bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract P4-10-02: Young Age Is Associated with Increased Risk of Local Recurrence Following Breast Conservation Surgery
Authors: Boughey JC , Gullerud RE , Degnim AC , Jakub JW , Lohse CM. 
Published: April 2011

Abstract
Background
Local recurrence after breast conservation surgery (BCS) varies with clinical risk factors. The aim of this study was to evaluate how local recurrence rates vary by patient age at time of BCS.
Methods
With IRB approval, all patients undergoing BCS for primary breast cancer between 1988 and 2001 at Mayo Clinic, Rochester were identified. Patients receiving neoadjuvant chemotherapy were excluded. Local recurrence-free survival rates were estimated using the Kaplan-Meier method. Associations with local recurrence-free survival were evaluated using log-rank tests and Cox proportional hazards regression models.
Results
3,075 patients underwent 3,143 BCS between 1988 and 2001. Mean age at BCS was 61 years (range 21-98). There were 177 (5.6%) patients aged &lt;40, 496 (15.8%) 40-49, 763 (24.3%) 50-59, 803 (25.6%) 60-69, and 904 (28.8%) who were 70+ years old at time of surgery. At last follow-up, 214 patients (6.9%) experienced a local recurrence at a median of 3.4 years following BCS (range 0.1-14.4). Median follow-up for patients who did not experience a local recurrence was 8.7 years (range 0.0-20.2). The 5-year local recurrence-free survival rate was 95.0%. The frequency of local recurrences by age group were as follows: age &lt;40 — 11.9%; age 40-49 — 5.9%; age 50-59 — 5.9%; age 60-69 — 7.6%; age 70 and older — 6.4%. The 5-year local recurrence-free survival rates for these age groups were 90.0%, 95.4%, 95.6%, 95.4%, and 94.7%, respectively (p=0.041; log-rank test).
On univariate analysis, patients &lt;40 years old were nearly twice as likely to experience a local recurrence following BCS compared with patients
DCIS was associated with an increased risk of local recurrence compared with T1, T2, T3, or T4 disease (HR 2.25; P&lt;0.001). Factors associated with a decreased risk of local recurrence on univariate analysis included ER positivity (HR 0.46; P&lt;0.001), PR positivity (HR 0.60; p=0.001), adjuvant radiation (HR 0.48; p=0.007) and endocrine therapy (HR 0.65; p=0.012).
Multivariate analysis of patients with complete data (n=2126) demonstrated that age &lt;40 and node positivity were associated with an increased risk of local recurrence, while ER positivity, adjuvant radiation and endocrine therapy were associated with a decreased risk of local recurrence.
Multivariable analysis of local recurrence after BCS
Conclusion
Risk factors for local recurrence after BCS include young age, node positivity, ER and PR negativity and absence of adjuvant radiation and endocrine therapy. Patients under age 40 are at increased risk of local recurrence following BCS for breast cancer.

Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P4-10-02.
Abstract P4-10-03: Long-Term Follow-Up of SweBCG 91RT, a Randomized Trial of Breast Conservation Surgery with and without Radiotherapy from the Swedish Breast Cancer Group
Authors: Malmström P , Killander F , Anderson H , Holmberg E , Lundstedt D , Mattsson JE , Holmberg L , Karlsson P. 
Published: April 2011

