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Query: UMLS:C0016632 (Fox)
 1,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The incidence of breast cancer increases with age, but women's participation in breast screening decreases with age. National and regional surveys indicate a number of barriers. Women over age 65 are more likely to say they have never heard of mammograms, that they did not know they needed them, and that their doctors did not recommend them. In a study conducted at Fox Chase Cancer Center, in Philadelphia, participation in an HMO-sponsored breast screening program appeared to reverse the usual age-related decrease in mammography. If mammography utilization is to increase in women over age 65, physicians must offer unambiguous referrals to older women. In addition, health education interventions are needed to improve knowledge and beliefs of older women and their physicians. And, finally, strategies also are needed to enhance access. With the advent of Medicare coverage, payment will be less of a barrier. But other barriers remain.
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PMID:Older women's participation in breast screening. 143 Aug 90

Bilateral primary breast cancers occur commonly enough to justify adoption of special pre- and post-initial therapy screening. A 13.2% incidence of bilateral breast carcinoma has been found in the breast cancer patients who presented to the Fox Chase Cancer Center with an operatively manageable primary in an arbitrarily defined 30-month period and who have been followed for at least 20 months thereafter. Of the 287 patients seen in those 30 months, 4.5% had synchronously detectable lesions. Xeroradiography is helpful in the initial and follow-up evaluation of the patient for detection of a second primary and may lead to the discovery of an earlier-stage lesion. A history of a family member having a breast cancer was shown to be significant, 26% and 24% for primary and secondary relatives, respectively, and warrant a special screening strategy. Recognition of these factors may lead to earlier detection of curable breast cancers.
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PMID:Bilateral breast carcinoma: prospective evaluation of factors assisting diagnosis. 373 61

The majority of information available today indicates that the most efficient and accurate method of screening women to detect early-stage breast cancer is an aggressive program of patient self-examination, physical examination by well-trained, motivated personnel, and high-quality x-ray mammography. There are two important factors in the implementation of mammographic screening. The first is the availability of facilities to perform high-quality, low-dose mammography, which is directly related to the second factor: the expense to society for support of this large-scale effort. Cost-benefit analysis is beyond the scope of this review. In 1979 Moskowitz and Fox attempted to address this issue, using data from the Breast Cancer Detection Demonstration Project in Cincinnati, but additional analysis is required. The cost for each "curable" cancer that is detected must be compared with the psychological, social, and personal losses that accrue, as well as the numerous medical expenses incurred, in a frequently protracted death from breast cancer. All other imaging techniques that have been reviewed should be regarded as adjuncts to rather than replacements for mammographic screening (Table 1). Ultrasound and computerized tomography are helpful when the physical examination and mammogram are equivocal. Other techniques, such as transillumination, thermography, and magnetic-resonance imaging, should be considered experimental. In patients with clinically evident lesions, x-ray mammography is helpful to evaluate the suspicious area, as well as to "screen" the remaining tissue in both breasts and to search for multicentric or bilateral lesions. Mammography is the only imaging technique that has been proved effective for screening. The low doses required by present-day mammographic technology pose a possible risk that is so small it is not measurable. The image quality has improved considerably over the past decade, and data supporting the benefits of mammography are increasing. As a result, the American Cancer Society has recently modified its recommendations to include mammographic screening of asymptomatic women beginning at the age of 40 years (Table 2). Before any new system can be considered a replacement for mammographic screening, carefully executed trials are necessary to prove efficacy beyond anecdotal claims.
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PMID:Breast imaging. 636 62

Two hundred seventy-five patients with breast cancer and no axillary metastases had mastectomies and axillary node dissection performed during the period between 1970 and 1979 at The Fox Chase Cancer Center. They had a mean age of 60 years (range, 21-91) and 38 (14%) patients have had recurrence to date. Poor histologic differentiation and skin involvement were related to a high risk of recurrence. Those patients with skin infiltration by tumor or a poorly differentiated tumor had a 53 +/- 9% expected five-year tumor-free survival, whereas patients without these had a 90 +/- 2% expected five-year tumor-free survival. Tumor involvement of the lymphatic vessels within the breast and estrogen receptor protein positivity or negativity were not helpful for identifying a subpopulation at increased risk of recurrence. Large tumor size was not a poor prognostic indicator for a patient subpopulation. These factors should be considered as indicators for inclusion in clinical trials and adjuvant therapy and used as stratification points for the analysis of the data developed in these trials.
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PMID:Breast cancer without axillary metastases. Are there high-risk biologic subpopulations? 711 7

