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Scalp cooling with Cool Cap can palliate or avoid alopecia of adverse event by chemotherapy for breast cancer
abstracts
Annals of Oncology MO2 3 2
Scalp cooling with Cool Cap can palliate or avoid alopecia of adverse event by chemotherapy for breast cancer
Koji Yamashita Department of Breast Surgery, International University of Health and Welfare
MO2 3 3
Analysis of epidemiological characteristics and treatment for male breast cancer patients in Japan
Taisuke Ishii1, Eriko Nakano2, Tomone Watanabe1, Takahiro Higashi1 Division of Health Services Research, National Cancer Center, 2Medical Oncology Department, St. lukes international hospital
1
Background: Male breast cancer (MBC) is a rare disease and its incident rate is increasing. However, there are no large studies which compare the characteristics and real world treatment of MBC to female breast cancer (FBC) in Japan. The aim of this study is to describe the characteristics and medical treatment details of MBC. Methods: We used a database that linked the National Database of the Hospital-Based Cancer Registry (HBCR) and health insurance claims data from the Diagnosis Procedure Combination (DPC) survey. We collected claims data from October 2011 to December 2016 to allow inclusion of all treatments performed for breast cancers newly diagnosed from 2012 to 2015. We compared the characteristics of the MBC to that of FBC. The secondary outcome was detecting factors associated with treatment differences between MBC and FBC. In secondary analysis, we divided all patients into stage 0III and stage IV. Results: Of 143,190 breast cancer patients (age 60614), 877 patients (0.61%) were MBC. MBC patients were about 10 years older and were diagnosed at higher stage than FBC patients (p < 0.001). MBC patients were more likely to receive hormone therapy and less likely to receive anti HER2 therapy. Stage0-III MBC patients were more likely to be treated with mastectomy (MBC 84.1% vs FBC 46.6%, p < 0.001). Moreover, stage 0-III MBC patients were less likely to receive adjuvant radiation therapy and adjuvant chemotherapy. Even after adjusting for age, pathological stage and surgical procedure, MBC patients were less likely to receive adjuvant radiation therapy and chemotherapy (OR 0.61, 95%CI 0.49-0.77 and OR 0.56, 95%CI 0.46-0.67 respectively). Conclusion: This study is the first to report MBC characteristics in Japan. MBC patients appears to be treated differently than the FBC patients. Future studies should address the factors that cause these differences.
MO2 3 5
Awareness Towards Breast and Cervical Cancer Risk factors and its prevention among students and patients in Bangladesh
Md Shariful Islam1, Farzana Sultana2, A.k.m. Nazrul Islam3, Nur-E- Alam1, Hedayet Ullah1, tarek Molla1, Mst. Mahmuda Khatun4, A.k.m. Mohiuddin1 1 Biotechnology and Genetic Engineering Department, Mawlana Bhashani Science and Technology University, Tangail-1902, Bangladesh, 2Jahurul Islam Medical College, University of Dhaka, Bhagalpur, Bajitpur, Kishoregonj 2336, Bangladesh, 3Department of Mechanical Systems Engineering, Tokyo University of Agriculture and Technology, 224-16, Naka-cho Koganei-city, Tokyo 184-8588, Japan, 4Biochemistry and Molecular Biology Department, Mawlana Bhashani Science and Technology University, Tangail1902, Bangladesh Background: The literature on breast and cervical cancer treatment in Bangladesh is nonexistent. There are significant challenges to the development of infrastructure for
Volume 30 | Supplement 6 | October 2019
MO2 3 6
Knowledge and Awareness of Early Detection Methods and Risk Factors towards Breast and Cervical Cancer in Bangladesh
Md Shariful Islam1, Yeasmin Akter2, A.k.m. Mohiuddin1, Fatematuz Zuhura Evamoni2, Mehedi Hasan2, Nabila Binte Jafar2, Rayhanul Islam2, Neamat Ullah2, Mithu Howlader2, Arpita Singha Roy2 1 Biotechnology and Genetic Engineering Department, Mawlana Bhashani Science and Technology University, Tangail-1902, Bangladesh, 2Department of Biotechnology and Genetic Engineering, Noakhali Science and Technology University (NSTU) Sonapur, Noakhali-3814, Bangladesh Background: In developing countries global incidence of breast and cervical cancer is rising and the increase is occurring at a faster rate. Cancer is the sixth leading cause of death in Bangladesh. Objective: To investigate the awareness of early detection method, symptoms and risk factors towards breast and cervical cancer screening amongst young adult female students in Bangladesh. Methods: A total of 1004 adult female students at the age of (18 - 26) years were randomly included in the study using a multistage cluster sampling technique. A questionnaire included socio-demographic characteristics and