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Breast cancer
Endoxifen Concentration Is Associated with Recurrence-Free Survival in Hormone-Sensitive Breast Cancer Patients
Beomki Lee, Seok Jin Nam, Seok Won Kim, Jonghan Yu, Byung-Joo Chae, Se Kyung Lee, Jai Min Ryu, Jeong Eon Lee, Soo-Youn Lee
Cancer Res Treat. 2025;57(1):140-149.   Published online June 18, 2024
DOI: https://doi.org/10.4143/crt.2023.1285
AbstractAbstract PDFPubReaderePub
Purpose
The metabolism of tamoxifen is influenced by various cytochrome p450 enzymes, including CYP2D6 and CYP2C19, leading to variations in the levels of endoxifen, even with the same tamoxifen dose. However, the clinical significance of endoxifen for the prognosis of breast cancer patients remains controversial. This study aimed to elucidate the relevance of endoxifen level to recurrence-free survival censored with tamoxifen discontinuation (RFSt), representing the RFS for tamoxifen itself, of breast cancer patients and determine a suitable cutoff for prognostication.
Materials and Methods
The study included 478 breast cancer patients. Tamoxifen and its metabolites, including endoxifen, were measured using liquid chromatography-tandem mass spectrometry. An optimal cutoff was determined with maximally selected rank statistics. Survival analysis and Cox regression were conducted based on this cutoff.
Results
An endoxifen level of 21.00 ng/mL was the optimal cutoff for prognostication. Survival analysis revealed a statistically significant difference in RFSt between the low endoxifen group (≤ 21.00 ng/mL) and the high endoxifen group (> 21.00 ng/mL) (log-rank test, p=0.032). The 10-year probability of RFSt was 83.2% (95% confidence interval [CI], 77.0 to 89.9) and 88.3% (95% CI, 83.3 to 93.5) in the low and high endoxifen groups, respectively. Multivariable Cox proportional hazards regression indicated endoxifen concentration as a significant factor associated with prognosis.
Conclusion
Endoxifen could serve as a marker for appropriate tamoxifen treatment with a cutoff of 21.00 ng/mL. Based on this cutoff, therapeutic drug monitoring would benefit patients displaying suboptimal endoxifen concentrations.
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Impact of Social Support during Diagnosis and Treatment on Disease Progression in Young Patients with Breast Cancer: A Prospective Cohort Study
Danbee Kang, Seri Park, Hyo Jung Kim, Seok Won Kim, Jeong Eon Lee, Jonghan Yu, Se Kyung Lee, Ji-Yeon Kim, Seok Jin Nam, Juhee Cho, Yeon Hee Park
Cancer Res Treat. 2024;56(1):125-133.   Published online September 4, 2023
DOI: https://doi.org/10.4143/crt.2023.673
AbstractAbstract PDFPubReaderePub
Purpose
We evaluated the association between changes in social support after cancer treatment and recurrence-free survival (RFS) in such patients using a prospective cohort study.
Materials and Methods
Data were obtained from a prospective cohort study (NCT03131089) conducted at Samsung Medical Center (2013-2021). The primary outcome measure was RFS. Social support was measured using the social and family well-being (SFWB) domain of the Functional Assessment of Cancer Therapy-General. We calculated the changes in SFWB scores before and during treatment and the hazard ratio for RFS by comparing such changes.
Results
The mean±standard deviation (SD) age of the patients was 35±3.9 years, and 71.5% and 64.8% of the patients were married and had children, respectively. The mean±SD SFWB score at baseline was 20.5±5.0 out of 26. After cancer treatment, 35.9%, 10.3%, and 53.8% of the participants had increasing, unchanged, and decreasing SFWB scores, respectively. The decreasing SFWB score group had a higher risk of mortality or recurrence than the increasing group. Risk factors for the decreasing score were the presence of children during diagnosis.
Conclusion
In this cohort, changes in social support after treatment were associated with RFS in young patients with breast cancer. Health professionals should develop family interventions to help them receive proper social support.
