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Li L, Li J, Jia J, He H, Li M, Yan X, Yu Q, Guo H, Wang H, Lv Z, Sun H, Liao G, Cui J. Clonal evolution characteristics and reduced dimension prognostic model for non-metastatic metachronous bilateral breast cancer. Front Oncol 2022; 12:963884. [PMID: 36249030 PMCID: PMC9559188 DOI: 10.3389/fonc.2022.963884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 08/31/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundHow to evaluate the prognosis and develop overall treatment strategies of metachronous bilateral breast cancer (MBBC) remains confused in clinical. Here, we investigated the correlation between clonal evolution and clinical characteristics of MBBC; we aim to establish a novel prognostic model in these patients.MethodsThe data from Surveillance, Epidemiology, and End Results (SEER) database and the First Hospital of Jilin University were analyzed for breast cancer–specific cumulative mortality (BCCM) by competing risk model. Meanwhile, whole-exome sequencing was applied for 10 lesions acquired at spatial–temporal distinct regions of five patients from our own hospital to reconstruct clonal evolutionary characteristics of MBBC. Then, dimensional-reduction (DR) cumulative incidence function (CIF) curves of MBBC features were established on different point in diagnostic interval time, to build a novel DR nomogram.ResultsSignificant heterogeneity in genome and clinical features of MBBC was widespread. The mutational diversity of contralateral BC (CBC) was significantly higher than that in primary BC (PBC), and the most effective prognostic MATH ratio was significantly correlated with interval time (R2 = 0.85, p< 0.05). In SEER cohort study (n = 13,304), the interval time was not only significantly affected the BCCM by multivariate analysis (p< 0.000) but determined the weight of clinical features (T/N stage, grade and ER status) on PBC and CBC in prognostic evaluation. Thus, clinical parameters after DR based on interval time were incorporated into the nomogram for prognostic predicting BCCM. Concordance index was 0.773 (95% CI, 0.769–0.776) in training cohort (n = 8,869), and 0.819 (95% CI, 0.813–0.826) in validation cohort (n = 4,435).ConclusionsBilateral heterogeneous characteristics and interval time were determinant prognostic factors of MBBC. The DR prognostic nomogram may help clinicians in prognostic evaluation and decision making.
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Affiliation(s)
- Lingyu Li
- Cancer Center, The First Hospital of Jilin University, Changchun, China
| | - Jiaxuan Li
- Cancer Center, The First Hospital of Jilin University, Changchun, China
| | - Jiwei Jia
- School of Mathematics, Jilin University, Changchun, China
- National Applied Mathematical Center (Jilin), Changchun, China
| | - Hua He
- Cancer Center, The First Hospital of Jilin University, Changchun, China
| | - Mingyang Li
- College of Electronic Science and Engineering, Jilin University, Changchun, China
| | - Xu Yan
- Cancer Center, The First Hospital of Jilin University, Changchun, China
| | - Qing Yu
- Department of Translational Medicine, Geneplus-Beijing, Beijing, China
| | - Hanfei Guo
- Cancer Center, The First Hospital of Jilin University, Changchun, China
| | - Hong Wang
- Cancer Center, The First Hospital of Jilin University, Changchun, China
| | - Zheng Lv
- Cancer Center, The First Hospital of Jilin University, Changchun, China
| | - Haishuang Sun
- Cancer Center, The First Hospital of Jilin University, Changchun, China
| | - Guidong Liao
- School of Mathematics, Jilin University, Changchun, China
| | - Jiuwei Cui
- Cancer Center, The First Hospital of Jilin University, Changchun, China
- *Correspondence: Jiuwei Cui,
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An J, Chang S, Kim HI, Song GW, Shim JH. The clinical behavior and survival of patients with hepatocellular carcinoma and a family history of the disease. Cancer Med 2019; 8:6624-6633. [PMID: 31532075 PMCID: PMC6825981 DOI: 10.1002/cam4.2543] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 08/19/2019] [Accepted: 08/20/2019] [Indexed: 12/14/2022] Open
Abstract
Purpose Familial clustering is a common feature of hepatocellular carcinoma (HCC) as well as a risk factor for the disease. We aimed to assess whether such a family history affected prognostic outcomes in patients with HCC diagnosed at different stages of the disease. Materials/Methods This hospital registry‐based cohort study included 5484 patients initially diagnosed with HCC. Individual family histories of cancer were obtained by interview and reported by trained nurses who constructed three‐generation pedigrees. Overall survival data were compared between cases with and without first‐degree relatives affected by HCC, with adjustment for other potential predictors. Results Of 5484 patients, 845 (15.4%) had first‐degree relatives with a history of HCC. Family history was associated with longer survival in the entire cohort (adjusted hazard ratio [HR] 0.89, 95% confidence interval [CI] 0.80‐0.98, P = .025). A significant trend for reduced risk of death with increasing number of affected family members was also observed (P for trend = 0.018). The stage‐stratified analysis showed that the presence of family history was especially associated with a reduced risk of death in the subset of patients with HCC at a (very) early stage (adjusted HR 0.83, 95% CI 0.69‐0.99; P = .042). The proportion of cases receiving curative treatment was also higher in early‐stage patients with a family history (72.6% vs 63.3%; P < .001). Conclusions A first‐degree family history of the disease is a prognostic factor for improved survival in patients with HCC, especially in those whose tumors can be cured by radical treatments.
