Does breast cancer growth rate really depend on tumor subtype? Measurement of tumor doubling time using serial ultrasonography between diagnosis and surgery

Nakashima, Kazuaki; Uematsu, Takayoshi; Takahashi, Kaoru; Nishimura, S.; Tadokoro, Yukiko; Hayashi, Takuma; Sugino, Takashi

doi:10.1007/s12282-018-0914-0

Cited by 39 publications

(54 citation statements)

References 30 publications

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“…Our finding of faster growth in ER negative tumours has been observed by others [ 11 , 12 ]. Interestingly, we found no significant association of doubling time with HER2 status.…”

Section: Discussionsupporting

confidence: 91%

“…In spite of these limitations, this study demonstrates the association of TVDT with age, tumour grade and oestrogen receptor status: The higher the grade, the shorter the doubling time, similarly, significantly increased growth rates were seen in ER negative cancers, in keeping with some but not all findings published by others [ 11 , 12 , 18 , 21 , 24 ]. In terms of association of growth rates with age and with histological grade, our results support clear trends of faster growth at younger ages and in grade 3 cancers.…”

Section: Discussionsupporting

confidence: 89%

“…Nakashima and colleagues identified significant differences in short-term pre-operative TVDTs according to histological grade, molecular subtype and Ki67. Shorter TVDTs were noted in high grade and triple negative cancers and where Ki67 indices were high, than in ER positive and/or HER2 positive tumours with lower grades or Ki67 indices [ 11 ]. The association of higher grade with reduced doubling time has also been reported in another study[ 12 ].…”

Section: Introductionmentioning

confidence: 99%

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Radiological audit of interval breast cancers: Estimation of tumour growth rates

et al. 2020

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Introduction This multicentre, retrospective study aimed to establish correlation between estimated tumour volume doubling times (TVDT) from a series of interval breast cancers with their clinicopathological features. The potential impact of delayed diagnosis on prognosis was also explored. Materials and methods Interval cancers, where screening mammograms demonstrated changes that were retrospectively classified as either uncertain or suspicious, were reviewed from five screening units within the UK NHS Breast Screening Programme (NHSBSP). Data collected included the time interval between screening mammogram and cancer diagnosis, the size of the initial mammographic abnormality and of the subsequent cancer, demographics, mammographic density and tumour biology. We estimated volume doubling times and the estimated change in size and node status, which would have followed if these cancers had been detected at the previous screen. Results 306 interval cancers meeting the inclusion criteria were identified. Average time from screening to diagnosis was 644 days (SD 276 days). 19% were diagnosed in the first twelve months, 42% in the subsequent twelve months and 39% thereafter. Overall average estimated TVDT was 167 days (95% CI 151–186). Significant differences were noted with age (p = 0.01), grade (p < 0.001) and ER status (p < 0.001) with women under 60, grade 3 cancers and ER negative cancers having shorter TVDTs. HER2 positive tumours had shorter doubling times than HER2 negative, but this difference was not statistically significant. It was estimated that diagnosing these cancers at the previous screen would have increased ten-year survival from 82% to 86%. Conclusion High grade, ER negativity and younger age were associated with shorter durations of TVDT. The role of HER2 status on interval cancer growth rate requires further assessment. It is likely that the delayed diagnosis of interval cancers confers a 4% reduction in ten-year survival.

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“…Our finding of faster growth in ER negative tumours has been observed by others [ 11 , 12 ]. Interestingly, we found no significant association of doubling time with HER2 status.…”

Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

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Radiological audit of interval breast cancers: Estimation of tumour growth rates

et al. 2020

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“…In this study, we found that posterior echo enhancement and calcification were independent US features for predicting tumor proliferation. Tumors with a high histological grade and high Ki‐67 expression are expected to have a high mitotic rate and short doubling time . The tumors are prone to be homogeneous with intensive cellularity, leading to less US wave attenuation and enhanced through‐transmission, which result in posterior echo enhancement .…”

Section: Discussionmentioning

confidence: 99%

The Association Between Ultrasound Features and Biological Properties of Invasive Breast Carcinoma Is Modified by Age, Tumor Size, and the Preoperative Axilla Status

