bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract P5-14-12: Management of Phyllodes Breast Tumours: A Review of 165 Cases
Authors: Guillot E , Couturaud B , Reyal F , Curnier A , Ravinet J , Laé M , Bollet M , Pierga JY , Salmon R , Fitoussi A. 
Published: April 2011

Abstract
Aim:The aim of our study was to examine the treatment and outcome of 165 patients with phyllodes tumours and to review the options for surgical management.
Patients and Methods: This is a retrospective study of 165 patients who presented to the Institut Curie between January 1994 and November 2008 for benign, borderline or malignant phyllodes tumours. Results: The median follow-up was 12.65 months [range 0 to 149.8]. The median age at diagnosis was 44 years [range 17 to 79]. One hundred and sixty patients (97%) had breast conserving treatment, of whom 3 patients (1. 8%) had oncoplastic breast surgery. Younger women had a significantly higher chance of having a benign phyllodes tumor (p = 0.0001) or a tumour of small size (&lt; 0.0001). Histological examination showed 114 benign (69%), 37 borderline (22%) and 14 malignant tumours (9%).
The median tumour size was 30 mm [range 5 to 150]. The tumour margins were considered incomplete (&lt; 10 mm) in 46 out of 165 cases (28%) with 52% revision surgery. Only the tumour grade was a significant risk factor for incomplete tumour margins (p = 0.005). Fifteen patients developed local recurrence (10%) and two, metastases. In univariate analysis, the histological grade (p = 0.008) and tumour size (p=0.02) were significative risk factors for local recurrence with an accentuated risk for borderline tumours and tumours of large size. Similar results were obtained using multivariate analysis (p=0.07)
Conclusion: The mainstay of treatment for phyllodes tumours remains excision with a safe surgical margin, taking advantage breast conserving surgery where amenable. For borderline or malignant phyllodes tumours or in cases of local tumour recurrence, mastectomy and immediate breast reconstruction may become the preferred option.Genetic analysis will potentially supplement classical histological examination in order to improve our management of these tumours. The role of adjuvant treatments is unproven and must be considered on a case-by-case basis.

Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P5-14-12.
Abstract P5-14-15: Contralateral Prophylactic Mastectomy: Clinical and Pathological Features of Women Treated at the University of Louisville
Authors: Johnson RR , Barry PN , Kruse B , Dragun AE. 
Published: April 2011

Abstract
Objective: To evaluate the clinical and pathological features of women who underwent contralateral prophylactic mastectomy (CPM) as a component of breast cancer therapy.
Materials & Methods: This is a retrospective review of a prospectively-maintained database of patients treated at the multi-disciplinary breast cancer clinic at the University of Louisville from 2003-2009. Patientswith unilateral pre-invasive and invasive adenocarcinoma who underwent mastectomy as primary surgical treatment for the involved breast with CPM were included. All information from surgical, medical and radiation oncology records were reviewed for this analysis.
Results: A total of 107 patients are included in this analysis. The median age was 48 years (range 26-80). A previous history of breast cancer was noted in 8% of patients, all of whom received lumpectomy and whole-breast radiotherapy. A family history of breast cancer was identified in 46% of patients and 4% of patients possessed a germline BRCA mutation. Ninety-three percent of tumors were invasive. Evaluation of the pathological tumor (T) stage yielded 7% Tis, 48% T1, 36% T2, 3% T3, and 3% T4. Four percent of tumors were pathologically T0 after a complete response to neoadjuvant chemotherapy. Pathological node (N) staging yielded 56% N0, 23% N1, 14% N2, and 7% N3. Two percent of patients had distant metastasis at diagnosis. Twenty-two percent of tumors were negative for the estrogen, progesterone, and HER2/neu receptors (triple negative). Lobular carcinoma in situ was found in 10% of tumors. Five occult tumors were detected in the contralateral breast, of which 4 were carcinoma in situ and 1 was invasive mucinous carcinoma. With a median follow-up of 27 months (range 7-83), 9 treatment failures have been noted. Four patients failed locoregionally, 3 failed distantly, and 2 failed both locoregionally and distantly. Five patients have died of metastatic disease. No contralateral chest wall failures have occurred.
Conclusions: CPM has become more popular over the past 6 years and patients present with a diverse array of clinical and pathological features. Occult disease in the contralateral breast is rare and was not encountered in our series. The pattern of failure is determined by the primary disease and the clinical utility of CPM therefore remains uncertain.
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P5-14-15.
Abstract P5-14-16: Resection of Breast Cancer Liver Metastases: Single Institution Experience
Authors: Nikolic S , Tomasevic Z , Inic M , Zegarac M , Pupic G. 
Published: April 2011

