bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cancer Survivorship Care: How Primary Care Providers Perceive Their Role.
Authors: Robinson P. , Rychlik K. , Mumby P. , Lo S. , Albain K. , Friend P. 
Published: December 2010

Abstract
Background: The majority of cancer survivors are breast cancer patients since about 80% live five years beyond diagnosis. It is projected that by 2020, demand for medical oncologists will exceed supply, in large part due to this increased number of cancer survivors. One proposed solution to address the disparity of resources is to enlist primary care physicians (PCP) in the care of cancer survivors. This pilot study aims to describe the perceptions of primary care physicians relative to cancer survivorship care.Materials and Methods: We conducted a prospective, cross sectional survey of PCPs including internists, family practitioners and gynecologists in the outpatient setting. The primary outcome measure was a 45 item measure of knowledge and perceived role of the PCP in the care of cancer survivors.Results: A total of 84 PCPs of 200 surveyed (42%) responded. Overall, 66 PCPs stated they are interested in participating in the care of cancer survivors (79%); however, only a minority of the PCPs commonly discuss the survivorship phase of the cancer control continuum (n=8, 10%). The majority of PCPs believe that the medical oncologist should remain active in the follow up care in association with the PCP (n=28, 36%) or as a single provider (n=17, 20%). Only 20 PCPs (25%) agreed or strongly agreed that survival outcomes are similar for PCPs and medical oncologists. Most PCPs felt that cancer survivors are more compliant with survivorship care recommendations when proposed by the medical oncologist versus PCP (n=42, 55%). The majority of PCPs felt that survivorship follow up care guidelines would be extremely helpful or very helpful (n=61, 81%), a treatment summary of care document would be extremely helpful or very helpful (n=60, 80%), and a treatment summary care plan would change current practice (n=67, 90%). PCPs treat co-morbidities such as diabetes mellitus, obesity and hypertension; however only a minority of PCPs are aware of the relationship between co-morbidities and cancer survivorship. A little over a third of the PCPs strongly agreed that co-morbidities impacted upon the incidence of cancer, incidence of cancer recurrence and overall cancer mortality; n=30, (39%), n=27 (35%), and n=41 (42%) respectively.Discussion: Although PCPs recognize the opportunity to favorably impact on cancer survivorship issues, there appears to be a level of uncertainty regarding their role. PCPs are receptive to participating in the care of cancer survivors provided that they are given the necessary educational resources to do so. Interventions need to be developed and validated to improve the role of the PCP cancer survivorship care.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 1061.
Bone Mineral Density (BMD) Changes at 1 Year in Postmenopausal Women Who Are Not Receiving Adjuvant Endocrine Therapy for Breast Cancer (BCA).
Authors: Van Poznak C. , Morris P. , D'Andrea G. , Schott A. , Griggs J. , Fornier M. , Smerage J. , Henry N. , Hurria A. , Drullinsky P. , Mills N. , Hayes D. , Hudis C. 
Published: December 2010

Abstract
Background: Adjuvant therapy for breast cancer (BCA) may be associated with an increased risk for osteoporosis. This prospective, observational study evaluates BMD changes in postmenopausal women undergoing adjuvant chemotherapy (CTX) for early stage BCA, in the absence of endocrine therapy.Methods: Women who have been postmenopausal for at least 5 years, and who were recently diagnosed with Stage 0-III BCA were eligible to undergo serial BMD if adjuvant endocrine therapy was not recommended. Study BMDs were performed at baseline, 1 and 2 years. All patients (pts) were counseled on calcium, vitamin D and weight bearing exercise. This study was designed to assess serial changes in BMD in the individual and to compare changes in those treated with CTX to those who received no systemic therapy (observation). The study was closed prior to reaching target sample size due to slow accrual.Results: Sixteen pts enrolled. Eleven pts received CTX with a dose dense anthracycline and taxane containing regimen and 5 pts received no systemic adjuvant therapy. Twelve pts, median age 63 (range 52-80), have completed the 1 year assessment and are reported here. Two pts treated with CTX and 1 pt on observation were on bisphosphonates at study entry. Baseline BMD mean in gm/cm2 at the lumbar spine (LS) was 1.112 (range 0.807-1.389) and total hip (TH) was 0.989 (range 0.760-1.213). At 1 year, mean BMD at LS was 1.078 (range 0.767-1.347) and TH was 0.956 (range 0.753-1.210). For all 12 pts at 1 year, the individual BMD changes in LS & TH BMD ranged from 10% loss to 2% gain, with 8 of the 9 CTX treated pts losing 1-10% of BMD and the 3 pts on observation staying within 2% of baseline. The mean dosage of dexamethasone used during CTX by the 9 CTX pts was 230 mg (range 156-288mg). The 3 observation pts had no exposure to steroids during the parallel time period.Conclusions: This prospective, observational study supports the hypothesis that adjuvant CTX, and/or its supportive medications, may be associated with acute changes in BMD in postmenopausal women. Patient follow up continues.Funded by Susan G. Komen for the Cure POP0402593
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 1066.
