scholarly journals Impact of Different Modules of 21-Gene Assay in Early Breast Cancer Patients

2021 ◽  
Author(s):  
Mengdi Chen ◽  
Deyue Liu ◽  
Weilin Chen ◽  
Weiguo Chen ◽  
Kunwei Shen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Young Patients ◽  
Breast Cancer Patients ◽  
Old Patients ◽  
Gene Assay ◽  
Risk Patients ◽  
Group A ◽  
Group B ◽  
The Impact

Abstract Background: Young patients were under-evaluated in the construction and validation of the 21-gene Assay Recurrence Score (RS). Previous evidence suggested that RS performed differently according the ages of patients. Our study aimed to explore the molecular driving patterns in patients of different ages.Methods: A total of 1,078 estrogen receptor (ER)-positive breast cancer patients between Jan 2009 and Mar 2017 from Shanghai Jiao Tong University Breast Cancer Data Base were divided into three subgroups: Group A, ≤40y and premenopausal (n=97); Group B, >40y and premenopausal (n=284); Group C, postmenopausal (n=697). The correlation of RS and its modules and the variance of RS modules was explored.Results: Estrogen module had a stronger correlation with RS in patients >40y (ρ = -0.76 in Group B and -0.79 in Group C) compared with patients ≤40y (ρ = -0.64). Contrarily, the correlation between RS and invasion group was weaker in patients >40y (ρ = 0.29 in Group B and 0.25 in Group C) than in patients ≤40y (ρ = 0.44). The proliferation module contributed most to the variance in young patients (37.3%) while ER module contributed most in old patients (54.1% in Group B and 53.4% in Group C). For RS >25, proliferation module was the leading driver in all three subgroups (ρ = 0.38, 0.53 and 0.52 in Group A, B and C) while estrogen module had a weaker association with RS. The negative impact of ER related features on RS was stronger in clinical low-risk patients while the positive effect of proliferation module was stronger in clinical high-risk patients.Conclusions: RS was primarily driven by estrogen module in patients regardless of age, but the proliferation module had a stronger impact on RS in patients ≤40y than in those >40y. The impact of modules varied in patients with different genetic and clinical risk.

scholarly journals Impact of Different Modules of 21-Gene Assay in Early Breast Cancer Patients

2021 ◽  
Vol 12 ◽  
Author(s):  
Mengdi Chen ◽  
Deyue Liu ◽  
Weilin Chen ◽  
Weiguo Chen ◽  
Kunwei Shen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
High Risk ◽  
Cancer Patients ◽  
Low Risk ◽  
Breast Cancer Patients ◽  
Younger Patients ◽  
Gene Assay ◽  
Risk Patients ◽  
Gene Modules ◽  
The Impact

BackgroundThe 21-gene assay recurrence score (RS) provides additional information on recurrence risk of breast cancer patients and prediction of chemotherapy benefit. Previous studies that examined the contribution of the individual genes and gene modules of RS were conducted mostly in postmenopausal patients. We aimed to evaluate the gene modules of RS in patients of different ages.MethodsA total of 1,078 estrogen receptor (ER)-positive and human epidermal growth factor receptor 2 (HER2)-negative breast cancer patients diagnosed between January 2009 and March 2017 from Shanghai Jiao Tong University Breast Cancer Data Base were included. All patients were divided into three subgroups: Group A, ≤40 years and premenopausal (n = 97); Group B, >40 years and premenopausal (n = 284); Group C, postmenopausal (n = 697). The estrogen, proliferation, invasion, and HER2 module scores from RS were used to characterize the respective molecular features. Spearman correlation and analysis of the variance tests were conducted for RS and its constituent modules.ResultsIn patients >40 years, RS had a strong negative correlation with its estrogen module (ρ = −0.76 and −0.79 in Groups B and C) and a weak positive correlation with its invasion module (ρ = 0.29 and 0.25 in Groups B and C). The proliferation module mostly contributed to the variance in young patients (37.3%) while the ER module contributed most in old patients (54.1% and 53.4% in Groups B and C). In the genetic high-risk (RS >25) group, the proliferation module was the leading driver in all patients (ρ = 0.38, 0.53, and 0.52 in Groups A, B, and C) while the estrogen module had a weaker correlation with RS. The impact of ER module on RS was stronger in clinical low-risk patients while the effect of the proliferation module was stronger in clinical high-risk patients. The association between the RS and estrogen module was weaker among younger patients, especially in genetic low-risk patients.ConclusionsRS was primarily driven by the estrogen module regardless of age, but the proliferation module had a stronger impact on RS in younger patients. The impact of modules varied in patients with different genetic and clinical risks.

