bluuebunny/crossref_metadata_2025_split huggingface dataset:
P1-08-10: Invasive Lobular Breast Cancer – No Increased Risk of Contralateral Disease.
Authors: Langlands F , Horgan K , Kearins O , Burns R , Dodwell D 
Published: June 2012

Abstract
Background: Invasive lobular carcinoma (ILC) is the second most common type of breast cancer accounting for up to 14% of invasive breast cancers. Worldwide the incidence of breast cancer is increasing each year. Large population based studies using the Surveillance, Epidemiology, and End results (SEER) data have shown that the incidence of ILC has increased from 1977 to 1995. ILC has historically been thought to be associated with an increased risk of developing contralateral breast cancer and this belief may, in part, be responsible for the increasing trend towards contralateral prophylactic mastectomy.
Methods: All female patients diagnosed with breast cancer during the time period 1998–2003 were identified from two large cancer registries, Northern and Yorkshire Cancer Registry and Information Service (NYCRIS) and West Midlands Cancer Intelligence Unit (WMCIU). All patients diagnosed with either Infiltrating duct(adeno) carcinoma, microinvasive ductal carcinoma, infiltrating ductular carcinoma (all classified as ‘ductal') or lobular (adeno)carcinoma were included. Patients with a mixed type of breast cancer were excluded from the analysis. Follow-up was complete until October 2010. Data were compiled for diagnosed contralateral breast cancer of any histological type.
Results: Of the 32,735 patients with invasive ductal cancer 898 (2.74%) developed a contralateral breast cancer. In comparison 166 (3.1%) of 5397 patients with lobular cancer developed a contralateral breast cancer. The median time to first contralateral event was equivalent for both morphologies (ductal 40 months and lobular 39 months).
Conclusion: This study suggests that there is no increased risk for developing a contralateral breast cancer in patients diagnosed with an invasive lobular breast cancer.
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P1-08-10.
P1-08-13: Determinants of Risk, Characteristics and Prognosis of Breast Cancer Occurring after Hodgkin Lymphoma.
Authors: Rapiti E , Veit-Rubin N , Usel M , Benhamou S , Vlastos G , Vinh Hung V , Bouchardy C 
Published: June 2012

Abstract
Background Several studies have evaluated the excess of breast cancer (BC) risk after Hodgkin lymphoma (HL) but none has reported of all the aspects of BC occurring after HL including determinants of risk, comparison with other BC profile, treatment and outcome. This is the aim of our study.
Patients and Methods We used data from the Surveillance, Epidemiology and End Results (SEER) Programme of the National Cancer Institute. To assess the risk and determinants of BC after HL we included all 9'620 women with first primary HL diagnosed between 1973 and 2007 and calculated age and period standardized incidence ratio (SIR) of BC as compared with general population. We also compared tumour characteristics and treatment between BC after HL (n= 316) vs. all other first primary BC occurring during the same period (n=450'413) by logistic regression. Finally, we compared breast cancer specific mortality between the two groups by Cox model.
Results Overall, HL patients had an increased risk of developing BC (SIR: 2.4, 95% confidence interval [CI]: 2.2−2.7); the risk decreased with increasing age at HL, and disappeared when HL occurred after 50 years. BC risk was the same among those treated with or without radiotherapy until 15 years after HL and then an excess appeared in the irradiated group and persisted over 30 years after diagnosis of HL. Compared with other BC, BC after HL occurred at younger age (Adjusted odds ratio [OR] for age 40–59 vs. &lt; 40 years 0.25, 95% CI: 0.20−0.33), was diagnosed at an early stage (OR for regional extension vs. localized 0.63, 95% CI: 0.42−0.89), expressed less frequently hormone receptors (OR for negative vs. positive status: 1.34, 95% CI: 0.99−1.81), was located more frequently in external quadrants (OR for internal vs. external: 0.61, 95% CI: 0.42−0.89), and received less frequently radiotherapy (OR for use vs. non use: 0.30, 95%CI: 0.22-042). The last two results were limited to patients who had received radiotherapy for HL. BC after HL presented higher breast cancer mortality (Hazard ratio: 1.36, 95%CI: 1.05−1.76) after adjustment for patients, tumour and treatment characteristics.
Conclusion: This study provides valuable results on various aspects of BC occurring after HL. In particular, we found earlier stage at diagnosis of BC probably linked to higher surveillance, more aggressive tumours probably due to iatrogenic effect of HL treatment, more frequent occurrence in outer quadrants less protected during mantel radiation. Also, this study confirms the poorer prognostic of those BC not explained by differences in patient, tumour or treatment characteristics.
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P1-08-13.
P1-08-25: Breast Cancer Burden, Risks and Outcomes in Latin America.
Authors: Justo NA , Wilking NE , Jönsson B 
Published: June 2012

