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Neagu AN, Bruno P, Johnson KR, Ballestas G, Darie CC. Biological Basis of Breast Cancer-Related Disparities in Precision Oncology Era. Int J Mol Sci 2024; 25:4113. [PMID: 38612922 PMCID: PMC11012526 DOI: 10.3390/ijms25074113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Revised: 04/03/2024] [Accepted: 04/05/2024] [Indexed: 04/14/2024] Open
Abstract
Precision oncology is based on deep knowledge of the molecular profile of tumors, allowing for more accurate and personalized therapy for specific groups of patients who are different in disease susceptibility as well as treatment response. Thus, onco-breastomics is able to discover novel biomarkers that have been found to have racial and ethnic differences, among other types of disparities such as chronological or biological age-, sex/gender- or environmental-related ones. Usually, evidence suggests that breast cancer (BC) disparities are due to ethnicity, aging rate, socioeconomic position, environmental or chemical exposures, psycho-social stressors, comorbidities, Western lifestyle, poverty and rurality, or organizational and health care system factors or access. The aim of this review was to deepen the understanding of BC-related disparities, mainly from a biomedical perspective, which includes genomic-based differences, disparities in breast tumor biology and developmental biology, differences in breast tumors' immune and metabolic landscapes, ecological factors involved in these disparities as well as microbiomics- and metagenomics-based disparities in BC. We can conclude that onco-breastomics, in principle, based on genomics, proteomics, epigenomics, hormonomics, metabolomics and exposomics data, is able to characterize the multiple biological processes and molecular pathways involved in BC disparities, clarifying the differences in incidence, mortality and treatment response for different groups of BC patients.
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Affiliation(s)
- Anca-Narcisa Neagu
- Laboratory of Animal Histology, Faculty of Biology, "Alexandru Ioan Cuza" University of Iași, Carol I bvd. 20A, 700505 Iasi, Romania
| | - Pathea Bruno
- Biochemistry & Proteomics Laboratories, Department of Chemistry and Biochemistry, Clarkson University, Potsdam, NY 13699-5810, USA
| | - Kaya R Johnson
- Biochemistry & Proteomics Laboratories, Department of Chemistry and Biochemistry, Clarkson University, Potsdam, NY 13699-5810, USA
| | - Gabriella Ballestas
- Biochemistry & Proteomics Laboratories, Department of Chemistry and Biochemistry, Clarkson University, Potsdam, NY 13699-5810, USA
| | - Costel C Darie
- Biochemistry & Proteomics Laboratories, Department of Chemistry and Biochemistry, Clarkson University, Potsdam, NY 13699-5810, USA
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Jackson EB, Curry L, Mariano C, Hsu T, Cook S, Pezo RC, Savard MF, Desautels DN, Leblanc D, Gelmon KA. Key Considerations for the Treatment of Advanced Breast Cancer in Older Adults: An Expert Consensus of the Canadian Treatment Landscape. Curr Oncol 2023; 31:145-167. [PMID: 38248095 PMCID: PMC10814011 DOI: 10.3390/curroncol31010010] [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: 10/25/2023] [Revised: 12/04/2023] [Accepted: 12/23/2023] [Indexed: 01/23/2024] Open
Abstract
The prevalence of breast cancer amongst older adults in Canada is increasing. This patient population faces unique challenges in the management of breast cancer, as older adults often have distinct biological, psychosocial, and treatment-related considerations. This paper presents an expert consensus of the Canadian treatment landscape, focusing on key considerations for optimizing selection of systemic therapy for advanced breast cancer in older adults. This paper aims to provide evidence-based recommendations and practical guidance for healthcare professionals involved in the care of older adults with breast cancer. By recognizing and addressing the specific needs of older adults, healthcare providers can optimize treatment outcomes and improve the overall quality of care for this population.
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Affiliation(s)
- Emily B. Jackson
- BC Cancer Vancouver Centre, 600 West 10th Avenue, Vancouver, BC V5Z 4E6, Canada; (L.C.)
- Department of Medicine, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| | - Lauren Curry
- BC Cancer Vancouver Centre, 600 West 10th Avenue, Vancouver, BC V5Z 4E6, Canada; (L.C.)
- Department of Medicine, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| | - Caroline Mariano
- BC Cancer Vancouver Centre, 600 West 10th Avenue, Vancouver, BC V5Z 4E6, Canada; (L.C.)
- Department of Medicine, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| | - Tina Hsu
- The Ottawa Hospital Cancer Centre, Ottawa, ON K1H 8L6, Canada (M.-F.S.)
