Endobronchial ultrasound-guided transbronchial needle aspiration in the diagnosis of lymphoma

BACKGROUND

The diagnostic accuracy of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for the diagnosis of lymphoma in patients with mediastinal lymphadenopathy is not well defined.

METHODS

A retrospective review was performed of all patients with mediastinal lymphadenopathy referred for EBUS-TBNA between August 2005 and December 2006 in whom lymphoma was suspected based on prior history or clinical presentation. Mediastinal biopsy specimens were taken using a linear array ultrasonic bronchoscope (Olympus XBF-UC 160F) and a 22-gauge cytology needle (NA-202C Olympus) with on-site cytopathological support. The EBUS-TBNA result was compared with a reference standard of pathological tissue diagnosis or a composite of > or =6 months of clinical follow-up with radiographic imaging.

RESULTS

Of 236 patients who underwent EBUS-TBNA, 25 were eligible for inclusion. Indications for EBUS-TBNA were suspected mediastinal recurrence of lymphoma (n = 13) and mediastinal lymphadenopathy of unknown cause (n = 12). Adequate lymph node sampling was accomplished in 24/25 patients (96%); there were no complications. EBUS-TBNA identified lymphoma in 10 patients and benign disease in 14 patients. There was one false negative EBUS-TBNA for lymphoma (lymphoma prevalence 11/25 (44%)). Follow-up over a median of 10.5 months (range 1-19) confirmed stable or regressive lymphadenopathy in all 14 patients without a lymphoma diagnosis, consistent with a benign diagnosis. Overall, EBUS-TBNA had a sensitivity of 90.9%, specificity of 100%, positive predictive value of 100% and negative predictive value of 92.9% for the diagnosis of lymphoma.

CONCLUSIONS

EBUS-TBNA is an accurate, safe and useful tool in the investigation of suspected lymphoma with isolated mediastinal adenopathy, and may diminish the need for more invasive procedures such as mediastinoscopy.

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Performance of the ATLAS trigger system in 2015

During 2015 the ATLAS experiment recorded [Formula: see text] of proton-proton collision data at a centre-of-mass energy of [Formula: see text]. The ATLAS trigger system is a crucial component of the experiment, responsible for selecting events of interest at a recording rate of approximately 1 kHz from up to 40 MHz of collisions. This paper presents a short overview of the changes to the trigger and data acquisition systems during the first long shutdown of the LHC and shows the performance of the trigger system and its components based on the 2015 proton-proton collision data.

Dietary inulin affects the expression of intestinal enterocyte iron transporters, receptors and storage protein and alters the microbiota in the pig intestine

Inulin, a linear β fructan, is present in a variety of plants including chicory root and wheat. It exhibits prebiotic properties and has been shown to enhance mineral absorption and increase beneficial bacteria in the colon. The aim of the present study was to assess the effect of dietary inulin on the gene expression of selected intestinal Fe transporters and binding proteins. Anaemic piglets at age 5 weeks were allocated to a standard maize–soya diet (control) or the same diet supplemented with inulin at a level of 4 %. After 6 weeks, the animals were killed and caecum contents and sections of the duodenum and colon were removed. Segments of the genes encoding for the pig divalent metal transporter 1 (DMT1) and duodenal cytochrome-b reductase (Dcytb) were isolated and sequenced. Semi-quantitative RT-PCR analyses were performed to evaluate the expression of DMT1, Dcytb, ferroportin, ferritin, transferrin receptor (TfR) and mucin genes. DMT1, Dcytb, ferroportin, ferritin and TfR mRNA levels in duodenal samples were significantly higher in the inulin group (P ≤ 0·05) compared with the control. In colon, DMT1, TfR and ferritin mRNA levels significantly increased in the inulin group. Additionally, the caecal content microflora was examined using 16S rDNA targeted probes from bacterial DNA. TheLactobacillusandBifidobacteriumpopulations were significantly increased in the inulin group (P ≤ 0·05) compared with the control group. These results indicate that dietary inulin might trigger an up regulation of genes encoding for Fe transporters in the enterocyte. The specific mechanism for this effect remains to be elucidated.

