Clinical findings and outcomes from MRI staging of breast cancers in women.

1124 Background: For patients diagnosed with breast cancer, case series have shown that staging MRI can detect occult breast cancers in 1-10% of cases. Prevalence and risk factors in underserved populations remain unclear. Methods: We performed a retrospective analysis of all patients, newly diagnosed, with breast cancer who had a preoperative staging MRI seen at Norris Comprehensive Cancer Center and LAC +USC, that cares for an underserved and minority population, from 2006 to 2011. Demographic, clinicopathologic and imaging data were obtained through a review of electronic records. Non index lesions were defined as those not known to be malignant, not presenting with clinical, mammographic or ultrasound findings, in a different quadrant and given an MRI BIRADS score of 4 or 5. Results: A total of 718 patients were analyzed and 148 patients (21%) had a total of 187 non index lesions; 63% were ipsilateral, 26% contralateral and 11% bilateral. As initial evaluation of non-index ipsilateral lesions, 71 (38%) had biopsy, 24 (13%) had excision and 34 (18%) had mastectomy. For contralateral non-index lesions, 41 (22%) had contralateral biopsy, 6 (3%) had excision and 11(6%) had mastectomy. Among all non index lesions, 111 (59%) were benign, 14 (7%) DCIS and 62 (33%) invasive cancer. Occult ipsilateral cancer was detected in 50 (6.9%) of patients and contralateral in 10 (1.4%) and bilateral in 6 (0.8%). Conclusions: The occult cancer detection rate with staging MRI was in this 9.2% of this diverse population. No clear risk factors were identified, with detailed factors, including BRCA status to be updated and reanalyzed. [Table: see text]

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Bone mineral density and FRAX as predictors of fracture risk in women with breast cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.26_suppl.121 ◽

2013 ◽

Vol 31 (26_suppl) ◽

pp. 121-121

Author(s):

Beatrice J. Edwards ◽

William John Gradishar ◽

Maureen Smith ◽

Jennifer A. Pacheco ◽

Jaimee S Holbrook ◽

...

Keyword(s):

Breast Cancer ◽

Risk Factors ◽

Cancer Therapy ◽

Fracture Risk ◽

Cancer Survivors ◽

World Health ◽

Comprehensive Cancer Center ◽

Cancer Center ◽

Mineral Density ◽

T Score

121 Background: The number of cancer survivors is rising in the USA, the 2007 CDC analysis of the SEER database estimated 11 million cancer survivors, with 90% being over the age of 65 years. Of these, 70% are women, and the most common cancer in survivors is breast cancer. Cancer therapy induced bone loss (CTIBL) contributes to an increase in fracture risk in women with breast cancer. Fractures are responsible for considerable morbidity, disability, hopitalizations and mortality in older adults. Fractures are often the cause for nursing home placement in seniors. Our objective was to analyze the prevalence of fractures after breast cancer therapy and to assess the effect of cancer therapy, clinical risk factors, bone density and the World Health Oragnization (WHO) fracture risk assessment [FRAX] as predictors of fracture occurrence. Methods: The study population consisted of breast cancer patients with invasive breast cancer who participated in a genetic databank within a NCI-Comprehensive Cancer Center. Demographic and clinical characteristics were abstracted from the EMR. Participants were followed for 6-12 years. Results: A total of 439 women with breast cancer were assessed; 79 had sustained fractures during the observation period (116 fractures), fractures occurred at multiple skeletal sites in 27 cases. The prevalence of fractures was 18%. Baseline characteristics revealed that women who sustained fractures were mostly Caucasian (91%, p=0.08), and had a family history of osteoporosis (36.9%, p=0.03). The time to fracture was 4.0 years (range 0-12 years) from diagnosis. Fracture cases had lower BMD at the femoral neck 0.86 ± 0.13 gm/cm2 (T-score= -1.0, p=0.04) than non- fracture cases, although BMD was in the low normal range. Eight cases of hip fractures were identified with a median age of 55 years (32-67 years) Median T-score -0.75. Cox proportional hazard analysis failed to identify any specific risk factors for fractures. Conclusions: Fractures occur shortly after commencing cancer therapy. BMD and FRAX risk calculation were not able to identify women who fractured. Occurrence of fractures in breast cancer raises the possibility of cancer-induced impairment in bone quality.

