bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract P1-11-08: The impact of social inequalities on breast cancer mortality in Brazil
Authors: Freitas-Junior Ruffo , Gonzaga Carolina M , Curado Maria-Paula , Sousa Ana-Luiza L , Souza Marta R 
Published: May 2015

Abstract
Introduction: Female breast cancer mortality has decreased considerably in developed nations. In contrast, an increase has been observed in developing countries. Objective: To describe the impact of social inequalities in female breast cancer mortality in Brazil, between the years of 1990 and 2011. Methods: Breast cancer mortality data and estimates for the resident population were obtained from the Brazilian National Health Service (SUS) database for the 1990-2011 period. Age-standardized mortality rates were calculated (20-39, 40-49, 50-69 and ≥70 years) by direct standardization using the 1960 standard world population. Trends were modeled using linear regression, with mortality rates as the dependent variable and the year of death as the independent variable. The Social Exclusion Index (SEI) and the Human Development Index (HDI) were used to classify the 27 Brazilian states. Pearson’s correlation was used to describe the association between the SEI and the HDI and the variations in mortality rates in each state. Results: Age-standardized mortality rates in Brazil were found to be stable (annual percent change [APC] = 0.32; 95%CI: -0.1 – 0.7). Statistically significant decreases in mortality rates were found in the states of Rio Grande do Sul, Rio de Janeiro and São Paulo. Increases in mortality rates were most notable in the states of Maranhão (APC = 11.2; 95%CI: 5.8 – 16.9), Piauí (APC = 9.8; 95%CI: 7.6 – 12.1) and Paraíba (APC = 9.3; 95%CI: 6.0 – 12.8). There was a statistically significant correlation between SEI and a change in female breast cancer mortality rates in the Brazilian states between 1990 and 2011 and between HDI and mortality between 2001 and 2011. This reduction was most notable in the Brazilian states with better socioeconomic conditions. Conclusions: It was observed a direct impact of social inequalities in female breast cancer mortality rates in Brazil. Reductions in these rates were found in the more developed states, possibly reflecting a better local healthcare.
Citation Format: Ruffo Freitas-Junior, Carolina M Gonzaga, Maria-Paula Curado, Ana-Luiza L Sousa, Marta R Souza. The impact of social inequalities on breast cancer mortality in Brazil [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 P1-11-08.
Abstract P1-11-13: An evaluation of mobile mammography outreach in urban and rural communities
Authors: Steward Lauren , Kraenzle Susan , Drake Bettina , Lyons Sarah , Goodman Melody 
Published: May 2015

Abstract
Background: Mobile mammography has been used to reach underserved women in a diverse number of settings. In this work, we demonstrate similarities and differences between rural and urban communities served by a single mobile mammography unit (MMU) affiliated with a comprehensive cancer center in Missouri.
Methods: An outreach registry of patients serviced by the MMU was created and includes data from medical records and responses to a brief questionnaire completed at each visit. Data was examined by point of care (urban/rural) to assess the efficacy of mobile mammography as an outreach strategy in each of these environments. Bivariate analyses were used to examine the relationships between demographic characteristics such as age, income, race/ethnicity, education, employment status, marital status, insurance status, and living environment proxy.
Results: Between 2006 and 2013, 9480 women received their care on the mobile mammography van. The sample was stratified by point of care (urban vs. rural) served, with majority of the women (86%) residing in urban/suburban St. Louis City/County, and 14% in rural regions. Urban zip codes had a lower percentage of women with income greater than $20,000 (12% v. 21%) and higher percentage of women with income less than $10,000 (49% v. 37%) in comparison to rural communities(p=0.01). There were higher proportions of black women in urban communities (63%) compared to rural communities (10%; p&lt;0.001). Almost half (47%) the women that received mobile mammography in rural zip code were married compared to less than a quarter of women from urban zip codes (24%; p&lt;0.001). Rural communities (83%) had a higher percentage of uninsured women compared to urban communities (67%; p&lt;0.001). Women in urban and rural communities were similar in respect to age, employment status, and education.
Conclusions: Mobile mammography has the potential to reach a large population of women with limited educational, financial, and healthcare resources. Future studies will be needed to determine if increasing the range and extent of mobile units, such as this one, would be effective in increasing the screening rates of not only women in Missouri, but also in other portions of this country.
Citation Format: Lauren Steward, Susan Kraenzle, Bettina Drake, Sarah Lyons, Melody Goodman. An evaluation of mobile mammography outreach in urban and rural communities [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 P1-11-13.
Abstract P1-12-07: Characteristics of recurrence after completing adjuvant tamoxifen therapy for 5 years
Authors: Lee Eunshin , Lee Han-Byoel , Kang Young Joon , Kim Yun-Gyoung , Yoo Tae-kyung , Kim Jongjin , Kim Min Kyoon , Moon Hyeong-Gon , Noh Dong-Young , Han Wonshik 
Published: May 2015

