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Elleson KM, Englander K, Gallagher J, Chintapally N, Sun W, Whiting J, Mallory M, Kiluk J, Hoover S, Khakpour N, Czerniecki B, Laronga C, Lee MC. Factors Predictive of Positive Lymph Nodes for Breast Cancer. Curr Oncol 2023; 30:10351-10362. [PMID: 38132388 PMCID: PMC10742655 DOI: 10.3390/curroncol30120754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 11/27/2023] [Accepted: 12/01/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Axillary node status is an important prognostic factor in breast cancer. The primary aim was to evaluate tumor size and other characteristics relative to axillary disease. MATERIALS AND METHODS Single institution retrospective chart review of stage I-III breast cancer patients collected demographic and clinical/pathologic data from 1998-2019. Student's t-test, Chi-squared test (or Fisher exact test if applicable), and logistic regression models were used for testing the association of pN+ to predictive variables. RESULTS Of 728 patients (mean age 59 yrs) with mean follow up of 50 months, 86% were estrogen receptor +, 10% Her2+, 78% ER+HER2-negative, and 10% triple-negative. In total, 351/728 (48.2%) were pN+ and mean tumor size was larger in pN+ cases compared to pN- cases (mean = 27.7 mm versus 15.5 mm) (p < 0.001). By univariate analysis, pN+ was associated with lymphovascular invasion (LVI), higher grade, Her2, and histology (p < 0.005). Tumor-to-nipple distance was shorter in pN+ compared to pN- (45 mm v. 62 mm; p< 0.001). Age < 60, LVI, recurrence, mastectomy, larger tumor size, and shorter tumor-nipple distance were associated with 3+ positive nodes (p < 0.05). CONCLUSIONS Larger tumor size and shorter tumor-nipple distance were associated with higher lymph node positivity. Age less than 60, LVI, recurrence, mastectomy, larger tumor size, and shorter tumor-nipple distance were all associated with 3+ positive lymph nodes.
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Affiliation(s)
- Kelly M. Elleson
- Regional Breast Care, Genesis Care Network, 8931 Colonial Center Dr #301, Fort Myers, FL 33905, USA
| | - Katherine Englander
- Morsani College of Medicine, University of South Florida, Tampa, Fl 33602, USA (N.C.)
| | - Julia Gallagher
- Morsani College of Medicine, University of South Florida, Tampa, Fl 33602, USA (N.C.)
| | - Neha Chintapally
- Morsani College of Medicine, University of South Florida, Tampa, Fl 33602, USA (N.C.)
| | - Weihong Sun
- Department of Breast Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA (C.L.)
| | - Junmin Whiting
- Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA
| | - Melissa Mallory
- Department of Breast Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA (C.L.)
| | - John Kiluk
- Department of Breast Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA (C.L.)
| | - Susan Hoover
- Department of Breast Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA (C.L.)
| | - Nazanin Khakpour
- Department of Breast Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA (C.L.)
| | - Brian Czerniecki
- Department of Breast Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA (C.L.)
| | - Christine Laronga
- Department of Breast Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA (C.L.)
| | - Marie Catherine Lee
- Department of Breast Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA (C.L.)
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Champion NT, Mooney B, Kim Y, Whiting J, Sun W, Kiluk J, Czerniecki B, Hoover S, Lee MC. ASO Visual Abstract: Surgeon and Radiologist Evaluation of Electromagnetic Chip Localization for Benign and Malignant Breast Lesions. Ann Surg Oncol 2023; 30:8478. [PMID: 37679539 DOI: 10.1245/s10434-023-14174-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/09/2023]
Affiliation(s)
| | - Blaise Mooney
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Youngchul Kim
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Junmin Whiting
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Weihong Sun
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - John Kiluk
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Brian Czerniecki
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Susan Hoover
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
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Champion NT, Mooney B, Kim Y, Whiting J, Sun W, Kiluk J, Czerniecki B, Hoover S, Lee MC. Surgeon and Radiologist Evaluation of Electromagnetic Chip Localization for Benign and Malignant Breast Lesions. Ann Surg Oncol 2023; 30:7081-7090. [PMID: 37552349 DOI: 10.1245/s10434-023-13976-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 05/15/2023] [Accepted: 07/04/2023] [Indexed: 08/09/2023]
Abstract
BACKGROUND SmartClipTM is a food and drug administration-approved, electromagnetic chip (EMC) localization system that provides three-dimensional navigation for the excision of soft tissue lesions. The purpose of this study was to analyze the accuracy and feasibility of EMC radiologic and surgical localization for benign and malignant breast lesions. PATIENTS AND METHODS An institutional review board-approved, single institution, prospective study from October 2020 to September 2022 of 38 women undergoing breast conserving surgery with EMC localization of a single lesion > 5 mm on mammogram (MMG) or ultrasound (US) imaging. Surveys from performing breast radiologists and breast surgeons were collected after image-guided localization and surgical excision. RESULTS Seventy-six survey responses from nine radiologists and four surgeons were received. The deployment needle and EMC were highly visible in 86.8% and 76.3% of procedures, respectively. There was no difficulty in deployment for 92.1% of procedures. The EMC was in the correct location on postdeployment MMG in 97.4% of cases. Three instances of EMC migration occurred, one 1 cm from target lesion. The targeted mass and EMC were within the surgical specimen in 97.4% of cases. On specimen radiograph, 39.5% of the EMCs were 0-1 mm from the center of the target lesion, 18.4% were within 2-4 mm, and 23.7% were within 5-10 mm. Mean operating room time for all cases was 65 min. One case required US to localize the target due to console malfunction. CONCLUSION There was successful EMC deployment by radiologists with accurate visualization and successful surgical excision in most cases. The EnVisioTM SmartClipTM system is a reproducible and accurate localization method for benign and malignant breast lesions.
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Affiliation(s)
| | - Blaise Mooney
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Youngchul Kim
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Junmin Whiting
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Weihong Sun
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - John Kiluk
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Brian Czerniecki
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Susan Hoover
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
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Liu L, Lewis N, Sun W, Whiting J, Hoover S, Costa RLB. Retrospective Study of Treatment Patterns and Natural History of Patients with T1a/b N0 Triple-Negative Breast Cancers: A Single-Institution Experience. Oncology 2023; 101:765-772. [PMID: 37527637 DOI: 10.1159/000533149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 07/11/2023] [Indexed: 08/03/2023]
Abstract
INTRODUCTION T1a/b, node-negative (node-), triple-negative breast cancers (TNBCs) are underrepresented in randomized drug-approving clinical trials. Given their low incidence, the clinicopathological features, natural history, and treatment patterns of these tumors remain insufficiently understood. METHODS We conducted a single-institution retrospective cohort study of patients with T1a/b, N0, M0 TNBCs. Deidentified patient- and tumor-related data were collected and summarized. Kruskal-Wallis, χ2, or Fisher exact tests were used to evaluate associations of interest. Kaplan-Meier methods, log-rank tests, and Cox's proportional hazards models were applied for survival analyses. RESULTS Of 108 cases of node- TNBCs measuring ≤2 cm, 34 node- T1a/b tumors were included in our analysis. All cases had an intermediate to high histological grade, and most had a Ki-67 score of ≥20%. All patients received adjuvant chemotherapy, and many underwent mastectomy (47%). Docetaxel combined with cyclophosphamide was the most common adjuvant chemotherapy regimen (75%). We did not observe significant associations between improved outcomes and treatment with anthracycline-containing regimens. Among patients with node- pT1a/b tumors, the estimated 3-year recurrence-free survival (RFS) and distant RFS rates were both 96.3% (95% CI: 76.5-99.5), and the overall survival rate was estimated to be 100% (95% CI: 100-100). There were no cases of local recurrences observed. CONCLUSIONS In our cohort, all patients with T1a/b node- TNBCs were treated with adjuvant chemotherapy and had favorable outcomes even when treated with anthracycline-sparing regimens.
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Affiliation(s)
- Langfeier Liu
- Morsani College of Medicine, University of South Florida, Tampa, Florida, USA
| | - Nicholas Lewis
- Morsani College of Medicine, University of South Florida, Tampa, Florida, USA
| | - Weihong Sun
- Department of Breast Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Junmin Whiting
- Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Susan Hoover
- Department of Breast Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Ricardo L B Costa
- Department of Breast Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
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Soliman H, Hogue D, Han H, Mooney B, Costa R, Lee MC, Niell B, Williams A, Chau A, Falcon S, Soyano A, Armaghani A, Khakpour N, Weinfurtner RJ, Hoover S, Kiluk J, Laronga C, Rosa M, Khong H, Czerniecki B. Author Correction: Oncolytic T-VEC virotherapy plus neoadjuvant chemotherapy in nonmetastatic triple-negative breast cancer: a phase 2 trial. Nat Med 2023:10.1038/s41591-023-02309-4. [PMID: 36932246 DOI: 10.1038/s41591-023-02309-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2023]
Affiliation(s)
- Hatem Soliman
- Department of Breast Oncology, Moffitt Cancer Center, Tampa, FL, USA.
