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Background: Male breast cancer is rare accounting for less than 0.5% of all cancer diagnoses in men. Previous epidemiological studies reported conflicting results regarding the prognosis of male breast cancer in comparison to female breast cancer. As treatment for breast cancer has improved significantly, we conducted this study to evaluate male breast cancer characteristics and mortality. Methods: All patients diagnosed with breast cancer between 2010 and 2015 from the population-based cancer registries of the Surveillance Epidemiology and End Results program (SEER) were analyzed. Descriptive statistics, Kaplan-Meier analysis and COX regression model were used to examine the data. Results: A total of 380,116 cases of breast cancer were found including 2,978 cases of male breast cancer. The age-adjusted incidence rate for male breast cancer during the study period was 1.2 per 100,000 individuals per year which is slightly higher than the rate during the 10 years period preceding our study date (1.1 per 100,000 per year). Out of all male breast cancer patients, 80.7% of them were white, 14.6% black and 4.7% from other races. The median age of diagnosis was 68. 34% of male breast cancer patients were diagnosed with stage I, 41.6% with stage II, 16.2% with stage III and 8.2% with stage IV. 97% of male breast cancer cases were ER/PR positive and 11.9% were HER2 positive. 5-year survival rate for male breast cancer patients was 90% for stage I, 86% for stage II, 78% for stage III and 28% for stage IV. Cox proportional-hazards model revealed a slight increase in mortality associated with male breast cancer in comparison to female breast cancer (adjusted hazard ratio, 1.15; 95% confidence interval, 1.06 to 1.24; P Conclusions: Male breast cancer represents less than 1% of breast cancer cases. Its age-adjusted incidence rate has slightly increased. It is mostly diagnosed as early stage with positive hormone receptors status. After controlling for other risk factors, male breast cancer patients have a worse survival outcome than female patients. Citation Format: John Khoury, Nwabundo Anusim, David Macari, Ishmael Jaiyesimi. Demographics and survival in male breast cancer: An updated analysis of SEER database [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P4-17-07.

Background: Inflammatory breast cancer (IBC) is a rare and aggressive malignancy, distinguished by characteristic skin changes with/without breast mass. While new therapies have improved the survival of IBC, the prognosis of metastatic disease (stage IV) remains poorly described. The current analysis is aimed at investigating the demographics of metastatic IBC and the impact of chemotherapy use and tumor subtype on survival. Methods: Using ICD-O-3 histology code 8530/3 in the Surveillance Epidemiology and End Results database (SEER), demographics and survival data on metastatic IBC diagnosed between 2010 and 2015 were abstracted. JMP 14 statistical software was used for data analysis. The SEER database does not record specific age above 85 years and these cases were excluded. Results: Over five years, 378 patients were diagnosed with metastatic IBC. All were women and most were Caucasian (282, 75%). Mean age was 60±14 years. During the observation period 284 (75%) patients died and of which 218 deaths were attributable to IBC. Cancer subtype was unknown in 61 patients; for the rest, Luminal A was the most common (121, 38%), followed by triple negative (74, 23%), HER2 enriched (62, 20%) and luminal B (60, 19%). Median overall survival (OS) was 18 months (95% CI 14-20), with a survival rate of 39% at 24 months from diagnosis. In unadjusted analyses, patients receiving chemotherapy (n=191) had increased survival at every time point compared to those who did not (n=93), (median OS 22 (95% CI 18-26) vs 5 months (95% CI 2-11), p Conclusion: From our data, IBC is common in Caucasian women in their 7th decade of life. Luminal B was the least common cancer subtype and had the best overall survival. Chemotherapy appears to play an important part in increasing survival; but ethnicity and tumor subtype are also important predictors of mortality. Keywords: Inflammatory breast cancer, Metastatic, Survival, Demographics Citation Format: Nwabundo Anusim, Filip Ionescu, John Khoury, Anish Konde, Ishmael Jaiyesimi. Demographics and survival in metastatic inflammatory breast cancer. SEER data analysis [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P6-15-05.

Background: Studies using the 21-gene recurrence score (RS) have shown early-stage, low-risk pathologic and genomic breast cancers do not benefit from systemic chemotherapy (CTx) whereas early stage, high-risk breast cancers have improved outcomes when treated with CTx. Data is lacking for patients with discordant risk factors and which feature, genomic or clinical, plays more of a role in determining outcomes. Methods: A retrospective analysis was conducted to identify early-stage breast cancer patients with discordant features, defined as low-risk genomic/high-risk pathologic factors (LG/HP) or high-risk genomic/low-risk pathologic factors (HG/LP), from August 2011–December 2016. LG/HP breast cancer was defined as a RS Results: There were 469 patients with low-risk RS identified of whom 118 (25%) met discordant high-risk pathologic criteria and 62 patients with high-risk RS of whom 14 (23%) met discordant low-risk pathologic criteria. Thirty patients in the LG/HP group received CTx despite a low RS. Of the 118 LG/HP patients, there were 22 (19%) breast cancer recurrences; 21 with locoregional and one with metastatic disease. Of the locoregional recurrences, 10 were contralateral breast whereas 11 were in-breast recurrence despite breast conservation therapy. Of the 14 HG/LP discordant patients, of whom 12 received CTx, 3 (21%) had breast cancer recurrence; one with metastatic disease to the lung and the other two with contralateral breast cancer. Majority of all recurrences occurred >5 years after initial diagnosis. Staging and management depicted below. Management (Mgt) of Discordant Risk Cancers LG/HP initial diagnosis (n=118)LG/HP recurrence (n=22)HG/LP initial diagnosis (n=14)HG/LP recurrence (n=3)Stage 004001A1411142IB14100IIA56500IIB25000IIIA2000IV0101Surgical Mgt Partial mastectomy737102Simple mastectomy431440LN Mgt Sentinel LN biopsy8510132Axillary LN dissection25310Unknown/Not Applicable6800Radiation Mgt Yes816103*No/Unknown351500Hormonal Therapy Yes9417143No/Unknown24500Systemic CTx Neoadjuvant6100Adjuvant242122No/Refused881921*metastatic pt with SBRT to lung Conclusions: Using traditional low-risk RS of 18, we observed more than expected recurrences in our LG/HP discordant patients. Thus suggesting, in patients with discordant results, clinicians must consider both pathologic and genomic factors to optimize patient-specific treatment. Further studies are needed to improve the outcomes of this unique patient population. Citation Format: Blankenship LM, Ezekwudo D, Jaiyesimi I, Stender M, Alassi O, Kresge C, Gaikazian S. Discordant breast cancer: Genomic verse clinicopathologic [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P1-07-17.

