A survey of cannabis use for symptom palliation in breast cancer patients by age and stage.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 12108-12108
Author(s):  
Marisa C. Weiss ◽  
Meghan Buckley ◽  
Julianne Hibbs ◽  
Adam Leitenberger ◽  
Melissa Jenkins ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Metastatic Disease ◽  
Significant Proportion ◽  
Breast Cancer Diagnosis ◽  
Breast Cancer Patients ◽  
Medical Cannabis ◽  
Eligibility Criteria ◽  
Chi Square ◽  
Post Surgery

12108 Background: Most US states have legalized medical cannabis for the treatment of serious conditions, including cancer. It is not well known which symptoms breast cancer patients seek to control with cannabis. Methods: Members of the Breastcancer.org and Healthline communities were invited to participate in this survey between 12/16/2019 and 1/19/2020. Eligibility criteria included age ≥18 years, resident of the US and a breast cancer diagnosis within the past 5 years. Eligible respondent data were analyzed for the symptomatic profile of cannabis users. Symptoms were compared between two groups using a Chi-square test of independence. The survey was led by Socanna, conducted by Outcomes Insights, and supported by a grant from Ananda Health/Ecofibre. Results: Among the 832 respondents who completed screening, 725 met the eligibility criteria, and 612 (84%) completed the survey. The median age of respondents was 57 years, and 85% had non-metastatic disease An estimated 42% of respondents have used medical cannabis to treat symptoms or side effects of breast cancer. Medical cannabis users reported using cannabis to treat insomnia (70%), joint and muscle aches, discomfort, stiffness, or pain (59%), anxiety (57%), and stress (51%). The medical cannabis users less than 50-year-old were more likely to use cannabis to treat these symptoms than their over 50-year-old counterparts, however, the differences were not statistically significant. Medical cannabis users under age 50 used cannabis significantly more than over 50 to treat nausea/vomiting (58% vs 40%; p = 0.010) and inflammation (34% vs 20%; p = 0.021). Medical cannabis users with metastatic disease were more likely to use medical cannabis to treat chronic pain 60% vs 41%; p = 0.017) than non-metastatic users. Post-surgery patients were most likely to use cannabis for nerve pain; and those who were beyond treatment, for stress. Patients suffered an average of 5 symptoms. Conclusions: A significant proportion of breast cancer patients reported using cannabis to treat a combination of symptoms from their cancer and its treatment. Although younger patients are somewhat more likely to use this form of palliative management, older patients are suffering from the same symptoms and their use is nearly as high. More research is needed on the personalization of safe and effective symptomatic management with medical cannabis, for people of all ages, stages, and forms of treatment.

COVID-related anxiety is prevalent and accurately reflects serious COVID risks in breast cancer patients.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 12053-12053
Author(s):  
Marisa C. Weiss ◽  
Stephanie Kjelstrom ◽  
Meghan Buckley ◽  
Adam Leitenberger ◽  
Melissa Jenkins ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Cancer Diagnosis ◽  
Breast Cancer Diagnosis ◽  
P Value ◽  
Breast Cancer Patients ◽  
Chi Square ◽  
Liver And Kidney ◽  
Chi Square Test ◽  
A Current

