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Hair-loss prevention maintains QoL in early stage breast cancer patients receiving chemotherapy
15th St.Gallen International Breast Cancer Conference / The Breast 32S1 (2017) S22–S77
tumour grade and patient demographics. The association between surgery and tumour grade was assessed with a chi-squared test. Results: 107 eligible cases were identified, aged 22–84 years (mean 60 y). 36% were low to intermediate grade, 64% were high grade. 78% underwent one surgery, 17% a second surgery, and 6% three or more surgeries. While 60% had initial breast conserving surgery (BCS), 50% had final surgery as mastectomy (including 4 bilateral). Widespread disease was a strong factor for mastectomy, however personal choice also influenced some patient decisions. For women with low or intermediate grade DCIS, 74% had BCS (a third of whom had radiotherapy). Mastectomy was performed in 26% (2/5 of whom had immediate reconstruction). For women with high grade DCIS, 39% had BCS, nearly all of whom also had radiotherapy. 61% had mastectomy (including 6% bilateral), and of those, half had an immediate reconstruction. One had radiotherapy post mastectomy. There was a strong association between surgery and tumour grade ( p < 0.0001); women with high grade DCIS were more likely to receive mastectomy, while those with low grade DCIS were more likely to receive BSC. Only 16 (15%) women were offered hormonal therapy, of whom 3 (19%) declined. Conclusions: Women undergoing surgery for DCIS often undergo extensive surgery, specifically mastectomy and occasionally bilateral mastectomy. While the majority of women with low grade tumours chose breast conservation, a significant proportion chose mastectomy and a significant proportion radiotherapy. Few have endocrine therapy. These women are unlikely to have a survival benefit from more extensive treatment and may have may have overestimated their risks of recurrence [2]. References [1] Ernster VL, Ballard-Barbash R, Barlow WE, Zheng Y, Weaver DL, Cutter G, et al. Detection of ductal carcinoma in situ in women undergoing screening mammography. J Natl Cancer Inst. 2002;94 (20):1546–54. [2] van Gestel YRBM, Voogd AC, Vingerhoets AJJM, Mols F, Nieuwenhuijzen GAP, van Driel OJR, et al. A comparison of quality of life, disease impact and risk perception in women with invasive breast cancer and ductal carcinoma in situ. European Journal of Cancer. 2007;43(3):549–56. Disclosure of Interest: No significant relationships. P092 Hair-loss prevention maintains QoL in early stage breast cancer patients receiving chemotherapy D. Erdem1 *, T. Kacan2, M. Gunaldi3. 1Department of Medical Oncology, Bahcesehir University Medical Faculty, Samsun, Turkey, 2Department of Medical Oncology, Afyonkarahisar State Hospital, Afyon, Turkey, 3 Department of Medical Oncology, Neolife Medical Center, Istanbul, Turkey Aims: Breast cancer patients benefit from adjuvant chemotherapy which can also cause some side effects. This study plans to examine the benefit and continuity of the modern scalp cooling system on breast cancer patients who undergo adjuvant chemotherapy. Also it explores the side effects of the device. Methods: Between November 2015 and December 2016, 17 women diagnosed with early stage breast cancer who received adjuvant chemotherapy in our single outpatient oncology clinic and had Paxman scalp cooling system in Samsun, Turkey were examined. Diseases causing alopesia like hematological malignancies, anemia, chronic inflammatory, pituitary and thyroidal diseases, migraines were excluded. Patients received either AC or FAC regimen. All patients underwent scalp cooling 30 minutes before, 20 minutes during and 2 hours after infusion.
