bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract P1-15-04: Luminal B Lobular Carcinomas In Situ Have a Higher Risk of Relapse Compared to the Other Molecular Types of Lobular Carcinomas In Situ: Results from a Pilot Retrospective Single Institution Study
Authors: Vincent-Salomon A , Hajage D , Cedenot A , Gautier C , Gruel N , Alran S , Sigal-Zafrani B , Fourquet A , Kirova Y. 
Published: April 2011

Abstract
Aims: To determine the molecular subtypes existing in a retrospective series of classical lobular carcinoma in situ (LCIS) and to evaluate the risk of relapse in the different groups. To assess by immunohistochemistry the expression of stem cell markers in LCIS.
Material and methods: A series of 58 LCIS have been retrospectively selected in our files according to the availability of clinical data. The expression of E-cadherin (clone 4A2C7, Invitrogen), ER (clone 6F11, Novocastra), PR (clone 1A6, Novocastra), ERBB2 (clone CB11, Novocastra), EGFR (clone 31G7, Zymed), KI67 (MIB1), CD44 (1563C11, Thermo Fisher Scientific), CD24 (clone SN3b, Thermo Fisher Scientific) and ALDH1 (clone 44/ALDH, BD transduction Laboratories) were determined on whole tissue sections for 47 patients with available paraffin blocks. For ER, PR, EGFR and Ki67, 10% of positive cells were used as cut-off. For ERBB2, the interpretation was performed according to the ASCO guidelines for invasive carcinomas. The molecular subtypes were defined as luminal A: ER+ ERBB2- and Ki67&lt;10%; luminal B: ER+, Ki67 &gt;10% or ERBB2+; ERBB2 ER-and ERBB2 3+; basal-like: ER-PR-ERBB2-and EGFR+. All patients’ charters were reviewed and clinical data was recorded. All of the patients underwent tumorectomy without any radiation therapy.
Results: Median age was 50 yrs (min 31; max 72). The majority of the lesions were diagnosed by microcalcifications on mammography (62% of the cases) and treated by lumpectomy (98%). The majority of the lesions were classical LCIS (97%). The majority of the cases were E-cadherin negative (53%), the other cases presenting a weak staining of 10 to 80% of the cells, ER +ve (91%), PR +ve (68%), ERBB2 -ve (100%), KI67 low (81%), EGFR-ve (89%). A total of 33 cases were defined as luminal A (72%), 9 cases as luminal B (20%) and 4 cases were ER-ve/ERBB2-ve. At five years, all patients were alive, 1/33 luminal A experienced a relapse contrasting with 4 out of 9 luminal B (1 LCIS, 3 invasive carcinomas including 2 ductal and 1 lobular) (p= 0.004). The majority of the cases was CD44 +ve (93%), CD24 -ve (57%) and ALDH1 -ve (74%). No statistically significant link was observed between the stem cell phenotype defined as CD44+/CD24-/ALDH1+ and a risk of relapse.
Conclusions: Classical LCIS are in majority of luminal A type (72%). 20% of LCIS are luminal B and present a risk of relapse higher than luminal A LCIS. In this retrospective pilot study, for the first time to our knowledge, we observed a higher risk of relapse associated with the luminal B phenotype of LCIS. This observation needs to be confirmed in a larger series but could contribute to improve the clinical management of classical LCIS patients.
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P1-15-04.
Abstract P2-01-01: Mammography and Patient or Physician Detected Breast Cancer in 21-39 Year Old Women
Authors: Kaplan HG , Malmgren JA , Atwood MK 
Published: April 2011

