bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract OT2-5-01: Brain metastases in breast cancer network Germany (BMBC, GBG 79): Multicentric, retro- and prospective collection of patient data and biomaterial from breast cancer patients with brain metastases
Authors: Witzel Isabell , Laakmann Elena , Fehm Tanja , Möbus Volker , vonMinckwitz Gunter , Kaiser Julia , Loibl Sibylle , Müller Volkmar
Published: May 2015

Background: The incidence of brain metastases in breast cancer patients is rising and has become a major clinical challenge in the last years. So far, limited therapeutic options and insights into the biology of brain metastases exist. Most reports include patients with brain metastases from different tumor entities and few studies so far analyzed exclusively patient data or tumor samples from breast cancer patients. In this context, an open, multicenter registry and biobank should be helpful for analysis of a large number of breast cancer patients with brain metastases. Therefore, we initiated the Brain Metastases in Breast Cancer Network Germany (BMBC; GBG79).

Trial design and eligibility criteria: Patients with brain metastases from breast cancer are eligible. Registration of patient data is allowed retrospectively and prospectively. To enable an easy access, an internet-based database was chosen ("MedCodes" by the German Breast Group).

Specific aims: Documented data cover incidence, symptoms, number and localization of brain metastases, histopathology, imaging methods, outcome, therapy, and quality of life measurement. Tissue of brain metastases and primary tumors will be collected for translational research projects. Planned analyses include treatment patterns in Germany, patient outcome, as well as validation of prognostic scoring systems in a multicenter setting and in the context of new targeted therapies. Translational research projects investigate the impact of glycosylation, resistance mechanisms against HER2-targeted therapies, role of the blood brain barrier, evaluation of markers of radioresistance and specific genomic alterations associated with brain tropism of breast cancer cells. The registry and biobank should be also open for cooperation with other groups.

Present accrual and target accrual: The accrual target is app. 1000 patients in the database and app. 400 tissues of brain metastases from German centers. The study was opened for documentation in April 2014 with more than 50 participating centers as of June 2014.

Citation Format: Isabell Witzel, Elena Laakmann, Tanja Fehm, Volker Möbus, Gunter vonMinckwitz, Julia Kaiser, Sibylle Loibl, Volkmar Müller. Brain metastases in breast cancer network Germany (BMBC, GBG 79): Multicentric, retro- and prospective collection of patient data and biomaterial from breast cancer patients with brain metastases [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr OT2-5-01.
Abstract P1-01-10: A preoperative PET/MR imaging for diagnosing malignant axillary lymph nodes in women evaluated for breast cancer
Authors: Yeu Kyung Jun , Park Jeong Yeong , Choi Jung Eun , Kang Su Hwan , Kong Eun-Jung , Cho Ihn-Ho , Lee Soo Jung
Published: May 2015

Objective: We determined whether and how malignant node could be diagnosed preoperatively with simultaneous PET/MR imaging.

Materials and methods:Two hundred thirty-six consecutive women with breast cancer were recruited to undergo preoperative PET/MR imaging. 52 patients were excluded; 31 DCIS, 7 neoadjuvant chemotherapy and 14 previous excisional biopsy. Thus, 184 women (51.9 ±10.2 years old) were included. Axial T1w without fat saturation, contrast enhanced image and diffusion-weighted images with simultaneous acquired PET images were analyzed by nuclear medicine physicians who were blinded the histologic findings. Visual FDG avidity, long axis and cortical thickness of axillary lymph node (ALN), morphologic feature-loss of fat hilum, cortical thickening, round shape or irregular shape- and ADC value were analyzed in most suspicious ALNs.

Results:In total, 70 patients (15 patients have only micrometastasis) exhibited ALN metastasis. Mean size of breast mass was 2.1 ±1.5 cm. Macrometastatic ALN showed high FDG uptake, longer axis, thicker cortex, more frequent morphologic abnormalities, higher signal intensity at DWI and higher ADC values with statistical significance. No significant difference between micrometastatic ALN and benign ALN in PET/MR imaging. With pathologic diagnosis as the reference standard, the sensitivity, specificity and accuracy of PET for determining ALN metastasis were 84%, 58% and 68%, respectively. Those are 77%, 84% and 82% in considering both PET with morphologic change and 81%, 66% and 72% in considering PET, morphologic change and DWI, respectively.

Conclusion:PET/MR imaging techniques showed high accuracy in the preoperative evaluation of axillary status in patients with breast cancer. Additional information by DWI is unlikely to be useful in predicting metastatic ALN.

Citation Format: Kyung Jun Yeu, Jeong Yeong Park, Jung Eun Choi, Su Hwan Kang, Eun-Jung Kong, Ihn-Ho Cho, Soo Jung Lee. A preoperative PET/MR imaging for diagnosing malignant axillary lymph nodes in women evaluated for breast cancer [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P1-01-10.
Abstract P1-01-12: Preoperative breast MRI does not affect survival outcomes in T1-2 breast cancer patients who underwent breast-conserving therapy
Authors: Ryu Jegyu , Kim Sanghwa , Kim Jee Ye , Park Hyung Seok , Park Seho , Kim Seung il
Published: May 2015

Purpose: The aim of the study is to evaluate the efficacy of preoperative breast MRI in T1-2 women with breast cancer.

