bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract P2-13-01: An innovative risk-reducing approach to post-mastectomy radiation delivery following autologous breast reconstruction
Authors: Piper ML , Evangelista M , Amara D , Daar DA , Foster RD , Fowble B , Sbitany H 
Published: May 2016

Abstract
Introduction:
There is no consensus among radiation oncologists regarding delivery of post-mastectomy radiation therapy (PMRT) after immediate autologous breast reconstruction, and plastic surgeons rarely participate in this decision-making process. However, radiation-induced changes markedly influence flap outcomes and affect the flap permanently. We present an innovative approach for PMRT delivery, through the use of custom bolus. This technique provides individualized, targeted PMRT to the reconstructed breast to minimize flap-related complications.
Methods:
All patients who underwent mastectomy with immediate autologous reconstruction between 2005 and 2014 at our institution were identified. Radiation was delivered to the reconstructed autologous breast in 29 patients. Post-irradiation complications and reconstruction outcomes were compared for patients treated with custom bolus, standard PMRT, and historical controls.
Results:
Over the past 10 years, 157 patients (226 breasts) underwent immediate autologous tissue breast reconstruction following mastectomy. Of the 29 patients who received PMRT, 10 were treated with custom bolus. The custom bolus uses perforated Aquaplast and a nearly tissue-equivalent wax to form a cast which conforms to the irregular contours of the chest wall, allowing for easy application through the duration of treatment. Pre-irradiation computed tomography was used to optimize dose distribution, evaluate the internal mammary vessels, and target the deeper tissues adjacent to the chest wall (minimizing dose inhomogeneity to the skin). Custom bolus resulted in fewer radiation-induced skin changes and less skin tethering/fibrosis than standard bolus (0% vs 10% and 20% vs 35%, respectively), and less volume loss and contour deformities compared with historical controls (10% vs 22.8% and 10% vs 30.7%, respectively).
Conclusion:
The use of custom bolus tailors radiation delivery to the internal mammary vessels, anastomoses, and skin; uniformly doses the surgical incision; and provides the necessary radiation dose to prevent recurrence, thus not compromising oncologic safety. It is easily fabricated, cost-effective and placement is straightforward and reproducible. Because radiation has negative effects on autologous breast reconstruction and often results in vascular intimal fibrosis and fat necrosis, plastic surgeons should participate in radiation planning. Our custom bolus PMRT technique reduces the incidence of these radiation effects.
Citation Format: Piper ML, Evangelista M, Amara D, Daar DA, Foster RD, Fowble B, Sbitany H. An innovative risk-reducing approach to post-mastectomy radiation delivery following autologous breast reconstruction. [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 P2-13-01.
Abstract P3-01-03: Optimal concentration of indocyanine green in near-infrared fluorescence guided sentinel lymph node biopsy in breast cancer
Authors: Paik H-J , Yi HW , Park S , Ryu JM , Nam SJ , Lee JE , Kil WH , Lee SK , Bae SY , Kim SW 
Published: May 2016

