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Rare cancer
Clinical Features of Li-Fraumeni Syndrome in Korea
Ran Song, Sun-Young Kong, Wonyoung Choi, Eun-Gyeong Lee, Jaeyeon Woo, Jai Hong Han, Seeyoun Lee, Han-Sung Kang, So-Youn Jung
Cancer Res Treat. 2024;56(1):334-341.   Published online August 9, 2023
DOI: https://doi.org/10.4143/crt.2023.794
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
Li-Fraumeni syndrome (LFS) is a hereditary disorder caused by germline mutation in TP53. Owing to the rarity of LFS, data on its clinical features are limited. This study aimed to evaluate the clinical characteristics and prognosis of Korean patients with LFS.
Materials and Methods
Patients who underwent genetic counseling and confirmed with germline TP53 mutation in the National Cancer Center in Korea between 2011 and 2022 were retrospectively reviewed. Data on family history with pedigree, types of mutation, clinical features, and prognosis were collected.
Results
Fourteen patients with LFS were included in this study. The median age at diagnosis of the first tumor was 32 years. Missense and nonsense mutations were observed in 13 and one patients, respectively. The repeated mutations were p.Arg273His, p.Ala138Val, and pPro190Leu. The sister with breast cancer harbored the same mutation of p.Ala138Val. Seven patients had multiple primary cancers. Breast cancer was most frequently observed, and other types of tumor included sarcoma, thyroid cancer, pancreatic cancer, brain tumor, adrenocortical carcinoma, ovarian cancer, endometrial cancer, colon cancer, vaginal cancer, skin cancer, and leukemia. The median follow-up period was 51.5 months. Two and four patients showed local recurrence and distant metastasis, respectively. Two patients died of leukemia and pancreatic cancer 3 and 23 months after diagnosis, respectively.
Conclusion
This study provides information on different characteristics of patients with LFS, including types of mutation, types of cancer, and prognostic outcomes. For more appropriate management of these patients, proper genetic screening and multidisciplinary discussion are required.

Citations

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  • Consensus Statement: Recommendations on Actionable Biomarker Testing for Thyroid Cancer Management
    Ozgur Mete, Andrée Boucher, Kasmintan A. Schrader, Omar Abdel-Rahman, Houda Bahig, Cheryl Ho, Olfat Kamel Hasan, Bernard Lemieux, Eric Winquist, Ralph Wong, Jonn Wu, Nicole Chau, Shereen Ezzat
    Endocrine Pathology.2024; 35(4): 293.     CrossRef
  • 3,614 View
  • 198 Download
  • 1 Web of Science
  • 1 Crossref
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Breast cancer
Androgen Receptor as a Predictive Marker for Pathologic Complete Response in Hormone Receptor–Positive and HER-2–Negative Breast Cancer with Neoadjuvant Chemotherapy
Eun-Gyeong Lee, Dong-Eun Lee, Hyun hee Kim, Jai Hong Han, Seeyoun Lee, Han-Sung Kang, Eun Sook Lee, Heejung Chae, Sung Hoon Sim, Keun Seok Lee, Youngmee Kwon, So-Youn Jung
Cancer Res Treat. 2023;55(2):542-550.   Published online September 8, 2022
DOI: https://doi.org/10.4143/crt.2022.834
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
This study investigated pathological complete response (pCR) according to androgen receptor (AR) in breast cancer patients undergoing neoadjuvant chemotherapy and estimated the relationship between AR expression and clinicopathological factors.
Materials and Methods
We identified 624 breast cancer patients who underwent surgery after neoadjuvant chemotherapy at the National Cancer Center in Goyang, Korea from April 2016 to October 2019. We retrospectively collected the clinicopathologic information and AR expression results and analyzed the data according to cancer stage, hormonal receptor (HR) status, human epidermal growth factor receptor 2 (HER2) status, tumor subtype, and pCR.
Results
Among the 624 breast cancer patients, 529 (84.8%) were AR-positive (AR+) patients and 95 (15.2%) were AR-negative (AR–) patients. AR+ patients showed more estrogen receptor (ER) positivity, progesterone receptor (PR) positivity, HER2-positivity, and HR-positive and HER2-negative (HR+/HER2–) subtype. The rate of pCR was 31.4% (196/624). AR– patients had a significantly higher rate of pCR than AR+ patients (AR– 43.2% vs. AR+ 29.3%, p=0.007). The tumor factors associated with pCR were early stage, histologic grade 3, ER-negative, PR-negative, AR-negative, HER2-positive, and high Ki-67 values. In univariable analysis, AR+ significantly decreased the state of pCR (odds ratio, 0.546; 95% confidence interval, 0.349 to 0.853; p=0.008). According to tumor subtype, AR– tumor showed higher pCR rate in HR+/HER2– subtype (AR– 28.6% vs. AR+ 7.3%, p=0.022).
Conclusion
AR expression is predominant in the HR+/HER2– subtype. AR– is significantly associated with the pCR rate in breast cancer patients, especially within HR+/HER2– subtype. When determining neoadjuvant chemotherapy for the HR+/HER2– subtype, AR expression can be considered as a pCR predictive marker.

