Patients Received Hormone Therapy Research Articles

Response of mucinous breast carcinoma to neoadjuvant chemotherapy.

Mucinous breast carcinoma (MBC) is thought to be a favorable-differentiated form of invasive breast cancer and is rarely preferred for neoadjuvant chemotherapy (NAC). The study aimed to define the response of MBCs to NAC. A review was made of the demographic, clinicopathologic characteristics, management and follow-up data of 70 patients diagnosed with MBC between May 2010 and December 2020 by examining the patients' historical files and oncology records. The median age, tumor size, and follow-up period of patients were 52.9 (range: 32-87) years, 25.8 (range: 8-88) mm, and 61.5 (range: 18-143) months, respectively. Of the 70 patients, 45 had conservative surgery, 25 had a mastectomy, and 22 had axillary clearance due to a positive sentinel node biopsy or clinical axilla. Eight patients (11.4%) received NAC. Twenty-one patients (30.0%) received adjuvant chemotherapy, whereas almost all the patients received hormone therapy. The preoperative core biopsy diagnosis of four of eight patients receiving NAC was unspecified invasive breast carcinoma. NAC was used as treatment in patients who were younger, had tumors larger in diameter, had tumors with an initial higher T-stage, and especially those with clinically positive axilla, and tumors with a higher Ki-67 index. Despite these preference criteria, both the overall mastectomy and axillary clearance rates were significantly higher in these patients. Two local and five systemic recurrences were observed in the follow-up period. NAC had no significant contribution to survival. It may be concluded that NAC is not sufficiently effective in either helping to diminish the need for mastectomy by downsizing the tumor, or in preventing axillary clearance in MBCs, and no significant benefit on survival could be observed. In addition, the results may emphasize the importance of identifying the MBC subtype, and the significant association between the degree of response to NAC and the subtype.

Adenocarcinoma in multiple adenomatous polyps: An analysis of demographic and socioeconomic factors.

e15619 Background: Adenocarcinoma in multiple adenomatous polyps (AMAP) is a form of gastrointestinal cancer characterized by adenomatous polyps in the gastrointestinal mucosa and distinct lesions found outside the intestines. A rare form of cancer, AMAP can be traced back to mutations in the APC gene, with higher rates of mutation correlating with worse prognosis. There is an association with familial adenomatous polyposis, which can lead to colorectal cancer in patients as young as 15. Examining demographic statistics on AMAP from the National Cancer Database (NCDB) sheds light on this rare form of colorectal cancer, unlocking new possibilities for diagnostics and treatment. Methods: A retrospective cohort analysis identified 193 patients with AMAP from the 2004-2020 NCDB using ICD-O-3 Code 8221 to identify them. Demographic factors such as age, sex, treatment type, and Charles/Deyo score were explored with descriptive statistics. Linear regression analysis was utilized to study incidence trends. Results: A total of 193 cases of histologically confirmed AMAP were retrieved from the 2004-2020 NCDB with a slight decline in incidence rates during this time (R² = 0.39). The majority of patients were male (55%), White (86%), privately insured (46%), and resided in metropolitan areas with a population size of at least one million (60%). Most patients also comprised the top two income quartiles based on median household income (64%). The mean age at diagnosis was 56.5 years (SD = 19.15, range = 15 - 90). The top primary sites affected were the Colon (26%), Sigmoid Colon (16%), and Rectum (11%). Furthermore, most patients were treated surgically (88%) with the average tumor size of 35.3 mm (SD = 20.5, range = 5.0 - 77.0). More patients received chemotherapy (28%) than radiation therapy (10.4%), with few patients receiving hormone therapy (0.5%) and none receiving immunotherapy. Over half (51%) of the patients were categorized as experiencing Stage 0 and Stage 1 cancer according to the NCDB Analytic Stage Group. The vast majority of patients (74%) had no comorbidities (Charlson-Deyo = 0) and did not receive any palliative care (97%). Conclusions: Our NCDB analysis on AMAP is a novel examination that provides insight into various demographics to better understand the disease. The majority of patients were males with adenocarcinoma lesions most commonly diagnosed in the colon and rectal areas, consistent with previous studies on multiple adenomatous polyps. Our analysis revealed that the majority of patients diagnosed with AMAP tend to be White, privately insured, reside in metropolitan areas, and hail from the top two quartiles of median household income. Additional research is required to gain a greater understanding of the demographic and socioeconomic factors that are important for accurate diagnosis, effective treatments, and improved outcomes.

