bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relationship between obesity and survival in advanced breast cancer.
Authors: Castagneris Nicolas , Cortes Matias Nicolas , Richardet Eduardo , Richardet Martin Eduardo , Laura Perelli , Molina Matias 
Published: March 2020

e11044 Background: Breast cancer is the second cause of cancer-related deaths. Obesity is defined as an excessive accumulation of fat. The body mass index (BMI) indicates relationship between weight and height and is used to identify obesity, which is associated with increased risk of cancer. Studies have shown the worst prognosis of obese patients undergoing adjuvant therapy. This paper aims to assess progression-free survival (PFS) and overall survival (OS) in relation to BMI, in patients with advanced breast cancer. Methods: We retrospectively analyzed medical records of 132 patients treated in the IONC from 2005 to 2010. We divided the patients into two groups: group A, BMI <30 (not obese), Group B, BMI ≥ 30 (obese). Analysis of SG and TLP were estimated by the Kaplan-Meier method and compared using the log-rank test. Results: The PFS for group A was 16.44 months, and for group B it was 13.08 (p = 0.40). OS was 31.93 and 27.12, respectively (p = 0.31). Regarding BMI and menopausal status, we observed a marked increase in survival for non-obese premenopausal patients with statistical significance. See table below. Conclusions: Patients with BMI <30 had higher survival rates, without reaching statistical significance. This could be due to small sample size and heterogeneity. Another relevant finding is the statistically significant difference in survival that favors premenopausal patients with lower BMI, which raises an area to be studied. This work demonstrates the importance of guiding patients towards a healthier life habit. [Table: see text] [Table: see text]
Equivocal results of HER2 fluorescent in situ hybridization (FISH) assessment in breast cancer: Diagnostic limitations and therapeutical implications.
Authors: Cruz Marcelo Rocha De Sousa , Ribeiro Adriana Regina G. , Santos Fábio Nasser , Cunha Isabela Werneck , Lima Vladmir C. 
Published: March 2020

e11058 Background: HER2/neu status is a well established prognostic and predictive factor for breast cancer (BC) patients. However, HER2 testing remains controversial because of technical issues, lack of consensus on cut point determinations and pathology interpretation. As a result, some patients present tumors with inconclusive or equivocal tests, making the indication of anti-HER2 therapy questionable. Methods: We evaluated the incidence of inconclusive and equivocal HER2 amplification by FISH after an equivocal HER2 immunohistochemical (IHC) result in a cohort of breast cancer patients treated at a cancer center. Equivocal IHC was defined as tumor cells showing 2+ membranous immunoreactivity out of a possible 3+. Inconclusive FISH was considered when probe signs were weak and did not allow proper evaluation. Equivocal FISH was defined according to ASCO/CAP recommendation. Patients’ clinical characteristics, treatments and outcomes were evaluated. Results: From 2006 to 2011 we analyzed BC tissue samples from 404 patients that underwent HER2 FISH assessment after equivocal IHC. Gene amplification was found in 28,7% (n=116) of samples; 65,5% (n=265) showed non-amplification results. Inconclusive (n=12) plus equivocal (n=11) FISH results were found in 5,7% (n=23) of patients. In the inconclusive/equivocal FISH cohort, 78% of evaluated tissue came from breast biopsy and 22% were extracted from metastatic sites. When HER2 amplification by FISH was reclassified according to the FDA criteria (HER2/CEP17 FISH ratio above 2.0), 45% of patients previously classified as equivocal became HER2 positive. None of equivocal HER2 FISH patients received anti-HER2 therapy. Conclusions: The incidence of BC patients with equivocal HER2 FISH at our institution is similar to other large series, reflecting our adequate quality assurance methods. Anti-HER2 therapy is the backbone for HER2-positive BC patients irrespective of hormone receptor status. Further analyses using different techniques for HER2 expression and amplification status assessment are urged in order to better select patients for appropriate therapy.
Pathologic response rate in HER2-positive locally advanced breast cancers treated with neoadjuvant trastuzumab and concurrent paclitaxel/radiotherapy.
Authors: Adams Sylvia , Hochman Tsivia , Huppert Nelly , Dhage Shubhada , Checka Cristina , Singh Baljit , Speyer James L. , Schneider Robert , Goldberg Judith D. , Formenti Silvia 
Published: March 2020

