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neoadjuvant chemotherapy in breast cancer

Erik R Nelson, Shenduo Li, Margaret Kennedy, Sturgis Payne, Kelly Kilibarda, Jeffrey Groth, Michelle Bowie, Edgardo Parilla-Castellar, Gustaaf de Ridder, Paul Kelly Marcom, Matthew Lyes, Bercedis L Peterson, Michael Cook, Salvatore V Pizzo, Donald P McDonnell, Robin E Bachelder
BACKGROUND: Although most triple-negative breast cancer (TNBC) patients initially respond to chemotherapy, residual tumor cells frequently persist and drive recurrent tumor growth. Previous studies from our laboratory and others' indicate that TNBC is heterogeneous, being composed of chemo-sensitive and chemo-resistant tumor cell subpopulations. In the current work, we studied the invasive behaviors of chemo-resistant TNBC, and sought to identify markers of invasion in chemo-residual TNBC...
October 18, 2016: Oncotarget
W Liu, J B Li, T Wang, L Bian, S H Zhang, H Q Zhang, J M Zhou, S T Song, Z F Jiang
Objective: To analyze the predict values of pathologic complete response (pCR) rates for patient outcome according to breast cancer (BC) molecular subtypes. Methods: Four hundred and sixteen patients with confirmed BC who received neoadjuvant chemotherapy (NCT) in The Affiliated Hospital of Military Medical Science Academy of the PLA were enrolled.The clinical and pathological characteristics of patients were collected. The primary endpoint was pCR rate and the secondary endpoint was disease free survival (DFS)...
September 27, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
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
Yue Yu, Ning Cui, Heng-Yu Li, Yan-Mei Wu, Lu Xu, Min Fang, Yuan Sheng
BACKGROUND: To evaluate the accuracy of sentinel lymph node biopsy (SLNB) after neoadjuvant chemotherapy (NAC) in breast cancer patients with axillary lymph node (ALN) metastasis. METHODS: A total of 122 patients with operable breast cancer were enrolled in this single-center retrospective study. Eighty patients were clinically diagnosed with a positive axillary lymph node (ALN) via imaging or physical examination (including 66 patients with biopsy-proven metastasis)...
October 18, 2016: BMC Cancer
Hyejin Cheon, Hye Jung Kim, Sang-Woo Lee, Do-Hoon Kim, Chang-Hee Lee, Seung Hyun Cho, Kyung Min Shin, So Mi Lee, Gab Chul Kim, Won Hwa Kim
PURPOSE: To evaluate the prevalence of and factors associated with internal mammary node (IMN) adenopathy on MRI and PET/CT used for initial staging in patients with operable breast cancer. METHODS: A total of 1320 patients diagnosed with invasive breast carcinoma between January 2011 and December 2015 underwent MRI and PET/CT for initial staging. The patients were considered to have IMN adenopathy when MRI revealed IMNs with the longest diameter of 5 mm or greater and a standardized uptake value greater than that of the mediastinal blood pool/contralateral parasternal area on PET/CT...
October 17, 2016: Breast Cancer Research and Treatment
Yan Ma, Shuo Zhang, Jing Li, Jianyi Li, Ye Kang, Weidong Ren
OBJECTIVE: To compare the diagnostic performances of strain elastography (SE) and shear-wave elastography (SWE) for predicting response to neoadjuvant chemotherapy (NACT) in patients with breast cancer. METHODS: This prospective study recruited 71 eligible patients from June 2014 to May 2016. All patients provided written informed consent. Tumour stiffness was assessed by the SE strain ratio (R), SWE maximum elasticity (Emax) and SWE mean elasticity (Emean). Ultrasonic elastography (UE) assessments were performed at each NACT cycle (t1 - t6)...
October 17, 2016: European Radiology
Xiu Chen, Peng Lu, Dan-Dan Wang, Su-Jin Yang, Ying Wu, Hong-Yu Shen, Shan-Liang Zhong, Jian-Hua Zhao, Jin-Hai Tang
PURPOSE: Chemoresistance mediated by miRNAs in breast cancer have been already validated by previous studies in vitro, while little is known concerning the expression of them in vivo. The aim of this study was to investigate the role of miR-222, miR-29a, miR-34a, miR-130a, miR-90b, miR-200b, miR-452, miR-197, miR-138, miR-210, miR-423, miR-4298, miR-4644, miR-139, miR-1246, miR-1268a, miR-140, miR-149, miR-3178, miR-3613, miR-4258, miR-574, miR-671, miR-6780b, miR-7107, miR-744 and miR-7847 linked to drug resistance in breast cancer formalin-fixed paraffin-embedded tissues and the association of prognosis with miRNAs, thus providing effective targets in chemotherapy, as well as potential biomarkers for guiding effective treatments of breast cancer...
