bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is obesity associated with increased recurrence risk in estrogen receptor (ER)-positive breast cancer?
Authors: Yap K. K. L. , Efiom-Ekaha D. N. 
Published: February 2017

171 Background: Oncotype DX Score is a 21-gene expression analysis that has been validated clinically as a reliable predictor of breast cancer recurrence for ER-positive, node-negative breast cancers. Obesity is recognized as a risk factor for many cancers, including breast cancer. Additionally obesity has been shown to be an independent prognostic factor in breast cancer. The primary objective of this study is to determine the correlation between obesity and Oncotype DX score, hence the relationship between obesity and breast cancer recurrence in ER-positive breast cancer. The secondary objective is to investigate the association between weight gain after diagnosis and breast cancer recurrence. Methods: An IRB-exempted retrospective chart review of female patients at Wellspan Group with ER-positive breast cancer who had Oncotype DX analysis in 2008 and 2009. Data collected included Oncotype DX score and BMI (at diagnosis, 6 months and 12 months). Data were analyzed to determine the correlation between Oncotype DX score and BMI at diagnosis, at 6 months and at 12 months. The correlation between Oncotype DX score and BMI changes at 12 months also was determined. Results: A total of 125 patients were identified; 103 had BMI recorded at diagnosis, 88 had BMI recorded at 6 months and 87 had BMI recorded at 12 months. Of these, we were able to determine the BMI changes at 12 months for 82 patients. The Pearson correlation scores were 0.091 (p = 0.361), 0.074 (p = 0.492), and 0.047 (p = 0.669) for BMI at diagnosis, at 6 months and at 12 months respectively. The Pearson correlation score was 0.007 (p = 0.948) for BMI changes at 12 months. Conclusions: Obesity and weight gain are not independent predictors of recurrence in patients with ER-positive breast cancer. The reported adverse prognostic associations may be more prominent in ER-negative breast cancers. This is consistent with the reports suggesting a higher rate of ER-negative, high-grade cancers in obese women as well as a greater magnitude of benefit from dietary and weight reduction interventions seen in women with ER-negative cancers.
Mammography screening and surgical breast cancer treatment in Norway.
Authors: Suhrke P. , Mæhlen J. , Schlichting E. , Zahl P. H. 
Published: February 2017

177 Background: We have investigated whether the introduction of organized mammography screening in Norway led to less aggressive breast cancer surgery in the invited age group. Methods: We obtained aggregate incidence and surgical treatment data for women treated for ductal carcinoma in situ or invasive breast cancer from the Norwegian Cancer Registry. Rates of breast operations (mastectomy plus breast conserving therapy) and rates of mastectomy only for three age groups; women aged 40-49, 50-69 and 70-79 years were calculated. Changes in rates from a pre-screening period (1993-95) to a screening introduction phase (1996-2004) and then to a screening period (2005-08) are presented as hazard ratios comparing invited and non-invited women. Results: From the pre-screening period (1993-95) to the screening period (2005-08) the annual breast operation rate increased by 70% (HR=1.70 95% CI 1.62 to 1.78), from 180 to 305 per 100 000 women in the invited age group (50-69 years). In contrast, the increase was only 8% (HR=1.08 95% CI 1.00 to 1.16), from 133 to 144 per 100 000 women per year in the younger, non-invited age group (40-49 years) while an 8% decline (HR=0.92 95% CI 0.86 to 1.00), from 227 to 214 per 100 000 women per year occurred in the older, non-invited age group (70-79 years). In the screening period (2005-08) mastectomy rates fell similarly in invited and non-invited women. However, during the screening introduction phase (1996-2004) the mastectomy rate was 31% (HR=1.31 95% CI 1.20 to 1.43) higher in screened compared to non-screened younger age group. Annual mastectomy rates increased in invited from the pre-screening period to the screening introduction period from 156 to 167 per 100,000 women compared to a decline from 109 to 91 per 100,000 women in younger non-invited. Conclusions: Mammography service screening is associated with a marked increase in breast operation rates in the invited age group and also an increase in mastectomy rates. While overdiagnosis likely caused the initial increase in mastectomy rates and the overall increase in use of surgery in the age group subjected to screening, the more recent decline in mastectomy rates has affected all age groups and is likely to have been caused by changes in surgical policy.
What has changed in the management of breast cancer in the past 25 years at the Istanbul University Hospital?
Authors: Aydogan F. , Gazioglu E. , Canbay E. , Aydin I. , Aydogan T. , Uras C. , Celik V. , Cengiz A. , Ferahman M. , Unal H. 
Published: February 2017

