bluuebunny/crossref_metadata_2025_split huggingface dataset:
Phase I/II study evaluating early tolerance in breast cancer patients undergoing accelerated partial breast irradiation treated with MammoSite balloon breast brachytherapy catheter using a two-day dose schedule.
Authors: Wallace MF , Martinez AA , Chen PY , Ghilezan MI , Benitez PR , Brown E , Vicini FA 
Published: December 2010

Abstract
Abstract #5131
Purpose: Initial phase I/II results utilizing balloon brachytherapy to deliver accelerated partial breast irradiation (APBI) in only 2-days in patients with early stage breast cancer are presented.&#x2028; Materials and Methods: From 3/2004 – 8/2007, 45 patients received adjuvant radiation therapy after lumpectomy with balloon brachytherapy in a phase I/II trial delivering 2800 cGy in 4 fractions of 700 cGy to a depth of 1 cm from the applicator surface. Inclusion criteria for the protocol included: (1) patient age &gt; 40 years, (2) pathological confirmation of stage 0/I/II breast carcinoma, (3) &gt; 3 cm tumor size, (4) &lt; 3 pathologically positive lymph nodes, and (5) negative margins (per NSABP criteria). Toxicities were evaluated using the NCI CTAE v3.0 scale and cosmesis (Harvard Criteria) was documented at &gt; 6 months.&#x2028; Results: The median age was 66 years (48-83) and median skin spacing was 12 mm (8-24). The median follow-up was 11.4 months (5.4-48 mo) with 20 patients (44%) followed greater than one year, 11 (24%) greater than 2 years and 6 (13%) greater than 3 years. At &lt; 6 mo (n=45), grade II toxicity rates were 9% radiation dermatitis (n=4), 13% breast pain (n=6), 2% edema (n=1), and 2% hyperpigmentation (n=1). Grade III breast pain was reported in 13% (n=6). At &gt; 6 months (n=43), grade II radiation dermatitis, induration, and hypopigmentation were 2% (n=1), grade III breast pain was reported in 2% (n=1). Infection was 16% (n=7) at &lt; 6 mo and 2% (n=1) at &gt; 6 mo. Of these pts, only 4% (n=2) had a positive culture, whereas the others were treated empirically due to brisk erythema. Persistent seroma &gt; 6 months was 30% (n=13). FN was seen in 9% (n=4), but only 1 pt required treatment. Rib fracture was seen in 5% (n=2). Cosmesis was good/excellent in 96% and fair in 4%.&#x2028; Conclusions: Treatment with balloon brachytherapy using a 2-day dose schedule resulted acceptable rates of grade II/III chronic toxicity rates and similar cosmetic results observed with standard 5-day APBI schedule.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 5131.
Preliminary result of a mono-institutional, prospective study of skin and cardiac toxicities in breast cancer patients treated by concurrent adjuvant trastuzumab and radiotherapy involving in most cases the internal mammary chain.
Authors: Bollet MA , Kirova YM , Granger B , Caussa L , Savignoni A , Pierga J , Campana F , Dendale R , Fourquet A 
Published: December 2010

