bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does total breastfeeding time influence the clinicopathologic characteristics and prognosis in breast cancer patients?
Authors: Yaman Sebnem , Aksoy Sercan , Sendur Mehmet Ali Nahit , Arik Zafer , Ozdemir Nuriye , Zengin Nurullah , Altundag Kadri 
Published: March 2020

e11033 Background: Several studies suggest that total breastfeeding time reduces breast cancer risk although the underlying mechanism is unclear. However the total breast feeding is not well studied as a prognostic factor in patients with cancer. We aimed to investigate the possible prognostic role of total breastfeeding time (TBT) in breast cancer patients both on relation with tumor characteristics and also on prognosis. Methods: We retrospectively evaluated 1673 breast cancer patients who followed up between 2004 and 2010 in our clinic. The total breastfeeding time was obtained by summing the breastfeeding time for each child. The total breastfeeding time was categorized as: 1-The total breastfeeding time between 0-12 months; 2-Total breastfeeding time more than 12 months. Results: The median total breastfeeding time of this population was 12 months. 1011(60.4%) of these have total breastfeeding time between 0-12 months and 662 (%39.6) of them have total breastfeeding time more than 12 months. T, N, M stages were similar in both groups. Total breastfeeding time was not correlated with any of clinical parameters including lymphovascular invasion, extracapsulary invasion, estrogen receptor, progesterone receptor, HER2 2 status, perineural invasion. There was a positive correlation found between total breastfeeding time and BMI (r=1.24; P<0.001).TBT (≥12 months) has poor disease free survival (DSF) time (116 vs. 75 months; p=0.002) and 3-years overall survival rate (98% vs 95.2%; p=0.049). Conclusions: In our study; total breastfeeding time was not found to be correlated with any of the clinico-pathological parameters. However, disease free survival and overall survival were statistically shorter in patients whose total breastfeeding time was more than 12 months.
Age as a prognostic factor for recurrence in premenopausal breast cancer patients.
Authors: Perello Antonia , Clemente Gemma , Duran Jose , Colom Bartomeu , Garcias-Espana Carmen , Torrecabota Joan , Avella Antoni , Canet Ramon , Rifa Julio 
Published: March 2020

e11036 Background: It remains controversial if young age at diagnosis is an independent prognostic factor for recurrence in breast cancer (BC) patients. Data regarding recurrence with long-term follow-up in premenopausal women are sparse. The aim of the study was to compare the outcome of young patients (<=39 years) with older premenopausal patients. Methods: We collected clinical and pathological data from an inception cohort of 241 premenopausal patients aged <=50 years at diagnosis with stage I-III BC between January 2000 and December 2005 in a single institution. Disease-free survival (DFS) event was defined as time from diagnosis to local or distant recurrence, contralateral invasive BC or death from any cause. Kaplan-Meier curves and Cox model were used to analyze the covariable predictors for recurrence. Results: Median age was 43 years (range: 24-50) and median follow-up was 100 months (range: 72-137). Seventy seven patients (32%) were <=39 and 164 (68%) >39 years of age at diagnosis. Five and 10-year disease-free survival rate was 61 % and 48% respectively for the younger group and 77% and 74% for the older group (p<0.001). In the univariate analysis the hazard ratio (HR) for recurrence in young patients was 2.16 (95%CI: 1.38-3.37) (p< 0.001) Adjusting for T stage (<=2 cm versus >2 cm), N (negative versus positive nodes), Grade (grade 1-2 versus grade 3) and Hormonal Receptor status (positive versus negative), age less than 40 remains and independent prognostic factor for recurrence with an adjusted HR of 2.42 (95%CI: 1.42-4.10) (p<0.001), and was the most important adverse independent predictor among the factors included in the model. Conclusions: BC patients younger than 40 years of age at diagnosis have worse prognosis than older premenopausal patients, and have an independent prognostic value for recurrence after adjusting for known prognostic factors.
Fulvestrant (F) plus sorafenib (S) as salvage therapy for hormone receptor positive (HR+) metastatic breast cancer (MBC) failing prior aromatase inhibitor (AI) treatment.
Authors: Lethert Kristine H. , Nauman Deirdre J. , Prado Yolanda , Seligman Mark , Karamlou Kasra , Ey Frederick S. , Chui Stephen Y. 
Published: March 2020

