Breast cancers classified T4 according to the TNM code are frequent in Burkina Faso. A better knowledge of these cancers would help to better organize the fight against breast cancer in general. We conducted this stud...Breast cancers classified T4 according to the TNM code are frequent in Burkina Faso. A better knowledge of these cancers would help to better organize the fight against breast cancer in general. We conducted this study to present the clinical and prognostic aspects of T4 breast cancer in Ouagadougou. It was a descriptive retrospective study based on the medical record of patients received from January 1, 2017 to December 31, 2021 in the cancer department of Yalgado Ouedraogo University Hospital. Patients followed for histologically confirmed breast cancer who were classified in the cT4 category of the TNM code 8e edition were included. We collected a total of 286 patients. Non-salaried patients accounted for 90.56%. In this study, 53.3% of patients lived in urban area and 36.7% in rural area. Menopausal patients accounted for 56.8% of cases. One hundred and thirty-three (46.5%) patients were overweight or obese and 121 (42.3%) patients had a normal weight. The average consultation time, which is the time between the first signs and consultation in a specialized center, was 12 months, with a median of 11 months. According to category T of the TNM code, 19 patients (6.6%) were classified T4d, 176 (61.5%) were classified T4c, 69 (24.1%) were classified T4b and 22 (7.7%) T4a. One hundred and twenty patients (42%) were metastatic. The median overall survival of all patients in our sample was 20 months. In univariate analysis, metastatic status was risk factor for death, while obesity and surgery were protective factors. In multivariate analysis, obesity, surgery and metastatic status were independently associated with survival;obesity and surgery were protective factors. Survival is poor due to advanced stages and difficulties in the management of these cancers. Measures to facilitate access to care would improve the prognosis of these cancers.展开更多
Background: Breast cancer is the most common cancer in the world, as well as in Cameroon, where it represents about 20.1% of all cancers recorded in 2020. The number of pathologists in the country is as few as seven f...Background: Breast cancer is the most common cancer in the world, as well as in Cameroon, where it represents about 20.1% of all cancers recorded in 2020. The number of pathologists in the country is as few as seven for a population of about 26 million. The diagnostic performances of diagnostic modalities other than histology—clinical breast examination (CBE), imaging and fine needle aspiration and cytology (FNA)—in our context are not known. Study Objectives: Our objectives were to estimate the proportions of cases managed with mammography, breast ultrasound and FNA and to estimate the sensitivity, specificity, positive and negative predictive values, and accuracy of CBE, mammography, breast ultrasound and FNA;using histology as reference. Study Methodology: The study was cross-sectional and analytical, and was carried out at the Yaoundé General Hospital. It lasted twelve months, April 2015 through March 2016 and covered the period January 2010 to February 2016. Using histology as reference, we calculated measures of diagnostic accuracy for all four modalities using the statistical methods of Galen and Gambino. Results: We recruited 107 cases, 105 females (98.1%) and 02 males. We had 112 breast lumps, 106 malignant (94.6%) and 6 benign. The mean lump size was 61.1 mm. The most frequently used diagnostic tool after CBE was FNA (49.1%), while the diagnostic accuracies were 76.8%, 79.1%, 82.9%, and 82.0% for CBE, breast US, mammography and FNA. Conclusion: The four baseline diagnostic modalities for breast cancer are used sub-optimally and FNA appears to be the most commonly used in our setting after CBE. We recommend that FNA should be considered for diagnosis as appropriate but a negative result should not stop the quest for histological elimination of presence of malignancy.展开更多
Introduction: Breast cancer is the leading cancer and the leading cause of cancer death in women worldwide. The objective of our study was to describe the epidemiological, clinical and therapeutic aspects of breast ca...Introduction: Breast cancer is the leading cancer and the leading cause of cancer death in women worldwide. The objective of our study was to describe the epidemiological, clinical and therapeutic aspects of breast cancer at the General Hospital of Loandjili in Pointe Noire. Patients and Methods: This was a descriptive and cross-sectional study that took place in the Cancer Department of the General Hospital of Loandjili in Pointe Noire during the period from January 1st, 2012 to December 31st, 2016 for duration of 5 years. 