October 13, 2016: Gene
A Hennigs, F Riedel, F Marmé, P Sinn, K Lindel, A Gondos, K Smetanay, M Golatta, C Sohn, F Schuetz, J Heil, A Schneeweiss
BACKGROUND: During the last decade, neoadjuvant chemotherapy (NACT) of early breast cancer (EBC) evolved from a therapy intended to enable operability to a standard treatment option aiming for increasing cure rates equivalent to adjuvant chemotherapy (ACT). In parallel, improvements in the quality control of breast cancer care have been established in specialized breast care units. PATIENTS AND METHODS: This study analyzed chemotherapy usage in patients with EBC treated at the Heidelberg University Breast Unit between January 2003 and December 2014...
October 15, 2016: Breast Cancer Research and Treatment
Brittany L Bychkovsky, Don S Dizon, William M Sikov
Breast cancer is a heterogenous disease, comprised of at least 3 major subtypes: hormone receptor-positive/HER2-(HR+), HER2+, and HR-/HER2-(triple negative) breast cancers. The medical management of each subype is distinct. In this article, we review contemporary data supporting the use of chemotherapy, endocrine therapy and biologic therapies, especially HER2-directed agents, in the adjuvant and neoadjuvant setting in patients with newly diagnosed nonmetastatic (stage I-III) breast cancer.
October 12, 2016: Clinical Obstetrics and Gynecology
Tae Hee Kim, Joon-Kee Yoon, Doo Kyoung Kang, Seok Yun Kang, Yong Sik Jung, Sehwan Han, Ji Young Kim, Hyunee Yim, Young-Sil An
We evaluated the role of metabolic parameters in the prediction of disease recurrence in operable invasive ductal breast cancer patients treated with neoadjuvant chemotherapy (NAC).We retrospectively evaluated 139 female patients (mean age, 46.5 years; range: 27-72 years) with invasive ductal breast cancer, treated with NAC followed by surgery. All patients underwent F-fluorodeoxyglucose positron emission tomography/computed tomography and magnetic resonance imaging at baseline and after completion of NAC before surgery...
October 2016: Medicine (Baltimore)
Xiao-Shan Cao, Hui-Juan Li, Bin-Bin Cong, Xiao Sun, Peng-Fei Qiu, Yan-Bing Liu, Chun-Jian Wang, Yong-Sheng Wang
With the improvement of neoadjuvant chemotherapy (NAC), the proportion of pathological complete response (pCR) in the breast and axillary lymph node (ALN) is increasing. The evaluation of pCR does not include the status of internal mammary lymph node (IMLN). This study is to evaluate the roles of both axillary sentinel lymph node biopsy (ASLNB) and internal mammary sentinel lymph node biopsy (IM-SLNB) in breast cancer patients after NAC. There were 74 patients enrolled into this study. IM-SLNB was performed on patients with radioactive internal mammary sentinel lymph node (IM-SLN)...
October 12, 2016: Oncotarget
Jose Vila, Mediget Teshome, Susan L Tucker, Wendy A Woodward, Mariana Chavez-MacGregor, Kelly K Hunt, Elizabeth A Mittendorf
OBJECTIVE: The current study was undertaken to determine if the CPS+EG score could stratify patients with respect to local-regional recurrence (LRR). BACKGROUND: We previously defined and validated a novel breast cancer staging system incorporating the American Joint Committee on Cancer clinical stage (CS), final pathologic stage (PS), estrogen receptor status (E), and nuclear grade (G) (CPS+EG score). The score is associated with disease-specific survival outcomes in patients treated with neoadjuvant chemotherapy...
October 4, 2016: Annals of Surgery
Ismail Jatoi, John R Benson, Masakazu Toi
With the advent of sentinel lymph node biopsy, surgical methods for accurately staging the axilla in patients with early-stage breast cancer have become progressively less extensive, with formal axillary lymph node dissection confined to a dwindling group of patients. Although details of methods for sentinel lymph node biopsy have yet to be standardised, this technique is now widely practised and accepted as standard of care worldwide. In the past 5 years, attention has focused on minimisation of surgical morbidity by restricting further axillary surgery or considering radiotherapy in patients with a small tumour burden in their sentinel nodes...
October 2016: Lancet Oncology
Misun Choi, Yeon Hee Park, Jin Seok Ahn, Young-Hyuck Im, Seok Jin Nam, Soo Youn Cho, Eun Yoon Cho
PURPOSE: Several pathologic classification systems have been developed to evaluate tumor response after neoadjuvant chemotherapy (NAC) for breast cancer. We aimed to compare pathologic classification systems and to investigate prognostic factors and risk stratification according to molecular subtype in relation to survival. METHODS: We retrospectively evaluated pathologic response after NAC in 485 breast cancer patients by applying the National Surgical Adjuvant Breast and Bowel Project B18 trial (NSABP-B18), Miller and Payne system, Chevallier's classification, Sataloff's classification, residual cancer burden (RCB), residual disease in breast and nodes (RDBN), and clinical-pathologic stage + estrogen receptor status and grade staging system (CPS + EG)...
