Breast Cancer With a Poor Prognosis Diagnosed After Screening Mammography With Negative Results

McCarthy, Anne Marie; Barlow, William E.; Conant, Emily F.; Haas, Jennifer S.; Li, Christopher I.; Sprague, Brian L.; Armstrong, Katrina

doi:10.1001/jamaoncol.2018.0352

Cited by 22 publications

(14 citation statements)

References 9 publications

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“…As shown in Figures 7A-D, the cuproptosis score was higher in the groups with younger ages and Basal subtype. Previous studies have demonstrated that younger patients and those with basal subtype BRCA have a poorer prognosis, which is consistent with the results that patients with low cuproptosis scores had better DFI (39). These results elucidated the fact that patients with a high cuproptosis score had a worse survival prognosis.…”

Section: Construction Of Cuproptosis Signatures and Functional Annota...supporting

confidence: 88%

Identification of cuproptosis-related patterns and construction of a scoring system for predicting prognosis, tumor microenvironment-infiltration characteristics, and immunotherapy efficacy in breast cancer

Zhang

Chen

et al. 2022

Front. Oncol.

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BackgroundCuproptosis, a recently discovered refreshing form of cell death, is distinct from other known mechanisms. As copper participates in cell death, the induction of cancer cell death with copper ionophores may emerge as a new avenue for cancer treatment. However, the role of cuproptosis in tumor microenvironment (TME) cell infiltration remains unknown.MethodsWe systematically evaluated the cuproptosis patterns in The Cancer Genome Atlas (TCGA) database in breast cancer (BRCA) samples based on 10 cuproptosis-related genes (CRGs), and correlated these patterns with the prognosis and characteristics of TME cell infiltration. A principal component analysis algorithm was used to construct a cuproptosis score to quantify the cuproptosis pattern in individual tumors. Further, the relationships between the cuproptosis score and transcription background, clinical features, characteristics of TME cell infiltration, drug response, and efficacy of immunotherapy were assessed.ResultsTwo distinct cuproptosis patterns with distinct prognoses were identified; their TME characteristics were found to be consistent with the immune-excluded and immune-inflamed phenotypes, respectively. The cuproptosis patterns in individual patients were evaluated using the cuproptosis score based on the cuproptosis phenotype-related genes, contributing to distinguishing biological processes, clinical outcome, immune cell infiltration, genetic variation, and drug response. Univariate and multivariate Cox regression analyses verified this score as an independent prognostic predictor in BRCA. A high cuproptosis score, characterized by immune activation, suggests an inflamed tumor and immune-inflamed phenotype with poor survival and a low cuproptosis score, characterized by immune suppression, indicates a non-inflamed tumor and immune-excluded phenotype with better survival. Significant differences were observed in the IC50 between the high and low cuproptosis score groups receiving chemotherapy and targeted therapy drugs. In the two immunotherapy cohorts, patients with a higher cuproptosis score experienced considerable therapeutic advantages and clinical benefits.ConclusionsThis study is the first to elucidate the prominent role of cuproptosis in the clinical outcome and the formation of TME diversity and complexity in BRCA. Estimating cuproptosis patterns in tumors could help predict the prognosis and characteristics of TME cell infiltration and guide more effective chemotherapeutic and immunotherapeutic strategies.

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Section: Construction Of Cuproptosis Signatures and Functional Annota...supporting

confidence: 88%

Identification of cuproptosis-related patterns and construction of a scoring system for predicting prognosis, tumor microenvironment-infiltration characteristics, and immunotherapy efficacy in breast cancer

Zhang

Chen

et al. 2022

Front. Oncol.

