Cancer Research and Treatment

Original Articles

Breast cancer

Health-Seeking Behavior Returning to Normalcy Overcoming COVID-19 Threat in Breast Cancer: Eun-Gyeong Lee, Yireh Han, Dong-Eun Lee, Hyeong-Gon Moon, Hyoung Won Koh, Eun-Kyu Kim, So-Youn Jung; Cancer Res Treat. 2023;55(4):1222-1230. Published online April 3, 2023; DOI: https://doi.org/10.4143/crt.2023.364

Abstract PDF Supplementary Material PubReader ePub: Purpose
The coronavirus disease 2019 (COVID-19) outbreak has significantly impacted the diagnosis and treatment of breast cancer. Our study investigated the change in diagnosis and treatment of breast cancer with the progress of COVID-19 pandemic.
Materials and Methods
The study group comprised 6,514 recently diagnosed breast cancer patients between January 1, 2019, and February 28, 2021. The patients were divided into two groups: pre–COVID-19 period (3,182; January 2019 to December 2019) and COVID-19 pandemic period (3,332; January 2020 to February 2021). Clinicopathological information related to the first treatment after breast cancer diagnosis was retrospectively collected and analyzed in the two groups.
Results
Among the 6,514 breast cancer patients, 3,182 were in the pre–COVID-19 period and 3,332 were in the COVID-19 pandemic period. According to our evaluation, the least breast cancer diagnosis (21.8%) was seen in the first quarter of 2020. The diagnosis increased gradually except for the fourth quarter in 2020. While early-stage breast cancer was diagnosed 1,601 (48.1%) during the COVID-19 pandemic (p=0.001), the number of surgical treatments increased 4.6% (p < 0.001), and the treatment time was slightly shorter 2 days (p=0.001). The breast cancer subtype distribution was not statistically different between the pre–COVID-19 and COVID-19 period groups.
Conclusion
In the early stages of the pandemic, the number of breast cancer cases temporarily decreased; however, they stabilized soon, and no significant differences could be identified in the diagnosis and treatment when compared to the period before the pandemic.

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Effect of Estrogen Receptor Expression Level and Hormonal Therapy on Prognosis of Early Breast Cancer: Kyung-Hwak Yoon, Yeshong Park, Eunyoung Kang, Eun-Kyu Kim, Jee Hyun Kim, Se Hyun Kim, Koung Jin Suh, Sun Mi Kim, Mijung Jang, Bo La Yun, So Yeon Park, Hee-Chul Shin; Cancer Res Treat. 2022;54(4):1081-1090. Published online November 17, 2021; DOI: https://doi.org/10.4143/crt.2021.890

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Purpose
Estrogen receptor (ER) expression in breast cancer plays an essential role in carcinogenesis and disease progression. Recently, tumors with low level (1%-10%) of ER expression have been separately defined as ER low positive (ER^low). It is suggested that ER^low tumors might be morphologically and behaviorally different from tumors with high ER expression (ERhigh).
Materials and Methods
Retrospective analysis of a prospective cohort database was performed. Patients who underwent curative surgery for early breast cancer and had available medical records were included for analysis. Difference in clinicopathological characteristics, endocrine responsiveness and five-year recurrence-free survival was evaluated between different ER subgroups (ERhigh, ER^low, and ER-negative [ER–]).
Results
A total of 2,162 breast cancer patients were included in the analysis, Tis and T1 stage. Among them, 1,654 (76.5%) were ERhigh, 54 (2.5%) were ER^low, and 454 (21.0%) were ER^- patients. ER^low cases were associated with smaller size, higher histologic grade, positive human epidermal growth factor receptor 2, negative progesterone receptor, and higher Ki-67 expression. Recurrence rate was highest in ER– tumors and was inversely proportional to ER expression. Recurrence-free survival was not affected by hormonal therapy in the ER^low group (p=0.418).
Conclusion
ER^low breast cancer showed distinct clinicopathological features. ER^low tumors seemed to have higher recurrence rates compared to ERhigh tumors, and they showed no significant benefit from hormonal therapy. Future large scale prospective studies are necessary to validate the treatment options for ER^low breast cancer.

