bluuebunny/crossref_metadata_2025_split huggingface dataset:
Correlation between clinical response according to WHO criteria and pathological response according to Chevallier and Sataloff in inflammatory breast cancer (IBC)
Authors: Bonneterre J. , Mailliez A. , Giard S. , Chaveron C. , Belkacemi Y. , Vanlemmens L. , Baranzelli M. 
Published: March 2020

11033 Introduction: IBC has a very poor prognosis ; the first treatment is first primary chemotherapy, followed by surgery and radiotherapy. It has been shown that patients experiencing a complete pathological response haved a longer survival . The pathological response has thus to be carefully assessed. Material and Methods: The aim of this retrospective study was to determine whether there islook for a correlation between clinical response with (WHO criteria) and pathological response using Chevallier’s and Sataloff’s classifications. 56 successive patients received an anthracycline- based chemotherapy regimen for IBC before surgery; for all of these patients a pathological analysis had beenwas performed before chemotherapytreatment and after surgery. Alll the specimens werehave been reviewed by the same pathologist. Results: There is a very good correlation between the 2 pathological classifications fAmong the 56 patients, there were 3 complete clinical responses, which were also pathological complete responses according to both classifications.or the complete responders only. In all the other cases, no correlation wascould be found between the 3 classifications . It was particularly striking for all the 41 patients tumours classified grade 3 according to Chevallier who could be classified clinically (with WHO) or pathologically (with Sataloff) in either of the 4 groups from complete responseders to progressive disease . Overall , in this our series , 3 patients according to Chevallier and 11 according to Sataloff were complete pathological responders. Discussion: The lack of correlation between clinical and pathological classifications could be explained , at least in part, by the fibrosis often observed after primary chemotherapy. The differences observed between the 2 pathological classifications highlight the fact that there is no standard and that further research is neede in that perspective. [Table: see text] No significant financial relationships to disclose.
The FinXX trial: Safety results in 600 patients (pts) randomized to either docetaxel (T) followed by cyclophosphamide (C) + epirubicin (E) + 5-FU (F) (CEF) or T + capecitabine (X) followed by CEX as adjuvant therapy for early breast cancer (BC)
Authors: Joensuu H. , Hemminki A. , Huovinen R. , Tanner M. , Kokko R. , Asola R. , Jukkola-Vuorinen A. , Lahtela S. , Lindman H. , Kellokumpu-Lehtinen P. 
Published: March 2020

11035 Background: Adding X to T extends survival in pts with metastatic BC. The primary objective of the FinXX trial is to compare recurrence-free survival with XT→CEX vs T→CEF as adjuvant therapy in pts with early stage BC. Secondary objectives were comparison of safety and overall survival. Methods: Between Jan 2004 and May 2005, 600 of a planned 1,500 pts were randomized to receive T x 3 → CEF x 3 (T 80 mg/m2 d1 → C 600 mg/m2 d1, E 75 mg/m2 d1, F 600 mg/m2 d1) or TX x 3 → CEX x 3 (T 60 mg/m2 d1 + X 900 mg/m2 bid d1–15 → C 600 mg/m2 d1, E 75 mg/m2 d1, X 900 mg/m2 bid d1–15) q3 wks. Results: Grade 3/4 toxicities (CTCAE, v3) in >5% of pts are shown below. 62 pts required G-CSF. Nos. of cycles with G-CSF were: T 34; XT 15; CEF 17; CEX 15. Adverse events (AEs) led to interruption of T in 7 pts (2%) and XT in 50 pts (16%). Median dose intensities at cycle 3 were T: 95%; XT: 84/97%; CEF: 98/97/98%; CEX: 98/98/84%. T dose reductions of =20% in cycle 3 were needed in 18% and 8% of pts receiving T and XT, respectively. 4 pts died during treatment: pulmonary embolism (n=1) with T and suicide, sudden death and colitis/sepsis (each n=1) with XT. Conclusions: XT→CEX is generally well tolerated. Treatment interruptions were more common with XT→CEX, but were effective in reducing development of grade 3/4 AEs. Neutropenic infections were less frequent with XT vs T and infrequent with XT, CEF and CEX. Rates of grade 3/4 diarrhea and HFS were acceptable with XT and minimal with CEX. Accrual is nearly complete; efficacy data are expected in 2009. [Table: see text] [Table: see text]
Dose-dense (DD) two-weekly docetaxel/doxorubicin/cyclophosphamide (TAC) with G-CSF support compared to standard adjuvant TAC in breast cancer patients
Authors: Latifzadeh S. Z. , Salimi M. , Naghnaeian M. , Entezari V. 
Published: March 2020