Abstract
Background: Postoperative radiotherapy remains the golden standard after breast conservation surgery. However, national breast screening programmes and increased public awareness of breast cancer have resulted in earlier detection of small tumours with favourable prognosis. The Swedish SweBCG 91RT multicentre study of breast conservation with and without radiotherapy was initiated in 1991. Five year results have been published.(Malmström P et al. Eur J Cancer 39: 1690, 2003). A gene expression signature for radioresistance has also been defined from this patient material. (Niméus-Malmström E et al. Breast Cancer Res 2008, 10:R3(doi10:1186/brc1997). Increasing knowledge of genetically defined subgroups of breast cancer is likely to have an impact on breast conservation treatment. We now present outcome after 15 years of follow-up. Patients and methods: After a standardised radical sector resection 1187 patients with T1-2N0M0 breast cancer were randomised to postoperative radiotherapy or no further treatment. 1178 patients fulfilled the inclusion criteria. The two treatment groups were well balanced with respect to prognostic factors. Median tumour size was 12 mm, and 65 % of cases were detected by mammography screening.
Radiotherapy with tangential MV photons, 48-54 Gy in 24-27 fractions, was administered to the remaining breast parenchyma. CT-based 3-D treatment planning was used. Adjuvant systemic therapy was prescribed according to regional treatment programmes. Nine percent received adjuvant systemic therapy. Patients were followed annually with bilateral mammography for 10 years and thereafter referred to the national Swedish breast screening programme.
Results: With a median follow-up of 15 years, the addition of postoperative radiotherapy did not affect overall survival, 70.8 % with RT vs 68.2 % without RT, p=0.79. This result is based on follow-up for survival until April 2010 for all patients. However, recurrence-free survival, RFS, was significantly improved by radiotherapy, 62,6 % vs 53.7 % after 15 years, P&lt;0.001. The cumulative incidence of local recurrences as first event was significantly lower in the irradiated group 11.8 % after 15 years compared to 24.3 % in the control group, P&lt;0.0001. Results for RFS and local recurrences are based on prolonged follow-up of 85 % of the cases and to 1999 for the remaining. Data with more complete follow-up will be presented at the meeting as will data on treatment efficacy in predefined subgroups.
Conclusions: Postoperative breast radiotherapy is indicated for the majority of patients operated with breast conservation surgery. Analysis of treatment efficacy in subgroups of patients may identify groups for which radiotherapy can be omitted in the future.
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P4-10-03.
Abstract P4-10-04: Rates of Second Malignancies after Definitive Local Treatment for Ductal Carcinoma In Situ of the Breast
Authors: Shaitelman SF , Grills IS , Kestin LL , Ye H , Nandalur S , Huang J , Vicini FA. 
Published: April 2011

Abstract
Background: We analyzed the risk of developing second malignancies in patients with ductal carcinoma in situ (DCIS) undergoing surgery and radiotherapy (S+RT) versus surgery alone (S).
Material and Methods: The S+RT cohort consisted of 256 women treated with breast conserving therapy at William Beaumont Hospital. The S cohort consisted of 2,788 women with DCIS in the regional SEER database treated during the same time period. A matched-pair analysis was performed in which each S+RT patient was randomly matched with 8 S patients (total of 2048 patients). Matching criteria included age +/− 2 years. The rates of second malignancies were analyzed overall and as contralateral breast versus non-breast cancers and by organ system. Results: Median follow-up was 13.7 years for the S+RT cohort and 13.3 years for the S cohort. The overall 10-/15-year rate of second malignancies among the S+RT and S cohorts were 14.2%/24.2% and 16.4%/22.6%, respectively (p=0.668). The 15-year second contralateral breast cancer rate was 14.2% in the S+RT cohort and 10.3% in the S cohort (p=0.439). The 15- year risk of a second non-breast malignancy was 14.2% for the S+RT cohort and 13.4% for the S alone cohort (p=0.660). When analyzed by organ system, the 10- and 15-year rates of second malignancies did not differ between the S+RT and the S cohorts for pulmonary, gastrointestinal, central nervous system, gynecological, genitourinary, lymphoid, sarcomatoid, head and neck, or unknown primary tumors.
Discussion: Compared with S alone, S +RT was not associated with an overall increased risk of second malignancies in women with DCIS.
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P4-10-04.
Abstract P4-10-11: Nobel Approach for Breast Conserving Surgery after Primary Systemic Therapy: Real-Time Virtual Navigation
Authors: Suzuki M , Koda K , Yamazaki M , Tezuka T , Kosugi C , Imai K , Hirano A , Nakagawa R , Adachi K , Shirakami R , Yasuda H. 
Published: April 2011

