Background

Breast cancer is increasing among young women around the world. Cancer Patients are often treated with invasive procedures, with a major impact on their appearance. Body image is a multi-dimensional construct. It presents an important component of a cancer patient's quality of life. Our purpose is to evaluate the body image of younger women treated for breast cancer.

Methods

A descriptive cross-sectional study of 60 young women (under 40 years old) followed for breast cancer in complete remission treated in our departement.The variable body image was measured through the validated Hopwood body image scale (BIS) and the Hospital Anxiety and Depression Scale (HADS). The statistical study was carried out with SPSS20.0 software. Correlations were analyzed using bivariate analysis and Spearman’s rank correlation coefficient.

Results

The average age of our patients was 34 [21-40]. 65% were married. 58.3% had high education levels, the others were illiterate. Regarding professional occupation, it was observed that a great share of women were employed before cancer diagnosis (68.3%), but 25% did not return to work. 21 women were treated by breast conserving surgery, 39 treated by mastectomy. Only 2 had breast reconstruction. 78.3% received chemotherapy. All patients received post-operative radiotherapy. 90% experienced secondary morbidities due to treatment. According to the BIS, The prevalence of body image dissatisfaction was 75% with an overall average score 21.47± 7,16. the average score for anxiety and depression was 19,58 ± 7,83. Associations between body image and marital status, education level and return to work after cancer treatment were not statistically significant. It is also revealed that patients who were treated by mastectomy presented significantly more body image concerns than those treated by BCS (p=0.03). Late treatment side effects were significantly associated with low self-esteem and negative body image (p=0.002). The score of BIS positively correlated with the HADS (p<0.001).

Conclusions

Body image concerns are prevalent among breast cancer survivors. Therefore, we suggest to intensify the presence of specialized professionals in the follow-up care initial treatment, focusing on aspects that directly influence body image.

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.

Background

Twenty breast cancer patients from Magdalena V. de Martínez Hospital, Buenos Aires, selected by their higher levels of progesterone receptor isoform A (PRA) than isoform B (PRB) were treated for 14 days with 200 mg mifepristone (MFP) p.o. before surgery (MIPRA; NCT02651844). A decrease in the proliferation index, greater than 30% was observed in 70% of the MFP-treated patients [primary endpoint (e.p.)]. RNA-Seq studies performed in 8 paired samples supported these findings and suggested that MFP increased tissue remodeling and immune-related pathways (secondary e.p.). We report herein the morphological changes and the regulation of different hormone receptor-related proteins associated with MFP treatment (secondary e.p.).

Methods

Core needle biopsies (CNB) and post-treatment samples (S) were formalin-fixed and embedded in paraffin for routine morphological and immunohistochemical (IHC) studies. Morphological features were quantitated in 21 paired samples as absent, low, moderate, or high. Tumor-infiltrating lymphocytes (TILs) were quantified following approved guidelines. Due to limited CNB material, IHC assays were performed in selected pair of samples.

Results

The most relevant changes registered were increases in a) loose stroma and/or tissue remodeling (61.9%); b) TILs (80.9%; p<0.001) and c) isolated apoptosis (52.3%). Areas of differentiation and/or the presence of secretory vacuoles were also observed in 33.3% of cases analyzed. Consistent with morphological findings, increases in calregulin (3/4) and active caspase 3 (3/5) expression were observed by IHC. A decrease (p<0.05) in PR, pSer294PR, estrogen receptor alpha (ER), pSer118ER and MYC staining intensity was observed in >50% of the pairs evaluated. No decrease in pSer167ER expression was observed.

Conclusions

The morphological features observed are consistent with Ki67 and RNA-Seq data, and support the therapeutic effects of MFP in patients with higher levels of PRA than PRB. The morphological changes and protein regulations were variable in different patients. The differential regulation in Ki67-responsive and non-responsive patients will be discussed.

Clinical trial identification

MIPRA; NCT02651844.

Legal entity responsible for the study

Hospital Magdalena V de Martínez, General Pacheco, Buenos Aires.

Funding

National Agency for the Promotion of Research, Technological Development and Innovation.

Disclosure

C.C. Lanari, P. Rojas: Financial Interests, Other: Patent (WO2013086379A2) regarding the use of antiprogestins in human breast cancer. All other authors have have declared no conflicts of interest.

Background

Neoadjuvant endocrine therapy (NET) is an attractive scenario to find novel biomarkers in oestrogen receptor-positive/HER2-negative breast cancer (ER+/HER2- BC). In this context, PAM50 multigene panel has been validated as a relapse predictor. This study aims to determine if PAM50-derived risk of recurrence (ROR) indexes at diagnosis correlate with biomarkers of response to NET.

Methods

We collected samples from postmenopausal ER+/HER2- BC patients treated with NET (n=58) over 3 months. We analyzed gene expression by Prosigna®-PAM50 to determine at diagnosis the ROR indexes: the original, the one related to intrinsic subtypes genset (ROR-S) and ROR plus a proliferation index (ROR-P). We pathologically characterized surgical tumour specimens and evaluated Ki67 expression by IHC. We studied the statistical association between ROR and (1) Ki67 expression at surgery, (2) ΔKi67 ( = [(Ki67 (%)surgery) – (Ki67 (%)baseline)] / (Ki67 (%) in baseline)) and (3) mPEPI score (Table).

