1
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Fabbri VP, Asioli S, Palandri G. An unusual case of "sterile" abscess within low-grade meningioma during anti androgenic therapy and LH-releasing hormone agonist treatment for prostate cancer. Clin Neurol Neurosurg 2020; 196:105993. [PMID: 32563976 DOI: 10.1016/j.clineuro.2020.105993] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 06/04/2020] [Accepted: 06/05/2020] [Indexed: 11/17/2022]
Affiliation(s)
- V P Fabbri
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Unit of Anatomic Pathology at Bellaria Hospital, Bologna, Italy.
| | - S Asioli
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Unit of Anatomic Pathology at Bellaria Hospital, Bologna, Italy
| | - G Palandri
- Department of Neurologic Surgery, IRCCS Institute of Neurological Science of Bologna, Bellaria Hospital, Bologna, Italy
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2
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Floiras JL, Hacene K, Turpin F, Spyratos F. Is Adjuvant Tamoxifen Recommended in Post-Menopausal Node-Negative Breast Cancer Patients with High Estrogen Receptor Values? Int J Biol Markers 2018; 15:135-8. [PMID: 10883886 DOI: 10.1177/172460080001500202] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The impact of ER levels on the response to tamoxifen was evaluated in 1,623 postmenopausal primary breast cancer patients treated at our center (median follow-up 8.2 years). In patients receiving adjuvant tamoxifen a significantly longer disease-free survival (DFS) was observed when ER levels were elevated (p<0.00001). Very high ER (>424 fmol/mg protein) appeared to be detrimental in node-negative patients not treated with tamoxifen.
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MESH Headings
- Aged
- Antineoplastic Agents, Hormonal/administration & dosage
- Antineoplastic Agents, Hormonal/therapeutic use
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Breast Neoplasms/chemistry
- Breast Neoplasms/drug therapy
- Breast Neoplasms/pathology
- Breast Neoplasms/surgery
- Chemotherapy, Adjuvant
- Combined Modality Therapy
- Disease-Free Survival
- Drug Evaluation
- Estrogen Antagonists/administration & dosage
- Estrogen Antagonists/therapeutic use
- Estrogens
- Female
- Humans
- Life Tables
- Lymph Node Excision
- Lymph Nodes/pathology
- Mastectomy, Modified Radical
- Mastectomy, Segmental
- Middle Aged
- Neoplasm Proteins/analysis
- Neoplasm Staging
- Neoplasms, Hormone-Dependent/chemistry
- Neoplasms, Hormone-Dependent/drug therapy
- Neoplasms, Hormone-Dependent/pathology
- Neoplasms, Hormone-Dependent/surgery
- Postmenopause
- Prognosis
- Receptors, Estrogen/analysis
- Retrospective Studies
- Tamoxifen/administration & dosage
- Tamoxifen/therapeutic use
- Treatment Outcome
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Affiliation(s)
- J L Floiras
- Department of Radiotherapy, Centre René Huguenin, St-Cloud, France
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3
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Vergine M, Musella A, Gulotta E, Frusone F, De Luca A, Maceli F, Libia A, Benedetti Panici P, Monti M. Paget's disease of the male breast: case report and a point of view from actual literature. G Chir 2018; 39:114-117. [PMID: 29694313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
INTRODUCTION Paget disease of the nipple in man is a very rare breast cancer, and there are not standard procedures or guidelines. In any cases, a Paget's disease could hide an invasive ductal breast cancer. CASE DESCRIPTION We report the case of a 77-years old man affected by Alzheimer's disease, who presented to our attention because of an ulcerated palpable mass in the right nipple. A biopsy of the lesion showed "intra-epidermic proliferation of epitelioid cells, associated with linfo-plasmacellular infiltration of superficial dermis, compatible with Paget's disease (pTis)". We discussed the case in the multidisciplinary meeting and decided to subject the patient to surgery, so a right mastectomy plus sentinel lymph node biopsy (SLNB) were performed. Histo-pathological examination revealed "invasive ductal carcinoma of the breast, associated with a small component of in situ ductal carcinoma and Paget's disease of the nipple with superficial ulceration". Resection margins were free. Sentinel lymph node was negative. Biological features were as follows: ER 95%, PR 60%, Her-2/neu 1+, Ki-67 35%. The patient was discharged in the third post-operative day in good conditions. In the following weeks the patient's healing process was good and free of complications. CONCLUSIONS Clinical recognition of Paget's disease is very important also in man, because it can be the alarm bell for an underlying invasive ductal breast cancer, often more aggressive than in woman.
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MESH Headings
- Aged
- Alzheimer Disease/complications
- Antineoplastic Agents, Hormonal/therapeutic use
- Breast Neoplasms, Male/complications
- Breast Neoplasms, Male/drug therapy
- Breast Neoplasms, Male/pathology
- Breast Neoplasms, Male/surgery
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Ductal, Breast/surgery
- Carcinoma, Intraductal, Noninfiltrating/pathology
- Carcinoma, Intraductal, Noninfiltrating/surgery
- Combined Modality Therapy
- Estrogens
- Humans
- Male
- Mastectomy
- Neoplasms, Hormone-Dependent/complications
- Neoplasms, Hormone-Dependent/drug therapy
- Neoplasms, Hormone-Dependent/pathology
- Neoplasms, Hormone-Dependent/surgery
- Neoplasms, Multiple Primary/pathology
- Neoplasms, Multiple Primary/surgery
- Nipples/pathology
- Paget's Disease, Mammary/complications
- Paget's Disease, Mammary/etiology
- Paget's Disease, Mammary/pathology
- Paget's Disease, Mammary/surgery
- Progesterone
- Skin Ulcer/etiology
- Tamoxifen/therapeutic use
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4
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Shiota M, Itsumi M, Takeuchi A, Imada K, Yokomizo A, Kuruma H, Inokuchi J, Tatsugami K, Uchiumi T, Oda Y, Naito S. Crosstalk between epithelial-mesenchymal transition and castration resistance mediated by Twist1/AR signaling in prostate cancer. Endocr Relat Cancer 2015; 22:889-900. [PMID: 26311513 DOI: 10.1530/erc-15-0225] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Accepted: 08/26/2015] [Indexed: 02/04/2023]
Abstract
Although invasive and metastatic progression via the epithelial-mesenchymal transition (EMT) and acquisition of resistance to castration are both critical steps in prostate cancer, the molecular mechanism of this interaction remains unclear. In this study, we aimed to elucidate the interaction of signaling between castration resistance and EMT, and to apply this information to the development of a novel therapeutic concept using transforming growth factor-β (TGF-β) inhibitor SB525334 combined with androgen-deprivation therapy against prostate cancer using an in vivo model. This study revealed that an EMT inducer (TGF-β) induced full-length androgen receptor (AR) and AR variant expression. In addition, a highly invasive clone showed augmented full-length AR and AR variant expression as well as acquisition of castration resistance. Conversely, full-length AR and AR as well as Twist1 and mesenchymal molecules variant expression were up-regulated in castration-resistant LNCaP xenograft. Finally, TGF-β inhibitor suppressed Twist1 and AR expression as well as prostate cancer growth combined with castration. Taken together, these results demonstrate that Twist1/AR signaling was augmented in castration resistant as well as mesenchymal-phenotype prostate cancer, indicating the molecular mechanism of mutual and functional crosstalk between EMT and castration resistance, which may play a crucial role in prostate carcinogenesis and progression.
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MESH Headings
- Adenocarcinoma/drug therapy
- Adenocarcinoma/genetics
- Adenocarcinoma/pathology
- Adenocarcinoma/physiopathology
- Adenocarcinoma/surgery
- Androgens
- Animals
- Cell Line, Tumor
- Cell Transformation, Neoplastic
- Combined Modality Therapy
- Epithelial-Mesenchymal Transition/physiology
- Gene Expression Profiling
- Gene Expression Regulation, Neoplastic
- Humans
- Imidazoles/pharmacology
- Imidazoles/therapeutic use
- Male
- Mice
- Mice, Nude
- Neoplasm Invasiveness
- Neoplasm Proteins/physiology
- Neoplasms, Hormone-Dependent/drug therapy
- Neoplasms, Hormone-Dependent/genetics
- Neoplasms, Hormone-Dependent/pathology
- Neoplasms, Hormone-Dependent/physiopathology
- Neoplasms, Hormone-Dependent/surgery
- Nuclear Proteins/physiology
- Orchiectomy
- Prostatic Neoplasms/drug therapy
- Prostatic Neoplasms/genetics
- Prostatic Neoplasms/pathology
- Prostatic Neoplasms/physiopathology
- Prostatic Neoplasms/surgery
- Quinoxalines/pharmacology
- Quinoxalines/therapeutic use
- RNA Interference
- RNA, Small Interfering/genetics
- Random Allocation
- Receptors, Androgen/biosynthesis
- Receptors, Androgen/chemistry
- Receptors, Androgen/genetics
- Receptors, Androgen/physiology
- Signal Transduction
- Transforming Growth Factor beta/antagonists & inhibitors
- Twist-Related Protein 1/physiology
- Xenograft Model Antitumor Assays
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Affiliation(s)
- Masaki Shiota
- Departments of UrologyAnatomic PathologyGraduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, JapanDepartment of UrologySchool of Medicine, Jikei University, Tokyo 105-0003, JapanDepartment of Clinical Chemistry and Laboratory MedicineGraduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Momoe Itsumi
- Departments of UrologyAnatomic PathologyGraduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, JapanDepartment of UrologySchool of Medicine, Jikei University, Tokyo 105-0003, JapanDepartment of Clinical Chemistry and Laboratory MedicineGraduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Ario Takeuchi
- Departments of UrologyAnatomic PathologyGraduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, JapanDepartment of UrologySchool of Medicine, Jikei University, Tokyo 105-0003, JapanDepartment of Clinical Chemistry and Laboratory MedicineGraduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Kenjiro Imada
- Departments of UrologyAnatomic PathologyGraduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, JapanDepartment of UrologySchool of Medicine, Jikei University, Tokyo 105-0003, JapanDepartment of Clinical Chemistry and Laboratory MedicineGraduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan Departments of UrologyAnatomic PathologyGraduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, JapanDepartment of UrologySchool of Medicine, Jikei University, Tokyo 105-0003, JapanDepartment of Clinical Chemistry and Laboratory MedicineGraduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Akira Yokomizo
- Departments of UrologyAnatomic PathologyGraduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, JapanDepartment of UrologySchool of Medicine, Jikei University, Tokyo 105-0003, JapanDepartment of Clinical Chemistry and Laboratory MedicineGraduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Hidetoshi Kuruma
- Departments of UrologyAnatomic PathologyGraduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, JapanDepartment of UrologySchool of Medicine, Jikei University, Tokyo 105-0003, JapanDepartment of Clinical Chemistry and Laboratory MedicineGraduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Junichi Inokuchi
- Departments of UrologyAnatomic PathologyGraduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, JapanDepartment of UrologySchool of Medicine, Jikei University, Tokyo 105-0003, JapanDepartment of Clinical Chemistry and Laboratory MedicineGraduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Katsunori Tatsugami
- Departments of UrologyAnatomic PathologyGraduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, JapanDepartment of UrologySchool of Medicine, Jikei University, Tokyo 105-0003, JapanDepartment of Clinical Chemistry and Laboratory MedicineGraduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Takeshi Uchiumi
- Departments of UrologyAnatomic PathologyGraduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, JapanDepartment of UrologySchool of Medicine, Jikei University, Tokyo 105-0003, JapanDepartment of Clinical Chemistry and Laboratory MedicineGraduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Yoshinao Oda
- Departments of UrologyAnatomic PathologyGraduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, JapanDepartment of UrologySchool of Medicine, Jikei University, Tokyo 105-0003, JapanDepartment of Clinical Chemistry and Laboratory MedicineGraduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Seiji Naito
- Departments of UrologyAnatomic PathologyGraduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, JapanDepartment of UrologySchool of Medicine, Jikei University, Tokyo 105-0003, JapanDepartment of Clinical Chemistry and Laboratory MedicineGraduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
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5
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Cipolla C, Graceffa G, La Mendola R, Fricano S, Fricano M, Vieni S. The prognostic value of sentinel lymph node micrometastases in patients with invasive breast carcinoma. Ann Ital Chir 2015; 86:497-502. [PMID: 26898168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
AIM The prognostic value of sentinel lymph node micrometastases in invasive breast cancer patients is still widely debated. Even if, in the absence of unequivocal guidelines, the axillary lynphadenectomy is not still performed in the routine clinical care of these patients. METHOD We have retrospectively analyzed 746 patients with operable invasive breast cancer and clinically negative axillary lymph nodes. These patients underwent conservative surgery or total mastectomy with sentinel lymph node biopsy. Patients with micrometastases in the sentinel lymph node treated with axillary dissection has been checked and the involvement of the remaining lymph nodes analyzed. Patients with micrometastases in the SLN not followed by axillary dissection have been checked as well and the incidence of recurrences has been evaluated in both groups. RESULTS Micrometastases were found in 51 (6.83%) patients and isolated tumor cells in 8 (1.07%) patients at frozen section and confirmed at the final hystopathologic examination. Fifteen of these patients underwent complete axillary dissection: two of them (13.33%) had metastatic involvement of other axillary lymph nodes. The other 44 patients didn't receive further surgical axillary procedure. No axillary recurrences in these patients were found during a median follow up of 65.3±9.65 months (range 42-78 months). CONCLUSION Based on the results and according to some recent randomized trials we can say that axillary lynphadenectomy can be avoided when micrometastases are found in sentinel lynph nodes. It should be performed anyway, depending on the analysis of the biomedical profile of the tumor. KEY WORDS Breast carcinoma, Micrometases, Sentinel lymph node.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Axilla
- Biopsy, Fine-Needle
- Breast Neoplasms/diagnostic imaging
- Breast Neoplasms/pathology
- Breast Neoplasms/surgery
- Breast Neoplasms/therapy
- Carcinoma, Ductal, Breast/diagnostic imaging
- Carcinoma, Ductal, Breast/secondary
- Carcinoma, Ductal, Breast/surgery
- Carcinoma, Ductal, Breast/therapy
- Carcinoma, Lobular/diagnostic imaging
- Carcinoma, Lobular/secondary
- Carcinoma, Lobular/surgery
- Carcinoma, Lobular/therapy
- Combined Modality Therapy
- Female
- Humans
- Lymph Node Excision/statistics & numerical data
- Lymphatic Metastasis/diagnosis
- Lymphatic Metastasis/diagnostic imaging
- Mastectomy/methods
- Middle Aged
- Neoplasm Micrometastasis/diagnosis
- Neoplasm Micrometastasis/diagnostic imaging
- Neoplasm Recurrence, Local/epidemiology
- Neoplasm Recurrence, Local/prevention & control
- Neoplasms, Hormone-Dependent/diagnostic imaging
- Neoplasms, Hormone-Dependent/secondary
- Neoplasms, Hormone-Dependent/surgery
- Neoplasms, Hormone-Dependent/therapy
- Prognosis
- Radionuclide Imaging
- Radiopharmaceuticals
- Retrospective Studies
- Sentinel Lymph Node/diagnostic imaging
- Sentinel Lymph Node/pathology
- Sentinel Lymph Node Biopsy/statistics & numerical data
- Technetium Tc 99m Aggregated Albumin
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6
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Gardrat S, Azarine A, Alsac JM, Bruneval P. [Unusual tumor of the inferior vena cava]. Ann Pathol 2014; 34:247-51. [PMID: 24950877 DOI: 10.1016/j.annpat.2014.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Revised: 09/16/2013] [Accepted: 03/18/2014] [Indexed: 11/17/2022]
Affiliation(s)
- Sophie Gardrat
- Service d'anatomie et de cytologie pathologiques, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
| | - Arshid Azarine
- Service d'imagerie cardiovasculaire, hôpital européen Georges-Pompidou, 75015 Paris, France
| | - Jean-Marc Alsac
- Service de chirurgie cardiovasculaire, hôpital européen Georges-Pompidou, 75015 Paris, France; Université Paris Descartes, 75005 Paris, France
| | - Patrick Bruneval
- Service d'anatomie et de cytologie pathologiques, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France; Université Paris Descartes, 75005 Paris, France.
