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Surgery in metastasic breast cancer

Monika Brzezinska, Linda J Williams, Jeremy Thomas, J Michael Dixon
PURPOSE: Inflammatory breast cancer (IBC) is rare and associated with a poor prognosis. Following neoadjuvant chemotherapy or endocrine therapy, the multidisciplinary team selected a small number of patients for breast-conservation therapy (BCT). The aim of this study was to determine the outcome of IBC patients treated with BCT in Edinburgh. METHODS: Between January 1999 and December 2013, thirty-five women with IBC were treated by BCT. The median follow-up was 80 months...
October 18, 2016: Breast Cancer Research and Treatment
R P Piggott, P S Waters, M J Kerin
BACKGROUND: Tumour metastatic disease reflects a complex interplay between tumour characteristics and local host factors. This complex relationship may have an influence on the development of metastatic disease and patient survival. Multiple factors of the primary tumour influence the development of metastases and survival in patients. Breast cancer subtype has been shown to influence patient prognosis and response to therapy. AIM: The aim of our study was to correlate breast cancer subtype with bony metastatic disease and patient survival...
October 12, 2016: Irish Journal of Medical Science
Muhammet A Kaplan, Ulku Y Arslan, Abdurrahman Işıkdogan, Faysal Dane, Berna Oksuzoglu, Mevlude Inanc, Tulay Akman, Mehmet Kucukoner, Havva Y Cinkir, Rashad Rzazade, Metin Ozkan, Ugur Yilmaz, Ibrahim V Bayoglu, Yusuf Gunaydin, Meltem Baykara, Dogan Yazilitas, Erdem Cubukcu, Ali Suner, Ugur Ersoy, Mehmet Bilici, Ozan Yazici, Kerim Cayır, Umut Demirci, Mukremin Uysal
PURPOSE: The aim of the study was to investigate the association between the molecular subtypes and patterns of relapse in breast cancer patients who had undergone curative surgery. METHODS: We retrospectively evaluated 1,350 breast cancer patients with relapses after curative surgery between 1998 and 2012 from referral centers in Turkey. Patients were divided into 4 biological subtypes according to immunohistochemistry and grade: triple negative, HER2 overexpressing, luminal A and luminal B...
August 2016: Breast Care
Yihong Wang, Shaolei Lu, Theresa Graves, Madhu M Ouseph, Murray B Resnick, Evgeny Yakirevich
BACKGROUND: Papillary carcinoma (PC) of the breast represents ∼0.5% of all newly diagnosed cases of breast cancer and usually has an indolent course. The current data suggest lack of a consensus in the surgical management of this disease. Because patients can occasionally develop metastatic disease, sentinel lymph node (SLN) biopsy is often performed during surgery. MATERIALS AND METHODS: In the present study, we retrospectively evaluated the histologic characteristics of 99 cases of PC with or without associated frank invasive carcinoma, including 43 encapsulated or intracystic PCs, 24 solid PCs, and 32 intraductal PCs, and correlated these with the incidence of nodal metastasis...
September 8, 2016: Clinical Breast Cancer
Giancarlo D'Andrea, Lucia Palombi, Giuseppe Minniti, Alessandro Pesce, Paolo Marchetti
OBJECTIVE: Brain metastases occur between 10 and 40% of patients with cancer and are more common than primary brain tumors (30-40%) and their incidence is growing because of the improvements in control of systemic disease, the prolonged survival and the better radiological detection. Modern treatment of brain metastases dramatically changed their expected prognosis that traditionally has been considered very poor referring such patients only to palliation because their terminal stage, and new prognostic indexes have been proposed to evaluate them...
September 22, 2016: World Neurosurgery
Fabinshy Thangarajah, Wolfram Malter, Stefanie Hamacher, Matthias Schmidt, Stefan Krämer, Peter Mallmann, Verena Kirn
OBJECTIVES: Since the introduction of the sentinel node technique for breast cancer in the 1990s patient's morbidity was reduced. Tracer uptake is known to be dependent from lymph node integrity and activity of macrophages. The aim of this study was to assess whether radioactivity of the tracer can predict sentinel lymph node metastases. Furthermore, a potential association with Ki-67 index was examined. Non-invasive prediction of lymph node metastases could lead to a further decrease of morbidity...
September 22, 2016: Breast: Official Journal of the European Society of Mastology
Jing Liu, Stephen J Blake, Michelle C R Yong, Heidi Harjunpaa, Shin Foong Ngiow, Kazuyoshi Takeda, Arabella Young, Jake S O'Donnell, Stacey Allen, Mark J Smyth, Michele W L Teng
Immunotherapy has recently entered a renaissance phase with the approval of multiple agents for the treatment of cancer. Immunotherapy stands ready to join traditional modalities, including surgery, chemotherapy, radiation, and hormone therapy, as a pillar of cancer treatment. Although immunotherapy has begun to have success in advanced cancer treatment, its scheduling and efficacy with surgery to treat earlier stages of cancer and prevent distant metastases has not been systematically examined. Here, we have used two models of spontaneously metastatic breast cancers in mice, to illustrate the significantly greater therapeutic power of neoadjuvant, compared with adjuvant immunotherapies in the context of primary tumor resection...
