ABSTRACT
Breast cancer is the most common type of cancer affecting women worldwide. Although there have been great improvements in treating the disease and at present between 80 and 90% of the women survive ≥5-years after their primary diagnosis. However, due to the high incidence of the disease >450,000 women succumb to breast cancer annually worldwide. The majority of improvements in breast cancer survival may be explained through better knowledge of the development and progression of the disease. Consequently, the treatments employed have become more effective. Furthermore, continuous efforts are being made for the identification of novel and efficient biomarkers for the timely prognosis of breast cancer. The present review aims to examine recent perspectives of breast cancer prognosis and the predictive factors involved.
ABSTRACT
The aim of the present study was to determine the usefulness of the positron emission tomography/computed tomography (PET/CT) with 18F-fluorodeoxyglucose (FDG) in the detection of recurrence or metastasization of differentiated thyroid carcinoma (DTC) in patients with abnormal thyroglobulin levels and negative findings on the 131I-diagnostic whole-body scanning (dWBS). Fifteen patients with DTC, abnormal thyroglobulin levels, and negative 131I-dWBS findings were scanned using the 18F-FDG PET/CT. Positive diagnosis was based on postoperative histologic findings, and clinical and imaging follow-up results obtained in the subsequent 6 months. In addition, preoperative and postoperative thyroglobulin levels were compared. Using the findings of 18F-FDG PET/CT and data on confirmed positive diagnosis, sensitivity and positive predictive value (PPV) were calculated. Sensitivity and PPV of PET/CT in detecting recurrence or metastasisization of DTC were 93.30 and 91.40%, respectively. Furthermore, postoperative thyroglobulin levels were markedly lower compared to the preoperative levels (respectively, 4.67±1.71 vs. 58.53±18.34 ng/ml; p<0.05). PET/CT scan with 18F-FDG is an informative technique for the detection of recurrent or metastasized DTC in patients with abnormal thyroglobulin levels and negative 131I-dWBS findings.
ABSTRACT
In the present study, we evaluated expressions of estrogen receptor (ER), progestin receptor (PR), human epidermal growth factor receptor-2 (HER-2), cyclooxygenase-2 (COX-2), and vascular endothelial growth factor (VEGF) in primary and relapsed/metastatic breast cancers to elucidate the clinical significance of these markers. The markers were evaluated by immunohistochemistry in specimens of 50 patients with primary or metastatic breast cancer. Positive rates of ER were significantly (p = 0.002) higher in primary versus relapsed/metastatic breast cancer (70 vs. 38 %, respectively). The VEGF positive expression rates were also significantly higher in primary versus metastatic cancer (82 vs. 38 %, respectively; p < 0.001). By contrast, positive rates of HER-2 and COX-2 were not significantly different between different types of cancer. COX-2 correlated with HER-2 expression in both primary and relapsed/metastatic focuses of breast cancer. COX-2 also correlated with VEGF expression in primary breast cancer. Expressions of ER, PR, HER2, and COX-2 did not correlate between primary and relapsed/metastatic breast cancers, indicating that the treatment decision should be made according to the status of these markers in relapsed/metastatic focuses. The total change rates of ER, PR, HER-2, COX-2, and VEGF were 26, 18, 10, 30, and 58 %, respectively. In conclusion, HER-2 and COX-2, along with VEGF, appear to play a role in the development and progression of breast cancer. In addition, all of the studied markers may serve as indicators of prognosis.