The significance of the single hormone receptor positive phenotype of breast cancer is still poorly understood. The use of hormone therapy has been found to be less effective for this type, which has a survival outcome midway between double positive and double negative phenotypes. The aim of this study was to investigate differences in patient and tumor characteristics and survival between double-receptor positive (ER+PR+), double receptor negative (ER-PR-) and single receptor positive (ER+PR- and ER-PR+) breast cancer in an Asian setting. A total of 1,992 patients with newly diagnosed stage I to IV breast cancer between 2003 and 2008, and where information on ER and PR were available, were included in this study. The majority of patients had ER+PR+ tumors (n=903: 45.3%), followed by 741 (37.2%) ER-PR-, 247 (12.4%) ER+PR-, and 101 (5.1%) ER-PR+ tumors. Using multivariate analysis, ER+PR- tumors were 2.4 times more likely to be grade 3 compared to ER+PR+ tumors. ER+PR- and ER-PR+ tumors were 82% and 86% respectively less likely to be grade 3 compared with ER-PR- tumors. ER-PR+ tumours were associated with younger age. There were no survival differences between patients with ER+PR+ and ER-PR+ tumors. However, ER+PR- tumors have poorer survival compared with ER+PR+ tumours. ER-PR- tumours had the worst survival. Adjuvant hormonal therapy with tamoxifen was found to have identical survival advantage in patients with ER+PR+ and ER-PR+ tumors whereas impact was slightly lower in patients with ER+PR- tumors. In conclusion, we found ER+PR- tumors to be more aggressive and have poorer survival when compared to ER+PR+ tumors, while patients with ER-PR+ tumours were younger, but had a similar survival to their counterparts with ER+PR+ tumours.
Bello, Marcelo Adeodato;de Menezes, Raquel Ferreira;de Sousa Silva, Brunna;da Silva, Rafael de Carvalho;Cavalcanti, Rousiane Silva;da Costa Moraes, Thayane de Fatima;Tonellotto, Fabiana;de Aguiar, Suzana Sales;Martucci, Renata Brum;Bergmann, Anke;Thuler, Luiz Claudio Santos
Asian Pacific Journal of Cancer Prevention
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v.17
no.10
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pp.4769-4774
/
2016
Objective: To analyze the survival of elderly patients with breast cancer according to the type of treatment used. Methods: A cohort study of women aged 80 or over with breast cancer registered with the Brazilian National Cancer Institute (Instituto Nacional do $C{\hat{a}}ncer$ - INCA) between 2008 and 2009 was conducted. Prognosis was analyzed according to the cancer treatment performed: surgery, radiotherapy, or hormone therapy. Analysis of the overall 5-year survival rate was performed using the Kaplan - Meier method, and comparisons of curves were undertaken using the log-rank test. For multiple regression analysis, Cox regression was used, adjusting for age and clinical stage, considering values of p < 0.05 as significant. Data were all analyzed using the statistical package SPSS version 20. Results: 70 women with a mean age of $84.0{\pm}3.7years$ at diagnosis participated in the study. The median follow-up time was 37.1 months (range 0.5-75.5), and 31 deaths (44.3%) occurred during this time. The median survival time was 51.2 months (95% CI, 44.9-57.4), higher in those who underwent surgery (p = 0.012) and those who had hormone therapy (p=0.001). Treatment with surgery reduced the risk of death by 61.7% (HR 0.3; 95% CI, 0.1-0.6; p = 0.001) when adjusted for clinical stage and age at diagnosis. However, there was no significant benefit from radiotherapy (HR 1.2; 95% CI, 0.5-2.5; p = 0.694). Conclusion: Treatment with surgery and hormone therapy increased the survival of our Brazilian patients with breast cancer aged 80 or over.
Background: The relationship between postmenopausal hormone therapy (HT) and invasive breast cancer has been extensively investigated, but that with breast carcinoma in situ (BCIS) has received relatively little attention. The aim of our present study was to review and summarize the evidence provided by longitudinal studies on the association between postmenopausal HT use and BCIS risk. Methods: A comprehensive literature search for articles published up to May 2012 was performed. Prior to performing a meta-analysis, the studies were evaluated for publication bias and heterogeneity. Relative risk (RR) or odds ratio (OR) values were calculated using 14 reports (8 case-control studies and 6 cohort studies), published between 1986 and 2012. Results: There was evidence of an association between ever postmenopausal estrogen use and BCIS based on a random-effects model (RR = 1.25, 95% confidence interval (CI) = 1.01, 1.55). However, we found no strong evidence of an association between ever postmenopausal estrogen combined with progesterone use and BCIS using a randomeffects model (RR = 1.55, 95% CI = 0.95, 2.51). Furthermore, our analysis showed a strong association between "> 5 years duration" of estrogen or estrogen combined with progesterone use and BCIS. Furthermore, current use of any HT is associated with increased risk of BCIS in cohort studies. Additional well-designed large studies are now required to validate this association in different populations.
