101
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Chow LWC, Biganzoli L, Leo AD, Kuroi K, Han HS, Patel J, Huang CS, Lu YS, Zhu L, Chow CYC, Loo WTY, Glück S, Toi M. Toxicity profile differences of adjuvant docetaxel/cyclophosphamide (TC) between Asian and Caucasian breast cancer patients. Asia Pac J Clin Oncol 2017; 13:372-378. [PMID: 28371190 DOI: 10.1111/ajco.12682] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 01/30/2017] [Indexed: 12/01/2022]
Abstract
AIM For early-stage breast cancer, four cycles of docetaxel and cyclophosphamide (TC) was proven superior to doxorubicin plus cyclophosphamide in the US Oncology 9375 trial. Given primary prophylactic antibiotics, 5% febrile neutropenia was recorded in a population comprising 75.5% Caucasians. Smaller trials and retrospective studies reviewing TC use in Asian patients did not produce similar incidence rates. This study aims to discover the variable hematological toxicities with TC use in Caucasian and Asian patients. METHODS Breast cancer data was retrospectively reviewed for patients receiving adjuvant docetaxel 60-75 mg/m2 plus cyclophosphamide 600 mg/m2 from six countries (China, Hong Kong, Japan, Taiwan, Italy, and United States). Similar number of patients with relatively balanced baseline characteristics were chosen for analysis of hematological and nonhematological toxicities and survival data. RESULTS From March 2004 to July 2013, data of 227 patients (127 Asians and 100 Caucasian) patients were analyzed for treatment-related toxicities. During the four cycles of TC, Asians had a significantly higher rate of grade ≥2 neutropenia than Caucasians (45.7% vs 6.0%; P <0.001) and significantly more grade ≥3 neutropenia events were documented (respectively 30.7% vs 4.0%, P <0.001). The prophylactic use of G-CSF was similar; 26.0% in Asians and 28.0% in Caucasian (P = 0.764). There were no differences in nonhematological toxicities. No significant difference in disease-free survival was observed between Asians and Caucasians (log-rank P = 0.910). CONCLUSIONS Ethnic differences in toxicity profile exist between Asian and Caucasian patients given adjuvant TC. Over 30% Asians but less than 5% Caucasians experienced grade ≥3 neutropenia.
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Affiliation(s)
- L W C Chow
- State Key Laboratory of Quality Research in Chinese Medicine, Macau Institute of Applied Medicine and Health, Macau University of Science and Technology, Macau.,Organisation for Oncology and Translational Research, Hong Kong.,UNIMED Medical Institute, Hong Kong
| | - L Biganzoli
- Sandro Pitigliani Medical Oncology Unit, Hospital of Prato, Italy
| | - A D Leo
- Sandro Pitigliani Medical Oncology Unit, Hospital of Prato, Italy
| | - K Kuroi
- Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - H S Han
- Department of Women's Oncology, H. Lee Moffitt Cancer Center and Research Institute, USA
| | - J Patel
- Department of Women's Oncology, H. Lee Moffitt Cancer Center and Research Institute, USA
| | - C S Huang
- Department of Surgery, National Taiwan University Hospital, Taiwan
| | - Y S Lu
- Department of Oncology, National Taiwan University Hospital, Taiwan
| | - L Zhu
- Department of Surgery, Shanghai Jiao Tong University, Shanghai, China
| | | | - W T Y Loo
- Organisation for Oncology and Translational Research, Hong Kong.,UNIMED Medical Institute, Hong Kong
| | - S Glück
- Sylvester Comprehensive Cancer Center, Leonard M. Miller School of Medicine, University of Miami, USA
| | - M Toi
- Organisation for Oncology and Translational Research, Hong Kong.,Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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102
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Lee CY, Wang HJ, Lai JH, Chang YC, Huang CS. Automatic Marker-free Longitudinal Infrared Image Registration by Shape Context Based Matching and Competitive Winner-guided Optimal Corresponding. Sci Rep 2017; 7:39834. [PMID: 28145474 PMCID: PMC5286440 DOI: 10.1038/srep39834] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 11/25/2016] [Indexed: 12/03/2022] Open
Abstract
Long-term comparisons of infrared image can facilitate the assessment of breast cancer tissue growth and early tumor detection, in which longitudinal infrared image registration is a necessary step. However, it is hard to keep markers attached on a body surface for weeks, and rather difficult to detect anatomic fiducial markers and match them in the infrared image during registration process. The proposed study, automatic longitudinal infrared registration algorithm, develops an automatic vascular intersection detection method and establishes feature descriptors by shape context to achieve robust matching, as well as to obtain control points for the deformation model. In addition, competitive winner-guided mechanism is developed for optimal corresponding. The proposed algorithm is evaluated in two ways. Results show that the algorithm can quickly lead to accurate image registration and that the effectiveness is superior to manual registration with a mean error being 0.91 pixels. These findings demonstrate that the proposed registration algorithm is reasonably accurate and provide a novel method of extracting a greater amount of useful data from infrared images.
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Affiliation(s)
- Chia-Yen Lee
- Department of Electrical Engineering, National United University, Taiwan
| | - Hao-Jen Wang
- Department of Electrical Engineering, National United University, Taiwan.,Institute of Biomedical Engineering, National Taiwan University, Taiwan
| | - Jhih-Hao Lai
- Department of Electrical Engineering, National United University, Taiwan
| | - Yeun-Chung Chang
- Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taiwan
| | - Chiun-Sheng Huang
- Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taiwan
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103
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Lin PH, Kuo WH, Huang AC, Lu YS, Lin CH, Kuo SH, Wang MY, Liu CY, Cheng FTF, Yeh MH, Li HY, Yang YH, Hsu YH, Fan SC, Li LY, Yu SL, Chang KJ, Chen PL, Ni YH, Huang CS. Multiple gene sequencing for risk assessment in patients with early-onset or familial breast cancer. Oncotarget 2016; 7:8310-20. [PMID: 26824983 PMCID: PMC4884994 DOI: 10.18632/oncotarget.7027] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Accepted: 01/01/2016] [Indexed: 12/31/2022] Open
Abstract
Since BRCA mutations are only responsible for 10–20% of cases of breast cancer in patients with early-onset or a family history and since next-generation sequencing technology allows the simultaneous sequencing of a large number of target genes, testing for multiple cancer-predisposing genes is now being considered, but its significance in clinical practice remains unclear. We then developed a sequencing panel containing 68 genes that had cancer risk association for patients with early-onset or familial breast cancer. A total of 133 patients were enrolled and 30 (22.6%) were found to carry germline deleterious mutations, 9 in BRCA1, 11 in BRCA2, 2 in RAD50, 2 in TP53 and one each in ATM, BRIP1, FANCI, MSH2, MUTYH, and RAD51C. Triple-negative breast cancer (TNBC) was associated with the highest mutation rate (45.5%, p = 0.025). Seven of the 9 BRCA1 mutations and the single FANCI mutation were in the TNBC group; 9 of the 11 BRCA2, 1 of the 2 RAD50 as well as BRIP1, MSH2, MUTYH, and RAD51C mutations were in the hormone receptor (HR)(+)Her2(−) group, and the other RAD50, ATM, and TP53 mutations were in the HR(+)Her2(+) group. Mutation carriers were considered as high-risk to develop malignancy and advised to receive cancer screening. Screening protocols of non-BRCA genes were based on their biologic functions; for example, patients carrying RAD51C mutation received a screening protocol similar to that for BRCA, since BRCA and RAD51C are both involved in homologous recombination. In conclusion, we consider that multiple gene sequencing in cancer risk assessment is clinically valuable.
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Affiliation(s)
- Po-Han Lin
- Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan.,Department of Medical Genetics, National Taiwan University Hospital, Taipei, Taiwan
| | - Wen-Hung Kuo
- Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - Ai-Chu Huang
- Department of Medical Genetics, National Taiwan University Hospital, Taipei, Taiwan
| | - Yen-Shen Lu
- Department of Medical Oncology, National Taiwan University Hospital, Taipei, Taiwan
| | - Ching-Hung Lin
- Department of Medical Oncology, National Taiwan University Hospital, Taipei, Taiwan
| | - Sung-Hsin Kuo
- Department of Medical Oncology, National Taiwan University Hospital, Taipei, Taiwan
| | - Ming-Yang Wang
- Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - Chun-Yu Liu
- Division of Medical Oncology, Department of Oncology, Taipei Veterans General Hospital, Taipei, Taiwan
| | | | - Ming-Hsin Yeh
- Department of Surgery, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Huei-Ying Li
- Department of Medical Genetics, National Taiwan University Hospital, Taipei, Taiwan
| | - Yu-Hsuan Yang
- Department of Medical Genetics, National Taiwan University Hospital, Taipei, Taiwan
| | - Yu-Hua Hsu
- Department of Medical Genetics, National Taiwan University Hospital, Taipei, Taiwan
| | - Sheng-Chih Fan
- Department of Medical Genetics, National Taiwan University Hospital, Taipei, Taiwan
| | - Long-Yuan Li
- Graduate Institute of Cancer Biology, China Medical University, Taichung, Taiwan
| | - Sung-Liang Yu
- Center of Genomic Medicine, National Taiwan University, Taipei, Taiwan
| | - King-Jen Chang
- Department of Surgery, Cheng Ching Hospital, Taichung, Taiwan
| | - Pei-Lung Chen
- Department of Medical Genetics, National Taiwan University Hospital, Taipei, Taiwan
| | - Yen-Hsuan Ni
- Department of Medical Genetics, National Taiwan University Hospital, Taipei, Taiwan.,Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
| | - Chiun-Sheng Huang
- Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
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104
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Huang YS, Chen JLY, Huang CS, Kuo SH, Jaw FS, Tseng YH, Ko WC, Chang YC. High mammographic breast density predicts locoregional recurrence after modified radical mastectomy for invasive breast cancer: a case-control study. Breast Cancer Res 2016; 18:120. [PMID: 27906044 PMCID: PMC5134100 DOI: 10.1186/s13058-016-0784-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 11/22/2016] [Indexed: 12/14/2022] Open
Abstract
Background We aimed to evaluate the influence of mammographic breast density at diagnosis on the risk of cancer recurrence and survival outcomes in patients with invasive breast cancer after modified radical mastectomy. Methods This case-control study included 121 case-control pairs of women diagnosed with invasive breast cancer between 2004 and 2009, and who had undergone modified radical mastectomy and had mammographic breast density measured before or at diagnosis. Women with known locoregional recurrence or distant metastasis were matched by pathological disease stage, age, and year of diagnosis to women without recurrence. Locoregional recurrence was defined as recurrence in the ipsilateral chest wall, or axillary, internal mammary, or supraclavicular nodes. The median follow-up duration was 84.0 months for case patients and 92.9 months for control patients. Results Patients with heterogeneously dense (50–75% density) and extremely dense (>75% density) breasts had an increased risk of locoregional recurrence (hazard ratios 3.1 and 5.7, 95% confidence intervals 1.1–9.8 and 1.2–34.9, p = 0.043 and 0.048, respectively) than did women with less dense breasts. Positive margins after surgery also increased the risk of locoregional recurrence (hazard ratio 3.3, 95% confidence interval 1.3–8.3, p = 0.010). Multivariate analysis that included dense breasts (>50% density), positive margin, no adjuvant radiotherapy, and no adjuvant chemotherapy revealed that dense breasts were significant factors for predicting locoregional recurrence risk (hazard ratio 3.6, 95% confidence interval 1.2–11.1, p = 0.025). Conclusions Our results demonstrate that dense breast tissue (>50% density) increased the risk of locoregional recurrence after modified radical mastectomy in patients with invasive breast cancer. Additional prospective studies are necessary to validate these findings. Trial registration The study is retrospectively registered with ClinicalTrials.gov, number NCT02771665, on May 11, 2016.
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Affiliation(s)
- Yu-Sen Huang
- Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei, Taiwan.,Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, No. 7, Chung-Shan S. Rd., Taipei, 100, Taiwan.,Department of Medical Imaging, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin, Taiwan
| | - Jenny Ling-Yu Chen
- Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei, Taiwan.,Department of Oncology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.,Department of Radiation Oncology, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan
| | - Chiun-Sheng Huang
- Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Sung-Hsin Kuo
- Department of Oncology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Fu-Shan Jaw
- Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei, Taiwan
| | - Yao-Hui Tseng
- Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, No. 7, Chung-Shan S. Rd., Taipei, 100, Taiwan
| | - Wei-Chun Ko
- Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, No. 7, Chung-Shan S. Rd., Taipei, 100, Taiwan
| | - Yeun-Chung Chang
- Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, No. 7, Chung-Shan S. Rd., Taipei, 100, Taiwan.
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105
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Lai SF, Chen YH, Kuo WH, Lien HC, Wang MY, Lu YS, Lo C, Kuo SH, Cheng AL, Huang CS. Locoregional Recurrence Risk for Postmastectomy Breast Cancer Patients With T1–2 and One to Three Positive Lymph Nodes Receiving Modern Systemic Treatment Without Radiotherapy. Ann Surg Oncol 2016; 23:3860-3869. [DOI: 10.1245/s10434-016-5435-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
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106
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Chen TWW, Lin CH, Huang CS. Should pertuzumab be used as part of neoadjuvant treatment prior to the release of the APHINITY trial results? Transl Cancer Res 2016. [DOI: 10.21037/tcr.2016.10.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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107
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Abstract
INTRODUCTION An elevated serum urate level is recognised as a cause of gouty arthritis and uric acid stone. The level of serum uric acid that accelerates kidney stone formation, however, has not yet been clarified. This study aimed to find out if a high serum urate level is associated with nephrolithiasis. METHODS Patients were recruited from the rheumatology clinic of Taipei City Hospital (Renai and Zhongxing branches) in Taiwan from March 2015 to February 2016. A total of 120 Chinese male patients with newly diagnosed gout and serum urate concentration of >7 mg/dL and no history of kidney stones were divided into two groups according to their serum urate level: <10 mg/dL (group 1, n=80) and ≥10 mg/dL (group 2, n=40). The mean body mass index, blood urea nitrogen level, creatinine level, urinary pH, and kidney ultrasonography were compared between the two groups. RESULTS There were no significant differences in blood urea nitrogen or creatinine level between the two groups. The urine pH in both groups was similar and not statistically significant. Kidney stone formation was detected via ultrasonography in 6.3% (5/80) and 82.5% (33/40) of patients in groups 1 and 2, respectively (P<0.05). CONCLUSION A serum urate level of ≥10 mg/dL may precipitate nephrolithiasis. Further studies are warranted to substantiate the relationship between serum urate level and kidney stone formation.
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Affiliation(s)
- K S Wan
- Department of Immunology and Rheumatology, Taipei City Hospital-Zhongxing Branch, Taiwan.,Department of Pediatrics, Taipei City Hospital-Renai Branch, Taiwan
| | - C K Liu
- Department of Urology, Taipei City Hospital-Zhongxing Branch, Taiwan.,Fu Jen Catholic University School of Medicine, Taiwan
| | - M C Ko
- Department of Urology, Taipei City Hospital-Zhongxing Branch, Taiwan
| | - W K Lee
- Department of Urology, Taipei City Hospital-Zhongxing Branch, Taiwan
| | - C S Huang
- Department of Pediatrics, Taipei City Hospital-Renai Branch, Taiwan
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108
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Lin CH, Lu TP, Huang RYJ, Lu YS, Lo KY, Kuo KT, Chuang EY, Wu PF, Chen IC, Thiery JP, Huang CS, Cheng AL. Abstract 4490: Comparisons of genetic alterations of breast cancer between East and West: Special emphases on young patients with ER+/HER2- tumors. Cancer Res 2016. [DOI: 10.1158/1538-7445.am2016-4490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
A rapid surge of female breast cancer has been observed in young East Asians. As a first step toward understanding this phenomenon, we compared the genetic alterations between breast cancer form Taiwan (East) and Western countries (West). Under the same array platforms, the differences in gene copy number alterations (n = 120 in East and 1,948 in West) and gene expressions (n = 327 in East and 423 in West) were analyzed as further stratified by age and estrogen receptor (ER)/ HER2 status. Gene-gene interaction networks were explored by analyzing the overlapping gene with ingenuity pathway analysis. The ingenuity pathway analysis revealed the common differences between East and West in NFkB, PI3K, Akt, MAPK, ERK, IFNα, and Jnk networks. Among the patients <50 years with ER+/ HER2- tumors, we identified a uniquely higher frequency of the APOA1/C3/A4/A5 (the lipid metabolizing genes) gene cluster loss (29% vs. 12%, P = .005) and low expressions of these four genes (East/ West ratios ranged from .07 to .39) in East than that in West. We conclude that NFkB, PI3K, Akt, MAPK, ERK, IFNα, and Jnk networks are common differences between East and West, while APOA1/C3/A4/A5 loss and low expressions are unique genetic alterations for young Asian patients with ER+/ HER2- tumors.
Citation Format: Ching-Hung Lin, Tzu-Pin Lu, Ruby Yun-Ju Huang, Yen-Shen Lu, Ko-Yun Lo, Kuan-Ting Kuo, Eric Y. Chuang, Pei-Fang Wu, I-Chun Chen, Jean Paul Thiery, Chiun-Sheng Huang, Ann-Lii Cheng. Comparisons of genetic alterations of breast cancer between East and West: Special emphases on young patients with ER+/HER2- tumors. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 4490.
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Affiliation(s)
| | | | | | - Yen-Shen Lu
- 1National Taiwan Univ. Hospital, Taipei, Taiwan
| | | | | | | | - Pei-Fang Wu
- 1National Taiwan Univ. Hospital, Taipei, Taiwan
| | - I-Chun Chen
- 1National Taiwan Univ. Hospital, Taipei, Taiwan
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109
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Huang CS, Yu AL, Tseng LM, Chow LWC, Hou MF, Hurvitz SA, Schwab RB, Wong CH, Murray JL, Chang HK, Chang HT, Chen SC, Kim SB, Shue YK, Rugo HS. Randomized phase II/III trial of active immunotherapy with OPT-822/OPT-821 in patients with metastatic breast cancer. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.1003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Chiun-Sheng Huang
- Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Alice L Yu
- Institute of Stem Cell and Translational Cancer Research, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | | | | | - Ming-Feng Hou
- Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung, Taiwan
| | | | | | | | - James L. Murray
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | | | | | - Sung-Bae Kim
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | | | - Hope S. Rugo
- University of California, San Francisco, San Francisco, CA
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110
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Hurvitz SA, Martin M, Symmans WF, Jung KH, Huang CS, Thompson AM, Harbeck N, Valero V, Stroyakovskiy D, Wildiers H, Afenjar K, Fresco R, Helms HJ, Xu J, Lin YG, Sparano JA, Slamon DJ. Pathologic complete response (pCR) rates after neoadjuvant trastuzumab emtansine (T-DM1 [K]) + pertuzumab (P) vs docetaxel + carboplatin + trastuzumab + P (TCHP) treatment in patients with HER2-positive (HER2+) early breast cancer (EBC) (KRISTINE). J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.500] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Sara A. Hurvitz
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA
| | - Miguel Martin
- Hospital Gregorio Maranon, Universidad Complutense, Madrid, Spain
| | | | - Kyung Hae Jung
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea South
| | - Chiun-Sheng Huang
- Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | | | - Nadia Harbeck
- Breast Center, University of Munich, Munich, Germany
| | - Vicente Valero
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | | | | | | | | | - Jin Xu
- Genentech, Inc., South San Francisco, CA
| | | | - Joseph A. Sparano
- Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY
| | - Dennis J. Slamon
- David Geffen School of Medicine, University of California Los Angeles, Santa Monica, CA
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111
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Kuo SH, Lin PH, Yang SY, Huang CS. Association of discovered novel SNPs of FGFR2 and MAP3K1 genes from next-generation sequencing with the prognosis of hormone receptor-positive early breast cancer patients. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.e12054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Sung Hsin Kuo
- Department of Oncology, National Taiwan University Hospital and National Taiwan University Cancer Center ; Graduate Institute of Oncology, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Po-Han Lin
- National Taiwan University Hospital, Taipei City, Taiwan
| | - Shi-Yi Yang
- Graduate Institute of Epidemiology, College of Public Health, National Taiwan University, Taipei, Taiwan
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112
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Lo CM, Chan SW, Yang YW, Chang YC, Huang CS, Jou YS, Chang RF. Feasibility Testing: Three-dimensional Tumor Mapping in Different Orientations of Automated Breast Ultrasound. Ultrasound Med Biol 2016; 42:1201-1210. [PMID: 26825468 DOI: 10.1016/j.ultrasmedbio.2015.12.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Revised: 11/20/2015] [Accepted: 12/02/2015] [Indexed: 06/05/2023]
Abstract
A tumor-mapping algorithm was proposed to identify the same regions in different passes of automated breast ultrasound (ABUS). A total of 53 abnormal passes with 41 biopsy-proven tumors and 13 normal passes were collected. After computer-aided tumor detection, a mapping pair was composed of a detected region in one pass and another region in another pass. Location criteria, including the radial position as on a clock, the relative distance and the distance to the nipple, were used to extract mapping pairs with close regions. Quantitative intensity, morphology, texture and location features were then combined in a classifier for further classification. The performance of the classifier achieved a mapping rate of 80.39% (41/51), with an error rate of 5.97% (4/67). The trade-offs between the mapping and error rates were evaluated, and Az = 0.9094 was obtained. The proposed tumor-mapping algorithm was capable of automatically providing location correspondence information that would be helpful in reviews of ABUS examinations.
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Affiliation(s)
- Chung-Ming Lo
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan; Department of Computer Science and Information Engineering, National Taiwan University, Taipei, Taiwan
| | - Si-Wa Chan
- Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan; Department of Radiology, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Ya-Wen Yang
- Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Yeun-Chung Chang
- Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Chiun-Sheng Huang
- Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
| | - Yi-Sheng Jou
- Department of Computer Science and Information Engineering, National Taiwan University, Taipei, Taiwan
| | - Ruey-Feng Chang
- Department of Computer Science and Information Engineering, National Taiwan University, Taipei, Taiwan; Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan.
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113
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Moon WK, Huang YS, Lo CM, Huang CS, Bae MS, Kim WH, Chen JH, Chang RF. Computer-aided diagnosis for distinguishing between triple-negative breast cancer and fibroadenomas based on ultrasound texture features. Med Phys 2016; 42:3024-35. [PMID: 26127055 DOI: 10.1118/1.4921123] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
PURPOSE Triple-negative breast cancer (TNBC), an aggressive subtype, is frequently misclassified as fibroadenoma due to benign morphologic features on breast ultrasound (US). This study aims to develop a computer-aided diagnosis (CAD) system based on texture features for distinguishing between TNBC and benign fibroadenomas in US images. METHODS US images of 169 pathology-proven tumors (mean size, 1.65 cm; range, 0.7-3.0 cm) composed of 84 benign fibroadenomas and 85 TNBC tumors are used in this study. After a tumor is segmented out using the level-set method, morphological, conventional texture, and multiresolution gray-scale invariant texture feature sets are computed using a best-fitting ellipse, gray-level co-occurrence matrices, and the ranklet transform, respectively. The linear support vector machine with leave-one-out cross-validation schema is used as a classifier, and the diagnostic performance is assessed with receiver operating characteristic curve analysis. RESULTS The Az values of the morphology, conventional texture, and multiresolution gray-scale invariant texture feature sets are 0.8470 [95% confidence intervals (CIs), 0.7826-0.8973], 0.8542 (95% CI, 0.7911-0.9030), and 0.9695 (95% CI, 0.9376-0.9865), respectively. The Az of the CAD system based on the combined feature sets is 0.9702 (95% CI, 0.9334-0.9882). CONCLUSIONS The CAD system based on texture features extracted via the ranklet transform may be useful for improving the ability to discriminate between TNBC and benign fibroadenomas.
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Affiliation(s)
- Woo Kyung Moon
- Department of Radiology, Seoul National University Hospital and Seoul National University College of Medicine, Seoul 110-744, South Korea
| | - Yao-Sian Huang
- Department of Computer Science and Information Engineering, National Taiwan University, Taipei 10617, Taiwan, Republic of China
| | - Chung-Ming Lo
- Department of Computer Science and Information Engineering, National Taiwan University, Taipei 10617, Taiwan, Republic of China
| | - Chiun-Sheng Huang
- Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei 10041, Taiwan, Republic of China and Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei 10617, Taiwan, Republic of China
| | - Min Sun Bae
- Department of Radiology, Seoul National University Hospital and Seoul National University College of Medicine, Seoul 110-744, South Korea
| | - Won Hwa Kim
- Department of Radiology, Seoul National University Hospital and Seoul National University College of Medicine, Seoul 110-744, South Korea
| | - Jeon-Hor Chen
- Center for Functional Onco-Imaging and Department of Radiological Science, University of California, Irvine, California 92868 and Department of Radiology, E-Da Hospital and I-Shou University, Kaohsiung 82445, Taiwan, Republic of China
| | - Ruey-Feng Chang
- Department of Computer Science and Information Engineering, National Taiwan University, Taipei 10617, Taiwan, Republic of China and Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei 10617, Taiwan, Republic of China
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114
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Chang RF, Chen HH, Chang YC, Huang CS, Chen JH, Lo CM. Quantification of breast tumor heterogeneity for ER status, HER2 status, and TN molecular subtype evaluation on DCE-MRI. Magn Reson Imaging 2016; 34:809-819. [PMID: 26968141 DOI: 10.1016/j.mri.2016.03.001] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Revised: 02/25/2016] [Accepted: 03/03/2016] [Indexed: 01/07/2023]
Abstract
PURPOSE Recognizing molecular markers is helpful for guiding treatment plans for breast cancer. This study correlated estrogen receptor (ER), human epidermal growth factor receptor 2 (HER2), and triple-negative breast cancer (TNBC) statuses to the degree of heterogeneity on breast dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). MATERIALS AND METHODS A total of 102 biopsy-proven cancers from 102 patients between October 2010 and December 2012 were used in this study, including ER (59 positive, 43 negative), HER2 (47 positive, 55 negative), and TNBC (22 TNBC, 80 non-TNBC). At first, the tumor region was segmented by using a region growing method. Then, the region-based features were extracted by the proposed regionalization method to quantify intra-tumoral heterogeneity on breast DCE-MRI. The three-dimensional morphological features (texture features and shape feature) and the pharmacokinetic model were also extracted from the segmented tumor region. After feature extraction, a logistic regression was used to classify ER, HER2, and TNBC statuses respectively. The performances were evaluated by using receiver operating characteristic (ROC) curve analysis. RESULTS The proposed region-based features achieved the accuracy of 73.53%, 82.35%, and 77.45% for ER, HER2, and TNBC classifications. The corresponding area under the ROC curves (Az) achieves 0.7320, 0.8458, and 0.8328 that were better than those of texture features, shape features, and Tofts pharmacokinetic model. CONCLUSION The intra-tumoral heterogeneity quantified by the region-based features can be used to reflect the vasculature complexity of different molecular markers and to provide prediction information of cell surface receptors on clinical examination.
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Affiliation(s)
- Ruey-Feng Chang
- Department of Computer Science and Information Engineering, National Taiwan University, Taipei, Taiwan; Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan
| | - Hong-Hao Chen
- Department of Computer Science and Information Engineering, National Taiwan University, Taipei, Taiwan
| | - Yeun-Chung Chang
- Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
| | - Chiun-Sheng Huang
- Department of Surgery, National Taiwan University Hospital and Nation Taiwan University College of Medicine, Taipei, Taiwan
| | - Jeon-Hor Chen
- Tu and Yuen Center for Functional Onco-Imaging, Department of Radiological Sciences, University of California, Irvine, CA, United States; Department of Radiology, E-Da Hospital and I-Shou University, Kaohsiung, Taiwan
| | - Chung-Ming Lo
- Department of Computer Science and Information Engineering, National Taiwan University, Taipei, Taiwan; Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan.
