1,257 results on '"estrogen receptor status"'
Search Results
2. Hormone receptor mRNA and protein levels as predictors of premenopausal tamoxifen benefit
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Terese Engström, Maria Ekholm, Mårten Fernö, Christine Lundgren, Bo Nordenskjöld, Olle Stål, Pär-Ola Bendahl, Julia Tutzauer, and Lisa Rydén
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breast cancer ,tamoxifen ,premenopausal patients ,randomized trial ,estrogen receptor status ,progesterone receptor status ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
ABSTRACT Background and purpose: Tamoxifen remains an important adjuvant treatment in premenopausal patients with hormone receptor-positive breast cancer. Thus, determination of hormone receptors is important. Here, we compare cytosol-based methods, immunohistochemistry (IHC), and gene expression (GEX) analysis for determining hormone receptor status in premenopausal breast cancer patients from a randomised tamoxifen trial, to evaluate their performance in identifying patients that benefit from tamoxifen. Patients and Methods: Premenopausal patients (n=564) were randomised to 2 years of tamoxifen or no systemic treatment. Estrogen receptor (ER) and progesterone receptor (PR) status by protein expression measured by cytosol-based methods and IHC, and mRNA by GEX analysis were compared in 313 patients with available data from all methods. Kaplan Meier estimates and Cox regression were used to evaluate the treatment-predictive value for recurrence-free interval (RFi) and overall survival (OS). Median follow-up for event-free patients was 26 (RFi) and 33 (OS) years. Results: The mRNA data of ESR1 and PGR distributed bimodally, patterns confirmed in an independent cohort. Kappa-values between all methods were 0.76 and 0.79 for ER and PR, respectively. Tamoxifen improved RFi in patients with ER-positive (ER+) or PR-positive (PR+) tumours (Hazard Ratio [HR] and 95% confidence interval [CI]), cytosol-ER+ 0.53 [0.36–0.79]; IHC-ER+ 0.55 [0.38–0.79]; GEX-ER+ 0.54 [0.37–0.77]; cytosol-PR+ 0.49 [0.34–0.72]; IHC-PR+ 0.58 [0.40–0.85]; GEX-PR+ 0.55 [0.38–0.80]). Results were similar for OS. Interpretation: These methods can all identify patients that benefit from 2 years of tamoxifen with equal performance, indicating that GEX data might be used to guide adjuvant tamoxifen therapy.
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- 2024
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3. Postdiagnosis circulating osteoprotegerin and TRAIL concentrations and survival and recurrence after a breast cancer diagnosis: results from the MARIE patient cohort
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Charlotte Le Cornet, Audrey Y. Jung, Theron S. Johnson, Sabine Behrens, Nadia Obi, Heiko Becher, Jenny Chang-Claude, and Renée T. Fortner
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OPG ,TRAIL ,Breast cancer survival ,Estrogen receptor status ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Abstract Background Experimental studies suggest a role for osteoprotegerin (OPG) and tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) in mammary tumor development and progression. These biomarkers have been minimally investigated with respect to outcomes in breast cancer patients. Methods OPG and TRAIL were evaluated in blood samples collected from 2459 breast cancer patients enrolled in the MARIE study, a prospective population-based patient cohort, at median of 129 days after diagnosis. Participants were between ages 50 and 74 at diagnosis and recruited from 2002 to 2005 in two regions of Germany. Follow-up for recurrence and mortality was conducted through June 2015. Delayed-entry Cox proportional hazards regression was used to assess associations between OPG and TRAIL with all-cause and breast cancer-specific mortality, and recurrence, both overall and by tumor hormone receptor status. Results Median follow-up time was 11.7 years, with 485 deaths reported (277 breast cancer-specific). Higher OPG concentrations were associated with a higher risk of all-cause mortality (hazard ratio for 1-unit log2-transformed concentration (HRlog2) = 1.24 (95% confidence interval 1.03–1.49). Associations were observed in women diagnosed with ER-PR- tumors or discordant hormone receptor status (ER-PR-, HRlog2 = 1.93 (1.20–3.10); discordant ERPR, 1.70 (1.03–2.81)), but not for women with ER + PR + tumors (HRlog2 = 1.06 (0.83–1.35)). OPG was associated with a higher risk of recurrence among women with ER-PR- disease (HRlog2 = 2.18 (1.39–3.40)). We observed no associations between OPG and breast cancer-specific survival, or for TRAIL and any outcome. Conclusions Higher circulating OPG may be a biomarker of a higher risk of poor outcome among women diagnosed with ER- breast cancer. Further mechanistic studies are warranted.
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- 2023
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4. Postdiagnosis circulating osteoprotegerin and TRAIL concentrations and survival and recurrence after a breast cancer diagnosis: results from the MARIE patient cohort.
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Le Cornet, Charlotte, Jung, Audrey Y., Johnson, Theron S., Behrens, Sabine, Obi, Nadia, Becher, Heiko, Chang-Claude, Jenny, and Fortner, Renée T.
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OSTEOPROTEGERIN ,BREAST cancer diagnosis ,CANCER relapse ,ESTROGEN receptors ,DISEASE progression - Abstract
Background: Experimental studies suggest a role for osteoprotegerin (OPG) and tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) in mammary tumor development and progression. These biomarkers have been minimally investigated with respect to outcomes in breast cancer patients. Methods: OPG and TRAIL were evaluated in blood samples collected from 2459 breast cancer patients enrolled in the MARIE study, a prospective population-based patient cohort, at median of 129 days after diagnosis. Participants were between ages 50 and 74 at diagnosis and recruited from 2002 to 2005 in two regions of Germany. Follow-up for recurrence and mortality was conducted through June 2015. Delayed-entry Cox proportional hazards regression was used to assess associations between OPG and TRAIL with all-cause and breast cancer-specific mortality, and recurrence, both overall and by tumor hormone receptor status. Results: Median follow-up time was 11.7 years, with 485 deaths reported (277 breast cancer-specific). Higher OPG concentrations were associated with a higher risk of all-cause mortality (hazard ratio for 1-unit log2-transformed concentration (HR
log2 ) = 1.24 (95% confidence interval 1.03–1.49). Associations were observed in women diagnosed with ER-PR- tumors or discordant hormone receptor status (ER-PR-, HRlog2 = 1.93 (1.20–3.10); discordant ERPR, 1.70 (1.03–2.81)), but not for women with ER + PR + tumors (HRlog2 = 1.06 (0.83–1.35)). OPG was associated with a higher risk of recurrence among women with ER-PR- disease (HRlog2 = 2.18 (1.39–3.40)). We observed no associations between OPG and breast cancer-specific survival, or for TRAIL and any outcome. Conclusions: Higher circulating OPG may be a biomarker of a higher risk of poor outcome among women diagnosed with ER- breast cancer. Further mechanistic studies are warranted. [ABSTRACT FROM AUTHOR]- Published
- 2023
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5. The Effect of Estrogen Receptor Status on Survival in Breast Cancer Patients in Ethiopia. Retrospective Cohort Study
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Belete AM, Aynalem YA, Gemeda BN, Demelew TM, and Shiferaw WS
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estrogen receptor status ,survival ,mortality ,breast cancer ,and ethiopia ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Abebe Muche Belete,1 Yared Asmare Aynalem,2 Belete Negese Gemeda,2 Tefera Mulugeta Demelew,3 Wondimeneh Shibabaw Shiferaw2 1Department of Biomedical Science, Debre Berhan University, Debre Berhan, Ethiopia; 2Department of Nursing, Debre Berhan University, Debre Berhan, Ethiopia; 3Department of Nursing, Addis Ababa University, Addis Ababa, EthiopiaCorrespondence: Abebe Muche Belete, Department of Biomedical Science, Debre Berhan University, P.O. Box 445, Debre Berhan, Ethiopia, Tel +251 938373278, Email abebemuche3@gmail.comBackground: There is wide global variance in survival from breast cancer, both in developed and developing country. However, the effect of estrogen receptor status has not been widely evaluated in Ethiopia where the incidence of breast cancer is rapidly increasing. Hence, the current study aimed to determine the effect of estrogen receptor status on the overall survival of breast cancer patients who were treated at Black Lion Specialized Hospital, Ethiopia.Methods: In this institution-based retrospective cohort study a total of 368 study participants were included with a one-to-one ratio of estrogen receptor negative to estrogen receptor positive. The main outcome of interest for this study was death due to breast cancer. The authors compared the women with estrogen receptor-positive and estrogen receptor-negative breast cancer for overall survival rate using log rank test. The incidence density rate of mortality was calculated for each exposed and non-exposed variable. The effect of estrogen receptor status on breast cancer mortality was estimated using the Cox proportional hazards model.Results: The incidence density rate of mortality among breast cancer patients for estrogen receptor positive were found to be 5.48 (95% CI=3.94– 7.64) per 1,000 person years observation; while for estrogen negative receptor status the mortality rate was found to be 10.47 (95% CI=8.19– 13.37) per 1,000 person years observation. In the Cox regression analysis after ful adjustments for confounder variables, the mortality event risk was 32% higher among estrogen receptor negative (HR=1.32; 95% CI=1.08– 2.91) as compared to estrogen receptor positive breast cancer patients.Conclusion: We have found that the incidence density rate of mortality among breast cancer patients was significantly higher in the estrogen receptor negative groups. Therefore, clinicians should give careful attention to the impact of estrogen receptor negative status on the overall outcome of clients.Keywords: estrogen receptor status, survival, mortality, breast cancer, Ethiopia
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- 2022
6. The Heterogeneity of Breast Cancer Metabolism
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Tan, Jessica, Le, Anne, Crusio, Wim E., Series Editor, Dong, Haidong, Series Editor, Radeke, Heinfried H., Series Editor, Rezaei, Nima, Series Editor, Xiao, Junjie, Series Editor, and Le, Anne, editor
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- 2021
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7. Effect of Estrogen on Heteronemin-Induced Anti-proliferative Effect in Breast Cancer Cells With Different Estrogen Receptor Status
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Yu-Chen S. H. Yang, Zi-Lin Li, Tung-Yung Huang, Kuan-Wei Su, Chi-Yu Lin, Chi-Hung Huang, Han-Yu Chen, Mei-Chin Lu, Haw-Ming Huang, Sheng-Yang Lee, Jaqueline Whang-Peng, Hung-Yun Lin, Paul J. Davis, and Kuan Wang
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heteronemin ,estrogen ,breast cancer ,estrogen receptor status ,anti-proliferation ,mitochondrial ROS ,Biology (General) ,QH301-705.5 - Abstract
Estrogen (E2) has multiple functions in breast cancers including stimulating cancer growth and interfering with chemotherapeutic efficacy. Heteronemin, a marine sesterterpenoid-type natural product, has cytotoxicity on cancer cells. Breast cancer cell lines, MCF-7 and MDA-MB-231, were used for investigating mechanisms involved in inhibitory effect of E2 on heteronemin-induced anti-proliferation in breast cancer cells with different estrogen receptor (ER) status. Cytotoxicity was detected by cell proliferation assay and flow cytometry, gene expressions were determined by qPCR, mechanisms were investigated by Western blot and Mitochondrial ROS assay. Heteronemin exhibited potent cytotoxic effects against both ER-positive and ER-negative breast cancer cells. E2 stimulated cell growth in ER-positive breast cancer cells. Heteronemin induced anti-proliferation via suppressing activation of ERK1/2 and STAT3. Heteronemin suppressed E2-induced proliferation in both breast cancer cells although some gene expressions and anti-proliferative effects were inhibited in the presence of E2 in MCF-7 and MDA-MB-231 cells with a higher concentration of heteronemin. Heteromenin decreased the Bcl-2/Bax ratio to inhibit proliferation in MDA-MB-231 but not in MCF-7 cells. Both heteronemin and E2 increased mitochondrial reactive oxygen species but combined treatment reversed superoxide dismutase (SOD)s accumulation in MCF-7 cells. Heteronemin caused G0/G1 phase arrest and reduced the percentage of cells in the S phase to suppress cancer cell growth. In conclusion, Heteronemin suppressed both ER-positive and ER-negative breast cancer cell proliferation. Interactions between E2 and heteronemin in signal transduction, gene expressions, and biological activities provide insights into the complex pathways by which anti-proliferation is induced by heteronemin in E2-replete environments.
