Jennifer Chun - Academia.edu (original) (raw)

Papers by Jennifer Chun

Research paper thumbnail of Prevalence of BRCA2 mutations and other clinical characteristics in women with triple-negative breast cancer

Journal of Clinical Oncology, 2014

160 Background: Triple-negative breast cancers (TNBC) represent 10%–20% of invasive breast cancer... more 160 Background: Triple-negative breast cancers (TNBC) represent 10%–20% of invasive breast cancers. Current guidelines recommend genetic testing for women who are diagnosed with TNBC. Studies have shown that BRCA1 mutations are associated with TNBC, but there is little information on the relationship of BRCA2 mutations and TNBC. The purpose of this study was to look at the clinical characteristics of TNBC compared to non-TNBC in a cohort of women with newly diagnosed breast cancer. Methods: The Breast Cancer Database at our institution was queried for patients with invasive breast cancer. We included the following variables: age, race, BRCA1,2, tumor characteristics, and personal history of breast cancer (PHBC). Statistical analyses included Pearson’s Chi-Square and Fisher’s Exact Tests. Results: Out of a total of 1,332 women, 125 (9%) had TNBC. The median age for both TNBC and non-TNBC was 59 years. Majority of women had early stage breast cancer (92%) with ductal carcinoma (80%). ...

Research paper thumbnail of Imaging and Clinicopathologic Characteristics in a Contemporary Cohort of Younger Women With Newly Diagnosed Breast Cancer

Cancer Treatment and Research Communications, 2016

Research paper thumbnail of Prevalence of BRCA2 mutations and other clinical characteristics in women with triple-negative breast cancer

Asco Meeting Abstracts, Sep 10, 2014

Research paper thumbnail of Tumor characteristics in obese women with breast cancer

Asco Meeting Abstracts, Sep 20, 2012

Research paper thumbnail of The relationship of breast density in mammography and magnetic resonance imaging in high-risk women and women with breast cancer

Clinical Imaging, 2015

To evaluate the relationship between mammographic breast density (MBD), background parenchymal en... more To evaluate the relationship between mammographic breast density (MBD), background parenchymal enhancement (BPE), and fibroglandular tissue (FGT) in women with breast cancer (BC) and at high risk for developing BC. Our institutional database was queried for patients who underwent mammography and MRI. Four hundred three (85%) had BC and 72 (15%) were at high risk. MBD (P=.0005), BPE (P<.0001), and FGT (P=.02) were all higher in high-risk women compared to the BC group. Higher levels of MBD, BPE and FGT are seen in women at higher risk for developing BC when compared to women with BC.

Research paper thumbnail of Abstract P1-09-03: Chemoprevention in patients with newly diagnosed breast cancers

Research paper thumbnail of Abstract P4-01-07: The Relationship of Breast Density in Mammography and Magnetic Resonance (MR) Imaging in a High Risk Population

Research paper thumbnail of Abstract P5-15-02: Beyond the learning curve: Surgical judgment in the approach to breast conserving surgery

Research paper thumbnail of Abstract P6-10-10: History of chemoprevention in patients with newly diagnosed breast cancers

Research paper thumbnail of Predictors of breast cancer development in a high-risk population

The American Journal of Surgery, 2006

The purpose of this study was to investigate the strongest predictors of breast cancer in a high-... more The purpose of this study was to investigate the strongest predictors of breast cancer in a high-risk population and to increase our understanding of the possible interactions between risk factors. The Women At Risk High-Risk Registry provided the study population. The variables of interest included age at enrollment, presence of lobular carcinoma in situ (LCIS), atypical ductal hyperplasia (ADH), atypical lobular hyperplasia, family history of breast cancer, body mass index, and Gail scores (5-year high-risk > or =1.7%). Univariate and multivariate analyses were conducted with the Cox proportional hazards regression model and years of follow-up evaluation as the time scale. Out of 1553 high-risk women, 79 (5%) developed breast cancer during a median follow-up period of 5 years. Results from the multivariate Cox model demonstrated that FHBC (hazard ratio [HR] = 1.76; 95% confidence interval [CI], 1.05-2.97), ADH (HR = 1.90; 95% CI, 1.16-3.13), LCIS (HR = 1.71; 95% CI, .99-2.95), and a body mass index > or =30 (HR = 2.22; 95% CI, 1.14-4.35) were statistically significant predictors of breast cancer within this high-risk population. These results support current literature showing the synergistic increase in risk for patients with ADH, LCIS, and a positive family history of breast cancer. Obesity was also a strong predictor of breast cancer risk, which suggests that there may be a potentiating effect of obesity on other risk factors. Obesity may represent a modifiable risk factor, providing women with an opportunity to reduce their risk with lifestyle modification. Women with a strong family history of breast cancer or a diagnosis of ADH or LCIS may benefit most from risk-reduction strategies, chemoprevention, and surveillance.