Evaluation of Important Contact Persons and Their Helpfulness in Coping with Metastatic Breast Cancer Induced Psycho-Social Distress. A Prospective Study at a Community-Based Oncology Group Practice in Germany.
Authors: Weide R. , Mergenthaler U. , Köppler H. , Thomalla J. , van Roye C. , Heymanns J. 
Published: December 2010

Abstract
Introduction: Since psycho-social distress is a prevalent condition in metastatic breast cancer patients, it is important to find out which contact persons are called on most frequently to find help in dealing with this situation. In addition to the significance of these contact persons we wanted to find out to what extend they were actually helpful for the patients when contacted.Methods: 57 patients with metastatic breast cancer visiting the practice in April and May 2009 were administered the Distress Thermometer (DT) and Problem List (PL). Thereafter a standardized personal interview was held concerning their important contact persons where patients were asked to name their important contact persons freely. After this additionally a list of possible contact persons was read to the patients to complete the set of persons the patient has contacted. For each contact person the patient was asked to indicate if this contact was helpful or not.Results: The mean distress level observed in this population of 57 metastatic breast cancer patients was 4.9. 36% showed a distress level &gt; 5. Physical problems as a source of distress were stated by 93%, emotional, familial, practical or spiritual problems were causing distress in 72%, 26%, 21% and 4% respectively. 88% of patients named their oncologist as an important person to help them with their distress. Children, partner, friends and general practitioner were important persons for 70%, 65%, 60% and 54% respectively. Regarding only the free answers the order of the most important persons was partner (60%), children (54%), friends (42%), other family members (35%), oncologist (28%), general practitioner (14%). All patients (100%) who sought help from their oncologist described this as helpful. Children, partner, friends and general practitioner were helpful in 90%, 86%, 94% and 94% of cases. 10 patients (18%) had contacted a psychiatrist. This was helpful for 8 (80%) of these patients.There is a positive and statistically significant correlation between distress level and number of persons contacted. (r=.283; p=0.033).Conclusions: Psycho-social distress in patients with metastatic breast cancer is mostly caused by physical and emotional problems. Patients treated in an oncology practice reported a network of care-giving persons as helpful in the coping process. Persons described as being most helpful were oncologists, partner, children, friends an general practitioner. Patients with higher distress levels tend to contact more different persons in trying to find help.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 1072.
The Relationship between Breast Cancer and Research; a Bibliometric Study.
Authors: Glynn R. , Chin J. , Kerin M. , Sweeney K. 
