Day 2 :
Keynote Forum
Peter Onneken
Institute of Diet and Health, Germany
Keynote: The Impact of Salvia hispanica l. enhanced nutrition on breast cancer prevention
Time : 10:00-10:45
Biography:
Peter Onneken is working as head of research at the Institute of Diet and Health, Germany. He is a member of the German Society of Orthomolecular Medicine, and the forum of Orthomolecular Medicine.Research Interests:1) nutrition and health benefits especially in the fields of “novel food”. 2) the role of novel food in health care and prevention 3) scientific evidence for so called “body and brain hacking”-nutrition.
Abstract:
The role of nutrition in the management of cancer and its prevention is vital.
There are so many important functional components in the daily diet.
Dietary supplement have been seen as a relevant breast cancer influencer for many years.
Different physiologically functional components are found in our daily nourishment. E.g. fibers, have been seen as an unique feature in the treatment of cancer. On the other hand an antioxidant rich diet has been seen as cancer-preventing in multiple studies.
Until now, there was a research lack on the effect of salvia hispanica L on breast cancer prevention. First studies on young females are promising that the combination of 60% ω-3 alpha-linolenic acid (ALA) and 20% ω-6 linolenic acid, and a high proportion of antioxidants could indeed work as a safeguard on breast cancer.
Keynote Forum
Stefan Glück
Celgene Corporation, USA
Keynote: Immuno-Oncology in Breast cancer: early promise?
Time : 10:50-11:35
Biography:
Professor Stefan Glück, MD, PhD, FRCPC is V.P of Global Medical Affairs, at Celgene Corporation since October 2014, and a medical oncologist with focus on breast cancer. He has overseen breast, ovarian, pancreatic and bladder cancer activities worldwide, as well as the Immuno-Oncology Program in solid tumors. Recently, his job requirements have shifted to include all solid tumors and most importantly Early Assets.
He previously served as a Sylvester Professor in the Department of Medicine at Miller School of Medicine, University of Miami, Florida until September 2014. From 2003–2008, he was the Clinical Director of the Braman Family Breast Cancer Institute, and from January 2009 - December 2010 Assistant Director of the Sylvester Comprehensive Cancer Center and Associate Chief, Division Hematology & Medical Oncology. He has been a PI of 37 clinical studies of breast cancer in Miami, as well as investigator in numerous scientific, translational projects. He has authored or co-authored over 270 articles. In addition, Dr Glück has written or co-written several book chapters and numerous journal abstracts, and has presented more than 380 papers at national and international meetings.
Abstract:
According to data published in 2013 (Nature), breast cancer (BrCa) is not a disease that harbors high mutational load; nevertheless, it seems that triple negative TN BrCa which by itself is a heterogenous group, may show much higher rates of mutations than hormone receptor (HR) positive BrCa. These mutations in turn might lead to a higher level of neoantigens which are antigenic and can induce an immune response in the host. This concept, has led investigators to design several clinical trials using immune checkpoint inhibitors (ICI) in early (ECB) and metastatic (MBC) BrCa. Unlike in other cancers, there are no ICI approved in this space yet. Several trials in EBC and MBC using ICI in combination will be reported this year which will hopefully result in advancing therapy and improving patients’ outcomes.
Keynote Forum
Matsumoto Yoko
Japan Nanomedicine Society , Japan
Keynote: Therapeutic effects of trehalose liposomes against breast tumors along with Apoptosis
Biography:
Yoko Matsumoto is a Professor of Department of Life Sciences at Sojo University, Japan. She received her PhD in Pharmacy from Kyushu University, Japan. She was a Visiting Researcher in Colorado University at Boulder with Prof. Tom Cech. She has received Outstanding Female Researcher Award from the Society of Chemical Engineering, Japan. She is one of Director for Japan Nanomedicine Society and Councilor for Japanese Association for Molecular Target Therapy of Cancer. Her current research interest focuses on trehalose liposomes for therapeutic applications. She has published more than 120 original papers.
