Background： Current understanding of tumor biology suggests that breast cancer is a group of diseases with different intrinsic molecular subtypes. Anatomic staging system alone is insufficient to provide future outco...Background： Current understanding of tumor biology suggests that breast cancer is a group of diseases with different intrinsic molecular subtypes. Anatomic staging system alone is insufficient to provide future outcome information. The American Joint Committee on Cancer （AJCC） expert panel updated the 8th edition of the staging manual with prognostic stage groups by incorporating biomarkers into the anatomic stage groups. In this study, we retrospectively analyzed the data from our center in China using the anatomic and prognostic staging system based on the AJCC 8th edition staging manual. Methods： We reviewed the data from January 2008 to December 2014 for cases with Luminal B Human Epidermal Growth Factor Receptor 2 （HER2）-negative breast cancer in our center. All cases were restaged using the AJCC 8th edition anatomic and prognostic staging system. The Kaplan-Meier method and log-rank test were used to compare the survival differences between different subgroups. SPSS software version 19.0 （IBM Corp., Armonk, NY, USA） was used for the statistical analyses. Results： This study consisted of 796 patients with Luminal B HER-negative breast cancer. The 5-year disease-free survival （DFS） of 769 Stage I-III patients was 89.7%, and the 5-year overall survival （OS） of all 796 patients was 91.7%. Both 5-year DFS and 5-year OS were significantly different in the different anatomic and prognostic stage groups, There were 372 cases （46.7%） assigned to a different group. The prognostic Stage II and III patients restaged from anatomic Stage III had significant differences in 5-year DFS （v2 = 11.319; P = 0.001） and 5-year OS （χ2 = 5.225, P = 0.022）. In addition, cases restaged as prognostic Stage I, II, or III from the anatomic Stage II group had statistically significant differences in 5-year DFS （χ2 = 6.510, P = 0.039） but no significant differences in 5-year OS （χ2 = 5.087, P = 0.079）. However, the restaged prognostic Stage I and II cases from anatomic Stage I had no statis展开更多
Objective： We retrospectively analyzed the clinical prognostic value of the 8th edition of the American Joint Committee on Cancer （AJCC） staging system for luminal A breast cancer. Methods： Using both the anatomic...Objective： We retrospectively analyzed the clinical prognostic value of the 8th edition of the American Joint Committee on Cancer （AJCC） staging system for luminal A breast cancer. Methods： Using both the anatomic and prognostic staging in the 8th edition of AJCC cancer staging system, we restaged patients with luminal A breast cancer treated at the Breast Disease Center, Peking University First Hospital from 2008 to 2014. Follow-up data including 5-year disease free survival （DFS）, overall survival （OS） and other clinic-pathological data were collected to analyze the differences between the two staging subgroups. Results： This study included 421 patients with luminal A breast cancer （median follow-up, 61 months）. The 5- year DFS and OS rates were 98.3% and 99.3%, respectively. Significant differences in 5-year DFS but not OS were observed between different anatomic disease stages. Significant differences were observed in both 5-year DFS and O S between different prognostic stages. Application of the prognostic staging system resulted in assignment of 175 of 421 patients （41.6%） to a different group compared to their original anatomic stages. In total, 102 of 103 patients with anatomic stage IlA changed to prognostic stage IB, and 24 of 52 patients with anatomic stage lib changed to prognostic stage IB, while 1 changed to prognostic stage liIB. Twenty-two of 33 patients with anatomic stage IliA were down-staged to IlA when staged by prognostic staging system, and the other 11 patients were down-staged to liB. Two patients with anatomic stage IIIB were down-staged to IliA. Among seven padents with anatomic stage IIIC cancer, two were down-staged to IliA and four were down-staged to stage I]IB. Conclusions： The 8th edition of AJCC prognostic staging system is an important supplement to the breast cancer staging system. More clinical trials are needed to prove its ability to guide selection of proper systemic therapy and predict prognosis of breast cancer.展开更多
