Comparison of the GMFM-66 and the PEDI Functional Skills Mobility domain in a group of Chinese children with cerebral palsy

BACKGROUND

Previous research has suggested there is a high level of comparability between the Gross Motor Function Measure-66 (GMFM-66) and the Pediatric Evaluation of Disability Inventory (PEDI) Functional Skills Mobility domain. However, there are only a few studies that have examined the correlations between these instruments. The purpose of this study was to determine the correlation between the GMFM-66 and the PEDI Functional Skills Mobility domain scaled scores in a group of Chinese children with spastic cerebral palsy, at the ages of 12-70 months, in order to explore the feasibility of using them interchangeably.

METHODS

Secondary data analysis was conducted of data collected during a prospective international collaborative study that used the GMFM-66 and the PEDI to examine the impact of treatment. This study examined the Pearson correlations between the GMFM-66 and the PEDI Functional Skills Mobility domain at six time points over the course of 28 consecutive weeks for 115 Chinese children who participated at baseline.

RESULTS

Pearson correlations between the GMFM-66 and the PEDI Functional Skills Mobility domain ranged from 0.83 to 0.90 for the six time points of data collection, with statistically significant P-values <0.0001 for each correlation.

CONCLUSIONS

These results support previous research that the GMFM-66 and the PEDI Functional Skills Mobility domain are complementary assessments that may be used interchangeably when it is not possible to administer both.

Study on Creep Behavior of PP/CaCO3 Molded by Vibration Injection Molding at Different Vibration Frequency and Vibration Pressure

Vibration injection molding technology has achieved some good properties, such as high impact strength and high tensile strength. Although many researchers have proved that the short-time mechanical properties of the polymer could be improved by vibration-injection molding technology, the long-time mechanical properties, such as the creep behavior, have not been paid enough attention. In this paper, the creep behavior of the calcium carbonate filled polypropylene (PP/CaCO3) prepared at various vibration conditions has been observed. The influences of the vibration pressure and the frequency on the mechanical properties and creep behavior were investigated via creep test and tensile test. Firstly, the tensile fracture strain reached the maximum (11%) at 0.72 Hz. Moreover, with the increasing vibration pressure amplitude, the tensile fracture strain would decrease. The changing tendency of tensile strength is basically contrary with the change of the tensile fracture strain. Secondly, when the vibration frequency reaches the 0.72 Hz, the tensile creep is larger than that of other frequencies samples at 50 MPa; meanwhile, the tensile creep of these PP/CaCO3 parts, which has been prepared at 0.48 Hz, decreases with the increasing vibration pressure amplitude. Finally, the dynamic mechanics analysis (DMA) and the wide-angle X-ray diffraction (WAXD) were adopted to analyze the reason of the creep behavior change. The different macromolecular chains mobility caused the different creep behavior.

Adjuvant chemotherapy for gastric cancer: Less drug, same efficacy

114

Background: Adjuvant chemotherapy is proved to improve survival in gastric cancer by meta-analyses. However, no evidence showed the best regimen. We conducted a retrospective analysis to compare triplets with doublets in the adjuvant setting.

Methods: We collected data from January 2004 to December 2008 from patients performed radical surgery and adjuvant chemotherapy. Doublets were defined as 5-FU 750 mg/m2 (d1- 5) or capecitabine 1,000 mg/m2 (d1-14) plus cisplatin 60 mg/m2 (d1) or oxaliplatin 130 mg/m2 (d1), while triplets had epirubicin 50 mg/m2 (d1) added. Chemotherapy was initiated within 6 weeks after surgery, repeated every three weeks and planned for 6 cycles. Patients were followed up in the outpatient clinic until death or April 30, 2010. Cox proportional-hazard model and chi-square test were used to test statistical difference.

Results: A total of 316 patients (210 in doublets, 106 in triplets) had a median follow-up time of 47 months. 77 patients died at the end of follow-up (3-year survival of 67.4%).Two groups were well balanced except age (median age of 57 in doublets, 51 in triplets, p < 0.001). All the patients tolerated well, with few grade 3/4 side effects (21.9% in doublets, 30.2% in triplets, p = 0.107). Two groups had similar disease-free survival (median DFS, 16 months vs. 23 months, p = 0.656) and overall survival (3-year survival rate, 59.6% vs. 64.8%, p = 0.293). Subgroup analysis showed the same benefit on survival between the two groups.