11052 Background: TAC confers a significant disease free and overall survival benefits vs. FAC for patients with node positive breast cancer and prophylactic use of G-CSF is a reasonable supportive therapy to minimize myelosuppresive complications of this regimen. DD scheduling has shown improved clinical outcomes in breast cancer therapy. This study is trying to compare toxicities and tolerability of DD TAC with G-CSF support with TAC every 3 wks supported with G-CSF. Methods: Thirty seven patients were enrolled during the period 1/04 to 1/06. Cohort A (N=25) received six cycles of TAC (75/50/500 mg/m2 every 3 wks) plus GCSF started on day 5 and Cohort B (N=12) received six cycles of TAC (75/50/500 mg/m2 every 2 wks) plus GCSF started on day 2. All patients had normal cardiac, renal and liver function. Toxicities were evaluated by clinical assessment, CBC and liver function tests. Results: The incidence of febrile neutropenia was 15.8% and 16.7% in cohort A and B respectively (RR =1.06, 95% CI = 0.20–5.42). Grade III/IV anemia was detected in 5.3% of cohort A patients and 8.0 % of cohort B patients (RR=1.58, 95% CI=0.10–22.99). Ten percent of cohort A patients developed stomatitis grade III/IV while none of cohort B patients had this toxicity (RR=1.06, 95% CI = 0.94–1.17). Hospitalization due to chemotherapy complications (mainly neutropenia) in cohort A and B were 5.3% and 8.3% (RR =1.58, 95%CI = 0.10–22.99). Conclusions: DD two weekly TCA was reported to be feasible in patients with stage II - III breast cancer (Margolis et al. JCO, 2005). This study shows that DD TCA plus G-CSF has comparable toxicity profile with standard TCA regimen with shorter treatment period.
Lack of effect of pegfilgrastim on anemia in breast cancer patients treated with dose-dense chemotherapy
Authors: Manzoni M. , Bencardino K. , Rovati B. , Mariucci S. , Cappuzzo F. , Chatzileontiadou S. , Grasso D. , Delfanti S. , Danova M. 
Published: March 2020

11071 Background: A greater risk of anemia has been evidenced among breast cancer (BC) pts receiving dose-dense CT. A recent report showed that filgrastim may play a role in worsening anemia in BC pts receiving intensified Epirubicin (E) + Cyclophosphamide (CTX), by inducing stem cells to differentiate into more committed hematopoietic progenitors (Papaldo P. JCO, 2006). No data are available about the impact of pegfilgrastim-induced leucocytosis on Hb levels without prophylactic erythropoietic support. Methods: We have focused on this point in 36 BC pts. 14 N+ pts received 4 cycles of E 90 mg/sqm + CTX 600 mg/sqm every 14 days in adjuvant setting. 22 pts with locally advanced disease received 4 cycles of E 75 mg/sqm + Docetaxel 80 mg/sqm every 14 days as primary CT. All pts received prophylactic pegfilgrastim 6 mg s.c, after CT. Three groups were defined on the basis of WBC: A = <10 x 103/mL; B = between 10 and 20 x 103/mL and C = > 20 x 103/mL. WBC and Hb levels at the beginning of treatment were normal in all pts and were subsequently determined on day 1 of each treatment cycle. Results: All pts received the planned CT dose intensity. Only 3 pts developed G2 anemia and were excluded from the analysis, because of receiving darbepoietin alpha support. Among the 14 pts treated in adjuvant setting, 5 dropped in group A, 6 in group B and 3 in group C. The mean Hb decrease from the baseline to the last CT course was - 1.5 g/dL; -1.4, -1.8 and -1.4 in group A, B and C, respectively. In the primary setting, 4 pts dropped in group A, 12 in group B and 4 in group C. The mean Hb decrease was -1.5 g/dL; -1.3, -1.4 and -1.8 in group A, B and C respectively. No statistically significant correlation was found between the Hb levels and the degree of leukocytosis. Conclusions: Pegfilgrastim does not worsen anemia in BC pts treated with dose- dense CT, even when its use is related to some degree of leucocytosis. No significant financial relationships to disclose.
Sentinel lymph node micrometastasis detection using immunohistochemistry and reverse transcription-polymerase chain reaction for cytokeratin 19 in breast cancer
Authors: Cao Q. , Wang S. , Liu X. , Lin L. , Zhao J. 
Published: March 2020

