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1.
Mohammad Hashemi Sara Sanaei Seyeh Mehdi Hashemi Ebrahim Eskandari Gholamreza Bahari 《Clinical breast cancer》2018,18(5):e883-e891
Introduction
The murine double minute 4 (MDM4) protein is a negative regulator of p53, and its upregulation has been observed in many tumor types. Previous literature suggested that genetic variations in the MDM4 gene are associated with risk of different cancers. The objective of the present study was to examine the effect of 3 common genetic variants of MDM4, rs4245739 A>C, rs11801299 G>A, and rs1380576 C>G, on the risk of breast cancer (BC) in a southeast Iranian population sample.Patients and Methods
A total of 265 BC patients and 221 healthy women were included in this case-control study. We used polymerase chain reaction (PCR)-restriction fragment length polymorphism and tetra amplification refractory mutation system-PCR methods for detection of MDM4 polymorphisms.Results
Our findings showed that rs1380576 C>G was associated with a reduced risk of BC using co-dominant (GC vs. CC: odds ratio [OR], 0.54; 95% confidence interval [CI], 0.34-0.84; P = .006; and GG vs. CC: OR, 0.49; 95% CI, 0.26-0.94; P = .044), dominant (CG+GG vs. CC: OR, 0.54; 95% CI, 0.35-0.82; P = .004), and allele models (G vs. C: OR, 0.74; 95% CI, 0.57-0.96; P = .025). However, our study failed to show any relationship between rs4245739 A>C and rs11801299 G>A variants and BC risk (P > .05). We also found no significant association between MDM4 variants and clinical characteristics of BC patients (P > .05).Conclusion
Our findings proposed that the MDM4 rs1380576 C>G polymorphism was a protective factor for BC risk in our population. Additional studies with larger sample sizes and diverse ethnicities are required to confirm our findings. 相似文献2.
R. Jared Weinfurtner Bethany Niell Yasmin Mekhail Emily Aguila Leena Kamat 《Clinical breast cancer》2018,18(5):e1031-e1036
Background
Women with breast imaging often seek second opinions at tertiary care centers. Our study measures the frequency of discrepancy between initial and second opinion breast imaging recommendations and evaluates the impact on patient management.Materials and Methods
A retrospective chart review was conducted on 504 consecutive patients with second opinion breast radiology interpretations performed by 6 sub-specialized breast radiologists at a dedicated cancer center from January 1, 2014 through September 1, 2014. Outside imaging reports were compared with second opinion reports to categorize discrepancies. Interpretations were considered discrepant in cases with Breast Imaging Reporting and Data System (BI-RADS) category changes, recommendation for additional imaging, or identification of previously undiagnosed additional extent of disease greater than 5 cm. The frequencies of discrepancy, alterations in surgical management, and incremental cancer detection were measured. Statistical analysis of associated factors was performed with the Fisher exact test, with a P-value < .05 considered significant.Results
Second opinion evaluation discrepancies were seen in 287 (57%) patients and resulted in percutaneous image-guided biopsies in 92 (18%). Forty-five additional sites of cancer were biopsy-detected in 41 (8%) patients, including 20 breast malignancies and 25 axillary metastases. Another 9 biopsies yielded high-risk pathology. Second opinion interpretations altered surgical management in 66 (13%) patients. Factors associated with increased discrepancy frequency were cancer diagnosis at presentation (P = .004), dense breasts (P = .005), and the absence of prior studies for comparison (P = .007).Conclusion
Although additional imaging and resources are required, second opinion radiology review by subspecialized breast radiologists increases cancer detection and results in clinically relevant changes in patient management. 相似文献3.
