3^rd World Congress on Women’s Health and Breast Cancer October 03-05, 2016 London, UK

Biography:

Dr. Shahla Masood is a Persian-born physician, who currently holds the positions of Professor and Chair of the Department of Pathology at University of Florida College of Medicine – Jacksonville and Chief of Pathology and Laboratory Medicine at Shands Jacksonville.She is the founder and Editor-in-Chief of The Breast Journal, the founder and past president of the “International Society of Breast Pathology,” the Director of the “Annual Multidisciplinary Symposium on Breast Disease”, “The Breast Cancer Public Forum”, and is currently the President of “The World Society for Breast Health.” She has been named as one of the Top Doctors in America and one of the 20 Top Professors in Oncology at an international level. Dr. Masood is a patient advocate, a partner in community affairs and an accomplished artist and gourmet chef.

Abstract:

During the last several years, increased public awareness, advances in breast imaging and enhanced screening programs have led to early breast cancer detection and attention to cancer prevention. The numbers of image-detected biopsies have increased and pathologists are expected to provide more information with smaller tissue samples. These biopsies have resulted in detection of increasing numbers of high-risk proliferative breast disease and in situ cancers. The general hypothesis is that some forms of breast cancers may arise from established forms of ductal carcinoma in situ (DCIS) and atypical ductal hyperplasia (ADH) and possibly from more common forms of ductal hyperplasia. However, this is an oversimplification of a very complex process, given the fact that the majority of breast cancers appears to arise de-novo or from a yet unknown precursor lesion. Currently, ADH and DCIS are considered as morphologic risk factors and precursor lesions for breast cancer. However, morphologic distinction between these two entities has remained a real issue that continues to lead to overdiagnosis and overtreatment. Aside from morphologic similarities between ADH and low grade DCIS, biomarker studies and molecular genetic testing’s have shown that morphologic overlaps are reflected at the molecular levels and raise questions about the validity of separating these two entities. It is hoped that as we better understand the genetic basis of these entities in relation to ultimate patient outcome, the suggested use of the term of “Borderline Breast Disease” can minimize the number of patients who are subject to overtreatment.

Biography:

Pier Luigi Santi has graduated in medicine and Surgery University of Genova(1974) at age 25 and he his specialist in Plastic and Reconstructive Surgery University of Milan 1977 and Oncology University of Messina 1986.Full professor University of Genova, Director of Plastic and Reconstructive department, IRCCS Cancer Institute, Genova since 1994. He has published more than 300 papers and some book chapters. Coordinator of courses and conferences national and international.

Abstract:

Immediate breast reconstruction has become a standard of care following mastectomy for cancer.Breast surgery affects the daily and the social life of a woman as well as her job and her relationships. Implant reconstruction (expander or prosthesis) permits a rapid recovery, fewer days of hospitalization, less morbidity' and it suit the most part of patients.The positionament of a mammary prosthesis or expander, after the mastectomy, is generally associated to the use of biological or synthetic scaffold to enhance lateral breast shape and provide total coverage of the prosthesis.After trying some differentmaterials we have activated a case-control study using data collected from January 1,2012 to December 31 2013 by enrolling 206 immediate breast reconstructions performed in 196 patients using a polyester mesh. No significant differences between two groups occurred for early postoperative complications, major complications that required surgical revision, volume or width of the prosthesis. The use of the scaffold from an aesthetic point of view has greatly improved breast shape especially in the lateral side. We are currently trying anacellular tissue matrixsupport from bio bank used as foil or mesh to check the speed of integration with the subcutaneous tissue in the lateral portion of the reconstructed breast.

Biography:

Guan Chen completed his PhD studies 26 years ago from Heidelberg University, Germany and postdoctoral training from Dana-Farber Cancer Institute, Harvard University, Boston, USA. He has been a tenured full-Professor of Pharmacology at Medical College of Wisconsin for more than 10 years with more 60 papers in high-ranking Journals and serves as an editorial board member of several International Journals

Abstract:

Triple negative breast cancer (TNBC) is highly progressive and lacks established targets for therapeutic intervention.  p38g mitogen-activated protein kinase (MAPK) (gene name: MAPK12) is overexpressed in TNBC but how overexpressed p38g contributes to TNBC remains unknown.  Here we show that p38g activation promotes TNBC development and progression by stimulating cancer stem-like cell (CSC) expansion and may serve as a novel therapeutic target for TNBC.  p38g silencing in TNBC cells inhibits mammosphere formation and reduces levels of key CSC drivers’ expression including Nanog, Oct3/4, and Sox2.  Moreover, p38g MAPK-forced expression alone is sufficient to stimulate CSC expansion and to induce malignant transformation with a phenotype resembling to TNBC in vitro and in vivo.  Furthermore, p38g depends on its activity to stimulate CSC expansion and breast cancer progression, indicating a therapeutic opportunity by application of its pharmacological inhibitor.  Indeed, the non-toxic p38g specific pharmacological inhibitor pirfenidone selectively inhibits TNBC growth in vitro and/or in vivo and significantly decreases CSC population.  Mechanistically, p38g stimulates Nanog expression through AP-1 via interaction with c-Jun.  These results together demonstrate that p38g drives TNBC development and progression and may be thus a novel therapeutic target by stimulating CSC expansion.  Inhibiting p38g activity with pirfenidone may be a novel strategy for the treatment of TNBC

Biography:

Shirley is a two-time Breast Cancer Survivor. In the year 2000 I was diagnosed with a collision tumour, triple-negative. My breast was partial removed and reconstructed with autologous tissue followed by chemotherapy and radiation. Exactly 5 years later I had a recurrence. I was lucky to be treated by an excellent Oncoplastic Breast Surgeon and I realized after my surgery how many patients, knowing they need surgery, are afraid of looking disfigured after their operation

Abstract:

“Yes, It Can!” Art can give a human touch in the healing process. The healing power of the Arts can strengthen the relationship between the doctor and the patient. Can medical students become better doctors by attending art courses? “Yes, I believe so”! Observation is Knowledge. Observation is essential to expertise in medicine. If medical students scrutinize paintings of the 18th Century in the museum this might improve their diagnostic skills at observation and empathy. They might then also look at their patients more in depth and not only relying on tests. So, Art should be a part of the education programs at medical schools, like in the US, which means training the Doctor´s Eye thru Art, because “opening Eyes opens Minds”. As a two-time Breast Cancer survivor I would like to stress that Breast Surgery is HIGH ART! Unfortunately, many doctors who perform surgery, are not Breast Surgery Specialists They may do just a handful cases a year. AND THAT IS THE POINT! Why do we see so many mutilations and unnecessary mastectomies? Because there is a lack of an official acknowledged accredited GLOBAL License in specialized Breast Cancer Surgery, accepted in all countries. We need a GLOBAL License with Oncological and Reconstructive Breast Surgery integrated as a part of Breast Surgical Training worldwide, a concept to be established by the WHO! It hurts to observe this lack, so I would like to announce an urgent Call-to-Action to work out a worldwide initiative for Breast Surgical Licensing. As I mentioned to you I am a two-time Breast Cancer Survivor. In the year 2000 I was diagnosed with a collision tumour, triple-negative. My breast was partial removed and reconstructed with autologous tissue followed by chemotherapy and radiation. Exactly 5 years later I had a recurrence. I was lucky to be treated by an excellent Oncoplastic Breast Surgeon and I realized after my surgery how many patients, knowing they need surgery, are afraid of looking disfigured after their operation. So what do we need? We need a global register with specialists available online to breast cancer patients! There are too many Breast Centres WITHOUT Specialized Breast Surgeons! After my surgery I began to paint, I had never painted before. Sòòò much had happened inside my body and soul… I became a productive painter and created, just by chance, a survivorship story filled with expressions of my feelings and emotions. Friends told me “Shirley, you have to do something with it”. So, I contacted international cancer organisations and offered them my slideshow. What I did not expect, was, that I soon received invitations to present and exhibit my paintings and to give speeches about “Getting Back into Life”. I am very proud to say that my painted survivorship story “Message of Hope” has been disseminated worldwide since 2010. Recently I was very honoured to exhibit my 22 paintings in the European Parliament on the occasion of “Cancer Survivors Day” Celebration in Brussels. I feel privileged that I have reached many cancer patients around the world. That I could encourage and give them hope, cheer them up with my colours, take their fear away for a couple of minutes, motivate and inspire them to unlock their creative potential during and after treatment, which might have helped healing both soul and body. Now I am aware: Art is Life and Life is An Art

Biography:

Dr Judith Edwards is a retired consultant child and adolescent psychoanalytic psychotherapist, who lectures and teaches around the world and has been published internationally. Her book of Selected Papers 'Love the Wild Swan' will be published in Routledge's World Mental Health series in November 2016.

