bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of Virtual MRI Sonography with Magnetic Navigation on Detecting Residual Tumors in Patients with Breast Cancer Who Undergo Neoadjuvant Chemotherapy; Initial Experience.
Authors: Nakano S. , Fujii K. , Yorozuya K. , Yoshida M. , Mouri Y. , Kousaka J. , Fukutomi T. , Kimura J. , Ishiguchi T. 
Published: December 2010

Abstract
Objective: The accurate evaluation of the extent of residual disease after neoadjuvant chemotherapy (NAC) for breast cancer appears essential for successful clinical outcomes. However, there are limited date about the success of achieving negative margins in breast conservation therapy. Recently, we have developed virtual MRI sonography with magnetic navigation (real-time virtual sonography; RVS). RVS can overlay high-resolution structural image taken by sonography with functional image reflecting vascular permeability taken by MRI of the same site in real time. The objective of our study was to determine the relative accuracy of RVS in detecting residual tumors after NAC.Materials and Methods: Between April 2007 and May 2009, 96 breast conservation therapy were performed for invasive ductal carcinoma at our hospital. Fourteen patients with stage IIA-IIIB palpable invasive ductal carcinoma were enrolled in a study investigating the effects of NAC on tumor imaging. All patients underwent mammography, sonography, MRI, and RVS before and after NAC. MRI was performed with a 1.5-T scanner in the supine position using a flexible body surface coil to achieve the same position as that used in sonography. Based on MRI results, the absence or presence of residual tumors was used to classify treatment response into a clinically complete response (cCR) or non-cCR, respectively. Nine patients received lumpectomy, and 5 received mastectomy. The surgical resection area was determined by RVS. Detection rate was determined for residual tumors with or without RVS. The pathologically complete response (pCR) was defined as no invasive carcinoma.Results: All index tumors were detected by sonography and MRI before NAC. After NAC, a cCR was seen in 5 (5 of 14, 36%) patients. MRI correctly diagnosed pCR in 4 (4 of 5, 80%) patients. Detection rate for residual tumors was 9% (1 of 11) for mammography, 33% (3 of 9) for sonography alone, 78% (7 of 9) for MRI, and 89% (8 of 9) for RVS. It was noteworthy that 5 (5 of 5, 100%) cases with cCR were accurately localized onto the body surface with supplementation using RVS combined with pre- and post-NAC imaging while we were checking sonography. Although surgical excision was incomplete in 5 (5 of 9, 56%) patients, all positive surgical margins were ductal carcinoma in situ.Conclusions: By using RVS, two different forms of diagnostic imaging can be integrated in real time and thereby complement each other. The present results suggest that RVS is a useful imaging technique for detecting residual tumors that have been associated with local recurrence after NAC.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 5024.
High Sensitivity and Specificity of Digital Infrared Imaging for Breast Cancer Detection in Younger Women Undergoing Breast Biopsy.
Authors: Wishart G. , Campisi M. , Chapman D. , Shackleton V. , Iddles S. , Hallett A. , Britton P. 
Published: December 2010

Abstract
Background and aim: Recent published evidence suggests that digital infrared breast scanning may be a useful adjunctive tool for breast cancer detection. In this study we have assessed the effectiveness of digital infrared imaging captured using Sentinel BreastScan (Infrared Sciences Corp., Bohemia, NY, USA) and compared the computer-generated reports from this system with expert manual review of the images as well as a new software programme currently under development called NoTouch BreastScan.Methods: A total of 100 patients scheduled for breast biopsy (n=106), following detection of an abnormality via clinical examination or breast imaging were recruited to this research ethics committee-approved study. After obtaining informed consent all patients were imaged using Sentinel BreastScan, prior to their scheduled biopsy procedure in the Cambridge Breast Unit. The data for each patient was analysed in four different ways for comparison with final pathology findings as follows: 1. Sentinel screening report (score 0 = normal, 1-5 = abnormal); 2.Sentinel neural network (positive or negative); 3. Independent expert review (positive or negative); 4. NoTouch BreastScan artificial intelligence (score 0-3 = normal, 4-10 abnormal).Results: Sensitivity for the whole group using Sentinel screening (53%) and neural network (48%) was low compared to recently published data (97%), expert review (78%) and NoTouch (70%).Sensitivity and specificity results for NoTouch BreastScan by age group are shown in table1Sensitivity and specificity results for NoTouch BreastScan by age group &lt;50 years, n=2150-70 years, n=73&gt;70 years, n=12All patients, n=106Sensitivity78%72%42%70%Specificity75%37%N/A48% Conclusion: This study confirms acceptable sensitivity (72%) for breast cancer detection using NoTouch BreastScan in women under 70 years of age despite the data being captured with Sentinel. This sensitivity increases to 78% for women &lt;50 years old and is combined with a marked increase in specificity (75%) in this group. These encouraging figures may increase even further when data is captured by the NoTouch software and studies are ongoing with this novel imaging system.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 5025.
A Nomogram To Predict Breast Cancer Probability in Patients with Nipple Discharge.
Authors: Mazouni C. , Bonnier P. , Uzan C. , Haddad O. , Delaloge S. , Rimareix F. , Garbay J. 
Published: December 2010

