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McAnena P, Moloney BM, Browne R, O’Halloran N, Walsh L, Walsh S, Sheppard D, Sweeney KJ, Kerin MJ, Lowery AJ. A radiomic model to classify response to neoadjuvant chemotherapy in breast cancer. BMC Med Imaging 2022; 22:225. [PMID: 36564734 PMCID: PMC9789647 DOI: 10.1186/s12880-022-00956-6] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 12/19/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Medical image analysis has evolved to facilitate the development of methods for high-throughput extraction of quantitative features that can potentially contribute to the diagnostic and treatment paradigm of cancer. There is a need for further improvement in the accuracy of predictive markers of response to neo-adjuvant chemotherapy (NAC). The aim of this study was to develop a radiomic classifier to enhance current approaches to predicting the response to NAC breast cancer. METHODS Data on patients treated for breast cancer with NAC prior to surgery who had a pre-NAC dynamic contrast enhanced breast MRI were included. Response to NAC was assessed using the Miller-Payne system on the excised tumor. Tumor segmentation was carried out manually under the supervision of a consultant breast radiologist. Features were selected using least absolute shrinkage selection operator regression. A support vector machine learning model was used to classify response to NAC. RESULTS 74 patients were included. Patients were classified as having a poor response to NAC (reduction in cellularity < 90%, n = 44) and an excellent response (> 90% reduction in cellularity, n = 30). 4 radiomics features (discretized kurtosis, NGDLM contrast, GLZLM_SZE and GLZLM_ZP) were identified as pertinent predictors of response to NAC. A SVM model using these features stratified patients into poor and excellent response groups producing an AUC of 0.75. Addition of estrogen receptor status improved the accuracy of the model with an AUC of 0.811. CONCLUSION This study identified a radiomic classifier incorporating 4 radiomics features to augment subtype based classification of response to NAC in breast cancer.
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Affiliation(s)
- Peter McAnena
- grid.412440.70000 0004 0617 9371Department of Surgery, Clinical Sciences Institute, University Hospital Galway, Galway, Ireland
| | - Brian M. Moloney
- grid.412440.70000 0004 0617 9371Department of Radiology, University Hospital Galway, Galway, Ireland
| | - Robert Browne
- grid.412440.70000 0004 0617 9371Department of Surgery, Clinical Sciences Institute, University Hospital Galway, Galway, Ireland
| | - Niamh O’Halloran
- grid.412440.70000 0004 0617 9371Department of Radiology, University Hospital Galway, Galway, Ireland
| | - Leon Walsh
- grid.412440.70000 0004 0617 9371Department of Radiology, University Hospital Galway, Galway, Ireland
| | - Sinead Walsh
- grid.412440.70000 0004 0617 9371Department of Radiology, University Hospital Galway, Galway, Ireland
| | - Declan Sheppard
- grid.412440.70000 0004 0617 9371Department of Radiology, University Hospital Galway, Galway, Ireland
| | - Karl J. Sweeney
- grid.412440.70000 0004 0617 9371Department of Surgery, Clinical Sciences Institute, University Hospital Galway, Galway, Ireland
| | - Michael J. Kerin
- grid.412440.70000 0004 0617 9371Department of Surgery, Clinical Sciences Institute, University Hospital Galway, Galway, Ireland ,grid.6142.10000 0004 0488 0789Discipline of Surgery, Lambe Institute for Translational Research, National University of Ireland, Galway, Ireland
| | - Aoife J. Lowery
- grid.412440.70000 0004 0617 9371Department of Surgery, Clinical Sciences Institute, University Hospital Galway, Galway, Ireland ,grid.6142.10000 0004 0488 0789Discipline of Surgery, Lambe Institute for Translational Research, National University of Ireland, Galway, Ireland
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Browne R, McAnena P, O'Halloran N, Moloney BM, Crilly E, Kerin MJ, Lowery AJ. Preoperative Breast Magnetic Resonance Imaging as a Predictor of Response to Neoadjuvant Chemotherapy. Breast Cancer (Auckl) 2022; 16:11782234221103504. [PMID: 35769423 PMCID: PMC9234834 DOI: 10.1177/11782234221103504] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 04/28/2022] [Indexed: 11/30/2022] Open
Abstract
Introduction: The ability to accurately predict pathologic complete response (pCR) after
neoadjuvant chemotherapy (NAC) in breast cancer would improve patient
selection for specific treatment strategies, would provide important
