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Rossing M, Pedersen CB, Tvedskov T, Vejborg I, Talman ML, Olsen LR, Kroman N, Nielsen FC, Jensen MB, Ejlertsen B. Clinical implications of intrinsic molecular subtypes of breast cancer for sentinel node status. Sci Rep 2021; 11:2259. [PMID: 33500440 DOI: 10.1038/s41598-021-81538-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 01/05/2021] [Indexed: 11/08/2022] Open
Abstract
Axillary lymph node status is an important prognostic factor for breast cancer patients and sentinel lymph node biopsy (SLNB) is a less invasive surgical proxy. We examined if consecutively derived molecular subtypes from primary breast cancers provide additional predictive value for SLNB status. 1556 patients with a breast cancer > 10 mm underwent primary surgical procedure including SLNB and tumor specimens were assigned with a transcriptomics-based molecular subtype. 1020 patients had a negative sentinel node (SN) and 536 a positive. A significant association between tumor size and SN status (p < 0.0001) was found across all samples, but no association between size and SN status (p = 0.14) was found for BasL tumors. A BasL subtype was a predictor of an SN-negative status (p = 0.001, OR 0.58, 95% CI 0.38;0.90) and among the BasL, postmenopausal status was a predictor for SN-negative status (p = 0.01). Overall survival was significantly lower (p = 0.02) in patients with BasL tumors and a positive SN. Interestingly, we identified a significant correlation between hormone receptor activity and SN status within the BasL subtype. Taken together, molecular subtypes and hormone receptor activity of breast cancers add predictive value for SLNB status.
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Qiu X, Jiang Y, Zhao Q, Yan C, Huang M, Jiang T. Could Ultrasound-Based Radiomics Noninvasively Predict Axillary Lymph Node Metastasis in Breast Cancer? J Ultrasound Med 2020; 39:1897-1905. [PMID: 32329142 PMCID: PMC7540260 DOI: 10.1002/jum.15294] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 03/12/2020] [Accepted: 03/25/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES This work aimed to investigate whether quantitative radiomics imaging features extracted from ultrasound (US) can noninvasively predict breast cancer (BC) metastasis to axillary lymph nodes (ALNs). METHODS Presurgical B-mode US data of 196 patients with BC were retrospectively studied. The cases were divided into the training and validation cohorts (n = 141 versus 55). The elastic net regression technique was used for selecting features and building a signature in the training cohort. A linear combination of the selected features weighted by their respective coefficients produced a radiomics signature for each individual. A radiomics nomogram was established based on the radiomics signature and US-reported ALN status. In a receiver operating characteristic curve analysis, areas under the curves (AUCs) were determined for assessing the accuracy of the prediction model in predicting ALN metastasis in both cohorts. The clinical value was assessed by a decision curve analysis. RESULTS In all, 843 radiomics features per case were obtained from expert-delineated lesions on US imaging in this study. Through radiomics feature selection, 21 features were selected to constitute the radiomics signature for predicting ALN metastasis. Area under the curve values of 0.778 and 0.725 were obtained in the training and validation cohorts, respectively, indicating moderate predictive ability. The radiomics nomogram comprising the radiomics signature and US-reported ALN status showed the best performance for ALN detection in the training cohort (AUC, 0.816) but moderate performance in the validation cohort (AUC, 0.759). The decision curve showed that both the radiomics signature and nomogram displayed good clinical utility. CONCLUSIONS This pilot radiomics study provided a noninvasive method for predicting presurgical ALN metastasis status in BC.