Abstract
Background: Nipple discharge is a symptoms of breast disease that lead to the diagnosis of breast cancer in 5% of cases. Our objective was to develop a scoring system based on clinical and radiological factors to predict the risk of breast cancer (BC).Methods: Predictive factors of breast cancer were identified in a population of 90 women operated for unilateral nipple discharge, at Institut Beauregard, in France. A scoring system that gives individual probability of BC was developed based on univariate and multivariate logistic regression models. This model was validated in an external independent data set of 263 patients treated at Institut Gustave Roussy, in France.Results: The frequency of BC was 50% and 19.1%, respectively in the training set and in the validation. set. Factors associated with BC were age (p=0.04), presence of a clinical tumor (p=0,03), presence of a nodular lesion (p=0,03) or microcalcifications (p= 0.006) at mammography, in univariate analysis. In multivariate analysis. Only age (p= 0.03), microcalcifications (p= 0,007), or nodular lesion (p=0.06) at mammography were significance or tend to reach significance in multivariate analysis. Based on AIC, factors entered in the model were: age, clinical mass, abnormal images at mammography. The model has a good auc (76.6%). In the validation set, the auc was lower (66.6%).Conclusion: A clinico-radiological model can be built to predict BC in women with nipple discharge to help the decision-making and plan the suitable surgery. A further validation and testing of biological parameters might improve our model.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 5031.
A Novel Tumour-Based Test To Identify Breast Cancer Due to BRCA1 and BRCA2 Mutations.
Authors: Eccles D. , An Q. , Jones L. , Tapper W. , Chelala C. , Iravani M. , McKay A. , Hammond V. , Durcan L. , Gerty S. , Strefford J. , Ferguson A. , Peock S. , Reis-Filho J. , Easton D. , Ashworth A. 
Published: December 2010

Abstract
Background: Family history and young onset are the usual indicators of an underlying genetic predisposition to breast cancer development. BRCA1 associated breast tumours are more likely to be ER negative and express “basal” markers, however most patients with ER negative/ basal marker positive breast cancers (especially young onset) do not have inherited BRCA1 mutations. BRCA1 and BRCA2 gene carriers may have novel treatment options available and may need to consider future cancer prevention strategies. Genetic counselling and germline mutation analysis remains a relatively expensive option that is not appropriate for most breast cancer patients.Aim: To design a sensitive and specific pathology based predictor that would improve identification of BRCA1 and 2 gene carriers.Method: We assembled a training panel of breast cancer tumour blocks from 67 BRCA1, 71 BRCA2 associated and 105 sporadic young onset cases (≤ 40 years at diagnosis). All gene carriers were diagnosed before 50 years and were matched to sporadic cases for ER status. Tissue micro arrays (TMAs) were assembled and subjected to immunohistochemical analysis with a panel of 18 antibodies. DNA was extracted from micro dissected tumour tissue and matched patient lymphocytes and subjected to high resolution tiling path microarray-based Comparative Genomic Hybridisation (aCGH). Using robust statistical approaches, regions significantly differentially lost, gained or amplified in BRCA1, BRCA2 and controls were identified. Probes for chromogenic in situ hybridisation (CISH) for amplified regions were generated.Results: Two differentially amplified clones in BRCA1 cases designated P1 at 3q25.31 and P2 at 3q25.2 and one in BRCA2 cases, P3 at 20q13.13, were identified and amplifications validated in the training set using CISH. Logistic regression analysis of the panel comprising CISH and IHC markers was used to develop the best predictor. The best predictor for BRCA1 gene carriers was a combination of P1, ER and HER2. This combination outperformed all combinations of immunohistochemical markers, including ER and basal markers; the Positive Predictive Value (PPV) was 87.5% and NPV 92% giving a Receiver Operator Characteristic (ROC) curve with an AUC of 0.92 (CI 0.88-0.97). The BRCA2 signature panel is currently being evaluated. These BRCA1 and BRCA2 predictor panels are being validated in a new set of TMAs comprising 223 tumours from the POSH study1.Conclusion: This tumour based predictor for BRCA1 and BRCA2 carriers may prove useful to identify gene carriers at low a priori chance of having a mutation, to direct BRCA1/2 targeted treatment approaches and to identify familial non BRCA1/2 cases that may be suitable for new gene discovery studies.1. Eccles D et al. BMC Cancer 2007; 7(1):160.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 5032.
Outcomes of Guided Imagery (GI) in Patients Receiving Radiation Therapy for Breast Cancer.
Authors: Serra D. , Robertson-Paris C. , Chadha M. , Carper E. , Fleishman S. , Harrison L. 
Published: December 2010

