Model-based survival estimates of female breast cancer data

Bayesian Inference of Lymph Node Ratio Estimation and Survival Prognosis for Breast Cancer Patients

OBJECTIVE

We evaluated the prognostic value of lymph node ratio (LNR) for the survival of breast cancer patients using Bayesian inference.

METHODS

Data on 5,279 women with infiltrating duct and lobular carcinoma breast cancer, diagnosed from 2006-2010, was obtained from the NCI SEER Cancer Registry. A prognostic modeling framework was proposed using Bayesian inference to estimate the impact of LNR in breast cancer survival. Based on the proposed model, we then developed a web application for estimating LNR and predicting overall survival.

RESULTS

The final survival model with LNR outperformed the other models considered (C-statistic 0.71). Compared to directly measured LNR, estimated LNR slightly increased the accuracy of the prognostic model. Model diagnostics and predictive performance confirmed the effectiveness of Bayesian modeling and the prognostic value of the LNR in predicting breast cancer survival.

CONCLUSION

The estimated LNR was found to have a significant predictive value for the overall survival of breast cancer patients.

SIGNIFICANCE

We used Bayesian inference to estimate LNR which was then used to predict overall survival. The models were developed from a large population-based cancer registry. We also built a user-friendly web application for individual patient survival prognosis. The diagnostic value of the LNR and the effectiveness of the proposed model were evaluated by comparisons with existing prediction models.

Function of microRNA‑141 in human breast cancer through cytotoxic CD4+ T cells regulated by MAP4K4 expression

The present study investigated the anti‑cancer effect of microRNA (miRNA)‑141 on apoptosis rate of breast cancer cells and the possible underlying mechanism. In patients with breast cancer, the expression of miRNA‑141 was downregulated. Overexpression of miRNA‑141 reduced breast cancer cell growth, inhibited the expression of cyclooxygenase‑2 (COX‑2), prostaglandin E2 (PGE2) and tumor necrosis factor (TNF)‑α, and increased the expression levels of interleukin (IL)‑10. However, downregulation of miRNA‑141 resulted in upregulation of COX‑2, PGE2 and TNF‑α expression levels, and an inhibition of IL‑10. Overexpression of miRNA‑141 suppressed mitogen‑activated protein kinase kinase kinase kinase 4 (MAP4K4) protein expression. Downregulation of miRNA‑141 markedly upregulated MAP4K4 protein expression in MCF‑7 cells. Promotion of MAP4K4 protein expression reduced the effects of miRNA‑141 on the toxicity of CD4+ T cells on breast cancer cells. The results of the present study indicated that miRNA‑141 may cause anti‑tumor effects in human breast cancer cells via cytotoxic CD4+ T cells.

Survival Time and Prognostic Factors for Breast Cancer among Women in North-East Peninsular Malaysia

Background:

Breast cancer is the most common malignant disease and the leading cause of cancer death among women globally. This study aimed to determine the median survival time and prognostic factors for breast cancer patients in a North-East State of Malaysia.

Methods:

This retrospective cohort study was conducted from January till April 2017 using secondary data obtained from the state’s cancer registry. All 549 cases of breast cancer diagnosed from 1st January 2007 until 31st December 2011 were selected and retrospectively followed-up until 31st December 2016. Sociodemographic and clinical information was collected to determine prognostic factors.

Results:

The average (SD) age at diagnosis was 50.4 (11.2) years, the majority of patients having Malay ethnicity (85.8%) and a histology of ductal carcinoma (81.5%). Median survival times for those presenting at stages III and IV were 50.8 (95% CI:25.34, 76.19) and 6.9 (95% CI:3.21, 10.61) months, respectively. Ethnicity (Adj. HR for Malay vs non-Malay ethnicity=2.52; 95% CI: 1.54, 4.13; p<0.001), stage at presentation (Adj. HR for Stage III vs Stage I=2.31; 95% CI: 1.57, 3.39; p<0.001 and Adj. HR for Stage IV vs Stage I=6.20; 95%CI: 4.45, 8.65; p<0.001), and history of surgical treatment (Adj. HR for patients with no surgical intervention=1.95; 95%CI: 1.52, 2.52; p<0.001) were observed to be the statistically significant prognostic factors associated with death caused by breast cancer.

Conclusion:

The median survival time among breast cancer patients in North-East State of Malaysia was short as compared to other studies. Primary and secondary prevention aimed at early diagnosis and surgical management of breast cancer, particularly among the Malay ethnic group, could improve treatment outcome.

Does Survival Vary for Breast Cancer Patients in the United States? A Study from Six Randomly Selected States

BACKGROUND

Breast cancer is the most common cancer in women. Disparities in some characteristics of breast cancer patients and their survival data for six randomly selected states in the US were examined.

MATERIALS AND METHODS

A probability random sampling method was used to select the records of 2,000 patients from each of six randomly selected states. Demographic and disease characteristics were extracted from the Surveillance Epidemiology and End Results (SEER) database. To evaluate relationships between variables, we employed a Cox Proportional Regression to compare survival times in the different states.

RESULTS

Iowa had the highest mean age of diagnosis at 64.14 years (SE = 0.324) and Georgia had the lowest at 57.97 years (SE = 0.313). New Mexico had the longest mean survival time of 189.09 months (SE = 20.414) and Hawaii the shortest at 119.01 (SE = 5.394) months, a 70.08-month difference (5.84 years). Analysis of stage of diagnosis showed that the highest survival times for Whites and American Indians/Alaska Natives were for stage I cancers. The highest survival times for Blacks varied. Stage IV cancer consistently showed the lowest survival times.