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Affiliation(s)
- Xiaoying Qiu
- Departments of UltrasonographyFirst Affiliated Hospital, College of Medicine, Zhejiang UniversityHangzhouChina
| | - Yongluo Jiang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer MedicineSun Yat‐sen University Cancer CenterGuangzhouChina
| | - Qiyu Zhao
- Departments of UltrasonographyFirst Affiliated Hospital, College of Medicine, Zhejiang UniversityHangzhouChina
- Hepatobiliary and Pancreatic SurgeryFirst Affiliated Hospital, College of Medicine, Zhejiang UniversityHangzhouChina
| | - Chunhong Yan
- Departments of UltrasonographyFirst Affiliated Hospital, College of Medicine, Zhejiang UniversityHangzhouChina
| | - Min Huang
- Departments of UltrasonographyFirst Affiliated Hospital, College of Medicine, Zhejiang UniversityHangzhouChina
| | - Tian'an Jiang
- Departments of UltrasonographyFirst Affiliated Hospital, College of Medicine, Zhejiang UniversityHangzhouChina
- Hepatobiliary and Pancreatic SurgeryFirst Affiliated Hospital, College of Medicine, Zhejiang UniversityHangzhouChina
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Marrazzo E, Frusone F, Milana F, Sagona A, Gatzemeier W, Barbieri E, Bottini A, Canavese G, Rubino AO, Eboli MG, Rossetti CM, Testori A, Errico V, De Luca A, Tinterri C. Mucinous breast cancer: A narrative review of the literature and a retrospective tertiary single-centre analysis. Breast 2019; 49:87-92. [PMID: 31783314 PMCID: PMC7375663 DOI: 10.1016/j.breast.2019.11.002] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 10/14/2019] [Accepted: 11/01/2019] [Indexed: 12/15/2022] Open
Abstract
Mucinous carcinoma (MC) is a rare breast cancer characterized by the presence of large extracellular mucin amount. Two main subtypes can be distinguished: pure (PMC) and mixed (MMC). We conducted a retrospective MC analysis in our prospective maintained database, calculating disease-free survival (DFS) and 5-year overall survival (OS). We found a global 92.1% OS (higher in MMC group and statistically significative) and a DFS of 95.3% (higher in MMC group but not statistically significative).
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Affiliation(s)
- Emilia Marrazzo
- Humanitas Research Hospital and Cancer Center, Breast Surgery Dept, Milan, Rozzano, Italy
| | - Federico Frusone
- Sapienza University of Rome, Department of Surgical Sciences, Rome, Italy.
| | - Flavio Milana
- Humanitas Research Hospital and Cancer Center, Breast Surgery Dept, Milan, Rozzano, Italy
| | - Andrea Sagona
- Humanitas Research Hospital and Cancer Center, Breast Surgery Dept, Milan, Rozzano, Italy
| | - Wolfgang Gatzemeier
- Humanitas Research Hospital and Cancer Center, Breast Surgery Dept, Milan, Rozzano, Italy
| | - Erika Barbieri
- Humanitas Research Hospital and Cancer Center, Breast Surgery Dept, Milan, Rozzano, Italy
| | - Alberto Bottini
- Humanitas Research Hospital and Cancer Center, Breast Surgery Dept, Milan, Rozzano, Italy
| | - Giuseppe Canavese
- Humanitas Research Hospital and Cancer Center, Breast Surgery Dept, Milan, Rozzano, Italy
| | - Arianna Olga Rubino
- Humanitas Research Hospital and Cancer Center, Breast Surgery Dept, Milan, Rozzano, Italy
| | - Marco Gaetano Eboli
- Humanitas Research Hospital and Cancer Center, Breast Surgery Dept, Milan, Rozzano, Italy
| | - Carlo Marco Rossetti
- Humanitas Research Hospital and Cancer Center, Breast Surgery Dept, Milan, Rozzano, Italy
| | - Alberto Testori
- Humanitas Research Hospital and Cancer Center, Thoracic Surgery Dept, Milan, Rozzano, Italy
| | - Valentina Errico
- Humanitas Research Hospital and Cancer Center, Thoracic Surgery Dept, Milan, Rozzano, Italy
| | - Alessandro De Luca
- Sapienza University of Rome, Department of Surgical Sciences, Rome, Italy
| | - Corrado Tinterri
- Humanitas Research Hospital and Cancer Center, Breast Surgery Dept, Milan, Rozzano, Italy