The purpose of this study is to find the difference of the climacteric symptoms and quality of life according to hormone replacement therapy (HRT) in climacteric women. The research design was a descriptive survey with questionaries. A convenience sample of 181 climacteric women aged 45-65 who had climacteric symptoms were selected in Kwangju city, Korea. Sixty-six climacteric women among those subjects were receiving HRT at K university hospital in Kwangju city. Data were collected by the interview with questionaries from Feb 3. 1999 to March 25, 1999. Climacteric symptoms were measured using scores developed by Neugarten(1965) and modified by Park(1989), and the quality of life scale related to climacteric symptoms developed by Hildtich(1996) and modified Kim(1998). Data were analyzed by $x^2$-test, t-test, ANOVA and Pearson's correlation procedures, using SAS/win PC+. The results were as follows ; 1. No statistically significant differences were found between the receiving HRT group and not receiving HRT group in demographic, obstetrical and health related characteristics. 2. There were no significant difference on the climacteric symptoms between the group of women receiving HRT (score 2.4) and the group of women who were not (score 2.6) except psychological area (t= 2.407, p= 0.017). 3. The quality of life of the group of women receiving HRT was significantly higher than that the group of women who were not (t=2.151, p=.032). 4. The quality of life of the group of women receiving HRT were high scores There were significantly high of the quality of life in the vaso-motor change area (t=2.634, p= 0.009), psycho-social change area (t=3.239, p=0.001), and physical change area (t=2.031, p=0,043) in the group of receiving HRT compared to not receiving HRT group. 5. The variables showed significantly differences on the degree of climacteric symptoms of the group of women not receiving HRT were the subjective health state (t=15.81, p=0.000), age (t=7.50, p=0.007), feeling of menopause (t=30.88, p=0,000) and climacteric periods (t=8.66, p=0.003), and receiving HRT were number of para (t=3.95, p=0.050) and feeling of menopause (t=3.94, p=0.050). 6. The variables showed significantly difference on the quality of life of the group of women not receiving HRT were the subjective health state (t=4.14, p=0.044) and feeling of menopause (t=10.86, p=0.001). 7. There were significantly positive correlations between the climacteric symptoms and the quality of life in climacteric women (r=0.512, p=0.000).
Background: Breast cancer is by far the most frequent cancer of women (23 % of all cancers), ranking second overall when both sexes are considered together. Contralateral breast cancer (CBC) is becoming an important public health issue because of the increased incidence of primary breast cancer and improved survival. The present communication concerns a study to evaluate the role of various clinico-pathological factors on the occurrence of contralateral breast cancer. Materials and Methods: A detailed analysis was carried out with respect to age, menopausal status, family history, disease stage, surgery performed, histopathology, hormone receptor status, and use of chemotherapy or hormonal therapy. The diagnosis of CBC was confirmed on histopathology report. Relative risk with 95%CI was calculated for different risk factors of contralateral breast cancer development. Results: CBC was found in 24 (4.5%) out of 532 patients. Mean age of presentation was 43.2 years. Family history of breast cancer was found in 37.5% of the patients. There was statistically significant higher rate (83.3%) of CBC in patients in age group of 20-40 years with RR=11.3 (95% CI: 1.4, 89.4, p=0.006) seen in 20-30 years and RR=10.8 (95% CI:1.5-79.6, p=0.002) in 30-40 years as compared to older age of 60-70 years. Risk of development was higher in premenopausal women (RR=8.6, 95% CI: 3.5-21.3, $p{\leq}0.001$). Women with family history of breast cancer had highest rate (20.9%) of CBC (RR=5.4, 95% CI: 2.5-11.6, $p{\leq}0.001$). Use of hormonal therapy in hormone receptor positive patients was protective factor in occurrence of CBC but not significant (RR=0.7, 95% CI: 0.3-1.5, p=0.333). Conclusions: Younger age, premenopausal status, and presence of family history were found to be significant risk factors for the development of CBC. Use of hormonal therapy in hormone receptor positive patients might be protective against occurrence of CBC but did not reach significance.
