bluuebunny/crossref_metadata_2025_split huggingface dataset:
Higher volumetric breast density to predict risk for aggressive breast cancer subtype in postmenopausal Korean women.
Authors: Park In Hae , Ko Kyungran , Choi Ji Soo , Jung So-youn , Lee Seeyoun , Kim Seok Won , Kwon Youngmee , Shin Kyung Hwan , Kang Han Sung , Lee Eun Sook , Lee Keun-Seok , Ro Jungsil 
Published: March 2020

e11584 Background: In Asian population, the peak incidence of breast cancer is women in their late forties. We investigated the association between volumetric breast density and breast cancer risk according to menstruation status and breast cancer subtypes in Korean women. Methods: We prospectively enrolled 509 newly diagnosed breast cancer patients and 1336 healthy control subjects who performed mammography at the National Cancer Center in Korea between Sep 2011 and Nov 2012. Breast density was estimated using volumetric breast composition measurement (VolparaTM). We collected clinical data including menstruation status, parity, BMI and use of postmenopausal hormones. For cancer patient, we additionally acquired following pathologic data: histologic type, tumor size and grade, receptor status, Ki-67, and nodal status. Results: Of a total of subjects, 1064 (57.7%) women were postmenopausal status. The risk of breast cancer increased progressively with increase in volumetric breast density (Ptrend <0.001) in all subjects. In addition, breast cancer risk increased in women < 60 years old (odds radio (OR) = 1.81), higher body mass index (BMI) (< 25kg/m2 vs. ≥ 25kg/m2) (OR = 2.41), and fewer childbirth (0/1 vs. ≥ 2) (OR=2.38). In postmenopausal women, higher breast density (category 4) showed a 3.00-fold (OR = 3.00, 95% confidence interval (CI) = 1.75-5.16, P<0.001) increased risk of breast cancer compared with lower breast density (category 1-2). In contrast, there was no such association in premenopausal women. The associations of volumetric breast density were stronger for HER2 positivity (Ptrend <0.019), and high Ki-67 (Ptrend <0.006) in postmenopausal breast cancer patients. There was a statistically significant association between lower breast density and hormone receptor (HR) positive/HER2 negative breast cancer (Ptrend <0.019). Conclusions: High volumetric breast density is associated with the risk of breast cancer having more aggressive tumor characteristics in postmenopausal women.
Long-duration chemotherapy, switch to endocrine therapy, or watch only? A single-center retrospective study of metastasis breast cancer with ER/PR(+) and CerbB2(-).
Authors: Jian Huang , Chen zhan-Hong , Cao Wenming , Ye Wei-Wu , Ping Huang , Xiying Shao ,   Zhejiang Cancer Hospital
Published: March 2020

e11589 Background: To evaluate the efficiency of long-duration chemotherapy used Capecitabine or switch to endocrine therapy in metastasis breast cancer (MBC) patients with ER/PR(+) and CerbB2(-). Methods: We retrospective analysis 112 patients of our center from 01/Jan/2009 to 30/April/2012, who with ER/PR(+) and CerbB2(-) MBC. All these patients accepted capecitabine -based regimen as first-line or 2nd-line chemotherapy. Three regimens included long-duration chemotherapy(LC) used capecitabine, switch to endocrine therapy(STET) or watch only(WO) were given after capecitabine-based regimen. We compared the differences among these three regimens. Results: 70/112 were first-line chemotherapy,52/112 were 2nd-line chemotherapy. All these patients used capecitabine-based regimen (include single-agent or in combination with another chemotherapy drug), and the response were: CR, PR, SD≥24 weeks. 29 patients were LC,28 patients were STET and 55 patients were WO after capecitabine-based regimen. The median progression-free survival (mPFS) was 7 months, one year survival rate was 32.0%, response rate(RR) was 35.7% in all these patients. The mPFS were 22 months, 12 months and 5 months in LC group, STET group and WO group respectively. The one year survival rate were 67.6%,46.5% and 5.1% in these three groups respectively. WO group was significantly worse than LC and STET groups on mPFS (p<0.0001) and one year survival rate (p<0.05). LC group and STET group was no significant difference in mPFS(p=0.1832) and one year survival rate (p=0.5012). The RR were 51.7%, 39.3% and 25.5% in these three groups respectively. LC group was significantly better than WO group (p=0.0287). No significant difference between LC and STET groups (p=0.4287) or STET groups and WO group (p=0.2145). Conclusions: Long-duration treatment is better than watch only(WO).Patients with ER/PR(+) and CerbB2(-) MBC used capecitabine-based regimen (include single-agent or in combination with another chemotherapy drug), and the response were: CR, PR, SD≥24 weeks maybe get more benefits from long-duration chemotherapy used capecitabine. A multicenter prospective study is going on.
Human epidermal growth receptor-2 overexpressing early operable primary breast cancers in older (≥70 years) women: Biology and clinical outcome in comparison with younger (<70 years) patients.
Authors: Syed Binafsha Manzoor , Green Andrew R. , Morgan Dal , Ellis Ian O. , Cheung Kwok-Leung 
Published: March 2020