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Epidemiology of Second Non-breast Primary Cancers among Survivors of Breast Cancer: A Korean Population–Based Study by the SMARTSHIP Group
Haeyoung Kim, Su SSan Kim, Ji Sung Lee, Jae Sun Yoon, Hyun Jo Youn, Hyukjai Shin, Jeong Eon Lee, Se Kyung Lee, Il Yong Chung, So-Youn Jung, Young Jin Choi, Jihyoung Cho, Sang Uk Woo, Korean Breast Cancer Society
Cancer Res Treat. 2023;55(2):580-591.   Published online December 27, 2022
DOI: https://doi.org/10.4143/crt.2022.410
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
This study aimed to evaluate the incidence and prognosis of second non-breast primary cancer (SNBPC) among Korean survivors of breast cancer.
Materials and Methods
Data from the Korean National Health Insurance Service were searched to identify women who received curative surgery for initial breast cancer (IBC) between 2003 and 2008 (n=64,340). Among them, patients with the following characteristics were excluded: other cancer diagnosis before IBC (n=10,866), radiotherapy before IBC (n=349), absence of data on sex or age (n=371), or male (n=248). Accordingly, data of 52,506 women until December 2017 were analyzed. SNBPC was defined as a newly diagnosed SNBPC that occurred 5 years or more after IBC diagnosis.
Results
The median follow-up time of all patients was 12.13 years. SNBPC was developed in 3,084 (5.87%) women after a median of 7.61 years following IBC diagnosis. The 10-year incidence of SNBPC was 5.78% (95% confidence interval [CI], 5.56 to 6.00). Higher SNBPC incidence was found in survivors with the following factors: old age at IBC diagnosis, low household income, and receiving combined chemotherapy with endocrine therapy, whereas receiving radiotherapy was related to a lower incidence of SNBPC (hazard ratio, 0.89; p < 0.01). Among the patients with SNBPC, the 5-year survival rate was 62.28% (95% CI, 65.53 to 69.02).
Conclusion
Approximately 5% of breast cancer survivors developed SNBPC within 10 years after IBC diagnosis. The risk of SNBPC was associated with patient’s age at IBC diagnosis, income level, and a receipt of systemic treatments.

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  • Association of radiotherapy for stage I–III breast cancer survivors and second primary malignant cancers: a population-based study
    Jin Shi, Jian Liu, Guo Tian, Daojuan Li, Di Liang, Jun Wang, Yutong He
    European Journal of Cancer Prevention.2024; 33(2): 115.     CrossRef
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General
Effectiveness of Self-Assessment, TAilored Information, and Lifestyle Management for Cancer Patients’ Returning to Work (START): A Multi-center, Randomized Controlled Trial
Danbee Kang, Ka Ryeong Bae, Yeojin Ahn, Nayeon Kim, Seok Jin Nam, Jeong Eon Lee, Se Kyung Lee, Young Mog Shim, Dong Hyun Sinn, Seung Yeop Oh, Mison Chun, Jaesung Heo, Juhee Cho
Cancer Res Treat. 2023;55(2):419-428.   Published online November 8, 2022
DOI: https://doi.org/10.4143/crt.2022.939
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
We developed a comprehensive return to work (RTW) intervention covering physical, psycho-social and practical issues for patients newly diagnosed and evaluated its efficacy in terms of RTW.
Materials and Methods
A multi-center randomized controlled trial was done to evaluate the efficacy of the intervention conducted at two university-based cancer centers in Korea. The intervention program comprised educational material at diagnosis, a face-to-face educational session at completion of active treatment, and three individualized telephone counseling sessions. The control group received other education at enrollment.
Results
At 1-month post-intervention (T2), the intervention group was more likely to be working compared to the control group after controlling working status at diagnosis (65.4% vs. 55.9%, p=0.037). Among patients who did not work at baseline, the intervention group was 1.99-times more likely to be working at T2. The mean of knowledge score was higher in the intervention group compared to the control group (7.4 vs. 6.8, p=0.029). At the 1-year follow-up, the intervention group was 65% (95% confidence interval, 0.78 to 3.48) more likely to have higher odds for having work.
Conclusion
The intervention improved work-related knowledge and was effective in facilitating cancer patients’ RTW.

