bluuebunny/crossref_metadata_2025_split huggingface dataset:
Taxonomic features of the red alga Meristotheca coacta (Solieriaceae, Gigartinales)
Authors: Faye Etienne Jean , Kogame Kazuhiro , Shimada Satoshi , Kawaguchi Shigeo , Masuda Michio 
Published: April 2007

SUMMARYVegetative and reproductive structures of the little‐known red alga, Meristotheca coacta Okamura (Solieriaceae, Gigartinales) were described on the basis of specimens collected from three localities in southern Japan, including an island close to the lectotype locality. Meristotheca coacta was shown to be a strongly supported monophyletic clade in our rbcL analyses. The taxonomic features of this species were reassessed. This species is characterized as follows: (i) the thalli consist of relatively thick (300–1400 μm from the uppermost to basal regions), elastic and rose‐red blades; (ii) the blades are irregularly lobed and branched into variously shaped segments with undulate and crispate margins; (iii) tetrasporangial initials are laterally attached to their parental cells and the lateral pit‐connections remain in mature tetrasporangia; (iv) gametophytes are dioecious; (v) carpogonial branches are three‐celled (occasionally two‐ or four‐celled); (vi) a darkly staining auxiliary cell complex is present and recognizable prior to diploidization; and (vii) cystocarps are produced along (or near) the margins of the blades and on the marginal proliferations and lack spinous outgrowths.
BS01 LOCALLY ADVANCED BREAST CANCER: NEED FOR A CO‐ORDINATED, MULTIDISCIPLINARY APPROACH
Authors: Chan A. 
Published: April 2007

Historically, patients presenting with large, inoperable cancers were treated with radiation therapy alone or radiation therapy followed by surgical resection. The use of systemic therapy in patients with locally advanced breast cancer (LABC) has led to improved disease outcome when compared with surgery or radiotherapy alone. In comparison with operable breast cancer, there is a relative paucity of randomised trials evaluating systemic therapy for LABC. Of the randomised trials published, a statistically significant survival benefit is only demonstrated in a few. The difficulties in performing large randomised trials in LABC relate to several issues. The classification of LABC which includes T3, T4, and N2 disease incorporates a heterogeneous group of patients. There is a variable approach taken by clinicians in terms of the type of pre‐operative chemotherapy used, sequencing of locoregional therapy and whether post‐operative adjuvant systemic therapy is also given. To date, the efficacy of systemic therapy in LABC has largely been established from results of non‐randomised Phase II studies. These studies compare favourably to historical data with higher 5‐ and 10‐year disease‐free and overall survival. A common finding in several trials of pre‐operative systemic treatment is that the rates of breast conserving surgery is increased and those patient achieving a complete pathological response have superior disease outcomes than those who do not.An overview of trials supporting the current management of LABC will be presented. The objectives and preliminary findings of a multicentre study initiated in Perth for women with LABC will also be discussed.
BS11 THE ROLE OF PRE‐OPERATIVE MRI IN PATIENTS WITH INVASIVE LOBULAR CARCINOMA OF BREAST
Authors: Edirimanne S. , Mckenzie K. , Wells S. , Dijkstra B. 
Published: April 2007

Background  Conventional breast imaging with mammography and ultrasonography have a tendency to underestimate the extent of invasive lobular carcinoma (ILC) of the breast. The aim of the study is to determine the role of routine pre‐operative breast MRI in treatment of patients with ILC of breast.Methods  33 patients with ILC and 6 patients with pleomorphic lobular cancer (PLC) of the breast had pre‐operative contrast enhanced MRI of the breasts. Suspicious additional foci were evaluated with focussed ultrasound and biopsy, selectively in ipsilateral breast and routinely in contralateral breast. The histological results of additional foci were correlated with MRI findings to determine the accuracy.Results  In 1 patient (3%) index tumour was detected only by MRI. In ipsilateral breast, additional foci were found in 16 patients (41%) that led to more extensive surgery in 13 patients (33%) with a false positive rate of 15%. In the contralateral breast MRI detected suspicious foci in 7 patients (18%) and malignancy was confirmed by biopsy in 1 patient (false positive rate 86%).Conclusions  In patients with ILC or PLC routine pre‐operative MRI alters management of ipsilateral breast significantly with a high accuracy. Due to high false positive rate contralateral breast surgery should not be undertaken based on MRI finding only without biopsy confirmation.
BS12 PREDICTIVE MARKERS FOR BREAST CANCER NEOADJUVANT CHEMOTHERAPY
Authors: Syed S. , Rogers P. A. W. , Ganju V. , Hart S. , Susil B. , Cann L. 
Published: April 2007