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- 2021
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8. Estrogen Receptor Status by Immunohistochemistry Is Superior to the Ligand-Binding Assay for Predicting Response to Adjuvant Endocrine Therapy in Breast Cancer
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Jennet Harvey, D. Craig Allred, Gary M. Clark, and C. Kent Osborne
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Oncology ,Adult ,medicine.medical_specialty ,Pathology ,Cancer Research ,medicine.drug_class ,medicine.medical_treatment ,Mammary gland ,Statistics as Topic ,Estrogen receptor ,Breast Neoplasms ,Ligands ,Breast cancer ,Predictive Value of Tests ,Internal medicine ,Biomarkers, Tumor ,Medicine ,Humans ,Estrogen Receptor Status ,Aged ,biology ,business.industry ,Middle Aged ,medicine.disease ,Prognosis ,Immunohistochemistry ,medicine.anatomical_structure ,Receptors, Estrogen ,Estrogen ,Chemotherapy, Adjuvant ,biology.protein ,Female ,Reagent Kits, Diagnostic ,Antibody ,business ,Adjuvant - Abstract
PURPOSE Immunohistochemistry (IHC) is a newer technique for assessing the estrogen receptor (ER) status of breast cancers, with the potential to overcome many of the shortcomings associated with the traditional ligand-binding assay (LBA). The purpose of this study was to evaluate the ability of ER status determination by IHC, compared with LBA, to predict clinical outcome—especially response to adjuvant endocrine therapy—in a large number of patients with long-term clinical follow-up. PATIENTS AND METHODS ER status was evaluated in 1,982 primary breast cancers by IHC on formalin-fixed paraffin-embedded tissue sections, using antibody 6F11 and standard methodology. Slides were scored on a scale representing the estimated proportion and intensity of positive-staining tumor cells (range, 0 to 8). Results were compared with ER values obtained by the LBA in the same tumors and to clinical outcome. RESULTS An IHC score of greater than 2 (corresponding to as few as 1% to 10% weakly positive cells) was used to define ER positivity on the basis of a univariate cut-point analysis of all possible scores and disease-free survival (DFS) in patients receiving any adjuvant endocrine therapy. Using this definition, 71% of all tumors were determined to be ER-positive by IHC, and the level of agreement with the LBA was 86%. In multivariate analyses of patients receiving adjuvant endocrine therapy alone, ER status determined by IHC was better than that determined by the LBA at predicting improved DFS (hazard ratios/ P = 0.474/.0008 and 0.707/.3214, respectively) and equivalent at predicting overall survival (0.379/.0001 and 0.381/.0003, respectively). CONCLUSION IHC is superior to the LBA for assessing ER status in primary breast cancer because it is easier, safer, and less expensive, and has an equivalent or better ability to predict response to adjuvant endocrine therapy.
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- 2023
9. Menstrual and reproductive characteristics and breast cancer risk by hormone receptor status and ethnicity: The Breast Cancer Etiology in Minorities study.
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John, Esther M., Phipps, Amanda I., Hines, Lisa M., Koo, Jocelyn, Ingles, Sue A., Baumgartner, Kathy B., Slattery, Martha L., and Wu, Anna H.
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HORMONE receptors ,ETIOLOGY of cancer ,PREMATURE menopause ,MENSTRUATION disorders ,BREAST cancer ,AFRICAN American women ,ETHNICITY - Abstract
We pooled multiethnic data from four population‐based studies and examined associations of menstrual and reproductive characteristics with breast cancer (BC) risk by tumor hormone receptor (HR) status [defined by estrogen receptor (ER) and progesterone receptor (PR)]. We estimated odds ratios and 95% confidence intervals using multivariable logistic regression, stratified by age (<50, ≥50 years) and ethnicity, for 5,186 HR+ (ER+ or PR+) cases, 1,365 HR− (ER− and PR−) cases and 7,480 controls. For HR+ BC, later menarche and earlier menopause were associated with lower risk in non‐Hispanic whites (NHWs) and Hispanics, and higher parity and longer breast‐feeding were associated with lower risk in Hispanics and Asian Americans, and suggestively in NHWs. Positive associations with later first full‐term pregnancy (FTP), longer interval between menarche and first FTP and shorter time since last FTP were limited to younger Hispanics and Asian Americans. Except for nulliparity, reproductive characteristics were not associated with risk in African Americans. For HR− BC, lower risk was associated with later menarche, except in African Americans and older Asian Americans and with longer breast‐feeding in Hispanics and Asian Americans only. In younger African Americans, HR− BC risk associated with higher parity (≥3 vs. 1 FTP) was increased fourfold in women who never breast‐fed, but not in those with a breast‐feeding history, suggesting that breast‐feeding may mitigate the adverse effect of higher parity in younger African American women. Further work needs to evaluate why menstrual and reproductive risk factors vary in importance according to age and ethnicity. What's new? To examine how breast cancer risk varies among ethnic groups, these authors pooled data from 4 population‐based studies. They analyzed the relationship between menstrual and reproductive characteristics and breast cancer risk by hormone receptor status. In non‐Hispanic whites, Hispanics, and Asian‐Americans, associations were as expected. Characteristics such as later onset of menstruation, earlier menopause, higher parity, and longer breastfeeding were associated with lower risk of HR+ cancer in these groups. Among African Americans, however, most menstrual and reproductive characteristics showed no association with breast cancer risk, in contrast to a previous study. They did detect an increased risk for HR‐ cancer in African‐American women with higher parity who never breast‐fed. [ABSTRACT FROM AUTHOR]
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- 2020
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10. Endocrine-disrupting metals in ambient air and female breast cancer incidence in US.
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Vu, Vivian, Navalkar, Nina, and Wei, Yudan
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BREAST cancer , *METALS , *ENDOCRINE disruptors , *ESTROGEN receptors , *AIR - Abstract
Metals could act as endocrine disruptors that mimic the actions of hormones, such as estrogens, and contribute to the development and progression of breast cancer. In this study, we examined the association between ambient air emissions of several endocrine-disrupting metals and the incidence of female breast cancer in the United States by analyzing county-level data from national datasets. Linear regression analysis was conducted to evaluate the association in unadjusted and adjusted models. Of the metals analyzed, air emissions of arsenic, cadmium, lead, and mercury, but not chromium VI, were significantly associated with the incidence of all breast cancers, after adjusting for potential confounders. Emissions of arsenic, lead, and mercury were found to be significantly associated with the incidence of estrogen receptor (ER)-positive breast cancer. Among these metals, air emissions of lead showed the strongest association with breast cancer incidence with the β of 3756.66 (95% CI: 1660.29, 5853.03) for all breast cancers and 2433.85 (440.59, 4427.10) for ER-positive breast cancer. Our results demonstrate that exposure to endocrine-disrupting metals in ambient air may be associated with an increased incidence of breast cancer in the United States. Further studies are needed to explore these interactions and to elucidate mechanisms of action. [ABSTRACT FROM AUTHOR]
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- 2019
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11. How to Build Up Adequate Prognostic Markers in the Molecular Biology Context of Breast Cancer
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Russo, Jose and Russo, Jose
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- 2016
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12. Trajectories of body mass index across the lifecourse and associations with post-menopausal breast cancer by estrogen receptor status
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Pedersen, Dorthe C., Aarestrup, Julie, Blond, Kim, Jensen, Britt W., Andersen, Zorana J., Mellemkjær, Lene, Tjønneland, Anne, Baker, Jennifer L., Pedersen, Dorthe C., Aarestrup, Julie, Blond, Kim, Jensen, Britt W., Andersen, Zorana J., Mellemkjær, Lene, Tjønneland, Anne, and Baker, Jennifer L.
- Abstract
Background Associations between a high body mass index (BMI) at single timepoints during child- and adulthood and risks of post-menopausal breast cancer are well-established, but associations with BMI across the lifecourse remains largely unknown. Therefore, we examined whether lifecourse BMI trajectories were associated with risks of post-menopausal breast cancer overall and by estrogen receptor (ER) status. Methods We included 6698 Danish women born 1930–1946. Information on BMI at ages 6–15 years came from the Copenhagen School Health Records Register, and information on BMI at ages 20, 30, 40, 50 and/or 50–64 years came from the Diet, Cancer and Health cohort. Breast cancer cases (n = 577) were identified in the Danish Breast Cancer Cooperative Group database. Six BMI trajectories were identified using latent class trajectory modelling. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated using Cox regression models. Results Compared to women with a trajectory characterized by an average BMI gain across life, women with the two trajectories with steep increases in BMI during childhood and adolescence that thereafter largely stabilized, had lower risks of post-menopausal breast cancer and ER-positive tumors. The adjusted HRs for ER-positive tumors were 0.67 (95% CI: 0.47–0.95) and 0.68 (95% CI: 0.46–1.01), respectively. In contrast, women with a trajectory with a low gain in BMI during childhood and adolescence followed by a subsequent steep increase during adulthood, had higher risks of post-menopausal breast cancer and ER-positive tumors when compared to women with an average BMI gain. The adjusted HR for ER-positive tumors was 1.28 (95% CI: 0.98–1.67). Conclusions Our findings suggest that the timing of excess gain in BMI across the lifecourse impacts subsequent post-menopausal breast cancer risks. Thus, the BMI development across life is likely useful in the identification of women at increased risks o, Background: Associations between a high body mass index (BMI) at single timepoints during child- and adulthood and risks of post-menopausal breast cancer are well-established, but associations with BMI across the lifecourse remains largely unknown. Therefore, we examined whether lifecourse BMI trajectories were associated with risks of post-menopausal breast cancer overall and by estrogen receptor (ER) status. Methods: We included 6698 Danish women born 1930–1946. Information on BMI at ages 6–15 years came from the Copenhagen School Health Records Register, and information on BMI at ages 20, 30, 40, 50 and/or 50–64 years came from the Diet, Cancer and Health cohort. Breast cancer cases (n = 577) were identified in the Danish Breast Cancer Cooperative Group database. Six BMI trajectories were identified using latent class trajectory modelling. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated using Cox regression models. Results: Compared to women with a trajectory characterized by an average BMI gain across life, women with the two trajectories with steep increases in BMI during childhood and adolescence that thereafter largely stabilized, had lower risks of post-menopausal breast cancer and ER-positive tumors. The adjusted HRs for ER-positive tumors were 0.67 (95% CI: 0.47–0.95) and 0.68 (95% CI: 0.46–1.01), respectively. In contrast, women with a trajectory with a low gain in BMI during childhood and adolescence followed by a subsequent steep increase during adulthood, had higher risks of post-menopausal breast cancer and ER-positive tumors when compared to women with an average BMI gain. The adjusted HR for ER-positive tumors was 1.28 (95% CI: 0.98–1.67). Conclusions: Our findings suggest that the timing of excess gain in BMI across the lifecourse impacts subsequent post-menopausal breast cancer risks. Thus, the BMI development across life is likely useful in the identification of women at increased risks of post-menopausal breast cancer.
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- 2023
13. Trajectories of body mass index across the lifecourse and associations with post-menopausal breast cancer by estrogen receptor status.