e11608 Background: There is dearth of literature reporting the prevalence and biological characteristics as well as the long-term clinical outcome of HER2 positive tumors in older women. This study aimed to analyse their biological characteristics and compare them with their younger counterparts from a single centre with long-term clinical follow-up. Methods: Over 37 years (1973-2010), 1,758 older (≥70 years) women with early operable (<5cm) primary breast cancer were managed in a dedicated clinic and have complete clinical information available. Of these 813 patients underwent primary surgery and 575 had good quality tumour samples available for tissue microarray (TMA) analysis using immunohistochemistry. Comparison was made with data from a well-characterised younger (<70years) series (N=1,711) treated between1986 - 1998 (before adjuvant trastuzumab became standard) in our institution. Thirty-nine (7.6%) and 140 (8.2%) patients from the older and younger series respectively (p=0.56) had HER2-positive tumours. Results: See Table. Conclusions: The HER2 positive tumours in older women showed relatively less aggressive phenotype and did not show any inferior long-term clinical outcome despite not having received chemotherapy as compared to the younger patients. The precise role of different adjuvant systemic therapies in this population needs to be delineated. [Table: see text]
Results of a novel neoadjuvant chemotherapy (NAC) regimen for breast cancer.
Authors: Rivera-Rodriguez Noridza , Cabanillas Fernando , Lawrenson Lesley , Negron Viviana , Pavia Orestes Antonio , Bruno Margarita , Echenique Miguel M. , Carlo Victor , Liboy Idalia 
Published: March 2020

e11610 Background: Achieving a pathologic complete response (pCR) after neoadjuvant chemotherapy (NAC) has been associated with improved disease free survival (DFS) and overall survival (OS). The Residual Cancer Burden Score (RCB) method is a useful tool that predicts DFS and OS after NAC. We present the results of pts with either triple negative or HER2 positive breast cancer treated with a novel NAC. Methods: 34 pts with localized breast cancer >1 cm with HER2+ (N=19) or triple negative breast cancer (TNBC) (N=15) were treated with this novel regimen consisting first of TEC (docetaxel 75 mg/m2, epirubicin 80 mg/m2, and cyclophosphamide 500 mg/m2) + PEG Filgrastim x 4 cycles. Following the 4th course, TNBC patients received 4 additional TEC cycles if they achieved CR by MRI, or were switched to a non cross-resistant regimen (vinorelbine, bevacizumab, capecitabine) if they had < CR. HER2+ pts received TEC x4 followed by docetaxel + trastuzumab x 4. RCB score was used to measure pathologic response. Pretreament PET scan was done and repeated after course 1 in order to correlate with RCB. Results: Median age was 56 (58 for Her2+ and 49 for TNBC). RCB= 0 (pCR) was achieved in 76%, while only 1 responded poorly (RCB=3). There was no significant difference in the pCR rate between Her2+ and TNBC patients (74% vs 80% respectively), but there was a difference in the rate of pCR without DCIS and invasive cancer between these two (see table, p=0.034). Pts with SUV drop > 5% after 1st TEC had 84% pCR while none with < 5% achieved pCR (p=0.001). Comparison of our results with other NAC regimens reported in the literature is summarized in the table below. Conclusions: This novel chemotherapy approach results in a high pCR rate and RCB 0-1, which have been associated with improved clinical outcomes. Early PET can predict pCR. Although sample size is modest, results are encouraging and deserve further evaluation. Clinical trial information: NCT 00830544. [Table: see text]
Use of locoregional treatment to improve survival in de novo stage IV breast cancer patients with luminal-like and HER2-rich subtypes.
Authors: Chen Pengyu , Cheng Skye H Hong-Chun 
Published: March 2020

