bluuebunny/crossref_metadata_2025_split huggingface dataset:
Breast self examination training and counseling as motivation strategies for breast awareness and participation in breast cancer screening programs
Authors: Artmann A. , Heyne M. , Kiechle M. , Harbeck N. 
Published: March 2020

1027 Background: In Germany, the particpation rate in gynecologic cancer and the Bavarian breast cancer screening program is only about 30%. Therefore, the impact of counseling and raising confidence in breast self examination (BSE) by a structured BSE training on breast awareness, acceptance of screening offer, and participation rate was evaluated. For evaluation of the training quality, specified MammaCare data sheets and questionnaires were used. Method: Since 2003, 167 women (mean age 35 y; range 19–65 y; 61% ≥40 y) got intensive breast cancer counceling and were professionally trained in MammaCare BSE; 41% had positive breast cancer family history. In their beginner’s course, trainees got general BSE information, covering breast anatomy, breast symptoms, breast cancer screening and therapy. Participants practised BSE, after training on tactually accurate silicone breast models with simulated lumps in order to discriminate normal nodularity from lumps. After 3 months, the supervision sessions included BSE evaluation and - again - professional instruction. In a model exam false positive and negative findings were documented. In breast exams, performance technique and breast tissue coverage were assessed. At both initial sessions and after 12 months, questionnaires on BSE practice, experience, and compliance, cancer worry, acceptance and participation at cancer screening programs were evaluated. Results: Breast cancer worry, anxiety, and lack of information were the main reasons for program participation. Within 3 months after the base course, mean decrease of breast cancer worry was about 95%. Participation in gynecologic and breast cancer screening (≥40 y) more than doubled (94% and 86%). Even after 12 months, these numbers remain consistent. 80% of participants practice BSE monthly, and 46% reported changes in lifestyle regarding nutrition and obesity. Conclusions: Our approach emphasizes importance of self confidence and awareness for participation in cancer screening, also in women with breast cancer family history. Counseling, BSE re-evaluation and reinforcement are correlated with decreased breast cancer worry, a main barrier against participation in breast and gynecologic cancer screening. [Table: see text]
Family information service (FIS) in a BRCA1 extended family
Authors: Lynch H. T. , Snyder C. , Lynch J. , Ghate S. , Thome S. 
Published: March 2020

1028 Background: Considering that 10% of breast cancer is hereditary, it is essential to effectively educate hereditary cancer family members regarding the syndrome, cancer risk, genetic testing and cancer control options. Researchers at Creighton University (CU) have for many years provided family (group-oriented) information services (FISs) for hereditary cancer families. Methods: Such a session was held in collaboration with a genetic counselor in a community where many members of an extended hereditary breast-ovarian cancer family with a known BRCA1 mutation reside. Family members helped contact relatives and invited them to attend the full-day FIS at a local hospital. Informal presentations were provided by a CU geneticist/oncologist, a CU nurse counselor, and a local genetic counselor. Questions and comments were encouraged. An opportunity to provide a blood sample for genetic testing was offered. Results: Contacting relatives for the FIS identified more than 400 family members from previously unknown branches. Many attendees indicated this was their first opportunity to learn about this hereditary cancer syndrome, their risk, and recommended cancer control options. Patient-stated benefits of the FIS included increased communication of cancer risk among family members as well as with their physicians, motivation to become more vigilant with screening and health management and receipt of initial cancer risk education in a non-threatening venue. Conclusions: The FIS is a relatively simple, cost-effective educational cancer control program that increases communication among family members and their physicians, educates high-risk individuals and provides an opportunity for genetic testing which will ultimately provide an accurate cancer risk status and thereby alter health management and cancer control strategies. No significant financial relationships to disclose.
Biology and prognosis of 1,685 recently diagnosed HER2-positive breast carcinomas
Authors: Ménard S. , De Placido S. , Scalone S. , Molino A. , Mottolese M. , Perrone F. , Querzoli P. , Sapino A. , Venturini M. , Viale G. 
Published: March 2020

