Breast Cancer Tumor Size Research Articles

Radiation-Induced Angiosarcoma of the Breast: A Systematic Review and Meta-Analysis

INTRODUCTION: The purpose of this study is to summarize the totality of evidence on Radiation Induced Angiosarcoma (RIAS) of the breast through a meta-analysis and systematic literature review to assess overall survival (OS), recurrence, mortality, and prognostic factors. METHODS: A systematic review and meta-analysis was performed in accordance with PRISMA guidelines. Patient demographics, index cancer, and RIAS characteristics, recurrence, and mortality data were collected. Univariate and multivariate statistical analysis were performed. Kaplan-Meier analysis was used to plot survival probabilities and log-rank statistics to determine radiation cutoff dose. RESULTS: Full-text review identified 201 studies that reported patient-specific data for 531 individual patients. The median age of RIAS diagnosis was 70. The median latency period, from index breast cancer to RIAS diagnosis, was 6.7 years. A recurrence rate of 48.13% was identified. Index breast cancer tumor size was significantly larger in patients who died vs survived (3 cm vs 2 cm, p = 0.028). A threshold radiation dose of 59 Gray was associated with decreased survival probability, p = 0.047 (Figure 1). The latency period was significantly longer for patients who received chemotherapy for their index breast cancer (90.6 vs 72.0 months, p = 0.024). Use of reirradiation as treatment for RIAS did not confer a significant mortality benefit or decrease recurrence. The 5-year overall survival was 55%.Figure 1CONCLUSION: RIAS of the breast is a highly morbid disease. Tumor size, index radiation dose, and chemotherapy use are prognostic factors of RIAS recurrence and mortality. Further research into effective treatment modalities is necessary.

LINC01234 Accelerates the Progression of Breast Cancer via the miR-525-5p/Cold Shock Domain-Containing E1 Axis.

Backgrounds Long noncoding RNAs (lncRNAs) are strongly associated with the development of breast cancer (BC). As yet, the function of LINC01234 in BC remains unknown. Methods Using biological information, the potential lncRNA, miRNA, and target gene were predicted. LINC01234 and miR-525-5p expression in BC tissues was detected using quantitative real-time reverse transcription polymerase chain reaction. Fluorescence in situ hybridization was used to determine the distribution of LINC01234. Cell proliferation was analyzed using CCK-8 assay, colony formation, terminal deoxynucleotidyl transferase dUTP nick end labeling staining, and apoptosis evaluated using flow cytometry. Western blotting was used to evaluate protein expression. Dual-luciferase® reporter, RNA pull-down, and RNA immunoprecipitation assays were performed to analyze the binding relationships among LINC01234, miR-525-5p, and cold shock domain-containing E1 (CSDE1). Results We screened out LINC01234, found to be significantly increased in BC tissues, associated with a poor prognosis, and positively correlated with tumor size of BC. Knockdown of LINC01234 suppressed BC cell growth and facilitated apoptosis. Dual-luciferase reporter®, RNA pull-down, and RNA immunoprecipitation assays confirmed that LINC01234 and CSDE1 directly interacted with miR-525-5p. Upregulation of miR-525-5p and suppression of CSDE1 inhibited BC cell growth and induced cell apoptosis. Conclusion Upregulation of LINC01234 contributes to the development of BC through the miR-525-5p/CSDE1 axis. LINC01234 may be one of the potential diagnostic and treatment targets for BC.

Abstract 1477: Circulating miR-125a-3p and miR-451a may be liquid biopsy biomarkers for the diagnosis of breast cancer