Abstract
Abstract #5132
Purpose: This study aimed to evaluate the skin and heart toxicities of a concurrent adjuvant trastuzumab (T) and radiotherapy (RT) for breast cancer (BC), especially in the case of IMC irradiation.&#x2028; Patients and methods: Prospective study of 57 pts treated at the Institut Curie between 02/2004 and 01/2007 by concurrent T-RT for non-metastatic BC. The perfusion of trastuzumab started either with or after chemotherapy (CT). RT, started at least 4 weeks after the completion of anthracycline-based chemotherapy, consisted of either whole breast (+/- boost) or chest wall normo-fractionated irradiation. When indicated the internal mammary chain (IMC) and supra/infra-clavicular lymph nodes were also irradiated. Left ventricular ejection fractions (LEVF), assessed at baseline, before start of RT (pre-RT), after completion of RT and then every 4-6 months with either echocardiography or multiple gated acquisition scanning, were considered normal if ≥50% or stated so by the cardiologist. A normal LVEF at baseline was one of the inclusion criteria. Skin toxicity was evaluated using CTCAEV3.&#x2028; Results: Median age was 49 years (25-80). CT with anthracycline was administered in 84% (48 pts) with either doxorubicine for 6 pts (median total dose 300 mg/m²) or epirubicine for 42 pts (median total dose 300mg/m²). All but one patient (treated weekly) received T every three weeks (8mg/kg followed by 6mg/kg) for a median duration of 12 months (6-33). The treated breast was the left one in 46% (26 pts). The IMC was irradiated in 88% (50 pts). Median follow-up for LVEF assessment was 13 months (2-33). LVEF at pre-RT were normal in 55 pts (100%, 2 Missing Data), at post-RT in 56 pts (98%, no MD) and at last follow-up in 54 pts (95%, no MD).&#x2028; Overall, there were 2 grade 0, 44 grade I, 11 grade II skin reactions. For the 27 patients with a skin toxicity assessment after 6months, late skin toxicity was grade 0 in 22 pts, grade 1 in 4, grade 2 in 1. There was no skin toxicity graded higher than 2.&#x2028; Conclusion: In this preliminary study of BC patients treated with T-RT with, in most cases, anthracycline-based CT and IMC irradiation, there was no significant increase in the rate of abnormal LVEF after concurrent T-RT and the skin toxicity was acceptable in routine. More patients and a longer follow-up are needed to ascertain that this regimen remains safe.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 5132.
Initial radiation experience evaluating early tolerance and toxicities in patients undergoing accelerated partial breast irradiation using the Contura™ multi-lumen balloon (MLB) breast brachytherapy catheter.
Authors: Brown S , McLaughlin M , Pope K , Haile K , Whitaker TJ , Hughes L , Israel P 
Published: December 2010

Abstract
Abstract #5138
Purpose: We reviewed our institution's experience treating patients with the Contura™ Multi-Lumen Balloon (MLB) breast brachytherapy catheter to deliver accelerated partial breast irradiation (APBI) to determine short-term treatment efficacy, cosmesis, toxicity and additional dosimetric capabilities of the new APBI device.&#x2028; Materials and Methods: From 05/07 to 05/08, 41 patients, from a single surgeon (PI), were treated with breast conserving therapy (BCT) received adjuvant radiation using the Contura™ catheter (34 Gy in 3.4 Gy fractions). 13/41 patients (31.7%) had stage 0 disease, 21 (51.2%) had stage I and 7 (17.1%) had stage II breast cancer.&#x2028; For each patient, the dosimetric plan was customized using the 5 high dose rate brachytherapy channels of the Contura™ catheter by selecting from 45 different dwell positions (9 per catheter).&#x2028; Results: Median, minimum skin spacing was 10 mm (range 2 to 17). The median maximum skin dose (% of prescribed dose [PD]) was 99.7 (57.1 to 124.1). Eight patients were able to be treated with a skin spacing of 5 mm or less, 2 had spacing of 2 mm. The median maximum rib dose was 102.6 % of PD (10.0 to 187.7), median percentage of the planning target volume (PTV) receiving 95% of the PD was 98.8 (79.4 to 107.4) and the median volume receiving 200% of the PD was 5.7 cc (range 1.3 to 9.9).&#x2028; The percentage of patients with excellent/good cosmetic results at 3 and 6 months was 94% (16 evaluable patients) and 89% (9 evaluable patients), respectively. One patient developed skin ulceration after receiving chemotherapy. Patient tolerance was assessed on a scale 0-10 (0=no pain, 10 = requiring narcotic analgesics). In 37/38 (97.3%) patients, pain was graded ≤ 3 at the time of catheter insertion. Four transient breast infections (11%) developed and one transient symptomatic seroma developed (3%).&#x2028; Conclusion: Adjuvant APBI using the Contura™ MLB catheter exhibited similar toxicities to standard single-lumen balloon brachytherapy with absolute improvements in dosimetric capabilities (i.e., reduced skin dose, improved PTV coverage and normal tissue avoidance). With multiple lumen planning, more conformal dosimtery was achieved as compared to single-lumen balloon treatment. This allowed the treatment of 8 patients with skin spacing of 5 mm or less, normally not achievable with single-lumen balloon treatment.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 5138.
Long term disease control outcomes for partial breast irradiation using MammoSite brachytherapy.
Authors: Harper JL , Watkins JM , Baker MK , Cole DJ , Dragun AE , Garrett-Mayer E , Wahlquist AE , Jenrette JM 
Published: December 2010

