bluuebunny/crossref_metadata_2025_split huggingface dataset:
P2-15-10: Do Patients with Incurable Advanced Breast Tumor and Distant Metastasis Derive Any Benefit from Primary Tumor Resection?
Authors: Takahashi M , Shibasaki S , Jotoku H , Watanabe K-I 
Published: June 2012

Abstract
Background
Metastatic breast cancer (MBC) is considered incurable. Surgical removal of primary tumors has not been established as a standard treatment for MBC because it is generally accepted that local therapy provides no survival advantage once metastases have occurred. Additionally, tumor excision may further stimulate metastasis.4 Therefore, primary tumor resection in patients with MBC is usually only applied as a palliative treatment for symptomatic wound complications such as bleeding, ulcer formation, unpleasant smell, and purulent discharge. In recent years, however, some retrospective studies have reported advantages of debulking surgery in terms of improving patient outcome. We retrospectively analyzed the surgical benefits and prognostic factors for patients with MBC who were treated at our center.
Methods: We retrospectively reviewed individual medical records from the Hokkaido Cancer Center. In this study, incurable advanced breast cancer is defined as the presence of a tumor, larger than 5 cm, and shows either (invasion to chest wall or skin or is an inflammatory carcinoma) and at least one metastatic site, including distant lymph nodes, bone, or visceral organs (lung, pleura, mediastinum, liver, and brain) at diagnosis. Between January 2000 and June 2010, 92 women were diagnosed with incurable advanced breast cancer at our institute. The effect of surgical treatment on survival was evaluated. Patient demographics and tumor characteristics were also investigated.
Results: Thirty-six patients had surgery for resection of primary tumors. There were no substantive differences between individuals, or between tumor characteristics, for patients who underwent surgery versus patients who did not. The median survival time for surgically treated patients was 25.0 months versus 24.8 months for patients who did not undergo surgical resection (P=0.352). Only three patients relapsed within three months of surgery. For the remaining majority of patients, primary tumor resection gave some relief from the often severe symptoms that come from harboring a large tumor for an extended time. In univariate and subsequent multivariate analyses of predictive indicators, a diagnosis of triple-negative breast cancer and/or metastasis to more than three sites was significantly associated with a severe prognosis.
Conclusion: Primary tumor resection failed to prolong overall survival times in patients with incurable advanced breast cancer that was greater than 5 cm. However, surgery did improve the quality of life in patients who were expected to have a relatively long prognosis.
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P2-15-10.
P2-15-11: Outcomes of Corrective Procedure with Vicryl Mesh as an Oncoplastic Surgery of the Breast.
Authors: Lim YA , Lee YO , Kim JH , Kim HS , Kang HJ , Kim LS , Hallym Sacred 
Published: June 2012

Abstract
Background: Both cosmetic and oncologic outcomes are becoming more important for breast cancer patients. Breast-conserving surgery (BCS) has an acceptable cosmetic result compared with mastectomy, but BCS is also associated with cosmetic failure. In this study, we evaluated the cosmetic outcome of reconstructive surgery with the absorbable implant vicryl mesh after BCS compared with the outcome of BCS alone.
Methods: From May 2007 to December 2009, 101 patients were involved in this study at Hallym University Sacred Heart Hospital. We used absorbable implants made of folding vicryl mesh and wrapped them with Interceed. In 79 cases, BCS with vicryl mesh implantation was performed; in the other 56 cases, only BCS was performed. Patient satisfaction with cosmetic outcomes was evaluated. We also analyzed other factors that affected cosmetic outcomes, including patient ages, body mass indices, tumor locations, and removed breast tissue.
Results: In the vicryl mesh implantation group, 65 of 79 patients (82.3%) were satisfied; in the BCS-only group, 24 of 56 patients (43%) were satisfied (P &lt; 0.05). In the vicryl mesh implantation group, patient ages, body mass indices, and removed breast tissue did not affect cosmetic outcomes. When the tumor was located in the upper outer quadrant, the patients were more satisfied (P &lt; 0.05). Conclusions: Reconstructive procedures with vicryl mesh are simple, safe, and less expensive than other plastic reconstruction techniques. This study suggests that the procedure was superior to BCS alone in cosmetic outcomes. We believe that the procedure could become a favorable technique in oncoplastic surgery.
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P2-15-11.
P2-15-12: Management Strategy of Early-Stage Breast Cancer Patients: With or without Axillary Lymph Node Dissection.
Authors: Yamamoto D , Tanaka K , Tsubota Y , Yosida H , Kanemastu S 
Published: June 2012