Purpose  Although neoadjuvant chemotherapy (NACT) is routinely used in the management of breast cancer, there is no definitive way of predicting which patients are more likely to respond to a particular therapy. The aim of this study was to identify markers that can be used to predict tumor response to chemotherapy in breast cancer.Methodology  We used immunohistochemistry to evaluate blood microvessel density (MVD) (CD31), tumor cell proliferation (Ki‐67), anti‐apoptotic marker (Bcl‐2), ER and PR expression, and HER‐2/neu expression in core biopsy samples (taken before chemotherapy) from patients with locally advanced breast cancer (n = 20), receiving neo‐adjuvant chemotherapy {anthracycline‐based regimen (FEC100) (n = 10) vs single agent taxane regimen (docetaxel) (n = 10), and correlated these factors with tumor response (as assessed clinically and by tumor imaging) after 4 cycles of treatment.Results  Tumors expressing low levels of Bcl‐2 showed significantly greater reduction in size to both taxane (P < 0.05) and anthracycline‐based (P < 0.01) regimens, compared to tumors expressing high levels of Bcl‐2. Further, HER‐2/neu positive tumors showed significantly greater reduction in size to taxane regimen (P < 0.05), while estrogen receptor (ER) negative tumors showed a trend of greater reduction in size to anthracycline‐based regimen (P = 0.06).Conclusions  Bcl‐2 and HER‐2/neu expression may be useful markers to predict response to neoadjuvant chemotherapy in breast cancer. While subject numbers are still too low to draw firm conclusions, the current data indicates that HER‐2/neu may specifically predict a positive tumor response to taxane regimen, and high Bcl‐2 is a marker of chemoresistance.
BS13 THE EFFECT OF ANTIBIOTIC TREATMENT OF INFLAMMATORY BREAST DISEASE ASSOCIATED WITH THE ISOLATION OF LIPOPHILIC CORYNEBACTERIA
Authors: Skinner A. M. , Holland D. J. , Taylor G. B. , Ellis‐Pegler R. , Jones W. O. , Paviour S. D. 
Published: April 2007

Granulomatous mastitis is a rare benign condition effecting women of reproductive age and is most commonly treated surgically. It is an inflammatory disease of the breast associated with the isolation of intracellular lipophilic corynebacteria and has a course of chronicity with recurrences.Purpose   Our aim was to observe the clinical response and subsequent course of women diagnosed with granulomatous mastitis and treated by a long course of lipophilic antibiotics. We also recorded the concurrent requirement for surgical intervention.Methodology   The clinical course of seventeen women with inflammatory breast disease and microbiologic and histologic evidence of infection with Corynebacterium kroppenstedtii were prospectively followed. 11 received treatment with doxycycline (or clindamycin if breast feeding), 5 women received alternative antibiotics, and one patient received no antibiotics.Results   Among the 11 who received doxycycline, full resolution without surgery of disease was achieved in 9 women while another woman showed improvement at follow up, further surgical management was required by 2. All the five women who received alternative antibiotics also had surgery. They each had full resolution of disease at follow up. Further admissions were required by one woman.Conclusion   Optimal treatment for granulomatous mastitis is yet to be determined. We found promising results with a small group of young women who were treated with the lipophilic antibiotic doxycycline alone. These had resolution of disease without requiring surgical intervention.
BS15P FACILITATING NATIONAL CONSISTENCY IN BREAST CANCER DATA COLLECTION
Authors: Roder D. , Kollias J. , Gillett D. , Pyke C. , Care O. , Zorbas H. 
Published: April 2007

