bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Population-Based Cross-Over Randomized Controlled Trial of Breast Cancer Screening with Alternate Mammography and Ultrasound for Women Aged 40 to 49 Years in Taiwan.
Authors: Huang C. , Fann C. , Hsu G. , Ho M. , Chang K. , Chen S. , Kon S. , Chen T. 
Published: December 2010

Abstract
Background: As there is paucity of data on population-based screening for breast cancer using mammography and ultrasound for oriental young women aged 40-49 years, the peak of incidence rate and high proportion of dense breast, we aimed to evaluate the relative performance of detecting breast cancer between ultrasound and mammography and also to assess complementary efficacy of ultrasound to mammography screening.Methods: A total of 79,691 female residents aged 40-49 years were invited from community in Taiwan since late 2003. These participants were first randomly assigned to mammography (n=20040), ultrasound (n=20088), and control group (n=39563). The two former groups were further done by a cross-over design with mammography and ultrasound on alternate year until 2008. Detection rate and annual incidence rate of interval cancer as a percentage of the control group (I/E ratio) were compared between mammography and ultrasound.Results: The attendance rate of the first round was 59% (11921/20040) for mammography and 56% (11249/20088) for ultrasound. The repeated attendance rate of both groups was 85% in the second round and 91% in the third round. In the first round of screen, the detection rate of breast cancer for the mammography group (0.34%) was 1.5-fold compared with the ultrasound group (0.22%). The additional detection rate was 0.16% contributed from a subsequent ultrasound screen and 0.36% contributed from a subsequent mammogram screen. The combination of mammography with ultrasound was as three to four times as likely to detect breast cancer compared with the control group (annual incidence rate was 0.17%). The I/E ratio was lower after mammography screening than that after ultrasound screening.Conclusion: The current randomized controlled trial not only demonstrated higher detection rate and better performance using mammography but also indicated the complementary role of ultrasound applied to young Taiwanese women. This further suggests the optimal screening modality for young women in Asian country is to combine mammography with ultrasound.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 73.
Is a Weekly Supervised Upper Limb Exercise Program of Value for Women with Early Breast Cancer?
Authors: Kilbreath S. , Refshauge K. , Beith J. , Simpson J. , Ward L. , Lee M. 
Published: December 2010

Abstract
The aim of this randomised single blinded study was to determine whether an upper limb exercise program, commencing 4-weeks after surgery for early breast cancer, prevents upper limb symptoms, such as pain, swelling, stiffness and weakness.Methods: 156 women, aged 52.5 ± 11.7 y, who had undergone either axillary node dissection (AND; n=94) or sentinel node biopsy (SNB; n=62) for unilateral breast cancer in combination with either mastectomy (n=74) or wide local excision (n=82) within the previous 4 weeks, participated. Women were randomised to either an 8-week exercise program (n=79) or to usual care (n=77); participants were stratified for type of axillary surgery (SNB or AND) and treatment site. The exercise program comprised a home program of daily passive stretching for shoulder muscles and resistance training using Thera-Band® on alternate days for muscles about the shoulder. Women also attended a weekly exercise session. Usual care included routine follow-up with their medical specialists, a breast nurse and a post-operative visit with the physiotherapist and occupational therapist who provided instructions about exercises. The primary outcome was self-reported arm and chest symptoms derived from the EORTC breast cancer specific questionnaire (BR23) which was scored out of 100 with a low score indicative of fewer symptoms. The secondary outcomes included physical measures of shoulder range of motion, strength, and swelling. Presence of lymphoedema (LE) was determined by the inter-limb impedance ratio, using bioimpedance spectroscopy.Results: After the 8-week intervention period, there was no significant difference between groups in either the self-reported or the physical measurements (Table 1).Table 1. Baseline and 8 weeks data (mean ± SD). Usual care group Exercise group Baseline8 weeksBaseline8 weeksSelf-report symptoms (max 100) Arm24.5 ± 14.514.6 ± 14.225.9 ± 18.512.5 ± 12.9Breast25.8 ± 16.219.2 ± 17.725.6 ± 19.217.1 ± 16.7Range of motion interlimb difference (deg) Flexion19.8 ± 19.06.9 ± 7.023.9 ± 19.05.4 ± 7.3Abduction14.5 ± 14.04.7 ± 8.821.1 ± 18.43.8 ± 8.1Inter-limb strength difference (Newtons) Flexion15.9 ± 21.55.6 ± 19.417.0 ± 21.84.0 ± 15.8Abduction20.0 ± 25.85.7 ± 19.725.2 ± 28.61.0 ± 19.3Swelling (n) Prevalence of LE (by impedance)7/7714/745/789/74 Conclusion: A weekly, supervised, 8-week upper limb exercise program is not warranted for all women with early breast cancer treated with surgery to the axilla. Usual care in which women are seen post-operatively by a physiotherapist, occupational therapist, and breast nurse with ongoing monitoring by the specialists is sufficient for most women.Acknowledgement: Supported by NSW Cancer Council
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 811.
Contralateral Breast Cancer in BRCA1/2 Mutation Carriers: Risk Assessment by Age at Diagnosis of the First Primary Breast Cancer.
Authors: Hooning M. , Heemskerk-Gerritsen B. , Jager A. , Collee M. , van den Ouweland A. , Menke - Pluymers M. , van Geel B. , van Doorn L. , Tilanus - Linthorst M. , Bartels C. , Seynaeve C. 
Published: December 2010