Abstract
Background: Near-infrared (NIR) fluorescence-guided sentinel lymph node biopsy (SLNB) using indocyanine green (ICG) has been successfully applied in various kinds of cancers, especially in breast cancer. Optimizing the concentration of ICG without using human serum albumin in natural lymphatic system is still required.
Methods: 25mg of ICG was diluted with distilled water (DW) or normal saline (NS). Dilution concentrations used for measurement were 0.25μg/mL, 0.5μg/mL, 2.5μg/mL, 5.0μg/mL, 25μg/mL, and 250μg/mL. The brightness of fluorescence was measured by an image system called Visual Navigator (SH System, Korea). We used graphic software (GIMP, version 2.8.14, The GIMP Team) to measure the brightness. We assumed that drained serous lymphatics from a breast cancer patient can reflect a natural lymphatic condition injected with ICG in the operation field. Drained lymphatics were mixed to reduce the concentration of ICG by half that was diluted with DW or NS. We also measured the brightness of fluorescence diluted with DW or NS that was mixed with drained lymphatics. After this screening test, we subdivided the range which brightness was measured as 100 and adjusted the intensity of illumination for more specific results.
Results: Highest brightness values were measured as 100 between 2.5μg/mL and 25μg/mL concentration of ICG with DW dilution in screening settings, and the values of brightness were measured as 100 between 2.5μg/mL and 5.0μg/mL concentration of ICG with NS dilution. When drained lymphatics were mixed together, the values of brightness were measured as 100 between 2.5μg/mL and 25μg/mL concentration of ICG with DW or NS dilution. After subdividing the ICG concentration to 2.5μg/mL, 3.13μg/mL, 5.0μg/mL, 6.25μg/mL, 12.5μg/mL and 25μg/mL with adjusting the intensity of illumination, the highest brightness value was measured as 76 in 5.0μg/mL concentration of ICG with DW dilution. When diluting with NS, the highest brightness value was measured as 61 in 5.0μg/mL ICG concentration. After mixing with drained lymphatics, the highest brightness value was both 79 in 5.0μg/mL concentration of ICG with DW and NS dilution.
Conclusions: This study showed a practically optimal ICG concentration range in fluorescence guided SLNB. The optimal range of ICG concentration is from 3.13μg/mL to 6.25μg/mL with DW or NS dilution. Although 5.0μg/mL met the best result, adjustment for individual settings may be considered.
Citation Format: Paik H-J, Yi HW, Park S, Ryu JM, Nam SJ, Lee JE, Kil WH, Lee SK, Bae SY, Kim SW. Optimal concentration of indocyanine green in near-infrared fluorescence guided sentinel lymph node biopsy in breast cancer. [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 P3-01-03.
Abstract P3-01-08: Sentinel lymph node biopsy alone after neoadjuvant chemotherapy in patients with cytologically proven node-positive breast cancer
Authors: Park S , Ryu JM , Paik H-J , Yi HW , Bae SY , Lee SK , Kil WH , Kim SW , Lee JE , Nam SJ 
Published: May 2016

Abstract
Background
The purpose of this study was to identify the feasibility and accuracy of sentinel lymph node biopsy (SLNB) after neoadjuvant chemotherapy (NAC) in patients with axillary lymph node (ALN) metastasis at diagnosis.
Methods
This is a retrospective study of 332 patients who were diagnosed with invasive breast cancer and ALN metastasis and treated with NAC followed by curative surgery at Samsung Medical Center between January 2007 and December 2013. Patients were classified into five groups according to surgical procedure for the ALNs and pathologic results; group 1, patients with negative SLN status and no further dissection was performed; group 2, patients with negative SLN status undergoing further axillary lymph node dissection (ALND); group 3, patients with positive or undetected SLNs undergoing further ALND; group 4, patients without residual axillary metastasis undergoing complete ALND; and group 5, patients with pathologic nodal positive disease undergoing ALND.
Results
Sentinel lymph nodes identification rate after NAC was 99.1% and false negative rate was 24.1%. The median number of retrieved SLNs was 4 (range, 1–10). There was no difference in the overall survival among the groups (p=0.06). There was no significant difference in the disease-free survival rate between the SLNB only and complete ALN dissection groups who revealed a pathologic complete node response (79.6% versus 80.5%) and the rate of axillary recurrence demonstrated no significant differences among the groups. (p=0.225) There was a statistical difference of recurrence between group 1 versus 2, and group 1 versus 4 in hormone receptor-negative patients. (p=0.027)
Conclusion
SLNB after NAC in breast cancer patients with initial ALN metastasis may help identify downstaging to negative nodal status and thereby reduce the surgical morbidity by avoiding standard ALN dissection.
Citation Format: Park S, Ryu JM, Paik H-J, Yi HW, Bae SY, Lee SK, Kil WH, Kim SW, Lee JE, Nam SJ. Sentinel lymph node biopsy alone after neoadjuvant chemotherapy in patients with cytologically proven node-positive breast cancer. [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 P3-01-08.
Abstract P3-01-10: Sentinel lymph node biopsy after neoadjuvant chemotherapy for patients with clinically node-positive breast cancer: A single institution retrospective evaluation
Authors: Gallant E , Ewing C , Wong J , Esserman L , Alvarado M 
Published: May 2016