| | - Deanna Hogue
- Clinical Trials Office, Moffitt Cancer Center, Tampa, FL, USA
| | - Hyo Han
- Department of Breast Oncology, Moffitt Cancer Center, Tampa, FL, USA
| | - Blaise Mooney
- Department of Radiology, Moffitt Cancer Center, Tampa, FL, USA
| | - Ricardo Costa
- Department of Breast Oncology, Moffitt Cancer Center, Tampa, FL, USA
| | - Marie C Lee
- Department of Breast Oncology, Moffitt Cancer Center, Tampa, FL, USA
| | - Bethany Niell
- Department of Radiology, Moffitt Cancer Center, Tampa, FL, USA
| | - Angela Williams
- Department of Radiology, Moffitt Cancer Center, Tampa, FL, USA
| | - Alec Chau
- Department of Radiology, Moffitt Cancer Center, Tampa, FL, USA
| | - Shannon Falcon
- Department of Radiology, Moffitt Cancer Center, Tampa, FL, USA
| | - Aixa Soyano
- Department of Breast Oncology, Moffitt Cancer Center, Tampa, FL, USA
| | - Avan Armaghani
- Department of Breast Oncology, Moffitt Cancer Center, Tampa, FL, USA
| | - Nazanin Khakpour
- Department of Breast Oncology, Moffitt Cancer Center, Tampa, FL, USA
| | | | - Susan Hoover
- Department of Breast Oncology, Moffitt Cancer Center, Tampa, FL, USA
| | - John Kiluk
- Department of Breast Oncology, Moffitt Cancer Center, Tampa, FL, USA
| | - Christine Laronga
- Department of Breast Oncology, Moffitt Cancer Center, Tampa, FL, USA
| | - Marilin Rosa
- Department of Pathology, Moffitt Cancer Center, Tampa, FL, USA
| | - Hung Khong
- Department of Breast Oncology, Moffitt Cancer Center, Tampa, FL, USA
| | - Brian Czerniecki
- Department of Breast Oncology, Moffitt Cancer Center, Tampa, FL, USA
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Soliman H, Hogue D, Han H, Mooney B, Costa R, Lee MC, Niell B, Williams A, Chau A, Falcon S, Soyano A, Armaghani A, Khakpour N, Weinfurtner RJ, Hoover S, Kiluk J, Laronga C, Rosa M, Khong H, Czerniecki B. Oncolytic T-VEC virotherapy plus neoadjuvant chemotherapy in nonmetastatic triple-negative breast cancer: a phase 2 trial. Nat Med 2023; 29:450-457. [PMID: 36759673 DOI: 10.1038/s41591-023-02210-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 01/06/2023] [Indexed: 02/11/2023]
Abstract
Talimogene laherparepvec (T-VEC) is an oncolytic virus hypothesized to enhance triple-negative breast cancer (TNBC) responses to neoadjuvant chemotherapy (NAC). This article describes the phase 2 trial of T-VEC plus NAC (ClinicalTrials.gov ID: NCT02779855 ). Patients with stage 2-3 TNBC received five intratumoral T-VEC injections with paclitaxel followed by doxorubicin and cyclophosphamide and surgery to assess residual cancer burden index (RCB). The primary end point was RCB0 rate. Secondary end points were RCB0-1 rate, recurrence rate, toxicity and immune correlates. Thirty-seven patients were evaluated. Common T-VEC toxicities were fevers, chills, headache, fatigue and injection site pain. NAC toxicities were as expected. Four thromboembolic events occurred. The primary end point was met with an estimated RCB0 rate = 45.9% and RCB0-1 descriptive rate = 65%. The 2-year disease-free rate is equal to 89% with no recurrences in RCB0-1 patients. Immune activation during treatment correlated with response. T-VEC plus NAC in TNBC may increase RCB0-1 rates. These results support continued investigation of T-VEC plus NAC for TNBC.
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Affiliation(s)
- Hatem Soliman
- Department of Breast Oncology, Moffitt Cancer Center, Tampa, FL, USA.
| | - Deanna Hogue
- Clinical Trials Office, Moffitt Cancer Center, Tampa, FL, USA
| | - Hyo Han
- Department of Breast Oncology, Moffitt Cancer Center, Tampa, FL, USA
| | - Blaise Mooney
- Department of Radiology, Moffitt Cancer Center, Tampa, FL, USA
| | - Ricardo Costa
- Department of Breast Oncology, Moffitt Cancer Center, Tampa, FL, USA
| | - Marie C Lee
- Department of Breast Oncology, Moffitt Cancer Center, Tampa, FL, USA
| | - Bethany Niell
- Department of Radiology, Moffitt Cancer Center, Tampa, FL, USA
| | - Angela Williams
- Department of Radiology, Moffitt Cancer Center, Tampa, FL, USA
| | - Alec Chau
- Department of Radiology, Moffitt Cancer Center, Tampa, FL, USA
| | - Shannon Falcon
- Department of Radiology, Moffitt Cancer Center, Tampa, FL, USA
| | - Aixa Soyano
- Department of Breast Oncology, Moffitt Cancer Center, Tampa, FL, USA
| | - Avan Armaghani
- Department of Breast Oncology, Moffitt Cancer Center, Tampa, FL, USA
| | - Nazanin Khakpour
- Department of Breast Oncology, Moffitt Cancer Center, Tampa, FL, USA
| | | | - Susan Hoover
- Department of Breast Oncology, Moffitt Cancer Center, Tampa, FL, USA
| | - John Kiluk
- Department of Breast Oncology, Moffitt Cancer Center, Tampa, FL, USA
| | - Christine Laronga
- Department of Breast Oncology, Moffitt Cancer Center, Tampa, FL, USA
| | - Marilin Rosa
- Department of Pathology, Moffitt Cancer Center, Tampa, FL, USA
| | - Hung Khong
- Department of Breast Oncology, Moffitt Cancer Center, Tampa, FL, USA
| | - Brian Czerniecki
- Department of Breast Oncology, Moffitt Cancer Center, Tampa, FL, USA
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Soliman HH, Han HS, Hogue D, Mooney B, Costa RL, Lee MC, Niell B, Williams A, Chau A, Falcon S, Khakpour N, Soyano A, Armaghani AJ, Weinfurtner RJ, Hoover S, Kiluk J, Rosa M, Fridley B, Khong HT, Czerniecki BJ. A phase 2 trial of talimogene laherparepvec (TVEC) in combination with neoadjuvant chemotherapy for the treatment of nonmetastatic triple-negative breast cancer. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.578] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
578 Background: TVEC is a modified oncolytic herpes simplex 1 (HSV1) virus currently FDA approved for the treatment of unresectable cutaneous and nodal melanoma. TVEC is designed to preferentially lyse tumor cells over normal tissue to release tumor associated antigens, produces GM-CSF to activate dendritic cells, and stimulates T cells to infiltrate the tumor (TILs). TILs in breast cancer are associated with better response to neoadjuvant chemotherapy (NAC), so we hypothesized that intratumoral TVEC may enhance response to NAC. We report results of a phase 2 trial combining NAC with TVEC in stage 2-3 TNBC. Methods: Stage II-III TNBC pts (N = 37) were to be enrolled into a single arm, optimal Simon 2 stage phase 2 trial with TVEC (10^6 PFU 1st dose then 10^8 PFU x 4 doses) weeks 1,4,6,8,10 + weekly paclitaxel (80mg/m2) IV x 12, followed by dose dense AC (doxorubicin/cyclophosphamide 60/600 mg/m2) IV q2weeks x 4 alone given preoperatively. Primary endpoint was residual cancer burden 0 rate (RCB0). Trial meets primary endpoint with ≥15 RCB0 responses out of 37 evaluable pts, assuming p1 = 45% vs. p0 = 30% with one sided type I error rate at 0.10 and power at 70%. Results: Forty pts were enrolled at Moffitt (5/2018 – 4/2020) and evaluable for safety with 3 pts non-evaluable for efficacy due to incomplete treatment. Study demographics: median age 49 (27-66), 67.5% White, 10% Black, 15% Hispanic, clinical stage II 83% and III 17%, node + 42%. The RCB0 rate = 16/37 (43%, 95% CI 27-61%) and additional 9 pts with RCB-1 (RCB0/1 rate 68%, 95% CI 50-82%). Toxicities did not differ significantly from expected NAC toxicities except for increased brief G1-2 fevers, chills, injection site pains. Four pts had G2-3 thromboembolic events (10%) slightly greater than expected 6% rate on NAC. Conclusions: Addition of TVEC to NAC increased RCB0 rates with manageable toxicities and warrants additional investigation in TNBC. Immune correlates and updated survival data will be presented at the meeting. Clinical trial information: NCT02779855.
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Affiliation(s)
| | - Hyo S. Han
- H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL
| | | | | | | | | | | | | | | | | | | | | | | | | | - Susan Hoover
- H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL
| | - John Kiluk
- H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL
| | - Marilin Rosa
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Brooke Fridley
- H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL
| | - Hung T. Khong
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
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Parikh P, Jameel Z, Falcon S, Rosa M, Kiluk J, Hoover S, Soliman H, Ataya D. Adenomyoepithelioma of the breast: Case series and literature review. Clin Imaging 2021; 75:157-164. [PMID: 33607537 DOI: 10.1016/j.clinimag.2021.02.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [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: 12/02/2020] [Revised: 01/11/2021] [Accepted: 02/01/2021] [Indexed: 01/03/2023]
Abstract
Adenomyoepithelioma of the breast is a rare tumor consisting of both epithelial and myoepithelial cells. Malignant transformation of either cell line can occur. We describe the imaging features, clinical presentation, and management of seven cases of biopsy-proven adenomyoepithelioma at our institution.
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Affiliation(s)
- Puja Parikh
- Department of Radiology, University of South Florida, Tampa, FL, USA
| | - Zena Jameel
- Department of Pathology, Division of Breast Pathology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Shannon Falcon
- Department of Radiology, Division of Breast Imaging, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Marilin Rosa
- Department of Pathology, Division of Breast Pathology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - John Kiluk
- Department of Breast Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Susan Hoover
- Department of Breast Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Hatem Soliman
- Department of Breast Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Dana Ataya
- Department of Radiology, Division of Breast Imaging, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
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Rajarajan N, Mariotti V, Basu A, Kodumudi K, Han H, Czerniecki B, Hoover S. Strategies to Combat Human Epidermal Growth Factor Receptor 2 (HER2) Resistance in HER2-Positive Breast Cancer. Crit Rev Oncog 2021; 25:209-231. [PMID: 33463942 DOI: 10.1615/critrevoncog.2020036417] [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: 11/13/2022]
Abstract
The discovery of human epidermal growth factor receptor 2 (HER2) and its role in breast cancer led to the development of the first targeted antibody treatment for HER2-positive breast cancer. This treatment breakthrough led to remarkable improvements in both early and late survival. Unfortunately, not all patients with HER2 breast cancer responded positively; some have innate resistance to treatment and others develop resistance over time. In this review, we discuss some research that is currently underway to understand HER2 resistance and strategies in overcoming it.