information related to their knowledge about breast and cervical cancer. Results: The results showed that about 61.3% participants were Undergraduate. Among them only 37.5% respondents aware about breast cancer risk; 25.7% aware about the detection method of breast cancer and only 21.1% have knowledge about cervical cancer risk factors. About 87.4% respondents have not any family history of cancer; 3.5% participants have sister or mother having breast tumor and 22.1% have at least more than one close relative who have cancer. Among the participants, only 2.5% drank alcohol; 24.7% girls wear tight bra; 4.1% have benign breast diseases. Participants with better knowledge score were 8.1% times more likely to practice BSE; only 6.3% were examined by clinically breast examination. Conclusion: It can be concluded that, knowledge of participants regarding breast and cervical cancer is very poor. Broad based study in large population with sound methodology is required to find out real situation about this matter in Bangladesh.
MO2 4 1
Sequential Anthracycline-Taxane Chemotherapy in Nodepositive Breast Cancer Amongst Asian Patients - Real-world Outcomes
Nisha Shariff, Wan Zamaniah Binti Wan Ishak Clinical Oncology Unit, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia Background: The use of taxanes in the adjuvant setting has been contradictory in randomized trials. Two meta-analyses supported the use of adjuvant taxanes which have since been incorporated into standard guidelines. However, their benefit needs to be validated in the real-world population. Methods: We retrospectively analyzed the outcomes of patients with node positive breast cancer treated with sequential 5-fluorouracil, epirubicin and cyclophosphamide (FEC) and docetaxel (FEC-D) compared to FEC alone in a university hospital in Kuala Lumpur, Malaysia. The primary outcome was overall survival (OS) and the secondary outcomes were disease free survival (DFS) and toxicity. Results: Between 2007 and 2011, 318 patients with node-positive breast cancer were recruited with 131 received FEC and 187 received FEC-D. Mean duration of follow up was 59.7 months for both groups. The 5-year OS was significantly higher with FEC-D (78.8% vs 64.2%; p value ¼ 0.014). Greater benefit was seen in postmenopausal patients, patients with 1-3 positive nodes and T2- 4 tumours. The 5-year DFS was no different between the two groups with 55.4% in the FEC arm vs. 69.4% in the FEC-D arm (p value ¼0.063). However the median DFS was not reached for FEC-D. The use of FEC-D with the hazard ratio 0.6 (95% CI 0.4 - 0.9; p value ¼ 0.014), tumours 2cm or less, 1-3 positive nodes and hormone receptor positivity were prognostic for survival.
doi:10.1093/annonc/mdz338 | vi101
Downloaded from https://academic.oup.com/annonc/article-abstract/30/Supplement_6/mdz338.046/5583045 by guest on 25 October 2019
Background: Alopecia induced by standard chemotherapy gives deep grief to breast cancer patients. Even if the hair will grow again after chemotherapy, it needs more than one year to recover the natural hair status without using wig. We applied the scalp cooling system of Cool Cap for breast cancer patients during chemotherapy. It can avoid alopecia perfectly or decrease hair loss in our patients. One patient’s hair is growing during chemotheraphy after chemotherapy-induced alopecia (CIA) by the first regimen of weekly paclitaxel without Cool Cap. Methods: Since December 2017, we have applied the scalp cooling system, PAXMAN Cool Cap, on ten breast cancer patients. The cooling cap is choiced its size and farmly compressed to the whole patient scalp. The whole scalp is evenly cooled to 20 centigrade. Pre-cooling time is 30 minutes. Scalp cooling is continued during the chemotherapy. And post-cooling time is 90 minutes. The chemotherapy regimens are standard as docetaxel, nab-paclitaxel, TC, and EC. All these regimens are supposed to give alopecia to almost all patients, without Cool Cap. Its effect is evaluated by the toxicity scale of WHO and the original scale of hair volume and patchy loss area. Results: The regimens are applied docetaxel to ten patients, nab-paclitaxel to one patient, TC to two patient, and EC to 7 patients for early and metastatic breast cancer patients. The evaluation of alopecia was grade 0 on fourteen patients, grade 1 on four patients, and grade 2 on two patient. Two patients needed hair wig for hair loss. One patient with CIA has her hair growing during the second part of chemotherapy with Cool Cap. Headache was prevented by NSAID. All patients were satisfied with this application of Cool Cap. Conclusions: The Cool Cap system is suprisingly effective to prevent CIA. It should be standard therapy for all breast cancer patients on chemotherapy.
