bluuebunny/crossref_metadata_2025_split huggingface dataset:
Correlation of mammographic breast density with Ki-67 expression in benign breast epithelial cells obtained by random periareolar fine needle aspiration of high risk women
Authors: Khan Q. J. , Kimler B. F. , Smith E. J. , O’Dea A. P. , Sharma P. , Fabian C. J. 
Published: March 2020

1011   >Background: Known risk factors for breast cancer development include elements incorporated into the Gail risk model, mammographic breast density and cytologic atypia detected by Random Periareolar Fine Needle Aspiration (RPFNA). Ki-67 expression is a possible risk biomarker and is currently being used as a response biomarker in chemoprevention trials. We have previously shown that Ki-67 expression is higher in RPFNA specimens of benign breast cells exhibiting cytologic atypia. It is not known whether there is a correlation between mammographic density and Ki-67 expression in benign breast ductal cells obtained by RPFNA. Methods: 344 women at high risk of developing breast cancer (based on personal or family history) seen at The University of Kansas Medical Center high risk breast clinic, who underwent RPFNA with cytomorphology and Ki-67 assessment, plus a mammogram were included in the study. Mammographic breast density was assessed using the Cumulus program. Categorical variables were analyzed by Chi-square test and continuous variables were analyzed by non-parametric test and linear regression. Results: 40% of women were premenopausal, 7% perimenopausal and 53% were postmenopausal. Median age was 49 years, median 5 year Gail Risk was 2.2%, and median Ki-67 was 1.9%. Median mammographic breast density was 37%. Ki-67 expression increased with cytologic abnormality and number of cells collected, but was unrelated to Gail risk (as observed previously). Breast density was higher in pre-menopausal women (p=0.001), those with lower BMI (p< 0.001), and lower 5-year Gail risk (p=0.012); Breast density showed no correlation with Ki-67 expression or cytomorphology. Conclusion: Given the lack of correlation of mammographic breast density with either cytomorphology or Ki-67 expression in RPFNA specimens, mammographic density and Ki-67 expression should be considered as potentially complementary response biomarkers for breast cancer chemoprevention trials. No significant financial relationships to disclose.
Aromatase inhibition and very low dose estradiol add-back: A pilot study for novel breast cancer prevention
Authors: Kendall A. , Smith I. , Folkerd E. , Dowsett M. 
Published: March 2020

1014 Background: Aromatase inhibitors (AIs) are important agents for the treatment of hormone receptor positive breast cancer in post menopausal women. They are being assessed as chemopreventives of breast cancer in large clinical trials, but there are known issues of tolerability notably affecting bone. It is possible that decreasing, but not abolishing, circulating estradiol levels may reduce breast cancer risk without such side effects. We have undertaken a novel pilot study to establish whether healthy volunteers on an AI could be delivered very low dose estradiol replacement to a predictable serum level of 10–20 pmol/L using a transdermal patch, and whether this would reverse changes in the bone resorption biomarker CTx. Methods: Ten healthy postmenopausal women with normal estradiol levels received letrozole 2.5mg/day for 16 weeks. From weeks 6–16 they were also given a quarter of Estraderm MX25 transdermal patch (6.25 μg of estradiol) replaced, twice weekly. Fasting blood samples were taken at baseline, 6, 10, 12, 14 and 16 weeks for estradiol, FSH, LH, SHBG and CTx. Results: Serum estradiol levels fell to <3pmol/L at 6 weeks consistent with AI therapy. The quarter patch successfully replaced estradiol levels to a median of 12pmol/L although there was marked inter and intrasubject variability. FSH rose significantly with AI therapy with no appreciable change in SHBG or LH. There is encouraging evidence that CTx levels which increased with AI (p=0.076) can be corrected with low dose estradiol replacement although this did not reach statistical significance in this initial group. We continue to collect data on a further 8 subjects already recruited into the study. Conclusions: A quarter of Estraderm MX25 transdermal patch can be used to provide a serum estradiol level of 10–20 pmol/l in postmenopausal women given an AI. Further data will confirm whether this novel approach to chemoprevention can reverse the negative impact of AIs on bone metabolism and be suitable for extending to a full chemoprevention trial. [Table: see text] No significant financial relationships to disclose.
Cancer screening trial to evaluate the efficacy of FDG-PET in healthy subjects: 2-year results of the Hamamatsu Medical Imaging Center study
Authors: Nishizawa S. , Inubushi M. , Okada H. , Ozawa F. , Kojima S. , Teramukai S. , Fukushima M. 
Published: March 2020

