Cancer Research and Treatment

Original Articles

Ten-Year Follow-Up Clinical Outcomes and the Role of Adjuvant Chemotherapy in HER2-Positive Patients with Microinvasive Breast Cancer: Yeokyeong Shin, Soo-Young Lee, Hyehyun Jeong, Jin-Hee Ahn, Kyung Hae Jung, Sung-Bae Kim, Hee Jeong Kim, Jong Won Lee, Byung Ho Son, BeomSeok Ko, Ji Sun Kim, Il Yong Chung, Hee Jin Lee, Gyungyub Gong, Sae Byul Lee, Jae Ho Jeong; Received November 22, 2024 Accepted March 3, 2025 Published online March 5, 2025; DOI: https://doi.org/10.4143/crt.2024.1120 [Accepted]

Abstract PDF: Purpose
Although HER2 positivity is prevalent in microinvasive breast cancer (MIBC), data focused on HER2-positive MIBC are limited. We investigated the clinical course and long-term outcomes of HER2-positive MIBC and evaluated the role of adjuvant chemotherapy.
Materials and Methods
The study included patients with curatively resected pT1mi pN0 HER2-positive breast cancer between January 2000 and January 2020. Treatments and survival outcomes, including invasive breast cancer-free survival (IBCFS), distant recurrence-free survival (DRFS), and overall survival (OS) were analyzed.
Results
The analysis included 799 female patients. The median age was 51 years (range, 23–79), and 51.6% (n=412) were premenopausal. Multifocality was confirmed in 17.3% (n=138), and estrogen receptor (ER) positivity in 29.8% (n = 238). Adjuvant chemotherapy was administered to 17.5% (n=140), with doxifluridine in 96.4% of cases. One patient (0.1%) received trastuzumab. With a median follow-up of 119.0 months (95% CI, 114.0–127.0), the 8-year IBCFS, DRFS, and OS were 91.2% (95% CI, 89.1–93.3), 97.5% (95% CI, 96.4–98.7), and 98.8% (95% CI, 98.0–99.6), respectively. No significant differences were observed between patients with and without adjuvant chemotherapy. The lack of differences in IBCFS by chemotherapy was consistent across subgroups, including pre-/postmenopausal patients, grade 1-2/3 tumors, and ER-negative disease.
Conclusion
A clinically meaningful proportion of HER2-positive MIBC patients experience IBCFS events with long-term follow-up. Adjuvant chemotherapy did not improve survival, potentially due to the use of an outdated, ineffective regimen. The role of modern adjuvant regimens, particularly those incorporating HER2-targeted therapy, warrants further exploration.

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Breast cancer

Implementation of BRCA Test among Young Breast Cancer Patients in South Korea: A Nationwide Cohort Study: Yung-Huyn Hwang, Tae-Kyung Yoo, Sae Byul Lee, Jisun Kim, Beom Seok Ko, Hee Jeong Kim, Jong Won Lee, Byung Ho Son, Il Yong Chung; Cancer Res Treat. 2024;56(3):802-808. Published online February 19, 2024; DOI: https://doi.org/10.4143/crt.2023.1186

Abstract PDF Supplementary Material PubReader ePub: Purpose
This study aimed to investigate the frequency of BRCA testing and related factors among young breast cancer patients (age < 40 years) in South Korea.
Materials and Methods
We conducted a nationwide retrospective cohort study using data from the Health Insurance Review and Assessment claims. Newly diagnosed breast cancer patients younger than 40 were included. Annual BRCA testing ratios (number of BRCA test recipients/the number of patients undergoing breast cancer surgery in each year) were analyzed by region and health care delivery system. We investigated the location of breast cancer diagnosis and BRCA testing.
Results
From January 2010 to December 2020, there were 25,665 newly diagnosed young breast cancer patients, of whom 12,186 (47.5%) underwent BRCA testing. The BRCA testing ratios increased gradually from 0.084 (154/1,842) in 2010 to 0.961 (1,975/2,055) in 2020. Medical aid (vs. health insurance) and undergoing surgery in metropolitan cities or others (vs. Seoul), general hospitals, and clinics (vs. tertiary hospitals) were associated with a lower likelihood of BRCA testing. While 97.8% of the patients diagnosed in Seoul underwent BRCA testing in Seoul, 22.9% and 29.2% of patients who were diagnosed in metropolitan areas and other regions moved to Seoul and underwent BRCA testing, respectively.
Conclusion
The frequency of BRCA testing has increased over time in South Korea, with Seoul showing a particularly high rate of testing. About one-quarter of patients diagnosed with breast cancer outside of Seoul moved to Seoul and underwent BRCA testing.

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The Association of Estrogen Receptor Activity, Interferon Signaling, and MHC Class I Expression in Breast Cancer: In Hye Song, Young-Ae Kim, Sun-Hee Heo, Won Seon Bang, Hye Seon Park, Yeon ho Choi, Heejae Lee, Jeong-Han Seo, Youngjin Cho, Sung Wook Jung, Hee Jeong Kim, Sei Hyun Ahn, Hee Jin Lee, Gyungyub Gong; Cancer Res Treat. 2022;54(4):1111-1120. Published online December 21, 2021; DOI: https://doi.org/10.4143/crt.2021.1017

