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Kneer A, Pfeiffer E, Ott G, Sauer G, Schröder-Luettgen E, Gerteis A. Kam es durch die geänderten Leitlinienempfehlungen zwischen 2006 und 2016 zu einer Reduktion der operativen Eingriffe in 2795 invasiven Mammakarzinomfällen bis zum Erreichen der R0-Resektion? Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- A Kneer
- Robert-Bosch-Krankenhaus Stuttgart, Gynäkologie, Stuttgart, Deutschland
| | - E Pfeiffer
- Robert-Bosch-Krankenhaus Stuttgart, Gynäkologie, Stuttgart, Deutschland
| | - G Ott
- Robert-Bosch-Krankenhaus Stuttgart, Pathologie, Stuttgart, Deutschland
| | - G Sauer
- Robert-Bosch-Krankenhaus Stuttgart, Gynäkologie, Stuttgart, Deutschland
| | | | - A Gerteis
- Robert-Bosch-Krankenhaus Stuttgart, Gynäkologie, Stuttgart, Deutschland
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Ritter B, Pfaff L, Sauer G, Ott G, Aulitzky WE, Gerteis A. Neoadjuvante Chemotherapie (NACT) beim frühen Mammakarzinom: retrospektive Analyse von 346 Fällen bezüglich pathologischer Komplettremission (pCR). Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- B Ritter
- Robert-Bosch-Krankenhaus Stuttgart, Gynäkologie und Geburtshilfe, Stuttgart, Deutschland
| | - L Pfaff
- Robert-Bosch-Krankenhaus Stuttgart, Gynäkologie und Geburtshilfe, Stuttgart, Deutschland
| | - G Sauer
- Robert-Bosch-Krankenhaus Stuttgart, Gynäkologie und Geburtshilfe, Stuttgart, Deutschland
| | - G Ott
- Robert-Bosch-Krankenhaus Stuttgart, Pathologie, Stuttgart, Deutschland
| | - WE Aulitzky
- Robert-Bosch-Krankenhaus Stuttgart, Hamatologie und Onkologie, Stuttgart, Deutschland
| | - A Gerteis
- Robert-Bosch-Krankenhaus Stuttgart, Gynäkologie und Geburtshilfe, Stuttgart, Deutschland
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Fritz P, Dippon J, Müller S, Goletz S, Trautmann C, Pappas X, Ott G, Brauch H, Schwab M, Winter S, Mürdter T, Brinkmann F, Faisst S, Rössle S, Gerteis A, Friedel G. Is Mistletoe Treatment Beneficial in Invasive Breast Cancer? A New Approach to an Unresolved Problem. Anticancer Res 2018; 38:1585-1593. [PMID: 29491089 DOI: 10.21873/anticanres.12388] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 01/16/2018] [Accepted: 01/17/2018] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM In this retrospective study, we compared breast cancer patients treated with and without mistletoe lectin I (ML-I) in addition to standard breast cancer treatment in order to determine a possible effect of this complementary treatment. PATIENTS AND METHODS This study included 18,528 patients with invasive breast cancer. Data on additional ML-I treatments were reported for 164 patients. We developed a "similar case" method with a distance measure retrieved from the beta variable in Cox regression to compare these patients, after stage adjustment, with their non-ML-1 treated counterparts in order to answer three hypotheses concerning overall survival, recurrence free survival and life quality. RESULTS Raw data analysis of an additional ML-I treatment yielded a worse outcome (p=0.02) for patients with ML treatment, possibly due to a bias inherent in the ML-I-treated patients. Using the "similar case" method (a case-based reasoning approach) we could not confirm this harm for patients using ML-I. Analysis of life quality data did not demonstrate reliable differences between patients treated with ML-I treatment and those without proven ML-I treatment. CONCLUSION Based on a "similar case" model we did not observe any differences in the overall survival (OS), recurrence-free survival (RFS), and quality of life data between breast cancer patients with standard treatment and those who in addition to standard treatment received ML-I treatment.