Denis RD, Stabile A, Stamen R, Stamm S, Stanecka E, Stanek RW, Stanescu C, Stanescu-Bellu M, Stanitzki MM, Stapnes S, Starchenko EA, Stark GH, Stark J, Staroba P, Starovoitov P, Stärz S, Staszewski R, Steinberg P, Stelzer B, Stelzer HJ, Stelzer-Chilton O, Stenzel H, Stewart GA, Stillings JA, Stockton MC, Stoebe M, Stoicea G, Stolte P, Stonjek S, Stradling AR, Straessner A, Stramaglia ME, Strandberg J, Strandberg S, Strandlie A, Strauss M, Strizenec P, Ströhmer R, Strom DM, Stroynowski R, Strubig A, Stucci SA, Stugu B, Styles NA, Su D, Su J, Subramaniam R, Suchek S, Sugaya Y, Suk M, Sulin VV, Sultansoy S, Sumida T, Sun S, Sun X, Sundermann JE, Suruliz K, Susinno G, Sutton MR, Suzuki S, Svatos M, Swiatlowski M, Sykora I, Sykora T, Ta D, Taccini C, Tackmann K, Taenzer J, Taffard A, Tafirout R, Taiblum N, Takai H, Takashima R, Takeshita T, Takubo Y, Talby M, Talyshev AA, Tam JYC, Tan KG, Tanaka J, Tanaka R, Tanaka S, Tannenwald BB, Tapia Araya S, Tapprogge S, Tarem S, Tartarelli GF, Tas P, Tasevsky M, Tashiro T, Tassi E, Tavares Delgado A, Tayalati Y, Taylor AC, Taylor GN, Taylor PTE, Taylor W, Teischinger FA, Teixeira-Dias P, Temming KK, Temple D, Ten Kate H, Teng PK, Teoh JJ, Tepel F, Terada S, Terashi K, Terron J, Terzo S, Testa M, Teuscher RJ, Theveneaux-Pelzer T, Thomas JP, Thomas-Wilsker J, Thompson EN, Thompson PD, Thompson AS, Thomsen LA, Thomson E, Thomson M, Tibbetts MJ, Ticse Torres RE, Tikhomirov VO, Tikhonov YA, Timoshenko S, Tipton P, Tisserant S, Todome K, Todorov T, Todorova-Nova S, Tojo J, Tokár S, Tokushuku K, Tolley E, Tomlinson L, Tomoto M, Tompkins L, Toms K, Tong B, Torrence E, Torres H, Torró Pastor E, Toth J, Touchard F, Tovey DR, Trefzger T, Tricoli A, Trigger IM, Trincaz-Duvoid S, Tripiana MF, Trischuk W, Trocmé B, Trofymov A, Troncon C, Trottier-McDonald M, Trovatelli M, Truong L, Trzebinski M, Trzupek A, Tseng JCL, Tsiareshka PV, Tsipolitis G, Tsirintanis N, Tsiskaridze S, Tsiskaridze V, Tskhadadze EG, Tsui KM, Tsukerman II, Tsulaia V, Tsuno S, Tsybychev D, Tudorache A, Tudorache V, Tuna AN, Tupputi SA, Turchikhin S, Turecek D, Turgeman D, Turra R, Turvey AJ, Tuts PM, Tyndel M, Ucchielli G, Ueda I, Ueno R, Ughetto M, Ukegawa F, Unal G, Undrus A, Unel G, Ungaro FC, Unno Y, Unverdorben C, Urban J, Urquijo P, Urrejola P, Usai G, Usanova A, Vacavant L, Vacek V, Vachon B, Valderanis C, Valdes Santurio E, Valencic N, Valentinetti S, Valero A, Valery L, Valkar S, Vallecorsa S, Valls Ferrer JA, Van Den Wollenberg W, Van Der Deijl PC, van der Geer R, van der Graaf H, van Eldik N, van Gemmeren P, Van Nieuwkoop J, van Vulpen I, van Woerden MC, Vanadia M, Vandelli W, Vanguri R, Vaniachine A, Vankov P, Vardanyan G, Vari R, Varnes EW, Varol T, Varouchas D, Vartapetian