Conclusions: Our study suggested doublets and triplets had the same efficacy as the adjuvant chemotherapy. Furthermore, doublets seem more cost-effective.

[Table: see text]

No significant financial relationships to disclose.

Abstract P2-09-39: Multi-Gene Predictors Developed from Breast Cancer Cell Lines To Predict Response to Chemotherapy: A Validation Study on US Oncology Study 02-103

PURPOSE: Multi-gene predictors (MGPs) of response to multidrug chemotherapy regimens were developed using an in vitro chemoresponse assay in which cell lines were exposed to chemotherapy. The goal of this study was to assess the predictive value of these MGPs using clinical breast cancer patient gene expression data from a clinical trial. METHOD: US Oncology 02-103 was a phase II trial in which women with stage II/III breast cancer were treated with neoadjuvant chemotherapy consisting of four cycles of fluorouracil/epirubicin/cyclophosphamide (FEC) followed by four cycles of docetaxel/capecitabine (TX). Most HER-2 positive patients also received trastuzumab. MGPs of FEC, TX and TFEC (docetaxel/fluorouracil/epirubicin/cyclophosphamide) sensitivity were developed using in vitro assay results from breast cancer cell lines exposed to these drug combinations and publicly-available gene expression data for the same cell lines. MGPs were not developed for trastuzumab treatment. Area under the receiver-operator curve (AUC) was used to evaluate the performance of the three MGPs’ to predict patient pathologic complete response (pCR). Patients who did or did not receive trastuzumab were evaluated separately. Validation was performed blindly and the predictors were applied without knowledge of patient clinical outcome. RESULTS: Eighty-six patients had genomic data available and were included in this analysis. The predictive performance of the FEC, TX and TFEC MGPs were AUCs of 0.72, 0.69, and 0.73, respectively, in the patients who received FEC-TX chemotherapy without trastuzumab (n=61). Within this group, higher AUCs were observed in ER-negative patients compared to ER-positive patients (0.69, 0.72, 0.74 vs. 0.64, 0.54, 0.62, respectively). The prediction accuracies were low (AUCs = 0.43, 0.56 and 0.43) for patients who received trastuzumab together with chemotherapy (n=25) as expected, indicating that the MGPs may have the potential to be regimen-specific.

CONCLUSION: Cell line-derived MGPs of multidrug chemotherapy regimens showed promising performance in this blinded validation study, particularly among patients with ER-negative breast cancers. Further clinical data are needed to confirm this finding.

Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P2-09-39.

Abstract P3-08-02: Pharmacogenomic Predictors of Patient Response to Chemotherapy Derived from Breast Cancer Cell Lines Combining Knowledge-Based and Data-Driven Methods

Background: Responses of breast cancer patients to chemotherapy treatments vary considerably, and population treatment response rates remain low. To improve patient outcomes, genomic profiles have been used to identify patients who would benefit from specific treatments. Several studies have used cancer cell lines to develop pharmacogenomic predictors by identifying genes associated with drug response. However, pharmacogenomic predictors derived by this data-driven approach may not readily elucidate the underlying mechanisms associated with drug responses, because the identified predictors by computational methods may not directly associate with drug responses considering the complex genetic regulatory network. To overcome this issue, we proposed a strategy to integrate data-driven methods with biological knowledge-based approaches to identify genomic predictors. We then applied this approach to breast cancer cell lines to identify genomic predictors of paclitaxel-5-fluorouracil-doxorubicin-cyclophosphamide (TFAC), the identified predictors are then evaluated by their ability to predict the clinical outcome of the breast cancer patients who are treated by TFAC. Material: Thirty immortalized breast cancer cell lines were exposed to various concentrations of TFAC using a chemosensitivity assay. Area under the dose-response curves was calculated to measure chemoresponses. Gene expression profiles of the 30 cell lines, the expression profiles as well as the pathologic complete response (pCR) information of 133 breast cancer patients treated by TFAC were publicly available. Methods: We performed pathway enrichment analysis in breast cancer cell lines to assess the association between drug response and curated gene sets predefined by molecular signature database. Pathways with p-value less than 0.01 were considered enriched. The genes from the enriched pathways whose expression values were highly correlated with drug sensitivity were selected as the pharmacogenomic predictors. To validate these predictors, the performances of their prediction for patients’ pCR were evaluated using principle component regression method.