This work examined the role of constitutional genetic variation at the glutathione S-transferase M1 (GSTM1) and NAD(P)H:quinone oxidoreductase 1 (NQO1) detoxification loci in breast cancer development. Methods included contrasting patterns of genetic variations at these loci between cases with breast cancer and healthy controls and assessing the association of genotypes with tumor characteristics. Participants were Caucasian women living in the Greater Philadelphia region, recruited from 1988 to 1994, with recently diagnosed women attending breast cancer clinics at Fox Chase Cancer Center (FCCC) and network affiliated hospitals as cases, and FCCC employees or women attending noncancer clinics as controls. The GSTM1 locus was determined for 402 cases and 238 controls, NQO1 for 346 cases and 235 controls. Results show that neither locus was associated with breast cancer occurrence, with the GSTM1 null genotype occurring at frequencies of 0.560 and 0.563 in cases and controls, respectively [odds ratio (OR) 0.98, 0.95 confidence interval (CI) 0.70-1.38] and the NQO1 wild-type allele at frequencies of 0.808 and 0.845, respectively (OR 0.77, 0.95 CI 0.55-1.06). The GSTM1 null genotype, however, was significantly overrepresented among larger (T3 and T4) primary tumors (OR 7.61, 0.95 CI 1.05-333) and with the occurrence of axillary lymph node metastases (OR 1.62, 0.95 CI 0.98-2.69). NQO1 results revealed that homozygotes for the wild type allele were more likely to have ductal carcinoma and poor histologic grade when compared with individuals carrying one or two mutated alleles (OR 3.50, 0.95 CI 1.41-9.0, and OR 2.26, 0.95 CI 1.18-4.35 for histology type and grade, respectively). We conclude that while these loci are not associated with breast cancer occurrence, the GSTM1 locus is likely associated with tumor progression. NQO1 results suggest that different quinones (possibly estrogenic quinone metabolites) might affect the histological development of breast tumors.
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PMID:Significance of genetic variation at the glutathione S-transferase M1 and NAD(P)H:quinone oxidoreductase 1 detoxification genes in breast cancer development. 1181 42

Fox Chase Cancer Center Partners (FCCCP) is a community hospital/academic partnership consisting of 25 hospitals in the Delaware Valley. Originally created in 1986, FCCCP promotes quality community cancer care through education, quality assurance, and access to clinical trial research. An important aspect of quality assurance is a yearly medical oncology audit that benchmarks quality indicators and guidelines and provides a roadmap for quality improvement initiatives in the community oncology clinical office setting. Each year, the FCCCP team and the Partner Medical Oncologists build disease site- and stage-specific indicators based on National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines in Oncology. Concordance with multiple indicators is assessed on 20 charts from each community practice. A report for each FCCCP medical oncology practice summarizes documentation, screening recommendations, new drug use, and research trends in a particular disease site. Descriptive statistics reflect indicators met, number of new cases seen per year, number of disease site cases from tumor registry information, and clinical trial accrual total. Education and documentation tools are provided to physicians and oncology office nursing staff. The FCCCP Clinical Operations Team, consisting of medical oncologists and oncology-certified nurses, has conducted quality audits in medical oncology offices for 7 years using NCCN-derived indicators. Successful audits comprising gastric, colorectal, and breast cancer have been the focus of recent evaluations. For the 2005 stage II/III breast cancer evaluation, mean compliance per parameter was 88%, with 15 of 16 practices achieving mean compliance greater than 80%. A large-scale quality assurance audit in a community cancer partner network is feasible. Recent evaluation of localized breast cancer shows high compliance with guidelines and identifies areas for focused education. Partnership between academic and community oncologists produces a quality review process that is broadly applicable and adaptable to changing medical knowledge.
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PMID:Development and implementation of a medical oncology quality improvement tool for a regional community oncology network: the Fox Chase Cancer Center Partners initiative. 1797