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Affiliation(s)
- Peter Fritz
- Department of Clinical Pathology, Robert Bosch Hospital, Stuttgart, Germany
| | - Jürgen Dippon
- Institute of Stochastics and Applications, University of Stuttgart, Stuttgart, Germany
| | - Simon Müller
- Institute of Stochastics and Applications, University of Stuttgart, Stuttgart, Germany
| | - Sven Goletz
- Institute of Stochastics and Applications, University of Stuttgart, Stuttgart, Germany
| | - Christian Trautmann
- Department of Gynecology and Obstetrics, Robert-Bosch-Hospital, Stuttgart, Germany
| | | | - German Ott
- Department of Clinical Pathology, Robert Bosch Hospital, Stuttgart, Germany
| | - Hiltrud Brauch
- Margarete Fischer-Bosch-Institute of Clinical Pharmacology and University of Tuebingen, Stuttgart, Germany
| | - Matthias Schwab
- Margarete Fischer-Bosch-Institute of Clinical Pharmacology and University of Tuebingen, Stuttgart, Germany.,Department of Clinical Pharmacology, University Hospital Tuebingen, Stuttgart, Germany
| | - Stefan Winter
- Margarete Fischer-Bosch-Institute of Clinical Pharmacology and University of Tuebingen, Stuttgart, Germany
| | - Thomas Mürdter
- Margarete Fischer-Bosch-Institute of Clinical Pharmacology and University of Tuebingen, Stuttgart, Germany
| | | | - Simone Faisst
- Onkologischer Schwerpunkt Stuttgart e.V., Stuttgart, Germany
| | - Susanne Rössle
- Onkologischer Schwerpunkt Stuttgart e.V., Stuttgart, Germany
| | - Andreas Gerteis
- Department of Gynecology and Obstetrics, Robert-Bosch-Hospital, Stuttgart, Germany
| | - Godehard Friedel
- Center for Pulmonology and Thoracic Surgery, Klinik Schillerhöhe, Stuttgart-Gerlingen, Germany
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Schroth W, Winter S, Büttner F, Goletz S, Faißt S, Brinkmann F, Saladores P, Heidemann E, Ott G, Gerteis A, Alscher MD, Dippon J, Schwab M, Brauch H, Fritz P. Clinical outcome and global gene expression data support the existence of the estrogen receptor-negative/progesterone receptor-positive invasive breast cancer phenotype. Breast Cancer Res Treat 2015; 155:85-97. [DOI: 10.1007/s10549-015-3651-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 11/26/2015] [Indexed: 01/08/2023]
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Fritz P, Bendrat K, Sonnenberg M, Trautmann C, Ott G, Heidemann E, Brinkmann F, Faisst S, Gerteis A, Brauch H, Schwab M, Lindner C, Friedrichs K, Alscher MD, Dippon J, Niendorf A. Tubular breast cancer. A retrospective study. Anticancer Res 2014; 34:3647-3656. [PMID: 24982382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND The well-characterized tubular-type of breast tumors is classified as low-risk breast cancer. PATIENTS AND METHODS We report on the results of a retrospective analysis on clinical and biological features of 248 tubular breast tumors including follow-up and treatment data from two German series of 21,065 breast cancer cases. The majority of tumors were stage I or stage II, ER- and PR-positive and c-erbB2-negative with a 5-year survival-rate of 96.3%. 51.3% of patients received hormonal treatment, 75.5% had post-operative radiotherapy and 11.8% were treated with a chemotherapeutical regimen. CONCLUSION Our retrospective analysis showed no treatment benefit for either anti-hormonal or chemotherapeutical regimens. Post-operative radiotherapy, however, improved the survival rate of patients with tubular carcinoma (log-rank=5, p=0.025). Our data suggest that post-operative radiotherapy is an important treatment to prolong survival for patients suffering from tubular breast cancer.