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7
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Martínez-Ramos D, Fortea-Sanchis C, Escrig-Sos J, Prats-de Puig M, Queralt-Martín R, Salvador-Sanchis JL. [Local recurrence based on size after conservative surgery in breast cancer stage T1-T2. A population-based study]. CIR CIR 2014; 82:252-261. [PMID: 25238466] [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 Conservative surgery can be regarded as the standard treatment for most early stage breast tumors. However, a minority of patients treated with conservative surgery will present local or locoregional recurrence. Therefore, it is of interest to evaluate the possible factors associated with this recurrence. METHODS A population-based retrospective study using data from the Tumor Registry of Castellón (Valencia, Spain) of patients operated on for primary nonmetastatic breast cancer between January 2000 and December 2008 was designed. Kaplan-Meier curves and log-rank test to estimate 5-year local recurrence were used. Two groups of patients were defined, one with conservative surgery and another with nonconservative surgery. Cox multivariate analysis was conducted. RESULTS The total number of patients was 410. Average local recurrence was 6.8%. In univariate analysis, only tumor size and lymph node involvement showed significant differences. On multivariate analysis, independent prognostic factors were conservative surgery (hazard ratio [HR] 4.62; 95% confidence interval [CI]: 1.12-16.82), number of positive lymph nodes (HR 1.07; 95% CI: 1.01-1.17) and tumor size (in mm) (HR 1.02; 95% CI: 1.01-1.06). CONCLUSIONS Local recurrence after breast-conserving surgery is higher in tumors >2 cm. Although tumor size should not be a contraindication for conservative surgery, it should be a risk factor to be considered.
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MESH Headings
- Aged
- Aged, 80 and over
- Breast Neoplasms/epidemiology
- Breast Neoplasms/pathology
- Breast Neoplasms/surgery
- Breast Neoplasms/therapy
- Carcinoma/epidemiology
- Carcinoma/pathology
- Carcinoma/surgery
- Carcinoma/therapy
- Chemotherapy, Adjuvant
- Combined Modality Therapy
- Estrogens
- Female
- Genes, erbB-2
- Humans
- Kaplan-Meier Estimate
- Lymphatic Metastasis
- Mastectomy, Segmental/methods
- Middle Aged
- Multivariate Analysis
- Neoplasm Recurrence, Local/epidemiology
- Neoplasm Recurrence, Local/pathology
- Neoplasm Staging
- Neoplasms, Hormone-Dependent/epidemiology
- Neoplasms, Hormone-Dependent/pathology
- Neoplasms, Hormone-Dependent/surgery
- Neoplasms, Hormone-Dependent/therapy
- Progesterone
- Prognosis
- Proportional Hazards Models
- Radiotherapy, Adjuvant
- Registries/statistics & numerical data
- Retrospective Studies
- Spain/epidemiology
- Triple Negative Breast Neoplasms/epidemiology
- Triple Negative Breast Neoplasms/pathology
- Triple Negative Breast Neoplasms/surgery
- Triple Negative Breast Neoplasms/therapy
- Tumor Burden
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Affiliation(s)
- David Martínez-Ramos
- Servicio de Cirugía General y Digestiva, Hospital General de Castellón, Castellón, Comunidad Valenciana, Spain.
| | - Carlos Fortea-Sanchis
- Servicio de Cirugía General y Digestiva, Hospital General de Castellón, Castellón, Comunidad Valenciana, Spain
| | - Javier Escrig-Sos
- Servicio de Cirugía General y Digestiva, Hospital General de Castellón, Castellón, Comunidad Valenciana, Spain
| | | | - Raquel Queralt-Martín
- Servicio de Cirugía General y Digestiva, Hospital General de Castellón, Castellón, Comunidad Valenciana, Spain
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8
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Missana MC, Germain MA. [Oncologic outcome of 11.6 lipofilling procedures for reconstructive breast surgery]. Bull Acad Natl Med 2014; 198:767-780. [PMID: 26753408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
AIMS OF THE STUDY Autologous fat graft injection has been systematically used by our team since 2001 in order to enhance the esthetic outcome of breast reconstruction. However, this technique remains controversial, notably in France. This study evaluated oncologic outcomes at 3 years among 110 patients operated on and monitored by two surgeons. PATIENTS AND METHODS 116fat graft injections in 110 patients who required reconstructive breast surgery between January 2001 and December 2011 were included in the analysis of oncologic outcomes. The AJCC (American Joint Committee on Staging) stages were: stage 0 (18 %), stage I (44 %), stage II (26.7 %), and stage III (11.3 %). Mean follow-up was 6.3 years (9 months to 17 years) after initial breast cancer surgery, and 3 years (6 months to 9.5 years) after the last lipofilling procedure. RESULTS The majority of patients (91.8 %) are alive and recurrence-free. Remote metastases occurred in 8.2 % of patients: one patient had a local and systemic recurrence, one patient had a local, regional and systemic recurrence. CONCLUSION Although confirmation is needed from multicenter randomized trials with longer follow-up, a larger group of patients and a control group matched for the cancer status of the lipofilling group, our results support the view that lipofilling has little or no effect on the risk of locoregional recurrence of breast cancer.
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9
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Cruz-Galarza D, Pérez-Rodríguez O, Laboy-Torres J, Gutiérrez-Rivera S. An unusual case of a borderline Brenner tumor associated with bilateral serous cystadenoma and endometrial carcinoma. Bol Asoc Med P R 2014; 106:54-56. [PMID: 24791367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Brenner tumor accounts for 1.5 to 2.5% of ovarian tumors. Nearly all are benign and 1% malignant. Less than twenty-five cases of borderline Brenner tumor have been reported worldwide. Our case is the first one related to a bilateral ovarian serous cystadenofibroma and endometrioid adenocarcinoma. This unusual case increases the limited data for borderline Brenner tumors.
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MESH Headings
- Antineoplastic Agents, Hormonal/adverse effects
- Antineoplastic Agents, Hormonal/therapeutic use
- Biomarkers, Tumor/analysis
- Breast Neoplasms/drug therapy
- Breast Neoplasms/surgery
- Brenner Tumor/metabolism
- Brenner Tumor/pathology
- Brenner Tumor/surgery
- Carcinoma, Ductal, Breast/drug therapy
- Carcinoma, Ductal, Breast/surgery
- Combined Modality Therapy
- Cystadenoma, Serous/pathology
- Cystadenoma, Serous/surgery
- Endometrial Neoplasms/chemically induced
- Endometrial Neoplasms/etiology
- Endometrial Neoplasms/pathology
- Endometrial Neoplasms/surgery
- Estrogens/metabolism
- Female
- Humans
- Hysterectomy
- Middle Aged
- Neoplasms, Hormone-Dependent/chemically induced
- Neoplasms, Hormone-Dependent/etiology
- Neoplasms, Hormone-Dependent/pathology
- Neoplasms, Hormone-Dependent/surgery
- Neoplasms, Multiple Primary/pathology
- Neoplasms, Multiple Primary/surgery
- Neoplasms, Second Primary/chemically induced
- Neoplasms, Second Primary/pathology
- Neoplasms, Second Primary/surgery
- Ovarian Cysts/complications
- Ovarian Neoplasms/metabolism
- Ovarian Neoplasms/pathology
- Ovarian Neoplasms/surgery
- Ovariectomy
- Salpingectomy
- Tamoxifen/adverse effects
- Tamoxifen/therapeutic use
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10
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Abstract
We report a breast cancer patient who developed acute myeloid leukemia (AML) one year following her adjuvant chemotherapy consisting of cyclophosphamide, adriamycin and 5-fluorouracil. Cytogenetic examination of bone marrow samples resulted in t(8;16)(p11.2;p13.3), which is a chromosome rearrangement observed in de novo and treatment related AML M4/M5 with a poor prognosis.
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MESH Headings
- Anastrozole
- Antineoplastic Agents, Hormonal/therapeutic use
- Antineoplastic Combined Chemotherapy Protocols/adverse effects
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Bone Marrow/pathology
- Breast Neoplasms/drug therapy
- Breast Neoplasms/pathology
- Breast Neoplasms/radiotherapy
- Breast Neoplasms/surgery
- Carcinoma, Ductal, Breast/drug therapy
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Ductal, Breast/radiotherapy
- Carcinoma, Ductal, Breast/surgery
- Carcinoma, Lobular/drug therapy
- Carcinoma, Lobular/pathology
- Carcinoma, Lobular/radiotherapy
- Carcinoma, Lobular/surgery
- Chemotherapy, Adjuvant/adverse effects
- Chromosomes, Human, Pair 16/genetics
- Chromosomes, Human, Pair 16/ultrastructure
- Chromosomes, Human, Pair 8/genetics
- Chromosomes, Human, Pair 8/ultrastructure
- Combined Modality Therapy
- Cyclophosphamide/administration & dosage
- Cyclophosphamide/adverse effects
- Cytarabine/administration & dosage
- Doxorubicin/administration & dosage
- Doxorubicin/adverse effects
- Estrogens
- Fatal Outcome
- Female
- Fluorouracil/administration & dosage
- Fluorouracil/adverse effects
- Humans
- Idarubicin/administration & dosage
- Leukemia, Myelomonocytic, Acute/chemically induced
- Leukemia, Myelomonocytic, Acute/drug therapy
- Leukemia, Myelomonocytic, Acute/genetics
- Leukemia, Myelomonocytic, Acute/pathology
- Mastectomy, Modified Radical
- Middle Aged
- Neoplasms, Hormone-Dependent/drug therapy
- Neoplasms, Hormone-Dependent/pathology
- Neoplasms, Hormone-Dependent/surgery
- Neoplasms, Multiple Primary/drug therapy
- Neoplasms, Multiple Primary/pathology
- Neoplasms, Multiple Primary/radiotherapy
- Neoplasms, Multiple Primary/surgery
- Neoplasms, Second Primary/drug therapy
- Neoplasms, Second Primary/genetics
- Neoplasms, Second Primary/pathology
- Nitriles/therapeutic use
- Radiotherapy, Adjuvant
- Translocation, Genetic
- Triazoles/therapeutic use
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Affiliation(s)
- Feride Iffet Sahin
- Baskent University Faculty of Medicine, Department of Medical Genetics, Ankara, Turkey.