Purpose: We reviewed the impact of a community based participatory process (CBPP) addressing cancer education, prevention, and screening in two ethnic/minority populations to determine their impact on personal health related decisions. Materials and Methods: From 2005 – 2008, 2,281 community members participated in CBPP outreach efforts (cancer education, prevention and screening forums) conducted by the Beaumont Cancer Institute in cooperation with the Arab American and Chaldean Council, the National Cancer Institute and the American Cancer Society. The study population consisted of 1,067 (46.7%) individuals completing a post-cancer forum survey: 642 (60.2%) from the African American (AA) and 425 (39.8%) from the Arab American & Chaldean (AAC) communities. Data were collected on behavioral intent and knowledge including: (1) forum content, (2) participants' cancer screening history, (3) symposium logistics (4) educational materials and (5) participation in subsequent cancer screening tests. Results: After attending at least one cancer education forum, 329 (30.8%) of the 1,067 participant respondents (14.4% of all attendees) underwent some type of cancer screening: 108 women (10.1%) underwent a screening mammogram, and 94 (8.8%) a pap smear. Thirty-eight men underwent (3.6%) a screening PSA, and 89 (8.3%) had other forms of cancer screenings (e.g. colonoscopy). Overall, 60.2% of AA versus 35% of ACC attendees completed a post-survey and 19.6% of AA versus 10% of AAC attendees underwent some type of cancer screening. Conclusions: The results of this study suggest that CBPP's based around perceived and/or serious diseases negatively affecting a target population can positively impact their personal health related decisions. Citation Information: Cancer Res 2009;69(23 Suppl):C61.

Background: Chemotherapy induced alopecia (CIA) is considered the most distressing side effect of chemotherapy for breast cancer patients. Scalp hypothermia offers hope to minimize chemotherapy induced alopecia (CIA) for breast cancer patients. We present data from a pilot study of scalp hypothermia with the Penguin Cold Cap System™ in patients receiving a combination chemotherapy regimen. Patients and Methods: Stage I-IIIC breast cancer patients, receiving adjuvant chemotherapy regimens with or without (A) were consented. Standard dose regimens included doxorubicin-cyclophosphamide (AC) x 4 cycles, dose dense, doxorubicin-cyclophosphamide followed by taxol (AC-T) x 8 cycles, taxotere-doxorubicin-cyclophosphamide (TAC) x 6 cycles, taxotere-cyclophosphamide (TC) x 4 cycles and taxotere-carboplatnium-trastuzumab (TCH) x 6 cycles. Photos were taken before and with each cycle and 3 weeks post chemotherapy, Dean's alopecia scale was used for grading. Caps were cooled to 8oC. Caps 1-2 were 20 minutes each prior to infusion, following caps were changed q 30 minutes throughout chemotherapy and for 3 hours post-chemotherapy. Results: See tables 1 and 2 for patient data. We enrolled 34 patients (22 (A) containing; 12 non (A) containing) after informed consent. Of patients withdrawn, 1 patient (AC-T) had metastatic disease at the time of registration and did not start scalp hypothermia,1 patient (TC) had scalp discoloration; 2 patients (AC and TAC) withdrew due to discomfort of cooling; 1 patient (TC) withdrew prior to start of therapy due to fear of discomfort and 1 patient (AC) was withdrawn for coloring hair at time of treatment. The mean percent of CIA in the (A) containing group was 52% (SD: 17 CI: 40-70) and the mean percent CIA in non (A) containing group was 25% (SD: 36 CI: 5-100). A comparison of the means yielded a p-value of 0.0003 in favor of non (A) containing regimens. Of the 12 patients in the non (A) containing regimen 83% (3 TCH, 7 TC) did not require a prostheses and of the patients receiving an (A) containing regimen 47% (8 AC) did not require a prostheses. For those patients who completed scalp hypothermia through chemotherapy, the median CIA for TC and TCH combined was 10% hair loss (5,25) and for AC, AC-T and TAC combined was 50% hair loss (45,70). Discussion: All patients who received TAC or AC-T had grade 4 CIA and needed a hair prostheses. Most AC patients preserved some of their hair. Hair thinning was even and not patchy in this group and most had no need for prostheses. Patients in the TC or TCH group, who were able to complete the scalp hypothermia therapy, retained 90% or better, of their hair and there was no need for prostheses in these groups. We found the scalp hypothermia technique used here reduces hair loss in AC patients and offers the possibility of CIA prevention for women with breast cancer receiving TC or TCH.Table 1. Data for all enrolled patientsRegimenEnrolledWithdrewCompletedAC1028AC-T716TAC514TC927TCH3-3 Table 2. Deans alopecia scale for all enrolled patientsRegimenGrade1 Excellent 75%AC2422AC-T---7TAC---5TC7--2TCH3--- Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 5040.