bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Value of Breast Ultrasound in BRCA1 and BRCA2 Mutation Carriers.
Authors: Bosse K. , Graeser M. , Rhiem K. , Gossmann A. , Hackenbroch M. , Warm M. , Mallmann P. , Schmutzler R. 
Published: December 2010

Abstract
OBJECTIVE: BRCA1/2 mutations carriers face a lifetime risk for breast cancer of 60 to 80%. Typically, tumor incidence is high at young age and tumor growth rates are significantly elevated. On ultrasound investigation the malignancies often mimic fibroadenomas with round shape, circumscribed margins and a homogeneous internal structure leading to a BIRADS 3 classification. On this background we evaluated the efficacy of ultrasound for the early detection of breast cancer in this high risk group.METHODS: Between 01/1997-07/2008 223 BRCA1/2 mutation carriers participated in a breast cancer screening program which included semi-annual ultrasound (US) and annual mammography (MG) and MR imaging (MRI).Screening procedures started from age 25, MG at age 30. As patients consecutively joint the study women underwent 5 (median) screening rounds with a range of 1 to 22 appointments, totaling 1855 rounds of screening. All three imaging modalities were coded according to the American College of Radiology (BI-RADS classification).RESULTS: We detected 15 primary and 14 secondary contralateral BRCA-associated tumors in 27 patients. Age at diagnosis ranged from 29 to 66 years (median 41 years). BI-RADS classification IV and V enabled the detection of 9 (32%) cancers by mammography, 21 (87,5%) by US and 27 (96%) by MRI scan. Specificity added up to 100%. Three (11%) tumors were detected by the semi-annual ultrasound screen and two patients presented with interval carcinomas (16 and 8 mm in diameter) between two screening appointments. Thus, the proportion of interval cancers was 7%.CONCLUSION: Semi-annual sonography as a supplementary examination enabled us to reveal 3 additional invasive cancers (two stage pT1b, one stage pT1c). Due to the specific tumor morphology and the considerably elevated tumor doubling time mutation carriers may benefit from the addition of semi-annual ultrasound as a highly sensitive and cost-effective method.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 4004.
Quality Assurance of an Organised Screening Programme for Breast Cancer in Denmark 1991-2008.
Authors: von Euler-Chelpin M. , Jacobsen K. , Vejborg I. 
Published: December 2010

Abstract
Background: The capital city of Copenhagen, Denmark, has had an organised programme for screening with mammography since 1991. All women resident within the area of uptake and aged 50-69, representing around 45000 women, are invited biennially, unless they actively have asked not to be invited. We have evaluated the programme with regard to the European guidelines for quality assurance in breast cancer screening and diagnosis, to assess performance and impact.Methods: The target population was identified through the national population register, identifying all women meeting the inclusion criteria in terms of age and place of residence, migration and death. The mammography programme supplied data on all invited women, participation and screening test results. Oncological data was retrieved from the National Cancer Register and the Danish Breast Cancer Group. Data was linked using the Danish unique personal identity number.Results: In the first invitation round (1991-1992) the invasive cancer detection rate was 10/1000 and was by the 8th invitation round (2006-2007) 8/1000. The in situ detection rate has been 1/1000 throughout the period. The programme sensitivity is approximately 70%. The detection rate of small tumours (≤ 10mm) was, on average, 39% over the first 4 invitation rounds and 62% by the 8th invitation round. The benign to malign ratio changed from 1:1.6 to 1:11.4, from the first to the 8th invitation round. Recall rates at initial screen dropped from 7% to 4% in the period, and for subsequent screens from 4% to 2%. The false positive rate was 5.5% in the first invitation round and had by the 8th invitation round dropped to 1.3%, with a cumulative risk of 15% over 8 rounds. In the 8th invitation round, there was 82% coverage, a participation rate of 61% and a long term adherence of 50%.Conclusions: The results for the majority of indicators were well within the recommended levels. There had been a significant improvement in the benign to malign ratio, despite that the false positive rate at assessment had decreased. The detection of small tumours had also improved significantly. Participation rates were, however, lower than recommended.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 4005.
Does the Additional Prognostic Benefit of Screen Detection in Early Breast Cancer Apply to All Patients?
Authors: Mansell J. , Komolafe O. , Angerson W. , Wilson C. , Doughty J. 
Published: December 2010

