bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract P2-14-23: Successful intraoperative margin assessment in DCIS and invasive breast cancer with diffuison-weighted MRI using the Clearsight™ system
Authors: Thill M , Kelling K , van Haasteren V , Traub L , Nölke J , Szwarcfiter I , Shapiro M , Schon A , Aulmann S 
Published: May 2019

Abstract
Aim
Aim of our study is to evaluate the performance of the ClearSight™ system (ClearCut Medical, Ltd.) in assessing surgical margins for DCIS and IBC in breast conserving surgery
Material and Methods
The ClearSight™ system utilizes a diffusion-weighted-imaging (DWI) protocol to create 2D surface maps showing T2*, a MR parameter related to the tissue's apparent diffusion coefficient (ADC), with a depth penetration of 1.5mm. ADC is a highly accurate differentiator for irregular versus normal tissue.
From November 2017 a prospective, blinded post marketing study (N=63), evaluating the performance of the ClearSight™ system has been conducted in the Breast Centre at the Agaplesion Markus Krankenhaus, Frankfurt, Germany. After standard evaluation with ultrasound and/or X-ray, the specimens were scanned with the ClearSight™ system, and results were compared with the final histopathology results on a margin per margin bases, applying a simple T2* threshold to flag irregular tissue.
Results
Breast specimens' margins from 60 patients were analyzed. Pursuant to the breast conserving surgery (BCS), 348 margins were scanned by the ClearSight™ system. A rigid T2* threshold comparison with the pathology findings resulted in a sensitivity of 80% and specificity of 84%. Accuracy for invasive and in-situ cancers was found to be similar for tissues scanned within one hour after excision. After that sensitivity for DCIS started to drop and was found to be 56% after 2 hours. Further accuracy improvements can be achieved if the reading physician is free to apply an intuitive diffusion map interpretation rather than adhere to a fixed threshold.
Conclusion
The data suggest that ClearSightTM can reduce excision rates by a robust 80% if the excised breast tissue is scanned within one hour. Tissue drying impacts sensitivity for DCIS negatively. Free map interpretation leads to better results than a fixed threshold.
Citation Format: Thill M, Kelling K, van Haasteren V, Traub L, Nölke J, Szwarcfiter I, Shapiro M, Schon A, Aulmann S. Successful intraoperative margin assessment in DCIS and invasive breast cancer with diffuison-weighted MRI using the Clearsight™ system [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P2-14-23.
Abstract P2-14-26: Withdrawn
Authors: Meybodi F , Sedaghat N , French J , Elder E 
Published: May 2019

Abstract
This abstract was withdrawn by the authors.
Citation Format: Meybodi F, Sedaghat N, French J, Elder E. Withdrawn [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P2-14-26.
Abstract P2-14-28: Local surgery improves survival in patients with primary metastatic breast cancer: A population-based study
Authors: Zhao Y , Sun H , Yang X , Zhao Y , Chen M , Jin W 
Published: May 2019

Abstract
Background
The aim of this study was to assess the prognosis of breast cancer patients with distant metastasis after surgery of the primary tumor and provide new understanding of treatment for these patients.
Methods
We retrospectively analyzed 8922 primary metastatic breast cancer (PMBC) patients from Surveillance, Epidemiology, and End Results (SEER) Database. The patients' clinical and pathological characteristics were investigated. Overall survival (OS) and breast cancer-specific survival (BCSS) were calculated by Kaplan-Meier method. Independent risk factors associated with disease special mortality were identified by Cox regression analysis.
Results
A total of 8922 PMBC patients from SEER database were identified, while 1724 (19.3%) of them received surgery therapy (ST) and 7198 (80.1%) patients were identified as no surgery therapy group (NST). Patients' underwent ST had dramatically increased OS (P&lt;0.001) and BCSS (P&lt;0.001) compared with those in NST group. And the result figured out that the patients with 1 or 2 distant metastatic sites might benefit most from local surgery, while the prognosis of patients with 3 or more showed no significant difference (p= 0.073 for OS, p= 0.091 for BCSS).
Furthermore, no differences were found in the survival rates between different surgical procedure groups (p= 0.886 for OS, p= 0.943 for BCSS). PMBC patients with ST tented to have increased OS (hazard ratio [HR] = 0.642; 95% confidence interval [CI], 0.583-0.707, p &lt; 0.001) and BCSS (HR = 0.649; 95% CI, 0.587-0.718, p &lt; 0.001), while age, grade, T stage, breast subtype, radiation, the number of metastatic site were also independent prognostic factors.
Conclusions
The current study demonstrated the survival benefit of ST in PMBC patients, especially those has 1 or 2 distant metastatic sites. Enlarged surgical range could not prolong survival. However, a large randomized clinical trial to validate the efficacy of ST in PMBC is essential in the future.
Key words: primary metastatic breast cancer; SEER Database; survival; surgery
Citation Format: Zhao Y, Sun H, Yang X, Zhao Y, Chen M, Jin W. Local surgery improves survival in patients with primary metastatic breast cancer: A population-based study [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P2-14-28.
Abstract P3-01-05: Circulating tumor cell detection predicts early recurrence in patients with non-metastatic breast cancer
Authors: Hall C , Meas S , Bowman Bauldry J , Kuerer H , Lucci A 
Published: May 2019