Abstract
Background: Mammography screening is not recommended for women under age 40. The American Cancer Society recommends clinical breast exam about every 3 years and breast self-exam as an option for women starting in their 20s. It is not clear what method is best for women at high risk.
Methods: We conducted a prospective cohort study of all women presenting with primary breast cancer, aged 21-39, biopsy confirmed Stage 0-IV from 1990-2008 identified and tracked by our registry. Clinical presentation characteristics including age, race, TNM stage converted to AJCC 6, first degree relative, family and pregnancy history, histologic type and method of detection by patient (PtD), physician (PhysD) or mammography (MgD) were chart abstracted at the time of diagnosis. A first degree relative is a mother, father, son, daughter or sibling with a BC diagnosis. Cases with unknown or other method of detection (n=7) were removed (n=602). For analysis purposes patient and physician detected cases were combined into one manually detected category. Forward conditional stepwise regression was used to test association significance with detection method and the Kaplan-Meier method was used for disease free survival (DFS) analysis.
Results: Women aged 21-39 represented 7% of the patients in our community based cancer center registry database. We did not observe any change in detection method over time with 12% MgD, 7% PhysD and 81% PtD. The majority of MgD cases were in the 30-34 (26%) and 35-39 (65%) year old age groups (Pearson chi square = 11.11, p=.011). 81% of the PhysD/PtD breast cancers were visible on subsequent mammography. 31% of the 74 MgD cases were stage 0 vs. 2.5% of the 528 PhysD/PtD cases. In a conditional logistic regression model with MgD BC yes/no as the binary outcome, age at diagnosis and having a first degree relative with breast cancer were significantly associated with mammography detection. DFS was significantly better in the MgD group (log rank test = 6.10, p=.014).
Conclusions: Mammography detection in 20-39 year old breast cancer patients is associated with age &gt; 30 years and presence of a BC affected first degree relative. Disease specific survival is significantly better in the mammography detected group largely due to lower stage at diagnosis. These results indicate mammography may be a reasonable option for screening high risk women aged 30-39.
Figure available in online version.

Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P2-01-01.
Abstract P2-02-01: Characterization of the Breast Lesions by Biexponential Signal Attenuation Analysis of Diffusion-Weighted Magnetic Resonance Images
Authors: Tamura T , Murakami S , Arihiro K , Usui S , Naito K , Akiyama M. 
Published: April 2011

Abstract
Purpose: Signal attenuation of diffusion-weighted magnetic resonance images (DWI) in vivo with high b-values is sometimes non-linear when plotted with a semilogarithmic function, but it fits well with the biexponential equation, Sb/S0=f1exp(bD1) + (1-f1)(bD2). Others have indicated that the fast and slow component fractions (f1, 1-f1) of the apparent diffusion coefficients (D1, D2) can be derived by biexponential fitting, and that these fractions correspond to actual diffusion components in the extra-and intracellular space. Here, we investigated the clinical value of DWI for breast screening by performing multi b-factor DWI on healthy volunteers and patients. We then analyzed signals by fitting them with the biexponential equation and compared the fitting parameters of breast lesions.
Patients and methods: This study was approved by our center's institutional review board and all patients and volunteers gave their informed consent. We analyzed data from eight healthy females (controls) and 80 female patients with a total of 100 breast tumors (42 benign and 58 malignant). We performed DWI using 12 and 6 b-values for the controls and patients up to a maximum b-value of 3500 sec/mm2.
Results: We identified the DWI signal attenuation features of the normal mammary gland, and of benign and malignant tumors [Figure1]. The DWI signal attenuation was similar between some proliferative benign tumors and malignancies. A comparison of the parameters derived from biexponential fitting revealed a significant difference in f1 between noninvasive and invasive ductal carcinoma [Figure 2]. Conclusion: The biexponential fitting parameters might reflect the features of tumor cellularity. Thus, to distinguish malignant from benign breast tumors only by DWI is difficult due to the pathological diagnosis that rather emphasizes cell configuration or shape rather than cellularity. Nevertheless, our findings will help to understand why malignant tumors present as high signal intensity in DWI.

Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P2-02-01.
Abstract P2-02-02: Uptake and Predictors of Screening Breast MRI in High Risk Women
Authors: Beattie MS , Blumenthal E , Creasman J , Cheung E , Crawford B. 
Published: April 2011

Abstract
BACKGROUND: Screening breast MRI is recommended in: BRCA carriers, their first degree relatives who have yet to test, and women with lifetime breast cancer risks of over 20-25%. It is unclear, however, whether women who receive screening breast MRI meet any of these criteria. As screening breast MRI becomes more available and accepted, it is also important to describe its uptake and identify its predictors. OBJECTIVE: To determine the uptake over time of screening breast MRI, as well as predictors of receiving screening breast MRI, in a cohort of women at high risk of hereditary breast cancer. METHODS: We surveyed all cancer-free women who enrolled in the UCSF Cancer Risk Program to determine their uptake of screening breast MRI, including their frequency of screening and the results of this screening. We also queried these women regarding their their risk perception, cancer worry, knowledge of high-risk screening recommendations, and their satisfaction with clinical care. We linked survey data to clinical and demographic data. Descriptive and comparative statistics, as well as multivariate logistic regression, were used to analyze this data. RESULTS: The survey response rate was 80% (n = 433) and the median follow up time was 2.7 years (range 0.5 — 12 years). The uptake of screening breast MRI doubled between 2005 and 2006, and doubled again between 2006 and 2008, with an overall uptake of 25% for ever receiving a screening breast MRI. Of the 92 BRCA carriers in this cohort, 74% reported every receiving a screening breast MRI compared to 18% of non-BRCA carriers (P&lt;0.01). The mean age of first screening breast MRI in this cohort was 40 (range 25-61) compared to the mean age overall of 47 (p = 0.03). Ten percent of women who received screening breast MRI reported that their study required a “call-back” and/or further imaging. Using the BRCAPRO risk prediction model to calculate lifetime risk, without knowing BRCA resutls, 28% of this population would meet the 20% lifetime risk threshold. When BRCA results are incorporated into this risk model, 20% of this population would meet the 20% lifetime risk threshold. Variables associated with obtaining a screening breasat MRI are in the table 1 below.
Table 1. Variables independently associated with screening breast MRI use in 433 high risk women withou t breast cancer
CONCLUSIONS: Screening breast MRI is growing substantially. Its use to date demonstrates adherence with high-risk recommendations and guidelines. BRCA positive status is the strongest predictor of its uptake, and most BRCA carriers report receiving at least one screening breast MRI. Early trends indicate that variables not associated with risk, such as site of care (public versus university hospital) and race, may play a role in the uptake of screening breast MRI as its use becomes more widespread.

Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P2-02-02.
Abstract P2-02-03: Influence of Pre-Operative MRI on the Eligibility for Accelerated Partial Breast Irradiation (APBI)
Authors: Kühr M , Stölzle M , Leutner C , Schrading S , Kuhl C , Kuhn W , Braun M. 
Published: April 2011

Abstract
Purpose: Accelerated partial breast irradiation (APBI) following breast-conserving therapy is currently under investigation in prospective randomized studies. Multifocality and multicentricity are exclusion criteria for APBI. It is proven that pre-operative breast MRI has the ability to dectect ipsilateral and contralateral invasive tumor foci or DCIS in addition to conventional diagnostic methods (clinical examination, mammography and ultrasonography). The objective of this retrospective study was to evaluate the impact of pre-operative MRI on the patient selection for APBI. Patients and methods: From 2002 until 2007 a total of 579 consecutive, non-selected patients with newly-diagnosed early-stage breast cancer received pre-operative Breast MRI in addition to conventional imaging studies at the Bonn University Breast Cancer Center. In total, 130 patients met the criteria for APBI by conventional imaging studies (pathologic tumor size ≥3 cm, negative axillary node status, unifocal disease, no evidence of distant metastases, no invasive lobular carcinoma, lobular carcinoma in situ or Paget's disease). We analyzed the amount of additional ipsi-and contralateral tumor foci detected by MRI.
Results: MRI detected additional tumor foci in 7,6 % of patients eligible for APBI (11 tumor foci in 10 out of 130 patients), either ipsilateral (n=7/5,4%) or contralateral (n=4/3.1 %). In one patient MRI found an additional tumor focus both ipsi-and contralateral. Conclusions: Pre-operative breast MRI may be useful for patient selection for APBI. Its ability to identify additional tumor foci in a clinically relevant number of cases may help to avoid undertreatment of these patients.
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P2-02-03.
Abstract P2-02-05: Combined Ultrasound/MRI for Breast Cancer Screening in Asian Women of Average Cancer Risk
Authors: Cheng GYC , Ko JS , Wu JNY , Cheng CS , Chen CJH. 
Published: April 2011

