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Characteristic No. %
Total 63
1 st Breast Cancer 53 84
Median Age Range 42 24–73
BRCA1 mutation 25 40
BRCA2 mutation 27 42
Stage
I 14 27
II 25 48
III 4 8
Unknown 9 17
Histology
Ductal 30 57
Other 10 19
Unknown 13 24
2 nd Breast Cancer 15 28
Median Age Range 48 36–71
BRCA1 mutation 5 33
BRCA2 mutation 8 53
Stage
Stage I 8 53
Stage II 3 20
Stage III 3 20
Histology
Ductal 12 80
Other 2 13
3 rd Breast Cancer 2 4
Median Age Range 54 53–55
BRCA2 mutation 2 100
Stage
I 1 50
III 1 50
Histology
Ductal 2 100
Disclosure: All authors have declared no conflicts of interest.
1450P EFFECT OF PRIOR METFORMIN INTAKE ON FIRST
DIAGNOSIS OF BREAST CANCER
S. Gupta 1 , D. Avila 2 , E.A. Mino 2 , P. Gosain 2 , K.K. Batra 2 , S. McDunn 3
1 Div of Hematology-Oncology, John H Stroger Jr Hospital of Cook County,
Chicago, IL, UNITED STATES OF AMERICA, 2 Internal Medicine, John H Stroger
Jr Hospital of Cook County, Chicago, IL, UNITED STATES OF AMERICA,
3 Hematology-Oncology, John H Stroger Jr Hospital of Cook County, Chicago,
IL, UNITED STATES OF AMERICA
Introduction: Metformin has been shown in pre clinical studies to have the ability to
reduce tumor growth and exert anti cancer effects. It is being tested as a part of
management of breast cancer (BC) in neoadjuvant and adjuvant settings and being
entertained as a modality of chemoprevention in BC. We studied the effect of prior
metformin intake on patients with first diagnosis of breast cancer.
Methods: All patients with a diagnosis of BC were identified from the Tumor
Registry of our hospital, which serves the underserved population of Chicago, USA.
All charts were retrospectively screened for age, tumor grade, node status at
diagnosis, onset of diabetes mellitus (DM) prior to cancer diagnosis and intake of
metformin including duration. Patients with a diagnosis of DM after cancer, intake
of metformin less than 6 months or incomplete medical record were excluded.
Difference in means was calculated using the student t-test.
Results: A total of 1569 patients were screened of which 133 patients were identified
to have a diagnosis of DM before breast cancer and met the inclusion criteria. Of
these, 95 patients were on metformin for an average 3.57 years (yrs) before BC
diagnosis. Thirty-nine patients on metformin were younger than 60 yrs and 56 were
older than 60 yrs age. Node positive disease was seen in 51.5% of metformin patients
compared to 49% DM patients not on metformin (p = NS). However in patients
younger than 60 yrs, node positive disease was seen in 66% of metformin patients
compared to 86% non-metformin patients. The young patients on metformin had an
average grade of 2.38 compared to non-metformin patients whose average grade was
2.83 (p = 0.02). More patients in young non-metformin group were Her2-neu
positive (43%) compared to 23% in young metformin group. In older patients more
non-metformin patients had triple negative disease (20%) compared to 9% in
metformin group.
Annals of Oncology
Conclusions: Prior metformin use may have a possible positive effect in patients
with initial diagnosis of BC. This effect seems more pronounced in patients younger
than 60 yrs of age where metformin intake was associated with a statistically
significant reduction in tumor grade with a trend towards reduction in node positive
disease and Her2 positivity. Further studies are needed to clarify the potential
protective role of metformin in this younger group.
Disclosure: All authors have declared no conflicts of interest.
