Risk factors of distant metastasis after surgery among different breast cancer subtypes: a hospital-based study in Indonesia

Anwar, Sumadi Lukman; Avanti, Widya Surya; Nugroho, Andreas Cahyo; Choridah, Lina; Dwianingsih, Ery Kus; Harahap, Wirsma Arif; Aryandono, Teguh; Wulaningsih, Wahyu

doi:10.1186/s12957-020-01893-w

Cited by 26 publications

(34 citation statements)

References 59 publications

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“…According to the clinical characteristics of primary cancer, patients with bilateral breast cancer were more frequently diagnosed in more advanced diseases, although the significant association was found only in the tumor size (T status, Table 3 ). Our last results might indicate the involvement of metastatic process of cancer cells in the development of contralateral cancer because the risk factors are overlapping with risks of distant spread as shown in our previous report [ 8 , 15 ]. However, some studies reported a lack of association between advanced tumor and risk of bilateral cancer [ 5 , 12 , 16 ].…”

Section: Discussionsupporting

confidence: 74%

“…Demographic and clinicopathologic data including the patient's age, tumor size, stage, histological type, axillary lymph node involvement, and presence or absence of distant metastasis at the initial primary breast cancer (first tumor) and the contralateral cancer (second cancer) as well as administered treatment were collected from the medical records. Grouping of stages, histological type, tumor grade, immunohistochemistry of hormonal receptors, breast cancer subtypes as well as demographic variables was performed as previously reported [ 8 ].…”

Section: Methodsmentioning

confidence: 99%

“…There is still a lack of information regarding bilateral breast cancer from countries without a breast cancer screening program including in Indonesia [ 7 ]. Women with lower social-economic status and living in rural areas have been associated with more advanced stages at diagnosis [ 8 ] and they might also have higher risks for the development of the contralateral breast cancer.…”

Section: Introductionmentioning

confidence: 99%

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Clinical characteristics and the associated risk factors of the development of bilateral breast cancers: A case-control study

Anwar

Prabowo

Avanti

et al. 2020

Annals of Medicine and Surgery

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Background The clinical impacts of bilateralism on prognosis and clinical decision-making remain contradictory particularly in areas with low incidence and delayed diagnosis of primary breast cancer. Identification of women at risk of bilateral breast cancer is required to improve patient management and to design the appropriate surveillance. Methods A total of 1083 women were enrolled and analyzed for the presence of synchronous and metachronous bilateral breast cancer as cases and unilateral breast cancer as controls during the median follow-up of 4.8 years. Results The incidence of bilateral breast cancer was 7.5% (81 of 1083). In comparison with unilateral breast cancers, bilateral cases were significantly diagnosed in younger women ( P = 0.037, mean age was 35.6 years) who had a larger tumor size ( P = 0.012, mean tumor size was 8 cm in diameter). Histological type of lobular cancer was identified as one of the risk factors for the development of contralateral breast cancer (OR 5.564, 95% CI: 3.219–9.620) and synchronous bilateral breast cancer (OR 2.561, 95% CI: 1.182–5.550). Bilateral breast cancer had significantly shorter progression-free survival (Mean survival was 26.6 vs 52.5 months for bilateral and unilateral breast cancers, respectively; P = 0.001) and shorter time to develop distant metastasis (Mean survival was 41.7 vs 104 months for bilateral and unilateral breast cancers, respectively; P = 0.001). Conclusion Patients with first primary breast tumors with lobular histological type and advanced stages were observed to have higher risks for the development of contralateral breast cancers.

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Section: Discussionsupporting

confidence: 74%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinical characteristics and the associated risk factors of the development of bilateral breast cancers: A case-control study

