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  • 1
    Online Resource
    Online Resource
    How to close the care gap: Factors hindering the use of BRCA mutation profiling of patients with breast cancer and ovarian cancer in a real world setting.
    American Society of Clinical Oncology (ASCO) ; 2023
    In:  Journal of Clinical Oncology Vol. 41, No. 16_suppl ( 2023-06-01), p. e18636-e18636
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 41, No. 16_suppl ( 2023-06-01), p. e18636-e18636
    Abstract: e18636 Background: The majority of hereditary breast and ovarian cancers are linked to BRCA1/2 mutations. However, in patients with a suggestive personal or family history, a specific predisposing gene is identified in 〈 30% of cases. Mutation testing is recommended for individual genes in the appropriate clinical setting with a high suspicion index for a specific mutated gene. The risk of contralateral breast cancer increases with the time since the first breast cancer, reaching 20%–30% at ten years of follow-up and 40%–50% at 20 years, depending on the gene involved. Methods: The study assessed the prevalence of BRCA testing among young breast cancer women (age less than 50 years) and explored the factors hindering the performance of the BRCA mutation test. Among the 3400 breast cancers reported from 2017 to 2022, 46.17% (n = 1570) of young breast cancer women were advised for BRCA testing. We administered the questionnaire on factors influencing the BRCA mutation profiling performance to all the young breast cancer women (n = 1532). The data was collected from the electronic medical records and the department of molecular oncology. We performed regression analysis to predict the act of BRCA mutation profile testing. Results: Among them (n = 1570), only 17.70% (n = 278) performed BRCA1/2 genetic testing. In 278 patients who had undergone BRCA testing, pathogenic or likely pathogenic BRCA1/2/HRR mutations were detected in 52 patients (18.7%). 38 (13.7%) with BRCA 1, 14(5%) with BRCA2. Somatic with HRR testing was done in 13(4.6%), Somatic testing in 37(13.3%) and germline testing was done in 228 (82%). BRCA mutation was detected in 18 (34.6%) patients with breast cancer, 32(61.5%) patients with ovarian cancer. The factors influencing not performing the BRCA testing were the higher Cost of the test (83.4%), delay in getting the result (32.4%), unawareness of the importance of the test (52.6%), and not being advised by the physician as a mandatory test to perform (47.6%) and male spouse as a decision maker (31.8%). Conclusions: BRCA mutation profile test is mandatory to know their recurrence risk and treatment decisions for opting for PARP inhibitor. But the Cost of the test is the main barrier to performing this in a low-middle-income country setting. Female gender and related decision-making conflict could be the other reasons not to perform the test.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.2023.41.16_suppl.e18636
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2023
    detail.hit.zdb_id: 2005181-5
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  • 2
    Online Resource
    Online Resource
    Triple-negative and non–triple-negative breast cancer in a south Indian cohort.
