Death In Breast Cancer Patients Research Articles

Abstract 3462: Mendelian randomization analysis of 27 cardiometabolic trait related polygenic scores identifies genetic risk for cardiometabolic and cardiovascular events in a large prospective study of breast cancer survivors

Abstract Background: CVD is the most common cause of non-cancer death in breast cancer patients. Due to cancer treatment-related cardiotoxicities, breast cancer survivors are at increased risk of cardiometabolic disease (CMD) and cardiovascular disease (CVD). In addition to treatment-related factors, behavioral risk factors such as diet, smoking, and obesity are shared between CVD and breast cancer. While clinical factors influencing the risk of CVD in breast cancer patients are well studied, the effects of genetic factors are less known. Methods: To investigate genetic factors contributing to risk of CMD and CVD in women with a history of breast cancer, we performed a Mendelian randomization analysis to explore the relationships between 27 polygenic scores (PGS) for CMD and CVD phenotypes selected from the PGS Catalog and literature and 13 incident CMD and CVD events in a large prospective cohort of 3,699 breast cancer survivors in the Pathways Study. Fine-Gray sub-distribution hazard ratios (HRs) and 95% confidence intervals (CIs) associated with one standard deviation of PGS were derived with adjustment for epidemiologic, clinical, and treatment factors. The time scale was defined as time since date of breast cancer diagnosis to first of incident event, health plan disenrollment, death, or end of study (12/31/2019). The proportional hazards assumption was tested using Schoenfeld residuals, and no violation was found. Results: We identified 19 PGS-CMD/CVD associations that met Bonferroni significance (P<1.17 × 10−4). Five PGS were associated with increased risk of dyslipidemia: apolipoprotein B (HR=1.52, 95% CI,1.38-1.65), LDL cholesterol (1.49, 1.36-1.63), total cholesterol (1.43, 1.31-1.56), triglyceride levels (1.24, 1.14-1.34), and coronary artery disease (1.22, 1.13-1.33). Four PGS were associated with increased risk of hypertension: systolic blood pressure (1.36, 1.25-1.48), diastolic blood pressure (1.21, 1.11-1.32), fasting glucose adjusted for BMI (1.19, 1.09-1.30), and hypertension (1.41, 1.29-1.54). PGS for atrial fibrillation was associated with increased risk of arrhythmia (1.40, 1.25-1.57) and any cardiovascular disease (1.22, 1.12-1.32). PGS for coronary artery disease and myocardial infarction were both associated with increased risk of ischemic heart disease (1.43, 1.21-1.70 and 1.38, 1.17-1.62, respectively). Conclusion: Our study provides strong evidence for the potential use of PGS to predict the risk of CVD and CMD in women with a history of breast cancer. Future studies may explore the use of PGS to identify women with breast cancer at high risk of CVD-related outcomes and strategies to mitigate this risk. Citation Format: Peter N. Fiorica, Haiyang Sheng, Cecile A. Laurent, Janise M. Roh, Valerie S. Lee, Alexa Zimbalist, Isaac J. Ergas, Qianqian Zhu, Richard K. Cheng, Eileen Rillamas-Sun, Carlos Iribarren, Jamal S. Rana, Mai Nguyen-Huynh, Dawn L. Hershman, Lawrence H. Kushi, Christine B. Ambrosone, Marilyn L. Kwan, Heather Greenlee, Song Yao. Mendelian randomization analysis of 27 cardiometabolic trait related polygenic scores identifies genetic risk for cardiometabolic and cardiovascular events in a large prospective study of breast cancer survivors [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 3462.

Cell morphology best predicts tumorigenicity and metastasis in vivo across multiple TNBC cell lines of different metastatic potential

