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Pathological response in breast cancer

Caitlin Murphy, Andrea Muscat, David Ashley, Violet Mukaro, Linda West, Yang Liao, David Chisanga, Wei Shi, Ian Collins, Sally Baron-Hay, Sujata Patil, Geoffrey Lindeman, Mustafa Khasraw
BACKGROUND: This study evaluated the feasibility of achieving high response rates in stage II or III breast cancer by tailoring neoadjuvant therapy using clinical and histopathological features and the Oncotype DX Breast Recurrence Score. Genomic determinants of response and resistance were also explored. PATIENTS AND OUTCOME MEASURES: Fifty-one patients were enrolled. The primary cohort comprised 40 patients: 15 human epidermal growth factor receptor type 2 (HER2)-amplified; 15 triple-negative (TNBC); and ten hormone receptor (HR)-positive, HER2-non-amplified tumours; with recurrence scores ≥25...
2019: PloS One
Wedad M Hanna, Carlos Parra-Herran, Fang-I Lu, Elzbieta Slodkowska, Eileen Rakovitch, Sharon Nofech-Mozes
Ductal carcinoma in situ (DCIS) is a neoplastic proliferation of mammary ductal epithelial cells confined to the ductal-lobular system, and a non-obligate precursor of invasive disease. While there has been a significant increase in the diagnosis of DCIS in recent years due to uptake of mammography screening, there has been little change in the rate of invasive recurrence, indicating that a large proportion of patients diagnosed with DCIS will never develop invasive disease. The main issue for clinicians is how to reliably predict the prognosis of DCIS in order to individualize patient treatment, especially as treatment ranges from surveillance only, breast-conserving surgery only, to breast-conserving surgery plus radiotherapy and/or hormonal therapy, and mastectomy with or without radiotherapy...
February 13, 2019: Modern Pathology: An Official Journal of the United States and Canadian Academy of Pathology, Inc
Raúl García-Vázquez, Laurence A Marchat, Erika Ruíz-García, Horacio Astudillo-de la Vega, Abelardo Meneses-García, Claudia Arce-Salinas, Enrique Bargallo-Rocha, Ángeles Carlos-Reyes, José Sullivan López-González, Carlos Pérez-Plasencia, Rosalío Ramos-Payán, Maribel Aguilar-Medina, César López-Camarillo
Almost 55% to 80% of patients with breast cancer have an unfavorable pathological complete response to chemotherapy. MicroRNAs are small noncoding RNAs involved in cancer progression; however, their utility as predictors of pathological complete response to neoadjuvant chemotherapy is unclear. Here, we investigated if miR-143 could discriminate between pathological complete response and no-polymerase chain reaction of patients with locally advanced triple negative breast cancer that have received a fluorouracil-cisplatin/paclitaxel-based neoadjuvant treatment...
January 1, 2019: Technology in Cancer Research & Treatment
Behjat Marzbani, Javad Nazari, Saeed Amini, Farid Najafi, Mehdi Moradinazar, Behnaz Marzbani, Sara Shahabadi, Mahin Amini, Yahya Pasdar, Ebrahim Shakiba
Objectives: Unhealthy dietary patterns are the most important changeable risk factors for breast cancer. The aim is to assess the relation between dietary patterns and risk of breast cancer among under 50 women in the west of Iran. Methods: All under 50 years old women with positive pathology of breast cancer between 2013-2015 who were referred to the oncology clinics in the west of Iran were selected as the cases (212 persons) and 408 under 50 years old women referred to the other outpatient clinics who were without breast or other cancers at the time of study and two years later were selected as the control group...
January 24, 2019: Epidemiology and Health
Parveen Jain, Dinesh Chandra Doval, Ullas Batra, Pankaj Goyal, Sneha Jatan Bothra, Chaturbhuj Agarwal, Dutta Kumardeep Choudhary, Abhishek Yadav, Venkata Pradeep Babu Koyalla, Mansi Sharma, Prashanta Dash, Vineet Talwar
Aims: To investigate Ki-67 index with regard to its ability to predict achievement of pathologic complete response (pCR) to neoadjuvant chemotherapy (NACT) in breast cancer patient. Material and methods: It was a prospective observational study, conducted in Department of Medical Oncology, Rajiv Gandhi Cancer Institute & Research Center (RGCIRC), New Delhi from February 2014 to March 2016. A total of 134 patients with Stage II/III breast cancer who underwent NACT followed by surgery at our center were enrolled and analyzed...