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Soliman H, Hogue D, Han H, Mooney B, Costa R, Lee MC, Niell B, Williams A, Chau A, Falcon S, Khakpour N, Weinfurtner RJ, Hoover S, Kiluk J, Rosa M, Khong H, Czerniecki B. A Phase I Trial of Talimogene Laherparepvec in Combination with Neoadjuvant Chemotherapy for the Treatment of Nonmetastatic Triple-Negative Breast Cancer. Clin Cancer Res 2020; 27:1012-1018. [PMID: 33219014 DOI: 10.1158/1078-0432.ccr-20-3105] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 10/19/2020] [Accepted: 11/17/2020] [Indexed: 11/16/2022]
Abstract
PURPOSE Talimogene laherparepvec (TVEC) is an oncolytic herpes simplex 1 virus approved for treatment of melanoma. We hypothesized intratumoral TVEC may enhance response to neoadjuvant chemotherapy (NAC). This article reports the results of a trial combining NAC with TVEC for triple-negative breast cancer (TNBC). PATIENTS AND METHODS Patients with stage II-III TNBC enrolled in a 3+3 phase I trial (NCT02779855) of two TVEC dose levels [DL; DL 1 = 106 plaque-forming units (PFU) × 5 doses; DL 2 = 106 PFUs first dose, then 108 PFUs × 4 doses] on weeks 1, 4, 6, 8, and 10 plus weekly paclitaxel (80 mg/m2) for 12 weeks, followed by doxorubicin/cyclophosphamide (60/600 mg/m2) every 2 weeks for 8 weeks. Postoperative response assessment using residual cancer burden (RCB) was performed. Primary endpoints were safety and MTD. Secondary endpoints were RCB0 rate and immune correlates. Dose-limiting toxicity (DLT) rule was grade 3-5 adverse events due to TVEC during first 5 weeks. RESULTS Nine patients [DL 1 (n = 3); DL 2 (n = 6)] were enrolled. Six had stage II disease, and 3 had stage III (6 clinically N+). No DLTs occurred, and MTD was DL 2. Most common toxicities with TVEC were fever (n = 8), chills (n = 3), hematomas (n = 3), and injection site pain (n = 3). Thromboembolic events (n = 2) and bradycardia (n = 1) occurred during or after NAC. Five patients (55%) achieved RCB0, 2 had RCB1 (22%), and 2 had RCB2 (22%). CONCLUSIONS The addition of TVEC to NAC was feasible at the approved dose, with manageable toxicity. The complete response rate was 55%.
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Affiliation(s)
- Hatem Soliman
- Breast Oncology Department, Moffitt Cancer Center, Tampa, Florida.
| | - Deanna Hogue
- Clinical Trials Office, Moffitt Cancer Center, Tampa, Florida
| | - Hyo Han
- Breast Oncology Department, Moffitt Cancer Center, Tampa, Florida
| | - Blaise Mooney
- Radiology Department, Moffitt Cancer Center, Tampa, Florida
| | - Ricardo Costa
- Breast Oncology Department, Moffitt Cancer Center, Tampa, Florida
| | - Marie C Lee
- Breast Oncology Department, Moffitt Cancer Center, Tampa, Florida
| | - Bethany Niell
- Radiology Department, Moffitt Cancer Center, Tampa, Florida
| | | | - Alec Chau
- Radiology Department, Moffitt Cancer Center, Tampa, Florida
| | - Shannon Falcon
- Radiology Department, Moffitt Cancer Center, Tampa, Florida
| | - Nazanin Khakpour
- Breast Oncology Department, Moffitt Cancer Center, Tampa, Florida
| | | | - Susan Hoover
- Breast Oncology Department, Moffitt Cancer Center, Tampa, Florida
| | - John Kiluk
- Breast Oncology Department, Moffitt Cancer Center, Tampa, Florida
| | - Marilin Rosa
- Anatomic Pathology Department, Moffitt Cancer Center, Tampa, Florida
| | - Hung Khong
- Breast Oncology Department, Moffitt Cancer Center, Tampa, Florida
| | - Brian Czerniecki
- Breast Oncology Department, Moffitt Cancer Center, Tampa, Florida
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Jenneman D, Zhong X, Ma J, Sun W, Han H, Soliman H, Loftus L, Costa R, Armaghani A, Soyano A, Czerniecki B, Lee MC, Kiluk J, Khakpour N, Hoover S, Laronga C, Khong HT. Abstract P2-17-03: Real-world benefit of CDK4/6 inhibitor and endocrine therapy combination in metastatic breast cancer and correlation with neutropenia. Cancer Res 2020. [DOI: 10.1158/1538-7445.sabcs19-p2-17-03] [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
Background: Combination of a CDK4/6 inhibitor plus endocrine therapy has been shown to significantly improve the progression free survival (PFS) in patients with hormone-receptor (HR)+, HER2- metastatic breast cancer. The aims of this retrospective study was: 1) to evaluate the real-world benefit of palbociclib plus endocrine therapy as the first line treatment in HR+, HER2- metastatic breast cancer (mBC) and 2) to correlate efficacy of the combination with neutropenia (which is a common toxicity of CDK4/6 inhibitors). Methods: This study included HR+, HER2- advanced mBC patients who were treated with palbociclib plus an endocrine therapy (mainly letrozole) at Moffitt Cancer Center between January 1, 2015 and March 1, 2018. The PFS was determined using Kaplan-Meier analysis. The predictive value of absolute neutrophil count (ANC) and neutrophil-to-lymphocyte ratio (NLR) for PFS were investigated using the univariable and multivariable Cox models. Results: A total of 165 patients were included in this retrospective cohort study. The median PFS of the full cohort was 24.19 months (95% CI 18.93 to not reached). For patients with bone metastasis only (n = 54), the median PFS was not reached (95% CI 18.21 to not reached). For patients with non-bone-only metastasis (n = 111), the median PFS was 24.19 months (95% CI 16.33 to 33.82). Patients with higher absolute neutrophil counts (ANC) are at high risk of disease progression (HR 1.15; 95% CI 1.03 to 1.29, p = 0.013). We did not find a significant association between the value of NLR and the risk of disease progression (HR 1.07 95% 0.97 to 1.18, p = 0.203). Both ANC and NLR were used as a time dependent variable. Conclusion:The effectiveness of palbociclib plus letrozole in the treatment of HR+, HER2- metastatic breast cancer in the real-world setting was found to be similar to the results from the PALOMA-2 trial. In addition, patients with a higher ANC were found to have a higher risk for early disease progression. This has implication for clinical practice [i.e., frequent dose delay and/or dose reduction based on ANC threshold of 1000/uL may not be an optimal approach. Since infection is rare, it is reasonable to reduce this threshold to a lower level such as 750-800/uL].
Citation Format: Dakota Jenneman, Xiaojun Zhong, Junjie Ma, Weihong Sun, Heather Han, Hatem Soliman, Loretta Loftus, Ricardo Costa, Avan Armaghani, Aixa Soyano, Brian Czerniecki, M. Catherine Lee, John Kiluk, Nazanin Khakpour, Susan Hoover, Christine Laronga, Hung T Khong. Real-world benefit of CDK4/6 inhibitor and endocrine therapy combination in metastatic breast cancer and correlation with neutropenia [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P2-17-03.
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Affiliation(s)
- Dakota Jenneman
- 1Moffitt Cancer Center and University of South Florida, Tampa, FL
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McLeod A, Leung S, Yuh J, Ghorbani A, Ramanuj R, Hoover S. A chimeric approach to purifying lentiviral vectors for CAR-T. Cytotherapy 2019. [DOI: 10.1016/j.jcyt.2019.03.331] [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: 11/29/2022]
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13
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Gorham PW, Nam J, Romero-Wolf A, Hoover S, Allison P, Banerjee O, Beatty JJ, Belov K, Besson DZ, Binns WR, Bugaev V, Cao P, Chen C, Chen P, Clem JM, Connolly A, Dailey B, Deaconu C, Cremonesi L, Dowkontt PF, DuVernois MA, Field RC, Fox BD, Goldstein D, Gordon J, Hast C, Hebert CL, Hill B, Hughes K, Hupe R, Israel MH, Javaid A, Kowalski J, Lam J, Learned JG, Liewer KM, Liu TC, Link JT, Lusczek E, Matsuno S, Mercurio BC, Miki C, Miočinović P, Mottram M, Mulrey K, Naudet CJ, Ng J, Nichol RJ, Palladino K, Rauch BF, Reil K, Roberts J, Rosen M, Rotter B, Russell J, Ruckman L, Saltzberg D, Seckel D, Schoorlemmer H, Stafford S, Stockham J, Stockham M, Strutt B, Tatem K, Varner GS, Vieregg AG, Walz D, Wissel SA, Wu F. Characteristics of Four Upward-Pointing Cosmic-Ray-like Events Observed with ANITA. Phys Rev Lett 2016; 117:071101. [PMID: 27563945 DOI: 10.1103/physrevlett.117.071101] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Indexed: 06/06/2023]
Abstract
We report on four radio-detected cosmic-ray (CR) or CR-like events observed with the Antarctic Impulsive Transient Antenna (ANITA), a NASA-sponsored long-duration balloon payload. Two of the four were previously identified as stratospheric CR air showers during the ANITA-I flight. A third stratospheric CR was detected during the ANITA-II flight. Here, we report on characteristics of these three unusual CR events, which develop nearly horizontally, 20-30 km above the surface of Earth. In addition, we report on a fourth steeply upward-pointing ANITA-I CR-like radio event which has characteristics consistent with a primary that emerged from the surface of the ice. This suggests a possible τ-lepton decay as the origin of this event, but such an interpretation would require significant suppression of the standard model τ-neutrino cross section.
