Status Of Breast Cancer Patients Research Articles

Oxidant/Antioxidant Status of Breast Cancer Patients in Pre- and Post-Operative Periods.

Background and Objectives: The purpose of this study is to evaluate the level of oxidative stress before and after breast cancer surgery. Materials and Methods: Malondialdehyde (MDA) level was tested using a thiobarbituric acid (TBA) assay based on the release of a color complex due to TBA reaction with MDA. The glutathione S-transferase (GST) activity was evaluated by enzymatic conjugation of reduced glutathione (GSH) with 1-chloro-2,4-dinitrobenzene. The level of total glutathione (reduced GSH and oxidized GSSG) was detected using a recycling system by 5,5-dithiobis(2-nitrobenzoic acid). The levels of the indices were determined in the serum of 52 patients before surgery, two hours and five days after surgery, and in 42 healthy women. Results: In the patients over 50 years old the level of MDA was higher after surgery in comparison with before surgery, and GST activity was lower in comparison with the control. The GSH + GSSG level in both ages groups after surgery was lower than in the control. Significant differences of MDA level were detected in patients with stage III after surgery compared to the control. The level of GSH + GSSG was significantly lower in the patients with I–III stages compared to the control. Conclusion: The most expressed changes demonstrate the significance of MDA as a marker to evaluate oxidative stress in breast cancer patients. The degree of oxidative stress depends on the patient’s age and stage of disease. (1) Malondialdehyde can be used as an oxidative stress marker; (2) A higher stage of the disease and older age correspond to a higher rise of malondialdehyde, suggesting more intensive oxidative stress.

Biological characteristics of breast cancers in a teaching hospital in Northwestern Nigeria

Background: Breast cancer is the number one killer of women in the world, and its incidence is rising in developing countries including Nigeria. Breast cancer has expressed variation in terms of histological types, hormonal receptor status, and Her-2-Neu receptor status in different races and environments. These biological characteristics are relevant in disease presentation, treatment, and outcome. Objective: This study examined the histology, hormone receptor status, and Her-2-Neu receptor status of breast cancer patients. Materials and Methods: This is a retrospective review of histology reports of breast cancers diagnosed over a 5-year period from January 1, 2010, to December 31, 2015, in Aminu Kano Teaching Hospital, Kano, Northwestern Nigeria. Data regarding age of the patient, histological type, hormone receptor, and Her-2-Neu overexpression were obtained. Results: The records of 215 patients with breast cancer during the period of the study were requested. Out of this number, only the record of 153 patients could be obtained. Furthermore, of the 153 patients, only 103 had complete records and were included in the study. The age of the patients ranged between 25 and 80 years. The modal age of the groups was 31–40 and 41–50 years, each having 27 participants (26.2%). More than two-thirds of the study participants, 74 (71.8%), had intraductal carcinoma. Other variants of breast cancer in the participants were papillary and medullary carcinoma, each accounting for 4 (3.9%). After receptor typing, it was found that 39 (37.9%) of the participants were positive for Her-2 and progesterone receptors, respectively, while 32 (31.1%) were positive for estrogen receptors. The mean age of women triple-negative status was lower (46.8 years) than that of women without triple-negative status (48.9 years). However, this was not statistically significant (t = 0.74, P = 0.462). More than half of the premenopausal women, 32 (61.5%), had triple-negative status while more than two-thirds of women who had attained menopause, 35 (68.6%), had triple-negative status. However, the relationship between age and negative status was not significant (χ2 = 0.569, P = 0.451). Conclusion: The predominant histological type of breast cancer in the study area remains intraductal carcinoma, and many patients had triple-negative tumors.

ST6GAL2 Downregulation Inhibits Cell Adhesion and Invasion and is Associated with Improved Patient Survival in Breast Cancer.

