bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract P2-13-14: Does therapeutic mammoplasty reduce mastectomy rates?
Authors: Pollard Jennifer , Wong Pang , Mansell James , Murray Juliette , Lannigan Alison , Doughty Julie , Romics Laszlo , Stallard Sheila , Wilson Christopher 
Published: May 2015

Abstract
Introduction: Therapeutic mammoplasty (TM) is increasing in popularity as a method for enhancing breast conserving surgery. Studies have shown it’s oncologically safe, whilst improving cosmetic outcome1,2,3. Therapeutic mammoplasty has been gaining popularity in West of Scotland over the past five years. Initially it was thought this may reduce requirement for mastectomy and immediate reconstruction. We have recorded type of surgery patients would have required had they not been suitable for TM, looking at changing demographic of surgical workload.
Methods: Prospective data collected about patients undergoing TM in West of Scotland since 2011 in Victoria Infirmary, Western Infirmary and in NHS Lanarkshire. We reviewed clinical indications for TM, surgical alternative, Body Mass Index (BMI) and smoker status.
Results: Seventy-nine patients were identified. In 67 cases, alternative surgical option of mastectomy or standard conservation was recorded. Mean BMI was 29. 41% of patients had contralateral surgery for symmetry at the same time. In 28 cases (35%) TM avoided need for mastectomy. In 39 cases (49%) it was felt that cosmetic result would be improved by TM compared with standard conservation. During the study period, rates of mastectomy with immediate reconstruction as a proportion of total number of treated cancers have remained similar.
Conclusions: Whilst introduction of therapeutic mammoplasty in our region has improved options offered to patients and likely cosmetic outcomes, it has not had a major impact in reducing mastectomy rates or demand for immediate reconstruction. It has probably increased surgical workload of plastic surgeons as these cases are often performed as joint procedures.
References:
1. Iwuchukwu OC, Harvey JR, Dordea M, Critchley AC, Drew PJ. The role of oncoplastic therapeutic mammoplasty in breast cancer surgery – A review. Surgical Oncology. 2012;21:133-141
2. McCulley SJ, Macmillan RD. Planning and use of therapeutic mammoplasty – Nottingham approach. British Journal of Plastic Surgery. 2005;58:889-901
3. Clough K, Lewis J, Couturand B, Fitoussi A, Nos C, Falcou M. Oncoplastic techniques allow extensive resections for breast-conserving therapy of breast carcinomas. Annals of Surgery. 2003;237(1):26-34.
Citation Format: Jennifer Pollard, Pang Wong, James Mansell, Juliette Murray, Alison Lannigan, Julie Doughty, Laszlo Romics, Sheila Stallard, Christopher Wilson. Does therapeutic mammoplasty reduce mastectomy rates? [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P2-13-14.
Abstract P2-13-16: Intraoperative ultrasound guided wire bracketing of nonpalpable breast lesions for excision
Authors: Rock David T , Stewart Aimee L , Sandadi Samith 
Published: May 2015

Abstract
Background. Mammographic wire localization is the primary means of localizing nonpalpable breast lesions for excision. Unfortunately, that procedure is associated with patient discomfort and vasovagal responses, scheduling difficulties, and problems with inaccurate wire placement or wire displacement. In addition, the wires often enter far from the target and take an indirect course resulting in high positive margin rates. We reviewed our experience with intraoperative ultrasound guided bracketing of nonpalpable lesions to determine if the accuracy of the excision and patient factors could be improved.
Methods. Patients that underwent intraoperative ultrasound guided wire bracketing were identified by electronic chart review. After the patient was anesthetized, high frequency linear array ultrasound was used to identify the target lesion. Under direct ultrasound visualization, the lesions were bracketed with 4 hook-wires placed perpendicular to the chest wall at the radial and antiradial margins of the lesion. Excision of the lesion was then performed with circumferential dissection around all 4 localization wires.
Results. Intraoperative localization was planned on 80 patients. The lesion was identified by preoperative ultrasound in 76 of those patients (95%). The remaining patients required mammographic localization. In 67 patients (88%) the lesion was identified for bracketing, in the remaining 11 patients the biopsy clip was seen by ultrasound and bracketed. Only 2 patients had positive margins (no tumor touching ink) requiring re-excision (2.6%).
Conclusions. The results of our experience show that intraoperative ultrasound guided wire bracketing is a reliable alternative to mammographic localization and is associated with a lower positive margin rate than reported for mammographic wire localization with a single wire. In addition, patient comfort is improved, cost is reduced, and there are no scheduling issues. The technique is especially useful for oncoplastic excisions where the incision is remote from the target lesion.
Citation Format: David T Rock, Aimee L Stewart, Samith Sandadi. Intraoperative ultrasound guided wire bracketing of nonpalpable breast lesions for excision [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P2-13-16.
Abstract P2-13-27: Nipple sparing mastectomy: Risks of wound complication in the setting of neo-adjuvant or adjuvant chemotherapy and/or radiation therapy
Authors: Samuel Selyne , Viscusi Rebecca , Waer Amy , Gonzalez Victor , Chalasani Pavani , Hurst Craig , Larson Ethan , Livingston Robert , Ley Michele 
Published: May 2015

