bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract P4-13-14: Risk of recurrence and death in breast cancer patients after delayed deep inferior epigastric perforator flap reconstruction
Authors: Adam H , Docherty Skogh A-C , Edsander Nord Å , Schultz I , Gahm J , Hall P , Frisell J , Halle M , de Boniface J 
Published: February 2018

Abstract
PURPOSE
Post-mastectomy reconstruction using the deep inferior epigastric perforator (DIEP) flap is increasingly performed in breast cancer patients. The procedure induces large tissue trauma and it has been hypothesized that the release of growth factors, angiogenic agonists and immunomodulating factors may reactivate dormant micrometastasis. The aim of our study was to contrast the risk of breast cancer recurrence in patients undergoing DIEP reconstruction to patients treated with mastectomy alone.
PATIENTS AND METHODS
We conducted a retrospective nested case-control study. Cases were defined as breast cancer patients operated with delayed DIEP reconstruction at Karolinska University Hospital, Sweden, between 1999-2013. Three controls, defined as breast cancer patients operated with conventional mastectomy without delayed reconstruction, were matched to each case based on age, tumour stage and year of mastectomy. The primary endpoint was breast cancer-specific survival. Survival analysis was carried out by Kaplan–Meier survival estimates and Cox proportional hazard regression analysis.
RESULTS
In all, 254 cases and 729 controls were included and had a median follow up of 134 and 122 months, respectively (p=0.004). Breast cancer recurrence occurred in 50 (19.7%) cases and 174 (23.9%) controls, respectively (p=0.171). Ten-year breast cancer-specific survival was 90.7% for cases and 85.2% in controls (p=0.067). The corresponding figures for 10-year overall survival was 89.6% and 80.0%, respectively (p&lt;0.001). Higher tumor stage and positive axillary lymph nodes, but not DIEP reconstruction, were independent risk factors for death due to breast cancer.
CONCLUSION
Our findings did not support the hypothesis that breast cancer patients undergoing DIEP reconstruction would have a higher rate of breast cancer recurrence than patients undergoing mastectomy alone.
Citation Format: Adam H, Docherty Skogh A-C, Edsander Nord Å, Schultz I, Gahm J, Hall P, Frisell J, Halle M, de Boniface J. Risk of recurrence and death in breast cancer patients after delayed deep inferior epigastric perforator flap reconstruction [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 P4-13-14.
Abstract P5-08-01: Reconstructing the evolutionary paths of BIG 1-98
Authors: Lara-Gonzalez LL , Loi S , Ferrari D , Papenfuss A , Goode DL 
Published: February 2018

Abstract
We are reconstructing the dynamics of tumour growth, treatment response, and origins of resistance of the Breast International Group (BIG) 1-98 study to determine the evolutionary paths of non-responders.
We established the somatic alteration landscape of primary tumours collected at surgery from BIG 1-98 patients using targeted DNA sequencing of 287 genes of FFPE samples from 538 patients. Combined analysis of genetic and clinical data indicates increased genomic instability; TP53 mutations and copy number variations of 11q13 and 8p11 are associated with poor prognosis. We developed an in silico simulation framework to investigate if the non-responder outcome is due to (over)-treatment or intrinsic to evolutionary selection prior to diagnosis.
To reconstruct the evolutionary history of tumours, we created a computational multitype branching process that tracks the expansion of diverse clonal lineages as they acquire driver and passenger mutations that alter their proliferation and mutation rates. To account for the heterogeneity between patients, we created a fitting procedure based on the Cramer-von Misses statistic to find the likelihood of parameters of our computational model that recreate the mutational landscape and clinicopathological factors observed in each patient. Once the fitting procedure is done, we simulate the course of treatment following the study arm scheme accounting for the cell-cycle action mechanism of Tamoxifen and Letrozole.
Using our tool, we are characterising the range of tumour development scenarios covering different degrees of aggressiveness and genomic instability. Our computational model allows simulation of diverse adjuvant-schemes to predict optimised treatment regimes for validation in patient-derived tumour xenograft mouse models.
Citation Format: Lara-Gonzalez LL, Loi S, Ferrari D, Papenfuss A, Goode DL. Reconstructing the evolutionary paths of BIG 1-98 [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 P5-08-01.
Abstract P5-11-01: The accuracy of nomograms based on large dataset using clinico-pathologic variables for prediction of oncotype DX breast cancer recurrence score
Authors: Kim J-M , Ryu JM , Kim I , Choi HJ , Nam SJ , Kim SW , Yu J , Lee SK , Lee JE 
Published: February 2018

