bluuebunny/crossref_metadata_2025_split huggingface dataset:
A clinical review of 33 cases of breast phyllodes tumor over the last 20 years
Authors: Lenhard M. S. , Kahlert S. , Himsl I. , Ditsch N. , Untch M. , Friese K. , Bauerfeind I. 
Published: March 2020

10629 Background: The “Cystosarcoma phyllodes” of the breast is a rare entity which accounts for 0.5 % of all breast neoplasms. The diagnosis should be considered in all rapidly growing breast nodules. We reviewed all cases of this rare disease that presented at our hospital in the last 20 years. Methods: The data of 5270 patients with primary breast neoplasms treated in our department between 1984 and 2005 were retrospectively analyzed for the histopathologic diagnosis of a cystosarcoma phyllodes. Results: 33 patients with cystosarcoma phyllodes of the breast could be identified. The median age at diagnosis was 47 years. Median follow up was 86 months. The tumors were classified histologically into benign (40%), borderline (27%) and malignant tumors (33%) based on standardized criteria; 3 tumors were unclassified. Surgery was conducted as a breast conserving (58%) or radical operation (mastectomy) (42%). Median tumor size was 7.1 cm, and no lymph node infiltration was found in the 8 patients who received axillary lymph node dissection. Local recurrence occured in 8 patients (26%). 75% (6/8) of the patients with a local recurrence had been treated with a breast conserving surgery. In patients with the diagnosis of a malignant phyllodes tumor we observed a recurrence rate of 40% (4/10), in those with borderline tumors of 25% (2/8) whereas those with benign phylloides tumor had a local relapse rate of 8% (1/12). Distant metastases were seen in 4 patients (12%) with a malignant phyllodes tumor. All patients with distant metastases in the follow up had been treated radically at primary diagnosis. Neither regarding age at primary diagnosis nor in tumor size there was a significant difference between patients with local recurrence or metastasic spread and those without (p = 0.284 tumor size, p = 0.739 for age, Wilcoxon-W). Conclusions: We recommend local excision with appropiate surgical margins in all patients if the tumor-to-breast ratio is sufficient for good cosmesis. Based on our data, routine axillary lymph node dissection is not recommended. Patients with a malignant tumor are at higher risk for local recurrence and metastasic spread. Therefore, the histopathologic classification seems to be the strongest prognostic factor in this disease. No significant financial relationships to disclose.
Circulating tumor cells (CTCs) detection in a randomized phase II trial of neoadjuvant chemotherapy for large operable and locally advanced breast cancer (REMAGUS 02): Preliminary results
Authors: Pierga J. Y. , Mathiot C. , Extra J. M. , Tresca P. , Asselah J. , Sigal-Zafrani B. , Brain E. , Diéras V. , Mignot L. , Marty M. 
Published: March 2020

10637 Background: The presence of CTCs in blood from metastatic breast cancer patients before first line chemotherapy and persistence of CTCs after initiation of treatment, are predictive of shorter overall survival (Cristofanilli M; et al, 2005, J Clin Oncol 23:1420–1430). CTCs could be used as a surrogate marker. The aim of this study was to determine if CTC were present in the blood of patients who received neoadjuvant chemotherapy (CT) for large operable and locally advanced breast cancer, before initiation of CT (preCT) and at the end of CT before surgery (postCT). Methods: 7.5 ml of blood were obtained on CellSave tube from patients included in an ongoing randomized phase II trial. All patients received 4 cycles of Epirubicin-Cyclophosphamide every 3 weeks followed by 4 cycles of docetaxel associated with or not trastuzumab for HER2 positive patients and with or not celecoxib for HER2 negative patients. CTCs were immunomagnetically separated and fluorescently stained with the CellSearch kit. Cells were classified using the CellSpotter Analyzer as CTCs if they stained positive for DAPI (nuclear dye), and cytokeratin 8, 18 and 19, and if they stained negative for the leucocyte-specific antibody CD45. Results: From 10/2004 to 12/2005, preCT blood samples were obtained in 60 patients, analyzed in 56 for technical reasons. At least one CTC was detected in 15/56 (27%, CI 95%: 15.5–38.5%), 1 to 17 cells per sample (median 1.5). With a threshold of 2 cells, 8/56 (14%, CI 95%: 5–23%) patients were classified positive. At time of analysis, pre CT and post CT samples from the same patient were available for 19 patients. Six had >1 CTC/sample before CT (31.5%) and only one (1/6, 17%) remained positive after CT. Thirteen were negative for CTC before CT and 2/13 (15%) became positive after CT, with only one cell per sample. Conclusions: CTCs can be detected in blood of patients with large operable or locally advanced breast cancer before initiation of neoadjuvant CT and can be monitored during treatment. Longer follow-up and a larger number of patients are expected before correlating these data with tumor response and survival. No significant financial relationships to disclose.
Liposomal doxorubicin (M) plus gemcitabine (G) as first line treatment in metastatic breast carcinoma: A phase I-II study
Authors: Colomer R. , Tusquets I. , Calvo L. , Dorca J. , Adrover E. , Sanchez-Rovira P. , Rifa J. , De La Haba J. , Virizuela J. A. , Beltran M. 
Published: March 2020

