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811 results on '"Browne L"'

1. Using the Agile software development lifecycle to develop a standalone application for generating colour magnitude diagrams

Author

Fitzgerald, K., Browne, L. -M., and Butler, R. F.

Subjects
Astrophysics - Instrumentation and Methods for Astrophysics, Astrophysics - Astrophysics of Galaxies, Computer Science - Software Engineering
Abstract

Virtual observatories allow the means by which an astronomer is able to discover, access, and process data seamlessly, regardless of its physical location. However, steep learning curves are often required to become proficient in the software employed to access, analyse and visualise this trove of data. It would be desirable, for both research and educational purposes, to have applications which allow users to visualise data at the click of a button. Therefore, we have developed a standalone application (written in Python) for plotting photometric Colour Magnitude Diagrams (CMDs) - one of the most widely used tools for studying and teaching about astronomical populations. The CMD Plot Tool application functions "out of the box" without the need for the user to install code interpreters, additional libraries and modules, or to modify system paths; and it is available on multiple platforms. Interacting via a graphical user interface (GUI), users can quickly and easily generate high quality plots, annotated and labelled as desired, from various data sources. This paper describes how CMD Plot Tool was developed using Object Orientated Programming and a formal software design lifecycle (SDLC). We highlight the need for the astronomical software development culture to identify appropriate programming paradigms and SDLCs. We outline the functionality and uses of CMD Plot Tool, with examples of star cluster photometry. All results plots were created using CMD Plot Tool on data readily available from various online virtual observatories, or acquired from observations and reduced with IRAF/PyRAF.

Published
2019
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2. An investigation of lipid modulation of low voltage activated currents in spiral ganglion neurons

Author

Browne, L. P., Jagger, D., Selwood, D., and McAlpine, D.

Subjects
617.8
Abstract

Type I spiral ganglion neurons (SGNs) synapse onto cochlear inner hair cells and constitute the majority of afferent fibres in the auditory nerve (AN). Better characterisation of their biophysical properties may identify therapeutic targets for optimising AN sensitivity. This study aimed to characterise the membrane physiology underlying the firing properties of post-hearing onset SGNs and investigated whether their properties could be modified by the presence of native and synthetic lipids. In dissociated ganglionic cultures, SGNs displayed an intrinsic variation in their firing properties; this could be correlated with the magnitudes of specific membrane currents. SGNs were categorised by their response to depolarising current injection; SGNs either adapted to the stimulus rapidly, slowly or not at all. Rapid adaptation, a mechanism that preserves temporal precision throughout the auditory system, was found to be regulated by a dendrotoxin-K (DTX-K) and tityustoxin-Kα (TsTx)-sensitive low-threshold voltage-activated (LVA) K+ current, suggesting contribution by Kv1.1 and Kv1.2 subunits. As Kv1.2 channels were known to be positively modulated by membrane phosphoinositides, we investigated the influence of phosphatidylinositol-4,5- bisphosphate (PIP2) availability on SGN K+ currents. Inhibiting PIP2 production using wortmannin, or sequestration using a palmitoylated peptide (PIP2-PP), slowed or abolished adaptation in SGNs. PIP2-PP specifically reduced SGN LVA currents in a manner that was partly rescued by intracellular dialysis with diC8PIP2, a nonhydrolysable analogue of PIP2. PIP2-PP application induced similar levels of current inhibition in Kv1.1/Kv1.2 channels heterologously expressed in HEK293 cells. Accordingly, the lipid sensitivity of the Kv1.2 channel was further explored with a range of native and synthetic free fatty acids. Polyunsaturated fatty acids were found to be strong inhibitors of Kv1.2 currents, offering further potential candidates for SGN modulation. Collectively, this data identifies Kv1.1 and Kv1.2 containing K+ channels as key regulators of excitability in the AN, and potential targets for pharmacological modulation.

Published
2016

3. Hummingbird diversity in a fragmented tropical landscape in the Chocó biogeographic zone

Author

Huh, KM, Ellis, M, Castillo, F, Carrasco, L, Rivero de Aguilar, J, Bonaccorso, E, Browne, L, and Karubian, J

Subjects
Ecology, Evolution, Behavior and Systematics
Abstract

Forest loss and fragmentation drive widespread declines in biodiversity. However, hummingbirds seem to exhibit relative resilience to disturbance, characterized by increasing abundance alongside declining species richness and evenness. Yet, how widespread this pattern may be, and the mechanisms by which it may occur, remain unclear. To fill in this knowledge gap, we investigated habitat- and site-level patterns of diversity, and community composition of hummingbirds between continuous forest (transects n = 16 in ~3500 ha) and more disturbed surrounding fragments (n = 39, 2.5–48.0 ha) in the Chocó rain forest of northwestern Ecuador. Next, we assessed within-patch and patch-matrix characteristics associated with hummingbird diversity and composition. We found higher hummingbird species richness in forest fragments relative to the continuous forest, driven by increased captures of rare species in fragments. Community composition also differed between continuous forest and fragments, with depressed evenness in fragments. Increased canopy openness and density of medium-sized trees correlated with hummingbird diversity in forest fragments, although this relationship became nonsignificant after applying false discovery rate (p

Published
2023

4. hist2RNA: An Efficient Deep Learning Architecture to Predict Gene Expression from Breast Cancer Histopathology Images

Author

Mondol, RK, Millar, EKA, Graham, PH, Browne, L, Sowmya, A, Meijering, E, Mondol, RK, Millar, EKA, Graham, PH, Browne, L, Sowmya, A, and Meijering, E

Abstract

Gene expression can be used to subtype breast cancer with improved prediction of risk of recurrence and treatment responsiveness over that obtained using routine immunohistochemistry IHC However in the clinic molecular profiling is primarily used for ER breast cancer which is costly tissue destructive requires specialised platforms and takes several weeks to obtain a result Deep learning algorithms can effectively extract morphological patterns in digital histopathology images to predict molecular phenotypes quickly and cost effectively We propose a new computationally efficient approach called hist2RNA inspired by bulk RNA sequencing techniques to predict the expression of 138 genes incorporated from 6 commercially available molecular profiling tests including luminal PAM50 subtype from hematoxylin and eosin H amp E stained whole slide images WSIs The training phase involves the aggregation of extracted features for each patient from a pretrained model to predict gene expression at the patient level using annotated H amp E images from The Cancer Genome Atlas TCGA n 335 We demonstrate successful gene prediction on a held out test set n 160 corr 0 82 across patients corr 0 29 across genes and perform exploratory analysis on an external tissue microarray TMA dataset n 498 with known IHC and survival information Our model is able to predict gene expression and luminal PAM50 subtype Luminal A versus Luminal B on the TMA dataset with prognostic significance for overall survival in univariate analysis c index 0 56 hazard ratio 2 16 95 CI 1 12 3 06 i p i lt 5 10 sup 3 sup and independent significance in multivariate analysis incorporating standard clinicopathological variables c index 0 65 hazard ratio 1 87 95 CI 1 30 2 68 i p i lt 5 10 sup 3 sup The proposed strategy achieves superior performance while requiring less training time resulting in less energy consumption and computational cost compared to patch based models Additionally hist2RNA predicts gene expression that