B.A. Wan V. Ganesh L. Zhang P. Sousa L. Drost J. Lorentz D. Vesprini J. Lee E. Rakovitch F.-I. Lu A. Eisen C. Yee H. Lam E. Chow 《Clinical oncology (Royal College of Radiologists (Great Britain))》2018,30(6):354-365
Aims
Male breast cancer is a rare disease with limited evidence-based guidelines for treatment. This study aimed to identify demographic, pathological and clinical factors associated with its prognosis.Materials and methods
A retrospective review of 161 male breast cancer patients diagnosed at a single institution from 1987 to June 2017 was conducted. Patient demographics, disease characteristics, treatment and outcome were extracted and included in competing-risk analysis and the univariate Cox proportional hazard model for univariate analysis. Factors with P < 0.10 were included in multivariable analysis.Results
The mean age at diagnosis was 67 years (standard deviation = 11.2) and the median follow-up duration was 5.3 years (range 0–25 years). There were 48 deaths, including 23 cancer-specific deaths. The actuarial median survival was 19.9 years. In multivariable analysis, factors associated with overall survival were size of tumours (hazard ratio 2.0; 95% confidence interval 1.4–2.7, P < 0.0001) and diagnosis of metastatic disease (hazard ratio 8.7; 95% confidence interval 1.9–40.6; P = 0.006). Of 138 patients without metastases at diagnoses, 11 had local-regional recurrence and 26 had distant metastases. In the multivariable model for local-regional recurrence, a more recent year of diagnosis was associated with reduced risk (hazard ratio 0.9, 95% confidence interval 0.8–1.0, P = 0.008), whereas more positive lymph nodes was associated with higher risk (hazard ratio 2.2, 95% confidence interval 1.2–4.0, P = 0.01). A higher risk of metastases was associated with more positive lymph nodes (hazard ratio 1.9; 95% confidence interval 1.1–3.3; P = 0.03) and tumour size (hazard ratio 1.8; 95% confidence interval 1.1–2.9; P = 0.01). A higher risk of any recurrence or metastases was associated with the number of positive nodes (hazard ratio 1.9; 95% confidence interval 1.2–3.0; P = 0.005) and tumour size (hazard ratio 1.6; 95% confidence interval 1.1–2.2; P = 0.01).Conclusion
In general, tumour size and more positive lymph nodes were associated with worse prognosis. Larger powered studies are needed to identify prognostic factors with smaller effect sizes. 相似文献4.
Background
Brain metastasis (BM) is a life-threatening event in breast cancer patients. Identifying patients at a high risk for BM can help to adopt screening programs and test preventive interventions. We tried to identify the incidence of BM in different stages and subtypes of breast cancer.Patients and Methods
We reviewed the clinical records of 2193 consecutive breast cancer patients who presented between January 1999 and December 2010. We explored the incidence of BM in relation to standard clinicopathological factors, and determined the cumulative risk of BM according to the disease stage and phenotype.Results
Of the 2193 included women, 160 (7.3%) developed BM at a median follow-up of 5.8 years. Age younger than 60 years (P = .015), larger tumors (P = .004), lymph node (LN) positivity (P < .001), high tumor grade (P = .012), and HER2 positivity (P < .001) were associated with higher incidence of BM in the whole population. In patients who presented with locoregional disease, 3 factors independently predicted BM: large tumors (hazard ratio [HR], 3.60; 95% confidence interval [CI], 1.54-8.38; P = .003), axillary LN metastasis (HR, 4.03; 95% CI, 1.91-8.52; P < .001), and HER2 positivity (HR, 1.89; 95% CI, 1.0-3.41; P = .049). A Brain Relapse Index was formulated using those 3 factors, with 5-year cumulative incidence of BM of 19.2% in those having the 2 or 3 risk factors versus 2.5% in those with no or 1 risk factor (P < .001). In metastatic patients, 3 factors were associated with higher risk of BM: HER2 positivity (P = .007), shorter relapse-free interval (P < .001), and lung metastasis (P < .001).Conclusion
Disease stage and biological subtypes predict the risk for BM and subsequent treatment outcome. 相似文献5.
