bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract P1-14-02: Different Outcomes in Breast Cancer (BC) Patients with CNS Metastases According to IHC Phenotype
Authors: Gómez HL , Vigil CE , Cruz WR , Neciosup SP , Pinto JA , Suazo JF , Mas LA , Doimi FF , Falla MJ , Vallejos CS. 
Published: April 2011

Abstract
Background: Phenotype plays an important role in BC biology and outcome. We evaluated the characteristics and outcomes of clinical stages I-III BC patients with recurrence according to the IHC phenotype: ER or PR+/HER2-; HER2+ (regardless the ER and PR status) and triple negative (ER-/PR-/HER2-), to determine the influence of phenotype in the SNC recurrence.
Methods: We reviewed 1,232 clinical stage I-III BC treated at INEN (2000-2002). Phenotypes were categorized by IHC into [ER+ and/or PR+, HER2-], [ER-, PR-, HER2-] and [HER2+ (regardless ER/PR status)]. Patients were classified in 3 risk groups (recursive partitioning analysis [RPA]; Gaspar et al. Int J Radiat Oncol Biol Phys 1997;37:745) according to 4 criteria: those with Karnofsky Performance Status (KPS) less than 70 (Class III), those with a KPS of or more, aged less than 65, with a controlled primary, no other systemic metastases (Class I), all other patients (Class II). We used Kaplan-Meier estimates for comparing CNS-free metastases survival and survival after CNS recurrence according to IHC phenotype or classes.
Results: A median follow-up of 7.6 years; 416 (33.8%) patients had local, regional or distant disease dissemination, and 454 (36.9%) deaths were registered. In total, 62 (5.0%) patients developed CNS metastases (60 cases of cerebral and 2 of meningeal metastases), 36 (2.9%) of whom had developed CNS metastases as the site of first recurrence. 12 (2.1%), 31 (7.7%) and 19 (7.5%) were ER or PR+/HER2-, HER2+ and triple negative, respectively. CNS metastases free survival shown significant differences between ER or PR+/HER2-, HER2+ and Triple negative (97.3%, 89.6% y 90.5%, respectively; P&lt;0.001). Main multivariate predictive factor was IHC phenotype (P&lt;0.001), using [ER or PR+/HER2-] as reference, other phenotypes were expressed by hazard ratios (HR); [HER2+] (HR=3.8, 95%CI; 1.9 - 7.4), triple-negative (HR=4.0, 95%CI; 1.9-8.4). In regard to the RPA groups, 3 (4.9%) were class I, 28 (45.9%) class II and 30 (49.2%) class III. Median survival after CNS recurrence was 12.9, 6.1 and 2.8 for RPA Class I,II and III, respectively]; however there was not significant differences (p=0.085). In the multivariate analysis for OS after SNC metastases, only phenotype was significant and Triple Negative have the higher risk (HR=2.064; IC95% 0.94 — 4.531; P=0.023), Risk groups have not significant effect (P=0.088).
Phenotype and outcome
Conclusion: IHC phenotype is a strong risk factor for outcome; triple negative, and Class III breast cancer patients present a shorter time to CNS recurrence and survival after CNS recurrence than other IHC phenotypes and other risk groups.

Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P1-14-02.
Abstract P1-14-03: New Breast Cancer Recursive Partitioning Analysis (RPA) Prognostic Index in Patients with Newly Diagnosed Brain Metastases
Authors: Niwinska A , Murawska M 
Published: April 2011

Abstract
Purpose: To analyze survival of 441 patients with breast cancer and brain metastases including prognostic factors related to patient, cancer and type of treatment. To present a new Breast Cancer Recursive Partitioning Analysis (RPA) prognostic index for patients with newly diagnosed brain metastases as a guide in clinical decision making. Methods and Materials: A group of 411 patients with breast cancer and brain metastases treated in one institution between the years 2003-2009 was assessed. Factors significant for univariate analysis were included into recursive partitioning analysis (RPA).
Results: Median survival from brain metastases in the entire group was 7 months. Three prognostic classes of new Breast Cancer RPA prognostic index were selected. Median survival of patients within prognostic class I, II and III was 29 months, 9 months and 2.4 months, respectively (P&lt;0.0001). Class I included patients with 1 or 2 brain metastases, without extracranial metastases or with controlled extracranial metastases and with Karnofsky performance status (KPS) of 100. Class III included patients with multiple brain metastases with KPS of &lt;=60. Class II included all other cases. Conclusions: Breast Cancer RPA prognostic index is a simple and valuable tool for usage in clinical practice. It can quickly select patients who required aggressive treatment (neurosurgery, stereotactic radiosurgery, systemic therapy) and those in whom corticoids and best supportive care, often even without whole-brain radiotherapy, is the most reasonable option. Individual approach is required for patients from prognostic class II.
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P1-14-03.
Abstract P1-17-02: Outcome after Locoregional Recurrence in Patients with Inflammatory Breast Cancer
Authors: Patel HJ , Li J , Gonzalez-Angulo AM , Strom E , Perkins GH , Tereffe W , Yu T-K , Hoffman K , Smith BD , Lucci A , Valero V , Buchholz TA , Woodward W. 
Published: April 2011

