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P159 Clinico-pathological features of surgically-treated bilateral breast cancers
S32
Poster Session I. Epidemiology/Prevention/Diagnosis
P156
Breast cancer in elderly patients
N. Boroday1 , S. Gribach2 , V. Chekhun1 . 1 Mechanisms of Anticancer Treatment, Re Kavetsky Inst Exptl Pathol, Oncol, Oncol & Radiobiol, 2 Regional Hospital, Kyiv, Ukraine Goals: The number of elderly breast cancer (BC) patients in Ukraine as well as in the Western world has increased. The data on biological characteristics and clinical behavior of BC in elderly patients are limited. The aim of the study is the biological features of BC in the elderly patients. Methods: The clinical, morphological and immunohistochemical methods and statistical analysis were used in the study. 65 BC patients were divided into two groups: patients aged 65 years and older (Group I – 30 pts) and patients aged 50−55 years (Group II – 35 pts). The following parameters were evaluated: tumor size, histology of tumor, the number of lymph nodes with metastases, receptors to estrogen (ER), progesterone (PR), and Her2/neu. Expression of ER and PR was assayed immunohistochemically with murine antihuman antibody clone 1D5 and clone PgR636 (DAKO Denmark). The cut-off for positivity of ER and PR is 10%. Her-2 expression in tumor was assayed with monoclonal antibody to Her2/neu (DAKO Denmark). The size of tumors was assessed as the larger diameter measured in pathological examination following surgery. t-test was used for assessing the statistical difference between the groups. Results: In Group I, the average size of the tumors was larger as compared to that in Group II (4.25±0.3 cm vs 3.4±0.4 cm). The histological type of the tumors was similar in both groups. Positive familial history was more frequent in patients in Group I. The percentage of the patients with the affected axillary lymph nodes was 69.7 % in Group I and 65.9 % in Group II. The inguinal lymph nodes were involved in 73.5 % and 82.1 %; the inguinal + subclavian lymph nodes were involved in 28.2 % and 19.5 % in patients of Group I and Group II, accordingly. ER and PR expression pattern was the following one: ER+PR+ in 36.4 % and 57 % (p < 0.01); ER−PR− in 11.6% and 8.9% (p > 0.05); ER+PR− in 14.2 and 27.3 % (p < 0.01), ER−PR+ in 9% and 11% (p > 0.05) in Group I and Group II, respectively. The overexpression of Her2/neu was detected in 53.5 % and 37.1 % patients in Group I and Group II (p < 0.01). Conclusion: The following features of BC in elderly patients were found out: increased size of tumors, increased percentage of ER- and PR-positive tumors, Her2/neu overexpression, and the increased number of the lymph nodes with metastases. Disclosure of Interest: None Declared
P157
A clinico-pathological analysis of breast cancer patients with a family history
Nakagawa1 ,
Kinoshita1 ,
Yoda1 ,
Tamura1 ,
Hojo1 ,
A. T. Y. N. T. S.A. Tanaka1 . 1 Division of Breast Surgery, National Cancer Center Hospital, Tokyo, Japan Goals: It has been said that the high incidence of breast cancer within family lines could be investigated efficiently from genetic and environmental aspects. There could be a strong enough relationship between various carcinogenic factors and these family members. In this study, we examined the clinical and pathological characteristics of breast cancer among patients with a family history. Methods: We put the definition of ‘Positive for a family history (FH+)’ for patients who had one or more members within three generations apart from the proband. Patients with family history of breast cancer were selected out of 10970 patients who were treated in our hospital between 1962 and 2008. Results: There were 1362 cases in FH+ and 9608 cases in ‘Negative for a family history (FH−)’ group. Distribution within the family line showed the highest percentage for sisters at 36.8%, aunts at 25.2% and a mother at 24.5%. The family history positive breast cancer patients were around 5% in 1960–1970 although the number increased up to 19.4% in 2008. There was similar increasing pattern in Europe and America. The survival rate had no significant difference between FH+ and FH− statistically, but the trend was toward a better prognosis in FH+ cases. There was no relationship between family history. The outbreak of contralateral breast cancer of FH+ was significantly higher than FH−. FH+ patients had significantly higher prevalence of a mastopathy compare to FH− patients. As for the history of other cancer species, the FH+ breast cancer patients within first generation apart from the proband had significantly higher chances compared to FH− patients. Conclusion: The breast cancer patients with family history require more detail examinations especially for the development of contralateral breast
