Center des Maladies du Sein Deschenes Fabia

Québec, Canada

Center des Maladies du Sein Deschenes Fabia

Québec, Canada
SEARCH FILTERS
Time filter
Source Type

Diorio C.,Center des Maladies du Sein Deschenes Fabia | Diorio C.,Laval University
Cancer Causes and Control | Year: 2014

Abstract: Purpose: Omega-3 (n-3) and n-6 fatty acids (FA) intake could influence the occurrence of certain diseases such as breast cancer but little is known about their relation to mammographic density (MD). The purpose of this study is to examine the association of the intake of n-3 FA and n-6 FA with MD among 777 premenopausal and 783 postmenopausal women. Methods: In this cross-sectional study, FA intake was assessed with a self-administered food-frequency questionnaire and MD was measured using a computer-assisted method. Multivariate analyses were performed by using generalized linear models to evaluate the associations of quartiles of FA intake with MD. Results: For increasing quartiles of total long-chain n-3 FA intake (< 0.11, 0.11-0.20, 0.21-0.32, and ≥ 0.33 g/day), adjusted mean MD was 29, 29, 27, and 25 %, respectively (P trend = 0.005). This association remained significant among postmenopausal (P trend = 0.006) but not among premenopausal (P trend = 0.21) women. No significant association was found between n-6 FA intake and MD. However, for increasing quartiles of the n-6 FA/long-chain n-3 FA ratio intake (< 31.75, 31.75-52.28, 52.29-94.28, and ≥ 94.29), adjusted mean MD was 26, 27, 29, and 29 %, respectively (P trend = 0.008). Conclusions: Higher intake of long-chain n-3 FA was associated with lower MD, suggesting that increased long-chain n-3 FA intake could be a strategy for breast cancer prevention. © 2014 Springer Science+Business Media Dordrecht.


Hanna M.,Laval University | Diorio C.,Center des Maladies du Sein Deschenes Fabia | Diorio C.,Laval University
Climacteric | Year: 2013

Mammographic density reflects variation in breast tissue composition as detected on mammogram. It is associated with a number of well-known breast cancer risk factors and itself is considered one of the strongest risk factors for breast cancer. If the expression of several proteins and genes within the breast tissue influences mammographic density in the same way as it influences breast cancer risk, then mammographic density might serve as an intermediate biomarker in future epidemiological studies on breast cancer. This has the potential to provide a quick means for predicting the effect of changes in the breast microenvironment on breast cancer risk without having to wait for an eventual development of breast cancer. In this review, the expression of several proteins and genes (growth factors, enzymes, proteoglycans and pro-inflammatory markers) within the breast tissue is shown to be associated with mammographic density. These proteins and genes are suspected to play a role in breast carcinogenesis. More studies assessing differential expression of proteins and genes in mammary epithelium and stroma and their association with mammographic density among premenopausal and postmenopausal women are required. Identification of proteins and genes influencing mammographic density may provide further insight on the molecular causes of breast cancer. © 2013 International Menopause Society.


Miles D.W.,Mount Vernon Cancer Center | De Haas S.L.,Hoffmann-La Roche | Dirix L.Y.,St Augustinus Hospital | Romieu G.,Center Re Gionale Of Lutte Contre Le Cancer | And 7 more authors.
British Journal of Cancer | Year: 2013

Background: Combining bevacizumab with first-line chemotherapy significantly improves progression-free survival (PFS) in HER2-negative metastatic breast cancer (mBC). However, identification of patients benefitting most from bevacizumab remains elusive. The AVADO trial included an extensive optional exploratory biomarker programme. Methods: Patients with HER2-negative mBC were randomised to receive docetaxel with placebo or bevacizumab. The primary end point was PFS. Plasma samples were analysed using a multiplex ELISA. Blood mRNA expression was assessed using quantitative PCR. Tumour tissue samples were analysed by immunohistochemistry. Single-nucleotide polymorphisms (SNPs) involved in the VEGF pathway were analysed in germline DNA.Results:Samples for biomarker analysis were available from 24-54% of the 736 treated patients (depending on specimen type). The most consistent potential predictive effect was observed with plasma VEGF-A and VEGFR-2; high baseline concentrations were associated with greater treatment effect. Blood mRNA analyses suggested a greater bevacizumab effect in patients with high VEGF 121. No consistent predictive effect was seen for tumour neuropilin or other candidate tumour markers by immunohistochemistry, or for any of the SNPs investigated. Conclusion: Plasma VEGF-A and VEGFR-2 are potential predictive markers for bevacizumab efficacy, supporting findings in gastric and pancreatic cancers. Plasma VEGF-A is being evaluated prospectively in mBC in the MERiDiAN trial. © 2013 Cancer Research UK. All rights reserved.


