bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract P2-11-15: Development of a web-based survey tool to assess change in breast cancer (BrCa) survivor knowledge after receipt of cancer treatment summary and survivorship care plan (SCP).
Authors: Custer JL , Rocque GB , Wisinski KB , Jones NR , Donohue S , Koehn TM , Champeny TL , Terhaar AR , Chen KB , Peck KA , Tun MT , Wiegmann DA , Sesto ME , Tevaarwerk AJ 
Published: August 2014

Abstract
Intro: The Institute of Medicine advocates survivorship care plans (SCPs) as tools to improve coordination of care by improving survivor knowledge of follow-up recommendations and future risks. No evidence exists to demonstrate that SCPs impact survivor knowledge of diagnosis, treatment, or future/chronic side effects. Furthermore, there is a lack of information on existing surveys and their ability to assess survivor knowledge regarding these issues, without change over time. The purpose of this research is to report on the development of a survey assessing knowledge of diagnosis, treatment, and side effects in BrCa survivors.
Methods: Using existing literature, two oncologists created 24 questions addressing knowledge of diagnosis, treatment, and side effects. Content experts including breast oncology providers (representing multiple subspecialties), Survey Research Shared Service (SRSS) and patient advocates reviewed and revised the questions. Next, potential questions were administered in a group setting to BrCa survivors to evaluate clarity of instructions and survey wording. The Breast Cancer Knowledge (BreaCK) survey was further revised based on survivor feedback.
For pilot testing, BrCa survivors were recruited from clinic to test BreaCK survey content and clarity. Survey 1 was administered in clinic online. SRSS conducted verbal assessments regarding content after Survey 1. Four weeks later, survivors received Survey 2 via email and answered online. Correct answers were abstracted from the medical record.
Results: Nine subjects completed both surveys. Qualitatively, little intra-subject variation was seen between surveys. Subjects did not feel that the survey was burdensome or intrusive. No subject was able to correctly answer all questions. Final survey adjustments were made based on subject feedback and common incorrect answers encountered when grading the surveys. Specifically, subjects had difficulty understanding “endocrine or hormone therapy.” Furthermore, subjects reported guessing in response to some questions – additional answer categories were added, including “I don't know.”
Conclusion: Survivor knowledge did not change significantly between surveys. This suggests survivor knowledge was not impacted by the survey over the four-week interval. The revised BreaCK survey may be a useful tool for assessing survivor knowledge of diagnosis, treatment and side effects. A larger cohort of BrCa survivors is being recruited, starting Summer 2012, and will be evaluated using the survey.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P2-11-15.
Abstract P2-12-01: Prospective Evaluation of Joint Symptoms in Postmenopausal Women Initiating Aromatase Inhibitors for Early Stage Breast Cancer
Authors: Crew KD , Chehayeb Makarem D , Awad D , Kalinsky K , Maurer M , Kranwinkel G , Brafman L , Fuentes D , Hershman DL 
Published: August 2014

Abstract
Background: Aromatase inhibitors (AIs) are widely prescribed to postmenopausal women for the adjuvant treatment of hormone-sensitive breast cancer (BC). However, musculoskeletal complaints can lead to nonadherence and early discontinuation. The aim of this study was to characterize the natural history of the AI-induced arthralgia syndrome and determine predictors of worsening symptoms.
Methods: Postmenopausal women with stage I-III BC initiating adjuvant AI therapy were enrolled. All patients completed the following questionnaires at baseline and every 3 months for a year: Modified Brief Pain Inventory-Short Form (BPI-SF), Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index and the Modified Assessment of Chronic Rheumatoid Affections of the Hands (M-SACRAH). Higher scores reflect worse symptoms. Quality of life was assessed using the Functional Assessment of Cancer Therapy-Endocrine Subscale (FACT-ES). Hand grip strength was measured at each visit with a Martin dynamometer. Paired t-tests were performed to compare follow-up evaluations to baseline. Linear Regression was performed to evaluate the association between baseline symptoms and change in symptoms.
Results: A total of 169 patients have been consented, 3-month data is available on 102; 6-month data on 85. Median age: 63 (42–89); White/Black/Asian/Hispanic: 61.48/30.33/3.28/25.6; median BMI (kg/m2): 28 (12–50). Compared to baseline, there was a statistically significant increase in BPI pain severity and endocrine related symptoms on the FACT-ES at 3 and 6 months. Significant changes in the BPI pain interference, M-SACRAH pain and stiffness, WOMAC function, physical well-being on the FACT-ES, trial outcome index and pinch grip strength were seen at 3 months; however these changes did not remain significant at 6 months. Logistic regression models evaluating predictors of patient reported outcome measures and grip strength were performed. Baseline score was the strongest predictor of worsening symptoms (p &lt; 0.01) after correcting for age, prior chemotherapy and baseline joint conditions.
Conclusions: Treatment with adjuvant AI therapy is associated with significant worsening of joint pain and stiffness which is most prominent at the 3 months evaluation. Patients with baseline joint symptoms are at greatest risk for worsening symptoms on AIs.

Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P2-12-01.
Abstract P2-12-10: Psycho-spiritual therapy for improving the quality of life and spiritual well-being of women with breast cancer
Authors: Loghmani A , Jafari N , Zamani A , Farajzadegan Z , Bahrami F , Emami H 
Published: August 2014

Abstract
Objective: Psychological distress and morbidity are common consequences of diagnosis and treatment of breast cancer and associated with poor quality of life (QOL). Among several approaches, spirituality has been shown to be significantly associated with improving the quality of life of these patients. The aim of this study was to assess the role of psycho-spiritual therapy intervention in improving the quality of life and spiritual well-being of patients with breast cancer.
Methods: This was a randomized controlled trial study which was conducted in the Breast Cancer Research Center, St. S. Al-Shohada hospital, Isfahan, Iran. Sixty-eight patients with breast cancer were randomized to either psycho-spiritual therapy intervention group or control group who received routine management and educational programs. Before and after 6 weeks of psycho-spiritual therapy sessions, the quality of life was evaluated using Cancer quality-of-life questionnaire (QLQ-C30) and its supplementary breast cancer questionnaire (QLQ-BR23) and Spiritual well-being was measured using the Functional Assessment of Chronic Illness Therapy Spiritual Well-being scale (FACIT-Sp12). Multivariate, repeated-measures ANOVA, T-test and Paired T-test were used for analysis using Predictive Analytic Soft Ware (PASW, version 18) for windows.
Results: In all sixty five patients actually completed the six-week intervention and were evaluated for the outcomes. The mean Global health status score/QOL reached from 44.37 (SD: 13.03) to 68.63 (SD: 10.86), (p &lt; 0.001), (Cohen's d effect size: 2.16, 95% CI: 1.56–2.78). There was a statistically significant difference in all functional scales of QLQ-C30 (p &lt; 0.05) as well as spiritual well-being after intervention. (p = 0.02)
Conclusions: The results of this trial showed that the psycho-spiritual therapy program can improve the spiritual well-being and QOL of women with breast cancer. This program, with its ease of implementation and home practice, could be adopted in comprehensive care programs for women with breast cancer.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P2-12-10.
Abstract P2-13-10: Prospective randomized and multicentric evaluation of cognition in menopausal breast cancer patients receiving adjuvant hormonotherapy: a phase III study (Preliminary results)
Authors: Vanlemmens L , Delbeuck X , Servent V , Mailliez A , Vanlemmens L , Lefeuvre-Plesse C , Kerbrat P , Petit T , Fournier C , Vendel Y , Clisant S , Bonneterre J , Pasquier F , Le Rhun E 
Published: August 2014