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Pedersen DC, Aarestrup J, Blond K, Jensen BW, Andersen ZJ, Mellemkjær L, Tjønneland A, and Baker JL
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- Adolescent, Female, Humans, Body Mass Index, Receptors, Estrogen, Risk Factors, Postmenopause, Breast Neoplasms pathology
- Abstract
Background: Associations between a high body mass index (BMI) at single timepoints during child- and adulthood and risks of post-menopausal breast cancer are well-established, but associations with BMI across the lifecourse remains largely unknown. Therefore, we examined whether lifecourse BMI trajectories were associated with risks of post-menopausal breast cancer overall and by estrogen receptor (ER) status., Methods: We included 6698 Danish women born 1930-1946. Information on BMI at ages 6-15 years came from the Copenhagen School Health Records Register, and information on BMI at ages 20, 30, 40, 50 and/or 50-64 years came from the Diet, Cancer and Health cohort. Breast cancer cases (n = 577) were identified in the Danish Breast Cancer Cooperative Group database. Six BMI trajectories were identified using latent class trajectory modelling. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated using Cox regression models., Results: Compared to women with a trajectory characterized by an average BMI gain across life, women with the two trajectories with steep increases in BMI during childhood and adolescence that thereafter largely stabilized, had lower risks of post-menopausal breast cancer and ER-positive tumors. The adjusted HRs for ER-positive tumors were 0.67 (95% CI: 0.47-0.95) and 0.68 (95% CI: 0.46-1.01), respectively. In contrast, women with a trajectory with a low gain in BMI during childhood and adolescence followed by a subsequent steep increase during adulthood, had higher risks of post-menopausal breast cancer and ER-positive tumors when compared to women with an average BMI gain. The adjusted HR for ER-positive tumors was 1.28 (95% CI: 0.98-1.67)., Conclusions: Our findings suggest that the timing of excess gain in BMI across the lifecourse impacts subsequent post-menopausal breast cancer risks. Thus, the BMI development across life is likely useful in the identification of women at increased risks of post-menopausal breast cancer., Competing Interests: Declaration of Competing Interest The authors report no conflict of interests., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)
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- 2023
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14. Supervised Normalization of Large-Scale Omic Datasets Using Blind Source Separation
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Teschendorff, Andrew E., Renard, Emilie, Absil, Pierre A., Naik, Ganesh R., editor, and Wang, Wenwu, editor
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- 2014
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15. Clinical Bioinformatics: A New Emerging Science of Biomarker Development
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Wu, Xiaodan, Fang, Xiaocong, Zhu, Zhitu, Wang, Xiangdong, Wang, Xiangdong, Series editor, and Marko-Varga, György, editor
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- 2014
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16. Associations of adult‐attained height and early life energy restriction with postmenopausal breast cancer risk according to estrogen and progesterone receptor status.
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Elands, Rachel J. J., Offermans, Nadine S. M., Simons, Colinda C. J. M, Schouten, Leo J., Verhage, Bas A., Brandt, Piet A., and Weijenberg, Matty P.
- Abstract
Adult‐attained height is a marker for underlying mechanisms, such as cell growth, that may also influence postmenopausal breast cancer (BC) risk, perhaps specifically hormone‐sensitive BC subtypes. Early life energy restriction may inhibit these mechanisms, resulting in shorter height and a reduced postmenopausal BC risk. Women (62,573) from the Netherlands Cohort Study completed a self‐administered questionnaire in 1986 when 55–69 years old, and were followed‐up for 20.3 years (case–cohort: Nsubcohort = 2,438; Ncases = 3,354). Cox multivariable‐adjusted hazard ratios (HR) and 95% confidence intervals (CI) were estimated for BC risk overall and by estrogen and progesterone receptor subtypes in relation to height and early life energy restriction during the Hunger Winter, War Years, and Economic Depression. Although energy restriction can only influence longitudinal growth in women exposed before and/or during the growth spurt, it may also influence BC risk when occurring after the growth spurt, possibly through different growth processes. Therefore, Cox analyses were additionally conducted according to timing of energy restriction in relation to the growth spurt. Height was associated with an increased BC risk (HRper 5cm = 1.07, 95%CI:1.01–1.13), particularly hormone receptor‐positive BC. Energy restriction before and/or during the growth spurt was associated with a decreased hormone receptor‐positive BC risk. Energy restriction during the Hunger Winter increased the estrogen receptor‐negative BC risk regardless of the timing of energy restriction. In conclusion, height and energy restriction before and/or during the growth spurt were both associated with hormone receptor‐positive BC risk, in the direction as expected, indicating critical exposure windows for hormonal growth‐related mechanisms. What's new? Evidence suggests that postmenopausal breast cancer risk increases with height, while risk is reduced among individuals who experience reduced caloric intake in early life, which can result in shorter adult stature. In this investigation of women in the Netherlands Cohort Study, significant early‐life energy restriction, either before or during the pubertal growth spurt, was associated specifically with a decreased risk of estrogen receptor‐positive and progesterone receptor‐positive postmenopausal breast cancer. Greater adult‐attained height was significantly associated with increased hormone receptor‐positive postmenopausal breast cancer risk. The findings highlight the influence of hormonal growth‐related mechanisms on later postmenopausal breast cancer risk. [ABSTRACT FROM AUTHOR]
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- 2019
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17. Foods, macronutrients and breast cancer risk in postmenopausal women: a large UK cohort.
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Key, Timothy J, Balkwill, Angela, Bradbury, Kathryn E, Reeves, Gillian K, Kuan, Ai Seon, Simpson, Rachel F, Green, Jane, Beral, Valerie, Angela, Balkwill, and Seon Kuan, Ai
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BREAST cancer , *ESTROGEN receptors , *MEASUREMENT errors , *STANDARD deviations , *CONFIDENCE intervals , *ALCOHOLIC beverages - Abstract
Background: The role of diet in breast cancer aetiology is unclear; recent studies have suggested associations may differ by estrogen receptor status.Methods: Baseline diet was assessed in 2000-04 using a validated questionnaire in 691 571 postmenopausal UK women without previous cancer, who had not changed their diet recently. They were followed by record linkage to national cancer and death databases. Cox regression yielded adjusted relative risks for breast cancer for 10 food items and eight macronutrients, subdivided mostly into five categories of baseline intake. Trends in risk across the baseline categories were calculated, assigning re-measured intakes to allow for measurement error and changes in intake over time; P-values allowed for multiple testing.Results: Women aged 59.9 (standard deviation (SD 4.9)) years at baseline were followed for 12 (SD 3) years; 29 005 were diagnosed with invasive breast cancer. Alcohol intake had the strongest association with breast cancer incidence: relative risk (RR) 1.08 [99% confidence interval (CI) 1.05-1.11] per 10 g/day higher intake, P = 5.8 × 10-14. There were inverse associations with fruit: RR 0.94 (99% CI 0.92-0.97) per 100 g/day higher intake, P = 1.1 × 10-6, and dietary fibre: RR 0.91 (99% CI 0.87-0.96) per 5 g/day increase, P = 1.1 × 10-4. Fruit and fibre intakes were correlated (ρ = 0.62) and were greater among women who were not overweight, so residual confounding cannot be excluded. There was no heterogeneity for any association by estrogen receptor status.Conclusions: By far the strongest association was between alcohol intake and an increased risk of breast cancer. Of the other 17 intakes examined, higher intakes of fruit and fibre were associated with lower risks of breast cancer, but it is unclear whether or not these associations are causal. [ABSTRACT FROM AUTHOR]- Published
- 2019
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18. Application of preoperative ultrasound features combined with clinical factors in predicting HER2-positive subtype (non-luminal) breast cancer
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Shichong Zhou, Cai Chang, Wenxiang Zhi, Qian Zhu, Jiawei Li, Yunxia Huang, An-qi Jin, Jiong Wu, Jin Zhou, and Lang Qian
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Oncology ,medicine.medical_specialty ,Receptor, ErbB-2 ,Estrogen receptor ,Breast Neoplasms ,Logistic regression ,Sensitivity and Specificity ,Progesterone receptor ,Breast cancer ,Predictive Value of Tests ,Internal medicine ,Ultrasound ,medicine ,Biomarkers, Tumor ,Medical technology ,Humans ,Radiology, Nuclear Medicine and imaging ,R855-855.5 ,Estrogen Receptor Status ,Lymph node ,Retrospective Studies ,Univariate analysis ,Receiver operating characteristic ,business.industry ,Research ,Middle Aged ,medicine.disease ,Human epidermal growth factor receptor-2 ,ErbB Receptors ,medicine.anatomical_structure ,Preoperative Period ,Female ,Ultrasonography, Mammary ,business ,Receptors, Progesterone - Abstract
Background Human epidermal growth factor receptor2+ subtype breast cancer has a high degree of malignancy and a poor prognosis. The aim of this study is to develop a prediction model for the human epidermal growth factor receptor2+ subtype (non-luminal) of breast cancer based on the clinical and ultrasound features related with estrogen receptor, progesterone receptor, and human epidermal growth factor receptor2. Methods We collected clinical data and reviewed preoperative ultrasound images of enrolled breast cancers from September 2017 to August 2020. We divided the data into in three groups as follows. Group I: estrogen receptor ± , Group II: progesterone receptor ± and Group III: human epidermal growth factor receptor2 ± . Univariate and multivariate logistic regression analyses were used to analyze the clinical and ultrasound features related with biomarkers among these groups. A model to predict human epidermal growth factor receptor2+ subtype was then developed based on the results of multivariate regression analyses, and the efficacy was evaluated using the area under receiver operating characteristic curve, accuracy, sensitivity, specificity. Results The human epidermal growth factor receptor2+ subtype accounted for 138 cases (11.8%) in the training set and 51 cases (10.1%) in the test set. In the multivariate regression analysis, age ≤ 50 years was an independent predictor of progesterone receptor + (p = 0.007), and posterior enhancement was a negative predictor of progesterone receptor + (p = 0.013) in Group II; palpable axillary lymph node, round, irregular shape and calcifications were independent predictors of the positivity for human epidermal growth factor receptor-2 in Group III (p = 0.001, p = 0.007, p = 0.010, p Conclusions Our study established a model to predict the human epidermal growth factor receptor2-positive subtype with moderate performance. And the results demonstrated that clinical and ultrasound features were significantly associated with biomarkers.
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- 2021
19. Integrative multiomics-histopathology analysis for breast cancer classification
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William Yuan, Kun-Hsing Yu, Yasha Ektefaie, Jeffrey A. Golden, Deborah A. Dillon, Isaac S. Kohane, and Nan Lin
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Oncology ,medicine.medical_specialty ,medicine.diagnostic_test ,Receiver operating characteristic ,business.industry ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,medicine.disease ,Subtyping ,Article ,Breast cancer ,Internal medicine ,Mutation (genetic algorithm) ,Biopsy ,Medicine ,Pharmacology (medical) ,Radiology, Nuclear Medicine and imaging ,Histopathology ,business ,Breast cancer classification ,Estrogen Receptor Status ,RC254-282 - Abstract
Histopathologic evaluation of biopsy slides is a critical step in diagnosing and subtyping breast cancers. However, the connections between histology and multi-omics status have never been systematically explored or interpreted. We developed weakly supervised deep learning models over hematoxylin-and-eosin-stained slides to examine the relations between visual morphological signal, clinical subtyping, gene expression, and mutation status in breast cancer. We first designed fully automated models for tumor detection and pathology subtype classification, with the results validated in independent cohorts (area under the receiver operating characteristic curve ≥ 0.950). Using only visual information, our models achieved strong predictive performance in estrogen/progesterone/HER2 receptor status, PAM50 status, and TP53 mutation status. We demonstrated that these models learned lymphocyte-specific morphological signals to identify estrogen receptor status. Examination of the PAM50 cohort revealed a subset of PAM50 genes whose expression reflects cancer morphology. This work demonstrates the utility of deep learning-based image models in both clinical and research regimes, through its ability to uncover connections between visual morphology and genetic statuses.