Citations

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  • The prevalence and clinical significance of residual occult breast cancer after neoadjuvant chemotherapy: reassessing surgical pathology in cases initially described as pathological complete response
    Di Ai, Eliel N Arrey, Lauren M Postlewait, Yuan Gao, Xiaoxian Li
    Histopathology.2025;[Epub]     CrossRef
  • Neo-adjuvant therapies for ER positive/HER2 negative breast cancers: from chemotherapy to hormonal therapy, CDK inhibitors, and beyond
    Athina Stravodimou, Ioannis A. Voutsadakis
    Expert Review of Anticancer Therapy.2024; 24(3-4): 117.     CrossRef
  • Luminal androgen receptor subtype and tumor-infiltrating lymphocytes groups based on triple-negative breast cancer molecular subclassification
    Miseon Lee, Tae-Kyung Yoo, Byung Joo Chae, Ahwon Lee, Yoon Jin Cha, Jieun Lee, Sung Gwe Ahn, Jun Kang
    Scientific Reports.2024;[Epub]     CrossRef
  • Evaluating the Clinico-Pathological Relationship Between Stromal Tumor-Infiltrating Lymphocytes and Androgen Receptor Expression Across Molecular Subtypes of Invasive Breast Carcinoma
    Adil Aziz Khan, Sana Ahuja, Kiruthikasri G., Sufian Zaheer
    Indian Journal of Surgical Oncology.2024; 15(4): 802.     CrossRef
  • Biomarkers and translational research approaches in breast cancer—an update
    Angelika M. Starzer, Anna S. Berghoff, Rupert Bartsch
    memo - Magazine of European Medical Oncology.2023; 16(1): 42.     CrossRef
  • Evaluation of predictive and prognostic value of androgen receptor expression in breast cancer subtypes treated with neoadjuvant chemotherapy
    Zhendong Shi, Yingxue Liu, Shichao Zhang, Shuanglong Cai, Xu Liu, Jie Meng, Jin Zhang
    Discover Oncology.2023;[Epub]     CrossRef
  • 5,329 View
  • 176 Download
  • 6 Web of Science
  • 6 Crossref
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Comparing the Characteristics and Outcomes of Male and Female Breast Cancer Patients in Korea: Korea Central Cancer Registry
Eun-Gyeong Lee, So-Youn Jung, Myong Cheol Lim, Jiwon Lim, Han-Sung Kang, Seeyoun Lee, Jai Hong Han, Heein Jo, Young-Joo Won, Eun Sook Lee
Cancer Res Treat. 2020;52(3):739-746.   Published online February 13, 2020
DOI: https://doi.org/10.4143/crt.2019.639
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
This study aimed to determine the incidence of male breast cancer (MBC) and its survival outcomes in Korea, and to compare these results to those for female breast cancer (FBC).
Materials and Methods
We searched the Korea Central Cancer Registry and identified 227,122 breast cancer cases that were diagnosed between 1999 and 2016. Demographic and clinical characteristics and overall survival (OS) rates were estimated according to sex, age, histological type, and cancer stage.
Results
The 227,122 patients included 1,094 MBC cases and 226,028 FBC cases. Based on the age-standardized rate, the male: female ratio was 0.0055:1. The most common ages at diagnosis were 60-69 years for MBC and 40-49 years for FBC (p < 0.001). Male patients were less likely than female patients to receive adjuvant radiotherapy (7.5% vs. 21.8%, p < 0.001) or adjuvant chemotherapy (40.1% vs. 55.4%, p < 0.001). The 5-year OS rates after diagnosis were 88.8% for all patients, although it was significantly lower for MBC than for FBC (76.2% vs. 88.9%, p < 0.001). In both groups, older age (≥ 60 years) was associated with shorter survival. The 5-year OS rates for the invasive histological types were 75.8% for men and 89.0% for women. The 5-year OS rates in both groups decreased with increasing cancer stage.
Conclusion
MBC was diagnosed at older ages than FBC, and male patients were less likely to receive radiotherapy and chemotherapy. The survival outcomes were worse for MBC than for FBC, with even poorer outcomes related to older age, the inflammatory histological types, and advanced stage. It is important that clinicians recognize the differences between FBC and MBC when treating these patients.