54 records of patients over 18 years of age with histological evidence were collected. The variables studied were: age, level of education, time to presentation, telltale sign, stage of extension, histological type, and histological grade. Chi-square test was used to compare variables and groups. Results: At the end of this study, we collected 54 files of breast cancer patients from 150 patients hospitalized in the Cancer Department. The frequency of breast cancer was 36%. The average age was 50 ± 13.6 years;the extremes were 27 years and 79 years. The most represented age group was from 37 to 40 years old with a percentage of 28%. The patient’s level of study was primary in the majority of cases (57%). The most represented histological type was invasive ductal carcinoma, (100%). The majority of patients arrived at advanced stages 44.4% and metastatic stages 26%. Patients were treated in most of cases by chemotherapy (82%), surgery (42%) and radiotherapy (10%). There was a correlation between time of presentation and stage of extension. Conclusion: Breast cancer is the first cancer of the woman in Pointe Noire. Patients arrive at advanced stages;the most common histological type is invasive ductal carcinoma. The presentation time is correlated with the extension stage. These results suggest the establishment of a cancer control program in developing countries.展开更多
Breast cancer is a major public health problem because of its incidence and mortality. Purpose: To establish the epidemiological and clinical characteristics of breast cancer seen at the radiotherapy center at the Mal...Breast cancer is a major public health problem because of its incidence and mortality. Purpose: To establish the epidemiological and clinical characteristics of breast cancer seen at the radiotherapy center at the Mali Hospital of Bamako. Patients and methods: It was a retrospective, descriptive study of data from patients seen for breast cancer at the Center of Radiotherapy of Mali Hospital between April 2014 and December 2016. The parameters studied were: age, sex, family history of breast cancer, menopausal status, parity, breast tumor location, histological type, histological grade, cancer classification stage. Results: 134 cases of breast cancer were collected, with a frequency of 15%. The sex ratio (H/F) of 0.007. The patient’s mean age was 47 ± 11 years old. The most represented age groups were 33 - 47 years old with 45.5% and 48 - 62 years old with 39%. Three percent (3%) of patients had a family history of breast cancer. Fifty (50%) of the patients were menopausal. The main clinical signs found were : mammary nodules (98%), mastodynia (65%), nodes (67%). Invasive ductal carcinomas were found in 94% of patients, followed by infiltrating lobular carcinomas with 3.7% and metaplastic carcinomas with 1.7%. SBR Grades II and III were mostly found with 37% and 23%. The average tumor size was 87 mm ± 43. Stage III was predominantly represented with 72%, followed by Stage II with 24% and Stages I and IV with 2% each. Conclusion: Breast cancer is common and reaches both before and after 50 years;the diagnosis is usually late;hence it is the importance of raising awareness and screening before the age of 50 and popularizing some complementary tests to better understand the prognosis of this disease and promote more targeted and conservative treatments that will improve survival.展开更多
Context: Breast cancer represents a significant public health problem concern the world, given its frequency (20% to 25% of female cancers) and diagnosis clinical stage with a particular frequency of locally advanced ...Context: Breast cancer represents a significant public health problem concern the world, given its frequency (20% to 25% of female cancers) and diagnosis clinical stage with a particular frequency of locally advanced cancers and inflammatory forms. Objectives: To describe the socio-demographic, clinical and histological characteristics of breast cancer at the University Clinics of Kinshasa. Methods: A descriptive and retrospective study was completed at University Clinics of Kinshasa from 1 January 2003 to 30 July 2018, including 300 cases of breast cancer diagnosed and treated. Results: The mean age of women at diagnosis was 47.5 ± 10.8 years. Most of the patients were married, multipara with an average parity of 3.7 ± 2.5 and non-menopausal. Breast mass was the main reason for medical visit (47.5%) and the majority of patients consulted 12 months after the onset of the disease (36.3%) at stage 3 (56%) and node extension was observed in 61.3%. The average size of the breast mass was 8.02 ± 3.7 cm. The infiltrating ductal carcinoma was the most common histological type in 82.5% of cases;the majority of tumors were histo-pronostic II in 47.5% of cases. 83% of the tumors were hormonal-dependent. Only 35.9% of the tumors over-expressed the HER 2/Neu receptor. Conclusion: Most patients consulted more than 12 months after the onset of the disease and the diagnosis was made at advanced stages. The tumor was large at diagnosis. The left breast was the most affected. The majority of tumors are of high histopronostic grade and are hormonal-dependent.展开更多