Abstract
BACKGROUND: Breast cancer (BC) burden and care vary substantially across Latin America (LA). Aim: Provide an overview of the epidemiology, outcomes and countries’ risk profiles in LA to identify opportunities for improvement.
METHODS: Review of literature (PubMed, LILACS, SCIELO), public databases (Globocan 2002 & 2008, CEPALSTAT, DIRAC, PAHO, WHOSYS, etc) and conference presentations (ASCO, ISPOR). Local experts & patient organizations were surveyed. Current BC epidemiology in LAC, future trends, countries’ risk profiles and outcomes (such as mortality-to-incidence ratios — MIRs) were analyzed and compared (Sweden as benchmark).
RESULTS: BC annual incidence (114,900 cases) & mortality (37,000 deaths) are the highest of all cancers in LA and twice as many deaths are expected by 2030. Countries more advanced in the demographic transition, like Uruguay and Argentina, present much higher incidence and mortality but also better outcomes as observed in their MIRs. In LA women are diagnosed younger and at a more advanced stage, especially in countries with poor outcomes, such as Ecuador, Mexico or Peru. The imbalanced progress since 2002 seems to widen the gap in BC outcomes, but countries like Costa Rica are catching up.

Age is the main risk factor; while the association of education and wealth with BC occurrence is less significant. Reproductive and lifestyle-related risk factors, proven at a patient level, were not significant at a country-aggregate level and the specialized literature indicates that the evidence on associations between BC and diet is inconclusive.

DISCUSSION: LA's considerable variation embedded within per-countries’ averages may be masking underlying causality. Though, it can be inferred that there is no one-suit-all prevention campaign and policies aimed at reducing the risk of developing BC will succeed as long as they are properly targeted and tailored for different needs. Early diagnosis and population-wide access to treatment following evidence-based best practices remain unresolved matters that endow many of these countries with the opportunity to substantially improve the care for their women.
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P1-08-25.
P1-09-07: Contribution of TP53 p.R337H Mutation to Breast Cancer Incidence in Brazil.
Authors: Giacomazzi J , Toledo de Bueno Osorio CA , Koehler-Santos P , Graudenz MS , Marthel-Planche G , Achatz MIW , Soares FA , Goldim JR , Caleffi M , Hainaut P , Camey SA , Ashton-Prolla P 
Published: June 2012

Abstract
Background: The exact contribution of TP53 germline mutations, associated with Li Fraumeni Syndrome — LFS, to the overall burden of cancer is still only partially known. Studies in Southern and Southeastern Brazil have shown that a particular mutant, TP53 p.R337H, has incomplete penetrance and may be present in a significant number of subjects (estimated frequency at the populational level of 1:300 individuals). In an exploratory approach, the aim of this study is to assess the prevalence of the TP53 p.R337H mutation in women with breast cancer diagnosed before 46 and after 55 years of age, unselected for family history of cancer and resident in Southern and Southeastern Brazil.
Methods: Formalin-fixed paraffin-embedded (FFPE) non-tumoral tissue of 521 women diagnosed with breast cancer between 2000 and 2010 in two pathology laboratories were obtained retrospectively and consecutively, and analyzed after anonimization. Genomic DNA was isolated with the QIAamp DNA Tissue Kit and genotyping performed by allelic discrimination using a TaqMan assay. Confirmation of all mutation-positive and a sample of mutation-negative cases was done by TP53 exon 10 sequencing.
Results: Analysis of the first 299 cases identified the TP53 p.R337H mutation in the germline of 15 (5,0%) cases: 13/142 (9,2%) before 46 years and 2/157 (1,3%) diagnosed after 55 years. The p53 expression pattern assessed by immunohistochemistry in the breast tumors was not different between p.R337H mutation carriers and non-carriers. Conclusion: Preliminary analysis in a sample of women with breast cancer in Southern Brazil indicates that the germline TP53 p.R337H founder mutation is present in a high proportion of cases, especially those diagnosed at a young age. Germline TP53 mutations are considered rare, occurring in about 1:5000 individuals of the general population. The occurrence of this founder mutation at such a high frequency in a particular geographic region has important implications for disease management and cancer risk counseling for these patients and families. This mutation likely contributes to a significant proportion of the health burden associated with breast cancer in Southern Brazil.
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P1-09-07.
P1-10-03: Colony Stimulating Factor Use with Taxane-Based Therapy for Metastatic Breast Cancer: Claims Analysis of Prophylaxis, Treatment, and Costs.
Authors: Force RW , Pugmire BA , Culbertson VL 
Published: June 2012

