scholarly journals Clinical relevance of a degree of extracapsular extension in a sentinel lymph node in breast cancer patients: a single-centre study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Tomasz Nowikiewicz ◽  
Andrzej Kurylcio ◽  
Iwona Głowacka-Mrotek ◽  
Maria Szymankiewicz ◽  
Magdalena Nowikiewicz ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Term Treatment ◽  
Extracapsular Extension ◽  
Group Iii ◽  
Metastatic Lesions ◽  
Cancer Metastases ◽  
Group I ◽  
Long Term Treatment

AbstractIn some breast cancer (BC) patients, an examination of lymph nodes dissected during sentinel lymph node biopsy (SLNB) demonstrates a presence of metastatic lesions and extracapsular extension (ECE) in a SLN. This study aimed to evaluate clinical relevance of ECE in BC patients. This is a retrospective analysis of 891 patients with cancer metastases to SLN, referred to supplementary axillary lymph node dissection (ALND), hospitalized between Jan 2007 and Dec 2017. Clinical and epidemiological data was evaluated. Long-term treatment outcomes were analysed. In 433 (48.6%) patients, cancer metastases were limited to the SLN (group I), in 61 (6.8%) patients the SLN capsule was exceeded focally (≤ 1 mm—group II). In 397 (44.6%) patients, a more extensive ECE was found (> 1 mm—group III). Metastases to non-sentinel lymph nodes (nSLNs) were diagnosed in 27.0% patients from group I, 44.3% patients from group II and in 49.6% patients from group III. No statistically significant differences were observed in long-term treatment outcomes for compared groups. The presence of ECE is accompanied by a higher stage of metastatic lesions in the lymphatic system. The differences in this respect were statistically significant, when compared to the group of ECE(−) patients. ECE, regardless of its extent, did not impact the long-term treatment results. ECE remains an indication for supplementary ALND and for other equivalent cancer treatment procedures, regardless of ECE size.

scholarly journals The Effects of Long-Term Administration of Sodium Nedocromil on Bronchial Hypereactivity

2003 ◽  
Vol 1 (3) ◽  
pp. 119-123 ◽  
Author(s):  
G. Ilonidis ◽  
G. Anogianakis ◽  
CH. Trakatelli ◽  
A. Anogeianaki ◽  
M. Chomatidis ◽  
...  
Keyword(s):  
Allergic Asthma ◽  
Term Treatment ◽  
Bronchial Hyperreactivity ◽  
Methacholine Challenge ◽  
Intrinsic Asthma ◽  
Group I ◽  
Long Term Treatment ◽  
The Mean ◽  
Group Ii

The effect of long-term treatment with sodium nedocromil on airway hypereactivity was investigated in two groups of 20 patients each. Group I patients presented with allergic asthma while Group II patients presented with intrinsic asthma. For each subject of the two groups, the base FEV1 was measured and nebulized methacholine was administrated in consecutively higher concentrations until a decrease in FEV1 of >20 % was observed. Following measurement, all patients included in the study were treated with 12 mg of sodium nedocromil per day for 12 months. At the end of the treatment, bronchial hyperreactivity was evaluated for a second time by administering the same dosage of methacholine that originally produced a decline in FEV1 of >20 %. In Group I patients (allergic asthma) mean FEV1 was 3126 ml, before challenge, while after methacholine challenge FEV1 was 2400ml. Following 1-year of sodium nedocromil administration the FEV1 was 2601ml (P<0.05). Before treatment, the mean fall in FEV1, following methacholine challenge, was 23.67% while following a 1-year-long sodium nedocromil administration this value reduced to 15.70% (P<0.05). Correspondingly, PC20 was 5.59 while after sodium nedocromil administration it increased to 11.66 (P<0.05). In Group II patients (intrinsic asthma) mean FEV1 was 2750 ml, before challenge, while after methacholine challenge FEV1 was 2066ml. Following 1-year of sodium nedocromil administration the FEV1 was 2223ml (P<0.05). Before treatment, the mean fall in FEV1, following methacholine challenge, was 27.65 % while following a 1-year-long sodium nedocromil administration this value reduced to 21.92 % (P<0.05). Correspondingly, PC20 was 5.91 while after sodium nedocromil administration it increased to 6.19 (P<0.05). The results suggest a positive effect of long-term sodium nedocromil administration in bronchial hyperreactivity for both groups of patients.