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Lale A, Yur M, Özgül H, Alkurt EG, Yıldırım N, Aygen E, Bahadır Öz A, Arıkan TB. Predictors of non-sentinel lymph node metastasis in clinical early stage (cT1-2N0) breast cancer patients with 1-2 metastatic sentinel lymph nodes. Asian J Surg 2020; 43:538-49. [PMID: 31519397 DOI: 10.1016/j.asjsur.2019.07.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 06/23/2019] [Accepted: 07/31/2019] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE The purpose of this study was to determine the risk factors that caused non-sentinel lymph nodes (nonSLNs) metastasis by considering the clinicopathological characteristics of patients who have 1-2 sentinel lymph node (SLN) metastasis in the clinical early stage (T1-2, N0) breast cancer. METHODS The demographic and clinicopathological characteristics of the patients were recorded retrospectively. Among these, age, size of the primary breast tumor, tumor localization and multifocality/multicentricity status, preoperative serum Neutrophil/Lymphocyte rate (NLR), c-erbB2/HER2-neu status, Estrogen Receptor (ER) and Progesterone Receptor (PR) status, primary tumor proliferation index (Ki-67), histopathological grade, molecular subtypes, histopathological subtypes, nipple/areola infiltration, Lymphatic Invasion (LI), Vascular Invasion (VI), Perineural Invasion (PNI), number of metastatic SLN m(SLN), mSLN diameter, SLN Extranodal Extension (ENE) status, and number of metastatic nonSLNs were recorded. RESULTS According to the univariate analysis, the HER2 positivity, Ki-67≥%20, mSLN diameter, LI, VI, PNI, ENE and molecular subtypes were found to be significant. However, the age, tumor localization, multifocality/multicentricity, T stage, ER and PR status, tumor size, histopathological grade and subtypes, nipple/areola infiltration and NLR were not found to be significant. In the multivariate analysis, significant independent predictors in nonSLN metastasis development were found to be HER2 positivity, PNI, mSLN diameter ≥10,5 mm and ENE. CONCLUSION The HER2 positivity, ENE, PNI and mSLN diameter ≥10,5 mm were found to be very strong predictors in nonSLN metastasis development. The findings of this study have the potential to be a guideline for surgeons and oncologists when determining their patients' treatment plan. These components are candidates for inclusion among the clinicopathological factors that may be used in the new nomograms due to their higher sensitivity and specificity.
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Li JW, Tong YY, Jiang YZ, Shui XJ, Shi ZT, Chang C. Clinicopathologic and Ultrasound Variables Associated With a Heavy Axillary Nodal Tumor Burden in Invasive Breast Carcinoma. J Ultrasound Med 2019; 38:1747-1755. [PMID: 30480341 DOI: 10.1002/jum.14863] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 10/12/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVES To identify clinicopathologic and ultrasound (US) variables that were associated with a heavy nodal tumor burden, which was defined as 3 or more lymph nodes involved with metastasis to the axilla after invasive breast carcinoma. METHODS With ethical approval, 621 patients with a pathologic diagnosis of invasive breast carcinoma were retrospectively analyzed for clinical, pathologic, and US data. Pathologic findings were ascertained by the final paraffin pathologic analysis. Ultrasound characteristics were evaluated on the basis of the American College of Radiology's Breast Imaging Reporting and Data System (BI-RADS). Univariate and multivariate logistic regression analyses were used to assess the clinicopathologic and US variables that were associated with a heavy nodal tumor burden at the axilla. RESULTS There were 107 cases (17.2%) of invasive breast carcinoma with a heavy tumor burden at the axilla. The independent clinicopathologic variables for a heavy tumor burden at the axilla included a tumor size of 2 to 5 cm (odds ratio [OR], 1.86; P = .036), the presence of lymphovascular invasion (OR, 23.52; P < .001), the presence of papillary invasion (OR, 2.93; P = .043), and a non-triple-negative subtype (OR, 2.34; P = .04). The independent US features of breast tumors that were associated with a heavy tumor burden at the axilla included BI-RADS category 5 (OR, 5.50; P = .024) and a posterior acoustic shadow (OR, 1.94; P = .024). CONCLUSIONS A large tumor size, lymphovascular invasion, papillary invasion, and a non-triple-negative subtype on the pathologic analysis as well as BI-RADS category 5 and a posterior acoustic shadow on a US assessment were associated with a heavy nodal tumor burden at the axilla. These US characteristics of the primary breast carcinoma might provide additional information to axillary US for the prediction of axillary nodal tumor loads.
