Prognostic Value of MammaPrint® in Invasive Lobular Breast Cancer.

BACKGROUND: MammaPrint® is a microarray-based gene expression test cleared by the US Food and Drug Administration to assess recurrence risk in early-stage breast cancer, aimed to guide physicians in making neoadjuvant and adjuvant treatment decisions. The increase in the incidence of invasive lobular carcinomas (ILCs) over the past decades and the modest representation of ILC in the MammaPrint development data set calls for a stratified survival analysis dedicated to this specific subgroup. STUDY AIM: The current study aimed to validate the prognostic value of the MammaPrint test for breast cancer patients with early-stage ILCs. MATERIALS AND METHODS: Univariate and multivariate survival associations for overall survival (OS), distant metastasis-free interval (DMFI), and distant metastasis-free survival (DMFS) were studied in a study population of 217 early-stage ILC breast cancer patients from five different clinical studies. RESULTS AND DISCUSSION: A significant association between MammaPrint High Risk and poor clinical outcome was shown for OS, DMFI, and DMFS. A subanalysis was performed on the lymph node-negative study population. In the lymph node-negative study population, we report an up to 11 times higher change in the diagnosis of an event in the MammaPrint High Risk group. For DMFI, the reported hazard ratio is 11.1 (95% confidence interval = 2.3-53.0). CONCLUSION: Study results validate MammaPrint as an independent factor for breast cancer patients with early-stage invasive lobular breast cancer. Hazard ratios up to 11 in multivariate analyses emphasize the independent value of MammaPrint, specifically in lymph node-negative ILC breast cancers.This study was supported in part by the European Union Seventh Framework Programme (FP7/2007–2013) under the RATHER project (Rational Therapy for Breast Cancer; grant agreement no. 258967

CT blurring induced bias of quantitative in-stent restenosis analyses

Rational and Objective: In CT systems, blurring is the main limiting factor for imaging in-stent restenosis. The aim of this study is to systematically analyze the effect of blurring related biases on the quantitative assessment of in-stent restenosis and to evaluate potential correction methods. Methods: 3D analytical models of a blurred, stented vessel are presented to quantify blurring related artifacts in the stent diameter measurement. Two correction methods are presented for an improved stent diameter measurement. We also examine the suitability of deconvolution techniques for correcting blurring artifacts. Results: Blurring results in a shift of the maximum of the signal intensity towards the center position of the stent, resulting in an underestimation of the stent diameter. This shift can be expressed as a function of the stent radius and width of the point spread function. The correction for this phenomenon reduces the error with 75 percent. Deconvolution reduces the blurring artifacts but introduces a ringing artifact. Conclusion: The analytical vessel models are well suited to study the influence of various parameters on blurring-induced artifacts. The blurring-related underestimation of the stent diameter can significantly be reduced using the presented corrections. Care should be taken into choosing suitable deconvolution filters since they may introduce new artifacts

Prognostic Value of MammaPrint(®) in Invasive Lobular Breast Cancer

BACKGROUND: MammaPrint® is a microarray-based gene expression test cleared by the US Food and Drug Administration to assess recurrence risk in early-stage breast cancer, aimed to guide physicians in making neoadjuvant and adjuvant treatment decisions. The increase in the incidence of invasive lobular carcinomas (ILCs) over the past decades and the modest representation of ILC in the MammaPrint development data set calls for a stratified survival analysis dedicated to this specific subgroup. STUDY AIM: The current study aimed to validate the prognostic value of the MammaPrint test for breast cancer patients with early-stage ILCs. MATERIALS AND METHODS: Univariate and multivariate survival associations for overall survival (OS), distant metastasis-free interval (DMFI), and distant metastasis-free survival (DMFS) were studied in a study population of 217 early-stage ILC breast cancer patients from five different clinical studies. RESULTS AND DISCUSSION: A significant association between MammaPrint High Risk and poor clinical outcome was shown for OS, DMFI, and DMFS. A subanalysis was performed on the lymph node-negative study population. In the lymph node-negative study population, we report an up to 11 times higher change in the diagnosis of an event in the MammaPrint High Risk group. For DMFI, the reported hazard ratio is 11.1 (95% confidence interval = 2.3-53.0). CONCLUSION: Study results validate MammaPrint as an independent factor for breast cancer patients with early-stage invasive lobular breast cancer. Hazard ratios up to 11 in multivariate analyses emphasize the independent value of MammaPrint, specifically in lymph node-negative ILC breast cancers