Abstract
Purpose: High rates of locoregional recurrence (LRR) have been reported in spite of comprehensive tri-modality therapy for patients with inflammatory breast cancer (IBC). The aim of this study was to examine the prognosis of patients who have experienced LRR after treated primary IBC. Methods:
We retrospectively reviewed information for 124 IBC patients who experienced a LRR seen in our institution from 1990-2008. 63 patients had simultaneous distant disease (DM) +/−3 months of LRR (simLRR),
5 patients had LRR &gt; 3 months subsequent to DM, while 56 patients had isolated LRR &gt;3 months prior to DM (isLRR). Overall survival (OS) was calculated from date of recurrence using the Kaplan-Meier method. Results:
Median time to LRR from diagnosis was 13 months (interquartile range 8-21 months). Median survival after LRR was 15 months. 2-yr OS was 46%. Regarding the primary tumors, 23% were estrogen receptor positive (ER+), 33% were HER2-neu positive (H2N+), 81% had lymph vascular space invasion (LVSI), and 83% were grade 3. Comparing isLRR and simLRR cohorts, median survival was 18 months vs. 10 months and 2 yr-OS was 66% vs. 28%, respectively. ER+ and H2N+ primary status predicted for longer 2 yr OS among patients with simLRR but not among isLRR patients. (simLRR, ER+ 57% vs. ER-19% p = 0.02, H2N+ 45% vs. H2N-17% p = 0.01; IsLRR ER+ vs. ER-92% vs. 55% p = 0.15, H2N+ 86% vs. H2N-57% p = 0.11). LVSI was not prognostic in either group and Grade 3 primary trended towards worse outcome among isLRR cohort only, Grade 2 83% vs. Grade 3 64% P = 0.08. Molecular subtyping using ER and H2N status to group tumors demonstrates basal subtype in the primary tumor compared to H2N, luminal B and luminal A is associated with significantly worse 2 yr OS after isLRR (43% vs. 88%, 82%, and 83%, P = 0.04) and simLRR (13% vs. 34%, 80%, 32% P = 0.005) respectively. Conclusions:
Forty-five% of LRR occurred as isolated first events. LRRs generally occur within 2 years after primary IBC treatment and are associated with poor outcomes even as first events. Basal subtype predicts for worse overall survival regardless of distant disease.
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P1-17-02.
Abstract P2-02-04: MRI Findings and Outcomes in an Underserved Breast Cancer Population Screened with BRCA Testing
Authors: Tang S , Fahed E , Azadi A , Ricker C , Larsen L , Lee S , Jain P , Spicer D , Tripathy D. 
Published: April 2011