184 Background: There have been important changes in diagnosis and treatment of the breast cancer during the last century. Diagnosing the cancer in early stages brought the new approaches such as breast conserving surgery instead of mastectomy and sentinel lymph node biopsy instead of direct axillary disection. In this study our purpose is to compare the operations which were performed in 1983 and 2008 on breast cancer patients of our clinic and to search the differences in their ages and tumor characteristics. Methods: In each group the files of 100 patients, who were operated in 1983 and 2008, were compared with each other including the variabilities such as size of the tumor, age of the patient and operation technique. Results: There were 100 patients in both of the groups. Six of the patients (6%), who were operated on in 1983, were found to be between the ages of 20-39 and this percentage was found to be much higher as 19% (19 patients) in 2008. In 1983, there wasn't any patient at stage 0 and the number of patients at stage 1 was 15 (15%), in 2008 the number of stage 0 patient was 9 (9%) and stage 1 patient was 25 (25%). Breast conserving surgery rate was found to be 9% in 1983 and 41% in 2008. Conclusions: According to the data of this study, breast cancer is now being seen at younger ages when compared to 25 years ago. Currently the patients have diagnosis at earlier stages and the breast conserving surgery is much more prevalent. Earlier-stage diagnosis can be explained by widespread use of screening mamographies and increasing consciousness of the patients.
Risk of breast cancer among Japanese women with a positive family history.
Authors: Suzuki J. , Hojo T. , Jimbo K. , Asaga S. , Kinoshita T. 
Published: February 2017

191 Background: Most breast cancer cases are sporadic, rather than associated with inherited gene mutations, such as BRCA1 and BRCA2. However, women with a family history of breast cancer are at increased risk of developing breast cancer compared to those women without any family history, even if they lack these gene mutations. Methods: We analyzed 10892 patients including bilateral breast cancer cases (total of 11398 breast cancers) who underwent surgery at our hospital between 1962 and 2009. We excluded 295 cases whose family history data were not available. Clinical and pathological differences between following patient groups were tested; 9528 patients or 9955 cancers (88%) with negative family history (FH-), 896 patients or 951 cancers (8%) who had at least one first-degree relative with breast cancer (1FH+), 468 patients or 492 cancers (4%) who had second-degree relative with breast cancer (2FH+), and 1364 patients or 1443 cancers (12%) with family history regardless of first- or second-degree relative (FH+). Significance was established at a p-value of < 0.05. Results: Among the family members, sisters were more likely to have treated for breast cancer (38% in FH+ group), followed by mothers (27%), aunts (26%), grandmothers (7%), and daughters (2%). The incidence of developing contralateral breast cancer was significantly higher in 1FH+ group, compared to patients in FH- and 2FH+ groups. No other factors showed any significant difference, including the incidence of cancer in other organs, pathological characteristics, and age of onset, although BRCA1 and BRCA2 mutation may be associated with increased risk of developing breast cancer at younger age. Outcome studies with available data did not show any significant difference in overall survival between FH+ and FH- patients. Conclusions: A Japanese woman with a positive family history has a higher risk of developing breast cancer than women without any close relatives with breast cancer, similar to the results reported in Western countries where prevalence of breast cancer is higher. Regular checkup of contralateral breast is important for those patients whose first-degree relatives have also been diagnosed with breast cancer.
The effect of combined therapy with 5-aza-2’-deoxycytidine, sodium butyrate, and tamoxifen on apoptosis of breast cancer cell lines.
Authors: Kim S. J. , Kim J. S. 
Published: February 2017