In the current study, we have examined the efficacy of a Src/Abl kinase inhibitor SKI-606 (Bosutinib) for its effect on prostate cancer growth and skeletal metastasis. Treatment of highly invasive human prostate cancer cells PC-3 and DU-145 with different doses of SKI-606 decreased Src activation, cell proliferation, migration, and invasion as determined by Matrigel Boyden chamber invasion assay. For in vivo studies, PC-3 cells were inoculated through s.c. or i.t. route into male BALB/c nu/nu or Fox Chase severe combined immunodeficient mice, respectively. Experimental animals treated with SKI-606 developed tumors of a significantly smaller volume and a significant decrease (50%) in experimental skeletal lesion area. A marked increase (32%) in bone volume to tumor volume ratio was also seen by micro-computed tomography analysis of tibias from control and experimental groups of animals. Western blot analysis showed the ability of SKI-606 to significantly decrease the phosphorylation of signaling molecules (AKT, mitogen-activated protein kinase, focal adhesion kinase) and the expression of tumor progression-associated genes uPAR, MMP-2, MMP-9, N-cadherin, fibronectin, BMP-2 (bone morphogenetic protein 2), BMP-6 (bone morphogenetic protein 6), IL-8 (interleukin 8), and TGF-beta (transforming growth factor beta) in prostate cancer cells. SKI-606 is currently in clinical trials for breast cancer and chronic myelogenous leukemia. Results from these studies provide convincing evidence for evaluating its efficacy in prostate cancer patients.
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PMID:SKI-606 (Bosutinib) blocks prostate cancer invasion, growth, and metastasis in vitro and in vivo through regulation of genes involved in cancer growth and skeletal metastasis. 2042 91

This study represents a first review of contemporarily knowledge concerning involvement of transcription factors in control of different ovarian functions. After introduction of basic functions and classification of transcription factors, the available data concerning involvement of transcription factors in control of the following ovarian events are present: follicular development and selection, ovarian cell proliferation and cancerogenesis, ovarian cell apoptosis, ovarian secretory activity, oocyte/cumulus maturation, ovulation and luteogenesis, mediation effect of hormones, growth factors, and cytokines. The importance of transcription factors of Smad family, of forkhead transcription factor (Fox) family, of breast cancer-associated genes/transcription factor, hypoxia-induced transcription factors and of other transcription factors in control of these processes has been demonstrated.
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PMID:Transcription factors and ovarian functions. 2050 92

Protein isoforms produced by alternative splicing (AS) of many genes have been implicated in several aspects of cancer genesis and progression. These observations motivated a genome-wide assessment of AS in breast cancer. We accomplished this by measuring exon level expression in 31 breast cancer and nonmalignant immortalized cell lines representing luminal, basal, and claudin-low breast cancer subtypes using Affymetrix Human Junction Arrays. We analyzed these data using a computational pipeline specifically designed to detect AS with a low false-positive rate. This identified 181 splice events representing 156 genes as candidates for AS. Reverse transcription-PCR validation of a subset of predicted AS events confirmed 90%. Approximately half of the AS events were associated with basal, luminal, or claudin-low breast cancer subtypes. Exons involved in claudin-low subtype-specific AS were significantly associated with the presence of evolutionarily conserved binding motifs for the tissue-specific Fox2 splicing factor. Small interfering RNA knockdown of Fox2 confirmed the involvement of this splicing factor in subtype-specific AS. The subtype-specific AS detected in this study likely reflects the splicing pattern in the breast cancer progenitor cells in which the tumor arose and suggests the utility of assays for Fox-mediated AS in cancer subtype definition and early detection. These data also suggest the possibility of reducing the toxicity of protein-targeted breast cancer treatments by targeting protein isoforms that are not present in limiting normal tissues.
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PMID:Exon-level microarray analyses identify alternative splicing programs in breast cancer. 2060 23

Fox Chase Cancer Center (FCCC) participated in the NCCN Opportunities for Improvement project with the purpose of optimizing the quality of care delivered at FCCC to patients with breast cancer based on the ASCO and NCCN Guidelines. Historically, FCCC's performance has demonstrated a high level of concordance, based on findings from the NCCN Oncology Outcomes Database project benchmarking data in breast cancer. Access to the NCCN Breast Cancer Timing in Continuation and Transition of Care (TiCToC) Measures data analysis (performed by NCCN) provided an opportunity to further identify specific opportunities related to care along the continuum. The initial goal of the project was to continue participation in the NCCN Oncology Outcomes Database for Breast Cancer, with the overall objective of sustaining high concordance. FCCC's recent data were compared with historical data and benchmarked against those from other participating NCCN Member Institutions.
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PMID:Reducing the time from initial call to first appointment: the impact of patient access redesign and a nurse navigation program. 2461 45


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