e12003 Background: Breast cancer has three major subtypes, including luminal-like (hormone receptor positive, no HER2 overexpression), HER2-rich (HER2 overexpression), and triple negative (hormone receptor negative and no HER2 overexpression). This study is to analyze the prognosis in each subtype of stage IV breast cancer patients. Methods: We reviewed 246 patients with de novo stage IV breast cancer treated at our hospital between 1990 and 2009. Multivariable Cox analysis was used to determine the survival associated the subtypes and clinicopathologic factors. Results: Patients with luminal-like subtype are mostly premonopausal (66.9%, P=0.0002), with abnormal CA 15-3 level at initial diagnosis (58.7%, P=0.01), with higher rate of bone mets (78.1%, P=0.02), and less rate of liver mets (23.1%, P<0.0001). Patients with HER2-rich and triple negative had higher rate of nuclear grade III of primary breast tumor, up to 35% and 40%, respectively (P=0.01). There is no difference in the systemic chemotherapy (82.2~95%, P=0.09) and locoregional treatment (40.0~51.2%, P=0.23) among three groups. The median overall survival of 246 patients was 23.1 months. The median overall survival in patients with luminal-like, HER2-rich, and triple negative subtype were 39.6, 17.9, and 13.3 months, respectively (P<0.0001). In multivariate analysis, hormone receptor and HER2 status were significant independent factors associated with survival (P<0.0001). Other significant factors associated with survival included liver mets (Hazard Ratio 2.3, P<0.0001), lung mets (Hazard Ratio 1.7, P=0.0004), and brain mets (Hazard Ratio 1.5, P=0.03). In subgroup analysis, locoregional treatment to primary breast tumor had significant survival benefit in patients with luminal-like (P=0.0001) and HER2-rich(P=0.0012) subtype. In triple negative subtype, local treatment did not improve outcome (P=0.9575). Conclusions: Hormone receptors and HER2 status are the most important factors affecting survival for these patients. Locoregional treatment to primary breast tumor may provide better outcome, especially those with luminal-like or HER2-rich subtype.
Estimating long-term efficacy of multi-catheter brachytherapy in Japanese breast cancer patients.
Authors: Sato Kazuhiko , Mizuno Yoshio , Shimo Takahiro , Kato Masahiro 
Published: March 2020

e12009 Background: The efficacy of an accelerated partial breast irradiation (APBI) has been investigated as an alternative method to whole breast irradiation (WBI) in breast-conserving treatment (BCT). We have previously reported that multi-catheter brachytherapy as APBI using intra-operative open-cavity implant (IOCI) technique is feasible for Japanese patients. Since the follow-up period of this technique was relatively short, a long-term efficacy has been evaluated using an individualized-case-control (ICC) analysis. Methods: 179 consequent patients with 183 lesions were treated with BCT using IOCI from October 2008 to January 2013. Patients with bilateral breast cancer were included in the database twice. After the confirmation of the free margin and negative sentinel-nodes for metastases using frozen section analysis, applicators were inserted. APBI was started the same day of the operation, delivering 32 Gy in 8 fractions. We performed an ICC analysis to estimate the number of patients with an ipsilateral breast recurrence (ILBR). The 10-year risk of ILBR for each patient if treated by BCT with WBI was calculated with web-based decision-making tool (IBTR!) and it was adjusted by the actual follow-up period using EBCTCG overview’s data. Results: 123 patients with pN0 and longer than 1 year follow-up were enrolled in this analysis. Their mean age was 54.9 years. Most tumors (94.3%) were 2 cm or less in diameter. The median follow-up period was 3.0 years (1.0-4.3 years). All toxicities related to radiation therapy were mild. When BCT was performed with and without WBI, we estimated that there should be 1.2-2.4 and 4.9-9.1 ILBR in this group, respectively. Although one ILBR was observed, there was no tumor-bed recurrence in this treatment group. Conclusions: There was only one ILBR (no tumor-bed recurrence), which was within an estimated range of local recurrences. Multi-catheter brachytherapy using this technique is expected to offer the same rates of long-term local control than WBI using ICC analysis.
Prospective, randomized trial comparing harmonic scalpel and electrocautery in breast surgery.
Authors: Mori Tsuyoshi , Abe Hajime , Kawai Yuki , Murakami Koichiro , Akabori Hiroya , Yamaguchi Tsuyoshi , Sonoda Hiromichi , Shimizu Tomoharu , Shiomi Hisanori , Kubota Yoshihiro , Naka Shigeyuki , Murata Satoshi , Yamamoto Hiroshi , Umeda Tomoko , Tani Tohru 
Published: March 2020

