bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mammography screening in France: Results of EDIFICE study
Authors: Serin D. , Namer M. , Cals L. , Rixe O. , Roussel C. , Coscas Y. , Blay J. , Pivot X. 
Published: March 2020

10701 Background: The EDIFICE study aimed to allow better understanding of population’s adhesion to the screening tests available for the 4 most frequent cancers: breast, colorectal, prostate and lung. Implementation of breast cancer screening (CS) was generalized since 2003 in France: women aged between 50 and 74 years are invited to do a mammography (M) every second year. Methods: This nationwide observational study was the first implemented in France (from January 18th to February 2nd, 2005) among a representative sample of 1504 subjects aged between 40 and 75 years including 773 women and a representative sample of 600 general practitioners (GPs). Information about participating subjects included socio-demographic characteristics, attitude towards CS and actual experience of CS, and about GPs’ medical practice regarding CS. Results: Among the 507 participating women (PW) aged between 50 and 74 years, 93% had done at least one M: 55% underwent this test on their own initiative and 45% of PW had it during a systematic screening plan. Most PW in the systematic screening (89%) had a M dating from less than 2 years vs 74% of the others (X2 = 18.9; p < 0,01). Main reasons for not performing the biennial screening test were: lack of care (18%), “it’s not a priority” (18%) and no advice from the GPs (15%). 79% of the PW had at least one M before 50 years (1st test at the mean age of 37.9±6 years). Among the 600 GPs, 68% systematically recommended M to their patients. GPs’ perceptions of the reasons for women’s avoidance of screening test were their unwillingness to be aware of M results (44%) and their belief in painful symptoms related to M (52%). Conclusions: This first nationwide study has shown the high rate of PW’s attendance at M screening. It pointed out that systematic and organized screening played a major role in regularity of screening over 2 years, and GP is a key actor in heightening public awareness. No significant financial relationships to disclose.
Phase II study of mitomycin-C and cisplatin in heavily pretreated advanced breast cancer
Authors: Hu X. , Guo H. , Yang X. , Zhao X. , Cai Y. , Wang Z. , Leaw S. , Li J. 
Published: March 2020

10713 Background: There were no standard chemotherapy regimen to patients with advanced breast cancer who had been exposed to anthracyclines, vinorelbine and taxanes. The mitomycin-C and cisplatin combination was investigated in this subgroup of patients. Methods: Three-weekly regimen consisted of mitomycin, 6 mg/m2 administered intravenously on day 1, and cisplatin, 25 mg/m2 intravenously on day 1–3. Results: 38 patients aged 25–75 years (median: 46 years) were treated with an overall response rate of 31.6%. The median time to progression (TTP) was 4.0 months. Median TTP for 12 patients with a complete or partial response was 9.0 months, while stable disease and progression of disease 4.0 months, p = 0.002. Grade 3/4 side effects of neutropenia, thrombocytopenia and nausea/vomiting were documented in 4 (10.5%), 4 (10.5%) and 3 (7.9%) patients, respectively. The median overall survival was 13+ months. Conclusions: The mitomycin-C/cisplatin doublet showed antitumor activity for anthracycline-, vinorelbine-, and taxane-resistant breast cancer comparable to other regimens. This well-tolerated regimen provides an affordable option for patients in China. No significant financial relationships to disclose.
Evaluation of early response to primary systemic chemotherapy in breast cancer patients by 18FDG PET: Preliminary findings from the Arianna Project 01
Authors: Zamagni C. , Fanti S. , Bernardi A. , Sperandi F. , Quercia S. , Santini D. , Musto A. , Castellucci P. , Taffurelli M. , Martoni A. 
Published: March 2020