information for patients to aid in the treatment selection process, and
could potentially avoid the need for more extensive surgery. The diagnostic
performance of magnetic resonance imaging (MRI) in predicting pCR has
previously been studied, with mixed results. Magnetic resonance imaging
performance may also be influenced by tumour and patient factors. Methods: Eighty-seven breast cancer patients who underwent NAC were studied. Pre-NAC
and post-NAC MRI findings were compared with pathologic findings
postsurgical excision. The impact of patient and tumour characteristics on
MRI accuracy was evaluated. Results: The mean (SD) age of participants was 48.7 (10.3) years. The rate of pCR
based on post-NAC MRI was 19.5% overall (19/87). The sensitivity,
specificity, positive predictive value (PPV), negative predictive value, and
accuracy in predicting pCR were 52.9%, 77.1%, 36.0%, 87.1%, and 72.4%,
respectively. Positive predictive value was the highest in nonluminal versus
Luminal A disease (45.0% vs 25.0%, P < .001), with
higher rates of false positivity in nonluminal subtypes
(P = .002). Tumour grade, T category, and histological
subtype were all independent predictors of MRI accuracy regarding post-NAC
tumour size. Conclusion: Magnetic resonance imaging alone is insufficient to accurately predict pCR in
breast cancer patients post-NAC. Magnetic resonance imaging predictions of
pCR are more accurate in nonluminal subtypes. Tumour grade, T category, and
histological subtype should be considered when evaluating post-NAC tumour
sizes.
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Affiliation(s)
- Robert Browne
- Department of Surgery, University Hospital Galway, Galway, Ireland
| | - Peter McAnena
- Department of Surgery, University Hospital Galway, Galway, Ireland
| | - Niamh O'Halloran
- Department of Radiology, University Hospital Galway, Galway, Ireland
| | - Brian M Moloney
- Department of Radiology, University Hospital Galway, Galway, Ireland
| | - Emily Crilly
- Department of Surgery, University Hospital Galway, Galway, Ireland
| | - Michael J Kerin
- Department of Surgery, University Hospital Galway, Galway, Ireland.,Discipline of Surgery, Lambe Institute for Translational Research, National University of Ireland Galway, Galway, Ireland
| | - Aoife J Lowery
- Department of Surgery, University Hospital Galway, Galway, Ireland.,Discipline of Surgery, Lambe Institute for Translational Research, National University of Ireland Galway, Galway, Ireland
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Kelly MA, Vukanic D, McAnena P, Quinlan JF. The opportunity cost of arthroplasty training in orthopaedic surgery. Surgeon 2021; 20:297-300. [PMID: 34801411 DOI: 10.1016/j.surge.2021.09.008] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 08/23/2021] [Accepted: 09/30/2021] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Training the next generation of surgeons is a crucial role fulfilled by consultant orthopaedic surgeons. However we are increasingly constrained by limited time and resources. We sought to compare operative time and length of stay (LOS) for total hip and total knee arthroplasties (THA, TKA) performed by a consultant orthopaedic surgeon with those performed by supervised trainees. MATERIALS AND METHODS A prospective database of arthroplasty procedures performed from 2015 to 2018 was collated. Primary surgeon grade was recorded. Patient demographics, ASA grade, LOS and operative time were recorded. For THA both cemented and uncemented arthroplasties were used. SPSS version 23 was used for statistical analysis. RESULTS 394 arthroplasty procedures were carried out during the study period. Trainee surgeons performed a high proportion of both THA (53.2%, n = 123) and TKA (44.8%, n = 73) surgeries. Trainees performed 57% of cemented THA procedures. LOS did not differ between consultant and trainee surgeons for THA (5.9 ± 4.8 days) or TKA (5.6 ± 4.1 days). Age had a significant effect on LOS (p < 0.001). For THA the mean operative time for trainees was 90.3 ± 19.23 min, 18.2 min longer than the consultant group. For TKA the mean operative time was 89.06 ± 18.87 min for trainees, 24.4 min longer than the consultant group. DISCUSSION At our institution trainee surgeons can be expected to take between 18 and 24 min longer to perform arthroplasty procedures. This should be factored into resource planning, as the training of orthopaedic surgeons is crucial to sustaining and improving health service provision.
