bluuebunny/crossref_metadata_2025_split huggingface dataset:
Complementary and Alternative Medicine Use and All-Cause Mortality among U.S.-Born and Foreign-Born Breast Cancer Cases: Results from the Hereditary Breast and Ovarian Cancer (HBOC) Study.
Authors: Bessonova L. , Largent J. , Anton-Culver H. 
Published: December 2010

Abstract
Background: Complementary and alternative medicine (CAM) therapies are used by people from all racial/ethnic backgrounds, and CAM use among cancer patients has recently been a focus of much research. Breast cancer patients, specifically, have embraced many CAM therapies. Use of these therapies is estimated to be between 48 and 70 percent among women diagnosed with breast cancer in the United States (Nahlez and Tabbara, 2003). Mortality patterns in foreign-born women diagnosed with breast and other cancers who immigrate to the United States are complex (Singh and Hiatt, 2006). However, it is unclear how country of birth relates to CAM use and overall survival among women with breast cancer. Therefore, we investigated the associations between country of birth, CAM use, and overall survival in the Hereditary Breast and Ovarian Cancer (HBOC) study, a population-based sample of breast cancer cases in California, comparing U.S.-born versus foreign-born women.Methods: Five hundred and fifty incident breast cancer cases (average age=54.68; SD=11.12) were sampled from the HBOC Study, which were identified through the Orange County regional registry for the state California Cancer Registry. Cases were contacted via telephone, and information on health behaviors, disease history, and socio-demographic characteristics were collected. A self-administered questionnaire queried use of any of the following CAM therapies: herbal teas, megavitamins, acupuncture, religious services, nonreligious services, aspirin, and/or non-prescription pain medicines. Chi-square test followed by Cox proportional hazards regression were used to compare overall survival between U.S.-born and foreign-born breast cancer cases as well as CAM ever- versus never-users.Results: Univariate analyses revealed that 59.5% of foreign-born breast cancer cases, versus 55.7% of U.S.-born reported having ever used CAM (Chi-square=0.76; p=0.38). In multivariate analyses, foreign-born women with breast cancer had roughly 3 times greater risk for all-cause cause mortality (HR=3.38; 95% CI: 2.14, 5.33) compared with U.S.-born breast cancer cases, adjusting for history of CAM use, education, number of existing co-morbidities, stage of tumor at diagnosis, and age at time of survey. Stratified analyses revealed that CAM use was not significantly associated with all-cause mortality using the above multivariate model among foreign-born (HR=1.35; 95% CI: 0.77, 2.37), or U.S.-born breast cancer cases (HR= 2.36; 95% CI: 0.99, 5.64).Discussion: These findings suggest that although foreign-born breast cancer cases are at greater risk for all-cause mortality, history of CAM use does not significantly protect nor increase the risk of death for this population.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 3069.
Impact of Older Age on Presentation and Management of Breast Cancer in the Multi-Ethnic Population of Singapore.
Authors: Verkooijen H. , Verkooijen H. , Saxena N. , Hussain Z. , Lim S. , Hartman M. , Chia K. , Lee S. 
Published: December 2010

Abstract
Background: Studies in Caucasian populations have shown that older breast cancer patients are less likely to be treated according to standard guidelines and that this under-treatment is strongly associated with impaired survival. In Asia, where population sizes and life expectancy rates are rising, the number of older women developing breast cancer is growing rapidly. This study aims to evaluate characteristics and treatment patterns of older breast cancer patients in the multi-ethnic population of Singapore, where breast cancer rates have tripled over the past three decades.Methods: This study includes all 2547 women, diagnosed with breast cancer between 1995 and 2006 at the National University Hospital in Singapore. Patients were classified into younger (&lt; 65 years, n=2220) and older (&gt;= 65 years, n=327). Differences in patient and tumor characteristics and treatment between older and younger age groups were explored using multivariate logistic regression models.Results: Even though older Singapore breast cancer patients had more favorable tumor characteristics than younger ones (better tumor differentiation, more often expressing estrogen and progesterone receptors), they presented significantly more often with stage III (adjusted Odds Ratio [ORadj] 1.57, 95%CI 1.0-2.4) and metastatic disease (ORadj 4.3, 95%CI 2.9-6.5). Elderly women were at increased risk not to receive breast surgery (ORadj 1.61, 95%CI 1.0-2.6) and axillary clearance (ORadj 1.74, 95%CI 1.2-2.6). In case of stage I disease, older women were significantly less likely than younger women to be treated with breast conserving surgery (ORadj 0.31, 95%CI 0.2-0.5).Conclusion: Similar to their Caucasian counterparts, older Asian breast cancer patients in Singapore are diagnosed at a later stage and receive less often standard treatment than younger women. Further studies are being undertaken to estimate the impact of these discrepancies on outcome.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 3078.
