Prognostic Significance of Inner Quadrant Involvement in Breast Cancer Treated with Neoadjuvant Chemotherapy

Chang, Ji Hyun; Jeon, Wha Sook; Kim, Kyubo; Shin, Kyung Hwan; Han, Wonshik; Noh, Dong Young; Im, Seock Ah; Kim, Tae You; Bang, Yung Jue

doi:10.4048/jbc.2016.19.4.394

Cited by 9 publications

(6 citation statements)

References 25 publications

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“…As a result, the five-year survival rate of IDC patients will be reduced, and the five-year survival rate of patients with primary tumors located in the central area, the inner upper quadrant, and inner lower quadrant will be lower than that of patients located in the outer upper quadrant and outer lower quadrant. In addition, due to the excessive penetration of mammography to the nipple-areolar complex, tumors in the central region are often overlooked, requiring the combination of multiple imaging techniques [ 28 ]. The molybdenum target detection rate of breast cancer in the central region is low, and the tumor is detected in a late stage, which delays the treatment time and reduces the five-year survival rate of patients [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

Clinicopathological Features of 166 Cases of Invasive Ductal Breast Carcinoma and Effect of Primary Tumor Location on Prognosis after Modified Radical Mastectomy

Chen

Yang

2022

Emergency Medicine International

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Objective. To investigate the clinicopathological features of 166 cases of invasive ductal carcinoma (IDC) of the breast and to analyze the effect of the location of the primary tumor on the prognosis of modified radical mastectomy. Materials and Methods. The clinical data of 166 patients with IDC who underwent modified radical mastectomy in our hospital from May 2015 to May 2017 were retrospectively analyzed. The clinicopathological features of IDC patients were recorded. Univariate analysis and the multivariate logistic regression model were used to analyze the relationship between the location of the primary tumor and the prognosis of IDC patients after modified radical surgery. The effect of primary tumor location on the prognosis of modified radical resection was used with Survival curve analysis. Results. Among the patients in the central region, 13.33% had tumors >5 cm in diameter, which was higher than those in the other four groups. Among the patients in the upper inner quadrant, 59.38% received hormone therapy after operation, which was higher than those in the other four groups ( P < 0.05 ). There were no significant differences in age, menopause, histological grading, molecular typing, lymph node metastasis, vascular invasion, radiation therapy, and chemotherapy among different groups ( P > 0.05 ). Univariate analysis showed that molecular typing, lymph node metastasis, vascular invasion, and location of the primary tumor were all related to the prognosis of IDC patients after modified radical surgery, and the differences were statistically significant ( P < 0.05 ). Logistic regression analysis showed that molecular typing, lymph node metastasis, vascular invasion, and primary tumor location were all independent influencing factors for prognosis of IDC patients after modified radical surgery ( P < 0.05 ). As of 31 May 2021, there were 11 patients with recurrence and metastasis and 20 patients with death. The median survival time in the outer upper quadrant group was 80 months, which was higher than that in the outer lower quadrant group by 72 months, the median survival time in the central region group by 71 months, the median survival time in the inner upper quadrant group by 67 months, and the median survival time in the inner lower quadrant group by 61 months. The log-rank test showed all P < 0.001 . Conclusion. Patients with primary tumors located in the central area have larger tumor diameters. Patients located in the central area, upper inner quadrant, and lower inner quadrant are more likely to have lymphatic metastasis, have a more serious condition, and have a shorter prognosis survival time. Unluminal type, multiple lymph node metastases, vascular invasion, and the location of the primary tumor in the inner quadrant are all independent risk factors for prognosis in patients after modified radical surgery for IDC.

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Section: Discussionmentioning

confidence: 99%

Clinicopathological Features of 166 Cases of Invasive Ductal Breast Carcinoma and Effect of Primary Tumor Location on Prognosis after Modified Radical Mastectomy

Chen

Yang

2022

Emergency Medicine International

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“…Compared with lower quadrants, we elucidated the favorable prognostic value of upper quadrants in various subgroups of breast cancer patients. Accordingly, pertinent studies have reported better prognosis of patients with tumors in UOQ [23,8], and tumors in LIQ have been veri ed as worse prognostic factor in breast cancer [24,12]. Anatomically, the lymphatics from the lower portion of the breast appear to occasionally communicate with those under the diaphragmatic region or peritoneal plexus by passing through the sheath of rectus abdominis, and Kamakura and colleagues [21] revealed that a lower quadrants tumor location was a signi cant prognostic factor for recurrence, especially soft tissue and visceral recurrence.…”