Thursday, 17 March 2011 cancer. Also carcinomatous examinations are important other than breast cancer to those patients who are in the first generation apart from the proband. Disclosure of Interest: None Declared
P158
The role of HPV in breast, ovarian and endometrial cancer
I. Antonova1 , L. Ashrafyan1 , A. Slonov1 . 1 Oncogynecology, FSC Russia’s Research Center of Radiology, Moscow, Russian Federation Goals: Viruses are known to be involved in the development of several cancers.There has been some research evidence suggesting that human papilloma virus (HPV) may also play a role in the development of some cases of breast (BC), endometrial (EC) and ovarian cancer (OC). The aim of the study was to determine the presence of HPV in patients with OC, EC and BC. Methods: The main group was of 67 OC patients; 60 of EC; 60 of BC and 30 patients were also studied as a non-malignant control group. HPV was analyzed through polymerase chain reaction (PCR). Results: DNA-diagnostics of HPV samples of OC were positive in 51 of 67 (76.1%) cases. And only in 2 from 30 (10.0%) samples of a normal ovarian tissues were registered positive results. It was established that OC was associated with HPV-18 (29.9%) and HPV-52 (29.9%) types. HPV infection was significantly higher in cancer tissues compared to controls (P < 0.01). In overwhelming majority of EC (53 from 60) HPV wasn’t found out. From remained 7 (11.7%) HPV-16 was determined in 4 (6.7%) cases and HPV-18 in 1 (1.7%) case. Thus in control group in 3 (10%) samples HPV-16 was found. All of the 4 (6.7%) positive cases among BC were HPV-16 positive. In control group was determine only HPV-16 in 4 from 30 (13.3%) cases. Thus in 50% of the virus-positive cases of samples (both in main, and in control group) HPV has been found not only in tumoral, but also in surrounding normal tissues. Conclusion: The results showed the presence of HPV in ovarian carcinoma, suggesting that HPV infection might play a role in ovarian carcinogenesis. Our study could not support a role of HPV in breast and endometrial carcinoma. More work still needs to be done to understand the precise role of HPV in reproductive cancer development. Disclosure of Interest: None Declared
P159
Clinico-pathological features of surgically-treated bilateral breast cancers
E. Tokuda1 , S. Tomiyama1 , T. Kosaka1 , I. Abe1 , K. Senuma1 , K. Nakai1 , H. Miura1 , A. Arakawa2 , M. Saito1 , F. Kasumi1 . 1 Breast Oncology, 2 Pathology, Juntendo University Hospital, Tokyo, Japan Goals: Recently, breast cancer has been increasing in Japan. We even treat some bilateral breast cancers. Some of the characteristics of both lesions seem to be very similar in bilateral breast cancer. However, uncertainly remains as to bilateral breast cancer on clinical parameters. In this study, we investigated the demographic features and clinico-pathological behavior of bilateral breast cancers to prove the similarity in both lesions. Methods: From 2007 to 2009, among 1176 women were treated for primary operable breast cancers at Breast Center in Juntendo University. 86 had bilateral primary operative breast cancers. 53 developed synchronous bilateral breast cancers (including 11 synchronous cases receiving neoadjuvant chemotherapy), and 33 developed metachronous disease. We compared unilateral, synchronous and metachronous groups for age at operation, histology, hormone receptor status, etc. Results: The 86 (7.2% of the total 1176) with bilateral breast carcinomas had a mean age of 58.8 years, while the mean age of all cases was 54.5 years. In synchronous cases, mean age at diagnosis was 57.6 years. In metachronous cases, a mean age at diagnosis of the first cancer was 45.8 years and at the second was 59.8 years. There were no significant differences among three groups for family histories. Twenty-eight women (33.7%) were premenopausal. The most common histological type was invasive ductal carcinoma, and 79 cases (91.9%) had this histology bilaterally. Hormone status was the same in both breasts in 80 cases (93.0%). Eleven patients underwent neoadjuvant chemotherapy which showed the same efficacy on both breast tumors. Conclusion: We hereby report clinico-pathological features and similarity of synchronous bilateral breast cancers. Based on our observations,