Methods: Total 1179 patients, who had T1-2 breast cancer and underwent definitive surgery between 2007 and 2010, were reviewed in this study. Preoperative breast MRI was performed in 981 women with breast cancer. We divided patients into two groups: Patients underwent preoperative MRI and breast-conserving therapy (BCT), those who did not undergo preoperative MRI but BCT. Patients underwent preoperative MRI and total mastectomy were excluded. Clinicopathological features were analyzed using Chi-square or Fisher’s exact test if indicated. Survival analyses were examined using Kaplan-Meier method and log-rank test. Cox-proportional hazard model was accessed as multivariate analysis.

Results: In 873 patients who underwent BCT, 675 patients (77.3%) received preoperative MRI, and 198 (22.7%) patients did not. Clinicopathological features including T-stage, Nodal status, histologic type, progesterone receptor, histologic grade, age group (≤ 35 vs. > 35 yr), adjuvant chemotherapy, radiation, and hormone therapy were not significantly different between two groups. Patients aged 50 or younger received more preoperative MRI than those over aged 50 years (42.8 % vs. 51.5%, p=0.02). Estrogen receptor positive-tumors were more common in patients with preoperative MRI (74.9% vs. 67.2%, p=0.03). HER2 over-expression was frequently found in women without preoperative MRI (7.9% vs. 14.6%, p<0.001). In univariate analyses, there was no significant difference in recurrence-free and overall survival between patients who underwent breast MRI and those who did not (p for RFS = 0.75, p for OS = 0.48). In multivariate analyses, preoperative MRI did not influence on RFS and OS (HR for RFS = 0.82, 95%CI= 0.35-1.91, HR for OS = 1.52, 95% CI= 0.40-5.76). Age group and HER2 were not associated with RFS and OS (all p>0.05). ER was an independent prognostic factor for RFS and OS (all p<0.01).

Conclusions: Routine use of preoperative MRI in women with T1-2 breast cancer may not translate into better RFS and OS.

Citation Format: Jegyu Ryu, Sanghwa Kim, Jee Ye Kim, Hyung Seok Park, Seho Park, Seung il Kim. Preoperative breast MRI does not affect survival outcomes in T1-2 breast cancer patients who underwent breast-conserving therapy [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P1-01-12.
Abstract P1-02-08: 18F-fluoro-2-deoxy-glucose positron emission tomography/ computed tomography evaluation shows the utility for predicting postoperative outcomes on Luminal types breast cancer patients
Authors: Aogi Kenjiro , Sugawara Yoshifumi , Kiyoto Sachiko , Kadoya Takayuki , Shigematsu Hideo , Masumoto Norio , Okada Morihito
Published: May 2015

Background: Hormonal receptor-positive, i.e. Luminal types, breast cancer has better prognosis compared with other phenotypes, but predictive factors for postoperative outcomes have been in research besides hormonal receptor expressions. 18F-fluoro-2-deoxy-glucose positron emission tomography/ computed tomography (18F-FDG PET/CT) using maximum standardized uptake value (maxSUV) has been reported its utility as one of predictive markers for relapse-free survival (RFS) on breast cancer patients. In this retrospective study, the utility of 18F-FDG PET/CT was evaluated on predicting postoperative outcomes especially on Luminal types breast cancer patients. Methods: Three hundred forty four breast cancer patients with clinical Stage I-III who underwent preoperative 18F-FDG PET/CT were enrolled between January 2006 and December 2011 in two institutes. Patients classified into Luminal types, Luminal A(166 patients): Estrogen receptor(ER)(+) or Progesterone receptor (PR)(+), human epidermal growth factor receptor type2 (HER2) (-), nuclear grade(NG)1-2 or Luminal B(96 patients): ER(+) or PR(+), HER2(-), NG3, were evaluated in this study. Moreover, patients were also divided in two groups according to cut-off maxSUV on receiver operating characteristic (ROC) analysis (≤4.0 group vs >4.0 group, AUC=0.830). Statistical analyses were performed using Student t test and log-rank test, and p values of less than 0.05 were considered to be statistically significant. Results: Significant correlations were shown between maxSUV and clinical T-factor, nuclear grade, vascular invasion and presence or absence of recurrence (p<0.0001, p<0.0001, p=0.0181, and p=0.0056, respectively). In uni- and multivariate analyses using Cox model for recurrence, only maxSUV was shown to be significant (p=0.021 and p=0.043, respectively). In RFS, the maxSUV≤4.0 group showed significantly better prognosis compared to that of the maxSUV >4.0 group (p=0.003). Conclusion: 18F-FDG PET/CT using maxSUV was concluded to be useful for predicting postoperative prognosis on luminal types breast cancer patients.

Citation Format: Kenjiro Aogi, Yoshifumi Sugawara, Sachiko Kiyoto, Takayuki Kadoya, Hideo Shigematsu, Norio Masumoto, Morihito Okada. 18F-fluoro-2-deoxy-glucose positron emission tomography/ computed tomography evaluation shows the utility for predicting postoperative outcomes on Luminal types breast cancer patients [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P1-02-08.
Abstract P1-02-10: Contrast enhanced spectral mammography (CESM) is a new breast imaging contrast study: A review of indications, protocol, interpretation and pitfalls
Authors: Liao Lydia , Li Luna , Germaine Pauline , Tinney Elizabeth , Brill Kristin , Hendershott Karen
Published: May 2015

Purpose: This presentation is to discuss the indications, protocol, interpretation and pitfalls of CESM using illustrations of breast malignant and benign cases performed in our institution, after a brief literature review. CESM characteristics for both benign and malignant lesions are defined after comparison to other imaging studies and correlation to final tissue diagnosis.