The effect of energy from reiki treatments on sleep quality for patients with breast and prostate cancer on hormone therapy.

e24076 Background: Manypatients with cancer receiving hormone therapy experience difficulty with sleeping and insomnia. Reiki is a technique where therapy is delivered to the patient with either no or very light physical touch whereas traditional massage therapy uses pressure and movement by the therapist to manipulate soft tissue. Both Reiki and traditional massage therapy have been shown by others to be effective in providing benefits in sleep quality. This study is the first to compare changes in sleep quality after massage and Reiki treatments in patients with prostate and breast cancer receiving hormone therapy. Methods: Eighty-seven, breast (n = 56) and prostate cancer (n = 31), patients receiving hormone therapy experiencing self-reported fatigue ≥4/10were included in this randomized controlled trial (RCT). Patients were randomized into one of three treatment arms for 4-weeks: Arm 1 received two massage treatments, Arm 2 received two Reiki treatments and Arm 3 received four Reiki treatments. Each treatment session was approximately 75 minutes. . Participants with a baseline score of ( ≥8) on the ISI were included in this analysis. Results: 75% of all enrolled participants (n = 65) met the inclusion criteria for baseline clinically meaningful insomnia. Both Reiki and massage provided improvement in sleep quality from pre to post intervention and there was no difference between 2 and 4 Reiki sessions. Reiki significantly increased sleep quality (p > .01) with a mean decrease in total ISI score of 2.96. Massage therapy showed a trend towards improved sleep quality (p = 0.06) with a mean decrease in ISI score of 1.95. There was a clinically meaningful decrease in total ISI score (≥6) in 15% of those who received massage therapy compared to 25% in the reiki therapy group. Conclusions: Four weeks of Reiki significantly improved sleep quality in patients with breast and prostate cancer receiving hormone therapy. Reiki may be a better non-pharmacologic therapeutic for improving sleep quality. Clinical trial information: NCT02758756 .

Rapidly expanding gender-affirming care based on consensus instead of evidence justifies rigorous governance and transparency.

Public services offering gender-affirming care to minors have rapidly expanded across Australia. Despite limited evidence of safety and efficacy, no public information about these services is routinely available. Data from freedom of information requests sent to Australian public gender services for minors is summarised. Gender service numbers increased rapidly in Queensland (2017:190 - 2022:922) and in Victoria (2019:472 - 2023:1290). Limited transparency prevented strong confidence in the number of patients receiving hormone therapy. Staff FTE employed by gender services jumped after 2020 in NSW (to 16.7 across two sites in 2023), Queensland (to 11.4 in 2023), Victoria (to 9.4 in 2022), and WA (to 10.2 in 2023). Despite low confidence in their safety and efficacy, the number of patients seen by public gender services has expanded rapidly since 2018. Limited transparency makes it difficult to judge the number of patients seen, treatments provided, and outcomes achieved. Safe, effective care of this vulnerable group requires clear treatment goals, and annual reporting.

Abstract B042: Analysis of predictive indicators of invasive breast cancer: Modeling survival rates

Abstract Objective: We aim to investigate indicators of risk for invasive breast cancer (IBC) and to predict and assess the impact of these risk indicators on survival rates in breast cancer (BC) patients who received various therapies. Background: It has been identified that several indicators including BC subtypes, age at diagnosis, history of breast disease, menopausal status, estrogen receptor (ER) status, progesterone receptor (PR) status, human epidermal growth receptor (HER2) status, tumor stage, tumor size, among others, can cause genomic alterations and driver mutations in BC, leading to invasive carcinogenesis. To assure improved BC outcomes, we investigate the influence of BC indicators on survival rates in patients receiving hormone therapy, chemotherapy and radiotherapy. Methods: This study uses the Molecular Taxonomy of Breast Cancer International Consortium (METABRIC) dataset, which included 31 clinical indicators, m-RNA levels z-score for 331 genes, and mutation in 175 genes for 1904 BC patients. Both bivariate and multivariate associations were examined using logistic regression and Cox proportional hazard models. The multivariate logistic regression analysis is used to determine predictors of IBC. The Cox proportional hazard model was also used to evaluate the magnitude of the impacts of clinical and demographic variables on IBC, as well as the effects of therapy on survival. All analyses for this investigation were carried out using SAS. A p-value < 0.05 was considered statistically significant. Results: We examined 1,043 patients (with the median age 61±13.1 years) from a total of 1904 for this study: 78.8% of patients had breast invasive ductal carcinoma; 87.4% were HER2 negative; 22.8%, 60.7%, and 67.6% received chemotherapy, hormone therapy, and radiotherapy treatments, respectively; 56.9% died but only 34.6% died from the disease; the average overall survival months was 127.3±77.6 months; and the most common age group was "65+ years" (39.4%). Chemotherapy (p=0.0474), neoplasm histologic grade (p=0.0015), Nottingham prognostic index (p<.0001), radiation (p=0.0068), and BReast CAncer gene 1 (BRCA1) (p=0.0251) were all associated with IBC. Overall survival was also correlated to age at diagnosis (p=0.0002), neoplasm histologic grade (p<.0001), lymph nodes (p<.0001), mutation count (p<.0001), Nottingham prognostic index (p<.0001), radiotherapy (p=0005), tumor size (p<.0001), tumor stage (p<.0001), BRCA1 (p=0.250), PTEN (p<.0001), and TP53 (p=0.0248). The overall accuracy of the model for each IBC and survival status was 82.1% and 74.2%, respectively. Conclusion: Our analysis demonstrated the importance of predictive analysis using the logistic regression model and survival analysis using the Cox proportional hazard model in cancer research. Predictive and survival analysis results aided in predicting the invasiveness and survival rate of BC among the study participants. In general, predictive and survival analyses are more accurate and may be used to make more realistic treatment decisions and precision oncology. Citation Format: Olumide Arigbede, Gebre-Egziabhe Kiros. Analysis of predictive indicators of invasive breast cancer: Modeling survival rates [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Translating Cancer Evolution and Data Science: The Next Frontier; 2023 Dec 3-6; Boston, Massachusetts. Philadelphia (PA): AACR; Cancer Res 2024;84(3 Suppl_2):Abstract nr B042.