Abstract
Background: There is an emerging recognition of the importance of Integrative Medicine in cancer care. We initiated a study evaluating the impact of GI on patients undergoing radiation therapy for breast cancer.Materials and Methods: A prospective, IRB-approved study evaluating the efficacy of GI among patients receiving radiation therapy for breast cancer was completed. Eligible patients had GI sessions with an Integrative Oncology Nurse (ION) and were given the tools and were trained techniques for self practice. The study endpoints include evaluating relaxation response to GI sessions using clinical variables that represent the level of an individuals stress and anxiety. These biofeedback measures included blood pressure (BP), respiration rate (RR), pulse rate (PR), and skin temperature (temp.) before and after the GI exercise. Further, the EQ-5D questionnaire, an established and validated tool for measuring health outcomes, was used for the subjective assessment. Patients completed the EQ-5D questionnaire prior to their first GI session (baseline data) and again at completion of radiation treatment. Patient feedback on their overall experience was collected at the end of the planned RT treatment through a satisfaction survey.Results: In all, 68 breast cancer patients have completed the protocol. The median age is 57 years. Median number of GI sessions with the ION was 4 (range: 1-6). In all cases, the parameters measured statistically significant improvement from baseline; median RR decreased from 19.6 per minute to 17.5 per minute; the mean drop of 4 beats/ minute in the pulse rate was observed. The mean drop in the systolic BP was 8.6mmHg, and the mean drop in the diastolic BP was 3.6 mmHg, and the mean skin temperature increased from 84.70F to 89.40F indicating increase in peripheral capillary flow secondary to a decrease in the sympathetic response. Results are summarized in Table 1. Overall 86% described the GI sessions as helpful, and 100% would recommend this intervention to others.Clinical VariablePrior to GI session (mean values)After GI session (mean values)p-valueRespiration rate19.617.5&lt;0.001Pulse rate77.073.00.002Diastolic BP71.668.00.02Systolic BP124.3115.7&lt;0.001Skin temp.84.7°F89.4°F0.007 Conclusion: The results of this study illustrate the positive impact of GI as measured through subjective and objective parameters. In improving the overall care of breast cancer patients there may be value to incorporating practices of Integrative Medicine.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 5039.
Prospective Evaluation of Joint Symptoms in Postmenopausal Women Initiating Aromatase Inhibitors for Early Stage Breast Cancer.
Authors: Crew K. , Podolanczuk A. , Brafman L. , Awad D. , Hershman D. 
Published: December 2010