Abstract:
Trehalose stabilizes membranes and proteins in cells most likely by hydrogen bonding. Trehalose liposomes (DMTre) composed of L-α-dimyristoylphosphatidylcholine
(DMPC) and trehalose micelles have been produced. Hydrodynamic diameter (dhy) of DMTre composed of 30 mol% DMPC and 70 mol% TreC14 was 100 nm with single and narrow range of size distribution, which was preserved for a period remaining stable for more than one month. The thickness of the fixed aqueous layer (TFAL) of DMTreCn was evaluated from the zeta potential and increase in TFAL values of DMTreCn was obtained in a dose-dependent manner. The TFAL values for DMTreCn were larger than that of DMPC liposomes. The remarkable inhibitory effects of DMTre on the growth of human colon, gastric, hepatocellular, lymphoblastic and lung carcinoma cells have been reported. In this study, the inhibitory effects of DMTre on the growth of breast tumor (MCF-7 and MDA-MB-453) cells were examined in vitro and in vivo. DMTre inhibited the growth of breast tumor cells leading to apoptosis. The activation of caspase-6 and 9 was obtained for breast tumor cells treated with DMTre. The suppression of tumor weight of xenograft mice model of carcinoma treated with DMTre was obtained. To investigate induction of apoptosis against tumor, the tissue section of tumor in xenograft mice model of carcinoma after the treatment with DMTre was dyed and observed using microscope. Many apoptotic brown color cells in the tissue section of tumor was observed, indicating that DMTre could induce apoptosis in tumor cells against mice model of carcinoma.
- Surgery Choices for Breast Cancer | Screening, Detecting and Diagnosing | Breast Cancer Breast Cancer Therpy , Prevention and Medicine
Location: Odenwald
Session Introduction
Wen Zhao
Xi’an Jiaotong University, China
Title: A predictive model to identify who would benefit from primary tumor surgery among patients with metastatic breast cancer at diagnosis: a population-based analysis
Biography:
My name is Wen Zhao. I am pursuing my Master’s degree in Clinical Medicine (oncolgy) at Xi’an Jiaotong University. I am under the guidance of Dr Jin Yang. Dr Jin Yang and our group concentrate on the effect of angiomotin protein family on tumorigenesis and new therapy directions of triple negative breast cancer. I major in the latter direction. Triple negative breast cancer, characterized by negative condition of ER, PR and Her-2, is lack of effective targets and I am very interested in it and have done some researches on it. After reading plenty of articles, I found PIM1 might be an effective target playing a significant role in triple negative breast cancer. Thus, I concluded the existing outcomes. My colleagues and I will have an investigation on PIM1 in the coming days.
Abstract:
Abstract: Purpose: the prognostic role of primary tumor surgery among female patients with metastatic breast cancer is controversial. We ought to investigate whether primary tumor surgery can improve the overall survival and identify a subset of patients that will benefit from primary tumor surgery.
Methods: we conducted a retrospective, population-based cohort study by analyzing the 2010-2014 Surveillance, Epidemiology, and End Results (SEER) program data. Using Kaplan-Meier curves, we investigated whether the primary tumor surgery could improve the overall survival. Analyzing the clinicopathological feathers by using Cox proportional hazards regression, we developed and validated a prediction model that predicts survival benefit in patients who undergone primary tumor surgery and identified patients that would benefit from primary tumor surgery in the non-surgery cohort.
Results: of 7217 SEER patients enrolled in our study, 3065 (32.5%) underwent breast and 4152(57.5%) did not. Patients who had surgery achieved both overall survival benefit (p<0.001) and breast cancer-specific survival (p<0.001). Age at diagnosis, race, differentiation grade, T stage, N stage, molecular subtype, metastatic sites, chemotherapy and radiation were associated with overall survival of patients among the surgery cohort. A prediction model was developed based on these factors and had been validated in an independent dataset. The model identified a subset of patients with remarkable survival and a subset of patients who would benefit from the primary tumor surgery.