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- 2021
20. Features of tumor heterogeneity in regional metastasis of breast cancer
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K K Konyshev and S V Sazonov
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business.industry ,Estrogen receptor ,General Medicine ,medicine.disease ,Somatic evolution in cancer ,Primary tumor ,Metastasis ,Breast cancer ,Cancer research ,Medicine ,Immunohistochemistry ,business ,Receptor ,Estrogen Receptor Status - Abstract
The review looked at the issues of tumor heterogeneity in breast cancer. Tumor heterogeneity is classified according to the main feature demonstrating regional differences within a tumor (for example, heterogeneity of clinical manifestations, histological heterogeneity, heterogeneity of protein expression, etc.) and by tumor regions (differences between primary tumors and metastases, differences between cell clones within a single tumor node, etc.). Temporal heterogeneity is also distinguished, which manifests itself in the clonal evolution of tumor cells. The review covers the heterogeneity in the expression of four biomarkers from the gold standard for immunohistochemical staining of breast cancer: estrogen receptors, progesterone receptors, Her2/neu and Ki67 in primary tumor tissue and regional metastases. According to various studies, discordance in estrogen receptor status of primary tumor cells and metastases was observed with a frequency of 4 to 62%, progesterone receptors from 12 to 54%, Her2/neu from 0 to 24%, Ki67 from 4 to 39%. The results of studies of changes in the expression levels of individual markers in breast cancer metastases, as well as the heterogeneity of surrogate subtypes of tumor tissue in metastasis, are briefly described. Possible reasons for heterogeneity in the expression of key prognostic and predictive markers by primary tumor and metastatic cells, such as artificial factors at the preanalytic and analytic stages of the study, polyclonality of the primary tumor before metastasis, clonal evolution of tumor cells during metastasis, selection of tumor clones under the therapy are highlighted.
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- 2021
21. Breast cancer treatment and outcomes at Cape Coast Teaching Hospital, Ghana
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Derek Anamaale Tuoyire, Anthony Baffour Appiah, Rosemary B. Duda, Martin Tangnaa Morna, Fejiro O. Okifo, and Samue Y. Debrah
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medicine.medical_specialty ,medicine.medical_treatment ,Breast Neoplasms ,Disease ,Ghana ,Breast cancer ,Internal medicine ,Humans ,Medicine ,Stage (cooking) ,Hospitals, Teaching ,Total Mastectomy ,Estrogen Receptor Status ,Mastectomy ,Retrospective Studies ,treatment ,Sub-Saharan Africa ,advanced stage presentation ,business.industry ,Medical record ,Cape Coast ,Cancer ,medicine.disease ,Radiation therapy ,Female ,business - Abstract
Objectives: This study sought to determine the presentation, treatment and outcomes of breast cancer among women in Cape Coast, Ghana.Design: Retrospective medical record reviewSetting: Cape Coast Teaching Hospital, Cape Coast, GhanaParticipants: Female breast cancer patientsInterventions: NoneMain outcome measures: Proportion of female breast cancer patients presenting with advanced disease.Results: Approximately 84% of women had a primary presentation of breast cancer, with metastatic disease present in 34% of patients. Surgical management mainly involved partial mastectomy (21.7%) and total mastectomy (78.6%), with the most common postoperative complications being surgical site infections (3.8%). Non-surgical management involved chemotherapy, radiation therapy and anti-estrogen therapy, with Stage 3 and 4 patients twofold more likely to receive neoadjuvant chemotherapy than earlier stages (OR= 2.0 95% CI (1.4, 3.0, p
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- 2021
22. Dairy foods, calcium, and risk of breast cancer overall and for subtypes defined by estrogen receptor status: a pooled analysis of 21 cohort studies
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Elisabete Weiderpass, Anna E. Prizment, Rachael Z. Stolzenberg-Solomon, Stephanie A. Smith-Warner, Sabina Sieri, Gretchen L. Gierach, Susanna C. Larsson, Shoichiro Tsugane, Roger L. Milne, Norie Sawada, Alicja Wolk, Anne Zeleniuch-Jacquotte, Chu Chen, You Wu, Linda M. Liao, Marian L. Neuhouser, Sven Sandin, Julie R. Palmer, Marjorie L. McCullough, Graham G. Giles, Vittorio Krogh, Neal D. Freedman, A. Heather Eliassen, Walter C. Willett, Leslie Bernstein, Peggy Reynolds, Yu Chen, Anthony B. Miller, Lynne R. Wilkens, Regina G. Ziegler, Ruyi Huang, Traci N. Bethea, Rashmi Sinha, Piet A. van den Brandt, Molin Wang, Thomas E. Rohan, Kristine R. Monroe, Mia M. Gaudet, Kim Robien, Kala Visvanathan, RS: GROW - R1 - Prevention, RS: CAPHRI - R5 - Optimising Patient Care, and Epidemiologie
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0301 basic medicine ,Oncology ,MILK CONSUMPTION ,Medicine (miscellaneous) ,Estrogen receptor ,Cohort Studies ,CONFIDENCE-INTERVALS ,0302 clinical medicine ,Risk Factors ,VITAMIN-D ,Estrogen Receptor Status ,milk ,Nutrition and Dietetics ,Hazard ratio ,WOMEN ,LOGISTIC-REGRESSION ,DIETARY PATTERNS ,Original Research Communications ,Receptors, Estrogen ,030220 oncology & carcinogenesis ,Female ,pooled analysis ,Cohort study ,medicine.medical_specialty ,chemistry.chemical_element ,Breast Neoplasms ,Calcium ,VALIDATION ,cheese ,03 medical and health sciences ,yogurt ,Breast cancer ,breast cancer ,Internal medicine ,medicine ,Vitamin D and neurology ,Humans ,FREQUENCY QUESTIONNAIRE ,METAANALYSIS ,calcium ,business.industry ,dairy products ,Cancer ,medicine.disease ,PREVENTION ,030104 developmental biology ,chemistry ,Multivariate Analysis ,business ,diet - Abstract
BACKGROUND: Epidemiologic studies examining the relations between dairy product and calcium intakes and breast cancer have been inconclusive, especially for tumor subtypes. OBJECTIVE: To evaluate the associations between intakes of specific dairy products and calcium and risk of breast cancer overall and for subtypes defined by estrogen receptor (ER) status. METHOD: We pooled the individual-level data of over 1 million women who were followed for a maximum of 8–20 years across studies. Associations were evaluated for dairy product and calcium intakes and risk of incident invasive breast cancer overall (n = 37,861 cases) and by subtypes defined by ER status. Study-specific multivariable hazard ratios (HRs) were estimated and then combined using random-effects models. RESULTS: Overall, no clear association was observed between the consumption of specific dairy foods, dietary (from foods only) calcium, and total (from foods and supplements) calcium, and risk of overall breast cancer. Although each dairy product showed a null or very weak inverse association with risk of overall breast cancer (P, test for trend >0.05 for all), differences by ER status were suggested for yogurt and cottage/ricotta cheese with associations observed for ER-negative tumors only (pooled HR = 0.90, 95% CI: 0.83, 0.98 comparing ≥60 g/d with
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- 2021
23. A brain metastasis prediction model in women with breast cancer.
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Cacho-Díaz B, Meneses-García AA, Valdés-Ferrer SI, and Reynoso-Noverón N
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Background: Breast cancer (BC) is a leading cause of mortality and the most frequent malignancy in women, and most deaths are due to metastatic disease, particularly brain metastases (BM). Currently, no biomarker or prediction model is used to predict BM accurately. The objective was to generate a BM prediction model from variables obtained at BC diagnosis., Methods: A retrospective cohort of women with BC diagnosed from 2009 to 2020 at a single center was divided into a training dataset (TD) and a validation dataset (VD). The prediction model was generated in the TD, and its performance was measured in the VD using the area under the curve (AUC) and C-statistic., Results: The cohort (n = 5009) was divided into a TD (n = 3339) and a VD (n = 1670). In the TD, the model with the best performance (lowest AIC) was built with the following variables: age, estrogen receptor status, tumor size, axillary adenopathy, anatomic clinical stage, Ki-67 expression, and Scarff-Bloom-Richardson score. This model had an AUC of 0.79 (95%CI, 0.76-0.82; p < 0.0001) in the TD. The 10-fold cross-validation showed the good stability of the model. The model displayed an AUC of 0.81 (95%CI, 0.77-0.85; P < 0.0001) in the VD. Four groups, according to the risk of BM, were generated. In the low-risk group, 1.2% were diagnosed with BM (reference); in the medium-risk group, 5.0% [HR 4.01 (95%CI, 1.8 - 8.8); P < 0.0001); in the high-risk group, 8.5% [HR 8.33 (95%CI, 4.1-17.1); P < 0.0001]; and in the very high-risk group, 23.7% [HR 29.72 (95%CI, 14.9 - 59.1); P < 0.0001]., Conclusion: This prediction model built with clinical and pathological variables at BC diagnosis demonstrated robust performance in determining the individual risk of BM among patients with BC, but external validation in different cohorts is needed., Competing Interests: Declaration of Competing Interest The authors declare that we have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. No funding was received for this work. We confirm that we have given due consideration to the protection of intellectual property associated with this work and that there are no impediments to publication, including the timing of publication, with respect to intellectual property., (Copyright © 2023 Elsevier Ltd. All rights reserved.)
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- 2023
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24. Hormonal Receptors PET-CT
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de Vries, Erik F. J., Glaudemans, Andor W. J. M., Schröder, Caroline P., Hospers, Geke A. P., Fanti, Stefano, editor, Farsad, Mohsen, editor, and Mansi, Luigi, editor
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- 2010
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25. Primary Endocrine Therapy for the Treatment of Early Breast Cancer in Older Women
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Wyld, Lynda, Hind, Daniel, Reed, Malcolm W., editor, and Audisio, Riccardo A., editor
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- 2010
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26. Reproductive history, breast‐feeding and risk of triple negative breast cancer: The Breast Cancer Etiology in Minorities (BEM) study.
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John, Esther M., Hines, Lisa M., Phipps, Amanda I., Koo, Jocelyn, Longacre, Teri A., Ingles, Sue A., Baumgartner, Kathy B., Slattery, Martha L., and Wu, Anna H.
- Abstract
Few risk factors have been identified for triple negative breast cancer (TNBC) which lacks expression of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2). This more aggressive subtype disproportionately affects some racial/ethnic minorities and is associated with lower survival. We pooled data from three population‐based studies (558 TNBC and 5,111 controls) and examined associations of TNBC risk with reproductive history and breast‐feeding. We estimated odds ratios (ORs) and 95% confidence intervals (CIs) using multivariable logistic regression. For younger women, aged <50 years, TNBC risk was increased two‐fold for parous women who never breast‐fed compared to nulliparous women (OR = 2.02, 95% CI = 1.12–3.63). For younger parous women, longer duration of lifetime breast‐feeding was associated with a borderline reduced risk (≥24
vs . 0 months: OR = 0.52, 95% CI = 0.26–1.04,P trend = 0.06). Considering the joint effect of parity and breast‐feeding, risk was increased two‐fold for women with ≥3 full‐term pregnancies (FTPs) and no or short‐term (<12 months) breast‐feeding compared to women with 1–2 FTPs and breast‐feeding ≥12 months (OR = 2.56, 95% CI = 1.22–5.35). None of these associations were observed among older women (≥50 years). Differences in reproductive patterns possibly contribute to the ethnic differences in TNBC incidence. Among controls aged <50 years, the prevalence of no or short‐term breast‐feeding and ≥3 FTPs was highest for Hispanics (22%), followed by African Americans (18%), Asian Americans (15%) and non‐Hispanic whites (6%). Breast‐feeding is a modifiable behavioral factor that may lower TNBC risk and mitigate the effect of FTPs in women under age 50 years. [ABSTRACT FROM AUTHOR]- Published
- 2018
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27. Female Sex Hormone Receptor Profiling in Uterine Adenosarcomas.