Citations

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  • Therapeutic Management in Elderly Male Breast Cancer Patients: A Scoping Review
    Alessia Di Rito, Antonietta Grillo, Roberta Carbonara
    Current Oncology Reports.2025; 27(2): 120.     CrossRef
  • HER2 expression and pathway status in male breast cancer patients: results of an integrated analysis among 6,150 patients
    Boqiang Lyu, Shidi Zhao, Hui Wang, Shouping Gong, Biyuan Wang
    Scientific Reports.2025;[Epub]     CrossRef
  • Trends and Age-Period-Cohort Effect on Incidence of Male Breast Cancer from 1980 to 2019 in Taiwan and the USA
    Jhao-Yang Peng, Yu-Kwang Lee, Rong-Qi Pham, Xiao-Han Shen, I-Hui Chen, Yong-Chen Chen, Hung-Shu Fan
    Cancers.2024; 16(2): 444.     CrossRef
  • The features of male breast cancer in China: A real-world study
    Yuxuan Gao, Mengmeng Zhang, Gang Sun, Li Ma, Jianyun Nie, Zhongyu Yuan, Zhenzhen Liu, Yali Cao, Jianbin Li, Qiang Liu, Songqing Ye, Bo Chen, Yuhua Song, Kun Wang, Yu Ren, Guolin Ye, Ling Xu, Shu Liu, Qianjun Chen, Weiwen Li, Xinxin Chen, Peifen Fu, Wei We
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    Meiling Huang, Jingjing Xiao, Changjiao Yan, Rui Ling, Ting Wang
    American Journal of Men's Health.2024;[Epub]     CrossRef
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    Fumani Charles Makhandule, Mirza Mohamod Zahir Uddin Bhuiyan
    European Journal of Medical and Health Sciences.2024; 6(6): 1.     CrossRef
  • Impacts of Subtype on Clinical Feature and Outcome of Male Breast Cancer: Multicenter Study in Korea (KCSG BR16-09)
    Jieun Lee, Keun Seok Lee, Sung Hoon Sim, Heejung Chae, Joohyuk Sohn, Gun Min Kim, Kyung-Hee Lee, Su Hwan Kang, Kyung Hae Jung, Jae-ho Jeong, Jae Ho Byun, Su-Jin Koh, Kyoung Eun Lee, Seungtaek Lim, Hee Jun Kim, Hye Sung Won, Hyung Soon Park, Guk Jin Lee, S
    Cancer Research and Treatment.2023; 55(1): 123.     CrossRef
  • Risk of Lymphedema and Death after Lymph Node Dissection with Neoadjuvant and Adjuvant Treatments in Patients with Breast Cancer: An Eight-Year Nationwide Cohort Study
    Ye-Seul Lee, Yu-Cheol Lim, Jiyoon Yeo, Song-Yi Kim, Yoon Jae Lee, In-Hyuk Ha
    Healthcare.2023; 11(13): 1833.     CrossRef
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    Mi-ri Kwon, Yoosoo Chang, Inyoung Youn, Shin Ho Kook, Yoosun Cho, Boyoung Park, Seungho Ryu
    Breast Cancer Research and Treatment.2023; 202(2): 357.     CrossRef
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    Lei Xi, Jinxing Zhou, Yan Wu, Rong Rong
    Medicine.2023; 102(30): e34408.     CrossRef
  • Germline variants profiling of BRCA1 and BRCA2 in Chinese Hakka breast and ovarian cancer patients
    Yunuo Zhang, Heming Wu, Zhikang Yu, Liang Li, Jinhong Zhang, Xinhong Liang, Qingyan Huang
    BMC Cancer.2022;[Epub]     CrossRef
  • Poor prognosis of male triple-positive breast Cancer patients: a propensity score matched SEER analysis and molecular portraits
    Biyuan Wang, Hui Wang, Andi Zhao, Mi Zhang, Jin Yang
    BMC Cancer.2021;[Epub]     CrossRef