Breast Cancer With Synchronous Metastases: Survival Impact of Exclusive Locoregional Radiotherapy

2009 ◽  
Vol 27 (9) ◽  
pp. 1375-1381 ◽  
Author(s):  
Romuald Le Scodan ◽  
Denise Stevens ◽  
Etienne Brain ◽  
Jean Louis Floiras ◽  
Christine Cohen-Solal ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Multivariate Analysis ◽  
Cancer Patients ◽  
Primary Tumor ◽  
Alternative Form ◽  
Breast Cancer Patients ◽  
Group A ◽  
Synchronous Metastases ◽  
Group B ◽  
The Impact

Purpose Several studies suggest that surgical excision of the primary tumor improves survival among patients with stage IV breast cancer at diagnosis. Exclusive locoregional radiotherapy (LRR) is an alternative form of locoregional treatment (LRT) in this setting. We retrospectively studied the impact of LRT on the survival of breast cancer patients with synchronous metastases. Patients and Methods Among 18,753 breast cancer patients treated in our institution between 1980 and 2004, 598 patients (3.2%) had synchronous metastasis at diagnosis. Demographic data, tumor characteristics, metastatic sites, and treatments were prospectively recorded. The impact of LRT on overall survival (OS) was evaluated by multivariate analysis including known prognostic factors. Results Among 581 eligible patients, 320 received LRT (group A), and 261 received no LRT (group B). LRT consisted of exclusive LRR in 249 patients (78%), surgery of the primary tumor with adjuvant LRR in 41 patients (13%), and surgery alone in 30 patients (9%). With a median follow-up time of 39 months, the 3-year OS rates were 43.4% and 26.7% in group A and group B (P =.00002), respectively. The association between LRT and improved survival was particularly marked in women with visceral metastases. LRT was an independent prognostic factor in multivariate analysis (hazard ratio [HR] = 0.70; 95% CI, 0.58 to 0.85; P = .0002). The adjusted HR for late death (≥ 1 year) was 0.76 (95% CI, 0.61 to 0.96; P = .02). Conclusion In our experience, LRT, consisting mainly of exclusive LRR, was associated with improved survival in breast cancer patients with synchronous metastases. Exclusive LRR may thus represent an active alternative to surgery.

scholarly journals Prospective study of hair recovery after (neo)adjuvant chemotherapy with scalp cooling in Japanese breast cancer patients

2021 ◽  
Author(s):  
Shozo Ohsumi ◽  
Sachiko Kiyoto ◽  
Mina Takahashi ◽  
Seiki Takashima ◽  
Kenjiro Aogi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Prospective Study ◽  
Cancer Patients ◽  
Scalp Cooling ◽  
Breast Cancer Patients ◽  
Chemotherapy Infusion ◽  
Group A ◽  
Neo Adjuvant Chemotherapy ◽  
Group B

Abstract Purpose Scalp cooling during chemotherapy infusion to mitigate alopecia for breast cancer patients is becoming widespread; however, studies regarding hair recovery after chemotherapy with scalp cooling are limited. We conducted a prospective study of hair recovery after chemotherapy with scalp cooling. Patients and methods One hundred and seventeen Japanese female breast cancer patients who completed planned (neo)adjuvant chemotherapy using the Paxman Scalp Cooling System for alopecia prevention were evaluated for alopecia prevention in our prospective study. We evaluated their hair recovery 1, 4, 7, 10, and 13 months after chemotherapy. Primary outcomes were grades of alopecia judged by two investigators (objective grades) and patients’ answers to the questionnaire regarding the use of a wig or hat (subjective grades). Results Of 117 patients, 75 completed scalp cooling during the planned chemotherapy cycles (Group A), but 42 discontinued it mostly after the first cycle (Group B). Objective and subjective grades were significantly better in Group A than in Group B throughout 1 year, and at 4 and 7 months after chemotherapy. When we restricted patients to those with objective Grade 3 (hair loss of > 50%) at 1 month, Group A exhibited slightly faster hair recovery based on the objective grades than Group B. There was less persistent alopecia in Group A than in Group B. Conclusions Scalp cooling during chemotherapy infusion for Japanese breast cancer patients increased the rate of hair recovery and had preventive effects against persistent alopecia.