Abstract Background: Breast cancer is the most prevalent female cancer. Emerging evidence suggests that the unique serum miRNAs can assist in the early detection and diagnosis of breast cancer. Cell-free circulating miRNAs (about 22 nucleotides) are potential diagnostic tools and minimally invasive biomarkers for breast cancer detection. This study aimed to identify specific microRNAs in the serum of patients with breast cancer, which may serve as promising diagnostic and prognostic biomarkers and therapeutic targets. Material and methods: Next-generation sequencing and quantitative real-time PCR (qRT-PCR) array analyses of microRNAs in sera from different subtypes of breast cancer patients and normal female individuals were performed. The differentially expressed microRNAs were verified in serum samples from 100 breast cancer patients. The predictive values of the selected microRNAs were statistically analyzed, determined by the correlation between microRNA expression and tumor parameters. Datasets were graphed using GraphPad Prism Software 8.0. and analysis was done using one-way ANOVA with unpaired two-tailed Student’s t-test. Result: High serum levels of miR-125a-3p and miR-451a were found to be associated with breast cancer tumor subtype, size, and lymph node metastasis. Further functional in vitro experiments and enrichment analysis showed that overexpression and knockdown of miR-451 might significantly affect tumorigenic signaling pathways in TNBC cells. Conclusion: Altogether, our data suggested that serum levels of microRNAs miR-125a-3p and miR-451a can potentially serve as liquid biopsy biomarkers in breast cancer. Citation Format: Hassan Yousefi, Steven C. Eastlack, Jordyn T Fong, Samuel C. Okpechi, Jovanny Zabaleta, Lyndsey R. Buckner, Donnalee N Trapani, Erin Sims, Alison McDaniel McDaniel, Heather Scuderi, Meredith A. Lakey, John T. Cole, Suresh K. Alahari. Circulating miR-125a-3p and miR-451a may be liquid biopsy biomarkers for the diagnosis of breast cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 1477.

Differences of Tumor Size Measured by Ultrasonography and Magnetic Resonance Imaging Compared to Pathological Tumor Size in Primary Breast Cancer

Differences of Tumor Size Measured by Ultrasonography and Magnetic Resonance Imaging Compared to Pathological Tumor Size in Primary Breast Cancer

65P Evaluation of survival outcome of adjuvant chemoradiotherapy compared to other treatment modalities stratified by tumor size in T1N0M0 triple-negative breast cancer

Triple-negative breast cancer (TNBC) is an aggressive type that lack Estrogen, progesterone and HER2 receptors.Targeted treatments aren't available for TNBC like other types of breast cancer but Several studies proved the benefit of adjuvant chemotherapy. This study aims to evaluate the survival outcome of adjuvant chemoradiotherapy compared to different treatment regimens in the management of node-negative T1a,T1b,T1c triple-negative breast cancer (TNBC).

Long-term oncologic safety of immediate reconstructive surgery in patients with invasive breast cancer: a retrospective matched-cohort study

ObjectiveImmediate reconstruction (IR) is a safe and effective surgical treatment for patients with breast cancer. We aimed to assess the prognosis, aesthetic outcomes, and patient satisfaction of IR compared with breast conservation surgery (BCS) and total mastectomy (TM).MethodsThis retrospective matched-cohort study was conducted between May 2005 and December 2014. We established two cohorts according to the tumor (T) size of breast cancer. In the T≤3cm group, cases (IR) and controls (BCS or TM) were matched for age, pathological tumor size, and pathologic nodal status in a 1:1:1 ratio. In the T>3cm group, cases (IR) and controls (TM) were matched with the same factors and ratio. The primary outcome was the 5-year disease-free survival (DFS). The secondary outcome was patient satisfaction and quality of life.ResultsA total of 12,678 breast cancer patients were assessed for eligibility, of which 587 were included (T≤3 cm group: 155 IR vs 155 BCS vs 155 TM; T>3cm group: 61 IR vs 61 TM). In the T≤3 cm cohort, patients who underwent IR had no difference compared with those who underwent BCS or TM regarding the 5-year DFS (P=0.539); however, an improved aesthetic satisfaction, psychosocial, and sexual well-being were achieved in the IR group (P<0.001). In the T>3 cm cohort, the IR group had a worse median 5-year DFS (P=0.044), especially for Her2+ or triple-negative breast carcinoma (TNBC) subtypes compared with the TM group.ConclusionsIR improves aesthetic satisfaction, psychosocial, and sexual well-being for breast cancer patients with T≤3 cm. For patients with T > 3 cm invasive breast cancer, TM is superior to IR as it predicts a better 5-year DFS.