February 12, 2019: Japanese Journal of Clinical Oncology
Leonardo Russo, Anggela Maltese, Luis Betancourt, Gabriel Romero, Daniela Cialoni, Liliana De la Fuente, Marianna Gutierrez, Angela Ruiz, Emperatriz Agüero, Silvia Hernández
OBJECTIVE: To evaluate the pathologic response after neoadjuvant chemotherapy in patients with breast cancer according to the stromal tumor-infiltrating lymphocytes (TILs) as well as the evaluation of overall and disease-free survival according to TILs. METHODS: A six years (2008-2013) review was done including patients with locally advanced breast cancer that received neoadjuvant therapy and then surgery. An evaluation of the percentage of TILs was done in the pretreatment biopsies and a correlation analysis and survival curves were done...
February 4, 2019: European Journal of Surgical Oncology
Hakan Ceylan, Immihan Ceren Yasa, Oncay Yasa, Ahmet Fatih Tabak, Joshua Giltinan, Metin Sitti
Untethered mobile microrobots has the potential to leverage minimally invasive theranostic functions precisely and efficiently in hard-to-reach, confined, and delicate inner body sites. However, such a complex task requires an integrated design and engineering, where powering, control, environmental sensing, medical functionality and biodegradability need to be considered altogether. The present study reports a hydrogel-based, magnetically powered and controlled, enzymatically degradable microswimmer, which is responsive to the pathological markers in its microenvironment for theranostic cargo delivery and release tasks...
February 11, 2019: ACS Nano
Katarzyna Dobruch-Sobczak, Hanna Piotrzkowska-Wróblewska, Ziemowit Klimonda, Katarzyna Roszkowska-Purska, Jerzy Litniewski
PURPOSE: To evaluate the ultrasound (US) response in patients with breast cancer (BC) during neoadjuvant chemotherapy (NAC). METHODS: Prospective US analysis was performed on 19 malignant tumors prior to NAC treatment and 7 days after each first four courses of NAC in 13 patients (median age = 57 years). Echogenicity, size, vascularity, and sonoelastography were measured and compared with posttreatment scores of residual cancers burden. RESULTS: Changes in the echogenicity of tumors after 3 courses of NAC had the most statistically strong correlation with the percentage of residual malignant cells used in histopathology to assess the response to treatment (odds ratio = 60, p < 0...
January 26, 2019: Clinical Imaging
Bruna Cerbelli, Andrea Botticelli, Annalinda Pisano, Domenico Campagna, Ludovica De Vincentiis, Angelina Pernazza, Federico Frusone, Paola Scavina, Massimo Monti, Lucio Fortunato, Leopoldo Costarelli, Giulia d'Amati
We evaluated the impact of breast cancer subtypes on pathologic complete response (pCR) in 181 patients with positive nodes undergoing neoadjuvant chemotherapy (NAC). After NAC, patients underwent surgery, with sentinel lymph node biopsy (SLNB) or axillary dissection (ALND). In 28.2% of cases a pCR was achieved, with the highest rate in Her2+ and triple negative tumors. Overall, nodal pCR was more frequent than breast pCR (P = 0.003) with higher percentages in Her2+ and LLB-Her2+ (P < 0.05). In the Her2+ group, nodal pCR was observed only with breast pCR...
February 7, 2019: Breast Journal
Sasagu Kurozumi, Kenichi Inoue, Hiroshi Matsumoto, Takaaki Fujii, Jun Horiguchi, Tetsunari Oyama, Masafumi Kurosumi, Ken Shirabe
Predictive utility of tumor-infiltrating lymphocytes (TILs) in HER2-positive breast cancer patients receiving neoadjuvant chemotherapy (NAC) with concurrent trastuzumab remains unclear. We examined TILs grades of pretreatment cancer tissue specimens and residual tumors after NAC with trastuzumab and determined the predictive utility of the TILs grade in pathological complete response (pCR) and the prognostic power of TILs in HER2-positive breast cancer. This cohort study included 128 HER2-positive breast cancer who received NAC with trastuzumab...
February 7, 2019: Scientific Reports
Tess O'Meara, Anton Safonov, David Casadevall, Tao Qing, Andrea Silber, Brigid Killelea, Christos Hatzis, Lajos Pusztai
PURPOSE: African-American (AA) patients with triple-negative breast cancer (TNBC) are less likely to achieve pathologic complete response from neoadjuvant chemotherapy and have poorer prognosis than Caucasian patients with TNBC, suggesting potential biological differences by race. Immune infiltration is the most consistent predictive marker for chemotherapy response and improved prognosis in TNBC. In this study, we test the hypothesis that the immune microenvironment differs between AA and Caucasian patients...
