bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract P1-15-09: What are the outcomes of importance for patient education in breast cancer?
Authors: Kazemi Ghazaleh , Levine Mark , Reiter Harold , Sinding Christina 
Published: March 2020

Abstract
Background: Patient education is an important component of quality cancer care. However, there remains much debate about its effects, merits and limitations. There is a lack of consensus on the intended effects of educational interventions and a lack of standardized outcome measures to assess quality. As a result, multiple outcomes measures are used without consistency and in differing combinations in the literature making it difficult to compare relative efficacy of interventions. The primary objective of this study was to identify outcomes of importance for patient education interventions in breast cancer.
Methods: A generic qualitative study using interpretive description was conducted to discover what key stakeholders in the process of patient education in breast cancer (patients, physicians and nurses) would identify as outcomes of importance. The study population included breast cancer patients, physicians and nurses caring for breast cancer patients at the Juravinski Hospital and Cancer Centre in Hamilton, Ontario. Four focus groups and one semi-structured interview was conducted using purposeful sampling and an iterative design.
Results: Eight patients, five nurses and four physicians participated in this study. Five common themes to all groups with respect to outcomes of importance in patient education were discovered: improving knowledge, improving coping ability, providing an orientation to the cancer system, enabling shared decision making and impacting behaviour during cancer treatment.
Conclusion: Despite the surprising variability and inconsistency of outcomes discovered in the patient education literature, this qualitative study demonstrated that patients, physicians and nurses generally agree on what constitute important outcomes and serves as a first step in the process of developing validated outcomes for patient education interventions in cancer.
Citation Format: Ghazaleh Kazemi, Mark Levine, Harold Reiter, Christina Sinding. What are the outcomes of importance for patient education in breast cancer? [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P1-15-09.
Abstract P1-17-07: Objective measurement of cognitive impairment in breast cancer survivors who received chemotherapy with the use of novel computerized testing
Authors: Godbole Manasi M , Singal Mukul , Benabou Reina , Choudary Iqra , Patel Mehul P 
Published: March 2020

Abstract
Background: Breast cancer is the most common cancer in women worldwide. With early detection and advancement in treatment, majority of women diagnosed with breast cancer will be cured. Some of these breast cancer survivors report Cognitive Impairment (CI) also known as “chemo-brain” or “mental fog”, especially those who have received chemotherapy. Few studies using functional neuroimaging have been conducted to foresee possible neurological alterations that could be linked to CI but research in this area remains in its early stages. Cognivue ® is an FDA cleared medical device that helps in assessment of cognitive dysfunction using novel computerized technology and is reported to be useful in detecting early stages of CI. Methods: We conducted a pilot study at the Lipson Cancer Institute/Rochester General Hospital for evaluation of CI in patients with breast cancer who received curative chemotherapy within the last 12 months of enrollment and self-reported CI. We enrolled 23 female patients between ages 19 and 90 years. Patients were subjected to Mini Mental Status Examination (MMSE) and St. Louis University Mental Status examination (SLUMS) as well as Cognivue ® testing. MMSE and SLUMS were scored according to scoring range guidance and digital data was obtained from the Cognivue® software. Analysis was performed using correlations of numeric data, ANOVA with Tukey’s post-hoc tests for categorical data, and Positive/Negative Percent Agreement (PPA/NPA) analysis for comparison of all cognitive testing methods. Results: Cognivue ® provides higher sensitivity to evaluate CI than MMSE and SLUMS, mainly in detecting earlier stages of CI. The cognitive domains most affected were executive function, abstraction and memory. There was a statistically significant correlation between Cognivue/CI score and duration of chemotherapy (p = 0.02). Age, type of chemotherapy or hormonal status of breast cancer were not significantly related with CI. Conclusions: Cognivue appears to be beneficial in its ability to detect CI in breast cancer patients. Specifically, detection of impairment in executive function domain could be predictive of daily life activity issues in such patients post-chemotherapy. This study also provides a possibility of detecting early cognitive dysfunction as well as the potential to develop a predictive algorithm of early intervention strategies for better patient outcomes.
Citation Format: Manasi M Godbole, Mukul Singal, Reina Benabou, Iqra Choudary, Mehul P Patel. Objective measurement of cognitive impairment in breast cancer survivors who received chemotherapy with the use of novel computerized testing [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P1-17-07.
Abstract P1-17-12: The influence of social demographics on genomic sequencing in metastatic breast cancer
Authors: Wecht Zoe , Brufsky Adam , Hsia Tiffaney , Rosenzweig Margaret Q 
Published: March 2020

