bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract PD5-02: Dcis as a risk lesion for invasive breast cancer and death from other cancers
Authors: Thompson Alastair , Hilton Bridget , Dulson-Cox Joanna , Clements Karen ,   Sloane Project NHS Breast Screening Group
Published: February 2021

Abstract
Introduction: Ductal carcinoma in situ (DCIS) is considered a non-obligatory precursor of invasive breast cancer. Using a prospective cohort study of screen detected non-invasive neoplasia from a national breast screening program, this analysis examined subsequent DCIS or invasive cancers and death due to other cancers or other causes. Methods: Prospective data on 9191 screen detected non-invasive breast neoplasia with a median 9.2 years follow up was matched to a subsequent diagnosis of invasive breast cancer or death from another primary, non-breast cancer at any site or other cause of death, cross validating data from the National Cancer Registry, Hospital Episode Statistics and mortality data.
Results: Following a diagnosis of screen detected DCIS, in 9191 women, for those undergoing breast conservation surgery (BCS), 413 women developed ipsilateral invasive breast cancer, at a proportion of 5/1000 per annum consistent over a decade and more. By contrast DCIS re-occurances in the same, conserved, breast (in 222 women) occurred at a similar rate for the first 5 years then the rate halved beyond 5 years. Contralateral breast cancer (DCIS or invasive) occurred in 431 women over the same time period. Mortality occurred in 1062/9191 (11.6%) women, attributed to breast cancer in 130/1062 (12.2%) and due to cancer at other sites in 397/1062 (37.4%). Death from other, non-breast, cancers was predominantly from primaries of the lung (98 women), ovary (43), pancreas (37) and colon (23) and rarely associated with a confounding diagnosis of invasive breast cancer (present in only 8% of those patients). Non-cancer mortality was identified in 496/1062 (46.7%) women, most commonly attributed to cardiovascular disease (in 188 women) or disease of the respiratory system (in 93). Conclusion: Screen detected DCIS is a marker for subsequent invasive breast cancer, but mortality from other, non-breast, cancers following treatment for DCIS is three times more likely than death due to breast cancer, suggesting DCIS is a more general marker for subsequent cancers than hitherto recognized. Awareness of, and potentially screening for, other cancers should be considered in women treated for DCIS.
Citation Format: Alastair Thompson, Bridget Hilton, Joanna Dulson-Cox, Karen Clements, Sloane Project NHS Breast Screening Group. Dcis as a risk lesion for invasive breast cancer and death from other cancers [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PD5-02.
Abstract PS1-26: Sentinel lymph node biopsy alone in locally advanced breast cancer after neoadjuvant chemotherapy: Turkish multicentric neosenti-turk MF-18-02-study
Authors: Cabioglu Neslihan , Karanlık Hasan , Muslumanoglu Mahmut , Karadeniz Çakmak Guldeniz , Trablus Didem Can , Tukenmez Mustafa , Ersoy Yeliz E. , Uras Cihan , Zengel Baha , Emiroğlu Selman , Polat Ayfer Kamalı , Yeniay Levent , Ozkurt Enver , Kara Halil , Ibis Kamuran , Aydiner Adnan , Ozmen Vahit , Igci Abdullah 
Published: February 2021

Abstract
BACKGROUND: Omitting axillary lymph node dissection (ALND) following sentinel lymph node biopsy (SLNB) in patients with locally advanced breast cancer (LABC) after neoadjuvant chemotherapy (NAC) is still controversial. In this study, we evaluated factors affecting local recurrence and outcome in patients with LABC, who underwent SLNB alone after NAC. METHODS: Between 2004 to 2018, 320 patients with clinically node-positive LABC who received NAC and underwent SLNB alone after negative axillary staging were analyzed. All patients had breast and/or regional nodal irradiation. RESULTS: Median age was 46 (23-70). Of those, 228 patients had ypN0 disease (71.25%), whereas 92 patients had ypN(+) disease including 19 (20.6%) isolated tumor cells (ITC), 33 micrometastasis (35.9%) and 40 macrometastases (43.5%). At a median follow-up of 37 months (24-172), one patient (0.3%) with macrometastatic SLN having extracapsular extension was found to have locoregional recurrence at the 60th month. Five-year disease-free survival (DFS) and disease specific survival (DSS) rates were found as 87% and 95%, respectively. Patients with cT3&4 (HR=2.22, 95% CI; 1.07-4.62), non-luminal molecular pathology (HR=2.71, 95% CI, 1.23-5.97), and non-pCR in the breast (HR=2.21, 95% CI, 0.94-5.17) were found to have an increased HR compared to others in 5-year DFS. However, no significant differences could be found between patients ypN0, ypN-ITC&micrometastasis and ypN-macrometastasis regarding 5-year DFS and DSS rates. CONCLUSIONS: ALND could be safely avoided in selected patients with LABC who underwent SLNB after NAC having cT1-2, luminal pathology, breast and/or nodal pCR or low volume nodal disease, as long as axillary radiotherapy is provided.
