bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract P4-10-19: Disparities in use of adjuvant radiotherapy following lumpectomy among California regions
Authors: Huang RJ , Mukhtar RA , Alvarado M 
Published: February 2018

Abstract
Background
Women undergoing lumpectomy for invasive breast cancer typically receive radiotherapy (RT) to reduce risk of recurrence. Previous studies have reported disparities in the utilization of RT by race, socioeconomic status (SES), and age. In this study, we evaluate whether various sociodemographic factors are associated with use of RT in the different regions of California.
Methods
Utilizing data from the California Cancer Registry, the authors identified cases of women whose first primary invasive breast cancer was diagnosed between January 1, 2007 and December 31, 2012, whose primary surgery was breast conserving surgery, and for whom information was complete (n = 71,767). Multivariate logistic regression was used to determine whether demographic factors (SES, race, payer status, age) were significantly associated with use of RT following lumpectomy (p &lt; .05), adjusting for tumor characteristics (size, stage, grade, hormone receptor status, and nodal status).
Results
In three out of eight regions in California, black race was associated with decreased odds of RT use (San Francisco, OR = 0.79, 95% CI = 0.68-0.92; Desert Sierra, OR = 0.72, 95% CI = 0.58-0.90; Los Angeles, OR = 0.78, 95% CI = 0.70-0.87). In Sacramento and Los Angeles regions, lower socioeconomic status was associated with declined odds of RT use. Age (70 years or older) was also associated with lower likelihood of RT use across all regions.
Conclusions
Even after accounting for payer status, racial and socioeconomic disparities persist in the use of RT. These disparities, previously documented in the time period of 2000-2007, have not disappeared. Hispanic race was not shown to be associated with decreased odds of RT use in Los Angeles, contrary to the results of a previous study. Women aged 70 years or older are less likely to receive RT.
Citation Format: Huang RJ, Mukhtar RA, Alvarado M. Disparities in use of adjuvant radiotherapy following lumpectomy among California regions [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P4-10-19.
Abstract P4-12-02: Cost-effectiveness of genetic testing with a hereditary cancer panel in women at risk of hereditary breast cancer
Authors: Li Y , Arellano AR , Bare LA , Devlin JJ 
Published: February 2018

Abstract
Background: The role of the BRCA1/2 genes in breast cancer risk has been well characterized. However, pathogenic variants in additional genes also confer hereditary breast cancer risk and if detected can lead to interventions that can facilitate increased life expectancy. For example, the National Comprehensive Cancer Network (NCCN) guidelines (Version 2.2017) recommend MRI screening for women who carry a pathogenic variant in CHEK2 and MRI screening or risk-reducing mastectomy for women who carry a pathogenic variant in PALB2. Testing women at risk of hereditary breast cancer with a 7-gene panel was recently reported to be more cost-effective than testing only BRCA1/2 genes (Li et al. Value Health, 2017).
Objectives: To evaluate the cost-effectiveness of a multigene panel testing strategy including 11 genes with risk reduction recommendations by the NCCN guidelines compared with testing only BRCA1/2 genes.
Methods: Using a Markov model modified from the recent Li et al. publication, the 11-gene model was used to estimate life expectancies and total healthcare costs from a payers' perspective. The model included costs for genetic testing, genetic consultation, and cancer treatment as well as risk reduction strategies recommended by the guidelines: prophylactic surgery, MRI surveillance, and mammography. Probabilistic sensitivity analyses were carried out to determine the robustness of the modeling.
Results: In the base case, the incremental cost-effectiveness ratio (ICER) for the 11-gene multigene testing strategy compared with BRCA1/2 testing was $22,377 per life-year gained ($47,240 per quality-adjusted life-year gained) for a 40-year-old cohort and $36,690 per life-year gained ($63,384 per quality-adjusted life-year gained) for a 50-year-old cohort. The sensitivity analysis indicated that the multigene testing strategy had a 97% chance of costing less than $100,000 per quality-adjusted life-year gained for the 40-year-old cohort.
Conclusion: In patients at risk of hereditary breast cancer, testing using a multigene panel followed by risk reducing interventions is cost-effective compared with testing only BRCA1/2 genes.
Citation Format: Li Y, Arellano AR, Bare LA, Devlin JJ. Cost-effectiveness of genetic testing with a hereditary cancer panel in women at risk of hereditary breast cancer [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P4-12-02.
Abstract P4-12-08: Palbociclib in hormone receptor positive advanced breast cancer: A cost-utility analysis
Authors: Raphael J , Helou J , Naimark DM 
Published: February 2018