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Affiliation(s)
- P W Gorham
- Department of Physics and Astronomy, University of Hawaii, Manoa, Hawaii 96822, USA
| | - J Nam
- Department of Physics, Graduate Institute of Astrophysics and Leung Center for Cosmology and Particle Astrophysics, National Taiwan University, Taipei 10617, Taiwan
| | - A Romero-Wolf
- Jet Propulsion Laboratory, Pasadena, California 91109, USA
| | - S Hoover
- Department of Physics and Astronomy, University of California, Los Angeles, Los Angeles, California 90095, USA
| | - P Allison
- Department of Physics, Ohio State University, Columbus, Ohio 43210, USA
- Center for Cosmology and Particle Astrophysics, Ohio State University, Columbus, Ohio 43210, USA
| | - O Banerjee
- Department of Physics, Ohio State University, Columbus, Ohio 43210, USA
| | - J J Beatty
- Department of Physics, Ohio State University, Columbus, Ohio 43210, USA
- Center for Cosmology and Particle Astrophysics, Ohio State University, Columbus, Ohio 43210, USA
| | - K Belov
- Jet Propulsion Laboratory, Pasadena, California 91109, USA
| | - D Z Besson
- Department of Physics and Astronomy, University of Kansas, Lawrence, Kansas 66045, USA
| | - W R Binns
- Department of Physics, Washington University in St. Louis, St. Louis, Missouri 63130, USA
| | - V Bugaev
- Department of Physics, Washington University in St. Louis, St. Louis, Missouri 63130, USA
| | - P Cao
- Department of Physics, University of Delaware, Newark, Delaware 19716, USA
| | - C Chen
- Department of Physics, Graduate Institute of Astrophysics and Leung Center for Cosmology and Particle Astrophysics, National Taiwan University, Taipei 10617, Taiwan
| | - P Chen
- Department of Physics, Graduate Institute of Astrophysics and Leung Center for Cosmology and Particle Astrophysics, National Taiwan University, Taipei 10617, Taiwan
| | - J M Clem
- Department of Physics, University of Delaware, Newark, Delaware 19716, USA
| | - A Connolly
- Department of Physics, Ohio State University, Columbus, Ohio 43210, USA
- Center for Cosmology and Particle Astrophysics, Ohio State University, Columbus, Ohio 43210, USA
| | - B Dailey
- Department of Physics, Ohio State University, Columbus, Ohio 43210, USA
| | - C Deaconu
- Department of Physics, Enrico Fermi Institute, Kavli Institute for Cosmological Physics, University of Chicago, Chicago, Illinois 60637, USA
| | - L Cremonesi
- Department of Physics and Astronomy, University College London, London WC1E 6BT, United Kingdom
| | - P F Dowkontt
- Department of Physics and Astronomy, University of California, Los Angeles, Los Angeles, California 90095, USA
| | - M A DuVernois
- Department of Physics and Astronomy, University of Hawaii, Manoa, Hawaii 96822, USA
| | - R C Field
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - B D Fox
- Department of Physics and Astronomy, University of Hawaii, Manoa, Hawaii 96822, USA
| | - D Goldstein
- Department of Physics, University of California, Irvine, California 92697, USA
| | - J Gordon
- Department of Physics, Ohio State University, Columbus, Ohio 43210, USA
| | - C Hast
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - C L Hebert
- Department of Physics and Astronomy, University of Hawaii, Manoa, Hawaii 96822, USA
| | - B Hill
- Department of Physics and Astronomy, University of Hawaii, Manoa, Hawaii 96822, USA
| | - K Hughes
- Department of Physics, Ohio State University, Columbus, Ohio 43210, USA
| | - R Hupe
- Department of Physics, Ohio State University, Columbus, Ohio 43210, USA
| | - M H Israel
- Department of Physics, Washington University in St. Louis, St. Louis, Missouri 63130, USA
| | - A Javaid
- Department of Physics, University of Delaware, Newark, Delaware 19716, USA
| | - J Kowalski
- Department of Physics and Astronomy, University of Hawaii, Manoa, Hawaii 96822, USA
| | - J Lam
- Department of Physics and Astronomy, University of California, Los Angeles, Los Angeles, California 90095, USA
| | - J G Learned
- Department of Physics and Astronomy, University of Hawaii, Manoa, Hawaii 96822, USA
| | - K M Liewer
- Jet Propulsion Laboratory, Pasadena, California 91109, USA
| | - T C Liu
- Department of Physics, Graduate Institute of Astrophysics and Leung Center for Cosmology and Particle Astrophysics, National Taiwan University, Taipei 10617, Taiwan
| | - J T Link
- Department of Physics and Astronomy, University of Hawaii, Manoa, Hawaii 96822, USA
| | - E Lusczek
- School of Physics and Astronomy, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - S Matsuno
- Department of Physics and Astronomy, University of Hawaii, Manoa, Hawaii 96822, USA
| | - B C Mercurio
- Department of Physics, Ohio State University, Columbus, Ohio 43210, USA
| | - C Miki
- Department of Physics and Astronomy, University of Hawaii, Manoa, Hawaii 96822, USA
| | - P Miočinović
- Department of Physics and Astronomy, University of Hawaii, Manoa, Hawaii 96822, USA
| | - M Mottram
- Department of Physics and Astronomy, University College London, London WC1E 6BT, United Kingdom
| | - K Mulrey
- Department of Physics, University of Delaware, Newark, Delaware 19716, USA
| | - C J Naudet
- Jet Propulsion Laboratory, Pasadena, California 91109, USA
| | - J Ng
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - R J Nichol
- Department of Physics and Astronomy, University College London, London WC1E 6BT, United Kingdom
| | - K Palladino
- Department of Physics, Ohio State University, Columbus, Ohio 43210, USA
| | - B F Rauch
- Department of Physics, Washington University in St. Louis, St. Louis, Missouri 63130, USA
| | - K Reil
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - J Roberts
- Department of Physics and Astronomy, University of Hawaii, Manoa, Hawaii 96822, USA
| | - M Rosen
- Department of Physics and Astronomy, University of Hawaii, Manoa, Hawaii 96822, USA
| | - B Rotter
- Department of Physics and Astronomy, University of Hawaii, Manoa, Hawaii 96822, USA
| | - J Russell
- Department of Physics and Astronomy, University of Hawaii, Manoa, Hawaii 96822, USA
| | - L Ruckman
- Department of Physics and Astronomy, University of Hawaii, Manoa, Hawaii 96822, USA
| | - D Saltzberg
- Department of Physics and Astronomy, University of California, Los Angeles, Los Angeles, California 90095, USA
| | - D Seckel
- Department of Physics, University of Delaware, Newark, Delaware 19716, USA
| | - H Schoorlemmer
- Department of Physics and Astronomy, University of Hawaii, Manoa, Hawaii 96822, USA
| | - S Stafford
- Department of Physics, Ohio State University, Columbus, Ohio 43210, USA
| | - J Stockham
- Department of Physics and Astronomy, University of Kansas, Lawrence, Kansas 66045, USA
| | - M Stockham
- Department of Physics and Astronomy, University of Kansas, Lawrence, Kansas 66045, USA
| | - B Strutt
- Department of Physics and Astronomy, University College London, London WC1E 6BT, United Kingdom
| | - K Tatem
- Department of Physics and Astronomy, University of Hawaii, Manoa, Hawaii 96822, USA
| | - G S Varner
- Department of Physics and Astronomy, University of Hawaii, Manoa, Hawaii 96822, USA
| | - A G Vieregg
- Department of Physics, Enrico Fermi Institute, Kavli Institute for Cosmological Physics, University of Chicago, Chicago, Illinois 60637, USA
| | - D Walz
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - S A Wissel
- Physics Department, California Polytechnic State University, San Luis Obispo, California 93407, USA
| | - F Wu
- Department of Physics and Astronomy, University of California, Los Angeles, Los Angeles, California 90095, USA
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Khazai L, Chau A, Hoover S, Rosa M. Papillary endothelial hyperplasia arising in the irradiated breast: A diagnostic dilemma. Pathol Res Pract 2016; 212:604-7. [PMID: 27157404 DOI: 10.1016/j.prp.2015.11.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Revised: 11/16/2015] [Accepted: 11/23/2015] [Indexed: 11/18/2022]
Abstract
Papillary endothelial hyperplasia (PEH) is a benign proliferative lesion that may occur in any site of the body, but most commonly affects the skin and subcutaneous tissues. In the breast, PEH has been documented but is rare. PEH is notorious for being misdiagnosed as angiosarcoma due to its complex growth pattern, papillary processes and interlacing vascular channels. The occurrence of PEH years after breast irradiation constitutes a pathological and clinical diagnostic challenge because angiosarcoma is far more common in this setting. The most important features that differentiate papillary endothelial hyperplasia from angiosarcoma are its presentation as a round nodule without infiltrative borders, its localization inside a vessel or in association with thrombus, and the lack of significant cytologic atypia or areas of solid growth, even in the presence of a complex architecture. Clinical history and site of involvement (cutaneous versus parenchymal) are usually of help to establish a correct diagnosis. Herein, we describe two cases of PEH presenting in patients with history of breast carcinoma and breast radiation therapy. The clinical and morphological features as well as the differential diagnoses are discussed. To our knowledge, no other cases of PEH of the breast occurring in the post-radiation setting have been described in the literature.
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Affiliation(s)
- Laila Khazai
- Department of Anatomic Pathology, H. Lee Moffitt Cancer Center and Research Institute, United States
| | - Alec Chau
- Department of Radiology, H. Lee Moffitt Cancer Center and Research Institute, United States
| | - Susan Hoover
- Breast Surgical Oncology, Comprehensive Breast Program, H. Lee Moffitt Cancer Center and Research Institute, United States
| | - Marilin Rosa
- Department of Anatomic Pathology, H. Lee Moffitt Cancer Center and Research Institute, United States.
