Prognostic & predictive factors of breast cancer
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1) Prognostic factors provide information about a patient's outcome without treatment, while predictive factors provide information about how a patient may respond to a specific treatment. 2) Many clinical factors, pathological features, tissue markers, and genomic expression profiles can provide prognostic and predictive information for breast cancer patients. 3) Key prognostic factors include age, tumor stage, tumor size, nodal involvement, histological grade, hormone receptor status, and intrinsic subtypes. Predictive factors include hormone receptor and HER2 status.
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Prognostic & predictive factors of breast cancer
- 1. Prognostic & Predictive factors of Breast Cancer Dr. MohammedFathyBayomy Lecturer of ClinicalOncology ZagazigUniversity
- 2. Definition Prognostic factor Parameter X Without Treatment Breast Cancer Population (Without X) (With X) Outcome 50% with Unfavorable outcome 50% with Favorable outcome 20% with Unfavorable outcome 80% with Favorable outcome (Positive or Negative prognostic factor)
- 3. Definition Predictive factor Parameter X TreatmentBreast Cancer Population (Without X) (With X) Response 90% with response 10% without response 10% with response 90% without response (Positive or negative predictive factor)
- 4. Definition Prognostic & Predictive factor Parameter X Receive or not Receive treatmentBreast Cancer Population (Without X) (With X) Response 90% with response 10% without response 10% with response 50% with Unfavorable outcome 50% with Favorable outcome 20% with Unfavorable outcome 80% with Favorable outcome 90% without response
- 5. Newly Diagnosed Non-Metastatic Breast Cancer Prognostics Clinical Factors Gene Expression Profile Patient Pathology Tissue Markers
- 6. Patient features Age Net Survival (%) Age Range Women 15–39 84.9 40–49 90.0 50–59 91.2 60–69 92.4 70–79 83.0 80–99 70.3 Five-Year Net Survival by Age, Women, England Breast Cancer (C50): 2009-2013 1 out of 5
- 7. Patient features Age 2 out of 5
- 8. Patient features Age 3 out of 5
- 9. Patient features Age 4 out of 5
- 10. Patient features Age 5 out of 5 Time Trend
- 11. Patient features Menopausal Status 1 out of 2 Age is a critical factor influencing the onset and persistence of chemotherapy-induced amenorrhea.
- 12. Patient features Menopausal Status 2 out of 2 Chemotherapy induced amenorrhea improve breast cancer treatment outcome.
- 13. Patient features Race 1 out of 2
- 14. Patient features Race 1 out of 1
- 15. Patient features Cigarette smoking 1 out of 1
- 16. Patient features Mammographic features: screening 1 out of 1
- 17. Patient features Mammographic features: breast density 1 out of 1
- 18. Patient features Mammographic features: multiplicity 1 out of 1
- 19. Pathological features Tumor Stage 1 out of 3
- 20. Pathological features Tumor Stage 2 out of 3
- 21. Pathological features Tumor Stage 3 out of 3
- 22. Pathological features Tumor Size (T) 1 out of 3
- 23. Pathological features Tumor Size (T) 2 out of 3
- 24. Pathological features Tumor Size (T) 3 out of 3
- 25. Pathological features Nodal Involvement 1 out of 2
- 26. Pathological features Nodal Involvement 2 out of 2
- 27. Pathological features Metastatic disease 1 out of 2
- 28. Pathological features Metastatic disease 2 out of 2
- 29. Pathological features Tumor Morphology 1 out of 4
- 30. Pathological features Tumor Morphology 2 out of 4
- 31. Pathological features Tumor Morphology 3 out of 4
- 32. Pathological features Tumor Morphology 4 out of 4
- 33. Pathological features Histological Grade 1 out of 1
- 34. Pathological features Peritumoral lymphovascular invasion (PLVI) 1 out of 2
- 35. Pathological features Peritumoral lymphovascular invasion (PLVI) 2 out of 2
- 36. Tissue Markers Hormone Receptors 1 out of 4
- 37. Tissue Markers Hormone Receptors 2 out of 4
- 38. Tissue Markers Hormone Receptors 3 out of 4
- 39. Tissue Markers Hormone Receptors 4 out of 4
- 40. Tissue Markers HER2 overexpression 1 out of 1
- 41. Genomic Profiles Genetic Heterogeneity 1 out of 1
- 42. Genomic Profiles Genetic Heterogeneity 1 out of 1
- 43. Genomic Profiles Gene Testing 1 out of 1 Heat Map
- 44. Genomic Profiles Gene Testing 1 out of 1