Margaret M. Kozak Clare E. Jacobson Rie von Eyben Emily Walck Erqi L. Pollom Melinda Telli Kathleen C. Horst 《Clinical breast cancer》2018,18(5):e1077-e1085
Purpose
To identify patterns of distant failure (DF) in premenopausal women receiving neoadjuvant chemotherapy (NAC) for breast cancer.Patients and Methods
Premenopausal patients treated with NAC between 2005 and 2015 at a single institution were retrospectively reviewed. Timing and location of local, regional, and distant metastases were described. Predictors for DF and overall survival (OS) were analyzed.Results
Of 225 patients, there were 24 (10.7%) local, 30 (13.3%) regional, and 63 (28.0%) distant recurrences. Cumulative incidence of DF was higher in patients younger than age 40 (P = .01), in those with residual tumor size > 2 cm (P < .0001), in those with positive lymph nodes after NAC (P = .0003), and in those without pathologic complete response (P < .0001). Cumulative incidence of brain metastases was most common in patients with human epidermal growth factor receptor 2 (HER2)-positive disease (P = .05). Time from development of metastatic disease to death varied by breast cancer subtype (P = .019), as did 5-year OS (P = .024). Women with HER2-positive and triple-negative disease had the highest incidence of brain metastases and the shortest time from development of metastases to death. On multivariable analysis, luminal B subtype (P = .025), pathologic complete response (P = .0014), young age (P = .0008), lack of hormone therapy (P < .0001), lymphovascular space involvement (P < .0001), and pathologic size of the primary tumor (P < .0001) were all significant predictors for DF.Conclusion
Patterns of DF after NAC in premenopausal women vary by breast cancer subtype, with DF more common than locoregional failure. Young age remains an independent poor prognostic factor, and OS differs by breast cancer subtype. 相似文献6.
Yunju Kim Sung Hoon Sim Boram Park Keun Seok Lee In Hye Chae In Hae Park Youngmi Kwon So-Youn Jung Seeyoun Lee Kyounglan Ko Han-Sung Kang Chan Wha Lee Eun Sook Lee 《Clinical breast cancer》2018,18(6):459-467.e1
Purpose
To investigate the diagnostic performance of magnetic resonance imaging (MRI) for predicting pathologic complete response after neoadjuvant chemotherapy (NAC) depending on subtypes of breast cancer using different interpretation thresholds of MRI negativity.Patients and Methods
A total of 353 women with breast cancer who had undergone NAC were included. Pathologic examination after complete surgical excision was the reference standard. Tumors were divided into 4 subtypes on the basis of expression of hormone receptor (HR) and human epidermal growth factor receptor 2 (HER2). Tumor enhancement was assessed on early and late phases of MRI. MRI negativity was divided into radiologic complete response (rCR, complete absence of enhancement on both early and late phases) and near-rCR (no discernible early enhancement but observed late enhancement).Results
Ninety (25.5%) of 353 patients experienced pathologic complete response. When analyzing the data of all patients, sensitivity of MRI was higher for rCR versus near-rCR (97.72% vs. 90.49%, P < .0001), whereas specificity was lower for rCR versus near-rCR (44.44% vs. 72.22%, P < .0001). Accuracy was equivalent (84.14% vs. 85.84%). In HR?HER2+ tumors, 100% sensitivity and negative predictive value were achieved by assessing early enhancement only. In HR+HER2? tumors, sensitivity of MRI was higher for rCR versus near-rCR (96.12% vs. 86.82%, P = .0005).Conclusion
Diagnostic performance of MRI after NAC differs in accordance with the subtypes and threshold of MRI negativity. MRI assessment with consideration of tumor subtypes is required, along with standardization of MRI interpretation criteria in the NAC setting. 相似文献7.
Ah Young Park Bo Kyoung Seo Heon Han Kyu Ran Cho Ok Hee Woo Sang Hoon Cha Jaehyung Cha 《Clinical breast cancer》2018,18(4):261-269
Background
This study was conducted to evaluate the clinical effect of real-time magnetic resonance imaging (MRI)-navigated ultrasonography (US) for preoperative second-look examination in patients with breast cancer.Patients and Methods
Between October 2013 and February 2015, 232 patients with breast cancer underwent MRI for staging; second-look US was performed in 70 patients to evaluate additional lesions suspected to be disease detected using MRI. We retrospectively included 67 lesions in 55 patients. Lesions were classified as detected on conventional US (group 1), and not visible on conventional US, but detected on MRI-navigated US (group 2). The imaging features between groups 1 and 2 were compared using Student t, χ2, or Fisher exact tests. We compared the detection rate and histopathology of additional lesions using a McNemar test.Results
Heterogeneous background echotexture (69.6% [16 of 23] vs. 34.1% [14 of 41]) and lesion isoechogenicity (65.2% [15 of 23] vs. 7.3% [3 of 41]) on US and middle or posterior lesion depth on MRI (78.3% [18 of 23] vs. 46.3% [19 of 41]) were more common in group 2 (P < .05). More lesions were detected using MRI-navigated US (64 of 67; 95.5%) than conventional US (41 of 67; 61.2%; P < .01). Using MRI-navigated US we found more high-risk or malignant lesions than conventional US (21 vs. 11; P < .01). The optimal treatment plan was determined for 9 of 16 (56.3%) patients by virtue of MRI-navigated US.Conclusion
Real-time MRI-navigated US significantly improved the detection of additional high-risk or malignant lesions during second-look US in preoperative evaluation of patients with breast cancer and ultimately determined the optimal treatment plan. 相似文献8.