Abstract
Purpose Age at diagnosis of the first breast cancer is a known predictive factor of the risk of contralateral breast cancer (CBC) in BRCA1/2 mutation carriers. However, accurate risk estimates for different age subgroups are scarce.Methods We studied the risk of CBC in 560 women with a primary breast cancer (PBC) from families with a proven BRCA1 or BRCA2 mutation in relation to the age at diagnosis of the first PBC, taking into account history of oophorectomy. Time at risk was the period between diagnosis of the first PBC and date of contralateral breast cancer, contralateral mastectomy, metastatic disease, death or last follow-up. Oophorectomy was treated as a time-dependent covariate. Patients with bilateral breast cancer diagnosed before the first visit at the family cancer clinic were excluded.Results We observed 96 CBCs in 423 BRCA1 mutation carriers and 21 cases in 137 BRCA2 mutation carriers. Actuarial risk of CBC at 5, 10 and 15 years was 14%, 34% and 39%, respectively, for BRCA1-, and 13%, 22% and 27%, respectively, for BRCA2 mutation carriers. For BRCA1 carriers 10-year actuarial risk of CBC was 54% for women with a PBC ≤ 30 years, 39% for the group with PBC between 31-40 years, 26% for the 41-50 group and 17% for those with PBC &gt; 50 years. In BRCA2 carriers 10-year risk of CBC was 28% for women with a PBC ≤ 40 years, 19% for the 41-50 group and 10% for those with PBC &gt; 50 years. For BRCA1 carriers who had an oophorectomy, 10-year risk of CBC was 33% and 26%, respectively, for those with PBC younger and older than 40 years, against 44% and 24% in women who had no such treatment. In BRCA2 carriers with a history of oophorectomy 10-year risk of CBC was 21% and 14%, respectively, for those with PBC younger and older than 40 years, while the risk was 29% and 17%, respectively, in women without oophorectomy. Effect of adjuvant therapy is being analyzed and will be presented at the meeting.Conclusions The availability of risk estimates of CBC by more detailed age groups at PBC is a helpful tool in the counselling process concerning screening and/or preventive surgery for breast cancer patients with a BRCA1 or BRCA2 mutation.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 903.
Low Risk Ductal Carcinoma In Situ (DCIS) Treated with Breast Conserving Surgery & Accelerated Partial Breast Irradation (APBI): Comparison of the Mammosite Registry Trial with Intergroup Study E5194.
Authors: Goyal S. , Vicini F. , Beitsch P. , Keisch M. , Jeruss J. , Lyden M. , Haffty B. 
Published: December 2010