Published: December 2010

Abstract
Background: Thousands of articles are published every year in the medical literature relating to the diagnosis and treatment of cancer patients. An area of contention of late has been the amount of research time and money being devoted to breast cancer, to what some believe is to the detriment of research into other forms of malignancy. The aims of this study were to further investigate the relationship between malignancy and research, in order to better quantify the degree to which breast cancer is being over- or under-represented in the research world.Methods: Bibliometrics is the science of studying written communication by systematic measurement and analysis of research publications. In this study, we examined research output over a one-year period for the 26 most commonly diagnosed cancers in the UK. Our strategy was based on that employed by a group in Edinburgh in 2001, and involved correlating research output with incidence and mortality statistics. In addition, we sought to elucidate changes in research output over time and then to correlate these changes with improvements in survival. The survival data used was that published by Coleman et al in 2004, and represents changes in survival over 5 year periods between 1986 and 1999 in England and Wales.Results: A total of 73,798 publications were included in this study. Breast cancer received more research attention than any other malignancy in the time period of this study. Proportional to its incidence and associated mortality, however, breast cancer was markedly underrepresented. This relationship was consistent across publication and study types, and in the higher impact journals. There was a strong positive correlation between improvement in 5-year survival and research output (p = 0.003). Those malignancies enjoying the greatest increases in output included those involving the prostate, non-hodgkins lymphoma, breast and vaginal cancer.Conclusions: This study was intended to provide a snapshot-in-time of research output in malignancy. It has shown that, on the basis of both incidence and mortality, breast cancer is not receiving disproportionate attention by the research community, contrary to popular opinion. Whilst the absolute figures clearly reflect the success of the breast cancer advocacy community in raising and maintaining the profile of the disease, the evidence suggests that, if anything, breast cancer is not receiving the interest it deserves, based on its burden to society.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 1080.
A Multi-Center Study To Determine the Optimum Duration of Neoadjuvant Letrozole on Tumour Regression To Permit Breast Conserving Surgery – An Interim Analysis.
Authors: Carpenter R. , Doughty J. , Cordiner C. , Moss N. , Gandhi A. , Wilson C. , Andrews C. , Gui G. 
Published: December 2010

Abstract
Background: Neoadjuvant letrozole is an attractive alternative to chemotherapy for post menopausal women with large, ER positive breast cancer, who are destined for mastectomy but would prefer breast conservation. Prospective studies have not investigated treatment duration beyond 6 months and retrospective studies suggest useful responses can occur after this period.Materials and Methods: This trial is a prospective, UK centrally quality assured, multi-centre, longitudinal study to assess the optimal duration of neoadjuvant letrozole treatment to allow breast conserving surgery for a period of up to12 months. Post menopausal women with large (≥T2), ER and/or PgR positive primary tumours, not considered eligible for breast conservation, were commenced on neoadjuvant letrozole and response was assessed every 2 months with clinical and ultrasound examination until sufficient shrinkage for breast conservation, progression or 12 months had been reached. Ultrasound and Mammography were undertaken at baseline and end-point. We present the initial analysis for time to response and breast conservation.Results: By January 2009, 103 women were available for analysis. 23 (22.3%) had undergone a mastectomy, 60 (58.3%) had achieved breast conservation and 20 (19.4%) remained under evaluation within the trial. The mean age of the group was 74.1 years (52-92). 25 (24.3%) had invasive lobular cancer and 13 (12.6%) had grade 3 tumours. 22 (21.4%) were node positive.Figure 1. Kaplan-Meier plot for time (days) to response sufficient for breast conservation.25% had breast conservation by 5.8 months, 50% by 8.2 months and 75% by 12 months. Median time to breast conservation was 8.2 months (95% CI 6.4-9.3)Figure 2. Median change in tumour volume from baselineAfter an initial rapid response in the first 4 months, the rate of response was slower and constant for a further 6 months. Tumour volume reduction to permit breast conservation varied between 65 and 80% .Discussion: This interim analysis indicates that the conventional treatment period of 4 to 6 months of neoadjuvant letrozole should be revised. For most women longer duration will increase the likelihood of achieving sufficient volume reduction to allow breast conserving surgery.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 1082.
Impact of Progression during Neoadjuvant Chemotherapy on Operative Management of Breast Cancer.
Authors: Caudle A. , Gonzalez-Angulo A. , Hunt K. , Kuerer H. , Pusztai L. , Kau S. , Mittendorf E. , Hortobagyi G. , Meric-Bernstam F. 