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Marcus, Jenna Z., Klobocista, Merieme, Karabakhtsian, Rouzan G., Prossnitz, Eric, Goldberg, Gary L., and Huang, Gloria S.
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Objective: This study aimed to identify the hormonal receptor status in uterine adenosarcoma (AS) and uterineASwith sarcomatous overgrowth (AS + SO), including thosewith high-grade histologic features (nuclear pleomorphism, atypical mitoses, necrosis), with or without heterologous elements. Estrogen receptor (ER) status, including estrogen receptor > (ER>), estrogen receptor A (ERA), andGproteinYcoupled estrogen receptor (GPER), and progesterone receptor (PgR) status were examined. Methods: From August 2001 to November 2013, 11 patients with histologic diagnosis of uterine AS were identified. Tumor tissue sections were stained for ER>, ERA, GPER, and PgR and examined both for percentage of overall cells stained and for intensity of staining. Descriptive statistics were calculated using clinicopathologic data abstracted from the medical record. Results: Eight cases of AS and 3 cases of AS with high-grade features were identified. Seven of 8 tumor samples of AS showed strong or moderate intensity immunostaining for ER>; all AS + SO tumor samples showed minimal to no immunoreactivity for ER>. There was a significant decrease in ER> H scores in high-grade tumors when compared with AS (P = 0.01). Lower PgR H scores were observed in high-grade tumors compared with those in AS (P = 0.04). Estrogen receptor A immunostaining was variable, and GPER immunostaining was absent in the majority of tumor samples. Conclusions: Higher expression of ER> and PgR was observed in AS when compared with those with AS + SO and high-grade features. Both tumor subtypes showed similar levels of ERA and GPER expression, although significant differences in ERA and GPER expression were not detected. In contrast to our previous findings in uterine carcinosarcoma, ERs ERA and GPER do not seem to play a significant role in AS in this study. [ABSTRACT FROM AUTHOR]
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- 2018
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28. Estrogens
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Krause, Walter K. H.
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- 2009
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29. The Effect of Postmastectomy Radiotherapy on Breast Cancer Patients After Neoadjuvant Chemotherapy by Molecular Subtype
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Jia-Chun Ma, Chuanxu Luo, Ting Luo, Ping He, Xi Yan, Lei Liu, Hong Zheng, Fang Liu, Tinglun Tian, Xiaorong Zhong, Zhongzheng Xiang, and Jiayuan Li
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Oncology ,medicine.medical_specialty ,Lymphovascular invasion ,medicine.medical_treatment ,Breast Neoplasms ,Subgroup analysis ,03 medical and health sciences ,0302 clinical medicine ,Breast cancer ,Internal medicine ,Humans ,Medicine ,Stage (cooking) ,Estrogen Receptor Status ,Mastectomy ,Neoplasm Staging ,Retrospective Studies ,business.industry ,Hazard ratio ,Nomogram ,medicine.disease ,Neoadjuvant Therapy ,030220 oncology & carcinogenesis ,Female ,Radiotherapy, Adjuvant ,030211 gastroenterology & hepatology ,Surgery ,Neoplasm Recurrence, Local ,business - Abstract
The effect of postmastectomy radiotherapy (PMRT) on patient outcomes after neoadjuvant chemotherapy (NAC) remains controversial. We aimed to establish a model to identify the subsets benefiting from PMRT and to examine the effect of PMRT according to molecular subtype. We retrospectively analyzed 1118 cT1-4cN0-3M0 breast cancer patients treated with NAC and mastectomy. A nomogram predicting locoregional recurrence (LRR) was established based on 418 unirradiated patients, and X-tile analysis was performed to divide the patients into two risk groups. The effect of PMRT on LRR, distant recurrence (DR), and breast cancer mortality (BCM) was estimated for patients with different molecular subtypes in two risk groups. A nomogram predicting LRR was developed using six factors: histologic classification, lymphovascular invasion, ypT stage, ypN stage, estrogen receptor status, and Ki-67 expression. Our study found that PMRT correlated with lower 5-year LRR, DR, and BCM rates for the high-risk group; however, no significant improvement in these endpoints was observed in the low-risk group. Among patients with high risk, subgroup analysis showed that LRR control was improved after PMRT for the human epidermal growth factor receptor 2 (HER2)-negative/hormone receptor (HR)-positive (HER2−/HR+), HER2-positive (HER2+)/HR+, and HER2−/HR-negative (HR−) subtypes, with hazard ratios of 0.113 (95% confidence [CI] 0.034–0.379; p
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- 2021
30. Postdiagnostic Dietary Glycemic Index, Glycemic Load, Dietary Insulin Index, and Insulin Load and Breast Cancer Survival
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Walter C. Willett, Maryam S. Farvid, Michelle D. Holmes, Wendy Y. Chen, Bernard Rosner, Rulla M. Tamimi, Elizabeth M. Poole, and A. Heather Eliassen
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Blood Glucose ,0301 basic medicine ,Oncology ,medicine.medical_specialty ,Epidemiology ,medicine.medical_treatment ,Breast Neoplasms ,03 medical and health sciences ,0302 clinical medicine ,Breast cancer ,Risk Factors ,Internal medicine ,Glycemic load ,Dietary Carbohydrates ,medicine ,Humans ,Insulin ,Estrogen Receptor Status ,business.industry ,Glycemic Load ,Prognosis ,medicine.disease ,Diet ,030104 developmental biology ,Postprandial ,Glycemic index ,Glycemic Index ,030220 oncology & carcinogenesis ,Female ,Insulin index ,business ,Body mass index - Abstract
Background: We investigated the associations of postdiagnostic dietary glycemic index (GI), glycemic load (GL), insulin index (II), and insulin load (IL) with breast cancer–specific and all-cause mortality. Methods: Among 8,932 women with stage I–III breast cancer identified in the Nurses' Health Study (NHS; 1980–2010) and NHSII (1991–2011), we prospectively evaluated the associations between postdiagnostic GI, GL, II, and IL, and breast cancer–specific and all-cause mortality. Participants completed a validated food frequency questionnaire every 4 years after diagnosis. Results: During follow-up by 2014 in the NHS and 2015 in the NHSII, 2,523 deaths, including 1,071 from breast cancer, were documented. Higher postdiagnostic GL was associated with higher risk of both breast cancer–specific mortality [HRQ5vsQ1 = 1.33; 95% confidence interval (CI) = 1.09–1.63; Ptrend = 0.008] and all-cause mortality (HRQ5vsQ1 = 1.26; 95% CI = 1.10–1.45; Ptrend = 0.0006). Higher all-cause mortality was also observed with higher postdiagnostic GI (HRQ5vsQ1 = 1.23; 95% CI = 1.08–1.40; Ptrend = 0.001), II (HRQ5vsQ1 = 1.20; 95% CI = 1.04–1.38; Ptrend = 0.005), and IL (HRQ5vsQ1 = 1.23; 95% CI = 1.07–1.42; Ptrend = 0.0003). The associations were not modified by insulin receptor or estrogen receptor status of the tumor, or body mass index. Conclusions: We found that higher dietary GL, reflecting postprandial glucose response, after a breast cancer diagnosis was associated with higher risk of breast cancer–specific mortality. Higher dietary GI, GL, II, and IL after a breast cancer diagnosis were associated with higher risk of death from any cause. Impact: These results suggest that carbohydrate quantity and quality may be important in breast cancer prognosis. See related commentary by McTiernan, p. 252
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- 2021
31. Classification of Expression Patterns Using Artificial Neural Networks
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Ringnér, Markus, Edén, Patrik, Johansson, Peter, Berrar, Daniel P., editor, Dubitzky, Werner, editor, and Granzow, Martin, editor
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- 2003
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32. Estrogen Receptor Expression Profile of Disseminated Epithelial Tumor Cells in Bone Marrow of Breast Cancer Patients
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Ditsch, Nina, Mayer, Barbara, Rolle, Michaela, Untch, Michael, Schildberg, Friedrich Wilhelm, Funke, Ilona, Schlag, P. M., editor, Senn, H.-J., editor, Kleihues, P., editor, Stiefel, F., editor, Groner, B., editor, Wallgren, A., editor, Allgayer, Heike, editor, Heiss, Markus M., editor, and Schildberg, Friedrich W., editor
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- 2003
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33. Application of DNA Microarray Technology to Clinical Biopsies of Breast Cancer
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Pusztai, Lajos, Symmans, W. Fraser, Buchholz, Thomas A., Stec, Jim, Ayers, Mark, Clark, Ed, Meric, Funda, Stivers, David, Hess, Kenneth, Zhang, Wei, editor, and Shmulevich, Ilya, editor
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- 2002
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34. Estrogens
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Hayat, M. A.
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- 2002
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35. Tamoxifen for the Treatment of Breast Cancer
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Jordan, V. Craig, Teicher, Beverly A., editor, Jordan, V. Craig, editor, and Furr, Barrington J.A., editor
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- 2002
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36. Molecular biological subtypes of breast cancer in BRCA1 mutation carriers
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N. I. Pospekhova, D. A. Golovina, M. G. Filippova, A. V. Semyanikhina, S. L. Dranko, A. M. Danishevich, and A. M. Stroganova
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0301 basic medicine ,Cancer Research ,medicine.medical_specialty ,Proliferation index ,Luma ,Gastroenterology ,brca1 mutation ,03 medical and health sciences ,symbols.namesake ,breast cancer ,0302 clinical medicine ,Breast cancer ,molecular tumor subtype ,triple negative subtype ,Internal medicine ,medicine ,Stage (cooking) ,Pharmacology, Toxicology and Pharmaceutics (miscellaneous) ,Estrogen Receptor Status ,RC254-282 ,Genetics (clinical) ,Fisher's exact test ,business.industry ,Biochemistry (medical) ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Progesterone Receptor Status ,medicine.disease ,030104 developmental biology ,030220 oncology & carcinogenesis ,symbols ,Immunohistochemistry ,business - Abstract
Background. According to the literature, BRCA1-associated breast cancer (BC) most often belongs to the triple negative (TNBC) molecular subtype. The data on the contribution of other molecular subtypes to this group of patients differ among different studies.The study objective is to evaluate the frequency of different tumor molecular subtypes in BC patients with BRCA1 gene mutation treated in N. N. Blokhin National Medical Research Center of Oncology in the period from 2017 to 2020.Materials and methods. The study included BC patients with a mutation in the BRCA1 gene (n = 209) identified as a result BRCA1 mutation screening of patients with BC. DNA diagnostics was carried out on blood samples of patients using the real-time polymerase chain reaction method. After analyzing the patients primary documentation clinical and morphological data were taken into account: the age of diagnosis, the stage of the disease, the results of immunohistochemical studies (estrogen receptor status, progesterone receptor status, HER2 expression, Ki-67 proliferation index). The assignment to the particular molecular tumour subtypes was performed according to estrogen receptor status, progesterone receptor status, HER2 status and Ki67 value.Results. Clinical and pathomorphological data of 209 patients with BRCA1-associated BC were analyzed. The age at diagnosis ranged from 23 to 72 years, the median age was 40 years, the mean age was 41.46 ± 9.82 years. BC associated with BRCA1 was found to be TNBC in 71.3 % and luminal B, HER2 negative (LumB–) in 19.1 % of the cases. Other tumour subtypes were much less common: luminal B, HER2 positive (LumB+) in 7.2 %, luminal A (LumA) in 1 % and HER2-positive (HER2+) in 1.4 % of the cases. The frequency of subtypes was estimated in different age groups (1st – patients 23–34 (n = 53), 2nd – 35–49 (n = 111), and 3rd – 50–72 (n = 45) years old). TNBC frequency was 81.1 % in the 1st group, 73.9 % in the 2nd and 53.4 % in the 3rd group; LumB– frequency was 15.1, 15.3 and 33.3 % respectively. Using the Fisher test it was shown that the differences in frequencies were statistically significant between groups 1st and 3 rd, as well as between groups 2 nd and 3 rd (p Conclusion. TNBC was the main molecular subtype in all age groups of BC patients with BRCA1 germinal mutation, TNBC frequency was lower in the older age group. LumB– subtype was also common in BRCA1-associated tumors especially in older women.