Abstract:

For any person, a cancer diagnosis is a shock and a trauma. Any shock stops thinking and for a time the shock of diagnosis can paralyse a person’s capacity to carry on in a constructive way with the next part of their life. This short talk, based on the international group built site www.cansurviving.com will discuss ways of proceeding and will explore complementary and alternative treatments to aid the healing process.

Why me? may be a question. And help!  'what can I do now?  For the understanding of those who have built this site, starting from the Site Founder Judith Edwards onwards, both the development of cancer and the kick-starting of the healing process is a multi-factorial issue, and there are no cast- iron guarantees offered in any route, orthodox or alternative. What is vital is for a renewed sense of self-empowerment to grow, despite inevitable setbacks, in order for body, mind and spirit to be parts of the healing process. As a psychoanalytic psychotherapist for over thirty years, I have found the processes of being contained, and thus being able to engender one's own sense of hope and  empowerment, to be constructive and indeed vital for change and growth to take place. This talk will open doors to different ways of thinking which can be used together to aid both physical and mental health.

Biography:

Dr. Linda deGraffenried completed her PhD in Molecular Medicine and postdoctoral fellowship in Breast Cancer studies at the UT Health Science Center at San Antonio. She is an Associate Professor at UT Austin, and has published more than 30 peer-reviewed studies in the field of cancer development and progression. She is on the editorial board of several prestigious journals, and serves as a referee for numerous cancer organizations, including the NIH/NCI, Susan G. Komen Foundation and American Cancer Society

Abstract:

Multiple studies have demonstrated that obesity is associated with a worse outcome for most breast cancer subtypes and that obese breast cancer patients do not respond as well as normal weight patients to hormone therapy as well as chemotherapy. While a number of reasons have been proposed to explain this link, including diagnosis bias and complications caused by co-morbidities such as Type II diabetes, recent studies have provided evidence that elevated local cyclooxygenase-2 (COX-2) expression and the resulting increase in prostaglandin E2 (PGE2) production may play an important role. COX-2 upregulation in breast tumors is associated with a poor prognosis, a connection generally attributed to PGE2's direct effects on apoptosis and invasion as well as its stimulation of pre-adipocyte aromatase expression and subsequent estrogen production. Research in this area has provided a strong foundation for the hypothesis that COX-2 signaling is involved in the obesity-breast cancer link. Our recent pre-clinical and clinical data suggest that this inflammation-related signaling modulates several pathways critical to cancer progression in the obese breast cancer patient – but importantly – suppression of this signaling through fairly non-toxic approaches may provide significant clinical benefit and improve response to standard therapies – which will be critical as obesity reaches epidemic levels world-wide

Biography:

Dr. Booth completed his Ph.D. at North Carolina State University and postdoctoral studies at the National Cancer Institute/National Institutes of Health. He joined the Institute for Biological Interfaces of Engineering at Clemson University in 2009 and the Department of Bioengineering in2015. He has published over 30 peer-reviewed articles and chapters.

Abstract:

Breast cancer accounts for almost 30$ of new cancer diagnoses and is one of the leading causes of cancer deaths in developed countries. Lumpectomy is a common procedure to remove breast tumors resulting in a tissue void. There are currently no highly regarded surgical techniques to repair these voids. The objective of this project is to develop an injectable tissue regeneration matrix with anti-cancer properties. Collagen type I is a common tissue-engineering scaffold due to its intrinsically bioactive and biodegradable qualities. Collagen is a naturally derived material and, when not crosslinked, is enzymatically degraded. Research efforts targeting the potential of natural compounds in the fight against cancer are growing. Tannic acid (TA) belongs to the class of hydrolysable tannins and is found in numerous plants and foods. TA functions as a collagen crosslinking agent through both hydrogen bonding and hydrophobic effects; thus, as crosslinked collagen is remodeled TA is released. If used as a biomaterial for tissue-engineering purposes, TA-crosslinked collaged type I would not only serve as an attachment scaffold for cells but also function as an extended release anti-cancer treatment. When normal adipocytes attach and grow on TA-crosslinked collagen type I beads the released TA induces apoptosis in ER+ and HER2+ breast cancer cells with minimal impact on normal breast epithelial cells and adipocytes. The TA-induced apoptosis is mediated by caspases 3, 7 and 9. In conclusion, TA-crosslinked collagen beads show promise as a potential tissue regeneration matrix while providing an anti-cancer effect.

Biography:

Prof. Daphne Gschwantler-Kaulich has completed her specialization in Obstetrics and Gynaecology at the Medical University of Vienna, Austria, in 2009 with further specialization in senology, hereditary breast cancer and breast reconstruction.  She has published more than 30 papers in reputed journals

Abstract:

Background: Comparative studies on the use of meshes and acellular dermal matrices(ADM) in implant- based breast reconstruction (IBBR) have not yet been performed.

Methods: This prospective, randomized, controlled, multicenter pilot study was performed atfour Austrian breast cancer centers. Fifty patients with oncologic or prophylactic indication for mastectomy and IBBR were randomized to immediate IBBR with either an ADM (Protexa®) or a titanized mesh (TiLOOP® Bra). Complications, failed reconstruction,cosmetic outcome, patients’ quality of life and the thickness of the overlying tissue were recorded immediately postoperatively and 3 and 6 months after surgery.

Results: 48 patients participated in the study (Protexa® group: 23 ; TiLOOP® Bra group: 25patients). The overall complication rate was 31.25% with similar rates in both groups(Protexa® group 9 vs.in and 6 in TiLOOP® Bra group; p=0.188). There was a higher incidenceof severe complications leading to failed reconstructions with implant loss in the Protexa®group than in the TiLOOP® Bra group (7 vs. 2; p<0.0001). An inverted T-incision techniqueled to significantly more complications and reconstructive failure with Protexa® (p=0.037,p=0.012, respectively). There were no significant differences in patients’ satisfaction withcosmetic results (p=0.632), but surgeons and external specialists graded significantly betteroutcomes with TiLOOP® Bra (p=0.034, p=0.032).

Conclusion: This pilot study showed use of TiLOOP® Bra or Protexa® in IBBR is feasibleleading to good cosmetic outcomes and high patient satisfaction. To validate the higher failurerates in the Protexa® group, data from a larger trial are required.

Biography:

Jamal Zekri has received his higher medical oncology training in Weston Park Hospital (Sheffield, England). He practiced as a consultant medical oncologist at Clatterbridge Centre for Oncology (Merseyside, England) until April 2008. Currently, he is an associate professor at Al Faisal University and the head of medical oncology services at King Faisal Specialist Hospital & Research Centre (Jeddah, Saudi Arabia). He has published more than 50 papers in peer reviewed journals and presented more than 30 abstracts of original research wok at international conferences.

Abstract:

Introduction: Aromatization of androgens accounts for the peripheral formation of significant proportion of estrogen. For this reason, aromatase inhibitors (AIs) including letrzole are standard adjuvant treatments for post-menopausal (PM) women with hormone receptor positive (HR+) breast cancer (BC). Aromatase enzyme activity is predominant in adipose tissue. This has led to speculation that aromatase activity is elevated in obese women and subsequently decreased clinical activity of AIs. In Saudi Arabia, 80% of women with BC are overweight, obese or morbidly obese. Results of international studies investigating the effect of body mass index (BMI) on clinical outcome of women with BC on adjuvant AIs are not conclusive.. Certainly, there are no such studies in women from Saudi Arabia.