e11064 Background: We demonstrated in three prospective trials that taxane-based concurrent chemo-radiation achieves high pathological response rates that correlate with decreased recurrence rates and improved survival in locally advanced breast cancers (LABC, Adams et al, BCRT 2010). We now report the results among HER-2 positive LABC patients treated with trastuzumab and concurrent paclitaxel and radiotherapy, preoperatively. Methods: Patients with HER-2 positive LABC (stages IIB-IIIC) were prospectively treated as part of an IRB-approved neoadjuvant trastuzumab-paclitaxel-radiotherapy protocol. Paclitaxel was administered at a dose of 30 mg/m2 twice a week and trastuzumab was given weekly at a dose of 2 mg/kg (after initial loading with 4 mg/kg) for a total of 10 weeks. Radiotherapy was delivered to the breast and regional lymph nodes during weeks 2-7, daily, at 1.8 Gy per fraction to a total dose of 45 Gy. A 14 Gy boost (2 Gy per fraction) was added to the area of the originally palpable tumor site. Tumor response was assessed at definitive cancer surgery; defined as pathological complete response (pCR) in the absence of invasive cancer in breast and lymph nodes; pathological partial response (pPR) as the persistence of < 10 microscopic foci of invasive carcinoma in breast or lymph nodes. All other patients were classified as having achieved no pathologic response. Results: Twenty-one patients with HER-2 positive LABC were treated. The median age of the patients was 50 years (range 28-76). The most common toxicity was acute dermatitis; no grade IV toxicity was detected. Pathological response (pCR and pPR) after neoadjuvant trastuzumab/paclitaxel/radiation was achieved in 12 patients (57%, 95% CI: 37% - 76%). Responses were observed in 8/12 patients with hormone receptor (HR)-negative (7 pCR, 1 pPR) and in 4/9 patients with HR-positive cancers (3 pCR, 1 pPR). Conclusions: In HER-2 positive LABC, neoadjuvant trastuzumab during paclitaxel and concurrent radiotherapy resulted in a 57% pathological response rate, independently of HR status.
Time of disease control (TDC) with hormone and chemotherapy in metastatic breast cancer (MBC).
Authors: Singh Hitesh , Hodges David , Reynolds Jana , Ashley Pandora , Ruud Christopher O. 
Published: March 2020

e11069 Background: Patients with metastatic breast cancer are treated with multiple lines of therapy. Less is known about the relative benefits from subsequent lines of hormone and chemotherapy and the influence of the molecular subtypes; luminal, HER2, and triple negative. Methods: The tumor registry at Scott & White Memorial Hospital (S&W) was queried for consecutive patients diagnosed with MBC between 2000 and 2009. Of the 409 patients identified, 252 patients met inclusion criteria. Exclusions were partial treatment at S&W (112), unknown ER or HER2 status (26), male sex (5), and palliative care only (14). Treatment regimen and start date was recorded for each line of therapy by review of EMRs. TDC for each line was defined as the treatment start date to the date of the next line of therapy, or the end date of treatment for the final line. Lines of therapy were reported sequentially relative to their order in either hormone or chemotherapy, not in regard to their overall line in systemic treatment. Results: For patients followed to death, median overall survival for luminal (104), HER2 (57), and triple negative (62) was 19.0, 24.1, and 9.3 months respectively. For those who underwent chemotherapy as their final line (162), the median time between last chemotherapy administration and death was 1.5 months. The table reports the median TDC for the first five lines of chemotherapy and first three lines of hormone therapy. Conclusions: All subtypes had continued benefit of chemotherapy on subsequent chemotherapy lines. Overall, HER2 exhibited longer TDCs on chemotherapy. Although biased by case selection, TDC on hormone therapy was superior to chemotherapy for the first three lines of hormone treatment. Our findings support the benefit of successive lines of hormone and chemotherapy for palliation in MBC. [Table: see text]
Correlation between triodothyronine levels and cancer cell proliferation in high Ki-67 estrogen receptor-positive breast cancer patients.
Authors: Tzovaras Alexandros , Mourouzis Iordanis , Tsapralis Nikos , Tsoukalas Grecory , Tsoukalas Nikolaos , Stamatopoulou Sofia , Oikonomopoulos Georgios , Misitzis Ioannis , Pantos Christos , Ardavanis Alexandros 
Published: March 2020

