15 research outputs found
Trends in complementary/alternative medicine use by breast cancer survivors: Comparing survey data from 1998 and 2005
BACKGROUND: Use of complementary and alternative medicine (CAM) by women with breast cancer is often said to be increasing, yet few data exist to confirm this commonly held belief. The purpose of this paper is to compare overall patterns of CAM use, as well as use of specific products and therapies at two different points in time (1998 vs 2005) by women diagnosed with breast cancer. METHODS: Surveys were mailed to women randomly selected from the Ontario Cancer Registry (Canada) in the spring of 1998 (n = 557) and again in the spring of 2005(n = 877). RESULTS: The response rates were 76.3% in 1998 and 63% in 2005. In 1998, 66.7% of women reported using either a CAM product/therapy or seeing a CAM therapist at some time in their lives as compared with 81.9% in 2005 (p = 0.0002). Increases were seen in both use of CAM products/therapies (62% in 1998 vs. 70.6% in 2005) and visits to CAM practitioners (39.4% of respondents in 1998 vs 57.4% of respondents in 2005). Women in 2005 reported that 41% used CAM for treating their breast cancer. The most commonly used products and practitioners for treating breast cancer as reported in 2005 were green tea, vitamin E, flaxseed, vitamin C, massage therapists and dietitians/nutritionists. CONCLUSION: CAM use (both self-medication with products and visits to CAM practitioners) increased significantly from 1998 to 2005. Now that more than 80% of all women with breast cancer report using CAM (41% in a specific attempt to management their breast cancer), CAM use can no longer be regarded as an "alternative" or unusual approach to managing breast cancer
The impact of patient characteristics and lifestyle factors on the risk of an ipsilateral event after a primary DCIS: a systematic review
ObjectiveThe majority of ‘low-risk’ (grade I/II) Ductal Carcinoma In Situ (DCIS) may not progress to invasive breast cancer during a women's lifetime. Therefore, the safety of active surveillance versus standard surgical treatment for DCIS is prospectively being evaluated in clinical trials. If proven safe and selectively implemented in clinical practice, a significant group of women with low-risk DCIS may forego surgery and radiotherapy in the future. Identification of modifiable and non-modifiable risk factors associated with prognosis after a primary DCIS would also enhance our care of women with low-risk DCIS.MethodsTo identify modifiable and non-modifiable risk factors for subsequent breast events after DCIS, we performed a systematic literature search in PUBMED, EMBASE and Scopus.ResultsSix out of the 3870 articles retrieved were included for final data extraction. These six studies included a total of 4950 patients with primary DCIS and 640 recorded subsequent breast events. There was moderate evidence for an association of a family history of breast cancer, premenopausal status, high BMI, and high breast density with a subsequent breast cancer or further DCIS.ConclusionThere is a limited number of recent studies published on the impact of modifiable and non-modifiable risk factors on subsequent events after DCIS. The available evidence is insufficient to identify potential targets for risk reduction strategies, reflecting the relatively small numbers and the lack of long-term follow-up in DCIS, a low-event condition.</p
An effective multisource informed consent procedure for research and clinical practice: an observational study of patient understanding and awareness of their roles as research stakeholders in a cancer biobank
Microcalcification crystallography as a potential marker of DCIS recurrence
Ductal carcinoma in-situ (DCIS) accounts for 20-25% of all new breast cancer diagnoses. DCIS has an uncertain risk of progression to invasive breast cancer and a lack of predictive biomarkers may result in relatively high levels (~ 75%) of overtreatment. To identify unique prognostic biomarkers of invasive progression, crystallographic and chemical features of DCIS microcalcifications have been explored. Samples from patients with at least 5-years of follow up and no known recurrence (174 calcifications in 67 patients) or ipsilateral invasive breast cancer recurrence (179 microcalcifications in 57 patients) were studied. Significant differences were noted between the two groups including whitlockite relative mass, hydroxyapatite and whitlockite crystal maturity and, elementally, sodium to calcium ion ratio. A preliminary predictive model for DCIS to invasive cancer progression was developed from these parameters with an AUC of 0.797. These results provide insights into the differing DCIS tissue microenvironments, and how these impact microcalcification formation. [Abstract copyright: © 2023. The Author(s).