1025 Background: Positron emission tomography with 18F-fluorodeoxyglucose (FDG-PET) is increasingly used for cancer screening in Japan. Although it is not rare that cancers at early stages are incidentally found on FDG-PET in usual clinical practice, it is still unknown whether FDG-PET is an effective tool for early detection of cancer and decrease of cancer death. To evaluate the efficacy of FDG-PET in cancer screening, we started a prospective study 2 years ago. Methods: From Aug 26 2003 to July 22 2004, 1197 healthy volunteers aged 35 years or older (46.7±7.7y.o.) participated in our cancer screening trial. They are supposed to undergo screening tests annually for 5 years and will be followed for years. The screening tests included whole-body FDG-PET, chest and abdominal CT, brain and pelvic MRI, tumor markers (CEA, CA19–9, SCC, PSA, CA125), and fecal occult blood test. From July 26 2004 to July 22 2005, 1158 subjects of the 1197 underwent the second screening a year after the first one. We made contact with 39 other subjects who skipped the second screening to check the occurrence of cancers. Results: In the 2-year period, primary cancers occurred in 19 subjects. Fifteen cancers (6 thyroid, 3 breast, 2 prostate, 3 lung, 1 ectopic thymus in thyroid grand) were detected on the first year and one (prostate) on the second year by the screening. Ten of the 16 were at stage I. Three subjects with negative findings at the screening developed gastric lymphoma, gastric cancer and malignant lymphoma of the kidney, respectively, within a year after the screening. FDG-PET was positive in 10 of 15 cancers (6 thyroid, 2 breast, 1 prostate and 1 ectopic thymus) on the first year. No PET positive cancer was found on the second year. Sensitivity of the screening tests as a whole and FDG-PET alone for the first year was 78.9% and 52.6%, respectively. Positive and negative predictive values and specificity of FDG-PET were 11.0% (10/91), 99.2% (1097/1106), and 93.1% (1097/1178), respectively. Conclusions: Cancer screening including FDG-PET showed reasonable accuracy and could detect a wide variety of cancers at early stages. This prospective study will clarify the details of efficacy and suitable interval of FDG-PET in cancer screening. No significant financial relationships to disclose.
Preference and compliance of stool occult blood testing in a rural cancer-screening program
Authors: Waheed S. , Linthacum T. A. 
Published: March 2020

1030 Background: Colon cancer is the third most common cancer in men and women. Screening for colon cancer reduces the incidence of colon cancer; decreases mortality associated with colon cancer and should be an integral part of all comprehensive cancer screening programs. The impact of patient preference and compliance when given the option between guaiac-based fecal occult smear method and immunochemical assay testing was reviewed at a rural cancer-screening clinic. Methods: All cancer screening participants over age 50 were educated about colon cancer prevention and screening. The immunochemical assay test and the guaiac-based fecal occult blood test directions and costs were thoroughly explained. A sample test packet of the chosen method was shown to the participant for further explanation on the directions. Data was collected for over one year with documentation of type of preference of test taken and the return rates of those tests. Results: A total of 2170 immunochemical assay or guaiac-based fecal occult blood tests were offered to participants over age 50. The total percentage of tests taken was 39% (852 participants). 81% (688 participants) of the participants chose the immunochemical test over the guaiac-based fecal occult blood test 18% (155 participants). The return rate continued in favor of the immunochemical test with 86% (380 participants) return rate as compared with only 14% return rate for guaiac-based fecal occult blood test (60 participants). The total return rate for both test combined was 51%. Conclusion: This study revealed a surprising lack of acceptance of colon caner screening by means of stool occult blood testing despite vast efforts at thorough explanations and education. When occult blood testing was accepted immunochemical assay testing was the preferred method. Further research should focus on patient barriers in accepting colon cancer testing. No significant financial relationships to disclose.
Evaluation of FDG PET in early axillary lymph node response to neoadjuvant chemotherapy in locally advanced breast cancer patients
Authors: Rousseau C. , Bodet-Milin C. , Bennouna J. , Ferrer L. , Campion L. , Bridji B. , Sagan C. , Ricaud M. , Resche I. , Kraeber-Bodere F. , Campone M. 
Published: March 2020

