scholarly journals Inflammatory breast cancer: Where are we now?

2003 ◽  
Vol 11 (3) ◽  
pp. 143-144
Author(s):  
Sladjana Filipovic
Keyword(s):  
Breast Cancer ◽  
Inflammatory Breast Cancer ◽  
Combined Modality Therapy ◽  
Survival Rates ◽  
Distant Metastases ◽  
Axillary Node ◽  
High Rate ◽  
Breast Cancers ◽  
Term Survival ◽  
Palpable Mass

Inflammatory breast cancer is perhaps the most aggressive form of breast neoplasm, with a poor prognosis. Clinically, inflammatory breast cancer is characterized by erythema and edema of the skin of the breast, called "peau d`orange", with or without an associated palpable mass. This form represents 1% to 6% (doubled during the past two decades) of all newly diagnosed breast malignancies and is often considered together with local advanced breast cancer, despite specific differential features. The reported 5-year survival rates range from 10% to 75%. On mammography, a diffuse increase in density and skin thickening may be present. Pathologic confirmation of invasion of dermal lymphatics by malignant cells can help distinguish this condition from benign mastitis. Most inflammatory breast cancers are on biopsy poorly differentiated ductal carcinomas, mainly estrogen and progesterone receptor negative. HER2/neu-overexpression and p53 gene mutations are frequently present. The probability of axillary node involvement is approximately 90%. Contralateral breast cancer develops in 25% to 50% of the patients, usually in the presence of metastases. Inflammatory breast cancer has a high rate of locoregional recurrence after surgery and/or radiotherapy and the rapid appearance of distant metastases. However, long-term survival is possible for these patients if treated with multimodality therapy including polychemotherapy, mastectomy, and loco-regional radiotherapy. The optimal sequencing of combined modality therapy has not been determined. Although not all patients are candidates for such a regimen (often due to progression during treatment), for those that complete all phases of therapy, more than one-third will be alive without disease at 10 years.

Prognosis of early-onset breast cancer based on BRCA1/2 mutation status in a French population-based cohort

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 591-591
Author(s):  
V. Bonadona ◽  
N. Voirin ◽  
O. Sinilnikova ◽  
H. Mignotte ◽  
A. Bremond ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Positive Impact ◽  
Brca1 Mutation ◽  
Survival Rates ◽  
Population Based ◽  
High Rate ◽  
French Population ◽  
Term Survival ◽  
Free Survival ◽  
Mutation Carriers

591 Background: The debate concerning poorer survival for patients with breast cancer (BC) carrying a BRCA1 germline mutation is unresolved, and requires additional data from population-based studies. Methods: We followed 232 women with invasive BC under age 46, ascertained prospectively through a French population-based BC registry, and tested for BRCA1/2 mutations (median follow-up: 82 months). We compared tumour characteristics and survival rates between 21 BRCA1/2 deleterious mutation carriers and 211 non-carriers. Results: As compared to sporadic tumours, BRCA1/2 tumours showed higher grade (p = 0.02), fewer ductal carcinoma in situ (p = 0.02), more frequent medullary histology (p = 0.02), more frequent negative oestrogen and progesterone receptors (p = 0.001 each). At five years, BC-specific survival, metastasis-free survival, ipsilateral recurrence-free survival and contralateral BC-free survival rates for BRCA1/2 mutation carriers were 95.0%, 94.7%, 100% and 90.0% respectively, compared with 89.6%, 78.2%, 88.8% and 94.4% respectively, for non-carriers (not significant). Rates for women carrying only a BRCA1 mutation were 93.3%, 93.3%, 100%, 86.7%, respectively. 76% of BRCA1/2 carriers received chemotherapy. Conclusions: Despite unfavourable tumour features, we found no evidence for poorer short-term survival in BRCA1 mutation carriers compared to non-carriers in this prospective population-based cohort. The high rate of BRCA1 carriers who received chemotherapy for their BC should question the positive impact of this treatment, as suggested by preclinical studies showing increased chemosensitivity of BRCA1-associated tumours. No significant financial relationships to disclose.

scholarly journals Therapeutic Strategies for Metastatic Triple-Negative Breast Cancers: From Negative to Positive

