Cancer Research and Treatment

Original Articles

Novel Breast Cancer Risk Assessment Tools for Pre- and Post-Menopausal Asian Women: Development and Validation in a Nationwide Mammographic Screening Cohort: Wonyoung Jung, Yong-Moon Mark Park, Sang Hyun Park, Kyungdo Han, Junhee Park, Yohwan Yeo, Jung Kwon Lee, Dale P. Sandler, Dong Wook Shin; Received September 4, 2024 Accepted January 30, 2025 Published online January 31, 2025; DOI: https://doi.org/10.4143/crt.2024.861 [Accepted]

Abstract PDF: Purpose
Widely used breast cancer risk-prediction tools are based on data from Western countries, but risk factors may differ for Asian women. Hence, we aimed to develop a risk assessment tool for breast cancer in Asian women using a nationwide, population-based mammographic screening cohort.
Materials and Methods
Women aged ≥40 years who underwent breast cancer screening and general health examination in 2009 were included. Age, body mass index (BMI), breast density, lifestyle and reproductive factors, and comorbidities were used to develop 5-year breast cancer risk-prediction models for premenopausal (n=771,856) and postmenopausal (n=1,108,047) women at baseline. The best-fit risk prediction model was constructed using backward stepwise selection in a Cox proportional hazards model and was transformed into a risk score nomogram. The performance was assessed by discrimination and calibration.
Results
In premenopausal women, high BMI, low parity, short breastfeeding period, early age at menarche, high breast density, a history of benign breast masses, and family history of breast cancer contributed to the risk prediction of breast cancer. In postmenopausal women, age, diabetes mellitus, dyslipidemia, late-onset menopause, and hormone replacement therapy use were additional risk predictors of breast cancer. Our risk-prediction model showed a concordant statistic of 0.58 (0.57–0.59) for premenopausal women and 0.64 (0.63–0.65) for postmenopausal women. The calibration plot demonstrated good correlations for both models.
Conclusion
Our breast cancer risk-prediction model demonstrated performance comparable to that of Western countries, especially among postmenopausal women. This provides a foundation for implementing risk-based screening recommendations in Asian women.

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Breast cancer

Short-term Impact of Hormone Replacement Therapy on Risk of Breast Cancer in BRCA Mutation Carriers: A Nationwide Study in South Korea: Hye Yeon Kim, Jisoo Park, Seok Joo Moon, Sohyeon Jeong, Jin Hwa Hong, Jae Kwan Lee, Geum Joon Cho, Hyun-Woong Cho; Cancer Res Treat. 2024;56(1):143-148. Published online August 16, 2023; DOI: https://doi.org/10.4143/crt.2023.653

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Purpose
BRCA1/2 mutations are well-known risk factors for breast and ovarian cancers in women. Risk-reducing salpingo-oophorectomy (RRSO) is the standard treatment for preventing ovarian cancer with BRCA mutations. Postmenopausal syndrome (symptoms after RRSO can be alleviated by hormone replacement therapy (HRT); however, the use of HRT in carriers of BRCA mutations has been controversial because of the concern that HRT increases the risk of breast cancer. This study aimed to evaluate the effects of HRT in BRCA mutation carriers who underwent RRSO.
Materials and Methods
A total of 151 carriers, who underwent RRSO between 2013 and 2020 after the diagnosis of BRCA1 or BRCA2 mutations were selected and followed up for a median of 3.03 years. Patients were divided into two groups: those who received HRT after RRSO (n=33) and those who did not (n=118). We compared the incidence of breast cancer over time between these two groups.
Results
There was no significant difference in the incidence of breast cancer between women who received HRT and those who did not (p=0.229). Multivariate logistic regression analysis, adjusted for age and parity revealed no significant difference in the risk of breast cancer between these two groups (hazard ratio, 0.312; 95% confidence interval, 0.039 to 2.480; p=0.278).
Conclusion
In this study, we found no relationship between post-RRSO HRT and breast cancer in the population with BRCA mutations. Therefore, healthcare providers may consider the alleviation of symptoms of postmenopausal syndrome through HRT in patients who underwent RRSO.