Published: December 2010

Abstract
Background: Neoadjuvant chemotherapy (NCT) is the standard of care for locally advanced breast cancer, but remains controversial in early stage disease. Some have raised concerns that disease progression may make breast-conserving therapy (BCT) or even mastectomy impossible. The goal of this study was to determine the impact of disease progression during NCT on operative management. Methods: We reviewed clinicopathologic data on patients receiving NCT for Stage I-III breast cancer at a cancer center between 1994 and 2007. Chemotherapy regimens were anthracycline and/or taxane-based as determined by the medical oncologist. Results: 1928 patients received NCT, of which 1762 (91%) had a response (minor, partial, or complete), 107 (6%) had stable disease (SD), and 59 (3%) progressed (PD) on at least one regimen. Of the 59 patients with progression, 13 (22%) had tumor response and 7 (12%) had SD with their first regimen, but progressed on their second regimen. Thirty-nine (66%) had progression on their first regimen of which 4 (10%) proceeded to surgery, 1 (3%) developed metastasis, and 1 (3%) refused further therapy. Thirty-three (85%) received a second chemotherapy regimen after progression on the first regimen; 18 (55%) had response to the second regimen, 5 (15%) had SD, and 10 (30%) had further progression. Eight (14%) had XRT to control local progression. In the 59 patients with progression at any point during NCT, 40 (68%) underwent mastectomy, 12 BCT (20%), and 7 (12%) had no surgery. In patients who had mastectomies, 3 (8%) were BCT candidates before progression, one (3%) was converted to mastectomy for technical reasons, and 2 (5%) were not evaluable from available data. Overall, disease progression changed the operative plan in 11 (0.5%): 2 developed distant metastasis, 2 developed clinical lymphadenopathy, 3 required mastectomy instead of BCT, 3 became inoperable, and 1 required flap closure. Conclusion: Patients treated with NCT should be evaluated by multi-disciplinary team members for response to therapy. Progression on NCT is infrequent (3%), but the optimal management in these patients needs further study. Overall, progression on NCT changes the operative management in only a small proportion of patients.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 1090.
Prognostic Factors for Locoregional Recurrence in Operable Breast Cancer Patients Treated with Preoperative Systemic Chemotherapy.
Authors: Jung S. , Min S. , Lee S. , Park C. , Kwon Y. , Kim E. , Ko K. , Lee K. , Park I. , Jeong J. , Shin K. , Lee S. , Kim S. , Kang H. , Ro J. 
Published: December 2010

Abstract
Background: We aimed to evaluate the clinicopathologic factors affecting locoregional recurrence (LRR) in potentially operable breast cancer patients receiving preoperative systemic chemotherapy (PST).Methods: We reviewed the records of 316 breast cancer patients treated with PST (doxorubicin/cyclophosphamide, 101; docetaxel /capecitabine, 103; paclitaxel/gemcitabine, 43; doxorubicin/docetaxel, 69) followed by surgery and adjuvant radiotherapy between 2002 and 2006. The majority of patients had clinical positive axillary lymph nodes. To define the prognostic factors for LRR, age, clinical stage, hormone receptor (HR) and HER2 status, clinical and pathologic response, type of operation, pathological characteristics including tumor size, tumor grade, nodal status, number of positive axillary nodes, size of metastatic lymph node and status of resection margin and tumor multiplicity before and after PST were analyzed.Results: Overall 52 patients (16.5%) in the primary tumor and 87 patients (27.5%) in the axillary nodes achieved a pathologic complete response (pCR), and 206 patients (65.2%) underwent breast conserving surgery (BCS). With a median follow-up of 52.4 month (range: 4.7 - 89.4), total 18 (5.7%) patients developed LRR; 2 of 110 (1.8%) patients with mastectomy vs. 16 of 206 (7.7%) patients with BCS (p=0.04). Other significant factors in the univariate analysis were clinical T stage, HR status, clinical response and tumor multiplicity. A pCR in the primary tumor or node was not a prognostic factor for LRR in this study. In multivariate analysis, clinical T stage (T3/4, HR 7.8; 95% CI, 2.33-26.24; P=0.001), hormone receptor status (negative, HR 6.2; 95% CI, 1.91-20.22; P=0.002) and type of surgery (BCS, HR 9.5; 95% CI, 1.97-46.37; P=0.005) were independent prognostic factors. Among patients with BCS, advanced clinical T stage (HR 12.4; 95% CI, 3.45-44.56; P&lt;0.001), negative hormone receptor (HR 4.74; 95% CI, 1.33-16.96; P=0.02), non-responding disease (HR 6.54; 95% CI, 1.07-40.12; P=0.04) and multiple tumors (HR 4.36; 95% CI, 1.06-17.90; P=0.04) developed more frequent LRR.Conclusions: Significantly more patients with advanced clinical T stage, negative HR status and BCS developed LRR in operable breast cancer treated with PST. Moreover, in patients with BCS after PST, clinically non-responding disease and multiple tumors showed unfavorable prognosis besides the larger tumors and negative hormone receptor.Partly supported by NCC Grant No 0610240
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 1095.