2021 ◽  
Vol 14 (5) ◽  
pp. 455
Author(s):  
Dey Nandini ◽  
Aske Jennifer ◽  
De Pradip
Keyword(s):  
Breast Cancer ◽  
Triple Negative ◽  
Checkpoint Inhibitors ◽  
Parp Inhibitor ◽  
Complex Form ◽  
High Rate ◽  
Breast Cancers ◽  
Antibody Drug Conjugate ◽  
Poor Overall Survival ◽  
Term Survival

Metastatic triple-negative breast cancer (TNBC) is a distinct and immensely complex form of breast cancer. Among all subtypes of breast cancers, TNBC has a comparatively high rate of relapse, a high rate of distant metastasis, and poor overall survival after standard chemotherapy. Chemotherapy regimens are an essential component of the management of this estrogen receptor-negative, progesterone receptor-negative, and epidermal growth factor receptor2 negative subtype of breast cancers. Chemotherapy is critical for preventing the recurrence of the disease and for achieving long-term survival. Currently, a couple of agents are approved for the management of this disease, including chemotherapy like eribulin, targeted therapy like PARP inhibitor, as well as an antibody-drug conjugate (ADC) to target TROP2. Like many other metastatic cancers, immune checkpoint inhibitors (ICIs) have also been approved for TNBC patients with PD-L1 positive tumors and high tumor mutational burden. In this review article, we discuss these newly approved and promising novel agents that may change the therapeutic landscape for advanced/metastatic TNBC patients.

scholarly journals Comparison of survival in non-metastatic inflammatory and other T4 breast cancers: a SEER population-based analysis

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Dechuang Jiao ◽  
Jingyang Zhang ◽  
Jiujun Zhu ◽  
Xuhui Guo ◽  
Yue Yang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cox Model ◽  
Survival Rates ◽  
Tumor Grade ◽  
Population Based ◽  
Rank Test ◽  
Breast Cancers ◽  
Significant Independent Predictor ◽  
Cancer Specific Survival ◽  
7Th Edition

Abstract Background Previous studies have reported poor survival rates in inflammatory breast cancer (IBC) patients than non-inflammatory local advanced breast cancer (non-IBC) patients. However, until now, the survival rate of IBC and other T4 non-IBC (T4-non-IBC) patients remains unexplored. Methods Surveillance, Epidemiology, and End Results (SEER) database was searched to identify cases with confirmed non-metastatic IBC and T4-non-IBC who had received surgery, chemotherapy, and radiotherapy between 2010 and 2015. IBC was defined as per the American Joint Committee on Cancer (AJCC) 7th edition. Breast Cancer-Specific Survival (BCSS) was estimated by plotting the Kaplan-Meier curve and compared across groups by using the log-rank test. Cox model was constructed to determine the association between IBC and BCSS after adjusting for age, race, stage of disease, tumor grade and surgery type. Results Out of a total of 1986 patients, 37.1% had IBC and mean age was 56.6 ± 12.4. After a median follow-up time of 28 months, 3-year BCSS rate for IBC and T4-non-IBC patients was 81.4 and 81.9%, respectively (log-rank p = 0.398). The 3-year BCSS rate in HR−/HER2+ cohort was higher for IBC patients than T4-non-IBC patients (89.5% vs. 80.8%; log-rank p = 0.028), and in HR−/HER2- cohort it was significantly lower for IBC patients than T4-non-IBC patients (57.4% vs. 67.5%; log-rank p = 0.010). However, it was identical between IBC and T4-non-IBC patients in both HR+/HER2- (85.0% vs. 85.3%; log-rank p = 0.567) and HR+/HER2+ (93.6% vs. 91.0%, log-rank p = 0.510) cohorts. After adjusting for potential confounding variables, we observed that IBC is a significant independent predictor for survival of HR−/HER2+ cohort (hazards ratio [HR] = 0.442; 95% CI: 0.216–0.902; P = 0.025) and HR−/HER2- cohort (HR = 1.738; 95% CI: 1.192–2.534; P = 0.004). Conclusions Patients with IBC and T4-non-IBC had a similar BCSS in the era of modern systemic treatment. In IBC patients, the HR−/HER2+ subtype is associated with a better outcome, and HR−/HER2- subtype is associated with poorer outcomes as compared to the T4-non-IBC patients.

scholarly journals Breast Cancer Survival in the Mammography Era in Brazil: A Population-Based Analysis of 2,715 Cases