Section: Discussionmentioning

confidence: 99%

Primary Tumor Location is Associated with Prognosis for Women with Breast Cancer

Zhuo-wei

Zhang

et al. 2021

Preprint

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Background: The prognostic impact of tumor location on breast cancer patients is not consistent and still controversial. We aimed to investigate the prognostic role of primary tumor location on the survival of patients with breast cancer. Methods: Using the Surveillance, Epidemiology, and End Results database, we identified 53,905 patients diagnosed with tumors in the lower quadrants (n=11,065), upper quadrants (n=38,974), or central and nipple (n=3,866). Chi-squared test was used to compare categorical variables across the groups. Cox proportional hazard models were applied to estimate the factors associated with prognosis.Results: Compared with the other quadrants, patients with central and nipple lesions showed generally more unfavorable clinicopathologic features and worse breast cancer-specific survival (BCSS) and overall survival (OS). Multivariate Cox analysis showed a higher hazard ratio (HR) for tumor location of central and nipple (BCSS: HR, 1.145, p = 0.036, 95% confidence interval [CI], 1.009-1.299; OS: HR, 1.118, p = 0.024, 95% CI: 1.015-1.232), while lower HR were observed for upper quadrants (BCSS: HR, 0.888, p = 0.004, 95% CI: 0.818-0.964; OS: HR, 0.930, p = 0.023, 95% CI: 0.873-0.990). Multivariate logistic regression indicated that tumors located in central and nipple were more likely to be inoperable disease (HR, 1.460, 95% CI: 1.300-1.640, p < 0.001), while tumors located in upper quadrants tend to be operable disease (HR, 0.895, p = 0.005, 95% CI, 0.829-0.967).Conclusion: Tumors located in central and nipple had negative contact with BCSS and OS, while tumor located in upper quadrants had favorable contact with survival.

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“…According to the results of the retrospective study by Chang et al (1), tumor site affects the survival of breast carcinoma patients who received NAC for the first time. Unlike the earlier clinical trials, our study primarily focused on three significant quadrants in our NAC setting.…”

Section: Discussionmentioning

confidence: 99%

“…The poor prognosis of lower-inner quadrant breast cancer in patients who received neoadjuvant chemotherapy occurrence, inner-quadrant cancer is often characterized by poor prognosis and shorter breast cancer-specific survival (BCSS) and overall survival (OS). Nevertheless, the study conducted by Chang et al (1) was the only clinical study to explore the prognostic value of tumor size on the survival of breast cancer patients who received NAC treatment. Moreover, the clinical trial conducted by Jiqiao Yang revealed that tumors in the lower-inner zone (LIZ) had a markedly poor prognosis in terms of disease-free survival (DFS) in patients in the NAC subgroup.…”

Section: Original Articlementioning

confidence: 99%

The poor prognosis of lower-inner quadrant breast cancer in patients who received neoadjuvant chemotherapy

Song

Zhang

2020

Ann Palliat Med

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Background: The elevated risk for recurrence in breast cancer patients after receiving neoadjuvant chemotherapy (NAC) is still controversial. The purpose of this paper was to investigate the prognostic significance of tumor location concerning the survival of patients with breast cancer treated with NAC.Methods: The clinical information of 676 patients with stage II-III breast carcinoma who were being treated with NAC between March 2009 and 2014 was investigated. The primary tumor sites were categorized into three groups: outer quadrant, upper-inner quadrant, and lower-inner/central quadrant.Results: According to the results of multivariate analyses, the number of tumor locations, nuclear grade, and the initial clinical stage was associated with disease-free survival (DFS), distant metastasis-free survival (DMFS), and overall survival (OS). When stratified into subgroups, tumors in the lower-inner/central quadrant were associated with a significantly worse prognosis in patients not treated with postmastectomy radiation therapy (PMRT) and in patients in the human epidermal growth factor receptor 2 (HER-2)-enriched and triple-negative subgroups. Conclusions:The primary tumor site is likely to be a critical feature that affects the prognosis of breast cancer tumors treated with NAC. To address the poor prognosis related to inner-quadrant participation in breast carcinoma, more aggressive NAC with internal mammary node radiotherapy (IMN-RT) should be conducted.

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Prognostic Significance of Inner Quadrant Involvement in Breast Cancer Treated with Neoadjuvant Chemotherapy

Cited by 9 publications

References 25 publications

Clinicopathological Features of 166 Cases of Invasive Ductal Breast Carcinoma and Effect of Primary Tumor Location on Prognosis after Modified Radical Mastectomy

Clinicopathological Features of 166 Cases of Invasive Ductal Breast Carcinoma and Effect of Primary Tumor Location on Prognosis after Modified Radical Mastectomy

Primary Tumor Location is Associated with Prognosis for Women with Breast Cancer

The poor prognosis of lower-inner quadrant breast cancer in patients who received neoadjuvant chemotherapy

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