BackgroundMetastasis is the leading cause of death in breast cancer patients. For metastasis to occur, tumor cells must invade locally, intravasate, and colonize distant tissues and organs, all steps that require tumor cell migration. The majority of studies on invasion and metastasis rely on human breast cancer cell lines. While it is known that these cells have different properties and abilities for growth and metastasis, the in vitro morphological, proliferative, migratory, and invasive behavior of these cell lines and their correlation to in vivo behavior is poorly understood. Thus, we sought to classify each cell line as poorly or highly metastatic by characterizing tumor growth and metastasis in a murine model of six commonly used human triple-negative breast cancer xenografts, as well as determine which in vitro assays commonly used to study cell motility best predict in vivo metastasis.MethodsWe evaluated the liver and lung metastasis of human TNBC cell lines MDA-MB-231, MDA-MB-468, BT549, Hs578T, BT20, and SUM159 in immunocompromised mice. We characterized each cell line's cell morphology, proliferation, and motility in 2D and 3D to determine the variation in these parameters between cell lines.ResultsWe identified MDA-MB-231, MDA-MB-468, and BT549 cells as highly tumorigenic and metastatic, Hs578T as poorly tumorigenic and metastatic, BT20 as intermediate tumorigenic with poor metastasis to the lungs but highly metastatic to the livers, and SUM159 as intermediate tumorigenic but poorly metastatic to the lungs and livers. We showed that metrics that characterize cell morphology are the most predictive of tumor growth and metastatic potential to the lungs and liver. Further, we found that no single in vitro motility assay in 2D or 3D significantly correlated with metastasis in vivo.ConclusionsOur results provide an important resource for the TNBC research community, identifying the metastatic potential of 6 commonly used cell lines. Our findings also support the use of cell morphological analysis to investigate the metastatic potential and emphasize the need for multiple in vitro motility metrics using multiple cell lines to represent the heterogeneity of metastasis in vivo.

Hsa_circ_0007990 promotes breast cancer growth via inhibiting YBX1 protein degradation to activate E2F1 transcription

Breast cancer (BC) is the most commonly diagnosed malignant tumour in females worldwide. Although remarkable advances in early detection and treatment strategies have led to decreased mortality, recurrence and metastasis remain the major causes of cancer death in BC patients. Increasing evidence has demonstrated that circular RNAs (circRNAs) play critical roles in cancer progression. However, the detailed biological functions and molecular mechanisms of circRNAs in BC are unclear. The aim of this study was to investigate the possible role of circRNAs in the progression of BC. Differentially expressed circRNAs in BC were identified by integrating breast tumour-associated somatic CNV data and circRNA high-throughput sequencing. Aberrant hsa_circ_0007990 expression and host gene copy number were detected in BC cell lines via quantitative polymerase chain reaction (qPCR). The expression level of hsa_circ_0007990 in BC tissues was validated by in situ hybridization (ISH). Loss- and gain-of-function experiments were performed in vitro and in vivo, respectively, to explore the potential biological function of hsa_circ_0007990 in BC. The underlying mechanisms of hsa_circ_0007990 were investigated through MS2 RNA pull-down, RNA immunoprecipitation, RNA fluorescence in situ hybridization, immunofluorescence, chromatin immunoprecipitation and luciferase reporter assays. The levels of hsa_circ_0007990 were elevated in BC tissues and cell lines, an effect that was partly due to host gene copy number gains. Functional assays showed that hsa_circ_0007990 promoted BC cell growth. Mechanistically, hsa_circ_0007990 could bind to YBX1 and inhibit its degradation by preventing ubiquitin/proteasome-dependent degradation, thus enhancing the expression of the cell cycle-associated gene E2F1. Rescue experiments suggested that hsa_circ_0007990 promoted BC progression through YBX1. In general, our study demonstrated that hsa_circ_0007990 modulates the ubiquitination and degradation of YBX1 protein and further regulates E2F1 expression to promote BC progression. We explored the possible function and molecular mechanism of hsa_circ_0007990 in BC and identified a novel candidate target for the treatment of BC.

Oncological Safety of Autologous Fat Grafting for Breast Reconstruction.

Autologous fat grafting has become a vital component of breast reconstruction. However, concerns remain regarding the safety of fat grafting after oncological resection and breast reconstruction. The purpose of the study was to evaluate the association of fat grafting after breast reconstruction with metastasis and death in breast cancer patients. A retrospective, population-based cohort study was conducted using deidentified claims data from 2001 to 2018 and included privately insured patients with breast cancer who underwent breast reconstruction after surgical resection. Breast reconstruction patients who underwent fat grafting were compared with those not undergoing fat grafting, evaluating metastasis and death up to 15 years after reconstruction. One-to-one propensity score matching was used to account for selection bias on patient risk factors comparing those with and without fat grafting. A total of 4709 patients were identified who underwent breast reconstruction after lumpectomy or mastectomy, of which 368 subsequently underwent fat grafting. In the propensity score-matched patients, fat grafting was not associated with an increased risk of lymph node metastasis (9.7% fat-grafted vs 11.4% in non-fat-grafted, P = 0.47) or distant metastasis (9.1% fat-grafted vs 10.5% in non-fat-grafted, P = 0.53). There was no increased risk of all-cause mortality after fat grafting for breast reconstruction (3.9% fat-grafted vs 6.6% non-fat-grafted, P = 0.10). Among breast cancer patients who subsequently underwent fat grafting, compared with no fat grafting, no significant increase was observed in distant metastasis or all-cause mortality. These findings suggest that autologous fat grafting after oncologic resection and reconstruction was not associated with an increased risk of future metastasis or death.

