scholarly journals Risk factors for distant metastasis of patients with primary triple-negative breast cancer

2019 ◽  
Vol 39 (6) ◽  
Author(s):  
Yi Yao ◽  
Yuxin Chu ◽  
Bin Xu ◽  
Qinyong Hu ◽  
Qibin Song
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Logistic Regression ◽  
Triple Negative Breast Cancer ◽  
Distant Metastasis ◽  
Tumor Size ◽  
Triple Negative ◽  
Clinical Stage ◽  
Multivariate Logistic Regression ◽  
Independent Risk Factors

AbstractObjective: Triple-negative breast cancer (TNBC) involves higher rates of recurrence and distant metastasis. The present study sought to characterize the risk factors for distant metastasis of TNBC.Methods: The Surveillance, Epidemiology, and End Results (SEER) database was exploited to enroll patients diagnosed with TNBC from 2010 to 2015. The eligible patients were dichotomized into locoregional and distant metastasis at the time of diagnosis. Patients’ demographics and tumor features, and treatment were evaluated to identify the risk factors for distant metastasis of primary TNBC. The categorical variables were examined by chi-square tests. Univariate and multivariate logistic regression analyses were used to determine the risk factors for distant metastasis. Breast cancer-specific survival (BCSS) and overall survival (OS) were estimated by Kaplan–Meier plots with log-rank tests.Results: We collected 26863 patients with primary TNBC, 1330 (5.0%) of them presented with distant metastasis. In the univariate analysis, all the variables indicated statistical significance. The significant variables were subsequently enlisted into the multivariate logistic regression analysis. Age > 50, higher clinical stage T and N, and tumor size > 5 cm were independent risk factors for distant metastasis of primary TNBC. Moreover, higher clinical stage T and stage N were independent risk factors for bone metastasis of the patients. TNBC patients with either bone or visceral metastasis have poor survival, with brain metastasis worst of all, though the OS difference was not statistically significant.Conclusions: TNBC patients with larger age, higher clinical stage, larger tumor size were more predisposed to have distant metastasis. Great attention should be paid to the prognosis of these patients with distant metastasis.

scholarly journals Reproductive and hormonal risk factors for postmenopausal luminal, HER-2-overexpressing, and triple-negative breast cancer

Cancer ◽  
2008 ◽  
Vol 113 (7) ◽  
pp. 1521-1526 ◽  
Author(s):  
Amanda I. Phipps ◽  
Kathleen E. Malone ◽  
Peggy L. Porter ◽  
Janet R. Daling ◽  
Christopher I. Li
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Triple Negative Breast Cancer ◽  
Triple Negative ◽  
Her 2

scholarly journals Locally Advanced Breast Cancer (LABC): Real-World Outcome of Patients From Cancer Institute, Chennai

2021 ◽  
pp. 767-781
Author(s):  
Manikandan Dhanushkodi ◽  
Velusamy Sridevi ◽  
Viswanathan Shanta ◽  
Ranganathan Rama ◽  
Rajaraman Swaminathan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Neoadjuvant Chemotherapy ◽  
Triple Negative Breast Cancer ◽  
Tumor Size ◽  
Triple Negative ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced

PURPOSE There are sparse data on the outcome of patients with locally advanced breast cancer (LABC). This report is on the prognostic factors and long-term outcome from Cancer Institute, Chennai. METHODS This is an analysis of untreated patients with LABC (stages IIIA-C) who were treated from January 2006 to December 2013. RESULTS Of the 4,577 patients with breast cancer who were treated, 2,137 patients (47%) with LABC were included for analysis. The median follow-up was 75 months (range, 1-170 months), and 2.3% (n = 49) were lost to follow-up at 5 years. The initial treatment was neoadjuvant concurrent chemoradiation (NACR) (77%), neoadjuvant chemotherapy (15%), or others (8%). Patients with triple-negative breast cancer had a pathologic complete response (PCR) of 41%. The 10-year overall survival was for stage IIIA (65.1%), stage IIIB (41.2%), and stage IIIC (26.7%). Recurrence of cancer was observed in 27% of patients (local 13% and distant 87%). Multivariate analysis showed that patients with a tumor size > 10 cm (hazard ratio [HR], 2.19; 95% CI, 1.62 to 2.98; P = .001), hormone receptor negativity (HR, 1.45; 95% CI, 1.22 to 1.72; P = .001), treatment modality (neoadjuvant chemotherapy, HR, 0.56; 95% CI, 0.43 to 0.73; P = .001), lack of PCR (HR, 2.36; 95% CI, 1.85 to 3.02; P = .001), and the presence of lymphovascular invasion (HR, 1.97; 95% CI, 1.60 to 2.44; P = .001) had decreased overall survival. CONCLUSION NACR was feasible in inoperable LABC and gave satisfactory long-term survival. PCR was significantly higher in patients with triple-negative breast cancer. The tumor size > 10 cm was significantly associated with inferior survival. However, this report acknowledges the limitations inherent in experience of management of LABC from a single center.