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Early-stage breast cancer (BC) patients: Factors associated with aromatase inhibitor-induced musculoskeletal symptoms.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.525 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. 525-525

Author(s):

Simran Arora Elder ◽

Yamin Sun ◽

Seungyoun Jung ◽

Candace Bavette Mainor ◽

Shruti Murali ◽

...

Keyword(s):

Breast Cancer ◽

Risk Factors ◽

Aromatase Inhibitor ◽

Early Stage ◽

Musculoskeletal Symptoms ◽

Comprehensive Cancer Center ◽

Cancer Center ◽

Tumor Characteristics ◽

Factors Associated ◽

The Mean

525 Background: Hormone receptor positive (HR+) breast cancer comprises the largest subgroup of breast cancer. Aromatase Inhibitors (AI) are a key treatment for HR+ BC patients (pts) and reduce mortality. Aromatase Inhibitor-Associated Musculoskeletal Symptoms (AIMSS), defined as myalgias, arthralgias, or joint stiffness, occur in up to 50% of pts leading to low adherence to and often discontinuation of therapy. Little is known of the mechanism of AIMSS or its predisposing risk factors. This study aims to identify risk factors associated with AIMSS development in BC patients on AI therapy. Methods: We conducted a medical record review of pts with non-metastatic HR+ BC on adjuvant AI therapy between January 2009 and June 2017 at the University of Maryland Comprehensive Cancer Center. This study included 194 ptswho were free of arthralgia prior to AI therapy. We analyzed pts’ demographics, lifestyle factors, reproductive history, tumor characteristics, medications, cancer treatment, co-morbidities, AI type, onset and severity of AIMSS. Severe AIMSS was defined as requiring change in AI therapy or discontinuation. Multivariable-adjusted logistic regression was used to identify risk factors for severe AIMSS. Results: The mean age of participants was 61. The mean BMI at diagnosis was 30 kg/m2. 41% of pts were White, 40% were Black, 7% other and 12% unknown. Most (79%) did not have a history of tamoxifen and 16% were on GnRH agonists. Most (71%) used letrozole as initial AI therapy; 18% anastrozole; and 11% exemestane. 56% experienced AIMSS while on AI therapy and 20% required change or hold of AI therapy. 4% permanently discontinued AI due to AIMSS severity. BMI at diagnosis was significantly positively associated with risk of AIMSS. Multivariate odds ratio (95% confidence intervals) comparing the highest to lowest tertile of body mass index (BMI) at diagnosis was 4.01 (1.07-10.90; Ptrend: 0.05). There were no significant associations with race, smoking, reproductive factors, type of AI therapy, tamoxifen use prior to AI therapy, medication use, experience of other cancer treatments, and tumor characteristics. Conclusions: 56% of BC pts on adjuvant AI therapy experienced AIMSS. 24% of these changed, held or discontinued AI regimen due to severe AIMSS. Higher BMI at diagnosis was associated with a higher risk of AIMSS. Our results confirm clinical significance of AIMSS among BC pts on AI therapy and suggest BMI as a modifiable factor for AIMSS. A larger study is warranted to replicate our findings and seek other possible risk factors for AIMSS.

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Risk stratification for prediction of locoregional recurrence in patients with pathologic T1–2N0 breast cancer after mastectomy

BMC Cancer ◽

10.1186/s12885-020-07594-7 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Jianyang Wang ◽

Yu Tang ◽

Hao Jing ◽

Guangyi Sun ◽

Jing Jin ◽

...

Keyword(s):