Construction and Validation of a Novel Nomogram for Predicting the Risk of Metastasis in a Luminal B Type Invasive Ductal Carcinoma Population.

Postoperative distant metastasis is the main cause of death in breast cancer patients. We aimed to construct a nomogram to predict the risk of metastasis of luminal B type invasive ductal carcinoma. We applied the data of 364 luminal B type breast cancer patients between 2008 and 2013. Patients were categorized into modeling group and validation group randomly (1:1). The breast cancer metastasis nomogram was developed from the logistic regression model using clinicopathological variables. The area under the receiver-operating characteristic curve (AUC) was calculated in modeling group and validation group to evaluate the predictive accuracy of the nomogram. The multivariate logistic regression analysis showed that tumor size, No. of the positive level 1 axillary lymph nodes, human epidermal growth factor receptor 2 (HER2) status and Ki67 index were the independent predictors of the breast cancer metastasis. The AUC values of the modeling group and the validation group were 0.855 and 0.818, respectively. The nomogram had a well-fitted calibration curve. The positive and negative predictive values were 49.3% and 92.7% in the modeling group, and 47.9% and 91.0% in the validation group. Patients who had a score of 60 or more were thought to have a high risk of breast cancer metastasis. The nomogram has a great predictive accuracy of predicting the risk of breast cancer metastasis. If patients had a score of 60 or more, necessary measures, like more standard treatment methods and higher treatment adherence of patients, are needed to take to lower the risk of metastasis and improve the prognosis.

Statin use is associated with a lower risk of mortality in patients with malignant breast cancer treated with anthracyclines. A global federated health database analysis

Abstract Introduction Anthracyclines (ANT are a key component in the treatment of early breast cancer but are associated with an enhanced oxidative stress which is associated with f short- and long-term adverse events. Statins are a well-known class of lipid lowering agent with anti-inflammatory properties that could potentially counteract ANT toxicity in cancer patients. Purpose To assess the potential therapeutic benefit of statins among malignant breast cancer patients treated with ANT. Methods Retrospective study utilizing a global federated health research network (TriNetX). Patients with malignant breast cancer (ICD code C50) treated with ANT were categorized in two groups: statin users (at least 1 month before the ANT treatment); and non-statin users. The primary outcome was the 5-year risk of all-cause death. Secondary outcomes were the intra-treatment (within 6 months), post-treatment (6 months-1 year) and long-term (1 year-5 years) risk of-all cause death. A further sensitivity analysis was done to assess the risk differences between hydrophilic (rosuvastatin and pravastatin) and lipophilic (atorvastatin, simvastatin, lovastatin) statins. Cox-regression analyses were used to produce hazard ratios (HRs) and 95% confidence intervals (CI) following 1:1 propensity score matching (PSM). Results Amongst the 36,770 patients with breast cancer identified (mean age 60±12.6 years, 98.6% female): 6,616 (17.9%) were statin users and 30,154 (81.1%) were non-statin users. Statins users were older and had more cardiovascular risk factors. After PSM, the 5-year risk of all-cause death was significantly lower in statin users (HR 0.72, 95%CI 0.63-0.83) compared to non-statins users. Analyzing the different time frames, the lowest risk of all-cause death was observed in the early period after the ATN treatment (Figure 1). The 5-year all-cause death was reduced in both the hydrophilic (HR: 0.69, 95%CI 0.58-0.83) and lipophilic statins (HR 0.72, 95%CI 0.65-0.79), when compared to non-statins users (Figure 2), with no significant differences between these two statin types (p=0.496). Conclusion Statin use was associated with a reduced risk of all-cause death in breast cancer patients treated with ATN. Further studies are needed to clarify the mechanism(s) by which statins counteract the ATN toxicity.

Fyn-Mediated Paxillin Tyrosine 31 Phosphorylation Regulates Migration and Invasion of Breast Cancer Cells.