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Affiliation(s)
- Jia-Wei Li
- Departments of Medical Ultrasound, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yu-Yang Tong
- Departments of Medical Ultrasound, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yi-Zhou Jiang
- Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Xu-Juan Shui
- Department of Medical Ultrasound, Wenzhou People's Hospital, Third Clinical Institute, affiliated with Wenzhou Medical University, Wenzhou, China
| | - Zhao-Ting Shi
- Departments of Medical Ultrasound, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Cai Chang
- Departments of Medical Ultrasound, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
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Wang J, Tang H, Li X, Song C, Xiong Z, Wang X, Xie X, Tang J. Is surgical axillary staging necessary in women with T1 breast cancer who are treated with breast-conserving therapy? Cancer Commun (Lond) 2019; 39:25. [PMID: 31068224 PMCID: PMC6505128 DOI: 10.1186/s40880-019-0371-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 04/25/2019] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND In the post-Z0011 trial era, the need to perform surgical axillary staging for early-stage breast cancer patients, who are treated with breast-conserving therapy (BCT), is being questioned. We conducted a retrospective cohort study using the Surveillance, Epidemiology, and End Results (SEER) database to evaluate the safety of waiving surgical axillary staging in patients with T1 breast cancer treated with BCT. METHODS A total of 166,615 eligible patients diagnosed between 2000 and 2012 were divided into staging (sentinel lymph node biopsy or axillary lymph node dissection) and non-staging (no lymph node examined or only needle aspiration biopsy of lymph nodes) groups. Propensity score matching (PSM) was performed to balance disparities between the two groups. Multivariate analysis with the Cox proportional hazards model was used to assess factors related to breast cancer-specific survival (BCSS). RESULTS Although the tumor size at time of presentation was decreasing over years, the rate of surgical axillary staging increased from 93.3% to 96.9%. The 5-year BCSS rates of the whole cohort (before PSM) and matched cohort (after PSM) were 98.0% and 97.5%. Within the matched cohort, the BCSS was significantly longer in the staging group than in the non-staging group (P < 0.001). However, surgical axillary staging did not benefit patients who were 50-79 years old, had tumor size < 1 cm, histological grade I disease, or favorable histological types (tubular/mucinous/papillary) in stratified analyses (P > 0.05). Race, marital status, hormone receptors, and chemotherapy were not associated with the favorable impact of surgical axillary staging on BCSS (P > 0.05). CONCLUSION Although surgical axillary staging remains important for T1 breast cancer patients treated with BCT, it might be unnecessary for patients with old age, small tumor, grade I disease, or favorable histological types.
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Affiliation(s)
- Jin Wang
- Department of Breast Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, No. 651 Dongfeng East Road, Yuexiu District, Guangzhou, 510060, Guangdong, P.R. China.
| | - Hailin Tang
- Department of Breast Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, No. 651 Dongfeng East Road, Yuexiu District, Guangzhou, 510060, Guangdong, P.R. China
| | - Xing Li
- Department of Breast Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, No. 651 Dongfeng East Road, Yuexiu District, Guangzhou, 510060, Guangdong, P.R. China
| | - Cailu Song
- Department of Breast Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, No. 651 Dongfeng East Road, Yuexiu District, Guangzhou, 510060, Guangdong, P.R. China
| | - Zhenchong Xiong
- Department of Breast Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, No. 651 Dongfeng East Road, Yuexiu District, Guangzhou, 510060, Guangdong, P.R. China
| | - Xi Wang
- Department of Breast Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, No. 651 Dongfeng East Road, Yuexiu District, Guangzhou, 510060, Guangdong, P.R. China
| | - Xiaoming Xie
- Department of Breast Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, No. 651 Dongfeng East Road, Yuexiu District, Guangzhou, 510060, Guangdong, P.R. China
| | - Jun Tang
- Department of Breast Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, No. 651 Dongfeng East Road, Yuexiu District, Guangzhou, 510060, Guangdong, P.R. China.