10501 Background: Understanding biology, prognosis and drug-sensitivity of HER2-positive breast cancer might help optimization of treatment of patients affected by this type of cancer. Most available studies are retrospective and suffer from the low frequency of this tumor subset. Methods: We conducted a large national retrospective/prospective study involving 1685 patients (cases) with HER2-positive (2+, 3+ score) primary breast carcinomas diagnosed in Italy in 2000/2001; for each case, in each participating center, a control was identified as the first consecutive patient with HER2-negative cancer (0, 1+ score). Results: In addition to the already known association with some pathologic parameters such as grade, hormone receptors, and ductal histotype, the four HER2 categories also displayed specific features, for example, a significantly higher frequency of p53-positivity among HER2–2+ tumors than in the other three categories, and a significantly lower frequency of lymphoid infiltration and desmoplasia, accompanied by a higher frequency of vascular invasion, in HER2–1+ as compared to HER2–0 tumors. Neither tumor size nor nodal involvement were associated with HER2 status. With a median follow-up of 4 yrs, the HER2-positive group showed a 20% relapse rate versus 14% in the HER2-negative group (p < 0.001). Analysis of relapse rates in the four HER2 categories indicated that only 3+ tumors show a significantly poorer prognosis, in both node-positive and node-negative subgroups; however, when patients who underwent invasive surgery are considered, the HER2–2+ patients also showed a significantly increased relapse rate as compared to negative cases, consistent with a stimulation of tumor cells by growth factors released at the time of surgery. Analysis of relapse rates according to type of therapy confirms the unresponsiveness to tamoxifen but sensitivity to chemotherapy, in particular taxanes, of HER2-positive tumors. Indeed, HER2-positive tumors were found to have a significantly better prognosis than HER2-negative when treated with taxanes. Conclusions: The present analysis conducted in a very large series of HER2-positive cases suggests innovative findings that can help optimization of treatment strategy for patients with HER2-positive breast cancer. No significant financial relationships to disclose.
Epidemiology of triple negative breast cancer in Nigerian women
Authors: Adebamowo C. A. , Ogundiran T. , Akang E. 
Published: March 2020

10504 Background: The epidemiology and immunohistochemistry of breast cancer in indigenous African populations is not well known with many studies relying on small case series. In this communication, we report a preliminary report from our study of the immunohistochemistry of breast tumors in Nigeria, highlighting the epidemiological characteristics of the “triple-negative” breast cancers and comparing these with non-triple negative breast tumors. Methods: 111 consecutive breast cancer patients presenting at the Oncology Clinic of the University College Hospital had tumor biopsied and demographic and epidemiological information collected. Standard histological and immunohistochemical analysis was done for ER, PR and HER2 status. Results: Most tumors were ER+ (65%, 69/106), PR+ (60%, 56/94) and HER2_ (91%, 82/90). 17% (13/76) of our patients had triple negative tumors. Patients with triple negative tumors were younger than those with triple negative (49.6 vs. 55.3 years p = 0.31), had shorter duration of symptoms (12.2 vs 20.7 months, p-value 0.18), later age at onset of menarche (17.4 vs 15.3, p-value = 0.25), lower BMI (27.2 vs 40.2, p-value = 0.01), greater height (157 vs 148 cm, p-value = 0.03), lower waist-hip ratio (0.84 vs 0.88, p-value = 0.16) and none of them had a positive family history of breast cancer. Conclusions: Contrary to previous reports, tumors in these African patients displayed immunohistochemical characteristics similar to those reported from Caucasian and other populations. Triple negative tumors were more likely to be associated with lower BMI and greater height, but more studies are needed. No significant financial relationships to disclose.
Chemotherapy-related amenorrhea in women with early breast cancer: The effect of paclitaxel or dose density
Authors: Abusief M. E. , Missmer S. A. , Ginsburg E. S. , Weeks J. C. , Winer E. P. , Partridge A. H. 
Published: March 2020