Conclusions: we have developed a predictive model to identify patients that will achieve long-term survival benefit from primary tumor surgery. This model will provide guidance to physicians considering whether to conduct a primary tumor surgery for female patients with metastatic breast cancer.
Wen Zhao
Xi’an Jiaotong University, China
Title: A predictive model to identify who would benefit from primary tumor surgery among patients with metastatic breast cancer at diagnosis: a population-based analysis
Biography:
I am pursuing my Master’s degree in Clinical Medicine (oncolgy) at Xi’an Jiaotong University. I am under the guidance of Dr Jin Yang. Dr Jin Yang and our group concentrate on the effect of angiomotin protein family on tumorigenesis and new therapy directions of triple negative breast cancer. I major in the latter direction. Triple negative breast cancer, characterized by negative condition of ER, PR and Her-2, is lack of effective targets and I am very interested in it and have done some researches on it. After reading plenty of articles, I found PIM1 might be an effective target playing a significant role in triple negative breast cancer. Thus, I concluded the existing outcomes. My colleagues and I will have an investigation on PIM1 in the coming days.
Abstract:
Abstract: Purpose: the prognostic role of primary tumor surgery among female patients with metastatic breast cancer is controversial. We ought to investigate whether primary tumor surgery can improve the overall survival and identify a subset of patients that will benefit from primary tumor surgery.
Methods: we conducted a retrospective, population-based cohort study by analyzing the 2010-2014 Surveillance, Epidemiology, and End Results (SEER) program data. Using Kaplan-Meier curves, we investigated whether the primary tumor surgery could improve the overall survival. Analyzing the clinicopathological feathers by using Cox proportional hazards regression, we developed and validated a prediction model that predicts survival benefit in patients who undergone primary tumor surgery and identified patients that would benefit from primary tumor surgery in the non-surgery cohort.
Results: of 7217 SEER patients enrolled in our study, 3065 (32.5%) underwent breast and 4152(57.5%) did not. Patients who had surgery achieved both overall survival benefit (p<0.001) and breast cancer-specific survival (p<0.001). Age at diagnosis, race, differentiation grade, T stage, N stage, molecular subtype, metastatic sites, chemotherapy and radiation were associated with overall survival of patients among the surgery cohort. A prediction model was developed based on these factors and had been validated in an independent dataset. The model identified a subset of patients with remarkable survival and a subset of patients who would benefit from the primary tumor surgery.
Conclusions: we have developed a predictive model to identify patients that will achieve long-term survival benefit from primary tumor surgery. This model will provide guidance to physicians considering whether to conduct a primary tumor surgery for female patients with metastatic breast cancer.
Peter Sandbichler
Department of surgery, Hospital St.Vinzenz, Austria
Title: Immediate breast reconstruction with laparoscopic harvested omental flap after breast cancer surgery
Biography:
Peter Sandbichler, born 2.8.1957 in Innsbruck, Austria. Medical studies and doctorate at the Medical University of Innsbruck 1975 – 1981. Surgical residency at the University Hospital Innsbruck, Department for Visceral and Transplant surgery from 1982 – 1990. Managing senior physician for surgery at the Hospital Hall near Innsbruck 1990-2000
Professor of surgery 1997. Head of the surgical department in the Hospital St.Vinzenz, Zams since January 2000. Focus on Oncologic and laparoscopic surgery
Abstract:
Introduction: We present here a rarely used technique for breast reconstruction after complete or subtotal subcutaneous mastectomy for breast cancer utilizing a laparoscopically harvested omental flap.
Indication: The procedure was performed in selected patients with multicentric carcinomas, large, central tumors (also post treatment with neoadjuvant chemotherapy), tumors with extensive intraductal component, diffuse ductal carcinoma in situ (DCIS), and in patients desiring the procedure. To date, 58 procedures (37 complete and 21 partial mastectomies) have been performed.