Patients and Methods: The electronic records of consecutive 320 PM women with HR+ BC starting adjuvant letrozole between January 2005 and December 2014 were retrospectively reviewed. Individual patients’ data were extracted including: BMI on day of starting letrozole, patients’ and tumors’ characteristics and disease outcome. The co-primary endpoints are (1) Frequency of obesity in this population (2) Comparing relapse free survival (RFS) in non-obese (Group 1: G1) and obese (Group 2: G2) patients.

Results: Obesity (BMI ≥30) and morbid obesity (BMI ≥35) are present in 220/320 (68.8%) and 115/320 (35.9%) patients respectively. RFS at 5 years (G1: 68.8% vs. G2: 80%) and at 8 years (G1: 68.8% vs. G2: 71.6%). Median RFS was not reached in both groups (Log Rank; P=0.097). Correlation between RFS and other patients’ and tumor characteristics will be presented at the congress.

Conclusion: About two thirds of PM women starting adjuvant AIs for BC are classified as obese. In this cohort, obesity did not adversely affect RFS. Larger cohort is needed to confirm this result.

Biography:

Bing Cui has completed his PhD at the age of 27 years from Peking Union Medical College and postdoctoral studies from University of California, San Diego.He has published 29 papers and filed 8 patents. As first author, the investigator’s papers have been published in several preeminent peer review journals such as Cancer Research, PNAS, Blood etc. As a principal investigator, Dr. Cui set up a new lab and research team in Institute of MateriaMedica, Chinese Academy of Medical Sciences in 2015.

Abstract:

B-cell CLL/lymphoma 6 (BCL6), a transcriptional repressor, is involved in the development and progression of breast cancers with uncertain mechanism. It was found that the expression of BCL6 positively associates with poor survival of breast cancer patients. The purpose of this study is to investigate the potential effect and mechanism of BCL6 in the regulation of epithelialmesenchymal transition (EMT), a critical cellular process for controlling the development and progression of breast cancers. We found that BCL6 promoted invasion, migration and growth by stimulating EMT in breast cancer cells. BCL6 induced EMT by enhancing the expression of transcriptional repressor ZEB1 which bound to the E-cadherin promoter and repressing the E-cadherin transcription. Deletion of ZEB1 protected against the pro-EMT roles of BCL6 by restoring the expression of E-cadherin in these cells. Moreover, inhibition of BCL6 with BCL6 inhibitor 79-6 suppressed these functions of BCL6 in breast cancer cells. These findings indicate that BCL6 promotes EMT via enhancing the ZEB1-mediated transcriptional repression of E-cadherin in breast cancer cells. Moreover, we recently find that BCL6 is involved in the dormancy-reactivation pathway from the published clinical breast cancer database, and BCL6 initiates and maintains cancer stem cell activity. Targeting BCL6 has therapeutic potential against the development and progression of breast cancer.

Biography:

M P Van Den Tol has completed her surgical training in 2002 and her training for oncological surgeon in 2004. She completed her Ph.D at the Erasmus University Rotterdam, The Netherlands in 2001. From 2004 till now she is working as a oncological surgeon and researcher at the VU Medical Center, Amsterdam, The Netherlands. She here provides clinical care for cancer patients, which she combines with training PhD candidates in research projects on surgical oncology and imaging. She has published more than 50 papers in reputed journals.

Abstract:

ABSTRACT

Aim of the study: The current study aims to assess margin status in relation to amount of healthy breast tissue resected in breast-conserving surgery (BCS) on a nationwide scale.

Methods: Using PALGA (a nationwide network and registry of histology and cytopathology in the Netherlands), all patients who underwent BCS for primary invasive carcinoma in 2012-13 were selected (10,058 excerpts). 9276 pathology excerpts were analysed for a range of criteria including oncological margin status and distance to closest margin, specimen weight/volume, greatest tumour diameter, and with or without localisation method. Calculated resection ratios (CRR) were assessed to determine excess healthy breast tissue resection.

Results: Margins for invasive carcinoma and in situ carcinoma combined were tumour-involved in 498 (5.4%) and focally involved in 1021 cases (11.0%) of cases. Unsatisfactory resections including (focally) involved margins and margins ≤1mm were reported in 33.8% of patients. The median lumpectomy volume was 46 cc (range 1 – 807 cc; SD 49.18) and median CRR 2.32 (range 0.10 – 104.17; SD 3.23), indicating the excision of 2.3 the optimal resection volume.

Conclusion: The unacceptable rate of tumour-involved margins as well as margins ≤ 1mm in one third of all patients is also achieved at the expense of healthy breast tissue resection, which may carry the drawback of high rates of cosmetic failure. These data clearly suggest the need for improvement in current breast conserving surgical procedures to decrease tumour-involved margin rates while reducing the amount of healthy breast tissue resected.

Biography:

Asli Giray Kurt has completed her PhD at the age of 33 years from Inonu University in Turkey and postdoctoral studies from Baskent University School of Medicine in Turkey. She has published more than 7 papers.

Abstract:

Breast cancer is the most common malignancy in 2015 in Europe. Estrogen receptors (ERs) and estrogen signaling regulate key molecular events in breast cancer development and progression. Estrogen receptor status is an important prognostic factor. BCL-2 protein family members regulate mitochondrial apoptotic pathway and impaired cell death signaling promotes cancer cell survival in response to chemotherapy, hypoxia or oncogenic stress. BH3-only proapoptotic BCL-2 proteins integrate cellular damage into mitochondrial apoptotic pathway either by selectively interacting with antiapoptotic BCL-2 proteins or by directly activating multidomain proapoptotic BCL-2 proteins. Here in this study we evaluated the how estrogen receptors’ intracellular localization affects mitochondrial cell death priming and endocrine therapy response in breast cancer cells by using CellTiterGlo cell viability assay, confocal immunofluorescence microscopy, immunoblotting, qPCR and BH3 profiling technique, which is a functional mitochondrial cell death assay for assessing apoptotic blocks employed by cancer cells. We found that ER-alpha is selectively expressed in breast cancer cell lines, but in contrast ER-beta is ubiquitously found in all breast cancer cells. Moreover, both ER-alpha and ER-beta in breast cancer cells are partially localized to mitochondria. We determined the BH3 profiles of breast cancer cells as well as EC50 values for tamoxifen, anastrozole and fulvestrant to evaluate how mitochondrial estrogen receptors affect mitochondrial cell death priming and endocrine therapy response. Our work highlights the promising potential of using BH3 profiling assay in predicting breast-cancer endocrine therapy response and the contribution of mitochondrial estrogen receptors in endocrine therapy-induced cell death in breast cancer cells.

Biography:

Jamal Zekri has received his higher medical oncology training in Weston Park Hospital (Sheffield, England). He practiced as a consultant medical oncologist at Clatterbridge Centre for Oncology (Merseyside, England) until April 2008. Currently, he is an associate professor at Al Faisal University and the head of medical oncology services at King Faisal Specialist Hospital & Research Centre (Jeddah, Saudi Arabia). He has published more than 50 papers in peer reviewed journals and presented more than 30 abstracts of original research wok at international conferences.

Abstract:

Introduction: Timely access to cancer treatment is expected to improve patients’ satisfaction and treatment outcome. A joint multidisciplinary breast cancer clinic (JMDBCC) is developed at the authors' hospital in January 2011 aiming to accelerate access to breast cancer care. Here, we assess the efficacy of this approach.

Methods: Patients were referred to relevant disciplines in different clinics on different days prior to the development of the JMDBCC. Metric data of access to care in 2010 represent the pre-JMDBCC era while those during the subsequent 5 years (2011-2015 inclusive) represent the post-JMDBCC era. The JMDBCC is comprised of 3 separate but closely adjacent sub-clinics conducted at the same time representing the 3 main relevant clinic based disciplines, namely, breast surgery, medical oncology and radiation oncology. A breast cancer coordinator facilitates the navigation of patients between the 3 sub-clinics. The aim of the clinic is to provide service within 7 days at each of the following stages: acceptance to first clinic visit (S1), first clinic visit to completion of appropriate investigations (S2) and completion of investigations to start of active treatment (S3). Thus, the total duration from acceptance to treatment (S1-3) is aimed to be within 21 days. A breast cancer coordinator liaises between relevant disciplines and facilitates the navigation of patients between the 3 sub-clinics.

