Background Skin-sparing and nipple-sparing mastectomies were considered as alternative techniques for modified radical mastectomy. In patients who are candidates for nipple-sparing mastectomy, preoperative assessment of the nipple-areolar complex (NAC) is essential for adequate surgical planning. Breast MRI is highly sensitive for cancer detection and has an important role in disease staging. The aim of this study was to estimate the role of DCE-MRI in predicting malignant NAC invasion by underlying breast cancer and assess the best predictors on MRI that can suspect malignant NAC invasion. Results Out of the 125 patients with breast cancer, 33 patients (26.4%) showed malignant NAC invasion. On basis of multivariate analysis, abnormal nipple enhancement, tumor nipple enhancement, tumor nipple distance ≤ 2 cm, and abnormal and asymmetric nipple morphology were all significant predictors of malignant NAC invasion (P < 0.001) with abnormal unilateral nipple enhancement as the most important independent MRI predictor of malignant NAC invasion (odds ratio = 61.07, 95% CI 12.81–291.22, P < 0.001). When combining more than positive suspicious MRI features, DCE-MRI had 66.6% sensitivity, 76% specificity, 50% PPV, 86.4% NPV, and 73.6% accuracy in prediction of malignant NAC invasion. Conclusion DCE-MRI could predict malignant NAC invasion with abnormal unilateral nipple enhancement as the most important independent MRI predictor.

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12529 Background: To evaluate efficacy of short- course radiotherapy(RT) in elderly (>60years) patients with glioblastoma multiforme(GBM), and compare this biological similar short -course radiotherapy with a standard radiotherapy Methods: Forty-four elderly patients with GBM were randomly assigned after surgery to receive either a short-course of radiotherapy (45 Gy in 15 fractions over 3 weeks ) or standard radiotherapy (60 Gy in 30 fractions over 6weeks) to a target volume described as tumor visible on CT scan and a 2- cm margin . The primary end point was overall survival. Results: The overall response rate and median duration of response were 60%and 8.5 months in short- course RT versus 65% and 8 months in standard RT . Improvement in pretreatment performance status and increase in post- treatment corticosteroid dosage were observed in 50% and 25% in short- course RT versus 40% and 50% in standard RT (P=0.09, P=0.031) respectively. Median survival time was 5.9 months in short-course RT versus 5.6 months in standard RT . Six months, 1-year survival and progression-free survival rates were 40%, 15% and 30% ,10% in short- course RT versus 45%, 10% and 35% , 5% in standard RT , respectively. In both treatment groups, females did significantly better than males, patients with KPS 60–70 did significantly better than those with KPS 50 , patients having tumors 4–5 cm did significantly better than those with tumors 6–8 cm as well as did those with more radical surgery when compared to those with biopsy only. On multivariate analysis , only tumor size and extent of surgery were found to independently influence survival. Acute toxicity was generally assessed as mild in the two treatment groups. While RT -induced brain necrosis appeared only in one patient received short- course RT, but this patient died from tumor recurrence. Conclusions: Hypofractionated RT is feasible and safe treatment for elderly patients with GBM. No significant financial relationships to disclose.

2042 Background: To evaluate efficacy of short- course radiotherapy(RT) in elderly (>60 years) patients with glioblastoma multiforme (GBM), and compare this biological similar short -course radiotherapy with a standard radiotherapy. Methods: Forty-four elderly patients with GBM were randomly assigned after surgery to receive either a short-course of radiotherapy (45 Gy in 15 fractions over 3 weeks) or standard radiotherapy (60 Gy in 30 fractions over 6 weeks) to a target volume described as tumor visible on CT scan and a 2 cm margin. The primary end point was overall survival. Results: The overall response rate and median duration of response were 60% and 8.5 months in short-course RT versus 65% and 8 months in standard RT. Improvement in pretreatment performance status and increase in post-treatment corticosteroid dosage were observed in 50% and 25% in short-course RT versus 40% and 50% in standard RT (P=0.09, P=0.031) respectively. Median survival time was 5.9 months in short-course RT versus 5.6 months in standard RT. Six months, 1-year survival and progression-free survival rates were 40%, 15% and 30% ,10% in short-course RT versus 45%, 10% and 35%, 5% in standard RT, respectively. In both treatment groups, females did significantly better than males, patients with KPS 60–70 did significantly better than those with KPS 50, patients having tumors 4–5 cm did significantly better than those with tumors 6–8 cm as well as did those with more radical surgery when compared to those with biopsy only. On multivariate analysis, only tumor size and extent of surgery were found to independently influence survival. Acute toxicity was generally assessed as mild in the two treatment groups. While RT-induced brain necrosis appeared only in one patient received short- course RT, but this patient died from tumor recurrence. Conclusions: Hypofractionated RT is feasible and safe treatment for elderly patients with GBM. No significant financial relationships to disclose.