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115
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Harbeck N, Huang CS, Hurvitz S, Yeh DC, Shao Z, Im SA, Jung KH, Shen K, Ro J, Jassem J, Zhang Q, Im YH, Wojtukiewicz M, Sun Q, Chen SC, Goeldner RG, Uttenreuther-Fischer M, Xu B, Piccart-Gebhart M. Afatinib plus vinorelbine versus trastuzumab plus vinorelbine in patients with HER2-overexpressing metastatic breast cancer who had progressed on one previous trastuzumab treatment (LUX-Breast 1): an open-label, randomised, phase 3 trial. Lancet Oncol 2016; 17:357-366. [DOI: 10.1016/s1470-2045(15)00540-9] [Citation(s) in RCA: 101] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Revised: 11/17/2015] [Accepted: 11/18/2015] [Indexed: 02/03/2023]
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116
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Chou CH, Huang MJ, Chen CH, Shyu MK, Huang J, Hung JS, Huang CS, Huang MC. Up-regulation of C1GALT1 promotes breast cancer cell growth through MUC1-C signaling pathway. Oncotarget 2016; 6:6123-35. [PMID: 25762620 PMCID: PMC4467426 DOI: 10.18632/oncotarget.3045] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Accepted: 01/06/2015] [Indexed: 11/25/2022] Open
Abstract
Aberrant glycosylation is frequently observed in cancers. Core 1 β1,3-galactosyltransferase (C1GALT1) is an exclusive enzyme in humans that catalyzes the biosynthesis of core 1 O-glycan structure, Gal-GalNAc-O-Ser/Thr, whose expression is commonly up-regulated during tumorigenesis. Little is known about the function of C1GALT1 in breast cancer. This study aims to determine the correlation between C1GALT1 expression and breast cancer clinicopathological features and roles of C1GALT1 in breast cancer malignant phenotypes. Public databases and our data showed that C1GALT1 mRNA and C1GALT1 protein are frequently up-regulated in breast cancer; and increased C1GALT1 expression correlates with higher histological grade and advanced tumor stage. Overexpression of C1GALT1 enhanced breast cancer cell growth, migration, and invasion in vitro as well as tumor growth in vivo. Conversely, C1GALT1 knockdown suppressed these malignant phenotypes. Furthermore, C1GALT1 modulates O-glycan structures on Mucin (MUC) 1 and promotes MUC1-C/β-catenin signaling in breast cancer cells. These findings suggest that C1GALT1 enhances breast cancer malignant progression through promoting MUC1-C/β-catenin signaling pathway. Unveiling the function of C1GALT1 in breast cancer opens new insights to the roles of C1GALT1 and O-glycosylation in tumorigenesis and renders the potential of C1GALT1 as a target of novel therapeutic agent development.
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Affiliation(s)
- Chih-Hsing Chou
- Graduate Institute of Anatomy and Cell Biology, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Miao-Juei Huang
- Graduate Institute of Anatomy and Cell Biology, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Chi-Hau Chen
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan
| | - Ming-Kwang Shyu
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan
| | - John Huang
- Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - Ji-Shiang Hung
- Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - Chiun-Sheng Huang
- Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - Min-Chuan Huang
- Graduate Institute of Anatomy and Cell Biology, National Taiwan University College of Medicine, Taipei, Taiwan.,Research Center for Developmental Biology and Regenerative Medicine, National Taiwan University, Taipei, Taiwan
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117
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Lien HC, Huang CS, Yang YW, Jeng YM. MED12 exon 2 mutation as a highly sensitive and specific marker in distinguishing phyllodes tumours from other spindle neoplasms of the breast. APMIS 2016; 124:356-64. [DOI: 10.1111/apm.12516] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Accepted: 12/17/2015] [Indexed: 01/18/2023]
Affiliation(s)
- Huang-Chun Lien
- Department of Pathology; National Taiwan University Hospital; Taipei Taiwan
- Graduate Institute of Pathology; National Taiwan University; Taipei Taiwan
| | - Chiun-Sheng Huang
- Department of Surgery; National Taiwan University Hospital; Taipei Taiwan
| | - Ya-Wen Yang
- Department of Surgery; National Taiwan University Hospital; Taipei Taiwan
| | - Yung-Ming Jeng
- Department of Pathology; National Taiwan University Hospital; Taipei Taiwan
- Graduate Institute of Pathology; National Taiwan University; Taipei Taiwan
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118
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Zhong T, Ren F, Huang CS, Zou WY, Yang Y, Pan YD, Sun B, Wang E, Guo QL. Swimming exercise ameliorates neurocognitive impairment induced by neonatal exposure to isoflurane and enhances hippocampal histone acetylation in mice. Neuroscience 2015; 316:378-88. [PMID: 26748054 DOI: 10.1016/j.neuroscience.2015.12.049] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Revised: 12/25/2015] [Accepted: 12/28/2015] [Indexed: 12/21/2022]
Abstract
Isoflurane-induced neurocognitive impairment in the developing rodent brain is well documented, and regular physical exercise has been demonstrated to be a viable intervention for some types of neurocognitive impairment. This study was designed to investigate the potential protective effect of swimming exercise on both neurocognitive impairment caused by repeated neonatal exposure to isoflurane and the underlying molecular mechanism. Mice received 0.75% isoflurane exposures for 4h on postnatal days 7, 8, and 9. From the third month after anesthesia, the mice were subjected to regular swimming exercise for 4weeks, followed by a contextual fear condition (CFC) trial. We found that repeated neonatal exposure to isoflurane reduced freezing behavior during CFC testing and deregulated hippocampal histone H4K12 acetylation. Conversely, mice subjected to regular swimming exercise showed enhanced hippocampal H3K9, H4K5, and H4K12 acetylation levels, increased numbers of c-Fos-positive cells 1h after CFC training, and less isoflurane-induced memory impairment. We also observed increases in histone acetylation and of cAMP-response element-binding protein (CREB)-binding protein (CBP) during the swimming exercise program. The results suggest that neonatal isoflurane exposure-induced memory impairment was associated with dysregulation of H4K12 acetylation, which may lead to less hippocampal activation following learning tasks. Swimming exercise was associated with enhanced hippocampal histone acetylation and CBP expression. Exercise most likely ameliorated isoflurane-induced memory impairment by enhancing hippocampal histone acetylation and activating more neuron cells during memory formation.
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Affiliation(s)
- T Zhong
- Department of Anesthesiology, Xiangya Hospital of Central South University, Changsha 410008, Hunan Province, PR China
| | - F Ren
- Department of Anesthesiology, Xiangya Hospital of Central South University, Changsha 410008, Hunan Province, PR China
| | - C S Huang
- Department of Anesthesiology, Xiangya Hospital of Central South University, Changsha 410008, Hunan Province, PR China
| | - W Y Zou
- Department of Anesthesiology, Xiangya Hospital of Central South University, Changsha 410008, Hunan Province, PR China
| | - Y Yang
- Department of Anesthesiology, Xiangya Hospital of Central South University, Changsha 410008, Hunan Province, PR China
| | - Y D Pan
- Department of Anesthesiology, Xiangya Hospital of Central South University, Changsha 410008, Hunan Province, PR China
| | - B Sun
- Department of Anesthesiology, Xiangya Hospital of Central South University, Changsha 410008, Hunan Province, PR China
| | - E Wang
- Department of Anesthesiology, Xiangya Hospital of Central South University, Changsha 410008, Hunan Province, PR China
| | - Q L Guo
- Department of Anesthesiology, Xiangya Hospital of Central South University, Changsha 410008, Hunan Province, PR China.
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Lin CH, Chen IC, Huang CS, Hu FC, Kuo WH, Kuo KT, Wang CC, Wu PF, Chang DY, Wang MY, Chang CH, Chen WW, Lu YS, Cheng AL. TP53 Mutational Analysis Enhances the Prognostic Accuracy of IHC4 and PAM50 Assays. Sci Rep 2015; 5:17879. [PMID: 26671300 PMCID: PMC4680865 DOI: 10.1038/srep17879] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Accepted: 11/06/2015] [Indexed: 02/04/2023] Open
Abstract
IHC4 and PAM50 assays have been shown to provide additional prognostic information for patients with early breast cancer. We evaluated whether incorporating TP53 mutation analysis can further enhance their prognostic accuracy. We examined TP53 mutation and the IHC4 score in tumors of 605 patients diagnosed with stage I-III breast cancer at National Taiwan University Hospital (the NTUH cohort). We obtained information regarding TP53 mutation and PAM50 subtypes in 699 tumors from the Molecular Taxonomy of Breast Cancer International Consortium (METABRIC) cohort. We found that TP53 mutation was significantly associated with high-risk IHC4 group and with luminal B, HER2-enriched, and basal-like subtypes. Despite the strong associations, TP53 mutation independently predicted shorter relapse-free survival (hazard ratio [HR] = 1.63, P = 0.007) in the NTUH cohort and shorter breast cancer-specific survival (HR = 2.35, P = <0.001) in the METABRIC cohort. TP53 mutational analysis added significant prognostic information in addition to the IHC4 score (∆ LR-χ(2) = 8.61, P = 0.002) in the NTUH cohort and the PAM50 subtypes (∆ LR-χ(2) = 18.9, P = <0.001) in the METABRIC cohort. We conclude that incorporating TP53 mutation analysis can enhance the prognostic accuracy of the IHC4 and PAM50 assays.
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Affiliation(s)
- Ching-Hung Lin
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan.,Department of Internal Medicine; National Taiwan University Hospital, Taipei, Taiwan.,Oncology Center, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan
| | - I-Chiun Chen
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
| | - Chiun-Sheng Huang
- Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - Fu-Chang Hu
- Graduate Institute of Clinical Medicine and School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan.,International-Harvard Statistical Consulting Company, Taipei, Taiwan
| | - Wen-Hung Kuo
- Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - Kuan-Ting Kuo
- Department of Pathology, National Taiwan University Hospital, Taipei, Taiwan
| | - Chung-Chieh Wang
- Department of Pathology, National Taiwan University Hospital, Taipei, Taiwan
| | - Pei-Fang Wu
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
| | - Dwan-Ying Chang
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
| | - Ming-Yang Wang
- Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - Chin-Hao Chang
- Department of Medical Research, National Taiwan University Hospital, Taipei, Taiwan
| | - Wei-Wu Chen
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
| | - Yen-Shen Lu
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan.,Department of Internal Medicine; National Taiwan University Hospital, Taipei, Taiwan
| | - Ann-Lii Cheng
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan.,Department of Internal Medicine; National Taiwan University Hospital, Taipei, Taiwan.,Graduate Institute of Oncology and Cancer Research Centre, College of Medicine, National Taiwan University, Taipei, Taiwan
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Piccart-Gebhart M, Holmes E, Baselga J, de Azambuja E, Dueck AC, Viale G, Zujewski JA, Goldhirsch A, Armour A, Pritchard KI, McCullough AE, Dolci S, McFadden E, Holmes AP, Tonghua L, Eidtmann H, Dinh P, Di Cosimo S, Harbeck N, Tjulandin S, Im YH, Huang CS, Diéras V, Hillman DW, Wolff AC, Jackisch C, Lang I, Untch M, Smith I, Boyle F, Xu B, Gomez H, Suter T, Gelber RD, Perez EA. Adjuvant Lapatinib and Trastuzumab for Early Human Epidermal Growth Factor Receptor 2-Positive Breast Cancer: Results From the Randomized Phase III Adjuvant Lapatinib and/or Trastuzumab Treatment Optimization Trial. J Clin Oncol 2015; 34:1034-42. [PMID: 26598744 DOI: 10.1200/jco.2015.62.1797] [Citation(s) in RCA: 268] [Impact Index Per Article: 29.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Lapatinib (L) plus trastuzumab (T) improves outcomes for metastatic human epidermal growth factor 2-positive breast cancer and increases the pathologic complete response in the neoadjuvant setting, but their role as adjuvant therapy remains uncertain. METHODS In the Adjuvant Lapatinib and/or Trastuzumab Treatment Optimization trial, patients with centrally confirmed human epidermal growth factor 2-positive early breast cancer were randomly assigned to 1 year of adjuvant therapy with T, L, their sequence (T→L), or their combination (L+T). The primary end point was disease-free survival (DFS), with 850 events required for 80% power to detect a hazard ratio (HR) of 0.8 for L+T versus T. RESULTS Between June 2007 and July 2011, 8,381 patients were enrolled. In 2011, due to futility to demonstrate noninferiority of L versus T, the L arm was closed, and patients free of disease were offered adjuvant T. A protocol modification required P ≤ .025 for the two remaining pairwise comparisons. At a protocol-specified analysis with a median follow-up of 4.5 years, a 16% reduction in the DFS hazard rate was observed with L+T compared with T (555 DFS events; HR, 0.84; 97.5% CI, 0.70 to 1.02; P = .048), and a 4% reduction was observed with T→L compared with T (HR, 0.96; 97.5% CI, 0.80 to 1.15; P = .61). L-treated patients experienced more diarrhea, cutaneous rash, and hepatic toxicity compared with T-treated patients. The incidence of cardiac toxicity was low in all treatment arms. CONCLUSION Adjuvant treatment that includes L did not significantly improve DFS compared with T alone and added toxicity. One year of adjuvant T remains standard of care.
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Affiliation(s)
- Martine Piccart-Gebhart
- Martine Piccart-Gebhart, Université Libre de Bruxelles, Brussels, Belgium; Eileen Holmes, Eleanor McFadden, and Andrew P. Holmes, Frontier Science (Scotland), Kincraig, Kingussie, United Kingdom; José Baselga, Memorial Sloan Kettering Cancer Center, New York, NY; Evandro de Azambuja, Institut Jules Bordet, Brussels, Belgium; Evandro de Azambuja and Stella Dolci, Breast European Adjuvant Study Team, Brussels, Belgium; Amylou C. Dueck and Anne E. McCullough, Mayo Clinic, Scottsdale, AZ; Giuseppe Viale, University of Milan, Milan, Italy; Giuseppe Viale and Aron Goldhirsch, Istituto Europeo di Oncologia, Milan, Italy; Jo Anne Zujewski, National Cancer Institute, Bethesda, MD; Aron Goldhirsch, Ospedale Regionale di Lugano, Viganello-Lugano, Switzerland; Alison Armour, GlaxoSmithKline, Collegeville, PA; Kathleen I. Pritchard, Sunnybrook Odette Cancer Centre, Toronto, Ontario, Canada; Kathleen I. Pritchard, University of Toronto, Toronto, Ontario, Canada; Liu Tonghua, Peking Union Medical College Hospital, Beijing, People's Republic of China; Liu Tonghua and Binghe Xu, China Academy of Chinese Medical Sciences, Beijing, People's Republic of China; Holger Eidtmann, University Hospital Kiel, Kiel, Germany; Phuong Dinh, Breast International Group, Brussels, Belgium; Serena Di Cosimo, Istituto Nazionale del Tumori, Milan, Italy; Serena Di Cosimo, SOLTI Breast Cancer Research Group, Barcelona, Spain; Nadia Harbeck, Frauenklinik der Universität München, Munich, Germany; Sergei Tjulandin, Blokhin Russian Cancer Research Center of RAMS, Moscow, Russia; Young-Hyuck Im, Korean Cancer Study Group, Seoul, South Korea; Young-Hyuck Im, Samsung Medical Center, Seoul, South Korea; Chiun-Shen Huang, National Taiwan University Hospital, Taipei, Republic of China; Véronique Diéras, Institut Curie, Paris, France; David W. Hillman, Mayo Clinic, Rochester, MN; Antonio C. Wolff, The Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Christian Jackisch, Klinikum Offenba
| | - Eileen Holmes
- Martine Piccart-Gebhart, Université Libre de Bruxelles, Brussels, Belgium; Eileen Holmes, Eleanor McFadden, and Andrew P. Holmes, Frontier Science (Scotland), Kincraig, Kingussie, United Kingdom; José Baselga, Memorial Sloan Kettering Cancer Center, New York, NY; Evandro de Azambuja, Institut Jules Bordet, Brussels, Belgium; Evandro de Azambuja and Stella Dolci, Breast European Adjuvant Study Team, Brussels, Belgium; Amylou C. Dueck and Anne E. McCullough, Mayo Clinic, Scottsdale, AZ; Giuseppe Viale, University of Milan, Milan, Italy; Giuseppe Viale and Aron Goldhirsch, Istituto Europeo di Oncologia, Milan, Italy; Jo Anne Zujewski, National Cancer Institute, Bethesda, MD; Aron Goldhirsch, Ospedale Regionale di Lugano, Viganello-Lugano, Switzerland; Alison Armour, GlaxoSmithKline, Collegeville, PA; Kathleen I. Pritchard, Sunnybrook Odette Cancer Centre, Toronto, Ontario, Canada; Kathleen I. Pritchard, University of Toronto, Toronto, Ontario, Canada; Liu Tonghua, Peking Union Medical College Hospital, Beijing, People's Republic of China; Liu Tonghua and Binghe Xu, China Academy of Chinese Medical Sciences, Beijing, People's Republic of China; Holger Eidtmann, University Hospital Kiel, Kiel, Germany; Phuong Dinh, Breast International Group, Brussels, Belgium; Serena Di Cosimo, Istituto Nazionale del Tumori, Milan, Italy; Serena Di Cosimo, SOLTI Breast Cancer Research Group, Barcelona, Spain; Nadia Harbeck, Frauenklinik der Universität München, Munich, Germany; Sergei Tjulandin, Blokhin Russian Cancer Research Center of RAMS, Moscow, Russia; Young-Hyuck Im, Korean Cancer Study Group, Seoul, South Korea; Young-Hyuck Im, Samsung Medical Center, Seoul, South Korea; Chiun-Shen Huang, National Taiwan University Hospital, Taipei, Republic of China; Véronique Diéras, Institut Curie, Paris, France; David W. Hillman, Mayo Clinic, Rochester, MN; Antonio C. Wolff, The Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Christian Jackisch, Klinikum Offenba
| | - José Baselga
- Martine Piccart-Gebhart, Université Libre de Bruxelles, Brussels, Belgium; Eileen Holmes, Eleanor McFadden, and Andrew P. Holmes, Frontier Science (Scotland), Kincraig, Kingussie, United Kingdom; José Baselga, Memorial Sloan Kettering Cancer Center, New York, NY; Evandro de Azambuja, Institut Jules Bordet, Brussels, Belgium; Evandro de Azambuja and Stella Dolci, Breast European Adjuvant Study Team, Brussels, Belgium; Amylou C. Dueck and Anne E. McCullough, Mayo Clinic, Scottsdale, AZ; Giuseppe Viale, University of Milan, Milan, Italy; Giuseppe Viale and Aron Goldhirsch, Istituto Europeo di Oncologia, Milan, Italy; Jo Anne Zujewski, National Cancer Institute, Bethesda, MD; Aron Goldhirsch, Ospedale Regionale di Lugano, Viganello-Lugano, Switzerland; Alison Armour, GlaxoSmithKline, Collegeville, PA; Kathleen I. Pritchard, Sunnybrook Odette Cancer Centre, Toronto, Ontario, Canada; Kathleen I. Pritchard, University of Toronto, Toronto, Ontario, Canada; Liu Tonghua, Peking Union Medical College Hospital, Beijing, People's Republic of China; Liu Tonghua and Binghe Xu, China Academy of Chinese Medical Sciences, Beijing, People's Republic of China; Holger Eidtmann, University Hospital Kiel, Kiel, Germany; Phuong Dinh, Breast International Group, Brussels, Belgium; Serena Di Cosimo, Istituto Nazionale del Tumori, Milan, Italy; Serena Di Cosimo, SOLTI Breast Cancer Research Group, Barcelona, Spain; Nadia Harbeck, Frauenklinik der Universität München, Munich, Germany; Sergei Tjulandin, Blokhin Russian Cancer Research Center of RAMS, Moscow, Russia; Young-Hyuck Im, Korean Cancer Study Group, Seoul, South Korea; Young-Hyuck Im, Samsung Medical Center, Seoul, South Korea; Chiun-Shen Huang, National Taiwan University Hospital, Taipei, Republic of China; Véronique Diéras, Institut Curie, Paris, France; David W. Hillman, Mayo Clinic, Rochester, MN; Antonio C. Wolff, The Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Christian Jackisch, Klinikum Offenba
| | - Evandro de Azambuja
- Martine Piccart-Gebhart, Université Libre de Bruxelles, Brussels, Belgium; Eileen Holmes, Eleanor McFadden, and Andrew P. Holmes, Frontier Science (Scotland), Kincraig, Kingussie, United Kingdom; José Baselga, Memorial Sloan Kettering Cancer Center, New York, NY; Evandro de Azambuja, Institut Jules Bordet, Brussels, Belgium; Evandro de Azambuja and Stella Dolci, Breast European Adjuvant Study Team, Brussels, Belgium; Amylou C. Dueck and Anne E. McCullough, Mayo Clinic, Scottsdale, AZ; Giuseppe Viale, University of Milan, Milan, Italy; Giuseppe Viale and Aron Goldhirsch, Istituto Europeo di Oncologia, Milan, Italy; Jo Anne Zujewski, National Cancer Institute, Bethesda, MD; Aron Goldhirsch, Ospedale Regionale di Lugano, Viganello-Lugano, Switzerland; Alison Armour, GlaxoSmithKline, Collegeville, PA; Kathleen I. Pritchard, Sunnybrook Odette Cancer Centre, Toronto, Ontario, Canada; Kathleen I. Pritchard, University of Toronto, Toronto, Ontario, Canada; Liu Tonghua, Peking Union Medical College Hospital, Beijing, People's Republic of China; Liu Tonghua and Binghe Xu, China Academy of Chinese Medical Sciences, Beijing, People's Republic of China; Holger Eidtmann, University Hospital Kiel, Kiel, Germany; Phuong Dinh, Breast International Group, Brussels, Belgium; Serena Di Cosimo, Istituto Nazionale del Tumori, Milan, Italy; Serena Di Cosimo, SOLTI Breast Cancer Research Group, Barcelona, Spain; Nadia Harbeck, Frauenklinik der Universität München, Munich, Germany; Sergei Tjulandin, Blokhin Russian Cancer Research Center of RAMS, Moscow, Russia; Young-Hyuck Im, Korean Cancer Study Group, Seoul, South Korea; Young-Hyuck Im, Samsung Medical Center, Seoul, South Korea; Chiun-Shen Huang, National Taiwan University Hospital, Taipei, Republic of China; Véronique Diéras, Institut Curie, Paris, France; David W. Hillman, Mayo Clinic, Rochester, MN; Antonio C. Wolff, The Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Christian Jackisch, Klinikum Offenba
| | - Amylou C Dueck
- Martine Piccart-Gebhart, Université Libre de Bruxelles, Brussels, Belgium; Eileen Holmes, Eleanor McFadden, and Andrew P. Holmes, Frontier Science (Scotland), Kincraig, Kingussie, United Kingdom; José Baselga, Memorial Sloan Kettering Cancer Center, New York, NY; Evandro de Azambuja, Institut Jules Bordet, Brussels, Belgium; Evandro de Azambuja and Stella Dolci, Breast European Adjuvant Study Team, Brussels, Belgium; Amylou C. Dueck and Anne E. McCullough, Mayo Clinic, Scottsdale, AZ; Giuseppe Viale, University of Milan, Milan, Italy; Giuseppe Viale and Aron Goldhirsch, Istituto Europeo di Oncologia, Milan, Italy; Jo Anne Zujewski, National Cancer Institute, Bethesda, MD; Aron Goldhirsch, Ospedale Regionale di Lugano, Viganello-Lugano, Switzerland; Alison Armour, GlaxoSmithKline, Collegeville, PA; Kathleen I. Pritchard, Sunnybrook Odette Cancer Centre, Toronto, Ontario, Canada; Kathleen I. Pritchard, University of Toronto, Toronto, Ontario, Canada; Liu Tonghua, Peking Union Medical College Hospital, Beijing, People's Republic of China; Liu Tonghua and Binghe Xu, China Academy of Chinese Medical Sciences, Beijing, People's Republic of China; Holger Eidtmann, University Hospital Kiel, Kiel, Germany; Phuong Dinh, Breast International Group, Brussels, Belgium; Serena Di Cosimo, Istituto Nazionale del Tumori, Milan, Italy; Serena Di Cosimo, SOLTI Breast Cancer Research Group, Barcelona, Spain; Nadia Harbeck, Frauenklinik der Universität München, Munich, Germany; Sergei Tjulandin, Blokhin Russian Cancer Research Center of RAMS, Moscow, Russia; Young-Hyuck Im, Korean Cancer Study Group, Seoul, South Korea; Young-Hyuck Im, Samsung Medical Center, Seoul, South Korea; Chiun-Shen Huang, National Taiwan University Hospital, Taipei, Republic of China; Véronique Diéras, Institut Curie, Paris, France; David W. Hillman, Mayo Clinic, Rochester, MN; Antonio C. Wolff, The Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Christian Jackisch, Klinikum Offenba
| | - Giuseppe Viale
- Martine Piccart-Gebhart, Université Libre de Bruxelles, Brussels, Belgium; Eileen Holmes, Eleanor McFadden, and Andrew P. Holmes, Frontier Science (Scotland), Kincraig, Kingussie, United Kingdom; José Baselga, Memorial Sloan Kettering Cancer Center, New York, NY; Evandro de Azambuja, Institut Jules Bordet, Brussels, Belgium; Evandro de Azambuja and Stella Dolci, Breast European Adjuvant Study Team, Brussels, Belgium; Amylou C. Dueck and Anne E. McCullough, Mayo Clinic, Scottsdale, AZ; Giuseppe Viale, University of Milan, Milan, Italy; Giuseppe Viale and Aron Goldhirsch, Istituto Europeo di Oncologia, Milan, Italy; Jo Anne Zujewski, National Cancer Institute, Bethesda, MD; Aron Goldhirsch, Ospedale Regionale di Lugano, Viganello-Lugano, Switzerland; Alison Armour, GlaxoSmithKline, Collegeville, PA; Kathleen I. Pritchard, Sunnybrook Odette Cancer Centre, Toronto, Ontario, Canada; Kathleen I. Pritchard, University of Toronto, Toronto, Ontario, Canada; Liu Tonghua, Peking Union Medical College Hospital, Beijing, People's Republic of China; Liu Tonghua and Binghe Xu, China Academy of Chinese Medical Sciences, Beijing, People's Republic of China; Holger Eidtmann, University Hospital Kiel, Kiel, Germany; Phuong Dinh, Breast International Group, Brussels, Belgium; Serena Di Cosimo, Istituto Nazionale del Tumori, Milan, Italy; Serena Di Cosimo, SOLTI Breast Cancer Research Group, Barcelona, Spain; Nadia Harbeck, Frauenklinik der Universität München, Munich, Germany; Sergei Tjulandin, Blokhin Russian Cancer Research Center of RAMS, Moscow, Russia; Young-Hyuck Im, Korean Cancer Study Group, Seoul, South Korea; Young-Hyuck Im, Samsung Medical Center, Seoul, South Korea; Chiun-Shen Huang, National Taiwan University Hospital, Taipei, Republic of China; Véronique Diéras, Institut Curie, Paris, France; David W. Hillman, Mayo Clinic, Rochester, MN; Antonio C. Wolff, The Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Christian Jackisch, Klinikum Offenba
