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Thorén L, Eriksson M, Lindh JD, Czene K, Bergh J, Eliasson E, Hall P, Margolin S. Impact of systemic adjuvant therapy and CYP2D6 activity on mammographic density in a cohort of tamoxifen-treated breast cancer patients. Breast Cancer Res Treat 2021; 190:451-462. [PMID: 34570302 PMCID: PMC8558195 DOI: 10.1007/s10549-021-06386-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 09/06/2021] [Indexed: 11/27/2022]
Abstract
PURPOSE Change in mammographic density has been suggested to be a proxy of tamoxifen response. We investigated the effect of additional adjuvant systemic therapy and CYP2D6 activity on MD change in a cohort of tamoxifen-treated pre- and postmenopausal breast cancer patients. METHODS Swedish breast cancer patients (n = 699) operated 2006-2014, genotyped for CYP2D6, having at least three months postoperative tamoxifen treatment, a baseline, and at least one follow-up digital mammogram were included in the study. Other systemic adjuvant treatment included chemotherapy, goserelin, and aromatase inhibitors. Change in MD, dense area, was assessed using the automated STRATUS method. Patients were stratified on baseline characteristics, treatments, and CYP2D6 activity (poor, intermediate, extensive, and ultrarapid). Relative density change was calculated at year 1, 2, and 5 during follow-up in relation to treatments and CYP2D6 activity. RESULTS Mean relative DA decreased under the follow-up period, with a more pronounced MD reduction in premenopausal patients. No significant effect of chemotherapy, aromatase inhibitors, goserelin, or CYP2D6 activity on DA change was found. DA did not revert to baseline levels after tamoxifen discontinuation. CONCLUSION Our results indicate that other systemic adjuvant therapy does not further reduce MD in tamoxifen-treated breast cancer patients. We could not confirm the previously suggested association between CYP2D6 activity and MD reduction in a clinical setting with multimodality adjuvant treatment. No rebound effect on MD decline after tamoxifen discontinuation was evident.
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Affiliation(s)
- Linda Thorén
- Department of Clinical Science and Education at Södersjukhuset, Karolinska Institutet, Stockholm, Sweden. .,Department of Oncology, Södersjukhuset, Stockholm, Sweden.
| | - Mikael Eriksson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Jonatan D Lindh
- Department of Laboratory Medicine, Clinical Pharmacology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Kamila Czene
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Jonas Bergh
- Department of Oncology-Pathology, Karolinska Institutet and Breast Cancer Center, Cancer Theme, Karolinska University Hospital, Karolinska Comprehensive Cancer Center, Stockholm, Sweden
| | - Erik Eliasson
- Department of Laboratory Medicine, Clinical Pharmacology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Per Hall
- Department of Oncology, Södersjukhuset, Stockholm, Sweden.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Sara Margolin
- Department of Clinical Science and Education at Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.,Department of Oncology, Södersjukhuset, Stockholm, Sweden
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2
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Suemasu T, Shimomura A, Shimizu C, Hashimoto K, Kitagawa D. Regarding the Appropriate Target and Duration of Chemoprevention in Breast Cancer. J Clin Oncol 2021; 39:2965-2966. [PMID: 34125580 DOI: 10.1200/jco.21.01060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Takahito Suemasu
- Takahito Suemasu, MD, Department of Breast and Endocrine Surgery, National Center for Global Health and Medicine, Tokyo, Japan; Akihiko Shimomura, MD, PhD, and Chikako Shimizu, MD, PhD, Department of Breast and Medical Oncology, National Center for Global Health and Medicine, Tokyo, Japan; and Kazuki Hashimoto, MD, and Dai Kitagawa, MD, PhD, Department of Breast and Endocrine Surgery, National Center for Global Health and Medicine, Tokyo, Japan
| | - Akihiko Shimomura