Evaluation of overall survival and disease-free survival of adjuvant chemotherapy and hormone therapy in patients with breast cancer

Background: This study evaluated the effect of adjuvant chemotherapy and hormone therapy on overall survival and disease-free survival in patients with breast cancer with hormone receptor-positive, HER2-negative tumors without lymph node involvement.
 Methods: Breast cancer patients with hormone receptor-positive, HER2-negative, and no lymph node involvement were included in this retrospective cohort study. Patient records were used to collect data on sex, age, time of disease onset, tumor subtype, tumor size, grade, lymphovascular and perineural involvement, ki67, and treatment protocols. Patients were divided into 2 groups: Patients who received both adjuvant chemotherapy and hormonal therapy and patients who received hormonal therapy only. Disease-free survival index (DFS) and overall survival index (OS) were evaluated.
 Results: Sixty-seven female patients were enrolled in this study. Of them, 68.2% received both adjuvant chemotherapy and hormonal therapy and 31.6% received hormonal therapy only. During follow-up, recurrences occurred in 8 patients. The 3-year and 5-year DFS were 93.4% and 90%, respectively. The 3-year and 5-year DFS was 94% and 92%, respectively, in patients who received both adjuvant chemotherapy and hormonal therapy, and 91% and 85%, respectively, in patients who received hormonal therapy. None of the factors studied affected the 3-year and 5-year DFS. The 3-year and 5-year DFS OS were 98.6% and 96.9%, respectively
 Conclusion: Adjuvant chemotherapy in patients with breast cancer with hormone receptor-positive, HER2-negative, and no lymph node involvement compared with similar patients receiving hormone therapy alone had no significant difference in disease-free survival index and overall survival index.

Probability of a high recurrence score for breast cancer on the Oncotype DX test in males: a case series

Abstract Introduction: Male breast cancer (MBC) is a rare disease that accounts for 1% of breast cancers. The Oncotype DX test (a genomic signature that assesses the expression of 21 genes to estimate the recurrence score [RS]) has been widely used in MBC to select patients for adjuvant chemotherapy. Objective: To describe 5 cases of MBC in which a nomogram was used to predict the probability of having a high Oncotype DX score for breast cancer and the need to perform genomic signature. Materials and methods: Case series study in which five patients with MBC treated between 2007 and 2020 at a cancer institution in Teresina (Brazil) were included. A nomogram was performed to evaluate five clinical and pathological variables (age, body size, tumor size, grade, recurrence score status, and histologic type of carcinoma). Case series: The mean age of the patients at diagnosis was 69 years (mean tumor size: 2.6cm). All patients received hormone therapy with tamoxifen, three received chemotherapy, and one received radiation therapy after breast surgery (mastectomy). During a median follow-up period of 88 months, one case had a recurrence (bone metastasis). Based on the nomogram results, two patients had a high probability of a high RS (36% and 45%) and only one patient (case 3) underwent Oncotype DX testing (RS: 20). Conclusions: In the present series of five cases, based on the nomogram results, only two patients (cases 3 and 4) had a high probability of a high Oncotype DX recurrence score; however, due to financial constraints, this test was only performed on one of these two patients. The patient who underwent the test (case 3) did not receive adjuvant chemotherapy and remained alive with bone metastases until the end of the follow-up period. Conversely, the patient who could not undergo the examination (case 4) received adjuvant chemotherapy and was alive without any signs of disease.