Abstract
Introduction
The addition of palbociclib to letrozole improves progression free survival (PFS) and response rates compared to letrozole alone in the 1st line treatment of hormone receptor positive advanced breast cancer. However palbociclib increases toxicity (i.e. neutropenia) and costs more than $6,250 per month in Canada. This study assesses the cost-utility of palbociclib from the Canadian healthcare payer perspective.
Methods
To evaluate the cost-utility of palbociclib, a probabilistic discrete event simulation model was developed. The model was parameterized with data from the phase 2 and 3 PALOMA 1 and 2 trials and other sources. The incremental cost per quality-adjusted life-month (QALM) gained for palbociclib was calculated. A time horizon of 15 years was used in the base case with costs and effectiveness discounted 5% annually. The time to progression and death were derived from a Weibull and exponential distribution. Expected costs were based on Ontario fees and other sources. Probabilistic sensitivity analyses were conducted to account for parameter uncertainty.
Results
Compared to letrozole alone, the addition of palbociclib provided an additional 14.7 QALM at an incremental cost of $161,508. The resulting incremental cost-effectiveness ratio was $10,999 per QALM gained. Assuming a willingness to pay (WTP) of $4,167 per QALM, the addition of palbociclib was not cost-effective and the probability of palbociclib to be cost-effective was 0%. Cost-effectiveness acceptability curves derived from a probabilistic sensitivity analysis showed that at a WTP of $11,667 per QALM gained, the probability of palbociclib to be cost-effective was 50%.
Conclusion
Compared with letrozole alone, the addition of palbociclib is unlikely to be cost-effective for the treatment of advanced breast cancer from a Canadian healthcare perspective with its current price. While advanced breast cancer patients derive a meaningful clinical benefit from palbociclib, considerations should be given to increase the WTP threshold and reduce the drug pricing, to render this strategy more affordable.
Citation Format: Raphael J, Helou J, Naimark DM. Palbociclib in hormone receptor positive advanced breast cancer: A cost-utility analysis [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P4-12-08.
Abstract P4-12-09: Molecular test for BRCA 1 and 2: Hereditary breast and ovarian cancer syndrome. Analysis of cost effectiveness of its implementation
Authors: Paez MC , Riggi MC , Gogorza SJ , Petracchi F 
Published: February 2018

Abstract
Introduction
Breast cancer is the leading cause of women cancer. Hereditary cause represents 5% -10% of cases. Molecular testing for BRCA1 and BRCA2 allows physicians to identify breast and ovarian cancer high risk women. Screening, diagnosis and treatment for high risk women differ from general population ones. As new drugs have been increasing health costs, the need of cost-effective strategies has raised. In Argentina, molecular tests are still very expensive and most health insurances do not cover it.
Objectives
To evaluate the long-term cost-effectiveness of germline BRCA1 and BRCA2 molecular testing in women with no personal history of cancer and &gt;=10% mutation risk based on family history criteria, compared to no testing women.
Methods
We performed a decision-analytic model (decision tree) to compare the risks of breast and ovarian cancer, mortality rates, and costs and effects (life-years and QALYs) in women with and without molecular testing for BRCA1 and BRCA2. Carrier's probability undergoing risk-reducing surgeries was considered.
This data has been analized in two private hospitals of Buenos Aires, Argentina.
Results
BRCA testing in all women with &gt;=10% mutation risk based on family history criteria resulted cost-effective and even cost-saving in our country, with an incremental cost-effectiveness ratio of -$315.353/QALY and -$1.357.143/life-year. Our results demonstrate to be robust after sensitivity analyses varying the input parameters.
Conclusion
BRCA testing is cost-saving in our country probably because of prophylactic risk-reducing surgeries in BRCA carriers. This leads to a reduction of breast and ovarian cancer cases.
Citation Format: Paez MC, Riggi MC, Gogorza SJ, Petracchi F. Molecular test for BRCA 1 and 2: Hereditary breast and ovarian cancer syndrome. Analysis of cost effectiveness of its implementation [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P4-12-09.
Abstract P4-13-15: A retrospective head-to-head comparison between TiLoop Bra/TiMesh and seragyn in 320 cases of reconstructive breast surgery
Authors: Eichler C , Schulz C , Brunnert K , Mathias W 
Published: February 2018