| | - Jo Anne Zujewski
- Martine Piccart-Gebhart, Université Libre de Bruxelles, Brussels, Belgium; Eileen Holmes, Eleanor McFadden, and Andrew P. Holmes, Frontier Science (Scotland), Kincraig, Kingussie, United Kingdom; José Baselga, Memorial Sloan Kettering Cancer Center, New York, NY; Evandro de Azambuja, Institut Jules Bordet, Brussels, Belgium; Evandro de Azambuja and Stella Dolci, Breast European Adjuvant Study Team, Brussels, Belgium; Amylou C. Dueck and Anne E. McCullough, Mayo Clinic, Scottsdale, AZ; Giuseppe Viale, University of Milan, Milan, Italy; Giuseppe Viale and Aron Goldhirsch, Istituto Europeo di Oncologia, Milan, Italy; Jo Anne Zujewski, National Cancer Institute, Bethesda, MD; Aron Goldhirsch, Ospedale Regionale di Lugano, Viganello-Lugano, Switzerland; Alison Armour, GlaxoSmithKline, Collegeville, PA; Kathleen I. Pritchard, Sunnybrook Odette Cancer Centre, Toronto, Ontario, Canada; Kathleen I. Pritchard, University of Toronto, Toronto, Ontario, Canada; Liu Tonghua, Peking Union Medical College Hospital, Beijing, People's Republic of China; Liu Tonghua and Binghe Xu, China Academy of Chinese Medical Sciences, Beijing, People's Republic of China; Holger Eidtmann, University Hospital Kiel, Kiel, Germany; Phuong Dinh, Breast International Group, Brussels, Belgium; Serena Di Cosimo, Istituto Nazionale del Tumori, Milan, Italy; Serena Di Cosimo, SOLTI Breast Cancer Research Group, Barcelona, Spain; Nadia Harbeck, Frauenklinik der Universität München, Munich, Germany; Sergei Tjulandin, Blokhin Russian Cancer Research Center of RAMS, Moscow, Russia; Young-Hyuck Im, Korean Cancer Study Group, Seoul, South Korea; Young-Hyuck Im, Samsung Medical Center, Seoul, South Korea; Chiun-Shen Huang, National Taiwan University Hospital, Taipei, Republic of China; Véronique Diéras, Institut Curie, Paris, France; David W. Hillman, Mayo Clinic, Rochester, MN; Antonio C. Wolff, The Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Christian Jackisch, Klinikum Offenba
| | - Aron Goldhirsch
- Martine Piccart-Gebhart, Université Libre de Bruxelles, Brussels, Belgium; Eileen Holmes, Eleanor McFadden, and Andrew P. Holmes, Frontier Science (Scotland), Kincraig, Kingussie, United Kingdom; José Baselga, Memorial Sloan Kettering Cancer Center, New York, NY; Evandro de Azambuja, Institut Jules Bordet, Brussels, Belgium; Evandro de Azambuja and Stella Dolci, Breast European Adjuvant Study Team, Brussels, Belgium; Amylou C. Dueck and Anne E. McCullough, Mayo Clinic, Scottsdale, AZ; Giuseppe Viale, University of Milan, Milan, Italy; Giuseppe Viale and Aron Goldhirsch, Istituto Europeo di Oncologia, Milan, Italy; Jo Anne Zujewski, National Cancer Institute, Bethesda, MD; Aron Goldhirsch, Ospedale Regionale di Lugano, Viganello-Lugano, Switzerland; Alison Armour, GlaxoSmithKline, Collegeville, PA; Kathleen I. Pritchard, Sunnybrook Odette Cancer Centre, Toronto, Ontario, Canada; Kathleen I. Pritchard, University of Toronto, Toronto, Ontario, Canada; Liu Tonghua, Peking Union Medical College Hospital, Beijing, People's Republic of China; Liu Tonghua and Binghe Xu, China Academy of Chinese Medical Sciences, Beijing, People's Republic of China; Holger Eidtmann, University Hospital Kiel, Kiel, Germany; Phuong Dinh, Breast International Group, Brussels, Belgium; Serena Di Cosimo, Istituto Nazionale del Tumori, Milan, Italy; Serena Di Cosimo, SOLTI Breast Cancer Research Group, Barcelona, Spain; Nadia Harbeck, Frauenklinik der Universität München, Munich, Germany; Sergei Tjulandin, Blokhin Russian Cancer Research Center of RAMS, Moscow, Russia; Young-Hyuck Im, Korean Cancer Study Group, Seoul, South Korea; Young-Hyuck Im, Samsung Medical Center, Seoul, South Korea; Chiun-Shen Huang, National Taiwan University Hospital, Taipei, Republic of China; Véronique Diéras, Institut Curie, Paris, France; David W. Hillman, Mayo Clinic, Rochester, MN; Antonio C. Wolff, The Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Christian Jackisch, Klinikum Offenba
| | - Alison Armour
- Martine Piccart-Gebhart, Université Libre de Bruxelles, Brussels, Belgium; Eileen Holmes, Eleanor McFadden, and Andrew P. Holmes, Frontier Science (Scotland), Kincraig, Kingussie, United Kingdom; José Baselga, Memorial Sloan Kettering Cancer Center, New York, NY; Evandro de Azambuja, Institut Jules Bordet, Brussels, Belgium; Evandro de Azambuja and Stella Dolci, Breast European Adjuvant Study Team, Brussels, Belgium; Amylou C. Dueck and Anne E. McCullough, Mayo Clinic, Scottsdale, AZ; Giuseppe Viale, University of Milan, Milan, Italy; Giuseppe Viale and Aron Goldhirsch, Istituto Europeo di Oncologia, Milan, Italy; Jo Anne Zujewski, National Cancer Institute, Bethesda, MD; Aron Goldhirsch, Ospedale Regionale di Lugano, Viganello-Lugano, Switzerland; Alison Armour, GlaxoSmithKline, Collegeville, PA; Kathleen I. Pritchard, Sunnybrook Odette Cancer Centre, Toronto, Ontario, Canada; Kathleen I. Pritchard, University of Toronto, Toronto, Ontario, Canada; Liu Tonghua, Peking Union Medical College Hospital, Beijing, People's Republic of China; Liu Tonghua and Binghe Xu, China Academy of Chinese Medical Sciences, Beijing, People's Republic of China; Holger Eidtmann, University Hospital Kiel, Kiel, Germany; Phuong Dinh, Breast International Group, Brussels, Belgium; Serena Di Cosimo, Istituto Nazionale del Tumori, Milan, Italy; Serena Di Cosimo, SOLTI Breast Cancer Research Group, Barcelona, Spain; Nadia Harbeck, Frauenklinik der Universität München, Munich, Germany; Sergei Tjulandin, Blokhin Russian Cancer Research Center of RAMS, Moscow, Russia; Young-Hyuck Im, Korean Cancer Study Group, Seoul, South Korea; Young-Hyuck Im, Samsung Medical Center, Seoul, South Korea; Chiun-Shen Huang, National Taiwan University Hospital, Taipei, Republic of China; Véronique Diéras, Institut Curie, Paris, France; David W. Hillman, Mayo Clinic, Rochester, MN; Antonio C. Wolff, The Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Christian Jackisch, Klinikum Offenba
| | - Kathleen I Pritchard
- Martine Piccart-Gebhart, Université Libre de Bruxelles, Brussels, Belgium; Eileen Holmes, Eleanor McFadden, and Andrew P. Holmes, Frontier Science (Scotland), Kincraig, Kingussie, United Kingdom; José Baselga, Memorial Sloan Kettering Cancer Center, New York, NY; Evandro de Azambuja, Institut Jules Bordet, Brussels, Belgium; Evandro de Azambuja and Stella Dolci, Breast European Adjuvant Study Team, Brussels, Belgium; Amylou C. Dueck and Anne E. McCullough, Mayo Clinic, Scottsdale, AZ; Giuseppe Viale, University of Milan, Milan, Italy; Giuseppe Viale and Aron Goldhirsch, Istituto Europeo di Oncologia, Milan, Italy; Jo Anne Zujewski, National Cancer Institute, Bethesda, MD; Aron Goldhirsch, Ospedale Regionale di Lugano, Viganello-Lugano, Switzerland; Alison Armour, GlaxoSmithKline, Collegeville, PA; Kathleen I. Pritchard, Sunnybrook Odette Cancer Centre, Toronto, Ontario, Canada; Kathleen I. Pritchard, University of Toronto, Toronto, Ontario, Canada; Liu Tonghua, Peking Union Medical College Hospital, Beijing, People's Republic of China; Liu Tonghua and Binghe Xu, China Academy of Chinese Medical Sciences, Beijing, People's Republic of China; Holger Eidtmann, University Hospital Kiel, Kiel, Germany; Phuong Dinh, Breast International Group, Brussels, Belgium; Serena Di Cosimo, Istituto Nazionale del Tumori, Milan, Italy; Serena Di Cosimo, SOLTI Breast Cancer Research Group, Barcelona, Spain; Nadia Harbeck, Frauenklinik der Universität München, Munich, Germany; Sergei Tjulandin, Blokhin Russian Cancer Research Center of RAMS, Moscow, Russia; Young-Hyuck Im, Korean Cancer Study Group, Seoul, South Korea; Young-Hyuck Im, Samsung Medical Center, Seoul, South Korea; Chiun-Shen Huang, National Taiwan University Hospital, Taipei, Republic of China; Véronique Diéras, Institut Curie, Paris, France; David W. Hillman, Mayo Clinic, Rochester, MN; Antonio C. Wolff, The Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Christian Jackisch, Klinikum Offenba
| | - Ann E McCullough
- Martine Piccart-Gebhart, Université Libre de Bruxelles, Brussels, Belgium; Eileen Holmes, Eleanor McFadden, and Andrew P. Holmes, Frontier Science (Scotland), Kincraig, Kingussie, United Kingdom; José Baselga, Memorial Sloan Kettering Cancer Center, New York, NY; Evandro de Azambuja, Institut Jules Bordet, Brussels, Belgium; Evandro de Azambuja and Stella Dolci, Breast European Adjuvant Study Team, Brussels, Belgium; Amylou C. Dueck and Anne E. McCullough, Mayo Clinic, Scottsdale, AZ; Giuseppe Viale, University of Milan, Milan, Italy; Giuseppe Viale and Aron Goldhirsch, Istituto Europeo di Oncologia, Milan, Italy; Jo Anne Zujewski, National Cancer Institute, Bethesda, MD; Aron Goldhirsch, Ospedale Regionale di Lugano, Viganello-Lugano, Switzerland; Alison Armour, GlaxoSmithKline, Collegeville, PA; Kathleen I. Pritchard, Sunnybrook Odette Cancer Centre, Toronto, Ontario, Canada; Kathleen I. Pritchard, University of Toronto, Toronto, Ontario, Canada; Liu Tonghua, Peking Union Medical College Hospital, Beijing, People's Republic of China; Liu Tonghua and Binghe Xu, China Academy of Chinese Medical Sciences, Beijing, People's Republic of China; Holger Eidtmann, University Hospital Kiel, Kiel, Germany; Phuong Dinh, Breast International Group, Brussels, Belgium; Serena Di Cosimo, Istituto Nazionale del Tumori, Milan, Italy; Serena Di Cosimo, SOLTI Breast Cancer Research Group, Barcelona, Spain; Nadia Harbeck, Frauenklinik der Universität München, Munich, Germany; Sergei Tjulandin, Blokhin Russian Cancer Research Center of RAMS, Moscow, Russia; Young-Hyuck Im, Korean Cancer Study Group, Seoul, South Korea; Young-Hyuck Im, Samsung Medical Center, Seoul, South Korea; Chiun-Shen Huang, National Taiwan University Hospital, Taipei, Republic of China; Véronique Diéras, Institut Curie, Paris, France; David W. Hillman, Mayo Clinic, Rochester, MN; Antonio C. Wolff, The Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Christian Jackisch, Klinikum Offenba
| | - Stella Dolci
- Martine Piccart-Gebhart, Université Libre de Bruxelles, Brussels, Belgium; Eileen Holmes, Eleanor McFadden, and Andrew P. Holmes, Frontier Science (Scotland), Kincraig, Kingussie, United Kingdom; José Baselga, Memorial Sloan Kettering Cancer Center, New York, NY; Evandro de Azambuja, Institut Jules Bordet, Brussels, Belgium; Evandro de Azambuja and Stella Dolci, Breast European Adjuvant Study Team, Brussels, Belgium; Amylou C. Dueck and Anne E. McCullough, Mayo Clinic, Scottsdale, AZ; Giuseppe Viale, University of Milan, Milan, Italy; Giuseppe Viale and Aron Goldhirsch, Istituto Europeo di Oncologia, Milan, Italy; Jo Anne Zujewski, National Cancer Institute, Bethesda, MD; Aron Goldhirsch, Ospedale Regionale di Lugano, Viganello-Lugano, Switzerland; Alison Armour, GlaxoSmithKline, Collegeville, PA; Kathleen I. Pritchard, Sunnybrook Odette Cancer Centre, Toronto, Ontario, Canada; Kathleen I. Pritchard, University of Toronto, Toronto, Ontario, Canada; Liu Tonghua, Peking Union Medical College Hospital, Beijing, People's Republic of China; Liu Tonghua and Binghe Xu, China Academy of Chinese Medical Sciences, Beijing, People's Republic of China; Holger Eidtmann, University Hospital Kiel, Kiel, Germany; Phuong Dinh, Breast International Group, Brussels, Belgium; Serena Di Cosimo, Istituto Nazionale del Tumori, Milan, Italy; Serena Di Cosimo, SOLTI Breast Cancer Research Group, Barcelona, Spain; Nadia Harbeck, Frauenklinik der Universität München, Munich, Germany; Sergei Tjulandin, Blokhin Russian Cancer Research Center of RAMS, Moscow, Russia; Young-Hyuck Im, Korean Cancer Study Group, Seoul, South Korea; Young-Hyuck Im, Samsung Medical Center, Seoul, South Korea; Chiun-Shen Huang, National Taiwan University Hospital, Taipei, Republic of China; Véronique Diéras, Institut Curie, Paris, France; David W. Hillman, Mayo Clinic, Rochester, MN; Antonio C. Wolff, The Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Christian Jackisch, Klinikum Offenba
| | - Eleanor McFadden
- Martine Piccart-Gebhart, Université Libre de Bruxelles, Brussels, Belgium; Eileen Holmes, Eleanor McFadden, and Andrew P. Holmes, Frontier Science (Scotland), Kincraig, Kingussie, United Kingdom; José Baselga, Memorial Sloan Kettering Cancer Center, New York, NY; Evandro de Azambuja, Institut Jules Bordet, Brussels, Belgium; Evandro de Azambuja and Stella Dolci, Breast European Adjuvant Study Team, Brussels, Belgium; Amylou C. Dueck and Anne E. McCullough, Mayo Clinic, Scottsdale, AZ; Giuseppe Viale, University of Milan, Milan, Italy; Giuseppe Viale and Aron Goldhirsch, Istituto Europeo di Oncologia, Milan, Italy; Jo Anne Zujewski, National Cancer Institute, Bethesda, MD; Aron Goldhirsch, Ospedale Regionale di Lugano, Viganello-Lugano, Switzerland; Alison Armour, GlaxoSmithKline, Collegeville, PA; Kathleen I. Pritchard, Sunnybrook Odette Cancer Centre, Toronto, Ontario, Canada; Kathleen I. Pritchard, University of Toronto, Toronto, Ontario, Canada; Liu Tonghua, Peking Union Medical College Hospital, Beijing, People's Republic of China; Liu Tonghua and Binghe Xu, China Academy of Chinese Medical Sciences, Beijing, People's Republic of China; Holger Eidtmann, University Hospital Kiel, Kiel, Germany; Phuong Dinh, Breast International Group, Brussels, Belgium; Serena Di Cosimo, Istituto Nazionale del Tumori, Milan, Italy; Serena Di Cosimo, SOLTI Breast Cancer Research Group, Barcelona, Spain; Nadia Harbeck, Frauenklinik der Universität München, Munich, Germany; Sergei Tjulandin, Blokhin Russian Cancer Research Center of RAMS, Moscow, Russia; Young-Hyuck Im, Korean Cancer Study Group, Seoul, South Korea; Young-Hyuck Im, Samsung Medical Center, Seoul, South Korea; Chiun-Shen Huang, National Taiwan University Hospital, Taipei, Republic of China; Véronique Diéras, Institut Curie, Paris, France; David W. Hillman, Mayo Clinic, Rochester, MN; Antonio C. Wolff, The Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Christian Jackisch, Klinikum Offenba
| | - Andrew P Holmes
- Martine Piccart-Gebhart, Université Libre de Bruxelles, Brussels, Belgium; Eileen Holmes, Eleanor McFadden, and Andrew P. Holmes, Frontier Science (Scotland), Kincraig, Kingussie, United Kingdom; José Baselga, Memorial Sloan Kettering Cancer Center, New York, NY; Evandro de Azambuja, Institut Jules Bordet, Brussels, Belgium; Evandro de Azambuja and Stella Dolci, Breast European Adjuvant Study Team, Brussels, Belgium; Amylou C. Dueck and Anne E. McCullough, Mayo Clinic, Scottsdale, AZ; Giuseppe Viale, University of Milan, Milan, Italy; Giuseppe Viale and Aron Goldhirsch, Istituto Europeo di Oncologia, Milan, Italy; Jo Anne Zujewski, National Cancer Institute, Bethesda, MD; Aron Goldhirsch, Ospedale Regionale di Lugano, Viganello-Lugano, Switzerland; Alison Armour, GlaxoSmithKline, Collegeville, PA; Kathleen I. Pritchard, Sunnybrook Odette Cancer Centre, Toronto, Ontario, Canada; Kathleen I. Pritchard, University of Toronto, Toronto, Ontario, Canada; Liu Tonghua, Peking Union Medical College Hospital, Beijing, People's Republic of China; Liu Tonghua and Binghe Xu, China Academy of Chinese Medical Sciences, Beijing, People's Republic of China; Holger Eidtmann, University Hospital Kiel, Kiel, Germany; Phuong Dinh, Breast International Group, Brussels, Belgium; Serena Di Cosimo, Istituto Nazionale del Tumori, Milan, Italy; Serena Di Cosimo, SOLTI Breast Cancer Research Group, Barcelona, Spain; Nadia Harbeck, Frauenklinik der Universität München, Munich, Germany; Sergei Tjulandin, Blokhin Russian Cancer Research Center of RAMS, Moscow, Russia; Young-Hyuck Im, Korean Cancer Study Group, Seoul, South Korea; Young-Hyuck Im, Samsung Medical Center, Seoul, South Korea; Chiun-Shen Huang, National Taiwan University Hospital, Taipei, Republic of China; Véronique Diéras, Institut Curie, Paris, France; David W. Hillman, Mayo Clinic, Rochester, MN; Antonio C. Wolff, The Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Christian Jackisch, Klinikum Offenba
| | - Liu Tonghua
- Martine Piccart-Gebhart, Université Libre de Bruxelles, Brussels, Belgium; Eileen Holmes, Eleanor McFadden, and Andrew P. Holmes, Frontier Science (Scotland), Kincraig, Kingussie, United Kingdom; José Baselga, Memorial Sloan Kettering Cancer Center, New York, NY; Evandro de Azambuja, Institut Jules Bordet, Brussels, Belgium; Evandro de Azambuja and Stella Dolci, Breast European Adjuvant Study Team, Brussels, Belgium; Amylou C. Dueck and Anne E. McCullough, Mayo Clinic, Scottsdale, AZ; Giuseppe Viale, University of Milan, Milan, Italy; Giuseppe Viale and Aron Goldhirsch, Istituto Europeo di Oncologia, Milan, Italy; Jo Anne Zujewski, National Cancer Institute, Bethesda, MD; Aron Goldhirsch, Ospedale Regionale di Lugano, Viganello-Lugano, Switzerland; Alison Armour, GlaxoSmithKline, Collegeville, PA; Kathleen I. Pritchard, Sunnybrook Odette Cancer Centre, Toronto, Ontario, Canada; Kathleen I. Pritchard, University of Toronto, Toronto, Ontario, Canada; Liu Tonghua, Peking Union Medical College Hospital, Beijing, People's Republic of China; Liu Tonghua and Binghe Xu, China Academy of Chinese Medical Sciences, Beijing, People's Republic of China; Holger Eidtmann, University Hospital Kiel, Kiel, Germany; Phuong Dinh, Breast International Group, Brussels, Belgium; Serena Di Cosimo, Istituto Nazionale del Tumori, Milan, Italy; Serena Di Cosimo, SOLTI Breast Cancer Research Group, Barcelona, Spain; Nadia Harbeck, Frauenklinik der Universität München, Munich, Germany; Sergei Tjulandin, Blokhin Russian Cancer Research Center of RAMS, Moscow, Russia; Young-Hyuck Im, Korean Cancer Study Group, Seoul, South Korea; Young-Hyuck Im, Samsung Medical Center, Seoul, South Korea; Chiun-Shen Huang, National Taiwan University Hospital, Taipei, Republic of China; Véronique Diéras, Institut Curie, Paris, France; David W. Hillman, Mayo Clinic, Rochester, MN; Antonio C. Wolff, The Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Christian Jackisch, Klinikum Offenba
| | - Holger Eidtmann
- Martine Piccart-Gebhart, Université Libre de Bruxelles, Brussels, Belgium; Eileen Holmes, Eleanor McFadden, and Andrew P. Holmes, Frontier Science (Scotland), Kincraig, Kingussie, United Kingdom; José Baselga, Memorial Sloan Kettering Cancer Center, New York, NY; Evandro de Azambuja, Institut Jules Bordet, Brussels, Belgium; Evandro de Azambuja and Stella Dolci, Breast European Adjuvant Study Team, Brussels, Belgium; Amylou C. Dueck and Anne E. McCullough, Mayo Clinic, Scottsdale, AZ; Giuseppe Viale, University of Milan, Milan, Italy; Giuseppe Viale and Aron Goldhirsch, Istituto Europeo di Oncologia, Milan, Italy; Jo Anne Zujewski, National Cancer Institute, Bethesda, MD; Aron Goldhirsch, Ospedale Regionale di Lugano, Viganello-Lugano, Switzerland; Alison Armour, GlaxoSmithKline, Collegeville, PA; Kathleen I. Pritchard, Sunnybrook Odette Cancer Centre, Toronto, Ontario, Canada; Kathleen I. Pritchard, University of Toronto, Toronto, Ontario, Canada; Liu Tonghua, Peking Union Medical College Hospital, Beijing, People's Republic of China; Liu Tonghua and Binghe Xu, China Academy of Chinese Medical Sciences, Beijing, People's Republic of China; Holger Eidtmann, University Hospital Kiel, Kiel, Germany; Phuong Dinh, Breast International Group, Brussels, Belgium; Serena Di Cosimo, Istituto Nazionale del Tumori, Milan, Italy; Serena Di Cosimo, SOLTI Breast Cancer Research Group, Barcelona, Spain; Nadia Harbeck, Frauenklinik der Universität München, Munich, Germany; Sergei Tjulandin, Blokhin Russian Cancer Research Center of RAMS, Moscow, Russia; Young-Hyuck Im, Korean Cancer Study Group, Seoul, South Korea; Young-Hyuck Im, Samsung Medical Center, Seoul, South Korea; Chiun-Shen Huang, National Taiwan University Hospital, Taipei, Republic of China; Véronique Diéras, Institut Curie, Paris, France; David W. Hillman, Mayo Clinic, Rochester, MN; Antonio C. Wolff, The Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Christian Jackisch, Klinikum Offenba
| | - Phuong Dinh
- Martine Piccart-Gebhart, Université Libre de Bruxelles, Brussels, Belgium; Eileen Holmes, Eleanor McFadden, and Andrew P. Holmes, Frontier Science (Scotland), Kincraig, Kingussie, United Kingdom; José Baselga, Memorial Sloan Kettering Cancer Center, New York, NY; Evandro de Azambuja, Institut Jules Bordet, Brussels, Belgium; Evandro de Azambuja and Stella Dolci, Breast European Adjuvant Study Team, Brussels, Belgium; Amylou C. Dueck and Anne E. McCullough, Mayo Clinic, Scottsdale, AZ; Giuseppe Viale, University of Milan, Milan, Italy; Giuseppe Viale and Aron Goldhirsch, Istituto Europeo di Oncologia, Milan, Italy; Jo Anne Zujewski, National Cancer Institute, Bethesda, MD; Aron Goldhirsch, Ospedale Regionale di Lugano, Viganello-Lugano, Switzerland; Alison Armour, GlaxoSmithKline, Collegeville, PA; Kathleen I. Pritchard, Sunnybrook Odette Cancer Centre, Toronto, Ontario, Canada; Kathleen I. Pritchard, University of Toronto, Toronto, Ontario, Canada; Liu Tonghua, Peking Union Medical College Hospital, Beijing, People's Republic of China; Liu Tonghua and Binghe Xu, China Academy of Chinese Medical Sciences, Beijing, People's Republic of China; Holger Eidtmann, University Hospital Kiel, Kiel, Germany; Phuong Dinh, Breast International Group, Brussels, Belgium; Serena Di Cosimo, Istituto Nazionale del Tumori, Milan, Italy; Serena Di Cosimo, SOLTI Breast Cancer Research Group, Barcelona, Spain; Nadia Harbeck, Frauenklinik der Universität München, Munich, Germany; Sergei Tjulandin, Blokhin Russian Cancer Research Center of RAMS, Moscow, Russia; Young-Hyuck Im, Korean Cancer Study Group, Seoul, South Korea; Young-Hyuck Im, Samsung Medical Center, Seoul, South Korea; Chiun-Shen Huang, National Taiwan University Hospital, Taipei, Republic of China; Véronique Diéras, Institut Curie, Paris, France; David W. Hillman, Mayo Clinic, Rochester, MN; Antonio C. Wolff, The Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Christian Jackisch, Klinikum Offenba
| | - Serena Di Cosimo
- Martine Piccart-Gebhart, Université Libre de Bruxelles, Brussels, Belgium; Eileen Holmes, Eleanor McFadden, and Andrew P. Holmes, Frontier Science (Scotland), Kincraig, Kingussie, United Kingdom; José Baselga, Memorial Sloan Kettering Cancer Center, New York, NY; Evandro de Azambuja, Institut Jules Bordet, Brussels, Belgium; Evandro de Azambuja and Stella Dolci, Breast European Adjuvant Study Team, Brussels, Belgium; Amylou C. Dueck and Anne E. McCullough, Mayo Clinic, Scottsdale, AZ; Giuseppe Viale, University of Milan, Milan, Italy; Giuseppe Viale and Aron Goldhirsch, Istituto Europeo di Oncologia, Milan, Italy; Jo Anne Zujewski, National Cancer Institute, Bethesda, MD; Aron Goldhirsch, Ospedale Regionale di Lugano, Viganello-Lugano, Switzerland; Alison Armour, GlaxoSmithKline, Collegeville, PA; Kathleen I. Pritchard, Sunnybrook Odette Cancer Centre, Toronto, Ontario, Canada; Kathleen I. Pritchard, University of Toronto, Toronto, Ontario, Canada; Liu Tonghua, Peking Union Medical College Hospital, Beijing, People's Republic of China; Liu Tonghua and Binghe Xu, China Academy of Chinese Medical Sciences, Beijing, People's Republic of China; Holger Eidtmann, University Hospital Kiel, Kiel, Germany; Phuong Dinh, Breast International Group, Brussels, Belgium; Serena Di Cosimo, Istituto Nazionale del Tumori, Milan, Italy; Serena Di Cosimo, SOLTI Breast Cancer Research Group, Barcelona, Spain; Nadia Harbeck, Frauenklinik der Universität München, Munich, Germany; Sergei Tjulandin, Blokhin Russian Cancer Research Center of RAMS, Moscow, Russia; Young-Hyuck Im, Korean Cancer Study Group, Seoul, South Korea; Young-Hyuck Im, Samsung Medical Center, Seoul, South Korea; Chiun-Shen Huang, National Taiwan University Hospital, Taipei, Republic of China; Véronique Diéras, Institut Curie, Paris, France; David W. Hillman, Mayo Clinic, Rochester, MN; Antonio C. Wolff, The Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Christian Jackisch, Klinikum Offenba
| | - Nadia Harbeck
- Martine Piccart-Gebhart, Université Libre de Bruxelles, Brussels, Belgium; Eileen Holmes, Eleanor McFadden, and Andrew P. Holmes, Frontier Science (Scotland), Kincraig, Kingussie, United Kingdom; José Baselga, Memorial Sloan Kettering Cancer Center, New York, NY; Evandro de Azambuja, Institut Jules Bordet, Brussels, Belgium; Evandro de Azambuja and Stella Dolci, Breast European Adjuvant Study Team, Brussels, Belgium; Amylou C. Dueck and Anne E. McCullough, Mayo Clinic, Scottsdale, AZ; Giuseppe Viale, University of Milan, Milan, Italy; Giuseppe Viale and Aron Goldhirsch, Istituto Europeo di Oncologia, Milan, Italy; Jo Anne Zujewski, National Cancer Institute, Bethesda, MD; Aron Goldhirsch, Ospedale Regionale di Lugano, Viganello-Lugano, Switzerland; Alison Armour, GlaxoSmithKline, Collegeville, PA; Kathleen I. Pritchard, Sunnybrook Odette Cancer Centre, Toronto, Ontario, Canada; Kathleen I. Pritchard, University of Toronto, Toronto, Ontario, Canada; Liu Tonghua, Peking Union Medical College Hospital, Beijing, People's Republic of China; Liu Tonghua and Binghe Xu, China Academy of Chinese Medical Sciences, Beijing, People's Republic of China; Holger Eidtmann, University Hospital Kiel, Kiel, Germany; Phuong Dinh, Breast International Group, Brussels, Belgium; Serena Di Cosimo, Istituto Nazionale del Tumori, Milan, Italy; Serena Di Cosimo, SOLTI Breast Cancer Research Group, Barcelona, Spain; Nadia Harbeck, Frauenklinik der Universität München, Munich, Germany; Sergei Tjulandin, Blokhin Russian Cancer Research Center of RAMS, Moscow, Russia; Young-Hyuck Im, Korean Cancer Study Group, Seoul, South Korea; Young-Hyuck Im, Samsung Medical Center, Seoul, South Korea; Chiun-Shen Huang, National Taiwan University Hospital, Taipei, Republic of China; Véronique Diéras, Institut Curie, Paris, France; David W. Hillman, Mayo Clinic, Rochester, MN; Antonio C. Wolff, The Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Christian Jackisch, Klinikum Offenba