ObjectiveBreast cancer is one of the most common and serious types of cancer, with a particularly unfavorable prognosis. Although dysregulation of β-galactoside α 2,6-sialyltransferase 2 (ST6GAL2) has been observed in multiple cancers, the mechanism involved remains to be clarified. In this study, we focused on the potential function of ST6GAL2 in the regulation of breast cancer.MethodsFlow cytometry and CCK-8 were used to measure markers of the cell cycle proliferation, adhesion, and invasion. Real-time PCR and immunohistochemistry analysis were used to detect the expression levels of ST6GAL2 in breast cancer tissues. Western blot was used to analyze the expression level of genes correlated with focal adhesion and metastasis pathways in breast cancer cells.ResultsST6GAL2 expression levels were higher in breast cancer tissues as compared to healthy tissues. ST6GAL2 expression was associated with tumor stage, survival time, and estrogen receptor (ER)/progesterone receptor (PR)/human epidermal growth factor receptor 2 (HER2) status of breast cancer patients. Silence of ST6GAL2 inhibited cancer progression by arresting cell cycle progression at G0/G1 phase and inhibiting cell adhesion and invasion. ST6GAL2 was positively correlated with focal adhesion and metastasis pathways, and its downregulation inhibited the expression of ICAM-1, VCAM-1, CD24, MMP2, MMP9, and CXCR4.ConclusionThese findings indicated that ST6GAL2 might serve as a useful potential target for treatment of breast cancer.

Evaluating the HER-2 status of breast cancer using mammography radiomics features

PurposeThe aim of our study was to evaluate the HER-2 status in breast cancer patients using mammography (MG) radiomics features. MethodsA total of 306 Chinese female patients with invasive ductal carcinoma of no special type (IDC-NST) enrolled from January 2013 to July 2018 were divided into a training set (n = 244) and a testing set (n = 62). One hundred and eighty-six radiomics features were extracted from digital MG images based on the training set. The least absolute shrinkage and selection operator (LASSO) method was used to select the optimal predictive features for HER-2 status from the training set. Both support vector machine (SVM) and logistic regression models were employed based on the selected features. The area under the receiver operating characteristic (ROC) curves (AUCs) of the training set and testing set were used to evaluate the predictive performance of the models. ResultsCompared with the SVM model, the performance of the logistic regression model using a combination of cranial caudal (CC) and mediolateral oblique (MLO) MG views was optimal. In the training set, the sensitivity, specificity, accuracy and area under the curve (AUC) values of the logistic regression model for evaluating HER-2 status based on quantitative radiomics features were 87.29%, 58.73%, 80.00% and 0.846 (95% confidence interval (CI), 0.800-0.887), respectively, and in the testing set, the values were 73.91%, 68.75%, 77.00% and 0.787 (95% CI, 0.673-0.885), respectively. ConclusionsRadiomics features could be an efficient tool for the preoperative evaluation of HER-2 status in patients with breast cancer.

Association of Gastrointestinal Chemotoxicity to the Performance Status of Breast Cancer Patients: A Preliminary Study

Abstract Background Chemotherapy is still the first line treatment for breast cancer patients. Gastrointestinal chemotoxicity such as nausea and vomiting remain as distressing adverse side effects. However, not many data discussed the impact of these side effect on the performance status of the patients. Thus, the aim of the study is to evaluate the Association of gastroenteric chemotoxicity to the performance status of Breast cancer patients. Method A cross-sectional study was done in our general hospital starting from October 2018 until February 2019. The patients included are those diagnosed with breast cancer and have undergone chemotherapy. Chemotherapy toxicity is assessed using the National cancer institute common toxicity criteria (NCI-CTC) with a cut-off above 1 point. and Eastern Cooperative Oncology Group (ECOG) was used to assess the patient´s performance status. The ECOG has a scoring system (0-5). Which 0 defines as fully active and 5 as dead. The correlation between both variables was analyzed with spearman using SPSS version 24.0 Result Data are collected from 32 patients with mean age 47.72±9.095. Out of the patients, only 6.2% experienced nausea and vomiting. The performance status data showed 46.9% scored 0, 50% scored 1, and only 3.1% scored 2. The association of these chemotoxicity to the patient´s status performance is less significant with r = 0.223, p-value=0.221 Conclusion Chemotoxicity did not occur in most patient. However patients still tends to have restricted in physically strenuous activity but ambulatory and able to carry out work of a light or sedentary nature. The study resulted in minimum coherence and significance from both variables. Therefore further study with a larger sample size should be done.

