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  • American Association for Cancer Research (AACR)  (8)
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  • American Association for Cancer Research (AACR)  (8)
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  • 1
    In: Molecular Cancer Research, American Association for Cancer Research (AACR), Vol. 21, No. 7 ( 2023-07-05), p. 726-740
    Kurzfassung: Patients with triple-negative breast cancer (TNBC) often develop metastases in visceral organs including the liver, but the detailed molecular mechanisms of TNBC liver metastasis is not clearly understood. In this study, we tried to dissect the process of premetastatic niche formation in the liver by using patient-derived xenograft (PDX) models of TNBC with different metastatic propensity. RNA sequencing of TNBC PDX models that successfully metastasized to liver showed upregulation of the Cx3cr1 gene in the liver microenvironment. In syngeneic breast cancer models, the Cx3cr1 upregulation in liver preceded the development of cancer cell metastasis and was the result of recruitment of CX3CR1-expressing macrophages. The recruitment was induced by the CX3CL1 production from the liver endothelial cells and this CX3CL1–CX3CR1 signaling in the premetastatic niche resulted in upregulation of MMP9 that promoted macrophage migration and cancer cell invasion. In addition, our data suggest that the extracellular vesicles derived from the breast cancer cells induced the TNFα expression in liver, which leads to the CX3CL1 upregulation. Lastly, the plasma CX3CL1 levels in 155 patients with breast cancer were significantly associated with development of liver metastasis. Implications: Our data provides previously unknown cascades regarding the molecular education of premetastatic niche in liver for TNBC.
    Materialart: Online-Ressource
    ISSN: 1541-7786 , 1557-3125
    Sprache: Englisch
    Verlag: American Association for Cancer Research (AACR)
    Publikationsdatum: 2023
    ZDB Id: 2097884-4
    SSG: 12
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 2
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 82, No. 4_Supplement ( 2022-02-15), p. P3-18-14-P3-18-14
    Kurzfassung: Introduction : Latissimus dorsi mini-flap (LDMF) with breast conserving surgery (BCS) was introduced as a useful volume replacement technique when the tumor is located in upper or outer portion of breast and the tumor size is large requiring extensive excision of breast tissue. However few studies have assessed quality of life (QoL) and objective cosmetic outcome of LDMF in breast cancer surgery. We tried to evaluate those in patients who underwent BCS with or without LDMF. Methods : This study was a prospective, single-center cohort study of patients who underwent LDMF and BCS between 2011 and 2018. As a control, patients who underwent BCS without any volume replacement and the tumor size equal to or greater than 2.5cm on the upper or upper outer of the breast on preoperative imaging. Breast Q questionnaire and body photo were taken at least 1 year after surgery. Two breast surgeons and one plastic surgeon who did not performed LDMF assessed the cosmetic outcome of the patients with photo. Results : 62 patients were in the BCS with LDMF group and 58 patients were in BCS-only group. Pathologic tumor size was significantly larger in LDMF group than BCS-only group (LDMF 3.89cm vs BCS-only 2.92cm, p= 0.001 ). Psychosocial well-being (P= 0.024), physical well-being (P= 0.000), and satisfaction with surgeon (p= 0.006) were significantly better in the BCS-only group than in the LDMF group respectively. But, there were no significant difference in neither sexual well-being (p= 0.286) nor satisfaction for breast (p=0.278) between BCS and LDMF group. In the physicians assessment, there was no significant difference in the cosmetic outcome score between the two groups (LDMF 2.56/4 vs. BCS-only 2.58/4, p= 0.884). Conclusion : In conclusion, physician assessed cosmetic outcome of LDMF was equivalent to that of BCS without LDMF although the tumor size was significantly larger in patients with LDMF. Some inferiority of QoL might be due to postoperative pain or arm movement discomfort. We are planning to evaluate objective cosmetic results using BCCT.core software. Citation Format: Jang-il Kim, Yireh Han, Changjin Lim, Jong-Ho Cheun, Ji Gwang Jung, Hong Kyu Kim, Han-Byoel Lee, Hyeong-Gon Moon, Wonshik Han. Assessment of quality of life and objective cosmetic outcome of breast conserving surgery with or without latissimus dorsi mini-flap in breast cancer [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P3-18-14.