Published
2023

8. Uptake of the culturally appropriate ASQ-TRAK developmental screening tool in the Australian Aboriginal and Torres Strait Islander context

Author

D'Aprano, A, Brookes, I, Browne, L, Bartlett, C, D'Aprano, A, Brookes, I, Browne, L, and Bartlett, C

Abstract

BACKGROUND: Recently in Australia, access to culturally safe developmental practices for Aboriginal and Torres Strait Islander families has been enhanced by the availability of a culturally appropriate developmental screening tool, the Ages and Stages Questionnaire - Talking about Raising Aboriginal Kids (ASQ-TRAK). This paper aims (i) to describe the uptake of the ASQ-TRAK developmental screening tool in Aboriginal Community Controlled Organizations and mainstream services in Australia and (ii) to explore the extent to which organizations using the ASQ-TRAK have engaged training for staff. METHODS: A retrospective review of ASQ-TRAK sales and training records from January 2015 to May 2020 to determine the ASQ-TRAK distribution by jurisdiction and service type and the number of services that have engaged training. RESULTS: Five hundred ASQ-TRAK kits have been distributed across 77 agencies. Of those, 100 kits (20%) have been purchased by Aboriginal Community Controlled Organizations. Most have been distributed in the Northern Territory (NT) (178, 36%), Western Australia (165, 33%) and South Australia (64, 13%). Of the 15 ASQ-TRAK training workshops, nine have been in the NT. Of the 196 practitioners trained, 25 were identified as facilitators for their organization. CONCLUSION: Despite substantive research translation across Australia, with evidence of its acceptability in different contexts, most Aboriginal Community Controlled Organizations have not yet accessed the ASQ-TRAK, and most organizations have not participated in training. There is an imperative to progress knowledge translation to improve quality and accessibility of culturally appropriate developmental care. Adequately resourced ASQ-TRAK implementation support is needed to ensure sustainable implementation at scale.

Published
2022

10. Impact of Prehospital Pain Management on Emergency Department Management of Injured Children

Author

Harris, M. I., primary, Adelgais, K. M., additional, Linakis, S. W., additional, Magill, C. F., additional, Brazauskas, R., additional, Shah, M. I., additional, Nishijima, D. K., additional, Lowe, G. S., additional, Chadha, K., additional, Chang, T. P., additional, Lerner, E. B., additional, Leonard, J. C., additional, Schwartz, H. P., additional, Gaither, J. B., additional, Studnek, J. R., additional, and Browne, L. R., additional

Published
2021
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13. Impact of Prehospital Pain Management on Emergency Department Management of Injured Children.

Author

Harris, M. I., Adelgais, K. M., Linakis, S. W., Magill, C. F., Brazauskas, R., Shah, M. I., Nishijima, D. K., Lowe, G. S., Chadha, K., Chang, T. P., Lerner, E. B., Leonard, J. C., Schwartz, H. P., Gaither, J. B., Studnek, J. R., and Browne, L. R.

Subjects
WOUND care, RESEARCH, ANALGESIA, HOSPITAL emergency services, TRANSPORTATION of patients, HEALTH outcome assessment, MANN Whitney U Test, SEVERITY of illness index, MATHEMATICAL variables, EMERGENCY medical services, KAPLAN-Meier estimator, DESCRIPTIVE statistics, CHI-squared test, RESEARCH funding, DATA analysis software, PAIN management, EMERGENCY medicine, SECONDARY analysis, LONGITUDINAL method, CHILDREN
Abstract

Provision of analgesia for injured children is challenging for Emergency Medical Services (EMS) clinicians. Little is known about the effect of prehospital analgesia on emergency department (ED) care. We aimed to determine the impact of prehospital pain interventions on initial ED pain scale scores, timing and dosing of ED analgesia for injured patients transported by EMS. This is a planned, secondary analysis of a prospective multicenter cohort of children with actual or suspected injuries transported to one of 11 PECARN-affiliated EDs from July 2019-April 2020. Using Wilcoxon rank sum for continuous variables and chi-square testing for categorical variables, we compared the change in EMS-to-ED pain scores and timing and dosing of ED-administered opioid analgesia in those who did and those who did not receive prehospital pain interventions. We enrolled 474 children with complete prehospital and ED pain management data. Prehospital interventions were performed on 262/474 (55%) of injured children and a total of 88 patients (19%) received prehospital opioids. Children who received prehospital opioids with or without adjunctive non-pharmacologic pain management experienced a greater reduction in pain severity and were more likely to receive ED opioids in higher doses earlier and throughout their ED care. Non-pharmacologic pain interventions alone did not impact ED care. We demonstrate that prehospital opioid analgesia is associated with both a significant reduction in pain severity at ED arrival and the administration of higher doses of opioid analgesia earlier and throughout ED care. [ABSTRACT FROM AUTHOR]

Published
2023
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19. Multiplexed immunofluorescence identifies high stromal CD68+PD-L1+ macrophages as a predictor of improved survival in triple negative breast cancer.

Author

Wang, J, Browne, L, Slapetova, I, Shang, F, Lee, K, Lynch, J, Beretov, J, Whan, R, Graham, PH, Millar, EKA, Wang, J, Browne, L, Slapetova, I, Shang, F, Lee, K, Lynch, J, Beretov, J, Whan, R, Graham, PH, and Millar, EKA

Abstract

Triple negative breast cancer (TNBC) comprises 10-15% of all breast cancers and has a poor prognosis with a high risk of recurrence within 5 years. PD-L1 is an important biomarker for patient selection for immunotherapy but its cellular expression and co-localization within the tumour immune microenvironment and associated prognostic value is not well defined. We aimed to characterise the phenotypes of immune cells expressing PD-L1 and determine their association with overall survival (OS) and breast cancer-specific survival (BCSS). Using tissue microarrays from a retrospective cohort of TNBC patients from St George Hospital, Sydney (n = 244), multiplexed immunofluorescence (mIF) was used to assess staining for CD3, CD8, CD20, CD68, PD-1, PD-L1, FOXP3 and pan-cytokeratin on the Vectra Polaris™ platform and analysed using QuPath. Cox multivariate analyses showed high CD68+PD-L1+ stromal cell counts were associated with improved prognosis for OS (HR 0.56, 95% CI 0.33-0.95, p = 0.030) and BCSS (HR 0.47, 95% CI 0.25-0.88, p = 0.018) in the whole cohort and in patients receiving chemotherapy, improving incrementally upon the predictive value of PD-L1+ alone for BCSS. These data suggest that CD68+PD-L1+ status can provide clinically useful prognostic information to identify sub-groups of patients with good or poor prognosis and guide treatment decisions in TNBC.

