bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of a home-based physical activity intervention upon exercise behaviors and anthropometric measures in women undergoing treatment for early stage breast cancer.
Authors: Ligibel JA , Campbell N , Anita G , Shockro L , Salinardi T , Winer EP 
Published: December 2010

Abstract
Abstract #1117
Women who gain weight after breast cancer diagnosis have a worse prognosis compared to women who avoid weight gain. Weight gain is especially common in women treated with adjuvant chemotherapy, many of whom develop sarcopenic obesity which involves an increase in body fat and loss of lean muscle mass. This type of weight gain has been associated with increases in insulin and other metabolic hormones linked to breast cancer risk and prognosis. Studies have demonstrated that weight gain in breast cancer patients occurs, at least in part, due to decreases in physical activity during and after treatment.&#x2028; Methods: In this single arm pilot study, sedentary women with early stage breast cancer participated in a home-based exercise intervention during adjuvant chemotherapy and/or radiation. The target activity goal was 150 minutes of aerobic exercise per week. Participants underwent evaluation of anthropometric measures, fitness (measured by modified Bruce ramp protocol treadmill test), fatigue and quality of life at baseline and after the 12 week intervention. Change in these measures over time was assessed using Wilcoxon signed rank test of the change scores (post-pre values).&#x2028; Results: Forty-one women were enrolled in the study and 33 (80%) completed the 12 week protocol. Average age of participants was 47, and women were an average of 4.5 months from diagnosis at the time of enrollment. All but one of the women (98%) received adjuvant or neoadjuvant chemotherapy. Baseline and week 12 values for study variables are presented in table 1. Participants were sedentary at baseline, engaging in an average of 13 minutes of weekly activity. Physical activity increased significantly during the study period, with participants averaging 105 minutes of activity per week. Participants avoided weight gain and increases in body fat over the course of the study, and experienced significant improvements in fitness, quality of life and fatigue scores.&#x2028; &#x2028; Discussion: Women who completed a 12-week home-based exercise intervention during adjuvant therapy significantly increased activity and avoided weight gain, which has been associated with poor prognosis in early stage breast cancer. This trial, in conjunction with other exercise studies in breast cancer patients, provides preliminary data to help guide the design of randomized trials examining the impact of exercise upon breast cancer outcomes.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 1117.
Onset and risk factors for aromatase inhibitor-related arthralgia in breast cancer survivors.
Authors: Mao JJ , Stricker CT , Bruner DW , Farrar JT , Bowman MA , Xie SX , Wolf J , DeMichele A 
Published: December 2010

Abstract
Abstract #1120
Purpose: Arthralgia is a common clinical phenomenon seen in postmenopausal women receiving aromatase inhibitors (AI). This study aims to evaluate the perceived onset, prevalence, and risk factors for AI-related arthralgia.&#x2028; Patients and Methods: We performed a cross-sectional analysis of a cohort of postmenopausal women with stage I-III breast cancer receiving adjuvant AI therapy at an outpatient breast oncology clinic at a large university hospital. Patient-reported symptoms and attribution of AI as a cause of arthralgia were main outcomes. Multivariate logistic regression analyses were performed to assess risk factor(s).&#x2028; Results: 300 patients have been enrolled, with a mean age of 61 +/- 10 years, 84% White, and 38(13%) Black. A total of 173 (58%) reported AI-related arhtralgia during the course of AI treatment and 139 (47%) attributed AI as a cause of their current arthralgia. While 103 (34%) reported having “arthritis” prior to AI initiation, 13% reported onset of symptoms within 1 month of medication initiation, 42% between 1-3 months, 27% between 3-6 months, 12% between 6-12 months, and 20% after 12 months. In a multivariate logistic regression model, time since last menstrual period (LMP) was the only significant predictor of reporting AI-related arthralgia; age, race, employment status, chemotherapy, and weight gain since breast cancer were not associated with the clinical syndrome. Controlling for these covariates, those who had LMP within 5 years had the highest probability of reporting AI-related arthralgia (73%), while those with LMP beyond 10 years had the lowest (35%), p=0.017. Prior arthritis was unrelated to AI-related arthralgia either in univariate or multivariate analyses.&#x2028; Conclusions: AI-related arthralgia is common and appears to be inversely related to the length of time since cessation of menstrual function. These findings suggest that estrogen withdrawal may compound these symptoms and may play a role in the mechanism of this disorder.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 1120.
Reversal of skeletal effects of endocrine treatments in the intergroup exemestane study.
Authors: Coleman RE , Banks LM , Girgis S , Vrdoljak E , Fox J , Cawthorn S , Patel A , Coombes C , Bliss JM , Kilburn LS , Group on Behalf of the IES 
Published: December 2010