Abstract
Background: The sentinel lymph node (SLN) biopsy has steadily replaced axillary lymph node dissection (ALND) for staging clinically node-negative breast cancer. However ALND remains the standard management of the axilla when a tumor-positive sentinel lymph node (SLN) is identified. The aim of this study was to evaluate the ALND in local, distant recurrence, and overall survival (OS) in breast cancer patients.
Methods: We identified 350 patients with breast cancer (clinically T1/T2N0M0) from the prospective database from five institutions from July 1999 and April 2004. All patient age ranged from 26 to 81 (median 49) years. All patients underwent mastectomy or breast conserving surgery (BCT) combined with either ALND or no ALND. Criteria of negative ALN metastasis are that minor axis of ALN is under 5 mm on CT images and fat tissue in the hilum of ALN does not disappear on ultra-sound images. In the case that hormone receptor expression is positive, pt was administered for 5 years. In the case of T1c or T2 under 70 years old, neoadjuvant and/or adjuvant anthracycline-based chemotherapies were administered. After surgery, patients without ALND/with ALND received tangential irradiation at the region of breast. ALND and no ALND groups were compared for incidence of local, regional, distant recurrence, and overall survival. Results: Patients with ALND (n=350) were compared with no ALND group (n=126). There were significant differences in primary tumor size, histology, nuclear grade, presence of LVI, ER/PgR/HER2 status between the two groups. Five years OS was 97.9% in ALND group, it was 98.0% in no ALND group (p&gt;0.01). Further there was no significant difference between two groups in local, regional, and distant recurrence.
Conclusions: These results indicate that ALND is omissible for cT1/T2N0M0 breast cancer by a combination of hormone therapy, neoadjuvant/adjuvant chemotherapy, and irradiation.
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P2-15-12.
P2-16-03: Outcomes of Nipple-Sparing Mastectomy (NSM) and Immediate Reconstruction.
Authors: Chidester JR , Olson JR , Poruk KE , Marengo JJ , Matsen CB , Neumayer L , Agarwal J 
Published: June 2012

Abstract
Background
Nipple-sparing mastectomy (NSM) is the surgical removal of breast tissue that preserves the entire skin envelope including the nipple areola skin (NAS). We report our experience performing NSMs and immediate breast reconstruction for both high-risk breast cancer treatment and prophylaxis over a six-year period at The University of Utah and Huntsman Cancer Hospital.
Methods: A retrospective chart review was performed on patients undergoing NSM from April 2005 - April 2011. Data collection included: patient demographics, oncologic details, surgical information (including reconstruction timing and type), and complications (infection, hematoma, seroma, skin necrosis, NAS complication, skin flap loss, premature expander exchange/removal, and capsular contracture).
Results: 130 patients underwent 205 NSMs. Of these, 106 (81.5%) patients received mastectomy treatment for cancer while 24 (18.5%) patients were prophylactically treated. 102 NSMs (49.8%) were on breasts with biopsy-proven cancer, while 103 (50.2%) NSMs were on breasts for prophylaxis. All patients were female with a mean age of 44.7 years (range, 16–82 years). 119 (92.2%) patients were Caucasian, 3 (2.3%) were Asian, and 1 (0.8%) was Hispanic. The mean weight was 65.2 kg (range, 42.8 - 98.8 kg) and BMI (n=106) was 23.7 kg/m2 (SE±0.4). 14 (10.9%) and 12 (9.3%) of the patients were known to have a BRCA1 and BRCA2 mutation, respectively. Two (1.6%) patients had a p53 mutation. 172 (83.5%) of the nipples were spared via an 8 cm incision lateral to the midpoint of the areola, while 5 (2.4%) of the incisions were made along the IMF. The remaining 28 (13.7%) incisions were made by other techniques. 201 (98.0%) breasts were immediately reconstructed with tissue expanders (193 went on to implant reconstruction and 8 underwent autologous tissue reconstruction). 4 (2.0%) breasts received delayed reconstruction. Positive margins were found in 15 (7.3%) of 205 breasts. 60 (58.8%) of 102 cancerous breasts that underwent NSM were Stage 0-I, 35 (34.3%) were Stage II and the remaining 8 (7.8%) were Stage III - IV. Complications by case (Table 1) and by breast (Table 2) are shown below.