Abstract
Background: Surgical care of breast cancer has evolved significantly over the past 40 years. Nipple sparing mastectomy (NSM) and skin sparing mastectomy (SSM) have become an increasingly used surgical management for women with malignant breast disease. To date, there are limited recommendations about the role of NSM in patients receiving aggressive adjuvant therapy. The purpose of this investigation is to determine whether NSM in the setting of neo-adjuvant or adjuvant chemotherapy and/or radiation therapy increased the risks for wound complications.
Methods: A retrospective chart review of nipple sparing mastectomies at a single institution was performed from 2007 to 2014. Multiple data points including neo-adjuvant or adjuvant chemotherapy and/or radiation therapy, obesity, smoking history, and type of reconstructive surgery were examined in detail.
Results: We counted the procedures by breasts affected and identified 76 NSM in the time period which met criteria. Of the 76 NSMs, 27 breasts received neo-adjuvant(20) or adjuvant chemotherapy and/or radiation(7) therapy. 21 breasts in the NSM group developed wound complications including skin flap necrosis (5), total nipple necrosis and loss (11) hematoma (2) infection(2) and seroma(1). The complications were seen in 11 in the non adjuvant treated setting (14%) and 9 (33%) in the adjuvant therapy setting.
Conclusions: Nipple sparing mastectomy are emerging as safe and adequate options for the management of malignant breast disease. Our results show there is a significant risk of wound complication associated with neo-adjuvant and adjuvant chemotherapy and radiation therapy in the setting of nipple sparing mastectomy. We are pursuing the development of new surgical techniques and guidelines to reduce these risks in these high risk patients.
Citation Format: Selyne Samuel, Rebecca Viscusi, Amy Waer, Victor Gonzalez, Pavani Chalasani, Craig Hurst, Ethan Larson, Robert Livingston, Michele Ley. Nipple sparing mastectomy: Risks of wound complication in the setting of neo-adjuvant or adjuvant chemotherapy and/or radiation therapy [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P2-13-27.
Abstract P2-14-06: Prediction of local recurrence following mastectomy
Authors: Al-Himdani Sarah , Timbrell Simon , Tan Kian , Morris Julie , Bundred Nigel 
Published: May 2015

Abstract
Background: Rates of local recurrence following mastectomy vary considerably in the literature, ranging from 1.7% to 11.5%. Previous studies have attempted to identify risk factors for recurrence and whether these relate to aggressive disease or to inadequate local treatment. We aimed to identify local recurrence rates at our institution to determine risk factors associated with local recurrence.
Methods and materials: A retrospective study of all women undergoing mastectomies for unilateral T1-T3 breast cancer between 2000-2005 was undertaken. Kaplan-Meier curves were created and the log-rank test calculated to assess for differences between groups. The incidence of local, regional and systemic recurrence was identified at 5 and 8 years post-mastectomy. Incomplete excision/margin involvement was defined as margins 1mm or less. Demographic, biological and treatment-related factors associated were used to identify predictors of local recurrence.
Results: In total, 581 women were studied (mean age: 59; range: 22-96); 462 simple mastectomies (SM) and 106 skin-sparing mastectomies (SSM) which included 199 (34%) screen-detected and 382 (66%) symptomatic cancers. Mean follow up was 6.7 years (range: 5-12.4) and longest was 12.4 years. SSM patients had a lower mean age (p=&lt;0.001), with a smaller tumour size (p=0.022), fewer positive lymph nodes (p=&lt;0.001) and less co-existing ductal carcinoma in situ (DCIS) (p=&lt;0.001) than SM patients. Recurrence rates for SM were 5.6% and 6.9% and for SSM, recurrence rates were 5.7% and 9.0% at 5 and 8 years respectively. Recurrence in node negative patients was 2.2% at 5 years. Predictors of local recurrence were node positivity (HR 8.03; 95% CI 3.2-20) and margin involvement/close margins (HR 3.34; 1.64-6.8).
Conclusion: No significant difference between recurrence rates in SSM and SSM groups was identified. The presence of over four positive lymph nodes and incomplete excision margins indicates an increased risk of recurrence and in these patients, immediate SSM reconstruction should be considered prudently.
Citation Format: Sarah Al-Himdani, Simon Timbrell, Kian Tan, Julie Morris, Nigel Bundred. Prediction of local recurrence following mastectomy [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P2-14-06.
Abstract P2-14-10: Technical results and complication rates after nipple-sparing mastectomy and direct-to-implant breast reconstruction using porcine acellular dermal matrix for implant coverage
Authors: Reitsamer Roland , Peintinger Florentia 
Published: May 2015