Jianyang Wang Shulian Wang Yu Tang Hao Jing Guangyi Sun Jing Jin Yueping Liu Yongwen Song Weihu Wang Hui Fang Hua Ren Zihao Yu Yexiong Li 《Clinical breast cancer》2018,18(5):e975-e984
Background
To investigate the superiority of breast-conserving surgery (BCS) plus radiotherapy (RT) compared with mastectomy alone for patients with stage I breast cancer in a real-world setting.Patients and Methods
The data from patients with histologically confirmed stage I breast cancer treated from 1999 to 2014 were retrospectively reviewed. The association of outcomes with the choice of treatment (BCS plus RT vs. mastectomy) was evaluated using multivariable proportional hazards regression and further confirmed using propensity score matching methods.Results
Of 6137 eligible patients in the present study, 1296 underwent BCS plus RT and 4841 underwent mastectomy plus axillary lymph node dissection without RT (mastectomy group). Multivariate analysis revealed that BCS plus RT was related to similar locoregional recurrence-free survival but greater distant metastasis-free survival (P = .003) and overall survival (P = .036) compared with mastectomy. For the 1252 pairs of patients matched using propensity score matching, the BCS plus RT groups enjoyed significantly greater 5-year overall survival (99.1% vs. 96.1%; P = .001), distant metastasis-free survival (97.0% vs. 92.2%; P < .001), and disease-free survival (95.3% vs. 90.2%; P = .001) compared with the mastectomy group.Conclusion
BCS plus RT provided better outcomes than mastectomy for eligible patients with stage I breast cancer and should be offered as a preferred treatment option. 相似文献9.
John V. Hegde Xiaoyan Wang Deanna J. Attai Maggie L. DiNome Amy Kusske Anne C. Hoyt Sara A. Hurvitz Joanne B. Weidhaas Michael L. Steinberg Susan A. McCloskey 《Clinical breast cancer》2018,18(2):e205-e218
Introduction
Contralateral prophylactic mastectomy (CPM) rates are rising, with fear implicated as a contributing factor. This study used a contralateral breast cancer (CBC) risk stratification tool to assess whether the selection of CPM is reflective of future CBC risk.Patients and Methods
This retrospective study evaluated 404 women with unilateral breast cancer treated with breast conservation, unilateral mastectomy, or bilateral mastectomy within a single multidisciplinary clinic. Women were evaluated by the Manchester risk tool to calculate lifetime CBC risk. Logistic regression analysis was used to evaluate whether CBC risk was associated with CPM, and the clinical rationale for prophylactic mastectomy justification was recorded.Results
Sixty-two percent underwent breast conservation, 18% unilateral mastectomy, and 20% bilateral mastectomy. In the CPM cohort, 36% had > 20% calculated lifetime CBC risk. In the invasive cohort, younger age (odds ratio 2.65, P < .0001) and genetic mutation positivity (odds ratio 35.39, P = .019) independently predicted CPM. Other contributing factors included benign contralateral breast findings (29%) and recommendations against breast conservation due to disease burden (28%). Six percent selected CPM as a result of an unsubstantiated fear regarding breast cancer.Conclusion
The majority of women (63%) who selected CPM had < 20% CBC risk. In these lower-risk women selecting CPM, factors increasing reasonable fear dominated surgical choice (81% of this subset). 相似文献10.
