Breast Cancer 2012 - New Aspects

Kolberg, Hans‐Christian; Lüftner, Diana; Lux, Michael P.; Maass, Nicolaì; Schütz, Florian; Fasching, Peter A.; Fehm, Tanja; Janni, Wolfgang; Kümmel, Sherko

doi:10.1055/s-0032-1315131

Cited by 21 publications

(19 citation statements)

References 73 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This topic has been investigated in recent studies with inconsistent results. Contrary to the prognostic markers, predictive markers shall support in decision making of certain therapies as they appreciate the potential to respond to a therapy [52–54]. Various studies have explored the predictive value of Ki-67-labeling index of which some of them reported an association between high-pretreatment Ki-67-labeling index and better responses to chemotherapy in the neoadjuvant setting [11, 55–58] whereas other studies found no such association [47, 57, 59–61].…”

Section: Discussionmentioning

confidence: 99%

Ki-67 is a prognostic parameter in breast cancer patients: results of a large population-based cohort of a cancer registry

Inwald

Klinkhammer‐Schalke

Hofstädter

et al. 2013

Breast Cancer Res Treat

506

336

View full text Add to dashboard Cite

The proliferation marker Ki-67 is one of the most controversially discussed parameters for treatment decisions in breast cancer patients. The purpose of this study was to evaluate the routine use and value of Ki-67 as a prognostic marker, and to analyze the associations between Ki-67 and common histopathological parameters in the routine clinical setting. Data from the clinical cancer registry Regensburg (Bavaria, Germany) were analyzed. Within the total data pool of 4,692 female patients, who had been diagnosed between 2005 and 2011, in 3,658 cases Ki-67 was routinely determined. Thus, a total of 3,658 patients with invasive breast cancer were included in the present study and used for statistical analysis. Ki-67 expression was associated with the common histopathological parameters. The strongest correlation was found between grading and Ki-67 (P < 0.001). In terms of survival analyses, Ki-67 was categorized into five categories (reference category Ki-67 ≤15 %) due to a nonlinear relationship to overall survival (OS). In multivariable analysis, Ki-67 was an independent prognostic parameter both for disease-free survival (DFS) (Ki-67 > 45 %, HR = 1.96, P = 0.001) as well as for OS (Ki-67: 26–35 %, HR = 1.71, P = 0.017; Ki-67: 36–45 %, HR = 2.05, P = 0.011; Ki-67 > 45 %, HR = 2.06, P = 0.002) independent of common clinical and histopathological factors. The 5-year DFS (OS) rate was 86.7 % (89.3 %) in patients with a Ki-67 value ≤15 % compared to 75.8 % (82.8 %) in patients with a Ki-67 value >45 %. Based on the data from a large cohort of a clinical cancer registry, it was demonstrated that Ki-67 is frequently determined in routine clinical work. Ki-67 expression is associated with common histopathological parameters, but is an additional independent prognostic parameter for DFS and OS in breast cancer patients. Future work should focus on standardization of Ki-67 assessment and specification of its role in treatment decisions.

show abstract

Section: Discussionmentioning

confidence: 99%

Ki-67 is a prognostic parameter in breast cancer patients: results of a large population-based cohort of a cancer registry

Inwald

Klinkhammer‐Schalke

Hofstädter

et al. 2013

Breast Cancer Res Treat

506

336

View full text Add to dashboard Cite

show abstract

“…Treatment and prevention measures are increasingly taking into account the molecular classification that has been established during the last 10 years (Sorlie et al, 2001;Fasching et al, 2012;Kolberg et al, 2012;Schmidt et al, 2012). With regard to tumor characteristics, links have already been reported between certain molecular markers and BC risk factors.…”