Abstract PDF Supplementary Material PubReader ePub

Purpose
The expression of major histocompatibility complex class I (MHC I) has previously been reported to be negatively associated with estrogen receptor (ER) expression. Furthermore, MHC I expression, level of tumor-infiltrating lymphocytes (TILs), and expression of interferon (IFN) mediator MxA are positively associated with one another in human breast cancers. This study aimed to investigate the mechanisms of association of MHC I with ER and IFN signaling.
Materials and Methods
The human leukocyte antigen (HLA)-ABC protein expression was analyzed in breast cancer cell lines. The expressions of HLA-A and MxA mRNAs were analyzed in MCF-7 cells in Gene Expression Omnibus (GEO) data. ER and HLA-ABC expressions, Ki-67 labeling index and TIL levels in tumor tissue were also analyzed in ER+/ human epidermal growth factor receptor 2 (HER2)- breast cancer patients who randomly received either neoadjuvant chemotherapy or estrogen modulator treatment followed by resection.
Results
HLA-ABC protein expression was decreased after β-estradiol treatment or hESR-GFP transfection and increased after fulvestrant or IFN-γ treatment in cell lines. In GEO data, HLA-A and MxA expression was increased after ESR1 shRNA transfection. In patients, ER Allred score was significantly lower and the HLA-ABC expression, TIL levels, and Ki-67 were significantly higher in the estrogen modulator treated group than the chemotherapy treated group.
Conclusion
MHC I expression and TIL levels might be affected by ER pathway modulation and IFN treatment. Further studies elucidating the mechanism of MHC I regulation could suggest a way to boost TIL influx in cancer in a clinical setting.

Citations

Citations to this article as recorded by

Identifying Safeguards Disabled by Epstein-Barr Virus Infections in Genomes From Patients With Breast Cancer: Chromosomal Bioinformatics Analysis
Bernard Friedenson
JMIRx Med.2025; 6: e50712. CrossRef
Progesterone receptor-dependent downregulation of MHC class I promotes tumor immune evasion and growth in breast cancer
Julio C Tinoco, Harmony I Saunders, Lauryn Rose Werner, Xiaopeng Sun, Eilidh I Chowanec, Amanda Heard, Prabhakar Chalise, Jeffery M Vahrenkamp, Andrea E Wilson, Cong-Xiao Liu, Gangjun Lei, Junping Wei, Hugo Cros, Hisham Mohammed, Melissa Troester, Charles
Journal for ImmunoTherapy of Cancer.2025; 13(3): e010179. CrossRef
Neoadjuvant Chemotherapy Efficacy in Breast Cancer: Insights from Magnetic Resonance Imaging Compilation (MAGIC)
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Academic Radiology.2025;[Epub] CrossRef
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Nannan Chen, Xiaotian Li, Shenrui Zhou, Xin Peng, Senlin Xue, Yuetong Liu, Tingwang Jiang, Wei Yan
Toxics.2025; 13(6): 423. CrossRef
Estrogen receptor regulation of the immune microenvironment in breast cancer
Conor McGuinness, Kara L. Britt
The Journal of Steroid Biochemistry and Molecular Biology.2024; 240: 106517. CrossRef
Bioinformatic-Experimental Screening Uncovers Multiple Targets for Increase of MHC-I Expression through Activating the Interferon Response in Breast Cancer
Xin Li, Zilun Ruan, Shuzhen Yang, Qing Yang, Jinpeng Li, Mingming Hu
International Journal of Molecular Sciences.2024; 25(19): 10546. CrossRef
Hormone Receptor Signaling and Breast Cancer Resistance to Anti-Tumor Immunity
Alexandra Moisand, Mathilde Madéry, Thomas Boyer, Charlotte Domblides, Céline Blaye, Nicolas Larmonier
International Journal of Molecular Sciences.2023; 24(20): 15048. CrossRef

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General

Functional Impairments in the Mental Health, Depression and Anxiety Related to the Viral Epidemic, and Disruption in Healthcare Service Utilization among Cancer Patients in the COVID-19 Pandemic Era: Kyumin Kim, Harin Kim, Joohee Lee, Inn-Kyu Cho, Myung Hee Ahn, Ki Young Son, Jeong Eun Kim, Hee Jeong Kim, Sang Min Yoon, So Hee Kim, Moon Jung Kwon, Hwa Jung Kim, Su-Jin Koh, Seyoung Seo, Seockhoon Chung; Cancer Res Treat. 2022;54(3):671-679. Published online September 17, 2021; DOI: https://doi.org/10.4143/crt.2021.585

Abstract PDF PubReader ePub

Purpose
Literature is scarce regarding cancer care utilization during the massive outbreak of coronavirus disease 2019 (COVID-19) in the Republic of Korea. We investigated functional impairments in mental health and their relationships with depression, anxiety regarding the viral epidemic, and disruptions in healthcare service utilization among cancer patients in the COVID-19 pandemic era.
Materials and Methods
We used an online survey with questions related to the disturbances faced by patients with cancer in utilizing healthcare services in the pandemic era. Current mental health status was assessed using the Work and Social Adjustment Scale (WSAS), Stress and Anxiety to Viral Epidemics-6 (SAVE-6) scale, Patient Health Questionnaire-9 (PHQ-9), Insomnia Severity Index (ISI), Brief Resilience Scale (BRS), Cancer-Related Dysfunctional Beliefs about Sleep Scale (C-DBS), and Fear of COVID-19 over Cancer (FCC).
Results
Among the 221 responders, 95 (43.0%) reported disruptions in healthcare service utilization during the COVID-19 pandemic. Logistic regression analysis revealed that functional impairment in the mental health of these patients was expected due to disruptions in healthcare service utilization, high levels of depression, anxiety regarding the viral epidemic, fear of COVID over cancer, and low resilience. Mediation analysis showed that patient resilience and cancer-related dysfunctional beliefs about sleep partially mediated the effects of viral anxiety on functional impairment.
Conclusion
In this pandemic era, patients with cancer experience depression, anxiety regarding the viral epidemic, and disruptions in healthcare service utilization, which may influence their functional impairments in mental health.