W.J. Choi J.H. Cha H.H. Kim H.J. Shin E.Y. Chae K.H. Jung J.-H. Ahn S.-B. Kim B.H. Son S.H. Ahn 《Clinical oncology (Royal College of Radiologists (Great Britain))》2017,29(10):653-661
Aims
To investigate whether preoperative magnetic resonance imaging (MRI) in patients with primary breast cancer is predictive of disease-free (DFS) and overall survival and to determine the prognostic factors indicating survival.Materials and methods
This retrospective study was approved by the institutional review board and the requirement for informed consent was waived. From 2009 to 2010, 828 women with primary breast cancer and preoperative MRI were matched with 1613 women without such imaging. Patients were matched with regards to 25 patient and tumour-related covariates. A Cox proportional hazards model was used to investigate the time to recurrence and to estimate the hazard ratio for preoperative MRI. Log-rank tests and Cox proportional hazards survival analysis were carried out on total recurrence DFS and overall survival in the unmatched datasets.Results
In total, 799 matched pairs were available for survival analysis. The MRI group showed a tendency towards better survival outcome; however, there were no significant differences in DFS and overall survival. Age at diagnosis (DFS hazard ratio = 0.98; overall survival hazard ratio = 1.04), larger tumour size (DFS hazard ratio = 1.01; overall survival hazard ratio = 1.02), triple negative breast cancer (DFS hazard ratio = 2.64; overall survival hazard ratio = 3.44) and the presence of lymphovascular invasion (DFS hazard ratio = 2.12; overall survival hazard ratio = 2.70) were independent significant variables for worse DFS and overall survival.Conclusion
Preoperative MRI did not result in an improvement in a patient's outcome. Age at diagnosis, tumour size, molecular subtype and lymphovascular invasion were significant independent factors affecting both DFS and overall survival. 相似文献11.
Introduction
The purpose of this study was to investigate the impact of single nucleotide polymorphisms (SNPs) in the acylphosphatase 2 gene and the SNP-SNP interactions on breast cancer (BC) risk in Chinese Han women.Patients and Methods
A logistic regression model was used to examine the association between SNPs and BC risk. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated. Generalized multifactor dimensionality reduction was employed to analyze the SNP-SNP interaction.Results
Logistic regression analysis showed that BC risk was significantly higher in carriers with the rs1682111-A allele than those with the TT genotype (TA + AA vs. TT; adjusted OR, 1.47; 95% CI, 1.21-1.92). In addition, we also found that BC risk was significantly higher in carriers with the rs10439478-C allele than those with the AA genotype (AC + CC vs. AA); adjusted OR, 1.67; 95% CI, 1.29-2.11. We found a significant 2-locus model (P = .0010) involving rs1682111 and rs10439478; the cross-validation consistency of this model was 10 of 10, and the testing accuracy was 60.11%. Participants with the TA or AA of rs1682111 and the AC or CC of rs10439478 genotype have the highest BC risk, compared with subjects with the TT of rs1682111 and the AA of rs10439478 genotype (OR, 2.52; 95% CI, 1.67-3.44), after covariate adjustment for gender, age, age at menarche, number of children, and body mass index.Conclusions
Minor allele of rs1682111 and rs10439478 and its interaction were associated with increased BC risk. 相似文献12.
Loïc Lelièvre Philippe Clézardin Laurent Magaud Laurent Roche Nicole Tubiana-Mathieu Jean-Dominique Tigaud Delphine Topart Nadia Raban Marie-Ange Mouret-Reynier Patrice Mathevet 《Clinical breast cancer》2018,18(6):e1311-e1321
Introduction
Neoadjuvant chemotherapy has become the treatment of choice for locally advanced breast cancer. Zoledronic acid (ZA) is a bisphosphonate initially used in the treatment of bone metastases because of its antibone resorption effect. Antitumor effects of ZA, including the inhibition of cell adhesion to mineralized bone or the antiangiogenic effect, have been demonstrated. However, the clinical significance of these effects remains to be determined.Materials and Methods
We undertook a multicenter open-label randomized trial to analyze the value of adding ZA to neoadjuvant chemotherapy for TNM clinical stage T2/T3 breast cancer. The primary endpoint was the evolution of serum VEGF.Results
The data from 24 patients were included in the ZA group and 26 in the control group. The evolution of serum VEGF was slightly in favor of ZA at 5.5 months (?0.7% vs. +7.5%), without reaching statistical significance (P = .52). The secondary endpoints were the breast conservation rate (higher with ZA; 83.3% vs. 65.4%; P = NS), pathologic complete response (no effect), and circulating tumor cells (odds ratio, 0.68 in favor of ZA; 95% confidence interval, 0.02-24.36). No cases of jaw necrosis or severe renal failure were observed in either group.Conclusion
ZA is an antitumor drug of interest because of its multiple effects on tumor biology. Larger trials with longer follow-up that include additional endpoints such as relapse and survival rates would be of interest. 相似文献13.
