• Title/Summary/Keyword: advanced breast disease

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Locally Advanced Breast Cancer in Jamaica: Prevalence, Disease Characteristics and Response to Preoperative Therapy

  • Chin, Sheray Nicole;Green, Cheryl May Antoinette;Gordon-Strachan, Georgiana Marie;Wharfe, Gilian Helen Frances
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.7
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    • pp.3323-3326
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    • 2014
  • Breast cancer is the most common cancer in Jamaican women. Locally advanced breast cancer (LABC) is associated with aggressive biology and poor prognosis, and has a predilection for African-American women. In this retrospective review, we assessed the prevalence of LABC as a breast cancer presentation in a population of mainly Afro-centric ethnicity, and determined disease characteristics and response to pre-operative chemotherapy. LABC was prevalent (20%), and had a low pathological response rate to pre-operative chemotherapy, with a high risk of disease recurrence. Increased utilization of breast cancer screening may help detect cancer at less advanced stages, and optimizing pre-operative chemotherapy is recommended to improve response rates and ultimately survival.

Trends of Breast Cancer and its Management in the Last Twenty Years in Aden and Adjacent Governorates, Yemen

  • Harhra, Nasser Aa;Basaleem, Huda O.
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.9
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    • pp.4347-4351
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    • 2012
  • Background: Breast cancer is the most common cancer of women and the principal cause of death in middle aged women. The objective of this study was to describe the trend of breast cancer and its management in Aden and adjacent south-eastern governorates of Yemen during the last 20 years. Patients and Methods: This is a retrospective analysis of previous studies on patients with breast cancer in Aden and adjacent south-eastern governorates, Yemen (January 1989 through December 2007). The studied variables were: sex, age, time and type of presentation, disease stage, pathological types and the performed surgical treatment. The sources of information were the treatment registry of Aden health office, archives of Al-Gamhouria teaching hospital; major referral and other public and private hospitals in Aden and Aden Cancer Registry. Results: The total number of patients was 476, 99% being females. The age range was 19-88 years. The most affected age was 30-50 years (60.5%), 95% presenting after one month of having breast symptoms. Forty-five percent presented with signs of advanced local disease, while 59.2% had palpable axillary lymph nodes on presentation. Early breast cancer (stages I-II) occurred in 47%, and late breast cancer (stages III-IV) in 51.5%. Invasive ductal carcinoma was the commonest pathology (89.3%). The main surgical treatment was mastectomy (modified radical mastectomy (50%). Conclusion: Breast cancer is predominantly a disease of young with late presentation and advanced disease. Improving health awareness and earlier diagnosis of the disease by health education, encouraging breast self-examination, and providing the mammography equipment and mammary clinics in hospitals are recommended. Establishment of oncology and radiotherapy centers in Aden is a necessity.

Fulvestrant 250mg versus Anastrozole 1 mg in the Treatment of Advanced Breast Cancer: a Meta-Analysis of Randomized Controlled Trials

  • Gong, Dan-Dan;Man, Chang-Feng;Xu, Juan;Fan, Yu
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.5
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    • pp.2095-2100
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    • 2014
  • Objective: Most patients with advanced breast cancer experience resistance to endocrine treatment and eventual disease progression. This meta-analysis was designed to compare the efficacy and tolerability of fulvestrant 250mg with anastrozole 1mg in postmenopausal women with advanced breast cancer. Methods: Electronic literature databases (Cochrane Library, Medline, and Embase) were searched for randomized controlled trials (RCTs) published prior to August 2013. Only RCTs that compared fulvestrant 250mg to anastrozole 1mg in postmenopausal women with advanced breast cancer were selected. The main outcomes were time to treatment failure (TTF), time to progression (TTP), duration of response (DOR), clinical benefit rate, and tolerability. Results: Four RCTs covering 1,226 patients (fulvestrant, n=621; anastrozole, n=605) were included in the meta-analysis. Fulvestrant increased the DOR compared to anastrozole (HR =1.31, 95% confidence interval [CI] 1.13-1.51). There was no statistically significant difference between fulvestrant and anastrozole in terms of TTF (HR=1.02, 95%CI 0.89-1.17), complete response (RR=1.79, 95%CI, 0.93-3.43), and partial response (RR=0.91, 95%CI 0.69-1.21). As for safety, there was no statistical significance between the two groups for common adverse events. Conclusion: Fulvestrant 250mg is as effective and well-tolerated as anastrozole 1mg treatment for advanced breast cancer in postmenopausal women whose disease progressed after prior endocrine treatment. Thus, fulvestrant may serve as a reasonable alternative to anastrozole when resistance is experienced in breast cancer cases.

