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Breast Cancer ,[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],Adjuvant systemic therapy Associated risks
[object Object],[object Object]
Most common prognostic and predictive factors for breast cancer ,[object Object],[object Object]
HER-2/neu ,[object Object],[object Object],[object Object],[object Object],[object Object]
Hormonal Receptors ,[object Object],[object Object],[object Object],[object Object]
Aim of Study ,[object Object],[object Object],[object Object],[object Object]
Patients and Methods ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object]
Patients and Methods ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Results
Distribution of Patient Baseline Characteristics (n=32) Characteristics Number(n=32) Percentage Age at diagnosis  (Years) <35  35-50 >50 2 15 15 6.2 46.9 46.9 Menstrual status Premenopausal Postmenopausal 15 17 46.9 53.1 Morphological stage IIB IIIA IIIB IIIC IV 7 12 7 4 2 21.9 37.5 21.9 12.5 6.2 Tumor size T1 T2 T3 T4 1 13 9 9 3.1 40.6 28.1 28.1 Nodal status N0 N1 N2 N3 4 13 11 4 12.5 40.6 34.4 12.5
Distribution of Patient Baseline Characteristics (n=32) Characteristics Number(n=32) Percentage Histological grade 1 2 3 Not known 0 15 9 8 0 46.9 28.1 25.0 Histological type Ductal Lobular Mixed Others 24 4 2 2 75.0 12.5 6.2 6.2 LVI Yes No Not known 3 21 8 9.4 65.6 25.0 HER-2 receptor Overexpressed/amplified No 16 16 50.0 50.0 Hormone receptor Both ER and PR positive ER/PR positive ER and PR negative 13 19 13 40.6 59.4 40.6
Distribution of Patient Baseline Characteristics (n=32) Characteristics Number(n=32) Percentage Neoadjuvant regimens CAF CMF Taxane-based and others 18 2 12 56.2 6.2 37.5 Surgery Modified radical mastectomy Radical mastectomy Not done 26 3 3 81.2 9.4 9.4 Adjuvant radiation therapy Yes No 24 8 75.0 25.0 Adjuvant endocrine therapy Yes No 19 13 59.4 40.6
Patient  Baseline Characteristics Stratified by Hormonal Receptor Status and HER-2 Overexpression Characterstics All patients n=32 HER-2 overexpression P Hormone receptor P Positive n(%) n=16 Negative n(%) n=16 Positive n(%) n=19 Negative n(%) n=13 Age <35 35-50 >50 2 15 15 1(6.3) 7(43.8) 8(50.0) 1(6.3) 8(50.0) 7(43.8) 0.94 1(5.3) 6(31.6) 12(61.2) 1(7.8) 9(69.2) 3(23.1) 0.08 Menstrual status Premenopausal Postmenopausal 15 17 8(50.0) 8(50.0) 7(43.8) 9(56.3) 1.00 11(57.9) 8(42.1) 4(30.8) 9(69.2) 0.25 Morphological stage IIB IIIA IIIB IIIC IV 7 12 7 4 2 3(18.8) 4(25.0) 4(25.0) 3(18.8) 2(12.5) 4(25.0) 8(50.0) 3(18.8) 1(6.3) 0(0) 0.33 5(26.3) 9(47.4) 3(15.8) 2(10.5) 0(0) 2(15.4) 3(23.1) 4(30.8) 2(15.4) 2(15.4) 0.24 Histological grade 1 2 3 Not known 0 15 9 8 0(0) 2(12.5) 9(56.3) 5(31.3) 0(0) 6(37.5) 6(37.5) 4(25.0) 0.26 0(0) 8(42.1) 9(47.4) 2(10.5) 0(0) 0(0) 6(46.1) 7(53.9) 0.005*
Correlation between Patient Characteristics and Clinical Response Characteristics All patients (n=32) Clinical response n(%) P value Age at diagnosis  (Years) <35  35-50 >50 2 15 15 1(50.0) 6(40.0) 8(53.3) 0.76 Menstrual status Premenopausal Postmenopausal 15 17 7(46.7) 8(47.1) 0.74 Morphological stage IIB IIIA IIIB IIIC IV 7 12 7 4 2 1(14.3) 6(50.0) 5(71.4) 2(50.0) 1(50.0) 0.31 Tumor size T1 T2 T3 T4 1 13 9 9 0(0) 7(53.8) 3(33.3) 5(55.6) 0.56 Nodal status N0 N1 N2 N3 4 13 11 4 2(50.0) 7(53.8) 4(36.4) 2(50.0) 0.86
