bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract P2-08-05: Association between the neutrophil-to-lymphocyte ratio (NLR) and the 21-gene recurrence score
Authors: Srikanthan A , Bedard PL , Goldstein S , Templeton A , Amir E 
Published: May 2016

Abstract
Introduction: A high neutrophil-to-lymphocyte ratio (NLR) has been reported to be a poor prognostic indicator in several malignancies including breast cancer. It is unknown whether the prognosis associated with high NLR can be explained by other prognostic factors such as proliferation or estrogen receptor signalling. Here we explore the association between NLR and the 21-gene recurrence score (RS).
Methods: The associations between RS, NLR, tumor size, histologic grade, and estrogen receptor (ER) and progesterone receptor (PgR) expression (assessed by immunohistochemistry) were explored in sequential women with early-stage, lymph node-negative (or with lymph node micrometastases), ER-positive and HER2-negative breast cancer treated at Princess Margaret Cancer Centre in Toronto, Canada and in whom results of the RS were available. NLR was measured prior to surgery. Patients with a documented history of pre-existing infectious/inflammatory condition were excluded. Associations were explored using simple linear regression and statistical significance was defined as p&lt;0.05.
Results: A total of 130 women diagnosed between January 2006 and April 2015 were included in the analysis. Median age was 55 (range 32-79), 87% were lymph node negative and 13% had nodal micrometastases. The median NLR was 2.2 (range 0.9-9.1) and was collected at a median of 12 days prior to surgery (range 0-60). The median RS was 18 (range 0-41). There was no association between RS and NLR (R=-0.10, p=0.31), grade (R=0.13, p=0.15), age (R=-0.05, p=0.58) or tumor size (R=0.06, p=0.48). RS was negatively associated with the magnitude of expression of both ER (R=-0.22, p=0.01) and PgR (R=-0.44, p&lt;0.001). There was no association between NLR and grade (R=0.20, p=0.15), age (R=-0.13, p=0.17), tumor size (R=0.14, p=0.93), ER (R=0.01, p=0.94) or PgR (R=0.13, p=0.23)
Conclusion: The poor outcomes associated with high NLR are unlikely explained by proliferation of estrogen receptor signalling.
Citation Format: Srikanthan A, Bedard PL, Goldstein S, Templeton A, Amir E. Association between the neutrophil-to-lymphocyte ratio (NLR) and the 21-gene recurrence score. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P2-08-05.
Abstract P2-08-14: Validation of gene expression profiling in prediction of locoregional recurrence for breast cancer patients after surgery
Authors: Cheng H-CS , Horng C-F , Huang T-T , Tsou M-H , Shih L-S , Yu B-L , Tsai Y-C , Chen C-M 
Published: May 2016