Allison C. Hu;Mengyuan T. Liu;Candace H. Chan;Saloni Gupta;Brian N. Dang;Gladys Y. Ng;Mark S. Litwin;George H. Rudkin;Amy K. Weimer;Justine C. Lee
Archives of Plastic Surgery
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v.50
no.1
/
pp.63-69
/
2023
Background An increasing number of nonbinary patients are receiving gender-affirming procedures due to improved access to care. However, the preferred treatments for nonbinary patients are underdescribed. The purpose of this study was to investigate the goals and treatments of nonbinary patients. Methods A retrospective study of patients who self-identified as nonbinary from our institutional Gender Health Program was conducted. Patient demographics, clinical characteristics, surgical goals, and operative variables were analyzed. Results Of the 375 patients with gender dysphoria, 67 (18%) were nonbinary. Over half of the nonbinary patients were assigned male at birth (n = 57, 85%) and nearly half preferred the gender pronoun they/them/theirs (n = 33, 49%). A total of 44 patients (66%) received hormone therapy for an average of 2.5±3.6 years, primarily estrogen (n = 39). Most patients (n = 46, 69%) received or are interested in gender-affirming surgery, of which, almost half were previously on hormone therapy (n = 32, 48%). The most common surgeries completed or desired were facial feminization surgery (n = 15, 22%), vaginoplasty (n = 15, 22%), mastectomy (n = 11, 16%), and orchiectomy (n = 9, 13%). Nonbinary patients who were assigned male at birth (NB-AMAB) were more often treated with hormones compared to nonbinary patients assigned female at birth (NB-AFAB) (72% vs. 30%, p = 0.010). Conversely, patients who were AFAB weremore likely to complete or desire surgical intervention than those who were AMAB (100% vs. 63.0%, p < 0.021). Conclusion Majority of nonbinary patients were assigned male at birth. NB-AFAB patients all underwent surgical treatment, whereas NB-AMAB patients were predominantly treated with hormone therapy.
Purpose: This study was performed to identify climacteric symptoms corresponding to the use of complementary and alternative therapy(CAT) in middle aged women. Method: The subjects of the study were 603women(40-64years) and were chosen by convenient sampling from 1 April to 31 July 2004. The collected data was analyzed using descriptive statics, chi-square, t-test analysis by SPSS/WIN program. Results: 1. It was shown that 63.8% of subjects have utilized one or more types of CAT. 2. It was shown that the most frequently used types are health supplement(40.5%), gold acupuncture(31.2%), acupress(24.7%), hand acupuncture(21.8%) 3. There was significant difference in the using experience CAT by religion(p=.029), job(p=.018), hormone replacement(p=.016), exercise(p=.007), health state(p=.013). 4. There was significant difference in climacteric symptoms(p=.000) corresponding to the using experience of CAT. 5. There was significant difference in climacteric symptoms(p=.028) corresponding to the using experience hand therapy of CAT. Conclusion: We found that middle aged women used CAT more than others populations. Future research examining the determinants of CAT use, incorporating attitudinal and health conditions, as well as clinical efficacy, effectiveness, and health outcome studies of specific CAT therapies are warranted.
Recently we observed and treated a 49-year-old postmenopausal female with enlarged uterine myoma who taking through the hormone replacement therapy(H.R.T). We regard the cause of this case as insufficiency of kidney-yin(腎陰虛), stagnation or the phlegm and pathologic blood(痰瘀阻滯) and H.R.T. ln general cases, myomas grow in size if estrogen and progesterone is present and do not increase in size if estrogen and progesterone levels are low. So if a woman can get to menopause without having symptoms from the myomas, then it is likely that she will never have problems from the growths that require treatment. But Taking postmenopausal estrogen and progestin replacement therapy can cause myomas to grow. So we recommended her to stop the H.R.T. gave herbal-medicine and acupuncture therapy. Thus we could get a good result as follows. The uterine myomas were significantly declined but no change on it's characters. Hot flush and general conditions were also significantly improved And body weight was lessened for about 4.7kg. But vaginal dryness was appeared, So we planed another therapy for that symptom.
A literature study on cancer therapy of warm-hot oriental medicine was done, and the results were as follows. 1. In oriental medicine, oncogens are six exopathogens, seven modes of emotion, overwork, pathogenic factors, and especially related with pathologic cold situation. 2. There are many capillaries in tuomr, and because temperature of inner space of tumor is higher than normal organization. Tumor cell has a character which is weak for high temperature. 3. Warm-hot herb drugs have effects of dissipating mass, warming kidney to reinforce yang and dispering, so it has a function of suppressing tumor as well as improving immunity in cancer therapy. 4. In traditional medical books, main prescriptions of cancer therapy are xinzhiyinyanggongjiwan(新製陰陽攻積丸), qianjinxiaoshiwan(千金硝石丸), feiqiwan(肥氣丸), xibenwan(息賁丸), fuliangwan(伏梁丸), beiqiwan, bentunwan(賁豚丸), zengsunwujiwan(增損五積丸), and these are composed of warm-hot herb drugs. 5. In current, the study of warm-hot drugs is progressed in immunological capacity, anti-tumor activity, stimulating bone marrow and regulating hormone secretion. It will be expected that advanced study of these must be accomplished in cancer patients.
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