| | - Sergei Tjulandin
- Martine Piccart-Gebhart, Université Libre de Bruxelles, Brussels, Belgium; Eileen Holmes, Eleanor McFadden, and Andrew P. Holmes, Frontier Science (Scotland), Kincraig, Kingussie, United Kingdom; José Baselga, Memorial Sloan Kettering Cancer Center, New York, NY; Evandro de Azambuja, Institut Jules Bordet, Brussels, Belgium; Evandro de Azambuja and Stella Dolci, Breast European Adjuvant Study Team, Brussels, Belgium; Amylou C. Dueck and Anne E. McCullough, Mayo Clinic, Scottsdale, AZ; Giuseppe Viale, University of Milan, Milan, Italy; Giuseppe Viale and Aron Goldhirsch, Istituto Europeo di Oncologia, Milan, Italy; Jo Anne Zujewski, National Cancer Institute, Bethesda, MD; Aron Goldhirsch, Ospedale Regionale di Lugano, Viganello-Lugano, Switzerland; Alison Armour, GlaxoSmithKline, Collegeville, PA; Kathleen I. Pritchard, Sunnybrook Odette Cancer Centre, Toronto, Ontario, Canada; Kathleen I. Pritchard, University of Toronto, Toronto, Ontario, Canada; Liu Tonghua, Peking Union Medical College Hospital, Beijing, People's Republic of China; Liu Tonghua and Binghe Xu, China Academy of Chinese Medical Sciences, Beijing, People's Republic of China; Holger Eidtmann, University Hospital Kiel, Kiel, Germany; Phuong Dinh, Breast International Group, Brussels, Belgium; Serena Di Cosimo, Istituto Nazionale del Tumori, Milan, Italy; Serena Di Cosimo, SOLTI Breast Cancer Research Group, Barcelona, Spain; Nadia Harbeck, Frauenklinik der Universität München, Munich, Germany; Sergei Tjulandin, Blokhin Russian Cancer Research Center of RAMS, Moscow, Russia; Young-Hyuck Im, Korean Cancer Study Group, Seoul, South Korea; Young-Hyuck Im, Samsung Medical Center, Seoul, South Korea; Chiun-Shen Huang, National Taiwan University Hospital, Taipei, Republic of China; Véronique Diéras, Institut Curie, Paris, France; David W. Hillman, Mayo Clinic, Rochester, MN; Antonio C. Wolff, The Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Christian Jackisch, Klinikum Offenba
| | - Young-Hyuck Im
- Martine Piccart-Gebhart, Université Libre de Bruxelles, Brussels, Belgium; Eileen Holmes, Eleanor McFadden, and Andrew P. Holmes, Frontier Science (Scotland), Kincraig, Kingussie, United Kingdom; José Baselga, Memorial Sloan Kettering Cancer Center, New York, NY; Evandro de Azambuja, Institut Jules Bordet, Brussels, Belgium; Evandro de Azambuja and Stella Dolci, Breast European Adjuvant Study Team, Brussels, Belgium; Amylou C. Dueck and Anne E. McCullough, Mayo Clinic, Scottsdale, AZ; Giuseppe Viale, University of Milan, Milan, Italy; Giuseppe Viale and Aron Goldhirsch, Istituto Europeo di Oncologia, Milan, Italy; Jo Anne Zujewski, National Cancer Institute, Bethesda, MD; Aron Goldhirsch, Ospedale Regionale di Lugano, Viganello-Lugano, Switzerland; Alison Armour, GlaxoSmithKline, Collegeville, PA; Kathleen I. Pritchard, Sunnybrook Odette Cancer Centre, Toronto, Ontario, Canada; Kathleen I. Pritchard, University of Toronto, Toronto, Ontario, Canada; Liu Tonghua, Peking Union Medical College Hospital, Beijing, People's Republic of China; Liu Tonghua and Binghe Xu, China Academy of Chinese Medical Sciences, Beijing, People's Republic of China; Holger Eidtmann, University Hospital Kiel, Kiel, Germany; Phuong Dinh, Breast International Group, Brussels, Belgium; Serena Di Cosimo, Istituto Nazionale del Tumori, Milan, Italy; Serena Di Cosimo, SOLTI Breast Cancer Research Group, Barcelona, Spain; Nadia Harbeck, Frauenklinik der Universität München, Munich, Germany; Sergei Tjulandin, Blokhin Russian Cancer Research Center of RAMS, Moscow, Russia; Young-Hyuck Im, Korean Cancer Study Group, Seoul, South Korea; Young-Hyuck Im, Samsung Medical Center, Seoul, South Korea; Chiun-Shen Huang, National Taiwan University Hospital, Taipei, Republic of China; Véronique Diéras, Institut Curie, Paris, France; David W. Hillman, Mayo Clinic, Rochester, MN; Antonio C. Wolff, The Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Christian Jackisch, Klinikum Offenba
| | - Chiun-Sheng Huang
- Martine Piccart-Gebhart, Université Libre de Bruxelles, Brussels, Belgium; Eileen Holmes, Eleanor McFadden, and Andrew P. Holmes, Frontier Science (Scotland), Kincraig, Kingussie, United Kingdom; José Baselga, Memorial Sloan Kettering Cancer Center, New York, NY; Evandro de Azambuja, Institut Jules Bordet, Brussels, Belgium; Evandro de Azambuja and Stella Dolci, Breast European Adjuvant Study Team, Brussels, Belgium; Amylou C. Dueck and Anne E. McCullough, Mayo Clinic, Scottsdale, AZ; Giuseppe Viale, University of Milan, Milan, Italy; Giuseppe Viale and Aron Goldhirsch, Istituto Europeo di Oncologia, Milan, Italy; Jo Anne Zujewski, National Cancer Institute, Bethesda, MD; Aron Goldhirsch, Ospedale Regionale di Lugano, Viganello-Lugano, Switzerland; Alison Armour, GlaxoSmithKline, Collegeville, PA; Kathleen I. Pritchard, Sunnybrook Odette Cancer Centre, Toronto, Ontario, Canada; Kathleen I. Pritchard, University of Toronto, Toronto, Ontario, Canada; Liu Tonghua, Peking Union Medical College Hospital, Beijing, People's Republic of China; Liu Tonghua and Binghe Xu, China Academy of Chinese Medical Sciences, Beijing, People's Republic of China; Holger Eidtmann, University Hospital Kiel, Kiel, Germany; Phuong Dinh, Breast International Group, Brussels, Belgium; Serena Di Cosimo, Istituto Nazionale del Tumori, Milan, Italy; Serena Di Cosimo, SOLTI Breast Cancer Research Group, Barcelona, Spain; Nadia Harbeck, Frauenklinik der Universität München, Munich, Germany; Sergei Tjulandin, Blokhin Russian Cancer Research Center of RAMS, Moscow, Russia; Young-Hyuck Im, Korean Cancer Study Group, Seoul, South Korea; Young-Hyuck Im, Samsung Medical Center, Seoul, South Korea; Chiun-Shen Huang, National Taiwan University Hospital, Taipei, Republic of China; Véronique Diéras, Institut Curie, Paris, France; David W. Hillman, Mayo Clinic, Rochester, MN; Antonio C. Wolff, The Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Christian Jackisch, Klinikum Offenba
| | - Véronique Diéras
- Martine Piccart-Gebhart, Université Libre de Bruxelles, Brussels, Belgium; Eileen Holmes, Eleanor McFadden, and Andrew P. Holmes, Frontier Science (Scotland), Kincraig, Kingussie, United Kingdom; José Baselga, Memorial Sloan Kettering Cancer Center, New York, NY; Evandro de Azambuja, Institut Jules Bordet, Brussels, Belgium; Evandro de Azambuja and Stella Dolci, Breast European Adjuvant Study Team, Brussels, Belgium; Amylou C. Dueck and Anne E. McCullough, Mayo Clinic, Scottsdale, AZ; Giuseppe Viale, University of Milan, Milan, Italy; Giuseppe Viale and Aron Goldhirsch, Istituto Europeo di Oncologia, Milan, Italy; Jo Anne Zujewski, National Cancer Institute, Bethesda, MD; Aron Goldhirsch, Ospedale Regionale di Lugano, Viganello-Lugano, Switzerland; Alison Armour, GlaxoSmithKline, Collegeville, PA; Kathleen I. Pritchard, Sunnybrook Odette Cancer Centre, Toronto, Ontario, Canada; Kathleen I. Pritchard, University of Toronto, Toronto, Ontario, Canada; Liu Tonghua, Peking Union Medical College Hospital, Beijing, People's Republic of China; Liu Tonghua and Binghe Xu, China Academy of Chinese Medical Sciences, Beijing, People's Republic of China; Holger Eidtmann, University Hospital Kiel, Kiel, Germany; Phuong Dinh, Breast International Group, Brussels, Belgium; Serena Di Cosimo, Istituto Nazionale del Tumori, Milan, Italy; Serena Di Cosimo, SOLTI Breast Cancer Research Group, Barcelona, Spain; Nadia Harbeck, Frauenklinik der Universität München, Munich, Germany; Sergei Tjulandin, Blokhin Russian Cancer Research Center of RAMS, Moscow, Russia; Young-Hyuck Im, Korean Cancer Study Group, Seoul, South Korea; Young-Hyuck Im, Samsung Medical Center, Seoul, South Korea; Chiun-Shen Huang, National Taiwan University Hospital, Taipei, Republic of China; Véronique Diéras, Institut Curie, Paris, France; David W. Hillman, Mayo Clinic, Rochester, MN; Antonio C. Wolff, The Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Christian Jackisch, Klinikum Offenba
| | - David W Hillman
- Martine Piccart-Gebhart, Université Libre de Bruxelles, Brussels, Belgium; Eileen Holmes, Eleanor McFadden, and Andrew P. Holmes, Frontier Science (Scotland), Kincraig, Kingussie, United Kingdom; José Baselga, Memorial Sloan Kettering Cancer Center, New York, NY; Evandro de Azambuja, Institut Jules Bordet, Brussels, Belgium; Evandro de Azambuja and Stella Dolci, Breast European Adjuvant Study Team, Brussels, Belgium; Amylou C. Dueck and Anne E. McCullough, Mayo Clinic, Scottsdale, AZ; Giuseppe Viale, University of Milan, Milan, Italy; Giuseppe Viale and Aron Goldhirsch, Istituto Europeo di Oncologia, Milan, Italy; Jo Anne Zujewski, National Cancer Institute, Bethesda, MD; Aron Goldhirsch, Ospedale Regionale di Lugano, Viganello-Lugano, Switzerland; Alison Armour, GlaxoSmithKline, Collegeville, PA; Kathleen I. Pritchard, Sunnybrook Odette Cancer Centre, Toronto, Ontario, Canada; Kathleen I. Pritchard, University of Toronto, Toronto, Ontario, Canada; Liu Tonghua, Peking Union Medical College Hospital, Beijing, People's Republic of China; Liu Tonghua and Binghe Xu, China Academy of Chinese Medical Sciences, Beijing, People's Republic of China; Holger Eidtmann, University Hospital Kiel, Kiel, Germany; Phuong Dinh, Breast International Group, Brussels, Belgium; Serena Di Cosimo, Istituto Nazionale del Tumori, Milan, Italy; Serena Di Cosimo, SOLTI Breast Cancer Research Group, Barcelona, Spain; Nadia Harbeck, Frauenklinik der Universität München, Munich, Germany; Sergei Tjulandin, Blokhin Russian Cancer Research Center of RAMS, Moscow, Russia; Young-Hyuck Im, Korean Cancer Study Group, Seoul, South Korea; Young-Hyuck Im, Samsung Medical Center, Seoul, South Korea; Chiun-Shen Huang, National Taiwan University Hospital, Taipei, Republic of China; Véronique Diéras, Institut Curie, Paris, France; David W. Hillman, Mayo Clinic, Rochester, MN; Antonio C. Wolff, The Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Christian Jackisch, Klinikum Offenba
| | - Antonio C Wolff
- Martine Piccart-Gebhart, Université Libre de Bruxelles, Brussels, Belgium; Eileen Holmes, Eleanor McFadden, and Andrew P. Holmes, Frontier Science (Scotland), Kincraig, Kingussie, United Kingdom; José Baselga, Memorial Sloan Kettering Cancer Center, New York, NY; Evandro de Azambuja, Institut Jules Bordet, Brussels, Belgium; Evandro de Azambuja and Stella Dolci, Breast European Adjuvant Study Team, Brussels, Belgium; Amylou C. Dueck and Anne E. McCullough, Mayo Clinic, Scottsdale, AZ; Giuseppe Viale, University of Milan, Milan, Italy; Giuseppe Viale and Aron Goldhirsch, Istituto Europeo di Oncologia, Milan, Italy; Jo Anne Zujewski, National Cancer Institute, Bethesda, MD; Aron Goldhirsch, Ospedale Regionale di Lugano, Viganello-Lugano, Switzerland; Alison Armour, GlaxoSmithKline, Collegeville, PA; Kathleen I. Pritchard, Sunnybrook Odette Cancer Centre, Toronto, Ontario, Canada; Kathleen I. Pritchard, University of Toronto, Toronto, Ontario, Canada; Liu Tonghua, Peking Union Medical College Hospital, Beijing, People's Republic of China; Liu Tonghua and Binghe Xu, China Academy of Chinese Medical Sciences, Beijing, People's Republic of China; Holger Eidtmann, University Hospital Kiel, Kiel, Germany; Phuong Dinh, Breast International Group, Brussels, Belgium; Serena Di Cosimo, Istituto Nazionale del Tumori, Milan, Italy; Serena Di Cosimo, SOLTI Breast Cancer Research Group, Barcelona, Spain; Nadia Harbeck, Frauenklinik der Universität München, Munich, Germany; Sergei Tjulandin, Blokhin Russian Cancer Research Center of RAMS, Moscow, Russia; Young-Hyuck Im, Korean Cancer Study Group, Seoul, South Korea; Young-Hyuck Im, Samsung Medical Center, Seoul, South Korea; Chiun-Shen Huang, National Taiwan University Hospital, Taipei, Republic of China; Véronique Diéras, Institut Curie, Paris, France; David W. Hillman, Mayo Clinic, Rochester, MN; Antonio C. Wolff, The Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Christian Jackisch, Klinikum Offenba
| | - Christian Jackisch
- Martine Piccart-Gebhart, Université Libre de Bruxelles, Brussels, Belgium; Eileen Holmes, Eleanor McFadden, and Andrew P. Holmes, Frontier Science (Scotland), Kincraig, Kingussie, United Kingdom; José Baselga, Memorial Sloan Kettering Cancer Center, New York, NY; Evandro de Azambuja, Institut Jules Bordet, Brussels, Belgium; Evandro de Azambuja and Stella Dolci, Breast European Adjuvant Study Team, Brussels, Belgium; Amylou C. Dueck and Anne E. McCullough, Mayo Clinic, Scottsdale, AZ; Giuseppe Viale, University of Milan, Milan, Italy; Giuseppe Viale and Aron Goldhirsch, Istituto Europeo di Oncologia, Milan, Italy; Jo Anne Zujewski, National Cancer Institute, Bethesda, MD; Aron Goldhirsch, Ospedale Regionale di Lugano, Viganello-Lugano, Switzerland; Alison Armour, GlaxoSmithKline, Collegeville, PA; Kathleen I. Pritchard, Sunnybrook Odette Cancer Centre, Toronto, Ontario, Canada; Kathleen I. Pritchard, University of Toronto, Toronto, Ontario, Canada; Liu Tonghua, Peking Union Medical College Hospital, Beijing, People's Republic of China; Liu Tonghua and Binghe Xu, China Academy of Chinese Medical Sciences, Beijing, People's Republic of China; Holger Eidtmann, University Hospital Kiel, Kiel, Germany; Phuong Dinh, Breast International Group, Brussels, Belgium; Serena Di Cosimo, Istituto Nazionale del Tumori, Milan, Italy; Serena Di Cosimo, SOLTI Breast Cancer Research Group, Barcelona, Spain; Nadia Harbeck, Frauenklinik der Universität München, Munich, Germany; Sergei Tjulandin, Blokhin Russian Cancer Research Center of RAMS, Moscow, Russia; Young-Hyuck Im, Korean Cancer Study Group, Seoul, South Korea; Young-Hyuck Im, Samsung Medical Center, Seoul, South Korea; Chiun-Shen Huang, National Taiwan University Hospital, Taipei, Republic of China; Véronique Diéras, Institut Curie, Paris, France; David W. Hillman, Mayo Clinic, Rochester, MN; Antonio C. Wolff, The Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Christian Jackisch, Klinikum Offenba
| | - Istvan Lang
- Martine Piccart-Gebhart, Université Libre de Bruxelles, Brussels, Belgium; Eileen Holmes, Eleanor McFadden, and Andrew P. Holmes, Frontier Science (Scotland), Kincraig, Kingussie, United Kingdom; José Baselga, Memorial Sloan Kettering Cancer Center, New York, NY; Evandro de Azambuja, Institut Jules Bordet, Brussels, Belgium; Evandro de Azambuja and Stella Dolci, Breast European Adjuvant Study Team, Brussels, Belgium; Amylou C. Dueck and Anne E. McCullough, Mayo Clinic, Scottsdale, AZ; Giuseppe Viale, University of Milan, Milan, Italy; Giuseppe Viale and Aron Goldhirsch, Istituto Europeo di Oncologia, Milan, Italy; Jo Anne Zujewski, National Cancer Institute, Bethesda, MD; Aron Goldhirsch, Ospedale Regionale di Lugano, Viganello-Lugano, Switzerland; Alison Armour, GlaxoSmithKline, Collegeville, PA; Kathleen I. Pritchard, Sunnybrook Odette Cancer Centre, Toronto, Ontario, Canada; Kathleen I. Pritchard, University of Toronto, Toronto, Ontario, Canada; Liu Tonghua, Peking Union Medical College Hospital, Beijing, People's Republic of China; Liu Tonghua and Binghe Xu, China Academy of Chinese Medical Sciences, Beijing, People's Republic of China; Holger Eidtmann, University Hospital Kiel, Kiel, Germany; Phuong Dinh, Breast International Group, Brussels, Belgium; Serena Di Cosimo, Istituto Nazionale del Tumori, Milan, Italy; Serena Di Cosimo, SOLTI Breast Cancer Research Group, Barcelona, Spain; Nadia Harbeck, Frauenklinik der Universität München, Munich, Germany; Sergei Tjulandin, Blokhin Russian Cancer Research Center of RAMS, Moscow, Russia; Young-Hyuck Im, Korean Cancer Study Group, Seoul, South Korea; Young-Hyuck Im, Samsung Medical Center, Seoul, South Korea; Chiun-Shen Huang, National Taiwan University Hospital, Taipei, Republic of China; Véronique Diéras, Institut Curie, Paris, France; David W. Hillman, Mayo Clinic, Rochester, MN; Antonio C. Wolff, The Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Christian Jackisch, Klinikum Offenba
| | - Michael Untch
- Martine Piccart-Gebhart, Université Libre de Bruxelles, Brussels, Belgium; Eileen Holmes, Eleanor McFadden, and Andrew P. Holmes, Frontier Science (Scotland), Kincraig, Kingussie, United Kingdom; José Baselga, Memorial Sloan Kettering Cancer Center, New York, NY; Evandro de Azambuja, Institut Jules Bordet, Brussels, Belgium; Evandro de Azambuja and Stella Dolci, Breast European Adjuvant Study Team, Brussels, Belgium; Amylou C. Dueck and Anne E. McCullough, Mayo Clinic, Scottsdale, AZ; Giuseppe Viale, University of Milan, Milan, Italy; Giuseppe Viale and Aron Goldhirsch, Istituto Europeo di Oncologia, Milan, Italy; Jo Anne Zujewski, National Cancer Institute, Bethesda, MD; Aron Goldhirsch, Ospedale Regionale di Lugano, Viganello-Lugano, Switzerland; Alison Armour, GlaxoSmithKline, Collegeville, PA; Kathleen I. Pritchard, Sunnybrook Odette Cancer Centre, Toronto, Ontario, Canada; Kathleen I. Pritchard, University of Toronto, Toronto, Ontario, Canada; Liu Tonghua, Peking Union Medical College Hospital, Beijing, People's Republic of China; Liu Tonghua and Binghe Xu, China Academy of Chinese Medical Sciences, Beijing, People's Republic of China; Holger Eidtmann, University Hospital Kiel, Kiel, Germany; Phuong Dinh, Breast International Group, Brussels, Belgium; Serena Di Cosimo, Istituto Nazionale del Tumori, Milan, Italy; Serena Di Cosimo, SOLTI Breast Cancer Research Group, Barcelona, Spain; Nadia Harbeck, Frauenklinik der Universität München, Munich, Germany; Sergei Tjulandin, Blokhin Russian Cancer Research Center of RAMS, Moscow, Russia; Young-Hyuck Im, Korean Cancer Study Group, Seoul, South Korea; Young-Hyuck Im, Samsung Medical Center, Seoul, South Korea; Chiun-Shen Huang, National Taiwan University Hospital, Taipei, Republic of China; Véronique Diéras, Institut Curie, Paris, France; David W. Hillman, Mayo Clinic, Rochester, MN; Antonio C. Wolff, The Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Christian Jackisch, Klinikum Offenba
| | - Ian Smith
- Martine Piccart-Gebhart, Université Libre de Bruxelles, Brussels, Belgium; Eileen Holmes, Eleanor McFadden, and Andrew P. Holmes, Frontier Science (Scotland), Kincraig, Kingussie, United Kingdom; José Baselga, Memorial Sloan Kettering Cancer Center, New York, NY; Evandro de Azambuja, Institut Jules Bordet, Brussels, Belgium; Evandro de Azambuja and Stella Dolci, Breast European Adjuvant Study Team, Brussels, Belgium; Amylou C. Dueck and Anne E. McCullough, Mayo Clinic, Scottsdale, AZ; Giuseppe Viale, University of Milan, Milan, Italy; Giuseppe Viale and Aron Goldhirsch, Istituto Europeo di Oncologia, Milan, Italy; Jo Anne Zujewski, National Cancer Institute, Bethesda, MD; Aron Goldhirsch, Ospedale Regionale di Lugano, Viganello-Lugano, Switzerland; Alison Armour, GlaxoSmithKline, Collegeville, PA; Kathleen I. Pritchard, Sunnybrook Odette Cancer Centre, Toronto, Ontario, Canada; Kathleen I. Pritchard, University of Toronto, Toronto, Ontario, Canada; Liu Tonghua, Peking Union Medical College Hospital, Beijing, People's Republic of China; Liu Tonghua and Binghe Xu, China Academy of Chinese Medical Sciences, Beijing, People's Republic of China; Holger Eidtmann, University Hospital Kiel, Kiel, Germany; Phuong Dinh, Breast International Group, Brussels, Belgium; Serena Di Cosimo, Istituto Nazionale del Tumori, Milan, Italy; Serena Di Cosimo, SOLTI Breast Cancer Research Group, Barcelona, Spain; Nadia Harbeck, Frauenklinik der Universität München, Munich, Germany; Sergei Tjulandin, Blokhin Russian Cancer Research Center of RAMS, Moscow, Russia; Young-Hyuck Im, Korean Cancer Study Group, Seoul, South Korea; Young-Hyuck Im, Samsung Medical Center, Seoul, South Korea; Chiun-Shen Huang, National Taiwan University Hospital, Taipei, Republic of China; Véronique Diéras, Institut Curie, Paris, France; David W. Hillman, Mayo Clinic, Rochester, MN; Antonio C. Wolff, The Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Christian Jackisch, Klinikum Offenba
| | - Frances Boyle
- Martine Piccart-Gebhart, Université Libre de Bruxelles, Brussels, Belgium; Eileen Holmes, Eleanor McFadden, and Andrew P. Holmes, Frontier Science (Scotland), Kincraig, Kingussie, United Kingdom; José Baselga, Memorial Sloan Kettering Cancer Center, New York, NY; Evandro de Azambuja, Institut Jules Bordet, Brussels, Belgium; Evandro de Azambuja and Stella Dolci, Breast European Adjuvant Study Team, Brussels, Belgium; Amylou C. Dueck and Anne E. McCullough, Mayo Clinic, Scottsdale, AZ; Giuseppe Viale, University of Milan, Milan, Italy; Giuseppe Viale and Aron Goldhirsch, Istituto Europeo di Oncologia, Milan, Italy; Jo Anne Zujewski, National Cancer Institute, Bethesda, MD; Aron Goldhirsch, Ospedale Regionale di Lugano, Viganello-Lugano, Switzerland; Alison Armour, GlaxoSmithKline, Collegeville, PA; Kathleen I. Pritchard, Sunnybrook Odette Cancer Centre, Toronto, Ontario, Canada; Kathleen I. Pritchard, University of Toronto, Toronto, Ontario, Canada; Liu Tonghua, Peking Union Medical College Hospital, Beijing, People's Republic of China; Liu Tonghua and Binghe Xu, China Academy of Chinese Medical Sciences, Beijing, People's Republic of China; Holger Eidtmann, University Hospital Kiel, Kiel, Germany; Phuong Dinh, Breast International Group, Brussels, Belgium; Serena Di Cosimo, Istituto Nazionale del Tumori, Milan, Italy; Serena Di Cosimo, SOLTI Breast Cancer Research Group, Barcelona, Spain; Nadia Harbeck, Frauenklinik der Universität München, Munich, Germany; Sergei Tjulandin, Blokhin Russian Cancer Research Center of RAMS, Moscow, Russia; Young-Hyuck Im, Korean Cancer Study Group, Seoul, South Korea; Young-Hyuck Im, Samsung Medical Center, Seoul, South Korea; Chiun-Shen Huang, National Taiwan University Hospital, Taipei, Republic of China; Véronique Diéras, Institut Curie, Paris, France; David W. Hillman, Mayo Clinic, Rochester, MN; Antonio C. Wolff, The Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Christian Jackisch, Klinikum Offenba
| | - Binghe Xu
- Martine Piccart-Gebhart, Université Libre de Bruxelles, Brussels, Belgium; Eileen Holmes, Eleanor McFadden, and Andrew P. Holmes, Frontier Science (Scotland), Kincraig, Kingussie, United Kingdom; José Baselga, Memorial Sloan Kettering Cancer Center, New York, NY; Evandro de Azambuja, Institut Jules Bordet, Brussels, Belgium; Evandro de Azambuja and Stella Dolci, Breast European Adjuvant Study Team, Brussels, Belgium; Amylou C. Dueck and Anne E. McCullough, Mayo Clinic, Scottsdale, AZ; Giuseppe Viale, University of Milan, Milan, Italy; Giuseppe Viale and Aron Goldhirsch, Istituto Europeo di Oncologia, Milan, Italy; Jo Anne Zujewski, National Cancer Institute, Bethesda, MD; Aron Goldhirsch, Ospedale Regionale di Lugano, Viganello-Lugano, Switzerland; Alison Armour, GlaxoSmithKline, Collegeville, PA; Kathleen I. Pritchard, Sunnybrook Odette Cancer Centre, Toronto, Ontario, Canada; Kathleen I. Pritchard, University of Toronto, Toronto, Ontario, Canada; Liu Tonghua, Peking Union Medical College Hospital, Beijing, People's Republic of China; Liu Tonghua and Binghe Xu, China Academy of Chinese Medical Sciences, Beijing, People's Republic of China; Holger Eidtmann, University Hospital Kiel, Kiel, Germany; Phuong Dinh, Breast International Group, Brussels, Belgium; Serena Di Cosimo, Istituto Nazionale del Tumori, Milan, Italy; Serena Di Cosimo, SOLTI Breast Cancer Research Group, Barcelona, Spain; Nadia Harbeck, Frauenklinik der Universität München, Munich, Germany; Sergei Tjulandin, Blokhin Russian Cancer Research Center of RAMS, Moscow, Russia; Young-Hyuck Im, Korean Cancer Study Group, Seoul, South Korea; Young-Hyuck Im, Samsung Medical Center, Seoul, South Korea; Chiun-Shen Huang, National Taiwan University Hospital, Taipei, Republic of China; Véronique Diéras, Institut Curie, Paris, France; David W. Hillman, Mayo Clinic, Rochester, MN; Antonio C. Wolff, The Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Christian Jackisch, Klinikum Offenba
| | - Henry Gomez
- Martine Piccart-Gebhart, Université Libre de Bruxelles, Brussels, Belgium; Eileen Holmes, Eleanor McFadden, and Andrew P. Holmes, Frontier Science (Scotland), Kincraig, Kingussie, United Kingdom; José Baselga, Memorial Sloan Kettering Cancer Center, New York, NY; Evandro de Azambuja, Institut Jules Bordet, Brussels, Belgium; Evandro de Azambuja and Stella Dolci, Breast European Adjuvant Study Team, Brussels, Belgium; Amylou C. Dueck and Anne E. McCullough, Mayo Clinic, Scottsdale, AZ; Giuseppe Viale, University of Milan, Milan, Italy; Giuseppe Viale and Aron Goldhirsch, Istituto Europeo di Oncologia, Milan, Italy; Jo Anne Zujewski, National Cancer Institute, Bethesda, MD; Aron Goldhirsch, Ospedale Regionale di Lugano, Viganello-Lugano, Switzerland; Alison Armour, GlaxoSmithKline, Collegeville, PA; Kathleen I. Pritchard, Sunnybrook Odette Cancer Centre, Toronto, Ontario, Canada; Kathleen I. Pritchard, University of Toronto, Toronto, Ontario, Canada; Liu Tonghua, Peking Union Medical College Hospital, Beijing, People's Republic of China; Liu Tonghua and Binghe Xu, China Academy of Chinese Medical Sciences, Beijing, People's Republic of China; Holger Eidtmann, University Hospital Kiel, Kiel, Germany; Phuong Dinh, Breast International Group, Brussels, Belgium; Serena Di Cosimo, Istituto Nazionale del Tumori, Milan, Italy; Serena Di Cosimo, SOLTI Breast Cancer Research Group, Barcelona, Spain; Nadia Harbeck, Frauenklinik der Universität München, Munich, Germany; Sergei Tjulandin, Blokhin Russian Cancer Research Center of RAMS, Moscow, Russia; Young-Hyuck Im, Korean Cancer Study Group, Seoul, South Korea; Young-Hyuck Im, Samsung Medical Center, Seoul, South Korea; Chiun-Shen Huang, National Taiwan University Hospital, Taipei, Republic of China; Véronique Diéras, Institut Curie, Paris, France; David W. Hillman, Mayo Clinic, Rochester, MN; Antonio C. Wolff, The Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Christian Jackisch, Klinikum Offenba