    American Society of Clinical Oncology (ASCO) ; 2020
    In:  Journal of Clinical Oncology Vol. 38, No. 15_suppl ( 2020-05-20), p. e13110-e13110
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 38, No. 15_suppl ( 2020-05-20), p. e13110-e13110
    Abstract: e13110 Background: The heterogeneity of breast cancer explains in part the differences in the morbidity and mortality of this disease. Triple-negative breast cancer (TNBC) is a specific subset of tumors characterized by the absence of the 3 most commonly targeted biomarkers considered for breast cancer treatment: Estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor (HER2). TNBC accounts for 15% to 20% of all breast cancer diagnoses and usually has a more aggressive clinical course, with worse evolution within the first 3 to 5 years after diagnosis; early and higher rates of distant recurrences, typically visceral; and poor survival. Methods: To analyze the clinical, pathological, and sociodemographic aspects between triple-negative breast cancer (TNBC) and non-TNBC in a Kerala cohort and identify potential prognostic factors. This hospital-based retrospective cohort study (From January 2017 till December 2018) included 465 women with breast cancer treated at MVR Cancer Centre & Research Institute in North Kerala. Overall and disease-free survival was compared; prognostic factors were evaluated. Results: Triple-negative breast cancer corresponded to 16.3% of breast cancer diagnosis and was more prevalent among rural women. The patients with TNBC tended to present with stage III cancer, high p53 expression, lymphocytic infiltration, and multifocality and treated with radical surgery and chemotherapy. The 2-year overall and disease-free survival were 52.1% and 43.5% for TNBC and 83.8% and 73.4% for non-TNBC, respectively ( P 〈 .001). The TNBC recurrence was associated with multicentricity, whereas lymph node involvement increased the risk of both recurrence and death. Non-TNBC worse clinical course was associated with rural women, younger age, lymph node involvement, and advanced stage. Conclusions: Triple-negative breast cancer exhibited a more aggressive behavior, earlier and more frequent recurrence, and worse survival compared with non-TNBC. While biological and social variables were associated with poorer prognosis in non-TNBC, only lymph node involvement and multicentricity were correlated with worse clinical outcomes in TNBC.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.2020.38.15_suppl.e13110
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2020
    detail.hit.zdb_id: 2005181-5
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  • 3
    Online Resource
    Online Resource
    A Retrospective audit comparing the neutropenic complications in the Pre-COVID and COVID era from a tertiary care center.
    American Society of Clinical Oncology (ASCO) ; 2021
    In:  Journal of Clinical Oncology Vol. 39, No. 15_suppl ( 2021-05-20), p. e18619-e18619
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 39, No. 15_suppl ( 2021-05-20), p. e18619-e18619
    Abstract: e18619 Background: The COVID era has shown a rise in Intensive Care Unit (ICU) admissions. This is mainly due to COVID related complications. On the contrary, the public around the world have become more aware about maintaining proper hygiene by wearing masks , using hand wash and keeping themselves clean. As an audit, we conducted a retrospective analysis comparing neutropenic complications during the pre COVID and COVID times at our tertiary care cancer hospital. Methods: We collected data of febrile neutropenia admissions in ICU from March to July 2019-Non Covid (NC) and March to July 2020-Covid (C). The data collection was done including data on nadir total WBC count, use of GCSF, positive cultures, type of malignancy and deaths. The statistical analysis was done using SPSS software version 22. Results: There were 15 patients in the NC dataset and 18 patients in the C dataset. The mean age of NC was 59 (SD-9.2) and that of C was 57. 3 (SD-14). The age and sex were comparable in both the groups. The number of solid organ malignancies constituted 5 (33.33%) in NC set and 8 (44.44%) in C set. The hematological malignancies constituted 10 in each of C and NC sets. Gram negative sepsis was seen in 26.67% and 22.22% in NC and C dataset respectively. There were 4 (26.67%) deaths in NC group and 5 (27.28%) C group. Growth factors were received by 9 (60%) patients in NC group and 15 (83.3%) patients in the C group (p=0.0005). There was no significant difference in the admission, complication and death rates in ICU when comparing the two groups. These results have been depicted in Table. Conclusions: Despite the precautions taken by community during the COVID times, we conclude that there was no significant difference in the neutropenic complications. It also suggests that most of the neutropenic infections are related to the person’s immunity rather than community transmission. The study limitation is that this is a single center study but further audits and prospective studies are warranted in this regard. Keywords - COVID, Non COVID, Neutropenia, Intensive Care Unit. [Table: see text]
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.2021.39.15_suppl.e18619
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2021
    detail.hit.zdb_id: 2005181-5
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  • 4
    Online Resource
    Online Resource
    Detect Early Be Safe–Care for Mother (DEBS-CaM) project: School-based interventions to improve awareness and screening for breast cancer among the young mothers of Kerala.