CONCLUSIONS

Differences in breast cancer characteristics across states highlight the need to understand differences between the states that result in variances in breast cancer survival.

Reducing the breast cancer menace: the role of the male partner in Ghana

BACKGROUND

Breast cancer continues to be the most common type of cancer afflicting many women worldwide. Presently, educational campaigns and research target only women as if men have no role in the management of this disease. The study examined the willingness of male partners to assist in early female breast cancer detection as well as their awareness and knowledge levels.

MATERIALS AND METHODS

Using a semi-structured questionnaire, data was collected from 500 public servants within the Tamale Metropolis and analyzed in SPSS.

RESULTS

The level of awareness of breast cancer was very high (98.8%) but there was a low level of knowledge of breast cancer among the male population. Marital status and religion had no effect on attitude, but increasing educational status significantly increased knowledge and positive attitude towards breast cancer examination (χ2=4.255, p=0.0391). The majority (92.0%) agreed that men can assist in early breast cancer detection and 96.2% were willing to be provided with breast examination skills.

CONCLUSIONS

Although level of awareness on female breast cancers among the men was high, they generally lack knowledge of the disease. Majority of male partners want to assist in early breast cancer detection if provided with the necessary skills.

Predictive factors of survival time of breast cancer in kurdistan province of Iran between 2006-2014: a cox regression approach

BACKGROUND

Breast cancer is the most common cancer and the second most common cause of cancer-induced mortalities in Iranian women, following gastric carcinoma. The survival of these patients depends on several factors, which are very important to identify in order to understand the natural history of the disease.

MATERIALS AND METHODS

In this retrospective study, 313 consecutive women with pathologically-proven diagnosis of breast cancer who had been treated during a seven-year period (January 2006 until March 2014) at Towhid hospital, Sanandaj city, Kurdistan province of Iran, were recruited. The Kaplan-Meier method was used for data analysis, and finally those factors that showed significant association on univariate analysis were entered in a Cox regression model.

RESULTS

the mean age of patients was 46.10±10.81 years. Based on Kaplan-Meier method median of survival time was 81 months and 5 year survival rate was 75%±0.43. Tumor metastasis (HR=9.06, p=0.0001), relapse (HR=3.20, p=0.001), clinical stage of cancer (HR=2.30, p=0.03) and place of metastasis (p=0.0001) had significant associations with the survival rate variation. Patients with tumor metastasis had the lowest five-year survival rate (37%)and among them patients who had brain metastasis were in the worst condition (5 year survival rate= 11%±0.10).

CONCLUSIONS

Our findings support the observation that those women with higher stages of breast malignancies (especially with metastatic cancer) have less chance of surviving the disease. Furthermore, screening programs and early detection of breast cancer may help to increase the survival of those women who are at risk of breast cancer.

Clinical and prognostic significance of SOX11 in breast cancer

Recently, the transcription factor SOX11 has gained extensive attention as a diagnostic marker in a series of cancers. However, to date, the possible roles of SOX11 in breast cancer has not been investigated. In this study, immunohistochemical staining for SOX11 was performed for 116 cases of breast cancer. Nuclear SOX11 was observed in 42 (36.2%) and cytoplasmic SOX11 in 52 (44.8%) of breast cancer samples. Moreover, high expression of cytoplasmic and nuclear SOX11 was associated with clinicopathological factors, including earlier tumor grade, absence of lymph node metastasis and smaller tumor size. Kaplan-Meier survival curves demonstrated high nuclear SOX11 expression to be associated with more prolonged overall survival than those with low expression and it could be an independent predictor of survival for breast cancer patients. It is worthwhile to note that cytoplasmic SOX11 was not correlated with prognosis of breast cancer patients. These data suggest the possibility that nuclear SOX11 could be as a potential target for breast cancer therapy.

Black Hispanic and Black non-Hispanic breast cancer survival data analysis with half-normal model application

BACKGROUND

Breast cancer is the second leading cause of cancer death for women in the United States. Differences in survival of breast cancer have been noted among racial and ethnic groups, but the reasons for these disparities remain unclear. This study presents the characteristics and the survival curve of two racial and ethnic groups and evaluates the effects of race on survival times by measuring the lifetime data-based half-normal model.

MATERIALS AND METHODS

The distributions among racial and ethnic groups are compared using female breast cancer patients from nine states in the country all taken from the National Cancer Institute's Surveillance, Epidemiology, and End RESULTS cancer registry. The main end points observed are: age at diagnosis, survival time in months, and marital status. The right skewed half-normal statistical probability model is used to show the differences in the survival times between black Hispanic (BH) and black non-Hispanic (BNH) female breast cancer patients. The Kaplan-Meier and Cox proportional hazard ratio are used to estimate and compare the relative risk of death in two minority groups, BH and BNH.

RESULTS

A probability random sample method was used to select representative samples from BNH and BH female breast cancer patients, who were diagnosed during the years of 1973-2009 in the United States. The sample contained 1,000 BNH and 298 BH female breast cancer patients. The median age at diagnosis was 57.75 years among BNH and 54.11 years among BH. The results of the half-normal model showed that the survival times formed positive skewed models with higher variability in BNH compared with BH. The Kaplan-Meir estimate was used to plot the survival curves for cancer patients; this test was positively skewed. The Kaplan-Meier and Cox proportional hazard ratio for survival analysis showed that BNH had a significantly longer survival time as compared to BH which is consistent with the results of the half-normal model.

CONCLUSIONS

The findings with the proposed model strategy will assist in the healthcare field to measure future outcomes for BH and BNH, given their past history and conditions. These findings may provide an enhanced and improved outlook for the diagnosis and treatment of breast cancer patients in the United States.