Abstract
Background:
Our group and others have shown that CTCs are identified in 20-25% of non-metastatic breast cancer patients. Recent data suggests that circulating tumor cell (CTC) detection at 5 years follow-up predicts late recurrence for non-metastatic, estrogen receptor positive, HER2/neu negative (ER+/HER2-) breast cancer patients. The aim of this study was to determine if CTC detection at time of surgery in ER+/HER2- predicts early (less than or equal to 5 years) recurrence, and to compare the median recurrence-free survival (RFS) to triple negative (TN) patients.
Methods:
We performed CTC enumeration on 506 patients with non-metastatic breast cancer just prior to surgical resection as part of an IRB approved study. CTCs (per 7.5 ml blood) were identified using the Cell SearchSystem (Menarini Silicon Biosystems). The presence of one or more CTC meeting morphological criteria for malignancy was considered a positive result. Patients with inflammatory breast cancer were excluded from our analysis. Log-rank test and Cox regression analysis were applied to establish the association of CTCs with RFS.
Results:
Median follow-up was 68 months and mean age was 53 years. Eighty-four percent of patients (417/498) had T1/T2 tumors, 63% (307/487) had grade 1 or 2 tumors, and 58% (292/501) had negative lymph nodes. Eighty-three percent (419/506) had ER+/HER2- tumors, and 17% (87/506) were TN. One or more CTC was identified in 22% (91/419) ER+/HER2- patients, and in 28% (24/87) of TN patients. Nine percent (45/506) of patients recurred within 5 years of CTC assessment. Of the 45 patients who relapsed, detection of one or more CTCs predicted shortened RFS. Median RFS for CTC-positive patients was 1.2 years, vs. 2.5 years for CTC-negative patients, irrespective of ER+/HER2- or TN subtype (log-rank P&lt;0.001, HR = 2.71, 95% CI, 1.50 to 4.87).
Conclusions: One or more CTCs identified at surgical resection predicted shortened RFS, irrespective of subtype, in non-metastatic breast cancer patients. This data warrants larger studies to determine if CTC positivity can be used to stratify both ER+ and TN patients who are at increased risk for early recurrence.
Citation Format: Hall C, Meas S, Bowman Bauldry J, Kuerer H, Lucci A. Circulating tumor cell detection predicts early recurrence in patients with non-metastatic breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-01-05.
Abstract P3-01-14: Diverse inter- and intra-patient circulating tumor cells (CTCs) phenotypic heterogeneity identified in metastatic breast cancer (MBC) cohort
Authors: Wang Y , Hom B , Ontiveros P , Landaverde C , Roth E , Levin MK , Hippely S , Landers M , Dittamore R , O'Shaughnessy JA 
Published: May 2019

