bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract P2-11-02: Perception and practice of reproductive specialists towards fertility preservation of young breast cancer patients
Authors: Shimizu C , Kato T , Tamura N , Asada Y , Hiroko B , Mizota Y , Yamamoto S , Fujiwara Y 
Published: August 2014

Abstract
Background: The potential for infertility caused by treatment is one of the important quality-of-life issues in young breast cancer (YBC) patients. Insufficient communication and partnership between oncologists and reproductive specialists has been identified as a major barrier to meeting their needs. However, the perception of reproductive specialists towards fertility preservation (FP) of YBC has not been evaluated.
Objective: To investigate the perception and needs of reproductive specialists towards FP of YBC patients.
Methods: A cross-sectional survey was developed and sent to 423 certified reproductive specialists registered to the Japan Society for Reproductive Medicine to self-evaluate their perceptions and practices regarding FP in YBC patients.
Results: Two hundred reproductive specialists (47%) responded to the survey.

99% responded that reproductive specialists should be engaged in FP of YBC patients. 46% responded that cancer treatment is more important than childbirth even if the patient was recurrence-free five years after primary treatment. 83% responded that they would like to treat YBC patients. Respondents affiliated with private clinics were more likely to accept both fertilized egg and unfertilized egg preservation than those affiliated with academic or general hospitals (p &lt; 0.01). 58% responded that ovulation induction methods should be modified in YBC patients. The choice of ovulation induction methods varied both in non-cancer women and YBC patients, however, the frequency of the use of letrozole was significantly higher (p &lt; 0.01) and that of LHRH-agonist short protocol was significantly less (p &lt; 0.05) in the management of breast cancer patients than in the practice of non-cancer women. 70% of the reproductive specialists responded that they were anxious in treating YBC patients. Concerns for greater or unknown risk of disease recurrence (66%), insufficient knowledge about breast cancer (47%), and lack of patient's spouse/partner (24%) were identified as major barriers in supporting FP for YBC patients.
Conclusion Reproductive specialists recognize the needs of FP in YBC patients and are willing to participate and support care for YBC. Affiliation of reproductive specialists was related to positive attitude towards to egg preservation. Various concerns regarding FP among reproductive specialists indicate the need for evidence that supports the safety of FP for YBC patients and guidelines that facilitate the practice and communication of oncologists and reproductive specialists.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P2-11-02.
Abstract P2-11-14: Symptoms, Physical Impairments, and Function in Breast Cancer Patients with Negative Axillary Lymph Nodes
Authors: Kesarwala AH , Pfalzer LA , O'Meara WP , Stout NL 
Published: August 2014

Abstract
Purpose/Objective(s): Breast cancer (BC) patients are recommended for post-operative regional nodal radiation therapy (RNRT) based on the number of positive axillary lymph nodes (LN). While RNRT is recommended for patients with 4 or more positive LN, it remains controversial in patients with 1–3 positive LN. For these patients, consideration of anticipated functional impairments often guides decision making, but these considerations are confounded by the inseparable effects of disease in and treatment of the axilla. The purpose of this analysis is to investigate the effect of various therapies on functional impairments in BC patients without axillary disease.
Materials/Methods: 166 women were diagnosed with BC between 2001–05 and enrolled and treated in a prospective surveillance physical therapy program. 110 had zero positive axillary LN on either sentinel LN biopsy or axillary LN dissection and were analyzed for this report. Participants' upper extremity (UE) range of motion, strength, and limb volume were assessed pre-operatively and at 1, 3, 6, 9, and 12+ months post-operatively by a physical therapist. Limb volume was assessed using infrared optoelectronic perometry. At 12+ months, overall health status, UE symptoms and function, and physical activity levels were reported using standardized questionnaires. Chi-square tests and one-way ANOVA analyses were used to determine significance between groups (p ≤ 0.05).
Results: Of these 110 patients, 34 received mastectomy without RT, 21 received mastectomy with RNRT, 10 received lumpectomy alone, and 45 received lumpectomy with whole breast tangent RT. No significant differences were found between groups with regard to stage, ER/PR status, and number of dissected LN. Rates of lymphedema, cording, and seroma were not significantly different between groups. By 12+ months post-operatively, there were no differences in shoulder abduction, shoulder flexion, internal rotation, or external rotation between groups. No differences were seen between groups in self-reported fatigue, UE swelling or weakness, arm stiffness, or ability to climb stairs.
Conclusions: Functional impairments represent an important category of morbidity for BC survivors and should be considered in pre-treatment decision making. In patients without axillary disease, post-operative RNRT or whole breast tangent RT may not contribute significantly to impairment over the first year of treatment when a prospective surveillance physical therapy program is part of the plan of care. Additional research is needed to assess longer-term changes and the impact of radiation in the context of the aggregate effect of disease burden combined with other BC treatment modalities.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P2-11-14.
Abstract P2-11-17: Pilot Study to Evaluate a Home-based Exercise and Weight Loss Intervention on Cardiopulmonary Fitness and Markers of Breast Cancer Risk in Postmenopausal Breast Cancer Survivors
Authors: Burnett D , Klemp JR , Porter C , Schmitz KJ , Fabian CJ , Kluding P 
Published: August 2014