Abstract
Background:
Breast-conserving surgery after primary systemic therapy (PST) has become a widely acceptable procedure for locally advanced breast cancers. Sometimes it is difficult to determine the appropriate resection-line at the time of surgical operation because of tumor size reduction or indistinct boundary of the tumor. Moreover we cannot detect tumors in cases with complete response. That was why we developed a new navigation technique using real-time image reconstruction.
Materials and methods: Multi-detector row computed tomography (MD-CT) has been performed for all breast cancer patients in our institute. DICOM images of MD-CT were analyzed by image processing software ‘OsiriX'. OsiriX is an open source software which anyone can download from website (http://www. osirix-viewer.com). OsiriX has been specifically designed for navigation and visualization of multimodality and multidimensional images. We used 3D volume rendering images. At the time of surgery, pre-PST volume rendering images ware superimposed directly on the patients’ skin from projector which was connected to a personal computer in the operating room.
Results: We could see ‘real-time’ rendering images (from skin to organ by layer to layer) on the patient's body. By using pre-PST imaging data, we could recognize precise tumor area and could perform breast conserving surgery safer and easier than before.
Conclusion: Using 3D reconstruction MD-CT images which were obtained before PST, ‘real-time’ virtual navigation was helpful to determine the resection-line for clear surgical margin in breast-conserving surgery after PST. This new technique does not need some expensive equipments and easily performed by surgeon. Ordinary personal computer and projector make it possible to demonstrate a new environment in surgical operation.

Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P4-10-11.
Abstract P4-11-09: Evidence of Better Cosmetic Outcome after Intra-Operative Radiotherapy with the TARGIT Technique Compared with External Beam Radiotherapy for Early Breast Cancer: Objective Assessment of Patients Enrolled in a Randomised Controlled Trial
Authors: Keshtgar MR , Williams NR , Corica T , Saunders C , Joseph DJ 
Published: April 2011

Abstract
Background: The international randomised TARGIT Trial started accrual in 2000 to determine if there is non-inferiority between the novel technique of TARGIT [intra-operative radiotherapy with Intrabeam® (Carl Zeiss, Germany)] and conventional external beam radiotherapy (EBRT) in women with early breast cancer, with the main outcome measure of risk of local relapse within the treated breast. We report here the data from a sub-protocol assessing cosmesis in a sub-set of patients over 50 years old participating in the TARGIT Trial from one centre (Perth, Australia). Materials and methods: Frontal digital photographs from 114 patients (59 TARGIT, 55 EBRT) taken at baseline and 1, 2 and 3 years after completion of breast conserving surgery were assessed blinded to allocated treatment using specialist software (BCCT.core 2.0, INESC Porto, Portugal) which produces a composite score (Excellent, Good, Fair, Poor) based on asymmetry, colour and scar.
Results: Median age at randomisation was 61 (IQR 56-67) years; all patients were free from recurrence. The categories Excellent and Good;
Fair and Poor; were combined to form EG and FP, respectively. Results are shown in Figure 1. On average patients in the TARGIT group attained EG significantly sooner than those in the EBRT group; a higher cumulative proportion of patients in the TARGIT group had attained EG by each of the three annual examinations post surgery, Log Rank test p=0.0244. By 1 year post surgery 74.6% (SE 5.7%) and 56.4% (SE 6.7%) had achieved EG cosmesis in the TARGIT and EBRT groups respectively. Discussion: These results indicate that the cosmetic effects of targeted radiotherapy using Intrabeam® are better than those obtained with conventional EBRT, with the largest difference one year after surgery.
Figure 1. Cosmetic outcome by randomised treatment

Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P4-11-09.
Abstract P4-11-12: Neurocognitive Function and Quality of Life of Patients Treated within a Prospective Randomised Clinical Trial Testing the Role of Prophylactic Cranial Radiotherapy (PCI) in Patients Treated with Trastuzumab (Herceptin®) for Metastatic Breast Cancer. The Anglo Celtic VII Trial
Authors: Canney PA , Paul J , Murray E , Lewsley L-A. 
Published: April 2011