Abstract
Background: There is unmet need for biomarkers to guide the treatment selection in MBC. We described phenotypic CTC heterogeneity in metastatic castrate resistant prostate cancer(mCRPC), and showed that pts with CTC high heterogeneity have improved OS with chemotherapy, while with pts low CTC heterogeneity pts have longer OS with AR inhibitors (Scher et al. 2017 Cancer Research). Here, the same methodology was applied to evaluate the feasibility of CTC heterogeneity analysis in MBC pts.
Material and methods: 92 blood samples from MBC pts were processed for HER2 CTC analysis utilizing the Epic Sciences platform. Following enumeration, multi-dimensional phenotypic characterization analysis was performed utilizing protein expression and digital pathology features. 20 features from each CTC were clustered using unsupervised approach (K-means) and the optimal number of clusters was determined using the elbow method with greater than 85% of variance taken into account. Shannon Index was used to score intra-patient CTC heterogeneity.
Results: CTCs were detected in 77.2% (71/92) of the MBC pts. 1501 CTCs from 60 pts were clustered into phenotypic subtypes which are distinctively different in nuclear size, circularity, CK and HER2 intensity etc. HER2 expression was enriched in cell types that had higher CK intensity and was more circular morphologies often associated with replicative stress. A wide range of CTC phenotypic heterogeneity was observed across pts, Shannon Index scores from 0 (low heterogeneity) to 1.67 (high heterogeneity) with a median of 0.60. CTC heterogeneity was independent of CTC counts, some low count pts had heterogeneous CTC subtypes while some high count pts had homogeneous CTC subtypes.
Conclusions: Diverse inter- and intra-patient phenotypic CTC heterogeneity were observed in this MBC cohort, consistent with that seen in mCRPC and other MBC cohorts (Beverly H et al, ASCO 2018). Studies linking degree and patterns of CTC heterogeneity to therapeutic outcomes are ongoing.
Citation Format: Wang Y, Hom B, Ontiveros P, Landaverde C, Roth E, Levin MK, Hippely S, Landers M, Dittamore R, O'Shaughnessy JA. Diverse inter- and intra-patient circulating tumor cells (CTCs) phenotypic heterogeneity identified in metastatic breast cancer (MBC) cohort [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-01-14.
Abstract P3-01-17: PD-L1 expression on circulating epithelial tumor cells (CETCs) correlates with aggressiveness of tumor in breast cancer patients
Authors: Schott D , Pizon M , Pachmann U , Pachmann K 
Published: May 2019

Abstract
Background: Strategies to improve the efficacy of the immune system against malignant tumors represent a major innovation focusing on the programmed death-1 receptor (PD-1), with its two ligands PD-L1 and PD-L2. The expression of PD-L1 has been evaluated in a number of different tumor types and can be used as a predictive biomarker for PD-1/PD-L1 checkpoint inhibitor treatment response. We used a non-invasive, real-time liquid biopsy to better characterize PD-L1 expression on circulating epithelial tumor cells (CETCs) in breast cancer patients.
Methods: CETCs were determined from blood of 72 patients suffering from breast cancer. The number of vital CETCs and their expression of PD-L1 was investigated using the maintrac® method.
Results: PD-L1 expressing CETCs were detected in 94.5 % of breast cancer patients. Breast cancer patients with metastatic disease had significantly more PD-L1 positive CETCs as compared to patients without metastasis (median 75% vs. 61.1%; p&lt;0.05). Furthermore, patients with positive lymph node status had significantly more PD-L1 positive CETCs as compared to patients with negative lymph nodes (median 60% vs. 93%, p&lt;0,05). Moreover, we observed a significant heterogeneity in PD-L1 immunostaining intensity across CETCs from the same patients.
Conclusion: Breast cancer patients have detectable CETCs with a high frequency of PD-L1 which correlates with progression of cancer disease. PD-L1 seems to be a major factor in immune evasion and may be a promising target of anticancer therapies. Monitoring the frequency of PD-L1 positive CETCs could reflect individual patient's response to an anti-PD-1/PD-L1 therapy.
Citation Format: Schott D, Pizon M, Pachmann U, Pachmann K. PD-L1 expression on circulating epithelial tumor cells (CETCs) correlates with aggressiveness of tumor in breast cancer patients [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-01-17.
Abstract P3-03-03: Sentinel node biopsy (SNB) vs Low axillary sampling (LAS) in predicting nodal status of post-chemotherapy axilla in women with breast cancer
Authors: Parmar V , Nair NS , Vanamali V , Hawaldar RW , Siddique S , Shet T , Desai SB , Rangarajan V , Patil A , Gupta S , Badwe RA 
Published: May 2019