Risk Factors and Neurologic Outcomes in Patients With Traumatic Brain Injury and Coagulopathy Within 72 Hours Post-operatively

2021 ◽  
Author(s):  
Tao Chang ◽  
Xigang Yan ◽  
Chao Zhao ◽  
Yufu Zhang ◽  
Bao Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Traumatic Brain Injury ◽  
Logistic Regression ◽  
Brain Injury ◽  
Multivariate Logistic Regression ◽  
Neurologic Outcomes ◽  
Post Operative Period ◽  
Duration Of Surgery ◽  
Independent Risk Factors ◽  
Time Of Admission

Abstract Background There are few studies on the development and effect of coagulopathy in patients with a traumatic brain injury (TBI) during the early post-operative period. We determined the risk factors and neurologic outcomes of in patients with a TBI and coagulopathy diagnosed by routine laboratory tests within 72 hours post-operatively. Methods The baseline characteristics, intra-operative management, and follow-up results of 462 patients with TBIs were obtained and retrospectively analyzed by multivariate logistic regression from January 2015 to June 2019. Coagulopathy was defined as an activated partial thromboplastin time > 40 seconds, international normalized ratio >1.4, or a platelet count < 100×109 /L.Results Multivariate logistic regression analysis revealed that the Glasgow Coma Scale (GCS) at the time of admission, Injury Severity Score (ISS) at the time of admission, pupil mydriasis, duration of surgery, intra-operative blood loss, and intra-operative crystalloid resuscitation were independent risk factors for patients who developed a coagulopathy post-operatively. There were statistical differences in mortality (p = 0.049), the Glasgow Outcome Scale-Extended (GCS-E; p = 0.024), and the modified Rankin Scale (p = 0.043) between patients with and without coagulopathy 1 week after surgery. Coagulopathy within 72 h after surgery revealed a trend for higher mortality at 1 week (66.7%), 3 months (71.4%), and 6 months (76.2%). Furthermore, coagulopathy and contusion expansion in the early post-operative period were independent risk factors for TBI mortality after surgery. Intra-operative crystalloid resuscitation had a substantial diagnostic accuracy in predicting coagulopathy within 72 h post-operatively (area under the curve [AUC] = 0.972).Conclusion Coagulopathy within 72 h post-operatively in patients with a TBI predicted worse disease progression and unfavorable neurologic outcomes. Hence, we should take practical and reasonable measures to manage these risk factors, which may protect patients with a TBI from post-operative coagulopathy.

Middle Cerebral Artery-to-Uterine Artery Pulsatility Index Ratio Independently Predicts Adverse Perinatal Outcome in Pregnancies at Term

2020 ◽  
Author(s):  
Sufen Zhou ◽  
Hongyan Guo ◽  
Heng Liu ◽  
Mingqun Li
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Middle Cerebral Artery ◽  
Perinatal Outcome ◽  
Pulsatility Index ◽  
Uterine Artery ◽  
Regression Analyses ◽  
Multivariate Logistic Regression ◽  
Adverse Perinatal Outcome ◽  
Independent Risk Factors

Abstract Background: This study aimed to investigate potential predictors, including cerebroplacental ratio (CPR), middle cerebral artery (MCA)/uterine artery pulsatility index (PI) ratio, for adverse perinatal outcome in pregnancies at term.Methods: This was an observational, prospective study of recruited pregnancies at term. An adverse perinatal outcome was set as the primary observational endpoint. The receiver operating characteristic (ROC) curve was plotted to investigate the predictive and cut-off values of risk factors for adverse perinatal outcome. Independent risk factors (maternal, neonatal, prenatal ultrasound and Doppler variables) for adverse perinatal outcome were evaluated by the univariate and multivariate logistic regression analyses.Results: A total of 392 pregnancies at term were included and 19.4% of them had suffered adverse perinatal outcome. CPR (OR: 0.42, 95%CI: 0.20-0.93, P=0.032) and MCA/uterine artery PI ratio (OR: 0.25, 95%CI: 0.16-0.42, P=0.032) were two independent risk factors for adverse perinatal outcome by univariate and multivariate logistic regression analyses.Conclusions: MCA/uterine artery PI ratio is a good predictor of adverse perinatal outcome in pregnancies at term.