    American Society of Clinical Oncology (ASCO) ; 2020
    In:  Journal of Clinical Oncology Vol. 38, No. 15_suppl ( 2020-05-20), p. e13570-e13570
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 38, No. 15_suppl ( 2020-05-20), p. e13570-e13570
    Abstract: e13570 Background: The prognosis rate among the breast cancer patients was less than 50% in India when compared to European countries due to the late diagnosis and most of them diagnosed at an advanced stage of disease. Early detection can reduce the risk of advancement of disease by 30%. There is an immediate need to target both younger population to empower the women with the knowledge on their breast cancer risk and self-breast examination (SBE). So the project aimed to examine the efficacy of a Brief Motivational Intervention (BMI) and Student based Parental intervention (SBPI) based on motivational interviewing as a universal preventive and early diagnosis interventions to fight against breast cancer among the school students using a randomized factorial design. Methods: Daughters and Mothers are always a good dyads for doing an personal health intervention. Since it is a ‘matter of closeness’, a mother and a daughter can easily communicate, intervene and ensure the act of doing in self breast examination.We identified 85 schools (including the Junior high and senior high schools in the northern region of Kerala. The female resource person from the MVR Cancer Centre & Research Institute delivered the awareness session on risk factors of breast cancer breast and SBE. So the attendees demonstrated the SBEs to their mothers and ensure the act of doing monthly. The study utilized a 2 × 2 × 3 factorial design, crossing a BMI; (yes, no) and SBPI (yes, no), with one within-subjects factor (Time; baseline and 10 months). Over 10 months, we recruited cohorts of parent-student dyads and randomize by dyad to one of four experimental conditions: BMI only and BMI and SBPI only. We did the randomization by computer algorithm to ensure that the experimental conditions will balance on prognostic indicators of students and their mother’s on breast cancer risk and including waist to hip ratio, frequency of SBE, healthy dietary intake and physically active. Results: Baseline data collected from students and parents during the summer prior to college matriculation. Follow-ups occurred at 10 months post-baseline for parents in the face to face interview with students at their schools. We found 17% of mothers detected any kind of breast abnormalities and among that, 68% of mothers went for further detailed diagnostic tests. Conclusions: It is an innovative approach incorporating the principles of primary prevention and early detection for the breast cancer among the young mothers of Kerala.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.2020.38.15_suppl.e13570
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2020
    detail.hit.zdb_id: 2005181-5
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  • 5
    Online Resource
    Online Resource
    Small cell neuroendocrine carcinoma of the breast - case series of a common tumour at a rare location
    GN1 Sistemas e Publicacoes Ltd. ; 2023
    In:  Brazilian Journal of Oncology Vol. 19 ( 2023)
    Details
    In: Brazilian Journal of Oncology, GN1 Sistemas e Publicacoes Ltd., Vol. 19 ( 2023)
    Type of Medium: Online Resource
    ISSN: 2526-8732
    Uniform Title: Carcinoma neuroendócrino de pequenas células da mama - série de casos de tumor comum em localização rara
    URL: Article
    DOI: 10.5935/2526-8732.20230415
    Language: Unknown
    Publisher: GN1 Sistemas e Publicacoes Ltd.
    Publication Date: 2023
    detail.hit.zdb_id: 3129063-2
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  • 6
    Online Resource
    Online Resource
    EGFR mutations in lung carcinomas: Mutation profile and survival analysis.