Abstract
BACKGROUND: With the potential for medications targeted to somatic mutations, the utilization of whole genome sequencing (WGS) in MBC is increasingly important. The current clinical protocols surrounding the routine testing of WGS in MBC are amorphic.
AIMS: We explored a cohort of patients with MBC to determine the prevalence and timing of WGS. Demographic and tumor characteristics of sequenced vs. non sequenced women with MBC were compared. Patient understanding of genomic sequencing was assessed.
METHODS: Retrospective chart review of all MBC patients of the Magee-Womens Cancer Center between October 2016 and May 2019 for collection of demographic information, including neighborhood deprivation index (NDI) (zip code derived 0-10; higher scores= higher deprivation), clinical data and sequencing results (FoundationOne®, Guardant360®, Tempus, Caris®). Of those sequenced - Patient questionnaires included test of genetic knowledge (higher = more knowledge). Descriptive statistics, chi square and independent sample t tests used for analysis.
Results: There has been an overall increase in the frequency of WGS in MBC; n=15 in 2016, n=30 in 2017, n=39 in 2018 and n=25 in the first 5 months of 2019.
Of 418 total MBC patients, 31.3% (N=131) had whole genome sequencing, while 68.7% (N=287) did not. The sequenced patients were more likely to be triple negative, 74.4%, (n=96) than non-sequenced 25.6%, (n=33), p=.001. Most patients were sequenced once (n=112, 88.2%). First sequencing occurred within a mean of 4.9 months (SD 2.2; range 1-9) from MBC diagnosis. No clinical trials were accessed as a direct result of sequencing. There was no racial difference in sequencing prevalence, but non sequenced patients were from more highly deprived neighborhoods (p=.000).
Of the patients sequenced, n=27 were interviewed. Mean knowledge of basic genetics was high at 12 (SD-2.1; Range 8-16). Knowledge of WGS and implication was poor. N=15 (80%) patients did not understand reasons and implications of sequencing while n=5 (20%) did. All who understood WGS and its implications were from non-deprived neighborhoods.
Conclusion: WGS is increasingly being utilized as a tool in MBC, particularly for triple negative patients, without strict clinical protocol or direct change in treatment. Patient understanding of WGS and its implication is poor.
Citation Format: Zoe Wecht, Adam Brufsky, Tiffaney Hsia, Margaret Q Rosenzweig. The influence of social demographics on genomic sequencing in metastatic breast cancer [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P1-17-12.
Abstract P1-17-13: Design of a cognitive bias modification eHealth app to improve implicit vitality in breast cancer patients: A co-creation process
Authors: Wolbers Roos G.M. , Bode Christina , Siemerink Ester J.M. , Siesling Sabine , Pieterse Marcel E. 
Published: March 2020

Abstract
Objective: More than 50% of all breast cancer patients experience fatigue symptoms during and after their treatment course. Recent evidence shows that fatigue is partly driven by cognitive biases, such as the self-as-fatigued identity bias, which may be corrected with computer-based Cognitive Bias Modification (CBM) techniques. The aim of the current study was the intervention design of such a CBM-training by adopting a co-creation approach.
Methods: Semi-structured interviews were conducted with seven health professionals, three breast cancer patients and two patient advocates. Aim of the interviews was to collect input for the design of the CBM-training taking the attitude and preferences of the stakeholders into account and to determine the timing and implementation of the training in the treatment course.
Results: Overall, the interviews showed that CBM was accepted among all stakeholders. Important requirements were revealed, such as that the training needs to be simple, undemanding, yet engaging and persuasive. Based on the results, eHealth app IVY (Implicit VitalitY) was created. Interviews suggested that IVY should be offered early in the treatment course and should be carefully aligned with clinical treatment.
Conclusion: CBM training tasks seem to be suitable for targeting fatigue in breast cancer patients. It is innovative to use CBM techniques for cancer-related fatigue in a preventive approach. The current study suggests CBM has several benefits, such as being simple, time-effective and possibly increase levels of self-control in patients. In the next step, effectiveness of the CBM-training will be tested.
Citation Format: Roos G.M. Wolbers, Christina Bode, Ester J.M. Siemerink, Sabine Siesling, Marcel E. Pieterse. Design of a cognitive bias modification eHealth app to improve implicit vitality in breast cancer patients: A co-creation process [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P1-17-13.
Abstract P1-17-14: Physical activity platform to improve bone health in cancer survivors
Authors: Skinner Cathy 
Published: March 2020