| | - Thomas Suter
- Martine Piccart-Gebhart, Université Libre de Bruxelles, Brussels, Belgium; Eileen Holmes, Eleanor McFadden, and Andrew P. Holmes, Frontier Science (Scotland), Kincraig, Kingussie, United Kingdom; José Baselga, Memorial Sloan Kettering Cancer Center, New York, NY; Evandro de Azambuja, Institut Jules Bordet, Brussels, Belgium; Evandro de Azambuja and Stella Dolci, Breast European Adjuvant Study Team, Brussels, Belgium; Amylou C. Dueck and Anne E. McCullough, Mayo Clinic, Scottsdale, AZ; Giuseppe Viale, University of Milan, Milan, Italy; Giuseppe Viale and Aron Goldhirsch, Istituto Europeo di Oncologia, Milan, Italy; Jo Anne Zujewski, National Cancer Institute, Bethesda, MD; Aron Goldhirsch, Ospedale Regionale di Lugano, Viganello-Lugano, Switzerland; Alison Armour, GlaxoSmithKline, Collegeville, PA; Kathleen I. Pritchard, Sunnybrook Odette Cancer Centre, Toronto, Ontario, Canada; Kathleen I. Pritchard, University of Toronto, Toronto, Ontario, Canada; Liu Tonghua, Peking Union Medical College Hospital, Beijing, People's Republic of China; Liu Tonghua and Binghe Xu, China Academy of Chinese Medical Sciences, Beijing, People's Republic of China; Holger Eidtmann, University Hospital Kiel, Kiel, Germany; Phuong Dinh, Breast International Group, Brussels, Belgium; Serena Di Cosimo, Istituto Nazionale del Tumori, Milan, Italy; Serena Di Cosimo, SOLTI Breast Cancer Research Group, Barcelona, Spain; Nadia Harbeck, Frauenklinik der Universität München, Munich, Germany; Sergei Tjulandin, Blokhin Russian Cancer Research Center of RAMS, Moscow, Russia; Young-Hyuck Im, Korean Cancer Study Group, Seoul, South Korea; Young-Hyuck Im, Samsung Medical Center, Seoul, South Korea; Chiun-Shen Huang, National Taiwan University Hospital, Taipei, Republic of China; Véronique Diéras, Institut Curie, Paris, France; David W. Hillman, Mayo Clinic, Rochester, MN; Antonio C. Wolff, The Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Christian Jackisch, Klinikum Offenba
| | - Richard D Gelber
- Martine Piccart-Gebhart, Université Libre de Bruxelles, Brussels, Belgium; Eileen Holmes, Eleanor McFadden, and Andrew P. Holmes, Frontier Science (Scotland), Kincraig, Kingussie, United Kingdom; José Baselga, Memorial Sloan Kettering Cancer Center, New York, NY; Evandro de Azambuja, Institut Jules Bordet, Brussels, Belgium; Evandro de Azambuja and Stella Dolci, Breast European Adjuvant Study Team, Brussels, Belgium; Amylou C. Dueck and Anne E. McCullough, Mayo Clinic, Scottsdale, AZ; Giuseppe Viale, University of Milan, Milan, Italy; Giuseppe Viale and Aron Goldhirsch, Istituto Europeo di Oncologia, Milan, Italy; Jo Anne Zujewski, National Cancer Institute, Bethesda, MD; Aron Goldhirsch, Ospedale Regionale di Lugano, Viganello-Lugano, Switzerland; Alison Armour, GlaxoSmithKline, Collegeville, PA; Kathleen I. Pritchard, Sunnybrook Odette Cancer Centre, Toronto, Ontario, Canada; Kathleen I. Pritchard, University of Toronto, Toronto, Ontario, Canada; Liu Tonghua, Peking Union Medical College Hospital, Beijing, People's Republic of China; Liu Tonghua and Binghe Xu, China Academy of Chinese Medical Sciences, Beijing, People's Republic of China; Holger Eidtmann, University Hospital Kiel, Kiel, Germany; Phuong Dinh, Breast International Group, Brussels, Belgium; Serena Di Cosimo, Istituto Nazionale del Tumori, Milan, Italy; Serena Di Cosimo, SOLTI Breast Cancer Research Group, Barcelona, Spain; Nadia Harbeck, Frauenklinik der Universität München, Munich, Germany; Sergei Tjulandin, Blokhin Russian Cancer Research Center of RAMS, Moscow, Russia; Young-Hyuck Im, Korean Cancer Study Group, Seoul, South Korea; Young-Hyuck Im, Samsung Medical Center, Seoul, South Korea; Chiun-Shen Huang, National Taiwan University Hospital, Taipei, Republic of China; Véronique Diéras, Institut Curie, Paris, France; David W. Hillman, Mayo Clinic, Rochester, MN; Antonio C. Wolff, The Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Christian Jackisch, Klinikum Offenba
| | - Edith A Perez
- Martine Piccart-Gebhart, Université Libre de Bruxelles, Brussels, Belgium; Eileen Holmes, Eleanor McFadden, and Andrew P. Holmes, Frontier Science (Scotland), Kincraig, Kingussie, United Kingdom; José Baselga, Memorial Sloan Kettering Cancer Center, New York, NY; Evandro de Azambuja, Institut Jules Bordet, Brussels, Belgium; Evandro de Azambuja and Stella Dolci, Breast European Adjuvant Study Team, Brussels, Belgium; Amylou C. Dueck and Anne E. McCullough, Mayo Clinic, Scottsdale, AZ; Giuseppe Viale, University of Milan, Milan, Italy; Giuseppe Viale and Aron Goldhirsch, Istituto Europeo di Oncologia, Milan, Italy; Jo Anne Zujewski, National Cancer Institute, Bethesda, MD; Aron Goldhirsch, Ospedale Regionale di Lugano, Viganello-Lugano, Switzerland; Alison Armour, GlaxoSmithKline, Collegeville, PA; Kathleen I. Pritchard, Sunnybrook Odette Cancer Centre, Toronto, Ontario, Canada; Kathleen I. Pritchard, University of Toronto, Toronto, Ontario, Canada; Liu Tonghua, Peking Union Medical College Hospital, Beijing, People's Republic of China; Liu Tonghua and Binghe Xu, China Academy of Chinese Medical Sciences, Beijing, People's Republic of China; Holger Eidtmann, University Hospital Kiel, Kiel, Germany; Phuong Dinh, Breast International Group, Brussels, Belgium; Serena Di Cosimo, Istituto Nazionale del Tumori, Milan, Italy; Serena Di Cosimo, SOLTI Breast Cancer Research Group, Barcelona, Spain; Nadia Harbeck, Frauenklinik der Universität München, Munich, Germany; Sergei Tjulandin, Blokhin Russian Cancer Research Center of RAMS, Moscow, Russia; Young-Hyuck Im, Korean Cancer Study Group, Seoul, South Korea; Young-Hyuck Im, Samsung Medical Center, Seoul, South Korea; Chiun-Shen Huang, National Taiwan University Hospital, Taipei, Republic of China; Véronique Diéras, Institut Curie, Paris, France; David W. Hillman, Mayo Clinic, Rochester, MN; Antonio C. Wolff, The Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Christian Jackisch, Klinikum Offenba
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Nakamura S, Kwong A, Kim SW, Iau P, Patmasiriwat P, Dofitas R, Aryandono T, Hu Z, Huang CS, Ginsburg O, Rashid MU, Sarin R, Teo SH. Current Status of the Management of Hereditary Breast and Ovarian Cancer in Asia: First Report by the Asian BRCA Consortium. Public Health Genomics 2015; 19:53-60. [PMID: 26575363 DOI: 10.1159/000441714] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Accepted: 10/17/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND BRCA1/BRCA2 mutations are associated with an increased lifetime risk for hereditary breast and ovarian cancer (HBOC). Compared with the Western developed countries, genetic testing and risk assessment for HBOC in Asia are less available, thus prohibiting the appropriate surveillance, clinical strategies and cancer management. METHODS The current status of HBOC management in 14 Asian countries, including genetic counselling/testing uptakes and clinical management options, was reviewed. We analysed how economic factors, healthcare and legal frameworks, and cultural issues affect the genetic service availability in Asia. RESULTS In 2012, only an estimated 4,000 breast cancer cases from 14 Asian countries have benefited from genetic services. Genetic testing costs and the absence of their adoption into national healthcare systems are the main economic barriers for approaching genetic services. Training programmes, regional accredited laboratories and healthcare professionals are not readily available in most of the studied countries. A lack of legal frameworks against genetic discrimination and a lack of public awareness of cancer risk assessment also provide challenges to HBOC management in Asia. CONCLUSIONS The Asian BRCA Consortium reports the current disparities in genetic services for HBOC in Asia and urges the policy makers, healthcare sectors and researchers to address the limitations in HBOC management.
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Affiliation(s)
- Seigo Nakamura
- Department of Surgery, Division of Breast Surgical Oncology, Showa University School of Medicine, Tokyo, Japan
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Hu J, Lomanto D, Dumanian G, Cheesborough J, Ponten J, Hameeteman M, Nienhuijs S, Zahiri H, Benenati M, Sibia U, Sivak B, Park A, Belyansky I, Huang CS, Verhagen T, Loos MJA, Scheltinga MRM, Roumen RMH, Morfesis F, Rose B, Zarrinkhoo E, Towfigh S, Miller J, Campanella AM, Licheri S, Barbarossa M, Porceddu G, Ferraro G, Virdis F, Reccia I, Aresu S, Pisanu A. Rectum Diastasis, Post Partum Floppy Wall & Obscure Groin Pain in Women. Hernia 2015; 19 Suppl 1:S73-6. [PMID: 26518865 DOI: 10.1007/bf03355330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- J Hu
- National University Health System, Singapore, Singapore
| | - D Lomanto
- National University Health System, Singapore, Singapore
| | - G Dumanian
- Northwestern Feinberg School of Medicine, Chicago, USA
| | | | - J Ponten
- Catharina Ziekenhuis, Eindhoven, Netherlands
| | - M Hameeteman
- Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands
| | - S Nienhuijs
- Catharina Ziekenhuis, Eindhoven, Netherlands
| | - H Zahiri
- Department of Surgery, Anne Arundel Medical Center, Annapolis, USA
| | - M Benenati
- Department of Surgery, Anne Arundel Medical Center, Annapolis, USA
| | - U Sibia
- Department of Surgery, Anne Arundel Medical Center, Annapolis, USA
| | - B Sivak
- Department of Surgery, Anne Arundel Medical Center, Annapolis, USA
| | - A Park
- Department of Surgery, Anne Arundel Medical Center, Annapolis, USA
| | - I Belyansky
- Department of Surgery, Anne Arundel Medical Center, Annapolis, USA
| | - C S Huang
- Cathay Medical Center, Taipei Medical University, Taipei, Taiwan
| | - T Verhagen
- Máxima Medical Center, Veldhoven, Netherlands
| | - M J A Loos
- Máxima Medical Center, Veldhoven, Netherlands
| | | | | | - F Morfesis
- Owen Drive Surgical Clinic of Fayetteville, Fayetteville, USA
| | - B Rose
- Owen Drive Surgical Clinic of Fayetteville, Fayetteville, USA
| | | | - S Towfigh
- Beverly Hills Hernia Center, Beverly Hills, USA
| | - J Miller
- Department of Radiology, Cedars Sinai Medical Center, Los Angeles, USA
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123
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Chiu HH, Tsai SJ, Tseng YJ, Wu MS, Liao WC, Huang CS, Kuo CH. An efficient and robust fatty acid profiling method for plasma metabolomic studies by gas chromatography-mass spectrometry. Clin Chim Acta 2015; 451:183-90. [PMID: 26436485 DOI: 10.1016/j.cca.2015.09.028] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Revised: 09/08/2015] [Accepted: 09/28/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND Targeted metabolomic analysis of fatty acids has linked the dysregulation of fatty acids to many diseases. This study selected five frequently used fatty acid derivatization methods for comparison. METHODS We compared the method precisions and derivatization efficiencies, the most economical and best performing method was subjected to method validation. Twenty-four fatty acid standards were used to validate the method, which was later applied to the investigation of potential fatty acid markers of breast cancer. RESULTS The acetyl chloride method was demonstrated to provide the best derivatization efficiency and lowest cost for plasma samples. The ionic liquid column successfully separated positional and geometric fatty acid isomers within 26 min under the optimized conditions. Intra-day and inter-day CVs for most of the fatty acids were <10%. Over 90% of the results showed recoveries within 85%-115%. The validated method was applied to investigate potential fatty acid markers of breast cancer. The fatty acid profiling results revealed that 3 fatty acids (C22:0, C24:0, C18:2n6) were significantly lower in both pre- and post-menopausal breast cancer patients (P<0.05). CONCLUSIONS We demonstrated that the proposed method is an accurate, efficient and economical method for plasma metabolomic studies of fatty acids.
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Affiliation(s)
- Huai-Hsuan Chiu
- School of Pharmacy, College of Medicine, National Taiwan University, Taiwan
| | - Sung-Jeng Tsai
- School of Pharmacy, College of Medicine, National Taiwan University, Taiwan
| | - Y Jane Tseng
- Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taiwan; The Metabolomics Core Laboratory, Center of Genomic Medicine, National Taiwan University, Taiwan
| | - Ming-Shiang Wu
- Department of Internal Medicine, National Taiwan University Hospital, Taiwan
| | - Wei-Chih Liao
- Department of Internal Medicine, National Taiwan University Hospital, Taiwan
| | | | - Ching-Hua Kuo
- School of Pharmacy, College of Medicine, National Taiwan University, Taiwan; The Metabolomics Core Laboratory, Center of Genomic Medicine, National Taiwan University, Taiwan; Department of Pharmacy, National Taiwan University Hospital, Taiwan.
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124
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Lien HC, Huang CS, Yang YW, Jeng YM. Mutational analysis of MED12 exon 2 in a spectrum of fibroepithelial tumours of the breast: implications for pathogenesis and histogenesis. Histopathology 2015; 68:433-41. [PMID: 26109290 DOI: 10.1111/his.12764] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Accepted: 06/19/2015] [Indexed: 01/31/2023]
Abstract
AIMS Fibroadenomas (FAs) and phyllodes tumours (PTs) are fibroepithelial tumours. Mutations in MED12 exon 2 have been reported in FAs. This study investigated the MED12 mutations in a spectrum of fibroepithelial tumours. METHODS AND RESULTS Using direct sequencing, we analysed MED12 exon 2 mutations on 121 samples, including PTs and FAs and variants. We found MED12 mutations in 71.4% of PTs. No significant difference in the mutation frequency was observed between benign, borderline and malignant PTs, and a general lack of correlation existed between mutations and pathological factors associated with PT grading. The mutation patterns were similar between PTs and FAs, with codon 44 being involved most frequently. MED12 mutations were identified in 47.1, 52.6 and 50.0% of complex FAs, juvenile FAs and tubular adenomas (TAs), respectively, and the frequency and mutation patterns were similar between these FA variants and usual FAs. CONCLUSIONS The high frequency and similar patterns of MED12 mutations in FAs and various grades of PTs implies that the MED12 mutation is a common and early pathological event in these fibroepithelial tumours. The similar frequency and patterns of the MED12 mutation between FAs and variants suggests that FA variants are bona fide FAs, with identical pathogenesis involving MED12 mutations.
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Affiliation(s)
- Huang-Chun Lien
- Department of Pathology, National Taiwan University Hospital, Taipei, Taiwan.,Graduate Institute of Pathology, National Taiwan University Hospital, Taipei, Taiwan
| | - Chiun-Sheng Huang
- Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - Ya-Wen Yang
- Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - Yung-Ming Jeng
- Department of Pathology, National Taiwan University Hospital, Taipei, Taiwan.,Graduate Institute of Pathology, National Taiwan University Hospital, Taipei, Taiwan
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125
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Chang RF, Hou YL, Lo CM, Huang CS, Chen JH, Kim WH, Chang JM, Bae MS, Moon WK. Quantitative analysis of breast echotexture patterns in automated breast ultrasound images. Med Phys 2015; 42:4566-78. [DOI: 10.1118/1.4923754] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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126
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Lo CM, Moon WK, Huang CS, Chen JH, Yang MC, Chang RF. Intensity-Invariant Texture Analysis for Classification of BI-RADS Category 3 Breast Masses. Ultrasound Med Biol 2015; 41:2039-2048. [PMID: 25843514 DOI: 10.1016/j.ultrasmedbio.2015.03.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2014] [Revised: 02/22/2015] [Accepted: 03/01/2015] [Indexed: 06/04/2023]
Abstract
Radiologists likely incorrectly classify benign masses as Breast Imaging Reporting and Data System (BI-RADS) category 3. A computer-aided diagnosis (CAD) system was developed in this study as a second viewer to avoid misclassification of carcinomas. Sixty-nine biopsy-proven BI-RADS category 3 masses, including 21 malignant and 48 benign masses, were used to evaluate the CAD system. To improve the texture features, gray-scale variations between images were reduced by transforming pixels into intensity-invariant ranklet coefficients. The textures of the tumor and speckle pixels were extracted from the transformed ranklet images to provide more robust features than in conventional CAD systems. As a result, tumor texture and speckle texture with ranklet transformation achieved significantly better areas under the receiver operating characteristic curve (Az) compared with those without ranklet transformation (Az = 0.83 vs. 0.58 and Az = 0.80 vs. 0.56, p value < 0.05). The improved CAD system can be a second reader to confirm the classification of BI-RADS category 3 masses.
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Affiliation(s)
- Chung-Ming Lo
- Department of Computer Science and Information Engineering, National Taiwan University, Taipei, Taiwan
| | - Woo Kyung Moon
- Department of Radiology, Seoul National University Hospital, Seoul, Korea.
| | - Chiun-Sheng Huang
- Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Jeon-Hor Chen
- Center for Functional Onco-Imaging and Department of Radiologic Science, University of California at Irvine, Irvine, California, USA; Department of Radiology, E-Da Hospital and I-Shou University, Kaohsiung, Taiwan
| | - Min-Chun Yang
- Department of Computer Science and Information Engineering, National Taiwan University, Taipei, Taiwan
| | - Ruey-Feng Chang
- Department of Computer Science and Information Engineering, National Taiwan University, Taipei, Taiwan; Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan.
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Lu YS, Yeh DC, Tseng LM, Chen ST, Lien HC, Chang HT, Chang YC, Huang SM, Lin CH, Cheng AL, Huang CS. Randomized study of tailored neoadjuvant chemotherapy according to the expression of tau, topo II α, and ERCC1 versus standard chemotherapy in HER2-negative breast cancer. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.1025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Yen-Shen Lu
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
| | - Dah-Cherng Yeh
- Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Ling-Ming Tseng
- Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Shou-Tung Chen
- Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan
| | - Huang-Chun Lien
- Department of Pathology, National Taiwan University Hospital, Taipei, Taiwan
| | | | | | - Shu-Min Huang
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
| | - Ching-Hung Lin
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
| | - Ann-Lii Cheng
- National Taiwan University Hospital, Taipei City, Taiwan
| | - Chiun-Sheng Huang
- Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
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128
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Parton M, Bardia A, Kummel S, Estevez LG, Huang CS, Castan JC, Ruiz Borrego M, Telli ML, Lluch A, Lopez R, Beck JT, Ismail-Khan R, Chen SC, Hurvitz SA, Mayer IA, Atienza RS, Cameron S, Krygowski M, Kim SB. A phase II, open-label, neoadjuvant, randomized study of LCL161 with paclitaxel in patients with triple-negative breast cancer (TNBC). J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.1014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Aditya Bardia
- Massachusetts General Hospital Cancer Center, Boston, MA
| | | | - Laura G Estevez
- Comprehensive Cancer Center Clara Campal (CIOCC), Madrid, Spain
| | - Chiun-Sheng Huang
- National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | | | - Manuel Ruiz Borrego
- Department of Medical Oncology, Hospital Universitario Virgen del Rocio, Seville, Spain
| | | | - Ana Lluch
- Hospital Clinico Universitario de Valencia, Valencia, Spain
| | - Rafael Lopez
- Hospital Clinico Universitario de Santiago de Compostela, Santiago De Compostela, Spain
| | | | | | | | | | | | | | - Scott Cameron
- Novartis Institutes for BioMedical Research, Cambridge, MA
| | | | - Sung-Bae Kim
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
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129
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Kuo SH, Chen YH, Kuo WH, Lien HC, Wang MY, Wang CP, Huang CS. Prognostic significance of clinicopathologic features in patients with breast ductal carcinoma in situ who received breast-conserving therapy. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.e11574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Sung Hsin Kuo
- Department of Oncology,National Taiwan University Hospital; Graduate Institute of Oncology, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Yu-Hsuan Chen
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
| | - Wen-Hung Kuo
- National Taiwan University Hospital, Taipei, Taiwan
| | - Huang-Chun Lien
- Department of Pathology, National Taiwan University Hospital, Taipei, Taiwan
| | - Ming-Yang Wang
- Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - Chao-Ping Wang
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
| | - Chiun-Sheng Huang
- Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
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130
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Chen IC, Chang YC, Lu YS, Huang CS, Kuo WH, Wang MY, Kuo KT, Wu PF, Hsueh TH, Lin CH, Cheng AL. Clinical significance of LKB1 protein and gene expression in breast cancer. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.e11538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- I Chun Chen
- Department of Oncology, National Taiwan University Hospital; Graduate Institute of Oncology, National Taiwan University, Taipei, Taiwan
| | | | - Yen-Shen Lu
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
| | - Chiun-Sheng Huang
- Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - Wen-Hung Kuo
- National Taiwan University Hospital, Taipei, Taiwan
| | - Ming-Yang Wang
- Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - Kuan-Ting Kuo
- Department of Pathology, National Taiwan University Hospital, Taipei, Taiwan
| | - Pei-Fang Wu
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
| | - Tsu-Hsin Hsueh
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
| | - Ching-Hung Lin
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
| | - Ann-Lii Cheng
- National Taiwan University Hospital, Taipei City, Taiwan
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Toi M, Winer EP, Benson JR, Inamoto T, Forbes JF, von Minckwitz G, Robertson JFR, Grobmyer SR, Jatoi I, Sasano H, Kunkler I, Ho AY, Yamauchi C, Chow LWC, Huang CS, Han W, Noguchi S, Pegram MD, Yamauchi H, Lee ES, Larionov AA, Bevilacqua JLB, Yoshimura M, Sugie T, Yamauchi A, Krop IE, Noh DY, Klimberg VS. Personalization of loco-regional care for primary breast cancer patients (part 1). Future Oncol 2015; 11:1297-300. [DOI: 10.2217/fon.15.65] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
ABSTRACT Kyoto Breast Cancer Consensus Conference, Kyoto, Japan, 18–20 February 2014 The loco-regional management of breast cancer is increasingly complex with application of primary systemic therapies, oncoplastic techniques and genetic testing for breast cancer susceptibility. Personalization of loco-regional treatment is integral to optimization of breast cancer care. Clinical and pathological tumor stage, biological features and host factors influence loco-regional treatment strategies and extent of surgical procedures. Key issues including axillary staging, axillary treatment, radiation therapy, primary systemic therapy (PST), preoperative hormonal therapy and genetic predisposition were identified and discussed at the Kyoto Breast Cancer Consensus Conference (KBCCC2014). In the first of a two part conference scene, consensus recommendations for axillary management are presented and focus on the following topics: indications for completion axillary lymph node dissection in primary surgical patients with ≤2 macrometastases or any sentinel nodal deposits after PST; the timing of sentinel lymph node biopsy in the context of PST; use of axillary irradiation as a component of primary treatment plans and the role of intraoperative node assessment in the post-Z0011 era.