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Affiliation(s)
- Jihyun An
- Gastroenterology and Hepatology, Hanyang University College of Medicine, Guri, Korea
| | - Seheon Chang
- Internal Medicine, Myongji Saint Mary's Hospital, Seoul, Korea
| | - Ha Il Kim
- Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Gi-Won Song
- Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.,Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ju Hyun Shim
- Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.,Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Song JL, Chen C, Yuan JP, Sun SR. The association between prognosis of breast cancer and first-degree family history of breast or ovarian cancer: a systematic review and meta-analysis. Fam Cancer 2018; 16:339-349. [PMID: 28176206 DOI: 10.1007/s10689-017-9969-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Whether a positive family history of breast cancer or ovarian cancer (FHBOC) would affect the prognosis of breast cancer is still up for debate and further study. This meta-analysis was performed to clarify this issue. We reviewed two databases (PubMed and CNKI) for research articles published at any time from the inception of these databases to April 1, 2016 for articles detecting the impact of FHBOC on the prognosis of breast cancer. A meta-analysis was conducted to generated combined hazard ratios (HR) with 95% confidence intervals (CI) for overall survival (OS) and breast cancer-specific survival (BCSS). Eighteen studies were included in our qualitative analysis, with 15 studies ultimately part of the quantitative analysis. The pooled results demonstrated that a positive FHBOC was associated with better OS (0.89, 95% CI 0.83-0.95) and BCSS (0.90, 95% CI 0.82-0.99). In subgroup analyses, several subgroups (maximally adjusted studies, population based studies, high quality studies, family history of breast cancer, studies from Europe, studies from Asia, 1 affected relative, or tumor size > 2 cm), a positive first-degree FHBOC was associated with better prognosis of breast cancer. Notably, for those patients who underwent breast-conserving surgery, first-degree FHBOC was not a risk factor for OS (HR 1.08, 95% CI 0.53-2.21). Our meta-analysis demonstrated that a first-degree FHBOC was associated with better OS and BCSS in patients with breast cancer. These findings support that clinical management should not differ between women with and without FHBOC.
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Affiliation(s)
- Jun-Long Song
- Department of Breast and Thyroid Surgery, Renmin Hospital of Wuhan University, No 238 Jiefang Road, Wuchang District, Wuhan, 430060, Hubei, People's Republic of China
| | - Chuang Chen
- Department of Breast and Thyroid Surgery, Renmin Hospital of Wuhan University, No 238 Jiefang Road, Wuchang District, Wuhan, 430060, Hubei, People's Republic of China
| | - Jing-Ping Yuan
- Department of Pathology, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei, People's Republic of China
| | - Sheng-Rong Sun
- Department of Breast and Thyroid Surgery, Renmin Hospital of Wuhan University, No 238 Jiefang Road, Wuchang District, Wuhan, 430060, Hubei, People's Republic of China.
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Jannot AS, Usel M, Bouchardy C, Schubert H, Rapiti E. Breast cancer family history leads to early breast cancer detection and optimal management. Cancer Causes Control 2017; 28:921-928. [PMID: 28752191 DOI: 10.1007/s10552-017-0928-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Accepted: 07/19/2017] [Indexed: 12/31/2022]
Abstract
PURPOSE We investigated whether the relationship between family history (FH) of breast cancer and survival of women with breast cancer is related to the quality of care received, once adjusted for other prognostic variables using data from the Geneva population-based cancer registry and quality of care indicators defined by the European Society of breast cancer specialists (EUSOMA). METHODS We included non-metastatic malignant breast tumor patients who had their surgery between 2001 and 2010. We assessed the association between FH and patient and tumor characteristics on one hand, and each quality of care indicator and an overall score of quality of care, on the other hand, through logistic regression. We assessed the impact of FH and the quality of care-score on 5-year survival with Cox regression adjusting for patient and tumor characteristics. RESULTS 2,672 patients were included in the study. Women with a positive FH were younger, more likely from Switzerland, screen detected, had positive estrogen and progesterone receptor status, and had smaller and ductal tumors. A positive FH was also associated with better management for several quality indicators. Women with a positive FH had a better crude survival (Hazard Ratio 0.61, p = 0.006). This association was not substantially affected when adjusting for quality of care. However, the effect of FH did not persist when also adjusting for patient and tumor characteristics. CONCLUSIONS A positive FH of breast cancer is associated with earlier breast cancer diagnosis, better tumor features, and higher quality of care. These factors explain the better survival observed among breast cancer women with a positive FH as compared to women without positive FH.