Abstract
Background: In patients with clinically node-negative breast cancer sentinel lymph node biopsy (SLNB) offers accurate staging information with considerably less morbidity than a full axillary lymph node dissection (ALND). However, for clinically node-positive (cN1) patients who undergo neoadjuvant chemotherapy SLNB is thought to have a high false-negative rate and not suitable for this population. We sought to evaluate the false-negative rate (FNR) of SLNB following chemotherapy in patients initially presenting with cN1 breast cancer at a single institution.
Methods: Patients undergoing neoadjuvant chemotherapy diagnosed with cN1 breast cancer between October 2004 and February 2014 were identified from the University of California, San Francisco cancer registry. All patients underwent single agent mapping with Tc99 and SLNB followed by completion axillary lymph node dissection (ALND). Pathologic complete response, number of sentinel nodes removed and FNR were calculated.
Results: Of the 80 patients who underwent SLNB and ALND, 43 had residual metastatic disease in the nodes producing a nodal pCR of 46.25% (95%CI. 35.0%-57.8%). In 14 patients, cancer was not identified in the SLNs but was discovered in the lymph nodes retrieved by ALND, resulting in an overall FNR of 32.6% (95% CI, 19.1%-48.5%). 49 patients had only 1 SLN removed. Of the patients with only 1 SLN removed, a false-negative SLN was identified in 9 of the 21 patients with a positive node for a FNR of 42.9% (95% CI, 21.8%-66.0%). Of the patient with more than 1 SLN removed, 5 of 18 patients with a positive node had a false-negative SLN yielding a FNR of 27.8% (95% CI, 9.7%-53.5%). Only 14 patients had more than two SLNs excised.
Conclusion: Recent studies including the French GANEA 2 and ACOSOG Z1071 trials demonstrated a significant decrease in FNR when more than 1 SLN was excised. In this retrospective study however a single SLN was sampled from most patients. The FNR from this study was more than three times the generally accepted threshold of 10%. This substantial FNR further supports the need to remove more than 1 SLN during surgery in order to accurately assess nodal disease. Furthermore the implementation of a dual mapping technique would likely facilitate this process.
Citation Format: Gallant E, Ewing C, Wong J, Esserman L, Alvarado M. Sentinel lymph node biopsy after neoadjuvant chemotherapy for patients with clinically node-positive breast cancer: A single institution retrospective evaluation. [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 P3-01-10.
Abstract P3-01-13: Risk factors of non-sentinel lymph node metastasis in breast cancer patients with metastatic sentinel lymph node
Authors: Huang J , Chen X , Shen K , Li Y , Chen W , He J , Zhu L , Huang O , Zong Y , Fei X , Jin X 
Published: May 2016

Abstract
Objective To study the factors influencing the non-sentinel lymph node(NSLN) status and to assess Memorial Sloan-Kettering Cancer Center (MSKCC) nomogram performance in predicting SLN metastases in a sentinel lymph node(SLN) positive Chinese breast cancer population. Methods Data were collected from breast cancer patients who were diagnosed with pathological positive sentinel lymph node and received further axillary lymph node dissection(ALND) in Shanghai Ruijin Hospital from January 2011 to August 2014. Use MSKCC nomogram to calculate each patient's NSLN metastasis risk score. The receiver operator characteristic curve(ROC curve)and the area under the ROC curve(AUC)was used to assess the predictive accuracy of the model. Results Among the 1147 patients who received sentinel biopsy in our center, 150 SLN positive patients who received ALND were enrolled in this study. By univariate analysis, multifocal breast cancer (P = 0.017), SLN+/SLN ratio (P = 0.010) and axillary lymphadenopathy displayed by ultrasound(P = 0.005) are the influencing factors of NSLN metastases. By multivariate analysis, multifocal breast cancer (OR 7.25, 95% CI 1.73∼30.43, P = 0.007), SLN+/SLN ratio≥0.5 (OR 2.564, 95% CI 1.22∼5.39, P = 0.013) and axillary lymphadenopathy displayed by ultrasound (OR 2.471, 95% CI 1.18∼5.19, P = 0.017) are the independent influencing factors of NSLN metastases. The AUC of MSKCC nomogram in this population is 0.677. Conclusion For breast cancer patients with positive sentinel lymph node, multifocality, SLN+/SLN ratio and axillary lymphadenopathy displayed by ultrasound is related to NSLN metastasis. MSKCC has low accuracy in predicting NSLN status of this population.
Citation Format: Huang J, Chen X, Shen K, Li Y, Chen W, He J, Zhu L, Huang O, Zong Y, Fei X, Jin X. Risk factors of non-sentinel lymph node metastasis in breast cancer patients with metastatic sentinel lymph node. [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 P3-01-13.
Abstract P3-01-22: Sentinel lymph node metastases in breast cancer: A contributor to distant metastases?
Authors: Pereira ER , Kedrin D , Jones D , Beech E , Taghian A , Padera TP 
Published: May 2016