S53
Results: The study included 17 women diagnosed with stage I or II breast cancer who received at least four cycles of adjuvant chemotherapy. The follow-up period was between 6 and 25 months with the mean of 12.9 months. The mean age is 54.2 years (range 38–71 years). 35% of patients (n = 6) were premenopausal. Six patients with stage IA and eleven patients with stage IIA disease were recorded. 41% of tumors were ER positive, 41% of tumors were PR positive and only 39% of tumors were cerbB2 3+. Nine patients had 4 AC and eight patients had 6 FAC regimen. During the treatment only 41% (n = 7) of patients had alopesia with only grade I toxicity which does not need wig use. Hair-loss in these seven patients was in the third cycle in 3 patients and second cycle in 4 patients. Only seven patients complain about side effects; 2 patients had headache, 1 had both headache and cold-intolerance, 1 with fullness on forepart of the head, 1 had light headedness and 2 of them had both cold-intolerance and dizziness. Only 42% (n = 3) of 7 patients with hair-loss had continuity of hair loss after finishing chemotherapy. Most of the patients (n = 11) experienced comfortness by using the device. Patients were asked if the device improve their QoL; 76% of patients with very good QoL and only four of the patients experienced good QoL. Conclusion: Some side effects like hair-loss may shade benefit of adjuvant chemotherapy in breast cancer. Preventing hair-loss in these patients may support physical and psychological health. Modern scalp cooling system may improve the quality of life in many patients by avoiding hair-loss. Disclosure of Interest: No significant relationships. P093 Obesity as prognostic factor in breast cancer E. Freitas*, M. Rêgo. Universidade Federal da Bahia, Salvador, Brazil Obesity has a negative impact on cancer prognostic. Obese patients tend to present, at the diagnosis of breast cancer, tumors with biological characteristics of greater aggressiveness compared to nonobese patients, reflecting higher rates of relapse and disease progression, reduction in disease-free survival and overall survival. The objective of this study was to evaluate the role of obesity as a prognostic factor in a group of women with breast cancer treated in a cancer center on the northeastern region of Brazil. This is a retrospective hospital based study that examined cancer registry data between January 2008 and December 2012. The dependent variable was the progression or death by breast cancer in follow-up of five years and the independent variable was obesity. The median progression free survival (PFS) and the overall survival (OS) were calculated using the Kaplan-Meier method and multivariate analysis using the Cox regression model. The total of 274 patients 62% were overweight and 28% were obese; 73% of patients had initial staging I and II at diagnosis. Obese patients presented a higher proportion of larger tumors at diagnosis, between 2.0 and 5.0 cm, and more advanced staging (E III), while the non-obese patients presented a higher proportion of smaller tumors than 1.0 cm and initial staging (E I) ( p = 0.007). Progression free survival rates in two years did not differ between the obese and non-obese: 87% and 85%, respectively, but there was a non-significant difference in five years 75% for non-obese and 79% for the obese ( p = 0,796). Overall survival rates in five years was 77% for obese and 81% for non-obese women ( p = 0.854). Obesity, in a multivariate model, was not an independent prognostic factor for overall survival and progression free survival. Node positive (HR = 4.53; 95% IC 2.15–9.56, p = 0.000), tumor size greater than 2 cm (HR = 3.11, IC 95% 1.47–6.8, p = 0.003) and triple negative subtype (HR = 4.47; 95% IC 2.11–9.49, p = 0.000) were independent factors of worse prognosis for overall survival. Age below 50 years (HR = 1.97; 95% IC 1.08–3.61, p = 0.000), node positive (HR = 4.7: 95% IC 2.39–9.24, p = 0.027), tumor size greater than 2 cm (HR = 2.64; 95% IC 1.39–5.02, p = 0.003) and negative hormone receptor (HR = 2.99; 95% IC 1.62–5.53, p = 0.000) were independent factors of worse prognosis for progression. This study showed obese
tumour grade and patient demographics. The association between surgery and tumour grade was assessed with a chi-squared test. Results: 107 eligible cases were identified, aged 22–84 years (mean 60 y). 36% were low to intermediate grade, 64% were high grade. 78% underwent one surgery, 17% a second surgery, and 6% three or more surgeries. While 60% had initial breast conserving surgery (BCS), 50% had final surgery as mastectomy (including 4 bilateral). Widespread disease was a strong factor for mastectomy, however personal choice also influenced some patient decisions. For women with low or intermediate grade DCIS, 74% had BCS (a third of whom had radiotherapy). Mastectomy was performed in 26% (2/5 of whom had immediate reconstruction). For women with high grade DCIS, 39% had BCS, nearly all of whom also had radiotherapy. 61% had mastectomy (including 6% bilateral), and of those, half had an immediate reconstruction. One had radiotherapy post mastectomy. There was a strong association between surgery and tumour grade ( p < 0.0001); women with high grade DCIS were more likely to receive mastectomy, while those with low grade DCIS were more likely to receive BSC. Only 16 (15%) women were offered hormonal therapy, of whom 3 (19%) declined. Conclusions: Women undergoing surgery for DCIS often undergo extensive surgery, specifically mastectomy and occasionally bilateral mastectomy. While the majority of women with low grade tumours chose breast conservation, a significant proportion chose mastectomy and a significant proportion radiotherapy. Few have endocrine therapy. These women are unlikely to have a survival benefit from more extensive treatment and may have may have overestimated their risks of recurrence [2]. References [1] Ernster VL, Ballard-Barbash R, Barlow WE, Zheng Y, Weaver DL, Cutter G, et al. Detection of ductal carcinoma in situ in women undergoing screening mammography. J Natl Cancer Inst. 2002;94 (20):1546–54. [2] van Gestel YRBM, Voogd AC, Vingerhoets AJJM, Mols F, Nieuwenhuijzen GAP, van Driel OJR, et al. A comparison of quality of life, disease impact and risk perception in women with invasive breast cancer and ductal carcinoma in situ. European Journal of Cancer. 2007;43(3):549–56. Disclosure of Interest: No significant relationships. P092 Hair-loss prevention maintains QoL in early stage breast cancer patients receiving chemotherapy D. Erdem1 *, T. Kacan2, M. Gunaldi3. 1Department of Medical Oncology, Bahcesehir University Medical Faculty, Samsun, Turkey, 2Department of Medical Oncology, Afyonkarahisar State Hospital, Afyon, Turkey, 3 Department of Medical Oncology, Neolife Medical Center, Istanbul, Turkey Aims: Breast cancer patients benefit from adjuvant chemotherapy which can also cause some side effects. This study plans to examine the benefit and continuity of the modern scalp cooling system on breast cancer patients who undergo adjuvant chemotherapy. Also it explores the side effects of the device. Methods: Between November 2015 and December 2016, 17 women diagnosed with early stage breast cancer who received adjuvant chemotherapy in our single outpatient oncology clinic and had Paxman scalp cooling system in Samsun, Turkey were examined. Diseases causing alopesia like hematological malignancies, anemia, chronic inflammatory, pituitary and thyroidal diseases, migraines were excluded. Patients received either AC or FAC regimen. All patients underwent scalp cooling 30 minutes before, 20 minutes during and 2 hours after infusion.
