Clinicopathological characteristics, practical treatments, prognosis, and clinical issues of older breast cancer patients in Japan

Sawaki, Masataka; Yamada, Akihiro; Kumamaru, Hiraku; Matsubara, Hiroaki; Nakayama, Kanako; Shimizu, Chikako; Miyashita, Mika; Honma, Naoko; Taira, Naruto

doi:10.1007/s12282-020-01188-8

Cited by 11 publications

(6 citation statements)

References 25 publications

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“…Clinicopathological characteristics, such as degree of histological differentiation and TNM stage, as reported previously ( 21 , 22 ), were closely correlated with the long-term prognosis in patients with FBC. In our study, a disparity in the patients enrolled, which could contribute to selection bias, was found in nearly all key methodological characteristics in the original cohort.…”

Section: Discussionsupporting

confidence: 79%

Effect of the Nipple-Excising Breast-Conserving Therapy in Female Breast Cancer: A Competing Risk Analysis and Propensity Score Matching Analysis of Results Based on the SEER Database

Zhao

Yan

et al. 2022

Front. Oncol.

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IntroductionDue to the lack of randomized controlled trial, the effectiveness and oncological safety of nipple-excising breast-conserving therapy (NE-BCT) for female breast cancer (FBC) remains unclear. We aimed to explore and investigate the prognostic value of NE-BCT versus nipple-sparing breast-conserving therapy (NS-BCT) for patients with early FBC.MethodsIn this cohort study, data between NE-BCT and NS-BCT groups of 276,661 patients diagnosed with tumor–node–metastasis (TNM) stage 0–III FBC from 1998 to 2015 were retrieved from the Surveillance, Epidemiology, and End Results database. Propensity score matching analysis, Kaplan–Meier, X-tile, Cox proportional hazards model, and competing risk model were performed to evaluate the effectiveness and oncological safety for patients in NE-BCT and NS-BCT groups.ResultsA total of 1,731 (0.63%) patients received NE-BCT (NE-BCT group) and 274,930 (99.37%) patients received NS-BCT (NS-BCT group); 44,070 subjects died after a median follow-up time of 77 months (ranging from 1 to 227 months). In the propensity score matching (PSM) cohort, NE-BCT was found to be an adversely independent prognostic factor affecting overall survival (OS) [hazard ratio (HR), 1.24; 95% CI, 1.06–1.45, p=0.0078]. Subjects in NE-BCT group had similar breast-cancer-specific survival (BCSS) (HR, 1.15; 95%CI, 0.88–1.52, p=0.30) and worse other-causes-specific death (OCSD) (HR, 1.217; 95%CI, 1.002–1.478, p=0.048<0.05) in comparison with those in the NS-BCT group.ConclusionsOur study demonstrated that the administration of NE-BCT is oncologically safe and reliable and can be widely recommended in clinics for women with non-metastatic breast cancer.

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Section: Discussionsupporting

confidence: 79%

Effect of the Nipple-Excising Breast-Conserving Therapy in Female Breast Cancer: A Competing Risk Analysis and Propensity Score Matching Analysis of Results Based on the SEER Database

Zhao

Yan

et al. 2022

Front. Oncol.

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“…To our knowledge, this is the rst study based on a large population to explore the prognostic signi cance of further axillary lymph node dissection for sentinel lymph node micrometastases in female breast cancer directly through a competing risk model. Clinicopathological characteristics such as age, TNM stage, tumor grade, and hormone receptor status have been considered reliable prognostic indicators that can be utilized to guide the clinical management of breast cancer patients [30]. In our research, some differences in clinicopathological factors were found for almost all essential features in the initial cohort, which could lead to selection bias.…”

Section: Discussionmentioning

confidence: 78%

The Prognostic Significance of Further Axillary Dissection for Sentinel Lymph Node Micrometastases in Female Breast Cancer: A Competing Risk Analysis using the SEER Database