197 Background: DNA methytransferase inhibitors and histone deacetylase inhibitors have been extensively studied in recent years as another novel and specific target therapy for cancer treatment. In this study, we investigate the effect of combined therapy of 5-aza-2’-deoxycytidine (5-aza-CdR), sodium butyrate (SB) and tamoxifen on tumor suppression and expression of anti- or proapoptic proteins in breast cancer cell lines. Methods: Water-soluble tetrazolium salt-1 was used to study the proliferation rate of the cells in MDA-MB-231 and MCF-7 breast cell lines treated with the different concentration of variable combinations of these agents. Western blot was used to explore the change of expression of proapaptic regulator proteins according to variable combined therapy. Methylation specific transcriptase-polymerase chain reaction and immunofluorescence staining were used to analyze the ER re-expression in the MDA-MB-231 and MCF-7 cell lines treated with 5-aza-CdR. Results: We observed that the survival fraction of MCF-7 and MDA-MB-231 cells treated with 2um, 4um, 8um 5-aza-CdR and 0.5mM, 1mM and 2mM SB respectively was decreased in inverse proportion to the concentration. The survival fraction of MCF-7 cells as ER positive cell lines treated with 2.5um, 5um and 10um tamoxifen was slightly decreased in inverse proportion to the concentration, but that of MDA-MB-231 cells as ER negative cell lines was slightly increased regardless the concentration. ER re-expression was detected in ER negative cell line, MDA-MB-231 treated with 5-aza-CdR. In cases of being treated with variable combination of agents in MCF-7 and MDA-MB-231 cell lines, the survival fraction treated with the combination of all 5-aza-CdR, SB and tamoxifen was the lowest. We also observed that the expression of proapoptic regulator protein were slightly decreased in MCF-7 and MDA-MB-231 cells treated with combined 5-aza-CdR with SB and combined with all agents. Conclusions: Our data indicate that combined therapy with 5-aza-CdR, SB and tamoxifen was the most effective in apoptosis of breast cancer cells and changed expression of the proapoptic regulator proteins.
Accuracy and upgrade rates of stereotactic vacuum-assisted breast biopsy: Impact of number of core samples taken on malignancy underestimation rates.
Authors: Vossen J. A. , Edwards S. D. , Pronovost M. , Reeser P. 
Published: February 2017

20 Background: There are multiple options for the diagnostic evaluation of mammographic suspicious breast abnormalities. The therapeutic strategy is often based on lesion histopathological information obtained from stereotactic vacuum-assisted biopsy (VAB). Therefore, accurate information obtained by VAB is very important. This study was performed to evaluate the impact of the number of core samples obtain during VAB on malignancy underestimation rates for mammographically detected breast lesions. Methods: The pathologic results of 128 consecutive stereotactic biopsies (January 2010-December 2010) were retrospectively reviewed. All biopsies were performed using a 9-gauge needle. Pathologic results of core biopsies and surgical excision were compared. Underestimation rates of malignancy were calculated and correlation was made with the number of core samples obtained. Results: Surgical excision was performed on 41% (52/128) lesions; 4 benign, 19 indeterminate and 29 malignant. Overall malignancy underestimation rate was 19%. There were 8 cases of ductal carcinoma in situ (DCIS) on core biopsy that were proven to be invasive ductal carcinoma (IDC) on surgical excision. There was one case of benign microcalcifications that was proven to be lobular neoplasia (LN). There was one case of an atypical papillary lesion that was proven to be DCIS. There was a significant difference (p=0.02) between the mean number of core samples taken in the underdiagnosed lesions (8, range 6-12) and the concordant lesions (10, range 6-20). Conclusions: In the case of stereotactic VAB diagnosis of breast lesions, the underestimation rate of malignancy is more likely with a lower number of core samples obtained.
Preliminary results from a comparative effectiveness study of breast cancer survivorship care: A University of California (UC) ATHENA Breast Health Network project.
Authors: Hahn E. E. , Ganz P. A. , Melisko M. E. , Pierce J. P. , Von Friederichs-Fitzwater M. M. , Lane K. , Hiatt R. A. 
Published: February 2017