Abstract
IntroductionScreen detection may confer prognostic benefit independent of disease stage in EBC leading to suggestions that mode of presentation should be considered when deciding adjuvant therapy. We aim to determine if this additional prognostic benefit is seen in all patients.MethodsData from 3 centres in Glasgow of consecutive women aged between 50-65yrs with EBC diagnosed between 1995 and 2001 were examined. Patients were grouped by mode of presentation into screen detection and symptomatic. Breast cancer specific survival was the endpoint. Multivariate analysis including interaction between mode of presentation and pathology was performed with further subgroup analysis if the interaction was significant.Results1534 women were included with a median follow up of 5.5yrs. Mode of presentation was screening in 1007 (65.6%) women. After adjustment for pathology screen detection had no significant survival benefit: HR 0.73 (0.50-1.08, p = 0.116). Mode of presentation had an independently significant interaction with both nodal status and ER status (p = 0.003 and p = 0.01 respectively). Further analysis demonstrated that screening was an independent predictor of survival in the 1-3 node positive group (HR 0.33 (0.15-0.73), p = 0.006); the ER positive group (HR 0.53 (0.31-0.89), p = 0.017) and in the moderate NPI group only (HR 0.54 (0.31-0.94), p = 0.030).ConclusionsThese results provide evidence of a significant interaction between mode of presentation and pathology. Further research is needed before incorporating mode of presentation into decisions regarding adjuvant therapy.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 4007.
Should the Age of Breast Cancer Screening for Ethnic Minorities Be Reduced?
Authors: Soumian S. , Sircar T. , Whisker L. , Skillman J. , Abbott N. , Winter H. , Kaur V. , Kearins O. , Lawrence G. 
Published: December 2010

Abstract
IntroductionThe National Health Service Breast Screening Programme (NHSBSP) offers breast screening every three years for all women aged 50 and over in the United Kingdom (UK). Women aged between 50 and 70 are routinely invited. The NHSBSP will extend the age range of women invited for breast screening from ages 47 to 73 in the future. However, the ideal age for screening should take into consideration the relative risk of the population. The UK has a significant population of ethnic minority groups, mainly Asian and Afro-Caribbean, comprising of about 8% of the total population. The ethnic minority groups have remained geographically concentrated in specific regions especially London and West Midlands, where they comprise 30% and 14% of the population respectively. It has been reported that ethnic minorities present with relatively advanced breast cancer at a younger age. These groups could potentially benefit from early screening. We wanted to test this hypothesis by assessing the age and route of presentation of breast cancer across ethnic groups in the West Midlands region.MethodsThe West Midlands Cancer Intelligence Unit (WMCIU), a population based registry, collects prospective data on breast cancer diagnosed and treated in this region. Data on patients treated for breast cancer from 2001 to 2007 was obtained from the WMCIU. The age and route of presentation (screening or symptomatic) of Asian, Afro-Caribbean and Caucasian patients were analysed and compared.Results.A total of 27,444 female patients were diagnosed during this period. Data regarding ethnicity was available for 18,941 Caucasians, 528 Asians and 274 Afro-Caribbean's. Diagnosis through screening was 37%, 26% and 29% for Asian, Afro-Caribbean and the Caucasian population respectively. In the symptomatic group, 26.5% of Asians and 35% of Afro-Caribbeans presented below the age of 47 years compared to 13% of the Caucasian population. Furthermore, 13.5% of Asians, 16.5%of Afro-Caribbeans and 5.9% of Caucasians presented at or below the age of 40 years.ConclusionA significant percentage of breast cancers diagnosed within ethnic groups will still be missed despite revising the screening age to 47 years. Unless the participation of ethnic groups in screening is targeted, the benefits (detecting disease at an earlier stage and potentially reduced mortality) will be lost.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 4008.
Diagnostic Work-Up of Contralateral Breast Cancers Has Not Improved over Calendar Period.
Authors: Sandberg M. , Hartman M. , Hall P. , Czene K. 
Published: December 2010