Abstract
Purpose/Objective(s): Recent data from Intergroup Study E5194 prospectively defined a low risk subset of ductal carcinoma in situ (DCIS) patients where radiation therapy was omitted after local excision alone. At 5 years, they found a 6.8% ipsilateral breast event rate (IBTR) in selected low/intermediate grade (LIG) patients and a 13.7% IBTR in selected high grade (HG) patients. The purpose of our study was to determine the IBTR in DCIS patients treated on the American Society of Breast Surgeons (ASBrS) MammoSite® Breast Brachytherapy registry trial who met the criteria of E5194 treated with local excision and adjuvant APBI.Material/Methods: A total of 194 patients with DCIS were treated between 2002 and 2004 on the Mammosite registry trial; of these, 69 patients met the enrollment criteria for E5194: 1. LIG: low to intermediate grade with a pathological size &gt; 0.3cm but &lt; 2.5cm and margins &gt;3mm (n=40) or 2. HG: high grade, pathological size &lt;1cm and margins &gt;3mm (n=29). All patients were treated with lumpectomy followed by adjuvant APBI (34 Gy in 3.4 Gy fractions). Median follow-up for surviving patients was 50.7 months (range, 0-73.4). Hormonal therapy was given to 51% of these patients (compared to 30% of patients on E5194). The clinical-pathologic data and long term outcomes for each patient were entered into a database for statistical analysis using SAS (v 8.2).Results: The median age of the entire cohort was 62.5 years. In the LIG cohort, the median size was 0.8cm. In the HG cohort, the median size was 0.6cm. In the LIG cohort, the 5-year IBTR was 0%, compared to 6.8% at 5 years in E5194. In the HG cohort, the 5-year IBTR was 5.3% compared to 13.7% at 5years in E5194. The overall the 5-year IBRT was 2% and there were no cases of elsewhere or regional failures in the entire cohort. The 5-year contralateral breast event rate was 0% and 5.6% in LIG and HG patients, respectively (compared to 3.5% and 4.2%, respectively, in E5194). The 5-year disease free survival and overall survival rate was 92.4% and 96.5%, respectively. In all patients with DCIS (n=194) treated with Mammosite on the registry trial, the 5-year actuarial IBTR, DFS, and OS was 3.1%, 93.8% and 98.2%, respectively.Conclusion: Adjuvant accelerated partial breast irradiation using Mammosite is a relatively convenient form of radiotherapy which shortens treatment time to 1 week. This study found that patients who met the criteria of E5194 treated with APBI had extremely low rates of recurrence (0% vs. 6.8% in the low to intermediate grade and 5.3% vs. 13.7% in the high grade). We conclude that all patients with DCIS who were eligible for E5194 have appreciable benefit from adjuvant APBI.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 951.
Our Inner Mouse: Genomic Insights from Mouse Mammary Cancer Models To Guide Pre-clinical Testing
Authors: Green J. 
Published: December 2010