2021 ◽  
Author(s):  
Juliana Fernandes ◽  
Beatriz Machado ◽  
Cassio Cardoso-Filho ◽  
Juliana Nativio ◽  
Cesar Cabello ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Survival ◽  
Survival Rates ◽  
Population Based ◽  
Breast Cancer Survival ◽  
Stage I ◽  
Current Status ◽  
Breast Cancers ◽  
Risk Of Death ◽  
Significant Difference

Abstract Background This study aims to assess breast cancer survival rates after one decade of mammography in a large urban area of Brazil. Methods It is a population-based retrospective cohort of women with breast cancer in Campinas, São Paulo, from 2010 to 2014. Age, vital status and stage were accessed through the cancer and mortality registry, and patients records. Statistics used Kaplan-Meier, log-rank and Cox's regression. Results Out of the 2,715 cases, 665 deaths (24.5%) were confirmed until early 2020. The mean age at diagnosis was 58.6 years. Women 50-69 years were 48.0%, and stage I the most frequent (25.0%). The overall mean survival was 8.4 years (8.2-8.5). The 5-year survival (5yOS) for overall, 40-49, 50-59, 60-69, 70-79 years was respectively 80.5%, 87.7%, 83.7%, 83.8% and 75.5%. The 5yOS for stages 0, I, II, III and IV was 95.2%, 92.6%, 89.4%, 71.1% and 47.1%. There was no significant difference in survival in stage I or II (p=0.058). Compared to women 50-59 years, death's risk was 2.3 times higher for women 70-79 years and 26% lower for women 40-49 years. Concerning stage I, the risk of death was 1.5, 4.1 and 8.6 times higher, and 34% lower, respectively, for stage II, III, IV and 0. Conclusions In Brazil, breast cancers are currently diagnosed in the early stages, although advanced cases persist. Survival rates may reflect improvements in screening, early detection and treatment. The results can reflect the current status of other regions or countries with similar health care conditions.

scholarly journals Targeting Signaling Pathways in Inflammatory Breast Cancer

Cancers ◽  
2020 ◽  
Vol 12 (9) ◽  
pp. 2479
Author(s):  
Xiaoping Wang ◽  
Takashi Semba ◽  
Lan Thi Hanh Phi ◽  
Sudpreeda Chainitikun ◽  
Toshiaki Iwase ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Signaling Pathways ◽  
Inflammatory Breast Cancer ◽  
Poor Prognosis ◽  
High Rate ◽  
Novel Therapies ◽  
Biological Functions ◽  
Novel Targets ◽  
Preclinical And Clinical Studies ◽  
Related Mortality

Inflammatory breast cancer (IBC), although rare, is the most aggressive type of breast cancer. Only 2–4% of breast cancer cases are classified as IBC, but—owing to its high rate of metastasis and poor prognosis—8% to 10% of breast cancer-related mortality occur in patients with IBC. Currently, IBC-specific targeted therapies are not available, and there is a critical need for novel therapies derived via understanding novel targets. In this review, we summarize the biological functions of critical signaling pathways in the progression of IBC and the preclinical and clinical studies of targeting these pathways in IBC. We also discuss studies of crosstalk between several signaling pathways and the IBC tumor microenvironment.

p53 and bcl-2 expression correlates with clinical outcome in a series of node-positive breast cancer patients.

1996 ◽  
Vol 14 (5) ◽  
pp. 1604-1610 ◽  
Author(s):  
R Silvestrini ◽  
E Benini ◽  
S Veneroni ◽  
M G Daidone ◽  
G Tomasic ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Clinical Outcome ◽  
Mitochondrial Protein ◽  
Axillary Node ◽  
Breast Cancers ◽  
Breast Cancer Patients ◽  
Prognostic Information ◽  
P53 Overexpression ◽  
P53 Expression ◽  
Node Positive