Aesthetic outcome and patient’s quality of life in breast cancer patients undergoing mastectomy with or without immediate reconstruction.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e12587-e12587
Author(s):  
Sidra Afzal ◽  
Asad Parvaiz ◽  
Nida Javed
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Well Being ◽  
Mean Difference ◽  
Breast Cancer Patients ◽  
Immediate Reconstruction ◽  
Patient’S Satisfaction ◽  
Group A ◽  
The Mean ◽  
Group B

e12587 Background: : Although post mastectomy Immediate breast reconstruction has shown to improve physical and psychosocial well-being of breast cancer patients, this is not a usual procedure in Pakistan due to limited resources and lack of awareness. The aim of our study is to evaluate patient’s satisfaction/ aesthetic outcomes between the patients undergoing mastectomy alone (Group A) and the ones undergoing mastectomy followed by immediate reconstruction (Group B). Methods: This is a prospective study conducted at Shaukat Khanum Hospital Pakistan comparing aesthetic outcome, patient’s satisfaction and Quality of life between two groups using Breast Q module. All patients undergoing mastectomy with and without reconstruction between April 2017 to July 2019 are included. Sample size of 84 was calculated (42 in each group). Results: The mean Q score of satisfaction with the breast in group B is 82.64 and in group A is 35.82 (P = 0.001). The mean Q score of Psychosocial well-being in group B is 89 vs 44.95 in group A (P = 0.001). The mean Q score of Physical well-being in group B is 98.23 vs 90.41 in group A (P = 0.002). The mean Q score of sexual well-being in group B is 81.93 vs 43 in Group A (P = 0.001). [Mean difference in score of 5-10 - little change, 10-20 - moderate change, > 20 - significant change].The mean difference between two groups in satisfaction with breast , psychosocial well-being and sexual well-being is more than 20 with a statistically significant p-value, while in physical well-being the mean difference is 7.8 which falls in little change group. Conclusions: Our study shows that reconstruction helps breast cancer patients in providing comprehensive care in a manner that they achieve a higher satisfaction with their appearance, psychological and sexual well-being without compromising oncological safety and this should be practiced more in our country. Also patients education about these procedures should be raised to help them fighting against this disease

scholarly journals Effects of Different Exercise Interventions on Quality of Life in Breast Cancer Patients: A Randomized Controlled Trial

2019 ◽  
Vol 18 ◽  
pp. 153473541988059
Author(s):  
Tetiana Odynets ◽  
Yuriy Briskin ◽  
Valentina Todorova
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Cancer Patients ◽  
Well Being ◽  
Breast Cancer Patients ◽  
Exercise Interventions ◽  
Water Exercise ◽  
Group A ◽  
Group B

Purpose: The aim of the present study was to evaluate the effects of different exercise interventions on quality of life parameters in breast cancer patients during 1 year of outpatient rehabilitation. Material and Methods: A total of 115 breast cancer patients met the eligibility criteria and completed the study. Participants were randomly allocated for the water exercise interventions (group A, n = 45), for the Pilates exercise interventions (group B, n = 40), and yoga exercise interventions (group C, n = 30). The 3 groups attended relevant programs for 1 year and received 144 rehabilitation sessions. Quality of life parameters were assessed using the Functional Assessment of Cancer Therapy questionnaire with a specific module for breast cancer patients (FACT-B). Quality of life data were recorded at baseline and after 6 and 12 months of exercise interventions. Results: A significant increase in quality of life indicators was observed in participants of all groups. Based on the results of the 12-month monitoring, patients of group A scored significantly more points for emotional well-being compared with group B and group C by 1.40 points ( P < .05) and 1.69 points ( P < .01), respectively, as well as by breast cancer subscale by 2.15 points ( P < .05) compared with group B. Patients in group C scored significantly better compared with group A in social/family well-being by 2.80 points ( P < .01). Conclusions: It was found that using water exercise intervention is more effective for improving emotional well-being and decreasing negative symptoms associated with breast cancer treatment compared with Pilates and yoga interventions, while yoga was more effective in improving social/family well-being. Further research on water interventions for different populations is warranted.

Mitomycin C in combination with capecitabine (Mi-Cap) as chemotherapy in breast cancer patients with extensive liver metastases and impaired hepatic function: A non-randomized multicentre phase II study

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 19597-19597
Author(s):  
S. Loibl ◽  
M. Schmidt ◽  
F. Marquardt ◽  
J. Huober ◽  
J. Bischoff ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Liver Metastases ◽  
Cancer Patients ◽  
Mitomycin C ◽  
Metastatic Disease ◽  
Liver Enzymes ◽  
Breast Cancer Patients ◽  
Elevated Liver Enzymes ◽  
Group A ◽  
Group B