Distant Metastasis Free Survival (DMFS) in Breast Cancer Patients with Micrometastases (pN1mi) in the Sentinel Lymph Node (SLN): Results in 582 Positive-SLN Patients in a Single Institution.
Authors: Alran S. , Toupet A. , De Rycke Y. , Pierga J. , Fourchotte V. , Falcou M. , Sigal-Zafrani B. , Salmon R. 
Published: December 2010

Abstract
Background:The risk of developing distant metastases (DM) in pN1mi and isolated tumor cells (pN0i+) patients remains under question. Does occult axillary node metastases is an additional factor for using an adjuvant systemic therapy (AST) in early breast cancer ?Patients and Methods:Among 2695 patients operated on from 2000 to 2006 for SLN, 582 patients had a positive SNB: 307 were pN1, 154 pN1mi and 121 pN0i+ (6th AJCC-classification). All patients underwent an immediate or delayed Axillary Lymph Node Dissection (ALND). We report the results for DMFS [median follow-up of 56 months (2-105)].We used Kaplan-Meier method and Cox regression for multivariate analysis.Results:ALND were positive in pN1, pN1mi and pN0i+ patients respectively in 127 (41,3%), 20 (13%) and 14 (11.6%) of these patients. On univariate and multivariate analysis, positive ALND, mitotic index, pathologic tumor size were significantly related to the DMFS; on multivariate analysis, the type of axillary lymph node metastases was an additional significative factor. There was not relationship between pN0i+ and the development of DM. Surprisingly, patients with pN1mi had a 2.8 higher risk for developing DM than pN1 patients. pN1 patients receive more AST than pN1mi (75% and 22%), however AST was not prognostic (p=0.49).Conclusion:In our series, patients with pN1mi were associated with a worse prognosis related to DMFS compared to pN1. Use of AST and/or biological primary tumor characteristics could explain this paradoxical result. Longer follow-up and larger series are needed to determine the prognostic significance of axillary occult metastases.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 308.
Promising Practices in Mammography Recruitment, Retention and Rescreening for Breast Cancer Early Detection among Community-Based Programs Supported by the Avon Foundation Breast Care Fund.
Authors: Hurlbert M. , McDonnell C. , Gates-Ferris K. , Opdyke K. , Pagaduan M. , Chi B. 