Results: Five hundred and fifty patients attended relevant clinics pre-JMDBCC era with mean time metrics as follow: 13, 18, 21 and 46 days for S1, S2, S3 and S1-3 respectively. More patients were served each year during the subsequent post-JMDBCC era with improvement (acceleration) in all time metrics. For example 2797 patents attended the JMDBC sub-clinics in 2013 with mean time metrics as follow: 4.3, 5.4, 5 and 15.4 days for S1, S2, S3 and S1-3 respectively. Number of patents and time metrics of other years in the post-JMDBCC era will be presented in details at the Congress.

Conclusion: A JMDBCC dramatically accelerates access to specialist multidisciplinary care. All institutions managing patients with breast cancer are encouraged to adopt such coordinated service. The impact of an effective JMDBCC on specific disease outcome (progression free and overall survival) should be addressed in future studies

Biography:

Dr. Zarka Samoon has completed her M.B.B.S, followed by MRCP in medicine and MRCP in medical oncology. She is a medical oncology faculty at Aga Khan University Hospital with keen interest in breast and female genital tract malignancies.

Abstract:

Abstract

Introduction

Metaplastic breast carcinoma (MBC) is a rare disease with an incidence of <1%. In comparison to invasive ductal carcinomas (IDC), MBC present with a larger tumor size, few nodes involved, mostly high grade and triple negative, and with a shorter overall survival.

Objectives To determine the progression free, and overall survival of patients with MBC.

Methods From July 2006 till June 2013, 32 patients with MBC treated at Aga Khan University Hospital, Karachi were identified and retrospectively reviewed. Kaplan-Meier method was used for survival analysis.

Results Prevalence of MBC was 1.92% among breast cancer patients. The median age at tumor diagnosis was 54 years. Twenty nine (90.6%) patients had grade III tumor. The most common histopathology was squamous (65.6%) followed by spindle (12.5%) and carcinosarcoma (9.4%). Median tumor size was 4.5 cm. Seventeen (53.1%) patients had nodal involvement. Two patients (6.2%) had metastatic disease at presentation.  Hormone receptors were positive in 16 (50%) patients  and  negative in 15 (46.9%) patients.  Her-2 neu receptor was positive in 3 (9.4%) patients. Twenty seven (84.4%) patients underwent modified radical mastectomy. Neoadjuvant and adjuvant chemotherapy (anthracycline based in most cases) was received by 10 (31.25%) and 15 (46.8%) patients respectively. The median progression free and overall survival was 26 months and 27 months respectively. Five year progression free and overall survival was 72% and 73% respectively.

Conclusion

Our patients had tumors which were mostly high grade, large, with around half of them having nodal and hormonal involvement however with better survival outcomes compared to series described earlier.

Biography:

Suparna Sengupta obtained her Ph.D. degree from Bose Institute, India and did post-doctoral research in the University of Kansas, USA. Currently, she is a senior scientist in Rajiv Gandhi Centre for Biotechnology, India and her research interest includes the role of cytoskeletal proteins on mitosis, apoptosis and drug development. She has published several papers in high impact journals and acts as reviewer in many national and international journals. Her awards include Indian Association for Cancer Research award, National Woman Bioscientist Award from Govt. of India.  She is a fellow of International Union Against Cancer.

Abstract:

Breast cancer therapy suffers serious obstacle for the presence of cancer stem cells in tumours as they can be responsible for poor prognosis and tumour relapse. Very few chemotherapeutic compounds show promise to kill these cells. Dietary compounds are welcome options for human diseases due to their time-tested acceptability by human bodies. The ginger-derived compound 6-shogaol was effective in killing both breast cancer monolayer cells and cancer-stem cell-like spheroids at doses that were not toxic to noncancerous cells. Both hormone responsive and triple negative breast cancer cells were sensitive to the lethal action of 6-shogaol. 6-shogaol treatment induced autophagy in both monolayer and spheroid culture. Kinetic analysis revealed that the autophagic flux instigated cell death in 6-shogaol treated breast cancer cells. Very low level of apoptosis induction and drastic reduction of cell death by the inhibition of autophagy suggested that autophagy is the major mode of cell death induced by 6-shogaol in breast cancer cells. 6-shogaol reduced the expression levels of Cleaved Notch1 and its target proteins Hes1 and Cyclin D1 in spheroids, and the reduction was further pronounced in presence of a γ-secretase inhibitor. Secondary sphere formation in presence of the inhibitor was also further reduced by 6-shogaol. Together, these results indicate that the inhibitory action of 6-shogaol on spheroid growth and sustainability is conferred through γ-secretase mediated down-regulation of Notch signaling. The efficacy of 6-shogaol in monolayer and cancer stem cell-like spheroids raise hope for its therapeutic benefit in breast cancer treatment

Biography:

Dr. Kim Jaffee is currently an Associate Professor in the School of Social Work at Wayne State University, Detroit, Michigan, USA. She received her Master degree in Social Work from the Ohio State University and her doctorate degree in Social Welfare from the State University of New York at Albany. Dr. Jaffee’s primary area of research is in the areas of health disparities - specifically, Arab health, mental health, maternal and child health, and gender minority health. She has published on health disparities in a variety of public health, social work, and psychiatric journals

Abstract:

Breast cancer (BC) is the second most common cancer among women worldwide and in the US (CDC, 2012). Among Israeli and Arab women in Israel, BC is the most common malignancy, and between 1996 and 2007 BC mortality decreased significantly among Israeli women but remained stable among Arab women (Keinan-Boker, et al., 2013). Delayed diagnosis contributes to BC mortality among women in Middle Eastern countries (WHO, 2006), as well as in the US. A number of studies have suggested that cancer is diagnosed at later stages for Arab Americans and that prevention efforts should be better understood (Arshad, 2011; Hirko et al., 2013).  Arab American women in Detroit were significantly less likely to have received a mammogram compared to all women in Michigan (Schwartz, 2008).  Psychosocial factors associated with BC screening among Arab women include fear of the screening process, fear of negative results, embarrassment and stigmatization, language barriers, lack of knowledge, transportation and economic barriers, and cultural and religious barriers (Cohen & Azaiza, 2008).  There are no known studies comparing BC screening barriers for Arab women in Israel and the US. The current study compares cultural barriers to BC screening and cancer screening adherence among Arab women in the US and Israel. The sample consisted of 416 women -- 77% (N=360) were Arab Israeli and 23% (N=90) were Arab American. Not only are cultural barriers significantly different among Arab American women compared to Israeli Arab women, but breast cancer cultural barriers are significantly associated with adherence to screening guidelines.

Biography:

Gaiane M. Rauch, M.D., Ph.D., completed her Radiology residency at the Baylor College of Medicine, Houston TX and Breast/Abdominal imaging fellowship at the UT MD Anderson Cancer Center, Houston, TX. She is an Associate Professor in the Department of Diagnostic Radiology, UT MD Anderson Cancer Center, with dual appointment in the breast and abdominal imaging. She published 32 peer-reviewed articles, 91 abstracts, 13 book chapters, 2 manuals.  She has been a PI, co-PI or co-Investigator on 33 research protocols. Dr. Rauch serves as a reviewer and/or editor for several journals

Abstract:

Molecular breast imaging (MBI) is an emerging technique that utilizes small semiconductor-based γ-cameras in a mammographic configuration to provide high-resolution functional images of the breast and requires injection of radioactive tracer of Tc99m sestamibi. Unlike mammography that generates radiographic images based on breast anatomy and morphology, MBI generates functional images based on the physiological processes within the breast tissue. Therefore, in contrast to mammography, the sensitivity of MBI is not influenced by the density of the breast tissue, implants, architectural distortion, or scars from prior surgery or radiation. In patients with suspected breast cancer, MBI has an overall sensitivity of 90%, with a sensitivity of 82% for lesions less than 10 mm in size. Studies have shown that MBI has comparable sensitivity to breast MRI, however higher specificity. MBI has been proven to be able to detect additional ipsilateral and contralateral malignant foci in patients with newly diagnosed breast cancer with a sensitivity (88-95% vs 89-98%) equivalent to MRI but with higher specificity (74-90% vs 40-65%).  Another promising MBI application is monitoring of neoadjuvant chemotherapy and assessment of residual disease, which may influence and alter surgical planning. MBI has been shown to be a useful supplemental screening modality to mammography, showing a sensitivity of 91% for detection of breast cancer in women with dense breasts. It was shown that addition of MBI to screening mammography provides lower cost per cancer detected than with screening mammography alone. MBI is a highly complementary functional breast imaging modality to existing anatomical techniques

Biography:

Neha Sharma is the director of Warwick Research Services, UK and   She is also Chief Executive Officer (CEO) of the International Research Initiative on India, China, Europe and Africa. Dr. Sharma has over 70 research articles and has been invited to speak at numerous national and international conferences. She has received many honors and awards including young scientist award and scientific excellence award. Dr Sharma has an international reputation in the field of the health and social care developing resources and practice for better health care.