Abstract
Objective:
To evaluate the feasibility and complication rates of nipple-sparing mastectomy (NSM) and direct-to-implant breast reconstruction using a porcine acellular dermal matrix (ADM) for implant coverage.
Methods:
NSM and direct-to-implant breast reconstruction using a porcine ADM for implant coverage was performed in a series of 91 breasts in 63 patients. Technical results, complications, and cosmetic results were collected from patient records.
Results:
Short-term complications within one month comprised minor complications as minimal nipple necrosis in 13.2%, and infection in 1.1%. Major complications, as hemorrhage with surgical evacuation in 4.4%, and implant loss due to skin breakdown in 4.4%, totaled in 8.8%. Within three months after primary surgery 3 further severe complications with reoperation ocurred. In 87.9% no second surgical intervention was necessary and cosmetic results were good or excellent. After a mean follow-up of 12 months (range 5 - 35 months) no further complications could be observed. Patient satisfaction was high for 92.3% of the patients and subjective cosmetic result was excellent in 90.1% and satisfactory in 2.2%.
Conclusion:
Direct-to-implant breast reconstruction using a porcine ADM for implant coverage after NSM is an innovative approach resulting in a high patient satisfaction. The technique is challenging but feasible and complication rates are acceptably low.
Citation Format: Roland Reitsamer, Florentia Peintinger. Technical results and complication rates after nipple-sparing mastectomy and direct-to-implant breast reconstruction using porcine acellular dermal matrix for implant coverage [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P2-14-10.
Abstract P3-02-05: Qatar experience of Standard risk breast cancer screening program (BCSP)
Authors: Bujassoum Salha , Alassam Reena , Bugrein Hekmat , Elmistiri Mufid 
Published: May 2015

Abstract
Background
Qatar has one of the highest age-adjusted breast cancer incidences in the Arab world. Although this is much lower than the incidence in the West. Breast cancer incidence in Qatar was 45 per 100,000 in 2003-2007.These higher incidence rates in Qatar are mainly due to the growing population. The prevalent age group, for Qatari and non-Qatari patients, was 40-50 years old. This suggests that the age-specific incidence of breast cancer in Qatari women is unlike the pattern usually seen in Western nations where median age at diagnosis is 61 years, moreover the diagnosis is often at advanced stages of breast cancer. These factors led to establishment the first hospital based (BCSP) in Qatar. It uses a distributed model of mammography service. The program launched 2008, accepts eligible asymptomatic women at ages 40 - 69 years.
Methods
A retrospective study was done during the period from April 2008 –December 2013.
Our aim is to describe our experience of (BCSP) in Qatar and to monitor performance indicators. Our (BCSP) includes an office call and recall as well as triple assessment. We also discuss positive cases in multi-disciplinary meeting.
Results
Total number of screened women was 4264 with an increasing participation, year by year. Out of these, Qatari patient’s accounts for 1145, and non Qatari for 3119. The age group of cases was (43-51). Total breast biopsies were 82, of which 45 were positive of breast carcinomas, (37) invasive ductal carcinoma, (8) noninvasive ductal carcinoma. The Invasive cancer detection rate was 8.2 %. The positive predictive value (PPV) was 46%. Sensitivity value has improved from 51% in 2008 to 70% in 2012 as well as specificity value that has increased from 77% in 2008 to 83% in 2012.
Conclusion
Public acceptance of (BCSP) in Qatar gradually increased and detection rates are higher than western countries. We’re detecting biologically aggressive tumors at younger age groups. We’ve a unique population and we need to utilize our data and evidence based medicine to guide policy makers and women to make the correct decision towards (BCSP).
Citation Format: Salha Bujassoum, Reena Alassam, Hekmat Bugrein, Mufid Elmistiri. Qatar experience of Standard risk breast cancer screening program (BCSP) [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P3-02-05.
Abstract P3-04-02: Multiple subtypes of triple negative breast cancer are dependent on androgen receptor
Authors: Barton Valerie N , D'Amato Nicholas C , Gordon Michael A , Jacobsen Britta M , Richer Jennifer K 
Published: May 2015