Abstract
Background: Aromatase inhibitors (AIs) are widely prescribed to postmenopausal women for the adjuvant treatment of hormone-sensitive breast cancer. However, musculoskeletal complaints, including joint pain and stiffness, are common, and can lead to nonadherence and treatment discontinuation. The aim of this study was to characterize the natural history of the AI-induced arthralgia syndrome.Methods: Postmenopausal women with stage I-III breast cancer initiating adjuvant AI therapy were enrolled. All patients completed the following questionnaires at baseline and every 3 months for a year: Modified Brief Pain Inventory-Short Form (BPI-SF), Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index and the Modified Assessment of Chronic Rheumatoid Affections of the Hands (M-SACRAH). Higher scores reflect worsening joint symptoms. Quality of life was assessed using the Functional Assessment of Cancer Therapy-Endocrine Subscale (FACT-ES), where higher scores signify improved well-being. Hand grip strength was measured at each visit with a Martin dynamometer. Paired t-tests were performed to compare follow-up evaluations to baseline.Results: A total of 34 patients have been enrolled to date. Three-month data is available on 22; six-month data on 12. Median age: 60 (42-81); White/Black/Hispanic/Asian: 13/6/2/1; median BMI (kg/m2): 28 (20-43). Compared to baseline, there was a statistically significant increase in BPI pain severity and pain-related interference at 3 and 6 months. Significant changes in the M-SACRAH were seen as early as 3 months, but no difference in grip strength was detected. Participants reported significantly more endocrine-related symptoms on the FACT-ES at 3 and 6 months after initiating AI therapy.Conclusions: Treatment with adjuvant AI therapy is associated with significant worsening of joint pain and stiffness which was seen as early as 3 months and persisted at the 6 month evaluation. Understanding the natural history of this toxicity and validating appropriate measures to be used in interventions to prevent and treat AI-induced arthralgias are critical. Baseline3 Months6 Months Mean (SD)Mean (SD)P-value*Mean (SD)P-value*BPI-SF Pain Severity (0-10)2.66 (2.52)3.85 (2.48)0.053.96 (2.42)0.02Pain Interference (0-10)1.40 (1.95)3.25 (2.53)0.022.60 (2.51)0.01M-SACRAH Pain (0-200)47 (46)74 (52)0.0373 (65)0.08Stiffness (0-200)51 (45)85 (54)0.0383 (54)0.01Function (0-800)59 (74)129 (143)0.14168 (190)0.05WOMAC Pain (0-500)67 (95)110 (126)0.19113 (135)0.06Stiffness (0-200)29 (40)45 (54)0.4643 (56)0.06Function (0-1700)271 (324)445 (400)0.15468 (373)0.06FACT-ES Functional (0-28)20 (7)20 (6)0.9619 (6)0.15Physical (0-28)22 (5)20 (6)0.4420 (5)0.32Endocrine (0-72)58 (9)52 (14)0.0451 (11)0.01* Based on paired t-test, as compared to baseline.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 5044.
Determining Issues of Importance for Patients with Breast Cancer: Results of a Web-Based Study in 1072 Patients To Enhance the Content Validity for the Development of a New Health-Related Quality of Life (Ql) Instrument, the Breast Cancer Symptom Scale (BCSS).
Authors: Weiselberg L. , Gralla R. , Horigan J. , Davis B. , Hollen P. , Petersen J. , Burg K. , Belland A. 
Published: December 2010

Abstract
Background:Identifying key issues for patients with malignancy is central to assessing QL and patient reported outcomes during all points of the illness trajectory. The involvement of patients in establishing content validity is crucial for instrument development. The conceptual model for the BCSS focuses on areas of importance for patients (Hollen, Supp Care Ca 1994).Methods:We used the established patient base of the web-based NexCura information resource to survey registered patients with breast cancer. Demographic stratifications included disease stage, age, menopausal status, time since diagnosis, prior/current treatment with surgery, RT, chemotherapy, hormonal, targeted, and CAM approaches. 1072 patients (median age 53, 65% stage I, 43% &gt; 2 years since diagnosis) completed the anonymous web-conducted survey. Patients ranked 21 issues on a 5-point scale, assessing the importance of each item. Issues included general, physical, functional, psychosocial and summative items.Results:The 9 highest ranked items are seen below. Results are described by the percent of patients choosing the top category (very important) and the top 2 importance categories. The five lowest ranked items dealt with appetite, breast-specific issues, hot flashes and sexuality. Ratings by breast cancer subsets (newly diagnosed, on treatment, NED, hormonal or non-hormonal treatment, metastatic disease, survivors) showed some differences compared with the whole group.[table1]N=1072Very ImportantVery Important +ImportantGood QL82%99%Maintaning independence75%97%Able to sleep69%97%Able to concentrate65%97%Perfrom normal activities62%97%Being fatigued61%95%Having depression51%85%Being anxious47%85%Having pain46%80% Conclusions:These results represent one of the largest surveys of concerns expressed by patients with breast cancer and support using computer-assisted technology to assess such information for rapid input of large patient samples. This study gives strong support for content validity for the BCSS and provides data on which to base separate QL instruments for specific breast cancer settings.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 5048.
How Important Is Cognition for Women with Breast Cancer? Results of a Web-Based Study of 1071 Breast Cancer Patients Used To Augment Content Validity of the Breast Cancer Symptom Scale (BCSS) a New Health-Related Quality of Life Instrument.
Authors: Shapira I. , Gralla R. , Davis B. , Petersen J. , Hollen P. , Horigan J. , Belland A. , Burg K. , Carleton J. 
Published: December 2010