19597 Background: Breast cancer patients with an impaired liver function due to liver metastases have very limited, evidence based treatment options. Based on our experience with mitomycin C, 5Fu and folinate (Loibl et al. 2004), we wanted to improve this schedule by including the oral antimetabolite capecitabine. Methods: Breast cancer patients (pts) with liver metastases and elevated liver enzymes defined as AST/ALT = 3×UNL (group A) or liver enzymes = 1.5×UNL and AP = 3×UNL (group B) were enrolled. Further inclusion criteria were as follows: bidimensionally measurable disease, normal hematological values (WBCs = 3×109/L; platelets = 100×109/L; hemoglobin = 10 g/dL), normal renal function. A three weekly cycle with Mitomycin C 8 mg/m2 i.v. on day 1, capecitabine 2,000 mg/m2 day 1–14 and prednison 5 mg day 1–5 orally was given. Primary endpoint is the progression free survival (PFS) measured from the planned 44 eligible patients who received at least one cycle of Mi-Cap. Results: Between April 2004 and December 2006, 35 patients with a median age of 57.1 years (range, 39–76) were enrolled. 29 pts. received an adjuvant or neoadjuvant chemotherapy of whom 20 received anthracyclines and 6 a taxane containing regimen. 9 pts. had no chemotherapy for metastatic disease and 9 pts. had 3 or more chemotherapies for metastatic disease. At the start of chemotherapy 24 pts belonged to group A and 11 to group B and 12 pts had hyperbilirubinemia. 20 pts had liver involvement only. So far 109 cycles had been given. 29 pts. received more than one cycle, 6 pts. received the 6 preplanned cycles so far. Myelosuppression and hand foot syndrome are the most frequent toxicities. 4 patients had a documented partial remission, 18 patients had stable disease or are still under treatment, and 13 patients progressed during treatment. The median time to progression is 6.4 months in all patients who received at least one cycle. The median overall survival for the total population was 8.3 months. Conclusion: Mi-Cap can be safely given. Initial observations show that pts with a decrease in liver enzymes or bilirubin in the first two cycles had a longer PFS. No significant financial relationships to disclose.

scholarly journals The Effect of Metformin When Combined With Neoadjuvant Chemotherapy in Breast Cancer Patients

2021 ◽  
Author(s):  
Shaimaa El-Khayat ◽  
Mohamed Abouegylah ◽  
Dina Abdallah ◽  
Ahmed Gaber Geweil ◽  
A.M. Elenbaby ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Cancer Patients ◽  
Pathological Response ◽  
Phase Iii ◽  
P Value ◽  
Base Line ◽  
Breast Cancer Patients ◽  
Group A ◽  
Group B

Abstract BackgroundMetformin has been used to treat type 2 Diabetes Mellitus since long time. It has two proposed anti-neoplastic mechanisms, direct (insulin-independent) and indirect (insulin-dependent) actions. PurposeTo assess the effect of Metformin on pathological response when combined with neoadjuvant chemotherapy in breast cancer. Material and MethodsA prospective study included stage II, III non-diabetic breast cancer patients who received neoadjuvant chemotherapy in our center during the period from May 2017 to March 2019. 59 patients met our inclusion criteria and completed the study, 27 patients received 850mg Metformin every 12 hrs with chemotherapy (group A), 32 patients received chemotherapy without Metformin (group B). Pathological response was assessed by Chevallier classification and residual cancer burden score (RCB). ResultsBoth groups were well balanced regarding base line characteristics. The results of our study showed that the rate of pathological complete response (pCR) was 14.8% in group (A) vs. 6.3% in group (B) with a P-value of 0.39. RCB class 3 was 40.7% in group (A) Vs. 68.8% in group (B) which was statistically significant with a (P-value of 0.031). Patients with triple-positive histology who had RCB class 3 were only (14.3%) in group (A) versus (60%) in group B. Patients with body mass index (BMI) ≥25 who had RCB 3 were 40% and 66.7% in group (A) and (B) respectively. ConclusionMetformin may increase the pCR especially in patients with BMI≥25 and patients with triple-positive histology, a larger phase III study is needed to confirm this finding.