Abstract
Breast cancer metastasis remains a major cause of mortality in patients. Although significant progress has been made in understanding the mechanisms of this complex process, the findings have yet to be translated into improved survival rates in patients with metastatic disease. The presence of lymph node metastasis in most breast cancer patients is associated with tumor aggressiveness, poorer prognosis and often results in the need for systemic therapy. However, whether tumor cells in the lymph node exit and contribute to distant metastases remains controversial. To track the fate of tumor cells that metastasized to the lymph node, we engineered breast tumor cell lines to express Dendra2, a photo-convertible protein that fluoresces green in the native state and on light activation converts to red fluorescence. Using a novel chronic lymph node window that allows time-lapse imaging over a period of 10 days, we were able to track the movement of cancer cells in the dynamic microenvironment using high- resolution multi-photon microscopy. Our studies show that tumor cells entering the lymph node through the afferent lymphatic vessel proliferate in the sub-capsular sinus and later begin to invade the lymph node parenchyma. Importantly, by photo-conversion of tumor cells in the lymph node, we are able to track the tumor cells that escaped the lymph node and entered the blood circulation. The circulating tumor cells that transited through the lymph node were viable and proliferated in vitro. Our data indicate that metastatic breast cancer cells can exit the node and potentially colonize distant organs.
Citation Format: Pereira ER, Kedrin D, Jones D, Beech E, Taghian A, Padera TP. Sentinel lymph node metastases in breast cancer: A contributor to distant metastases?. [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 P3-01-22.
Abstract P3-04-03: Investigating the therapeutic use of estrogen receptor β agonists in breast cancer
Authors: Samayoa C , Krishnegowda NK , Vadlamudi R , Tekmal RR 
Published: May 2016

Abstract
In breast cancer, estrogen receptor status reflects the biology of the tumor and is used to determine the likelihood of responding to endocrine therapy. 70% of all breast cancers express Estrogen Receptor α, which is indicative of estrogen dependence for growth. Current therapies aim to lower estrogen levels, or inhibit estrogen receptor signaling to ultimately prevent recurrence. However, only two-thirds of ERα-positive respond to endocrine therapy. The Estrogen Receptors are ligand-activated transcription factors with similar structures that slightly differ in their DNA binding sites and ligand binding domains. Estrogen Receptor α has been shown to induce the proliferation of mammary gland cells, whereas Estrogen Receptor β exhibits tumor suppressive properties. The objective of this study was to investigate the utility of selective ERβ agonists as a treatment for breast cancer. Using different breast cancer models, we investigated the effects of ERβ agonist treatment on growth, migration, apoptosis, cell cycle distribution and gene expression. In this study, we demonstrate that treatment with ERβ agonist results in inhibition of cell growth and migration. Additionally, treatment also impacts cell cycle distribution and affects key proteins involved in cell cycle regulation. We also demonstrate an increase in ERβ mRNA and protein levels upon treatment. This shift in the ERβ to ERα ratio, represents a viable targeting strategy in the treatment of breast cancer. To determine if our finding translate in-vivo, we employed xenograft and syngeneic mouse models. Our in-vivo studies demonstrated reduced tumor volumes in mice treated with ERβ agonists in combination with conventional therapy, confirming the growth inhibitory activity of ERβ agonists. Selective activation of ERβ, through the use of ERβ agonists has enabled us to exploit its tumor suppressive function and investigate the utility as a treatment for breast cancer. This study suggest that activation of ERβ signaling is a valuable strategy to inhibit breast cancer growth and progression.
Citation Format: Samayoa C, Krishnegowda NK, Vadlamudi R, Tekmal RR. Investigating the therapeutic use of estrogen receptor β agonists in breast cancer. [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 P3-04-03.
Abstract P3-04-04: Estrogen receptor β5 increases aggressiveness of the triple negative breast cancer cell line SUM159
Authors: Faria M , Tin-U C , Dey P , Gustafsson J-A , Strom AM 
Published: May 2016