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Yang J, Wang T, Yang L, Wang Y, Li H, Zhou X, Zhao W, Ren J, Li X, Tian J, Huang L. Preoperative Prediction of Axillary Lymph Node Metastasis in Breast Cancer Using Mammography-Based Radiomics Method. Sci Rep 2019; 9:4429. [PMID: 30872652 PMCID: PMC6418289 DOI: 10.1038/s41598-019-40831-z] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 02/14/2019] [Indexed: 12/13/2022] Open
Abstract
It is difficult to accurately assess axillary lymph nodes metastasis and the diagnosis of axillary lymph nodes in patients with breast cancer is invasive and has low-sensitivity preoperatively. This study aims to develop a mammography-based radiomics nomogram for the preoperative prediction of ALN metastasis in patients with breast cancer. This study enrolled 147 patients with clinicopathologically confirmed breast cancer and preoperative mammography. Features were extracted from each patient's mammography images. The least absolute shrinkage and selection operator regression method was used to select features and build a signature in the primary cohort. The performance of the signature was assessed using support vector machines. We developed a nomogram by incorporating the signature with the clinicopathologic risk factors. The nomogram performance was estimated by its calibration ability in the primary and validation cohorts. The signature was consisted of 10 selected ALN-status-related features. The AUC of the signature from the primary cohort was 0.895 (95% CI, 0.887-0.909) and 0.875 (95% CI, 0.698-0.891) for the validation cohort. The C-Index of the nomogram from the primary cohort was 0.779 (95% CI, 0.752-0.793) and 0.809 (95% CI, 0.794-0.833) for the validation cohort. Our nomogram is a reliable and non-invasive tool for preoperative prediction of ALN status and can be used to optimize current treatment strategy for breast cancer patients.
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Affiliation(s)
- Jingbo Yang
- School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, 710071, China
| | - Tao Wang
- Department of Radiology, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, 710068, China
| | - Lifeng Yang
- School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, 710071, China
| | - Yubo Wang
- School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, 710071, China
| | - Hongmei Li
- Department of Breast Diseases, Yan'an University Affiliated Hospital, Yan'an, Shaanxi, 716000, China
| | - Xiaobo Zhou
- Department of Radiology, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina, 27157, USA.
| | - Weiling Zhao
- Department of Radiology, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina, 27157, USA
| | - Junchan Ren
- School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, 710071, China
| | - Xiaoyong Li
- Department of Breast Diseases, Yan'an University Affiliated Hospital, Yan'an, Shaanxi, 716000, China
| | - Jie Tian
- School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, 710071, China
| | - Liyu Huang
- School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, 710071, China.
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Sandoughdaran S, Malekzadeh M, Mohammad Esmaeil ME. Frequency and Predictors of Axillary Lymph Node Metastases in Iranian Women with Early Breast Cancer. Asian Pac J Cancer Prev 2018; 19:1617-1620. [PMID: 29936787 PMCID: PMC6103571 DOI: 10.22034/apjcp.2018.19.6.1617] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background: Axillary lymph node metastasis is the most important predictive factor for recurrence risk and survival in patients with invasive breast carcinoma. The aim of this study was to determine factors associated with metastatic involvement of axillary lymph nodes in Iranian women with early breast cancer. Methods: This article reports a retrospective study of 774 patients with T1-T2 breast cancer who underwent resection of the primary tumor and axillary staging by SLNB and/or ALND between 2005 and 2015 at our institution. Results: Of the 774 patients included in this study, 35.5% (275 cases) had axillary lymph node involvement at the time of diagnosis. Factors associated with nodal involvement in univariate analyses were tumor size, lymphovascular invasion (LVI), tumor grade, ER/PR status and HER2 expression. All factors identified with univariate analyses were entered into a multivariate logistic regression model and tumor size (OR= 3.01, CI 2.01–4.49, P <0.001), ER/PR positivity (OR = 1.74, CI 1.1.16–2.62, P = 0.007) and presence of LVI (OR = 3.3.8, CI 2.31–4.95, P <0.001) remained as independent predictors of axillary lymph node involvement. Conclusions: In conclusion, the results of this study suggests that positive hormonal receptor status, LVI and tumor size are predictive factors for ALNM in Iranian women with early breast cancer.