Citations

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Liangjia Wei, Jiao Qin, Zhifeng Lin, Xinju Huang, Jinfeng He, Dee Yu, Fei Zhang, Sisi Li, Ping Cen, Mu Li, Tong Luo, Rongjing Zhang, Shanmei Zhong, Cai Qin, Zeyu Li, Yuan Yang, Huiqi Pan, Mengdi Zhao, Xiaoqiong Wu, Junjun Jiang, Hao Liang, Li Ye, Bingyu L
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Risk factors for heightened COVID‐19‐Related anxiety among breast cancer patients
Yash B. Shah, Stephanie Kjelstrom, Diana Martinez, Adam Leitenberger, Donna‐Marie Manasseh, Melissa Bollmann‐Jenkins, Ann Partridge, Virginia Kaklamani, Rowen Chlebowski, Sharon Larson, Marisa Weiss
Cancer Medicine.2023; 12(3): 3577. CrossRef
Discrepancy between desired time in bed and desired total sleep time in patients with cancer: The DBST index and its relationship with insomnia severity and sleep onset latency
Eulah Cho, Jaeeun Song, Joohee Lee, Inn-Kyu Cho, Dongin Lee, Hayun Choi, Harin Kim, Seockhoon Chung
Frontiers in Psychiatry.2023;[Epub] CrossRef
Health-related quality of life and depressive symptoms of patients with chronic diseases and the general population before and during the COVID-19 pandemic in Korea
Yeeun Park, Kyong Park
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Zahra Khiyali, Zeinab Naderi, Mohammadkazem Vakil, Hajar Ghasemi, Azizallah Dehghan, Mostafa Bijani
BMC Psychology.2023;[Epub] CrossRef
Does Viral Anxiety Influence the Insomnia Severity Among Patients With Insomnia Disorder During COVID-19 Pandemic?
Jana Sleiman, Eulah Cho, Dongin Lee, Inn-Kyu Cho, Seockhoon Chung, Omer Faruk Uygur
Sleep Medicine Research.2023; 14(1): 25. CrossRef
Associations of psychological status and ultrasonic characteristics of thyroid nodules in adults during the COVID-19 pandemic
Zhengwu Lei, Zhongxiang He, Ying Mei, Xiaoya Qi, Pingping Yu, Guoqiong Xu, Hongfeng Cheng, Ruixue Bai, Jing Deng
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The Impact of COVID-19 on Psychiatric Health in the Korean Population
Sheng-Min Wang, Sung-Hwan Kim, Won-Seok Choi, Hyun Kook Lim, Young Sup Woo, Chi-Un Pae, Won-Myong Bahk
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Adherence to Physical Distancing and Health Beliefs About COVID-19 Among Patients With Cancer
Sajida Fawaz Hammoudi, Oli Ahmed, Hoyoung An, Youjin Hong, Myung Hee Ahn, Seockhoon Chung
Journal of Korean Medical Science.2023;[Epub] CrossRef
Catastrophizing Maladaptive Coping Affects the Association Between Viral Anxiety and Fear of Progression in Cancer Patients During COVID-19 Pandemic
Hyuk Joo Lee, Cheolkyung Sin, Hyeyeong Kim, Hyeon-Su Im, Jae-Cheol Jo, Yoo Jin Lee, Youjin Kim, Junseok Ahn, Soyoung Yoo, Su-Jin Koh, Seockhoon Chung
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Esther Ortiz-Calvo, Gonzalo Martínez-Alés, Roberto Mediavilla, Elisabeth González-Gómez, Eduardo Fernández-Jiménez, María-Fe Bravo-Ortiz, Berta Moreno-Küstner
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The Validation Study of the Stress and Anxiety to Viral Epidemics−6 Scale Among Patients With Cancer in the COVID-19 Pandemic
Hyeyeong Kim, Harin Kim, Hyuk Joo Lee, Eulah Cho, Su-Jin Koh, Oli Ahmed, Seockhoon Chung
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Resilience, Social Support, and Anxious Preoccupation in Patients with Advanced Cancer during COVID-19 Pandemic
Veronica Velasco-Durantez, Paula Jimenez-Fonseca, Carla M. Martín Abreu, Ismael Ghanem, Manuel González Moya, Elena Asensio, María J. Corral, Adan Rodriguez-Gonzalez, Mireia Gil-Raga, Alberto Carmona-Bayonas, Caterina Calderon
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Mental Health in Postoperative Thyroid Patients During the COVID-19 Pandemic
Shijie Yang, Xiequn Xu
Frontiers in Endocrinology.2022;[Epub] CrossRef
Effect of Cancer-Related Dysfunctional Beliefs About Sleep on Fear of Cancer Progression in the Coronavirus Pandemic
Harin Kim, Inn-Kyu Cho, Dongin Lee, Kyumin Kim, Joohee Lee, Eulah Cho, C. Hyung Keun Park, Seockhoon Chung
Journal of Korean Medical Science.2022;[Epub] CrossRef
Insomnia Mediate the Influence of Reassurance-Seeking Behavior and Viral Anxiety on Preoccupation With COVID-19 Among the General Population
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Kyumin Kim, Seockhoon Chung, Eulah Cho, Jung Mun Choi, Dongin Lee, Inn-Kyu Cho
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A Nomogram for Predicting the Oncotype DX Recurrence Score in Women with T1-3N0-1miM0 Hormone Receptor‒Positive, Human Epidermal Growth Factor 2 (HER2)‒Negative Breast Cancer: Sae Byul Lee, Junetae Kim, Guiyun Sohn, Jisun Kim, Il Yong Chung, Hee Jeong Kim, Beom Seok Ko, Byung Ho Son, Sei-Hyun Ahn, Jong Won Lee, Kyung Hae Jung; Cancer Res Treat. 2019;51(3):1073-1085. Published online November 1, 2018; DOI: https://doi.org/10.4143/crt.2018.357

