bluuebunny/crossref_metadata_2025_split huggingface dataset:
Correlate effects of local therapy for the primary tumor in metastatic breast cancer at diagnosis with molecular subtypes.
Authors: Hijri Fatima Zahra , Arifi Samia , Brahmi Sami Aziz , Bouyahia Nezar , Benbrahim Zineb , Daoudi Khaoula , Najdi Adil , Berreho Mohamed Amine , Nejjari Chakib , Amarti Affaf , Nawfel Mellas , El Mesbahi Omar 
Published: March 2020

e11502 Background: Few studies demonstrated that surgical resection of the primary tumor in patients with metastatic breast cancer at diagnosis is associated with significant improvement of survival. The aim of this study is to evaluate the correlation impact of local surgery in metastatic breast cancer at diagnosis with molecular subtypes. Methods: A retrospective study was conducted from 2007 to 2011 in our institution, of all stage IV breast cancer patients; who undergo breast surgery. Clinical , tumor characteristics, molecular subtypes, prognostic factors, therapeutic results data were analyzed. Results: We selected 59 cases. The mean age was 36 years (range: 22-44). 55 % women presented with locally advanced breast cancer with 13% T4 d . All patients underwent mastectomy except 4 who underwent conservative surgery .41 patients had axillary lymph node dissection. 63% were luminal A, 17% were luminal B, 7% were Her2-positive and 13% were basal-like . All patients received anthracycline based regimen and only 33% received taxanes. Loco regional radiotherapy (RT) was given to 6 women. Average follow-up was 13 months: - 20 patients represented partial response : 15 patients in luminal A , 3 patients in luminal B ,1 patients in basal-like and 1 patient in HER2-positive. - 11 patients (19%) were stable : 9 patients in luminal A and 2 patient in luminal B . -24 patients represented a progressive disease including 11 patients presented locoregional recurrence : 75 % in HER-positive, 40 % in basal-like, 50% in luminal B and 30% in luminal A (p=0.4). - 4 patients died in basal-like. The median local recurrence-free survival was 19 months and the median progression-free survival was 20 months. The local relapse is less observed in patients who: have a small tumor size (p = 0.003), had axillary lymph node dissection (p = 0.02) and loco regional radiotherapy (p = 0.03). The metastatic progression is less observed in patients with small tumor size (p = 0.01). Conclusions: Local Therapy of the primary tumor improves local control of disease, particularly in women with Small tumors. However, no significant correlation between impact of locale therapy and Molecular Subtypes was observed.
Correlation of target motion with the dosimetric variance on breast and OAR during whole breast radiotherapy with 4D-CT.
Authors: Li Jianbin , Wang Wei 
Published: March 2020

e11521 Background: To explore the correlation between the respiration-induced target motion and volume variation with the dosimetric variance on breast and OAR during free breathing. Methods: Seventeen patients after breast conserving surgery underwent respiration-synchronized 4DCT simulation scans during free breathing. The treatment planning constructed using the end inspiration (EI) scan, then copied and applied to the other respiratory phases and the dose distribution was calculated separately. To evaluate the dose–volume histograms parameters for the PTV, ipsilateral lung and heart. Results: During free breathing, the CTV motion vector was 2.09 ± 0.74 mm, and the volume variation was 3.05 ± 0.94%. There was no correlation between the volume variation of CTV and target/OAR dosimetric variation (|r| = 0.39 ~ 0.48). In anteroposterior (AP), superoinferior (SI) and vector directions,the CTV movement correlated well with the mean PTV dose, conformal index (CI), and the lung volume receiving high dose (V20, V30, V40, and V50) (|r| = 0.651 ~ 0.975); in SI and vector directions, the CTV displacement only correlated with the heart volume receiving >5Gy (V5) (r = -0.795, 0.687). The lung volume variation and the lung volume receiving high dose correlated reasonably well (r = 0.655 ~ 0.882), and the correlation only exist between the heat volume variation and the V5 of heart (r = -0.701). Conclusions: Target movement correlated well with the target/OAR dosimetric variation in certain directions, indicating that whole breast IMRT assisted with breathing control or respiratory-adapted gated treatment will promote the accuracy of dose delivery during radiotherapy. To minimize lung irradiation, gated treatment maybe most precise if centered at end expiration.
Dream content and sleep changes in women after mastectomy.
Authors: Cicolin Alessandro , Airoldi Mario , Giordano Alessandra , Francese Valentina , Peila Elena , Tribolo Antonella , Pedani Fulvia , Torta Riccardo 
Published: March 2020

