Prediction of long-term survival using expression of FOXA1, a determinant of estrogen response domains in breast cancer

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 539-539
Author(s):  
S. Badve ◽  
D. Turbin ◽  
A. Morimiya ◽  
T. Nielsen ◽  
C. Perou ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Disease Free Survival ◽  
Tumor Grade ◽  
Nodal Status ◽  
Breast Cancers ◽  
Luminal A ◽  
Term Survival ◽  
Free Survival ◽  
Disease Free ◽  
Foxa1 Expression

539 Background: Recent studies have demonstrated cofactor dependency of estrogen receptor alpha (ERα) in defining specific pattern of estrogen (E2) response in breast cancer. FOXA1, also called HNF3α, a forkhead family transcription factor, has emerged as a major cofactor that is essential for optimum transcription of ∼50% of ERα:E2 responsive genes. FOXA1 is expressed in breast cancer cells and in cDNA microarray cluster analysis segregates with genes that characterize the luminal A subtype such as ERα, GATA3, and XBP-1. Detailed expression analysis of FOXA1 in human breast tumors has not been previously performed and it is not known whether it is an independent prognostic factor in breast cancer. Methods: A tissue microarray comprising tumors from 438 patients with 20 years follow-up was analyzed for FOXA1 expression using goat-anti-human FOXA1 antibody by immunohistochemistry. Percentage (P) and intensity (I) of expression was analyzed to generate numerical score (S= P × I). FOXA1 expression was correlated with tumor grade, nodal status, disease free survival, and expression of ER, PR, GATA3, HER2, p27kip1, phospho-AKT, and luminal A subtype (defined as ER &/or PR+, bcl-2+ and Her-2-neg). Results: FOXA1 expression (score greater than 100) was seen in 187 of 438 breast cancers and correlated with greater likelihood of survival at 20 year (p=0.0114). A significant positive correlation was observed between FOXA1 expression and expression of ERα (p= 0.000001), GATA3 (p= 0.000001), PR (p= 0.00001), phospho-AKT (p= 0.00001). Similarly, a significant correlation was noted with luminal A subtype. An inverse correlation was noted with tumor grade and mdm-2 expression (p=0.00001). HER2 or p27kip1 expression and nodal status showed no correlation with FOXA1. Conclusions: FOXA1 is good prognostic marker predicting disease free survival in patients with breast cancer. Since its expression correlates well with breast cancer of luminal A subtype, it can also be used to identify these good prognosis tumors from the rest of the ER positive breast cancers in archival paraffin embedded breast tissues. No significant financial relationships to disclose.

Disease-free survival pattern in breast cancer patients in India treated in a single institution.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e12030-e12030 ◽  
Author(s):  
Basavalinga S. Ajaikumar ◽  
Kodaganur Srinivasachar Gopinath ◽  
B S Srinath ◽  
Ramesh Bilimagga S ◽  
Nalini K Rao ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Locally Advanced ◽  
Disease Free Survival ◽  
Advanced Breast ◽  
Breast Cancers ◽  
Breast Cancer Patients ◽  
Free Survival ◽  
Distant Failure ◽  
Her 2 ◽  
Disease Free

e12030 Background: This study elucidates data from a 5 year retrospective study evaluating survival rates and prognostic factors in breast carcinoma patients in a private cancer set up in south India. Methods: 1046 patients who were treated between years 2003 to 2008 were analyzed. Clinical data including stage, histopathology type, age, node positivity, treatment plan, chemotherapy regimen, ER/ PR and Her2 Neu status, type of surgery etc were abstracted in a database. Five year disease free survival, local failure free survival and distant failure free survival was calculated using Kaplan Meier survival curves. Log rank mantel hazel tests were used to compare two survival curves. Results: Local recurrence was seen in 4% and distant metastases in 22% of the study sample. 62% of patients presented with early breast cancer (AJCC Stage I, II and IIIA). 85.6% of early and 73.1% of locally advanced breast cancers were disease free at 5 years (p<0.001).90.6% of early and 82.4% of locally advanced breast cancers had distant failure free survival at 5 years (p=0.001). Local failure free survival was 96.1% in both early and locally advanced breast disease at 5 years.94.9% of her 2 negative and 83.5% Her 2 positive were disease free at 5 years (p=0.001). 5 years progression free survival was 91.5% for breast conservation surgery vs 84.1% for mastectomy with axillary clearance (p=0.01). 75.4% with triple negative status and 80.8% non triple negative receptor status had 5 years DFS. Conclusion: This is a first report of survival patterns of breast cancer patients treated in a single centre in India. High early stage patient numbers and high median disease free survival times could be because of improvement in screening and treatment of breast cancer in a developing country like India.