Artificial Intelligence to Assess Hormonal Status of Breast Cancer Patients

The pathological review of tumor samples, even for common molecular biomarkers such as estrogen receptor (ER), progesterone receptor (PR), and human

Relevant Word Order Vectorization for Improved Natural Language Processing in Electronic Health Records

Electronic health records (EHR) represent a rich resource for conducting observational studies, supporting clinical trials, and more. However, much of the data contains unstructured text, presenting an obstacle to automated extraction. Natural language processing (NLP) can structure and learn from text, but NLP algorithms were not designed for the unique characteristics of EHR. Here, we propose Relevant Word Order Vectorization (RWOV) to aid with structuring. RWOV is based on finding the positional relationship between the most relevant words to predicting the class of a text. This facilitates machine learning algorithms to use the interaction of not just keywords but positional dependencies (e.g. a relevant word occurs 5 relevant words before some term of interest). As a proof-of-concept, we attempted to classify the hormone receptor status of breast cancer patients treated at the University of Kansas Medical Center, comparing RWOV to other methods using the F1 score and AUC. RWOV performed as well as, or better than other methods in all but one case. For F1 score, RWOV had a clear edge on most tasks. AUC tended to be closer, but for HER2, RWOV was significantly better for most comparisons. These results suggest RWOV should be further developed for EHR-related NLP.

Effect of radiotherapy on the residual circulating epithelial tumor cells (CETCs) and their programmed cell death ligand 1 (PD-L1) status in breast cancer patients.

e14034 Background: Preclinical studies have suggested that radiotherapy (RT) followed by immunotherapy could be a promising strategy for synergistic enhancement of treatment efficacy. RT induces immunogenic changes in cancer cells which can lead to adaptive up-regulation of PD-L1 expression. Moreover, radiotherapy reduces not only local recurrence but also improves overall survival by preventing distant metastases, which indicates its influence on the remaining occult tumor, such as circulating tumor cells. For this reason the aim of this study was to determine the PD-L1 status on CETCs before and during RT. Methods: CETCs were determined in 54 primary breast cancer patients in early and locally advanced stages. The number of CETCs and their expression of PDL-L1 were investigated using the maintrac method. The fraction of PD-L1 positive CETCs was assessed prior to (baseline), 3 and 6 weeks after the start of radiotherapy. Results: We found a correlation between the PD-L1 status of CETCs and aggressiveness of cancer disease prior to radiotherapy. Patients with positive lymph node status presented more PD-L1 positive CETCs compared to patients with negative lymph nodes (mean 73% vs. 50%, p < 0.01). Moreover, the HER2 expression of the primary tumor was also positively correlated with PD-L1 expression. Lower numbers of CETCs were detected in patients who had not received chemotherapy or adjuvant chemotherapy before RT than in those who received neoadjuvant chemotherapy (median 20 vs 25 vs 120 CETC/100µl blood, p < 0.001). Surprisingly, the fraction of PD-L1 positive CETCs decreased during radiotherapy only in patients who had received neoadjuvant chemotherapy. Conclusions: Although the number of CETCs and the fraction of PD-L1 positive CETCs were higher in patients who had received neoadjuvant chemotherapy, radiotherapy reduced both measured biomarkers. In the future PD-1/PD-L1 checkpoint inhibitors after radiotherapy might have additional benefit in breast cancer patients.

Unveiling the real-world outcomes of breast cancer (BC) patients with taxanes-induced neuropathy using a digital patient-powered network (PPN).