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Mullinax J, Carr D, Vera N, Sun W, Lee MC, Hoover S, Fulp WJ, Acs G, Laronga C. Distant recurrence risk with prospective use of the 21-gene assay at a single institution. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.28_suppl.131] [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: 11/20/2022] Open
Abstract
131 Background: Distant recurrence (DR) is the cause of most breast cancer deaths. The 21-gene assay (ODX) Recurrence Score (RS) result predicts both 5 and 10-yr DR risk and can guide adjuvant chemotherapy (CT) recommendations to mitigate this risk. This study analyzed the use of the RS result to guide adjuvant treatment decisions in a large single-institution, prospective cohort of patients (pts). Methods: This is an IRB-approved review of a prospective database of pts receiving ODX on an initial primary breast cancer. Data collected included demographics, primary operation, margin status, receptor status, RS, adjuvant treatment, recurrence, and survival. Pts were stratified as low risk (RS < 18), intermediate risk, or high risk (RS > 30). The primary analysis computed Kaplan-Meier estimates for rate of DR at 5 yrs when pts were stratified by RS. Results: From 2003 to 2009, a RS result was obtained on 606 pts. Median follow up was 2.9 yrs (0.1-9.7) and median age was 58 yrs (27-84). Median RS result was 16 (0-63); 344(57%) pts were low, 212(35%) intermediate, 50(8%) high. Endocrine therapy was given to 92.4%, 94.3%, and 87.5% low, intermediate, and high risk pts, respectively. Adjuvant CT was given to 8.6%, 47.6%, and 70.8% low, intermediate, and high risk pts, respectively. There were 8 DR events with 1.8% 5-yr estimated risk of DR. The 5-yr estimated risk of DR was 0.7% for low risk (344) pts, 3.4% for intermediate risk (211) pts, and 2.6% for high risk (50) pts. Among node negative [N(-)] pts (502), the 5-yr estimated risk of DR was 0.8% for low risk (287) pts, 3.7% for intermediate risk (174) pts, and 3.3% for high risk (41) pts. Among node positive [(N+)] pts (54) there was only 1 DR, which was in a high risk pt. Of pts with unknown nodal status (50), there were no DRs. Conclusions: The RS result is predictive of DR at 5 yrs as shown in historical datasets (Table). The use of ODX to guide adjuvant treatment recommendations in our contemporary, prospective cohort resulted in a much lower 5-year DR rate and thus supports its use to guide adjuvant treatment decisions. [Table: see text]
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Affiliation(s)
- John Mullinax
- H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL
| | | | - Nora Vera
- USF Morsani College of Medicine, Tampa, FL
| | - Weihong Sun
- H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL
| | | | - Susan Hoover
- H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL
| | - William J. Fulp
- Department of Biostatistics, Moffit Cancer Center, Tampa, FL
| | - Geza Acs
- Ruffolo, Hooper and Associates, Tampa, FL
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Story KT, Hanson D, Ade PAR, Aird KA, Austermann JE, J. A. Beall, Bender AN, Benson BA, Bleem LE, Carlstrom JE, Chang CL, Chiang HC, Cho HM, Citron R, Crawford TM, Crites AT, Haan TD, Dobbs MA, Everett W, Gallicchio J, Gao J, George EM, Gilbert A, Halverson NW, Harrington N, Henning JW, Hilton GC, Holder GP, Holzapfel WL, Hoover S, Hou Z, Hrubes JD, Huang N, Hubmayr J, Irwin KD, Keisler R, Knox L, Lee AT, Leitch EM, Li D, Liang C, Luong-Van D, McMahon JJ, Mehl J, Meyer SS, Mocanu L, Montroy TE, Natoli T, Nibarger JP, Novosad V, Padin S, Pryke C, Reichardt CL, Ruhl JE, Saliwanchik BR, Sayre JT, Schaffer KK, Smecher G, Stark AA, Tucker C, Vanderlinde K, Vieira JD, Wang G, Whitehorn N, Yefremenko V, Zahn O. A MEASUREMENT OF THE COSMIC MICROWAVE BACKGROUND GRAVITATIONAL LENSING POTENTIAL FROM 100 SQUARE DEGREES OF SPTPOL DATA. ACTA ACUST UNITED AC 2015. [DOI: 10.1088/0004-637x/810/1/50] [Citation(s) in RCA: 82] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Keisler R, Hoover S, Harrington N, Henning JW, Ade PAR, Aird KA, Austermann JE, Beall JA, Bender AN, Benson BA, Bleem LE, Carlstrom JE, Chang CL, Chiang HC, Cho HM, Citron R, Crawford TM, Crites AT, de Haan T, Dobbs MA, Everett W, Gallicchio J, Gao J, George EM, Gilbert A, Halverson NW, Hanson D, Hilton GC, Holder GP, Holzapfel WL, Hou Z, Hrubes JD, Huang N, Hubmayr J, Irwin KD, Knox L, Lee AT, Leitch EM, Li D, Luong-Van D, Marrone DP, McMahon JJ, Mehl J, Meyer SS, Mocanu L, Natoli T, Nibarger JP, Novosad V, Padin S, Pryke C, Reichardt CL, Ruhl JE, Saliwanchik BR, Sayre JT, Schaffer KK, Shirokoff E, Smecher G, Stark AA, Story KT, Tucker C, Vanderlinde K, Vieira JD, Wang G, Whitehorn N, Yefremenko V, Zahn O. MEASUREMENTS OF SUB-DEGREEB-MODE POLARIZATION IN THE COSMIC MICROWAVE BACKGROUND FROM 100 SQUARE DEGREES OF SPTPOL DATA. ACTA ACUST UNITED AC 2015. [DOI: 10.1088/0004-637x/807/2/151] [Citation(s) in RCA: 111] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Zimmerman A, Locke FL, Emole J, Rosa M, Horna P, Hoover S, Dayicioglu D. Recurrent Systemic Anaplastic Lymphoma Kinase–Negative Anaplastic Large Cell Lymphoma Presenting as a Breast Implant–Associated Lesion. Cancer Control 2015; 22:369-73. [DOI: 10.1177/107327481502200317] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Amanda Zimmerman
- Division of Plastic Surgery, Department of Surgery, University of South Florida Morsani College of Medicine, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida
| | - Frederick L. Locke
- Departments of Blood & Marrow Transplantation, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida
| | - Josephine Emole
- Hematology/Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida
| | - Marilin Rosa
- Anatomic Pathology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida
- Women's Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida
| | - Pedro Horna
- Pathology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida
| | - Susan Hoover
- Breast Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida
| | - Deniz Dayicioglu
- Plastic Surgery, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida
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Crites AT, Henning JW, Ade PAR, Aird KA, Austermann JE, Beall JA, Bender AN, Benson BA, Bleem LE, Carlstrom JE, Chang CL, Chiang HC, Cho HM, Citron R, Crawford TM, Haan TD, Dobbs MA, Everett W, Gallicchio J, Gao J, George EM, Gilbert A, Halverson NW, Hanson D, Harrington N, Hilton GC, Holder GP, Holzapfel WL, Hoover S, Hou Z, Hrubes JD, Huang N, Hubmayr J, Irwin KD, Keisler R, Knox L, Lee AT, Leitch EM, Li D, Liang C, Luong-Van D, McMahon JJ, Mehl J, Meyer SS, Mocanu L, Montroy TE, Natoli T, Nibarger JP, Novosad V, Padin S, Pryke C, Reichardt CL, Ruhl JE, Saliwanchik BR, Sayre JT, Schaffer KK, Smecher G, Stark AA, Story KT, Tucker C, Vanderlinde K, Vieira JD, Wang G, Whitehorn N, Yefremenko V, Zahn O. MEASUREMENTS OF E-MODE POLARIZATION AND TEMPERATURE-E-MODE CORRELATION IN THE COSMIC MICROWAVE BACKGROUND FROM 100 SQUARE DEGREES OF SPTPOL DATA. ACTA ACUST UNITED AC 2015. [DOI: 10.1088/0004-637x/805/1/36] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Jafarian N, Kuppler K, Rosa M, Hoover S, Patel B. Chronic Lymphocytic Leukemia and Invasive Ductal Carcinoma Presenting as a Collision Breast Tumor. Clin Breast Cancer 2015; 15:e209-12. [PMID: 25818398 DOI: 10.1016/j.clbc.2015.02.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Accepted: 02/08/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Neda Jafarian
- Department of Radiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
| | - Kevin Kuppler
- Department of Radiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Marilin Rosa
- Department of Anatomic Pathology and Women's Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Susan Hoover
- Comprehensive Breast Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Bhavika Patel
- Department of Radiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
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Hanson D, Hoover S, Crites A, Ade PAR, Aird KA, Austermann JE, Beall JA, Bender AN, Benson BA, Bleem LE, Bock JJ, Carlstrom JE, Chang CL, Chiang HC, Cho HM, Conley A, Crawford TM, de Haan T, Dobbs MA, Everett W, Gallicchio J, Gao J, George EM, Halverson NW, Harrington N, Henning JW, Hilton GC, Holder GP, Holzapfel WL, Hrubes JD, Huang N, Hubmayr J, Irwin KD, Keisler R, Knox L, Lee AT, Leitch E, Li D, Liang C, Luong-Van D, Marsden G, McMahon JJ, Mehl J, Meyer SS, Mocanu L, Montroy TE, Natoli T, Nibarger JP, Novosad V, Padin S, Pryke C, Reichardt CL, Ruhl JE, Saliwanchik BR, Sayre JT, Schaffer KK, Schulz B, Smecher G, Stark AA, Story KT, Tucker C, Vanderlinde K, Vieira JD, Viero MP, Wang G, Yefremenko V, Zahn O, Zemcov M. Detection of B-mode polarization in the cosmic microwave background with data from the South Pole Telescope. Phys Rev Lett 2013; 111:141301. [PMID: 24138230 DOI: 10.1103/physrevlett.111.141301] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2013] [Indexed: 06/02/2023]
Abstract
Gravitational lensing of the cosmic microwave background generates a curl pattern in the observed polarization. This "B-mode" signal provides a measure of the projected mass distribution over the entire observable Universe and also acts as a contaminant for the measurement of primordial gravity-wave signals. In this Letter we present the first detection of gravitational lensing B modes, using first-season data from the polarization-sensitive receiver on the South Pole Telescope (SPTpol). We construct a template for the lensing B-mode signal by combining E-mode polarization measured by SPTpol with estimates of the lensing potential from a Herschel-SPIRE map of the cosmic infrared background. We compare this template to the B modes measured directly by SPTpol, finding a nonzero correlation at 7.7σ significance. The correlation has an amplitude and scale dependence consistent with theoretical expectations, is robust with respect to analysis choices, and constitutes the first measurement of a powerful cosmological observable.
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Affiliation(s)
- D Hanson
- Department of Physics, McGill University, Montreal, Quebec H3A 2T8, Canada
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McDonald M, Bayliss M, Benson BA, Foley RJ, Ruel J, Sullivan P, Veilleux S, Aird KA, Ashby MLN, Bautz M, Bazin G, Bleem LE, Brodwin M, Carlstrom JE, Chang CL, Cho HM, Clocchiatti A, Crawford TM, Crites AT, de Haan T, Desai S, Dobbs MA, Dudley JP, Egami E, Forman WR, Garmire GP, George EM, Gladders MD, Gonzalez AH, Halverson NW, Harrington NL, High FW, Holder GP, Holzapfel WL, Hoover S, Hrubes JD, Jones C, Joy M, Keisler R, Knox L, Lee AT, Leitch EM, Liu J, Lueker M, Luong-Van D, Mantz A, Marrone DP, McMahon JJ, Mehl J, Meyer SS, Miller ED, Mocanu L, Mohr JJ, Montroy TE, Murray SS, Natoli T, Padin S, Plagge T, Pryke C, Rawle TD, Reichardt CL, Rest A, Rex M, Ruhl JE, Saliwanchik BR, Saro A, Sayre JT, Schaffer KK, Shaw L, Shirokoff E, Simcoe R, Song J, Spieler HG, Stalder B, Staniszewski Z, Stark AA, Story K, Stubbs CW, Šuhada R, van Engelen A, Vanderlinde K, Vieira JD, Vikhlinin A, Williamson R, Zahn O, Zenteno A. A massive, cooling-flow-induced starburst in the core of a luminous cluster of galaxies. Nature 2012; 488:349-52. [DOI: 10.1038/nature11379] [Citation(s) in RCA: 135] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2012] [Accepted: 07/12/2012] [Indexed: 11/09/2022]
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Abstract
Breast conservation therapy (BCT), which is the marriage of breast conserving surgery and radiation therapy to the breast, has revolutionized the treatment of breast cancer over the last few decades. Surgical direction had seen a heightened interest in the performance of cosmetically superior partial and segmental resections in breast conservation as well as increased demand by patients for breast preservation. The broadening of approaches to delivery of breast irradiation from whole breast to accelerated partial breast has allowed more patients to opt for breast conservation and allowed for what appears to be comparable measurable outcomes in emerging data. As well, the addition of state-of-the-art chemotherapeutic and hormonal therapies has allowed improved outcomes of patients from both local regional recurrence and overall survival standpoints. This paper will provide an overview of BCT and review some of the newest developments in optimizing this therapy for patients with breast cancer from a surgical-, medical-, and radiation-oncology standpoint.
