scholarly journals Surgery for primary tumor benefits survival for breast cancer patients with bone metastases: a large cohort retrospective study

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhangheng Huang ◽  
Xin Zhou ◽  
Yuexin Tong ◽  
Lujian Zhu ◽  
Ruhan Zhao ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Prognostic Factors ◽  
Bone Metastases ◽  
Cancer Patients ◽  
Primary Tumor ◽  
Predictive Accuracy ◽  
Rank Test ◽  
Breast Cancer Patients ◽  
Risk Of Death ◽  
The Impact

Abstract Background The role of surgery for the primary tumor in breast cancer patients with bone metastases (BM) remains unclear. The purpose of this study was to determine the impact of surgery for the primary tumor in breast cancer patients with BM and to develop prognostic nomograms to predict the overall survival (OS) of breast cancer patients with BM. Methods A total of 3956 breast cancer patients with BM from the Surveillance, Epidemiology, and End Results database between 2010 and 2016 were included. Propensity score matching (PSM) was used to eliminate the bias between the surgery and non-surgery groups. The Kaplan-Meier analysis and the log-rank test were performed to compare the OS between two groups. Cox proportional risk regression models were used to identify independent prognostic factors. Two nomograms were constructed for predicting the OS of patients in the surgery and non-surgery groups, respectively. In addition, calibration curve, receiver operating characteristic (ROC) curve, and decision curve analysis (DCA) were used to evaluate the performance of nomograms. Result The survival analysis showed that the surgery of the primary tumor significantly improved the OS for breast cancer patients with BM. Based on independent prognostic factors, separate nomograms were constructed for the surgery and non-surgery groups. The calibration and ROC curves of these nomograms indicated that both two models have high predictive accuracy, with the area under the curve values ≥0.700 on both the training and validation cohorts. Moreover, DCA showed that nomograms have strong clinical utility. Based on the results of the X-tile analysis, all patients were classified in the low-risk-of-death subgroup had a better prognosis. Conclusion The surgery of the primary tumor may provide survival benefits for breast cancer patients with BM. Furthermore, these prognostic nomograms we constructed may be used as a tool to accurately assess the long-term prognosis of patients and help clinicians to develop individualized treatment strategies.

scholarly journals Surgery for Primary Tumor Benefits Survival for Breast Cancer Patients With Bone Metastases: A Large Cohort Retrospective Study

2020 ◽  
Author(s):  
Zhangheng Huang ◽  
Xin Zhou ◽  
Yuexin Tong ◽  
Lujian Zhu ◽  
Ruhan Zhao ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Prognostic Factors ◽  
Bone Metastases ◽  
Cancer Patients ◽  
Primary Tumor ◽  
Predictive Accuracy ◽  
Rank Test ◽  
Breast Cancer Patients ◽  
Risk Of Death ◽  
The Impact

Abstract Background: The role of surgery for the primary tumor in breast cancer patients with bone metastases (BM) remains unclear. The purpose of this study was to determine the impact of surgery for the primary tumor in breast cancer patients with BM and to develop prognostic nomograms to predict the overall survival (OS) of breast cancer patients with BM.Methods: A total of 3,956 breast cancer patients with BM from the Surveillance, Epidemiology, and End Results database between 2010 and 2016 were included. Propensity score matching (PSM) was used to eliminate the bias between the surgery and non-surgery groups. The Kaplan-Meier analysis and the log-rank test were performed to compare the OS between two groups. Cox proportional risk regression models were used to identify independent prognostic factors. Two nomograms were constructed for predicting the OS of patients in the surgery and non-surgery groups, respectively. In addition, calibration curve, receiver operating characteristic (ROC) curve, and decision curve analysis (DCA) were used to evaluate the performance of nomograms.Result: The survival analysis showed that the surgery of the primary tumor significantly improved the OS for breast cancer patients with BM. Based on independent prognostic factors, separate nomograms were constructed for the surgery and non-surgery groups. The calibration and ROC curves of these nomograms indicated that both two models have high predictive accuracy, with the area under the curve values ≥0.700 on both the training and validation cohorts. Moreover, DCA showed that nomograms have strong clinical utility. Based on the results of the X-tile analysis, all patients were classified in the low-risk-of-death subgroup had a better prognosis.Conclusion: The surgery of the primary tumor can provide survival benefits for breast cancer patients with BM. Furthermore, these prognostic nomograms we constructed can be used as a tool to accurately assess the long-term prognosis of patients and help clinicians to develop individualized treatment strategies.