10506 Background: The effect of the addition of paclitaxel (T) to adriamycin and cyclophosphamide (AC), or dose density (DD, q2wk) on menstrual functioning in women with early breast cancer remains uncertain. Methods: We reviewed data from premenopausal women treated at Dana-Farber Cancer Institute and Brigham and Women’s Hospital who received adjuvant chemotherapy with either AC or AC-T from 1997–2005 for whom pre- and post-treatment menstrual data were available. A multivariable logistic regression model evaluating amenorrhea at 6 months or greater follow-up was conducted. Results: Of the 403 patients eligible for analysis, average age at diagnosis was 41 years (range 25–50); average weight was 67kg; 10% were smokers, 53% had never smoked; 24% were nulliparous. 60% of women received AC, 40% AC-T; 20% of women received DD therapy (either AC or AC-T); 72% received tamoxifen. The multivariable model adjusting for age, weight, gravity, parity, smoking, alcohol use, and tamoxifen use, revealed that risk of amenorrhea was not statistically different in patients receiving AC-T versus AC (OR = 1.45, 95% CI 0.78–2.69) or in patients receiving DD therapy versus standard (OR = 1.61, 95% CI 0.74–3.49). However, a planned future analysis including data from an additional 200+ patients may yield significant differences. Age directly correlated with risk of amenorrhea, OR = 1.40, 95% CI 1.30–1.50) for every year increase in age, and women receiving tamoxifen were more likely to be amenorrheic (OR = 1.99, 95% CI 1.05–3.79). Conclusions: The addition of T to AC or use of DD therapy does not appear to increase the likelihood of amenorrhea in follow-up. These findings may assist premenopausal women with breast cancer when making decisions at diagnosis and in follow-up. No significant financial relationships to disclose.
Long-term effect in outcomes of intensified primary chemotherapy in poor prognosis LABC T4 patients: Results of a multicenter Italian study
Authors: Ionta M. , Atzori F. , Nonnis D. , Deidda M. , Contu A. , Farris A. , Catino A. , Palmeri S. , Minerba L. , Massidda B. 
Published: March 2020

10518 Background: Recent data showed that anthracycline-based chemotherapy with increased dose-intensity improves clinical outcomes as compared to conventional regimens in adjuvant setting, particularly in high risk patients with HR negative tumors. Nevertheless dose-intensity in neoadjuvant setting remain controversial. The aim of this study was to evaluate the outcome between two different primary regimens and, furthermore, among soubgroups identified by HR status. Methods: Between 1996 and 2001, 72 consecutive LABC patients, (77% T4abc; 23% T4d; 88% axillary nodes involvement) median age 51 (29–70), ER neg 39%; PgR neg 71%, were treated with PEV regimen (cisplatin 50 mg/m2; epirubicin 100 mg/m2; vinorelbine 25 mg/m2) as primary chemotherapy. The regimen was delivered with different number of cycles and treatment intervals (3 wks × 4 cycles in the first 24 pts as PEV21 × 4; 2 wks × 6 cycles in the subsequent 48 pts as PEV14 × 6); the entire treatment in both groups lasted 12 weeks. All 72 patients received adjuvant CMF, RT and Hormonal treatment when indicated. Results: after a median follow up of 76 months (46–111), higher DFS and OS were observed in the intensified PEV14 × 6 group as compared to the counterpart (69% vs 42% p = 0.02 and 78% vs 58% p = 0.05 respectively). Statistically better DFS and OS were observed in the group ER/ PgR negative which received intensified PEV 14 × 6, whereas no statistically difference was found among ER/ PgR postive patients, regardless of the type of regimen. Conclusions: Our results suggest that primary intensified chemotherapy is associated with a better clinical outcome in poor prognosis LABC T4 patients,and that HR negative tumors benefit greatly from intensified regimen. Further prospective randomized studies are needed to confirm our data. [Table: see text] No significant financial relationships to disclose.
Proteomic analyses of normal and malignant breast tissue—Identification of a tumor-specific protein expression profile
Authors: Hudelist G. , Singer C. , Pischinger K. , Kaserer K. , Manavi M. , Kubista E. , Czerwenka K. 
Published: March 2020

10524 Background: Gene expression analysis has become a promising tool in predicting the clinical course of malignant disease and the response to antineoplastic therapy. Suprisingly, only little is known about the protein expression pattern of human tumors. Recent advances in proteomic analysis allow to identify proteins of interest by their expression and/or modification pattern in 2D-PAGE rather than using the traditional approach of translating gene expression data. Methods: In order to identify a proteomic pattern that is characteristic for malignant breast epithelium, we performed differential 2D-PAGE analysis in sets of microdissected malignant breast epithelia and corresponding adjacent normal breast epithelia from 5 patients with invasive breast carcinoma. Results: Thirty-two protein spots were found to be selectively regulated in malignant epithelium, and were subjected to MALDI-TOF and/or immunoblotting for protein identification. Thirteen of the identified proteins had previously not been associated with breast cancer. The validity of these findings was confirmed by literature review and immunohistochemistry for identified proteins in an independent cohort of 50 breast cancer specimens. Conclusions: We here describe a proteomic analysis of matched normal and malignant epithelia from invasive breast carcinomas. This strategy leads to a better understanding of oncogenesis at an operational level and helps to characterize the malignant phenotype of individual tumors and thereby to identify novel targets for antineoplastic therapy. No significant financial relationships to disclose.
Weight gain in breast cancer patients: Tamoxifen versus anastrazole
Authors: McGowan P. , Perry M. C. , Hewett J. E. , Ge B. , Sanfilippo K. 
Published: March 2020

