bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract P1-09-03: Socioeconomic characteristics of African American women with breast cancer
Authors: Winter A , Raska P , Ornstein M , Moore H , Montero A , Budd GT , Tullio K , Bailey J , Abraham J 
Published: May 2016

Abstract
Background: Breast cancer is the most common cancer among African American (AA) women. Despite having a lower incidence of breast cancer compared to white women (124.4 compared to 127.9 per 100,000), AAs have a higher death rate (30.2 compared to 21.3 per 100,000). One explanation for this discrepancy is that breast cancer in AAs is often detected at a later stage compared to white women. We conducted this retrospective study to examine socioeconomic characteristics among AA women with breast cancer to see if there were factors associated with stage of diagnosis which may contribute to the known disparities. Methods: We identified all AA women diagnosed with any stage breast cancer from 2006-2014 within the Cleveland Clinic Cancer Data Warehouse and classified them into either early or late stage disease at time of diagnosis. Stages 0-II were classified as early and stages III-IV as late. We examined several variables at diagnosis including age, marital status, tobacco use, alcohol use, Medicaid insurance status, and breast cancer subtype which included HER-2 positive (HER+), hormone receptor positive/HER2 negative (HR+/HER-), and triple negative(TN). AA median income was obtained from US census data according to the zip code at diagnosis. We conducted univariate logistic regression for individual estimates and confidence intervals and multiple logistic regression and model selection to determine significant predictors of stage of diagnosis. Results: Of the 771 AA women identified, 108 (14%) were diagnosed at a late stage of disease with a median age of 59 years. Receptor status distribution was 12.4%, 31%, and 16.6% for HER+, HR+/HER-, and TN respectively for early stage, and 15.7%, 27%, and 25% for late stage. Among early stage 50% were current or previous smokers and 2.6% had Medicaid insurance compared to late stage patients where 63% were current or previous smokers and 9.2% had Medicaid insurance. Multiplicative effect estimates and 95% confidence intervals from univariate logistic regressions identified the following significant factors: tobacco use 1.48 [1.11-1.96] and Medicaid 3.73 [1.56-8.51] (p-values&lt;0.01), and TNBC 1.67 [1.02-2.68] (p-value&lt;0.05). In a stepwise model selection, only tobacco use and Medicaid were retained in the model, as well as age at diagnosis. Conclusions: There are socioeconomic differences among AA women with breast cancer. Only tobacco use, Medicaid insurance, and age at diagnosis were predictive of late stage in this study.
Citation Format: Winter A, Raska P, Ornstein M, Moore H, Montero A, Budd GT, Tullio K, Bailey J, Abraham J. Socioeconomic characteristics of African American women with 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 P1-09-03.
Abstract P1-10-23: Bladder symptoms in women with newly diagnosed breast cancer
Authors: Wong L , Chung C , Flores S , Mortimer J 
Published: May 2016

Abstract
Background: Changes in bladder function are recognized effects of aging and menopause but have not generally been reported in women treated for breast cancer. We initiated a prospective trial to assess the impact of (neo) adjuvant therapy on women with early stage breast cancer.
Methods: Women with newly diagnosed invasive breast cancer who were to initiate (neo) adjuvant chemotherapy or endocrine therapy were approached for study participation. At baseline a urinalysis, urine culture, and self assessment quality of life questionnaires were completed. The Urogenital Distress Inventory (UDI-6) assesses bladder symptoms and the Incontinence Impact Questionnaire (IIQ-7) assesses the impact of bladder symptoms on quality of life. Three months after initiation of (neo)adjuvant therapy, the quality of life questionnaires were repeated. We report the results of the pretreatment questionnaires.