Metastasis is the leading cause of death in breast cancer patients due to the lack of effective therapies. Elevated levels of paxillin expression have been observed in various cancer types, with tyrosine phosphorylation shown to play a critical role in driving cancer cell migration. However, the specific impact of the distinct tyrosine phosphorylation events of paxillin in the progression of breast cancer remains to be fully elucidated. Here, we found that paxillin overexpression in breast cancer tissue is associated with a patient's poor prognosis. Paxillin knockdown inhibited the migration and invasion of breast cancer cells. Furthermore, the phosphorylation of paxillin tyrosine residue 31 (Tyr31) was significantly increased upon the TGF-β1-induced migration and invasion of breast cancer cells. Inhibiting Fyn activity or silencing Fyn decreases paxillin Tyr31 phosphorylation. The wild-type and constitutively active Fyn directly phosphorylate paxillin Tyr31 in an in vitro system, indicating that Fyn directly phosphorylates paxillin Tyr31. Additionally, the non-phosphorylatable mutant of paxillin at Tyr31 reduces actin stress fiber formation, migration, and invasion of breast cancer cells. Taken together, our results provide direct evidence that Fyn-mediated paxillin Tyr31 phosphorylation is required for breast cancer migration and invasion, suggesting that targeting paxillin Tyr31 phosphorylation could be a potential therapeutic strategy for mitigating breast cancer metastasis.

Rimonabant and Cannabidiol Rewrite the Interactions between Breast Cancer Cells and Tumor Microenvironment.

The spread of breast cancer to distant sites is the major cause of death in breast cancer patients. Increasing evidence supports the role of the tumor microenvironment (TME) in breast cancers, and its pathologic assessment has become a diagnostic and therapeutic tool. In the TME, a bidirectional interplay between tumor and stromal cells occurs, both at the primary and metastatic site. Hundreds of molecules, including cytokines, chemokines, and growth factors, contribute to this fine interaction to promote tumor spreading. Here, we investigated the effects of Rimonabant and Cannabidiol, known for their antitumor activity, on reprogramming the breast TME. Both compounds directly affect the activity of several pathways involved in breast cancer progression. To mimic tumor-stroma interactions during breast-to-lung metastasis, we investigated the effect of the compounds on growth factor secretion from metastatic breast cancer cells and normal and activated lung fibroblasts. In this setting, we demonstrated the anti-metastatic potential of the two compounds, and the membrane array analyses highlighted their ability to alter the release of factors involved in the autocrine and paracrine regulation of tumor proliferation, angiogenesis, and immune reprogramming. The results enforce the antitumor potential of Rimonabant and Cannabidiol, providing a novel potential tool for breast cancer TME management.

CdGAP is a talin-binding protein and a target of TGF-β signaling that promotes HER2-positive breast cancer growth and metastasis

Epithelial-to-mesenchymal transition (EMT) plays a crucial role in metastasis, which is the leading cause of death in breast cancer patients. Here, we show that Cdc42 GTPase-activating protein (CdGAP) promotes tumor formation and metastasis to lungs in the HER2-positive (HER2+) murine breast cancer model. CdGAP facilitates intravasation, extravasation, and growth at metastatic sites. CdGAP depletion in HER2+ murine primary tumors mediates crosstalk with a Dlc1-RhoA pathway and is associated with a transforming growth factor β (TGF-β)-induced EMT transcriptional signature. CdGAP is positively regulated by TGF-β signaling during EMT and interacts with the adaptor talin to modulate focal adhesion dynamics and integrin activation. Moreover, HER2+ breast cancer patients with high CdGAP mRNA expression combined with a high TGF-β-EMT signature are more likely to present lymph node invasion. Our results suggest CdGAP as a candidate therapeutic target for HER2+ metastatic breast cancer by inhibiting TGF-β and integrin/talin signaling pathways.

Caffeic acid phenethyl ester suppresses metastasis of breast cancer cells by inactivating FGFR1 via MD2.

Tumor metastasis is the main cause of death for breast cancer patients. Caffeic acid phenethyl ester (CAPE) has strong anti-tumor effects with very low toxicity and may be a potential candidate drug. However, the anti-metastatic effect and molecular mechanism of CAPE on breast cancer need more research. MCF-7 and MDA-MB-231 breast cancer cells were used here. Wound healing and Transwell assay were used for migration and invasion detection. Western blot and RT-qPCR were carried out for the epithelial-to-myofibroblast transformation (EMT) process investigation. Western blot and immunofluorescence were performed for fibroblast growth factor receptor1 (FGFR1) phosphorylation and nuclear transfer detection. Co-immunoprecipitation was used for the FGFR1/myeloid differentiation protein2 (MD2) complex investigation. Our results suggested that CAPE blocks the migration, invasion, and EMT process of breast cancer cells. Mechanistically, CAPE inhibits FGFR1 phosphorylation and nuclear transfer while overexpression of FGFR1 reduces the anti-metastasis effect of CAPE. Further, we found that FGFR1 is bound to MD2, and silencing MD2 inhibits FGFR1 phosphorylation and nuclear transfer as well as cell migration and invasion. This study illustrated that CAPE restrained FGFR1 activation and nuclear transfer through MD2/FGFR1 complex inhibition and showed good inhibitory effects on the metastasis of breast cancer cells.

