Effect of Cognitive-Existential Group Therapy on Survival in Early-Stage Breast Cancer

2004 ◽  
Vol 22 (21) ◽  
pp. 4255-4260 ◽  
Author(s):  
David W. Kissane ◽  
Anthony Love ◽  
Allison Hatton ◽  
Sidney Bloch ◽  
Graeme Smith ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Adjuvant Chemotherapy ◽  
Group Therapy ◽  
Axillary Lymph Node ◽  
Early Stage ◽  
Hazard Ratio ◽  
Early Stage Breast Cancer ◽  
Lymph Node Status ◽  
Axillary Lymph

Purpose Cognitive-existential group therapy (CEGT) was developed to improve mood and mental attitude toward cancer in women with early-stage breast cancer receiving adjuvant chemotherapy. Given the debate about group therapy's association with increased survival in women with metastatic breast cancer, we were curious to check its effect at a much earlier stage in the cancer journey. Patients and Methods We randomly assigned 303 women with early-stage breast cancer who were receiving adjuvant chemotherapy to either 20 sessions of weekly group therapy plus three relaxation classes (n = 154) or to a control condition of three relaxation classes alone (n = 149). The primary outcome was survival. Results CEGT did not extend survival; the median survival time was 81.9 months (95% CI, 64.8 to 99.0 months) in the group-therapy women and 85.5 months (95% CI, 67.5 to 103.6 months) in the control arm. The hazard ratio for death was 1.35 (95% CI, 0.76 to 2.39; P = .31). In contrast, histology and axillary lymph node status were significant predictors of survival. Low-grade histology yielded a hazard ratio of 0.342 (95% CI, 0.17 to 0.69), and axillary lymph node–negative status yielded a hazard ratio of 0.397 (95% CI, 0.20 to 0.78). Conclusion CEGT does not prolong survival in women with early-stage breast cancer.

scholarly journals MicroRNA-1291 Is Associated With Locoregional Metastases in Patients With Early-Stage Breast Cancer

2020 ◽  
Vol 11 ◽  
Author(s):  
Daniel Escuin ◽  
Laura López-Vilaró ◽  
Olga Bell ◽  
Josefina Mora ◽  
Antonio Moral ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Signaling Pathways ◽  
Axillary Lymph Node ◽  
Target Genes ◽  
Early Stage ◽  
Early Stage Breast Cancer ◽  
Axillary Lymph ◽  
Illumina Platform ◽  
Down Regulation

Evidence that microRNAs (miRNAs) regulate the various steps of metastasis is increasing. Several studies have looked at the miRNA expression profile in primary breast tumors but few have compared primary tumor and sentinel lymph node (SLN) metastasis. We correlated the expression of miRNAs with the SLN status and the outcome of axillary lymph node dissection (ALND) in 60 patients with early breast cancer. We profiled the expression of miRNAs in paired breast tumor samples and SLNs using the NextSeq500 Illumina platform and key findings were validated by qPCR. MultiMiR Bioconductor and Reactome pathways analysis were performed to identify target genes and signaling pathways affected by altered expressed miRNAs. Our results show that nine miRNAs were differentially expressed in tumor tissues (q ≤ 0.05). In tumor samples, a 13.5-fold up-regulation of miR-7641-2 (q < 0.001) and a 2.9-fold down-regulation of miR-1291 (q < 0.001) were associated with tumors with positive SLNs. However, only down-regulation of miR-1291 (q = 0.048) remained significant in paired SLNs samples. Interestingly, a 10.5 up-regulation of miR-1291 in SLNs samples was associated with additional axillary lymph node involvement (q < 0.001). The enrichment analyses showed that canonical and non-canonical WNT pathways and negative regulation of various receptor tyrosine kinases signaling pathways were targets of miR-1291 and supports the role of miR-1291 as a tumor suppressor gene (TSG). Further studies are warranted to investigate the use of miR-1291 as a surrogate biomarker of SLN node metastasis in patients with early-stage breast cancer.