Abstract
Accelerating the pre-clinical testing of novel therapies or combination therapies is an important goal of translational research. This is particularly true for identifying potentially new therapeutic approaches for triple-negative (TN) breast cancer (lacking expression of ER, PR and her2) for which no specifically targeted therapies currently exist. This sub-type of breast cancer, which generally falls into a basal category, has a poorer prognosis than breast cancers expressing ER/PR with a luminal phenotype. Most basal TN breast tumors have lost normal function of the tumor suppressor genes p53 and Rb. Using genetically-engineered mouse tumor models where p53 and Rb have been functionally inactivated through over-expression of SV40 T/t-antigens, we have identified a core gene expression (Tag) signature of about 150 genes involved in cell proliferation, cell replication, DNA repair, and apoptosis that is very relevant to human epithelial cancer. This signature, which is highly represented in the basal TN, C3(1)/SV40 T/t-antigen (Tag) mouse model of breast cancer, segregates human breast cancers with the basal TN phenotype and poor prognosis from luminal type tumors with a better prognosis. Based upon this cross-species analysis, we are determining whether genes within the Tag signature are potential therapeutic targets for basal TN breast cancer using human basal breast cancer cell lines and cell lines derived from the C3(1)/Tag tumors. This is initially being assessed using siRNA, drugs that inhibit specific targets within the signature, drugs in clinical use and combinations of these to find potentially novel therapeutic approaches for basal TN tumors. Additionally, in vivo studies are being performed using both human xenograft and Tag tumor transplant models for preclinical testing of selected therapies. Unlike studies using human xenografts in immunocompromised mice, experiments using Tag tumor transplants can be performed in mice with an intact immune system, adding an important dimension to these pre-clinical studies. Our approach demonstrates the values of cross-species genomic analyses to identify an appropriate model of basal TN breast cancer for pre-clinical testing, potential therapeutic targets, and an accelerated means of performing pre-clinical studies.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr BS1-1.
The Evolving Role of Adjuvant Chemotherapy.
Authors: Winer E. 
Published: December 2010

Abstract
Decision-making for the medical oncologist was once far simpler than it is today. Following the 2000 NIH Consensus Conference on the treatment of early stage breast, almost all women with tumors &gt; 1cm or positive lymph nodes were offered a course of adjuvant chemotherapy. There were some choices to be made in terms of the specific adjuvant regimen, but the oncologist could rely upon the results of large, randomized trials and choose a regimen that had been shown to be beneficial. Indeed, some might argue that a medical oncologist in 2009 could take the same approach. But the breast cancer world has evolved substantially over the past 5-7 years, and such an approach would not take full advantage of our understanding of breast cancer in 2009. We now understand that there is a great degree of intrinsic heterogeneity across breast tumors, and that the benefits associated with adjuvant chemotherapy vary substantially by subtype of disease. At minimum, we should consider three groups of patients separately: 1) individuals with HER2 positive disease; 2) individuals with triple negative disease; and 3) individuals with ER+ and HER2 non-amplified, non-overexpressed disease, who represent the vast majority of the patients with breast cancer in the United States. For patients with HER2+ disease, trastuzumab-based therapy has become the standard of care for all but women who have very small (T1a) tumors in the setting of negative lymph. Even in those women, there are physicians who would recommend a course of adjuvant trastuzumab-based chemotherapy. The major question is what chemotherapy to use in combination with trastuzumab, and this is a matter of considerable debate. In addition, uncertainty exists surrounding the optimal treatment for individuals who have indeterminate HER2 test results. For women with triple negative breast cancer, chemotherapy is also given to almost all patients apart from those with the very smallest tumors in the context of negative lymph nodes. For most patients, one of the standard anthracycline-taxane regimens remains the usual course of therapy. For patients with a low disease burden, first or second generation regimens such as AC, TC, or CMF are reasonable considerations. The most difficult questions arise concerning the use of chemotherapy in women with ER+ and HER2 normal disease. In this setting, the average benefit associated with chemotherapy is far less than in women with HER2+ or triple negative disease. Recent retrospective studies suggest that there are large groups of women who likely derive almost no or almost no benefit from chemotherapy. Increasingly, assays such as the Oncotype Dx Recurrence Score are used to aid clinical decisions, but even these complex genetic assays do not always provide a clear roadmap. Controversies and practical considerations surrounding the use of chemotherapy in women with ER+ and HER2 normal disease will be discussed in detail.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr CS1-2.
What Is the Histone Code, and Why Is It Important?
Authors: Oesterreich S. 
Published: December 2010