- Department of Medicine, University of Ottawa, Ottawa, ON K1H 8L6, Canada
| | - Sarah Cook
- Tom Baker Cancer Centre, Calgary, AB T2N 4N2, Canada
- Department of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Rossanna C. Pezo
- Sunnybrook Odette Cancer Centre, Toronto, ON M4N 3M5, Canada;
- Department of Medicine, Division of Medical Oncology, University of Toronto, Toronto, ON M5S 1A1, Canada
| | - Marie-France Savard
- The Ottawa Hospital Cancer Centre, Ottawa, ON K1H 8L6, Canada (M.-F.S.)
- Department of Medicine, University of Ottawa, Ottawa, ON K1H 8L6, Canada
| | - Danielle N. Desautels
- Department of Internal Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3E 3P4, Canada;
- Paul Albrechtsen Research Institute, CancerCare Manitoba, Winnipeg, MB R3E 0V9, Canada
| | - Dominique Leblanc
- Centre Hospitalier Universitaire de Québec, Université Laval, Québec, QC G1V 0A6, Canada
| | - Karen A. Gelmon
- BC Cancer Vancouver Centre, 600 West 10th Avenue, Vancouver, BC V5Z 4E6, Canada; (L.C.)
- Department of Medicine, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
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3
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Fentiman IS. Prognostic difficulties of men with breast cancer. Breast J 2021; 27:877-882. [PMID: 34652050 DOI: 10.1111/tbj.14297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 09/30/2021] [Accepted: 09/30/2021] [Indexed: 11/26/2022]
Abstract
Most adequately powered studies confirm a worse prognosis for males versus matched females with breast cancer. There is in-stage migration for stage I cancers with a different ratio of tumor/normal breast tissue in males. Younger men have a better prognosis, largely the result of increased morbidity in the elderly, exacerbated by smoking, low socioeconomic differences, and ethnic disparity. BRCA2 carriers with MBC have a worse outcome than noncarriers as do men with amplification of EMSY. Men with tumors having a high cytosol level of plasminogen activator inhibitor 1 (PAI-1) may have more invasive cancers leading to earlier spread and hence a worse outcome. PREDICT+ is a useful prognostic model for MBC and multigene testing enables more specific systemic therapies to be used.
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Affiliation(s)
- Ian S Fentiman
- Professor of Surgical Oncology, Research Oncology, Guy's Hospital, London, UK
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Plichta JK, Ren Y, Marks CE, Thomas SM, Greenup RA, Rosenberger LH, Fayanju OM, McDuff SGR, Hwang ES, Force J. Surgery for Men with Breast Cancer: Do the Same Data Still Apply? Ann Surg Oncol 2020; 27:4720-4729. [PMID: 32705510 DOI: 10.1245/s10434-020-08901-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 06/30/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Men represent a small proportion of breast cancer diagnoses, and they are often excluded from clinical trials. Current treatments are largely extrapolated from evidence in women. We compare practice patterns between men and women with breast cancer following the publication of several landmark clinical trials in surgery. PATIENTS AND METHODS Patients with invasive breast cancer (2004-2015) from the National Cancer Data Base were identified; subcohorts were created based on eligibility for NSABP-B06, CALGB 9343, and ACOSOG Z0011. Practice patterns were stratified by gender and compared. Cox proportional hazards regression analyses were utilized to estimate the association between OS and gender. RESULTS Of the 1,664,746 patients identified, 99% were women and 1% were men. Among NSABP-B06 eligible men, mastectomy rates did not change (consistently ~ 80%), and their adjusted OS was minimally worse compared with women (HR 1.19, 95% CI 1.11-1.28). Following publication of CALGB 9343, omission of radiation after lumpectomy was less likely in men and lagged behind that of women, despite similar OS (male HR 0.92, 95% CI 0.59-1.44). Application of ACOSOG Z0011 findings resulted in deescalation of axillary surgery for men and women with comparable OS (male HR 0.69, 95% CI 0.33-1.45). CONCLUSIONS Uptake of clinical trial results for men with breast cancer often mirrors that for women, despite exclusion from these studies. Furthermore, when study findings were applied to eligible patients, men and women demonstrated similar survival. Observational studies can help inform the potential application of study findings to this unique population and improve patient enrollment in clinical trials.