e11524 Background: The concerns people express in their dreams are the concerns they have in waking life (Domhoff – Dreaming 11: 13-33; 2001) . In this abstract we report in breast cancer patients (BCP) the dream content, sleep quality and quantity , and their mood both before and after mastectomy (M), to determine whether a loss of a body part could change body schema and actuate a sexual sphere restructuring. Methods: Consecutive menopausal BCP without impaired cognitive impairment (MMSE < 24), without psychiatric and/or sleep disorders, not assuming drug that could affect REM sleep and waiting for M were enrolled. Pts were evaluated at T0 (7-10 days before M) and at T1 (3 months after M) with: 1) Dream Report Form (DRF – Domhoff , 1996) in which pts describe 5 recent dreams; 2) Dream Remind Questionnaire (DRQ) to obtain explicit content of dreams; 3) Beck Depression Inventory (BDI); 4) State Trait Anxiety Inventory , Form Y(STAI-Y). Results: Thirty pts were eligible: 15 pts dropped out (withdrew consent between T0 and T1); 15 pts completed the study (mean age = 51 yrs , range 45-66 yrs; education = 10 +/- 4 yrs). After M the total sleep time was significantly increased ( p<.05) ; sleep quality was unchanged .STAI and BDI were not significantly different. . At T1 we found a statistically significant increase in stated presence of wise self, determined self, curiosity, anger and shame. Excitement was reduced in T1.At T1 there is a reduction of violent and erotic environments, frightened-self perceptions, and repulsions, along with a slight increase of loved and powerful self-perception. In T1 dreams we found an increased presence of males and family characters, the proportion of dead people, striving elements with failure, a decreased presence of friends and aggressiveness. Torso-anatomy was significantly different in T1. Conclusions: Our results confirm a continuity between dreams and waking life. Dream content modifications are specifically related to body image.
Prognostic value of Bcl-2 in breast cancer.
Authors: Ibeas Patricia , Lopez-Gonzalez Ana , Doger de Speville Bernard Gaston , Huelves Miriam , Lopez Roberto , Almagro Elena , Palka Magda , Ruiz-Valdepeñas Andrea , Perez Callejo David , Provencio Mariano 
Published: March 2020

e11527 Background: Breast cancer is a heterogeneous disease with prognostic factors used by the oncologists to decide the treatment. Bcl2 is an antiapoptotic proto-oncogen involved in DNA break process that has been defined historically as a poor prognostic factor. This study was conducted to confirm whether or not bcl-2 is an independent prognostic factor. Methods: In this study, we have reviewed all patients who were diagnosed at our hospital between January 2007 and December 2008 (99 patients). Inclusion criteria were patients diagnosed of breast cancer whose anatomopathological report showed bcl-2 status as well as the rest of the parameters measured. The parameters measured were age, past medical history, menopausal status, TNM, hormone receptors, HER2, p53, Ki67, bcl-2, treatment applied, date of relapse (if any), date of death ( if occurred). All of them characterized by centralization measures. We conducted an analysis of prognostic factor that influenced survival. Results: The average age of diagnosis is 54.6 years (30-94 years). 42.4% were premenopausal. The average tumor size was 2.59 cm ( 0.5-7.5 cm). 81.8% had positive estrogen receptors. 92% were HER2 negative by inmunohistochemistry. 62.6% were p53 negative. Bcl-2 was 84.8% positive. The distribution by stage at diagnosis was: stage I 26.3%; stage II 49.5%; stage III 22.2%. Disease free survival for patients bcl2(+) was 45.6 months versus 22.6 months for patients bcl2 (-) (0.12-22.2; p: 0.00125). Overall survival for the group bcl2(+) was 48 months (41.6-54.3) and bcl2 (-) was 48.24 months (42.48 to 54). Conclusions: We can state that bcl2 is not an independent prognostic factor. Despite the value in other diseases, the determination of bcl-2 by inmunohistochemistry in breast cancer in stages I, II and III at the moment of the diagnosis does not provide any prognostic information.
Results of a phase II study of capecitabine-based doublets in the treatment of metastatic triple-negative breast cancer (mTNBC).
Authors: Fan Ying , Xu Binghe , Liao Yuqian , Ma Fei , Yuan Peng , Wang Jiayu , Zhang Pin , Li Qing , Xuan Lixue , Luo Yang , Ding Xiaoyan 
Published: March 2020