Research paper thumbnail of Screening prior to Breast Cancer Diagnosis: The More Things Change, the More They Stay the Same

International Journal of Breast Cancer, 2013

revised their breast cancer screening guidelines. We evaluated the pattern of screening subsequen... more revised their breast cancer screening guidelines. We evaluated the pattern of screening subsequent to the altered guidelines in a cohort of women. Methods. Our database was queried for the following variables: age, race, method of diagnosis, mass palpability, screening frequency, histology, and stage. Statistical analyses were performed using Pearson's chi-square and Fisher's exact tests. Results. 1112 women were diagnosed with breast cancer from January 2010 to 2012. The median age at diagnosis was 60 years. Most cancers were detected on mammography (61%). The majority of patients had invasive ductal carcinoma (59%), stage 0 (23%), and stage 1 (50%) cancers. The frequency of screening did not change significantly over time ( = 0.30). However, nonregular screeners had an increased risk of being diagnosed with later stage breast cancer ( < 0.001) and were more likely to present with a palpable mass compared to regular screeners (56% versus 21%; < 0.001). Conclusions. In our study, screening behavior did not significantly change in the years following the USPSTF guidelines. These results suggest that women who are not screened annually are at increased risk of a delay in breast cancer diagnosis, which may impact treatment options and outcomes.

Research paper thumbnail of The Breast Cancer Lifestyle Intervention Pilot Study

Journal of Cancer Therapy, 2014

Purpose: Weight loss after breast cancer diagnosis has been associated with a decrease in risk of... more Purpose: Weight loss after breast cancer diagnosis has been associated with a decrease in risk of breast cancer recurrence and mortality. The purpose of this study is to examine the barriers, acceptance, and sustainability of an exercise intervention program offered at our institution to overweight women with newly diagnosed breast cancer. Methods: The Breast Cancer Database was queried for women newly diagnosed with breast cancer and a body mass index (BMI) ≥ 25 kg/m 2 . Eligible patients participated in the Moving for Life (MFL) exercise program for 16 sessions. Questionnaires were administered. Statistical analyses included descriptives and paired t-tests to summarize patient characteristics and assess changes over time. Results: Of 40 patients, 22 declined, 18 consented and 13 (72%) completed the study. The mean age was 61 years (range: 38 -76). The mean BMI was 31 kg/m 2 . After the intervention, there was a decrease in weight and BMI (p = 0.04). The average weight loss was 10 lbs. Participants reported greater enjoyment of exercise (p = 0.02) and decreased pain related to treatment (p = 0.05). These initial positive results were not maintained after 6 months and 1 year. Conclusions: The MFL intervention had a high rate of acceptance among overweight women newly diagnosed with breast cancer. These results demonstrated significant benefits of exercise immediately after cancer diagnosis and highlight the importance of developing sustainable lifestyle interventions. Interventions targeted at modifiable lifestyle factors in women with early stage disease may provide benefit that is comparable to certain adjuvant systemic therapies. Therefore, adjuvant lifestyle interventions supported by clinicians may improve breast cancer survival outcomes.

Research paper thumbnail of The value of clinical characteristics and breast imaging studies in predicting a histopathologic diagnosis of cancer or high-risk lesion in patients with spontaneous nipple discharge

The American Journal of Surgery, 2007

Research paper thumbnail of Pregnancy-associated breast cancer and increased risk of pregnancy-associated recurrence: a case report