Abstract
Background Treatment with tamoxifen (TMX) reduces the recurrence rate and increase overall survival in patients with hormone receptor positive breast cancer. Up to now, 5-year TMX therapy is generally accepted, but it is demonstrated that the rate of late recurrence after 5 years is considerably higher in hormone receptor positive type than in other subtype. Several clinical trials such as ATLAS and aTTom showed the benefit of continuing tamoxifen up to 10 years instead of stopping at 5 years without increasing mortality due to the effect of extended tamoxifen medication.
Method We collected data of 1633 hormone receptor positive breast cancer patients who received surgery at Seoul National University Hospital from 1997 to 2007, and had completed 5-year TMX therapy with no recurrence within 5 years after diagnosis. Mean age of the patients was 43.3, and the patients have estrogen receptor or progesterone receptor. We included from the stage I to stage IV patients underwent curative surgery and received adequate adjuvant therapy such as chemotherapy or radiation therapy after surgery. We excluded the cases treated aromatase inhibitor (AI) or switched to AI.
Result Among these patients, recurrences after 5 years of TMX therapy were found in 93 patients (late recurrence group). Local recurrences and distant metastases were found in 43 and 50 patients, respectively. Electronic medical records were retrospectively reviewed for clinicopathological factors. When comparing between patients with no recurrence and patients with late recurrence, p53 and HER-2 expression were significantly related to late recurrence (p=0.01, p&lt;0.001 respectively). Also when subgroup analysis was done for distant metastasis of late recurrence group, distant metastasis was significantly associated with HER-2 expression and high nuclear grade (p=0.005, p=0.006 respectively). There are no relation between late recurrence and age, stage and ki-67.
Conclusion our data shows that p53 and HER-2 expression is associated to late recurrence and especially HER-2 expression is related to distant metastasis after completing TMX for 5 years. On the basis of the result of large clinical trials, extending TMX therapy significantly reduces recurrence rate and increase survival. Our result support continuing TMX in patients with HER-2 expression and high nuclear grade is considerable after 5 years of TMX medication.
Citation Format: Eunshin Lee, Han-Byoel Lee, Young Joon Kang, Yun-Gyoung Kim, Tae-kyung Yoo, Jongjin Kim, Min Kyoon Kim, Hyeong-Gon Moon, Dong-Young Noh, Wonshik Han. Characteristics of recurrence after completing adjuvant tamoxifen therapy for 5 years [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 P1-12-07.
Abstract P1-12-10: Tamoxifen treated patients have a better survival than patients treated with aromatase inhibitors - A population based registry study in Sweden
Authors: Olsson Håkan , Einefors Rickard , Broberg Per 
Published: May 2015