Abstract
Background: Contralateral breast cancer (CBC) is diagnosed in 1-2.6 % of all breast cancer patients directly at diagnosis, after that the risk still remains high (0.7% per year) throughout life of the patient. Breast cancer patients are followed up by palpation and clinical mammography after their diagnosis, partly to be able to diagnose a possible CBC. The aim of this study is to investigate if the diagnostic work-up of patients with breast cancer has improved over the last thirty years and resulted in earlier CBC diagnosis.Materials and Methods: Synchronous contralateral breast cancer is here defined as two cancers occurring maximum 3 months apart, cancers with longer latency time are defined as metachronous. The study population is restricted to patients with maximum three years between the two cancer diagnoses. In this study we used two cohorts; all CBCs in Sweden 1976-2004 (N: 3260), and all CBCs in Stockholm during 1976-2005 (N: 688), the smaller cohort had more detailed information. The study participants were selected from two population-based registers (Sweden Cancer Register and Stockholm Breast Cancer Register). With logistic regression we calculated the odds ratio of being diagnosed synchronously, as compared to metachronously, adjusted for calendar period and age at first diagnosis.Results: The risk of synchronous diagnosis was increased by 27% per each 5-year period, the change was statistically significant. We then investigate if this risk increase by calendar period was due to improved clinical work-up, by including detection mode in the model. We found that the risk estimates for calendar period persisted, thus giving no evidence for improvement of clinical work-up during the study period. This result did not change when stratifying the study population by age at first diagnosis (below/above 55). Next, we instead included adjuvant therapy for the first cancer in the model and the association with calendar period decreased to non-significant levels. We also showed that the proportion of CBCs detected trough clinical work-up has not increased over calendar period (p=0.89), neither when including, nor excluding, screening mammography as part of the work-up. The mean tumour size of the contralateral breast cancer was 16.0 mm and has not decreased over the study period (p:0.62)Discussion: We found an increase in the proportion of synchonous CBCs compared to metachronous over calendar period, this change is not associated with clinical work-up, but with adjuvant therapy. This study gives no indications of any improvement in diagnostic work-up of contralateral breast cancer over the last thirty years. Such an improvement would potentially be very important for survival of the growing population of (first) breast cancer survivors.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 4011.
Breast Lesions of Uncertain Malignant Potential: A Challenge for Surgeons.
Authors: Deslauriers N. , Leblanc G. , Sidéris L. , Dubé P. , Leclerc Y. , Dufresne M. 
Published: December 2010