Artificial nanoplatelet regulation of tumor immune microenvironment to inhibit post-surgical tumor recurrence and lung metastasis

Tumor recurrence and metastasis are important causes of death in breast cancer patients after surgery. However, the nanomedicines are often difficult to accumulate and retain in residual microtumors because the surgery disrupts the original network of blood vessels in the solid tumor, which is a crucial factor leading to tumor recurrence and metastasis after surgery. Herein, an engineered artificial nanoplatelet (MOAP) was established by loading antigen protein ovalbumin (OVA) and PD-L1 inhibitor (aptamer-PD-L1) on MnOx nanoflowers and further coating with platelet membrane. MOAP can mimic platelets to participate in the coagulation process, target thrombus at the residual tumor site, and release OVA and Apt-PD-L1 under 808 nm laser irradiation to block immune checkpoint inhibition and prevent immune escape. Moreover, MnOx alleviated hypoxia, promoted the polarization of tumor-associated macrophages from M2 to M1 phenotype, and significantly reversed the tumor immunosuppressive microenvironment, thus enhancing the infiltration of cytotoxic T lymphocytes at the tumor site. In vivo experiments revealed that pre-surgery or post-surgery treatment of artificial platelets had a good anti-tumor effect, and inhibited tumor recurrence and lung metastasis after surgery, which demonstrated that MOAP is a suitable system for the treatment of post-surgery tumors.

Subcellular Organelle-Targeted Nanostructured Lipid Carriers for the Treatment of Metastatic Breast Cancer.

Subcellular organelle targeted nano-formulations for cancer treatment are receiving increasing attention owing to their benefits of precise drug delivery, maximized therapeutic index, and reduced off-target side effects. The nucleus and mitochondria, as the main subcellular organelles, are the significant organelles responsible for maintaining cell operation and metabolism. They can be involved in many essential physiological and pathological processes such as cell proliferation, organism metabolism, intracellular transportation, and play a critical role in regulating cell biology. Meanwhile, breast cancer metastasis is one of the leading causes of death in breast cancer patients. With the development of nanotechnology, nanomaterials have been widely used in tumor therapy. We designed a subcellular organelle targeted nanostructured lipid carriers (NLC) to deliver paclitaxel (PTX) and gambogic acid (GA) to tumor tissues. Due to the surface of NLC being modified by subcellular organelle targeted peptide, the PTX and GA co-loaded NLC can accurately release PTX and GA in tumor cells. This property makes NLC able to easy to enter tumor site and target the specific subcellular organelle. The modified NLC can efficiently inhibit the growth of 4T1 primary tumor and lung metastasis, which may be related to the down-regulation of matrix metalloproteinase-9 (MMP-9) and BCL-2 levels, up-regulation of E-cadherin level, and antagonized PTX-induced increase of C-C chemokine ligand 2 (CCL-2) levels by GA. Meanwhile, the synergistic anti-tumor effect of GA and PTX has also been verified in vitro and in vivo experiments. The subcellular organelle targeted peptide modified PTX+GA multifunctional nano-drug delivery system has a good therapeutic effect on tumors, and this study provides significant insights into the role of different subcellular organelles in inhibiting tumor growth and metastasis and inspires researchers to develop highly effective cancer therapeutic strategies through subcellular organelle targeted drugs.