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11
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Jiménez-Vieyra CR, Quintana-Romero V, Aguilera-Maldonado LV, Solís-Moreno TK. [Case report. Aggressive angiomyxoma of vagina. A rare tumor diagnosed]. Ginecol Obstet Mex 2013; 81:403-408. [PMID: 23971387] [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] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The case of a female patient of 35 years of age, with a pedunculated tumor dependent of the vagina, of approximately 25 x 12 x 8 cm, who had a wide resection. The report was consistent with myxoid aggressive angiomyxoma. This is a myxoid mesenchymal neoplasm of slow growth, which mainly appears in deep soft tissues of the pelvic, genital or perineal areas of adult women. It is usually diagnosed after surgical resection by histopathologic examination. Routine evaluation includes: complete physical examination, imaging and pathology report of diagnostic confirmation.
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Affiliation(s)
- Carlos Ramón Jiménez-Vieyra
- Hospital Victor Manuel Espinosa de los Reyes Sánchez, Institute Mexicano del Seguro Social (IMSS), México DF
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12
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García-Mejido JA, Delgado-Jiménez C, Gutiérrez-Palomino L, Sánchez-Sevilla M, Iglesias-Bravo E, Caballero-Fernández V. [Synchronous bilateral breast cancer in a male]. CIR CIR 2013; 81:225-227. [PMID: 23769252] [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: 06/02/2023]
Abstract
BACKGROUND male breast cancer is a disease with low incidence, which is further reduced when it comes to bilateral synchronous presentation. There are few published cases in recent years. The aim is to establish guidelines for the management of this disorder that is so rare. CLINICAL CASE a 75-year-old with tumors in both breasts, which were completely resected with removal of palpable nodes. The histopathological study reported ductal carcinoma. The indicated treatment was adjuvant tamoxifen and radiotherapy. The patient is currently in a disease-free period. CONCLUSIONS this is a rare disease, whose main treatment is surgery, hence the importance of early diagnosis. Most cases require adjuvant chemotherapy and radiotherapy because they are usually diagnosed at an advanced stage.
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MESH Headings
- Aged
- Antineoplastic Agents, Hormonal/therapeutic use
- Breast Neoplasms, Male/drug therapy
- Breast Neoplasms, Male/epidemiology
- Breast Neoplasms, Male/pathology
- Breast Neoplasms, Male/radiotherapy
- Breast Neoplasms, Male/surgery
- Carcinoma, Ductal, Breast/drug therapy
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Ductal, Breast/radiotherapy
- Carcinoma, Ductal, Breast/surgery
- Chemotherapy, Adjuvant
- Combined Modality Therapy
- Estrogen Receptor Modulators/therapeutic use
- Estrogens
- Humans
- Lymph Node Excision
- Male
- Mastectomy
- Neoplasms, Hormone-Dependent/drug therapy
- Neoplasms, Hormone-Dependent/pathology
- Neoplasms, Hormone-Dependent/radiotherapy
- Neoplasms, Hormone-Dependent/surgery
- Neoplasms, Multiple Primary/drug therapy
- Neoplasms, Multiple Primary/epidemiology
- Neoplasms, Multiple Primary/pathology
- Neoplasms, Multiple Primary/radiotherapy
- Neoplasms, Multiple Primary/surgery
- Radiotherapy, Adjuvant
- Tamoxifen/therapeutic use
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13
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García-Cruz E, Castañeda-Argáiz R, Carrión A, Alcover J, Sallent A, Leibar-Tamayo A, Romero-Otero J, Alcaraz A. Preoperative hormonal pattern in patients undergoing radical prostatectomy due to prostate cancer. Actas Urol Esp 2013; 37:280-5. [PMID: 23246101 DOI: 10.1016/j.acuro.2012.08.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2012] [Revised: 08/02/2012] [Accepted: 08/07/2012] [Indexed: 11/30/2022]
Abstract
OBJECTIVE There is controversial evidence regarding preoperative testosterone (T) levels related to poor prognosis factors after radical prostatectomy (RP). The aim of this manuscript is to determine the relationship between preoperative T levels and final pathologic report together to biochemical recurrence after RP. MATERIALS AND METHODS We prospectively analysed 143 patients submitted to RP from February 2008 to June 2010 in our centre. Pretreatment T and sex hormone-binding globulin levels were determined as part of our clinical protocol. Free calculated (fT) and bioavailable (bioT) T were calculated using Vermeulen's formula. Low T levels were defined as 346 ng/dL or less. A comparative analysis with variables pTNM, positive margins, tumour burden, Gleason score, multifocality and biochemical recurrence (using both PSA>0.4 ng/dL and PSA>0.2 ng/dL as cut-off values) was performed, according to preoperative levels of T. RESULTS Variables Gleason score, rate and number of positive margins, tumour burden, tumour multifocality, time to biochemical recurrence and pathological stage were not related to preoperative hormonal levels. Preoperative T<346 ng/dL was not found to be related to PSA recurrence (PSA>0,4 ng/dL log-rank, P=.512), although a trend was observed when PSA>0,2 ng/dL (log-rank, P=.097). CONCLUSION Preoperative T levels were not related to final pathological report or to biochemical recurrence.
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Affiliation(s)
- E García-Cruz
- Departamento de Urología, Hospital Clínic, Barcelona, España.
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14
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Eichholz A, Ferraldeschi R, Attard G, de Bono JS. Putting the brakes on continued androgen receptor signaling in castration-resistant prostate cancer. Mol Cell Endocrinol 2012; 360:68-75. [PMID: 21986558 DOI: 10.1016/j.mce.2011.09.038] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2011] [Accepted: 09/26/2011] [Indexed: 10/17/2022]
Abstract
Patients with advanced prostate cancer initially respond very well to medical or surgical castration. Despite a good initial response, the disease progresses to a castration-resistant state. Castration-resistant prostate cancer (CRPC) remains addicted to androgen receptor signaling. The addition of conventional anti-androgen agents, such as bicalutamide, only provides a transient benefit. This has led to a search for further drug targets. Cytochrome P450 17 (CYP17) is an enzyme that is vital for the adrenal biosynthesis of androgens. The CYP17 inhibitor abiraterone acetate has a proven benefit in a phase III randomized trial and other CYP17 inhibitors are currently being evaluated. The novel antiandrogen MDV3100 is a small molecule androgen receptor antagonist with promising activity. Heat shock proteins (HSPs) bind to the androgen receptor and modify its activity. Several HSP inhibitors are under evaluation in clinical trials. This review explores the role of CYP17 inhibitors, MDV3100, and HSP inhibitors.
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Affiliation(s)
- Andrew Eichholz
- Institute of Cancer Research, 15 Cotswold Road, Sutton, Surrey SM2 5NG, United Kingdom.
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15
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Waltering KK, Urbanucci A, Visakorpi T. Androgen receptor (AR) aberrations in castration-resistant prostate cancer. Mol Cell Endocrinol 2012; 360:38-43. [PMID: 22245783 DOI: 10.1016/j.mce.2011.12.019] [Citation(s) in RCA: 123] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2011] [Revised: 12/29/2011] [Accepted: 12/29/2011] [Indexed: 11/20/2022]
Abstract
Genetic aberrations affecting the androgen receptor (AR) are rare in untreated prostate cancers (PCs) but have been found in castration-resistant prostate cancers (CRPCs). Further, successful treatment with novel endocrine therapies indicates that CRPCs remain androgen-sensitive. Known AR aberrations include amplification of the AR gene leading to the overexpression of the receptor, point mutations of AR resulting in promiscuous ligand usage, and constitutively active AR splice variants. Gain, or amplification, of the AR gene is one of the most frequent genetic alterations observed in CRPCs. Up to 80% of CRPCs have been reported to carry an elevated AR gene copy number, and about 30% have a high-level amplification of the gene. AR mutations are also commonly observed and have been found in approximately 10-30% of the CRPC treated with antiandrogens; however, the frequency and significance of AR splice variants is still unclear. Because AR aberrations are found almost exclusively in CRPC, these alterations must have been selected for during therapy. Interestingly, these aberrations lead to activation of the receptor, despite treatment-induced emergence of therapy-resistant tumor clones. Therefore, future novel treatment strategies should focus on suppressing AR activity in CRPC.
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Affiliation(s)
- Kati K Waltering
- Computational Systems Biology, Tampere University of Technology, Tampere, Finland
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16
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Hu JC, Williams SB, O'Malley AJ, Smith MR, Nguyen PL, Keating NL. Androgen-deprivation therapy for nonmetastatic prostate cancer is associated with an increased risk of peripheral arterial disease and venous thromboembolism. Eur Urol 2012; 61:1119-28. [PMID: 22336376 PMCID: PMC3719131 DOI: 10.1016/j.eururo.2012.01.045] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2011] [Accepted: 01/24/2012] [Indexed: 11/22/2022]
Abstract
BACKGROUND Previous studies demonstrate that androgen-deprivation therapy (ADT) with gonadotropin-releasing hormone (GnRH) agonists and orchiectomy for prostate cancer (PCa) is associated with cardiovascular disease. However, few studies have examined its effect on the peripheral vascular system. OBJECTIVE To study the risk of peripheral artery disease (PAD) and venous thromboembolism associated with ADT for PCa. DESIGN, SETTINGS, AND PARTICIPANTS This was a population-based observational study of 182 757 US men ≥ 66 yr of age who were diagnosed with nonmetastatic PCa from 1992 to 2007, with a median follow-up of 5.1 yr, of whom 47.8% received GnRH agonists and 2.2% orchiectomy. MEASUREMENTS We used Cox proportional hazards models with time-varying treatment variables to adjust for demographic and tumor characteristics in assessing whether treatment with GnRH agonists or orchiectomy were associated with PAD and/or venous thromboembolism. RESULTS AND LIMITATIONS GnRH agonist use was associated with an increased risk of incident PAD (adjusted hazard ratio [HR]: 1.16; 95% confidence interval [CI], 1.12-1.21) and incident venous thromboembolism (adjusted HR: 1.10; 95% CI, 1.04-1.15). In addition, orchiectomy was associated with an increased risk of peripheral arterial disease (adjusted HR: 1.13; 95% CI, 1.02-1.26) and venous thromboembolism (adjusted HR: 1.27; 95% CI, 1.11-1.45). Limitations include the observational study design and the inability to assess the use of oral antiandrogens. CONCLUSIONS ADT for nonmetastatic PCa is associated with an increased risk of PAD and venous thromboembolism. Additional research is needed to better understand the potential risks and benefits of ADT, so that this treatment can be targeted to patients for whom the benefits are clearest.
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Affiliation(s)
- Jim C Hu
- Institute of Urologic Oncology, Department of Urology, David Geffen School of Medicine at UCLA, Los Angeles, CA 90024, USA.
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17
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Schallier D, Decoster L, Braeckman J, Fontaine C, Degrève J. Docetaxel in the treatment of metastatic castration-resistant prostate cancer (mCRPC): an observational study in a single institution. Anticancer Res 2012; 32:633-641. [PMID: 22287756] [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: 05/31/2023]
Abstract
BACKGROUND Treatment with docetaxel in combination with prednisone is the standard first-line treatment in patients with metastatic castration-resistant prostate cancer (mCRPC). For patients failing first-line docetaxel no standard has emerged. OBJECTIVES The outcome in routine daily clinical practice of a cohort of unselected chemotherapy-naïve mCRPC patients treated with docetaxel plus methylprednisolone as first- and further-line treatment in a single institution was investigated. PATIENTS AND METHODS Data from the medical records of patients treated with docetaxel plus methylprednisolone either in a three-weekly (75 mg/m(2)) (D3) or a three-of-four-weekly (35 mg/m(2))(D1) schedule as first- or further-line treatment were analysed with respect to clinical and prostate-specific antigen (PSA) response, time-on-treatment (TOT), treatment-free interval (TFI), overall survival time (OS) and toxicity and were compared to the results of the registration study TAX 327. RESULTS Out of 41 patients, 28 and 13 received first-line docetaxel according to the D3 and the D1 schedules respectively. An overall PSA response ≥50% was achieved in thirty patients (73%). In ten patients (24%) the PSA level was normalised. The median OS of the total population was 18.7 months. No significant differences were observed between the D3 and the D1 regimens with respect to PSA response, duration of PSA response, TOT, TFI and OS. Patients obtaining a normalisation of PSA level achieved a significantly superior OS, TOT and TFI compared to those without normalisation of PSA. Second-line treatment with docetaxel in nine patients induced a normalisation in PSA level in two (22%). The TOT and TFI from the start of second-line treatment, was significantly superior in docetaxel compared to non-docetaxel treated patients. Treatment with docetaxel was well-tolerated and only two patients were withdrawn for non-haematological toxicity during first- and further-line treatment. There were no differences in either subjective or objective side-effects between both treatment schedules. CONCLUSION The results of the retrospective analysis of non-selected patients with mCRPC treated with docetaxel chemotherapy are in line with the data from TAX 327. Normalisation of PSA during first-line treatment with docetaxel is associated with a better survival irrespective of second- or further-line treatment used. Retreatment with docetaxel in second- or further-line remains a treatment option in docetaxel-sensitive patients.
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Affiliation(s)
- D Schallier
- UZ Brussels, Laarbeeklaan 101, 1090 Brussels, Belgium.
