Changes in diet and supplement use after breast cancer diagnosis in a UK, multicentre study

1108 Conclusions: The service provided by our breast unit for mastalgia is well received. Interestingly, some women were unaware of the risks of radiation with mammography despite leaflet based information made available, yet they still seek additional reassurance from mammography. The survey supports the idea that nurse-led breast pain clinics are beneficial. The patient study illustrates the persistent anxiety in patients post discharge and the lack of understanding of mammography risks and warrants further study. P4. Changes in diet and supplement use after breast cancer diagnosis in a UK, multicentre study Louiza Velentzisa, J. Woodsideb, M. Cantwellb, A. Leathema, M. Keshtgarc a University College London, Breast Cancer Research Group, 1st Floor Maple House, 149 Tottenham Court Road, London, W1T 7DN b Queens University Belfast, Belfast c Royal Free Hospital, London Introduction: Many cancer survivors change health behaviours following diagnosis, but few studies have assessed such changes both before and after diagnosis. A comparison of pre- and post-diagnostic dietary intake and supplement use reported by 1760 breast cancer patients is presented. Methods: As part of the ethically approved DietCompLyf study two food frequency questionnaires were administered to participants at study entry (one year after diagnosis) one representing diet before diagnosis and the other, after diagnosis. Comparison of food group and nutrient intake and supplement use before and after diagnosis was evaluated by chi-squared tests. Results: Consumption of poultry, fish, fruit, vegetables, wholegrain foods, nuts and tea significantly increased post-diagnosis (p<0.05, each). Conversely, intake of red meat, refined grain products, high-fat/sugar foods, coffee and alcoholic drinks significantly decreased (p<0.05, each). Dietary intake of retinol decreased after diagnosis but intake of other vitamins and minerals increased (p<0.05, each). Supplement use was prevalent in this cohort with 59% reporting use before diagnosis, increasing to 64% after diagnosis. Fish oils, multivitamin/mineral products and evening primrose oil were most commonly used with increased intake after diagnosis (p<0.05, each). Estrogenic botanical supplements (EBS) were used by 64 patients (3.6%) prior to diagnosis, increasing to 172 patients (9.7%) after diagnosis (p<0.05). Only a third of named EBS referred to use for menopausal or hormone-related symptoms. Conclusions: DietCompLyf participants made significant dietary changes following their cancer diagnosis. It is important for clinicians to be aware of such changes so as to inform their patients of healthier post-diagnostic lifestyle choices. P5. Role of the proteasome in regulating p27 in docetaxel-resistant breast cancer cells Iain Brown, B. Arnold, G. Petrighe-Polidori, A. Schofield, S. Heys University of Aberdeen, Cancer Medicine Group, Division of Applied Medicine, Polwarth Building, Foresterhill, Aberdeen, AB252ZD P27 is a key regulator of the cell cycle and reduced expression is associated with docetaxel resistance in breast cancer cells. The ubiquitin pathway (the proteasome) is a crucial mechanism of degrading cellular proteins. We hypothesise that p27 expression is reduced through this pathway leading to drug resistance. Blocking degradation of p27, using proteasome inhibitors, may represent a strategy to overcome resistance. An in vitro model of docetaxel resistance (parental docetaxel-sensitive and resistant sublines of MCF-7 and MDA-MB-231 cells) was used. Global proteasome activity was determined by luminescent proteasome activity assay and the effect of lactacystin on docetaxel response was assessed using a cell viability assay to determine IC50 values. Western blotting was used to determine protein expression levels. Ubiquitin trapping, followed by western blotting, was used to assess levels of ubiquitinated p27 before and after treatment with lactacystin.

ABSTRACTS Proteasome activity was significantly increased in both docetaxel-resistant cell lines and this activity was inhibited by lactacystin. IC50 values of docetaxel was decreased by 9-fold in MCF-7 cells (P<0.05) and decreased by 1.6-fold in MDA-MB-231 cells (P<0.01), following treatment in resistant cells. Lactacystin also increased p27 protein expression and increased presence of polyubiquitinated p27 proteins, which would otherwise have been degraded by the proteasome. We suggest that reduced expression of p27 in resistant cells may be a result of abnormal proteasome targeting of p27 through increased global proteasome activity. Lactacystin enhanced the sensitivity of docetaxel in breast cancer cells suggesting that proteasome inhibitors may be used to overcome drug resistance. P6. Until the Twelfth of Never: An Audit of Breast Cancer Follow-up in Wales Rhiannon Harries, A. Cox, K. Gomez Nevill Hall Hospital, Brecon Road, Abergavenny, Monmouthshire, NP7 7EG Aims: NICE clinical guidance for early and locally advanced breast cancer (February 2009) recommends that patients should be followed up with annual mammograms for a maximum of 5 years. Evidence has shown that routine follow-up beyond 5 years has little benefit as recurrence is usually symptomatic and occurs within the first 3 years. The aims of the audit were to assess the current breast cancer follow-up practice in Wales. Method: A unique questionnaire was e-mailed to all consultant breast surgeons in Wales. If the consultants failed to respond, a telephonic interview was conducted with a breast care nurse within the unit. Results: Our results show that there is no unified approach to followup of breast cancer patients within Wales. The duration of follow-up varied from ten years, until the age of 50, until the age of 50/five years (whichever was sooner) or until the age of 50/ten years. Breast units followed-up young patients with MRI in north Wales but mammography in south Wales. Breast units in south-west Wales offered yearly mammograms until the age of 50 for younger patients and five years for all others, while southeast Wales had the most varied and prolonged follow-up. Older consultants also tended to follow-up their patients for longer. Conclusion: There are wide geographical differences in breast cancer follow-up throughout Wales. We recommend a unified protocol, based on NICE guidelines, of annual review for five years, and access to breast clinic only in the presence of new symptoms. P7. Gene expression analysis to detect sentinel lymph node involvement. A review of our first 100 cases Haytham Sumrien, R. Kannan, S. Khawaja, G. Tewari, Y. Sharaiha, S. Holt Prince Philip Hospital, Dafen Road, Llanelli, SA14 8QF Standard surgical treatment for breast cancer is either wide local excision or mastectomy with sentinel lymph node (SLN) biopsy. If any of the sentinel nodes are involved with metastases, then axillary clearance is recommended. Detection of metastases in the SLN up to now has been mainly determined histologically. This process takes several days resulting in axillary clearance, if required, being performed as a second and subsequent procedure. Gene expression analysis using real time polymerase chain reaction technology allows the detection of mammary derived cells in SLN within about 50 minutes to a high degree of accuracy (95.6%). This allows clearance of the axilla to be performed immediately if needed. Since March 2009, 100 patients have had their sentinel nodes analyzed introperatively using the Veridex Gene Search BLN assay with the following results: 79 negative and 21 positive of which 20 patients proceeded to immediate clearance sparing them a second procedure. 3 patients testing negative had involvement histologically, (1 intramammary lymph node, 1 isolated tumour cells and 1 0.4 micrometastasis).