e11073 Background: Although thyroid hormone is a critical regulator of cell growth, differentiation and survival during development, the relationship between thyroid hormone status and breast cancer has not been adequately explored. Recent findings suggest that T3 administration reduces cancer cell proliferation depending on the type of tumor cell line with aggressive tumors to be more sensitive to thyroid hormone treatment. Thus, the present study investigated the potential relationship between thyroid hormone levels and strong prognostic factors (such as tumor size, nodal status, and Ki67) in estrogen receptor positive (ER+) breast cancer patients. Methods: 86 ER(+) breast cancer patients were studied. Levels of TSH (μΙU/ml), FT3 (pg/ml) and FT4 (ng/ml) were measured in all patients before surgery. After surgical excision of the tumor, samples were taken for histopathological analysis to determine tumor size, an index of cell proliferation Ki67 and HER2 receptor expression. HER2 receptor when amplified, it results in an aggressive subtype of breast cancer. In addition, activation of Akt and ERK signaling was examined in tumor samples by western blotting analysis. Akt signaling activation is linked to cell differentiation, while ERK signaling activation induces cell proliferation and dedifferentiation. Results: See table. HER2(+) breast cancers were found to have 2.0 fold increase in levels of phospho-p44/total p44 ERK and 3.0 fold decrease in levels of phospho-Akt/total Akt as compared to HER2(-) breast cancers. In HER(-) breast cancers no correlation was found between TSH, FT3 or FT4 and tumor size, Ki67 and nodal status. However, in HER(+) breast cancers a strong negative correlation was found only between FT3 levels and Ki67, r = -0.60 and p = 0.004. Conclusions: Levels of FT3 show a negative strong correlation with cell proliferation of HER2(+) aggressive breast cancers. This finding may have important therapeutic implications. [Table: see text]
Observational cross-sectional study to evaluate the prognostic factors influencing the selection of bevacizumab combined with chemotherapy in patients with HER2-negative metastatic breast cancer in routine clinical practice. ONCOSUR-AVALOX study.
Authors: Manso Luis , Perez-Carrion Ramon , Chacon Lopez-Muniz Jose Ignacio , Garcia Palomo Andres , Galve Calvo Elena , Llorente Rosa M. , Cassinello Javier , Catalan Gustavo , Llorca Cristina , Torregrosa Maria Dolores , Alvarez Inaki , Gallegos Sancho Isabel , Blanco Esperanza , Oruezabal Mauro , Mielgo Rubio Xabier , Garcia Lopez Maria Jose , Hernando Blanca , Enrech Santos , Lara Miguel Angel , Cortes-Funes Hernan 
Published: March 2020

e11074 Background: Combining bevacizumab (BEV) with chemotherapy (CT) improves survival in HER2-negative metastatic breast cancer (MBC). We investigated the influence of age, ECOG, hormonal status, number of sites and location of metastases and patient decision on the selection of BEV combined with CT in MBC. Methods: Observational cross-sectional multicenter study in pts with HER2-negative MBC who have received first-line CT with BEV. Results: From November 2010 to November 2011, 124 pts were included: median age 51 (45-64) yr; ECOG: 0=50%; 60% pre-menopausic; 23% triple-negative (TN); 77% hormone receptor-positive (HR+). Metastatic disease: ≥3 sites=42% (TN: 32%; HR+: 45%); location: 44% bone, 35% lung, 30% liver. Most frequent BEV-based combinations were paclitaxel/BEV (53%) and docetaxel/BEV (14.5%); median no. of CT cycles: 6 (5-8). A disease-free survival (DFS) ≥12 months was achieved by 73%; TN: 68%; HR+: 76%. Overall response rate (ORR) was 58%: 51% partial response (PR), 7% complete response (CR); 28% stable disease (SD) and 10% disease progression. TN: ORR 44% (40% PR), clinical benefit 80% (36% SD); HR+: ORR 62% (54% PR), clinical benefit 87% (25% SD). 58% presented at least one toxicity, mainly grade 1-2; 26% BEV-related: only 3 (2.4%) grade 3 toxicities; no grade 4. Receiving adjuvant hormonal therapy was associated to DFS ≥12 months (p<0.05). ER+ tumors (OR: 0.215; 95% CI: 0.08-0.56; p=0.002) and one metastatic site, vs. ≥3 sites (OR: 0.309; 95% CI: 0.12-0.83; p=0,020) were independent factors associated with the selection of paclitaxel-BEV therapy in the overall population (TN or HR+). Metastases in the liver were significantly related to paclitaxel-BEV administration (p<0.01). Conclusions: Our findings suggest that first-line CT with BEV is an active and tolerable treatment option for pts with TN and HR+ MBC. ER+ tumors and a single metastatic site were identified as independent factors for the selection of a paclitaxel-BEV therapy. The presence of metastases in the liver was significantly associated to the administration of a paclitaxel-BEV regimen.
Simultaneous peripheral facial palsies (SPFP) and bilateral foot drops after initiation of eribulin in a patient with triple-negative breast cancer.
Authors: Morrison Tara , Swaby Ramona F. , Ryan Paula D. , Ambady Prakash 
Published: March 2020