Abstract
Introduction
There is no safe method of avoiding complete axillary lymph node dissection in women with breast cancer after neo-adjuvant chemotherapy. sentinel node biopsy (SNB) has had prohibitively high false negative rate. We tested low axillary sampling (LAS) and SNB performed in same patient to predict axillary lymph node status in clinically node negative women undergoing breast conservation or modified radical mastectomy after neo-adjuvant chemotherapy.
Methodology
Post neo-adjuvant chemotherapy 751 women who had no palpable axillary lymph node underwent LAS (all lymph nodes below intercosto-brachial nerve). Of these 751 women, 730 also underwent SNB by dual technique after injection of blue dye as well as radio-isotope. SN was identified within and outside axillary sampling specimen. SN as well as LAS specimens were distinctly examined for nodal metastasis. The rest of the axillary dissection was completed in all patients. Post NACT 292/751(38.9%) had residual positive lymph nodes on pathology. The identification rate, false negative rate (FNR), and negative predictive value (NPV) of SNB and LAS were compared for predicting negative axillary lymph node status.
Results
The median clinical tumor size was 5cm (1-15cm) and 533(71%) patients were N1 or N2 at presentation. The SNB identification rate was 87.1% (636 of 730), with a median of 5 nodes and node positive in 238 of 636 (37.4%). LAS identification rate was 98% (736 of 751), with a median of 7 nodes and node positive in 292 of 736 (39.6%). In all but one case, the SN was found within the LAS specimen. The FNR of SNB (blue, hot and adjacent palpable nodes) was 19.7% (47 of 238, one sided 95% upper CI 24.0) compared to LAS with FNR of 9.9% (29 of 292, one-sided 95% upper CI 12.8) (p&lt;0.001). Comparative NPV for SNB and LAS were 89.4% and 93.9% respectively. If SNB was confined to blue/hot node excluding adjacent palpable nodes, FNR was 31.6% (74 of 234, 95% upper CI 36.6).
Conclusions
LAS is superior to SNB in identification rate, FNR and NPV in predicting node negative axilla post-neoadjuvant chemotherapy. LAS can be safely used to predict negative axilla with less than 10% chance of leaving residual disease.
Citation Format: Parmar V, Nair NS, Vanamali V, Hawaldar RW, Siddique S, Shet T, Desai SB, Rangarajan V, Patil A, Gupta S, Badwe RA. Sentinel node biopsy (SNB) vs Low axillary sampling (LAS) in predicting nodal status of post-chemotherapy axilla in women with breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-03-03.
Abstract P3-03-04: Withdrawn
Authors: Wu S , Wang Y , Li J , Zhang N , Liu G 
Published: May 2019

Abstract
This abstract was withdrawn by the authors.
Citation Format: Wu S, Wang Y, Li J, Zhang N, Liu G. Withdrawn [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-03-04.
Abstract P3-03-10: Pre-operative lymphoscintigraphy for sentinel lymph node localisation: Is it necessary?
Authors: Clark SL , Yilmaz D , Arun K , Javadzadeh S , Saeed S , Ullah MZ 
Published: May 2019