12053 Background: A current cancer diagnosis is a risk factor for serious COVID-19 complications (CDC). In addition, the pandemic has caused major disruptions in medical care and support networks, resulting in treatment delays, limited access to doctors, worsening health disparities, social isolation; and driving higher utilization of telemedicine and online resources. Breastcancer.org has experienced a sustained surge of new and repeat users seeking urgent information and support. To better understand these unmet needs, we conducted a survey of the Breastcancer.org Community. Methods: Members of the Breastcancer.org Community were invited to complete a survey on the effects of the COVID-19 pandemic on their breast cancer care, including questions on demographics, comorbidities (including lung, heart, liver and kidney disease, asthma, diabetes, obesity, and other chronic health conditions); care delays, anxiety due to COVID-related care delays, use of telemedicine, and satisfaction with care during COVID. The survey was conducted between 4/27/2020-6/1/2020 using Survey Monkey. Results were tabulated and compared by chi square test. A p-value of 0.05 is considered significant. Data were analyzed using Stata 16.0 (Stata Corp., Inc, College Station, TX). Results: Our analysis included 568 breast cancer patients of whom 44% had ≥1 other comorbidities associated with serious COVID-19 complications (per CDC) and 37% had moderate to extreme anxiety about contracting COVID. This anxiety increased with the number of comorbidities (p=0.021), age (p=0.040), and with a current breast cancer diagnosis (p=0.011) (see table). Anxiety was significantly higher in those currently diagnosed, ≥65, or with ≥3 other comorbidities, compared to those diagnosed in the past, age <44, or without other comorbidities. Conclusions: Our survey reveals that COVID-related anxiety is prevalent at any age regardless of overall health status, but it increased with the number of other comorbidities, older age, and a current breast cancer diagnosis. Thus, reported anxiety is proportional to the risk of developing serious complications from COVID. Current breast cancer patients of all ages—especially with other comorbidities—require emotional support, safe access to their providers, and prioritization for vaccination.[Table: see text]

Secondary Myeloid Neoplasms in Older Women with Breast Cancer after Radiotherapy: A Population-Based Study

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 1676-1676
Author(s):  
Amer M. Zeidan ◽  
Jessica B. Long ◽  
Rong Wang ◽  
James B. Yu ◽  
Jane Hall ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Cancer Diagnosis ◽  
Research Funding ◽  
Breast Cancer Diagnosis ◽  
Breast Cancer Patients ◽  
Treatment Delivery ◽  
Post Surgery ◽  
Single Modality

Abstract BACKGROUND: Chemotherapy and combined chemo-radiotherapy are well-documented risk factors for myelodysplastic syndromes (MDS) and acute myeloid leukemia (AML), collectively referred to in this setting as therapy-related myeloid neoplasms (t-MN). While single-modality radiotherapy post-lumpectomy has been shown to reduce local recurrence among breast cancer patients, data regarding the impact on development of t-MN are limited and inconsistent. METHODS: We conducted a retrospective cohort study of elderly female breast cancer patients (aged 67-94 years at diagnosis) who were diagnosed with in situ or stage 1-3 breast cancer between 1/1/2004 and 12/31/2011 using the National Cancer Institute's Surveillance, Epidemiology and End Results (SEER)-Medicare linked database. Eligibility criteria included 1) enrollment in Medicare Parts A and B continuously through death or end of study (12/31/2013); 2) underwent surgery for breast cancer within 9 months of diagnosis; and 3) were not diagnosed with other neoplasms prior to breast cancer diagnosis. Delivery of radiation therapy was ascertained using the Healthcare Common Procedural Coding System codes. In order to be considered a recipient of radiotherapy, the patient had to receive radiotherapy within 9 months of diagnosis and had any treatment delivery code for brachytherapy or ≥ 4 treatment delivery codes for external bream radiotherapy. Competing-risk analysis was used to assess the risk of developing t-MN in radiotherapy-treated patients compared to those treated with surgery alone. Patients were censored at the time of receiving chemotherapy or at development of another malignancy (aside of t-MN) during follow-up. Competing-risk analysis was used to assess the risk of developing secondary MN women who received radiation therapy compared to those who did not. These models included adjustment for breast cancer diagnosis age and year, number of comorbidities, anemia, functional status prior to breast cancer diagnosis and breast cancer stage. RESULTS: A total of 63,543 patients were included in the study. Median follow-up for all participants was 48 months. A total of 32,809 patients (51.6%) received radiotherapy post-surgery while 30,734 patients (48.4%) were not treated with radiotherapy post-surgery. Patients who received radiotherapy had significantly better overall survival than those who did not (median overall survival [OS] 107 vs. 89 months, p<0.001). During follow-up, a total of 167 patients were diagnosed with MDS or AML (89 cases among those who received radiotherapy and 78 among those who did not receive radiotherapy). The median time to develop MDS/AML was 24 months. In the unadjusted model, there was no significantly increased risk of subsequent AML/MDS among breast cancer patients who received single-modality radiotherapy compared to those who underwent surgery alone (hazard ratio [HR] = 1.11, 95% confidence interval [CI]: 0.82-1.51, p=0.49). Similarly, no significant difference in subsequent MDS/AML according to receipt of radiotherapy was observed in the adjusted analysis (HR = 1.16, 95% CI: 0.84-1.59, p=0.36). CONCLUSIONS: Older patients with early breast cancer who were treated with single-modality radiotherapy post-surgery did not have a higher risk of subsequent MDS/AML compared to patients who did not receive radiotherapy, and the overall rate of MN was low.While additional studies with a longer duration of follow-up are warranted, these results suggest that the single-modality radiotherapy administered in the contemporary management of early breast cancer is not a risk factor for t-MN in this population. Disclosures Yu: 21st-Century Oncology LLC: Research Funding. Gore:Celgene: Consultancy, Honoraria, Research Funding. Gross:Johnson and Johnson: Research Funding; Medtronic: Research Funding; 21st-Century Oncology LLC: Research Funding. Ma:Celgene Corp: Consultancy; Incyte Corp: Consultancy. Davidoff:Celgene: Consultancy, Research Funding.

