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Multicentric Breast Cancer of the Axillary and Pectoral Breasts: A Case Report and Literature Review. 腋窝及胸侧乳房多中心性乳腺癌1例报告及文献复习。
IF 2.4 4区 医学 Q2 Medicine Pub Date : 2022-10-01 Epub Date: 2022-07-18 DOI: 10.4048/jbc.2022.25.e33
Harim Kim, Eun Young Ko, Boo-Kyung Han, Ji-Yeon Kim, Byung Joo Chae, Hyunwoo Lee

Multicentric cancer of the pectoral and ectopic breasts is extremely rare, and diagnosing this malignancy remains challenging because axillary breast cancer is easily misdiagnosed as lymph node metastasis. Moreover, there are no established treatment guidelines for this disease. We present our experience with a multicentric breast cancer patient who showed different responses to neoadjuvant chemotherapy (NAC) and underwent surgical treatments that differed from those in previous studies. In our case, the preoperative imaging of both lesions and subsequent core needle biopsy of each lesion were crucial, as these procedures confirm the diagnosis and help decide the chemotherapy regimen based on the subtype. After NAC, the patient underwent right breast-conserving surgery, sentinel lymph node biopsy (SLNB), and excision of accessory breast tissue in the right axilla. SLNB should be the initial step in staging multicentric breast cancer, unless imaging scan shows evidence of lymph node metastasis.

胸侧和异位乳房的多中心癌是非常罕见的,诊断这种恶性肿瘤仍然具有挑战性,因为腋窝乳腺癌很容易误诊为淋巴结转移。此外,目前还没有针对这种疾病的既定治疗指南。我们报告了一位多中心乳腺癌患者的经验,该患者对新辅助化疗(NAC)表现出不同的反应,并接受了与以往研究不同的手术治疗。在我们的病例中,两个病变的术前成像和随后的每个病变的核心针活检是至关重要的,因为这些程序可以确认诊断并帮助确定基于亚型的化疗方案。NAC术后,患者行右侧保乳手术,前哨淋巴结活检(SLNB),右腋窝副乳组织切除。除非影像学扫描显示淋巴结转移的证据,否则SLNB应该是分期多中心乳腺癌的第一步。
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引用次数: 0
The Significance of p-AKT1 as a Prognostic Marker and Therapeutic Target in Patients With Hormone Receptor-Positive and Human Epidermal Growth Factor Receptor-2-Positive Early Breast Cancer. p-AKT1作为激素受体阳性和人表皮生长因子受体2阳性早期乳腺癌患者预后标志物和治疗靶点的意义
IF 2.4 4区 医学 Q2 Medicine Pub Date : 2022-10-01 DOI: 10.4048/jbc.2022.25.e43
Ji Yea Kim, Chan Sub Park, Se-Kyeong Jang, Hyesil Seol, Min-Ki Seong, Woo Chul Noh, In-Chul Park, Hyun-Ah Kim

Purpose: Phosphorylated AKT1 (p-AKT1) at Ser473 is a functional isoform of AKT and a key component of the PI3K/mTOR/AKT pathway. This study aimed to evaluate the prognostic significance of p-AKT1 (Ser473) based on the molecular subtypes of breast cancer.

Methods: To investigate the prognostic value of p-AKT1 (Ser473), we performed a retrospective chart review of patients with breast cancer. Data on p-AKT1 (Ser473) positivity, hormone receptor (HR) status, human epidermal growth factor receptor 2 (HER2) expression status, and other clinicopathological factors were obtained. Furthermore, the therapeutic effect of blocking p-AKT1 (Ser473) in breast cancer cells was evaluated using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay, cell apoptosis assay, apoptosis protein array, and western blot analysis.

Results: A total of 3,044 patients were evaluated, and the median follow-up time was 43 (range: 0-125) months. In patients with HR-positive and HER2-positive disease, the p-AKT1 (Ser473)-positive group had worse disease-free survival (DFS) than the p-AKT1 (Ser473)-negative group (hazard ratio, 1.9; 95% confidence interval, 1.1-3.5; p = 0.024). In the multivariate analysis, p-AKT1 (Ser473) remained a significantly worse prognostic factor in patients with HR-positive/HER2-positive breast cancer (p = 0.03). There was no difference in DFS according to p-AKT1 (Ser473) status among patients with other breast cancer subgroups. In vitro analysis showed that blocking p-AKT1 (Ser473) levels enhanced trastuzumab-induced cell death in HR-positive/HER2-positive and p-AKT1 (Ser473)-positive breast cancer cells.

Conclusion: p-AKT1 (Ser473) is a prognostic marker for poor outcomes in patients with HR-positive/HER2-positive breast cancer and may have a potential value as a therapeutic target.