e11085 Background: Simultaneous peripheral facial palsy (SPFP) is extremely rare. Unlike Bell’s palsy it is seldom idiopathic. We describe a case of acute SPFP and bilateral foot drops attributed to the novel chemotherapeutic agent, eribulin mesylate (EM), a synthetic microtubule inhibitor. Methods: Utilizing the medical record as well as physical evaluation and assessment, we diagnosed SPFP and bilateral foot drops temporally related to administration of EM for metastatic triple negative (ER neg/PR neg/HER2 neg) breast cancer. Results: A 71-year-old woman initially diagnosed with Stage I, T1N0M0, ER neg/PR neg/HER2 neg invasive ductal carcinoma of the left breast treated with adjuvant radiotherapy recurred 3 years later with liver metastases. Salvage treatment included first-line capecitabine for 6 months followed by paclitaxel for 13 months with residual grade 1 peripheral neuropathy. Fourteen days following last paclitaxel dosing, EM was started. Within 3 weeks of initiation of therapy, the patient presented with bilateral SPFP, as well as bilateral complete foot drops. She was unable to speak or take liquid or solid oral intake and unable to bear weight. Extensive work-up including initial CT of the brain, followed by MRI and LP revealed no metastatic or infectious (i.e. – Lyme disease, ACE, TSH, ANA, SPEP) etiology. After discontinuation of EM, physical and speech therapy were instituted including in-patient rehab. After follow-up of 16 weeks, she has partial resolution of the facial palsy and improved ambulation with bilateral foot braces and walking cane. Conclusions: Unlike unilateral Bell’s palsy, the differential diagnosis for SPFP includes many conditions that can potentially turn fatal within a short period of time if they are not diagnosed and treated promptly. To the best of our knowledge, CIN presenting with SPFP or foot drop due to EM has not been reported. We highlight the need to screen patients for pre-existing neuropathy and continued close monitoring for development of neuropathy to avoid potentially dose-limiting disabilities before initiating eribulin.
Non-breast solid malignancies among breast cancer survivors.
Authors: Altundag Kadri , Petekkaya Ibrahim , Sahin Ugur , Solak Mustafa , Ozisik Yavuz 
Published: March 2020

e11092 Background: Due to advances in treatment modalities and palliative care patients with breast cancer live longer compared to the past and thus encounter an increased risk for secondary cancers. This study aims at finding the frequency of other solid cancers in a retrospective cohort. Methods: A search for the history of a non-breast solid tumor (NBST) among 1914 women admitted to our institute with stage I to IV breast cancer between 2006 – 2012 was conducted. Frequency of NBST according to temporal relation with breast cancer diagnosis was calculated Results: Overall 79 NBST and 75 patients (3.9 %) with another solid tumor were discovered. Of the patients 4 had more than one tumor. For these patients the median age at diagnosis was 55 (28 – 93), median follow-up time for breast cancer was 32 months (1 – 132). Post-menopausality was 60.8 %. The most common breast cancer histology was infiltrative ductal carcinoma (70.9 %). Of the 79 NBST, 34 (43.0 %) were diagnosed after breast cancer; 30 (38.0 %) before; and 15 (19.0 %) synchronously. Median time of diagnosis for NBST after breast cancer was 21 months (7 – 296). The most common malignancies were cancers of the ovary, thyroid and uterus (17.7, 15.2 and 11.4 %, respectively). Conclusions: The frequency of gynecological cancers and thyroid cancer along the course of breast cancer is high. Common environmental and genetic factors and may be involved. These patients should be followed closely
Diagnosis of axillar lymph node status and sentinel node biopy (SNB) by indocyanin green (ICG) fluorescence imaging in early breast cancer patients.
Authors: Hisamatsu Kazufumi 
Published: March 2020

