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Wärnberg, Fredrik
Alternative names
Publications (10 of 46) Show all publications
Wärnberg, F., Garmo, H., Folkvaljon, Y., Holmberg, L., Karlsson, P., Sandelin, K., . . . Bremer, T. (2018). Abstract GS5-08: A validation of DCIS biological risk profile in a randomised study for radiation therapy with 20 year follow-up (SweDCIS). Paper presented at San Antonio Breast Cancer Symposium, DEC 05-09, 2017, San Antonio, TX. Cancer Research, 78(4)
Open this publication in new window or tab >>Abstract GS5-08: A validation of DCIS biological risk profile in a randomised study for radiation therapy with 20 year follow-up (SweDCIS)
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2018 (English)In: Cancer Research, ISSN 0008-5472, E-ISSN 1538-7445, Vol. 78, no 4Article in journal, Meeting abstract (Other academic) Published
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:uu:diva-351602 (URN)10.1158/1538-7445.SABCS17-GS5-08 (DOI)000425489400036 ()
Conference
San Antonio Breast Cancer Symposium, DEC 05-09, 2017, San Antonio, TX
Note

Wos title: A validation of DCIS biological risk profile in a randomised study for radiation therapy with 20 year follow-up (SweDCIS)

Supplement: S

Meeting Abstract: GS5-08

Available from: 2018-05-29 Created: 2018-05-29 Last updated: 2018-05-29
Wärnberg, M., Karakatsanis, A., Abdsaleh, S. & Wärnberg, F. (2018). Abstract P3-01-11: Discoloration after injection of super paramagnetic iron oxide (SPIO) for sentinel node biopsy. A long term qualitative follow-up study. Paper presented at San Antonio Breast Cancer Symposium, DEC 05-09, 2017, San Antonio, TX. Cancer Research, 78(4)
Open this publication in new window or tab >>Abstract P3-01-11: Discoloration after injection of super paramagnetic iron oxide (SPIO) for sentinel node biopsy. A long term qualitative follow-up study
2018 (English)In: Cancer Research, ISSN 0008-5472, E-ISSN 1538-7445, Vol. 78, no 4Article in journal, Meeting abstract (Other academic) Published
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:uu:diva-351603 (URN)10.1158/1538-7445.SABCS17-P3-01-11 (DOI)000425489400340 ()
Conference
San Antonio Breast Cancer Symposium, DEC 05-09, 2017, San Antonio, TX
Note

Wos title: Discoloration after injection of super paramagnetic iron oxide (SPIO) for sentinel node biopsy. A long term qualitative follow-up study

Available from: 2018-05-29 Created: 2018-05-29 Last updated: 2018-05-29Bibliographically approved
Plate, S., Emilsson, L., Söderberg, M., Brandberg, Y. & Wärnberg, F. (2018). High experienced continuity in breast cancer care is associated with high health related quality of life. BMC Health Services Research, 18, Article ID 127.
Open this publication in new window or tab >>High experienced continuity in breast cancer care is associated with high health related quality of life
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2018 (English)In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 18, article id 127Article in journal (Refereed) Published
Abstract [en]

Background: High experienced continuity is known to be associated with lower needs for supportive care and most likely higher quality of life. On this background, the aim of this study was to investigate if patient-experienced continuity of care was associated with health-related quality of life (HRQoL) in breast cancer patients treated at two different-sized breast cancer units.

Methods: In 2016, two questionnaires, "Statements on experienced continuity of care" and "The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30)", were sent out to patients diagnosed between 2011 and 2014 at two different-sized breast cancer units in Sweden. Lead times and other data reflecting medical quality were collected from the patients' medical records and from the National Swedish Breast Cancer Quality Register.

Results: Of 356 eligible patients, 231 (65%) answered the questionnaires, of whom 218 patients were included in the analyses. A statistically significant association was found between high experienced continuity and high global HRQoL (p = 0.03). Continuity was higher at the smaller unit, while no major differences between the units were found regarding medical quality or lead times.

Conclusion: The study found that high experienced continuity and HRQoL was strongly associated. A statistically significant higher continuity of care was found at the smaller unit, in line with what was expected. The absence of clinically relevant differences in lead times and medical quality may indicate that continuity could be achieved without loss of quality.