Breast Cancer ◽

Risk Factors ◽

Risk Stratification ◽

Locoregional Recurrence ◽

Risk Model ◽

Tumor Location ◽

Cancer Center ◽

Breast Cancers ◽

Independent Risk Factors

Abstract Background Previous studies have revealed that nearly 15–20% of selected high-risk T1–2N0 breast cancers developed LRR after mastectomy. This study is aim to indentify the risk factors of locoregional recurrence (LRR) in patients with pathologic T1–2N0 breast cancer after mastectomy in a real-world and distinguish individuals who warrant postmastectomy radiotherapy (PMRT). Methods Female patients treated from 1999 to 2014 in National Cancer Center of China were retrospectively reviewed. A competing risk model was developed to estimate the cumulative incidence of LRR with death treated as a competing event. Results A total of 4841 patients were eligible. All underwent mastectomy plus axillary nodes dissection or sentinel node biopsy without PMRT. With a median follow-up of 56.4 months (range, 1–222 months), the 5-year LRR rate was 3.9%.Besides treatment era, age ≤ 40 years old (p < 0.001, hazard ratio [HR] = 2.262), tumor located in inner quadrant (p < 0.001, HR = 2.236), T2 stage (p = 0.020, HR = 1.419), and negative expressions of estrogen receptor (ER) and progesterone receptor (PR) (p = 0.032, HR = 1.485), were patients-related independent risk factors for LRR. The 5-year LRR rates were 1.7, 3.5, and 15.0% for patients with zero, 1–2, and 3–4 risk factors (p < 0.001). Conclusions Risk Stratification based on age, T stage, ER/PR status and tumor location can stratify patients with pT1–2 N0 breast cancer into subgroups with different risk of LRR. PMRT might be suggested for patients with 3–4 risk factors.

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321 Phase I clinical trial assessing the combination of systemic chemokine modulatory regimen targeting TLR3 with neoadjuvant chemotherapy in triple negative breast cancer

Journal for ImmunoTherapy of Cancer ◽

10.1136/jitc-2020-sitc2020.0321 ◽

2020 ◽

Vol 8 (Suppl 3) ◽

pp. A347-A347

Author(s):

Shipra Gandhi ◽

Mateusz Opyrchal ◽

Cayla Ford ◽

Victoria Fitzpatrick ◽

Melissa Grimm ◽

...

Keyword(s):

Breast Cancer ◽

Neoadjuvant Chemotherapy ◽

Phase I ◽

Triple Negative Breast Cancer ◽

Triple Negative ◽

Early Stage ◽

Standard Dose ◽

Surrogate Marker ◽

Comprehensive Cancer Center ◽

Cancer Center

BackgroundNeoadjuvant chemotherapy (NAC) with taxanes is the standard of care in triple negative breast cancer (TNBC). Intratumoral prevalence of CD8+ cytotoxic T-lymphocytes (CTLs) is associated with an improvement in relapse-free survival (RFS) and overall survival (OS), while regulatory T-cells (Treg) and myeloid derived suppressor cells (MDSC) are associated with poor survival. Higher ratio of CTL/Treg is associated with higher probability of obtaining pathological complete response (pCR), a surrogate marker for RFS. Intratumoral production of CCL5, CXCL9, CXCL10 and CXCL11 is critical for local infiltration with CTLs, while CCL22 is responsible for Treg attraction. Previous studies have shown that CXCL9 expression in the pre-treatment breast tissue is associated with a three-fold higher rate of achieving pCR. Our preclinical data show that Chemokine modulating (CKM) regimen, combining rintatolimod (TLR3 agonist), interferon (IFN)-α2b, and celecoxib (COX-2 inhibitor) increases CTL-attracting, and decreases MDSC-, Treg-favoring chemokines, increasing CTL/Treg ratio in tumor microenvironment, with preferential tumor tissue activation than adjacent healthy tissues. We hypothesize that the combination of CKM with paclitaxel will result in infiltration of TNBC with CTLs, and along with doxorubicin/cyclophosphamide (AC), result in higher pCR, translating into improved RFS and OS.MethodsIn this phase I study NCT04081389, eligibility includes age ≥18 years, confirmed resectable TNBC, radiographically measurable disease ≥1 cm, ECOG PS ≤ 2, adequate organ and marrow function. Patients with autoimmune disease, serious mood disorders, invasive carcinoma within 3 years, history of peptic ulcers or hypersensitivity to NSAIDs will be excluded. We plan to treat three patients with early stage TNBC with paclitaxel 80 mg/m2 IV weekly for 12 weeks, rintatolimod 200 mg IV, celecoxib 200 mg oral twice daily, and accelerated titration of IFN-α2b at doses 0, 5, or 10 million units (MU)/m2 [Dose Levels (DL) 1, 2 and 3 respectively] on days 1–3 (no intra-patient dose escalation) in weeks 1–3. Dose-limiting toxicity (DLT) is defined as grade 3 or higher toxicities within the first 3 weeks. Any DLT will mandate recruitment per the 3+3 model. If no DLT, three patients will be enrolled at DL 4 at 20 MU/m2 IFN- α2b. This will be followed by standard dose-dense AC, and then surgery. The primary endpoint is safety and tolerability of combination and to identify the appropriate DL of CKM and paclitaxel for extended efficacy study. The secondary endpoints include investigation of efficacy (pCR and breast MRI response), along with RFS and OS. Intratumoral biomarkers will be analyzed in an exploratory manner.ResultsN/AConclusionsN/ATrial RegistrationNCT04081389Ethics ApprovalThe study was approved by Roswell Park Comprehensive Cancer Center Institution’s Ethics Board, approval number I-73718.