e18248 Background: Taxanes-induced neuropathy is common in BC patients receiving taxanes, forcing dose reductions and treatment delays and posing serious challenges for the long-term patient QoL. Discovering neuropathy predictors in patients could guide better treatment decisions, improved QoL and reduce healthcare costs. Belong digital PPN is a social network for cancer patients and caregivers that supports disease management. In this study we used our artificial intelligence (AI) engine to classify the prevalence, characteristics and taxanes-induced neuropathy status of BC patients. Methods: We analyzed real-world patient-reported outcomes provided voluntarily and anonymously from users on the Belong PPN. Data from BC patients reporting treatment with taxanes was extracted and additional analysis segmented the data to those who experienced neuropathy and those who did not. Further validation of the data was performed by our research team to assure accuracy. Results: We evaluated 169 BC cancer patients from the US treated with taxanes. In the cohort 72% were Paclitaxel-treated and 28% Docetaxel-treated at various disease stages: 68% at early stage BC (0-2) and 32% at the advanced/metastatic stages (3-4). 83% of Paclitaxel-treated patients and 67% of Docetaxel-treated patients reported experiencing neuropathy in the Belong platform. These real-world reports indicated significantly higher incidence of taxane-induced neuropathy in comparison to literature summarizing data from clinical trials, suggesting neuropathy incidence of 27% for paclitaxel and 16% for docetaxel (grades 2-4). Conclusions: Real-world patient-reported outcomes from the Belong PPN captured the prevalence of taxanes-induced neuropathy in BC patients and correlated it to the specific drug in use. Evidence for higher incidence of taxanes-induced neuropathy may lead to lower patient QoL and higher healthcare costs and should stimulate better treatment decisions. Further exploration of the gap between controlled clinical studies and real-world evidence is urgently needed to understand the true patient outcomes and optimize healthcare accordingly.

Impact of Awareness on Health Status of Breast Cancer Patients

Impact of Awareness on Health Status of Breast Cancer Patients

Predicting factors for survival of breast cancer patients using machine learning techniques

BackgroundBreast cancer is one of the most common diseases in women worldwide. Many studies have been conducted to predict the survival indicators, however most of these analyses were predominantly performed using basic statistical methods. As an alternative, this study used machine learning techniques to build models for detecting and visualising significant prognostic indicators of breast cancer survival rate.MethodsA large hospital-based breast cancer dataset retrieved from the University Malaya Medical Centre, Kuala Lumpur, Malaysia (n = 8066) with diagnosis information between 1993 and 2016 was used in this study. The dataset contained 23 predictor variables and one dependent variable, which referred to the survival status of the patients (alive or dead). In determining the significant prognostic factors of breast cancer survival rate, prediction models were built using decision tree, random forest, neural networks, extreme boost, logistic regression, and support vector machine. Next, the dataset was clustered based on the receptor status of breast cancer patients identified via immunohistochemistry to perform advanced modelling using random forest. Subsequently, the important variables were ranked via variable selection methods in random forest. Finally, decision trees were built and validation was performed using survival analysis.ResultsIn terms of both model accuracy and calibration measure, all algorithms produced close outcomes, with the lowest obtained from decision tree (accuracy = 79.8%) and the highest from random forest (accuracy = 82.7%). The important variables identified in this study were cancer stage classification, tumour size, number of total axillary lymph nodes removed, number of positive lymph nodes, types of primary treatment, and methods of diagnosis.ConclusionInterestingly the various machine learning algorithms used in this study yielded close accuracy hence these methods could be used as alternative predictive tools in the breast cancer survival studies, particularly in the Asian region. The important prognostic factors influencing survival rate of breast cancer identified in this study, which were validated by survival curves, are useful and could be translated into decision support tools in the medical domain.

Postchemotherapy hippocampal functional connectivity patterns in patients with breast cancer: a longitudinal resting state functional MR imaging study

