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Dilawar H, Ahmed A, Habib S, Iqbal J, Abdul Rehman T, Hadi I, Nisa N, Fatima S. Gastric Metastasis from Invasive Lobular Breast Cancer, Resembling Primary Gastric Cancer. J Nucl Med Technol 2024; 52:68-70. [PMID: 37699646 DOI: 10.2967/jnmt.123.266035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 08/04/2023] [Indexed: 09/14/2023] Open
Abstract
Invasive lobular carcinoma (ILC) is the second most common subtype of invasive breast cancer and sometimes presents with an unusual metastatic pattern. Its gastric metastasis is difficult to differentiate from primary adenocarcinoma. This report presents a case of breast ILC for which the initial presentation was gastric metastasis. A 62-y-old woman presented with gastric outlet obstruction secondary to a gastric mass that had been diagnosed on upper gastrointestinal endoscopy and biopsy. The patient had been referred for 18F-FDG PET/CT for staging. The baseline 18F-FDG PET/CT scan demonstrated extensive axillary nodal and gastric metastases with a breast mass, which raised suspicion of a primary breast carcinoma. Distinguishing primary gastric adenocarcinoma from metastatic breast ILC is essential, considering that the 2 diagnoses lead to divergent treatments. Therefore, this entity needs to be considered in the differential diagnosis in clinical practice.
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Affiliation(s)
- Hasnain Dilawar
- Department of Nuclear Medicine and Molecular Imaging, Karachi Institute of Radiotherapy and Nuclear Medicine, Karachi, Pakistan
| | - Akhtar Ahmed
- Department of Nuclear Medicine and Molecular Imaging, Karachi Institute of Radiotherapy and Nuclear Medicine, Karachi, Pakistan
| | - Salman Habib
- Department of Nuclear Medicine and Molecular Imaging, Karachi Institute of Radiotherapy and Nuclear Medicine, Karachi, Pakistan
| | - Javaid Iqbal
- Department of Nuclear Medicine and Molecular Imaging, Karachi Institute of Radiotherapy and Nuclear Medicine, Karachi, Pakistan
| | - Talal Abdul Rehman
- Department of Nuclear Medicine and Molecular Imaging, Karachi Institute of Radiotherapy and Nuclear Medicine, Karachi, Pakistan
| | - Imran Hadi
- Department of Nuclear Medicine and Molecular Imaging, Karachi Institute of Radiotherapy and Nuclear Medicine, Karachi, Pakistan
| | - Noor Nisa
- Department of Nuclear Medicine and Molecular Imaging, Karachi Institute of Radiotherapy and Nuclear Medicine, Karachi, Pakistan
| | - Shazia Fatima
- Department of Nuclear Medicine and Molecular Imaging, Karachi Institute of Radiotherapy and Nuclear Medicine, Karachi, Pakistan
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Saad HA, Baz A, Riad M, Eraky ME, El-Taher A, Farid MI, Sharaf K, Said HEM, Ibrahim LA. Tumor microenvironment and immune system preservation in early-stage breast cancer: routes for early recurrence after mastectomy and treatment for lobular and ductal forms of disease. BMC Immunol 2024; 25:9. [PMID: 38273260 PMCID: PMC10809557 DOI: 10.1186/s12865-023-00591-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 12/07/2023] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Intra-ductal cancer (IDC) is the most common type of breast cancer, with intra-lobular cancer (ILC) coming in second. Surgery is the primary treatment for early stage breast cancer. There are now irrefutable data demonstrating that the immune context of breast tumors can influence growth and metastasis. Adjuvant chemotherapy may be administered in patients who are at a high risk of recurrence. Our goal was to identify the processes underlying both types of early local recurrences. METHODS This was a case-control observational study. Within 2 years of receiving adjuvant taxan and anthracycline-based chemotherapy, as well as modified radical mastectomy (MRM), early stage IDC and ILC recurred. Vimentin, α-smooth muscle actin (SMA), platelet-derived growth factor (PDGF), matrix metalloproteinase (MMP1), and clustered differentiation (CD95) were investigated. RESULTS Of the samples in the ductal type group, 25 showed local recurrence, and 25 did not. Six individuals in the lobular-type group did not experience recurrence, whereas seven did. Vimentin (p = 0.000 and 0.021), PDGF (p = 0.000 and 0.002), and CD95 (p = 0.000 and 0.045) expressions were significantly different in ductal and lobular carcinoma types, respectively. Measurement of ductal type was the sole significant difference found in MMP1 (p = 0.000) and α-SMA (p = 0.000). α-SMA and CD95 were two variables that helped the recurrence mechanism in the ductal type according to the pathway analysis. In contrast, the CD95 route is a recurrent mechanism for the lobular form. CONCLUSIONS While the immune system plays a larger role in ILC, the tumor microenvironment and immune system both influence the recurrence of IDC. According to this study, improving the immune system may be a viable cancer treatment option.
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Affiliation(s)
- Hassan A Saad
- Surgical Department, Faculty of Medicine, Zagazig University, Zagazig City, 44661, Egypt.
| | - Azza Baz
- Surgical Department, Alahrar Teaching Hospital, Zagazig University, Zagazig City, 55971, Egypt
| | - Mohamed Riad
- Surgical Department, Faculty of Medicine, Zagazig University, Zagazig City, 44661, Egypt
| | - Mohamed E Eraky
- Surgical Department, Faculty of Medicine, Zagazig University, Zagazig City, 44661, Egypt
| | - Ahmed El-Taher
- Surgical Department, Faculty of Medicine, Zagazig University, Zagazig City, 44661, Egypt
| | - Mohamed I Farid
- Surgical Department, Faculty of Medicine, Zagazig University, Zagazig City, 44661, Egypt
| | - Khaled Sharaf
- Surgical Department, Faculty of Medicine, Zagazig University, Zagazig City, 44661, Egypt
| | - Huda E M Said
- Clinical Pathology Department, Faculty of Medicine, Zagazig University, Zagazig City, 55971, Egypt
| | - Lotfy A Ibrahim
- Surgical Department, AlAzhar University, Nasr City, Cairo, 55888, Egypt
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Yoshida T, Ide M, Katayama K, Yanai M, Kurosaki R, Shimizu H, Arakawa K, Miyazaki T, Saeki H, Shirabe K. Traumatic sigmoid colon rupture due to breast cancer metastasis: a case report. Clin J Gastroenterol 2023; 16:854-858. [PMID: 37733231 DOI: 10.1007/s12328-023-01859-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 09/06/2023] [Indexed: 09/22/2023]
Abstract
The metastasis of breast cancer to the gastrointestinal tract is rare. Herein, we presented the case of an 85-year-old woman who had a history of invasive lobular carcinoma and experienced complete colon rupture due to relatively low-energy trauma. The patient underwent bilateral total mastectomy and axillary dissection following preoperative chemotherapy 6 years ago. She had a local recurrence 2 years after the surgery and underwent chemotherapy. Subsequently, the cancer metastasized to the thoracolumbar area and retroperitoneum. In addition, the patient fell from a height of 30 cm while hanging laundry and her abdomen hit a hose reel. Emergency surgery was performed, and the entire circumference of the sigmoid colon was ruptured. The ruptured colon lesion was resected, and the stump was closed. A double-barrel transverse colostomy was created as it was impossible to lift the stump up to the abdominal wall. Histopathological examination revealed the invasive lobular carcinoma metastasis and a linitis plastica-like change of the colon wall, which probably consequently weakened. In addition, minimal trauma can damage the gastrointestinal tract that had invasive lobular carcinoma metastasis.
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Affiliation(s)
- Tomonori Yoshida
- Department of Surgery, Japanese Red Cross Maebashi Hospital, 389-1, Asakura-machi, Maebashi, Gunma, 371-0811, Japan.
| | - Munenori Ide
- Department of Pathology Diagnosis, Japanese Red Cross Maebashi Hospital, Maebashi, Gunma, Japan
| | - Kazuhisa Katayama
- Department of Breast and Endocrine Surgery, Isesaki Municipal Hospital, Isesaki, Gunma, Japan
| | - Mitsuhiro Yanai
- Department of Surgery, Japanese Red Cross Maebashi Hospital, 389-1, Asakura-machi, Maebashi, Gunma, 371-0811, Japan
| | - Ryo Kurosaki
- Department of Surgery, Japanese Red Cross Maebashi Hospital, 389-1, Asakura-machi, Maebashi, Gunma, 371-0811, Japan
| | - Hisashi Shimizu
- Department of Surgery, Japanese Red Cross Maebashi Hospital, 389-1, Asakura-machi, Maebashi, Gunma, 371-0811, Japan
| | - Kazuhisa Arakawa
- Department of Surgery, Japanese Red Cross Maebashi Hospital, 389-1, Asakura-machi, Maebashi, Gunma, 371-0811, Japan
| | - Tatsuya Miyazaki
- Department of Surgery, Japanese Red Cross Maebashi Hospital, 389-1, Asakura-machi, Maebashi, Gunma, 371-0811, Japan
| | - Hiroshi Saeki
- Department of General Surgical Science, Gunma University Graduate School of Medicine, Gunma University, Maebashi, Gunma, Japan
| | - Ken Shirabe
- Department of General Surgical Science, Gunma University Graduate School of Medicine, Gunma University, Maebashi, Gunma, Japan
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Choo ZY, Xu AZ. Predictors and outcomes of cutaneous metastatic breast carcinoma: a retrospective, single-institution review. Arch Dermatol Res 2023; 315:2725-2728. [PMID: 37490055 DOI: 10.1007/s00403-023-02676-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 06/13/2023] [Accepted: 07/16/2023] [Indexed: 07/26/2023]
Affiliation(s)
- Zi-Yi Choo
- Pritzker School of Medicine, University of Chicago, Chicago, IL, USA
| | - Amy Z Xu
- Department of Medicine, Section of Dermatology, University of Chicago, 5841 South Maryland Ave, MC5067, Chicago, IL, 60637, USA.
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Siregar KB, Al Anas M. Unveiling bone metastasis: Exploring histological subtypes of breast cancer in Indonesia's tertiary referral hospital. Cancer Treat Res Commun 2023; 37:100764. [PMID: 37769530 DOI: 10.1016/j.ctarc.2023.100764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 09/15/2023] [Accepted: 09/20/2023] [Indexed: 10/03/2023]
Abstract
INTRODUCTION The histological grade of a tumor is an important prognostic indicator in both primary breast cancer and metastatic. We aimed to show the distribution of bone metastasis locations across different histological subtypes of breast cancer and how they relate to each. METHODS The cohort retrospective study comprised 65 patients diagnosed with bone-only metastatic breast cancer, all female. The secondary statistics for 2014 to 2022 were derived from breast cancer registration data collected to determine the relationships between patterns of bone metastases sites and histopathological grading in various histological categories. RESULTS The average age was 44.28±9.80 years (25-62 years), with 38 patients (58.5%) diagnosed with Invasive Ductal Carcinoma (IDC) and 27 patients (41.5%) with Invasive Lobular Carcinoma (ILC). Grade III were found in 34 patients (50.8%), Grade II in 31 patients (47.7%) and Grade I in one patient (1.5%). The most common sites of bone metastases are costae, followed by femur, vertebrae and pelvic. Vertebrae and costae metastasis are significantly correlated with histological grading and breast cancer pathology (p: 0.027 and 0.033, respectively). CONCLUSION There is a considerable difference between vertebrae and costae metastasis in terms of histological grading and breast cancer pathology which indicates the higher grade contains a greater variety of bone metastases sites.
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Affiliation(s)
- Kamal Basri Siregar
- Division of Surgical Oncology, Department of Surgery, Faculty of Medicine, Universitas Sumatera Utara/H. Adam Malik General Hospital, Medan, North Sumatera, Indonesia.
| | - Muhammad Al Anas
- Faculty of Medicine, Universitas Muhammadiyah Sumatera Utara, Indonesia
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Drozgyik A, Molnár FT, Tokodi Z, Bodoky G, Kollár D, Oláh A. Emlőrák hasüregi áttétei - Egy szokatlan entitás klinikopatológiai jellemzői. Magy Seb 2022; 75:265-269. [PMID: 36515915 DOI: 10.1556/1046.2022.40003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 09/29/2022] [Indexed: 06/17/2023]
Abstract
CASE REPORT A sixty-five-year-old female patient underwent surgery for severe gastrointestinal symptoms, following an alarming CT image. Laparotomy revealed irresectable gastric cancer and peritoneal carcinosis. Palliative gastro-jejunostomy and ileo-descendostomy were performed. The endoscopic diagnosis - linitis plastica - and the intraoperative macroscopic appearance matched and agreed on the histologically presumed shigillocellular carcinoma. Three years following the initial abdominal symptoms, histological samples taken from newly detected cutaneous metastases which developed during oncological palliative treatment verified occult lobular breast carcinoma. Histological revision of the sample taken from abdominal exploration confirmed the latter diagnosis. The hormone receptor positive, human epidermal growth factor receptor-2 negative malignancy showed very good regression for the palliative hormone treatment. DISCUSSION About ten percent of breast cancer cases are lobular carcinomas, which are more often multicentric, bilateral, occult and have a propensity to metastasize to serous membranes, abdominal and pelvic viscera. Due to the increasing survival of breast cancer patients, the number of abdominal metastases of breast cancer is expected to increase. Histological confirmation is indispensable even in case of advanced abdominal malignancies, especially in the case of an unusual medical history. The currently rare case demonstrates the need for multidisciplinary cooperation in all diagnostic and therapeutic fields of breast cancer.
