فهرست مطالب

Archives of Breast Cancer
Volume:4 Issue: 4, Nov 2017

  • تاریخ انتشار: 1396/10/27
  • تعداد عناوین: 7
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  • Mohammed Reza Safaei Keshtgar Page 107
  • Hedieh Saghari, Elnaz Tabibian Pages 108-109
  • Amin Safavi, Ahmad Kaviani, Narjes Mohammadzadeh, Sanaz Zand, Ahmad Elahi, David Krag Pages 110-123
    Background
    The AJCC pN-staging system is the current risk stratification strategy for axillary nodal staging in most cancer centers. Recently, another staging system named "Lymph Node Ratio" or LNR has been developed and also postulated to have prognostic value. Precise prognostication of breast cancer by these two systems has multiple methodological dilemmas which are overlooked in the literature and still remain matters of debate.
    Methods
    These two issues are categorized into seven queries, including: the number of nodes considered adequate for proper axillary staging; attitude toward Z-0011 trial; impacts of neo-adjuvant therapies; the origin and evolution of stratification cutoffs; the position where patients without axillary involvement should be placed; role of diverse endpoints in survival definition, outcome analyses and prognosis prediction; and ultimately the current opinion regarding the superiority between the two systems. This review sought to explore these topics through analysis of 58 recently published articles found by MEDLINE search.
    Results
    The analysis revealed that precise prognostication by pN-staging system requires at least 10 excised-nodes, but LNR system minimally depends on the quantity of excised-nodes. Adhering to Z-0011 trial findings obstructs the provision of sufficient nodes for pN-staging. Neo-adjuvant chemotherapy alters the axillary nodal climate and therefore disrupts proper axillary staging. Cutoffs of LNR system have a more clear history of formation than the pN-stagings. Breast cancer-specific survival is the type of survival better portraying cancer-related events.
    Conclusions
    LNR system seems at least as accurate as pN-staging in prognostication of breast cancer patients.
    Keywords: Breast cancer, Prognostication, Pathologic node staging, Lymph node ratio, Z-0011 trial, Neo-adjuvant chemotherapy
  • Allan Ramos-Esquivel, Denis Landaverdea Pages 124-128
    Background
    Data regarding the prognostic value of androgen receptor (AR) expression in locally advanced breast cancer (LABC) is limited. We aimed to determine the pathological complete response, defined as ypT0/is and ypN0, in a group of patients with AR-positive breast cancer after preoperative treatment.
    Methods
    We evaluated immunohistochemical AR expression in 40 patients treated in our referral center. Univariate and multivariate models were used to assess the association between AR expression and pathological complete response (pCR).
    Results
    AR expression varied from 75% in estrogen receptor-positive tumors to 11.7% in triple-negative tumors (P
    Keywords: Androgen receptor, Breast cancer, Chemotherapy, Neoadjuvant treatment
  • Negar Mashoori, Sanaz Zand, Ryan Nazemian, Ahmad Kaviani Pages 129-135
    Background
    Breast cancer is the most prevalent site-specific cancer and one of the most frequent causes of cancer death in women worldwide. Neoadjuvant chemotherapy, along with surgical treatment—breast conserving surgery (BCS) or mastectomy—is an important part of treatment for locally advanced breast cancer. As BCS is preferred to mastectomy in terms of cosmetic, quality-of-life, and functional outcomes, it would be the preferred treatment for locally advanced breast cancer (LABC), if its oncological safety is confirmed.
    Methods
    In this study, we retrospectively compared the oncologic outcomes of post-neoadjuvant chemotherapy BCS with mastectomy in 202 patients with LABC.
    Results
    There were no significant differences between BCS and mastectomy regarding overall survival, local recurrence, contralateral breast cancer, and distant metastasis.
    Conclusions
    Our study showed that post-neoadjuvant chemotherapy BCS is an oncologically safe surgical treatment in LABC and that BCS can be considered as an acceptable treatment in selected patients with LABC.
    Keywords: Breast cancer, Neoadjuvant chemotherapy, Mastectomy, Breast-conserving surgery, Outcome, Survival
  • Sedigheh Hoseini, Bita Nasrolahi, Mahdi Aghili Pages 136-140
    Background
    Psychological factors such as hope of life can slow cancer progression by improving immune function, which results in better protection against illness and may help the body to fight cancer. It is of high importance in cancer patients, especially in women with breast cancer who may experience more stress. The present study investigated the predictability of hope of life based on spiritual well-being and psychological hardiness in women with breast cancer.
    Methods
    The population of this study included all women with breast cancer who were referred to Cancer Institute of Iran for follow-up in the fall of 2016. One-hundred four patients were recruited based on purposive sampling. They completed the validated questionnaires for hope, spiritual well-being, and psychological hardiness (consisting of commitment, control, and challenge subscales). Data were analyzed by using Pearson's correlation coefficient and hierarchical multiple regression.
    Results
    Finding indicated a significant positive relationship between hope of life and spiritual well-being as well as psychological hardiness (commitment, control, and challenge) in women with breast cancer (P
    Conclusion
    According to this study, patients with higher spiritual well-being and higher commitment (a subscale of psychological hardiness) had greater hope of life. Psychological interventions for strengthening these factors in women with breast cancer are suggested.
    Keywords: Hope, Spiritual well-being, Psychological hardiness, Breast cancer
  • Saeed Karimkhani Zandi, Fatemeh Heidari Pages 141-145
    Background
    Primary non-Hodgkin breast lymphoma is a rare pathology, representing 0.5 percent of malignant breast tumors.
    Case Presentation
    Here, we report a 54-year-old female presenting a mass in the left breast diagnosed by needle biopsy and IHC as a diffuse large B-cell lymphoma (DLBCL). Radiation therapy with conventional fields was applied for whole breast irradiation after the patient received 6 courses of R-CHOP (Rituximab plus Cyclophosphamide, Doxorubicin, Vincristine, and Prednisolone) chemotherapy. At the follow-up period 11 months after radiation therapy, no morbidities occurred and the patient is surviving with no evidence of disease.
    Conclusions
    The common treatments for breast lymphomas are surgery, radiation therapy, and chemotherapy. Although no agreement has been reached on the best therapy for primary breast lymphomas, these methods are commonly applied alone or in combination. It seems that R-CHOP combined with radiation therapy regimen could be an important treatment modality in avoiding unnecessary surgery.
    Keywords: Breast lymphoma, Primary breast lymphoma (PBL), Diffuse large B-cell lymphoma (DLBCL)