High-risk breast cancer detection mode is associated with patient prognosis

According to a study presented at the 12th European Breast Cancer Conference on Saturday, breast cancers detected between mammograms in national screening programs have the same biology but are better than breast cancers detected during screening. The prognosis is poor.

Analysis of the results of a follow-up of more than 8 years in an international MINDACT randomized phase III clinical trial shows that tumors may have the same genetic makeup, but the way they are detected is the period prior to disease. Shows that it makes an important difference in whether it begins to spread to other parts of the body or leads to death, whichever comes first. This is known as distant metastasis-free interval (DMFI).

Dr. Josephine Lopez Cardoso (MD), PhD candidate for the Dutch Cancer Institute (NKI) in Amsterdam, the Netherlands, and a medical fellow at the European Cancer Research and Treatment Organization (EORTC) in Brussels, Belgium, have detection methods. He told the conference that he should provide additional prognostic information. Take this into consideration when deciding what treatment is needed in addition to surgery.

Dr. Lopes Cardozo and her colleagues have previously discovered that tumors that develop between mammography screenings are likely to have a high-risk genetic profile, as shown in tests examining 70 activities.Gene tumor Tissue (70 gene signature, commercially known as MammaPrint), therefore, was at high risk of distant metastasis.

“But some cancers have been detected by screening with the characteristics of 70 high-risk genes,” she said. “Current analysis shows significant differences in survival between high-risk cancers detected during screening or between screening intervals. The 8-year DMFI rate was higher in women with cancers detected during screening. It was higher than women with interval cancer. 93.8% vs. 85.2%.

“These tumors have the same biology, but all have 70 genes, high risk, and similar tumor characteristics, but show different prognosis based on the detection method. This is because the detection methods are in this group. The detection method combined with the 70 gene signature can further optimize the treatment of patients at high risk of recurrence. Patients with very low risk of recurrence. In the case of, longer follow-up also helps identify patients who are currently at risk. They are over-treated. “

1102 Dutch in total breast cancer Enrolled in the MINDACT trial between 2007 and 2011, participated in a national screening program, and included patients aged 50-75 years in the analysis. The Dutch National Screening Program invites women aged 50-75 to screen every two years. The researchers evaluated the difference in DMFI between high-risk, low-risk, and ultra-low-risk tumors, classified by the characteristics of 70 genes. A total of 754 cases were detected during the screening and 348 cases were detected between screenings.

Fifty percent of patients have reached at least 8.6 years of follow-up, with 83 distant metastases or deaths from breast cancer. Of the cancer patients detected by screening, 36% do not receive adjuvant systemic therapy (such as chemotherapy and hormone therapy in addition to surgery and radiation therapy), 33% receive only hormone therapy, and 30% receive hormone therapy. I received chemotherapy with or without. Of patients with intermittent cancer, 17% did not receive adjuvant systemic therapy, 35% received only hormone therapy, and 47% received chemotherapy with or without chemotherapy. Hormone therapy..

“Most patients who did not receive adjuvant systemic therapy had grade I tumors <2 cm, had no signs of cancer in the lymph nodes, and were classified as ultra-low risk or low-risk by 70-gene characteristics." Said Dr. Lopes Cardozo. ..

When researchers examined 8-year survival, screening-detected 8-year DMFI rates for cancer patients were 98.2% in 118 women with ultra-low-risk tumors and 94.6% in 398 low-risk women. I found out that there is. 93.8% of 238 women with risky tumors and high-risk tumors.

The 8-year DMFI rate for patients with intermittent cancer was 97.4% in 39 women with ultra-low-risk tumors, 92.2% in 143 women with low-risk tumors, and 85.2% in 166 women with high-risk tumors. ..

In patients with high-risk tumors, patients detected between screenings were 2.4 times more likely to develop distant metastases than patients with cancer detected during screening.

Dr. Lopes Cardozo concludes: “Both breast cancers detected by screening and intermittent breast cancers have a very good 8-year interval rate without distant metastases, but a significant screen for patients with high-risk tumors classified by the 70-gene signature. Differences in these percentages of cancers detected in and interval cancers. The combination of prognostic information provided by the 70-gene signature and detection methods will help select the best treatment for these patients. “

Professor David Cameron of the University of Edinburgh Cancer Center, who represents the European Breast Cancer Council of EBCC12, was not involved in this study. He commented: “This study highlights an interesting difference between breast cancer detected when women attend scheduled appointments as part of a national screening program (screening detection) and breast cancer diagnosed between screenings (interval cancer). Interval cancer is likely to be of high grade and was previously pointed out to be associated with poor outcome, but a new finding here is biological by the 70-gene signature test. About cancers that have been identified as being at high risk. What is detected by screening is better than what appears as intermittent cancer.

“If these results are confirmed in another series, it is Sieving The number of more biologically aggressive cancers is worth it: Screen detection of such cancers may improve patient survival.The findings also suggest that clinicians should consider detection methods as an additional prognostic factor when considering adjuvant therapy, allowing further personalization of therapy for individual women and her. ing cancer.. This is important for both low-risk and high-risk cancers. With longer follow-up periods for low-risk cancers, these tumors can recur after 15 to 20 years, which may provide more information about whether more aggressive treatment can be avoided. There is. ”

For more information:
Abstract No .: 11, “Breast cancer detected on screen has a different tumor biology and a better prognosis than interval breast cancer,” proposed paper session, Saturday 13.15 to 15.00 hours, Channel 3 (Dr Lopes Cardozo) The presentation will be 13.45 hours).

Provided by European organizations for cancer research and treatment