e11042 Background: Upon MBC progression with AI treatment; F, an estrogen receptor (ER) antagonist, is often used. Furthermore, vascular endothelial growth factor (VEGF) remains a potential target in MBC. S is a multi-kinase inhibitor of VEGF, Raf, platelet-derived growth factor receptor beta, Flt-3, and c-KIT. Prior studies of S show activity with chemotherapy and as a single agent. Combination therapy with an anti-estrogen and a VEGF inhibitor may be more effective than either agent alone. This pilot study combines F + S for HR+ MBC. Methods: Upon disease progression with an AI, 8 pts were treated with F. Concurrent S was administered starting day 1 until disease progression or unacceptable toxicity. Assessment of tumor status with computed tomography and/or bone scan was performed at baseline and every 2 cycles until disease progression. Results: Median age = 58; 75 % <65. ER and PR + = 6 pts; ER + and PR - = 2 pts. 6 pts were treated with adjuvant chemotherapy and endocrine therapy, with subsequent AI for MBC. 2 pts were metastatic at presentation and treated with prior AI. Median number of days on treatment = 220; median number of cycles = 7. 75% had grade 2/3 HFS; 50% required S dose modification. However, HFS and rash/desquamation were the only grade 3 toxicities (3 pts) with no additional grade 3/4 toxicities or dose modifications for other toxicities. Other grade 2 toxicities: neutropenia, myalgias, arthralgias, fatigue, pruritis. Only 1 pt discontinued the study at investigator’s decision for grade 3 HFS. There were no deaths on study. The remaining 7 pts continued F + S until disease progression with stable disease over a range of 2 to 22 cycles. Median time to progression was 7.3 months. Conclusions: Upon progression with an AI, treatment with F + S may provide advantage for some HR+ MBC pts beyond treatment with F alone. Future studies involving S in MBC should focus on identifying the population that will benefit the most in exchange for toxicities associated with S. [Table: see text]
Reasons for changing hormonal therapy of advanced breast cancer.
Authors: Petrakova Katarina , Petruzelka Lubos B. , Kandrnal Vit 
Published: March 2020

e11047 Background: Blood levels of tumor markers are widely used to assess response/progression to breast cancer treatment and guide therapy change in the real world setting compared to clinical trials where treatment efficacy is assessed by imaging methods. Our aim was to describe management of ER+ advanced breast cancer and reasons for treatment change in postmenopausal patients (pt) with hormone sensitive advanced breast cancer in the Czech Republic. Methods: The study was a retrospective, multi-centre, observational study that collected data from postmenopausal pt with hormone sensitive advanced breast cancer that have been treated with minimum two hormonal agents according to approved SmPC. Data collection started in February 2011in 16 centres in the Czech republic. The target number of enrolled pt was 400. Standard descriptive statistical methods were used for data analysis. Confidence intervals are reported where applicable. Results: We present an interim analysis of the study based on 169 pt enrolled till 21st July 2011. 150 pt have evaluable data. Median age was 55 years. Median time from diagnosis of BC to metastatic dissemination is 44.0 months (mean time 62.5 months). BC was diagnosed in Stage I in 12.0%, Stage II 43.3%, Stage III 24.0% and Stage IV 20.7%. Rebiopsy was done in 27.0% of pt who developed metastases (M). 63,5% pt were diagnosed with bone M, 45,3% with lymph node and soft tissue M, 22,3% with lung M, only 9,5% with liver M. 65% pt were treated with hormonotherapy in the first line and 84,2% in the second line. The main reason for hormonotherapy change was the progression according to examination (63%), elevation of tumor markers (13%), progression of symptoms (8%) intolerance of the treatment (3%) and other reasons (13%). Conclusions: Pt treated in the first line with hormonotherapy in daily practice in the Czech Republic are mostly pt without organ M. Pt with organ M are treated first with chemotherapy. Increase of tumor markers is the reason for treatment change in 13% of pt, progression of symptoms in 8%.
Frequency of PIK3CA mutations in HER2+ surgically resected breast cancers in a Hispanic cohort.
Authors: Munive Carlos , Gallo Aly , Neciosup Silvia P. , Doimi Franco , Dyer Richard , Pinto Joseph , Lopez-Ilasaca Marco , Gomez Henry 
Published: March 2020