Section: Introductionmentioning

confidence: 99%

Association of molecular subtypes with breast cancer risk factors

Rauh¹,

Gaß²,

Haeberle³

et al. 2015

European Journal of Cancer Prevention

View full text Add to dashboard Cite

As breast cancer (BC) screening identifies many BCs with a good prognosis, which might be overdiagnosed and therefore overtreated, the identification of subgroups with a high risk for aggressive subtypes might be helpful. The aim of this case-case analysis was to investigate the association between epidemiological risk factors and molecular subtypes in a cohort of BC patients. Epidemiological risk factors for 2587 BC patients were obtained using a structured questionnaire and from the patients' charts. The histopathological information (estrogen and progesterone receptor, HER2 and Ki-67) used in the analysis was retrieved from the original pathology reports. Analyses using conditional inference regression trees were carried out on these data. The strongest influence factor on the distribution of the molecular subtypes was age at first diagnosis of BC. An influence of BMI was also identified in patients aged either more than 42 years or 49.6 years or less. Older patients aged more than 49.6 years and perimenopausal women with a BMI of 32.4 kg/m or less were most likely to develop luminal A-like BC. Young patients aged 42 years or less and perimenopausal patients with a BMI more than 32.4 kg/m more often developed triple-negative BC. The study confirmed that age at diagnosis is an important factor influencing the distribution of molecular subtypes. In the perimenopausal group, it may be postulated that BMI plays a critical role in the pathogenesis of BC, defining a subgroup that is more likely to develop triple-negative BC or luminal B-like disease and another group in which there is a more postmenopausal distribution pattern.

show abstract

“…Large-scale randomized controlled trials (RCTs) investigated the use of AIs as either a substitute or add-on to tamoxifen and showed a superiority of the AIs over tamoxifen in postmenopausal patients (Baum et al 2002 ; Thürlimann et al 2009 ; Coombes et al 2004 ; Goss et al 2003 ; Dowsett et al 2010 ). Different strategies including AIs are possible, e.g., upfront monotherapy or switch to an AI after 2–3 years of tamoxifen or switch to tamoxifen after 2–3 years of AIs, and extended adjuvant treatment with an AI after 5 years of tamoxifen (Lux et al 2013 ; Kolberg et al 2012 ). Currently, the prolongation of ET beyond 5 years is discussed.…”

Section: Introductionmentioning

confidence: 99%

Adjuvant endocrine therapy in pre- versus postmenopausal patients with steroid hormone receptor-positive breast cancer: results from a large population-based cohort of a cancer registry

Inwald

Koller

Klinkhammer‐Schalke

et al. 2015

J Cancer Res Clin Oncol

View full text Add to dashboard Cite

Purpose Adjuvant endocrine therapy (ET) is indicated in patients with steroid hormone receptor (HR)-positive breast cancer. The aim of this study was to evaluate the quality of HR determination and adjuvant endocrine treatment of breast cancer patients in a large cohort of more than 7000 women by analyzing data from a population-based regional cancer registry.MethodsData from the Clinical Cancer Registry Regensburg (Bavaria, Germany) were analyzed. Female patients with primary, nonmetastatic invasive breast cancer who were diagnosed between 2000 and 2012 (n = 7421) were included. HR-status was available in 97.4 % (n = 7229) of the patients. This data set (n = 7229) was used for subsequent statistical analyses.ResultsSince 2009, almost a complete rate of 99.6 % of analyzed HR-status was achieved. In sum, 85.8 % of the patients (n = 6199) were HR-positive, whereas 14.2 % (n = 1030) were HR-negative. Overall, 85.3 % (n = 5285) of HR-positive patients received ET either alone or in combination with chemotherapy (CHT) and/or trastuzumab. The majority of premenopausal patients received CHT plus ET (716 patients, 52.3 %). In postmenopausal patients, the most frequent systemic therapy was ET alone (2670 patients, 55.3 %). Best overall survival (OS) was found in HER2-/HR-positive patients receiving CHT plus ET plus trastuzumab (7-year OS rate of 97.2 % in premenopausal patients versus 86.9 % in postmenopausal patients). Premenopausal patients had a reduced benefit from additional CHT than postmenopausal patients. Premenopausal patients receiving only ET had a 7-year OS rate of 95.3 % compared to 92.7 % of patients receiving CHT plus ET. In contrast, postmenopausal patients treated with CHT plus ET had a 7-year OS rate of 84.0 % in comparison with those patients receiving only ET with a 7-year OS rate of 81.7 %.ConclusionsAnalysis of HR in patients with early breast cancer achieved a very high quality in recent years. The vast majority of HR-positive patients received ET, and this guideline-adherent use improved OS. Inverse effects of the CHT plus ET combination in premenopausal versus postmenopausal patients and a still existing minority of patients not receiving guideline-adherent treatment should be further investigated in future studies.

show abstract

Breast Cancer 2012 - New Aspects

Cited by 21 publications

References 73 publications

Ki-67 is a prognostic parameter in breast cancer patients: results of a large population-based cohort of a cancer registry

Ki-67 is a prognostic parameter in breast cancer patients: results of a large population-based cohort of a cancer registry

Association of molecular subtypes with breast cancer risk factors

Adjuvant endocrine therapy in pre- versus postmenopausal patients with steroid hormone receptor-positive breast cancer: results from a large population-based cohort of a cancer registry

Contact Info

Product

Resources

About