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HPV-Associated Breast Cancer: Myth or Fact? Pathogens 2022; 11:pathogens11121510. [PMID: 36558844 PMCID: PMC9786769 DOI: 10.3390/pathogens11121510] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 12/01/2022] [Accepted: 12/08/2022] [Indexed: 12/14/2022] Open
Abstract
Some estimates place the proportion of human malignancies attributable to viruses at between 15 and 20 percent. Viruses including the human papillomavirus are considered an interesting but controversial etiological risk factor for breast cancer. HPV infection is anticipated to be an early trigger in breast cancer carcinogenesis, followed by cumulative alterations over time ("hit and run" mechanism) through synergy with other environmental factors. The association between HPV and breast cancer has not yet been verified. There are very conflicting data on the presence of HPV DNA in breast cancer samples, and we lack a clarified, exact mode of HPV transmission to the breast. In our review article we analyzed the up-to-date knowledge about the association of HPV and breast cancer. Furthermore, we summarized the available original research published since 2010. In conclusion, the complexity and inconsistency of the available results together with the relatively low prevalence of HPV infection requires extensive research with much larger studies and exact and unified diagnostic methods are required to better understand the role of the HPV in breast carcinogenesis.
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Koshariya M, Shukla S, Ansari F, Khare V. Breast Carcinoma in Young Females: A Prospective Study in Terms of Clinicopathological Presentation at a Tertiary Care Center in India. Cureus 2022; 14:e27237. [PMID: 36035040 PMCID: PMC9399668 DOI: 10.7759/cureus.27237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2022] [Indexed: 11/30/2022] Open
Abstract
Introduction: The incidence of breast carcinoma in young women is on the rise, particularly in developing Asian countries like India. Owing to a unique presentation in terms of genetic background, clinical features, and histological characteristics, the prognosis becomes challenging, which therefore entails a detailed study for better understanding and management of the disease. This study aimed to establish the role of clinical and pathological parameters in breast cancer disease in young women. Methods: This was a prospective comparative study conducted at the Department of Surgery, Hamidia Hospital, Bhopal, India, which spanned a total duration of one year between November 2018 and October 2019, and included a total of 98 consecutive in-house breast carcinoma patients. The patients were categorized into two groups based on age, i.e., the young age group (age < 40 years) and the old age group (age ≥ 40 years). Results: Of the patients, 37 fell in the young age group and 61 in the old age group. There was a significant association between positive family history of breast carcinoma and young age (p = 0.01). Estrogen and progesterone receptor positivity was found to be associated more commonly with old age group patients. The proportion of patients with human epidermal growth factor receptor 2 (HER2)/neu over-expression was higher among the young age group. Triple negativity was more frequently observed amongst young age group patients. Conclusion: Hormone receptor analysis should be an absolute part of the initial work-up of breast carcinoma. Raising awareness among women in society should be of paramount importance. Family history is crucial, particularly in young women, and should not be dismissed. With timely presentation and effective diagnosis, a safer state with a relatively better prognosis can be achieved.
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Avci O, Tacar SY, Seber ES, Yetisyigit T. Breast cancer in young and very young women; Is age related to outcome? J Cancer Res Ther 2021; 17:1322-1327. [PMID: 34916360 DOI: 10.4103/jcrt.jcrt_545_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Breast cancer in young women is associated with aggressive biology. We analyzed histopathological and clinical properties of breast cancer patients diagnosed at ≤40 years of age. Methods Breast cancer patients who were admitted between 2015 and 2019 were included. Baseline characteristics of the patients with treatment-related outcomes were assessed. The study group was divided into two subgroups; <35 years old as "very young" and ≥35 years old as "young." Results The data of 137 patients (60 patients <35 years) were reviewed. The mean age was 34.7 years. The mean follow-up duration was 44.45 ± 26.39 months, and the mean disease-free survival was 36.17 ± 21.97 months. 11.4% of the patients were diagnosed with Stage 4 disease. Pathologic subtype was invasive ductal carcinoma in 86% of patients. 16.8% of the patients were luminal A, 38.7% luminal B, 30.5% were human epidermal growth factor receptor-2-positive type, and 15.3% were triple-negative. Only 5 (3.3%) patients had given birth after chemotherapy. During the follow-up period of early-staged diagnosed patients, metastatic disease occurred in 24.6%. The rate of distant metastasis development was statistically higher in the very young group (31% vs. 11%; P = 0.004). Thirteen patients (10.7%) died due to disease progression. Thirty-seven percent of the patients had a positive family history for either breast or ovarian cancer. Conclusions Very young breast cancer patients seem to have a more aggressive disease course. The low rate of childbearing in this young patient population is conspicuous. An interdisciplinary approach for the management of this special patient population should be taken into consideration.