e11066 Background: PI3K signaling pathway is responsible for balancing cell survival and apoptosis, and plays an important role in the pathogenesis and progression of human breast cancers. Alterations in this pathway could influence the response to targeted therapy. Our aim is to know the frequency of mutations in the PIK3CA gene in HER2+, operable breast tumors in an Andean population. Methods: We include a cohort of 59 patients with HER2+ surgically resected breast cancer that received adjuvant anti-HER2 targeted therapy at the Instituto Nacional de Enfermedades Neoplásicas. Genomic DNA was extracted from Paraffin embedded-formalin fixed tumor samples and mutational status of PIK3CA gene was using PCR-based DNA sequencing Results: At the current date, the median of follow-up in our cohort is 2.4 years and two recurrences have been registered. Four samples were not evaluable for molecular analysis. Mutation in PIK3CA gene was detected in 12 cases (20.3%). In cases where PIK3CA mutation was detected, eight cases (66.7%) had mutations in exon 9 (A1634C/E545A in 6 cases; G1624A/E542K in 1 case and G1633A/E545K in 1 case). Four cases (33.3%) had exon 20 mutated (A3140G/H1047R in all cases). There was not coexistence of mutations in both exons. One case of tumor recurrence had mutation in exon 9. Conclusions: We found similar rates of PIK3CA mutations as described previously to HER2+, breast tumors. A longest follow upwill show the prognostic value of PIK3CA status in our cohort treated with targeted anti-HER2 therapy. [Table: see text]
Metronomic cyclophosphamide and capecitabine combined with lapatinib in heavily pretreated metastatic breast cancer (MBC) HER2-positive patients.
Authors: Cagossi Katia , Lazzaretti Maria Grazia , Ferrari Alessia , Razzini Giorgia , Leporati Meri , Silvestri Rosangela , Iadanza Manlio , Iop Aldo , Artioli Fabrizio 
Published: March 2020

e11071 Background: Current therapeutic goals for MBC, as an incurable disease, are symptoms and prolonged disease control together with good quality of life. Metronomic chemotherapy has shown efficacy in patients with metastatic breast cancer. We evaluated the efficacy and tolerability of the combination of anti-angiogenetic activity of metronomic chemotherapy with a tyrosine kinase inhibitor such as lapatinib in heavily pre-treated MBC HER-2 positive patients. Methods: Metastatic breast cancer patients HER-2 positive with CEA or Ca15.3 elevated, measurable disease, prior systemic therapy (chemotherapy and/or hormonal therapy) for advanced disease, ECOG performance status < 1 and life expectancy longer than 3 months. MBC patients were treated with metronomic oral capecitabine (1500 mg daily) and cyclophosphamide (50 mg daily) plus lapatinib (1250 mg daily). The treatment was given until disease progression or unacceptable toxicity. Primary objective was time to progression (TTP) and safety. Results: Tenpatients were included. Median age was 56 years old (range 46-76). Median number of previous chemotherapy lines was 5 (range 2-10). Median time to tumor progression was 4 months (2-7). No complete response was observed. Six out of ten patients (60%) with pre-existing only bone metastases achieved a stable disease and/or partial response and are still on treatment after 6 month of therapy. At the same time 100% of these patients exhibited reduction of serum marker concentrations to normal range. No grade 3-4 toxicity was reported. There was no decline in cardiac function. Hematological and gastro-intestinal toxicity was well tolerated (G1-2). No reduction of dose was needed. Conclusions: The treatment appears to be an effective and less toxic option in heavily pretreated MBC patients. Of note is the observed activity in patients with exclusive bone metastases. Monitoring of CEA and Ca15.3 during the first two months of treatment appears to provide a sensitive and economical means of identifying those patients who are responding to the therapy. Therefore, the combination of lapatinib with metronomic chemotherapy should be explored in advance for osseous MBC.
Lapatinib efficacy according to metastatic sites in trastuzumab pretreated patients with HER2-positive metastatic breast cancer: An analysis form IntERB registry in the Czech Republic.
Authors: Grell Peter , Kandrnal Vit , Zbynek Bortlicek , Vyzula Rostislav 
Published: March 2020