Abstract
Triple negative breast cancer (TNBC) constitutes 10-20% of invasive breast carcinomas and has the lowest five-year survival rate. Currently, there are no targeted therapies for TNBC. Recent studies demonstrate that the androgen receptor (AR) is expressed in up to a third of TNBC. AR is highly expressed in the "luminal AR (LAR)" molecular TNBC subtype, but is also present in other TNBC subtypes and may present an opportunity for targeted therapy. We hypothesized that AR+ TNBC critically depend on AR and that AR inhibition will decrease tumor burden in preclinical models of breast cancer. To determine the extent to which AR+ TNBC depend on AR, we inhibited AR activity with the AR antagonist enzalutamide (ENZ) and shRNAs against AR in multiple TNBC subtypes. Treatment with ENZ prevented AR nuclear localization in response to DHT in multiple TNBC cell lines, reduced baseline proliferation in 2D culture (p&lt;0.05), and decreased anchorage independent growth in soft agar (p&lt;0.01). AR knockdown significantly reduced proliferation (p&lt;0.001) and increased apoptosis (p&lt;0.001) compared to cells transduced with a non-targeting control. In addition to reduced proliferation, AR knockdown or treatment with ENZ altered cellular morphology from stellate to round in Matrigel and significantly decreased migration (p&lt;0.05) and invasion (p&lt;0.001) of cell lines spanning multiple TNBC subtypes. Microarray profiling and ELISA of TNBC lines treated with DHT and ENZ suggested that AR regulation of the EGFR ligand amphiregulin (AREG, p&lt;0.05) is a mechanism by which AR influences proliferation, migration and invasion in TNBC. Indeed, treatment with exogenous AREG rescued decreased proliferation, migration and invasion of AR knockdown cell lines (p&lt;0.05). In vivo, ENZ significantly decreased tumor viability (p=0.008) and increased necrosis (p=0.009) in SUM159PT xenografts. Our findings suggest that AR influences both proliferation and invasion of AR+ TNBC cells representing multiple TNBC subtypes and provide promising preclinical data on the efficacy of ENZ in AR+ TNBC. Thus, inhibition of AR by anti-androgens such as ENZ may represent an effective targeted therapy for TNBC.
Citation Format: Valerie N Barton, Nicholas C D'Amato, Michael A Gordon, Britta M Jacobsen, Jennifer K Richer. Multiple subtypes of triple negative breast cancer are dependent on androgen receptor [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P3-04-02.
Abstract P3-04-03: PIK3CA mutations in androgen receptor-positive triple negative breast cancer confer sensitivity to the combination of PI3K and androgen receptor inhibitors
Authors: Lehmann Brian D , Bauer Joshua A , Schafer Johanna M , Pendleton Christopher S , Tang Luojia , Johnson Kimberly C , Chen Xi , Balko Justin M , Gomez Henry , Arteaga Carlos L , Mills Gordon B , Sanders Melinda E , Pietenpol Jennifer A 
Published: May 2015