Abstract
Background. Randomised trials suggest that therapy with aromatase inhibitors improves survival in breast cancer compared with tamoxifen therapy in postmenopausal cases with hormone receptor positive breast cancer. Whether these results from randomized studies transform into the general population is unknown. We have therefore compared survival for all breast cancer cases in Sweden diagnosed 2000-2008 (n=54406) who received adjuvant antihormonal therapy.
Material and methods. The study includes all women with BC diagnosed in Sweden between 2000 through 2008 (n=54406). The women had no previous cancer diagnosis during the period of 1958-1999. Dates of birth, BC diagnosis and TNM-stage where directly extracted from the cancer registry. The women’s antihormonal therapy was gathered from the Swedish Prescription Registry (22213 women were on antihormonal therapy). Information regarding the cause of death and date of death was obtained from the Cause of Death Registry and tbe Swedish Population Register up until the 31st of December 2012 and 31st of December 2013 respectively. The breast cancer death and overall death have been calculated and the survival was compared between tamoxifen and aromatase inhibitor treated breast cancer patients. Analyses were adjusted for TNM-stage and age at diagnosis and restricted to women aged 50 and above.
Results. Patients being treated with tamoxifen had a better breast cancer prognosis compared with aromatase inhibitor treated patients (HR 0.54, 95%CI 0.48-0.61). Restricting the analysis to stage 1 disease confirmed a better prognosis for tamoxifen treated women (HR 0.48, 95%CI 0.34-0.66). A better prognosis could be seen in all age strata studies, 50-60.61-70.71-90. The findings for overall survival gave similar results.
Conclusion .This population based observational study show that women treated with aromatase inhibitors have a worse overall and breast cancer specific survival compared with tamoxifen treated women regardless of age and tumor stage.
Citation Format: Håkan Olsson, Rickard Einefors, Per Broberg. Tamoxifen treated patients have a better survival than patients treated with aromatase inhibitors - A population based registry study in Sweden [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 P1-12-10.
Abstract P1-12-12: The insulin like growth factor axis and development of tamoxifen resistance in breast cancer
Authors: Hawsawi Yousef M , Beattie James , El-Gendy Reem , Speirs Valerie , Twelves Christopher 
Published: May 2015

Abstract
Background
Insulin-like growth factors (IGF). IGFs are potent mitogens for breast epithelial cells that modulate the action of AKT, which has been reported to be associated with tamoxifen resistance. To date, however, anti-IGF strategies have proved disappointing in clinical trials We have investigated whether the IGFBP family of proteins, which modulate the activity of IGF, may play a role in tamoxifen resistance, opening up the route for alternative anti-IGF based therapies.
Methodology
We investigated the expression of IGF axis genes in parental and tamoxifen-resistant (TamR) MCF-7 cells using qRT-PCR. Gene and protein expression was confirmed using ELISA, Western, and ligand blotting. shRNA transfection was used to silence candidate IGF axis genes in both cell lines. Cell sensitivity 4-hydroxytamoxifen (4-HT) was investigated by WST-1 cell proliferation assay.
Results
IGF-IR, IGF-2R, IGFBP-2, -4 and -5 genes had the highest expression levels. IGFBP-5 was down-regulated 7-fold while IGFBP-2 was up-regulated by 2-fold in TamR v wt cells. Changes in IGFBP-5 and IGFBP-2 gene expression were mirrored in protein levels measured in conditioned media by ELISA, Western and Ligand blot. Importantly knock down of IGFBP-2 in TamR cells restored sensitivity to 4-HT suggesting a causal role for IGFBP-2 in the acquisition of tamoxifen resistance.
Conclusion
IGFBP-5 and IGFPB-2 are reciprocally regulated on the acquisition of tamoxifen resistance by MCF-7 cells. Preliminary studies suggest that IGFBP-2 may play a role in the development of tamoxifen resistance in vitro.
Citation Format: Yousef M Hawsawi, James Beattie, Reem El-Gendy, Valerie Speirs, Christopher Twelves. The insulin like growth factor axis and development of tamoxifen resistance in 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 P1-12-12.
Abstract P1-12-14: Retinoic acid sensitizes triple-negative breast cancer cells to tamoxifen treatment
Authors: Coyle Krysta M , Dean Cheryl A , Jo Diana B , Thomas Margaret , Sultan Mohammad , Marcato Paola 
Published: May 2015