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Affiliation(s)
- Peter Fritz
- Institute of Digital Medicine, Stuttgart, Germany Robert Bosch Hospital, Department of Clinical Pathology, Stuttgart, Germany
| | | | - Maike Sonnenberg
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology and University of Tuebingen, Stuttgart, Germany
| | | | - German Ott
- Robert Bosch Hospital, Department of Clinical Pathology, Stuttgart, Germany
| | - Else Heidemann
- Onkologischer Schwerpunkt Stuttgart e.V., Stuttgart, Germany
| | | | - Simone Faisst
- Onkologischer Schwerpunkt Stuttgart e.V., Stuttgart, Germany
| | - Andreas Gerteis
- Robert Bosch Hospital, Department of Gynecology, Stuttgart, Germany
| | - Hiltrud Brauch
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology and University of Tuebingen, Stuttgart, Germany
| | - Matthias Schwab
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology and University of Tuebingen, Stuttgart, Germany Department of Clinical Pharmacology, University Hospital Tubingen, Tubingen, Germany
| | | | | | | | - Juergen Dippon
- University of Stuttgart, Institute of Stochastics and Applications, Stuttgart, Germany
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Fritz P, Klenk S, Goletz S, Gerteis A, Simon W, Brinkmann F, Heidemann E, Lütttgen E, Ott G, Alscher MD, Schwab M, Dippon J. Clinical impacts of histological subtyping primary breast cancer. Anticancer Res 2010; 30:5137-5144. [PMID: 21187502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND Treatment decisions in breast cancer depend on TNM classification and the assessment of additional variables with have an impact on survival. We examined whether histological subtyping breast cancer as either ductal or lobular is related to disease outcome. PATIENTS AND METHODS We examined a large data base of 14198 breast cancer patients. RESULTS Histological sub-classification of invasive breast cancer as either ductal or lobular is not correlated with disease outcome. However, the data further showed that invasive lobular carcinomas have a higher probability of being oestrogen receptor (ER)- and progesterone receptor (PR)-positive and a lower probability of being c-erbB2-positive. They also showed a higher average age at the time of diagnosis in comparison with invasive ductal carcinoma. Local recurrence rates were lower in invasive lobular carcinoma in comparison with invasive ductal carcinoma (3.5% vs. 6.2%; p = 0.031). The multivariable Cox regression analysis showed that ER, PR, nodal status, grade and tumour size predicted disease outcome with statistical significance, while the histological subtype (invasive ductal or lobular) was not a significant predictor of disease outcome. CONCLUSION Histological sub-classification of invasive breast cancer as either ductal or lobular is not correlated with disease outcome. On the other hand our data gives some indication that lobular and ductal breast cancer appear to be different biological entities.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Breast Neoplasms/classification
- Breast Neoplasms/metabolism
- Breast Neoplasms/pathology
- Carcinoma, Ductal, Breast/metabolism
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Lobular/metabolism
- Carcinoma, Lobular/pathology
- Female
- Follow-Up Studies
- Humans
- Middle Aged
- Multivariate Analysis
- Neoplasm Recurrence, Local/metabolism
- Neoplasm Recurrence, Local/pathology
- Neoplasm Staging
- Receptors, Estrogen/biosynthesis
- Receptors, Progesterone/biosynthesis
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Affiliation(s)
- P Fritz
- Institute of Digital Medicine, Stuttgart, Germany
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van der Kuip H, Mürdter TE, Sonnenberg M, McClellan M, Gutzeit S, Gerteis A, Simon W, Fritz P, Aulitzky WE. Short term culture of breast cancer tissues to study the activity of the anticancer drug taxol in an intact tumor environment. BMC Cancer 2006; 6:86. [PMID: 16603054 PMCID: PMC1456977 DOI: 10.1186/1471-2407-6-86] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2005] [Accepted: 04/07/2006] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Sensitivity of breast tumors to anticancer drugs depends upon dynamic interactions between epithelial tumor cells and their microenvironment including stromal cells and extracellular matrix. To study drug-sensitivity within different compartments of an individual tumor ex vivo, culture models directly established from fresh tumor tissues are absolutely essential. METHODS We prepared 0.2 mm thick tissue slices from freshly excised tumor samples and cultivated them individually in the presence or absence of taxol for 4 days. To visualize viability, cell death, and expression of surface molecules in different compartments of non-fixed primary breast cancer tissues we established a method based on confocal imaging using mitochondria- and DNA-selective dyes and fluorescent-conjugated antibodies. Proliferation and apoptosis was assessed by immunohistochemistry in sections from paraffin-embedded slices. Overall viability was also analyzed in homogenized tissue slices by a combined ATP/DNA quantification assay. RESULTS We obtained a mean of 49 tissue slices from 22 breast cancer specimens allowing a wide range of experiments in each individual tumor. In our culture system, cells remained viable and proliferated for at least 4 days within their tissue environment. Viability of tissue slices decreased significantly in the presence of taxol in a dose-dependent manner. A three-color fluorescence viability assay enabled a rapid and authentic estimation of cell viability in the different tumor compartments within non-fixed tissue slices. CONCLUSION We describe a tissue culture method combined with a novel read out system for both tissue cultivation and rapid assessment of drug efficacy together with the simultaneous identification of different cell types within non-fixed breast cancer tissues. This method has potential significance for studying tumor responses to anticancer drugs in the complex environment of a primary cancer tissue.
