8/12/2019 OOTR SessionII Sasano

1/15

Prognostic and PredictivePrognostic and Predictive

BreastBreast CancerCancer

Hironobu Sasano, MD

Tohoku University Graduate School of Medicine,

8/12/2019 OOTR SessionII Sasano

2/15

e e n on o ar y reas ancer

enera

consensus:

pT1N0M0

Tumor 2.0 cm or less in greatest dimension

m c: m cro nvas on . cm or ess

T1a: 0.1 cm to 0.5 cm in greatest dimension

T1b: 0.5 cm to 1.0 cm in greatest dimension

T1c: 1.0 cm to 2.0 cm in greatest dimension

The size of the tumor is still one of the most

.

Fewer than 2% of T1a/T1bN0M0 patients wil l die of diseasewithin 5 yearsBreast. In: American Joint Committee on Cancer.: AJCC Cancer Staging Manual. 6th ed. New York, NY: Springer, 2002, pp 171-180.

8/12/2019 OOTR SessionII Sasano

3/15

8/12/2019 OOTR SessionII Sasano

4/15

Distinction Between Prognostic &

Predictive Factors

100105

Luminal A

Disease-Free Survival Prognosis in Japanese Patients

7580

8590 Luminal B

HER2

Basal

50556065 Unclassified

Trastuzumab

0 25 50 75 100 1253540 prognosis

Luminal A vs HER2: P = .0059

Luminal B vs HER2: P = .0046

8/12/2019 OOTR SessionII Sasano

5/15

N tti h difi ti ftti h difi ti f

o s an ar o rognos c ac ors

Nottingham modification ofottingham modification of

loom and Richardsonloom and Richardson

Tubular formation>75% of the tumor 1 10% to 75% 2

8/12/2019 OOTR SessionII Sasano

6/15

8/12/2019 OOTR SessionII Sasano

7/15

Biological Behavior of Carcinoma

Invasion Cell proliferation

In early breast cancer, cell proliferation

status is considered to la more im ortant

roles in biological behavior

8/12/2019 OOTR SessionII Sasano

8/15

8/12/2019 OOTR SessionII Sasano

9/15

8/12/2019 OOTR SessionII Sasano

10/15

8/12/2019 OOTR SessionII Sasano

11/15

8/12/2019 OOTR SessionII Sasano

12/15

Oncotype DX

Stage I & II ER(+), LN(-) patients: recurrence risks

and addit ive chemotherapy + tamoxifen treatment

Can be classified into low-risk, intermediate-risk, & high-risks patients

-

Paik S, et al. N Engl J Med. 2004;351:2817-2826. Paik S, et al. J Clin Oncol. 2006;24:3726-3734.

May need more studies for incorporation

8/12/2019 OOTR SessionII Sasano

13/15

What you can do in the management of

earl breast cancer in our dail ractice

sFOUR precise evaluations

in the resected s ecimens

for the benefits of the patients

8/12/2019 OOTR SessionII Sasano

14/15

1. Precise measurement of the size

.

Nottingham s criteria

8/12/2019 OOTR SessionII Sasano

15/15