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Affiliation(s)
- Saleh Sandoughdaran
- Department of Radiation Oncology, Shohada-e-Tajrish Hospital, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran,Student Research Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Kondov B, Milenkovikj Z, Kondov G, Petrushevska G, Basheska N, Bogdanovska-Todorovska M, Tolevska N, Ivkovski L. Presentation of the Molecular Subtypes of Breast Cancer Detected By Immunohistochemistry in Surgically Treated Patients. Open Access Maced J Med Sci 2018; 6:961-967. [PMID: 29983785 PMCID: PMC6026408 DOI: 10.3889/oamjms.2018.231] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 05/27/2018] [Accepted: 05/28/2018] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION The detection of estrogen, progesterone and HER-2 neu receptors on the surface of the tumour cell is a significant prognostic factor, alone or in combination. The presence or absence of receptors on the surface of the tumour cell is associated with the conditional gene expression in the tumour cell itself. Based on these genetically determined expressions of the tumour cell, five molecular subtypes of breast cancer have been classified on the St. Gallen International Expert Consensus in 2011 that can be immunohistochemically detected, with each subtype manifesting certain prognosis and aggression. AIM Analyzing the presentation of molecular subtypes of breast cancer that are immunohistochemically detected in surgically treated patients at the Clinic for Thoracic and Vascular Surgery. MATERIAL AND METHODS We used the international classification on molecular subtypes of breast cancer which divides them into: Luminal A (ER+ and/or PR+, HER-2 negative, Ki-67 < 14%), Luminal B with HER-2 negative (ER+ and/or PR+, HER-2 negative, Ki-67 ≥ 14%), Luminal B with HER-2 positive (ER+ and/or PR+, HER-2+, any Ki-67), HER-2 enriched (ER-, PR-, HER-2+), and basal-like (triple negative) (ER-, PR-, HER-2 negative, CK5/6+ and/or EGFR+). A total of 290 patients, surgically treated for breast cancer, were analysed during 2014. RESULTS In our analysis, we found that Luminal A was present in 77 (26.55%) patients, Luminal B HER-2 negative was present in 91 (31.38%) patients, Luminal B HER-2 positive was present in 70 (24.14%) patients, HER-2 enriched was present in 25 (8.62%) patients and basal-like (or triple negative) was present in 27 (9.31%) patients. CONCLUSION Detecting the subtype of breast cancer is important for evaluating the prognosis of the disease, but also for determining and providing an adequate therapy. Therefore, determining the subtype of breast cancer is necessary for the routine histopathological assay.