Abstract
Purpose
We have identified 34 genes of interest that can distinguish post-mastectomy cancer patients into high- and low-risk of locoregional recurrence (LRR) in 2006. In this study, we validate the performance of 18 of 34 genes in prediction of LRR after mastectomy and breast conserving surgery (BCS).
Materials and methods
A total of 124 breast cancer patients who underwent mastectomy from 2005 to 2012 and had DNA microarray study on the primary tumor tissues were chosen for this study. Eligible patients should have no post-mastectomy radiotherapy (PMRT) with a minimum of 2-year follow-up. Among the 34 genes in previous report, only 30 genes could be found in Affymetrix U95 to U133 Plus2.0 array. Eighteen of 30 genes (18-Gene classifier) were used to distinguish low-risk and high-risk patients. Patients with 18-Gene score 31 or more were defined as high-risk and score less than 31 defined as low-risk group. We then examined the performance of the 18-Gene classifier in breast conserving patients (n=87) who usually had adjuvant radiotherapy (94%) and were treated in the same study periods.
Results
The overall accuracy of the prediction of LRR is 87% (sensitivity 91% and specificity 87%). By the 18-Gene classifier, the 5-year LRR rate in high-risk group was 42%, and in low-risk group &lt;1% (p &lt; 0.0001).
LRR and 18-gene score in non-PMRT patients18-Gene scoreNo LRR #LRR #5-year LR control probabilityScore &lt;31971100%Score &gt;= 31151157.7% 11212 LRR: Locoregional recurrence
Multivariate analysis of mastectomy patients revealed that 18-Gene score is the independent prognostic factor that predicts the likelihood of LRR regardless of nodal status and breast cancer subtype. The predictive ability of LRR by the 18-Gene classifier in BCS patients is independent from adjuvant radiotherapy, and is consistent with the performance in mastectomy patients.
Multivariate analysis in BCS patientsRisk factorPatient #LRR #LRR rateUnivariate analysisMultivariate analysisLVI Absent/focal7345.5% Prominent14321.4%4.3(1.0,19.3)5.1*(1.1,23.1)18-Gene score Low risk6623.0% High risk21523.8%9.4*(1.8,48.4)10.4*(2.0,54.2)Adjuvant R/T No5240%10.3*(2.0,53.9) Yes8256.1% LVI: lymphovascular invasion; R/T: radiotherapy; *p&lt;0.05
Discussion
This 18-Gene classifier is capable of identifying high-risk patients of LRR after mastectomy and breast conserving surgery.
Citation Format: Cheng H-CS, Horng C-F, Huang T-T, Tsou M-H, Shih L-S, Yu B-L, Tsai Y-C, Chen C-M. Validation of gene expression profiling in prediction of locoregional recurrence for breast cancer patients after surgery. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P2-08-14.
Abstract P2-09-03: Breast cancer prevention: Is it time for population-based mutation screening of high risk genes?
Authors: Campbell IG , Trainer AH , Devereux L , Young M-A , Mitchell G , Rowley S , Li N , James PA , Thompson E 
Published: May 2016

Abstract
The traditional model of familial breast cancer practice involves ascertaining high-risk individuals based on family history. However, most individuals who carry a BRCA1 or BRCA2 mutation will not have a family history of breast or other cancer in a close relative. Moving germline testing from the familial cancer center to the population will result in many essentially unanticipated findings of great significance in regards to the risk of breast cancer in healthy relatives. To date there have been no large studies that have directly measured the frequency of BRCA1 and BRCA2 mutations in a cancer-free general population. As a first step toward population based BRCA1 or BRCA2 screening, we sequenced the entire coding region of these genes in 1,997 cancer-free Australian women recruited from the lifepool study (www.lifepool.org) which is a cohort of women attending the Australian population based mammographic screening program. Sequencing data were filtered for known pathogenic or novel loss of function mutations. Twelve individuals were identified with pathogenic mutations in either BRCA1 (4 mutations) or BRCA2 (8 mutations), which is consistent with previous indirect estimates for Caucasian populations but to our knowledge this is the largest direct assessment of their prevalence.
Interestingly, the self-reported cancer family history of the majority of the 12 mutation positive women was unremarkable. All 12 women subsequently accepted an invitation to attend a Familial Cancer Centre for advice on whether to proceed with formal clinical genetic testing.
A population carrier frequency of 0.6% for mutations in BRCA1 and BRCA2, coupled with the rapidly declining costs of gene panel sequencing, suggests that population-based screening for these genes will be a highly cost effective way of reducing the incidence of breast and ovarian cancer through preventative strategies.
Citation Format: Campbell IG, Trainer AH, Devereux L, Young M-A, Mitchell G, Rowley S, Li N, James PA, Thompson E. Breast cancer prevention: Is it time for population-based mutation screening of high risk genes?. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P2-09-03.
Abstract P2-09-06: Multi-gene panel testing for hereditary cancer risk
Authors: Yadav S , Ladkany R , Fulbright J , Dreyfuss H , Reeves A , Campian S , Thomas V , Zakalik D 
Published: May 2016