- Takahito Suemasu, MD, Department of Breast and Endocrine Surgery, National Center for Global Health and Medicine, Tokyo, Japan; Akihiko Shimomura, MD, PhD, and Chikako Shimizu, MD, PhD, Department of Breast and Medical Oncology, National Center for Global Health and Medicine, Tokyo, Japan; and Kazuki Hashimoto, MD, and Dai Kitagawa, MD, PhD, Department of Breast and Endocrine Surgery, National Center for Global Health and Medicine, Tokyo, Japan
| | - Chikako Shimizu
- Takahito Suemasu, MD, Department of Breast and Endocrine Surgery, National Center for Global Health and Medicine, Tokyo, Japan; Akihiko Shimomura, MD, PhD, and Chikako Shimizu, MD, PhD, Department of Breast and Medical Oncology, National Center for Global Health and Medicine, Tokyo, Japan; and Kazuki Hashimoto, MD, and Dai Kitagawa, MD, PhD, Department of Breast and Endocrine Surgery, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kazuki Hashimoto
- Takahito Suemasu, MD, Department of Breast and Endocrine Surgery, National Center for Global Health and Medicine, Tokyo, Japan; Akihiko Shimomura, MD, PhD, and Chikako Shimizu, MD, PhD, Department of Breast and Medical Oncology, National Center for Global Health and Medicine, Tokyo, Japan; and Kazuki Hashimoto, MD, and Dai Kitagawa, MD, PhD, Department of Breast and Endocrine Surgery, National Center for Global Health and Medicine, Tokyo, Japan
| | - Dai Kitagawa
- Takahito Suemasu, MD, Department of Breast and Endocrine Surgery, National Center for Global Health and Medicine, Tokyo, Japan; Akihiko Shimomura, MD, PhD, and Chikako Shimizu, MD, PhD, Department of Breast and Medical Oncology, National Center for Global Health and Medicine, Tokyo, Japan; and Kazuki Hashimoto, MD, and Dai Kitagawa, MD, PhD, Department of Breast and Endocrine Surgery, National Center for Global Health and Medicine, Tokyo, Japan
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3
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Kanbayti IH, Rae WID, McEntee MF, Ekpo EU. Mammographic density changes following BC treatment. Clin Imaging 2021; 76:88-97. [PMID: 33578136 DOI: 10.1016/j.clinimag.2021.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 12/03/2020] [Accepted: 01/04/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Mammographic density (MD) reduction is associated with lower risk of breast cancer (BC) recurrence and may be used as a marker of treatment outcome; however, trends in MD following BC therapies and the factors associated with such trends are poorly understood. The aim of this study was to investigate MD changes following BC treatment and the factors associated with these changes. METHODS A total of 226 BC-affected patients who received BC treatments were examined. MD was assessed by the Laboratory for individualized Radiodensity Assessment (LIBRA) software. A Wilcoxon ranked signed test was used to investigate the differences in MD before and after treatment and median independent test to assess the associated factors. RESULTS Significant differences in MD between baseline and follow-up mammograms were observed for all MD measures: percent density (p ≤ 0.005), dense area (p ≤ 0.004), and nondense area (p ≤ 0.02). After adjustment, these differences were more pronounced among younger at BC diagnosis (p ≤ 0.001), premenopausal (p ≤ 0.003), and obese women (p ≤ 0.05). Changes in MD were evident regardless of the treatment regimen. MD reduction was observed among patients with high baseline MD (p < 0.001), younger at BC diagnosis (p ≤ 0.04), premenopausal (p < 0.001), and normal body mass index (p = 0.04). Patients who experienced an increase in nondense area had high percent density at baseline (p ≤ 0.001). CONCLUSION Two different MD changes were observed over time: MD increase and decrease. Baseline MD, menopausal status, age at BC diagnosis, and body mass index influenced these changes.
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Affiliation(s)
- Ibrahem H Kanbayti
- Diagnostic Radiography Technology Department, Faculty of Applied Medical Sciences, King Abdul-Aziz University, Saudi Arabia; Medical Image Optimisation and Perception Group (MIOPeG), Faculty of Medicine and Health, The University of Sydney, Australia.