Abstract
Background
Metastatic breast cancer (MBC) is considered incurable and systemic treatment is usually given, even when liver metastasis is solitary and the only metastatic site. However, occasionally in selected, for surgery highly motivated patients, liver metastases resection is performed. The definitive disease outcome for those patients is rarely reported. The aim of this analysis is to evaluate outcomes for patients after breast cancer liver metastases resection. Patients and methods
From December 2002-March 2010, 36 MBC patients were referred to surgery for liver metastases resection. Median age at MBC was 48 (range 29-71), median DFI from breast cancer diagnosis to metastases development was 36 (0-144 months).
Steroid receptor status was positive (defined as ER and or PGR Qucik score ≥4) in 20 primary BC (74%), negative (Quick score&lt;4) in 6 primary BC (22%), and unknown for 7 pts (22.5%).
HER2 status was known for 24 pts (77.4%), and was positive (IHC 3+, and CISH+ for HER2 2+) in 5 pts. (21%), and negative in 19 pts (79%) Results
Five pts were excluded because metastases in other organ sites were detected.
In 3/31 pts who underwent surgery, inoperable multiple, metastases were intra-operatively confirmed despite initial diagnostic procedures indicate solitary lesions. Outcome for those patients is not shown in this analysis. In 3 pts, metastases were ruled out by biopsy during laparatomy. In 25 pts who underwent liver resection median number of liver metastases was 1 (range 1-5), median size 25 mm (7-50). All pts received systemic, postoperative chemotherapy, +/− treatment according to molecular characteristics of metastases (reported elsewhere). Outcome after liver resection: 7/25 (28%) patients are lost of follow-up;
3/25 (12%) died; NED stage (no evidence of disease) is achieved in 16/25 pts and 5/16 (31.5%) are still free of disease, for median 36 months.
Conclusion
Median 36 months after metastases resection,5/16 (31.5%) of patients remained in NED stage.
That percentage of durable response is et least equal to systemic treatments response.
It seems that there is a subgroup of patients who could benefit of metastases resection achieving long lasting NED stage. Still, the most important characteristics of this subgroup in not well recognized.

Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P5-14-16.
Abstract P5-15-04: A Randomized Trial Comparing Intermittent Pneumatic Compression with Manual Lymphatic Drainage for Treatment of Lymphedema in Patients with Breast Cancer
Authors: Ozkan Gurdal S , Kostanoglu A , Cavdar I , Ozbas A , Cabioglu N , Ozcinar B , Muslumanoglu M , Igci A , Ozmen V. 
Published: April 2011

