M1947 Does a Family History of Breast Cancer Trump a Family History of Colorectal Cancer for Colonic Neoplasia in a Prospectively Evaluated High Risk Population?

AbstractPatients with triple-negative breast cancer (TNBC) who have residual disease after neoadjuvant therapy have a high risk of recurrence. We tested the impact of DNA-damaging chemotherapy alone or with PARP inhibition in this high-risk population. Patients with TNBC or deleterious BRCA mutation (TNBC/BRCAmut) who had >2 cm of invasive disease in the breast or persistent lymph node (LN) involvement after neoadjuvant therapy were assigned 1:1 to cisplatin alone or with rucaparib. Germline mutations were identified with BROCA analysis. The primary endpoint was 2-year disease-free survival (DFS) with 80% power to detect an HR 0.5. From Feb 2010 to May 2013, 128 patients were enrolled. Median tumor size at surgery was 1.9 cm (0–11.5 cm) with 1 (0–38) involved LN; median Residual Cancer Burden (RCB) score was 2.6. Six patients had known deleterious BRCA1 or BRCA2 mutations at study entry, but BROCA identified deleterious mutations in 22% of patients with available samples. Toxicity was similar in both arms. Despite frequent dose reductions (21% of patients) and delays (43.8% of patients), 73% of patients completed planned cisplatin. Rucaparib exposure was limited with median concentration 275 (82–4694) ng/mL post-infusion on day 3. The addition of rucaparib to cisplatin did not increase 2-year DFS (54.2% cisplatin vs. 64.1% cisplatin + rucaparib; P = 0.29). In the high-risk post preoperative TNBC/BRCAmut setting, the addition of low-dose rucaparib did not improve 2-year DFS or increase the toxicity of cisplatin. Genetic testing was underutilized in this high-risk population.

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Dementia screening in elderly high-risk patients following heart failure decompensation may predict unfavorable long-term clinical outcomes

European Heart Journal ◽

10.1093/ehjci/ehaa946.0979 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

K Stepien ◽

P Furczynska ◽

M Zalewska ◽

K Nowak ◽

A Wlodarczyk ◽

...

Keyword(s):

Heart Failure ◽

High Risk ◽

Clinical Outcomes ◽

Mmse Score ◽

Coronary Revascularization ◽

High Risk Population ◽

Risk Population ◽

History Of

Abstract Background Recently heart failure (HF) has been found to be a new dementia risk factor, nevertheless their relations in patients following HF decompensation remain unknown. Purpose We sought to investigate whether a screening diagnosis for dementia (SDD) in this high-risk population may predict unfavorable long-term clinical outcomes. Methods 142 patients following HF decompensation requiring hospitalization were enrolled. Within a median time of 55 months all patients were screened for dementia with ALFI-MMSE scale whereas their compliance was assessed with the Morisky Medication Adherence Scale. Any incidents of myocardial infarction, coronary revascularization, stroke or transient ischemic attack (TIA), revascularization, HF hospitalization and bleedings during follow-up were collected. Results SDD was established in 37 patients (26%) based on the result of an ALFI-MMSE score of <17 points. By multivariate analysis the lower results of the ALFI-MMSE score were associated with a history of stroke/TIA (β=−0.29, P<0.001), peripheral arterial disease (PAD) (β=−0.20, P=0.011) and lower glomerular filtration rate (β=0.24, P=0.009). During the follow-up, patients with SDD were more often rehospitalized following HF decompensation (48.7% vs 28.6%, P=0.014) than patients without SDD, despite a similar level of compliance (P=0.25). Irrespective of stroke/TIA history, SDD independently increased the risk of rehospitalization due to HF decompensation (HR 2.22, 95% CI 1.23–4.01, P=0.007). Conclusions As shown for the first time in literature patients following decompensated HF, a history of stroke/TIA, PAD and impaired renal function independently influenced SDD. In this high-risk population, SDD was not associated with patients' compliance but irrespective of the stroke/TIA history it increased the risk of recurrent HF hospitalization. The survival free of rehospitalization Funding Acknowledgement Type of funding source: None

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Should GLP-1 receptor agonists be used with caution in high risk population for colorectal cancer?

Medical Hypotheses ◽

10.1016/j.mehy.2013.11.034 ◽

2014 ◽

Vol 82 (3) ◽

pp. 255-256 ◽

Cited By ~ 3

Author(s):

Yang Sun ◽

Lei Fan ◽

Jin Meng ◽

Feng Zhang ◽

Dian Zhang ◽

...