Abstract
Background and purpose: MRI is not recommended for screening women at average risk because it is associated with substantial numbers of false-positive results and cost. MRI as a screening tool for breast cancer, however, involves a complexity of cancer epidemiology, socio-economic situation, healthcare policy, and awareness and compliance of general population. Breast MRI may be particularly beneficial as a screening tool for Asian women due to their dense breast. In this study we reported the breast MRI screening results in Chinese women in Taiwan. Materials and Methods: In a period of 8 years, 3681 women underwent breast MRI examination in our imaging center. Of them, 95 women were known to have prior histories of cancers and were excluded from this study. The remaining breast MR images from 3,586 asymptomatic healthy women (mean age, 45.3 years) were retrospectively analyzed in this study. All subjects came to our imaging center for screening breast MR studies by self-referral due to high concern of cancer. All subjects were examined at a 1.5T scanner. The imaging interpretation was based on the criteria of ACR BI-RADS lexicon. After the breast MRI examination, complementary US was performed. If suspicious lesions were detected on MRI but showed negative results on US, double check with targeted US were done by the same radiologist immediately. US was also used to guide needle biopsy when in need.
Results: Overall, among 3,586 cases, totally 115 subjects were suspected to have malignant lesions and ultrasound-guided biopsy (N=106) and/or aspiration cytology study (N=122) was performed in all these 115 subjects. 47 were proved to have malignant lesions in pathology (35 invasive cancers — 27 IDC, 7 ILC, and one apocrine carcinoma; and 12 cases of carcinoma in situ). 31 additional cases of pre-cancerous lesions were found. The mean age in cancer group was 49 y/o and 52.2 y/o in CIS group. Subjects at age 41-50 group had the highest incidence of cancer detection, including 6 in situ lesions and 19 invasive cancers. Five cases were found to have breast cancers 1 or 2 years later. The incidence for malignancy in our asymptomatic group was about 1.31% (47/3586) and increased to 2.2% (78/3586) if precancerous lesions were included. The overall sensitivity of combined US/MRI was 94% and specificity was 99%. Conclusions: Breast MRI can be an option for Asian women of average risk, who usually have dense breast, at their own cost. From our results, it was shown that combined ultrasound and MRI can achieve high sensitivity and specificity for women of average risk. The unnecessary biopsy due to the false positive diagnosis of breast MRI can also be reduced remarkably.
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P2-02-05.
Abstract P2-05-02: Optical Parameters of Breast Cancer before and after Chemotherapy
Authors: Ogura H , Yamashita D , Nasu H , Teruya C , Ohmae E , Yoshimoto K , Suzuki T , Ueda Y , Oda M , Yamashita Y , Sakahara H. 
Published: April 2011