Citation Format: Neslihan Cabioglu, Hasan Karanlık, Mahmut Muslumanoglu, Guldeniz Karadeniz Çakmak, Didem Can Trablus, Mustafa Tukenmez, Yeliz E. Ersoy, Cihan Uras, Baha Zengel, Selman Emiroğlu, Ayfer Kamalı Polat, Levent Yeniay, Enver Ozkurt, Halil Kara, Kamuran Ibis, Adnan Aydiner, Vahit Ozmen, Abdullah Igci. Sentinel lymph node biopsy alone in locally advanced breast cancer after neoadjuvant chemotherapy: Turkish multicentric neosenti-turk MF-18-02-study [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS1-26.
Abstract PS1-50: Locoregional therapy in de novo metastatic breast cancer: Systemic review and meta-analysis
Authors: Reinhorn Daniel Jack , Mutai Raz , Yerushalmi Rinat , Moore Assaf , Amir Eitan , Goldvaser Hadar 
Published: February 2021

Abstract
Background: De novo metastatic breast cancer represents around 6% of breast cancer diagnoses. Retrospective data suggest that locoregional therapy (LRT) for the primary breast cancer in metastatic disease may improve outcomes. Randomized control trials (RCTs) have evaluated the role of LRT in this setting with inconsistent results. Methods: We searched PubMed to identify RCTs that compared LRT and standard systemic therapy to standard therapy alone in de novo metastatic breast cancer. The search was supplemented by a review of abstracts from key conferences. Hazard ratios (HRs) and their associated 95% confidence intervals (CIs) were computed and pooled in a meta-analysis using generic inverse variance. Overall survival (OS) data were extracted for the intention to treat (ITT) population and for pre-specified subgroups defined by tumor subtype and by site of metastases. Subgroup analysis evaluated the effect of systemic treatment prior randomization to LRT. Results: Analyses included 4 trials comprising 970 patients. LRT included standard surgery to the primary breast tumor in all studies, and adjuvant radiation per standard of care was mandatory in 3 studies. Systemic treatment prior randomization showed similar results (HR=0.92 and HR=1.06 for upfront LRT and LRT following systemic treatment, respectively, p for the subgroup difference=0.72). LRT was not associated with improved OS in the ITT population (HR 0.97, 95% CI 0.72-1.29, p=0.81). LRT was not associated with improved OS in any tumor subtypes, including hormone receptor positive (HR for OS= 0.96, 95% CI 0.65-1.43, p=0.85), triple negative (HR 1.4, 95% CI 0.50-3.91, p=0.52) and human epidermal growth factor receptor 2 (HER2) positive disease (HR 0.93, 95% CI 0.68-1.28, p=0.67). Additionally, LRT did not improve OS in bone only disease (HR 0.97, 95% CI 0.58-1.62, p=0.92) and in visceral disease (HR=1.02, 95% CI 0.77-1.35, p=0.90). Conclusions: LRT in de novo metastatic breast cancer is not associated with improved OS. Results are consistent among different breast cancer subgroups.
Citation Format: Daniel Jack Reinhorn, Raz Mutai, Rinat Yerushalmi, Assaf Moore, Eitan Amir, Hadar Goldvaser. Locoregional therapy in de novo metastatic breast cancer: Systemic review and meta-analysis [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS1-50.