Abstract
Background: Patients with breast cancer and a familial risk and/or BRCA 1 or 2 mutations are at high risk of contralateral breast cancer and ipsilateral recurrence. While MRI screening is recommended for patients with BRCA mutations, and MRI staging for breast cancer is being increasingly used, the outcomes of such testing are not well described, especially in underserved populations. At Los Angeles County Hospital (LAC) for the last 3 years, we have enacted a program of genetic counseling and testing based standard guidelines as well as MRI evaluation of all patients newly diagnosed with breast cancer. LAC serves a population that includes a high number of indigent patients, primarily Hispanic (60%) and Asian (15%). Methods: We undertook a retrospective evaluation of all patients seen at LAC from March 2008 to March 2010 who underwent genetic counseling/testing and MRI as preoperative assessment for histologically documented breast cancer or followup after cancer treatment. IRB approval was obtained to extract data for this analysis. Demographic information along with clinical presentation, MRI and mammography results, additional imaging results, biopsy and surgical procedure and corresponding pathology data were obtained through the review of electronic medical records and clinic charts.
Results: A total of 90 patients had both genetic testing and MRI reports available. The median age of all tested patients was 41 years. Ethnicity was 78% Hispanic, 9% Asian, 7% African American, 2% Caucasian and 4% other. BRCA mutation was seen in 20 cases (22%), 12 BRCA-1, 8 BRCA-2, 4 variants of unknown significance, and 66 had no mutation. Breast mass or other symptoms were the mode of detection in 89% of the overall cohort, and 81% in mutation carriers. The index lesion was visible on MRI in 78% and by mammogram in 82% of all patients. Ipsilateral MRI showed 7 abnormal non-index findings in 6 patients (7%); 6 of 7 lesions biopsied showed cancer. In the contralateral breast, 7 abnormalities were noted on MRI, but only 5 were amenable to biopsy as 2 could not be visualized by any means on follow up, and 1 showed cancer. Interestingly, only one of the 13 patients with abnormal findings carried a mutation (BRCA-1) and this patient did not have cancer on contralateral lesion biopsy. Mastectomy was performed in 91% and 78% of patients with and without mutation. Conclusions: Screening, counseling and testing for BRCA mutations is feasible in an underserved population, with a 22% mutation identification rate. MRI detected 5 non-index ipsilateral cancers and one contralateral cancer among 90 patients, with none of the detected cancers among the 20 mutation carriers. While MRI staging may be effective at detecting additional cancers in this underserved and high familial risk population, this appears to be independent of BRCA status.
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P2-02-04.
Abstract P2-02-09: The Effect of Breast-MRI in Work-Up of Primary Operable Breast Cancer
Authors: Huttenhuis J , Bourez R , Faneyte I , Kouwenhoven E. 
Published: April 2011

Abstract
Background: Breast magnetic resonance imaging (MRI) is becoming an often-utilized examination in the preoperative planning for breast cancer. However, it is not yet accepted as a routine examination for all breast cancer patients due to the lack of data regarding whether breast MRI has any effect on recurrence or survival.
Aim: The aim of this study is to evaluate the effect of MRI on surgical management in operable breast cancer.
Methods: From April 2008 till January 2010 consecutive primary operable breast cancer patients had a preoperative breast-MRI in addition to regular mammography and ultrasonography. Additional lesions newly found by MRI were evaluated with a target ultrasound and if needed biopsied. Moreover MRI tumor size was compared to mammographic and ultrasonographic tumor size.
Blinded for MRI results and the performed surgical plan, surgical management based on traditional radiological work-up was determined retrospectively by 2 surgeons. Change of surgical plan by MRI was subsequently analysed. Accuracy of MRI based surgical plan was evaluated by comparing definitive pathology.
Results Hundred ninety eight consecutive patients were analyzed. Median age was 59 years (23-82). Additional ipsilateral and contralateral suspicious lesions were detected by MRI in 53 patients (27%). Twenty two patients had additionally target-ultrasonography: 5 lesions were not found, 4 lesions had benign aspect. Five out of 13 biopsied patients had second breast cancer, 3 patients had contralateral breast cancer and 2 patients had multicentric breast cancer. In 31 patients no further evaluation was performed because the new focus was supposed to be a satellite (n=12) or mastectomy was already chosen to be done (n=19). There was a change in surgical plan due to MRI results in 35 of 198 patients (18%), all of whom received more extensive surgery than previously planned: in 17 patients mastectomy was performed instead of lumpectomy, 15 patients had a more extensive lumpectomy. Three patients had contralateral surgery for breast cancer.
In 24 patients (69%) MRI based surgical plan was confirmed by definitive pathology. In 11 patients MRI overestimated tumor size or misinterpreted a satellite lesion.
Conclusion. Breast MRI contributes to a significantly change of surgical plan. However, false-positive findings are frequent. Therefore, in unselected primary operable breast cancer patients routine implementation of breast MRI is not right away justified.
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P2-02-09.
Abstract P2-02-12: Utility of Targeted Sonography Using Real-Time Virtual Sonography (RVS) for Breast Lesions That Were Suspicious on MRI
Authors: Nakano S , Fujii K , Yorozuya K , Yoshida M , Kousaka J , Mouri Y , Fukutomi T , Ishiguchi T. 
Published: April 2011