Abstract
Abstract #5145
Purpose: To describe 4-year local and ipsilateral breast recurrence-free intervals, overall freedom from disease failure, and disease-specific and overall survivals in a cohort of MammoSite Brachytherapy (MBT) patients with mature follow-up, treated at a single institution over a 6-year period.&#x2028; Methods and Materials: An analysis of MBT cases was performed using prospectively collected quality assurance database, departmental chart review, and electronic medical records. Patient-, tumor-, treatment-, and outcome-specific data were extracted and recorded into a research database. Eligible patients were required to have &gt;6 months post-MBT follow-up. Local tumor failure was defined as pathologically-proven recurrence within 2 cm of the resected tumor bed, with all other ipsilateral breast recurrences (excluding axilla or internal mammary nodal failures) defined as ipsilateral breast failures. Any local, ipsilateral breast, nodal, or distant failure was censored for overall freedom from failure.&#x2028; Results: From 2004 through 2008, 115 MBT patients have been treated, of which 104 were eligible for the present analysis. Median patient age was 62 years (range 25–86). Primary tumors included ductal carcinoma in situ (DCIS) for 20 patients, T1a (12), T1b (31), T1c (34), and T2 (7). Lymph nodes were assessed in 94 patients (including all patients with invasive carcinomas), and revealed pN0 disease in 85 patients, pN1(mic) (3), and pN1a (6). Histologies of invasive carcinomas were ductal in 68 patients, lobular (3), mixed ductal/lobular (3), mucinous/colloid (7), medullary (2), and tubular (1). At a median follow up of 45.7 months (range 7.3-71.4), 6 patients have experienced disease recurrence, including 4 within the ipsilateral breast. Three patients with ipsilateral breast recurrence underwent salvage mastectomy, two of whom remain without evidence of disease recurrence at 56 and 14 months, respectively. Seven patients have died, 3 of or with recurrent breast cancer. Estimated 4-year outcomes for the entire cohort were: local tumor control 100%, ipsilateral breast control 97.0% (95% CI, 93.6%-100%), overall freedom from failure 93.8% (88.5%-99.5%), disease specific survival 97.8% (94.8%-100%) and overall survival 92.7% (87.2%-98.6%).&#x2028; Conclusions: The present study demonstrates low rates of local and ipsilateral breast disease failure in a well-defined cohort of MBT patients with mature follow-up.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 5145.
Do conventional radiotherapy fields irradiate the regional lymphatics correctly in patients with breast cancer?.
Authors: Haydaroglu A , Karakoyun-Celik O , Hoca S , Bolukbasi Y , Olacak N 
Published: December 2010

Abstract
Abstract #5147
Purpose: In this study, we compared the 3-Dimentional Conformal Radiotherapy (Method I) and conventional radiotherapy (Method II) plans of patients who receive loco-regional irradiation for breast cancer. Two methods were analyzed statistically with DVH's.&#x2028; Material and Methods: Twenty-five patients underwent computed tomography (CT) scanning in the supine treatment position and axial images with slice thickness of 5 mm were obtained. The patients were virtually treated and a total dose of 50 Gy with 2 Gy/fraction was prescribed to the PTV using 6 MV photon beams. In Method I, breast or chest wall volumes, axillary levels (AL) I, II and III and supraclavicular lymph node (SC) volumes delineated and then radiotherapy fields, tangents, SC and posterior axillary boost (PAB) were developed according to each patients own anatomy. The depth for SC lymph nodes was measured from the isocenter of SC field, for AL's II and III lymph nodes from the isocenter of PAB field in each patient. In Method II, conventional radiotherapy fields which include standard tangents, SC and PAB fields were developed on DRR images for each patient. Dose prescribed to a tissue depth of 3 cm for SC, to the midaxillary depth for PAB field. Analyses were done using composite plans of tangents, SC and PAB fields of each method. The volumes of AL's II and III out of PAB field were identified, and the dose distributions were assessed from the DVH's of the contoured volumes.&#x2028; Results: The mean depth of midaxillary level was 7.75 cm (6.5-8.5). In Method I, the maximum mean depths for AL II and III were 6.5 and 5.3 respectively; both two levels were anterior to the midaxillary level. The mean depth of SC lymph nodes was 4.6 cm (3.3-8.6) that is more that 3 cm. In Method II, the mean volume percentage received 50 Gy was lower than Method I. This was due to SC depth, majority of the patients had more that 3 cm SC depth. Mean 50 Gy volume was 98 % in Method I, where as 65% in Method II (p=0.00001). In Method II, a part of AL II lymph nodes were out of PAB field in 9 (36%) patients and a part of AL III lymph nodes were out of PAB field in 18 (72%) patients.&#x2028; Conclusion: Both SC and AL's II and III lymph node depths were presented a wide variety. Additionally, AL II and III lymph nodes were out of PAB fields in a significant number of patient's Method II plans. According to this study, the mean depth of SC lymph nodes was deeper than 3 cm and AL II and III lymph nodes were anterior to the midaxillary depth. For this reasons, SC lymph nodes received less than prescribed 50 Gy. Three-Dimensional Conformal Radiotherapy, delineating regional lymph nodes is more effective in achieving better dose and nodal volume coverage than that of the conventional radiotherapy in patients with breast cancer.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 5147.
Breast conservation in the treatment of T2 breast tumors – analysis of 1988-2003 SEER data.
Authors: Rouzier R , Lesieur B , Gligorov J , Huguet F , Uzan S 
Published: December 2010

