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Objective To evaluate the safety of immediate breast reconstruction using deep inferior epigastric perforator (DIEP) flaps in the patients after neoadjuvant treatment. Methods From January 2019 to February 2021, the data of patients with breast cancer undergoing total mastectomy and immediate breast reconstruction using DIEP flap in Comprehensive Breast Health Center, Department of General Surgery, Ruijin Hospital were collected. Comparison of clinicopathological features was done between neoadjuvant treatment group and control group. Univariate analysis was used to compare the rate of surgical complications between two groups. Results A total of 110 patients were enrolled with 23 cases (20.9%) in neoadjuvant treatment group and 87 cases (79.1%) in control group. None of carcinoma in situ (0 vs. 19.5%, P=0.003) and higher pTNM stage (P

Objective To investigate tumour suppressor gene TP53 mutation, clinicopathological features and prognosis in the patients with triple-negative breast cancer (TNBC). Methods The rate and distribution of TP53 mutation, clinicopathological features, and prognosis in the patients with TNBC and with surgery at our center from January 2012 to March 2019 were retrospectively analyzed. Results In total of 234 TNBC cases, 144 (61.54%) cases were with TP53 mutation type and 90 (38.46%) cases with TP53 wild type. Most mutation was located at exon 5-8 region. The cases with TP53 mutation were divided into the group of missense mutation 85(59.03%) cases and the group of non-missense mutation 59 (40.97%) cases. More cases with TP53 mutation type had higher proliferation antigen(Ki-67) expression (>30%) when compared with the cases with TP53 wild type (80.56% vs. 63.33%, P=0.004, OR=2.40). There was no significant diffe-rence in prognosis between the group of mutation type and the group of wild type in relapse-free survival (RFS) (P=0.447), overall survival (OS) (P=0.083), and distant relapse-free survival (DRFS) (P=0.131). Similarly, there was no significant difference in prognosis between TP53 missense mutation and non-missense mutation in RFS(P=0.226), OS(P=0.885), and DRFS(P=0.172). Conclusions TNBC patients with TP53 mutation exhibited higher Ki-67 expression, however, similar prognosis between TP53 mutation type and wild type.

Breast cancer is the most commonly diagnosed female cancer in the world and 20%-30% patients faced the risk of recurrence and metastasis. Minimal residual disease(MRD) was believed as one of the important factors promo-ting disease progress in breast cancer and was closely associated with poor prognosis. Detection of MRD currently used liquid biopsy including detection of circulating tumor DNA and circulating tumor cell. The methods of detecting MRD in the evaluation of effect and prognosis and recurrence monitoring in breast cancer were explored in this review.

With overweight and obese population increasing worldwide, the association of body mass index(BMI) of breast cancer patients with the prognosis and treatment efficacy has become a hot topic. Here we reviewed the impact of obesity on prognosis and efficacy of adjuvant therapy of early breast cancer. A number of studies have shown that higher BMI was associated with larger tumors and increased lymph node involvement, more grading and higher proliferation. The effect of obesity on prognosis of early breast cancer differed across disease subtypes. Obesity was associated with poorer prognosis for hormone receptor-positive breast cancer, while the association of obesity with prognosis for other breast cancer subtypes was still controversial. Obesity could probably decrease the efficacy of adjuvant lipophilic chemotherapies for early breast cancer. The impact of obesity on efficacy of adjuvant endocrine therapy might depend on the type of aromatase inhibitor. The correlation between obesity and efficacy of adjuvant HER2- targeted therapy has not been clear.

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BackgroundThe current exploratory analysis was performed to evaluate the efficacy and safety of everolimus for treatment of human epidermal growth factor receptor 2-positive (HER2+) advanced breast cancer in the Asian subset of patients in the BOLERO-1 trial.MethodsPostmenopausal women with HER2+ advanced breast cancer, who had not received systemic therapy for advanced disease, were randomized 2:1 to receive everolimus or placebo, plus trastuzumab and paclitaxel. The two primary end points were investigator-assessed progression-free survival (PFS) in the full population and in the hormone receptor-negative (HR-) subpopulation. Secondary end points included assessment of the objective response rate, the clinical benefit rate, and safety.ResultsIn the Asian subset, median PFS was similar in the everolimus (n = 198) and placebo (n = 105) arms in the full analysis set (hazard ratio = 0.82 (95% CI 0.61-1.11)). In the HR- subpopulation, everolimus prolonged median PFS by 10.97 months vs placebo (25.46 vs 14.49 months; hazard ratio = 0.48 (95% CI 0.29-0.79)). In the everolimus arm of the Asian subset, the most common adverse events of any grade were stomatitis (62.2%), diarrhea (48.0%), rash (43.4%) and neutropenia (42.3%). Neutropenia (grade 3: 27.6%; grade 4: 4.6%) and decreased neutrophil count (grade 3: 11.2%; grade 4: 3.6%) were the most frequent grade 3/4 adverse events. Serious adverse events included pneumonia (5.1%), pneumonitis (3.1%), and interstitial lung disease (3.1%). There were three deaths (1.5%) during treatment in the everolimus arm vs none in the placebo arm.ConclusionsThe efficacy and safety of everolimus plus trastuzumab and paclitaxel as first-line treatment for HER2+ advanced breast cancer in the Asian subset was consistent with that reported previously in the overall population.Trial registrationClinicalTrials.gov, NCT00876395 . Registered on 2 April 2009.