10500 Background: Regional axillary lymph node status has remained the single most independent variable to predict prognosis both in terms of disease recurrence and survival. This study aimed to prospectively assess sequential FDG PET findings as early predictors of axillary lymph node response to neoadjuvant chemotherapy in locally advanced breast cancer patients. Methods: A total of 255 attenuation-corrected scans were obtained from 51 patients. Images were acquired with a PET/CT scanner (GE Discovery LS) following administration of FDG (5 MBq/kg) at baseline, and after the first, second, third, and sixth course of chemotherapy. Clinical examination and US were used to assess the size of axillary lymph nodes. PET data were interpreted using standardized uptake values (SUV) corrected or not for partial volume effects. Changes in the SUV were considered as surgical/histopathological responses. Results: This study focused on axillary lymph node staging, therefore, primary breast tumor data were not considered in the analysis. The sensitivity, specificity, and accuracy of axillary node staging was higher with PET (75%, 87%, 80%) than with clinical examination and US (50%, 78%, 63%, and 50%, 83%, and 65%, respectively), and even the more so when PET images were corrected for partial volume effects (86%, 83%, 84%). Significant differences between absolute FDG uptake values in responders and non-responders were observed at baseline (p < 0.05). While FDG uptake did not vary much in non-reponders, as confirmed by histopathology, it markedly decreased to baseline levels in responders (p < 10−5). Fifty percent of baseline SUV was considered the best cut-off value to distinguish responders from non-responders. The sensitivity, specificity, negative predictive value, and accuracy of FDG PET after one course of chemotherapy were respectively, 96%, 75%, 95%, and 84%. Tumor response assessment by clinical examination or US was never statistically significant whatever the cut-off. Conclusions: The pathological status of regional axillary lymph nodes in locally advanced breast cancer patients can be accurately predicted after one course of neoadjuvant chemotherapy based on FDG PET images. No significant financial relationships to disclose.
Multicenter phase II study of a cremophor-free polymeric micelle-formulated paclitaxel in patients (pts) with metastatic breast cancer (MBC)
Authors: Lee K. S. , Chung H. C. , Im S. A. , Park Y. H. , Kim S. B. , Kim C. S. , Ro J. 
Published: March 2020

10520 Background: The results of a phase I trial of a novel taxane, a cremophor-free polymeric micelle-formulated paclitaxel (Genexol-PM), were previously reported (Clin Cancer Res 10:3708, 2004). The dose limiting toxicities were neuropathy, myalgia, and neutropenia. Notably, acute hypersensitivity reaction was not observed. Methods: This was a single arm phase II study performed at 6 major hospitals in Korea to evaluate the efficacy and safety of Genexol-PM as a 1st- or 2nd-line therapy for MBC. Genexol-PM with no premedication was given at 300 mg/m2 i.v. over 3 hr on day 1 every 3 weeks until disease progression or intolerability. Two-stage group sequential design was used. If more than 14 responses were attained in the first 30 pts, early termination was possible. Results: Forty-three pts with MBC were enrolled from 7/2004 to 12/2004. Median follow-up duration was 7.0 mo. Thirty-seven of 41 pts excluding 2 pts who did not receive Genexol-PM received Genexol-PM as a first-line therapy. Nineteen pts received prior anthracycline containing regimen in adjuvant (15) and in metastatic (4) settings. No pts were anthracycline-resistant. Median age was 48 years (range; 30 to 69 years) with ECOG PS 0 or 1. A total of 331 cycles were administered, with median of 8 per patient (range; 1 to 16). Of 39 pts evaluable for efficacy, there were 5 CRs /19 PRs with response rate of 61.5%, 13 SDs and 2 PDs. Median response duration was not reached (range; 1.9+ to 10.0+ mo). Median TTP and OS were 9.8 and 11.2 mo, respectively. G3 non-hematologic toxicities included peripheral sensory neuropathy (51.2%) and myalgia (2.4%). Hematologic toxicities were G3/G4 neutropenia (51.2%, 17.1%, respectively) and G1/2 thrombocytopenia (22.0%). Seventeen pts (41.5%) required dose reductions due to G3 neuropathy. No febrile neutropenia was observed. Eight pts developed hypersensitivity reactions with G3 in 2 pts. Mean dose intensity (DI) was 87.4 mg/m2/wk (range; 27.7 to 116.7) at 87.4% of planned DI. Conclusions: Genexol-PM at 300 mg/m2 appears a promising agent with high response rate for anthracycline sensitive MBC. Further trials at a different dose schedule or duration of delivery, or in combination with other drugs are warranted. Supported by Samyang Co, Korea. No significant financial relationships to disclose.
Does adjuvant chemotherapy (CT) exacerbate cognitive impairment in elderly breast cancer (BC) patients? Results of a prospective, longitudinal study
Authors: Rodin M. B. , Wallace J. A. , Lacy M. , Kuball K. , Pykkonen B. , Fleming G. 
Published: March 2020