1451P FIVE-YEAR RESULTS OF THE BREAST CANCER SCREENING
PROGRAMME IN UGRA
N.A. Zakharova 1 , S.W. Duffy 2 , J. Mackay 3 , E.V. Kotlyarov 4 , A.V. Filimonov 5 ,
K. Barinov 1 , I. Gromut 1 , E.V. Belan 1
1 Oncological, State Oncology Center, Khanty-Mansiysk, RUSSIAN
FEDERATION, 2 Wolfson Institute of Preventive Medicine, Queen Mary University
of London, London, UNITED KINGDOM, 3 Consultant Clinical Genetic
Oncologist, University College London, London, UNITED KINGDOM, 4 Oncology,
State Medical Academy, Khanty-Mansiysk, RUSSIAN FEDERATION, 5 Chief,
State Healthcare Department, Khanty-Mansiysk, RUSSIAN FEDERATION
The main purpose of this study is to estimate the five-year result of the Breast
Cancer Screening Program (BCSP) performed in the Khanty-Mansiysk Autonomous
Okrug - Ugra. This Programme was initiated in 2007. The screening covers women
over 40 years old. The screening interval is 2 years, with two-view mammography
(MLO and CC) and single reading as the standard. During 2007–2011 within the
BCSP, 201668 women were screened (177475 - prevalence screening). The screening
coverage rate is approximately 56.4%. In 2011 we also evaluated the efficacy of usage
for the mammography equipment in each district. According to the standard (RF) –
there are 2840 examinations per day (2381 examinations per day - the average
number in Ugra). Thus, the coverage rate only for the districts with the sufficient
number of the examinations per day estimated as 68.4%. 10.3% of screened women
were referred for further assessment. There were 460 breast cancer cases detected at
the first round of screening and 22 cases in subsequent rounds. The cancer detection
rate for prevalence was 2.6 and for subsequent rounds 0.9 per 1000 screened women.
The test sensitivity for the first round was estimated as 77%. Also, we have tentatively
evaluated the likely future effect on mortality from the breast cancer as a result of the
BCSP in Ugra, on the basis of the changes in mortality seen at this early stage of the
programme and of the changes in size and node status of the cancers diagnosed. In
2009–11, a reduction in breast cancer mortality of the order of 15–20% was
observed, compared to previous years. We anticipate a 20% reduction in deaths from
breast cancer by 2015, on the basis of this and of reductions in the proportion of
tumours of size >20 mm. The changes in the tumour size distribution do not appear
to be due to length bias or overdiagnosis, since the overall incidence is consistent
with pre-screening trends of increasing incidence. Analysis of node status is
complicated by possible changes in practice with respect to axillary investigation. We
are planning to increase the proportion of the digital mammography equipment in
order to improve the quality of the examination and then - to implement the CAD
(computer-aided detection) system. Thus, in the future in Ugra, it is planned to
continue the BCSP, and to continue to improve the quality of screening.
Disclosure: All authors have declared no conflicts of interest.
1452P CANCER SCREENING IN UNDERSERVED, VULNERABLE
POPULATION. RESULTS FROM THE EDIFICE SURVEY
F. Eisinger 1 , J. Viguier 2 , C. Touboul 3 , Y. Coscas 4 , X. Pivot 5 , J. Blay 6 , C. Lhomel 4 ,
J. Morère 7
1 Oncology, IPC INSERM UMR 599, Marseille, FRANCE, 2 Centre De
Coordination Des Dépistages Des Cancers, CHRU Trousseau, Tours, FRANCE,
3 Oncology, Kantar Health, Montrouge, FRANCE, 4 Oncology, Clinique de la Porte
de Saint Cloud, Boulogne Billancourt, FRANCE, 5 Service Oncologie Medicale, C.
H.U. Jean Minjoz, Besancon, FRANCE, 6 Oncology, Centre Léon Bérard, Lyon,
FRANCE, 7 Oncology, Hôpital Avicenne, Bobigny, FRANCE
Background: Reducing cancer inequalities is one of the most critical goals of the
current National Cancer Plan. The French health system allows fair access to care for
all affected persons. In contrast, exposure to risk factors is far worse for underserved
populations. The issue of cancer screening attendance distribution according to social
factors, deserves to be assessed and regularly monitored.
Methods: Accurate data on cancer screening in the population is available; however
it is difficult to assess who belongs to an underserved/vulnerable subgroup. Many
indicators could be used, such as the validated questionnaire “EPICES” with eleven
yes/no questions.We analysed a sample of the general population (N = 1603) to
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