Abstract
The field of epigenetics is rapidly expanding, and has changed and revised traditional paradigms of inheritance. Epigenetics, literally “beyond genetics” or “in addition to genetics”, is defined as the study of heritable changes in gene expression that occur without a change in DNA sequence. Within this presentation, I will focus on modifications of histones, an important mechanism to convey epigenetic information. Histones, small proteins which serve as spools for DNA wrapped in nucleosomes, are critical regulators of the dynamic state of chromatin. They are subject to numerous posttranslational modifications, including acetylation, methylation, ubiquitylation, and phosphorylation. The best characterized modifications are acetylations and methylations. Increased acetylation of histones by histone acetyltransferases is associated with gene activation due to weakened charge attraction between DNA and histone; histone deacetylases in contrast remove acetyl groups leading to gene inactivation. Histone methylation mediated by histone methyltransferases has either positive effects or negative effects on gene expression depending on location and association of other protein complexes. In general, it is difficult to predict gene regulation based on the study of a single histone modification, since it is the combination of these modifications, also called the histone code, which ultimately controls gene expression. I will discuss details of the histone modification, how they regulate gene expression, and also their relevance in disease, especially breast cancer.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr ES4-2.
Overview of the Randomised Trials of Radiotherapy in Early Breast Cancer.
Authors: Darby S. ,   on Behalf of the Early Breast Cancer Trialists' Collaborative Group
Published: December 2010

Abstract
The Early Breast Cancer Trialists' Collaborative Group (EBCTCG) was set up in the mid-1980s to co-ordinate 5-yearly meta-analyses of centrally collated individual patient data from women in all randomised trials of the treatment of early breast cancer. The present cycle considers trials that began by 2000 and includes follow-up to 2006 where available. The latest results from the overview of trials of radiotherapy versus the same management but without radiotherapy will be presented.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr MS3-1.
How Will the '4:1 Ratio' Change with Increasingly Effective Systemic Therapy.
Authors: Harris J. 
Published: December 2010

Abstract
The 4:1 ratio between a reduction in local recurrence at 5 years and a reduction in mortality at 15 years has been well established in clinical practice. The Ratio is particularly useful to estimate the survival benefit of adding RT, particularly in the postmastectomy setting where the use of RT is not routine. It is worth noting, however, that the 4:1 ratio is an average effect that is largely based on trials without systemic therapy and does not account for the interrelated issues of (1) competing risks of local recurrence and distant metastases, (2) biologic heterogeneity, and (3) the impact of (improving) systemic therapy. If the ratio becomes less than 4:1, it means that local treatment is even more important for long-term survival. In this talk, emerging data will be presented illustrating how the '4:1 ratio' is influenced by competing risks of local recurrence and distant metastases, biologic heterogeneity, and the impact of improving systemic therapy. The current data suggest that over the short to intermediate time frame, with increasingly effective systemic therapy, the risk of LR will be less, but the ratio will also be less. Current systemic therapy is most effective in the setting of microscopic residual disease or micrometastases. As systemic therapies are better able to sterilize distant disease, improvements in local-regional control have become more important. As systemic therapy continues to improve such that it can control both distant and local-regional disease, the eventual goal is that local therapy could be completely eliminated; however, that is likely to be sometime into the future.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr MS3-2.
An Epidemiological Perspective on the Causes and Prevention of Breast Cancer.
Authors: Beral V. 
Published: December 2010

Abstract
Breast cancer is the most common cancer in women worldwide, with over 1 million new cases occurring annually. Incidence rates used to be 6-7 times more common in developed than in less developed countries, but the gap is narrowing, as breast cancer rates in less developed countries are now increasing rapidly. The contribution to the total burden of breast cancer from the well-established and potentially modifiable causes will be described. Most of the difference between breast cancer rates in developed and less developed countries is because of the small average family size in developed countries and the relatively short duration of lactation. However, it is neither desirable nor feasible for women to revert to childbearing patterns of the past to prevent breast cancer. If we seriously want an acceptable way of achieving a sizeable reduction in breast cancer incidence we need work out the appropriate way of mimicking the effects of childbearing on the breast. The epidemiological evidence points to persistent, lifelong, protection from short-term exposures to hormones of late pregnancy and lactation (probably not from oestrogens and progesterone alone). It should therefore be possible to develop a short-term 'hormonal vaccine' to provide long-term protection against breast cancer.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr P1-1.