Day 2 :
Keynote Forum
Michael Thompson
Institute for Biomedical Engineering at the University of Toronto, Canada
Keynote: Towards early stage detection of ovarian cancer via lysophosphatidic acid as a biomarker
Biography:
Michael Thompson has obtained his PhD from McMaster Ujniversity in Hamilton, Ontario. He is Professor of Bioanalytical Chemistry in both the Department of Chemistry and Institute for Biomedical Engineering at the University of Toronto. He has published close to 300 papers in international journals and has received many prestiguous awards for his research. He served on the Editorial Boards of majour journals and is currently Editor in Chief of the Royal Society of Chemistry book series on Detection Science. He was made a Fellow of the Royal Society of Canada in 1999.
Abstract:
The existing CA-125 assay for ovarian cancer has been used for many years but is widely regarded to be inadequate ,especially for detection of early development of the disease (stages I and II). Accordingly, there is an urgent requirement for a srreening assay that can detect the presence of ovarian or fallopian tube tumours at the early stage of the dieease via biomarker technology. Our technology involves the biomarker, lysophosphatic acid (LPA), which has clearly been shown to be present in the early stages of disease. Currently, there is no simple screening assay for this molecule in serum or blood. We are in the process of developing both a simple screening assay, and a biosensor technique specially desigend for the clinical biochemistry lab for LPA. The design of our assay is based upon the highly selective disruption of the binding of gelsolin to the protein actin by LPA, which is signalled via a rhodamine dye. We have studied the concentration-dependant break up of the gelsolin-actin-rhodamine complex at LPA concentrations of biological significance (1-50 micromolar). This chemistry has been shown to effective in serum. In order to produce a future assay, it is necessary to transfer the chemistry to a suitable material surface. This has been succesfully achieved by Ni- NTA linkers via their attachment to His tags on gelsolin (to plastic, silica and metal). For these surfaces we have developed nanoparticle technology (SiO2) that increases the surface area available for protein probe binding. To date we have demonstrated that LPA concentrations at sub- 20 micromolar concentration can be measured directly in human serum.
Keynote Forum
Winnie Yeo
Prince of Wales Hospital- Chinese University of Hong Kong, Hong Kong
Keynote: Incidence of hyperlipidaemias among premenopausal Chinese breast cancer patients after adjuvant cytotoxic chemotherapy
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
- Breast Cancer Therapy, Clinical trails
Session Introduction
Saranya Chumsri
Mayo Clinic, Jacksonville, USA
Title: Update on Triple Negative Breast Cancer
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
Jun Yang
St Jude Children’s Research Hospital, Memphis, USA
Title: Hypoxia, epigenetics and estrogen receptor in breast cancer
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.
Maude Hébert
University of Quebec in Trois-Rivieres, Quebec, Canada
Title: Not feeling sick from breast cancer: a framework on health status perceptions transition process
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
Gia Nemsadze
The Institute of Clinical Oncology, Georgia
Title: The influence of nonstandard type operations during metastatic breast cancer
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.
Diana Nemsazde
The Institute of Clinical Oncology, Georgia
Title: The influence of nonstandard type operations during metastatic breast cancer
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.
Chang Gong
Sun Yat-Sen University, Guangzhou, China
Title: A combination of Nottingham prognostic index and IHC4 score predicts pathological complete response of neoadjuvant chemotherapy in estrogen receptor positive breast cancer
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.
Vessela N. Kristensen
University of Oslo Norway
Title: Integrated Molecular Profiling of Breast Cancer
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.
Vasco Fonseca
Portuguese Institute of Oncology - Lisbon, Portugal
Title: Preservation of Fertility in Breast Cancer Patients in Five Hospitals in Portugal
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.
Pooja Saini
The University of Liverpool, UK
Title: A systematic review of barriers and enablers to South Asian women’s attendance for asymptomatic screening of breast and cervical cancers
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.
Marco Bernini
Careggi University Hospital, Florence ITALY
Title: Current surgical, oncological and reconstructive outcomes of nipple sparing mastectomy: results from a national multicentric registry with 1006 cases over a six-year period
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.
Naheel Herbawi Abu-Khalaf
Bradford University, Institute of Cancer Therapeutics , UK
Title: The impact of consanguinity on breast cancer among palestinian women
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.
Ameneh safarzadeh
Zahedan University of Medical Sciences, Iran
Title: The effect of Fordyce cognitive-behavioral happiness training on general health of primiparous women
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.
Sergio Aguggini
Breast Cancer Unit-Women’s Centre- ASST of Cremona,Italy
Title: Hypoxia-related biological markers as predictors of epirubicin-based treatment responsiveness and resistance in locally advanced breast cancer
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.
Gaiane M. Rauch
University of Texas MD Anderson Cancer Center, USA
Title: MR imaging of gynecological malignancies
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.
Winnie Yeo
Chinese University of Hong Kong, Hong Kong
Title: Incidence of hyperlipidaemias among premenopausal Chinese breast cancer patients after adjuvant cytotoxic chemotherapy
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
Michelle M. MartÃnez-Montemayor
Universidad Central del Caribe – School of Medicine, USA
Title: Ganoderma lucidum extract and Erlotinib synergistically reduce inflammatory breast cancer progression
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