Abstract
Background: The taxanes (paclitaxel, docetaxel, and albumin-bound paclitaxel) are used in women with metastatic breast cancer (MBC). Clinical trials indicate that these drugs may differ in their toxicity profiles, including rates of neutropenia and need for colony stimulating factor (CSF) supportive therapy. Utilizing medical claims data, we evaluated prophylactic and treatment-related CSF use among women receive taxane-based chemotherapy regimens.
Objective: To determine if differences exist in rates of CSF use for prophylaxis, treatment and associated costs in women receiving taxane-based chemotherapy for MBC.
Methods: Women with MBC were identified with ICD-9-CM codes and by their prior use of adjuvant chemo regimens. Paid medical claims (source: Ingenix Consulting) from May 1, 2006 to April 30, 2009 were analyzed. Study groups were defined according to the first taxane administered. CSF utilization was classified as prophylaxis (0-5 days post-taxane administration), treatment (6-21 days post-taxane,) or non-taxane associated use (&gt;21 days post-taxane). Comparisons were made between the taxane groups. All CSF costs were captured from date of first taxane to end of taxane therapy +21 days and categorized as above. Patients censored if ≥35 days elapsed with no taxane therapy. Two-stage regression analyses were performed. Control variables included age, Romano comorbidity score, and use of prior and other concurrent chemotherapy. Results: 4,503 women (mean age: 53 +/− 10 years) with MBC were identified: 2,599 in the docetaxel group; 1,643 received paclitaxel; and 261 received nab-paclitaxel. More patients receiving docetaxel received any CSF (75.6%) than either paclitaxel (49.8%) or albumin-bound paclitaxel (36.8% P&lt;0.05 for each comparison). For docetaxel 70.5% of women received prophylactic CSF, whereas the rates were 47.0% for paclitaxel and 33.0 for albumin-bound paclitaxel (P&lt;0.05). The rate of women receiving CSF in the albumin-bound paclitaxel group was not different than the other groups. Daily per-patient CSF expenditures during taxane therapy were $176.81 (95% CI, $168.20-$185.52) for docetaxel, $127.71(95% CI, $113.62-$142.60) for paclitaxel, and 46.24 (95% CI, $29.37-$67.25) for albumin-bound paclitaxel.
Conclusions: Compared with docetaxel and paclitaxel, patients receiving albumin-bound paclitaxel had significantly lower prophylactic CSF use, yet did not experience any difference in treatment-related use. Daily per-patient CSF expenditures for albumin-bound paclitaxel were significantly lower than the other two taxanes.
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P1-10-03.
P1-10-07: Comparing Breast Cancer Screening Guidelines: A Stage-Survival-Cost Model in a Public Hospital.
Authors: Friedman DT , Raskind-Hood C , Adams K , Becker E , Habtes I , D'Orsi C , Gundry K , Birdsong G , Gabram-Mendola S 
Published: June 2012

