Abstract P5-21-09: Oncologist treatment choices in patients with early stage invasive lobular breast carcinoma - a survey
Bibliographic record
Abstract
Abstract Introduction: Invasive lobular carcinoma (ILC) is common and accounts for 5-15% of all breast cancers. ILC has distinct clinical and histological features that separate it from invasive ductal carcinoma (IDC) with regards to its breast imaging characteristics, patterns of recurrence and sensitivity to systemic therapy. ILC presents challenges to the physician in many aspects of local-regional and systemic therapy choices. We surveyed breast cancer physicians on their beliefs and practice patterns on issues around the management of ILC. Methods: A questionnaire was developed and circulated electronically using a modified Dillman technique to surgical, radiation, and medical oncologists across Canada and Ireland. Results: The questionnaire was completed by 91 of 429 physicians (21% response rate). Response rate by specialty was 25/69 (36%), 21/54 (41%) and 45/306 (13%) for surgical, radiation and medical oncologists respectively. Most surgeon responders (77%) would feel "uncomfortable making treatment decisions for ILC with a mammogram alone" and 100% would be "more comfortable with an MRI". Although 55% reported treating ILC as they would IDC, 22% of surgeons will purposefully obtain larger gross margins intra-operatively. Some radiation oncologists believe ILC is an independent risk factor for local-regional recurrence after breast conserving surgery (49%), and after mastectomy (29%). 33% of radiation oncologists would offer radiation therapy after mastectomy specifically because of the ILC subtype even in the absence of usual indications for radiotherapy. Most medical oncologists treat ILC comparably to IDC with the factors having the largest influence on systemic treatment decisions being tumour stage, hormone receptor status and HER-2 status. 51% of medical oncologists treat ILC with adjuvant chemotherapy as they do for IDC at least ‘most of the time’, while 40% use neoadjuvant chemotherapy as frequently as they do for IDC at least ‘most of the time’. 75% of medical oncologists manage the hormonal treatment of ILC as they do IDC ‘most of the time’ or ‘always’. Conclusions: There remains significant clinical equipoise in the local-regional and systemic management of ILC. This survey has demonstrated wide variations in both beliefs and practices of management for ILC. Clinical guidance, developed on clinical trials specifically assessing the management of ILC, is required. Citation Format: Carmel Jacobs, Mark Clemons, Mohamed FK Ibrahim, Christina Addison, Jean-Michel Caudrelier, Ian D Graham, Brain Hutton, Angel Arnaout. Oncologist treatment choices in patients with early stage invasive lobular breast carcinoma - a survey [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P5-21-09.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".