Abstract
Abstract #1128
The Intergroup Exemestane Study (IES) has demonstrated significantly improved disease related outcomes for post-menopausal women with ER+/unknown early breast cancer who switch to exemestane (E) after 2-3 years pre-treatment with tamoxifen (T). In comparison to 5 years T, a switch to E is associated with a favorable adverse event profile other than an increase in musculoskeletal side effects, accelerated bone loss & increased fracture incidence. Here we report effects of endocrine treatment withdrawal on bone mineral density (BMD) at lumbar spine (LS) & total hip (TH), bone turnover markers (BTM) & fracture rates.&#x2028; Of the 4724 patients (pts) who took part in IES, 206pts (101E, 105T) at selected centres with no evidence of osteoporosis or osteoporotic fracture were included in a bone health substudy. BMD & BTM were assessed pre-randomization, after 6, 12, & 24 months (m) treatment, end of treatment (EOT), 12 & 24m post EOT. BTM were also assessed after 3, 9, 18, 30 & 3m post EOT. To evaluate treatment withdrawal effects, 12 & 24m post EOT BMD results are available for 160 (76E, 84T) & 159 (75E, 84T) pts respectively. Similar pt numbers also had BTM (urinary NTX & DPD, serum CTX, bone ALP, osteocalcin & PICP) measured post EOT.&#x2028; At EOT an ITT analysis showed that the switch to E was associated with a -3.9% & -3.0% reduction since randomization in LS & TH BMD respectively, compared with -1.2% &-1.6% for continuing on T, resulting in an EOT difference between mean E & T BMD of 2.8% (p=&lt;.0001) & 1.4% (p=.002). Following treatment withdrawal this difference was partially reversed. LS & TH BMD increased after E by 1.7% & 0.3% & fell by 2.2% & 2.8% with T at 24m from EOT. At 2 years post EOT there were no significant differences in BMD between treatment strategies.&#x2028; &#x2028; Corresponding changes in BTM were seen with an increase following T withdrawal & a reduction in previously E induced acceleration of bone turnover. In IES main study a higher number of fractures were seen in E pts after a median follow-up of 74m; further analyses will describe changing pattern of events over time. The adverse effects of E on bone are partially reversed on treatment withdrawal while beneficial effects of T are lost during the 2 years after EOT.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 1128.
Effects of tamoxifen and exemestane on cognitive functioning of postmenopausal patients with early breast cancer: results from the TEAM trial neuropsychological side study.
Authors: Schilder CM , Seynaeve C , Linn SC , Boogerd W , Beex LV , Gundy CM , Huizenga HM , Nortier JW , v/d Velde CJ , van Dam FS , Schagen SB 
Published: December 2010

Abstract
Abstract #1133
Background&#x2028; Adjuvant hormonal therapies (HT) are frequently used in primary breast cancer (BC), yet few studies have examined their potential impact on cognition. Fundamental and human research indicate that estrogens play an important role in certain cognitive functions; therefore it is plausible that HT can affect cognition in BC patients (pts). Due to different mechanisms of action, distinctive effects between selective estrogen receptor modulators (SERMs) and aromatase inhibitors (AIs) are possible.&#x2028; Methods&#x2028; Neuropsychological examinations were used to study cognitive performance before the start of adjuvant HT (T1) and after one year of HT (T2) in postmenopausal BC pts not qualified to receive chemotherapy. Study pts participated in the Dutch part of the international TEAM-trial, a prospective randomized study investigating tamoxifen (SERM) versus exemestane (AI) as adjuvant therapy for hormone-sensitive BC. The study sample consisted of 80 tamoxifen users (mean age 68.7 yrs, range 51-84) and 99 exemestane users (mean age 68.3 yrs, range 50-82). A healthy control group (n=120, mean age 66.2 yrs; range 49-86) was assessed with a similar interval. Differences in performance at T2 on 8 cognitive domains were studied among the three groups by use of ANCOVA twice: (1) adjusting for performance at T1 and (2) with additional adjustment for the covariates anxiety/depression, fatigue and menopausal symptoms at T2.&#x2028; Results&#x2028; After one year of therapy, exemestane users did not perform significantly worse than healthy controls on any cognitive domain. Tamoxifen users performed worse than healthy controls on 'verbal memory' (P=.003, Cohen's d = .43) and 'executive functioning' (P=.005, Cohen's d = .40) and worse than exemestane users on 'information processing speed' (P=.019, Cohen's d = .36). Adjustment for covariates did not change these results. For 'visual memory', 'working memory', 'verbal fluency', 'reaction speed' and 'motor speed' no significant differences between groups were found.&#x2028; Discussion&#x2028; After one year of therapy, tamoxifen has a negative impact on certain cognitive functions, while exemestane does not negatively affect cognition in this population. Although the burden of these effects on the daily life of pts has yet to be determined, intact cognition is known to be an important precondition for independent living and wellbeing. Currently, the options of HT in BC are increasing and optimization of HT with respect to the choice, sequence and duration of treatments is given high research priority. Our results underscore the need to include cognitive effects of HT in long-term safety studies.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 1133.
Bone effects of exemestane vs. tamoxifen within the TEAM trial: results of a prospective randomized bone sub study.
Authors: Hadji P , Ziller M , Kieback D , Dornoff W , Tessen HW , Kuck J , Hasenburg A 
Published: December 2010