Abstract
Background: BrCa survivors have an estimated 4-fold increase in risk for developing cardiovascular disease compared to women never treated for breast cancer and a nearly 3-fold increase in breast cancer mortality in women with an exercise capacity (VO2max) less than 28mL kg−1 min−1. Cardiac events are the second most common cause of death in long-term breast cancer (BrCa) survivors.
Purpose: We conducted a study to investigate the effects of standard exercise or structured exercise on targeted cardiovascular outcomes during a home-based diet and exercise intervention for breast cancer survivors.
Method: Cross-sectional within- and between-group design. A total of 19 breast cancer survivors, average age of 52.6+/−9.3, were enrolled in the study. A convenient sample was enrolled into two exercise groups receiving either: standard (150 minutes per week of usual care (exercise without instruction) cardiovascular exercise + resistance training) or structured (150 minutes per week of gradual increased intensity cardiovascular exercise + resistance training) exercise instruction along with a group based behavioral weight loss intervention. All participants underwent baseline and 17 week assessments including maximal exercise testing (VO2max and minutes on the treadmill), measurements of body composition (weight, BMI, % body fat), and assessment of quality of life.
Results: We report on the 16 participants who completed the baseline and 17 week assessments (9 = Standard Exercise Group; 7 = Structured Exercise Group). The structured exercise group exhibited significantly greater improvements in measures of cardiorespiratory fitness: VO2max (p = 0.05) and duration on treadmill (p = 0.02). No significant differences were noted for all other cardiorespiratory fitness testing outcomes. Significant improvements from baseline to 17 weeks were seen across both groups for all measures of body composition. Lean body mass did not significantly change from baseline to 17 weeks in both groups. There were no significant between group differences for change in body composition.

Conclusion: In this study, both standard exercise and structured exercise improved CR fitness measured by VO2max, but the structured exercise group experienced significantly greater improvements.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P2-11-17.
Abstract P2-12-02: Comorbidities and patient-reported cognitive function among women with stage I-II breast cancer randomized to hormonal therapy (HT) alone versus chemotherapy followed by hormonal therapy (C+HT) treated on the Trial Assigning IndividuaLized Options
Authors: Wagner Lynne I , Gray Robert , Sledge George , Whelan Tim , Hayes Daniel , Geyer Charles , Dees E Claire , Cella David , Sparano Joseph A 
Published: August 2014

Abstract
Withdrawn by Author
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P2-12-02.
Abstract P2-12-07: A review of clinical endpoints and use of quality-of-life outcomes in phase III metastatic breast cancer clinical trials
Authors: Tatla R , Landaverde D , Victor C , Miles D , Verma S 
Published: August 2014