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Affiliation(s)
- Borislav Kondov
- University Clinic for Thoracic and Vascular Surgery, Medical Faculty, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
| | - Zvonko Milenkovikj
- University Clinic for Infectious Disease and Febrile Conditions, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
| | - Goran Kondov
- University Clinic for Thoracic and Vascular Surgery, Medical Faculty, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
| | - Gordana Petrushevska
- Institute of Pathology, Medical Faculty, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
| | - Neli Basheska
- Laboratory for Cytology and Pathology, University Clinic of Oncology and Radiotherapy, Medical Faculty, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
| | | | - Natasha Tolevska
- University Clinic for Thoracic and Vascular Surgery, Medical Faculty, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
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Majid S, Rydén L, Manjer J. Predictive factors for sentinel node metastases in primary invasive breast cancer: a population-based cohort study of 2552 consecutive patients. World J Surg Oncol 2018. [PMID: 29530065 PMCID: PMC5848524 DOI: 10.1186/s12957-018-1353-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Axillary lymph node status is one of the most important prognostic factors for breast cancer. The aim of this study was to determine predictive factors for metastasis to sentinel node (SN) in primary invasive breast cancer. METHOD This is a study of 3979 patients with primary breast cancer during 2008-2013 in Malmö and Lund scheduled for surgery and included in the information retrieved from Information Network for Cancer Care (INCA). The final study population included 2552 patients with primary invasive breast cancer. The risk of metastases to SN were examined in relation to potential clinicopathological factors such as age, screening mammography, tumor size, tumor type, histological grade, estrogen status, progesterone status, Her-2 status, multifocality, and lymphovascular invasion. Binary logistic regression was used; adjusted analyses yielded odds ratio (OR) with 95% confidence interval. RESULTS Tumors detected by mammography screening were less likely to be associated with metastases to SN compared to those not found by mammography screening (0.63; 0.51-0.80). Negative hormonal status for estrogen associated with lower risk for SN metastases compared to tumor with positive estrogen status (0.64; 0.42-0.99). Tumors with a size more than 20 mm had higher risk to metastasize to SN (1.84; 1.47-2.33) compared to tumors less than 20 mm. Multifocality (1.90; 1.45-2.47) and lymphovascular invasion (3.74; 2.66-5.27) were also strong predictive factors for SN metastases. CONCLUSION SN metastasis is less likely to occur in women with invasive breast cancer diagnosed by screening mammogram. Tumors with negative estrogen status are associated with low risk for SN metastases. Tumors larger than 20 mm, multifocality, or lymphovascular invasion are also factors associated with high risk for SN metastases.
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Affiliation(s)
- Shabaz Majid
- Department of Surgery, Central Hospital of Kristianstad, SE-291 85, Kristianstad, Sweden. .,Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden.
| | - Lisa Rydén
- Department of Surgery, Skåne University Hospital, Malmö, Sweden.,Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Jonas Manjer
- Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden.,Department of Surgery, Skåne University Hospital, Malmö, Sweden
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Marrazzo A, Damiano G, Taormina P, Buscemi S, Lo Monte AI, Marrazzo E. Does Conservative Surgery for Breast Carcinoma Still Require Axillary Lymph Node Evaluation? A Retrospective Analysis of 1156 Consecutive Women With Early Breast Cancer. Clin Breast Cancer 2017; 17:e53-e57. [DOI: 10.1016/j.clbc.2016.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 09/06/2016] [Accepted: 10/12/2016] [Indexed: 02/05/2023]
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Paula LM, De Moraes LHF, Do Canto AL, Dos Santos L, Martin AA, Rogatto SR, De Azevedo Canevari R. Analysis of molecular markers as predictive factors of lymph node involvement in breast carcinoma. Oncol Lett 2017; 13:488-496. [PMID: 28123587 DOI: 10.3892/ol.2016.5438] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 09/15/2016] [Indexed: 11/06/2022] Open
Abstract
Nodal status is the most significant independent prognostic factor in breast cancer. Identification of molecular markers would allow stratification of patients who require surgical assessment of lymph nodes from the large numbers of patients for whom this surgical procedure is unnecessary, thus leading to a more accurate prognosis. However, up to now, the reported studies are preliminary and controversial, and although hundreds of markers have been assessed, few of them have been used in clinical practice for treatment or prognosis in breast cancer. The purpose of the present study was to determine whether protein phosphatase Mg2+/Mn2+ dependent 1D, β-1,3-N-acetylglucosaminyltransferase, neural precursor cell expressed, developmentally down-regulated 9, prohibitin, phosphoinositide-3-kinase regulatory subunit 5 (PIK3R5), phosphatidylinositol-5-phosphate 4-kinase type IIα, TRF1-interacting ankyrin-related ADP-ribose polymerase 2, BCL2 associated agonist of cell death, G2 and S-phase expressed 1 and PAX interacting protein 1 genes, described as prognostic markers in breast cancer in a previous microarray study, are also predictors of lymph node involvement in breast carcinoma Reverse transcription-quantitative polymerase chain reaction analysis was performed on primary breast tumor tissues from women with negative lymph node involvement (n=27) compared with primary tumor tissues from women with positive lymph node involvement (n=23), and was also performed on primary tumors and paired lymph node metastases (n=11). For all genes analyzed, only the PIK3R5 gene exhibited differential expression in samples of primary tumors with positive lymph node involvement compared with primary tumors with negative lymph node involvement (P=0.0347). These results demonstrate that the PIK3R5 gene may be considered predictive of lymph node involvement in breast carcinoma. Although the other genes evaluated in the present study have been previously characterized to be involved with the development of distant metastases, they did not have predictive potential.