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Affiliation(s)
- András Drozgyik
- 1Petz Aladár Egyetemi Oktató Kórház, Sebészeti Osztály, Győr, Magyarország
| | - F Tamás Molnár
- 1Petz Aladár Egyetemi Oktató Kórház, Sebészeti Osztály, Győr, Magyarország
- 2Pécsi Tudományegyetem, Általános Orvosi Kar, Orvosi Készségfejlesztő és Innovációs Központ, Műveleti Medicina Tanszék, Pécs, Magyarország
| | - Zsófia Tokodi
- 3Dél-pesti Centrumkórház, Országos Hematológiai és Infektológiai Intézet, Onkológiai Osztály, Budapest, Magyarország
| | - György Bodoky
- 3Dél-pesti Centrumkórház, Országos Hematológiai és Infektológiai Intézet, Onkológiai Osztály, Budapest, Magyarország
| | - Dániel Kollár
- 1Petz Aladár Egyetemi Oktató Kórház, Sebészeti Osztály, Győr, Magyarország
| | - Attila Oláh
- 1Petz Aladár Egyetemi Oktató Kórház, Sebészeti Osztály, Győr, Magyarország
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Fimereli D, Venet D, Rediti M, Boeckx B, Maetens M, Majjaj S, Rouas G, Marchio C, Bertucci F, Mariani O, Capra M, Bonizzi G, Contaldo F, Galant C, Van den Eynden G, Salgado R, Biganzoli E, Vincent-Salomon A, Pruneri G, Larsimont D, Lambrechts D, Desmedt C, Brown DN, Rothé F, Sotiriou C. Timing evolution of lobular breast cancer through phylogenetic analysis. EBioMedicine 2022; 82:104169. [PMID: 35882101 PMCID: PMC9309404 DOI: 10.1016/j.ebiom.2022.104169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 06/22/2022] [Accepted: 06/30/2022] [Indexed: 11/19/2022] Open
Affiliation(s)
- Danai Fimereli
- J.-C. Heuson Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - David Venet
- J.-C. Heuson Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Mattia Rediti
- J.-C. Heuson Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Bram Boeckx
- Laboratory of Translational Genetics, VIB Center for Cancer Biology, Leuven, Belgium; Laboratory of Translational Genetics, Department of Human Genetics, KU Leuven, Leuven, Belgium
| | - Marion Maetens
- J.-C. Heuson Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Laboratory for Translational Breast Cancer Research, Department of Oncology, KU Leuven, Leuven, Belgium
| | - Samira Majjaj
- J.-C. Heuson Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Ghizlane Rouas
- J.-C. Heuson Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Caterina Marchio
- Department of Medical Sciences, University of Turin, Turin, Italy; FPO-IRCCS Candiolo Cancer Institute, Candiolo, Italy
| | - Francois Bertucci
- Predictive Oncology Laboratory, Institut Paoli-Calmettes, CRCM, INSERM U1068, CNRS UMR7258, Aix-Marseille Université Marseille, France
| | - Odette Mariani
- Department of Pathology, Institut Curie, Paris Sciences Lettres Research University, Paris, France
| | - Maria Capra
- Biobank for Translational and Digital Medicine, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Giuseppina Bonizzi
- Biobank for Translational and Digital Medicine, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Federica Contaldo
- Biobank for Translational and Digital Medicine, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Christine Galant
- Department of Pathology, Cliniques Universitaires Saint Luc, Brussels, Belgium; IREC, Université Catholique de Louvain, Brussels, Belgium
| | | | - Roberto Salgado
- Department of Pathology, GZA-ZNA Hospitals, Antwerp, Belgium; Division of Research, Peter Mac Callum Cancer Centre, Melbourne, Australia
| | - Elia Biganzoli
- Department of Biomedical and Clinical Sciences (DIBIC) "L. Sacco" & DSRC, LITA Vialba campus, University of Milan, Milan, Italy
| | - Anne Vincent-Salomon
- Department of Pathology, Institut Curie, Paris Sciences Lettres Research University, Paris, France
| | - Giancarlo Pruneri
- Division of Pathology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; School of Medicine, University of Milan, Milano, Milan, Italy
| | - Denis Larsimont
- Department of Pathology, Institut Jules Bordet, Brussels, Belgium
| | - Diether Lambrechts
- Laboratory of Translational Genetics, VIB Center for Cancer Biology, Leuven, Belgium; Laboratory of Translational Genetics, Department of Human Genetics, KU Leuven, Leuven, Belgium
| | - Christine Desmedt
- Laboratory for Translational Breast Cancer Research, Department of Oncology, KU Leuven, Leuven, Belgium
| | - David N Brown
- J.-C. Heuson Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Françoise Rothé
- J.-C. Heuson Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Christos Sotiriou
- J.-C. Heuson Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium.
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Lv Z, Zhang W, Zhang Y, Zhong G, Zhang X, Yang Q, Li Y. Metastasis patterns and prognosis of octogenarians with metastatic breast cancer: A large-cohort retrospective study. PLoS One 2022; 17:e0263104. [PMID: 35176034 PMCID: PMC8853583 DOI: 10.1371/journal.pone.0263104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 01/12/2022] [Indexed: 11/23/2022] Open
Abstract
Background Breast cancer may differ biologically in patients aged over 80 years. The objective of the current study was to analyze the metastasis patterns and prognosis of elderly patients with metastatic breast cancer (MBC) and compare it to patients of other ages. Methods The Surveillance, Epidemiology, and End Results (SEER) database was utilized to select MBC patients from 2010 to 2015. Chi-squared test was used to compare clinicopathological characteristics among different aged groups. The Kaplan-Meier method and multivariate Cox model were utilized for survival analysis. Results A total of 10479 MBC patients were included, among which 1036 (9.9%) patients were aged over 80 years. Compared with other aged group, the elderly patients tended to have a higher proportion of HR+/Her2- subtype, white race, lower tumor differentiation, and receive less treatment, including surgery, chemotherapy and radiotherapy (P< 0.001). MBC patients with different age presented with distinctive metastatic patterns. The older patients were more likely to have lung metastasis, but less likely to have bone, brain, liver and multiple sites metastasis than the younger group (P <0.001). The proportion of TNBC subtype increased substantially in the older patients with brain metastasis, compared to the younger and middle-aged group. The old age was demonstrated to significantly associate with worse prognosis of MBC patients. Additionally, our findings also showed that older MBC patients could achieve dramatical overall survival benefit from surgery (HR = 0.58; P <0.001) and chemotherapy (HR = 0.59; P <0.001), but not the radiotherapy (HR = 0.96; P = 0.097). Conclusion The elderly MBC patients presented with distinctive metastatic patterns, clinical characteristics, and prognostic outcomes compared with younger patients. Our findings could assist clinicians in making appropriate therapeutic decision.
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Affiliation(s)
- Zhenye Lv
- Division of Breast Surgery, Department of General Surgery, Cancer Center, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Wendan Zhang
- Department of Gynaecology and Obstetrics, The 903 Hospital of the Joint Logistics Support Force of the Chinese People’s Liberation Army, Hangzhou, Zhejiang, China
| | - Yingjiao Zhang
- Department of Gastroenterology, The 903 Hospital of the Joint Logistics Support Force of the Chinese People’s Liberation Army, Hangzhou, Zhejiang, China
| | - Guansheng Zhong
- Department of Breast Surgery, College of Medicine, The First Affiliated Hospital, Zhejiang University, Hangzhou, Zhejiang, China
| | - Xiaofei Zhang
- Division of Breast Surgery, Department of General Surgery, Cancer Center, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Qiong Yang
- Division of Breast Surgery, Department of General Surgery, Cancer Center, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China
- * E-mail: (YL); (QY)
| | - Ying Li
- Division of Breast Surgery, Department of General Surgery, Cancer Center, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China
- * E-mail: (YL); (QY)
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Abstract
We evaluated the clinicopathologic features of 38 cases of metastatic lobular (n=33) or predominantly lobular (n=5) carcinoma involving the ovary. The patients were from 39 to 91 years of age (mean: 53 y). In 2 cases, the breast primary and ovarian metastasis were diagnosed synchronously, and in 5, the breast primary was only discovered after the metastatic carcinoma in the ovary was found. In the majority of cases (79%), both ovaries were involved; the mean ovarian tumor size was 5.9 cm. The ovarian tumors demonstrated a range of architectural patterns including macronodular (71%), diffuse/solid growth (87%), single-cell infiltration (87%), cords (74%), and small nests/clusters (50%). Nine cases demonstrated focal signet ring cell morphology. The associated stromal reaction ranged from none to marked, with almost half of cases demonstrating a marked stromal response, largely prominent sclerosis. A variety of neoplasms, most typically sex cord-stromal tumors, lymphoma/leukemia, and desmoplastic small round cell tumor, may enter the differential. In addition to the obvious help afforded in most cases by the clinical history, a combination of judicious sampling, particularly to unearth the delicate cords or single-cell growth of lobular carcinoma, appropriate consideration of the cytologic features of the neoplastic cells, and immunohistochemistry can resolve the diverse issues in differential diagnosis that may arise.
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Affiliation(s)
- Ai-Ying Chuang
- Department of Pathology, Koo Foundation Sun Yat-Sen Cancer Center
- School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Jaclyn C Watkins
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Robert H Young
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Melinda F Lerwill
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
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Altundag K. Synchronous metastases of infiltrating lobular breast carcinoma to stomach and colon: ; rare but it does occur. J BUON 2021; 26:1684-1685. [PMID: 34565039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Affiliation(s)
- Kadri Altundag
- MKA Breast Cancer Clinic, Tepe Prime, Cankaya, 06800 Ankara, Turkey
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11
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Abstract
Tumor-to-tumor metastasis (TTM) is a rare, but well-described phenomenon occurring in patients with multiple synchronous or metachronous primary malignancies. Olfactory neuroblastoma (ONB) is a rare malignant, neuroectodermal sinonasal tract tumor that occurs within the ethmoid sinus involving the cribriform plate. Very few cases of ONB have been documented to metastasize to other primary malignancies, but the reverse scenario is exceptional. During an evaluation for anosmia, a right nasal polyp was identified on imaging and endoscopy in a 66-year-old woman, with a polypectomy performed. Histologic examination showed classical features of a low-grade olfactory neuroblastoma, but within the tumor were isolated epithelioid cells which were strongly pancytokeratin immunoreactive. Review of the clinical history revealed lobular breast carcinoma treated 10 years earlier. Further evaluation with immunohistochemistry showed strong and diffuse nuclear estrogen and progesterone receptor reactivity, along with GATA3. These results confirmed TTM of an invasive lobular breast carcinoma to ONB. By employing a limited immunohistochemistry panel for all small round blue cell tumors that includes pancytokeratin, p40, S100 protein, SOX10, synaptophysin, desmin, CD99, and CD45, one is able to more accurately diagnose the classical tumor types, while also showing potentially unusual tumor features or exceptionally rare events like metastatic lobular breast carcinoma to ONB.
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Affiliation(s)
- Kent M Swimley
- Department of Pathology & Medicine, Houston Methodist Hospital, Houston, TX, USA
| | - Silvana Di Palma
- Histopathology Department, Royal Surrey Hospital, Guildford, Surrey, UK
| | - Lester D R Thompson
- Southern California Permanente Medical Group, Department of Pathology, 5601 De Soto Avenue, Woodland Hills, CA, 91365, USA.
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Abu Zaanona MI, Gulati A, Rowland K. Colon metastases as first clinical manifestation of lobular breast carcinoma with no subsequent evidence of breast disease. BMJ Case Rep 2020; 13:e236225. [PMID: 33257365 PMCID: PMC7705550 DOI: 10.1136/bcr-2020-236225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2020] [Indexed: 11/03/2022] Open
Abstract
A 73-year-old woman was brought to the oestrogen receptor for altered mental status. She was found to be hypotensive and hypoglycaemic and admitted to the intensive care unit. She had a history of chronic watery diarrhoea which had recently increased over the last 2 weeks and was associated with vague abdominal pain. A CT showed bowel wall thickening concerning for colitis. Due to the increasing diarrhoea, a colonoscopy was done after all stool studies came back negative. Polyps in the ascending, transverse and sigmoid colon were found to be tubular adenomas but random colonic mucosa biopsies were revealed to be histologically consistent with metastatic lobular breast carcinoma. Further workup revealed no primary breast disease.
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Affiliation(s)
| | - Aishwarya Gulati
- Internal Medicine, Carle Foundation Hospital, Urbana, Illinois, USA
- Radiology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
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13
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Abstract
RATIONALE Breast cancer is a common malignant tumor. The most common metastatic sites of breast cancer are the bone, brain, liver and lung, and gastrointestinal metastases are rare. Considering that the median time interval from the initial breast cancer diagnosis to stomach metastasis is 77.5 months, gastrointestinal metastases are rarely observed 10 years after primary breast cancer. PATIENT CONCERNS Here, we present a 63-year-old female with unusual endoscopy results that revealed scattered polyps and mucosal infiltration throughout the stomach, which were later confirmed to be metastatic lobular carcinoma of the breast that had been surgically removed 10 years earlier. DIAGNOSIS The patient was diagnosed with gastric metastases of breast cancer by immunohistochemistry. INTERVENTIONS The patient underwent endocrine therapy with palbociclib and tamoxifen. OUTCOMES After 1 year of endocrine therapy, the symptoms of upper abdominal discomfort and fatigue were relieved and a new gastroscopy revealed there had been no significant progression of the gastric metastasis. According to the Response Evaluation Criteria in Solid Tumors (RECIST), the patient reached a state of stable disease. LESSONS Gastric metastases of breast cancer are rare in the clinical setting. However, considering the possibility of gastric metastases from breast cancer and performing an upper endoscopy are crucial for patients who present with any subtle gastric symptoms and have a past medical history of breast cancer, even if the breast cancer occurred more than 10 years ago.
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Affiliation(s)
- Ji-Xin Fu
- Department of Gastrointestinal Surgery
| | | | - Long-Li
- Department of Gastrointestinal Surgery
| | - Xin-Jian Wang
- Department of Gastrointestinal Surgery, Weihai Central Hospital, Weihai, Shandong, China
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14
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Kobayashi M, Tashima T, Nagata K, Sakuramoto S, Osaki A, Ryozawa S. Colorectal and gastric metastases from lobular breast cancer that resembled superficial neoplastic lesions. Clin J Gastroenterol 2020; 14:103-108. [PMID: 33159678 DOI: 10.1007/s12328-020-01285-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 10/22/2020] [Indexed: 01/01/2023]
Abstract
Breast cancer is the most common malignancy in women and has a risk of late recurrence. We report a case of metastasis to the stomach and colon 23 years after surgery, with characteristic findings. A 74-year-old woman underwent breast cancer resection at the age of 51. At the time, no additional therapy was performed despite the histological diagnosis of invasive lobular carcinoma with lymph node metastasis. Upper gastrointestinal endoscopy, which was performed as a follow-up for her chronic gastritis, revealed multiple erosions. Histology revealed diffuse proliferation of signet ring cell-like atypical cells, that were positive for cytokeratin CAM5.2 and estrogen receptor. These findings suggested metastasis from the invasive lobular breast carcinoma. Positron-emission tomography revealed sternal and vertebral metastases. Colonoscopy also performed to screen for intestinal metastasis revealed several lesions that resembled hyperplastic polyps. Although these lesions were not strongly suspected of metastasis, histology surprisingly revealed the same findings as the gastric metastasis. This case involved gastric and colorectal superficial metastases that were synchronously detected 23 years after primary treatment. We report that early-stage colorectal metastasis may resemble hyperplastic polyps, and biopsy should always be considered in patients with a history of breast cancer, regardless of years elapsed since treatment.
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Affiliation(s)
- Masanori Kobayashi
- Department of Gastroenterology, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka-city, Saitama, 350-1298, Japan.
- Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University (TMDU), Tokyo, Japan.
| | - Tomoaki Tashima
- Department of Gastroenterology, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka-city, Saitama, 350-1298, Japan
| | - Koji Nagata
- Department of Pathology, Saitama Medical University International Medical Center, Saitama, Japan
- Department of Pathology, Nippon Medical School Tamanagayama Hospital, Tokyo, Japan
| | - Shinichi Sakuramoto
- Department of Esophagogastric Surgery, Saitama Medical University International Medical Center, Saitama, Japan
| | - Akihiko Osaki
- Department of Breast Oncology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Shomei Ryozawa
- Department of Gastroenterology, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka-city, Saitama, 350-1298, Japan
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15
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Dehghani M, Keshavarz P, Talei A, Akrami M, Tahmasebi S, Safaie A, Ghanbari M. The Effects of Low HER2/neu Expression on the Clinicopathological Characteristics of Triple-Negative Breast Cancer Patients. Asian Pac J Cancer Prev 2020; 21:3027-3032. [PMID: 33112563 PMCID: PMC7798168 DOI: 10.31557/apjcp.2020.21.10.3027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 10/12/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Triple-negative breast cancer (TNBC) is an aggressive type of breast cancer (BC), and its diagnosis is associated with negative expression of hormone receptors and HER2/neu. It consists of 10-20% of all BCs diagnosed. METHODS AND MATERIALS This study focuses on three groups with different pathology: group one showed complete triple-negative HER2 expression with IHC of BC; groups two and three included patients with ER-, PR-, and HER21+, and ER-, PR-, and HER22+ with a negative FISH test. These three groups were compared from the point of prognosis, which consisted of tumor size, patients' age, lymphatic, vascular and perineural invasion, organ metastasis, number of lymph nodes involvement, and the survival rate. RESULTS A total of 459 TNBC patients were enrolled, of which 268 were placed in the HER20 group, 146 in the HER21+ group, and 45 in the HER22+ group. Distant metastasis and recurrence rate were more common in HER20 patients, but bone metastasis was more common in patients with low HER2 expression. All patients with HER20 had a smaller tumor size at the time of BC diagnosis in comparison to patients in the low HER2 expression group. Patients with HER22+ had less lymphatic and vascular invasion as well as axillary lymph nodes involvement, but larger tumor size at presentation, resulting in a lower rate of recurrence and higher overall survival. CONCLUSION The findings revealed that patients with HER22+ had better outcome in comparison to the patients with HER20 and HER21+. Furthermore, the results showed that many patients with HER22+ expression were not basal-like and had good prognosis amongst TNBC patients.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Biomarkers, Tumor/metabolism
- Carcinoma, Ductal, Breast/metabolism
- Carcinoma, Ductal, Breast/secondary
- Carcinoma, Ductal, Breast/surgery
- Carcinoma, Lobular/metabolism
- Carcinoma, Lobular/secondary
- Carcinoma, Lobular/surgery
- Cross-Sectional Studies
- Female
- Follow-Up Studies
- Humans
- Lymphatic Metastasis
- Middle Aged
- Neoplasm Invasiveness
- Neoplasm Recurrence, Local/metabolism
- Neoplasm Recurrence, Local/pathology
- Neoplasm Recurrence, Local/surgery
- Prognosis
- Receptor, ErbB-2/metabolism
- Retrospective Studies
- Triple Negative Breast Neoplasms/metabolism
- Triple Negative Breast Neoplasms/pathology
- Triple Negative Breast Neoplasms/surgery
- Young Adult
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Affiliation(s)
- Mehdi Dehghani
- Hematology Research Center, Department of Hematology and Medical oncology, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Pedram Keshavarz
- Department of Radiology, Medical Imaging Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Abdolrasoul Talei
- Breast Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Majid Akrami
- Breast Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Sedighe Tahmasebi
- Breast Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Akbar Safaie
- Department of Pathology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Maryam Ghanbari
- Department of Internal Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
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16
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Yoo TK, Kang BJ, Kim SH, Song BJ, Ahn J, Park WC, Chae BJ. Axillary lymph node dissection is not obligatory in breast cancer patients with biopsy-proven axillary lymph node metastasis. Breast Cancer Res Treat 2020; 181:403-409. [PMID: 32328848 DOI: 10.1007/s10549-020-05636-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 04/08/2020] [Indexed: 01/08/2023]
Abstract
PURPOSE The ACOSOG Z0011 trial demonstrated that axillary lymph node dissection (ALND) is unnecessary in select patients with cT1-2N0 tumors undergoing breast-conserving therapy with 1-2 positive sentinel lymph nodes (SLNs). However, patients with preoperatively confirmed ALN metastasis were not included and may be subjected to unnecessary ALND. The aim of this study is to identify patients who can be considered for ALND omission when the preoperative ALN biopsy results are positive. METHODS Breast cancer patients who underwent preoperative ALN biopsy and primary surgery were retrospectively reviewed. Among patients with positive ALN biopsy results, clinicopathological and imaging characteristics were compared according to LN disease burden (1-2 positive LNs vs. ≥ 3 positive LNs). RESULTS A total of 542 patients were included in the analysis. Among them, 225 (41.5%) patients had a preoperative positive ALN biopsy. More than 40% of the patients (n = 99, 44.0%) with a positive biopsy had only 1-2 positive ALNs. The association between nodal burden and imaging factors was strongest when ≥ 2 suspicious LNs were identified on PET/CT images (HR 8.795, 95% CI 4.756 to 13.262). More than one imaging modality showing ≥ 2 suspicious LNs was also strongly correlated with ≥ 3 positive ALNs (HR 5.148, 95% CI 2.881 to 9.200). CONCLUSIONS Nearly half of patients with a preoperative biopsy-proven ALN metastasis had only 1-2 positive LNs on ALND. Patients meeting ACOSOG Z0011 criteria with only one suspicious LN on PET/CT or those presenting with few abnormal ALNs on only one imaging modality appear appropriate for SLNB and consideration of ALND omission.
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MESH Headings
- Axilla
- Breast Neoplasms/diagnostic imaging
- Breast Neoplasms/pathology
- Breast Neoplasms/surgery
- Carcinoma, Ductal, Breast/diagnostic imaging
- Carcinoma, Ductal, Breast/secondary
- Carcinoma, Ductal, Breast/surgery
- Carcinoma, Lobular/diagnostic imaging
- Carcinoma, Lobular/secondary
- Carcinoma, Lobular/surgery
- Female
- Follow-Up Studies
- Humans
- Lymph Node Excision
- Lymph Nodes/pathology
- Lymph Nodes/surgery
- Lymphatic Metastasis
- Mastectomy, Segmental/methods
- Middle Aged
- Positron Emission Tomography Computed Tomography
- Prognosis
- Receptor, ErbB-2/metabolism
- Receptors, Estrogen/metabolism
- Receptors, Progesterone/metabolism
- Retrospective Studies
- Sentinel Lymph Node Biopsy/methods
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Affiliation(s)
- Tae-Kyung Yoo
- Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
- Cancer Research Institute, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Bong Joo Kang
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Sung Hun Kim
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Byung Joo Song
- Division of Breast-Thyroid Surgery, Department of Surgery, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 327 Sosa-ro, Wonmi-gu, Gyeonggi-do, 14647, Republic of Korea
| | - Juneyoung Ahn
- Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Woo-Chan Park
- Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Byung Joo Chae
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University, 81 Irwon-Ro, Gangnam-Gu, Seoul, 06351, Republic of Korea.
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17
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Vande Berg P, Fonseca S, Al-Awa A, Rezai Monfared M, Delande S, Chamlou R, Etogo-Asse FE, Van Maele P. A rectal metastasis of an unknown lobular breast carcinoma and its management. Acta Gastroenterol Belg 2020; 83:327-330. [PMID: 32603055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Breast cancer is the most common cancer in women but gastro- intestinal metastases of breast cancer are rare. They can occur years after the diagnosis or at the diagnosis of breast cancer. We report the case of a patient complaining of dyschesia, tenesmus and anal incontinence leading to the discovery of a rectal metastasis of an unknown breast neoplasia. Given the oligo-metastatic condition, multidisciplinary and aggressive management was the chosen therapy.
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Affiliation(s)
- P Vande Berg
- Université catholique de Louvain, Bruxelles, Belgium
| | - S Fonseca
- Clinique Saint Jean, Bruxelles, Belgium
| | - A Al-Awa
- Vrije Universiteit Brussel, Belgium
| | | | - S Delande
- Clinique Saint Jean, Bruxelles, Belgium
| | - R Chamlou
- Clinique Saint Jean, Bruxelles, Belgium
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18
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Chun YS, Mizuno T, Cloyd JM, Ha MJ, Omichi K, Tzeng CWD, Aloia TA, Ueno NT, Kuerer HM, Barcenas CH, Vauthey JN. Hepatic resection for breast cancer liver metastases: Impact of intrinsic subtypes. Eur J Surg Oncol 2020; 46:1588-1595. [PMID: 32253074 DOI: 10.1016/j.ejso.2020.03.214] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 03/09/2020] [Accepted: 03/21/2020] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION The role of surgery for breast cancer liver metastases (BCLM) remains controversial. This study aimed to analyze survival in patients treated with hepatectomy plus systemic therapy or systemic therapy alone for BCLM and to determine selection factors to guide surgical therapy. MATERIALS AND METHODS Patients who underwent hepatectomy plus systemic therapy (n = 136) and systemic therapy alone for isolated BCLM (n = 763) were compared. Overall survival (OS) was analyzed after propensity score matching. Intrinsic subtypes were defined as: luminal A (estrogen receptor [ER]+ and/or progesterone receptor positive [PR]+, human epidermal growth factor receptor 2 [HER2]-), luminal B (ER and/or PR+, HER2+), HER2-enriched (ER and PR-, HER2+), and basal-like (ER, PR, HER2-). RESULTS After hepatectomy, independent predictors of poor OS were number and size of liver metastases, and intrinsic subtype (hazard ratios, 1.11, 1.16, and 4.28, respectively). Median OS was 75 and 81 months among patients with luminal B and HER2-enriched subtypes, compared with 17 and 53 months among patients with basal-like and luminal A subtypes (P < .001). Median progression-free survival (PFS) was 60 months with the HER2-enriched subtype, compared with 17, 16, and 5 months with luminal A, luminal B, and basal-like subtypes, respectively (P < .001). After propensity score matching, 5-year OS rates were 56% vs. 40% in the surgery vs. systemic therapy alone groups (P = .018). CONCLUSION Surgical resection of BCLM yielded higher OS compared with systemic therapy alone and prolonged PFS among patients with the HER2-enriched subtype. These findings support the use of surgical therapy in appropriately selected patients, based on intrinsic subtypes.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Antineoplastic Agents/therapeutic use
- Breast Neoplasms/metabolism
- Breast Neoplasms/pathology
- Carcinoma, Ductal, Breast/drug therapy
- Carcinoma, Ductal, Breast/metabolism
- Carcinoma, Ductal, Breast/secondary
- Carcinoma, Ductal, Breast/surgery
- Carcinoma, Lobular/drug therapy
- Carcinoma, Lobular/metabolism
- Carcinoma, Lobular/secondary
- Carcinoma, Lobular/surgery
- Combined Modality Therapy
- Female
- Hepatectomy
- Humans
- Liver Neoplasms/drug therapy
- Liver Neoplasms/metabolism
- Liver Neoplasms/secondary
- Liver Neoplasms/surgery
- Margins of Excision
- Metastasectomy
- Middle Aged
- Prognosis
- Progression-Free Survival
- Propensity Score
- Proportional Hazards Models
- Receptor, ErbB-2/metabolism
- Receptors, Estrogen/metabolism
- Receptors, Progesterone/metabolism
- Survival Rate
- Tumor Burden
- Young Adult
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Affiliation(s)
- Yun Shin Chun
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
| | - Takashi Mizuno
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jordan M Cloyd
- Department of Surgery, Ohio State University, Columbus, OH, USA
| | - Min Jin Ha
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Kiyohiko Omichi
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Ching-Wei D Tzeng
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Thomas A Aloia
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Naoto T Ueno
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Henry M Kuerer
- Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Carlos H Barcenas
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jean-Nicolas Vauthey
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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19
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Kim JS, Kim K, Jung W, Shin KH, Im SA, Kim HJ, Kim YB, Chang JS, Choi DH, Park YH, Kim DY, Kim TH, Choi BO, Lee SW, Kim S, Kwon J, Kang KM, Chung WK, Kim KS, Nam JH, Yoon WS, Kim JH, Cha J, Oh YK, Kim IA. Survival outcomes of breast cancer patients with brain metastases: A multicenter retrospective study in Korea (KROG 16-12). Breast 2020; 49:41-47. [PMID: 31677532 PMCID: PMC7375558 DOI: 10.1016/j.breast.2019.10.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 10/09/2019] [Accepted: 10/15/2019] [Indexed: 11/30/2022] Open
Abstract
PURPOSE This study evaluated the influence of prognostic factors and whole brain radiotherapy (WBRT) on overall survival (OS) of breast cancer (BC) patients with brain metastases (BM). METHODS AND MATERIALS Medical records of 730 BC patients diagnosed with BM from 2000 to 2014 at 17 institutions were retrospectively reviewed. OS was calculated from BM diagnosis. Median follow-up duration was 11.9 months (range, 0.1-126.2). RESULTS Median OS was 15.0 months (95% CI: 14.0-16.9). Patients with different BC-specific graded prognostic assessment (GPA) scores showed significant differences (p < 0.001) in OS. In multivariate analysis, histologic grade 3 (p = 0.014), presence of extracranial metastasis (p < 0.001), the number of BM (>4; p = 0.002), hormone receptor negativity (p = 0.005), HER2-negativity (p = 0.003), and shorter time interval (<30 months) between BC and BM diagnosis (p = 0.007) were associated with inferior OS. By summing the β-coefficients of variables that were prognostic in multivariate analyses, we developed a prognostic model that stratified patients into low-risk (≤0.673) and high-risk (>0.673) subgroups; the high-risk subgroup had poorer median OS (10.1 months, 95% CI: 7.9-11.9 vs. 21.9 months, 95% CI: 19.5-27.1, p < 0.001). Univariate and multivariate analyses of propensity score-matched patients diagnosed with BM ≥ 30 months after BC diagnosis (n = 389, "late BM") revealed that WBRT-treated patients showed superior OS compared to non-WBRT-treated patients (p = 0.070 and 0.030, respectively). CONCLUSION Our prognostic model identified high-risk BC patients with BM who might benefit from increased surveillance; if validated, our model could guide treatment selection for such patients. Patients with late BM might benefit from WBRT as initial local treatment.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Brain Neoplasms/mortality
- Brain Neoplasms/radiotherapy
- Brain Neoplasms/secondary
- Breast Neoplasms/mortality
- Breast Neoplasms/pathology
- Carcinoma, Ductal, Breast/mortality
- Carcinoma, Ductal, Breast/radiotherapy
- Carcinoma, Ductal, Breast/secondary
- Carcinoma, Lobular/mortality
- Carcinoma, Lobular/radiotherapy
- Carcinoma, Lobular/secondary
- Female
- Follow-Up Studies
- Humans
- Middle Aged
- Prognosis
- Republic of Korea/epidemiology
- Retrospective Studies
- Survival Analysis
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Affiliation(s)
- Jae Sik Kim
- Department of Radiation Oncology, Seoul National University College of Medicine, Republic of Korea
| | - Kyubo Kim
- Department of Radiation Oncology, Ewha Womans University College of Medicine, Republic of Korea.
| | - Wonguen Jung
- Department of Radiation Oncology, Ewha Womans University College of Medicine, Republic of Korea
| | - Kyung Hwan Shin
- Department of Radiation Oncology, Seoul National University College of Medicine, Republic of Korea
| | - Seock-Ah Im
- Department of Internal Medicine, Seoul National University College of Medicine, Republic of Korea
| | - Hee-Jun Kim
- Department of Internal Medicine, Chung-Ang University College of Medicine, Republic of Korea
| | - Yong Bae Kim
- Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Republic of Korea
| | - Jee Suk Chang
- Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Republic of Korea
| | - Doo Ho Choi
- Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Republic of Korea
| | - Yeon Hee Park
- Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Republic of Korea
| | - Dae Yong Kim
- Proton Therapy Center, National Cancer Center, Republic of Korea
| | - Tae Hyun Kim
- Proton Therapy Center, National Cancer Center, Republic of Korea
| | - Byung Ock Choi
- Department of Radiation Oncology, Seoul St. Mary's Hospital, The Catholic University of Korea, Republic of Korea
| | - Sea-Won Lee
- Department of Radiation Oncology, Seoul St. Mary's Hospital, The Catholic University of Korea, Republic of Korea
| | - Suzy Kim
- Department of Radiation Oncology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Republic of Korea
| | - Jeanny Kwon
- Department of Radiation Oncology, Chungnam National University College of Medicine, Republic of Korea
| | - Ki Mun Kang
- Department of Radiation Oncology, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Republic of Korea
| | - Woong-Ki Chung
- Department of Radiation Oncology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Republic of Korea
| | - Kyung Su Kim
- Department of Radiation Oncology, Ewha Womans University College of Medicine, Republic of Korea; Department of Radiation Oncology, Dongnam Institute of Radiological and Medical Sciences, Republic of Korea
| | - Ji Ho Nam
- Department of Radiation Oncology, Yangsan Pusan National University Hospital, Pusan National University School of Medicine, Republic of Korea
| | - Won Sup Yoon
- Department of Radiation Oncology, Ansan Hospital, Korea University Medical College, Republic of Korea
| | - Jin Hee Kim
- Department of Radiation Oncology, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Republic of Korea
| | - Jihye Cha
- Department of Radiation Oncology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Republic of Korea
| | - Yoon Kyeong Oh
- Department of Radiation Oncology, Chosun University Medical School, Republic of Korea
| | - In Ah Kim
- Department of Radiation Oncology, Seoul National University College of Medicine, Republic of Korea.