Abstract
Background: As an alternative option to ADMs (acellular dermal matrices) synthetic meshes are a cheaper and equally effective option in implanted breast reconstruction. However, clinical data concerning these synthetic meshes is limited. Also, direct comparisons between titanium-coated polypropylene mesh (TiLoop Bra/TiMesh) and partially absorbable polypropylene mesh (Seragyn) have not yet been reported. Therefore, this work will report clinical complication rate data on 320 cases of synthetic meshes TiLoop Bra/TiMesh and Seragyn.
Methods: This analysis represents a retrospective single surgeon multi-center study of 320 cases over 14 years (2003 until 2016) using either TiLoop Bra/TiMesh (n=192) or Seragyn (n=128) in breast reconstruction. Patient recruitment was consecutive. 124 cases of the TiLoop Bra /TiMesh cohort and 74 cases in the Seragyn cohort were oncological interventions. Results were correlated with ADM based reconstructions (Epiflex and SurgiMend) performed by the same surgeon.
Results: Major complication rates (i.e. revision surgery) occurred in 3.9 % (Seragyn) and 8.3 % (TiLoop Bra/TiMesh) of all cases. (not statistically significant). Minor complications (i.e. seroma requiring aspiration, infection requiring antibiotics, red breast syndrome/rash (RBS) and wound dehiscence occurred in 18 % (Seragyn) and 8.9 % (TiLoop Bra/TiMesh). Overall minor complication rates did also not differ statistically significant. However, subgroup analysis showed RBS to occur more often in the Seragyn group (3.9 % Seragyn vs. 0.5 % TiLoop Bra/TiMesh, p&lt;0.05). A significant difference between SurgiMend and Epiflex compared to the synthetic meshes could also not been shown.
Conclusion: This retrospective analysis shows that titanium-coated polypropylene meshes like TiLoop Bra/TiMesh and partially absorbable meshes like Seragyn do not differ significantly in complication rates. Compared to the exponentially more expensive ADM alternatives complication rates did also not differ significantly. Synthetic meshes seem to be a cheaper and equally effective option.
Citation Format: Eichler C, Schulz C, Brunnert K, Mathias W. A retrospective head-to-head comparison between TiLoop Bra/TiMesh and seragyn in 320 cases of reconstructive breast surgery [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P4-13-15.
Abstract P4-15-12: Evaluating the significance of the Van Nuys prognostic index for the management of ductal carcinoma in situ – one center's experience
Authors: Niwinska A , Galecki J , Nagadowska M , Piechocki J , Kunkiel M , Jagiello-Gruszfeld AI , Nowecki Z 
Published: February 2018