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Affiliation(s)
- Masakazu Toi
- Breast Surgery, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawara-cho, Sakyo-ku, Kyoto 606–8507, Japan
| | - Eric P Winer
- Breast Oncology Center, Dana-Farber Cancer Institute, Brigham & Women's Cancer Center, Harvard Medical School, Boston, MA 02215, USA
| | - John R Benson
- Cambridge Breast Unit, Addenbrooke's Hospital & University of Cambridge, Cambridge, UK
| | - Takashi Inamoto
- Faculty of Health Care, Tenri Health Care University, Nara, Japan
| | - John F Forbes
- Surgical Oncology, University of Newcastle, Newcastle, Australia
| | | | - John FR Robertson
- Breast Surgery, University of Nottingham, Royal Derby Hospital, Nottingham, UK
| | - Stephen R Grobmyer
- Cleveland Clinic & Lerner College of Medicine of Case Western Reserve University, Cleveland, OH 44195, USA
| | - Ismail Jatoi
- The University of Texas Health Science Center, San Antonio, TX 78229, USA
| | - Hironobu Sasano
- Pathology, Tohoku University School of Medicine, Sendai, Japan
| | - Ian Kunkler
- Edinburgh Cancer Research UK Centre, The University of Edinburgh, UK
| | - Alice Y Ho
- Radiation Oncology, Memorial Sloan–Kettering Cancer Center, NY 10065, USA
| | - Chikako Yamauchi
- Radiation Oncology, Shiga Medical Center for Adults, Moriyama, Japan
| | - Louis WC Chow
- UNIMED Medical Institute/University of Hong Kong, Hong Kong
| | - Chiun-Sheng Huang
- Surgery, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Wonshik Han
- Surgery, Seoul National University Hospital, Seoul, South Korea
| | - Shinzaburo Noguchi
- Breast & Endocrine Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Mark D Pegram
- Stanford Cancer Institute, School of Medicine, Stanford University, CA 94305, USA
| | | | - Eun-Sook Lee
- Surgery, Seoul National University Hospital, Seoul, South Korea
| | - Alexey A Larionov
- Statistics & Computational Biology Laboratory, University of Cambridge, Cancer Research UK Cambridge Institute, UK
| | - Jose LB Bevilacqua
- Department of Breast Surgery, AC Camargo Cancer Center, Sao Paulo, Brazil
| | - Michio Yoshimura
- Radiation Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | | | - Akira Yamauchi
- Breast Center, Kitano Hospital, The Tazuke Kofukai Medical Research Institute, Osaka, Japan
| | - Ian E Krop
- Breast Oncology Center, Dana-Farber Cancer Institute, Brigham & Women's Cancer Center, Harvard Medical School, Boston, MA 02215, USA
| | - Dong Young Noh
- Surgery, Seoul National University Hospital, Seoul, South Korea
| | - V Suzanne Klimberg
- Surgery, Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, AR 72205, USA
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Toi M, Winer EP, Benson JR, Inamoto T, Forbes JF, von Minckwitz G, Robertson JFR, Grobmyer SR, Jatoi I, Sasano H, Kunkler I, Ho AY, Yamauchi C, Chow LWC, Huang CS, Han W, Noguchi S, Pegram MD, Yamauchi H, Lee ES, Larionov AA, Bevilacqua JLB, Yoshimura M, Sugie T, Yamauchi A, Krop IE, Noh DY, Klimberg VS. Personalization of loco-regional care for primary breast cancer patients (part 2). Future Oncol 2015; 11:1301-5. [DOI: 10.2217/fon.15.66] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Kyoto Breast Cancer Consensus Conference, Kyoto, Japan, 18–20 February 2014 The loco-regional management of breast cancer is increasingly complex with application of primary systemic therapies, oncoplastic techniques and genetic testing for breast cancer susceptibility. Personalization of loco-regional treatment is integral to optimization of breast cancer care. Clinical and pathological tumor stage, biological features and host factors influence loco-regional treatment strategies and extent of surgical procedures. Key issues including axillary staging, axillary treatment, radiation therapy, primary systemic therapy (PST), preoperative hormonal therapy and genetic predisposition were identified and discussed at the Kyoto Breast Cancer Consensus Conference (KBCCC2014). In the second of a two part conference scene, consensus recommendations for radiation treatment, primary systemic therapies and management of genetic predisposition are reported and focus on the following topics: influence of both clinical response to PST and stage at presentation on recommendations for postmastectomy radiotherapy; use of regional nodal irradiation in selected node-positive patients and those with adverse pathological factors; extent of surgical resection following downstaging of tumors with PST; use of preoperative hormonal therapy in premenopausal women with larger, node-negative luminal A-like tumors and managing increasing demands for contralateral prophylactic mastectomy in patients with a unilateral sporadic breast cancer.
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Affiliation(s)
- Masakazu Toi
- Breast Surgery, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawara-cho, Sakyo-ku, Kyoto 606–8507, Japan
| | - Eric P Winer
- Breast Oncology Center, Dana-Farber Cancer Institute, Brigham & Women's Cancer Center, Harvard Medical School, Boston, MA 02215, USA
| | - John R Benson
- Cambridge Breast Unit, Addenbrooke's Hospital & University of Cambridge, Cambridge, UK
| | - Takashi Inamoto
- Faculty of Health Care, Tenri Health Care University, Nara, Japan
| | - John F Forbes
- Surgical Oncology, University of Newcastle, Newcastle, Australia
| | | | - John FR Robertson
- Breast Surgery, University of Nottingham, Royal Derby Hospital, Nottingham, UK
| | - Stephen R Grobmyer
- Cleveland Clinic & Lerner College of Medicine of Case Western Reserve University, Cleveland, OH 44195, USA
| | - Ismail Jatoi
- The University of Texas Health Science Center, San Antonio, TX 78229, USA
| | - Hironobu Sasano
- Pathology, Tohoku University School of Medicine, Sendai, Japan
| | - Ian Kunkler
- Edinburgh Cancer Research UK Centre, The University of Edinburgh, UK
| | - Alice Y Ho
- Radiation Oncology, Memorial Sloan-Kettering Cancer Center, NY 10065, USA
| | - Chikako Yamauchi
- Radiation Oncology, Shiga Medical Center for Adults, Moriyama, Japan
| | - Louis WC Chow
- UNIMED Medical Institute/University of Hong Kong, Hong Kong
| | - Chiun-Sheng Huang
- Surgery, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Wonshik Han
- Surgery, Seoul National University Hospital, Seoul, South Korea
| | - Shinzaburo Noguchi
- Breast & Endocrine Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Mark D Pegram
- Stanford Cancer Institute, School of Medicine, Stanford University, USA
| | | | - Eun-Sook Lee
- Surgery, Seoul National University Hospital, Seoul, South Korea
| | - Alexey A Larionov
- Statistics & Computational Biology Laboratory, University of Cambridge, Cancer Research UK Cambridge Institute, UK
| | - Jose LB Bevilacqua
- Department of Breast Surgery, AC Camargo Cancer Center, Sao Paulo, Brazil
| | - Michio Yoshimura
- Radiation Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | | | - Akira Yamauchi
- Breast Center, Kitano Hospital, The Tazuke Kofukai Medical Research Institute, Osaka, Japan
| | - Ian E Krop
- Breast Oncology Center, Dana-Farber Cancer Institute, Brigham & Women's Cancer Center, Harvard Medical School, Boston, MA 02215, USA
| | - Dong Young Noh
- Surgery, Seoul National University Hospital, Seoul, South Korea
| | - V Suzanne Klimberg
- Surgery, Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, AR 72205, USA
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Lin CH, Shen CY, Lee JH, Huang CS, Yang CH, Kuo WH, Chang DY, Hsiung CN, Kuo KT, Chen WW, Chen IC, Wu PF, Kuo SH, Chen CJ, Lu YS, Cheng AL. High Prevalence of the BIM Deletion Polymorphism in Young Female Breast Cancer in an East Asian Country. PLoS One 2015; 10:e0124908. [PMID: 25909194 PMCID: PMC4409392 DOI: 10.1371/journal.pone.0124908] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Accepted: 03/10/2015] [Indexed: 11/19/2022] Open
Abstract
Background A rapid surge of female breast cancer has been observed in young women in several East Asian countries. The BIM deletion polymorphism, which confers cell resistance to apoptosis, was recently found exclusively in East Asian people with prevalence rate of 12%. We aimed to evaluate the possible role of this genetic alteration in carcinogenesis of breast cancer in East Asians. Method Female healthy volunteers (n = 307), patients in one consecutive stage I-III breast cancer cohort (n = 692) and one metastatic breast cancer cohort (n = 189) were evaluated. BIM wild-type and deletion alleles were separately genotyped in genomic DNAs. Results Both cancer cohorts consistently showed inverse associations between the BIM deletion polymorphism and patient age (≤35 y vs. 36-50 y vs. >50 y: 29% vs. 22% vs. 15%, P = 0.006 in the consecutive cohort, and 40% vs. 23% vs. 13%, P = 0.023 in the metastatic cohort). In healthy volunteers, the frequencies of the BIM deletion polymorphism were similar (13%-14%) in all age groups. Further analyses indicated that the BIM deletion polymorphism was not associated with specific clinicopathologic features, but it was associated with poor overall survival (adjusted hazard ratio 1.71) in the consecutive cohort. Conclusions BIM deletion polymorphism may be involved in the tumorigenesis of the early-onset breast cancer among East Asians.
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Affiliation(s)
- Ching-Hung Lin
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
- Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Chen-Yang Shen
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan
- Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan
- School of Public Health, China Medical University, Taichung, Taiwan
| | - Jih-Hsiang Lee
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
| | - Chiun-Sheng Huang
- Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - Chih-Hsin Yang
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
- Graduate Institute of Oncology and Cancer Research Centre, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Wen-Hung Kuo
- Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - Dwan-Ying Chang
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
| | - Chia-Ni Hsiung
- Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan
| | - Kuan-Ting Kuo
- Department of Pathology, National Taiwan University Hospital, Taipei, Taiwan
| | - Wei-Wu Chen
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
| | - I-Chun Chen
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
| | - Pei-Fang Wu
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
| | - Sung-Hsin Kuo
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
- Graduate Institute of Oncology and Cancer Research Centre, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chien-Jen Chen
- Genomics Research Center, Academia Sinica, Taipei, Taiwan
| | - Yen-Shen Lu
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
- Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Ann-Lii Cheng
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
- Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Graduate Institute of Oncology and Cancer Research Centre, College of Medicine, National Taiwan University, Taipei, Taiwan
- * E-mail:
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134
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Wu LA, Chang RF, Huang CS, Lu YS, Chen HH, Chen JY, Chang YC. Evaluation of the treatment response to neoadjuvant chemotherapy in locally advanced breast cancer using combined magnetic resonance vascular maps and apparent diffusion coefficient. J Magn Reson Imaging 2015; 42:1407-20. [PMID: 25875904 DOI: 10.1002/jmri.24915] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Accepted: 03/31/2015] [Indexed: 12/12/2022] Open
Abstract
PURPOSE To evaluate the treatment response of locally advanced breast cancer (LABC) to neoadjuvant chemotherapy using magnetic resonance (MR) vascular maps and apparent diffusion coefficient (ADC) at 3T. Materials and Methods Thirty-one patients with LABC who underwent breast MR studies before, after the first course, and after completing neoadjuvant chemotherapy were enrolled. Vascular morphology was retrieved via Hessian matrix and the voxels of the vessels and volume of vessels were measured automatically. Whole tumor mean ADC values were calculated. Clinical responders were defined as >50% tumor reduction in the final MR studies. Pathologically complete responders were also recorded. RESULTS There were 21 clinical responders and 10 nonresponders. Compared to the nonresponders after the first course, the responders were characterized by more vascular reduction of the breast lesion and decreased bilateral vascular discrepancy (voxels and volume), and increments in the ADC value and ADC percentage of the lesions (all P < 0.05). There were three pathological complete responders who showed more apparent early vascular reduction of the lesion breast (voxels and volume) and increments in the ADC value than others (P = 0.02, 0.01 and 0.02, respectively). CONCLUSION The early changes of MR vascular maps and ADC are associated with the final treatment response of LABC.
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Affiliation(s)
- Li-An Wu
- Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.,Department of Medical Imaging, Taipei City Hospital, Heping, Branch, Taipei, Taiwan
| | - Ruey-Feng Chang
- Department of Computer Science and Information Engineering, National Taiwan University, Taipei, Taiwan
| | - Chiun-Sheng Huang
- Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Yen-Shen Lu
- Department of Oncology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Hong-Hao Chen
- Department of Computer Science and Information Engineering, National Taiwan University, Taipei, Taiwan
| | - Jo-Yu Chen
- Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Yeun-Chung Chang
- Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
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135
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Ma WY, Hsiung LC, Wang CH, Chiang CL, Lin CH, Huang CS, Wo AM. A novel 96well-formatted micro-gap plate enabling drug response profiling on primary tumour samples. Sci Rep 2015; 5:9656. [PMID: 25866290 PMCID: PMC4394194 DOI: 10.1038/srep09656] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Accepted: 03/03/2015] [Indexed: 12/04/2022] Open
Abstract
Drug-based treatments are the most widely used interventions for cancer management. Personalized drug response profiling remains inherently challenging with low cell count harvested from tumour sample. We present a 96well-formatted microfluidic plate with built-in micro-gap that preserves up to 99.2% of cells during multiple assay/wash operation and only 9,000 cells needed for a single reagent test (i.e. 1,000 cells per test spot x 3 selected concentration x triplication), enabling drug screening and compatibility with conventional automated workstations. Results with MCF7 and MDA-MB-231 cell lines showed that no statistical significance was found in dose-response between the device and conventional 96-well plate control. Primary tumour samples from breast cancer patients tested in the device also showed good IC50 prediction. With drug screening of primary cancer cells must consider a wide range of scenarios, e.g. suspended/attached cell types and rare/abundant cell availability, the device enables high throughput screening even for suspended cells with low cell count since the signature microfluidic cell-trapping feature ensures cell preservation in a multiple solution exchange protocol.
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Affiliation(s)
- Wei-Yuan Ma
- Institute of Applied Mechanics, National Taiwan University, Taipei, Taiwan
| | - Lo-Chang Hsiung
- Institute of Applied Mechanics, National Taiwan University, Taipei, Taiwan
| | - Chen-Ho Wang
- Institute of Applied Mechanics, National Taiwan University, Taipei, Taiwan
| | - Chi-Ling Chiang
- Institute of Zoology, National Taiwan University, Taipei, Taiwan
| | - Ching-Hung Lin
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
| | - Chiun-Sheng Huang
- Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - Andrew M Wo
- Institute of Applied Mechanics, National Taiwan University, Taipei, Taiwan
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Lu YS, Chen TWW, Lin CH, Yeh DC, Tseng LM, Wu PF, Rau KM, Chen BB, Chao TC, Huang SM, Huang CS, Shih TTF, Cheng AL. Bevacizumab preconditioning followed by Etoposide and Cisplatin is highly effective in treating brain metastases of breast cancer progressing from whole-brain radiotherapy. Clin Cancer Res 2015; 21:1851-8. [PMID: 25700303 DOI: 10.1158/1078-0432.ccr-14-2075] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Accepted: 01/19/2015] [Indexed: 11/16/2022]
Abstract
PURPOSE We hypothesized that a window period between bevacizumab and cytotoxic agents may enhance drug delivery into tumor tissue through bevacizumab-induced vascular normalization in patients with brain metastases of breast cancer (BMBC). EXPERIMENTAL DESIGN A single-arm phase II study was conducted in which BMBC patients refractory to whole-brain radiotherapy (WBRT) were enrolled. In a 21-day cycle, patients received bevacizumab (15 mg/kg) on day 1, which, with a 1-day window period, was followed by etoposide (70 mg/m(2)/day; days 2-4) and cisplatin (70 mg/m(2); day 2; BEEP regimen). The BEEP regimen was administered for a maximum of 6 cycles. The primary endpoint was the central nervous system (CNS)-objective response rate according to volumetric response criteria. RESULTS A total of 35 patients were enrolled between January 2011 and January 2013. The median age was 54.3 years (range, 33-75); 19 patients (54.3%) had an Eastern Cooperative Oncology Group performance status of 2 or 3. Twenty-seven patients [77.1%; 95% confidence interval (CI), 59.9-89.6] achieved a CNS-objective response, including 13 patients (37.1%) with a ≥80% volumetric reduction of CNS lesions. With a median follow-up of 16.1 months, the median CNS progression-free survival and overall survival times were 7.3 months (95% CI, 6.5-8.1) and 10.5 months (95% CI, 7.8-13.2), respectively. Common grade 3 or 4 toxicities included neutropenia (30.8%) and infection (21.3%). CONCLUSIONS By administering bevacizumab 1 day before etoposide and cisplatin, the BEEP regimen appeared highly effective in BMBC refractory to WBRT. Further study of vascular normalization window concept is warranted.
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Affiliation(s)
- Yen-Shen Lu
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan. Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Tom Wei-Wu Chen
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
| | - Ching-Hung Lin
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan. Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Dah-Cherng Yeh
- Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Ling-Ming Tseng
- Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Pei-Fang Wu
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
| | - Kun-Ming Rau
- Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Bang-Bin Chen
- Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan
| | - Ta-Chung Chao
- Division of Hematology and Oncology, Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Shu-Min Huang
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
| | - Chiun-Sheng Huang
- Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | | | - Ann-Lii Cheng
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan. Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
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Chang YY, Kuo WH, Hung JH, Lee CY, Lee YH, Chang YC, Lin WC, Shen CY, Huang CS, Hsieh FJ, Lai LC, Tsai MH, Chang KJ, Chuang EY. Deregulated microRNAs in triple-negative breast cancer revealed by deep sequencing. Mol Cancer 2015; 14:36. [PMID: 25888956 PMCID: PMC4351690 DOI: 10.1186/s12943-015-0301-9] [Citation(s) in RCA: 88] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Accepted: 01/21/2015] [Indexed: 12/21/2022] Open
Abstract
Background MicroRNAs (miRNAs) are short, non-coding RNA molecules that play critical roles in human malignancy. However, the regulatory characteristics of miRNAs in triple-negative breast cancer, a phenotype of breast cancer that does not express the genes for estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2, are still poorly understood. Methods In this study, miRNA expression profiles of 24 triple-negative breast cancers and 14 adjacent normal tissues were analyzed using deep sequencing technology. Expression levels of miRNA reads were normalized with the quantile-quantile scaling method. Deregulated miRNAs in triple-negative breast cancer were identified from the sequencing data using the Student’s t-test. Quantitative reverse transcription PCR validations were carried out to examine miRNA expression levels. Potential target candidates of a miRNA were predicted using published target prediction algorithms. Luciferase reporter assay experiments were performed to verify a putative miRNA-target relationship. Validated molecular targets of the deregulated miRNAs were retrieved from curated databases and their associations with cancer progression were discussed. Results A novel 25-miRNA expression signature was found to effectively distinguish triple-negative breast cancers from surrounding normal tissues in a hierarchical clustering analysis. We documented the evidence of seven polycistronic miRNA clusters preferentially harboring deregulated miRNAs in triple-negative breast cancer. Two of these miRNA clusters (miR-143-145 at 5q32 and miR-497-195 at 17p13.1) were markedly down-regulated in triple-negative breast cancer, while the other five miRNA clusters (miR-17-92 at 13q31.3, miR-183-182 at 7q32.2, miR-200-429 at 1p36.33, miR-301b-130b at 22q11.21, and miR-532-502 at Xp11.23) were up-regulated in triple-negative breast cancer. Moreover, miR-130b-5p from the miR-301b-130b cluster was shown to directly repress the cyclin G2 (CCNG2) gene, a crucial cell cycle regulator, in triple-negative breast cancer cells. Luciferase reporter assays showed that miR-130b-5p-mediated repression of CCNG2 was dependent on the sequence of the 3′-untranslated region. The findings described in this study implicate a miR-130b-5p-CCNG2 axis that may be involved in the malignant progression of triple-negative breast cancer. Conclusions Our work delivers a clear picture of the global miRNA regulatory characteristics in triple-negative breast cancer and extends the current knowledge of microRNA regulatory network. Electronic supplementary material The online version of this article (doi:10.1186/s12943-015-0301-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yao-Yin Chang
- Department of Electrical Engineering, Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan.
| | - Wen-Hung Kuo
- Department of Surgery, College of Medicine, National Taiwan University, Taipei, Taiwan.
| | - Jui-Hui Hung
- Department of Electrical Engineering, Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan. .,Bioinformatics and Biostatistics Core, NTU Center of Genomic Medicine, Taipei, Taiwan.
| | - Chien-Yueh Lee
- Department of Electrical Engineering, Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan. .,Bioinformatics and Biostatistics Core, NTU Center of Genomic Medicine, Taipei, Taiwan.
| | - Yung-Hua Lee
- Bioinformatics and Biostatistics Core, NTU Center of Genomic Medicine, Taipei, Taiwan.
| | - Ya-Chu Chang
- Institute of Biotechnology, College of Bio-resources and Agriculture, National Taiwan University, Taipei, Taiwan.
| | - Wen-Chun Lin
- Institute of Biotechnology, College of Bio-resources and Agriculture, National Taiwan University, Taipei, Taiwan.
| | - Cheng-Ying Shen
- Institute of Biotechnology, College of Bio-resources and Agriculture, National Taiwan University, Taipei, Taiwan.
| | - Chiun-Sheng Huang
- Department of Surgery, College of Medicine, National Taiwan University, Taipei, Taiwan.
| | - Fon-Jou Hsieh
- Department of Obstetrics and Gynecology, College of Medicine, National Taiwan University, Taipei, Taiwan.
| | - Liang-Chuan Lai
- Department of Physiology, College of Medicine, National Taiwan University, Taipei, Taiwan.
| | - Mong-Hsun Tsai
- Institute of Biotechnology, College of Bio-resources and Agriculture, National Taiwan University, Taipei, Taiwan.
| | - King-Jen Chang
- Department of Surgery, College of Medicine, National Taiwan University, Taipei, Taiwan. .,Department of Surgery, Cheng Ching General Hospital, Taichung, Taiwan.
| | - Eric Y Chuang
- Department of Electrical Engineering, Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan. .,Bioinformatics and Biostatistics Core, NTU Center of Genomic Medicine, Taipei, Taiwan.
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Huang CS, Dutkowski K, Fuller A, Walton K. Evaluation of a pilot volunteer feeding assistance program: influences on the dietary intakes of elderly hospitalised patients and lessons learnt. J Nutr Health Aging 2015; 19:206-10. [PMID: 25651447 DOI: 10.1007/s12603-014-0529-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVES Malnutrition is a serious concern in hospitals and is known to be associated with increased complications for patients, increased hospital costs and length of stay. Trained volunteers that assist 'at risk' and malnourished patients at lunch meals have been shown to effectively increase nutritional intake in a suburban hospital in Sydney. The pilot study reported here aimed to evaluate and share learnings from a similar, newly implemented program, comparing energy and macronutrient intakes on days with no volunteer assistance, to days with volunteers. DESIGN Dietary intakes were determined by visual estimation of meal trays before and after meals, for two days without volunteers, and two days with volunteer assistance at lunch. Macronutrient and energy intakes were compared and data such as weight, height, diet type and medical history were obtained from medical records. Questionnaires were completed by nurses and volunteers in regards to their views and experiences with the program. SETTING Hospital based. RESULTS Eight patients (83±4.5 years) participated in the study. When volunteers were present at lunch, the average macronutrient and energy intakes increased, though not statistically significantly. The mean increases were 316 kJ (p=0.175) for energy, 3.1 g (p=0.468) for protein, 1.4 g (p=0.418) for fat and 11.6 g (p=0.084) for carbohydrates. Non-significant increases in macronutrients were also noted for the average daily intakes. CONCLUSION Although not statistically significant, energy and macronutrient intakes increased when volunteers were present. The implementation of a volunteer feeding assistance program is one strategy to assist dietary intakes but requires a ready team of volunteers, training, acceptance and significant time to develop.
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Affiliation(s)
- C S Huang
- Dr Karen Walton, School of Medicine University of Wollongong, NSW, Australia 2522, tel +61+2-4221 5197,
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139
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Chen TWW, Chen HM, Lin CH, Huang CS, Cheng AL, Lai MS, Lu YS. No increased venous thromboembolism risk in Asian breast cancer patients receiving adjuvant tamoxifen. Breast Cancer Res Treat 2014; 148:135-42. [PMID: 25240736 DOI: 10.1007/s10549-014-3140-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Accepted: 09/16/2014] [Indexed: 11/25/2022]
Abstract
Tamoxifen is an effective endocrine treatment for early breast cancer (EBC) but increases the risk of venous thromboembolism. Whether Asian EBC patients (pts) bear the same risk when treated with adjuvant tamoxifen is uncertain. EBC pts diagnosed between 2004 and 2009 were selected from a population database in Taiwan. The pts were followed up from the index date to December 31, 2011 to collect events of deep vein thrombosis (DVT) and pulmonary embolism (PE). Cumulative incidence rates and hazard ratios (HRs) were used to compare the risk between pts treated with and without tamoxifen. In addition, comorbidities were included in an adjusted model of the risk of DVT and PE. A total of 28,029 EBC pts, including 17,843 (63.8 %) in the tamoxifen group and 10,155 (36.2 %) in the nontamoxifen group, were analyzed. The 7-year cumulative incidence rates for DVT and PE were 2.58 and 0.32 % in the tamoxifen group and 2.51 and 0.32 % in the nontamoxifen group (P = 0.92 for DVT, P = 0. 65 for PE), respectively. The HR for the nonadjusted and adjusted models showed no differences in DVT and PE risks between the tamoxifen and nontamoxifen groups. The uterine cancer risk was significantly increased in the pts receiving tamoxifen (adjusted HR = 2.79, P < 0.001), suggesting tamoxifen compliance. The risks of developing DVT and PE are not increased in Asian EBC pts receiving adjuvant tamoxifen. Ethnicity differences should be considered when discussing optimal endocrine treatments with EBC pts.
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Affiliation(s)
- Tom Wei-Wu Chen
- Department of Oncology, National Taiwan University Hospital, 7, Chung-Shan South Rd., Taipei, 10002, Taiwan
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140
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de Azambuja E, Holmes AP, Piccart-Gebhart M, Holmes E, Di Cosimo S, Swaby RF, Untch M, Jackisch C, Lang I, Smith I, Boyle F, Xu B, Barrios CH, Perez EA, Azim HA, Kim SB, Kuemmel S, Huang CS, Vuylsteke P, Hsieh RK, Gorbunova V, Eniu A, Dreosti L, Tavartkiladze N, Gelber RD, Eidtmann H, Baselga J. Lapatinib with trastuzumab for HER2-positive early breast cancer (NeoALTTO): survival outcomes of a randomised, open-label, multicentre, phase 3 trial and their association with pathological complete response. Lancet Oncol 2014; 15:1137-46. [DOI: 10.1016/s1470-2045(14)70320-1] [Citation(s) in RCA: 260] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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141
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Chang YC, Huang YS, Huang CS, Chen JH, Chang RF. Intrinsic subtypes and tumor grades in breast cancer are associated with distinct 3-D power Doppler sonographic vascular features. Eur J Radiol 2014; 83:1368-74. [DOI: 10.1016/j.ejrad.2014.05.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2013] [Revised: 04/07/2014] [Accepted: 05/02/2014] [Indexed: 10/25/2022]
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142
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Lo CM, Chen YP, Chang YC, Lo C, Huang CS, Chang RF. Computer-Aided Strain Evaluation for Acoustic Radiation Force Impulse Imaging of Breast Masses. Ultrason Imaging 2014; 36:151-166. [PMID: 24894867 DOI: 10.1177/0161734613520599] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Acoustic radiation force impulse (ARFI) is a newly developed elastography technique that uses acoustic radiation force to provide additional stiffness information to conventional sonography. A computer-aided diagnosis (CAD) system was proposed to automatically specify the tumor boundaries in ARFI images and quantify the statistical stiffness information to reduce user dependence. The level-set segmentation was used to delineate tumor boundaries in B-mode images, and the segmented boundaries were then mapped to the corresponding area in ARFI images for a gray-scale calculation. A total of 61 benign and 51 malignant tumors were evaluated in the experiment. The CAD system based on the proposed ARFI features achieved an accuracy of 80% (90/112), a sensitivity of 80% (41/51), and a specificity of 80% (49/61), which is significantly better than that of the quantitative B-mode features (p < 0.05). The ARFI features were further combined with the B-mode features, including shape and texture features, to further improve performance (area under the curve [AUC], 0.90 vs. 0.86). In conclusion, the CAD system based on the proposed ARFI features is a promising and efficient diagnostic method.