Abstract
Background: Multi-gene panels are widely available for assessing hereditary cancer risk in high risk individuals. Due to the use of these panels, many genetic mutations other than BRCA 1 or 2 can be detected which can potentially affect management. This study presents the results of multi-gene panel testing performed at Beaumont Health System.
Methods:All patients who underwent multi-gene panel testing at Beaumont Health System between November 1, 2012 and January 15, 2015 were included in this study. This cohort consisted of patients who met criteria for genetic testing due to personal or family history. All patients received comprehensive pre and post-test genetic counseling. The panels ranged from 5 to 43 genes associated with risk for breast and other cancers.
Results: 653 multi-gene panel tests were performed. The majority of these consisted of either a 5 gene high risk breast panel (25%), an 18 gene moderate to high risk breast panel (21%), or a 9 gene high risk breast and gynecologic panel (17%). 184 variants of undetermined significance (VUS) were identified with a pooled VUS rate of 28%. Among the commonly used panels, there was a positive correlation between VUS rate and the number of genes included in the panel (r = 0.86, p = 0.01, Range 6% to 70%). A pathogenic mutation was identified in one or more genes in 65 (10%) panels for a total of 67 mutations. Of these, 17 mutations were in BRCA1 or BRCA2 gene. Fifty non-BRCA deleterious mutations were identified with the following frequencies: CHEK2(12), MUTYH(7 monoallelic, 1 biallelic), TP53(4), PTEN(4), ATM(4), MSH6(3), PALB2(3), MSH2(2), CDH1(2), APC(2), NF1(2), BARD1(2), MLH1(1) and PMS2(1). Of these non-BRCA mutations, 41(82%) had a significant impact on management.
Conclusions: Our study demonstrates that multi-gene panel testing identifies several genes that can impact management and would likely not have been discovered by pedigree analysis alone. However, this added detection is associated with a higher VUS rate, especially using larger panels. Further research is needed to better define the role of multi-gene panel testing in high risk patients, with a focus on choosing appropriate genes, understanding the magnitude of cancer risk and delineating impact on management.
Citation Format: Yadav S, Ladkany R, Fulbright J, Dreyfuss H, Reeves A, Campian S, Thomas V, Zakalik D. Multi-gene panel testing for hereditary cancer risk. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P2-09-06.
Abstract P2-09-14: Surveillance program for women carrying BRCA1/BRCA2 genetic predisposition
Authors: Sidoni T , Cocciolone V , Cannita K , Di Giacomo D , Ciccozzi A , Bafile A , Pizzorno L , Resta V , Marsecano C , Ferrari F , Di Cesare E , Ficorella C , Ricevuto E 
Published: May 2016

Abstract
Between January 2003 and January 2015, women at genetic risk of developing breast and/or ovarian cancer were selected for a surveillance program. The monitoring strategy consisted of the association of breast ultrasound (US), every six months, and Rx-mammography (XM) and breast MRI (MRI) to be performed annually. To date, 29 women have been included in the surveillance program: BRCA1 mutation carriers, 18; BRCA2 mutation carriers, 11.
Eight women (28%) had already developed breast and/or ovarian cancer, while 21 (72%) were unaffected carriers.
At a median surveillance time of 33 months (range 0-144), 4 incidental breast cancers were diagnosed in 4 BRCA1/2 mutation carriers (4/29, 14%), 2 BRCA1+ and 2 BRCA2+; 3/21 (14%) unaffected carriers and 1/8 (13%) previously affected carriers. Two cancers (50%) were detected by all three diagnostic tools; 2 (50%) were identified only by US and MRI in patients aging 33 and 43, respectively.
Characteristics of patients with breast cancer diagnosed during surveillanceagemutated geneprevious cancerUSXMMRIhistologysurveillance time (months)33BRCA2-+-+ductal74+43BRCA2-+-+ductal40+45BRCA1-+++ductal60+40BRCA1yes+++ductal74+
One of these four patients, affected by breast cancer, died at 31 months of overall survival; three underwent surgery, chemotherapy and radiotherapy and are still disease free, in follow-up at 59, 28 and 26 months, respectively.
In conclusion, 29 BRCA1/2 carriers have been included in the surveillance program, the median age was 42.5 months (range 27-68) and the median surveillance time was 33 months (range 0-144). Our preliminary data confirm the 3% expected rate of diagnosed cancers and the effectiveness of performing the triple diagnostic surveillance with US, XM and MRI.
Citation Format: Sidoni T, Cocciolone V, Cannita K, Di Giacomo D, Ciccozzi A, Bafile A, Pizzorno L, Resta V, Marsecano C, Ferrari F, Di Cesare E, Ficorella C, Ricevuto E. Surveillance program for women carrying BRCA1/BRCA2 genetic predisposition. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P2-09-14.
Abstract P2-12-06: Prevention of seroma formation after mastectomy by local methylprednisolone injection - A randomized controlled clinical trial
Authors: Qvamme G , Axelsson CK , Lanng C , Wegeberg B , Mortensen MB , Okholm M , Arpi MR , Szecsi PB 
Published: May 2016

