bluuebunny/crossref_metadata_2025_split huggingface dataset:
Weight trajectories during first two years of endocrine treatment: Premenopausal compared to postmenopausal early breast cancer survivors.
Authors: Nyrop Kirsten A , Deal Allison Mary , Lee Jordan T , Muss Hyman B. , Choi Seul Ki , Wheless Amy , Carey Lisa A. , Shachar Shlomit S. 
Published: September 2018

e12069 Background: Obesity and weight gain in breast cancer survivors (BCS) can impact prognosis, survival, and quality of life. Women who were premenopausal (PreBCS) or postmenopausal (PostBCS) at BC diagnosis are compared regarding weight change during the first 2 years of endocrine treatment (ET) and factors associated with > 2kg weight gain. Methods: Data were gathered by retrospective chart review, with weights assessed by nursing staff during routine clinic visits. Chi-squared and t-tests were used to compare PostBCS and PreBCS characteristics, and log-binomial regression models to evaluate factors associated with > 2kg weight gain. Results: In a final sample of N = 447 BCS, 33% were PreBCS (mean age 44) and 67% were PostBCS (mean age 65). PreBCS had lower BMI at diagnosis (p = 0.003), lower proportion of white (p = 0.04), fewer comorbidities (p < 0.0001); higher stage (p < 0.0001), grade (p = 0.008), node positive (p < 0.0001), PR positive (p = 0.03), and HER2 positive (p = 0.03) BC tumors; higher proportion of mastectomies (p < 0.0001), axillary node dissection (p = 0.005), chemotherapy (p < 0.0001), radiation treatment (p = 0.009), and Tamoxifen use (p < 0.0001); and less weight loss between diagnosis and start of ET (p = 0.013). After 2 years of ET, 48% of PreBCS and 39% of PostBCS had gained > 2kg (p = 0.08). In univariate analysis, factors associated with > 2kg weight gain were: weight loss between BC diagnosis and ET start (p < .0001), lower age at start of ET (p = .002), higher tumor size (p = .003), increasing stage (p < .0001), mastectomy (p = .0002), axillary node dissection (p = .005), positive nodal status (p = 0.0003), and chemotherapy (p < .0001). In multivariable analysis controlling for covariates that differed between PreBCS/PostBCS, only weight change between BC diagnosis and ET start was associated with > 2kg weight gain (p = 0.0005). Conclusions: In our sample, neither menopausal status nor type of ET was significantly associated with weight gain during ET. Our research suggests that BC survivors with higher risk tumors and associated treatments may experience higher weight gain during ET and warrant weight management counseling.
Network meta-analysis of adjuvant chemotherapy in early breast cancer.
Authors: John Preethi , Bannuru Raveendhara R , Cohen Joshua T. , Buchsbaum Rachel J. , Erban John Kalil 
Published: September 2018

e12071 Background: The NCCN recommends several adjuvant regimens for early stage breast cancer (ESBC) that have not been directly compared in randomized clinical trials (RCTs) making the optimal regimen unclear. Regimens of interest include dose dense doxorubicin/cyclophosphamide followed by paclitaxel (DDAC-T), doxorubicin/cyclophosphamide followed by weekly paclitaxel (ACwkT), docetaxel/doxorubicin/cyclophosphamide (TAC), and docetaxel/cyclophosphamide (TC) x 4 cycles. This is the first network meta-analysis (NMA) to compare the effectiveness of these regimens. Methods: A systematic literature review was performed to identify RCTs that included the above regimens. To complete the network, doxorubicin/cyclophosphamide (AC), doxorubicin/cyclophosphamide followed by paclitaxel (AC-T) every 3 wks, and doxorubicin/cyclophosphamide followed by docetaxel (AC-D) every 3 wks were included. Primary outcomes were progression free survival (PFS) and overall survival (OS) estimated as odds ratios (OR). OR > 1 indicates better survival. Bayesian random effects model with non-informative priors was used. Results: 5 RCTs involving 12,579 females with mainly node positive, Her2- ESBC were analyzed. Although there were no statistically significant differences in PFS or OS among these regimens, AC-D, ACwkT, DDAC-T, TAC, and TC demonstrated better survival outcomes compared to AC and AC-T (not shown). Survival outcomes among DDAC-T, ACwkT, TAC, and TC were comparable. DDAC-T survival outcomes were marginally better than the other regimens. Conclusions: DDAC-T, ACwkT, TC, and TAC were similar in efficacy. Final results with at least one additional RCT will be presented. Although NMA is not a substitute for direct comparison RCTs, it allows indirect comparisons to aid in decision making. Future results from ongoing RCTs will refine estimates of anthracycline vs non anthracycline efficacy and toxicity. [Table: see text]
Complementary medicine use during adjuvant radiotherapy of breast cancer.
Authors: Buecker Rebecca , Schafer Ulrich 
Published: September 2018

