Background/Aim: The aim of the study was to investigate the efficacy of neoadjuvant and chemotherapy (NACT) and adjuvant chemotherapy (ACT) in Hispanic/Latino (H/L) women with TNBC. Patients and Methods: We reviewed the charts of patients with TNBC, stages I-III, treated at TTUHSC from 2006 to 2016. Overall survival (OS) and recurrence-free survival (RFS) were estimated and compared between the treatment groups. Kaplan-Meier curve and Cox proportional hazards regression analyses were conducted to estimate unadjusted and adjusted effects of NACT compared to ACT. Results: A total of 104 patients with TNBC, 30 (29%) received NACT and 74 (71%) ACT. Women undergoing NACT were younger, with a mean age of 50.8 years. Of the 30 patients who received NACT, 12 (40%) had pathologically complete response (pCR). Women who achieved pCR had an excellent RFS (HR=0.5, p=0.001). Women with residual cancer after NACT had worse outcome compared to patients who received ACT (HR=1.7, p=0.005). Conclusion: pCR to NACT is a powerful surrogate for OS in H/L women with TNBC. Breast cancer is the second leading cause of cancer death after lung cancer. In 2019, the American Cancer Association estimated that there were 252,700 new cases of breast cancer in the United States and 41,000 deaths from the disease (1, 2). Breast cancer is a heterogeneous disease, biologically characterized by the expression of one or more steroid hormone receptors such as estrogen receptor (ER) or progesterone receptor (PR) along with the oncogeneepidermal growth factor receptor ErbB2 (Her-2neu). Of those subtypes, triple-negative breast cancer (TNBC) is biologically defined by the absence of expression of ER, PR, and Her-2neu receptors (3). It is a heterogenic subgroup of breast cancer that comprises approximately 15% of all types of breast cancer. TNBC is highly aggressive and has worse disease-specific outcomes than any other subtype of breast cancer (3, 4). One possible explanation is the absence of well-defined molecular targets such as ER, PR, or Her2-neu, which limits options for treating this subtype of breast cancer. Systemic chemotherapy has remained the only available option for these patients for almost two decades. Historically, NACT has been used to downstage unresectable breast cancer to allow for better locoregional control and to increase the chance for breast-conserving surgery. It has been recognized that NACT represents an excellent in vivo approach to directly test tumor sensitivity to chemotherapy. Unfortunately, the large National Surgical Adjuvant Breast and Bowel Project (NSABP) randomized clinical trial B-18 did not show any statistically significant difference in the overall survival (OS) between patients who underwent NACT and those who underwent adjuvant chemotherapy (ACT) (5). There was, however, a trend in favor of NACT in women younger than 50 years of age. The major limitation of the B-18 trial was the lack of subgroup analysis by hormonal status. Furthermore, multiple published retrospective clinical studies comparing the efficacy...

The mean age was 61.6±9.4 years, and 109 (91.6%) selfidentified as Hispanic/Latino. A total of 58% reported an annual income of $15,000 or less. Overall, 40.3% had completed eighth grade or less education, 31.9% high school, and 12% had obtained a technical degree. The majority of patients (56%) had either a medium (45%) or a low level of adherence (11%). High adherence was noted in 44% of participants. Seven (5.6%) patients scored 2 or below on a 4-point scale for intentional adherence, and 18 (13.5%) scored 2 or below on a 4-point scale for unintentional adherence. Conclusion: These data suggest that the majority of Hispanic/Latino women with breast cancer have medium or low levels of adherence to therapy with AIs. Factors associated with medium and low adherence were unintentional (forgetfulness), but also included intentional factors, such as avoidance of adverse effects and delays with obtaining refills (cost-related nonadherence). Breast cancer (BC) is the second leading cause of cancer death after lung cancer in the United States (1). In 2018, the American Cancer Association estimated that there were 252,700 new cases of BC in the United States and 41,000 deaths from the disease (1). It is the major type of cancer among Hispanic/Latino women in the United States, with approximately 20,000 new cases and 3,000 deaths per year(2). From 2003 to 2018, the incidence rate of BC remained stable in both Hispanic and non-Hispanic White women (2). The use of screening mammography and advances in treatment modalities including the use of adjuvant endocrine therapy have contributed to the reduction of mortality from BC in the United States by approximately 24% since 1990 (3). Multiple studies have shown substantial benefits from adjuvant endocrine therapy in improving progression-free and overall survival (4-7). For almost two decades, adjuvant endocrine therapy with an aromatase inhibitor (AI) has remained a gold-standard for patients with hormonal receptor-positive BC. In 2003, the first results of ATAC (arimidex, tamoxifen, alone or in combination) phase 857 This article is freely accessible online.

Breast cancer patients receiving endocrine therapy with aromatase Inhibitors (AIs) often experience musculoskeletal and joint-related side effects. The purpose of this study was to evaluate the effect of Vitamin B12 supplements on musculoskeletal symptoms such as pain and arthralgias induced by AIs and to correlate response with serum and inflammatory biomarkers. Upon receiving approval by the Institutional Review Board (IRB), the majority of the patients consented into the study were treated at the Texas Tech Breast Care Center. Included were patients who had a diagnosis of invasive breast cancer (Stages I-III), and were experiencing significant musculoskeletal symptoms associated to AIs. Only patients with an average pain score ≥ 4, as assessed by the Brief Pain Inventory-Short Form (BPI-SF) questionnaire, were included in the study. Participants received 2500 mcg of sublingual vitamin B12 daily for 90 days. Assessments at baseline and at 3 months included: BPI-SF pain scores, the impact on quality of life determined by Functional Assessment of Cancer Therapy-Endocrine Symptoms (FACT-ES), and correlative serum markers relative to baseline (a pre-post study). A total of forty-one patients were enrolled. Average pain scores were improved by 34% (P < .0001) at 3 months compared to baseline. In addition, a 23% improvement in worst pain was noted (P = .0003). Analysis of the results for the FACT-ES scoring showed improvement on all scales. No significant adverse events were observed. Decrease in pain score was correlated with increased serum B12 levels. This study suggests that Vitamin B12 reduces pain and improves quality of life for patients taking AIs who experienced AI-related musculoskeletal symptoms. If confirmed in large randomized prospective trials, Vitamin B12 would be a safe and cost-effective option for the treatment of AI-related musculoskeletal symptoms.