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Survival outcomes in patients with IDC and ILC breast cancer: A well matched single institution study.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.e13056 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. e13056-e13056

Author(s):

Michael Grimm ◽

Bhuvaneswari Ramaswamy ◽

Maryam B. Lustberg ◽

Robert Wesolowski ◽

Sagar D. Sardesai ◽

...

Keyword(s):

Breast Cancer ◽

Endocrine Therapy ◽

Metastatic Breast ◽

Comprehensive Cancer Center ◽

Cancer Center ◽

Her2 Status ◽

Single Institution ◽

First Line ◽

Response To Chemotherapy ◽

Significant Difference

e13056 Background: Invasive lobular carcinoma (ILC) accounts for only 10-15% of all invasive breast cancers but has distinct clinicopathologic characteristics and genomic profiles. In particular, metastatic lobular cancers (mILC) have unique sites of metastasis and it is unclear if the response to initial endocrine therapy differs from metastatic ductal cancers (mIDC). Therefore we have undertaken a single-institution, retrospective analysis to compare overall outcomes and response to initial endocrine therapy (ET) in patients (pts) with metastatic ILC and IDC. Methods: An IRB approved retrospective review of medical records was conducted evaluating pts treated for metastatic IDC and ILC at The Ohio State University Comprehensive Cancer Center from January 1, 2004 to December 31, 2014. Pts diagnosed with mIDC were matched on age, year of diagnosis, estrogen receptor/progesterone receptor and HER2 status and site of metastasis 2:1 to patients diagnosed with mILC. Overall survival (OS) was defined as the time from metastasis to death or last known follow-up. Progression-free survival (PFS) was defined as time from metastasis to progression on first-line ET. Time to chemotherapy (TTC) was defined as time from starting ET for metastasis to initiation of chemotherapy. Kaplan Meier (KM) methods were used to calculate median OS, PFS and TTC. Results: A total of one hundred sixty one pts with metastatic breast cancer were included in this analysis. The demographic features between the two groups were well balanced and included in the table below. The median OS was 2.6 yrs (95% CI: 1.55, 3.22) for mILC and 2.2 yrs (95% CI: 1.95, 2.62) for mIDC. A subset of 111 patients who started on endocrine therapy were used in the PFS and TTC analyses. The median PFS following first-line ET was 2.2 yrs (95% CI: 0.1.0, 2.7) for mILC and 1.4 yrs (95% CI: 0.91, 1.90) for mIDC. Median TTC was 2.1 yrs (95% CI: 1.71, 4.92) for mILC and 2.4 yrs (95% CI: 1.90, 4.77) for mIDC. There was no statistically significant difference in outcomes between the two groups. Conclusions: Outcomes in patients with ILC and IDC have been varied, with several studies reporting that patients with ILC have worse outcomes and response to chemotherapy. Our retrospective study examining outcomes in mILC in comparison with mIDC showed no difference in OS. Given the concern of resistance to conventional therapies in patients with lobular cancers, it is reassuring to see that the median PFS on first line ET and TTC was similar to metastatic ductal cancers.[Table: see text]

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The effect of hyperbaric oxygen treatment on late radiation tissue injury after breast cancer: A case-series of 67 patients

Diving and Hyperbaric Medicine Journal ◽

10.28920/dhm50.3.206-213 ◽

2020 ◽

Vol 50 (3) ◽

pp. 206-213

Author(s):

