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Eggeman H.,University Hospital Magdeburg | Stoblen F.,Hyssensstift Kliniken Essen Mitte | Thill M.,University of Lubeck | Schmid P.,University of Sussex | And 5 more authors.
Anticancer Research | Year: 2011

Background/Aim: The aim of the present study was to investigate the effects of conventional and dose-dense chemotherapy on serum levels of soluble adhesion molecules sICAM-1 and sVCAM-1 in node-positive patients with breast cancer. Patients and Methods: sICAM-1 and sVCAM-1 were measured in the blood serum of 147 patients with breast cancer and with 1 to 3 affected lymph nodes prior to and after conventional or dose-dense chemotherapy within a randomized phase III study (NOGGO trial). Results: The increase in sICAM-1 (p<0.0001) and sVCAM-1 (p<0.001) levels after chemotherapy was statistically significant within the entire sample and the dose-dense study arm. sVCAM-1 levels were not altered by conventional chemotherapy, but were markedly and significantly increased after the dose-dense regimen. Higher sICAM-1 concentrations were found in postmenopausal patients, and the difference was significant before, but not after treatment. There was no significant correlation with other prognostic criteria. Conclusion: Both sVCAM-1 and sICAM-1 levels changed significantly after adjuvant chemotherapy, the effect being more marked under the dose-dense regimen. The possible prognostic relevance of adhesion molecule concentration and the effect of different modes of chemotherapy remains to be determined. Source


Stoblen F.,Hyssensstift Kliniken Essen Mitte | Landt S.,Heinrich Heine University Dusseldorf | Stelkens-Gebhardt R.,Hyssensstift Kliniken Essen Mitte | Sehouli J.,Charite - Medical University of Berlin | And 2 more authors.
Anticancer Research | Year: 2011

Background/Aim: Automated ultrasound examination of suspicious findings can reduce the physician's workload in screening mammography. The present study examines the diagnostic accuracy of this method in comparison to mammography as the reference standard for the first time. Patients and Methods: A total of 304 patients underwent automated 3D ultrasound examination after screening mammography. Mammograms and ultrasound images were assessed by independent examiners, and sensitivity, specificity and the degree of agreement between both methods were calculated. Results: The degree of agreement was moderate (Cohen's K=0.130 for all and 0.153 for positive/negative ratings), mainly owing to a high percentage of false-positive ultrasound results. However, the results of sonographical reexamination of suspicious mammograms were favorable. The only two undetected proven malignant lesions were microcalcified, and in three more cases with disagreement, the ultrasound diagnosis was correct. Conclusion: Automated 3D ultrasound imaging appears to be on a par with hand-held ultrasound in terms of diagnostic quality. Source


Stoblen F.,Hyssensstift Kliniken Essen Mitte | Landt S.,Heinrich Heine University Dusseldorf | Ishaq R.,Toshiba Medical Systems GmbH | Stelkens-Gebhardt R.,Hyssensstift Kliniken Essen Mitte | And 5 more authors.
Anticancer Research | Year: 2011

Aim: To retrospectively evaluate the diagnostic value of high-frequency ultrasound for the detection of microcalcifications screening in BI-RADS 4a patients. Patients and Methods: A total of 52 women (mean age 60.5±65 years) classified as BI-RADS 4a with microcalcifications, but without associated masses after X-ray mammography (XRM) underwent ultrasound (US) examination (B-mode, ApliPure™, and MicroPure™ imaging). The results were assessed by two independent investigators and analyzed in relation to the B-classification. Written informed consent was obtained before enrolment. Results: The rate of US microcalcification detection was 98.1% (B-mode), 100% (ApliPure™) and 25% (MicroPure™), respectively. The microcalcification extent was significantly underestimated with all US modalities in comparison with XRM, but the difference was lower for ApliPure™ as compared to B-mode. ApliPure™ was also superior in terms of puncture feasibility, facilitating US-guided biopsy in 673% as compared to 48.1% (B-mode) and 15.4% (MicroPure™). Conclusion: In BI-RADS 4a patients, both high-frequency B-mode US and ApliPure™ imaging are highly sensitive for the detection of microcalcifications, whereas MicroPure™ ultrasound imaging is unsuitable. ApliPure™ imaging allowed US guided biopsy for 67.3% of lesions, providing a convenient and economical alternative to stereotactically guided biopsy. Source

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