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ER-positive and BRCA2-mutated breast cancer: a literature review
Pu-Chun Li, Yi-Fan Zhu, Wen-Ming Cao, Bei Li
European Journal of Medical Research.2024;[Epub] CrossRef
Affibody PET Imaging of HER2-Expressing Cancers as a Key to Guide HER2-Targeted Therapy
Nina Eissler, Renske Altena, Ali Alhuseinalkhudhur, Olga Bragina, Joachim Feldwisch, Guido Wuerth, Annika Loftenius, Nikolai Brun, Rimma Axelsson, Vladimir Tolmachev, Jens Sörensen, Fredrik Y. Frejd
Biomedicines.2024; 12(5): 1088. CrossRef
Distinct ER and PR expression patterns significantly affect the clinical outcomes of early HER2-positive breast cancer: A real-world analysis of 871 patients treated with neoadjuvant therapy
Haizhu Chen, Xiujuan Gui, Ziwei Zhou, Fengxi Su, Chang Gong, Shunrong Li, Wei Wu, Nanyan Rao, Qiang Liu, Herui Yao
The Breast.2024; 75: 103733. CrossRef
HR-positive/HER2-negative breast cancer arising in patients with or without BRCA2 mutation: different biological phenotype and similar prognosis
Pu-Chun Li, Yi-Fan Zhu, Jia-Ni Pan, Qiao-Yan Zhu, Yu-Yang Liao, Xiao-Wen Ding, Lin-Feng Zheng, Wen-Ming Cao
Therapeutic Advances in Medical Oncology.2024;[Epub] CrossRef
Is the percentage of hormone receptor positivity in HR+ HER2-metastatic breast cancer patients receiving CDK 4/6 inhibitor with endocrine therapy predictive and prognostic?
Merve Keskinkilic, Huseyin Salih Semiz, Tugba Yavuzsen, Ilhan Oztop
Frontiers in Oncology.2024;[Epub] CrossRef
Rat Models of Hormone Receptor-Positive Breast Cancer
Raquel Nicotra, Catrin Lutz, Hendrik A. Messal, Jos Jonkers
Journal of Mammary Gland Biology and Neoplasia.2024;[Epub] CrossRef
Immune and gene-expression profiling in estrogen receptor low and negative early breast cancer
Davide Massa, Claudio Vernieri, Lorenzo Nicolè, Carmen Criscitiello, Florence Boissière-Michot, Séverine Guiu, Angélique Bobrie, Gaia Griguolo, Federica Miglietta, Andrea Vingiani, Riccardo Lobefaro, Beatrice Taurelli Salimbeni, Claudia Pinato, Francesca
JNCI: Journal of the National Cancer Institute.2024; 116(12): 1914. CrossRef
Trends in the incidence and survival of women with hormone receptor-positive breast cancer from 1990 to 2019: a large population-based analysis
Hongbo Huang, Tingting Wei, Aijie Zhang, Heng Zhang, Lingquan Kong, Yunhai Li, Fan Li
Scientific Reports.2024;[Epub] CrossRef
The “lows”: Update on ER-low and HER2-low breast cancer
Nicola Fusco, Giuseppe Viale
The Breast.2024; 78: 103831. CrossRef
Estrogenized HSA induced high-affinity autoantibodies in breast cancer - Novel biomarker for early detection
Subuhi Sherwani, Mohd Wajid Ali Khan, Wahid Ali Khan, Saravanan Rajendrasozhan, Khalid Al-Motair, Hamda Khan, Saheem Ahmad
Frontiers in Oncology.2024;[Epub] CrossRef
Missing link between tissue specific expressing pattern of ERβ and the clinical manifestations in LGBLEL
Xujuan Zhang, Pengxiang Zhao, Mingshen Ma, Hao Wu, Rui Liu, Ziyi Liu, Zisong Cai, Mengyu Liu, Fei Xie, Xuemei Ma
Frontiers in Medicine.2023;[Epub] CrossRef
Assessment of breast cytoarchitecture and its associated axillary lymph node status under normal and pathological conditions in Egyptian women
Omnia Mansour, Amani Kazem, Abeer El Wakil
Tissue and Cell.2023; 85: 102244. CrossRef
Estrogen-Receptor-Low-Positive Breast Cancer: Pathological and Clinical Perspectives
Christina Panagiotis Malainou, Nikolina Stachika, Aikaterini Konstantina Damianou, Aristotelis Anastopoulos, Ioanna Ploumaki, Efthymios Triantafyllou, Konstantinos Drougkas, Georgia Gomatou, Elias Kotteas
Current Oncology.2023; 30(11): 9734. CrossRef