Abstract
Background: Cognitive impairment has been considered to be a possible adverse effect of aromatase inhibitors (AI). The aim of the study was to compare the impact of tamoxifen or AI on verbal memory (Rey auditory-verbal learning test) and other cognitive functions (memory, executive and attentional functions) after 6 months of treatment.
Methods: In this randomized, open-label phase III study, menopausal patients treated with adjuvant hormonotherapy for early breast cancer were enrolled at the end of the radiotherapy. Patients over 70 years, with a history of cognitive disorder or with prior chemotherapy were excluded. Detailed neuropsychological assessments and quality of life evaluations were performed before the 1st administration of hormonotherapy and then 6 months later. Considering the usual norms of the auditivo-verbal Rey test, an alpha risk of 5% and a 95% power, 27 patients per arm had to be included. Statistical analyses included Chi2 test and Student tests when appropriate.
Results: 62 consecutive evaluable patients were randomized in 2 arms between March 2009 and April 2011. Patients received tamoxifen in arm A (n = 31) and AI in arm B (letrozole n=17; anastrozole n=12; exemestane n= 2). Median age at inclusion was 61.4 years. The median time since menopause was 10 years. Characteristics of the breast tumor and initial neuropsychological evaluations did not differ significantly between the 2 arms. After 6 months, we observed a significant decline of the performance at the episodic memory test (immediate recall of the Rey auditory verbal learning test) (p = 0.0015) in arm A only and a significant improvement on executive measures (Trail Making Test and Stroop test) (respectively p = 0.03/p = 0.002) in arm B. Quality of life didn't differ after 6 months of treatment.
Conclusions: These preliminary results do not support that AI have a worse adverse effect on cognitive functions than tamoxifen after 6 months of treatment. A confirmation is planned after one year of treatment.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P2-13-10.
Abstract P2-14-01: Fulvestrant vs exemestane for treatment of metastatic breast cancer in patients with acquired resistance to non-steroidal aromatase inhibitors – a meta-analysis of EFECT and SoFEA (CRUKE/03/021 & CRUK/09/007)
Authors: Johnston SRD , Chia S , Kilburn LS , Gradishar WJ , Cameron D , Dodwell D , Ellis P , Howell A , Im Y-H , Coombes G , Piccart M , Dowsett M , Bliss J ,   the SoFEA and EFECT Investigators
Published: August 2014

Abstract
Background: Optimal endocrine treatment (trt) for post-menopausal women with ER+ advanced breast cancer (ABC) progressing on or following a non-steroidal (NS) aromatase inhibitor (AI) is unclear. The EFECT study showed no difference in efficacy between the steroidal antiestrogen fulvestrant (F) & steroidal AI exemestane (E) in this setting (HR = 0.96, 95%CI: 0.82, 1.13; p = 0.65). Pre-clinical data suggest F may be more effective in a low estrogen environment. SoFEA investigated F combined with anastrozole (F+A) in patients (pts) with acquired resistance to previous AI compared with F alone & F alone vs. E. The combination of F+A was no better than F (HR = 1.00, 95%CI: 0.83, 1.21; p = 0.98) nor F alone better than E (HR = 0.95, 95%CI: 0.79, 1.14; p = 0.56); the lack of added benefit for F+A is consistent with previous 1st-line studies that have assessed this combination versus A alone (FACT & SWOG-S0226).
Methods: SoFEA is a multi-center partially blinded randomized phase III study postmenopausal women were allocated to F plus A (F+A n=243), F plus placebo (n = 231) or E (n = 249). Similarly, EFECT is a randomized, double-blind, placebo controlled, multi-center phase III trial of F (n = 351) versus E (n = 342) in postmenopausal women (see table). However, given the differences in prior endocrine therapy/responsiveness within SoFEA & EFECT populations, an individual pt meta-analysis combining data from SoFEA & EFECT will be conducted enabling exploration of putative effects within specific pt subgroups to establish evidence in support, or not, of a pt subgroup sensitive to F at the dose used in these trials. Subgroups to be analysed include receptor status, visceral involvement, AI sensitivity, age, NSAI setting & time on NSAI.
Results: 723 pts (480 in F & E) were enrolled from 82 UK & 4 South Korean centers (03/2004-04/2010) in SoFEA. 693 pts were enrolled from 138 centers worldwide (08/2003-11/2005) in EFECT. Trt was well tolerated in both trials; serious adverse events were rare. The meta-analysis will be conducted in July 2012 & results presented.
Conclusion: Combining individual pt data from SoFEA & EFECT via meta-analysis will provide definitive clinical information on pt's response to F at the dose used in these studies, in particular whether certain pts with acquired resistance to NSAI do experience benefit of use of this antiestrogen as opposed to E.

Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P2-14-01.
Abstract P2-14-03: “Ethinylestradiol” is beneficial for postmenopausal advanced breast cancer patients heavily pre-treated with endocrine agents
Authors: Iwase H , Yamamoto Y , Murakami K-I , Yamamoto-Ibusuki M , Tomita S , Omoto Y 
Published: August 2014

Abstract
Purpose and Methods: Estrogen deprivation therapy using aromatase inhibitors is a standard therapy in postmenopausal hormone-dependent breast cancer. Paradoxically, low-dose estradiol was reported to be beneficial for the postmenopausal patients who have been heavily pre-treated with long-term sequential anti-estrogen therapies. To determine efficacy and safety of ethinylestradiol (3mg/day oral), a phase 2 study has been performed for the postmenopausal patients with advanced or recurrent breast cancer who became resistant to sequential endocrine treatments. The primary endpoint was clinical benefit rate, secondary were safety, objective response rate and time to progression. The interim data will be reported because of the extremely beneficial results.
Results: Eighteen cases with ER-positive tumor which showed resistance to previous sequential-endocrine therapies including SERMs and/or aromatase inhibitors were registered from Oct 2010 to May 2012. Their mean age was 62 years-old and the mean observation time was 9.2 months. Nine cases were evaluated as partial response, 1 case as long NC, 3 cases as stable disease, and another 2 cases as progressive disease. In three cases of all 18 cases, the estradiol administration was withdrawn within 1 week with their early endocrine-related symptoms, such as nausea, general fatigue and fever. Duration of effect in the case of the PR (including the 4 ongoing cases) was more than 24 weeks. All of 9 responders had high ER expression in the primary or metastatic tumor and had a history of long-term endocrine therapies in metastatic setting and had response to previous endocrine therapies. Serum estradiol levels elevated as 30–100pg/mL, and FSH was suppressed below premenopausal levels in 4 weeks later administration. Although the weight gain, irregular vaginal bleeding, or endometrial thickening was observed in patients treated with long-term treatment, there was no severe adverse event, such as deep venous thrombosis or other malignancies in this series.
Discussion: The mechanism of low-dose estrogen treatment can be considered the estrogen-induced apoptosis. The high ER expression and the response to previous endocrine therapies might be recognized as predictive factor of this treatment. This low-dose estrogen therapy may contribute to overturn the common sense of the endocrine therapy for breast cancer.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P2-14-03.
Abstract P2-16-01: Prospective breast cancer quality evaluation application developed for native Android tablet and web browser for improving mutltidisciplinary breast cancer care
Authors: Grobmyer SR , Raum N , Sposato V 
Published: August 2014

Abstract
Introduction: Easy to implement, prospective and user-friendly data collection tools are needed to insure optimal breast cancer care as defined by national quality measures. Prospective quality measurement can effectively allow rapid identification of gaps in care and identification for sources of programmatic improvement in multidisciplinary care.
Methods: Our group has designed a novel prospective quality assessment tool system, which consists of 3 major integrated components: 1) a web application for administration and reporting of the data, 2) a native Android tablet application for real-time data collection of breast cancer quality parameters during tumor board, and 3) a backend database where parameters are stored and reported on.
Results: The web application is the primary interface for the breast cancer coordinator (BCC) to enter information for the applicable Tumorboards. Quality parameters for measurement as determined by the breast program leadership are entered into the system by the BCC on the web application. The BCC will also enter medical record numbers of patients to be presented at each tumor board in the web based system. In order to maximize work flow and reduce error, the system was designed to interface with the hospital electronic medical record for retrieval of patient demographic data based on medical record number entry.
The Android tablet is the interface to the system during weekly breast cancer tumor board. The tablet application facilitates real time, prospective collection of: tumor board attendance, tumor staging, tumor type, and collection of center chosen and required breast cancer quality measures. Data collected on the android system is stored in real time a central and secure database.
Real time quality data analysis and graphical display for user defined time periods is available on the web application and Android tablet. Required tumor hospital tumor registry data is also compiled in real time reports to faciliate communication with the hospital tumor registry.
Conclusions: A novel real time Android based solution has been developed for real time breast cancer care quality and tumor registry information. Use of this technology greatly simplifies data collection required for participation national breast cancer accreditation organizations such as NAPBC as well as the American Joint Commission on Cancer. Its ease of implementation and use favor its widespread adoption. Efforts to quantify the impact of this unique tool on quality of performance in a multidisciplinary breast cancer program are underway.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P2-16-01.
Abstract P3-01-02: Correlation of Mammographic breast density and tumor characteristics in Korean breast cancer patients
Authors: Cho JY , Ahn SH , Lee JW , Yu JH , Koh BS , Kim HJ , Lee JW , Son BH , Gong G-y , Kim HH 
Published: August 2014