目的:磷酸化AKT1 (p-AKT1) Ser473位点是AKT的功能亚型,是PI3K/mTOR/AKT通路的关键组成部分。本研究旨在基于乳腺癌分子亚型评估p-AKT1 (Ser473)的预后意义。方法:为了研究p-AKT1 (Ser473)的预后价值,我们对乳腺癌患者进行了回顾性的图表回顾。获得p-AKT1 (Ser473)阳性、激素受体(HR)状态、人表皮生长因子受体2 (HER2)表达状态及其他临床病理因素的数据。此外,通过3-(4,5-二甲基噻唑-2-基)-2,5-二苯基溴化四唑(MTT)实验、细胞凋亡实验、凋亡蛋白阵列和western blot分析,评估阻断p-AKT1 (Ser473)对乳腺癌细胞的治疗效果。结果:共评估3044例患者,中位随访时间为43个月(范围:0-125)。在hr阳性和her2阳性疾病患者中,p-AKT1 (Ser473)阳性组的无病生存期(DFS)低于p-AKT1 (Ser473)阴性组(风险比,1.9;95%置信区间为1.1-3.5;P = 0.024)。在多因素分析中,p- akt1 (Ser473)在hr阳性/ her2阳性乳腺癌患者中仍然是一个显著较差的预后因素(p = 0.03)。根据p-AKT1 (Ser473)状态,其他乳腺癌亚组患者的DFS没有差异。体外分析显示,阻断p-AKT1 (Ser473)水平可增强曲妥珠单抗诱导的hr阳性/ her2阳性和p-AKT1 (Ser473)阳性乳腺癌细胞的细胞死亡。结论:p-AKT1 (Ser473)是hr阳性/ her2阳性乳腺癌患者预后不良的预后标志物,可能作为治疗靶点具有潜在价值。
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引用次数: 0
Intensity Modulated Radiotherapy and Volumetric Modulated Arc Therapy in the Treatment of Breast Cancer: An Updated Review. 强度调制放疗和体积调制弧线治疗乳腺癌:最新综述。
IF 2.4 4区 医学 Q2 Medicine Pub Date : 2022-10-01 Epub Date: 2022-08-24 DOI: 10.4048/jbc.2022.25.e37
Jee Suk Chang, Ji Hyun Chang, Nalee Kim, Yong Bae Kim, Kyung Hwan Shin, Kyubo Kim

Radiation therapy (RT) plays a critical role in breast cancer treatment. In the modern technological era, innovations and progress in breast RT and delivery techniques have greatly improved the clinical outcomes. Intensity-modulated RT (IMRT) is a modern RT technology that permits the modulation of RT beams, ensuring a more uniform dose distribution through the target tissue and better avoidance of underlying critical structures. Recently, several studies have been published on breast IMRT. However, the interpretation of these results can be challenging because of the wide diversity of patients and treatment. The purpose of this study was to review these studies, focusing on the impact of IMRT on reducing toxicity and increasing convenience, as well as addressing concerns regarding breast IMRT.

放射治疗(RT)在乳腺癌治疗中起着至关重要的作用。在现代科技时代,乳房放射治疗和输送技术的创新和进步极大地改善了临床效果。强度调制放射治疗(IMRT)是一种现代放射治疗技术,它允许对放射光束进行调制,确保通过靶组织的更均匀的剂量分布,并更好地避免潜在的关键结构。最近,一些关于乳房IMRT的研究已经发表。然而,由于患者和治疗方法的广泛差异,这些结果的解释可能具有挑战性。本研究的目的是回顾这些研究,重点关注IMRT在降低毒性和增加便利性方面的影响,以及解决有关乳腺IMRT的问题。
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引用次数: 5
Effects of Mobile Healthcare Applications on the Lifestyle of Patients With Breast Cancer: A Protocol for a Randomized Clinical Trial. 移动医疗应用程序对乳腺癌患者生活方式的影响:一项随机临床试验方案
IF 2.4 4区 医学 Q2 Medicine Pub Date : 2022-10-01 DOI: 10.4048/jbc.2022.25.e42
Soo Yeon Baek, Sae Byul Lee, Yura Lee, Seockhoon Chung, Chang-Min Choi, Hui Jeong Lee, Min-Woo Jo, Sung-Cheol Yun, Jong Won Lee

Purpose: Physical activity (PA) in patients with breast cancer is associated with improved quality of life (QoL); however, many breast cancer survivors do not meet the recommended PA level. This study aims to evaluate the effect of digital health interventions using mobile apps to promote PA and QoL in patients with postoperative breast cancer. This study will also identify effective digital intervention methods and perform an economic analysis. The main hypothesis is that the use of mobile healthcare apps will improve health-related quality of life (HRQOL), promote PA, and reduce healthcare costs.

Methods: The Promotion of a better lifestyle (PA) with Precise and Practicable digital healthcare in postoperative CANCER patients through a Multi-Disciplinary Network (P4CancerMDnet) study is examined by a prospective 4-group randomized controlled trial with a concurrent cost-utility evaluation. Patients are randomly assigned to 3 different mobile app intervention groups or control groups in a 1:1:1:1 ratio. The intervention group is encouraged to use the assigned mobile app. The targeted outcomes are HRQOL, metabolic health markers, and quality-adjusted life-years. The outcomes will be measured at the 6- and 12-month follow-ups.

Discussion: This study will contribute towards a better lifestyle and HRQOL through digital healthcare for postoperative breast cancer patients. These findings are expected to provide evidence of the effectiveness of mobile apps for breast cancer survivors.

Trial registration: Clinical Research Information Service Identifier: KCT0005447.