10722 Background: Pathological complete remission after primary systemic chemotherapy (PSC) for early breast cancer (BC) correlates with a better prognosis in terms of survival. The Arianna Project 01 was designed to study the relationship between clinical, hystological, biological, gene-expression profile characteristics and response to PSC in BC pts. Methods: Pts treated with 6 cycles of adriamycin 60 mg/m2 and paclitaxel 200 mg/m2 were evaluated at baseline and before each cycle by physical exam, 18FDG-PET, circulating tumor cells and bio-markers (serum EGFR, VEGF, UPA, plasma PAI-I and the circulating portion of HER2/neu receptor). At baseline and every other cycle mammography, ultrasound and breast MRI were also done. This preliminary report is focused on the correlation between PET monitoring and pathological response. Changes in tumoral 18FDG uptake, expressed as Standardized Uptake Value (SUV), were compared with the hystopathological response assessed according to Miller-Payne scale, which estimates the Tumour Regression Grade (TRG). Results: Up to now 12 pts (T > 2 cm) have been enrolled in the study and 9 completed PSC and were submitted to surgery. Baseline PET was abnormal in all pts (SUVmax range: 3.9–17.1). No cases of complete pathological remission have been observed so far. In 2 pts the TRG was grade 4 ( > 90% reduction of tumor cells), TRG was grade 3 (30 to 90% reduction) in 3 cases, grade 2 (minor loss of tumor cells) in 4 cases. After the 1st, the 2nd and the 3rd cycle of PSC the SUV decrease (Δ SUV) in primary tumors was ≥ 50%, ≥ 75% and ≥ 85% only in the two pts that at the end of PSC obtained a TRG grade 4 (see table ). Conclusions: Our preliminary results suggest that an early prediction of pathological response by PET is possible and the optimal timing to perform PET during PSC could be after 2 or 3 cycles. The study is still ongoing and the relationship between evaluation performed by PET and by mammography, ultrasound and breast MRI will be presented at the ASCO meeting. [Table: see text] No significant financial relationships to disclose.
Breast cancer (BC): May intra-arterial (IA) chemotherapy (CT) play a role in the treatment of locally advanced disease or liver metastases? Report of our experience
Authors: Milandri C. , Calzolari F. , Passardi A. , Giampalma E. , Tison C. , Cecconetto L. , Calpona S. , Ridolfi L. 
Published: March 2020

10726 Background: IA infusion of CT increases drug concentrations within a tumor. We investigated if it is effective in BC patients (pts) with locally advanced disease or liver metastases. Methods: Twenty-five pts were treated with IA CT using angiographic technique in the Department of Medical Oncology, Morgagni-Pierantoni Hospital in Forlì. Pts received a short IA infusion through the proper hepatic artery (liver metastases) or the internal mammary artery (locally advanced disease). Drugs were: Epirubicin (EPI) 30 mg/m2, Mitomycin-c (MMC) 7 mg/m2 and 5-fluoruracil (5FU) 1000 mg on day 1 every 21 days. EPI was not administered in anthracycline pretreated pts. Results: Median age was 54.3 years (31–75 years) and ECOG Performance Status (PS) was ≤2. Nine pts had liver metastases and 16 had locally advanced disease. Twenty-three (96%) of the 25 pts had received adjuvant treatment (21 CT, 7 endocrine therapy), 20 (80%) had had at least one treatment for metastatic disease (20 CT, 11 endocrine therapy, 8 radiotherapy), and 11 pts (40%) had received concomitant therapy (3 CT and 8 endocrine). Fifteen pts were anthracycline-naïve. A total of 88 angiographic sessions were carried out, with a median number of 3.5 cycles per patient (1–8 cycles). One transitory ischaemic attack occurred during angiographic procedure . No other serious complications were observed. The only cases of toxicity higher than grade 2 were one grade III neutropenia and one grade IV thrombocytopenia. A dose reduction was necessary in 4 pts (2 due to PS, 1 to toxicity and 1 to pre-treatment) and treatment was interrupted in 4 pts (2 due to PS, 1 to early progression and 1 to technical problems). Among the 19 pts assessable for response, 13 (68%) had a partial response, 2 (11%) showed stable disease and 4 (21%) progressed. Median time to progression and median overall survival will be given. Conclusions: Our results suggest that IA CT may play a role in the treatment of advanced pre-treated BC pts. No significant financial relationships to disclose.
Clinical efficacy of capecitabine as first-line chemotherapy in metastatic breast cancer
Authors: Yap Y. , Kendall A. , Banerji U. , Walsh G. , Smith I. E. 
Published: March 2020