Results: Using pathway enrichment analysis, 17 pathways were identified to be related to TFAC drug response. These pathways are related to different biological functions, including breast cancer ER status and BRCA type, immune response, differentiation, and drug response. Using supervised principal component regression, 59 genes involved in at least one of these 17 pathways were selected as genomic predictors. The prediction accuracy of patient pCR was 0.70, sensitivity was 0.71, and specificity was 0.70. Conclusion: By combining knowledge-based and data-driven methods, we have identified 59 genes from breast cancer cell lines as pharmacogenomic predictors of drug response to TFAC. These results support the viability of using breast cancer cell lines to predict breast cancer patient response to chemotherapy. Further functional study of these pharmacogenomic predictors will extend our understanding of individual drug response and facilitate personalized treatment.

Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P3-08-02.

Abstract P2-09-10: Feasibility Assessment of Pharmacogenomic Predictors Developed from Breast Cancer Cell Lines To Predict Breast Cancer Patient Pathological Response in Neoadjuvant Chemotherapy

Background: Studies of developing pharmacogenomic predictors from cancer cell lines to predict cancer patient clinical response and outcome to chemotherapy have yielded both positive and negative results. The variability in these results may arise from the noise inherent of microarray technology as well as the small sample size of in cell line studies. Therefore, it is greatly needed to evaluate the feasibility of using cell lines to develop pharmacogenomic predictors of patient pathological response. Material and Methods: Thirty breast cancer cell lines were exposed to 10 concentrations of paclitaxel-5-fluorouracil-doxorubicin-cyclophosphamide (TFAC) to measure in vitro chemosensitivity. Two independent and publicly available microarray datasets (Hoeflich and Neve) on these breast cancer cell lines together with the chemosensitivity results were used to identify pharmacogenomic predictors from each dataset. Two independent clinical trials (Hess and Popovici) with publically available data, having 130 and 100 patients respectively, were used as test sets to validate the accuracy of the pharmacogenomic predictors. All patients received TFAC as neoadjuvant therapy and the gene expression profiles of patients were assessed before receiving chemotherapy treatment. The patient's pathological complete response (pCR) was determined after treatment to evaluate the chemotherapy efficacy.

The pharmacogenomic predictors developed from each of the cell line studies were evaluated for their ability to predict patient pCR in each of the clinical trials using the supervised principle component regression method.

Results: The pharmacogenomic predictors identified from the Hoeflich and Neve cell line data (training sets) predicted pCR of the patients in the two clinical trials (test sets) with 64%-68% accuracy, 70%-87% sensitivity, and 60%-67% specificity when 100 genes were selected as pharmacogenomic predictors (Table 1).

Conclusions: The four independent prediction results generated in this study demonstrate the feasibility of using breast cancer cell lines to identify pharmacogenomic predictors of response to chemotherapy treatment for breast cancer patients. Future studies will examine the use of drug responses from primary cultures of patient tumors to develop pharmacogenomic predictors of breast cancer patient responses to chemotherapy treatment.

Table 1. Prediction of breast cancer patients’ pCR by pharmacogenomic predictors derived from breast cancer cell lines.

Diffusion-Weighted MRI in Predicting the Efficacy of Neoadjuvant Chemotherapy of Breast Cancer