Anwar

Prabowo

Avanti

et al. 2020

Annals of Medicine and Surgery

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“…In our country (Indonesia), almost 350,000 new cases and 208,000 deaths were reported due to cancer [ 2 ]. Triple-negative breast cancer has especially attracted more attention due to the high mortality in females [ 3 ]. The high expression of the matrix metalloproteinase9 (MMP9) protein is one of the indicators during diagnosis [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Bioguided Fractionation of Local Plants against Matrix Metalloproteinase9 and Its Cytotoxicity against Breast Cancer Cell Models: In Silico and In Vitro Study (Part II)

et al. 2021

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In our previous work, the partitions (1 mg/mL) of Ageratum conyzoides (AC) aerial parts and Ixora coccinea (IC) leaves showed inhibitions of 94% and 96%, respectively, whereas their fractions showed IC50 43 and 116 µg/mL, respectively, toward Matrix Metalloproteinase9 (MMP9), an enzyme that catalyzes a proteolysis of extracellular matrix. In this present study, we performed IC50 determinations for AC n-hexane, IC n-hexane, and IC ethylacetate partitions, followed by the cytotoxicity study of individual partitions against MDA-MB-231, 4T1, T47D, MCF7, and Vero cell lines. Successive fractionations from AC n-hexane and IC ethylacetate partitions led to the isolation of two compounds, oxytetracycline (OTC) and dioctyl phthalate (DOP). The result showed that AC n-hexane, IC n-hexane, and IC ethylacetate partitions inhibit MMP9 with their respective IC50 as follows: 246.1 µg/mL, 5.66 µg/mL, and 2.75 × 10−2 µg/mL. Toward MDA-MB-231, 4T1, T47D, and MCF7, AC n-hexane demonstrated IC50 2.05, 265, 109.70, and 2.11 µg/mL, respectively, whereas IC ethylacetate showed IC50 1.92, 57.5, 371.5, and 2.01 µg/mL, respectively. The inhibitions toward MMP9 by OTC were indicated by its IC50 18.69 µM, whereas DOP was inactive. A molecular docking study suggested that OTC prefers to bind to PEX9 rather than its catalytic domain. Against 4T1, OTC showed inhibition with IC50 414.20 µM. In conclusion, this study furtherly supports the previous finding that AC and IC are two herbals with potential to be developed as triple-negative anti-breast cancer agents.

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“…Approximately 30% of patients with breast cancer will eventually develop distant metastasis including those who are diagnosed in early stages [ 1 ]. Patterns of locoregional recurrence and distant metastasis in patients with breast cancer vary depending on the tumor size, lymph node infiltration, histological subtype, differentiation grades, status of resection margin, immune response, lymphovascular invasion, and intrinsic molecular subtypes [ 2 ]. Also, social determinants causing non-adherence in breast cancer treatment have been associated with a higher risk of distant spread and poor functional well-being [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Concurrent manifestations of Horner’s syndrome and esophageal metastasis of breast cancer: case report of a young woman after a period of non-adherence to treatment: a case report

et al. 2021

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Background Esophageal involvement and Horner’s syndrome are rare manifestations of breast cancer distant metastases that can pose a significant challenge in diagnosis and treatment. In addition to the more aggressive behavior of breast cancer diagnosed in young women, non-adherence to treatment is associated with increased risk of distant metastasis. Case presentation A 36-year-old Javanese woman presented to our institution with dysphagia, hoarseness, and frequent hiccups. In the 6 weeks prior to the current admission, the patient also reported tingling in the neck and shoulder, anhidrosis in the left hemifacial region, and drooping of the upper left eyelid. She was previously managed as tuberculoid laryngitis. Plain X-rays showed burst fractures of the cervical vertebrae and slight pleural effusion. Laryngoscopy revealed bowing of the vocal cords and liquid residue in the vallecula that was reduced upon chin tuck. Esophageal metastasis was confirmed with endoscopy showing thickening of the wall and positive cytology swab with ductal malignant cells. The patient had a history of breast cancer with a period of loss to follow-up of 4 years. Conclusions Physicians should consider potential distant metastasis of breast cancer to the esophagus and sympathetic nervous system of the neck particularly in a high-risk woman with presentation of dysphagia and manifestations of Horner’s syndrome.

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Risk factors of distant metastasis after surgery among different breast cancer subtypes: a hospital-based study in Indonesia

Cited by 26 publications

References 59 publications

Clinical characteristics and the associated risk factors of the development of bilateral breast cancers: A case-control study

Clinical characteristics and the associated risk factors of the development of bilateral breast cancers: A case-control study

Bioguided Fractionation of Local Plants against Matrix Metalloproteinase9 and Its Cytotoxicity against Breast Cancer Cell Models: In Silico and In Vitro Study (Part II)

Concurrent manifestations of Horner’s syndrome and esophageal metastasis of breast cancer: case report of a young woman after a period of non-adherence to treatment: a case report

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