Adjuvant Chemotherapy Guidance for pT1-3N0-1 Breast Cancer Patients with HR+, HER2- subtype: a study based on SEER database

2021 ◽  
Author(s):  
juanjuan Qiu ◽  
Li Xu ◽  
Yu Wang ◽  
Jia Zhang ◽  
Jiqiao Yang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Prognostic Factors ◽  
High Risk ◽  
Cancer Patients ◽  
Risk Group ◽  
High Risk Group ◽  
Low Risk ◽  
Rank Test ◽  
Breast Cancer Patients ◽  
Group Score

Abstract Background Although the results of gene testing can guide early breast cancer patients with HR+, HER2- to decide whether they need chemotherapy, there are still many patients worldwide whose problems cannot be solved well by genetic testing. Methods 144 735 patients with HR+, HER2-, pT1-3N0-1 breast cancer from the Surveillance, Epidemiology, and End Results database were included from 2010 to 2015. They were divided into chemotherapy (n = 38 392) and no chemotherapy (n = 106 343) group, and after propensity score matching, 23 297 pairs of patients were left. Overall survival (OS) and breast cancer-specific survival (BCSS) were tested by Kaplan–Meier plot and log-rank test and Cox proportional hazards regression model was used to identify independent prognostic factors. A nomogram was constructed and validated by C-index and calibrate curves. Patients were divided into high- or low-risk group according to their nomogram score using X-tile. Results Patients receiving chemotherapy had better OS before and after matching (p < 0.05) but BCSS was not significantly different between patients with and without chemotherapy after matching: hazard ratio (HR) 1.005 (95%CI 0.897, 1.126). Independent prognostic factors were included to construct the nomogram to predict BCSS of patients without chemotherapy. Patients in the high-risk group (score > 238) can get better OS HR 0.583 (0.507, 0.671) and BCSS HR 0.791 (0.663, 0.944) from chemotherapy but the low-risk group (score ≤ 238) cannot. Conclusion The well-validated nomogram and a risk stratification model was built. Patients in the high-risk group should receive chemotherapy while patients in low-risk group may be exempt from chemotherapy.

The Impact of Primary Tumor Surgery on Survival in HER2 Positive Stage IV Breast Cancer Patients in the Current Era of Targeted Therapy

2020 ◽  
Vol 27 (8) ◽  
pp. 2711-2720 ◽  
Author(s):  
Ross Mudgway ◽  
Carlos Chavez de Paz Villanueva ◽  
Ann C. Lin ◽  
Maheswari Senthil ◽  
Carlos A. Garberoglio ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Targeted Therapy ◽  
Cancer Patients ◽  
Primary Tumor ◽  
Stage Iv ◽  
Tumor Surgery ◽  
Breast Cancer Patients ◽  
Her2 Positive ◽  
Stage Iv Breast Cancer ◽  
The Impact

Phase II Trial Evaluating the Palliative Benefit of Second-Line Zoledronic Acid in Breast Cancer Patients With Either a Skeletal-Related Event or Progressive Bone Metastases Despite First-Line Bisphosphonate Therapy

2006 ◽  
Vol 24 (30) ◽  
pp. 4895-4900 ◽  
Author(s):  
Mark J. Clemons ◽  
George Dranitsaris ◽  
Wei S. Ooi ◽  
Geetha Yogendran ◽  
Tatjana Sukovic ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Zoledronic Acid ◽  
Bone Turnover ◽  
Bone Metastases ◽  
Cancer Patients ◽  
Pain Control ◽  
Second Line ◽  
Breast Cancer Patients ◽  
First Line ◽  
The Impact