目的:乳腺癌患者的身体活动(PA)与生活质量(QoL)的改善相关;然而,许多乳腺癌幸存者没有达到推荐的PA水平。本研究旨在评估使用移动应用程序的数字健康干预对乳腺癌术后患者的生活质量和生活质量的影响。本研究还将确定有效的数字干预方法并进行经济分析。主要假设是,使用移动医疗应用程序将提高与健康相关的生活质量(HRQOL),促进PA,并降低医疗成本。方法:通过一项多学科网络(P4CancerMDnet)研究,通过一项前瞻性四组随机对照试验,同时进行成本-效用评估,研究通过精确和可行的数字医疗保健促进癌症术后患者更好的生活方式(PA)。将患者按1:1:1:1的比例随机分为3个不同的移动应用干预组或对照组。干预组被鼓励使用指定的移动应用程序。目标结果是HRQOL、代谢健康指标和质量调整生命年。结果将在6个月和12个月的随访中进行测量。讨论:本研究将有助于通过数字医疗为乳腺癌术后患者提供更好的生活方式和HRQOL。这些发现有望为移动应用程序对乳腺癌幸存者的有效性提供证据。试验注册:临床研究信息服务标识:KCT0005447。
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引用次数: 0
Somatic Mutations of TP53 Identified by Targeted Next-Generation Sequencing Are Poor Prognostic Factors for Primary Operable Breast Cancer: A Single-Center Study. 靶向下一代测序鉴定的TP53体细胞突变是原发性可手术乳腺癌的不良预后因素:一项单中心研究
IF 2.4 4区 医学 Q2 Medicine Pub Date : 2022-10-01 DOI: 10.4048/jbc.2022.25.e41
Jung Ho Park, Mi Jung Kwon, Jinwon Seo, Ho Young Kim, Soo Kee Min, Lee Su Kim

Few studies have reported on the clinical utility of targeted next-generation sequencing (NGS) for breast cancer in Korea. We retrospectively reviewed the targeted NGS data of 219 patients with breast cancer who underwent surgical resection between August 2018 and April 2021. Here, we described the mutational profiles of breast cancer and examined their prognostic implications. The most frequently mutated gene was PIK3CA (n = 97/219, 44.3%), followed by TP53 (n = 79/219, 36.1%), AKT1 (n = 23/219, 10.5%), and GATA3 (n = 20/219, 9.1%). TP53 mutations were associated with aggressive histologic features. We followed up for 31 (range, 1-39) months and observed 11 (5.0%) recurrences: nine were TP53 mutant and two were TP53 wild-type. Multivariable analysis revealed that TP53 mutation was an independent prognostic factor for recurrence (p = 0.012). Although no drug is currently available for TP53 mutations, it is valuable to know the mutational status of TP53 for the precise management of breast cancer.

在韩国,靶向下一代测序(NGS)治疗乳腺癌的临床应用研究很少。我们回顾性回顾了2018年8月至2021年4月219例接受手术切除的乳腺癌患者的靶向NGS数据。在这里,我们描述了乳腺癌的突变概况,并检查了它们的预后意义。最常见的突变基因是PIK3CA (n = 97/219, 44.3%),其次是TP53 (n = 79/219, 36.1%)、AKT1 (n = 23/219, 10.5%)和GATA3 (n = 20/219, 9.1%)。TP53突变与侵袭性组织学特征相关。随访31个月(1-39个月),11例(5.0%)复发,其中9例为TP53突变型,2例为TP53野生型。多变量分析显示TP53突变是复发的独立预后因素(p = 0.012)。虽然目前还没有针对TP53突变的药物,但了解TP53的突变状态对于乳腺癌的精确治疗是有价值的。
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引用次数: 4
Musculoskeletal Pain and the Prevalence of Rheumatoid Arthritis in Breast Cancer Patients During Cancer Treatment: A Retrospective Study. 乳腺癌患者在癌症治疗期间的肌肉骨骼疼痛和类风湿关节炎患病率:一项回顾性研究。
IF 2.4 4区 医学 Q2 Medicine Pub Date : 2022-10-01 Epub Date: 2022-10-13 DOI: 10.4048/jbc.2022.25.e40
Ju Yeon Kim, Min Jung Kim, Eun Bong Lee, Tae-Yong Kim, Kyung-Hun Lee, Seock-Ah Im, Jin Kyun Park

Purpose: Breast cancer patients often develop musculoskeletal pain, resembling that experienced by patients with rheumatoid arthritis (RA), during cancer treatment. This study aimed to investigate the causes of musculoskeletal pain, including RA, among breast cancer patients.

Methods: This retrospective study included breast cancer patients experiencing new-onset arthralgia during cancer treatment along with age- and sex-matched controls without breast cancer, who were evaluated at the Rheumatologic clinic between 2004 and 2017. The causes of musculoskeletal pain were compared between breast cancer patients and controls. The effects of cancer treatment on arthralgia and factors associated with RA were examined.