10530 Background: Over the last few years, several retrospective studies documented cognitive impairment in post-chemotherapy BC patients. This decline was hypothesized to be related to CT (“chemo-brain”). More recently, a prospective study (Wefel et al. 2005) documented significant cognitive impairment at baseline, which may impact response to CT, along with treatment related effects. While all previous studies focused on the cognitive response of young BC women, older patients may be much more susceptible to any CT related neurotoxicity. Thus, the current study investigated the incidence and course of cognitive impairment in older, post-menopausal BC patients undergoing CT. Methods: 19 postmenopausal women (≥50 yrs) with no prior chemo or hormonal cancer treatment, and baseline MMSE >23 completed a comprehensive neurocognitive battery of tests along with anxiety and depression measures, prior to treatment. At 6 months, 12 patients returned for post-chemotherapy evaluation, with 8 evaluated at 2 years. Ten DCIS patients were also evaluated at baseline and 6 months. Results: Mean age at baseline was 67 yrs with 14 years of education. Prior to treatment, 37% displayed significant cognitive impairment not accounted for by other variables. At six months, within and between group analyses revealed only improved fine motor speed (Finger tapping, p.01) related to practice effects, but no decline in cognitive functions. There were no significant differences across measures between BC and DCIS groups. However, RCI revealed 3 of 12 BC patients improved on memory tasks. Two year longitudinal analyses again revealed improved motor speed and possible cognitive flexibility (TMT-A, p.02), along with decreased anxiety (STAI-S, p = .03). Conclusion: This small study does not support a finding of treatment-associated cognitive impairment among elderly women receiving standard CT for breast cancer. However, like Wefel’s sample, we documented significant cognitive impairment prior to initiation of treatment. Studies addressing the etiologic mechanism related to this cognitive dysfunction are warranted. Limitations of the current study will be discussed. No significant financial relationships to disclose.
Preoperative prediction of the axillary lymph nodes status in patients with breast cancer
Authors: Angelidou E. , Sotiropoulou G. , Poulianou E. , Politi E. , Koutselini H. 
Published: March 2020

10547 Background: We developed a preoperative score-system (S) and evaluated prospectively its predictive value for the axillary(a) status of patients (p) with breast cancer. Our aim was to select preoperatively (p) with negative axilla, who could possibly avoid the standard (a) surgery. (S) uses preoperative clinical, epidemiological and immunocytological data, obtained from the FNA-smears of (p)‘ tumors, and attempts to guide the choice of (a) treatment, as an alternative to the method of sentinel lymph node. Methods: (S) is calculated by adding the preoperative values of clinical tumor size, (p) age, nuclear grade (NG), type of the cancer cells and the immunocytochemical positiveness of the biomarkers p53, HER2 and MIB1. Values range from 1–4 for size (1–10, 11–15, 16–20, 20–30 mm), 1 to 4 for age (70 and over, 51–69, 41–50, 40 years or less), 1–3 for NG1–3, 1–2 for type of cancer cells (lobular, ductal) respectively and 0–3 for the expression (1 point for every positive biomarker) or absence (0) of p53, HER2 and MIB1 in the FNA of the primary tumors of the (p). (S) ranges from 4 to 16.We applied (S) to 224 (p), with clinically negative axilla. These (p) underwent modified radical mastectomy or lumpectomy and standard (a) dissection level I and II. The number of the infiltrated nodes was identified in each case. Results: (S) of 4 - 8 (57 patients, group 1) identify (p) with free nodes ( node positive rate 0%). (S) of 9 and 10 (67 patients, group 2) carry an average node positive rate of 65,67%, of which 31,34% involves the invasion of 1 node, 23,88% of 2–3 and 10,44% of 4 or more nodes (P < 0.001, group 1 versus group 2). (S) of 11 and more (100 patients, group 3) identify (p) with an average node positive rate of 83%, of which 55% involves the invasion of 4 or more nodes (P < 0.001, group 3 versus group 1). (S) allows the separation of (p) into two (a) management groups. Group 1 are those (p), who possibly have free lymph nodes and therefore may need no (a) surgery at all, whereas group 2 and 3 may be considered for standard (a) dissection, because they present with increased possibility infiltrated nodes. Conclusion: (S) was studied to aid the selection of (p) towards reasonable (a) treatment choices for the benefit of (p). (S) might serve as a guideline in the clinical practice to reduce the postoperative morbidity of the breast cancer (p). No significant financial relationships to disclose.
Clinical and pathological correlations in male breast cancer (MBC): Intratumoral aromatase expression (ITA) via tissue microarray (TMA)
Authors: Gray S. , Dakin-Hache K. A. , Barnes P. J. , Dewar R. , Younis T. , Rayson D. 
Published: March 2020