Abstract
Abstract #5151
Background: Breast-conserving therapy (BCT) has been shown to be as effective as mastectomy in the treatment of tumors 5 cm or smaller. However, few patients with tumors larger than 2 cm have been included in the randomized trials. We sought to investigate the prognosis of patients with tumors measuring 2.1 to 5 cm according to local treatment in the SEER database.&#x2028; Methods: The SEER registry provided data from 17 registries. Survival was studied according to surgical treatment of tumor with stratifications on tumor size, nodal status, pathological characteristics and adjuvant radiation therapy. Cause specific survival was measured by SEER as the time from diagnosis to date of death and date of last follow-up, respectively. We used the Kaplan-Meier product limit method to describe cause specific survival and the log-rank test to assess differences between patient groups. All tests were two tailed, and p values &lt; 0.05 were considered to denote significant differences. All analyses were performed using the R package with the Design, Hmisc, and Survival libraries.&#x2028; Results: The study population comprised 128,454 patients. The median follow-up for patients alive at the last follow-up visit was 47 months. Survivals according to tumor size are reported in the table below. For patients with T2 tumors measuring 4.1-5cm, a better survival at 5 years (74%) was observed for patients treated by mastectomy compared to patients treated by BCT (67.5%) (P=1.22e-15) (Figure A). Subgroup analysis revealed that absence of radiation after BCT was the only reason for a higher survival in patients treated with mastectomy (Figure B). No clear deleterious effect of BCT was observed according to nodal status, grade or ER status.&#x2028; Conclusion: Our study demonstrates that T2 tumor patients should not be treated with BCT if adjuvant radiation therapy cannot be administered.&#x2028; &#x2028; Survival according to local treatment in patients with 4.1-5 cm tumors.[figure1]
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 5151.
Breast conservation: factors predictive of residual disease following reoperation for narrow surgical margins.
Authors: Forouhi P , Brahmbhatt DH , Benson JR , Wishart GC 
Published: December 2010