Abstract
Purpose
The 21 gene expression assay, Oncotype DX (ODX) is costly (the current estimated cost is ˜$4000), and were tested in only approximately one-third of breast cancer patients who meet the inclusion criteria in the United States. Recent study of University of Tennessee Medical Center reported a novel nomogram for prediction of ODX recurrence score using clinico-pathologic data, which was based on a large dataset from the National Cancer Data Base (NCDB). The purpose of this study was to confirm that the nomogram could predict ODX score group accurately with Korean data, which is different from the NCDB in terms of ethnicity.
Methods
A retrospective review was performed with 218 patients who received breast-conserving surgery or mastectomy at Samsung Medical Center and were tested with the ODX from April 2011 to January 2017. An online nomogram calculator, provided by the University of Tennessee Medical Center on their website was used in order to calculate the probability of a low-risk or a high-risk ODX score for each patient. The cut-off value for predictive accuracy of the nomogram was set same as the original study.
Results
With the cut-off value as 90% for inspection of the commercial ODX score, high-risk group showed 33.3% positive predictive value (PPV) and low-risk group showed 68.7%. With the cut-off value as 86% for TAILORx score, PPV was 66.7% for high-risk group, and 38.9% for low-risk group. The sensitivity of the nomogram for the low-risk group commercial ODX score was 96.8%, and 33.3% for the TAILORx score. For the high-risk group, sensitivity was 20% for the commercial ODX score, and 16.7% for the TAILORx score.
Conclusions
Although the nomogram for prediction of ODX score was based on a large dataset of NCDB, it could not be generalized to patients in Asia. Further studies based on large data from different ethnicities should be performed to develop the nomogram for patients worldwide.
Citation Format: Kim J-M, Ryu JM, Kim I, Choi HJ, Nam SJ, Kim SW, Yu J, Lee SK, Lee JE. The accuracy of nomograms based on large dataset using clinico-pathologic variables for prediction of oncotype DX breast cancer recurrence score [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 P5-11-01.
Abstract P5-22-21: Radioactive seed and targeted axillary dissection: A feasibility study
Authors: Boulva K , Rodriguez-Qizilbash S , Guilarte L , Lazizi S , Robidoux A , Younan R , Patocskai E 
Published: February 2018

Abstract
Targeted axillary dissection (TAD) with a radioactive seed is a new and promising technique to evaluate the axillary status in post-neoadjuvant chemotherapy (NACT) node-positive breast cancer patients. This study aims to evaluate the feasibility of TAD with a radioactive seed in a Canadian setting.
We conducted a retrospective observational study of a prospectively gathered database of patients having undergone TAD with a radioactive seed implanted in a proven metastatic axillary node, between 2015 and 2017 in our institution. An iodine-125 radioactive seed was implanted under ultrasound guidance by trained radiologists. Patients then underwent standard sentinel lymph node biopsy (SLNB) using technicium-99 and blue dye, as well as selective removal of the node containing the radioactive seed. Data was gathered from electronic medical records and chart review.
Nine patients with a median age of 54 underwent TAD for unilateral breast cancer post-NACT between 2015 and 2017, three of which were "triple-negative". A median of 3 lymph nodes were removed, including that which contained the radioactive seed. Postoperative pathological evaluation showed 4 patients with positive nodes and 5 pathologic complete responses in the axilla. In all patients, the seed had been accurately positioned in a positive node (no false negatives). The seed also located a positive retropectoral node that would otherwise have been missed using standard dual tracer SLNB. No complications due to the use of the radioactive seed were encountered. All implanted seeds were identified and retrieved within the pathology specimen.
In our experience, TAD with a radioactive seed combined to dual tracer SLNB is an accurate and safe method of evaluating the axillary lymph node status in post-NACT node positive breast cancer patients. Further studies with larger cohorts are warranted to ensure continued feasibility and reproducibility of our positive results.
Citation Format: Boulva K, Rodriguez-Qizilbash S, Guilarte L, Lazizi S, Robidoux A, Younan R, Patocskai E. Radioactive seed and targeted axillary dissection: A feasibility study [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 P5-22-21.
Abstract P6-05-02: Targeting vesicular trafficking machinery for breast cancer therapeutics
Authors: Mitra S , Vykoukal J , Jeong K , Mills G 
Published: February 2018