e12014 Background: The objective of this study was to compare the potential advantages of the harmonic scalpel with those of electrocautery for axillary lymph node dissection in breast surgery. Methods: A prospective randomized study of axillary lymph node dissection procedures performed between March 2011 and September 2012 was conducted. Primary breast cancer patients with axillary node-positive status (n = 25) were randomly assigned to the harmonic scalpel (group A, n = 13) or electrocautery (group B, n = 12) groups.The patients underwent breast-conservation surgery or mastectomy with a level I and II axillary dissection, which was performed by one surgeon. The time required for resection and the blood loss during the lymphadenectomy were recorded. The HARMONIC FOCUS (Ethicon Endo-Surgery, Inc.) was used as the ultrasonic scalpel. A low-pressure vacuum drain was placed in the axilla and removed when the drainage volume reduced to less than 50 ml over 24 hours. After the operations, the patients were assessed for the presence of seroma in an outpatient setting. Results: Resection timein group A was significantly shorter than that in group B (mean, 28.6 ± 5.1 vs. 40.3 ± 5.6 min; P = 0.0001). Similarly, blood loss in group A was significantly lower than that in group B (mean, 7.9 ± 5.3 vs. 22.9 ± 11.5 ml; P = 0.001). Duration of drain placement in group A was significantly lower than that in group B (mean, 3.5 ± 1.1 vs. 5.0 ± 0.9 days; P = 0.01), and the seroma rate in group A was lower than that in group B (23% vs. 66%; P = 0.04). Conclusions: For axillary lymph node dissection, the harmonic scalpel is more effective in terms of resection time, blood loss, duration of drain placement, and postoperative seroma formation.
A novel anticancer agent, benzene-poly-carboxylic acids complex with cis-diammineplatinum (II) dichloride, activates multiple immunologic mechanisms of an antitumor response.
Authors: Kirkin Alexei , Dzhandzhugazyan Karina , Fang Jens , Lindkair-Jensen Steen , Guldberg Per 
Published: March 2020

e12024 Background: BP-C1 (a combination of a benzene polycarboxylic acids complex (BP-Cx-1) with cis-diamineplatinum in a very low concentration) was demonstrated to be safe and effective in the treatment of stage IV breast cancer. Methods: In order to investigate whether the immune system mediates some of the clinical activity of BP-C1, we conducted an in vitro study of the immune modulating properties of this compound. The study was done using peripheral blood mononuclear cells from healthy donors. Results: It was demonstrated that the production of a number of cytokines was significantly increased by BP-C1, first of all IL-1beta, TNF-alpha, GM-CSF, IFN-gamma, and IL-25. The carrier molecule, BP-Cx-1, alone also stimulated IL-6 production. Experiments with isolated cultures of monocytes and lymphocytes indicated that the primary targets for these reagents are monocytes. Activation of monocytes leads to two major effects: a) the production of cytokines that are able to increase the anti-tumor activity of lymphocytes, and b) the acquired ability of monocytes to inhibit tumor cell growth. In addition, direct effects on lymphocytes were also demonstrated, exemplified by the induction of IL-25 production. Conclusions: In conclusion, it was demonstrated that BP-C1 and the related compounds are able to activate multiple immunological mechanisms of anti-tumor response.
Neoadjuvant chemotherapy with metronomic doxorubicin, cyclophosphamide, and capecitabine in patients with locally advanced (LA) triple-negative breast cancer (TNBC).
Authors: Frolova Mona , Skrypnikova Marina , Ignatova Ekaterina , Petrovsky Alexander , Stenina Marina , Ivankina Oxana , Vishnevskaja Yana , Tjulandin Sergei 
Published: March 2020