Abstract PDF Supplementary Material PubReader ePub

Purpose
This preliminary study was conducted to evaluate the association between Oncotype DX (ODX) recurrence score and traditional prognostic factors. We also developed a nomogram to predict subgroups with low ODX recurrence scores (less than 25) and to avoid additional chemotherapy treatments for those patients.
Materials and Methods
Clinicopathological and immunohistochemical variables were retrospectively retrieved and analyzed from a series of 485 T1-3N0-1miM0 hormone receptor-positive, human epidermal growth factor 2‒negative breast cancer patients with available ODX test results at Asan Medical Center from 2010 to 2016. One hundred twenty-seven patients (26%) had positive axillary lymph node micrometastases, and 408 (84%) had ODX recurrence scores of ≤25. Logistic regression was performed to build a nomogram for predicting a low-risk subgroup of the ODX assay.
Results
Multivariate analysis revealed that estrogen receptor (ER) score, progesterone receptor (PR) score, histologic grade, lymphovascular invasion (LVI), and Ki-67 had a statistically significant association with the low-risk subgroup. With these variables, we developed a nomogram to predict the low-risk subgroup with ODX recurrence scores of ≤25. The area under the receiver operating characteristic curve was 0.90 (95% confidence interval [CI], 0.85 to 0.96). When applied to the validation group the nomogram was accurate with an area under the curve = 0.88 (95% CI, 0.83 to 0.95).
Conclusion
The low ODX recurrence score subgroup can be predicted by a nomogram incorporating five traditional prognostic factors: ER, PR, histologic grade, LVI, and Ki-67. Our nomogram, which predicts a low-risk ODX recurrence score, will be a useful tool to help select patients who may or may not need additional ODX testing.

Citations

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A Novel Nomogram for Estimating a High-Risk Result in the EndoPredict® Test for Estrogen Receptor-Positive/Human Epidermal Growth Factor Receptor 2 (HER2)-Negative Breast Carcinoma
Víctor Macarrón, Itsaso Losantos-García, Alberto Peláez-García, Laura Yébenes, Alberto Berjón, Laura Frías, Covadonga Martí, Pilar Zamora, José Ignacio Sánchez-Méndez, David Hardisson
Cancers.2025; 17(2): 273. CrossRef
Nomogram Development for Assessing Oncotype DX Recurrence Scores in Breast Cancer: A Chinese Population Study
Jiayin Song, Lin Yang, Zhengqi Feng, Liyu Jiang
Cancer Medicine.2025;[Epub] CrossRef
Efficacy, safety, and predictive model of Palbociclib in the treatment of HR-positive and HER2-negative metastatic breast cancer
Wei Wang, Wenqian Lei, Ziru Fang, Ruiyuan Jiang, Xiaojia Wang
BMC Cancer.2024;[Epub] CrossRef
Development and validation of a clinical breast cancer tool for accurate prediction of recurrence
Asim Dhungana, Augustin Vannier, Fangyuan Zhao, Jincong Q. Freeman, Poornima Saha, Megan Sullivan, Katharine Yao, Elbio M. Flores, Olufunmilayo I. Olopade, Alexander T. Pearson, Dezheng Huo, Frederick M. Howard
npj Breast Cancer.2024;[Epub] CrossRef
Prediction of Oncotype DX Recurrence Score Based on Systematic Evaluation of Ki-67 Scores in Hormone Receptor-Positive Early Breast Cancer
Ji Min Kim, Eun Yoon Cho
Journal of Breast Cancer.2024; 27(3): 201. CrossRef
Development of a nomogram to predict recurrence scores obtained using Oncotype DX in Japanese patients with breast cancer
Akio Shibata, Nobuko Tamura, Keiichi Kinowaki, Aya Nishikawa, Kiyo Tanaka, Yoko Kobayashi, Takuya Ogura, Yuko Tanabe, Hidetaka Kawabata
Breast Cancer.2024; 31(6): 1018. CrossRef
Shear-wave elastography-based nomograms predicting 21-gene recurrence score for adjuvant chemotherapy decisions in patients with breast cancer
Ji Hyun Youk, Eun Ju Son, Joon Jeong, Hye Mi Gweon, Na Lae Eun, Jeong-Ah Kim
European Journal of Radiology.2023; 158: 110638. CrossRef
Prediction of Oncotype DX Recurrence Score Using Clinicopathological Variables in Estrogen Receptor-Positive/Human Epidermal Growth Factor Receptor 2-Negative Breast Cancer
Min Chong Kim, Sun Young Kwon, Jung Eun Choi, Su Hwan Kang, Young Kyung Bae
Journal of Breast Cancer.2023; 26(2): 105. CrossRef
Clinicopathological Factors Associated with Oncotype DX Risk Group in Patients with ER+/HER2- Breast Cancer
Ran Song, Dong-Eun Lee, Eun-Gyeong Lee, Seeyoun Lee, Han-Sung Kang, Jai Hong Han, Keun Seok Lee, Sung Hoon Sim, Heejung Chae, Youngmee Kwon, Jaeyeon Woo, So-Youn Jung
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A simplified risk scoring system for predicting high-risk groups in gene expression tests for patients with estrogen receptor-positive, human epidermal growth factor receptor 2-negative, and node-positive breast cancer
Kwang Hyun Yoon, Suk Jun Lee, Yujin Kim, Jee Hyun Ahn, Jee Ye Kim, Hyung Seok Park, Seung Il Kim, Seho Park
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Deep Learning-Based Pathology Image Analysis Enhances Magee Feature Correlation With Oncotype DX Breast Recurrence Score
Hongxiao Li, Jigang Wang, Zaibo Li, Melad Dababneh, Fusheng Wang, Peng Zhao, Geoffrey H. Smith, George Teodoro, Meijie Li, Jun Kong, Xiaoxian Li
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Matthew G. Davey, Amirhossein Jalali, Éanna J. Ryan, Ray P. McLaughlin, Karl J. Sweeney, Michael K. Barry, Carmel M. Malone, Maccon M. Keane, Aoife J. Lowery, Nicola Miller, Michael J. Kerin
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Austin D. Williams, Kate R. Pawloski, Hannah Y. Wen, Varadan Sevilimedu, Donna Thompson, Monica Morrow, Mahmoud El-Tamer
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Jing Yu, Jiayi Wu, Ou Huang, Jianrong He, Li Zhu, Weiguo Chen, Yafen Li, Xiaosong Chen, Kunwei Shen
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Matthew G. Davey, Éanna J. Ryan, Sami Abd Elwahab, Jessie A. Elliott, Peter F. McAnena, Karl J. Sweeney, Carmel M. Malone, Ray McLaughlin, Michael K. Barry, Maccon M. Keane, Aoife J. Lowery, Michael J. Kerin
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Bo Bae Choi
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Minji Koh, Jinhong Jung, Su Ssan Kim, Seung Do Ahn, Eun Kyung Choi, Il Yong Chung, Jong Won Lee, Sung-Bae Kim, Jae Ho Jeong
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Oncotype DX Predictive Nomogram for Recurrence Score Output: The Novel System ADAPTED01 Based on Quantitative Immunochemistry Analysis
Fabio Marazzi, Roberto Barone, Valeria Masiello, Valentina Magri, Antonino Mulè, Angela Santoro, Federica Cacciatori, Luca Boldrini, Gianluca Franceschini, Francesca Moschella, Giuseppe Naso, Silverio Tomao, Maria Antonietta Gambacorta, Giovanna Mantini,
Clinical Breast Cancer.2020; 20(5): e600. CrossRef