Abstract:

Radiation dermatitis is most common side effects of radiotherapy during cancer treatment, causing    itching and pain, treatment delays, and diminished aesthetic appearance-and poor quality of life. The aim of the study was to assess the effect of homeopathy treatment on radiation-induced skin reactions in breast cancer patients. 

Material and Methods: 

Double-blinded, randomized placebo controlled trial recruited patients from 3 cancer centers in North India. 160 patients after the surgery scheduled for postoperative radiotherapy were randomized in either homeopathy (n=80) or placebo group(n=80) .  Provider-assessed maximum grade of Common Terminology Criteria for Adverse Events (CTCAE) was primary endpoint of the study. Secondary endpoints included the Skindex-16, the Skin Toxicity, Symptom Experience, and quality of life self-assessment. Assessment was performed at baseline, weekly during radiotherapy, and for 4 weeks after.  

Results: 

In total, 148 patients completed (homeopathy, n=76; placebo, n=72). Follow up showed significant difference in maximum grade of radiation dermatitis by homeopathy   (P < 0.5). CTCAE toxicity was greater in placebo group (P=.002). after the treatment, homeopathy group showed less itching (P<.0001), less irritation (P <0.0001), less symptom persistence or recurrence (P=.000), and less annoyance with skin problems (P=.002); less burning sensation (P=.002). Also, during follow-up period, less percentage of patients in homeopathy (23.6%) developed dermatitis compared to placebo group (77.8%) which indicates sooner improvement of this patients. 

Conclusion: 

Patients receiving daily homeopathy during radiotherapy is significantly more effective in reducing radiation dermatitis. 

Biography:

Saranya Chumsri, M.D. is a medical oncologist who is specialized in breast cancer. Her research is focusing on several aspects of breast cancer, including genomics, immunologic, epigenetics, breast cancer stem cells, endocrine resistance, as well as an aggressive form of breast cancer lacking estrogen receptor, progesterone receptor, and HER2, termed triple negative breast cancer. Dr. Chumsri is a clinician scientist reviewer for the Breast Cancer Research Program for the Department of Defense Congressionally Directed Medical Research Programs, 2012-2015. She was also the Co-leader disease oriented group: breast cancer for the University of Chicago Phase II Consortium between 2011-2014

Abstract:

Triple negative breast cancer (TNBC) is an aggressive form of breast cancer that accounts for 10-15% of breast cancer. Patients with TNBC often have poorer prognosis with the median survival of 13 months in metastatic setting. TNBC is more prevalent in younger women and patients with germ line BRCA1 mutation. This form of breast cancer lacks all currently established druggable targets in breast cancer, namely estrogen receptor, progesterone receptor, and HER2. Based on tumor genomic landscape, studies showed that TNBC is heterogeneous and comprises of at least 6 unique subtypes. Each subtype appears to have differential response to different targeted therapies. One of the targeted therapies that has gain more interest in the past few years is the anti-androgens that target androgen receptors. Currently, there are 2 phase II trials that showed prolonged benefit of treatments that target androgen receptors in patients with TNBC expressing androgen receptor. Emerging studies demonstrated that immune system also plays a critical role in TNBC. Furthermore, targeting host immune system using immune checkpoint blockade agents have been recently shown to have promising durable responses in several patients with TNBC.  Several researches are ongoing to evaluate the role of these immunotherapies in patients with TNBC

Biography:

Jun Yang completed his PhD from The Institute of Caner Research, Sutton, UK, and postdoctoral studies from Oxford University and St Jude Children’s Research Hospital. He is the faculty in Department of Surgery, St Jude Children’s Research Hospital. He has published more than 20 papers in reputed journals.

Abstract:

More than 1.7 million new cases of breast cancer occur every year, 70% of which are estrogen receptor alpha (ERα) positive. Anti-estrogen therapy to block ERα function is the most important approach in treatment of ERα positive patients. However, resistance eventually will develop for various reasons. Previous clinical studies suggest that the in vivo tumor environment may play a role in tamoxifen resistance, as hypoxia-inducible factor 1 alpha (HIF-1α) protein expression was associated with tamoxifen resistance in neoadjuvant, primary therapy of ERα-positive breast cancers as well as resistance to chemoendocrine therapy. However, whether HIF-1α plays an autonomous role in modulating endocrine therapy efficacy such as tamoxifen resistance is unknown. It is also puzzling why increased HIF-1α is associated with ERα positivity in clinical samples, since ERα negative breast cancer is more hypoxic. And how these two important oncogenic transcriptional factors interact has not yet been defined. In this presentation, I will discuss a new signaling pathway between ERα and HIF-1α, providing evidence that HIF-1α may account for anti-hormone therapy. I will also discuss how HIF-1α and ERα cooperate to drive expression of histone demethylase KDM4B in breast cancer, and demonstrate KDM4B as a potential therapeutic target.

Biography:

Maude Hébert R.N. Ph.D. is Professor at the University of Québec in Trois-Rivières. She did her graduate studies with women diagnosed of breast cancer. She teaches research methodology and therapeutic relationship. Her research interests cover the concept of transition between health and illness and the perceptions of health and illness in the population in oncology.  

Abstract:

Purpose: In what state of health do women with breast cancer consider themselves to be? Health pro- fessionals classify them as cancer victims but few studies have examined women's perceptions of their own health following a breast cancer diagnosis. We looked at the transition in health status perceptions between before and after receiving the diagnosis. Methods: A grounded theory design was chosen to develop a framework. Results: From an analysis of semi-structured individual interviews with 32 women, it emerged that 1) over a two-year period, the participants went through four iterative steps between receipt of the official diagnosis and the return of the level of energy once the treatments are done. Theses four steps are: reacting emotionally, facing the situation, constructing a new identity and reacting to social represen- tations of cancer, 2) the participants did not feel sick from breast cancer.

Conclusion: This study shows learning to live with a sword of Damocles over the head during the transition process. The emergent steps of the health status perceptions transition process in breast cancer trajectory give direction for care

Biography:

Gia Nemsadze has completed his PhD at the age of 36 years from National Cancer Centre st. Peterburg, He has become a Professor at the age 45 . He is the head of Boards of the Clinic named "The Institute Of Clinical Oncology" Tbilisi, Georgia. He works in clinical Oncology and General Surgery (more Then 750 operations per year). He has been the Principal Investigator for 12 studies in Oncology. Published more than 120 papers in reputed journals. He is The Member of New York Academy since 1996. Full Member Of ESMO, since 2005. He earned the Patent in "Mastectomy and post mastectomy reconstruction" in 1996. Gia Nemsadze is the winner of "Georgian State Prize" in science and technology-1998

Abstract:

Notwithstanding of recent development of diagnostics and new approaches in treatment of stage IV breast cancer disease, the treatment of metastatic Brest cancer yet remains as one of the significant problems of the medical World.