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20
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Birla R, Dinu D, Iosif C, Constantinoiu S. Gastric Metastasis of Invasive Lobular Breast Carcinoma, a Current Diagnostic and Treatment Challenge - A Review. Chirurgia (Bucur) 2019; 114:571-578. [PMID: 31670632 DOI: 10.21614/chirurgia.114.5.571] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2019] [Indexed: 11/23/2022]
Abstract
Introduction: The predilection of lobular invasive breast cancer metastasis for the stomach is a topic that has succumbed to various assumptions over the time. Background and Aims: Gastric metastasis of lobular breast cancer is unusual and it can be diagnosed after a long period of time from primary tumor diagnosis. The aim of this study was to review current knowledge regarding the current methods of diagnosis and treatment of gastric metastasis of breast cancer. Methods: A systematic literature search was performed in the Pub-Med Medline database using the terms "gastric metastasis of lobular breast cancer" and "gastric metastasis features" to identify articles relevant to gastric metastasis of lobular breast cancer. Results: Several papers have shown that the topic is rarely presented in the form of case presentations or miniseries by summing up sporadic cases. Due to its rarity and metastasis specificity as host type and appearance after latency of lobular breast cancer makes its gastric metastasis considered atypical and occasionally confused with a primary stomach malignancy. The most recent articles present the immunohistochemical diagnostic criteria of this clinical entity and a new therapeutic approach. Conclusion: At patients with gastric metastasis of lobular breast cancer, obtaining pathologic material and biopsies interpretation can be a real challenge for getting a correct pathologic diagnosis, immunohistochemistry gives us definite diagnosis. The introduction of an endoscopic surveillance protocol for patients with lobular breast cancer could be a proposal for the detection of early gastric metastases allowing for appropriate therapy.
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Li Y, Zhang X, Qiu J, Pang T, Huang L, Zeng Q. Comparisons of p53, KI67 and BRCA1 expressions in patients with different molecular subtypes of breast cancer and their relationships with pathology and prognosis. J BUON 2019; 24:2361-2368. [PMID: 31983107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
PURPOSE To compare the expressions of p53, a tumor suppressor gene, KI67, a proliferating cell nuclear antigen, and breast cancer 1 (BRCA1), a breast cancer susceptibility gene, in patients with different molecular subtypes of breast cancer (BC) and investigate their relationships with pathology and prognosis. METHODS A total of 134 BC postoperative tissue specimens preserved from January 2012 to August 2013 were selected. The expressions of p53, KI67, and BRCA1 in different molecular subtypes of BC were compared, their relationships with pathological features were explored, and the expression correlations among p53, KI67, and BRCA1 were analyzed at the same time. RESULTS P53 expression was the lowest in Luminal A subtype and similar in human epidermal growth factor receptor 2 (HER-2)-overexpression subtype and triple-negative subtype, with higher expression rates than those in other molecular subtypes. The expression of KI67 was the lowest in Luminal A subtype, showing a significant difference (p<0.05) from that in other molecular subtypes and it was the highest in Luminal B subtype (p<0.05). BRCA1 exhibited the lowest expression in Luminal B-like subtype but the highest expression in Luminal A subtype. The protein expressions of p53 and KI67 were not related to age but correlated with tumor size, histological grade, lymph node metastasis, estrogen receptor (ER)/progesterone receptor (PR) status, and HER-2 status. The expression of p53 was increased with larger tumor size, higher histological grade, presence of lymph node metastasis (n), lower expression of ER/PR, and higher expression of HER-2. BRCA1 expression had no relation with age, tumor size, histological grade, lymph node metastasis (n), ER/PR status, and HER-2 status. A positive correlation was found between p53 and KI67 (r=0.893, p=0.021). There were negative correlations between p53 and BRCA1 (r=-0.921, p=0.011), and between KI67 and BRCA1 (r=-0.821, p=0.032). The median survival time of patients with positive expressions of p53, KI67 and BRCA1 was significantly shorter than those of patients with negative expressions. CONCLUSION The expressions of p53, KI67 and BRCA1 in different molecular subtypes of BC are evidently different and related to pathological features. The above protein expressions are helpful in predicting the prognosis, diagnosis, and treatment of BC.
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MESH Headings
- Adult
- Aged
- BRCA1 Protein/metabolism
- Biomarkers, Tumor/metabolism
- Breast Neoplasms/metabolism
- Breast Neoplasms/pathology
- Breast Neoplasms/surgery
- Carcinoma, Ductal, Breast/metabolism
- Carcinoma, Ductal, Breast/secondary
- Carcinoma, Ductal, Breast/surgery
- Carcinoma, Lobular/metabolism
- Carcinoma, Lobular/secondary
- Carcinoma, Lobular/surgery
- Female
- Follow-Up Studies
- Humans
- Ki-67 Antigen/metabolism
- Lymphatic Metastasis
- Middle Aged
- Prognosis
- Receptor, ErbB-2/metabolism
- Receptors, Estrogen/metabolism
- Receptors, Progesterone/metabolism
- Survival Rate
- Tumor Suppressor Protein p53/metabolism
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Affiliation(s)
- Yi Li
- Department of Thyroid & Breast Surgery, the Fifth Affiliated Hospital, Sun Yat-Sen University, Zhuhai 519000, China
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Houts AC, Olufade T, Shenolikar R, Walker MS, Schwartzberg LS. Treatment patterns, clinical outcomes, health resource utilization, and cost in patients with BRCA-mutated metastatic breast cancer treated in community oncology settings. Cancer Treat Res Commun 2019; 19:100121. [PMID: 30785027 DOI: 10.1016/j.ctarc.2019.100121] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 01/14/2019] [Accepted: 02/05/2019] [Indexed: 06/09/2023]
Abstract
PURPOSE This retrospective study of community oncology patients with breast cancer gene (BRCA)-mutated metastatic breast cancer (MBC) examined treatment outcomes and health resource utilization (HRU) and costs for a sample of patients with human epidermal growth factor receptor 2 (HER2)-negative disease who were either hormone receptor positive (HR+) or triple negative breast cancer (TNBC). METHODS Evidence from the Vector Oncology Data Warehouse, a repository of electronic medical records/billing data and provider notes, was analyzed. Treatment outcomes were progression-free survival (PFS) and overall survival (OS) from start of first-line therapy in the metastatic setting. HRU and cost measures were collected from the time of MBC diagnosis to end of the record. HRU included hospitalizations, emergency room visits, infused/parenteral supportive care drugs, and outpatient visits. Costs were computed both as total and monthly costs. RESULTS 57 HR+ and 57 TNBC patients (2013-2015) met inclusion criteria. Eight TNBC patients did not get treatment. HR+ patients had median first line PFS of 12.1 months and TNBC patients had 6.1 months. HR+ patients had median OS from start of first line of 38.4 months, and TNBC patients had 23.4 months. Rate of use of infused/parenteral supportive care drugs was 25.5% overall and 36.7% among TNBC patients with 15.8% among HR+ patients. CONCLUSION There is an unmet need in BRCA-mutated patients with MBC, including those with HR+ and TNBC disease. The unmet need among TNBC patients was most evident in that 12% were not treated and TNBC patients appeared to have poor treatment outcomes. MICRO ABSTRACT Reviewed medical records for outcomes, resource utilization, and costs in 114 community patients with BRCA mutated metastatic breast cancer. 57 hormone positive (HP); 57 triple negative (TN). RESULTS median PFS: 12.1 months HP; 6.1 TN. HP OS was 38.4; TN 23.4. Rate of infused supportive care drugs: 25.5% HP; 36.7% TN. Patients with TN disease need better therapeutic options.
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MESH Headings
- Adult
- Aged
- Antineoplastic Combined Chemotherapy Protocols/economics
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- BRCA1 Protein/genetics
- BRCA2 Protein/genetics
- Biomarkers, Tumor/genetics
- Breast Neoplasms/drug therapy
- Breast Neoplasms/economics
- Breast Neoplasms/genetics
- Breast Neoplasms/pathology
- Carcinoma, Ductal, Breast/drug therapy
- Carcinoma, Ductal, Breast/economics
- Carcinoma, Ductal, Breast/genetics
- Carcinoma, Ductal, Breast/secondary
- Carcinoma, Lobular/drug therapy
- Carcinoma, Lobular/economics
- Carcinoma, Lobular/genetics
- Carcinoma, Lobular/secondary
- Community Health Centers
- Costs and Cost Analysis
- Female
- Follow-Up Studies
- Health Care Rationing/economics
- Health Care Rationing/statistics & numerical data
- Humans
- Inflammatory Breast Neoplasms/drug therapy
- Inflammatory Breast Neoplasms/economics
- Inflammatory Breast Neoplasms/genetics
- Inflammatory Breast Neoplasms/secondary
- Middle Aged
- Mutation
- Retrospective Studies
- Survival Rate
- Treatment Outcome
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Affiliation(s)
- Arthur C Houts
- Vector Oncology, 6555 Quince, Suite 400, Memphis, TN 38119, United States
| | - Tope Olufade
- AstraZeneca, 101 Orchard Ridge Dr. (3233D), Gaithersburg, MD 20878, United States
| | - Rahul Shenolikar
- AstraZeneca, 101 Orchard Ridge Dr. (3233D), Gaithersburg, MD 20878, United States
| | - Mark S Walker
- Vector Oncology, 6555 Quince, Suite 400, Memphis, TN 38119, United States.
| | - Lee S Schwartzberg
- West Cancer Center, 7945 Wolf River Boulevard, Germantown, TN 38138, United States
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Birla R, Dinu D, Iosif C, Constantinoiu S. Portal Vein Thrombosis a Rare but Life-threatening Complication after Laparoscopic Sleeve Gastrectomy: A 5 Years Study in a Bariatric Center of Excellence. Chirurgia (Bucur) 2019; 114:711-724. [PMID: 31670632 DOI: 10.21614/chirurgia.114.6.711] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2019] [Indexed: 11/23/2022]
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24
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Sazuka T, Kimura M, Ikeda Y, Kamata T, Isozaki T, Urahama R, Tasaki K, Sugamoto Y, Watanabe Y, Asai Y, Fukunaga T, Matsubara H. [A Case of Colon Metastasis from Invasive Lobular Carcinoma of the Breast]. Gan To Kagaku Ryoho 2018; 45:2473-2475. [PMID: 30692502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The patient was a 48-year-old woman. She consulted our hospital with a chief complaint of vomiting. Colonoscopy showed stenosis and edematous mucosa, and biopsy was performed. Histological examination demonstrated the lesion to be colonic metastasis of breast cancer, invasive lobular carcinoma. Although colorectal metastasis of breast cancer has a poor prognosis and chemotherapy is considered as the main treatment modality, hormone therapy is also a treatment option depending on the condition.
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25
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Affiliation(s)
- Aditya Bardia
- From the Departments of Medicine (A.B.), Radiology (M.D.H.), and Pathology (E.F.B., V.N.), Massachusetts General Hospital, and the Departments of Medicine (A.B.), Radiology (M.D.H.), and Pathology (E.F.B., V.N.), Harvard Medical School - both in Boston
| | - Meline D Hovnanian
- From the Departments of Medicine (A.B.), Radiology (M.D.H.), and Pathology (E.F.B., V.N.), Massachusetts General Hospital, and the Departments of Medicine (A.B.), Radiology (M.D.H.), and Pathology (E.F.B., V.N.), Harvard Medical School - both in Boston
| | - Elena F Brachtel
- From the Departments of Medicine (A.B.), Radiology (M.D.H.), and Pathology (E.F.B., V.N.), Massachusetts General Hospital, and the Departments of Medicine (A.B.), Radiology (M.D.H.), and Pathology (E.F.B., V.N.), Harvard Medical School - both in Boston
| | - Valentina Nardi
- From the Departments of Medicine (A.B.), Radiology (M.D.H.), and Pathology (E.F.B., V.N.), Massachusetts General Hospital, and the Departments of Medicine (A.B.), Radiology (M.D.H.), and Pathology (E.F.B., V.N.), Harvard Medical School - both in Boston
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26
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Shao B, Song G, Li H, Dil L, Jiang H, Liang X, Yan Y, Zhang R, Ran R, Wang J, Liu X, You M. Combination versus sequential paclitaxel plus gemcitabine as first-line chemotherapy for women with metastatic breast cancer: a prospective randomized phase II study. J BUON 2018; 23:1583-1590. [PMID: 30610781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
PURPOSE Paclitaxel (T) plus gemcitabine (G) is an active concomitant combination for the treatment of metastatic breast cancer (MBC). However, the efficacy of sequential administration of these two drugs is unclear. This randomized phase II study was conducted to evaluate the efficacy of T and G administered either as a concomitant or as a sequential regimen in patients with MBC. METHODS Patients with MBC (n=66) were randomized to either receive 6 cycles of concomitant T and G or 4 cycles of T followed by 4 cycles of G, as first line chemotherapy. With no progression, the arms would switch to maintenance with paclitaxel. Progression free survival (PFS) was defined as the primary endpoint; secondary endpoints were the overall response rate (ORR), overall survival (OS), and toxicity. In total, 33 patients were randomized to the concomitant or sequential arms. Patient characteristics were well balanced. The median number of chemotherapy cycles was 6 for the concomitant arm and 8 for the sequential arm. RESULTS No significant difference was observed in terms of PFS, ORR, and OS. Only 13 (39.4%) patients progressed in the sequential arm. Although there was no significant difference between the two arms (p=0.056),the sequential arm had a remarkable trend of longer PFS than the concomitant arm. Toxicities were manageable and similar in both arms.The incidence of neutropenia was significantly higher in the concomitant arm (90.9%) than in the sequential arm (60.6%). Grade 3 or 4 neutropenia was not significantly different between the two arms. CONCLUSIONS Concomitant and sequential treatment with paclitaxel and gemcitabine had no significant difference in terms of PFS.
