bluuebunny/crossref_metadata_2025_split huggingface dataset:
The black to white breast cancer incidence rate crossover.
Authors: Anderson WF , Rosenberg PS , Jatoi I , Pfeiffer RM 
Published: December 2010

Abstract
Abstract #2086
Background: Although breast cancer incidence rates are higher among Blacks than Whites prior to age 40 years, the reverse is true after age 40 years. This so-called Black to White ethnic crossover has been described but never systematically studied.&#x2028; Materials and Methods: To further assess the Black to White incidence rate crossover, we obtained data from the National Cancer Institute's Surveillance, Epidemiology, and End Results program. Invasive female breast cancers were stratified by Black and White race and estrogen receptor (ER) expression. Standard descriptive epidemiology was supplemented with “comparative” age-period-cohort (APC) models.&#x2028; Results:]We observed “qualitative” (reversing or crossing) age-interactions by race, stratified by birth-cohort and adjusted for calendar-period. For example, APC fitted age-at-onset curves were higher among Blacks than Whites prior to age 40 years, and then rates crossed, after which age-specific rates were higher for Whites (p ∼ 0 for difference). In contrast to age-related differences, secular trends were similar for Blacks and Whites (net drifts, p = 0.85 for difference). For all time periods and age groups, ER negative incidence rates were higher among Blacks, whereas ER positive rates were higher among Whites.&#x2028; Conclusion: When viewed as a qualitative (crossing) age-interaction, the Black to White ethnic crossover reflects the reversal of incidence rate ratios for early-onset/poor prognosis and late-onset/good prognosis breast cancer types. Blacks have more early-onset and ER-negative tumors, even after adjustment for calendar-period (screening) and birth-cohort (exposure) effects.&#x2028; &#x2028;
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 2086.
Molecular differences between the triple negative tumors of African-American women and white women.
Authors: Lund M , Eley JW , O'Regan RM , Gabram SS , Saavedra HI , Liff JM , Brawley OW , Porter PL 
Published: December 2010

Abstract
Abstract #2087
Purpose. We recently reported associations between triple negative tumors (TNTs) and several key cell-cycle proteins. TNTs have also been associated with: 1) younger age and African-American (AA) race, 2) a relative lack of therapeutic targets, and 3) higher recurrence and poorer survival relative to other tumor subtypes. Furthermore, AA women diagnosed with TNTs experience worse outcomes than white women. TNTs are a mixed group of tumors that includes both basal and non-basal types. Markers that could help differentiate tumors with the poorest outcome would be of great use in determing how to effectively treat women with TNT. This study examines whether there are racial differences in key cell-cycle and apoptotic proteins among women with TNTs and could help to identify potential molecular mechanisms underlying racial disparities in these aggressive tumors.&#x2028; Methods. Invasive TNTs from a population-based cohort of 136 Atlanta women (56 AA and 79 white) aged 20–54, diagnosed between 1990 and 1992, were centrally reviewed and immuno-histochemically analyzed for ER, PR, HER2, Bcl2, Cyclins D1 and E, pRb, p16, p21, p27, p53, p130, Ki67, and apoptotic index (AI). Weighted frequency distributions, Chi-square tests, and logistic regression were used to assess racial differences. Age and stage-adjusted odds ratios (OR) and 95% confidence intervals (CI) were estimated.&#x2028; Results. Among the 136 women diagnosed with TNTs, AA women were significantly more likely than white women to present at a later stage, with larger tumors, and increased grade, mitotic activity, tumor necrosis, and apoptotic index. AA women were also significantly younger, poorer, and obese. Cell cycle protein differences between AA and white women diagnosed with TNTs included higher expression of Cyclin E [OR = 4.0 (95% CI=1.9, 8.5)], pRB [OR = 2.8 (95% CI=1.6, 4.9)], p16 [OR = 2.2 (95% CI=1.3,3.8)], p21 [OR = 2.0 (95% CI=1.1, 3.5)], AI [OR = 2.1 (95% CI=1.3, 3.9)], and lower expression of p130 [OR = 0.6 (95% CI=0.3, 1.0)].&#x2028; Conclusions. Exclusively among triple negative tumors, we identified racial differences in expression levels of several key cell-cycle and apoptotic related proteins. Combined with other poor prognostic factors, these differences may account for racial disparities in outcome. Future etiologic studies and clinical trials dedicated to TNTs should consider underlying molecular differences.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 2087.