Lack of effect of pegfilgrastim on anemia in breast cancer patients treated with dose-dense chemotherapy

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 11071-11071
Author(s):  
M. Manzoni ◽  
K. Bencardino ◽  
B. Rovati ◽  
S. Mariucci ◽  
F. Cappuzzo ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Locally Advanced ◽  
Dose Intensity ◽  
Breast Cancer Patients ◽  
Adjuvant Setting ◽  
Group A ◽  
The Mean ◽  
Dose Dense ◽  
Group B ◽  
The Impact

11071 Background: A greater risk of anemia has been evidenced among breast cancer (BC) pts receiving dose-dense CT. A recent report showed that filgrastim may play a role in worsening anemia in BC pts receiving intensified Epirubicin (E) + Cyclophosphamide (CTX), by inducing stem cells to differentiate into more committed hematopoietic progenitors (Papaldo P. JCO, 2006). No data are available about the impact of pegfilgrastim-induced leucocytosis on Hb levels without prophylactic erythropoietic support. Methods: We have focused on this point in 36 BC pts. 14 N+ pts received 4 cycles of E 90 mg/sqm + CTX 600 mg/sqm every 14 days in adjuvant setting. 22 pts with locally advanced disease received 4 cycles of E 75 mg/sqm + Docetaxel 80 mg/sqm every 14 days as primary CT. All pts received prophylactic pegfilgrastim 6 mg s.c, after CT. Three groups were defined on the basis of WBC: A = <10 x 103/mL; B = between 10 and 20 x 103/mL and C = > 20 x 103/mL. WBC and Hb levels at the beginning of treatment were normal in all pts and were subsequently determined on day 1 of each treatment cycle. Results: All pts received the planned CT dose intensity. Only 3 pts developed G2 anemia and were excluded from the analysis, because of receiving darbepoietin alpha support. Among the 14 pts treated in adjuvant setting, 5 dropped in group A, 6 in group B and 3 in group C. The mean Hb decrease from the baseline to the last CT course was - 1.5 g/dL; -1.4, -1.8 and -1.4 in group A, B and C, respectively. In the primary setting, 4 pts dropped in group A, 12 in group B and 4 in group C. The mean Hb decrease was -1.5 g/dL; -1.3, -1.4 and -1.8 in group A, B and C respectively. No statistically significant correlation was found between the Hb levels and the degree of leukocytosis. Conclusions: Pegfilgrastim does not worsen anemia in BC pts treated with dose- dense CT, even when its use is related to some degree of leucocytosis. No significant financial relationships to disclose.

Prediction of preclinical myocardial damage utilizing cardiac biomarkers and ultrasound myocardial tissue characterization by integrated backscatter in patients with breast cancer treated with postoperative adjuvant radiotherapy.

2012 ◽  
Vol 30 (27_suppl) ◽  
pp. 169-169
Author(s):  
Yong Zhang
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Myocardial Damage ◽  
Posterior Wall ◽  
Left Ventricular ◽  
Cardiac Biomarkers ◽  
Breast Cancer Patients ◽  
Radiotherapy Group ◽  
Group A ◽  
Group B

169 Background: To evaluate whether cardiac biomarkers, ultrasonic integrated backscatter (IBS) can predict early myocardial damage in breast cancer patients treated with postoperative adjuvant radiotherapy. Methods: Forty-eight left-sided breast cancer patients treated with modified radical mastectomy and non-anthracycline containing chemotherapy regimen were examined. Baseline blood samples were drawn for cardiac markers analysis, including Troponin T (TnT), C-reactive protein (CRP), and brain natriuretic peptide (BNP). Calibrated myocardial IBS (CMIBS, assessed by comparison of the anterior wall (AW), inferior wall (IW), anteroseptum (AS) and posterior wall (PW) with pericardial IBS intensity), cyclic variation of IBS (CVIBS) and conventional echocardiography parameters (LVIDd: the left ventricular internal diameter at end-diastole; IVSTd: the intraventricular septal thickness at end-diastole; PWTd: the posterior wall thickness at end-diastole; LVDs: the left ventricular end-systolic dimension; EF: the left ventricular ejection fraction; FS: the left ventricular fractional shortening. The peak velocity of early (E) and late ventricular filling (A) were also determined for calculating the ratio E/A) were investigated before the initiation of radiotherapy (group A), during (group B, 3 weeks after the initiation, the cumulative dose was about 30Gy) and after radiotherapy (group C, 5 weeks, the cumulative dose was about 50Gy). At each time point, blood was drawn to measure TnT, CRP, and BNP. Results: TnT, CRP, and BNP did not change over time. CMIBS of AW and AS were significantly increased after radiotherapy both during (group B, p<0.05) and at the end of treatment (group C, p<0.01) and meanwhile CVIBS and E/A were decreased significantly throughout the treatment period (group B, p<0.05 for both; group C, p<0.01 for both) compared with the beginning (group A). Conclusions: Myocardial IBS offers a promising approach for early clinical detection and characterization of evolution of cardiomyopathy induced by radiotherapy in breast cancer patients.

Sign in / Sign up

Export Citation Format

Share Document