Abstract PS1-51: A nomogram for predicting three or more axillary lymph node involvement before breast cancer surgery
Authors: Kang Young-Joon 
Published: February 2021

Abstract
Introduction Focus has moved to de-escalate of axillary surgery in the management of early breast cancer. Based on the American College of Surgeons Oncology Group-Z0011, our team created the nomogram to be useful for identifying patients who do not require intraoperative analysis of the sentinel lymph node. The nomogram could identify as patients likely to three or more positive axillary lymph nodes by preoperative imaging. But the nomogram had several limitations. This study investigated a developed nomogram by excluding the chest computed tomography (CT) and adding 18F-Fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT as a modality. Material and Methods Patients underwent preoperative ultrasonography (US) and PET/CT. The training set consisted of 1030 patients with clinical T1-2 and node-negative invasive breast cancer. Factors associated with ≥ 3 involved axillary lymph nodes (ALNs) were evaluated by logistic regression analysis. The validation set consisted of 781 independent patients. The nomogram was applied to 1,067 patients who met the selection criteria of the ACOSOG-Z0011. Results Of the 1,030 patients, 89 (8.6%) had ≥ 3 positive nodes. Multivariate analysis according to be used for making a new nomogram to predict the probability of involvement ≥ 3 nodes, there was significantly associated with larger tumor size, higher grade ultrasonographic ALN classification, and findings suspicious of positive ALN on PET/CT. The areas under the receiver operating characteristic curve of the nomogram were 0.856 (95% confidence interval [CI], 0.815 to 0.897) for the training set and 0.866 (95% CI, 0.799 to 0.934) for the validation set. Application of the nomogram to the patients who met the ACOSOG-Z0011 showed that 90/1067 (8.4%) had scores above the cut-off and the false-negative rate was 37/977 (3.8%). And the specificity was 93.8%, and the negative predictive value was 96.4%. Conclusion The upgraded nomogram improved predictive accuracy, and that was possible using only US and PET/CT. It reduced operation time and cost, with a very low re-operation rate. This nomogram is useful for identifying patients who do not require intraoperative analysis of sentinel lymph nodes.
Citation Format: Young-Joon Kang. A nomogram for predicting three or more axillary lymph node involvement before breast cancer surgery [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS1-51.
Abstract PS1-54: Risk factors for lymph node metastasis and the role of SLNB in microinvasive breast cancer
Authors: Paik Pill Sun , Cho Min Kyung , Ahn Juneyoung , Yoon Chang Ik , Yoo Tae-Kyung , Park Woo-Chan 
Published: February 2021

Abstract
Introduction Incidence of microinvasive Breast cancer (DCISM) along with ductal carcinoma in situ is increasing due to mammographic screening. However, DCISM is not a common pathologic entity and surgical management of the axilla, overall treatment, and prognosis of this entity still remains unclear. Our study aims to determine whether sentinel lymph node biopsy (SLNB) is necessary for all DCISM patients and analyze the characteristics of lymph node-positive patients among DCISM patients to identify risk factors associated with lymph node metastasis. Materials and MethodsA total of 184,007 Breast cancer patients treated were registered in the Korean Breast Cancer Society Registry between 1978 to 2020. A retrospective review of the database was performed and the analysis includes diagnostic and clinic-pathologic characteristics such as positive lymph node and immunohistochemistry. A univariate analysis was carried out to determine associations between lymph node positivity and the clinical variables via Fisher’s exact test.ResultsOf the 184,007 patients, 2,556 (1.4%) breast cancer patients were classified as DCISM and 134 (5.2%) had at least one lymph node (node-positive), while 2,422 were node-negative patients. We found statistically significant results with hormone receptor status between node-positive and node-negative patients. Estrogen receptor (ER) and progesterone receptor (PR)-negative cases were associated with lower ORs (ER: OR=0.63, 95CI=0.43-0.92, P=0.016; PR: 0.67, 0.46-0.96, 0.026, respectively). A particularly interesting finding is that human epidermal growth factor receptor 2 (HER2)-negative cases were associated with higher OR (HER2: 2.03, 1.36-3.06, 0.001), suggesting hormone receptor status could be useful to identify potential lymph node metastases.ConclusionOur study suggests that we could omit axillary staging in DCISM patients, and consider optional SLNB in patients with ER, PR, and HER2 status with other overrepresented clinical entities such as palpable mass, BMI, and histologic grade.KeywordsMicroinvasive ductal carcinoma, Sentinel lymph node biopsy, lymph node metastasis
Citation Format: Pill Sun Paik, Min Kyung Cho, Juneyoung Ahn, Chang Ik Yoon, Tae-Kyung Yoo, Woo-Chan Park. Risk factors for lymph node metastasis and the role of SLNB in microinvasive breast cancer [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS1-54.