Abstract
Tamoxifen, an estrogen receptor (ER) antagonist, is often used as an adjuvant endocrine therapy in the successful treatment of ER+ breast tumors. Tumors that lack ER, progesterone receptor (PR) and HER2 expression (i.e. triple-negative breast cancers) cannot be treated with adjuvant endocrine therapies, like tamoxifen, and are often more aggressive. Inducing ER expression is a potential strategy for sensitization of triple-negative breast cancers to adjuvant endocrine therapies. Given recent evidence suggesting cross-talk between the retinoic acid (RA) and estrogen signaling pathways, we investigated if RA induces expression of ER in triple-negative breast cancer cells. We hypothesize that this would lead to sensitization of the cells to tamoxifen treatment. Quantitative PCR of mRNA isolated from triple-negative MDA-MB-231 cells treated with RA and estradiol had increased ER transcript levels. Furthermore, treatment with estradiol and RA synergistically induced increased expression of RA-inducible genes. In cell proliferation studies, neither RA nor estradiol treatment alone significantly altered the growth of MDA-MB-231 cells; however, when treated with both estradiol and RA together, the growth of the cells increased significantly. This suggests that the RA-mediated increase in ER expression sensitizes MDA-MB-231 cells to estradiol-induced cell growth. Next, we investigated whether the increased ER expression sensitized MDA-MB-231 cells to tamoxifen treatment. Tamoxifen did not decrease the growth of MDA-MB-231 cells; however, when applied in combination with both estradiol and RA, tamoxifen significantly reduced MDA-MB-231 proliferation. Furthermore, tamoxifen treatment reduced the synergistic effects of estradiol/RA on RA-inducible gene expression. Together, these results suggest that the use of RA in combination with tamoxifen warrants further investigation as a potential treatment for triple-negative breast cancers. The success of the combination treatment of tamoxifen and RA in the reduction of triple-negative breast cancer cell tumor xenografts will provide further justification for this strategy in the treatment of triple-negative breast cancers.
Citation Format: Krysta M Coyle, Cheryl A Dean, Diana B Jo, Margaret Thomas, Mohammad Sultan, Paola Marcato. Retinoic acid sensitizes triple-negative breast cancer cells to tamoxifen treatment [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 P1-12-14.
Abstract P1-16-06: Margin Probe device is able to reduce re-excision rate of breast conserving surgery in invasive and pre-invasive breast cancer independent from any patient or tumor related factors
Authors: Blohmer Jens Uwe , Tanko Julia , Voelker Ragna , de Grahl Julia , Gross Jessica 
Published: May 2015

Abstract
Background: A positive margin status after breast conserving surgery (BCS) is one of the strongest predictors of local recurrence of intraductal and invasive carcinoma. As much as 20-50% of all patients with BCS need to undergo a second operation in order to receive free margins. In this study we tested the clinical performance of Margin Probe (Dune Medical Devices), a novel device for intraoperative margin evaluation.
Methods: A prospective clinical trial was performed: The device was applied to 150 lumpectomy specimen from consecutive patients with BCS treated during the first three months in 2013. The re-excision rate was compared to the re-excision rate of a historical group of 156 patients treated with BCS during the first three months in 2012, without the application of the device. We analyzed whether Margin Probe is affected by tumor morphology, grading, size of the tumor, breast density, age, body-mass-index or the use of wire-marker.
Results: Due to the application of Margin Probe the re-excision rate decreased significantly by 51% from 39.7% to 14.6%. In the subgroup of intraductal carcinoma (DCIS) the re-excision rate was reduced about two thirds from 66.7% to 23.1%. In the subgroup of invasive lobular carcinomas the re-excision rate decreased from 37.0% to 19.0%. Margin Probe results are not affected by grading, tumor size, breast-density, age, body-mass-index or wire-marker application.
Conclusion: Margin Probe is an effective tool for detection of positive margins during BCS and significantly decreases the re-excision rate. It is not limited to invasive carcinoma but also detects involved margins in DCIS as well as in invasive lobular carcinoma. It does not interfere with any of the factors we examined.
Citation Format: Jens Uwe Blohmer, Julia Tanko, Ragna Voelker, Julia de Grahl, Jessica Gross. Margin Probe device is able to reduce re-excision rate of breast conserving surgery in invasive and pre-invasive breast cancer independent from any patient or tumor related factors [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 P1-16-06.
Abstract P1-16-07: Translating the concept of intrinsic subtypes into an oncoplastic cohort of more than 1000 patients-predictors of recurrence and survival
Authors: Rezai Mahdi , Kellersmann Stephanie , Knispel Sarah , Kimmig Rainer , Kern Peter 
Published: May 2015