e11538 Background: It is extremely important to identify proper cytotoxic agents for TNBC which had limited choices except chemotherapy. Capecitabine are well established as a major chemotherapeutic agent in metastatic setting. The efficacy of capecitabine-based chemotherapy has not been prospectively studied in TNBC and data remains scant. This study was designed to investigate the efficacy of capecitabine-based doublets in the treatment of metastatic TNBC. Methods: Eligible metastatic TNBC women with measurable diseases were recruited to receive either TX regimen (docetaxel 75mg/m2 iv d1 plus capecitabine 1000mg/m2 bid, d1-14,q3w) or NX regimen (vinorelbine 25mg/m2 iv d1, 8 plus capecitabine 1000mg/m2 bid, d1-14, q3w) at the discretion of physicians for up to 6 cycles, until disease progression or unacceptable toxicity. The primary endpoint was objective response rate and secondary endpoints included progression free survival (PFS), overall survival (OS). Results: 45 mTNBC patients, 27 in TX and 18 in NX were recruited, mostly (73.3%) as 1st line and the remaining as the 2nd line. The total objective response rate was 20.0% and clinical benefit rate was 62.2%. After a median follow-up of 28 months, PFS was 5.2 months (95%CI, 4.1-6.3mons) and OS was 18.2months (95%CI, 8.7-27.7mons). Almost half of the patients (22/45) progressed during treatment or within one month of the treatment discontinuation. PFS was significantly longer if patients got CR/PR (9.6 vs 4.3mons, P=0.015). When comparing two doublets, the response rate was numerically but not statistically lower in TX group than in NX group (14.8% vs 27.8%, P=0.449). Similarly, no difference was found in either PFS (4.9 vs 5.2 mons, P=0.483) or OS (21.5 vs 18.3 mons, P=0.964) between two regimens. Conclusions: Although the overall survival seems to be reasonable, efficacy of capecitabine-contained TX or NX regimen was relatively poor in terms of tumor remission and progression free survival in mTNBC patients, suggesting capecitabine may have limited potency in this subtype. These two combinations may be considered to be acceptable but may not be recommended as prior choice for mTNBC patients.
Compartmentalization of tumor cells to the CSF or peripheral blood of a breast cancer patient with CNS metastasis.
Authors: Allen Joshua , Patel Akshal , Dicker David , Sheehan Jonas , Glantz Michael J. , El-Deiry Wafik 
Published: March 2020

e11544 Background: We recently adapted the CellSearch system to detect cerebrospinal fluid tumor cells (CSFTCs) in breast cancer patients with CNS metastases and found that the CSFTCs correlate with disease burden. Here, we present the enumeration of CSFTCs and peripheral blood tumor cells (PBTCs) in a patient with metastatic breast cancer during treatment with intrathecal (IT) chemotherapy. Methods: We enumerated CSFTCs and PBTCs in a patient with ER+, Her2-, BRCA2+ breast cancer and CNS metastases who received IT chemotherapy and systemic chemoradiation. The patient was initially diagnosed with locally advanced breast cancer and underwent bilateral mastectomies followed by AC-T one year prior to CNS relapse. Tumor cell enumeration was conducted every 1-2 weeks from 7.5mL of peripheral blood or 9mL of CSF along with CSF cytology, Karnofsky performance status (KPS), neurologic examination and radiographic studies during the IT chemotherapy and subsequent systemic chemoradiation. Results: At the beginning of the IT chemotherapy the patient presented with diplopia, gait ataxia, 7th facial nerve palsy, confusion, and intractable headaches, an initial burden of 19570 CSFTCs and 10-45 PBTCs, a KPS of 80, and no systemic disease. Tumor cell counts dropped rapidly in response to IT therapy alone to 0-1 CSFTCs and 3 PBTCs, all neurologic symptoms resolved, and the KPS increased to 90. The patient subsequently suffered progression of systemic disease with development of bone and brachial plexus metastases. PBTCs rose from 3 to 64 during this same period, whereas CSFTCs remained at 0-1. The CA 27-29 level increased from 111 to 214. CSF cytology and neuro-radiographic imaging cleared in the face of progressive systemic disease. Conclusions: There was a compartmentalization of metastatic tumor cells to either the blood or the CSF in this patient. We hypothesize that tumor cells in the CSF or peripheral blood migrate to the untreated compartment during compartmentalized therapy, resulting in disease recurrence in the untreated compartment. Preliminary data on other patients supports this hypothesis, which may represent an important mechanism for disease recurrence in patients with potentially curable disease.
Analysis of pattern, time, and risk factors influencing recurrence in triple-negative breast cancer patients.
Authors: Niwinska Anna , Pogoda Katarzyna , Murawska Magdalena , Pienkowski Tadeusz 
Published: March 2020