Objective: To approach the apparent diffusion coefficient(ADC) obtained on diffusion weighted imaging (DWI) in predicting the response of breast cancer to neoadjuvant chemotherapy.Methods: 53 locally advanced breast cancer patients participated in this prospective study on neoadjuvant chemotherapy. All patients were treated with weekly neoadjuvant paclitaxel plus carboplatin for 4 cycles. DWI and ADC value were examined before chemotherapy(the first time point), after the first and the forth cycle of chemotherapy(the second and the third time point). Patients were categorized as high responders if their ADC at the second time point were higher by 2 times the standard deviation than the mean pre-chemotherapy ADC, and otherwise the patients were considered as low responders. Logistic regression was conducted to examine the independent factors predictive of clinical complete response(CR) and pathologic complete response(pCR).Results: CR was documented in 13 patients (24.5%); partial response in 36 patients (67.9%); stable disease in 4 patients (7.5%) and no patient had progressive disease. 11 patients(20.8%) have achieved pCR. There was a strong positive correlation between the percentage changes in ADC value at the third time points and the degree of the tumor reduction. A significant increase in ADC value was observed at the second time point compared with the first time point (1.104±0.117×10-3mm2/s, 1.220±0.158×10-3mm2/s, P&lt;0.001), while the decrease of the longest diameter of the tumors measured by physical examination, ultrasound or MRI or the tumor volumn measured by MRI were not (P&gt;0.05). Logistic regression revealed that percentage changes of ADC value at the second time point were significantly associated with CR(P=0.022, hazard ratio[HR] =1.08, 95% confidence interval[CI]: 1.01∼1.16) and pCR(P=0.022, HR =1.11, 95%CI: 1.02∼1.21). The AUC value of the receiver operating characteristic curve were 0.721(95%CI: 0.512∼0.931, P=0.017) and 0.775(95%CI: 0.598∼0.952, P=0.005) in the two diagnostic tests for CR and pCR, and the sensitivity and specificity were 76.9%, 63.6% and 77.5%, 90.5%, respectively. According to categorizing system described above, 10 patients(18.9%) were considered as high responders and 43 patients(81.1%) low responders. 7 patients(70%) of the high responders have achieved clinical CR and pCR while for the low responders there were only 6 patients(14.0%) and 4 patients (9.3%) proven to have CR and pCR. The difference have both reached statistical significance(P=0.001, P&lt;0.001). Logistic regression confirmed that the categorizing system was independently predictive of CR(P=0.006, HR=42.26, 95%CI: 2.86∼624.08) and pCR(P=0.013, HR=25.19, 95%CI: 2.00∼318.91). Taking this categorizing system as a dignostic test, the sensitivity and specificity were 53.8% and 92.5% for CR and 63.6% and 92.9% for pCR, respectively.Conclusions: The change of ADC value obtained on DWI after the first cycle of neoadjuvant chemotherapy occured prior to the morphologic changes of the tumor and at this time ADC value could to some extent predict the efficacy of neoadjuvant chemotherapy.

Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 4025.

Estrogen Receptor Expression: Possible Predictor of Pathological Complete Response to Neoadjuvant Chemotherapy in Locally Advanced Breast Cancer Patients

BackgroundEstrogen receptor(ER) status has been found to correlate inversely to pathologic complete response (pCR) rates of neoadjuvant chemotherapy(NAC) of breast cancer. However, not all ER-positive breast cancer respond equally to NAC. The present study aimed to determine the relationship between different ER expression level with pCR in locally advanced breast cancer(LABC) patients who have received NAC.MethodsA retrospective study of 332 female unilateral LABC patients undergoing NAC was performed. All patients were confirmed as invasive breast cancer before treated with NAC, including VE (vinorelbine, epirubicin), CEF (cyclophosphamide, epirubicin, fluorouracil) and PCb regimen (paclitaxel, carboplatin). All patients underwent radical surgery and pCR was defined as the absence of invasive breast cancer in both breast and axillary lymph nodes. ER status were checked using the established immunohistochemical(IHC) method and defined as negative, weakly positive(1+), medium positive(2+) and strongly positive(3+). Binary logistic regression was performed to determine the independent predictors of pCR.ResultsER negativity, 1+, 2+ and 3+ were found in 156, 108, 37 and 31 patients, of which 42(26.9%), 21(19.4%), 3(8.1%) and 1 patients(3.2%) have achieved pCR. Binary logistic regression showed that different ER expression level(P=0.021) and HER2 status(P=0.007, hazard ratio[HR] =2.557, 95% confidence interval[CI]: 1.297∼5.038) were significantly associated with the pCR rates. pCR was much more likely to occur in patients with ER-negative(P=0.024, HR =13.119, 95% CI: 1.402∼122.774) or ER 1+(P=0.025, HR=12.928, 95% CI: 1.388∼120.390) tumors than those with ER 3+ tumors.ConclusionER weekly positive patients also gain considerable benefit from NAC, which is probably less effective in ER strongly positive patients in terms of pCR.

Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 1104.

Prediction of Response to Paclitaxel by ChemoFx assay Correlates with Estrogen Receptor Status and Changes in Apoptosis Pathway in Human Breast Cancers

Background: Paclitaxel belongs to the taxane family of therapeutics, which have emerged as critically important drugs for breast cancer treatment. In addition to inhibiting cell growth by interfering with microtubule disassembly, its mechanism of action also includes induction of apoptosis. Recent studies suggest that besides being a key predictor for endocrine therapy response, Estrogen Receptor (ER) status also influences sensitivity of breast cancer to paclitaxel, with ER negative tumors being more responsive to the drug.Methods: The ChemoFx live cell chemoresponse assay was performed on 25 breast cancer cell lines (10 ER+ and 15 ER-). These cells were treated with a range of 10 doses of paclitaxel for 72 hours before DAPI staining of nuclei and counting. AUC (Area Under Curve) values were calculated and additional statistical analysis was performed on the resulting dose-response curves. Differential gene expression analysis was conducted to compare ER+ (n=82) and ER- (n=51) breast cancer patients using a public Microarray database. In addition, 2 of the 25 breast cancer cell lines, T47D (ER+) and SKBR3 (ER-), were treated with paclitaxel, lysed, and analyzed with Western blotting to detect cleaved caspase-3 and cleaved PARP expression, with beta-actin employed as a normal control.Results: The ChemoFx assay results revealed that none of the ER+ cells were categorized as R (responsive) to paclitaxel, with seven NR (non-responsive) and one IR (intermediate responsive). On the contrary, of the 15 ER- cell lines, three were categorized as R, only four were categorized as NR, and eight were categorized as IR. Statistical analysis suggested that paclitaxel responsiveness based on ChemoFx assay correlates with ER status (Chi-square test, p&lt;0.05), with ER- breast tumors being more responsive to paclitaxel. Microarray analysis revealed differential expressions of genes implicated in the apoptosis pathway (q&lt; 0.05) in ER+ and ER- breast cancers. Western blot analysis showed that paclitaxel induced cleaved caspase-3 and cleaved PARP expressions, both of which are indicators of activation of apoptosis, in SKBR3 cells (ER-), but not in T47D cells (ER+).Conclusions: ER status appears to predict in part, the response of breast cancer cells to paclitaxel as determined by the ChemoFx assay. ER-negative breast cancer cells are more likely to be responsive, which is consistent with established clinical findings. Our assay also distinguishes between NR/IR and R to paclitaxel within the ER- population. Similar ChemoFx assays are being performed on primary cultures from ER+ and ER- breast cancer patient specimens. Results from RNA microarray and Western blot analyses indicate that differences in gene expression in the apoptosis pathway, and in activation of apoptosis pathway, namely changes in expressions of cleaved PARP and cleaved caspase-3 in response to paclitaxel, may explain differences in the responsiveness of ER+ and ER- breast cancers to paclitaxel. This also suggests a potential role of cleaved PARP and cleaved caspase-3 as biomarkers in addition to ER for prediction of paclitaxel responsiveness in breast cancer.

Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 2028.

Medical treatment of craniosynostosis: recombinant Noggin inhibits coronal suture closure in the rat craniosynostosis model

INTRODUCTION - The mechanisms underlying craniosynostosis remains unknown. However, mutations in FGFR2 are associated with craniosynostotic syndromes. We previously compared gene expression patterns of patent and synostosing coronal sutures in the nude rat and demonstrated down regulation of Noggin in synostosing sutures. Noggin expression is also suppressed by FGF2 and constitutive FGFR2 signaling [Warren et al. (2003) Nature, vol. 422, pp. 625-9; McMahon et al. (1998) Genes Dev, vol. 12, pp. 1438-52]. Thus, we therefore hypothesized that the addition of rhNoggin to prematurely fusing sutures should prevent synostosis. MATERIALS AND METHODS - Cohorts of nude rats were subjected to: 1) surgical elevation of the coronal suture (shams); 2) surgical elevation and placement of normal or FGFR2 mutant human osteoblasts onto the underlying dura (xenotransplants); or 3) xenotransplantation with co-application of heparin acrylic beads soaked with recombinant human (rh) Noggin. Eleven days post-surgery the sutures were harvested, stained, and histologically examined. RESULTS - Animals that received control osteoblasts, sham surgery, or no surgery demonstrated normal skull growth and coronal suture histology, whereas animals transplanted only with FGFR2 mutant osteoblasts showed evidence of bridging synostosis on the calvarial dural surface. Sutures treated with FGFR2 mutant osteoblasts and rhNoggin remained patent. CONCLUSION - The chimeric nude rate model is a viable model of craniosynostosis. FGFR2 mutations in osteoblasts induce bridging osteosynthesis demonstrating one of the mechanisms for premature suture fusion. Topical application of rhNoggin protein prevents craniosynostosis in the weanling nude rat xenotransplantation model of syndromic craniosynostosis.