Nicole E Spruijt ◽

◽

Roy van den Berg ◽

Keyword(s):

Breast Cancer ◽

Risk Factors ◽

Hyperbaric Oxygen ◽

Tissue Injury ◽

Case Series ◽

Shoulder Abduction ◽

Hyperbaric Oxygen Treatment ◽

Normal Tissues ◽

Oxygen Treatment ◽

Shoulder Motion

Introduction: Late radiation tissue injury (LRTI) after breast cancer may benefit from hyperbaric oxygen treatment (HBOT). This study aimed to report the LRTI symptom scores up to 12 months after HBOT and identify risk factors for poor scores. Methods: A case-series of 67 patients who underwent a mean of 44 sessions of HBOT was analysed. LRTI symptoms were scored at four time points using the LENT-SOMA scale (Late Effects in Normal Tissues – Subjective, Objective, Management, and Analytic), a visual analog scale for pain, and the range of shoulder motion. Results: Between starting HBOT and 12 months after HBOT 57 patients (85%) reported at least one point improvement in their LENT-SOMA score. Median pain and fibrosis scores improved significantly between the start and end of HBOT (P < 0.001), and remained stable three and 12 months after HBOT. The median breast oedema score improved significantly 12 months after HBOT (P = 0.003). Median shoulder abduction increased significantly from 90 to 165 degrees (P = 0.001) and median shoulder anteflexion increased significantly from 115 to 150 degrees (P = 0.004). Various risk factors were identified for poor scores despite HBOT; the most common risk factor was a poor score at start of HBOT. Conclusions: In this case-series, patients who underwent HBOT for LRTI after breast cancer reported significant improvement in pain, fibrosis, oedema, and shoulder movement. The improvement persisted up to 12 months after HBOT. A poor score at the start of HBOT was predictive for a poor score 12 months after HBOT.

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Future Burden of Cancer Attributable to Current Modifiable Behaviours: A Pooled Study of Seven Australian Cohorts

Journal of Global Oncology ◽

10.1200/jgo.18.18500 ◽

2018 ◽

Vol 4 (Supplement 2) ◽

pp. 5s-5s

Author(s):

M.A. Laaksonen ◽

M.E. Arriaga ◽

K. Canfell ◽

R.J. MacInnis ◽

P. Hull ◽

...

Keyword(s):

Breast Cancer ◽

Risk Factors ◽

Risk Factor ◽

Alcohol Intake ◽

Breast Cancers ◽

Premenopausal Breast Cancer ◽

Current Smoking ◽

Cancer Burden ◽

The Future ◽

Future Burden

Background: The Population Attributable Fraction (PAF) quantifies the fraction of cancer cases attributable to specific exposures. PAF estimates for the future burden of cancer preventable through modifications to current exposure distributions are lacking. Previous PAF studies have also not compared population subgroup differences. Aim: To apply a novel PAF method and i) assess the future burden of cancer in Australia preventable through modifications to current behaviors, and ii) compare the distribution of the preventable cancer burden between population subgroups. Methods: We harmonized and pooled data from seven Australian cohort studies (N=367058) and linked them to national registries to identify cancers and deaths. We estimated the strength of the associations between behaviors and cancer incidence and death using a proportional hazards model, adjusting for age, sex, study and other risk factors. Exposure prevalence was estimated from contemporary national health surveys. We then combined these estimates to calculate PAFs and their 95% confidence intervals for both individual and joint behavior modifications using a novel method accounting for competing risk of death and risk factor interdependence. We also compared PAFs between population subgroups by calculating the 95% confidence interval of the difference in PAF estimates. Results: During the first 10 years of follow-up, there were 22078 deaths and 27483 incident cancers, including 2025 lung, 3471 colorectal, 640 premenopausal and 2632 postmenopausal breast cancers. The leading preventable cause for lung cancer is current smoking (PAF = 53.7%), for colorectal and postmenopausal breast cancer body fatness or BMI ≥ 25 kg/m2 (PAF = 11.1% and 10.9% respectively), and for premenopausal breast cancer regular alcohol intake (PAF = 12.3%). Three in five lung cancers, but only one in five colorectal and breast cancers, are jointly attributable to potentially modifiable exposures, which also included physical inactivity and inadequate fruit intake for lung, excessive alcohol intake and current smoking for colorectal, regular alcohol intake and current menopausal hormone therapy for 1 year or more for postmenopausal breast and current oral contraceptive use for 5 years or more for premenopausal breast cancer. The cancer burden attributable to modifiable factors is markedly higher in certain population subgroups, including men (lung, colorectal), people with risk factor clustering (lung, colorectal, breast), and individuals with low educational attainment (lung, breast). Conclusion: We provided up-to-date estimates of the future Australian cancer burden attributable to modifiable risk factors, and identified population subgroups that experience the highest preventable burden. Application of the novel PAF method can inform timely public health action to improve health and health equity, by identifying those with the most to gain from programs that support behavior change and early detection.

