bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract P4-16-11: Impact of receptor status on prognosis among breast cancer patients with brain metastases treated with Cyberknife radiosurgery
Authors: Fasola CE , Gibbs IC , Soltys SG , Horst KC 
Published: August 2014

Abstract
Purpose: Stereotactic radiosurgery (SRS) is increasingly used in the management of brain metastases. Receptor status is an important prognostic factor among women with breast cancer. The aim of this study was to evaluate the effect of receptor status on clinical outcomes in breast cancer patients with brain metastases treated with SRS.
Materials and Methods: We performed a retrospective review of 102 primary breast cancer patients with brain metastases treated with Cyberknife radiosurgery at Stanford University Medical Center between 2004 and 2011. The clinical characteristics, pathologic features, treatment details and clinical outcomes were reviewed. Median follow-up time was 18 months from the date of treatment with Cyberknife radiosurgery. All analyses were performed using SAS software, version 9.3 (SAS Institute, Cary, NC).
Results: Patients with Her-2/neu positive receptor status treated with trastuzumab had a significantly improved median overall survival after treatment with stereotactic radiosurgery compared to patients with Her-2/neu negative receptor status (27 months vs 7 months, p = 0.002) or patients with Her-2/neu positive receptor status who did not receive trastuzumab (27 months vs 12 months, p = 0.04). In contrast, patients with estrogen receptor, progesterone receptor and Her-2/neu negative receptor status had significantly worse median overall survival after treatment with stereotactic radiosurgery compared to patients with at least one positive receptor (8 months vs 17 months, p = 0.02). On multivariable analysis, Her-2/neu status emerged as the only significant predictor of survival (p = 0.01).
Conclusions: Her-2/neu receptor status was found to be a significant prognostic factor influencing survival among breast cancer patients with brain metastases treated with SRS. Importantly, the addition of treatment with trastuzumab among Her-2 neu positive patients significantly improved clinical outcomes.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P4-16-11.
Abstract P4-17-05: Reconstructive breast surgery using an acellular dermal matrix: prospective outcomes of an observational, cohort study (POBRAD).
Authors: Westbroek David , Kothari Ash , Hamed Hisham , Agbaje Olorunsola , Douek Michael 
Published: August 2014

Abstract
Withdrawn by Author
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P4-17-05.
Abstract P4-17-06: The use of specialist nurse-led clinics in preparation for reconstructive breast surgery.
Authors: Affan AM , Ali RA , Morton-Gittens JA , Perry A , Harry A , O'Donoghue JM , Rampaul R 
Published: August 2014

Abstract
Objective: To assess the effectiveness of a specialist nurse in a breast oncoplastic clinic. This was done by comparing patient reported outcome measures (PROMS) following information given about breast reconstructive surgery by either a specialist nurse or consultant surgeon.
Design & Methods: From June 2011 to December 2011 a study specific questionnaire was administered to patients who were considering breast reconstruction at the St. James Breast Service in Trinidad. A modified questionnaire was used which employed a Likert scale in order to provide a measure of patient satisfaction with the preoperative information and preparation provided by either a specialist breast cancer nurse (Group 1) as compared to the consultant breast surgeon (Group 2). The scale graded satisfaction levels from one to five where one represented patient dissatisfaction while five indicated complete satisfaction. Data was collated and analyzed using SPSS 17 with the significance level set at p = 0.05.
Results: Seventy-five (75) patients were obtained for the study. Sixty-three (63) of these patients responded adequately to the questionnaire resulting in an eighty-five percent (85%) response rate. There was a 97% overall satisfaction (n = 61) with the preoperative information given whether administered by the specialist nurse or the consultant surgeon. Ninety-five percent (95%) (n = 60) of patients indicated that verbal information from the consultant was extremely useful while eighty-seven percent (87%) (n = 55) of patients responded favorably to the information departed by the specialist nurse (X21.21; p = 0.271). Additonally, ninety-five percent (95%) (n = 60) were completely satisfied with the response from the consultant while ninety percent (90%) (n = 56) with that of the specialist nurse (X22.072; p = 0.150). Overall conversion rate to breast reconstruction has been 89%.
Conclusions: This data demonstrates that there appears to be no difference between the patient reported outcomes when receiving information from either the specialist nurse or the surgeon. Therefore, a pre-operative nurse led clinic for breast reconstruction can be an effective and acceptable approach for patients seeking this service.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P4-17-06.
Abstract P4-17-07: Reconstructive Outcomes of Nipple-Sparing Mastectomy: A Five Year Experience
Authors: Guth AA , Blechman K , Samra F , Shapiro R , Axelrod D , Choi M , Karp N , Alperovich M 
Published: August 2014