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A contemporary review of breast cancer risk factors and the role of artificial intelligence
Orietta Nicolis, Denisse De Los Angeles, Carla Taramasco
Frontiers in Oncology.2024;[Epub] CrossRef

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Real-World Clinical Data of Palbociclib in Asian Metastatic Breast Cancer Patients: Experiences from Eight Institutions: Jieun Lee, Hyung Soon Park, Hye Sung Won, Ji Hyun Yang, Hee Yeon Lee, In Sook Woo, Kabsoo Shin, Ji Hyung Hong, Young Joon Yang, Sang Hoon Chun, Jae Ho Byun; Cancer Res Treat. 2021;53(2):409-423. Published online October 28, 2020; DOI: https://doi.org/10.4143/crt.2020.451

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Purpose
Use of cyclin-dependent kinase 4/6 inhibitors improved survival outcome of hormone receptor (HR) positive metastatic breast cancer (MBC) patients, including Asian population. However, Asian real-world data of palbociclib is limited. We analyzed the real-world clinical practice patterns and outcome in HR-positive, MBC Asian patients treated with palbociclib.
Materials and Methods
Between April 2017 to November 2019, 169 HR-positive, human epidermal growth factor-2–negative MBC patients treated with letrozole or fulvestrant plus palbocilib were enrolled from eight institutions. Survival outcome (progression-free survival [PFS]), treatment response and toxicity profiles were analyzed.
Results
Median age of letrozole plus palbociclib (145 patients, 85.8%) and fulvestrant plus palbociclib (24 patients, 14.2%) was 58 and 53.5 years, with median follow-up duration of 14.63 months (range 0.2 to 33.9 months). Median PFS (mPFS) of letrozole plus palbociclib and fulvestrant plus palbociclib was 25.6 (95% confidence interval [CI], 19.1 to not reached) and 6.37 months (95% CI, 5.33 to not reached), comparable to previous phase 3 trials. In letrozole plus palbociclib arm, luminal A (hazard ratio, 2.86; 95% CI, 1.20 to 6.80; p=0.017) and patients with good performance (Eastern Cooperative Oncology Group 0-1 [hazard ratio, 3.68; 95% CI, 1.70 to 7.96]) showed better mPFS. In fulvestrant plus palbociclib group, chemotherapy naïve patients showed better mPFS (hazard ratio, 12.51, 95% CI, 1.59 to 99.17; p=0.017). The most common grade 3 or 4 adverse event was neutropenia (letrozole 86.3%, fulvestrant 88.3%).
Conclusion
To our knowledge, this is the first real-world data of palbociclib reported in Asia. Palbociclib showed comparable benefit to previous phase 3 trials in Asian patients during daily clinical practice.