Randomized phase II trial of adding carboplatin and/or bevacizumab to neoadjuvant weekly paclitaxel and dose-dense AC in triple-negative breast cancer.
Abstract S2-05: Event-free and overall survival following neoadjuvant weekly paclitaxel and dose-dense AC +/- carboplatin and/or bevacizumab in triple-negative breast cancer: outcomes from CALGB 40603 (Alliance)
BACKGROUND: CALGB (Alliance) 40603 measured the effects of adding carboplatin (Cb) and/or bevacizumab (Bev) to standard neoadjuvant chemotherapy (weekly paclitaxel x 12 then doxorubicin/cyclophosphamide every 2 weeks x 4) on pathologic complete response (pCR) rates in stage II-III triple-negative breast cancer (TNBC). As previously reported (Sikov et al, JCO 2015), pCR breast (ypT0/is) and pCR breast/axilla (pCR Br/Ax) (ypT0/isN0) rates increased from 46% to 60% and 41% to 54%, respectively, with Cb and from 48% to 59% and 44% to 52%, respectively, with Bev. Secondary endpoints included event-free survival (EFS) and overall survival (OS).
METHODS: EFS is measured from study entry to ipsilateral invasive breast or locoregional recurrence, distant recurrence or death from any cause and OS from study entry to death from any cause in all patients (pts) who started study treatment. Pts without an event were censored as of their last clinical assessment. Hazard ratios (HR) were calculated for pts who achieved pCR vs. not and for pts assigned to receive drug (Cb or Bev) vs. not. All p-values are 2-sided.
RESULTS: 443 pts started study treatment. Median follow-up was 39 months (range 28-66). 110 EFS events and 77 deaths have been reported. At 3 yrs, overall EFS was 74.1% and OS 83.2%. Pts who achieved pCR breast had 3-yr EFS of 84.8% vs. 61.8% for those who did not. Table 1 shows the association between pCR and pCR or minimal residual invasive disease (Residual Cancer Burden Class I (RCB I), Symmans et al, JCO 2007) and outcomes; p-values for all comparisons \u3c0.0001: Table 1 pCR Breast pCR Br/Ax pCR Br/Ax or RCB I Yes/No N (%) 231 (52%)/212 (48%) 207 (47%)/236 (53%) 266 (60%)/177 (40%) EFS-HR 0.33 (0.22-0.50) 0.30 (0.19-0.46) 0.29 (0.20-0.43) OS-HR 0.28 (0.17-0.46) 0.20 (0.11-0.36) 0.21 (0.13-0.34)
Pts assigned to Cb vs. not had 3-yr EFS 76.5% vs. 71.6% and OS 81.9% vs. 84.6%. Pts assigned to Bev vs. not had 3-yr EFS 75.5% vs. 72.9% and OS 85.5% vs. 80.9%. Table 2 shows HRs by assigned treatment: Table 2 Cb Bev N (Yes/No) 225/218 222/221 EFS - HR 0.84 (0.58-1.22) p=0.36 0.80 (0.55-1.17) p=0.25 OS - HR 1.15 (0.74-1.79) p=0.53 0.76 (0.49-1.19) p=0.23
CONCLUSIONS: Pts with TNBC who achieved pCR with study treatment had significantly better EFS and OS than pts who did not, consistent with findings from a published meta-analysis (Cortazar et al, Lancet 2014); the addition of RCB I did not weaken this association. Our study was not powered to assess the impact of Cb or Bev on these endpoints. While our findings are consistent with predictions from the meta-analysis as to the impact of raising the pCR rate on EFS (Berry-Hudis, JAMA Oncology 2015), the wide confidence intervals illustrate the challenge of conclusively demonstrating a correlation between pCR increment and EFS benefit, especially as the control pCR rate rises. While the addition of Bev has failed to improve long-term outcomes in TNBC in large randomized adjuvant trials, our results support ongoing and planned neoadjuvant and adjuvant studies designed to further assess the value of Cb-containing regimens in stage II-III TNBC.