Abstract
Abstract #1143
Background: A prospective open label randomized multicenter trial was performed in the German TEAM Trial Group to compare the effects of the steroidal aromatase inhibitor Exemestane (EXE) and the ER agonist/antagonist Tamoxifen (TAM) on bone mineral density (BMD) and markers of bone turnover during adjuvant treatment of postmenopausal women with estrogen receptor positive breast cancer.&#x2028; Methods: 200 postmenopausal estrogen receptor positive breast cancer women&#x2028; were included in the bone substudy. Women with a history of osteoporosis or a disease or treatment known to effect bone metabolism were excluded. BMD and markers of bone turnover were assessed at baseline, after 6 and 12 months of treatment. BMD was performed using dual x-ray absorptiometry (DXA) at the lumber spine and femoral neck (FN). Marker of bone formation, PINP, bone specific alkaline phosphatase (BAP) and osteocalcin (OC) as well as bone resorption marker (ICPM) were analysed using standardised methods. Intent-to-treat analysis was performed based on 200 patients. The primary endpoint was to compare Exemestane and Tamoxifen with regard to changes from baseline to month 12 in BMD (g/cm²) in lumbar spine (integral of L1-L4). Results: 156 patients with a mean age of 61 yr. (+/- 7.3 yr.) were available for final analysis. Both groups were comparable regarding age, height, tumor grade and stage. Compared to women on Tamoxifen, who comprised an BMD increase of +0.9% and +0.9% after 6 and 12 months at the spine, women on EXE showed a decrease of -2.8% and -3.6%. Conversely, BMD at the FN showed a decrease of -2.1% and -2.2% in women on TAM while women on EXE showed a decrease of -3.4% after 6 and an increase of +1.1% after 12 months, respectivly. Bone formation and absorption was modulated in both groups. Details will be presented at the meeting.Conclusion: The results of the 12 months analysis in the TEAM Bone substudy confirm the bone protective effect of TAM at the spine while conversely the results at the FN showed a decrease. Women on EXE showed a decrease at the spine while there was a neutral effect at the FN. Futher evaluation of the 24 months data as well as the fracture rate of the total TEAM trial are nessecary to evaluate the effect of EXE on bone health.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 1143.
A global perspective on the use of aromatase inhibitors in early-stage breast cancer.
Authors: Jackisch C , Verma S 
Published: December 2010