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Affiliation(s)
- Susan Hoover
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
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Vinh DC, Schwartz B, Hsu AP, Miranda DJ, Valdez PA, Fink D, Lau KP, Long-Priel D, Kuhns DB, Uzel G, Pittaluga S, Hoover S, Galgiani JN, Holland SM. Interleukin-12 receptor β1 deficiency predisposing to disseminated Coccidioidomycosis. Clin Infect Dis 2011; 52:e99-e102. [PMID: 21258095 DOI: 10.1093/cid/ciq215] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Affiliation(s)
- Donald C Vinh
- Immunopathogenesis Section, Laboratory of Clinical Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
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Detrixhe M, Besson D, Gorham PW, Allison P, Baughmann B, Beatty JJ, Belov K, Bevan S, Binns WR, Chen C, Chen P, Clem JM, Connolly A, De Marco D, Dowkontt PF, DuVernois MA, Frankenfeld C, Grashorn EW, Hogan DP, Griffith N, Hill B, Hoover S, Israel MH, Javaid A, Liewer KM, Matsuno S, Mercurio BC, Miki C, Mottram M, Nam J, Nichol RJ, Palladino K, Romero-Wolf A, Ruckman L, Saltzberg D, Seckel D, Varner GS, Vieregg AG, Wang Y. Ultrarelativistic magnetic monopole search with the ANITA-II balloon-borne radio interferometer. Int J Clin Exp Med 2011. [DOI: 10.1103/physrevd.83.023513] [Citation(s) in RCA: 29] [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] [Indexed: 11/07/2022]
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Hoover S, Nam J, Gorham PW, Grashorn E, Allison P, Barwick SW, Beatty JJ, Belov K, Besson DZ, Binns WR, Chen C, Chen P, Clem JM, Connolly A, Dowkontt PF, DuVernois MA, Field RC, Goldstein D, Vieregg AG, Hast C, Israel MH, Javaid A, Kowalski J, Learned JG, Liewer KM, Link JT, Lusczek E, Matsuno S, Mercurio BC, Miki C, Miočinović P, Naudet CJ, Ng J, Nichol RJ, Palladino K, Reil K, Romero-Wolf A, Rosen M, Ruckman L, Saltzberg D, Seckel D, Varner GS, Walz D, Wu F. Observation of ultrahigh-energy cosmic rays with the ANITA balloon-borne radio interferometer. Phys Rev Lett 2010; 105:151101. [PMID: 21230887 DOI: 10.1103/physrevlett.105.151101] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2010] [Indexed: 05/30/2023]
Abstract
We report the observation of 16 cosmic ray events with a mean energy of 1.5 × 10¹⁹ eV via radio pulses originating from the interaction of the cosmic ray air shower with the Antarctic geomagnetic field, a process known as geosynchrotron emission. We present measurements in the 300-900 MHz range, which are the first self-triggered, first ultrawide band, first far-field, and the highest energy sample of cosmic ray events collected with the radio technique. Their properties are inconsistent with current ground-based geosynchrotron models. The emission is 100% polarized in the plane perpendicular to the projected geomagnetic field. Fourteen events are seen to have a phase inversion due to reflection of the radio beam off the ice surface, and two additional events are seen directly from above the horizon. Based on a likelihood analysis, we estimate angular pointing precision of order 2° for the event arrival directions.
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Affiliation(s)
- S Hoover
- Department of Physics and Astronomy, University of California, Los Angeles, California 90095, USA
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Grose-Fifer J, Yuksel-Sokmen O, Rodrigues A, Hoover S, Zottoli T. The fear factor: Attentional capture by fearful faces in adolescence. J Vis 2010. [DOI: 10.1167/10.7.578] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Grose-Fifer J, Hoover S, Rodrigues A, Zottoli T. Attentional capture by emotional faces in adolescence. J Vis 2010. [DOI: 10.1167/9.8.114] [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: 11/24/2022] Open
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Sarnaik AA, Meade T, King J, Acs G, Hoover S, Cox CE, Carter WB, Laronga C. Adenoid cystic carcinoma of the breast: a review of a single institution's experience. Breast J 2009; 16:208-10. [PMID: 20030648 DOI: 10.1111/j.1524-4741.2009.00876.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Laronga C, Lee MC, McGuire KP, Meade T, Carter WB, Hoover S, Cox CE. Indications for sentinel lymph node biopsy in the setting of prophylactic mastectomy. J Am Coll Surg 2009; 209:746-52; quiz 800-1. [PMID: 19959044 DOI: 10.1016/j.jamcollsurg.2009.08.010] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2009] [Revised: 08/12/2009] [Accepted: 08/12/2009] [Indexed: 10/20/2022]
Abstract
BACKGROUND Bilateral/contralateral prophylactic mastectomy (PM) is offered to high-risk women to decrease their actual or perceived breast cancer risk. When an invasive occult cancer is identified, prevailing wisdom suggests that an axillary dissection be performed. This single-institution study aims to identify patients who may benefit from sentinel node biopsy (SLNB) at the time of prophylactic mastectomy. STUDY DESIGN We performed a retrospective review of a prospective database of patients treated at our institution with bilateral/contralateral PM between 1995 and 2006. We examined patients' clinicopathologic characteristics in comparison with their incidence of occult cancer in the contralateral breast or axilla. RESULTS There were 449 patients who underwent PM and SLNB. Twenty-eight underwent bilateral PM. Of the 28, no occult cancers were identified. Occult cancers were identified in 18 of 420 (4.3%) contralateral prophylactic specimens; they were invasive in 6 (1.4%). In cases of occult carcinoma, the primary established tumor was more likely to be of invasive lobular histology. Eight of 420 (2%) patients had a positive contralateral sentinel node, and within this subset of 8 patients the majority had locally advanced disease on the known tumor side. Other features associated with a positive contralateral sentinel node included the presence of lymphovascular involvement or skin or nipple involvement and grade 2 to 3 invasive primary established tumors. CONCLUSIONS Overall, SLNB in patients undergoing bilateral PM or contralateral PM associated with early-stage disease is not indicated. But patients with locally advanced primary breast cancers have a significantly increased risk of occult cancer in the contralateral axilla, likely due to crossover metastasis; this select group of patients may benefit from SLNB at the time of surgery.
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Affiliation(s)
- Christine Laronga
- Don & Erika Wallace Comprehensive Breast Program, H Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Dr, MCC-BRPROG, Tampa, FL 33612, USA
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Gorham PW, Allison P, Barwick SW, Beatty JJ, Besson DZ, Binns WR, Chen C, Chen P, Clem JM, Connolly A, Dowkontt PF, Duvernois MA, Field RC, Goldstein D, Goodhue A, Hast C, Hebert CL, Hoover S, Israel MH, Kowalski J, Learned JG, Liewer KM, Link JT, Lusczek E, Matsuno S, Mercurio BC, Miki C, Miocinović P, Nam J, Naudet CJ, Ng J, Nichol RJ, Palladino K, Reil K, Romero-Wolf A, Rosen M, Ruckman L, Saltzberg D, Seckel D, Varner GS, Walz D, Wang Y, Wu F. New limits on the ultrahigh energy cosmic neutrino flux from the ANITA experiment. Phys Rev Lett 2009; 103:051103. [PMID: 19792479 DOI: 10.1103/physrevlett.103.051103] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2008] [Revised: 04/15/2009] [Indexed: 05/28/2023]
Abstract
We report initial results of the first flight of the Antarctic Impulsive Transient Antenna (ANITA-1) 2006-2007 Long Duration Balloon flight, which searched for evidence of a diffuse flux of cosmic neutrinos above energies of E(nu) approximately 3 x 10(18) eV. ANITA-1 flew for 35 days looking for radio impulses due to the Askaryan effect in neutrino-induced electromagnetic showers within the Antarctic ice sheets. We report here on our initial analysis, which was performed as a blind search of the data. No neutrino candidates are seen, with no detected physics background. We set model-independent limits based on this result. Upper limits derived from our analysis rule out the highest cosmogenic neutrino models. In a background horizontal-polarization channel, we also detect six events consistent with radio impulses from ultrahigh energy extensive air showers.
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Affiliation(s)
- P W Gorham
- Department of Physics and Astronomy, University of Hawaii, Manoa, Hawaii 96822, USA
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Shhadeh A, Hoover S, Gardner K, Cornett O, Gandhi C, Prestigiacomo C. 004 Aneurysm aspect ratio predicts the probability of recanalization after coil embolization. J Neurointerv Surg 2009. [DOI: 10.1136/jnis.2009.000869d] [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: 11/04/2022]
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Shhadeh A, Hoover S, Gardner K, Cornett O, Prestigiacomo C, Gandhi C. 006 Aneurysm configuration predicts the probability of recanalization after coil embolization. J Neurointerv Surg 2009. [DOI: 10.1136/jnis.2009.000869f] [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: 11/03/2022]
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34
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Gorham PW, Barwick SW, Beatty JJ, Besson DZ, Binns WR, Chen C, Chen P, Clem JM, Connolly A, Dowkontt PF, DuVernois MA, Field RC, Goldstein D, Goodhue A, Hast C, Hebert CL, Hoover S, Israel MH, Kowalski J, Learned JG, Liewer KM, Link JT, Lusczek E, Matsuno S, Mercurio B, Miki C, Miocinović P, Nam J, Naudet CJ, Ng J, Nichol R, Palladino K, Reil K, Romero-Wolf A, Rosen M, Ruckman L, Saltzberg D, Seckel D, Varner GS, Walz D, Wu F. Observations of the Askaryan effect in ice. Phys Rev Lett 2007; 99:171101. [PMID: 17995315 DOI: 10.1103/physrevlett.99.171101] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2006] [Revised: 06/15/2007] [Indexed: 05/25/2023]
Abstract
We report on observations of coherent, impulsive radio Cherenkov radiation from electromagnetic showers in solid ice. This is the first observation of the Askaryan effect in ice. As part of the complete validation process for the ANITA experiment, we performed an experiment at the Stanford Linear Accelerator Center in June 2006 using a 7.5 metric ton ice target. We measure for the first time the large-scale angular dependence of the radiation pattern, a major factor in determining the solid-angle acceptance of ultrahigh-energy neutrino detectors.