Results: Between February and June, 2015, forty-nine women with newly diagnosed breast cancer were enrolled on study. The median age was 54 (Range 25-78); 21 were premenopausal and 28 postmenopausal. Twenty nine (59%) were treated in the adjuvant setting; 12 with chemotherapy and 17 with endocrine therapy. Twenty patients, (41%) were treated in the neoadjuvant setting with chemotherapy. Prior to initiation of therapy, " Frequent urination" was reported in 38 (65%), " Leakage related to urgency" in 5 ( 10%), " Leakage with physical activity" in 32 (55%) and "Small amounts of leakage" in 32 (55%). Bladder symptoms impacted the ability to perform household chores in 8 (16%), Physical recreation in 10 (20%), social activities in 9 (18%), and Emotional health in 5 (10%).
Conclusions: Symptoms of bladder dysfunction are common in women with newly diagnosed breast cancer even before therapy is initiated.
Citation Format: Wong L, Chung C, Flores S, Mortimer J. Bladder symptoms in women with newly diagnosed 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 P1-10-23.
Abstract P1-11-03: Patient reporting pain intensity immediately after surgery can be associated with underlying depression in women with breast cancer
Authors: Kim YS , Lee JW , Kim J , Lee SB , Yu J , Ko BS , Kim HJ , Son BH , Ahn SH 
Published: May 2016

Abstract
Objective
The aims of this study were to determine the prevalence of severe, definite depression symptoms, as measured using the Center for Epidemiological Studies Depression Scale (CES-D), and the association between high CES-D scores (i.e., ≥25) and sociodemographic and perioperative factors during perioperative period.
Methods
Among 1690 consecutive breast cancer patients who were admitted for definitive breast surgery during the study period, 1499 patients were included in this study. Patients with a past medical history of psychiatric medication or support, a plan for elective surgery due to locoregional recurrence or any metastatic disease were excluded. The CES-D score was checked 1 day before definitive surgeries. The sociodemographic data and perioperative data were analyzed.
Results
The mean CES-D score was 18.5, with 24.1% (362/1499) and 56.7% (850/1499) having high CES-D scores of ≥25 and ≥16, respectively. Multivariate analysis revealed that the number of family members with any malignancy (≥2 vs 0), sedative medication (yes vs no) and postoperative numeric rating scale (NRS) scores (persistent, severe pain vs stably mild pain) were significant associated factors for severe, definite depression symptoms [CES-D score of ≥25: adjusted odds ratio (OR)=1.56, 95% confidence interval (CI)=1.10–2.21, P=0.013; adjusted OR=1.65, 95% CI=1.00–2.71, P=0.048; and adjusted OR=2.14, 95% CI=1.15–3.95, P=0.016, respectively].
Conclusion
Depression may increase the intensity of postoperative acute pain. Self-reporting of persistent postoperative pain intensity is potentially useful in detecting hidden depression symptoms in breast cancer patients during the perioperative period.
Citation Format: Kim YS, Lee JW, Kim J, Lee SB, Yu J, Ko BS, Kim HJ, Son BH, Ahn SH. Patient reporting pain intensity immediately after surgery can be associated with underlying depression in women with 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 P1-11-03.
Abstract P1-12-07: Delayed initiation of adjuvant chemotherapy among breast cancer patients: A population-based study
Authors: Chavez-MacGregor M , Clark CA , Lichetensztajn DY , Giordano SH 
Published: May 2016

Abstract
BACKGROUND: Adjuvant chemotherapy improves outcomes of breast cancer patients; however the optimal timing to initiation of chemotherapy remains unknown. No study has evaluated the relationship between time to chemotherapy (TTC) and outcome in a population-based study of patients treated with contemporary regimens according to tumor subtype. In this large study we identified the determinants associated with a delay in the initiation of chemotherapy and determined whether TTC is related to outcome.
METHODS: Breast cancer patients diagnosed with stage I-III breast cancer between 2005-2010 and treated with adjuvant chemotherapy were identified in the California Cancer Registry. TTC was defined as number of days between surgery and the day the first dose of adjuvant chemotherapy was administered. Delayed TTC was defined as &gt;91 days. Logistic regression and Cox-proportional hazard modeling were used.