10544 Background: Weight gain is a common complaint among breast cancer patients, especially those taking tamoxifen. Aromatase inhibitors have been increasingly used in postmenopausal breast cancer patients, and are generally thought to have a more tolerable side-effect profile than selective estrogen receptor modulators (SERM’s). This study specifically addresses weight gain in patients on the SERM, tamoxifen, compared to patients on the aromatase inhibitor, anastrazole. Methods: Ninety-six outpatients with primary breast cancer of any stage received standard doses of adjuvant hormonal therapy. Seventy received tamoxifen (Group T) and 26 anastrazole (Group A). The nursing staff in the clinic weighed all patients at the time of diagnosis, at start of chemotherapy (if received), at start of hormone therapy, and at 3 month intervals for 12 months after starting hormone therapy. Data were gathered in a retrospective manner. Results: Demographic variables were compared between the two groups. In all patients, it was noted that increasing age was correlated with greater weight gain at 3 months after starting hormone therapy (p = 0.0257), but not at any other intervals. No other variables were significantly correlated with weight gain. In Group T, mean weight gain was clinically (>1.8 kgs) and statistically significant at 9 and 12 months (p = 0.0137, p = 0.0003). In Group A, mean weight gain was not clinically significant at any point. Using the Wilcoxon two-sample tests to compare groups T and A, it was shown that there was no statistically significant difference in weight gain between the two groups at any interval (see table). Conclusions: These results are consistent with previous studies that show significant weight gain in breast cancer patients on tamoxifen. This study failed to show a statistically significant difference in weight gain between patients on tamoxifen and patients on anastrazole. Group A did not have statistically significant weight gain at any interval after starting hormone therapy. [Table: see text] No significant financial relationships to disclose.
Tailored vinorelbine-capecitabine treatment in elderly metastatic breast cancer patients. A SICOG phase II study
Authors: Carreca I. , Iodice G. , D’Aiuto G. , Thomas R. , Costanzo R. , Licenziato M. , Petrillo A. , Maiorino L. , Frasci G. , Comella G. 
Published: March 2020

10556 Purpose: To determine the antitumor activity of vinorelbine (VNR) and capecitabine (Xeloda) when given together, as first-line treatment, in elderly metastatic breast cancer (MBC) patients. Patients and Methods: MBC patients, aged >65 years, with no prior chemotherapy for metastatic disease, received capecitabine 1,000–1,250 mg/m2 d 1→14 and VNR 20–25 mg/m2 d 1–8, q3wk for a maximum of 6 cycles. Doses of VNR and Xeloda were alternately escalated in each patient (VNR 20→25 on 2nd cycle, Xeloda 1,000→1,250 on 3rd cycle), in absence or relevant hematologic/nonhematologic toxicity. Results: Forty-seven MBC pts., median age 72 (range: 66–82) were enrolled. Metastatic sites: visceral/other = 30/17. Adjuvant chemotherapy: Yes/no = 21/27. The doses were escalated as planned in 24/47 pts. To date, 41/47 pts. are evaluable for response. Three CRs and 25 PRs have been recorded, giving a 68% ORR (Visceral/other = 59%/85%). At a median follow-up of 15.3 months, 19 pts. have progressed, and 18 died, median PFS and OS being 14.1, and 20.3 months, respectively. Toxicity has been in general mild or moderate. Grade 3–4 neutropenia has occurred in 29% of pts., with only 2 episodes of neutropenic sepsis. Severe gastrointestinal side effects have been observed in only 2 pts., while severe mucositis and hand-foot syndrome have never occurred. Conclusions: VNR-Xeloda combination is highly active in elderly MBC patients. The adoption of an intrapatient dose escalation permits to minimize the risk of severe toxicity, without compromising efficacy. The accrual still continues until the planned sample size (60 pts.). No significant financial relationships to disclose.
Megestrol acetate after aromatase inhibitor failure in metastatic breast cancer
Authors: Branco L. P. , Dienstmann R. , Bines J. 
Published: March 2020