Journal of Medical Case Reports, 2012

Introduction: Pregnancy-associated breast cancer refers to breast cancer diagnosed during pregnan... more Introduction: Pregnancy-associated breast cancer refers to breast cancer diagnosed during pregnancy, lactation, or within twelve months postpartum. Recent studies suggest that, when matched for age and stage, the prognosis of pregnancy-associated breast cancer is comparable to non-pregnancy-associated breast cancer. However, the risk for breast cancer recurrence associated with subsequent pregnancies in this population is not clear. Case presentation: We describe the case of a Caucasian woman who was initially treated for pregnancy-associated breast cancer at age 23, three months after the birth of her third child. She underwent a total mastectomy with axillary node dissection, followed by chemotherapy and hormonal therapy. Ten years later, when the patient was 24 weeks pregnant with her fourth child, she presented with an ipsilateral chest wall recurrence of breast cancer. To the best of our knowledge, this represents the first reported case of a pregnancy-associated recurrence in a patient previously treated for pregnancy-associated breast cancer. Conclusion: The case described here is the first report of a second occurrence of pregnancy-associated breast cancer. This case raises the possibility that pregnancy may represent a unique trigger for breast malignancy in a specific cohort of women. Although there is data showing no increase in the risk of recurrence for women who become pregnant after breast cancer treatment, pregnancy-associated breast cancer may be a distinct clinical category where subsequent pregnancies after treatment may confer an increased risk of recurrent disease.

Research paper thumbnail of Abstract P2-01-02: The Incidence of Mammographically-Occult Breast Cancer in Women Older than Seventy Years

Research paper thumbnail of Incidence and Clinical Significance of Lymph Node Metastasis Detected by Cytokeratin Immunohistochemical Staining in Ductal Carcinoma In Situ

Annals of Surgical Oncology, 2005

This study explored the long-term prognosis of patients with ductal carcinoma-in-situ (DCIS) and ... more This study explored the long-term prognosis of patients with ductal carcinoma-in-situ (DCIS) and lymph node metastasis detected by cytokeratin immunohistochemical stains (CK-IHC). Using the Columbia University breast cancer database, we identified all DCIS patients who had eight or more axillary nodes dissected and free of metastasis. Five-micrometer sections from all paraffin blocks containing lymph node tissue were stained with an anticytokeratin antibody cocktail (AE1/AE3 and KL1). The results of the CK-IHC and updated database were anonymized and merged. Survival of CK-IHC-positive and -negative patients was compared by using Kaplan-Meier curves and log-rank tests. CK-IHC was performed on 301 DCIS patients, who had an average of 16.7 axillary nodes dissected. Eighteen (6%) of 301 patients tested positive by CK-IHC. Seventy patients with bilateral breast cancer and 2 patients without any follow-up data were excluded, for a final study population of 229 patients. Among the 216 patients with negative CK-IHC, 18 patients died, compared with 1 of 13 patients with positive CK-IHC. The median follow-up for the study group was 127 months. Kaplan-Meier overall and breast cancer-specific survival estimates were similar for CK-IHC-positive and -negative patients (P = .81 and P = .73, respectively). CK-IHC increases the incidence of positive nodes by 6% in DCIS patients. A positive node by CK-IHC does not seem to affect survival in these patients. These results raise concerns regarding the clinical significance of positive nodes by CK-IHC in DCIS patients.

Research paper thumbnail of The Relationship of Mammographic Density and Age: Implications for Breast Cancer Screening

American Journal of Roentgenology, 2012

Breast density is increasingly recognized as an independent risk factor for the development of br... more Breast density is increasingly recognized as an independent risk factor for the development of breast cancer, because it has been shown to be associated with a four- to sixfold increase in a woman&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s risk of malignant breast disease. Increased breast density as identified on mammography is also known to decrease the diagnostic sensitivity of the examination, which is of great concern to women at increased risk for breast cancer. Dense tissue has generally been associated with younger age and premenopausal status, with the assumption that breast density gradually decreases after menopause. However, the actual proportion of older women with dense breasts is unknown. The purpose of this study was to examine the relationship between age and breast density, particularly focusing on postmenopausal women. All screening mammograms completed at the New York University Langone Medical Center in 2008 were retrospectively reviewed. Analysis of variance and descriptive analyses were used to evaluate the relationship between patient age and breast density. A total of 7007 screening mammograms were performed. The median age of our cohort was 57 years. Within each subgroup categorized by decade of age, there was a normal distribution among the categories of breast density. There was a significant inverse relationship between age and breast density (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). Seventy-four percent of patients between 40 and 49 years old had dense breasts. This percentage decreased to 57% of women in their 50s. However, 44% of women in their 60s and 36% of women in their 70s had dense breasts as characterized on their screening mammograms. In general, we found an inverse relationship between patient age and mammographic breast density. However, there were outliers at the extremes of age. A meaningful proportion of young women had predominantly fatty breasts and a subset of older women had extremely dense breasts. Increased density renders mammography a less sensitive tool for early detection. Breast density should be considered when evaluating the potential benefit of extended imaging for breast cancer screening, especially for women at increased risk for the disease.