October 11, 2016: Breast Cancer Research and Treatment
Kyungmin Shin, Abigail S Caudle, Henry M Kuerer, Lumarie Santiago, Rosalind P Candelaria, Basak Dogan, Jessica Leung, Savitri Krishnamurthy, Wei Yang
OBJECTIVE: The purpose of this article is to describe the feasibility and safety of a multidisciplinary approach to imaging-guided axillary staging that facilitates personalized, less invasive surgical management of the axilla through targeted axillary dissection in patients with biopsy-proven nodal metastasis undergoing neoadjuvant chemotherapy. CONCLUSION: Axillary nodal status, critical in breast cancer staging, affects prognosis and treatment. As the paradigm shifts toward minimally invasive therapy, a clip marker is placed in the biopsied metastatic node for patients with N1-N2 disease undergoing neoadjuvant chemotherapy to facilitate targeted axillary dissection of the clipped node...
October 11, 2016: AJR. American Journal of Roentgenology
Yoon Yang Jung, Chang Lim Hyun, Min-Sun Jin, In Ae Park, Yul Ri Chung, Bobae Shim, Kyu Ho Lee, Han Suk Ryu
PURPOSE: There is no standard targeted therapy for the treatment of triple-negative breast cancer (TNBC). Therefore, its management heavily depends on adjuvant chemotherapy. Using core needle biopsy, this study evaluated the histological factors of TNBC predicting the response to chemotherapy. METHODS: One hundred forty-three TNBC patients who received single-regimen neoadjuvant chemotherapy (NAC) with the combination of doxorubicin, cyclophosphamide, and docetaxel were enrolled...
September 2016: Journal of Breast Cancer
Alba Fiorentino, Umberto Tebano, Ruggero Ruggieri, Francesco Ricchetti, Filippo Alongi
AIM: For simultaneous bilateral breast cancer (SBBC) treatment, conventional radiotherapy (RT) has a number of critical shortcomings. Thus, the usefulness of volumetric arc therapy (VMAT) for SBBC is undeniable. CASE REPORT: A 34-year-old woman with SBBC received neoadjuvant chemotherapy followed by breast-conserving surgery and bilateral lymph node dissection. Given the conservative surgery and the nodal involvement after neoadjuvant chemotherapy, bilateral adjuvant RT to the breasts and regional nodes with doses of 50 Gy in 25 fractions and a simultaneous integrated boost (SIB) of 60 Gy to the surgical bed was proposed...
September 27, 2016: Tumori
R Elsoueidi, C Gresham, L Michael, D Chaney, H Mourad
WHAT IS KNOWN AND OBJECTIVE: CASE DESCRIPTION: A 74-year-old female with achondroplastic dwarfism was diagnosed with ER-, BR- and HER2- breast cancer. No guideline currently exists to direct chemotherapy dosing in this population. She received neoadjuvant chemotherapy based on body surface area utilizing actual height and weight with dose-dense doxorubicin and cyclophosphamide followed by paclitaxel with the use of granulocyte colony-stimulating factor. Satisfactory clinical response and remission were achieved, and treatment proceeded without any significant toxicity or delays...
October 6, 2016: Journal of Clinical Pharmacy and Therapeutics
Moo Hyun Lee, So-Youn Jung, Sun Hee Kang, Eun Jin Song, In Hae Park, Sun-Young Kong, Young Mee Kwon, Keun Seok Lee, Han-Sung Kang, Eun Sook Lee
PURPOSE: This study evaluated the association of serum HER2 (sHER2) levels at diagnosis with clinicopathologic parameters and disease free survival (DFS) in operable breast cancer patients according to intrinsic subtype. METHODS: The sHER2 levels were measured using a chemiluminescence immunoassay. The HER2 status in all tumor tissues was determined by immunohistochemistry, and confirmed in equivocal cases by fluorescence in situ. RESULTS: There were 436 consecutive stage I-III breast cancer patients with sHER2 result at diagnosis between Nov 2004 and Dec 2011...
2016: PloS One
Jieqiong Liu, Kai Chen, Wen Jiang, Kai Mao, Shunrong Li, Min Ji Kim, Qiang Liu, Lisa K Jacobs
PURPOSE: To study the impact of hormone receptor (HR)- and human epidermal growth factor receptor 2 (HER2)-defined subtypes on survival of inflammatory breast cancer (IBC), and to determine whether sensitivity to neoadjuvant chemotherapy (NAC) varies with subtypes in a large IBC population. METHODS: We analyzed 593 IBCs with known HR/HER2 statuses between 2010 and 2011 from National Cancer Database. We compared pathologic complete response (pCR) rates among four molecular subtypes by Chi-square test...
October 4, 2016: Journal of Cancer Research and Clinical Oncology
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