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Hui-Chen Su, Ho-Wei Lin, Ka-Wai Tam
Targeted Oncology.2025; 20(1): 71. CrossRef
Palbociclib in Older Patients with Advanced/Metastatic Breast Cancer: A Systematic Review
Etienne Brain, Connie Chen, Sofia Simon, Vinay Pasupuleti, Kathleen Vieira Pfitzer, Karen A. Gelmon
Targeted Oncology.2024; 19(3): 303. CrossRef
Real-world progression-free survival and overall survival of palbociclib plus endocrine therapy (ET) in Japanese patients with hormone receptor-positive/human epidermal growth factor receptor 2-negative advanced breast cancer in the first-line or second-l
Tetsuhiro Yoshinami, Shigenori E. Nagai, Masaya Hattori, Takuho Okamura, Kenichi Watanabe, Takahiro Nakayama, Hiroko Masuda, Michiko Tsuneizumi, Daisuke Takabatake, Michiko Harao, Hiroshi Yoshino, Natsuko Mori, Hiroyuki Yasojima, Chiya Oshiro, Madoka Iwas
Breast Cancer.2024; 31(4): 621. CrossRef
The Effect of C-Reactive Protein/Lymphocyte Ratio (CLR) on PFS in Metastatic Breast Cancer Patients Treated with CDK4/6 Inhibitors: A Novel Biomarker
Mehmet Buyukbayram, Zekeriya Hannarici, Yakup Duzkopru, Aykut Turhan, Alperen Caglar, Pınar Coban Esdur, Mehmet Bilici, Salim Tekin, Doğan Yazılıtaş
Breast Cancer: Targets and Therapy.2024; Volume 16: 329. CrossRef
The treatment pattern of advanced HR-positive and HER2-negative breast cancer in central southern China: a hospital-based cross-sectional study
Zhe-Yu Hu, Binliang Liu, Ning Xie, Xiaohong Yang, Liping Liu, Huawu Xiao, Jing Li, Hui Wu, Jianxiang Gao, Jun Lu, Xuming Hu, Min Cao, Zhengrong Shui, Can Tian, Quchang Ouyang
BMC Cancer.2024;[Epub] CrossRef
Palbociclib in HR-Positive, HER2-Negative Advanced/Metastatic Breast Cancer: A Systematic Scoping Review of Real-World Evidence from Countries Outside of Western Regions that Are Underrepresented in Clinical Trials
Amit Rauthan, Ankita Jain, Manmohan Singh, Mehmet A. N. Sendur
Oncology and Therapy.2024; 12(3): 395. CrossRef
Real-world comparison of palbociclib, abemaciclib, and dalpiciclib as first-line treatments for Chinese HR+/HER2−metastatic breast cancer patients: a multicenter study (YOUNGBC-28)
Yifan Chen, Yizhao Xie, Die Sang, Ning Xie, Xinhua Han, Yanxia Zhao, Juanjuan Li, Jian Yue, Peng Yuan, Biyun Wang
Therapeutic Advances in Medical Oncology.2024;[Epub] CrossRef
Palbociclib plus endocrine therapy in hormone receptor-positive and HER2 negative metastatic breast cancer: a multicenter real-world study in the northwest of China
Jiao Yang, Bing Zhao, Xiaoling Ling, Donghui Li, Jiuda Zhao, Yonggang Lv, Guangxi Wang, Xinlan Liu, Nanlin Li, Jin Yang
BMC Cancer.2023;[Epub] CrossRef
A real-world study of the first use of palbociclib for the treatment of advanced breast cancer within the UK National Health Service as part of the novel Ibrance® Patient Program
Carlo Palmieri, Alison Musson, Catherine Harper-Wynne, Duncan Wheatley, Gianfilippo Bertelli, Iain R. Macpherson, Mark Nathan, Ellie McDowall, Ajay Bhojwani, Mark Verrill, Joe Eva, Colm Doody, Ruhe Chowdhury
British Journal of Cancer.2023; 129(5): 852. CrossRef
Real-world effectiveness of palbociclib plus fulvestrant in advanced breast cancer: Results from a population-based cohort study
Fábio Cardoso Borges, Filipa Alves da Costa, Adriana Ramos, Catarina Ramos, Catarina Bernardo, Cláudia Brito, Alexandra Mayer-da-Silva, Cláudia Furtado, Arlindo R. Ferreira, Diogo Martins-Branco, Ana Miranda, António Lourenço
The Breast.2022; 62: 135. CrossRef
