Abstract P5-11-06: BEAUTY and the breast: Is adjuvant chemotherapy the right time for a beauty boost? Results of a randomised controlled trial

This abstract was not presented at the symposium.

Concordance between HER-2 status determined by qPCR in Fine Needle Aspiration Cytology (FNAC) samples compared with IHC and FISH in Core Needle Biopsy (CNB) or surgical specimens in breast cancer patients

Determining the status of HER2-neu amplification and overexpression in breast cancer is crucial for prognosis but mostly for treatment purposes. Standard techniques include the determination of IHC in combination with in situ hybridization techniques to confirm a HER2-neu amplification in case of IHC2+ using either a core-needle biopsy or a surgical specimen. qPCR has been also demonstrated to be able to determine HER2 status, mostly in core biopsies or in surgical specimens. Fine-needle aspiration is a reliable, quicker and less invasive technique that is widely used for diagnosis of invasive breast cancer. In this study, we assessed the performance of qPCR in invasive breast carcinomas to determine HER2-neu status by using fine-needle aspiration samples and comparing to standard IHC and FISH. From a total of 154 samples from patients who had nodular breast lesions and attended the 1-day-stop clinic at the Gustave Roussy from March 2013 to October 2014, qPCR was able to determine the HER2 status in a mean of 3.7 days (SD 3.1). The overall concordance with standard HER2-testing was very high: 97% (95% CI 0.94 to 0.99); sensitivity was 96% (0.87-1), specificity 98% (0.95-1) and positive and negative predictive values 88% (0.75-1) and 99% (0.98-1), respectively. In conclusion, our study demonstrates that qPCR performed using fine-needle aspiration samples from a primary tumour is a reliable and fast method to determine HER2/neu status in patients with early breast cancer.

Abstract P5-13-02: Decision making from multidisciplinary team meetings to bedside: factors predicting for physicians' and breast cancer patients' acceptance of clinical trials proposed by MTMs

Background: In University hospitals or Comprehensive Cancer Centers (CCC), breast cancer (BC) patients have a theoretically large access to clinical trials as part of the management and treatment of their localized or advanced disease. Though, most patients are not proposed inclusion into suitable trials or studies or do not accept them. We aimed at determining the factors that influence physicians and patient's choice to respectively propose or enter clinical trials for which the patients were considered eligible by MTM.

Methods: Patients who were considered eligible for a clinical trial by a BC-specific multidisciplinary team meeting (MTM) assessing their cases were prospectively registered during a 6 months period. The complete files of these patients were prospectively registered following initial written proposal by the MTM. The 27 clinical trials proposed were classified in 5 categories: cognitive studies, imaging, radiation therapy, diagnostic/prognostic biology, or interventional therapeutic studies. Detailed analysis of factors predicting physician's proposal and patient's final inclusion was conducted. Candidate factors were age, socio-demographic characteristics, PS, type of clinician, time intervals, stage of disease, type of disease, type of study, single vs multiple study proposal.

Results: MTM proposed 547 inclusions into clinical trials for 397 patients between March 3rd and Sept 21st, 2011. 267 pts were considered eligible for 1 trial, 100 for 2, 25 for 3, 4 for 4 and 1 for 5 trials; 211 for cognitive studies, 13 for imaging, 71 for radiation therapy, 136 for diagnostic/prognostic biology, 116 for interventional therapeutic studies. Upon referral physician's visit, the trial was only proposed in 39.3% and pts were finally included in 29.1% of the cases. Reasons for non inclusion were patients' refusal in only 5–11%, but absence of proposal by physician in 45–81%, according to the types of studies. The only factor predicting both proposal by the referral physician's and final inclusion into trials was type of study (both p < 0.001). Diagnostic/prognostic biology trials were proposed in 71%, while interventional therapeutic and cognitive studies were only respectively proposed in 35 and 19% of the cases. The factors predicting non-inclusion upon physicians' proposal were professional status (p = 0.03) and type of study (p = 0.0007). The highest inclusion rates were among retired pts and those with executive work (84 and 76% respectively).

Conclusion: The main reason for non inclusion into clinical trials remains absence of physicians' proposal, while professional status and type of study influence both the physicians' and the patients' decision. Educative measures dedicated mostly to treating physicians might be proposed.

Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P5-13-02.