The Effects of Long-Term Treatment by Immunotherapy and Fluticazone on Broncial Hyperreactivity

2003 ◽  
Vol 1 (1) ◽  
pp. 13-16
Author(s):  
G. Ilonidis ◽  
G. Anogianakis ◽  
Chr. Trakatelli ◽  
A. Anogeianaki ◽  
J. Giavazis ◽  
...  
Keyword(s):  
Provocation Test ◽  
Term Treatment ◽  
Provocation Tests ◽  
Group I ◽  
Long Term Treatment ◽  
Group Ii ◽  
Male Subjects

Thirty subjects (20 female and 10 male), all allergic to the mites D. Pteronyssinus and D. Farinae, participated in the present study which covered a period of four years. The subjects were randomly divided in two groups. Group I included 10 female and 5 male subjects, with an average age of 25.8 (+/− 3.5) years who received immunotherapy only. Group II had an average age of 31.5 (+/− 4) years and they received immunotherapy along with fluticazone propionate (1000mcg/day). The protocol for immunotherapy was the same for both groups. The basis FEV1 was determined for each subject of both Groups I and II and afterwards they were subjected to provocation tests of nebulized methacholine solution administered in consecutively larger concentrations until a drop in FEV1 >20 % (PC20), was observed. Three years later, when their therapy was completed, all subjects were subjected to the same provocation test and a significant reduction in bronchial hyperactivity was documented for both groups. In particular, for Group I, the percentage of change in FEV1 values was 27.25 +/- 5.23 % and PC20 5.11 +/− 2.64 mg/ml before immunotherapy, while after immunotherapy the same indicators were 22.22 +/- 7.08 % (P<0.05) and 6.85 +/− 4.03 mg/ml, (P<0.05) respectively. For Group II, the percentage of change in FEV1 values was 26.28 +/− 2.5 % and PC20 5.42 +/− 2.5 mg/ml before immunotherapy, while after immunotherapy the same indicators were 12.27 +/- 2.49 % (P<0.01)and 11.64 +/− 5.14 mg/ml, P<0.01 respectively. It is concluded that although significant reduction in hyperreactivity can be achieved through immunotherapy, the combination of immunotherapy with daily fluticazone propionate administration shows the most promising results.

The Optimal Duration and Selection of Adjuvant Endocrine Therapy for Breast Cancer: How Long Is Enough?

2014 ◽  
pp. e16-e24 ◽  
Author(s):  
Ian E. Smith ◽  
Belinda Yeo ◽  
Gaia Schiavon
Keyword(s):  
Breast Cancer ◽  
Endocrine Therapy ◽  
Prognostic Significance ◽  
Indirect Evidence ◽  
Late Recurrence ◽  
Term Treatment ◽  
Adjuvant Endocrine Therapy ◽  
Risk Of Recurrence ◽  
Long Term Treatment

Women with estrogen receptor (ER)+ early breast cancer (BC) are at continuing risk of relapse up to at least 15 years after diagnosis, despite being on adjuvant endocrine therapy for approximately 5 years. Extended adjuvant endocrine therapy with an aromatase inhibitor (AI) after 5 years of tamoxifen further reduces the risk of recurrence in postmenopausal women. More recently, continuing tamoxifen for 10 years has also been shown to further reduce the risk of recurrence compared with 5 years. There are no direct comparative data on the relative merits of extended tamoxifen compared with an AI; indirect evidence suggests that an AI may have increased efficacy but a greater adverse effect on quality of life. Results are awaited on the need for continuing front-line adjuvant AIs for more than 5 years. The next challenge is to determine which patients will benefit from this long-term treatment. Currently, tumor size, nodal involvement, and gene expression profile as measured by the PAM50 Risk of Recurrence (ROR) score have all been shown to have prognostic significance for late recurrence beyond 5 years.

scholarly journals Clinical end pharmacoeconomic aspects of neoadjuvant therapy of breast cancer

2018 ◽  
pp. 140-145
Author(s):  
V. A. Kostorov ◽  
T. Yu. Semiglazova ◽  
A. V. Pavlysh
Keyword(s):  
Breast Cancer ◽  
Treatment Outcome ◽  
Neoadjuvant Therapy ◽  
Term Treatment ◽  
Targeted Drugs ◽  
Breast Cancer Therapy ◽  
Her2 Positive ◽  
Long Term Treatment ◽  
Positive Breast Cancer

Achievement of complete Pathomorphologic Response (pCR) after neoadjuvant therapy of breast cancer significantly improves long-term treatment outcome. Correlation between pCR and long-term treatment outcome is strongest in HER2-positive breast cancer; this data clearly supports use of double HER2-blockade in neoadjuvant breast cancer therapy. However, the high cost of targeted drugs requires pharmacoecomomic assessments for choosing of the most optimal treatment course.