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Affiliation(s)
- Anne-Sophie Jannot
- Geneva Cancer Registry, University of Geneva, CMU, 1211, Geneva 4, Switzerland
- Division of Clinical Epidemiology, Geneva University Hospital, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva, Switzerland
| | - Massimo Usel
- Geneva Cancer Registry, University of Geneva, CMU, 1211, Geneva 4, Switzerland
| | - Christine Bouchardy
- Geneva Cancer Registry, University of Geneva, CMU, 1211, Geneva 4, Switzerland
| | - Hyma Schubert
- Geneva Cancer Registry, University of Geneva, CMU, 1211, Geneva 4, Switzerland
| | - Elisabetta Rapiti
- Geneva Cancer Registry, University of Geneva, CMU, 1211, Geneva 4, Switzerland.
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Melvin JC, Wulaningsih W, Hana Z, Purushotham AD, Pinder SE, Fentiman I, Gillett C, Mera A, Holmberg L, Van Hemelrijck M. Family history of breast cancer and its association with disease severity and mortality. Cancer Med 2016; 5:942-9. [PMID: 26799372 PMCID: PMC4864823 DOI: 10.1002/cam4.648] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Revised: 12/22/2015] [Accepted: 12/29/2015] [Indexed: 11/26/2022] Open
Abstract
A family history (FH) of breast cancer (BC) is known to increase an individual's risk of disease onset. However, its role in disease severity and mortality is less clear. We aimed to ascertain associations between FH of BC, severity and BC‐specific mortality in a hospital‐based cohort of 5354 women with prospective information on FH. We included women diagnosed at Guy's and St Thomas’ NHS Foundation Trust between 1975 and 2012 (n = 5354). BC severity was defined and categorized as good, moderate, and poor prognosis. Data on BC‐specific mortality was obtained from the National Cancer Registry and medical records. Associations between FH and disease severity or BC‐specific mortality were evaluated using proportional odds models and Cox proportional hazard regression models, respectively. Available data allowed adjustment for potential confounders (e.g., treatment, socioeconomic status, and ethnicity). FH of any degree was not associated with disease severity at time of diagnosis (adjusted proportional OR: 1.00 [95% CI: 0.85 to 1.17]), which remained true also after stratification by period of diagnosis. FH of BC was not associated with BC‐mortality HR: 0.99 (95% CI: 0.93 to 1.05). We did not find evidence to support an association between FH of BC and severity and BC‐specific mortality. Our results indicate that clinical management should not differ between women with and without FH, when the underlying mutation is unknown.
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Affiliation(s)
- Jennifer C Melvin
- Faculty of Life Sciences and Medicine, Division of Cancer Studies, Cancer Epidemiology Group, King's College London, London, United Kingdom
| | - Wahyu Wulaningsih
- Faculty of Life Sciences and Medicine, Division of Cancer Studies, Cancer Epidemiology Group, King's College London, London, United Kingdom
| | - Zac Hana
- Faculty of Life Sciences and Medicine, Division of Cancer Studies, Cancer Epidemiology Group, King's College London, London, United Kingdom
| | - Arnie D Purushotham
- Faculty of Life Sciences and Medicine, Division of Cancer Studies, Section of Research Oncology, King's College London, London, United Kingdom.,Guy's and St. Thomas' NHS Foundation Trust, London, United Kingdom
| | - Sarah E Pinder
- Faculty of Life Sciences and Medicine, Division of Cancer Studies, Section of Research Oncology, King's College London, London, United Kingdom.,Guy's and St. Thomas' NHS Foundation Trust, London, United Kingdom
| | - Ian Fentiman
- Regional Cancer Centre, Uppsala/Orebro, Uppsala, Sweden
| | - Cheryl Gillett
- Faculty of Life Sciences and Medicine, Division of Cancer Studies, Section of Research Oncology, King's College London, London, United Kingdom
| | - Anca Mera
- Faculty of Life Sciences and Medicine, Division of Cancer Studies, Cancer Epidemiology Group, King's College London, London, United Kingdom
| | - Lars Holmberg
- Faculty of Life Sciences and Medicine, Division of Cancer Studies, Cancer Epidemiology Group, King's College London, London, United Kingdom.,Research Oncology, Guy's Hospital, London, United Kingdom.,Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Mieke Van Hemelrijck
- Faculty of Life Sciences and Medicine, Division of Cancer Studies, Cancer Epidemiology Group, King's College London, London, United Kingdom
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