A, Varvell KE, Vasquez JG, Vazeille F, Vazquez Schroeder T, Veatch J, Veloce LM, Veloso F, Veneziano S, Ventura A, Venturi M, Venturi N, Venturini A, Vercesi V, Verducci M, Verkerke W, Vermeulen JC, Vest A, Vetterli MC, Viazlo O, Vichou I, Vickey T, Vickey Boeriu OE, Viehhauser GHA, Viel S, Vigani L, Vigne R, Villa M, Villaplana Perez M, Vilucchi E, Vincter MG, Vinogradov VB, Vittori C, Vivarelli I, Vlachos S, Vlasak M, Vogel M, Vokac P, Volpi G, Volpi M, von der Schmitt H, von Toerne E, Vorobel V, Vorobev K, Vos M, Voss R, Vossebeld JH, Vranjes N, Vranjes Milosavljevic M, Vrba V, Vreeswijk M, Vuillermet R, Vukotic I, Vykydal Z, Wagner P, Wagner W, Wahlberg H, Wahrmund S, Wakabayashi J, Walder J, Walker R, Walkowiak W, Wallangen V, Wang C, Wang C, Wang F, Wang H, Wang H, Wang J, Wang J, Wang K, Wang R, Wang SM, Wang T, Wang T, Wang X, Wanotayaroj C, Warburton A, Ward CP, Wardrope DR, Washbrook A, Watkins PM, Watson AT, Watson MF, Watts G, Watts S, Waugh BM, Webb S, Weber MS, Weber SW, Webster JS, Weidberg AR, Weinert B, Weingarten J, Weiser C, Weits H, Wells PS, Wenaus T, Wengler T, Wenig S, Wermes N, Werner M, Werner P, Wessels M, Wetter J, Whalen K, Whallon NL, Wharton AM, White A, White MJ, White R, White S, Whiteson D, Wickens FJ, Wiedenmann W, Wielers M, Wienemann P, Wiglesworth C, Wiik-Fuchs LAM, Wildauer A, Wilk F, Wilkens HG, Williams HH, Williams S, Willis C, Willocq S, Wilson JA, Wingerter-Seez I, Winklmeier F, Winston OJ, Winter BT, Wittgen M, Wittkowski J, Wollstadt SJ, Wolter MW, Wolters H, Wosiek BK, Wotschack J, Woudstra MJ, Wozniak KW, Wu M, Wu M, Wu SL, Wu X, Wu Y, Wyatt TR, Wynne BM, Xella S, Xu D, Xu L, Yabsley B, Yacoob S, Yakabe R, Yamaguchi D, Yamaguchi Y, Yamamoto A, Yamamoto S, Yamanaka T, Yamauchi K, Yamazaki Y, Yan Z, Yang H, Yang H, Yang Y, Yang Z, Yao WM, Yap YC, Yasu Y, Yatsenko E, Yau Wong KH, Ye J, Ye S, Yeletskikh I, Yen AL, Yildirim E, Yorita K, Yoshida R, Yoshihara K, Young C, Young CJS, Youssef S, Yu DR, Yu J, Yu JM, Yu J, Yuan L, Yuen SPY, Yusuff I, Zabinski B, Zaidan R, Zaitsev AM, Zakharchuk N, Zalieckas J, Zaman A, Zambito S, Zanello L, Zanzi D, Zeitnitz C, Zeman M, Zemla A, Zeng JC, Zeng Q, Zengel K, Zenin O, Ženiš T, Zerwas D, Zhang D, Zhang F, Zhang G, Zhang H, Zhang J, Zhang L, Zhang R, Zhang R, Zhang X, Zhang Z, Zhao X, Zhao Y, Zhao Z, Zhemchugov A, Zhong J, Zhou B, Zhou C, Zhou L, Zhou L, Zhou M, Zhou N, Zhu CG, Zhu H, Zhu J, Zhu Y, Zhuang X, Zhukov K, Zibell A, Zieminska D, Zimine NI, Zimmermann C, Zimmermann S, Zinonos Z, Zinser M, Ziolkowski M, Živković L, Zobernig G, Zoccoli A, zur Nedden M, Zurzolo G, Zwalinski L. Muon reconstruction performance of the ATLAS detector in proton-proton collision data at [Formula: see text]=13 TeV