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Affiliation(s)
- Luciana Marques Paula
- Laboratory of Molecular Biology of Cancer, Institute of Research and Development (IP&D), University of Vale do Paraíba, São José dos Campos, 12244-000 São Paulo, Brazil
| | | | - Abaeté Leite Do Canto
- Center for Diagnostic Medicine, Pathology and Cytology (CIPAX), São José dos Campos, 12243-000 São Paulo, Brazil
| | - Laurita Dos Santos
- Laboratory of Biomedical Vibrational Spectroscopy, Institute of Research and Development (IP&D), University of Vale do Paraíba, São José dos Campos, 12244-000 São Paulo, Brazil
| | - Airton Abrahão Martin
- Laboratory of Biomedical Vibrational Spectroscopy, Institute of Research and Development (IP&D), University of Vale do Paraíba, São José dos Campos, 12244-000 São Paulo, Brazil
| | - Silvia Regina Rogatto
- NeoGene Laboratory, Urology Department, Sao Paulo State University, Botucatu, 18618-000 São Paulo, Brazil
| | - Renata De Azevedo Canevari
- Laboratory of Molecular Biology of Cancer, Institute of Research and Development (IP&D), University of Vale do Paraíba, São José dos Campos, 12244-000 São Paulo, Brazil
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13
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Soto S, Toesca A, Hamza A, Della Corte GA, Iera M, Peradze N, Rocco N, Enrica GV, Bonanni B, Corso G, Luini A, Rietjens M, De Lorenzi F, Veronesi P, Martella S. Supernumerary Axillary Breast Cancer. Breast J 2016; 23:246-248. [DOI: 10.1111/tbj.12724] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Santos Soto
- Division of Breast Surgery; European Institute of Oncology; Milan Italy
- Division of Plastic and Reconstructive Surgery; European Institute of Oncology; Milan Italy
| | - Antonio Toesca
- Division of Breast Surgery; European Institute of Oncology; Milan Italy
| | - Alaa Hamza
- Division of Plastic and Reconstructive Surgery; European Institute of Oncology; Milan Italy
| | | | - Marco Iera
- Division of Plastic and Reconstructive Surgery; European Institute of Oncology; Milan Italy
| | - Nickolas Peradze
- Division of Breast Surgery; European Institute of Oncology; Milan Italy
| | - Nicola Rocco
- Department of Clinical Medicine and Surgery; University of Naples “Federico II”; Naples Italy
| | | | - Bernardo Bonanni
- Division of Cancer Prevention and Genetics; European Institute of Oncology; Milan Italy
| | - Giovanni Corso
- Division of Breast Surgery; European Institute of Oncology; Milan Italy
| | - Alberto Luini
- Division of Breast Surgery; European Institute of Oncology; Milan Italy
| | - Mario Rietjens
- Division of Plastic and Reconstructive Surgery; European Institute of Oncology; Milan Italy
| | - Francesca De Lorenzi
- Division of Plastic and Reconstructive Surgery; European Institute of Oncology; Milan Italy
| | - Paolo Veronesi
- Division of Breast Surgery; European Institute of Oncology; Milan Italy
- School of Medicine; University of Milan; Milan Italy
| | - Stefano Martella
- Division of Plastic and Reconstructive Surgery; European Institute of Oncology; Milan Italy
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