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    Ian S. Fentiman
    The Breast Journal.2021; 27(12): 877.     CrossRef
  • Clinicopathological features and prognosis of male breast cancer
    Xinli Wang, Shusong Liu, Yan Xue
    Journal of International Medical Research.2021;[Epub]     CrossRef
  • Prognostic Factors in Male Breast Cancer: A Retrospective Nationwide Study in South Korea by the Study of SMARTSHIP Group
    Sungmin Park, Ho Hur, Ji Sung Lee, JaeSun Yoon, Sung Mo Hur, Il Yong Chung, Jong Won Lee, Hyun Jo Youn, Se Jeong Oh, Cheol Wan Lim, Jihyoun Lee
    Journal of Breast Cancer.2021; 24(6): 561.     CrossRef
  • Male breast cancer: A closer look at patient and tumor characteristics and factors associated with survival
    Jing Zhao, Bin Wang, Jing Zhao, Yiran Mao, Jun Liu, Yanfang Yang
    Thoracic Cancer.2020; 11(11): 3107.     CrossRef
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  • 207 Download
  • 17 Web of Science
  • 16 Crossref
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Different Patterns of Risk Reducing Decisions in Affected or Unaffected BRCA Pathogenic Variant Carriers
Eun-Gyeong Lee, Hyok Jo Kang, Myong Cheol Lim, Boyoung Park, Soo Jin Park, So-Youn Jung, Seeyoun Lee, Han-Sung Kang, Sang-Yoon Park, Boram Park, Jungnam Joo, Jai Hong Han, Sun-Young Kong, Eun Sook Lee
Cancer Res Treat. 2019;51(1):280-288.   Published online May 4, 2018
DOI: https://doi.org/10.4143/crt.2018.079
AbstractAbstract PDFPubReaderePub
Purpose
The purpose of this study was to investigate decision patterns to reduce the risks of BRCArelated breast and gynecologic cancers in carriers of BRCA pathogenic variants. We found a change in risk-reducing (RR) management patterns after December 2012, when the National Health Insurance System (NHIS) of Korea began to pay for BRCA testing and riskreducing salpingo-oophorectomy (RRSO) in pathogenic-variant carriers.
Materials and Methods
The study group consisted of 992 patients, including 705 with breast cancer (BC), 23 with ovarian cancer (OC), 10 with both, and 254 relatives of high-risk patients who underwent BRCA testing at the National Cancer Center of Korea from January 2008 to December 2016.We analyzed patterns of and factors in RR management.
Results
Of the 992 patients, 220 (22.2%) were carriers of BRCA pathogenic variants. About 92.3% (203/220) had a family history of BC and/or OC,which significantly differed between BRCA1 and BRCA2 carriers (p < 0.001). All 41 male carriers chose surveillance. Of the 179 female carriers, 59 of the 83 carriers (71.1%) with BC and the 39 of 79 unaffected carriers (49.4%) underwent RR management. None of the carriers affected with OC underwent RR management. Of the management types, RRSO had the highest rate (42.5%) of patient choice. The rate of RR surgery was significantly higher after 2013 than before 2013 (46.3% [74/160] vs. 31.6% [6/19], p < 0.001).
Conclusion
RRSO was the preferred management for carriers of BRCA pathogenic variants. The most important factors in treatment choice were NHIS reimbursement and/or the severity of illness.