| | - William I D Rae
- Medical Image Optimisation and Perception Group (MIOPeG), Faculty of Medicine and Health, The University of Sydney, Australia
| | - Mark F McEntee
- Medical Image Optimisation and Perception Group (MIOPeG), Faculty of Medicine and Health, The University of Sydney, Australia; Department of Medicine Roinn na Sláinte, UG 12 Áras Watson, Brookfield Health Sciences |T12 AK54, Ireland
| | - Ernest U Ekpo
- Medical Image Optimisation and Perception Group (MIOPeG), Faculty of Medicine and Health, The University of Sydney, Australia; Orange Radiology, Laboratories and Research Centre, Calabar, Nigeria
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4
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Lian J, Li K. A Review of Breast Density Implications and Breast Cancer Screening. Clin Breast Cancer 2020; 20:283-290. [DOI: 10.1016/j.clbc.2020.03.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 02/10/2020] [Accepted: 03/12/2020] [Indexed: 12/15/2022]
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5
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Oceguera-Basurto P, Topete A, Oceguera-Villanueva A, Rivas-Carrillo J, Paz-Davalos M, Quintero-Ramos A, Del Toro-Arreola A, Daneri-Navarro A. Selective estrogen receptor modulators in the prevention of breast cancer in premenopausal women: a review. Transl Cancer Res 2020; 9:4444-4456. [PMID: 35117809 PMCID: PMC8797886 DOI: 10.21037/tcr-19-1956] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 06/15/2020] [Indexed: 12/28/2022]
Abstract
The detection of premenopausal women at high risk of breast cancer is key to chemoprevention. Therapy with selective estrogen receptor modulators (SERMs) induces a significant antiproliferative effect in estrogen receptor (ER) positive breast cancer. This review was designed according the guidelines of the 2009 PRISMA statement. Searching different databases, including PubMed, MedlinePlus, PLoS One, Cochrane Breast Cancer Specialized Register, Clinical Trials.gov and American Society of Clinical Oncology. From 168 records screened, 15 full text articles were assessed for eligibility and only 7 studies met the inclusion criteria. Three of the studies included analyzed changes in Ki-67 expression, revealing weaker expression after treatment with acolbifene and raloxifene (P<0.001). Three studies also analyzed the breast volume by magnetic resonance imagining (MRI) and demonstrate a significant difference after 1 year with raloxifene treatment (P=0.0017). Moreover, a 20% reduction in breast density was observed after a 2-year treatment with tamoxifen in premenopausal women. SERMs reduce the risk of developing breast cancer. The studies reviewed here demonstrate the modulation of Ki-67 expression and changes in breast density, suggesting an important preventive role for this group of drugs in prevention for premenopausal women at high risk of developing breast cancer.
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Affiliation(s)
- Paola Oceguera-Basurto
- Departamento de Fisiología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Jalisco, México
| | - Antonio Topete
- Departamento de Fisiología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Jalisco, México
| | | | - Jorge Rivas-Carrillo
- Departamento de Fisiología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Jalisco, México
| | | | - Antonio Quintero-Ramos
- Departamento de Fisiología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Jalisco, México
| | - Alicia Del Toro-Arreola
- Departamento de Fisiología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Jalisco, México
| | - Adrián Daneri-Navarro
- Departamento de Fisiología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Jalisco, México
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Effect of neoadjuvant chemotherapy on breast tissue composition: a longitudinal mammographic study with automated volumetric measurement. Eur Radiol 2020; 30:4785-4794. [PMID: 32314056 DOI: 10.1007/s00330-020-06830-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 03/05/2020] [Accepted: 03/23/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES To investigate the effect of neoadjuvant chemotherapy (NAC) on breast tissue composition with mammographic automated volumetric measurement. METHODS This retrospective study included 168 breast cancer patients who were treated with NAC and underwent serial mammography (pre-treatment, mid-treatment, and post-treatment) between January 2015 and October 2018. Automated volumetric measurements of the contralateral breast volume (BV), fibroglandular volume (FGV), and breast density (BD) were performed using Volpara software. BD grades were divided into 4 groups by Volpara density grade (VDG). The longitudinal changes in BV, FGV, BD, and their associated factors were evaluated. RESULTS Repeated-measures analysis of variance demonstrated a significant reduction in BV, FGV, and BD over time (p < 0.001, p < 0.001, and p = 0.002, respectively). BV showed a greater reduction in the second half than in the first half (- 28.6 cm3 vs. - 15.2 cm3), BD showed a greater reduction in the first half than in the second half (- 0.8% vs. - 0.1%), and FGV steadily decreased (- 4.6 cm3 and - 3.9 cm3 in the first and second halves). On multivariable linear regression analysis, chemotherapy regimen was associated with BV change between pre- and post-treatment (p = 0.002); age (p = 0.024) and VDG (p = 0.027) were associated with FGV change; age (p = 0.037), VDG (p = 0.002), and chemotherapy regimen (p = 0.003) were associated with BD change. CONCLUSIONS NAC affects breast tissue composition, reflected as reductions in BV, FGV, and BD. Mammography with automated volumetric measurement can capture quantitative changes in these breast tissue parameters during NAC. KEY POINTS • Neoadjuvant chemotherapy (NAC) affects breast tissue composition with different patterns of reduction in breast volume, fibroglandular volume, and breast density. • Age, Volpara density grades, and NAC regimen were independent factors associated with breast density change between pre-treatment and post-treatment. • Mammography with automated volumetric measurement enables identification of longitudinal changes in breast tissue composition.