    Materialart: Online-Ressource
    ISSN: 0008-5472 , 1538-7445
    RVK:
    RVK:
    Sprache: Englisch
    Verlag: American Association for Cancer Research (AACR)
    Publikationsdatum: 2022
    ZDB Id: 2036785-5
    ZDB Id: 1432-1
    ZDB Id: 410466-3
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 3
    Online-Ressource
    Online-Ressource
    American Association for Cancer Research (AACR) ; 2021
    In:  Cancer Research Vol. 81, No. 4_Supplement ( 2021-02-15), p. PS7-36-PS7-36
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 81, No. 4_Supplement ( 2021-02-15), p. PS7-36-PS7-36
    Kurzfassung: Background While numerous studies have consistently reported that the molecular subtypes of breast cancer are associated with different patterns of distant metastasis, the impact of molecular subtypes on the locoregional recurrence has not been thoroughly investigated. Currently, major guidelines in breast cancer recommend annual mammography for locoregional surveillance. In the present study, we investigated the patterns of locoregional recurrence in a large cohort of breast cancer patients who underwent standardized treatment at a single institution. Methods We retrospectively reviewed the clinical records of all patients who underwent breast cancer surgery for stage I-III diseases between January 2000 and December 2018. The patients with ductal carcinoma in situ who underwent standard treatment were also included. The events were classified into ipsilateral breast cancer recurrence (IBTR), locoregional recurrence (LRR) and contralateral breast cancer (CBC). All IBTR events were included in the LRR events. The patients with initial stage IV breast cancer, with recurrence breast cancer previously treated at elsewhere, or patients with insufficient follow-up period were excluded. Results A total of 16,505 patients were identified and included in the analysis. For all patients, the rate of IBTR, LRR, and CBC at 10 year was 2.6%, 4.9% and 1.9%, retrospectively. There was no significant association between the IHC-based molecular subtype and tumor recurrences in the 1,535 patients with ductal carcinoma in situ. For 14,970 patients with invasive disease, we observed significant differences in IBTR, LRR, and CBC between different molecular subtypes. For all events, HR-/HER2+ subtype and HR-/HER2- subtype showed worst recurrence-free survival compared to other subtypes (p & lt;0.001). However, when each event-types was separately analyzed, we observed a unique subtype-specific outcome differences according to different types of events. For IBTR, HR-/HER2- subtype showed significantly worse outcome compared to HR+ tumors (p & lt;0.001) but HR-/HER2+ subtype showed significantly higher number of events even compared to HR-/HER2- (p=0.026). For LRR, HR-/HER2+ and HR-/HER2- subtypes showed similar degree of worsening outcome compared to other subtypes (p & lt;0.001). For CBC, HR+/HER2- subtype showed significantly better outcome compared to other subtypes (p & lt;0.001). Interestingly, while the risk of development of LRR in HR+ subtypes was steady over time, the HR- subtypes showed increased risk of developing LRR during the first three years of follow-up. After that, all subtypes showed constant risk of developing LRR. In HR-/HER2+ subtype and HR-/HER- subtype, 68.2% and 75.5% of LRR events were manifested during the first three years, respectively. In contrast, HR+/HER2- and HR+/HER2+ subtypes had 43.5% and 56.5% of LRR events during the same period. In terms of CBC, all subtypes showed consistent annual risk of developing CBC during the follow-up period. The HR-/HER2- showed significantly increased risk of developing CBC compared to HR+/HER2- subtype until seven years of follow-up. Conclusions We propose a subtype-specific locoregional and contralateral breast recurrence patterns in operable breast cancer patients by using a large cohort of breast cancer patients with sufficient long-term follow-up. These findings suggest a subtype-based tailored approach for locoregional and contralateral breast recurrences after curative treatment Citation Format: Jong Ho Cheun, Han-Byoel Lee, Wonshink Han, Dong-Young Noh, Hyeong-Gon Moon. Subtype-dependent locoregional recurrence patterns in different subtypes of breast cancer: A retrospective analysis of 16,505 patients over 10 years of follow-up [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS7-36.