Survival in patients with brain metastasis secondary to breast cancer from Saudi Arabia.

e14018 Background: Breast cancer (BC) is the most common malignancy in women from Saudi Arabia. Nearly one-third of the patients present with metastatic disease. Data on the incidence, pattern and outcome of brain metastasis (BM) in breast cancer patients is yet to be reported to inform the practice and help in assessing the current standard of care. Methods: A retrospective cohort study between the years 2015 and 2020 that included BC patients with BM was conducted. Demographic data, tumor clinico-pathological features, treatment modalities and outcomes were obtained. Survival, factors influencing survival time and the risk of death were examined. A p-value of less than 0.05 was considered statistically significant. Results: 111 patients with BM due to BC were included in the analysis. All are female with a mean age 50.28 ± 11.61 years. IDC histology (93%), grade III (71%), tumor > T2 (64%) and N-positive (60%) BC accounted for the majority. Human epidermal growth factor receptor2 (HER2)-positive/Hormone receptors (HR)-negative was 21%, HER2-positive/HR-positive was 16%, HR-positive/HER2-negative was 31%, TNBC was 22.5% and unknown subtype in 10%. 60% had metastatic disease on presentation with 41% had both skeletal and visceral metastases. Brain lesions > three were reported in nearly half of the cohort. Whole brain radiotherapy (WBRT), surgical resection and SRS were reported in 84%, 16% and 22%, respectively. The mean survival time was 3.31 years with a maximum of 4.23 years and a minimum of 2.39 years. Patients with HR-positive and HER2-positive BC had a significant longer survival (p=0.039, 0.033 respectively). Neither tumor size nor nodal status in BC patients with BM influenced survival time. The presence of visceral metastasesincreased the likelihood of death in BC patients with BM up to 6 folds (p=0.031). The relationship between risk of death, treatment modalities, and response of BM is shown. Conclusions: Although BM secondary to BC represents a therapeutic challenge with an expected unfavorable impact on survival, mortality was associated with the presence of extra-cranial metastases, particularly visceral metastases in this cohort. Longer survival was seen with specific subtypes (HR-positive and HER2-positive), suggesting advancement in systemic treatments against them. [Table: see text]

Garcinone E suppresses breast cancer growth and metastasis by modulating tumor-associated macrophages polarization via STAT6 signaling.

Cancer metastasis remains the most common cause of death in breast cancer patients. Tumor-associated macrophages (TAMs) are a novel therapeutic target for the treatment of metastatic breast cancer. Despite the good anti-cancer activity of garcinone E (GE), there are no reports on its therapeutic effects on breast cancer metastasis. The objective of this study was to examine the anti-cancer effects of GE on metastatic breast cancer. RAW 264.7 and THP-1 cells were polarized to M2 macrophages by IL-4/IL-13 in vitro. A 4T1 mouse breast cancer model and the tail vein breast cancer metastasis model were used to explore the effect of GE on breast cancer growth and metastasis in vivo. In vitro studies showed that GE dose-dependently suppressed IL-4 + IL-13-induced expression of CD206 in both RAW 264.7 cells and differentiated THP-1 macrophages. However, GE did not affect the LPS + IFN-γ-induced polarization to the M1-like macrophages in vitro. GE inhibited the expression of the M2 macrophage specific genes in RAW 264.7 cells, and simultaneously impaired M2 macrophage-induced breast cancer cell proliferation and migration, and angiogenesis. In animal studies, GE significantly suppressed tumor growth, angiogenesis, and lung metastasis in 4T1 tumor-bearing mice, without causing toxicity. In both tumor and lung tissues, the proportion of M2-like TAMs was significantly decreased while the proportion of M1-like TAMs was markedly increased by GE treatment. Mechanistically, GE inhibited phosphorylation of STAT6 in vitro and in vivo. Our results demonstrate for the first time that GE suppresses breast cancer growth and pulmonary metastasis by modulating M2-like macrophage polarization through the STAT6 signaling pathway.

The impact of tumor characteristics on cardiovascular disease death in breast cancer patients with CT or RT: a population-based study.

Previous studies focused on the impact of cardiovascular diseases (CVD) risk factors in breast cancer patients with chemotherapy (CT) or radiotherapy (RT). This study aimed to identify the impact of tumor characteristics on CVD death in these patients. Data of female breast cancer patients with CT or RT between 2004 and 2016 were included. The risk factors of CVD death were identified using Cox regression analyses. A nomogram was constructed to evaluate the predicted value of tumor characteristics, and then validated by the concordance indexes (C-index) and calibration curves. A total of 28,539 patients were included with an average follow-up of 6.1 years. Tumor size > 45 mm (adjusted HR = 1.431, 95% CI = 1.116-1.836, P = 0.005), regional (adjusted HR = 1.278, 95% CI = 1.048-1.560, P = 0.015) and distant stage (adjusted HR = 2.240, 95% CI = 1.444-3.474, P < 0.001) were risk factors of CVD death for breast cancer patients with CT or RT. The prediction nomogram of tumor characteristics (tumor size and stage) on CVD survival was established. The C-index of internal and external validation were 0.780 (95% Cl = 0.751-0.809), and 0.809 (95% Cl = 0.768-0.850), respectively. The calibration curves showed consistency between the actual observation and nomogram. The risk stratification was also significant distinction (P < 0.05). Tumor size and stage were related to the risk of CVD death for breast cancer patients with CT or RT. The management of CVD death risk in breast cancer patients with CT or RT should focus not only on CVD risk factors but also on tumor size and stage.