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18
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Takei H, Ohsumi S, Shimozuma K, Takehara M, Suemasu K, Ohashi Y, Hozumi Y. Health-related quality of life, psychological distress, and adverse events in postmenopausal women with breast cancer who receive tamoxifen, exemestane, or anastrozole as adjuvant endocrine therapy: National Surgical Adjuvant Study of Breast Cancer 04 (N-SAS BC 04). Breast Cancer Res Treat 2012; 133:227-36. [PMID: 22234519 DOI: 10.1007/s10549-011-1943-y] [Citation(s) in RCA: 35] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2011] [Accepted: 12/23/2011] [Indexed: 11/25/2022]
Abstract
Health-related quality of life (HRQOL), symptoms of depression, and adverse events (AEs) were compared between Japanese postmenopausal patients with hormone-sensitive breast cancer (BC) who received adjuvant tamoxifen, exemestane, or anastrozole in an open-labeled, randomized, multicenter trial designated as the National Surgical Adjuvant Study of Breast Cancer (N-SAS BC) 04 substudy of the Tamoxifen Exemestane Adjuvant Multinational (TEAM) trial. During the first year of treatment, HRQOL and symptoms of depression were analyzed using the Functional Assessment of Cancer Therapy-Breast (FACT-B) and its Endocrine Symptom Subscale (ES), and the Center for Epidemiologic Studies Depression Scale (CES-D), respectively. In addition, predefined AEs were analyzed. A total of 166 eligible patients were randomly assigned to receive adjuvant tamoxifen, exemestane, or anastrozole. FACT-B scores increased after treatment began and remained significantly higher in the tamoxifen group than in the exemestane group or anastrozole group during the first year (P = 0.045). FACT-B scores were similar in the exemestane group and anastrozole group. ES scores and CES-D scores were similar in all treatment groups. Arthralgia and fatigue were less frequent, but vaginal discharge was more frequent in the tamoxifen group than in the exemestane group or anastrozole group. HRQOL was better in Japanese postmenopausal women treated with tamoxifen than those treated with exemestane or anastrozole. HRQOL and AEs were similar with exemestane and anastrozole. Given the results of the TEAM trial, upfront use of tamoxifen followed by an aromatase inhibitor (AI) may be an important option for adjuvant endocrine therapy in Japanese postmenopausal women.
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Affiliation(s)
- Hiroyuki Takei
- Division of Breast Surgery, Saitama Cancer Center, 818 Komuro Ina, Kita-Adachi, Saitama 362-0806, Japan.
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19
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Novoa Vargas A, Font López KC, Amador DD. [Letrozole vs. tamoxifen as neoadjuvant therapy for postmenopausal patients with hormone-dependent locally-advanced breast cancer]. Ginecol Obstet Mex 2011; 79:553-557. [PMID: 21966856] [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] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND Previous studies demonstrated that Letrozole (aromatase inhibitor) and tamoxifen (selective modulator of estrogen receptors) are effective in the treatment of postmenopausal women with locally advanced tumors, stage III and hormone dependent. OBJECTIVE To present display the complete clinical answer incidence and the complete pathological answer with the use of induction hormonotherapy. METHODS Put-analysis in 40 patients with breast cancer, to chanalicular infiltrated, eligible were treated in a prospective study, to double blind person, using per os: letrozol, 2.5 mg; tamoxifen, 20 mg, known widely like selective modulator of estrogen receivers; oral route, during 36 consecutive months. Reports at the beginning were taken, subsequent to 3, 6 and 12 months to evaluate the frequency of complete respond. The patients, who did not show answer neoadjuvant therapy, were put under treatment with radiotherapy. The patients who showed good partial pathological respond, or clinical partial respond, went candidates to radical mastectomy. According to the protocol of the study, the patients subsequent to surgery who showed partial pathological respond or complete pathological respond, continued adjuvant handling adyuvant therapy by 2 years consecutive or until the presence of progression of the disease. It was used like statistical method Chi2, with p of Table cloth to evaluate the differences. RESULTS During a period of 3 years, january of the 2003 to january of the 2005, 2 groups of patients, 40 studied altogether; the age average was of 65,5 years, with a rank of 55 to 75 years with breast cancer, stages: IIA to IIIB. Without complete respond 25% of the group with tamoxifen; 20% with letrozol Those patients happened to radiotherapy. The collateral effects of the use of hormonotherapy with letrozol appeared in a 55% and with the use of tamoxifen in a 60% of the patients with breast cancer (p = 0.5). They did not respond to neoadyuvant therapy (hormonal receptors < to 30%): with letrozol 19% of them and 25% with tamoxifen; reason why they received treatment with radiotherapy. All patients candidates to surgery, were benefitted with the mastectomy handling. CONCLUSIONS Results although preliminary, suggest that neoadyuvant treatment with hormone-therapy in postmenopausal patients with breast cancer, have good prognosis. Induction therapy, were better tolerated, with greater effectiveness and improved the clinical and objective respond in women with breast cancer in the postmenopausal. Work serves as tool to determine the indication to us of induction hormonotherapy; and identify to those patients with breast cancer, locally advanced in post menopause with better prognosis to be rescued with radical mastectomy. Study needs more background and show the impact of letrozol, as hormonotherapy used in neoadjuvancy, to confirm if relieves period without disease or survives, before mastectomy. In a near future, it shall important to investigate if is useful the radical mastectomy in those postmenopausal patients with complete objective respond, after the use of an aromatase inhibitor.
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MESH Headings
- Aged
- Antineoplastic Agents, Hormonal/therapeutic use
- Breast Neoplasms/diagnostic imaging
- Breast Neoplasms/drug therapy
- Breast Neoplasms/radiotherapy
- Breast Neoplasms/surgery
- Carcinoma, Ductal, Breast/diagnostic imaging
- Carcinoma, Ductal, Breast/drug therapy
- Carcinoma, Ductal, Breast/radiotherapy
- Carcinoma, Ductal, Breast/surgery
- Combined Modality Therapy
- Double-Blind Method
- Estrogens
- Female
- Humans
- Letrozole
- Mastectomy, Radical
- Middle Aged
- Neoadjuvant Therapy
- Neoplasms, Hormone-Dependent/diagnostic imaging
- Neoplasms, Hormone-Dependent/drug therapy
- Neoplasms, Hormone-Dependent/radiotherapy
- Neoplasms, Hormone-Dependent/surgery
- Nitriles/therapeutic use
- Palliative Care
- Postmenopause
- Progesterone
- Prospective Studies
- Remission Induction
- Selective Estrogen Receptor Modulators/therapeutic use
- Tamoxifen/therapeutic use
- Treatment Outcome
- Triazoles/therapeutic use
- Ultrasonography
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20
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Cleffi S, Neto AS, Reis LO, Maia P, Fonseca F, Wroclawski ML, Neves M, Pompeo ACL, Del Giglio A, Faria EF, Tobias-Machado M. [Androgen deprivation therapy and morbid obesity: do they share cardiovascular risk through metabolic syndrome?]. Actas Urol Esp 2011; 35:259-65. [PMID: 21459486 DOI: 10.1016/j.acuro.2011.01.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2010] [Revised: 12/31/2010] [Accepted: 01/12/2011] [Indexed: 11/18/2022]
Abstract
BACKGROUND Although the use of androgen deprivation therapy (ADT) has resulted in improved survival in men with advanced prostate cancer, the resulting hypogonadism is associated with profound adverse effects comparable to those found in morbid obesity, being cardiovascular risk among the most lethal. OBJECTIVES Evaluate metabolic syndrome, metabolic abnormalities and cardiovascular risk in patients with prostate cancer under ADT, not under ADT and morbid obese men. METHODS This is a cross-sectional study that involves 79 men presenting prostate cancer, of whom 54 under ADT and 25 not under ADT and 91 morbidly obese patients paired by sex and age. To define metabolic syndrome, we used the International Diabetes Federation (IDF) criteria. Metabolic abnormalities, metabolic markers and Framingham score to predict the ten year coronary heart disease risk were compared among patients under ADT, not under ADT and morbid obese. RESULTS Patients under ADT presented significantly greater occurrence of diabetes and central obesity and higher levels of total cholesterol and low density lipoprotein (LDL) compared to eugonadal men. The mean cardiovascular risk was significantly higher in patients under ADT (39.97±12.53% vs. 26.09±14.80%; p=0.021). Morbidly obese subjects had increased ten year coronary heart disease risk; comparable to patients under ADT (p=0.054). CONCLUSION This study suggests that patients under ADT show higher prevalence of metabolic abnormalities and cardiovascular risk similar to those found in morbidly obese subjects. It is possible that both processes share cardiovascular risk through metabolic syndrome.
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Affiliation(s)
- S Cleffi
- Departamento de Cardiología, FMABC, São Paulo, Brasil
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21
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Heinrich E, Probst K, Michel MS, Trojan L. Gastrin-releasing peptide: predictor of castration-resistant prostate cancer? Prostate 2011; 71:642-8. [PMID: 20945407 DOI: 10.1002/pros.21280] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2010] [Accepted: 08/30/2010] [Indexed: 11/05/2022]
Abstract
BACKGROUND Neuroendocrine (NE) cells of the prostate are known to be androgen-independent and NE peptides like gastrin-releasing peptide (GRP) or neuron-specific enolase (NSE) can stimulate growth in a paracrine manner, and this is thought to be one of the escape mechanisms in castration-resistant prostate cancer (CRPCa). In a longitudinal study, we investigated the development of the NE serum factors GRP, NSE, and chromogranin A and their correlation with prostate-specific androgen (PSA) during hormonal treatment. MATERIALS AND METHODS Thirty two patients, with histology-proven, localized or metastatic prostatic carcinoma (PCa), who were undergoing therapy with LHRH analogue or a combination of LHRH analog and peripheral androgen blockade, took part in the study. In addition, eight healthy volunteers were each tested twice for serum GRP to elicit a "physiological" standard value. Blood samples were taken periodically from each patient within an 18-month time frame. RESULTS We defined the standard value for GRP in the healthy participants as 0.852 ng/ml (mean + 2 SD) and observed that the GRP values for patients with PCa were significantly higher (P = 0.034). There was a positive correlation between PSA and GRP in patients with biochemical failure. CgA correlated with PSA development in the CRPCa patients. NSE values rose steadily over the study period, but with no correlation to PSA. CONCLUSION Our data confirm that NE factors are elevated during hormonal treatment of prostate cancer. GRP is higher in PCa patients undergoing androgen deprivation therapy and is possibly involved in the initiation of hormonal escape in PCa.
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Affiliation(s)
- Elmar Heinrich
- Department of Urology, University Hospital Mannheim, Mannheim, Germany.
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22
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Sartor AO. Progression of metastatic castrate-resistant prostate cancer: impact of therapeutic intervention in the post-docetaxel space. J Hematol Oncol 2011; 4:18. [PMID: 21513551 PMCID: PMC3102641 DOI: 10.1186/1756-8722-4-18] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2011] [Accepted: 04/23/2011] [Indexed: 02/01/2023] Open
Abstract
Despite the proven success of hormonal therapy for prostate cancer using chemical or surgical castration, most patients eventually will progress to a phase of the disease that is metastatic and shows resistance to further hormonal manipulation. This has been termed metastatic castrate-resistant prostate cancer (mCRPC). Despite this designation, however, there is evidence that androgen receptor (AR)-mediated signaling and gene expression can persist in mCRPC, even in the face of castrate levels of androgen. This may be due in part to the upregulation of enzymes involved in androgen synthesis, the overexpression of AR, or the emergence of mutant ARs with promiscuous recognition of various steroidal ligands. The therapeutic options were limited and palliative in nature until trials in 2004 demonstrated that docetaxel chemotherapy could significantly improve survival. These results established first-line docetaxel as the standard of care for mCRPC. After resistance to further docetaxel therapy develops, treatment options were once again limited. Recently reported results from phase 3 trials have shown that additional therapy with the novel taxane cabazitaxel (with prednisone), or treatment with the antiandrogen abiraterone (with prednisone) could improve survival for patients with mCRPC following docetaxel therapy. Compared with mitoxantrone/prednisone, cabazitaxel/prednisone significantly improved overall survival, with a 30% reduction in rate of death, in patients with progression of mCRPC after docetaxel therapy in the TROPIC trial. Similarly, abiraterone acetate (an inhibitor of androgen biosynthesis) plus prednisone significantly decreased the rate of death by 35% compared with placebo plus prednisone in mCRPC patients progressing after prior docetaxel therapy in the COU-AA-301 trial. Results of these trials have thus established two additional treatment options for mCRPC patients in the "post-docetaxel space." In view of the continued AR-mediated signaling on mCRPC, results from additional phase 3 studies with novel antiandrogens which are directed at inhibition of the AR (e.g., MDV3100), as well as other agents, are awaited with interest and may further expand the treatment choices for this difficult-to-manage population of patients.
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Affiliation(s)
- A Oliver Sartor
- Department of Medicine, Tulane University School of Medicine, 1430 Tulane Ave, SL-42, New Orleans, LA 70115, USA.