10727 Background: Capecitabine is commonly used in metastatic breast cancer (MBC), but there are limited data on its efficacy in the first-line setting. The clinical efficacy of capecitabine monotherapy was evaluated in our institution. Methods: Patients who received capecitabine monotherapy (starting dose 1 g/m2 twice daily every 2 out of 3 weeks) between April 2001 and April 2005 as first-line treatment for advanced disease were retrospectively identified from our prospectively maintained database. Endpoints included response rate (RR), response duration, time to progression (TTP) and overall survival (OS). Results: 63 patients were evaluated. The median age was 57 (30–79) years. The sites of disease were soft tissue and/or bone only in 24 (38%) patients, and involved visceral sites in 39 (62%) patients. 45 (71%) patients had previously received adjuvant or neoadjuvant chemotherapy. The median number of cycles administered was 5 (1–40). 48 (76%) had measurable disease with a RR of 29% (14/48). Chemotherapy-naive patients with measurable disease had a RR of 33% (5/15), while patients previously exposed to neoadjuvant or adjuvant chemotherapy had a RR of 27% (9/33). The median response duration was 24(9–68) weeks. The median TTP was 18 (range 2–122) weeks. However 12(19%) had a TTP of 9 months or more, including 7 (11%) with a TTP of >1 year (14–28 months). Of these, 6/7 were oestrogen receptor +ve and 5/7 had bone and/or soft tissue disease only. 21 (33%) patients developed disease progression on treatment, and response was not evaluable in 4 (6%) patients who stopped capecitabine after 2 or fewer cycles due to medical co-morbidities. Conclusions: These audit results on first line capecitabine monotherapy in MBC are consistent with a previously published study(1). The overall RR may be less than for anthracyclines and taxanes (generally 30–50%) in this setting, but for a subgroup of patients with predominantly soft tissue/bone disease capecitabine can result in prolonged TTP with minimal toxicity. This should be evaluated further in a randomized clinical trial. References 1. O’Shaughnessey JA et al. Ann Oncol 2001 Sept; 12 (9): 1247–54. [Table: see text]
Neoadjuvant chemotherapy with epirubicin and cyclophosphamide followed by docetaxel (ECT) in locally advanced and inflammatory breast cancer (BC): Saint Louis experience
Authors: Giacchetti S. , Habdous M. , Hocini H. , Cuvier C. , De Roquancourt A. , Perret F. , Espié M. 
Published: March 2020