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Clinicopathological Features of Patients with the BRCA1 c.5339T>C (p.Leu1780Pro) Variant: Hyung Seok Park, Jai Min Ryu, Ji Soo Park, Seock-Ah Im, So-Youn Jung, Eun-Kyu Kim, Woo-Chan Park, Jun Won Min, Jeeyeon Lee, Ji Young You, Jeong Eon Lee, Sung-Won Kim; Cancer Res Treat. 2020;52(3):680-688. Published online January 28, 2020; DOI: https://doi.org/10.4143/crt.2019.351

Abstract PDF Supplementary Material PubReader ePub

Purpose
Recent studies revealed the BRCA1 c.5339T>C, p.Leu1780Pro variant (L1780P) is highly suggested as a likely pathogenic. The aim of this study was to evaluate clinicopathologic features of L1780P with breast cancer (BC) using multicenter data from Korea to reinforce the evidence as a pathogenic mutation and to compare L1780P and other BRCA1/2mutations using Korean Hereditary Breast Cancer (KOHBRA) study data.
Materials and Methods
The data of 54 BC patients with L1780P variant from 10 institutions were collected and the clinicopathologic characteristics of the patients were reviewed. The hereditary breast and/or ovarian cancer–related characteristics of the L1780P variant were compared to those of BC patients in the KOHBRA study.
Results
The median age of all patients was 38 years, and 75.9% of cases showed triple-negative breast cancer. Comparison of cases with L1780P to carriers from the KOHBRA study revealed that the L1780P patients group was more likely to have family history (FHx) of ovarian cancer (OC) (24.1% vs. 19.6% vs. 11.2%, p < 0.001 and p=0.001) and a personal history of OC (16.7% vs. 2.9% vs. 1.3%, p=0.003 and p=0.001) without significant difference in FHx of BC and bilateral BC. The cumulative risk of contralateral BC at 10 years after diagnosis was 31.9%, while the cumulative risk of OC at 50 years of age was 20.0%. Patients with L1780P showed similar features with BRCA1 carriers and showed higher penetrance of OC than patients with other BRCA1 mutations.
Conclusion
L1780P should be considered as a pathogenic mutation. Risk-reducing salpingo-oophorectomy is highly recommended for women with L1780P.

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Whole Exome-Wide Association Identifies Rare Variants in GALNT9 Associated with Middle Eastern Papillary Thyroid Carcinoma Risk
Rong Bu, Abdul K. Siraj, Saud Azam, Kaleem Iqbal, Zeeshan Qadri, Maha Al-Rasheed, Saif S. Al-Sobhi, Fouad Al-Dayel, Khawla S. Al-Kuraya
Cancers.2023; 15(17): 4235. CrossRef
Feasibility of targeted cascade genetic testing in the family members of BRCA1/2 gene pathogenic variant/likely pathogenic variant carriers
Jeeyeon Lee, Ji Yeon Ham, Ho Yong Park, Jin Hyang Jung, Wan Wook Kim, Byeongju Kang, Yee Soo Chae, Soo Jung Lee, In Hee Lee, Nan Young Lee
Scientific Reports.2022;[Epub] CrossRef
Molecular Characterization of BRCA1 c.5339T>C Missense Mutation in DNA Damage Response of Triple-Negative Breast Cancer
Jeong Dong Lee, Won-Ji Ryu, Hyun Ju Han, Tae Yeong Kim, Min Hwan Kim, Joohyuk Sohn
Cancers.2022; 14(10): 2405. CrossRef
Discovery of BRCA1/BRCA2 founder variants by haplotype analysis
Won Kyung Kwon, Hyeok-Jae Jang, Jeong Eon Lee, Yeon Hee Park, Jai Min Ryu, Jonghan Yu, Ja-Hyun Jang, Jong-Won Kim
Cancer Genetics.2022; 266-267: 19. CrossRef
Local Laboratory Testing of Germline BRCA Mutations vs. Myriad: A Single-Institution Experience in Korea
Joohyun Hong, Jiyun Lee, Minsuk Kwon, Ji-Yeon Kim, Jong-Won Kim, Jin Seok Ahn, Young-Hyuck Im, Yeon Hee Park
Diagnostics.2021; 11(2): 370. CrossRef
Analysis of BRCA1/2 variants of unknown significance in the prospective Korean Hereditary Breast Cancer study
Joo Heung Kim, Sunggyun Park, Hyung Seok Park, Ji Soo Park, Seung-Tae Lee, Sung-Won Kim, Jong Won Lee, Min Hyuk Lee, Sue K. Park, Woo-Chul Noh, Doo Ho Choi, Wonshik Han, Sung Hoo Jung
Scientific Reports.2021;[Epub] CrossRef
A Population-Based Analysis of BRCA1/2 Genes and Associated Breast and Ovarian Cancer Risk in Korean Patients: A Multicenter Cohort Study
Kyung-Sun Park, Woochang Lee, Moon-Woo Seong, Sun-Young Kong, Kyung-A Lee, Jung-Sook Ha, Eun-Hae Cho, Sung-Hee Han, Inho Park, Jong-Won Kim
Cancers.2021; 13(9): 2192. CrossRef