The studies and practice at our clinic has defined many different cases which included both - standard type of treatment (i.e. metastatic liver and pulmonary surgical interference); and the ones that can be considered as non-standard approach when the surgery derives from non-standard metastatic development of the breast caner. There are cases when the secondary damages were discovered in the form of ulcerated tumor of sternum; ulcerated supraclavicular area; neck lymph nodes; soft tissue damages in different areas and also combined damage of pleura with ribs.

We have carried out more than 30 non-standard operations during 2012-2016  related to the patients that has developed metastatic diseases in one of above motioned areas.

These are the patients who were not the De'novo patients and all of them have previously gone through the both: the surgical; and systemic treatment of primary breast cancer such as: chemo, target, hormone/radiation therapies.

However, the decision to go through the surgery has been taken after the resistance of the disease towards the systemic therapy was defined. In most of the cases the quality of the patients life was deteriorating because of paraneoplastic syndromes and fast growing visualized tumor development (depression,  pain, ulceration, secondary infection, bleeding etc..).      

Surgeries:   

21 cases of supraclavicular area and neck lymph nodes. The operations included:

Neck area lymphadenectomy, or tumor conglomerate excision from supraclavicular area. 

3 cases of local recurrence with tumor incision in the ribs. The operations included:

The resection of local recurrence in one block of damaged area.

2 cases of parietal pleura damage. The operations included:

Tumor atypical resection.

4 cases of total damage of sternum with adjusted problems of ulcerated and bleeding tumor. 

The operations included:

combined resection of the tumor tissue together with the damaged sternum.

Biography:

Diana Nemsazde working as an ocologist at The Institute of Clinical Oncology,  Georgia

Abstract:

Notwithstanding of recent development of diagnostics and new approaches in treatment of stage IV breast cancer disease, the treatment of metastatic Brest cancer yet remains as one of the significant problems of the medical World.

The studies and practice at our clinic has defined many different cases which included both - standard type of treatment (i.e. metastatic liver and pulmonary surgical interference); and the ones that can be considered as non-standard approach when the surgery derives from non-standard metastatic development of the breast caner. There are cases when the secondary damages were discovered in the form of ulcerated tumor of sternum; ulcerated supraclavicular area; neck lymph nodes; soft tissue damages in different areas and also combined damage of pleura with ribs.

We have carried out more than 30 non-standard operations during 2012-2016  related to the patients that has developed metastatic diseases in one of above motioned areas.

These are the patients who were not the De'novo patients and all of them have previously gone through the both: the surgical; and systemic treatment of primary breast cancer such as: chemo, target, hormone/radiation therapies.

However, the decision to go through the surgery has been taken after the resistance of the disease towards the systemic therapy was defined. In most of the cases the quality of the patients life was deteriorating because of paraneoplastic syndromes and fast growing visualized tumor development (depression,  pain, ulceration, secondary infection, bleeding etc..).      

Surgeries:   

21 cases of supraclavicular area and neck lymph nodes. The operations included:

Neck area lymphadenectomy, or tumor conglomerate excision from supraclavicular area. 

3 cases of local recurrence with tumor incision in the ribs. The operations included:

The resection of local recurrence in one block of damaged area.

2 cases of parietal pleura damage. The operations included:

Tumor atypical resection.

4 cases of total damage of sternum with adjusted problems of ulcerated and bleeding tumor. 

The operations included:

combined resection of the tumor tissue together with the damaged sternum.

Biography:

Chang Gong has completed her PhD at the age of 30 years from Sun Yat-Sen University and postdoctoral studies from INSERM of  France and Cardiff University of UK. She is a breast surgeon and an associate professor of  Breast Tumor Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University. She has published more than 30 papers in cancer  related journals.
 

Abstract:

Pathologic complete response (pCR) prediction after neoadjuvant chemotherapy (NAC) is important for clinical decision-making in breast cancer. Nottingham prognostic index (NPI) and Immunohistochemical four (IHC4) score are cost-effective prognostic biomarkers. However, whether these factors can predict pCR remains unknown. A new NPI+IHC4 scoring system was built on the combination of NPI and IHC4 score by variable assignment method. A new predictive biomarker named NPI+IHC4 was developed to predict pCR in a study set (n=443) and validated in an external validation set (n=296). Multivariate analysis of variables for a pCR was performed via logistic regression analysis. The ROC curves were employed to test the sensitivity and specificity of variables in predicting pCR and disease-free survival (DFS).In the study set, a lower IHC4 score, NPI and NPI+IHC4 were significantly associated a high pCR rate, multivariable analysis showed tumor size, TNM, NPI and IHC4 score were independent predictors of. NPI+IHC4 showed a better sensitivity and specificity for pCR prediction (AUC 0.699, 95% CI 0.626-0.772) than IHC4 score, NPI, tumor size and TNM stage. In the validation set, NPI+IHC4 had a better predictive value for pCR (AUC 0.665, 95% CI 0.579-0.751) than IHC4 score or NPI alone. In addition, ER+ patients with lower IHC4, NPI and NPI+IHC4 scores had significantly better DFS in both study and validation sets. NPI+IHC4 can predict pCR following NAC and prognosis in ER+ breast cancer. This study provides evidence that incorporating macro-anatomic features and molecular information can improve pCR prediction following NAC.

Biography:

Vessela N. Kristensen is a Professor I at the Medical Faculty of the University in Oslo (UiO) in Clinical Epidemiology at the Department of Clinical Molecular Biology and Lab science (EpiGen), Akershus university hospital, and Group Leader at the Department of Genetics, IKF, Det Norske Radiumhospital. She has been also visiting adjunct professor at Princeton University, Professor II at the Centre for Integrative Genetics, University of Life Sciences, Ås and assistant professor at the Advanced Technology Center at NCI, NIH, Bethesda. Kristensen has also worked Berzelius Laboratory at Karolinska Institutet. She was also granted a fellowship to study in the lab of Dr. N. Harada at Fujita Health University, Nagoya, Japan. Kristensen’s research interests are related to how genetic variation affects occurrence of somatic alterations, gene expression patterns and genome wide copy number alterations in human breast and ovarian tumors (http://www.ous-research. no/kristensen/). This work has lead to the communication of 132 scientific papers since 2002. She is a recipient of several national and international grants and awards, member of scientific and administrative boards in Norway and abroad and member of academic evaluating committees in Norway, Sweden, Denmark and Iceland. Current topics of research are in the field of genomic variation in relation to susceptibility, clinical presentation, treatment response and adverse side effects of treatment, gene regulation and proximal phenotypes (RNA expression and metabolic profiles) in breast cancer

Abstract:

The tumor initiation, progression and clinical presentation are directly dependent on its genetic and biochemical environment – the entire body. Our group is working on different projects related to how genetic variation affects occurrence of somatic alterations, gene expression patterns and genome wide copy number alterations in human breast and ovarian tumors. Understanding inherited genetic variability and how it affects crucial biological pathways is likely to lead to new successful prevention and treatment strategies. The research in the group is focusing on constitutive variation such as single nucleotide polymorphisms (SNPs), somatic mutations and copy number variations (CNVs) in relation to susceptibility, clinical presentation, treatment response and adverse side effects of treatment. Gene regulation and proximal phenotypes (RNA expression and metabolic profiles), Genomic Instability and DNA methylation patterns in cancer as well as molecular mechanisms underlying treatment response will be discussed.

Biography:

Vasco Carvalho Lourenço da Fonseca is 42 years old and has been practicing medicine for 16 years, following a family tradition of medical doctors. He is currently an oncologist. Throughout his career, he has had the privilege to work on various health reference units, as well as in a renewed research center. He is married and the father of 4 children. He was a high competition athlete in equestrian sports. His interest in his community and in societal issues, led him to integrate the list that is currently in functions at Câmara Municipal de Lisboa (City hall). Currently working as Hospital Assistant on Medical Oncology at the Oncology unit of the “Centro Hospitalar de Lisboa Ocidental” (located at the hospital “São Francisco Xavier”), highlighting his involvement on Breast cancer.