Berube S.,Center des maladies du sein Deschenes Fabia | Lemieux J.,Center des maladies du sein Deschenes Fabia | Lemieux J.,Laval University | Moore L.,Laval University | And 4 more authors.
Breast Cancer Research | Year: 2014

Introduction: In women with breast cancer who smoke, it is unclear whether smoking could impair their survival from the disease.Methods: We examined the relation of smoking at diagnosis to breast cancer-specific and overall survival among 5,892 women with invasive breast cancer treated in one Canadian center (1987 to 2008). Women were classified as never, former or current smokers. Current smokers were further classified according to total, intensity and duration of smoking. Deaths were identified through linkage to population mortality data. Cox proportional-hazards multivariate models were used. A systematic review with meta-analysis combines new findings with published results.Results: Compared with never smokers, current smokers at diagnosis had a slightly, but not statistically significant, higher breast cancer-specific mortality (hazard ratio = 1.15, 95% confidence interval (CI): 0.97 to 1.37). Among current smokers, breast cancer-specific mortality increased with total exposure to, intensity and duration of smoking (all Ptrend <0.05). Compared to never smokers, breast cancer-specific mortality was 32 to 56% higher among heavy smokers (more than 30 pack years of smoking, more than 20 cigarettes per day or more than 30 years of smoking). Smoking at diagnosis was associated with an increased all-cause mortality rate. A meta-analysis of all studies showed a statistically significant, 33% increased mortality from breast cancer in women with breast cancer who are smokers at diagnosis compared to never smokers (hazard ratio = 1.33, 95% CI: 1.12 to 1.58).Conclusions: Available evidence to date indicates that smoking at diagnosis is associated with a reduction of both overall and breast cancer-specific survival. Studies of the effect of smoking cessation after diagnosis on breast cancer-specific outcomes are needed. © 2014 Bérubé et al.; licensee BioMed Central Ltd.


PubMed | Osaka National Hospital, Jules Bordet Cancer Institute, AZ Nikolaas, Sloan Kettering Cancer Center and 8 more.
Type: Journal Article | Journal: Journal of clinical oncology : official journal of the American Society of Clinical Oncology | Year: 2017

LBA509 Background: Everolimus (EVE) plus exemestane (EXE) more than doubled progression-free survival (PFS) while maintaining quality of life vs EXE alone in postmenopausal women with hormone-receptor positive (HRExon sequence and gene copy number variations were analyzed in 182 cancer-related genes by next-generation sequencing (NGS). Correlations with PFS were evaluated using both univariate and multivariate Cox models.NGS data (>250x coverage) were successfully generated from archival tumor specimens from 227 patients (NGS population, 157 and 70 in EVE+EXE and EXE arms, respectively) whose baseline characteristics and clinical outcome were comparable with the trial population (PFS HR = 0.40 and 0.45, respectively). The treatment benefit of EVE+EXE over EXE is maintained in the subgroups defined by each of the nine genes with a mutation rate >10% (eg, PIK3CA, FGFR1, and CCND1), or when less frequently mutated genes (eg, PTEN, AKT1) were included in their respective pathways. Patients with no or only 1 genetic alteration in PI3K or FGFR pathways, or CCND1, had a greater treatment effect from EVE (HR = 0.27, 95% CI 0.18-0.41, adjusted by covariates, in 76% of the NGS population), indicating the value of these pathways for predicting sensitivity/resistance to EVE in this setting.This is the first global registration trial in which efficacy-predictive biomarkers were explored by correlating broad genetic variations with clinical efficacy. It demonstrated the feasibility of applying large-scale NGS and subsequent correlative analysis to such trials. The observations suggest that a large subgroup of patients (76%), defined by minimal genetic variations in the PI3K or FGFR pathways, or CCND1, derives the most benefit from EVE therapy (HR = 0.27 vs 0.40 for the full NGS population). These exploratory results and their implication in understanding the interplay of multiple pathways in tumor cells and testing new hypotheses for targeted combination therapies in HRNCT00863655.