Abstract
Aim: Lymphedema is a serious complication associated with axillary surgery and/or radiotherapy in patients with breast cancer. The aim of this randomized study was to assess the efficacy of two different treatment modalities of lymphedema by comparing the manual lymphatic drainage and compression bandage with intermittent pneumatic compression and self-lymphatic drainage.
Material and Methods: Thirty patients diagnosed with lymphedema after treatment for breast cancer were randomized to either manual lymphatic drainage (MLD)by physicotherapists with compression bandage-group (n=15) or to the intermittent pneumatic compression (IPC)-group with self-lymphatic drainage massage (n=15). In both groups, treatment program was performed three days a week, every other day for 6 weeks. To determine the efficacy of the treatment modalities, arm circumferences were measured from wrist to shoulder girdle with 10 cm distance before and after treatment for lymphedema at the 1st, 3rd, and 6th weeks of the therapies. Tests evaluating the quality of life including EORTC-QLQ and ASES-test were also performed before and after treatment at 6th week.
Results: The median age of patients was 54.5 years (31-74) and lymphedema occured after a median time of 18 months following surgery (range, 6-72 months). Patients in both groups had similar demographic and clinical characteristics. At the 6th week, even though both treatment modalities resulted in significant decreases (p&lt; 0.001) in the total arm volume (12.2% decrease in IPC-group versus 14.9% decrease in MLD-group), no significant difference could be found in the therapeutic efficacy between the IPC-and MLD-groups. Furthermore, significant improvements of ASES scores were detected after both IPC-and MLD-therapies (p=0.001), but there was no statistically significance between two groups. In the EORTC-QLQ-C30 quality of life test, however, global health status, functional and cognitive functioning scores appeared to be improved only after MLD-therapy, whereas emotional functioning scores, fatique and pain scores significantly improved after MLD-or IPC-therapy. Conclusion: Both treatment modalities by MLD and IPC appear to be effective in the treatment of lymphedema with similar therapeutic efficacy in patients with breast cancer. MLD-therapy seems to be superior to IPC-therapy since there is a trend of an improvement in the quality of life in patients treated with MLD. However, IPC might still be the preferred treatment for some patients who work at the day time since it could be performed easily at home by themselves without a need for a physicotherapist at the hospital.
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P5-15-04.
Abstract P6-01-06: Identification of Molecular Subtypes of DCIS and Invasive Breast Cancer Using Computerized Image Analysis for Data Integration
Authors: Adeyanju OO , Khramtsov A , Verma A , Liu L , Wang X , Sattar H , Olopade OI , Huo D. 
Published: April 2011

Abstract
Background: Breast cancer is a heterogeneous disease with different putative therapeutic targets based upon the particular subtype. The particular subtype can have profound implications for therapy, as in the case of basal-like carcinomas which tend to be more aggressive with less therapeutic options. Although many studies have examined the transition from Ductal Carcinoma in-situ (DCIS) to Invasive Breast Cancer (IBC), the mechanisms involving the transformation are poorly understood. DCIS cases that are more likely to progress to IBC can be treated more aggressively. This study used image analysis to examine the association between predictive molecular biomarkers between pure DCIS, DCIS associated with IBC and IBC.
Methods: With approval by the Institutional Review Board, we evaluated tissue microarrays comprising 453 tissue cores from 149 patients. Five immunohistochemical biomarkers were utilized: estrogen (ER), progesterone (PR), human epidermal growth factor receptor 2 (HER2), epidermal growth factor receptor (EGFR), and cytokeratin 5/6 (CK-5/6). We then employed the Automated Cellular Image Analysis (ACIS) to score the biomarker status. We compared regional scoring (rated 0, 1, 2, or 3) between an experienced pathologist's subjective assessment and an automated score derived from ACIS. An image library was generated and integrated to our Translational Data Mart (TraM: http://tram.uchicago. edu). Statistical analyses included a comparison of histological grade, race, age, tumor size, and lymph node status associated with the prevalence of subtypes between pure DCIS tumors and those that advanced to IBCs. Results: The concordance between ACIS-based and pathologist-based scoring was moderate (kappa = 0.38). There was more variability in the pathologist's scoring with a standard deviation of 1.14 as compared to 0.85 for ACIS. Subtypes associated with IBC were also present in DCIS. In the pure DCIS cases, there was a higher proportion of the luminal A subtype (74.1%, n = 54) as compared to DCIS adjacent to IBC (54.2%, n=24) or pure IBC cases (57.4%, n = 115) (p=0.05). In contrast, there was more basal-like subtypes in DCIS juxtaposed with IBC (20.8%) and IBC (27.8%) than in pure DCIS tumors (9.3%).
Discussion: Molecular subtype analysis of DCIS could be useful in predicting DCIS with high risk of progressing to invasive cancer. The resemblance between subtypes bolsters the hypothesis that IBCs and DCIS originate from the same precursor lesion. Although the automated scoring featured by ACIS would be useful in expediting readings, it must be validated by a pathologist's assessment.
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P6-01-06.
Abstract P6-02-03: The Use of Charcoal Suspension Labeling as an Adjunct in the Detection of Non-Palpable Breast Lesions
Authors: Santos Cavalcanti TC , Budel VM , Gasperin P. 
Published: April 2011