e12088 Background: Complementary medicine (CM) is used widely in cancer patients, mostly in palliative treatment regimes or during chemotherapy. In contrast, the use of CM during curative Radiotherapy (RT) is less frequent.The aim of this study was to evaluate the influence of CM with regard to toxicity and recurrence during postoperative radiotherapy for breast cancer. Methods: Between 2010 and 2013 all patients intended for adjuvant radiotherapy for breast cancer received a questionnaire concerning the use of CM e.g. Vitamins, trace elements, enzymes, natural herbs etc. (yes / no) and if yes what kinds. Radiotherapy was applied with 50.4 Gy to the whole breast and a Boost of 10.8 Gy in 6.5 weeks.6 weeks after radiotherapy the side effects were analyzed. Follow up for progression rates was done yearly. Results: A total number of 879 patients with breast cancer completed the questionnaire, 641 (73%) did not take any CM and 238 (27%) took CM. There were almost 40 different products mentioned and the most common were magnesium (n=71) and selenium (n=38). The RT side effects (Dermatitis RTOG grade 0, I, II, III/IV) 6 weeks after completion of RT were as follow: in the non CM group 53% grade 0, 41% grade I, and 6% grade II, 0% grade III/IV. And in the CM group 54%, 39%, 9%, and 0% respectively. The corresponding side effects for the group taking magnesium were 35% 42%, 6% and 1% and for the selenium group 47%, 47%, 5% and 0%. There was no significant difference in side effects between the non CM and CM patients, respectively magnesium and selenium group . The sum of all registered disease progression (0 years – 5 years) were in the non CM group 6.4%, in the CM group 6.3%, in the magnesium group 5.6% and in the selenium group 7.9%, no significant difference could be detected between all groups. Conclusions: In this cohort, 27 % of patients used CM during adjuvant radiotherapy of breast cancer. The most commonly product is magnesium followed by selenium. A measurable influence of CM on RT side effects or disease progression could not be identified.
Relationship between the pre-operative background enhancement coefficient under MRI of breast cancer and recurrence of postoperative chest wall.
Authors: Ren Ruimei , Lin Haimin , Zhao Tianshu 
Published: September 2018

e12091 Background: With the rapid development of MRI scanning technology , DCE-MRI in breast cancer has been one of the most sensitive examinations for the reason of allowing precise imaging, which can be helpful to demonstrate and evaluate the anatomical structures of breast cancer and its surrounding. What is more,through application of postprocessing technique of MRI,quantitative and half-qualitative data can be obtained for the diagnosis and the differential diagnosis of breast cancer. It is reported that the recurrence of breast cancer after breast conserving surgery is related with elevated BEC of MRI before operation as the result of the difficulty to find the micro-lesions and the margin of infiltrative lesions. Objective: Study on the relationship between the background enhancement coefficient of breast cancer under MRI before operation and recurrence of postoperative chest wall. Material and Methods: 194 cases of breast cancer patients undergoing radical surgery were retrospectively analyzed, all of which were confirmed by pathology and molecular classification.Before surgery all the patients did MRI and the BEC was measured.Aim for study on the relevance of the elevated BEC and chest wall recurrence,we investigate the relationship between the stage, grade,molecular subtype of breast cancer and the elevated BEC statistically. Results: The elevated BEC of the breast before operation is associated with chest wall recurrence after operation (P=0.045), and high expression of HER-2 (P=0.07). Multiple lesions of breast cancer and Ki-67>14% also appeared to be associated with the elevated BEC (P=0.08).While there seem to be no correlation between the size of tumor ,LN metastases, nuclear and pathological grade,molecular typing, PR expression,ER expression, status of the LN capsule and the elevated BEC. Conclusions: The elevated BEC of breast before operation is an independent prognostic factor for chest wall recurrence after operation.Given BEC get a potential to make a brand new biomarker for breast cancer,further relevant research is needed.
Areola sparing mastectomy without preservation of nipple: A clinicopathological assessment and a case series.
Authors: Yang Houpu , Wang Shu , Xie Fei , Guo Jiajia , Chen Xiaoyong , Yu Changjiang , Wang Chuan , Zhang Zhiqiong , Yu Xiaoxia 
Published: September 2018