Abstract
Background. Various authors have reported a relatively high incidence of CNS metastases in patients with HER2 positive tumours receiving Trastuzumab based therapy for metastatic breast cancer. There has been concern with regard to the possible neuropsychological sequelae of PCI, although data from two prospective randomised trials assessing toxicity and quality of life after PCI for small cell lung cancer (UK02 and PCI 85) have failed to confirm this.
Methods. The HER-PCI trial was a prospective randomised trial of PCI in patients with HER2 positive breast cancer who had progressive systemic disease and had Trastuzumab therapy + chemotherapy as planned treatment. Patients had a screening MRI or CT of the brain after randomisation with a view to excluding those with sub-clinical CNS disease. Neurocognitive function was assessed at baseline, 3,6 and 9 months from randomisation using EORTC QLQC30, EORTC neurological sub-scale BN20, Hospital anxiety and depression score (HADS) and the Addenbrookes Cognitive Examination (ACE-R). Patients were randomised 1:1 to no PCI or PCI delivered at around 6 weeks after the start of their systemic treatment for metastatic disease. The PCI dose was 30Gy in 10 fractions, a fraction deferred if due on a day of planned chemotherapy.
Results. 51 patients entered the randomisation between March 2007 and March 2010. 25 received PCI and 26 did not. 46 (90%) of patients received Trastuzumab + chemotherapy and 5 patients single agent Trastuzumab. The mean age was 54 years. Results of the neurcognitive testing and QOL will be presented
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P4-11-12.
Abstract P4-12-01: A New Resource To Accelerate Research into the Cause and Prevention of Breast Cancer: The Love/Avon Army of Women
Authors: Love SM. Dr 
Published: April 2011

Abstract
Background: It is well established that there is a need for more research into the cause and prevention of breast cancer. While many studies are done in cell lines and laboratory animals, translation of findings to women often falters due to perceived difficulty in recruiting women for research. The Dr. Susan Love Research Foundation received a grant from the Avon Foundation to form the Love/Avon Army of Women (AOW); an online recruitment resource designed to partner women with the research community in an effort to accelerate breast cancer research.
Methods: The AOW was launched in 2008 with the goal of recruiting one million women interested in participating in breast cancer research, and of encouraging researchers to submit studies for recruitment. Researchers interested in having the AOW recruit for their studies submit a proposal that will be reviewed by the AOW Scientific Advisory Committee, comprised of nominees from AACR and NBCC. If a study is accepted, a mass e-mail describing the study procedures and inclusion/exclusion criteria is sent to the entire AOW database. Women sign up at www.armyofwomen.org to join the AOW. Women aren't committing to participating in a particular study, but agree to receive AOW e-mails about breast cancer research studies. Women self select based on interest and study criteria, and undergoa secondary on-line screening before contact information is passed on to the researcher for the enrollment process.
Results: Over 334,000 women have signed up, including survivors and healthy women, ranging from ages 18 to 100, representing all 50 US states and 47 countries. To date, the AOW has recruited for 31 studies, both regional and national, that vary from biomarker and circadian rhythm research to psycho-social and quality of life studies. With over 41,000 AOW members having participated in the research process, this method of recruitment has been found to be effective and efficient. The diversity of the AOW members has proved beneficial for many studies such as those needing to enroll African American women, women of varying sexual orientations, or young survivors.
Many studies were closed to enrollment within the first 48 hours after accruing all subjects while others were very quickly over-enrolled by 5-10%. This overwhelming response has led many researchers to seek additional funding to increase their statistical significance and accommodate all eligible subjects.
Conclusions: The Love/Avon Army of Women is a novel resource for scientists to accelerate accrual, expand the number and diversity of their subject population and to obtain exactly the type of specimens they need when they need it. This new partnership between women and scientists can revolutionize research and accelerate efforts to eradicate breast cancer.
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P4-12-01.
Abstract P5-01-03: MRI vs Breast Specific Gamma Imaging (BSGI) in Newly Diagnosed Breast Cancer: A Prospective Head-to-Head Trial
Authors: Kirstein LJ , Fulop T , McPartland L , Cohen I , Boolbol SK. 
Published: April 2011