11074 Background: In breast cancer, the sentinel lymph node (SLN) can be used to assess the axillary nodal status to guide the axillary surgery, tumor staging and adjuvant systematic therapy. Histology and immunohistochemistry (IHC) are currently the routine methods of SLN assay. The facts that about 30% of node-negative breast cancer patients relapse within five years and that micrometastasis were found in 9%∼30% negative lymph nodes when they were re-examined using serial sectioning suggest that current histological detection methods are inadequate for identifying metastatic tumor cells in lymph nodes. The primary objective of this study was to develop an assay by using a combination of reverse transcription-polymerase chain reaction (RT-PCR) and immunohistochemistry for cytokeratin 19 (KT19) expression in SLN. Methods:139 SLN samples were collected from 139 breast cancer patients undergoing SLN biopsy using Isosulfan Blue dye during modified mastectomy between June 2002 and June 2005. The SLNs were dissected into two parts, half were frozen in liquid nitrogen during sugery for RT-PCR detection and another half were kept in liquor formaldehyde for routine hematoxylin-eosin (H&E) examination and IHC detection. In 62 tumor-negative SLNs at routine H&E examination (pN0), we performed IHC and RT-PCR for KT19. Results: Of the 62 tumor-negative SLNs at routine H&E examination, 11% (7/62) were positive on extensive IHC analyses for KT-19, which were all positively identified by RT-PCR assay. Six SLNs (10%) were negative for micrometastases (with H&E and IHC for KT-19) but RT-PCR positive. There was asignificant difference in detective rate between these two methods statistically (χ2 = 4.1667 , P = 0.0412) and the coincidence were high ( kappa = 0.6483) Conclusions: As IHC analysis resulted in a 11% detection rate in H&E negative SLNs, IHC is essential to avoid false- negative SLN micrometastases. Molecular analysis with KT19 allows detection of breast cancer micrometastases with an additional 10% detection rate in H&E negative SLNs and resulted in a high coincidence with IHC analysis. However, the clinical value of these histologically negative but RT-PCR positive SLNs can only be determined with long term follow up. No significant financial relationships to disclose.
Effect of zoledronic acid on bone loss by letrozole
Authors: Jung S. S. , Cha S. , Bae J. , Park W. , Seo Y. , Oh S. , Kim J. , Jeon H. , Song B. J. 
Published: March 2020

11077 Background: The aromatase inhibitors cause bone loss by estrogen depletion. Zoledronic acid (ZA) can prevent bone mineral density (BMD) loss associated with the use of aromatase inhibitors. Accordingly interest has arisen in measuring surrogate markers of bone resorption to monitor the response of treatment of BMD loss in place of radiologic assessment. This study was designed to determine whether ZA would prevent bone loss that is known to occur with letrozole and identified surrogate markers of bone resorption in an animal model. Methods: In ovariectomized or sham-operated rat, we administrated ZA and letrozole to 5 different groups including: a sham operation control group (OC), a group in which an ovariectomy was performed followed by saline administration (OS), an ovariectomy with ZA treatment group (OZ), an ovariectomy with letrozole treatment group (OL) and an; ovariectomy with ZA and letrozole combined treatment group (OZL). The levels of serum osteocalcin, serum bone alkaline phosphatase (BALP), serum calcium and urine N-telopeptide (NTX) and BMD were estimated and compared at the same periods for each group. The distinct microscopic findings of proximal tibia at week sixteen were also compared. Results: Significantly intense increment of BDM in the OZ group and the OZL group and lower increment in the OL group were valued in correlation to the OS group, 31.3%, 35.0%, 10.5% and 13.0% respectively. Serum osteocalcin levels and urine calcium levels were close to each group. Serum calcium levels and BALP levels were relatively lowering in the OZ group and the OZL group than other group. Meaningfully lower levels of urine NTX were measured in the OZ group and the OZL group, 6.6% and 16.5% respectively. In the OL group levels of urine NTX were rise of 55.9%. Less cancellous bone loss and increase bone trabeculae were noted in the microscopic findings of tibia. Conclusions: The combination treatment with ZA and letrozole are effective in the inhibition of bone resorption and in the maintenance of BMD. Measurement of serum osteocalcin, urine NTX, and BMD, levels are recommended as surrogate markers for determining the response for the treatment of bone loss. No significant financial relationships to disclose.
Nipple-sparing mastectomy and immediate reconstruction: Indications, technique, and results of 110 patients with breast cancer
Authors: Son B. , Ahn S. , Kim H. , Jang M. , Park E. , Lee T. , Um J. , Kim S. , Ahn J. , Gong G. 
Published: March 2020