Tong

Sun

Zhou

et al. 2019

J of Ultrasound Medicine

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Objectives-To investigate the value of ultrasound (US) feature-based models in predicting the proliferation and invasiveness of invasive breast cancer (IBC) and to compare the performance of models based solely on US features with models that combined US features, patient age, tumor size, and axilla status from US.Methods-With ethical approval, 746 patients with a pathologic diagnosis of IBC were reviewed for preoperative clinical, US, and postoperative pathologic data. The proliferation and invasiveness properties of the IBC included the histologic grade and Ki-67 status and lymphovascular invasion (LVI) and axillary lymph node metastasis (ALNM), respectively. Logistic regression analyses were used to identify independent risk factors for tumor proliferation and invasiveness.Results-Posterior echo enhancement, calcification, a tumor size larger than 2 cm, and suspicion of ALNM from axillary US were independent risk factors for a high histologic grade and high Ki-67 expression of IBC (P < .05). A posterior echo shadow, patient age younger than 45 years, and suspicious findings on axillary US imaging were independent variables for predicting the presence of LVI and ALNM in IBC (P < .05). Calcification was the independent factor for predicting LVI (P = .013). The predictive performance of the combined models was improved compared with the US feature-based models, with a higher accuracy rate and negative predictive value. The area under curve of the combined models was also significantly higher than that of the single models (P < .05).Conclusions-Compared with the US feature-based models, the combined models yielded better predictive performance. This may provide a more robust model to predict the tumor biological properties of IBC before surgery.

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“…The TVDT is one of the most critical parameters used to develop the consolidated mathematical growth model of the PT and sdMTSs of BC (CoMPaS) and to calculate the earliest diagnostic period of sdMTSs in patients with BC [ 21 ]. The TVDT, which helped in the development of the mathematical growth model, is a combined quality indicator that reflects the subtype of BC, the proliferative activity, the degree of tumor differentiation, the Nottingham prognostic index (NPI) score, receptor activity (ER(+), ER(−), PR(+), PR(−), HER2(+), HER2(−), Ki-67), and triple-negative BC [ 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 90 , 91 , 92 , 93 , 94 , 95 , 96 , 97 , 98 , 99 , 100 ]. Hence, patients can obtain a personalized approach for building a schedule of multimodal examinations to detect sdMTSs at the early stage and to start early treatment that can increase the patient’s life [ 43 ].…”

Section: Discussionmentioning

confidence: 99%

A Mathematical Model to Predict Diagnostic Periods for Secondary Distant Metastases in Patients with ER/PR/HER2/Ki-67 Subtypes of Breast Cancer

Tyuryumina

Neznanov

Turumin³

2020

Cancers

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Previously, a consolidated mathematical model of primary tumor (PT) growth and secondary distant metastasis (sdMTS) growth in breast cancer (BC) (CoMPaS) was presented. The aim was to detect the diagnostic periods for visible sdMTS via CoMPaS in patients with different subtypes ER/PR/HER2/Ki-67 (Estrogen Receptor/Progesterone Receptor/Human Epidermal growth factor Receptor 2/Ki-67 marker) of breast cancer. CoMPaS is based on an exponential growth model and complementing formulas, and the model corresponds to the tumor-node-metastasis (TNM) staging system and BC subtypes (ER/PR/HER2/Ki-67). The CoMPaS model reflects (1) the subtypes of BC, such as ER/PR/HER2/Ki-67, and (2) the growth processes of the PT and sdMTSs in BC patients without or with lymph node metastases (MTSs) in accordance with the eighth edition American Joint Committee on Cancer prognostic staging system for breast cancer. CoMPaS correctly describes the growth of the PT in the ER/PR/HER2/Ki-67 subtypes of BC patients and helps to calculate the different diagnostic periods, depending on the tumor volume doubling time of sdMTS, when sdMTSs might appear. CoMPaS and the corresponding software tool can help (1) to start the early treatment of small sdMTSs in BC patients with different tumor subtypes (ER/PR/HER2/Ki-67), and (2) to consider the patient almost healthy if sdMTSs do not appear during the different diagnostic periods.

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Does breast cancer growth rate really depend on tumor subtype? Measurement of tumor doubling time using serial ultrasonography between diagnosis and surgery

Cited by 39 publications

References 30 publications

Radiological audit of interval breast cancers: Estimation of tumour growth rates

Radiological audit of interval breast cancers: Estimation of tumour growth rates

The Association Between Ultrasound Features and Biological Properties of Invasive Breast Carcinoma Is Modified by Age, Tumor Size, and the Preoperative Axilla Status

A Mathematical Model to Predict Diagnostic Periods for Secondary Distant Metastases in Patients with ER/PR/HER2/Ki-67 Subtypes of Breast Cancer

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