Indicators of prognosis in node-negative breast cancer

Article Abstract:

Studies of survival after the diagnosis of breast cancer suggest that patients fall into two groups, in terms of potential for cancer recurrence. Women in one group suffer from breast cancer that is rapidly fatal, while women in the other group have a survival rate that is similar to that of women without breast cancer. The majority of patients whose breast cancer is node-negative, meaning it has not spread to the lymph nodes, can simply have the tumor removed and will never experience recurrence. More breast cancer patients are expected to have this positive outcome, as improved screening methods are being used to diagnose the disease earlier. It has been predicted that over 50 percent of patients with a new diagnosis of breast cancer will be found to have node-negative cancer. Prognostic indicators are needed for categorizing women with node-negative cancer into those who should have systemic therapy, such as chemotherapy, after surgery and those who do not need it. Women at greater risk for recurrence should be identified and given the adjuvant (additional) therapy, while those at lower risk may not benefit from such treatment and may be harmed by the side effects. A group of 367 Swedish women with node-negative breast cancer were studied to identify prognostic indicators. All had the tumors surgically removed, and 83 women (28 percent) also received adjuvant therapy, which was tamoxifen in most cases. Different characteristics of the patients and their tumors were evaluated for their association with prognosis. Three useful indicators were identified; these were tumor size, progesterone-receptor status, and S-phase fraction, a characteristic of the tumor cells. Using these three indicators in a prognostic model, the subjects were divided into two groups: 37 percent of subjects were classified as high-risk for a delayed recurrence of cancer and the other 63 percent were low-risk. The low-risk group had a five-year overall survival rate of 92 percent, which did not differ from that of other Swedish women of the same ages. A prognostic index such as the one used here, which indicated the proliferative activity of the tumor cells, may be able to identify those patients with node-negative breast cancer who are at low-risk for recurrence and can safely avoid chemotherapy. (Consumer Summary produced by Reliance Medical Information, Inc.)

Management, Prognosis, Chemotherapy

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Gene-expression profiles in hereditary breast cancer

Article Abstract:

Women with hereditary breast cancer may have different levels of gene expression depending on whether they have the BRCA1 mutation or the BRCA2 mutation. In a study of 21 women with breast cancer, researchers found 176 genes that were expressed differently depending on whether the BRCA1 mutation was present of the BRCA2.

Gene expression

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Epigenetics in cancer

Article Abstract:

A number of epigenetic alterations occur during all stages of cancer that can be reversed easily by the use of therapeutic interventions. Some of these changes can be used as biomakers for early detection of cancer and help in treatment.

United States, Health aspects, Care and treatment, Diagnosis, Chromatin, Phenotype, Phenotypes, Epigenetic inheritance

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