Postsurgical drainage and the risk of breast cancer recurrence in Chinese breast cancer patients

e22234

Background: Clinical investigations suggest that while primary breast cancer surgical removal favorably modifiers the natural history of breast cancer. Postoperative drainage, a surgery-derived discharge after breast cancer surgery, reflecting some biological features of surgical stimulation, was assessed and explored its relationship with breast cancer recurrence in this study. Methods: A total of 1445 women undergoing surgery between Jan 1, 2000 and Dec31, 2002 in Cancer Hospital of Fudan University, Shanghai, China was retrospectively studied. Survival curves were performed with Kaplan-Meier method and the predictive value of postsurgical drainage was estimated using proportional Cox regression model. Conclusions: The larger drainage volume POD 1 is a useful marker, suggesting a greater stimulation to surgical treatment compared to the lower ones. Awareness of the relationship between early surgery-stimulated effects and harmful wound healing response might help to explore new strategies to block or deplete these harmful effects, resulting in improving patients' survival.

No significant financial relationships to disclose.

Demographic features and prognostic profiles of breast cancer patients presenting with nipple discharge in Chinese population

e22204

Background: Breast cancer patients with nipple discharge (ND) may constitute a distinct clinical entity compared to those without ND, which has not been well elucidated in previous reports. We sought to analyze the demographic features and prognostic profiles of breast cancer patients presenting with nipple discharge in Chinese population. Methods: A total of 3234 patients, categorized as ND (2.47%) and non-nipple discharge (NND; 97.53%) according to different initial signs, were retrospectively analyzed. Survival curves were performed with Kaplan-Meier method and annual recurrence hazard was estimated by hazard function. Results: ND group tended to have smaller tumors and less axillary lymph node (ALN) involvement than NND group (P < 0.05). In the univariate analysis, we found significantly different recurrence-free survivals (RFS) between subgroups (P = 0.0182), with the rate of 77.78% for ND group and 72.46% for the other at the 11th year respectively. In Cox proportional hazards regression analysis, we found that tumor size (P < 0.001), ALN status (P < 0.001) were independent prognostic factors for RFS. To further evaluate whether prognostic effect of ND status remained unabated over time, the test for lack of proportionality was performed. However, it was statistically significant (global test, P = 0.039), which hinted at a demand for the employment of Cox non-proportional hazards regression in this analysis. In time dependent Cox model, ND status (P = 0.0495) as well as ERBB2 status (P = 0.017), tumor size (P < 0.001), ALN status (P < 0.001) were independent prognostic factors when ND and ERBB2 status were taken as time-varying covariates. Annual hazard rates for recurrence remained lower on ND group until approximately 4.5 years after surgery, while the situation was just the opposite thereafter. Conclusions: Our findings suggested that demographic features and prognostic profiles were quite different between breast cancers presenting with and without ND in Chinese population, which may indirectly uncover distinct biological behaviors and potentially enlighten novel therapeutic approaches for patients with different initial signs.

No significant financial relationships to disclose.