September 23, 2016: Cancer Discovery
Irene L Wapnir, Shari Gelber, Stewart J Anderson, Eleftherios P Mamounas, André Robidoux, Miguel Martín, Johan W R Nortier, Charles E Geyer, Alexander H G Paterson, István Láng, Karen N Price, Alan S Coates, Richard D Gelber, Priya Rastogi, Meredith M Regan, Norman Wolmark, Stefan Aebi
BACKGROUND: Isolated locoregional recurrences (ILRRs) of breast cancer confer a significant risk for the development of distant metastasis. Management practices and second ILRR events in the Chemotherapy as Adjuvant for LOcally Recurrent breast cancer (CALOR) trial were investigated. METHODS: In this study, 162 patients with ILRR were randomly assigned to receive postoperative chemotherapy or no chemotherapy. Descriptive statistics characterize outcomes according to local therapy and the influence of hormone receptor status on subsequent recurrences...
September 23, 2016: Annals of Surgical Oncology
Ippei Fukada, Kazuhiro Araki, Kokoro Kobayashi, Tomoko Shibayama, Masaru Hatano, Shunji Takahashi, Takuji Iwase, Shinji Ohno, Yoshinori Ito
INTRODUCTION: Pulmonary tumor thrombotic microangiopathy (PTTM) is rare, cancer-related pulmonary complication leading to hypoxia, pulmonary hypertension, and heart failure. The standard treatment for PTTM is not established. However, imatinib, a tyrosine kinase inhibitor of the PDGF receptor, may cause regression of pulmonary hypertension and pulmonary artery remodeling in PTTM. CASE DESCRIPTIONS: We report two cases of PTTM who received an anti-PDGF agent of imatinib for PTTM developed during chemotherapy for metastatic breast cancer...
2016: SpringerPlus
Vyshak Alva Venur, José Pablo Leone
The discovery of various driver pathways and targeted small molecule agents/antibodies have revolutionized the management of metastatic breast cancer. Currently, the major targets of clinical utility in breast cancer include the human epidermal growth factor receptor 2 (HER2) and epidermal growth factor receptor (EGFR), vascular endothelial growth factor (VEGF) receptor, mechanistic target of rapamycin (mTOR) pathway, and the cyclin-dependent kinase 4/6 (CDK-4/6) pathway. Brain metastasis, however, remains a thorn in the flesh, leading to morbidity, neuro-cognitive decline, and interruptions in the management of systemic disease...
September 13, 2016: International Journal of Molecular Sciences
Fiorenza De Rose, Antonella Fogliata, Davide Franceschini, Piera Navarria, Elisa Villa, Cristina Iftode, Giuseppe D'Agostino, Luca Cozzi, Francesca Lobefalo, Pietro Mancosu, Stefano Tomatis, Marta Scorsetti
BACKGROUND: To report toxicity and early clinical outcomes of hypofractionated simultaneous integrated boost (SIB) approach with Volumetric Modulated Arc Therapy (VMAT) as adjuvant treatment after breast-conserving surgery. METHODS: Patients presenting early-stage breast cancer were enrolled in a phase II trial. ELIGIBILITY CRITERIA: age > 18 years old, invasive cancer or ductal carcinoma in situ (DCIS), Stage I-II (T < 3 cm and N ≤ 3), breast-conserving surgery without oncoplastic reconstruction...
September 17, 2016: Radiation Oncology
Yvonne Ying Ru Ng, Veronique Kiak Mien Tan, Terence Lin Hon Goh, Wei Sean Yong, Chow Yin Wong, Gay Hui Ho, Preetha Madhukumar, Kong Wee Ong, Yee Siang Ong, Yirong Sim, Bien Keem Tan, Benita Kiat Tee Tan
Post-mastectomy breast reconstruction is an integral component of breast cancer treatment. It is often perceived that women in Asian countries have a lower rate of post-mastectomy reconstruction than Western populations. This study describes trends in timing and types of breast reconstruction performed in the largest healthcare provider in Singapore, over a period of 12 years. It also reports on the oncological outcomes and surgical safety. A retrospective review of all patients who underwent post-mastectomy reconstruction from January 2001 to December 2012 at the National Cancer Centre Singapore and Singapore General Hospital was performed...
September 16, 2016: Breast Journal
Ippei Fukada, Kazuhiro Araki, Kokoro Kobayashi, Tomoko Shibayama, Shunji Takahashi, Rie Horii, Futoshi Akiyama, Takuji Iwase, Shinji Ohno, Kiyohiko Hatake, Yasuo Hozumi, Naohiro Sata, Yoshinori Ito
BACKGROUND: Pathological complete response (pCR) with neoadjuvant chemotherapy (NAC) has been regarded as a surrogate endpoint for disease-free survival (DFS) and overall survival (OS) of patients with breast cancer. No consensus regarding the definition of pCR has been established; there are several definitions according to a variety of classifications. Eradication of cancer cells in both breast and lymph nodes has been better associated with improved prognosis than in the breast alone...