Methods: 1000 CESM cases including 100 breast cancer and 200 benign lesions were retrospectively analyzed. These cases were performed in our institution from October 2012 to March 2014. GE Senographe Essential Full Field Digital System (SenoBright) was utilized for CESM studies. Both low and high energy images were obtained after intravenous 75-100cc Isovue 370 administration at flow rate of 1.5-2cc per second. Both low energy and subtracted images were reviewed on GE Centricity Imagecast on 5 megapigxel monitor. Abnormal CESM lesions underwent further evaluation and tissue sampling for a final diagnosis to determine the presence of breast cancer.

Results: CESM is one of the contrast studies. It provides both morphologic and functional information of breast lesions. The sensitivity of CESM for cancer detection was 93-100% per patient in contrast to 95-100% of breast MRI. There are morphological and enhancement features for both malignant and benign lesions on CESM. CESM could pick up lesions when regular digital mammography and ultrasound are negative. CESM is a part of diagnostic study on selected patients. It has a short duration exam time and results are easily accessible. Some CESM artifacts are unique and commonly occurred.

Conclusion: CESM is a new breast imaging contrast study. The sensitivity for breast cancer detection is comparable to breast MRI. With its easy accessibility and cost effectiveness, CESM may play an important role in breast cancer detection in conjunct with diagnostic mammography and breast ultrasound. Recognition of CESM artifacts helps to increase diagnostic accuracy.

Citation Format: Lydia Liao, Luna Li, Pauline Germaine, Elizabeth Tinney, Kristin Brill, Karen Hendershott. Contrast enhanced spectral mammography (CESM) is a new breast imaging contrast study: A review of indications, protocol, interpretation and pitfalls [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P1-02-10.
Abstract P1-03-05: Genetic variant in the OPG gene is associated with aromatase inhibitor-related musculoskeletal toxicity in breast cancer patients
Authors: Lintermans Anneleen , Van Asten Kathleen , Laenen Annouschka , Van Brussel Thomas , Verhaeghe Johan , Vanderschueren Dirk , Lambrechts Diether , Neven Patrick
Published: May 2015

Background

Aromatase inhibitor (AI) therapy is associated with musculoskeletal toxicity, which adversely affects quality of life and therapy adherence. Our objective was to evaluate genetic predictors for endocrine therapy-related musculoskeletal pain in a prospective cohort study, which was previously published.

Patients & methods

254 early breast cancer patients starting AI (n=159) or tamoxifen therapy (n=95) were included in this genetic biomarker study. Musculoskeletal symptoms were assessed at baseline and at 3, 6 and 12 months thereafter. AI-induced musculoskeletal pain was defined as an increase in arthralgia or myalgia relative to baseline. Single nucleotide polymorphisms (SNP) in candidate genes involved in estrogen signaling or reported to have associations with AI-related musculoskeletal pain or estrogen levels were selected. Of the 40 selected SNPs, 7 failed genotyping and were excluded from further analysis.

Results

Twenty SNPs exhibited a minor allele frequency <0.05 and were omitted from the final analysis. Overall, 13 SNPs in CYP19, CYP17, osteoprotegerin (OPG) and estrogen receptor 1 were included.

74% of AI-users reported new or worsened musculoskeletal pain compared to 33% of tamoxifen-treated patients. The OPG SNP rs2073618 was significantly associated with AI-induced musculoskeletal toxicity after correction for multiple testing (p=0.039). None of the other SNPs showed significant associations, both in AI and tamoxifen-treated patients.

Conclusion

The SNP rs2073618 in OPG predicts the risk of musculoskeletal symptoms with AI therapy, which has not been reported so far. Validation of this finding and further functional studies are needed.

Citation Format: Anneleen Lintermans, Kathleen Van Asten, Annouschka Laenen, Thomas Van Brussel, Johan Verhaeghe, Dirk Vanderschueren, Diether Lambrechts, Patrick Neven. Genetic variant in the OPG gene is associated with aromatase inhibitor-related musculoskeletal toxicity in breast cancer patients [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P1-03-05.
Abstract P1-06-04: Super-enhancer analysis defines breast cancer subtype and identifies tumor dependencies
Authors: Guenther Matthew G , Orlando David A , Eaton Matthew L , Collins Cindy A , Chen Mei Wei , Solanki Sneha , Loven Jakob , Fritz Christian C , Olson Eric R
Published: May 2015

Epigenomic modifications define gene regulatory features that control transcription and disease cell state. Recent studies of these regulatory features have identified large clusters of enhancers, termed super-enhancers, which define key cell identity and disease genes. Using ChIP-seq and RNA-seq analysis, we have discovered Super-enhancers in breast cancer cell line models and in primary tissue and have characterized their roles in establishing tumor cell state. We find that Super-enhancers recapitulate clinical subgroups in both breast cancer cell line models and in invasive ductal carcinoma. Super-enhancer-associated genes encode known and novel therapeutic targets including kinases, phosphatases, chromatin regulators and transmembrane proteins. Such genes include key drivers such as ERRB2 in HER2+ patient samples, ESR1 in estrogen receptor positive samples, and CCND1 in samples of luminal subtype. We describe the biological and disease relevance of Super-enhancer-associated genes in the context of tumor cell state and drug target discovery.