Thursday, 17 March 2011 we conclude that it is important to evaluate the contra-lateral breast at the time a cancer in one breast is diagnosed, especially for young patients. Disclosure of Interest: None Declared
P160
Review of breast cancer diagnosed in a cohort of BRCA1/2 carriers
A. Clara1 , C.S. Costa2 , J.C. Marques3 , A. Luis4 , S. Bento4 , P. Rodrigues4 , S. Andre5 , F. Vaz4 . 1 Medical Oncology, 2 Breast Surgery, 3 Radiology, 4 Breast cancer evaluation clinic, 5 Pathology, Instituto Portugues Oncologia Lisboa, Lisbon, Portugal Goals: From January 2000 a multidisciplinary program for the identification, counselling and follow up of individuals at high risk of breast cancer was set up in our centre. BRCA1/2 genetic screening is an essential component of this program that includes long-term follow up of BRCA1/2 carriers. Methods: Individual and family files of BRCA1/2 carriers registered between January 2000–November 2010 were reviewed to the characteristics of breast cancer observed in this population. Preliminary descriptive review is reported in this abstract. Results: Two-hundred and twenty (220) BRCA1/2 carriers (170 female and 50 male) were diagnosed with BRCA1/2 mutations (33 BRCA1 and 187 BRCA2). Breast cancer was the most frequent diagnosis in this population, with 93 individuals affected (79 female and 14 male). Of these, 8 were female bilateral breast cancers cases and 2 male bilateral cases. Thirteen breast cancer survivors and 15 healthy carriers consented on prophylactic surgery (breast contralateral and/or ovarian) and breast bilateral and/or ovarian), respectively. During follow up, diagnosis of new cases of breast cancer were as follows: one male contralateral breast cancer was in a cancer survivor and 13 female breast cancer cases in 11 patients (2 cases bilateral). Female breast cancer cases: 3 contralateral cases and 10 cases in previously healthy women (medium age at diagnosis: 50 years). Of the previously healthy patients, 2 are undergoing surgery and 1 is starting adjuvant chemotherapy. Concerning the remaining 9 patients only 2 (1 BRCA1 and 1 BRCA2) were not treated with chemotherapy. In all others, either due to poor differentiation, or triple negative phenotype at early age, or (1 case) because of 3 positive axillary nodes, chemotherapy was recommended. Anyway, in all cases, so far, all are alive without relapse. No new cases of breast cancer were observed in pts with previous prophylactic surgery. Conclusion: Long term follow up of this rare population is needed to study the real impact of new screening methods (like breast magnetic resonance) and surgical prevention in BRCA1/2 carriers. Disclosure of Interest: None Declared
P161
Relationship of breast size and cancer lymphogenous dissemination
Z. Zautashvili1 , M. Ratiani2 , M. Sharashidze1 , D. Giorgadze1 , D. Baliev2 . 1 Senology, M. Sharashidze Medical Center, Tbilisi, Georgia, 2 Senology, Daugavpilz Oncology Clinic, Daugavpilz, Latvia Goals: Axillary lymphatic collector is potentially one of the most vigorous drainage systems of the human body. This is related to the anatomic feature of this region, which has a lot of lymph nodes and is topographically near to the main venous vessel. Methods: Breast – external glandular organ of female body – is the symbol of beauty and maternity and can be small, medium and big in volume. Breast of any form and droopiness receives in brassiere a shape of hemisphere, diameter of basis of which (D) can be measured with special caliper. Numerous measurements conducted by us have shown that the average value D = 14 cm. In our opinion, some of the postulates of this classification require logical correction. Results: It should be noted that limiting value for T category is 2 cm. All the patients with tumors less than this value in maximal measurement and absence of lymph nodes’ MTS affection belong to low-risk group. The rest of the patients with the greater values of these categories are in average- and high-risk groups. Tactics of the treatment are planned accordingly. International system of malignant tumors stage classification, which exists for almost 70 years, takes no into consideration the size of the breast affected with the disease, which can be from the very