Abstract
Background: The management of metastatic breast cancer (MBC) is often considered to be palliative, with most interventions intended to relieve disease symptoms, minimize treatment effects and prolong patient survival. The impact of disease and treatment on a patient's functional abilities has led to the emphasis of incorporating quality of life (QoL) measures into clinical trials. The primary objective of this study is to evaluate phase III clinical trials in MBC, and assess the inclusion of QoL as an endpoint, in addition to conventional progression and survival endpoints.
Methods: A structured PubMed search was conducted to identify phase III clinical trials published between Jan. 1990 and Aug. 2011, which evaluated systemic treatment in MBC patients. Data pertaining to treatment regimens, study endpoints and clinical findings were collected, with a particular focus on progression-based (PB), overall survival (OS), and QoL endpoints. The instrument(s) used in evaluating QoL were also noted (when applicable).
Results: Of 520 publications identified, 122 phase III MBC clinical trials met the inclusion criteria. Of these studies, 98.4% and 95.9% included PB and OS respectively, as clinical endpoints, while QoL was assessed in only 46 (37.7%) studies. 14 instruments were identified as QoL measurement tools among these studies, with EORTC QLQ-C30 and FACT-B accounting for 54.7% of the instruments used. While the inclusion of QoL was not associated with the significance of PB results, there was an association between the inclusion of QoL and OS results, with 59% of significant OS studies and 32% of non-significant OS studies including QoL as a clinical endpoint (p = 0.016). When stratified by treatment arm, it was found that studies favouring standard therapy were more likely to include QoL (75%, p = 0.045), compared to those favouring the intervention (56%), and those without significant differences (32%).
Conclusions: Although the importance of QoL is often emphasized in MBC management and treatment decisions, only one-third of identified phase III clinical trials included an assessment of QoL. About half of these trials showed no statistically significant differences in QoL endpoint; of note, instruments of varying validity were utilized. There needs to be greater emphasis on the evaluation of QoL, with the use of standard and validated QoL tools in MBC clinical trials, especially as we increasingly focus on progression-based endpoints.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P2-12-07.
Abstract P2-12-14: Use of the MD Anderson Symptom Inventory to Screen for Depression in Breast Cancer
Authors: Kvale EA , Azuero CB , Azuero A , Fisch M , Ritchie C 
Published: August 2014

Abstract
Background: The prevalence of depression among breast cancer patients is estimated to be twice that in the general population, is linked to diminished quality of life and impaired adherence to therapy. Depression is frequently underdiagnosed or misdiagnosed in this population. Efficient screening for depression is central to patient-centered care and enhanced clinical outcomes for breast cancer patients.
Purpose: To evaluate the use of a commonly utilized symptom assessment instrument as a screen to enhance identification of breast cancer patients experiencing depression.
Methods: Data from a longitudinal surveillance database in outpatient supportive and palliative care were utilized, 174 breast cancer patient contacts were evaluated. Patients completed both the MD Anderson Symptom Inventory (MDASI) and the 9-item Patient Health Questionnaire (PHQ-9) as components of a routinely collected patient-reported outcomes battery. Performance of the MDASI (using the 1–10 Depression question) in identifying cases of depression (defined as a score ≥ 15 on the PHQ-9) was determined using receiver operating characteristic (ROC) analysis.
Results: Data were available on 174 patient contacts. When scored as a continuous measure, the MDASI performed well with an area under the ROC curve of 0.87 (95% confidence interval [CI], 0.81–0.94). An MDASI cutoff score of &gt;= 6 provided a sensitivity of 73% (95% CI, 58%–88%), a specificity of 80% (95% CI, 74%–87%), a positive predictive value (PPV) of 46%, and a negative predictive value (NPV) of 93%.
Conclusion: The “depression” component of the MDASI as a screening instrument for depression in breast cancer patients yields suboptimal sensitivity and specificity for use as a screening tool. Further efforts to evaluate subsequent iterations of the MDASI and combinations of elements in the MDASI that may enhance performance are indicated.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P2-12-14.
Abstract P2-12-15: Understanding the complex non face-to-face interventions delivered by the clinical nurse specialists in metastatic breast cancer.
Authors: Warren M , Mackie D , Leary A 
Published: August 2014