Abstract
Introduction: Functional breast imaging is emerging as an adjunct to mammography and ultrasound in newly diagnosed breast cancer patients. Magnetic resonance Imaging (MRI) is the modality most widely employed. However, it is expensive, uncomfortable for certain patients, and interpretation is variable, depending upon a radiologist's expertise. Breast Specific Gamma Imaging (BSGI) has emerged as an alternative functional imaging study. While MRI evaluates differential enhancement of benign versus malignant lesions, BSGI evaluates the metabolic activity of normal versus abnormal cells by tagging mitochondria with Technecium99. In retrospective analyses, BSGI has been found to have similar sensitivity to MRI, but to date there has not been a prospective trial comparing these modalities in newly diagnosed breast cancer patients. We sought to prospectively compare BSGI to MRI in newly diagnosed breast cancer patients, to determine if this newer functional imaging study is as sensitive to MRI in detecting index lesions.
Methods: Patients with newly diagnosed invasive breast cancer from June 1, 2009 through May 31, 2010 were consented for an IRB approved protocol in which they underwent both breast MRI and BSGI. Each imaging study was read by a dedicated breast radiologist, with one radiologist reading all MRI, and another reading all BSGI studies. All subsequent biopsies were performed percutaneously, using image guidance. Patients were excluded if excisional biopsy was performed for diagnosis, or their MRI was performed at an outside facility. Patients with DCIS were also excluded. The sensitivity for each modality was calculated. Results: There were 53 patients enrolled in the study that had both MRI and BSGI for newly diagnosed invasive breast cancer. The sensitivity for MRI was 96% and for BSGI was 91% (Table 1) (P&gt;0.5, ns). There was one index tumor not seen on either MRI or BSGI. It was a 2mm invasive ductal carcinoma diagnosed by calcifications on mammogram. The other index tumor not seen on MRI was visualized on BSGI. Two of the remaining four index tumors not visualized on BSGI were located in the posterior breast. Two studies were false negative. These four lesions were visualized on MRI.
Discussion: In this prospective study comparing BSGI to MRI for newly diagnosed invasive breast cancer, BSGI was found to be as sensitive as MRI at detecting index lesions. Of the four false negative BSGI, two tumors were located near the chest wall, a known limitation of this technology. Larger prospective studies need to be performed to determine the true sensitivity and specificity of BSGI.

Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P5-01-03.
Abstract P5-01-08: Preoperative Positron Emission Tomography/Computed Tomography (PET/CT) and 18F-Fluorodeoxyglucose (18F-FDG) Compared with Conventional Assessment in Patients with Early Primary Breast Cancer: Preliminary Results of a Prospective Study
Authors: Petersen MB , Berthelsen AK , Timmermans-Wielenga V , Kroman N , Binderup T , Tange UB , Andersson M , Kjaer A , Loft A , Graff J. 
Published: April 2011

Abstract
Background: The prognosis and clinical management of patients with newly diagnosed breast cancer depends on the extent of disease. The aim of this study was to compare the diagnostic and therapeutic impact of preoperative PET/CT, using 18F-FDG in the initial extra-axillary staging of patients with early breast cancer, to the results of conventional assessment. One hundred patients are planned enrolled. We here report the results of the first fifty consecutive patients.
Patients and methods: Fifty consecutive patients with newly diagnosed early operable breast cancer with tumors ≥2 cm were examined preoperatively with conventional assessment (mammography, breast/axilla ultrasound, chest x-ray and blood samples) and PET/CT. Conventional assessment and PET/CT were evaluated independently with no prior knowledge of the other. Distant metastases/new primary cancers found on PET/CT were confirmed histologically, by other imaging modalities or with at least 1 year of follow-up.
Results: The mean age was 56 ± 11 years. PET/CT identified primary tumor in all but two patients (96%). Nine cases of extra-axillary lymph node involvement were solely revealed by PET/CT in the internal mammary chain (n=7) and the supraclavicular region (n=2). Additionally, PET/CT solely detected distant metastasis (ovary, bone) in two patients and new primary cancers (ovary, lung) in another two patients. Two patients (4%) had non-malignant focal uptake of 18F-FDG confirmed with histologic biopsies (schwannoma, colon adenoma).
In 12 patients (24%) extra-axillary malignancy was detected by PET/CT only, leading to an upgrade of initial staging in 20% (10/50) of patients and ultimately a modification of planned treatment in 4 (8%) patients. No patient was down staged by PET/CT.
Conclusion: PET/CT is a valuable tool to provide information on extra-axillary lymph node involvement, distant metastases and other occult primary cancers. Preoperative 18F-FDG-PET/CT has a substantially impact on initial staging and on clinical management in patients with early stage breast cancer.
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P5-01-08.