Results: A total of 146 breast cancer patients and 102 controls were included in the final analysis. The most common cause of arthralgia during breast cancer treatment was osteoarthritis (OA, 61.0%), followed by enthesopathy/tendinopathy (28.1%), which included tendinitis, adhesive capsulitis, and carpal tunnel syndrome. Overall, 50.0% of 72 breast cancer patients receiving aromatase inhibitors (AIs) satisfied the criteria of AI-induced musculoskeletal symptoms (AIMSS). The mean symptom duration (i.e., the time between pain onset and evaluation by a rheumatologist) was shorter in breast cancer patients than in controls (7.0 ± 12.1 vs. 14.8 ± 24.9 months, respectively; p = 0.004). RA was diagnosed in 3 (2.1%) breast cancer patients and 3 (2.9%) controls. All breast cancer patients with RA had an elevated erythrocyte sedimentation rate (ESR, 66.7 ± 25.0 mm/h), whereas those without RA had a normal ESR (20.4 ± 21.5 mm/h). Patients with breast cancer required more analgesics than the controls.

Conclusion: OA and enthesopathy/tendinopathy are the most common causes of arthralgia in breast cancer patients, which may concurrently manifest as AIMSS. Patients with breast cancer did not have a higher prevalence of RA than those without breast cancer.

目的:乳腺癌患者在癌症治疗期间经常出现肌肉骨骼疼痛,类似于类风湿性关节炎(RA)患者所经历的疼痛。本研究旨在调查乳腺癌患者中肌肉骨骼疼痛的原因,包括类风湿性关节炎。方法:本回顾性研究纳入了2004年至2017年期间在风湿病临床进行评估的在癌症治疗期间出现新发关节炎的乳腺癌患者以及年龄和性别匹配的非乳腺癌对照组。比较了乳腺癌患者和对照组之间肌肉骨骼疼痛的原因。研究了癌症治疗对关节痛和类风湿性关节炎相关因素的影响。结果:共有146例乳腺癌患者和102例对照组纳入最终分析。乳腺癌治疗期间最常见的关节痛原因是骨关节炎(OA, 61.0%),其次是肌腱病/肌腱病(28.1%),包括肌腱炎、粘连性囊炎和腕管综合征。总体而言,接受芳香化酶抑制剂(AIs)治疗的72例乳腺癌患者中,50.0%满足ai诱导的肌肉骨骼症状(AIMSS)标准。乳腺癌患者的平均症状持续时间(即疼痛发作和风湿病专家评估之间的时间)比对照组短(分别为7.0±12.1个月和14.8±24.9个月);P = 0.004)。3例(2.1%)乳腺癌患者和3例(2.9%)对照组被诊断为类风湿性关节炎。所有合并RA的乳腺癌患者的红细胞沉降率均升高(ESR, 66.7±25.0 mm/h),而未合并RA的患者的ESR正常(20.4±21.5 mm/h)。乳腺癌患者比对照组需要更多的镇痛剂。结论:骨性关节炎和腱鞘病/肌腱病是乳腺癌患者关节痛最常见的原因,并可能同时表现为AIMSS。乳腺癌患者的RA患病率并不比非乳腺癌患者高。
{"title":"Musculoskeletal Pain and the Prevalence of Rheumatoid Arthritis in Breast Cancer Patients During Cancer Treatment: A Retrospective Study.","authors":"Ju Yeon Kim,&nbsp;Min Jung Kim,&nbsp;Eun Bong Lee,&nbsp;Tae-Yong Kim,&nbsp;Kyung-Hun Lee,&nbsp;Seock-Ah Im,&nbsp;Jin Kyun Park","doi":"10.4048/jbc.2022.25.e40","DOIUrl":"https://doi.org/10.4048/jbc.2022.25.e40","url":null,"abstract":"<p><strong>Purpose: </strong>Breast cancer patients often develop musculoskeletal pain, resembling that experienced by patients with rheumatoid arthritis (RA), during cancer treatment. This study aimed to investigate the causes of musculoskeletal pain, including RA, among breast cancer patients.</p><p><strong>Methods: </strong>This retrospective study included breast cancer patients experiencing new-onset arthralgia during cancer treatment along with age- and sex-matched controls without breast cancer, who were evaluated at the Rheumatologic clinic between 2004 and 2017. The causes of musculoskeletal pain were compared between breast cancer patients and controls. The effects of cancer treatment on arthralgia and factors associated with RA were examined.</p><p><strong>Results: </strong>A total of 146 breast cancer patients and 102 controls were included in the final analysis. The most common cause of arthralgia during breast cancer treatment was osteoarthritis (OA, 61.0%), followed by enthesopathy/tendinopathy (28.1%), which included tendinitis, adhesive capsulitis, and carpal tunnel syndrome. Overall, 50.0% of 72 breast cancer patients receiving aromatase inhibitors (AIs) satisfied the criteria of AI-induced musculoskeletal symptoms (AIMSS). The mean symptom duration (i.e., the time between pain onset and evaluation by a rheumatologist) was shorter in breast cancer patients than in controls (7.0 ± 12.1 vs. 14.8 ± 24.9 months, respectively; <i>p</i> = 0.004). RA was diagnosed in 3 (2.1%) breast cancer patients and 3 (2.9%) controls. All breast cancer patients with RA had an elevated erythrocyte sedimentation rate (ESR, 66.7 ± 25.0 mm/h), whereas those without RA had a normal ESR (20.4 ± 21.5 mm/h). Patients with breast cancer required more analgesics than the controls.</p><p><strong>Conclusion: </strong>OA and enthesopathy/tendinopathy are the most common causes of arthralgia in breast cancer patients, which may concurrently manifest as AIMSS. Patients with breast cancer did not have a higher prevalence of RA than those without breast cancer.</p>","PeriodicalId":15206,"journal":{"name":"Journal of Breast Cancer","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8d/41/jbc-25-404.PMC9629969.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40647937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Clinical Application of Next-Generation Sequencing in Patients With Breast Cancer: Real-World Data. 新一代测序在乳腺癌患者中的临床应用:真实世界数据。
IF 2.4 4区 医学 Q2 Medicine Pub Date : 2022-10-01 Epub Date: 2022-06-28 DOI: 10.4048/jbc.2022.25.e30
Koung Jin Suh, Se Hyun Kim, Yu Jung Kim, Heechul Shin, Eunyoung Kang, Eun-Kyu Kim, Sejoon Lee, Ji Won Woo, Hee Young Na, Soomin Ahn, Bum-Sup Jang, In Ah Kim, So Yeon Park, Jee Hyun Kim