Demographic Pattern, Tumor Size and Stage of Breast Cancer in Africa: A Meta-analysis

Purpose: Understanding the epidemiology of breast cancer (BC) in Africa, as well as regional variation is essential for planning future intervention. Our objective was to describe summary estimates of socio-demographic and clinical characteristics of BC in Africa, thus providing researchers and policymakers baseline data for planning diagnostic and treatment programs to improve BC outcomes in the future.Method: We screened African publications on BC between 2010 and 2019 in PubMed, AJOL, Google, ScienceDirect, and ResearchGate to estimate the distribution of socio-demographic and clinical tumor characteristics. The meta-analysis used the random effect model. Result: Eighty articles were eligible, including 33,199 total patients. Overall, 58% of patients were &lt;50 years old. In East Africa, 38% (95% CI 31-45) were diagnosed before 40 years. Conversely, in Southern Africa, 37% were diagnosed after 60 years, with Caucasian-like age distribution. The overall prevalence of male BC was high (3%), with East Africa having the highest prevalence (5% (95% CI 5.0-6.0)). Only 2% (95% CI 1-2) of patients were diagnosed with carcinoma-in-situ. Invasive tumors were 7% stage I, 26% stage II, 50% stage III, and 17% stage IV. Seventy per-cent (95% CI 60-80) had clinical nodal involvement. The smallest tumors were in North Africa. The largest and most advanced tumors were in West Africa. Trend analysis showed decreasing age, an increasing population of unmarried BC patients, a relatively high proportion of uneducated BC patients, and a stable proportion of late-stage disease in the last decade. Conclusion: Regional variation in the presentation of BC throughout Africa necessitates region/country-specific targets for improving BC control.

Predicting the expression level of Ki-67 in breast cancer using multi-modal ultrasound parameters

ObjectiveThis study investigated the feasibility of predicting the expression levels of Ki-67 in breast cancer using ultrasonographic findings and clinical features.MethodsFifty-eight breast cancer patients, with 82 lesions confirmed by surgical pathology, were selected retrospectively for this study. Conventional ultrasound examination and elastography examination were performed before surgery. Clinical features (age, estrogen receptor (ER), progesterone receptor, and human epidermal growth factor receptor-2 expression levels), ultrasonographic findings, and elastography scores, including the maximum size, location, number, margin, borderline, blood flow, and elastography score of the mass, were collected. The expression of Ki-67 was recorded using immunohistochemical staining, and the patients were divided into a high (≥ 20%) expression group and a low (< 20%) expression group. SPSS 23.0 software was used for statistical analysis. An independent sample t-test was used for measurement data, and a χ2 test was used for enumeration data. Logistic regression analysis was performed for meaningful indicators, and the receiver operating characteristic curve was used to calculate the best diagnostic cut-off point.ResultsMonofactorial analysis showed that there was a statistically significant difference (p < 0.05) between the high expression of Ki-67 and the maximum diameter of the mass, the margin of the mass, the color Doppler flow imaging of the blood flow, and the resistance index of the blood flow. There were no significant differences in age, mass location, number, morphology, borderline, microcalcification, and elastography score (p > 0.05). Multiple factor regression analysis showed that a large mass and a mass with a rich blood flow had an independent predictive value for Ki-67. When the diameter was > 21.5 mm, the diagnostic sensitivity and specificity were 91.9% and 71.3%, respectively. The expression level of Ki-67 was negatively correlated with that of ER.ConclusionThe tumor size and blood flow of breast cancer is correlated with the expression level of Ki-67 and, thus, it could be used to predict the expression level of Ki-67 in ultrasound diagnosis. The margin condition and the expression level of ER of an ultrasonic mass could also indirectly reflect the Ki-67 expression level of the mass.