Correlation between Patient Characteristics and Clinical Response Characteristics All patients (n=32) Clinical response n(%) P value Histological grade 1 2 3 Not known 0 15 9 8 0(0) 1(6.7) 9(100) 5(62.5) 0.08 HER-2 receptor Overexpressed/amplified No 16 16 7(43.5) 8(50) 1.0 Hormone receptor Positive Negative 19 13 7(36.8) 8(61.5) 0.31 Neoadjuvant regimens CAF CMF Taxane-based and others 18 2 12 8(44.4) 0(0) 7(58.3) 0.29
Kaplan-Meier Analysis of Overall Survival Mean OS HER-2 +    36.25 months HER-2 -    41.5 months Logrank test  P = 0.03 ,[object Object]
Kaplan-Meier Analysis of Overall Survival Mean OS HR +    41 months HR -    36.5 months Logrank test  P = 0.0009 (b) By Hormonal Receptor Status
Kaplan-Meier Analysis of Progression Free Survival  Mean PFS HER-2 +    14 months HER-2 -    22 months Logrank test  P = 0.14 (a) By HER-2 Receptor Status
Kaplan-Meier Analysis of Progression Free Survival  (b) By Hormonal Receptor Status
Univariate  Analysis of Prognostic Factors Factors OS P PFS P HR 95% CI HR 95% CI Age < 50 ≤   50 0.76 Reference 0.36-1.54 Reference 0.43 0.94 Reference 0.44-1.95 Reference 0.84 Tumor size T1-2 T3-4 1.07 Reference 0.51-2.25  Reference 0.85 0.84 Reference 0.38-1.72 Reference 0.59 Node N0-1 N2-3 0.83 Reference 0.39-1.68  Reference 0.58 0.63 Reference 0.25-1.23  Reference 0.15 Morphological staging IIB/IIIA-IIIB IIIC & IV 0.65 Reference 0.19-1.70  Reference 0.32 Reference 5.62 Reference 15.31-751.77 < 0.0001* HER-2 Positive Negative 1.96 Reference  1.07-5.33  Reference 0.03* 1.59  Reference 0.82-3.93  Reference 0.14 Hormone receptor Positive Negative Reference  2.87 Reference  1.92-12.76 0.0009* Reference  2.52 Reference  1.66-11.13 0.003*
[object Object],[object Object],[object Object],[object Object],Discussion
Discussion ,[object Object],[object Object],[object Object]
Conclusions ,[object Object],[object Object]
Breast Cancer Awareness

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Pyae phyo aung's thesis (breast cancer)

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  • 13. Distribution of Patient Baseline Characteristics (n=32) Characteristics Number(n=32) Percentage Age at diagnosis (Years) <35 35-50 >50 2 15 15 6.2 46.9 46.9 Menstrual status Premenopausal Postmenopausal 15 17 46.9 53.1 Morphological stage IIB IIIA IIIB IIIC IV 7 12 7 4 2 21.9 37.5 21.9 12.5 6.2 Tumor size T1 T2 T3 T4 1 13 9 9 3.1 40.6 28.1 28.1 Nodal status N0 N1 N2 N3 4 13 11 4 12.5 40.6 34.4 12.5
  • 14. Distribution of Patient Baseline Characteristics (n=32) Characteristics Number(n=32) Percentage Histological grade 1 2 3 Not known 0 15 9 8 0 46.9 28.1 25.0 Histological type Ductal Lobular Mixed Others 24 4 2 2 75.0 12.5 6.2 6.2 LVI Yes No Not known 3 21 8 9.4 65.6 25.0 HER-2 receptor Overexpressed/amplified No 16 16 50.0 50.0 Hormone receptor Both ER and PR positive ER/PR positive ER and PR negative 13 19 13 40.6 59.4 40.6
  • 15. Distribution of Patient Baseline Characteristics (n=32) Characteristics Number(n=32) Percentage Neoadjuvant regimens CAF CMF Taxane-based and others 18 2 12 56.2 6.2 37.5 Surgery Modified radical mastectomy Radical mastectomy Not done 26 3 3 81.2 9.4 9.4 Adjuvant radiation therapy Yes No 24 8 75.0 25.0 Adjuvant endocrine therapy Yes No 19 13 59.4 40.6
