Breast cancer in pregnancy will increase as more women postpone childbearing until later in life. Objective: To review the literature on diagnosis, staging, treatment, and prognosis. Design and Methods: Articles were obtained from MEDLINE (1966-present) using the keywords breast, cancer, carcinoma, and pregnancy. Additional articles were sought using the references of those obtained. A total of 171 articles were found, 125 in English. More than 100 were reviewed, including 7 prospective and 40 retrospective studies, 6 case reports, and at least 47 review articles on various aspects of pregnancy and cancer. Data extraction was performed by 1 reviewer. Results: Diagnostic delays are shorter than in the past but remain common. Mammography has a high falsenegative rate during pregnancy. Biopsy or needle aspi

Background The study of disparities in minority recruitment to cancer clinical trials has focused primarily on inquiries among minority populations. Yet, very little is known about the perceptions of individuals actively involved in minority recruitment to clinical trials within cancer centers. Therefore, we sought to assess the perspectives of cancer center clinical and research personnel on barriers and facilitators to minority recruitment. Methods We conducted 91 qualitative interviews at 5 U.S. cancer centers among 4 stakeholder groups: cancer center leaders, principal investigators, research staff, and referring clinicians. All interviews were recorded and transcribed. Qualitative analyses of response data was focused on identifying prominent themes related to barriers and facilitators to minority recruitment. Results The perspectives of the 4 stakeholder groups were largely overlapping with some variations based on their unique roles in minority recruitment. Four prominent themes were identified: 1) Racial and ethnic minorities are influenced by varying degrees of skepticism related to trial participation; 2) Potential minority participants often face multi-level barriers that preclude them from being offered an opportunity to participate in a clinical trial; 3) Facilitators at both the institutional- and participant-level potentially encourage minority recruitment; and 4) Variation between internal and external trial referral procedures may limit clinical trial opportunities for racial and ethnic minorities. Conclusions Multi-level approaches are needed to address barriers and optimize facilitators within cancer centers to enhance minority recruitment for cancer clinical trials.

The high incidence and debilitating effects of lymphedema must be weighed against the benefits of PMRT. Efforts to prevent lymphedema should be emphasized.

The majority of the adenocarcinomas arising in Barrett esophagus manifest clinically at an advanced stage and have a poor prognosis. As a result of this poor prognosis, much attention has been directed toward the exploration of markers for neoplastic progression in Barrett esophagus. The objective of the present study was to determine the expression of beta-catenin by immunohistochemical analysis in 70 adenocarcinomas developed in Barrett esophagus and to examine its relationship to various prognostic factors currently in use. Abnormal beta-catenin expression, consisting of the loss of membranous staining and the appearance of the nuclear staining, was found in 43 cases (61%). Of patients with the 43 tumors showing abnormal beta-catenin expression, 25 (58%) survived more than 1 year. In contrast, only 7 (26%) of 27 patients with tumors showing normal beta-catenin expression survived longer than 1 year. Most of the superficial (Tis-T1) tumors (83% [10/12]) exhibited abnormal beta-catenin expression compared with only 53% (31/58) in the T2-T3 group. These results suggest a possible correlation among beta-catenin expression, tumor stage, and length of survival as prognostic factors in patients with adenocarcinoma in Barrett esophagus.

The Clinical Translation Science Award (CTSA) initiative calls upon academic health centers to engage communities around a clinical research relationship measured ultimately in terms of public health. Among a few initiatives involving university accountability for advancing public interests, a small CTSA workgroup devised a community engagement (CE) logic model that organizes common activities within a university-community infrastructure to facilitate community engagement in research. While the model focuses on the range of institutional CE inputs, it purposefully does not include an approach for assessing how community engagement influences research implementation and outcomes. Rather, with communities and individuals beginning to transition into new research roles, this article emphasizes studying community engagement through specific relationship types and assessing how expanded research teams contribute to the full spectrum of translational science. The authors propose a typology consisting of three relationship types—engagement, collaboration and shared leadership—to provide a foundation for investigating community–academic contributions to the new CTSA research paradigm. The typology shifts attention from specific community–academic activities and, instead, encourages analyses focused on measuring the strength of relationships through variables like synergy and trust. The collaborative study of CE relationships will inform an understanding of CTSA infrastructure development in support of translational research and its goal, which is expressed in the logic model: better science, better answers, better population health.