cancer care in Bangladesh. Methodology: This cross-sectional study was conducted at Jahurul Islam Medical College and Hospital, Bangladesh. Among 685 participants of the survey, 379 respondents were medical students at the age of 18 to 26 years and rest of the participants (306 patients of the hospital) were randomly included in the study using a multistage cluster sampling technique. The IBM SPSS statistics (V21.0) software was used to analyze survey data. Results: The results of the survey indicates that the majority of medical students are familiar with the early detection methods of breast cancer. However, the students were not aware of the risk factors of cervical cancer including HIV infection (27.2%) and the long-term use of contraceptive pill (22.7%). The students also are not going through the regular smear or Pap test (28.0%) or not aware of infection from HPV (16.6%). Only a few students are aware of the risk of breast cancer including Hormone replacement therapy (3.2%) and Benign breast disease (5.5%). On the other hand, the randomly selected patients of the hospital (100%) have no idea about the risk factors of breast and cervical cancer. As a result, they have no knowledge about the early detection methods of breast cancer. Conclusion: The summary of this study indicates that the medical students and patients of the hospital are not sufficiently aware of the sign symptoms, risk factors, and preventive measures for breast and cervical cancer. Therefore, necessary steps are very crucial to grow awareness among the general people of Bangladesh from the respective authority to be careful about breast cancer and cervical cancer.
Annals of Oncology MO2 3 2
Scalp cooling with Cool Cap can palliate or avoid alopecia of adverse event by chemotherapy for breast cancer
Koji Yamashita Department of Breast Surgery, International University of Health and Welfare
MO2 3 3
Analysis of epidemiological characteristics and treatment for male breast cancer patients in Japan
Taisuke Ishii1, Eriko Nakano2, Tomone Watanabe1, Takahiro Higashi1 Division of Health Services Research, National Cancer Center, 2Medical Oncology Department, St. lukes international hospital
1
Background: Male breast cancer (MBC) is a rare disease and its incident rate is increasing. However, there are no large studies which compare the characteristics and real world treatment of MBC to female breast cancer (FBC) in Japan. The aim of this study is to describe the characteristics and medical treatment details of MBC. Methods: We used a database that linked the National Database of the Hospital-Based Cancer Registry (HBCR) and health insurance claims data from the Diagnosis Procedure Combination (DPC) survey. We collected claims data from October 2011 to December 2016 to allow inclusion of all treatments performed for breast cancers newly diagnosed from 2012 to 2015. We compared the characteristics of the MBC to that of FBC. The secondary outcome was detecting factors associated with treatment differences between MBC and FBC. In secondary analysis, we divided all patients into stage 0III and stage IV. Results: Of 143,190 breast cancer patients (age 60614), 877 patients (0.61%) were MBC. MBC patients were about 10 years older and were diagnosed at higher stage than FBC patients (p < 0.001). MBC patients were more likely to receive hormone therapy and less likely to receive anti HER2 therapy. Stage0-III MBC patients were more likely to be treated with mastectomy (MBC 84.1% vs FBC 46.6%, p < 0.001). Moreover, stage 0-III MBC patients were less likely to receive adjuvant radiation therapy and adjuvant chemotherapy. Even after adjusting for age, pathological stage and surgical procedure, MBC patients were less likely to receive adjuvant radiation therapy and chemotherapy (OR 0.61, 95%CI 0.49-0.77 and OR 0.56, 95%CI 0.46-0.67 respectively). Conclusion: This study is the first to report MBC characteristics in Japan. MBC patients appears to be treated differently than the FBC patients. Future studies should address the factors that cause these differences.
