Relative and disease-free survival for breast cancer in relation to subtype: a population-based study

Minicozzi, Pamela; Bella, Francesca; Toss, Angela; Giacomin, Adriano; Fusco, Mario; Zarcone, Maurizio; Tumino, Rosario; Falcini, Fabio; Cesaraccio, Rosaria; Candela, Giuseppa; Rosa, Francesco La; Federico, Massimo; Sant, Milena

doi:10.1007/s00432-013-1478-1

Cited by 40 publications

(30 citation statements)

References 30 publications

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“…The Italian study reported that the survival of breast cancer patients with triple negative and HER2-enriched had lower survival rates than patients with other molecular subtypes (Minicozzi et al, 2013). Our findings are also supported by a study of breast cancer in black women, which found that triple negative and HER2-enriched patients had the lowest survival 5-year survival rates (Ihemelandu et al, 2008).…”

Section: Discussionsupporting

confidence: 86%

Survival Time and Molecular Subtypes of Breast Cancer after Radiotherapy in Thailand

Kongsiang

Tangvoraphonkchai²,

Jirapornkul³

et al. 2015

Asian Pacific Journal of Cancer Prevention

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Section: Discussionsupporting

confidence: 86%

Survival Time and Molecular Subtypes of Breast Cancer after Radiotherapy in Thailand

Kongsiang

Tangvoraphonkchai²,

Jirapornkul³

et al. 2015

Asian Pacific Journal of Cancer Prevention

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“…Our results, in terms of high percentage of HER2 positive tumors among de novo metastatic BC (27.5%), are consistent with those reported in literature, [17][18][19] confirming the tendency of this subtype to be more aggressive and to rapidly spread to distant sites. Furthermore, in the period 2006-2009, among 30 patients with HER2 positive BC, 6 cases were diagnosed with brain metastasis (20%).…”

Section: Discussionsupporting

confidence: 93%

Twenty-years experience withde novometastatic breast cancer

et al. 2015

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Although new treatments have been widely studied to improve the survival of patients with metastatic breast cancer (BC), prognosis continues to be poor with an average survival time no longer than 3 years. We carried on a population-based study with the purpose of evaluating the outcome of metastatic breast cancer in the province of Modena from 1990 to 2009. We examined the Modena Cancer Registry and evaluated the 5-year overall survival (OS) of women diagnosed with a de novo metastatic breast cancer between 1990 and 2009, defining 5 periods of 4 years each. After a median followup time of 29 months, the 5-year OS was 11% for years 1990-1993, 15% for years 1994-1997, 12% for years 1998-2001, 20% for years 2002-2005 and 29% for years 2006-2009 (p 5 0.012). Overall, although no OS differences were noted in the first decade analyzed, a real advantage has been shown in the last two cohorts. In a multivariate analysis, the 5-year OS was significantly increased only for hormone receptor positive and HER21 tumors, whereas chemotherapy treatments were not significant independent predictors of survival in "de novo" metastatic BC (p 5 0.08). Our analysis confirms that the prognosis of de novo metastatic breast cancer has improved overtime, particularly in the last decade. Trastuzumab, LH-RH analogues and aromatase inhibitors have determined a significant clinical benefit and costeffectiveness in metastatic breast cancer treatment.Breast cancer (BC) continues to be the most common form of cancer that affects women, but currently is no longer the leading cause of cancer deaths. However, the prognosis of patients with metastatic disease continues to be poor, with an average survival time no longer than 3 years.1,2 Although clinical trials suggest that early detection strategies and advances in adjuvant therapy are improving outcomes, it is unclear if this may affect patterns of relapse and 20-30% of patients with early BC will eventually develop relapse with distant metastatic disease. Therefore, distant recurrence remains common and incurable and, currently, the principal goal of treatment for women with metastatic disease is to improve quality of life and to prolong survival. 3,4 Although new treatments have been widely investigated in the metastatic setting, it is not clear whether the overall outcome has improved. Particularly, Seruga et al.5 observed no significant change in outcome or in absolute benefit of experimental therapies in Phase III randomized clinical trials evaluating treatment for metastatic BC. Moreover, the costs of experimental medical therapies approved for metastatic disease increase [mt]100-fold each month, without any gain in the absolute benefit. Therefore, Seruga et al.5 demonstrated that new and expensive treatments of metastatic BC lead to unchanging levels of benefit and rapidly increasing costs, concluding that new therapies are becoming much less costeffective. Moreover, Galy et al.6 performed a retrospective study to examine temporal trends in the use of chemotherapeutic agents for the treat...

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“…Tumor stage pT4, pN2-pN3 and biological factors such as HER2 positivity and triple negativity are indicated as the most relevant prognostic factors to classify patients at high risk of disease progression. These choices are in agreement with literature data showing that pathological stage and intrinsic breast cancer subtypes are the most relevant prognostic factors able to influence clinical outcome [31], [32], [33], [34]. Interestingly, van Hezewijk et al [8], using a web-based 29-item questionnaire, reported that 130 respondents of different disciplines (surgeons, medical oncologists, radiation oncologists and nurse practitioners) identified as patients at high risk to follow-up with a higher frequency of visits those of younger age and with pT3-4/pN2-3 tumor, not taking into account tumor biology, as medical oncologists did in the present study.…”

Section: Discussionsupporting

confidence: 91%

Breast Cancer “Tailored Follow-up” in Italian Oncology Units: A Web-Based Survey

Natoli

Brocco

Sperduti³

et al. 2014

PLoS ONE

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PurposeBreast cancer follow-up procedures after primary treatment are still a controversial issue. Aim of this study was to investigate, through a web-based survey, surveillance methodologies selected by Italian oncologists in everyday clinical practice.MethodsReferents of Italian medical oncology units were invited to participate to the study via e-mail through the SurveyMonkey website. Participants were asked how, in their institution, exams of disease staging and follow-up are planned in asymptomatic women and if surveillance continues beyond the 5th year.ResultsBetween February and May 2013, 125 out of 233 (53.6%) invited referents of Italian medical oncology units agreed to participate in the survey. Ninety-seven (77.6%) referents state that modalities of breast cancer follow-up are planned according to the risk of disease progression at diagnosis and only 12 (9.6%) oncology units apply the minimal follow-up procedures according to international guidelines. Minimal follow-up is never applied in high risk asymptomatic women. Ninety-eight (78.4%) oncology units continue follow-up in all patients beyond 5 years.ConclusionsOur survey shows that 90.4% of participating Italian oncology units declare they do not apply the minimal breast cancer follow-up procedures after primary treatment in asymptomatic women, as suggested by national and international guidelines. Interestingly, about 80.0% of interviewed referents performs the so called “tailored follow-up”, high intensity for high risk, low intensity for low risk patients. There is an urgent need of randomized clinical trials able to determine the effectiveness of risk-based follow-up modalities, their ideal frequency and persistence in time.

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Relative and disease-free survival for breast cancer in relation to subtype: a population-based study

Abstract: Our population-based findings confirm that subtype is an independent prognostic factor for BC. Triple-negative and HER2-enriched subtypes would benefit from the development and wide application, respectively, of targeted treatments, which would also improve survival for younger patients.

Cited by 40 publications

References 30 publications

Survival Time and Molecular Subtypes of Breast Cancer after Radiotherapy in Thailand

Survival Time and Molecular Subtypes of Breast Cancer after Radiotherapy in Thailand

Twenty-years experience withde novometastatic breast cancer

Breast Cancer “Tailored Follow-up” in Italian Oncology Units: A Web-Based Survey

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