212 Background: The ATHENA Breast Health Network collaboration is a large scale, UC system-wide project initiated with the intent to drive innovation in breast cancer prevention, screening and treatment. An IRB approved research protocol was developed to examine survivorship care across Network sites, which includes key informant interviews at each site and patient/survivor surveys. This abstract presents preliminary analyses from the key informant interviews. Methods: Investigators at each site conducted semi-structured interviews with oncology specialists and primary care providers (PCPs). Interviews used case study examples and open and closed-ended questions on the delivery of post-treatment breast cancer care. Informant responses were manually recorded by the interviewer, compiled in a database, then coded and analyzed using NVIVO9 software. Results: There were 39 key informants across five participating UC sites: 14 medical oncologists, 7 radiation oncologists, 11 surgeons, 3 oncology nurses, and 4 PCPs. Care coordination is a major unprompted theme identified in the interviews. 85% of all participants reported using shared care coordination between PCP and oncology for post-treatment follow-up. 49% report the need for greater care coordination in general, and 28% report the need for greater care coordination within oncology, particularly to help avoid duplication of follow-up care and services. The responses demonstrate wide variability among provider types and institutions (Table). Additional analyses from this study will be updated in our presentation. Conclusions: These preliminary results identify the need for focus on care coordination during the post-treatment phase of breast cancer care within the UC system. [Table: see text]
Utilization of pegfilgrastim in adjuvant chemotherapy regimens for breast cancer in the community.
Authors: Patt D. A. , Espirito J. L. , Turnwald B. , Hoverman J. R. , Neubauer M. A. , Busby L. T. , Brooks B. D. , Kolodziej M. A. , Anderson R. W. , Beveridge R. A. ,   US Oncology Pathways Task Force and Clinical Content Development Team
Published: February 2017

213 Background: Selection of adjuvant breast cancer (BC) therapy varies based on patient risk factors. Choice of chemotherapy (CT), schedule, duration, and supportive care affects costs and toxicity. Because pegfilgrastim (PEG) is a large driver of cost in adjuvant therapy it is important to understand the utilization characteristics. We aimed to characterize PEG utilization during neoadjuvant/adjuvant (N/Ad) CT by age and regimen type. Methods: Using the US Oncology iKnowMed EHR database, we retrospectively identified female BC patients (pts) diagnosed with stage I-III BC, between 7/2006 and 11/2010. Secondary diagnoses were excluded. Pts were characterized by age, ER and HER2 status, tumor size, grade, and nodes. CT utilization was determined by the number of pts assigned an N/Ad line of therapy (LOT) during the study period. Regimens were categorized by CT title and drugs. Clinical trial pts were included. PEG utilization was characterized if administered within 6 months of being assigned to an N/Ad CT regimen. Results: During the time period, 40,881 newly diagnosed localized BC pts were identified. Of these, 15,328 pts (37%) were assigned an N/Ad CT regimen and 72% (11, 022 pts) received PEG at any time within 6 months of their N/Ad CT. When analyzed by regimen type, TC, TAC, TCH, and dose-dense AC-paclitaxel were the most highly utilized regimens accounting for 64% of all PEG use. PEG use with the TC regimen was 70% and represented 25% of all N/Ad PEG utilization. PEG utilization by age was characterized as 81% of pts <40 yrs, 74% of pts 40-49 yrs, 70% of pts 50-59 yrs, 71% of pts 60-69 yrs, 68% of pts 70-79 yrs, and 40% of pts ≥80 yrs. Conclusions: While 37% of women treated in the N/Ad setting received CT, PEG was given to 72% of that subset. Utilization was high among all age groups. Dose-dense and docetaxel-containing regimens accounted for the majority of PEG use. With availability of generic docetaxel, commonly used drugs in adjuvant BC except trastuzumab will have generic equivalents and PEG will be the largest cost driver in women receiving adjuvant CT in the community. Since febrile neutropenia occurred in 5% of pts on the original TC trial, determination of appropriate level of use of PEG in the adjuvant setting needs further study.
Association of gene expression module biomarkers with clinical and therapeutic endpoints and their use with a universal companion diagnostic assay.
Authors: Tomlins S. A. , Williams P. , Sadis S. , Wyngaard P. , Oades K. , Lee B. , Chattopadhyay S. , Wang Y. , Monforte J. , Rhodes D. 
Published: February 2017