Abstract:

The authors propose a presentation which will discuss our experience of preservation of fertility in breast cancer patients in a group of five Hospitals in Portugal. To begin with, the presentation will outline the selection criteria and related ethical questions concerning whether a patient can be referred for preservation of fertility. From here, the discussion will move on to cover the different techniques which we employ in our clinical practice, as well as the optimal timings for each. This will also raise questions of coordination between different Hospitals and Centers. Following this, the presentation will focus on our experience in this area, including the complications that we have encountered in both coordination and clinical practice. We will then highlight the importance of using clinical trials, the oncological register and expert opinion in order to best advice patients who wish to proceed with a pregnancy, before concluding with a discussion of the ethical implications of genetic counseling.

Biography:

Pooja Saini has completed her PhD at the age of 36 years from University of Manchester and is a postdoctoral research at the University of Liverpool. She is the Knowledge Exchange and Implementation Manager for the NIHR CLAHRC  NWC. She has published more than 10 papers in reputed journals and has been serving as the Co-Princliple Investigator for the systematic review, Co-Founder of Women Reach Women CIC and is an active  member of the Asian Breast Cancer Support Goup promoting improvements in healthcare, health promotion & research in the UK's South Asian communities

Abstract:

Although cancer incidence rates are often lower in ethnic minority groups than in the general population of England, rates are rising in some minority groups to equal or exceed general population prevalence. Mortality and morbidity are reduced through early detection, but South Asian women are less likely to participate in cancer screening programmes for breast and cervical cancer than the general female population of the UK. Low screening rates and delayed symptom reporting in South Asian women are attributable to culturally-related factors such as communication barriers, fear of cancer, stigmatism and embarrassment over medical procedures/screening practices. In depth information is required to understand precisely how these barriers are experienced by women, how they influence behaviour, how they vary between different cultural subgroups and how they can be overcome. The purpose of this review is to collate information on studies of asymptomatic screening attendance by South Asian women for breast and cervical cancer. We will synthesize the literature concerning cultural and individual beliefs and attitudes and their effects on individual women’s screening attendance. This review aims to inform policy on targeting relevant public health messages to the south Asian communities about screening for cancer, and be useful for healthcare commissioners to decide how best to invest resources in areas with large ethnic groups.

Biography:

Marco Bernini graduated from Florence University Med School in 2001, completed a Surgery Master in USA in 2002. He obtained a period of research appointment in Scotland (UK) in 2008 and completed General Surgery residency in 2008. Received his PhD in 2011 from University of Florence. He is a Breast Oncologic and Reconstructive Consultant Surgeon at Florence University Hospital Breast Unit. He has published more than 37 papers in indexed journals, has served as an editor for a journal, and has participated as speaker and as a board member in international
congresses.

Abstract:

NSM is deemed safe upon several reviews from literature. Defined a “conservative
mastectomy”, NSM implies an immediate reconstruction. No randomized trials have
proven its surgical and oncological safety nor the best reconstructive approach. Such trials are unlikely due to NSM wide acceptance and use. Large multi-institutional data-sets are therefore essential to analyze current outcomes of NSM. Present study evaluates results of the Italian National NSM registry. In 2011 a panel of specialists agreed upon and designed a National database of NSM. Centers with at least 150 cancers per year and following the National follow-up guidelines could enter NSM cases, retrospectively and prospectively. During 2015 last oncological and reconstructive follow-ups and data extraction were performed. Present analysis consists of selected cases including those between January 1st 2009 and December 31st 2014. 913 women were included, accounting for 1006 procedures. Prophylactic mastectomies were 124 (12.3%). MRI increased over time. NAC necrosis rate was 4.8%. Larger skin-flap necrosis rate was 2.3%. Major surgical complications rate was 4.4%. Oncological outcomes (for primitive EBC cases) were: locoregional recurrences 2.9% (NAC recurrence 0.7%), and 1.0% of systemic recurrences. Five deaths (0.7%) occurred. Reconstructions were prosthetic in 93% of cases, with DTI equal to TE/two-stage reconstruction in 2014. Flaps decreased
over time, despite 0% failure rate. Overall reconstruction failure was 2.6%. 12.3% are prophylactic mastectomies. Surgical and oncological outcomes prove NSM  effectiveness, with low prosthetic reconstruction failures. This National multicentric analysis enables comparisons of results with no geographical differences and a “safe” state-of-the-art of NSM in Italy.

 

Biography:

Naheel Abu-Khalaf  has completed  her Mphil  at the age of 26 years from Bradford University, UK , in 1986 , in Medical Sciences and Clinical Oncology unit ,  a PhD candidate at the Institute of Cancer Therapeutics at Bradford University in  2016  .She is the director of KARMA CLINIC in Nablus , Palestine , a Palliative care Center  , she has published more than 6 papers in reputed journals in the feild of cancer. Speaker and head of session at the 8th Eurobean conference on Health Promotion and Education , Palestinian Ecperience in breast cancer, Head of session about Marginalised people. 

Worked at The  Italian Cooperation Office in Jerusalem ,as a “National Cancer Control Project Officer” for West Bank & Gaza, implementing the PAST Program ( The Italian Technocal Assistance for Palestinian , established  the first Breast cancer screening  center in Palestine ( Mammography Unit ) at Beit-Jala Hospital in WB and at Al-Shifa Hospital in Gaza

Abstract:

Consanguinity (marriage with ‘blood relatives’) is a deeply rooted social trend in the Middle East, West Asia and North Africa and in Palestine, it is particularly common because of social and economic factors.Such marriages carry the risk of promoting congenital and genetic disorders and raises concerns about the increased risk of genetic diseases such as cancer. The reasons behind the steep rise in breast cancer incidence in Palestine over the last 10 years are not known but the hypothesis being tested in this project is that consanguinity contributes towards the increased incidence of breast cancer in Palestinian women.To test this hypothesis, two approaches were used. The first was a genetic analysis of BRCA1 and BRCA2 genes using DNA samples obtained from 31 women of Arab origin affected by breast (n = 28) and ovarian cancer (n = 3). All participants had a well-documented family history. Using denaturing high performance liquid chromatography, a novel BRCA1 mutation(E1373X in exon 12) was initially identified in one of the patients affected with ovarian cancer.  The same mutation was found in four of her family members 2 sisters with breast /ovarian cancer, one with breast cancer another healthy sister also possessed this mutation. The significance of the novel BRCA1 mutation is not known and further studies are required to determine whether the incidence of this mutation and other BRCA1/2 mutations is greater in patients where consanguineous marriages have taken place. The second approach employed a case-control study, the aim of which was to examine the possible effect of consanguinity on the risk of breast cancer. One hundred and fifty five breast cancer cases and two hundred controls were obtained from two major cancer centers.A questionnaire that soughtsocio-demographic information, type of consanguinity, medical history and tumor grade was designed and evaluated. The study revealed that, although the consanguinity rate is high in the Palestinian population, no significant difference exists between consanguinity in breast cancer and control groups. The number of individuals studies was however low and this conclusion needs to be tempered by the need to expand the number of individuals involved.

Biography:

Ameneh safarzadeh has completed her Master’s degree from Isfahan University of Medical Sciences, Isfahan, Iran. She is the Faculty Member in Midwifery Department at Pregnancy Health Research Center, Zahedan University of Medical Sciences, Iran. She has published more than 16 papers in reputed journals and has been serving as an Editorial Board Member of Austin journal pain and relief.

Abstract:

Background: Serious physiological and psychological changes may be accompanied during pregnancy. Antenatal education reveals numerous effects on women’s general health. It is important to survey interventions being used to educate primiparous women about their general health during this time. So, this study was conducted to determine the effect of the Fordyce cognitive-behavioral happiness training on pregnant women's general health. Methods: This quasi-experimental study with the pretest-posttest design was performed on 74 primiparous women referred to Zahedan Health Centers in 2015. The subjects were selected through random convenient sampling method and divided into 2 groups of intervention and control. Data was collected using standard Goldberg general health questionnaire (28-GHQ). After 6 weeks training, the GHQ was completed by groups. The data was analyzed using descriptive statistics, chi-square test, independent t-test, paired t-test and covariance analysis of SPSS software version 16. Results: Total means of the score of the general health of the experimental group and the control group before the intervention was (19.89±7.63) and (19.94±7.90), respectively; and after the intervention, the respective scores were (17.78±5.50) and (21.64±7.21). Although after the intervention control groups showed a significant decreased level of general health, the difference in general health between both groups after the intervention was significant in the experimental group (P <0.05). Conclusion: Our results showed the effectiveness of the Fordyce cognitive-behavioral happiness training on pregnant women's general health. It is recommended that this educational method is used in the routine prenatal training programs by healthcare professionals.