Abstract
Triple negative breast cancer (TNBC) is a heterogeneous collection of biologically diverse cancers, which contributes to variable clinical outcomes. Previously, we identified a TNBC subtype that has a luminal phenotype and expresses androgen receptor (AR+). TNBC cells derived from these luminal AR+ tumors have high frequency PIK3CA mutations. The purpose of this study was to determine if targeting PI3K alone or in combination with an AR antagonist is effective in AR+ TNBC.
Methods: We determined the frequency of activating PIK3CA mutations in AR+ and AR- TNBC clinical cases. Using AR+ TNBC cell lines and xenograft models we evaluated the effectiveness of PI3K inhibitors, used alone or in combination with an AR antagonist, on tumor cell growth and viability.
Results: PIK3CA kinase mutations were highly clonal, more frequent in AR+ vs. AR- TNBC (40% vs. 4%), and often associated with concurrent amplification of the PIK3CA locus. PI3K/mTOR inhibitors had an additive growth inhibitory effect when combined with genetic or pharmacological AR targeting in AR+ TNBC cells. We also analyzed the combination of bicalutamide +/- the pan-PI3K inhibitor GDC-0941 or the dual PI3K/mTOR inhibitor GDC-0980 in xenograft tumor studies and observed additive effects.
Conclusions: While approximately one third of TNBC patients respond to neoadjuvant/adjuvant chemotherapy, recent studies have shown that patients with androgen receptor positive (AR+) TNBC are far less likely to benefit from the current standard of care chemotherapy regimens and novel targeted approaches need to be investigated. In this study, we show that activating PIK3CA mutations are enriched in AR+ TNBC; and, the growth and viability of AR+ TNBC cell line models is significantly reduced after treatment with PI3K inhibitors used in combination with an AR antagonist. These results provide rationale for pre-selection of TNBC patients with a biomarker (AR expression) to investigate the use of AR antagonists in combination with PI3K/mTOR inhibitors.
Citation Format: Brian D Lehmann, Joshua A Bauer, Johanna M Schafer, Christopher S Pendleton, Luojia Tang, Kimberly C Johnson, Xi Chen, Justin M Balko, Henry Gomez, Carlos L Arteaga, Gordon B Mills, Melinda E Sanders, Jennifer A Pietenpol. PIK3CA mutations in androgen receptor-positive triple negative breast cancer confer sensitivity to the combination of PI3K and androgen receptor inhibitors [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P3-04-03.
Abstract P3-05-21: Investigation into the oncogenic potential of the androgen receptor in aromatase inhibitor resistant breast cancer
Authors: Young Leonie , Creevey Laura , Ali Azlena , Hill Arnold DK , McIlroy Marie 
Published: May 2015

Abstract
The heterogenous nature of breast cancer, exemplified by a wide range of subtype classifications, has been well documented. The identification of the novel molecular apocrine breast tumours (ER-, PR-ve, HER2-ve, AR+), with a gene expression profile reflective of ER+ luminal breast cancer, has led to the proposition of an alternative role for the androgen receptor as a pseudo ER. This proposition was borne out of global expression profiling and AR recruitment of molecular apocrine cells, demonstrating that more than 50% of AR binding to the genome mirrors the pattern of ER binding suggesting that in the absence of ER, AR can mimic ER in its DNA binding capabilities.
Aromatase Inhibitor (AI) therapy is the gold standard first line therapy for postmenopausal breast cancer. AIs function by abrogating the activity of the enzyme Cyp 19 (aromatase), which is responsible for converting circulating androgens to estrogen. By preventing this conversion step, this eradicates the main steroid driving breast cancer growth and in turn results in a more androgenic environment. We hypothesise that AR may also act as a pseudo ER in our AI resistant (MCF7-letrozole resistant) cells. Preliminary data demonstrates that AR is recruited to some but not all classical ER target genes as well as some AR target genes in MCF7-LetR cells, therefore highlighting the potential of AR to act as an oncogene in this setting. Analysis of AR protein expression also demonstrates higher levels of AR in AI resistant cells versus sensitive cells. In the evaluation of the responsiveness of a range of breast cancer cell lines to the AR antagonist Bicalutamide, it was noted that our AI resistant cells demonstrated responsiveness to Bicalutamide treatment.
RNA sequencing experiments following AR knockdown in AI resistant cells also provide crucial information as to the key genes differentially regulated by AR. Given that resistance to AI therapy is an emerging clinical issue, further elucidation of the potential mechanisms of AI resistance and potential AR targets is highly warranted.
Citation Format: Leonie Young, Laura Creevey, Azlena Ali, Arnold DK Hill, Marie McIlroy. Investigation into the oncogenic potential of the androgen receptor in aromatase inhibitor resistant breast cancer [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P3-05-21.