e11553 Background: The aim of the study was to assess the rate, pattern and time of recurrence in patients with triple-negative breast cancer (TNBC) treated in one institution. The second goal was to evaluate factors influencing recurrence and overall survival in this group of patients. Methods: 2534 consecutive breast cancer patients were diagnosed at the Cancer Center and Institute of Oncology in Warsaw, Poland, between January 2005 and December 2006. Out of 2534 patients, 228 (9%) were TNBC (ER/PR/HER2-negative). The clinicopathological characteristics were determined using descriptive statistics. The overall survival (OS) and disease-free survival (DFS) were calculated using the Kaplan-Meier method. The univariate and multivariate analyses were developed to identify factors influencing recurrence and survival in TNBC patients. Results: Most of the patients were diagnosed with stage II or III breast cancer (47% and 34%, respectively), the median age at diagnosis was 54.5 years. The most common histological type was ductal cancer (81%). 31% of patients were treated with neoadjuvant chemotherapy and 49% with adjuvant chemotherapy – almost all consisted of anthracyclines. 6 years of observation revealed that the metastatic disease occurred in 35% of all TNBC patients: 15% in the brain, 14% in the lungs, 11% in the bones, 8% in the liver and 14% had locoregional relapse. The highest risk of recurrence was during the first 3 years after primary treatment and then during the next two years of observation it did not change. Median DFS and OS were not reached at the time of analysis, 6-year DFS and OS were 68% and 62%, respectively.Factors influencing recurrence were: tumor size and systemic adjuvant chemotherapy while factors influencing overall survival were: tumor size, nodal status, adjuvant/neoadjuvant treatment and metastases in the brain, liver and bones. Conclusions: Characteristic pattern of recurrence in time was revealed. The tumor size was responsible for recurrence despite lack of involvement of lymph nodes. Aggressive adjuvant/neoadjuvant treatment ordered in all clinical stages of TNBC (including N0) was factor responsible for avoiding local and distant relapse and prolonging overall survival.
Planning the boost in early-stage breast carcinoma: Comparison of two methods.
Authors: Krakobsky Vanesa 
Published: March 2020

e11555 Background: When it comes to breast-conserving surgery the boost volume becomes a critical target: it has the highest risk of residual cancer cells. Failing this target may impact local recurrence outcomes. At our institution the most common methods to contour the tumor bed are: the scar-based planning guided by fluoroscopy (2DP) and the one that relies on the visualization of the seroma under CT (3DP). Since clips are not routinely used the boost demarcation becomes challenging. We evaluated the accuracy of the breast boost volume treated with 2DP compared with 3DP. Additionally we evaluated whether or not the lumpectomy scar is a suitable landmark to define the tumor bed. Methods: 20 patients diagnosed with breast cancer stage I-IIA underwent tumor bed boost planning using two techniques: 2DP and 3DP. CTV prescription dose: 16.2 Gy, 1.8 Gy/d. All the information concerning to the 2DP was reproduced in a radiotherapy planning system. Statistical analysis: match pair t-test and coefficient of variation were used to test for an association among the two planning techniques for tumor bed coverage. D95, D90, V15, volume, medium lung dose (MLD) and geographic miss (GM) were analyzed. Pearson correlation analysis was used to assess the relationship between CVS, date of surgery, age and previous chemotherapy. Other items taken into account were the match between the scar and the seroma and how good the visualization of the seroma was by using the CVS. Results: 2DP was inaccurate: the mean D95, D90 and V15 were 3.12 Gy, 4.6 Gy and 29% respectively (variation coefficient: 135%, 107% and 65% respectively) The mean D95, D90 and V15 for the 3DP were 14.34 Gy, 15 Gy and 88% respectively (variation coefficient: 6%, 3% and 7% respectively). The difference between the mean 2DP D95 and 3DP D95 was 11 Gy (95% CI, 9 Gy to 13 Gy, p< 0.001). Percentage of GM was: 80% (95% CI, 63% to 97%). All the seromas were finely visualized There was no correlation between CVS, age, prior chemotherapy and date of surgery. Larger volumes and MLD 3DP: 373.1 cm3 vs. 248.8 cm3 and 0.27Gy vs. 0.14 Gy respectively. Only 45% of the lumpectomy scars matched the seroma. Conclusions: CT-based planning allows for optimal tumor bed coverage. The lumpectomy scar is often a poor indicator of the tumor bed.
Accurate excision of nonpalpable breast lesions with the new device system.
Authors: Luo Zhongyao 
Published: March 2020