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Masuda N, Iwata H, Rai Y, Anan K, Takeuchi T, Kohno N, Takei H, Yanagita Y, Noguchi S. Monthly versus 3-monthly goserelin acetate treatment in pre-menopausal patients with estrogen receptor-positive early breast cancer. Breast Cancer Res Treat 2011; 126:443-51. [PMID: 21221770 DOI: 10.1007/s10549-010-1332-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2010] [Accepted: 12/23/2010] [Indexed: 01/14/2023]
Abstract
This study compared the efficacy and safety of a 3-monthly 10.8-mg depot goserelin (Zoladex(TM)) injection with the current 3.6 mg monthly dose in pre-menopausal Japanese women with estrogen receptor-positive (ER+) early breast cancer. This was a multicenter, open-label, randomized study. Primary endpoint was a non-inferiority analysis (10.8/3.6 mg) of the area under the concentration-time curve (AUC) of estradiol (E(2)) over the first 24 weeks. Secondary endpoints included E(2) and follicle-stimulating hormone (FSH) concentrations, menstruation, and safety and tolerability. In total, 170 patients were randomized to receive goserelin 10.8 mg every 3 months (n = 86) or 3.6 mg every month (n = 84). Mean AUCs for E(2) were similar between treatment groups (18.32 and 18.95 pg/ml·week for goserelin 10.8 and 3.6 mg, respectively). AUC ratio was 0.974 (95% confidence interval, 0.80, 1.19), indicating non-inferiority for goserelin 10.8 mg. Serum E(2) and FSH remained suppressed throughout the study and no patient experienced menses after week 16. No clinically important differences in safety and tolerability were observed between the two groups. In terms of E(2) suppression, 3-monthly goserelin 10.8 mg was non-inferior to monthly goserelin 3.6 mg in pre-menopausal women with ER+ breast cancer.
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Affiliation(s)
- Norikazu Masuda
- National Hospital Organization Osaka National Hospital, Osaka, Japan
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24
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Di Vita M, Zanghì A, Lanzafame S, Cavallaro A, Piccolo G, Berretta M, Grosso G, Cappellani A. Gallbladder metastases of breast cancer: from clinical-pathological patterns to diagnostic and therapeutic strategy. Clin Ter 2011; 162:451-456. [PMID: 22041804] [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] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Gallbladder metastasis of breast cancer are rare, particularly linked to lobular histotype and synchronous just in 1/4 cases. A review of the literature has been performed aimed to evidence the patterns of gallbladder metastases of breast cancer finding 15 cases to whom we added a 48 years old post-menopausal woman. 3 weeks after surgery for mixed ductal-lobular breast carcinoma she showed at the abdominal ultrasound, performed for staging, diffuse thickening of the gallbladder wall , coherent with a chronic cholecystitis and with the mild right-upper-abdominal pain that the patient complained in the last months. After laparoscopic cholecystectomy, the pathology report showed a metastatic lobular carcinoma of the breast. Two years later she presented with SNC metastases and died four months later. Lobular histotype is the most frequent breast neoplasm associated with gallbladder metastases. Usually metachronous, these metastases are sinchronous in 28% of cases. Symptoms are usually linked to coexisting acute or cronic cholecystitis. Rarely massive invasions lead to acute abdomen or jaundice. Imaging is rarely diagnostic for neoplasm. Our experience and data from literature lead to careful evaluate every anomaly observed in breast cancer patients. A careful evaluation of abdominal symptoms and of routine imaging examinations performed for staging and for treatment planning, could consent to detect and radically treat the metastases and appropriately assign the chemotherapy. Such approach can lead to discrete survival even in these unfortunate patients. Surgeons and gastroenterologists should be aware of the risk hidden behind apparently benign, mild diseases in such patients.
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MESH Headings
- Antineoplastic Agents, Hormonal/administration & dosage
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Aromatase Inhibitors/administration & dosage
- Biomarkers, Tumor/analysis
- Brain Neoplasms/secondary
- Breast Neoplasms/drug therapy
- Breast Neoplasms/pathology
- Breast Neoplasms/radiotherapy
- Breast Neoplasms/surgery
- Carcinoma, Ductal, Breast/diagnosis
- Carcinoma, Ductal, Breast/drug therapy
- Carcinoma, Ductal, Breast/radiotherapy
- Carcinoma, Ductal, Breast/secondary
- Carcinoma, Ductal, Breast/surgery
- Carcinoma, Lobular/diagnosis
- Carcinoma, Lobular/drug therapy
- Carcinoma, Lobular/radiotherapy
- Carcinoma, Lobular/secondary
- Carcinoma, Lobular/surgery
- Chemotherapy, Adjuvant
- Cholecystectomy, Laparoscopic
- Combined Modality Therapy
- Cyclophosphamide/administration & dosage
- Doxorubicin/administration & dosage
- Estrogens
- Fatal Outcome
- Female
- Gallbladder Neoplasms/diagnosis
- Gallbladder Neoplasms/drug therapy
- Gallbladder Neoplasms/secondary
- Gallbladder Neoplasms/surgery
- Humans
- Lymph Node Excision
- Mastectomy, Segmental
- Middle Aged
- Neoplasms, Hormone-Dependent/diagnosis
- Neoplasms, Hormone-Dependent/secondary
- Neoplasms, Hormone-Dependent/surgery
- Paclitaxel/administration & dosage
- Postmenopause
- Progesterone
- Radiotherapy, Adjuvant
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Affiliation(s)
- M Di Vita
- Department of Surgery-Catania University Hospital, General and Breast Surgery Unit, University of Catania, Italy.
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Chowdhury S, Harper P, Powles T. Castration refractory prostate cancer: cinderella finally comes to the ball. Onkologie 2010; 33:655-656. [PMID: 21124035 DOI: 10.1159/000322635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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26
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Izumi K, Mizokami A, Shima T, Narimoto K, Sugimoto K, Kobori Y, Maeda Y, Konaka H, Koh E, Namiki M. Preliminary results of tranilast treatment for patients with advanced castration-resistant prostate cancer. Anticancer Res 2010; 30:3077-3081. [PMID: 20683058] [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: 05/29/2023]
Abstract
BACKGROUND Tranilast is a therapeutic agent used in treatment of allergic diseases. It has been reported previously that tranilast has antitumour effects on prostate cancer cells. This study examined whether tranilast has clinical benefit for prostate cancer patients. PATIENTS AND METHODS Twenty-one Japanese patients with advanced castration-resistant prostate cancer (CRPC) were administered tranilast orally. RESULTS All patients had already been treated with combined androgen blockade followed by one or more salvage therapies and their prostate-specific antigen (PSA) continued to increase before starting tranilast. Median follow-up time was 14 months and median tranilast treatment time was 5 months. PSA progression was inhibited in 5 CRPC patients with bone metastasis. The survival rates at 12 and 24 months were 74.5% and 61.5%, respectively. CONCLUSION Although this study involved only pilot data, it indicates that tranilast may improve the prognosis of patients with advanced CRPC.
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Affiliation(s)
- Kouji Izumi
- Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, 13-1 Takara-machi, Kanazawa, Ishikawa 920-8641, Japan
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27
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Endri M, Cartei G, Zustovich F, Serino FS, Fassina A. Differential diagnosis of lung nodules: breast cancer metastases and lung tuberculosis. Infez Med 2010; 18:39-42. [PMID: 20424525] [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] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
In a follow-up a 74-year-old woman with breast cancer (clinical stage T4N1M0 at onset, treatment by surgical resection and tamoxifen) presented a combination of two distinct diseases in the lung: breast cancer metastasis and tuberculosis. A CT scan showed multiple pulmonary nodular lesions and in only one lesion fine needle aspiration cytology (FNAC) diagnosed tuberculosis. After specific antibiotic therapy, isoniazide and rifampin, a CT scan highlighted disappearance of tubercular lesion. Because occurrence of tuberculosis during chemo or hormone therapy for metastatic breast cancer is rare, the present case is noteworthy. Indeed, it is worth pointing out the differential diagnosis of pulmonary nodular lesions in patients with cancer and the possible reactivation of tuberculosis even in patients without specific symptoms, without typical tubercular radiological features.
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MESH Headings
- Aged
- Androstadienes/therapeutic use
- Antineoplastic Agents, Hormonal/therapeutic use
- Breast Neoplasms/complications
- Breast Neoplasms/drug therapy
- Breast Neoplasms/surgery
- Carcinoma, Ductal, Breast/complications
- Carcinoma, Ductal, Breast/drug therapy
- Carcinoma, Ductal, Breast/secondary
- Carcinoma, Ductal, Breast/surgery
- Diagnosis, Differential
- Estrogens
- Female
- Humans
- Lung Neoplasms/drug therapy
- Lung Neoplasms/secondary
- Lymphatic Metastasis
- Neoplasms, Hormone-Dependent/drug therapy
- Neoplasms, Hormone-Dependent/secondary
- Neoplasms, Hormone-Dependent/surgery
- Progesterone
- Recurrence
- Tamoxifen/therapeutic use
- Tomography, X-Ray Computed
- Tuberculosis, Pulmonary/complications
- Tuberculosis, Pulmonary/diagnosis
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Affiliation(s)
- Mauro Endri
- Department of Medicine, Operative Unit of Medicine 2, Azienda Ospedaliera Santa Maria degli Angeli, Pordenone City Hospital, Pordenone, Italy
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28
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Abstract
The biological functions of clusterin (CLU, also known as ApoJ, SGP2, TRPM-2, CLI) have been puzzling the researchers since its first discovery in the early 80's. We know that CLU is a single 9-exons gene expressing three protein forms with different sub-cellular localisations and diverse biological functions. Despite the many reports from many research teams on CLU action and its relation to tumourigenesis, contradictions in the data and alternative hypothesis still exist. Understanding the role of CLU in tumourigenesis is complicated not only by the existence of different protein forms but also by the changes of tumours over time and the selection pressures imposed by treatments such as hormone ablation or chemotherapy. This review focuses on recent discoveries concerning the role of CLU in prostate and breast cancer onset and progression. Although CLU acts primarily as a tumour suppressor in the early stages of carcinogenesis, consistent with its role in the involution of the prostate following castration, late stage cancer may overexpress CLU following chemotherapeutic drugs or hormonal ablation therapy. High expression of secreted or cytoplasmic CLU may represent a pro-survival stimulus because it confers increased resistance to killing by anti-cancer drugs or enhances tumour cell survival in specific niches.
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Affiliation(s)
- Federica Rizzi
- Dipartimento di Medicina Sperimentale, Sezione di Biochimica, Biochimica Clinica e Biochimica dell'Esercizio Fisico, Università di Parma, Parma, Italy
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29
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Gasent Blesa JM, Alberola Candel V, Giner Marco V, Giner-Bosch V, Provencio Pulla M, Laforga Canales JB. Experience with fulvestrant acetate in castration-resistant prostate cancer patients. Ann Oncol 2010; 21:1131-2. [PMID: 20139153 DOI: 10.1093/annonc/mdq010] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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30
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Carlesimo B, Tempesta M, Fioramonti P, Bistoni G, Ruggiero M, Marchetti F. [Breast cancer metastasis in distal phalanx of the big toe. Case report]. G Chir 2009; 30:487-489. [PMID: 20109377] [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: 05/28/2023]
Abstract
Breast cancer represents the most prevalent malignancies in women and bone is the first site of metastasis in 26-50% of cases. Usually metastasis involve limbs in 16%. We present a rare case of 47-year-old woman, who underwent to monolateral mastectomy for lobular cancer. After 8 years from surgery, she presented pain, swelling and functional limitations, gradually increasing, to the left big toe. X-rays and MRI showed a lucent area of bone destruction on the shaft of the distal phalanx of the left big toe. Surgical biopsy on the excised bone assessed for breast cancer metastasis.
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MESH Headings
- Antineoplastic Agents, Hormonal/therapeutic use
- Bone Neoplasms/diagnosis
- Bone Neoplasms/secondary
- Breast Neoplasms/drug therapy
- Breast Neoplasms/pathology
- Breast Neoplasms/surgery
- Carcinoma, Lobular/diagnosis
- Carcinoma, Lobular/drug therapy
- Carcinoma, Lobular/secondary
- Carcinoma, Lobular/surgery
- Chemotherapy, Adjuvant
- Combined Modality Therapy
- Diagnostic Errors
- Estrogens
- Female
- Humans
- Lung Neoplasms/diagnostic imaging
- Lung Neoplasms/secondary
- Mastectomy, Radical
- Middle Aged
- Neoplasms, Hormone-Dependent/diagnosis
- Neoplasms, Hormone-Dependent/drug therapy
- Neoplasms, Hormone-Dependent/secondary
- Neoplasms, Hormone-Dependent/surgery
- Osteomyelitis/diagnosis
- Radiography
- Tamoxifen/therapeutic use
- Toe Phalanges/pathology
- Toe Phalanges/surgery
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Affiliation(s)
- B Carlesimo
- "Sapienza" Università di Roma, Policlinico Umberto l di Roma, Cattedra Chirurgia Plastica Ricostruttiva ed Estetica
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31
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Malewski T, Milewicz T, Krzysiek J, Gregoraszczuk EL, Augustowska K. Regulation of Msx2 Gene Expression by Steroid Hormones in Human Nonmalignant and Malignant Breast Cancer Explants Cultured in Vitro. Cancer Invest 2009; 23:222-8. [PMID: 15945508 DOI: 10.1081/cnv-200055958] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Muscle segment homeobox genes, which regulate developmental programs and are expressed in embryonic and adult tissue, play a role in development of some malignancies. There are no reports on the expression of these families of genes in breast cancer tissue. The aim of this study was to compare expression of Msx2 gene in breast cancer of different genotypes as well as in surrounding nonmalignant tissues. Explants obtained during surgery were divided according to their sex steroid receptor status determined by immunocytochemistry. Four explants obtained from malignant and nonmalignant tissue of each individual patient were incubated in a control medium or with the addition of progesterone (10(-7) M) alone, estradiol 17 beta (10(-5) M) or both. The relative level of Msx2 transcripts was evaluated by a semiquantitative RT-PCR and cell proliferation by Alamar Blue test. Results of RT-PCR analysis showed that the relative expression of Msx2 gene depended on the presence of ER/PR receptors both in nonmalignant and malignant tissues Relative amount of Msx2 mRNA was the highest in surrounding nonmalignant ER+/PR- and ER-/PR+ tissue, whereas in ER-/PR- and ER+/PR+ tissue it was 1.4-1.6-fold lower. Tumorigenesis led to about a twofold decrease in the relative amount of Msx2 mRNA except for ER+/PR+ immunophenotype, where no changes were observed. Addition of estradiol or progesterone to the culture of ER-/PR- type tissue explants did not change significantly the relative amount of Msx2 gene mRNA. An opposite effect was observed in ER+/PR- type of tissue. Addition of estradiol alone, or estradiol and progesterone together to tissue culture explants decreased two to three fold the relative amount of Msx2 gene mRNA in both, malignant and surrounding tissues. Progesterone alone had no effect on Msx2 gene expression in this type of tissue. The most complicated regulation was observed in ER+/PR+ type of tissue. Culture of tissue explants supplemented with estradiol significantly increased the relative amount of Msx2 gene mRNA in the surrounding tissue. Progesterone enhanced the stimulatory effect of estradiol in surrounding tissues but not in the malignant tissue. Increased expression of Msx2 correlated with an increased proliferation in ER-/PR- and ER+/PR+ types, but not in ER+/PR- type of tissues. In conclusion, obtained results provide evidence that estrogen affects Msx2 gene expression. Significant changes in the relative amount of Msx2 gene mRNA and lack of canonical ERE element in 5'-upstream sequence of this gene suggest that regulation takes place indirectly probably by protein-protein interaction. The decrease in the relative amount of Msx2 gene mRNA in ER+/PR- type tumor suggests that progesterone also affects Msx2 gene expression by an indirect mechanism(s).