Abstract
PURPOSE : MRI-detected suspicious breast lesions that are not expected from previous MMG or sonography, are detectable initially on MRI in 48% maximum. Therefore, biopsy is required for definitive diagnosis of MRI-detected lesions. Although MRI-guided biopsy is often necessary, sonographically guided biopsy after targeted sonography is more broadly available and less time-consuming and costly. The aim of this study was to verify the utility of targeted sonography using Real-time Virtual Sonography (RVS) for the identification of MRI-detected suspicious lesions.
METHOD AND MATERIALS : From 196 breast MRI examinations, all MRI-detected suspicious lesions and subsequent biopsy were identified between February 2006 and December 2009. All patients were examined using MMG, sonography, MRI and RVS that could synchronize a sonography image and the MRI cutaway images of the same site to be displayed in real time using magnetic navigation system. Following the conventional dynamic enhanced image, MRI was obtained on a 1.5-T imager in the supine position using a flexible body surface coil in order to achieve the same position as in sonography. We searched all cases for MRI-detected suspicious lesions and investigated targeted sonography with or without RVS in identifying the lesions.
RESULTS : Of the 196 patients, MRI-detected suspicious lesions were detected in 55 (28%) patients. A total of 67 suspicious lesions in 55 patients comprised this analysis. Of the study lesions, 24 (36%) were malignant and 43 (64%) were benign. Overall mean lesion size was 6.7mm. A total of 46 (69%) mass lesions were identified, compared with 16 (24%) foci and 5 (7%) nonmasslike lesions. 18 (27%) lesions were detected in targeted sonography without RVS and were revealed as cancers in eight, benign lesions in 10. In contrast, 60 (90%) lesions were detected in targeted sonography with RVS and were revealed as cancers in 21, benign lesions in 39. Although seven (10%) lesions were not detected with RVS, all lesions were able to project enhanced MRI information onto a body surface correctly as we checked ultrasound form images without the use of large-scale equipment.
CONCLUSION: The present results suggest that targeted sonography with RVS appears to be not time consuming technique which can identify a large part of MRI-detected suspicious lesions.

Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P2-02-12.
Abstract P2-03-01: An Investigation of Factors Influencing Real-Time Tissue Elastography Score
Authors: Nishiyama Y , Sakaguchi U , Matsushita K 
Published: April 2011

Abstract
[Purpose]
At 32nd SABCS, we reported that Real-time Tissue Elastography (EG) score was useful in the examinations of mass-forming breast lesions. The results suggested that a possibility of being invasive carcinoma may practically be ruled out when a mass-forming breast lesion scored 1 or 2 on EG. Because the stiffness is relatively visualized in EG, it is possible that the score is influenced by the state of the patient's breast. We examined the factors influencing EG scores in mass-forming breast lesions. [Subject and Method]
EG scores of 502 patients with breast lesions (150 malignant, 352 benign) whose tissues were diagnosed histopathologically from October 2007 to December 2009 were studied. The hardness was scored on a scale 1 to 5 on Tsukuba elasticity scoring system. [Results]
In the 502 cases of mass-forming breast lesions there was a significantly higher score for non-invasive carcinoma and invasive carcinoma than for benign lesions (&lt; 0.0001). No difference in score was observed in a comparison of the location (lateral quadrants, medial quadrants) of the mass-forming lesion. There were significantly lower scores (&lt; 0.0001) in 10 mm in diameter or smaller when comparing three groups of tumor mass diameters: 10 mm in diameter or smaller, 11-20 mm, and 21-30 mm. When the breast density of two groups were examined, “almost entirely fat or scattered fibroglandular tissue” group and “heterogeneously dense or extremely dense” group, there were significantly low scores in the “heterogeneously dense or extremely dense” group (&lt; 0.0001). When the two groups divided by median area of the mammography were examined, there were significantly low scores in the larger breast group (&lt; 0.0001). Although in the total cases examined, all cases were benign in score 1, 6% were malignant in score 2 (5 cases non-invasive carcinoma, 4 cases invasive carcinoma). When 3 cases in which pathology results of the surgical specimen were obtained were examined among the 4 cases of invasive carcinoma, widespread intraductal spread was observed in the surrounding invasive carcinoma. [Conclusion]
Through this investigation we ascertained that EG scores are influenced by lesion size and the state of the patient's breast. In addition, care must be taken given the possibility of low scores in invasive carcinoma with widespread intraductal spread.
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P2-03-01.
Abstract P2-06-17: Biological Study of the Effects of GW572016 (Lapatinib) in Ras/Raf/MAK and PI3K/Akt Signaling Pathways in HER2 Positive Ductal Breast Carcinoma in Situ (DCIS)
Authors: Estevez LG , Suarez A , Calvo I , Ugidos L , Miró C , Durán H , Quijano Y , Herrero M , López-Ríos F , Hidalgo M. 
Published: April 2011