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- 2021
37. Comparison of the performance of four staging systems in determining the prognosis of breast cancer among women undergoing neoadjuvant chemotherapy
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Anke Bergmann, Marcelo Adeodato Bello, Luiz Claudio Santos Thuler, and Isabella Cristina Santos Soares
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0301 basic medicine ,Oncology ,Cancer Research ,medicine.medical_specialty ,Receptor, ErbB-2 ,medicine.medical_treatment ,Breast Neoplasms ,03 medical and health sciences ,0302 clinical medicine ,Breast cancer chemotherapy ,Breast cancer ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Humans ,Stage (cooking) ,Estrogen Receptor Status ,Aged ,Neoplasm Staging ,Retrospective Studies ,Chemotherapy ,Receiver operating characteristic ,business.industry ,Cancer ,Retrospective cohort study ,Middle Aged ,Prognosis ,medicine.disease ,Neoadjuvant Therapy ,030104 developmental biology ,Chemotherapy, Adjuvant ,030220 oncology & carcinogenesis ,Female ,business ,Brazil - Abstract
Different tumor-related factors have been proposed to assess the risk of disease progression and death in women undergoing neoadjuvant breast cancer chemotherapy. Recently, besides the classical pre-treatment clinical stage (CS) and post-treatment pathologic stage (PS), estrogen receptor status and histologic grade (CPS + EG score) and HER2 results (Neo-Bioscore) have also been added to this suite of staging systems, generating new scores. The present study aims to compare the performance of these four staging systems, namely CS, PS, CPS + EG and Neo-Bioscore, in the prognosis of breast cancer in women undergoing neoadjuvant chemotherapy. This study comprises a retrospective cohort study of female breast cancer patients diagnosed at the Brazilian National Cancer Institute, Brazil from January 2013 to December 2015. A descriptive analysis of patient characteristics was conducted, and Kaplan–Meier curves, a Cox proportional hazard analysis and Receiver Operating Characteristic (ROC) curves were developed according to the assessed staging system scores. A total of 803 patients were eligible for this study. Most were under 65 years old (88.0%), presented advanced tumors (clinical stage ≥ IIB 77.1%), with positive estrogen receptor (71.2%) and negative HER2 (75.7%) results. During the follow-up, 172 patients (21.4%) evolved to death. A statistical difference (p
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- 2021
38. Distinct JNK/VEGFR signaling on angiogenesis of breast cancer‐associated pleural fluid based on hormone receptor status
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Hsin-Han Chang, Hao-Chung Tsai, Chieh-Yung Wang, Chih-Ying Changchien, Li-Ting Cheng, Ying Chen, Ming-Sheng Shen, Ming-Shen Dai, Chen-Liang Tsai, Wen-Chiuan Tsai, and Herng-Sheng Lee
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0301 basic medicine ,Cancer Research ,MAP Kinase Signaling System ,Angiogenesis ,Breast Neoplasms ,angiogenesis ,03 medical and health sciences ,breast cancer ,p‐JNK ,0302 clinical medicine ,Breast cancer ,Clinical Research ,medicine ,Humans ,Malignant pleural effusion ,malignant pleural effusion ,skin and connective tissue diseases ,Estrogen Receptor Status ,Aged ,Tube formation ,Neovascularization, Pathologic ,business.industry ,Kinase insert domain receptor ,Original Articles ,General Medicine ,Middle Aged ,medicine.disease ,Vascular Endothelial Growth Factor Receptor-2 ,Metastatic breast cancer ,Pleural Effusion, Malignant ,VEGFR2 ,030104 developmental biology ,Oncology ,Hormone receptor ,030220 oncology & carcinogenesis ,cardiovascular system ,Cancer research ,Original Article ,Female ,business ,vascular endothelium - Abstract
Malignant pleural effusion is a common complication in metastatic breast cancer (MBC); however, changes in the pleural microenvironment are poorly characterized, especially with respect to estrogen receptor status. Histologically, MBC presents with increased microvessels beneath the parietal and visceral pleura, indicating generalized angiogenic activity. Breast cancer‐associated pleural fluid (BAPF) was collected and cultured with HUVECs to recapitulate the molecular changes in subpleural endothelial cells. The clinical progression of triple‐negative breast cancer (TNBC) is much more aggressive than that of hormone receptor‐positive breast cancer (HPBC). However, BAPF from HPBC (BAPF‐HP) and TNBC (BAPF‐TN) homogeneously induced endothelial proliferation, migration, and angiogenesis. In addition, BAPF elicited negligible changes in the protein marker of endothelial‐mesenchymal transition. Both BAPF‐HP and BAPF‐TN exclusively upregulated JNK signaling among all MAPKs in HUVECs. By contrast, the response to the JNK inhibitor was insignificant in Transwell and tube formation assays of the HUVECs cultured with BAPF‐TN. The distinct contribution of p‐JNK to endothelial angiogenesis was consequently thought to be induced by BAPF‐HP and BAPF‐TN. Due to increased angiogenic factors in HUVECs cultured with BAPF, vascular endothelial growth factor receptor 2 (VEGFR2) inhibitor was applied accordingly. Responses to VEGFR2 blockade were observed in both BAPF‐HP and BAPF‐TN concerning endothelial migration and angiogenesis. In conclusion, the above results revealed microvessel formation in the pleura of MBC and the underlying activation of p‐JNK/VEGFR2 signaling. Distinct responses to blocking p‐JNK and VEGFR2 in HUVECs cultured with BAPF‐HP or BAPF‐TN could lay the groundwork for future investigations in treating MBC based on hormone receptor status., Current study evaluated the angiogenic response of HUVECs cultured with breast cancer‐associated pleural fluid (BAPF) obtained from hormone positive (HP) and triple negative (TN) breast cancer, respectively. Both BAPF‐HP and BAPF‐TN stimulated endothelial angiogenesis with upregulation of vascular endothelial growth factor receptor 2 (VEGFR2) and p‐JNK expressions. In contrast, application of p‐JNK inhibitor only showed efficacy in HUVECs cultured with BAPF‐HP, but not BAPF‐TN. Blockade of VEGFR2 signaling revealed potent inhibition on endothelial motility and angiogenesis induced by BAPF‐HP and BAPF‐TN.
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- 2021
39. Impact of Primary Site Surgery on Survival of Patients with de novo Stage IV Breast Cancer
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Changyuan Wei, Zhen Huang, Qixing Tan, Qinghong Qin, and Qinguo Mo
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0301 basic medicine ,medicine.medical_specialty ,survival ,Metastasis ,surgery ,03 medical and health sciences ,0302 clinical medicine ,Breast cancer ,medicine ,Lymph node ,Estrogen Receptor Status ,Survival analysis ,Original Research ,business.industry ,Bone metastasis ,Cancer ,stage IV breast cancer ,medicine.disease ,Metastatic breast cancer ,Surgery ,030104 developmental biology ,medicine.anatomical_structure ,Oncology ,Cancer Management and Research ,030220 oncology & carcinogenesis ,business - Abstract
Zhen Huang,* Qixing Tan,* Qinghong Qin, Qinguo Mo, Changyuan Wei Department of Breast Surgery, Guangxi Medical University Cancer Hospital, Nanning, People’s Republic of China*These authors contributed equally to this workCorrespondence: Qinguo Mo; Changyuan WeiDepartment of Breast Surgery, Guangxi Medical University Cancer Hospital, 71 Hedi Road, Nanning 530021, People’s Republic of ChinaTel +86-771-5308593; + 86-771-5308593Fax +86-771-5312000Email qgmo135@263.net; weichangyuan@gxmu.edu.cnPurpose: The efficacy of primary site surgery in patients with de novo stage IV breast cancer remains controversial. However, few real-world studies have evaluated the benefits of local surgery on the primary site of stage IV breast cancer in China. The purpose of this study was to investigate the role of local surgery in the de novo stage IV breast cancer.Materials and Methods: Women with metastatic breast cancer at diagnosis were identified from Guangxi medical university cancer hospital (China) database from 2009 to 2017. The clinical and tumor features, surgical treatment, and survival rates were compared between surgical and non-surgical patients.Results: Two hundred forty-three patients were included, of whom 125 underwent primary site surgery. Patients who underwent surgery were more often had small primary tumors, fewer lymph node metastases, and had less visceral involvement. Patients in the surgery group had dramatically longer OS (median 35 vs 22 months, log-rank P=0.006). Stratified survival analysis showed that patients with bone metastasis alone or ≤ 3 metastasis benefit from surgery, while patients with visceral metastasis did not benefit from surgery. In multivariate analysis, surgical treatment, estrogen receptor status, progesterone receptor status and visceral metastases remained independent factors for survival.Conclusion: Surgical resection of the primary site can improve survival in selected de novo stage IV breast cancer patients.Keywords: stage IV breast cancer, surgery, survival
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- 2021
40. Oxytocin receptor expression is associated with estrogen receptor status in breast tumors
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T S Kalinina, Vladislav V Kononchuk, G R Abdullin, S V Sidorov, D A Obukhova, and Lyudmila F. Gulyaeva
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Receptor, ErbB-2 ,Clinical Biochemistry ,Estrogen receptor ,Breast Neoplasms ,General Medicine ,Biology ,Oxytocin ,medicine.disease ,Biochemistry ,Oxytocin receptor ,General Biochemistry, Genetics and Molecular Biology ,Andrology ,Breast cancer ,Receptors, Estrogen ,Receptors, Oxytocin ,Progesterone receptor ,medicine ,Humans ,Molecular Medicine ,Immunohistochemistry ,Biomarker (medicine) ,Female ,skin and connective tissue diseases ,Receptor ,Estrogen Receptor Status - Abstract
The oxytocin receptor (OXTR) plays an important role in childbirth, breastfeeding, and social interactions. There is emerging evidence that OXTR is associated with the breast cancer (BC) initiation and progression. However, the mechanisms leading to a change in its expression, the diagnostic or prognostic value of the receptor in BC are currently poorly understood. Here, we have evaluated the relative level of OXTR expression in BC samples (n=107), and also investigated the effect of estradiol on its expression in MCF-7 and MDA-MB-231 cells. The level of OXTR expression was significantly lower in breast tumor tissue than in normal tissue obtained from the same patient. The expression of OXTR was dependent on the status and expression of the estrogen receptor (ER): the level of OXTR mRNA was significantly lower in ER-negative BC samples compared to ER-positive BC samples. Moreover, OXTR expression was also lower in samples from patients with luminal subtype with a low value of ER expression (0-5 score according to the IHC assay, Allred scoring) compared with samples with high ER expression (6-8 score). In luminal BC, OXTR expression was associated with the HER2 expression level: the OXTR mRNA level was higher in tumors with a HER2 IHC score of 1+ as compared to cases with the HER2 expression score of 2+, 3+. We also showed that estradiol increased the level of OXTR mRNA in MCF-7 cells, but not in ER-negative MDA-MB-231 cells. These data indicate that changes in OXTR expression in BC tissues can be caused by increased ER expression. We found no association between OXTR and T or N stages and progesterone receptor expression.Retseptor oksitotsina (OXTR) igraet vazhnuiu rol' v protsessakh detorozhdeniia, grudnogo vskarmlivaniia i sotsial'nykh vzaimodeĭstviĭ. V poslednie gody poiavilis' dannye v pol'zu togo, chto OXTR sviazan s razvitiem i progressirovaniem raka molochnoĭ zhelezy (RMZh). Odnako mekhanizmy, privodiashchie k izmeneniiu ego ékspressii, diagnosticheskaia ili prognosticheskaia tsennost' retseptora pri RMZh na dannyĭ moment maloizuchenny. Poétomu my postavili tsel' otsenit' uroven' ékspressii OXTR v obraztsakh RMZh (n=107), a takzhe issledovat' vliianie éstradiola na ego ékspressiiu v kletkakh liniĭ MCF-7 i MDA-MB-231. Uroven' ékspressii OXTR byl znachitel'no nizhe v opukholevoĭ tkani molochnoĭ zhelezy, chem v normal'noĭ tkani, vziatoĭ ot togo zhe patsienta. Ékspressiia OXTR zavisela ot statusa i ékspressii éstrogenovogo retseptora (ER): uroven' mRNK OXTR byl dostoverno nizhe v obraztsakh ER-negativnogo RMZh po sravneniiu s obraztsami ER-pozitivnogo RMZh. Ékspressiia OXTR byla nizhe v obraztsakh patsientov s liuminal'nym RMZh pri nizkom znachenii ékspressii ER (0-5 ballov soglasno immunogistokhimicheskomu (IGKh) issledovaniiu, shkala Allred) po sravneniiu s obraztsami s vysokoĭ ékspressieĭ ER. Uroven' mRNK OXTR byl assotsiirovan s urovnem ékspressii HER2: uroven' mRNK OXTR byl znachitel'no povyshen v obraztsakh liuminal'nogo RMZh s urovnem ékspressii HER2 1 ball, soglasno IGKh issledovaniiu, po sravneniiu s opukholiami s vysokoĭ ékspressieĭ HER2 (2-3 balla). My takzhe pokazali, chto pod deĭstviem éstradiola uvelichivalsia uroven' mRNK OXTR v kletkakh MCF-7, no ne v ER-negativnykh kletkakh MDA-MB-231. Poluchennye dannye ukazyvaiut na to, chto izmenenie ékspressii OXTR v tkaniakh RMZh mozhet byt' vyzvano usileniem ékspressii ER. Sviazi OXTR so statusom T ili N opukholi i ékspressieĭ progesteronovogo retseptora vyiavleno ne bylo.