Poster Session I. Epidemiology/Prevention/Diagnosis
S33
minimal to the giant. For the purpose of criteria objectification we have introduced for convenience the index of Z as a value, which designates tumor size and breast size ratio. We have also created the formula Z = D:d [SAKPATENTI No. 1789 − 02.07.2006] and calculated its threshold. For the breast of average size with the solitary single tumor Z0 = 7 (14:2) and for the multicentric cancer the formula is − Zm = D:(d1 + d2 + · · ·). Relying on our formula we have researched the rate of lymph node MTS presence. In Z1 > 7 it was 5.5% and in Z2 < 7 it was 77%. Hence, we can say that the smaller is the breast, the closer is the tumor to the regional lymphatic collector active zone (therefore MTS rate is high). And vice versa − we had cases when Z1 = 9 and there were no lymph nodes MTS. Conclusion: Therefore small breast, when affected by cancer, is a bad prognostic factor and this should be considered in guidelines when categorizing risk degrees along with parameters such as tumor size and affected lymph nodes number. Disclosure of Interest: None Declared
P162
A new mammographic classification as a potential predictor of breast disorders for Asian women
K. Tamaki1 , H. Sasano2 , M. Miyashita1 , T. Ishida1 , N. Ohuchi1 , N. Tamaki3 . 1 Surgical oncology, 2 Pathology, Tohoku University, Sendai, Miyagi, 3 Breast Surgery, Nahanishi Clinic, Okinawa, Japan Goals: Mammographic findings of Asian women do not exactly correspond to BI-RADS lexicon and the goals also are not quite the same. Therefore, we have to develop new criteria of mammographic diagnoses for predicting breast malignancies for Asian women. Methods: We examined 1267 Japanese women (707 malignant and 560 benign) who underwent mammography and needle biopsies or surgical resection. The median age was 52 years (21−89 years). We examined a new classification for predicting malignancies segregated by 20% of malignant ratio. We also examined the correlation between mammographic findings and malignant ratio, and additionally examined the powerful predictors for malignancies by age groups. Results: The malignant ratio of Class I-V were 13.2% (9/68), 24.5% (98/400), 42.5% (96/226), 72.4% (92/127) and 92.8% (411/443) with statistically significances (P < 0.001). Lobular and irregular mass shape, no circumscribed margin and higher density were more powerful predictors for malignancy than the other findings (P < 0.001). Necrotic calcification and segmental distribution were powerful predictors for malignancy (P < 0.001). Especially in young age groups, calcifications and no mammographic findings became the predictors of breast malignancies (P < 0.001). Conclusion: The striking difference is that the peak age for breast cancer was between 40 years in this study. There were some differences in mammographic findings between young and old women. In addition, younger women have denser breasts than older women, and this is the most important reason why it is difficult to detect malignant findings in younger women. Therefore, we established a new mammographic classification for Asian women through this study. We believe our present study contribute additional clinical evidence showing that the new mammographic classification represents a powerful clinical tool for mammographic reporting in Asian countries. Disclosure of Interest: None Declared
P163
Preliminary study of Chinese high-risk population screening model for breast cancer
Q. Zhang1 , G.Z. Yu1 , X.C. Jia2,3 , Z.C. Geng4 , H.J. Tang5 , J. Zhang6 , Y.L. Liu7 . 1 Department of Breast Disease, The Second Hospital of Shandong University, Jinan, China, 2 Department of Sociology, State University of New York College at Buffalo, New York, United States, 3 Epidemiology Institute, School of Public Health, Shandong University, Jinan, 4 Department of Breast Disease, the Fourth Hospital of Hebei Medical University, Shijiazhuang, 5 Department of Breast Disease, Jiangsu Cancer Hospital, Nanjing, 6 Department of Breast Disease, Tianjin Cancer Hospital, Tianjin, 7 Department of Breast Disease, School of Public Health, Shandong University, Jinan, China Goals: This study was designed to establish a screening model of breast cancer for Chinese females. Methods: Case-control studies were conducted to develop several highrisk population screening models. All cases and controls were selected