Abstract
The Rab GTPase family is a key regulator of vesicular import, transport and export. Deregulation of vesicular trafficking promotes undesirable intercellular cross talk via exosomes that contribute to cancer pathophysiology. Preclinical and clinical studies underscore a role for exosomes and their cargo in breast cancer development, progression, metastasis, and resistance to therapy. While many studies have approached the role of exosomes in cancer pathophysiology, the 'rules' governing their production and cargo sorting represents a major unexplored gap in knowledge. Exosomes arise from internal budding of specific endosomal compartments. Rab11 GTPase family members comprised of Rab11a, Rab11b and Rab25 are critical regulators of endocytic cargo trafficking specifically of apical and recycling endosomes. Previously, our lab has shown that Rab25 is amplified and contributes to oncogenesis in both ovarian and Luminal B breast cancers. However, Rab25 is lost and when re-expressed ectopically, it inhibits invasion and migration in Claudin Low tumors suggesting a cell-lineage and context dependent function. Importantly, while in Luminal B cancer, Rab25 and its downstream effector RCP (Rab coupling protein), collaborate in driving oncogenesis, in Her2+ cancers, RCP expression is protective. Further our group recently uncovered the presence of a stroma enriched “reactive protein signature” in ER+/Her- group that is indicative of good outcome for patients. Indeed, many of the “reactive signature” proteins are reported in exosomal cargo by others. Taking together, our ongoing study utilizes a panel of breast cancer cell lines representing ER+ve/Her2+; ER+/Her-, ER-/Her2+, and ER-/Her- to evaluate the role of Rab11 family in modulating vesicular trafficking that alters the exosome biology and how that may contribute to tumor- stroma communications. Our preliminary results show that indeed over expression of Rab25 differentially alters size and number of extracellular vesicles in Luminal B cancers when compared to the Claudin
Low subtype. Using a novel class of peptides that interrupt the cellular functions 25, we are investigating if Rab25 expression can be associated with an exosomal cargo profile in each subtype of breast cancer, which could then serve as a biomarker for tumor-stroma interaction.
Citation Format: Mitra S, Vykoukal J, Jeong K, Mills G. Targeting vesicular trafficking machinery for breast cancer therapeutics [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 P6-05-02.
Abstract P6-08-21: Early breast cancer-specific mortality in women with early stage breast cancer: Epidemiological and clinical characteristics
Authors: Johnson HM , Wong JH , Vohra NA , Muzaffar M 
Published: February 2018

