Standardized data on the incidence and mortality of female and male breast cancers in Hungary between 2000 and 2016. / A noi és a férfiemlorák standardizált incidencia- és mortalitásadatai Magyarországon 2000 és 2016 között.

Összefoglaló. Bevezetés: A rákbetegségek incidencia- (gyakorisági) értékei világszerte, így Magyarországon is folyamatosan növekednek. Az emlorákok elofordulása és kórlefolyása a két nemben azonban sajátosan különbözik. Célkituzés: Célul tuztük ki, hogy megvizsgáljuk és értékeljük a noi és a férfiemlorák incidencia- és mortalitási (halálozási) adatait Magyarországon 2000 és 2016 között. Módszer: A Központi Statisztikai Hivatalból és a Nemzeti Rákregiszterbol származó adatok standardizált, 100 000 fore számított feldolgozása. Eredmények: Magyarországon a vizsgált idoszakban az emlorákok gyakoriságának növekedése megközelítoleg ugyanolyan mértéku (39%) volt, mint az összes ráké (34%). Az emelkedés jelentos: a 2016-ban 8,7% részarányú noi emlorák esetében 39%, a 0,22%-os részarányú férfiráknál 60%. Ezzel szemben a halálozási adatok jelentos mértéku csökkenéseket mutatnak mind az összes daganat, mind a noi emlorák vonatkozásában, míg a férfiemlorák esetében a csökkenés nagyobb mértéku. A rosszindulatú daganatok incidenciája és a 2-es típusú diabetes mellitus (2DM) prevalenciája egyaránt magasan szignifikáns korrelációt mutatott az egy fore jutó bruttó nemzeti össztermék (GDP) értékének növekedésével. Új megfigyelés, hogy a 2DM-növekedés idoben megelozte a daganatok incidenciájának növekedését. Következtetés: A vizsgált idoszakban a noi és a férfiemlorákok magyarországi gyakorisági és halálozási adatai a nemzetköziekhez hasonló tendenciákat mutatnak. A férfiemlorákok sokkal ritkábbak, de kezelésük kevésbé hatékony. Új szempont, hogy a rosszindulatú daganatok gyakoribb megjelenésében a klinikailag kedvezotlenebb 2DM százalékos arányának (prevalenciájának) emelkedése is jelentos tényezo lehet az elhízáshoz kapcsolódva. A GDP növekedése kedvezoen hathatott a halálozások csökkenésében a kedvezobb gyógyítási és megelozési feltételek megteremtésével. Ugyanakkor ennek a növekedésnek szerepe lehet az elhízással összefüggo 2DM prevalenciájának emelkedésében is. Orv Hetil. 2022; 163(5): 181-186. INTRODUCTION: The incidence of malignant cancers is continuously growing. In breast cancers, the incidence and clinical course are greatly different in the two genders. OBJECTIVE: We aimed to investigate the incidence and mortality of breast cancers in females and males in Hungary between 2000 and 2016. METHODS: The data derived from the Hungarian Central Statistical Office and the National Cancer Registry were evaluated and standardized for 100 000 inhabitants. RESULTS: In Hungary, the elevation of breast cancer incidence (39%) showed a similar extent as that of total tumours (34%). In female breast cancers representing a much greater percent (8.7% in 2016) than that in males (0.22%), the increase was significant (39%) as in males (60 %). On the other hand, mortality was significantly lower for both of them regarding total malignant and female breast tumours, whereas the decrease was greater in the male breast cancers. The increase of GDP per capita showed highly significant correlation with the incidence of malignant tumours and prevalence of diabetes mellitus type 2 (2DM). It was a new finding that the increase in the prevalence of 2DM precedes the elevation of the incidence of cancer. CONCLUSION: In Hungary, the data of incidence and mortality of female and male breast cancers showed similar tendencies as the international ones. The breast cancers of males were rarer but their treatment was less effective. However, it was a new aspect that in the increased incidence of malignant tumours also the greater prevalence of 2DM could be an important factor related to obesity. Orv Hetil. 2022; 163(5): 181-186.

Prognosis and Treatment Outcomes of Patients Undergoing Resection of Brain Metastases from Breast Cancer.

BACKGROUND: Brain metastases from breast cancer have poor prognosis and are a challenge to treat. Multiple treatment options are available. Descriptive and prognostic data on breast cancer brain metastases is limited. PATIENTS AND METHODS: This study analyzed clinical data of patients who underwent surgical resection of one or more brain metastases. Histological and clinical characteristics, as well as treatment modalities, were analyzed. RESULTS: Initial tumor stage or grade was found not to correlate with the median time to developing brain metastases or survival. Human epidermal growth factor receptor 2 (HER2)-positive status was not associated with shorter median time to developing brain metastases. No correlation was found between the number of brain metastases and patient outcome. Results confirm the survival benefit of surgical resection with or without irradiation. CONCLUSION: Data showed that patients with HER2-positive and those with triple-negative breast cancer develop brain metastases at lower stages but not earlier after diagnosis, and survival is mostly dependent on treatment modality rather than histological subtype.

Combined dabrafenib and trametinib treatment in a case of chemotherapy-refractory extrahepatic BRAF V600E mutant cholangiocarcinoma: dramatic clinical and radiological response with a confusing synchronic new liver lesion.

Since the prognosis of advanced cholangiocarcinoma (CCA) remains poor with traditional chemotherapy, attention has shifted to molecularly targeted agents. Results of available clinical studies reveal little or no benefit of using targeted agents in advanced CCA. Limitations of these trials could be the lack of comprehensive molecular and genetic characterization of CCA samples in order to identify potential drug targets. Here we report a case of a 59-year-old female with chemotherapy-refractor, metastatic extrahepatic cholangiocarcinoma (EHCCA). After failure of first-line chemotherapy with cisplatin plus gemcitabine, next generation sequencing (NGS) based tumor molecular profiling was performed on aspiration cytological sample, that revealed BRAF V600E mutation. Multidisciplinary team decided on the initiation of combined treatment with BRAF and MEK inhibitors. Dabrafenib was started orally 150 mg twice a day, adding trametinib 2 mg once a day. Right from the initiation of targeted therapy, significant clinical improvement had been observed. Even though the first restaging computed tomography (CT) scan at 8 weeks revealed spectacular decrease in all metastatic sites, a new hepatic mass of 67 mm × 40 mm was identified and interpreted as new metastatic lesion. As the clinical and radiological response was contradictory, CT-guided biopsy was taken from the hepatic lesion while the therapy was continued on. Histopathologic evaluation excluded the hepatic lesion from being a metastasis, instead described it as a fibrotic, inflammatory lesion. At 12 week, PET CT confirmed further tumor regression with complete regression of the multiple cerebral metastases. The therapy has been extremely well tolerated by the patient. According to our knowledge, this is the first reported case on a successful treatment of EHCCA with the combination of dabrafenib and trametinib. Our case highlights the importance of molecular profiling in CCA, in order to find potential actionable driver mutations for personalised treatment.