Abstract
Cancer treatment-induced bone loss and the subsequent risk of fractures in both men and women is a significant burden on national health care. The number of cancer survivors in the United States will reach 18 million by 2022 and by 2025, the projected burden of osteoporosis is $25.3 billion. Cancer patients treated with medications that lower hormone levels face an increased risk of fractures. Clinical studies report that moderate- intensity resistance exercises prevent a decline in bone health in female cancer survivors, and that strength training may reduce complications associated with cancer such as fatigue, muscle wasting, and bone loss. Unfortunately, only a small percentage of female cancer survivors engage in and adhere to a strength training exercise routine. Several factors account for this low level of engagement such as poor awareness of the benefits of exercise, lack of motivation, and the lack of affordable and easily accessible exercise programs designed for cancer survivors. Internet-based self-managed programs of exercises and guidance can potentially address these problems, and can be scaled for broader dissemination. The Thrivors™ internet-based platform seeks to shift the current paradigm of poor adherence to exercise by providing an affordable and accessible means of improving outcomes for cancer survivors. The product, Thrivors plus Bone Health (Thrivors+BH), will be a first-of-its-kind offering of clinically validated bone health exercises that can be customized to a cancer survivor's pain and energy levels, with several novel interactive feedback features. The product has supportive modules for connecting with a community of other users, mindfulness training, nutritional advice and a repository of educational information. The Thrivors™ platform is scalable, device-agnostic, and allows analysis of de-identified usage data. With commercialization potential for healthcare providers and health insurance payers, Thrivors™ provides a value-based care delivery model focused on outcomes. There are multiple important physiologic and psychosocial secondary conditions that could be positively impacted by the Thrivors™ platform. For this specific clinical trial, we focus on adherence to bone health exercises.
Investigators: Cathy Skinner, MA - CEO and Founder, Thrivors (https://www.linkedin.com/in/cathyskinner/) Doug Yee, MD - Director of the Masonic Cancer Center, University of Minnesota (https://www.linkedin.com/in/douglas-yee-50402a14/) Kerri Winters-Stone, PhD - Professor, OHSU (https://www.linkedin.com/in/kerriwintersstone/) Kathryn Schmitz, PhD, MPH - Professor, Penn State - (https://www.linkedin.com/in/kathryn-schmitz-32a3891b/)
Citation Format: Cathy Skinner. Physical activity platform to improve bone health in cancer survivors [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P1-17-14.
Abstract P1-17-16: Deconstructing breast cancer reconstruction
Authors: Allison Cecelia , Fear David 
Published: March 2020

Abstract
Background: The American Cancer Society currently invests more in breast cancer research than any other cancer type. However surgical treatments for breast cancer have been studied as far back as 3,000 BCE. Until the mid 19th century, the surgical treatment of breast cancer was limited either by sociocultural and religious views or technology. The advent of anesthesia and sterile practice in the late 1800s and early 1900s paved the way for innovation and precision.
Synopsis: Despite being completely against breast reconstruction, Dr. William Halsted completely reconstructed breast cancer surgery. At the turn of the 20th century, Halsted’s new mastectomy procedure demonstrated to the world how technological advancements showed promise for a cure for breast cancer. The “Halsted Radical Mastectomy” recommended the removal of all diseased tissue including the pectoralis major muscle. Halsted later recommended further dissection of rectus abdominis, serratus anterior, subscapularis, latissimus dorsi and the teres major muscle without any breast reconstruction. With a local recurrence rate of 7% - an unheard of figure among the surgeons of the time- the “Halsted Radical Mastectomy” dominated the field for almost a century. With Halsted’s domination of technique came domination of thought. Halsted’s strong opinion against breast reconstruction influenced the American standard of care for breast cancer surgery for decades to follow. His treatment plan of mastectomy without reconstruction was the standard, so much so that other procedures for reconstruction, such as the latissimus dorsi pedicle flap (the first myocutaneous flap for breast reconstruction) were forgotten about for almost 70 years. Despite Halsted’s tight grasp on surgical thought, later 20th century innovations in breast reconstruction showed aesthetic results. Gradually, immediate breast reconstruction began to be advocated for all patients who were eligible. Breast cancer surgery and treatments continued to evolve and improve to ultimately lead to personalized medicine plans which have greatly improved patient outcomes. The shift in American surgical culture around breast reconstruction after mastectomies provide a lesson on how the power of cultural context shapes modern medical treatments.
Significance: The medical recognition and treatment of breast cancer long outdated the modern day anesthetized, sterile, evidence-based procedures. Today, most women with early stage breast cancer will have some type of surgery. Therefore, it is important to appreciate the advancements and improvements in technology that have led us to the personalized medicine plans that have greatly improved outcomes.
Citation Format: Cecelia Allison, David Fear. Deconstructing breast cancer reconstruction [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P1-17-16.
Abstract P1-18-27: Developing a novel combination therapy using EZH2i for HER2+ breast cancer
Authors: Watanabe Marina , Kuzmickas Rysn , Cichowski Karen 
Published: March 2020