BACKGROUND AND PURPOSE The tumor-suppressor gene TP53 and the proto-oncogene bcl-2 encode, respectively, for a nuclear phosphoprotein and for a mitochondrial protein involved in multiple cellular functions. The proteins provide prognostic information in node-negative breast cancer and are supposed to influence treatment responsiveness. We analyzed the predictive role of p53 and bcl-2 expression, alone and in association with other variables, in postmenopausal women with node-positive, estrogen receptor-positive (ER+) breast cancers treated with radical or conservative surgery plus radiotherapy and adjuvant tamoxifen for at least 1 year. PATIENTS AND METHODS On 240 resectable cancers, we determined the expression of p53 and bcl-2, using immunohistochemistry, cell proliferation (3H-thymidine labeling index [3H-dT LI]), and ER and progesterone receptors (PgR). RESULTS p53 expression and 3H-dT LI were weakly related to one another and both were unrelated to bcl-2. Relapse-free and distant metastasis-free survival at 5 years were significantly lower for patients with tumors that highly expressed p53 (P = .0001) and for those that weakly expressed or did not express bcl-2 (P = .02). However, p53, but not bcl-2, provided prognostic information independent of tumor size, axillary node involvement, steroid receptors, and 3H-dT LI. Moreover, the simultaneous p53 overexpression and lack of PgR identified patients at maximum risk of relapse, whereas bcl-2 overexpression, associated with a low 3H-dT LI or the presence of PgR, improved the prognostic resolution for low-risk patients. CONCLUSION p53 expression appears to be indicative of clinical outcome in postmenopausal patients treated with tamoxifen. Whether p53 overexpression and weak bcl-2 expression are indicators of biologic aggressiveness, regardless of treatment, or of hormone resistance remains to be defined.

Inflammatory breast cancer: a review.

1992 ◽  
Vol 10 (6) ◽  
pp. 1014-1024 ◽  
Author(s):  
I A Jaiyesimi ◽  
A U Buzdar ◽  
G Hortobagyi
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Natural History ◽  
Inflammatory Breast Cancer ◽  
Survival Rates ◽  
Autologous Bone Marrow ◽  
High Dose ◽  
Combined Modality ◽  
History Of ◽  
Disease Free

PURPOSE The natural history of inflammatory breast cancer and the recent advances in its management were reviewed. DESIGN The English medical literature from 1924 to 1990 was reviewed using the Cancerline and Medline retrieval systems, and through a manual review of bibliographies of identified articles. RESULTS The majority of patients with inflammatory breast cancer treated only with local therapies died 18 to 24 months after diagnosis. A combined modality approach with chemotherapy, surgery, and radiation therapy has improved disease-free and overall survival rates for inflammatory breast cancer. Approximately 35% to 55% of patients treated with combined modality regimens remain disease-free and alive at 5 years. CONCLUSION Induction combination chemotherapy administered with radiation therapy, mastectomy, both, or with additional chemotherapy favorably alters the natural history of inflammatory breast cancer. New drug combinations and high-dose chemotherapy with autologous bone marrow support are being evaluated to improve further patient survival.

scholarly journals Salvage radiotherapy for second oligo-recurrence in patients with breast cancer

2017 ◽  
Vol 59 (1) ◽  
pp. 58-66 ◽  
Author(s):  
Mari Miyata ◽  
Takayuki Ohguri ◽  
Katsuya Yahara ◽  
Shinsaku Yamaguchi ◽  
Hajime Imada ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Objective Response ◽  
Local Therapy ◽  
Progression Free Survival ◽  
Late Toxicity ◽  
Distant Metastases ◽  
Salvage Radiotherapy ◽  
Severe Toxicity ◽  
Term Survival ◽  
Grade 3

Abstract A new concept designated ‘oligo-recurrence (OR)’ has been proposed, which indicates one to several distant metastases/recurrences in one or more organs, which can be treated with local therapy, after the primary site of the cancer has been controlled. The purpose of this study was to assess the efficacy and toxicity of salvage radiotherapy (RT) for the second OR of breast cancer. The second OR was defined as once-salvaged patients with OR who had a second failure that was also detected as the state of OR. Twenty-one patients with second OR were treated with salvage RT and were retrospectively analyzed. The sites of the second OR were locoregional recurrence in 7 patients and distant metastasis in 14 patients. Salvage RT was performed at a median total dose of 60 Gy. Nineteen (90%) patients had an objective response. The median overall survival and progression-free survival (PFS) times were 41 and 24 months after salvage RT for the second OR, respectively. The 3-year local (in-field) control (LC) rates were 93%. The toxicities were mild; acute toxicities ≥Grade 3 were seen in one patient with Grade 3 dermatitis, and no late toxicity ≥Grade 2 was observed. In conclusion, salvage RT for the second OR was able to achieve a better LC rate and longer PFS time without inducing severe toxicity, and therefore may be a potentially effective modality for inducing long-term survival in select patients.