Citations

Citations to this article as recorded by  
  • Supporting Life Adjustment in Patients With Lung Cancer Through a Comprehensive Care Program: Protocol for a Controlled Before-and-After Trial
    Wonyoung Jung, Alice Ahn, Genehee Lee, Sunga Kong, Danbee Kang, Dongok Lee, Tae Eun Kim, Young Mog Shim, Hong Kwan Kim, Jongho Cho, Juhee Cho, Dong Wook Shin
    JMIR Research Protocols.2024; 13: e54707.     CrossRef
  • A visualized and bibliometric analysis of cancer vocational rehabilitation research using CiteSpace
    Zebing Luo, Xuejia Liu, Chujun Chen
    Work.2024; : 1.     CrossRef
  • Psychosocial Adjustment Experiences Among Nasopharyngeal Carcinoma Survivors
    Jie Jiang, Ming-Hui Yan, Yu-Ying Fan, Jun-E Zhang
    Cancer Nursing.2023;[Epub]     CrossRef
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Breast cancer
Real World Evidence of Neoadjuvant Docetaxel/Carboplatin/Trastuzumab/Pertuzumab (TCHP) in Patients with HER2-Positive Early or Locally Advanced Breast Cancer: A Single-Institutional Clinical Experience
Ji-Yeon Kim, Seok Jin Nam, Jeong Eon Lee, Jonghan Yu, Byung Joo Chae, Se Kyung Lee, Jai Min Ryu, Jin Seok Ahn, Young-Hyuck Im, Seok Won Kim, Yeon Hee Park
Cancer Res Treat. 2022;54(4):1091-1098.   Published online January 10, 2022
DOI: https://doi.org/10.4143/crt.2021.901
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
Docetaxel/carboplatin/trastuzumab/pertuzumab (TCHP) regimen is frequently used to treat early and locally advanced human epidermal growth factor receptor 2 (HER2)–positive breast cancer (BC) in neoadjuvant setting. However, large-scaled real-world evidence did not exist.
Materials and Methods
We retrospectively reviewed medical records of patients with early or locally advanced HER2-positive BC who underwent neoadjuvant TCHP followed by curative surgery at Samsung Medical Center between January 2016 and August 2020.
Results
Of 447 patients, 316 (70.7%) received breast-conserving surgery and 131 (29.3%) received total mastectomy. In terms of neoadjuvant chemotherapy response, pathologic complete response (pCR) and residual cancer burden (RCB) score were analyzed. The rate of pCR was 64% a class of RCB 0 was observed in 65% of cases, RCB class I in 12%, RCB class II in 14%, and RCB class III in 2%. The 3-year event-free survival rate was 90.6%, BC with pCR occurred in 92.8%, and BC with non-pCR in 86.3% (p=0.016). In terms of distant metastasis, the 3-year distant recurrence-free survival rate was 93.5%; BC with pCR occurred in 95.9% and BC with non-pCR in 89.2% (p=0.013). Mucositis (85.2%), pain (83.2%), and diarrhea (70.5%) were the most common non-hematologic adverse events. In terms of hematologic adverse events, anemia (89.9%) was the most commonly observed adverse events followed by thrombocytopenia (29.8%).
Conclusion
Neoadjuvant TCHP therapy had a pCR rate of 64% and a 3-year event-free survival of 90% in real world experience. In terms of toxicity profile, anemia was frequently observed and adequate management including occasional transfusion was required.

