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- Alkner, Sara, et al.
(author)
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The role of AIB1 and PAX2 in primary breast cancer: validation of AIB1 as a negative prognostic factor.
- 2013
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In: Annals of Oncology. - : Elsevier BV. - 1569-8041 .- 0923-7534. ; 24:5, s. 1244-1252
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Journal article (peer-reviewed)abstract
- BackgroundThe steroid-receptor coactivator amplified in breast cancer one (AIB1) is implicated to be a prognostic factor, although the results are not unanimous. Recently its effect was suggested to be modified by paired box 2 gene product (PAX2).Patients and methodsUsing immunohistochemistry (IHC) AIB1 and PAX2 were investigated in two cohorts of early breast cancer, including systemically untreated premenopausal lymph-node-negative women and pre- and postmenopausal women receiving tamoxifen.ResultsAIB1 scores were available for 490 patients and PAX2 scores were available for 463 patients. High AIB1 was a negative prognostic factor for distant disease-free survival (DDFS, P = 0.02) and overall survival (OS, P < 0.001) in systemically untreated women, while no prognostic effect was seen in the tamoxifen-treated cohort, indicating AIB1 to be a predictor of tamoxifen response. In systemically untreated patients, PAX2 was not a prognostic factor, nor did it modify the effect of AIB1. However, in ER-positive patients receiving tamoxifen, PAX2 appeared to be a positive prognostic factor in premenopausal patients, while a negative factor in postmenopausal. The interaction between the menopausal status and PAX2 was significant (P = 0.01).ConclusionsIn an independent cohort of low-risk premenopausal patients, we validate AIB1 as a negative prognostic factor, indicating AIB1 to be an interesting target for new anti-cancer therapies. The effect of PAX2 warrants further studies.
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- Andersén, Christoffer, 1991-, et al.
(author)
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Presults for the aI-Brachy study : Utilizing deep learning for needle reconstruction in prostate brachytherapy
- 2019
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Conference paper (peer-reviewed)abstract
- Purpose To develop a deep neural network for automatic reconstruction of needles in ultrasound images depicting the prostate during brachytherapy treatment of prostate cancer.Methods Ultrasound tomographies of the prostate from 907 treatments were used to train the artificial intelligent (AI) algorithm. The image matrices were downsampled to 128x128x128 and were used as in-data when training the AI, a 27 layer convolutional neural network. The needles were identified manually by medical physicists using conventional software. These reconstructions were used as gold standard when training the algorithm. An additional set of examinations were used for validation where the needle reconstructions by the AI were compared to the manual reconstructions. The root mean square deviation (RMSD) of needle position, including the central part (70 slices) of the needle was measured in order to avoid influence from artefacts around the needle tip. The result was also evaluated through visual inspection (see image). The times spent for manual vs. AI reconstruction were compared.Results RMSD for manual vs. AI reconstruction is on average (n=170) 1.18±1.0mm, whereas the difference between two manual operators is 0.02±0.06mm, which suggests that the AI is inferior to manual operators. The visual inspection, however, shows AI to be very accurate in positioning the needles. Manual reconstruction took approximately 11.0 minutes, whereas the time for the trained AI is negligible in comparison. Worth noticing regarding RMSD calculations is that, due to limited image resolution, small values may be under-estimated, hence overestimating the difference between the reconstruction methods.Conclusions The study implies that an AI may reconstruct needles for brachytherapy treatments of prostate cancer. The larger deviations between AI algorithm and manual operators, compared to between human operators appears to disagree with the high accuracy of the visual evaluation. However, visually, manual needle reconstructions appear to deviate more from the ultrasound image than do the AI reconstructions. This discrepancy is mainly caused by manual reconstruction software assuming straight needles, unlike the AI. We conclude that AI gives the opportunity to save a substantial amount of treatment planning time, when the patient is anesthetised. Further studies are needed to determine whether different reconstruction methods impact treatment plans.
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- Andersson, Lars Gustaf, et al.
(author)
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Mannen på gatan : Håkan Alexanderssons sista film
- 2010
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In: Ferlin och alla de andra. Festskrift till Jenny Westerström. ; , s. 29-33
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Book chapter (pop. science, debate, etc.)abstract
- Short analysis of the experimental short film "Mannen på gatan" ('The Man in the Street') by Swedish filmmaker Håkan Alexandersson (1940 - 2004).
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| 5. |
- Axelsson, Ulrika, et al.