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Affiliation(s)
- Jennifer K Plichta
- Department of Surgery, Duke University Medical Center, Durham, NC, USA. .,Duke Cancer Institute, Durham, NC, USA.
| | - Yi Ren
- Duke Cancer Institute, Durham, NC, USA
| | - Caitlin E Marks
- Department of Surgery, Duke University Medical Center, Durham, NC, USA
| | - Samantha M Thomas
- Duke Cancer Institute, Durham, NC, USA.,Department of Biostatistics & Bioinformatics, Duke University, Durham, NC, USA
| | - Rachel A Greenup
- Department of Surgery, Duke University Medical Center, Durham, NC, USA.,Duke Cancer Institute, Durham, NC, USA
| | - Laura H Rosenberger
- Department of Surgery, Duke University Medical Center, Durham, NC, USA.,Duke Cancer Institute, Durham, NC, USA
| | - Oluwadamilola M Fayanju
- Department of Surgery, Duke University Medical Center, Durham, NC, USA.,Duke Cancer Institute, Durham, NC, USA.,Department of Surgery, Durham VA Medical Center, Durham, NC, USA
| | - Susan G R McDuff
- Duke Cancer Institute, Durham, NC, USA.,Department of Radiation Oncology, Duke University Medical Center, Durham, NC, USA
| | - E Shelley Hwang
- Department of Surgery, Duke University Medical Center, Durham, NC, USA.,Duke Cancer Institute, Durham, NC, USA
| | - Jeremy Force
- Duke Cancer Institute, Durham, NC, USA.,Department of Medicine, Duke University Medical Center, Durham, NC, USA
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André S, Pereira T, Silva F, Machado P, Vaz F, Aparício M, Silva GL, Pinto AE. Male breast cancer: Specific biological characteristics and survival in a Portuguese cohort. Mol Clin Oncol 2019; 10:644-654. [PMID: 31031981 PMCID: PMC6482395 DOI: 10.3892/mco.2019.1841] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 03/29/2019] [Indexed: 12/12/2022] Open
Abstract
Male breast cancer (BC) represents an individual subtype of BC, with therapeutic procedures based on female BC therapy results. The present study evaluated the parameters currently used for the characterization and therapy of male BC, and their association with disease-free (DFS) and overall survival (OS), aiming to obtain a comprehensive basis to improve the personalized care of male BC. A total of 196 patients from March 1970 to March 2018 (mean follow-up, 84.9 months) were profiled, using clinicopathological review, molecular assessment [BRCA1/2, DNA repair associated (BRCA1/2) status, immunohistochemistry, fluorescence in situ hybridization and DNA flow cytometry] and Cox regression statistical analysis. The median age of patients was 66.5 years. At presentation, 39.2% of patients with invasive carcinomas were in anatomic stage (AS) I. Patients exhibited primarily invasive carcinomas of no special type, histological grade 2, estrogen receptor α-(ERα) and progesterone receptor (PR)-positive, receptor tyrosine kinase erbB-2-negative, high Ki-67, Luminal B-like and aneuploid tumors. A total of 13 of the 44 (29.5%) BRCA-evaluated patients exhibited BRCA2 mutations, significantly associated with family history (FH), bilaterality, high Ki-67 expression, absence of PR and Luminal B-like tumors. Bilaterality was associated with the occurrence of non-breast primary neoplasms (NBPN). The 5 and 10-year DFS rates, excluding patients with distant metastasis, NBPN and in situ carcinomas (n=145) were 65.9 and 58.2%, respectively, and the 5 and 10-year OS rates were 77.5 and 59.2%, respectively. In the univariate analysis, Luminal B-like subtype, BRCA2 mutations, high Ki-67 expression, and AS II and III were significantly associated with shorter DFS and OS. In addition, age >70 years was associated with low OS. In the multivariate analysis, FH, AS II and III, and Luminal B-like subtypes were associated with poorer OS. In conclusion, the data from the present study emphasize the high incidence of BRCA2 mutation in male BC, and its association with FH, bilaterality, high Ki-67 expression, negative PR expression and Luminal B-like subtypes, and with shorter DFS and OS in univariate analysis.