A survey of breast cancer patients’ use of cannabis before, during, and after treatment.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e19210-e19210
Author(s):  
Marisa C. Weiss ◽  
Julianne Hibbs ◽  
Terri W. McHugh ◽  
Meghan Buckley ◽  
Sharon Larson ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Informed Consent ◽  
Cancer Patients ◽  
Therapeutic Agents ◽  
Cannabis Use ◽  
Efficacy And Safety ◽  
Breast Cancer Patients ◽  
Medical Cannabis ◽  
Eligibility Criteria ◽  
Metastatic Sites

e19210 Background: The availability of cannabis is rapidly expanding and cancer is a qualifying condition in all states allowing medical cannabis. However, there are many unknowns with respect to patterns of cannabis use among breast cancer patients. The goal of this study was to better understand how and when cannabis is used among breast cancer patients. Methods: Between 12/16/2019 and 1/19/2020, U.S.-based members of Breastcancer.org and the Healthline communities were invited to participate in a cannabis survey. Subjects confirmed they were age ≥18 and diagnosed with breast cancer within 5 years. After informed consent, data were collected, de-identified and analyzed in aggregate. The study was led by Socanna, conducted by Outcomes Insights, and supported by a grant from Ananda Health/Ecofibre. Results: A total of 3522 persons initiated screening, 832 completed screening, and 725 met eligibility criteria, of whom 612 completed the survey (84%). The results showed that 42% of participants had used medical cannabis products to relieve symptoms, including insomnia (70%), pain (59%), anxiety (57%), stress (51%), and nausea/vomiting (46%). Additionally, cannabis was used prior to treatment in 24%, during treatment in 79%, and after treatment in 54%. Of subjects reporting cannabis use during treatment: 86% used it during chemotherapy, 71% during HER2 therapy, 65% during hormonal therapy, 49% during breast radiation, and 47% during radiation for metastatic sites. Post-surgical use was reported in 51% after mastectomy alone, 40% after lumpectomy, and 38% after mastectomy/reconstruction. An average of 3-4 cannabis products were utilized. Products were sourced from medical dispensaries (54%), family/friends (33%), and recreational sources (27%). Although cannabis using subjects strongly preferred medical sources, 77% had also utilized recreational sources. Conclusions: This survey shows that almost half of breast cancer patients reported using cannabis to help relieve common symptoms from breast cancer or its treatments. Of those, 79% used cannabis during active treatment, which can impact efficacy and safety. To date, studies have not investigated drug interactions between cannabis and these therapeutic agents. Furthermore, there is a concern regarding contaminants. Although most medical cannabis is tested for pathogens and contaminants, this is not the case for cannabis obtained from other sources. The results of this study highlight the need for research regarding cannabis for medical purposes, including safety and interaction studies.

