Breast cancer research and treatment
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Breast Cancer Res. Treat. · Jul 2009
Randomized Controlled TrialGene expression of estrogen receptor, progesterone receptor and microtubule-associated protein Tau in high-risk early breast cancer: a quest for molecular predictors of treatment benefit in the context of a Hellenic Cooperative Oncology Group trial.
Estrogen receptor (ER) and progesterone receptor (PgR) protein expression carry weak prognostic and moderate predictive utility for the outcome of early breast cancer patients on adjuvant chemohormonotherapy. We sought to study the predictive significance and correlations of transcriptional profiling of the ER, PgR and microtubule-associated protein Tau (MAP-Tau) genes in early breast cancer. ⋯ ER gene transcription carries weak predictive significance for benefit from endocrine therapy or for outcome, with no apparent dose-response association. The predictive significance is possibly exerted via MAP-Tau gene expression, an ER-inducible tubulin modulator with strong predictive significance for patient outcome. However, MAP-Tau mRNA did not predict benefit from the addition of a taxane to adjuvant chemotherapy. Further study of the biologic function and utility of MAP-Tau for individualising adjuvant therapy is warranted.
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Breast Cancer Res. Treat. · Jul 2009
Cognitive impairments associated with breast cancer treatments: results from a longitudinal study.
Published cross-sectional studies have revealed that chemotherapy for breast cancer is associated with significant cognitive impairments. However, because these studies included no baseline assessment, it is unknown whether the cognitive impairments were pre-existent to cancer treatment or truly secondary to chemotherapy. To resolve this issue, this prospective study aimed to compare the effects of chemotherapy to the effect of radiotherapy on cognitive functioning in women treated for non-metastatic breast cancer. ⋯ Overall, this study reveals subtle cognitive impairments associated with breast cancer treatment. Specifically, it suggests that chemotherapy has a specific negative effect on verbal fluency, that breast cancer treatment in general negatively affects verbal memory, but that other cognitive functions are well preserved. Future studies should, however, attempt to better control the practice effect that may have masked other subtle alterations and use more ecologically valid measures of cognitive functioning.
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Breast Cancer Res. Treat. · Jul 2009
Clinical TrialFactors predicting in-breast tumor recurrence after breast-conserving surgery.
The main objectives of this study were to identify risk factors for local in-breast tumor recurrence after breast-conservation and to evaluate the impact of IBTR (in-breast tumor recurrence) on overall survival. ⋯ Concomitant lobular carcinomas in situ, as well as R1 surgical status are independent significant risk factors for in breast tumor recurrence after breast conserving therapy.
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Breast Cancer Res. Treat. · Jul 2009
The 70-gene prognosis-signature predicts disease outcome in breast cancer patients with 1-3 positive lymph nodes in an independent validation study.
The 70-gene prognosis-signature has shown to be a valid prognostic tool in node-negative breast cancer. Although axillary lymph node status is considered to be one of the most important prognostic factors, still 25-30% of node-positive breast cancer patients will remain free of distant metastases, even without adjuvant systemic therapy. We therefore investigated whether the 70-gene prognosis-signature can accurately identify patients with 1-3 positive lymph nodes who have an excellent disease outcome. ⋯ The 70-gene prognosis-signature outperforms traditional prognostic factors in predicting disease outcome in patients with 1-3 positive nodes. Moreover, the signature can accurately identify patients with an excellent disease outcome in node-positive breast cancer, who may be safely spared adjuvant chemotherapy.
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Breast Cancer Res. Treat. · Jul 2009
Clinical significance of axillary nodal ratio in stage II/III breast cancer treated with neoadjuvant chemotherapy.
Neoadjuvant chemotherapy may modify the yield of involved axillary lymph nodes. The purpose of this study was to identify the clinical significance of the involved nodal ratios in patients with stage II/III breast cancer treated with neoadjuvant chemotherapy. ⋯ Axillary nodal ratios have an independent prognostic value in stage II/III breast cancer treated with neoadjuvant chemotherapy. Nodal ratio might be a useful tool to identify the patients at high risk of relapse in the neoadjuvant setting.