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Affiliation(s)
- T Malewski
- Department of Molecular Biology, Institute of Genetics and Animal Breeding, Polish Academy of Sciences, Jastrzêbiec, Poland
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33
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Nemitz N, Kurmann PT, Van Linthoudt D. [Intensification of a diffuse chronic pain syndrome by the introduction of an aromatase inhibitor]. Praxis (Bern 1994) 2008; 97:137-141. [PMID: 18549014 DOI: 10.1024/1661-8157.97.3.137] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
A case of a menopausal woman known for a chronic diffuse pain syndrome and breast cancer positive for estrogen receptors is presented. She developed an increase of her diffuse pain syndrome and joint aches after the introduction of an aromatase inhibitor. Soreness quickly improved after the interruption of the drug. We emphasize some etiological hypotheses concerning the painful symptoms, especially the role of aromatase and estrogens.
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MESH Headings
- Aged
- Anastrozole
- Antineoplastic Agents, Hormonal/adverse effects
- Antineoplastic Agents, Hormonal/therapeutic use
- Aromatase Inhibitors/adverse effects
- Aromatase Inhibitors/therapeutic use
- Breast Neoplasms/drug therapy
- Breast Neoplasms/pathology
- Breast Neoplasms/surgery
- Carcinoma, Ductal/drug therapy
- Carcinoma, Ductal/pathology
- Carcinoma, Ductal/surgery
- Chemotherapy, Adjuvant
- Combined Modality Therapy
- Disease Progression
- Female
- Fibromyalgia/chemically induced
- Fibromyalgia/diagnosis
- Humans
- Mastectomy
- Neoplasms, Hormone-Dependent/drug therapy
- Neoplasms, Hormone-Dependent/pathology
- Neoplasms, Hormone-Dependent/surgery
- Nitriles/adverse effects
- Nitriles/therapeutic use
- Receptors, Estrogen/analysis
- Receptors, Estrogen/drug effects
- Receptors, Progesterone/analysis
- Receptors, Progesterone/drug effects
- Triazoles/adverse effects
- Triazoles/therapeutic use
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Affiliation(s)
- N Nemitz
- Département de Médecine, service de Rhumatologie, Hôpital Neuchâtelois, La Chaux-de-Fonds
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34
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Bershteĭn LM, Tsyrlina EV, Porozova AA, Poroshina TE. [Estrogen-dependence of thyroid carcinoma: testing with estradiol preparations and tamoxifen]. Vopr Onkol 2008; 54:710-714. [PMID: 19241844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Twenty-four patients with thyroid carcinoma receiving thyroxine were examined. The thyroid gland had been extirpated in 20; hemithyreoidectomy (4). Tests with ethinyl estradiol (50 mcg, per os, 6 days) (8), estradiol valerate (2 mg, per os, 12 days) (10), and tamoxifen (40 mg, per os, 14 days) (6) were carried out on the assumption of normal and neoplastic thyroid epithelium sensitivity to estrogen stimulation. Blood thyroglobulin, TSH and estradiol levels were assayed before and after loading. Thyroglobulin concentrations increased in 5 out of 24 patients (ethinyl estradiol--1 out of 8, estradiol valerate--2 out of 10 and tamoxifen--2 out of 6); those of TSH--in 6 out 24 (3 out of 8, 2 out of 10 and 1 out of 6, respectively). Enhanced thyroglobulin correlated with higher levels of TSH in 2 out of 5 and with blood-estradiol--in 4 out of 5. It was suggested that at least, in some patients, the preparations might produce a direct stimulating effect on thyroglobulin biosynthesis in the thyroid tissue remnants. Further research is suggested or on whether tamoxifen exerts pro- or antiestrogenic influence on thyroid epithelium.
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Abstract
Neoadjuvant chemotherapy trials have consistently reported lower response rates in hormone receptor-positive (HR+) breast cancer when compared with HR− cases. Preoperative endocrine therapy has therefore become a logical alternative and has gained considerable momentum from the finding that aromatase inhibitors (AIs) are more effective than tamoxifen for HR+ breast cancer in both the neoadjuvant and adjuvant settings. The most convincing neoadjuvant trial to demonstrate the superiority of an AI versus tamoxifen was the P024 study, a large multinational double-blind trial in postmenopausal women with HR+ breast cancer ineligible for breast-conserving surgery. The overall response rate (ORR) was 55% for letrozole and 36% for tamoxifen (P < 0.001). Significantly more letrozole-treated patients underwent breast-conserving surgery (45 vs. 35%, respectively; P = 0.022). In addition, ORR was significantly higher with letrozole than tamoxifen in the human epidermal growth factor receptor HER1/HER2+ subgroup (P = 0.0004). The clinical efficacy of letrozole in HER2+ breast cancer was confirmed by fluorescent in situ hybridization analysis and was found to be comparable to that of HER2− cases (ORR 71% in both subsets). Biomarker studies confirmed the superiority of letrozole in centrally assessed estrogen receptor-positive (ER+) tumors and found a strong relationship with the degree of ER positivity for both agents. Interestingly, letrozole was effective even in marginally ER+ tumors and, unlike tamoxifen, consistently reduced the expression from estrogen-regulated genes (progesterone receptor and trefoil factor 1). Furthermore, when analyzed by Ki67 immunohistochemistry, letrozole was significantly more effective than tamoxifen in reducing tumor proliferation (P = 0.0009). Thus, neoadjuvant letrozole is safe and superior to tamoxifen in the treatment of postmenopausal women with HR+ locally advanced breast cancer.
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Affiliation(s)
- Matthew J Ellis
- Medical Oncology, Washington University, Campus Box 8056, 660 Euclid Ave, St Louis, MO 63110, USA.
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36
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Toi M, Ikeda T, Akiyama F, Kurosumi M, Tsuda H, Sakamoto G, Abe O. Predictive implications of nucleoside metabolizing enzymes in premenopausal women with node-positive primary breast cancer who were randomly assigned to receive tamoxifen alone or tamoxifen plus tegafur-uracil as adjuvant therapy. Int J Oncol 2007; 31:899-906. [PMID: 17786323] [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: 05/17/2023] Open
Abstract
Recent studies have demonstrated that tegafur-uracil (UFT) is useful for the adjuvant treatment of various types of cancers. To determine whether nucleoside metabolizing enzymes could be used to predict the response to UFT treatment in women with primary breast cancer, we retrospectively analyzed archived tumor tissue samples obtained from the 3rd Adjuvant Chemo-Endocrine Therapy for Breast Cancer (ACETBC) study, in which adjuvant treatment with tamoxifen (TAM) plus UFT for 2 years was compared with TAM alone for 2 years. Samples of tumor tissue were obtained from 192 premenopausal women with node-positive invasive breast cancer. The tissue samples were examined immunohistochemically to study the expression of thymidylate synthase (TS), thymidine phosphorylase (TP), and dihydropyrimidine dehydrogenase (DPD), as well as the expression of Her2 and p53. In patients with TS-positive tumors, the risk of relapse was significantly lower in the tamoxifen plus UFT group than in the tamoxifen alone group. After 2 years, however, there was a trend towards a decrease in the relative predictive value (RPV) of TS with time. No relationship to outcome was detected for TP or DPD. Expression of Her2 or p53 was a significant prognostic indicator in the tamoxifen alone group. TS, but not TP or DPD, may be a useful predictor of response to UFT therapy. After 2 years, the RPV of TS decreased with time, suggesting that 2 years of treatment with oral fluorouracil derivatives may be inadequate. Further studies are required to investigate this possibility.
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Affiliation(s)
- Masakazu Toi
- Department of Surgery (Breast Surgery), Graduate School of Medicine, Kyoto University, Kyoto 606-8507, Japan.
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Abstract
Adjuvant endocrine therapy plays an important role in the management of hormone-receptor-positive early breast cancer, and has increased life expectancy for millions of women. Many patients receive adjuvant treatment for at least 5 years following tumor resection, hence good long-term safety is important for endocrine agents to gain widespread acceptance. Tamoxifen has been used as adjuvant therapy for early breast cancer for many years, and safety data have been well documented, but a poor risk:benefit profile limits treatment duration to 5 years. Increased efficacy over tamoxifen and good tolerability have recently made the third-generation aromatase inhibitors (AIs) the first-choice agents for adjuvant endocrine therapy; however, it is currently not known whether AI therapy, like tamoxifen, will be limited to 5 years. Many side effects of endocrine therapy, such as hot flushes and mood disturbances, are related to estrogen deprivation and are common to tamoxifen and AIs, reflecting the mechanism of action of these drugs. In addition, tamoxifen has estrogenic effects that are beneficial in some tissues: tamoxifen lowers serum cholesterol levels and protects against bone loss and cardiovascular disease, but is also associated with potentially life-threatening side effects, such as endometrial cancer and thromboembolic disease. As AIs lack estrogenic activity, they are not associated with these serious adverse events. Clinical trials comparing AIs with tamoxifen in the adjuvant setting have shown that AIs are well tolerated and are associated with a lower incidence of gynecological symptoms and hot flushes than tamoxifen. However, AIs are associated with musculoskeletal side effects, such as arthralgia, myalgia and bone loss, but these events are preventable or manageable. The effects of AIs on lipid metabolism and the cardiovascular system are still debatable, but placebo-controlled trials provide no evidence to suggest that AIs adversely affect these systems. Furthermore, the AIs allow women to maintain a good quality of life, comparable with women receiving tamoxifen or placebo, and are a cost-effective therapeutic option. Ongoing trials will provide more information regarding the long-term effects of AI therapy and will provide comparative data on the efficacy and safety of the different AIs, thereby helping to determine the optimal treatment strategy for these highly effective and well-tolerated drugs.
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Kennedy T, Stewart AK, Bilimoria KY, Patel-Parekh L, Sener SF, Winchester DP. Treatment trends and factors associated with survival in T1aN0 and T1bN0 breast cancer patients. Ann Surg Oncol 2007; 14:2918-27. [PMID: 17638060 DOI: 10.1245/s10434-007-9441-5] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2006] [Accepted: 04/09/2007] [Indexed: 11/18/2022]
Abstract
BACKGROUND Breast conservation therapy (BCT) and adjuvant hormonal therapy for estrogen-receptor positive breast cancers have become standard of care. Our objectives were to evaluate trends in the surgical management and adjuvant therapy for early-stage breast cancer and to identify factors predicting survival. METHODS Using the National Cancer Data Base (NCDB), patients with node-negative breast cancers less than 1 cm (T1aN0M0 and T1bN0M0) from 1993-2004 were identified. The time periods of 1993-1994, 1998-1999, and 2003-2004 were compared to analyze trends in surgical management and adjuvant therapy. Cox Proportional Hazards modeling was used to examine factors predicting survival. RESULTS Overall, 123,212 cases of T1aN0M0 or T1bN0M0 breast cancer were identified. The use of breast conservation surgery increased from 61.3% in 1993/1994 to 78.3% in 2003/2004 with a concomitant decrease in the use of mastectomy. The use of radiation therapy also increased from 51.9% in 1993/1994 to 62.0% in 2003/2004. Adjuvant hormonal therapy administration rose sharply from 26.7% in 1993/1994 to 44.7% in 2003/2004. After adjusting for potential confounders, the difference in 5-year survival rates for T1a (94.3%) and T1b (93.1%) tumors was marginal (P = .04). Age, grade, size, and failure of BCS patients to receive radiation therapy and hormonal therapy were independent predictors of a higher likelihood of death. CONCLUSIONS BCS utilization increased over time, but mastectomy rates may still be considered high given the small size of tumors in this cohort and the percent of patients eligible for BCT. The use of hormonal therapy increased significantly over the past decade. Further investigation into patient and physician factors affecting treatment choices is needed if BCT and hormonal therapy utilization is to increase.