Conclusion: When comparing NSMs in both patients and individual breasts with cancer to patients and breasts treated for prophylaxis, there is no significant difference in complication rates by case or breast, except for the capsular contracture rate, which was significantly higher in breasts treated for cancer. Overall, complication rates are low in both cases of cancer and prophylaxis; this demonstrates that NSM and immediate reconstruction is a highly effective method of treatment for both groups.
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P2-16-03.
P2-16-08: Expander-Implant-Reconstruction – Aesthetic Outcome and Patients' Satisfaction in a 10-Year-Period.
Authors: Kern PA , Zarth F , Rainer K , Scherag A , Mahdi R 
Published: June 2012

Abstract
Background. Breast reconstruction after mastectomy is gaining increasing significance avoiding the post-mastectomy-trauma and providing the patients with a normal body image after breast cancer survival. This study was conducted to investigate the patients’ characteristics and comorbidities in correlation with the surgical outcome of expander-implant-reconstruction after mastectomy. Patients’ satisfaction with the surgical result and self-perception as well as their partner interaction were also analyzed in their dependance of these patient-related data.
Methods. In this large retrospective cohort study 258 women were enrolled with expander- and/or implant-reconstruction in a single-institution-setting of a 10-years-period (2000-2009). Patient's satisfaction with the result of surgery was evaluated by questionnaires and interviews and patient-related data were retrieved like BMI, smoking, pre-existing diseases and chemo- and radiotherapy, the differentiation between one-stage/two-stage reconstruction, immediate/delayed reconstruction, antibiotics and complications (secondary bleeding, pain, capsular contracture, implant rotation, etc.). Finally, the patients’ interaction with their partners and their adhaerence to their decision for reconstruction was investigated. For explorative statistical analyses we used standard univariate methods appropriately for the scale level of the variables (e.g. Fishers exact tests for n x m Tables or exact Wilcoxon Mann Whitney tests to compare two distributions) and applied a significance level a of 5% to each test.
Results: BMI and patients’ satisfaction with the aesthetic result was inversely correlated (p=0,004) and a negative self-perception had a negative impact on interaction with the partner (p&lt;0,001) after breast reconstruction. BMI was positively correlated with the loss of the implant (p=0,005). Further comorbidities led to worse patients’ satisfaction in rating of the aesthetic results.
Conclusion: Patients characteristics like obesity and other comorbidites are associated with lower patients’ satisfaction with the surgical outcome after expander-implant-breast reconstruction. A decrease of satisfaction is detectable after expander-implant reconstruction within years compared to autologous reconstruction. These results should be taken into consideration for counselling of patients opting for breast reconstruction after mastectomy. This is to our knowledge the largest single-institution study evaluating the patients’ satisfaction with implant-reconstruction after breast cancer treatment and comparing the outcome with various patient characteristics giving a rationale for selection of the optimal reconstructive method.
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P2-16-08.
P2-16-15: Oncological Safety and Survival Rate According to Reconstructive Surgery in Advanced Breast Cancer after Neoadjuvant Chemotherapy.
Authors: Kim WW , Lee JJ , Nam KH , Jung JH , Chae YS , Yang JD , Lee YH , Park HY 
Published: June 2012

Abstract
Purpose: Oncoplastic surgery has received attention according as the incidence of breast cancer is rising and quality of life including cosmetic result after surgery is regarded as important. The aim of this study is to compare combined reconstructive surgery with standard surgery regarding to oncological safety and survival rate in advanced breast cancer after neoadjuvant chemotherapy (CTx).
Method: Thirty-seven patients underwent neoadjuvant CTx and surgery with advanced breast cancer were analyzed from September 2007 to March 2010. Group A (n=12) received combined reconstructive surgery, group B (n=25) had standard surgery.
Results: There were no differences in age, size, metastatic LN, stage, ER/PR/Her-2 status, recurrence, metastasis and death between group A and B. Patients with good response in neoadjuvant chemotherapy (26 cases (72.9%)) had CTx-operation-radiation therapy (RTx), cases with poor response (10 cases (27.1%)) underwent CTx-RTx-operation. There was significant difference in order of treatment, eight patients among group A(66.6%) had CTx-RTx-operation, 22 cases in group B(88.0%) received CTx-operation-RTx (p=0.006). Mean follow up period was 22 months, 2 patients (5.2%) experienced local recurrences, 11 cases (34.3%) diagnosed with distant metastasis, and 4 patients (10.5%) expired with breast cancer.