e11557 Background: A histological diagnosis for nonpalpable breast lesions (NPBL) is required to determine suitable therapy. The open-breast biopsy (OBB) is the gold standard to determine the nature of NPBL. However, it is not easy to accurately remove whole breast lesions due to insufficient safe margin of lesions excised. To improve accuracy for removal of NPBL, we designed new tools to assist surgeons to accurately localize and remove NPBL during OBB. Methods: The new device system has two primary parts. First is a set of accurate-resection devices composed of a rotary cutter, a pair of inner and outer tubes, two pairs of concave and convex curved hooks, and a curved incision plate. The second part is the 12 o'clock localization method used to accurately position lesions three-dimensionally after the breast tissue is excised cylindrically. Thus, the exact location of breast lesions removed can be precisely traced back to the original breast tissue location. Results: 100 patients with a total of 149 OBB were studied using the new device system guided with needle localization under ultrasound. 112 out of 149 procedures were identified as nodule. Among 112 cases, 95 were breast fibroadenomas, 10 were mammary adenosis with a trend to form fibroadenoma, 5 were mammary adenosis, and 2 were adipomas. The remaining 37 cases possessed clusters of calcified lesions with small nodule. 32 were benign lesions with calcinosis, and the other 5 lesions were identified as breast cancer. Pathological examination demonstrated that 144 NPBL were accurately resected with accurate-resection devices. However, 19 out of 144 breast lesions were not completely removed the first time. Thus the second surgical procedure was performed for the 19 cases based on 12 o'clock localization method. The results demonstrated that the remaining lesions were accurately and completely eliminated with the second procedure. All patients were followed up with for 2 to 48 months post procedures. These patients treated with accurate resection devices were very satisfied with no breast deformation. Conclusions: The new device system is easy to use and has very low cost. It is very comfortable for the patient and is of great help in accurately localizing and resecting the lesions to the surgeon.
Expression of stathmin in tumor to predict response to neoadjuvant chemotherapy with docetaxel-containing regimens in locally advanced breast cancer.
Authors: Meng Xuli 
Published: March 2020

e11566 Background: We performed this retrospective study to evaluate the value of clinicopathological factors and a novel molecular marker stathmin in predicting treatment response to neoadjuvant chemotherapy (NCT) with docetaxel-containing regimens in patients with locally advanced breast cancer. Methods: Fifty-four consecutive locally advanced patients receiving docetaxel-containing NCT between January 2006 and July 2010 in Zhejiang Cancer Hospital were included. The expression levels of estrogen receptor (ER), progesterone receptor (PR), epidermal growth factor receptor-2 (HER-2), and p53 were detected by immunohistochemistry, while expression of stathmin mRNA was measured by Quanti-Gene assay. Results: The overall clinical objective response (cOR) rate was 75.9% (41/54) in breast. A total of 34 patients (63.0%) experienced pathological OR (pOR), with pathological complete remission (pCR) rate of 20.4% (11/54) in breast and 16.7% (9/54) in both breast and axilla. In univariate analysis, there were associations of pOR in both breast and axilla with age (P=0.054), ER status (P=0.059), subtypes (P=0.062), p53 (P=0.030), and stathmin expression (three terciles) (P=0.039). Mean expression of stathmin in pOR group was 0.410, compared with that in no response group of 0.556 (P=0.051 by Student’s t-test). Similarly, a lower expression of stathmin might represent a higher pCR rate (P=0.061). Moreover, the LOWESS smoothing plot showed the same trend, i.e., that tumor with a lower level of stathmin expression had a higher probability of response to docetaxel-containing NCT. After multivariate adjustment, both ER and stathmin kept being significant with hazard ratio of 4.58 (95% CI: 1.11-18.94, P=0.036) and 2.94 (95% CI: 1.26-6.86, P=0.012), respectively. Conclusions: ER and stathmin were independent predictive factors for NCT with docetaxel-containing regimens.