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- 2021
41. Comparison of ER, PR & HER2/neu(C-erb B2) reactivity pattern with various histomorphological patterns in patients with breast cancer
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Tejas Chokshi, Atul Shrivastava, Alpesh M. Maru, and A. S. Agnihotri
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Pathology ,medicine.medical_specialty ,business.industry ,Progesterone Receptor Status ,Malignancy ,medicine.disease ,medicine.anatomical_structure ,Breast cancer ,Invasive lobular carcinoma ,Medicine ,Immunohistochemistry ,business ,Breast carcinoma ,Lymph node ,Estrogen Receptor Status - Abstract
Introduction: Globally carcinoma breast is the leading cause of cancer death in women .Prognosis of such patients is related to a variety of Histomorphological features which includes, Histological grade, type, tumor size and lymph node metastases. Estrogen and progesterone receptors (ER, PR) and more recently, HER-2/neu have with increasing importance influenced the management of the malignancy. Materials and Methods: This study was carried out at tertiary care hospital which included 70 cases of breast cancer that we have reported at our department during a period from June 2012 to June 2014.Specimens were fixed overnight in 10% Neutral buffered formalin and processed as routine for H&E staining. Representative sections with tumour with adjacent normal breast tissue (internal control) were taken on Poly-L-Lysine coated slides and proceed for antigen retrieval, HRP Polymerization steps and than processed for ER, PR and HER-2/neu immuno-histochemical staining with respective antibody. Observation and Results: Maximum No. Of cases were in age group 5th and 6th decade with Invasive ductal carcinoma was predominately observed followed by invasive lobular carcinoma. Among 70 cases, 25 cases (35.71%) showing ER/PR+ HER 2- pattern which is predominant pattern in this study. While 23 cases (32.85%) showing Tripple negative pattern. Conclusion: most important cost effective, prognostic markers are estrogen receptor status, progesterone receptor status and HER2/neu status. Correlation of these marker status with clinical parameters helps in predicting the future treatment modalities and disease free survival for the patient in developing countries. Keywords: ER-Estrogen receptor, PR-Progesteron recptor, Immunohistochemistry.
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- 2020
42. The use of a second core needle biopsy to predict response to neoadjuvant chemotherapy in breast cancer patients, especially in the HER2-positive population
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Ying Zhou, Ying Zhang, Siyu Wu, Juping Shen, Guangyu Liu, and Zhimin Shao
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Adult ,medicine.medical_specialty ,Neoplasm, Residual ,Receptor, ErbB-2 ,medicine.medical_treatment ,Population ,Breast Neoplasms ,Breast cancer ,Predictive Value of Tests ,Antineoplastic Combined Chemotherapy Protocols ,Biopsy ,medicine ,Humans ,Breast ,education ,Estrogen Receptor Status ,Mastectomy ,Retrospective Studies ,Chemotherapy ,education.field_of_study ,medicine.diagnostic_test ,business.industry ,Magnetic resonance imaging ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,Neoadjuvant Therapy ,Treatment Outcome ,Chemotherapy, Adjuvant ,Predictive value of tests ,Female ,Surgery ,Biopsy, Large-Core Needle ,Radiology ,business - Abstract
Background Early and accurate assessment of the response to neoadjuvant chemotherapy offers the potential to optimize treatment to obtain improved responses. We aimed to predict the response to neoadjuvant chemotherapy using a second breast core needle biopsy after a median of 2 cycles of neoadjuvant chemotherapy. Methods We evaluated 805 consecutive patients undergoing neoadjuvant chemotherapy who had a second core needle biopsy between 2013 and 2017. The second core needle biopsy was performed after a median of 2 cycles of neoadjuvant chemotherapy. Pathologic response was evaluated after completion of all the chemotherapy cycles. Diagnostic values were compared and evaluated between the second core needle biopsy and contrast-enhanced magnetic resonance imaging in both the whole and the human epidermal growth factor receptor 2–positive populations. Results Overall, 653 patients were eligible and underwent a median of 6 chemotherapy cycles. The second core needle biopsy predicted residual breast cancer earlier than the final contrast-enhanced magnetic resonance imaging, with a greater positive predictive value (positive predictive value: 0.856 vs 0.802, P = .028). Multivariate analysis revealed that a estrogen receptor status, human epidermal growth factor receptor 2 positivity, findings on the final contrast-enhanced magnetic resonance imaging and the pathologic findings of the second core needle biopsy pathology were independent predictive factors for treatment response. The superiority in diagnostic value of a second core needle biopsy pathology in human epidermal growth factor receptor 2–positive patients was consistent with that in the whole population, with a positive predictive value of 0.785 (95% confidence interval: 0.707–0.847). The second core needle biopsy predicted the response to neoadjuvant chemotherapy as early as after 2 cycles, but the accuracy increased from 0.744 to 0.872 if the procedure was performed after more cycles (P = .002). Conclusion The second core needle biopsy predicted the response to neoadjuvant chemotherapy after 2 cycles quite well, especially in human epidermal growth factor receptor 2–positive patients. The ability of the prediction of response improved if the second biopsy was performed after 3 or 4 cycles.
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- 2020
43. The Effect of Adjuvant Treatment in Small Node-negative HER2-positive Breast Cancer: Which Subgroup Will Benefit?
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Shishi Zhou, Wanfen Tang, Xifeng Xu, Xiayun Jin, Chenyang Ge, Jianfei Fu, Xia Zhang, Jinlin Du, Hongjuan Zheng, Haiping Lin, and Qinghua Wang
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Adult ,0301 basic medicine ,Oncology ,Cancer Research ,medicine.medical_specialty ,Receptor, ErbB-2 ,medicine.medical_treatment ,Estrogen receptor ,Antineoplastic Agents ,Breast Neoplasms ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Breast cancer ,Internal medicine ,Epidemiology ,medicine ,Adjuvant therapy ,Humans ,Breast ,skin and connective tissue diseases ,Estrogen Receptor Status ,Mastectomy ,Aged ,Neoplasm Staging ,Aged, 80 and over ,Chemotherapy ,business.industry ,Hazard ratio ,Middle Aged ,Prognosis ,medicine.disease ,Survival Analysis ,Tumor Burden ,Treatment Outcome ,030104 developmental biology ,Chemotherapy, Adjuvant ,030220 oncology & carcinogenesis ,Female ,Radiotherapy, Adjuvant ,Lymph Nodes ,business ,Adjuvant ,Follow-Up Studies ,SEER Program - Abstract
Background We conducted this study to evaluate whether patients with T1a/b, node-negative (N−), human epidermal growth factor receptor 2-positive (HER2+) breast cancers benefited from adjuvant therapy, and explored better treatment strategies for these patients. Patients and Methods Patients with T1a/b, N−, HER2+ breast cancers during 2000 through 2004 were identified from the Surveillance, Epidemiology, and End Results (SEER) database. The Gray test was used to evaluate breast cancer-specific death (BCSD) and non-BCSD. To identify patients more suitable for chemotherapy, subgroup analyses were conducted according to tumor size and estrogen receptor (ER) status, and plots of hazard rate of death (HRD) were drawn to present the changes of BCSD. Results A total of 2940 patients with T1a/b, N−, HER2+ breast cancers were included; more patients in the T1b group received chemotherapy compared with the T1a group (65.18% vs. 29.30%; P Conclusion Chemotherapy, which is mainly decided by tumor size, fails to render survival benefits for patients with T1a/b, N−, HER2+ breast cancers. ER status, rather than tumor size, is important for clinicians to make adjuvant treatment decisions. The peak of BCSD occurs 2 to 5 years after diagnosis, and an at least 5-year follow-up is recommended for these patients.
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- 2020
44. Breast Cancer-Specific Mortality in Small-Sized Tumor with Stage IV Breast Cancer: A Population-Based Study
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Yi-Zi Zheng, Zhi-Ming Shao, Xian-Ming Wang, and Lei Fan
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0301 basic medicine ,Oncology ,Cancer Research ,medicine.medical_specialty ,Breast Neoplasms ,03 medical and health sciences ,0302 clinical medicine ,Breast cancer ,Internal medicine ,Breast Cancer ,medicine ,Humans ,Lymph node ,Estrogen Receptor Status ,Neoplasm Staging ,Retrospective Studies ,Proportional hazards model ,business.industry ,Cancer ,Progesterone Receptor Status ,Prognosis ,medicine.disease ,Primary tumor ,030104 developmental biology ,medicine.anatomical_structure ,Lymphatic Metastasis ,030220 oncology & carcinogenesis ,T-stage ,Female ,business - Abstract
Background Small-sized primary tumor does not always indicate a better prognosis. We hypothesized that very small primary breast tumors with extensive lymph node (LN) metastases represented an aggressive biologic behavior in stage IV disease. Materials and Methods Data between 2010 and 2015 were retrieved retrospectively from the Surveillance, Epidemiology, and End Results database with inclusion criteria of female sex, unilateral, metastatic, and T1/2 invasive ductal carcinoma. Primary study variables included T stage, N stage, grade, metastatic sites, number of involved sites, estrogen receptor status, progesterone receptor status, and human epidermal growth factor receptor 2 status. Kaplan-Meier and adjusted Cox proportional hazards models with interaction terms were used. One-, 2- and 3-year breast cancer-specific mortality (BCSM) was examined according to tumor size. Results We identified 5,340 eligible patients with breast cancer. In multivariate analysis, race, age, grade, molecular subtype, surgery, brain metastases, and liver metastases were found to be independently associated with BCSM. For T1 tumors, the N0, N1, and N2+ groups had the same BCSM. In tumors smaller than 50 mm, the 1-, 2-, and 3-year BCSM did not decline with the decrease of tumor size. For triple-negative breast cancers (TNBCs), the T1a/T1bN2+ group had significantly worse BCSM than any other group did. Conclusion Patients with stage IV cancer with small-sized tumors may have BCSM as high as those with larger tumors. In TNBCs, very small tumors with severe LN involvement are associated with the worst BCSM. Continued efforts are needed to further investigate Ta1/T1bN2 + M1 TNBCs and individualize the treatment for affected patients. Implications for Practice This study revealed that for stage IV breast cancer, smaller primary tumors were not always associated with better breast cancer-specific mortality. This study illustrated that very small triple-negative breast cancers (TNBCs) with extensive regional lymph node involvement may be a surrogate for biologically aggressive disease. Because of poor prognosis of T1a/T1bN2+ TNBCs, there might be an urgent need of more individualized treatment for affected patients. Future correlative studies ought to focus on the genetic and molecular differences in Ta1/T1bN2+ TNBCs that contribute to the biological behavior. Clarification of the regulation mechanism of very small-sized primary TNBCs with metastatic outgrowth in nodes and distant sites will play an integral role in developing targeted therapies.