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MESH Headings
- Adenocarcinoma, Mucinous/pathology
- Adenosine Triphosphate/analysis
- Antineoplastic Agents, Phytogenic/pharmacology
- Apoptosis/drug effects
- Breast Neoplasms/pathology
- Carcinoma, Ductal, Breast/pathology
- Cell Division/drug effects
- Cell Survival
- DNA, Neoplasm/analysis
- Drug Screening Assays, Antitumor/methods
- Female
- Humans
- Microscopy, Confocal
- Microscopy, Fluorescence
- Paclitaxel/pharmacology
- Tumor Cells, Cultured/chemistry
- Tumor Cells, Cultured/drug effects
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Affiliation(s)
- Heiko van der Kuip
- Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany
| | - Thomas E Mürdter
- Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany
| | - Maike Sonnenberg
- Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany
| | - Monika McClellan
- Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany
| | - Susanne Gutzeit
- Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany
| | - Andreas Gerteis
- Department of Gynecology, Robert Bosch Hospital, Stuttgart, Germany
| | - Wolfgang Simon
- Department of Gynecology, Robert Bosch Hospital, Stuttgart, Germany
| | - Peter Fritz
- Department of Diagnostic Medicine, Pathology, Robert Bosch Hospital, Stuttgart, Germany
| | - Walter E Aulitzky
- 2Department of Internal Medicine, Oncology and Hematology, Robert Bosch Hospital, Stuttgart, Germany
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8
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Fritz P, Cabrera CM, Dippon J, Gerteis A, Simon W, Aulitzky WE, van der Kuip H. c-erbB2 and topoisomerase IIalpha protein expression independently predict poor survival in primary human breast cancer: a retrospective study. Breast Cancer Res 2005; 7:R374-84. [PMID: 15987433 PMCID: PMC1143560 DOI: 10.1186/bcr1012] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2004] [Revised: 02/07/2005] [Accepted: 02/23/2005] [Indexed: 11/10/2022] Open
Abstract
Introduction c-erbB2 (also known as HER-2/neu) and topoisomerase IIα are frequently overexpressed in breast cancer. The aim of the study was to analyze retrospectively whether the expression of c-erbB2 and topoisomerase IIα protein influences the long-term outcome of patients with primary breast cancer. Methods In this study c-erbB2 and topoisomerase IIα protein were evaluated by immunohistochemistry in formalin-fixed paraffin-embedded tissue from 225 samples of primary breast cancer, obtained between 1986 and 1998. The prognostic value of these markers was analyzed. Results Of 225 primary breast tumor samples, 78 (34.7%) showed overexpression of either c-erbB2 (9.8%) or topoisomerase IIα protein (24.9%), whereas in 21 tumors (9.3%) both proteins were found to be overexpressed. Patients lacking both c-erbB2 and topoisomerase IIα overexpression had the best long-term survival. Overexpression of either c-erbB2 or topoisomerase IIα was associated with shortened survival, whereas patients overexpressing both c-erbB2 and topoisomerase IIα showed the worst disease outcome (P < 0.0001). Treatment with anthracyclines was not capable of reversing the negative prognostic impact of topoisomerase IIα or c-erbB2 overexpression. Conclusion The results of this exploratory study suggest that protein expression of c-erbB2 and topoisomerase IIα in primary breast cancer tissues are independent prognostic factors and are not exclusively predictive factors for anthracycline response in patients with primary breast cancer.
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Affiliation(s)
- Peter Fritz
- Department of Diagnostic Medicine, Pathology, Robert Bosch Hospital, Stuttgart, Germany
| | - Cristina M Cabrera
- Dr Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany
| | - Jürgen Dippon
- Department of Mathematics, University of Stuttgart, Stuttgart, Germany
| | - Andreas Gerteis
- Department of Gynaecology, Robert Bosch Hospital, Stuttgart, Germany
| | - Wolfgang Simon
- Department of Gynaecology, Robert Bosch Hospital, Stuttgart, Germany
| | - Walter E Aulitzky
- 2nd Department of Internal Medicine, Oncology and Hematology, Robert Bosch Hospital, Stuttgart, Germany
| | - Heiko van der Kuip
- Dr Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany
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