e12099 Background: Preservation of the nipple-areolar complex has gained worldwide popularity due to significantly improved cosmetic result of mastectomy, while 4% to 58% involvement of nipple and assumed increased recurrence risk made it controversial on the oncological safety of nipple sparing mastectomy. This study focuses on the oncological feasibility of areola sparing mastectomy without preservation of nipple by evaluating involvement of the areola and nipple separately in consecutive mastectomy specimens. Methods: During Aug 3, 2016 to Jan 25, 2017, consecutive specimens from women underwent traditional mastectomy were analyzed. Areolae and nipples were resected and sectioned separately. Involvement of nipple and areola and clinicopathological data were analyzed. The results of 4 patients underwent areola sparing mastectomy were studied. Results: The overall frequency of malignant involvement of the areola among the breasts was 3 of 127 (2.3%), which was significantly lower than that of the nipple (11 of 127, 8.7%, p = 0.03). In patients whose tumors were ≤3cm, outside areolar area, and without dimpling of areola or inflammatory appearance, the incidence of areolar involvement was low to zero. A total of 4 patients received areola sparing mastectomy by “nipple coring” and immediate implant based reconstruction. No patients desired nipple reconstruction. Cosmetic results were all good. Conclusions: Areolae were rarely involved in breasts with tumor ≤3cm, and without inflammatory skin, dimpling of areola or retro-areolar tumor. Areola sparing mastectomy might be oncologically safe and should be a potential treatment in selected patients.
BRCAness and prognosis of triple-negative breast cancer patients treated with neoadjuvant chemotherapy.
Authors: Akashi-Tanaka Sadako , Tanino Yuichi , Yamamoto Yutaka , Nishimiya Hiroshi , Yamamoto-ibusuki Mutsuko , Iwase Hirotaka , Nakamura Seigo 
Published: September 2018

e12111 Background: Triple-negative breast cancers (TNBCs) consist of patients which are recalcitrant to chemotherapy. Dysfunction of BRCA, called “BRCAness” may be predictive of sensitivity to DNA repair inhibitors. However, adequate assay of “BRCAness” are still not confirmed. Multiplex ligation-dependent probe amplification (MLPA) with the Probemix P376-B2 BRCA1ness (MRC-Holland, The Netherlands) can be one method to determine BRCAness. We previously reported that “BRCAness” by MLPA predict resistance to taxane during neoadjuvant chemotherapy (NAC) and poor outcome. In the present study, we evaluated the clinical significance of BRCAness in a multicenter retrospective study. Methods: The data on 94 patients with TNBC treated with NAC were obtained from 3 hospitals in Japan. Most of them were treated by anthracyclines plus taxanes in 86 patients between 2005 and 2015. BRCAness was determined by core needle biopsy (CNB) specimens prior to NAC and surgical specimens. Genes from those specimens were amplified by MLPA, and the amplicons were scored. BRCA1-like type (BRCAness) was determined by tumors with greater than 0.5 Results: pCR (ypT0/Tis/N0) rate was 46%. Recurrence occurred in 22 patients, 11 of whom died from breast cancer. (1) BRCA1-like type accounted for 51 patients while the sporadic type in 43 patients in CNB specimens. No major differences in pCR rates and recurrence were observed between the BRCA1-like type and sporadic type (19/51 vs. 24/43), respectively. Patients with BRCA1-like tended to resist taxane than those with sporadic type when treated with taxane first. Among the 51 non-pCR patients, 19 were BRCA1-like type and 31 were sporadic type upon surgical specimens. Patients with a BRCA1-like tumors had more recurrences, than non-BRCA-1-like (13/19 vs. 9/31, respectively, P < 0.01). Conclusions: Tumors with BRCA-1 like tended to resist taxane than sporadic type when treated by taxane first. Anthracycline first might mask the progression during taxane regimen. Patients with BRCA1-like after NAC had more recurrences than those with sporadic type. Further study is needed to evaluate the significance of BRCAness.
A population model to predict progression free survival in breast cancer patients treated with neoadjuvant chemotherapy ñ vaccines based on tumour growth inhibition metrics.
Authors: P.Solans Belen , Salas Diego , Abengozar Marta , Pina Luis Javier , Elizalde Arlette , Cosgaya Maria Cruz Martinez , De La Cruz Susana , Salgado Pascual Esteban , Gil-Bazo Ignacio , Aramendia Jose Manuel , Troconiz Inaki F , Santisteban Marta 
Published: September 2018