AKR1B10 promotes breast cancer cell proliferation and migration via the PI3K/AKT/NF-\u03baB signaling pathway

BackgroundAberrant expression of Aldo-Keto reductase family 1 member B10 (AKR1B10) was associated with tumor size and metastasis of breast cancer in our published preliminary studies. However, little is known about the detailed function and underlying molecular mechanism of AKR1B10 in the pathological process of breast cancer.MethodsThe relationship between elevated AKR1B10 expression and the overall survival and disease-free survival of breast cancer patients was analyzed by Kaplan–Meier Plotter database. Breast cancer cell lines overexpressing AKR1B10 (MCF-7/AKR1B10) and breast cancer cell lines with knockdown of AKR1B10 (BT-20/shAKR1B10) were constructed to analyze the impact of AKR1B10 expression on cell proliferation and migration of breast cancer. The expression levels of AKR1B10 were detected and compared in the breast cancer cell lines and tissues by RT-qPCR, western blot and immunohistochemistry. The proliferation of breast cancer cells was monitored by CCK8 cell proliferation assay, and the migration and invasion of breast cancer cells was observed by cell scratch test and transwell assay. The proliferation- and EMT-related proteins including cyclinD1, c-myc, Survivin, Twist, SNAI1, SLUG, ZEB1, E-cadherin, PI3K, p-PI3K, AKT, p-AKT, IKBα, p-IKBα, NF-κB p65, p-NF-κB p65 were detected by western blot in breast cancer cells. MCF-7/AKR1B10 cells were treated with LY294002, a PI3K inhibitor, to consider the impact of AKR1B10 overexpression on the PI3K/AKT/NF-κB signal cascade and the presence of NF-κB p65 in nuclear. In vivo tumor xenograft experiments were used to observe the role of AKR1B10 in breast cancer growth in mice.ResultsAKR1B10 expression was significantly greater in breast cancer tissue compared to paired non-cancerous tissue. The expression of AKR1B10 positively correlated with lymph node metastasis, tumor size, Ki67 expression, and p53 expression, but inversely correlated with overall and disease-free survival rates. Gene Ontology analysis showed that AKR1B10 activity contributes to cell proliferation. Overexpression of AKR1B10 facilitated the proliferation of MCF-7 cells, and induced the migration and invasion of MCF-7 cells in vitro in association with induction of epithelial-mesenchymal transition (EMT). Conversely, knockdown of AKR1B10 inhibited these effects in BT-20 cells. Mechanistically, AKR1B10 activated PI3K, AKT, and NF-κB p65, and induced nuclear translocation of NF-κB p65, and expression of proliferation-related proteins including c-myc, cyclinD1, Survivin, and EMT-related proteins including ZEB1, SLUG, Twist, but downregulated E-cadherin expression in MCF-7 cells. AKR1B10 silencing reduced the phosphorylation of PI3K, AKT, and NF-κB p65, the nuclear translocation of NF-κB p65, and the expression of proliferation- and migration-related proteins in BT-20 cells. LY294002, a PI3K inhibitor, attenuated the phosphorylation of PI3K, AKT, and NF-κB p65, and the nuclear translocation of NF-κB p65. In vivo tumor xenograft experiments confirmed that AKR1B10 promoted breast cancer growth in mice.ConclusionsAKR1B10 promotes the proliferation, migration and invasion of breast cancer cells via the PI3K/AKT/NF-κB signaling pathway and represents a novel prognostic indicator as well as a potential therapeutic target in breast cancer.

Synergistic Effects of Exercise Training and Vitamin D Supplementation on Mitochondrial Function of Cardiac Tissue, Antioxidant Capacity, and Tumor Growth in Breast Cancer in Bearing-4T1 Mice.

Both regular exercise training and vitamin D consumption are beneficial for patients with cancer. The study investigated the effects of interval exercise training (IET) or/and vitamin D supplementation on the gene expression involved in mitochondrial function of heart tissue, tumor size, and total antioxidant capacity (TAC) in breast cancer (BC) model mice. We assigned random 40 female NMRI mice to five equal groups (n = 8); the healthy control group (H.C), cancer control group (Ca.C), cancer with the vitamin D group (Ca.VD), cancer exercise group (Ca.Ex), and cancer exercise along with the vitamin D group (Ca.Ex.VD). Forty-eight hours after treatment, we anesthetized the animals and performed the isolation of heart tissue and blood serum for further studies. The results showed that the lowest mean body weight at the end of the treatments was related to Ca.C (p = 0.001). Vitamin D treatment alone has increased tumor volume growth by approximately 23%; in contrast, co-treatment with exercise and vitamin D inhibited tumor growth in mice (P = 0.001), compared with the cancer control (12%). TAC levels were higher in the group that received both vitamin D and exercise training (Ca.Ex.VD) than in the other treatment groups (Ca.VD and Ca.Ex) (p = 0.001). In cardiac tissue, vitamin D treatment induces an elevation significantly of the mRNA expression of Pgc1−α, Mfn-1, and Drp-1 genes (p = 0.001). The study has shown the overexpression of vitamin D in female mice, and synergistic effects of IET with vitamin D on weight loss controlling, antitumorigenesis, improvement of antioxidant defense, and the modulation of gene expression. The synergistic responses were likely by increasing mitochondrial fusion and TAC to control oxidative stress. We recommended being conducted further studies on mitochondrial dynamics and biogenesis focusing on risk factors of cardiovascular disease (CVD) in patients with BC.