目的探讨PR在Luminal B HER2（-）腋窝淋巴结阴性的乳腺癌中的预后价值，为该类患者的治疗提供参考。方法收集2010年1月至2011年12月青岛大学附属医院乳腺病诊疗中心诊治的1401例乳腺癌患者的临床病理资料，选取其中196例Luminal B HER2...目的探讨PR在Luminal B HER2（-）腋窝淋巴结阴性的乳腺癌中的预后价值，为该类患者的治疗提供参考。方法收集2010年1月至2011年12月青岛大学附属医院乳腺病诊疗中心诊治的1401例乳腺癌患者的临床病理资料，选取其中196例Luminal B HER2（-）腋窝淋巴结阴性的患者，分析PR与临床病理特征的相关性及其对该亚型患者5年无病生存（disease-free survival，DFS）和总生存（overall survival，OS）影响。结果在收集的1401例乳腺癌患者的资料中，有14.0%（196/1401）为Luminal B HER2（-）腋窝淋巴结阴性。在196名该亚型患者中，其中有14.8%（29/196）患者PR阴性，85.2%（167/196）患者PR阳性。PR阴性与月经状态（P=0.029）及组织学分级（P=0.001）有显著差异，而年龄、肿瘤大小、脉管癌栓及Ki67则与PR无显著差异（P均〉0.05）。中位随访60个月后，9.7%（19/196）的患者出现复发和转移，其中4.1%（8/196）患者因肿瘤进展而死亡。5年总体DFS为90.3%，其中PR阴性组5年DFS为75.9%，PR阳性组5年DFS为92.8%，差异有统计学意义（Log rank P=0.001）。5年总体OS为95.9%，其中PR阴性组5年OS为89.7%，PR阳性组5年OS为97.0%，差异有统计学意义（Log rank P=0.023）。多因素分析显示，PR是5年DFS的独立影响因素（HR=2.85,95.0% CI：1.05~7.72，P=0.039），不是5年OS的独立预后因素，差异无统计学意义（HR=1.78,95.0% CI： 0.34~9.35,P=0.495）。结论PR是Luminal B HER2（-）腋窝淋巴结阴性的乳腺癌复发转移的独立影响因素。展开更多
Background The incidence of brain metastases in patients with breast cancer is approximately 10%-16%, and survival after diagnosis of brain metastases is usually short. This study was designed to evaluate the risk fac...Background The incidence of brain metastases in patients with breast cancer is approximately 10%-16%, and survival after diagnosis of brain metastases is usually short. This study was designed to evaluate the risk factors associated with brain metastases in advanced breast cancer patients, with a view to help predict patient groups with high risk of brain metastases. Methods In total, 295 patients with advanced breast cancer were evaluated. All patients were pathologically confirmed and metastatic lesions were confirmed pathologically or by imaging. All patients were examined at least once every 6 months with head CT or MRI. Patients showing symptoms underwent immediate inspection, and brain metastatic lesions were confirmed by head CT and/or MRI. Results At a median follow-up of 12 months from the occurrence of metastases, brain metastases had occurred in 49 patients （16.6%）. In our univariate analysis, variables significantly related to increased risk of brain metastases were hormone receptor-negative tumors, epidermal growth factor receptor 2 （HER2）-positive tumors, and multiple distant metastases. Patients with dominant tumor sites in soft tissue, or defined as Luminal A subtype, tended to have a lower risk of brain metastases than patients with visceral metastases, Luminal B subtype, triple-negative subtype or HER2-enriched subtype tumors. Conclusions Our results strongly suggest that factors such as Luminal B, triple-negative, and HER2-enriched subtypes are high risk factors for brain metastases. These data, therefore, provide pivotal clinical evidence towards a comprehensive understanding of the risk factors of brain metastases in advanced breast cancer patients.展开更多
文摘Background： Current understanding of tumor biology suggests that breast cancer is a group of diseases with different intrinsic molecular subtypes. Anatomic staging system alone is insufficient to provide future outcome information. The American Joint Committee on Cancer （AJCC） expert panel updated the 8th edition of the staging manual with prognostic stage groups by incorporating biomarkers into the anatomic stage groups. In this study, we retrospectively analyzed the data from our center in China using the anatomic and prognostic staging system based on the AJCC 8th edition staging manual. Methods： We reviewed the data from January 2008 to December 2014 for cases with Luminal B Human Epidermal Growth Factor Receptor 2 （HER2）-negative breast cancer in our center. All cases were restaged using the AJCC 8th edition anatomic and prognostic staging system. The Kaplan-Meier method and log-rank test were used to compare the survival differences between different subgroups. SPSS software version 19.0 （IBM Corp., Armonk, NY, USA） was used for the statistical analyses. Results： This study consisted of 796 patients with Luminal B HER-negative breast cancer. The 5-year disease-free survival （DFS） of 769 Stage I-III patients was 89.7%, and the 5-year overall survival （OS） of all 796 patients was 91.7%. Both 5-year DFS and 5-year OS were significantly different in the different anatomic and prognostic stage groups, There were 372 cases （46.7%） assigned to a different group. The prognostic Stage II and III patients restaged from anatomic Stage III had significant differences in 5-year DFS （v2 = 11.319; P = 0.001） and 5-year OS （χ2 = 5.225, P = 0.022）. In addition, cases restaged as prognostic Stage I, II, or III from the anatomic Stage II group had statistically significant differences in 5-year DFS （χ2 = 6.510, P = 0.039） but no significant differences in 5-year OS （χ2 = 5.087, P = 0.079）. However, the restaged prognostic Stage I and II cases from anatomic Stage I had no statis