PubMed | Osaka National Hospital, Novartis, University of Houston, Sloan Kettering Cancer Center and 9 more.
Type: Journal Article | Journal: Journal of clinical oncology : official journal of the American Society of Clinical Oncology | Year: 2017

142 Background: Everolimus (EVE) plus exemestane (EXE) more than doubled progression-free survival (PFS) while maintaining quality of life vs EXE alone in postmenopausal women with hormone receptor-positive (HR+), HER2-negative (HER2-) advanced breast cancer (BOLERO-2 phase III; NCT00863655). PFS benefit was seen in all clinically defined subgroups. We evaluated genetic variations of a broad panel of cancer-related genes and explored their correlations with EVE benefit.Exon sequence and gene copy number variations were analyzed in 182 cancer-related genes by next-generation sequencing (NGS). Correlations with PFS were evaluated using univariate and multivariate Cox models.NGS data (>250x coverage) were successfully generated from archival tumor specimens from 227 patients (NGS population, 157 in EVE + EXE arm and 70 in EXE arm) whose baseline characteristics and clinical outcome were comparable to the trial population (PFS HR = 0.40 and 0.45, respectively). The treatment benefit of EVE + EXE over EXE was maintained in the subgroups defined by each of the 9 genes with a mutation rate >10% (e.g., PIK3CA, FGFR1, CCND1) or when less frequently mutated genes (e.g., PTEN, AKT1) were included in their respective pathways. Patients with 0 or 1 genetic alteration in PI3K or FGFR pathways or CCND1 had a greater treatment effect from EVE (HR = 0.27, 95% CI 0.18-0.41, adjusted by covariates, in 76% of the NGS population), indicating the value of these pathways for predicting sensitivity to EVE in this setting.This is the first global registration trial in which efficacy-predictive biomarkers were explored by correlating broad genetic variations with clinical efficacy. The preliminary results suggest that a large subgroup of patients (76%), defined by minimal genetic variations in the PI3K or FGFR pathways or CCND1, derives the most benefit from EVE therapy (HR = 0.27 vs 0.40 for the full NGS population). These exploratory results and their implication in understanding the interplay of multiple pathways in tumor cells and testing new hypotheses for targeted combination therapies in HR+/HER2- BC will be further investigated.NCT00863655.


Pritchard K.I.,University of Toronto | Gelmon K.A.,BC Cancer Agency | Rayson D.,Health science Center | Provencher L.,Center des Maladies du Sein Deschenes Fabia | And 3 more authors.
Current Oncology | Year: 2013

Approximately 22,700 Canadian women were expected to be diagnosed with breast cancer in 2012. Despite improvements in screening and adjuvant treatment options, a substantial number of postmenopausal women with hormone receptor positive (hr+) breast cancer will continue to develop metastatic disease during or after adjuvant endocrine therapy. Guidance on the selection of endocrine therapy for patients with hr+ disease that is negative for the human epidermal growth factor receptor 2 (her2-) and that has relapsed or progressed on earlier nonsteroidal aromatase inhibitor (nsai) therapy is of increasing clinical importance. Exemestane, fulvestrant, and tamoxifen are approved therapeutic options in this context. Four phase iii trials involving 2876 patients-efect, sofea, confirm, and bolero-2-have assessed the efficacy of various treatment options in this clinical setting. Data from those trials suggest that standard-dose fulvestrant (250 mg monthly) and exemestane are of comparable efficacy, that doubling the dose of fulvestrant from 250 mg to 500 mg monthly results in a 15% reduction in the risk of progression, and that adding everolimus to exemestane (compared with exemestane alone) results in a 57% reduction in the risk of progression, albeit with increased toxicity. Multiple treatment options are now available to women with hr+ her2- advanced breast cancer recurring or progressing on earlier nsai therapy, although current clinical trial data suggest more robust clinical efficacy with everolimus plus exemestane. Consideration should be given to the patient's age, functional status, and comorbidities during selection of an endocrine therapy, and use of a proactive everolimus safety management strategy is encouraged. © 2013 Multimed Inc.