INTRODUCTION: The objective of our study was to determine the epidemiological clinical and histological aspects of gynecological and breast cancers in Pointe-Noire. PATIENTS AND METHODS: This was a retrospective descr...INTRODUCTION: The objective of our study was to determine the epidemiological clinical and histological aspects of gynecological and breast cancers in Pointe-Noire. PATIENTS AND METHODS: This was a retrospective descriptive study that took place in the cancerology and internal medicine department during the period from January 1, 2012 to December 31, 2021, i.e. a period of 10 years. Women with histological diagnosis of gynecological and breast cancers were included in our study. The variables studied were: frequency, age, alcohol and tobacco consumption, histological type, stage of extension, location of cancer. Bivariate analysis was done between age and location of the tumour. The statistical test used was the KHI2 test. The results were statistically significant for a value of p RESULTS: We collected 400 files from women with cancer. Among the 400 files, 265 were represented by gynecological and breast cancers, that is a frequency of 65.43%. Among the 265 cases of gynecological and breast cancer identified during this study period, breast cancer represented the first rank with 52% frequency. Cervical cancer accounted for 41% followed by ovarian cancer (5%) and endometrial (2%). Cancer of vulva was represented by a single case. The average age of patients with gynecological and breast cancers during our study was 52 ± 12 years. The average age of patients with cancer of the breast, cervix, ovarian, endometrial was respectively 49 ± 11.97 years, 54.73 ± 12.91 years old, 50 ± 14 years, 67 ± 14.24 years, the age of the vulva cancer patient was 51 years old. The histological type of breast cancer was represented by infiltrating ductal adenocarcinoma in 91% of cases, invasive lobular carcinoma in 7% and sarcoma in 2%. Cervical cancers were represented by squamous cell carcinomas in 95% of cases and adenocarcinomas in 5% of cases. Vulva cancer was represented by squamous cell carcinoma, ovarian cancer was represented by epithelial tumors (adenocarcinoma) in 100% of cases. Endometrial cancers were represented by endometrial adenocarcinoma. All cancers were diagnosed at advanced stages (locoregional and metastatic stage). Patients over the age of 50 had more gynecological and breast cancers;but this result was not significant. CONCLUSION: Gynecological and breast cancers are frequent and constitute the first cancer of Congolese women in Pointe-Noire. Breast cancer is the first cancer followed by cancer of the cervix and ovaries. The histological types are those of the literature. Patients with gynecological and breast cancers consult at very advanced stages.展开更多
OBJECTIVE To investigate the clinical and pathological features,as well as prognosis in triple-negative breast cancer patients.METHODS A total of 509 cases of operable breast cancer from January,2002 to June,2002 trea...OBJECTIVE To investigate the clinical and pathological features,as well as prognosis in triple-negative breast cancer patients.METHODS A total of 509 cases of operable breast cancer from January,2002 to June,2002 treated in the Cancer Hospital of Tianjin Medical University were analyzed.The Her-2,ER and PR status was determined using immunohistochemistry.Of the total cases,one group was identifi ed as triple negative breast cancer,ie defi ned as ER,PR and Her-2 negative.The other group was non-triple-negative breast cancer.Clinicopathologic features of the groups were compared and 5-year disease-free survival(DFS) analyzed by the Kaplan-Meier method.RESULTS Of the total cases,21.4%(109/509) of cases were found to be triple-negative while 78.6%(400/509) were non-triple-negative.The triple negative group had higher incidence rates than the non-triple-negative group of the medullary type and Grade Ⅲ tumors(P < 0.05).There was no other difference in the clinicopathologic features between the 2 groups.From follow-up to June,2007,21.1%(23/109) of the triple-negative group and 12.7%(51/400) of the non-triple negative group had a local recurrence or distant metastasis,resulting in a signifi cant difference(P < 0.05).In the triple-negative group and non-triple-negative group,5-year DFS were 78.9% and 87.3% respectively.There was a statistically signifi cant difference between the 2 groups(P = 0.031).CONCLUSION Compared with non-triple-negative breast cancer,triple-negative breast cancer patients have an increased likehood of a local recurrence or distant metastasis and a poorer prognosis.展开更多