Surgical Procedure: After the sentinel node biopsy, laparoscopy was performed in order to estimate the size of the omentum. The omentum was dissected, preserving the right gastroepiploic vessels as the pedicle of the omental flap. After performing the subcutaneous mastectomy through an inframammary incision, a subcutaneous tunnel was created, and the omentum pulled out through a 2 to 3 cm paraxiphoidal incision, and placed within the breast defect.
Results: The cosmetic result was excellent to satisfactory in the majority of cases. There was one loss of the omental flap due to fat necrosis, and one gastric perforation was managed laparoscopically. In five patients an additional augmentation with lipofilling became necessary. Small skin necroses could be conservatively treated. Postoperative irradiation in patients with positive lymph nodes and subtotal mastectomy was performed without complications. There was no local recurrence to date.
Summary: In selected patients, this technique produces good results creating a breast with a natural, soft consistency, and with minimal donor site morbidity. It provides an esthetically appealing supplement to the established methods. Difficulties include preoperative estimation of the size of the omentum, however initially inadequate volume frequently increases within the first 6 months. The technique can only be applied for unilateral reconstruction.
Imrana Masroor
Aga Khan University Hospital Karachi, Pakistan
Title: Preoperative ultrasound guided biopsy of axillary nodes for staging in patients with clinically negative axilla – in a tertiary care center in a third world country
Biography:
Dr. Imrana Masroor is currently working as an associate professor and section head Women imaging at Radiology Department Aga Khan University Hospital Karachi, Pakistan. Dr. Masroor has two fellowships in diagnostic imaging one from college of physician and surgeons Pakistan and second from Royal College of Radiologist UK. She also holds the European Diploma in breast imaging. She is also the program director for the fellowship program in Women Imaging at the department. She has a number of national and international publications to her credit in field of expertize.
Abstract:
Objective: The aim of the current study is to determine the feasibility and accuracy of ultrasound guided core biopsy for staging the axilla in clinically node negative patients with invasive breast cancer.
Introduction: Historically, axillary lymph node staging was performed by means of axillary lymph node dissection. Because of the high morbidity of this procedure, sentinel lymph node biopsy (SLNB) has become the standard of care in patients with clinically node-negative breast cancer. However; SLNB also has some morbidity and anesthetic risk. Not only is it expansive and time consuming, SLNB can be complicated by formation of a seroma, sensory nerve injury, lymphedema and limitation of the range of shoulder motion. Furthermore, in order to avoid a second procedure many centers rely on the availability of frozen section for the analysis of the node. In our part of the world not all the centers have the facility of frozen section available. Moreover, the analysis of published data shows that the accuracy of frozen section with a combination of H&E staining and immunohistochemistry on sentinel lymph nodes laid between 73 to 96%. Pre-operative identification of axillary node positivity in patients with clinically negative nodes would allow one-stage axillary clearance, avoiding the sentinel node biopsy (SLNB) step. As clinical examination is unreliable in determining node positivity, pre-operative diagnosis presently depends on imaging of the axilla using imaging modalities. Pre-operative staging of suspicious lymph nodes detected by US guided core biopsy can decrease the need for SLNB by 21% to 70%. The aim is to determine the accuracy and feasibility of ultrasound guided core biopsy to stage the axilla in clinically node negative patients, comparing with final histopathology as gold standard.
Material & Methods: It was a non-randomized, prospective interventional study, done at radiology department of Aga Khan Hospital, all the patients who were diagnosed with breast cancer (histologically proven) and had clinically negative axilla and had ipsilateral positive axillary ultrasound, underwent axillary lymph node biopsy. If the result was negative they were subjected to SLNB, histopathology result were used as gold standard. Results: The sensitivity of ultrasound guided biopsy was 88%, specificity 100%,PPV 100%, NPV 89.28% and diagnostic accuracy 94%.
Conclusion: Axillary lymph node biopsy under ultrasound guidance is standard of care in clinically negative axilla avoiding unnecessary axillary dissection.