This article documents the performance of the ATLAS muon identification and reconstruction using the LHC dataset recorded at [Formula: see text] TeV in 2015. Using a large sample of [Formula: see text] and [Formula: see text] decays from 3.2 fb[Formula: see text] of pp collision data, measurements of the reconstruction efficiency, as well as of the momentum scale and resolution, are presented and compared to Monte Carlo simulations. The reconstruction efficiency is measured to be close to [Formula: see text] over most of the covered phase space ([Formula: see text] and [Formula: see text] GeV). The isolation efficiency varies between 93 and [Formula: see text] depending on the selection applied and on the momentum of the muon. Both efficiencies are well reproduced in simulation. In the central region of the detector, the momentum resolution is measured to be [Formula: see text] ([Formula: see text]) for muons from [Formula: see text] ([Formula: see text]) decays, and the momentum scale is known with an uncertainty of [Formula: see text]. In the region [Formula: see text], the [Formula: see text] resolution for muons from [Formula: see text] decays is [Formula: see text] while the precision of the momentum scale for low-[Formula: see text] muons from [Formula: see text] decays is about [Formula: see text].

A multicentre, double-blind, randomized, placebo-controlled, parallel group study of multiple treatments of botulinum toxin type A (BoNTA) for the prophylaxis of episodic migraine headaches

Our aim was to evaluate the safety and efficacy of botulinum toxin type A (BoNTA; BOTOX) for prophylaxis of episodic migraine. In this double-blind, placebo-controlled study, patients were randomized to 225, 150 or 75 U of BoNTA or placebo after a 30-day placebo run-in for three 90-day treatment cycles. The primary efficacy end-point was the mean reduction from baseline in the frequency of migraine episodes at day 180 in the placebo non-responder stratum. All groups (N = 495) improved, with no significant differences. At day 180, the frequency of migraine episodes was reduced from baseline means of 4.3, 4.7, 4.7 and 4.4 by 1.6, 1.7, 1.5 and 1.4 for BoNTA 225 U, 150 U and 75 U and placebo, respectively. The primary end-point was not met. Treatment-related adverse events were transient and mild to moderate. BoNTA treatment was safe and well tolerated but did not result in significantly greater improvement than placebo in this study. Several factors may have confounded the results.

Influence of cell deformation on leukocyte rolling adhesion in shear flow

Blood cell interaction with vascular endothelium is important in microcirculation, where rolling adhesion of circulating leukocytes along the surface of endothelial cells is a prerequisite for leukocyte emigration under flow conditions. HL-60 cell rolling adhesion to surface-immobilized P-selectin in shear flow was investigated using a side-view flow chamber, which permitted measurements of cell deformation and cell-substrate contact length as well as cell rolling velocity. A two-dimensional model was developed based on the assumption that fluid energy input to a rolling cell was essentially distributed into two parts: cytoplasmic viscous dissipation, and energy needed to break adhesion bonds between the rolling cell and its substrate. The flow fields of extracellular fluid and intracellular cytoplasm were solved using finite element methods with a deformable cell membrane represented by an elastic ring. The adhesion energy loss was calculated based on receptor-ligand kinetics equations. It was found that, as a result of shear-flow-induced cell deformation, cell-substrate contact area under high wall shear stresses (20 dyn/cm2) could be as much as twice of that under low stresses (0.5 dyn/cm2). An increase in contact area may cause more energy dissipation to both adhesion bonds and viscous cytoplasm, whereas the fluid energy input may decrease due to the flattened cell shape. Our model predicts that leukocyte rolling velocity will reach a plateau as shear stress increases, which agrees with both in vivo and in vitro experimental observations.

Topological cell clustering in the ATLAS calorimeters and its performance in LHC Run 1

The reconstruction of the signal from hadrons and jets emerging from the proton-proton collisions at the Large Hadron Collider (LHC) and entering the ATLAS calorimeters is based on a three-dimensional topological clustering of individual calorimeter cell signals. The cluster formation follows cell signal-significance patterns generated by electromagnetic and hadronic showers. In this, the clustering algorithm implicitly performs a topological noise suppression by removing cells with insignificant signals which are not in close proximity to cells with significant signals. The resulting topological cell clusters have shape and location information, which is exploited to apply a local energy calibration and corrections depending on the nature of the cluster. Topological cell clustering is established as a well-performing calorimeter signal definition for jet and missing transverse momentum reconstruction in ATLAS.

Luminosity determination in pp collisions at [Formula: see text] = 8 TeV using the ATLAS detector at the LHC

The luminosity determination for the ATLAS detector at the LHC during pp collisions at [Formula: see text] 8 TeV in 2012 is presented. The evaluation of the luminosity scale is performed using several luminometers, and comparisons between these luminosity detectors are made to assess the accuracy, consistency and long-term stability of the results. A luminosity uncertainty of [Formula: see text] is obtained for the [Formula: see text] of pp collision data delivered to ATLAS at [Formula: see text] 8 TeV in 2012.