The Impact of Real-World Alternative Dosing Strategies of Palbociclib on Progression-Free Survival in Patients with Metastatic Breast Cancer
Fulbert Fu, Jessica Kano, Julia Ma, Mera Guindy
Current Oncology.2022; 29(3): 1761. CrossRef
Treatment patterns, effectiveness, and patient‐reported outcomes of palbociclib therapy in Chinese patients with advanced breast cancer: A multicenter ambispective real‐world study
Lesang Shen, Jun Zhou, Yiding Chen, Jinhua Ding, Haiyan Wei, Jian Liu, Wenjie Xia, Bojian Xie, Xiaohong Xie, Xujun Li, Yuechu Dai, Guobing Zhang, Xia Qiu, Chao Li, Shanshan Sun, Wuzhen Chen, Dihe Gong, Hengyu Li, Jian Huang, Xia Jiang, Chao Ni
Cancer Medicine.2022; 11(22): 4157. CrossRef
Starting dose selection of palbociclib in Chinese patients with breast cancer based on population kinetic–pharmacodynamic model of neutropenia
Weizhe Jian, Junsheng Xue, Qingyu Yao, Rong Chen, Ye Yao, Mopei Wang, Tianyan Zhou
Cancer Chemotherapy and Pharmacology.2022; 90(6): 489. CrossRef
Early Application of Palbociclib Plus Endocrine Therapy in HR+/HER2− Metastatic Breast Cancer: A Better Choice Based on Data From the Chinese Population
Yusi Zhang, Wenlin Chen, Shuanglong Chen, Qingmo Yang, Zhong Ouyang
Technology in Cancer Research & Treatment.2022;[Epub] CrossRef
Real-world Treatment Patterns and Clinical Outcomes Associated With Palbociclib Combination Therapy: A Multinational, Pooled Analysis From the Ibrance Real World Insights Study
Katie Mycock, Kent A. Hanson, Gavin Taylor-Stokes, Gary Milligan, Christian Atkinson, Debanjali Mitra, Salena Preciado, Ernest H. Law
Clinical Therapeutics.2022; 44(12): 1588. CrossRef
Multicentric real world evidence with palbociclib in hormone positive HER2 negative metastatic breast cancer in Indian population
Chaturbhuj Agrawal, Pankaj Goyal, Amit Agarwal, Rupal Tripathi, Chandragouda Dodagoudar, Saphalta Baghmar, Archana Sharma, Ullas Batra, Vineet Talwar, Sumit Goyal, Rajeev Kumar, Dinesh Chandra Doval
Scientific Reports.2021;[Epub] CrossRef
Which Clinicopathologic Parameters Suggest Primary Resistance to Palbociclib in Combination With Letrozole as the First-Line Treatment for Hormone Receptor-Positive, HER2-Negative Advanced Breast Cancer?
Ji-Yeon Kim, Jung Min Oh, Yeon Hee Park, Jin Seok Ahn, Young-Hyuck Im
Frontiers in Oncology.2021;[Epub] 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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Incomplete ovarian function suppression in premenopausal breast cancer patients treated with gonadotropin-releasing hormone agonists
Jinna Lin, Shuqi Zheng, Qiang Liu
Cancer Treatment Reviews.2025; 133: 102879. CrossRef
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
Long-term effect of repeated deslorelin acetate treatment in bitches for reproduction control
Brändli SP, Palm J, Kowalewski MP, Reichler IM
Theriogenology.2021; 173: 73. CrossRef
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
Cancer Management and Research.2021; Volume 13: 6537. CrossRef
Oophorectomy as a Hormonal Ablation Therapy in Metastatic and Recurrent Breast Cancer: Current Indications and Results
Islam H. Metwally, Omar Hamdy, Saleh S. Elbalka, Mohamed Elbadrawy, Dina M. Elsaid
Indian Journal of Surgical Oncology.2019; 10(3): 542. CrossRef
Targeted Therapy for Premenopausal Women with HR+, HER2− Advanced Breast Cancer: Focus on Special Considerations and Latest Advances
Aditya Bardia, Sara Hurvitz
Clinical Cancer Research.2018; 24(21): 5206. CrossRef