10572 Background: As aromatase inhibitors (AI) are now an essential component of the adjuvant hormonal treatment in breast cancer, it is important to define strategies after progression. Progestational agents have significant activity in endocrine-responsive breast cancer. This is the first report of megestrol acetate (MA) after AI failure. Methods: We have retrospectively reviewed the charts of all patients treated with MA for the last 2 years at the Instituto Nacional de Câncer, in Brazil. All the patients were postmenopausal and had metastatic breast cancer. The treatment sequence was as follows: tamoxifen ⋄ AI ⋄ MA. MA was given at a dose of 160 mg PO daily. Results: A total of 27 postmenopausal patients were treated between December 2003 and December 2005. Median age was 71 years (37–93). Seven patients had visceral metastases and 20 had bone, soft tissue or pleural disease. Eight patients are still on treatment. Median time to disease progression was 16 weeks (4–81), with no difference between those with or without visceral metastases: 17 and 16 weeks, respectively. Treatment was well tolerated and no patient discontinued therapy due to toxicity. There was no report of venous thromboembolism. Conclusions: Despite the limitations of a retrospective analysis, our results compare favorably with exemestane and high-dose estrogens in a similar setting. These agents have been studied in phase II trials (Lonning PE. JCO 18: 2234, 2000 and BCRT 67: 111, 2001) and showed time to progression of 15 and 18 weeks, respectively. A prospective trial of MA after AI failure is warranted. No significant financial relationships to disclose.
The impact of 18F-fluorodeoxyglucose positron emission tomography (18F-FDG-PET) on the decision-making process in breast cancer patients: The experience of Bologna’s S.Orsola-Malpighi Hospital
Authors: Sperandi F. , Fanti S. , Franchi R. , Martoni A. 
Published: March 2020

10588 Background: 18F-FDG-PET is rapidly spreading “technology” in oncology. Its appropriate use and the clinical settings in which it can modify decision-making need to be defined. Methods: All the requests for 18F-FDG-PET issued by the Medical Oncology Unit are submitted to internal audit. The aim is to evaluate the impact of the information deriving from the test on the subsequent therapeutic strategy in breast cancer patients (pts). From July 2002 to July 2005, 195 18F-FDG-PET examinations were performed in 110 pts. Pt series have been subdivided according to disease stage or clinical setting: Group 1) NED during the follow-up 23 (11.8%); Group 2) suspected first recurrence 52 (26.7%) (included 20 cases with an isolated elevation of CA15.3 and/or CEA serum levels); Group 3) overt metastases: a) single lesion 10 (5.1%), b) multiple lesions with suspected disease progression 26 (13.3%), c) re-evaluation of non-progressive metastatic disease 84 (43.1%). Results: Overall, 18F-FDG-PET was positive in 112 (57.4%) cases: in Groups 1), 2), 3a), 3b) and 3c) positivity was 13%, 63.5%, 60%, 73.1% and 60.7%, respectively. As concerns those pts with an isolated marker serum level increase during the follow-up, 18F-FDG-PET was positive in 13 (65%) cases. Overall, the result of 18F-FDG-PET determined a therapeutic strategy change in 79 (40.5%) cases. This change consisted in a decision to start or re-start anti-tumor medical treatment in 46 (58.2%), to perform or exclude surgery or radiotherapy with a potentially radical purpose in 10 (12.7%), to continue follow-up or to stop treatment in 23 (29.1%). The change of strategy according to Groups 1), 2), 3a), 3b) and 3c) was 13%, 75%, 90%, 61.5% and 14.3%, respectively. Conclusions: A “clinical” approach to the use of 18F-FDG-PET in breast cancer pts allows us to change the decision-making in about 40% of pts. Clinical situations in which 18F-FDG-PET is more useful are in cases of suspected recurrence and oligometastatic disease. No significant financial relationships to disclose.