Abstract
Background: The need for surgical resection of brest lesions of uncertain malignant potential diagnosed at core biopsy is not well established. The aim of our study was to determine the incidence of these lesions on core biopsy and to find the rate of upgrade at surgery and during follow-up.Material and Methods :All breast biopsies at Maisonneuve-Rosemont hospital were prospectively collected from November 1999 to December 2008. We reviewed the records of all patients diagnosed with lobular carcinoma in situ (LCIS), atypical lobular neoplasia (ALH), atypical ductal hyperplasia (ADH) and radial scar during that period. Patients were excluded if there was also presence of invasive carcinoma or ductal carcinoma in situ on the biopsy. An upgrade was defined as the presence of invasive carcinoma or ductal carcinoma in situ on the surgical specimen.Results: During that period, 9325 breast biopsies were done. The women were aged from 37 to 89 years with a mean age of 56 years and were followed for an average of 27 months .There were 20 patients with LCIS (0.2%), 36 ALH (0.4%), 60 radial scars (0.6%) and 110 ADH (1.2%). For lobular neoplasia, 85% of LCIS patients had surgical resection with an upgrade rate of 29% (5/17). On follow-up no patients developed a breast cancer at the site biopsied. 28% of ALH had surgical resection with only one patient presenting an upgrade. For radial scars 58% had surgical resection with an upgrade rate of 3/35 (8%). In all three patients with an upgrade, the biopsy was done on an hypoechogenic lesion. No patients with a radial scar visible only on mammogram presented an upgrade and no patients on follow-up developed a cancer at the site of biopsy. For patients with ADH, 48% had a surgical excision (53/110) with an upgrade rate of 18.9% (9/53). Nine patients of the 49 who did not undergo a surgical excision developed a cancer at the site of biopsy during follow-up (18%). Also, during follow-up, 51% of the patients with ADH who did not have surgery had to be rebiosied around the site of the previous biopsy.Conclusion: The important rate of upgrade in LCIS and ADH mandates a surgical excision when these lesions are found on biopsy results. Also, surgical excision for women with ADH might spare the stress of repeat investigation and biopsy.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 4012.
Retrospective Study Assessing the Role of MRI in the Diagnostic Procedures for Early Breast Carcinoma: A Correlation of New Foci in the MRI with Tumor Pathological Features.
Authors: Calvo Plaza I. , Ugidos de la Verga L. , Miró C. , Suarez A. , Perez P. , Quevedo P. , Parras M. , Torres M. , Herrero M. , Buelga P. , García L. , Alonso P. , de la Cruz J. , López Ríos F. , Hidalgo M. , G Estévez L. 
Published: December 2010

Abstract
Purpose: To analyze the role of MRI in the detection of additional disease and the need to perform additional biopsies in early breast carcinoma patients. In addition, to correlate the detection of new foci with tumor pathological features.Methods: Early breast carcinoma patients that had undergone a MRI as well as a mammography as diagnostic procedures were included in the study. The following pathologic features were studied: carcinoma type, histological grade, estrogen (ER)/progesterone (PR) receptors, HER2 and Ki67. HER2 status was established by FISH, while ER, PR and Ki67 status were established by inmunohistochemistry. Univariate analysis was conducted to ascertain significant correlation among detection of new foci and each of the tumor pathological features.Results: To date, data from 98 patients have been analyzed: median age 49 years (range: 35-79); carcinoma type: a) infiltrative ductal carcinoma (n=73, 74%), b) infiltrative lobular cancer (n=13, 13%), c)ductal carcinoma in situ (n= 6, 6%); amplified HER2 (n=18, 18%); grade III (n=33, 33%);Ki67 ≥ 25%(n=33, 33%); positive ER and PR (n=78, 79%); triple negative tumors (n=8, 8%). MRI detected additional disease in 38 cases (39%) that led to an additional biopsy in 20 cases (20%). Thirty-nine patients (39%) underwent mastectomy. A statistically significant correlation was established between the finding of new foci in MRI and high proliferative tumors through the biomarker Ki67 (cutoff ≥ 25%) (p&lt;0.005). No other statistically significant correlation was established with any of the other pathological features analyzed.Conclusion: In patients diagnosed with early breast cancer, MRI detected the presence of additional disease in 39% of the cases, requiring an additional biopsy in 20% of the cases. Tumors with high proliferative index were significantly correlated with the detection of new foci in MRI. An update of the results will be presented at the symposium.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 4018.
The Effect of Preoperative MRI on Mastectomy Rates in Breast Cancer Patients.
Authors: Cobain E. , Hong S. , Abe H. , Jansen S. , Jaskowiak N. , Newstead G. , Olopade O. 
Published: December 2010