Giovanni Grandi Angela Toss Angelo Cagnacci Luigi Marcheselli Silvia Pavesi Fabio Facchinetti Stefano Cascinu Laura Cortesi 《Clinical breast cancer》2018,18(1):e15-e24
Background
We estimated the association between combined hormonal contraceptive (CHC) use and breast cancer (BC) incidence in a well-selected population of women at familial risk of BC at the Modena Family Cancer Clinic.Materials and Methods
We performed a retrospective cohort study by reviewing the data from 2527 women (4.5% BRCA mutation carriers, 72.2% high risk, and 23.3% intermediate risk using the Modena criteria and the Tyrer-Cuzick model).Results
We did not find any specific feature of breast cancer (infiltration, hormone receptor and HER2 status, onset before age 35 years, multiple diagnoses) in the CHC users (P > .05). Only 2.0% of women used a preparation with ≥ 50 μg of ethinylestradiol (EE). The use of CHCs was not associated with an increased risk of breast cancer (cumulative hazard: never used, 0.17; CHC users, 0.20; P = .998), regardless of the duration of use (cumulative hazard: never used, 0.17, used < 5 years, 0.20; used 5-10 years, 0.14; used > 10 years, 0.25; P = .414). This was confirmed for the different risk groups when interacted in a Cox proportional hazard regression model. The EE dose did not influence the risk of BC (cumulative hazard, 2.37; 95% confidence interval, 0.53-10.1; never used, 0.18; EE < 20 μg used, 0.04; EE ≥ 20 μg used, 0.16; P = .259). The types of progestins used might influence the risk, with some, such as gestodene (P = .028) and cyproterone acetate (P = .031), associated with an even greater reduced risk.Conclusions
CHC use does not increase the risk of BC in a population of women with a family history, encouraging CHC use in this group of women. 相似文献14.
Apostolos Gaitanidis Michail Alevizakos Christos Tsalikidis Alexandra Tsaroucha Constantinos Simopoulos Michail Pitiakoudis 《Clinical breast cancer》2018,18(4):e469-e476
Background
It has been reported that some patients with breast cancer may refuse cancer-directed surgery, but the incidence in the United States is not currently known. The purpose of this study was to identify the incidence, trends, risk factors, and eventual survival outcomes associated with refusal of recommended breast cancer–directed surgery.Patients
A retrospective review of the Surveillance Epidemiology and End Results (SEER) database between 2004 and 2013 was performed. Patients who underwent cancer-directed surgery were compared with patients in whom cancer-directed surgery was refused, even though it was recommended.Results
Of 531,700 patients identified, 3389 (0.64%) refused surgery. An increasing trend was observed from 2004 to 2013 (P = .009). Older age (50-69: odds ratio [OR] 4.96; 95% confidence interval, 1.23-19.96; P = .024, ≥ 70 years: OR 17.27; 95% CI, 4.29-69.54; P < .001), ethnicity (P < .001), marital status (single: OR 2.28; 95% CI, 1.98-2.62; P < .001, separated/divorced/widowed: OR 2.26; 95% CI, 2.01-2.53; P < .001), higher stage (II: OR 2.05; 95% CI, 1.83-2.3; P < .001, III: OR 2.2; 95% CI, 1.87-2.6; P < .001, IV: OR 13.3; 95% CI, 11.67-15.16; P < .001), and lack of medical insurance (OR 2.11; 95% CI, 1.59-2.8; P < .001) were identified as risk factors associated with refusal of surgery. Survival analysis showed a 2.42 higher risk of mortality in these patients.Conclusion
There has been an increasing rate of patients refusing recommended surgery, which significantly affects survival. Age, ethnicity, marital status, disease stage, and lack of insurance are associated with higher risk of refusal of surgery. 相似文献15.