Published
2021

22. FRUIT REMOVAL BY LARGE AVIAN FRUGIVORES VARIES IN RELATION TO HABITAT QUALITY IN CONTINUOUS NEOTROPICAL RAINFOREST

Author

Mahoney, M. C., Browne, L., Diaz-Martin, Z., Olivo, J., Cabrera, J., Gonzalez, M., Jenny Hazlehurst, and Karubian, J.

Abstract

∙ Animal-mediated seed dispersal shapes key ecological processes including seedling recruitment and demography. Anthropogenic activities have substantively impacted tropical habitats, yet the degree of sensitivity exhibited by different frugivores to changes in habitat quality and how this may impact seed dispersal outcomes remains poorly understood. This is particularly true in contexts of low to moderate habitat alteration. To address this knowledge gap, we characterized the diurnal disperser community for an ecologically important canopy palm, Oenocarpus bataua, in continuous forest with differing degrees of human modification in northwest Ecuador. Our specific goal was to assess the degree to which visitation and fruit removal rates vary in relation to fine-scale forest structure. Frugivory and seed dispersal (i.e., removal of fruits with intact seeds) was dominated by three large bird species; smaller birds and some mammals visited fruiting trees but did not substantively contribute to seed dispersal. One of the three effective dispersal agents, the Long-wattled Umbrellabird (Cephalopterus penduliger), an endangered species threatened by habitat loss and degradation, exhibited higher visitation and fruit consumption rates in areas characterized by denser canopies, suggesting preference for foraging in undisturbed habitat. In contrast, two relatively common toucan species, Chocó Toucan (Ramphastos brevis) and Chestnut-mandibled Toucan (R. swainsonii), exhibited no variation in foraging behavior in relation to the habitat metrics we assessed. These findings highlight the degree to which differences in sensitivity to habitat disturbance among frugivore species may impact foraging ecology and suggest that variation in forest structure within continuous forest can impact seed removal and seed dispersal processes.Resumen ∙ La remoción de frutas por aves frugívoras de gran tamaño varía con respecto a la calidad de hábitat en bosques continuos Neotropicales La dispersión de semillas mediada por animales moldea procesos ecológicos claves como la posterior supervivencia y demografía de plántulas. Las actividades antropogénicas han afectado substancialmente los hábitats tropicales, sin embargo, el nivel de sensibilidad que presentan los diferentes frugívoros a cambios en la calidad del hábitat y cómo esto afecta a la dispersión de semillas, sigue siendo poco conocido. Esto es particularmente cierto en un contexto de poca a moderada alteración de hábitat. Para lograr comprender este vacío de conocimiento caracterizamos la comunidad de dispersores diurnos de una palma de dosel de importancia ecológica, Oenocarpus bataua, en bosques continuos con niveles diferentes de afectación humana en el noroccidente del Ecuador. Nuestro objetivo principal era de conocer el nivel en el cual las visitas y las tasas de remoción de frutas varía en relación a la estructura del bosque a escala muy fina. La frugivoría y la dispersión de semillas (es decir remoción de frutos con semillas intactas) fue dominada por tres especies de aves de gran tamaño; las aves más pequeñas y ciertos mamíferos visitaron palmas en fruto pero no contribuyeron substancialmente a la dispersión de semillas. Uno de los tres agentes de dispersión efectiva – el Pájaro Toro (Cephalopterus penduliger), una especie amenazada debido a la pérdida y degradación de su hábitat – realizó un mayor número de visitas y tasa de consumo de frutos en áreas caracterizadas por doseles más densos, lo cual sugiere una preferencia de forrajeo en hábitats no alterados. Por el contrario, dos especies relativamente comunes de tucanes, Tucán del Chocó (Ramphastos brevis) y Tucán de Pico Castaño (R. swainsonii), no presentaron diferencias en el comportamiento de forrajeo con respecto a las métricas de hábitat que nosotros utilizamos. Estos hallazgos resaltan el nivel en el cual diferencias en la sensibilidad a la alteración del hábitat entre especies frugívoras pueden impactar la ecología de forrajeo. Sugiere también que la variación en la estructura del bosque dentro de bosques continuos puede impactar la remoción de semillas y el proceso de dispersión de las mismas.

Published
2018

41. 20-year risks of breast-cancer recurrence after stopping endocrine therapy at 5 years