10651 Background: We designed a phase I-II trial to determine the combination dose of liposomal doxorubicin (Myocet) plus gemcitabine (Gemzar), and to evaluate the safety and feasibility of the regimen Methods: Patients with histologically confirmed breast cancer, untreated distant metastasis, age >18 years old, left ventricular ejection fraction (LVEF) >50% and adequate bone marrow, renal and hepatic function were included in the study. Patients received up to six cycles of treatment. No G-CSF support was used prophylactically. LVEF was repeated at 3, and 6 months, and every 6 months thereafter. Results: Phase I: After 6 patients, the recommended dose was M (55 mg/m2) D1 and G (900 mg/m2) D1 and 8, administered every 21 days. Phase II: 53 patients have been enrolled; 52 are included in the safety analysis and 42 in the efficacy analysis. The median age of the population was 61 years of age (32–79). ECOG PS was 0 in 55%, 1 in 41%, 2 in 4%. Postmenopausal status in 87%. Main histology was ductal carcinoma (85%). Prior adjuvant anthracyclines had been administered in 19 cases (median dose of doxorubicin: 300 mg/m2, or epirubicin: 425 mg/m2). Metastasic lesions were in liver (25), lung (17), bone (16), and lymph nodes (25). Patients received a median number of 5 cycles (range 1–6). Median relative dose intensity was 83% for M and 75% for G. Grade III-IV hematologic toxicity per administered cycles was: leukopenia (21.9%), neutropenia (31.2%), febrile neutropenia (4 %), and thrombocytopenia (7.4%). Grade III-IV non-hematologic toxicities were stomatitis (4.8%), nausea (1.7%), vomiting (2.2%), asthenia (2.6%) and diarrhea (0.8%). Thirteen of 52 pts (25%) had alopecia grade III-IV. No signs or symptoms of cardiac impairment have been seen. An objective response rate of 62% was obtained (95% CI: 45.6- 76.4%). Two patients had complete response (4.8%), 24 partial response (57.1%), 10 stable disease and 6 progressive disease. The response rate was similar in patients with or without previous adjuvant anthracyclines (68.5% and 61%, respectively). Conclusions: The combination of liposomal doxorubicin plus gemcitabine has high efficacy and low toxicity in advanced breast cancer patients, and may be a valuable option in patients that have received adjuvant anthracyclines. [Table: see text]
Ten-year experience with weekly chemotherapy in metastatic breast cancer patients: Multivariate analysis of prognostic factors
Authors: Nistico’ C. , Cuppone F. , Bria E. , Giannarelli D. , Mottolese M. , Novelli F. , Natoli G. , Astorre P. , Terzoli E. 
Published: March 2020

10652 Introduction: Weekly administration of chemotherapy represents an emerging option for the treatment optimization of metastatic breast cancer (MBC). Moreover, evidences suggest a intriguing mechanism of action for weekly paclitaxel, which involves pro-apoptotic and anti-angiogenetic pathways. In order to identify clinical and biological prognostic factors for weekly chemotherapy outcome, we performed a multivariate analysis in a 10-years experience of weekly 1st line chemotherapy for MBC patients. Methods: The original databases of phase II trials of MBC patients undergone 1st line weekly chemotherapy were collected. Clinical and biological co-variables were screened for the eventual relationship with time to progression (TTP) and overall survival (OS) into a Cox model. Results: From 1990 to 2003, 184 patients were enrolled in 3 consecutive phase II studies, to evaluate activity and tolerability of weekly epirubicin with lonidamine, or vinorelbine or paclitaxel, for 24 weeks. All patients were evaluable for clinical variables, while histological samples were available in only 40 patients. At a median follow-up of 24 months, median TTP was 9 months (95% CI 8–10) and median OS 34 (95% CI 24–42). Independent variables were: response (HR 2.34, p < 0.0001), receptor status (HR 1.62, p = 0.01) Performance Status (PS) (HR 2.31, p < 0.0001) for TTP, and response (HR 1.86, p = 0.005), PS (HR 2.81, p < 0.0001), dominant metastatic site (HR 2.27, p < 0.0001), enrollment period (HR 2.51, p = 0.001) for OS. Although no biological factors entered the Cox model due to the small sample size, some sub-populations showed negative trend in survival. Conclusions: In our series of patients undergone weekly chemotherapy for MBC, independent prognostic factors for survival improvement were responders, PS 0–1, non-visceral dominant metastatic site, and enrollment period. Further greater populations are needed to extensively screen for biological prognostic factors. No significant financial relationships to disclose.
Continous low dose oral chemotherapy administration in heavily pretreated breast cancer patients
Authors: Pavese I. , Di Palma M. , Capuano G. , Satta F. 
Published: March 2020