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Influence of Germline BRCA Genotype on the Survival of Patients with Triple-Negative Breast Cancer

Cancer Research Communications ◽

10.1158/2767-9764.crc-21-0099 ◽

2021 ◽

Vol 1 (3) ◽

pp. 140-147

Author(s):

Cynthia Villarreal-Garza ◽

Ana S. Ferrigno ◽

Alejandro Aranda-Gutierrez ◽

Paul H. Frankel ◽

Nora H. Ruel ◽

...

Keyword(s):

Breast Cancer ◽

Triple Negative Breast Cancer ◽

Triple Negative ◽

Point Mutations ◽

Treatment Resistance ◽

Cancer Center ◽

Breast Cancers ◽

Entire Cohort ◽

Pathogenic Variants ◽

Mutational Status

The presence of BRCA pathogenic variants (PV) in triple-negative breast cancer (TNBC) is associated with a distinctive genomic profile that makes the tumor particularly susceptible to DNA-damaging treatments. However, patients with BRCA PVs can develop treatment resistance through the appearance of reversion mutations and restored BRCA expression. As copy-number variants (CNV) could be less susceptible to reversion mutations than point mutations, we hypothesize that carriers of BRCA CNVs may have improved survival after treatment compared with carriers of other BRCA PVs or BRCA wild-type. Women diagnosed with stage I–III TNBC at ≤50 years at a cancer center in Mexico City were screened for BRCA PVs using a recurrent PV assay (HISPANEL; 77% sensitivity). Recurrence-free survival (RFS) and overall survival (OS) were compared according to the mutational status. Among 180 women, 17 (9%) were carriers of BRCA1 ex9–12del CNVs and 26 (14%) of other BRCA PVs. RFS at ten years for the whole cohort was 79.2% [95% confidence interval (CI), 72.3–84.6], with no significant differences according to mutational status. 10-year OS for the entire cohort was 85.3% (95% CI, 78.7–90.0), with BRCA CNV carriers demonstrating numerically superior OS rates other PV carriers and noncarriers (100% vs. 78.6% and 84.7%; log-rank P = 0.037 and P = 0.051, respectively). This study suggests that BRCA1 ex9–12del CNV carriers with TNBC may have a better OS, and supports the hypothesis that the genotype of BRCA PVs may influence survival by limiting treatment resistance mediated by reversion mutations among CNV carriers. Significance: Large CNV BRCA carriers in a cohort of young Mexican patients with TNBC had superior OS rates than carriers of other BRCA pathogenic variants (i.e., small indels or point mutations). We hypothesize that this is due to the resistance of CNVs to reversion mutations mediating resistance to therapy. If validated, these findings have important prognostic and clinical treatment implications for BRCA-associated breast cancers.

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Analysis of Low Estrogen Receptor (ER+) Breast Carcinomas in a Large Community Breast Cancer Center in Northern California

American Journal of Clinical Pathology ◽

10.1093/ajcp/aqab191.051 ◽

2021 ◽

Vol 156 (Supplement_1) ◽

pp. S26-S27

Author(s):

G Bulusu ◽

K Duncan ◽

A Wheeler

Keyword(s):