RESULTS: A total of 24,843 patients were included. Factors associated with delays in TTC included low socioeconomic status, reconstructive surgical procedure, non-private insurance and Hispanic or non-Hispanic black race/ethnicity. Compared to patients receiving chemotherapy within 31 days from surgery, there was no evidence of adverse outcome among those with TTC of 31-60 or 60-90 days. To the contrary, patients treated &gt;91 days from surgery experienced statistically significant worse overall survival (OS) (HR=1.34; 95%CI 1.15-1.57) and worse breast cancer specific survival (BCSS) (HR=1.27; 95%CI 1.05-1.53). In a subgroup analysis according to breast cancer subtype, TTC &gt;91 days had a statistically significant detrimental impact among patients with triple negative breast cancer (TNBC) in terms of both OS (HR=1.53; 95%CI 1.17-2.00) and BCSS (HR=1.53; 95%CI 1.17-2.07).
CONCLUSIONS: In this large cohort of breast cancer patients treated with contemporary regimens, a delaying in the initiation of adjuvant chemotherapy &gt;91 days was associated with adverse outcomes. A delay in TTC is particularly detrimental among patients with TNBC. The majority of the determinants of delays in chemotherapy initiation are socio-demographic in nature. As medical providers we must make every effort to provide timely care to all our patients so they can receive the full benefit of our current treatments.
Citation Format: Chavez-MacGregor M, Clark CA, Lichetensztajn DY, Giordano SH. Delayed initiation of adjuvant chemotherapy among breast cancer patients: A population-based 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 P1-12-07.
Abstract P1-12-09: The oncologic effect of a gonadotropin releasing hormone (GnRH) agonist for ovarian protection during breast cancer chemotherapy
Authors: Kim HJ , Lee MH , Lee JE , Park SH , Lee ES , Kang Y-J , Lee JH , Shin HN , Kim SI , Im SA , Ahn SH , Lee KS , Sohn J , Han W , Nam SJ 
Published: May 2016

Abstract
Background: Recently, chemotherapy with a GnRH agonist was reported to protect against ovarian failure. This study was aimed at determining the oncologic effect of a GnRH agonist concurrent with chemotherapy for breast cancer patients.
Patients and Methods: A total of 1189 patients aged 20 to 40 years with stage I to III breast cancer who received (neo or adjuvant) chemotherapy from five hospitals in Korea from 2002 to 2012 were reviewed. A gonadotropin releasing hormone (GnRH) agonist was given to 410 patients for ovarian protection during chemotherapy (GnRH agonist group), and 779 patients received chemotherapy without ovarian protection (Chemotherapy alone group). A matching strategy was used to create matched sets of two groups by age, stage, hormone receptor status, Her2/neu status, neo or adjuvant chemotherapy, and institute.
Results: Survival analysis using Cox regression showed that the GnRH agonist group had better distant metastatic-free survival (HR=0.65, 95%CI 0.44-0.97) outcomes but similar disease free survival (HR=0.78, 95% CI 0.57-1.08) compared with the chemotherapy alone group. The survival benefit was significant for hormone receptor positive, Her2/neu negative breast cancer on distant metastasis (HR=0.44, 95% CI 0.20-0.99) and disease free survival (HR0.47 95% CI 0.23-0.93).
Conclusion: Ovarian protection using a GnRH agonist can be safely considered for premenopausal breast cancer patients for whom chemotherapy is planned.
Citation Format: Kim HJ, Lee MH, Lee JE, Park SH, Lee ES, Kang Y-J, Lee JH, Shin HN, Kim SI, Im SA, Ahn SH, Lee KS, Sohn J, Han W, Nam SJ. The oncologic effect of a gonadotropin releasing hormone (GnRH) agonist for ovarian protection during breast cancer chemotherapy. [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 P1-12-09.