Research paper thumbnail of Race, Oncotype DX, and other characteristics in a highly screened population

Asco Meeting Abstracts, Sep 10, 2014

Research paper thumbnail of Prevalence of BRCA2 mutations and other clinical characteristics in women with triple-negative breast cancer

Journal of Clinical Oncology, 2014

160 Background: Triple-negative breast cancers (TNBC) represent 10%–20% of invasive breast cancer... more 160 Background: Triple-negative breast cancers (TNBC) represent 10%–20% of invasive breast cancers. Current guidelines recommend genetic testing for women who are diagnosed with TNBC. Studies have shown that BRCA1 mutations are associated with TNBC, but there is little information on the relationship of BRCA2 mutations and TNBC. The purpose of this study was to look at the clinical characteristics of TNBC compared to non-TNBC in a cohort of women with newly diagnosed breast cancer. Methods: The Breast Cancer Database at our institution was queried for patients with invasive breast cancer. We included the following variables: age, race, BRCA1,2, tumor characteristics, and personal history of breast cancer (PHBC). Statistical analyses included Pearson’s Chi-Square and Fisher’s Exact Tests. Results: Out of a total of 1,332 women, 125 (9%) had TNBC. The median age for both TNBC and non-TNBC was 59 years. Majority of women had early stage breast cancer (92%) with ductal carcinoma (80%). ...

Research paper thumbnail of Imaging and Clinicopathologic Characteristics in a Contemporary Cohort of Younger Women With Newly Diagnosed Breast Cancer

Cancer Treatment and Research Communications, 2016

Research paper thumbnail of Prevalence of BRCA2 mutations and other clinical characteristics in women with triple-negative breast cancer

Asco Meeting Abstracts, Sep 10, 2014

Research paper thumbnail of Tumor characteristics in obese women with breast cancer

Asco Meeting Abstracts, Sep 20, 2012

Research paper thumbnail of The relationship of breast density in mammography and magnetic resonance imaging in high-risk women and women with breast cancer

Clinical Imaging, 2015

To evaluate the relationship between mammographic breast density (MBD), background parenchymal en... more To evaluate the relationship between mammographic breast density (MBD), background parenchymal enhancement (BPE), and fibroglandular tissue (FGT) in women with breast cancer (BC) and at high risk for developing BC. Our institutional database was queried for patients who underwent mammography and MRI. Four hundred three (85%) had BC and 72 (15%) were at high risk. MBD (P=.0005), BPE (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;.0001), and FGT (P=.02) were all higher in high-risk women compared to the BC group. Higher levels of MBD, BPE and FGT are seen in women at higher risk for developing BC when compared to women with BC.

Research paper thumbnail of Abstract P1-09-03: Chemoprevention in patients with newly diagnosed breast cancers

Research paper thumbnail of Abstract P4-01-07: The Relationship of Breast Density in Mammography and Magnetic Resonance (MR) Imaging in a High Risk Population

Research paper thumbnail of Abstract P5-15-02: Beyond the learning curve: Surgical judgment in the approach to breast conserving surgery

Research paper thumbnail of Abstract P6-10-10: History of chemoprevention in patients with newly diagnosed breast cancers

Research paper thumbnail of Predictors of breast cancer development in a high-risk population

The American Journal of Surgery, 2006

The purpose of this study was to investigate the strongest predictors of breast cancer in a high-... more The purpose of this study was to investigate the strongest predictors of breast cancer in a high-risk population and to increase our understanding of the possible interactions between risk factors. The Women At Risk High-Risk Registry provided the study population. The variables of interest included age at enrollment, presence of lobular carcinoma in situ (LCIS), atypical ductal hyperplasia (ADH), atypical lobular hyperplasia, family history of breast cancer, body mass index, and Gail scores (5-year high-risk &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; or =1.7%). Univariate and multivariate analyses were conducted with the Cox proportional hazards regression model and years of follow-up evaluation as the time scale. Out of 1553 high-risk women, 79 (5%) developed breast cancer during a median follow-up period of 5 years. Results from the multivariate Cox model demonstrated that FHBC (hazard ratio [HR] = 1.76; 95% confidence interval [CI], 1.05-2.97), ADH (HR = 1.90; 95% CI, 1.16-3.13), LCIS (HR = 1.71; 95% CI, .99-2.95), and a body mass index &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; or =30 (HR = 2.22; 95% CI, 1.14-4.35) were statistically significant predictors of breast cancer within this high-risk population. These results support current literature showing the synergistic increase in risk for patients with ADH, LCIS, and a positive family history of breast cancer. Obesity was also a strong predictor of breast cancer risk, which suggests that there may be a potentiating effect of obesity on other risk factors. Obesity may represent a modifiable risk factor, providing women with an opportunity to reduce their risk with lifestyle modification. Women with a strong family history of breast cancer or a diagnosis of ADH or LCIS may benefit most from risk-reduction strategies, chemoprevention, and surveillance.