228 Background: Gene expression patterns are increasingly capable of stratifying patients based on prognosis and response to therapy. Given the limited availability of sample tissue, however, it is not feasible to utilize every test for every patient, suggesting the need for a universal companion diagnostic assay that is informative with respect to multiple clinical and therapeutic endpoints. Key challenges are identification of appropriate gene expression biomarkers, translation of biomarkers to clinical assays, and development of reliable gene expression profiling of formalin-fixed clinical specimens. Here we describe a novel RT-PCR biomarker assay optimized for FFPE clinical samples that has broad prognostic and predictive potential. Methods: A co-expression meta-analysis of 5,339 breast tumors from 56 microarray datasets identified highly co-expressed sets of genes (modules) across multiple datasets. Module biomarkers were tested for their ability to associate with prognostic and predictive targets in published datasets. In addition, each module was reduced from 10–1000 genes to 2-3 genes for use in companion diagnostic assays based on degree of co-expression across the meta-analysis, and validated against an independent panel of tumor samples. Results: This study demonstrates that a single test utilizing multiple module biomarkers is informative with respect to standard parameters such as ER, PR and Her2, and in addition reproduces existing prognostic and predictive genomic signatures. Furthermore, we show that modules of 10-1000 genes can be represented by 2-3 genes for direct use in companion diagnostics development. Conclusions: The molecular heterogeneity of breast cancer can be summarized by discrete gene expression modules that individually represent distinct biological programs, and that collectively can be represented by as few as 96 genes. Modules, together with outlier genes, allow for summation of the entire transcriptional program and provide a universal assay with broad application to companion diagnostics development.
Elective bilateral risk-reducing mastectomy (BRRM) in patients (pts) without breast cancer (BC): Experience at Mastologica Lomas Breast Center in Mexico City.
Authors: Sanchez-Forgach E. R. , Sanchez Basurto C. 
Published: February 2017

235 Background: BRRM otherwise known as prophylactic or preventive mastectomy has increased in frequency due to patient (pt) and/or physician preference. Variables included indications, medical or pt initiative, efficacy, complications and degree of satisfaction. Methods: Retrospective review of cases of BRRM from 2005-2010. Pts. were divided by indications including high risk factors, specimen pathology, breast reconstructions technique, complications, patient satisfaction index, and pt status. Results: A total of 16 pts. had a BRRM either for medical recommendations due to high risk features (including history of first degree relatives with BC (2 pts were BRCA 1 positive) or premalignant pathology in previous biopsies) in 13 (81.25%) cases and 3 (18.75%) owing to personal issues i.e. cancerophobia.Reconstruction technique for BRRM included 12 (75%) subpectoralis implants, 1 (6.25%) tissue expanders and secondary implants, and one (6.25%) latissimus dorsi flap with implant. BRRM complications included diverse degrees of seroma , diverse degrees of nipple-areola complex necrosis, total breast necrosis in one pt. 3 (18.75%) pts. had atypical ductal hyperplasia, 1 of which was bilateral. No BC cases have been recorded to date. Satisfaction with procedure is good to excellent in 14 (87.5%). Conclusions: BRRM is a safe procedure. Indications include medical evaluation (premalignant disease, high risk profile), or patient preference. Satisfaction with procedure is high.