SURVIVAL ANALYSIS OF BREAST CANCER PATIENTS IN KANO STATE

Cancer is a deadly malignant disease and is prevalent in Sub Saharan Africa. Specifically, breast cancer is now the most popular cancer and the second leading cause of death in Nigeria among women. This research is aimed at assessing the length of life of patients and prognostic factors associated with survival of breast cancer patients. Research subjects were breast cancer patients who went to Aminu Kano Teaching hospital (AKTH), patient’s follow-up data were obtained from the medical records and pathological variables were obtained from the department of Pathology from 2018- 2022. The survival analysis was performed using Kaplan Meier, log rank and Cox proportional regression model(semi-parametric). The Kaplan Meier results reveals the overall survival to be 0.75(75%). The median survival time is approximately 44 months, that is the probability that half of the patients have died. From the log-rank test, the survival times significantly differ across groups of Tumor stages, Age groups, Lymph node stages and Treatment Types. Results for the Cox proportional hazards model shows that, Treatment type and Tumor stage breast cancer were the risk factor for death in breast cancer patients. It was found that the hazard of death is twice or more for patients with a tumor characterized as tumor stage IV compared to other tumor stages. The hazard of death for patients on Radiotherapy treatment was 1.4 times as patients on Chemotherapy or Hormonal-therapy treatment. The Proportional Hazard assumption was assessed and all the variables meets the assumption.

Clinicopathological features and prognoses of very young patients (≤35 years) with breast cancer: a retrospective population-based study in China.

Clinicopathological features and prognoses of very young patients (≤35 years) with breast cancer: a retrospective population-based study in China.

LncRNA MIR17HG Suppresses Breast Cancer Proliferation and Migration as ceRNA to Target FAM135A by Sponging miR-454-3p

Breast cancer is one of the most common malignant tumors in women, and causes a large number of cancer-related deaths. The main cause of death of breast cancer patients is tumor recurrence and metastasis. Recent studies show that lncRNA (Long non-coding RNA) plays an important role in breast cancer. However, the overall biological activity and clinical consequences of the lncRNA MIR17HG in breast cancer remain unclear. Thus, we investigate how the MIR17HG/miR-454-3p network impacts breast cancer cell proliferation and migration. Given the TCGA and Oncomine databases, the researchers evaluated variations in MIR17HG expression for the survival rates of breast cancer patients. The influence of MIR17HG on cell proliferation, migration, cell cycle, and the mRNA expression level of miR-454-3p and FAM135A (family with sequence similarity 135 member A) is identified. Luciferase assay was used to detect the regulatory effect of miR-454-3p on the 3′UTR region of FAM135A, and rescue experiments demonstrated that MIR17HG can up-regulate FAM135A expression by competitively binding miR-454-3p. The effect of FAM135A on the cloning and invasion of MCF-7 cells was detected. MIR17HG expression is reduced in breast cancer tissues, and patients with greater levels of MIR17HG expression have a better prognosis. MIR17HG overexpression caused G2/M arrest in breast cancer cells according to a flow cytometry assay. FAM135A knockdown enhances breast cancer cell proliferation and clone creation, as well as two-dimensional and three-dimensional migratory capacities. Patients with high FAM135A expression in their breast cancer had a better prognosis. These novel findings indicate that MIR17HG may be a potential target for breast cancer. Our findings demonstrated that MIR17HG might suppress breast cancer cell proliferation and migration by sponge miR-454-3p through ceRNA(competing endogenous RNAs) mechanism, indicating that targeting MIR17HG may be a feasible therapeutic candidate for breast cancer.Graphical

Abstract PD2-09: Characterization of the lymphovascular invasion microenvironment reveals immune response dichotomy

