Breast conserving surgery (BCS) for early breast cancer is now an accepted treatment, but there are controversies about its comparability with mastectomy. Thus, we investigated the survival outcomes who underwent BCS and modified radical mastectomy (MRM).
In this retrospective review, we analyzed the survival outcomes of 618 patients with early breast cancer who underwent two different surgery from January 2002 to December 2009. Postoperative pathologic difference, disease free survival period, overall survival period, recurrence pattern, recurrent rate and site were compared. In addition, preoperative patients data are also collected.
Disease free survival period of MRM and BCS was 108.46 months and 80.82 months, respectively (P< 0.01). However, there was no significant correlation between overall survival period and operative methods (P= 0.67). In addition, recurrence pattern (P= 0.21), recurrent rate (P= 0.36) and site (P= 0.45, P= 0.09) were not associated with operative method.
In this study, we can suggest that early breast cancer patients could improve their disease free survival if they underwent MRM. So, when we operate high risk breast cancer patients, MRM could be considered for their disease free life. Further studies may be required to establish appropriate strategy of surgery for early breast cancer.
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Peritoneal and gastrointestinal metastasis from breast cancer is very rare. We report here a rare case of metastatic peritoneal and gastric cancer from breast lobular carcinoma after modified radical mastectomy. A 65-year old woman presented with anorexia, nausea, vomiting and dyspepsia for several weeks at 44 months after surgery. Radiologic study showed peritoneal metastasis, and surgical histopathology reported peritoneal and omental metastatic carcinoma. Esophagogastroduodenoscopic (EGD) biopsy also confirmed metastatic carcinoma originated from breast primary.
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p53 is a tumor suppressor gene and plays an important role in the etiology of breast cancer. The aim of this study is to clarify clinical significance of p53 in Ductal Carcinoma in situ (DCIS), and discuss about survival effect.
The study subjects, 69 women with breast cancer, were a subset of patients operated from Jan 2005 to Dec 2006. We used a cutoff of 10% to distinguish between positive and negative p53 staining. The University of Southern California (USC)/Van Nuys Prognostic Index (VNPI) were compared with 2 categories of p53.
The positivity of p53 was found in 20 patients (29.0%) in DCIS. And negativity of p53 was found in 49 patients (71.0%). And 15 patients (21.7%) had a low USC/VNPI score, 42 patients (60.9%) intermediate and 12 patients (17.4%) a high score. The positivity of p53 was correlated with high USC/VNPI (
According to our study, p53 was associated with high USC/VNPI. These findings suggest that p53 can be used to classify DCIS into at least two subtypes with differing prognoses.
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Circulating tumor cells (CTCs) are defined as tumor cells circulating in the peripheral blood of patients, shed from either the primary tumor or from its metastases. The detection of circulating tumor cells (CTCs) in the peripheral blood of breast cancer patients may account for the different steps in the biologic progression of the disease. The detection of microscopic disease in patients with breast cancer is imperative to prognosis and can predict the efficacy of targeted treatments. In general, there are two main methods for their detection. These are based on cytometric and nucleic acid manipulation. Both methods generally require an enrichment step to increase sensitivity of the assay. This step is based on either detection of specific surface markers using immuno-selection and/or on morphological features, such as cell size or density. We review the methods of detecting CTCs, their prognostic implications, and opportunities to exploit the properties of CTCs to develop personalized therapy.
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