Abstract PS1-57: Mastectomy versus breast conserving surgery for the management of locally advanced breast cancer
Authors: Arora Roochi , Kazemi Ghazaleh , Lucas Graydon 
Published: February 2021

Abstract
Background: Breast conserving surgery (BCS) has become increasingly employed as a surgical option for patients with locally advanced breast cancer (LABC). However, guidelines on selecting appropriate LABC patients for BCS remain vague. Methods: Our Local Integrated Health Network (LHIN) conducted a multidisciplinary conference, known as the LHIN4 day, during which consensus criteria on which LABC patients may be safely offered BCS were established. These criteria included: clinical T3 or smaller, clinical and/or radiographic response to neoadjuvant therapy, patient seen by radiation oncology and deemed a candidate for post-operative radiation, and surgeon confident that negative margins could be achieved. A retrospective chart review was then performed of patients treated with neoadjuvant systemic therapy for LABC in the one year before, and three years after the LHIN4 day, which was between June 2015 and June 2019. Objectives: The primary objective of this study was to determine the rates of local and distant breast cancer recurrence in LABC patients treated with BCS using our consensus guidelines. The secondary objectives were: (1) to determine if there was an increase in BCS being performed following the LHIN4 educational day as compared to before this day, (2) to determine the rates of mastectomy followed by reconstruction among the patients treated within the past 3 years, and (3) to determine the rates of pathologic complete response (PCR). Results: A total of 391 patients were included in this study. Among the 26 patients who underwent BCS, the rate of local recurrence was 0% (0/26), and the rate of distant recurrence was 12% (3/26). Rates of BCS were 1.9% (2/108) before the LHIN4 day, and 8.5% (24/283) after the LHIN4 day. Rates of mastectomy followed by reconstruction were 12% (21/181) in the last 3 years. PCR was achieved in 15% (58/391) of all patients, of which 57% (33/58) were Her2 positive and 24% (14/58) were triple negative. Conclusion: We propose specific criteria for appropriately selecting LABC patients for BCS. Our results indicate that these criteria can be feasibly applied with low rates of local and distant breast cancer recurrence. A minority of patients with LABC who do not undergo BCS, either due to ineligibility or personal preference, are opting for mastectomy with reconstruction.
Citation Format: Roochi Arora, Ghazaleh Kazemi, Graydon Lucas. Mastectomy versus breast conserving surgery for the management of locally advanced breast cancer [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS1-57.
Abstract PS1-65: What lessons can be learned from the poly implant prothese scandal ? A french retrospective study
Authors: Pauly Lea , Couturaud Benoit , Reyal Fabien 
Published: February 2021

Abstract
Background : Silicone breast implants from the French manufacturer Poly Implant Prothese (PIP) were recalled from the French market after the use of a non-medical silicone filler has been established. The systematic explantation of the implants had been proposed to women with PIP implants in France, a preventive measure concerning approximately 30,000 patients.Objectives : This study aimed to evaluate the consequences of having at least one PIP breast implant on overall and disease-free survival after breast reconstruction for cancer or prophylactic surgery.Materials and Methods : We performed a multicentric retrospective cohort study on women who underwent immediate or delayed implant-based reconstruction after curative or prophylactic mastectomy between January 01,2002 and March 30,2010 in three French private health institutions of public interest. These dates correspond respectively to the arrival of PIP breast implants on the French market and the decision to withdraw them by the French government. The primary endpoints were disease-free and overall survival, depending on whether or not having a PIP breast implant used during breast reconstruction of prophylactic surgery.Results : We identified 2499 patients with the use of 4106 breast implants between 2002 and 2010.The median age of cancer diagnosis was 47 years (19-77). This patient population selected for breast reconstruction had good prognosis criteria (77% T1 and 68% N0). PIP was the most common brand used between 2002 and 2010 and represented 45% of all breast implants (1764 implants). PIP has been preferentially used in courses with immediate breast reconstruction. On the 1764 PIP, 1408 (80%) were removed, mainly after the preventive measure recommending systematic explantation. Censored data on March 30, 2010, showed that the incidence of PIP implants removal is lower than other brands (Log-rank test : p&lt;0.001). Overall survival of patients who had at least on PIP was no different from that of patients who never had a PIP (Log-rank test : p=0.2). Disease-free survival was also similar between these two populations (Log-rank test : p=0.12).Conclusion : We did not identify any increase in local-regional recurrence or overall mortality associated with the use of PIP.