Immediate Breast and Chest Wall Reconstruction for Advanced Breast Cancer (진행성 유방암에서 즉시 유방 및 흉벽 재건술)

  • Yang, Jung-Dug;Kim, Hak-Tae;Chung, Ho-Yun;Cho, Byung-Chae;Choi, Kang-Young;Lee, Jung-Hun;Lee, Jeong-Woo;Park, Ho-Yong;Jung, Jin-Hyang;Chae, Yee-Soo
    • Archives of Plastic Surgery
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    • v.38 no.5
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    • pp.627-635
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    • 2011
  • Purpose: Advanced breast cancer traditionally has been perceived as a contraindication to immediate breast reconstruction, because of concerns regarding adjuvant treatment delays and the cosmetic effects of radiotherapy to breast reconstruction, so delayed reconstruction is usually preferred in advanced breast cancer patients undergoing mastectomy. However, with the improved outcome using multimodality therapy, consisting of perioperative chemotherapy and radiotherapy, immediate breast reconstruction is now being performed as surgical option for selected advanced breast cancer patients. Additionally, advanced breast cancer patients may be needed soft tissue coverage of an extensive skin and soft tussue defect after mastectomy. Current authors have experienced several types of immediate breast and chest wall reconstruction for advanced breast cancer. Methods: From December of 2007 to June of 2009, 14 women performed for immediate breast and chest wall reconstruction for advanced breast cancer. They had been treated with neoadjuvant chemotherapy or chemoradiotherapy followed by modified radical mastectomy or radical mastectomy. Four different techniques were used immediate breast and chest wall reconstruction, which are pedicled TRAM flap (4 cases), extended LD flap with STSG (3 cases), thoracoabdominal flap (4 cases) and thoracoepigastric flap (3 cases). Results: The mean age was 53 years and mean follow up period was 9 months. Patients' oncologic status ranged stage IIIa to stage IV. Two patients had major complications: partial flap necrosis of TRAM flap and one distal necrosis of thoracoabdominal flap. Three patients with stage IV disease died from metastases. Conclusion: The result of this study suggests that immediate breast and chest wall reconstruction can be considered as surgical option for advanced breast cancer. But we need long term follow up and large prospective studies for recurrence and survival.

Analysis of Feature Variables for Breast Cancer Diagnosis

  • Jung, Yong Gyu;Kim, Jang Il;Sihn, Sung Chul;Heo, Jun
    • International journal of advanced smart convergence
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    • v.2 no.2
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    • pp.36-39
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    • 2013
  • It is becoming more important as the growing of health information and increasing in cancer patients diagnose over the time gradually. Among the various types of cancer, we focuses on breast cancer diagnosis. The accuracy of breast cancer diagnosis is increasing when the diagnosis is based on evidence and statistics. To do this we use the weka data mining tools and analysis algorithms significantly associated with the decision tree uses rules. In addition, the data pre-processing and cross-validation are used to increase the reliability of the results. The number and cause of the disease becomes important to increase evidence-based medical doctors. As the evidence-based medical, the data obtained from patients in the past through the disease by calculating the probability for future patients to diagnose and predict disease and treatment plan. It can be found by improving the survival rate plays an important role.

A Hybrid Mod K-Means Clustering with Mod SVM Algorithm to Enhance the Cancer Prediction