Abstract
Aim: This was to assess the treatment outcomes of ductal carcinoma of the breast (DCIS) based on the Van Nuys Prognostic Index.
Material and Methods: 634 consecutive patients with DCIS were treated at the Warsaw Cancer Center, Poland between 1996 and 2008 based on the VNPI score. Tumorectomy without radiotherapy (T) was performed in 123 (20%) patients, breast conserving treatment (BCT) in 206 (32%) and mastectomy (M) in 305 (48%). Disease-free survival (DFS) and overall survival (OS) were analysed within 3 groups and a multivariate analysis was performed to determine the most important factor affecting local relapse.
Results: 5-year, 10-year and 15-year DFS in the M group were respectively 98%, 97% and 97% whilst 5-year, 10-year and 15-year DFS in the BCT group were respectively 91%, 87% and 80%. 5-year, 10-year and 15-year DFS in the T group were respectively 92%, 73% and 67%. Local recurrence was observed in 54 patients. In 40% cases this was noninvasive and in 60 % invasive. Only 4 of 54 patients with recurrence died due to breast cancer. 5-year, 10-year and 15-year OS in the M group were respectively 96%, 92% and 89%. 5-year, 10-year and 15-year OS in the BCT group were respectively 99%, 94% and 85%. 5-year, 10-year and 15-year OS in the T group were respectively 95%, 90% and 73% (p=0.422). Tumor size assessed by mammography was the only variable affecting DFS.
Conclusions: Treatment outcomes of DCIS based on the Van Nuys Prognostic Index are comparable with those cited the literature, however, the recurrence rate in the T group seems to be very high. This group requires that new risk factors be sought for prior to taking a treatment decision.
Citation Format: Niwinska A, Galecki J, Nagadowska M, Piechocki J, Kunkiel M, Jagiello-Gruszfeld AI, Nowecki Z. Evaluating the significance of the Van Nuys prognostic index for the management of ductal carcinoma in situ – one center's experience [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P4-15-12.
Abstract P5-07-13: MicroRNA-mediated restoration of tamoxifen sensitivity in triple negative breast cancer through modulation of estrogen receptor alpha/beta ratio using Myrothamnus flabellifolius
Authors: Fultang N , Klase Z , Mercier I , Peethambaran B 
Published: February 2018

Abstract
Triple negative breast cancer (TNBC) represents approximately 20% of all breast cancer cases worldwide. Prognosis for this subtype of cancer is especially dire due to the absence of Estrogen (ER), Progesterone and Human Epidermal Growth Factor receptors, usually targeted by neoadjuvant therapies like Tamoxifen. Myrothamnus flabellifolius (MF), a well-studied South African medicinal herb, has shown significant potency against TNBC with minimal effect on normal cells. In this study, we use miRNA profiling, Ingenuity Pathway Analysis (Qiagen), MTT, immunoblots and immunofluorescence to characterize the targeted cytotoxic mechanism of MF in TNBC. We found deregulation in the expression of several oncogenic and anti-cancer miRNAs in TNBC post MF treatment. Using Ingenuity Pathway Analysis to analyze the miRNA expression profiles of the treated cells, we determined Estrogen Signaling as a pathway significantly affected by MF in TNBC. Immunoblots confirmed increase of the ERa/ERß ratio in TNBC, a well-studied marker for Tamoxifen-therapy sensitivity in TNBC. MTT cell viability assay and Annexin V staining confirmed increased sensitivity to Tamoxifen post treatment with low doses of MF, with up to 70% cell death at half the IC50 of Tamoxifen in TNBC. This study establishes a potential non-toxic therapeutic to supplement Estrogen-receptor targeting therapies in TNBC by increasing the ERa/ERß ratio. The data also evaluates the ERa/ERß ratio as a potential target for combination therapies in TNBC.
Citation Format: Fultang N, Klase Z, Mercier I, Peethambaran B. MicroRNA-mediated restoration of tamoxifen sensitivity in triple negative breast cancer through modulation of estrogen receptor alpha/beta ratio using Myrothamnus flabellifolius [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P5-07-13.
Abstract P5-12-02: B-vitamin intake from diet and supplements and breast cancer risk in middle-aged women: Results from the prospective NutriNet-Santé cohort
Authors: Egnell M , Fassier P , Lécuyer L , Zelek L , Vasson M-P , Hercberg S , Latino-Martel P , Galan P , Deschasaux M , Touvier M 
Published: February 2018