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MESH Headings
- Aged
- Aged, 80 and over
- Antineoplastic Agents, Hormonal/therapeutic use
- Breast Neoplasms/drug therapy
- Breast Neoplasms/mortality
- Breast Neoplasms/pathology
- Breast Neoplasms/surgery
- Chemotherapy, Adjuvant/trends
- Combined Modality Therapy/trends
- Databases, Factual
- Disease-Free Survival
- Drug Utilization/trends
- Female
- Guideline Adherence/trends
- Humans
- Lymph Nodes/pathology
- Mastectomy, Segmental/trends
- Middle Aged
- National Cancer Institute (U.S.)
- Neoplasm Staging
- Neoplasms, Hormone-Dependent/drug therapy
- Neoplasms, Hormone-Dependent/mortality
- Neoplasms, Hormone-Dependent/pathology
- Neoplasms, Hormone-Dependent/surgery
- Proportional Hazards Models
- Radiotherapy, Adjuvant/trends
- United States
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Affiliation(s)
- Timothy Kennedy
- Department of Surgery, Feinberg School of Medicine, Chicago, IL, USA
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39
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Hrushesky WJM, Retsky M, Baum M, Demicheli R. Re: Prognostic value of Ki67 expression after short-term presurgical endocrine therapy for primary breast cancer. J Natl Cancer Inst 2007; 99:1053; author reply 1053-4. [PMID: 17596578 DOI: 10.1093/jnci/djm019] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
MESH Headings
- Antineoplastic Agents, Hormonal/therapeutic use
- Biomarkers, Tumor
- Biopsy, Needle
- Breast Neoplasms/chemistry
- Breast Neoplasms/drug therapy
- Breast Neoplasms/immunology
- Breast Neoplasms/surgery
- Chemotherapy, Adjuvant
- Data Interpretation, Statistical
- Disease-Free Survival
- Female
- Gene Expression Regulation, Neoplastic
- Humans
- Ki-67 Antigen/analysis
- Ki-67 Antigen/metabolism
- Middle Aged
- Neoadjuvant Therapy/methods
- Neoplasms, Hormone-Dependent/chemistry
- Neoplasms, Hormone-Dependent/drug therapy
- Neoplasms, Hormone-Dependent/immunology
- Neoplasms, Hormone-Dependent/surgery
- Time Factors
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40
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Affiliation(s)
- P Neven
- Department of Gynecology, UZ Leuven, Belgium.
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41
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Mazouni C, Kau SW, Frye D, Andre F, Kuerer HM, Buchholz TA, Symmans WF, Anderson K, Hess KR, Gonzalez-Angulo AM, Hortobagyi GN, Buzdar AU, Pusztai L. Inclusion of taxanes, particularly weekly paclitaxel, in preoperative chemotherapy improves pathologic complete response rate in estrogen receptor-positive breast cancers. Ann Oncol 2007; 18:874-80. [PMID: 17293601 DOI: 10.1093/annonc/mdm008] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND We examined if inclusion of a taxane and more prolonged preoperative chemotherapy improves pathologic complete response (pCR) rate in estrogen receptor (ER)-positive breast cancer compared with three to four courses of 5-fluorouracil, doxorubicin, cyclophosphamide (FAC). PATIENTS AND METHODS Pooled analysis of results from seven consecutive neo-adjuvant chemotherapy trials including 1079 patients was carried out. These studies were conducted at MD Anderson Cancer Center from 1974 to 2001. Four hundred and twenty-six (39.5%) patients received taxane-based neo-adjuvant therapy. pCR rates and survival times were analyzed as a function of chemotherapy regimen and ER status. Multivariate logistic and Cox regression analysis were carried out to identify variables associated with pCR and survival. RESULTS Patients with ER-negative cancer had higher overall pCR rate than patients with ER-positive tumors (20.1% versus 4.9%, P < 0.001). In ER-negative patients, the pCR rates were 29% and 15% with and without a taxane (P < 0.001). In ER-positive patients, the pCR rates were 8.8% and 2.0% with and without a taxane (P < 0.001). In multivariate analysis, clinical tumor size (P < 0.001), ER-negative status (P < 0.001) and inclusion of a taxane (P = 0.01) were independently associated with pCR. For patients with pCR, survival was similar regardless of ER status or the type of regimen that induced pCR. CONCLUSION pCR rates increased for patients with both ER-positive and ER-negative tumors as regimens started to include a taxane and became longer. This indicates that a subset of patients with ER-positive breast cancer benefits from more aggressive chemotherapy, similarly to patients with ER-negative tumors.
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Affiliation(s)
- C Mazouni
- Department of Breast Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX 77230, USA
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42
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Tanaka S, Kawamura T, Nakamura N, Teramoto K, Arii S. Mucinous cystadenocarcinoma of the pancreas developing during hormone replacement therapy. Dig Dis Sci 2007; 52:1326-8. [PMID: 17372823 DOI: 10.1007/s10620-006-9482-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2006] [Accepted: 06/11/2006] [Indexed: 12/09/2022]
Abstract
Hormone replacement therapy (HRT) containing estrogens is generally used to relieve climacteric symptoms and to prevent osteoporosis and coronary heart disease [1], however, there has been increasing evidence of the HRT as the risk of hormone-dependent neoplasms including breast cancer [2], uterine endometrial cancer [3], ovarian cancer [4], and even lung cancer [5]. Noteworthy is mucinous cyst neoplasms (MCNs) of the pancreas, characterized by mucin-producing columnar epithelium supported by "ovarian-like" mesenchymal stroma, occur mostly in females expressing estrogen receptors [6, 7]. Although several reports regarding the closed relationship between MCNs and pregnancy [8, 9] might imply potential sex hormone-dependency of the MCNs [10], no correlation has been reported. This is the first case report of malignant MCN developing during continuous HRT after hysterectomy.
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MESH Headings
- Cystadenocarcinoma, Mucinous/chemically induced
- Cystadenocarcinoma, Mucinous/chemistry
- Cystadenocarcinoma, Mucinous/pathology
- Cystadenocarcinoma, Mucinous/surgery
- Estrogen Replacement Therapy/adverse effects
- Female
- Humans
- Hysterectomy
- Inhibins/analysis
- Middle Aged
- Neoplasms, Hormone-Dependent/chemically induced
- Neoplasms, Hormone-Dependent/chemistry
- Neoplasms, Hormone-Dependent/pathology
- Neoplasms, Hormone-Dependent/surgery
- Pancreatectomy
- Pancreatic Neoplasms/chemically induced
- Pancreatic Neoplasms/chemistry
- Pancreatic Neoplasms/pathology
- Pancreatic Neoplasms/surgery
- Receptors, Estrogen/analysis
- Receptors, Progesterone/analysis
- Splenectomy
- Stromal Cells/chemistry
- Stromal Cells/drug effects
- Stromal Cells/pathology
- Treatment Outcome
- Ultrasonography/methods
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Affiliation(s)
- Shinji Tanaka
- Department of Hepato-Biliary-Pancreatic Surgery, Tokyo Medical and Dental University, Graduate School of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.
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43
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Dowsett M, Smith IE, Ebbs SR, Dixon JM, Skene A, A'Hern R, Salter J, Detre S, Hills M, Walsh G. Prognostic value of Ki67 expression after short-term presurgical endocrine therapy for primary breast cancer. J Natl Cancer Inst 2007; 99:167-70. [PMID: 17228000 DOI: 10.1093/jnci/djk020] [Citation(s) in RCA: 473] [Impact Index Per Article: 27.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Tumor expression of the proliferation antigen Ki67 is widely used to assess the prognosis of cancer patients. A change in the expression of Ki67 after short-term exposure of patients to therapeutic agents is frequently used as a pharmacodynamic marker of efficacy, particularly among breast cancer patients before undergoing surgery. To determine the clinical significance of the level of tumor cell proliferation during endocrine therapy for breast cancer, we measured the expression of Ki67 in tumor biopsy samples taken before and after 2 weeks of presurgical treatment with anastrozole or tamoxifen or the combination of anastrozole plus tamoxifen in 158 patients with hormone receptor-positive primary disease. In a multivariable analysis, we found that higher Ki67 expression after 2 weeks of endocrine therapy was statistically significantly associated with lower recurrence-free survival (P = .004) whereas higher Ki67 expression at baseline was not. Larger baseline tumor size and lower estrogen receptor level after 2 weeks of treatment were also statistically significantly associated with poorer recurrence-free survival (P < .001 and P = .04, respectively). Our data indicate that measurements of tumor Ki67 level after short-term endocrine treatment may improve the prediction of recurrence-free survival by integrating the prognostic value of Ki67 level at baseline with changes in Ki67 level that are associated with treatment benefit.
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Affiliation(s)
- Mitch Dowsett
- Academic Department of Biochemistry, 4th Floor, Wallace Wing, The Royal Marsden Hospital, Fulham Road, London SW3 6 JJ, UK.
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44
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Abstract
Tamoxifen has been the gold standard adjuvant therapy for the treatment of postmenopausal women with hormone-receptor-positive (HR+) early breast cancer for many years. Tamoxifen treatment is limited to 5 years because of the development of de novo and acquired resistance, and an ongoing risk of adverse events, including endometrial cancer, thromboembolic events, and gynecological symptoms with long-term use. The third-generation aromatase inhibitors (AIs), letrozole, anastrozole, and exemestane, are displacing tamoxifen as the first-choice therapy for HR+ early breast cancer, and are now recommended as the preferred therapy by national and international guidelines. Recent randomized trials have demonstrated that the AIs are more effective than tamoxifen in preventing disease recurrence when used in substitution and sequential strategies in the early adjuvant setting, and letrozole has been shown to be more effective than placebo in the extended adjuvant setting (after 5 years of tamoxifen therapy). Trial safety data show that the overall tolerability of AIs is similar to that of tamoxifen, with adverse events being predictably characteristic of estrogen deprivation; however, some important differences in adverse event profiles between tamoxifen and the AIs have been demonstrated. In addition to antiestrogenic effects, tamoxifen acts as an estrogen agonist in some tissues, which can lead to serious side effects not associated with the AIs, which prevent estrogen biosynthesis. A lower incidence of gynecological and thromboembolic events is observed in patients taking AIs, and fewer cases of endometrial cancer are seen compared with tamoxifen. Adverse events that are more frequent with adjuvant AI therapy compared with tamoxifen include arthralgia and myalgia, bone loss, and effects on the cardiovascular system and blood lipids. The effects of AIs on bone are predictable and may be easily managed, where necessary, with bisphosphonates. Studies examining the effects of AIs on the cardiovascular system and lipid profiles, including in the extended adjuvant setting, suggest that these adverse events may be due to the absence of a protective effect of tamoxifen rather than true AI toxicity. Further studies are required to determine the long-term safety of AI therapy in postmenopausal women with HR+ early breast cancer.
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Affiliation(s)
- PierFranco Conte
- Department of Oncology and Hematology, The University of Modena and Reggio Emilia, Modena, Italy. conte.
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45
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Abstract
Endocrine therapy is a required element of the management of premenopausal women with early-stage steroid hormone receptor-positive breast cancer. There is uncertainty about how best to implement that therapy using the strategies of tamoxifen and estrogen deprivation as well as how to integrate these approaches with chemotherapy. Other research focuses on identification of improved markers for endocrine response or resistance and on the special side effects of endocrine therapy in young women.
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Affiliation(s)
- Regina J Brown
- Breast Cancer Program, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD 21231-1000, USA
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46
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Aneja R, Zhou J, Zhou B, Chandra R, Joshi HC. Treatment of hormone-refractory breast cancer: apoptosis and regression of human tumors implanted in mice. Mol Cancer Ther 2006; 5:2366-77. [PMID: 16985071 DOI: 10.1158/1535-7163.mct-06-0205] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Following surgery, the hormone dependence of breast tumors is exploited for therapy using antagonists such as tamoxifen, although occasional hormone-resistant clones do appear. Another chemotherapeutic strategy uses microtubule inhibitors such as taxanes. Unfortunately, these agents elicit toxicities such as leukocytopenia, diarrhea, alopecia, and peripheral neuropathies and are also associated with the emergence of drug resistance. We have previously described a tubulin-binding, natural compound, noscapine, that was nontoxic and triggered apoptosis in many cancer types albeit at 10 mumol/L or higher concentrations depending on the cell type. We now show that a synthetic analogue of noscapine, 9-bromonoscapine, is approximately 10-fold to 15-fold more potent than noscapine in inhibiting cell proliferation and induces apoptosis following G2-M arrest in hormone-insensitive human breast cancers (MDA-MB-231). Furthermore, a clear loss of mitochondrial membrane potential, release of cytochrome c, activation of the terminal caspase-3, and the cleavage of its substrates such as poly(ADP-ribose) polymerase, suggest an intrinsic apoptotic mechanism. Taken together, these data point to a mitochondrially mediated apoptosis of hormone-insensitive breast cancer cells. Human tumor xenografts in nude mice showed significant tumor volume reduction and a surprising increase in longevity without signs of obvious toxicity. Thus, our data provide compelling evidence that 9-bromonoscapine can be useful for the therapy of hormone-refractory breast cancer.