Abstract
Introduction: Western studies have demonstrated high breast density as a strong risk factor for breast cancer, it is poorly understood whether breast density affects the diverse phenotypes of breast cancer. We examined the association between various tumor characteristics and mammographic breast density in women with breast cancer.
Methods: We conducted a cross-sectional analysis in 910 Korean women diagnosed with breast cancer to evaluate the associations between breast density and tumor size, lymph node status, lymphovascular invasion, histologic grade, estrogen receptor, progesterone receptor, HER2. Breast density was classified as fatty (percent density less than 50% by a computer-assisted thresholding program, named “Cumulus™”; n = 470) or dense (percent density 50% or more; n = 440) for the cancer-free breast at the time of operation. Logistic regression was used to examine whether the relationships were modified by adjustment for body mass index, age at diagnosis, age at first birth, menopausal status, history of breast-feeding, and breast cancer staging.
Results: Total 910 patients were involved, the mean age and median age at the operation was 48 years old (range 20–82), and the mean percent density was 48.09 (SD = 9.62 %: normally distributed, Kolmogorov-Smirnov test p = 0.32). Crude analysis shows that tumor size over than 0.5cm were more likely to have dense breasts compared with women with a tumor size &lt;=0.5 cm (OR = 3.21, 95% CI = 1.59–6.45, p = 0.001 for tumor sizes 0.6–1.0cm; OR = 2.02, 95% CI = 1.09–3.74, p = 0.03 for tumor sizes 1.1–1.5cm; OR = 1.8, 95% CI = 0.97–3.33, p = 0.06 for tumor sizes 1.6–2.0cm; and OR = 1.64, 95% CI = 0.92–2.94, p = 0.1 for tumor sizes 2.1cm or more). PD and histologic grade shows reverse association between histologic grade 1 and grade 2,3. Progesteron receptor positive patients tend to have more dense(OR = 1.27, 95% CI=0.97–1.66, p = 0.07) breast than receptor negative patients, although after adjustment of age the statistical significant disappeared. Percent density was not significantly associated with, ER (p = 0.74), HER2 (p = 0.72).

Conclusion: These results suggest that breast density is associated with tumor size and histologic grade and progesterone receptor positivity. Additional studies are needed to address whether these associations are due to just density masking the detection of some tumors, biological causation, or both.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P3-01-02.
Abstract P3-01-03: Breast density profile in a prospective large breast cancer screening program in South Brazil.
Authors: Caleffi M , Zignani J , Clarissa A , Ademar BJ , Ribeiro R , Dakir DF 
Published: August 2014

Abstract
Introduction: Women involved in breast cancer (BC) screening of NMPOA cohort, in South Brazil, are undergoing their 8th year of follow up. As mammography breast density is a well-established risk factor for breast cancer, since the beginning of this study, all mammograms were characterized according to breast density Birads pattern. Recently, a study published in the JNCI showed an association of this pattern of breast density with tumors that presented more aggressive characteristics.
Objective: To characterize the mammography density patterns of women involved in a prospective NMPOA cohort, and describe the mammography density appearance of those diagnosed with BC, correlating it with genomic classification and stages.
Methods: First screening mammogram of all women in the cohort was reviewed. All mammograms were classified according to BIRADS® patterns of density, which take into account the percentage of fibroglandular tissue (A: less than 25%; B: from 25 to 50%; C: from 50% to 75%, and D: more the 75%). Also, we compared breast density among the 17 incidental breast cancers diagnosed during follow up. Genomic classification and staging of the diagnosed cancers was described.
Results: A total of 2943 first mammograms were done until the end of women accrued inclusion in the cohort (April of 2006). Women's age ranged from 40 to 69 years. From these, 820 were A density, 893 B, 970 C and 260 D (graphic 1). Until November 2011, 17 cancer cases were found in the screening population. From these, 04 were A, 06 were B, 06 were C and 1 were D (graphic 2).
Cancer staging and genomic classification according to each mammogram density are summarized on Tables 1 and 2. No differences were observed in BC staging when we compared the A and B density with C and D (p = 1.0). The same occurred with the genomic classification (p = 0.48).
Conclusion: Our screening population has a predominance of low mammogram densities, probably due to the high body mass index observed in previous studies of this cohort. With respect to cancer cases, the absence of statistical significance results suggests that longer follow up will be necessary for definitive conclusions.

Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P3-01-03.