Conclusion: Advanced breast cancer with poorly responded in neoadjuvant CTx could be actively treated with sequential CTx-RTx-reconstructive surgery. Combined reconstructive surgery was oncologically safe operation in advanced breast cancer.
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P2-16-15.
P2-18-03: Systemic Adjuvant Treatment of T1a and T1b N0M0 HER2+ Breast Carcinomas; an AERIO/UNICANCER Study.
Authors: Peron J , Vano Y , Frenel J-S , Wassermann J , Albiges L , Rodrigues MJ , Cottu PH 
Published: June 2012

Abstract
Background: Trials have shown benefit of adjuvant trastuzumab (TZM) for node-positive (N+) or T1c+ HER2−positive breast carcinomas.
Methods: Retrospective series in 6 french cancer centers from 2000 to 2010 of T1abN0M0 HER2 positive breast carcinomas. Multifocal tumors were excluded.
Results: Two hundred five N- cases were retrieved. Median size was 8 mm (range, 2 to 10 mm), 51 were T1a (25%), 152 tumors were T1b; 120 tumors (59 %) exhibited significant hormonal receptors (HR) expression. All patients had surgery, 65 % (n= 133) had a local irradiation. Ninety percent of HR+ patients (108/120) received hormonotherapy: 77 received aromatase inhibitors (AI) upfront or sequential; 23 received tamoxifen (TAM) alone 13 received LHRH agonists alone or in combination with TAM or AI. Forty-nine percent (n= 101) had chemotherapy (CT) (Anthracycline alone for 41 cases, taxane alone for 31 cases, sequential A/T for 28 cases and concurrent for 1 case), associated with TZM in 90 cases. TZM was administered without chemotherapy in 3 cases. Decision of adjuvant CT and/or TZM was associated with (all p&lt;0.05) HR-negative status, Elston-Ellis grade 2/3 and high mitotic index (MI) while patients with HR+/ low MI tumors were rarely treated (p&lt;0.01). With a 41 months median follow-up, there was a statistically significant difference in invasive recurrences between TZM treated patients and others (log-rank test p=0.04). Twelve of the 112 patients treated without TZM (11%) had a recurrent invasive disease including 6 metastatic cases and 3 fatal events. There was one invasive recurrence in TZM group. There were as much recurrences in T1a as in T1b tumors. Three of the 12 recurrences (25%) in the group without TZM occurred in T1a cases.
Conclusion: T1abN0M0 HER2 positive tumors have a significant risk of recurrence which could be avoided by adjuvant chemotherapy associated with TZM. Interestingly, there were no differences in the risk of recurrence between T1a and T1b. Adjuvant chemotherapy associated with TZM should not only be discussed in T1bN0 HER2−positive tumors but also in T1aN0 HER2−positive cases.
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P2-18-03.
P2-19-04: Changes in Adjuvant Treatment of Early Breast Cancer in Italy between 2000 and 2008. The NEMESI Study Versus the NORA Study.
Authors: Mustacchi G , Cazzaniga ME , Pronzato P , Clavarezza M , Del Mastro L , Venturini M , Amadori D , Bidoli P , Boni C , Caruso M , Riccardi F , Dondi D 
Published: June 2012