(author)
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A multicenter study investigating the molecular fingerprint of psychological resilience in breast cancer patients : Study protocol of the SCAN-B resilience study
- 2018
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In: BMC Cancer. - : Springer Science and Business Media LLC. - 1471-2407. ; 18:1
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Journal article (peer-reviewed)abstract
- Background: Individual patients differ in their psychological response when receiving a cancer diagnosis, in this case breast cancer. Given the same disease burden, some patients master the situation well, while others experience a great deal of stress, depression and lowered quality of life. Patients with high psychological resilience are likely to experience fewer stress reactions and better adapt to and manage the life threat and the demanding treatment that follows the diagnosis. If this phenomenon of mastering difficult situations is reflected also in biomolecular processes is not much studied, nor has its capacity for impacting the cancer prognosis been addressed. This project specifically aims, for the first time, to investigate how a breast cancer patient's psychological resilience is coupled to biomolecular parameters using advanced "omics" and, as a secondary aim, whether it relates to prognosis and quality of life one year after diagnosis. Method: The study population consists of newly diagnosed breast cancer patients enrolled in the Sweden Cancerome Analysis Network - Breast (SCAN-B) at four hospitals in Sweden. At the time of cancer diagnosis, the patient fills out the standardized method to measure psychological resilience, the "Connor-Davidson Resilience scale" (CD-RISC), the quality of life measure SF-36, as well as providing social and socioeconomic variables. In addition, one blood sample is collected. At the one-year follow-up, the patient will be subjected to the same assessments, and we also collect information regarding smoking, exercise habits, and BMI, as well as patients' trust in the treatment and their satisfaction with the care and treatment. Discussion: This explorative hypothesis-generating project will pave the way for larger validation studies, potentially leading to a standardized method of measuring psychological resilience as an important parameter in cancer care. Revealing the body-mind interaction, in terms of psychological resilience and quality of life, will herald the development of truly personalized psychosocial care and cancer intervention treatment strategies. Trial registration: This is a retrospectively registered trial at ClinicalTrials.gov, ID: NCT03430492on February 6, 2018.
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| 6. |
- Berg, Per G, et al.
(author)
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11. Urbanisation and Urban-Rural Cooperation
- 2012. - 1
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In: Rural Development and Land Use. - Uppsala : Baltic University Press. - 9789186189112 ; , s. 141-154
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Book chapter (pop. science, debate, etc.)
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| 7. |
- Browall, Maria, et al.
(author)
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A prospective exploration of symptom burden clusters in women with breast cancer during chemotherapy treatment
- 2017
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In: Supportive Care in Cancer. - : Springer. - 0941-4355 .- 1433-7339. ; 25:5, s. 1423-1429
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Journal article (peer-reviewed)abstract
- PurposeThe aim was to prospectively map symptom clusters in patients with stage I–IIIa breast cancer during standard chemotherapy treatment in a randomised study.MethodsParticipants completed the Memorial Symptom Assessment Scale (MSAS) at baseline, day 12 after the first and third cycle of FEC 75 or FEC 100, and day 12 after the last cycle of Taxotere. Cut-off values for symptom scores, a mean value based on each individual reporting a symptom including occurrence, frequency, severity and distress for inclusion in analysis, were determined.ResultsThe symptom burden cluster analysis was conducted in two steps and included symptoms with high frequency and high levels of distress. The factor analysis revealed three symptom clusters; physical, gastro (phys/gastro) and emotional, with core symptoms that remained stable over time. The most prevalent symptoms for the total sample during all cycles were as follows: lack of energy (range between 48 and 90%), feeling sad (48–79%), difficulty sleeping (54–78%), difficulty concentrating (53–74%), worrying (54–74%) and pain (29–67%).ConclusionIn summary, we have prospectively established that symptom clusters remain stable over time with a basis of core symptoms. This knowledge will aid in the development of effective core symptom-focused interventions to minimise symptom burden for patients treated with chemotherapy for breast cancer.
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| 9. |
- Ehinger, Anna, et al.
(author)
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Histological grade provides significant prognostic information in addition to breast cancer subtypes defined according to St Gallen 2013
- 2017
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In: Acta Oncologica. - : TAYLOR & FRANCIS LTD. - 0284-186X .- 1651-226X. ; 56:1, s. 68-74
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Journal article (peer-reviewed)abstract
- Background: The St Gallen surrogate definition of the intrinsic subtypes of breast cancer consist of five subgroups based on estrogen receptor (ER), progesterone receptor (PgR), human epidermal growth factor receptor type 2 (HER2), and Ki-67. PgR and Ki-67 are used for discriminating between the Luminal A-like and Luminal B-like (HER2-negative) subtypes. Histological grade (G) has prognostic value in breast cancer; however, its relationship to the St Gallen subtypes is not clear. Based on a previous pilot study, we hypothesized that G could be a primary discriminator for ER-positive/HER2-negative breast cancers that were G1 or G3, whereas Ki-67 and PgR could provide additional prognostic information specifically for patients with G2 tumors. To test this hypothesis, a larger patient cohort was examined. Patients and methods: Six hundred seventy-one patients (amp;gt;= 35 years of age, pT1-2, pN0-1) with ER-positive/HER2-negative breast cancer and complete data for PgR, Ki-67, G, lymph node status, tumor size, age, and distant disease-free survival (DDFS; median follow-up 9.2 years) were included. Results: Luminal A-like tumors were mostly G1 or G2 (90%) whereas Luminal B-like tumors were mostly G2 or G3 (87%) and corresponded with good and poor DDFS, respectively. In Luminal B-like tumors that were G1 (n = 23), no metastasis occurred, whereas 14 of 40 Luminal A-like tumors that were G3 metastasized. In the G2 subgroup, low PgR and high Ki-67 were associated with an increased risk of distant metastases, hazard ratio (HR) and 95% confidence interval (CI) 1.8 (0.95-3.4) and 1.5 (0.80-2.8), respectively. Conclusions: Patients with ER-positive/HER2-negative/G1 breast cancer have a good prognosis, similar to that of Luminal A-like, while those with ER-positive/HER2-negative/G3 breast cancer have a worse prognosis, similar to that of Luminal B-like, when assessed independently of PgR and Ki-67. Therapy decisions based on Ki-67 and PgR might thus be restricted to the subgroup G2.
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