Fine-tuning of metallaborane geometries: chemistry of iridaboranes derived from the reaction of

From reaction of [(Cp*Ir)2HxCl(4-x)] (x=1, 0) and LiBH4, arachno-[[Cp*IrH2]B3H7](1) is produced in moderate yield concurrently with [Cp*IrH4]. In contrast, reaction of [(Cp*Ir)2H2Cl2] with LiBH4 results in arachno-[[Cp*IrH]2(mu-H)B2H5] (3) in high yield at room temperature but a mixture of 1 and [[Cp*IrH]2(mu-H)BH4] (2) at 0 degrees C. BH3 x THF converts 1 to arachno-[(Cp*IrHB4H9] (4) and 2 to 3 with 1 as a minor product. Further, reaction of 3 with excess of BH3 x THF results in formation of nido-[[Cp*Ir]2-(mu-H)B4H7] (6) formed by loss of H2 from the intermediate arachno-[[Cp*IrH]2B4H8] (5). Reaction of 1 with [Co2(CO)8] permits the isolation of two metallaboranes, arachno-[[Cp*Ir(CO)]-B3H7] (7) and nido-[1-[Cp*Ir]-2,3-Co2-(CO)4(mu-CO)B3H7] (8). Treatment of 4 with [Co2(CO)8] gives only one single mixed-metal metallaborane nido-[1-[Cp*Ir]-2-Co(CO)3B4H7 (9) in high yield. Finally, pyrolysis of 8 results in loss of hydrogen and formation of pileo-[1-[Cp*Ir]-2,3-Co2(CO)5B3H5] (10) with a BH-capped square-pyramidal structure. With kinetic control rational synthesis of a variety metallaboranes has been achieved by varying the number of chlorides in the monocyclopentadienylmetal halide dimer, reaction temperature, types of monoborane, and metal fragment sources.

Role of the transition metal in metallaborane chemistry. Reactivity of (Cp*ReH2)2B4H4 with BH3.thf, CO, and Co2(CO)8

The reaction of Cp*ReCl4, [Cp*ReCl3]2, or [Cp*ReCl2]2 (Cp* = eta 5-C5Me5) with LiBH4 leads to the formation of 7-skeletal-electron-pair (7-sep) (Cp*ReH2)2(B2H3)2 (1) together with Cp*ReH6. Compound 1 is metastable and eliminates H2 at room temperature to generate 6-sep (Cp*ReH2)2B4H4 (2). The reaction of 2 with BH3.thf produces 7-sep (Cp*Re)2B7H7, a hypoelectronic cluster characterized previously. Heating of 2 with 1 atm of CO leads to 6-sep (Cp*ReCO)(Cp*ReH2)B4H4 (3). Both 2 and 3 have the same bicapped Re2B2 tetrahedral cluster core structure. Monitoring the reaction of 2 with CO at room temperature by NMR reveals the formation of a 7-sep, metastable intermediate, (Cp*ReCO)(Cp*ReH2)(B2H3)2 (4), which converts to 3 on heating. An X-ray structure determination reveals two isomeric forms (4-cis and 4-trans) in the crystallographic asymmetric unit which differ in geometry relative to the disposition of the metal ancillary ligands with respect to the Re-Re bond. The presence of these isomers in solution is corroborated by the solution NMR data and the infrared spectrum. In both isomers, the metallaborane core consists of fused B2Re2 tetrahedra sharing the Re2 fragment. On the basis of similarities in electron count and spectroscopic data, 1 also possesses the same bitetrahedral structure. The reaction of 2 with CO2(CO)8 results in the formal replacement of the four rhenium hydrides with a 4-electron CO2(CO)5 fragment, thereby closing the open face in 2 to produce the 6-sep hypoelectronic cluster (Cp*Re)2CO2(CO)5B4H4 (5). These reaction outcomes are compared and contrasted with those previously observed for 5-sep (Cp*Cr2)2B4H8.

Multifocality and multicentricity in breast cancer and survival outcomes

BACKGROUND

The clinicopathological characteristics and the prognostic significance of multifocal (MF) and multicentric (MC) breast cancers are not well established.

PATIENTS AND METHODS

MF and MC were defined as more than one lesion in the same quadrant or in separate quadrants, respectively. The Kaplan-Meier product limit was used to calculate recurrence-free survival (RFS), breast cancer-specific survival (BCSS), and overall survival (OS). Cox proportional hazards models were fit to determine independent associations of MF/MC disease with survival outcomes.

RESULTS

Of 3924 patients, 942 (24%) had MF (n = 695) or MC (n = 247) disease. MF/MC disease was associated with higher T stages (T2: 26% versus 21.6%; T3: 7.4% versus 2.3%, P < 0.001), grade 3 disease (44% versus 38.2%, P < 0.001), lymphovascular invasion (26.2% versus 19.3%, P < 0.001), and lymph node metastases (43.1% versus 27.3%, P < 0.001). MC, but not MF, breast cancers were associated with a worse 5-year RFS (90% versus 95%, P = 0.02) and BCSS (95% versus 97%, P = 0.01). Multivariate analysis shows that MF or MC did not have an independent impact on RFS, BCSS, or OS.