10664 Background: The efficacy and the antiangiogenic effect of low dose continous (metronomic) administration of chemotherapy are well known. In thi study we tested the clinical activity of oral Ciclophosphamide (CTX) and Methotrexate (MTX) in advanced breast cancer (ABC). Methods: From november 2004 to september 2005 35 ABC patients were enrolled. Median age 59 (range 36–74), ECOG PS 0–2. All patients received at least two prior chemotherapeutic regimens (range 2–4). Metastatic sites were as follow: liver (16), lung (6), bone (9) and skin (4). patients with CNS involvement were excluded. All patients received CTX at the dose of 50 mg/die and MTX at the dose of 2.5 mg twice daily on days 3 and 4 of each week. After two months of treatment patients were re-evalated for disease response. Results: All patients were evaluable for response. After 2 months of treatment we observed 3 PR (8.5%) and 12 SD (34%), for an overall RR of 42%. 23 patients experienced PD. On the whole treatment was well tolerated, with mild toxicity; no patients discontinued treatment due to toxicity. Grade 2 or 3 neutropenia was observed in 14/35 patients and grade 2 trombocytopenia was observed in 9/35 patients. No grade 4 toxicity was observed. Conclusions: Metronomic administration of chemotherapy is well tolerated even in pretreated patients and shows moderate activity in advanced breast cancer No significant financial relationships to disclose.
Partial breast irradiation (PBI) concurrent with adjuvant dose-dense doxorubicin and dyclophosphamide (ddAC) chemotherapy in early-stage breast cancer: Preliminary safety results from a feasibility trial
Authors: Zellars R. C. , Frassica D. , Stearns V. , Fetting J. H. , Armstrong D. K. , Myers L. , Tsangaris T. N. , Jacobs L. , Lange J. R. , Wolf A. C. 
Published: March 2020

10675 Background: Adjuvant anthracycline-based chemotherapy regimens and radiation therapy as part of breast conservation therapy (BCT) are given sequentially to avoid excessive skin toxicity. PBI employs a shorter course of radiation therapy to a smaller breast field and is the subject of randomized efficacy trials. Concurrent administration of PBI and adjuvant chemotherapy would decrease duration of therapy, allow more women to pursue BCT, improve compliance, and potentially enhance local control. Methods: To examine the feasibility, safety, and short-term risk of recurrence of concurrent PBI with adjuvant ddAC, we are conducting a prospective one-stage, single-arm trial of PBI during the first 2 of 4 cycles of ddAC (60 and 600 mg/m2, respectively) delivered q14d with growth factor support. Patients (pts) with T1–2 N0–1 breast cancer and lumpectomy margins ≥ 3mm are eligible. PBI starts within 3 days of first chemo dose and treats the lumpectomy bed plus margin with 270 cGy fractions × 15 (4050 cGy total). Primary endpoints (skin/soft tissue toxicity and cosmetic outcome) are graded by a panel of physicians using commonly accepted scales. Digital images at baseline, during, and q 3–6 months after PBI are obtained for comparison. Additional chemo and endocrine Rx post ddAC given at the physician’s discretion. We report preliminary safety data. Results: Between 11/04 and 9/05, 10 pts were enrolled and received study therapy (accrual goal = 42); 2 pts also received dd paclitaxel 175 mg/m2 post ddAC. All pts received planned PBI (med. f/u 6 mos, range 3–12 mos). 2 pts missed 1 and 2 cycles of ddAC because of stomatitis (Gr 3) and diverticulitis, respectively. 3 other pts had 1–2 wk chemo delay because of hand-foot syndrome, brief pulmonary syndrome, and febrile neutropenia. No pts developed radiation dermatitis > Gr 1 or radiation recall. All pts had cosmetic outcome grades of good or excellent shortly after completion of therapy. No pts with ≥ 6 mos f/u since PBI had late skin toxicity. Conclusion: Early results suggest that PBI concurrent with ddAC appears feasible and safe. Trial enrolment continues and longer f/u is required. (Funded by The Breast Cancer Research Foundation). No significant financial relationships to disclose.
Diagnosis of recurrent breast cancer: 18F-FDG PET/TAC as first choice
Authors: Mion M. , Chierichetti F. , Liessi G. , Bissoli S. , Milan E. , Oniga F. , Sartor L. , Bortolin M. , Vicario G. , Sgarbossa G. , Manente P. 
Published: March 2020