Abstract
Background: Nipple-sparing mastectomy (NSM) has gained popularity, but remains contoversial as the procedure's reconstructive outcomes and oncologic safety are still somewhat uncertain.
Methods: We retrospectively reviewed the New York University-Langone Medical Center experience with NSM from 2006–2011. Outcomes measured include post-operative complications, breast cancer recurrence, presence of cancer at the nipple-areolar complex, and nipple-areolar complex viability.
Results: Our data include patients who underwent NSM from 2006–2011. In total, the records of 235 (145 prophylactic, 90 theraputic) NSM at NYULMC were reviewed. Our reconstructive dta included all forms of reconstruction, including 144 tissue expanders, 74 microvascular free flaps, 16 immediate implants, and 1 combination latissimus dorsi flap with implant. Mean follow-up time was 19 months. No differences existed between the theraputic and prophylactic breast patients.
The major complication rate of 4.3% (10/235) included 4 intraoperative hematoma evacuations, 1 flap anastomosis revision, and 3 explanted implants. One patient expired 4 months following surgery secondary to progression of disease. The microvascular free flap loss rate for this group was 0. Minor complications in 6.8% of patients consisted of implant exchange for asymmetry, operative revision of partial flap necrosis, intravenous antibiotics for infection, and 1 non-operative hematoma.
In total, 5.9% of nipples were resected due to malignant or premalignant disease. There were 3 positive intraoperative biopsies with 9 additional biopsies positive on final pathology. To date, there have been no recurrences involving the nipple-areolar complex. The viability rate for the remaining nipples was 93.2% with1.7% of nipples undergoing complete necrosis, 3.8% partial necrosis, and 1.3% undergoing epiderolysis.
Conclusions: This experience with NSM demonstrates the in a carefully selected cohort, oncologic safety and reconstructive outcome are comparable to the current standard of total mastectomy.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P4-17-07.
Abstract P4-17-09: Efficacy and safety of lipomodelling and adipose tissue derived degenerative stem cells(ADRC) for breast reconstruction – Medium term follow up
Authors: Noor L , Bhaskar P , Hennessy C 
Published: August 2014

Abstract
Background: Past and current literature support Lipomodelling as a tool for breast reconstruction. Lipomodelling with Adipose tissue Derived Regenerative Stem Cells dramatically improves the graft survival through both adipogenesis and angiogenesis. Literature regarding safety of this procedure for breast reconstruction is limited. Our aim was to assess the safety and efficacy of ADRC-enriched fat grafts for breast reconstruction.
Material & Methods: A prospective study from September 2008 – April 2012 at a District General Hospital UK including patients operated by two breast surgeons. The indications and the fat grafting procedures used are analyzed (Cytori Celution 800/CRS or Cytori pure graft system). Patients with benign indications were followed for 1 year and those with cancer were followed for 5 years according to regional guide lines with breast imaging.
Results: Out of total 50 patients, 10 had benign diagnosis while 40 had breast cancer treatment. 30 patients had correction after breast conservation, 17 had revision of reconstruction (8 TRAM, 4 LD and 5 implant based reconstruction) while 3 had other procedures. 19/40 had history of breast irradiation as adjuvant treatment after surgery for breast cancer. Median age was 52 years with range 18–72 years. ADRC enriched fat grafting was done in 40 cases and pure graft in10 patients. Graft volume injected was 80–420 mls (average 247 mls). 90% patients are satisfied with outcome of surgery with good to excellent cosmetic outcome. Only 4 patients had noticeable fat resorption, 3 underwent redo grafting. At average follow up of 21 months (1–48 months) no significant complications were seen, imaging showed fat necrosis in 3 and oil cyst in 1 patient though no one required biopsy. No patient developed local recurrence, although 4 subsequently found to have metastatic disease.
Conclusion: We found it a useful, safe and effective technique for breast reconstruction with high patient satisfaction. We recommend a central database of all patients with this procedure to substantiate findings of this study and as recommended by Association of Breast Surgery (ABS) & British Association of Plastic Reconstructive & Aesthetic Surgeons (BAPRAS).
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P4-17-09.
Abstract P5-01-03: Discordant Estrogen and Progesterone Receptor Status in Breast Cancer
Authors: Hefti MM , Hu R , Knoblauch N , Collins L , Tamimi RM , Beck AH 
Published: August 2014