10729 Background: Neoadjuvant chemotherapy is increasingly used in locally advanced breast cancer ptes. We studied the histological response after neoadjuvant chemotherapy in ptes with locally advanced and inflammatory breast cancer. Methods: From 2003 to 2005, 50 ptes with locally advanced and inflammatory breast cancer received neoadjuvant chemotherapy (Epirubicin 75 mg/m2, Cyclophosphamide 750 mg/m2 (d1-q21, 4 courses (c)) followed by Docetaxel 100 mg/m2 (d1-q21, 4 c). All ptes had a surgical biopsy prior chemotherapy, initial conservative surgery was impossible. Clinical responses were evaluated by the same oncologist and the surgery slices reviewed by the same pathologist. Histological complete response is defined as no infiltrative and/or in situ tumor in the breast and negative lymph nodes. Results: Ptes characteristics: median age 50 y (30–74), 30 premenopausal ptes; T2: 5 ptes, T3: 24, T4: 21, median tumor size 60 mm; N0: 12, N1: 38, 11 ptes had inflammatory tumor. Histological features: 43 infiltrating ductal carcinoma, 7 infiltrating lobular carcinoma, SBR grade 1/2/3: 2/23/24; vascular embols (13 positive, 37 negative), RH+: 28 ptes (16 RE+/RP+; 12 RE+/RP-) and 22 RH-, C-erb2 status (43 negative and 7 positive). All the ptes received 8 courses of chemo. Clinical response at 8 c: 22 (44 %) ptes had a complete response, 14 (32%) partial response, 9 (20%) stable disease, 4 ptes (8%) had progressive disease, 1 was not evaluated. 42 ptes had breast surgery, 5 are too early, 2 progressed and received a second line chemo, 1 refuse surgery. Out of 42 operated ptes, 37 had mammectomy, 5 tumorectomy, 39 had axillary dissection. Histological response: 7 ptes had a complete pathological response (pCR) (17 %), 3 had pCR with persistant in situ carcinoma (7%), 32 ptes (76%) had persistant infiltrative carcinoma [histological response >50% 14 ptes (33%), <50% 18 ptes (43%)]; 11 (26%) ptes had negative lymph nodes, 28 (66 %) had positive lymph nodes [10 1–3 N+; 18 ≥ 4 N+]. Conclusion: In this population with a large amount of T3-T4 (median size 60mm) and inflammatory cancers the complete histological response rate of 17% (24% with in situ) is close to the series with smaller tumors. The rate of breast conservation is low (12%). No significant financial relationships to disclose.
Central nervous system metastases after trastuzumab therapy in patients with breast cancer
Authors: Daw Sr. H. , Muslimani A. , Ahluwalia M. , Kundranda M. 
Published: March 2020

10747 Background: trastuzumab (Tz), a humanized anti-HER-2/neu antibody, has been shown to improve survival in patients with HER2-positive breast cancer. A high incidence of brain metastases (BM) has been noted in patients receiving trastuzumab. Here we report 4 cases of HER-2 positive advanced breast cancer patients who developed BM while on TZ therapy. Cases: all 4 patients were treated initially with a combination of taxane-trastuzumab followed by maintenance trastuzumab. Tumors were classified as HER-2 over expressing if they were scored 3+ by immunohistochemistry or showed amplification by fluorescence in situ hybridization. Mean age at diagnosis was 48. Mean duration of trastuzumab therapy prior to BM was 20 months. All patients had achieved a complete remission of extracranial disease at the time of BM diagnosis. Mean number of intracranial lesions as determined by magnetic resonance imaging was 4. Treatment included radiosurgery, surgical resection, whole brain radiation, temozolomide, high dose methotrexate, thalidomide and in one patient, intra-arterial chemotherapy. All 4 patients are alive at the date of last follow-up (median =3 years) after BM diagnosis. Conclusions: this report suggests that patients who develop BM after trastuzumab can have a relatively long survival rate. The importance of a multidisciplinary approach to these patients cannot be overemphasized. Development of BM on TZ therapy does not represent resistance to TZ, but instead likely reflects the inability of TZ to cross the brain-blood barrier. Further research in this area is needed to optimize management while minimizing late effects. In this regard, alternatives to whole brain radiation should continue to be studied. In addition, the role of prophylactic cranial irradiation and the search for drugs that target HER-2 and cross the blood-brain barrier should be investigated. No significant financial relationships to disclose.
A pilot study of weekly versus 3-week docetaxel in combination with capecitabine in patients with anthracycline-pretreated metastatic breast cancer
Authors: Jiang Z. , Zhang S. , Xie X. , Liu J. , Ren J. , Wang H. , Sun Q. , Bai Y. , Cheng Y. , Liang X. , Jiao S. 
Published: March 2020