Purpose: Next-generation sequencing (NGS)-based tumor panel testing has been reimbursed by the Korean government since 2017. We evaluated the use of NGS-based tumor panel testing in real-world clinical practice, focusing on molecular profiling (MP)-guided breast cancer treatment.

Methods: A total of 137 breast cancer patients underwent NGS panel testing between December 2017 and July 2020 at Seoul National University Bundang Hospital (SNUBH). Samples from patients were profiled using an in-house SNUBH pan-cancer panel. Sixty-four patients were profiled on SNUBH Pan_Cancer v1.0, targeting 89 genes, while 73 patients were profiled on SNUBH Pan_Cancer v2.0, targeting 546 genes.

Results: Breast cancer subtypes included hormone receptor+/human epidermal growth factor receptor 2 (HER2)- (n = 87), triple-negative (n = 44), and HER2+ (n = 6). Most patients had locally advanced or metastatic cancers (92%). Approximately 92% (126/137) of the patients had significant genomic alterations (tiers I and II), and 62% (85/137) had targetable genomic alterations. The most common targetable genomic alterations were PIK3CA (39%) and ESR1 mutations (9%), followed by ERBB2 (7%), PTEN (7%), BRCA2 (6%), and BRCA1 mutations (4%). Of the 81 patients with locally advanced/metastatic breast cancer with targetable genomic alterations, 6 (7.4%) received MP-guided treatments, including PARP inhibitor (n = 4), ERBB2-directed therapy (n = 1), and PI3K inhibitor (n = 1). Among these 6 patients, 4 participated in clinical trials, 1 underwent treatment at their own expense, and 1 received drugs through an expanded access program. The remaining 66 patients (81%) with targetable genomic alteration did not receive MP-guided treatment due to lack of matched drugs and/or clinical trials, poor performance status, and/or financial burden.

Conclusion: NGS panel testing allowed MP-guided treatment in only 4.7% (6/127) of patients with advanced breast cancer in a real-world setting. The availability of matched drugs is critical for the realistic implementation of personalized treatment.

目的:从2017年开始,以下一代测序(NGS)为基础的肿瘤小组检测由韩国政府报销。我们评估了基于ngs的肿瘤小组测试在现实世界临床实践中的应用,重点是分子谱(MP)引导的乳腺癌治疗。方法:2017年12月至2020年7月,共有137名乳腺癌患者在首尔国立大学盆唐医院(SNUBH)接受了NGS面板检测。使用内部SNUBH泛癌症小组对患者样本进行分析。64例患者在SNUBH Pan_Cancer v1.0上被分析,涉及89个基因;73例患者在SNUBH Pan_Cancer v2.0上被分析,涉及546个基因。结果:乳腺癌亚型包括激素受体+/人表皮生长因子受体2 (HER2)- (n = 87)、三阴性(n = 44)和HER2+ (n = 6)。大多数患者为局部晚期或转移性癌症(92%)。大约92%(126/137)的患者有显著的基因组改变(I级和II级),62%(85/137)的患者有可靶向的基因组改变。最常见的可靶向基因组改变是PIK3CA(39%)和ESR1突变(9%),其次是ERBB2(7%)、PTEN(7%)、BRCA2(6%)和BRCA1突变(4%)。在81例可靶向基因组改变的局部晚期/转移性乳腺癌患者中,6例(7.4%)接受了mp引导治疗,包括PARP抑制剂(n = 4)、erbb2靶向治疗(n = 1)和PI3K抑制剂(n = 1)。在这6例患者中,4例参加了临床试验,1例自费治疗,1例通过扩大准入计划接受药物治疗。其余66例(81%)可靶向基因组改变的患者由于缺乏匹配的药物和/或临床试验,表现不佳和/或经济负担而未接受mp指导治疗。结论:在现实世界中,NGS面板测试仅允许4.7%(6/127)的晚期乳腺癌患者接受mp引导治疗。匹配药物的可用性对于个性化治疗的现实实施至关重要。
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引用次数: 3
Income Disparity in Breast Cancer Incidence and Stage at Presentation: A National Population Study of South Korea. 收入差距对乳腺癌发病率和发病分期的影响:韩国全国人口研究。
IF 2.4 4区 医学 Q2 Medicine Pub Date : 2022-10-01 Epub Date: 2022-09-30 DOI: 10.4048/jbc.2022.25.e38
Seung-Ah Choe, Minji Roh, Hye Ri Kim, Soohyeon Lee, Myung Ki, Domyung Paek, Mia Son

Purpose: This study aims to explore income-based disparities in breast cancer (BC) incidence and stage at presentation in a national population in South Korea, where a National Cancer Screening Program (NCSP) has been implemented.