Citations

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  • Characteristics of second primary breast cancer after ovarian cancer: a Korea central cancer registry retrospective study
    Eun-Gyeong Lee, Jiwon Lim, Hyeong In Ha, Myong Cheol Lim, Yoon Jung Chang, Young-Joo Won, So-Youn Jung
    Frontiers in Oncology.2023;[Epub]     CrossRef
  • Differences in Willingness to Undergo BRCA1/2 Testing and Risk Reducing Surgery among the General Public, Cancer Patients, and Healthcare Professionals: A Large Population-Based Survey
    Yoon Jung Chang, Seungyeon Cho, Jungnam Joo, Kum Hei Ryu, Sangwon Lee, Juhee Cho, Myong Cheol Lim, So-Youn Jung, Jai Hong Han, Eun Sook Lee, Sun-Young Kong
    Journal of Personalized Medicine.2022; 12(5): 818.     CrossRef
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    M.L. Riis
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    Journal of Korean Medical Science.2021;[Epub]     CrossRef
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    Sung Mi Jung, Jai Min Ryu, Hyung Seok Park, Ji Soo Park, Eunyoung Kang, Seeyoun Lee, Han-Byoel Lee, Hyun Jo Youn, Tae-Kyung Yoo, Jisun Kim, Jeong Eon Lee, Sang Ah Han, Dongwon Kim, Sung-Won Kim
    Journal of Breast Cancer.2020; 23(6): 647.     CrossRef
  • 10,929 View
  • 230 Download
  • 15 Web of Science
  • 13 Crossref
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Effects of Postoperative Radiotherapy on Leptomeningeal Carcinomatosis or Dural Metastasis after Resection of Brain Metastases in Breast Cancer Patients
Boram Ha, Seung Yeun Chung, Yeon-Joo Kim, Ho-Shin Gwak, Jong Hee Chang, Sang Hyun Lee, In Hae Park, Keun Seok Lee, Seeyoun Lee, Tae Hyun Kim, Dae Yong Kim, Seok-Gu Kang, Chang-Ok Suh
Cancer Res Treat. 2017;49(3):748-758.   Published online October 31, 2016
DOI: https://doi.org/10.4143/crt.2016.303
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
In this retrospective study, we compared the incidence of leptomeningeal carcinomatosis or dural metastasis (LMCDM) in patients who received whole brain radiotherapy (WBRT), partial radiotherapy (PRT), or no radiotherapy (RT) following resection of brain metastases from breast cancer.
Materials and Methods
Fifty-one patients with breast cancer underwent surgical resection for newly diagnosed brain metastases in two institutions between March 2001 and March 2015. Among these, 34 received postoperative WBRT (n=24) or PRT (n=10) and 17 did not.
Results
With a median follow-up of 12.4 months (range, 2.3 to 83.6 months), 22/51 patients developed LMCDM at a median of 8.6 months (range, 4.8 to 51.2 months) after surgery. The 18-months LMCDM-free survival (LMCDM-FS) rates were 77.5%, 30.0%, and 13.6%, in the WBRT, PRT, and no RT groups, respectively (p=0.013). The presence of a tumor adjacent to cerebrospinal fluid flow and no systemic treatment after treatment for brain metastases were also associated with poor LMCDM-FS rate. Multivariate analysis showed that WBRT compared to PRT (p=0.009) and systemic treatment (p < 0.001) were independently associated with reduced incidence of LMCDM.
Conclusion
WBRT improved LMCDM-FS rate after resection of brain metastases compared to PRT in breast cancer patients.

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Identification of Prognostic Risk Factors for Transient and Persistent Lymphedema after Multimodal Treatment for Breast Cancer
Myungsoo Kim, Kyung Hwan Shin, So-Youn Jung, Seeyoun Lee, Han-Sung Kang, Eun Sook Lee, Seung Hyun Chung, Yeon-Joo Kim, Tae Hyun Kim, Kwan Ho Cho
Cancer Res Treat. 2016;48(4):1330-1337.   Published online February 3, 2016
DOI: https://doi.org/10.4143/crt.2015.463
AbstractAbstract PDFPubReaderePub
Purpose
The purpose of this study is to identify risk factors for transient lymphedema (TLE) and persistent lymphedema (PLE) following treatment for breast cancer. Materials and Methods A total of 1,073 patients who underwent curative breast surgery were analyzed. TLE was defined as one episode of arm swelling that had resolved spontaneously by the next followup; arm swelling that persisted over two consecutive examinations was considered PLE.
Results
At a median follow-up period of 5.1 years, 370 cases of lymphedema were reported, including 120 TLE (11.2%) and 250 PLE (23.3%). Initial grade 1 swelling was observed in 351 patients, of which 120 were limited to TLE (34%), while the other 231 progressed to PLE (66%). All initial swelling observed in TLE patients was classified as grade 1. In multivariate analysis, chemotherapy with taxane and supraclavicular radiation therapy (SCRT) were associated with development of TLE, whereas SCRT, stage III cancer and chemotherapy with taxane were identified as risk factors for PLE (p < 0.05). The estimated incidence of TLE among initial grade 1 patients was calculated using up to three treatment-related risk factors (number of dissected axillary lymph nodes, SCRT, and taxane chemotherapy). The approximate ratios of TLE and PLE based on the number of risk factors were 7:1 (no factor), 1:1 (one factor), 1:2 (two factors), and 1:3 (three factors). Conclusion One-third of initial swelling events were transient, whereas the other two-thirds of patients experienced PLE. Estimation of TLE and PLE based on known treatment factors could facilitate prediction of this life-long complication.

