The use of molecular assays to establish definitively the clonality of ipsilateral breast tumor recurrences and patterns of in‐breast failure in patients with early‐stage breast cancer treated with breast‐conserving therapy

Vicini, Frank A.; Antonucci, J. Vito; Goldstein, Neal S.; Wallace, Michelle; Kestin, Larry L.; Krauss, Daniel; Kunzmann, Jonathan; Gilbert, Sarah L.; Schell, Scott R.

doi:10.1002/cncr.22529

Cited by 42 publications

(29 citation statements)

References 43 publications

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“…Contrary to others (Haffty et al, 1993;Goldstein et al, 2005;Vicini et al, 2007), we found no indication that tumours more prone to be true recurrences because of conserved histological type, location or both, recur sooner or are deadlier than the others. The same applied to the conservation of histological type and features of equal or lesser differentiation.…”

Section: Discussioncontrasting

confidence: 99%

“…However, because of the overwhelmingly high rate of the ductal histological type among breast cancers, there is need to improve the definition of true recurrences by using new biological tools of clonal relation such as pan-genomic profiles (Waldman et al, Table 4 Comparison of pathological features of primary tumours and of IBTR according to the free interval between the two (within or after 2 years) , loss of heterozygosity (Schlechter et al, 2004;Vicini et al, 2007), p53 mutation analysis (van der Sijp et al, 2002) or the inactivation of the X chromosome (Shibata et al, 1996). Caution is however still needed as some of these techniques conclude that only 65% of clonally related ipsilateral breast tumour recurrences have the same histological types as their primary tumours (Vicini et al, 2007).…”

Section: Discussionmentioning

confidence: 99%

“…Caution is however still needed as some of these techniques conclude that only 65% of clonally related ipsilateral breast tumour recurrences have the same histological types as their primary tumours (Vicini et al, 2007). We hope that a better distinction of true recurrences will open new perspectives.…”

Section: Discussionmentioning

confidence: 99%

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Are ipsilateral breast tumour invasive recurrences in young (⩽40 years) women more aggressive than their primary tumours?

Sigal‐Zafrani

Antoni

et al. 2007

Br J Cancer

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The characteristics of ipsilateral breast tumour recurrences (IBTRs) relative to those of their primary tumours (PTs) remain scarcely studied. Of 70 young (p40 years) premenopausal women with IBTRs, we studied a series of 63 with paired histological data. Median follow-up since IBTR was 10 years. Rates of histological types, grades or hormonal receptors were not significantly different in PTs and in IBTRs. The concordance between IBTRs and their PTs was good for histological types. IBTRs with conserved histological types tended to occur more locally, but not significantly sooner than others. These IBTRs had good concordance for hormone receptors. In discordant cases there were as many losses as appearances of the receptors. The concordance was weak for grades, with equivalent numbers of IBTRs graded lower as higher than their PTs. The 10-year overall survival rate was 70%. Neither the conservation of histological type, location, nor of the two combined were associated with deaths. Early (o2 years) IBTRs, tended to be associated with poorer survival (HR ¼ 2.24 (0.92 -5.41); P ¼ 0.08). IBTRs did not display features of higher aggressiveness than PTs. Neither clinical nor histological definition of a true recurrence could be established other than the conservation of the histological type. British Journal of Cancer (2007) Breast-conserving treatments of early stage breast cancer exposes the patient to the risk of ipsilateral breast tumour recurrence (IBTR). The most important prognostic factor for local recurrence is the young age of the patient (Vrieling et al, 2003) and this remains true among young (o40 years old), premenopausal women treated either by surgery first (Bollet et al, 2007) or by neoadjuvant chemotherapy (Oh et al, 2006). Many questions remain unanswered concerning the real nature of these ipsilateral breast tumour recurrences. We shall examine how different they are from primary tumours and whether there are clinical or histological factors to help distinguish between a re-growth of malignant cells not removed by surgery and not killed by radiotherapy (also called a true recurrence, TR) and a de novo malignancy arising from mammary epithelial cells of residual breast tissues (also known as new primary tumours, NP) (Haffty et al, 1993). Some have implied that ipsilateral breast tumour recurrences should display features of, at least as much aggressiveness (differentiation (Huang et al, 2002), ploidy (Haffty et al, 1993) and percentage of invasiveness (Haffty et al, 1993;Smith et al, 2000;Huang et al, 2002)) to qualify as true recurrences. We shall see whether biological evidence can be found to support this definition. Finally, we shall investigate whether the characteristics of ipsilateral breast tumour recurrences are associated with prognosis. PATIENTS AND METHODSOut of a previously described series of 209 premenopausal women, younger than 40 years old, treated at the Institut Curie between 1985 and 1995 for early breast cancers (clinical T1-2, N0-1 ; Sobin and Wittekind, 2002) with primary brea...

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Are ipsilateral breast tumour invasive recurrences in young (⩽40 years) women more aggressive than their primary tumours?

Sigal‐Zafrani

Antoni

et al. 2007

Br J Cancer

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“…17 This study was reviewed and granted approval by the William Beaumont Hospital Human Investigation Committee. Patients with AJCC stage I/II invasive breast carcinoma treated with BCT who developed an IBTR and had no distant metastases (DM) prior to the IBTR were analyzed.…”

Section: Methodsmentioning

confidence: 99%

Long-Term Patterns of In-Breast Failure in Patients With Early Stage Breast Cancer Treated With Breast-Conserving Therapy

McGrath¹,

Antonucci²,

Goldstein³

et al. 2010

American Journal of Clinical Oncology

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This analysis demonstrates the inaccuracy of clinically establishing the clonality of most IBTRs. Clonally related IBTRs occurred sooner than clonally different IBTRs, were more frequently associated with the development of distant metastases and had a worse prognosis. Molecular clonality assays provide a reliable means of identifying patients who may benefit from aggressive systemic therapy at the time of IBTR and provide an accurate assessment of the efficacy of various forms of local therapy.

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“…La différence entre vraie récidive et nouveau cancer repose actuellement sur des critères mal défi nis, non standardisés. L'utilisation de la biologie moléculaire (génotypage sur fragments de tumeurs congelées [11], technique PCR sur tumeurs « bien techniquées » en paraffi ne [35,67,102]) est actuellement en cours d'évaluation pour essayer de mieux caractériser « vraie RL » et nouveau cancer, à l'aide de biomarqueurs permettant une classifi cation standardisée et reproductible de ces deux entités [75].…”

Section: Dossierunclassified

Prise en charge de la récidive homolatérale d’un cancer du sein après traitement conservateur initial

Barreau¹,

Ettore²,

Giard³

et al. 2011

Oncologie

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The use of molecular assays to establish definitively the clonality of ipsilateral breast tumor recurrences and patterns of in‐breast failure in patients with early‐stage breast cancer treated with breast‐conserving therapy

Cited by 42 publications

References 43 publications

Are ipsilateral breast tumour invasive recurrences in young (⩽40 years) women more aggressive than their primary tumours?

Are ipsilateral breast tumour invasive recurrences in young (⩽40 years) women more aggressive than their primary tumours?

Long-Term Patterns of In-Breast Failure in Patients With Early Stage Breast Cancer Treated With Breast-Conserving Therapy

Prise en charge de la récidive homolatérale d’un cancer du sein après traitement conservateur initial

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