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Fernández-Nogueira P, Mancino M, Fuster G, Bragado P, Prats de Puig M, Gascón P, Casado FJ, Carbó N. Breast Mammographic Density: Stromal Implications on Breast Cancer Detection and Therapy. J Clin Med 2020; 9:jcm9030776. [PMID: 32178425 PMCID: PMC7141321 DOI: 10.3390/jcm9030776] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 03/06/2020] [Accepted: 03/09/2020] [Indexed: 12/21/2022] Open
Abstract
Current evidences state clear that both normal development of breast tissue as well as its malignant progression need many-sided local and systemic communications between epithelial cells and stromal components. During development, the stroma, through remarkably regulated contextual signals, affects the fate of the different mammary cells regarding their specification and differentiation. Likewise, the stroma can generate tumour environments that facilitate the neoplastic growth of the breast carcinoma. Mammographic density has been described as a risk factor in the development of breast cancer and is ascribed to modifications in the composition of breast tissue, including both stromal and glandular compartments. Thus, stroma composition can dramatically affect the progression of breast cancer but also its early detection since it is mainly responsible for the differences in mammographic density among individuals. This review highlights both the pathological and biological evidences for a pivotal role of the breast stroma in mammographic density, with particular emphasis on dense and malignant stromas, their clinical meaning and potential therapeutic implications for breast cancer patients.
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Affiliation(s)
- Patricia Fernández-Nogueira
- Institut d’Investigacions Biomèdiques Augustí Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain
- Correspondence: (P.F.-N.); (M.M.)
| | - Mario Mancino
- Department of Biochemistry and Molecular Biomedicine, University of Barcelona, Institute of Biomedicine, University of Barcelona (IBUB), 08028 Barcelona, Spain
- Department of Medicine, University of Barcelona, 08036 Barcelona, Spain
- Correspondence: (P.F.-N.); (M.M.)