Citations

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Effect of Time Interval between Breast-Conserving Surgery and Radiation Therapy on Outcomes of Node-Positive Breast Cancer Patients Treated with Adjuvant Doxorubicin/Cyclophosphamide Followed by Taxane
Hyeon Kang Koh, Kyung Hwan Shin, Kyubo Kim, Eun Sook Lee, In Hae Park, Keun Seok Lee, Jungsil Ro, So-Youn Jung, Seeyoun Lee, Seok Won Kim, Han-Sung Kang, Eui Kyu Chie, Wonshik Han, Dong-Young Noh, Kyung-Hun Lee, Seock-Ah Im, Sung Whan Ha
Cancer Res Treat. 2016;48(2):483-490.   Published online June 5, 2015
DOI: https://doi.org/10.4143/crt.2015.111
AbstractAbstract PDFPubReaderePub
Purpose
This study evaluated the effect of surgery-radiotherapy interval (SRI) on outcomes in patients treated with adjuvant radiotherapy (RT) after breast-conserving surgery (BCS) and adjuvant four cycles of doxorubicin/cyclophosphamide (AC) followed by four cycles of taxane. Materials and Methods From 1999 to 2007, 397 eligible patients were diagnosed. The effect of SRI on outcomes was analyzed using a Cox proportional hazards model, and a maximal chi-square method was used to identify optimal cut-off value of SRI for each outcome.
Results
The median SRI was 6.7 months (range, 5.6 to 10.3 months). A SRI of 7 months was the significant cut-off value for distant metastasis-free survival (DMFS) and disease-free survival (DFS) using a maximal chi-square method. For overall survival, a significant cut-off value was not found. The patients with SRI > 7 months had worse 6-year DMFS and DFS than those with SRI ≤ 7 months on univariate analysis (DMFS, 81% vs. 91%, p=0.003; DFS, 78% vs. 89%, p=0.002). On multivariate analysis, SRI > 7 months did not affect DMFS and DFS. Conclusion RT delayed for more than 7 months after BCS and adjuvant four cycles of AC followed by four cycles of taxane did not compromise clinical outcomes.

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Breast Cancer–Related Lymphedema after Neoadjuvant Chemotherapy
Myungsoo Kim, In Hae Park, Keun Seok Lee, Jungsil Ro, So-Youn Jung, Seeyoun Lee, Han-Sung Kang, Eun Sook Lee, Tae Hyun Kim, Kwan Ho Cho, Kyung Hwan Shin
Cancer Res Treat. 2015;47(3):416-423.   Published online November 17, 2014
DOI: https://doi.org/10.4143/crt.2014.079
AbstractAbstract PDFPubReaderePub
Purpose
The risk for lymphedema (LE) after neoadjuvant chemotherapy (NCT) in breast cancer patients has not been fully understood thus far. This study is conducted to investigate the incidence and time course of LE after NCT. Materials and Methods A total of 313 patients with clinically node-positive breast cancer who underwent NCT followed by surgery with axillary lymph node (ALN) dissection from 2004 to 2009 were retrospectively analyzed. All patients received breast and supraclavicular radiation therapy (SCRT). The determination of LE was based on both objective and subjective methods, as part of a prospective database. Results At a median follow-up of 5.6 years, 132 patients had developed LE: 88 (28%) were grade 1; 42 (13%) were grade 2; and two (1%) were grade 3. The overall 5-year cumulative incidence of LE was 42%. LE first occurred within 6 months after surgery in 62%; 1 year in 77%; 2 years in 91%; and 3 years in 96%. In a multivariate analysis, age (hazard ratio [HR], 1.66; p < 0.01) and the number of dissected ALNs (HR, 1.68; p < 0.01) were independent risk factors for LE. Patients with both of these risk factors showed a significantly higher 5-year cumulative incidence of LE compared with patients with no or one risk factor (61% and 37%, respectively; p < 0.001). The addition of adjuvant chemotherapy did not significantly correlate with LE. Conclusion LE after NCT, surgery, and SCRT developed early after treatment, and with a high incidence rate. More frequent surveillance of arm swelling may be necessary in patients after NCT, especially during the first few years of follow-up.

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