Breast Cancer ◽

Estrogen Receptor ◽

Histological Grade ◽

Statistical Significance ◽

Cancer Center ◽

Pathology Report ◽

Breast Cancers ◽

Breast Carcinomas ◽

Ki 67 ◽

Er Positive

Abstract Introduction/Objective Estrogen Receptor (ER) expression in breast cancers is a crucial factor for endocrine therapy in patients with tumors expressing ER in ≥1% of tumor cells. The 2019 guidelines published by ASCO/CAP states that breast cancers that have a 1% to 10% of cells staining Estrogen Receptor (ER) positive should be reported as ER Low Positive cases. This study aims to address this subset of low-positive ER tumors and compare the clinical features to other known breast cancer subtypes. Methods/Case Report We conducted a retrospective review of a prospectively maintained breast cancer registry from 2013 to 2021 at Mills-Peninsula Medical Center, a Sutter Health Affiliate. The study reviewed patient charts with respect to the pathology report, operative report, chemotherapy regimen, and clinical outcomes. Statistical analyses were conducted using R Project for Statistical Coding, with The Student’s T-test used to compare continuous variables. Two-sided P values less than 0.05 indicate statistical significance. Results (if a Case Study enter NA) Our study identified 1316 cases of invasive breast carcinomas, of which 29 (2.16%) demonstrated ER Low-Positive expression. We aimed to evaluate the clinical and pathological features, such as histological grade, ER, PR, HER-2, Ki-67%, and patient age for these tumors. We found that ER Low-Positive tumors demonstrated higher mean histological grade morphology (2.5 out of 3, p<0.001) that was similar to that of Triple Negative Breast Cancers (TNBC) (3 of 3, p<0.001) than to High ER-Positive (1.6 of 3, p<0.001) cancers. Further observations, through examining proliferation rates by utilizing the Ki-67 index, indicate comparative trends between the ER Low-Positive cohort and the TNBC cohort. Conclusion The results suggest that the ER Low-Positive carcinomas, despite reported as ER-positive cases, present with similar clinicopathological features to those of ER-negative tumors. Through this study and future research, we would like to emphasize a stricter set of guidelines that can be adopted to reduce variability for reporting biomarkers. This standardization will allow oncologists to provide more appropriate treatment options and improve the quality of patient care.

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A culturally specific dietary plan to manage weight gain among African American breast cancer survivors

Nutrition and Health ◽

10.1177/0260106012459938 ◽

2012 ◽

Vol 21 (2) ◽

pp. 97-105 ◽

Cited By ~ 11

Author(s):

Kathleen A Griffith ◽

Renee Royak-Schaler ◽

Kim Nesbitt ◽

Min Zhan ◽

Adriane Kozlovsky ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Survivors ◽

Breast Cancer Survivors ◽

Vegetable Intake ◽

Survival Rates ◽

Comprehensive Cancer Center ◽

Cancer Center ◽

Daily Consumption ◽

Culturally Specific ◽

Fat Consumption

Breast cancer survival rates are lower in African Americans (AAs) than in Caucasians, owing in part to a higher prevalence of obesity in the former, which increases the risk of recurrence and mortality. The Women’s Intervention Nutrition Study (WINS) found that Caucasian women who followed a low-fat eating plan experienced a lower rate of cancer recurrence than women who maintained their usual diets. The purpose of this study was to test the feasibility of a WINS plan tailored to the cultural needs of AA breast cancer survivors. This feasibility pilot study was conducted at a university National Cancer Institute-designated comprehensive cancer center outpatient clinic with AA breast cancer survivors. The culturally specific WINS (WINS-c) plan included eight individual counseling sessions, five educational group meetings, and follow-up telephone calls over a 1-year period. Outcome measures included dietary fat, triglyceride, insulin and glucose levels, and fruit and vegetable intake. Participants ( n = 8) had a mean age of 61.1 years (standard error of the mean (SEM) 3.1 years) and a mean BMI of 32 kg/m2 (SEM 4.25 kg/m)2. Baseline daily fat consumption decreased from 64.6 g (range 36.8–119.6g) to 44.0 g (21.6–73.4g) at 52 weeks ( p = 0.07). Mean daily consumption of fruits and vegetables increased by 36% and 15%, respectively. Mean triglyceride levels decreased at 12 months ( p < 0.05). Sustained hyperinsulinemia was noted in most participants, including those without diabetes. Mean calcium and vitamin D consumption decreased over the 1-year study period. In AA breast cancer survivors, the WINS-c program resulted in a trend toward reduced fat consumption and may represent a sustainable approach in this population for improvement of diet quality after breast cancer.

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