Breast cancer research and treatment
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Breast Cancer Res. Treat. · Apr 2008
Neutrophil gelatinase-associated lipocalin (NGAL) is a predictor of poor prognosis in human primary breast cancer.
Neutrophil gelatinase-associated lipocalin (NGAL) is a small, secreted glycoprotein with proposed functions in cell proliferation, survival and morphogenesis. NGAL is expressed in a variety of tumor types including breast carcinomas, but it is not known whether NGAL contributes directly to breast cancer progression. This study examines the relationship between NGAL expression in breast carcinomas and established clinical prognostic markers as well as clinical outcome. ⋯ In multivariate analysis, NGAL remained an independent prognostic marker for disease-free survival. In a subset of patients with estrogen receptor positive tumors, NGAL was significantly associated with decreased disease-free survival. The results show that NGAL expression is a predictor of poor prognosis in primary human breast cancer and suggest that NGAL detection may provide information for risk assessment and identify a subset of patients requiring more aggressive adjuvant therapy.
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Breast Cancer Res. Treat. · Apr 2008
Randomized Controlled TrialCost-effectiveness of letrozole versus tamoxifen as initial adjuvant therapy in postmenopausal women with hormone-receptor positive early breast cancer from a Canadian perspective.
In the primary core analysis of BIG 1-98, a randomized, double-blind trial comparing 5 years of initial adjuvant therapy with letrozole versus tamoxifen in postmenopausal women with hormone receptor-positive (HR+) early breast cancer, letrozole significantly improved disease-free survival by 19% and reduced the risk of breast cancer recurrence by 28% and distant recurrence by 27%. ⋯ In postmenopausal women with HR+ early breast cancer, initial adjuvant treatment with letrozole is cost-effective from the Canadian healthcare system perspective.
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Breast Cancer Res. Treat. · Apr 2008
Germline TP53 mutations in BRCA1 and BRCA2 mutation-negative French Canadian breast cancer families.
About 40% of French Canadian breast and/or ovarian cancer families harbor germline BRCA1 or BRCA1 mutations where common mutations account for about 84% of all mutations identified in cancer families. Within a series of BRCA1 and BRCA2 mutation-negative families, a germline TP53 13398 G>A (Arg213Gln) mutation was identified, which was selected for mutation analysis in this gene because of a family history consistent with Li-Fraumeni syndrome (LFS). Given the founder effects in this population, the 13398 G>A mutation was screened in series of 52 BRCA1 and BRCA2 mutation-negative cancer families, and a mutation-positive family was identified. ⋯ However, the 14538 G>A (Arg290His) mutation was identified in a family which did not exhibit features consistent with LFS or Li-Fraumeni-like (LFL) syndrome. Neither of the TP53 mutations was detected in 381 French Canadian women with breast cancer diagnosed before 50 years of age not selected for family history of cancer. In all, germline TP53 mutations were identified in two of 52 (3.8%) cancer families, suggesting that TP53 is not a major contributor to BRCA1 and BRCA2 mutation-negative breast and/or ovarian cancer families of French Canadian descent.
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Breast Cancer Res. Treat. · Mar 2008
Epidemiology and economic burden of brain metastases among patients with primary breast cancer: results from a US claims data analysis.
To estimate the incidence, prevalence, and economic burden of secondary breast cancer brain metastases (BCBM) among a US-based population of patients with primary breast cancer. ⋯ Secondary BCBM is a common occurrence among breast cancer patients, with rates increasing over time. Breast cancer patients with secondary BCBM incurred significantly more health care resources following diagnosis compared to those with breast cancer but no BCBM. Mean total costs for BCBM patients were more than double those of patients without BCBM at 6 and 12 months. The increasing prevalence and economic burden associated with BCBM suggests an unmet need that could be filled with newer treatments that improve breast cancer outcomes, including the prevention or delay of BCBM.
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Breast Cancer Res. Treat. · Feb 2008
Advanced stages and poorly differentiated grade are associated with an increased risk of HER2/neu positive breast carcinoma only in White women: findings from a prospective cohort study of African-American and White-American women.
The primary objective of this study was to evaluate the race-specific risk associated with HER2/neu positive breast carcinoma in a prospective cohort design. Our secondary objectives were to assess prevalence of different breast cancer phenotypes between African-American and White women and to determine if race was associated with the risk of basal-like breast carcinoma phenotype in this cohort. ⋯ The risk of HER2/neu positive breast carcinoma differs between African-American and White women. For White women only, this risk was statistically significant and increased almost linearly within each TNM stage with grade dedifferentiation. The statistically significantly higher prevalence of "ER(-)/PR(-), HER2(- )" phenotype in African American women potentially is the attributing factor to observed lack of an association between the risk of HER2/neu positive breast carcinoma with advanced stages and poorly differentiated grade. Among women diagnosed with "ER(-)/PR(-), HER2(-)" phenotype the odds ratios of being African-American and pre-menopausal was 1.72 (95% CI 1.17-2.54, P = 0.006) and 1.94 (95% CI 1.27-2.96, P = 0.002), respectively. The histologic features of basal-like and ER(-)/HER2(+ )carcinomas overlaps. Differences in the biology of breast carcinoma between African American and White women are partially attributed to the disparity in more adverse pathologic prognostic indicators at the initial clinical presentation of this disease.