11088 Background: Nipple-sparing mastectomy (NSM) and immediate reconstruction has recently been accepted as a new surgical procedure that provides good cosmetic results, although it is necessary to establish oncological safety. We reported our experience to evaluate indications, technique, results, and complications of NSM. Methods: Between 1999 and 2005, medical records of 113 patients with breast cancer undertaken NSM at the Asan Medical Center were analyzed retrospectively. Median age of the patients was 40 years and complications were assessed 3 months later postoperatively. Results: For preoperative indications of NSM, mulifocal or multicentric cancers were 60 cases (53.1%), diffuse microcalcifications on MMG were 27 cases (23.9%), failure of breast conserving surgery due to tumor involvement of resection margin were 12 cases (10.6%), central located small cancers were 11 cases (9.7%). Immediate reconstruction methods were 85 cases (75.2%) in TRAM and 28 cases (24.8%) in direct implant. Intraoperative frozen section biopsy for evaluation of tumor involvement at the NAC showed accuracy of 100%. Pathologic tumor size were 24 cases (21.2%) in Tis, 56 cases (49.6%) in T1, 33 cases (29.2%) in T2, respectively. Lymph node status showed 81 cases (71.7%) in N0, 24 cases (21.2%) in N1, 7 cases (6.2%), and one case (0.9%) in N3, respectively. During 20 months of the median follow-up, four patients developed recurrences; one local recurrence (subcutaneous), two (lung, brain) distant failures, and one local and distant failure. The rate of major NA necrotic complication was 14.6%, but all cases were improved with conservative management. 91.7% of patients were satisfied with their cosmetic results. Conclusions: Although the presented study does not establish conclusion with regard to oncological safety due to short follow-up period, the procedure of NSM with intraoperative pathologic assessment of the subareola tissue, and immediate reconstruction is a reasonable option for a selected patients. Good candidates for NSM are patients unsuitable for breast conservation either for multicentric or multofocal cancers, or because of extensive microcalcification, or involvement of resection margin during breast conserving surgery. No significant financial relationships to disclose.
Neoadjuvant chemotherapy (NACT) with prolonged high-dose (HD) doxorubicin (A) and cyclophosphamide (C) with G-CSF support in locally advanced breast cancer (LABC): Long-term follow-up data
Authors: Altintas S. , Huizing M. T. , Spoormans I. , Van den Brande J. , Wilmes P. , Tjalma W. , Van den Weyngaert D. , Van Goethem M. , Vermorken J. B. 
Published: March 2020

11090 Background: NACT improves survival in LABC. The optimal regimen, dose and duration is still under study Objective: To determine the efficacy and safety of prolonged preoperative HD-AC plus G-CSF. Methods: LABC patients (pts) were treated with AC for 6 cycles (Cy): Cy 1: A 90 mg/m2, C 1000 mg/m2; Cy 2–3: A 82.5 mg/m2, C 875 mg/m2; Cy 4–6: A 75mg/m2, C 750 mg/m2) with prophylactic (peg)filgastrim q3wks. In case of cardiotoxicity or poor tumor response (TR) pts switched to Docetaxel (D) 100mg/m2 q3wks. Within 5 weeks after NACT, pts underwent mastectomy with axillary lymph node dissection followed by radiotherapy. In case of positive estrogen (ER) or progesteron receptor (PgR), hormonal treatment was given for 5 yrs. Toxicity was scored weekly (NCI-CTC 2), response every 3 wks (WHO). Kaplan-Meier analysis was performed to calculate disease free survival (DFS) and overall survival (OS). Results: Between 8/1997 and 10/2003 21 pts (median age 55 years, range 22–74) were enrolled. One pt had stage IIB, 6 stage IIIA, 14 stage IIIB disease (10 T4d). 10 tumors were ER+, 5 PgR+, none overexpressed Her-2/Neu. A total of 130 NACT Cy was given. 15 pts completed all 6 AC Cy, 6 switched to D because of a decrease in left ventricular ejection fraction (LVEF? >10%, n=2) or insufficient TR (n=4). Dose reduction of AC was needed in 1 pt (last Cy), dose delays in 4 pts. Nausea and vomiting were generally mild; grade 4 anorexia occured in one pt. Grade 4 leucopenia and neutropenia in 14 and 18 pts, respectively. Neutropenic fever requiring hospitalization occurred in 5 pts, thrombocytopenia grade 4 in 7 pts and grade 3 anemia in 3 pts. Two pts developed cardiomyopathy (9.5%) < 2 years after NACT. The overall TR rate (PR and CR) was 81%, clinical CR rate 14%, pathologic CR rate 10% and 14% had minimal residual disease. Three pts showed SD and only 1 pt had PD. The median follow up of all pts was 51 months (range 9–110), 5 yrs DFS 47%, OS 56%. 5 yrs DFS and OS for pT4d pts was 50% and 56%, respectively. Conclusions: NACT with HD-AC plus G-CSF for 6 Cy in this poor risk population is active and further supports the use of prolonged preoperative CT. The routine use of D after a restricted number of AC Cy may further improve results and decrease (cardio)toxicity. No significant financial relationships to disclose.
Audit of open breast biopsies in a Nigerian teaching hospital
Authors: Adisa A. C. 
Published: March 2020

