bluuebunny/crossref_metadata_2025_split huggingface dataset:
Frequency, determinants, and temporal trends in lymph node assessment in women with ductal carcinoma in situ
Authors: Griggs J. J. , Sorbero M. E. , Ahrendt G. M. , Stark A. , Dick A. W. 
Published: March 2020

11050 Background: This study examined factors associated with lymph node (LN) assessment in women with ductal carcinoma in situ (DCIS) at two sites in the U.S. Methods: Detailed clinical, pathologic, and radiographic information was collected through medical record review for 1090 patients with pure DCIS treated between 1985 and 2000 in Monroe County, New York and the Henry Ford Health System (HFHS), Detroit, Michigan. Sociodemographic, clinical, pathologic, and radiologic factors associated with LN assessment were examined using logistic regression models. Covariates were interacted with a site indicator; models were tested down to include only interactions with treatment and year. Results: 395 (36.2%) women had LN assessment; 43 of these were sentinel node dissections. Of the 438 women who had a mastectomy, 341 (86.3%) had LN assessment compared with 54 (13.7%) of the 598 women who had breast conserving surgery (p = 0.0001). In multivariate logistic regression, factors positively associated with LN assessment were mastectomy (OR, 45.5 95% CI 23.9, 86.5), private insurance (OR 2.3, 95% CI 1.2, 4.4), and high nuclear grade (OR 3.7, 95% CI 1.5, 9.2). Smoking was negatively associated with LN assessment (OR 0.5, 95% CI .3, .9). Age, race, method of detection (palpable mass vs. mammography), histologic subtype, and presence of multifocal disease were not associated with LN assessment. Statistically significant downward trends over time existed and did not differ between the two sites. LN assessment rates differed by treatment by site. Women who had mastectomy at HFHS were more likely to have LN assessment than women who had mastectomy in Monroe County (OR 5.0, 95% CI 1.5, 16.7), but women at HFHS who had autogenous reconstruction following mastectomy were substantially less likely to have LN assessment than their counterparts in Monroe County (OR 0.2, 95% CI .04, .65). Conclusions: The finding that LN assessment rates in women with DCIS vary according to non-clinical factors, such as treatment site and insurance type, suggests uncertainty about the role of LN assessment exists. Local treatment culture and financial incentives may play a role in the variations in LN assessment patterns. No significant financial relationships to disclose.
Assessment of pathological complete response (pCR) to neoadjuvant dose-dense chemotherapy in HER2+ patients with locally advanced breast cancer (LABC) treated with trastuzumab (T) compared with HER2+ and HER2- patients treated without T
Authors: Sanchez-Muñoz A. , García-Tapiador A. M. , Dueñas-García R. , Jaén-Morago A. , Martínez-Ortega E. , Fernández-Navarro M. , de la Torre-Cabrera C. , Dueñas B. , Morales F. , Sánchez-Rovira P. 
Published: March 2020

11057 Purpose: To identify Her2+expression as predictive factor for pCR to T in pts with LABC treated with neoadjuvant chemotherapy. Methods: A total of 127 newly diagnosed stage II-III, including inflammatory tumors, breast cancer pts were reviewed. Median age was 47,7 (r 26,4 - 73,6). Median tumor size was 5 cm (1–10). 57 (44,8%) were T2, 33 (26%) T3 and 37 (29,2%) T4 (25 of them inflammatory). 59 (46,5%) pts were clinically lymph node positive before treatment. 50 pts (39,4%) were hormonal receptor negative, and 38 (30,4%) Her2+. The pts received one of the 2 chemotherapy regimens every 2 weeks with prophylactic growth factors support: A) epirubicin 90 mg/m2-cyclophophamide 600 mg/m2 d1 for 3 cycles, followed by a second sequence with paclitaxel (P) 150 mg/m2- gemcitabine (G) 2500 mg/m2 d1 ± T 2mg/kg/wk according to status Her2 (n= 73); B) adriamicin 40mg/m2 d1 plus P 150mg/m2-G 2000 mg/m2 d2 for 6 cycles (n=54). Subsequently pats underwent surgery and radiotherapy and/or adjuvant hormonal therapy according to institutional practice. Results: 43 (33,9 %) pts achieved a pCR (absence of invasive tumor in the breast). The pts were classified in two groups to analyze the influence of the treatment with T on pCR: (1) Her2+ pats treated with T (20 pts): pCR 50%; (2) The rest of the pts, treated only with chemotherapy (107 pts: 18 Her2+ and 89 Her2- ): pCR 32% (p=0.068). Breast-conserving surgery was performed in 77 pts (60,6%). Conclusions: Both dose dense chemotherapy regimens were highly effective in terms of pCR. Although there were not a significative correlation of Her2+ status and trastuzumab therapy with pCR, probably due to the small number of pts, a favorable tendency was seen in the group of Her2+ tumors treated with T. At the meeting, analysis of the correlation of pCR with progression free survival will be presented. No significant financial relationships to disclose.
Cardiac safety of pegylated liposomal doxorubicin (PLD) in combination with trastuzumab (T) in patients with metastatic breast cancer (MBC): Results from a multicenter phase II study
Authors: Stickeler E. , Watermann D. O. , Woll J. , Foeldi M. , Gitsch G. 
Published: March 2020