2016: PloS One
Lei Lei, Xiaojia Wang, Zhanhong Chen
Monitoring recurrence and evaluating response to therapy are important aspects of clinical decision making in the treatment of breast cancer. In this literature review, the authors highlight several of the key areas where integrated fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) measurements are anticipated to have a significant impact on monitoring recurrence and evaluating response to therapy. These areas include comparing FDG PET/CT with conventional imaging for detecting breast cancer metastases; evaluating the role of FDG PET/CT in the presence of elevated tumor markers during follow-up period after the primary surgery; using FDG PET/CT to assess response to neoadjuvant chemotherapy (NAC), targeted and endocrine therapies; using FDG PET/CT to predict response to NAC according to different molecular phenotypes of breast cancer; and applying PET/CT and some new breast-related PET tracers to evaluate response to anticancer treatment...
March 2016: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
M Sakaguchi, T Maebayashi, T Aizawa, N Ishibashi, T Saito
AIM: Important factors typically associated with prognosis in brain metastases include Karnofsky performance status (KPS), extracranial or cerebellar localization and combination chemotherapy. However, few studies investigated the prognostic role of leptomeningeal metastases (LM) following whole brain radiotherapy (WBRT). On the basis of our experience suggesting better survival of asymptomatic patients with LM than those with brain metastases, we herein evaluated LM as a prognostic factor after WBRT...
September 13, 2016: Asia-Pacific Journal of Clinical Oncology
Sandra Casimiro, Arlindo R Ferreira, André Mansinho, Irina Alho, Luis Costa
Bone metastases ultimately result from a complex interaction between cancer cells and bone microenvironment. However, prior to the colonization of the bone, cancer cells must succeed through a series of steps that will allow them to detach from the primary tumor, enter into circulation, recognize and adhere to specific endothelium, and overcome dormancy. We now know that as important as the metastatic cascade, tumor cells prime the secondary organ microenvironment prior to their arrival, reflecting the existence of specific metastasis-initiating cells in the primary tumor and circulating osteotropic factors...
2016: International Journal of Molecular Sciences
Jai Min Ryu, Hyouk Jin Lee, Tae In Yoon, Eun Sook Lee, Soo Jung Lee, Jin Hyang Jung, Byung Joo Chae, Seok Jin Nam, Jeong Eon Lee, Se Kyung Lee, Soo Youn Bae, Jonghan Yu, Seok Won Kim
Tumor size and number of lymph node (LN) metastases are well known as the most important prognostic factors of breast cancer. We hypothesized that very small breast cancers with LN metastasis represent a progressive biologic behavior and evaluated tumor size stratified by LN metastasis. Data between 1990 and 2010 were obtained retrospectively from the Korean Breast Cancer Society Registry with inclusion criteria of female, non-metastatic, unilateral, and T1/2 breast cancer. We collected the following variables: age at surgery, tumor size, number of LN metastases, nuclear grade (NG), lymphovascular invasion (LVI), estrogen receptor status, progesterone receptor status, and epidermal growth factor receptor-2 status...
October 2016: Breast Cancer Research and Treatment
Xiang-Rong Zhao, Chao Gao, Yong Zhang, Lei Kong, Wei Qu, Jia Li, Yong-Sheng Gao, Yong-Hua Yu
BACKGROUND: The urachus is a vestigial tubular structure that connects the urinary bladder to the allantois during early embryonic development. Urachal carcinoma develops in the urachus, which is an embryological remnant of the urogenital sinus and allantois. The estimated annual incidence of urachal carcinoma in the general population is 0.01% of all cancers in adults. Moreover, urachal carcinoma accounts for 0.34% to 0.7% of all bladder carcinoma cases. And breast metastasis is extremely rarer...
August 2016: Medicine (Baltimore)
Samir Pathak, Sanjay Pandanaboyana, Ian Daniels, Neil Smart, K R Prasad
Colorectal cancer (CRC) is the third commonest malignancy after lung and breast cancer. The most common cause of mortality from CRC is from distant metastases. Obesity is a known risk factor for primary CRC development. However, its role in metastatic disease progression is not fully understood. The article aims to provide an overview of the role of obesity in colorectal liver metastases (CRLM). Furthermore, possible strategies to minimise this effect are discussed. An electronic search of MedLine, EMBASE, CINAHL and google scholar was performed...
September 2016: Surgical Oncology
Yasuhiro Tamaki
The one-step nucleic acid amplification (OSNA) assay was initially developed for the intraoperative assessment of sentinel lymph node metastases in breast cancer. This assay measures cytokeratin 19 (CK19) mRNA copy number and is widely used in hospitals. The results of the IBCSG 23-01, ACOSOG Z0011, and AMAROS trials demonstrated that no further axillary dissection is required for patients with sentinel lymph nodes that tested positive for cancer, which has led to a decreasing trend in the need for intraoperative assessment of lymph nodes...
August 22, 2016: International Journal of Clinical Oncology
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