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Affiliation(s)
- P W Gorham
- Department of Physics and Astronomy, University of Hawaii, Manoa, Hawaii 96822, USA
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Bevers TB, Anderson BO, Bonaccio E, Borgen PI, Buys S, Daly MB, Dempsey PJ, Farrar WB, Fleming I, Garber JE, Harris RE, Helvie M, Hoover S, Krontiras H, Shaw S, Singletary E, Sugg Skinner C, Smith ML, Tsangaris TN, Wiley EL, Williams C. Breast cancer screening and diagnosis. J Natl Compr Canc Netw 2006; 4:480-508. [PMID: 16687096 DOI: 10.6004/jnccn.2006.0040] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [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: 11/17/2022]
Abstract
The lifetime risk of a woman developing breast cancer has increased over the past 5 years in the United States: of every 7 women, 1 is at risk based on a life expectancy of 85 years. An estimated 214,640 new cases (212,920 women and 1,720 men) of breast cancer and 41,430 deaths (40,970 women and 460 men) from this disease will occur in the United States in 2006. However, mortality from breast cancer has decreased slightly, attributed partly to mammographic screening. Early detection and accurate diagnosis made in a cost-effective manner are critical to a continued reduction in mortality. These practice guidelines are designed to facilitate clinical decision making.
For the most recent version of the guidelines, please visit NCCN.org
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Affiliation(s)
- Therese B Bevers
- University of Texas, M. D. Anderson Cancer Center, Houston, TX 77030, USA
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Laronga C, Hasson D, Hoover S, Cox J, Cantor A, Cox C, Carter WB. Paget’s disease in the era of sentinel lymph node biopsy. Am J Surg 2006; 192:481-3. [PMID: 16978954 DOI: 10.1016/j.amjsurg.2006.06.023] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [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: 04/06/2006] [Revised: 06/04/2006] [Accepted: 06/04/2006] [Indexed: 11/28/2022]
Abstract
BACKGROUND Paget's disease of the breast is an uncommon cancer. "Breast cancer" management has evolved to include sentinel lymph node biopsy (SLNB). Our objective is to determine utilization of SLNB in the surgical algorithm of Paget's disease. METHODS After institutional review board approval, a database review of patients with Paget's disease was conducted. Patient demographics, tumor characteristics, treatment including use of SLNB, and survival were reviewed. Patient characteristics and outcomes were analyzed by using contingency table chi-square, pooled t tests, and log-rank tests for comparisons. RESULTS Fifty-four patients with Paget's disease were identified and divided into 2 cohorts (18 no SLNB and 36 SLNB). The mean age was 66 years for the no-SLNB group and 60 years for the SLNB group (P = .17). Paget's disease only was present in 33%, Paget's disease + DCIS in 41%, and Paget's disease + invasive cancer in 26%. The mean invasive tumor size was 1.62 cm in the no-SLNB group and 1.59 cm in the SLNB group (P = .96). For invasive disease, ER/PR status was similar, but Her2 was more likely to be overexpressed in SLNB (P = .04). Surgery choice ranged from "no surgery" to lumpectomy to mastectomy. Axillary staging was performed in 45 of 54 patients, with 11% in both cohorts having nodal disease. A sentinel lymph node was identified in 97% of patients. Five-year overall and disease-free survival was 100% in the no-SLNB group and 88% in the SLNB group (P = .97) and 76% in the no-SLNB group and 84% in the SLNB group (P = .88), respectively. CONCLUSIONS Paget's disease remains rare but should be treated similar to other "breast cancer." SLNB should be performed to evaluate the axilla when invasive disease is identified or a mastectomy is planned.
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Affiliation(s)
- Christine Laronga
- Department of Interdisciplinary Oncology, H. Lee Moffitt Cancer Center and Research Institute at the University of South Florida, 12902 Magnolia Drive, MCC-BRPROG, Tampa, FL 33612-9497, USA.
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Meng S, Tripathy D, Frenkel EP, Shete S, Naftalis EZ, Huth JF, Beitsch PD, Leitch M, Hoover S, Euhus D, Haley B, Morrison L, Fleming TP, Herlyn D, Terstappen LWMM, Fehm T, Tucker TF, Lane N, Wang J, Uhr JW. Circulating tumor cells in patients with breast cancer dormancy. Clin Cancer Res 2005; 10:8152-62. [PMID: 15623589 DOI: 10.1158/1078-0432.ccr-04-1110] [Citation(s) in RCA: 681] [Impact Index Per Article: 35.8] [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: 12/16/2022]
Abstract
PURPOSE The purpose of this study was to test the hypothesis that circulating tumor cells (CTCs) are present in patients many years after mastectomy without evidence of disease and that these CTCs are shed from persisting tumor in patients with breast cancer dormancy. EXPERIMENTAL DESIGN We searched for CTCs in 36 dormancy candidate patients and 26 age-matched controls using stringent criteria for cytomorphology, immunophenotype, and aneusomy. RESULTS Thirteen of 36 dormancy candidates, 7 to 22 years after mastectomy and without evidence of clinical disease, had CTCs, usually on more than one occasion. Only 1 of 26 controls had a possible CTC (no aneusomy). The statistical difference of these two distributions was significant (exact P = 0.0043). The CTCs in patients whose primary breast cancer was just removed had a half-life measured in 1 to 2.4 hours. CONCLUSIONS The CTCs that are dying must be replenished every few hours by replicating tumor cells somewhere in the tissues. Hence, there appears to be a balance between tumor replication and cell death for as long as 22 years in dormancy candidates. We conclude that this is one mechanism underlying tumor dormancy.
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Affiliation(s)
- Songdong Meng
- Cancer Immunobiology Center, University of Texas Southwestern Medical Center, Dallas, Texas 75390-8576, USA
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Abstract
BACKGROUND It is believed that atypical cells identified by nipple duct lavage (NDL) indicate an increased risk for breast carcinoma similar to atypical ductal hyperplasia diagnosed by tissue biopsy, but many basic performance characteristics of NDL currently are undefined. METHODS NDL was performed in 108 patients unselected for breast carcinoma risk and then was repeated after 2-14 months (median, 8 months) if the initial lavage was classified as atypical. Breast magnetic resonance images (MRIs) were obtained from a subset of patients who had atypical lavage results. RESULTS Marked atypia was diagnosed in 22% of 36 breasts with an incident carcinoma compared with 7% of 172 unaffected breasts (P = 0.01). After excluding breasts with an incident carcinoma, there were 32 patients (30%) with either mild or marked atypia. The lavage was repeated in 23 of these women, and the second lavage was classified as atypical in 48%. Neither marked atypia on the initial lavage nor a 5-year Gail risk > or = 1.7% predicted atypia on repeat lavage, but there was a trend for improved reproducibility when the atypia initially was diagnosed in a fluid-producing duct. MRIs were abnormal in 13% of 24 breasts with an atypical lavage, and ductal carcinoma in situ was diagnosed subsequently in 1 breast. CONCLUSIONS Atypia frequently is diagnosed by NDL, but the reproducibility of repeat lavage is low. Lavage atypia may be physiologic or artifactual rather than pathologic in many instances. Marked atypia occasionally may represent mammographically occult ductal carcinoma in situ.
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Affiliation(s)
- April Johnson-Maddux
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA
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Maddux AJ, Ashfaq R, Naftalis E, Leitch AM, Hoover S, Euhus D. Patient and duct selection for nipple duct lavage. Am J Surg 2004; 188:390-4. [PMID: 15474432 DOI: 10.1016/j.amjsurg.2004.06.021] [Citation(s) in RCA: 18] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2004] [Revised: 06/06/2004] [Indexed: 11/20/2022]
Abstract
BACKGROUND Nipple ductal lavage (NDL) is a new minimally invasive procedure with the potential to help identify women who could benefit from breast cancer risk intervention. NDL is currently encouraged for women with fluid-producing ducts and a 5-year Gail risk > or =1.7%. The purpose of this study was to evaluate the atypia rate by NDL in fluid-producing ducts compared with non-fluid-producing ducts and the atypia rate in high-risk verses low-risk patients to determine if current recommendations are supported. METHODS Fifty-nine women were studied with NDL. The 226 ducts lavaged included all fluid-producing ducts (n = 136) and any dry ducts we could cannulate (n = 90). Breast cancer risk was calculated using mathematic models. RESULTS There were 26 (44%) women with a 5-year Gail risk > or =1.7% and 33 (56%) with a 5-year Gail risk <1.7%. Cytologic atypia was diagnosed in 20 of 59 (34%) of patients. The atypia rate was similar for women with a 5-year Gail risk > or =1.7% (9 of 26 or 35%) compared with lower-risk women (11 of 33 or 33%, P = 1.0) and for fluid-producing ducts (26 of 136 or 19%) compared with dry ducts (14 of 90 or 15%, P = 0.61). No significant differences were found when the atypia was categorized as mild versus marked. Of note, the insufficient sample rate was higher for dry ducts (33%) compared with fluid-producing duct (22%, P = 0.07). CONCLUSIONS If NDL results are found to correlate with breast cancer incidence, it will be important to apply the test in a way that maximizes sensitivity for the detection of atypia in a screened population. We were unable to identify patient or duct characteristics that predict NDL atypia rates.
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Affiliation(s)
- April Johnson Maddux
- Department of Surgery, University of Texas Southwestern Medical Center at Dallas, 5323 Harry Hines Blvd., Dallas, TX 75390-9155, USA
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Meng S, Tripathy D, Shete S, Ashfaq R, Haley B, Perkins S, Beitsch P, Khan A, Euhus D, Osborne C, Frenkel E, Hoover S, Leitch M, Clifford E, Vitetta E, Morrison L, Herlyn D, Terstappen LWMM, Fleming T, Fehm T, Tucker T, Lane N, Wang J, Uhr J. HER-2 gene amplification can be acquired as breast cancer progresses. Proc Natl Acad Sci U S A 2004; 101:9393-8. [PMID: 15194824 PMCID: PMC438987 DOI: 10.1073/pnas.0402993101] [Citation(s) in RCA: 420] [Impact Index Per Article: 21.0] [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: 12/20/2022] Open
Abstract
Amplification and overexpression of the HER-2 oncogene in breast cancer is felt to be stable over the course of disease and concordant between primary tumor and metastases. Therefore, patients with HER-2-negative primary tumors rarely will receive anti-Her-2 antibody (trastuzumab, Herceptin) therapy. A very sensitive blood test was used to capture circulating tumor cells (CTCs) and evaluate their HER-2 gene status by fluorescence in situ hybridization. The HER-2 status of the primary tumor and corresponding CTCs in 31 patients showed 97% agreement, with no false positives. In 10 patients with HER-2-positive tumors, the HER-2/chromosome enumerator probe 17 ratio in each tumor was about twice that of the corresponding CTCs (mean 6.64 +/- 2.72 vs. 2.8 +/- 0.6). Hence, the ratio of the CTCs is a reliable surrogate marker for the expected high ratio in the primary tumor. Her-2 protein expression of 10 CTCs was sufficient to make a definitive diagnosis of the HER-2 gene status of the whole population of CTCs in 19 patients with recurrent breast cancer. Nine of 24 breast cancer patients whose primary tumor was HER-2-negative each acquired HER-2 gene amplification in their CTCs during cancer progression, i.e., 37.5% (95% confidence interval of 18.8-59.4%). Four of the 9 patients were treated with Herceptin-containing therapy. One had a complete response and 2 had a partial response.