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Affiliation(s)
- Okan Avci
- Department of Medical Oncology, Namik Kemal University, Tekirdağ, Turkey
| | - Seher Yildiz Tacar
- Department of Medical Oncology, Namik Kemal University, Tekirdağ, Turkey
| | | | - Tarkan Yetisyigit
- Department of Medical Oncology, Namik Kemal University, Tekirdağ, Turkey
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Karihtala P, Jääskeläinen A, Roininen N, Jukkola A. Real-world, single-centre prospective data of age at breast cancer onset: focus on survival and reproductive history. BMJ Open 2021; 11:e041706. [PMID: 33518519 PMCID: PMC7852949 DOI: 10.1136/bmjopen-2020-041706] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES Being either young or old at the time of breast cancer diagnosis has been suggested as an indicator of a poor prognosis. We studied the effect of age at breast cancer onset in relation to survival, focusing in particular on biological subtypes and reproductive anamnesis. DESIGN, SETTING AND PARTICIPANTS Patients with early breast cancer (n=594) treated in a Finnish University Hospital during 2003-2013 were prospectively collected and followed in median 102 months. RESULTS Patients with luminal A-like breast cancer were older than the patients with luminal B-like (HER2-positive) (p=0.045) or patients with the HER2-positive (non-luminal) subtype (p=0.029). Patients ≥70 years received substantially less adjuvant chemotherapy (p=1.5×10-9) and radiotherapy (p=5.9×10-7) than younger women. Nevertheless, the estimated 10-year breast cancer-specific rates of survival were 84.2%, 92.9% and 87.0% in age groups <41 years, 41-69 years and ≥70 years, respectively, with no statistical difference (p=0.115). Survival rates were also comparable between the three age groups when assessed separately in different biological subtypes, and for patients with metastatic breast cancer there was similarly no difference between the age groups. Later menarche (p=5.7×10-8) and high parity (p=0.000078) correlated with increased age at breast cancer diagnosis, but, according to the patients' oestrogen receptor (ER) status, only among ER-positive patients. CONCLUSIONS Despite the suggested undertreatment of older patients, we report excellent long-term outcomes in all age groups in this prospective cohort. Later endogenous endocrine exposure may cause delay in breast cancer onset, but the exact biology behind this phenomenon is so far unclear.
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Affiliation(s)
- Peeter Karihtala
- Department of Oncology, Helsinki University Hospital Comprehensive Cancer Centre, University of Helsinki, Helsinki, Finland
| | - Anniina Jääskeläinen
- Department of Oncology and Radiotherapy, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Nelli Roininen
- Department of Oncology and Radiotherapy, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Arja Jukkola
- Department of Oncology and Radiotherapy, Faculty of Medicine and Health Technology, Tampere University Hospital, Tampere University, Tampere, Finland
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Tiofack ATZ, Simo G, Ofon EA, bell ED, Kamla CM, Ananga SN, Roger T, Nana TN, Nguefack CT, Fewou A, Takongmo S, Lueong S. The TP63 Gene Polymorphism rs17506395 is Associated with Early Breast Cancer in Cameroon. Asian Pac J Cancer Prev 2020; 21:2199-2208. [PMID: 32856845 PMCID: PMC7771916 DOI: 10.31557/apjcp.2020.21.8.2199] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 08/20/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Breast cancer (BC) is a leading female cancer worldwide and cause of cancer-related death, especially in developing countries. Genetic predispositions to BC development in African population is poorly studied, and meanwhile the SNP rs17506395 in TP63 gene locus has been associated with the development of breast cancer in Asian women, no investigation has been undertaken within African population. We investigated the impact of this polymorphism in a representative African population. METHODS We undertook a case-control study including 335 women, of which 111 were breast cancer patients and 224 controls. Using blood-derived germline DNA, PCR-RFLP was used to investigate the polymorphism of TP63 gene at rs17506395 locus. Unconditional logistic regression was used to study the association between the TP63 gene polymorphism and risk of BC development. After stratification into different age and ethno-linguistic groups as well as menopausal status, the Cochran-Mantel-Haenszel test was used to measure significance of the associations. RESULTS Comparing cases with controls, no significant associations between genotype and disease development was observed. Similarly, when cases were stratified according to menopausal status and ethno-linguistic groups, no significant association was observed between genotype and disease development. However, in women of 40 years and below, TT and TG genotypes were associated with breast cancer development. The minor G allele seems to protective against early breast cancer onset OR of 0.5 (95%CI = 0.26-0.94, p = 0.03). CONCLUSION Our data revealed an association between rs15706395 and the risk of early breast cancer onset. The GG genotype seems to reduce the risk of early breast cancer. Larger studies are needed to confirm the potential of this SNP as biomarker for breast cancer prognostic. .