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Negative Conversion of Progesterone Receptor Status after Primary Systemic Therapy Is Associated with Poor Clinical Outcome in Patients with Breast Cancer: Soomin Ahn, Hyun Jeong Kim, Milim Kim, Yul Ri Chung, Eunyoung Kang, Eun-Kyu Kim, Se Hyun Kim, Yu Jung Kim, Jee Hyun Kim, In Ah Kim, So Yeon Park; Cancer Res Treat. 2018;50(4):1418-1432. Published online January 24, 2018; DOI: https://doi.org/10.4143/crt.2017.552

Abstract PDF PubReader ePub

Purpose
Alteration of biomarker status after primary systemic therapy (PST) is occasionally found in breast cancer. This study was conducted to clarify the clinical implications of change of biomarker status in breast cancer patients treated with PST.
Materials and Methods
The pre-chemotherapeutic biopsy and post-chemotherapeutic resection specimens of 442 breast cancer patients who had residual disease after PST were included in this study. The association between changes of biomarker status after PST and clinicopathologic features of tumors, and survival of the patients, were analyzed.
Results
Estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) status changed after PST in 18 (4.1%), 80 (18.1%), and 15 (3.4%) patients,respectively. ER and PR mainly underwent positive to negative conversion,whereas HER2 status underwent negative to positive conversion. Negative conversion of ER and PR status after PST was associated with reduced disease-free survival. Moreover, a decline in the Allred score for PR in post-PST specimens was significantly associated with poor clinical outcome of the patients. HER2 change did not have prognostic significance. In multivariate analyses, negative PR status after PST was found to be an independent adverse prognostic factor in the whole patient group, in the adjuvant endocrine therapy-treated subgroup, and also in pre-PST PR positive subgroup.
Conclusion
ER and HER2 status changed little after PST, whereas PR status changed significantly. In particular, negative conversion of PR status was revealed as a poor prognostic indicator, suggesting that re-evaluation of basic biomarkers is mandatory in breast cancer after PST for proper management and prognostication of patients.