CONCLUSIONS

MF/MC breast cancers were associated with poor prognostic factors, but were not independent predictors of worse survival outcomes. Our findings support the current TNM staging system of using the diameter of the largest lesion to assign T stage.

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Performance of pile-up mitigation techniques for jets in [Formula: see text] collisions at [Formula: see text] TeV using the ATLAS detector

The large rate of multiple simultaneous proton-proton interactions, or pile-up, generated by the Large Hadron Collider in Run 1 required the development of many new techniques to mitigate the adverse effects of these conditions. This paper describes the methods employed in the ATLAS experiment to correct for the impact of pile-up on jet energy and jet shapes, and for the presence of spurious additional jets, with a primary focus on the large 20.3 [Formula: see text] data sample collected at a centre-of-mass energy of [Formula: see text]. The energy correction techniques that incorporate sophisticated estimates of the average pile-up energy density and tracking information are presented. Jet-to-vertex association techniques are discussed and projections of performance for the future are considered. Lastly, the extension of these techniques to mitigate the effect of pile-up on jet shapes using subtraction and grooming procedures is presented.

COMT rs4680 Met is not always the 'smart allele': Val allele is associated with better working memory and larger hippocampal volume in healthy Chinese

Catechol-O-methyltransferase (COMT) Val158Met (rs4680) polymorphism plays a crucial role in regulating brain dopamine level. Converging evidence from Caucasian samples showed that, compared with rs4680 Val allele, the Met allele was linked to lower COMT activity, which in turn was linked to better cognitive performance such as working memory (WM) and to a larger hippocampus (a brain region important for WM). However, some behavioral studies have shown that the function of rs4680 appears to vary across different ethnic groups, with Chinese subjects showing an opposite pattern as that for Caucasians (i.e. the Val allele is linked to better cognitive functions related to WM in Chinese). Using a sample of healthy Han Chinese college students (ages from 19 to 21 years), this study investigated the association of COMT Val158Met genotype with behavioral data on a two-back WM task (n = 443, 189M/254F) and T1 MRI data (n = 320, 134M/186F). Results showed that, compared to the Met allele, the Val allele was associated with larger hippocampal volume (the right hippocampus: β = -0.118, t = -2.367, P = 0.019, and the left hippocampus: β = -0.099, t = -1.949, P = 0.052) and better WM performance (β = -0.110, t = -2.315, P = 0.021). These results add to the growing literature on differentiated effects of COMT rs4680 polymorphism on WM across populations and offer a brain structural mechanism for such population-specific genetic effects.

Survival of women with inflammatory breast cancer: a large population-based study

BACKGROUND

Our group has previously reported that women with inflammatory breast cancer (IBC) continue to have worse outcome compared with those with non-IBC. We undertook this population-based study to see if there have been improvements in survival among women with stage III IBC, over time.

PATIENT AND METHODS

We searched the Surveillance, Epidemiology and End Results Registry to identify female patients diagnosed with stage III IBC between 1990 and 2010. Patients were divided into four groups according to year of diagnosis: 1990-1995, 1996-2000, 2001-2005, and 2006-2010. Breast cancer-specific survival (BCSS) was estimated using the Kaplan-Meier method and compared across groups using the log-rank test. Cox models were then fit to determine the association of year of diagnosis and BCSS after adjusting for patient and tumor characteristics.

RESULTS

A total of 7679 patients with IBC were identified of whom 1084 patients (14.1%) were diagnosed between 1990 and 1995, 1614 patients (21.0%) between 1996 and 2000, 2683 patients (34.9%) between 2001 and 2005, and 2298 patients (29.9%) between 2006 and 2010. The 2-year BCSS for the whole cohort was 71%. Two-year BCSS were 62%, 67%, 72%, and 76% for patients diagnosed between 1990-1995, 1996-2000, 2001-2005, and 2006-2010, respectively (P < 0.0001). In the multivariable analysis, increasing year of diagnosis (modeled as a continuous variable) was associated with decreasing risks of death from breast cancer (HR = 0.98, 95% confidence interval 0.97-0.99, P < 0.0001).

CONCLUSION

There has been a significant improvement in survival of patients diagnosed with IBC over a two-decade time span in this large population-based study. This suggests that therapeutic strategies researched and evolved in the context of non-IBC have also had a positive impact in women with IBC.