The implementation of molecular profiling technologies in oncology deepens our knowledge for the molecular landscapes of cancer diagnoses, identifying aberrations that could be linked with specific therapeutic vulnera...The implementation of molecular profiling technologies in oncology deepens our knowledge for the molecular landscapes of cancer diagnoses, identifying aberrations that could be linked with specific therapeutic vulnerabilities. In particular, there is an increasing list of molecularly targeted anticancer agents undergoing clinical development that aim to block specific molecular aberrations. This leads to a paradigm shift, with an increasing list of specific aberrations dictating the treatment of patients with cancer. This paradigm shift impacts the field of clinical trials, since the classical approach of having clinico-pathological disease characteristics dictating the patients' enrolment in oncology trials shifts towards the implementation of molecular profiling as prescreening step. In order to facilitate the successful clinical development of these new anticancer drugs within specific molecular niches of cancer diagnoses, there have been developed new, innovative trial designs that could be classified as follows: i)longitudinal cohort studies that implement(or not) "nested" downstream trials, 2) studies that assess the clinical utility of molecular profiling, 3) "master" protocol trials, iv) "basket" trials, v) trials following an adaptive design. In the present article, we review these innovative study designs, providing representative examples from each category and we discuss the challenges that still need to be addressed in this era of new generation oncology trials implementing molecular profiling. Emphasis is put on the field of breast cancer clinical trials.展开更多
<span style="font-family:Verdana;">Breast conservation surgery (BCS) and nipple-areola-sparing (NAS) mastectomy have been recognized as two milestones in this period. This study included 60 Egyptian fe...<span style="font-family:Verdana;">Breast conservation surgery (BCS) and nipple-areola-sparing (NAS) mastectomy have been recognized as two milestones in this period. This study included 60 Egyptian female patients with breast cancer, all of them were subjected to modified radical mastectomy operation. Methods: This study included female patients > 18 years old who have breast cancer with healthy looking non invaded skin of nipple and areola and excluded patients < 18 years old, patients unfit for surger, patients previously subjected to chemo or radiotherapy for breast cancer. We peformed clinical examination of 60 patients with breast cancer. We studied the relevant factors that affect NAC invasion such as patient’s age, menstrual state, family history, tumor size, tumor location (central vs peripheral), tumor to nipple distance, lymphovascular invasion of NAC, lymph node metastasis, histological tumor type, tumor stage, multifocal/multicentric tumors and (ER, PR, HER2) status. Result: In our study, we have shown that NAC invasion is strongly associated with: 1) Nipple retraction as a patient’s complaint;2) Tumor site;3) Tumor-nipple-distance ≤ 4 cm;4) Multifocal/multicentric tumor;5) Tumor grade (grade III tumors);6) Positive lymph node invasion;7) ER and PR receptors negativity;8) HER2 positivity. This helps in preoperative planning for selecting patients for NAS mastectomy. Conclusion: The ideal patients for NAS mastectomy are with these criteria: 1) Clinically normal nipple areola complex;2) Distance from the tumor to the nipple is >4 cm;3) No multifocal/multicentric tumor;4) Absence of lymph node invasion;5) Tumor grade (grade I, II);6) Peripheral not central tumor;7) No sub-areolar lymphovascular invasion (LVI);8) ER receptor positive;9) PR receptor positive;10) HER2 negative.</span>展开更多
文摘Breast cancers classified T4 according to the TNM code are frequent in Burkina Faso. A better knowledge of these cancers would help to better organize the fight against breast cancer in general. We conducted this study to present the clinical and prognostic aspects of T4 breast cancer in Ouagadougou. It was a descriptive retrospective study based on the medical record of patients received from January 1, 2017 to December 31, 2021 in the cancer department of Yalgado Ouedraogo University Hospital. Patients followed for histologically confirmed breast cancer who were classified in the cT4 category of the TNM code 8e edition were included. We collected a total of 286 patients. Non-salaried patients accounted for 90.56%. In this study, 53.3% of patients lived in urban area and 36.7% in rural area. Menopausal patients accounted for 56.8% of cases. One hundred and thirty-three (46.5%) patients were overweight or obese and 121 (42.3%) patients had a normal weight. The average consultation time, which is the time between the first signs and consultation in a specialized center, was 12 months, with a median of 11 months. According to category T of the TNM code, 19 patients (6.6%) were classified T4d, 176 (61.5%) were classified T4c, 69 (24.1%) were classified T4b and 22 (7.7%) T4a. One hundred and twenty patients (42%) were metastatic. The median overall survival of all patients in our sample was 20 months. In univariate analysis, metastatic status was risk factor for death, while obesity and surgery were protective factors. In multivariate analysis, obesity, surgery and metastatic status were independently associated with survival;obesity and surgery were protective factors. Survival is poor due to advanced stages and difficulties in the management of these cancers. Measures to facilitate access to care would improve the prognosis of these cancers.