Place, publisher, year, edition, pages
BIOMED CENTRAL LTD, 2018
Keywords
Continuity of care, Health-related quality of life, HRQoL, Breast cancer, Patient reported outcome
National Category
Nursing
Identifiers
urn:nbn:se:uu:diva-349349 (URN)10.1186/s12913-018-2925-0 (DOI)000425530200003 ()29458376 (PubMedID)
Available from: 2018-04-27 Created: 2018-04-27 Last updated: 2018-04-27Bibliographically approved
Karakatsanis, A., Tasoulis, M. K., Wärnberg, F., Nilsson, G. & MacNeill, F. (2018). Meta-analysis of neoadjuvant therapy and its impact in facilitating breast conservation in operable breast cancer. Paper presented at Annual Meeting of the Swedish-Surgical-Society, AUG, 2017, Jonkoping, SWEDEN. British Journal of Surgery, 105(5), 469-481
Open this publication in new window or tab >>Meta-analysis of neoadjuvant therapy and its impact in facilitating breast conservation in operable breast cancer
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2018 (English)In: British Journal of Surgery, ISSN 0007-1323, E-ISSN 1365-2168, Vol. 105, no 5, p. 469-481Article in journal (Refereed) Published
Abstract [en]

Background

Neoadjuvant therapy (NAT) for operable breast cancer may facilitate more breast-conserving surgery (BCS). It seems, however, that this benefit is not being realized fully.

Methods

A systematic review of the literature was performed. RCTs were included. The criteria for inclusion were: documentation of surgical assessment before and after NAT, surgery performed (BCS or mastectomy), and clinical and pathological responses.

Results

A total of 1452 patients from seven RCTs met the inclusion criteria. After NAT, the feasibilityof BCS increased from 43⋅3to60⋅4 per cent (P < 0⋅001), but BCS was performed in only 51⋅8percent(P = 0⋅04). Only 31 per cent of patients who became eligible for BCS (assessed on clinical response)underwent BCS (pooled rate ratio 0⋅31, 95 per cent c.i. 0⋅22 to 0⋅44; P < 0⋅001). Of the mastectomycandidates who achieved a pathological complete response after NAT, only 41 per cent underwent BCS(pooled rate ratio 0⋅41, 0⋅23 to 0⋅74; P = 0⋅003). The main factors that influenced the decision not to shiftto BCS, even though it was feasible, were clinical assessment before NAT, multicentricity and tumoursize at presentation.

Conclusion

Breast surgery performed after NAT does not reflect tumour response, resulting in potentially unnecessary radical surgery, especially mastectomy. The barriers to maximizing the surgical benefits of NAT need to be better understood and explored. Still unnecessary mastectomies

National Category
Surgery
Identifiers
urn:nbn:se:uu:diva-354236 (URN)10.1002/bjs.10807 (DOI)000428846100003 ()29603132 (PubMedID)
Conference
Annual Meeting of the Swedish-Surgical-Society, AUG, 2017, Jonkoping, SWEDEN
Available from: 2018-06-29 Created: 2018-06-29 Last updated: 2018-06-29Bibliographically approved
Wadsten, C., Garmo, H., Fredriksson, I., Sund, M. & Wärnberg, F. (2017). DCIS and the risk of breast cancer death - A case control study. Paper presented at San Antonio Breast Cancer Symposium, DEC 06-10, 2016, San Antonio, TX. Cancer Research, 77
Open this publication in new window or tab >>DCIS and the risk of breast cancer death - A case control study
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2017 (English)In: Cancer Research, ISSN 0008-5472, E-ISSN 1538-7445, Vol. 77Article in journal (Refereed) Published
Place, publisher, year, edition, pages
Sundsvall Hosp, Sundsvall, Sweden. Umea Univ, Umea, Sweden. Uppsala Univ, Uppsala, Sweden. Uppsala Orebro, Reg Canc Ctr, Uppsala, Sweden. Kings Coll London, Canc Epidemiol & Populat Hlth, London, England. Karolinska Inst, Solna, Sweden.: AMER ASSOC CANCER RESEARCH, 2017
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:uu:diva-320981 (URN)10.1158/1538-7445.SABCS16-P3-17-03 (DOI)000397999001245 ()
Conference
San Antonio Breast Cancer Symposium, DEC 06-10, 2016, San Antonio, TX
Available from: 2017-04-27 Created: 2017-04-27 Last updated: 2017-04-27Bibliographically approved
Zhou, W., Sollie, T., Tot, T., Blomqvist, C., Abdsaleh, S., Liljegren, G. & Wärnberg, F. (2017). Ductal Breast Carcinoma In Situ: Mammographic Features and Its Relation to Prognosis and Tumour Biology in a Population Based Cohort. International Journal of Breast Cancer, Article ID 4351319.
Open this publication in new window or tab >>Ductal Breast Carcinoma In Situ: Mammographic Features and Its Relation to Prognosis and Tumour Biology in a Population Based Cohort
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2017 (English)In: International Journal of Breast Cancer, ISSN 2090-3170, E-ISSN 2090-3189, article id 4351319Article in journal (Refereed) Published
Abstract [en]