Poster Session I. Epidemiology/Prevention/Diagnosis
P156
Breast cancer in elderly patients
N. Boroday1 , S. Gribach2 , V. Chekhun1 . 1 Mechanisms of Anticancer Treatment, Re Kavetsky Inst Exptl Pathol, Oncol, Oncol & Radiobiol, 2 Regional Hospital, Kyiv, Ukraine Goals: The number of elderly breast cancer (BC) patients in Ukraine as well as in the Western world has increased. The data on biological characteristics and clinical behavior of BC in elderly patients are limited. The aim of the study is the biological features of BC in the elderly patients. Methods: The clinical, morphological and immunohistochemical methods and statistical analysis were used in the study. 65 BC patients were divided into two groups: patients aged 65 years and older (Group I – 30 pts) and patients aged 50−55 years (Group II – 35 pts). The following parameters were evaluated: tumor size, histology of tumor, the number of lymph nodes with metastases, receptors to estrogen (ER), progesterone (PR), and Her2/neu. Expression of ER and PR was assayed immunohistochemically with murine antihuman antibody clone 1D5 and clone PgR636 (DAKO Denmark). The cut-off for positivity of ER and PR is 10%. Her-2 expression in tumor was assayed with monoclonal antibody to Her2/neu (DAKO Denmark). The size of tumors was assessed as the larger diameter measured in pathological examination following surgery. t-test was used for assessing the statistical difference between the groups. Results: In Group I, the average size of the tumors was larger as compared to that in Group II (4.25±0.3 cm vs 3.4±0.4 cm). The histological type of the tumors was similar in both groups. Positive familial history was more frequent in patients in Group I. The percentage of the patients with the affected axillary lymph nodes was 69.7 % in Group I and 65.9 % in Group II. The inguinal lymph nodes were involved in 73.5 % and 82.1 %; the inguinal + subclavian lymph nodes were involved in 28.2 % and 19.5 % in patients of Group I and Group II, accordingly. ER and PR expression pattern was the following one: ER+PR+ in 36.4 % and 57 % (p < 0.01); ER−PR− in 11.6% and 8.9% (p > 0.05); ER+PR− in 14.2 and 27.3 % (p < 0.01), ER−PR+ in 9% and 11% (p > 0.05) in Group I and Group II, respectively. The overexpression of Her2/neu was detected in 53.5 % and 37.1 % patients in Group I and Group II (p < 0.01). Conclusion: The following features of BC in elderly patients were found out: increased size of tumors, increased percentage of ER- and PR-positive tumors, Her2/neu overexpression, and the increased number of the lymph nodes with metastases. Disclosure of Interest: None Declared
P157
A clinico-pathological analysis of breast cancer patients with a family history
Nakagawa1 ,
Kinoshita1 ,
Yoda1 ,
Tamura1 ,
Hojo1 ,
A. T. Y. N. T. S.A. Tanaka1 . 1 Division of Breast Surgery, National Cancer Center Hospital, Tokyo, Japan Goals: It has been said that the high incidence of breast cancer within family lines could be investigated efficiently from genetic and environmental aspects. There could be a strong enough relationship between various carcinogenic factors and these family members. In this study, we examined the clinical and pathological characteristics of breast cancer among patients with a family history. Methods: We put the definition of ‘Positive for a family history (FH+)’ for patients who had one or more members within three generations apart from the proband. Patients with family history of breast cancer were selected out of 10970 patients who were treated in our hospital between 1962 and 2008. Results: There were 1362 cases in FH+ and 9608 cases in ‘Negative for a family history (FH−)’ group. Distribution within the family line showed the highest percentage for sisters at 36.8%, aunts at 25.2% and a mother at 24.5%. The family history positive breast cancer patients were around 5% in 1960–1970 although the number increased up to 19.4% in 2008. There was similar increasing pattern in Europe and America. The survival rate had no significant difference between FH+ and FH− statistically, but the trend was toward a better prognosis in FH+ cases. There was no relationship between family history. The outbreak of contralateral breast cancer of FH+ was significantly higher than FH−. FH+ patients had significantly higher prevalence of a mastopathy compare to FH− patients. As for the history of other cancer species, the FH+ breast cancer patients within first generation apart from the proband had significantly higher chances compared to FH− patients. Conclusion: The breast cancer patients with family history require more detail examinations especially for the development of contralateral breast