Upregulation of LINC00511 expression by DNA hypomethylation promotes the progression of breast cancer

LINC00511 is a newly discovered long intergenic nonprotein-coding RNA (Ribonucleic acid) with unknown. Differential gene expression analysis was performed on breast cancer microarray data, and the upregulated expression of LINC00511 in breast cancer tissues and breast cancer cell lines was verified by qRT-PCR (quantitative Reverse Transcription-Polymerase Chain Reaction). A cohort study revealed a correlation between the expression of LINC00511 and the clinicopathological features in breast cancer patients. The effects of LINC00511 on breast cancer migration and invasion were studied in vitro. Then, an experiment using the Illumina Infinium Human Methylation450 Beadchip data was conducted to study the role of DNA (Deoxyribonucleic acid) methylation in LINC00511 expression, and DAVID (Database for Annotation, Visualization and Integrated Discovery) Functional Annotation Bioinformatics Microarray Analysis was used to determine the biological functions and potential pathways of LINC00511 in breast cancer. Then, LINC00511 and key genes associated with breast cancer disease progression were further studied in TCGA (The Cancer Genome Atlas), and western blotting was used to verify the results at the protein level. Finally, we further studied the effect of LINC00511 on Panobinostat drug sensitivity in breast cancer and its effect on the prognosis of breast cancer patients. LINC00511 was upregulated in breast cancer patients. The expression of LINC00511 was closely related to lymph node metastasis, tumor size and molecular subtypes of breast cancer. The in vitro studies revealed that LINC00511 could promote the migration and invasion in MDA-MB-231 and MCF-7 cells. In terms of mechanism, DNA hypomethylation promoted the expression of LINC00511, furthermore LINC00511 promoted the expression of Wnt10A, E2F2, TGFA, and MET, which participate in the progression of breast cancer. In addition, LINC00511 reduced the sensitivity of breast cancer cells to Panobinostat. Moreover, breast cancer patients with a high expression of LINC00511 had a poor prognosis. DNA hypomethylation promotes the expression of LINC00511 in breast cancer, and LINC00511 promotes the progression of breast cancer by upregulating Wnt10A, E2F2, TGFA and MET. High expression of LINC00511 is associated with poor prognosis. Our study identified the mechanism of LINC00511 upregulation and provides novel information on the progression of breast cancer.

Prediction of tumor size in patients with invasive ductal carcinoma using FT-IR spectroscopy combined with chemometrics: a preliminary study.

Precise detection of tumor size is essential for early diagnosis, treatment, and evaluation of the prognosis of breast cancer. However, there are some errors between the tumor size of breast cancer measured by conventional imaging methods and the pathological tumor size. Invasive ductal carcinoma (IDC) is a common pathological type of breast cancer. In this study, serum Fourier transform infrared spectroscopy (FT-IR) combined with chemometric methods was used to predict the maximum diameter and maximum vertical diameter of tumors in IDC patients. Three models were evaluated based on the pathological tumor size measured after surgery and included grid search support vector machine regression (GS-SVR), back propagation neural network optimized by genetic algorithm (GA-BP-ANN), and back propagation neural network optimized by particle swarm optimization (PSO-BP-ANN). The results show that three models can accurately predict tumor size. The GA-BP-ANN model provided the best fitting quality of the largest tumor diameter with the determination coefficients of 0.984 in test set. And the GS-SVR model provided the best fitting quality of the largest vertical tumor diameter with the determination coefficients of 0.982 in test set. The GS-SVR model had the highest prediction efficiency and the lowest time complexity of the models. The results indicate that serum FT-IR spectroscopy combined with chemometric methods can predict tumor size in IDC patients. In addition, compared with traditional imaging methods, we found that the experimental results of the three models are better than traditional imaging methods in terms of correlation and fitting degree. And the average fitting error of PSO-BP-ANN and GA-BP-ANN models was less than 0.3mm. The minimally invasive detection method is expected to be developed into a new clinical diagnostic method for tumor size estimation to reduce the diagnostic trauma of patients and provide new diagnostic experience for patients. Graphical Abstract.