Abstract
Introduction
Sentinel lymph node biopsy (SLNB) has replaced lymph node clearance for staging of the axilla in patients with early invasive breast cancer and no evidence of lymph node involvement on ultrasound or needle biopsy. It is recommended that a dual technique, using isotope and blue dye, is used to locate the sentinel lymph node (SLN) intra-operatively. Often, at the time of radioisotope injection, a lymphoscintigram (nuclear medicine scan) is obtained to demonstrate the 'hot' sentinel lymph node with or without skin marking of its anatomical position.
Performing a lymphoscintigram adds time and cost to the localisation process. In our centre, this investigation costs £899-999 (˜US $1180-1300).
Aims
The aim of this study is to find out whether obtaining a pre-operative lymphoscintigram aids the surgeon in the localisation of the SLN or affects the number of sentinel lymph nodes biopsied in the axillary staging of patients with early invasive breast cancer.
Methods
We carried out a retrospective study of patients who underwent SLNB for breast cancer in our hospital Trust between March 2012 and November 2017. We identified those patients who had a lymphoscintigram performed pre-operatively for SLN localisation. We recorded the number of SLNs identified on imaging and compared this with the number of SLNs biopsied during the operation.
Results
349 patients underwent 354 SLNBs during the study period. One patient was male, the remainders were female. The mean age of patients was 57.2 years (range 25 to 98 years).
In 295 (83.3%) cases, a lymphoscintigram was obtained prior to SLNB for node localisation, and 268 (90.8%) of these scans were able to identify one or more SLNs. In 173 (58.6%) scans, a single SLN was identified. In 27 (9.1%) scans it was either unclear how many SLNs were demonstrated or no SLNs were seen (16/295 no SLN identified, 11/295 unclear how many SLNs).
In 102 (34.6%) cases, the number of SLNs biopsied matched the number of SLNs identified on imaging. Of those that did not match, 76.2% had more and 15.0% fewer SLNs excised than shown on imaging. In 8.8% it was unknown if the number of SLNs matched that seen on imaging due to lack of histopathology results.
Conclusion
Lymphoscintigraphy for SLN localisation is costly and time consuming. In a high proportion of cases, number of SLNs identified on imaging does not match the number biopsied and thus, we suggest, that it is not required prior to SLNB and should be removed from practice.
Citation Format: Clark SL, Yilmaz D, Arun K, Javadzadeh S, Saeed S, Ullah MZ. Pre-operative lymphoscintigraphy for sentinel lymph node localisation: Is it necessary? [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-03-10.
Abstract P3-03-28: Withdrawn
Authors: Yoo T-K , Chae BJ , Ahn JY , Ryu J , Eom YH , Park WC , Song BJ 
Published: May 2019

Abstract
This abstract was withdrawn by the authors.
Citation Format: Yoo T-K, Chae BJ, Ahn JY, Ryu J, Eom YH, Park WC, Song BJ. Withdrawn [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-03-28.
Abstract P3-03-29: Evaluation of a direct reverse transcription loop-mediated isothermal amplification method without RNA extraction (direct RT-LAMP) for the detection of lymph node metastasis in early breast cancer
Authors: Lee IH , Jung J , Lee S , Lee J , Lee RK , Park H , Jung J , Kang J , Chae Y 
Published: May 2019

Abstract
Backgroud: The detection of lymph node metastasis by reverse transcription loop-mediated isothermal amplification method (RT-LAMP) had been studied previously. Even though, RT-LAMP method provides improved performance compared to intraoperative histology sentinel lymph node (SLN) evaluation, direct RT-LAMP method without RNA extraction can be more efficient and easily accessible process. Therefore, we evaluated the performance and efficacy of a direct reverse transcription loop-mediated isothermal amplification (direct RT-LAMP) assay for visual detection of CK19, CK20, and CEA mRNAs to identify lymph node metastasis in patients with early breast cancer.
Methods: A total of 92 lymph nodes dissected from 40 patients with breast cancer were collected at the breast cancer center of Kyungpook National University Chilgok Hospital between November 2015 and February 2016. All of the samples were analyzed by direct RT-LAMP assay and routine histopathology examination. Cutoff values to distinguish metastasis and nonmetasis were determined by measuring cytokerain 19 (CK19) mRNA in histopathologically positive and negative lymph node using direct RT-LAMP.
Results: We set the cutoff value of direct RT-LAMP assay for CK 19 mRNA at 1ng to distinguish status of LN metastasis. The sensitivity and specificity of the RT-LAMP assay were 85.7% and 100%, respectively. The positive predictive value and negative predictive value were 100% and 94.4%.
Conclusion: Direct RT-LAMP assay can allow detection of SLN metastasis in breast cancer patients intraoperatively with a good sensitivity through cost-effective and time–saving manner.
Citation Format: Lee IH, Jung J, Lee S, Lee J, Lee RK, Park H, Jung J, Kang J, Chae Y. Evaluation of a direct reverse transcription loop-mediated isothermal amplification method without RNA extraction (direct RT-LAMP) for the detection of lymph node metastasis in early breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-03-29.
Abstract P3-03-33: Withdrawn
Authors: Blackhall VI , Bugelli M , Abbott NA , Mullen R 
Published: May 2019

Abstract
This abstract was withdrawn by the authors.
Citation Format: Blackhall VI, Bugelli M, Abbott NA, Mullen R. Withdrawn [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-03-33.