Evaluation of the AJCC Eighth-Edition Prognostic Staging System for Breast Cancer in a Latin American Cohort

Cervera-Bonilla, Sergio; Rodríguez-Ossa, Paola; Vallejo-Ortega, Maria Teresa; Osorio-Ruiz, Ana; Mendoza‐Diaz, Sara; Orozco‐Ospino, Martha; Lehmann-Mosquera, Carlos; Duarte, Carlos; Angel-Aristizabal, Javier; Guzman-Abisaab, Luis; García-Mora, Mauricio; Casas, Sandra Esperanza Diaz

doi:10.1245/s10434-021-09907-x

Cited by 6 publications

(2 citation statements)

References 10 publications

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“…Recently, in Colombia, Cervera et al described the prognostic upstaging and downstaging, compared to the anatomic staging in a large Colombian breast cancer cohort. They reported that prognostic staging decreases were more frequent than those of staging increases [25]. We observed a higher frequency in the increased staging than a descent when comparing anatomical to prognostic staging.…”

Section: Discussionsupporting

confidence: 40%

Sociodemographic, Clinical, and Variation Outcomes for Breast Cancer and Breast Cancer-Related Mutations in a Ten-Year Cohort From Neiva, Huila, Colombia

Olaya¹,

Sanjuán²,

Torres-Lopez³

et al. 2022

Cureus

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BackgroundSome breast cancer cases are related to inherited mutations, and this is the reason why early mutation screening is emerging as an area of focus for cost-effective care. However, breast cancer-related mutations vary according to race, ethnicity, geographic origin, and healthcare access. Surveillance for familial breast cancer is not performed routinely in Colombia. Our main aim in this study was to describe a cohort of breast cancer patients, carrying founder breast cancer gene (BRCA) mutations, which were followed up for up to 10 years (2010)(2011)(2012)(2013)(2014)(2015)(2016)(2017)(2018)(2019) in Neiva, Colombia. MethodsWe performed a retrospective description from an outpatient care center in Huila, Colombia, a region with high breast cancer rates. This study included patients with both a breast cancer diagnosis and an incident genetic mutation for breast cancer (detected during a breast cancer consultation). We captured information from patient medical records. Descriptive analyses were performed. ResultsA total of 105 patients met the study's inclusion criteria and were included patients with the BRCA1 mutation and three with BRCA2 mutations. They had a median age of 45 years (IQR, 36 to 51 years). Relatives with a breast cancer history were found in 74 carriers (70.5%). Most patients had a report of Breast Imaging-Reporting and Data System (BIRADS) ≥ 4. A TNM (tumor, node, metastasis) changed reclassification was observed in anatomical vs. prognostic classification. Median follow-up was of 74 months (IQR, 44 to 130), overall observed mortality was 22.9%, and specific mortality was 19.1%. ConclusionWomen with breast cancer who carry a mutation related to breast cancer are usually younger than age 50 at diagnosis. Developing strategies and specific policies for this population is needed, and a prevalent BRCA1 c.3331_3334delCAAG mutation could be used as a cost-effective first approach. Among these patients, a risk-increased reclassification was observed.

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Section: Discussionsupporting

confidence: 40%

Sociodemographic, Clinical, and Variation Outcomes for Breast Cancer and Breast Cancer-Related Mutations in a Ten-Year Cohort From Neiva, Huila, Colombia

Olaya¹,

Sanjuán²,

Torres-Lopez³

et al. 2022

Cureus

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“…Palabras clave: neoplasias de la mama, estudios de extensión, metástasis de la neoplasia, estadificación de neoplasias aumento de estadio en el 14,5% de los casos y una disminución en el 40,3%; este resultado se atribuyó en parte al mayor porcentaje de tumores localmente avanzados dentro de la institución (4). En el INC, el 31,0% de las pacientes ingresan en estadio temprano, 48,2% en estadios localmente avanzados y 16,9% en estadio metastásico.…”

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Estudios de extensión para la estadificación del cáncer de mama infiltrante. Revisión de la evidencia y abordaje terapéutico en el Instituto Nacional de Cancerología - Colombia

Duran

Hurtado

Ortiz

et al. 2023

Rev. colomb. cancerol.