Thursday, 17 March 2011 cancer. Also carcinomatous examinations are important other than breast cancer to those patients who are in the first generation apart from the proband. Disclosure of Interest: None Declared
P158
The role of HPV in breast, ovarian and endometrial cancer
I. Antonova1 , L. Ashrafyan1 , A. Slonov1 . 1 Oncogynecology, FSC Russia’s Research Center of Radiology, Moscow, Russian Federation Goals: Viruses are known to be involved in the development of several cancers.There has been some research evidence suggesting that human papilloma virus (HPV) may also play a role in the development of some cases of breast (BC), endometrial (EC) and ovarian cancer (OC). The aim of the study was to determine the presence of HPV in patients with OC, EC and BC. Methods: The main group was of 67 OC patients; 60 of EC; 60 of BC and 30 patients were also studied as a non-malignant control group. HPV was analyzed through polymerase chain reaction (PCR). Results: DNA-diagnostics of HPV samples of OC were positive in 51 of 67 (76.1%) cases. And only in 2 from 30 (10.0%) samples of a normal ovarian tissues were registered positive results. It was established that OC was associated with HPV-18 (29.9%) and HPV-52 (29.9%) types. HPV infection was significantly higher in cancer tissues compared to controls (P < 0.01). In overwhelming majority of EC (53 from 60) HPV wasn’t found out. From remained 7 (11.7%) HPV-16 was determined in 4 (6.7%) cases and HPV-18 in 1 (1.7%) case. Thus in control group in 3 (10%) samples HPV-16 was found. All of the 4 (6.7%) positive cases among BC were HPV-16 positive. In control group was determine only HPV-16 in 4 from 30 (13.3%) cases. Thus in 50% of the virus-positive cases of samples (both in main, and in control group) HPV has been found not only in tumoral, but also in surrounding normal tissues. Conclusion: The results showed the presence of HPV in ovarian carcinoma, suggesting that HPV infection might play a role in ovarian carcinogenesis. Our study could not support a role of HPV in breast and endometrial carcinoma. More work still needs to be done to understand the precise role of HPV in reproductive cancer development. Disclosure of Interest: None Declared
P159
Clinico-pathological features of surgically-treated bilateral breast cancers
E. Tokuda1 , S. Tomiyama1 , T. Kosaka1 , I. Abe1 , K. Senuma1 , K. Nakai1 , H. Miura1 , A. Arakawa2 , M. Saito1 , F. Kasumi1 . 1 Breast Oncology, 2 Pathology, Juntendo University Hospital, Tokyo, Japan Goals: Recently, breast cancer has been increasing in Japan. We even treat some bilateral breast cancers. Some of the characteristics of both lesions seem to be very similar in bilateral breast cancer. However, uncertainly remains as to bilateral breast cancer on clinical parameters. In this study, we investigated the demographic features and clinico-pathological behavior of bilateral breast cancers to prove the similarity in both lesions. Methods: From 2007 to 2009, among 1176 women were treated for primary operable breast cancers at Breast Center in Juntendo University. 86 had bilateral primary operative breast cancers. 53 developed synchronous bilateral breast cancers (including 11 synchronous cases receiving neoadjuvant chemotherapy), and 33 developed metachronous disease. We compared unilateral, synchronous and metachronous groups for age at operation, histology, hormone receptor status, etc. Results: The 86 (7.2% of the total 1176) with bilateral breast carcinomas had a mean age of 58.8 years, while the mean age of all cases was 54.5 years. In synchronous cases, mean age at diagnosis was 57.6 years. In metachronous cases, a mean age at diagnosis of the first cancer was 45.8 years and at the second was 59.8 years. There were no significant differences among three groups for family histories. Twenty-eight women (33.7%) were premenopausal. The most common histological type was invasive ductal carcinoma, and 79 cases (91.9%) had this histology bilaterally. Hormone status was the same in both breasts in 80 cases (93.0%). Eleven patients underwent neoadjuvant chemotherapy which showed the same efficacy on both breast tumors. Conclusion: We hereby report clinico-pathological features and similarity of synchronous bilateral breast cancers. Based on our observations,