Author

Pan, H, Gray, R, Braybrooke, J, Davies, C, Taylor, C, Mcgale, P, Peto, R, Pritchard, Ki, Bergh, J, Dowsett, M, Hayes, Df, Albain, K, Anderson, S, Arriagada, R, Barlow, W, Bartlett, J, Bergsten‐nordström, E, Bliss, J, Boccardo, F, Bradley, R, Brain, E, Cameron, D, Clarke, M, Coates, A, Coleman, R, Correa, C, Costantino, J, Cuzick, J, Davidson, N, Dodwell, D, Di Leo, A, Ewertz, M, Forbes, J, Gelber, R, Gnant, M, Goldhirsch, A, Goodwin, P, Hill, C, Ingle, J, Jagsi, R, Janni, W, Loibl, S, Mackinnon, E, Martin, M, Mukai, H, Norton, L, Ohashi, Y, Paik, S, Perez, E, Piccart, M, Pierce, L, Poortmans, P, Raina, V, Ravdin, P, Regan, M, Robertson, J, Rutgers, E, Slamon, D, Sparano, J, Swain, S, Tutt, A, Viale, G, Von Minckwitz, G, Wang, X, Whelan, T, Wilcken, N, Winer, E, Wolmark, N, Wood, W, Zambetti, M, Alberro, Ja, Ballester, B, Deulofeu, P, Fábregas, R, Fraile, M, Gubern, Jm, Janer, J, Moral, A, De Pablo Jl, Peñalva, G, Puig, P, Ramos, M, Rojo, R, Santesteban, P, Serra, C, Solà, M, Solarnau, L, Solsona, J, Veloso, E, Vidal, S, Abe, O, Abe, R, Enomoto, K, Kikuchi, K, Koyama, H, Masuda, H, Nomura, Y, Sakai, K, Sugimachi, K, Toi, M, Tominaga, T, Uchino, J, Yoshida, M, Haybittle, Jl, Leonard, Cf, Calais, G, Garaud, P, Collett, V, Delmestri, A, Sayer, J, Harvey, Vj, Holdaway, Im, Kay, Rg, Mason, Bh, Forbes, Jf, Balic, M, Bartsch, R, Fesl, C, Fitzal, F, Fohler, H, Greil, R, Jakesz, R, Marth, C, Mlineritsch, B, Pfeiler, G, Singer, Cf, Steger, Gg, Stöger, H, Canney, P, Yosef, Hma, Focan, C, Peek, U, Oates, Gd, Powell, J, Durand, M, Mauriac, L, Dolci, S, Larsimont, D, Nogaret, Jm, Philippson, C, Piccart, Mj, Masood, Mb, Parker, D, Price, Jj, Lindsay, Ma, Mackey, J, Hupperets, Psgj, Bates, T, Blamey, Rw, Chetty, U, Ellis, Io, Mallon, E, Morgan, Dal, Patnick, J, Pinder, S, Lohrisch, C, Nichol, A, Bramwell, Vh, Chen, Be, Gelmon, K, Goss, Pe, Levine, Mn, Parulekar, W, Pater, Jl, Shepherd, Le, Tu, D, Berry, D, Broadwater, G, Cirrincione, C, Muss, H, Weiss, Rb, Abu‐zahra, Ht, Portnoj, Sm, Bowden, S, Brookes, C, Dunn, J, Fernando, I, Lee, M, Poole, C, Rea, D, Spooner, D, Barrett‐lee, Pj, Mansel, Re, Monypenny, Ij, Gordon, Nh, Davis, Hl, Sestak, I, Lehingue, Y, Romestaing, P, Dubois, Jb, Delozier, T, Griffon, B, Mace Lesec’h, J, De La Lande, B, Mouret‐fourme, E, Mustacchi, G, Petruzelka, L, Pribylova, O, Owen, Jr, Harbeck, N, Jänicke, F, Meisner, C, Schmitt, M, Thomssen, C, Meier, P, Shan, Y, Shao, Yf, Zhao, Db, Chen, Zm, Howell, A, Swindell, R, Boddington, C, Burrett, Ja, Cutter, D, Duane, F, Evans, V, Gettins, L, Godwin, J, James, S, Kerr, A, Liu, H, Mannu, G, Mchugh, T, Morris, P, Read, S, Wang, Y, Wang, Z, Albano, J, De Oliveira Cf, Gervásio, H, Gordilho, J, Ejlertsen, B, Jensen, Mb, Johansen, H, Mouridsen, H, Palshof, T, Gelman, Rs, Harris, Jr, Henderson, C, Shapiro, Cl, Christiansen, P, Mouridsen, Ht, Fehm, T, Trampisch, Hj, Dalesio, O, De Vries Ege, Rodenhuis, S, Van Tinteren, H, Comis, Rl, Davidson, Ne, Robert, N, Sledge, G, Solin, Lj, Sparano, Ja, Tormey, Dc, Dixon, Jm, Forrest, P, Jack, W, Kunkler, I, Rossbach, J, Klijn, Jgm, Treurniet‐donker, Ad, Van Putten Wlj, Rotmensz, N, Veronesi, U, Bartelink, H, Bijker, N, Bogaerts, J, Cardoso, F, Cufer, T, Julien, Jp, Van De Velde Cjh, Cunningham, Mp, Brufsky, Am, Coleman, Re, Llombart, Ha, Huovinen, R, Joensuu, H, Costa, A, Bonadonna, G, Gianni, L, Valagussa, P, Goldstein, Lj, Bonneterre, J, Fargeot, P, Fumoleau, P, Kerbrat, P, Luporsi, E, Namer, M, Carrasco, E, Segui, Ma, Eiermann, W, Hilfrich, J, Jonat, W, Kaufmann, M, Kreienberg, R, Schumacher, M, Bastert, G, Rauschecker, H, Sauer, R, Sauerbrei, W, Schauer, A, Blohmer, Ju, Costa, Sd, Eidtmann, H, Gerber, B, Jackisch, C, De Schryver, A, Vakaet, L, Belfiglio, M, Nicolucci, A, Pellegrini, F, Pirozzoli, Mc, Sacco, M, Valentini, M, Mcardle, Cs, Smith, Dc, Stallard, S, Dent, Dm, Gudgeon, Ca, Hacking, A, Murray, E, Panieri, E, Werner, Id, Galligioni, E, Leone, B, Vallejo, Ct, Zwenger, A, Lopez, M, Erazo, A, Medina, Jy, Horiguchi, J, Takei, H, Fentiman, Is, Hayward, Jl, Rubens, Rd, Skilton, D, Scheurlen, H, Sohn, Hc, Untch, M, Dafni, U, Markopoulos, C, Fountzilas, G, Mavroudis, D, Klefstrom, P, Blomqvist, C, Saarto, T, Gallen, M, Tinterri, C, Margreiter, R, De Lafontan, B, Mihura, J, Roché, H, Asselain, B, Salmon, Rj, Vilcoq, Jr, André, F, Delaloge, S, Koscielny, S, Michiels, S, Rubino, C, A'Hern, R, Ellis, P, Kilburn, L, Yarnold, Jr, Benraadt, J, Kooi, M, Van De Velde Ao, Van Dongen Ja, Vermorken, Jb, Castiglione, M, Colleoni, M, Collins, J, Gelber, Rd, Lindtner, J, Price, Kn, Regan, Mm, Rudenstam, Cm, Senn, Hj, Thuerlimann, B, Bliss, Jm, Chilvers, Ced, Coombes, Rc, Hall, E, Marty, M, Buyse, M, Possinger, K, Schmid, P, Wallwiener, D, Bighin, C, Bruzzi, P, Del Mastro, L, Dozin, B, Pastorino, S, Pronzato, P, Sertoli, Mr, Foster, L, George, Wd, Stewart, Hj, Stroner, P, Borovik, R, Hayat, H, Inbar, Mj, Peretz, T, Robinson, E, Camerini, T, Formelli, F, Martelli, G, Di Mauro Mg, Perrone, F, Amadori, D, Martoni, A, Pannuti, F, Camisa, R, Musolino, A, Passalacqua, R, Iwata, H, Shien, T, Ikeda, T, Inokuchi, K, Sawa, K, Sonoo, H, Sadoon, M, Tulusan, Ah, Kohno, N, Miyashita, M, Takao, S, Ahn, Jh, Jung, Kh, Korzeniowski, S, Skolyszewski, J, Ogawa, M, Yamashita, J, Bastiaannet, E, Liefers, Gj, Christiaens, R, Neven, P, Paridaens, R, Van Den Bogaert, W, Braun, S, Martin, P, Romain, S, Janauer, M, Seifert, M, Sevelda, P, Zielinski, Cc, Hakes, T, Hudis, Ca, Wittes, R, Giokas, G, Kondylis, D, Lissaios, B, De La Huerta, R, Sainz, Mg, Ro, J, Camphausen, K, Danforth, D, Lichter, A, Lippman, M, Smart, D, Steinberg, S, D’Amico, C, Lioce, M, Paradiso, A, Ohno, S, Bass, G, Brown, A, Bryant, J, Dignam, J, Fisher, B, Geyer, C, Mamounas, Ep, Redmond, C, Wickerham, L, Aihara, T, Hozumi, Y, Baum, M, Jackson, Im, Palmer, Mk, Ingle, Jn, Suman, Vj, Bengtsson, No, Emdin, S, Jonsson, H, Venturini, M, Lythgoe, Jp, Kissin, M, Erikstein, B, Hannisdal, E, Jacobsen, Ab, Reinertsen, Kv, Varhaug, Je, Gundersen, S, Hauer‐jensen, M, Høst, H, Nissen‐meyer, R, Mitchell, Ak, Robertson, Jfr, Ueo, H, Di Palma, M, Mathé, G, Misset, Jl, Levine, M, Morimoto, K, Takatsuka, Y, Crossley, E, Harris, A, Talbot, D, Taylor, M, Cocconi, G, Di Blasio, B, Ivanov, V, Paltuev, R, Semiglazov, V, Brockschmidt, J, Cooper, Mr, Falkson, Ci, Hadji, P, A’Hern, R, Makris, A, Parton, M, Pennert, K, Powles, Tj, Smith, Ie, Gazet, Jc, Browne, L, Graham, P, Corcoran, N, Clack, G, Van Poznak, C, Deshpande, N, Di Martino, L, Douglas, P, Lindtner, A, Notter, G, Bryant, Ajs, Ewing, Gh, Firth, La, Krushen‐kosloski, Jl, Anderson, H, Killander, F, Malmström, P, Rydén, L, Arnesson, Lg, Carstensen, J, Dufmats, M, Fohlin, H, Nordenskjöld, B, Söderberg, M, Carpenter, Jt, Murray, N, Royle, Gt, Simmonds, Pd, Crowley, J, Gralow, J, Hortobagyi, G, Livingston, R, Martino, S, Osborne, Ck, Ravdin, Pm, Bondesson, T, Celebioglu, F, Dahlberg, K, Fornander, T, Fredriksson, I, Frisell, J, Göransson, E, Iiristo, M, Johansson, U, Lenner, E, Löfgren, L, Nikolaidis, P, Perbeck, L, Rotstein, S, Sandelin, K, Skoog, L, Svane, G, Af Trampe, E, Wadström, C, Maibach, R, Thürlimann, B, Holli, K, Rouhento, K, Safra, T, Brenner, H, Hercbergs, A, Yoshimoto, M, Paterson, Ahg, Fyles, A, Meakin, Jw, Panzarella, T, Bahi, J, Lemonnier, J, Martin, Al, Reid, M, Spittle, M, Bishop, H, Bundred, Nj, Forsyth, S, Pinder, Se, Deutsch, Gp, Kwong, Dlw, Pai, Vr, Senanayake, F, Rubagotti, A, Hackshaw, A, Houghton, J, Ledermann, J, Monson, K, Tobias, Js, Carlomagno, C, De Laurentiis, M, De Placido, S, Williams, L, Bell, R, Hinsley, S, Marshall, Hc, Pierce, Lj, Solomayer, E, Horsman, Jm, Lester, J, Winter, Mc, Buzdar, Au, Hsu, L, Love, Rr, Ahlgren, J, Garmo, H, Holmberg, L, Liljegren, G, Lindman, H, Wärnberg, F, Asmar, L, Jones, Se, Aft, R, Gluz, O, Liedtke, C, Nitz, U, Litton, A, Wallgren, A, Karlsson, P, Linderholm, Bk, Chlebowski, Rt, Caffier, H., Guided Treatment in Optimal Selected Cancer Patients (GUTS), Other departments, CCA - Cancer Treatment and Quality of Life, Radiotherapy, Pan, Hongchao, Gray, Richard, Braybrooke, Jeremy, Davies, Christina, Taylor, Carolyn, Mcgale, Paul, Peto, Richard, Pritchard, Kathleen I, Bergh, Jona, Dowsett, Mitch, Hayes, Daniel F, De Laurentiis, Michelino, MUMC+: MA Medische Oncologie (9), RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy, and Interne Geneeskunde

