bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract P4-09-09: Serum SDF-1: Biomarker of Bone Relapse in the NCIC MA.14 Adjuvant Breast Cancer Trial
Authors: Ali SM , Aguilar-Mahecha A , Chapman J-AW , Lipton A , Leitzel K , Jahan K , Hassan S , Shepherd LE , Han L , Wilson CF , Pritchard KI , Pollak MN , Basik M. 
Published: April 2011

Abstract
Background: Massague et al have shown that breast cancer cell line subpopulations with elevated bone metastatic activity overexpress chemokine receptor 4 (CXCR4), interleukin 11 (IL11), osteopontin (OPN) and connective tissue growth factor (CTGF) (Cancer Cell 3:537, 2003). CXCR4 overexpression results in bone-homing and extravasation of tumor cells in bone. In MA.14, we found that serum β-CTx was associated with bone-only relapse while Basik et.al showed that higher serum stromal cell-derived factor 1 (SDF-1) (ligand for CXCR-4) levels were associated with worse overall event-free survival (EFS) (ASCO 2010). In this study, we examined concurrently the association of both β-CTx and serum SDF-1 with bone relapse.
Methods: Serum β-CTx (Serum CrossLaps, Nordic Biosciences, Copenhagen, DN) was determined in pretreatment sera from 621 of 667 NCIC CTG MA.14 patients. SDF-1 (CXCL12) (R&D Systems, Minneapolis, MN) levels were successfully determined in the 4 month post-treatment serum (SDF-1) for 508 (76%) of the patients. Trial stratification was by administration of adjuvant chemotherapy, axillary lymph node status, and ER and/or PR status. Recurrence-free survival (RFS) was defined as the time from randomization to the time of recurrence of the primary disease. Adjusted and unadjusted Cox step-wise forward multivariate analyses were used to assess the effects of β-CTx, SDF-1, trial therapy and baseline patient characteristics on non-bone, all bone and bone-only RFS; a factor was added if p&lt;=0.05.
Results: Joint assessment of β-CTx and SDF-1 was possible for 493 (74%) of the 667 patients. Imbalances in who was, or was not, included in this subset led to the trial arm of Tamoxifen + Octreotide LAR having a significant longer unadjusted ITT non-bone RFS (p=0.03-0.06). There was shorter time to bone metastasis of any type with higher lymph node involvement (p=0.001), larger T (p=0.02), and higher log SDF-1 (p=0.03). Meanwhile, high categorical and continuous β-CTx was associated multivariately with shorter bone-only RFS (p=0.04 and 0.01, respectively); higher log SDF-1 was only associated with shorter bone-only RFS (p=0.02) when the number of strata were reduced to 2 categories per factor.
Conclusions: Higher serum SDF-1 level may be associated with bone metastasis, although there is less evidence of its relevance in bone-only relapse than there is for the biomarker β-CTx. Serum SDF-1 deserves further study as a promising predictive factor of bone relapse in breast cancer.
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P4-09-09.
Abstract P4-09-11: Variables of Worse Outcome in Premenopausal ≥35 Years old Patients (pts)
Authors: Vallejos CS , Gómez HL , Cotrina JM , Marcelo MJ , Doimi FF , Neciosup SP , Suazo JF , Pinto JA , Velarde RG , Vigil CE. 
Published: April 2011

Abstract
Background: Breast cancer (BC) has a worse prognosis in young than in older women; there is a lack of a standard definition of ages included in definition of young women; however ≥35 years old (yo) is frequently used. We analyzed pts according to their age at diagnosis and menopausal status (premenopausal ≥35 yo, premenopausal &gt;35 yo and postmenopausal). Methods: We reviewed 1024 cases with operable stage I-III BC from INEN, Lima-Perú (2000 - 2002). We used Kaplan-Meier estimates for comparing disease free survival (DFS) and overall survival (OS) by age at diagnosis and menopausal status according to clinicopathologic characteristics and IHC phenotype: [ER+ and/or PR+, HER2-], [ER-, PR-, HER2-] and [HER2+ (regardless ER/PR status)].
Results: 84 pts were premenopausal ≥35yo (8.2%), 425 premenopausal &gt;35yo (41.5%) and 515 postmenopausal (50.3%). We found significant association between groups and RP (P&lt;0.001) and RE (P=0.042) status; tumor size (P=0.002); nodal involvement (P=0.014); extracapsular extension (P=0.04); pathological stage (P=0.028) and phenotype (P=0.007). With a median of follow-up of 7.6 years, the DFS and OS to 6 years show differences in the group of ≥35 yo pts compared to premenopausal &gt; 35 yo
and postmenopausal pts (DFS: 58.4, 79.4 and 78.7%, P&lt;0.001; OS: 64.7, 84.3 and 80.5% respectively, P&lt;0.001). We found significant differences in DFS and OS between groups stratified by phenotype. differences were greater in [ER+ and/or PR+, HER2-] pts.
OS y phenotype
In this subset, we found significant association between ER status with premenopausal ≥35yo, &gt;35yo and postmenopausal pts (ER-=20.6 v 3.5 v 1.9%; P&lt;0.001).
Conclusion: Premenopausal pts with ≥35 yo has a worse prognosis than older premenopausal and postmenopausal pts; phenotypes [ER+ and/or PR+, HER2-] and [HER2+] present higher recurrence risks in premenopausal ≥35yo pts. In [ER+ and/or PR+, HER2-] ≥35yo pts, negative RE is an indicator of worse prognosis.

Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P4-09-11.
Abstract P4-09-15: Preoperative TPS as Valuable Prognostic Marker for Breast Cancer
Authors: Ahn SK , Moon HG , Shin HC , Kim HS , Yom CK , Han W , Noh D-Y. 
Published: April 2011

Abstract
BACKGROUND: Several serum markers are used in management of breast cancer patients. Among these, tissue polypeptide specific antigen (TPS) has been recently proposed as a potential new marker for breast cancer.
METHODS: We reviewed the records of 2247 patents with breast cancer treated between November 2000 and December 2007. We evaluated the association between clinicopathologic features and recurrence free survival with preoperative TPS.
RESULTS: Among 2271 breast cancer patients, elevated preoperative TPS level (TPS&gt;80 U/L) were identified in 479 patients (21.1%). Age (&gt;45), tumor size (&gt;2cm), tumor stage, nodal metastasis, progesterone receptor, Ki-67, recurrence and visceral metastasis were associated with elevated TPS levels. 193 patients had evidence of relapse. Elevated TPS were associated with poor recurrence free survival. (P&lt;0.001) On a multivariate analysis with using the Cox model, nodal metastasis, estrogen receptor, Ki-67, histologic grade and elevated TPS(p=0.053) were independent prognostic factors for recurrence free survival.
CONCLUSION: Elevated preoperative TPS levels are associated with poor breast cancer outcome. Preoperative TPS can be a valuable prognostic marker for breast cancer.
Figure available in online version.

Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P4-09-15.
Abstract P4-10-01: Twenty-Five Year Results in the Treatment of Early Breast Carcinoma with Mastectomy Versus Breast Conservation Therapy: The National Cancer Institute Randomized Trial
Authors: Simone NL , Dan TD , Smith SL , Shih JH , Lita E , Sciuto L , Danforth D , Camphausen K. 
Published: April 2011

Abstract
Background: Breast conservation therapy (BCT) has become an accepted treatment in women with early stage breast cancer due to multiple randomized trials showing equivalent mortality rates when compared to modified radical mastectomy (MRM). Results of the National Cancer Institute's prospective randomized trial comparing MRM to BCT are now reported at a median follow up of 25.4 years.
Methods: Between 1979 and 1987, 237 evaluable patients with biopsy proven clinical Stage I or Stage II primary breast cancer were randomized to receive a MRM or a lumpectomy followed by definitive radiation to the entire breast followed by a boost to the tumor bed. An axillary dissection was performed in both arms. Negative margins were not required. Patients with node positive disease in either arm were treated with adriamycin and cytoxan. The primary endpoints were overall survival and disease-free survival.
Results: At a median follow-up of 25.4 years, there was no statistical difference in overall survival between either arm, with 45.7% of patients alive in the MRM group and 38.0% alive in the BCT group (p=0.43). Although disease-free survival was significantly worse in patients randomized to BCT (57% vs 82%, P&lt;0.001), the additional treatment failures in the BCT group were primarily isolated ipsilateral breast tumor recurrences (IBTR's) which were salvaged by MRM. 22.3% of BCT patients experienced an IBTR but those patients had no significant decrease in overall survival. There were no differences in distant metastasis between the groups. Clinical factors associated with a worse prognosis include the presence of nodal disease (HR 2.46, 95% CI 1.71-2.71, P&lt;0.05) and tumor size (HR 1.91, 95% CI 1.346-2.711, P&lt;0.05).
Conclusion: The 25 year survival rate among women receiving BCT vs MRM in the National Cancer Institute randomized trial appears to be equivalent and is consistent with findings across multiple trials. In patients receiving BCT there is an increased incidence of IBTR's. Despite a higher risk of local failure in the BCT group, there is no increased risk of distant failure or mortality. The risk of local failure however, should be discussed when counseling patients regarding their treatment options.
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P4-10-01.
Abstract P4-10-12: Wire Guided Breast Procedures with Intraoperative Ultrasound
Authors: Komenaka IK , Bouton ME , Wilhelmson KL. 
Published: April 2011