Results

First, we observed that tumours with a low ROR-S/P at diagnosis present low Ki67 expression after NET, conversely to those with a high ROR-S/P; both, p <0.0001. Regarding to ΔKi67 and ROR, tumours with strong decrease in Ki67 expression after NET presented a low ROR-S/P at diagnosis, compared to those with increase or not change in Ki67; p = 0.0041 and p = 0.0071, respectively. Similarly, we found a significant association between mPEPI and ROR-S/P. Tumours with low mPEPI also presented low ROR-S/P at diagnosis while high mPEPI correlates with high ROR-S/P; p = 0.0195 and p = 0.005, respectively. Table: 96P

Distribution of ROR-S/P, mPEPI score and Ki67 expression

Conclusions

This study supports use of PAM50 derived ROR indexes as a tool to individualize the use of NET, conjointly with other clinical parameters. However, more data is needed to validate these findings.

Legal entity responsible for the study

Biodonostia Health Research Institute, San Sebastián, Spain and Gipuzkoa Cancer Unit/OSI Donostialdea – Onkologikoa, San Sebastián, Spain.

Funding

Biodonostia Health Research Institute, San Sebastián, Spain and Gipuzkoa Cancer Unit/OSI Donostialdea – Onkologikoa, San Sebastián, Spain.

Disclosure

All authors have declared no conflicts of interest.

Background

Three dimensional conformal radiotherapy (3D-CRT) has long been used as a standard treatment for early stage breast cancer. However, the homogeneity, conformity in the target volume (PTV), and the dose to nearly organs at risk (OAR) was a concern. Using field-in-field as intensity modulation improved the homogeneity and conformity in the PTV, yet the dose to OARs still require further improvement. In this study, we aimed at analyze the dose volumetric parameters (DVP) of 3D-CRT and VMAT plan to identify a better for left breast cancer, in particular dose reduction to heart and the left anterior descending artery (LAD).

Methods

A retrospective study was conducted based on 28 patients, who were treated for stage I and II left breast cancer. Planning CT and corresponding structure set were used to plan a 3D-CRT plan with field-in-field as intensity modulation, and a VMAT plan with 3 partial arcs. The prescription was to give 50Gy to PTV in 25 fractions. Dose to PTV, to the heart and to the LAD were analyzed by non-parametric paired T-test.

Results

There was significant improvement in dose homogeneity to PTV in the VMAT plan when compare to the 3D-CRT plan. For dose to the heart, the V₂₀ of VMAT was significantly lower than that of 3D-CRT by 1.96%, p=0.003. For dose to LAD, the Dmax was significantly lower in VMAT than that of 3D-CRT by 9.12Gy, p=0.003.

Conclusions

The VMAT in this study showed more favorable DVP in the heart and the LAD for early stage left breast cancer when compared to 3D-CRT. The features of dose distribution can be applied in precision medicine in oncology.

Legal entity responsible for the study

The author.

Funding

Has not received any funding.

Disclosure

The author has declared no conflicts of interest.

Background

HER2 IHC1+ or IHC2+ and in situ hybridization (ISH)-negative results are sometimes referred to as HER2-Low. SG is a novel antibody-drug conjugate composed of an anti–Trop-2 antibody coupled to SN-38 via a proprietary, hydrolyzable linker. SG is approved in mTNBC for the second line (2L) onwards. In the ASCENT study, SG had significant progression-free survival (PFS) and overall survival (OS) benefit vs chemotherapy of physician’s choice (TPC). This ASCENT post hoc subgroup analysis evaluates SG efficacy in HER2 IHC0 and HER2-Low mTNBC.

Methods

Patients (pts) with mTNBC refractory/relapsing after ≥2 prior chemotherapies (≥1 in the metastatic setting) were randomized 1:1 to receive SG (10 mg/kg IV on d 1 and 8, every 21 d) or TPC (capecitabine, eribulin, vinorelbine, or gemcitabine) until unacceptable toxicity/progression. Primary endpoint was PFS per RECIST 1.1 by central review. Pts with known HER2-positive disease were ineligible, but HER2 status was not assessed centrally in ASCENT. Local HER2 IHC results were analyzed retrospectively.

Results

In the intent-to-treat (ITT) population (SG vs TPC), 149 vs 144, 63 vs 60, and 55 vs 58 pts had HER2 IHC0, HER2-Low, and missing HER2 IHC results, respectively; 79% of the ITT population was HER2-evaluable. Baseline characteristics between HER2 IHC0 vs HER2-Low were comparable and similar to the ITT population. Median PFS and OS were significantly improved, and objective response rate was numerically higher with SG vs TPC in the HER2 IHC0 and HER2-Low groups (Table). HER2-Low had numerically better outcomes vs HER2 ICH0 in both the SG and TPC arms.

Conclusions

Clinical benefit with SG in HER2 IHC0 and HER2-Low mTNBC was consistent with that of the ASCENT ITT population, regardless of HER2 status. SG should be considered an effective treatment option for pts with mTNBC eligible for 2L or later therapy. Table: 168P

Clinical trial identification

NCT02574455.

Editorial acknowledgement

Editorial support was provided by Yao Bian, PhD, of Team 9 Science and funded by Gilead Sciences, Inc.

Legal entity responsible for the study

Gilead Sciences, Inc.

Funding

Gilead Sciences, Inc.

Disclosure

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