Magnetic resonance imaging and ultrasound for prediction of residual tumor size in early breast cancer within the ADAPT subtrials

BackgroundPrediction of histological tumor size by post-neoadjuvant therapy (NAT) ultrasound and magnetic resonance imaging (MRI) was evaluated in different breast cancer subtypes.MethodsImaging was performed after 12-week NAT in patients enrolled into three neoadjuvant WSG ADAPT subtrials. Imaging performance was analyzed for prediction of residual tumor measuring ≤10 mm and summarized using positive (PPV) and negative (NPV) predictive values.ResultsA total of 248 and 588 patients had MRI and ultrasound, respectively. Tumor size was over- or underestimated by < 10 mm in 4.4% and 21.8% of patients by MRI and in 10.2% and 15.8% by ultrasound. Overall, NPV (proportion of correctly predicted tumor size ≤10 mm) of MRI and ultrasound was 0.92 and 0.83; PPV (correctly predicted tumor size > 10 mm) was 0.52 and 0.61. MRI demonstrated a higher NPV and lower PPV than ultrasound in hormone receptor (HR)-positive/human epidermal growth factor receptor 2 (HER2)-positive and in HR−/HER2+ tumors. Both methods had a comparable NPV and PPV in HR−/HER2− tumors.ConclusionsIn HR+/HER2+ and HR−/HER2+ breast cancer, MRI is less likely than ultrasound to underestimate while ultrasound is associated with a lower risk to overestimate tumor size. These findings may help to select the most optimal imaging approach for planning surgery after NAT.Trial registrationClinicaltrials.gov, NCT01815242 (registered on March 21, 2013), NCT01817452 (registered on March 25, 2013), and NCT01779206 (registered on January 30, 2013).

P019 - Single nucleotide polymorphisms rs17335780 and rs11979255 of the epidermal growth factor receptor (EGFR) correlate with tumor size in breast cancer

P019 - Single nucleotide polymorphisms rs17335780 and rs11979255 of the epidermal growth factor receptor (EGFR) correlate with tumor size in breast cancer

P133 - The assessment of primary breast cancer tumor size by magnetic resonance imaging, breast ultrasonography and mammography: a comparative study across intrinsic tumor subtype

P133 - The assessment of primary breast cancer tumor size by magnetic resonance imaging, breast ultrasonography and mammography: a comparative study across intrinsic tumor subtype

Random effects models of lymph node metastases in breast cancer: quantifying the roles of covariates and screening using a continuous growth model

We recently described a joint model of breast cancer tumor size and number of affected lymph nodes, which conditions on screening history, mammographic density, and mode of detection, and can be used to infer growth rates, time to symptomatic detection, screening sensitivity, and rates of lymph node spread. The model of lymph node spread can be estimated in isolation from measurements of tumor volume and number of affected lymph nodes, giving inference identical to the joint model. Here, we extend our model to include covariate effects. We also derive theoretical results in order to study the role of screening on lymph node metastases at diagnosis. We analyze the association between hormone replacement therapy (HRT) and breast cancer lymph node spread, using data from a case-control study designed specifically to study the effects of HRT on breast cancer. Using our method, we estimate that women using HRT at time of diagnosis have a 36% lower rate of lymph node spread than nonusers (95% confidence interval [CI] =(8%,58%)). This can be contrasted with the effect of HRT on the tumor growth rate, estimated here to be 15% slower in HRT users (95% CI = (-34%,+7%)). For screen-detected cancers, we illustrate how lead time can relate to lymph node spread; and using symptomatic cancers, we illustrate the potential consequences of false negative screens in terms of lymph nodespread.