The hippocampus plays a key role in cognitive function and emotion regulation due to its wide connection with the whole brain. This study examined the acute effect of chemotherapy on hippocampal and subfield functional connectivity and neuropsychological status in breast cancer patients (BC). This IRB approved study included 29BC and 25 age matched healthy controls (HCs) who underwent resting state functional magnetic resonance imaging (Rs-fMRI), neuropsychological tests and blood examinations at baseline and one week after completing chemotherapy or in the same time interval. Within-group comparisons and group-by-time interactions analysis of hippocampus- and subregion- based functional connectivity were performed between the two groups. Functional connectivity changes were correlated with changes of blood examination and neuropsychological test scores in the BC group. The BC group had higher depression and anxiety scores, poorer performance on visual mobility, auditory memory and executive function than HCs (p < 0.05), and significantly abnormal estrodiol, total cholesterol and triglycerides (p < 0.05). BC survivors showed significant hippocampal functional connectivity changes mainly in the left insula, temporal lobe (Gaussian Random Field theory correction, P < 0.001) and the left inferior frontal gyrus (P < 0.01). The functional connections from the anterior hippocampus to the left temporal lobe were greater than the posterior hippocampus (P < 0.05). The hippocampus functional connectivity alterations were closely related to changes in depression scores, estrodiol and triglycerides (all p < 0.05). Chemotherapy induced especially anterior hippocampal functional connectivity abnormality, which is related to depression symptom, estrodiol and triglycerides disorders.

DESCRIPTIVE STUDY OF FUNCTIONAL STATUS BREAST CANCER PATIENTS WITH CHEMOTHERAPY

Chemotherapy can experience changes in functional status breast cancer patients. The purpose of this study was to describe the functional status of breast cancer patients with chemotherapy, with design uses descriptive analysis. The sample is all breast cancer patients with chemotherapy at RSUD Kraton Kabupaten Pekalongan. The respondents is 46, with sampling method used total sampling. The results of this study is 67.4% had an assessment of functional status in category A which meant that they were independent in 6 function including the functions of bathing, dressing, toileting, moving, continental and eating. 10.9% of respondents have functional status category F. 4.3% of respondents have functional status categories B, C, D, E, and G. Comprehensive nursing care is needed to improve the functional status of breast cancer patients with chemotherapy.

Elevated serum HER‐2 predicts poor prognosis in breast cancer and is correlated to ADAM10 expression

Human epidermal growth factor receptor‐2 (HER‐2) overexpression in breast tumor tissues is associated with a poor prognosis but may benefit from treatment with trastuzumab. The extracellular domain (ECD) of HER‐2 can be measured in serum and which has been a new inspection item in clinical laboratory of several hospitals. However, whether serum HER‐2 ECD can be a marker of HER‐2 status in tumor tissues still confused clinicians. This study is a retrospective observation to explore the correlation between serum HER‐2 ECD shedding and tissue HER‐2 status in breast cancer patients. Meanwhile, we will further uncover the potential clinical significance of serum HER‐2 ECD detection. A total of 545 unselected breast cancer patients from Fudan University Shanghai Cancer Center were enrolled in this study. At primary diagnosis without any treatment, serum HER‐2 ECD was measured on ADVIA Centaur assay; meanwhile, tissue HER‐2 from core needle biopsy was tested through immunohistochemistry (IHC) and fluorescent in situ hybridization (FISH). We showed that serum HER‐2 ECD concentration was related to tissue HER‐2 status. Nevertheless, 36.9% of patients with tissue HER‐2 overexpression had low levels of HER‐2 ECD shedding (<15 ng/mL) in serum. Here, we demonstrated that HER‐2 ECD shedding was also associated with protein expression and alpha‐secretase activity of a disintegrin and metalloproteinase 10 (ADAM10) using tumor tissues and cell lines. Progression‐free survival (PFS) data from breast cancer patients in TNM phase II and III with tissue HER‐2 IHC 3+ were analyzed using Kaplan‐Meier plotter. The patients with serum HER‐2 ECD above 15 ng/mL had lower progression‐free survival than those with serum HER‐2 ECD <15 ng/mL. Thus, serum HER‐2 ECD could be a biomarker to identify the subgroup of poorer outcome among HER‐2 overexpression breast cancer patients. Inhibition of ADAM10 activity may have potential therapeutic benefit for this most aggressive tumor subgroup.

A Mobile Game for Patients With Breast Cancer for Chemotherapy Self-Management and Quality-of-Life Improvement: Randomized Controlled Trial.