10681 Background: we began using PET diagnosis in 1994 and since the beginning of 2000 we started with a PET/CT system. Aim of our study was to evaluate if this new imaging modality may be the first step in the detection of recurrence in patients with a history of breast tumors. Methods: we reviewed retrospectively 22 patients (mean age 60, range 46–76 years) already treated for a breast cancer. A total of 32 PET/CT scans were performed (repeated in 10 patients). All patients were submitted to other examinations, such as bone scintigraphy and liver ecography, but also mammography and CT scan. Results: 14/32 PET/CT were negative for recurrence in 10 patients (4 scans as a second one). In a mean follow up of 10 months, 1 case is not yet clear: in presence of relevant increase of Ca15.3 (up to 176 ng/ml) the first scan was negative and the second one evidentiated a pattern of lung inflammation. Among the other 13/14 negative scans, 3 patients presented ambiguous/positive bone scintigraphy for metastases, not assessed at the final diagnosis. 18/32 PET/CT scans were positive for local recurrence or distant metastases. Among these positive cases, a patient with normal bone scintigraphy presented a mild uptake of FDG in the right omerus. The second scan (5 months later) showed focal increased uptake of FDG in the same bone site, not evident in the CT images, and many small lung nodules, 1–2 mm size. In 3 patients PET localized muliple bone lesions, in 2 CT was completely normal. Finally, 1 out of the 18 positive results was false positive: a patients with a single lung nodule (1.5 cm) was submitted to surgery and the final diagnosis was benign lesion. PET/CT was crucial for the patient’s management in 19 out of 22 patients. Conclusions: recurrent breast cancer is generally characterized by multiple sites of metastases and few cases take advantage of surgical resection. In our group of 22 patients just 2 out of them received surgery (for local relapse and lung metastases). Therefore, in most cases a whole body examination, like PET/CT may be more useful respect to other modalities to assess how spread is the recurrence. Further data are needed but, in our preliminary experience, PET/CT seems to be the first choice to evaluate patients with previous breast cancer. No significant financial relationships to disclose.
Phase II study of capecitabine (X) in combination with vinorelbine (N) in patients (pts) with pretreated metastatic breast cancer (MBC)
Authors: Batista N. , Estevez L. , Sánchez-Rovira P. , Velasco A. , Dómine M. , Lobo F. , Oramas J. , Cruz J. 
Published: March 2020

10693 Background: X monotherapy is consistently effective and very well tolerated in pretreated MBC. N is also commonly used in this indication. In several studies, the combination of X + N led to response rates ranging from 43–67% in first-line MBC. As there are few data on the combination in pts with pretreated MBC, we evaluated the efficacy and safety of X + N in a multicenter phase II trial of pts previously treated with anthracycline- and taxane-containing regimens. Methods: Women >18 years of age with pretreated MBC, PS 0–2 and adequate organ function were enrolled to receive a 3-weekly regimen of XN: X 1000mg/m2 twice daily on days 1–14 and N 25mg/m2 on days 1&8, every 3 weeks up to a maximum of 6 cycles, disease progression or unacceptable toxicities. Results: A total of 32 pts were enrolled, median age 58 years (range 41–77), PS 0(74%), 1(19%), postmenopausal (61%). The most frequent sites of metastases were: liver (68%), nodes (36%), lung (36%). 58% of pts had ≥2 metastatic sites. 27 patients (87%) previously failed on anthracycline and taxane chemotherapy regimens. 152 cycles were administered with a median of 3 cycles/pt (range 1–10). Median relative dose intensity was 0.86 (0.51–1.01] for N and 0.85 (0.26–1.03] for X. All pts were evaluable for safety. The most common grade 3/4 clinical adverse events were vomiting (15%), asthenia (9%), and hand-foot syndrome (6%). Grade 3/4 hematological toxicities were: neutropenia (47%), leucopenia (9%), thrombocytopenia (3%). One pt died due to septic shock after the first cycle. 29 pts are evaluable for efficacy: the overall response rate was 52% (4 CR, 11 PR), with stable disease in 8 pts (28%). Median TTP was 7.5 months [95% CI, 5.7–9.8]. Conclusions: Our preliminary data indicate that the combination of X and N has promising clinical activity and good safety in pts with MBC who have failed prior taxane- and anthracycline-containing regimens. No significant financial relationships to disclose.
Long median survival with capecitabine (X) single-agent therapy for patients (pts) with anthracycline- and taxane-pretreated metastatic breast cancer (MBC)
Authors: Largillier R. , Fumoleau P. , Clippe C. , Dieras V. , Orfeuvre H. , Lesimple T. , Culine S. , Audhuy B. , Serin D. , Bobadilla L. 
Published: March 2020

