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- SourceAvailable from: Pawel Domagala[Show abstract] [Hide abstract]
ABSTRACT: PURPOSE To estimate 10-year overall survival (OS) rates for patients with early-onset breast cancer, with and without a BRCA1 mutation, and to identify prognostic factors among those with BRCA1-positive breast cancer. PATIENTS AND METHODSA total of 3,345 women with stage I to III breast cancer, age ≤ 50 years, were tested for three founder mutations in BRCA1. Information on tumor characteristics and treatments received was retrieved from medical records. Dates of death were obtained from the vital statistics registry. Survival curves for the mutation-positive and -negative subcohorts were compared. Predictors of OS were determined using the Cox proportional hazards model. RESULTS Of the 3,345 patients enrolled onto the study, 233 (7.0%) carried a BRCA1 mutation. The 10-year survival rate for mutation carriers was 80.9% (95% CI, 75.4% to 86.4%); for noncarriers, it was 82.2% (95% CI, 80.5% to 83.7%). The adjusted hazard ratio (HR) associated with carrying a BRCA1 mutation was 1.81 (95% CI, 1.26 to 2.61). Among BRCA1 carriers with a small (< 2 cm) node-negative tumor, the 10-year survival rate was 89.9%. Among BRCA1 mutation carriers, positive lymph node status was a strong predictor of mortality (adjusted HR, 4.1; 95% CI, 1.8 to 8.9). Oophorectomy was associated with improved survival in BRCA1 carriers (adjusted HR, 0.30; 95% CI, 0.12 to 0.75). CONCLUSION The 10-year survival rate among women with breast cancer and a BRCA1 mutation is similar to that of patients without a BRCA1 mutation. Among women with a BRCA1 mutation, survival was much improved after oophorectomy.
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ABSTRACT: Aims: Evaluation of FDG-PET usefulness in diagnosis and qualification for surgical treatment of advanced gastric cancer. Material and methods: Sixteen advanc ed gastric cancer patients (T2,N0-3,M0-1) who underwent FDG-PET/CT imaging and surgical treatment were evaluated retrospectively. Detailed data influencing cancer detection such as primary tumour size, depth of invasion, histological and Lauren classification type as well as tumour location were analysed. Correspondence between FDG-PET/CT and postoperative histo pathological evaluation of nodal involvement was assessed. Results: 60% of tumours larger than 4 cm, 75% of pT2 and pT3 tumours, 60% of mucocellular type and 75% of poorly or undifferentiated type tumours, and 77% of non-intestinal Lauren type tumours were detected. No tumour smaller than 4 cm was identified. 75% of tumours located in the middle one-third of the stomach were not detected. Also no resectable gastric cancer patient with nodal involvement was N(+) with FDG-PET/CT. Conclusions: 1. Primary tumour size and location may influence FDG-PET/CT results. 2. FDG-PET/CT is not a sufficient method of detection of all histological types of gastric cancer. 3. FDG-PET/CT is not a sufficient method of preoperative assessment of perigastric lymph nodes; thus this examination does not enable proper qualification for radical operative treatment in advanced gastric cancer (T2-4,N0-3,M0-1). 5. Detection of increased FDG uptake in perigastric lymph nodes may support unresectability of gastric cancer.
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