scholarly journals Low-dose aspirin confers a survival benefit in patients with pathological advanced-stage oral squamous cell carcinoma

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sheng-Dean Luo ◽  
Shao-Chun Wu ◽  
Wei-Chih Chen ◽  
Ching-Nung Wu ◽  
Tai-Jan Chiu ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Oral Squamous Cell Carcinoma ◽  
Oral Cavity ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Cox Regression ◽  
Survival Rates ◽  
Distant Metastases ◽  
Good Prognosis ◽  
High Rate

AbstractOral squamous cell carcinoma (OSCC) remains one of the most challenging clinical problems in the field due to its high rate of locoregional and distant metastases. However, studies that assess the association between aspirin use and survival in patients with OSCC are limited. Moreover, patients that recruited from those studies might have tumors that arose from different anatomic regions of the head and neck, including the oral cavity, oropharynx, etc. Since tumors within these distinct anatomic regions are unique in the context of epidemiology and tumor progression, we sought to evaluate the association of aspirin use with squamous cell carcinomas located within the oral cavity only. In this 10-year cohort study, we evaluated aspirin use and survival rates in relation to clinical characteristics as well as duration of aspirin use in patients with OSCC. Our findings suggest that OSCC patients with aspirin use for more than 180 days showed improved overall and disease-specific survival rates. Aspirin also improves survival in patients across various stages of OSCC. Cox regression models indicated that aspirin use was associated with a good prognosis. In conclusion, this evidence indicates that aspirin may be potentially used as an adjuvant therapy for OSCC.

scholarly journals Prognostic factors and survival in endocrine tumor patients: comparison between gastrointestinal and pancreatic localization

2005 ◽  
Vol 12 (4) ◽  
pp. 1083-1092 ◽  
Author(s):  
Francesco Panzuto ◽  
Silvia Nasoni ◽  
Massimo Falconi ◽  
Vito Domenico Corleto ◽  
Gabriele Capurso ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Primary Tumor ◽  
Rate Ratio ◽  
Survival Rates ◽  
Hepatic Metastases ◽  
Distant Metastases ◽  
Endocrine Tumors ◽  
Term Survival ◽  
Pancreatic Endocrine Tumors ◽  
Degree Of Differentiation

Since gastro-entero-pancreatic endocrine tumors are rare and heterogeneous diseases, their prognosis and long-term survival are not well known. This study aimed at identifying prognostic factors and assessing long-term survival in gastro-entero-pancreatic endocrine tumors. A total of 156 patients enrolled. Prognostic factors were determined by univariate/multivariate analysis; survival rates were assessed by the Kaplan–Meier method. The tumors were non-functioning in 59.6% of patients, and originated from the pancreas in 42.9%. At diagnosis, 64.3% of patients had metastases. The tumors were well differentiated in 89.6% of patients. Ki67 was >2% in 39.6% of patients. Primary tumor size was >3 cm in 49.6% of cases studied. For the univariate analysis, the negative prognostic factors were: pancreatic origin (rate ratio 4.64, P = 0.0002), poorly differentiated tumor (rate ratio 7.70, P = 0.0001), primary tumor size >3 cm (rate ratio 4.26, P = 0.0009), presence of distant metastases (liver: rate ratio 5.88, P = 0.01; distant extra-hepatic: rate ratio 13.41, P = 0.0008). The pancreatic site, the poor degree of differentiation and the distant metastases were confirmed as negative prognostic factors at multivariate analysis. Overall 5-year survival rate was 77.5%. Survival rates differed according to: primary tumor site (62% for pancreatic vs 89.9% for gastrointestinal tract, P = 0.0001) and size (65.7% for >3 cm vs 88.8% for ≤ 3 cm, P = 0.0003), degree of differentiation (22% for poor vs 86.8% for good, P<0.0001), Ki67 (53.5% for > 2% vs 90.1% for ≤ 2%, P = 0.003), metastases (96.1, 77, 73.3 and 50.1% for absent, local, liver and distant extra-hepatic metastases respectively), age at diagnosis (85.3% for ≤ 50 years vs 70.3% for > 50 years, P = 0.03). Although 64.3% of gastro-entero-pancreatic endocrine tumors present metastases at diagnosis, the 5-year survival rate is 77.5%. Pancreatic site, a poor degree of tumor cell differentiation and distant extra-hepatic metastases are the major negative prognostic factors.

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