e12114 Background: Breast cancer (BC) is the most commonly diagnosed malignancy in women. Neoadjuvant chemotherapy selects patients with optimal pathological responses and increases tumorectomy versus total mastectomy. Changes in tumor size (CTS) are related to an early clinical benefit and to Progression Free Survival (PFS) and Overall Survival (OS) in BC patients. Thus, the identification of new prognostic factors in the neoadjuvant scenario is crucial. Objectives:To assess the link between tumor growth inhibition metrics (TGI) and progression free survival (PFS) based on data obtained from BC patients with neoadjuvant therapy Methods: Data were obtained from 218 patients with BC treated at the University Clinic of Navarra, diagnosed from January 2008 to February 2016, with a median age of 49 years (range 25 to 84). Classification of molecular subtypes was based on IHC and found as follows: Her2 (6%), LA ( 23%), LB ( 36%), LB-Her2 (10%) and TN ( 25%). Patients were treated with ddECx 4 followed Docetaxel x 4. Her2 patients had therapy with Trastuzumab. 18% of the patients (LB and TN) received vaccination with dendritic cells. Data were analysed under the population approach with NONMEN 7.3. A model accounting for the dynamics of tumor growth and antitumor effect of the neoadjuvant therapy was developed. The model describes tumor size as the sum of the longest diameters of target lesions as a function of time and drug exposure. A PFS model was developed to describe the PFS time distribution as a function of covariates Results: The TGI was able to individually and accurately describe the tumor shrinkage. Vaccinated patients had an increased shrinkage rate of 36% (p < 0.001) than those who were not (p < 0.001). PFS (months) was best described by a Weibull model, and greater tumor size at diagnosis (p < 0.05), smaller CTS (p < 0.05) and TN subtype (p < 0.001) were identified as poor prognostic factors Conclusions: A PFS model that uses a model-based estimate of tumor growth to predict the PFS of BC patients receiving neoadjuvant therapy has been developed. This model helps to gain early understanding of potential clinical benefit to facilitate go/no-go decision making.
Genomic predictors of neoadjuvant chemotherapy (NACT) response in breast cancer (BC).
Authors: Wong Andrea Li Ann , Tan Kar Tong , Sundar Raghav , Ow Samuel , Pang Angela , Yap Hui-Ling , Chan Ching-Wan , Hartman Mikael , Iau Philip , Buhari Shaik Ahmad , Mogro Maria Jannet , Tan Iain BeeHuat , Wang Ling-Zhi , Yang Henry , Goh Boon C. , Lee Soo-Chin 
Published: September 2018

e12122 Background: We assessed effects of NACT on BC mutational landscape. Methods: Baseline (BL) and post-NACT tumor / matched normal DNA from 12 newly diagnosed BC patients on NACT (4 x doxorubicin/cyclophosphamide + low dose sunitinib; NCT01176799) were subject to whole exome sequencing. Nonsynonymous somatic single nucleotide variants from 34 genes in known BC signaling pathways were evaluated for changes in mutant variant allele frequency (VAF) according to clinical outcome. Poor outcome was defined as <50% target lesion reduction after NACT or BC relapse / progression (PD) within 2 years; significant change was defined as > 0.2 difference in BL vs post-NACT mutant VAF. Results: Mean tumor size was 6.4 + 2.9cm; 50% were N+; 8% were M1; 7/12 patients had poor outcomes. Tumors harbored mutations in PI3K (58%), NOTCH (42%), Wnt (42%), TP53 (33%) and FOXA (17%) pathways. Change in no. of somatic mutations post-NACT correlated with outcome (mean percent change +14% vs -30% in patients with poor vs good outcome, p=0.04). 11 patients had >1 of 23 putative driver mutations identified ( Table 1). Mutant VAF declined significantly in those with good outcomes, except for a new NOTCH2 mutation in A2 and rise in mutant VAF in A4. In patients with poor outcomes, mutant VAF persisted or rose, and emergent mutations (AKT1, PIK3CA) occurred in 2 patients. Conclusions: Chemoresistance and emergent mutations were revealed by tracking mutant VAF in BC patients on NACT. Clinical trial information: NCT01176799. [Table: see text]
Optical blood irradiation in improving the effectiveness of neoadjuvant polychemotherapy for breast cancer.
Authors: Sheiko Elena A. , Shikhlyarova Alla Ivanovna , Vashchenko Larisa Nikolaevna , Babieva Stella 
Published: September 2018