Abstract
Abstract #1144
Background: Aromatase inhibitors (AIs) are considered to be the standard of care for the adjuvant treatment of postmenopausal patients with hormone-receptor positive (HR+) early breast cancer (EBC). However, there is a lack of data on the use of these drugs in the non-trial setting and in regional practice around the world.&#x2028; Methods: This survey examined the use of endocrine therapies in breast cancer by physicians in 7 countries. From July 27 to October 8, 2007, 462 physicians in the United States, Germany, the United Kingdom, France, Spain, Italy, and Japan were surveyed, and information was collected via an internet Web site. Data included the physicians' reported activity during the last month, AI profiles, and patient profiles according to treatment stage.&#x2028; Results: Surveyed were 381 oncologists, 14 gynecologists, 36 surgeons, and 31 mammary gland clinicians. Physician perceptions were similar to the actual patient data. Half of all women being treated for breast cancer were HR+ and postmenopausal (less in Japan: 38%), and almost all of those patients (80-95%) were receiving endocrine therapy for the adjuvant treatment of EBC. AIs were the most common hormone agents used in the initial adjuvant setting of postmenopausal women with HR+ EBC across all countries surveyed (55-93%; median 88%). An upfront AI strategy was the most common practice overall, particularly in Japan, the United States, and France (89%, 86%, and 86%, respectively). Initial tamoxifen therapy was used predominantly in Germany (36%), the United Kingdom (51%), and Italy (55%). However, in the United Kingdom and Germany, the intent in nearly half of these patients was to switch to an AI following 2 years of tamoxifen therapy. The rates at which the 3 AIs were prescribed for different types of adjuvant treatment were generally consistent across countries. Guidelines were identified as a major decision-making factor in all countries.&#x2028; Conclusion: There are variations in practice across the surveyed countries despite the presence of international guidelines, eg, the American Society of Clinical Oncology and St. Gallen 2007. These practice trends may reflect the various guidelines in each region. Differences in treatment are particularly seen in Europe, which may reflect the number of varying guidelines and less descriptive nature of the guidelines.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 1144.
Adriamycin and cyclophosphamide followed by tamoxifen, versus the combination of gonadotropin-releasing hormone analog and tamoxifen, in the treatment of premenopausal endocrine-responsive node-negative breast cancer.
Authors: Kim H , Lim W , Park E , Sei J , Koh B , Son B , Kim S , Ahn J , Gong G , Kim H , Jung K , Ahn S 
Published: December 2010

Abstract
Abstract #1151
Purpose&#x2028; To compare the efficacy of adriamycin and cyclophosphamide (AC) followed by tamoxifen (AC-&gt;T) with gonadotropin-releasing hormone analog plus tamoxifen (GnRHa+T) in premenopausal women with hormone-response, node-negative breast cancer.&#x2028; Patients and Methods &#x2028; We retrospectively reviewed the records of 587 premenopausal women with hormone- responsive, node-negative breast cancer. Of these, 269 were treated with AC-&gt;T, and 318 were treated with GnRHa (goserelin acetate 3.6 mg/kg or leuprorelin acetate 3.75 mg/kg every 28 days subcutaneously)+T. The main study outcome was disease-free survival (DFS).&#x2028; Results&#x2028; At a median follow-up time of 30 months, eight patients had relapsed and three had died. DFS did not differ between the AC-&gt;T and GnRHa+T groups. Of the three deaths, two were not related to breast cancer. The third patient, in the AC -&gt;T group, died because of brain metastasis. GnRHa+T treatment had no effect on blood profile and did not cause the development of detrimental symptoms but decreased bone mineral density. The efficacy of leuprorelin was similar to that of goserelin.&#x2028; Conclusion &#x2028; GnRHa +T and AC-&gt;T had comparable efficacy after 30 months of follow-up. The efficacy and tolerability of leuprorelin acetate was similar to that of goserelin.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 1151.
Effect of exemestane on bone turnover markers and bone mineral density (BMD): 2 year results of the Dutch/Belgian Tamoxifen Exemestane Adjuvant Multicentre (TEAM) trial.
Authors: van Nes JG , Papapoulos SE , Braun JJ , Dirix L , Putter H , Zwaan RE , Ballieux BE , van Rongen I , van de Velde CJ , Seynaeve C , Nortier JW 
Published: December 2010