Abstract
Recent clinical studies are indicating that the estrogen receptor β variant β5 (ERβ5) expression correlates to worse prognosis. We wanted to know if expression of ERβ5 is changing the growth behavior of the triple negative cell line SUM159. Estrogen receptor β5 is highly similar to estrogen receptor β1 except for a truncated C-terminus making the remaining ligand binding domain incapable of binding to estrogen. In addition a 4 amino acid unique peptide is added to the C-terminal end. Stably expressing ERβ5 using a transposon integrated tetracycline regulated expression system we find that expression of ERβ5 increases proliferation of the triple negative SUM159 cells especially in reduced serum condition compared to control cells. Since SUM159 have been shown to depend on autocrine stimulation for growth we are suggesting that expression of ERβ5 is affecting the production of autocrine growth factors.
Citation Format: Faria M, Tin-U C, Dey P, Gustafsson J-A, Strom AM. Estrogen receptor β5 increases aggressiveness of the triple negative breast cancer cell line SUM159. [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 P3-04-04.
Abstract P3-06-10: t-Darpp enhances protein kinase A signaling through direct effects on PKA holoenzyme and indirectly influences cell metabolism, proliferation and apoptosis
Authors: Lenz G , Theile D , Kane SE 
Published: May 2016

Abstract
Trastuzumab has dramatically improved the adjuvant therapy of Her2-positive breast cancer. However, acquired resistance to trastuzumab frequently occurs. Breast cancer cells in vitro selected for trastuzumab resistance exhibit over-expression of t-Darpp, a truncated form of the 32 kDa dopamine and cAMP-regulated phosphoprotein (Darpp-32). t-Darpp over-expression has previously been demonstrated to confer trastuzumab resistance and to result in increased protein kinase A (PKA) activity and signaling. Phosphorylation of Darpp-32 at threonine 75 has been shown to promote inhibition (not activation) of PKA by a yet unknown mechanism. T75 phosphorylation on t-Darpp is required for its trastuzumab resistance activity but the role of T75 phosphorylation in PKA activation by t-Darpp is not known and the molecular mechanism by which t-Darpp enhances PKA activity has not been reported. We used cells stably over-expressing either wild type t-Darpp or a T75A mutant of t-Darpp. Using proximity ligation assays, we found that t-Darpp binds directly to the RI regulatory subunit of PKA leading to 75% less RI subunit bound to the catalytic subunit of PKA (PKAc), compared to parental cells. In contrast, the t-Darpp-T75A mutant does not bind RI and those cells have only 34% less RI bound to PKAc compared to parental. These results suggest a direct effect of t-Darpp on PKA activation by binding the regulatory subunit RI and thereby preventing RI from inhibiting PKAc. The T75 phosphorylation site appears to be required for this activity. Using enzymatic and caspase activity assays, we also show that cells over-expressing t-Darpp, but not t-Darpp-T75A, have increased proliferation, up to 4-fold more cellular ATP, and diminished apoptotic response to etoposide, relative to parental cell controls. So far, this data suggests a dual mode of t-Darpp action: modulation of cell metabolism (possibly via effects on ATP production) and direct effects on PKA holoenzyme. Ultimately, pro-apoptotic response is diminished. Further studies will determine whether PKA activation by t-Darpp is responsible for, or separately influenced by, the metabolic effects of t-Darpp.
Citation Format: Lenz G, Theile D, Kane SE. t-Darpp enhances protein kinase A signaling through direct effects on PKA holoenzyme and indirectly influences cell metabolism, proliferation and apoptosis. [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 P3-06-10.