In Australia there is currently no consistent approach to collecting breast cancer specific data. The National Health Data Dictionary (NHDD) recommends a core set of generic data items for clinical cancer registration. However this list does not include the more detailed items required by specific tumour streams. The NBCC has developed a supplementary set of Breast Specific Data Items and definitions to serve as a guide for specialist breast cancer data collection in Australia.A multidisciplinary Working Group comprising clinical and consumer representation, including three breast surgeons, identified 16 breast specific data items for collection. The items are designed to align with items collected through the RACS National Breast Cancer Audit and leading cancer centres. A range of items from patient data (menopausal status), diagnostic data (HER2 status, sentinel lymph node), treatment (surgical margin clearance and involvement), and breast reconstruction are included.The data items are recommended as best practice for breast cancer specific data collection and aim to facilitate national consistency in defining, recording, and monitoring information about patients with breast cancer. This national approach will contribute to improved patient outcomes by informing planning, quality improvement and evaluation strategies for cancer services. The items are currently being piloted in two sites in NSW and will be available nationally in late 2007.
BS17P UTILISATION OF CYTOLOGICAL AND HISTOLOGICAL DIAGNOSIS IN THE MANAGEMENT OF BREAST CANCER BY NEW ZEALAND SURGEONS
Authors: Scarlett A. , Dijkstra B. , Mercer P. 
Published: April 2007

The purpose of the study was to determine the practice of breast surgeons working in New Zealand with regard to utilisation of fine needle aspiration and core biopsy in the diagnosis of breast cancer. Surveys were distributed to surgeons in New Zealand involved in breast cancer surgery. Two cases examples were given and their subsequent management questioned. There were 68 respondents (87% response rate).For a palpable breast abnormality which is clinically, radiologically and cytologically (C5) consistent with breast cancer but without pre‐operative histology: 81.5% of respondents would be comfortable to proceed with wide excision 46.2% mastectomy 44.6% with axillary clearance.For a non‐palpable breast abnormality which is radiologically and cytologically (C5) consistent with breast cancer but without pre‐operative histology: 66.2% of respondents would be comfortable to proceed with wide excision 27.7% mastectomy 26.1% with axillary clearance.This survey shows a wide variation in New Zealand in the management of breast cancer with respect to the use of cytology and/or histology to establish diagnosis. There was no statistically significant difference between those who were members of Aotearoa Breast Screening New Zealand, number of years as a surgeon or number of years working in New Zealand.The concern is that patients with non‐invasive disease will undergo an axillary clearance or procedure unnecessarily. Axillary clearance/procedure is not recommended for non‐invasive malignancy. FNA cannot distinguish between non‐invasive and invasive malignancy as can a core biopsy.
BS18 DCIS AND TREATMENT
Authors: Bundred N. J. 
Published: April 2007

Ductal carcinoma in situ now represents 30% of all screen detected breast cancers. Breast conserving surgery for ductal carcinoma in situ is now established although the extent of margin clearance necessary to prevent recurrence after breast conserving surgery remains controversial. None of the previous trials which compared radiotherapy with breast conserving surgery alone have achieved clear margin status in all patients and analysis of their data suggests that the recurrence rate when clear margins around the ductal carcinoma in situ are achieved is low (approximately 10% at six years). Data from randomised trials indicates that a margin of greater than 1 mm clearance is sufficient to minimise recurrence in the breast. Several centres have published that clear margins are essential in the management of ductal carcinoma in situ whether radiotherapy is used or not.Tamoxifen has been studied after wide local excision and radiotherapy in the NSABP24 trial and in the UK DCIS trial. In the former trial a 40% reduction in recurrence in the breast using tamoxifen was seen but the majority of this effect was in women under 50 years of age and only a marginal effect was seen in older patients. In the UK DCIS trial a 20% non‐significant reduction in recurrence was seen in women who were not given radiotherapy. Studies show that younger women (less than 50 years of age) have a significantly higher risk of recurrence after ductal carcinoma in situ treatment and tamoxifen is therefore recommended in women under 50 years of age who are undergoing wide local excision for ductal carcinoma in situ. Oestrogen receptor status was retrospectively assessed in the NSABP B24 trial and ER positive DCIS had a 60% reduction in recurrence whilst ER negative DCIS had no benefit. The BASO DCIS II trial assesses the benefit of adding radiotherapy in ER positive DCIS treated with 5 years Tamoxifen on local recurrence. Aromatase inhibitors are more effective in the presence of CerbB2 oncogene, which is frequently expressed in ductal carcinoma in situ and studies comparing aromatase inhibition with Tamoxifen in ductal carcinoma in situ are already underway (IBIS II). These studies should take account of oestrogen receptor status in the ductal carcinoma in situ to allow us to more adequately define the role of oestrogen receptor status in predicting response to therapy in patients with ductal carcinoma in situ.
BS19 BRCA 1 & BRCA2 GENE TESTING FOR BREAST AND OVARIAN CANCER IN AUSTRALIA AND NEW ZEALAND – THE GTG EXPERIENCE
Authors: Firgaira F. 
Published: April 2007