Citation Format: Matthew G Guenther, David A Orlando, Matthew L Eaton, Cindy A Collins, Mei Wei Chen, Sneha Solanki, Jakob Loven, Christian C Fritz, Eric R Olson. Super-enhancer analysis defines breast cancer subtype and identifies tumor dependencies [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P1-06-04.
Abstract P1-07-24: Modeling breast cancer metastasis in the mouse via measurement of circulating tumor cells
Authors: Gorman Jennifer L , Parsons Michael , Zacksenhaus Eldad , Egan Sean , Chang Martin , Woodgett Jim R
Published: May 2015

Objectives: Advances in the detection of circulating tumor cells (CTC) in the blood of metastatic breast cancer patients have indicated that patients with greater than 5 CTC/7.5mL of blood have poorer prognosis; however, little is known about the biology of these cells and what characteristics are critical for breast tumor cell dissemination. We are developing and evaluating several mouse models of breast cancer to characterize important markers that distinguish CTCs from other cell types in the blood as well as to assess whether silencing of various metastasis supporting genes leads to reductions in CTC counts and formation of metastatic tumors.

Methods: This study involves two separate approaches to characterize CTCs. The first involves xenograft models using human breast cancer cells injected into the fat pad of immunocompromised mice. These cells are tagged with both mCherry, for detection in blood, and luciferase, to track metastatic spread of the primary tumor cells to other sites via intravital imaging. Blood was collected from tumor bearing mice at end point, processed and stained for characterized CTC markers. The second approach involves endogenous mouse models to characterize CTC counts and relevant markers in a variety of metastatic and non-metastatic murine breast cancer models using negative depletion to remove contaminating normal and hematopoietic cells. In both approaches CTCs have been assessed using the Imagestream by Amnis.

Results: Initial xenograft experiments with MDA-MB-231 cells injected into the mouse mammary gland fat pad revealed a low concentration of mCherry+/cytokeratin+/Hoechst+/CD45- cells in the blood of mice without confirmed metastatic dissemination. Pilot studies on endogenous tumor models have demonstrated the utility of our negative depletion approach to remove contaminating hematopoietic cells as well as the detection of a population of EpCAM+/Hoechst+/CD45- cells.

Conclusions: Initial experiments have provided feasibility for detailed characterization of mouse CTCs, which will be presented. This work complements our study being carried out on characterizing CTCs in metastatic breast cancer patients. Increasing understanding of the biology of circulating tumor cells and relating their characteristics to those of both the primary and metastatic tumors may reveal mediators common and functionally important to all 3 tumor cell populations and may therefore serve as better targets for treatments that are effective against both the primary and metastatic tumors.

Citation Format: Jennifer L Gorman, Michael Parsons, Eldad Zacksenhaus, Sean Egan, Martin Chang, Jim R Woodgett. Modeling breast cancer metastasis in the mouse via measurement of circulating tumor cells [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P1-07-24.
Abstract P1-09-02: BMI and metabolic factors in long-term breast cancer survivors: Changes from diagnosis and comparison to non-breast cancer controls
Authors: Lohmann Ana Elisa , Ennis Marguerite , Goodwin Pamela J
Published: May 2015

Background: The metabolic syndrome is associated with poor breast cancer (BC) outcome. We evaluated changes from diagnosis in metabolic factors and BMI in long-term survivors and compared their status at long-term follow-up (LTFU) to that of age-matched women with no history of BC.

Methods: A total of 535 women with early breast cancer were enrolled between 1989 and 1996 and followed prospectively. From 2005 to 2007, those alive without distant recurrence were re-contacted to participate in a long-term followed-up study and 285 agreed. A control group of 167 age-matched women without cancer history was recruited from women presenting for screening mammograms. Mean changes in metabolic factors from diagnosis to long-term follow-up were assessed with paired t-tests. In spite of matching, controls were younger and had higher income than survivors and the comparison to controls was made using age-adjusted regression models. Variables were transformed to normality before statistical testing.

Results: With a median follow-up of 12.5 years, BC survivors gained on average 2.35 kg and BMI, waist and hip circumference, waist-hip ratio, glucose, insulin, HOMA, total cholesterol and its components (but not triglycerides) increased significantly. After age adjustment, waist circumference, glucose, HOMA and total triglycerides were significantly higher in BC survivors compared to controls

Comparison of LTFU BC survivors to non-cancer controls Unadjusted mean ± standard deviationUnadjusted mean ± standard deviation  BC patientscontrolsP-value for age-adjusted differencewaist circumference (cm)85 ± 1281 ± 10.01Glucose (mmol/L)5.5 ± 1.05.2 ± 0.9.01Insulin (pmol/L)60.9 ± 50.547.1 ± 28.3.06HOMA2.25 ± 2.241.64 ± 1.24.03Triglycerides (mmol/L)1.28 ± 0.641.10 ± 0.57.01BMI (kg/m2)26.3 ± 4.925.4 ± 4.5.26

Despite exclusion of BC patients with diabetes at study entry, 24.9% of BC survivors self reported diabetes or pre-diabetes (1.99%/year) versus 12.6% in controls (OR 2.3, p= .0017).