MO2 3 5
Awareness Towards Breast and Cervical Cancer Risk factors and its prevention among students and patients in Bangladesh
Md Shariful Islam1, Farzana Sultana2, A.k.m. Nazrul Islam3, Nur-E- Alam1, Hedayet Ullah1, tarek Molla1, Mst. Mahmuda Khatun4, A.k.m. Mohiuddin1 1 Biotechnology and Genetic Engineering Department, Mawlana Bhashani Science and Technology University, Tangail-1902, Bangladesh, 2Jahurul Islam Medical College, University of Dhaka, Bhagalpur, Bajitpur, Kishoregonj 2336, Bangladesh, 3Department of Mechanical Systems Engineering, Tokyo University of Agriculture and Technology, 224-16, Naka-cho Koganei-city, Tokyo 184-8588, Japan, 4Biochemistry and Molecular Biology Department, Mawlana Bhashani Science and Technology University, Tangail1902, Bangladesh Background: The literature on breast and cervical cancer treatment in Bangladesh is nonexistent. There are significant challenges to the development of infrastructure for
Volume 30 | Supplement 6 | October 2019
MO2 3 6
Knowledge and Awareness of Early Detection Methods and Risk Factors towards Breast and Cervical Cancer in Bangladesh
Md Shariful Islam1, Yeasmin Akter2, A.k.m. Mohiuddin1, Fatematuz Zuhura Evamoni2, Mehedi Hasan2, Nabila Binte Jafar2, Rayhanul Islam2, Neamat Ullah2, Mithu Howlader2, Arpita Singha Roy2 1 Biotechnology and Genetic Engineering Department, Mawlana Bhashani Science and Technology University, Tangail-1902, Bangladesh, 2Department of Biotechnology and Genetic Engineering, Noakhali Science and Technology University (NSTU) Sonapur, Noakhali-3814, Bangladesh Background: In developing countries global incidence of breast and cervical cancer is rising and the increase is occurring at a faster rate. Cancer is the sixth leading cause of death in Bangladesh. Objective: To investigate the awareness of early detection method, symptoms and risk factors towards breast and cervical cancer screening amongst young adult female students in Bangladesh. Methods: A total of 1004 adult female students at the age of (18 - 26) years were randomly included in the study using a multistage cluster sampling technique. A questionnaire included socio-demographic characteristics and information related to their knowledge about breast and cervical cancer. Results: The results showed that about 61.3% participants were Undergraduate. Among them only 37.5% respondents aware about breast cancer risk; 25.7% aware about the detection method of breast cancer and only 21.1% have knowledge about cervical cancer risk factors. About 87.4% respondents have not any family history of cancer; 3.5% participants have sister or mother having breast tumor and 22.1% have at least more than one close relative who have cancer. Among the participants, only 2.5% drank alcohol; 24.7% girls wear tight bra; 4.1% have benign breast diseases. Participants with better knowledge score were 8.1% times more likely to practice BSE; only 6.3% were examined by clinically breast examination. Conclusion: It can be concluded that, knowledge of participants regarding breast and cervical cancer is very poor. Broad based study in large population with sound methodology is required to find out real situation about this matter in Bangladesh.