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Affiliation(s)
- Ritu Aneja
- Department of Cell Biology, Emory University School of Medicine, Atlanta, GA 30322, USA.
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47
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Ejlertsen B, Mouridsen HT, Jensen MB, Bengtsson NO, Bergh J, Cold S, Edlund P, Ewertz M, de Graaf PW, Kamby C, Nielsen DL. Similar efficacy for ovarian ablation compared with cyclophosphamide, methotrexate, and fluorouracil: from a randomized comparison of premenopausal patients with node-positive, hormone receptor-positive breast cancer. J Clin Oncol 2006; 24:4956-62. [PMID: 17075113 DOI: 10.1200/jco.2005.05.1235] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To compare the efficacy of ovarian ablation versus chemotherapy in early breast cancer patients with hormone receptor-positive disease. PATIENTS AND METHODS We conducted an open, randomized, multicenter trial including premenopausal breast cancer patients with hormone receptor-positive tumors and either axillary lymph node metastases or tumors with a size of 5 cm or more. Patients were randomly assigned to ovarian ablation by irradiation or to nine courses of chemotherapy with intravenous cyclophosphamide, methotrexate, and fluorouracil (CMF) administered every 3 weeks. RESULTS Between 1990 and May 1998, 762 patients were randomly assigned, and the present analysis is based on 358 first events. After a median follow-up time of 8.5 years, the unadjusted hazard ratio for disease-free survival in the ovarian ablation group compared with the CMF group was 0.99 (95% CI, 0.81 to 1.22). After a median follow-up time of 10.5 years, overall survival (OS) was similar in the two groups, with a hazard ratio of 1.11 (95% CI, 0.88 to 1.42) for the ovarian ablation group compared with the CMF group. CONCLUSION In this study, ablation of ovarian function in premenopausal women with hormone receptor-positive breast cancer had a similar effect to CMF on disease-free and OS. No significant interactions were demonstrated between treatment modality and hormone receptor content, age, or any of the well-known prognostic factors.
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Affiliation(s)
- Bent Ejlertsen
- Department of Oncology, Bldg 5012 Rigshospitalet, Copenhagen University Hospital, DK-2100 Copenhagen, Denmark.
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48
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Chong SJ, Kim SY, Kim HS, Kim GM, Kim SY, Jung JH. Cutaneous ciliated cyst in a 16-year-old girl. J Am Acad Dermatol 2006; 56:159-60. [PMID: 17097367 DOI: 10.1016/j.jaad.2006.08.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2006] [Revised: 08/01/2006] [Accepted: 08/03/2006] [Indexed: 12/19/2022]
Abstract
A 16-year-old girl was seen for a painless subcutaneous mass of 1 year's duration. On excisional biopsy, a collapsed cystic structure lined by stratified, ciliated, columnar epithelium was noted; findings were consistent with cutaneous ciliated cyst. Immunohistochemical staining for progesterone receptor and epithelial membrane antigen were positive, whereas it was negative for carcinoembryonic antigen, which supports the theory of heteropia of the ciliated epithelium from the Müllerian epithelium in its histopathogenesis.
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Affiliation(s)
- Su-Jean Chong
- Department of Dermatology, St. Vincent Hospital, The Catholic University, Suwon, Republic of Korea
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49
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Huang CJ, Hou MF, Lin SD, Chuang HY, Huang MY, Fu OY, Lian SL. Comparison of Local Recurrence and Distant Metastases between Breast Cancer Patients after Postmastectomy Radiotherapy with and without Immediate TRAM Flap Reconstruction. Plast Reconstr Surg 2006; 118:1079-1086. [PMID: 17016170 DOI: 10.1097/01.prs.0000220527.35442.44] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The purpose of this study was to compare the local recurrence and distant metastasis of postmastectomy radiotherapy for breast cancer patients with and without immediate transverse rectus abdominis musculocutaneous (TRAM) flap reconstruction. METHODS Between March of 1997 and October of 2001, 191 breast cancer patients received postmastectomy radiotherapy: 82 patients had TRAM flap reconstruction (TRAM flap group) and 109 patients did not (non-TRAM flap group). The mean radiation dose to the chest wall or entire TRAM flap, axillary area, and lower neck was 50 Gy (range, 48 to 54 Gy). The median follow-up period was 40 months. RESULTS The percentages of chest wall recurrence were 3.7 percent (three of 82) in the TRAM flap group and 1.8 percent (two of 109) in the non-TRAM flap group (p = 0.653). The percentages of distant metastases were 12.2 percent (10 of 82) in the TRAM group and 15.6 percent (17 of 109) for the non-TRAM group (p = 0.67). The percentages of acute radiation dermatitis according to Radiation Therapy Oncology Group scoring criteria (TRAM flap group versus non-TRAM flap group) were as follows: grade I, 74 of 82 (90 percent) versus 93 of 109 (85 percent); grade II, seven of 82 (9 percent) versus 13 of 109 (12 percent); grade III, one of 82 (1 percent) versus three of 109 (3 percent) (p = 0.558). In the TRAM flap group, the increased percentage of fat necrosis was 8 percent. No flap loss was detected. CONCLUSIONS There were no significant differences in the incidences of complication, locoregional recurrence, and distant metastasis between the TRAM flap and non-TRAM flap patients. The authors' results suggest that immediate TRAM flap reconstruction can be considered a feasible treatment for breast cancer patients requiring postmastectomy radiotherapy.
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MESH Headings
- Adult
- Aged
- Antineoplastic Agents, Hormonal/therapeutic use
- Antineoplastic Agents, Phytogenic/therapeutic use
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Breast Neoplasms/drug therapy
- Breast Neoplasms/epidemiology
- Breast Neoplasms/pathology
- Breast Neoplasms/radiotherapy
- Breast Neoplasms/surgery
- Carcinoma/drug therapy
- Carcinoma/epidemiology
- Carcinoma/pathology
- Carcinoma/radiotherapy
- Carcinoma/secondary
- Carcinoma/surgery
- Chemotherapy, Adjuvant
- Combined Modality Therapy
- Cyclophosphamide/administration & dosage
- Doxorubicin/administration & dosage
- Estrogen Antagonists/therapeutic use
- Feasibility Studies
- Female
- Fluorouracil/administration & dosage
- Follow-Up Studies
- Humans
- Mammaplasty
- Mastectomy, Modified Radical
- Middle Aged
- Neoplasm Recurrence, Local/epidemiology
- Neoplasms, Hormone-Dependent/drug therapy
- Neoplasms, Hormone-Dependent/pathology
- Neoplasms, Hormone-Dependent/radiotherapy
- Neoplasms, Hormone-Dependent/surgery
- Neoplasms, Second Primary/epidemiology
- Patient Satisfaction
- Postoperative Complications/epidemiology
- Postoperative Complications/etiology
- Postoperative Complications/psychology
- Radiodermatitis/etiology
- Radiotherapy, Adjuvant/adverse effects
- Retrospective Studies
- Surgical Flaps
- Tamoxifen/therapeutic use
- Taxoids/therapeutic use
- Thoracic Wall/pathology
- Thoracic Wall/radiation effects
- Thoracic Wall/surgery
- Time Factors
- Treatment Outcome
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Affiliation(s)
- Chih-Jen Huang
- Taiwan, Republic of China From the Departments of Radiation Oncology, General Surgery, Plastic Surgery, and Clinical Research, Kaohsiung Medical University Hospital
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50
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Ghebeh H, Mohammed S, Al-Omair A, Qattan A, Lehe C, Al-Qudaihi G, Elkum N, Alshabanah M, Amer SB, Tulbah A, Ajarim D, Al-Tweigeri T, Dermime S. The B7-H1 (PD-L1) T lymphocyte-inhibitory molecule is expressed in breast cancer patients with infiltrating ductal carcinoma: correlation with important high-risk prognostic factors. Neoplasia 2006; 8:190-8. [PMID: 16611412 PMCID: PMC1578520 DOI: 10.1593/neo.05733] [Citation(s) in RCA: 461] [Impact Index Per Article: 25.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
B7-H1 molecule increases the apoptosis of tumor-reactive T lymphocytes and reduces their immunogenicity. Breast cancer is the second most common cause of mortality after lung cancer. Direct evidence linking B7-H1 with cancer has been shown in several malignancies; however, its expression in breast cancer has not been investigated. We used immunohistochemistry to investigate the expression of the B7-H1 molecule in 44 breast cancer specimens and to study its correlation with patients' clinicopathological parameters. The expression of B7-H1 was shown in 22 of 44 patients and was not restricted to the tumor epithelium (15 of 44, 34% in tumor cells), but was also expressed by tumor-infiltrating lymphocytes (TIL; 18 of 44, 41%). Interestingly, intratumor expression of B7-H1 was significantly associated with histologic grade III-negative (P = .012), estrogen receptor-negative (P = .036), and progesterone receptor-negative (P = .040) patients. In addition, the expression of B7-H1 in TIL was associated with large tumor size (P = .042), histologic grade III (P = .015), positivity of Her2/neu status (P = .019), and severe tumor lymphocyte infiltration (P = .001). Taken together, these data suggest that B7-H1 may be an important risk factor in breast cancer patients and may represent a potential immunotherapeutic target using monoclonal antibody against the B7-H1 molecule.
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MESH Headings
- Adult
- Aged
- Antigens, CD/analysis
- B7-H1 Antigen
- Breast Neoplasms/chemistry
- Breast Neoplasms/drug therapy
- Breast Neoplasms/epidemiology
- Breast Neoplasms/immunology
- Breast Neoplasms/surgery
- Carcinoma, Ductal, Breast/chemistry
- Carcinoma, Ductal, Breast/drug therapy
- Carcinoma, Ductal, Breast/epidemiology
- Carcinoma, Ductal, Breast/immunology
- Carcinoma, Ductal, Breast/surgery
- Cell Line, Tumor/chemistry
- Cell Line, Tumor/immunology
- Cell Line, Tumor/pathology
- Combined Modality Therapy
- Epithelial Cells/metabolism
- Estrogens
- Female
- Humans
- Lymphatic Metastasis
- Lymphocytes, Tumor-Infiltrating/metabolism
- Mastectomy
- Middle Aged
- Neoadjuvant Therapy
- Neoplasm Proteins/analysis
- Neoplasms, Hormone-Dependent/chemistry
- Neoplasms, Hormone-Dependent/drug therapy
- Neoplasms, Hormone-Dependent/immunology
- Neoplasms, Hormone-Dependent/pathology
- Neoplasms, Hormone-Dependent/surgery
- Progesterone
- Prognosis
- Receptors, Estrogen/analysis
- Receptors, Progesterone/analysis
- Risk Factors
- Saudi Arabia/epidemiology
- Tumor Burden
- Tumor Escape/immunology
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Affiliation(s)
- Hazem Ghebeh
- Tumor Immunology Unit, Department of Biological and Medical Research; King Faisal Specialist Hospital and Research Center, PO Box 3354, Riyadh 11211, Saudi Arabia
| | - Shamayel Mohammed
- Department of Pathology; King Faisal Specialist Hospital and Research Center, PO Box 3354, Riyadh 11211, Saudi Arabia
| | - Abeer Al-Omair
- Tumor Immunology Unit, Department of Biological and Medical Research; King Faisal Specialist Hospital and Research Center, PO Box 3354, Riyadh 11211, Saudi Arabia
| | - Amal Qattan
- Breast Cancer Unit, Department of Biological and Medical Research; King Faisal Specialist Hospital and Research Center, PO Box 3354, Riyadh 11211, Saudi Arabia
| | - Cynthia Lehe
- Tumor Immunology Unit, Department of Biological and Medical Research; King Faisal Specialist Hospital and Research Center, PO Box 3354, Riyadh 11211, Saudi Arabia
| | - Ghofran Al-Qudaihi
- Tumor Immunology Unit, Department of Biological and Medical Research; King Faisal Specialist Hospital and Research Center, PO Box 3354, Riyadh 11211, Saudi Arabia
| | - Naser Elkum
- Department of Biostatistics, Epidemiology, and Scientific Computing, King Faisal Specialist Hospital and Research Center, PO Box 3354, Riyadh 11211, Saudi Arabia
| | - Mohamed Alshabanah
- Department of Oncology, King Faisal Specialist Hospital and Research Center, PO Box 3354, Riyadh 11211, Saudi Arabia
| | - Suad Bin Amer
- Breast Cancer Unit, Department of Biological and Medical Research; King Faisal Specialist Hospital and Research Center, PO Box 3354, Riyadh 11211, Saudi Arabia
| | - Asma Tulbah
- Department of Pathology; King Faisal Specialist Hospital and Research Center, PO Box 3354, Riyadh 11211, Saudi Arabia
| | - Dahish Ajarim
- Department of Oncology, King Faisal Specialist Hospital and Research Center, PO Box 3354, Riyadh 11211, Saudi Arabia
| | - Taher Al-Tweigeri
- Department of Oncology, King Faisal Specialist Hospital and Research Center, PO Box 3354, Riyadh 11211, Saudi Arabia
| | - Said Dermime
- Tumor Immunology Unit, Department of Biological and Medical Research; King Faisal Specialist Hospital and Research Center, PO Box 3354, Riyadh 11211, Saudi Arabia
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