  • Kumar, Rethina;Ganapathy, Gopinath;Kang, Jeong-Jin
    • International Journal of Internet, Broadcasting and Communication
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    • v.13 no.2
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    • pp.231-243
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    • 2021
  • In Recent years the way we analyze the breast cancer has changed dramatically. Breast cancer is the most common and complex disease diagnosed among women. There are several subtypes of breast cancer and many options are there for the treatment. The most important is to educate the patients. As the research continues to expand, the understanding of the disease and its current treatments types, the researchers are constantly being updated with new researching techniques. Breast cancer survival rates have been increased with the use of new advanced treatments, largely due to the factors such as earlier detection, a new personalized approach to treatment and a better understanding of the disease. Many machine learning classification models have been adopted and modified to diagnose the breast cancer disease. In order to enhance the performance of classification model, our research proposes a model using A Hybrid Modified K-Means Clustering with Modified SVM (Support Vector Machine) Machine learning algorithm to create a new method which can highly improve the performance and prediction. The proposed Machine Learning model is to improve the performance of machine learning classifier. The Proposed Model rectifies the irregularity in the dataset and they can create a new high quality dataset with high accuracy performance and prediction. The recognized datasets Wisconsin Diagnostic Breast Cancer (WDBC) Dataset have been used to perform our research. Using the Wisconsin Diagnostic Breast Cancer (WDBC) Dataset, We have created our Model that can help to diagnose the patients and predict the probability of the breast cancer. A few machine learning classifiers will be explored in this research and compared with our Proposed Model "A Hybrid Modified K-Means with Modified SVM Machine Learning Algorithm to Enhance the Cancer Prediction" to implement and evaluated. Our research results show that our Proposed Model has a significant performance compared to other previous research and with high accuracy level of 99% which will enhance the Cancer Prediction.

Clinicopathologic Profile of Breast Cancer Patients in Pakistan: Ten Years Data of a Local Cancer Hospital

  • Khokher, Samina;Qureshi, Muhammad Usman;Riaz, Masooma;Akhtar, Naseem;Saleem, Afaf
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.2
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    • pp.693-698
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    • 2012
  • Breast cancer is the most frequent cancer of women worldwide, with considerable geographic and racial/ethnic variation. Data are generally derived from population based cancer registries in the developed countries but hospital data are the most reliable source in the developing countries. Ten years data from 1st Jan 2000 to 31st Dec 2009 of a cancer hospital in Pakistan were here analyzed by descriptive statistics to evaluate the clinicopathologic profile of local breast cancer patients. Among 28,740 cancer patients, 6,718 were registered as breast cancer. The female to male ratio was 100:2. Breast cancer accounted for 23% of all and 41% of female cancers. Some 46% were residents of Lahore, with a mean age of $47{\pm}12$ years. Less than 1% were at Stage 0 and 10%, 32%, 35% and 23% were at Stage I, II, III and IV respectively. Histopathology was unknown in 4% while 91%, 2% and 1% had invasive ductal carcinoma (IDC), invasive lobular carcinoma (ILC) and mucinous carcinoma respectively. Rare carcinomas accounted for the rest. Tumor grade 1, 2 and 3 was 11%, 55% and 34% among the known. Profile of breast cancer patients in Pakistan follows a pattern similar to that of other developing countries with earlier peak age and advanced disease stage at presentation. The male breast cancer accounts for higher proportion in the local population. Local women have higher frequency of IDC and lower frequency of ILC and DCIS, owing probably to a different risk profile. Use of hospital information systems and establishment of population based cancer registry is required to have accurate and detailed local data. Promotion of breast health awareness and better health care system is required to decrease the burden of advanced disease.

Determinants of Advanced Stage at Initial Diagnosis of Breast Cancer in Pakistan: Adverse Tumor Biology vs Delay in Diagnosis