Subjects
0301 basic medicine, Oncology, medicine.medical_treatment, Kaplan-Meier Estimate, law.invention, 0302 clinical medicine, Randomized controlled trial, law, Recurrence, Receptors, Neoplasm Metastasis, AMERICAN SOCIETY, Adjuvant, CLINICAL-PRACTICE GUIDELINE, Absolute risk reduction, Estrogen Antagonists, General Medicine, Estrogen Antagonist, CHEMOTHERAPY, Middle Aged, Prognosis, Neoplasm Metastasi, Local, POSTMENOPAUSAL WOMEN, Receptors, Estrogen, Chemotherapy, Adjuvant, 030220 oncology & carcinogenesis, Meta-analysis, Lymphatic Metastasis, Female, Human, Estrogen Antagonists/therapeutic use, Adult, Risk, medicine.medical_specialty, Prognosi, medicine.drug_class, DISCONTINUATION, Breast Neoplasms, Article, Drug Administration Schedule, LATE DISTANT RECURRENCE, 03 medical and health sciences, Breast cancer, Breast Neoplasms/drug therapy, Internal medicine, SCORE, medicine, Humans, SURGICAL ADJUVANT BREAST, Aged, Proportional Hazards Models, Chemotherapy, business.industry, Proportional hazards model, Lymphatic Metastasi, TAMOXIFEN THERAPY, ta3122, medicine.disease, Estrogen, RANDOMIZED-TRIALS, Discontinuation, Surgery, Neoplasm Recurrence, 030104 developmental biology, Proportional Hazards Model, Neoplasm Grading, Neoplasm Recurrence, Local, business
Abstract

Background The administration of endocrine therapy for 5 years substantially reduces recurrence rates during and after treatment in women with early-stage, estrogen-receptor (ER)–positive breast cancer. Extending such therapy beyond 5 years offers further protection but has additional side effects. Obtaining data on the absolute risk of subsequent distant recurrence if therapy stops at 5 years could help determine whether to extend treatment. Methods In this meta-analysis of the results of 88 trials involving 62,923 women with ER-positive breast cancer who were disease-free after 5 years of scheduled endocrine therapy, we used Kaplan–Meier and Cox regression analyses, stratified according to trial and treatment, to assess the associations of tumor diameter and nodal status (TN), tumor grade, and other factors with patients’ outcomes during the period from 5 to 20 years. Results Breast-cancer recurrences occurred at a steady rate throughout the study period from 5 to 20 years. The risk of distant recurrence was strongly correlated with the original TN status. Among the patients with stage T1 disease, the risk of distant recurrence was 13% with no nodal involvement (T1N0), 20% with one to three nodes involved (T1N1–3), and 34% with four to nine nodes involved (T1N4–9); among those with stage T2 disease, the risks were 19% with T2N0, 26% with T2N1–3, and 41% with T2N4–9. The risk of death from breast cancer was similarly dependent on TN status, but the risk of contralateral breast cancer was not. Given the TN status, the factors of tumor grade (available in 43,590 patients) and Ki-67 status (available in 7692 patients), which are strongly correlated with each other, were of only moderate independent predictive value for distant recurrence, but the status regarding the progesterone receptor (in 54,115 patients) and human epidermal growth factor receptor type 2 (HER2) (in 15,418 patients in trials with no use of trastuzumab) was not predictive. During the study period from 5 to 20 years, the absolute risk of distant recurrence among patients with T1N0 breast cancer was 10% for low-grade disease, 13% for moderate-grade disease, and 17% for high-grade disease; the corresponding risks of any recurrence or a contralateral breast cancer were 17%, 22%, and 26%, respectively. Conclusions After 5 years of adjuvant endocrine therapy, breast-cancer recurrences continued to occur steadily throughout the study period from 5 to 20 years. The risk of distant recurrence was strongly correlated with the original TN status, with risks ranging from 10 to 41%, depending on TN status and tumor grade. (Funded by Cancer Research UK and others.)