scholarly journals 15-year Follow-up of Comparing Mastoscopic and Conventional Axillary Dissection in Breast Cancer: A Multicentres, Randomized Controlled Trial

2020 ◽  
Author(s):  
Chengyu Luo ◽  
Guang Cao ◽  
wenbin Guo ◽  
Jie Yang ◽  
Qiuru Sun ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Survival Rates ◽  
Disease Free Survival ◽  
Axillary Lymph ◽  
Term Survival ◽  
Free Survival ◽  
Significant Difference ◽  
Disease Free

Abstract Backgroud: Longer follow-up was necessary to testify the exact value of mastoscopic axillary lymph node dissection (MALND).Methods：From January 1, 2003 to December 31, 2005,1027 patients with operable breast cancer were randomly assigned to two groups: MALND and CALND. 996 eligible patients were enrolled. The end points are disease free survival and overall survival.Results：The final cohort of 996 patients was followed for an average of 184 months. The distribution of all events was fairly similar between two groups of patients. The incidence of local in-breast events did not differ in a significant manner between two cohorts. Similarly, the rate of distant metastases was not significantly different with 30.0% in MLND and 32.6% in CALND. And no significant difference was observed in other primary tumor between two groups (p=0.46). Patients who remain alive with no event comprise a total of 37.2% in MALND and 35.4% in CALND. Other primary cancers and deaths from other causes were distributed equally between two groups. The 15-year disease-free survival rates were41.1 percent for the MALND group and 39.6 percent for the CALND group (p=0.79). MALND was found to be not inferior for overall survival (P =0.54). The 15-year overall survival rates were 49.5 percentafter MALND and 51.2 percentafter CALND (p=0.86). Probability of overall survival was not significantly different between two groups.Conclusions：MALND does not increase unfavorable events, and also does not affect the long-term survival of patients. Therefore, MALND should be one of the preferred approaches for breast cancer surgery.

scholarly journals Testing for HER2 in Breast Cancer: A Continuing Evolution

2011 ◽  
Vol 2011 ◽  
pp. 1-16 ◽  
Author(s):  
Sejal Shah ◽  
Beiyun Chen
Keyword(s):  
Breast Cancer ◽  
Growth Factor Receptor ◽  
Disease Free Survival ◽  
Breast Cancers ◽  
Her2 Positive ◽  
Free Survival ◽  
Humanized Monoclonal Antibody ◽  
Epidermal Growth ◽  
Invasive Breast Carcinomas ◽  
Disease Free

Human epidermal growth factor receptor 2 (HER2) is an important prognostic and predictive factor in breast cancer. HER2 is overexpressed in approximately 15%–20% of invasive breast carcinomas and is associated with earlier recurrence, shortened disease free survival, and poor prognosis. Trastuzumab (Herceptin) a “humanized” monoclonal antibody targets the extracellular domain of HER2 and is widely used in the management of HER2 positive breast cancers. Accurate assessment of HER2 is thus critical in the management of breast cancer. The aim of this paper is to present a comprehensive review of HER2 with reference to its discovery and biology, clinical significance, prognostic value, targeted therapy, current and new testing modalities, and the interpretation guidelines and pitfalls.

Resection of Single Metachronous Liver Metastases from Breast Cancer Stage I-II Yield Excellent Overall and Disease-Free Survival. Single Center Experience and Review of the Literature

2015 ◽  
Vol 32 (1) ◽  
pp. 52-59 ◽  
Author(s):  
Céline Vertriest ◽  
Giammauro Berardi ◽  
Federico Tomassini ◽  
Rudy Vanden Broucke ◽  
Herman Depypere ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Liver Metastases ◽  
Metastatic Cancer ◽  
Disease Free Survival ◽  
Stage I ◽  
Review Of The Literature ◽  
Term Survival ◽  
Free Survival ◽  
Disease Free