    American Society of Clinical Oncology (ASCO) ; 2022
    In:  Journal of Clinical Oncology Vol. 40, No. 16_suppl ( 2022-06-01), p. e20518-e20518
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 40, No. 16_suppl ( 2022-06-01), p. e20518-e20518
    Abstract: e20518 Background: Epidermal growth factor receptor (EGFR) mutation have been demonstrated to be both predictive and prognostic for patients with metastatic lung cancer. The administration of EGFR tyrosine kinase inhibitors (TKIs) has improved survival in this group of patients. Several generations of EGFR TKIs are currently available. The EGFR mutations have been divided into common and rare. The common mutations include Exon 19 deletion and Exon 21 L858R mutations and rest are grouped as rare. The presence of visceral metastasis in the brain and liver are usually portends a poor prognosis. Methods: We conducted a retrospective analysis of lung cancer patients who attended our hospital outpatient department from 2017 to 2021. The prevalence, demographics and clinical profile of EGFR common and rare mutations were studied using descriptive statistics. Survival of EGFR mutated patients was plotted using Kaplan Meier plots. SPSS was used for statistical analysis. Results: The prevalence of EGFR mutation among metastatic lung cancer was 14.10% (161/1148). The median age of the group was 60 years (23- 104 years). Smokers with EGFR mutations were 11.8% (n = 19). Male to Female ratios was 76:85 (47.2% and 52.8%). Three patients with squamous cell carcinoma exhibited EGFR mutation. Most common EGFR TKI used was Gefitnib. Osimertinib was used in 13 patients (1.4%). The percentage of common mutations were 85.75% (N = 132) and rare mutations were 14.3% (n = 22). The type of mutations could not be identified in 10 patients. The percentage of patients with exon 19 deletion were 63% (n = 97) and L858R were 24.7% (n = 38). Visceral metastasis (brain and liver) was seen in 47 patients (n = 29.2%). Brain progression was seen in 32 patients (n = 19.9%). The survival of patients with EGFR exon 19 deletion and L858R mutation was 16.36 + 8.97 months and 15.97+ 10.93 months, Survival among patients with common mutation was 16.20 + 9.57 months and among rare mutation was 13.43 + 12.19 months. Median Survival period of patients with visceral metastasis was 12 months (0 to 38 months). Conclusions: In our retrospective study, there was no significant difference between survival among common and rare EGFR mutations.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.2022.40.16_suppl.e20518
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2022
    detail.hit.zdb_id: 2005181-5
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  • 7
    Online Resource
    Online Resource
    Can COV Direct: Effectiveness of a tele-medicine self- care interventions for cancer survivors during COVID 19 pandemic.
    American Society of Clinical Oncology (ASCO) ; 2021
    In:  Journal of Clinical Oncology Vol. 39, No. 15_suppl ( 2021-05-20), p. 1583-1583
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 39, No. 15_suppl ( 2021-05-20), p. 1583-1583
    Abstract: 1583 Background: Good mental health improves the overall quality of life. Anxiety and depression in post-treatment cancer survivors is common and can affect adversely on the individual. CanCovDirect is a novel, tele-medicine self-care intervention for cancer survivors. We practiced a randomized controlled superiority trial to compare CanCovDirect with usual standard care (SC) in this population.Methods: Individuals completing cancer treatment within the past 3 years who had symptoms with or without anxiety or depression were recruited from clinical and community settings in Northern Kerala. We allocated the participants using block randomization (CanCovDirect plus SC or to SC alone). Assessments of anxiety and depression severity (Centre for Epidemiological Studies-Depression scale [CES-D]; primary outcome) and secondary outcomes anxiety symptoms (Hospital Anxiety and Depression Scale) health-related quality of life (Short Form Survey-12 mental and physical component summaries), were conducted at baseline, as well as 3 and 6 months (primary time point). Analyses of outcomes were adjusted for covariates using linear regression. Results: Participants recruited between June 2020 and November 2020 were randomly assigned to CanCovDirect (n = 152) or SC (n = 152). Among 350 participants randomly assigned, 304 (86.85%) completed the primary outcome at 6 months. CanCovDirect participants reported less severe anxiety and depressive symptoms on the CES-D than SC participants at 6 months, adjusted effect size (ES) 1.68 (95% CI, 1.28 to 2.05). CanCovDirect participants also had significantly greater quality of life compared with SC. Exploratory analysis suggested that types of cancer was a modifier of the primary outcome (interaction term P value =.04); the intervention was effective in women (ES, 0.62; 95% CI, −0.45 to 0.89). Conclusions: CanCovDirect is an essential method of managing mild-moderate depression and anxiety symptoms in cancer survivors.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.2021.39.15_suppl.1583