Neuroendocrine prostate cancer

In Russia, prostate cancer is a common disease with fast increasing incidence. In the vast majority of prostate cancer patients receiving hormone therapy, on average 18–36 months after the start of treatment refractoriness to androgen ablation develops. In 15–20 % of patients, signs of neuroendocrine differentiation may develop.Neuroendocrine prostate cancer is an aggressive variant of castration-resistant prostate cancer with poor prognosis and low survival.Due to the rarity of these types of tumors, specific diagnostic and treatment algorithms have not been developed. As a rule, they are similar to the methods for other malignant forms of prostate cancer and neuroendocrine tumors.

Hormone therapy in prostate cancer: Understanding patients' and caregivers' supportive care needs

AbstractResearch Question Q1: What are the supportive care needs of individuals with prostate cancer in hormone therapy? Q2: What are the supportive care needs of individuals who care for prostate cancer patients? Research ProblemOur study aims to identify the supportive care needs of not only prostate cancer patients receiving hormone therapy, but also their caregivers.Literature ReviewThe literature review of this study was made by scanning the related field studies from the Google database, BNI, and so forth.MethodologyThis is a cross‐sectional definitive study conducted between February and June 2022 in the Shock Wave Lithography Unit (ESWL—where patients are given hormone therapy treatment needles) at Dokuz Eylul University Hospital in Turkey. The study involved 66 prostate cancer patients and 64 caregivers. The sample size was found by power analysis. The data obtained in the study were analysed on the SPSS 25 software package.Results79.9% of the caregivers were female and 43.8% were patients' spouses. 36% of the patients had 80%–90% performance rates on the Karnofsky scale. Due to drug side effects, ±45.1 of patients required support for sexual issues before and after diagnosis, and ±46.27 needed supportive care for water retention. Due to the difficulties experienced in the care process the caregivers; ±40.88 needed family support, and ±21.25 needed social services support (p < 0.05).ConclusionsIt was found that prostate cancer patients receiving hormone therapy and their caregivers had a range of supportive care needs due to the difficulties they faced.

Effect of Serelys Homme on the Incidence and Severity of Vasomotor Symptoms and Quality-of-Life Impairments in Patients Receiving Hormone Therapy and Radiation for Localized Prostate Cancer: Results of the ESCULAPE Phase 2 Prospective Study

Androgen deprivation therapy (ADT) may cause vasomotor symptoms (VMS) including hot flushes and sweats, which affect quality of life (QoL). Serelys Homme is a nonhormonal and a natural origin product that could affect VMS in men undergoing ADT. We evaluated effectiveness and tolerance of Serelys Homme administration on VMS and QoL of patients undergoing combined ADT and radiation therapy for prostate cancer. Between April 2017 and July 2019, 103 patients were screened, and 53 patients refused to participate in the study. Serelys Homme therapy consisted of a daily administration of 2 tablets for 6 months. Patients were evaluated with 4 questionnaires including the adapted Modified Rankin Scale (adapted-MRS), European Quality of Life 5 Dimensions 3 Level Version (EQ 5D3L), Functional Assessment of Cancer Therapy-Prostate (FACT-P), and Hot Flash Related Daily Interference Scale (HFRDIS) at day 0, day 90 (D90), and day 180 (D180). Statistical evaluation was performed using the Wilcoxon rank sign test. A 2-sided P < .05 was considered statistically significant. Among the 50 patients, 4 withdrew after inclusion. All patients (n=46) received either postoperative or definitive radiation therapy combined with a short (n=15) or long course (n=31) of ADT. Serelys Homme administration significantly decreased the rate of patients who had ≥7 VMS and 3 to 6 VMS per day. The number of patients presenting with moderate or severe VMS was decreased at D90 (P=.005) and at D180 (P=.005). In addition, VMS duration was reduced at D90 (P=.002) and D180 (P < .001). Finally, at D90 and D180, 11.1% and 16.0% of patients, respectively, with initial severe or moderate VMS had a complete response without further symptoms. Among QoL parameters, fatigue decreased significantly. Effectiveness evaluated by doctors was rated as moderate or good to excellent VMS control in 20% and 60% of the patients, respectively. No side effects were recorded in the whole population. This study demonstrated effectiveness and excellent tolerance of Serelys Homme. We observed a significant reduction of the frequency, duration, and intensity of hot flushes and sweats induced by ADT. Serelys Homme increased QoL scores. These encouraging results open the prospect to further studies and Serelys Homme use in patients undergoing ADT for prostate cancer.

