Current Issue : April - June Volume : 2020 Issue Number : 2 Articles : 5 Articles
Background: Given that breast cancer and normal dense fibroglandular tissue have similar radiographic\nattenuation, we examine whether automated volumetric density measures identify a differential change between\nbreasts in women with cancer and compare to healthy controls.\nMethods: Eligible cases (n = 1160) had unilateral invasive breast cancer and bilateral full-field digital mammograms\n(FFDMs) at two time points: within 2 months and 1-5 years before diagnosis. Controls (n = 2360) were matched to\ncases on age and date of FFDMs. Dense volume (DV) and volumetric percent density (VPD) for each breast were\nassessed using Volparaâ?¢. Differences in DV and VPD between mammograms (median 3 years apart) were calculated\nper breast separately for cases and controls and their difference evaluated by using the Wilcoxon signed-rank test.\nTo simulate clinical practice where cancer laterality is unknown, we examined whether the absolute difference\nbetween breasts can discriminate cases from controls using area under the ROC curve (AUC) analysis, adjusting for\nage, BMI, and time.\nResults: Among cases, the VPD and DV between mammograms of the cancerous breast decreased to a lesser\ndegree (- 0.26% and - 2.10 cm3) than the normal breast (- 0.39% and - 2.74 cm3) for a difference of 0.13% (p value\n< 0.001) and 0.63 cm3 (p = 0.002), respectively. Among controls, the differences between breasts were nearly\nidentical for VPD (- 0.02 [p = 0.92]) and DV (0.05 [p = 0.77]). The AUC for discriminating cases from controls using\nabsolute difference between breasts was 0.54 (95% CI 0.52, 0.56) for VPD and 0.56 (95% CI, 0.54, 0.58) for DV.\nConclusion: There is a small relative increase in volumetric density measures over time in the breast with cancer\nwhich is not found in the normal breast. However, the magnitude of this difference is small, and this measure alone\ndoes not appear to be a good discriminator between women with and without breast cancer....
Background: Primary care providers (PCPs) have always played an important role in cancer diagnosis. There is\nincreasing awareness of the importance of their role during treatment and survivorship. We examined changes in\nPCP utilization from pre-diagnosis to survival for women diagnosed with breast cancer, factors associated with\nbeing a high user of primary care, and variation across four Canadian provinces.\nMethods: The cohorts included women 18+ years of age diagnosed with stage I-III invasive breast cancer in years\n2007â??2012 in British Columbia (BC), Manitoba (MB), Ontario (ON), and Nova Scotia (NS) who had surgery plus\nadjuvant chemotherapy and were alive 30+ months after diagnosis (N = 19,589). We compared the rate of PCP visits\nin each province across phases of care (pre-diagnosis, diagnosis, treatment, and survival years 1 to 4).\nResults: PCP use was greatest during treatment and decreased with each successive survival year in all provinces.\nThe unadjusted difference in PCP use between treatment and pre-diagnosis was most pronounced in BC where\nPCP use was six times higher during treatment than pre-diagnosis. Factors associated with being a high user of\nprimary care during treatment included comorbidity and being a high user of care pre-diagnosis in all provinces.\nThese factors were also associated with being a higher user of care during diagnosis and survival.\nConclusions: Contrary to the traditional view that PCPs focus primarily on cancer prevention and early detection,\nwe found that PCPs are involved in the care of women diagnosed with breast cancer across all phases of care....
Background: Alteration of the PI3K/AKT/mTOR pathway is a common genomic abnormality detected in triplenegative\nbreast cancer (TNBC). Everolimus acts synergistically with eribulin in TNBC cell lines and xenograft models.\nThis phase I trial was designed to test the safety and tolerability of combining eribulin and everolimus in patients\nwith metastatic TNBC.\nMethods: The primary objective of this study was to evaluate the safety and toxicities of the combination. Patients\nwith metastatic TNBC who had up to four lines of prior chemotherapies were enrolled. The combination of eribulin\nand everolimus was tested using three dosing levels: A1 (everolimus 5 mg daily; eribulin 1.4 mg/m2 days 1 and 8\nevery 3 weeks), A2 (everolimus 7.5 mg daily; eribulin 1.4 mg/m2, days 1 and 8 every 3 weeks), and B1 (everolimus 5\nmg daily; eribulin 1.1 mg/m2 days 1 and 8 every 3 weeks).\nResults: Twenty-seven patients with median age 55 years were enrolled. Among 8 evaluable patients who received\ndose level A1, 4 had dose-limiting toxicities (DLTs). Among 3 evaluable patients treated with dose level A2, 2 had\nDLTs. Among 12 evaluable patients who received dose level B1, 4 had DLTs. The DLTs were neutropenia, stomatitis,\nand hyperglycemia. ...................................
Background: Physical activity (PA) before and after breast cancer diagnosis has been reported to be associated\nwith lower mortality. However, whether changes in the activity after diagnosis impact prognosis is unclear and has\nnot received much attention. This study aimed to examine pre- to postdiagnosis leisure-time PA and breast cancer\nprognosis.\nMethods: We used data from the MARIE study, a prospective population-based patient cohort study of 3813\npostmenopausal breast cancer patients, aged 50-74 at diagnosis, recruited from 2002 to 2005, re-interviewed in\n2009, and followed up until June 2015. Prediagnosis PA was assessed at recruitment; postdiagnosis PA was assessed\nat re-interview in 2009. To examine pre- to postdiagnosis change in PA, women were categorized by pre- and\npostdiagnosis PA using a cut-off of 7.5 MET-h/week for meeting PA recommendations and combined into four\ngroups: insufficiently active, increasingly active, decreasingly active, and sufficiently active. Cox regression models\nwith delayed entry were used to assess associations between pre- to postdiagnosis patterns of PA and overall\nmortality (OM), breast cancer mortality (BCM), and recurrence-free survival (RFS). Additional analyses of pre- and\npostdiagnosis PA (no activity (reference), low activity, sufficient activity) with cancer outcomes, such as using a timedependent\nmodel, were performed. In total, 2042 patients were included in the analyses.\nResults: There were 206 deaths (114 from breast cancer) after a median follow-up time of 6.0 years after the 2009\ninterview. Compared to insufficiently active women, increasingly active women were at lower risk of OM, BCM, and\nRFS (HR (95%CI) of 0.50 (0.31-0.82), 0.54 (0.30-1.00), 0.58 (0.40-0.84), respectively). In sufficiently active women,\nassociations for OM (0.75 (0.48-1.15)), BCM (0.61 (0.33-1.13)), and RFS 0.80 (0.57-1.14)) were similar to increasingly\nactive women but attenuated, and decreasingly active women were not at lower risk for OM (0.91 (0.61-1.36)), BCM\n(0.80 (0.45-1.42)), and RFS (1.04 (0.76-1.43)). In time-dependent analyses, sufficient activity vs. no activity was\nassociated with better OM (0.73 (0.57-0.93)), BCM (0.64 (0.46-0.89)), and RFS (0.82 (0.68-0.99)). Low activity was not\nsignificantly associated with prognosis.\nConclusion: Our data support benefits for breast cancer prognosis in being physically active pre- and postdiagnosis\nparticularly for women who were insufficiently active prediagnosis....
Background: Obesity is a well-known risk factor for breast cancer recurrence\nand poor prognosis. The objective of this study was to evaluate the effect of\nbody mass index (BMI) on survival in breast cancer patients. Methods: We\nperformed a retrospective analysis of 50 breast cancer patients treated in our\nhospital from January 2012 to December 2013. Patients were divided according\nto body mass index when diagnosed into: normal weight ..............................
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