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Survival Outcome of Combined GnRH Agonist and Tamoxifen Is Comparable to That of Sequential Adriamycin and Cyclophosphamide Chemotherapy Plus Tamoxifen in Premenopausal Patients with Lymph-Node–Negative, Hormone-Responsive, HER2-Negative, T1-T2 Breast Cancer: Guiyun Sohn, Sei Hyun Ahn, Hee Jeong Kim, Byung-Ho Son, Jong Won Lee, Beom Seok Ko, Yura Lee, Sae Byul Lee, Seunghee Baek; Cancer Res Treat. 2016;48(4):1351-1362. Published online April 6, 2016; DOI: https://doi.org/10.4143/crt.2015.444

Abstract PDF PubReader ePub

Purpose
The purpose of this study was to compare treatment outcomes between combined gonadotropin-releasing hormone agonist and tamoxifen (GnRHa+T) and sequential adriamycin and cyclophosphamide chemotherapy and tamoxifen (AC->T) in premenopausal patients with hormone-responsive, lymph-node–negative breast cancer.
Materials and Methods
In total, 994 premenopausal women with T1-T2, lymph-node–negative, hormone-receptor-positive, HER2-negative breast cancer between January 2003 and December 2008 were included in this retrospective cohort study. GnRHa+T and AC->T were administered to 608 patients (61.2%) and 386 patients (38.8%), respectively. Propensity score matching and inverse probability weighting were applied to the original cohort, and 260 patients for each treatment arm were included in the final analysis. Recurrence-free, cancer-specific, and overall survival was compared between the two treatment groups.
Results
A total of 994 patients were followed up for a median of 7.4 years (range, 0.5 to 11.4 years). The 5-year follow-up rate was 98.7%, and 13 patients were lost to follow-up. In propensity=matched cohorts (n=520), there was no difference in recurrence-free, cancer-specific, and overall survival rates between the two treatment groups (p=0.306, p=0.212, and p=0.102, respectively), and this was maintained after applying inverse probability weighting.
Conclusion
GnRHa+T is a reasonable alternative to AC-> T in patients with premenopausal, hormoneresponsive, HER2-negative, lymph-node–negative, T1-T2 breast cancer.

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Effectiveness of post-mastectomy adjuvant chemotherapy for the treatment of patients with prognostic stage IB breast cancer: A SEER-based study
HongMei Wang, Yi Peng, Jianbin Wu, ZhuangWei Chen, HuaLe Zhang
Asian Journal of Surgery.2023; 46(9): 3634. CrossRef
Risk of recurrence among patients with HR-positive, HER2-negative, early breast cancer receiving adjuvant endocrine therapy: A systematic review and meta-analysis
Elizabeth M. Salvo, Abril Oliva Ramirez, Jenilee Cueto, Ernest H. Law, Aaron Situ, Chris Cameron, Imtiaz A. Samjoo
The Breast.2021; 57: 5. CrossRef
Effectiveness of a 6-Month 22.5-mg Leuprolide Acetate Depot Formulation With Tamoxifen for Postoperative Premenopausal Estrogen Suppression in Hormone Receptor-Positive Breast Cancer
Zhen-Yu Wu, Young-jin Lee, Heejeong Kim, Jongwon Lee, Il Yong Chung, Jisun Kim, Saebyeol Lee, Byung-Ho Son, Sung-Bae Kim, Jae Ho Jeong, Gyungyub Gong, Sei-Hyun Ahn, BeomSeok Ko
Frontiers in Oncology.2021;[Epub] CrossRef
Changes in bone mineral density during 5 years of adjuvant treatment in premenopausal breast cancer patients
Minsung Kim, Hanna Kim, Sei Hyun Ahn, Vafa Tabatabaie, Sung Wook Choi, Guiyun Sohn, Sae Byul Lee, Beom Seok Ko, Il Yong Chung, Jisun Kim, Jong Won Lee, Byung Ho Son, Hee Jeong Kim
Breast Cancer Research and Treatment.2020; 180(3): 657. CrossRef
Change in Estradiol Levels among Premenopausal Patients with Breast Cancer Treated Using Leuprolide Acetate 11.25 Milligrams 3-Month Depot and Tamoxifen
Young-jin Lee, Zhen-Yu Wu, Hee jeong Kim, Jong Won Lee, Il Yong Chung, Jisun Kim, Sae Byul Lee, Byung Ho Son, Sung-Bae Kim, Jae Ho Jung, Gyungyub Gong, Sei-Hyun Ahn, BeomSeok Ko
Journal of Breast Cancer.2020; 23(5): 553. CrossRef
Survival outcome of combined GnRH agonist and tamoxifen is comparable to that of sequential adriamycin and cyclophosphamide chemotherapy plus tamoxifen in premenopausal patients with early breast cancer
Doonyapat Sa‑Nguanraksa, Thitikon Krisorakun, Wanee Pongthong, Pornchai O‑Charoenrat
Molecular and Clinical Oncology.2019;[Epub] CrossRef