e12124 Background: Breast cancer (BC) incidence rates are increasing worldwide. Development of multicomponent programs, in particular polychemotherapy combined with technologies of quantum medicine, can help increase BC treatment effectiveness. The purpose of the study was to assess clinical efficacy of neoadjuvant polychemotherapy (PCT) modified with extracorporeal optical blood processing in BC. Methods: The study included 90 patients, mean age 48 years, with stage IIIB BC: nodular BC with secondary edema – 80 (88.8%) patients, edematous-infiltrative BC – 10 (11.2%) patients. Menstrual function was preserved in 20 (22.3%) patients; the other 70 (77.7%) women were menopausal. The control group (30 patients) received PCT with the total course doses of cytostatics: doxorubicin - 200 mg, 5-fluorouracil - 3000 mg, cyclophosphan - 100 mg, methotrexate - 100 mg. The main group (60 patients): 200 ml of blood from a peripheral vein was obtained into tubes with Glugicir, and then doxorubicin 50 mg/m2, methotrexate 25 mg/m2, 5-fluorouracil 750 mg/m2 and cyclophosphan 600 mg/m2 were added and incubated for 40 min at 37оC. The blood was continuously irradiated for 3 minutes using red light λ=0.67 µm, W=5 J/cm2. After that, the blood was transfused back to the patient intravenously. Each course included 3 procedures with a 3-day interval, and patients received 2-3 courses with a 3-week interval. Results: The assessment of neoadjuvant chemotherapy modified with extracorporeal optical blood processing showed increased rates of resectable BC by 2.8 times; an objective antitumor effect increased by 20%, and tumor growth rates reduced by 3.5 times. Conclusions: This technology can become an effective additional factor improving the effectiveness of anticancer therapy.
Phase II trial with letrozole as neoadjuvant treatment in postmenopausal and premenopausal patients with highly endocrine responsive operable breast cancer.
Authors: Cheng Min-Yi , Zhang Yi-Fang , Yang Ci-Qiu , Zhang Liu-Lu , Zhu Teng , Gao Hong-Fei , Chen Fu-Long , Xiong Qian-Qian , Zhang Yi , Wang Kun 
Published: September 2018

e12125 Background: Neoadjuvant endocrine therapy (NET)is effective in postmenopausal patients with breast cancers expressing oestrogen receptor. However, the therapeutic benefit of NET in premenopausal population is not fully characterized. We aimed to assess the efficacy and safety of endocrine therapy between the postmenopausal and premenopausal patients with highly endocrine responsiveoperable breast cancer for primary systemic therapy. Methods: Previously untreated patients with operable breast cancer and highly endocrine responsive breast cancer (ER/PR≥50% and Her2-) were recruited. Patients were assigned to receive letrozole 2.5mg daily (combined with triptorelin in premenopausal patients) for a period of at least 6 months. The primary end point of the study was the objective response rate (ORR) measured by breast ultrasound. Secondary end points included safety, pathologically complete response (pCR) rate, breast conservative surgery (BCS) rate. Results: Between September 2012 and December 2016, 41 patients were enrolled in the study (16 postmenopausal, 25 premenopausal ). The total ORR of this study was 73.2% (30 of 41). No significant differences were seen in the ORR, 76.0% (19 of 25 premenopausal patients) and 68.8% (11 of 16 postmenopausal patients) (P = 0.723). The pCR rate was 8% (2 of 25) for the premenopausal and 0%(0 of 16) for the postmenopausal (p=0.512). The BCS rate was 40% (10 of 25) for the premenopausal and 37.5%(6 of 16) for the postmenopausal (P = 0.873). No treatment-related grade 3/4 adverse events were recorded in both groups. Conclusions: Letrozole shows a high activity and excellent tolerability as neoadjuvant therapy in both postmenopausal and premenopausal patients with highly endocrine responsive operable breast cancer.