Thursday, 17 March 2011 we conclude that it is important to evaluate the contra-lateral breast at the time a cancer in one breast is diagnosed, especially for young patients. Disclosure of Interest: None Declared
P160
Review of breast cancer diagnosed in a cohort of BRCA1/2 carriers
A. Clara1 , C.S. Costa2 , J.C. Marques3 , A. Luis4 , S. Bento4 , P. Rodrigues4 , S. Andre5 , F. Vaz4 . 1 Medical Oncology, 2 Breast Surgery, 3 Radiology, 4 Breast cancer evaluation clinic, 5 Pathology, Instituto Portugues Oncologia Lisboa, Lisbon, Portugal Goals: From January 2000 a multidisciplinary program for the identification, counselling and follow up of individuals at high risk of breast cancer was set up in our centre. BRCA1/2 genetic screening is an essential component of this program that includes long-term follow up of BRCA1/2 carriers. Methods: Individual and family files of BRCA1/2 carriers registered between January 2000–November 2010 were reviewed to the characteristics of breast cancer observed in this population. Preliminary descriptive review is reported in this abstract. Results: Two-hundred and twenty (220) BRCA1/2 carriers (170 female and 50 male) were diagnosed with BRCA1/2 mutations (33 BRCA1 and 187 BRCA2). Breast cancer was the most frequent diagnosis in this population, with 93 individuals affected (79 female and 14 male). Of these, 8 were female bilateral breast cancers cases and 2 male bilateral cases. Thirteen breast cancer survivors and 15 healthy carriers consented on prophylactic surgery (breast contralateral and/or ovarian) and breast bilateral and/or ovarian), respectively. During follow up, diagnosis of new cases of breast cancer were as follows: one male contralateral breast cancer was in a cancer survivor and 13 female breast cancer cases in 11 patients (2 cases bilateral). Female breast cancer cases: 3 contralateral cases and 10 cases in previously healthy women (medium age at diagnosis: 50 years). Of the previously healthy patients, 2 are undergoing surgery and 1 is starting adjuvant chemotherapy. Concerning the remaining 9 patients only 2 (1 BRCA1 and 1 BRCA2) were not treated with chemotherapy. In all others, either due to poor differentiation, or triple negative phenotype at early age, or (1 case) because of 3 positive axillary nodes, chemotherapy was recommended. Anyway, in all cases, so far, all are alive without relapse. No new cases of breast cancer were observed in pts with previous prophylactic surgery. Conclusion: Long term follow up of this rare population is needed to study the real impact of new screening methods (like breast magnetic resonance) and surgical prevention in BRCA1/2 carriers. Disclosure of Interest: None Declared
P161
Relationship of breast size and cancer lymphogenous dissemination
Z. Zautashvili1 , M. Ratiani2 , M. Sharashidze1 , D. Giorgadze1 , D. Baliev2 . 1 Senology, M. Sharashidze Medical Center, Tbilisi, Georgia, 2 Senology, Daugavpilz Oncology Clinic, Daugavpilz, Latvia Goals: Axillary lymphatic collector is potentially one of the most vigorous drainage systems of the human body. This is related to the anatomic feature of this region, which has a lot of lymph nodes and is topographically near to the main venous vessel. Methods: Breast – external glandular organ of female body – is the symbol of beauty and maternity and can be small, medium and big in volume. Breast of any form and droopiness receives in brassiere a shape of hemisphere, diameter of basis of which (D) can be measured with special caliper. Numerous measurements conducted by us have shown that the average value D = 14 cm. In our opinion, some of the postulates of this classification require logical correction. Results: It should be noted that limiting value for T category is 2 cm. All the patients with tumors less than this value in maximal measurement and absence of lymph nodes’ MTS affection belong to low-risk group. The rest of the patients with the greater values of these categories are in average- and high-risk groups. Tactics of the treatment are planned accordingly. International system of malignant tumors stage classification, which exists for almost 70 years, takes no into consideration the size of the breast affected with the disease, which can be from the very