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Axillary Lymph Node Dissection Does Not Improve Post-mastectomy Overall or Disease-Free Survival among Breast Cancer Patients with 1-3 Positive Nodes: Ji Hyeon Joo, Su Ssan Kim, Byung Ho Son, Seung Do Ahn, Jin Hong Jung, Eun Kyung Choi, Sei Hyun Ahn, Jong Won Lee, Hee Jeong Kim, Beom Seok Ko; Cancer Res Treat. 2019;51(3):1011-1021. Published online October 16, 2018; DOI: https://doi.org/10.4143/crt.2018.438

Abstract PDF Supplementary Material PubReader ePub

Purpose
Axillary lymph node dissection (ALND) may be avoidable for breast cancer patients with 1-2 positive lymph nodes (LN) after breast-conserving therapy. However, the effects of ALND after mastectomy remain unclear because radiation is not routinely used. Herein, we compared the benefits of post-mastectomy ALND versus sentinel node biopsy (SNB) alone for breast cancer patients with 1-3 metastatic LNs.
Materials and Methods
A total of 1,697 patients with pN1 disease who underwent mastectomy during 2000-2015 were identified from an institutional database. Outcomes were compared using the inverse probability of treatment weighted method.
Results
Patients who underwent SNB tended to have smaller tumors, a lower histology grade, a lower number of positive LNs, and better immunohistochemical findings. After correcting all confounding factors regarding patient, tumor, and adjuvant treatment, the SNB and ALND groups did not differ in terms of overall survival (OS) and disease-free survival (DFS), distant metastasis and locoregional recurrence. The 10-year DFS and OS rates were 83% and 84%, respectively, during a median follow-up period of 93 months.
Conclusion
ALND did not improve post-mastectomy survival outcomes among patients with N1 breast cancer, even after adjusting for all histopathologic and treatment-related factors.

