bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract P4-11-17: Can We Specifiy the Minimum Breast Size at Which Therapeutic Mammoplasty Should Be Considered To Mitigate Radiotherapy Toxicity in Patients Undergoing Breast Conserving Surgery for Breast Cancer?
Authors: Lambert KV , Tanteles GA , Mills J , Murray R , Chakraborti P , Chan S , Cheung KL , Osman A , Peat I , Woodings P , Barwell J , Talbot C , Symonds P , Shokuhi S , Stotter AT. 
Published: April 2011

Abstract
Background
For breast cancer patients undergoing breast conserving surgery, local complications after breast radiotherapy have in the past been shown to be proportional to breast size. Therapeutic mammoplasty is an option to extend the role of breast conserving surgery. In our units, it has been used in larger breasted women undergoing breast conserving surgery to reduce the risk of local radiotherapy complications.
Aim
The aim of this multicentre study was to determine, with modern radiotherapy dosing schedules, if it is possible to specify a minimum bra cup size at which therapeutic mammoplasty should be considered.
Methods
Recurrence free breast cancer patients (at least 3 years post conservative surgery and radiotherapy) were identified from three oncology follow up clinics in the United Kingdom.
50Gy in 25 fractions over 5 weeks prescribed to the 100% isodose at the ICRU reference point, on the central outline of the breast had been a typical dosing schedule. Radiotherapy effects were graded using the Late Effects of Normal Tissue-Subjective Objective Management Analytical (LENT-SOMA) score. A score of two or above was taken as representing that the particular toxicity variable was present. The relationship between radiotherapy toxicity variables was calculated using the Pearson correlation co-efficient.
Results
479 breast cancer patients were assessed. Increasing cup size correlated with oedema (Pearson correlation co-efficient r=0.30, p=&lt;0.0001), induration (r=0.31, p=&lt;0.0001), telangiectasia (r=0.24, p=&lt;0.0001), breast retraction (r=0.15, p=0.002) and pain (r=0.10, p=0.030). 2.3% of patients with cup size AA/A exhibited fibrosis, 6.6% with cup size B or C, 11.8% cup size D and 25.5% with cup size DD and above. Conclusion
Local radiotherapy complications following breast conserving surgery for breast cancer remain proportional to breast size even with modern radiotherapy equipment and dosing schedules. This effect is most pronounced in women with a bra cup size D and above. For these women, therapeutic mammoplasty should be considered. Further work to identify the genetic determinants of normal-tissue radiation damage is underway to optimise the surgical decision.
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P4-11-17.
Abstract P4-11-20: Integration of SPECT/CT Lymphoscintigraphy into Breast Cancer Radiation for Lymphatic Sparing
Authors: Cheville AL , Petersen IA , Brinkman DH , Ward SB , Mullan BP , Durski J , O'Connor MK , Schomberg PJ , Yan E , Garces YI , Laack NN. 
Published: April 2011

Abstract
Lymphedema (LE) is a common complication of cancer treatment, and has been identified as the number one issue by breast cancer survivors with incidence as high as 70%. Given the long-term survivorship of these women, LE is a widely prevalent condition. Irradiation of axillary and supraclavicular lymph nodes increases a patient's risk of LE onset and progression by as much as 2-fold. It is anticipated that a more individualized approach to post-surgical irradiation of breast cancer patients may reduce radiation-induced lymph node (LN) damage without sacrificing control rates, although it is noted that a definitive radiation exposure threshold below which LNs physiological integrity will be preserved is currently lacking.
To identify the locations of the small, non-pathological but physiologically relevant LNs which drain the arm after breast cancer surgery and incorporate them into radiation planning, filtered 99mTc sulfur colloid (TcSC) was administered and a SPECT-CT scan was acquired for 22 patients immobilized in the treatment position. These images were registered with the Radiation Oncology planning CT scan, and draining LN were contoured automatically using a threshold of 50% maximum intensity.
Two treatment plans were generated for each patient, one per routine clinical practice (STD) and the other (MOD) with treatment fields modified to minimize dose to the LNs visible on SPECT/CT images while ensuringthat ≥50Gy or biologic equivalent is delivered to target tissues. 53 draining LN were identified, 54% of which were inside the STD plan fields but could be blocked in the MOD plan fields. 62% of LN in the STD plans vs. 17% in the MOD plans receiving a mean of ≥10Gy, and 27% in the STD plans vs. 6% in the MOD plans receiving a mean of ≥40Gy.
Patient-specific LN dose reduction can be achieved through integration of SPECT/CT images into the radiation planning process. These patients will be followed for the development of LE, to estimate an exposure threshold below which LN preservation is assured.

Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P4-11-20.
Abstract P4-11-21: Dosimetric Comparison of Radiotherapy for Left Sided Breast Cancer: Breath-Hold Versus Free-Breathing
Authors: Zagar TM , Palta M , Catalano S , O'Neill L , Yoo S , Horton J , Prosnitz LR. 
Published: April 2011

Abstract
Background: Radiotherapy for left sided breast cancer potentially increases risk for late toxicity to the heart. The simple technique of breath-hold (BH) can be instituted in an attempt to reduce volume of lung and heart irradiated in tangential fields. We report on patients with left sided breast cancer that were planned both with conventional free-breathing (FB) and BH radiation techniques from a single institution.
Methods: From 10/2006 to 5/2010, 20 patients with node-negative, early stage breast cancer underwent CT simulation for left sided breast cancer and were selected for analysis in this report. FB and BH CT scans were obtained and treatment plans using opposed tangential fields were created to compare various dosimetric indices.
Results: BH plans resulted in lower doses to the heart (max dose 1774 vs. 4560cGy, P&lt;0.0001; mean dose 175 vs. 296cGy, p=0.0178; V25 0 vs. 1.85%, P&lt;0.0001; volume in tangential field 0 vs. 10.11cc p=0.0002) compared to FB. The ipsilateral lung received lower doses but a larger volume of lung was encompassed in the tangential fields (V20 13.32 vs. 20.32%, P&lt;0.0001; mean dose 741 vs. 1025cGy, p=0.0003; volume in tangential field 198.8 vs. 256.8cc P&lt;0.0001) compared to FB.
Conclusions: Treatment of early stage left sided breast cancer with BH technique is a simple method for minimizing cardiac and ipsilateral lung dose. Long term follow-up is necessary to demonstrate if these dosimetric differences translate into clinically meaningful differences.
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P4-11-21.
Abstract P5-01-06: 18[F]-FDG Tumoral Uptake and Metabolic Response after 1 Cycle of Primary Chemotherapy According to Tumoral Phenotype of Breast Cancer
Authors: Berriolo-Riedinger A , Humbert O , Riedinger J-M , Arnoud L , Coudert B , Dygai-Cochet I , Cochet A , Toubeau M , Fumoleau P , Brunotte F. 
Published: April 2011

Abstract
To compare the 18[F]-FDG-PET (PET) metabolic characteristics in triple-negative, luminal and positive HER2 breast cancer. Material and Methods: One hundred and forty-five patients with newly diagnosed locally advanced breast cancer were evaluated. Twenty one metastatic patients (discovered in baseline PET) were excluded and 9 patients were lost. One hundred and fifteen had undergone FDG PET before and after the first course of neoadjuvant chemotherapy. Breast cancer lesions were imaged at 80-90 minutes after administration of FDG. Maximum standardized uptake values (SUV) were measured at both time point (SUV1 and SUV 2). Metabolic response was measured by the relative decrease of SUV (ΔSUV). Using Immunohistochemistry as a surrogate for expression profiling, the tumours were classified as follows: triple negative defined by the lack of oestrogen receptors, progesterone receptors and human epidermal growth factor receptors 2 (HER2) expression, luminal (hormonal receptor positive, HER2 negative) and HER2 positive (overexpression of HER 2). Relationships between baseline [18F]-FDG uptake and clinical, histopathological and biological parameters were assessed by Mann-Whitney test. Relationships between SUV1, SUV2, ΔSUV and the tumoral phenotype were assessed by Kruskal-Wallis test.
Results: In the overall population the mean ±SD SUV1, SUV2 and ΔSUV values were 6.7± 5.9, 3.7± 3 and −36.7% ± 35.7%, respectively. Significant relationships were found between baseline FDG uptake and initial clinical and histopathological parameters : a high mitotic activity (p≥0.0001), a high nuclear pleomorphism (≥0.0002), a high tumour grading (p≥0.0001) and a negative oestrogen hormonal receptor status (p≥0.0001) were associated with a high baseline SUV. Patient age, lymph node involvement, architectural differentiation, progesterone hormonal receptor and HER2 status were not found to be related with SUV values.
Metabolic characteristics (mean ± SD) according to tumoral phenotype:
Conclusion: Our results show a significant positive relationship between the baseline FDG uptake and the proliferation markers, the tumour grading, the number of mitoses and the nuclear pleomorphism. A significant negative relationship was found between the baseline FDG uptake and the oestrogen hormonal receptor status. The triple negative phenotype was associated with higher baseline FDG uptake and higher residual FDG uptake after one course of chemotherapy commensurate with their aggressive biology. Luminal tumours showed a lower ΔSUV reflecting their lower chemosensibility.

Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P5-01-06.
Abstract P5-01-10: Tumor Optic Properties Measured Using Diffuse Optic Spectroscopy Imaging Correlate with Proliferation and Glucose Metabolism in Breast Cancer Patients
Authors: Ueda S , Cerussi AE , Carpenter PM , Roblyer D , Durkin A , Hsiang D , Mehta RS , Butler JA , Tromberg BJ. 
Published: April 2011

Abstract
(Background) Diffuse Optic Spectroscopy Imaging (DOSI) is non-invasive imaging technology that employs near-infrared (NIR) light to quantitatively characterize the hemodynamic and metabolic properties of breast cancer tumors.
(Methods) We utilized DOSI to measure baseline tumor concentrations of oxy-hemoglobin (ctO2Hb), deoxy-hemoglobin (ctHHb), total hemoglobin (ctTHb), oxygen saturation (stO2), as well as water and lipid content of tumors from sixteen patients with primary breast cancer prior to neoadjuvant chemotherapy. Core-needle biopsy specimens were also collected from these patients and analyzed for Ki67, Glut-1, and Fatty acid synthese (FAS), biomarkers of cancer proliferation, glucose metabolism and fatty acid metabolism, respectively. These optic and biological biomarkers were statistically compared to each other and to overall therapy response. (Results) Ki67 score was positively correlated with baseline levels of ctO2Hb (µM) (r = 0.51, p = 0.04), ctTHb (µM) (r = 0.51, p = 0.05), and stO2 (%) (r = 0.57, p = 0.02), and negatively correlated with lipid content (%) (r = -0.52, p = 0.04). Tumors with positive Glut-1 status (n=8) showed significantly higher baseline levels of ctO2Hb (26.2±12.5 v.s 19.9±10.1, p = 0.04), ctTHb (41±13.3 v.s 27.5±11.7, p = 0.05), and stO2 (81.1±6.6 v.s 70.2±9.9, p = 0.02) and lower baseline levels of lipid (49±17.1 v.s 66.2±10.4, p = 0.03) compared to those with negative Glut-1 status (n = 8). There were no correlation between FAS and the optic properties. Five (31.3%) of 16 tumors achieved pathologic complete response (pCR) after completion of chemotherapy followed by surgery. Tumors with pCR showed higher stO2, higher Ki67 score and higher likelihood of Glut-1 expression than those with non-pCR (p = 0.009, 0.01, 0.03, respectively).
Only p-values with statistical significance were described.
(Conclusion) Higher tumoral expression levels of Ki67 and Glut-1 were correlated with higher oxygenation and lower lipid concentration and associated with a pathologic complete response to chemotherapy. Non-invasive optic properties measured using DOSI are potential surrogate markers for tumor proliferation and glucose metabolism.

Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P5-01-10.
Abstract P5-01-11: Monitoring Primary Medical Therapy with Three-Dimensional Optical Mammography
Authors: Enfield LC , Cantanhede G , Gibson AP , Hebden JC , Douek M , Purushotham A. 
Published: April 2011

Abstract
Background: Optical tomography is a functional imaging technique using near-infrared (NIR) light to produce three-dimensional (3D) breast images of tissue oxygen saturation and haemoglobin concentration. The advantages include the lack of ionising radiation and the quantative physiological information obtained. With increasing use of primary medical therapy, there is a need for a non-invasive functional imaging tool to evaluate response to treatment. Optical tomography was evaluated for monitoring early response to treatment.
Materials and Methods: Women with newly diagnosed breast cancer, suitable for primary medical therapy, were recruited. Changes in physiological and optical properties within the tumour were evaluated during the course of neoadjuvant chemotherapy or endocrine therapy. For patient undergoing neoadjuvant chemotherapy, optical imaging wasperformed prior to treatment, at 2 week, halfway through and on completion of chemotherapy. Images of light absorption and scatter, haemoglobin concentration ([HbT]) and oxygenation (SO2) are produced. Results: To date, ten women have been recruited to the project, and are being scanned throughout the course of their treatment. Five women are undergoing neoadjuvant chemotherapy and five are undergoing endocrine treatment prior to surgery. Nine women have been scanned more than once with five women scanned three times, and one has completed the protocol. The contrast between the tumour and the background tissue was calculated and any changes in ROI contrast and physiological parameters tracked. Initial scans show an increase in [HbT] and a decrease in SO2 in the region of the tumour. Changes in contrast and [HbT] in the tumour ROI can be seen early in treatment. A 45 year old patient was being treated with neoadjuvant taxane chemotherapy for a 26x21x34 mm Grade 2 carcinoma. The tumour [HbT] was 43.95±4.20 μM prior to treatment, falling to 25.6±6.43 μM by Week 9 and 19.19±0.36 μM by Week 18 of treatment and 23.5871± 1.6616 at the final scan. Background tissue [HbT] remained constant at ∼21±4 μM. Biopsy results classified the patient as a good responder to treatment. Initial data from other patients show changes in [HbT] at the two week scan, some showing a decrease and others show an increase in measured [HbT]. Future work will include correlation of optical data with clinical MRI findings, biopsy results and clinical outcome. Discussion: Optical imaging of the breast is feasible during primary medical therapy and can be used to assess response to treatment.
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P5-01-11.
Abstract P5-01-12: Specific Tumor Component Spectrum as a Predictor of Response to Neoadjuvant Chemotherapy in Breast Cancer
Authors: Xu S , Cerussi AE , Tromberg B , Gratton E. 
Published: April 2011

Abstract
BACKGROUND: Monitoring individual tumor response to neoadjuvant chemotherapy could provide surrogate markers for oncologists to adjust therapeutics in order to minimize collateral damage from ineffective therapies. Diffuse optical spectroscopy imaging (DOSI), by increasing the wavelength range and resolution, has been employed to characterize malignant tumor and its response to neoadjuvant chemotherapy since it measures the abundance in the four major chromophores (lipid, oxy-hemoglobin, deoxy-hemoglobin and water). Through the application of a spectral analysis method, Self-Referencing Differential Spectroscopy (SRDS) analysis, which accounts for only intersubject variability, a novel optical intrinsic biomarker which is unique to cancer was revealed. By fitting the difference spectrum between tumor and normal tissues to the four component basis spectra, the residuals disclose a spectral fingerprint called specific tumor component (STC) spectrum which contains specific absorption bands which separate normal from abnormal tissue and benign from malignant tumors.
PATIENTS AND METHODS: 14 patients were enrolled in this study and all the subjects provided informed written consent according to an institution-approved protocol. Measurements were taken pre-, post-neoajuvant chemotherapy and the midpoint in the treatment. The chemotherapy regimen is 2-4 cycles of doxorubicin-cyclophosphamide (A/C), followed by 2-4 cycles of carboplatin-taxol/abraxane-avastin (nabTC). Tumor classification was confirmed by pathology reports and 8 out of 14 patients were classified as complete responders (CR); the rest as noneresponders (NR). Pre and post-treatment STC spectra were compared in different pathological responding categories. Data were analyzed by using custom software designed for Matlab. The concentrations of NIR absorbers will be calculated from a spectral model of tissue absorption by using the basis spectra. For the SRDS method, the absorption spectra will be further analyzed by using custom software (Elantest; Laboratory for Fluorescence Dynamics, Irvine, Calif, www.lfd.edu). Details of SRDS method has been described previously.
RESULTS: The shape of STC spectra for non-responders was well preserved since insusceptible tumor structure will remain basically unaffected during the chemotherapy. Whereas in the completed responders, the therapy-induced changes in tumor microvasculature, edema, and necrosis lead to a significant dissimilarity in STC spectra.
CONCLUSION: STC spectrum, as an endogenous in vivo biomarker, can predict pathological response in breast tumors treated with neoadjuvant chemotherapy.

Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P5-01-12.
Abstract P5-02-01: FGFR Signalling Drives the Growth of Triple Negative and Basal-Like Breast Cancer Cell Lines Both In Vitro and In Vivo
Authors: Turner N , Sharpe R , Johnson D , Pearson A , Ashworth A. 
Published: April 2011

Abstract
Background: Substantial evidence now links aberrant signalling by the fibroblast growth factor receptors (FGFRs) to the development of multiple different cancer types. The oncogenic drivers of triple negative and basal-like breast cancers are largely unknown and we examined for a potential role of FGFR signalling in the oncogenesis of triple negative breast cancer.
Methods: We examined the sensitivity of a panel of 40 breast cancer cell lines to the selective fibroblast growth factor receptor (FGFR) inhibitor PD173074.
Results: Triple negative (TN) breast cancer cell lines were more sensitive to PD173074 than comparator cell lines (p=0.0028), with half (8/16) of TN cell lines demonstrating significantly reduced growth. The majority of TN cell lines demonstrated only modest sensitivity to FGFR inhibition in two-dimensional growth, but were highly sensitive in anchorage independent conditions. PD173074 inhibited down stream MAPK signalling and induced cell cycle arrest and apoptosis. Basal-like breast cancer cell lines were found to express autocrine FGF2 ligand, and RNA interference targeting of FGF2 significantly reduced anchorage independent growth. Finally, PD173074 significantly reduced the growth of basal-like breast cancer cell line xenografts.
Conclusion: Basal-like breast cancer cell lines express autocrine FGF2 and demonstrate substantial sensitivity to FGFR inhibitors, identifying a potential novel therapeutic approach for these cancers.
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P5-02-01.
Abstract P5-02-02: Decreased Expression of Gremlin Correlates with Bone Metastasis and Poor Prognosis in Breast Cancer
Authors: Ye L , Mansel RE , Jiang WG. 
Published: April 2011

Abstract
Background: Bone morphogenetic proteins belong to TGF-β superfamily, which are a group of pluripotent factors, widely involved in prenatal and postnatal development and homeostasis of various tissues and organs. BMPs and their signaling have been indicated in tumorigenesis and progression of certain solid tumors. Recent studies have demonstrated a profound role played by Noggin, a BMP antagonist in bone metastasis from breast cancer, and have indicated a sound therapeutic potential. The current study examined expression of Gremlin, a BMP antagonist which is poorly understood in breast cancer, t, and its relevance to pathological and clinical parameters.
Methods: Breast cancer tissues (n=82) and normal background tissues (n=24) were collected immediately after surgery. The clinical follow-up was routinely performed after surgery. The median follow-up period was 120 months. The expression of Gremlin was examined in a breast cancer cohort using quantitative real time PCR and immunhistochemistry (IHC).
Results: IHC revealed a pattern of cytoplamic staining of Gremlin in mammary epithelial cells in breast tissues. Gremlin staining tended to be decreased in breast cancer, but there was no significant difference in its transcripts levels compared with that of normal background tissues. Gremlin transcripts were lower in both moderately differentiated and poorly differentiated tumors compared with well differentiated tumors. The level of Gremlin transcripts in primary tumors was decreased in the patients with poor prognosis (13343±6001) including those patients had local recurrence, metastases and died of breast cancer, p=0.023 when compared with 146209±56574 of patients remained disease free. This decreasing expression was also seen in the patients with disease specific bone metastases, which was 18834±13159 and p=0.032 compared to that of patients being disease free.
Conclusions: Taken together, decreasing level of Gremlin transcript in primary tumors of breast cancer correlates with bone metastasis and poor prognosis. Its implication in disease specific bone metastasis and therapeutic potential warrants further investigation.
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P5-02-02.