e12027 Background: TNBC is associated with aggressive behavior and poor prognosis. It has been shown that patients (pts) with TNBC with pathological complete regression (pCR) after neoadjuvant chemotherapy have a higher survival. Rates of pCR with standard antracycline- and taxanebased chemotherapy regimens don’t exceed 20-27%. Dose-dense and metronomic schedules may be more effective in these highly proliferative tumors. We performed a prospective pilot trial to evaluate efficacy of metronomic schedule of doxorubicin, cyclophosphamide and capecitabine in pts with LA TNBC. Methods: Pts with LA TNBC (cT2-4N1-3M0) were treated with doxorubicin 25 mg/m2 iv weekly, cyclophosphamide 50 mg po daily and capecitabine 1500 mg po daily for planned 16-19 weeks followed by surgery. Pathological response was evaluated according to the Chevallier classification. Results: Twenty pts was included in the study in 2009-2010. Median agewas 47 years (33-70), 63% of pts had tumor grade 3, Ki67 was >20% in all cases. Nineteen pts completed chemotherapy (median treatment duration 17.1 weeks) and underwent surgery. One pt had a disease progression during chemotherapy and was switched to 2nd-line chemotherapy. Seven pts (36,8%) achieved a pCR (6 pts class 1 and 1 pt class 2). With median follow-up of 33 months, 3-year DFS and OS were 60%. All but one pt with pCR, who developed brain mts shortly after surgery, are currently alive without relapse. In contrast 50% of pts with residual tumor relapsed. Pts with pCR had significantly higher median cumulative dose of doxorubicin (420 mg/m2) than pts with residual disease (300 mg/m2, p=0.046). The dose-limiting toxicities were hand-foot syndrome (26.3% grade 3), mucositis (31.6% grade 3), and neutropenia (31.6% grade 3-4), which resulted in permanent discontinuation of doxorubicin in 4 pts. Conclusions: Despiterelatively hightoxicity metronomic doxorubicin, cyclophosphamide and capecitabine regimen shows promising activity as neoadjuvant treatment of LA TNBC. Achievement of pCR and higher cumulative dose of doxorubicin were strongly associated with improvement of survival.
Access to medical treatments in relation to the social status of the cancer patient cured at the Veneto Oncology Institute of Padua (IOV).
Authors: Imbevaro Silvia , Bortolami Alberto , Mazurek Magdalena , Rescigno Paola , Jirillo Antonio , Giacobbo Maria 
Published: March 2020

e12028 Background: The NHS in Italy is a public system of universal nature that guarantees health care to all citizens. Few Italian studies relate the therapy received by a cancer patients with their socio-economic status, so we decided to analyze the situation of the IOV. Methods: It is an observational monoinstitutional study conducted on 886 patients (pts) treated at the IOV from May 2006 to December 2011. They were selected from the Onco-AIFA registry which is a national tool used to monitor anticancer high-cost therapies. The socio-demographic data were obtained from medical records.We verified if there are differences in access to treatments (number of diagnostic tests, chemotherapy treatments, specialist and follow visits) in association with the socioeconomic determinants. We analyzed the survival differences in connection with demographic and clinical characteristics.The statistical analysis was performed using the Kruskal-Wallis test and the Cox model. Results: There are 520 pts evaluable of the 886 pts selected: 42% suffering from colorectal cancer, 28% lung cancer and 30% breast cancer. The median age is 63 years (41% male). With regard to the profession the sample is divided as follows: 34% traders/artisans/workers, 25% technical professions/office workers, 14% highly specialized occupations, 25% retired/housewives. The statistical analysis shows no significant differences in the number of exams and medical services in relation to the profession, except one that regards the mean number of chemotherapy infusions (25 manual professions vs. 20 other professions, p = 0.007). The socioeconomic variables do not affect survival, unlike the age (hazard ratio [HR], 1.42, p <.001) and the type of cancer (HR, 0.72, p <.001). The average cost of benefits per pt is about 4.600,00 euro/year, there is a major expense for traders/artisans /workers compared to other professions (+19%). Conclusions: The analysis of the sample of cancer pts did not reveal significant differences if it comes to access to care, so the system does not seem discriminatory. Probably these differences are homogenized by the state of economic well-being enjoyed so far by pts of the IOV.