Abstract
Introduction: Hormone receptor status is used to guide clinical therapy in breast cancer. Estrogen receptor (ER) assays from pathology reports have been shown to be in agreement with ER measured by a centralized laboratory on tissue microarray 87% of the time (Kappa = 0.64); however, little is known of reproducibility within subsets of patients defined by ER/PR status (1).
Methods: We computed percent agreement and Kappa statistics for ER/PR status as reported in pathology reports from Nurse's Health Study (NHS) participants with breast cancer from 1976 to 2000, and as scored by immunohistochemistry (IHC) on tissue microarrays at a central laboratory (n = 2011). Statistics were computed separately for 4 subsets of patients stratified by ER/PR status as defined by pathology reports (ER+/PR+, ER+/PR−, ER−/PR+, ER−/PR−). We also used a curated compilation of publicly available gene expression data sets providing both IHC and microarray data on ER and PR expression (n = 1236).
Results: We observed significant heterogeneity in Kappa values across the four groups of patients, with ER+/PR+ and ER−/PR- showing the strongest agreement, ER+/PR- showing fair agreement, and ER−/PR+ showing no significant agreement: 89.1% of ER+/PR+ cases from medical record were ER+/PR+ by TMA (κ=.60), 69.4% of ER−/PR- cases from medical record were ER−/PR- by TMA (κ=.63), 42% of ER+/PR- cases from medical record were ER+/PR- by TMA (κ=.37), and only 6% of cases of ER−/PR+ cases from medical record were ER−/PR+ by TMA (κ=.06). Using publicly available microarray data, we observed similar results comparing IHC to gene expression data in the same samples. Expression values were scaled across patients, and a patient was classified as positive for the marker by microarray if the scaled expression value was greater than zero. The agreement between IHC data and gene expression-based classification was 50.0% (k = .50), 80.8% (κ=.54), 42.0% (κ=.15), and 7.2% (κ = −.006) for ER+/PR+, ER−/PR−, ER+/PR−, and ER−/PR+, respectively.
Conclusion: ER−/PR+ is by far the most rare and least reproducible subset of breast cancer cases. Given the lack of reproducibility of the ER−/PR+ group and the minimal reported benefit from hormonal therapy in these patients (2), these data question the clinical utility of assessment of PR, particularly in ER− breast cancer.
1. Collins LC, Marotti JD, Baer HJ, Tamimi RM. Comparison of estrogen receptor results from pathology reports with results from central laboratory testing. Journal of the National Cancer Institute. 2008;100(3):218–21. 2. Anderson H, Hills M, Zabaglo L, A'Hern R, Leary AF, Haynes BP, et al. Relationship between estrogen receptor, progesterone receptor, HER-2 and Ki67 expression and efficacy of aromatase inhibitors in advanced breast cancer. Annals of oncology: official journal of the European Society for Medical Oncology/ESMO. 2011;22(8):1770–6.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P5-01-03.
Abstract P5-01-05: Could c-myc amplification replace Cahan's criterias to discriminate secondary from primary angiosarcoma of the breast?
Authors: Laé M , Hamel F , Hadj-Hamou S , Malfoy B , Kirova YM 
Published: August 2014