11091 Background: Open biopsy is an accurate method for diagnosis of breast tumors especially where facilities for needle biopsies like tru cut needle biopsy or aspiration cytology method are not readily available. We report a 10-year retrospective study of the clinical and pathological characteristics of excised breast masses in our centre. Methods: Clinical records and pathological results of all breast biopsies of consecutive patients referred to the Breast Clinic of the Abia State University Teaching Hospital, Aba, Nigeria were studied from January 1994 to December 2003. We present the outcome of the histology reports from breast biopsy for a period of 10 years (1994- 2003) in Abia State University Teaching Hospital. Results: A total of 421 patients had open biopsies for breast masses. The age ranged from 12 years to 80 years with the median age of 34 years. The commonest symptom was painless breast lump in 90% of patients; breast pain was present in less than 5% of cases. Malignancies were discovered in 24% of the cases and the predominant histological type was infiltrating ductal carcinoma (NOS) which was found in 78% of cases, lobular carcinoma was found in 2% of cases. 79% of the breast cancers occur in pre menopausal women and the majorities (85%) were late stages. 79% of the patients with cancer of the breast were 50 years old or younger and the youngest patient was 14 years. The benign lesions in order of frequency were fibroadenoma (45%), fibroadenosis (41%), granulomas (5%), breast cyst (3%), and galactocele (2%).Other less common pathologies include lipoma, chronic abscesses and parasitic cysts. Conclusions: Majority of breast masses in Nigerian women are benign. The preponderance of late staged tumors and pre menopausal patients call for early detection, public awareness and improved screening methods No significant financial relationships to disclose.
Gemcitabine and vinorelbine as third-line therapy in elderly patients (pts) with advanced breast cancer (ABC) pretreated with taxanes and anthracyclines
Authors: Botto H. G. , Botto M. E. 
Published: March 2020

1110 Background: Gemcitabine (G) and vinorelbine (V) combinations are active in ABC pts. In this trial our purpose was to study in elderly pts with ABC and pretreated with T and A, the response rate (RR), the time to progression (TTP), the overall survival (OS) and the tolerance, with G and V as third line therapy. Methods: Sixteen pts with ABC pretreated with T and A combinations, median age 69 years (range 66–81 y). PS: 0=7, 1=8, 2=1, with normal organic functions, sites of disease: hepatic 8, bone 7, lung 5, soft tissue 3; two or three sites of disease 9 pts, more than three sites 7 pts. Treatment: G/1,200 mg/m2 and V 35 mg/m2, day 1, every 21 days. Median N° of cycles 4 (range 2–8). Total N° of cycles 71. All pts were evaluated for RR, OS and toxicity. Results: PR 25%, SD 37%. All PR pts and one SD pt, have previously showed response to T and A combinations. The total median TTP was 4 months (range 2–20 m), the total overall survival was 7 months (range 3–36 m). In non responders and responders pts to previous T and A combinations, the median TTP was 3 and 5 months respectively, and the median OS was 5 and 10 months respectively. Tocixity, neutropenia Gr.3–4: 6 pts, Gr.2: 10 pts, anemia Gr.2: 7 pts, thrombocitopenia Gr.2: 3 pts. Conclusions: In this trial the gemcitabine and vinorelbine as third line therapy, in elderly pts with ABC, pretreated with T and A combinations, showed good response rate, good overall survival and acceptable toxicity. Pts who have responded to the previous T and A regimens obtained better response than pts who have not responded. No significant financial relationships to disclose.