Importance of surgical role on anxiety of patients with breast cancer: Twelve-month follow-up prospective study.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 195-195
Author(s):  
Sungmin Park ◽  
Sekyung Lee ◽  
Soo Youn Bae ◽  
Jeong Eon Lee ◽  
Seok Won Kim ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Depression Scale ◽  
Metastatic Breast ◽  
Breast Cancer Diagnosis ◽  
Physical Symptoms ◽  
Breast Cancer Patients ◽  
Post Surgery ◽  
Abnormal Group

195 Background: Breast cancer diagnosis and treatment often produce stress in patients.Anxiety is one of the most prevalent psychological symptoms perceived by breast cancer patients. This study aims to evaluate the temporal patterns of anxiety and find factors associated with persistent anxiety during breast cancer treatment. Methods: This is prospective cohort study. Between July 2010 and July 2011, we recruited patients with non-metastatic breast cancer who were expected to receive adjuvant chemotherapy (N = 411) from two cancer hospitals in Seoul, Korea. Trained researchers interviewed participants and the patients also completed questionnaires on quality of life at enrollment (before surgery), 2 weeks, 3 months, 6 months and 12 months post-surgery. Anxiety was measured using the Hospital Anxiety and Depression Scale (HADS). Borderline and abnormal levels of HADS scores were classified into the abnormal group for comparison purposes. Results: The mean age of the participants was 46.4 (±7.9) years. Preoperatively, 44.5 % (183/411) of the patients showed abnormal anxiety. The proportion of the subnormal anxiety group significantly decreased after surgery (P < .01) and this phenomenon continued until the 12 month follow-up point. Patients experienced renewed anxiety at 12 months when the main adjuvant therapies were finished. Socioeconomic factors were not associated with persistent anxiety. Pain, breast, and arm symptoms were significantly higher in the persistently abnormal group, especially at postoperative 6months and 12months. Conclusions: Anxiety disorder was common in patients who were diagnosed with breast cancer (44.5%). Surgery was a major relieving factor of anxiety, and patients who finished their main adjuvant treatment experienced renewed anxiety. Surgeons should be the main detectors and care-givers with respect to psychological distress in breast cancer patients. To reduce persistent anxiety, caring for the patient’s physical symptoms is important.

Overexpression of microRNA-21 in the Serum of Breast Cancer Patients

MicroRNA ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. 58-63
Author(s):  
Batool Savari ◽  
Sohrab Boozarpour ◽  
Maryam Tahmasebi-Birgani ◽  
Hossein Sabouri ◽  
Seyed Mohammad Hosseini
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Cancer Progression ◽  
Tumor Resection ◽  
Tumor Grade ◽  
Healthy Controls ◽  
Breast Cancer Patients ◽  
Serum Samples ◽  
Post Surgery ◽  
Polymerase Chain

Background: Breast cancer is the most common cancer diagnosed in women worldwide. So it seems that there's a good chance of recovery if it's detected in its early stages even before the appearances of symptoms. Recent studies have shown that miRNAs play an important role during cancer progression. These transcripts can be tracked in liquid samples to reveal if cancer exists, for earlier treatment. MicroRNA-21 (miR-21) has been shown to be a key regulator of carcinogenesis, and breast tumor is no exception. Objective: The present study was aimed to track the miR-21 expression level in serum of the breast cancer patients in comparison with that of normal counterparts. Methods: Comparative real-time polymerase chain reaction was applied to determine the levels of expression of miR-21 in the serum samples of 57 participants from which, 42 were the patients with breast cancer including pre-surgery patients (n = 30) and post-surgery patients (n = 12), and the others were the healthy controls (n = 15). Results: MiR-21 was significantly over expressed in the serum of breast cancer patients as compared with healthy controls (P = 0.002). A significant decrease was also observed following tumor resection (P < 0.0001). Moreover, it was found that miR-21 overexpression level was significantly associated with tumor grade (P = 0.004). Conclusion: These findings suggest that miR-21 has the potential to be used as a novel breast cancer biomarker for early detection and prognosis, although further experiments are needed.

scholarly journals Serum Long Non-Coding RNAs PVT1, HOTAIR, and NEAT1 as Potential Biomarkers in Egyptian Women with Breast Cancer