    Materialart: Online-Ressource
    ISSN: 0008-5472 , 1538-7445
    RVK:
    RVK:
    Sprache: Englisch
    Verlag: American Association for Cancer Research (AACR)
    Publikationsdatum: 2021
    ZDB Id: 2036785-5
    ZDB Id: 1432-1
    ZDB Id: 410466-3
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 4
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 82, No. 4_Supplement ( 2022-02-15), p. P4-07-07-P4-07-07
    Kurzfassung: Introduction Metaplastic carcinoma (MC) of the breast is a rare pathologic entity accounting for & lt;1% of all invasive breast cancers and is generally negative for hormone receptors and HER2. They often show more aggressive characteristics and are resistant to treatment. Although triple negative breast cancers (TNBCs) have good response to neoadjuvant chemotherapy (NAC) and a pathologic complete response (pCR) rate of about 40%, benefit of NAC for MC is not clear. The aim of this study was to compare the Clinicopathologic characteristics and prognosis of MC with non-MC TNBC, and assess the usefulness of NAC for MC. Methods Retrospective chart review of TNBC patients who underwent breast surgery at Seoul National University Hospital between January 2000 and December 2018 were included for analysis. Clinicopathologic features including age, TNM stage, Ki-67 and histologic grade were collected. For patients who had received NAC, tumor size on ultrasound before NAC and pathologic size of residual tumor was used to assess responsiveness to NAC. We used 3:1 propensity score matching according to age, neoadjuvant chemotherapy, pT stage, pN stage. Kaplan-Meier analysis and log-rank test were performed. Results Among 1783 TNBC patients included for analysis, 82 (4.59%) were MC and 1701 (95.34%) were non-MC. MC had a worse DFS and OS. After propensity score matching, there was no difference in survival outcomes. The 5-year disease-free survival and overall survival between MC vs. non-MC TN was 61.9% vs. 73.0% (HR 1.379, 95% CI 0.594-3.202, p-value = 0.430) and 71.4% vs. 74.6% (HR 1.007, 95% CI 0.393-2.579, p-value = 0.480), respectively. The proportion of patients who received NAC among MC and propensity matched non-MC TNBC were 21/82 (25.6%) and 63/1701 (3.7%), respectively. The pathologic complete response rate for all and propensity score matched non-MC TNBC was 76/364 (20.9%) and 11/63 (17.5%), respectively, whereas no MC patients achieved a pathologic complete response (HR 1.404 95% CI 1.213-1.624, p-value = 0.058). Conclusions MC has comparable prognosis compared to non-MC TNBC in terms of disease-free survival and overall survival, while showing lower rate of pathologic complete response after NAC. Upfront surgery may be more beneficial for MC. A prospective study with larger number of patients evaluating the role of NAC in MC is warranted. Citation Format: Changjin Lim, Jang-il Kim, Yireh Han, Jong-ho Cheun, Ji Gwang Jung, Hong Kyu Kim, Hyeong-Gon Moon, Wonshik Han, Han-Byoel Lee. Metaplastic carcinoma of the breast has comparable prognosis to non-metaplastic triple negative breast cancer despite poor response to chemotherapy [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P4-07-07.
    Materialart: Online-Ressource
    ISSN: 0008-5472 , 1538-7445
    RVK:
    RVK:
    Sprache: Englisch
    Verlag: American Association for Cancer Research (AACR)
    Publikationsdatum: 2022
    ZDB Id: 2036785-5
    ZDB Id: 1432-1
    ZDB Id: 410466-3
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 5
    Online-Ressource
    Online-Ressource
    American Association for Cancer Research (AACR) ; 2021
    In:  Cancer Research Vol. 81, No. 4_Supplement ( 2021-02-15), p. PS10-13-PS10-13
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 81, No. 4_Supplement ( 2021-02-15), p. PS10-13-PS10-13
    Kurzfassung: Background: Trastuzumab is well known to be effective to control locoregional recurrence and distant metastasis of human epidermal growth factor receptor 2 (HER2)-overexpressing breast tumor. However, few studies have reported the effect of ipsilateral breast tumor recurrence (IBTR) in spite of higher incidence of IBTR for HER2 overexpressing subtype than other subtypes. The purpose of this study is to investigate the difference in the incidence of IBTR of HER2-overexpressing breast tumor according to adjuvant trastuzumab. Methods: We retrospectively reviewed 996 patients who had done surgery for HER2-overexpressing breast cancer between January 2000 and December 2017 in our institution. Patients with tumors smaller than 0.5cm without axillar node metastasis were excluded. As regarding IBTR as recurrence “in” the ipsilateral breast, only patients who had done breast conserving surgery were included. Results: There were 735 patients who had finished adjuvant trastuzumab as first planned and 555 patients with hormone receptor positive. Median follow-up period for all patients was 70.7 months (range 12.7-239.6 months). The 10-year IBTR-free survival rate showed a significant benefit for the group treatment with trastuzumab than the group without trastuzumab (97.0% versus 91.9%; p=0.007). In a