Abstract
Introduction: Despite improving survival rates in breast cancer, globally one third of patients diagnosed with primary breast cancer will go onto develop metastatic breast cancer. In recent years treatment for metastatic breast cancer in the United Kingdom has moved to the ambulatory setting using treatments such as, oral chemotherapies, oral biological and bisphosphonate therapies meaning telephone consultation and clinical management, pivotal to confluent care.
Research Objectives: To determine the number and complexity of incoming telephone calls, the stage of the metastatic breast cancer disease pathway for example at diagnosis, treatment, follow-up, and palliative care, the nursing interventions, outcomes and the reason for contact from patients and carers.
Rationale: Previous studies demonstrate much of the clinical work of the clinical nurse specialist is delivered via the telephone. The rationale of this study was to examine the complexity of non face-to-face patient interaction with the metastatic breast cancer clinical nurse specialist.
Method: A prospective study conducted over a 1 – month period at a United Kingdom National Health Service Foundation Hospital Trust. Data was collected by two clinical nurse specialists on incoming calls using Excel and a bespoke interrelational structured query database. These data were then mined using standard data mining techniques and pattern recognition techniques.
Results: The study collected 28 days of data. 229 patient and carer telephone contacts were recorded. Most calls were from patients (62.5%). Incoming calls resulted in the delivery of 1282 interventions, a mean of six interventions per call (range1-8) and clustered into four areas: meeting information needs (29%), symptom management (26%), psychological/social issues (33%) and other issues (12%). The incoming telephone work accounted for 63 h which represented 30% of the total working time of the clinical nurse specialist. Calls primarily originated from patients who were in the follow-up phase (43% of calls), a group usually thought to prefer self management.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P2-12-15.
Abstract P2-13-04: Superior efficacy of anastrozole to tamoxifen as adjuvant therapy for postmenopausal patients with hormone-responsive breast cancer. Efficacy results of long-term follow-up data from N-SAS BC 03 trial
Authors: Imoto S , Osumi S , Aogi K , Hozumi Y , Mukai H , Iwata H , Yokota I , Yamaguchi T , Ohashi Y , Watanabe T , Takatsuka Y , Aihara T 
Published: August 2014

Abstract
Background: Aromatase inhibitors have been shown to be superior to tamoxifen as adjuvant therapy in postmenopausal patients with hormone-responsive breast cancer. Here we report the efficacy results of long-term follow-up data from N-SAS BC 03 trial (UMIN CTRID: C000000056), in which anastrozole was compared to tamoxifen in hormone-responsive postmenopausal early breast cancer patients who had taken tamoxifen for 1—4 years out of a total of 5 years of treatment as adjuvant therapy.
Patients and methods: Out of a total of 706 recruited patients, 696 patients (tamoxifen group, n=345; anastrozole group, n=351) were used as the full analysis set for the present study. The log-rank test was used to compare the two groups in terms of disease-free survival (DFS) and relapse-free survival (RFS), Kaplan-Meier estimates were calculated. The treatment effects were estimated by Cox's proportional hazard model and were expressed as hazard ratios, with associated 95% confidence intervals (CIs).
Results: After a median follow-up of 76.1 months, (range: 1.3–110 months), the unadjusted hazard ratio was 0.87 (95%Cl 0.60–1.26; log-rank p = 0.457) for DFS and 0.77 (95%Cl 0.49–1.22; log-rank p = 0.266) for RFS, both in favor of anastrozole. The estimated hazard ratio (95%CIs) for DFS and for RFS until each time point (right censored data) was as follows: until 30 months: 0.54 (0.30–0.98) and 0.48 (0.23–0.98), until 42 months; 0.65 (0.40–1.06) and 0.53 (0.29–0.97), until 54 months: 0.77 (0.50–1.19) and 0.63 (0.37–1.06), until 66 months: 0.82 (0.55–1.24) and 0.72 (0.44–1.17), until 78 months: 0.83 (0.57–1.23) and 0.73 (0.46–1.17), respectively. The hazard ratios (95%CIs) for DFS and for RFS until 36 months were 0.72 (95%Cl 0.43–1.22) and 0.58 (95%Cl 0.30–1.12), and those after 36 months were 1.06 (95%Cl 0.62–1.81) and 0.98 (95%Cl 0.51–1.88), respectively.
Conclusion: Superior efficacy of anastrozole to tamoxifen in the Japanese population was suggested over a long-term follow-up period. It was the greatest early after switching from tamoxifen and then decreased thereafter.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P2-13-04.
Abstract P3-02-02: Use of contrast-enhanced computed tomography in clinical staging of asymptomatic breast cancer patients to detect asymptomatic distant metastases.
Authors: Tanaka S , Sato N , Fujioka H , Takahashi Y , Kimura K , Iwamoto M , Uchiyama K 
Published: August 2014