1106 Background: Combination therapy of doxorubicin and trastuzumab is highly effective for Her2 positive MBC but characterized by frequent cardiac toxicity (CT). PLD can significantly reduce CT compared to conventional doxorubicin. Patients and Methods: 15 patients were enrolled in a phase II trial to evaluate cardiac safety of T (4 mg/Kg loading dose day 2, followed by weekly 2 mg/Kg) in combination with PLD (40 mg/m2 IV bolus day 1, q 28 d). 75% of pts. presented with more than 1 metastatic site and 40% for second line treatment. PLD was administered for 6 or 9 cycles, respectively, T until disease progression. To assess CT, all pts were evaluated with electrocardiogram (ECG) and echocardiograms (E) for Left Ventricular Ejection Fraction (LVEF) at baseline, every cycle during PLD and T, and every three months during T therapy alone. CT was defined as appearance of signs/ symptoms of congestive heart failure and/or an absolute decrease in LVEF > 10 units (below 50%) or decrease in LVEF > 15 units (above 50%). Results: Four pts. received 6 cycles, 4 pts. received 9 cycles of PLD, 4 pts discontinued treatment due to PD, 3 pts. due to toxicity. After a median follow up time of 15.4 months, 6 pts. (42.9%) demonstrated a clinical benefit and median OS was 16.2 months. Non cardiac side effects were mild with only 3 CTC Grade 3 events of 247 treatment cycles (1.2%). Three pts. developed minor ECG changes without pathological significance and 5 pts. had minor changes in their E with slight diastolic (n=3) or systolic (n=2) dysfunction. During follow-up, 3 pts. were diagnosed with pathological E findings, including 1 slight decrease of LVEF, one diffuse hypokinesia and one strong decrease in LVEF.The median LVEF in the study cohort was 66.1% at baseline, 62.7% after 6 cycles of therapy, 64.4% at the first follow up and did not change significantly until the 5 th examination. Conclusions: This study supports the combination of PLD and H in pts. with HER2 overexpressing metastatic breast cancer as a safe and feasible therapy. Due to the promising clinical response rates in this prognostically unfavorable group, this combination should be evaluated in larger studies as a potential regimen for adjuvant treatment of breast cancer. No significant financial relationships to disclose.
Is there any difference between microscopic residual disease (pTm) and no invasive disease (pT0) in the breast when there is residual disease in the axilla after primary chemotherapy for breast cancer (BC)? Results of a multicenter study
Authors: Barni S. , Ionta M. T. , Cazzaniga M. E. , Atzori F. , Petrelli F. , Murru M. , Cabiddu M. , Guerzoni D. , Minerba L. , Massidda B. 
Published: March 2020