Abstract 5787: Modelling the spatial heterogeneity of CD45-positive tumor infiltrating lymphocytes in early-stage, estrogen receptor-positive breast cancer

Abstract The frequency of lymphocytes infiltrating tumors is a known prognostic in estrogen receptor (ER) negative cancers. ER+ disease is putatively believed to be immune cold, however, there exists a subset of ER+ tumors with high immune infiltrate and with a significant spatial heterogeneity. The clinic impact of such infiltrate - especially between the Oncotype Dx Recurrence Score risk categories - remains unclear. Moreover, the distribution of tumor and stromal tissues, while noted as significantly heterogenous, is still ill-defined and not yet clinically used prognostically, despite evidence to support its utility. Using a cohort (n=450) of serial sections taken from early-stage, ER+/HER2- breast tumors of the Irish arm of the TAILORx clinical trial, we aimed to investigate the tumor architecture and spatial distribution of tumor immune infiltrate and proliferating tumor cells using digital image analysis. Antibodies against Ki67 (proliferation marker) and CD45 (leukocyte common antigen), and a routine Haematoxylin and Eosin stain were applied to serial sections of 450 full-face tumors via chromogenic immunohistochemistry, as outlined previously [1]. Digital image analysis was performed using open-source software, QuPath [2]. Pixel classifiers were trained and validated against an expert pathologist in order to define observed lymphocytes as tumor or stromal-infiltrating, and to establish a classifier to quantify the tumor-stroma ratio (TSR) and infiltrating tumor area. Distances of CD45-positive cells from tumor were computed, along with autocorrelation statistics [3,4] of CD45 and Ki67 hotspots; firstly in order to quantify spatial heterogeneity, and secondly to examine whether Ki67 as a component gene in the Oncotype Dx assay has a foundation in tumor biology or is being confounded by potentially Ki67-positive lymphocytes. Subdividing by Oncotype Dx risk categories, no significant difference in TSR was observed (p=0.09799), neither for intermediary risk patients receiving hormone therapy alone or in combination with chemotherapy (p=0.3873). While there was an observed trend overall (p=0.092), no significance was found for recurrence between intermediary risk subcategories (HT alone: p=0.393, HT+CT: p=0.288). However, in the cohort as a whole, median TSR was 0.3215 (range 0 - 5.023), with statistically significant differences in recurrence risk observed (cohort high v low by median TSR. HR: 6.356, 95CI: 2.263-17.84, p&amp;lt;0.0001). Citation Format: Zak Kinsella, Anna Blümel, Mairi Lucas, Andreas Lindner, Claudia A. Gonzalez, Arman Rahman, Joanna Fay, Tony O'Grady, Verena Murphy, John Crown, Cathy Kelly, William Gallagher, Darran O'Connor. Modelling the spatial heterogeneity of CD45-positive tumor infiltrating lymphocytes in early-stage, estrogen receptor-positive breast cancer. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 5787.

Clinical characteristics of IgG4-related disease with lung involvement in 14 patients.

Immunoglobulin G4-related diseases (IgG4-RD) is a rare autoimmune disease, and there is no specific diagnostic test for patients with lung involvement yet. This study aims to summarize the clinical characteristics of IgG4-RD with lung involvement and improve the understanding and diagnosis of this disease. All patients diagnosed with IgG4-RD in the Second Xiangya Hospital from December 2014 to February 2022 were re-diagnosed according to the recommendations of Chinese Expert Consensus on the Diagnosis and Treatment of IGG4-Related Diseases in 2021. The clinical data of 14 IgG4-RD patients with pulmonary abnormalities were collected and analyzed. Among the 14 patients, 11 were males and 3 were females, and the median age of diagnosis was 66 (22-82) years old. Six cases had respiratory symptoms such as cough, sputum and short breath. Extrapulmonary involvement was the most common in the glands of head and neck (6/14), followed by pancreas and bile duct (4/14). Elevated serum IgG4 level was found in all patients, and most (11/14) were accompanied by abnormal inflammatory markers. Patients' pulmonary imaging findings were diverse, the most common performances were mediastinal/hilar lymphadenopathy (12/14), followed by multiple pulmonary nodules (9/14), patchy density enhancement (7/14) and the increased broncho vascular bundles (6/14). Lung biopsy was performed in 9 patients, their pathology results showed lymphoplasmic cell infiltration, 5 cases of them had interstitial fibrosis, 2 cases with phlebitis, and extrapulmonary biopsy was performed in 8 patients. Immunohistochemical results of all the patients showed that the number of IgG4+ plasma cells was more than 10 per high magnification, and the ratio of IgG4/IgG was more than 40%. For treatment, 12 patients received hormone therapy, and 5 patients combined immunosuppressive therapy with hormone. 10 patients were in remission after treatment, while 2 patients were progressed. IgG4-RD with lung involvement is rare and has no specific clinical manifestation. Its pulmonary imaging is diverse. Diagnosis for it should combine with serum IgG4 level and pathological examination. Glucocorticoid is the first line treatment, and combination with immunosuppressant can help prevent disease recurrence.

