Local Recurrence After Breast-Conserving Therapy for Invasive Breast Cancer: High Incidence in Young Patients and Association with Poor Survival

Elkhuizen, Paula H.M.; Vijver, Marc J. van de; Hermans, J.; Zonderland, H M; Velde, Cornelis J.H. van de; Leer, Jan-Willem H.

doi:10.1016/s0360-3016(97)00917-6

Cited by 212 publications

(144 citation statements)

References 45 publications

Supporting

Mentioning

131

Contrasting

Order By: Relevance

“…14 -16 Tumor specimens from young patients have been reported to have poor biologic features that lead to a less favorable prognosis. 3,17 Our results, however, are limited by self-reports and by missing more aggressive biologic features such as HER-2/neu. Reports concerning age and prognosis have shown that high tumor grade represents a discriminatory prognostic factor between younger and older premenopausal patients with operable breast carcinoma.…”

Section: Discussionmentioning

confidence: 78%

Women age ≤ 35 years with primary breast carcinoma

González-Angulo

Broglio

Kau

et al. 2005

Cancer

View full text Add to dashboard Cite

BACKGROUNDThe purpose of the current study was to describe a population of young patients with breast carcinoma, their characteristics at the time of diagnosis, and the association of these characteristics with disease recurrence and survival.METHODSFour hundred fifty‐two women age ≤ 35 years with breast carcinoma were registered at The University of Texas M. D. Anderson Cancer Center (Houston, TX) between 1990 and 2002. The relation between clinicopathologic factors and disease recurrence‐free survival (RFS) and overall survival (OS) was assessed. Cox regression analysis was used to identify independent survival predictors.RESULTSThe median age of the patients was 32 years. Most of the patients were white, and 20% were obese. Approximately 50% reported oral contraceptive use, 34% reported a family history of breast carcinoma, and 5% reported a family history of ovarian carcinoma. Sixty‐nine percent of tumors were nuclear Grade 3 (using the modified Black's nuclear grading system), 52% had positive estrogen receptors, and 48% had positive progesterone receptors. HER‐2/neu status was available in 60% of tumor specimens and 34% were HER‐2/neu positive. The median follow‐up was 36 months. There were 185 disease recurrences and 84 deaths. RFS was significantly shorter in patients who reported a family history of ovarian carcinoma (P < 0.0001) and in those who had hormone receptor‐negative tumor specimens (P = 0.001). OS was significantly shorter in patients who reported a family history of ovarian carcinoma (P = 0.001), those who had hormone receptor‐negative tumor specimens (P < 0.0001), or those with > nuclear Grade 3 tumor specimens (P = 0.005).CONCLUSIONSThis young population with breast carcinoma was found to have more aggressive biologic features. Hormone receptor negativity and a family history of ovarian carcinoma were associated with shorter RFS and OS. Cancer 2005. © 2005 American Cancer Society.

show abstract

Section: Discussionmentioning

confidence: 78%

Women age ≤ 35 years with primary breast carcinoma

González-Angulo

Broglio

Kau

et al. 2005

Cancer

View full text Add to dashboard Cite

show abstract

“…There are two main factors which need to be considered in order to weigh up this trade-off: the risk of local relapse (LR) and the risk of radiation-related heart disease (RRHD). The risk of LR is increased by factors such as young age [16][17][18][19], high tumour grade [19], the presence of extensive ductal carcinoma in situ (DCIS) [17] and negative ER status [20], and particular caution should be used when compromising target tissue coverage in these groups of patients. To help with this problem, nomograms have been developed to assess the risk of ipsilateral breast recurrence, such as that from the EORTC 22881-10882 boost versus no boost trial [21].…”

Section: Discussionmentioning

confidence: 99%

Multileaf Collimation Cardiac Shielding in Breast Radiotherapy: Cardiac Doses are Reduced, But at What Cost?

et al. 2013

View full text Add to dashboard Cite

“…To our knowledge, no other oncogenic markers as predictors of locoregional recurrence have been identified previously. At present, the common risk factors for local control after breastconserving treatment are: patient age, margin status, and the presence of an extensive intraductal component (De la Rochefordiere et al, 1993;Elkhuizen et al, 1998;Voogd et al, 1999Voogd et al, , 2001). The addition of new predictive markers for locoregional recurrence may help in guiding the optimal type of local therapy.…”

Section: Discussionmentioning

confidence: 99%

Overexpression of P70 S6 kinase protein is associated with increased risk of locoregional recurrence in node-negative premenopausal early breast cancer patients

et al. 2004

View full text Add to dashboard Cite

The RPS6KB1 gene is amplified and overexpressed in approximately 10% of breast carcinomas and has been found associated with poor prognosis. We studied the prognostic significance of P70 S6 kinase protein (PS6K) overexpression in a series of 452 nodenegative premenopausal early-stage breast cancer patients (median follow-up: 10.8 years). Immunohistochemistry was used to assess PS6K expression in the primary tumour, which had previously been analysed for a panel of established prognostic factors in breast cancer. In a univariate analysis, PS6K overexpression was associated with worse distant disease-free survival as well as impaired locoregional control (HR 1.80, P 0.025 and HR 2.50, P 0.006, respectively). In a multivariate analysis including other prognostic factors, PS6K overexpression remained an independent predictor for poor locoregional control (RR 2.67, P 0.003). To our knowledge, P70 S6 kinase protein is the first oncogenic marker that has prognostic impact on locoregional control and therefore may have clinical implications in determining the local treatment strategy in early-stage breast cancer patients. The treatment of breast cancer is guided by risk factors. Approximately 70% of all node-negative breast cancer patients can be cured by locoregional therapy alone. This automatically implies that the remaining 30% of these patients will develop a recurrence despite adequate locoregional therapy. Currently, treatment strategy in breast cancer is based upon tumour stage, grade, and hormone receptor status. Additional prognostic factors are greatly needed, first to select those patients who might benefit from adjuvant systemic therapy and second to optimise locoregional therapy in order to avoid locoregional recurrences.The prognostic significance of a considerable number of tumour markers has already been investigated but to date, none of these factors can be used to guide the treatment of primary breast cancer.A recent study by Barlund et al (2000a) demonstrated that amplification of a putative tumour marker called P70 S6 kinase protein (PS6K) might be associated with poor outcome in breast cancer. In addition, the authors reported that RPS6KB1 gene amplification and PS6K overexpression are significantly correlated.The RPS6KB1 gene is located at 17q23 and amplified in approximately 10% of all primary breast cancer cases. PS6K is a ribosomal protein that is involved in the progression from the G1 to S phase of the cell cycle. It is rapidly activated in response to mitogenic stimuli, for example, growth factors, cytokines, and oncogene products (Grove et

show abstract

Local Recurrence After Breast-Conserving Therapy for Invasive Breast Cancer: High Incidence in Young Patients and Association with Poor Survival

Cited by 212 publications

References 45 publications

Women age ≤ 35 years with primary breast carcinoma

Women age ≤ 35 years with primary breast carcinoma

Multileaf Collimation Cardiac Shielding in Breast Radiotherapy: Cardiac Doses are Reduced, But at What Cost?

Overexpression of P70 S6 kinase protein is associated with increased risk of locoregional recurrence in node-negative premenopausal early breast cancer patients

Contact Info

Product

Resources

About