Hathout L.,Center Affilie niversite Of Montreal | Hijal T.,McGill University | Theberge V.,University of Québec | Theberge V.,Center des Maladies du Sein Deschenes Fabia | And 10 more authors.
International Journal of Radiation Oncology Biology Physics | Year: 2013

Purpose Conventional radiation therapy (RT) administered in 25 fractions after breast-conserving surgery (BCS) is the standard treatment for ductal carcinoma in situ (DCIS) of the breast. Although accelerated hypofractionated regimens in 16 fractions have been shown to be equivalent to conventional RT for invasive breast cancer, few studies have reported results of using hypofractionated RT in DCIS. Methods and Materials In this multicenter collaborative effort, we retrospectively reviewed the records of all women with DCIS at 3 institutions treated with BCS followed by hypofractionated whole-breast RT (WBRT) delivered in 16 fractions. Results Between 2003 and 2010, 440 patients with DCIS underwent BCS followed by hypofractionated WBRT in 16 fractions for a total dose of 42.5 Gy (2.66 Gy per fraction). Boost RT to the surgical bed was given to 125 patients (28%) at a median dose of 10 Gy in 4 fractions (2.5 Gy per fraction). After a median follow-up time of 4.4 years, 14 patients had an ipsilateral local relapse, resulting in a local recurrence-free survival of 97% at 5 years. Positive surgical margins, high nuclear grade, age less than 50 years, and a premenopausal status were all statistically associated with an increased occurrence of local recurrence. Tumor hormone receptor status, use of adjuvant hormonal therapy, and administration of additional boost RT did not have an impact on local control in our cohort. On multivariate analysis, positive margins, premenopausal status, and nuclear grade 3 tumors had a statistically significant worse local control rate. Conclusions Hypofractionated RT using 42.5 Gy in 16 fractions provides excellent local control for patients with DCIS undergoing BCS. © 2013 The Authors. Published by Elsevier Inc. All rights reserved.


Rainville F.,Laval University | Dumont S.,Laval University | Simard S.,University of Québec | Savard M.-H.,Center des Maladies du Sein Deschenes Fabia
Journal of Psychosocial Oncology | Year: 2012

The objective of this exploratory study was to evaluate the impact of advanced parental cancer on adolescents psychological status. A sample of 28 adolescents, having a parent with advanced cancer, was recruited and compared with a sample from the general population (N = 2,346). Late adolescents (age 15 to 18) experienced significantly more psychological distress than early adolescents (age 12 to 14). Moreover, late adolescents experienced significantly higher psychological distress than the general population for the same age group, which was not the case for early adolescents. Implications for adolescents living in families touched by advanced cancer are discussed. © 2012 Taylor & Francis Group, LLC.


Lemieux J.,Center des Maladies du Sein Deschenes Fabia | Lemieux J.,University of Québec | Lemieux J.,Laval University | Desbiens C.,Center des Maladies du Sein Deschenes Fabia | And 3 more authors.
Breast Cancer Research and Treatment | Year: 2011

Chemotherapy-induced alopecia is a commonly feared chemotherapy side effect and can be prevented using scalp cooling. Scalp metastasis is a rare site of recurrence. There is a question about whether or not the risk might be increased with the use of scalp cooling. Two cases of breast cancer with scalp metastases as first metastatic site are presented. The first patient presented with a scalp metastasis as first metastatic site 9 years following breast cancer chemotherapy treatments; she used scalp cooling for the adjuvant treatment. Second case presented a scalp metastasis as first metastatic site 7 years following treatments for her first cancer; overall, she used scalp cooling in only one of her six adjuvant chemotherapy cycles. Scalp metastases as the first site of recurrence are very rare entities. Scalp cooling is unlikely to have contributed in the cases presented here. © 2011 Springer Science+Business Media, LLC.

Loading Center des Maladies du Sein Deschenes Fabia collaborators
Loading Center des Maladies du Sein Deschenes Fabia collaborators