Effects of hormone therapy on the clinical outcomes of endoscopic intervention in patients with endometriosis-related ureteral obstruction.

We investigated whether endoscopic interventions, including laser endoureterotomy and balloon dilatation following hormone therapy, are a good choice to treat ureteral obstruction due to ureteral endometriosis instead of laparoscopic or open surgery. Patients with ureteral obstruction due to endometriosis who underwent endoscopic intervention between 2004 and 2021 were reviewed. Patients with other causes of ureteral obstruction or previous ureteral surgery were excluded from the study. The primary endpoint was the 3-month success rate of endoscopic intervention with or without hormone therapy. Secondary endpoints were the success rate of endoscopic intervention between the hormone-treated and hormone-untreated groups at 6 months and the success rate according to the hormone therapy response of endometriosis at 3 and 6 months. Eighteen patients with 19 ureter units were evaluated in this study, including 12 patients receiving hormone therapy and six patients not receiving hormone therapy. Among patients receiving hormone therapy, one patient had bilateral ureteral obstruction. The success rate of endoscopic intervention was higher in patients who received hormone therapy than in those who did not receive hormone therapy three months after endoscopic intervention (76.9% vs. 0.0%, p=0.003). The same result was also found 6 months after endoscopic intervention (75.0% vs. 0.0%, p=0.005). In addition, the success rates were higher in the hormone-responsive group than in the non-responsive group (100.0% vs. 57.1%), although the difference was not statistically significant (p=0.122). Ureteral obstruction caused by endometriosis can be effectively treated by endoscopic intervention with hormone therapy in select patients.

Mammographic Density Reduction is Associated to the Prognosis in Asian Breast Cancer Patients Receiving Hormone Therapy.

Using mammographic density as a significant biomarker for predicting prognosis in adjuvant hormone therapy patients is controversial due to the conflicting results of recent studies. This study aimed to evaluate hormone therapy-induced mammographic density reduction and its association with prognosis in Taiwanese patients. In this retrospective study, 1941 patients with breast cancer were screened, and 399 patients with estrogen receptor-positive breast cancer who received adjuvant hormone therapy were enrolled. The mammographic density was measured using a fully automatic estimation procedure based on full-field digital mammography. The prognosis included relapse and metastasis during treatment follow-up. The Kaplan-Meier method and Cox proportional hazards model were used for disease-free survival analysis. A mammographic density reduction rate >20.8%, measured preoperatively and after receiving hormone therapy from 12-18 months, was a significant threshold for predicting prognosis in patients with breast cancer. The disease-free survival rate was significantly higher in patients whose mammographic density reduction rate was >20.8% (P = .048). This study's findings could help estimate the prognosis for patients with breast cancer and may improve the quality of adjuvant hormone therapy after enlarging the study cohort in the future.

A novel treatment workflow of idiopathic hypereosinophilic syndrome: a single-center retrospective cohort study.

A novel treatment workflow of idiopathic hypereosinophilic syndrome: a single-center retrospective cohort study.

Pure Mucinous Breast Carcinoma With a Favorable Tumor Biology and Clinical Outcomes.