Support: U10s - CA180821, CA180882, CA180820, CA076001, CA025224, CA180868, CA180888
FNIRS BRAIN IMAGING IS CAPABLE OF DISCERNING HEMISPHERIC LATERALITY DURING LOWER-BODY CONTRACTIONS
Rob MacLennan1, Jesus Hernandez-Sarabia2, Shawn Reese1, Jocarol Shields1, Claire Smith1, Katharina Stute3, Jordyn Collyar1, Alex Olmos1, Tyler Danielson1, Demi MacLennan4, Jason Pagan5, Ryan Girts6, Kylie Harmon7, Nicholas Coker8, Joshua Carr9, Xin Ye10, Jonathan Perry11, Matt Stock5 and Jason DeFreitas1
1Oklahoma State University, Stillwater, OK
2California State University – Bakersfield, Bakersfield, CA
3Chemnitz University of Technology, Chemnitz, Germany
4The Ohio State University, Columbus, OH
5University of Central Florida, Orlando, FL
6Pfeiffer University, Misenheimer, NC
7Syracuse University, Syracuse NJ
8Springfield College, Springfield, MA
9Texas Christian University, Fort Worth, TX
10University of Hartford, West Hartford, CT
11Houston, TX
BACKGROUND: Use of functional near-infrared spectroscopy (fNIRS) to measure and image brain activity during movement is increasing. This technique uses near-infrared light to detect changes in oxygenation in the cortex which are associated with increased cortical activity. However, fNIRS is known to have lower spatial resolution than other brain imaging techniques. Due to its relatively low spatial resolution, it is unclear if fNIRS can discriminate between nearby areas of the motor cortex (M1). This capability is particularly important in studies requiring lower extremity contractions for 2 reasons: 1.) the left and right leg areas of the motor cortex are in close proximity, with only the longitudinal fissure separating them, and 2.) the cortical areas responsible for the most distal musculature descend inferiorly into the fissure, and are therefore deeper than most motor areas.
PURPOSE: To determine fNIRS’ ability to discern laterality of isolated unilateral lower body contractions.
METHODS: Thirty-five young volunteers visited the lab one time. Subjects wore a cap with an optical source over the intersection of the central sulcus and the longitudinal fissure and 2 optical detectors positioned 3 cm laterally in both directions over the left and right motor cortices. Brain activity was recorded while subjects performed sustained 15-second contractions with their right and left legs against an isometric dynamometer at 30% of their maximal force. The mean hemodynamic responses were analyzed with a 2-way (contraction type [left & right legs] × hemisphere [left & right detectors]) repeated measures ANOVA.
RESULTS: There was a significant contraction type × hemisphere interaction (p = 0.002). During right leg contractions, activity in the left hemisphere was 77% higher than activity in the right hemisphere. During left leg contractions, activity in the right hemisphere was 43% higher than activity in the left hemisphere.
CONCLUSION: The significant interaction found in this study suggests that fNIRS is capable of discerning nearby areas of the motor cortex. Further, this technology has sufficient depth of penetration and spatial resolution to identify which cortical hemisphere is active during a unilateral lower body contraction
Community Needs, Concerns, and Perceptions About Health Research: Findings From the Clinical and Translational Science Award Sentinel Network
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Concerted epithelial and stromal changes during progression of Barrett’s Esophagus to invasive adenocarcinoma exposed by multi-scale, multi-omics analysis
Esophageal adenocarcinoma arises from Barrett's esophagus, a precancerous metaplastic replacement of squamous by columnar epithelium in response to chronic inflammation. Multi-omics profiling, integrating single-cell transcriptomics, extracellular matrix proteomics, tissue-mechanics and spatial proteomics of 64 samples from 12 patients' paths of progression from squamous epithelium through metaplasia, dysplasia to adenocarcinoma, revealed shared and patient-specific progression characteristics. The classic metaplastic replacement of epithelial cells was paralleled by metaplastic changes in stromal cells, ECM and tissue stiffness. Strikingly, this change in tissue state at metaplasia was already accompanied by appearance of fibroblasts with characteristics of carcinoma-associated fibroblasts and of an NK cell-associated immunosuppressive microenvironment. Thus, Barrett's esophagus progresses as a coordinated multi-component system, supporting treatment paradigms that go beyond targeting cancerous cells to incorporating stromal reprogramming