Research paper thumbnail of Screening prior to Breast Cancer Diagnosis: The More Things Change, the More They Stay the Same

International Journal of Breast Cancer, 2013

revised their breast cancer screening guidelines. We evaluated the pattern of screening subsequen... more revised their breast cancer screening guidelines. We evaluated the pattern of screening subsequent to the altered guidelines in a cohort of women. Methods. Our database was queried for the following variables: age, race, method of diagnosis, mass palpability, screening frequency, histology, and stage. Statistical analyses were performed using Pearson's chi-square and Fisher's exact tests. Results. 1112 women were diagnosed with breast cancer from January 2010 to 2012. The median age at diagnosis was 60 years. Most cancers were detected on mammography (61%). The majority of patients had invasive ductal carcinoma (59%), stage 0 (23%), and stage 1 (50%) cancers. The frequency of screening did not change significantly over time ( = 0.30). However, nonregular screeners had an increased risk of being diagnosed with later stage breast cancer ( < 0.001) and were more likely to present with a palpable mass compared to regular screeners (56% versus 21%; < 0.001). Conclusions. In our study, screening behavior did not significantly change in the years following the USPSTF guidelines. These results suggest that women who are not screened annually are at increased risk of a delay in breast cancer diagnosis, which may impact treatment options and outcomes.

Research paper thumbnail of The Breast Cancer Lifestyle Intervention Pilot Study

Journal of Cancer Therapy, 2014

Purpose: Weight loss after breast cancer diagnosis has been associated with a decrease in risk of... more Purpose: Weight loss after breast cancer diagnosis has been associated with a decrease in risk of breast cancer recurrence and mortality. The purpose of this study is to examine the barriers, acceptance, and sustainability of an exercise intervention program offered at our institution to overweight women with newly diagnosed breast cancer. Methods: The Breast Cancer Database was queried for women newly diagnosed with breast cancer and a body mass index (BMI) ≥ 25 kg/m 2 . Eligible patients participated in the Moving for Life (MFL) exercise program for 16 sessions. Questionnaires were administered. Statistical analyses included descriptives and paired t-tests to summarize patient characteristics and assess changes over time. Results: Of 40 patients, 22 declined, 18 consented and 13 (72%) completed the study. The mean age was 61 years (range: 38 -76). The mean BMI was 31 kg/m 2 . After the intervention, there was a decrease in weight and BMI (p = 0.04). The average weight loss was 10 lbs. Participants reported greater enjoyment of exercise (p = 0.02) and decreased pain related to treatment (p = 0.05). These initial positive results were not maintained after 6 months and 1 year. Conclusions: The MFL intervention had a high rate of acceptance among overweight women newly diagnosed with breast cancer. These results demonstrated significant benefits of exercise immediately after cancer diagnosis and highlight the importance of developing sustainable lifestyle interventions. Interventions targeted at modifiable lifestyle factors in women with early stage disease may provide benefit that is comparable to certain adjuvant systemic therapies. Therefore, adjuvant lifestyle interventions supported by clinicians may improve breast cancer survival outcomes.

Research paper thumbnail of The value of clinical characteristics and breast imaging studies in predicting a histopathologic diagnosis of cancer or high-risk lesion in patients with spontaneous nipple discharge

The American Journal of Surgery, 2007

Research paper thumbnail of Pregnancy-associated breast cancer and increased risk of pregnancy-associated recurrence: a case report

Journal of Medical Case Reports, 2012

Introduction: Pregnancy-associated breast cancer refers to breast cancer diagnosed during pregnan... more Introduction: Pregnancy-associated breast cancer refers to breast cancer diagnosed during pregnancy, lactation, or within twelve months postpartum. Recent studies suggest that, when matched for age and stage, the prognosis of pregnancy-associated breast cancer is comparable to non-pregnancy-associated breast cancer. However, the risk for breast cancer recurrence associated with subsequent pregnancies in this population is not clear. Case presentation: We describe the case of a Caucasian woman who was initially treated for pregnancy-associated breast cancer at age 23, three months after the birth of her third child. She underwent a total mastectomy with axillary node dissection, followed by chemotherapy and hormonal therapy. Ten years later, when the patient was 24 weeks pregnant with her fourth child, she presented with an ipsilateral chest wall recurrence of breast cancer. To the best of our knowledge, this represents the first reported case of a pregnancy-associated recurrence in a patient previously treated for pregnancy-associated breast cancer. Conclusion: The case described here is the first report of a second occurrence of pregnancy-associated breast cancer. This case raises the possibility that pregnancy may represent a unique trigger for breast malignancy in a specific cohort of women. Although there is data showing no increase in the risk of recurrence for women who become pregnant after breast cancer treatment, pregnancy-associated breast cancer may be a distinct clinical category where subsequent pregnancies after treatment may confer an increased risk of recurrent disease.