Abstract
The receptor tyrosine kinase (RTK) human epidermal growth factor receptor 2 (HER2) is overexpressed in 15-25% of breast cancers and acts as a driver of tumor growth. Though there are FDA-approved agents in the clinic that specifically target HER2, metastatic HER2+ breast cancer remains incurable with a median overall survival of 56.5 months. In addition, the response rates of patients with metastatic disease vary considerably, with 20-50% and 60-80% of patients unresponsive to first- and second-line therapies respectively. Therefore, it is necessary to discover a new therapy able to overcome the therapeutic resistance of HER2+ breast cancer that currently leads to patient relapse, and ultimately, death.
One approach that our lab has successfully used to develop more effective therapies for other tumor types is to co-target different oncogenic pathways for a more potent effect. A target of interest is the histone methyltransferase enhancer of zeste homolog 2 (EZH2), which is overexpressed in many cancer types including breast, prostate, bladder, gastric, lung, and hepatocellular carcinoma. Interestingly, in breast cancer, EZH2 is overexpressed in the more aggressive subtypes including HER2+. EZH2 expression levels correlate with a worse prognosis and parallels cancer progression. We chose to investigate the therapeutic potential of combining EZH2 inhibitors (EZH2i) with lapatinib, an FDA-approved HER2-targeted therapy for late stage HER2+ breast cancer. In vitro assays show that the combination has a potent cytotoxic effect and renders lapatinib-sensitive HER2+ breast lines more sensitive, and causes lapatinib-resistant lines to become sensitive. In addition, in vivo testing of both lapatinib-sensitive and resistant HER2+ xenografts showed potent regression with the combination, confirming the extremely promising results. Using RNA-Seq and ChIP-Seq, we have identified that the Rb/E2F pathway may be involved in the combination’s mechanism of action. We will identify the biological settings in which this combination may be most effective and elucidate its molecular mechanism of action. This work will not only validate a promising new therapeutic combination, but will also provide insight into additional vulnerabilities of HER2+ breast cancer, possibly leading to additional therapeutic strategies.
Citation Format: Marina Watanabe, Rysn Kuzmickas, Karen Cichowski. Developing a novel combination therapy using EZH2i for HER2+ breast cancer [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P1-18-27.
Abstract P1-20-20: Intraoperative ultrasound localization (IOUS) for non-palpable breast cancer
Authors: Zahed Shideh Pour , Andersen Thor Knudsen 
Published: March 2020

Abstract
Background: With the introduction of breast cancer screening the number of non-palpable breast cancers and so the number of breast conserving surgery (BCS) has increased. Wire-guided localization (WGL) is used as invasive standard method for localization. IOUS is an alternative non-invasive, time-sparing and safe localization method with many cost benefits.
Patient and methods: A retrospective observational study was performed in a single breast unit where IOUS was used as localization method by two surgeons in the period June 2013 to October2016. The surgeons did not have any special experience with Ultrasound (US) apart from one week of bed-side training.
Results: During a 41 months period the two surgeons treated 452 with BCS. Of them 126 were non-palpable and visible by US 28%. The 126 cancers were identified with IOUS at surgery and removed successfully by the surgeons. In the period a total of 156 had a BCS with WGL. These cases had a nonpalpable cancer which were non-visible on US with either calcifications, DCIS or non-specific lesions. In the study we also found that the re-lumpectomy rate for BCS with IOUS was lower than without IOUS. In the entire breast unit, the number of BCS were 848 and number of BCS+WGL were 320 in the same period. Of them 263 (22.5%) had a re-lumpectomy. The number BCS with IOUS were 452 and the number of BCS+WGL with IOUS were 156. Of them 72 (11.8%) had a re-lumpectomy.
Conclusion: In our breast unit, IOUS was used after a short bed-side training, with 100% success rate, to remove non-palpable cancers if visible on US. IOUS is easy to learn and easy to use and offers many financial and time-sparing benefits. IOUS has a reasonable learning curve and can reduce the work load on the Radiology Department.
Citation Format: Shideh Pour Zahed, Thor Knudsen Andersen. Intraoperative ultrasound localization (IOUS) for non-palpable breast cancer [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P1-20-20.