e11072 Background: Lapatinib is an oral dual tyrosin kinase inhibitor of EGFR and HER2 and compared to trastuzumab penetrates to CNS. We evaluated efficacy and safety of lapatinib treatment according to different metastatic sites involvement using data from IntERB registry that has been initiated and run by Czech Society for Oncology and Institute of Biostatistics and Analyses at Masaryk University, Brno, Czech Republic. Methods: An analysis included 213 patients with HER2 positive metastatic breast cancer treated from January 2007 to September 2011. Lapatinib was mostly administered orally 1250mg/day with capecitabine (2000mg/m2 D1-14), 16 patients received lapatinib in monotherapy. All patients had experienced progression during prior trastuzumab based therapy. Results: Median age was 56 years (range 23 – 78). Median duration of lapatinib therapy was 20.6 weeks (range 1–146). Complete response was achieved in 13 patients (6.1%), partial response in 31 (14.6%), stable disease in 118 (55.4%). In 26 disease have progressed (12.2%); response could not be assessed in 25 patients (11.7%). PFS for whole group was 7.1 months (95% CI 5.9-8.5). Overall survival was 17.2m (95% CI 15.8-18.6), probability of 6m OS was 80.3% and 1-year OS was 64%. Metastatic sites specific survival was evaluated in 103 patients. CNS dissemination was initially diagnosed in 31 patients (30.1%), PFS in this group was 6.2m (95% CI 3.3-9.1), OS was not reached, 6-m OS was 67.3%. In non-CNS group (skeletal metastasis in 49.5%, lung 38.8%, hepatic 36.9%, lymphatic 17.5%, other 15.5%) was PFS 6.3m (95% CI 1.6-11.1), OS 22.0m (95% CI 15.3-28.8) and 6-m OS was 88.2%. Most common toxicities were diarrhea in 11.7% patients, rash/skin toxicity in 10.8%, nausea/vomitus in 5.2% and hepatotoxicity in 2.3%. No cardiac toxicity was reported. Therapy was discontinued due toxicity in 9.0%. Conclusions: Lapatinib in combination with capecitabine proved its efficacy in trastuzumab pretreated HER2 positive metastatic breast cancer. Even in patients with CNS involvement was achieved a notable PFS and OS, comparable to non-CNS group of patients. Therapy was well tolerated.
Prognostic analysis according to the expression of hormone receptors in HER2-positive breast cancer.
Authors: Gallego Jimenez Inmaculada , Morales Pancorbo David , Fuentes Pradera Jose , Salvador Javier , Bayo Juan L. , Bernabé Reyes , Rodriguez de la Borbolla Maria , Fernandez Parra Eva , Lopez Ladron Amelia 
Published: March 2020

e11075 Background: Overexpression HER 2 + + + is a distinct group within the breast cancer with different treatments in both the adjuvant and advanced setting. However, from the clinical point of view, there are significant differences within this group HER2 + + + referred to response to trastuzumab, metastatic sites and survival intervals. Recently reported data guides to a worse prognosis in the subgroup expressing hormone receptors. We propose to study these differences in HER2 + + + between subgroups hormone receptor positive and negative. Methods: Retrospective observational study of all patients diagnosed with HER2 + + + at the Hospital Virgen de Valme between the years 2005-2011. We studied the disease-free interval (DFS) and global survival (OS). We also studied the frequency of brain metastases and cerebral disease-free interval (BDFS). We explore differences between the hormone receptor-negative groups (group A) and positive (group B). All patients have been treated with at least one line of trastuzumab. Results: N = 73 (40 group A and 33 group B). Median age was 58 and 55 respectively. 33 patients had metastases in the course of the disease. 7 patients initially diagnosed with metastatic stage. There is a difference of 5.0 months in group A favorable DFS (p = 0.28). The OS was 52 months in group A versus 48 months in group B (difference of 4 months p = 0.18). The BDFS was 57 months for group A and 15 months for group B (p = 0.1). The incidence of brain metastases was 27% versus 9%. Conclusions: Our data suggests a better prognosis in terms of DFS, OS and BDFS in hormone receptor-negative group. Likewise, the incidence of brain metastases was three times lower. We need well design clinical trials, monitoring and therapeutic strategies for this subgroup of patients.
Population-based outcomes of patients (pt) with early-stage HER2-positive breast cancer treated with adjuvant trastuzumab (T).
Authors: Noonan Krista , McCarthy Joy S. 
Published: March 2020

e11079 Background: Phase III trials have shown clinical efficacy of T when combined with chemotherapy in HER2-positive early stage breast cancer, decreasing recurrence by 50% and increasing survival by 30%. 15-20% of early stage breast cancers demonstrate amplification of the HER2 gene, which is associated with a poor prognosis. The aims of this study were to evaluate the clinical effectiveness of T, and explore potential prognostic factors. Methods: Pts with stage I-III breast cancer overexpressing HER2 from 2005 to 2010, assessed in Newfoundland and Labrador’s cancer centre were retrospectively identified from the Provincial Tumour Registry. Pt, treatment, and tumour characteristics were extracted. Kaplan-Meier curves were used for survival analysis, and Cox Proportional Hazards Models were used to identify prognostic factors and evaluate their impact on outcomes. Results: A total of 148 pts were identified. The median age was 56 years, and 76% received T. At a median follow-up of 25 months, overall survival (OS) was 97% (p=0.0002), and disease-free survival was 96% (p<0.00) for pts receiving T. Younger age, smaller tumour size, and lymph node negativity were favorable prognostic factors. There was an 83% decrease in risk of breast cancer recurrence in the patients receiving T. Discontinuation of T occurred in 6.2% of patients due to a decreased ejection fraction. Conclusions: This population-based analysis demonstrates T’s favorable impact on 25-month DFS, OS, and safety. This adds to the body of literature, showing clinical effectiveness and tolerability of T. [Table: see text]
Role of lapatinib in metastatic carcinoma breast.
Authors: Behera Manoj Kumar , Julka Pramod Kumar , Rath Goura Kishore 
Published: March 2020