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Affiliation(s)
- Arnol T Z Tiofack
- Molecular Parasitology & Entomology Unit, Department of Biochemistry, Faculty of Science, University of Dschang, Dschang, Cameroun.
| | - Gustave Simo
- Molecular Parasitology & Entomology Unit, Department of Biochemistry, Faculty of Science, University of Dschang, Dschang, Cameroun.
| | - Elvis A Ofon
- Molecular Parasitology & Entomology Unit, Department of Biochemistry, Faculty of Science, University of Dschang, Dschang, Cameroun.
| | - Ester Dina bell
- Medical Oncology, Direction of the Bonassama District Hospital, Douala, Cameroon.
| | - Chancelin M Kamla
- Faculty of Medicine and Pharmaceutical Science, University of Douala, Douala, Cameroon.
| | - Sidonie N Ananga
- Service of AnatomocytoPathotogy, General Hospital of Douala, Douala, Cameroon.
| | | | - Theophile N Nana
- Service of Obstetrics and Gynecology, General Hospital of Douala and Faculty of Medicine, University of Buea.
| | - Charlotte T Nguefack
- Service of Obstetrics and Gynecology, General Hospital of Douala and Faculty of Medicine, University of Buea.
| | - Adamou Fewou
- Service of AnatomocytoPathotogy, General Hospital of Douala, Douala, Cameroon.
- Faculty of Medicine and Biomedical Sciences, University of Yaounde, Yaounde, Cameroon.
| | - Samuel Takongmo
- Faculty of Medicine and Biomedical Sciences, University of Yaounde, Yaounde, Cameroon.
- Medico-surgical center of Yaounde-Nsimeyong Hospital, Yaounde, Cameroon.
| | - Smiths Lueong
- Molecular Parasitology & Entomology Unit, Department of Biochemistry, Faculty of Science, University of Dschang, Dschang, Cameroun.
- German Cancer Research Center, Essen, Germany.
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Martínez MT, Oltra SS, Peña-Chilet M, Alonso E, Hernando C, Burgues O, Chirivella I, Bermejo B, Lluch A, Ribas G. Breast Cancer in Very Young Patients in a Spanish Cohort: Age as an Independent Bad Prognostic Indicator. BREAST CANCER-BASIC AND CLINICAL RESEARCH 2019; 13:1178223419828766. [PMID: 30814839 PMCID: PMC6383086 DOI: 10.1177/1178223419828766] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 12/28/2018] [Indexed: 12/24/2022]
Abstract
Purpose: Breast cancer (BC) in very young women (BCVY) is more aggressive than in
older women. The purpose of this study was to evaluate the relevance of a
range of clinico-pathological factors in the prognosis of BCVY patients. Methods: We retrospectively analyzed 258 patients diagnosed with BCVY at our hospital
from 1998 to 2014; the control group comprised 101 older patients with BC.
We correlated clinicopathological factors, treatments, relapse and exitus
with age and with previously published miRNA expression data. Results: We identified some significant differences in risk factors between BCVY and
older patients. The age at menarche, number of pregnancies, and age at first
pregnancy were lower in the BCVY group and had a greater probability of
recurrence and death in all cases. Lymph node-positive patients in the BCVY
group are associated with a worse prognosis
(P = .02), an immunohistochemical
HER2+ subtype, and disease relapse
(P = .03). Moreover, there was a
shorter time between diagnosis and first relapse in BCVY patients compared
with controls, and they were more likely to die from the disease
(P = .002). Finally, from our panel of
miRNAs deregulated in BC, reduced miR-30c expression was associated with
more aggressive BC in very young patients, lower overall survival, and with
axillary lymph node metastases. Conclusions: Patient age and axillary lymph node status post-surgery are independent and
significant predictors of distant disease-free survival, local
recurrence-free survival, and overall survival. The HER2+ subtype
and lower miR-30c expression are related to poor prognosis in lymph
node-positive young BC patients.