Abstract
Background: Despite advances in diagnosis and treatment of breast cancer in the United States, racial disparities in survival persist. Female breast cancer represented the costliest cancer site in 2010 with further increases projected to 2020. Mammography screening guidelines reflect the inherent difficulty in reconciling mortality reduction with potential harms to patients and cost-effectiveness concerns. Controversy still surrounds the 2009 updated USPSTF recommendations, as critics and advocates alike evaluate lives saved, costs, and how best to compare screening strategies. This study simulates USPSTF and ACS guidelines’ effects on stage, 5-year survival, and cost of treatment vs. usual practice in women treated in an urban public hospital.
Methods: Charts of 84 patients diagnosed with Stage I-III breast cancer in 2008 were reviewed. Published tumor doubling times guided a retrospective model to predict size at diagnosis by simulated ACS or USPSTF guidelines. AJCC-7 stages were then assigned to produce 3 distributions: 1) actual stage; 2) stage under ACS; and 3) stage under USPSTF. Survival estimates by stage and year from diagnosis were drawn from NCDB statistics and applied to each stage distribution, yielding average predicted survival for the actual and hypothetical scenarios. Finally, treatment costs for women continuously enrolled in Medicaid for 18 months were calculated from merged claims and registry data and similarly applied.
Results: Study patients averaged 55 years; 85% were African American. Forty-nine percent were covered by Medicaid and 23% by Medicare. Comparing actual and predicted stages at diagnosis showed significant shifts in stage distribution between all three scenarios (Table 1).

ACS guidelines predicted higher survival (87.5% at 5 years) than actual (85.5%; p&lt;0.01) or USPSTF (84.6%; p&lt;0.0001), while no significant difference was revealed between actual and USPSTF. ACS guidelines also predicted lower costs of treatment relative to USPSTF and actual, while USPSTF guidelines were more expensive than actual (Table 2).

Discussion: To our knowledge, no studies have compared the impact of alternative screening guidelines on outcomes in a predominantly African-American, public hospital population. These data support continued use of and adherence to ACS screening recommendations for inner city patients to achieve the best survival and the lowest cost. Given the likelihood of patients to be uninsured or covered by federal programs, this study carries implications for public policy and patient education, especially in low-resource programs caring for underserved patients.
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P1-10-07.
P1-11-10: Quality of Breast Cancer Care in a Boston Area Patient Navigator Program.
Authors: Raj A , Ko N , Battaglia T , Moy B 
Published: June 2012

Abstract
Background: Elimination of disparities is critically important for lessening the burden of cancer. Patient navigator programs (PNPs) assist with all aspects of care, including access, cancer prevention, screening, post-diagnosis care, and survivorship care. Little is known about the effect of PNPs on patient care and outcomes following the diagnosis of breast cancer (BC). We examined quality measures (QMs) of breast cancer care among women participating in the Massachusetts General Hospital Avon Breast Care Patient Navigator Program (MABCP), which provides patient navigation services to disadvantaged minority communities in the greater Boston area.
Methods: Women diagnosed with BC who participated in the MABCP from 2001 to 2011 were followed to determine the proportion whose care was concordant with American Society of Clinical Oncology/National Comprehensive Cancer Network (ASCO/NCCN) QMs. QMs included 1) hormonal therapy (HT) within 1 year of diagnosis for HR+ tumors &gt; 1 cm; 2)chemotherapy within 120 days of diagnosis of HR- &gt;1cm tumors for women &lt;70 years; and 3) post-lumpectomy radiation therapy (XRT). Descriptive statistics were used to report characteristics of MABCP patients.
Results: Of the 186 MABCP patients diagnosed with BC, some treatment data was available on 158 (85%) and race/stage information was available on 149 (80%) [Table 1]. Among the MABCP patients, concordant care was received by 70/74 (95%) for the HT QM, 15/17 (88%) for the chemotherapy QM, and 65/71 (92%) for the XRT QM. In comparison, available benchmark concordance rates of BC patients treated at 8 NCCN centers from 2003–6 are: 340/382 (89%) for the HT QM, 156/179 (87%) for the chemotherapy QM, and 141/148 (95%) for the XRT QM.
Conclusions: Overall, breast cancer care in the MABCP PNP is concordant with published ASCO/NCCN quality measures. At present, the sample is insufficient to compare concordance rates with NCCN patients but preliminarily, it appears that the quality of care is comparable. Future research should include prospective analyses of quality metrics to assess the process and outcomes of patient navigation in diverse settings, compared with control populations.

Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P1-11-10.
P1-11-11: Wait Times for Breast Cancer Care in Manitoba 2009–2010. Time To Face the Challenge.
Authors: Carpenter-Kellett T , Nashed M 
Published: June 2012

Abstract
Background: Wait times for patients with breast cancer to receive oncological treatment vary significantly. In Manitoba, the radiation treatment wait times improved in the year 2005 compared to 2001. However, other parts of the patient's journey have lengthened and negated the reduction seen in radiation treatment wait times. Aims: To examine the overall time from disease suspicion to treatment of breast cancer patients from June 2009 to June 2010 and to compare to the previously published wait times.
Methods: This population-based retrospective study looked at representative samples of women newly diagnosed with breast cancer. Patients were followed from the time of first presentation, either to their family physician or after a suspicious screening mammogram, to the time adjuvant treatment was started. Each patient's journey was subdivided into different chronological stages. The data was compared to the wait times reported in 2005.
Results: 363 patients’ data was collected and analyzed. The median elapsed time in days for each phase of the journey was calculated. Total wait times from suspicion to diagnosis were also calculated. The wait times of most stages of the patients’ journey have worsened when compared to 2005. However, there was some improvement in the diagnostic part of the journey. Delays to surgery and pathology have contributed to lengthening of the total journey. There was also a systematic and repetitive administration delay at each transition. Screen-detected cases had a shorter journey than those who presented through a family physician.
Conclusions: In spite of improvements achieved in the wait times at some stages of the journey, the total length of the patient journey has not been shortened. This represents not only individual team failures but also a built in complexity in the health system. In order to achieve a meaningful cut in wait times for breast cancer patients, the entire trajectory of care needs to be addressed.
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P1-11-11.
P1-12-01: Pregnancy during and Following Adjuvant Trastuzumab in Patients with HER2−Positive Breast Cancer: An Analysis from the HERA Trial (BIG 01-01).
Authors: Azim HA , Metzger-Filho O , de Azambuja E , Loibl S , Focant F , Gresko E , Procter M , Piccart-Gebhart M 
Published: June 2012

Abstract
Background: 1-year of adjuvant trastuzumab (T) is the standard of care in managing patients (pts) with early HER2−positive breast cancer (BC). As T is not known to alter fertility, pts with childbearing potential could become pregnant during or following treatment with T. Cases of oligohydramnios, some associated with fatal pulmonary hypoplasia of the fetus have been reported in women receiving T during pregnancy (preg). Here we report the outcome of preg in all pts enrolled in the HERA trial.
Methods: Pregnancies in the HERA trial are reported on a distinct “pregnancy form” for up to 10 years following T completion. The form includes information on approximate date of conception, preg course & outcome, fetal measurements at birth, and congenital anomalies. Any missing data were retrieved from the study site, if available. For this analysis, pts were grouped into 3 groups: 1) preg during and up to 3 months after T, 2) preg &gt; 3 months of last T dose, and 3) preg with no prior exposure to T.
Results: By March 2010, 70 preg were reported in 58 out of 5102 pts randomized. Five, 30 and 7 completed preg were reported in groups 1, 2 & 3 respectively.

As per protocol, all pts on T were required to use adequate contraceptive measures, yet 16 pts became pregnant during the course of T and up to 3 months thereafter. The percentage of completed preg was lowest in group 1, with 4 spontaneous and 7 induced abortions. In group 2, preg occurred at a mean of 29 months following completion of T, with 6 spontaneous and 4 induced abortions. In group 3, abortion was induced in 3 pts and no spontaneous abortions reported. Across all 3 groups, all but 1 spontaneous abortion occurred during the 1st trimester. Two congenital anomalies were reported; a Down's syndrome in a 43 year old pt &gt;5 years after completing T for which abortion was induced, and one with partial fusion of the 2nd and 3rd toe born to a pt in group 3.
Conclusions: Unintentional exposure to T during preg may be associated with spontaneous abortion, yet the numbers remain low to draw firm conclusions (spontaneous abortion rate in general population is up to 20%). No oligohydramnios or anomalies were observed in group 1. While an increased risk of oligohydramnios has been reported when T is administered after the 1st trimester, T administered to Cynomolgus monkeys during organogenesis did not cause fetal harm (Pentsuk et al; 2009). Nevertheless, women of childbearing potential should be advised to use effective contraception during and up to 6 months after treatment with T. On the other hand, prior exposure to T did not appear to affect the preg course or outcome. We are planning to collect information from the other T adjuvant trials to confirm our findings.
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P1-12-01.