Background and Aim: Young women diagnosed with breast cancer (BC) face considerable psychological and emotional distress, impacting their interactions with themselves, their families, and the wider community. This study sought to explore the interaction patterns of young Omani BC survivors following their diagnosis and during treatment. Materials and Methods: Semi-structured individual interviews were conducted with 11 Omani women diagnosed with BC, recruited from the Sultan Qaboos Comprehensive Cancer Care and Research Centre in Muscat, Oman. Participants were selected using purposive sampling to target Omani BC survivors aged under 45 years, with one to five years of survivorship post-diagnosis. Framework analysis was employed to analyse the qualitative data. Results: Six key types of interactions with various groups were identified: self, children, spouses, family, friends, and society. While many BC survivors demonstrated resilience through their strong faith, viewing the illness as part of a divine plan, others experienced diminished confidence and social withdrawal due to body image issues. Interactions with children centred on maintaining normalcy, while spouses typically provided emotional support despite challenges with intimacy. Family and friends offered crucial support, although concerns regarding societal stigma led some women to conceal their diagnosis. Conclusions: Participants in this study demonstrated a strong sense of acceptance of their cancer diagnosis as a result of their faith, viewing it as part of a divine plan. Their belief in divine guidance, paired with optimism about the available treatments, fostered resilience, allowing them to maintain a calm and hopeful outlook during their journey of treatment and recovery. However, some participants experienced a decline in self-confidence, particularly after treatment. This affected their willingness to socialise and interact with others, leading to introversion and a marked withdrawal from social interactions, often related to changed self-perception or fear of judgment following changes in appearance.

Immune-checkpoint inhibitors (ICIs) have revolutionized treatment of solid malignancies, leading in some cases to durable responses. However, an unchecked immune response might lead to mild to severe immune-related adverse events (irAEs). Pulmonary toxicity, though often referred to as Immune checkpoint inhibitor–related pneumonitis (ICI-pneumonitis), covers a broad and overlapping spectrum of pulmonary manifestations and has been described in <10% of patients receiving ICI either alone or in combination. However, the actual numbers in real-world populations are high, and are likely to increase as the therapeutic indications for ICIs continue to expand to include other malignancies. Drug withdrawal is the mainstay of treatment for ICI-pneumonitis. However, a good number of patients with higher grades of toxicity may need corticosteroids. Patients with refractory disease need additional immunosuppressive agents. In this brief review, we succinctly discuss the incidence, risk factors, mechanisms, clinical and radiologic manifestations, diagnosis and summarize the current management strategies of ICI-pneumonitis.

Candida species frequently cause bloodstream infections; however, there is a lack of epidemiological studies on candidemia in Oman. To address this, we conducted a retrospective study at Sultan Qaboos Comprehensive Cancer and Research Center from October 2021 to October 2023. Our study identified 27 episodes of candidemia among 26 patients with cancer, with an incidence of 4.9 per 1000 admissions. Non-albicans Candida (NAC) prevailed over C. albicans (70.37% vs 29.62%), with C. glabrata as the predominant NAC species (n = 10; 37%). The 30-day mortality rate was 40.7%, showing no significant difference between NAC and C. albicans but was notably higher in critically ill patients (P = 0.03). In Oman, NAC surpasses C. albicans as a causative pathogen for candidemia with a high mortality rate.

E22109 Using Magee equations to predict OncoDx Recurrence Scores - a potential cost and time saving strategy? Khalid Al-Baimani¹MD, Stephanie Petkiewicz² MD, Xinni Song³ MD, Gregory Pond⁴ PhD, Mark Clemons⁵ MD, Susan Robertson⁶ MD Background: The three Magee equations incorporate readily available tumor characteristics (i.e. tumor size; grade, ER, PR, Her2, Ki-67)(see table) to formulate a score that correlate with OncoDx Recurrence Scores (ODX). However, Magee equations require the pathologist to perform impractical H scores of ER & PR. We evaluated Magee equations using a surrogate H score based on Allred range and average intensity. This could reduce the number of specimens sent for ODX, saving both time and money. Methods: Magee scores were calculated using surrogate H score for 118 patients with available ODX results. Correlation and discordance rates were calculated. Results: Of the 118 patients; 62 (52.5%) were low-risk, 49 (41.5%) were intermediate and 7 (5.9%) were high-risk. None of the low Magee risk scores were high risk by ODX. None of the Magee high-risk scores were low risk by ODX. Conclusions: This study would suggest that the Magee 2 & 3 equations (using the modified H score based on Allred) could be used in low and high risk cases to avoid performing ODX-RS, saving considerable time and money. The intermediate scores with both Magee and ODX remain a therapeutic challenge. Larger confirmatory studies are needed.

E13526 Background: The incidence of leptomeningeal carcinomatosis (LC) in breast cancer patients (LC-BC) is rising. Despite significantly impacting patient survival and quality of life (QoL), little is known about its optimal management. A systematic review of treatment strategies for LC-BC was performed. Methods: EMBASE, Ovid Medline(R), Pubmed, and the Cochrane Central Register of Controlled Trials were searched from 1946 to September 2015 for trials reporting on treatments for LC-BC. All treatment modalities were considered. Outcome measures of interest included: overall survival (OS), time to neurologic progression (TTNP), QoL and treatment toxicity. Results: Of 724 unique citations, 181 studies met the pre-specified eligibility criteria. Most studies were not specific to LC-BC patients. Of four identified randomized controlled trials, one was specific to LC-BC patients and compared standard systemic therapy and involved field radiotherapy +/- intrathecal (IT) methotrexate (35 patients), while the remaining three compared different IT chemotherapy regimens (157 total patients, 58 with LC-BC). Of the remaining studies, 19 were non-randomized, interventional studies (225 LC-BC patients); 156 were observational studies (3438 LC-BC patients); and 2 were systematic reviews (17 LC-BC patients). There was minimal prospective data available on OS, TTNP, QoL, or toxicity. Due to study heterogeneity, a meta-analysis was not performed. Conclusions: Minimal high-quality evidence exists regarding optimal treatment of LC-BC. Identified studies were heterogeneous in nature and often methodologically poor. With no established standard of care, a wide variety of treatment strategies are employed worldwide, with no data to support any one therapeutic approach over another. The only RCT that specifically assessed IT chemotherapy in the presence of standard systemic and radiation therapy showed no benefit and, if anything, harm. If the management of these patients is to be improved, further prospective, tumour-specific trials are urgently needed with improved inter-study methodological consistency and appropriately reported data on OS, TTNP, QoL and toxicity.