Abstract
Background and Aim:
The five-year survival for women with stage I-II breast cancer is 93-100%. Despite standard of care treatment, a small subset of these women suffer early breast cancer-specific mortality and die within 12 months of diagnosis. This subset of women has not been previously described. The aim of this study is to characterize the incidence, demographics, and clinical characteristics of women with early stage breast cancer who suffer early breast cancer-specific mortality.
Methods:
Retrospective population study of the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) registry of women diagnosed with stage I, IIA, or IIB breast cancer between 2004 and 2010. Data were filtered to histology codes 8500-8543 and 8575. Patient demographics (age, race, ethnicity) and clinical characteristics (stage, T stage, N stage, grade, ER status, PR status) of women in the early mortality subset were compared with those of women who survived &gt; 12 months via the Chi-square test and the student t-test.
Results:
259,380 women formed the basis of our analysis. 4,572 women (0.018%) died within 12 months of diagnosis. Compared with those who survived &gt; 12 months, women who suffered early breast cancer-specific mortality were on average older (mean age 65.7 years versus 60.3 years, p&lt;0.00001) and more likely to be Hispanic (14.3% versus 8.9%, p&lt;0.00001) or black (11.0% versus 9.1%, p&lt;0.00001). Clinical characteristics associated with early mortality included higher stage (stage IIA 34.2% versus 29.4%, stage IIB 21.8% versus 12.9%, p&lt;0.00001), higher T stage (T2 40.5% versus 28.1%, T3 3.1% versus 1.6%, p&lt;0.00001), higher N stage (N1 29.7% versus 23.2%, N2 0.8% versus 0.4%, N3 0.4% versus 0.1%, p&lt;0.00001), higher grade (moderate 39.3% versus 42.5%, high 40.0% versus 31.5%, p&lt;0.00001), higher rates of ER negativity (27.2% versus 19.0%, p&lt;0.00001), and higher rates of PR negativity (38.5% versus 30.2%, p&lt;0.00001).
Conclusions:
Breast cancer-specific mortality within 12 months of diagnosis of stage I-II breast cancer is a rare phenomenon which has not been previously characterized. There are several demographic and clinical features associated with early mortality, however further research is needed to identify specific prognostic factors that will allow identification of women at risk for early mortality at the time of diagnosis.
Citation Format: Johnson HM, Wong JH, Vohra NA, Muzaffar M. Early breast cancer-specific mortality in women with early stage breast cancer: Epidemiological and clinical characteristics [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 P6-08-21.
Abstract P6-09-03: Gene expression patterns in younger versus older HR+ breast cancer patients: An age-related analysis of HoxB13/IL17BR (H/I), proliferation status, and quantitative hormone receptor expression
Authors: Melisko M , Chien AJ , Poage GM , Salganik M , Schnabel CA , Ruddy KJ , Blackwell K 
Published: February 2018

Abstract
Background: HR+ breast cancer in younger vs older patients may have distinct biological features. The Breast Cancer Index (BCI) is a gene expression-based assay that includes two component biomarkers: the HoxB13/IL17BR (H/I ratio), an endocrine response biomarker; and the molecular grade index (MGI), a set of proliferation-related genes. The objective of this study was to assess age-related associations with endocrine sensitivity (H/I), proliferative status (MGI), and quantitative expression of ER and PR.
Methods: Data were extracted from the BCI Clinical Database for Correlative Studies, an IRB-approved de-identified database containing clinicopathologic and molecular variables from clinical cases submitted for BCI testing. Molecular results from H/I, MGI, and quantitative (qPCR–based) ER and PR were analyzed across age groups. Chi-squared tests and ANOVA were used to compare the results between age groups (&lt;40y, 40-49y, 50-59y, 60-69y, and ≥70y).
Results: Analyses included 19,126 patients (median age at diagnosis 58.6y; 4.5% &lt;40y, 20.6% 40-49y, 28.9% 50-59y, 32.5% 60-69y, and 13.6% ≥70y). Proliferation status (MGI) was significantly higher in patients &lt;40y and 40-49y compared to older groups (P&lt;.0001).H/I analysis indicated a similar distribution of high versus low endocrine responsiveness across all groups (P=.94), except the 40-49y group, in which fewer patients had high H/I (44.2% in &lt;40y, 39.4% in 40-49y, 43.7% in 50-59y, 43.7% in 60-69y, and 43.1% in ≥70y; P=.0001). Median qER increased with age (P&lt;0.0001), while qPR was similar across all age groups except for the 40-49y group (P=.57), in which expression was higher (P&lt;.0001).
Conclusion: Results from &gt;19,000 patients with early-stage HR+ breast cancer and BCI testing showed a broad distribution in all variables. Tumors from the youngest patients (&lt;40y) had the highest expression of proliferative genes and the lowest quantitative ER expression. However, endocrine response, according to the H/I biomarker, does not appear to be strongly linked to age.
Citation Format: Melisko M, Chien AJ, Poage GM, Salganik M, Schnabel CA, Ruddy KJ, Blackwell K. Gene expression patterns in younger versus older HR+ breast cancer patients: An age-related analysis of HoxB13/IL17BR (H/I), proliferation status, and quantitative hormone receptor expression [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 P6-09-03.
Abstract P6-11-20: Not presented
Authors: Bargallo-Rocha JE , Gutierrez-Zacarias LM , Gallardo-Alvarado LN , Esparza-Arias N , Shaw-Dulin RJ , Vazquez-Romo R , Robles-Vidal CD , Cantu-De Leon DF 
Published: February 2018