Citations

Citations to this article as recorded by  
  • De-escalation of neoadjuvant taxane and carboplatin therapy in HER2-positive breast cancer with dual HER2 blockade: a multicenter real-world experience in China
    Song Wu, Li Bian, Haibo Wang, Shaohua Zhang, Tao Wang, Zhigang Yu, Jianbin Li, Feng Li, Kun Wang, Zefei Jiang
    World Journal of Surgical Oncology.2024;[Epub]     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
  • Impact of adding pertuzumab to trastuzumab plus chemotherapy in neoadjuvant treatment of HER2 positive breast cancer patients: a multicenter real-life HER2PATH study
    Ahmet Bilici, Omer Fatih Olmez, Muhammed Ali Kaplan, Berna Oksuzoglu, Ahmet Sezer, Nuri Karadurmus, Erdem Cubukcu, Mehmet Ali Nahit Sendur, Sercan Aksoy, Dilek Erdem, Gul Basaran, Burcu Cakar, Abdallah T. M. Shbair, Cagatay Arslan, Ahmet Taner Sumbul, Sem
    Acta Oncologica.2023; 62(4): 381.     CrossRef
  • Pathologic Complete Response Achieved in Early-Stage HER2-Positive Breast Cancer After Neoadjuvant Therapy With Trastuzumab and Chemotherapy vs. Trastuzumab, Chemotherapy, and Pertuzumab: A Systematic Review and Meta-Analysis of Clinical Trials
    Faizan Fazal, Muhammad Nauman Bashir, Maham Leeza Adil, Usama Tanveer, Mansoor Ahmed, Taha Zahid Chaudhry, Ali Ahmad Ijaz, Muhammad Haider
    Cureus.2023;[Epub]     CrossRef
  • Trends of axillary surgery in breast cancer patients with axillary lymph node metastasis: a comprehensive single-center retrospective study
    Yeon Jin Kim, Hye Jin Kim, Soo Yeon Chung, Se Kyung Lee, Byung Joo Chae, Jonghan Yu, Jeong Eon Lee, Seok Won Kim, Seok Jin Nam, Jai Min Ryu
    Annals of Surgical Treatment and Research.2023; 105(1): 10.     CrossRef
  • Anthracyclines versus No Anthracyclines in the Neoadjuvant Strategy for HER2+ Breast Cancer: Real-World Evidence
    Inês Soares de Pinho, Paulo Luz, Lucy Alves, Raquel Lopes-Brás, Vanessa Patel, Miguel Esperança-Martins, Lisa Gonçalves, Ritas Freitas, Diana Simão, Maria Roldán Galnares, Isabel Fernandes, Silvia Artacho Criado, Salvador Gamez Casado, Jose Baena Cañada,
    Clinical Drug Investigation.2023; 43(9): 691.     CrossRef
  • Benefit of postoperative regional nodal irradiation in patients receiving preoperative systemic therapy with docetaxel/carboplatin/trastuzumab/pertuzumab for HER2-positive breast cancer
    Nalee Kim, Ji-Yeon Kim, Won Park, Won Kyung Cho, Tae Gyu Kim, Young-Hyuck Im, Jin Seok Ahn, Jeong Eon Lee, Seok Jin Nam, Seok Won Kim, Jonghan Yu, Byung Joo Chae, Sei Kyung Lee, Jai-Min Ryu, Yeon Hee Park, Haeyoung Kim
    The Breast.2023; 72: 103594.     CrossRef
  • Response Rate and Safety of a Neoadjuvant Pertuzumab, Atezolizumab, Docetaxel, and Trastuzumab Regimen for Patients With ERBB2-Positive Stage II/III Breast Cancer
    Hee Kyung Ahn, Sung Hoon Sim, Koung Jin Suh, Min Hwan Kim, Jae Ho Jeong, Ji-Yeon Kim, Dae-Won Lee, Jin-Hee Ahn, Heejung Chae, Kyung-Hun Lee, Jee Hyun Kim, Keun Seok Lee, Joo Hyuk Sohn, Yoon-La Choi, Seock-Ah Im, Kyung Hae Jung, Yeon Hee Park
    JAMA Oncology.2022; 8(9): 1271.     CrossRef
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Clinicopathological Characterization of Double Heterozygosity for BRCA1 and BRCA2 Variants in Korean Breast Cancer Patients
Yoon Ju Bang, Won Kyung Kwon, Seok Jin Nam, Seok Won Kim, Byung-Joo Chae, Se Kyung Lee, Jai Min Ryu, Jong-Won Kim, Jonghan Yu, Jeong Eon Lee
Cancer Res Treat. 2022;54(3):827-833.   Published online October 13, 2021
DOI: https://doi.org/10.4143/crt.2021.791
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
Double heterozygosity (DH) for BRCA1 and BRCA2 variant is very rare with only a few cases reported, and most those in Caucasians. In this article, we present seven unrelated cases of DH for BRCA1/2 identified from a single institution in Korea, and describe the characteristics and phenotype of DH individuals compared to those with a single BRCA variant.