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Affiliation(s)
- Songdong Meng
- Cancer Immunobiology Center, University of Texas Southwestern Medical Center, 6000 Harry Hines Boulevard, Dallas, TX 75390, USA
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Abstract
BACKGROUND The epidemiology of community-acquired respiratory viruses at the Children's Hospital of Wisconsin between 1996 and 1998 was examined with molecular [multiplex (M) PCR] and standard virologic methods. METHODS AND RESULTS A total of 3325 patients with lower respiratory infection (LRI) [bronchiolitis (42%), pneumonia (38%) and croup (12%)] were identified. It is estimated that 545,000 LRI hospitalizations occur each year in the United States in children younger than 18 years old (viral, 428,000; pneumonia, 221,000; bronchiolitis, 222,000; croup, 65,000), including a continued increase in bronchiolitis hospitalizations (47.8/1000; <1 year). The most common viruses detected each year in hospitalized children included respiratory syncytial virus (A and B; 117,000), parainfluenza virus (PIV-1 and -2, 48 000; PIV-3, 18,000) and influenza (A and B, 39,000). With multiplex reverse transcription polymerase chain reaction (MPCR), different patient populations demonstrated different LRI epidemiology in relation to specific syndromes and viral causes. At least 21% of LRI hospitalizations were in children with significant medical problems.PIVs were detected much more frequently in immunocompromised children than in previously healthy children (33% vs. 16%). Similarly 15% of respiratory syncytial virus was detected between May and October, mostly in immunocompromised children. Influenza caused 19% of bronchiolitis in previously healthy children, and no virus could be reliably predicted based on clinical presentation, including wheezing. Of children hospitalized for LRI, 40% tested positive for the seven most common respiratory viruses by MPCR. CONCLUSIONS Work is under way to expand the number of viruses detected by MPCR and to determine whether newly discovered viruses, such as human metapneumovirus, contribute to the burden of pediatric LRI hospitalizations.
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Affiliation(s)
- Kelly J Henrickson
- Department of Pediatrics, Medical College of Wisconsin and Children's Hospital of Wisconsin, Milwaukee, 53226, USA.
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Rizzardi GP, De Boer RJ, Hoover S, Tambussi G, Chapuis A, Halkic N, Bart PA, Miller V, Staszewski S, Notermans DW, Perrin L, Fox CH, Lange JM, Lazzarin A, Pantaleo G. Predicting the duration of antiviral treatment needed to suppress plasma HIV-1 RNA. J Clin Invest 2000; 105:777-82. [PMID: 10727446 PMCID: PMC377467 DOI: 10.1172/jci9079] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.3] [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: 11/17/2022] Open
Abstract
Effective therapeutic interventions and clinical care of adults infected with HIV-1 require an understanding of factors that influence time of response to antiretroviral therapy. We have studied a cohort of 118 HIV-1-infected subjects naive to antiretroviral therapy and have correlated the time of response to treatment with a series of virological and immunological measures, including levels of viral load in blood and lymph node, percent of CD4 T cells in lymph nodes, and CD4 T-cell count in blood at study entry. Suppression of viremia below the limit of detection, 50 HIV-1 RNA copies/mL of plasma, served as a benchmark for a successful virological response. We employed these correlations to predict the length of treatment required to attain a virological response in each patient. Baseline plasma viremia emerged as the factor most tightly correlated with the duration of treatment required, allowing us to estimate the required time as a function of this one measure.
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Affiliation(s)
- G P Rizzardi
- Laboratory of AIDS Immunopathogenesis, Department of Internal Medicine, Division of Infectious Diseases, Centre Hospitalier Universitaire Vaudois, University of Lausanne, 1011 Lausanne, Switzerland
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Cohen OJ, Vaccarezza M, Lam GK, Baird BF, Wildt K, Murphy PM, Zimmerman PA, Nutman TB, Fox CH, Hoover S, Adelsberger J, Baseler M, Arthos J, Davey RT, Dewar RL, Metcalf J, Schwartzentruber DJ, Orenstein JM, Buchbinder S, Saah AJ, Detels R, Phair J, Rinaldo C, Margolick JB, Pantaleo G, Fauci AS. Heterozygosity for a defective gene for CC chemokine receptor 5 is not the sole determinant for the immunologic and virologic phenotype of HIV-infected long-term nonprogressors. J Clin Invest 1997; 100:1581-9. [PMID: 9294127 PMCID: PMC508340 DOI: 10.1172/jci119682] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.4] [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: 02/05/2023] Open
Abstract
HIV-1-infected long-term nonprogressors are a heterogeneous group of individuals with regard to immunologic and virologic markers of HIV-1 disease. CC chemokine receptor 5 (CCR5) has recently been identified as an important coreceptor for HIV-1 entry into CD4+ T cells. A mutant allele of CCR5 confers a high degree of resistance to HIV-1 infection in homozygous individuals and partial protection against HIV disease progression in heterozygotes. The frequency of CCR5 heterozygotes is increased among HIV-1- infected long-term nonprogressors compared with progressors; however, the host defense mechanisms responsible for nonprogression in CCR5 heterozygotes are unknown. We hypothesized that nonprogressors who were heterozygous for the mutant CCR5 gene might define a subgroup of nonprogressors with higher CD4+ T cell counts and lower viral load compared with CCR5 wild-type nonprogressors. However, in a cohort of 33 HIV-1-infected long-term nonprogressors, those who were heterozygous for the mutant CCR5 gene were indistinguishable from CCR5 wild-type nonprogressors with regard to all measured immunologic and virologic parameters. Although epidemiologic data support a role for the mutant CCR5 allele in the determination of the state of long-term nonprogression in some HIV-1- infected individuals, it is not the only determinant. Furthermore, long-term nonprogressors with the wild-type CCR5 genotype are indistinguishable from heterozygotes from an immunologic and virologic standpoint.
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Affiliation(s)
- O J Cohen
- Laboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases, Bethesda, Maryland 20892, USA
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Hoover S. The "25 percent challenge". Forging a new supply chain. Mater Manag Health Care 1995; 4:48, 50. [PMID: 10143823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Affiliation(s)
- S Hoover
- Johnson City Medical Center, TN, USA
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Goodman RM, Steckler A, Hoover S, Schwartz R. A critique of contemporary community health promotion approaches: based on a qualitative review of six programs in Maine. Am J Health Promot 1993; 7:208-20. [PMID: 10148708 DOI: 10.4278/0890-1171-7.3.208] [Citation(s) in RCA: 65] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE This article reports on a process evaluation of three Planned Approach to Community Health (PATCH) projects and three Community Chronic Disease Prevention Programs (CCDPP) that operated in the State of Maine. PATCH and CCDPP are similar approaches to community health promotion developed and disseminated by the Centers for Disease Control. The evaluators studied how the Planned Approach to Community Health and the Community Chronic Disease Prevention Program models worked as community health strategies across the six field sites. RESEARCH METHODS USED: Qualitative methods were used in a cross-case comparison of the six field sites. In studying each site, the evaluators focused on six stages common to both the Planned Approach to Community Health and the Community Chronic Disease Prevention program models: Stage 1: conducting a community needs assessment; Stage 2: analyzing needs assessment data; Stage 3: setting priorities for the project based on the data; Stage 4: implementing activities; Stage 5: producing process outcomes; and Stage 6: institutionalizing the project. The analysis focused on how each of the six communities traversed these stages. SUMMARY OF FINDINGS Eight recommendations for refining Planned Approach to Community Health and Community Chronic Disease Prevention strategies resulted from the study: 1) do a community capacity assessment prior to initiating a community needs assessment; 2) do not overly rely on Behavioral Risk Factor Surveys; 3) analyze needs assessment data rapidly for community consumption; 4) allow flexibility and community input in determining priority health objectives; 5) provide technical assistance throughout a project, not just in the beginning; 6) fund at least one full-time local coordinator and extensive capacity building; 7) emphasize multiple interventions around one chronic condition at a time; and 8) emphasize program institutionalization. CONCLUSIONS Community development approaches like Planned Approach to Community Health and Community Chronic Disease Prevention are promising health promotion strategies. To be optimally effective, however, these strategies need refinement based on systematic study in field settings. Because this study was limited to six sites in Maine, some of these findings may have limited generalizability.
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Affiliation(s)
- R M Goodman
- Department of Health Promotion and Education, School of Public Health, University of South Carolina, Columbia
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Hoover S. JIT. Just in time. Materials management for the 90s. South Hosp 1991; 57:20, 22. [PMID: 10115668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
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Murthy AK, Taylor SG, Showel J, Caldarelli DD, Hutchinson JC, Holinger LD, Witt TR, Hoover S. Treatment of advanced head and neck cancer with concomitant radiation and chemotherapy. Int J Radiat Oncol Biol Phys 1987; 13:1807-13. [PMID: 3679917 DOI: 10.1016/0360-3016(87)90345-2] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.1] [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: 01/06/2023]
Abstract
Forty-four patients with predominantly inoperable or recurrent head and neck cancers were treated with combined chemotherapy (CT) and radiation therapy (RT) in a Phase I/II study. CT and RT were combined in a concomitant fashion to take advantage of radiosensitizing properties of the chemotherapeutic agents. Each treatment cycle consisted of cisplatin 60 mg/M2 on day 1, 5-FU infusion at a dose of 800 mg/M2 per day continuously for 5 days and RT at 200 cGy per day, days 1 through 5. The treatment cycle was repeated every 2 weeks for 7 cycles in patients treated curatively and for 2 to 6 cycles in patients treated palliatively due to prior radiation therapy or the presence of metastatic disease. Regional control was achieved in 98% of the patients. Regional control has persisted in 87% of the patients treated curatively with a minimum follow-up of 24 months. Distant failure occurred in 23% of this group. Actuarial survival of 2 years for the curative group is 66%. Concomitant combination of radiation with radiation potentiating chemotherapeutic agents shows promise of increase in local control.
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Affiliation(s)
- A K Murthy
- Department of Therapeutic Radiology, Rush-Presbyterian-St. Luke's Medical Center, Chicago, IL 60612
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