Differences in breast cancer subtype distribution exist among ethnic subgroups of Asian women in California.
Authors: Telli ML , Kurian AW , Chang ET , Keegan TH , McClure LA , Ford JM , Gomez SL 
Published: December 2010

Abstract
Abstract #2088
Background: Distinct breast cancer subtypes have been identified by gene expression analysis. Little is known about the distribution of these subtypes among Asian women. We previously reported an increased frequency of HER2-positive breast cancers among certain ethnic subgroups of Asian women in California. To follow up on that finding in detail, we undertook the current analysis to explore factors associated with differences in breast cancer subtype distribution among Asian women in California.&#x2028; Methods: We defined immunohistochemical surrogates for each breast cancer subtype among Chinese, Japanese, Filipina, Korean, Vietnamese and South Asian patients in the population-based California Cancer Registry diagnosed in the period 1999-2005. Subtypes were defined using combinations of immunohistochemical markers: luminal A (ER+ and/or PR+, HER2-), luminal B (ER+ and/or PR+, HER2+), basal-like (ER-, PR-, HER2-) and HER2+/ER- (ER-, PR-, HER2+). Polytomous logistic regression was used to evaluate associations between breast cancer subtype and age, race, AJCC stage, tumor grade, tumor histology, socioeconomic status, nativity and hospital ownership (private vs. public). Models were used to compare differences in these characteristics simultaneously across the four breast cancer subtypes.&#x2028; Results: Of 12,245 Asian women diagnosed with invasive breast cancer, 7,217 (59%) women had data for all three immunohistochemical markers. The majority of breast cancers among Japanese women were of the luminal A subtype (67%), with a low frequency of basal-like (10%) and HER2+ (22%) cancers. Korean, Filipina and Vietnamese women had a high frequency of HER2+ cancers (35%, 31% and 31%, respectively) compared to Non-Hispanic White women diagnosed during this period (n=12,996, 21%). In regression analyses among Asian women, the four subtypes varied significantly in their associations with age group (p=0.01), detailed Asian ethnicity (p&lt;0.0001), stage (p&lt;0.0001), grade (p&lt;0.0001), histology (p&lt;0.0001), year of diagnosis (continuous; p=0.03) and hospital ownership (p&lt;0.0001). However, there was no significant variation among the subtypes in their relationships with socioeconomic status (p=0.94) or nativity (p=0.29).&#x2028; Conclusions: Differences in the distribution of breast cancer subtypes exist among Asian women according to ethnicity, as well as other demographic and disease characteristics. These differences were not associated with place of birth or socioeconomic status. Breast cancers among Japanese women had the most favorable subtype distribution, while Korean women had the least favorable distribution. Further study may identify genetic and environmental risk factors responsible for these differences, with implications for prevention and treatment.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 2088.
Disparate racial benefits of chemotherapy in breast cancer.