Methods: In 2007, new patients with BC were identified using the Korea Central Cancer Registry database. We calculated adjusted odds ratios (aORs) to evaluate the association between individual income level and the risk of distant stage BC at presentation, adjusting for women's age, body mass index, disability registration, employment, region of residence, and year of diagnosis.

Results: The cumulative age-standardized incidence of BC in the 11 years was highest among women in the richest quintile (2,040 per 100,000 women for 11 years), whereas the proportion of distant stage at presentation was the highest (10.2%) among the medical aid beneficiaries. The aOR of distant stage diagnosis at presentation was higher for lower-income quintiles, and the risk was the highest in the medical aid beneficiaries (aOR, 2.25; 95% confidence interval, 1.97-2.58) than in the richest quintile. The income-based gradient in aORs for distant stage did not differ between younger (< 40 years) and older patients.

Conclusion: A higher risk of distant stage BC at presentation among the lower-income and medical aid groups in the context of a NCSP was observed. A more focused approach toward women in lower-income groups is necessary to alleviate the disparity in the risk of advanced BC.

目的:本研究旨在探讨韩国全国人口中乳腺癌(BC)发病率和发病阶段的收入差异,韩国实施了国家癌症筛查计划(NCSP)。方法:2007年,使用韩国中央癌症登记处数据库确定了新的BC患者。我们计算了调整后的优势比(aORs)来评估个人收入水平与发病时远期BC风险之间的关系,调整了女性的年龄、体重指数、残疾登记、就业、居住地区和诊断年份。结果:11年中BC的累积年龄标准化发病率在最富裕的五分之一的妇女中最高(11年中每10万名妇女中有2040名),而在医疗救助受益人中,发病时远期的比例最高(10.2%)。低收入五分之一家庭的发病时远期诊断的aOR较高,医疗救助受益人的风险最高(aOR, 2.25;95%置信区间(1.97-2.58)比最富有的五分位数高。在年轻(< 40岁)和老年患者之间,远期aORs的基于收入的梯度没有差异。结论:在NCSP的背景下,观察到低收入和医疗援助群体在出现时远处期BC的风险较高。有必要对低收入群体的妇女采取更有针对性的方法,以减轻晚期BC风险的差异。
{"title":"Income Disparity in Breast Cancer Incidence and Stage at Presentation: A National Population Study of South Korea.","authors":"Seung-Ah Choe,&nbsp;Minji Roh,&nbsp;Hye Ri Kim,&nbsp;Soohyeon Lee,&nbsp;Myung Ki,&nbsp;Domyung Paek,&nbsp;Mia Son","doi":"10.4048/jbc.2022.25.e38","DOIUrl":"https://doi.org/10.4048/jbc.2022.25.e38","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to explore income-based disparities in breast cancer (BC) incidence and stage at presentation in a national population in South Korea, where a National Cancer Screening Program (NCSP) has been implemented.</p><p><strong>Methods: </strong>In 2007, new patients with BC were identified using the Korea Central Cancer Registry database. We calculated adjusted odds ratios (aORs) to evaluate the association between individual income level and the risk of distant stage BC at presentation, adjusting for women's age, body mass index, disability registration, employment, region of residence, and year of diagnosis.</p><p><strong>Results: </strong>The cumulative age-standardized incidence of BC in the 11 years was highest among women in the richest quintile (2,040 per 100,000 women for 11 years), whereas the proportion of distant stage at presentation was the highest (10.2%) among the medical aid beneficiaries. The aOR of distant stage diagnosis at presentation was higher for lower-income quintiles, and the risk was the highest in the medical aid beneficiaries (aOR, 2.25; 95% confidence interval, 1.97-2.58) than in the richest quintile. The income-based gradient in aORs for distant stage did not differ between younger (< 40 years) and older patients.</p><p><strong>Conclusion: </strong>A higher risk of distant stage BC at presentation among the lower-income and medical aid groups in the context of a NCSP was observed. A more focused approach toward women in lower-income groups is necessary to alleviate the disparity in the risk of advanced BC.</p>","PeriodicalId":15206,"journal":{"name":"Journal of Breast Cancer","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/17/3a/jbc-25-415.PMC9629970.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40647936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Characteristics and Prognosis of Estrogen Receptor Low-Positive Breast Cancer. 雌激素受体低阳性乳腺癌的特点及预后。
IF 2.4 4区 医学 Q2 Medicine Pub Date : 2022-08-01 Epub Date: 2022-06-29 DOI: 10.4048/jbc.2022.25.e31
Min Chong Kim, Min Hui Park, Jung Eun Choi, Su Hwan Kang, Young Kyung Bae

Purpose: The updated American Society of Clinical Oncology/College of American Pathologists guideline for estrogen receptor (ER) testing recommends that breast cancer with ER expression in 1-10% of tumor cells should be reported as ER-low positive (ERlow), although limited data are available on the overall benefits of endocrine therapy. We investigated the clinicopathological characteristics and clinical outcomes of ERlow breast cancer and to compare them with those of ER-negative (ERneg) and ER-high (> 10% of tumor cells, ERhigh) breast cancers.

