Breast Disease Center

Port-Saint-Louis-du-Rhône, France

Breast Disease Center

Port-Saint-Louis-du-Rhône, France
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Biganzoli L.,Prato Hospital | Di Vincenzo E.,Prato Hospital | Jiang Z.,307 Hospital | Lichinitser M.,Modality | And 15 more authors.
Annals of Oncology | Year: 2012

Background: There are limited data on treatment outcomes in the growing population of elderly patients with locally recurrent/metastatic breast cancer (LR/mBC). To gain information on first-line bevacizumab combined with chemotherapy in the elderly, we analyzed data from the ATHENA trial in routine oncology practice. Patients and methods: Patients with human epidermal growth factor receptor-2-negative LR/mBC received firstline bevacizumab with standard chemotherapy until disease progression, unacceptable toxicity, or physician/patient decision. We carried out a subgroup analysis of safety and efficacy in patients aged ≥70 years. Possible correlations between tolerability and baseline comorbidities or Eastern Cooperative Oncology Group status were explored. Results: Bevacizumab was combined with single-agent paclitaxel in 46% of older patients. Only hypertension and proteinuria were more common in older than in younger patients (grade ≥3 hypertension: 6.9% versus 4.2%, respectively; grade ≥3 proteinuria: 4.0% versus 1.5%, respectively). Grade ≥3 arterial/venous thromboembolism occurred in 2.9% versus 3.3%, respectively. Further analysis revealed no relationship between baseline presence and severity of hypertension and risk of developing hypertension during bevacizumab-containing therapy. Median time to progression was 10.4 months in patients aged ≥70 years. Conclusions: These findings suggest that bevacizumab-containing therapy is tolerable and active in patients aged ≥70 years. Hypertension was more common than in younger patients but was manageable. We find no evidence precluding the use of bevacizumab in older patients, including those with hypertension, although age may influence chemotherapy choice. © The Author 2011. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved.


Frank S.,Breast Disease Center | Dupont A.,Clinical Epidemiology | Teixeira L.,Breast Disease Center | Teixeira L.,University Paris Diderot | And 7 more authors.
Breast | Year: 2016

Objectives: Since mammographic screening programmes, the proportion of DCIS has dramatically increased. Adjuvant radiotherapy (RT) after local excision (LE) has become a solid option for DCIS since 4 randomised trials have proven a decrease in local relapse (LR), though failing to prove a benefit on mortality rate. DCIS is a heterogeneous disease and it is unclear whether all patients uniformly benefit from radiotherapy. We report a descriptive analysis including all types of treatment. Materials and methods: Our retrospective cohort describes 608 women treated for DCIS in our centre between 1983 and 2013. Mastectomy was recommended before 1992, or for multifocal or >3 cm DCIS. LE alone was an option for DCIS ≤10 mm, with low or intermediate grade, and clear margins (≥2 mm). LE + RT was recommended for all other cases. Results: The median follow-up time was 6.7 years. Treatment consisted in mastectomy for 252 women, LE + RT for 269 and LE for 86. The major prognosis factor for LR rate was the type of treatment: LE + RT or LE was associated with a higher LR-rate than those treated by mastectomy (HR respectively 2.06; 95%CI 1.33-3.19; p = 0.001 and 2.12; 95%CI 1.20-3.65; p = 0.007). In our selected population, women treated by LE + RT versus LE showed no significant differences in LR (HR 0.97; 95%CI 0.61-1.7; p = 0.91).The overall survival rate was 99.7% after ten years, with no differences between the treatment groups. Conclusion: Although retrospective, our monocentric study suggests that LE alone could be an option for DCIS with good prognosis factors. Confirmation by larger randomised studies is needed. © 2015 Elsevier Ltd.


PubMed | Breast Disease Center, University Paris Diderot and Clinical Epidemiology
Type: | Journal: Breast (Edinburgh, Scotland) | Year: 2016

Since mammographic screening programmes, the proportion of DCIS has dramatically increased. Adjuvant radiotherapy (RT) after local excision (LE) has become a solid option for DCIS since 4 randomised trials have proven a decrease in local relapse (LR), though failing to prove a benefit on mortality rate. DCIS is a heterogeneous disease and it is unclear whether all patients uniformly benefit from radiotherapy. We report a descriptive analysis including all types of treatment.Our retrospective cohort describes 608 women treated for DCIS in our centre between 1983 and 2013. Mastectomy was recommended before 1992, or for multifocal or >3cm DCIS. LE alone was an option for DCIS 10mm, with low or intermediate grade, and clear margins (2mm). LE+RT was recommended for all other cases.The median follow-up time was 6.7 years. Treatment consisted in mastectomy for 252 women, LE+RT for 269 and LE for 86. The major prognosis factor for LR rate was the type of treatment: LE+RT or LE was associated with a higher LR-rate than those treated by mastectomy (HR respectively 2.06; 95%CI 1.33-3.19; p=0.001 and 2.12; 95%CI 1.20-3.65; p=0.007). In our selected population, women treated by LE+RT versus LE showed no significant differences in LR (HR 0.97; 95%CI 0.61-1.7; p=0.91). The overall survival rate was 99.7% after ten years, with no differences between the treatment groups.Although retrospective, our monocentric study suggests that LE alone could be an option for DCIS with good prognosis factors. Confirmation by larger randomised studies is needed.

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