Casting-type calcifications and a histopathological picture with cancer-filled duct-like structures have been presented as breast cancer with neoductgenesis. We correlated mammographic features and histopathological neoductgenesis with prognosis in a DCIS cohort with long follow-up. Mammographic features were classified into seven groups according to Tabar. Histopathological neoductgenesis was defined by concentration of ducts, lymphocyte infiltration, and periductal fibrosis. Endpoints were ipsilateral (IBE) in situ and invasive events. Casting-type calcifications and neoductgenesis were both related to high nuclear grade, ER-and PR-negativity, and HER2 overexpression but not to each other. Casting-type calcifications and neoductgenesis were both related to a nonsignificant lower risk of invasive IBE, HR 0.38 (0.13-1.08) and 0.82 (0.29-2.27), respectively, and the HR of an in situ IBE was 0.90 (0.41-1.95) and 1.60 (0.75-3.39), respectively. Casting-type calcifications could not be related to a worse prognosis in DCIS. We cannot explain why a more aggressive phenotype of DCIS did not correspond to a worse prognosis. Further studies on how the progression from in situ to invasive carcinoma is driven are needed.

Place, publisher, year, edition, pages
Hindawi Publishing Corporation, 2017
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:uu:diva-319323 (URN)10.1155/2017/4351319 (DOI)000394652400001 ()
Available from: 2017-04-10 Created: 2017-04-10 Last updated: 2017-11-29Bibliographically approved
Plate, S., Emilsson, L., Söderberg, M., Brandberg, Y. & Wärnberg, F. (2017). High experienced continuity in breast cancer care is associated with high health related quality of life and compatible with good medical quality and approved lead times. Paper presented at ECCO European Cancer Congress, JAN 27-30, 2017, Amsterdam, NETHERLANDS.. European Journal of Cancer, 72(Supplement: 1), S24-S25
Open this publication in new window or tab >>High experienced continuity in breast cancer care is associated with high health related quality of life and compatible with good medical quality and approved lead times
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2017 (English)In: European Journal of Cancer, ISSN 0959-8049, E-ISSN 1879-0852, Vol. 72, no Supplement: 1, p. S24-S25Article in journal, Meeting abstract (Other academic) Published
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:uu:diva-347742 (URN)10.1016/S0959-8049(17)30160-0 (DOI)000417650200072 ()
Conference
ECCO European Cancer Congress, JAN 27-30, 2017, Amsterdam, NETHERLANDS.
Note

Meeting Abstract: 207A

Available from: 2018-04-17 Created: 2018-04-17 Last updated: 2018-04-17Bibliographically approved
Karakatsanis, A., Olofsson, H. M., Eriksson, S., Andersson, Y., Bergkvist, L. A., Mohammed, I., . . . Wärnberg, F. (2017). SentiNot: A way to avoid sentinel node biopsy (SNB) in patients with a preoperative diagnosis of ductal cancer in situ (DCIS). Paper presented at San Antonio Breast Cancer Symposium, DEC 06-10, 2016, San Antonio, TX. Cancer Research, 77
Open this publication in new window or tab >>SentiNot: A way to avoid sentinel node biopsy (SNB) in patients with a preoperative diagnosis of ductal cancer in situ (DCIS)
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2017 (English)In: Cancer Research, ISSN 0008-5472, E-ISSN 1538-7445, Vol. 77Article in journal (Refereed) Published
Place, publisher, year, edition, pages
Univ Uppsala Hosp, Sect Endocrine & Breast Surg, Uppsala, Sweden. Univ Uppsala Hosp, Uppsala, Sweden. Vastmanland Cty Hosp, Vasteras, Vasteras, Sweden. Uppsala Clin Res Ctr, Uppsala, Sweden. Kalmar Cty Hosp, Sect Breast Surg, Kalmar, Sweden. Univ Uppsala Hosp, Inst Radiol Oncol & Radiotherapy, Uppsala, Sweden. Norrlands Univ Hosp, Umea, Sweden.: AMER ASSOC CANCER RESEARCH, 2017
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:uu:diva-320979 (URN)10.1158/1538-7445.SABCS16-P2-01-19 (DOI)000397999000308 ()
Conference
San Antonio Breast Cancer Symposium, DEC 06-10, 2016, San Antonio, TX
Available from: 2017-04-27 Created: 2017-04-27 Last updated: 2017-04-27Bibliographically approved
Karakatsanis, A., Daskalakis, K., Stålberg, P., Olofsson, H., Andersson, Y., Eriksson, S., . . . Wärnberg, F. (2017). Superparamagnetic iron oxide nanoparticles as the sole method for sentinel node biopsy detection in patients with breast cancer. British Journal of Surgery, 104(12), 1675-1685
Open this publication in new window or tab >>Superparamagnetic iron oxide nanoparticles as the sole method for sentinel node biopsy detection in patients with breast cancer
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2017 (English)In: British Journal of Surgery, ISSN 0007-1323, E-ISSN 1365-2168, Vol. 104, no 12, p. 1675-1685Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Sentinel node biopsy (SNB) using superparamagnetic iron oxide (SPIO) nanoparticles is a novel method in breast cancer. Several studies have verified the non-inferiority of SPIO compared with the standard use of radioisotope (99m) Tc with or without blue dye. The aim of the MONOS study presented here was to evaluate the use of SPIO as a sole tracer and the efficacy of tracer injection in the preoperative setting.