  • Khokher, Samina;Qureshi, Muhammad Usman;Mahmood, Saqib;Sadiq, Sadia
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.2
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    • pp.759-765
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    • 2016
  • Background: Breast cancer is the most frequent cancer of women in Pakistan with the majority presenting with stage III or IV lesionsat initial diagnosis. Patient and health system related factors are well known determinants of delay in presentation and diagnosis. Additionally, breast cancer being a heterogeneous disease, the various molecular subtypes featuring different aggressiveness also need to be considered. The present study evaluated the association of stage at initial diagnosis of breast cancer with these two factors in local women at a tertiary level health care facility in Lahore, Pakistan. Materials and Methods: Patient and tumor features were recorded separately during diagnostic workup in Breast Clinics at INMOL and at Services Hospital, Lahore. Data were entered in MS Excel and analyzed by descriptive statistics and Chi-Square test. Results: Among the 261 patients, 64% were staged as late breast cancer (LBC), the mean age was 46.8 with standard deviation of 13 years. Some 92% had invasive ductal carcinoma (IDC), 61% had luminal types (LT) of non-aggressive tumor while 39% had the non-luminal types (NLT) of of HER2-enriched or basal aggressive tumors. While 70% of patients presented within one year of symptomatic disease (early report group "ERG"), 30% reported after a mean delay of 4 years with a standard deviation of 3.75 years. The stage distribution among ERG patients was not statistically different from those reporting late (P=0.123). Statistically larger proportion of patients with NLT presented as LBC as compared to the LT (P =0.034). Among the ERG, statistically different stage distribution of disease was observed for the NLT versus LT (P=0.047). Among those presenting late, this difference was insignificant (P=0.416). Conclusions: Breast cancer is a distinct disease in Pakistan with a high frequency of aggressive molecular types affecting younger women, with the majority presenting as LBC. Association of NLT with higher stage at diagnosis is statistically significant whereas time delay in diagnosis is not. Further research is required to define the risk profile and features in local patients. The burden of LBC can be reduced by promoting breast health awareness and by establishing easily accessible dedicated breast care set ups in the hospitals.

The investigation of an age as a prognostic factor of breast cancer (유방암의 예후인자로서 젊은 연령에 대한 고찰)

  • No, Dong-Yeong
    • Journal of Korea Association of Health Promotion
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    • v.2 no.1
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    • pp.39-46
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    • 2004
  • Purpose:It has been known that the prognosis of a young woman's breast cancer is Poorer than the other woman However, the effect of age on the prognosis is not well-defined We performed this study to investigate age as a prognostic factor of breast cancer. Materials and Methods : A retrospective study was conducted for 3209 breast cancer patients who underwent operations in Department of Surgery, Seoul National University Hospital from January 1981 to December 2000. Patients were divided into two groups, young age(≤35) and old age(>35) groups. And tumor stage, histopathologic characteristics(such as histology, nuclear grade, histologic grade, hormonal receptor, etc), overall survival and disease free survival rates were compared between age groups. Results . The age ranged from 17 to 88 years. 396 patients(12.3%) were included in young age group(median=32) and 2813 Patients(87.7%) in old age group(median=47).There are more advanced stages and poor nuclear grades in young age group(p=0.000, p=0.003), By log-rank test, the young age group had poorer overall survival and disease free survival rates(p<0.05, p=0.0002). Although, the young age group had more advanced TMN stages(p=0.000) and poorer nuclear grade than the old age group(p=0.003) in multi variate analysis, the age was not a significant independent prognostic factor. (P=0.642)Conclusion: Our study showed that the age was not a significant independent prognostic factor.

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Characteristics of Invasive Breast Ductal Carcinoma, NOS, Diagnosed in a Tertiary Institution in the East Coast of Malaysia with a Focus on Tumor Angiogenesis

  • Ch'ng, Ewe Seng;Sharif, Sharifah Emilia Tuan;Jaafar, Hasnan
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.9
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    • pp.4445-4452
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    • 2012
  • Background: Prognosis of breast cancer depends on classic pathological factors and also tumor angiogenesis. This study aimed to evaluate the clinicopathological factors of breast cancer in a tertiary centre with a focus on the relationship between tumor angiogenesis and clinicopathological factors. Methods: Clinicopathological data were retrieved from the archived formal pathology reports for surgical specimens diagnosed as invasive ductal carcinoma, NOS. Microvessels were immunohistochemically stained with anti-CD34 antibody and quantified as microvessel density. Results: At least 50% of 94 cases of invasive breast ductal carcinoma in the study were advanced stage. The majority had poor prognosis factors such as tumor size larger than 50mm (48.9%), positive lymph node metastasis (60.6%), and tumor grade III (52.1%). Higher percentages of estrogen and progesterone receptor negative cases were recorded (46.8% and 46.8% respectively). Her-2 overexpression cases and triple negative breast cancers constituted 24.5% and 22.3% respectively. Significantly higher microvessel density was observed in the younger patient age group (p=0.012). There were no significant associations between microvessel density and other clinicopathological factors (p>0.05). Conclusions: Majority of the breast cancer patients of this institution had advanced stage disease with poorer prognostic factors as compared to other local and western studies. Breast cancer in younger patients might be more proangiogenic.