Citation Format: Lea Pauly, Benoit Couturaud, Fabien Reyal. What lessons can be learned from the poly implant prothese scandal ? A french retrospective study [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS1-65.
Abstract PS10-14: Efficacy and safety of palbociclib (PAL) in patients (pts) with estrogen receptor-positive (ER+)/human epidermal growth factor receptor 2-negative (HER2-) advanced breast cancer (ABC) with preexisting conditions: A post hoc analysis of PALOMA-2
Authors: Gelmon Karen , Walshe Janice M , Mahtani Reshma , Joy Anil A , Karuturi Meghan , Neven Patrick , Lu Dongrui Ray , Kim Sindy , Schnell Patrick , Bananis Eustratios , Schwartzberg Lee 
Published: February 2021

Abstract
Background: In the PALOMA-2 trial, PAL + letrozole (LET) significantly prolonged progression-free survival (PFS) vs placebo (PBO) + LET in pts with ER+/HER2– ABC. This post hoc analysis assessed efficacy and safety of PAL + LET in pts from PALOMA-2 with baseline preexisting conditions grouped by Medical Dictionary for Regulatory Activities (MedDRA) System Organ Class (SOC). Methods: Postmenopausal pts with ER+/HER2– ABC received PAL (125 mg/d, 3/1 schedule) + LET (2.5 mg/d, continuous) or PBO + LET. Pts were grouped by the following MedDRA SOC preexisting conditions: Gastrointestinal, Musculoskeletal, Metabolism, and Vascular/Cardiac. Baseline characteristics, PFS, and safety were assessed. Results: At baseline, 41.4% of pts had preexisting gastrointestinal disorders, 58.6% musculoskeletal disorders, 38.9% metabolism disorders, and 57.4% vascular/cardiac disorders. Baseline characteristics were similar between treatment arms within each subgroup and also between subgroups. Within each subgroup, ≥40% of pts also had ≥1 of the other coexisting conditions. Median PFS (mPFS) was significantly longer with PAL + LET vs PBO + LET regardless of preexisting condition (Table). In general, adverse events (AEs) were more frequent with PAL + LET in all subgroups; neutropenia was most common. Within each treatment arm, AEs and dose modifications due to AEs were similar regardless of preexisting condition. Conclusion: PAL + LET showed prolonged PFS and a consistent safety profile regardless of baseline preexisting condition in pts with ER+/HER2– ABC. Clinical trial identification: Pfizer Inc (NCT01740427)
TablePreexisting ConditionPAL + LETPBO + LETPAL + LET vs PBO + LETnmPFS (95% CI)nmPFS (95% CI)HR (95% CI)P ValueGastrointestinal17627.6 (17.5–33.1)10013.6 (11.0–18.5)0.57 (0.42–0.78)&lt;0.001Musculoskeletal25227.6 (21.4–33.1)13816.3 (11.2–19.1)0.53 (0.41–0.69)&lt;0.001Metabolism18627.6 (19.3–30.6)7313.8 (8.3–27.4)0.62 (0.44–0.87)0.003Vascular/Cardiac25430.4 (25.1–36.2)12814.5 (11.0–18.5)0.51 (0.39–0.66)&lt;0.001
Citation Format: Karen Gelmon, Janice M Walshe, Reshma Mahtani, Anil A Joy, Meghan Karuturi, Patrick Neven, Dongrui Ray Lu, Sindy Kim, Patrick Schnell, Eustratios Bananis, Lee Schwartzberg. Efficacy and safety of palbociclib (PAL) in patients (pts) with estrogen receptor-positive (ER+)/human epidermal growth factor receptor 2-negative (HER2-) advanced breast cancer (ABC) with preexisting conditions: A post hoc analysis of PALOMA-2 [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS10-14.