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Affiliation(s)
- Bin Shao
- Department of Medical Oncology, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Breast Oncology, Peking University Cancer Hospital & Institute, Haidian District, Beijing 100142, China
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27
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Esin E, Oksuzoglu B, Bilici A, Cicin I, Kostek O, Kaplan MA, Aksoy S, Aktas BY, Ozdemir O, Alacacioglu A, Cabuk D, Sumbul AT, Sakin A, Paydas S, Yetisir E, Er O, Korkmaz T, Yildirim N, Sakalar T, Demir H, Artac M, Karaagac M, Harputluoglu H, Bilen E, Erdur E, Degirmencioglu S, Aliyev A, Cil T, Olgun P, Basaran G, Gumusay O, Demir A, Tanrikulu E, Yumuk PF, Imamoglu I, Oyan B, Cetin B, Haksoyler V, Karadurmus N, Erturk I, Evrensel T, Yilmaz H, Beypinar I, Kocer M, Pilanci KN, Seker M, Urun Y, Yildirim N, Eren T, Demirci U. Pertuzumab, trastuzumab and taxane-based treatment for visceral organ metastatic, trastuzumab-naïve breast cancer: real-life practice outcomes. Cancer Chemother Pharmacol 2018; 83:131-143. [PMID: 30377778 DOI: 10.1007/s00280-018-3712-7] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 10/25/2018] [Indexed: 01/19/2023]
Abstract
PURPOSE In this study, we aimed to describe the real-life practice outcomes of pertuzumab-trastuzumab-taxane (PTT) combination in visceral organ metastatic, trastuzumab-naive breast cancer (BC) patients. METHODS This study was conducted by Turkish Oncology Group and included 317 patients' data from 36 centers. RESULTS Median age was 51 (22-82). Median PFS was 28.5 months, while median OS was 40.3 months. Patients with brain metastases (n: 13, 4.1%) had worse PFS (16.8 m vs. 28.5 m; p = 0.002) and OS (26.7 m vs. 40.3 m; p = 0.009). Patients older than 65 years of age (n: 42, 13.2%) had significantly lower OS results (19.8 m vs. 40.3 m; p = 0.01). Two hundred sixty-eight patients (86.7%) received docetaxel while 37 patients (11.7%) received paclitaxel. PFS and OS were similar between taxane groups. In eight patients (2.5%), 5-40% ejection fraction decrement from baseline was detected without any clinical sign of heart failure. CONCLUSIONS Our RLP trial included only visceral metastatic, trastuzumab-naïve BC patients including cases with brain involvement who received PTT combination in the first-line treatment. Regardless of negative prognostic characteristics, our results are in parallel with pivotal trial. Further strategies for brain metastasis should be developed to improve outcomes despite encouraging results with PTT treatment. Taxane selection can be personalized and endocrine maintenance may further improve outcomes after taxanes were discontinued. To our knowledge, this is the largest scale real-life clinical practice study of pertuzumab-trastuzumab-taxane therapy to date.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Antibodies, Monoclonal, Humanized/administration & dosage
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Breast Neoplasms/drug therapy
- Breast Neoplasms/mortality
- Breast Neoplasms/pathology
- Carcinoma, Ductal, Breast/drug therapy
- Carcinoma, Ductal, Breast/mortality
- Carcinoma, Ductal, Breast/secondary
- Carcinoma, Lobular/drug therapy
- Carcinoma, Lobular/mortality
- Carcinoma, Lobular/secondary
- Docetaxel/administration & dosage
- Female
- Follow-Up Studies
- Humans
- Middle Aged
- Neoplasm Invasiveness
- Neoplasm Metastasis
- Paclitaxel/administration & dosage
- Practice Patterns, Physicians'
- Prognosis
- Retrospective Studies
- Survival Rate
- Trastuzumab/administration & dosage
- Young Adult
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Affiliation(s)
- Ece Esin
- Department of Medical Oncology, Dr. A. Y. Ankara Oncology Education and Research Hospital, University of Health Sciences, Yenimahalle, Ankara, Turkey.
| | - B Oksuzoglu
- Department of Medical Oncology, Dr. A. Y. Ankara Oncology Education and Research Hospital, University of Health Sciences, Yenimahalle, Ankara, Turkey
| | - A Bilici
- Departmant of Medical Oncology, Medipol University International Health Center, Istanbul, Turkey
| | - I Cicin
- Department of Medical Oncology, Trakya University, Edirne, Turkey
| | - O Kostek
- Department of Medical Oncology, Trakya University, Edirne, Turkey
| | - M A Kaplan
- Department of Medical Oncology, Faculty of Medicine, Dicle University, Diyarbakir, Turkey
| | - S Aksoy
- Department of Medical Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - B Y Aktas
- Department of Medical Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - O Ozdemir
- Department of Medical Oncology, Ataturk Education and Research Hospital, İzmir K.C. University, Izmir, Turkey
| | - A Alacacioglu
- Department of Medical Oncology, Ataturk Education and Research Hospital, İzmir K.C. University, Izmir, Turkey
| | - D Cabuk
- Department of Medical Oncology, Faculty of Medicine, Kocaeli University, Izmit, Turkey
| | - A T Sumbul
- Department of Medical Oncology, Baskent University Adana Hospital, Adana, Turkey
| | - A Sakin
- Department of Medical Oncology, Istanbul Okmeydani Education and Research Hospital, Istanbul, Turkey
| | - S Paydas
- Department of Medical Oncology, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - E Yetisir
- Department of Medical Oncology, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - O Er
- Department of Medical Oncology, Acibadem Maslak Hospital, Acibadem MAA University, Istanbul, Turkey
| | - T Korkmaz
- Department of Medical Oncology, Acibadem Altunizade Hospital, Acibadem MAA University, Istanbul, Turkey
| | - N Yildirim
- Department of Medical Oncology, Dr. Ersin Arslan Training and Research Hospital, Gaziantep, Turkey
| | - T Sakalar
- Department of Medical Oncology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - H Demir
- Department of Medical Oncology, Kayseri Education and Research Hospital, University of Health Sciences, Kayseri, Turkey
| | - M Artac
- Department of Medical Oncology, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
| | - M Karaagac
- Department of Medical Oncology, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
| | - H Harputluoglu
- Department of Medical Oncology, Turgut Ozal Medical Center, Inonu University, Malatya, Turkey
| | - E Bilen
- Department of Medical Oncology, Turgut Ozal Medical Center, Inonu University, Malatya, Turkey
| | - E Erdur
- Department of Medical Oncology, Dr. A. Y. Ankara Oncology Education and Research Hospital, University of Health Sciences, Yenimahalle, Ankara, Turkey
| | - S Degirmencioglu
- Department of Medical Oncology, Faculty of Medicine, Pamukkale University, Denizli, Turkey
| | - A Aliyev
- Department of Medical Oncology, Faculty of Medicine, Bezmialem University, Istanbul, Turkey
| | - T Cil
- Department of Medical Oncology, Adana City Hospital, University of Health Sciences, Adana, Turkey
| | - P Olgun
- Department of Medical Oncology, Adana City Hospital, University of Health Sciences, Adana, Turkey
| | - G Basaran
- Department of Medical Oncology, Acibadem Maslak Hospital, Acibadem MAA University, Istanbul, Turkey
| | - O Gumusay
- Department of Medical Oncology, Faculty of Medicine, Gaziosmanpasa University, Tokat, Turkey
| | - A Demir
- Department of Medical Oncology, Istanbul Okmeydani Education and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - E Tanrikulu
- Department of Medical Oncology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - P F Yumuk
- Department of Medical Oncology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Inanc Imamoglu
- Department of Medical Oncology, Ankara Diskapi Education and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - B Oyan
- Department of Medical Oncology, Acibadem Altunizade Hospital, Acibadem MAA University, Istanbul, Turkey
| | - B Cetin
- Department of Medical Oncology, Faculty of Medicine, RTE University, Rize, Turkey
| | - V Haksoyler
- Department of Medical Oncology, Diyarbakir G.Y. Education and Research Hospital, University of Health Sciences, Diyarbakir, Turkey
| | - N Karadurmus
- Department of Medical Oncology, Gulhane Education and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - I Erturk
- Department of Medical Oncology, Gulhane Education and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - T Evrensel
- Department of Medical Oncology, Faculty of Medicine, Uludag University, Bursa, Turkey
| | - H Yilmaz
- Department of Medical Oncology, Faculty of Medicine, Uludag University, Bursa, Turkey
| | - I Beypinar
- Department of Medical Oncology, Faculty of Medicine, Afyon Kocatepe University, Afyon, Turkey
| | - M Kocer
- Department of Medical Oncology, Faculty of Medicine, Isparta S.D University, Isparta, Turkey
| | - K N Pilanci
- Department of Medical Oncology, Haseki Education and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - M Seker
- Department of Medical Oncology, Ankara Bayindir Hospital, Ankara, Turkey
| | - Y Urun
- Department of Medical Oncology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - N Yildirim
- Department of Medical Oncology, Numune Education and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - T Eren
- Department of Medical Oncology, Numune Education and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - U Demirci
- Department of Medical Oncology, Dr. A. Y. Ankara Oncology Education and Research Hospital, University of Health Sciences, Yenimahalle, Ankara, Turkey
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Weiss J, Afghahi A, Shagisultanova E, Diamond JR. Approaching Use of CDK4/6 Inhibitors in Metastatic HR+, HER2- Breast Cancer. Oncology (Williston Park) 2018; 32:513-515. [PMID: 30334242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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Abstract
BACKGROUND/OBJECTIVE The 21-gene Oncotype DX® Breast Recurrence Score® (RS) assay has been prospectively validated as prognostic and predictive in node-negative, estrogen receptor-positive (ER+)/HER2- breast cancer patients. Less is known about its prognostic role in node-positive breast cancer. We compared RS results among patients with lymph node-negative (N0), micrometastatic (N1mi), and macrometastatic (N+) breast cancer to determine if nodal metastases are associated with more aggressive biology, as determined by RS. METHODS Overall, 610,350 tumor specimens examined by the Genomic Health laboratory from February 2004 to August 2017 were studied. Histology was classified centrally, while lymph node status was determined locally. RS distribution (low: < 18; intermediate: 18-30; high: ≥ 31) was compared by nodal status. RESULTS Eighty percent (n = 486,013) of patients were N0, 4% (n = 24,325) were N1mi, 9% (n = 56,100) were N+, and 7% (n = 43,912) had unknown nodal status. Mean RS result was 18, 16.7, 17.3 and 18.9 in the N0, N1mi, N+, and unknown groups, respectively. An RS ≥ 31 was seen in 10% of N0 patients, 7% of N1mi patients, and 8.0% of N+ patients. The likelihood of an RS ≥ 31 in N1mi and N+ patients varied with tumor histology, with only 2% of patients with classic infiltrating lobular cancer having an RS ≥ 31, versus 7-9% of those with ductal carcinoma. CONCLUSIONS RS distribution among N0, N1mi, and N+ patients is similar, suggesting a spectrum of biology and potential chemotherapy benefit exists among node-negative and node-positive ER+/HER2- breast cancer patients. If RxPONDER does not show a chemotherapy benefit in N+ patients with a low RS result, our findings indicate that substantial numbers of patients could be spared the burden of chemotherapy.
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MESH Headings
- Aged
- Biomarkers, Tumor/genetics
- Biomarkers, Tumor/metabolism
- Breast Neoplasms/genetics
- Breast Neoplasms/metabolism
- Breast Neoplasms/pathology
- Carcinoma, Ductal, Breast/genetics
- Carcinoma, Ductal, Breast/metabolism
- Carcinoma, Ductal, Breast/secondary
- Carcinoma, Lobular/genetics
- Carcinoma, Lobular/metabolism
- Carcinoma, Lobular/secondary
- Female
- Follow-Up Studies
- Gene Expression Profiling/methods
- Humans
- Lymph Nodes/metabolism
- Lymph Nodes/pathology
- Lymphatic Metastasis
- Middle Aged
- Neoplasm Recurrence, Local/genetics
- Neoplasm Recurrence, Local/metabolism
- Neoplasm Recurrence, Local/pathology
- Prognosis
- Prospective Studies
- Receptor, ErbB-2/metabolism
- Receptors, Estrogen/metabolism
- Receptors, Progesterone/metabolism
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Affiliation(s)
- Danielle M Bello
- Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | | | | | - Monica Morrow
- Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
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30
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Sunar V, T Dogan H, Sarici F, Ates O, Akin S, Baspinar B, Aksoy S, Altundag K. Association between androgen receptor status and prognosis in triple negative breast cancer. J BUON 2018; 23:1325-1330. [PMID: 30570854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
PURPOSE Triple negative breast cancer (TNBC) is a heterogeneous disease group with a higher recurrence risk and poorer prognosis. In this study, we aimed to investigate the frequency and prognostic value of androgen receptor (AR) expression in tissues of TNBC patients. METHODS A total of 84 TNBC patients treated between 2000 - 2015 in Hacettepe University Cancer Institute were included and their medical records were analyzed retrospectively. The available paraffin blocks were assessed immunohistochemically to determine AR expression. Tumors with ≥1% nuclear staining were considered AR-positive, while the ones with <1% staining were considered AR-negative. We analyzed the association between AR expression, and clinical-pathologic characteristics and prognosis in TNBC. RESULTS Of the 84 TNBC patients, 25 (29.8%) were AR-positive. The frequency of grade 3 tumors was lower among AR-positive TNBC tumors compared to AR-negative tumors (40 vs 86.4%, p<0.001). In the AR-positive group, invasive ductal carcinoma (IDC) was less prevalent compared to AR-negative group (56 vs 86.4%, p<0.002). However, there were not statistically significant differences between AR positive and negative groups in terms of overall survival (OS) and disease free survival (DFS) (p=0.449, p=0.733, respectively). We found that grade 3 tumors were less frequent in AR-positive TNBC in our study. Nonetheless, we did not detect statistically significant difference in terms of overall survival and disease free survival between AR positive and negative TNBC. CONCLUSION Routine evaluation of AR could contribute to further studies that may enlighten the role of AR targeting therapies in TNBC.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Biomarkers, Tumor/metabolism
- Carcinoma, Ductal, Breast/metabolism
- Carcinoma, Ductal, Breast/secondary
- Carcinoma, Ductal, Breast/therapy
- Carcinoma, Lobular/metabolism
- Carcinoma, Lobular/secondary
- Carcinoma, Lobular/therapy
- Combined Modality Therapy
- Female
- Follow-Up Studies
- Humans
- Lymphatic Metastasis
- Middle Aged
- Neoplasm Invasiveness
- Prognosis
- Receptors, Androgen/metabolism
- Retrospective Studies
- Survival Rate
- Triple Negative Breast Neoplasms/metabolism
- Triple Negative Breast Neoplasms/pathology
- Triple Negative Breast Neoplasms/therapy
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Affiliation(s)
- Veli Sunar
- Hacettepe University Cancer Institute, Department of Medical Oncology, Ankara, Turkey
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Sosa PS, Colla-Machado PE, Cristiano E. [Pisa syndrome associated with codeine]. Rev Neurol 2018; 67:73-74. [PMID: 29971761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- P S Sosa
- Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | | | - E Cristiano
- Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
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Abstract
Metastatic involvement of the extrahepatic digestive system is rare. We here report the case of a 62-year-old woman who presented with a bowel obstruction related to a metastasis of breast cancer occurring 12 years after a mastectomy for lobular carcinoma. No other distant metastases were detected except for two nodules of 20 and 5 mm on the right chest wall. Biopsy of the larger nodule showed a lobular carcinoma. The patient underwent a right hemicolectomy and then received chemotherapy combined with letrozole, resulting in a partial response. The literature revealed only a few cases of breast cancer metastatic to the colon. Patients with known breast cancer, particularly of the lobular histological type, who present with specific or less specific abdominal symptoms or signs such a microcytic anemia, should be endoscopically explored in order to detect possible metastases of the primary breast tumor.