Abstract P1-16-07: Pharmacogenomics-pharmacokinetics study of selective estrogen-receptor modulators with intra-patient dose-escalation for Japanese breast cancer patients
Authors: Ohno S , Ishiguro H , Yamamoto Y , Takao S , Sato N , Fujisawa T , Kadoya T , Kuroi K , Bando H , Teramura Y , Iwata H , Tanaka S , Toi M 
Published: May 2016

Abstract
Background
The association between CYP2D6 polymorphisms and efficacy of tamoxifen (TAM) is inconclusive, partly due to inaccurate prediction of active metabolite, endoxifen exposure by solely CYP2D6 genotype. Moreover, TAM dose escalation is not effective for poor metabolizers. Since the contribution of CYP2D6 to toremifen (TOR) activation is small, TOR might be a good alternative to TAM for poor metabolizers.
Methods
Patients who maintained good compliance with TAM or TOR without regular use of strong CYP2D6 inhibitors were enrolled in a screening study. The pharmacokinetics (PK) of TAM or TOR and the pharmacogenomics (PGx) of metabolizing enzymes and transporters were assessed. Associations between TAM and TOR PK and PGx, other CYP inhibitor use, and smoking status were examined by regression analysis. An intra-patient dose escalation study was conducted for patients showing low endoxifen levels during TAM treatment (n = 14). TAM was switched to 40 mg of TOR, and then increased to 120 mg for ≥24 weeks with periodic PK sampling. Total TAM or TOR activity was calculated as the sum of the concentration of each active metabolite adjusted by their respective in vitro activity.
Results
CYP2D6 genotype was the major determinant for TAM activity (p &lt; 0.01) for Japanese breast cancer patients. Current smoking status (p = 0.07) and CYP2C19 (p = 0.07), but not CYP2D6 genotype (p = 0.61), showed marginally significant effects on TOR activity. TOR activity sufficiently increased with dose escalation from 40 mg to 120 mg, even among the poor TAM metabolizers, and was maintained for ≥24 weeks.
Total Activity of TOR (ng/mL) Screening (n=271)Intra-patient dose escalation (n=14)Dose (mg)4040120120*120/40120*/40120*/120Mean (ng/mL)4168.53218.18758.67268.03.12.60.9Median (ng/mL)3865.43020.38924.67579.72.82.50.8SD1446.21207.01707.11793.21.20.80.2p-value0.04 &lt;0.01&lt;0.010.054*(Sample taken at ≥24 weeks)
Conclusion
Since the contribution of CYP2D6 to TOR metabolism is relatively small, TOR is a valid alternative to TAM, especially in patients predicted to be poor TAM metabolizers. Further clinical trials are warranted to validate this concept.
Citation Format: Ohno S, Ishiguro H, Yamamoto Y, Takao S, Sato N, Fujisawa T, Kadoya T, Kuroi K, Bando H, Teramura Y, Iwata H, Tanaka S, Toi M. Pharmacogenomics-pharmacokinetics study of selective estrogen-receptor modulators with intra-patient dose-escalation for Japanese breast cancer patients. [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 P1-16-07.
Abstract P2-01-07: Neutrophil lymphocyte ratio and breast cancer: A future prognostic indicator for outcome after surgery?
Authors: Williams GJ , Huws AM , Holt SDH , Sharaiha YM 
Published: May 2016

Abstract
There is a growing body of literature highlighting the prognostic use of pre-operatively comparing certain white blood cell differentials, namely neutrophils and lymphocytes, with outcomes in many different types of solid tumour cancers. It has been postulated that a raised neutrophil to lymphocyte ratio (NLR) may reflect a greater tumour burden on the patient, and therefore lead to poorer outcomes. There is some evidence that a raised pre-operative NLR may help to predict poorer outcomes following surgery for breast cancer.
This observational retrospective proof of concept study aims to assess the association between pre-operative NLR and breast cancer outcomes over a three year period of follow-up from a cohort of 147 patients. The results of this study revealed that the cohort of patients with a raised pre-operative NLR was associated with a clinically significant increased rate of local recurrence of their breast cancer following surgery with curative intent (with or without adjuvant chemotherapy and radiotherapy) compared to those that had a low or normal NLR (20.4% ± 4.9% vs 5.1% ± 4.9% respectively, CI 95%; p=0.004). In relation to intra-operative sentinel lymph node biopsy, the analysis also showed that the incidence of a raised pre-operative NLR was not related to whether there was nodal involvement or not at the time of surgery (33% vs 33%, p=1). This suggests that a raised pre-operative NLR may be an independent prognostic indicator for breast cancer outcomes.