multivariate analysis, presence of lymphovascular invasion (Hazard ratio [HR], 2.53; 95% Confidence interval [CI] , 1.19 - 5.41), closed or involved resection margin (HR, 2.62; 95% CI, 1.20 - 5.74), positive hormone receptor (HR, 3.70; 95% CI, 1.69 - 8.08), positive axillar lymph node (HR, 5.21; 95% CI, 1.75 - 15.57), and omitted or uncompleted adjuvant trastuzumab (HR, 2.72; 95% CI, 1.11 - 6.67) were independent predictors of IBTR. However, subgroup analysis of the patients with hormone receptor negative tumor showed no benefit of adjuvant trastuzumab (98.1% versus 96.6%, p=0.669) while it controlled IBTR for hormone receptor positive tumor (95.7% versus 86.2%; p=0.002). When additionally analzyed, trastuzumab showed benefit for 10-year locoregional recurrence-free survival (95.5% versus 89.7%, p=0.012) and distant metastasis-free survival (93.5% versus 77.8%, p & lt;0.001). Conclusions: Trastuzumab has a clinical benefit in not only locoregional recurrence but also IBTR among HER2-overexpression breast cancer, especially with negative hormone receptor. Citation Format: Jong Ho Cheun, Han-Byoel Lee, Hyeong-Gon Moon, Dong-Young Noh, Wonshink Han. Impact of trastuzumab on Ipsilateral breast tumor recurrence after breast conserving surgery [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS10-13.
    Materialart: Online-Ressource
    ISSN: 0008-5472 , 1538-7445
    RVK:
    RVK:
    Sprache: Englisch
    Verlag: American Association for Cancer Research (AACR)
    Publikationsdatum: 2021
    ZDB Id: 2036785-5
    ZDB Id: 1432-1
    ZDB Id: 410466-3
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 6
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 83, No. 5_Supplement ( 2023-03-01), p. P3-05-06-P3-05-06
    Kurzfassung: Background: Obesity, the modern ‘epidemic’, has shared correlation with fatty liver disease and breast cancer. However, previous studies on the relation between fatty liver and breast cancer have shown conflicting results on the impact of fatty liver on the survival and recurrence of breast cancer patients. And there was no attempt to find out the effect of liver fibrosis, which is the consequence of fatty liver disease, on female breast cancer patients. So we attempted to investigate the prognostic value of non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis(NASH)-related liver fibrosis in patients with breast cancer undergoing surgery, using noninvasive tools like liver-to-spleen attenuation(L/S) ratio and Fibrosis-4(FIB-4) score, respectively. Methods: A total of 933 patients diagnosed with primary invasive breast cancer and receiving surgery at the university-affiliated referral center between April 2006 and December 2019 were included. After excluding patients who had significant alcohol consumption and hepatitis viral infection,838 patients were divided into two groups according to the L/S ratio of 1 measured by the preoperative low-dose computed tomography: 91 patients(10.9%) with a L/S ratio & lt; 1 vs 747 patients(89.1%) with a L/S ratio≥1. They were also divided into two groups based on the FIB-4 score of 2.67: 804 patients (95.9%) with a FIB-4 score & lt; 2.67 vs 34 patients (4.1%) with a FIB-4 score≥2.67. The Cox proportional hazards model was used to calculate the hazard ratio (HR) and the 95% confidence interval (CI). Results: Patients with NAFLD were older, had higher BMI, and had a higher proportion of mastectomy and hyper-transaminasemia. They showed worse overall, disease-free, and regional recurrence-free survivals compared to those without NAFLD (p=0.008, 0.043, and 0.017, respectively), but no significant differences in local recurrence-free, systemic recurrence-free, and contralateral breast cancer-free survivals. The survival outcome of breast cancer did not show any relationship with NASH-related liver fibrosis (overall survival; p=0.061, disease-free survival; p=0.557). NAFLD was a significant risk factor for mortality in multivariable analysis (HR, 2.077; 95% CI, 1.052–4.102; p=0.035). After stratifying for subtypes of breast cancer, the L/S ratio remained a significant predictor of overall, disease-free, local recurrence-free, and regional recurrence-free survivals in only the hormone receptor-positive/HER2−negative subtype (p=0.007, 0.005, 0.009, and & lt; 0.001, respectively). Conclusion: NAFLD is significantly associated with decreased overall survival, disease-free survival and increased regional recurrence in patients with breast cancer especially the hormone receptor-positive/HER2−negative subtype. NASH-related fibrosis was not associated with survival. Therefore, NAFLD should be assessed in the preoperative setting for predicting long-term prognoses of breast cancer patients Citation Format: Hyunsu Yeoh, Siwon Jang, Jong-Ho Cheun, Jin Ah Kwon, Myoung Seok Lee, Bumjo Oh, In Sil Choi, Sohee Oh, Jongjin Kim, Jeong Hwan Park, Won Kim, Ki-Tae Hwang. Prognostic impact of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis-related liver fibrosis on postoperative long-term outcomes of breast cancer [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P3-05-06.