Authors: May KA , Hair BY , Zaky SS , Gabram-Mendola SG , Rizzo M , Bumpers HL , Oprea G , O'Regan RM , Lund M 
Published: December 2010

Abstract
Abstract #2091
Purpose: Patients with triple negative breast tumors (TNTs) have high recurrence and poor survival rates. African-American (AA) women have a higher prevalence of TNTs and worse outcomes than Caucasian (CA) women. The addition of a taxane to anthracycline-based chemotherapy in the adjuvant setting appears to improve outcome to a greater extent in estrogen receptor (ER)- compared to ER+ cancers. There is insufficient data examining currently approved adjuvant chemotherapy regimens in AA. We evaluated the outcomes associated with different chemotherapy regimens in a largely AA group with early stage breast cancer. Methods: The Surveillance Epidemiology End Results (SEER) registry identified 509 AA or CA female breast cancer patients (Stages I-III) diagnosed during 2003-2004 at 3 Atlanta-based hospitals who were residents of Fulton/DeKalb counties. SEER data was augmented by medical record abstraction. Frequency distributions, chi-square tests of independence, logistic regression, and Cox models were used to assess recurrence and mortality by tumor subtype and chemotherapy regimen. Results: The mean follow-up was 3.2 years. Of 509 patients, 66.2% were AA. TNTs represented 17.1% (N=87), with a higher proportion in AA (20.2%) than CA (11.0%) women. Compared to ER+PR+HER2- tumors, patients with TNTs were more likely to experience a recurrence (HR=3.1, 95% CI 1.3, 7.0) and to die (HR=2.9, 95% CI 1.3, 6.3) after adjusting for receipt of chemotherapy, age, race, socioeconomic status, stage, and grade. Among chemotherapy-treated women with ER+PR+HER2- cancers, AA had higher recurrence (27.1% v. 8.3%) and death (21.3% v. 3.7%) rates than CA women; however, similar recurrence (42.2% v. 33.3%) and death (28.0% v. 35.7%) rates were found in the chemotherapy-treated AA and CA patients with TNTs. Among women treated with adriamycin-based regimens, the addition of a taxane did not appear to impact recurrence or survival in the ER+PR+HER2- or TNT subgroups. Conclusions: This data supports prior data demonstrating a two-fold increase in TNTs in AA compared to CA women. TNTs in this majority AA population were associated with a higher likelihood of short-term recurrence and mortality than other subtypes. Chemotherapy was not as beneficial for AA women with ER+PR+HER2- tumors compared to CA women. No statistically significant differences in outcome were noted for AA or CA women with TNT treated with chemotherapy. The addition of a taxane to adriamycin-based chemotherapy did not improve recurrence or survival rates for women with ER+PR+HER2- or TNTs. Clinical trials with consideration of racial diversity are needed to further assess the effectiveness of chemotherapy regimens on reducing recurrence and mortality in breast cancer patients.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 2091.
Role of phosphoserine phosphatase-like in breast disease in African American women.
Authors: Field LA , Love B , Kane J , Deyarmin B , Hooke JA , Ellsworth RE , Shriver CD 
Published: December 2010

Abstract
Abstract #2095
Background: Although breast cancer incidence is higher among Caucasian women (CW), mortality is higher in African American women (AAW). AAW also tend to be diagnosed at a younger age and with larger and more aggressive tumors. Previously, we have found that gene expression patterns in AAW and CW differ in both breast tissues from women without breast disease as well as those from women with invasive breast cancer. Characterization of these differentially expressed genes is critical to understanding breast pathogenesis in AAW.&#x2028; Methods: Total RNA was isolated from breast tissue from 29 AAW and 26 CW without evidence of breast disease using the RNeasy Lipid Tissue Midi kit (Qiagen) and from laser microdissected primary breast tumors from 23 AAW and 24 CW using the RNAqueous Micro kit (Ambion). Based on earlier microarray results, genes were selected for validation by quantitative real-time PCR using TaqMan Gene Expression Assays (Applied Biosystems). All TaqMan assays were performed on duplicate samples using the iCycler Real-Time Detection System (Bio-Rad). Relative expression levels were determined using the Comparative Ct Method. A Wilcoxon test was used to determine significance.&#x2028; Results: Among those genes that were confirmed to be differentially expressed in breast tissues from AAW and CW was phosphoserine phosphatase-like, or PSPHL. PSPHL showed significantly higher expression in both disease-free samples as well as primary tumors from AAW when compared to the same sample type from CW. In tissues from disease-free women, the relative level of PSPHL expression was significantly higher in AAW (median = 17.15) compared to CW (median = 0; P&lt;0.000001). Similarly, primary tumors from AAW also had higher levels of PSPHL expression (median = 42.22) compared to those from CW (median = 0; P&lt;0.0005).&#x2028; Discussion: The current study has confirmed that expression of PSPHL is significantly higher in both disease-free and invasive breast tissues from AAW than those from CW. Recently, PSPHL has also been shown to have higher expression in prostate tumors from African American men than those from Caucasian men. The function of PSPHL is unknown; however, its increased expression has been associated with aberrant cellular proliferation and cell cycle progression in Fanconi anemia. Higher expression of PSPHL in both normal and diseased breast tissues may, therefore, increase cellular proliferation, contributing to the initial development and/or aggressiveness of breast tumors in AAW.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 2095.