  • 16. Patient Baseline Characteristics Stratified by Hormonal Receptor Status and HER-2 Overexpression Characterstics All patients n=32 HER-2 overexpression P Hormone receptor P Positive n(%) n=16 Negative n(%) n=16 Positive n(%) n=19 Negative n(%) n=13 Age <35 35-50 >50 2 15 15 1(6.3) 7(43.8) 8(50.0) 1(6.3) 8(50.0) 7(43.8) 0.94 1(5.3) 6(31.6) 12(61.2) 1(7.8) 9(69.2) 3(23.1) 0.08 Menstrual status Premenopausal Postmenopausal 15 17 8(50.0) 8(50.0) 7(43.8) 9(56.3) 1.00 11(57.9) 8(42.1) 4(30.8) 9(69.2) 0.25 Morphological stage IIB IIIA IIIB IIIC IV 7 12 7 4 2 3(18.8) 4(25.0) 4(25.0) 3(18.8) 2(12.5) 4(25.0) 8(50.0) 3(18.8) 1(6.3) 0(0) 0.33 5(26.3) 9(47.4) 3(15.8) 2(10.5) 0(0) 2(15.4) 3(23.1) 4(30.8) 2(15.4) 2(15.4) 0.24 Histological grade 1 2 3 Not known 0 15 9 8 0(0) 2(12.5) 9(56.3) 5(31.3) 0(0) 6(37.5) 6(37.5) 4(25.0) 0.26 0(0) 8(42.1) 9(47.4) 2(10.5) 0(0) 0(0) 6(46.1) 7(53.9) 0.005*
  • 17. Correlation between Patient Characteristics and Clinical Response Characteristics All patients (n=32) Clinical response n(%) P value Age at diagnosis (Years) <35 35-50 >50 2 15 15 1(50.0) 6(40.0) 8(53.3) 0.76 Menstrual status Premenopausal Postmenopausal 15 17 7(46.7) 8(47.1) 0.74 Morphological stage IIB IIIA IIIB IIIC IV 7 12 7 4 2 1(14.3) 6(50.0) 5(71.4) 2(50.0) 1(50.0) 0.31 Tumor size T1 T2 T3 T4 1 13 9 9 0(0) 7(53.8) 3(33.3) 5(55.6) 0.56 Nodal status N0 N1 N2 N3 4 13 11 4 2(50.0) 7(53.8) 4(36.4) 2(50.0) 0.86
  • 18. Correlation between Patient Characteristics and Clinical Response Characteristics All patients (n=32) Clinical response n(%) P value Histological grade 1 2 3 Not known 0 15 9 8 0(0) 1(6.7) 9(100) 5(62.5) 0.08 HER-2 receptor Overexpressed/amplified No 16 16 7(43.5) 8(50) 1.0 Hormone receptor Positive Negative 19 13 7(36.8) 8(61.5) 0.31 Neoadjuvant regimens CAF CMF Taxane-based and others 18 2 12 8(44.4) 0(0) 7(58.3) 0.29
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  • 20. Kaplan-Meier Analysis of Overall Survival Mean OS HR + 41 months HR - 36.5 months Logrank test P = 0.0009 (b) By Hormonal Receptor Status
  • 21. Kaplan-Meier Analysis of Progression Free Survival Mean PFS HER-2 + 14 months HER-2 - 22 months Logrank test P = 0.14 (a) By HER-2 Receptor Status
  • 22. Kaplan-Meier Analysis of Progression Free Survival (b) By Hormonal Receptor Status
  • 23. Univariate Analysis of Prognostic Factors Factors OS P PFS P HR 95% CI HR 95% CI Age < 50 ≤ 50 0.76 Reference 0.36-1.54 Reference 0.43 0.94 Reference 0.44-1.95 Reference 0.84 Tumor size T1-2 T3-4 1.07 Reference 0.51-2.25 Reference 0.85 0.84 Reference 0.38-1.72 Reference 0.59 Node N0-1 N2-3 0.83 Reference 0.39-1.68 Reference 0.58 0.63 Reference 0.25-1.23 Reference 0.15 Morphological staging IIB/IIIA-IIIB IIIC & IV 0.65 Reference 0.19-1.70 Reference 0.32 Reference 5.62 Reference 15.31-751.77 < 0.0001* HER-2 Positive Negative 1.96 Reference 1.07-5.33 Reference 0.03* 1.59 Reference 0.82-3.93 Reference 0.14 Hormone receptor Positive Negative Reference 2.87 Reference 1.92-12.76 0.0009* Reference 2.52 Reference 1.66-11.13 0.003*
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