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Ovarian Ablation Using Goserelin Improves Survival of Premenopausal Patients with Stage II/III Hormone Receptor-Positive Breast Cancer without Chemotherapy-Induced Amenorrhea: Juan Zhou, San-Gang Wu, Jun-Jie Wang, Jia-Yuan Sun, Feng-Yan Li, Qin Lin, Huan-Xin Lin, Zhen-Yu He; Cancer Res Treat. 2015;47(1):55-63. Published online August 21, 2014; DOI: https://doi.org/10.4143/crt.2013.165

Abstract PDF PubReader ePub

Purpose
The purpose of this study was to assess the value of ovarian ablation using goserelin in premenopausal patients with stage II/III hormone receptor-positive breast cancer without chemotherapy-induced amenorrhea (CIA). Materials and Methods We retrospectively reviewed the data of breast patients treated between October 1999 and November 2007 without CIA. The Kaplan-Meier method was used for calculation of the survival rate. Log rank method and Cox regression analysis were used for univariate and multivariate prognostic analysis. Results The median follow-up period was 61 months. Initially, 353 patients remained without CIA after chemotherapy and 98 among those who received goserelin and tamoxifen (TAM). In univariate analysis, goserelin improved locoregional recurrence-free survival (LRFS) (98.9% vs. 94.1%, p=0.041), distant metastasis-free survival (DMFS) (85.4% vs. 71.9%, p=0.006), disease-free survival (DFS) (85.4% vs. 71.6%, p=0.005), and overall survival (OS) (93.5% vs. 83.5%, p=0.010). In multivariate analysis, goserelin treatment was an independent factor influencing DMFS (hazard ratio [HR], 1.603; 95% confidence interval [CI], 1.228 to 2.092; p=0.001), DFS (HR, 1.606; 95% CI, 1.231 to 2.096; p=0.001), and OS (HR, 3.311; 95% CI, 1.416 to 7.742; p=0.006). In addition, treatment with goserelin resulted in significantly improved LRFS (p=0.039), DMFS (p=0.043), DFS (p=0.036), and OS (p=0.010) in patients aged < 40 years. In patients aged ≥ 40 years, goserelin only improved DMFS (p=0.028) and DFS (p=0.027). Conclusion Ovarian ablation with goserelin plus TAM resulted in significantly improved therapeutic efficacy in premenopausal patients with stage II/III hormone receptor-positive breast cancer without CIA.

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An updated systematic review about various effects of microplastics on cancer: A pharmacological and in-silico based analysis
Akmaral Baspakova, Afshin Zare, Roza Suleimenova, Aidar B. Berdygaliev, Bibigul Karimsakova, Kymbat Tussupkaliyeva, Nadiar M. Mussin, Kulyash R. Zhilisbayeva, Nader Tanideh, Amin Tamadon
Molecular Aspects of Medicine.2025; 101: 101336. CrossRef
Adjuvant ovarian function suppression and tamoxifen in premenopausal breast cancer patients: A meta-analysis
Hamdy A. Azim, Kyrillus S. Shohdy, David F. Kaldas, Loay Kassem, Hatem A. Azim
Current Problems in Cancer.2020; 44(6): 100592. CrossRef
Feasibility and efficacy of ultrasonographic and laparoscopic guidance for microwave ablation of clinically normal canine ovaries
Valentine D. Verpaalen, J. Brad Case, Michael J. Dark, S. Joel Cardenas-Goicoechea, Matt D. Winter, Sarah E. Boston, Fernando Garcia-Pereira, Alice S. Rhoton-Vlasak, Beau B. Toskich
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D. N. Kravchenko, A. A. Parokonnaya, M. I. Nechushkin, E. A. Nikitina, N. D. Hakurinova
Tumors of female reproductive system.2018; 14(3): 55. CrossRef
Evaluating the Survival Benefit Following Ovarian Function Suppression in Premenopausal Patients with Hormone Receptor Positive Early Breast Cancer
Lin Qiu, Fangmeng Fu, Meng Huang, Yuxiang Lin, Yazhen chen, Minyan Chen, Chuan Wang
Scientific Reports.2016;[Epub] CrossRef
Evaluation of a Survivorship Care Plan: Long-Term Use, Care Coordination and Quality of Life in Breast Cancer Survivors
Meagan E Brennan, Frances M Boyle, Phyllis N Butow, Andrew J Spillane
Breast Cancer Management.2015; 4(3): 145. CrossRef
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Pamela N. Munster
Journal of Clinical Oncology.2015; 33(22): 2413. CrossRef