10553 Background: Most cases of MBC are hormone-receptor (HR) positive and there is anecdotal evidence of disease response to aromatase inhibitors in the metastatic setting. Study objectives were to (i) assess clinical-pathologic characteristics in a cohort of MBC, (ii) evaluate intratumoral aromatase expression and (iii) assess its’ prognostic impact. Methods: A retrospective chart review was conducted for all cases of MBC seen at the Nova Scotia Cancer Centre between 1985–2005. Data abstracted included disease stage, tumor grade, HR status (ER/PR), HER2-neu and ITA expression as well as dates of disease recurrence and death. Tumor blocks were incorporated into 3 TMA’s with control specimens (gynecomastia, benign breast tissue, liver). Four 1.0 mm cores were taken of each tumor. Immunohistochemistry (IHC) was performed with the following antibodies; 6F11 ER primary Ab (Ventana, USA), 1A6 PR primary Ab (Ventana, USA), TAB250 monoclonal mouse anti-HER2 (Zymed, USA), DAKO 0185 rabbit anti-human c-erbB2 (DAKO, Canada), mouse anti-human p450 aromatase Ab (Cedarlane, Canada). ITA staining intensity and distribution was compared to benign hepatic tissue and if > or = to liver was called ’strong’ while < liver was called ’weak’. The log-rank test was used for survival comparisons. Kaplan-Meyer curves were used to estimate 5year disease-free (DFS) and overall (OS) survival probabilities. Results: 54 cases were identified with median age at diagnosis of 64 (31–85 yrs). Median tumor size was 2.6 cms (0.9–8cms) and 22 (41%) had nodal metastases. 45 cases had tissue available for IHC. Of these, 40 (89%) were ER and 33 (73%) were PR positive. HER2-neu was overexpressed in 4/42 (9.5%) and 12/45 (27%) had strong ITA expression. 5 yr DFS was 71% and OS was 64%. In univariate analysis strong (vs weak) ITA expression was associated with improved 5 yr OS (92% vs 49%, p = 0.038) but not DFS (82% vs 76%, p = 0.44) rates. Conclusion: The suggestion of improved OS but not DFS for those tumors with strong ITA expression may imply that these were more responsive to hormonal therapy in the metastatic setting or had a more indolent pace of progression. It is suggested that further investigation of ITA and response to hormonal therapy in MBC is warranted. No significant financial relationships to disclose.
A prospective survey evaluating the use of soy products in breast cancer
Authors: Walker S. , Franciose J. , Vashi P. G. , Lammersfeld C. , Grutsch J. F. , Lis C. G. , Gupta D. , Williams S. 
Published: March 2020

10562 Background: Many studies have evaluated the potential role of soy in the prevention of breast cancer. A number of components in soy appear to have anticancer properties, including isoflavones, genistein and daidzein. The use of soy by women with breast cancer is now being questioned because of the estrogen-like effects of isoflavones and possible interactions with tamoxifen. Clinicians providing nutrition counseling to these women are concerned because the availability of soy foods has increased dramatically in the past few years. The goal of this study was to quantify the intake of isoflavones in women with breast cancer to determine if their intake is of clinical significance. Methods: We evaluated a consecutive case series of 100 women with breast cancer treated at Cancer Treatment Centers of America between 09/03 and 02/04. After obtaining informed consent, each patient was asked to complete a soy food frequency questionnaire (FFQ) that was scored by Fred Hutchinson Cancer Research Center, the institute that developed and validated FFQ. Results: Mean age was 50.5 years (std. dev. = 9.4; range 31–70) and mean BMI was 27.3kg/m2 (std. dev. = 6.75; range 17–59). Table 1 shows detailed characteristics of our patients. Genistein and Daidzein consumption was limited to 65 patients with a mean intake of 81.5 mg/week (std. dev. = 153; range 0.02–682) and 52.9 mg/week (std. dev. = 98.8; range 0.02–482) respectively. Soy foods with highest reported consumption were soy sauce (37%), soy milk (23%), soy bars (18%), roasted soy nuts (13%) and tofu (13%). Conclusions: Our study suggests that the isoflavone intake of breast cancer patients at our hospital was quite variable. Thirty-five patients reported no soy intake. The mean daily intake translates into 11.6 mg genistein and 7.4 mg daidzein, which is equivalent of less than ¼ cup of tofu per day. This amount is slightly higher than what has been previously reported in non-Asian American women. [Table: see text] No significant financial relationships to disclose.