Breast cancer outcomes in a population with high prevalence of obesity.

Background: Obesity has been associated with poor prognosis in breast cancer. However, most previous studies examined populations with relatively low proportions of obese patients. Given that forecasts predict obesity rates to exceed 50% by 2030, it is important to examine breast cancer outcomes in populations with higher rates of obesity.

Effect of January vacations and prior night call status on resident ABSITE performance.

Objective: To determine if vacations in January or on-call status have an effect on American Board of Surgery In-Training Examination (ABSITE) scores.

Design: Retrospective review of the performance of general surgery residents on ABSITE. Data collected included ABSITE scores, United States Medical Licensing Examination Step 2 scores, January vacation schedules, and call schedules.

Does obesity have an effect on outcomes in triple-negative breast cancer?

Background: Among patients with breast cancer, obesity has been associated with an increased likelihood of having triple-negative breast cancer (TNBC). This association has been thought to be due to the antiapoptotic effects of obesity-related proteins. However, the effect of obesity on the outcomes in patients with TNBC remains unclear.

Is chronic kidney disease an independent risk factor for mortality in breast cancer?

Background: Chronic kidney disease (CKD) is an independent risk factor for morbidity and mortality in multiple disease processes. However, not much is known about the relationship between breast cancer and CKD. CKD is associated with increased difficulty in breast cancer screening or surveillance due to increased calcifications on mammography.

Virotherapy using a novel chimeric oncolytic adenovirus prolongs survival in a human pancreatic cancer xenograft model.

Introduction: Pancreatic adenocarcinoma is an aggressive malignancy. Oncolytic adenoviruses (Ads) are modified genetically to target tumor cells while sparing normal cells. We modified the knob domain of the Ad serotype 5 with a serotype 3 knob domain and incorporated the CXCR4 promoter to regulate Ad E1A gene expression (Ad5/3-CXCR4-E1A).

Outcome for patients with triple-negative breast cancer is not dependent on race/ethnicity.

Introduction. Triple negative breast cancer (TNBC) is biologically aggressive and is associated with a worse prognosis. To understand the impact of race/ethnicity on outcome for patients with TNBC, confounding factors such as socioeconomic status (SES) need to be controlled.

The chemokine receptor CXCR4 as a novel independent prognostic marker for node-positive breast cancer patients.

Background: Node-positive breast cancer patients are a high-risk group. However, not all such patients will succumb to the disease. The molecular basis for this biologic heterogeneity is poorly understood.

Should a routine metastatic workup be performed for all patients with pathologic N2/N3 breast cancer?

Background: Node-positive breast cancer patients are at risk for metastatic disease. A routine metastatic workup might or might not be necessary for all patients with N2 or N3 diseases. The National Comprehensive Cancer Network guidelines recommend a metastatic workup for patients with T3N1 disease, yet no definitive recommendations are made for N2/N3 diseases.

Establishment of a mammary carcinoma cell line from Syrian hamsters treated with N-methyl-N-nitrosourea.

Clearly new breast cancer models are necessary in developing novel therapies. To address this challenge, we examined mammary tumor formation in the Syrian hamster using the chemical carcinogen N-methyl-N-nitrosourea (MNU). A single 50mg/kg intraperitoneal dose of MNU resulted in a 60% incidence of premalignant mammary lesions, and a 20% incidence of mammary adenocarcinomas.

Chemokine receptor CXCR4 level in primary tumors independently predicts outcome for patients with locally advanced breast cancer.

Background: Chemokine receptor CXCR4 is a marker of metastatic disease. We found initially that CXCR4 level is a predictive marker for patients with locally advanced breast cancer (LABC). We now confirm our initial observations.

The role of chemokine receptor CXCR4 in the biologic behavior of human soft tissue sarcoma.

The molecular basis of sarcoma remains poorly understood. However, recent studies have begun to uncover some of the molecular pathways involved in sarcomagenesis. The chemokine receptor CXCR4 has been implicated in sarcoma development and has been found to be a prognostic marker for poor clinical outcome.

CXCR4 as a predictive marker for locally advanced breast cancer post-neoadjuvant therapy.

Background: CXCR4 is a G-protein coupled receptor that has been linked with metastasis in several cancers, including breast cancer. We recently demonstrated that high CXCR4 levels in primary tumors of patients with breast cancer had a prognostic significance. We hypothesize that patients whose tumors had a low CXCR4 overexpression level following neoadjuvant chemotherapy will have a lower recurrence rate than those whose tumors remained high.

The utility of a tissue slice model system to determine breast cancer infectivity by oncolytic adenoviruses.

Background: Due to advances in viral design, oncolytic adenoviruses have emerged as a promising approach for treatment of breast cancer. Tumor tissue slices offer a stringent model system for preclinical evaluation of adenovirus therapies, since the slices retain a morphology and phenotype that more closely resembles the in vivo setting than cell line cultures, and this system has been shown to have utility in the evaluation of viral infectivity and replication. In this study, we evaluated the efficacy of viral infection and replication using a tropism-modified oncolytic adenovirus.