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Affiliation(s)
- María Teresa Martínez
- Medical Oncology and Hematology Unit, Health Research Institute INCLIVA, Valencia, Spain.,Centre of Networked Biomedical Cancer Research (CIBERONC), Valencia, Spain
| | - Sara S Oltra
- Medical Oncology and Hematology Unit, Health Research Institute INCLIVA, Valencia, Spain.,Centre of Networked Biomedical Cancer Research (CIBERONC), Valencia, Spain
| | - María Peña-Chilet
- Medical Oncology and Hematology Unit, Health Research Institute INCLIVA, Valencia, Spain.,Centre of Networked Biomedical Cancer Research (CIBERONC), Valencia, Spain
| | - Elisa Alonso
- Department of Pathology, Health Research Institute INCLIVA, Valencia, Spain
| | - Cristina Hernando
- Medical Oncology and Hematology Unit, Health Research Institute INCLIVA, Valencia, Spain.,Centre of Networked Biomedical Cancer Research (CIBERONC), Valencia, Spain
| | - Octavio Burgues
- Department of Pathology, Health Research Institute INCLIVA, Valencia, Spain
| | - Isabel Chirivella
- Medical Oncology and Hematology Unit, Health Research Institute INCLIVA, Valencia, Spain.,Centre of Networked Biomedical Cancer Research (CIBERONC), Valencia, Spain
| | - Begoña Bermejo
- Medical Oncology and Hematology Unit, Health Research Institute INCLIVA, Valencia, Spain.,Centre of Networked Biomedical Cancer Research (CIBERONC), Valencia, Spain
| | - Ana Lluch
- Medical Oncology and Hematology Unit, Health Research Institute INCLIVA, Valencia, Spain.,Centre of Networked Biomedical Cancer Research (CIBERONC), Valencia, Spain
| | - Gloria Ribas
- Medical Oncology and Hematology Unit, Health Research Institute INCLIVA, Valencia, Spain.,Centre of Networked Biomedical Cancer Research (CIBERONC), Valencia, Spain
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7
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Lin H, Zhang F, Wang L, Zeng D. Use of clinical nomograms for predicting survival outcomes in young women with breast cancer. Oncol Lett 2019; 17:1505-1516. [PMID: 30675206 PMCID: PMC6341825 DOI: 10.3892/ol.2018.9772] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 10/12/2018] [Indexed: 02/05/2023] Open
Abstract
Early-onset breast cancer (BC) has been recognized to be more aggressive compared with its later counterparts. Survival models of BC in young patients have rarely been reported in previous studies. The current study aimed to establish and validate prediction models with clinicopathological variables for visceral metastasis-free survival (VFS), disease-free-survival (DFS) and overall survival (OS) time in young patients with BC. Clinicopathological data were obtained for 351 patients with primary breast tumors who were ≤40 years old. Univariate and multivariate analyses were performed and nomograms were established to screen and illustrate the prognostic factors. Risk scores were calculated based on coefficients from the Cox regression analysis. Internal validation of the prediction models was conducted by predicting the prognosis of cases randomly sampled from the cohort used in the current study. Multivariate analysis demonstrated that N stage (P=0.004), molecular subtype (P=0.007) and age (P=0.005) were significant independent prognostic factors for VFS. Similarly, N stage (P=0.002) and molecular subtype (P=0.001) were significantly associated with DFS. In addition, N stage (P=0.006), molecular subtype (P=0.006) and the presence of an initially inoperable tumor (P=0.005) were significant independent prognostic factors for OS. According to the Cox regression analysis, nomograms were generated to illustrate the effect of independent prognostic factors on VFS, DFS and OS. Risk scores were calculated and internal validation demonstrated the reliability of the prediction models. In conclusion, N stage and molecular subtype were identified as predictors for VFS, DFS and OS in early-onset BC. Furthermore, an age of <35 years at diagnosis was revealed to be unfavorable for VFS and the presence of an initially inoperable tumor was identified to reduce OS time.