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Affiliation(s)
- Chung-Ming Lo
- Department of Computer Science and Information Engineering, National Taiwan University, Taipei, Taiwan, Republic of China
| | - Yen-Po Chen
- Department of Computer Science and Information Engineering, National Taiwan University, Taipei, Taiwan, Republic of China
| | - Yeun-Chung Chang
- Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan, Republic of China
| | - Chiao Lo
- Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan, Republic of China
| | - Chiun-Sheng Huang
- Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan, Republic of China
| | - Ruey-Feng Chang
- Department of Computer Science and Information Engineering, National Taiwan University, Taipei, Taiwan, Republic of China Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan, Republic of China
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143
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Lo CM, Chen RT, Chang YC, Yang YW, Hung MJ, Huang CS, Chang RF. Multi-dimensional tumor detection in automated whole breast ultrasound using topographic watershed. IEEE Trans Med Imaging 2014; 33:1503-1511. [PMID: 24718570 DOI: 10.1109/tmi.2014.2315206] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Automated whole breast ultrasound (ABUS) is becoming a popular screening modality for whole breast examination. Compared to conventional handheld ultrasound, ABUS achieves operator-independent and is feasible for mass screening. However, reviewing hundreds of slices in an ABUS image volume is time-consuming. A computer-aided detection (CADe) system based on watershed transform was proposed in this study to accelerate the reviewing. The watershed transform was applied to gather similar tissues around local minima to be homogeneous regions. The likelihoods of being tumors of the regions were estimated using the quantitative morphology, intensity, and texture features in the 2-D/3-D false positive reduction (FPR). The collected database comprised 68 benign and 65 malignant tumors. As a result, the proposed system achieved sensitivities of 100% (133/133), 90% (121/133), and 80% (107/133) with FPs/pass of 9.44, 5.42, and 3.33, respectively. The figure of merit of the combination of three feature sets is 0.46 which is significantly better than that of other feature sets ( [Formula: see text]). In summary, the proposed CADe system based on the multi-dimensional FPR using the integrated feature set is promising in detecting tumors in ABUS images.
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144
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Lo C, Lee PC, Yen RF, Huang CS. Most frequent location of the sentinel lymph nodes. Asian J Surg 2014; 37:125-9. [DOI: 10.1016/j.asjsur.2014.01.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2013] [Revised: 09/26/2013] [Accepted: 01/14/2014] [Indexed: 11/15/2022] Open
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145
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Chang YC, Huang YH, Huang CS, Chen JH, Chang RF. Computerized breast lesions detection using kinetic and morphologic analysis for dynamic contrast-enhanced MRI. Magn Reson Imaging 2014; 32:514-22. [DOI: 10.1016/j.mri.2014.01.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Revised: 12/02/2013] [Accepted: 01/13/2014] [Indexed: 10/25/2022]
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Johnson N, Dudbridge F, Orr N, Gibson L, Jones ME, Schoemaker MJ, Folkerd EJ, Haynes BP, Hopper JL, Southey MC, Dite GS, Apicella C, Schmidt MK, Broeks A, Van't Veer LJ, Atsma F, Muir K, Lophatananon A, Fasching PA, Beckmann MW, Ekici AB, Renner SP, Sawyer E, Tomlinson I, Kerin M, Miller N, Burwinkel B, Marme F, Schneeweiss A, Sohn C, Guénel P, Truong T, Cordina E, Menegaux F, Bojesen SE, Nordestgaard BG, Flyger H, Milne R, Zamora MP, Arias Perez JI, Benitez J, Bernstein L, Anton-Culver H, Ziogas A, Clarke Dur C, Brenner H, Müller H, Arndt V, Dieffenbach AK, Meindl A, Heil J, Bartram CR, Schmutzler RK, Brauch H, Justenhoven C, Ko YD, Nevanlinna H, Muranen TA, Aittomäki K, Blomqvist C, Matsuo K, Dörk T, Bogdanova NV, Antonenkova NN, Lindblom A, Mannermaa A, Kataja V, Kosma VM, Hartikainen JM, Chenevix-Trench G, Beesley J, Wu AH, Van den Berg D, Tseng CC, Lambrechts D, Smeets D, Neven P, Wildiers H, Chang-Claude J, Rudolph A, Nickels S, Flesch-Janys D, Radice P, Peterlongo P, Bonanni B, Pensotti V, Couch FJ, Olson JE, Wang X, Fredericksen Z, Pankratz VS, Giles GG, Severi G, Baglietto L, Haiman C, Simard J, Goldberg MS, Labrèche F, Dumont M, Soucy P, Teo S, Yip CH, Phuah SY, Cornes BK, Kristensen VN, Grenaker Alnæs G, Børresen-Dale AL, Zheng W, Winqvist R, Pylkäs K, Jukkola-Vuorinen A, Grip M, Andrulis IL, Knight JA, Glendon G, Mulligan AM, Devillee P, Figueroa J, Chanock SJ, Lissowska J, Sherman ME, Hall P, Schoof N, Hooning M, Hollestelle A, Oldenburg RA, Tilanus-Linthorst M, Liu J, Cox A, Brock IW, Reed MWR, Cross SS, Blot W, Signorello LB, Pharoah PDP, Dunning AM, Shah M, Kang D, Noh DY, Park SK, Choi JY, Hartman M, Miao H, Lim WY, Tang A, Hamann U, Försti A, Rüdiger T, Ulmer HU, Jakubowska A, Lubinski J, Jaworska-Bieniek K, Durda K, Sangrajrang S, Gaborieau V, Brennan P, McKay J, Slager S, Toland AE, Vachon C, Yannoukakos D, Shen CY, Yu JC, Huang CS, Hou MF, González-Neira A, Tessier DC, Vincent D, Bacot F, Luccarini C, Dennis J, Michailidou K, Bolla MK, Wang J, Easton DF, García-Closas M, Dowsett M, Ashworth A, Swerdlow AJ, Peto J, dos Santos Silva I, Fletcher O. Genetic variation at CYP3A is associated with age at menarche and breast cancer risk: a case-control study. Breast Cancer Res 2014; 16:R51. [PMID: 24887515 PMCID: PMC4522594 DOI: 10.1186/bcr3662] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2013] [Accepted: 04/24/2014] [Indexed: 01/15/2023] Open
Abstract
INTRODUCTION We have previously shown that a tag single nucleotide polymorphism (rs10235235), which maps to the CYP3A locus (7q22.1), was associated with a reduction in premenopausal urinary estrone glucuronide levels and a modest reduction in risk of breast cancer in women age ≤50 years. METHODS We further investigated the association of rs10235235 with breast cancer risk in a large case control study of 47,346 cases and 47,570 controls from 52 studies participating in the Breast Cancer Association Consortium. Genotyping of rs10235235 was conducted using a custom Illumina Infinium array. Stratified analyses were conducted to determine whether this association was modified by age at diagnosis, ethnicity, age at menarche or tumor characteristics. RESULTS We confirmed the association of rs10235235 with breast cancer risk for women of European ancestry but found no evidence that this association differed with age at diagnosis. Heterozygote and homozygote odds ratios (ORs) were OR = 0.98 (95% CI 0.94, 1.01; P = 0.2) and OR = 0.80 (95% CI 0.69, 0.93; P = 0.004), respectively (P(trend) = 0.02). There was no evidence of effect modification by tumor characteristics. rs10235235 was, however, associated with age at menarche in controls (P(trend) = 0.005) but not cases (P(trend) = 0.97). Consequently the association between rs10235235 and breast cancer risk differed according to age at menarche (P(het) = 0.02); the rare allele of rs10235235 was associated with a reduction in breast cancer risk for women who had their menarche age ≥15 years (OR(het) = 0.84, 95% CI 0.75, 0.94; OR(hom) = 0.81, 95% CI 0.51, 1.30; P(trend) = 0.002) but not for those who had their menarche age ≤11 years (OR(het) = 1.06, 95% CI 0.95, 1.19, OR(hom) = 1.07, 95% CI 0.67, 1.72; P(trend) = 0.29). CONCLUSIONS To our knowledge rs10235235 is the first single nucleotide polymorphism to be associated with both breast cancer risk and age at menarche consistent with the well-documented association between later age at menarche and a reduction in breast cancer risk. These associations are likely mediated via an effect on circulating hormone levels.
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Affiliation(s)
- Nichola Johnson
- Breakthrough Breast Cancer Research Centre, The Institute of Cancer Research, 237 Fulham Road, London, SW3 6JB, UK.
- Division of Breast Cancer Research, The Institute of Cancer Research, 237 Fulham Road, London, SW3 6JB, UK.
| | - Frank Dudbridge
- Non-communicable Disease Epidemiology Department, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
| | - Nick Orr
- Breakthrough Breast Cancer Research Centre, The Institute of Cancer Research, 237 Fulham Road, London, SW3 6JB, UK.
- Division of Breast Cancer Research, The Institute of Cancer Research, 237 Fulham Road, London, SW3 6JB, UK.
| | - Lorna Gibson
- Non-communicable Disease Epidemiology Department, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
| | - Michael E Jones
- Division of Genetics and Epidemiology, The Institute of Cancer Research, 15 Cotswold Road, Belmont, Sutton, Surrey, SM2 5NG, UK.
| | - Minouk J Schoemaker
- Division of Genetics and Epidemiology, The Institute of Cancer Research, 15 Cotswold Road, Belmont, Sutton, Surrey, SM2 5NG, UK.
| | - Elizabeth J Folkerd
- The Academic Department of Biochemistry, The Royal Marsden Hospital, Fulham Road, London, SW3 6JJ, UK.
| | - Ben P Haynes
- The Academic Department of Biochemistry, The Royal Marsden Hospital, Fulham Road, London, SW3 6JJ, UK.
| | - John L Hopper
- Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, University of Melbourne, 1-100 Gratton Street, Parkville, Melbourne, Victoria, 3010, Australia.
| | - Melissa C Southey
- Genetic Epidemiology Department, Department of Pathology, The University of Melbourne, 1-100 Gratton Street, Parkville, Melbourne, Victoria, 3010, Australia.
| | - Gillian S Dite
- Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, University of Melbourne, 1-100 Gratton Street, Parkville, Melbourne, Victoria, 3010, Australia.
| | - Carmel Apicella
- Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, University of Melbourne, 1-100 Gratton Street, Parkville, Melbourne, Victoria, 3010, Australia.
| | - Marjanka K Schmidt
- Division of Molecular Pathology, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066CX, Amsterdam, The Netherlands.
| | - Annegien Broeks
- Division of Molecular Pathology, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066CX, Amsterdam, The Netherlands.
| | - Laura J Van't Veer
- Division of Molecular Pathology, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066CX, Amsterdam, The Netherlands.
| | - Femke Atsma
- Sanquin, Radboud Universiteit Nijmegen, 6525 GA, Nijmegen, The Netherlands.
| | - Kenneth Muir
- Warwick Medical School, University of Warwick, Coventry, CV4 7AJ, UK.
| | | | - Peter A Fasching
- University Breast Center, Department of Gynecology and Obstetrics, University Hospital Erlangen, Postfach 2306, D-91012, Erlangen, Germany.
- David Geffen School of Medicine, Department of Medicine, Division of Hematology and Oncology, University of California, 10833 Le Conte Avenue, Los Angeles, CA, 90095, USA.
| | - Matthias W Beckmann
- University Breast Center, Department of Gynecology and Obstetrics, University Hospital Erlangen, Postfach 2306, D-91012, Erlangen, Germany.
| | - Arif B Ekici
- Institute of Human Genetics, Friedrich Alexander University Erlangen- Nuremberg, Schlossplatz 4, 91054, Erlangen, Germany.
| | - Stefan P Renner
- University Breast Center, Department of Gynecology and Obstetrics, University Hospital Erlangen, Postfach 2306, D-91012, Erlangen, Germany.
| | - Elinor Sawyer
- Division of Cancer Studies, NIHR Comprehensive Biomedical Research Centre, Guy's & St. Thomas' NHS Foundation Trust in partnership with King's College London, Guy's Hospital, Great Maze Pond, London, SE1 9RT, UK.
| | - Ian Tomlinson
- Welcome Trust Centre for Human Genetics, University of Oxford, Roosevelt Drive, Oxford, OX3 7BN, UK.
- Oxford Biomedical Research Centre, University of Oxford, The Churchill Hospital, Old Road, Headington, OX3 7LE, Oxford, UK.
| | - Michael Kerin
- Surgery, Clinical Science Institute, Galway University Hospital and National University of Ireland, University Road, Galway, Ireland.
| | - Nicola Miller
- Surgery, Clinical Science Institute, Galway University Hospital and National University of Ireland, University Road, Galway, Ireland.
| | - Barbara Burwinkel
- Department of Obstetrics and Gynecology, University of Heidelberg, Vosstrasse 9, 69115, Heidelberg, Germany.
- Unit Molecular Epidemiology C080, German Cancer Research Center, DKFZ, Im Neuenheimer Feld 280, 69120, Heidelberg, Germany.
| | - Frederik Marme
- Department of Obstetrics and Gynecology, University of Heidelberg, Vosstrasse 9, 69115, Heidelberg, Germany.
| | - Andreas Schneeweiss
- Department of Obstetrics and Gynecology, University of Heidelberg, Vosstrasse 9, 69115, Heidelberg, Germany.
| | - Christof Sohn
- Department of Obstetrics and Gynecology, University of Heidelberg, Vosstrasse 9, 69115, Heidelberg, Germany.
- National Center for Tumor Diseases, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
| | - Pascal Guénel
- Inserm (National Institute of Health and Medical Research), CESP (Center for Research in Epidemiology and Population Health), U1018, Environmental Epidemiology of Cancer, 101 rue de Tolbiac, Villejuif, 75654, Paris, France.
- University Paris-Sud, UMRS 1018, 101 rue de Tolbiac, Villejuif, 75654, Paris, France.
| | - Therese Truong
- Inserm (National Institute of Health and Medical Research), CESP (Center for Research in Epidemiology and Population Health), U1018, Environmental Epidemiology of Cancer, 101 rue de Tolbiac, Villejuif, 75654, Paris, France.
- University Paris-Sud, UMRS 1018, 101 rue de Tolbiac, Villejuif, 75654, Paris, France.
| | - Emilie Cordina
- Inserm (National Institute of Health and Medical Research), CESP (Center for Research in Epidemiology and Population Health), U1018, Environmental Epidemiology of Cancer, 101 rue de Tolbiac, Villejuif, 75654, Paris, France.
- University Paris-Sud, UMRS 1018, 101 rue de Tolbiac, Villejuif, 75654, Paris, France.
| | - Florence Menegaux
- Inserm (National Institute of Health and Medical Research), CESP (Center for Research in Epidemiology and Population Health), U1018, Environmental Epidemiology of Cancer, 101 rue de Tolbiac, Villejuif, 75654, Paris, France.
- University Paris-Sud, UMRS 1018, 101 rue de Tolbiac, Villejuif, 75654, Paris, France.
| | - Stig E Bojesen
- Copenhagen General Population Study, Herlev Hospital, Copenhagen University Hospital, Herlev Rinvej 75, 2730, Herlev, Copenhagen, Denmark.
- Department of Clinical Biochemistry, Herlev Hospital, Copenhagen University Hospital, Herlev Rinvej 75, 2730, Herlev, Copenhagen, Denmark.
| | - Børge G Nordestgaard
- Copenhagen General Population Study, Herlev Hospital, Copenhagen University Hospital, Herlev Rinvej 75, 2730, Herlev, Copenhagen, Denmark.
- Department of Clinical Biochemistry, Herlev Hospital, Copenhagen University Hospital, Herlev Rinvej 75, 2730, Herlev, Copenhagen, Denmark.
| | - Henrik Flyger
- Department of Breast Surgery, Herlev Hospital, Copenhagen University Hospital, Herlev Rinvej 75, Herlev, 2730, Copenhagen, Denmark.
| | - Roger Milne
- Genetic and Molecular Epidemiology Group, Human Cancer Genetics Program, Spanish National Cancer Research Centre (CNIO), Calle de Melchor Fernandez Almagro, 3, 28029, Madrid, Spain.
| | - M Pilar Zamora
- Servicio de Oncología Médica, Hospital Universitario La Paz, Paseo de la Castellana, 261, 28046, Madrid, Spain.
| | - Jose Ignacio Arias Perez
- Servicio de Cirugía General y Especialidades, Hospital Monte Naranco, Avda. Dres. Fernández Vega, 107, Oviedo, Spain.
| | - Javier Benitez
- Human Genotyping-CEGEN Unit, Human Cancer Genetics Program, Spanish National Cancer Research Centre (CNIO), Calle de Melchor Fernandez Almagro, 3, 28029, Madrid, Spain.
- Centro de Investigación en Red de Enfermedades Raras (CIBERER), Calle de Melchor Fernandez Almagro, 3, 28029, Madrid, Spain.
| | - Leslie Bernstein
- Division of Cancer Etiology, Department of Population Sciences, Beckman Research Institute of the City of Hope, Duarte, CA, USA.
| | - Hoda Anton-Culver
- Department of Epidemiology, School of Medicine, University of California Irvine, 224 Irvine Hall, Irvine, California, 92697-7550, USA.
| | - Argyrios Ziogas
- Department of Epidemiology, School of Medicine, University of California Irvine, 224 Irvine Hall, Irvine, California, 92697-7550, USA.
| | - Christina Clarke Dur
- Cancer Prevention Institute of California, 2201 Walnut Avenue, Suite 300, Fremont, California, 95438, USA.
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Im Neuenheimer Feld 280, 69121, Heidelberg, Germany.
- German Cancer Consortium (DKTK), Im Neuenheimer Feld 280, 69121, Heidelberg, Germany.
| | - Heiko Müller
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Im Neuenheimer Feld 280, 69121, Heidelberg, Germany.
| | - Volker Arndt
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Im Neuenheimer Feld 280, 69121, Heidelberg, Germany.
| | - Aida Karina Dieffenbach
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Im Neuenheimer Feld 280, 69121, Heidelberg, Germany.
- German Cancer Consortium (DKTK), Im Neuenheimer Feld 280, 69121, Heidelberg, Germany.
| | - Alfons Meindl
- Clinic of Gynecology and Obstetrics, Division of Tumor Genetics, Klinikum rechts der Isar, Technical University Munich, Ismaninger Strasse 22, D-81675, Munich, Germany.
| | - Joerg Heil
- Department of Obstetrics and Gynecology, University of Heidelberg, Vosstrasse 9, 69115, Heidelberg, Germany.
| | - Claus R Bartram
- Institute of Human Genetics, University of Heidelberg, Im Neuenheimer Feld 366, 69121, Heidelberg, Germany.
| | - Rita K Schmutzler
- Division of Molecular Gyneco-Oncology, Department of Gynaecology and Obstetrics, Center of Molecular Medicine Cologne (CMMC), University Hospital of Cologne, ZMMK-Forschungsgebäude, Robert-Koch-Strasse 21, 50931, Cologne, Germany.
| | - Hiltrud Brauch
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Robert Bosch Stiftung GmbH, Heidehofstrasse 31, 70184, Stuttgart, Germany.
- University of Tübingen, Geschwister-Scholl-Platz, 72074, Tübingen, Germany.
| | - Christina Justenhoven
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Robert Bosch Stiftung GmbH, Heidehofstrasse 31, 70184, Stuttgart, Germany.
- University of Tübingen, Geschwister-Scholl-Platz, 72074, Tübingen, Germany.
| | - Yon-Dschun Ko
- Department of Internal Medicine, Evangelische Kliniken Bonn GGmbH, Johanniter Krankenhaus, 53113, Bonn, Germany.
| | - Heli Nevanlinna
- Department of Obstetrics and Gynecology, Helsinki University Central Hospital, University of Helsinki, Haartmaninkatu 2, P.O. Box 140, FIN-00029, Helsinki, Finland.
| | - Taru A Muranen
- Department of Obstetrics and Gynecology, Helsinki University Central Hospital, University of Helsinki, Haartmaninkatu 2, P.O. Box 140, FIN-00029, Helsinki, Finland.
| | - Kristiina Aittomäki
- Department of Clinical Genetics, Helsinki University Central Hospital, Haartmaninkatu 2, P.O. Box 140, FIN-00029, Helsinki, Finland.
| | - Carl Blomqvist
- Department of Oncology, Helsinki University Central Hospital, Haartmaninkatu 2, P.O. Box 140, FIN-00029, Helsinki, Finland.
| | - Keitaro Matsuo
- Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, 1-1Kanokoden, Chikusa-ku, Nagoya, 464-8681, Japan.
| | - Thilo Dörk
- Department of Obstetrics and Gynaecology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
| | - Natalia V Bogdanova
- Department of Radiation Oncology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
| | - Natalia N Antonenkova
- N.N. Alexandrov Research Institute of Oncology and Medical Radiology, 223040, p. Lesnoy, Minsk, Belarus.
| | - Annika Lindblom
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Solnavägen 1, 171 77, Solna, Stockholm, Sweden.
| | - Arto Mannermaa
- School of Medicine, Institute of Clinical Medicine, Pathology and Forensic Medicine, University of Eastern Finland, Yliopistonranta 1, P.O. Box 1627, FI-70211, Kuopio, Finland.
- Biocenter Kuopio, Cancer Center of Eastern Finland, University of Eastern Finland, Yliopistonranta 1, P.O. Box 1627, FI-70211, Kuopio, Finland.
- Imaging Center, Department of Clinical Pathology, Kuopio University Hospital, P.O. Box 100, FI-70029, Kuopio, Finland.
| | - Vesa Kataja
- School of Medicine, Institute of Clinical Medicine, Pathology and Forensic Medicine, University of Eastern Finland, Yliopistonranta 1, P.O. Box 1627, FI-70211, Kuopio, Finland.
- Biocenter Kuopio, Cancer Center of Eastern Finland, University of Eastern Finland, Yliopistonranta 1, P.O. Box 1627, FI-70211, Kuopio, Finland.
- Imaging Center, Department of Clinical Pathology, Kuopio University Hospital, P.O. Box 100, FI-70029, Kuopio, Finland.
| | - Veli-Matti Kosma
- School of Medicine, Institute of Clinical Medicine, Pathology and Forensic Medicine, University of Eastern Finland, Yliopistonranta 1, P.O. Box 1627, FI-70211, Kuopio, Finland.
- Biocenter Kuopio, Cancer Center of Eastern Finland, University of Eastern Finland, Yliopistonranta 1, P.O. Box 1627, FI-70211, Kuopio, Finland.
- Imaging Center, Department of Clinical Pathology, Kuopio University Hospital, P.O. Box 100, FI-70029, Kuopio, Finland.
| | - Jaana M Hartikainen
- School of Medicine, Institute of Clinical Medicine, Pathology and Forensic Medicine, University of Eastern Finland, Yliopistonranta 1, P.O. Box 1627, FI-70211, Kuopio, Finland.
- Biocenter Kuopio, Cancer Center of Eastern Finland, University of Eastern Finland, Yliopistonranta 1, P.O. Box 1627, FI-70211, Kuopio, Finland.
- Imaging Center, Department of Clinical Pathology, Kuopio University Hospital, P.O. Box 100, FI-70029, Kuopio, Finland.
| | - Georgia Chenevix-Trench
- Department of Genetics, Queensland Institute of Medical Research, 300 Herston Rd, Herston, Brisbane Queensland, 4006, Australia.
| | - Jonathan Beesley
- Department of Genetics, Queensland Institute of Medical Research, 300 Herston Rd, Herston, Brisbane Queensland, 4006, Australia.
| | - Anna H Wu
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 1975 Zonal Ave, Los Angeles, CA, 90033, USA.
| | - David Van den Berg
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 1975 Zonal Ave, Los Angeles, CA, 90033, USA.
| | - Chiu-Chen Tseng
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 1975 Zonal Ave, Los Angeles, CA, 90033, USA.
| | - Diether Lambrechts
- Laboratory for Translational Genetics, Department of Oncology, University of Leuven, Oude Markt 13 - bus 5005, 3000, Leuven, Belgium.
- Vesalius Research Center, VIB, Herestraat 49, box 912, Onderwijs & Navorsing 4, Building 404-24, 3000, Leuven, Belgium.
| | - Dominiek Smeets
- Laboratory for Translational Genetics, Department of Oncology, University of Leuven, Oude Markt 13 - bus 5005, 3000, Leuven, Belgium.
- Vesalius Research Center, VIB, Herestraat 49, box 912, Onderwijs & Navorsing 4, Building 404-24, 3000, Leuven, Belgium.
| | - Patrick Neven
- Multidisciplinary Breast Center, University Hospital Gasthuisberg, Herestraat 49, 3000, Leuven, Belgium.
| | - Hans Wildiers
- Multidisciplinary Breast Center, University Hospital Gasthuisberg, Herestraat 49, 3000, Leuven, Belgium.
| | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany.
| | - Anja Rudolph
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany.
| | - Stefan Nickels
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany.
| | - Dieter Flesch-Janys
- Department of Cancer Epidemiology/Clinical Cancer Registry, University Clinic Hamburg-Eppendorf, Martinistrasse 52, D - 20246, Hamburg, Germany.
- Institute for Medical Biometrics and Epidemiology, University Clinic Hamburg-Eppendorf, Martinistrasse 52, D - 20246, Hamburg, Germany.
| | - Paolo Radice
- Unit of Molecular Bases of Genetic Risk and Genetic Testing, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Via Venezian 1, 20133, Milan, Italy.
| | - Paolo Peterlongo
- Unit of Molecular Bases of Genetic Risk and Genetic Testing, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Via Venezian 1, 20133, Milan, Italy.
- IFOM, Fondazione Istituto FIRC di Oncologia Molecolare, Via Adamello 16, 20139, Milan, Italy.
| | - Bernardo Bonanni
- Division of Cancer Prevention and Genetics, Istituto Europeo di Oncologia (IEO), Via Giuseppe Ripamonti 435, 20141, Milan, Italy.
| | - Valeria Pensotti
- IFOM, Fondazione Istituto FIRC di Oncologia Molecolare, Via Adamello 16, 20139, Milan, Italy.
- Cogentech Cancer Genetic Test Laboratory, IFOM-IEO Campus, Via Adamello16, 20139, Milan, Italy.
| | - Fergus J Couch
- Department of Laboratory Medicine and Pathology, Division of Experimental Pathology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
| | - Janet E Olson
- Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
| | - Xianshu Wang
- Department of Laboratory Medicine and Pathology, Division of Experimental Pathology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
| | - Zachary Fredericksen
- Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
| | - Vernon S Pankratz
- Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
| | - Graham G Giles
- Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, University of Melbourne, 1-100 Gratton Street, Parkville, Melbourne, Victoria, 3010, Australia.
- Cancer Epidemiology Centre, The Cancer Council Victoria, 615 St Kilda Road, Melbourne, Victoria, 3004, Australia.
| | - Gianluca Severi
- Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, University of Melbourne, 1-100 Gratton Street, Parkville, Melbourne, Victoria, 3010, Australia.
- Cancer Epidemiology Centre, The Cancer Council Victoria, 615 St Kilda Road, Melbourne, Victoria, 3004, Australia.
| | - Laura Baglietto
- Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, University of Melbourne, 1-100 Gratton Street, Parkville, Melbourne, Victoria, 3010, Australia.