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Changing the phenotype of breast cancer in the process treatment: literature review
M. S. Shvedsky, R. I. Tamrazov, T. P. Shevlyukova, L. A. Bakhova
Surgery and Oncology.2024; 13(4): 50. CrossRef
HER2-low breast cancer and response to neoadjuvant chemotherapy: a population-based cohort study
Ximena Baez-Navarro, Mieke R. van Bockstal, Agnes Jager, Carolien H.M. van Deurzen
Pathology.2024; 56(3): 334. CrossRef
NGS mutational status on first diagnostic tissue, liquid biopsy and mastectomy in G2–G3 breast cancer
Carmen Maria Ardeleanu, Maria Victoria Olinca , Cristian Gabriel Viişoreanu , Horaţiu Alin Mureşan , Adriana Tecuceanu-Vulpe , Georgiana Manole , Iulia Elena Gune , Bianca Gălăţeanu , Andreea-Corina Ilie-Petrov
Romanian Journal of Morphology and Embryology.2024; 65(2): 195. CrossRef
Applicability of Quantum Dots in Breast Cancer Diagnostic and Therapeutic Modalities—A State-of-the-Art Review
Dominika Kunachowicz, Karolina Kłosowska, Natalia Sobczak, Marta Kepinska
Nanomaterials.2024; 14(17): 1424. CrossRef
Establishment and evaluation of digital PCR methods for HER2 copy number variation in breast cancer
Xia Wang, Dechun Xing, Zheng Liu, Yujing Zhang, Bo Cheng, Suozhu Sun, Qingtao Wang, Lianhua Dong
Analytical and Bioanalytical Chemistry.2023; 415(4): 725. CrossRef
Clinical significance and prognostic value of receptor conversion after neoadjuvant chemotherapy in breast cancer patients
Yang He, Jing Zhang, Hui Chen, Ying Zhou, Liping Hong, Yue Ma, Nannan Chen, Weipeng Zhao, Zhongsheng Tong
Frontiers in Surgery.2023;[Epub] CrossRef
Conversion of ER and HER2 Status After Neoadjuvant Therapy in Chinese Breast Cancer Patients
Jiaqi Bo, Baohua Yu, Rui Bi, Xiaoli Xu, Yufan Cheng, Xiaoyu Tu, Qianming Bai, Wentao Yang, Ruohong Shui
Clinical Breast Cancer.2023; 23(4): 436. CrossRef
Récepteur du facteur de croissance épidermique HER2, tests utilisés pour rechercher son amplification dans le cancer du sein : principes et limites
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Luo Wang, Qi Jiang, Meng-Ye He, Peng Shen
World Journal of Clinical Cases.2022; 10(1): 260. CrossRef
Experience with olaparib in a patient with luminal HER2-positive metastatic breast cancer
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Machine learning on MRI radiomic features: identification of molecular subtype alteration in breast cancer after neoadjuvant therapy
Hai-Qing Liu, Si-Ying Lin, Yi-Dong Song, Si-Yao Mai, Yue-dong Yang, Kai Chen, Zhuo Wu, Hui-Ying Zhao
European Radiology.2022; 33(4): 2965. CrossRef
Biomarker Alteration after Neoadjuvant Endocrine Therapy or Chemotherapy in Estrogen Receptor-Positive Breast Cancer
Mengping Long, Chong You, Qianqian Song, Lina Hu, Zhaorong Guo, Qian Yao, Wei Hou, Wei Sun, Baosheng Liang, Xiao-Hua Zhou, Yiqiang Liu, Taobo Hu
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The impact of progesterone receptor negativity on oncological outcomes in oestrogen-receptor-positive breast cancer
M G Davey, É J Ryan, P J Folan, N O’Halloran, M R Boland, M K Barry, K J Sweeney, C M Malone, R J McLaughlin, M J Kerin, A J Lowery
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Yul Ri Chung, Ji Won Woo, Soomin Ahn, Eunyoung Kang, Eun-Kyu Kim, Mijung Jang, Sun Mi Kim, Se Hyun Kim, Jee Hyun Kim, So Yeon Park
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Saverio Coiro, Elisa Gasparini, Giuseppe Falco, Giacomo Santandrea, Moira Foroni, Giulia Besutti, Valentina Iotti, Roberto Di Cicilia, Monica Foroni, Simone Mele, Guglielmo Ferrari, Giancarlo Bisagni, Moira Ragazzi
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A Novel Prognostic Nomogram for Predicting Risks of Distant Failure in Patients with Invasive Breast Cancer Following Postoperative Adjuvant Radiotherapy: Yu Jin Lim, Sea-Won Lee, Noorie Choi, Jeanny Kwon, Keun-Yong Eom, Eunyoung Kang, Eun-Kyu Kim, Jee Hyun Kim, Yu Jung Kim, Se Hyun Kim, So Yeon Park, In Ah Kim; Cancer Res Treat. 2018;50(4):1140-1148. Published online December 7, 2017; DOI: https://doi.org/10.4143/crt.2017.508