Materials and Methods
This study included 27,678 patients diagnosed with breast cancer and surgically treated at Samsung Medical Center (SMC) between January 2008 and June 2020. In total, 4,215 high-risk breast cancer patients were tested for the BRCA1/2 genes, and electronic medical records from 456 cases with pathogenic/likely pathogenic variants (PVs/LPVs) were reviewed.
Results
A younger mean age at diagnosis was associated with DH than a single variant of BRCA1/2. More triple-negative breast cancer (TNBC) and higher nuclear and histologic grade cancer occurred with DH than BRCA2 variant. All 7 cases of DH were unrelated, and their mutation combinations were different. There were no Ashkenazi founder variants detected.
Conclusion
We suggest that patients with DH for BRCA1/2 variants develop breast cancer at a younger age, but the histopathologic features are similar to those of BRCA1.

Citations

Citations to this article as recorded by  
  • Multi-locus inherited neoplasia alleles syndromes in cancer: implications for clinical practice
    Jeanette Yuen, Siqin Zhou, Rebecca Caeser, Mallika Venkatramani, Diana Nur Bte Ishak, Shao-Tzu Li, Zewen Zhang, Jianbang Chiang, Sock Hoai Chan, Joanne Ngeow
    European Journal of Human Genetics.2025;[Epub]     CrossRef
  • Cost-effectiveness of talazoparib for patients with germline BRCA1/2 mutated HER2-negative advanced breast cancer in China and the US
    Junjie Pan, Ning Ren, Lanqi Ren, YiBei Yang, Qiaoping Xu
    Scientific Reports.2024;[Epub]     CrossRef
  • Characteristics of Chinese breast cancer patients with double heterozygosity for BRCA1 and BRCA2 germline pathogenic variants
    Song Wen, Meng Zhang, Jiuan Chen, Li Hu, Jie Sun, Lu Yao, Ye Xu, Juan Zhang, Yuntao Xie
    Breast Cancer Research and Treatment.2024; 208(1): 155.     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
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Validation of Korean Version of the COmprehensive Score for financial Toxicity (COST) Among Breast Cancer Survivors
Sungkeun Shim, Danbee Kang, Nayeon Kim, Gayeon Han, Jihyun Lim, Hyunsoo Kim, Jeonghyun Park, Mankyung Lee, Jeong Eon Lee, Seok Won Kim, Jonghan Yu, Byung Joo Chae, Jai Min Ryu, Seok Jin Nam, Se Kyung Lee, Juhee Cho
Cancer Res Treat. 2022;54(3):834-841.   Published online October 13, 2021
DOI: https://doi.org/10.4143/crt.2021.784
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
Little is known about the impact of financial toxicity in disease-free breast cancer survivors. We aim to validate the COmprehensive Score for financial Toxicity in Korean (COST-K) and evaluate financial toxicity among disease-free breast cancer survivors.
Materials and Methods
We conducted linguistic validation following a standardized methodology recommended by Functional Assessment of Chronic Illness Therapy multilingual translation (FACITtrans). For psychometric validation, we conducted a cross-sectional survey with 4,297 disease-free breast cancer survivors at a tertiary hospital in Seoul, Korea between November 2018 and April 2019. Survivors were asked to complete the COST-K and European Organization for Research and Treatment of Cancer Quality of Life Core 30 (EORTC QLQ-C30) questionnaires. The test-retest reliability, internal consistency, and validity of the COST-K were assessed using standard scale construction techniques.
Results
The COST-K demonstrated good internal consistency, with a Cronbach’s α of 0.81. The test-retest analysis revealed an intraclass correlation coefficient of 0.78. The COST-K had moderate correlation (r=–0.60) with the financial difficulty item of the EORTC QLQ-C30 and week correlation with the items on acute and chronic symptom burdens (nausea/vomiting, –0.18; constipation, –0.14; diarrhea, –0.14), showing good convergent and divergent validity. The median COST-K was 27 (range, 0 to 44; mean±standard deivation [SD], 27.1±7.5) and about 30% and 5% of cancer survivors experienced mild and severe financial toxicity, respectively. Younger age, lower education, lower household income was associated with higher financial toxicity.
Conclusion
The COST-K is a valid and reliable instrument for measuring financial toxicity in disease-free breast cancer survivors. Considering its impact on the health-related quality of life, more studies need to be conducted to evaluate financial toxicity in cancer survivors and design interventions.