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Affiliation(s)
- M A Kelly
- Specialist Registrar in Trauma & Orthopaedic Surgery, Tallaght University Hospital, Dublin, Ireland.
| | - D Vukanic
- Specialist Registrar in Trauma & Orthopaedic Surgery, Tallaght University Hospital, Dublin, Ireland.
| | - P McAnena
- Surgical Registrar & Clinical Researcher, Lambe Institute for Translational Research, University Hospital Galway, Ireland.
| | - J F Quinlan
- Consultant Trauma and Orthopaedic Surgeon, Tallaght University Hospital, Dublin, Ireland.
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Davey MG, Kerin E, O'Flaherty C, Maher E, Richard V, McAnena P, McLaughlin RP, Sweeney KJ, Barry MK, Malone CM, Wyns W, Soliman O, Miller N, Keane MM, Lowery AJ, Kerin MJ. Clinicopathological response to neoadjuvant therapies and pathological complete response as a biomarker of survival in human epidermal growth factor receptor-2 enriched breast cancer - A retrospective cohort study. Breast 2021; 59:67-75. [PMID: 34171619 PMCID: PMC8234352 DOI: 10.1016/j.breast.2021.06.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 06/13/2021] [Accepted: 06/14/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Human epidermal growth factor receptor-2 (HER2) is overexpressed in 20-25% of breast cancers. Complete eradication of disease following neoadjuvant therapies and chemotherapy has been referred to as pathological complete response (pCR). AIMS To determine clinicopathological predictors of pCR to neoadjuvant therapies and to evaluate pCR as a surrogate to enhanced survival. METHODS Consecutive female patients with HER2 positive (HER+) breast cancer managed surgically in a single institution between 2005 and 2015 were included. Descriptive statistics and binary logistic regression were used to determine predictors of pCR. Appraisal of pCR as a predictor of survival was performed using Kaplan-Meier curves and Cox regression analysis. RESULTS 451 patients were included with a mean age of 56.6 ± 13.4 years (range 23-95). Disease-free (DFS) and overall survival (OS) was 82.3% (371/451) and 82.6% (376/451) respectively with a median follow-up of 108.0 months (range 3-184.0). 118 were treated in the neoadjuvant setting (26.2%): tumour size <50 mm (Odds Ratio (OR): 12.156, P = 0.023) and progesterone receptor negativity (OR: 2.762, P = 0.008) independently predicted breast pCR, while ductal carcinoma (OR: 3.203, P = 0.030) and grade 3 disease (OR: 2.788, P = 0.018) predicted axillary pCR. Both breast and axillary pCR predicted enhanced DFS (Hazard Ratio (HR): 0.470 & HR: 0.449) and OS (HR: 0.383 & HR: 0.307). Axillary pCR independently predicted improved OS (HR: 0.326). CONCLUSION pCR is sensitive biomarker and surrogate to survival outcomes in HER2+ breast cancer. Patients likely to achieve pCR may be predicted from traditional clinicopathological characteristics and molecular parameters.
