Early breast cancer

早期乳腺癌
  • 文章类型: Case Reports
    免疫治疗是一种有前途的抗癌策略。在本报告中,一名36岁的女性患者,经病理诊断,报告左三阴性乳腺癌和腋窝淋巴结受累。患者接受免疫治疗联合无蒽环类新辅助化疗6个周期,在进行左乳房切除术和左腋窝淋巴结清扫术之前。术后病理是对治疗的完全反应,涉及从乳腺和相关淋巴结中根除肿瘤。然而,新辅助治疗2个周期后出现甲状腺功能异常.甲状腺疾病的临床表现是短暂的甲状腺功能亢进4周和随后的甲状腺功能减退症,需要激素替代疗法.
    Immunotherapy is a promising anticancer strategy. In the present report, the case of a 36-year-old female patient with pathologically diagnosed, left triple-negative breast cancer and axillary lymph node involvement is reported. The patient received immunotherapy in combination with neoadjuvant anthracycline-free chemotherapy for six cycles, before undergoing left mastectomy and left axillary lymph node dissection. The postoperative pathology was a complete response to treatment, involving eradication of tumor from both the breast and the relevant lymph nodes. However, thyroid dysfunction occurred after two cycles of neoadjuvant treatment. The clinical presentation of the thyroid disorder was transient hyperthyroidism for 4 weeks and subsequent hypothyroidism, which required hormone replacement therapy.
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  • 文章类型: Multicenter Study
    背景:在非常年轻的患者中,缺乏探索早期乳腺癌(eBC)的数据。与36至50岁的对照组相比,我们评估了大量年龄≤35岁的患者的共同和内在预后因素。
    方法:在1990年至2014年期间接受初次手术的23,134例eBC患者的多中心队列中,对≤50例患者进行了回顾性分析。建立了DFS和OS的多变量Cox分析。评估年龄的独立影响,对≤35和36-50岁的患者进行1至3例病例对照分析。
    结果:在6481名患者中,556岁≤35岁,5925岁从36岁到50岁。年龄≤35岁与较大的肿瘤有关,更高等级,ER消极,宏观淋巴结受累(pN+宏观),淋巴管浸润(LVI),乳房切除术,和化疗(CT)的使用。在多变量分析中,年龄≤35岁与DFS恶化相关[HR1.56,95%CI1.32-1.84;p<0.001],和OS[HR1.29,95%CI1.03-1.60;p=0.025],就像高年级一样,大肿瘤,LVI,pN+宏,ER消极,诊断期,和缺乏ET或CT(对于DFS)。在DFS的病例对照匹配分析中,年龄≤35岁对预后有不利影响[HR1.56,95CI1.28-1.91,p<0.001],和OS[HR1.33,95CI1.02-1.73,p=0.032]。当仅考虑患者≤35时,ER,肿瘤大小,节点状态,LVI和LVI与本亚组的生存率独立相关.
    结论:年龄≤35岁与不良表现和更积极的治疗策略相关。我们的结果支持年轻时的不良预后价值,在调整其他预后因素和治疗时,这种情况独立存在。
    BACKGROUND: There is a scarcity of data exploring early breast cancer (eBC) in very young patients. We assessed shared and intrinsic prognostic factors in a large cohort of patients aged ≤35, compared to a control group aged 36 to 50.
    METHODS: Patients ≤50 were retrospectively identified from a multicentric cohort of 23,134 eBC patients who underwent primary surgery between 1990 and 2014. Multivariate Cox analyses for DFS and OS were built. To assess the independent impact of age, 1 to 3 case-control analysis was performed by matching ≤35 and 36-50 years patients.
    RESULTS: Of 6481 patients, 556 were aged ≤35, and 5925 from 36 to 50. Age ≤35 was associated with larger tumors, higher grade, ER-negativity, macroscopic lymph node involvement (pN + macro), lymphovascular invasion (LVI), mastectomy, and chemotherapy (CT) use. In multivariate analysis, age ≤35 was associated with worse DFS [HR 1.56, 95% CI 1.32-1.84; p < 0.001], and OS [HR 1.29, 95% CI 1.03-1.60; p = 0.025], as were high grade, large tumor, LVI, pN + macro, ER-negativity, period of diagnostic, and absence of ET or CT (for DFS). Adverse prognostic impact of age ≤35 was maintained in the case control-matched analysis for DFS [HR 1.56, 95%CI 1.28-1.91, p < 0.001], and OS [HR 1.33, 95%CI 1.02-1.73, p = 0.032]. When only considering patients ≤35, ER, tumor size, nodal status, and LVI were independently associated with survival in this subgroup.
    CONCLUSIONS: Age ≤35 is associated with less favorable presentation and more aggressive treatment strategies. Our results support the poor prognosis value of young age, which independently persisted when adjusting for other prognostic factors and treatments.
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  • 文章类型: Case Reports
    Taxane-based chemotherapy regimens are in widespread use as standard of care treatment for patients with early breast cancer, though rarely its use can be complicated by taxane-induced pneumonitis (TIP). While breast cancer is the most diagnosed cancer in women worldwide, TIP remains under-described in this setting. Key questions relate to its incidence, diagnosis and management, potential predictive biomarkers, and the balance between this life-threatening toxicity and curatively intended treatment. At a single Australian institution, 6 cases of TIP are identified among 132 patients treated with a paclitaxel-containing regimen for early breast cancer (4.55%, 95% confidence interval 1.69-9.63%). This review first outlines the presentation, management, and outcomes for these cases, then answers these questions and proposes an approach to suspected TIP in patients with breast cancer.
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