Luminal group may give more benefit for invasive micropapillary carcinoma component breast cancer patients: experience from Cancer Hospital Fudan University

Abstract #6152

Objective: Comparative studies on clinical features and outcomes of very rare invasive micropapillary carcinoma of breast cancer of 4 subtypes by immunohistochemistry staining.&#x2028; Methods: From Aug 2005 to Mar 2008, a total of 52 breast cancer patients(BCPs) with an invasive micropapillary component (IMPC) among 1951 Chinese BCPs with complete of clinicopathologic data in our institution were enrolled into a retrospective analysis. We characterized all these 52 patients and analyzed using various parameters.&#x2028; Results: The 52 cases of breast carcinoma with an IMPC all occurred in women. Mean age was 51 years (range from 26-82). All of these patients had breast masses; one also had metastasis to the supraclavicular lymph node at the time of diagnosis., mean tumor size was 2.83cm(T2), 23.08%(12/52) was pure invasive micropapillary carcinoma, and lymph node positive percentage was 75.59 %( 36/51).Fifty one patients received surgery, while one of them lost the chance of surgery. Forty of them received the modified mastectomy while one was performed lumpectomy due to old age. One was performed LAND alone and four were performed lumpectomy and sentinel lymph node biopsy.&#x2028; By using IHC staining, when we regard HER2/neu 0 and +as negative. The Luminal A group, Luminal B, trip-negative, HER2+ /ER- were 76.92% (40/52), 11.54 %( 6/52), 7.69 %( 4/52), 3.85 %( 2/52), respectively. Compared to the database of 2005 breast cancer carcinoma in our institution, there was more Luminal A group patients than the whole group (P=0.01, chi-square test.), more Luminal B (P=0.028, Fisher exact possibility test), less trip-negative group (P=0.001, chi-square test). The positive lymph node among the Luminal A group, Luminal B, trip-negative, HER2+ /ER- were 65%,80%, 100%, 100%, respectively, while the lymphvascular invasion were 55%,33.33%,50%,50%,respectively, Mulifocality in Luminal A was 25% , 16.67% in Luminal B , while 50% in both trip-negative and HER2+/ER-.&#x2028; Twenty-one of them received both anthracyclines and Taxane, while 27 only received anthracyclines, Four patients only were received only AIs due to old age. All the luminal group patients received endrocine therapy after chemo. After nearly 14 months (2∼34 months) follow up, thirty-six women were disease free, one had local recurrence, and 1 had lung metastasis, while 1 had ovary carcinoma when the diagnosis of breast malignant, one patient lost following up due to mental disorder. Among the luminal B, one had metastasis when diagnosis, others were disease free. One woman of the trip-negative died of non-breast cancer disease,the HER2+/ER- group was no recurrence or metastasis.&#x2028; Discussion: The prelimary results showed that more luminal group in the IMPC may get benefit from the endocrine therapy. However the number of these cases is small and follow-up time is not very long, further studies are necessary to explain these rare and unique pattern of invasive carcinoma.

Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 6152.

Time distributions and prognosis factors of breast cancer recurrence in different sites after operation

Abstract #2080

Objective Our study aims to analyze the breast caner patients with different sites of recurrence, and to have knowledge of the regular patterns and influence factors of metastastic breast cancer.&#x2028; Methods We performed a retrospective study of 210 female breast cancer patients who were continuously followed up in our hospital from January 2005 to May 2007 and had complete data of metastasis. The clinical and biological characteristics were compared between the patients with organ metastases (lung, liver, brain) and non-viscera metastases (lymph node, bone).&#x2028; Results Cox regression analysis-hazard function showed that patients with elder age (RR=0.927 95%CI 0.877∼0.981, P=0.008) and HER-2 negative(RR=0.253 95%CI 0.076∼0.836, P=0.024)tended to develop non-viscera metastases, while patients with larger tumors (RR=3.832 95%CI 1.073∼13.687, P=0.039) tended to develop organ metastasesp.&#x2028; &#x2028; When stratified by the prognostic factors, the annual risk hazard curve of the patients with high risk of recurrence had double peaks at the second year and the ninth years after mastectomy respectively, and it was significantly higher than those of the patients with middle and low risk.[figure1]Annual risk hazard curves of both local relapse and metastasis also showed a double-peaked pattern. The curves for lymph node, bone, lung and liver metastasis showed a similar pattern, but all the peaks of curve emerged later than that of the local relapse.&#x2028; &#x2028; Conclusion Patients with different clinical and biological characteristics may develop recurrence in different sites. There are certain regular patterns of time distribution for different metastasis sites after mastectomy. The local recurrence may be the foreboding for the metastasis and we should pay attention to the local relapse signs especially in the patients with high risk.

Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 2080.

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