejca.2021.06.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 06/03/2021] [Accepted: 06/08/2021] [Indexed: 12/31/2022]
Abstract
AIM This study aimed at investigating the real-world prognostic impact of systemic treatment in older patients with stage II/III breast cancer (BC). METHODS This retrospective cohort study included patients with stage II/III primary BC, aged ≥55 years, and registered in the Japanese Breast Cancer Registry from 2004 to 2011. The clinicopathological characteristics, treatments, and prognosis of patients aged ≥75 years (older) were compared to those of younger patients. RESULTS In total, 56,093 patients (12,727, ≥75 years; 17,860, 65-74 years; 25,506, 55-64 years) were enrolled. In the older group, 9.2% with a luminal (hormone receptor [HR]+/human epidermal growth factor receptor 2 [HER2]-), 32.9% with a triple-negative (TN, HR-/HER2-), and 27.4% with a HER2-positive (any-HR/HER2+) receptor were administered chemotherapy. In those with luminal cancer, the 5-year breast cancer-specific survival (BCSS) was approximately 95% in all age groups. Meanwhile, among those with TN and HER2-positive BC, the older group had a poorer BCSS. The 5-year overall survival (OS) was also poorer in the older group across all subtypes. Among older patients matched using clinicopathological factors, chemotherapy use was associated with improved OS in the luminal and HER2-positive subtypes. CONCLUSIONS Chemotherapy use was lower among older patients with stage II/III breast cancer. Those with TN and HER2-positive BC had a lower BCSS than their younger counterparts. Chemotherapy may be beneficial in improving the OS in older patients with luminal and HER2-positive BCs. Treatment for older patients should be individualized, based on tumor-related factors, quality of life, and the patient's health status.
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Affiliation(s)
- Akimitsu Yamada
- Department of Gastroenterological Surgery Yokohama, City University Graduate School of Medicine, Yokohama, Japan.
| | - Hiraku Kumamaru
- Department of Healthcare Quality Assessment, University of Tokyo Graduate School of Medicine, Tokyo, Japan.
| | - Chikako Shimizu
- Department of Breast and Medical Oncology, National Center for Global Health and Medicine, Tokyo, Japan.
| | - Naruto Taira
- Department of Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan.
| | - Kanako Nakayama
- Department of Breast Surgery, National Center for Global Health and Medicine, Tokyo, Japan.
| | - Mika Miyashita
- Department of Gerontological and Oncology Nursing, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
| | - Naoko Honma
- Department of Pathology, Toho University School of Medicine, Tokyo, Japan.
| | - Hiroaki Miyata
- Department of Healthcare Quality Assessment, University of Tokyo Graduate School of Medicine, Tokyo, Japan.
| | - Itaru Endo
- Department of Gastroenterological Surgery Yokohama, City University Graduate School of Medicine, Yokohama, Japan.
| | - Shigehira Saji
- Department of Medical Oncology, Fukushima Medical University, Fukushima, Japan.
| | - Masataka Sawaki
- Department of Breast Oncology, Aichi Cancer Center, Nagoya, Japan.
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14
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Naoi Y, Tsunashima R, Shimazu K, Noguchi S. The multigene classifiers 95GC/42GC/155GC for precision medicine in ER-positive HER2-negative early breast cancer. Cancer Sci 2021; 112:1369-1375. [PMID: 33544932 PMCID: PMC8019222 DOI: 10.1111/cas.14838] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 01/30/2021] [Accepted: 02/02/2021] [Indexed: 12/27/2022] Open
Abstract
In clinical decision‐making, to decide the indication for adjuvant chemotherapy for estrogen receptor‐positive (ER+), human epidermal growth factor receptor‐2‐negative (HER2−), and node‐negative (n0) breast cancer patients, the accurate estimation of recurrence risk is essential. Unfortunately, conventional prognostic factors, such as tumor size, histological grade and ER, progesterone receptor (PR), and HER2 status as well as Ki67 index, are not sufficiently accurate for such estimation. Therefore, several multigene assays (MGAs) based on the mRNA expression analysis of multiple genes in tumor tissue have been developed to better predict patient prognosis. These assays include Oncotype DX, MammaPrint, PAM50, GGI, EndoPredict, and BCI. We developed Curebest™ 95‐Gene Classifier Breast (95GC) classifier, which is unique in that mRNA expression data of all 20 000 human genes are secondarily obtainable, as the 95GC assay is performed using Affymetrix microarray. This can capture mRNA expression of not only 95 genes but also every gene at once, and such gene expression data can be utilized by the other MGAs that we have developed, such as the 155GC, which is used for the prognostic prediction of ER+/HER2− breast cancer patients treated with neoadjuvant chemotherapy. We also developed the 42GC for predicting late recurrence in ER+/HER2− breast cancer patients. In this mini‐review, our recent attempt at the development of various MGAs, which is expected to facilitate the implementation of precision medicine in ER+/HER2− breast cancer patients, is presented with a special emphasis on 95GC.