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Affiliation(s)
- Hui Lin
- Department of Breast Medical Oncology, Cancer Hospital of Shantou University Medical College, Shantou, Guangdong 515041, P.R. China
- Correspondence to: Dr Hui Lin, Department of Breast Medical Oncology, Cancer Hospital of Shantou University Medical College, 7 Raoping Road, Shantou, Guangdong 515041, P.R. China, E-mail:
| | - Fan Zhang
- Guangdong Provincial Key Laboratory for Breast Cancer Diagnosis and Treatment, Cancer Hospital of Shantou University Medical College, Shantou, Guangdong 515041, P.R. China
| | - Luanhong Wang
- Department of Gynecology, Cancer Hospital of Shantou University Medical College, Shantou, Guangdong 515041, P.R. China
| | - De Zeng
- Department of Breast Medical Oncology, Cancer Hospital of Shantou University Medical College, Shantou, Guangdong 515041, P.R. China
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Talei A, Tahmasebi S, Akrami M, Zangouri V, Rezaianzadeh A, Arasteh P, Eghbali T, Hosseini S. The Shiraz Breast Cancer Registry (SBCR): study design and primary reports. Per Med 2018; 15:471-479. [PMID: 30375263 DOI: 10.2217/pme-2018-0047] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 08/10/2018] [Indexed: 12/18/2022]
Abstract
AIM This is a description of the largest breast cancer (BC) registry in Iran, termed the Shiraz Breast Cancer Registry (SBCR). METHODS Data on baseline and clinical characteristics, socioeconomic status, imaging, physical examination, histopathology, treatment and prognosis have been recorded for each individual. RESULTS Overall, 5937 were included in the report. Mean age of first presentation was 49.05 ± 11.69 years. Mean tumor size was 2.78 ± 1.76 cm. Most patients had stage 2 (46.9%) and 3 (25.5%) BCs, respectively. Most common type of BC was invasive ductal carcinoma (83.3%), followed by medullary carcinoma (3.8%). Overall, 12.9% were triple negative (HER2-, ER- and PR-). CONCLUSION The study provides an overview on the status of BC's in Iran and a wide opportunity for future studies.
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Affiliation(s)
- Abdolrasoul Talei
- Breast Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sedigheh Tahmasebi
- Breast Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Majid Akrami
- Breast Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Vahid Zangouri
- Surgical Oncology Division, General Surgery Department, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Abbas Rezaianzadeh
- Breast Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Peyman Arasteh
- Breast Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Tannaz Eghbali
- Breast Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sara Hosseini
- Breast Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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9
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Pedrini JL, Savaris RF, Schorr MC, Cambruzi E, Grudzinski M, Zettler CG. The Effect of Neoadjuvant Chemotherapy on Hormone Receptor Status, HER2/neu and Prolactin in Breast Cancer. TUMORI JOURNAL 2018; 97:704-10. [DOI: 10.1177/030089161109700605] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aims and Background Histological and immunohistochemical findings may vary in cases of breast cancer. Possible changes in tumor markers between biopsies performed before and after neoadjuvant chemotherapy are controversial and pose a challenge when a clinical decision is needed. The objectives of the present study were: (i) to compare the immunohistochemical expression of estrogen, progesterone and prolactin receptors and HER-2/neu in breast cancer before and after neoadjuvant chemotherapy; and (ii) to correlate the expression of these tumor markers with partial tumor response to neoadjuvant chemotherapy. Methods and Study Design Immunohistochemical staining for breast tumor markers was performed in 90 cases of breast cancer. Statistical analysis was carried out using Fisher's exact test, McNemar's test, Spearman's correlation and the Kappa index with linear weighting (κ). Results Agreement between markers before and after neoadjuvant chemotherapy was fair to moderate (κ = 0.37–0.51). The immunohistochemical expression of HER-2/neu and prolactin receptors showed a significant, albeit weak correlation before and after neoadjuvant chemotherapy (HER-2/neu, rho = 0.34; P = 0.0009; κ = 0.35 [95% CI, 0.19–0.51]). Prolactin status changed in 28/90 cases (P = 0.001; McNemar's test), whereas no changes were found in estrogen or progesterone receptors. No association was found between tumor marker expression and tumor response. Conclusions It seems prudent to reevaluate immunohistochemical markers such as HER-2/neu after neoadjuvant chemotherapy, since the findings will guide the strategy for implementation of adjuvant systemic treatment. No correlation was found between the tumor markers analyzed in the present study and partial tumor response to neoadjuvant chemotherapy.
