Breast cancer is increasingly diagnosed in the early stages without regional nodal involvement. The aim of the present study was to determine the 5-year overall (OS) and breast cancer specific ...survival (BCSS) for patients with node-negative breast cancer treated at the University Medical Centre Maribor, and compare it with survival at the national level.
Medical records were searched for information on patients with lymph node-negative invasive breast cancer who received primary treatment at the University Medical Centre Maribor in the period 2000-2009. Information on all Slovenian node-negative breast cancer patients diagnosed in the same period was obtained from the Cancer Registry of Republic of Slovenia. Time trends in survival were assessed by comparing the periods 2000-2004 and 2005-2009.
The 5-year OS and BCSS of patients treated in Maribor in the period 2000-2009 were 92.3% (95% CI, 90.5%- 94.1%) and 96.4% (95% CI, 95.2%-97.6%), respectively, and did not differ from the corresponding OS and BCSS for Slovenian patients. Although the improvement in OS for patients from Maribor diagnosed in the period 2005-2009 compared to 2000-2004 did not reach statistical significance (HR 0.73; 95% CI, 0.51-1.05; p=0.086), BCSS significantly improved over the same time periods (HR 0.53; 95% CI, 0.30-0.94; p=0.028).
Survival of node-negative breast cancer patients treated at the University Medical Centre Maribor is comparable to survival of corresponding patients at the national level. The rising number of long-term breast cancer survivors places additional importance on survivorship care.
The value of ultrasound-guided surgery for breast cancer Arko, Darja; Čas Sikošek, Nina; Kozar, Nejc ...
European journal of obstetrics & gynecology and reproductive biology,
September 2017, 2017-Sep, 2017-09-00, 20170901, Letnik:
216
Journal Article
Recenzirano
An increasing number of breast-conserving surgeries (BCS) has lead clinicians to the dilemma how to provide patients with the best pathological, short-term and long-term outcomes, while at the same ...time improving the cosmetic outcome and the patients’ quality of life. A proposed solution is the use of intraoperative ultrasound (IOUS) for lesion resection in palpable as well as non-palpable breast cancer.
This review identifies and compares evidence on palpation-guided/wire-guided vs. US-guided localization as well as stand-alone observational IOUS studies published between June 2001 and July 2017, indexed in Medline. A cornerstone of this review is the discussion on technology advancement as well as alternative IOUS approaches and their feasibility in treatment of patients with calcifications and multifocal lesions currently not treated with IOUS localization.
In comparison to other available methods, IOUS provided in most studies better rates of clear margins, lower rates of re-excisions as well as better cosmetic outcomes. Currently, there is a lack of available multicenter data on method comparisons as well as several limitations to the use of IOUS.
With a comparable follow-up rate of loco-regional recurrences and a higher reported long-term quality of life, IOUS should be a highly regarded method of localization in the planning of BCS.
Objective
Clinical and pathological characteristics of triple negative breast cancer (TNBC) treatment are required for escalation or de-escalation of treatment because of a lack of druggable targets. ...This study aimed to identify the factors affecting the risk of disease recurrence and disease-related death in patients with TNBC.
Methods
Patients with TNBC who were treated at the University Medical Centre Maribor between January 2010 and December 2017 were studied. Clinical and pathological data were analyzed using multivariate analysis and non-parametric tests. Subgroup analysis was performed to examine additional factors that affect 5-year overall survival (OS) and recurrence-free survival.
Results
Multivariate analysis showed that tumor size and the lymph node ratio (LNR) were significant risks in our population. Better discrimination of patients at risk of a shorter recurrence-free survival and OS was achieved by using the LNR. Only lymphovascular invasion was significant for predicting 5-year OS.
Conclusion
For risk-based decision-making systems, the LNR is useful for discriminating between high- and low-risk patients with TNBC.
Purpose: This study presents a rare skin manifestation of Lyme borreliosis, specifically affecting the areola in a child in the absence of a history of a tick bite or erythema migrans.
Case report: ...A 9-year-old boy presented with symptomless erythematous swelling of the breast areola for one month. Initial treatment for gynecomastia and then mastitis proved ineffective. A biopsy was performed, with histological findings revealing lymphocytoma, likely stemming from an insect bite. Serology for Borrelia burgdorferi was positive. Following a two-week course of oral amoxicillin, the lesion completely resolved.
Conclusion: The consideration of Lyme disease should be a component of the differential diagnosis of skin lesions localised in typical areas, particularly in patients living in endemic regions.