Poster Session I. Epidemiology/Prevention/Diagnosis
S33
minimal to the giant. For the purpose of criteria objectification we have introduced for convenience the index of Z as a value, which designates tumor size and breast size ratio. We have also created the formula Z = D:d [SAKPATENTI No. 1789 − 02.07.2006] and calculated its threshold. For the breast of average size with the solitary single tumor Z0 = 7 (14:2) and for the multicentric cancer the formula is − Zm = D:(d1 + d2 + · · ·). Relying on our formula we have researched the rate of lymph node MTS presence. In Z1 > 7 it was 5.5% and in Z2 < 7 it was 77%. Hence, we can say that the smaller is the breast, the closer is the tumor to the regional lymphatic collector active zone (therefore MTS rate is high). And vice versa − we had cases when Z1 = 9 and there were no lymph nodes MTS. Conclusion: Therefore small breast, when affected by cancer, is a bad prognostic factor and this should be considered in guidelines when categorizing risk degrees along with parameters such as tumor size and affected lymph nodes number. Disclosure of Interest: None Declared
P162
A new mammographic classification as a potential predictor of breast disorders for Asian women
K. Tamaki1 , H. Sasano2 , M. Miyashita1 , T. Ishida1 , N. Ohuchi1 , N. Tamaki3 . 1 Surgical oncology, 2 Pathology, Tohoku University, Sendai, Miyagi, 3 Breast Surgery, Nahanishi Clinic, Okinawa, Japan Goals: Mammographic findings of Asian women do not exactly correspond to BI-RADS lexicon and the goals also are not quite the same. Therefore, we have to develop new criteria of mammographic diagnoses for predicting breast malignancies for Asian women. Methods: We examined 1267 Japanese women (707 malignant and 560 benign) who underwent mammography and needle biopsies or surgical resection. The median age was 52 years (21−89 years). We examined a new classification for predicting malignancies segregated by 20% of malignant ratio. We also examined the correlation between mammographic findings and malignant ratio, and additionally examined the powerful predictors for malignancies by age groups. Results: The malignant ratio of Class I-V were 13.2% (9/68), 24.5% (98/400), 42.5% (96/226), 72.4% (92/127) and 92.8% (411/443) with statistically significances (P < 0.001). Lobular and irregular mass shape, no circumscribed margin and higher density were more powerful predictors for malignancy than the other findings (P < 0.001). Necrotic calcification and segmental distribution were powerful predictors for malignancy (P < 0.001). Especially in young age groups, calcifications and no mammographic findings became the predictors of breast malignancies (P < 0.001). Conclusion: The striking difference is that the peak age for breast cancer was between 40 years in this study. There were some differences in mammographic findings between young and old women. In addition, younger women have denser breasts than older women, and this is the most important reason why it is difficult to detect malignant findings in younger women. Therefore, we established a new mammographic classification for Asian women through this study. We believe our present study contribute additional clinical evidence showing that the new mammographic classification represents a powerful clinical tool for mammographic reporting in Asian countries. Disclosure of Interest: None Declared
P163
Preliminary study of Chinese high-risk population screening model for breast cancer
Q. Zhang1 , G.Z. Yu1 , X.C. Jia2,3 , Z.C. Geng4 , H.J. Tang5 , J. Zhang6 , Y.L. Liu7 . 1 Department of Breast Disease, The Second Hospital of Shandong University, Jinan, China, 2 Department of Sociology, State University of New York College at Buffalo, New York, United States, 3 Epidemiology Institute, School of Public Health, Shandong University, Jinan, 4 Department of Breast Disease, the Fourth Hospital of Hebei Medical University, Shijiazhuang, 5 Department of Breast Disease, Jiangsu Cancer Hospital, Nanjing, 6 Department of Breast Disease, Tianjin Cancer Hospital, Tianjin, 7 Department of Breast Disease, School of Public Health, Shandong University, Jinan, China Goals: This study was designed to establish a screening model of breast cancer for Chinese females. Methods: Case-control studies were conducted to develop several highrisk population screening models. All cases and controls were selected