scholarly journals Trends in axillary lymph node dissection for early-stage breast cancer in Europe: Impact of evidence on practice

The Breast ◽  
2019 ◽  
Vol 45 ◽  
pp. 89-96 ◽  
Author(s):  
Carlos A. Garcia-Etienne ◽  
Robert E. Mansel ◽  
Mariano Tomatis ◽  
Joerg Heil ◽  
Laura Biganzoli ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Axillary Lymph Node Dissection ◽  
Lymph Node Dissection ◽  
Axillary Lymph Node ◽  
Early Stage ◽  
Early Stage Breast Cancer ◽  
Axillary Lymph ◽  
Node Dissection

Occult axillary lymph node metastases do not have prognostic significance in early stage breast cancer

Cancer ◽  
2011 ◽  
Vol 118 (6) ◽  
pp. 1507-1514 ◽  
Author(s):  
Yun Wu ◽  
Elizabeth A. Mittendorf ◽  
Canan Kelten ◽  
Susan L. Tucker ◽  
Wei Wei ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Lymph Node Metastases ◽  
Axillary Lymph Node ◽  
Early Stage ◽  
Prognostic Significance ◽  
Early Stage Breast Cancer ◽  
Axillary Lymph ◽  
Axillary Lymph Node Metastases ◽  
Node Metastases

Radiomics Model Based on Shear-Wave Elastography Can Predict the Axillary Lymph Node Status in Early-Stage Breast Cancer

2020 ◽  
Author(s):  
Meng Jiang ◽  
Chang-Li Li ◽  
Rui-Xue Chen ◽  
Shi-Chu Tang ◽  
Xiao-Mao Luo ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Shear Wave ◽  
Axillary Lymph Node ◽  
Validation Cohort ◽  
Early Stage ◽  
Shear Wave Elastography ◽  
Early Stage Breast Cancer ◽  
Axillary Lymph ◽  
Training Cohort

Abstract Background: Accurate prediction of axillary lymph node (ALN) involvement in early-stage breast cancer is important for determining appropriate axillary treatment and therefore avoiding unnecessary axillary surgery and complications. This study aimed to develop and validate an ultrasound radiomics nomogram for preoperative evaluation of the ALN burden. Methods: Data of 303 patients from Wuhan Tongji Hospital (training cohort) and 130 cases from Hunan Provincial Tumour Hospital (external validation cohort) between Jun 2016 and May 2019 were enrolled. Radiomic features were extracted from shear-wave elastography (SWE) and corresponding B-mode ultrasound (BMUS) images. Then, the minimum redundancy maximum relevance (MRMR) and least absolute shrinkage and selection operator (LASSO) algorithm were used to select ALN status-related features and construct the SWE and BMUS radiomic signatures. Proportional odds ordinal logistic regression was performed using the radiomic signature together with clinical data, and an ordinal nomogram was subsequently developed. We evaluated the performance of the nomogram using C-index, calibration, and compared it with clinical model.Results: Multivariate analysis indicated that SWE signature, US-reported LN status and molecular subtype were independent risk factors associated with ALN status. The radiomics nomogram based on these variables showed good calibration and discrimination in the training set (overall C-index: 0.842; 95%CI, 0.773–0.879) and the validation set (overall C-index: 0.822; 95%CI, 0.765–0.838). For discriminating between disease-free axilla (N0) and any axillary metastasis (N + (≥1)), it achieved C-index of 0.845 (95%CI, 0.777–0.914) for the training cohort and 0.817 (95%CI, 0.769–0.865) for the validation cohort. The tool could also discriminate between low (N + (1–2)) and heavy metastatic burden of ALN (N + (≥3)), with C-index of 0.827 (95%CI, 0.742–0.913) for the training cohort and 0.810 (95%CI, 0.755–0.864) for the validation cohort. Conclusions: The presented radiomics nomogram shows favourable predictive ability for ALN staging in patients with early-stage breast cancer, which could provide incremental information for preoperative decision-making.

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