BackgroundThe application of game-based learning in clinical practice has shown potential advantages in previous studies. However, there have been little efforts to use smartphone-based mobile games in the management of adult patients with cancer.ObjectiveThe objective of our study was to evaluate if patient education using a mobile game may increase drug compliance, decrease physical side effects of chemotherapy, and improve psychological status in breast cancer patients.MethodsA total of 76 patients with metastatic breast cancer who were planned to receive cytotoxic chemotherapy were enrolled in this trial. Study participants were randomly assigned to a mobile game play group (game group, n=36) or a conventional education group (control group, n=40) in a ratio of 1:1. The patients were unblinded and followed prospectively for 3 weeks. Outcome measures included time spent for education, compliance to medication, physical side effects, and psychological side effects including quality of life (QoL).ResultsOverall, 72 out of 76 patients completed the study after 3 weeks (95%). The subjects in the game group showed high levels of satisfaction with the app. The time spent playing the mobile game in the game group was longer than that spent for self-education in the control group (mean 22.2, SD 6.1 vs mean 5.5, SD 4.0 minutes a day; P<.001). The mobile game group showed better drug adherence (Korean version of the Medication Adherence Rating Scale; mean 7.6, SD 0.7 vs mean 6.5, SD 0.5; P<.001). The use of the mobile game was associated with lower rates of chemotherapy-related side effects, such as nausea, fatigue, numbness of hand or foot, and hair loss, than the control group. The game group exhibited better QoL during chemotherapy (mean 74.9, SD 3.5 vs mean 72.2, SD 5.3; P=.01). However, there were no significant differences in terms of depression and anxiety scales.ConclusionsThis study suggests the feasibility and potentiality of the use of smartphone mobile games for patients with breast cancer receiving chemotherapy. Education using a mobile game led to better patient education, improved drug compliance, decreased side effects, and better QoL compared with conventional education. Mobile games can be used as easy, fun, and effective measures for patient education and have the potential to improve treatment outcomes.Trial RegistrationClinicalTrials.gov NCT03205969; http://clinicaltrials.gov/ct2/show/NCT03205969 (Archived by WebCite at http://www.webcitation.org/71jfSBOq9).

Risk factors for loco-regional recurrence after breast conserving surgery: impact of young age and surgical margin status in breast cancer patients

Background: Breast cancer is a common malignant tumor and treatment predominantly consists of surgery. Modern society has increased the demands of women to have higher requirements for breast appearance and quality of life. Therefore, exploring effective measures to control or reduce the rate of loco-regional recurrence (LRR) after breast conserving surgery (BCS) is the main focus of this study.Methods: This cohort included 743 consecutive patients with invasive breast cancer, treated with BCS in 2 centers in Tehran, Iran between 2005 and 2010. The primary endpoint was the rate of loco-regional recurrence in a 5-year follow- up period. Authors also investigated the factors that could predict LRR after BCS.Results: The prevalence of LRR after BCS was 7.6% in a median follow-up of 56.9 months. The Median time to local recurrence was 20.45 months. A correlation between follow-up outcome and age; histologic sub-type; surgical margin; number of positive nodes; complete pathologic response to neo-adjuvant chemotherapy; chemotherapy and hormone therapy was recognized. Surgical margin status, hormone therapy, histologic sub-type, age and Ki67 were shown to be significant risk factors for LRR in univariate analysis whereas surgical margin status emerged as an independent risk factor in multivariate analysis.Conclusions: Increased LRR was observed among those with higher ki67, aged under35, not receiving hormone therapy and with a surgical margin less than 2mm. These factors appeared to be risk factors for LRR after BCS, while, histologic grade, axillary nodal status, tumor size and biologic sub-type did not predict LRR after BCS.