- Cancer Epidemiology Centre, The Cancer Council Victoria, 615 St Kilda Road, Melbourne, Victoria, 3004, Australia.
| | - Chris Haiman
- Laboratory for Translational Genetics, Department of Oncology, University of Leuven, Oude Markt 13 - bus 5005, 3000, Leuven, Belgium.
| | - Jacques Simard
- Department of Medicine, McGill University and Division of Clinical Epidemiology, McGill University Health Centre, Royal Victoria Hospital, 687 Pine Avenue West, Montréal, Québec, H3A 1A1, Canada.
| | - Mark S Goldberg
- Department of Medicine, McGill University and Division of Clinical Epidemiology, McGill University Health Centre, Royal Victoria Hospital, 687 Pine Avenue West, Montréal, Québec, H3A 1A1, Canada.
| | - France Labrèche
- Department of Social and Preventive Medicine and Department of Environmental and Occupational Health at Work, University of Montréal, Marguerite d'Youville Pavilion, 2375 Côte Ste-Catherine, Suite 4095, Montréal, Québec, H3T 1A8, Canada.
| | - Martine Dumont
- Cancer Genomics Laboratory, Centre Hospitalier Universitaire de Québec Research Center and Laval University, 2325 Rue de l'Université, Québec City, Québec, G1V 0A6, Canada.
| | - Penny Soucy
- Cancer Genomics Laboratory, Centre Hospitalier Universitaire de Québec Research Center and Laval University, 2325 Rue de l'Université, Québec City, Québec, G1V 0A6, Canada.
| | - Soo Teo
- Breast Cancer Research Unit, University of Malaya Cancer Research Institute, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
- Cancer Research Initiatives Foundation, Sime Darby Medical Centre Subang Jaya, 1, Jalan SS 12 / 1A, 47500, Subang Jaya, Selangor Darul Ehsan, Malaysia.
| | - Cheng Har Yip
- Breast Cancer Research Unit, University of Malaya Cancer Research Institute, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
| | - Sze Yee Phuah
- Breast Cancer Research Unit, University of Malaya Cancer Research Institute, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
- Cancer Research Initiatives Foundation, Sime Darby Medical Centre Subang Jaya, 1, Jalan SS 12 / 1A, 47500, Subang Jaya, Selangor Darul Ehsan, Malaysia.
| | - Belinda K Cornes
- Singapore Eye Research Institute, National University of Singapore, Singapore National Eye Centre, 11 Third Hospital Avenue, Singapore, 168751, Singapore.
| | - Vessela N Kristensen
- Department of Genetics, Institute for Cancer Research, Oslo University Hospital, The Norwegian Radium Hospital, N-0310, Oslo, Norway.
- Faculty of Medicine (Faculty Division Ahus), University of Oslo, Sogn Arena, Klaus Torgårds vei 3, 2. etg, 0372, Oslo, Norway.
| | - Grethe Grenaker Alnæs
- Faculty of Medicine (Faculty Division Ahus), University of Oslo, Sogn Arena, Klaus Torgårds vei 3, 2. etg, 0372, Oslo, Norway.
| | - Anne-Lise Børresen-Dale
- Department of Genetics, Institute for Cancer Research, Oslo University Hospital, The Norwegian Radium Hospital, N-0310, Oslo, Norway.
- Faculty of Medicine (Faculty Division Ahus), University of Oslo, Sogn Arena, Klaus Torgårds vei 3, 2. etg, 0372, Oslo, Norway.
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, 1161 21st Ave S # T1217, Nashville, TN, 37232, USA.
| | - Robert Winqvist
- Laboratory of Cancer Genetics and Tumor Biology, Department of Clinical Chemistry and Biocenter Oulu, University of Oulu, Oulu University Hospital, Kajaanintie 50, 90220, Oulu, Finland.
| | - Katri Pylkäs
- Laboratory of Cancer Genetics and Tumor Biology, Department of Clinical Chemistry and Biocenter Oulu, University of Oulu, Oulu University Hospital, Kajaanintie 50, 90220, Oulu, Finland.
| | - Arja Jukkola-Vuorinen
- Department of Oncology, Oulu University Hospital, University of Oulu, Kajaanintie 50, 90220, Oulu, Finland.
| | - Mervi Grip
- Department of Surgery, Oulu University Hospital, University of Oulu, Kajaanintie 50, 90220, Oulu, Finland.
| | - Irene L Andrulis
- Samuel Lunenfeld Research Institute, Mount Sinai Hospital, 982 - 600 University Avenue, Toronto, Ontario, M5G 1X5, Canada.
- Department of Molecular Genetics, University of Toronto, Medical Science Building, Room 4386, 1 King's College Cir, Toronto, Ontario, M5S 1A8, Canada.
| | - Julia A Knight
- Samuel Lunenfeld Research Institute, Mount Sinai Hospital, 982 - 600 University Avenue, Toronto, Ontario, M5G 1X5, Canada.
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, 6th floor, 155 College St, Toronto, Ontario, M5T 3M7, Canada.
| | - Gord Glendon
- Samuel Lunenfeld Research Institute, Mount Sinai Hospital, 982 - 600 University Avenue, Toronto, Ontario, M5G 1X5, Canada.
- Ontario Cancer Genetics Network, 620 University Avenue, Toronto, Ontario, M5G 2L7, Canada.
| | - Anna Marie Mulligan
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Medical Sciences Building, 6th Floor, 1 King's College Cir, Toronto, Ontario, M5S 1A8, Canada.
- University Health Network, R. Fraser Elliott Building, 1st Floor, 190 Elizabeth St, Toronto, Ontario, M5G 2C4, Canada.
| | - Peter Devillee
- Department of Human Genetics & Department of Pathology, Leiden University Medical Center, Einthovenweg 20, 2333, ZC, Leiden, The Netherlands.
| | - Jonine Figueroa
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD, 20850, USA.
| | - Stephen J Chanock
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD, 20850, USA.
| | - Jolanta Lissowska
- Department of Cancer Epidemiology and Prevention, M. Sklodowska-Curie Memorial Cancer Center & Institute of Oncology, Roentena 5, 02-781, Warsaw, Poland.
| | - Mark E Sherman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD, 20850, USA.
| | - Per Hall
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solnavägen 1, Stockholm, 17177, Sweden.
| | - Nils Schoof
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solnavägen 1, Stockholm, 17177, Sweden.
| | - Maartje Hooning
- Department of Medical Oncology, Family Cancer Clinic, Erasmus University Medical Center, Groene Hilledijk 301, Rotterdam, EA, 3075, The Netherlands.
| | - Antoinette Hollestelle
- Department of Medical Oncology, Josephine Nefkens Institute, Erasmus University Medical Center, Groene Hilledijk 301, 3075, EA, Rotterdam, The Netherlands.
| | - Rogier A Oldenburg
- Department of Clinical Genetics, Family Cancer Clinic, Erasmus University Medical Center, Groene Hilledijk 301, 3075, EA, Rotterdam, The Netherlands.
| | - Madeleine Tilanus-Linthorst
- Department of Clinical Genetics, Family Cancer Clinic, Erasmus University Medical Center, Groene Hilledijk 301, 3075, EA, Rotterdam, The Netherlands.
| | - Jianjun Liu
- Human Genetics Division, Genome Institute of Singapore, 60 Biopolis St, Singapore, 138672, Singapore.
| | - Angie Cox
- Institute for Cancer Studies, Department of Oncology, CRUK/YCR Sheffield Cancer Research Centre, University of Sheffield, 385a Glossop Road, Sheffield, S10 2HQ, UK.
| | - Ian W Brock
- Institute for Cancer Studies, Department of Oncology, CRUK/YCR Sheffield Cancer Research Centre, University of Sheffield, 385a Glossop Road, Sheffield, S10 2HQ, UK.
| | - Malcolm W R Reed
- Academic Unit of Surgical Oncology, Department of Oncology, CRUK/YCR Sheffield Cancer Research Centre, University of Sheffield, 385a Glossop Road, Sheffield, S10 2HQ, UK.
| | - Simon S Cross
- Academic Unit of Pathology, Department of Neuroscience, University of Sheffield, 385a Glossop Road, Sheffield, S10 2HQ, UK.
| | - William Blot
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, 1161 21st Ave S # T1217, Nashville, TN, 37232, USA.
- International Epidemiology Institute, 1455 Research Blvd, Rockville, MD, 20850, USA.
| | - Lisa B Signorello
- Department of Epidemiology, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA.
- Channing Division of Network Medicine, Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA.
- Dana-Farber/Harvard Cancer Center, 450 Brookline Ave, Boston, MA, 02215, USA.
| | - Paul D P Pharoah
- Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge, Strangeways Research Laboratory, Worts Causeway, Cambridge, CB1 8RN, UK.
| | - Alison M Dunning
- Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge, Strangeways Research Laboratory, Worts Causeway, Cambridge, CB1 8RN, UK.
| | - Mitul Shah
- Seoul National University College of Medicine, Yongeon-103 Daehangno, Jongno-gu, Seoul, 110-799, Korea.
| | - Daehee Kang
- Seoul National University College of Medicine, Yongeon-103 Daehangno, Jongno-gu, Seoul, 110-799, Korea.
| | - Dong-Young Noh
- Seoul National University College of Medicine, Yongeon-103 Daehangno, Jongno-gu, Seoul, 110-799, Korea.
| | - Sue K Park
- Department of Preventive Medicine, Seoul National University College of Medicine, Yongeon-103 Daehangno, Jongno-gu, Seoul, 110-799, Korea.
- Department of Biomedical Science, Seoul National University Graduate School, Yongeon-103 Daehangno, Jongno-gu, Seoul, 110-799, Korea.
- Cancer Research Institute, Seoul National University, Yongeon-103 Daehangno, Jongno-gu, Seoul, 110-799, Korea.
| | - Ji-Yeob Choi
- Seoul National University College of Medicine, Yongeon-103 Daehangno, Jongno-gu, Seoul, 110-799, Korea.
| | - Mikael Hartman
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, 1E, Kent Ridge Road, Singapore, 119228, Singapore.
- National University Health System, 1E, Kent Ridge Road, Singapore, 119228, Singapore.
- Saw Swee Hock School of Public Health, National University of Singapore, MD3, 16 Medical Drive, Singapore, 117597, Singapore.
| | - Hui Miao
- Department of Epidemiology, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA.
- Channing Division of Network Medicine, Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA.
| | - Wei Yen Lim
- National University Health System, 1E, Kent Ridge Road, Singapore, 119228, Singapore.
- Saw Swee Hock School of Public Health, National University of Singapore, MD3, 16 Medical Drive, Singapore, 117597, Singapore.
| | - Anthony Tang
- Division of General Surgery, National University Health System, 1E, Kent Ridge Road, Singapore, 119228, Singapore.
| | - Ute Hamann
- Molecular Genetics of Breast Cancer, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany.
| | - Asta Försti
- Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany.
- Center for Primary Health Care Research, University of Lund, Paradisgatan 5, SE-221 00, Lund, Malmö, Sweden.
| | - Thomas Rüdiger
- Institute of Pathology, Städtisches Klinikum Karlsruhe, Moltkestrasse 90, 76133, Karlsruhe, Germany.
| | - Hans Ulrich Ulmer
- Frauenklinik der Stadtklinik Baden-Baden, Balger Strasse 50, 76532, Baden-Württemberg, Germany.
| | - Anna Jakubowska
- Department of Genetics and Pathology, Pomeranian Medical University, Rybacka 1, 70-204, Szczecin, Poland.
| | - Jan Lubinski
- Department of Genetics and Pathology, Pomeranian Medical University, Rybacka 1, 70-204, Szczecin, Poland.
| | - Katarzyna Jaworska-Bieniek
- Department of Genetics and Pathology, Pomeranian Medical University, Rybacka 1, 70-204, Szczecin, Poland.
- Postgraduate School of Molecular Medicine, Warsaw Medical University, Żwirki i Wigury 61, 02-091, Warsaw, Poland.
| | - Katarzyna Durda
- Department of Genetics and Pathology, Pomeranian Medical University, Rybacka 1, 70-204, Szczecin, Poland.
| | | | - Valerie Gaborieau
- International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372, Lyon, CEDEX 08, France.
| | - Paul Brennan
- International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372, Lyon, CEDEX 08, France.
| | - James McKay
- International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372, Lyon, CEDEX 08, France.
| | - Susan Slager
- Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
| | - Amanda E Toland
- Department of Molecular Virology, Immunology and Medical Genetics, Comprehensive Cancer Center, The Ohio State University, 410 W. 10th Avenue, Columbus, OH, 43210, USA.
| | - Celine Vachon
- Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
| | - Drakoulis Yannoukakos
- Molecular Diagnostics Laboratory, IRRP, National Centre for Scientific Research "Demokritos", Aghia Paraskevi Attikis 153 10, Athens, Greece.
| | - Chen-Yang Shen
- College of Public Health, China Medical University, No.91, Hsueh-Shih Road, Taichung, 40402, Taiwan.
- Institute of Biomedical Sciences, Academia Sinica, 2 Academia Road, Nankang, Taipei 115, Taiwan.
| | - Jyh-Cherng Yu
- Department of Surgery, Tri-Service General Hospital, No.325, Sec.2 Chenggong Road, Taipei City 114, Neihu District, Taiwan.
| | - Chiun-Sheng Huang
- Department of Surgery, National Taiwan University Hospital, No.1, Changde Street, Taipei City, 10048, Zhongzheng District, Taiwan.
| | - Ming-Feng Hou
- Cancer Center, Kaohsiung Medical University Chung-Ho Memorial Hospital, No.100, Tzyou 1st Road, Kaohsiung, 807, Taiwan.
- Department of Surgery, Kaohsiung Medical University Chung-Ho Memorial Hospital, No.100, Tzyou 1st Road, Kaohsiung, 807, Taiwan.
| | - Anna González-Neira
- Human Genotyping-CEGEN Unit, Human Cancer Genetics Program, Spanish National Cancer Research Centre (CNIO), Calle de Melchor Fernandez Almagro, 3, 28029, Madrid, Spain.
| | - Daniel C Tessier
- McGill University and Génome Québec Innovation Centre, 740, Dr. Penfield Avenue, Room 7104, Montréal, Québec, H3A 0G1, Canada.
| | - Daniel Vincent
- McGill University and Génome Québec Innovation Centre, 740, Dr. Penfield Avenue, Room 7104, Montréal, Québec, H3A 0G1, Canada.
| | - Francois Bacot
- McGill University and Génome Québec Innovation Centre, 740, Dr. Penfield Avenue, Room 7104, Montréal, Québec, H3A 0G1, Canada.
| | - Craig Luccarini
- Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge, Strangeways Research Laboratory, Worts Causeway, Cambridge, CB1 8RN, UK.
| | - Joe Dennis
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Strangeways Research Laboratory, Worts Causeway, Cambridge, CB1 8RN, UK.
| | - Kyriaki Michailidou
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Strangeways Research Laboratory, Worts Causeway, Cambridge, CB1 8RN, UK.
| | - Manjeet K Bolla
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Strangeways Research Laboratory, Worts Causeway, Cambridge, CB1 8RN, UK.
| | - Jean Wang
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Strangeways Research Laboratory, Worts Causeway, Cambridge, CB1 8RN, UK.
| | - Douglas F Easton
- Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge, Strangeways Research Laboratory, Worts Causeway, Cambridge, CB1 8RN, UK.
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Strangeways Research Laboratory, Worts Causeway, Cambridge, CB1 8RN, UK.
| | - Montserrat García-Closas
- Breakthrough Breast Cancer Research Centre, The Institute of Cancer Research, 237 Fulham Road, London, SW3 6JB, UK.
- Division of Breast Cancer Research, The Institute of Cancer Research, 237 Fulham Road, London, SW3 6JB, UK.
- Division of Genetics and Epidemiology, The Institute of Cancer Research, 15 Cotswold Road, Belmont, Sutton, Surrey, SM2 5NG, UK.
| | - Mitch Dowsett
- The Academic Department of Biochemistry, The Royal Marsden Hospital, Fulham Road, London, SW3 6JJ, UK.
| | - Alan Ashworth
- Breakthrough Breast Cancer Research Centre, The Institute of Cancer Research, 237 Fulham Road, London, SW3 6JB, UK.
- Division of Breast Cancer Research, The Institute of Cancer Research, 237 Fulham Road, London, SW3 6JB, UK.
| | - Anthony J Swerdlow
- Breakthrough Breast Cancer Research Centre, The Institute of Cancer Research, 237 Fulham Road, London, SW3 6JB, UK.
- Division of Breast Cancer Research, The Institute of Cancer Research, 237 Fulham Road, London, SW3 6JB, UK.
- Division of Genetics and Epidemiology, The Institute of Cancer Research, 15 Cotswold Road, Belmont, Sutton, Surrey, SM2 5NG, UK.
| | - Julian Peto
- Non-communicable Disease Epidemiology Department, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
| | - Isabel dos Santos Silva
- Non-communicable Disease Epidemiology Department, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
| | - Olivia Fletcher
- Breakthrough Breast Cancer Research Centre, The Institute of Cancer Research, 237 Fulham Road, London, SW3 6JB, UK.
- Division of Breast Cancer Research, The Institute of Cancer Research, 237 Fulham Road, London, SW3 6JB, UK.
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Lin CH, Chuang PY, Chiang CJ, Lu YS, Cheng AL, Kuo WH, Huang CS, Lai MS, You SL, Tang CH. Distinct clinicopathological features and prognosis of emerging young-female breast cancer in an East Asian country: a nationwide cancer registry-based study. Oncologist 2014; 19:583-91. [PMID: 24807917 DOI: 10.1634/theoncologist.2014-0047] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND A rapid surge of young-female breast cancer (YFBC) has been observed in Taiwan and other East Asian countries. We recently reported that these cases of YFBC, in contrast to their Western counterparts, are predominantly luminal A subtype. YFBC in Asia may have distinct clinicopathological features and outcomes. METHODS Data collected prospectively by participating hospitals were retrieved from the Taiwan Cancer Database. A total of 15,881 women with newly diagnosed stage I-III breast cancer in 2002-2006 were included. The age at diagnosis was categorized into nine 5-year groups (from <30 years to ≥65 years). Clinicopathological variables and patient disease-free survival (DFS) were compared by age group. RESULTS The rates of stage I, estrogen receptor-positive (ER+), and progesterone receptor-positive breast cancer were higher in the younger patients (<50 years) than in the older patients (≥50 years). Univariate analysis showed that the 40-44 and 45-49 age groups were significantly associated with longer DFS than the other age groups. In the ER+ subgroup, multivariate analysis consistently showed that the 40-44 age group was significantly associated with longer DFS than the other age groups except for the 45-49 age group. In contrast, multivariate analysis of the ER-negative subgroup revealed no significant difference of DFS between the 40-44 age group and other age groups. CONCLUSION Emerging YFBC in Taiwan is uniquely associated with favorable pathological features and better outcomes and should not be regarded as the mirror image of its Western counterpart.
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Affiliation(s)
- Ching-Hung Lin
- Departments of Oncology, Internal Medicine, and Surgery, National Taiwan University Hospital, Taipei, Taiwan; School of Health Care Administration, Taipei Medical University, Taipei, Taiwan; Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Taiwan Cancer Registry, Taiwan; Center for Comparative Effectiveness Research, National Center of Excellence for Clinical Trial and Research, Taipei, Taiwan; Genomics Research Center, Academia Sinica, Taipei, Taiwan; Department of Public Health, Fu-Jen Catholic University, New Taipei, Taiwan
| | - Po-Ya Chuang
- Departments of Oncology, Internal Medicine, and Surgery, National Taiwan University Hospital, Taipei, Taiwan; School of Health Care Administration, Taipei Medical University, Taipei, Taiwan; Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Taiwan Cancer Registry, Taiwan; Center for Comparative Effectiveness Research, National Center of Excellence for Clinical Trial and Research, Taipei, Taiwan; Genomics Research Center, Academia Sinica, Taipei, Taiwan; Department of Public Health, Fu-Jen Catholic University, New Taipei, Taiwan
| | - Chun-Ju Chiang
- Departments of Oncology, Internal Medicine, and Surgery, National Taiwan University Hospital, Taipei, Taiwan; School of Health Care Administration, Taipei Medical University, Taipei, Taiwan; Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Taiwan Cancer Registry, Taiwan; Center for Comparative Effectiveness Research, National Center of Excellence for Clinical Trial and Research, Taipei, Taiwan; Genomics Research Center, Academia Sinica, Taipei, Taiwan; Department of Public Health, Fu-Jen Catholic University, New Taipei, Taiwan
| | - Yen-Shen Lu
- Departments of Oncology, Internal Medicine, and Surgery, National Taiwan University Hospital, Taipei, Taiwan; School of Health Care Administration, Taipei Medical University, Taipei, Taiwan; Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Taiwan Cancer Registry, Taiwan; Center for Comparative Effectiveness Research, National Center of Excellence for Clinical Trial and Research, Taipei, Taiwan; Genomics Research Center, Academia Sinica, Taipei, Taiwan; Department of Public Health, Fu-Jen Catholic University, New Taipei, Taiwan
| | - Ann-Lii Cheng
- Departments of Oncology, Internal Medicine, and Surgery, National Taiwan University Hospital, Taipei, Taiwan; School of Health Care Administration, Taipei Medical University, Taipei, Taiwan; Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Taiwan Cancer Registry, Taiwan; Center for Comparative Effectiveness Research, National Center of Excellence for Clinical Trial and Research, Taipei, Taiwan; Genomics Research Center, Academia Sinica, Taipei, Taiwan; Department of Public Health, Fu-Jen Catholic University, New Taipei, Taiwan
| | - Wen-Hung Kuo
- Departments of Oncology, Internal Medicine, and Surgery, National Taiwan University Hospital, Taipei, Taiwan; School of Health Care Administration, Taipei Medical University, Taipei, Taiwan; Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Taiwan Cancer Registry, Taiwan; Center for Comparative Effectiveness Research, National Center of Excellence for Clinical Trial and Research, Taipei, Taiwan; Genomics Research Center, Academia Sinica, Taipei, Taiwan; Department of Public Health, Fu-Jen Catholic University, New Taipei, Taiwan
| | - Chiun-Sheng Huang
- Departments of Oncology, Internal Medicine, and Surgery, National Taiwan University Hospital, Taipei, Taiwan; School of Health Care Administration, Taipei Medical University, Taipei, Taiwan; Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Taiwan Cancer Registry, Taiwan; Center for Comparative Effectiveness Research, National Center of Excellence for Clinical Trial and Research, Taipei, Taiwan; Genomics Research Center, Academia Sinica, Taipei, Taiwan; Department of Public Health, Fu-Jen Catholic University, New Taipei, Taiwan
| | - Mei-Shu Lai
- Departments of Oncology, Internal Medicine, and Surgery, National Taiwan University Hospital, Taipei, Taiwan; School of Health Care Administration, Taipei Medical University, Taipei, Taiwan; Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Taiwan Cancer Registry, Taiwan; Center for Comparative Effectiveness Research, National Center of Excellence for Clinical Trial and Research, Taipei, Taiwan; Genomics Research Center, Academia Sinica, Taipei, Taiwan; Department of Public Health, Fu-Jen Catholic University, New Taipei, Taiwan
| | - San-Lin You
- Departments of Oncology, Internal Medicine, and Surgery, National Taiwan University Hospital, Taipei, Taiwan; School of Health Care Administration, Taipei Medical University, Taipei, Taiwan; Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Taiwan Cancer Registry, Taiwan; Center for Comparative Effectiveness Research, National Center of Excellence for Clinical Trial and Research, Taipei, Taiwan; Genomics Research Center, Academia Sinica, Taipei, Taiwan; Department of Public Health, Fu-Jen Catholic University, New Taipei, Taiwan
| | - Chao-Hsiun Tang
- Departments of Oncology, Internal Medicine, and Surgery, National Taiwan University Hospital, Taipei, Taiwan; School of Health Care Administration, Taipei Medical University, Taipei, Taiwan; Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Taiwan Cancer Registry, Taiwan; Center for Comparative Effectiveness Research, National Center of Excellence for Clinical Trial and Research, Taipei, Taiwan; Genomics Research Center, Academia Sinica, Taipei, Taiwan; Department of Public Health, Fu-Jen Catholic University, New Taipei, Taiwan
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Moon WK, Lo CM, Chen RT, Shen YW, Chang JM, Huang CS, Chen JH, Hsu WW, Chang RF. Tumor detection in automated breast ultrasound images using quantitative tissue clustering. Med Phys 2014; 41:042901. [DOI: 10.1118/1.4869264] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Lin JJ, Huang CS, Yu J, Liao GS, Lien HC, Hung JT, Lin RJ, Chou FP, Yeh KT, Yu AL. Malignant phyllodes tumors display mesenchymal stem cell features and aldehyde dehydrogenase/disialoganglioside identify their tumor stem cells. Breast Cancer Res 2014; 16:R29. [PMID: 24670249 PMCID: PMC4053203 DOI: 10.1186/bcr3631] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Accepted: 03/10/2014] [Indexed: 12/21/2022] Open
Abstract
Introduction Although breast phyllodes tumors are rare, there is no effective therapy other than surgery. Little is known about their tumor biology. A malignant phyllodes tumor contains heterologous stromal elements, and can transform into rhabdomyosarcoma, liposarcoma and osteosarcoma. These versatile properties prompted us to explore their possible relationship to mesenchymal stem cells (MSCs) and to search for the presence of cancer stem cells (CSCs) in phyllodes tumors. Methods Paraffin sections of malignant phyllodes tumors were examined for various markers by immunohistochemical staining. Xenografts of human primary phyllodes tumors were established by injecting freshly isolated tumor cells into the mammary fat pad of non-obese diabetic-severe combined immunodeficient (NOD-SCID) mice. To search for CSCs, xenografted tumor cells were sorted into various subpopulations by flow cytometry and examined for their in vitro mammosphere forming capacity, in vivo tumorigenicity in NOD-SCID mice and their ability to undergo differentiation. Results Immunohistochemical analysis revealed the expression of the following 10 markers: CD44, CD29, CD106, CD166, CD105, CD90, disialoganglioside (GD2), CD117, Aldehyde dehydrogenase 1 (ALDH), and Oct-4, and 7 clinically relevant markers (CD10, CD34, p53, p63, Ki-67, Bcl-2, vimentin, and Globo H) in all 51 malignant phyllodes tumors examined, albeit to different extents. Four xenografts were successfully established from human primary phyllodes tumors. In vitro, ALDH+ cells sorted from xenografts displayed approximately 10-fold greater mammosphere-forming capacity than ALDH- cells. GD2+ cells showed a 3.9-fold greater capacity than GD2- cells. ALDH+/GD2+cells displayed 12.8-fold greater mammosphere forming ability than ALDH-/GD2- cells. In vivo, the tumor-initiating frequency of ALDH+/GD2+ cells were up to 33-fold higher than that of ALDH+ cells, with as few as 50 ALDH+/GD2+ cells being sufficient for engraftment. Moreover, we provided the first evidence for the induction of ALDH+/GD2+ cells to differentiate into neural cells of various lineages, along with the observation of neural differentiation in clinical specimens and xenografts of malignant phyllodes tumors. ALDH+ or ALDH+/GD2+ cells could also be induced to differentiate into adipocytes, osteocytes or chondrocytes. Conclusions Our findings revealed that malignant phyllodes tumors possessed many characteristics of MSC, and their CSCs were enriched in ALDH+ and ALDH+/GD2+ subpopulations.
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Hsiao FH, Jow GM, Kuo WH, Huang CS, Lai YM, Liu YF, Chang KJ. The partner's insecure attachment, depression and psychological well-being as predictors of diurnal cortisol patterns for breast cancer survivors and their spouses. Stress 2014; 17:169-75. [PMID: 24393005 DOI: 10.3109/10253890.2014.880833] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The purpose of this study was to explore whether stress from individual's and partner's depression, anxiety, sleep disturbances, insecure attachment and meaning in life were predictors of diurnal cortisol patterns in breast cancer survivors and their spouses. Thirty-four couple dyads participated in this eight-month follow-up study. The breast cancer survivors and their spouses completed the Medical Outcomes Study Sleep scale, the Beck Depression Inventory-II, the State Trait Anxiety Inventory, the Experiences in Close Relationships-Revised scale and the Meaning in Life Questionnaire, and they collected salivary cortisol at home at the time of awakening, 30 and 45 min after waking and at 1200 h, 1700 h and 2100 h. Diurnal cortisol slopes of survivors and spouses are positively correlated. But the factors associated with diurnal cortisol patterns are different between survivors and spouses. For survivors, neither survivor individuals' nor spouses' psychosocial factors were the predictors of survivors' diurnal cortisol patterns. For spouses, the survivors' higher anxious attachment style was the main predictor of spouses' flatter diurnal cortisol patterns. In conclusion, for spouses, psychophysiological stress responses are mainly influenced by breast cancer survivors' insecure attachment. Future couple supportive care interventions can address survivors' attachment styles in close relationships in order to improve neuroendocrine functions for both breast cancer survivors and their spouses.
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Affiliation(s)
- Fei-Hsiu Hsiao
- Department of Nursing, College of Medicine, National Taiwan University , Taipei , Taiwan
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