scholarly journals Clinicopathologic Features Predictive of Distant Metastasis in Patients Diagnosed With Invasive Breast Cancer

2020 ◽  
pp. 1346-1351
Author(s):  
Basim Ali ◽  
Fatima Mubarik ◽  
Nida Zahid ◽  
Abida K. Sattar
Keyword(s):  
Breast Cancer ◽  
Metastatic Disease ◽  
Invasive Breast Cancer ◽  
Distant Metastasis ◽  
Tumor Size ◽  
Clinical Stage ◽  
Stage Iv ◽  
Clinicopathologic Features ◽  
Pathologic Staging ◽  
Stage Iv Disease

PURPOSE National Comprehensive Cancer Network and European Society for Medical Oncology guidelines suggest screening for distant metastasis (M1) in symptomatic patients or those with locally advanced breast cancer. These guidelines are based on studies that often used pathologic staging for analysis. Physician variability in screening for M1 has also resulted in overuse of diagnostic tests. We sought to identify clinicopathologic features at diagnosis that could guide testing for metastatic disease. METHODS Patients diagnosed with invasive breast cancer between January 2014 and December 2015 were identified from our institutional database. Demographic and clinical variables were collected, including receptor profiles and clinical TNM staging. Rates of upstaging for each clinical stage and rates of concordance of pathologic and clinical staging were analyzed. Univariate analysis and multivariate regression analysis ( P < .05) identified predictors of upstaging to stage IV disease. RESULTS A total of 370 patients met the inclusion criteria. Seventy patients (18.9%) had metastatic disease at diagnosis. The rate of upstaging for stages I, IIA, IIB, and III were 0%, 5.6%, 18.8%, and 36.6%, respectively. Advancing clinical stage, tumor size, and nodal status resulted in a significantly higher rate ( P < .001) of upstaging to M1 disease. Age and hormone receptor status were not associated with upstaging to stage IV disease. Clinical stages I-III were concordant with pathologic staging in 65(42.8%) of 152 patients (kappa’s index, 0.197; P < .000). CONCLUSION Advancing clinical stage, tumor size, and nodal status at diagnosis were predictive of upstaging to M1 disease in patients with breast cancer. Distant metastatic workup should be considered in patients with clinical stage IIB disease or higher.

Does radiation therapy increase late cardiac death in patients with left breast cancer?

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 1127-1127
Author(s):  
Chi Lin ◽  
Kyle A. Denniston ◽  
Mary E. Charlton
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Logistic Regression ◽  
Radiation Therapy ◽  
Cardiac Death ◽  
Lower Risk ◽  
Logistic Regression Model ◽  
Left Breast ◽  
Multivariate Logistic Regression Model ◽  
Multivariate Logistic Regression

1127 Background: The objective of this study was to evaluate the effect of external beam radiation therapy (RT) on late cardiac death (CD) in patients with left breast cancer. Methods: A total of 529,246 patients who were diagnosed with adenocarcinoma of the breast between 1983 and 2004 and survived ≥ 5 years were identified from the SEER database. After excluding patients who were male, had right breast cancer, received brachytherapy or had missing data, 163,894 patients remained. Examined risk factors for CD include age (≤49/50-59/60-69/70-100), race (white/non-white), stage (In situ/local/regional/distant), breast subsite (nipple and areola/inner quadrant/outer quadrant), diagnosis year (1983-1993/1994-2004), surgery status (none/less than mastectomy/mastectomy) and RT. Time to CD was evaluated using the Kaplan-Meier method. A multivariate logistic regression model was used to evaluate factors associated with the use of RT and the Cox Proportional Hazards model was used to evaluate risk factors for CD. Results: A multivariate logistic regression model revealed that patients who received RT tended to be younger, white, more recently diagnosed, have inner quadrant and more advanced disease and undergo less than mastectomy. Median overall survival for patients with RT was significantly longer than those without RT (263 vs. 226 months, Log-Rank p < .0001). RT group had a lower risk of CD than no-RT group (Log-Rank p < .0001). Median time to CD was not reached in either group. The probability of CD was increased with increasing age and stage, and decreased with more recent diagnosis year and after mastectomy. Cox model found RT to be associated with lower probability of CD (HR 0.66, 95% CI 0.62-0.70), after adjusting for age, stage, surgery status and diagnosis year. Race and breast subsite were not associated with CD. Conclusions: Patients with left breast cancer who survived ≥ 5 years and received RT had a lower risk of cardiac death than those who did not. The cause of this difference is unclear but suggests influence from an uninvestigated factor, potentially the increased use of cardiotoxic chemotherapy or other cardiovascular comorbidity in those patients not receiving RT. Continued study, accounting for such factors, is warranted.

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