Locoregional treatment of primary breast cancer

Kaufmann, M.; Morrow, Monica; Minckwitz, Gϋnter von; Harris, Jay R.

doi:10.1002/cncr.24874

Cited by 185 publications

(40 citation statements)

References 40 publications

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“…All enrolled patients received adjuvant hormonal therapy. Adjuvant radiotherapy was administered to all patients after breast conservation surgery [51, 52]. After surgery and adjuvant therapy, the patients were regularly followed up in our clinic.…”

Section: Methodsmentioning

confidence: 99%

Polymorphisms ofESR1, UGT1A1, HCN1, MAP3K1andCYP2B6are associated with the prognosis of hormone receptor-positive early breast cancer

et al. 2017

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In this study, we investigated whether single nucleotide polymorphisms (SNPs) identified by genome-wide association study (GWAS) (MAP3K1, FGFR2, TNRC9, HCN1, and 5p12), and SNPs involved in the metabolism of estrogen (CYP19, COMT, ESR1, and UGT1A1), tamoxifen (CYP2C9, CYP2C19, CYP3A5, and CYP2D6), and chemotherapeutic agents (ABCB1, ALDH3A1, and CYP2B6) are associated with the prognoses of 414 hormone receptor (HR)-positive early breast cancers with negative or 1 to 3 nodal metastases. At a median follow-up period of 10.6 years, 363 patients were alive, and 51 (12.3%) had died. Multiple-adjusted hazard ratios (aHRs) and the corresponding 95% confidence intervals for distant disease-free survival (DDFS), disease-free survival (DFS), and overall survival (OS) in association with the genotypes of 34 SNPs from the above-mentioned 16 genes were evaluated, using the stepwise selection Cox model. We found that the SNP, ESR1-codon325 rs1801132 (G/G+G/C), was associated with a longer DDFS, whereas UGT1A1 rs4148323 (A/A+A/G), and HCN1 rs981782 (A/A+A/C) were significantly associated with poorer DDFS. MAP3K1 rs889312 (C/C) and CYP2B6 rs3211371 (T/C) were significantly associated with poor DFS, DDFS and OS. Among premenopausal women, MAP3K1 rs889312 (C/C), CYP2B6 rs3211371 (T/C), CYP2B6 rs4802101 (T/T), ABCB1 rs2032582 (C/C), and ALDH3A1 rs2231142 (G/G) were significantly associated with poor DDFS, DFS, or OS. Our results provide additional evidence that genetic polymorphisms observed in SNPs are associated with the prognoses of patients with HR-positive breast cancers; this may indicate different treatment strategies for these patients.

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Section: Methodsmentioning

confidence: 99%

Polymorphisms ofESR1, UGT1A1, HCN1, MAP3K1andCYP2B6are associated with the prognosis of hormone receptor-positive early breast cancer

et al. 2017

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“…Most western countries have implemented guidelines to optimally apply the elaborate diagnostic and treatment procedures available for patients with breast cancer. A strict adherence to these guidelines is required to secure the benefits in quality of life provided by the contemporary therapy, without compromising survival [3,4,5,6]. 10-24% of patients presenting with breast cancer are treated in rural/non-urban settings [7].…”

Section: Introductionmentioning

confidence: 99%

Outcome of Early Breast Cancer Treated in an Urban and a Rural Breast Cancer Unit in Germany

Heitz

Bender²,

Barinoff³

et al. 2013

Oncol Res Treat

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Background: Conflicting evidence has been published concerning survival disadvantages in the outcome of breast cancer patients in relationship to their residency in urban or rural communities. Methods: The primary aim of this study was to evaluate differences in patients and treatment characteristics between an urban and a rural breast cancer unit. Therefore, all early breast cancer patients treated consecutively between 1999 and 2007 in a rural and an urban breast cancer unit were included. Patient and tumor characteristics, treatment strategies, and guideline adherence were included to evaluate the prognoses of both populations. Results: Overall, data from 2,566 patients were included in this analysis. The 610 patients treated in the rural unit showed significantly more negative prognostic criteria than the 1,956 patients treated in the urban center. No differences were observed with respect to surgical and systemic treatment after adjustment for prognostic parameters. Adherence to national guidelines did not differ significantly between both settings and ranged between 78.0 and 95.6%. Furthermore, no differences regarding recurrence-free and overall survival were observed. Conclusions: The stage-adjusted pattern of care was similar in 2 German breast care units in a rural region and an urban area. Nevertheless, an earlier diagnosis of breast cancer should be enforced in rural areas to avoid extended treatment burden.

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“…The recommended range of the clear resection margin between 1 and 10 mm is extremely wide, and guidelines agree only on the necessity of re-resection in case of positive margin 7,13,14,15 . In a previous study that aimed to determine what percentage of the cavity reresection specimen contain tumor cells in the case reresection is performed until clear resection margin of at least 5 mm is obtained, we reported that around 30% of specimen re-resected to achieve 5mm free resection margin will contain tumor tissue 16 .…”

Section: Discussionmentioning

confidence: 99%

Significance of resection margin as a risk factor for local control of early stage breast cancer

Gatěk¹,

Vrána²,

Lukešová³

et al. 2013

BIOMED PAP

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Introduction. Breast conserving surgery combined with sentinel node biopsy represents currently the gold standard of treatment for early breast cancer. Although breast conserving surgery has been a widely accepted method for many years, there remain some highly controversial unresolved issues. The present analysis focused on the resection margin as one of the key factors for local control of the disease. Methods. Patient disease free survival and overall survival were collected from patients undergoing breast conserving surgery from 2004 to 2009 at the Department of Surgery Atlas hospital Zlin, Czech Republic. All patients with resection margin less then 5 mm were re-resected to achieve this clear resection margin of 5mm or more. Disease free survival (more specifically local relapse free survival, metastasis free survival and regional free survival) and overall survival were assessed. Results. The data on 330 patients were analyzed and 286/330 cases had complete follow-up. After a median follow-up of 70 months, 7 patients with isolated local relapse were identified (2.44%), 13 patients with distant metastasis without local relapse (4.54%) and 2 patients with relapse in the axilla without local relapse in the breast (0.7%). Conclusion.The final decision about the extent of resection margin remains controversial but based on the data on local control presented here it seems reasonable to increase the criteria for a clear resection margin to 5 mm.

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Locoregional treatment of primary breast cancer

Cited by 185 publications

References 40 publications

Polymorphisms ofESR1, UGT1A1, HCN1, MAP3K1andCYP2B6are associated with the prognosis of hormone receptor-positive early breast cancer

Polymorphisms ofESR1, UGT1A1, HCN1, MAP3K1andCYP2B6are associated with the prognosis of hormone receptor-positive early breast cancer

Outcome of Early Breast Cancer Treated in an Urban and a Rural Breast Cancer Unit in Germany

Significance of resection margin as a risk factor for local control of early stage breast cancer

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