文摘Background: Breast cancer is the most common cancer in the world, as well as in Cameroon, where it represents about 20.1% of all cancers recorded in 2020. The number of pathologists in the country is as few as seven for a population of about 26 million. The diagnostic performances of diagnostic modalities other than histology—clinical breast examination (CBE), imaging and fine needle aspiration and cytology (FNA)—in our context are not known. Study Objectives: Our objectives were to estimate the proportions of cases managed with mammography, breast ultrasound and FNA and to estimate the sensitivity, specificity, positive and negative predictive values, and accuracy of CBE, mammography, breast ultrasound and FNA;using histology as reference. Study Methodology: The study was cross-sectional and analytical, and was carried out at the Yaoundé General Hospital. It lasted twelve months, April 2015 through March 2016 and covered the period January 2010 to February 2016. Using histology as reference, we calculated measures of diagnostic accuracy for all four modalities using the statistical methods of Galen and Gambino. Results: We recruited 107 cases, 105 females (98.1%) and 02 males. We had 112 breast lumps, 106 malignant (94.6%) and 6 benign. The mean lump size was 61.1 mm. The most frequently used diagnostic tool after CBE was FNA (49.1%), while the diagnostic accuracies were 76.8%, 79.1%, 82.9%, and 82.0% for CBE, breast US, mammography and FNA. Conclusion: The four baseline diagnostic modalities for breast cancer are used sub-optimally and FNA appears to be the most commonly used in our setting after CBE. We recommend that FNA should be considered for diagnosis as appropriate but a negative result should not stop the quest for histological elimination of presence of malignancy.
文摘Introduction: Breast cancer is the leading cancer and the leading cause of cancer death in women worldwide. The objective of our study was to describe the epidemiological, clinical and therapeutic aspects of breast cancer at the General Hospital of Loandjili in Pointe Noire. Patients and Methods: This was a descriptive and cross-sectional study that took place in the Cancer Department of the General Hospital of Loandjili in Pointe Noire during the period from January 1st, 2012 to December 31st, 2016 for duration of 5 years. 54 records of patients over 18 years of age with histological evidence were collected. The variables studied were: age, level of education, time to presentation, telltale sign, stage of extension, histological type, and histological grade. Chi-square test was used to compare variables and groups. Results: At the end of this study, we collected 54 files of breast cancer patients from 150 patients hospitalized in the Cancer Department. The frequency of breast cancer was 36%. The average age was 50 ± 13.6 years;the extremes were 27 years and 79 years. The most represented age group was from 37 to 40 years old with a percentage of 28%. The patient’s level of study was primary in the majority of cases (57%). The most represented histological type was invasive ductal carcinoma, (100%). The majority of patients arrived at advanced stages 44.4% and metastatic stages 26%. Patients were treated in most of cases by chemotherapy (82%), surgery (42%) and radiotherapy (10%). There was a correlation between time of presentation and stage of extension. Conclusion: Breast cancer is the first cancer of the woman in Pointe Noire. Patients arrive at advanced stages;the most common histological type is invasive ductal carcinoma. The presentation time is correlated with the extension stage. These results suggest the establishment of a cancer control program in developing countries.
文摘Breast cancer is a major public health problem because of its incidence and mortality. Purpose: To establish the epidemiological and clinical characteristics of breast cancer seen at the radiotherapy center at the Mali Hospital of Bamako. Patients and methods: It was a retrospective, descriptive study of data from patients seen for breast cancer at the Center of Radiotherapy of Mali Hospital between April 2014 and December 2016. The parameters studied were: age, sex, family history of breast cancer, menopausal status, parity, breast tumor location, histological type, histological grade, cancer classification stage. Results: 134 cases of breast cancer were collected, with a frequency of 15%. The sex ratio (H/F) of 0.007. The patient’s mean age was 47 ± 11 years old. The most represented age groups were 33 - 47 years old with 45.5% and 48 - 62 years old with 39%. Three percent (3%) of patients had a family history of breast cancer. Fifty (50%) of the patients were menopausal. The main clinical signs found were : mammary nodules (98%), mastodynia (65%), nodes (67%). Invasive ductal carcinomas were found in 94% of patients, followed by infiltrating lobular carcinomas with 3.7% and metaplastic carcinomas with 1.7%. SBR Grades II and III were mostly found with 37% and 23%. The average tumor size was 87 mm ± 43. Stage III was predominantly represented with 72%, followed by Stage II with 24% and Stages I and IV with 2% each. Conclusion: Breast cancer is common and reaches both before and after 50 years;the diagnosis is usually late;hence it is the importance of raising awareness and screening before the age of 50 and popularizing some complementary tests to better understand the prognosis of this disease and promote more targeted and conservative treatments that will improve survival.