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Affiliation(s)
- José Luiz Pedrini
- Universidade Federal de Ciências da Saúde de Porto Alegre, Hospital Nossa Senhora da Conceição, Grupo Hospitalar Conceição, Porto Alegre
| | - Ricardo Francalacci Savaris
- Dept Ginecologia e Obstetrícia, e Programa de Pós-Graduação em Medicina: Ciências Cirúrgicas, Universidade Federal do Rio Grande do Sul, Porto Alegre
| | | | - Eduardo Cambruzi
- Hospital Nossa Senhora da Conceição – Grupo Hospitalar Conceição, Porto Alegre
| | - Melina Grudzinski
- Hospital Nossa Senhora da Conceição – Grupo Hospitalar Conceição, Porto Alegre
| | - Cláudio Galleano Zettler
- Dept de Patologia – Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil
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10
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Bakkach J, Mansouri M, Derkaoui T, Loudiyi A, Fihri M, Hassani S, Barakat A, Ghailani Nourouti N, Bennani Mechita M. Clinicopathologic and prognostic features of breast cancer in young women: a series from North of Morocco. BMC Womens Health 2017; 17:106. [PMID: 29121898 PMCID: PMC5680801 DOI: 10.1186/s12905-017-0456-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Accepted: 10/31/2017] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Literature data reported a higher frequency of breast cancer in young women (BCYW) in developing countries. BCYW is associated with delayed diagnosis, aggressive biology and poor prognosis. However, our knowledge of biological profile, treatment received and outcome of young patients is still limited in Morocco. We propose to analyze clinicopathologic, therapeutic and prognostic features of BCYW among a series of patients native and/or inhabitant of North of Morocco. METHODS We carried out a retro-prospective study of 331 infiltrating breast cancer cases registered between January 2010 and December 2015. Details of tumor pathology, treatment and outcome were collected. Disease-Free Survival (DFS) and Overall Survival (OS) were assessed by Kaplan-Meier analysis. RESULTS A total of 82 patients were diagnosed with breast cancer at the age of 40 or younger (24.8%). Median age was 36 years. More than one quarter (26%) of patients had family history of breast or ovarian cancer. Advanced stages accounted for 34.2% of cases. Median tumor diameter was 2.8 cm. Intermediate and high-grade tumors represented 47.6% and 40.2%, respectively. Nodal involvement was present in 58.5% and lymphovascular invasion was found in 47.7% of the patients. About two thirds (66.2%) of tumors were hormone receptor positive, 29.2% over-expressed HER2 receptor and 23% were triple negative. Patients underwent breast conserving surgery in 38.2% of cases, 61.7% were offered adjuvant chemotherapy and 84.6% received hormone therapy. Five-year DFS and OS were respectively 88.9% and 75.6%. Locoregional recurrence occurred in 2.8% of cases and 8.3% of patients developed distant metastases. CONCLUSION Our findings are in accordance with previous studies that have shown a higher frequency of breast cancer among Moroccan young women. In line with literature data, clinicopathologic profile seems to be aggressive and prognosis is pejorative in our series.