Abstract
Introduction and Objectives: Inert charcoal suspension is used as a tissue marker, which provides innumerous advantages over other labeling methods and techniques, such as dyes and metallic needles. In addition, the use of charcoal does not present problems with regards to its diffusion, labeling the trajectory from the lesion to the skin, being easily identified by both the surgeon and pathologist. The occurrence of morphological alterations due to the use of charcoal is very rare. In contrast, there are still doubts and questions concerning the interference of charcoal labeling with regards to the anatomopathological diagnosis accuracy. The main objectives in this study are to analyze the efficiency of labeling impalpable breast lesions with inert charcoal suspension; to evaluate the morphological alterations associated with its use and to determine whether the use of charcoal labeling hampers with the diagnostic interpretation of the pathologist. Materials and Methods: The study evaluated a total of 135 cases of impalpable breast lesions, previously labeled with charcoal suspension. Histological H/E stained slides containing charcoal pigments were analyzed using optical microscopy, by which both quantitative and qualitative evaluations with regards to inflammatory response and interference in diagnosis were performed. Lymphocyte, giant cells and neutrophils were evaluated and quantified. Moreover, the distribution of the charcoal suspension present in the lesions was evaluated. Results: As to the quantitative and qualitative evaluation of the inflammatory response caused by the use of charcoal labeling, it was observed that granulomas were present in all samples, regardless of the quantity of injected charcoal. Lymphocytic inflammatory response was absent in 5.19% of the samples only, were 82.22% demonstrated discrete intensity and 12.59% was moderate. With regards to acute inflammatory response, 42.96% showed total absence of neutrophilic exudate, were as 42.22% demonstrated discrete and 11.11% moderate, and only 3.7% of cases were intense. Conclusion: This study corroborates the utility and easiness of the charcoal method as a means of efficient labeling of impalpable breast lesions. In addition, this technique is easy to use, has a low cost, high efficiency and does not interfere with the histological analysis. Moreover, it is comfortable for the patient and is of great help in finding and localizing the lesions to both the surgeon and pathologist.
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P6-02-03.
Abstract P6-04-02: Profiling of BRCA1 Mutated Breast Tumours Using a Breast Cancer Specific Microarray To Identify a Profile of BRCAl-Deficiency
Authors: Irwin G , Lamers E , McDyer F , Mulligan J , Couch F , Kennedy R , Harkin P , Quinn J. 
Published: April 2011