Abstract
Background: DCIS is a heterogeneous disease, with increasing incidence. Up to 37% of DCIS overexpress HER2. Lapatinib is a tyrosine kinase inhibitor that directly inhibits HER2 receptor signaling by blocking the receptor's kinase activity. This work tested the hypothesis that Lapatinib inhibits Ras/Raf/MAK and PI3K/AKT signaling in HER2 positive DCIS.
Patients and Methods: Patients with HER2 positive (FISH rate &gt;2.2) DCIS diagnosed by core needle biopsy with low risk of having a hidden invasive component were eligible. Neoadjuvant Lapatinib 1500mg daily was administered for 4 weeks prior to surgical resection. EGFR was analyzed by FISH in the biopsy specimen. Ki67, PTEN, AKT, pAKT and pERK were evaluated by IHQ. PI3KCA mutations were screened at exons 9 and 20 by PCR. Apoptosis was analyzed by TUNEL assay. All biological markers were measured before and after Lapatinib treatment. Results: Eleven pts with HER2 positive DCIS have been included to date. Median FISH amplification was 7 (range 2, 70-14). Evaluation pre-Lapatinib showed that: none of the pts had EGFR amplification; six pts (54%) had a Ki67 &gt;25%; pAKT was overexpressed in 3 pts (27%) and pERK in 2 pts (18%); PTEN was deleted in 3 pts (27%). PI3KCA mutations were detected in only 1 pt (9%). After Lapatinib treatment, 9 pts were evaluable. We observed a trend for inactivation of the Ras/Raf/MAK signaling pathway in 7 pts (70%) patients. Interestingly, 3 of these pts had paradoxical activation of PI3K/Akt suggesting a compensatory feed back loop. One out of these 3 pts has PTEN deleted. In addition, 3 pts (33%) showed an increase in the apoptotic index. Conclusions: In our study, four weeks of Lapatinib against HER2 positive DCIS resulted in inactivation of Ras/Raf/MAK pathway; however an activation of the PI3K/Akt was seen as the same time in 3 pts. Nevertheless this trend needs to be confirmed with the inclusion of more pts.
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P2-06-17.
Abstract P2-06-19: Transferrin Receptor (CD71) Identifies Poor Response to Tamoxifen in Oestrogen Receptor Positive Breast Cancer Patients
Authors: Nicholson RI , Habashy HO , Gee JM , Finlay P , Farrow L , Jasani B , Barrett-Lee P , Robertson JF , Ellis IO. 
Published: April 2011

Abstract
Background: CD71 is involved in the cellular uptake of iron and is expressed on cells with high proliferation. Interestingly, we have Interestingly, we shown that its expression is associated with elevated tumour proliferation, shortened breast cancer specific survival and worsened outlook in ER+ adjuvant tamoxifen treated early breast cancer patients (Habashy et al, 2010). Here we extend our studies of the relationship between CD71 and tamoxifen outcome by study of an exploratory series of patients where endocrine response was directly assessable.
Material and Methods: CD71 (clone 10F11 antibody; Abcam, Cambridge, UK) and proliferation (MIB1) immunohistochemistry were performed as described in Habashy et al (2010) on 87 formalin fixed paraffin-embedded breast cancers. These were obtained from patients within the Nottingham Tenovus Multiple Antibody Study who had received systemic tamoxifen therapy for locally advanced primary carcinoma or metastatic disease or for recurrence after surgery alone. All had lesions assessable for response quality at 6 months, with survival and duration of antihormone response measured from initiation of antihormone to death or progression on therapy respectively. 48 tumours were classified as ER+ and 39 ER-. Results: Within this tamoxifen treated series, 68/87 patients were deemed positive for CD71 (plasma membrane and cytoplasmic), showing HScore values &gt;=5. In the ER+ subgroup, a greater clinical response rate to tamoxifen was seen in CD71 — tumours (10 CR/PR, 3 S and 2 P) versus their CD71+ counterparts (CR/PR, 11 S and 16 P, p=0.015). CD71 positivity was associated with a significantly shortened time to progression and death (Kaplan Meier Test, p=0.026 and p=0.005 respectively). Examination of the proliferation marker MIB1 in ER+ tumours revealed a positive association with CD71 expression (Spearman's Test, p=0.01). In ER-patients, comprising predominantly progressive disease on tamoxifen therapy, CD71 status showed no impact on either time to progression of the disease or death.
Discussion: The present study extends our novel findings relating CD71 expression to loss of response to tamoxifen in ER+ breast cancer and reveals CD71 associates with increased tumour cell proliferation in clinical disease. Whether CD71 plays a causative role in the direction of these events and can be targeted to improve endocrine response requires to be ascertained.
Habashy HO et al, 2010, Breast Cancer Research and Treatment 119:283-293
Abd El-Rehim DM et al, 2005, Int J Cancer 116: 340-350
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P2-06-19.