Biomolecules ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 301
Author(s):  
Amal Ahmed Abd El-Fattah ◽  
Nermin Abdel Hamid Sadik ◽  
Olfat Gamil Shaker ◽  
Amal Mohamed Kamal ◽  
Nancy Nabil Shahin
Keyword(s):  
Breast Cancer ◽  
Logistic Regression ◽  
Cancer Patients ◽  
Breast Cancer Diagnosis ◽  
Serum Levels ◽  
Breast Cancer Patients ◽  
Multivariate Logistic Regression ◽  
Expression Levels ◽  
Non Coding Rnas ◽  
Pai 1

Long non-coding RNAs play an important role in tumor growth, angiogenesis, and metastasis in several types of cancer. However, the clinical significance of using lncRNAs as biomarkers for breast cancer diagnosis and prognosis is still poorly investigated. In this study, we analyzed the serum expression levels of lncRNAs PVT1, HOTAIR, NEAT1, and MALAT1, and their associated proteins, PAI-1, and OPN, in breast cancer patients compared to fibroadenoma patients and healthy subjects. Using quantitative real-time PCR (qRT-PCR), we compared the serum expression levels of the four circulating lncRNAs in patients with breast cancer (n = 50), fibroadenoma (n = 25), and healthy controls (n = 25). The serum levels of PAI-1 and OPN were measured using ELISA. Receiveroperating-characteristic (ROC) analysis and multivariate logistic regression were used to evaluate the diagnostic value of the selected parameters. The serum levels of HOTAIR, PAI-1, and OPN were significantly higher in breast cancer patients compared to controls and fibroadenoma patients. The serum level of PVT1 was significantly higher in breast cancer patients than in the controls, while that of NEAT1 was significantly lower in breast cancer patients compared to controls and fibroadenoma patients. Both ROC and multivariate logistic regression analyses revealed that PAI-1 has the greatest power in discriminating breast cancer from the control, whereas HOTAIR, PAI-1, and OPN have the greatest power in discriminating breast cancer from fibroadenoma patients. In conclusion, our data suggest that the serum levels of PVT1, HOTAIR, NEAT1, PAI-1, and OPN could serve as promising diagnostic biomarkers for breast cancer.

Screening for metastatic disease in newly diagnosed breast cancer patients

2008 ◽  
Vol 6 (7) ◽  
pp. 61
Author(s):  
E. Una ◽  
M.J. Borau ◽  
J. Nieto ◽  
A. De la Torre ◽  
G. Fernandez ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Metastatic Disease ◽  
Newly Diagnosed ◽  
Breast Cancer Patients

scholarly journals What mediates the racial/ethnic disparity in psychosocial stress among breast cancer patients?

2021 ◽  
Author(s):  
C. T. Sánchez-Díaz ◽  
S. Strayhorn ◽  
S. Tejeda ◽  
G. Vijayasiri ◽  
G. H. Rauscher ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Social Support ◽  
Cancer Patients ◽  
Cancer Diagnosis ◽  
Psychosocial Stress ◽  
Breast Cancer Diagnosis ◽  
Support Needs ◽  
Breast Cancer Patients ◽  
Hispanic Patients ◽  
Racial Ethnic

Abstract Background Prior studies have observed greater levels of psychosocial stress (PSS) among non-Hispanic (nH) African American and Hispanic women when compared to nH White patients after a breast cancer diagnosis. We aimed to determine the independent and interdependent roles of socioeconomic position (SEP) and unmet support in the racial disparity in PSS among breast cancer patients. Methods Participants were recruited from the Breast Cancer Care in Chicago study (n = 989). For all recently diagnosed breast cancer patients, aged 25–79, income, education, and tract-level disadvantage and affluence were summed to create a standardized socioeconomic position (SEP) score. Three measures of PSS related to loneliness, perceived stress, and psychological consequences of a breast cancer diagnosis were defined based on previously validated scales. Five domains of unmet social support needs (emotional, spiritual, informational, financial, and practical) were defined from interviews. We conducted path models in MPlus to estimate the extent to which PSS disparities were mediated by SEP and unmet social support needs. Results Black and Hispanic patients reported greater PSS compared to white patients and greater unmet social support needs (p = 0.001 for all domains). Virtually all of the disparity in PSS could be explained by SEP. A substantial portion of the mediating influence of SEP was further transmitted by unmet financial and practical needs among Black patients and by unmet emotional needs for Hispanic patients. Conclusions SEP appeared to be a root cause of the racial/ethnic disparities in PSS within our sample. Our findings further suggest that different interventions may be necessary to alleviate the burden of SEP for nH AA (i.e., more financial support) and Hispanic patients (i.e., more emotional support).