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Affiliation(s)
- Yasuto Naoi
- Department of Breast and Endocrine Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Ryo Tsunashima
- Department of Breast and Endocrine Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Kenzo Shimazu
- Department of Breast and Endocrine Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Shinzaburo Noguchi
- Department of Breast and Endocrine Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
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Takahashi E, Terata K, Nanjo H, Ishiyama K, Hiroshima Y, Yamaguchi A, Yatsuyanagi M, Kudo C, Wakita A, Takashima S, Sato Y, Imai K, Motoyama S, Minamiya Y. A male with primary accessory breast carcinoma in an axilla is strongly suspected of having hereditary breast cancer. Int Cancer Conf J 2021; 10:107-111. [PMID: 33782642 PMCID: PMC7947143 DOI: 10.1007/s13691-020-00466-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 12/23/2020] [Indexed: 10/24/2022] Open
Abstract
We herein report on a male with primary accessory breast cancer in an axilla. A 75-year-old man first noticed a subcutaneous nodule about 2 cm in diameter in the area of his right axilla. The patient underwent extirpation of the mass in a public hospital. Histological examination revealed invasive breast carcinoma of no special type associated with mucinous carcinoma, invasive micropapillary carcinoma and intraductal components. Immunohistochemical analysis showed that the tumor cells were positive for Gross cystic disease fluid protein (GCDFP)-15, mammaglobin and GATA3. Staining for estrogen receptor (ER) and progesterone receptor (PR) was positive, and human epidermal growth factor receptor 2 (HER2) was negative. The Ki67 labeling index (LI) was 33.6%. Imaging revealed no evidence of a primary tumor in any other organ or in the bilateral mammary gland. We performed radical resection of the right axilla, including the scar, and axillary lymph node dissection. The final pathological examination of the surgical specimen showed normal mammary gland tissue that was not connected to the proper mammary gland, and no residual cancer or metastatic lymph nodes. Based on our clinical and pathological findings, this tumor was diagnosed as breast cancer originating from the accessory mammary gland in the right axilla. After surgery, tamoxifen was administered as adjuvant therapy. Since the surgery, 2 years ago, there has been no evidence of recurrence. Hereditary Breast and Ovarian Cancer syndrome was suspected in this case because the patient was a male with breast cancer, and he had two first-degree relatives with breast cancer. This patient had no BRCA mutations on genetic testing. Nonetheless, in cases of male breast cancer, it is necessary to obtain genetic information due to the possibility of hereditary breast cancer, including cancers associated with BRCA gene mutation.