Citations

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  • Severity of Financial Toxicity for Patients Receiving Palliative Radiation Therapy
    Jeremy P. Harris, Eric Ku, Garrett Harada, Sophie Hsu, Elaine Chiao, Pranathi Rao, Erin Healy, Misako Nagasaka, Jessica Humphreys, Michael A. Hoyt
    American Journal of Hospice and Palliative Medicine®.2024; 41(6): 592.     CrossRef
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    Victoria S. Wu, Xinglei Shen, Janet de Moor, Fumiko Chino, Jonathan Klein
    Advances in Radiation Oncology.2024; 9(3): 101419.     CrossRef
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    L. B. Thomy, M. Crichton, L. Jones, P. M. Yates, N. H. Hart, L. G. Collins, R. J. Chan
    Supportive Care in Cancer.2024;[Epub]     CrossRef
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    Binh Thang Tran, Dinh Duong Le, Thanh Gia Nguyen, Minh Tu Nguyen, Minh Hanh Nguyen, Cao Khoa Dang, Dinh Trung Tran, Le An Pham
    PLOS ONE.2024; 19(6): e0306339.     CrossRef
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    Stevanus Pangestu, Fanni Rencz
    Value in Health.2023; 26(2): 300.     CrossRef
  • Association between financial toxicity and health-related quality of life of patients with gynecologic cancer
    Yusuke Kajimoto, Kazunori Honda, Shiro Suzuki, Masahiko Mori, Hirofumi Tsubouchi, Kohshiro Nakao, Anri Azuma, Takashi Shibutani, Shoji Nagao, Takahiro Koyanagi, Izumi Kohara, Shuko Tamaki, Midori Yabuki, Lida Teng, Keiichi Fujiwara, Ataru Igarashi
    International Journal of Clinical Oncology.2023; 28(3): 454.     CrossRef
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    Veni V. Sakti, Mahmoud Danaee, Cheng-Har Yip, Ros S. A. Bustamam, Marniza Saad, Gin Gin Gan, Jerome Tan, Yueh Ni Lim, Flora L.T. Chong, Murallitharan Munisamy, Farahida Mohd Farid, Boon Lui Sew, Yek-Ching Kong, Nishalini Muniandy, Nirmala Bhoo-Pathy
    Cancer Care Research Online.2023; 3(3): e044.     CrossRef
  • Financial Toxicity Among Breast Cancer Patients
    Yi Kuang, Xiaoyi Yuan, Zheng Zhu, Weijie Xing
    Cancer Nursing.2023;[Epub]     CrossRef
  • Heterogeneity of financial toxicity and associated risk factors for older cancer survivors in China
    Mingzhu Su, Siqi Liu, Li Liu, Fang Wang, Jiahui Lao, Xiaojie Sun
    iScience.2023; 26(10): 107768.     CrossRef
  • Evaluation of financial toxicity and associated factors in female patients with breast cancer: a systematic review and meta-analysis
    Yusuf Çeli̇k, Sevilay Şenol Çeli̇k, Seda Sarıköse, Hande Nur Arslan
    Supportive Care in Cancer.2023;[Epub]     CrossRef
  • Validity of the COmprehensive Score for financial Toxicity (COST) in patients with gynecologic cancer
    Yusuke Kajimoto, Takashi Shibutani, Shoji Nagao, Satoshi Yamaguchi, Shiro Suzuki, Masahiko Mori, Hirofumi Tsubouchi, Kohshiro Nakao, Anri Azuma, Takahiro Koyanagi, Izumi Kohara, Shuko Tamaki, Midori Yabuki, Lida Teng, Kazunori Honda, Ataru Igarashi
    International Journal of Gynecologic Cancer.2022; : ijgc-2022-003410.     CrossRef
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Clinicopathologic Features and Long-Term Outcomes of Elderly Breast Cancer Patients: Experiences at a Single Institution in Korea
Hee Kyung Kim, Jun Soo Ham, Seonggyu Byeon, Kwai Han Yoo, Ki Sun Jung, Haa-Na Song, Jinhyun Cho, Ji Yun Lee, Sung Hee Lim, Hae Su Kim, Ji-Yeon Kim, Jeong Eon Lee, Seok Won Kim, Seok Jin Nam, Se Kyung Lee, Soo Youn Bae, Jin Seok Ahn, Young-Hyuck Im, Yeon Hee Park
Cancer Res Treat. 2016;48(4):1382-1388.   Published online March 11, 2016
DOI: https://doi.org/10.4143/crt.2015.423
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
The purpose of this study was to assess the tumor characteristics and long-term clinical outcomes of adjuvant treatments after surgery with a curative aim for patients with breast cancer who are 65 years and older. Materials and Methods Patients with breast cancer who underwent curative surgery from 2000 to 2009 were analyzed (n=4,388). Tumor characteristics and survival outcome were compared by dividing the patients into two age groups (< 65 and ≥ 65 years old). The Kaplan-Meier method was used for comparison of survival rates by log-rank test, and a Cox regression model was used to examine the effect of variables.