Clinical significance of crown-like structures to trastuzumab response in patients with primary invasive HER2+ breast cancer.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e12533-e12533
Author(s):  
Constantinos Savva ◽  
Charles N Birts ◽  
Stéphanie A Laversin ◽  
Alicia Lefas ◽  
Jamie Krishnan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adipose Tissue ◽  
Cancer Patients ◽  
Metastatic Disease ◽  
Cox Regression ◽  
Prognostic Significance ◽  
Metabolic Reprogramming ◽  
Breast Cancer Patients ◽  
Adjuvant Trastuzumab ◽  
Her2 Breast Cancer

e12533 Background: Obesity is associated with breast cancer development and worse survival. Obesity can initiate, promote, and maintain systemic inflammation via metabolic reprogramming of macrophages that encircle adipocytes, termed crown-like structures (CLS). In breast cancer patients, CLS are present in 36-50% of patients and have been associated with anthropometric parameters. Here we focus on HER2+ breast cancer. The role of adiposity in HER2+ breast cancer is conflicting which may be attributed to the tumour heterogeneity. Adiposity has also been shown to affect the local immune environment of solid tumours. However, the prognostic significance of CLS in HER2+ breast cancer is still unknown. Methods: We investigated the prognostic significance of CLS in a cohort of 219 patients with primary HER2+ breast cancer who were diagnosed between 1982 to 2012 in Southampton General Hospital. This cohort includes 76 HER2+ trastuzumab naïve patients and 143 HER2+ patients treated with adjuvant trastuzumab. We stained FFPE tumour samples for the expression of CD68, CD16 and CD32B on CLS and correlated these to clinical outcomes. CLS were defined as CLS within distant adipose tissue, CLS within the adipose-tumour border (B-CLS) and intratumoural CLS. CLS were quantified manually in full face sections by two independent scorers and descriptive and Cox regression analysis was carried out. Results: A total of 201 tumours were suitable for CLS analyses. The median follow-up was 34.74 months (range, 0.43-299.08). In the trastuzumab naive cohort, B-CLS≤1 and B-CLS > 1 were present in 37 (52.11%) and 34 (47.89%), respectively. In the trastuzumab treated cohort, B-CLS≤1 were identified in 69 (53.08%) and B-CLS > 1 were found in 61 (46.92%) of the tumours. CLS were more commonly found in the adipose-tumour border (60.89%) rather than in the distant adipose tissue (36.14%) or intratumorally (14.36%). The presence of any CLS was significantly associated with BMI≥25 kg/m2 (p = 0.018). There was strong evidence of association between CD68+CD32B+ B-CLS and BMI≥25 kg/m2 (p = 0.007). Co-expression of CD16 and CD32B by B-CLS was more frequent in patients with BMI≥25 kg/m2 (p = 0.036). Survival analysis showed shorter time to metastatic disease in patients with CD68+ B-CLS > 1 (p = 0.011) in the trastuzumab treated cohort. Subgroup analysis revealed that in the BMI≥25 kg/m2 group, patients with CD68+ B-CLS > 1 had shorter time to metastatic disease compared to patients with B-CLS≤1 (p = 0.004). Multivariate cox regression showed that B-CLS > 1 is an independent prognostic factor for shorter time to metastatic disease in patients with primary HER2+ breast cancer that received adjuvant trastuzumab (HR 6.81, 95%CI (1.38-33.54), p = 0.018). Conclusions: B-CLS can be potentially used as a predictive biomarker to optimize the stratification and personalisation of treatment in HER2-overexpressed breast cancer patients.

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