Low eicosapentaenoic acid and gamma-linolenic acid levels in breast adipose tissue are associated with inflammatory breast cancer.

OBJECTIVE: Since it is thought that breast adipose tissue could influence breast cancer clinical presentation, we wanted to characterize specifically the relationship between breast adipose tissue fatty acid profile and Inflammatory Breast cancer (IBC). METHODS: Two hundred thirty-four women presenting with breast cancer were managed in our centre between January 2009 and December 2011. Breast adipose tissue specimens were collected during breast surgery. We established the biochemical profile of adipose tissue fatty acids (FA) by gas chromatography and assessed whether there were differences in function of the presence of breast inflammation or not. RESULTS: We found that IBC was associated with decreased levels in breast adipose tissue of eicosapentaenoic acid (EPA), one of the two main polyunsaturated n-3 fatty acids (n-3 PUFA) of marine origin, but also with decreased levels of Gamma Linolenic acid (GLA). Inversely, an increase in palmitic acid levels was associated with IBC. CONCLUSION: These differences in lipid content may contribute to the occurrence of breast cancer inflammation.

Risk scoring system for predicting axillary response after neoadjuvant chemotherapy in initially node-positive women with breast cancer.

BACKGROUND: One of the current therapeutic challenges for women with breast cancer receiving neoadjuvant chemotherapy (NAC) is distinguishing women with complete axillary nodal response from those with axillary residual disease to promote a personalized therapeutic strategy including sparing axillary surgery. This study set out to develop a risk scoring system (RSS) for predicting probability of nodal pathological complete response (pCR) in women presenting with cN1 breast cancer who received NAC. METHODS: Data of 116 women with cN1 breast cancer who received NAC between January 2009 and December 2013 were abstracted from our prospectively maintained database. A risk model based on factors impacting nodal axillary was developed. RESULTS: The overall nodal conversion rate was 36.2% (42/116). Axillary nodal response was associated with three variables: menopausal status [Odds ratio (OR) = 0.23; 95% confidence interval (CI) 0.09-0.60], the radiological % of breast tumour shrinkage ≥50% (OR = 3.71; 95% CI 1.51-9.10), and negative hormone receptors (ER-, PR-) (OR = 2.41; 95% CI 0.99-5.87). These variables were included in the RSS and assigned scores ranging from 0 to 2. The discrimination of the RSS was 0.78 [95% confidence interval (CI) 0.69-0.86]. A total score of 3 points corresponded to the optimal threshold of the RSS. The diagnostic accuracy was 74.1%. CONCLUSIONS: This study shows that the probability of axillary nodal pCR after NAC can be accurately predicted so that women at high probability may be spared of axillary surgery.

Intrinsic and extrinsic flaws of the nomogram predicting bone-only metastasis in women with early breast cancer: An external validation study.

BACKGROUND: The recently developed MDACC nomogram purports to predict the risk of bone-only metastasis in women with early breast carcinoma based on five clinical and pathological characteristics. We set out to externally validate and assess its robustness using a tertiary breast cancer centre database. METHODS: All consecutive women treated for early breast cancer in our centre between January 1989 and December 2013 and who had all the nomogram variables documented were eligible for analysis. RESULTS: We identified 1255 eligible women for external validation analysis. The median follow-up was 54 months (range: 1-312) and time to initial metastasis 20 months (range: 1-80). The correspondence between the actual bone-only metastasis and the nomogram predictions implied poor calibration of the nomogram in the validation cohort, be it in the whole cohort or when stratified by breast cancer subtype. CONCLUSION: This external validation study of the MDACC nomogram showed limitations in its generalizability to a new and independent European patient population.