MO2 4 1
Sequential Anthracycline-Taxane Chemotherapy in Nodepositive Breast Cancer Amongst Asian Patients - Real-world Outcomes
Nisha Shariff, Wan Zamaniah Binti Wan Ishak Clinical Oncology Unit, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia Background: The use of taxanes in the adjuvant setting has been contradictory in randomized trials. Two meta-analyses supported the use of adjuvant taxanes which have since been incorporated into standard guidelines. However, their benefit needs to be validated in the real-world population. Methods: We retrospectively analyzed the outcomes of patients with node positive breast cancer treated with sequential 5-fluorouracil, epirubicin and cyclophosphamide (FEC) and docetaxel (FEC-D) compared to FEC alone in a university hospital in Kuala Lumpur, Malaysia. The primary outcome was overall survival (OS) and the secondary outcomes were disease free survival (DFS) and toxicity. Results: Between 2007 and 2011, 318 patients with node-positive breast cancer were recruited with 131 received FEC and 187 received FEC-D. Mean duration of follow up was 59.7 months for both groups. The 5-year OS was significantly higher with FEC-D (78.8% vs 64.2%; p value ¼ 0.014). Greater benefit was seen in postmenopausal patients, patients with 1-3 positive nodes and T2- 4 tumours. The 5-year DFS was no different between the two groups with 55.4% in the FEC arm vs. 69.4% in the FEC-D arm (p value ¼0.063). However the median DFS was not reached for FEC-D. The use of FEC-D with the hazard ratio 0.6 (95% CI 0.4 - 0.9; p value ¼ 0.014), tumours 2cm or less, 1-3 positive nodes and hormone receptor positivity were prognostic for survival.
doi:10.1093/annonc/mdz338 | vi101
Downloaded from https://academic.oup.com/annonc/article-abstract/30/Supplement_6/mdz338.046/5583045 by guest on 25 October 2019
Background: Alopecia induced by standard chemotherapy gives deep grief to breast cancer patients. Even if the hair will grow again after chemotherapy, it needs more than one year to recover the natural hair status without using wig. We applied the scalp cooling system of Cool Cap for breast cancer patients during chemotherapy. It can avoid alopecia perfectly or decrease hair loss in our patients. One patient’s hair is growing during chemotheraphy after chemotherapy-induced alopecia (CIA) by the first regimen of weekly paclitaxel without Cool Cap. Methods: Since December 2017, we have applied the scalp cooling system, PAXMAN Cool Cap, on ten breast cancer patients. The cooling cap is choiced its size and farmly compressed to the whole patient scalp. The whole scalp is evenly cooled to 20 centigrade. Pre-cooling time is 30 minutes. Scalp cooling is continued during the chemotherapy. And post-cooling time is 90 minutes. The chemotherapy regimens are standard as docetaxel, nab-paclitaxel, TC, and EC. All these regimens are supposed to give alopecia to almost all patients, without Cool Cap. Its effect is evaluated by the toxicity scale of WHO and the original scale of hair volume and patchy loss area. Results: The regimens are applied docetaxel to ten patients, nab-paclitaxel to one patient, TC to two patient, and EC to 7 patients for early and metastatic breast cancer patients. The evaluation of alopecia was grade 0 on fourteen patients, grade 1 on four patients, and grade 2 on two patient. Two patients needed hair wig for hair loss. One patient with CIA has her hair growing during the second part of chemotherapy with Cool Cap. Headache was prevented by NSAID. All patients were satisfied with this application of Cool Cap. Conclusions: The Cool Cap system is suprisingly effective to prevent CIA. It should be standard therapy for all breast cancer patients on chemotherapy.
cancer care in Bangladesh. Methodology: This cross-sectional study was conducted at Jahurul Islam Medical College and Hospital, Bangladesh. Among 685 participants of the survey, 379 respondents were medical students at the age of 18 to 26 years and rest of the participants (306 patients of the hospital) were randomly included in the study using a multistage cluster sampling technique. The IBM SPSS statistics (V21.0) software was used to analyze survey data. Results: The results of the survey indicates that the majority of medical students are familiar with the early detection methods of breast cancer. However, the students were not aware of the risk factors of cervical cancer including HIV infection (27.2%) and the long-term use of contraceptive pill (22.7%). The students also are not going through the regular smear or Pap test (28.0%) or not aware of infection from HPV (16.6%). Only a few students are aware of the risk of breast cancer including Hormone replacement therapy (3.2%) and Benign breast disease (5.5%). On the other hand, the randomly selected patients of the hospital (100%) have no idea about the risk factors of breast and cervical cancer. As a result, they have no knowledge about the early detection methods of breast cancer. Conclusion: The summary of this study indicates that the medical students and patients of the hospital are not sufficiently aware of the sign symptoms, risk factors, and preventive measures for breast and cervical cancer. Therefore, necessary steps are very crucial to grow awareness among the general people of Bangladesh from the respective authority to be careful about breast cancer and cervical cancer.