Abstract
Objectives: To analyze optical parameters of cancer before and after chemotherapy in breast cancer patients.Patients and Methods: Absorption coefficient (µa) and reduced scattering coefficient (µs') of cancer and contra-lateral normal region before and after chemotherapy were measured by using TRS-20SH (Hamamatsu Photonics K.K.). A pulsed laser of 760, 800, and 830 nm wave-length was irradiated at multiple sites in both breasts with time-resolved spectroscopy method and scattered light was analyzed by photon diffusion equation. A total of ten breast cancer patients who underwent neoadjuvant chemotherapy participated in the trial. Written informed consent was obtained from all of the patients.Results: Absorption coefficient (µa, 1/cm) of breast cancer was significantly higher than that of contra-lateral normal region before chemotherapy. In 800 nm wave-length, absorption coefficient of breast cancer decreased significantly after chemotherapy (before:0.0927, after;0.0498, p=0.002). Although absorption coefficient of contra-lateral normal region also decreased (before:0.0561, after;0.0437, p=0.006), cancer showed more significant decrease than contra-lateral normal region (cancer:-43.1%, normal region;-19.0%, P&lt;0.01).
Figure 1. Absorption coefficient (pa, cm-1), at 800rim (cancer-normal)
Similar results were observed in 760 and 830 nm wave-length. There was no difference in reduced scattering coefficient (µs') between before and after chemotherapy in both breast cancer and contra-lateral normal region.
Conclusion: The absorption coefficient of cancer was significantly higher than that of contra-lateral normal region before chemotherapy and decreased significantly after chemotherapy.

Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P2-05-02.
Abstract P2-06-02: Health Economic Impact of Risk Group Selection According to ASCO-Recommended Biomarkers uPA/PAI-1 in Node-Negative Primary Breast Cancer
Authors: Jacobs VR , Kates R , Kantelhardt EJ , Vetter M , Schmitt M , Jaenicke F , Untch M , Thomssen C , Harbeck N. 
Published: April 2011

Abstract
Background
Invasion factors uPA/PAI-1 are guideline-recommended (ASCO, AGO) biomarkers for decision support regarding adjuvant chemotherapy (CTX) in primary breast cancer (BC). Methods
Potential savings in direct, per-patient expected costs of two leading CTX regimens (6xFEC or 3xFEC-3xDOC) resulting from uPA/PAI-1 test were calculated from a German health provider's perspective for a hypothetical 55 year old, N0, ER+, HER-patient in otherwise good health. Assumptions: patient always receives adjuvant endocrine therapy; without uPA/PAI-1 test, patient also receives CTX; with test, adjuvant CTX given only for high uPA/PAI-1 (60%); cost of testing all patients is included. Results
Testing costs (with tissue handling) are 385€. Adjuvant CTX costs are saved in 40% of patients by testing; including medications, prophylaxis, diagnostics, additional supporting therapies and procedures, CTX costs about 20000€ for both regimens considered (6xFEC ∼18000€; 3xFEC+3xDOC ∼21000€); relapse medical costs were modeled at 40000€. Consider a low-uPA/PAI-1 patient: Survival curves without CTX were estimated using CHEMO N0 10y-disease-free survival (89%) plus endocrine therapy benefit (hazard ratio (HR)=0.7). Expected lost life years (LY) due to relapse (with versus without test) were estimated from corresponding survival curves using age-adjusted life expectancy (minus 2y post-relapse survival).
Cost per life year gained in low-risk patients treated by adjuvant chemotherapy
The figure shows estimated savings (∼18500€) per low-risk patient (lowest curve), survival impact (decreasing curve) and cost per LY of not giving the uPA/PAI-1 test (increasing curve), as the assumed adjuvant CTX benefit in the low-risk group (no testing) is varied between HR=0.8 and HR=0.99. If the health care provider were willing to pay 50000€ for 1 LY, then a HR of at most 0.85 would be required in the low-risk group. Very low CTX benefit (HR approaching 1) is associated with astronomical costs/LY.
Conclusions
In clinical practice, the fraction of G2 ER+ HER2- patients for whom CTX savings could be realized could be affected by 1. existence of sufficient tissue for the assay; 2. availability of logistics; 3. additional clinicopathological decision criteria. The main driver of cost utility in low-uPA/PAI-1 patients is their benefit (HR) for adjuvant CTX. Our estimates show that the uPA/PAI-1 test is likely to be cost effective even with respect to LY; its cost effectiveness is expected to be even stronger when quality of life or severe chemotherapy risks such as heart damage and leukemia are considered. Our model thus lends health economic support to current guideline recommendations that uPA/PAI-1 testing is beneficial in node-negative BC.

Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P2-06-02.