Objective: To analyze the diagnosis, treatment and prognosis of breast cancer patients in Ruijin Hospital for further clinical management and study. Methods Non-metastatic breast cancer patients with surgical treatment in our hospital were included from January 2009 to December 2018. Clinicopathological features of enrolled patients and chan-ging trend of different surgery including breast conserving surgery and sentinel lymph node biopsy (SLNB) in the period of this study were analyzed. Kaplan-Meier curve analysis was used to compare 5-year and 10-year disease free survival (DFS) and overall survival(OS) of patients with different treatments. Results This study had 8 210 patients. There were 959 (11.7%) patients with in situ disease and 5 379(71.3%) patients with negative lymph node in 7 549 patients without neoadjuvant therapy. There were 949(12.6%) cases and 2964 (39.3%) cases with breast cancer at stage 0 and stage I, respectively. A total of 2377(29.0%) patients underwent breast conserving surgery with increase from 16.5% in 2009 to 34.8% in 2013. The patients with SLNB were 4149 cases (52.5%) from 0.6% in 2009 to 69.3% in 2018. All patients from 2009 to 2018 achieved complete follow-up with a median follow-up of 46 months: 5-year and 10-year DFS were 87.6% and 80.5%; 5-year and 10-year OS were 94.2% and 90.7%, respectively. There were 3800 patients with surgery followed from year 2009 to 2014 with a median-follow-up of 79 months: 5-year DFS rate and OS rate were 86.9% and 93.1%; 10-year DFS rate and OS rate were 79.1% and 88.4%, respectively. Conclusions Both rates of breast conserving surgery and SLNB in Ruijin Hospital increased in last 10 years. Patients had more than 93% of 5-year OS with modern treatment modality of breast cancer, which could indicate clinical management and research in future.

Background: The global BOLERO-2 trial established the efficacy and safety of combination everolimus (EVE) and exemestane (EXE) in the treatment of estrogen receptor positive (ER +), HER2-, advanced breast cancer (ABC). BOLERO-5 investigated this combination in a Chinese population (NCT03312738). Methods: BOLERO-5 is a randomized, double-blind, multicenter, placebo controlled, phase II trial comparing EVE (10 mg/day) or placebo (PBO) in combination with EXE (25 mg/day). The primary endpoint was progression-free survival (PFS) per investigator assessment. Secondary endpoints included PFS per blinded independent review committee (BIRC), overall survival (OS), overall response rate (ORR), clinical benefit rate (CBR), pharmacokinetics, and safety. Results: A total of 159 patients were randomized to EVE + EXE (n = 80) or PBO + EXE (n = 79). By investigator assessment, treatment with EVE + EXE prolonged median PFS by 5.4 months (HR 0.52; 90% CI 0.38, 0.71), from 2.0 months (PBO + EXE; 90% CI 1.9, 3.6) to 7.4 months (EVE + EXE; 90% CI 5.5, 9.0). Similar results were observed following assessment by BIRC, with median PFS prolonged by 4.3 months. Treatment with EVE + EXE was also associated with improvements in ORR and CBR. No new safety signals were identified in BOLERO-5, with the incidence of adverse events in Chinese patients consistent with the safety profile of both drugs. Conclusion: The efficacy and safety results of BOLERO-5 validate the findings from BOLERO-2, and further support the use of EVE + EXE in Chinese post-menopausal women with ER + , HER2- ABC. NCT03312738, registered 18 October 2017. [ABSTRACT FROM AUTHOR]

The randomized, multicenter, double-blind, placebo-controlled, phase III PEONY trial (NCT02586025) demonstrated significantly improved total pathologic complete response (primary endpoint) with dual HER2 blockade in HER2-positive early/locally advanced breast cancer, as previously reported. Here, we present the final, long-term efficacy (secondary endpoints: event-free survival, disease-free survival, overall survival) and safety analysis (62.9 months' median follow-up). Patients (female; n = 329; randomized 2:1) received neoadjuvant pertuzumab/placebo with trastuzumab and docetaxel, followed by adjuvant 5-fluorouracil, epirubicin, and cyclophosphamide, then pertuzumab/placebo with trastuzumab until disease recurrence or unacceptable toxicity, for up to 1 year. Five-year event-free survival estimates are 84.8% with pertuzumab and 73.7% with placebo (hazard ratio 0.53; 95% confidence interval 0.32–0.89); 5-year disease-free survival rates are 86.0% and 75.0%, respectively (hazard ratio 0.52; 95% confidence interval 0.30–0.88). Safety data are consistent with the known pertuzumab safety profile and generally comparable between arms, except for diarrhea. Limitations include the lack of ado-trastuzumab emtansine as an option for patients with residual disease and the descriptive nature of the secondary, long-term efficacy endpoints. PEONY confirms the positive benefit:risk ratio of neoadjuvant/adjuvant pertuzumab, trastuzumab, and docetaxel treatment in this patient population. Previously, the authors reported the primary analysis of a phase III randomized control trial investigating dual HER2 blockade in HER2-positive early/locally advanced breast cancer. Here, the authors report the long-term efficacy and safety analysis of this trial. [ABSTRACT FROM AUTHOR]