Summary
Objective
This retrospective study was undertaken to evaluate the role of intraoperative ultrasound in breast-conserving surgery of nonpalpable breast cancer.
Methods
The data about 125 ...patients with preoperatively diagnosed breast cancer operated with the help of intraoperative ultrasound between January 2009 and December 2012 were retrospectively analyzed.
Results
The mean volume of the excised tissue was 42.1 cm
3
(± 22.0 cm
3
). Immediate re-excision after ultrasound examination of the excised tissue was performed in 27 patients (21.6 %). Secondary procedure owing to positive histological margins was necessary only in four patients (3.2 %).
Conclusions
Intraoperative ultrasound offers some advantages in comparison with other localization techniques for nonpalpable breast cancer surgery.
Background: The natural course of traditionally prognostically unfavorable human epidermal growth factor receptor 2 (HER2)-positive breast cancer has been changed by anti-HER2 therapy. It is not ...clear whether the prognosis for HER2-positive patients treated with adjuvant trastuzumab differs from that of HER2-negative patients. Methods: We performed a retrospective study including patients with lymph node-negative invasive breast cancer treated at our institution in the period 2000-2009. Disease-free (DFS) and overall survival (OS) were calculated using the Kaplan-Meier method. The Cox proportional hazards model was applied to control for other clinically important variables. Results: Median follow-up was 90-109 months. The 5-year DFS rates for HER2-negative patients, HER2-positive patients without adjuvant trastuzumab and trastuzumab-treated HER2-positive patients were 88.1% (95% confidence interval (CI) 85.6-90.6%), 73.1% (95% CI 64.3-81.9%) and 90.7% (95% CI 83.1-98.3%), respectively. No significant difference in DFS was observed between trastuzumab-treated HER2-positive patients and HER2-negative patients in multivariate analysis (hazard ratio 1.15; 95% CI 0.53-2.46; p = 0.728). There were no differences in OS among the 3 groups. Conclusion: Based on our results, the negative prognostic effect of HER2 positivity seen before targeted anti-HER2 treatment has completely disappeared in the era of routine trastuzumab administration in the adjuvant setting.
Urokinase plasminogen activator (uPA) and plasminogen activator inhibitor type-1 (PAI-1) play a key role in tumour invasion and metastasis. High levels of both proteolytic enzymes are associated with ...poor prognosis in breast cancer patients. The purpose of this study was to evaluate the correlation between traditional prognostic factors and uPA and PAI-1 expression in primary tumour of breast cancer patients.
606 primary breast cancer patients were enrolled in the prospective study in the Department of gynaecological oncology and breast oncology at the University Medical Centre Maribor between the years 2004 and 2010. We evaluated the traditional prognostic factors (age, menopausal status, tumour size, pathohistological type, histologic grade, lymph node status, lymphovascular invasion and hormone receptor status), together with uPA and PAI-1. We used Spearman’s rank correlation, Mann Whitney U test and χ
test for statistical analysis.
Our findings indicate a positive correlation between uPA and tumour size (p < 0.001), grade (p < 0.001), histological type (p < 0.001), lymphovascular invasion (p = 0.01) and a negative correlation between uPA and hormone receptor status (p < 0.001). They also indicate a positive correlation between PAI-1 and tumour size (p = 0.004), grade (p < 0.001), pathohistological type (p < 0.001) and negative correlation between PAI-1 and hormone receptor status (p = 0.002).
Our study showed a relationship between uPA and PAI-1 and traditional prognostic factors. Their role as prognostic and predictive factors remains to be further evaluated.
Background: This paper describes the role of urokinase-type plasminogen activator (uPA) and its inhibitor, PAI-1, in breast cancer invasion and metastasis. These two parts of fibrinolytic system were ...the first novel tumor biological factors to be validated at the highest level of evidence (LOE I) regarding their clinical utility in breast cancer. Conclusions: Numerous independent studies have demonstrated that breast cancer patients with low levels of uPA and PAI-1 in their primary tumor tissue have a significantly better survival than patients with high levels of either factor. uPA and PAI-1 are recognized as level 1 tumor prognostic markers in early breast cancer. The methodology of determination is standardized and validated. The involvement of uPA and PAI-1 in cancer progression identifies its components as suitable targets for anti-cancer therapy. Several therapeutic approaches have been shown to be active in vitro, and are being currently tested in phase 2 clinical trials. The information provided in this brief review aims to inform the professional public of the latest knowledge and to promote greater interest in the role of the plasminogen activator system in breast cancer.
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