Breast density change as a predictive surrogate for response to adjuvant endocrine therapy in hormone receptor positive breast cancer
| Autor: | Woo Kyung Moon, Jung Min Chang, Seock-Ah Im, Hee-Chul Shin, Hye Ryoung Koo, Jee-Man You, Tae-You Kim, Sae-Won Han, Soo Kyung Ahn, Dong-Young Noh, Wonshik Han, Jisun Kim, Nariya Cho, Hyeong-Gon Moon |
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| Rok vydání: | 2012 |
| Předmět: |
Adult
Oncology medicine.medical_specialty Antineoplastic Agents Hormonal Estrogen receptor Breast Neoplasms Young Adult Breast cancer Risk Factors Surgical oncology Internal medicine medicine Humans Neoplasm Metastasis Aromatase Lymph node Survival analysis Aged Medicine(all) Gynecology biology business.industry Hazard ratio Middle Aged medicine.disease Combined Modality Therapy Tumor Burden Treatment Outcome medicine.anatomical_structure Receptors Estrogen Chemotherapy Adjuvant biology.protein Female Neoplasm Recurrence Local Receptors Progesterone business Biomarkers Tamoxifen Research Article Densitometry Follow-Up Studies Mammography medicine.drug |
| Zdroj: | Breast Cancer Research : BCR |
| ISSN: | 1465-542X |
| Popis: | Introduction Anti-estrogen therapy has been shown to reduce mammographic breast density (MD). We hypothesized that a short-term change in breast density may be a surrogate biomarker predicting response to adjuvant endocrine therapy (ET) in breast cancer. Methods We analyzed data for 1,065 estrogen receptor (ER)-positive breast cancer patients who underwent surgery between 2003 and 2006 and received at least 2 years of ET, including tamoxifen and aromatase inhibitors. MD was measured using Cumulus software 4.0 and expressed as a percentage. MD reduction (MDR) was defined as the absolute difference in MD of mammograms taken preoperatively and 8-20 months after the start of ET. Results At a median follow-up of 68.8 months, the overall breast cancer recurrence rate was 7.5% (80/1065). Mean MDR was 5.9% (range, -17.2% to 36.9%). Logistic regression analysis showed that age < 50 years, high preoperative MD, and long interval between start of ET to follow-up mammogram were significantly associated with larger MDR (p < 0.05). In a survival analysis, tumor size, lymph node positivity, high Ki-67 (≥ 10%), and low MDR were independent factors significantly associated with recurrence-free survival (p < 0.05). Compared with the group showing the greatest MDR (≥ 10%), the hazard ratios for MDRs of 5-10%, 0-5%, and < 0% were 1.33, 1.92, and 2.26, respectively. Conclusions MD change during short-term use of adjuvant ET was a significant predictor of long-term recurrence in women with ER-positive breast cancer. Effective treatment strategies are urgently needed in patients with low MDR despite about 1 year of ET. |
| Databáze: | OpenAIRE |
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