Research paper thumbnail of Abstract P2-01-02: The Incidence of Mammographically-Occult Breast Cancer in Women Older than Seventy Years

Research paper thumbnail of Incidence and Clinical Significance of Lymph Node Metastasis Detected by Cytokeratin Immunohistochemical Staining in Ductal Carcinoma In Situ

Annals of Surgical Oncology, 2005

This study explored the long-term prognosis of patients with ductal carcinoma-in-situ (DCIS) and ... more This study explored the long-term prognosis of patients with ductal carcinoma-in-situ (DCIS) and lymph node metastasis detected by cytokeratin immunohistochemical stains (CK-IHC). Using the Columbia University breast cancer database, we identified all DCIS patients who had eight or more axillary nodes dissected and free of metastasis. Five-micrometer sections from all paraffin blocks containing lymph node tissue were stained with an anticytokeratin antibody cocktail (AE1/AE3 and KL1). The results of the CK-IHC and updated database were anonymized and merged. Survival of CK-IHC-positive and -negative patients was compared by using Kaplan-Meier curves and log-rank tests. CK-IHC was performed on 301 DCIS patients, who had an average of 16.7 axillary nodes dissected. Eighteen (6%) of 301 patients tested positive by CK-IHC. Seventy patients with bilateral breast cancer and 2 patients without any follow-up data were excluded, for a final study population of 229 patients. Among the 216 patients with negative CK-IHC, 18 patients died, compared with 1 of 13 patients with positive CK-IHC. The median follow-up for the study group was 127 months. Kaplan-Meier overall and breast cancer-specific survival estimates were similar for CK-IHC-positive and -negative patients (P = .81 and P = .73, respectively). CK-IHC increases the incidence of positive nodes by 6% in DCIS patients. A positive node by CK-IHC does not seem to affect survival in these patients. These results raise concerns regarding the clinical significance of positive nodes by CK-IHC in DCIS patients.

Research paper thumbnail of The Relationship of Mammographic Density and Age: Implications for Breast Cancer Screening

American Journal of Roentgenology, 2012

Breast density is increasingly recognized as an independent risk factor for the development of br... more Breast density is increasingly recognized as an independent risk factor for the development of breast cancer, because it has been shown to be associated with a four- to sixfold increase in a woman&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s risk of malignant breast disease. Increased breast density as identified on mammography is also known to decrease the diagnostic sensitivity of the examination, which is of great concern to women at increased risk for breast cancer. Dense tissue has generally been associated with younger age and premenopausal status, with the assumption that breast density gradually decreases after menopause. However, the actual proportion of older women with dense breasts is unknown. The purpose of this study was to examine the relationship between age and breast density, particularly focusing on postmenopausal women. All screening mammograms completed at the New York University Langone Medical Center in 2008 were retrospectively reviewed. Analysis of variance and descriptive analyses were used to evaluate the relationship between patient age and breast density. A total of 7007 screening mammograms were performed. The median age of our cohort was 57 years. Within each subgroup categorized by decade of age, there was a normal distribution among the categories of breast density. There was a significant inverse relationship between age and breast density (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). Seventy-four percent of patients between 40 and 49 years old had dense breasts. This percentage decreased to 57% of women in their 50s. However, 44% of women in their 60s and 36% of women in their 70s had dense breasts as characterized on their screening mammograms. In general, we found an inverse relationship between patient age and mammographic breast density. However, there were outliers at the extremes of age. A meaningful proportion of young women had predominantly fatty breasts and a subset of older women had extremely dense breasts. Increased density renders mammography a less sensitive tool for early detection. Breast density should be considered when evaluating the potential benefit of extended imaging for breast cancer screening, especially for women at increased risk for the disease.

Research paper thumbnail of Race, Oncotype DX, and other characteristics in a highly screened population

Asco Meeting Abstracts, Sep 10, 2014