文摘Context: Breast cancer represents a significant public health problem concern the world, given its frequency (20% to 25% of female cancers) and diagnosis clinical stage with a particular frequency of locally advanced cancers and inflammatory forms. Objectives: To describe the socio-demographic, clinical and histological characteristics of breast cancer at the University Clinics of Kinshasa. Methods: A descriptive and retrospective study was completed at University Clinics of Kinshasa from 1 January 2003 to 30 July 2018, including 300 cases of breast cancer diagnosed and treated. Results: The mean age of women at diagnosis was 47.5 ± 10.8 years. Most of the patients were married, multipara with an average parity of 3.7 ± 2.5 and non-menopausal. Breast mass was the main reason for medical visit (47.5%) and the majority of patients consulted 12 months after the onset of the disease (36.3%) at stage 3 (56%) and node extension was observed in 61.3%. The average size of the breast mass was 8.02 ± 3.7 cm. The infiltrating ductal carcinoma was the most common histological type in 82.5% of cases;the majority of tumors were histo-pronostic II in 47.5% of cases. 83% of the tumors were hormonal-dependent. Only 35.9% of the tumors over-expressed the HER 2/Neu receptor. Conclusion: Most patients consulted more than 12 months after the onset of the disease and the diagnosis was made at advanced stages. The tumor was large at diagnosis. The left breast was the most affected. The majority of tumors are of high histopronostic grade and are hormonal-dependent.
文摘INTRODUCTION: The objective of our study was to determine the epidemiological clinical and histological aspects of gynecological and breast cancers in Pointe-Noire. PATIENTS AND METHODS: This was a retrospective descriptive study that took place in the cancerology and internal medicine department during the period from January 1, 2012 to December 31, 2021, i.e. a period of 10 years. Women with histological diagnosis of gynecological and breast cancers were included in our study. The variables studied were: frequency, age, alcohol and tobacco consumption, histological type, stage of extension, location of cancer. Bivariate analysis was done between age and location of the tumour. The statistical test used was the KHI2 test. The results were statistically significant for a value of p RESULTS: We collected 400 files from women with cancer. Among the 400 files, 265 were represented by gynecological and breast cancers, that is a frequency of 65.43%. Among the 265 cases of gynecological and breast cancer identified during this study period, breast cancer represented the first rank with 52% frequency. Cervical cancer accounted for 41% followed by ovarian cancer (5%) and endometrial (2%). Cancer of vulva was represented by a single case. The average age of patients with gynecological and breast cancers during our study was 52 ± 12 years. The average age of patients with cancer of the breast, cervix, ovarian, endometrial was respectively 49 ± 11.97 years, 54.73 ± 12.91 years old, 50 ± 14 years, 67 ± 14.24 years, the age of the vulva cancer patient was 51 years old. The histological type of breast cancer was represented by infiltrating ductal adenocarcinoma in 91% of cases, invasive lobular carcinoma in 7% and sarcoma in 2%. Cervical cancers were represented by squamous cell carcinomas in 95% of cases and adenocarcinomas in 5% of cases. Vulva cancer was represented by squamous cell carcinoma, ovarian cancer was represented by epithelial tumors (adenocarcinoma) in 100% of cases. Endometrial cancers were represented by endometrial adenocarcinoma. All cancers were diagnosed at advanced stages (locoregional and metastatic stage). Patients over the age of 50 had more gynecological and breast cancers;but this result was not significant. CONCLUSION: Gynecological and breast cancers are frequent and constitute the first cancer of Congolese women in Pointe-Noire. Breast cancer is the first cancer followed by cancer of the cervix and ovaries. The histological types are those of the literature. Patients with gynecological and breast cancers consult at very advanced stages.