Published: December 2010

Abstract
Background/Significance: National guidelines recommend women age 40 and older have mammograms every 1-2 years. Since 2000, the Avon Foundation Breast Care Fund (AFBCF), a project of Cicatelli Associates Inc., has supported nonprofit community-based organizations (CBOs) to provide breast health education and outreach to link medically underserved women with free/low-cost breast cancer screening services. These organizations have developed effective strategies for recruiting, retaining and rescreening clients. This evaluation study aims to identify promising practices for effective mammography recruitment, retention and rescreening among un/underinsured, low-income, and racial and/or ethnic minority women.Methods: Twenty of 144 AFBCF-funded CBOs were selected to participate in a retrospective study to determine clients' rescreening rates.CBOs provided de-identified data on mammography screening by age and visit date to determine their rescreening rate, defined as the proportion of female outreach clients age 40+ years receiving a mammogram and subsequent mammogram through that agency within the following 6-18 and/or 18-30 months. CBOs also completed a qualitative survey about program strategies and systems. Qualitative data were linked with rescreening rates to identify promising practices. Survey results were also used to develop a discrete questionnaire administered to 144 AFBCF-funded CBOs to identify which agencies currently employ identified promising practices.Results: Data analysis will be completed in September 2009.Preliminary results indicate that rescreening rates vary widely across agencies, from 15% to over 90%. In addition, findings indicate that some CBOs lack mechanisms to routinely monitor client rescreening. Utilizing unique client identifiers in conjunction with the use of electronic data tracking systems would facilitate tracking clients over time and improve targeted outreach efforts to increase rescreening rates.Discussion: Combined qualitative and quantitative analyses of differences in practices directed at encouraging mammography rescreening among medically underserved women will enable a description of promising practices for increasing rescreening rates in this population. Analysis will include an explanation of mammography rescreening rates among medically underserved women. Agencies with high rescreening rates will be identified and discussion regarding organizational characteristics and practices will be presented. Additionally, unique and innovative strategies for reaching specific populations will be examined.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 3080.
Post-Mastectomy Breast Reconstruction among the Largely Hispanic Underinsured of Southern California: An Analysis of Factors Leading to Lower Referral and Reconstruction Rates over Two Decades.
Authors: Mussman J. , Modad G. , Kalina S. 
Published: December 2010

Abstract
Background: This study investigates improvements in the rate of reconstruction over the last decade for the, predominantly Hispanic, county hospital population of Riverside County, California. This is accomplished be comparison to a similar study within the same institution by Kalina et al for the preceding decade. In addition, comparisons to national trends are also made as a global measure of the success of the reconstructive process in the study population. While previous national studies have focused solely on reconstructive rates, the present study also examines post-mastectomy referral rates. Additional investigation was carried out into the factors affecting both referral and reconstructive rates within this population.Methods: A retrospective review of all female patients' charts who underwent mastectomy from Aug 1998- June 2007 was performed. Factors investigated in relation to referral and reconstruction rates were stage of the cancer, smoking status, race, surgeon performing mastectomy, and age. Ten studies were selected for comparison that represented reconstruction rates from various national database and single institution studies from 1984-2003. Logistic regression was used to analyze the data.Results: n=163. Mean Age 52. Hispanics comprised 42% followed by whites at 26%. Eighty seven (53%) patients were referred to plastics for reconstruction and 24 (15%) underwent reconstruction. There was a 273% and 333% increase compared to the previous decade in referral and reconstruction rates respectively within the study population. Rate of reconstruction (15%) within the study population was 58% lower than what was projected by national trends (36%). The surgeon performing the mastectomy was the most significant factor affecting referral (odds ratio 3.35). Younger age (&lt;45) also led to significantly more referrals to plastic surgery (odds ratio 2.68). Prognosis, radiation therapy, and race had no significant impact on referral or reconstruction rates.Conclusions: Significant gains have been made in the rates of postmastectomy referral and reconstruction over the last decade within the county hospital population of Riverside County, California. However, comparisons with national trends indicate that the rate of reconstruction has fallen to less than half of what has been reported throughout the nation. A low referral rate to plastic surgery has been the reason for the low the reconstruction rate. The main contributing factor to whether a patient was referred was surgeon bias among the primary surgeons performing the mastectomy. The authors urge protocol driven referral patterns surrounding breast cancer diagnosis be adopted in every hospital to circumvent any bias that may exist.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 3081.
Wait Times and Diagnostic Pathways among Women with Invasive Breast Cancer in a Population-Based Publicly Funded Cancer Centre, British Columbia, Canada.
Authors: Martin L. , Banno B. , Joffres M. , Wong F. , Sherriff C. 