    Materialart: Online-Ressource
    ISSN: 1538-7445
    Sprache: Englisch
    Verlag: American Association for Cancer Research (AACR)
    Publikationsdatum: 2023
    ZDB Id: 2036785-5
    ZDB Id: 1432-1
    ZDB Id: 410466-3
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 7
    Online-Ressource
    Online-Ressource
    American Association for Cancer Research (AACR) ; 2022
    In:  Cancer Research Vol. 82, No. 4_Supplement ( 2022-02-15), p. P2-11-07-P2-11-07
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 82, No. 4_Supplement ( 2022-02-15), p. P2-11-07-P2-11-07
    Kurzfassung: Introduction: The mammographic density (MD), which is the reflection of the proportion of the fibrogladular tissue in breast, is a well-known risk factor for breast cancer development. Recent studies have suggested that MD can also increase the risk of ipsilateral breast tumor recurrence (IBTR) and contralateral breast cancer (CBC) development. However, the data regarding the role of MD on IBTR and CBC is conflicting. To address this issue, we aimed to investigate the relationship between MD and IBTR and CBC in a large cohort of patients treated in a single institution to minimize the heterogeneity of MD assessment and breast cancer treatments.Methods: In this study, we retrospectively reviewed the MD data for 9,011 female breast cancer patients who underwent unilateral breast conserving surgeries between January 2000 and and December 2018 at Seoul National University Hospital. This study was approved by the Institutional Review Board of Seoul National University Hospital (IRB No: 2107-002-1231). The baseline MD for each patient was determined by the digital mammography image obtained within one year since the time of diagnosis. The patients were classified into 'high MD' or 'low MD' based on their baseline MD according to the 5th edition BI-RADS recommendation from the American College of Radiology. Results:The median age of the patients is 49.3 (19-88). Among the 9,011 patients, 6,440 (71.5%) were classified as 'high density' according to their baseline MD. The median follow-up duration was 75.2 months.The cumulative incidence of IBTR in our patient cohort was 2.1% at 10 years. The 'high MD' group experienced more incidences of IBTR with the hazard ratio of 1.44 (95% C.I., 1.07-1.95). Age at the time of diagnosis was also shown to be a significant prognostic factor for IBTR (p & lt;0.001, HR, 0.95; 95%CI, 0.94 - 0.97) and the younger age was significantly associated with high MD (p & lt;0.001). To adjust for the effect of age on IBTR, we stratified the patients according to their age at diagnosis. When the patients were stratified at their median age, the MD did not show significant effect on the development of IBTR. Cox regression analysis also revealed that the degree of MD does not independently predict the risk of IBTR development.For CBC, the cumulative rate at 5 year was 1.4%. Similar to the IBTR, high MD group and young age were significantly risk factors of developing CBC. However, the prognostic impact of high MD was more evident in patients of less than 50 years old. Furthermore, unlike the IBTR, the MD group remained to be independent predictor of CBC after adjusting for other prognostic factors. Conclusion:The degree of MD did not independently predict the risk of IBTR in patients undergoing breast conserving surgery. However, high MD was significantly associated with increased risk of developing CBC especially in younger breast cancer patients. Citation Format: Jong Ho Cheun, Hong-Kyu Kim, Han-Byoel Lee, Wonshik Han, Hyeong-Gon Moon. Mammographic density is associated with increased risk of contralateral breast cancers but not of ipsilateral breast tumor recurrences [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P2-11-07.
    Materialart: Online-Ressource
    ISSN: 0008-5472 , 1538-7445
    RVK:
    RVK:
    Sprache: Englisch
    Verlag: American Association for Cancer Research (AACR)
    Publikationsdatum: 2022
    ZDB Id: 2036785-5
    ZDB Id: 1432-1
    ZDB Id: 410466-3
    Standort Signatur Einschränkungen Verfügbarkeit
    BibTip Andere fanden auch interessant ...