11069 Background: Several studies have demonstrated the importance of achieving pCR both in the breast and axilla, in terms of DFS and OS. We previously demonstrated that no difference exists between microscopic residual (pTm) and no invasive residual (pT0) tumour in the breast in terms of DFS and OS in breast cancer (BC) patients (pts) following primary chemotherapy (CHT). Nevertheless, when pN0 is achieved, we observed a statistical significant advantage for pT0 in comparison to pTm pts (DFS 94.7% vs 80%, p=0.03; OS 100% vs 86%, p=0.08). Aim of the present study was to investigate the clinical significance of pTm in the breast when there is residual tumour in the axilla. Methods: We analysed 48 out of 287 pts with clinical T2–4 BC, who achieved pCR, according to Sataloff’s classification, following different kinds of neoadjuvant CHT. One pt was considered not valuable for clinical outcomes, because lost to follow up. Median age was 47 years (29–68), clinical TN stage was T4 in approximately half of the pts (22/48, 45.8%) and N+ in 11/48 (22.9%). Hormone receptor status was ER- in 20 pts (41.7%) and PR- in 26 (54.2%). All pts received anthracycline-based neoadjuvant CHT, even standard (Q21 days) or intensified (Q14). Median number of administered cycles was 3 (2–6). Median follow up was 89 months (9–189). Results: Thirteen pts (27.6%) had residual disease in the axilla at the end of primary CHT, of whom 6 achieved pT0 and 7 pTm in the breast. Surprisingly, pTm pts had a significant better DFS and OS in comparison to pT0 pts. Results are shown in Table 1 . Conclusions: Our data indicate that the achievement of pT0 in the breast is not of clinical significance when there is residual tumour in the axilla. These results, even if affected by the small number of pts, could be explained by the fact that less aggressive treatments have been delivered to pT0 pts due to the complete clearance of the tumour. [Table: see text] No significant financial relationships to disclose.
Adjuvant trastuzumab (T) in early stage breast cancer (EBC): Is cardiac dysfunction (CD) clinically significant?
Authors: Dent S. F. , Vandermeer L. A. , Spaans J. N. , Verreault J. L. , Azzi J. S. , Hopkins S. , Verma S. 
Published: March 2020

11072 Background: T was funded for women with EBC in Ontario in Aug 05. Clinicians remain concerned about the potential cardiotoxicity of T in women with EBC. The purpose of this retrospective study is to evaluate CD in women with EBC prescribed adjuvant T therapy. Methods: Women with HER2-overexpressing EBC who were initiated on T and chemotherapy (CT) at TOHRCC between Aug 05 and Nov 06 were included in this analysis. A retrospective chart review collected: demographics, CT regimen, T treatment (dose delays, termination of T), CD (defined by the New York Heart Association functional classification, 2002), and management. Results: Outcomes reflect the preliminary results of 108 patients (pts) initiated on adjuvant T therapy. Median age was 52 years (range 30–79). 107 pts (95%) received T and CT; 1 pt received T alone. Pts received an average of 6 cycles of CT (range 1–12), including anthracycline (A; 99%) (A alone 55%; A-taxane 44%) and non-A (1%) regimens. 18 pts (28%) were treated with concurrent T and taxol. Therapy with T has been completed (median 46.7 weeks) in 28 pts (26%) while 72 pts (67%) remain on T. 85% of pts underwent at least 3 MUGA scans during T treatment. CD was observed in 18 pts (17%): congestive heart failure (2 pts), decrease in left ventricular ejection fraction (LVEF) of =10% to less than 55% (14 pts) or decrease in LVEF >20% (2pts). Of 18 pts with CD, 7 underwent a treatment delay (median 8 weeks) 3 permanently stopped T (median 45 weeks) and 8 pts continued T. 31 pts experiencing any decrease in LVEF were managed successfully through: delay, (16 pts), referral to a cardiologist (14 pts) and medical treatment with: ACE-inhibitors (5 pts), beta blockers (1 pt), or combination (2 pts). Discussion: The results of this first analysis indicate that outside of a clinical trial setting, the majority of women receive adjuvant T according to treatment guidelines, do not experience significant CD and are able to complete therapy uninterrupted. The long term consequences of CD in these pts are unknown. No significant financial relationships to disclose.
Patients’ preferences for adjuvant radiation therapy in early breast cancers
Authors: Pendlebury S. C. , Duric V. , Joseph D. , Rodger A. , Rodger A. , Taylor K. , Hedges R. , Corica T. , Smith R. , Stockler M. 
Published: March 2020