Purpose: Improved survival after liver resection for breast cancer liver metastases (BCLM) has been proven; however, there is still controversy on predictive factors influencing outcomes. The analysis of factors related to primary and metastatic cancer eventually influencing long-term outcomes and a review of the literature are presented in this report. Methods: Twenty-seven patients diagnosed with metachronous BCLM between 1996 and 2013 were retrospectively reviewed. Patients who had a minimum disease-free interval between primary tumor and liver metastasis of 12 months, no more than 3 liver lesions, no macroscopic extra-hepatic disease and in which systemic therapy showed a good response were included. Results: Twenty-two patients (82%) were initially diagnosed with a stage I-II disease. Twelve patients presented with multiple liver metastases. The 5 years overall survival (OS) rate was 78%, while the 5 years disease-free survival (DFS) rate was 36%. Initial tumor stage III-IV at first diagnosis and number of metastases >1 was significantly associated with a shorter DFS at multivariate analysis (p = 0.03 and p = 0.04 respectively). Patients with multiple lesions had a median DFS of 15 months compared to 47 months in patients with a single lesion (p = 0.03). Conclusions: Resection of single BCLM from primary stage I-II cancer offers very good long-term survival rates and a low morbidity.

New molecular breast cancer classification with adjuvant therapy in our population

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e11624-e11624
Author(s):  
E. Richardet ◽  
B Mascheroni ◽  
I Magri ◽  
L Perelli ◽  
M Cortés
Keyword(s):  
Breast Cancer ◽  
Adjuvant Therapy ◽  
Adjuvant Treatment ◽  
Disease Free Survival ◽  
Type A ◽  
Molecular Classification ◽  
Luminal A ◽  
Free Survival ◽  
Luminal B ◽  
Disease Free

e11624 Background: The molecular classification (Perou) helped to identify new groups of patients with different biological behaviors. A retrospective, descriptive, comparative trial with adjuvant chemotherapy treatment was conducted. Objectives: Analyze the natural history of the subgroups of patients, frequency, site of relapse and Disease-free survival (DFS). Materials and Methods: 200 Medical charts of patients with breast cancer were analyzed from 1997 to 2007, who had received adjuvant treatment without Trastuzumab. The 92, 5 % of Luminal A, 91 % of Luminal B y C, the 75.9 % of Her2 (+) and the 69.2 % of Triple Negative (TN) had received adjuvant therapy with FAC, while 30% of the last two groups were treated with taxanes and anthracyclines. We evaluated the site of the first relapse after adjuvant treatment in relation to the new molecular classification. Log-rank test was used to compare the rates of Disease-free survival (DFS). Results: Frequency: Luminal A (86, 42%) Luminal B y C (65, 33%) Her2 + (33, 17%) TN: (16, 8%) The locoregional relapse in the TN group was 36.4% (P = 0.003), the average of bone relapses were 64.5% on the four groups without statically significance compared to other groups. The CNS had a greater trend in TN groups (16.7%) and Her2+ (13.6%), compared to Luminal Type A-B (0 % y 8.3 %). Disease-free survival (DFS): Luminal A 65.0 ± 5.0 months Luminal B y C 50.3 ± 4.3 months HER2 42.9 ± 5.5 months TN 31.1 ± 7.3 months In the analysis of type A luminal subgroup, a prolonged disease free time was showed when compared with the others subgroups, of major statistical significance Log rank (p = 0.002). Conclusions: Her2 negative and TN tumors have less DFS and a higher locoregional and CNS relapse. No significant financial relationships to disclose.

Molecular pattern of breast cancer among a series of Egyptian patients.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e11614-e11614
Author(s):  
Salah Eldeen Elmesidy ◽  
Wessam Elsherief ◽  
Mohamed Abdelshafy ◽  
Walid Hammam
Keyword(s):  
Breast Cancer ◽  
Disease Free Survival ◽  
Breast Cancer Patients ◽  
Luminal A ◽  
Free Survival ◽  
Luminal B ◽  
Platinum Based Chemotherapy ◽  
Egyptian Patients ◽  
Platinum Chemotherapy ◽  
Disease Free

