title: Adjuvant chemotherapy in node-negative breast cancer: UPA/PAI-1 determinations for 163 cases.
abstract: BACKGROUND
  The urokinase-type plasminogen activator (UPA) and its main inhibitor plasminogen activator inhibitor-1 (PAI-1) are involved in tumor interactions with the microenvironment. The UPA/PAI-1 content in tumor tissue can be used to identify populations at low-or high-risk of recurrence of breast cancer, even without other standard prognostic markers.
  
  
  METHODS
  The purpose of the present study was to compare adjuvant chemotherapy decisions made by a multi-disciplinary board for 163 node-negative breast cancer cases, based on clinicopathological (CP) and UPA/PAI-1 risk assessment.
  
  
  RESULTS
  The UPA/PAI-1 levels identified 37% of the population as being at low risk. Adjuvant chemotherapy indication was spared in high-CP risk in 17%, but maintained in low-CP risk in 33%.
  
  
  CONCLUSIONS
  The use of UPA/PAI-1 data did not consistently result in a decrease of adjuvant chemotherapy. This study highlighted the difficulties encountered in a local multi-disciplinary board in determining appropriate roles and weights of new prognostic markers (UPA/PAI-1 was not routinely employed in France) when no data are available for assessing their prognostic and predictive power compared to other prognostic factors.
authors.affiliation: Department of Medical Oncology, University Hospital, 2 avenue Martin Luther King, 87042 Limoges cedex, France. oncologie@chu-limoges.fr.
authors.forename: Laurence
authors.initials: L
authors.lastname: Vénat-Bouvet
authors.forename: Veronique
authors.initials: V
authors.lastname: Fermeaux
authors.forename: Sophie
authors.initials: S
authors.lastname: Leobon
authors.forename: Nadira
authors.initials: N
authors.lastname: Saidi
authors.forename: Jacques
authors.initials: J
authors.lastname: Monteil
authors.forename: Joelle
authors.initials: J
authors.lastname: Mollard
authors.forename: Yves
authors.initials: Y
authors.lastname: Aubard
authors.forename: Isabelle
authors.initials: I
authors.lastname: Jammet
authors.forename: Nicole
authors.initials: N
authors.lastname: Tubiana-Mathieu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000378:metabolism; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D017024:Chemotherapy, Adjuvant; D003657:Decision Making; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008198:Lymph Nodes / Q000378:metabolism / Q000473:pathology*; D008875:Middle Aged; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D009367:Neoplasm Staging; D017395:Plasminogen Activator Inhibitor 1 / Q000378:metabolism*; D011379:Prognosis; D011446:Prospective Studies; D014568:Urokinase-Type Plasminogen Activator / Q000378:metabolism*
chemical_list: D014408:Biomarkers, Tumor; D017395:Plasminogen Activator Inhibitor 1; D014568:Urokinase-Type Plasminogen Activator
keywords: UPA-PAI-1; adjuvant chemotherapy; molecular biomarkers; node-negative breast cancer