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Effects of the Expression of Leptin and Leptin Receptor (OBR) on the Prognosis of Early-stage Breast Cancers: Yongnam Kim, Si-Young Kim, Jae Jin Lee, Jeongho Seo, Youn-Wha Kim, Suck Hwan Koh, Hwi-Joong Yoon, Kyung Sam Cho; Cancer Res Treat. 2006;38(3):126-132. Published online June 30, 2006; DOI: https://doi.org/10.4143/crt.2006.38.3.126

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Purpose

Obesity-related leptin and leptin receptor (OBR) have a relation to the development of cancer and metastasis and also the low survival rate for breast cancer patients. Leptin has been associated with increased aromatase activity and it displays functional cross-talk with estrogen. This study was designed to determine the relationship between the expression of leptin and OBR in breast cancer tissue and the prognosis of early-stage breast cancer patients, and especially for the tamoxifen-treated patients.

Materials and Methods

Ninety-five patients with early-stage breast cancer and who had undergone surgical treatment at Kyung Hee University Hospital between January 1994 and June 2004 were analyzed. The surgical specimens underwent immunohistochemical analysis for leptin and OBR. The patients' survival and clinical characteristics were obtained from the medical records.

Results

Of the 95 patients, 79 (83%) and 32 (33.7%) showed the expression of leptin and OBR in breast cancer tissue, respectively. The expression of leptin and OBR in breast cancer tissue was not significantly related to the clinicopathological characteristics, including obesity, the expression of hormonal receptor, the HER-2/neu expression, menopause, stage and the nuclear grade. The expression of leptin and OBR was not significantly related to the overall disease-free survival (DFS). For the tamoxifen-treated postmenopausal obese patients, the DFS of the leptin-positive group was higher than that of the leptin-negative group (p=0.017).

Conclusion

The expression of leptin and OBR in breast cancer tissue may be not a prognostic factor for disease-free survival of breast cancer patients. In the future, further studies are needed to determine whether leptin expression could be a predictive factor for tamoxifen therapy in the postmenopausal obese subgroup among the early breast cancer patients.

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Exploring the multifaceted role of obesity in breast cancer progression
Sooraj Kakkat, Prabhat Suman, Elba A. Turbat- Herrera, Seema Singh, Debanjan Chakroborty, Chandrani Sarkar
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Greater Body Fatness Is Associated With Higher Protein Expression of LEPR in Breast Tumor Tissues: A Cross-Sectional Analysis in the Women’s Circle of Health Study
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Yan Li, Chunyan Yu, Weimin Deng
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Immunohistochemical analysis of adipokine and adipokine receptor expression in the breast tumor microenvironment: associations of lower leptin receptor expression with estrogen receptor-negative status and triple-negative subtype
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Leptin signaling axis specifically associates with clinical prognosis and is multifunctional in regulating cancer progression
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Relation between Body Size and Body Mass Index and Breast Cancer by Menopausal Status in Korea: Se Hyun Ahn, Mi Kyung Kim, Suk Il Kim; J Korean Cancer Assoc. 1999;31(1):72-81.