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Affiliation(s)
- Matthew G Davey
- The Lambe Institute for Translational Research, National University of Ireland, Galway, Ireland; Department of Surgery, Galway University Hospitals, Galway, Ireland
| | - Eoin Kerin
- The Lambe Institute for Translational Research, National University of Ireland, Galway, Ireland
| | - C O'Flaherty
- The Lambe Institute for Translational Research, National University of Ireland, Galway, Ireland
| | - Elizabeth Maher
- The Lambe Institute for Translational Research, National University of Ireland, Galway, Ireland
| | - Vinitha Richard
- The Lambe Institute for Translational Research, National University of Ireland, Galway, Ireland
| | - Peter McAnena
- Department of Surgery, Galway University Hospitals, Galway, Ireland
| | - Ray P McLaughlin
- Department of Surgery, Galway University Hospitals, Galway, Ireland
| | - Karl J Sweeney
- Department of Surgery, Galway University Hospitals, Galway, Ireland
| | - Michael K Barry
- Department of Surgery, Galway University Hospitals, Galway, Ireland
| | - Carmel M Malone
- Department of Surgery, Galway University Hospitals, Galway, Ireland
| | - William Wyns
- Department of Cardiology, Galway University Hospitals, Galway, Ireland
| | - Osama Soliman
- Department of Cardiology, Galway University Hospitals, Galway, Ireland
| | - Nicola Miller
- The Lambe Institute for Translational Research, National University of Ireland, Galway, Ireland
| | - Maccon M Keane
- Department of Medical Oncology, Galway University Hospitals, Galway, Ireland
| | - Aoife J Lowery
- The Lambe Institute for Translational Research, National University of Ireland, Galway, Ireland; Department of Surgery, Galway University Hospitals, Galway, Ireland
| | - Michael J Kerin
- The Lambe Institute for Translational Research, National University of Ireland, Galway, Ireland; Department of Surgery, Galway University Hospitals, Galway, Ireland
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Neary C, McAnena P, McAnena O, Kerin M, Collins C. C-Reactive Protein-Lymphocyte Ratio Identifies Patients at Low Risk for Major Morbidity after Oesophagogastric Resection for Cancer. Dig Surg 2020; 37:515-523. [PMID: 33105139 DOI: 10.1159/000510963] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 08/17/2020] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Complications following oesophagogastric surgery have significant implications for patient recovery. OBJECTIVE identify cost-effective biomarkers which can predict morbidity. METHODS Analysis of all upper gastrointestinal resections in Galway University Hospital from 2014 to 2018 was performed. The ability of C-reactive protein (CRP), neutrophil-lymphocyte ratio (NLR), and CRP-lymphocyte ratio (CLR) to predict morbidity, including anastomotic leak (AL), was assessed and compared. RESULTS Seventy-one oesophagectomies and 77 gastrectomies were performed. There were 2 (1%) 30-day mortalities and 83 (56%) morbidities of which 30 (20%) were of Clavien-Dindo grade 3 or higher. The rate of major morbidity within the oesophagectomy cohort was 27% and was 14% in the gastrectomy cohort. There were 11 (7%) ALs, 7 in the oesophagectomy cohort, and 4 in the gastrectomy cohort. From post-operative day (POD) 2 onwards, CRP could predict AL (POD2 AUC = 0.705, p = 0.025; POD3 AUC = 0.757, p = 0.005, POD4 AUC = 0.811, p = 0.001; and POD5 AUC = 0.824, p = 0.001). CLR predicted AL on POD2 onwards (POD2 AUC = 0.722, p = 0.005; POD3 AUC = 0.736, p = 0.01; POD4 AUC = 0.775, p = 0.003; and POD5 AUC = 0.817, p = 0.001). CRP level of 218 mg/dL and CLR level of 301 at POD 2 generated negative predictive values of 97 and 98%, respectively, for AL. Post-operative NLR did not display sufficient discriminatory ability for the outcomes. CONCLUSION CRP and CLR are reliable negative predictors of major morbidity, including AL, after oesophagogastric resection. Their use can inform patient intervention and recovery.