Conclusion: The metabolic status of long-term BC survivors deteriorated over time and age-adjusted at LTFU were worse with respect to a number of factors compared to the control group.

Citation Format: Ana Elisa Lohmann, Marguerite Ennis, Pamela J Goodwin. BMI and metabolic factors in long-term breast cancer survivors: Changes from diagnosis and comparison to non-breast cancer controls [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P1-09-02.
Abstract P1-09-21: Metabolic syndrome is prevalent in women with newly diagnosed breast cancer
Authors: Wong Louise C , Behrendt Carolyn , Smith Robin , Mortimer Joanne E
Published: May 2015

Purpose: We estimate the prevalence of metabolic syndrome (MetSyn) among women with newly diagnosed breast cancer and explore potential risk factors.

Methods: From January 2012 to May 2014, women with newly diagnosed localized breast cancer were enrolled into a longitudinal survivorship study. At baseline, results of physical exam, use of concomitant medications, serum lipid profile and vitamin D were obtained from the medical record, while quality of life variables were measured via questionnaires in English. MetSyn was defined as at least 3 of 5 criteria: central obesity (BMI >30 or waist >=88 cm); triglycerides >=150 mg/dL; HDL cholesterol <50 mg/dL or cholesterol-lowering treatment; systolic >=130 or diastolic >=85 mm Hg blood pressure or treatment for hypertension; fasting glucose >=100mg/dL or diagnosis of Type 2 diabetes. Risk factors for MetSyn (age, education, serum vitamin D, self-reported energy in past month) were evaluated using multivariate logistic regression.

Results: Subjects (n=154) were age 52.0 +10.1 years. Prevalence of MetSyn at baseline was 46.1(+4.0)%; for another 1.9(+1.1)% (n=3), MetSyn status was indeterminate due to lack of data on HDL and triglycerides. Among subjects with MetSyn (n=71), most had been diagnosed with hypertension (81.7%) and diabetes (61.4%). Without MetSyn (n=80), the latter conditions were much less prevalent (31.3% and 22.5%, respectively, both p<0.0001). Adjusted for race and year of accrual, the likelihood of MetSyn at baseline was higher per year of age (Odds Ratio (O.R.) 1.05, 95% CI 1.01-1.10, p=0.015), lower per increasing educational attainment (from less than high school to high school/some college, to bachelor’s, to graduate degree: O.R. 0.58, 0.36-0.93, p=0.024), and higher per increasing "time in past month with a lot of energy" (from little/no time to most of the time, to all of the time: O.R. 2.30, 1.11-4.75, p=0.025). An inverse association with serum Vit D (p=0.14) did not reach statistical significance.

Conclusions: Metabolic syndrome is present in nearly half of women newly diagnosed with breast cancer and is associated with age, less education, and more energy in past month.

Citation Format: Louise C Wong, Carolyn Behrendt, Robin Smith, Joanne E Mortimer. Metabolic syndrome is prevalent in women with newly diagnosed breast cancer [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P1-09-21.
Abstract P1-09-23: Symptoms, desire for help, and quality of life among recent breast cancer survivors
Authors: Palmer Steven C , Panzer SarahLena L , Glanz Karen , Schapira Marilyn M , DeMichele Angela M , Jacobs Linda A
Published: May 2015

Introduction:

Advances in detection and treatment have led to improved survival among breast cancer (BC) patients and 89% can expect >5 year survival. Progress comes at a cost, however, and patients experience lasting effects from disease and treatment. It is not clear how these effects impact quality of life (QoL) achieved by BC survivors. We examined relationships between symptoms, desire for help, and QoL among recent BC survivors.

Method:

Eligibility included non-metastatic BC treated < 1 year prior and attendance at a survivorship clinic. QoL was assessed with the SF-12. 19 common symptoms were assessed on a 0-5 bother scale. Participants reported desire for help item for each symptom rated > 1.

Results:

171 primarily white (73%), middle aged (M=54.9 yrs), and Stage I (58%) BC survivors were recruited. Both Physical (M=48.1) and Mental (M=53.8) QoL were similar to national norms. Survivors reported an average of 12 symptoms, most commonly Fatigue (90%), Insomnia (75%), Hot Flashes (73%), and Joint Pain (70%). Most bothersome symptoms included Joint Pain (M=2.9), Decreased Sexual Drive (M=2.8), Hot Flashes (M=2.8), and Vaginal Dryness (M=2.7). Participants desired help with few symptoms (M=2.3), primarily Weight Gain (50%), Joint Pain (45%), and Numbness in Hands/Feet (44%). Both Physical and Mental QoL were negatively associated with number of symptoms experienced (r = -.46 and -.41, respectively) and number of symptoms for which help was desired (r = -.16 and -.41, respectively).

Conclusion:

Symptoms are common among recent breast cancer survivors and negatively impact Physical and Mental QoL. Desire for help is less common, though similarly associated with impairment in QoL. Assessing QoL in isolation from symptom burden may miss important areas for which remediation is possible and could result in improved QoL. Patient education regarding the potential for and value of symptom reduction may be needed in BC survivors.