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Affiliation(s)
- Carlo Signorelli
- Medical Oncology Unit, Department of Oncology-Hematology, Belcolle Hospital, Viterbo, Italy.
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33
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Abstract
Metastatic involvement of the upper gastrointestinal tract from breast cancer has been reported in autopsy series as occurring in more than 15% of patients, usually associated with extensive systemic spread; clinical manifestations from such metastases have been described in less than 1% of cases. Lobular infiltrating carcinoma seems to have a different metastatic pattern than the ductal type, with an apparent predilection for the gastrointestinal tract. Metastatic presentation as an isolated intestinal obstruction without other signs of metastatic spread is extremely rare. We present a case of isolated duodenal metastasis from breast cancer, associated with intestinal obstruction, as the first sign of metastatic spread.
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Syed A, Eleti S, Kumar V, Ahmad A, Thomas H. Validation of Memorial Sloan Kettering Cancer Center nomogram to detect non-sentinel lymph node metastases in a United Kingdom cohort. G Chir 2018; 39:12-19. [PMID: 29549676 DOI: 10.11138/gchir/2018.39.1.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
AIM Axillary lymph node dissection, although associated with long-term morbidity, has been the standard of treatment for all nodepositive breast cancer patients. We assessed the risk prediction ability (validity) of Memorial Sloan Kettering Cancer Center (MSKCC) nomogram for non-sentinel lymph node metastases and analysed the outcome of patients with sentinel node metastases. PATIENTS AND METHODS All operable early breast cancer patients with sentinel node macro metastases (size > 2mm) who underwent axillary dissection from April 2009 to March 2015 were considered eligible. The risk of non-sentinel lymph node metastases was calculated using an online MSKCC calculator, and accuracy was determined based on the area under the receiver-operating characteristic curve (AUC-ROC). Tumour characteristics and overall survival were also analysed as secondary end points. RESULTS Of 1745 patients who were diagnosed with operable breast cancer during the study period, 114 patients were considered eligible. The AUC-ROC was 0.66 suggestive of lesser accuracy in prediction and not statistically significant (p value = 0.7303). Seventysix (50.7%) of these patients did not have any non-sentinel node metastases. At a mean follow up of four years, the disease-free survival was 86.4% and overall survival rate was 88.4%. CONCLUSIONS The MSKCC nomogram was unable to accurately predict the risk in our cohort of patients with more than half of this cohort of patients not requiring axillary dissection. These findings are consistent with other European studies. This study thus highlights the need for modified prediction model for European cohorts.
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35
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Invento A, Mirandola S, Pellini F, Pollini GP, Grigolato D. Breast cancer and gastrointestinal metastasis. A case report and review of the literature. Ann Ital Chir 2018; 89:153-156. [PMID: 29848817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
INTRODUCTION Invasive lobular cancer (ILC) is the second most common type of a heterogeneous group of different histological types of invasive breast carcinoma. Breast cancer can metastatize anywhere, the most common sites are bones, liver, lungs and brain. Gastrointestinal tract (GI) metastases observed in autopsy studies account for about 6% to 18% of the overall metastases from breast cancer. OBJECTIVE We describe a 54-year old woman with recurrent ILC in the contralateral breast. She underwent right mastectomy 16 years before. After symptomatic presentation a duodenal invasion was found and subjected to diagnostic scrutiny (FDG PET/CT, diagnostic CT, MR, EGDS). In particular, we analyse if FDG PET/CT is enough accurate in the restaging of the patient. A review of our database and of the literature of similar cases were made. RESULTS In this patient CT and RM were suspicious for a slow developing process of the duodenum but FDG PET/CT did not show pathological uptake in the affected duodenal tract. A highly intense focus was described in a cervical lymph node, that there isn't metastatic lesion, whereas the recurrent breast lesion had only slight increased glycolytic activity. CONCLUSION Metastatic lobular carcinoma of the breast is a rare entity with a heterogeneous range of clinical presentations. Detection of eventual gastrointestinal metastases are complicated to assess. ILC has various scale of glycolytic activity both in the primary lesion as well in the metastatic foci. When the level of suspicion is high and there is no uptake of FDG, further investigations are necessary. KEY WORD Abdominal metastasis, FGD PET-TC, Lobular Breast Cancer.
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36
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Bernichon E, Vallard A, Wang Q, Attignon V, Pissaloux D, Bachelot T, Heudel PE, Ray-Coquard I, Bonnet E, de la Fouchardière A, Faure C, Chopin N, Beurrier F, Racadot S, Sunyach MP, Rancoule C, Perol D, Corset V, Agrapart V, Tinquaut F, Blay JY, Magné N, Trédan O. Genomic alterations and radioresistance in breast cancer: an analysis of the ProfiLER protocol. Ann Oncol 2017; 28:2773-2779. [PMID: 28945826 DOI: 10.1093/annonc/mdx488] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Breast cancer (BC) patients with comparable prognostic features have heterogeneous outcomes, party related to a possible radiotherapy resistance leading to local-regional recurrences (LRR). The objective of the present study was to identify predictive molecular biomarkers of LRR of BC. PATIENTS AND METHODS Genetic profile of 146 BC patients' tumours included in the ProfiLER clinical trial (NC01774409) between 2013 and 2016 were analysed using next-generation-sequencing and comparative-genomic-hybridization tests. Patients and tumour characteristics were retrospectively collected and analysed for association with genomic rearrangements (mutations, amplification, deletions). Only gene alterations observed in >3% of the tumours were selected. RESULTS A total of 193 genomic rearrangements were identified, and 16 were observed in >3% of tumours. One was statistically correlated to the risk of local relapse. A median loco-regional progression-free survival (LRPFS) of 23.6 years was reported for PIK3CA mutation carriers (n = 31, 21.2%) versus 9.9 years for PIK3CA wild-type patients (HR 0.27, 95% CI 0.12-0.65, P = 0.002 in univariate analysis). PIK3CA mutation was identified as an independent protective factor on LRR using multivariate analysis (HR 0.29, 95% CI 0.09-0.99, P = 0.047). All other mutations, amplifications or deletions were not found associated with LRPFS. CONCLUSION PIK3CA mutation was associated with a lower risk of local relapse in this population of BCs. This is consistent with recent studies suggesting PIK3CA to be part of biological pathways impacting the radiosensitivity.
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MESH Headings
- Adult
- Biomarkers, Tumor/genetics
- Breast Neoplasms/genetics
- Breast Neoplasms/pathology
- Breast Neoplasms/radiotherapy
- Carcinoma, Ductal, Breast/genetics
- Carcinoma, Ductal, Breast/radiotherapy
- Carcinoma, Ductal, Breast/secondary
- Carcinoma, Lobular/genetics
- Carcinoma, Lobular/radiotherapy
- Carcinoma, Lobular/secondary
- Class I Phosphatidylinositol 3-Kinases/genetics
- Combined Modality Therapy
- Female
- Follow-Up Studies
- Gene Rearrangement
- Genomics
- High-Throughput Nucleotide Sequencing
- Humans
- Lymphatic Metastasis
- Middle Aged
- Mutation
- Neoplasm Invasiveness
- Neoplasm Recurrence, Local/genetics
- Neoplasm Recurrence, Local/pathology
- Neoplasm Recurrence, Local/radiotherapy
- Prognosis
- Prospective Studies
- Radiation Tolerance/genetics
- Retrospective Studies
- Survival Rate
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Affiliation(s)
| | - A Vallard
- Department of Radiation Oncology, Lucien Neuwirth Cancer Institute, Saint-Priest-en-Jarez
| | - Q Wang
- Department of Translational Research
| | | | | | | | | | | | | | | | | | | | | | | | | | - C Rancoule
- Department of Radiation Oncology, Lucien Neuwirth Cancer Institute, Saint-Priest-en-Jarez
| | - D Perol
- Department of Clinical Research, Léon Bérard Cancer Centre, Lyon
| | - V Corset
- Department of Clinical Research, Léon Bérard Cancer Centre, Lyon
| | - V Agrapart
- Department of Clinical Research, Léon Bérard Cancer Centre, Lyon
| | - F Tinquaut
- Department of Hygée Center, Lucien Neuwirth Cancer Institute, Saint-Priest-en-Jarez
| | - J-Y Blay
- Department of Translational Research; Department of Medical Oncology
| | - N Magné
- Department of Radiation Oncology, Lucien Neuwirth Cancer Institute, Saint-Priest-en-Jarez; Department of Laboratoire de Radiobiologie Cellulaire et Moléculaire, CNRS UMR 5822, Institut de Physique Nucléaire de Lyon, IPNL, Lyon Medicine University, Lyon, France.
| | - O Trédan
- Department of Translational Research; Department of Medical Oncology
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Sánchez Orgaz M, Gonzalez Pessolani T, Pozo Kreilinger JJ, Zamora P, Martí Álvarez C, Boto-de-Los-Bueis A. Orbital and conjunctival metastasis from lobular breast carcinoma. Orbit 2017; 36:197-200. [PMID: 28441073 DOI: 10.1080/01676830.2017.1310255] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This article examines the clinical presentation of ocular metastasis from an infiltrating lobular breast carcinoma. We examined a conjunctival biopsy from a 69-year-old woman who developed unilateral conjunctival inflammation together with a neurotrophic corneal ulcer and proptosis. Infiltrating lobular breast carcinoma (ILBC) was diagnosed using routine histology and immunohistochemistry. She had a past history of a hormone receptor-positive infiltrating ILBC 11 years ago with cutaneous and diffuse osteoblastic metastases, and she was kept under treatment with lezotrol. Treatment was initiated with systemic corticosteroids but an annular conjunctival perilimbal infiltration was found to have spread, which did not respond either to local radiotherapy (total dose 60 Gy, 2 Gy per day). A new extensive corneal epithelial defect recurred, and because it had not responded to matrix therapy agent (RGTA, Cacicol®) eye drops, autologous serum eye drops and a therapeutic contact lens, a permanent total tarsorrhaphy was performed. Progression of the diffuse bone metastases was detected and the treatment with lezotrol was replaced by fulvestrant.Infiltrating lobular breast carcinoma is a rare cause of conjunctival metastasis. This aggressive malignancy did not respond to external beam radiotherapy.
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Affiliation(s)
| | | | | | - Pilar Zamora
- c Oncology Department , La Paz University Hospital , Madrid , Spain
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38
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Mamtani A, Patil S, Stempel M, Morrow M. Axillary Micrometastases and Isolated Tumor Cells Are Not an Indication for Post-mastectomy Radiotherapy in Stage 1 and 2 Breast Cancer. Ann Surg Oncol 2017; 24:2182-2188. [PMID: 28429197 PMCID: PMC5568787 DOI: 10.1245/s10434-017-5866-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Indexed: 01/18/2023]
Abstract
BACKGROUND Randomized trials demonstrate equivalent locoregional control with sentinel lymph node biopsy (SLNB) or axillary lymph node dissection (ALND) for T1-2 micrometastatic breast cancer, but include few mastectomy patients. Consensus is lacking on indications for post-mastectomy radiotherapy (PMRT) in this population. Herein, we evaluate locoregional recurrence (LRR) in an unselected, modern cohort of T1-2 breast cancer patients with micrometastases or isolated tumor cells (ITCs; N0i+/N1mi) having a mastectomy. METHODS We identified patients with T1-2N0i+/N1mi breast cancer treated with mastectomy from January 2006 to December 2011. Recurrent, bilateral, and neoadjuvant cases were excluded. The primary outcome of interest was LRR. RESULTS Overall, 352 patients [211 (60%) with ITCs and 141 (40%) with micrometastases] were identified. 162 (46%) patients had SLNB alone and one node was positive in 295 (84%) cases; 31 (9%) patients had PMRT and 95% had systemic therapy. At a median 6 years of follow-up, the overall crude LRR rate was 2.8% (n = 9), with no axillary recurrences, and the crude LRR rate was 3.9% among those who had SNB alone. Those with LRR had a median age of 55 years, median tumor size of 1.7 cm, and ductal histology; the majority were high-grade (89%) and estrogen receptor positive (78%), with one positive node (89%). There was no association between LRR and receipt of PMRT (p = 0.4), SLNB versus ALND (p = 0.2), or number of positive nodes (p = 0.7) using the log-rank test. CONCLUSIONS LRR was infrequent among T1-2N0i+/N1mi patients treated with mastectomy without PMRT, with no axillary failures, suggesting that PMRT or nodal radiotherapy are not routinely indicated in this population.
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Affiliation(s)
- Anita Mamtani
- Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Sujata Patil
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Michelle Stempel
- Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Monica Morrow
- Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
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39
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Eliyatkin N, Aktas S, Diniz G, Ozgur HH, Ekin ZY, Kupelioglu A. Expression of Stromal Caveolin- 1 May Be a Predictor for Aggressive Behaviour of Breast Cancer. Pathol Oncol Res 2017; 24:59-65. [PMID: 28236153 DOI: 10.1007/s12253-017-0212-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 02/16/2017] [Indexed: 12/30/2022]
Abstract
Caveolin-1 (Cav-1) is well known as a principal scaffolding protein of caveolae which are specialized plasma membrane structures. The role of Cav-1 in tumorigenesis of breast cancers is relatively less studied. The aim of the present study is to describe the biological roles of Cav-1 in breast cancers considering its contrasting dual functions as an oncogene and as a tumor suppressor. This study included 71 females with breast cancer who had been histopathologically diagnosed in Private Gunes Pathology Laboratory between the years 2007, and 2012. The mean age is 52.48 ± 12.8 years. Patients were followed up for a mean period of 47.97 ± 20.48 months. We didn't determine Cav-1 positive tumor cells. In 36 cases (50.7%), there were stromal expressions of Cav-1. In the statistical analysis, there was a statistically significant correlation between Cav-1 expression and ER (p = 0.033), metastasis (p = 0.005), lymphatic invasion (p = 0.000), nodal metastasis (p = 0,003), perinodal invasion (p = 0.003), metastasis (p = 0.005) and survival (p = 0.009). We found that Cav-1 expression is associated with tumor size, histological grade, lymph node involvement. Accordingly, we have suggested that Cav-1 may be a predictive biomarker for breast cancer.