Tolerability of lapatinib given concurrently with paclitaxel and trastuzumab as part of adjuvant therapy in patients with resected HER2+ breast cancer: initial safety data from the Mayo Clinic cancer research consortium trial RC0639.
Authors: Johnson BS , Dueck AC , Dakhil SR , Stella PJ , Nikcevich DA , Franco SX , Wender DB , Schaefer PL , Colon-Otero G , Diekmann BB , Perez EA 
Published: December 2010

Abstract
Abstract #2109
Background: Despite the impressive results of the recently released trastuzumab adjuvant therapy trials, 15% of patients with HER2 overexpressing or amplified breast cancer developed tumor relapse at 4 years. Lapatinib is a small molecule reversible TKI that inhibits both ErbB1 and ErbB2. The current study was developed to assess the cardiac safety and feasibility of adding lapatinib to paclitaxel and trastuzumab following as part of adjuvant therapy.&#x2028; Methods: A single-arm phase II study of doxorubicin (A, 60 mg/m2 day 1) and cyclophosphamide (C, 600 mg/m2 day 1) [q2w or q3w for 4 cycles]; followed by paclitaxel (P, 80 mg/m2 days 1, 8, 15), trastuzumab (T, 4 mg/kg loading dose then 2 mg/kg days 1, 8, 15), and lapatinib (L, 1000 mg days 1-21) [12 weeks]; followed by T (6 mg/kg day 1) and L (1000 mg days 1-21) [40 weeks] was conducted. The primary endpoint was the incidence of congestive heart failure. The current unplanned safety analysis was undertaken due to the observance of a high rate of G3/4 diarrhea.&#x2028; Results: From April 2007 to June 2008, 98 pts were enrolled and initiated study treatment. Median age was 51 (range 32-72). Among 83 pts with adverse event (AE) data available, 50 (60%) pts have experienced a G3/4 non-hematologic AE. During post-AC treatment, among 53 pts with AE data available, 31 (58.5%) patients have experienced a G3/4 non-hematologic AE with 24 (45%) patients reporting G3/4 diarrhea. Median cycle of onset of G3/4 diarrhea was cycle 5 (first cycle of PTL) with 16 (64%) cases first reported during cycle 5 and 5 (20%) cases first reported during cycle 6. Among 57, 46, 38, and 32 pts receiving treatment with PTL during cycles 5-8, 65%, 57%, 61%, and 72% of patients received the full L dose, respectively. 31 patients have ended active treatment with 10 due to patient refusal and 8 due to adverse events.&#x2028; Conclusions: Preliminary data suggest that L given concurrently with P and T at a dose of 1000 mg per day induces an unacceptable rate of moderate to severe diarrhea. Careful monitoring of diarrhea as well as L dose reduction and initiation of loperamide at first occurrence of diarrhea are recommended. The dose of L when given concurrently with P and T has been amended to 750 mg per day in the current study and safety data for the 1000 mg and 750 mg per day cohorts will be presented. Implications for the ongoing ALTTO study will also be presented.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 2109.
Guideline-conform systemic treatment improves survival of breast cancer patients.