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Affiliation(s)
- Colm Neary
- Discipline of Surgery, Lambe Institute for Translational Research, National University of Ireland Galway, Galway, Ireland,
| | - Peter McAnena
- Discipline of Surgery, Lambe Institute for Translational Research, National University of Ireland Galway, Galway, Ireland
| | - Oliver McAnena
- Discipline of Surgery, Lambe Institute for Translational Research, National University of Ireland Galway, Galway, Ireland.,Department of Upper Gastrointestinal Surgery, Galway University Hospital, Galway, Ireland
| | - Michael Kerin
- Discipline of Surgery, Lambe Institute for Translational Research, National University of Ireland Galway, Galway, Ireland
| | - Chris Collins
- Discipline of Surgery, Lambe Institute for Translational Research, National University of Ireland Galway, Galway, Ireland.,Department of Upper Gastrointestinal Surgery, Galway University Hospital, Galway, Ireland
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Davey M, Elwahaab SA, Elliott JA, McAnena P, Curran C, Malone C, Sweeney K, Barry K, McLaughlin R, Lowery A, Kerin M. AB076. Oncotype DX™: a necessary expense in the era of personalised medicine? Mesentery Peritoneum 2020; 4:AB076-AB076. [DOI: 10.21037/map.2020.ab076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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McAnena P, Neary C, Doyle C, Kerin MJ, McAnena OJ, Collins C. Serial CRP levels following oesophagectomy: a marker for anastomotic dehiscence. Ir J Med Sci 2019; 189:277-282. [PMID: 31372815 DOI: 10.1007/s11845-019-02072-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 05/23/2019] [Accepted: 07/20/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND Following oesophagectomy, the most concerning complication is that of anastomotic leak (AL). Prompt diagnosis and intervention are crucial to facilitate an optimal outcome. Other complications, particularly respiratory, are not infrequent. Early identification of AL versus other sources of the inflammatory response can be problematic. AIMS To evaluate the role of serial CRP as a prognosticator for oesophagogastric AL. METHODS All oesophagectomies carried out at our institution from 2010 to 2017 were included. Serial C-reactive protein (CRP) and white cell count (WCC) were recorded pre-operatively and on each consecutive day up to day 10 post-op. All complications were recorded and the timing of diagnosis compared with serial CRP and WCC measurements to determine any correlation. RESULTS One hundred and two patients underwent oesophagectomy (84 male, 18 female) with a mean age of 62.5 years (± 9.8). Forty-seven patients developed post-operative complications, with pulmonary (n = 28) the most common. There were 5 cases of AL. Patients in the AL group (n = 5) had a significantly higher mean CRP compared to those who did not develop AL (n = 97) pre-operatively (50 vs. 14, p = 0.046), on post-op day 3 (300 vs. 218, p = 0.02) and on post-op day 4 (279 vs. 184, p = 0.009). There was no significant difference in mean daily CRP between patients with pulmonary complications (PC, n = 29) and those who did not develop complications (NC, n = 54). CONCLUSIONS Elevated CRP may be a useful marker in facilitating the prompt diagnosis of AL following oesophagectomy. Serial CRP may not contribute to identifying lower respiratory tract infections, partly as a result of the pro-inflammatory response following surgery.
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Affiliation(s)
- Peter McAnena
- Discipline of Surgery, Lambe Institute for Translational Research, School of Medicine, National University of Ireland Galway, Galway, Ireland.
| | - Colm Neary
- Discipline of Surgery, Lambe Institute for Translational Research, School of Medicine, National University of Ireland Galway, Galway, Ireland
| | - Conor Doyle
- School of Medicine, University College Dublin, Dublin 4, Ireland
| | - Michael J Kerin
- Discipline of Surgery, Lambe Institute for Translational Research, School of Medicine, National University of Ireland Galway, Galway, Ireland
| | - Oliver J McAnena
- Discipline of Surgery, Lambe Institute for Translational Research, School of Medicine, National University of Ireland Galway, Galway, Ireland
| | - Chris Collins
- Discipline of Surgery, Lambe Institute for Translational Research, School of Medicine, National University of Ireland Galway, Galway, Ireland