Abstract
Abstract #5152
Introduction:&#x2028; Ensuring pathologically tumor free surgical margins reduces local recurrence rates following breast conserving surgery for breast cancer or DCIS. There is no general agreement regarding the definition of a clear margin but units with an agreed policy report reduced local recurrence rates. In our unit all patients with a surgical clearance of &lt;5mm are offered further surgery either by mastectomy or by re-excision. We have examined factors that may predict residual disease in re-excised tissues.&#x2028; Method:&#x2028; All attempted breast conserving operations between 01/01/2004 to 31/09/2007 were identified from a dedicated database. Patient age, presentation (symptomatic or screening), surgeon (any of 4 surgeons), weight of tissue removed, tumour size, grade, presence of lymphovascular invasion (LVI) and the closest radial margin (categorised as involved, &lt;2mm, 2-5mm) were examined.&#x2028; Results:&#x2028; Breast conservation was attempted in 605 women (mean age 60; 297 symptomatic, 308 screening). Further surgery was performed in 166 (27.4%) women, including 89 (14.7%) mastectomies. Median tumour size was 20mm (range 0-109). Residual disease was found in 83(50%) of re excisions (66/111 with involved margins, 16/40 for non involved margins up to 2mm, and 1/15 for margins over 2mm). On univariate analysis excision margin (OR=0.33, p=0.000) and total tumor size (OR=4.0 p=0.045 for the smallest size quartile versus the largest) were associated with residual disease. On multivariate analysis only tumor margin remained predictive (OR for &lt;2mm vs involved: 0.46, p=0.043; OR for 2-5mm vs involved: 0.05, p=0.004).&#x2028; Conclusion:&#x2028; In a unit with an aggressive re-excision policy, involved or close surgical margins predict the presence of residual disease in re-excision specimens. A margin of greater than 2mm reduces the risk of residual disease to 1/20 of that seen with microscopically involved margins. This study supports a 2mm minimum radial margin policy when attempting breast conservation for breast malignancy.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 5152.
Radiofrequency ablation therapy: results in 100 patients with breast cancer.
Authors: Oura S , Tamaki T , Yoshimasu T , Ohta F , Hirai Y , Naito K , Miyasaka M 
Published: December 2010

Abstract
Abstract #5153
Background: Radiofrequency ablation therapy (RFA) is one of the most minimally invasive approaches for the treatment of hepatic cancers and other solid malignancies. The aim of this study is to assess the safety and local controllability of RFA against breast cancer.&#x2028; Patients and Methods: A total of 100 pts with localized early breast cancer were enrolled. Ductal spreading and/or daughter nodules were preoperatively checked with mammography, ultrasound and MRI. Tumor size was 0.5-2.0cm (median 1.5cm). LeVeen system and Cool-tip RF system was used in 5 pts and 95 pts respectively. One session of RFA was applied to 96 pts, 2 sessions to 4 pts. To avoid skin burn, 5% glucose was injected subcutaneously just above the tumor and the skin was cooled during RFA. After completing RFA, temperatures along the needle tract were measured at 1 cm intervals in 89 pts. All pts underwent cytological and MR-imaging study 3-4 weeks after operation, and received adjuvant radiotherapy (50Gy) to the breast.&#x2028; Results: RFA heated the tumors up to over 60° in 1 pt, 70° in 4 pts, 80° in 21 pts, 90° in 51 pts, and 100° in 13 pts. Skin burn was found in 2 pts over the tumor, and 1 pt at the grounding pads. No major side effects except for skin burn were found. Postoperative cytological and imaging study showed complete ablation of all the target tumors. No pts developed local and distant recurrence for 16-54 months (median 31 months).&#x2028; Discussion: Our RFA procedures can offer good local control without serious adverse events to breast cancer patients.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 5153.
Immediate breast reconstruction with contralateral pectoralis major myomammary flap for breast conserving surgery.
Authors: Lee S , Bae Y , Lee J , Kang T 
Published: December 2010

Abstract
Abstract #5157
Purpose: The breast reconstruction techniques are mandatory in case of the indication permits for there has been lots of data showing no less survival as far as surgery keeps the principle of cancer surgery. It could be selected by many factors but mainly by breast size, site of tumor. The latissimus dorsi musculocutaneous flap (LDMCF) is one of the most commonly used techniques in early breast cancer patient who has small breast. But, it has difficulties to supply enough tissues to the widely excised tumor site. And especially in case of ptosis patient, reduction mammoplasty only is not enough to get the symmetry of the breast. We suggest a pectoralis major myomammary flap(PMMF) as a useful technique for the patients with ptosis.&#x2028; Methods: Seventeen patients with ptosis were treated with breast conserving using PMMF surgery. A quadrantectomy rather than lumpectomy was performed through a planned skin incision, and axillary lymph node dissection was performed according to the sentinel lymph node result. PMMF is harvested carefully without perforating branch injury of internal thoracic artery. And reconstruction was done by the PMMF through the medial tunnel between both breasts.&#x2028; Results: Among those of seventeen patients, seroma occurred in two patients and no necrosis was occurred. The cosmetic result showed good in fifteen and excellent in two patients based on four-point scoring system of breast cosmetics.&#x2028; Conclusions: After enough quadrantectomy to keep the cancer surgery principles, PMMF was quite useful to supply proper tissues for breast reconstructions, especially for the ptosis patient.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 5157.