- Email: [email protected]
2 carriers
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
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