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“…Our findings challenge previous reports suggesting that IBCs have outcomes similar to SBCs. 3 , 4 , 14 Substantial compromise in outcomes of IBC compared with SBC reflects the differences in natural history of the 2 types of cancers and highlights inadequacies in current breast cancer screening practice. Breast cancer is a highly heterogenous disease; although indolent cancers with likelihood of better outcomes are detected easily by screening mammography raising overall incidence of breast cancer, many of the aggressive and lethal forms of breast cancers either go unnoticed on mammogram or develop in the interval between mammograms.…”

Section: Discussionmentioning

confidence: 99%

Incidence, Characteristics, and Outcomes of Interval Breast Cancers Compared With Screening-Detected Breast Cancers

Niraula

Biswanger

et al. 2020

JAMA Netw Open

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Key Points Question What are the differences and similarities in characteristics and outcomes of breast cancers detected by mammographic screening vs those detected between screening mammograms (interval cancers) in women participating in a population-based screening program? Findings In this cohort study of 69 025 women, interval breast cancers accounted for one-fourth of breast cancers in routinely screened women, were 6 times more likely to be grade III, and had 3.5 times increased hazards of breast cancer death compared with screen-detected cancers. Meaning Heterogeneity in breast cancer defies assumptions necessary for screening mammography in its current form to be maximally effective; strategies beyond routine screening mammography are needed to prevent, detect, and avert deaths from the more lethal interval breast cancers.

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“…[48][49][50][51][52][53] Specifically, interval cancers are more likely to be larger and node positive at the time of diagnosis, with more advanced stage; these factors result in poorer outcomes. 33,36,37 More advanced tumors require more aggressive therapy with respect to both surgery and either neoadjuvant or adjuvant therapy. 54 A wide range of 17 to 30% of breast cancers detected in women in European population-based screening programs are interval cancers, the highest occurring in programs that screen triennially.…”

Section: Discussionmentioning

confidence: 99%

“…3,34,35 Such interval cancers are often more aggressive and in several studies are more likely to be larger and to have spread to axillary nodes at presentation than are cancers detected on screening. 33,[36][37][38][39][40] Interval cancers are associated with a 2-3 times greater mortality rate in women with dense breasts. 7,41 One measure of the effectiveness of a screening program is the interval cancer rate (ICR), typically for invasive cancers, also referred to as post-invasive cancer rate.…”

Section: Introductionmentioning

confidence: 99%

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Breast Density and Risk of Interval Cancers: The Effect of Annual Versus Biennial Screening Mammography Policies in Canada

et al. 2021

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Regular screening mammography reduces breast cancer mortality. However, in women with dense breasts, the performance of screening mammography is reduced, which is reflected in higher interval cancer rates (ICR). In Canada, population-based screening mammography programs generally screen women biennially; however, some provinces and territories offer annual mammography for women with dense breast tissue routinely and/or on recommendation of the radiologist. This study compared the ICRs in those breast screening programs with a policy of annual vs. those with biennial screening for women with dense breasts. Among 148,575 women with dense breasts screened between 2008 to 2010, there were 288 invasive interval breast cancers; screening programs with policies offering annual screening for women with dense breasts had fewer interval cancers 63/70,814 (ICR 0.89/1000, 95% CI: 0.67-1.11) compared with those with policies of usual biennial screening 225/77,761 (ICR 1.45 /1000 (annualized), 95% CI: 1.19-1.72) i.e. 63% higher (p = 0.0016). In screening programs where radiologists’ screening recommendations were able to be analyzed, a total of 76,103 women were screened, with 87 interval cancers; the ICR was lower for recommended annual (65/69,650, ICR 0.93/1000, 95% CI: 0.71, 1.16) versus recommended biennial screening (22/6,453, ICR 1.70/1000 (annualized), 95%CI: 0.70, 2.71)(p = 0.0605). Screening program policies of annual as compared with biennial screening in women with dense breasts had the greatest impact on reducing interval cancer rates. We review our results in the context of current dense breast notification in Canada.

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Breast Cancer With a Poor Prognosis Diagnosed After Screening Mammography With Negative Results

Abstract: Role of the Funder/Sponsor: The funding sources had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Cited by 22 publications

References 9 publications

Identification of cuproptosis-related patterns and construction of a scoring system for predicting prognosis, tumor microenvironment-infiltration characteristics, and immunotherapy efficacy in breast cancer

Identification of cuproptosis-related patterns and construction of a scoring system for predicting prognosis, tumor microenvironment-infiltration characteristics, and immunotherapy efficacy in breast cancer

Incidence, Characteristics, and Outcomes of Interval Breast Cancers Compared With Screening-Detected Breast Cancers

Breast Density and Risk of Interval Cancers: The Effect of Annual Versus Biennial Screening Mammography Policies in Canada

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