Safety of long-term administration of capecitabine in metastatic breast cancer patients

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 10755-10755
Author(s):  
M. Lomas ◽  
J. Salvador ◽  
M. Ruiz ◽  
J. L. Bayo
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Cancer Patients ◽  
Performance Status ◽  
Metastatic Breast ◽  
Term Treatment ◽  
Breast Cancer Patients ◽  
Ecog Performance Status ◽  
Long Term Treatment

10755 Background: To evaluate the effectiveness and tolerability of long -term treatment with capecitabine in metastatic breast cancer patients. Capecitabine (C) has been administered offering clinical benefit to women with metastatic breast cancer (MBC) (ORR: 42%). The aim of this trial was to evaluate the efficacy and tolerance of capecitbine in long-term treatment, administered as first, second and third line treatment in MBC. Methods: Patients ≥ 18 years old with MBC, ECOG performance status (PS) ≤2, HER-2 neu negative, non-chemotherapy naive were included in this prospective, multicentre, non-randomized. To date, twenty-two ambulatory patients were evaluable for toxicity and response. Median age 59.2 years (37–81). All of patients had previously received adjuvant treatment. Hormonal therapy were allowed as clinically required. They received three weekly cycles of oral capecitabine 1000–1250 mg/m2 twice daily, days 1–14, followed one week rest until progression or relapse. Results: The overall response rate (ORR) is including PR, CR, and EE 78%. The median treatment duration was 14 months, median range (3–32). Median progression-free and overall survival have not yet been reached. The most common grade ½ (NCIC CTC) treatment related adverse events were /23, hand foot syndrome 4/23, diarrea 1/23. Conclusions: These preliminary data confirm that the treatment with capecitabine (C) is an effective and well tolerated regiment in metastatic breast cancer patients. No significant financial relationships to disclose.

Long-Term Treatment After Preoperative High-Dose Chemotherapy in a Lactating Breast Cancer Patient

2013 ◽  
Vol 69 (1) ◽  
pp. 61-64
Author(s):  
Chengyun Yao ◽  
Hongping Xia ◽  
Yongsheng Wang ◽  
Jinhai Tang ◽  
Xiaobo Wang
Keyword(s):  
Breast Cancer ◽  
Cancer Patient ◽  
Breast Cancer Patient ◽  
High Dose Chemotherapy ◽  
Term Treatment ◽  
High Dose ◽  
Long Term Treatment ◽  
Lactating Breast

scholarly journals Reduced susceptibility to fluconazole in a cat with histoplasmosis

2017 ◽  
Vol 3 (2) ◽  
pp. 205511691774336
Author(s):  
Janelle S Renschler ◽  
Gary D Norsworthy ◽  
Rubie A Rakian ◽  
Audrey I Rakian ◽  
Lawrence J Wheat ◽  
...  
Keyword(s):  
Lymph Node ◽  
Histoplasma Capsulatum ◽  
Antifungal Susceptibility ◽  
Initial Response ◽  
Term Treatment ◽  
Dimorphic Fungi ◽  
Abdominal Lymph Node ◽  
Long Term Treatment ◽  
Fluconazole Therapy

Case summary An 11-year-old neutered male domestic longhair cat was diagnosed with histoplasmosis from fine-needle aspirates of an abdominal lymph node. Lymph node size initially decreased with fluconazole therapy (11.8 mg/kg PO q12h); however, after 13 months of continuous fluconazole therapy, lymphadenomegaly worsened and samples were collected for culture and antifungal susceptibility. The Histoplasma capsulatum isolate had a very high fluconazole minimum inhibitory concentration (MIC) of 64 µg/ml and an itraconazole MIC of 0.06 µg/ml. The owner declined a change to itraconazole and, ultimately, the cat developed neurologic signs and was euthanized. Owing to the initial response to fluconazole followed by treatment failure and high MIC value, acquired fluconazole resistance was suspected. Clinical breakpoints for fluconazole for the dimorphic fungi are not available to define true antifungal resistance. Relevance and novel information This is the first published report of reduced susceptibility to fluconazole in a cat being treated for histoplasmosis. Fluconazole failure and increases in MIC between pretreatment and long-term treatment isolates are known to occur in humans with histoplasmosis. Practitioners should be aware of this possibility when treating cats with fluconazole (particularly in cases with long-term [>1 year] fluconazole therapy or in cases with disease recrudescence).

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