Zhou

Jiang

et al. 2022

Preprint

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On the basis of the Surveillance, Epidemiology, and End Results (SEER) database, the aim of this study is to identify whether complete axillary lymph node dissection (ALND) is actually required and has an impact on breast cancer-specific survival (BCSS) and overall survival (OS) in breast cancer patients with micrometastases. We identified 13,848 women whose nodal status was micrometastases (pTxN1miM0) were classified into two groups: the sentinel lymph node biopsy (SLNB) only group and SLNB with complete ALND group. After the PSM, we found that the SLNB with complete ALND showed no significant difference in OS (HR = 1.04, 95% CI: 0.84–1.28, P = 0.73) or BCSS (HR = 1.03, 95% CI: 0.79–1.35, P = 0.82) compared to the SLNB only group. There was no statistically significant difference in the cumulative incidence of BCSD (Grey’s test, P = 0.819) or OCSD (Grey’s test, P = 0.788) for between the two groups either. Our results suggest that in early breast cancer patients with micrometastasis, complete ALND does not seem to be required and that SLNB suffices to control locoregional and distant disease, with no significant adverse effects on survival compared to complete ALND.

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“…In contrast, Japanese, Chinese and Ethiopian studies showed that most breast cancer patients had clinical stage II and III cancer. 21–23 Nonetheless, the predominant proportion of prostate cancer patients (73%) had an advanced stage of the disease. This urges the implementation of public awareness strategies of prostate cancer’s early signs and symptoms in our setting to circumvent the high prevalence of advanced-stage prostate cancer patients.…”

Section: Discussionmentioning

confidence: 99%

Treatment Outcomes and Its Associated Factors Among Adult Patients with Selected Solid Malignancies at Kenyatta National Hospital: A Hospital-Based Prospective Cohort Study

Degu¹,

Terefe²,

Some³

et al. 2022

CMAR

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Introduction The treatment outcome of cancer is poor in the African setting due to inadequate treatment and diagnostic facilities. However, there is a paucity of data on solid cancers in Kenya. Hence, this study aimed to investigate the treatment outcomes and its determinant factors among adult patients diagnosed with selected solid malignancies at Kenyatta National Hospital (KNH). Materials and Methods A prospective cohort study was employed at the Oncology Department of KNH from 1 st July 2020 to 31 st December 2021. All new patients with a confirmed diagnosis of lymphoma, prostate cancer and breast cancer were studied. A consecutive sample of 99 breast cancer, 50 lymphomas, and 82 prostate cancer patients was included in the study. Semi-structured questionnaires consisting of socio-demographics, clinical characteristics, and quality of life were employed to collect the data. All enrolled patients were followed prospectively for 12 months. Treatment outcomes were reported as mortality, cancer-specific survival and health-related quality of life. The data were entered and analyzed using the SPSS 20.0 statistical software. Survival outcomes and its predictors were evaluated using the Kaplan–Meier analysis and Cox regression analyses, respectively. Results The study showed that the mortality rate among breast and prostate cancer patients was 3% and 4.9%, respectively. In contrast, the mortality rate was 10% among lymphoma patients. Most of the patients had partial remission and a good overall global health-related quality of life. Older age above 60 years, co-morbidity, distant metastasis and advanced stages of disease were significant predictors of mortality. Conclusion Although the mortality was not high at 12 months, only a few patients had complete remission. For many patients, the disease was progressing, despite 12-month mortality was not high. Therefore, longer follow-up will be required to report cancer mortality accurately. In addition, most of the patients had a good overall global health-related quality of life.

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Clinicopathological characteristics, practical treatments, prognosis, and clinical issues of older breast cancer patients in Japan

Cited by 11 publications

References 25 publications

Effect of the Nipple-Excising Breast-Conserving Therapy in Female Breast Cancer: A Competing Risk Analysis and Propensity Score Matching Analysis of Results Based on the SEER Database

Effect of the Nipple-Excising Breast-Conserving Therapy in Female Breast Cancer: A Competing Risk Analysis and Propensity Score Matching Analysis of Results Based on the SEER Database

The Prognostic Significance of Further Axillary Dissection for Sentinel Lymph Node Micrometastases in Female Breast Cancer: A Competing Risk Analysis using the SEER Database

Treatment Outcomes and Its Associated Factors Among Adult Patients with Selected Solid Malignancies at Kenyatta National Hospital: A Hospital-Based Prospective Cohort Study

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