11083 Background: Adjuvant radiation therapy (ART) reduces the risk of local recurrence in women with breast cancers. In good prognosis tumours in older women the absolute benefits are small. The aim of this study is to determine the smallest improvement in local recurrence rates that women would consider sufficient to make their adjuvant therapy worthwhile. Methods: 95 women who had completed ART 2–4 years earlier for T1N0M0 breast cancers had their preferences elicited by 1 of 3 interviewers. Women were presented 3 sets of hypothetical scenarios about the risks of recurrence with and without radiation using baseline risks of 5%, 10%,and 20%without ART. The order scenarios were presented was allocated randomly. Results: The women’s median age was 63 years 54% had dependants, and 58% travelled 20km or less to their ART centre. A 1% reduction in risk of local recurrence was judged sufficient to to make ART worthwhile by 77% of the women. More than half the women judged ART worthwhile even if it conferred no benefit. 3–8% of the women judged even the maximum possible benefits insufficient to make ART worthwhile. Women’s preferences were almost identical for all 3 scenarios(Spearman’s rank correlations of 0.89 to 0.94). Preferences were unaffected by the order of scenario presentation, interviewer, participants age, cancer recurrence prior to interview,support during ART, dependants, distance to travel to ART, or time since completing ART. Conclusions: Most women judged small benefits in local recurrence sufficient to make ART worthwhile. Many women judged negligible benefits sufficient suggesting the importance of considerations other than the trade-off between direct benefits and harms. No significant financial relationships to disclose.
Five-year review of incidence and characteristics of breast cancer referrals to the Mid-Western Cancer Centre, Ireland
Authors: Higgins M. J. , Woulfe B. , Gupta R. K. 
Published: March 2020

11084 Background: There are no detailed reports of the epidemiological patterns of Irish breast cancer (BC) patients. The Midwestern cancer centre (MWCC) opened in 2001 and serves an unscreened population of approximately 340,000. We sought to characterise the age, histology, stage and outcome of all newly diagnosed BC patients referred to the MWCC over a 5 year period. Methods: All referrals between January 1 2001 and December 31 2005 were included. We collated information from patient charts, hospital information systems and the Medical Oncology database. Status as of November 1 2006 was established from the database and liaison with local surgical, palliative and primary care services. Results: 505 (504 female, 1 male) referrals of new invasive or non-invasive BC were received in the 5 year period. Of these, 14 were diagnosed with bilateral BC. There were 14 cases of non-invasive BC. Age at diagnosis ranged from 23 to 90 years (y) with an average of 56 and median of 55.3y. Of the 499 breast cancers that were staged at diagnosis, 452 (90.6%) had locoregional disease (AJCC stage IIIC or less) while 47 (9.4%) had distant metastases. Results of pathological analyses of the tumours are shown in table . HER2neu status was not routinely tested in our institution during the review period. Patients were treated according to standard adjuvant or palliative protocols. Follow up data is available for 471 patients with a median length of follow up of 35 months. The Surveillance, Epidemiology and End Results (SEER) program in the USA in a similar time frame (2000–2003) found a median age at diagnosis of BC of 61y in whites with only 5% of these patients having distant spread at time of diagnosis. Conclusions: We present unique and recent epidemiology of BC patients in Ireland’s Midwest. Initial comparison to SEER data suggests that our patients are younger with higher stage disease at diagnosis. [Table: see text] No significant financial relationships to disclose.
Open-configuration magnetic resonance (MR) guided microwave thermocoagulation treatment for breast tumors: Preliminary report of hepatic metastases and resected breast tumors
Authors: Abe H. , Shimizu T. , Naka S. , Shiomi H. , Demura K. , Murakami K. , Kurumi Y. , Morikawa S. , Tani T. 
Published: March 2020

11095 Background: Minimally invasive therapies such as radiofrequency ablation, focused ultrasound surgery, and cryotherapy for early stage primary breast cancers may be appropriate in carefully selected patients. In this study, open-configuration magnetic resonance (MR)-guided microwave thermocoagulation treatment was used for breast tumors, and the efficacy of this treatment was assessed. Methods: We used MR-guided microwave thermocoagulation treatment on eight patients with metastatic liver tumors from breast cancer. A 0.5 T open-configuration MR system and a microwave coagulator were used. Near-real-time MR images and real-time temperature images were collected and displayed on the monitor. Secondly, it was examined whether the description of breast tumors was possible with open- configuration MR device, and simulated a tumor puncture while imaging a real-time MR image. The resected breast tumor was punctured while confirming the tumor with open-configuration MR system, and microwave thermocoagulation was enforced. Tumor tissue viability after microwave thermocoagulation was assessed by hematoxylin and eosin and NADH vital staining. Results: The visibility of the tumor by MR imaging was not disturbed throughout the procedure. In 8 patients, 11 hepatic metastases were treated by MR-guided microwave thermocoagulation treatment successfully without any major adverse event. Five of the 8 patients are alive with new metastatic foci with a mean observation period of 25.9 months (range 1 - 43 months). It was able to be confirmed that viability of the tumor had disappeared by the microwave thermocoagulation in resected breast tumors. Conclusions: This technique is feasible and safe to treatment of breast tumor with real-time observation. Open-configuration MR-guided microwave thermocoagulation therapy appears to be a feasible method with advantages to add to the growing list for nonsurgical ablation therapy of early stage primary breast cancer and should be investigated in further comparative studies. No significant financial relationships to disclose.
Efficacy of primary systemic chemotherapy regimen containing anthracyclines with/without taxanes in comparison to CMF in women with early breast cancer
Authors: Gschwantler-Kaulich D. , Fink-Retter A. , Bachrich T. , Ledesma M. , Ruecklinger E. , Kubista E. , Singer C. F. 
Published: March 2020