Methods: Consecutive patients with invasive breast cancer who underwent curative surgery between November 2007 and December 2014 were included. Clinicopathological characteristics and disease-free survival (DFS) of ERlow tumors were compared with those of ERneg and ERhigh tumors.

Results: Of the 2,309 cases included, 46 (2%), 643 (27.8%), and 1,620 (70.2%) were ERlow, ERneg, and ERhigh, respectively. ERlow tumors were associated with no special type of histology (p = 0.011), advanced pT (p = 0.017), pN (p = 0.009) and anatomic stages (p < 0.001), high grade (p < 0.001), negative/low progesterone receptor (PR) status (p < 0.001), human epidermal growth factor receptor 2 positivity (p < 0.001), high Ki-67 (p < 0.001), and recurrence (p = 0.006) compared to ERhigh tumors. DFS was significantly dependent on ER status, and ERlow tumors showed poorer DFS than ERhigh tumors (p = 0.001), however, there was no significant survival difference between ERlow and ERneg tumors. Furthermore, DFS in ERhigh patients was affected by hormone therapy (p < 0.001), while it was not affected in ERlow patients.

Conclusion: Patients with ERlow breast cancer have clinicopathological characteristics that differ from those with ERhigh tumors. Although this study was limited by the small sample size of the ERlow group, no benefit from hormone therapy was observed in the ERlow group compared with the ERhigh group.

目的:最新的美国临床肿瘤学会/美国病理学家学会雌激素受体(ER)检测指南建议,雌激素受体在1-10%的肿瘤细胞中表达的乳腺癌应报告为ER低阳性(ERlow),尽管关于内分泌治疗的总体益处的数据有限。我们研究了ERlow乳腺癌的临床病理特征和临床转归,并将其与er阴性(ERneg)和er高(> 10%的肿瘤细胞,ERhigh)乳腺癌的临床病理特征进行了比较。方法:纳入2007年11月至2014年12月连续行根治性手术的浸润性乳腺癌患者。比较ERlow肿瘤与ERneg和ERhigh肿瘤的临床病理特征和无病生存期(DFS)。结果:2309例患者中ERlow、ERneg、ERhigh分别为46例(2%)、643例(27.8%)、1620例(70.2%)。与ERhigh肿瘤相比,ERlow肿瘤没有特殊的组织学类型(p = 0.011)、晚期pT (p = 0.017)、pN (p = 0.009)和解剖分期(p < 0.001)、高分级(p < 0.001)、孕激素受体(PR)阴性/低状态(p < 0.001)、人表皮生长因子受体2阳性(p < 0.001)、高Ki-67 (p < 0.001)和复发(p = 0.006)相关。DFS显著依赖于ER状态,ERlow肿瘤的DFS较ERhigh肿瘤差(p = 0.001),而ERlow和ERneg肿瘤的生存率无显著差异。此外,激素治疗对ERhigh患者的DFS有影响(p < 0.001),而对ERlow患者无影响。结论:ERlow乳腺癌患者具有不同于ERhigh肿瘤的临床病理特征。虽然本研究受到ERlow组小样本量的限制,但与ERhigh组相比,ERlow组未观察到激素治疗的益处。
{"title":"Characteristics and Prognosis of Estrogen Receptor Low-Positive Breast Cancer.","authors":"Min Chong Kim,&nbsp;Min Hui Park,&nbsp;Jung Eun Choi,&nbsp;Su Hwan Kang,&nbsp;Young Kyung Bae","doi":"10.4048/jbc.2022.25.e31","DOIUrl":"https://doi.org/10.4048/jbc.2022.25.e31","url":null,"abstract":"<p><strong>Purpose: </strong>The updated American Society of Clinical Oncology/College of American Pathologists guideline for estrogen receptor (ER) testing recommends that breast cancer with ER expression in 1-10% of tumor cells should be reported as ER-low positive (ER<sup>low</sup>), although limited data are available on the overall benefits of endocrine therapy. We investigated the clinicopathological characteristics and clinical outcomes of ER<sup>low</sup> breast cancer and to compare them with those of ER-negative (ER<sup>neg</sup>) and ER-high (> 10% of tumor cells, ER<sup>high</sup>) breast cancers.</p><p><strong>Methods: </strong>Consecutive patients with invasive breast cancer who underwent curative surgery between November 2007 and December 2014 were included. Clinicopathological characteristics and disease-free survival (DFS) of ER<sup>low</sup> tumors were compared with those of ER<sup>neg</sup> and ER<sup>high</sup> tumors.</p><p><strong>Results: </strong>Of the 2,309 cases included, 46 (2%), 643 (27.8%), and 1,620 (70.2%) were ER<sup>low</sup>, ER<sup>neg</sup>, and ER<sup>high</sup>, respectively. ER<sup>low</sup> tumors were associated with no special type of histology (<i>p</i> = 0.011), advanced pT (<i>p</i> = 0.017), pN (<i>p</i> = 0.009) and anatomic stages (<i>p</i> < 0.001), high grade (<i>p</i> < 0.001), negative/low progesterone receptor (PR) status (<i>p</i> < 0.001), human epidermal growth factor receptor 2 positivity (<i>p</i> < 0.001), high Ki-67 (<i>p</i> < 0.001), and recurrence (<i>p</i> = 0.006) compared to ER<sup>high</sup> tumors. DFS was significantly dependent on ER status, and ER<sup>low</sup> tumors showed poorer DFS than ER<sup>high</sup> tumors (<i>p</i> = 0.001), however, there was no significant survival difference between ER<sup>low</sup> and ER<sup>neg</sup> tumors. Furthermore, DFS in ER<sup>high</sup> patients was affected by hormone therapy (<i>p</i> < 0.001), while it was not affected in ER<sup>low</sup> patients.</p><p><strong>Conclusion: </strong>Patients with ER<sup>low</sup> breast cancer have clinicopathological characteristics that differ from those with ER<sup>high</sup> tumors. Although this study was limited by the small sample size of the ER<sup>low</sup> group, no benefit from hormone therapy was observed in the ER<sup>low</sup> group compared with the ER<sup>high</sup> group.</p>","PeriodicalId":15206,"journal":{"name":"Journal of Breast Cancer","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c2/14/jbc-25-318.PMC9411025.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40576511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 4
Assessment of Neoadjuvant Treatment Response Using Automated Breast Ultrasound in Breast Cancer. 利用自动乳腺超声评估乳腺癌新辅助治疗反应
IF 2.2 4区 医学 Q3 ONCOLOGY Pub Date : 2022-08-01 Epub Date: 2022-07-08 DOI: 10.4048/jbc.2022.25.e32
Xiaozhi Dang, Xin Zhang, Yi Gao, Hongping Song