e11503 Background: In breast cancer patients, diagnosis of Axillar lymph node (Ax LN) status is practical use in deciding treatment strategy. But, diagnostic methods are different by different institution. The purpose of this study was to review diagnostic methods of Ax LN status. Methods: From December 2006, 483 cases were underwent breast cancer operation and within 356 (74%) clinical node negative primary breast cancer cases underwent Sentinel Node biopsy (SNB) by indocyanine green (ICG) fluorescence imaging. Dye was injected sub dermal in the areola. After one minute massage, subcutaneous lymphatic channel draining from the areola to the axilla was observed by Image processing and measuring system (PDE C9830, Hamamatsu Photonics Co). Skin incision was done at the point which fluorescence imaging disappeared (ASCO2011, Electronic Publication only). From September 2010, Aspiration Biopsy Cytology (ABC) of Ax LN (LN-ABC), Ultrasonography (US) and CT were done as routine workup in breast cancer patients. Node positive cases were received pre-operative chemotherapy or Ax LN dissection and node negative cases were underwent SNB by ICG fluorescence imaging during operation. Results: From December 2006, SNB were done 356 clinical node negative primary breast cancer cases. SN was detected 342 cases, detective rate was 96 %. This rate was as good as SNB done by radioactive colloid (Phytate radiolabelled by Tc98) with dye (detective rate was 95%, ASCO2011). The lymph node metastasis was detected 48 cases (14%). From Sep 2010 to Oct 2011, LN-ABC was done 49 cases of the 142 primary breast cancer patients. Fourteen cases were LN-ABC positive and 35cases were LN-ABC negative. Positive SNB were detected 3 of the 35 cases (2 cases had micro metastasis and one case had macro metastasis). Within three SNB positive cases, pre-operative US and CT had no positive finding. Positive LN-ABC cases (14 cases) were received pre-operative therapy or Ax LN dissection. Conclusions: These results suggest that LN-ABC was useful procedure detecting positive Ax LN and SNB by ICG fluorescence imaging was useful and easy tool in operative breast cancer patients.
Feasibility of dietary intervention in a breast cancer population.
Authors: Champ Colin E. , Anne Pramila R. , Showalter Timothy Norman , Heersink Mila J , Iacono Rosanne , Mishra Mark Vikas , Dicker Adam P. , Rosenberg Anne Louise , Simone Nicole L. 
Published: March 2020

e11505 Background: Caloric restriction (CR), or reducing caloric intake by 20-40%, induces molecular changes which are also altered in breast cancer leaving cancer cells more susceptible to cytotoxic treatment. In vivo, CR decreases tumor growth and metastases. Recent research shows that breast cancer patients with metabolic syndrome and high blood glucose had higher mortality and poorer response to treatment. Diet modification may be an attractive potential adjunct to improve standard therapies, but little is known of the feasibility of enrolling patients into such a trial. Methods: After obtaining IRB approval, a survey was administered to a sample of patients in an academic breast cancer clinic to determine their interest in participating in nutrition trials during cancer treatment. Women were questioned regarding demographics, overall health status, comorbidities, and willingness to participate in clinical trials aimed at potentially increasing the efficacy of treatment through diet. Results: 50 breast cancer patients participated. 48% had comorbidities, 56% were self or physician-described as overweight, and 76% exercise at least once per week. 70% of respondents state that nutrition was never discussed with a physician prior to cancer care, 32% searched online for dietary information, and 62% expressed willingness to participate in a clinical trial involving a dietary regimen. Patients willing to participate in such a trial were more likely to be: currently exercising (73%), vitamin users (90%), not obese (64%), and more educated about diet related information (78%). Patients determined the most important tools to help them with dietary trial compliance would be speaking with a dietician weekly and weekly phone calls with the physician. Adherence would be increased if participants were provided meals. Conclusions: A significant proportion of breast cancer patients in this survey are interested in nutritional guidance and there is strong interest in participating in clinical trials with a dietary modification. Promising approaches include weekly meetings with dieticians and phone-based support. Based on these data, clinical trials of nutritional interventions appear warranted and feasible for enrolling breast cancer patients.