基金supported by research grants from the Beijing Municipal Commission of Health and Family Planning(No.2009-1011)the Beijing Municipal Science and Technology Commission(No.D090507043409010 and Z131107002213007)the Precision Medicine Special Project of National Key Research and Development Program(No.2016YFC0901302)
文摘Objective： We retrospectively analyzed the clinical prognostic value of the 8th edition of the American Joint Committee on Cancer （AJCC） staging system for luminal A breast cancer. Methods： Using both the anatomic and prognostic staging in the 8th edition of AJCC cancer staging system, we restaged patients with luminal A breast cancer treated at the Breast Disease Center, Peking University First Hospital from 2008 to 2014. Follow-up data including 5-year disease free survival （DFS）, overall survival （OS） and other clinic-pathological data were collected to analyze the differences between the two staging subgroups. Results： This study included 421 patients with luminal A breast cancer （median follow-up, 61 months）. The 5- year DFS and OS rates were 98.3% and 99.3%, respectively. Significant differences in 5-year DFS but not OS were observed between different anatomic disease stages. Significant differences were observed in both 5-year DFS and O S between different prognostic stages. Application of the prognostic staging system resulted in assignment of 175 of 421 patients （41.6%） to a different group compared to their original anatomic stages. In total, 102 of 103 patients with anatomic stage IlA changed to prognostic stage IB, and 24 of 52 patients with anatomic stage lib changed to prognostic stage IB, while 1 changed to prognostic stage liIB. Twenty-two of 33 patients with anatomic stage IliA were down-staged to IlA when staged by prognostic staging system, and the other 11 patients were down-staged to liB. Two patients with anatomic stage IIIB were down-staged to IliA. Among seven padents with anatomic stage IIIC cancer, two were down-staged to IliA and four were down-staged to stage I]IB. Conclusions： The 8th edition of AJCC prognostic staging system is an important supplement to the breast cancer staging system. More clinical trials are needed to prove its ability to guide selection of proper systemic therapy and predict prognosis of breast cancer.
文摘目的探讨PR在Luminal B HER2（-）腋窝淋巴结阴性的乳腺癌中的预后价值，为该类患者的治疗提供参考。方法收集2010年1月至2011年12月青岛大学附属医院乳腺病诊疗中心诊治的1401例乳腺癌患者的临床病理资料，选取其中196例Luminal B HER2（-）腋窝淋巴结阴性的患者，分析PR与临床病理特征的相关性及其对该亚型患者5年无病生存（disease-free survival，DFS）和总生存（overall survival，OS）影响。结果在收集的1401例乳腺癌患者的资料中，有14.0%（196/1401）为Luminal B HER2（-）腋窝淋巴结阴性。在196名该亚型患者中，其中有14.8%（29/196）患者PR阴性，85.2%（167/196）患者PR阳性。PR阴性与月经状态（P=0.029）及组织学分级（P=0.001）有显著差异，而年龄、肿瘤大小、脉管癌栓及Ki67则与PR无显著差异（P均〉0.05）。中位随访60个月后，9.7%（19/196）的患者出现复发和转移，其中4.1%（8/196）患者因肿瘤进展而死亡。5年总体DFS为90.3%，其中PR阴性组5年DFS为75.9%，PR阳性组5年DFS为92.8%，差异有统计学意义（Log rank P=0.001）。5年总体OS为95.9%，其中PR阴性组5年OS为89.7%，PR阳性组5年OS为97.0%，差异有统计学意义（Log rank P=0.023）。多因素分析显示，PR是5年DFS的独立影响因素（HR=2.85,95.0% CI：1.05~7.72，P=0.039），不是5年OS的独立预后因素，差异无统计学意义（HR=1.78,95.0% CI： 0.34~9.35,P=0.495）。结论PR是Luminal B HER2（-）腋窝淋巴结阴性的乳腺癌复发转移的独立影响因素。
文摘Background The incidence of brain metastases in patients with breast cancer is approximately 10%-16%, and survival after diagnosis of brain metastases is usually short. This study was designed to evaluate the risk factors associated with brain metastases in advanced breast cancer patients, with a view to help predict patient groups with high risk of brain metastases. Methods In total, 295 patients with advanced breast cancer were evaluated. All patients were pathologically confirmed and metastatic lesions were confirmed pathologically or by imaging. All patients were examined at least once every 6 months with head CT or MRI. Patients showing symptoms underwent immediate inspection, and brain metastatic lesions were confirmed by head CT and/or MRI. Results At a median follow-up of 12 months from the occurrence of metastases, brain metastases had occurred in 49 patients （16.6%）. In our univariate analysis, variables significantly related to increased risk of brain metastases were hormone receptor-negative tumors, epidermal growth factor receptor 2 （HER2）-positive tumors, and multiple distant metastases. Patients with dominant tumor sites in soft tissue, or defined as Luminal A subtype, tended to have a lower risk of brain metastases than patients with visceral metastases, Luminal B subtype, triple-negative subtype or HER2-enriched subtype tumors. Conclusions Our results strongly suggest that factors such as Luminal B, triple-negative, and HER2-enriched subtypes are high risk factors for brain metastases. These data, therefore, provide pivotal clinical evidence towards a comprehensive understanding of the risk factors of brain metastases in advanced breast cancer patients.