- 45. Genomic Profiles Gene Cluster 1 out of 3
- 46. Genomic Profiles Gene Cluster 2 out of 3
- 47. Genomic Profiles Gene Cluster 3 out of 3
- 48. Genomic Profiles Intrinsic List 1 out of 2
- 49. Genomic Profiles Intrinsic List 2 out of 2
- 56. Genomic Profiles Intrinsic Subtypes 1 out of 1
- 71. Express ER Most common. Luminal A possess a higher expression of the ER and oestrogen-associated genes ESR1, GATA3 and FOXA1 Do not express HER2/neu Ki-67 proliferation index- low Luminal A tumours are associated with a better prognosis Genomic Profiles Intrinsic Subtypes Luminal A
- 72. Express ER Variable HER2/neu expression Increased frequency of TP53 mutations Ki-67 proliferation index- high Luminal B tumours are associated with worse prognosis compared to Luminal A Genomic Profiles Intrinsic Subtypes Luminal B
- 73. Increased expression of genes located in the same region on chromosome 17q: human epidermal growth factor receptor 2 (ERBB2) and growth factor receptor bound protein 7 (GRB7). Associated with a high histological grade, low expression of ER and PR. Poor clinical outcome. Genomic Profiles Intrinsic Subtypes HER2 Enriched
- 74. Hormone receptor (ER and PR) and HER2/neu receptor negative. Expression of genes associated with myoepithelial cells: KRT5 (keratin 5), KRT17 (keratin 17), CNN1 (calponin 1), CAV1 (caveolin) and LAMB1 (laminin). Aggressive with a poorer disease-free and overall survival than the other breast cancer subtypes. Genomic Profiles Intrinsic Subtypes ER-negative subtypes
- 84. Genomic Expression Profiles 1 out of 3
- 85. Genomic Expression Profiles 2 out of 3
- 86. Genomic Expression Profiles 3 out of 3
- 87. Genomic Expression Profiles Recurrence Score (RS) Oncotype Dx 1 out of 7
- 88. Genomic Expression Profiles Recurrence Score (RS) Oncotype Dx 2 out of 7
- 89. Genomic Expression Profiles Recurrence Score (RS) Oncotype Dx 3 out of 7
- 90. Genomic Expression Profiles Recurrence Score (RS) Oncotype Dx 4 out of 7
- 91. Genomic Expression Profiles Recurrence Score (RS) Oncotype Dx 5 out of 7
- 92. Genomic Expression Profiles Recurrence Score (RS) Oncotype Dx 6 out of 7
- 93. Genomic Expression Profiles Recurrence Score (RS) Oncotype Dx 7 out of 7
- 94. Genomic Expression Profiles EP & Epclin score - Endopredict 1 out of 5
- 95. Genomic Expression Profiles 2 out of 5 EP & Epclin score - Endopredict Epclin score = EP score + Tumor size + N
- 96. Genomic Expression Profiles 3 out of 5 EP & Epclin score - Endopredict
- 97. Genomic Expression Profiles 4 out of 5 EP & Epclin score - Endopredict
- 98. Genomic Expression Profiles 5 out of 5 EP & Epclin score - Endopredict
- 99. Genomic Expression Profiles 1 out of 3 Breast Cancer Index (BCI)
- 100. Genomic Expression Profiles 2 out of 3 Breast Cancer Index (BCI)
- 101. Genomic Expression Profiles 2 out of 3 Breast Cancer Index (BCI)
- 102. Genomic Expression Profiles 1 out of 2 Risk of Recurrence (ROR) score - PAM50 (Prosigna)
- 103. Genomic Expression Profiles 2 out of 2 Risk of Recurrence (ROR) score - PAM50 (Prosigna)
- 104. Genomic Expression Profiles 1 out of 2 70-Gene Breast Cancer Recurrence Assay - MammaPrint MammaPrint Index (MPI)
- 105. Genomic Expression Profiles 1 out of 2 70-Gene Breast Cancer Recurrence Assay - MammaPrint
- 106. Genomic Expression Profiles 1 out of 1 80-Gene Molecular subtyping Assay - BluePrint
- 107. Genomic Expression Profiles 1 out of 1 Genomic Grade Index (GGI) - MapQuant Dx
- 108. Genomic Expression Profiles 1 out of 1 IHC4 Test
- 109. Genomic Expression Profiles 1 out of 7
- 110. Genomic Expression Profiles 2 out of 7
- 111. Genomic Expression Profiles 3 out of 7
- 112. Genomic Expression Profiles 4 out of 7
- 113. Genomic Expression Profiles 5 out of 7
- 114. Genomic Expression Profiles 6 out of 7
- 115. Genomic Expression Profiles 7 out of 7
- 116. Markers of Proliferation Mitotic Count S-phase fraction (SPF) 1 out of 2
- 117. Markers of Proliferation Ki-67 2 out of 2
- 118. Urokinase Plasminogen Activator (uPA) 1 out of 2
- 119. Urokinase Plasminogen Activator (uPA) 2 out of 2
- 120. Measurement of p53 1 out of 1
- 121. Measurement of HER2-ECD 1 out of 1
- 122. Other markers of invasion & metastasis 1 out of 1
- 123. Disseminated Tumor Cells (DTCs) 1 out of 1
- 124. Circulating Tumor Cells (CTCs) 1 out of 1
- 125. Circulating Tumor DNA (ctDNA) 1 out of 1