February 6, 2019: Breast Cancer Research and Treatment
Néstor Llinás-Quintero, Eduardo Cabrera-Florez, Gustavo Mendoza-Fandiño, Gustavo Matute-Turizo, Elsa M Vasquez-Trespalacios, Luis J Gallón-Villegas
We report a case of a 52-year-old female with a family history of pancreatic and colon cancers who presented with a right breast mass positive for high-grade medullar carcinoma with triple-negative biomolecular profile. Further workup was performed finding a left ovarian mass. The patient underwent laparotomy performing optimal cytoreduction on bilateral ovarian tumors; the pathology and immunohistochemistry confirmed bilateral ovary adenocarcinoma with positive peritoneal malignancy. Due to her synchronic breast and ovarian cancers, a genetic profile was performed detecting a new pathogenic variant in the BRCA2 gene: c...
2019: Case Reports in Oncological Medicine
Min Han, Arsalan Salamat, Li Zhu, Huina Zhang, Beth Z Clark, David J Dabbs, Gloria J Carter, Adam M Brufsky, Rachel C Jankowitz, Shannon L Puhalla, Ronald R Johnson, Atilla Soran, Jennifer G Steiman, Priscilla F McAuliffe, Emilia J Diego, Rohit Bhargava
Metaplastic breast carcinoma is a rare heterogeneous category of breast cancer, often associated with a poor prognosis. Clinical-pathologic studies with respect to varied morphologic subtypes are lacking. There is also a dearth of studies assessing the response of metaplastic breast carcinoma to neoadjuvant chemotherapy. Cases of metaplastic breast carcinoma diagnosed between 2007 and 2017 were identified. Various clinical-pathologic variables were tested for association with survival. Patients who underwent neoadjuvant chemotherapy were assessed for pathologic response...
February 5, 2019: Modern Pathology: An Official Journal of the United States and Canadian Academy of Pathology, Inc
Ingrid A Mayer, Aleix Prat, Daniel Egle, Sibel Blau, Jose Alejandro Perez Fidalgo, Michael Gnant, Peter A Fasching, Marco Colleoni, Antonio C Wolff, Eric P Winer, Christian F Singer, Sara A Hurvitz, Laura Garcia Estevez, Peter A van Dam, Sherko Kümmel, Christoph Mundhenke, Frankie A Holmes, Naveen Babbar, Laure Charbonnier, Ivan Diaz-Padilla, Florian D Vogl, Dalila Sellami, Carlos L Arteaga
PURPOSE: Addition of alpelisib to fulvestrant significantly extended progression-free survival in PIK3CA-mutant, hormone receptor-positive (HR+) advanced/metastatic breast cancer in the phase III SOLAR-1 study. The combination of alpelisib and letrozole also had promising activity in phase I studies of HR+ advanced/metastatic breast cancer. NEO-ORB aimed to determine if addition of alpelisib to letrozole could increase response rates in the neoadjuvant setting. EXPERIMENTAL DESIGN: Postmenopausal women with HR+, human epidermal growth factor receptor 2-negative, T1c-T3 breast cancer were assigned to the PIK3CA-wild-type or PIK3CA-mutant cohort according to their tumor PIK3CA status, and randomized (1:1) to 2...
February 5, 2019: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
Roisin M Connolly, Jeffrey P Leal, Lilja Solnes, Chiung-Yu Huang, Ashley Carpenter, Katy Gaffney, Vandana Abramson, Lisa A Carey, Minetta C Liu, Mothaffar Rimawi, Jennifer Specht, Anna Maria Storniolo, Vicente Valero, Christos Vaklavas, Ian E Krop, Eric P Winer, Melissa Camp, Robert S Miller, Antonio C Wolff, Ashley Cimino-Mathews, Ben H Park, Richard L Wahl, Vered Stearns
PURPOSE: Predictive biomarkers to identify patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer who may benefit from targeted therapy alone are required. We hypothesized that early measurements of tumor maximum standardized uptake values corrected for lean body mass (SULmax) on [18 F]fluorodeoxyglucose positron emission tomography/computed tomography would predict pathologic complete response (pCR) to neoadjuvant pertuzumab and trastuzumab (PT). PATIENTS AND METHODS: Patients with stage II/III, estrogen receptor-negative, HER2-positive breast cancer received four cycles of neoadjuvant PT...