10710 Background: X (Xeloda) is an oral fluoropyrmidine with consistently high activity in MBC, a good safety profile with little myelosuppression and no alopecia, and the convenience of oral administration. The addition of X to docetaxel in anthracycline-pretreated pts also increases survival. This non-randomized phase II study was conducted to evaluate the efficacy, safety and impact on quality of life (QoL) of X in pts with MBC pretreated with anthracyclines and taxanes. Main findings from this trial have been published previously [Fumoleau et al. Eur J Cancer 2004;40:536–42]. Here we present mature data after a follow-up of 48 months. Methods: Pts with anthracycline- and taxane-pretreated MBC received X 1250 mg/m2 twice daily on days 1–14 every 3 weeks for a median of 6 cycles (range 1–15). Results: Baseline characteristics of the 126 pts enrolled were typical of a pretreated MBC population. X achieved complete/partial response or stable disease in 63% of patients (overall response rate, 28%). Median time to progression was 4.9 months (95% CI: 4.0–6.4).Median duration of response was 5.9 months (95% CI: 4.5–12.7). The only grade 3/4 events occurring in ≥ 10% of patients were diarrhea (10%) and HFS (21%). The most common grade 3/4 laboratory abnormality was granulocytopenia (14%). After a follow-up of 48 months, 8 patients are still alive. Updated median overall survival is 15.9 months (95% CI: 13.5–21.3). 1-, 2- and 3-year survival rates are 63%, 37% and 17%, respectively. QoL assessment showed that X treatment was associated with an increase in mean Global Health Score up to cycle 6, with the increase maintained at subsequent evaluations. Conclusions: X is highly active in patients with anthracycline- and taxane-pretreated MBC, leading to a long median survival of 15.9 months. X is also well tolerated and improves QoL. [Table: see text]
Male breast cancer: Our experience
Authors: Tozzi L. , D’Addetta C. , Bisceglia M. , Murgo R. , Cilenti G. , El Jaouni M. , Latiano T. P. , Scaramuzzi G. , Parisi S. , Maiello E. 
Published: March 2020

10733 Background: Male breast is an uncommon disease, accounting for <1% of all malingnancies in the man. In contrast to women with breast cancer, men with breast cancer are older and have more advanced disease. Methods: Data regarding 25 male patients who underwent surgery for breast cancer in the our Istitution between January 1994 and December 2005 were analyzed. The main characteristics of these patients included: median age 64 years (range 32–87); positivity family cancer history: specific 4 pts, non-specific 3, no circumstance 18; risk factors: obesity 6 pts, gynaecomastia 4, diabetes 5, liver transplant 1. Five cases of second neoplasia were observed: 2 patient with prostate cancer, 1 synchronous colon carcinoma, 1 head and neck cancer, 1 pancreatic cancer. Results: All but one pts (with syncrhronous metastases at presentation) underwent mastectomy. Pathological characteristics included: pT1 tumors 3 pts (12%); pT2 7 pts (28%), pT3 2 (8%), pT4 13 (52 %); infiltrating ductal carcinomas in 88% of cases; axillary lymph node involvement in 12 (50%); 22 patients had estrogen- and progesterone-receptor positive tumors, 2 pts negative, 1 pts unknown. After surgery 14 pts received RT, 13 pts hormonotherapy and 16 patients adjuvant chemotherapy (7 CMF, 9 anthracyclin-based therapy). Median disease free survival was 41.5 months (range 5–116).With a median follow-up of 66 months, we observed 12 deaths (10 pts for progressive disease) and the overall survival rate was 52% (13 pts; 11 disease-free). According to the family cancer history we observed 5/7 (71%) and 7/18 (39%) deaths in positive and negative cases, respectively. Conclusions: The approach to male breast cancer patients is similar to that for female patients. Our data confirm the suspected epidemiologic risk factors such as prostate cancer, gynecomastia and dietary factors; furthermore, cases with family cancer history seems to have a worse prognosis. No significant financial relationships to disclose.