Ibandronate Shows Marked Pain Relief and a Favorable Renal Safety Profile – Updated Results of a Non Interventional Study in Breast Cancer Patients with Metastatic Bone Disease.
Authors: Schmidt M. , Hesse T. , Kuehnle H. , Lerchenmueller C. , Schlag R. 
Published: December 2010

Abstract
Background: Bisphosphonates (BP), the current standard of care for patients with metastatic bone disease (MBD) due to breast cancer (BC), effectively reduce the incidence of skeletal related events (SRE) and the severity of bone pain. However, BP treatment may adversely affect kidney function and thus renal safety is a key determinant of BP risk/benefit assessment. In randomized clinical trials (RCT), Ibandronate (IBA), a third generation amino-BP available in IV and oral formulations, has demonstrated sustained effects on SRE and bone pain with a low incidence of renal adverse events. To verify those results under real life conditions, a large-scale non interventional study (NIS) is currently being conducted in Germany.Patients and methods: In accordance with the terms of the marketing authorization, BC patients with MBD receive 6 mg IBA IV every 3–4 weeks or 50 mg of oral IBA once daily (at the physician's discretion) for up to 24 weeks. Pain severity (VAS), analgesic use (WHO analgesic ladder), SRE, and renal function (serum creatinine levels and estimated creatinine clearance, eCrCl; Cockcroft-Gault formula) are recorded in 4-week-intervals.Results: For this interim analysis, data for 2676 patients, mean age 63.6 ±11.8 years, were evaluated. 1735 (65%) were BP-naïve; 317 (12%) had received prior treatment with IBA, 614 (23%) with other BPs, including zoledronic acid (ZOL) (393; 15%) and pamidronate (PAM) (210; 8%). At baseline, mean pain severity (VAS) was lower for patients pretreated with IBA (2.7 ± 2.2) compared to BP-naïve patients (3.3 ± 2.4; p &lt; 0.0001) or patients pretreated with other BPs (3.2 ± 2.4; p= 0.0041) and analgesic use was less frequent (38% vs 49% and 47%, respectively).In patients reporting pain at baseline, mean pain severity decreased on IBA treatment throughout the observation period (VAS: 3.2 ± 2.4 to 2.4 ± 2; p &lt; 0.0001). In parallel, there was an overall reduction of analgesic use with 57% of patients not requiring analgesics at the end of the observation period. SRE were rare (7%), irrespective of prior treatment. For patients evaluable for renal function throughout the observation period, mean eCrCl at baseline was significantly lower in patients pretreated with ZOL (70.7 ml/min) than in BP-naïve (78.9 ± 30.9 ml/min; p &lt; 0.0001) or IBA-pretreated patients (78 ± 29.1 ml/min; p=0.00386). Changes in renal function during IBA treatment were small and balanced across all subgroups. Overall tolerability of IBA treatment was rated as very good or good by 96% of physicians and patients alike.Conclusion: In this interim analysis of a large scale NIS in BC patients with MBD, IV and oral IBA showed marked and sustained pain relief with an overall reduction of analgesic use and a renal safety profile comparable to results of RCTs.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 1108.