Accuracy of digital mammography, ultrasound and MRI in predicting the pathological complete response and residual tumor size of breast cancer after completion of neoadjuvant chemotherapy.

Neoadjuvant chemotherapy (NACT) is the standard of care for the treatment of locally advanced or non-metastatic breast cancer, which may increase the chances of breast conservative surgery (BCS) in place of radical mastectomy without compromising on the overall survival. The aim of this study was to evaluate the accuracy of mammography (MG), ultrasound (US), and magnetic resonance imaging (MRI) in predicting the complete response and to assess the extent of residual breast cancer in women treated with NACT. Fifty-six consecutive patients with stage II or III breast cancer, who underwent imaging evaluation of breast with digital mammogram, US, and MRI after NACT and before the breast surgery, were included in the study. For each patient, pathologic complete response (pCR) or residual tumor (non-pCR) was predicted and the maximum extent of the residual tumor was measured on each imaging modality. These measurements were subsequently compared with the final histopathology results. Of 56 patients, 22 showed pCR with MRI having better accuracy for predicting complete response than the MG and US (area under the receiver operating characteristic curve: 0.86, 0.68, and 0.65, respectively; p = 0.0001 for MRI; p = 0.06 for MG, and p = 0.02 for US). The sensitivity of MRI for detecting pCR was 72.7%; specificity and positive predictive value were 100%. For pathological residual tumor, the size measured on MRI showed significantly higher correlation with the pathologic size (correlation coefficient, r = 0.786), than the MG (r = 0.293) and US (r = 0.508) with P < 0.05. Accuracy of MRI for predicting pathological complete response was significantly higher than the MG and US. Pathologic residual tumor size was also more precisely reflected by the longest tumor dimension on MRI with the strong positive correlation coefficient.

Evaluation of Post-Neoadjuvant Chemotherapy Pathologic Complete Response and Residual Tumor Size of Breast Cancer: Analysis on Accuracy of MRI and Affecting Factors

목적신보강화학요법을 시행한 유방암 환자에서 병리학적 관해와 잔류 암의 크기를 평가하는 데 있어 유방자기공명영상의 정확도를 분석하고 이에 영향을 미치는 인자들이 무엇인지 알아본다.대상과 방법2010년부터 2017년까지 본원에서 신보강화학요법 후 수술을 시행한 88명의 유방암 환자를 대상으로 하였다. 병리학적 관해는 수술 병리 결과에서 침윤성 유방암이 발견되지 않는 것으로 정의하였고 자기공명영상과 병리 조직의 잔류 암 크기 차이는 최대 직경으로 비교하였다. 병리학적 관해 및 자기공명영상과 병리 조직에서의 잔류 암 크기 차이에 영향을 미치는 인자를 알아보기 위해 통계분석을 시행하였다.결과전체 환자의 10%가 병리학적 관해에 도달하였다. 자기공명영상으로 관해를 예측할 때의 정확도와 곡선하부면적은 각각 90.91%, 0.8017이었다. 신보강화학요법 시행 후 유방자기공명영상과 병리 조직에서 측정한 잔류 암의 크기는 매우 강한 연관성을 보였고(r = 0.9, p < 0.001), 특히 영상에서 단일 종괴로 보였던 병변에서(p = 0.047) 그러하였다. 자기공명영상과 병리 조직 간의 잔류 암 크기는 내강형(p = 0.023), 그리고 자기공명영상에서 다초점 종괴 및 비종괴성 조영증강을 보인(p = 0.047) 환자군에서 유의미하게 큰 차이를 보였다.결론자기공명영상은 유방암의 병리학적 완전 관해와 잔류 암 크기의 평가에 있어서 정확도가 높은 검사이다. 유방암 아형과 병변의 영상의학적 소견이 자기공명영상의 정확도에 영향을 미친다.