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Affiliation(s)
- Joaira Bakkach
- Human Genomic Research Laboratory, Faculty of Sciences and Techniques of Tangier, University Abdelmalek Essaâdi, Tangier, Morocco
| | - Mohamed Mansouri
- Human Genomic Research Laboratory, Faculty of Sciences and Techniques of Tangier, University Abdelmalek Essaâdi, Tangier, Morocco
- Oncology Clinic AL AMAL of Tangier, Tangier, Morocco
| | - Touria Derkaoui
- Human Genomic Research Laboratory, Faculty of Sciences and Techniques of Tangier, University Abdelmalek Essaâdi, Tangier, Morocco
| | - Ali Loudiyi
- Oncology Clinic AL AMAL of Tangier, Tangier, Morocco
| | - Mohamed Fihri
- Mathematics and Applications Laboratory, Faculty of Sciences and Techniques of Tangier, University Abdelmalek Essaâdi, Tangier, Morocco
| | - Samia Hassani
- Human Genomic Research Laboratory, Faculty of Sciences and Techniques of Tangier, University Abdelmalek Essaâdi, Tangier, Morocco
| | - Amina Barakat
- Human Genomic Research Laboratory, Faculty of Sciences and Techniques of Tangier, University Abdelmalek Essaâdi, Tangier, Morocco
| | - Naima Ghailani Nourouti
- Human Genomic Research Laboratory, Faculty of Sciences and Techniques of Tangier, University Abdelmalek Essaâdi, Tangier, Morocco
| | - Mohcine Bennani Mechita
- Human Genomic Research Laboratory, Faculty of Sciences and Techniques of Tangier, University Abdelmalek Essaâdi, Tangier, Morocco
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11
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Hearne BJ, Teare MD, Butt M, Donaldson L. Comparison of Nottingham Prognostic Index and Adjuvant Online prognostic tools in young women with breast cancer: review of a single-institution experience. BMJ Open 2015; 5:e005576. [PMID: 25628047 PMCID: PMC4316437 DOI: 10.1136/bmjopen-2014-005576] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Accurately predicting the prognosis of young patients with breast cancer (<40 years) is uncertain since the literature suggests they have a higher mortality and that age is an independent risk factor. In this cohort study we considered two prognostic tools; Nottingham Prognostic Index and Adjuvant Online (Adjuvant!), in a group of young patients, comparing their predicted prognosis with their actual survival. SETTING North East England PARTICIPANTS Data was prospectively collected from the breast unit at a Hospital in Grimsby between January 1998 and December 2007. A cohort of 102 young patients with primary breast cancer was identified and actual survival data was recorded. The Nottingham Prognostic Index and Adjuvant! scores were calculated and used to estimate 10-year survival probabilities. Pearson's correlation coefficient was used to demonstrate the association between the Nottingham Prognostic Index and Adjuvant! scores. A constant yearly hazard rate was assumed to generate 10-year cumulative survival curves using the Nottingham Prognostic Index and Adjuvant! predictions. RESULTS Actual 10-year survival for the 92 patients who underwent potentially curative surgery for invasive cancer was 77.2% (CI 68.6% to 85.8%). There was no significant difference between the actual survival and the Nottingham Prognostic Index and Adjuvant! 10-year estimated survival, which was 77.3% (CI 74.4% to 80.2%) and 82.1% (CI 79.1% to 85.1%), respectively. The Nottingham Prognostic Index and Adjuvant! results demonstrated strong correlation and both predicted cumulative survival curves accurately reflected the actual survival in young patients. CONCLUSIONS The Nottingham Prognostic Index and Adjuvant! are widely used to predict survival in patients with breast cancer. In this study no statistically significant difference was shown between the predicted prognosis and actual survival of a group of young patients with breast cancer.
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Affiliation(s)
- Benjamin Joseph Hearne
- Breast Care Unit, Pink Rose Suite, Diana Princess of Wales Hospital, Grimsby, UK
- UCL Medical School, Royal Free Hospital, London, UK
| | - M Dawn Teare
- Design Trials and Statistics Section, School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Mohammad Butt
- Breast Care Unit, Pink Rose Suite, Diana Princess of Wales Hospital, Grimsby, UK
| | - Leslie Donaldson
- Breast Care Unit, Pink Rose Suite, Diana Princess of Wales Hospital, Grimsby, UK
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Abstract
Lymph node ratio (LNR) is a powerful prognostic factor for breast cancer. We conducted a recursive partitioning analysis (RPA) of the LNR to identify the prognostic risk groups in breast cancer patients. Records of newly diagnosed breast cancer patients between 2002 and 2006 were searched in the Taiwan Cancer Database. The end of follow-up was December 31, 2009. We excluded patients with distant metastases, inflammatory breast cancer, survival <1 month, no mastectomy, or missing lymph node status. Primary outcome was 5-year overall survival (OS). For univariate significant predictors, RPA were used to determine the risk groups. Among the 11,349 eligible patients, we identified 4 prognostic factors (including LNR) for survival, resulting in 8 terminal nodes. The LNR cutoffs were 0.038, 0.259, and 0.738, which divided LNR into 4 categories: very low (LNR ≤ 0.038), low (0.038 < LNR ≤ 0.259), moderate (0.259 < LNR ≤ 0.738), and high (0.738 < LNR). Then, 4 risk groups were determined as follows: Class 1 (very low risk, 8,265 patients), Class 2 (low risk, 1,901 patients), Class 3 (moderate risk, 274 patients), and Class 4 (high risk, 900 patients). The 5-year OS for Class 1, 2, 3, and 4 were 93.2%, 83.1%, 72.3%, and 56.9%, respectively (P< 0.001). The hazard ratio of death was 2.70, 4.52, and 8.59 (95% confidence interval 2.32-3.13, 3.49-5.86, and 7.48-9.88, respectively) times for Class 2, 3, and 4 compared with Class 1 (P < 0.001). In conclusion, we identified the optimal cutoff LNR values based on RPA and determined the related risk groups, which successfully predict 5-year OS in breast cancer patients.