Abstract
Objective: To investigate the effect of local steroid administration on seroma formation until 14 days of dryness.
Background: Seroma formation, the most prevalent postoperative complication after mastectomy, is an inflammatory process that is potentially preventable via local steroid administration.
Methods: This double-blind, randomized, placebo-controlled intervention study included 212 women who were scheduled for mastectomy for primary breast cancer. The patients were classified according to the surgical axillary procedure: mastectomy with sentinel lymph node biopsy (M+SLNB) or mastectomy with level I-II axillary lymph node dissection (M+ALND). The participants received either 80 mg of methylprednisolone or saline intracavitary via the drain orifice upon drain removal.
Results: After M+SLNB, 46% (32 of 69) of the patients developed seromas in the steroid group vs. 78% (52 of 67) in the saline group (p&lt;0.0001). The mean cumulative seroma volume in the intention-to-treat material for the first 10 and 30 days was significantly lower in the steroid group than in the saline group (24 vs.127 mL and 177 vs. 328 mL, respectively) (p&lt;0.0001). After M+ALND, 94% of the patients developed seromas in both the steroid (35 of 37) and saline (34 of 36) groups, and steroid administration displayed no significant effect on seroma formation. Additionally, no difference in the infection rate was observed.
Conclusion: Methylprednisolone administered intracavitary on the first postoperative day after M+SLNB exerted a highly significant preventive effect against seroma formation during the first 30 days. Future studies may clarify whether higher or repeated steroid doses enhance these effects.
Citation Format: Qvamme G, Axelsson CK, Lanng C, Wegeberg B, Mortensen MB, Okholm M, Arpi MR, Szecsi PB. Prevention of seroma formation after mastectomy by local methylprednisolone injection - A randomized controlled clinical trial. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P2-12-06.
Abstract P2-12-07: Treatment of the breast in occult breast cancer: Results of a prospective Dutch national cohort study with 5 years follow up
Authors: de Maat M , Bretveld R , Steevens J , Vissers Y , Hulsewé K 
Published: May 2016

Abstract
Introduction
Occult breast cancer (cT0N+M0) is a rare diagnosis and there is insufficient evidence on which to base treatment of the ipsilateral breast.
Methods
From 2006 till 2008 the Dutch National Cancer Registry identified patients nationwide with possible occult breast cancer. These patients were diagnosed with axillary nodal metastases with no evidence of the primary tumor on physical examination, mammography and ultrasound. Data on histopathology, imaging diagnostics and treatment were collected. After a minimum of 5 years follow up, data on recurrence and survival were gathered and analyzed.
Results
A group of 71 patients with occult breast cancer was identified. Of these, 7 patients received no local therapy. The remaining 64 patients all underwent surgery with axillary lymph node dissection. Ninety-two percent had MRI of the breast. Three groups were formed: Group A (n=25) had surgery of the breast, group B (n=28) received breast irradiation and group C (n=11) consisted of patients who had no treatment of the breast. Recurrence in the ipsilateral breast was seen in 4 patients (14%) in group B and in 3 patients (30%) in group C. There was 1 local recurrence in group A after breast conserving treatment and no significant differences between groups. After a median of 85 months of follow-up, overall survival (72%, 82% and 82% for group A, B and C, respectively) and distant recurrence rates (12%, 11% and 10% for group A, B and C, respectively) were not significantly different between groups assessed by log-rank test.
Conclusion
In occult cT0N+M0 breast cancer, conservative treatment of the breast is an acceptable modality which results in similar distant recurrence and overall survival rates. Surgery and breast irradiation appear to reduce the risk of ipsilateral breast recurrence. This is the first prospective study that provides evidence in the current clinical setting to guide treatment for patients with occult breast cancer.
Citation Format: de Maat M, Bretveld R, Steevens J, Vissers Y, Hulsewé K. Treatment of the breast in occult breast cancer: Results of a prospective Dutch national cohort study with 5 years follow up. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P2-12-07.
Abstract P2-12-11: Does postmastectomy radiotherapy improve survival in patients with 1-3 positive axillary lymph nodes? A systematic review and meta-analysis of the current literature
Authors: Kasem A , Headon H , Mokbel K 
Published: May 2016

