Come, Steven E.
Works: | 13 works in 40 publications in 1 language and 99 library holdings |
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Genres: | Conference papers and proceedings |
Roles: | Editor, Contributor, Author, Publishing director |
Classifications: | RC267, 616.994 |
22 editions published between 2003 and 2006 in English and held by 59 WorldCat member libraries worldwide
3 editions published in 2005 in English and held by 13 WorldCat member libraries worldwide
2 editions published in 2004 in English and held by 9 WorldCat member libraries worldwide
3 editions published in 2001 in English and held by 4 WorldCat member libraries worldwide
2 editions published in 2008 in English and held by 3 WorldCat member libraries worldwide
1 edition published in 2004 in English and held by 2 WorldCat member libraries worldwide
1 edition published in 1972 in English and held by 2 WorldCat member libraries worldwide
1 edition published in 2008 in English and held by 2 WorldCat member libraries worldwide
1 edition published in 2014 in English and held by 2 WorldCat member libraries worldwide
1 edition published in 2016 in English and held by 1 WorldCat member library worldwide
Abstract : Background: Despite guideline recommendations, baseline laboratory testing and advanced imaging are widely ordered in clinical practice to stage asymptomatic patients with clinical stage II breast cancer (BC). Materials and Methods: A retrospective study at two academic centers in Boston, Massachusetts, between 2006 and 2007 explored the use, results, and implications of laboratory tests, tumor markers, and imaging in patients with clinical stage II BC. Results: Among 411 patients, 233 (57%) had liver function testing, 134 (33%) had tumor marker tests, and 237 (58%) had computed tomography (CT) as part of their initial diagnostic workup. Median age was 52 (range, 23-90 years). On multivariable analysis, young age, more advanced stage, and tumor subtype (human epidermal growth receptor-positive [HER2+] and triple-negative breast cancer [TNBC]) were significantly associated with baseline CT. The rate of detection of true metastatic disease with use of baseline staging imaging was 2.1% (95% confidence interval, 0.7%-5%). It was 2.2% (3 of 135) for estrogen receptor/progesterone receptor-positive disease, 1.9% (1 of 54) for HER2+ disease, and 2.1% (1 of 48) for TNBC. At 5 years of follow-up, 46 of 406 patients were diagnosed with metastatic breast cancer. Thirty-four of 46 (73.9%) who developed recurrent disease had imaging at their initial diagnosis, and of these, five had abnormalities on their initial imaging that was correlated with where they developed metastatic disease. Conclusion: In this cohort of women with stage II BC, staging imaging at diagnosis had a low yield in detecting distant metastases (2.1%). The detection rate was not higher with HER2+ disease or TNBC, despite the trend that patients with these subtypes were more likely to undergo imaging. Implications for Practice: Despite guideline recommendations, asymptomatic patients with stage II breast cancer (BC) often undergo staging imaging with computed tomography, bone scanning, or positron emission tomography. Physicians have often reported that they order imaging despite recommendations because they believe that younger patients or patients with more aggressive BC phenotypes, such as human epidermal receptor 2-positive BC or triple-negative BC, benefit from staging imaging. In this cohort of women younger than those in prior studies, the yield of detecting distant metastatic disease in patients with clinical stage II BC was very low and the detection rate was not higher in the presence of HER2-positive or triple-negative BC. Abstract : This study suggests that liver function tests, tumor markers, and routine body imaging are unnecessary for the initial evaluation of asymptomatic women with stage II breast cancer, even for subgroups of young women and patients with human epidermal receptor 2-positive breast cancer, triple-negative breast cancer, or stage IIB disease
1 edition published in 2004 in English and held by 1 WorldCat member library worldwide
1 edition published in 2015 in English and held by 1 WorldCat member library worldwide
Abstract : Background: The increase in breast cancer risk during pregnancy and postpartum is well known; however, the molecular phenotype of breast cancers occurring shortly after pregnancy has not been well studied. Given this, we investigated whether nulliparity and the time interval since pregnancy among parous women affects the breast cancer phenotype in young women. Materials and Methods: We examined molecular phenotype in relation to time since pregnancy in a prospective cohort of 707 young women (aged d"0 years) with breast cancer. Parity was ascertained from study questionnaires. Using tumor histologic grade on central review and biomarker expression, cancers were categorized as luminal A- or B-like, HER2 enriched, and triple negative. Results: Overall, 32% were luminal A-like, 41% were luminal B-like, 9% were HER2 enriched, and 18% were triple negative. Although, numerically, patients diagnosed>5 years after pregnancy had more luminal A-like subtypes than women with shorter intervals since pregnancy, there was no evidence of a relationship between these intervals and molecular subtypes once family history of breast cancer and age at diagnosis were considered. Conclusion: Distribution of breast cancer molecular phenotype did not differ significantly among young women by parity or time interval since parturition when important predictors of tumor phenotype such as age and family history were considered. Implications for Practice: Distribution of breast cancer molecular phenotype did not differ among parous young women by time interval since pregnancy. The implication of these findings for clinical practice suggests that pregnancy-associated breast cancers may be seen up to 5 years beyond parturition. Abstract : This study investigated whether nulliparity and the time interval since pregnancy among parous women affected the breast cancer phenotype in young women. Distribution of breast cancer molecular phenotype did not differ among parous young women by time interval since pregnancy. The implication of these findings for clinical practice suggests that pregnancy-associated breast cancers may be seen up to 5 years beyond parturition
1 edition published in 2003 in English and held by 0 WorldCat member libraries worldwide


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- Buzdar, Aman U. Publishing director
- International Conference on Recent Advances and Future Directions in Endocrine Manipulation of Breast Cancer 2004 Cambridge,
Mass
- International Conference on Recent Advances and Future Directions in Endocrine Manipulation of Breast Cancer (3, 2003, Cambridge,
Mass.)
- International Conference on Recent Advances and Future Directions in Endocrine Therapy for Breast Cancer. <2, 2002, Cambridge,
Mass.>.
- International Conference on Recent Advances and Future Directions in Endocrine Manipulation of Breast Cancer 2005 Cambridge,
Mass
- SpringerLink (Online service) Other
- International Conference on Recent Advances and Future Directions in Endocrine Manipulation of Breast Cancer Other
- Gilmore, Hannah Contributor
- Robertson, John F.R Author
- Clarke, David A.