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Affiliation(s)
- Eriko Takahashi
- Department of Thoracic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543 Japan
| | - Kaori Terata
- Department of Thoracic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543 Japan
| | - Hiroshi Nanjo
- Department of Pathology, Akita University Hospital, Akita, Japan
| | - Koichi Ishiyama
- Department of Diagnostic Radiology, Akita University Hospital, Akita, Japan
| | - Yuko Hiroshima
- Department of Pathology, Akita University Hospital, Akita, Japan
| | - Ayuko Yamaguchi
- Department of Thoracic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543 Japan
| | - Misako Yatsuyanagi
- Department of Thoracic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543 Japan
| | - Chiaki Kudo
- Department of Thoracic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543 Japan
| | - Akiyuki Wakita
- Department of Thoracic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543 Japan
| | - Shinogu Takashima
- Department of Thoracic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543 Japan
| | - Yusuke Sato
- Department of Thoracic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543 Japan
| | - Kazuhiro Imai
- Department of Thoracic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543 Japan
| | - Satoru Motoyama
- Department of Thoracic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543 Japan
| | - Yoshihiro Minamiya
- Department of Thoracic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543 Japan
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16
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Clinicopathological characteristics, practical treatments, prognosis, and clinical issues of older breast cancer patients in Japan. Breast Cancer 2020; 28:1-8. [PMID: 33219915 DOI: 10.1007/s12282-020-01188-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Accepted: 11/08/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Minimal data are available to support the clinical management of older breast cancer patients. Consequently, the standard of care remains unclear. Our aim was to clarify the clinicopathological characteristics, practical treatments, and prognosis of older Japanese breast cancer patients and discuss clinical issues. METHODS We reviewed 132,240 cases, diagnosed between 2004 and 2011, from the Japanese Breast Cancer Registry. Focusing on older patients, we compared data among three age groups: 75 years and over (n = 27,385), 65-74 years (n = 43,839), and 55-64 years (n = 61,016). RESULTS Data revealed the proportions of mucinous and apocrine carcinoma were higher in older patients, and they more frequently had clinical stage II and III cancer. Their ER-positive rates were higher, in contrast to the lower HER2-positive, breast-conserving surgery (BCS), post-BCS irradiation, and adjuvant chemotherapy rates. Almost half of the older patients who underwent chemotherapy received CMF or oral 5FU, during hormone therapy, Tamoxifen was administered more frequently. The overall survival rate decreased with age, but the breast cancer-specific survival (BCSS) at 5 years remained similar. The rate of other cause of death in the oldest group was about a half, and more than double that in those aged 55-64 years. CONCLUSIONS We showed clinical data of older breast cancer patients in Japan. Their disease was more advanced at the time of diagnosis, post-BCS irradiation and primary systemic chemotherapy were omitted more frequently, and overall, BCSS was similar among age categories, although the rate of other causes of death was higher.
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17
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Konishi T, Fujiogi M, Michihata N, Morita K, Matsui H, Fushimi K, Tanabe M, Seto Y, Yasunaga H. Association between body mass index and localization of breast cancer: results from a nationwide inpatient database in Japan. Breast Cancer Res Treat 2020; 185:175-182. [PMID: 32949351 DOI: 10.1007/s10549-020-05934-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 09/05/2020] [Indexed: 11/27/2022]
Abstract
PURPOSE Although both localization of breast cancer and body mass index (BMI) are associated with prognosis, the association between localization of breast cancer and BMI remains unclear. This study aimed to investigate the association between localization of breast cancer and BMI at diagnosis. METHODS Patients who underwent surgery for stage 0-III breast cancer July 2010-March 2017 were identified retrospectively in a Japanese nationwide inpatient database. Multinomial logistic regression analyses adjusting for patient's age were conducted to compare the outcomes among five BMI groups: < 18.5 kg/m2 (n = 31,724; 9.3%), 18.5-24.9 kg/m2 (n = 218,244; 64.3%), 25.0-29.9 kg/m2 (n = 69,813; 20.6%), 30.0-34.9 kg/m2 (n = 16,052; 4.7%), and ≥ 35.0 kg/m2 (n = 3716; 1.1%). The outcomes were the quadrant and side of the breast where tumors were detected. RESULTS In total, about half of the patients had breast cancer in the upper-outer quadrant (49.7%) and in the left breast (51.1%). In the multinomial analysis, BMI ≥ 25.0 kg/m2 was associated with the occurrence of breast cancer in the upper-inner and lower-outer quadrants and in the central area, whereas BMI < 18.5 kg/m2 was associated with the occurrence of breast cancer in the central area only. The side of breast cancer did not differ significantly among the five BMI groups. CONCLUSIONS Localization of breast cancer was associated with BMI in this large nationwide cohort. The findings may benefit patients' self-checks and doctors' examinations, potentially resulting in early detection and treatment.
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Affiliation(s)
- Takaaki Konishi
- Department of Breast and Endocrine Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. .,Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
| | - Michimasa Fujiogi
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.,Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Boston, MA, 02114, USA
| | - Nobuaki Michihata
- Department of Health Services Research, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Kojiro Morita
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.,Department of Health Services, Faculty of Medicine, University of Tsukuba, 1-1-1 Ten-nodai, Tsukuba, Ibaraki, 305-8577, Japan
| | - Hiroki Matsui
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Kiyohide Fushimi
- Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Masahiko Tanabe
- Department of Breast and Endocrine Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Yasuyuki Seto
- Department of Breast and Endocrine Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.,Department of Gastrointestinal Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Hideo Yasunaga
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
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