10771 Background: Capecitabine in combination with docetaxel given every 3 weeks has shown a high degree of activity in anthracycline-pretreated metastatic breast cancer (MBC), but with high toxicities. To improve the therapeutic index, we performed a clinical pilot trial to evaluate the efficacy and safety of weekly or 3-week docetaxel in combination with capecitabine given for 14 days every 21 days. Methods: Patients with at least one measurable lesion were randomized to receive the treatment arms: docetaxel 75mg/m2 on days 1, oral capecitabine 950 mg/m2 twice daily on days 1–14 (Arm A); docetaxel 37.5mg/m2 on days 1 and 8, oral capecitabine 950 mg/m2 twice daily on days 1–14 (arm B). Each cycle was repeated every 3 weeks. Patients remained on study for a maximum 6 cycles or until tumor progression or unacceptable toxicity occurred, response assessments were scheduled every two cycles. Results: 64 pts were enrolled, 62 eligible for safety and tumor assessment. Key baseline variables were well balanced. Dominant site of disease was visceral in 66.1%; 24.2% had ≥3 organ sites of disease; all patients had previously received anthracyclines, 24.2% for MBC. 43. 6% were ER negative and 46.8% were HER-2 overexpress. The overall clinical response rate of all groups was 59.7% (37/62). There was no progressive disease (PD) after two cycles. Efficacy outcomes were similar in the two arms. The response rate of group A and B were 60% (18/30) and 59.4% (19/32) respectively. There were no drug-related deaths observed. Neutropenia was the most common toxicity. In all, the frequence of Grade 3/4 neutropenia were similar in two arm, but Grade 4 neutropenia of Group A 66.7% (20/30) was higher than Group B 34.4% (11/32), P = 0.021. Conclusions: The study confirmed the superior activity of docetaxe-capecitabine combination therapy in anthracycline resistant MBC, and comparing with 3-week schedule, weekly docetaxel plus capecitabine has same high efficacy with a favourable safety profile. No significant financial relationships to disclose.
Changing demographics of locally advanced breast cancer: Data from a regional cancer centre
Authors: Segal R. , Dent S. F. , Verma S. , Canil C. M. , Azzi J. , Vandermeer L. , Spaans J. 
Published: March 2020

10780 Background: Locally advanced breast cancer (LABC) (including inflammatory breast cancer (IBC)) accounts for less than 5% of women diagnosed with breast cancer in North America each year. This population of women continues to represent a challenge in terms of timely diagnosis and treatment. Methods: A retrospective database was developed using the American Joint Committee on Cancer (AJCC)2002 staging classification for all women who presented to TOHRCC with LABC between Jan 1/02 - April 1/05. Information was abstracted from clinic charts and the patient self-reported health questionnaires. Results: These results reflect the demographics of the first 50 women entered into our database. Median age at presentation was 57 years (range 28–88); 62% were post-menopausal and 28% had a 1st/2nd degree relative with breast cancer. Clinical diagnosis was made by: self-detection (79%); mammography (5%), routine physical exam (9%) and CT scan (2%). Clinical tumour stage at presentation was: IIIA (25.6%); IIIB (53.5%) and IIIC (9.3%). The majority of women were diagnosed with infiltrating ductal carcinoma (72%). Women with T4d tumours (IBC) (38%) tended to be younger (54.5 vs 59.2 years); presented earlier (2.7 vs. 6.3 months); had larger tumours at the time of diagnosis (9.7 vs 5.5 cm); were more likely grade III (30 vs 20%) and were more often ER negative (42.1% vs 33.3%) and PR negative (63.2% vs. 50%). Only 13% of women in this database were tested for HER-2 of whom 70% were positive. Conclusions: This data utilizing the new AJCC (2002) staging system reflects important shifts in LABC that will influence clinical care in the future. Compared to historical databases, patients tended to be younger and have more aggressive disease including ER negative and HER-2 positive disease. Supplemental microarray studies to further explore this entity are planned. We will present clinical management outcomes in an additional submission. No significant financial relationships to disclose.
Sentinel lymph nodes navigation surgery for stage I or IIA breast cancer patients
Authors: Hirata M. , Kawabata H. , Tanaka K. 
Published: March 2020

