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  • Thomssen, C  (3)
  • 2010-2014  (3)
  • 2011  (3)
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  • 2010-2014  (3)
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  • 2011  (3)
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  • 1
    Online Resource
    Online Resource
    American Association for Cancer Research (AACR) ; 2011
    In:  Cancer Research Vol. 71, No. 24_Supplement ( 2011-12-15), p. P2-08-13-P2-08-13
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 71, No. 24_Supplement ( 2011-12-15), p. P2-08-13-P2-08-13
    Abstract: Introduction: The role of routine preoperative breast MRI in patients diagnosed with breast cancer is still under discussion. In a milestone review, Houssami et al. (CA Cancer J Clin 2009;59;290) did not demonstrate an advantage with regard to DFS or OS. We reviewed our case series (n=793) in order to add evidence to the current discussion of whether or not preoperative MRI would influence the outcome. Material and Methods: In our database we identified four years of diagnosis (2004-07) in which a high percentage (72%) of patients (349 of 483) with histologically confirmed invasive breast cancer received preoperative MRI. In the following years (2008/09), MRI was still done in 31% of the cases (97 of 309). All pts were treated according to national guidelines; however, patients with additional lesions in MRI were subjected to an additional MRI-guided needle biopsy or additional wire-guided excision. The median follow-up time was 31.5 months (0-81). The patients were followed clinically. In most cases local surveillance was done by mammography. Results: In the total cohort, 20% of the patients had additional needle biopsies and/or wire-localisation due to MRI-findings. By MRI, lesions that subsequently led to an additional preoperative needle biopsy were found in 82 pts. Interestingly, only ten contralateral second cancers were found. In 357 pts, MRI was used as guidance during the operation with (n=118) or without MRI-supported wire localization (n=238). The percentage of additional MRI-needle biopsy or MRI-supported localisation did not differ between invasive ductal (n=655) and lobular cancer (n=91): 10% versus 13% needle biopsies and 15% versus 20% wire localisations. The number of surgical procedures to achieve tumor-free margins did not differ between patients with or without preoperative MRI. In this series, 69 of 100 patients who received neoadjuvant chemotherapy, also had MRI-imaging. Considering the patient cohort with follow-up available (n=737), no significant difference of DFS probability was observed between pts with and without preoperative MRI. Discussion: This retrospective analysis did not demonstrate any advantage for routine preoperative MRI with regard to local treatment and DFS probability. The observed rate of 20% additional operative procedures corresponds to similar published data (16% additional multicentric or multifocal lesions found by MRI, Solin, Breast. 2010;19:7). Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P2-08-13.
    Type of Medium: Online Resource
    ISSN: 0008-5472 , 1538-7445
    RVK:
    RVK:
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2011
    detail.hit.zdb_id: 2036785-5
    detail.hit.zdb_id: 1432-1
    detail.hit.zdb_id: 410466-3
    Location Call Number Limitation Availability
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  • 2
    Online Resource
    Online Resource
    American Association for Cancer Research (AACR) ; 2011
    In:  Cancer Research Vol. 71, No. 24_Supplement ( 2011-12-15), p. P4-09-05-P4-09-05
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 71, No. 24_Supplement ( 2011-12-15), p. P4-09-05-P4-09-05
    Abstract: Background: Prognostic markers are essential for the decision about individual therapy for patients with newly diagnosed breast cancer. Biological meaningful cancer types are revealed by gene expression analysis. Steroid hormone receptor (HR) and HER2 status of the tumor by immunohistochemistry (IHC) are more easily available and predominantly resemble these cancer types. The “luminal” type as HR pos. and HER2 neg., the “luminalHER2” type as HR pos. and HER2 pos., the “HER2” type as HR neg. and HER2 pos. and the “triple neg.” type as HER neg. and HER2 ***neg.. We evaluated preoperative serum CA 15–3 and CEA within IHC-cancer types and outcome using our own cohort from 1999–2010. Material and Methods: Since 1999 all patients with breast cancer were entered in our tumor registry. Patients were treated by surgery and adjuvant therapy according to national guidelines (www.ago-online.de). Data was entered into SPSS by a specially trained study nurse. Follow-up was obtained yearly using our own out-patient clinic, information from general practitioners and the general cancer registry. Informed consent was taken from the patients at time of diagnosis. CA 15–3 and CEA were defined elevated if above 25 U/ml or 4,6 μg/l respectively. Results: Preoperative serum CA15-3 available for 1149 patients. Patients with elevated results showed a reduced 5year disease-free survival (DFS) of 74.4% as compared to 84.7% (p & lt;0.001). CA15-3 remained an independent prognostic factor in multivariate analysis (nodal status, grading, HR). Within HR positive disease, normal CA15-3 values predict a significantly better 5years DFS of 89.9% compared to 79.7% (p & lt;0.001). No significant difference was seen in HR negative patients (5year DFS 57.5% vs 68.4%; p=n.s.). Patients with HER2 status available (n=700) were classified into biological tumor types by IHC. Significant differences in DFS were seen for “luminal” (n=435) tumors only (5year DFS 81.0% vs 91.8% (p & lt;0.001). Only trends of differences in DFS were seen in the other less frequent tumor types “luminalHER2” (n=90) or “triple neg.” (n=112) types. Within the “HER2” (n=63) group no discrimination by serum levels of CA15-3 was seen. CEA did not add information on prognosis. Discussion: Decision on adjuvant therapy is increasingly based on tumor biology. Particularly, in “luminal” tumors additional prognostic information is needed to decide on adjuvant chemotherapy. CA15-3 may be an easily available, independent marker to identify patients with a higher risk of recurrence within this group. Prospective validation and comparison to molecular typing is needed. Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P4-09-05.
    Type of Medium: Online Resource
    ISSN: 0008-5472 , 1538-7445
    RVK:
    RVK:
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2011
    detail.hit.zdb_id: 2036785-5
    detail.hit.zdb_id: 1432-1
    detail.hit.zdb_id: 410466-3
    Location Call Number Limitation Availability
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  • 3
    In: Geburtshilfe und Frauenheilkunde, Georg Thieme Verlag KG, Vol. 71, No. 08 ( 2011-8)
    Type of Medium: Online Resource
    ISSN: 0016-5751 , 1438-8804
    Language: German
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2011
    detail.hit.zdb_id: 2026496-3
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