Local therapy and survival in breast cancer with distant metastases

Noguchi, Masakuni; Nakano, Yukiko; Noguchi, Miki; Ohno, Yukako; Kosaka, Takeo

doi:10.1002/jso.22056

Cited by 6 publications

(3 citation statements)

References 80 publications

(110 reference statements)

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“…Circulating tumor cells (CTCs) form clusters and migrate in the bloodstream (84)(85)(86). Various cytokines, chemokines and growth factors secreted by the primary foci and MSCs recruited from the bone marrow also enter the target organ in advance, which shapes the targeted microenvironment and forms a pre-metastatic niche to welcome the arrival of the CTCs (83,(87)(88)(89)(90)(91)(92). Organ specificity during metastasis is regulated by chemokines, exosomes, integrins and other factors, such as chemokine receptors (87)(88)(89)(93)(94)(95)(96)(97).…”

Section: Mechanisms Through Which Lrt Benefits Patients With Dnmbcmentioning

confidence: 99%

Aggressive local therapy for de novo metastatic breast cancer: Challenges and updates (Review)

Liu

Lü

2023

Oncol Rep

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Systemic therapy has been viewed as the mainstay for de novo metastatic breast cancer (dnMBC). However, as dnMBC is highly heterogeneous both biologically and clinically, and with ever-improving systemic strategies, it has been implied that the local therapy of the primary tumor (PT) may be beneficial for certain patients with dnMBC. However, the results from retrospective studies have been questioned due to their selection bias and retrospective nature. To the best of our knowledge, there are two published randomized clinical trials addressing this issue with conflicting conclusions: i) TATA study from India indicated no overall survival (OS) superiority with early local radiotherapy (LRT); and ii) MF07-01 indicated a 5-year OS rate improvement of 17% with upfront LRT. The updated results of a randomized phase III ECOG-ACRIN E2108 trial released in the 2020 American Society of Clinical Oncology (ASCO) meeting reported a negative survival effect of early LRT treatment in patients with dnMBC responding to initial systemic treatment, despite LRT significantly reducing the locoregional failure. Thus, a number of issues, such as the exact value of LRT, the optimal means of LRT (surgery and/or RT to the PT), the ideal timing of LRT and the population most likely to benefit from LRT, warrant further investigation. Herein, the related studies focusing on these aspects were comprehensively reviewed and a decision algorithm was proposed to select suitable patients with dnMBC for reasonable LRT. Generally, upfront systemic therapy is recommended. For good respondents and a subgroup of favorable profiles (young age, good general condition, low tumor burden, hormone receptor-positive and so on), radical LRT including PT surgery followed by RT and the resection of distant metastases is recommended. LRT should also be administered if the PT is still symptomatic. LRT may benefit patients with dnMBC due to the following reasons: Control of the PT decreases tumor burden, eliminates the source of dissemination, enhances the sensitivity to therapy and exerts positive immunomodulation. Therefore, the treatment paradigm for dnMBC may change from ‘palliative LRT’ into ‘curative LRT’ in a highly selected entity with careful evaluation.

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Section: Mechanisms Through Which Lrt Benefits Patients With Dnmbcmentioning

confidence: 99%

Aggressive local therapy for de novo metastatic breast cancer: Challenges and updates (Review)

Liu

Lü

2023

Oncol Rep

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“…Several recent studies have reported that local therapy for loco-regional recurrence and solitary metastatic lesions yielded unexpectedly promising results (4,5). In addition, an increasing number of randomized clinical trials have documented survival benefit in metastatic breast cancers with newer chemotherapeutic agents (6,7).…”

Section: To the Editormentioning

confidence: 99%

Intensive Postoperative Surveillance using Chest CT and Bone Scan in Patients with Locally Advanced Breast Cancer

Kim

Park

et al. 2014

Breast J

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“…yroid and breast diseases are common superficial problems [1,2]. Epidemiological data show that the five-year survival rates for breast cancer and thyroid carcinoma rank first and second [3,4], and thus, early diagnosis and treatment favor a good prognosis [5]. Ultrasound is the primary means of detection for thyroid and breast diseases.…”

Section: Introductionmentioning

confidence: 99%

Convolutional Neural Network for Breast and Thyroid Nodules Diagnosis in Ultrasound Imaging

Liang

Liao

et al. 2020

BioMed Research International

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Objective. The incidence of superficial organ diseases has increased rapidly in recent years. New methods such as computer-aided diagnosis (CAD) are widely used to improve diagnostic efficiency. Convolutional neural networks (CNNs) are one of the most popular methods, and further improvements of CNNs should be considered. This paper aims to develop a multiorgan CAD system based on CNNs for classifying both thyroid and breast nodules and investigate the impact of this system on the diagnostic efficiency of different preprocessing approaches. Methods. The training and validation sets comprised randomly selected thyroid and breast nodule images. The data were subgrouped into 4 models according to the different preprocessing methods (depending on segmentation and the classification method). A prospective data set was selected to verify the clinical value of the CNN model by comparison with ultrasound guidelines. Diagnostic efficiency was assessed based on receiver operating characteristic (ROC) curves. Results. Among the 4 models, the CNN model using segmented images for classification achieved the best result. For the validation set, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy, and area under the curve (AUC) of our CNN model were 84.9%, 69.0%, 62.5%, 88.2%, 75.0%, and 0.769, respectively. There was no statistically significant difference between the CNN model and the ultrasound guidelines. The combination of the two methods achieved superior diagnostic efficiency compared with their use individually. Conclusions. The study demonstrates the probability, feasibility, and clinical value of CAD in the ultrasound diagnosis of multiple organs. The use of segmented images and classification by the nature of the disease are the main factors responsible for the improvement of the CNN model. Moreover, the combination of the CNN model and ultrasound guidelines results in better diagnostic performance, which will contribute to the improved diagnostic efficiency of CAD systems.

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Local therapy and survival in breast cancer with distant metastases

Cited by 6 publications

References 80 publications

Aggressive local therapy for de novo metastatic breast cancer: Challenges and updates (Review)

Aggressive local therapy for de novo metastatic breast cancer: Challenges and updates (Review)

Intensive Postoperative Surveillance using Chest CT and Bone Scan in Patients with Locally Advanced Breast Cancer

Convolutional Neural Network for Breast and Thyroid Nodules Diagnosis in Ultrasound Imaging

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