Abstract
This abstract was not presented at the symposium.
Abstract P6-13-03: Breast cancer-specific mortality (BCSM) in patients with node-positive (N+) breast cancer (BC) treated based on the 21-gene assay in clinical practice
Authors: Shak S , McCullough D , Petkov VI 
Published: February 2018

Abstract
Introduction: The Recurrence Score® (RS) assay was shown in SWOG 8814 to predict chemotherapy (CT) benefit for patients (pts) with N+ BC and RS ≥31 but not RS &lt;18. As we await the randomized RxPONDER results for RS 0-25, we characterized BCSM for RS groups (cutoffs of 11, 18, 25, and 31) in the large population-based SEER study of pts treated based on RS results.
Methods: RS results were provided electronically to SEER registries per their linkage methods (Petkov npj Breast Cancer 2016). Eligible pts were diagnosed (Jan 2004 - Dec 2012) with N+ (micrometastases, 1-3 positive nodes), HR+, HER2-negative BC, and had no prior malignancy or multiple tumors. BCSM estimates by reported CT use were computed using standard cutpoints of 18 and 31 and TAILORx/RxPONDER cutpoints of 11 and 25, and should be interpreted cautiously given known under-reporting of CT use to SEER and lack of randomization.
Results: Among 6,483 pts with RS results, 1,312 (20%) had RS &lt;11, 2,478 (38%) had RS 11-17, 1,831 (28%) had RS 18-25, 432 (7%) had RS 26-30, and 430 (7%) had RS ≥31. There was a significant association between RS results and BCSM (p&lt;0.001) without and with adjustment for age, tumor size, and grade. Reported CT use and 5-y BCSM increased with increasing RS result (Table). For pts with RS &lt;11 and RS 11-17, CT use was reported in approximately a quarter of pts, and 5-y BCSM was low regardless of CT use. For pts with RS 18-25, CT use was more common and the 5-y BCSM was about 2%. For pts with RS of 26-30 or ≥31, CT was common, and higher 5-y BCSM was observed.
5-y BCSM, by RS Group and Reported CT Use CT reported as ‘No/Unknown’CT reported as ‘Yes’RS groupN (%)5-y BCSM (95% CI)N (%)5-y BCSM (95% CI)&lt;111066 (81%)1.8% (0.7%, 4.6%)246 (19%)1.3% (0.3%, 5.3%)11-171869 (75%)0.5% (0.2%, 1.1%)609 (25%)2.3% (0.9%, 5.8%)18-251034 (56%)2.0% (1.0%, 3.9%)797 (44%)1.9% (0.8%, 4.5%)26-30144 (33%)7.7% (2.8%, 20.3%)288 (67%)4.0% (1.6%, 10.1%)≥3199 (23%)11.9% (5.3%, 25.6%)331 (77%)11.1% (6.9%, 17.6%)
Conclusion: Reported CT use and 5-y BCSM in N+ BC increased with increasing RS results in “real-world” clinical practice. 5-y BCSM with RS &lt;18 was less than 2% in pts with no or unknown CT use. 5-y BCSM in pts treated based on RS results appears to increase considerably with RS &gt;25.
Citation Format: Shak S, McCullough D, Petkov VI. Breast cancer-specific mortality (BCSM) in patients with node-positive (N+) breast cancer (BC) treated based on the 21-gene assay in clinical practice [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 P6-13-03.