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Affiliation(s)
- Nuket Eliyatkin
- Pathology Department, Adnan Menderes University Medical Faculty, Aydin, Turkey
| | - Safiye Aktas
- Basic Oncology Department, Dokuz Eylul University Oncology Institute, Izmir, Turkey
| | - Gulden Diniz
- Pathology Department, Tepecik Education and Research Hospital, Kibris Sehitleri Cad 51/11 Alsancak, 35220, Izmir, Turkey.
| | | | - Zubeyde Yildirim Ekin
- Pathology Department, Tepecik Education and Research Hospital, Kibris Sehitleri Cad 51/11 Alsancak, 35220, Izmir, Turkey
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40
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Alnajar H, Rosen L, Javidiparsijani S, Al-Ghamdi Y, Gattuso P. Prognostic Markers and Histologic Subtypes in Patients with Meningeal Carcinomatosis in Breast Cancer. Acta Cytol 2017; 61:140-144. [PMID: 28231581 DOI: 10.1159/000455115] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Accepted: 12/15/2016] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Meningeal carcinomatosis (MC) is a rare complication in breast cancer patients. It is defined as a diffuse or multifocal leptomeningeal metastasis. STUDY DESIGN From our institution database, we retrospectively studied 19 patients diagnosed with MC in the cerebrospinal fluid (CSF) in 1997-2015, in order to evaluate tumor prognostic markers, histologic subtypes, and clinical outcome. RESULTS All patients were female, with a mean age of 53 years (range 36-75 years). The mean interval between diagnosis of breast carcinoma and MC was 28 months (range 6-62 months). The median survival from the time of diagnosis was 2 months (1-51 months). Sixteen cases (84%) were the ductal phenotype, 62% of which were of a high grade (grade 3), and 3 cases (16%) were lobular. Estrogen and progesterone receptors were positive on immunohistochemistry (IHC) in 53 and 33% of patients, respectively. HER2 IHC was positive (3+) in 20% of the cases; all were amplified by fluorescence in situ hybridization. The incidence of MC in triple-negative tumors was 40%. Twelve patients (63%) already had known metastasis at the time of diagnosis. CONCLUSIONS Most cases of MC are high-grade ductal. MC is more common in triple-negative breast cancers. The outcome of these breast cancer patients with MC was poor. There was no survival difference according to age, histologic subtype, grade, or hormonal or HER2 status.
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MESH Headings
- Adult
- Aged
- Biomarkers, Tumor/analysis
- Biomarkers, Tumor/genetics
- Biopsy
- Breast Neoplasms/chemistry
- Breast Neoplasms/mortality
- Breast Neoplasms/pathology
- Carcinoma, Ductal, Breast/chemistry
- Carcinoma, Ductal, Breast/mortality
- Carcinoma, Ductal, Breast/secondary
- Carcinoma, Lobular/chemistry
- Carcinoma, Lobular/mortality
- Carcinoma, Lobular/secondary
- Databases, Factual
- Female
- Humans
- Illinois
- Immunohistochemistry
- In Situ Hybridization, Fluorescence
- Meningeal Carcinomatosis/mortality
- Meningeal Carcinomatosis/secondary
- Middle Aged
- Neoplasm Grading
- Receptor, ErbB-2/analysis
- Receptor, ErbB-2/genetics
- Receptors, Estrogen/analysis
- Receptors, Progesterone/analysis
- Retrospective Studies
- Survival Analysis
- Time Factors
- Triple Negative Breast Neoplasms/chemistry
- Triple Negative Breast Neoplasms/mortality
- Triple Negative Breast Neoplasms/pathology
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Affiliation(s)
- Hussein Alnajar
- Department of Pathology, Rush University Medical Center, Chicago, IL, USA
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41
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Chiappa C, Rovera F, Rausei S, Del Ferraro S, Fachinetti A, Lavazza M, Marchionini V, Arlant V, Tanda ML, Piantanida E, Kim HY, Anuwong A, Dionigi G. Breast cancer and thyroid diseases: analysis of 867 consecutive cases. J Endocrinol Invest 2017; 40:179-184. [PMID: 27624298 DOI: 10.1007/s40618-016-0543-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 08/31/2016] [Indexed: 12/12/2022]
Abstract
INTRODUCTION The aim of this study was to evaluate the association of breast cancer with thyroid diseases. Many authors have already studied the possible relationship between these two diseases, but the results are nowadays conflicting. MATERIALS AND METHODS Our study examining 867 patients with breast cancer (862 women and 5 men, average age = 61 years old) of whom 141 also had thyroid disease evaluated the recurrence of thyroid diseases and their association with different types of breast cancer. Statistical analyses were performed using SPSS software for Windows; we used nonparametric tests (Chi-square and Mann-Whitney), and the level of significance was set at p < 0.05. RESULTS We found a significant association between breast cancer diagnosed after menopause and thyroid disease (p < 0.003). Moreover, we analyzed the role of thyroid autoimmunity identifying an association between chronic autoimmune thyroiditis and breast cancer diagnosed before menopause (p < 0.05). Regarding receptor profile of breast carcinoma, we have found an increased expression of estrogen receptors in patients with autoimmune thyroiditis compared to patients with any other thyroid diseases (p < 0.03). Contrariwise, we do not have found any difference between the group with every thyroid disease and the group without thyroid disease (p < 1.00). We did not find other statistically significant associations with breast cancer's parameters like family history, tumor size, lymph node metastasis, distant metastasis, cancer clinical and pathological stage, differentiation grade and expression of Ki67, p53 and Her2 in the two main groups with or without thyroid disease. Likewise, we did not found other statistically significant association between hypothyroidism or hyperthyroidism and breast cancer.
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MESH Headings
- Biomarkers, Tumor/metabolism
- Breast Neoplasms/etiology
- Breast Neoplasms/metabolism
- Breast Neoplasms/pathology
- Carcinoma, Ductal, Breast/etiology
- Carcinoma, Ductal, Breast/metabolism
- Carcinoma, Ductal, Breast/secondary
- Carcinoma, Lobular/etiology
- Carcinoma, Lobular/metabolism
- Carcinoma, Lobular/secondary
- Female
- Follow-Up Studies
- Humans
- Lymphatic Metastasis
- Male
- Middle Aged
- Neoplasm Grading
- Prognosis
- Receptors, Estrogen/metabolism
- Receptors, Progesterone/metabolism
- Thyroid Diseases/complications
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Affiliation(s)
- C Chiappa
- Senology Research Center - 1st Division of Surgery, Department of Surgical and Morphological Sciences, University of Insubria, Varese, Italy.
| | - F Rovera
- Senology Research Center - 1st Division of Surgery, Department of Surgical and Morphological Sciences, University of Insubria, Varese, Italy
| | - S Rausei
- Senology Research Center - 1st Division of Surgery, Department of Surgical and Morphological Sciences, University of Insubria, Varese, Italy
| | - S Del Ferraro
- Senology Research Center - 1st Division of Surgery, Department of Surgical and Morphological Sciences, University of Insubria, Varese, Italy
| | - A Fachinetti
- Senology Research Center - 1st Division of Surgery, Department of Surgical and Morphological Sciences, University of Insubria, Varese, Italy
| | - M Lavazza
- Senology Research Center - 1st Division of Surgery, Department of Surgical and Morphological Sciences, University of Insubria, Varese, Italy
| | - V Marchionini
- Senology Research Center - 1st Division of Surgery, Department of Surgical and Morphological Sciences, University of Insubria, Varese, Italy
| | - V Arlant
- Senology Research Center - 1st Division of Surgery, Department of Surgical and Morphological Sciences, University of Insubria, Varese, Italy
| | - M L Tanda
- Endocrine Unit, Ospedale di Circolo - University of Insubria, Varese, Italy
| | - E Piantanida
- Endocrine Unit, Ospedale di Circolo - University of Insubria, Varese, Italy
| | - H Y Kim
- KUMC Thyroid Center, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - A Anuwong
- Department of Surgery, Police General Hospital, Faculty of Medicine, Siam University, Pathumwan, Bangkok, Thailand
| | - G Dionigi
- Senology Research Center - 1st Division of Surgery, Department of Surgical and Morphological Sciences, University of Insubria, Varese, Italy
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Rabi ZA, Todorović-Raković N, Vujasinović T, Milovanović J, Nikolić-Vukosavljević D. Markers of progression and invasion in short term follow up of untreated breast cancer patients. Cancer Biomark 2016; 15:745-54. [PMID: 26406416 DOI: 10.3233/cbm-150516] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Cancer progression and metastasis are complex processes, dependent of molecules involved in inflammation, degradation and invasion. These molecules can be used as prognostic indicators to single out patients with higher risk of recurrence. Interleukin-8 (IL-8) has a role in inflammation, urokinase plasminogen activator (uPA), plasminogen activator inhibitor type-1 (PAI-1) and matrix metalloproteinase-2, -9 have a decisive part in the process of degradation and invasion, while vascular endothelial growth factor (VEGF) is consequential for angiogenesis. OBJECTIVES Aim of our study is to determine relations between IL-8, uPA, PAI-1, MMP-2, -9, VEGF as their prognostic significance in terms of recurrence free survival. METHODS This study included 91 untreated patients with lymph node negative (N0) primary breast cancer. RESULTS Patients with higher levels of uPA (p= 0.05), PAI-1 (0.05), MMP2 (p= 0.05) and IL-8 (p= 0.02) have a poor prognosis. Positive correlations were found between ER - PR, uPA - PAI-1, uPA - MMP9, PAI-1 - IL-8, MMP9 - IL-8, MMP9 - VEGF. Negative correlations were found between ER - IL-8, uPA - IL-8, MMP2 - VEGF. CONCLUSIONS Higher concentrations of IL-8, uPA, PAI-1 and MMP2, as is MMP9 and VEGF, confirmed aggressive phenotype and poor prognosis in different subgroups.
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MESH Headings
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Biomarkers, Tumor/metabolism
- Breast Neoplasms/metabolism
- Breast Neoplasms/pathology
- Breast Neoplasms/surgery
- Carcinoma, Ductal, Breast/metabolism
- Carcinoma, Ductal, Breast/secondary
- Carcinoma, Ductal, Breast/surgery
- Carcinoma, Lobular/metabolism
- Carcinoma, Lobular/secondary
- Carcinoma, Lobular/surgery
- Combined Modality Therapy
- Female
- Follow-Up Studies
- Humans
- Immunoenzyme Techniques
- Interleukin-8/metabolism
- Lymphatic Metastasis
- Mastectomy
- Matrix Metalloproteinase 2/metabolism
- Matrix Metalloproteinase 9/metabolism
- Neoplasm Invasiveness
- Neoplasm Recurrence, Local/metabolism
- Neoplasm Recurrence, Local/pathology
- Neoplasm Recurrence, Local/surgery
- Neoplasm Staging
- Plasminogen Activator Inhibitor 1/metabolism
- Prognosis
- Receptor, ErbB-2/metabolism
- Receptors, Estrogen/metabolism
- Receptors, Progesterone/metabolism
- Survival Rate
- Urokinase-Type Plasminogen Activator/metabolism
- Vascular Endothelial Growth Factor A/metabolism
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Rack B, Jückstock J, Trapp E, Weissenbacher T, Alunni-Fabbroni M, Schramm A, Widschwendter P, Lato K, Zwingers T, Lorenz R, Tesch H, Schneeweiss A, Fasching P, Mahner S, Beckmann MW, Lichtenegger W, Janni W. CA27.29 as a tumour marker for risk evaluation and therapy monitoring in primary breast cancer patients. Tumour Biol 2016; 37:13769-13775. [PMID: 27481512 DOI: 10.1007/s13277-016-5171-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 07/12/2016] [Indexed: 11/26/2022] Open
Abstract
Several trials showed that tumour markers are associated with an impaired prognosis for breast cancer. Whether earlier treatment can improve the course of the disease remains controversial. The SUCCESS Trial compares FEC (500/100/500)-docetaxel (100) vs. FEC (500/100/500)-docetaxel/gemcitabine (75/2000) as well as 2 vs. 5 years of zoledronate in high-risk primary breast cancer patients. In 2669 patients, CA27.29 was measured before and after chemotherapy with the ST AIA-PACK CA27.29 reagent for the AIA-600II automated enzyme immunoassay (Tosoh Bioscience, Belgium). Values above 31 U/ml were considered positive. Of the patients, 7.6 % (n = 202, mean 19, range 3-410) and 19.1 % (n = 511, mean 21, range 3-331) had elevated marker levels before and after chemotherapy, respectively. Of the patients, 4.9 and 78 % showed elevated and low CA27.29, respectively, at both time points. After treatment, 35 % of the pre-therapy positive patients were negative, and 15 % of the initially negative patients became positive. The correlation between both time points was significant (p < 0.0001). No correlations among nodal status, grading, hormonal status, HER2 status and CA27.29 levels were found. However, tumour size (p = 0.02), older age (p < 0.001) and post-menopausal status (p = 0.006) were significantly associated with higher CA27.29 levels. Before treatment, the prevalence of elevated CA27.29 was equally distributed between both treatment arms, whereas after chemotherapy, 13.7 % of the patients in the FEC-doc arm showed an increased level vs. 25.4 % of the patients in the FEC-doc/gemcitabine arm (p < 0.0001). However, we could not show a significant association between the G-CSF application (yes vs. no) and CA27.29 status before/after chemotherapy (p = 0.75). These results indicate a close relationship between CA27.29 levels and tumour mass. Increased values after the completion of chemotherapy might be attributed to treatment effects and should be considered with caution.