Citation Format: Steven C Palmer, SarahLena L Panzer, Karen Glanz, Marilyn M Schapira, Angela M DeMichele, Linda A Jacobs. Symptoms, desire for help, and quality of life among recent breast cancer survivors [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P1-09-23.
Abstract P1-09-28: What is a healthful diet? – Cancer survivors' interpretations of their own dietary recall data
Authors: Klassen Ann C , Smith Katherine C , Brosbe Michelle , Coa Kisha , Hannum Susan , Caulfield Laura
Published: May 2015

Background

The number of long-term cancer survivors will continue to grow, and developing strategies for tertiary prevention of recurrence, cancer-related comorbidities, and general chronic disease-related health burden is critical. Nutrition and energy balance are increasingly recognized to play important roles in both decreasing recurrence risk, and improving health and well-being throughout survivorship. To inform strategies for nutrition education and behavior change for cancer survivors, we used a mixed methods approach to explore concepts about healthful diet and eating patterns among long-term cancer survivors.

Methods

We collected three ASA-24 dietary recalls from 53 breast, prostate and non-Hodgkins lymphoma survivors. Utilizing qualitative interviews, we provided participants with feedback on how their eating patterns compared to dietary guidelines, and asked respondents to reflect upon their diet and dietary changes.

Results

Like most American adults, respondents were not eating in accordance with many dietary recommendations. In terms of adequate intake of recommended nutrients, 68% met fruit and vegetable guidelines, but only 15% reported adequate intake of fiber. In terms of following recommendations for limits on intake, 89% reported diets that met guidelines for limiting alcohol intake, but only 55% met limits for cholesterol, 40% for saturated fat, 19% for caloric intake, and only 2% limited their sodium intake to within recommended levels. Respondents were often surprised by their own dietary patterns, and had differing conceptualizations of a "healthful" diet.

Conclusions

Cancer survivorship may provide motivation for dietary change, but survivors need nutrition education to identify specific strategies for dietary improvement.

Citation Format: Ann C Klassen, Katherine C Smith, Michelle Brosbe, Kisha Coa, Susan Hannum, Laura Caulfield. What is a healthful diet? – Cancer survivors' interpretations of their own dietary recall data [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P1-09-28.
Abstract P1-10-05: A cost utility analysis from a Chinese health care perspective of Nab-paclitaxel or docetaxel, both as alternatives to solvent-based paclitaxel in metastatic breast cancer (MBC)
Authors: Dranitsaris George , Yu Bo , King Jennifer , Zhang Adams , Kaura Satyn , Qing Zhai
Published: May 2015

Background: Paclitaxel and docetaxel are commonly used for the treatment of MBC in China. However, one important drawback, particularly with docetaxel, is the potential for dose-limiting toxicity. To improve the side effect profile and efficacy of paclitaxel, an albumin-bound formulation (nab-paclitaxel) is currently available in China (Abraxane®). To provide health economic data for China, a cost utility analysis comparing nab-paclitaxel to docetaxel, both as alternatives to paclitaxel was conducted.

Methods: Clinical data was obtained from a meta analysis of randomized trials comparing either nab-paclitaxel (260 mg/m2 q3wk) or branded docetaxel (100 mg/m2 q3wk) to solvent-based branded paclitaxel (175 mg/m2 q3wk). Health care resource use for the delivery of chemotherapy and the management of grade 3/4 toxicity was collected from a time and motion study in three Chinese cancer centers, from a survey of clinicians and from the oncology literature. Using the Time Trade-off technique, treatment preferences and utility estimates were obtained from interviewing 28 cancer patients from two centres in China. All costs were reported in 2014 $U.S.

Results: Nab-paclitaxel had the most favourable safety profile characterized with the lowest incidence of grade 3/4 neutropenia, febrile neutropenia, anemia, emesis and stomatitis. This translated to lower costs for managing the grade 3/4 side effects of nab-paclitaxel relative to both docetaxel and paclitaxel ($21 vs. $166 vs. $81) In the preference assessment, 22 of 28 (78.6%) patients selected nab-paclitaxel as their preferred agent. As an alternative to paclitaxel, the incremental cost per quality adjusted life year (QALY) gained was determined to be more favourable with nab-paclitaxel than docetaxel ($57,900 vs. $130,600).

Conclusions: Nab-paclitaxel is an economically attractive alternative to both paclitaxel and docetaxel in MBC patients, providing a substantially lower cost per QALY. Additionally in the patient preference survey, the majority of patients surveyed selected nab-paclitaxel as their preferred agent.

Citation Format: George Dranitsaris, Bo Yu, Jennifer King, Adams Zhang, Satyn Kaura, Zhai Qing. A cost utility analysis from a Chinese health care perspective of Nab-paclitaxel or docetaxel, both as alternatives to solvent-based paclitaxel in metastatic breast cancer (MBC) [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P1-10-05.
Abstract P1-11-08: The impact of social inequalities on breast cancer mortality in Brazil
Authors: Freitas-Junior Ruffo , Gonzaga Carolina M , Curado Maria-Paula , Sousa Ana-Luiza L , Souza Marta R
Published: May 2015