11098 Background: Neoadjuvant chemotherapy is the treatment of choice for locally-advanced breast cancer and leads to down staging and improved BCT rates. While its efficacy is well established, considerably less is known about the most effective regimen. Methods: We have performed a retrospective analysis of 132 breast cancer patients who had undergone neoadjuvant chemotherapy at our institution. Patients had either received a) anthracyclines (“A”, n=35), b) anthracyclines and taxanes (“AT”, n=55), or c) neither of the two compounds (“NoA/T”, n=42). Clinical response, pathological response and survival were evaluated in each arm. Results: While all three regimen resulted in significant tumor regression, AT was most effective with a mean tumor shrinkage of 39% (ultrasound) and 41% (mammography) (Kruskal-Wallis, p=0.004, and p=0.027). Breast conservation was achieved in 75% by AT, in 49% by A, and in 19% by NoA/T (Kruskal-Wallis, p<0.001). The treatment groups did not differ in respect to pCR (χ2-test, p=0.068), although higher cumulative anthracycline doses were predictive of pCR in multivariate analyses (p=0.022). While the mammographic and not the ultrasound-determined tumor diameter determined whether a woman underwent BCT, only an ultrasound-determined size reduction was predictive for DFS and OS (log rank, p=0.0093, and p=0.044, respectively). Other parameters that affected BCT rates were age (p= 0.003), year of diagnosis (p=<0.001), presence of multifocal disease (p= 0.032) and the cumulative anthracycline dose (p= <0.001). Conclusions: While the combination of anthracyclines and taxanes is most effective in achieving clinical remission and BCT, the cumulative anthracycline dose appears most important for achieving pCR. No significant financial relationships to disclose.
A phase II study of doxorubicin plus paclitaxel followed by weekly paclitaxel as neoadjuvant chemotherapy for breast cancer (SBCCSG-07)
Authors: Inoue K. , Takei H. , Kurozumi M. , Futsuhara K. , Kai T. , Kuroda T. , Ueda S. , Miyake H. , Hakamada Y. , Suemasu K. , Tabei T. 
Published: March 2020

11103 Background: The primary aim of this study was to estimate the rate of clinical and pathologic response to preoperative doxorubicin and paclitaxel followed by weekly paclitaxel in stage II /III breast cancer. Secondary objective included the determination of time to progression, over all survival, the rate of breast conservation surgery, feasibility and safty. Saitama breast cancer clinical study group-07 study (SBCCSG-07; CTR:UMIN000000504) Methods: Patients were treated with 50 mg/m2 of doxorubicin intravenously and 150 mg/m2 of paclitaxel both administered intravenously on day 1 every 21 days for 4 courses followed by 80 mg/m2 of paclitaxel administered intravenously on day 1 every week for 12 courses(AP-wP). The rate of pathological, clinical response and breast conserving surgery and adverse events (CTCAE ver.3.0) were analyzed in stage II /III breast cancer. Results: From December 2005 to August 2006, 40 planned patients have been enrolled. One patient canceled chemotherapy for interstitial pneumonia. 16 patients have finished their treatment, received surgery and are evaluable for response. Clinical response rate was 81.2% (50.0%CR; 31.2%PR). Stable disease and progressive disease occurred in 2 (12.5%) patients and 1 (6.3%) patient. Four patients (25%) had pathological complete response. Conclusions: Preliminary results indicate that the AP-wP regimen feasible and very active as induction chemotherapy of operable breast cancer. Updated data including evaluation of biological markers will be presented at the meeting. No significant financial relationships to disclose.