10784 Background: We applied indigocarmine for sentinel lymph nodes staining for Stage I or IIA breast cancer patients. We compared patient survival between sentinel lymph nodes navigastion surgery group and ordinary surgery with axillary lymph nodes dissection group. Methods: Patients consisted of 160 histologically proven breast cancer women (Stage I: 108 cases, Stage II: 52 cases, 51.8 ± 11.1 years, SN group) and other 320 breast cacner women (Stage I: 187 cases, Stage II: 146 cases, 53.4 ± 9.7 years, non-SN group). All patients underwent partial resection of their breast with histologically proven cancer cells negative margin (SN group: May 2000–December 2003, non-SN group: January 1996–December 2003). Fifteeen minutes before surgery, 0.4% Indigocarmine (10 ml) was injected around the tumor by use of 24 gauge syringe. Sentinel lymph node (SN) was defined as the stained lymph node. Intra operative cytology and histopathological examination was performed for SN and one or two lymph nodes around the SN. When any cancer cells were found in either of SN or the lymph nodes around the SN, axillary lymph nodes dissection was performed. When all of SN and several lymph nodes around the SN were diagnosed as cancer cells negative, axillary lymph nodes dissection was omitted. Patient survival and disease free survival were calculated by Kaplan-Meier method. Results: About patients characteristics including age, diameter of the tumor, hormone receptor status, treatment after surgery, etc., no significant difference was found between two groups. We could find SN in 156 patients (97.5%) out of 160 cases in SN group. Four years patient survival was 97.6% (stage I, SN group), 96.6% (stage I, non SN group), and 96.6% (stage IIA, SN group), 93.5% (stage IIA, non SN group), respectively (no significant difference). Four years disease free survival was 97.6% (stage I, SN group), 95.4% (stage I, non SN group), and 82.5% (stage IIA, SN group), 86.4% (stage IIA, non SN group), respectively (no significant difference). Conclusions: Sentinel lymph nodes navigation surgery for stage I or IIA breast cancer patients by use of 0.4% Indigocarmine revealed comparable patient survival and disease free patient survival to ordinary surgery. No significant financial relationships to disclose.
Axillary lymphadenectomy can be safely avoided in patients with breast cancer and negative sentinel lymph node biopsy
Authors: Millastre E. , Ruiz-Echarri Sr. M. , Ortega M. , Mayordomo J. I. , Lastra R. , Prats E. , Lambea J. , Aguirre E. , Razola P. , Andrés R. , Tres A. , Banzo J. 
Published: March 2020

10787 Background: Patients with breast cancer in which sentinel lymph node biopsy is histologically negative for tumor cells, have a low probability of having involvement of additional regional lymph nodes. Lymph node dissection may be avoided in these cases. Methods: Ninety-six consecutive patients with invasive breast cancer and tumour size less than 2 centimeters by mammography, had lymphoscintigraphy with colloidal 99Tc and radioisotope-guided sentinel lymph node biopsy in the University Hospital of Zaragoza from 1999 to 2005.Pathological assessment included serial sections of the sentinel lymph node with immunohistochemistry for cytokeratins in selected cases. Results: Sentinel lymph node biopsy was negative in 57 patients. There were 56 females and 1 male. Median age was 57 years (range 24–87). Median pathological tumor size was 15 mm (range 5–31). Location of the sentinel lymph node was axillary in 47patients, internal mammary in 0 patients, and both in 10 patients. Median number of resected lymph nodes was 2 (range 1–4). With median follow-up of 33 months, no local or systemic relapses have occurred. Conclusions: Avoidance of regional lymph node dissection is safe in patients with breast cancer and histologically negative sentinel lymph node biopsy. No significant financial relationships to disclose.