Woo Jung Choi Won Kyung Kim Hee Jung Shin Joo Hee Cha Eun Young Chae Hak Hee Kim 《Clinical breast cancer》2018,18(1):e115-e121
Background
We evaluated the tumor response after neoadjuvant chemotherapy (NAC) in breast cancer patients using dynamic contrast-enhanced (DCE) magnetic resonance (MR) imaging parameters assessed using a commercially available computer-aided system. We also analyzed their correlation with pathologic tumor cellularity.Materials and Methods
We retrospectively reviewed the data from 130 patients with breast cancer who had undergone NAC followed by surgery from January to October 2013. Maximum diameter, volume, peak enhancement, and persistent, plateau, and washout-enhancing components were measured using a computer-aided system on DCE MR images and correlated with the Miller-Payne grading system. Patients with a Miller-Payne grade of 5 were classified into the pathologic complete response (pCR) group. Patients with grades 1, 2, 3, and 4 were included in the non-pCR group. Diagnostic performance was evaluated using receiver operating characteristic curve analysis.Results
Twenty patients were included in the pCR group and 110 patients in the non-pCR group. Of the 6 parameters, the rate of tumor volume reduction (r = 0.729, P < .001) showed the strongest correlation with the Miller-Payne grading system, followed by the maximum diameter (r = 0.706, P < .001) and washout component (r = 0.606, P < .001). The area under the receiver operating characteristic curve (Az value) was the largest for the rate of volume reduction (Az = 0.895), followed by the maximum diameter (Az = 0.891).Conclusion
The tumor volume changes in breast cancers before and after NAC, measured automatically using a commercially available computer-aided system and a clinical DCE MR imaging protocol might be the most accurate tool for evaluation of the pathologic response after NAC. 相似文献16.
Background
Breast cancer is the most common cancer in women characterized by a high variable clinical outcome among individuals treated with targeted therapies.Patients and Methods
In this study, we performed a population-based approach intersecting high-throughput genotype data from Iraqi populations with publicly available pharmacogenomics information to estimate the frequency of genotypes correlated with responsiveness to breast cancer treatment thus improving the clinical management of this disease in an efficient and cost effective way. A total of 50 patients and 25 healthy controls were enrolled in our study. Genotyping of rs4880, rs4244285, and rs1801274 were examined in association with breast cancer in Iraqi women.Results
We found that individuals carrying the CT genotype of rs4880 manifested an increased risk of breast cancer compared with those carrying the TT genotype (odds ratio [OR], 0.171; 95% confidence interval [CI], 0.053-0.551; P = .002). In the dominant model, we observed that the CT and CC genotype of rs4880 showed an increased risk of breast cancer compared with the TT genotype (OR, 0.248; 95% CI, 0.089-0.690; P = .006). Moreover, subjects with the GA genotype of rs4244285 presented a higher risk of breast cancer than the GG genotype (OR, 0.256; 95% CI, 0.066-0.987; P = .038) and dominant models (OR, 0.025; 95% CI, 0.054-0.775; P = .013).Conclusion
The analysis revealed that rs1801274 showed linkage disequilibrium and decreased risk of breast cancer. In conclusion, our study suggests that rs4880 and rs4244285 polymorphisms play an important role in development of breast cancer in an Iraqi population, and no significant association was found between rs1801274 and the risk of breast cancer. 相似文献17.
Ye-Lei Xiao Kang Wang Qiang Liu Jie Li Xiang Zhang Hong-Yuan Li 《Clinical breast cancer》2019,19(1):e48-e65
Background
Objections have been raised to performing risk-reducing salpingo-oophorectomy (RRSO) to reduce disease incidence and mortality of women with BRCA mutations. We aimed to examine the relationship between RRSO and breast cancer (BC) risk and mortality with a meta-analysis.Materials and Methods
We conducted a comprehensive literature search using the PubMed and Embase databases for literature published from these databases' creation to September 2017. Hazard ratio (HR) estimates were identified directly from the original articles. Pooled results were calculated on the basis of nonoverlapping studies by fixed-effect meta-analysis.Results
RRSO was associated with a significant reduction in the incidence of BC in women with BRCA1/2 mutations who had no history of BC (HR = 0.58; 95% confidence interval [CI], 0.37 to 0.78). Even in women with a history of BC, RRSO could reduce the risk of recurrence (HR = 0.50; 95% CI, 0.31 to 0.69). We further found that publication year was a critical interaction factor from a corresponding subgroup analyses in BC risk (Pheterogeneity = .024). In addition, we found that RRSO could improve the survival of women with BC (HR = 0.33; 95% CI, 0.28 to 0.38).Conclusion
Summary estimates presented here indicate that RRSO was closely related to the reduced risk of BC caused by BRCA mutations, but publication year was a critical interaction factor and it should be noted that more recent studies have failed to find a significant reduction in BC risk associated with RRSO. 相似文献18.