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Affiliation(s)
- Yao-Jen Chang
- From the Department of Surgery (Yao-Jen Chang), Taipei Branch, Buddhist Tzu Chi General Hospital; Graduate Institute of Health Policy and Management (K-PC, L-JC), College of Public Health, National Taiwan University; Department of Ophthalmology (L-JC), HepingFuyou Branch; Department of General Surgery (Yun-Jau Chang), Zhong-Xing Branch, Taipei City Hospital; and Department of General Surgery (Yun-Jau Chang), National Taiwan University Hospital, Taipei, Taiwan
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13
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Afsharfard A, Mozaffar M, Orang E, Tahmasbpour E. Trends in epidemiology, clinical and histopathological characteristics of breast cancer in Iran: results of a 17 year study. Asian Pac J Cancer Prev 2014; 14:6905-11. [PMID: 24377624 DOI: 10.7314/apjcp.2013.14.11.6905] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Breast cancer (BC) is the top cancer among women worldwide and the most frequent malignancy among Iranian women over the past few decades. The increasing trend and high mortality rate of BC in the developing world necessitates studies concentrating on its characteristics in countries in Asia. The current study focused on clinical and histopathological features of BC among Iranian females. MATERIALS AND METHODS This retrospective study involved 714 Iranian patients with histopathologically proven BC undergoing resection of primary tumours and axillary clearance. Demographic, clinical and histopathological data were obtained and studied between ten year age groups (≤ 40 years, 41-50 years, 51-60 years, 61-70 years, and ≤ 71 years) in four chronologic phases from 1994-2009. RESULTS Mean age of patients was 49.4 ± 13.1 years. Most of cases (33.2%) were in 41-50 group. Mean size of primary tumors was 3.94 ± 2.47 cm and 87.1% of cases had infiltrative ductal carcinoma. Modified radical mastectomy was the most common method of surgery carried out (48.8%). Some 57.1% of tumors were in pT2 and tumor size decreased significantly during the period (p<0.05). The most common BC stage was llla (27%). Lower BC stages (0 and 1) constituted 13.9% of the diagnosed tumors. Our series of patients aged ≤ 40 had larger tumors (mean 4.73 ≤ 3.02 cm) compared to older age groups (p=0.003). Lower stages (0 and I) were more frequent among the oldest patients while nearly 50% of patients aged ≤ 40 had tumor stage III. We also observed a significant decreasing trend in the mean LN count (p<0.05) and blood vessel invasion (p=0.023) from younger to older age groups. CONCLUSIONS More aggressive disease for younger age groups, earlier peak incidence age and high rate of advanced BC at the time of diagnosis among Iranian women, were the main findings of this study.
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Affiliation(s)
- Aboulfazl Afsharfard
- Department of Surgery, Shohadaye Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran E-mail :
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Liu D, Chen Y, Deng M, Xie G, Wang J, Zhang L, Liu Q, Yuan P, Feng X. Lymph node ratio and breast cancer prognosis: a meta-analysis. Breast Cancer 2013; 21:1-9. [DOI: 10.1007/s12282-013-0497-8] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2013] [Accepted: 09/24/2013] [Indexed: 12/26/2022]
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Bai LS, Chen C, Gong YP, Wei W, Tu Y, Yao F, Li JJ, Wang LJ, Sun SR. Lymph Node Ratio is More Predictive than Traditional Lymph Node Stratification in Lymph Node Positive Invasive Breast Cancer. Asian Pac J Cancer Prev 2013; 14:753-7. [DOI: 10.7314/apjcp.2013.14.2.753] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Malmgren J, Atwood M, Kaplan H. Breast Cancer Detection Method Among 20- to 49-Year-Old Patients at a Community Based Cancer Center: 1990-2008. Breast J 2012; 18:257-60. [DOI: 10.1111/j.1524-4741.2012.01231.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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