Study of Receptor Status in Carcinoma Breast Patient

Background: Estimation of Estrogen Receptor (ER) Progesterone Receptor (PR) and Human Epidermal Growth Factor Receptor 2 (HER2) is mandatory for choosing treatment options and prognosis of breast cancer patients. This estimation can be done by Immunohistochemistry (IHC) and Fluoroscence In Situ Hybridization (FISH) test. As the tests are expensive many of our patients can’t afford to do it. But if we practice doing the test routinely the cost will be reduced and our patients will be benefited. So we underwent a primitive study on receptor status in breast cancer patients. Our goal was to encourage the surgeons to advice receptor status routinely and treat the patients accordingly as patients prognosis will be much more better if they are treated according to their receptor status.Methods: This was a retrospective observational study of 74 breast cancer patients in a private clinic. In this study we have shown their receptor status by IHC and the data were analyzed.Results: Among the 74 patients 32 were ER +ve PR +ve, 11 were ER +ve PR -ve, 02 were ER –ve PR +ve, 29 were ER -ve PR -ve. ER &amp;/or PR positive patients will be more responsive to hormone therapy. 28 patients were HER2 +ve, 34 patients were HER2 –ve and 9 were equivocal. HER2 positive patients will be benefited from targeted therapy. Among the patients 11 were triple negative that means they have worst prognosis.Conclusion: As knowing the receptor status in breast cancer help us as a predictive, prognostic and therapeutic indicator, we must advice it routinely and take steps to make it cheaper and easily available.Chatt Maa Shi Hosp Med Coll J; Vol.16 (2); July 2017; Page 48-50

Preoperative assessment of axillary lymph node status in breast cancer patients by ultrasonography combined with mammography: A STROBE compliant article.

Preoperative assessment of nodal stage is of importance in breast cancer treatment decision-making. This study was done to determine the power of combined mammography and ultrasonography in differentiating N0–N1 from N2–N3 breast cancer.We retrospectively reviewed clinical data of 3944 female patients with invasive breast cancer by preoperative mammography and ultrasonography between January 2006 and December 2013 at our hospital. Pathological diagnosis was available for each patient. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of mammography alone, ultrasonography alone, and combination of them for assessment of axillary lymph node (ALN) status were calculated, using definitive histological results as the baseline.The sensitivity, specificity, PPV, NPV, and accuracy was 90.4%, 68.2%, 36.5%, 97.2%, and 71.9% for ultrasonography; was 66.9%, 80.8%, 41.3%, 92.3%, and 78.4% for mammography; and was 94.9%, 62.4%, 33.8%, and 98.4% for combined mammography and ultrasonography. For combination, accuracy and the area under the receiver operating characteristic curve was 67.9% and 0.85, respectively.In conclusion, combining ultrasonography and mammography improves the sensitivity in differentiating N0–N1 breast cancer from N2–N3 breast cancer, but leading to a reduced specificity. Addition of mammography to ultrasonography seems not to provide significant benefits in predicting ALN status in breast cancer patients.

Immunohistochemical HER2 Status Evaluation in Breast Cancer Pathology Samples: A Multicenter, Parallel-Design Concordance Study.

As patients with increased human epidermal growth factor receptor (HER2) overexpression are more likely to benefit from trastuzumab treatment, the accuracy of HER2 receptor status in breast cancer patients is significant for appropriate disease management. However, this assessment is not harmonized and results may be highly variable between centers. The aim of this study was to investigate the degree of interlaboratory variability in the results of HER2 expression reported by 5 participating centers and to assess the concordance between these centers and a reference laboratory.Materials and Methods: A total of 30 breast cancer samples were tested and scored for HER2 expression using immunohistochemical method in 5 centers from Turkey and in a reference laboratory from Netherlands (Academic Medical Center, Amsterdam). All the participating centers had an experience of more than 10 years regarding the HER2 testing. The results were compared both among the centers and with the reference laboratory. When the concordance of participating centers and the reference laboratory was evaluated regarding negative (0-1+), equivocal 2(+) and positive 3(+) classification of HER2 immunostaining, the highest concordance was found in Center-A, and the lowest in Center-C (Kendall's tau-b concordance coefficient 0.911 and 0.724, respectively). The concordance of the centers with reference laboratory was 80.0% both in equivocal and positive samples, while it increased up to 91.8% in negative samples. This study showed that in general there is sufficiently good agreement between the reference laboratory and the participating centers for immunohistochemical HER2 assessment.

Germline BRCA mutations (gBRCAmut) on breast cancer (BC) outcomes: A large meta-analysis.

e12575Background: Past studies evaluating prognosis of gBRCAmut status in BC patients have had inconsistent results. We summarized existing systematic literature reviews and performed a meta-analys...