Keyword(s):

Colorectal Cancer ◽

High Risk ◽

High Risk Population ◽

Risk Population ◽

Receptor Agonists

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Knowledge and Awareness about Colorectal Cancer and Its Screening Guidelines among Doctors in Al Ahsa, Eastern Province, Kingdom of Saudi Arabia

Global Journal of Health Science ◽

10.5539/gjhs.v9n6p145 ◽

2016 ◽

Vol 9 (6) ◽

pp. 145

Author(s):

Bathula Surendra ◽

Muhammad Mujtaba Hashir ◽

Fahad Salman Al Harbi ◽

Mohammed Jassim Al Nuwaysir ◽

Khalid Majed Al Khaldi ◽

...

Keyword(s):

Colorectal Cancer ◽

Saudi Arabia ◽

High Risk ◽

Public Health Problem ◽

Screening Tests ◽

High Risk Population ◽

Major Public Health Problem ◽

Eastern Province ◽

Risk Population ◽

Screening Guidelines

INTRODUCTION: Cancer is a major public health problem. Worldwide, colorectal cancer (CRC) is a leading cause of deaths due to cancer in both men and women. Among, Saudi men, CRC is the most common malignancy while it is the third most common among Saudi women. Over, two decades the incidence and deaths due to CRC have been steadily increasing in Saudi Arabia. Regular and timely screening has the potential in reducing the incidence and deaths due to colorectal cancer. The present study is conducted to evaluate the knowledge and awareness about colorectal cancer and its screening among the doctors.OBJECTIVES: To measure the frequency of knowledge and awareness about colorectal cancer and its screening guidelines among doctors in Al-Ahssa.METHODS: A questionnaire based survey of the doctors (Specialists & residents), working in different hospitals and primary health centers under the Ministry of Health in Al Ahssa region, Eastern province, KSA. Knowledge and awareness about colorectal cancer and its screening among the doctors is evaluated.RESULTS: Over 80% of the doctors knew, screening reduces deaths due to CRC. Only 60% were aware about the risk factors and less than 50% knew the clinical features of CRC. About 60% doctors agreed Colonoscopy is gold standard screening test. While, less than 60% knew the ideal age to initiate screening and the actual interval of screening tests in the standard risk and high-risk population. Fewer than 25% doctors were aware about the American cancer society recommended screening guidelines. Majority of the doctors expressed keen interest to know and receive information about CRC and its screening guidelines. CONCLUSIONS: Regular and timely screening reduces deaths due to CRC. There is a need for improving knowledge and awareness of doctors about CRC and its screening. Awareness among the doctors improves uptake of screening by the general and high-risk population.

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Male Breast Cancer: Surgical and Genetic Features and a Multidisciplinary Management Strategy

Breast Care ◽

10.1159/000501711 ◽

2019 ◽

Vol 15 (1) ◽

pp. 14-21 ◽

Cited By ~ 1

Author(s):

Francesca Pellini ◽

Eleonora Granuzzo ◽

Silvia Urbani ◽

Sara Mirandola ◽

Marina Caldana ◽

...

Keyword(s):

Breast Cancer ◽

Family History ◽

High Risk ◽

Male Breast Cancer ◽

Brca2 Mutation ◽

Positive Family History ◽

Male Breast ◽

Mutation Carriers ◽

History Of ◽

Clinical Records

Background: Male breast cancer (MBC) is a rare disease with a rising incidence trend. The major risk factors related to MBC are a positive family history of breast cancer (BC) and BRCA1/2 mutations, which indicate a relevant genetic role. Methods: In this retrospective series, we enrolled 69 male patients presenting with male breast cancer (MBC) between 01/01/1992 and 31/12/2018, and 26 high-risk not-affected men presenting between 01/01/2016 and 31/12/2018. Participants’ electronic clinical records were reviewed. Patients’ data reported age at diagnosis, tumor characteristics, therapeutic management, and BRCA1/2 status as well as a family history of breast, ovarian, or prostate cancer (PCa) in first-degree relatives. Results: We analyzed 69 MBC patients. Median age was 64 years. The majority of tumors diagnosed were of an early TNM stage. The most frequent histological subtype was invasive ductal carcinoma (76.7%). Hormone receptors were positive in >90% of MBC cases. Nearly all patients underwent modified radical mastectomy or total mastectomy. Adjuvant endocrine therapy was delivered in 59.4%. Among MBC-affected patients, we recorded a high percentage of a positive family history of BC. Mutational analysis for the BRCA1/2 genes was performed in 17 MBC patients; 11.8% were carriers of BRCA2 pathogenic mutations. Among 26 healthy high-risk subjects included in this case series, 4 were BRCA1 mutation carriers and 9 were BRCA2 mutation carriers. Discussion: We evaluated the distribution of clinicopathological characteristics in MBC subjects and assessed the frequency of mutations in the BRCA genes in affected patients and healthy high-risk subjects, with the aim of proposing a surveillance program for BC and PCa.

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