Abstract
In breast cancer with more than four positive axillary lymph nodes, it is common practice to deliver radiotherapy to the affected site following a mastectomy. However, less is known about the benefit s this might offer in women with 1-3 positive lymph nodes. In order to assess whether postmastectomy radiotherapy has any benefit in these women, a meta-analysis was performed to assess whether postmastectomy radiotherapy improved overall survival or reduced locoregional recurrence in this group of women. It was found that postmastectomy radiotherapy significantly reduced the risk of locoregional recurrence, with a relative risk ratio of 0.3 (95% confidence interval 0.23-0.38), and resulted in a small benefit in overall survival, with a relative risk ratio of 1.03 (95% confidence interval 1.00-1.07). Therefore, in women with 1-3 positive lymph nodes, postmastectomy radiotherapy reduces the risk of locoregional recurrence and is associated with a small benefit in overall survival, so should be recommended within this group after careful multidisciplinary discussion.
Citation Format: Kasem A, Headon H, Mokbel K. Does postmastectomy radiotherapy improve survival in patients with 1-3 positive axillary lymph nodes? A systematic review and meta-analysis of the current literature. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P2-12-11.
Abstract P2-12-13: Modified pectoral nerves block for postoperative analgesia after modified radical mastectomy: A comparative study
Authors: Kanitkar R , Mane A , Agashe A , Kulkarni M , Deshmukh S 
Published: May 2016

Abstract
Background: The modified pectoral nerves block (Pecs II) as a method of analgesia for breast cancer surgery has shown excellent results in recent publications. This technique blocks the long thoracic nerve, thoracic intercostal nerves from T2-T6 & thoracodorsal nerve.
Aims: To evaluate the effectiveness of the Pecs II block for pain relief in the postoperative period of patients undergoing modified radical mastectomy (MRM).
Methods: A prospective comparative study was conducted at our instituition between November 2014 and March 2015. Patients scheduled to undergo MRM were randomly assigned to the test group (endotracheal anaesthesia along with Pecs II) and the control group (endotracheal anaesthesia only). In the postoperative period the patients were evaluated using a visual analogue scale to determine pain scores at 6, 12 & 24 hours.
Results: Fifty patients (25 in each group), between the ages of 24 to 76 years (54.76 ± 10) were included in the study. There was no significant difference in ages between test & control groups. In the postoperative period, the test group had significantly lower median pain scores at 6, 12 & 24 hours as compared to the control group.
Table 1: Comparative analysis for Pecs II block TestControlp valueeffect size (r)Average age (years)54.44 ± 10.7855.08 ± 9.370.824-Median postoperative pain scores 6 hours2 (1)6 (2)&lt;0.001*- 0.8312 hours3 (1)5 (2)&lt;0.001*- 0.6224 hours3 (1)0.034*- 0.30* statistically significant
Conclusion: The modified pectoral nerves block (Pecs II) is a novel & effective technique for postoperative analgesia in patients undergoing modified radical mastectomy.
Citation Format: Kanitkar R, Mane A, Agashe A, Kulkarni M, Deshmukh S. Modified pectoral nerves block for postoperative analgesia after modified radical mastectomy: A comparative study. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P2-12-13.