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2021
    detail.hit.zdb_id: 2005181-5
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  • 8
    Online Resource
    Online Resource
    Death following pulmonary complications of surgery before and during the SARS-CoV-2 pandemic
    Oxford University Press (OUP) ; 2021
    In:  British Journal of Surgery Vol. 108, No. 12 ( 2021-12-01), p. 1448-1464
    Details
    In: British Journal of Surgery, Oxford University Press (OUP), Vol. 108, No. 12 ( 2021-12-01), p. 1448-1464
    Abstract: This study aimed to determine the impact of pulmonary complications on death after surgery both before and during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. Methods This was a patient-level, comparative analysis of two, international prospective cohort studies: one before the pandemic (January–October 2019) and the second during the SARS-CoV-2 pandemic (local emergence of COVID-19 up to 19 April 2020). Both included patients undergoing elective resection of an intra-abdominal cancer with curative intent across five surgical oncology disciplines. Patient selection and rates of 30-day postoperative pulmonary complications were compared. The primary outcome was 30-day postoperative mortality. Mediation analysis using a natural-effects model was used to estimate the proportion of deaths during the pandemic attributable to SARS-CoV-2 infection. Results This study included 7402 patients from 50 countries; 3031 (40.9 per cent) underwent surgery before and 4371 (59.1 per cent) during the pandemic. Overall, 4.3 per cent (187 of 4371) developed postoperative SARS-CoV-2 in the pandemic cohort. The pulmonary complication rate was similar (7.1 per cent (216 of 3031) versus 6.3 per cent (274 of 4371); P = 0.158) but the mortality rate was significantly higher (0.7 per cent (20 of 3031) versus 2.0 per cent (87 of 4371); P  & lt; 0.001) among patients who had surgery during the pandemic. The adjusted odds of death were higher during than before the pandemic (odds ratio (OR) 2.72, 95 per cent c.i. 1.58 to 4.67; P  & lt; 0.001). In mediation analysis, 54.8 per cent of excess postoperative deaths during the pandemic were estimated to be attributable to SARS-CoV-2 (OR 1.73, 1.40 to 2.13; P  & lt; 0.001). Conclusion Although providers may have selected patients with a lower risk profile for surgery during the pandemic, this did not mitigate the likelihood of death through SARS-CoV-2 infection. Care providers must act urgently to protect surgical patients from SARS-CoV-2 infection.
    Type of Medium: Online Resource
    ISSN: 0007-1323 , 1365-2168
    URL: Article
    DOI: 10.1093/bjs/znab336
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
    detail.hit.zdb_id: 2006309-X
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  • 9
    Online Resource
    Online Resource
    Outcomes of gynecologic cancer surgery during the COVID-19 pandemic: an international, multicenter, prospective CovidSurg-Gynecologic Oncology Cancer study
    Elsevier BV ; 2022
    In:  American Journal of Obstetrics and Gynecology Vol. 227, No. 5 ( 2022-11), p. 735.e1-735.e25
    Details
    In: American Journal of Obstetrics and Gynecology, Elsevier BV, Vol. 227, No. 5 ( 2022-11), p. 735.e1-735.e25
    Type of Medium: Online Resource
    ISSN: 0002-9378
    URL: Article
    DOI: 10.1016/j.ajog.2022.06.052
    RVK:
    XA 19400
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2022
    detail.hit.zdb_id: 2003357-6
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  • 10
    Online Resource
    Online Resource
    Effect of COVID-19 pandemic lockdowns on planned cancer surgery for 15 tumour types in 61 countries: an international, prospective, cohort study
    Elsevier BV ; 2021
    In:  The Lancet Oncology Vol. 22, No. 11 ( 2021-11), p. 1507-1517
    Details
    In: The Lancet Oncology, Elsevier BV, Vol. 22, No. 11 ( 2021-11), p. 1507-1517
    Type of Medium: Online Resource
    ISSN: 1470-2045
    URL: Article
    DOI: 10.1016/S1470-2045(21)00493-9
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2021
    detail.hit.zdb_id: 2049730-1
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