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McAnena P, Tanriverdi K, Curran C, Gilligan K, Freedman JE, Brown JAL, Kerin MJ. Circulating microRNAs miR-331 and miR-195 differentiate local luminal a from metastatic breast cancer. BMC Cancer 2019; 19:436. [PMID: 31077182 PMCID: PMC6511137 DOI: 10.1186/s12885-019-5636-y] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 04/23/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Breast cancer is the leading cause of cancer related death in women, with metastasis the principle cause of mortality. New non-invasive prognostic markers are needed for the early detection of metastasis, facilitating treatment decision optimisation. MicroRNA (miRNA) are small, non-coding RNAs regulating gene expression and involved in many cellular processes, including metastasis. As biomarkers, circulating miRNAs (in blood) hold great promise for informing diagnosis or monitoring treatment responses. METHODS Plasma extracted RNA from age matched local Luminal A (n = 4) or metastatic disease (n = 4) were profiled using Next Generation Sequencing. Selected differentially expressed miRNA were validated on a whole blood extracted miRNA cohort [distant metastatic disease (n = 22), local disease (n = 31), healthy controls (n = 21)]. Area Under the Curve (AUC) in Receiver Operating Characteristic (ROC) analyses was performed. RESULTS Of 4 miRNA targets tested (miR-181a, miR-329, miR-331, miR-195), mir-331 was significantly over-expressed in patients with metastatic disease, compared to patients with local disease (p < 0.001) or healthy controls (p < 0.001). miR-195 was significantly under-expressed in patients with metastatic disease, compared to patients with local disease (p < 0.001) or healthy controls (p = 0.043). In combination, miR-331 and miR-195 produced an AUC of 0.902, distinguishing metastatic from local breast cancer. CONCLUSIONS We identified and validated two circulating miRNAs differentiating local Luminal A breast cancers from metastatic breast cancers. Further investigation will reveal the molecular role of these miRNAs in metastasis, and determine if they are subtype specific. This work demonstrates the ability of circulating miRNA to identify metastatic disease, and potentially inform diagnosis or treatment effectiveness.
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Affiliation(s)
- Peter McAnena
- Discipline of Surgery, Lambe Institute for Translational Research, School of Medicine, National University of Ireland Galway, Galway, Ireland
| | - Kahraman Tanriverdi
- UMass Memorial Heart & Vascular Center, University of Massachusetts Medical School, The Albert Sherman Center, 7th Floor West, AS7-1051, 368 Plantation St, Worcester, MA, 01605-4319, USA
| | - Catherine Curran
- Discipline of Surgery, Lambe Institute for Translational Research, School of Medicine, National University of Ireland Galway, Galway, Ireland
| | - K Gilligan
- Discipline of Surgery, Lambe Institute for Translational Research, School of Medicine, National University of Ireland Galway, Galway, Ireland
| | - Jane E Freedman
- UMass Memorial Heart & Vascular Center, University of Massachusetts Medical School, The Albert Sherman Center, 7th Floor West, AS7-1051, 368 Plantation St, Worcester, MA, 01605-4319, USA
| | - James A L Brown
- Discipline of Surgery, Lambe Institute for Translational Research, School of Medicine, National University of Ireland Galway, Galway, Ireland.
| | - Michael J Kerin
- Discipline of Surgery, Lambe Institute for Translational Research, School of Medicine, National University of Ireland Galway, Galway, Ireland.
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Abstract
BACKGROUND The management of breast cancer has changed dramatically in the molecular era. Micro-RNAs can contribute to multiple facets of cancer surgery. METHODS This narrative review, based on years of research on the role of micro-RNAs, focused on the potential of these small, robust RNAs to influence all aspects of breast cancer surgery. RESULTS Micro-RNAs have a potential role as biomarkers in the diagnosis, prognosis and evaluation of response to therapy in breast cancer. They may also contribute to future therapeutic strategies. CONCLUSION The molecular era has changed understanding of cancer. Micro-RNAs have the potential for use in personalized cancer strategies.
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Affiliation(s)
- P McAnena
- Discipline of Surgery, Lambe Institute for Translational Research, School of Medicine, National University of Ireland, Galway, Ireland
| | - A Lowery
- Discipline of Surgery, Lambe Institute for Translational Research, School of Medicine, National University of Ireland, Galway, Ireland
| | - M J Kerin
- Discipline of Surgery, Lambe Institute for Translational Research, School of Medicine, National University of Ireland, Galway, Ireland
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O'Beirn E, Balasubramanian I, McAnena P, Lowery A, Kerin M. Modern axillary management is more focused and less invasive. Eur J Surg Oncol 2018. [DOI: 10.1016/j.ejso.2018.02.242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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