Abstract PDF Supplementary Material PubReader ePub

Purpose
This study aimed to identify predictors for distant metastatic behavior and build a related prognostic nomogram in breast cancer.
Materials and Methods
A total of 1,181 patients with non-metastatic breast cancer between 2003 and 2011 were analyzed. To predict the probability of distant metastasis, a nomogram was constructed based on prognostic factors identified using a Cox proportional hazards model.
Results
The 7-year overall survival and 5-year post-progression survival of locoregional versus distant recurrence groups were 67.6% versus 39.1% (p=0.027) and 54.2% versus 33.5% (p=0.043), respectively. Patients who developed distant metastasis showed early and late mortality risk peaks within 3 and after 5 years of follow-up, respectively, but a broad and low risk increment was observed in other patients with locoregional relapse. In multivariate analysis of distant metastasis-free interval, age (≥ 45 years vs. < 45 years), molecular subtypes (luminal A vs. luminal B, human epidermal growth receptor 2, and triple negative), T category (T1 vs. T2-3 and T4), and N category (N0 vs. N1 and N2-3) were independently associated (p < 0.05 for all). Regarding the significant factors, a well-validated nomogram was established (concordance index, 0.812). The risk score level of patients with initial brain failure was higher than those of non-brain sites (p=0.029).
Conclusion
The nomogram could be useful for predicting the individual probability of distant recurrence in breast cancer. In high-risk patients based on the risk scores, more aggressive systemic therapy and closer surveillance for metastatic failure should be considered.

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Predicting Patterns of Distant Metastasis in Breast Cancer Patients following Local Regional Therapy Using Machine Learning
Audrey Shiner, Alex Kiss, Khadijeh Saednia, Katarzyna J. Jerzak, Sonal Gandhi, Fang-I Lu, Urban Emmenegger, Lauren Fleshner, Andrew Lagree, Marie Angeli Alera, Mateusz Bielecki, Ethan Law, Brianna Law, Dylan Kam, Jonathan Klein, Christopher J. Pinard, Ale
Genes.2023; 14(9): 1768. CrossRef
Nomograms for Predicting Specific Distant Metastatic Sites and Overall Survival of Breast Invasive Ductal Carcinoma Patients After Surgery: A Large Population-Based Study
Yuqian Feng, Yiting Zhang, Yuying Xiang, Kaibo Guo, Huimin Jin, Shanming Ruan, Zhuoya Guan
Frontiers in Surgery.2022;[Epub] CrossRef
Cost-effectiveness of postmastectomy hypofractionated radiation therapy vs conventional fractionated radiation therapy for high-risk breast cancer
Jing Yang, Shu-Nan Qi, Hui Fang, Yong-Wen Song, Jing Jin, Yue-Ping Liu, Wei-Hu Wang, Yong Yang, Yu Tang, Hua Ren, Bo Chen, Ning-Ning Lu, Yuan Tang, Ning Li, Hao Jing, Shu-Lian Wang, Ye-Xiong Li
The Breast.2021; 58: 72. CrossRef
Prediction of distant metastatic recurrence by tumor-infiltrating lymphocytes in hormone receptor-positive breast cancer
Koji Takada, Shinichiro Kashiwagi, Yuka Asano, Wataru Goto, Rika Kouhashi, Akimichi Yabumoto, Sae Ishihara, Tamami Morisaki, Masatsune Shibutani, Hiroaki Tanaka, Kosei Hirakawa, Masaichi Ohira
BMC Women's Health.2021;[Epub] CrossRef
Nomogram for the personalisation of radiotherapy treatments in breast cancer patients
Inmaculada Beato Tortajada, Carlos Ferrer Albiach, Virginia Morillo Macias
The Breast.2021; 60: 255. CrossRef
Prognostic Factors and Nomograms to Predict Overall and Cancer-Specific Survival for Children with Wilms’ Tumor
Fucai Tang, Hanbin Zhang, Zechao Lu, Jiamin Wang, Chengwu He, Zhaohui He
Disease Markers.2019; 2019: 1. CrossRef
Score for the Survival Probability in Metastasis Breast Cancer: A Nomogram-Based Risk Assessment Model
Zhenchong Xiong, Guangzheng Deng, Xinjian Huang, Xing Li, Xinhua Xie, Jin Wang, Zeyu Shuang, Xi Wang
Cancer Research and Treatment.2018; 50(4): 1260. CrossRef