Results
Among 4,388 patients with invasive breast cancer, 317 patients (7.2%) were 65 years or older and the median age of all patients was 47 years (range, 18 to 91 years). Tumor characteristics were similar between the two age groups, but the older patients were treated less often with adjuvant treatments. During a median follow-up period of 122 months, recurrence-free survival (RFS) was equivalent for patients 65 years and older compared to younger patients, but significantly worse in overall survival (OS) and breast cancer–specific survival (BCSS) (5-year OS, 94.3% vs. 90.5%; p < 0.001 and 5-year BCSS, 94.7% vs. 91.8%; p=0.031). In the multivariate model, age ≥ 65 years old was identified as an independent risk factor for OS and RFS. Conclusion Elderly breast cancer appeared to have worse outcomes with very low prevalence in Korea, despite similar tumor characteristics. More active adjuvant therapies would have a role for aggressive subtypes for fit, elderly patients.

Citations

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Association between Mutation and Expression of TP53 as a Potential Prognostic Marker of Triple-Negative Breast Cancer
Ji-Yeon Kim, Kyunghee Park, Hae Hyun Jung, Eunjin Lee, Eun Yoon Cho, Kwang Hee Lee, Soo Youn Bae, Se Kyung Lee, Seok Won Kim, Jeong Eon Lee, Seok Jin Nam, Jin Seok Ahn, Young-Hyuck Im, Yeon Hee Park
Cancer Res Treat. 2016;48(4):1338-1350.   Published online February 18, 2016
DOI: https://doi.org/10.4143/crt.2015.430
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
TP53, the most frequently mutated gene in breast cancer, is more frequently altered in HER2-enriched and basal-like breast cancer. However, no studies have clarified the role of TP53 status as a prognostic and predictive marker of triple-negative breast cancer (TNBC).
Materials and Methods
We performed p53 immunohistochemistry (IHC), nCounter mRNA expression assay, and DNA sequencing to determine the relationship between TP53 alteration and clinical outcomes of TNBC patients.
Results
Seventy-seven of 174 TNBC patients were found to harbor a TP53 mutation. Patients with missense mutations showed high protein expression in contrast to patients with deletion mutations (positivity of IHC: wild type vs. missense vs. deletion mutation, 53.6% vs. 89.8% vs. 25.0%, respectively; p < 0.001). TP53 mRNA expression was influenced by mutation status (mRNA expression [median]: wild type vs. missense vs. deletion mutation, 207.36± 132.73 vs. 339.61±143.21 vs. 99.53±99.57,respectively; p < 0.001). According to survival analysis, neither class of mutation nor protein or mRNA expression status had any impact on patient prognosis. In subgroup analysis, low mRNA expression was associated with poor prognosis in patientswith a TP53 missense mutation (5-year distantrecurrence-free survival [5Y DRFS]: low vs. high, 50.0% vs. 87.8%; p=0.009), while high mRNA expression with a TP53 deletion mutation indicated poor prognosis (5Y DRFS: low vs. high, 91.7% vs. 75.0%; p=0.316).
Conclusion
Association between TP53 mutation and expression indicates a potential prognostic marker of TNBC; hence both DNA sequencing and mRNA expression analysis may be required to predict the prognosis of TNBC patients.

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