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MESH Headings
- Adult
- Aged
- Antigens, Tumor-Associated, Carbohydrate/blood
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Biomarkers, Tumor/blood
- Breast Neoplasms/blood
- Breast Neoplasms/drug therapy
- Breast Neoplasms/pathology
- Carcinoma, Ductal, Breast/drug therapy
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Ductal, Breast/secondary
- Carcinoma, Lobular/drug therapy
- Carcinoma, Lobular/pathology
- Carcinoma, Lobular/secondary
- Chemotherapy, Adjuvant
- Female
- Follow-Up Studies
- Humans
- Lymphatic Metastasis
- Middle Aged
- Neoplasm Invasiveness
- Neoplasm Staging
- Prognosis
- Prospective Studies
- Risk Assessment
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Affiliation(s)
- Brigitte Rack
- Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe Campus Innenstadt, Ludwig-Maximilians-Universitaet Muenchen, Maistr. 11, 80337, Munich, Germany.
| | - Julia Jückstock
- Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe Campus Innenstadt, Ludwig-Maximilians-Universitaet Muenchen, Maistr. 11, 80337, Munich, Germany
| | - Elisabeth Trapp
- Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe Campus Innenstadt, Ludwig-Maximilians-Universitaet Muenchen, Maistr. 11, 80337, Munich, Germany
| | - Tobias Weissenbacher
- Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe Campus Innenstadt, Ludwig-Maximilians-Universitaet Muenchen, Maistr. 11, 80337, Munich, Germany
| | - Marianna Alunni-Fabbroni
- Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe Campus Innenstadt, Ludwig-Maximilians-Universitaet Muenchen, Maistr. 11, 80337, Munich, Germany
| | - Amelie Schramm
- Universitätsfrauenklinik Ulm, Prittwitzstrasse, 43 89075, Ulm, Germany
| | | | - Krisztian Lato
- Universitätsfrauenklinik Ulm, Prittwitzstrasse, 43 89075, Ulm, Germany
| | - Thomas Zwingers
- estimate GmbH, Konrad-Adenauer-Allee 1, 86150, Augsburg, Germany
| | - Ralf Lorenz
- Praxis Lorenz/Hecker, Hagenmarkt 19-20, 38100, Braunschweig, Germany
| | - Hans Tesch
- Praxis Prof. Tesch, Im Prüfling 17-19, 60389, Frankfurt, Germany
| | - Andreas Schneeweiss
- National Center for Tumor Diseases, University Hospital, Im Neuenheimer Feld 460, D-69120, Heidelberg, Germany
| | - Peter Fasching
- Universitaetsfrauenklinik Erlangen, Universitaetsstrasse 21-23, D-, 91054, Erlangen, Germany
| | - Sven Mahner
- Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe Campus Innenstadt, Ludwig-Maximilians-Universitaet Muenchen, Maistr. 11, 80337, Munich, Germany
| | - Matthias W Beckmann
- National Center for Tumor Diseases, University Hospital, Im Neuenheimer Feld 460, D-69120, Heidelberg, Germany
| | - Werner Lichtenegger
- Frauenklinik des Universitaetsklinikums Charité Campus Virchow-Klinikum, Augustenburger Platz 1, D-, 13353, Berlin, Germany
| | - Wolfgang Janni
- Universitätsfrauenklinik Ulm, Prittwitzstrasse, 43 89075, Ulm, Germany
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Shagalov D, Xu M, Liebman T, Taylor G. Unilateral indurated plaque in the axilla: a case of metastatic breast carcinoma. Dermatol Online J 2016; 22:13030/qt8vw382nx. [PMID: 27617728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Accepted: 07/15/2016] [Indexed: 06/06/2023] Open
Abstract
Breast cancer is the most commonly diagnosed cancer among American women and is also the most common internal malignancy to metastasize to the skin. Rarely, cutaneous metastases represent the first indication of breast carcinoma, putting dermatologists in an instrumental position to make the diagnosis of breast carcinoma. We report the case of a 71-year-old woman with a 10-year history of a slowly-enlarging, indurated plaque in the right axilla. Review of symptoms was significant only for occasional numbness and tingling that extended from the right axilla to the right hand. Biopsy revealed cells infiltrating in a single-file between the collagen bundles in the dermis and subcutis and immunohistochemical staining consistent with a diagnosis of invasive lobular carcinoma. Subsequent work up revealed a primary breast lesion and extensive bony metastases.
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Affiliation(s)
- Devorah Shagalov
- Department of Dermatology, State University of New York (SUNY) Downstate Medical Center, Brooklyn.
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Stojmenović GM, Pavlović AM, Gazibara MS, Grujicić D, Radojicić A, Sternić NC. Leptomeningeal carcinomatosis can be presenting manifestation of breast carcinoma. VOJNOSANIT PREGL 2016; 73:293-295. [PMID: 27295918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023] Open
Abstract
INTRODUCTION Leptomeningeal carcinomatosis (LC) is a serious complication occuring in solid cancer patients with rather poor prognosis. CASE REPORT We presented a 47-year-old woman with the 6-month history of diffuse headache, nausea and visual obscuration. Initially, clinical status and brain magnetic resonance imaging (MRI) indicated syndrome of idiopathic intracranial hypertension. Due to clinical progression and high papillary stasis, cerebrospinal fluid (CSF) examination was performed only after ventriculoperitoneal shunt was implanted. This led to a significant although transient clinical improvement. Futher investigations led to the diagnosis of invasive lobular breast carcinoma and repeated CSF analysis revealed malignant breast carcinoma cells. In this case LC was an initial presentation of a malignant-disease. CONCLUSION In the presence of a high clinical suspicion of LC, in spite of initially negative findings, a clinician should persist in repeating relevant tests, such are MRI with larger amounts of gadolinium and high-volume cytological CSF analyses in order to make the diagnosis.
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Cecene G, Ak S, Eskiler GG, Demirdogen E, Erturk E, Gokgoz S, Polatkan V, Egeli U, Tunca B, Tezcan G, Topal U, Tolunay S, Tasdelen I. Circulating miR-195 as a Therapeutic Biomarker in Turkish Breast Cancer Patients. Asian Pac J Cancer Prev 2016; 17:4241-4246. [PMID: 27797225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023] Open
Abstract
BACKGROUND Dysregulation of miRNA expression may be used as a biomarker for specific tumours because it may contribute to development of cancer. Circulating miRNA profiles have been highlighted for their potential as predictive markers in heterogeneous diseases such as breast cancer. In the literature, there is evidence that miR-195 levels are differentially expressed pre- and post-operative periods in breast cancer patients. At the same time, miRNA expression levels may vary because of ethnic origins. This study aimed to determine expression levels and potential roles of miR-195 in Turkish breast cancer patients. MATERIALS AND METHODS The expression patterns of miR-195 were initially examined in breast cancer tissues (luminal A and B type) (n=96). Subsequently, blood samples were prospectively collected from preoperative and postoperative Turkish breast cancer patients and disease free controls. Total RNA was isolated, and the expression level of miR-195 was quantified by real-time PCR. RESULTS We found that miR-195 level was altered in Turkish breast cancer patients, with down-regulation evident in breast cancer tissues compared to normal adjacent specimens. Furthermore, circulating levels of miR- 195 was significantly decreased in post-operative blood samples compared with pre-operative levels (p=0.01 and <0.05). However, miR-195 was significantly increased in pre-operative blood samples of the luminal B type (p= 0.04 and <0.05). CONCLUSIONS This study represents the first report of a miR-195 expression profile in Turkish breast cancer patients. Our data suggests that miR-195 levels might be a clinically useful biomarker in the earliest stage of Turkish breast cancer patients.
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MESH Headings
- Adult
- Aged
- Biomarkers, Tumor/blood
- Biomarkers, Tumor/genetics
- Breast Neoplasms/blood
- Breast Neoplasms/pathology
- Breast Neoplasms/surgery
- Carcinoma, Ductal, Breast/blood
- Carcinoma, Ductal, Breast/secondary
- Carcinoma, Ductal, Breast/surgery
- Carcinoma, Lobular/blood
- Carcinoma, Lobular/secondary
- Carcinoma, Lobular/surgery
- Case-Control Studies
- Female
- Follow-Up Studies
- Gene Expression Profiling
- Gene Expression Regulation, Neoplastic
- Humans
- Lymphatic Metastasis
- MicroRNAs/blood
- MicroRNAs/genetics
- Middle Aged
- Neoplasm Invasiveness
- Neoplasm Staging
- Oligonucleotide Array Sequence Analysis
- Prognosis
- Real-Time Polymerase Chain Reaction
- Turkey
- Young Adult
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Affiliation(s)
- Gulsah Cecene
- Department of Medical Biology, Medical Faculty, Uludag University, Turkey E-mail :
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Parada-Huerta E, Alvarez-Dominguez T, Uribe-Escamilla R, Rodriguez-Joya J, Ponce-Medrano JD, Padron-Lucio S, Alfaro-Rodriguez A, Bandala C. Metastasis Risk Reduction Related with Beta-Blocker Treatment in Mexican Women with Breast Cancer. Asian Pac J Cancer Prev 2016; 17:2953-2957. [PMID: 27356717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023] Open
Abstract
BACKGROUND Breast Cancer (BCa) is the most common malignant tumour in Mexican women. In BCa, several studies have linked β2-adrenergic receptor activation with increased tumour growth and progression as related with Epinephrine-NorEpinephrine (E-NE) stimulation. The aim of this study was to describe Beta-Blocker (BB) treatment related with reduction of the risk of metastasis in Mexican patients with BCa. MATERIALS AND METHODS We collected data of 120 patients seen at the High-Specialty Naval General Hospital in Mexico City (HOSGENAES), all of these with a histopathological diagnosis of BCa. Four groups of patients were divided as follows: without Systemic Arterial Hypertension (SAH); with SAH treatment with non-selective BB; with SAH treatment with selective BB, and with SAH treatment with other antihypertensive drugs. Chi-square, Mantel- Haenszel, Student t, and ANOVA tests were performed for data analysis. RESULTS On average, patients were 54.8±11.8 years of age. Risk factors such as smoking and consuming alcohol exhibited a frequency of 33 and 36.5% respectively. Clinical stages III- IV were found in 50% of patients, while, 30% of patients had arterial hypertension (n=29 and N=96, respectively) and 17.5% used BB. One hundred percent of patients with arterial hypertension treated with BB for β1 - and β2 -adrenergic-receptors did not present metastasis globally, but patients treated with β1 BB presented 30% of metastasis while patients treated with no BB or without SAH had around 70% of metastasis. CONCLUSIONS In Mexican patients with BCa and SAH treated with non-selective (β1- and β2-adrenergic receptors) BB, a decrease in the risk for metastasis was observed at the time of diagnosis.
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Affiliation(s)
- E Parada-Huerta
- Naval Medical School, Secretary of the Navy, Mexico E-mail :
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Haraldsdóttir KH, Ingvar C, Stenram U, Tranberg KG. Long-term Follow-up After Interstitial Laser Thermotherapy of Breast Cancer. Anticancer Res 2015; 35:6147-6152. [PMID: 26504041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
AIM To review the effect of immunological changes induced by interstitial laser thermotherapy (ILT) on long-term outcome of patients with breast cancer. PATIENTS AND METHODS Twenty-four patients with invasive breast cancer were treated with ILT followed by standard surgical excision. Immunohistological reactions on immunocompetent cells were performed on specimens obtained before and after ILT. Follow-up time was 116 (range=91-136) months. RESULTS Significant prognostic factors were histologically-positive axillary lymph nodes and Ki67 positivity. ILT increased cytotoxic T (CD8(+)) lymphocytes within the tumor and mature dendritic cells (CD83(+)) and reduced the number of T-regulatory cells (Treg) CD25(+)/Forkhead box p3(+) (FOXP3(+)) lymphocytes in regional lymph nodes. These changes did not correlate with prognosis. The number of CD8(+) cells within the tumor, both before and after treatment, was significantly higher in patients with recurrence than in those without recurrence (p<0.01 and p<0.05, respectively). Patients with recurrent disease had a lower number of CD57(+) cells in tumor-free lymph nodes than did patients without recurrence (p<0.05). CONCLUSION ILT did not have any long-term adverse effects. The clinical impact of the supposedly favourable immune changes after ILT should be examined in a larger patient population.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Breast Neoplasms/immunology
- Breast Neoplasms/pathology
- Breast Neoplasms/therapy
- CD8-Positive T-Lymphocytes/immunology
- CD8-Positive T-Lymphocytes/pathology
- Carcinoma, Ductal, Breast/immunology
- Carcinoma, Ductal, Breast/secondary
- Carcinoma, Ductal, Breast/therapy
- Carcinoma, Lobular/immunology
- Carcinoma, Lobular/secondary
- Carcinoma, Lobular/therapy
- Dendritic Cells/immunology
- Dendritic Cells/pathology
- Female
- Follow-Up Studies
- Humans
- Hyperthermia, Induced/methods
- Immunoenzyme Techniques
- Laser Therapy/methods
- Lymph Nodes/immunology
- Lymph Nodes/pathology
- Lymphatic Metastasis
- Middle Aged
- Neoplasm Grading
- Neoplasm Recurrence, Local/immunology
- Neoplasm Recurrence, Local/pathology
- Neoplasm Recurrence, Local/therapy
- Neoplasm Staging
- Prognosis
- Receptor, ErbB-2/metabolism
- Receptors, Estrogen/metabolism
- Receptors, Progesterone/metabolism
- T-Lymphocytes, Regulatory/immunology
- T-Lymphocytes, Regulatory/pathology
- Time Factors
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Affiliation(s)
| | - Christian Ingvar
- Department of Surgery, Lund University and Lund University Hospital, Lund, Sweden
| | - Unne Stenram
- Department of Pathology, Lund University and Lund University Hospital, Lund, Sweden
| | - Karl-Göran Tranberg
- Department of Surgery, Lund University and Lund University Hospital, Lund, Sweden
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Caglar M, Kupik O, Karabulut E, Høilund-Carlsen PF. Detection of bone metastases in breast cancer patients in the PET/CT era: Do we still need the bone scan? Rev Esp Med Nucl Imagen Mol 2015; 35:3-11. [PMID: 26514321 DOI: 10.1016/j.remn.2015.08.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Revised: 08/17/2015] [Accepted: 08/30/2015] [Indexed: 11/18/2022]
Abstract
AIM To examine the value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) for the detection of bone metastasis in breast cancer patients and assess whether whole body bone scan (BS) with (99m)Tc-methylene diphosphonate provides any additional information. MATERIAL AND METHODS Study group comprised 150 patients, mean age 52 years (range 27-85) with breast cancer, suspected of having bone metastases. All patients had undergone both FDG-PET/CT and BS with or without single photon emission tomography/computed tomography (SPECT/CT) within a period of 6 weeks. The final diagnosis of bone metastasis was established by histopathological findings, additional imaging, or clinical follow-up longer than 10 months. Cancer antigen 15-3 (CA15-3) and carcinoembryogenic antigen (CEA) were measured in all patients. RESULTS Histologically 83%, 7% and 10% had infiltrating ductal, lobular and mixed carcinoma respectively. Confirmed bone metastases were present in 86 patients (57.3%) and absent in 64 (42.7%). Mean CA15-3 and CEA values in patients with bone metastases were 74.6ng/mL and 60.4U/mL respectively, compared to 21.3ng/mL and 3.2U/mL without metastases (p<0.001). The sensitivity of FDG-PET/CT for the detection of bone metastases was 97.6% compared to 89.5% with SPECT/CT. In 57 patients, FDG-PET/CT correctly identified additional pulmonary, hepatic, nodal and other soft tissue metastases, not detected by BS. CONCLUSION Our findings suggest that FDG-PET/CT is superior to BS with or without SPECT/CT.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Biomarkers, Tumor/blood
- Bone Neoplasms/blood
- Bone Neoplasms/diagnostic imaging
- Bone Neoplasms/secondary
- Breast Neoplasms/pathology
- Carcinoembryonic Antigen/blood
- Carcinoma, Ductal, Breast/blood
- Carcinoma, Ductal, Breast/diagnostic imaging
- Carcinoma, Ductal, Breast/secondary
- Carcinoma, Lobular/blood
- Carcinoma, Lobular/diagnostic imaging
- Carcinoma, Lobular/secondary
- Female
- Fluorine Radioisotopes/analysis
- Fluorodeoxyglucose F18/analysis
- Humans
- Middle Aged
- Mucin-1/blood
- Positron Emission Tomography Computed Tomography
- Positron-Emission Tomography
- Radiopharmaceuticals/analysis
- Retrospective Studies
- Single Photon Emission Computed Tomography Computed Tomography
- Technetium Tc 99m Medronate/analysis
- Whole Body Imaging
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Affiliation(s)
- M Caglar
- Hacettepe University Medical Faculty, Department of Nuclear Medicine, Sihhiye, Ankara 06100, Turkey.
| | - O Kupik
- Hacettepe University Medical Faculty, Department of Nuclear Medicine, Sihhiye, Ankara 06100, Turkey
| | - E Karabulut
- Hacettepe University Medical Faculty, Department of Biostatistics, Sihhiye, Ankara 06100, Turkey
| | - P F Høilund-Carlsen
- Department of Nuclear Medicine, Odense University Hospital, 5000 Odense C, Denmark
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