Abstract
Background
The BRCA 1 tumour suppressor gene is mutated in a significant proportion of hereditary breast cancer cases. Additionally, downregulation of BRCA1 mRNA and protein expression is reported in approximately one third of sporadic breast cancers. BRCA1 is strongly implicated in the maintenance of genomic stability by its involvement in multiple cellular pathways including: DNA damage signalling, DNA repair, cell cycle regulation, protein ubiquitination, chromatin remodelling, transcriptional regulation and apoptosis. To date, gene expression profiling has identified: (1) at least five breast cancer subtypes and (2) that BRCA1 mutant tumours segregate with basal-like breast cancers. These studies also provide evidence that breast cancers with germline mutations in BRCA1 are different from non BRCA1-related tumours. The main aim of this study is to investigate the underlying biology of BRCA1-mutated breast cancer. Methods
Extensive gene expression profiling and data analysis were performed on a cohort of 70 FFPE (Formalin Fixed Paraffin Embedded) derived BRCA 1 mutated breast tumours and matched sporadic controls using the Almac Breast Cancer DSATM research tool. Functional analysis was performed with DAVID and METACORE. Validation of gene targets was performed by qRT-PCR and Western blotting. Results
A list of differentially expressed transcripts has been derived from the comparison of these BRCA1 mutant breast tumours and matched sporadic controls. Functional analysis of this gene list has identified the key genes and molecular pathways that are deregulated in these tumours. BRCA1 deficiency was associated with deregulation of pathways involved in: (1) immune response, (2) metastasis and invasion, (3) cytoskeletal remodelling, (4) spindle assembly and chromosome separation, (5) apoptosis and survival. Validation of the key genes underlying this BRCA1-deficient breast cancer profile has been performed. Conclusions
This approach has revealed a set of transcripts that could potentially be used to identify both hereditary and sporadic breast cancer patients with BRCA1- deficiency. The ability to perform gene expression profiling from FFPE derived breast tissue could also have significant clinical application.
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P6-04-02.
Abstract P6-04-08: Microarray Characterization of 24 Cases of Pure Mucinous Carcinoma of the Breast
Authors: Sanchez-Salazar AJ , Gunn SR , Yeh I-T. 
Published: April 2011

Abstract
Background: Mucinous carcinoma of the breast has been shown to be a distinct histological entity with a better clinical prognosis than invasive ductal carcinoma, NOS. Only a few cases have thus far been studied by molecular analysis. The purpose of this is study is to further evaluate the genomic changes in mucinous carcinoma of the breast. Design: 24 pure mucinous breast carcinomas with available fresh frozen tissue were retrieved from our files. The cases were reviewed for histologic grade (SBR), mitoses, percent mucin, intracytoplasmic mucin, type A or B mucinous carcinoma, and estrogen receptor (ER) and progesterone receptor (PR) expression. Follow-up was available for 13 patients and included 4 recurrences. Representative sections of the tumors were dissected from the normal tissue present in the blocks and were assayed by Agilent (Santa Clara, CA, USA) human genome CGH microarray kit 105A. Analysis was performed using Agilent (Santa Clara, CA, USA) genomic workbench 5.0 software.
Results: The 24 mucinous carcinomas were composed of 19 type A and 5 type B mucinous carcinomas, including 21 with &gt;60% mucin and 3 with &lt;60% mucin. Seven cases contained intracytoplasmic mucin. Tumors were grade 1 in 20 cases and grade 2 in 4 cases. Mitotic count per 10hpfs was 0 or 1-2 in 19 cases and &gt;3 in 5 cases. ER was positive in all cases, and PR was positive in all but 4 cases. Analysis of the genome arrays showed that 17 of the cases had a complex level of genetic instability with three or more (up to 15) of the chromosomes showing instability while four show only one or two chromosomes affected. On the other hand, there are no abnormalities found in four of the cases. The most frequently affected chromosome is chromosome 1 which is involved in 12 of the cases, with three cases showing 1p partial loss/full loss, and nine cases showing 1q partial gain/full gain. Gains were also commonly seen in 8p, 8q, 11q, 16p, 17q and 20q. Losses were most frequently seen in 6q, 11q, 16q and 17p. Four of five Type B tumors exhibited a complex pattern, and all four grade 2 tumors had a complex pattern. Of the tumors that recurred, three of four had a complex pattern of genetic instability.
Conclusions: Evaluation of pure mucinous carcinomas studied showed a high level of genomic complexity with multiple chromosomal changes in most cases. Tumors that were grade 2 and mucinous type B tumors tended to be of higher complexity than grade 1 and type A mucinous tumors. The most commonly affected chromosomes include chromosomes 1, 6, 8, 11, 16, and 17.
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P6-04-08.