S53
Results: The study included 17 women diagnosed with stage I or II breast cancer who received at least four cycles of adjuvant chemotherapy. The follow-up period was between 6 and 25 months with the mean of 12.9 months. The mean age is 54.2 years (range 38–71 years). 35% of patients (n = 6) were premenopausal. Six patients with stage IA and eleven patients with stage IIA disease were recorded. 41% of tumors were ER positive, 41% of tumors were PR positive and only 39% of tumors were cerbB2 3+. Nine patients had 4 AC and eight patients had 6 FAC regimen. During the treatment only 41% (n = 7) of patients had alopesia with only grade I toxicity which does not need wig use. Hair-loss in these seven patients was in the third cycle in 3 patients and second cycle in 4 patients. Only seven patients complain about side effects; 2 patients had headache, 1 had both headache and cold-intolerance, 1 with fullness on forepart of the head, 1 had light headedness and 2 of them had both cold-intolerance and dizziness. Only 42% (n = 3) of 7 patients with hair-loss had continuity of hair loss after finishing chemotherapy. Most of the patients (n = 11) experienced comfortness by using the device. Patients were asked if the device improve their QoL; 76% of patients with very good QoL and only four of the patients experienced good QoL. Conclusion: Some side effects like hair-loss may shade benefit of adjuvant chemotherapy in breast cancer. Preventing hair-loss in these patients may support physical and psychological health. Modern scalp cooling system may improve the quality of life in many patients by avoiding hair-loss. Disclosure of Interest: No significant relationships. P093 Obesity as prognostic factor in breast cancer E. Freitas*, M. Rêgo. Universidade Federal da Bahia, Salvador, Brazil Obesity has a negative impact on cancer prognostic. Obese patients tend to present, at the diagnosis of breast cancer, tumors with biological characteristics of greater aggressiveness compared to nonobese patients, reflecting higher rates of relapse and disease progression, reduction in disease-free survival and overall survival. The objective of this study was to evaluate the role of obesity as a prognostic factor in a group of women with breast cancer treated in a cancer center on the northeastern region of Brazil. This is a retrospective hospital based study that examined cancer registry data between January 2008 and December 2012. The dependent variable was the progression or death by breast cancer in follow-up of five years and the independent variable was obesity. The median progression free survival (PFS) and the overall survival (OS) were calculated using the Kaplan-Meier method and multivariate analysis using the Cox regression model. The total of 274 patients 62% were overweight and 28% were obese; 73% of patients had initial staging I and II at diagnosis. Obese patients presented a higher proportion of larger tumors at diagnosis, between 2.0 and 5.0 cm, and more advanced staging (E III), while the non-obese patients presented a higher proportion of smaller tumors than 1.0 cm and initial staging (E I) ( p = 0.007). Progression free survival rates in two years did not differ between the obese and non-obese: 87% and 85%, respectively, but there was a non-significant difference in five years 75% for non-obese and 79% for the obese ( p = 0,796). Overall survival rates in five years was 77% for obese and 81% for non-obese women ( p = 0.854). Obesity, in a multivariate model, was not an independent prognostic factor for overall survival and progression free survival. Node positive (HR = 4.53; 95% IC 2.15–9.56, p = 0.000), tumor size greater than 2 cm (HR = 3.11, IC 95% 1.47–6.8, p = 0.003) and triple negative subtype (HR = 4.47; 95% IC 2.11–9.49, p = 0.000) were independent factors of worse prognosis for overall survival. Age below 50 years (HR = 1.97; 95% IC 1.08–3.61, p = 0.000), node positive (HR = 4.7: 95% IC 2.39–9.24, p = 0.027), tumor size greater than 2 cm (HR = 2.64; 95% IC 1.39–5.02, p = 0.003) and negative hormone receptor (HR = 2.99; 95% IC 1.62–5.53, p = 0.000) were independent factors of worse prognosis for progression. This study showed obese