A few studies suggest that mucinous breast carcinoma (MBC) is a rare breast carcinoma with good prognostic features. Therefore, the aim of this study was to evaluate biological features and clinicopathological characteristics of pure mucinous breast carcinoma (PMBC) to determine clinical outcome in PMBC. The data of 87 patients diagnosed with PMBC between November 2004 and February 2022 were retrospectively analyzed in terms of clinicopathological and demographic characteristics, management, and outcome. The majority of the patients in this study were female, with a median (range) age of 63 (28-90) years. Out of 87 patients, 60 had breast conserving surgery, 27 had a mastectomy, 58 had sentinel lymph node biopsy (SLNB), and 24 had axillary dissection due to a positive SLNB or clinical axilla. Due to age and comorbidities, five patients were not suitable for axillary surgery. The median largest tumor diameter was 23 (5-100) mm. Only 23 patients (26.4%) received adjuvant chemotherapy, whereas almost all patients received hormone therapy. The median duration of follow-up was 53 (6-207) months. There was no local or systemic recurrence in any of the patients. Only 10 patients (11.5%) died from non-cancer causes during the follow-up and treatment period. In this study, tumor diameter was significantly higher in grade II/III tumors (p = 0.039) and in patients under the age of 50 (p = 0.027). Furthermore, lymph node metastasis was statistically significantly more likely in patients under the age of 50 (60% versus 40%, p = 0.013). Patients who had not received chemotherapy or radiotherapy tended to be older than 50 years (p = 0.002). In this study, the majority of patients were in the luminal subgroups with excellent prognosis and low incidences of lymph node metastasis. As a result, PMBC has favorable tumor biology. We believe that minimal axillary surgery would be the most appropriate approach during patient treatment, due to the low rate of lymph node involvement and favorable prognosis in PMBC patients.

MEDULLARY CARCINOMA OF THE BREAST-EPIDEMIOLOGY, THE PATTERN OF CARE, AND TREATMENT OUTCOME: EXPERIENCE FROM THE TERTIARY CANCER CARE CENTER

Objectives: Medullary breast carcinoma is a very rare subtype of invasive ductal carcinoma breast which accounts for about 1–7% of all breast carcinoma. The natural history of this uncommon histological subtype is unknown because of the lack of adequate reported data in the literature and the rare variety of this tumor. In our retrospective analysis, we have tried to identify demographic clinicopathological features and treatment outcomes of this rare subtype. Methods: Between January 2012 and December 2017, total of 1271 breast carcinoma cases were identified, and clinic pathological, demographic profile, and treatment received were recorded from the medical records file. American joint committee on Cancer tumor, node, and metastasis system was used for staging. Results: Out of 1271 breast carcinomas, 19 histologically confirmed medullary carcinoma cases were identified and constitute about 1.5% of the total case. About 78% of patients were with Stage II and Stage III disease at the time of diagnosis. Eleven patients were initially treated with MRM followed by adjuvant chemotherapy and radiotherapy. Eight patients received neoadjuvant chemotherapy followed by surgery and radiotherapy. In addition to cytotoxic chemotherapy, two patients received trastuzumab also. None of the patients received hormone therapy as all the patients were hormone receptor-negative. Conclusions: Out of all invasive carcinoma, approximately 1.5% of cases were medullary carcinoma. About 90% of cases were triple-negative. Triple-negative breast cancer is usually associated with poor outcomes but medullary carcinoma despite being triple-negative, patients with medullary carcinoma have a good chance of long-term survival.

Prostate Cancer in Male-to-Female Transgender Individuals: Histopathologic Findings and Association With Gender-affirming Hormonal Therapy.

Male-to-female (MtF) transgender individuals are at risk for prostate cancer, although guidelines for screening and management in this population are not well established. We describe a series of 9 MtF transgender patients who underwent prostate tissue sampling and highlight histopathologic features and challenges related to pathologic interpretation of prostate tissue in this patient population. Seven of 9 total patients were diagnosed with prostate cancer and all had elevated prostate-specific antigen at the time of diagnosis. Three of the 7 patients diagnosed with prostate cancer had received different types of hormone therapy for gender affirmation before the diagnosis of prostate cancer, and in all 3 of these patients, there was histologic evidence of hormone therapy effect in both benign prostate tissue and/or the adenocarcinoma. The 2 patients with benign prostate tissue underwent transurethral resection for lower urinary tract symptoms and were previously on hormone therapy for gender affirmation. Both of these specimens showed diffuse glandular atrophy and basal cell hyperplasia, indicative of hormone therapy effect on benign prostatic tissue. In the patients diagnosed with prostate cancer, a spectrum of grades was observed, ranging from Grade Group 1 to Grade Group 5. Four patients underwent radical prostatectomy, with 2 cases showing extraprostatic extension and Grade Group 5 prostatic adenocarcinoma, and 2 showing Grade Group 2 prostatic adenocarcinoma. Three of the 4 patients who underwent radical prostatectomy had received gender-affirming hormone therapy before surgery, and all 3 of these specimens showed hormone therapy effect in non-neoplastic prostate tissue and focal hormone therapy effect in prostatic adenocarcinoma. The presence of areas of viable carcinoma without hormone therapy effect enabled the assignment of a Gleason score and Grade Group in these 3 cases. Hormone therapy administered for gender identity affirmation induces histopathologic changes to both benign prostate tissue (nonkeratinizing squamous metaplasia, diffuse atrophy, basal cell hyperplasia, and stromal dominance with decreased numbers of glands) and prostatic adenocarcinoma (nuclear pyknosis, atrophy, cytoplasmic vacuolization, and architectural patterns that would qualify for Gleason 4 and 5 in the absence of hormone therapy effect) that have been traditionally seen in cis-male prostate cancer patients receiving hormone therapy. In the absence of hormone therapy, the morphology of prostatic adenocarcinoma in transgender patients shows classic morphologic features similar to those seen in cis-male patients not on hormone therapy. Prostate cancer with hormone therapy effect may not only be histologically quite subtle and may be overlooked if not suspected, but also should not be assigned a Gleason score because the Gleason score would substantially overstate its biologic potential. Therefore, similar to cis-male patients who have received androgen deprivation therapy for prostate cancer, transgender patients on hormone therapy for gender affirmation may be at risk for both underrecognition and over-grading of prostate cancer, particularly if the pathologist is not aware of the clinical history.