Published: December 2010

Abstract
Rationale and background: The Fraser Valley Cancer Center serves a large geographic population of urban and rural areas. Selected data on wait times and diagnostic pathways are available for mammography screening programs in British Columbia (BC), but not for patients presenting with clinical abnormalities such as a palpable breast lump. Diagnostic pathways in BC are managed by primary care physicians and community surgeons. Anecdotal evidence from oncology services suggests large variation in wait times and pathways.Objective: To examine time intervals and pathways between the detection of a breast abnormality and formal assessment by medical or radiation oncology for adjuvant treatment.Methods: Retrospective chart review of all patients with a new diagnosis of breast cancer first seen at the Fraser Valley Cancer Center in 2002, linked with demographic and other registry data. Data collected included type, location, date of investigations, surgical procedures, diagnosis, treatment and stage. Exclusion criteria were patients initially diagnosed with metastatic breast cancer, patients with recurrent breast cancer, male breast cancer patients, patients diagnosed or previously treated outside BC. Microsoft Access and SAS 9.2 were used to enter and analyse data.Results: From a total of 513 women diagnosed in 2002 with invasive breast cancer, 422 women (82%), without metastases (age 30 to 97 yrs, median 59 yrs), presented with abnormal screen (45%), breast lump (47%) or other findings. These women had up to 7 different radiological breast investigations and up to 5 surgical interventions. About 5% had 5 or more breast investigations. Median time (days) from presentation to first surgery was 41 days and varied by location of first investigation. Time to surgery was highest among women who presented with abnormal screening mammogram (median 49 days). Median time from first surgery consultation to first surgery was lowest for women presenting with breast lumps (15 days).Conclusions: These data indicate wait times beyond national and international targets and identified wide variability and some inefficient, redundant or unnecessary steps. Recognition and analysis of abnormal pathways will guide changes in breast health service delivery.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 3083.
Phase II Study of Sorafenib with Anastrozole To Overcome Resistance to Aromatase Inhibitors (AIs) in Patients with Hormone Receptor Positive (ER/PR+) AI Resistant Metastatic Breast Cancer (MBC).
Authors: Isaacs C. , Wilkinson M. , Liu M. , Ottaviano Y. , Chung G. , Warren R. , Jennifer E. , Cohen P. , Smith K. , Novielli A. , Castle J. , Slack R. 
Published: December 2010

Abstract
Background: Studies are focusing on agents which may overcome endocrine therapy resistance in patients with hormone receptor positive (ER/PR+) MBC. Activation of the Ras-Raf-MAPK pathway has been proposed as a mechanism of resistance to AIs. Thus, we are evaluating the use of sorafenib (SOR), a multi (Raf)-kinase inhibitor targeting both tumor cells and the tumor vasculature in patients with AI-resistant MBC.Methods: We are conducting a phase I/II study of SOR in combination with anastrozole 1 mg po daily (ANT) in MBC patients utilizing an optimal 2-stage design. Eligible patients include post-menopausal women with ER/PR+ MBC with disease recurrence or progression on an AI. Participants may not have received &gt; 2 prior chemotherapies for MBC. Primary objectives are to determine the recommended dose and clinical benefit rate (CBR) (CR, PR and SD ≥ 24 weeks) of SOR with ANT. Secondary objectives are to determine toxicity, enumerate circulating endothelial cells (CECs) as an angiogenesis biomarker, and analyze the effect of treatment on CYP3A4-metabolized steroids.Results: 0/3 patients in cohort 1 (200mg BID) and 0/3 in cohort 2 (400mg BID) had dose-limiting toxicities in cycle 1. Thus, our recommended Phase II dose of SOR was 400 mg BID. Interim analysis of the first 12 patients showed &gt;30% CBR, allowing for continued accrual to planned 35 patients. All patients had ECOG PS of 0-2. The median age was 55 years. Among 35 enrolled patients, 5 had stable disease for &gt; 24 weeks, 2 had durable PR &gt; 6 months, and 19 had progressive disease before 6 months. 8 patients were not response-evaluable. 1 patient on active therapy is too early to evaluate response. Clinical benefit rate is 20%. Adverse events (AEs) were generally Grade 1/2. The most common AEs (all; Grade 3/4) were fatigue (66%; 14%), diarrhea (54%; 6%), nausea/vomiting (60%; 9%), and skin rash of any kind (66%; 43%) including hand-foot syndrome (57%; 34%). G3/4 hypertension occurred in 11%. Preliminary analysis suggests that decrease in CECs from baseline to 1 week after treatment predicts for a response. Correlative science analyses are ongoing.Conclusions: The combination of SOR and ANT in patients with ER/PR+ AI-resistant MBC demonstrated an encouraging 20% CBR and is worthy of further study. A decrease in CECs appears to predict response. Toxicity with 400 mg po bid SOR occurred frequently but was manageable with dose reductions. Given the negligible activity of single-agent SOR in MBC, we believe that the benefit may be attributable to the restoration of sensitivity to AIs through inhibition of the Ras-Raf-MAPK pathway. Supported Patient for Progress Award 3 P30CA051008-15S3 and Sorafenib provided by CTEP-NCI.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 3090.