Published
2017

44. HEPATOCELLULAR CARCINOMA IN A MINIATURE SCHNAUZER.

Author

CHONG, B. Y. L., KHOR, K. H., SIMON, A. J., CHIANG, M. X. Y., BROWNE, L., and RADZI, R.

Subjects
HEPATOCELLULAR carcinoma, MINIATURE schnauzer, LIVER cancer, ULTRASONIC imaging, METASTASIS, HISTOPATHOLOGY, LIVER enzymes
Abstract

A 14-year-old spayed female Miniature Schnauzer diagnosed with liver cancer was presented for a second opinion. Upon physical examination, the temperature was normal with pale mucous membrane and a distended abdominen with enlarged liver was palpated. Abdominal ultrasonography revealed one single mass of the left liver lobe. Pre-anesthetic screening of the blood result revealed non-regenerative, normochromic, and normocytic anaemic with the elevation of liver enzyme. A complete left lateral liver lobectomy was performed and the excised liver was examined. A solid mass sized approximately 6 cm x 4 cm was found at the tip of the left lateral liver lobe. Histopathological examination of the mass revealed a well-differentiated hepatocellular carcinoma. There was no recurrence or metastasis detected for post-11-month surgery. [ABSTRACT FROM AUTHOR]

Published
2020

45. Low-Reynolds-number effects in a fully developed turbulent channel flow

Author

Antonia, R. A, Teitel, M, Kim, J, and Browne, L. W. B

Subjects
Fluid Mechanics And Heat Transfer
Abstract

Low-Reynolds-number effects are observed in the inner region of a fully developed turbulent channel flow, using data obtained either from experiments or by direct numerical simulations. The Reynolds-number influence is observed on the turbulence intensities and to a lesser degree on the average production and dissipation of the turbulent energy. In the near-wall region, the data confirm Wei and Willmarth's (1989) conclusion that the Reynolds stresses do not scale on wall variables. One of the reasons proposed to account for this behavior, namely, the 'geometry' effect or direct interaction between inner regions on opposite walls, was investigated in some detail by introducing temperature at one of the walls, both in experiment and simulation. Although the extent of penetration of thermal excursions into the opposite side of the channel can be significant at low Reynolds numbers, the contribution these excursions make to the Reynolds shear stress and the spanwise vorticity in the opposite wall region is negligible. In the inner region, spectra and cospectra of the velocity fluctuations u and v change rapidly with the Reynolds number, the variations being mainly confined to low wavenumbers in the u spectrum.

Published
1992

46. Some characteristics of small-scale turbulence in a turbulent duct flow

Author

Antonia, R. A, Browne, L. W. B, and Kim, J

Subjects
Fluid Mechanics And Heat Transfer
Abstract

The fine-scale structure of turbulence in a fully developed turbulent duct flow is examined by considering the 3D velocity derivative field obtained from direct numerical simulations at two relatively small Reynolds numbers. The magnitudes of all mean-square derivatives (normalized by wall variables) increase with the Reynolds number, the increase being largest at the wall. These magnitudes are not consistent with the assumption of local isotropy except perhaps near the duct center-line. When the assumption of local isotropy is relaxed to one of local axisymmetry, or invariance with respect to rotation about a coordinate axis (here chosen in the streamwise direction), satisfactory agreement is indicated by the data outside the wall region. Support for axisymmetry is demonstrated by anisotropy invariant maps of the dissipation and vorticity tensors.

Published
1991

50. Effect of radiotherapy after mastectomy and axillary surgery on 10-year recurrence and 20-year breast cancer mortality: meta-analysis of individual patient data for 8135 women in 22 randomised trials