The correlation analysis of 21-gene assay use in uninsured and underrepresented minorities with estrogen receptor (ER) positive HER2 negative breast cancer.

e12531 Background: 21-gene breast cancer recurrence-score assay (Oncotype DX) have been used to predict recurrence risks and guide adjuvant chemotherapy. However, access to such tests is limited, especially in a population concentrated with uninsured and underserved patient populations. Previously equations such as the Magee equation has been proposed to predict correlation of the recurrence score and the estimated recurrence score with high concordance rate. This study examines the concordance of such an assay to predicted scores in uninsured and underrepresented minority heavy public hospital. Methods: We performed a retrospective chart review of 68 women with hormone receptor-positive, human epidermal growth factor receptor 2 (HER2)-negative breast cancer seen at University Hospital (public safety net hospital in Newark, New Jersey with greater majority of the patient population consists of underrepresented minorities such as Black/African Americans and Latino/Hispanics). 6 patients did not have pathology records, 9 patients did not have the Oncotype information available, and 4 patients were waiting on the results. Of the pre-menopausal eligible patients, two did not have any treatment or follow up information available and were included as part of the correlation assay, however, no. Results: Of the 47 eligible patients with follow-up information, 13 had a low recurrence score of up to 10 if post-menopausal and up to 15 if pre-menopausal, 22 had an intermediate recurrence score of 11 to 25 if post-menopausal and 16 to 25 if pre-menopausal, and 12 had a high recurrence score of greater than 26 according to the national comprehensive cancer network guidelines. The Pearson correlation between the Magee predicted score and Oncotype recurrence score was 0.73 (p &lt; 0.001). All patients received hormone therapy and 5 patients total had recurred. 2 were pre-menopausal and had received adjuvant chemotherapy. 3 were post-menopausal in low and intermediate categories who had not received adjuvant chemotherapy. Conclusions: This study shows a high correlation between the predicted Magee score and Oncotype recurrence score. This reflects a possible use in the prediction scoring system as another resource for prognostication and guidance in treatment especially in the underinsured population.

Older patients' experience of living with cognitive impairment related to hormone therapy for breast cancer: A qualitative study.

Patients with breast cancer may develop cognitive impairment as a result of hormone therapy and aging. This study aimed to describe older patients' experience of cognitive impairment related to hormone therapy for breast cancer. A qualitative and descriptive design was used. Semi-structured interviews were conducted with 11 patients asking about their experience in daily life related to their cognitive impairment. Study participants were evaluated by cancer-specific geriatric assessment. Inductive content analysis was conducted using the interview records. Three themes emerged from the patients' narrative data: recognizing of cognitive impairments, impacts on mental health, and coping with cognitive impairments. Recognizing of cognitive function consisted of two categories: perception of cognitive changes and acknowledging their cognitive function status through interacting with others. Impacts on mental health consisted of six categories: decreased motivation for social activities, upset by perception of cognitive decline, concerns about impacts of cognitive impairment on treatment of breast cancer, concerns about the care burden of their family, concerns about progression of cognitive impairments, and feeling secure that their cognitive impairment is not unusual. Coping with cognitive impairments consisted of two categories: coping with problems related to cognitive impairment and trying to maintain and improve cognitive function. Oncology nurses should assess cognitive function and complete a comprehensive evaluation of older patients receiving hormone therapy for breast cancer. An evaluation of cognitive function would enable a tailored approach to education and support to enhance coping ability in the longer term.