Breast imaging techniques are used to assess the tumor response to neoadjuvant treatment (NAT), which is increasingly one of the preferred therapeutic options and increases the rate of breast conservation for breast cancer. Herein, we report a case in which a woman was diagnosed with invasive ductal carcinoma in the left breast and received NAT before surgery. Automated breast ultrasound (AB US) was regularly performed before and during the NAT to evaluate the tumor response to NAT by measuring diameter changes and volume reductions of the tumor. Images showed that the tumor size was significantly reduced and disappeared after 7 cycles of NAT, except for macrocalcification. Postoperative histopathological examination confirmed that there were no residual tumor cells. We found that AB US overcame the limitations of handheld US, such as operator dependence, poor reproducibility and limited field of view, and can be an alternative modality to assess the tumor response of NAT in the absence of magnetic resonance imaging (MRI) instruments.

乳腺成像技术用于评估肿瘤对新辅助治疗(NAT)的反应,新辅助治疗日益成为首选治疗方案之一,并提高了乳腺癌的保乳率。在此,我们报告了一例妇女被诊断为左乳腺浸润性导管癌并在手术前接受 NAT 治疗的病例。在接受 NAT 之前和期间定期进行了自动乳腺超声检查(AB US),通过测量肿瘤直径的变化和体积的缩小来评估肿瘤对 NAT 的反应。图像显示,经过7个周期的NAT治疗后,除大钙化外,肿瘤体积明显缩小并消失。术后组织病理学检查证实没有残留肿瘤细胞。我们发现 AB US 克服了手持 US 的局限性,如对操作者的依赖性、可重复性差和视野有限,可以作为在没有磁共振成像(MRI)仪器的情况下评估 NAT 的肿瘤反应的替代方式。
{"title":"Assessment of Neoadjuvant Treatment Response Using Automated Breast Ultrasound in Breast Cancer.","authors":"Xiaozhi Dang, Xin Zhang, Yi Gao, Hongping Song","doi":"10.4048/jbc.2022.25.e32","DOIUrl":"10.4048/jbc.2022.25.e32","url":null,"abstract":"<p><p>Breast imaging techniques are used to assess the tumor response to neoadjuvant treatment (NAT), which is increasingly one of the preferred therapeutic options and increases the rate of breast conservation for breast cancer. Herein, we report a case in which a woman was diagnosed with invasive ductal carcinoma in the left breast and received NAT before surgery. Automated breast ultrasound (AB US) was regularly performed before and during the NAT to evaluate the tumor response to NAT by measuring diameter changes and volume reductions of the tumor. Images showed that the tumor size was significantly reduced and disappeared after 7 cycles of NAT, except for macrocalcification. Postoperative histopathological examination confirmed that there were no residual tumor cells. We found that AB US overcame the limitations of handheld US, such as operator dependence, poor reproducibility and limited field of view, and can be an alternative modality to assess the tumor response of NAT in the absence of magnetic resonance imaging (MRI) instruments.</p>","PeriodicalId":15206,"journal":{"name":"Journal of Breast Cancer","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/75/5c/jbc-25-344.PMC9411026.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40575912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Journal of Breast Cancer
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