Introduction: Female breast cancer mortality has decreased considerably in developed nations. In contrast, an increase has been observed in developing countries. Objective: To describe the impact of social inequalities in female breast cancer mortality in Brazil, between the years of 1990 and 2011. Methods: Breast cancer mortality data and estimates for the resident population were obtained from the Brazilian National Health Service (SUS) database for the 1990-2011 period. Age-standardized mortality rates were calculated (20-39, 40-49, 50-69 and ≥70 years) by direct standardization using the 1960 standard world population. Trends were modeled using linear regression, with mortality rates as the dependent variable and the year of death as the independent variable. The Social Exclusion Index (SEI) and the Human Development Index (HDI) were used to classify the 27 Brazilian states. Pearson’s correlation was used to describe the association between the SEI and the HDI and the variations in mortality rates in each state. Results: Age-standardized mortality rates in Brazil were found to be stable (annual percent change [APC] = 0.32; 95%CI: -0.1 – 0.7). Statistically significant decreases in mortality rates were found in the states of Rio Grande do Sul, Rio de Janeiro and São Paulo. Increases in mortality rates were most notable in the states of Maranhão (APC = 11.2; 95%CI: 5.8 – 16.9), Piauí (APC = 9.8; 95%CI: 7.6 – 12.1) and Paraíba (APC = 9.3; 95%CI: 6.0 – 12.8). There was a statistically significant correlation between SEI and a change in female breast cancer mortality rates in the Brazilian states between 1990 and 2011 and between HDI and mortality between 2001 and 2011. This reduction was most notable in the Brazilian states with better socioeconomic conditions. Conclusions: It was observed a direct impact of social inequalities in female breast cancer mortality rates in Brazil. Reductions in these rates were found in the more developed states, possibly reflecting a better local healthcare.

Citation Format: Ruffo Freitas-Junior, Carolina M Gonzaga, Maria-Paula Curado, Ana-Luiza L Sousa, Marta R Souza. The impact of social inequalities on breast cancer mortality in Brazil [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P1-11-08.
Abstract P1-11-13: An evaluation of mobile mammography outreach in urban and rural communities
Authors: Steward Lauren , Kraenzle Susan , Drake Bettina , Lyons Sarah , Goodman Melody
Published: May 2015

Background: Mobile mammography has been used to reach underserved women in a diverse number of settings. In this work, we demonstrate similarities and differences between rural and urban communities served by a single mobile mammography unit (MMU) affiliated with a comprehensive cancer center in Missouri.

Methods: An outreach registry of patients serviced by the MMU was created and includes data from medical records and responses to a brief questionnaire completed at each visit. Data was examined by point of care (urban/rural) to assess the efficacy of mobile mammography as an outreach strategy in each of these environments. Bivariate analyses were used to examine the relationships between demographic characteristics such as age, income, race/ethnicity, education, employment status, marital status, insurance status, and living environment proxy.

Results: Between 2006 and 2013, 9480 women received their care on the mobile mammography van. The sample was stratified by point of care (urban vs. rural) served, with majority of the women (86%) residing in urban/suburban St. Louis City/County, and 14% in rural regions. Urban zip codes had a lower percentage of women with income greater than $20,000 (12% v. 21%) and higher percentage of women with income less than $10,000 (49% v. 37%) in comparison to rural communities(p=0.01). There were higher proportions of black women in urban communities (63%) compared to rural communities (10%; p<0.001). Almost half (47%) the women that received mobile mammography in rural zip code were married compared to less than a quarter of women from urban zip codes (24%; p<0.001). Rural communities (83%) had a higher percentage of uninsured women compared to urban communities (67%; p<0.001). Women in urban and rural communities were similar in respect to age, employment status, and education.

Conclusions: Mobile mammography has the potential to reach a large population of women with limited educational, financial, and healthcare resources. Future studies will be needed to determine if increasing the range and extent of mobile units, such as this one, would be effective in increasing the screening rates of not only women in Missouri, but also in other portions of this country.

Citation Format: Lauren Steward, Susan Kraenzle, Bettina Drake, Sarah Lyons, Melody Goodman. An evaluation of mobile mammography outreach in urban and rural communities [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P1-11-13.
Abstract P1-12-07: Characteristics of recurrence after completing adjuvant tamoxifen therapy for 5 years
Authors: Lee Eunshin , Lee Han-Byoel , Kang Young Joon , Kim Yun-Gyoung , Yoo Tae-kyung , Kim Jongjin , Kim Min Kyoon , Moon Hyeong-Gon , Noh Dong-Young , Han Wonshik
Published: May 2015

Background Treatment with tamoxifen (TMX) reduces the recurrence rate and increase overall survival in patients with hormone receptor positive breast cancer. Up to now, 5-year TMX therapy is generally accepted, but it is demonstrated that the rate of late recurrence after 5 years is considerably higher in hormone receptor positive type than in other subtype. Several clinical trials such as ATLAS and aTTom showed the benefit of continuing tamoxifen up to 10 years instead of stopping at 5 years without increasing mortality due to the effect of extended tamoxifen medication.

Method We collected data of 1633 hormone receptor positive breast cancer patients who received surgery at Seoul National University Hospital from 1997 to 2007, and had completed 5-year TMX therapy with no recurrence within 5 years after diagnosis. Mean age of the patients was 43.3, and the patients have estrogen receptor or progesterone receptor. We included from the stage I to stage IV patients underwent curative surgery and received adequate adjuvant therapy such as chemotherapy or radiation therapy after surgery. We excluded the cases treated aromatase inhibitor (AI) or switched to AI.

Result Among these patients, recurrences after 5 years of TMX therapy were found in 93 patients (late recurrence group). Local recurrences and distant metastases were found in 43 and 50 patients, respectively. Electronic medical records were retrospectively reviewed for clinicopathological factors. When comparing between patients with no recurrence and patients with late recurrence, p53 and HER-2 expression were significantly related to late recurrence (p=0.01, p<0.001 respectively). Also when subgroup analysis was done for distant metastasis of late recurrence group, distant metastasis was significantly associated with HER-2 expression and high nuclear grade (p=0.005, p=0.006 respectively). There are no relation between late recurrence and age, stage and ki-67.