Abstract
Abstract #1154
Background Aromatase inhibitors (AIs) given to women with early breast cancer may adversely affect bone metabolism. We studied the effect of exemestane (E) on bone mineral density (BMD) and bone turnover and compared it to the effect of tamoxifen (T) treatment in a group of women participating in the Dutch and Belgian Tamoxifen Exemestane Adjuvant Multicentre (TEAM) trial. In this trial, postmenopausal women with hormone sensitive early breast cancer (n=3168) were randomised between 5 years E or 2½-3 years T followed by 2½-2 years of E.&#x2028; Methods In this subprotocol, 87 women were followed for two years. Patients with bone diseases were excluded. Total hip and lumbar spine BMD were assessed at baseline and after 1 and 2 years. The bone resorption marker cross-linked telopeptide of type-I collagen (CTX) and the bone formation marker N-terminal propeptide of type I collagen (PINP) were measured in fasting serum at baseline and after 3, 6, 12 and 24 months.&#x2028; Results At baseline, there was no difference in total hip (E: 0.85g/cm2, T: 0.80g/cm2; p=0.642) and lumbar spine BMD (E: 0.99g/cm2, T: 1.02g/cm2; p=0.545) between both groups. After 2 years, there were no significant changes in total hip BMD (E: 0.02 g/cm2 95%CI -0.05;0.08, p=0.849; T: 0.03 g/cm2, 95%CI -0.02;0.09, p=0.466) and in spine BMD (E: -0.02 g/cm2 95%CI -0.11;0.06, p=0.834; T: 0.02 g/cm2 95%CI -0.05;0.10, p=0.747). At baseline, there was no difference in serum CTX (E: 0.34ng/mL, T: 0.29ng/mL; p=0.271) and P1NP (E: 57ng/L, T:58ng/L, p=0.973) between both groups. After 2 years of treatment, serum CTX increased, although not significantly in the E group (20%, 95%CI -6%;54%, p=0.223) while it decreased significantly in the T group (-40%, 95%CI -23%;-53%, p&lt;0.001). At 24 months, the CTX was 0. 44ng/mL (E) and 0. 18ng/mL (T). Serum P1NP did not change in the E group (-2%, 95%CI -20%;19%, p=0.837) but decreased significantly in the T group (-48%, 95%CI -36%;-58%, p&lt;0.001). At 24 months, the P1NP was 55ng/L (E) and 28ng (T).&#x2028; Conclusion Although there was a trend for an increase in bone resorption with E treatment, this was not significant and was not associated with a decrease in BMD. The magnitude of the reported negative effect of aromatase inhibitors on bone metabolism in studies using T as comparator treatment may be overestimated by the effect of T on bone turnover.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 1154.
Local control with conventional and hypofractionated adjuvant radiotherapy for ductal carcinoma in-situ: is there a difference in outcome?.
Authors: Williamson D , Fung S , Pintilie M , Dinniwell R , Fyles A 
Published: December 2010

Abstract
Abstract #1162
Purpose&#x2028; Trials of adjuvant whole breast radiotherapy (WBRT) following breast-conserving surgery for invasive breast cancer indicate equivalent efficacy and morbidity for conventional and hypofractionated treatment. WBRT for ductal carcinoma in-situ (DCIS) improves local control, however an optimal dose fractionation remains undefined. Our group policy allowed for the use of both schedules, therefore we compared local control in women with DCIS following breast-conserving surgery.&#x2028; Methods&#x2028; Two hundred and sixty six patients treated between January 1999 and December 2004 with conventional (50 Gy/25 fractions) or hypofractionated (42.4 Gy/16 daily fractions or 40 Gy/16 fractions + 12.5 Gy/5 fraction boost) radiotherapy schedules to the whole breast after breast-conserving surgery for DCIS were identified and retrospectively reviewed. Treatment schedules were evaluated for outcomes in terms of ipsilateral breast recurrence.&#x2028; Results&#x2028; The median age at diagnosis 56.7 years (range 32.2-83.8 years), and 82% (218 patients) presented with mammographic abnormality. Median tumour size was 1.5 cm (range 0.4-10 cm), grade 3 tumours were present in 105 women (39%), and comedonecrosis in 145 (55%). Fifty-one patients (19%) had multifocal disease. Median follow-up was 45.1 months (range 0.7-106.8 months). Prognostic features were well matched in both groups.&#x2028; One-hundred and four patients (39%) were treated with conventional and 162 (61%) with hypofractionated WBRT. There were a total of 14 confirmed local recurrences in the previously radiated breast. Six recurrences occurred in the 104 (5.8%) patients treated with a conventional schedule and 8 of 162 (4.9%) patients treated with a hypofractionated schedule. Actuarial risk of recurrence at 4 years was 7% with hypofractionated WBRT and 5% with a standard schedule (p=0.85).&#x2028; &#x2028; Eight patients recurred with DCIS and 6 with invasive carcinomas, all 14 were treated surgically with adjuvant treatment as indicated clinically, 1 patient with clinical recurrent disease refused biopsy and further conventional treatment. Univariate analysis showed a trend to increased risk of recurrence with grade 3 tumours (10% at 4 years vs. 3% for grade1/2, p=0.053) and presence of comedonecrosis (8% vs. 2%, p=0.096), but not multi-focal disease (7% vs. 5%, p=0.78).&#x2028; Conclusions&#x2028; Hypofractionated adjuvant WBRT schedules following breast-conserving surgery for DCIS have comparable local control rates to a conventional radiation schedule. Hypofractionated WBRT is more convenient for patients, has equivalent morbidity and should be considered in this patient group.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 1162.