Citations

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Xueyi Zhao, Liu Yang, Congbo Cao, Zhenchuan Song
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Damiano GENTILE, Corrado TINTERRI
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Can Axillary Lymph Node Dissection be Omitted in Breast Cancer Patients with Metastatic Sentinel Lymph Nodes Undergoing Mastectomy? A Systematic Review and Meta‐Analysis of Real‐World Evidence
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World Journal of Surgery.2023; 47(10): 2446. CrossRef
De-implementation of Axillary Dissection in Women Undergoing Mastectomy for Breast Cancer
Laura D. Leonard, Thiago B. de Araujo, Christopher Quinn, Madeline B. Thomas, Laurel Beaty, Nicole M. Mott, Kathryn Colborn, Alicia A. Heelan, Sarah E. A. Tevis, Nicole Christian, Gretchen Arhendt, Ana L. Gleisner
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A multi-dimensional nomogram to predict non-sentinel lymph node metastases in T1–2HR+ breast cancer
Ke Xiang, Jialin Chen, Yu Min, Hang Chen, Jiaxin Yang, Daixing Hu, Yuling Han, Guobing Yin, Yang Feng
Frontiers in Endocrinology.2023;[Epub] CrossRef
Sentinel lymph node biopsy versus axillary lymph node dissection in breast cancer patients undergoing mastectomy with one to two metastatic sentinel lymph nodes: sub-analysis of the SINODAR-ONE multicentre randomized clinical trial and reopening of enrolm
Corrado Tinterri, Giuseppe Canavese, Wolfgang Gatzemeier, Erika Barbieri, Alberto Bottini, Andrea Sagona, Giulia Caraceni, Alberto Testori, Simone Di Maria Grimaldi, Carla Dani, Luca Boni, Paolo Bruzzi, Bethania Fernandes, Marta Scorsetti, Alberto Zambell
British Journal of Surgery.2023; 110(9): 1143. CrossRef
Efficacy and safety comparison between axillary lymph node dissection with no axillary surgery in patients with sentinel node-positive breast cancer: a systematic review and meta-analysis
Yu-Jia Fan, Jin-Cheng Li, De-Miao Zhu, Hai-Long Zhu, Yi Zhao, Xin-Bing Zhu, Gang Wu, Ting-ting Bai
BMC Surgery.2023;[Epub] CrossRef
Factores predictivos de metástasis en ganglios no centinela en el cáncer de mama con ganglio centinela positivo
Mariana Peyroteo, Rita Canotilho, Ana Margarida Correia, Catarina Baía, Cátia Ribeiro, Paulo Reis, Abreu de Sousa
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Optimizing Axillary Management in Clinical T1-2N0 Mastectomy Patients with Positive Sentinel Lymph Nodes
Olga Kantor, Jessica Means, Samantha Grossmith, Tanujit Dey, Jennifer R. Bellon, Elizabeth A. Mittendorf, Tari A. King
Annals of Surgical Oncology.2022; 29(2): 972. CrossRef
Predictive factors of non-sentinel lymph node disease in breast cancer patients with positive sentinel lymph node
Mariana Peyroteo, Rita Canotilho, Ana Margarida Correia, Catarina Baía, Cátia Ribeiro, Paulo Reis, Abreu de Sousa
Cirugía Española (English Edition).2022; 100(2): 81. CrossRef
Axilla lymph node dissection can be safely omitted in patients with 1–2 positive sentinel nodes receiving mastectomy: a large multi-institutional study and a systemic meta-analysis
Weiqi Gao, Shuangshuang Lu, Yufei Zeng, Xiaosong Chen, Kunwei Shen
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Surgeon Bias in the Management of Positive Sentinel Lymph Nodes
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James Sun, Brittany J. Mathias, Christine Laronga, Weihong Sun, Jun-Min Zhou, William J. Fulp, John V. Kiluk, M. Catherine Lee
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André Hennigs, Fabian Riedel, Manuel Feißt, Melitta Köpke, Mahdi Rezai, Ulrike Nitz, Mareike Moderow, Michael Golatta, Christof Sohn, Jörg Heil
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No Association of Positive Superficial and/or Deep Margins with Local Recurrence in Invasive Breast Cancer Treated with Breast-Conserving Surgery: Tae In Yoon, Jong Won Lee, Sae Byul Lee, Guiyun Sohn, Jisun Kim, Il Young Chung, Hee Jeong Kim, Beom Seok Ko, Byung Ho Son, Gyungyub Gong, Sung-Bae Kim, Su Ssan Kim, Seung Do Ahn, Minsung Chung, Sei Hyun Ahn; Cancer Res Treat. 2018;50(1):275-282. Published online April 14, 2017; DOI: https://doi.org/10.4143/crt.2017.041

Abstract PDF Supplementary Material PubReader ePub

Purpose
We evaluated the effect of positive superficial and/or deep margin status on local recurrence (LR) in invasive breast cancer treated with breast-conserving surgery (BCS) followed by radiotherapy.
Materials and Methods
In total, 3,403 stage 1 and 2 invasive breast cancer patients treated with BCS followed by radiotherapy from January 2000 to December 2008 were included in this study. These patients were divided into three groups according to margin status: clear resection margin status for all sections (group 1, n=3,195); positive margin status in superficial and/or deep sections (group 2, n=121); and positive peripheral parenchymal margin regardless of superficial and/or deep margin involvement (group 3, n=87). The LR-free survival between these three groups was compared and the prognostic role of margin status was analyzed.
Results
Across all groups, age, tumor size, nodal status, and human epidermal growth factor receptor 2 status did not significantly differ. High grade, positive extensive intraductal component, hormone receptor positivity, hormone therapy received, and chemotherapy not received were more prevalent in groups 2 and 3 than in group 1. Five-year LR rates in groups 1, 2, and 3 were 1.9%, 1.7%, and 7.7%, respectively. Multivariate analysis revealed that group 3 was a significant predictor for LR (hazard ratio [HR], 4.78; p < 0.001), but that positive superficial and/or deep margin was not (HR, 0.66; p=0.57).
Conclusion
Superficial and/or deep margin involvement following BCS is not an important predictor for LR.