基金a grant from Science and Technology Planning Project of Tanjin,China(No.043111111)
文摘OBJECTIVE To investigate the clinical and pathological features,as well as prognosis in triple-negative breast cancer patients.METHODS A total of 509 cases of operable breast cancer from January,2002 to June,2002 treated in the Cancer Hospital of Tianjin Medical University were analyzed.The Her-2,ER and PR status was determined using immunohistochemistry.Of the total cases,one group was identifi ed as triple negative breast cancer,ie defi ned as ER,PR and Her-2 negative.The other group was non-triple-negative breast cancer.Clinicopathologic features of the groups were compared and 5-year disease-free survival(DFS) analyzed by the Kaplan-Meier method.RESULTS Of the total cases,21.4%(109/509) of cases were found to be triple-negative while 78.6%(400/509) were non-triple-negative.The triple negative group had higher incidence rates than the non-triple-negative group of the medullary type and Grade Ⅲ tumors(P < 0.05).There was no other difference in the clinicopathologic features between the 2 groups.From follow-up to June,2007,21.1%(23/109) of the triple-negative group and 12.7%(51/400) of the non-triple negative group had a local recurrence or distant metastasis,resulting in a signifi cant difference(P < 0.05).In the triple-negative group and non-triple-negative group,5-year DFS were 78.9% and 87.3% respectively.There was a statistically signifi cant difference between the 2 groups(P = 0.031).CONCLUSION Compared with non-triple-negative breast cancer,triple-negative breast cancer patients have an increased likehood of a local recurrence or distant metastasis and a poorer prognosis.
文摘The implementation of molecular profiling technologies in oncology deepens our knowledge for the molecular landscapes of cancer diagnoses, identifying aberrations that could be linked with specific therapeutic vulnerabilities. In particular, there is an increasing list of molecularly targeted anticancer agents undergoing clinical development that aim to block specific molecular aberrations. This leads to a paradigm shift, with an increasing list of specific aberrations dictating the treatment of patients with cancer. This paradigm shift impacts the field of clinical trials, since the classical approach of having clinico-pathological disease characteristics dictating the patients' enrolment in oncology trials shifts towards the implementation of molecular profiling as prescreening step. In order to facilitate the successful clinical development of these new anticancer drugs within specific molecular niches of cancer diagnoses, there have been developed new, innovative trial designs that could be classified as follows: i)longitudinal cohort studies that implement(or not) "nested" downstream trials, 2) studies that assess the clinical utility of molecular profiling, 3) "master" protocol trials, iv) "basket" trials, v) trials following an adaptive design. In the present article, we review these innovative study designs, providing representative examples from each category and we discuss the challenges that still need to be addressed in this era of new generation oncology trials implementing molecular profiling. Emphasis is put on the field of breast cancer clinical trials.
文摘<span style="font-family:Verdana;">Breast conservation surgery (BCS) and nipple-areola-sparing (NAS) mastectomy have been recognized as two milestones in this period. This study included 60 Egyptian female patients with breast cancer, all of them were subjected to modified radical mastectomy operation. Methods: This study included female patients > 18 years old who have breast cancer with healthy looking non invaded skin of nipple and areola and excluded patients < 18 years old, patients unfit for surger, patients previously subjected to chemo or radiotherapy for breast cancer. We peformed clinical examination of 60 patients with breast cancer. We studied the relevant factors that affect NAC invasion such as patient’s age, menstrual state, family history, tumor size, tumor location (central vs peripheral), tumor to nipple distance, lymphovascular invasion of NAC, lymph node metastasis, histological tumor type, tumor stage, multifocal/multicentric tumors and (ER, PR, HER2) status. Result: In our study, we have shown that NAC invasion is strongly associated with: 1) Nipple retraction as a patient’s complaint;2) Tumor site;3) Tumor-nipple-distance ≤ 4 cm;4) Multifocal/multicentric tumor;5) Tumor grade (grade III tumors);6) Positive lymph node invasion;7) ER and PR receptors negativity;8) HER2 positivity. This helps in preoperative planning for selecting patients for NAS mastectomy. Conclusion: The ideal patients for NAS mastectomy are with these criteria: 1) Clinically normal nipple areola complex;2) Distance from the tumor to the nipple is >4 cm;3) No multifocal/multicentric tumor;4) Absence of lymph node invasion;5) Tumor grade (grade I, II);6) Peripheral not central tumor;7) No sub-areolar lymphovascular invasion (LVI);8) ER receptor positive;9) PR receptor positive;10) HER2 negative.</span>