Abstract
Background: Angiosarcomas (AS) are a relatively rare histological subtype of sarcomas. Despite their rarity, AS display remarkable clinical heterogeneity. These tumors can occur in any location in the body, but the breast AS are important part of these tumours. Cahan et al. defined the criteria for the diagnosis of radiation induced sarcomas (RIS), used since 1948: i) prior history of RT; ii) asymptomatic latent period of several years; iii) the occurrence of a sarcoma within a previously irradiated field; iiii) histological confirmation of sarcomatous nature of the post-irradiation lesion.
Purpose: The aim of this study is to show a new biological data which can help us to recognize these rare tumors.
Material and Methods: Forty-one breast AS were studied (pathological review, clinical and follow-up information obtained), as well as the transcriptome signatures of the radiation tumorigenesis. For all RIS, the patients' radiotherapy plans and hospital records were reviewed and their radiation related nature was confirmed if they respected the classic Cahan's criteria. Interphase FISH was performed by hybridization of probes covering C-MYC (chromosome 8q24.21) and CEP8 on tissue sections from each of the forty-one tumors.
Results: Among forty-one breast AS, thirty one were secondary tumors and ten primary tumors. Amplification (5 to 20 fold) of the MYC oncogene was found in all breast secondary AS (31 cases) but in none of the 10 primary AS except one. The relationships between clinical, pathological and biological features are studied. These data point the pathways preferentially involved in the pathogenesis of secondary AS of the breast and may provide the basis for an additional targeted therapy.
Conclusion: The presence of c-myc amplification on biopsy or surgical specimen represents an important additional tool to discriminate secondary from primary angiosarcoma of the breast when radiotherapy data are not available.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P5-01-05.
Abstract P5-01-06: Differences in FGF1 and FGFR2 expression in BRCA1-associated, BRCA2-associated, and sporadic breast carcinomas
Authors: Vos S , van der Wall E , van Diest PJ , van der Groep P 
Published: August 2014

Abstract
Introduction. In contrast to BRCA1-associated breast cancer, a distinctive phenotype for BRCA2-associated carcinomas has not been identified yet as there is no clear distinction between BRCA2- and non-BRCA mutation related or sporadic carcinomas. Recently, studies suggest overexpression of fibroblast growth factor 1 (FGF1) and fibroblast growth factor receptor 2 (FGFR2) in BRCA2 related cancers. The aim of the study was therefore to investigate whether there is differential expression of FGF1 and/or FGFR2 between BRCA2 related and sporadic and BRCA1 related cancers. This would reveal the usefulness of FGF1 and FGFR2 immunohistochemistry in daily pathology practise.
Method. Invasive breast carcinomas of 33 BRCA1 and 22 BRCA2 germline mutation carriers and a tissue microarray containing 104 sporadic invasive breast carcinomas were immunohistochemically stained for FGF1, FGFR2, estrogen receptor (ER), progesterone receptor (PR), HER2, epidermal growth factor receptor 1 (EGFR), cytokeratin (CK) 5/6 and CK14.
Results. FGFR2 expression was seen in 68.2% and 79.0% of BRCA2-associated and sporadic carcinomas respectively, in contrast to 22.6% of BRCA1-associated tumors (p = 0.000). FGF1 expression was seen in 72.7% of BRCA2-associated carcinomas and in 45.2% and 41.8% in BRCA1-associated and sporadic carcinomas, respectively (p = 0.032).
Conclusion. FGFR2 expression differs significantly between BRCA1- and BRCA2 associated breast carcinomas but not between BRCA2 and sporadic cancers. FGF1 expression differs significantly between BRCA2-associated and sporadic carcinomas and could be used as a BRCA2-specific biomarker.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P5-01-06.
Abstract P5-01-10: Clinical-pathological features and outcomes of Invasive lobular (ILC) vs Invasive ductal (IDC) breast cancer (BC): a mono-institutional series.
Authors: Ferro A , Eccher C , Triolo R , Caldara A , Di Pasquale MC , Russo LM , De Carli NL , Cuorvo LV , Barbareschi M , Gasperetti F , Berlanda G , Pellegrini M , Moroso S , Galligioni E 
Published: August 2014