Citations

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Locoregional Recurrence-Free Survival in Postmastectomy Breast Cancer: A Comparative Longitudinal Study of Hypofractionated Versus Conventional Fractionated Radiation Therapy
Suma Susan Meloot, Ciniraj Raveendran, IP Yadev
Indian Journal of Surgical Oncology.2025;[Epub] CrossRef
Assessment of Eligibility and Utilization of Accelerated Partial Breast Irradiation in Korean Breast Cancer Patients (KROG 22-15)
Seok-Joo Chun, Ji Hwan Jo, Yong Bae Kim, Sangjoon Park, Sung-Ja Ahn, Su Ssan Kim, Kyubo Kim, Kyung Hwan Shin
Cancer Research and Treatment.2024; 56(2): 549. CrossRef
Surgical margin status and survival outcomes of breast cancer patients treated with breast-conserving surgery and whole-breast irradiation after neoadjuvant chemotherapy
Jong-Ho Cheun, Young Joo Lee, Jun-Hee Lee, Yungil Shin, Jung Whan Chun, Soo Yeon Baek, Hong-Kyu Kim, Han-Byoel Lee, Jonghan Yu, Byung Joo Chae, Wonshik Han, Jeong Eon Lee
Breast Cancer Research and Treatment.2022; 194(3): 683. CrossRef
Comparison of Recurrence Rate Between Re-Excision With Radiotherapy and Radiotherapy-Only Groups in Surgical Margin Involvement of In Situ Carcinoma
Jun-Hee Lee, Hyunjun Lee, Yoon Ju Bang, Jai Min Ryu, Se Kyung Lee, Jonghan Yu, Jeong Eon Lee, Seok Won Kim, Seok Jin Nam, Byung Joo Chae
Journal of Breast Cancer.2022; 25(4): 288. CrossRef
Updates and Debate Concerning Margin Adequacy and Management following Breast-Conserving Surgery
Serena Bertozzi, Ambrogio P Londero, Jose Andres Diaz Nanez, Francesco Leone, Barbara Baita, Lucia La Verghetta, Milena Nobile, Daria Almesberger, Carla Cedolini
Clinical and Experimental Obstetrics & Gynecology.2022;[Epub] CrossRef
Feasibility and safety of breast-conserving surgery via a periareolar incision for cancers located far from the nipple–areolar complex: a retrospective study
Joohyun Woo, Jihae Lee, Se Hyun Paek, Woosung Lim
Journal of Cancer Research and Clinical Oncology.2021; 147(3): 893. CrossRef
Breast-conserving surgery with 3D-printed surgical guide: a single-center, prospective clinical study
Zhen-Yu Wu, Hee Jeong Kim, Jongwon Lee, Il Yong Chung, Jisun Kim, Saebyeol Lee, Byung Ho Son, Sei-Hyun Ahn, Hak Hee Kim, Joon Beom Seo, Jae Ho Jeong, Gyungyub Gong, Namkug Kim, BeomSeok Ko
Scientific Reports.2021;[Epub] CrossRef
Usefulness of 3D-surgical guides in breast conserving surgery after neoadjuvant treatment
Han Shin Lee, Hee Jeong Kim, Il Yong Chung, Jisun Kim, Sae Byul Lee, Jong Won Lee, Byung Ho Son, Sei Hyun Ahn, Hak Hee Kim, Joon Beom Seo, Jin Hee Ahn, Gyungyub Gong, Sangwook Lee, Namkug Kim, Beom Seok Ko
Scientific Reports.2021;[Epub] CrossRef
Partial chest wall radiation therapy for positive or close surgical margins after modified radical mastectomy for breast cancer without lymph node metastasis
Naoya Ishibashi, Haruna Nishimaki, Toshiya Maebayashi, Keita Adachi, Kenichi Sakurai, Shinobu Masuda, Masaharu Hata, Masahiro Okada
Asia-Pacific Journal of Clinical Oncology.2020; 16(1): 28. CrossRef
Impact of Oncotype DX Recurrence Score on the Patterns of Locoregional Recurrence in Breast Cancer (Korean Radiation Oncology Group 19-06)
Kyubo Kim, Jinhong Jung, Kyung Hwan Shin, Jin Ho Kim, Ji Hyun Chang, Su Ssan Kim, Haeyoung Kim, Won Park, Yong Bae Kim, Jee Suk Chang
Journal of Breast Cancer.2020; 23(3): 314. CrossRef
Magnetic resonance imaging based 3-dimensional printed breast surgical guide for breast-conserving surgery in ductal carcinoma in situ: a clinical trial
Zhen-Yu Wu, Aisha Alzuhair, Heejeong Kim, Jong Won Lee, Il Yong Chung, Jisun Kim, Sae Byul Lee, Byung Ho Son, Gyungyub Gong, Hak Hee Kim, Joon Beom Seo, Sei Hyun Ahn, Namkug Kim, BeomSeok Ko
Scientific Reports.2020;[Epub] CrossRef
Aktuelle chirurgische Therapie des Mammakarzinoms
Jasmin Zeindler, Fabienne Schwab
InFo Hämatologie + Onkologie.2019; 22(4): 15. CrossRef
Comparing long-term local recurrence rates of surgical and non-surgical management of close anterior margins in breast conserving surgery
George Boundouki, Joseph Ryan Wong Sik Hee, Natalie Croghan, Katie Stocking, Andrew Pieri, Adam Critchley, Cliona C. Kirwan, James R. Harvey
Breast Cancer Research and Treatment.2019; 176(2): 311. CrossRef
Therapy of isolated locoregional recurrent carcinoma of the breast
Lena Gabriel, Marina Schmidt, Stephanie Juhasz-Böss, Patrick Melchior, Anika von Heesen, Gilda Schmidt, Nicole Kranzhöfer, Erich-Franz Solomayer, Ingolf Juhasz-Böss, Georg-Peter Breitbach
Archives of Gynecology and Obstetrics.2019; 300(2): 365. CrossRef

