IntroductionHigher all-cause mortality and shorter life expectancies for people with severe mental illness (SMI, including schizophrenia, schizoaffective disorder, and bipolar disorder) have been frequently reported. Cancer contributes a substantial proportion of mortality (20 to 30%) as the second or third leading cause of death among people with SMI. Outcomes of cancer incidence studies in SMI were considerably heterogeneous, varying by cancer types and mental disorders.Objectives/AimsTo compare the incidence of overall and each type of cancer between people with SMI in southeast London and general population in UK.MethodsUsing the anonymised linkage between a regional monopoly secondary mental health service provider covering four southeast London boroughs and a population-based cancer register, we carried out the comparisons of cancer incidences between people with SMI and general population by age- and gender-standardisation in 2011.ResultsAmong SMI subjects with cancer (N=105), the most common cancer types were lung and colorectal cancer followed by breast cancer for women and prostate cancer for men in this area. Standardised incidence ratios (SIRs) for all cancers in SMI were 1.19 (95% CI: 0.97-1.44) overall, 2.43 (95% CI: 1.98-2.94) in men (n=61), and 0.98 (95% CI: 0.71-1.31) in women (n=44). Based on relatively small case numbers, raised SIRs were found for lung cancer in men (SIR=7.57, 95% CI: 3.04-15.6) and women (SIR=7.61, 95% CI: 2.79-16.6), and in women for colorectal (SIR=7.85, 95%CI: 2.55-18.32) and breast cancer (SIR=7.86, 95% CI: 4.58-12.59).ConclusionsSpecific pattern of elevated risks of cancer incidence were found for people with SMI.
Background: Recent multi-center trial results are concerning for the ability to identify SLNs after NCT. SLN localization was shown to be less successful (80%) after NCT when compared with no NCT (99%) (SENTINA), and the SLN identification rate in Z1071 in which all patients received NCT was 93%. Purpose: To examine the effect of NCT, patient and disease characteristics, imaging and surgical technique on SLN localization rates in breast cancer patients undergoing chemotherapy. Methods: Retrospective, single institution study was performed on patients who underwent surgery for breast cancer from January 2008 to December 2013. All patients who underwent SLN biopsy and either adjuvant chemotherapy (ACT) or NCT, were included. All patients underwent lymphoscintigraphy, and SLN biopsy was performed with the definitive breast surgery. Results: 68 patients underwent NCT, and 133 underwent ACT. Our SLN localization rate was 198/201 (98.5%) overall; 98.6% (67 of 68) with NCT and 97.7% (130/133) with ACT (p=1.0). Compared with the NCT group, the ACT patients were significantly older, white, with more ER/PR positive tumors. The NCT group had more positive nodes on preop imaging (64% v. 20%, p<0.001), FNA (82% v. 22%, p<0.001), and a lower use of blue dye (37% v. 61%, p=0.05) but there were no differences in the number of SLN removed (1.43 v. 1.33 p=0.32), or nodes that were positive on intraoperative evaluation (30 v. 33%, p=0.75). Comparing the patients who had successful and failed SLN localization, there were no differences in demographics, tumor type, Stage, prior breast surgery, preoperative node positivity on imaging or FNA or timing of chemotherapy. Conclusion: In this single institution series, SLN non-localization was a rare event and not associated with NCT. We were unable to identify any patient or disease characteristics, imaging or surgical techniques associated with SLN non-localization. The etiology of the lower SLN identification rates with NCT in multi-institutional trials remains to be elucidated. Citation Format: Sugg S, Hayes R, Gbenon A, Lizarraga I, Erdahl L, Weigel R, Liao J, Menda Y, Scott-Conner C. Sentinel lymph node (SLN) localization is highly successful after neoadjuvant chemotherapy (NCT) for breast cancer. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P3-01-11.
Dietary factors have been inconsistently associated with breast cancer risk among various ethnicities. Diet however, may influence breast cancer through mechanisms of obesity. The purpose of this study was to compare intake of dietary chemopreventive nutrients and obesity across three racial/ethnic groups: Latina, African American and Asian women. Methods: Eighty subjects from Inland Empire, California were enrolled into the study from five different sites. Dietary intake was assessed using a validated food frequency questionnaire. The questionnaire includes 19 adjustment questions used to modify food-item responses in regard to fat, fiber, and sodium intake followed by 122 specific food item-lines that capture frequency and serving sizes for select foods. Women also completed a demographic and breast cancer survey. Chi-square tests were used for categorical variables, ANOVA, and Kruskal-Wallis one-way analysis of variance was used for nutrient variables. Results: The age of the study population ranged from 24 to 79. Subjects included 30 Latina, 35 African American and 15 Asian women. The mean body mass index for Latina, African American and Asian women was 26.8±4.2, 30.8±7.24, 24.41±3.85 respectively. Mean fat percent for the three races was 34.21±5.80 for Latina, 41.57±6.33 for African American and 35.5±8.74 for Asian. African American women were significantly (p=0.001) more obese compared to Latina and Asian women. Total breast cancer cases for Latina is 3, African American 6 and Asian 2. Family history of reported breast cancer among Latina, African American and Asian was 0, 11, 0 respectively. There was a significant difference among racially ethic groups in alcohol consumption (p=0.001), alpha carotene (p=0.005), beta-carotene (p=0.031), beta-Cryptoxanthin (p=0.022), Lycopene (p=0.000) MUFA (p=0.017), PUFA (p=0.000) animal protein (0.49) and total Vitamin A (0.044). Conclusion: Significant differences were found in obesity and dietary intake of chemopreventive nutrients among the three racial groups. African Americans had higher rates of obesity and lower consumption of total vegetable intake. This data is consistent with the general US population data in terms of obesity and risk for breast cancer. Further studies will include larger sample size to identify specific nutrients that may protect against breast cancer risk among diverse populations. Citation Format: Padma P. Tadi Uppala, Sozina Katuli, Alfredo Mejia, Sherine Brown-Fraser, Brian Yuen Yau Wong, Ryan Hayes, Maheswari Senthil, Carlos Garberoglio. Role of obesity and dietary chemopreventive nutrients on risk for breast cancer among ethnically diverse women [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 5274.
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