| | - Gemma Fuster
- Department of Biochemistry and Molecular Biomedicine, University of Barcelona, Institute of Biomedicine, University of Barcelona (IBUB), 08028 Barcelona, Spain
- Department of Biochemistry & Physiology, School of Pharmacy and Food Sciences, University of Barcelona, 08028 Barcelona, Spain
- Department of Biosciences, Faculty of Sciences and Technology, University of Vic, 08500 Vic, Spain
| | - Paloma Bragado
- Department of Biochemistry and Molecular Biology, Faculty of Pharmacy, Complutense University of Madrid, Health Research Institute of the Hospital Clínico San Carlos, 28040 Madrid, Spain
| | - Miquel Prats de Puig
- Department of Medicine, University of Barcelona, 08036 Barcelona, Spain
- Breast Committee, Hospital El Pilar, Quirón salud Group, 08006 Barcelona, Spain
| | - Pere Gascón
- Department of Biochemistry and Molecular Biomedicine, University of Barcelona, Institute of Biomedicine, University of Barcelona (IBUB), 08028 Barcelona, Spain
- Oncology and Multidisciplinary Knowledge, 08036 Barcelona, Spain
| | - Francisco Javier Casado
- Department of Biochemistry and Molecular Biomedicine, University of Barcelona, Institute of Biomedicine, University of Barcelona (IBUB), 08028 Barcelona, Spain
| | - Neus Carbó
- Department of Biochemistry and Molecular Biomedicine, University of Barcelona, Institute of Biomedicine, University of Barcelona (IBUB), 08028 Barcelona, Spain
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8
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Feng X, Li J, Li H, Chen H, Li F, Liu Q, You ZH, Zhou F. Age Is Important for the Early-Stage Detection of Breast Cancer on Both Transcriptomic and Methylomic Biomarkers. Front Genet 2019; 10:212. [PMID: 30984234 PMCID: PMC6448048 DOI: 10.3389/fgene.2019.00212] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Accepted: 02/27/2019] [Indexed: 12/27/2022] Open
Abstract
Patients at different ages have different rates of cell development and metabolisms. As a result, age should be an essential part of how a disease diagnosis model is trained and optimized. Unfortunately, most of the existing studies have not taken age into account. This study demonstrated that disease diagnosis models could be improved by merely applying individual models for patients of different age groups. Both transcriptomes and methylomes of the TCGA breast cancer dataset (TCGA-BRCA) were utilized for the analysis procedure of feature selection and classification. Our experimental data strongly suggested that disease diagnosis modeling should integrate patient age into the whole experimental design.
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Affiliation(s)
- Xin Feng
- BioKnow Health Informatics Lab, College of Computer Science and Technology, Jilin University, Changchun, China.,Key Laboratory of Symbolic Computation and Knowledge Engineering of Ministry of Education, Jilin University, Changchun, China
| | - Jialiang Li
- BioKnow Health Informatics Lab, College of Software, Jilin University, Changchun, China.,Key Laboratory of Symbolic Computation and Knowledge Engineering of Ministry of Education, Jilin University, Changchun, China
| | - Han Li
- BioKnow Health Informatics Lab, College of Software, Jilin University, Changchun, China.,Key Laboratory of Symbolic Computation and Knowledge Engineering of Ministry of Education, Jilin University, Changchun, China
| | - Hang Chen
- BioKnow Health Informatics Lab, College of Computer Science and Technology, Jilin University, Changchun, China.,Key Laboratory of Symbolic Computation and Knowledge Engineering of Ministry of Education, Jilin University, Changchun, China
| | - Fei Li
- BioKnow Health Informatics Lab, College of Software, Jilin University, Changchun, China.,Key Laboratory of Symbolic Computation and Knowledge Engineering of Ministry of Education, Jilin University, Changchun, China
| | - Quewang Liu
- BioKnow Health Informatics Lab, College of Computer Science and Technology, Jilin University, Changchun, China.,Key Laboratory of Symbolic Computation and Knowledge Engineering of Ministry of Education, Jilin University, Changchun, China
| | - Zhu-Hong You
- Xinjiang Technical Institute of Physics and Chemistry, Chinese Academy of Sciences, Ürümqi, China
| | - Fengfeng Zhou
- BioKnow Health Informatics Lab, College of Computer Science and Technology, Jilin University, Changchun, China.,Key Laboratory of Symbolic Computation and Knowledge Engineering of Ministry of Education, Jilin University, Changchun, China.,BioKnow Health Informatics Lab, College of Software, Jilin University, Changchun, China.,Key Laboratory of Symbolic Computation and Knowledge Engineering of Ministry of Education, Jilin University, Changchun, China
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9
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Mullooly M, Gierach GL. The Potential for Mammographic Breast Density Change as a Biosensor of Adjuvant Tamoxifen Therapy Adherence and Response. JNCI Cancer Spectr 2018; 2:pky072. [PMID: 30746510 PMCID: PMC6357814 DOI: 10.1093/jncics/pky072] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 11/21/2018] [Indexed: 01/09/2023] Open
Affiliation(s)
| | - Gretchen L Gierach
- Correspondence to: Gretchen L. Gierach, PhD, MPH, Division of Cancer Epidemiology and Genetics and Division of Cancer Prevention, National Cancer Institute, 9609 Medical Center Drive, Rm 7E-102, Bethesda, MD 20892 (e-mail: )
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