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Survival Outcome of Combined GnRH Agonist and Tamoxifen Is Comparable to That of Sequential Adriamycin and Cyclophosphamide Chemotherapy Plus Tamoxifen in Premenopausal Patients with Lymph-Node–Negative, Hormone-Responsive, HER2-Negative, T1-T2 Breast Cancer: Guiyun Sohn, Sei Hyun Ahn, Hee Jeong Kim, Byung-Ho Son, Jong Won Lee, Beom Seok Ko, Yura Lee, Sae Byul Lee, Seunghee Baek; Cancer Res Treat. 2016;48(4):1351-1362. Published online April 6, 2016; DOI: https://doi.org/10.4143/crt.2015.444

Abstract PDF PubReader ePub

Purpose
The purpose of this study was to compare treatment outcomes between combined gonadotropin-releasing hormone agonist and tamoxifen (GnRHa+T) and sequential adriamycin and cyclophosphamide chemotherapy and tamoxifen (AC->T) in premenopausal patients with hormone-responsive, lymph-node–negative breast cancer.
Materials and Methods
In total, 994 premenopausal women with T1-T2, lymph-node–negative, hormone-receptor-positive, HER2-negative breast cancer between January 2003 and December 2008 were included in this retrospective cohort study. GnRHa+T and AC->T were administered to 608 patients (61.2%) and 386 patients (38.8%), respectively. Propensity score matching and inverse probability weighting were applied to the original cohort, and 260 patients for each treatment arm were included in the final analysis. Recurrence-free, cancer-specific, and overall survival was compared between the two treatment groups.
Results
A total of 994 patients were followed up for a median of 7.4 years (range, 0.5 to 11.4 years). The 5-year follow-up rate was 98.7%, and 13 patients were lost to follow-up. In propensity=matched cohorts (n=520), there was no difference in recurrence-free, cancer-specific, and overall survival rates between the two treatment groups (p=0.306, p=0.212, and p=0.102, respectively), and this was maintained after applying inverse probability weighting.
Conclusion
GnRHa+T is a reasonable alternative to AC-> T in patients with premenopausal, hormoneresponsive, HER2-negative, lymph-node–negative, T1-T2 breast cancer.

Citations

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Effectiveness of post-mastectomy adjuvant chemotherapy for the treatment of patients with prognostic stage IB breast cancer: A SEER-based study
HongMei Wang, Yi Peng, Jianbin Wu, ZhuangWei Chen, HuaLe Zhang
Asian Journal of Surgery.2023; 46(9): 3634. CrossRef
Risk of recurrence among patients with HR-positive, HER2-negative, early breast cancer receiving adjuvant endocrine therapy: A systematic review and meta-analysis
Elizabeth M. Salvo, Abril Oliva Ramirez, Jenilee Cueto, Ernest H. Law, Aaron Situ, Chris Cameron, Imtiaz A. Samjoo
The Breast.2021; 57: 5. CrossRef
Effectiveness of a 6-Month 22.5-mg Leuprolide Acetate Depot Formulation With Tamoxifen for Postoperative Premenopausal Estrogen Suppression in Hormone Receptor-Positive Breast Cancer
Zhen-Yu Wu, Young-jin Lee, Heejeong Kim, Jongwon Lee, Il Yong Chung, Jisun Kim, Saebyeol Lee, Byung-Ho Son, Sung-Bae Kim, Jae Ho Jeong, Gyungyub Gong, Sei-Hyun Ahn, BeomSeok Ko
Frontiers in Oncology.2021;[Epub] CrossRef
Changes in bone mineral density during 5 years of adjuvant treatment in premenopausal breast cancer patients
Minsung Kim, Hanna Kim, Sei Hyun Ahn, Vafa Tabatabaie, Sung Wook Choi, Guiyun Sohn, Sae Byul Lee, Beom Seok Ko, Il Yong Chung, Jisun Kim, Jong Won Lee, Byung Ho Son, Hee Jeong Kim
Breast Cancer Research and Treatment.2020; 180(3): 657. CrossRef
Change in Estradiol Levels among Premenopausal Patients with Breast Cancer Treated Using Leuprolide Acetate 11.25 Milligrams 3-Month Depot and Tamoxifen
Young-jin Lee, Zhen-Yu Wu, Hee jeong Kim, Jong Won Lee, Il Yong Chung, Jisun Kim, Sae Byul Lee, Byung Ho Son, Sung-Bae Kim, Jae Ho Jung, Gyungyub Gong, Sei-Hyun Ahn, BeomSeok Ko
Journal of Breast Cancer.2020; 23(5): 553. CrossRef
Survival outcome of combined GnRH agonist and tamoxifen is comparable to that of sequential adriamycin and cyclophosphamide chemotherapy plus tamoxifen in premenopausal patients with early breast cancer
Doonyapat Sa‑Nguanraksa, Thitikon Krisorakun, Wanee Pongthong, Pornchai O‑Charoenrat
Molecular and Clinical Oncology.2019;[Epub] CrossRef

15,492 View
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