Abstract Background: Metastasis is the leading cause of cancer related deaths in breast cancer patients. Lymphovascular invasion represents one of the earliest stages of metastasis wherein the cells are introduced to a very different and distinct microenvironment. Methods: We leveraged spatial techniques developed for limited specimens in archival tissue to study patient matched cross-sectional tumor samples from different stages of breast neoplasia including normal breast, ductal carcinoma in situ (DCIS), primary invasive carcinoma (IBC), lymphovascular invasion (LVI) and regional lymph node metastasis. We selected a set of 21 patients with ER+ breast cancer to generate cross-sectional samples of each of these stages, for a total of 331 samples. The areas of LVI were identified by a combination of H&amp;E review and immunohistochemistry for podoplanin. We performed smart-3SEQ for gene expression profiling and light pass whole genome sequencing for DNA copy number alterations. Results: We profiled the spectrum of neoplasia for transcriptome-wide gene expression. Principal component analysis of all 252 DCIS, LVI, IBC, or metastasis samples using the top 500 genes with the highest variance demonstrated that clustering was roughly based on the diagnostic stage (i.e. DCIS, LVI, IBC, or metastasis). Differential gene expression profiling identified thousands of genes increased or decreased in expression across the transitional stages with the largest change in gene expression being the transition from normal breast to DCIS, dominated by gene expression down regulation. We next performed NMF clustering on 62 samples of LVI from 18 cases and identified two patterns of gene expression which define two subgroups. Gene ontology analysis revealed that one cluster was associated with increased proliferation and metabolism, whereas the second cluster was dominated by an immune response. When we analyzed the immune and proliferative LVI subgroups separately, we found that the immune profiles in the patient matched IBC and LVI samples from the LVI Immune cluster were similar, whereas the immune profiles in the patient matched IBC and LVI samples from the Proliferative cluster were significantly different. At the LVI stage, all immune cell populations estimated by CibersortX were decreased in the Proliferative LVI cluster. These changes were validated using immunofluorescence for proliferation (Ki67), T cells (CD3) and macrophages (CD68) on the same samples. Using the LVI centroids, we built a model that could predict the same clusters in the METABRIC IBC. Kaplan-Meier analysis showed a significant difference between groups, with the Proliferative-like IBC group having a worse prognosis than the Immune-like IBC group. Conclusions: We observed a dichotomy at the LVI stage with a more proliferative cluster that may escape the immune response and an immune cluster which has a microenvironment with a similar pattern to its primary IBC. The recognition of two groups of LVI, differing in immune association and proliferation, raises the possibility that the risk of metastasis could be different in these two groups, leading to different biological pathways of progression. Citation Format: Belén Rivero-Gutiérrez, Diego Mallo, Almudena Espín-Pérez, Sujay Vennam, Chunfang Zhu, Sushama Varma, Greg Scott, Joseph Foley, E Shelley Hwang, Carlo Maley, Robert West. Characterization of the lymphovascular invasion microenvironment reveals immune response dichotomy [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr PD2-09.

유방암 환자 사망의 역학적 특성과 건강증진 방안 : 국가 암등록 자료를 이용하여

Objectives: The purpose of this study was to identify the major influencing factors of breast cancer death and to suggest policy measures to promote the health of breast cancer patients. Methods: The method of this study performed statistical analysis by applying weights to 2,300 cases of breast cancer registration statistics in Korea collected in 2018 due to the relatively small number of mortality data compared to survival. Statistical processing of the collected data was analyzed using SPSS 26.0. Results: The epidemiologic characteristics of death in breast cancer patients were 31.8% in those aged 70 years or older, and the mortality rate was 5.25 times higher in patients aged 70 years or older than those aged 39 years or younger. The anatomical site code was 36.4% in C50.4~C50.6, and the mortality rate was 1.82 times higher in C50.4~C50.6 than in C50.0~C50.1. The tumor size was 40.4% and larger than 4cm, and the mortality rate was 4.53 times higher in tumors larger than 4cm than those smaller than 1cm. The degree of differentiation was 13.9% in the poorly differentiated group, and the mortality rate was 4.38 times higher in the poorly differentiated group than in the highly differentiated group. In the hormone receptor test, non-triple negative cases were 59.6%, and the mortality rate was 0.57 times lower in non-triple negative cases than in triple negative cases. As for lymph node involvement, the presence or absence of lymph node involvement was 78.8%, and the mortality rate with lymph node involvement was 1.36 times higher than that without lymph node involvement. The survival period of 13 to 24 months was the highest at 26.5%, and the average survival period was 25.68 months (±14.830). Conclusion: A policy to advance the timing of national health examinations for early detection of breast cancer is necessary. In addition, a bill for the mandatory placement of health educators in medical institutions for patients with special diseases such as breast cancer should be prepared.