Abstract
Introduction:
The concept of breast cancer experienced a paradigm shift by Sørlie T. et al. with intrinsic subtypes as prognostic classification of breast cancer [1]. We validated this concept in a large cohort study of oncoplastic surgery.
Patients and methods:
We analysed 1035 patients with oncoplastic surgery (2004-2009) and survival parameters related to histopathological approximated intrinsic subtypes.
Data were retrieved from customized questionnaires and patients charts. Survival data were determined from cancer registries.
Results:
A total of 944 patients with primary unilateral breast cancer, median age 58 years, were eligible for analysis. At a median follow-up of 5.3 years, LRR was 4.1%, with 5-year-OS of 94.5% and DFS of 90.9%. Stage distribution was as follows: T1a 3%, T1b 12 %, T1c 44,2 % and T2 was 22,1%. 70,4 % of patients were nodal-negative and nodal involvement was predominantly low.
Intrinsic subtypes, not T-size, nodal-status, resection margin width nor histopathology, governed the prognosis of this cohort. Triple-negative and Her2 non luminal breast cancer had the highest recurrence and the lowest survival rates compared to Luminal A: Recurrence TNBC 11,3 %, Her2pos non luminal 9,3 %, Luminal A 2,5 %; Overall survival: TNBC 91,3 %, Her2 non luminal 93,7 %; Luminal A: 96,3 %. Our data confirmed the intrinsic subtype concept on a large basis in oncoplastic surgery.
(1) Sørlie T, Perou CM, Tibshirani R, Aas T, Geisler S, Johnsen H, Hastie T, Eisen MB, van de Rijn M, Jeffrey SS, Thorsen T, Quist H, Matese JC, Brown PO, Botstein D, Lønning PE, Børresen-Dale AL: Gene expression patterns of breast carcinomas distinguish tumor subclasses with clinical implications. Proc Natl Acad Sci USA 2001; 98: 10869–10874.
Citation Format: Mahdi Rezai, Stephanie Kellersmann, Sarah Knispel, Rainer Kimmig, Peter Kern. Translating the concept of intrinsic subtypes into an oncoplastic cohort of more than 1000 patients-predictors of recurrence and survival [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 P1-16-07.
Abstract P2-01-19: Long-term follow-up of the node-negative breast cancer patients before treatment evaluated with sentinel node biopsy alone following neoadjuvant chemotherapy
Authors: Nogi Hiroko , Uchida Ken , Kamio Makiko , Kato Kumiko , Toriumi Yasuo , Takeyama Hiroshi 
Published: May 2015

Abstract
BACKGROUND Sentinel node biopsy (SNB) for the node negative breast cancer is standard treatment as an accurate assessment of axillary lymph node status. The use of neoadjuvant chemotherapy (NAC) has increased during the past several years. At present, the use of SNB following NAC is controversial. Proponents of SNB after NAC prefer a single surgical procedure with potential for fewer axillary dissections.
OBJECTIVE Our objective was to examine SNB evaluation alone following NAC in patients with clinically node-negative breast cancer before treatment and to evaluate the axillary lymph node recurrence for patients undergoing NAC versus patients undergoing surgery first.
METHODS A total of 1176 patients with clinically node negative breast cancer underwent SNB from 2007 to 2013. Clinicopathologic and survival data were reviewed and comparisons made between patients receiving NAC and those undergoing surgery first. Lymphatic mapping was performed with both radioactive colloid and blue dye. Patients with negative SN for metastasis were followed without axillary lymph node dissection (ALND). Patients with metastases to a SN underwent ALND.
RESULTS Of the patients, 180 (15.3%) underwent SNB following NAC and 996 (84.7%) underwent surgery first. SN identification rates were 98.3% in the NAC group and 98.9% in the surgery first group. 152 (84.4%) patients in the NAC group and 877 patients (88.1%) had negative SNs. At median follow-up of 49.2 months, 1 patient (0.007%) in the NAC group and 3 patients (0.003%) in surgery first group had axillary lymph node recurrences. There were not any significant differences between the NAC group and the surgery first group.
CONCLUSION The SNB following NAC in patients with node-negative breast cancer has a low axillary recurrence rate and could be acceptable.
Citation Format: Hiroko Nogi, Ken Uchida, Makiko Kamio, Kumiko Kato, Yasuo Toriumi, Hiroshi Takeyama. Long-term follow-up of the node-negative breast cancer patients before treatment evaluated with sentinel node biopsy alone following neoadjuvant chemotherapy [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 P2-01-19.