Abstract
Experimental studies suggest a protective effect of B-vitamins on breast cancer risk, potentially modulated by alcohol intake. However, epidemiological studies are limited, especially regarding non-folate B-vitamins. Furthermore, few of them included quantitative assessment of supplemental intake. This prospective study aimed at investigating the associations between intakes of B-vitamins (dietary, supplemental, total) and breast cancer risk. 27,853 women aged ≥45y from the NutriNet-Santé cohort (2009-2016) were included, with a median follow-up time of 4.2 years. Dietary data were collected using repeated 24h records. A specific questionnaire assessed dietary supplement use over a 12-month period. A composition database of 8000 supplements was developed. Associations were characterized by multivariable Cox models. 462 incident breast cancers were diagnosed. Dietary (HRQ4vs.Q1=0.74(0.55,0.99), P-trend=0.05), supplemental (HRQ4vs.Q1=0.61(0.38,0.98), P-trend=0.05) and total (HRQ4vs.Q1=0.67(0.50,0.91), P-trend=0.01) pyridoxine intakes were inversely associated with breast cancer risk. Total thiamin intake was borderline inversely associated with breast cancer risk (HRper 1-unit increment=0.78(0.61,1.00), P=0.05). Statistically significant interactions between alcohol consumption and B-vitamin (thiamin, riboflavin, niacin, pantothenic acid, pyridoxine, folate, and cobalamin) supplemental intake were observed, the latter being inversely associated with breast cancer risk in non-to-low alcohol drinkers but not in higher drinkers. This large prospective study, including quantitative assessment of supplemental intake, suggests a potential protective effect of pyridoxine and thiamin on breast cancer risk in middle-aged women.
Citation Format: Egnell M, Fassier P, Lécuyer L, Zelek L, Vasson M-P, Hercberg S, Latino-Martel P, Galan P, Deschasaux M, Touvier M. B-vitamin intake from diet and supplements and breast cancer risk in middle-aged women: Results from the prospective NutriNet-Santé cohort [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P5-12-02.
Abstract P5-14-02: Effects of bazedoxifene and/or letrozole in the prevention of chemically-induced mammary cancers
Authors: Dunn BK , Grubbs CJ 
Published: February 2018

Abstract
Bazedoxifene is described as a third-generation selective estrogen receptor modulator (SERM) that has been approved in Europe for the prevention and treatment of postmenopausal osteoporosis. The agent has also been shown to have therapeutic activity against estrogen receptor positive (ER+) breast cancer. Our laboratory has evaluated bazedoxifene for chemopreventive efficacy against mammary cancers when given alone or in combination with the aromatase inhibitor letrozole. Initially, the agents were evaluated alone to determine effective chemopreventive doses in the methylnitrosourea (MNU) ER+ mammary cancer model using female Sprague-Dawley rats. Bazedoxifene was mixed directly into a standard (Teklad, 4% fat) diet, while letrozole was gavaged 7x/week (vehicle was ethanol: PEG 400, 10:90, v/v). When evaluated alone in rats receiving MNU at 50 days of age, bazedoxifene (started one week after MNU) at doses of 100 and 30 mg/kg diet decreased mammary cancer multiplicity by 93 and 88%, respectively. In a similar protocol, letrozole at a dose of 0.1 mg/kg BW/day reduced cancer multiplicity by 89%, while a dose of 0.05 mg/kg BW/day reduced the number by 47%. In a separate study evaluating lower doses of bazedoxifene (5 mg/kg diet) and letrozole (0.04 mg/kg BW/day), mammary cancer multiplicity was decreased by 73% by both agents. When the agents were given in combination at these lower dose levels, cancer number was reduced by 91%. It is obvious that bazedoxifene is as effective as letrozole in the prevention of ER+ mammary cancers. Furthermore, administration of the agents in combination suggests an additive effect. The large increase in body weight gain generally noted in letrozole treated rats was not observed in rats receiving bazedoxifene; of interest, rats receiving the combination also had no increase in body weights. Several published invitro studies suggested that bazedoxifene might also be effective in preventing ER- mammary cancers; e.g., the agent is a novel inhibitor of IL-6/GP130 protein-protein interactions using multiple ligand simultaneous docking and drug repositioning approaches that result in apoptosis. In an initial study using MMTV/Neu mice (N=21/group) that received dimethylbenzanthracene (DMBA), we showed that administering bazedoxifene (15 mg/kg diet) would reduce the mammary tumor multiplicity from 5.4/mouse in controls to 1.1/mouse (an 80% decrease). These studies suggested that bazedozxifene is superior to other similar agents in that both ER+ and ER- mammary cancers are prevented at non-toxic doses. Supported by NCI contract HHSN261201200021I, Task Order HHSN26100007.
Citation Format: Dunn BK, Grubbs CJ. Effects of bazedoxifene and/or letrozole in the prevention of chemically-induced mammary cancers [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P5-14-02.