This study provides a template for a prospective observational study which is needed to corroborate this result and to account for confounding factors such as concomitant chronic disease. Additionally, a larger cohort sample size with a follow-up of five years is necessary to assess the relationship between pre-operative NLR and mortality due to the latter's relatively low incidence in breast cancer. However, this study further supports that consideration of the pre-operatively calculated NLR may provide an early prognostic indicator for breast cancer outcomes and warrants further investigation.
Citation Format: Williams GJ, Huws AM, Holt SDH, Sharaiha YM. Neutrophil lymphocyte ratio and breast cancer: A future prognostic indicator for outcome 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 P2-01-07.
Abstract P2-02-06: Impact of apoptotic circulating tumor cells in metastatic breast cancer
Authors: Wallwiener M , Deutsch TM , Riethdorf S , Hartkopf AD , Taran F-A , Trumpp A , Brucker S , Schütz F , Rom J , Pantel K , Schneeweiss A 
Published: May 2016

Abstract
Background
Circulating tumor cells (CTC) are a heterogeneous cell population and an independent negative prognostic factor for progression-free (PFS) and overall survival (OS) in patients with metastatic breast cancer (MBC). The study aimed to prospectively assess CTC status for the subtypes apoptotic CTC (aCTC) and intact CTC (iCTC) at baseline (CTCBL) and after one cycle of a new line of systemic therapy (CTC1C). Changes from CTCBL to CTC1C (CTC kinetics, CTCKIN) were evaluated for their utility in predicting response, progression-free (PFS) and overall survival (OS).
Methods
423 MBC patients were included in a prospective trial prior to a new regimen of treatment. Intact and apoptotic CTC were analyzed at baseline (CTCBL) and after one cycle of systemic therapy (CTC1C) using CellSearch™ (Veridex) and morphologic criteria. Samples with ≥5 CTC/7.5ml blood were regarded as positive. Therapy response was assessed using the RECIST-criteria on three-monthly radiological controls. CTCKIN were characterized by ≥25% change from CTCBL to CTC1C to differentiate stable, increased and decreased CTC kinetic.
Results
35% of patients were iCTCBL-positive and 28% aCTCBL-positive at baseline (CTCBL). PFS and OS differ significantly between the iCTCBL-positive and the iCTCBL-negative group (PFS 4.5 vs. 8.0; OS 12.5 vs. 27.2 (months)). Positive aCTC in conjunction with positive iCTCBL at baseline has worst prognostic impact (PFS 6.3; OS 8.7).
Regarding the CTCKIN (BL to 1C), aCTC-decrease (≥25%) is a positive prognostic factor compared to aCTC-stable and aCTC-increase (PFS 7.6 vs. 3.7; 3.3 and OS 21.0 vs. 4.8; 5.7). Decreasing aCTCKIN shows favorable prognostic impact versus decreasing iCTCKIN (PFS 7.6 vs. 5.9 and OS 21.0 vs 16.4).
Conclusion
Elevated aCTC levels at baseline have an unfavorable prognostic impact on both OS and PFS in conjunction with elevated iCTC. Additionally, the decrease of aCTC is a relevant prognostic value for systemic therapy response. aCTCKIN allows better differentiation for therapy response in patients with positive CTC-status at baseline. Differentiated enumeration of intact and apoptotic CTC should be considered in clinical application.
Citation Format: Wallwiener M, Deutsch TM, Riethdorf S, Hartkopf AD, Taran F-A, Trumpp A, Brucker S, Schütz F, Rom J, Pantel K, Schneeweiss A. Impact of apoptotic circulating tumor cells in metastatic 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 P2-02-06.