Abstract
Background: Currently, there are two primary surgical options for the treatment of early stage breast cancer: modified radical mastectomy and breast conserving surgery (BCS) with post-surgical radiation. Numerous studies have shown that there is no survival difference between the two surgical treatments, however, in recent years, there is data to suggest that mastectomy rates have been on the rise. While many factors undoubtedly influence surgical management decisions in breast cancer patients, the effect of routine use of preoperative breast MRI may be a contributor to the rise in mastectomy rates. Methods: Breast cancer patients who were treated surgically and received a preoperative MRI were identified using a database from the University of Chicago Department of Radiology, which contains information on over 4200 patients who have received breast MRI since 2002. These patients were cross-referenced with data from the University of Chicago Cancer Registry, which contains information regarding type of surgical treatment, surgeon, stage of cancer at time of diagnosis and surgical stage for all breast cancer patients treated at the University of Chicago Hospitals from 2000-2007. Annual mastectomy rates from 2000-2007 were calculated and compared using Pearson's Chi Square test. Annual mastectomy rates were stratified by mean age at diagnosis and stage of disease. Mastectomy rates prior to routine use of preoperative MRI (2000-2002) and after routine use of preoperative MRI (2005-2007) were calculated for breast cancer patients under 45 and over 45 years of age and rates were compared using Fisher's exact test. Results: A total of 1,404 patients received surgical treatment for a new diagnosis of breast cancer between 2000 and 2007 at the University of Chicago Hospitals. Results to date indicate that mastectomy rates across all years are not significantly different (p = 0.315). Results also indicate that the mean age at diagnosis of patients who receive mastectomy as the initial surgical treatment for their breast cancer is higher than those who receive BCS from 2000-2002, but is lower than those who receive BCS from 2003-2007. In addition, breast cancer patients under the age of 45 have higher rates of mastectomy since the routine use of preoperative MRI which trends toward statistical significance (p = 0.0598). Conclusion: These preliminary results indicate that overall mastectomy rates at the University of Chicago Hospitals are not increasing in concordance with the increased use of preoperative MRI testing, but that younger breast cancer patients may have higher rates of mastectomy in the MRI era.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 4019.
Evaluation of Neoadjuvant Chemotherapeutic Effects of Breast Cancer by MRI: Accuracy of MRI in Predicting Pathological Complete Response.
Authors: Fukuda T. , Gomi N. , Miyagi Y. , Tokudome N. , Takahashi S. , Ito Y. , Iwase T. , Akiyama F. 
Published: December 2010

Abstract
Purpose: The importance of the evaluation of pathological complete response (pCR) has been confirmed by the fact that, there is a close correlation between pCR to neoadjuvant chemotherapy (NAC) and prognosis for breast cancer. The objective of our study was to evaluate the accuracy of MRI in predicting CR after NAC.Methods and Materials: 305 women with stage IIB-III palpable solid breast cancer received adriacin(50mg per sqare meter), cyclophosphamide(500mg per sqare meter), plus fluorouracil(500mg per sqare meter) for 6 cycles, followed by 12 cycles of paclitaxel (80mg per sqare meter) or 4 cycles of Docetaxel (75mg per sqare meter) as NAC. They underwent dynamic contrast-enhanced T1WI of the entire breast, before and after NAC. On imaging, complete response (iCR) was defined as no enhanced tumor on all serial images. All patients underwent radical or conservative surgery between Jan. 2005 and Dec.2007, and imaging findings were compared with pathologic findings.Results: 43 out of 305 patients had iCR after NAC. 23 out of the iCR (53%) were identified correctly with pCR (no histological evidence of invasive tumor cells). Yet in 20 out of iCR patients (47% ), MRI underestimated the residual tumor. In 17 out of the 20 patients who were underestimated on MRI, resected specimens showed marked response to chemotherapy and only a small amount of residual tumor was detected. In 3 out of 20 patients who were underestimated on MRI, resected specimens showed mild response to chemotherapy, and considerable amount of residual tumor among fibrotic change was detected.Conclusion: MRI seems to reflects pathological conditions after neoadjuvant chemotherapy effectively, and appears to provide good correlation with pCR.53% of the patients who were evaluated as iCR were pCR.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 4026.