  • 8
    Online-Ressource
    Online-Ressource
    American Association for Cancer Research (AACR) ; 2022
    In:  Cancer Research Vol. 82, No. 4_Supplement ( 2022-02-15), p. P3-18-12-P3-18-12
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 82, No. 4_Supplement ( 2022-02-15), p. P3-18-12-P3-18-12
    Kurzfassung: Introduction: Currently, the widely accepted principle in managing lumpectomy margins in early breast cancer patients is to avoid the presence of tumor cell at the margin. The presence of tumor cells on lumpectomy margin can represent two different aspects of local control in breast cancer. One aspect is related to the potential technical failure that may lead to an incomplete resection of the tumor. The other aspect of positive margin is associated with a biologic nature of the tumor. For example, some tumors show features of extensive intraductal component which often result in positive lumpectomy margins and may lead to increased risk of local recurrence after breast conservation surgery. Therefore, the two-fold increase of IBTR risk with positive margin would be the reflection of the combined effect of both technical failure and the biologic features.In this study, we aimed to address this issue by investigating the IBTR rates of patients in whom negative margins were achieved by initial lumpectomy or by re-excision. Our assumption was if the IBTR rates of the two groups are identical, then the two-fold increase of IBTR risk is mostly caused by the technical incomplete resection and therefore the measures to achieve negative margins would be justified. Methods: We retrospectively reviewed the data of 5,633 patients who underwent breast conservation surgery and whole breast irradiation for invasive breast cancer between January 2004 and December 2018 from Seoul National University Hospital. During the period, a total of 828 patients had positive lumpectomy margin after their initial surgery. Among them, thirty-five patients who did not undergo re-operation were excluded due to the small sample size. Results: The median age of the studied patients was 49 years old (19-92), and nearly two third of the patients had T1 tumors (64.3%). 4,293 patients (76.7%) were node negative and 4,332 patients (77.4%) had hormone receptor positive tumors. During the median follow-up period of 76.6 ( ± 44.6) months, a total of 121 patients (2.2%) experienced IBTR. Patients who underwent re-excision to achieve negative margins experienced significantly higher rate of IBTR compared to patients in whom the margins were clear at the first lumpectomy (p=0.031, HR: 1.61; 95% C.I., 1.04-2.48). The survival curves began to separate around 4-5 years after surgery (98.5% vs 98.0% at 5 year and 97.4% vs 94.7% at 10 years of follow-up). The survival difference was more clearly observed for younger patients (p=0.033, HR 1.72; 95% C.I., 1.04-2.85 for age less than 50). When the patients were divided according to their hormone receptor and HER2 amplification status, we observed significant difference in HR+/HER2- and HR-/HER2- subtypes while the HER2-amplified tumors showed no significant differences.By using Cox regression analysis, we adjusted for other significant predictors of IBTR such as age, histologic grade, lymphovascular invasion, hormone receptor status, HER2 amplification status, and Ki-67 levels. The results of the Cox regression analysis showed that re-excision to achieve negative margin is significantly associated with the risk of IBTR after adjusting for these variables (p=0.023, HR: 1.72; 95% C.I., 1.08-2.74). Conclusion: Patients who underwent re-excision after lumpectomy for initial positive margin carry increased risk of developing IBTR even they achieve final negative margin when compared to patients with initially negative lumpectomy margin. Our observation indicate that a substantial proportion of the increasing risk of IBTR associated with positive lumpectomy margin can be attributed to the biologic characteristics of the tumor rather than technical incomplete resection. Citation Format: Jong Ho Cheun, Hong-Kyu Kim, Han-Byoel Lee, Wonshik Han, Hyeong-Gon Moon. Achieving negative margin after repeated attempts for lumpectomy does not nullify the risk of ipsilateral breast tumor recurrences [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P3-18-12.
    Materialart: Online-Ressource
    ISSN: 0008-5472 , 1538-7445
    RVK:
    RVK:
    Sprache: Englisch
    Verlag: American Association for Cancer Research (AACR)
    Publikationsdatum: 2022
    ZDB Id: 2036785-5
    ZDB Id: 1432-1
    ZDB Id: 410466-3
    Standort Signatur Einschränkungen Verfügbarkeit
    BibTip Andere fanden auch interessant ...
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