Over the past three years, Genetic Technologies Ltd (GTG) has been providing a fee for service (commercial) BRCA 1 & 2 genetic pathology testing service. Full gene screening isperformed within 8 weeks and fast tracking of testing for clinical management purposes cab be performed in 2–4 weeks.We present a schema for testing that utilizes robotics, LIMS, automated DNA sequencing, computer aided analysis and ISO15189 / NATA / RCPA accredited test protocols.Despite the active testing that has been carried out of the BRCA1 & 2 genes worldwide over the past decade, it is interesting to note that significant numbers of new (not previously reported) BRCA mutational events and gene variants have been identified in our testing service – the GTG experience.
BS21 SCREENING FOR BREAST CANCER – THE UK APPROACH
Authors: Bundred N. J. 
Published: April 2007

In the United Kingdom the Forest Report in 1985 recommended the setting up of breast screening with women aged 50–64 years screened every 3 years by single view mammography. Since 2000 the screening process has been increased to women aged 50–70 years and the screening every 3 years is now with two view mammography, producing a 40% expansion in workload.Screening for breast cancer was funded centrally with allocation to each region and regional and national quality assurance centres were set up for both surgery, pathology and radiology. The programme is dependant on a high compliance rate with a low recall rate and a high cancer detection rate. It is carried out by a combination of mobile vans and static site for screening. Around 5% of women are recalled to the assessment clinics and 16% of these will have cancer (CF symptomatic practice where 6% have cancer).Survival rates in screening programmes of those patients who attend is 90.2% at 10 years whereas for non‐attendees it is 52% survival from diagnosed breast cancer. The cancer detection rate per 1,000 women has gone up regularly from inception such that last year it was 8 cancers detected per 1,000 women screened, with a total of 14,040 cancers detected in the screening programme in the UK.The development of breast screening centres led to the development of breast specialisation in pathology surgery and radiology across the UK and has had a major impact in the multidisciplinary management of breast cancer and the improvement in overall survival.
BS24 APOPTOSIS: WHY SURGEONS NEED TO UNDERSTAND IT
Authors: Bundred N. J. 
Published: April 2007

Apoptosis (programmed cell death) is a mechanism which enables regulation of cell number in tissues and elimination of unneeded, ageing or damaged cells. Imbalances between epithelial proliferation and apoptosis contributes tumour genesis and tumour progression. Apoptosis is morphologically characterised by nuclear condensation and cytoplasmic shrinkage. The process of proliferation and apoptosis within tumours is closely linked with higher proliferative accounts being associated with higher apoptotic rates. Initial therapeutic advances involved agents that block proliferation but evidence is mounting that it is blocks to apoptosis which need to be overcome to enhance treatments for breast cancer. A newer group of novel biological agents such as the HER2 inhibitors trigger apoptosis to achieve responses.Apoptosis occurs via two predominant pathways, which act via a Caspase effector mechanism. An extrinsic pathway activated by ligands to the TRAIL, FAS/TNF family of cell membrane bound death receptors which recruits intracellular adaptor proteins including pro‐Caspases to induce apoptosis in the cells. Recent studies suggest Caspase 8 alterations influence breast cancer development via the extrinsic pathway.The intrinsic pathway starts from the mitochondria and can be activated by a large number of signals including irradiation, DNA damage and alteration of the ratio of BCL2, BAX family members. This leads to release of Cytochrome C and activation of Caspase 9 leading to apoptosis. Apoptosis and activation of Caspase 9 can be prevented by the Inhibitor of Apoptosis Protein (IAP) family. Breast cancers often express mutated p53 which makes them resistant to apoptosis induced by alkylating agent chemotherapy. Pro‐apoptotic agents will potentially improve the effectiveness of chemotherapy. Breast cancer expresses the BCL2 family proteins which are induced by oestrogen and thus anti‐oestrogens such as Tamoxifen and Fulvestrant can induce apoptosis by increasing BAX expression and decreasing BCL2 activity.Newer agents such as Herceptin, Lapatinib (dual molecular HER1/HER2 inhibitor) and the RAS farnesylation transferase inhibitors induce apoptosis by activating the pro‐apoptotic protein BAD another member of the BCL2 family. Combinations of drugs which induce apoptosis can potentially be used to cause tumour regression. For instance, a one per cent increase in apoptosis is likely to have the same effect as a 50% reduction in cell proliferation on tumour growth. Current targets for drug discovery includes targets against endogenous antagonists of Caspase activation and IAP antagonists. Therapies for inducing apoptosis will be discussed.
BS25 BREAST RECONSTRUCTION WITH TRANSVERSE RECTUS ABDOMINUS MYOCUTANEOUS FLAP
Authors: Codner M. A. , Weinfeld A. B. 
Published: April 2007