Abstract
Objective: The use of computed tomography (CT) with regards to the clinical staging of breast cancer (BC) patients has been on the increase in clinical practice. However, NCCN guidelines recommended the use of imaginng only in cases with locally advanced disease or signs of distant metastases (DM), and the benefits of routine CT have yet to be fully clarified. This study investigated the value of employing contrast-enhanced CT (CECT) to screen for DM in patients with asymptomatic BC.
Methods: The clinical records of 483 patients with asymptomatic BC who underwent CECT, also in order to detect BC spread, between April 2006 and January 2011 were reviewed. The CECT results were classified into normal, true-positive (metastases) or false-positive findings.
Results: Abnormal CECT findings, including true- and false-positive results, were detected in 65 patients (13.5%). Of these, 26 patients (5.4%) showed confirmed true metastatic disease, including 18 lung metastases, 11 liver metastases and 13 bone metastases. Upstaging to stage IV due to the results of the CECT was significantly associated with only larger tumos size (odds ratio, 33.4; 95% CI 12.1–92.5; P &lt; 0.0001) and lymph node status (odds ratio, 37.1; 95% CI 14.2–96.8; P &lt; 0.0001.)

Upstaging to stage IV occurred in 0 of 155 patients at stage I, 5 of 261 patients (1.9%) at stage II and 21 of 67 patients (31.3%) at stage III.

Conclusions: Routine CECT did not appear to be useful for detecting DM in completely asymptomatic patients. Conversely, a small number of patients were upstaged from early to stage IV and a predictive factor beyond T and N stage alone appears to be needed in order to predict which asymptomatic patients have DM.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P3-02-02.
Abstract P3-05-04: Intra-tumor heterogeneity as a predictor of therapy response in HER2 positive breast cancer
Authors: Rye IH , Helland Å , Sætersdal A , Naume B , Almendro V , Polyak K , Børessen-Dale A-L , Russnes HG 
Published: August 2014

Abstract
Background: Breast cancer is known to be a heterogeneous disease both at the clinical and molecular level. In addition, heterogeneity can also exist within a given tumor, and subpopulations can have distinct phenotypic and genomic features. Little is known about the relationship between intra-tumor heterogeneity and prediction of response to treatment. This study aimed at using a combination of immunofluorescence and fluorescence in situ (FISH) technique (“double immunoFISH”) to identify intra-tumor heterogeneity in tumors from neo-adjuvant treated patients prior to and after therapy, searching for features predicting the response to neo adjuvant treatment.
Material and methods: Twentytwo patients diagnosed with HER2 positive, neo-adjuvant treated breast cancer ((3–4 FEC100 followed by 4 docetaxel plus trastuzumab, 3qw) were selected. Half of the patients had complete response and the others had partial response. By double immunoFISH both phenotypic (ER and HER2 protein) and genomic changes (copy number of HER2 gene and centromere 17) were assessed in the same cells simultaneously on biopsies before and after treatment. The samples were photographed in a Zeiss Axio Imager M1 with 5 fluorescence channels and analyzed with axiovision software. The intensity and localization of HER2 and ER immunofluorescence were semi-quantitatively estimated while the HER2 and centromere 17 FISH signals were counted in 100 cells.
Results: The patients with partial response displayed a high grade of cell-to-cell diversity regarding HER2 copy number, nuclear shape and size and the expression of the membrane protein HER2. This was in contrast to the results from the complete responders who showed a reduced diversity and were more frequently ER negative. In the patients with partial response, a higher diversity was seen after treatment.
Conclusion: The genomic variability prior to therapy was higher in the partial-responders vs. the complete responders, and the remaining tumor was even more heterogeneous after treatment than prior to treatment. Double immunoFISH is a valuable tool for visualization of both phenotypic and genomic alterations in the same cell in FFPE sections. The cohort will be expanded to explore the diversity further, and the results will be presented.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P3-05-04.