e11614 Background: Triple negative (TN) breast cancer has a bad prognosis. It is associated with a poor progression-free and overall survivals. Accordingly, we explored the outcome of different molecular subtypes among a series of Egyptian breast cancer patients. Methods: A total of 661 non-metastatic breast cancer patients' files with were reviewed from Kasr Al-Aini Center of Clinical Oncology and Nuclear Medicine of Cairo University between January 2005 and December 2010. Data were analyzed for age; menopausal status, tumour size, nodal status, pathological type, grade; estrogen status, progesterone status, and human epidermal growth factor receptor 2 (HER2) status. Disease free survival (DFS) was the primary end point. Results: The median age was 50 years. 50.4% of patients were premenopausal, 93.1% had invasive duct carcinoma, 93.3% had grade II tumours, 79.4% had early tumours (T1&T2), 70.4% had positive lymph nodes, 51.7% had luminal A subtype, 21.3% had luminal B, 10.2% had HER2-enriched and 16.6% had TN. Disease free survival after 3 years for each subtype was 87.8% for luminal A, 86% for luminal B, 69% for TN and 66% for HER2 (p= .008). The 3-year disease-free survival was significantly better for postmenopausal patients 92.1% as compared with premenopausal patients 80.1% (P= <0.001), with early tumours (T1&T2) 92.1% & 87.3% respectively as compared with advanced tumours (T3+T4) 80.1% (p= <0.001), LN negative (N0) 98.1% as compared with LN positive (N1+N2) 85.2% and (N3) 68% (p= <0.001), (ER) positive 90.2% as compared with (ER) negative 78.2% (p= <0.001), (PR) positive 90% as compared with (PR) negative 80.2% (p= 0.003), non TNBC 89.8% as compared with TN 72.1% (p= 0.012). The 3-year disease-free survival for TN patients who received adjuvant platinum-based chemotherapy was 46% and for those who received adjuvant non-platinum chemotherapy was 78% (p= 0.135). Conclusions: In our series of Egyptian patients luminal breast cancer subtypes (A and B) had the highest 3-year disease-free survival followed by TN then HER2-enriched type. Adjuvant platinum based chemotherapy had no impact on the 3-year disease-free survival when compared with non-platinum chemotherapy in TN patients.

Outcome Evaluation in Pre-Trastuzumab Era between Different Breast Cancer Phenotypes: A Population-Based Study on Italian Women

2012 ◽  
Vol 98 (6) ◽  
pp. 743-750 ◽  
Author(s):  
Laura Cortesi ◽  
Elisabetta De Matteis ◽  
Claudia Cirilli ◽  
Luigi Marcheselli ◽  
Manuela Proietto ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Triple Negative ◽  
Disease Free Survival ◽  
Luminal A ◽  
Free Survival ◽  
Luminal B ◽  
Italian Women ◽  
Disease Free ◽  
Over Time

Aims and background Based on estrogen receptor (ER), progesterone receptor (PgR) and Her2/neu (HER2) expression, four breast cancer subtypes have been distinguished: luminal A (ER and/or PgR/HER2–, Ki67 <14%), luminal B (ER and/or PgR/HER2–, Ki67 ≥14% or ER and/or PgR/HER2), triple-negative (ER-/PgR-/HER2–), and HER2 (ER-/PgR-/HER2). Our aim was to evaluate the prognosis of these phenotypes in the pre-trastuzumab era in a large cohort of Italian women. Methods and study design We studied 2347 breast cancer patients, in stage I-II, registered by the Modena Cancer Registry from 1999 to 2006 in the Modena province, Italy. Overall survival, disease-free survival and second non-mammary tumors were evaluated. Results A total of 1868 luminal A (79.6%), 195 luminal B (8.3%), 205 triple-negative (8.7%) and 79 HER2 (3.4%) patients were identified. A better prognosis was observed for luminal A than for luminal B, HER2 and triple-negative subtypes (5-year overall survival, 91% vs 89% vs 87% vs 86%, respectively, P <0.001). Disease-free survival for pT1a and pT1b tumors was worse in HER2 (82%) than in triple-negative (90%), luminal B (95%) and luminal A (97%) (P = 0.013). Finally, luminal B patients had a significantly higher rate of second non-mammary tumors than the other groups. Conclusions In the pre-trastuzumab era, luminal A patients showed a better 5-year overall survival than luminal B, HER2 and triple-negative patients, but in terms of disease-free survival, HER2 subtype represented an unfavorable group over time, whereas the triple-negative group had an increased risk of relapse in the first 42 months and then decreased. Among each prognostic factor, ER <10%, Ki67 >14% and HER2 overexpression are considered as risk factors, but only HER2 positivity seems to preserve the role over time.

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