Abstract PDF: PURPOSE
Because the breast cancer is one of the major causes of mortality among women, it is important to identify modifiable risk factors for this disease. Some reported that overweight/obesity is a risk factor for breast cancer, but the results are not consistent. Human breast cancer has different characteristics according to the status of menopause (premenopause and postmenopause). For the premenopaused women, the majority of the relevant prospective studies support an inverse relationship between body mass index and the development of breast cancer. In contrast, for the postmenopaused women, a positive relationship between body mass index and development of breast cancer has been reported in only half of prospective studies on this topic. This study was undertaken to determine the role of body size and body mass index by status of menopause in development of breast cancer in Korea using retrospective case-control study.
MATERIALS AND METHODS
The breast cancer cases (n=683) and controls (n=501) were recruited from January 1993 to April 1998 at the Asan Medical Center. The authors collected information on demographic, reproductive and anthropometric characteristics by interviews. Quetelets index was calculated using height and weight. Multiple logistic regression was done to estimate adjusted odds ratios (ORs) by menopausal status, controlling age, age at first full-tenn pregnancy, age at menarche, number of parity, family history of breast cancer.
RESULTS
Overall, there was a moderate, but significant association between obesity and breast cancer. Among premenopausal women, in comparison with women whose weights were less than 50 kg, the ORs for the upper quintile group of weight was 1.71 (95% confidence interval (CI), 1.01~2.89). The heaviest premenopausal women had a higher risk (OR=1.16, 95% CI, 1.05~1.29, P=0.005). The adjusted OR for the highest quintile of BMI relative to the lowest was 2.02 (95% CI, 1.18~3.45). Higher body mass index was significantly associated with increased risk of premenopausal breast cancer (OR=1.08, 95% CI, 1.02~1.15, P=0.006). Among postmenopausal women, higher body mass index and weight were associated with increased risk of breast cancer. In comparison with women whose weights were less than 50 kg, the OR for the upper quintile group of weight was 2.08 (95% CI, 1.064.08). The adjusted OR for the highest quintile of BMI relative to the lowest was 2.02 (95% CI, 1.02~4.01).
CONCLUSION
Our findings suggest that overweight/obesity may play an important role in the incidence of premenopausal and postmenopausal breast cancer in Korea.

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Comparison of Risk Factor in Breast Cancer Patients by Menopausal Status: Woo Suk Kim, Koo Jeong Kang, You Sah Kim; J Korean Cancer Assoc. 1996;28(5):829-835.

Abstract PDF: Some of the risk factors for breast cancer were compared by menopausal status on 427 patients with proven breast cancer. Statistical analysis was performed with t-test or Chi-Square test and five-year survival rate was obtained by Kaplan-Meier survival method. The results were as follows. 1) In premenopausal patients, the mean age was 40 years old and the peak incidence was in the 5th decades. In postmenopausal patients, the mean age was 55 and the peak incedence was in the 6th decades. 2) Breast feeding was used in 170 premenopausal patients (79.8%) and in 109 postmenopausal patients (94.9%) and the difference was statistically significant (p=0.0001). 3) The mean body weight of premenopausal patients was 59.5Kg and that op postmenopausal patients was 56.4 Kg and there was no statistically significant difference. 4) The mean ages at menarch were 15.7 and 16.4 years old for pre and postmenopausal patients respectively, and the difference was statistically significant. 5) In premenopausal patients the first full term delivery occurred most frequently between the ages of 24 and 29 years and in postmenopausal patients this occurred most frequently before the age of 23. There were 16 nulliparous women in premenopausal patients and l9 in postmenopausal patients. 6) Infiltrating ductal carcinoma was the most common histologic type in both pre and postmeaopausal patients. The histologic types were similar in both group of patients except mucinous carcinoma which was more common in premenopausal patients 7) The five-year survival rates of pre and postmenopausal patients were 86.7% and 81.0 %, respectively, and there was no statistically significant difference (p=0.315).

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