Comparison of ER, PR and HER-2/NEU reactivity pattern with histological grade, type, tumour size, Lymphovascular invasion, mitotic index and lymph node status in breast cancer

Context: Breast cancer prognosis is related to a variety of clinical, pathologic and molecular features which include classical prognostic factors viz. Histological grade, morphological type, tumour size, mitotic index, Lymphovascular invasion and lymph node metastases. Estrogen and progesterone receptors (ER, PR) and more recently, HER-2/neu have with increasing importance influenced the management of the malignancy. The presence of hormone receptors (ER and PR) in the tumour tissue correlates well with the response to hormone therapy and chemotherapy. Aims: To assess ER, PR and Her2neu status in breast cancer and to compare ER, PR and Her2neu status with other prognostic factors like tumour size, pathological type, histological grade, lymph node status, mitotic index and Lymphovascular invasion in breast cancer. Methods and materials: A total of 100 cases of breast cancer reported at pathology department during a period from January 2019 to August 2020 are enrolled in the study. Representative sections with tumour and the adjacent normal breast tissue (internal control) are processed for ER, PR and HER-2/neu immuno-histochemical staining. Tumour size, morphological type, Histological grading, Mitotic index, Lymphovascular invasion, Lymph Node status were studied. Results: Occurrence of breast carcinoma is higher in older women (> 50 years of age). The prevalence of ER, PR, HER-2/neu expression are high (ER-73.0%, PR - 65.0% and HER-2/neu - 28.0%). About 14.0% tumour are triple negative. Increased HER2/neu positivity is noticed in ER and PR negative tumours. Two third (66.0%) tumour’s size is from 2 to 5 cm. Proportion of Grade II (39.0%) and Grade III tumour (37.0%) are high. Most common pathologic type of carcinoma is Infiltrating duct carcinoma, not otherwise specified (85.0%) followed by Mucinous carcinoma (5.0%), Invasive papillary carcinoma (4.0%) and Invasive lobular carcinoma (2.0%). PR positivity is increased with increasing tumour size. (p value = 0.01). PR positivity decreases with the increase in grade. (p value = 0.03). HER/ 2neu expression decreased with rising age. (p value = 0.03). Conclusion: The findings suggest that women in our population more often have histologically less aggressive breast carcinoma with a smaller number of triple negative tumours (14%), so they are likely to be more susceptible to conventional hormonal and targeted antibody treatment.

A Novel Biosignature to Assess Residual Risk in Early Stage Invasive Breast Cancer after Standard Breast Conserving Surgery

Despite continually improving outcomes for women diagnosed with early stage breast cancer, there is an unmet need to identify those with elevated risk after standard treatment for whom enhanced treatment strategies should be considered. A poor response-type (RSt) signature has been assessed in women treated with breast conserving surgery. This study includes patients from two separate hospitals in Sweden diagnosed with early stage breast cancer (tumor size 20 mm or less) and treated with breast conserving therapy between 1987 and 2004. Women with positive margins, lymph node metastases, or those treated with mastectomy or chemotherapy were excluded. The RSt biosignature was calculated using biomarkers (ER, p16/INK4A, Ki-67, COX-2, PgR, HER2, FOXA1, SIAH2) scored by board certified pathologists in a CLIA certified laboratory. Pathology and clinical data were collected from medical records. There were 284 eligible patients with biomarker data and 102 received hormone therapy. Multivariate Cox proportional hazards and survival analysis were used to assess cumulative incidence risk differences, hazard ratios, and 10-year risks. Women with a poor RSt remained at particularly elevated risk after treatment with breast conserving surgery and radiation therapy with a 17% 10-yr risk and HR = 3.7 (95%CI 2.0-7.10), p<0.00001 (Table 1). The distribution of size and grade were similar for good versus poor RSt. Patients with a poor RSt had an elevated risk of disease-specific death; HR = 2.9 (95%CI 1.3-6.7), p = 0.01. A novel biosignature identified women diagnosed with early stage invasive breast cancer with a low risk and a poor RSt. Women with a poor RSt remained at particularly elevated risk even after RT, and thus enhanced treatment strategies should be considered for these women.Abstract 2041; TableRSt GroupPatientsEvents10-Year Event Risk (95% CI)Local Regional Events10-Year Specific Death (95% CI)Breast Cancer DeathsLow Risk16574% (1-8)52% (0-5)2Poor RSt681117% (7-25)513% (5-21)9 Open table in a new tab