Author

Mcgale, P., Taylor, C., Correa, C., Cutter, D., Duane, F., Ewertz, M., Gray, R., Mannu, G., Peto, R., Whelan, T., Wang, Y., Wang, Z., Darby, S., Albain, K., Anderson, S., Arriagada, R., Barlow, W., Bergh, J., Bergsten Nordström, E., Bliss, J., Burrett, J. A., Buyse, M., Cameron, D., Carrasco, E., Clarke, M., Coleman, R., Coates, A., Collins, R., Costantino, J., Cuzick, J., Davidson, N., Davies, C., Davies, K., Delmestri, A., Di Leo, A., Dowsett, M., Elphinstone, P., Evans, V., Forbes, J., Gelber, R., Gettins, L., Geyer, C., Gianni, L., Gnant, M., Goldhirsch, A., Godwin, J., Gregory, C., Hayes, D., Hill, C., Ingle, J., Jakesz, R., James, S., Janni, W., Kaufmann, M., Kerr, A., Liu, H., Mackinnon, E., Martín, M., Mchugh, T., Morris, P., Norton, L., Ohashi, Y., Paik, S., Pan, H. C., Perez, E., Piccart, M., Pierce, L., Pritchard, K., Pruneri, G., Raina, V., Ravdin, P., Robertson, J., Rutgers, E., Shao, Y. F., Sparano, J., Swain, S., Valagussa, P., Viale, G., Von Minckwitz, G., Winer, E., Wiang, X., Wood, Abe O, W., Abe, R, Enomoto, K, Kikuchi, K, Koyama, H, Masuda, H, Nomura, Y, Ohashi, Y, Sakai, K, Sugimachi, K, Toi, M, Tominaga, T, Uchino, J, Yoshida, M, Haybittle, Jl, Leonard, Cf, Calais, G, Geraud, P, Collett, V, Davies, C, Delmestri, A, Sayer, J, Harvey, Vj, Holdaway, Im, Kay, Rg, Mason, Bh, Forbes, Jf, Wilcken, N, Bartsch, R, Dubsky, P, Fesl, C, Fohler, H, Gnant, M, Greil, R, Jakesz, R, Lang, A, Luschin-Ebengreuth, G, Marth, C, Mlineritsch, B, Samonigg, H, Singer, Cf, Steger, Gg, Stöger, H, Canney, P, Yosef, Hm, Focan, C, Peek, U, Oates, Gd, Powell, J, Durand, M, Mauriac, L, Di Leo, A, Dolci, S, Larsimont, D, Nogaret, Jm, Philippson, C, Piccart, Mj, Masood, Mb, Parker, D, Price, Jj, Lindsay, Ma, Mackey, J, Martin, M, Hupperets, Ps, Bates, T, Blamey, Rw, Chetty, U, Ellis, Io, Mallon, E, Morgan, Da, Patnick, J, Pinder, S, Olivotto, I, Ragaz, J, Berry, D, Broadwater, G, Cirrincione, C, Muss, H, Norton, L, Weiss, Rb, Abu-Zahra, Ht, Portnoj, Sm, Bowden, S, Brookes, C, Dunn, J, Fernando, I, Lee, M, Poole, C, Rea, D, Spooner, D, Barrett-Lee, Pj, Mansel, Re, Monypenny, Ij, Gordon, Nh, Davis, Hl, Cuzick, J, Lehingue, Y, Romestaing, P, Dubois, Jb, Delozier, T, Griffon, B, Mace Lesech, J, Brain, E, de La Lande, B, Mouret-Fourme, E, Mustacchi, G, Petruzelka, L, Pribylova, O, Owen, Jr, Harbeck, N, Jänicke, F, Meisner, C, Schmitt, M, Thomssen, C, Meier, P, Shan, Y, Shao, Yf, Wang, X, Zhao, Db, Chen, Zm, Pan, Hc, Howell, A, Swindell, R, Burrett, Ja, Clarke, M, Collins, R, Correa, C, Cutter, D, Darby, S, Davies, K, Elphinstone, P, Evans, V, Gettins, L, Godwin, J, Gray, R, Gregory, C, Hermans, D, Hicks, C, James, S, Kerr, A, Liu, H, Mackinnon, E, Lay, M, Mcgale, P, Mchugh, T, Morris, P, Peto, R, Taylor, C, Wang, Y, Albano, J, de Oliveira CF, Gervásio, H, Gordilho, J, Ejlertsen, B, Jensen, Mb, Johansen, H, Mouridsen, H, Palshof, T, Gelman, Rs, Harris, Jr, Hayes, D, Henderson, C, Shapiro, Cl, Winer, E, Christiansen, P, Ewertz, M, Møller, S, Mouridsen, Ht, Trampisch, Hj, Dalesio, O, de Vries EG, Rodenhuis, S, van Tinteren, H, Comis, Rl, Davidson, Ne, Robert, N, Sledge, G, Solin, Lj, Sparano, Ja, Tormey, Dc, Wood, W, Cameron, D, Dixon, Jm, Forrest, P, Jack, W, Kunkler, I, Rossbach, J, Klijn, Jg, Treurniet-Donker, Ad, van Putten WL, Rotmensz, N, Veronesi, U, Viale, G, Bartelink, H, Bijker, N, Bogaerts, J, Cardoso, F, Cufer, T, Julien, Jp, Rutgers, E, van de Velde CJ, Cunningham, Mp, Huovinen, R, Joensuu, H, Costa, A, Bonadonna, G, Gianni, L, Valagussa, P, Goldstein, Lj, Bonneterre, J, Fargeot, P, Fumoleau, P, Kerbrat, P, Luporsi, E, Namer, M, Eiermann, W, Hilfrich, J, Jonat, W, Kaufmann, M, Kreienberg, R, Schumacher, M, Bastert, G, Rauschecker, H, Sauer, R, Sauerbrei, W, Schauer, A, Blohmer, Ju, Costa, Sd, Eidtmann, H, Gerber, B, Jackisch, C, Loibl, S, von Minckwitz, G, de Schryver, A, Vakaet, L, Belfiglio, M, Nicolucci, A, Pellegrini, F, Pirozzoli, Mc, Sacco, M, Valentini, M, Mcardle, Cs, Smith, Dc, Stallard, S, Dent, Dm, Gudgeon, Ca, Hacking, A, Murray, E, Panieri, E, Werner, Id, Carrasco, E, Segui, Ma, Galligioni, E, Lopez, M, Erazo, A, Medina, Jy, Horiguchi, J, Takei, H, Fentiman, Is, Hayward, Jl, Rubens, Rd, Skilton, D, Scheurlen, H, Sohn, Hc, Untch, M, Dafni, U, Markopoulos, C, Fountzilas, G, Mavroudis, D, Klefstrom, P, Blomqvist, C, Saarto, T, Gallen, M, Tinterri, C, Margreiter, R, de Lafontan, B, Mihura, J, Roché, H, Asselain, B, Salmon, Rj, Vilcoq, Jr, André, F, Arriagada, R, Delaloge, S, Hill, C, Koscielny, S, Michiels, S, Rubino, C, A'Hern, R, Bliss, J, Ellis, P, Kilburn, L, Yarnold, Jr, Benraadt, J, Kooi, M, van de Velde AO, van Dongen JA, Vermorken, Jb, Castiglione, M, Coates, A, Colleoni, M, Collins, J, Forbes, J, Gelber, Rd, Goldhirsch, A, Lindtner, J, Price, Kn, Regan, Mm, Rudenstam, Cm, Senn, Hj, Thuerlimann, B, Bliss, Jm, Chilvers, Ce, Coombes, Rc, Hall, E, Marty, M, Buyse, M, Possinger, K, Schmid, P, Wallwiener, D, Foster, L, George, Wd, Stewart, Hj, Stroner, P, Borovik, R, Hayat, H, Inbar, Mj, Peretz, T, Robinson, E, Bruzzi, P, Del Mastro, L, Pronzato, P, Sertoli, Mr, Venturini, M, Camerini, T, De Palo, G, Di Mauro MG, Formelli, F, Amadori, D, Martoni, A, Pannuti, F, Camisa, R, Cocconi, G, Colozza, A, Passalacqua, R, Aogi, K, Takashima, S, Abe, O, Ikeda, T, Inokuchi, K, Sawa, K, Sonoo, H, Korzeniowski, S, Skolyszewski, J, Ogawa, M, Yamashita, J, Bastiaannet, E, van de Water, W, van Nes JG, Christiaens, R, Neven, P, Paridaens, R, Van den Bogaert, W, Braun, S, Martin, P, Romain, S, Janauer, M, Seifert, M, Sevelda, P, Zielinski, Cc, Hakes, T, Hudis, Ca, Wittes, R, Giokas, G, Kondylis, D, Lissaios, B, de la Huerta, R, Sainz, Mg, Altemus, R, Camphausen, K, Cowan, K, Danforth, D, Lichter, A, Lippman, M, O'Shaughnessy, J, Pierce, Lj, Steinberg, S, Venzon, D, Zujewski, Ja, D'Amico, C, Lioce, M, Paradiso, A, Chapman, Ja, Gelmon, K, Goss, Pe, Levine, Mn, Meyer, R, Parulekar, W, Pater, Jl, Pritchard, Ki, Shepherd, Le, Tu, D, Whelan, T, Ohno, S, Anderson, S, Bass, G, Brown, A, Bryant, J, Costantino, J, Dignam, J, Fisher, B, Geyer, C, Mamounas, Ep, Paik, S, Redmond, C, Swain, S, Wickerham, L, Wolmark, N, Baum, M, Jackson, Im, Palmer, Mk, Perez, E, Ingle, Jn, Suman, Vj, Bengtsson, No, Emdin, S, Jonsson, H, Lythgoe, Jp, Kissin, M, Erikstein, B, Hannisdal, E, Jacobsen, Ab, Varhaug, Je, Gundersen, S, Hauer-Jensen, M, Høst, H, Nissen-Meyer, R, Reinertsen, K, Mitchell, Ak, Robertson, Jf, Ueo, H, Di Palma, M, Mathé, G, Misset, Jl, Levine, M, Morimoto, K, Takatsuka, Y, Crossley, E, Harris, A, Talbot, D, Taylor, M, di Blasio, B, Ivanov, V, Paltuev, R, Semiglazov, V, Brockschmidt, J, Cooper, Mr, Falkson, Ci, Dowsett, M, Makris, A, Parton, M, Pennert, K, Powles, Tj, Smith, Ie, Gazet, Jc, Browne, L, Graham, P, Corcoran, N, Businico, A, Deshpande, N, di Martino, L, Douglas, P, Lindtner, A, Notter, G, Bryant, Aj, Ewing, Gh, Firth, La, Krushen-Kosloski, Jl, Anderson, H, Killander, F, Malmström, P, Rydén, L, Arnesson, Lg, Carstensen, J, Dufmats, M, Fohlin, H, Nordenskjöld, B, Söderberg, M, Carpenter, Jt, Murray, N, Royle, Gt, Simmonds, Pd, Albain, K, Barlow, W, Crowley, J, Gralow, J, Hortobagyi, G, Livingston, R, Martino, S, Osborne, Ck, Ravdin, Pm, Adolfsson, J, Bergh, J, Bondesson, T, Celebioglu, F, Dahlberg, K, Fornander, T, Fredriksson, I, Frisell, J, Göransson, E, Iiristo, M, Johansson, U, Lenner, E, Löfgren, L, Nikolaidis, P, Perbeck, L, Rotstein, S, Sandelin, K, Skoog, L, Svane, G, af Trampe, E, Wadström, C, Janni, W, Maibach, R, Thürlimann, B, Hakama, M, Holli, K, Isola, J, Rouhento, K, Saaristo, R, Brenner, H, Hercbergs, A, Yoshimoto, M, Paterson, Ah, Fyles, A, Meakin, Jw, Panzarella, T, Bahi, J, Reid, M, Spittle, M, Bishop, H, Bundred, Nj, Forsyth, S, Pinder, Se, Sestak, I, Deutsch, Gp, Kwong, Dl, Pai, Vr, Senanayake, F, Martin, Al, Boccardo, F, Rubagotti, A, Hackshaw, A, Houghton, J, Ledermann, J, Monson, K, Tobias, Js, Carlomagno, C, De Laurentiis, M, De Placido, S, Williams, L, Broglio, K, Buzdar, Au, Hsu, L, Love, Rr, Ahlgren, J, Garmo, H, Holmberg, L, Liljegren, G, Lindman, H, Wärnberg, F, Asmar, L, Jones, Se, Gluz, O, Liedtke, C, Nitz, U, Litton, A, Wallgren, A, Karlsson, P, Linderholm, Bk, Chlebowski, Rt, Caffier, H., McGale, P, Taylor, C, Correa, C, Cutter, D, Duane, F, Ewertz, M, Gray, R, Mannu, G, Peto, R, Whelan, T, Wang, Y, Wang, Z, Darby, S, Biomedische Technologie, RS: GROW - Oncology, RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy, Mcgale, P, DE LAURENTIIS, Michelino, Other departments, CCA -Cancer Center Amsterdam, and Radiotherapy