Introduction  In the absence of contraindications, autologous tissue reconstruction is an attractive method of breast reconstruction. The TRAM flap has become the cornerstone of autologous tissue only breast reconstruction. In most women, there is sufficient abdominal adipose tissue and skin for bilateral breast reconstruction without the need for prosthetic devices. This flap can be employed for both immediate and delayed reconstruction. It provides soft pliable tissue for post‐mastectomy reconstruction and in general has fewer radiation therapy associated complications than implant based methods of breast reconstruction.Methods  Pedicled TRAM flaps are employed for breast reconstruction. Each hemi‐TRAM is based on a single pedicle. In cases of immediate breast reconstruction the flap is raised at the same time the mastectomy is being performed. In cases of DM, tobacco history, or moderate obesity, a vascular delay is performed by ligating the DIEP vessels 2 weeks prior to elevating the flap and a bipedicle flap is used to maximize blood supply. The rectus sheath fascia is repaired primarily, and the abdominal wall is reinforced with onlay marlex mesh. The TRAM flap is inset and shaped to form a youthful but mildly ptotic breast. Drains are used in both the donor site and recipient site. Long term catheter delivery of local anesthetic is employed at the donor site.Results  Over the past years 10 years, 78 TRAM breast reconstructions have been performed with satisfactory to excellent results. 90% were performed for immediate reconstruction and 10% for delayed reconstructions 10% underwent surgical vascular delay of the flap for the indications discussed above and in order to avoid a free flap. There were 2 cases of total flap loss. The percentage of fat necrosis was 15%. Other complications included mastectomy skin loss (8%), hematoma/seroma (5%), and infection (5%). Revision surgery to improve the aesthetic outcome was performed in (20%). NAC reconstruction using the purse‐string method was performed in 95% of the patients.Conclusions  TRAM flap breast reconstruction is a very favorable method for assisting in the overall care of a patient with breast cancer. Satisfaction is very high and major complications are acceptable. The disadvantages include longer operative time and prolonged recovery compared to tissue expander reconstruction. I feel the advantages of autologous tissue reconstruction outweigh these riskes in addition to the risks of complications associated with tissue expander, implant reconstruction. A staged approach to TRAM flap reconstruction should be considered for patients who may require postoperative radiation for local control in order to avoid the deleterious effects of radiation on the TRAM flap.
BS03 PATTERNS AND PROGNOSIS OF BREAST CANCER RECURRENCE
Authors: Gillett D. J. , Elder E. , Gluch L. , Carmalt H. C. 
Published: April 2007

The data base of The Strathfield Breast Centre (TSBC) was reviewed to determine the patterns of recurrence and their prognosis after the treatment of breast cancer.The TSBC has a prospective data base from 1989 forward with information on 2509 patients up to 2002. The follow‐up on these patients is 81%. This data was interrogated.Breast conservation was performed in 1390 (55.4%) and of these 84.7% had adjuvant radiotherapy and 62.7% had adjuvant systemic treatment. Rates of recurrence were related to grade and stage of the tumour.Local regional or distant relapse occurred in 456 (18%). The site of first cancer recurrence was local 27.2%, bone 27.4%, lung 16% liver 12.5% and supraclavicular fossa 5.5%.At the end of the study 527 patients had died, 323 were cancer related deaths, the majority of the recurrences occurred in the first three years (58%) and 79% occurred within 5 years.Local recurrence in the breast occurred in 4.6% of patients and in the chest wall in 5.2%. The 5 yr disease free survival of these patients was 49.4% and 33.1% respectively.Distant metastases occurred to bone, lung and liver in the majority of cases in which it happened. The 5 yr survival for these patients was16%, 12% and 0%.The recurrence data from the TSBC is comparable to that reported elsewhere. The majority of recurrences occurr in the first 5 yrs, The prognosis after relapse varies with site.Local in the b reast being better than in the chest wall and bone being better than visceral.