February 5, 2019: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Eleftherios Kontopodis, Maria Venianaki, George Manikis, Katerina Nikiforaki, Ovidio Salvetti, Efrosini Papadaki, Georgios Papadakis, Apostolos Karantanas, Kostas Marias
Imaging biomarkers (IBs) play a critical role in the clinical management of breast cancer (BRCA) patients throughout the cancer continuum for screening, diagnosis and therapy assessment especially in the neoadjuvant setting. However, certain model-based IBs suffer from significant variability due to the complex workflows involved in their computation, whereas model-free IBs have not been properly studied regarding clinical outcome. In the present study, IBs from 35 BRCA patients who received neoadjuvant chemotherapy (NAC) were extracted from dynamic contrast enhanced MR imaging (DCE-MRI) data with two different approaches, a model-free approach based on pattern recognition (PR), and a model-based one using pharmacokinetic compartmental modeling...
January 31, 2019: IEEE Journal of Biomedical and Health Informatics
Ramon Colomer, Cristina Saura, Pedro Sánchez-Rovira, Tomás Pascual, Isabel T Rubio, Octavio Burgués, Lourdes Marcos, César A Rodríguez, Miguel Martín, Ana Lluch
BACKGROUND: Neoadjuvant treatment is increasingly one of the preferred therapeutic options for early breast cancer and may have some unique outcomes, such as identifying predictive and prognostic factors of response or increasing the knowledge of individual tumor biology. DESIGN: A panel of experts from different specialties reviewed published clinical studies on the neoadjuvant management of breast cancer. Recommendations were made that emphasized the clinical multidisciplinary management and the investigational leverage in early breast cancer...
February 1, 2019: Oncologist
Simon Peter Gampenrieder, Andreas Peer, Christian Weismann, Matthias Meissnitzer, Gabriel Rinnerthaler, Johanna Webhofer, Theresa Westphal, Marina Riedmann, Thomas Meissnitzer, Heike Egger, Frederike Klaassen Federspiel, Roland Reitsamer, Cornelia Hauser-Kronberger, Katharina Stering, Klaus Hergan, Brigitte Mlineritsch, Richard Greil
BACKGROUND: Patients with early breast cancer (EBC) achieving pathologic complete response (pCR) after neoadjuvant chemotherapy (NACT) have a favorable prognosis. Breast surgery might be avoided in patients in whom the presence of residual tumor can be ruled out with high confidence. Here, we investigated the diagnostic accuracy of contrast-enhanced MRI (CE-MRI) in predicting pCR and long-term outcome after NACT. METHODS: Patients with EBC, including patients with locally advanced disease, who had undergone CE-MRI after NACT, were retrospectively analyzed (n = 246)...
January 31, 2019: Breast Cancer Research: BCR
Laura L Michel, Laura Sommer, Rosa González Silos, Justo Lorenzo Bermejo, Alexandra von Au, Julia Seitz, André Hennigs, Katharina Smetanay, Michael Golatta, Jörg Heil, Florian Schütz, Christof Sohn, Andreas Schneeweiss, Frederik Marmé
BACKGROUND: Locoregional recurrence after neoadjuvant chemotherapy for primary breast cancer is associated with poor prognosis. It is essential to identify patients at high risk of locoregional recurrence who may benefit from extended local therapy. Here, we examined the prediction accuracy and clinical applicability of the MD Anderson Prognostic Index (MDAPI). METHODS: Prospective clinical data from 456 patients treated between 2003 and 2011 was analyzed. The Kaplan-Meier method was used to examine the probabilities of locoregional recurrence, local recurrence and distant metastases according to individual prognosis score, stratified by type of surgery (breast conserving therapy or mastectomy)...
2019: PloS One
Chi Zhang, Ying Guo, Jiyu Li, Xingsong Tian, Xuening Duan
PURPOSE: The addition of anti-HER2 therapies to neoadjuvant treatment significantly enhances pathological complete response (PCR) rate in patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer. Selecting patients unlikely to benefit from neoadjuvant anti-HER2 therapies is increasingly important. In this study, we proposed to assess the role of the phosphatase and tensin homolog (PTEN) as a biomarker in predicting PCR to neoadjuvant anti-HER2 therapies by conducting meta-analysis...
February 2019: Medicine (Baltimore)
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