Purpose This study evaluated whether additional palliative benefits could be derived from the second-line use of the more potent bisphosphonate zoledronic acid in metastatic breast cancer patients with either progressive bone metastases or skeletal-related events (SRE), despite first-line therapy with either pamidronate or clodronate. Patients and Methods This prospective study evaluated the impact of second-line zoledronic acid on pain, quality of life, and markers of bone turnover (for example, urinary N-telopeptide [NTX]). Patients received monthly zoledronic acid (4mg) for 3 months. Study evaluations were made weekly during the first month and again at week 8. No changes in chemotherapy or endocrine therapy were allowed in the month before or after commencing study treatment. Results Thirty-one women completed this study. By week 8, patients had experienced significant improvements in pain control (P < .001). There was a downward trend in urinary NTX levels over the same time period (P = .008). Overall, there was a trend towards a positive correlation between improvement in pain control and reduction in week one urinary NTX relative to baseline (Spearman's rho r = 0.27; P = .15). Conclusion This is the first study to demonstrate that patients with either progressive bone metastases or SREs while on clodronate or pamidronate can have relevant palliative benefits with a switch to the more potent bisphosphonate zoledronic acid. This is reflected by significant improvements in pain control and bone turnover markers. If confirmed in randomized trials, these findings have major implications to the use of bisphosphonates in both the metastatic and adjuvant settings.

scholarly journals The Effect of Intraoperative Radiotherapy on Breast Cancer: Focus on the Levels of Angiogenic Factors

2021 ◽  
Author(s):  
Nahid Nafisi ◽  
Maryam Mohammadlou ◽  
Mohammad Esmaeil Akbari ◽  
Seyed Rabie Mahdavi ◽  
Maryam Sheikh ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Linear Regression Analysis ◽  
Intraoperative Radiotherapy ◽  
Angiogenic Factors ◽  
Breast Cancer Patients ◽  
Risk Of Death ◽  
Post Surgery ◽  
Before And After ◽  
The Impact

Abstract Objective: Angiogenesis is one of the hallmarks of cancers that is involved in tumor progression. Angiogenic factors induce the formation of new blood vessels and tumor extension, and finally reduce the survival of patients. Intraoperative radiotherapy (IORT), in which radiation is delivered to the tumor bed can kill cells and change tumor microenvironment. Here, we compared the impact of IORT on the levels of angiogenic factors in the blood and surgical wound fluids (SWF) of the breast cancer patients. Patients and Methods: Blood and drained wound fluid (WF) samples were collected from the breast cancer patients before and after surgery, followed by quantification of the amounts of TGF-β, EGF, FGF, VEGF and DLL4 in the patients using ELISA.Results: Our results were indicative of significant differences between the pre-surgery and post-surgery serum levels of EGF, DLL4 and VEGF. In addition, linear regression analysis showed the significant impact of IORT, vascular invasion and lymph node (LN) involvement on the difference between TGF-β levels in the blood before and after surgery-IORT. According to the outcomes of multivariate analysis, IORT changed the levels of EGF and FGF in the blood and WF. Furthermore, logistic regression analyses showed that TGF-β and EGF can be used as predictor markers of the late-stage and LN involvement of the disease. Interestingly, IORT was able to reduce the risk of death and the recurrence rate of disease. Conclusions: In summary, IORT is a safe and effective treatment that can affect angiogenesis and improve the survival of breast cancer patients.

Incidence of Venous Thromboembolism and the Impact on Survival in Breast Cancer Patients

2007 ◽  
Vol 26 (1) ◽  
pp. 70-76 ◽  
Author(s):  
Helen K. Chew ◽  
Theodore Wun ◽  
Danielle J. Harvey ◽  
Hong Zhou ◽  
Richard H. White
Keyword(s):  
Breast Cancer ◽  
Venous Thromboembolism ◽  
Cancer Patients ◽  
Metastatic Disease ◽  
Cancer Stage ◽  
Breast Cancer Patients ◽  
Data Set ◽  
Discharge Data ◽  
Risk Of Death ◽  
The Impact