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La estadificación del cáncer de mama tiene como objetivo determinar la extensión de la enfermedad, definir el tratamiento y el pronóstico de la misma. La American Joint Committee on Cancer (AJCC) ha asignado el estadio utilizando el tamaño del tumor (T), la presencia de compromiso ganglionar (N), y la presencia o ausencia de metástasis a distancia (M). Con el advenimiento de la biología molecular, se integra a la estadificación anatómica la información pronóstica con el grado histológico, el estado de los receptores hormonales y el resultado del receptor de HER2. En el Instituto Nacional de Cancerología (INC), la incorporación del TNM pronóstico trajo consigo un aumento de estadio en el 14,47% de los casos y una disminución en el 40,3%; este resultado se atribuyó en parte al mayor porcentaje de tumores localmente avanzados dentro de la institución. Por subtipo biológico, los tumores luminales presentan mayor riesgo de metástasis óseas, los tumores triple negativo a pulmón y sistema nervioso central; y los tumores HER2 a SNC, hígado y pulmón. Teniendo en cuenta este compromiso a distancia, los métodos de estadificación comúnmente utilizados son gammagrafía ósea (GO), radiografía de tórax (RxT), ecografía hepática (UH) y/o tomografía computarizada (TC).En el caso de identificar hallazgos sospechosos en estos exámenes o si el cuadro clínico del paciente lo sugiere, se realizan estudios adicionales como TC o resonancia magnética nuclear (RMN). Los cambios en la estadificación clínica y la biología del cáncer de mama motivaron a las Unidades de Seno y Tejidos Blandos y Oncología Clínica del Instituto Nacional de Cancerología a revisar la evidencia científica disponible para recomendar la pertinencia de los estudios de extensión.

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Impact of AJCC prognostic staging on prognosis and postmastectomy radiotherapy decision-making in hormone receptor-positive and HER2-positive breast cancer

Zhang

et al. 2022

BJS Open

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Background The role of postmastectomy radiotherapy (PMRT) in patients with node-positive hormone receptor-positive (HoR) and HER2-positive breast cancer (BC) regarding AJCC pathological prognostic staging (PPS) has not been fully determined. This study aimed to validate PPS in patients with node-positive HoR+/HER2+ BC after mastectomy and to investigate the role of PPS on PMRT decision-making in this patient subset. Methods Patients diagnosed with BC from the Surveillance, Epidemiology, and End Results database were included. Patients were classified based on the anatomical staging (AS) and PPS. Breast cancer-specific survival (BCSS) was calculated. Results In total, 6862 patients were included: 4306 (62.8 per cent) patients received PMRT and 2556 (37.2 per cent) patients had not. Compared to AS, PPS downstaged 5260 patients (76.7 per cent) and no patients were upstaged. The C-index was similar between PPS and AS (0.690 versus 0.682; P = 0.346). Regarding AS, patients who received PMRT had significantly better BCSS than those who had not in stage IIIA (P = 0.017) and stage IIIC (P < 0.001) disease, but not in stage IB (P = 0.675), IIA (P = 0.677), IIB (P = 0.100), and IIIB (P = 0.747) disease. Regarding PPS, patients who received PMRT had significantly better BCSS than those who had not in stage IIIA (P = 0.038) and stage IIIB (P = 0.017) disease, but not in stage IA (P = 0.336), IB (P = 0.893), IIA (P = 0.815), and IIB (P = 0.120) disease. PPS might allow approximately 1390 stage III patients (45.0 per cent) in the AS criterion to avoid PMRT. Conclusion PPS does not provide better risk discriminatory ability in predicting prognosis than AS in patients with node-positive HoR+/HER2+ BC after mastectomy. However, PPS is valuable in providing prognostic counselling to patients and may also guide PMRT decision-making.

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Evaluation of the AJCC Eighth-Edition Prognostic Staging System for Breast Cancer in a Latin American Cohort

Cited by 6 publications

References 10 publications

Sociodemographic, Clinical, and Variation Outcomes for Breast Cancer and Breast Cancer-Related Mutations in a Ten-Year Cohort From Neiva, Huila, Colombia

Sociodemographic, Clinical, and Variation Outcomes for Breast Cancer and Breast Cancer-Related Mutations in a Ten-Year Cohort From Neiva, Huila, Colombia

Estudios de extensión para la estadificación del cáncer de mama infiltrante. Revisión de la evidencia y abordaje terapéutico en el Instituto Nacional de Cancerología - Colombia

Impact of AJCC prognostic staging on prognosis and postmastectomy radiotherapy decision-making in hormone receptor-positive and HER2-positive breast cancer

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