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- 2020
45. Deep learning-enabled breast cancer hormonal receptor status determination from base-level H&E stains
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Michael F. Press, Ali Madani, Nitish Shirish Keskar, David B. Agus, Daniel Ruderman, Nikhil Naik, Richard Socher, and Andre Esteva
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0301 basic medicine ,Oncology ,Receptors, Steroid ,medicine.medical_specialty ,Receptor Status ,Science ,H&E stain ,General Physics and Astronomy ,Breast Neoplasms ,Article ,General Biochemistry, Genetics and Molecular Biology ,03 medical and health sciences ,Breast cancer ,Deep Learning ,0302 clinical medicine ,Internal medicine ,Machine learning ,Humans ,Medicine ,Receptor ,lcsh:Science ,Estrogen Receptor Status ,Neoplasm Grading ,Multidisciplinary ,Staining and Labeling ,business.industry ,General Chemistry ,medicine.disease ,030104 developmental biology ,Hormone receptor ,Area Under Curve ,030220 oncology & carcinogenesis ,Immunohistochemistry ,Female ,lcsh:Q ,business - Abstract
For newly diagnosed breast cancer, estrogen receptor status (ERS) is a key molecular marker used for prognosis and treatment decisions. During clinical management, ERS is determined by pathologists from immunohistochemistry (IHC) staining of biopsied tissue for the targeted receptor, which highlights the presence of cellular surface antigens. This is an expensive, time-consuming process which introduces discordance in results due to variability in IHC preparation and pathologist subjectivity. In contrast, hematoxylin and eosin (H&E) staining—which highlights cellular morphology—is quick, less expensive, and less variable in preparation. Here we show that machine learning can determine molecular marker status, as assessed by hormone receptors, directly from cellular morphology. We develop a multiple instance learning-based deep neural network that determines ERS from H&E-stained whole slide images (WSI). Our algorithm—trained strictly with WSI-level annotations—is accurate on a varied, multi-country dataset of 3,474 patients, achieving an area under the curve (AUC) of 0.92 for sensitivity and specificity. Our approach has the potential to augment clinicians’ capabilities in cancer prognosis and theragnosis by harnessing biological signals imperceptible to the human eye., Determination of estrogen receptor status (ERS) in breast cancer tissue requires immunohistochemistry, which is sensitive to the vagaries of sample processing and the subjectivity of pathologists. Here the authors present a deep learning model that determines ERS from H&E stained tissue, which could improve oncology decisions in under-resourced settings.
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- 2020
46. Prognostic Significance of a Novel Score Model Based on Preoperative Indicators in Patients with Breast Cancer Spine Metastases (BCSM)
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Zhipeng Wu, Qi Jia, Chenglong Zhao, Wei Xu, Jianru Xiao, Yao Wang, Xiaopan Cai, Dongsheng Wang, Sun Haitao, Haiyi Gong, and Ting Wang
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0301 basic medicine ,Oncology ,medicine.medical_specialty ,Multivariate analysis ,business.industry ,Surgical operation ,Nomogram ,medicine.disease ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,Breast cancer ,030220 oncology & carcinogenesis ,Internal medicine ,medicine ,In patient ,Blood parameters ,business ,Estrogen Receptor Status ,Pathological - Abstract
Background Surgery remains the mainstay of treatment for breast cancer spinal metastasis (BCSM) to relieve symptoms and improve the quality of life of BCSM patients. Therefore, it is important to effectively predict the prognosis of patients to determine whether they can undergo surgical operation. However, the prevalent methods for prognosis evaluation lack specificity and sensitivity for indicated malignancies like breast cancer because they are built on a relatively small number of heterogeneous types of primary tumors. The aim of the present study was to explore a novel predictive model based on the clinical, pathological and blood parameters obtained from BCSM patients before they received surgical intervention. Methods Altogether, 144 patients were included in this study. Univariate and multivariate analyses were performed to investigate the significance of preoperative parameters and identify independent factors for prognostic prediction of BCSM. A nomogram for survival prediction was then established and validated. Time-dependent ROC (TDROC) curves were graphed to evaluate the accuracy of the novel model vs other scoring systems including Tomita Score, revised Tokuhashi Score, modified Bauer Score and New England Spinal Metastasis Score. P values
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- 2020
47. Night work and breast cancer estrogen receptor status – results from the German GENICA study
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Sylvia Rabstein, Volker Harth, Beate Pesch, Dirk Pallapies, Anne Lotz, Christina Justenhoven, Christian Baisch, Markus Schiffermann, Susanne Haas, Hans-Peter Fischer, Evelyn Heinze, Christiane Pierl, Hiltrud Brauch, Ute Hamann, Yon Ko, and Thomas Brüning
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occupation ,breast cancer ,health ,shift work ,night work ,estrogen receptor ,case–control study ,germany ,circadian disruption ,estrogen receptor status ,genica ,Public aspects of medicine ,RA1-1270 - Abstract
OBJECTIVES: The potential mechanisms that link night-shift work with breast cancer have been extensively discussed. Exposure to light at night (LAN) depletes melatonin that has oncostatic and anti-estrogenic properties and may lead to a modified expression of estrogen receptor (ER) α. Here, we explored the association between shift work and breast cancer in subgroups of patients with ER-positive and -negative tumors. METHODS: GENICA (Gene–ENvironment Interaction and breast CAncer) is a population-based case–control study on breast cancer with detailed information on shift work from 857 breast cancer cases and 892 controls. ER status was assessed by immunohistochemical staining. Associations between night-shift work and ER-positive and -negative breast cancer were analyzed with conditional logistic regression models, adjusted for potential confounders. RESULTS: ER status was assessed for 827 cases and was positive in 653 and negative in 174 breast tumors. Overall, 49 cases and 54 controls were “ever employed” in shift work including night shifts for ≥1 year. In total, “ever shift work” and “ever night work” were not associated with an elevated risk of ER-positive or -negative breast tumors. Night work for ≥20 years was associated with a significantly elevated risk of ER-negative breast cancer [odds ratio (OR) 4.73, 95% confidence interval (95% CI) 1.22–18.36]. CONCLUSIONS: Our case–control study suggests that long-term night-shift work is associated with an increased risk of ER-negative breast cancers. Further studies on histological subtypes and the analysis of other potentially relevant factors are crucial for discovering putative mechanisms
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- 2013
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48. Therapeutic Potential of Melatonin in Immunodeficiency States, Viral Diseases, and Cancer
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Maestroni, George J. M., Huether, Gerald, editor, Kochen, Walter, editor, Simat, Thomas J., editor, and Steinhart, Hans, editor
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- 1999
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49. Targeting HER2 heterogeneity in early-stage breast cancer
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Sonia Pernas and Sara M. Tolaney
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0301 basic medicine ,Cancer Research ,Chemotherapy ,business.industry ,medicine.drug_class ,medicine.medical_treatment ,Disease ,medicine.disease ,Continuous variable ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,Breast cancer ,Text mining ,Oncology ,Estrogen ,030220 oncology & carcinogenesis ,medicine ,Cancer research ,Stage (cooking) ,skin and connective tissue diseases ,business ,neoplasms ,Estrogen Receptor Status - Abstract
Purpose of review HER2-positive (HER2+) breast cancer is clinically and biologically a heterogenous disease and not all patients benefit to the same extent from current anti-HER2 therapies. Recent findings Among HER2+ breast cancer, molecular intrinsic subtypes, PIK3CA mutation status, levels of HER2 gene/protein, immune infiltration, or intratumor heterogeneity modulate HER2-treatment sensitivity. HER2-enriched carcinomas, with high levels of HER2 and tumor-infiltrating lymphocytes (TILs) are highly sensitive to anti-HER2 therapies, regardless of chemotherapy. Luminal A/B tumors are more estrogen receptor-dependent than HER2-dependent, harbor higher rates of PIK3CA mutations, and are less responsive to anti-HER2 treatment. HER2 intratumoral heterogeneity that exists in approximately 10% of HER2+ disease may also cause treatment resistance. Early changes occur during neoadjuvant anti-HER2 therapy that can predict response. Importantly, HER2 expression is not a binary but rather a continuous variable. Overall, 34-63% of HER2-negative breast cancers express HER2, and HER2-low tumors have become a new entity, for which novel-targeted therapies may be effective. Summary Although much of what is discussed currently remains investigational, it is clear that HER2+ breast cancer is a complex disease comprising different entities. Future strategies to escalate or de-escalate treatment in early-stage HER2+ disease should consider other biomarkers beyond HER2 and estrogen receptor status, including intrinsic subtype, HER2 levels, and TILs; and evaluate different treatment strategies among patients with estrogen receptor-positive/HER2+ and estrogen receptor-negative/HER2+ diseases.
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- 2020
50. Distant metastasis prediction via a multi-feature fusion model in breast cancer
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Min Mao, Henian Sun, Karl Peltzer, Zheng Liu, Guijun Xu, Haixiao Wu, Peifang Liu, Natalia V Kharchenko, Xin Wang, Lisha Qi, Wenjuan Ma, Yao Xu, Vladimir P. Chekhonin, Zhuming Yin, Vladimir P. Baklaushev, Chao Zhang, and Yan-Bo Li
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Oncology ,Aging ,medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Distant metastasis ,Magnetic resonance imaging ,Cell Biology ,Nomogram ,Progesterone Receptor Status ,medicine.disease ,artificial intelligence ,Multiple masses ,neoplasm metastasis ,Multi feature fusion ,Breast cancer ,Internal medicine ,medicine ,breast neoplasms ,business ,early detection ,Estrogen Receptor Status ,Research Paper - Abstract
This study aimed to develop a model that fused multiple features (multi-feature fusion model) for predicting metachronous distant metastasis (DM) in breast cancer (BC) based on clinicopathological characteristics and magnetic resonance imaging (MRI). A nomogram based on clinicopathological features (clinicopathological-feature model) and a nomogram based on the multi-feature fusion model were constructed based on BC patients with DM (n=67) and matched patients (n=134) without DM. DM was diagnosed on average (17.31±13.12) months after diagnosis. The clinicopathological-feature model included seven features: reproductive history, lymph node metastasis, estrogen receptor status, progesterone receptor status, CA153, CEA, and endocrine therapy. The multi-feature fusion model included the same features and an additional three MRI features (multiple masses, fat-saturated T2WI signal, and mass size). The multi-feature fusion model was relatively better at predicting DM. The sensitivity, specificity, diagnostic accuracy and AUC of the multi-feature fusion model were 0.746 (95% CI: 0.623-0.841), 0.806 (0.727-0.867), 0.786 (0.723-0.841), and 0.854 (0.798-0.911), respectively. Both internal and external validations suggested good generalizability of the multi-feature fusion model to the clinic. The incorporation of MRI factors significantly improved the specificity and sensitivity of the nomogram. The constructed multi-feature fusion nomogram may guide DM screening and the implementation of prophylactic treatment for BC.
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- 2020
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