Abstract
Background: In the early 2000s, we identified treatment patterns of early breast cancer (EBC) in Italy (NORA study). To ascertain whether attitudes have changed, we conducted a similar study in 2008. Patients and methods: In this retrospective study (NEMESI), we recorded the clinical, tumour and treatment characteristics of 1.894 EBC patients in 63 Italian oncological centres in 2008, and compared the results with those of NORA, on 3.515 patients in 70 same/similar Italian institutions, in 2000–2003. Tumor stage, surgery and endocrine-responsiveness are not comparable because of different recruitment protocols, patients charactheristics and adjuvant treatment strategies are perfectly comparable as a reliable picture of adjuvant strategies in Italy.
Results: There was no difference in age class distribution, menopausal status, ECOG performance status, tumor grade, ki67 and estrogen receptors content. HER2 status was simila but determined in 98% of cases in NEMESI vs 46.2% in NORA. The overall use of endocrine treatment (HT) increased from 80.3% in NORA to 83.5% in NEMESI (p = 0.005); the overall use of chemotherapy (CHT) decreased from 68.4% to 57.8% (p = 0.00001). HT alone increased from 31.6% to 42.2% (P = 0.00001) and CHT alone decreased from 18.8% to 16.2% (p = 0.017). The use of both treatments decreased from 49.2% to 41.6% (p = 0.00001). Trastuzumab was never given in NORA and in 15% of cases in NEMESI (85% of all HER2 positive cases).
The choice for HT was tamoxifen for 5 years in 32.5% of cases in NEMESI and 86.6% in NORA (p = 0.000001), and aromatase inhibitors for 5 years in 55.2% vs 13.3% of cases, respectively (P = 0.000001). The “switch” from tamoxifen 2–3 years to aromatase inhibitors 2–3 years was planned in 10.1% of cases in NEMESI and actually done in 12.9% of cases in NORA (p = 0.001). The overall use of LHRH analogues was significantly higher in NEMESI vs NORA (26.7% vs 3.0%, p = 0.00001). CMF-like regimens decreased from 37.0% in NORA to 9.1% (p = 0.000001). Anthracycline-containing regimens decreased from 52.1% in NORA to 48.8% in NEMESI; p = 0.0001) in favour of of regimens containing anthracyclines and taxanes, either in combination or sequential (0.9% in NORA vs 38.4% in NEMESIS, p = 0.000001). The use of taxanes alone regimens remained low (3.5% vs 3.7%, ns). The overall use of anthracyclines and taxanes increased from 53.0% to 87.5% and from 4.3% to 42.1%, respectively (both p =0.00001).
Conclusions: EBC treatment has changed significantly in 6 years. Adjuvant strategies are significantly different, with a great increase of aromatase inhibitors and LHRH analogues associated with tamoxifen; anthra-taxane combinations have also significantly increased.
Financial Support by Sanofi Aventis Italy
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P2-19-04.
P3-01-09: Oncogenic Activation of HSF1 Enables the Malignant Progression of Breast Carcinoma.
Authors: Mendillo ML , Santagata S , Koeva M , Fraenkel E , Ince TA , Whitesell L , Lindquist S 
Published: June 2012

Abstract
HSF1 is best known for its role as the master transcriptional regulator of the evolutionarily conserved heat-shock response. In mice, Hsf1 knock-outs dramatically reduce susceptibility to malignant transformation and tumor formation, and markedly increased survival in cancers driven by both oncogenic and tumor suppressor mutations. Likewise, RNAi-mediated knockdown markedly reduces the growth and survival of human cell lines established from cancers driven by a diversity of genetic lesions. The transcriptional network that HSF1 coordinates during heat-shock is known, but is unknown in malignancy. We compare HSF1 function in isogenic breast cancer cells of high and low malignant potential. HSF1 orchestrates a far-reaching transcriptional program that is dependent on transformation and the degree of malignancy. The oncogenic HSF1 program differs markedly from the classical heat-shock response. It is enriched for genes involved in a myriad of cellular processes known to be important in malignancy, including transcription, translation, glucose metabolism and cellular adhesion. It includes only a particular subset of heat-shock protein genes, and many of these are regulated in a manner that differs from their regulation by heat-shock. We also find that HSF1 is overexpressed and activated in a large subset of all conventionally defined classes of breast cancer. Moreover, tumors with high expression of the oncogenic HSF1 transcriptional network are strongly associated with poor outcome as monitored by metastasis and death. Our findings suggest that the oncogenic HSF1 activation program is rooted in fundamental aspects of tumor biology and will prove a powerful new tool in the clinical management of patients with breast cancer and, likely, other malignancies as well.
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P3-01-09.