Abstract
Background: Wire guided breast procedures (WGBP) are the most commonly used breast conserving operation for non-palpable cancers. Suboptimal needle placement can result in a larger amount of tissue removed and increased difficulty in removal of the lesion. The use of intraoperative ultrasound can improve the execution of wire guided breast procedures by more precisely demonstrating the direction and depth of the wire as well as the location of the wire hook and radiographic clip. These benefits allow a more appropriately located incision and smaller volume of tissue removed.
Methods: A retrospective review of all patients who underwent the WGBP at a county hospital with associated surgical residency program. 28 patients underwent the procedure with intraoperative ultrasound from June 2009 to March 2010.
Results: Breast cancer patients who underwent a wire-guided lumpectomy with intraoperative ultrasound had a lower rate of positive margins (9% vs. 26%, p = 0.28) and a smaller volume of tissue removed (126 cm3 vs. 146 cm3, p = 0.57) compared to patients who underwent wire guided lumpectomy alone. In patients who underwent wire guided excisional biopsy for diagnostic purposes, the volume of tissue removed was smaller in the intraoperative ultrasound group (30 cm3 vs. 44 cm3, p = 0.17) and the targeted area was more likely to be removed in one specimen (1.1 vs. 1.5, p = 0.03) compared to those who underwent the procedure without intraoperative ultrasound. Two illustrative cases with figures are presented. The first demonstrates the benefit when the distance from skin entry point of the wire to the target area is great. The hook can be localized with ultrasound for optimal placement of the incision.
The second demonstrates potential benefit when wire placement is suboptimal and the wire hook is distant from the target. The surgeon may use the wire location to identify the approximate area of the lesion and then the exact location of the radiographic clip can be localized with intraoperative ultrasound.
Conclusions: Intraoperative ultrasound can improve surgical outcomes of the wire guided breast procedure.
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P4-10-12.
Abstract P4-10-13: Therapeutic Delays, Mode of Diagnosis and Surgical Treatment of Operable Invasive Breast Cancer (BC) in Elderly Versus Non Elderly Patients in the Community
Authors: Tazi Y , Garbay J-R , Berrada N , Chevalier J , Mazouni C , Mathieu M-C , Bourgier C , Domont J , Spielmann M , Dionysopoulos D , Delaloge S. 
Published: April 2011

Abstract
Background: National mammography screening program covers populations aged 50-74. We wondered whether breast cancer characteristics and treatment delays were influenced by age and screening method in a community-based breast unit.
Patients and Methods: We analyzed complete data of prospectively recorded community operable breast cancer cases in a single regional cancer center between Jan 1st, 2005 and Oct 10th, 2007. Pts were eligible if they i. had a final diagnosis of invasive BC ii. were operated as first trt for BC, iii. had no history of other previous malignancy within the past 5 year period. Logistic regression analyses (SAS) were used to determine factors influencing delays between first description of the lesion and first appointment at breast unit.
Results: 1044 pts met the inclusion criteria and had full data available. Age did not appear as a predictor of therapeutic delay, with both elderly and non-elderly pts having a median delay of 19 days between first screening/evidence of disease and 1st appointment at the breast unit. 59% of elderly and 65% of non-elderly pts had respectively had their breast cancer diagnosed through mammographic screening. As expected, mammographic screening as mode of discovery of the cancer was highest, among the 688 pts aged 50-74 (73%). Tumors characteristics and surgical treatment did not differ according to age categories elderly/non elderly as described in Table 1. Conservation rates were high in both populations.
Conclusion: Despite absence of national mammographic screening program in elderly populations, patterns of screening and care appear efficient in a community-based setting, with absence of therapeutic delays, similar tumor staging and similar accesss to conservative surgery as compared to younger populations.

Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P4-10-13.
Abstract P4-10-14: Risk of Ipsilateral Breast Events in Patients with Ductal Carcinoma In Situ after Local Excision
Authors: Yi M , Kuerer HM , Lucci A , Meric-Bernstam F , Babiera GV , Thomas CL , Ross MI , Hunt KK. 
Published: April 2011

Abstract
Purpose
To determine the risk of ipsilateral breast events (IBE) in patients with ductal carcinoma in situ (DCIS) treated with local excision. Patients and Methods
We retrospectively identified 692 patients who had undergone local excision from 1968 through 2007 at our institution with a final diagnosis of DCIS. Factors evaluated included age, race, method of detection, menopausal status, bloody nipple discharge, histological type, final margin status, grade, status at last follow-up and recurrence information. An IBE was defined as the development of breast cancer of invasive histology or DCIS (but not lobular carcinoma in situ) in the treated breast.
Results
At a median follow-up of 6.1 years, 47 (6.8%) IBEs occurred in the 692 patients. Among 47 IBE, 23 (48.9%) were DCIS and 19 (40%) were invasive cancer and 5 (10.6%) were unknown type of IBE. Patients with IBE were younger (53 Vs 57, P=0.04). Whether patients had final positive margin (4 patients) had no influence on IBE. Use of a Cox proportional hazards model showed that patients with high grade tumors and those who did not receive adjuvant radiation therapy (XRT) were more likely to have an IBE (Hazard ratio: 4.1, 95% CI:1.3-13.4, P=0.019). The 5-year rate of ipsilateral breast events for patients with grade III DCIS who did not undergo adjuvant radiation therapy was significantly higher than all others: 15% vs. 4.6% compared to grade I/II with XRT, 15% vs. 10% compared to grade I/II without XRT, and 15% vs. 9.9% in grade III with XRT (P=0.017). Conclusions
Patients with low or intermediate grade DCIS have an acceptably low rate of ipsilateral breast events after local excision with adjuvant radiation therapy. Patients with high-grade lesions treated without irradiation have a rate of IBE of 15% at 6 years, suggesting that excision alone is inadequate treatment in this group. Further follow-up is necessary to document long-term results.
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P4-10-14.
Abstract P4-11-03: The Impact of Fractionation on Local Relapse for Patients with Grade 3 Breast Cancer
Authors: Tyldesley S , Woods R , Speers C , Nichol A , Weir L , Olivotto I. 
Published: April 2011

Abstract
Background: Several randomized trials have demonstrated that hypofractionated (HF) and conventionally fractionated (CF) radiotherapy (RT) provide equivalent local control following breast conserving surgery (BCS). However, an update of the Canadian trial suggested that patients with grade 3 disease had an increased risk of local relapse after HF. The risk of local relapse following HF or CF according to grade was investigated among a population-based cohort from British Columbia, Canada. Materials and methods: Female patients diagnosed between 1990 and 2000 with T1-T2N0M0 breast cancer treated with lumpectomy, axillary dissection and RT with at least 6 nodes removed and RT delivered to the breast were identified. Whole breast RT prescriptions were distributed in two groups : HF (typically 42.5 to 44 Gy in 16 fractions), and CF (45Gy to 50 Gy in 25 fractions). The 45 Gy prescription was followed by a boost to the biopsy cavity regardless of the margin status. Patients with close or positive margins received a boost (typically 7.5 to 10Gy in 3 to 4 fractions, or 10 to 20Gy in 5 to 10 fractions). Baseline demographic (age, year of diagnosis), tumour (grade, histology, size, lymphatic vascular space invasion (LVI), presence of extensive DCIS) and treatment factors (margin status, hormonal or chemotherapy use, RT fractionation group, and RT boost use) were abstracted. Cumulative rates of local relapse were estimated using a competing risk approach (distant relapses or death were competing risks) and compared across groups using Gray's test. Factors significant on univariate analysis were included with fractionation group in a multivariate (Fine and Gray) model among grade 3 patients. Results: The cohort consisted of 1,335 patients diagnosed with grade 3 breast cancers: 252 received CF and 1083 patients received HF. The fractionation groups were well balanced for most of the aforementioned factors except median age (56 years for CF vs 52 years for HF (P&lt;0.01), and use of systemic therapy (hormones alone: 26% vs 19%; chemotherapy alone: 27%vs 33%; and chemo+hormone therapy: 8% vs 10% (p=0.04) for HF compared to CF). The 10-year cumulative incidence rate of local relapse in patients with grade 3 breast cancers was 6.9% for the HF group and 6.2 % for the CF group (p=0.99). A Fine and Gray multivariate competing risk model showed that age under 40 years (p=0.02), positive margins (p=0.05) and negative ER status (p=0.01) were associated with an increased risk of local relapse, but fractionation group was not (Hazard ratio=0.95, p=0.88).
Conclusions: There was no evidence that hypofractionation was inferior to conventional fractionation for breast conserving therapy in patients with T1-T2 N0, grade 3 breast cancer in a population-based series.
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P4-11-03.
Abstract P4-11-07: Quantitative Coronary Angiography Findings of Patients Who Received Previous Breast Radiotherapy
Authors: Wang W , Wainstein R , Freixa X , Dzavik V , Fyles A. 
Published: April 2011