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Bilateral Salpingo-oophorectomy Compared to Gonadotropin-Releasing Hormone Agonists in Premenopausal Hormone Receptor–Positive Metastatic Breast Cancer Patients Treated with Aromatase Inhibitors: Koung Jin Suh, Se Hyun Kim, Kyung-Hun Lee, Tae-Yong Kim, Yu Jung Kim, Sae-Won Han, Eunyoung Kang, Eun-Kyu Kim, Kidong Kim, Jae Hong No, Wonshik Han, Dong-Young Noh, Maria Lee, Hee Seung Kim, Seock-Ah Im, Jee Hyun Kim; Cancer Res Treat. 2017;49(4):1153-1163. Published online February 27, 2017; DOI: https://doi.org/10.4143/crt.2016.463

Abstract PDF Supplementary Material PubReader ePub

Purpose
Although combining aromatase inhibitors (AI) with gonadotropin-releasing hormone agonists (GnRHa) is becoming more common, it is still not clear if GnRHa is as effective as bilateral salpingo-oophorectomy (BSO).
Materials and Methods
We retrospectively analyzed data of 66 premenopausal patients with hormone receptor– positive, human epidermal growth factor receptor 2–negative recurrent and metastatic breast cancer who had been treated with AIs in combination with GnRHa or BSO between 2002 and 2015.
Results
The median patient age was 44 years. Overall, 24 (36%) received BSO and 42 (64%) received GnRHa. The clinical benefit rate was higher in the BSO group than in the GnRHa group (88% vs. 69%, p=0.092). Median progression-free survival (PFS) was longer in the BSO group, although statistical significance was not reached (17.2 months vs. 13.3 months, p=0.245). When propensity score matching was performed, the median PFS was 17.2 months for the BSO group and 8.2 months for the GnRHa group (p=0.137). Multivariate analyses revealed that the luminal B subtype (hazard ratio, 1.67; 95% confidence interval [CI], 1.08 to 2.60; p=0.022) and later-line treatment (≥ third line vs. first line; hazard ratio, 3.24; 95% CI, 1.59 to 6.59; p=0.001) were independent predictive factors for a shorter PFS. Incomplete ovarian suppression was observed in a subset of GnRHa-treated patients whose disease showed progression, with E2 levels higher than 21 pg/mL.
Conclusion
Both BSO and GnRHa were found to be effective in our AI-treated premenopausal metastatic breast cancer patient cohort. However, further studies in larger populations are needed to determine if BSO is superior to GnRHa.

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Effectiveness of gonadotropin-releasing hormone agonists for ovarian function suppression in premenopausal patients with hormone receptor-positive breast cancer: a retrospective single-center real-world study
Yifei Chen, Ruyan Zhang, Ying Yan, Huiping Li, Guohong Song
Breast Cancer Research and Treatment.2024; 206(3): 543. CrossRef
Oophorectomy in Premenopausal Patients with Estrogen Receptor-Positive Breast Cancer: New Insights into Long-Term Effects
Fatima Khan, Kristin Rojas, Matthew Schlumbrecht, Patricia Jeudin
Current Oncology.2023; 30(2): 1794. CrossRef
Comparison of outcomes in patients with luminal type breast cancer treated with a gonadotropin-releasing hormone analog or bilateral salpingo-oophorectomy: A cohort retrospective study
Dwi Ris Andriyanto, Prihantono, Salman Ardi Syamsu, Muhammad Ihwan Kusuma, Joko Hendarto, Indra, Nilam Smaradania, Elridho Sampepajung, Asrul Mappiwali, Muhammad Faruk
Annals of Medicine & Surgery.2022;[Epub] CrossRef
Awareness of the Causes Leading to Surgical Ablation of Ovarian Function in Premenopausal Breast Cancer—A Single-Center Analysis
Joana Correia Oliveira, Filipa Costa Sousa, Inês Gante, Margarida Figueiredo Dias
Medicina.2021; 57(4): 385. CrossRef
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Brändli SP, Palm J, Kowalewski MP, Reichler IM
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Prognostic Factors in Hormone Receptor-Positive/Human Epidermal Growth Factor Receptor 2-Negative (HR+/HER2–) Advanced Breast Cancer: A Systematic Literature Review
Gebra Cuyún Carter, Maitreyee Mohanty, Keri Stenger, Claudia Morato Guimaraes, Shivaprasad Singuru, Pradeep Basa, Sheena Singh, Vanita Tongbram, Sherko Kuemmel, Valentina Guarneri, Sara M Tolaney
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