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Affiliation(s)
- Saudade André
- Department of Pathology, Portuguese Institute of Oncology of Lisbon, 1099-023 Lisbon, Portugal
| | - Teresa Pereira
- Department of Pathology, Portuguese Institute of Oncology of Lisbon, 1099-023 Lisbon, Portugal
| | - Fernanda Silva
- NOVA Medical School, NOVA University, 1169-056 Lisbon, Portugal
| | - Patrícia Machado
- Breast Cancer Risk Evaluation Clinic, Portuguese Institute of Oncology of Lisbon, 1099-023 Lisbon, Portugal
| | - Fátima Vaz
- Breast Cancer Risk Evaluation Clinic, Portuguese Institute of Oncology of Lisbon, 1099-023 Lisbon, Portugal
| | - Mariana Aparício
- Department of Mathematics of Higher Technical Institute, University of Lisbon, Portugal
| | - Giovani L. Silva
- Department of Mathematics of Higher Technical Institute, University of Lisbon, Portugal
- Statistics and Applications Center of University of Lisbon, 1049-001 Lisbon, Portugal
| | - António E. Pinto
- Department of Pathology, Portuguese Institute of Oncology of Lisbon, 1099-023 Lisbon, Portugal
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Oliveira LLD, Aguiar SSD, Bender PFM, Bergmann A, Thuler LCS. Men Have a Higher Incidence of Seroma after Breast Cancer
Surgery. Asian Pac J Cancer Prev 2017; 18:1423-1427. [PMID: 28612597 PMCID: PMC5555557 DOI: 10.22034/apjcp.2017.18.5.1423] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background and Objectives: Male breast cancer (MBC) is rare. While surgical treatment may result in several complications in women, little is known about how it affects men. The objective of this study was to compare the incidence of postoperative wound complications between men and women after breast cancer surgery. Methods: This cohort study included all male patients enrolled for breast cancer surgical treatment at the Brazilian National Cancer Institute, between 1999 and 2013. Each was matched with three female breast cancer patients. Parameters analyzed were necrosis, seroma and infection. Odds ratios (OR) were generated and statistical significance was considered at p<0.05. Results: We included in this study 71 men and 213 women with an average age of 63.5 (±12.0). The incidences of complications in men and women were: necrosis, 32.8% and 37.8% (p=0.477); seroma, 80.6% and 59.4% (p=0.003); and surgical site infection, 14.8% and 18.2% (p=0.54). After adjustment, men had a 3 times greater risk of developing seroma compared to women (OR=3.0; IC95%=1.4-6.4; p=0.004). No statistically significant differences was detected in the incidences of wound infection and necrosis. Conclusion: Men have a greater risk of developing seroma after surgery for breast cancer than women, whereas infection and necrosis occur at similar frequencies in both genders.
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Cerebral Metastasis from Breast Cancer in a Male Patient with HIV. Case Rep Neurol Med 2015; 2015:482839. [PMID: 25694836 PMCID: PMC4324742 DOI: 10.1155/2015/482839] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Accepted: 12/30/2014] [Indexed: 11/17/2022] Open
Abstract
Context. Breast cancer (BC) in men is a rare condition, corresponding to 1% of all neoplasms in this gender. Some studies show that up to 93% of BC cases in men are advanced disease. If its occurrence constitutes an uncommon fact, the appearance of a metastasis to the central nervous system (CNS) is extremely rare. The objective of the present study is to present the case of a male patient, bearer of HIV infection, who presented with BC and later metastasis to the CNS. We also include a brief review of the literature. Case Report. We describe a case of a male patient, 59 years old, with HIV infection and a history of BC treated 4 years earlier, which progressed into headache and vertigo. Neuroimaging exams showed lesions suggestive of cerebral metastasis and a stereotaxic biopsy confirmed BC metastasis. Conclusion. Breast cancer in men with metastasis to the CNS is a rare condition and similar reports were not found in the available databases. It should be pointed out that even though rare, it should be considered among the differential diagnoses for SNC metastases in men, although HIV infection favors the appearance of some types of cancer.
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Soliman AA, Denewer AT, El-Sadda W, Abdel-Aty AH, Refky B. A retrospective analysis of survival and prognostic factors of male breast cancer from a single center. BMC Cancer 2014; 14:227. [PMID: 24673740 PMCID: PMC3987167 DOI: 10.1186/1471-2407-14-227] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Accepted: 03/25/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Less than 1% of all breast cancer cases are found in men, who reportedly have inferior outcomes compared with matched women patients. Ethnic differences may also affect their prognosis. Here, we investigated overall survival (OS) and major prognostic factors for male breast cancer (MBC) in a cohort of Egyptian patients. METHODS We retrospectively analyzed OS in a cohort of 69 male patients with MBC who were surgically treated at the Mansoura Cancer Center, Egypt between 2000 and 2007. We registered demographic data, age, height, weight and body mass index, tumor size, histology, number of infiltrated axillary lymph nodes, hormone receptor (HR) status and metastatic presence, and TNM staging. Patients' OS was the primary endpoint. Patients received treatment to the medical standards at the time of their diagnosis. RESULTS In the 69 patients who met the inclusion criteria and had complete stored patient data, tumors ranged from T1c to T3. We could gather cancer-related survival data from only 56 patients. The collective 5-year survival in this cohort was 46.4%. Only five patients had distant metastasis at diagnosis, but they showed a null percent 5-year survival, whereas those with no lymph node infiltration showed a 100% 5-year survival. Lymph node status and tumor grading were the only prognostic factors that significantly affected OS. CONCLUSIONS Lymph node status and tumor grade are the most important prognostic factors for overall survival of MBC in Egyptian male patients; whereas even remarkably low HR expression in MBC did not significantly affect OS. Further research is needed to understand the factors that affect this disease.
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Affiliation(s)
- Amr A Soliman
- Department of Obstetrics and Gynecology, El-Shatby Maternity University Hospital, University of Alexandria, Port Said Street, El Shatby, Alexandria 21526, Egypt.
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