Abstract
Purpose: To compare the coronary angiographic findings, between patients who had previous left sided breast radiotherapy (RT) and those who had right sided RT.
Methods: Between 1995 and 2009, 12696 patients who underwent curative RT for breast cancer in Princess Margaret Hospital were screened to check if they had a post-RT coronary angiogram. Two cardiologists, blinded to treatment, assessed all angiograms and measured the percentage of stenotic lesions and the mean diameter of each segment of the left anterior descending artery (LAD) and the right coronary artery (RCA) using Quantitative Coronary Angiography (QCA).
Results: Ninety-one patients were included, 49 and 42 patients had left sided RT and right sided RT respectively. The median time from RT to coronary angiogram was 4.4 years (range: 22 days - 16.9 years). Nineteen patients (39%) in the left sided RT group and 17 (40%) in the right sided RT group needed coronary revascularization (percutaneous coronary intervention or by-pass surgery). The LAD territory was revascularized in 14 (29%) and 11 (26%) patients respectively. The degree of stenoses and mean vessel diameter were not significantly different between the two groups.
Table 1: Quantitative
The proportion of patients who developed clinically significant stenoses of coronary arteries were not statistically different between the two groups.
Table 2: Patiens
In 32 patient who had coronary angiograms &gt;5 years after breast RT (16 left-sided and 16 right-sided), the only statistically significant finding (P&lt;0.05) was marginally narrower mid RCA segments among those who had right sided RT: 2.52 mm versus 2.92 mm (P = 0.039). Conclusions: Left sided breast RT did not increase the risk of premature coronary artery disease as compared with right sided RT. However, with the limitation of short duration between radiotherapy and coronary angiogram, late development of coronary artery stenoses 10-15 years after left sided RT can not be excluded.

Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P4-11-07.
Abstract P4-11-16: Accelerated Partial Breast Irradiation for Ductal Carcinoma In Situ: An Analysis of the Susan G Komen Clinical Trial
Authors: Abbott AM , Gay J , Han L , Kinney M , Washington T , Tuttle TM. 
Published: April 2011

Abstract
Introduction
In 2002 the Food and Drug Administration approved a device, MammoSite, that delivers accelerated partial breast irradiation (APBI). Our aim was to determine outcomes with MammoSite in the treatment of ductal carcinoma in situ (DCIS). Methods
We conducted a prospective multi-center trial between 2003 and 2009. Inclusion criteria included age &gt; 18 years, biopsy diagnosis of DCIS, and no prior breast cancer history. Patients underwent breast-conserving surgery plus MammoSite placement. Radiation was given twice daily for 5 days for a total of 34 Gy. Patients were evaluated for development of toxicities (according to the EROTC/RTOG Acute Radiation Morbidity Scoring Criteria), cosmetic outcome, and ipsilateral breast tumor recurrence (IBTR). Results
We enrolled 45 patients into the study. APBI was not initiated in 5 patients due to inadequate distance from tumor cavity to the skin. Toxicities were observed in 30 patients (75%). Grade 1 toxicity was the most common (78%); most were subcutaneous and cutaneous changes. Cosmetic outcome at 12 months was reported as good to excellent in 93% of surgeon and 90% of patient responses. Median follow up was 36.5 months. Among treated patients, 4 (10%), developed an IBTR, (all DCIS). All IBTRs were outside the treatment field. Among patients with IBTRs the mean age was 49.8 years and the mean time to recurrence was 29.8 months.
Conclusions
APBI, using MammoSite, appears to provide a safe cosmetically acceptable outcome; however the 10% IBTR rate with median follow up of only 36.5 months is concerning. Randomized trials are necessary before use of APBI for DCIS.
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P4-11-16.