Purpose The incidence of venous thromboembolism (VTE) and the risk factors associated with development of VTE have not been reported in a large population-based study of breast cancer patients. Patients and Methods The California Cancer Registry was merged with the Patient Discharge Data Set, and the number of VTE events determined among patients diagnosed between 1993 and 1999. Results Among 108,255 patients with breast cancer, the 2-year cumulative VTE incidence was 1.2%, with a rate of 1.2 and 0.6 events/100 patient-years during the first and second half-year, respectively. The 1-year incidence of VTE was significantly increased compared with the general population (standardized incidence ratio of VTE, 4.2; 95% CI, 3.9 to 4.4). In a multivariate model, significant predictors of developing VTE within 2 years were: age (hazard ratio [HR], 2.0 if > 75 years v < 45; 95% CI, 1.6 to 2.6), the number of chronic medical comorbidities (HR, 2.9 if 3 v 0; 95% CI, 2.4 to 3.5), and advancing cancer stage (HR, 6.3; 95% CI, 5.3 to 7.5 for metastatic v local disease). In multivariate models, VTE was a significant predictor of decreased 2-year survival (HR, 2.3; 95% CI, 2.1 to 2.6) and when stratified by initial cancer stage, the effect was highest in patients with localized (HR, 5.1; 95% CI, 3.6 to 7.1) or regional stage (HR, 3.5; 95% CI, 2.5 to 4.8) cancer compared with patients with metastatic disease (HR, 1.9; 95% CI, 1.5 to 2.4). Conclusion Approximately 1% of breast cancer patients developed VTE within 2 years, with the highest incidence in the first 6 months after diagnosis. Metastatic disease and comorbidities were the strongest predictors. The diagnosis of VTE was associated with a higher risk of death within 2 years.

Assessment of circulating tumor cell (CTC) patterns among disease-free breast cancer patients vaccinated with a preventive HER2/neu E75-peptide vaccine

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 3059-3059 ◽  
Author(s):  
A. Amin ◽  
A. Stojadinovic ◽  
J. P. Holmes ◽  
C. E. Storrer ◽  
A. M. Smith ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Prognostic Factors ◽  
Cancer Patients ◽  
Peptide Vaccine ◽  
Metastatic Breast ◽  
Prognostic Indicators ◽  
Breast Cancer Patients ◽  
Post Vaccination ◽  
The Impact ◽  
Disease Free

3059 Background: The quantity of CTC and post-treatment reduction predict outcome in medically treated metastatic breast cancer patients (BCa); however, the impact on survival of CTC in patients at risk for recurrence rendered free of disease after multimodality treatment is unknown. We conducted a pilot study to assess CTC in clinically disease-free node-positive (NP) BCa patients, and to determine the effect on CTC of vaccination with the immunogenic HER2/neu peptide E75. Methods: The CellSearch System (Veridex, LLC Warren, NJ) was used to enumerate total CTC and HER2/neu+ CTC in 20 ml of blood from selected samples obtained from patients (n=16) throughout and after the E75 vaccination series. Standard prognostic factors were collected on these patients as were measures of their immunologic response to the vaccine. Results: 14/16 patients (88%) had at least 1 CTC and 10/16 (63%) had 2 or more CTC identified. Standard clinical prognostic factors (tumor size, grade, lymph nodes and HER2/neu overexpression) did not correlate with number of CTC. Thus far, 9 patients have had multiple samples collected prior to, during and/or after the vaccine series. Early levels of CTC were significantly higher (mean±SE=5.2±0.5) vs. post-vaccination levels (0.3±0.1, p=0.005). Levels of HER2/neu+ CTC were also significantly different (early 3.4±0.3 vs. post 0.4±0.1, p=0.01). All patients showed a decline in CTC from early to post levels while demonstrating HER2/neu immunity as measured by DTH to the E75 peptide post- vaccination (22.9±1.8 mm vs. control 4±0.9 mm, p=0.006). Conclusions: CTCs are readily demonstrated in clinically disease-free NP BCa patients. Prognostic indicators do not seem to correlate with the number of CTCs. CTCs decline during the course of vaccination. These data suggest a potential role for the CTC assay in assessing response to preventive vaccine-based immunotherapy. The views expressed in this abstract are those of the authors and do not necessarily reflect the official policy or position of the Departments of Army or Navy, Department of Defense or the U.S. Government. No significant financial relationships to disclose.

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