Subjects
medicine.medical_specialty, medicine.medical_treatment, Breast Neoplasms, Rate ratio, Lower risk, Systemic therapy, Statistical significance, Medicine, Humans, Mastectomy, Randomized Controlled Trials as Topic, business.industry, Articles, General Medicine, Surgery, Radiation therapy, Axilla, Neoplasm Recurrence, medicine.anatomical_structure, Local, Meta-analysis, Lymphatic Metastasis, Lymph Node Excision, Female, Neoplasm Recurrence, Local, business, Breast Neoplasm, Human
Abstract

BACKGROUND: Postmastectomy radiotherapy was shown in previous meta-analyses to reduce the risks of both recurrence and breast cancer mortality in all women with node-positive disease considered together. However, the benefit in women with only one to three positive lymph nodes is uncertain. We aimed to assess the effect of radiotherapy in these women after mastectomy and axillary dissection.METHODS: We did a meta-analysis of individual data for 8135 women randomly assigned to treatment groups during 1964-86 in 22 trials of radiotherapy to the chest wall and regional lymph nodes after mastectomy and axillary surgery versus the same surgery but no radiotherapy. Follow-up lasted 10 years for recurrence and to Jan 1, 2009, for mortality. Analyses were stratified by trial, individual follow-up year, age at entry, and pathological nodal status.FINDINGS: 3786 women had axillary dissection to at least level II and had zero, one to three, or four or more positive nodes. All were in trials in which radiotherapy included the chest wall, supraclavicular or axillary fossa (or both), and internal mammary chain. For 700 women with axillary dissection and no positive nodes, radiotherapy had no significant effect on locoregional recurrence (two-sided significance level [2p]>0·1), overall recurrence (rate ratio [RR], irradiated vs not, 1·06, 95% CI 0·76-1·48, 2p>0·1), or breast cancer mortality (RR 1·18, 95% CI 0·89-1·55, 2p>0·1). For 1314 women with axillary dissection and one to three positive nodes, radiotherapy reduced locoregional recurrence (2pINTERPRETATION: After mastectomy and axillary dissection, radiotherapy reduced both recurrence and breast cancer mortality in the women with one to three positive lymph nodes in these trials even when systemic therapy was given. For today's women, who in many countries are at lower risk of recurrence, absolute gains might be smaller but proportional gains might be larger because of more effective radiotherapy.FUNDING: Cancer Research UK, British Heart Foundation, UK Medical Research Council.

Published
2016

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