Biography:

Dr S. Aguggini is a breast surgeon at Breast Cancer Unit-Women’s Centre. He has completed his MD and PhD at the University of Milano. He is in charge of the screening programme of the Unit. He has published more than 25 papers in reputed journals

Abstract:

Because hypoxia mediates resistance to anthracyclines  in vitro, we aimed to identify hypoxia-related biological markers involved in the response and resistance to epirubicin in patients with locally advanced breast cancer. One hundred seventy-six women with T2-4 N0-1 breast tumors were randomly assigned to receive epirubicin 120 mg/m²/1-21 (EPI ARM), epirubicin 120 mg/m²/1-21 + erythropoietin 10.000 IU sc three times weekly (EPI-EPO ARM) and epirubicin 40 mg/m²/w-q21 (EPI-W ARM). Sixteen tumor proteins involved in cell survival, hypoxia, angiogenesis and growth factor, were assessed by immunohistochemistry in pre-treatment samples and a multivariate generalized linear regression approach was applied using a penalized least-square minimization to perform variable selection and regularization. Ten-fold cross-validation and iterative leave-one-out were employed to validate and test the model, respectively. High VEGF and GLUT-1 and low ER were significant factors for complete clinical response to treatment in all leave-one-out iterations. EPO expression was positively correlated with pCR. High HB levels, bcl-2  and HIF-1 expression were significantly negatively correlated with pCR, HB baseline level and HIF-1 alpha nuclear expression were significantly positively associated with a higher risk of relapse and with overall survival.

Biography:

Gaiane M. Rauch, M.D., Ph.D., completed her Radiology residency at the Baylor College of Medicine, Houston TX and Breast/Abdominal imaging fellowship at the UT MD Anderson Cancer Center, Houston, TX. She is an Associate Professor in the Department of Diagnostic Radiology, UT MD Anderson Cancer Center, with dual appointment in the breast and abdominal imaging. She published 32 peer-reviewed articles, 91 abstracts, 13 book chapters, 2 manuals.  She has been a PI, co-PI or co-Investigator on 33 research protocols. Dr. Rauch serves as a reviewer and/or editor for several journals

Abstract:

MR imaging plays an important role in the evaluation of disease extent, treatment planning and follow up in patients with gynecologic malignancies. For cervical cancer patients MR imaging improves FIGO clinical staging leading to better treatment selection, monitors response to treatment, helps in planning of radiotherapy, including brachytherapy, which improves local control and survival. MR imaging in endometrial cancer provides accurate surgical planning, differentiating low risk disease that doesn’t need extensive surgery from high risk patients that require pelvic and papraaortic nodal dissection. MR imaging is essential for endometrial and cervical cancer patients that desire fertility preservation assessing patient’s eligibility for fertility sparing surgical procedures.  For ovarian malignancies MR imaging serves as a problem solving tool. MR imaging is not part of the FIGO staging of vaginal cancer, however there is increased evidence that it provides accurate assessment of local disease extent, guiding treatment planning. High resolution MR imaging is an important part of multidisciplinary approach for gynecological malignancies - an approach that provides accurate staging, re-staging, risk stratification and individualized treatment.

Biography:

Winnie Yeo is currently a Clinical Professor of the Department of Clinical Oncology, the Chinese University of Hong Kong. Professor Yeo graduated from King’s College Hospital, University of London.  She has undergone postgraduate training in Addenbrooke’s Hospital, Cambridge, and at King’s College, Westminster and Royal Marsden Hospitals in London before returning to Hong Kong. Professor Yeo is the Past Chairman of the Medical Oncology Specialty of the Hong Kong College of Physicians. She has served in expert panels and committees within the University, the Hong Kong Hospital Authority and various professional boards. She has authored and coauthored over 200 papers

Abstract:

The outcome of patients with early breast cancer is improved by adjuvant chemotherapy. However, chemotherapy may be associated with long term side-effects. In this prospective cross-sectional study, the objectives were to determine the incidence of hyperlipidaemias and the associated factors among premenopausal Chinese breast cancer patients after adjuvant chemotherapy. Eligibility criteria include Chinese patients with stage I-III breast cancer who were aged less than 45 at diagnosis. They should have received adjuvant chemotherapy, and should be within 3-10 years after diagnosis. Individual’ characteristics, anti-cancer treatments, body weight and height at the time of diagnosis prior to chemotherapy were collected. At study entry, patients had body weight and fasting blood lipids determined. Incidence of chemotherapy-related amenorrhoea and menopause were determined. Factors associated with hyperlipidaemias were analyzed. 280 patients entered the study. The median time from breast cancer diagnosis was 5.0 years. 91% developed chemotherapy-related amenorrhoea; 49% had become menopausal while 10% were peri-menopausal. At study entry, the mean weight gain was 1.8 kg; 52% were overweight/obese. Abnormal total-cholesterol, LDL-cholesterol, HDL-cholesterol and triglyceride levels occurred in 34.3%, 56.1%, 6.6% and 22.9% respectively. Overweight/obese and age were associated with hypercholesterolaemia. Tamoxifen was associated with reduced risk, while older age, corticosteroid premedication and having increase in BMI categories were associated with increased risk of abnormal LDL-cholesterol. Clinicians need to increase awareness of hyperlipidaemias which occurs frequently after adjuvant chemotherapy for breast cancer.

Acknowledgement: This study was supported by Hong Kong Cancer Fund and Madam Diana Hon Fun Kong Donation for Cancer Research

Biography:

Dr. Martínez-Montemayor completed her PhD in 2004 at Michigan State University and postdoctoral studies from University of Puerto Rico, Rio Piedras, and Universidad Central del Caribe School of Medicine. She is an Associate Professor of the Department of Biochemistry, and leads a cancer and diabetes research laboratory focused on experimental therapeutics and biology of disease. She has published more than 10 papers in reputed journals, has been serving as an editorial board member of repute, and is ad hoc reviewer for scientific journals. She has NIH-NIGMS and US-DOE funding and trains high-school, undergraduate, graduate, medical and postdocs in the lab

Abstract:

Small molecule Tyrosine Kinase Inhibitors (TKIs) are among the current therapeutic strategies used to inhibit the epidermal growth factor receptor (EGFR). The high incidence of resistance to these therapies has greatly diminished their overall effectiveness, thus our objective is to investigate the efficacy of treatments that may be combined with TKI’s to provide a sustained response for breast cancer (BC) patients. Here, we investigate the therapeutic potential of Ganoderma lucidum extract (GLE) in BC, focusing on the regulation of the EGFR signaling cascade when treated with the EGFR-TKI, Erlotinib. SUM-149 inflammatory breast cancer (IBC) cells, intrinsic Erlotinib resistant MDA-MB-231 non-IBC BC cells, and a successfully developed Erlotinib resistant IBC cell line, rSUM-149, were treated with increasing concentrations of Erlotinib, GLE, or their combination (Erlotinib/GLE) for 72h. Treatment effects were tested on cell viability, migration and invasion. To determine tumor progression, SUM-149 severe combined immunodeficient xenografts were treated with Erlotinib/GLE or Erlotinib for 13wks. We assessed the expression of extracellular signal-regulated kinase (ERK)-1/2 and serine/threonine-specific protein kinase (AKT) in vitro and in vivo. Our results show that GLE synergizes with Erlotinib to sensitize SUM-149 cells to drug treatment, and overcomes intrinsic and acquired Erlotinib resistance. Also, the combination of both drugs decreases SUM-149 cell viability, proliferation, migration and invasion. We show that GLE increases Erlotinib sensitivity by inactivating AKT and ERK signaling pathways. We conclude that a combinatorial therapeutic approach might be an effective alternative to increase prognosis in breast cancer patients with EGFR overexpressing tumors