Maki Namura Hiroko Tsunoda Hiroshi Yagata Naoki Hayashi Atsushi Yoshida Emiko Morishita Junko Takei Koyu Suzuki Hideko Yamauchi 《Clinical breast cancer》2018,18(2):128-134
Introduction
The influence of breast cancer (BC) subtype in discrepancies between pathologic complete response (pCR) and complete response by magnetic resonance imaging (MRI-CR) after neoadjuvant chemotherapy (NAC) have not been discussed well. We evaluated the association between BC subtype and pCR or only residual in situ lesion without invasive cancer (pCR/in situ+) in patients with MRI-CR (positive predictive value [PPV]).Material and Methods
From the data of 716 patients with primary BC who were diagnosed with invasive cancer and treated with NAC and then surgery from January 2009 to May 2014 at St. Luke's International Hospital, 180 patients were determined to have MRI-CR by retrospective chart review. BC subtypes at baseline were classified into 6 subtypes, as strong estrogen receptor (ER++), moderately positive ER (ER+), negative ER (ER?), and HER2 status expression.Results
Three subtypes had PPV (pCR) ≥ 50%: ER?/HER2+ (56.3%, 27/48), ER?/HER2? (57.6%, 34/59), and ER+/HER2+ (56.2%, 9/16). However, PPV (pCR) for the ER++/HER2? and ER++/HER2+ subtypes was < 30%; notably, only 12.0% (3/25) for the ER++/HER2? subtype, which was significantly low (P < .001) compared with ER++/HER2? and other subtypes. PPV (pCR/in situ+) was significantly low at 20.0% in the ER++/HER2? subtype (P < .001 compared with other subtypes). PPV (pCR/in situ+) in other subtypes was collectively greater than 60%, and was 91.7% in the ER?/HER2+ subtype.Conclusion
We should interpret carefully MRI-CR of NAC to evaluate residual disease for ER++/HER2? BC. 相似文献19.
Qiuxia Cui Deguang Kong Zhihua Li Philemon Ahiable Kun Wang Kongming Wu Gaosong Wu 《Clinical breast cancer》2018,18(5):e875-e882
Introduction
Male breast cancer (MBC) is rare and little is known about its biological behavior. In this study we described clinical characteristics and prognosis of MBC and evaluated roles of different factors between MBC and female breast cancer (FBC).Patients and Methods
We retrospectively reviewed 42 MBC patients matched with 84 consecutive FBC patients with similar year, age, tumor, node, metastases (TNM) stage, and estrogen receptor (ER) expression from 2003 to 2016. Their clinical characteristics, treatments, and prognosis were analyzed, and immunohistochemistry for androgen receptor (AR), dachshund 1 (DACH1), sine oculis 1 (SIX1), eyes absent 1, B-cell lymphoma-2, and p53 were performed on paraffin sections.Results
MBC constituted 0.56% (42 of 7561) of consecutive breast cancer and had a median age of 55 years. The 14 paraffin samples from men and 28 from women expressed all the assessed proteins, and DACH1 was significantly higher in women (P = .043). Body mass index (P = .023) and DACH1 (P = .034) were correlated with MBC prognosis, whereas the expression of AR (P = .049), SIX1 (P = .048), surgery (P < .001), and chemotherapy (P = .001) were important for FBC in addition to already known factors: tumor size and location, TNM stage (lymph nodes and organ metastasis), radiotherapy, and ER and human epidermalgrowth factor receptor-2 (HER2) expression. No distinct difference in recurrence was observed between MBC and FBC (P = .667).Conclusion
In this study we found that DACH1 was expressed less in MBC and HER2 was expressed more in FBC. They were respectively correlated with MBC and FBC prognosis. Although no significant differences were observed between MBC and FBC prognosis, DACH1, SIX1, and AR expression requires greater attention to develop treatment strategies for MBC and FBC. 相似文献20.
Yihong Wang Alexander S. Brodsky Jinjun Xiong Mary L. Lopresti Dongfang Yang Murray B. Resnick 《Clinical breast cancer》2018,18(3):e373-e379