METHODS: This prospective cohort study was carried out in two hospitals, one using (99m) Tc and the other SPIO. (99m) Tc was injected in the morning of the day of surgery or the day before. SPIO was either injected before surgery in the outpatient clinic or 1 h before the operation.

RESULTS: A total of 338 consecutive patients with breast cancer underwent 343 procedures; SPIO nanoparticles were used in 184 procedures and (99m) Tc-labelled tracer in 159. Detection rates for SPIO and (99m) Tc were 95·6 and 96·9 per cent respectively (P = 0·537). All nodes with SPIO uptake were coloured brown. Fewer nodes were retrieved with SPIO (mean 1·35 versus 1·89), regardless of whether blue dye was used (P < 0·001). Preoperative SPIO injection (58·7 per cent of procedures), a median of 16 (range 2-27) days before the procedure, was associated with a better tracer-specific detection rate (95·3 versus 86 per cent; P = 0·031) and retrieval of more nodes (mean 1·43 versus 1·03; P < 0·001) than perioperative administration. Skin staining was present in 39·9 per cent of patients, and was related to breast-conserving surgery and periareolar injection.

CONCLUSION: The use of SPIO alone is a safe alternative, with results comparable to those of the standard dual technique using (99m) Tc and blue dye. The efficacy of injection in the preoperative setting simplifies logistics and improves performance. Skin staining can be prevented by a deeper peritumoral injection.

National Category
Surgery
Identifiers
urn:nbn:se:uu:diva-333258 (URN)10.1002/bjs.10606 (DOI)000413157100012 ()28877348 (PubMedID)
Available from: 2017-11-09 Created: 2017-11-09 Last updated: 2018-01-26Bibliographically approved
Wadsten, C., Heyman, H., Holmqvist, M., Ahlgren, J., Lambe, M., Sund, M. & Wärnberg, F. (2016). A validation of DCIS registration in a population-based breast cancer quality register and a study of treatment and prognosis for DCIS during 20 years. Acta Oncologica, 55(11), 1338-1343
Open this publication in new window or tab >>A validation of DCIS registration in a population-based breast cancer quality register and a study of treatment and prognosis for DCIS during 20 years
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2016 (English)In: Acta Oncologica, ISSN 0284-186X, E-ISSN 1651-226X, Vol. 55, no 11, p. 1338-1343Article in journal (Refereed) Published
Abstract [en]

AIMS: Sweden has a long history of population-based cancer registration. The aim of our study was to assess the validity of DCIS registration in a regional Breast Cancer Quality Register (BCQR) and to analyze trends in incidence, treatment and outcome of DCIS, over a 20-year period.

MATERIAL AND METHODS: All patients with a diagnosis of primary DCIS reported in the BCQR of the Uppsala-Örebro healthcare region in Sweden 1992-2012 were included. Three hundred women were randomly selected and their medical records were compared to register data. The study period was divided into four time periods.

RESULTS: A total of 2952 women were registered with a DCIS diagnosis. In the final validation cohort of 295 patients, 23 were found to have either recurrent DCIS or invasive breast cancer and eight had LCIS. The completeness and validity of key variables were 91-99%. Twenty of 31 local recurrences were registered (65%).The proportion of DCIS to all breast cancers was 9.5%. Tumor size increased over time. The frequency of mastectomy increased from 23.0% to 39.0%. The proportion of patients receiving radiotherapy after breast conserving surgery increased from 30.1% to 67.6%. The reported local recurrence rate was 9.7% after 10 years. Reported recurrences after BCS and mastectomy were 12.0 and 7.0%, respectively. The recurrence rate did not differ between women undergoing BCS with or without radiotherapy.

CONCLUSION: Only 89.5% of reported DCIS was a primary pure DCIS. The completeness of primary treatment and tumor data was high. The proportion of reported local recurrences was disappointingly low, 65%. The proportion of DCIS was stable over time with a trend towards more intensified treatment. The reported recurrence rate was low independent of treatment and can reflect adequate patient selection, but also over treatment. Our results address the necessity to validate register data on a regular basis.

National Category
Cancer and Oncology
Identifiers
urn:nbn:se:uu:diva-308542 (URN)10.1080/0284186X.2016.1211317 (DOI)000386374500013 ()27548561 (PubMedID)
Available from: 2016-11-28 Created: 2016-11-28 Last updated: 2017-11-29Bibliographically approved
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