Authors: Kurzeder C , Wöckel A , König J , Blettner M , Koretz K , Döhner H , Kreienberg R 
Published: December 2010

Abstract
Abstract #2115
Purpose: The influence of guidelines for systemic therapy of early-stage breast cancer on survival of patients is still not clear. We investigated to which extend adherence to the St Gallen expert consensus recommendations can improve outcome of the disease.&#x2028; Methods: Clinical characteristics and survival data of 2454 patients with early breast cancer which received primary therapy between 1992 and 2005 at a cancer referral center were collected by patient chart review, queries to local death registries and physicians involved in follow-up care. Patients were assigned one of three risk categories and an algorithm based on the St Gallen Expert Consensus 2005 on primary therapy of early-stage breast cancer was developed to estimate risk reduction by compliance to consensus recommendations using different Cox proportional hazard models.&#x2028; Results: According to the St Gallen consensus recommendations, indication for endocrine therapy was classified as mandatory in 78.3% (n=1922) of patients and as optional in 3.7% (n=92). A significant risk reduction by guideline-compliant endocrine therapy in patients with mandatory indication (HR = 0.62, CI 0.48 - 0.81) and also in patients with optional indication for endocrine therapy (HR = 0.20, CI 0.04 - 0.90) was estimated after adjustment for prognostic factors, co-existing morbidity and adjuvant treatment measures. Based on the consensus, indication for chemotherapy was classified as mandatory in 42.5% (n=1044) of the patients and as optional in 53.7% (n=1318). A significant risk reduction was observed for both subgroups of patients after adjustment for prognostic factors, co-existing morbidity and adjuvant treatment measures (HR = 0.80, CI 0.59 - 1.09 and HR = 0.53, CI 0.33 - 0.86). Model based estimates of overall survival for the subgroup of patients for whom endocrine therapy is mandatory and chemotherapy is optional is shown in figure 1, even more pronounced effects were found in patients for whom both endocrine therapy and chemotherapy are mandatory.&#x2028; &#x2028; &#x2028; &#x2028; Conclusion: Systemic adjuvant therapy in accordance with the St Gallen consensus recommendations 2005 is clearly associated with prolonged survival. Chemotherapy and endocrine therapy are beneficial when applied in accordance with the indications of St. Gallen consensus recommendations.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 2115.
Adjuvant therapy decisions in breast cancer: comparison of a multi disciplinary team's decisions with the recommendations of web-based computer programme “Adjuvant Online”.
Authors: Nowak VA , Ravichandran D , Austin A , Ah-See M 
Published: December 2010

Abstract
Abstract #2117
Introduction: Adjuvant therapy decisions in breast cancer impact on survival, recurrence and quality of life. We compared the hormonal and chemotherapy recommendations of a multi-disciplinary team (MDT) with the “best treatment” recommended by an evidence-based online computer programme “Adjuvant Online” (AO).&#x2028; Materials and Methods: We prospectively monitored a breast cancer MDT for a period of one year. Among 218 breast cancer patients discussed, patients who had DCIS, neoadjuvant therapy, primary hormonal therapy, multifocal disease and micrometastases only in the axillary lymph nodes and recurrent disease were excluded leaving 122 suitable for input into AO. The MDT recommendation and actual treatment received were recorded. Ten-year cancer-related death and relapse rates were calculated using AO and estimates of proportional risk reduction with MDT recommended therapy and AO “best treatment” were made.&#x2028; Results: Median age was 61 years (range 28-86). MDT recommended endocrine therapy (ET) to all patients with ER/PR positive cancers (n=103). Among 30 women aged 55 years or less with ER/PR positive cancers, 25 had tamoxifen, 4 had an aromatase inhibitor (AI) and one switched from tamoxifen to an AI. AO suggested AI or tamoxifen-AI switch as the best treatment for post-menopausal women. Among 73 women aged over 55 years with ER/PR positive cancers, 46% (n=34) received tamoxifen as per local cancer-network guidelines, which recommended tamoxifen for low-risk (T1 N0 M0) post-menopausal breast cancer. Others received an AI (n=38) except one patient who declined ET. There were 54 patients with &gt;10% risk of cancer-related death in 10 years. Among these 36 were offered and 29 received chemotherapy. Chemotherapy was not offered to 17 patients due to age and/or comorbidity. Only 1 suitable patient with &gt;10% risk was not offered chemotherapy by the MDT. Among those who had chemotherapy, only 31% had 3rd generation chemotherapy as recommended by AO, the main reason being national guidelines in the United Kingdom limiting the use of this regimen.&#x2028; Discussion: There are differences between the adjuvant therapy decisions by the MDT and the “best treatment” recommended by Adjuvant Online. This study shows that in the majority of these cases the differences are due to either local or national guidelines that are in force in the United Kingdom. Cancer MDTs in the UK National Health Service are expected to adhere to these guidelines. However, calculation of the risk of death and recurrence rates using AO may be useful to facilitate decision making of the MDT by giving quantitative prognostic estimates and this could be a useful adjunct to help patients make informed decisions.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 2117.