Chemokine receptor CXCR4 overexpression predicts recurrence for hormone receptor-positive, node-negative breast cancer patients.

Background: The expected outcome for hormone receptor-positive, node-negative patients should be favorable. However, some patients do develop metastatic disease and the mechanism for this observation is poorly understood. CXCR4 is a chemokine receptor that has been implicated to play a pivotal role in breast cancer growth and metastasis.

Is breast conservation therapy a viable option for patients with triple-receptor negative breast cancer?

Background: Triple-receptor negative breast cancers (TNBC) are aggressive neoplasms that lack estrogen-receptor, progesterone-receptor, and HER-2 expressions. Comparative analysis of breast conservation therapy (BCT) versus mastectomy for TNBC is reported sparsely. We hypothesized that, despite its aggressive behavior, TNBC can be managed with BCT.

Impact of race and ethnicity on outcomes for estrogen receptor-negative breast cancers: experience of an academic center with a charity hospital.

Background: African American women have a higher breast cancer mortality rate than Caucasian women. Estrogen receptor (ER)-negative tumors, which are more aggressive than ER-positive tumors, occur more frequently in African American women than in Caucasian women and may contribute to apparent disparities in outcomes. However, outcome results need to be controlled for socioeconomic status (SES).

Predictive value of eIF4E reduction after neoadjuvant therapy in breast cancer.

Introduction: Initiation factor 4E (eIF4E) overexpression has prognostic significance in breast cancer. Up-regulation of downstream gene products associated with high eIF4E overexpression has been linked to chemoresistance. We hypothesize patients whose tumors had eIF4E reduction after neoadjuvant chemotherapy will have lower cancer recurrence compared with those who did not.

Citrus auraptene suppresses cyclin D1 and significantly delays N-methyl nitrosourea induced mammary carcinogenesis in female Sprague-Dawley rats.

Background: Breast cancer is a major problem in the United States leading to tens of thousands of deaths each year. Although citrus auraptene suppresses cancer in numerous rodent models, its role in breast cancer prevention previously has not been reported. Thus, our goal was to determine the anticarcinogenic effects of auraptene against breast cancer.

Eukaryotic initiation factor 4E overexpression in triple-negative breast cancer predicts a worse outcome.

Background: Triple-negative (estrogen receptor [ER], progesterone receptor [PR], and HER2/neu receptor negative) breast neoplasms are typically high grade and portend a higher risk for relapse. Not being amendable to ER, PR, or HER2-targeted therapy, adjuvant cytotoxic chemotherapy remains the only option. High eukaryotic Initiation Factor 4E (eIF4E) overexpression in tumor specimens is an independent predictor for relapse in breast cancer, perhaps secondary to tousled-like kinase 1B upregulation and subsequent doxorubicin resistance.

Race/Ethnicity has no effect on outcome for breast cancer patients treated at an academic center with a public hospital.

Background: African American women have a higher breast cancer mortality rate than Caucasian women. To understand this difference, socioeconomic status (SES) needs to be controlled, which can be achieved by evaluating outcome within a population that is underinsured or low SES. We elected to examine the effect of race/ethnicity on outcome of patients with operable breast cancer by evaluating outcome in a population with low SES and similar access to care.

Overexpression of CXCR4 in primary tumor of patients with HER-2 negative breast cancer was predictive of a poor disease-free survival: a validation study.

Background: Although HER-2 negative tumors are thought to be less aggressive than their counterpart, there is a subset that behaves poorly. The molecular mechanism to account for this is unknown. The chemokine receptor CXCR4 is often upregulated in a wide array of cancers.

High chemokine receptor CXCR4 level in triple negative breast cancer specimens predicts poor clinical outcome.

Introduction: Basal-like tumors or triple negative breast cancers are those that lack hormone-receptor and HER-2 expressions. They are considered to be aggressive tumors, and molecular mechanism to account for this is poorly understood. CXCR4 is a chemokine receptor that has been linked to breast cancer invasion and metastasis.

Tissue microarray analysis of eIF4E and its downstream effector proteins in human breast cancer.

Background: Eukaryotic initiation factor 4E (eIF4E) is elevated in many cancers and is a prognostic indicator in breast cancer. Many pro-tumorigenic proteins are selectively translated via eIF4E, including c-Myc, cyclin D1, ornithine decarboxylase (ODC), vascular endothelial growth factor (VEGF) and Tousled-like kinase 1B (TLK1B). However, western blot analysis of these factors in human breast cancer has been limited by the availability of fresh frozen tissue and the labor-intensive nature of the multiple assays required.

Li-Fraumeni syndrome: the genetics and treatment considerations for the sarcoma and associated neoplasms.

Li-Fraumeni syndrome is an autosomal dominant disorder first reported by Drs Li and Fraumeni in 1969. Malkin was the first to describe a germline mutation as an underlying defect of Li-Fraumeni syndrome. Cancer risk in mutation carriers has been estimated to be 50% by age 40 and 90% by age 60.