Dasatinib Plus Capecitabine for Advanced Breast Cancer: Safety and Efficacy Data from Phase 1 Study CA180-004.
Authors: Cortes J. , Specht J. , Gradishar W. , Strauss L. , Rybicki A. , Wu X. , Vahdat L. , Paz-Ares L. , Somlo G. 
Published: December 2010

Abstract
Background: SRC is a potential therapeutic target in breast cancer and has a central role in hormone therapy resistance and in osteoclast activity. Dasatinib is a potent SRC inhibitor that inhibits breast cancer cell proliferation and migration in vitro, including synergy with 5FU in some cell lines, and inhibits osteoclast activity in clinical trials. CA180-004 is a phase 1 study designed to identify dose-limiting toxicities (DLT) and recommended phase 2 doses of dasatinib plus capecitabine in women with advanced breast cancer (ABC). Safety and efficacy data are now reported with additional follow-up.Methods: Cohorts of pts with ABC were treated at four dose levels (DL) with capecitabine (mg/m2 twice daily [BID] on D1-14 of 21-day cycles) and dasatinib (mg daily): DL1: capecitabine 825 + dasatinib 50 BID; DL2: capecitabine 825 + dasatinib 70 BID; DL3: capecitabine 1000 + dasatinib 70 BID; DL3a: capecitabine 1000 + dasatinib 100 once daily (QD). All pts had performance status 0-1, prior taxane and/or anthracycline and ≤2 prior chemotherapy-containing regimens for advanced disease. Disease assessments were performed every 6 weeks. DL3a was expanded for further safety and efficacy estimate using best objective response and progression-free survival (PFS) rates.Results: To date, 47 pts with ABC have been treated, 31 in escalation phase plus 16 in expansion (5 too early). Median age was 52 years (range 35-77). Tumor subtypes: 14% were Her2-amplified, 57% ER+ or PR+, 29% triple-negative. Safety was previously reported (ASCO 2009) for escalation phase; no MTD was defined based on DLTs. Of 20 evaluable pts in DL3a, 2 DLTs have been observed: 1 pneumonia, pain and pleural effusion plus 1 diarrhea, neutropenia, vomiting, mucositis and anemia. The most common drug-related adverse events (AEs, any grade) were headache, fatigue/asthenia, nausea/vomiting, diarrhea, hand-foot syndrome (HFS) and pleural effusion. The most common grade 3/4 AEs were fatigue/asthenia, HFS, vomiting and diarrhea. To date, 19 have remained on treatment ≥4 months, including 3 for &gt;1 year. Median duration of treatment (n=42) was 13 weeks; 23 pts have discontinued for progression and 7 for toxicity. Of 38 pts with on-study assessment, 6 had confirmed partial response (treatment durations 17+, 23, 25, 36+, 71, 73 wks), 6 had unconfirmed partial or clinical response (5, 11, 13, 18, 23+, 24 wks), and 9 had prolonged stable disease (16+, 17, 23+, 24+, 25+, 29, 39+, 48+, 63+ wks). Updated efficacy data, including PFS by hormone receptor status, will be presented.Conclusions: Dasatinib and capecitabine combination treatment was well tolerated and encouraging efficacy was observed. Further assessment of this combination is warranted.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 3092.