e11082 Background: Metastatic breast cancer (MBC)is the leading cause of cancer death among women. Lapatinib is a small-molecule TKI that constitutes an alternative in HER2 intracellular signaling pathway blockade, with no cross resistance with Trastuzumab. The combination of Lapatinib and Capecitabine in women with HER2+ advanced breast cancer that progressed following treatment with anthracycline, taxanes and trastuzumab is superior to single agent therapy with Capecitabine. Methods: In this study conducted from March 2010 to June 2011, a total of 30 patients with progressive HER2+ MBC following therapy with at least anthracycline, taxanes and Trastuzumab and then receiving Capecitabine@2gm/m2/day for D1-14, 3 weekly with Lapatinib@1250mgm/day, daily were analyzed. Palliative RT of 8Gy/1# was delivered to the involved bones, and WBRT of 30Gy/10#/2 weeks was delivered to the patients with brain metastasis before starting this combination oral chemotherapy. Results: The median age at primary diagnosis was 45 years. 18 patients were ER and/or PR +. Most common site of metastasis was bone (50%) and brain (23%). 30% of patients had multiple sites of metastasis. All the patients of stage III-IV had received NACT for 3 cycles at least. 80% patients had received adjuvant chemotherapy according to the aggressiveness of the disease before/after loco regional RT. 68% patients also received adjuvant Trastuzumab. With a median follow up of 4 months of treatment with Lapatinib with Capeciatbine, the overall response rate achieved was 75% with only 3 patients of solitary lung and liver metastasis showed CR. 40% patients had PR and 33% had stable disease and rest of the patients progressed. Bony symptoms were better controlled with palliative RT and it was seen that pain control was much better in those patients who received this combination. The TTP ranged from 2 to 6 months. All the patients tolerated well except 4 patients who presented with Gr III diarrhea, responded with Capeciatbine dose reduction by 20%. Conclusions: It is evident from this study that this combination regimen of Lapatinib and Capecitabine is effective and well tolerated in patients of HER2 + MBC. Further larger studies are required to confirm the significance of this regimen in our set up.
Concomitant chemoradiotherapy in women with stage II-III breast cancer.
Authors: Richardet Eduardo arnoldo , Laura Perelli , Richardet Martin Eduardo , Castagneris Nicolas , Cortes Matias Nicolas , Molina Matias 
Published: March 2020

e11501 Background: To demonstrate the compliance of radiotherapy and chemotherapy with concomitant taxanes by avoiding delays initiation of that treatment Methods: Retrospective, observational, and descriptive. We analyzed the medical records of 50 patients from June 2006 to December 2010 with an average follow up of 27.26 months (9 months to 56 months), in which all completed conservative surgery. The chemotherapy used was AC x 4 cycles (doxorubicin 60 mg/m2, Cyclophosphamide 600 mg/m2 on day 1 every 21 days) followed by weekly paclitaxel 80 mg/m2 for twelve weeks, concomitant with radiation in the affected breast. Standardized treatment was indicated to patients with positive hormone receptors. Results: Patients`s age averaged 53.58 years (33 years and 74 years) All patients received the planned chemotherapy, with a delay of 63.24 days, from the surgery to the first cycle of chemotherapy (20 days to 110 days. The radiation treatment was initiated in 143.4 days (90 to 205 days) on average after the surgical treatment.It was reported that 8% (n = 4) discontinued the treatment due to the toxicity of the radiation therapy: actinic dermatitis grade 3 and 4. The average number of days without radiation therapy due to toxicity was 6 days (3 to 9 days).With respect to chemotherapy, 22% (11) interrupted it because of hematologic toxicities (neutropenia, thrombocytopenia), constitutional toxicities (fatigue) and arthralgias. Regarding chemotherapy, the average time without treatment was 18 days (1 to 4 cycles).There were no cardiac or lung related adverse events. All other toxicities were well tolerated with concomitant medication. Conclusions: In our population, it is possible to carry out concomitant chemo-radiotherapy with acceptable early toxicities and compliance in patients with breast cancer.