Abstract
Background:Cognitive difficulties, such as loss of memory or ability to concentrate, have been associated with chemotherapy and other treatments for breast cancer. Causes for intellectual impairments have been proposed, including biological and psychological factors, however, strong evidence is lacking. Regardless of the cause, it is important for caregivers to appreciate, which cognitive impairments most concern their patients. As part of this survey, we sought the opinions of women with breast cancer to ascertain how these women rated the ability to concentrate among 21 major issues.Methods:We utilized the established patient base of the web-based NexCura information resource to survey registered patients with breast cancer. Demographic stratifications included disease stage, age, menopausal status, time since diagnosis, prior/current treatment with surgery, RT, chemotherapy, hormonal, targeted, and CAM approaches. 1071 women (median age 53, 65% stage I, 43% &gt; 2 years since diagnosis) completed the anonymous web-conducted survey. Patients ranked the importance of 21 issues on a 5-point scale. Issues included general, physical, functional, psychosocial and summative items.Results:Of all 21 items, the 1071 women ranked the ability to concentrate as one of the four most important factors, as determined by those who rated it in the top category (very important, 65%) and the top 2 importance categories (97%). It followed only overall quality of life in the “very important” category, and was tied with maintaining independence and the ability to sleep in the sum of the top 2 importance categories. Analysis is being conducted to determine if ratings by breast cancer subsets (newly diagnosed, on treatment, NED, hormonal or non-hormonal treatment, metastatic disease, survivor-status) will differ compared with the whole group.Conclusions:Interference with concentration can affect nearly every aspect of functioning and quality of life, and can have an impact on quality decision making. Regardless of whether causes of cognitive impairment have supporting evidence, caregivers should be aware of the level of importance of concentration to patients with breast cancer and report symptoms related to executive function.Our results from one of the largest groups of breast cancer patients surveyed to date support the belief that women value the ability to concentrate most highly.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 5049.
Effect of Density and Altered Structure of Adipose Stromal Cells on Breast Cancer Initiation.
Authors: Ghosh S. , Walter M. , Sitai L. , Hornsby P. , Hu Y. , Li R. 
Published: December 2010

Abstract
Increased adiposity is strongly associated with higher risk of estrogen-receptor positive postmenopausal breast cancer and increased mortality of breast cancer. Adipose stromal cells (ASC) play critical role in both development and metastasis of cancer as well as initiation of the disease. Within tumor microenvironment role of ASC is well studied, however, its role in initiation of the disease is less understood. In this study we uncovered novel function of ASC in both estrogen-dependent and independent cancer development. We showed that ASC induces aromatase, a key enzyme in estrogen biosynthesis, under the influence of cell density-stimulated shape change mechanism in cancer-free individuals. The activation of aromatase transcription is mediated by IkB kinase b (IKKb), a kinase previously known for its cancer-promoting activity in tumor cells. Activation of IKKb leads to elevated expression of transcription factor C/EBPb, which binds to and stimulates two breast cancer-associated promoters of the aromatase gene. We also show that shape-induced estrogen production in ASCs can stimulate estrogen-dependent transcription in ER-positive breast tumor cells. We developed a xenograft model that supported our in vitro observation.Here we further showed that density-driven ASCs significantly stimulated migration and invasion of ER-negative breast cancer cells in vitro and tumor invasion in a co-transplant xenograft mouse model. Our study also identified cofilin-1, a known regulator of actin dynamics, as an important determinant for the stimulatory activity of ASCs. The cofilin-dependent pathway controled the production of interleukin 6 (IL-6) in ASCs. Depletion of IL-6 from ASC-conditioned medium abrogated the stimulatory effect of ASCs on the migration and invasion of breast tumor cells. Thus, our study revealed how ASC, under an altered cellular architecture, may contribute to the breast cancer risk in obesity and high breast density.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 505.