Conclusion our data shows that p53 and HER-2 expression is associated to late recurrence and especially HER-2 expression is related to distant metastasis after completing TMX for 5 years. On the basis of the result of large clinical trials, extending TMX therapy significantly reduces recurrence rate and increase survival. Our result support continuing TMX in patients with HER-2 expression and high nuclear grade is considerable after 5 years of TMX medication.

Citation Format: Eunshin Lee, Han-Byoel Lee, Young Joon Kang, Yun-Gyoung Kim, Tae-kyung Yoo, Jongjin Kim, Min Kyoon Kim, Hyeong-Gon Moon, Dong-Young Noh, Wonshik Han. Characteristics of recurrence after completing adjuvant tamoxifen therapy for 5 years [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P1-12-07.
Abstract P1-12-10: Tamoxifen treated patients have a better survival than patients treated with aromatase inhibitors - A population based registry study in Sweden
Authors: Olsson Håkan , Einefors Rickard , Broberg Per
Published: May 2015

Background. Randomised trials suggest that therapy with aromatase inhibitors improves survival in breast cancer compared with tamoxifen therapy in postmenopausal cases with hormone receptor positive breast cancer. Whether these results from randomized studies transform into the general population is unknown. We have therefore compared survival for all breast cancer cases in Sweden diagnosed 2000-2008 (n=54406) who received adjuvant antihormonal therapy.

Material and methods. The study includes all women with BC diagnosed in Sweden between 2000 through 2008 (n=54406). The women had no previous cancer diagnosis during the period of 1958-1999. Dates of birth, BC diagnosis and TNM-stage where directly extracted from the cancer registry. The women’s antihormonal therapy was gathered from the Swedish Prescription Registry (22213 women were on antihormonal therapy). Information regarding the cause of death and date of death was obtained from the Cause of Death Registry and tbe Swedish Population Register up until the 31st of December 2012 and 31st of December 2013 respectively. The breast cancer death and overall death have been calculated and the survival was compared between tamoxifen and aromatase inhibitor treated breast cancer patients. Analyses were adjusted for TNM-stage and age at diagnosis and restricted to women aged 50 and above.

Results. Patients being treated with tamoxifen had a better breast cancer prognosis compared with aromatase inhibitor treated patients (HR 0.54, 95%CI 0.48-0.61). Restricting the analysis to stage 1 disease confirmed a better prognosis for tamoxifen treated women (HR 0.48, 95%CI 0.34-0.66). A better prognosis could be seen in all age strata studies, 50-60.61-70.71-90. The findings for overall survival gave similar results.

Conclusion .This population based observational study show that women treated with aromatase inhibitors have a worse overall and breast cancer specific survival compared with tamoxifen treated women regardless of age and tumor stage.

Citation Format: Håkan Olsson, Rickard Einefors, Per Broberg. Tamoxifen treated patients have a better survival than patients treated with aromatase inhibitors - A population based registry study in Sweden [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P1-12-10.
Abstract P1-12-12: The insulin like growth factor axis and development of tamoxifen resistance in breast cancer
Authors: Hawsawi Yousef M , Beattie James , El-Gendy Reem , Speirs Valerie , Twelves Christopher
Published: May 2015

Background

Insulin-like growth factors (IGF). IGFs are potent mitogens for breast epithelial cells that modulate the action of AKT, which has been reported to be associated with tamoxifen resistance. To date, however, anti-IGF strategies have proved disappointing in clinical trials We have investigated whether the IGFBP family of proteins, which modulate the activity of IGF, may play a role in tamoxifen resistance, opening up the route for alternative anti-IGF based therapies.

Methodology

We investigated the expression of IGF axis genes in parental and tamoxifen-resistant (TamR) MCF-7 cells using qRT-PCR. Gene and protein expression was confirmed using ELISA, Western, and ligand blotting. shRNA transfection was used to silence candidate IGF axis genes in both cell lines. Cell sensitivity 4-hydroxytamoxifen (4-HT) was investigated by WST-1 cell proliferation assay.

Results

IGF-IR, IGF-2R, IGFBP-2, -4 and -5 genes had the highest expression levels. IGFBP-5 was down-regulated 7-fold while IGFBP-2 was up-regulated by 2-fold in TamR v wt cells. Changes in IGFBP-5 and IGFBP-2 gene expression were mirrored in protein levels measured in conditioned media by ELISA, Western and Ligand blot. Importantly knock down of IGFBP-2 in TamR cells restored sensitivity to 4-HT suggesting a causal role for IGFBP-2 in the acquisition of tamoxifen resistance.

Conclusion

IGFBP-5 and IGFPB-2 are reciprocally regulated on the acquisition of tamoxifen resistance by MCF-7 cells. Preliminary studies suggest that IGFBP-2 may play a role in the development of tamoxifen resistance in vitro.

Citation Format: Yousef M Hawsawi, James Beattie, Reem El-Gendy, Valerie Speirs, Christopher Twelves. The insulin like growth factor axis and development of tamoxifen resistance in breast cancer [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P1-12-12.