Abstract
Purpose: The aim of our study was to investigate different clinico-biological behavior associated to ILC compared to IDC evaluating implications on survival outcomes
Methods: We analyzed data from 3749 cases of IBC treated from 1995 to 2008 and categorized as having ILC, IDC and mixed/other. Associations between clinical-pathological variables and the ILC/IDC histotype were assessed using a χ2 test. Log-rank test and Cox regression model were performed to evaluate the impact of hystologic types on overall survival (OS), Event Free Survival (EFS) and Post-Progression Survival (PPS).
Results: We identified 445 (12%) ILC, 3021 (80.5%) IDC, 149 mixed (ductal-lobular) BC (3.9%) and 134 other hystotypes (3.6%). Median age was 61 (25–97) years. Compared with IDC, ILC occurred significantly (p &lt; 0.001) more likely in older age, larger in size (T≥2: 46 vs 34%) with frequent axilla involvement (43 vs 37%). It was associated with better differentiated tumors usually presenting low ki67, high level of ER expression and HER2 negative status. Mastectomies were more frequent (45%) in ILC than in IDC (37%). As ILC showed higher ER expression rates, adjuvant hormonal (± previous chemo) therapy was more frequently given to them than IDC (77 vs 64%). At a median follow up of 77 (0–272) months, there were not significant differences in EFS (81.4 vs 82.1%, p = 0.7) and OS (82.8 vs 84.6%; p = 0.19) between ILC vs IDC. Relapses, contralateral and second tumors were 65 (15%), 9 (2%) and 22 (5%) in ILC vs 404 (13%), 84 (2.8%) and 174 (5.7%) in IDC. Local recurences were 16 (3.6%) vs 175 (5.7%) in ILC vs IDC; preferential sites of distant relapses were similar in both histotypes. Median time to first event was 38.3 in ILC vs 35.23 months in IDC. PPS was 16.5 m (0–100) in ILC and 22.2 m (0–187) in IDC. ILC showed worse prognosis than IDC within luminal A (86.9 vs 93.5%; p = 0.003), C (70.4 vs 88.5%; p = 0.028) and in triple negative subtypes (50 vs 73.1%; p = 0.021). No difference in OS was seen for age, size, hormonal and nodal status, except in N &gt;3 ILC pts, in whom a trend of worse prognosis (55.6 vs 60.2%) was observed.
Conclusions: Despite the quite favorable biological pattern, ILC did not show a better outcomes than IDC.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P5-01-10.
Abstract P5-01-12: Over- and Undergrading of Breast Cancer on Core Biopsies in Comparison to Surgical Specimens
Authors: Decker T , Focke CM , Gläser D , Finsterbusch K 
Published: August 2014

Abstract
Background: In numerous studies histological grade (HG) remained an independent prognostic factor for ER positive tumours even after the inclusion of gene signatures in the multivariate models. Moreover, grade 3 is judged as clear argument in favour of chemotherapy. Therefore, there are many reasons to provide patients and doctors with HG as important prognostic and predictive information already preoperatively. To evaluate the relevance of histological grading (HG) based on core biopsies (CB) for clinical decision making in breast cancer (BC) we evaluated the concordance with HG from surgical specimen (SSP) and the reasons for under- or overgrading.
Methods: CB and related SSP of 398 BCs were prospectively graded according to the Nottingham grading system (SSP: 65 G1, 162 G2 and 171 G3). CB/SSP agreement rates and positive predictive values (PPV) of CB based HG were calculated. Rates of over- and underestimation of glandular differentiation (GD), nuclear pleomorphism (NP) and mitotic activity (MA) were calculated.
Results: CB/SSP agreement rates came out with 95% for G1, 73% for G2, and 56 % for G3. The PPVs of CB based HG were 56% for G1, 61% for G2 and 100% for G3. The overgrading and undergrading rates on CB were 1% and 37%, respectively. Main causes for undergrading in CB were underestimated MA (40%) and a combination of underestimated NP and MA (32%).
Conclusions: Whereas overgrading on CB is an exception, undergrading derives largely from underestimation of proliferation. G3 assessed on CB came out with the highest PPV, providing a reliable base for preoperative decisions i.e. about primary chemotherapy. Reversely, because of the relative low PPV of G1 on CB one has to be aware of potential upgrading on surgical specimen later on.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P5-01-12.