Prevention of breast cancer in the context of a national breast screening programme

Breast cancer is not only increasing in the west but also particularly rapidly in eastern countries where traditionally the incidence has been low. The rise in incidence is mainly related to changes in reproductive patterns and lifestyle. These trends could potentially be reversed by defining women at greatest risk and offering appropriate preventive measures. A model for this approach was the establishment of Family History Clinics (FHCs), which have resulted in improved survival in younger women at high risk. New predictive models of risk that include reproductive and lifestyle factors, mammographic density and measurement of risk-associated single nucleotide polymorphisms (SNPs) may give more precise information concerning risk and enable better targeting for mammographic screening programmes and of preventive measures. Endocrine prevention using anti-oestrogens and aromatase inhibitors is effective, and observational studies suggest lifestyle modification may also be effective. However, referral to FHCs is opportunistic and predominantly includes younger women. A better approach for identifying older women at risk may be to use national breast screening programmes. Here were described pilot studies to assess whether the routine assessment of breast cancer risk is feasible within a population-based screening programme, whether the feedback and advice on risk-reducing interventions would be welcomed and taken up, and to consider whether the screening interval should be modified according to breast cancer risk.

[The effect of diet induced obesity on testicular tissue and serum oxidative stress parameters]

OBJECTIVE

The aim of this study was to evaluate the effects of diet induced obesity on semen parameters and serum antioxidant enzyme levels.

MATERIAL AND METHODS

Six-week-old male rats were randomized into three groups are as follows: group 1 (n=10) received a control diet, group 2 (n=9) received a high-fat diet and group 3 (n=11) received high-fat diet plus anastrozole. At the completion of a 10-week period, testicular tissues were obtained and spermatogenesis was evaluated with Johnsen Score System. The normal Johnsen Score was accepted as >9.39. In addition, serum antioxidant enzyme levels, triglyceride, cholesterol, testosterone, luteinizing hormone (LH), follicle stimilating hormone (FSH) and estradiol levels were measured in serum.

RESULTS

Body weight were significantly increased in mice fed with a high-fat diet compared to normal diet (P<.05). The mean triglyceride levels was 64.00±20.48 mg/dl, 98.89±27.80 mg/dl and 95.27±15.02 mg/dl in group 1, group 2 and group 3, respectively (P<.05). Male rats fed with a high-fat diet had significantly lower levels of testosterone compared with the control diet male rats (P=.005). Testicular pathology revealed that Johnsen Score System were 9.60±0.15, 8.72±1.81 and 9.29 in group 1, group 2 and group 3, respectively (P=.169). In addition serum nitric oxide (NO) levels were higher in group 2 and group 3 compared to group 1 (P<.05).

CONCLUSION

As a result it may be concluded that obesity may induce oxidative stress and decrease testosterone levels. These changes may alter testicular functions and consequently it may be speculated that obesity can be important causative factor in the etiology of the male infertility.

P4-11-07: Feasibility and Acceptability of Offering Breast Cancer Risk Estimation in the Context of the UK National Health Service Breast Cancer Screening Programme: A New Paradigm for Cancer Prevention

Background: Currently there are no real attempts internationally to tailor breast screening programmes to individual risk Methods: We have assessed the feasibility of collecting breast cancer risk information during routine mammographic screening in the National Health Service Breast Screening Programme (NHSBSP) in England, in order to consider, ultimately, adapting the screening interval to risk of breast cancer and introducing preventive strategies in women at high risk. The study Predicting Risk Of Cancer At Screening (PROCAS) aims to recruit 60,000 women over 3 years. Results: 26,000 women (June 8th 2011) have so far given consent to join the study. Thirty six percent of the first 20,000 women in nineteen screening sites in Manchester consented to enter the study and completed a risk factor questionnaire. The median 10 year breast cancer risk was 2.65%, with 926 (9.26%) of the first 10,000 women having a 10 year risk of ≥5% and 92 (0.92%) having a 10 year risk of ≥8% (Tyrer-Cuzick), IQR:1.35. 832 (8.32%) women had a mammographic density of 60% or greater (Visual Analogue Scale). We collected saliva samples from 1019 women for genetic analysis and will extend this to 18% of participants. Of those who agreed to participate in the study, 94% indicated that they wished to know their breast cancer risk. Women with a 10-year risk of ≥8%, and women with a 10-year risk of ≥5% and mammographic density ≥60% were invited to attend or be telephoned to be counselled. To date 138 have accepted with 135, so far, having received risk counselling. Nineteen percent of the high-risk women identified subsequently decided to enter a randomised breast cancer prevention study with either a dietary or drug intervention (IBIS2, anastrazole vs placebo). Results from the first 1,000 women who provided DNA samples suggest that the risk information from the 18 validated SNPS may enhance existing risk models. Conclusion: This study demonstrates that it is feasible to determine individual breast cancer risk and offer women appropriate risk-reducing interventions within the context of a population-based mammographic screening programme.

Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P4-11-07.

Distribution of HLA-B27 and CYP2D6*4 mutations in the middle Black Sea area (Tokat) of Turkey

We analyzed distribution of HLA-B27 and CYP2D6*4 mutations in 249 patients from Tokat province in Turkey with symptoms of arthritis, sacroiliac, joint and back pain, using a LightCycler 480 II Real-Time PCR thermal cycler. The Genes-4U was applied for studying HLA-B27 mutation, and the Tib-Molbiol commercial kit was used to examine the CYP2D6*4 mutation. Among the 249 patients, 18.5% had the HLA-B27 mutation. The CYP2D6*4 mutation was found in 22.0% (six homozygotes). Ten patients had both mutations. These frequencies are similar to what has been reported from other populations.

Effects of short period frequent milking on milk yield in two East Friesian crosses: Tahirova and Sonmez sheep

Abstract. Though East Friesian sheep are known to have very high milk yield, their various degree crosses may have different levels of milk yield under different conditions due to genotype × environment interaction. The major purpose of this study was to investigate whether increasing milking frequency for a short period (21 days) increases milk yield in two East Friesian crosses, Tahirova and Sonmez sheep. Tahirova is 75 % East Friesian and 25 % Kivircik, while Sonmez is 75 % Tahirova and 25 % Sakiz (Chios). Two milking groups were formed and were treated the same in terms of feeding and management. The sheep in the 4× group were milked 4 times a day after weaning for a short period, namely 21 days and then were milked twice a day for the rest of the lactation. The sheep in the 2× group were milked twice a day throughout the whole milking season. Repeated measures analyses indicated that overall differences between the 2× (520.68 g) and 4× (873.03 g) groups were highly significant for milk yield (P<0.01). Parity differences were significant in the treatment group and the 3rd lactation animals responded better to the 4× treatment (P<0.01), but they were non-significantly different than the 2nd lactation animals in the 2× group. Sheep in the 4× group had higher milk fat yield (P=0.02) but the groups were similar in terms of fat percentage (P=0.11). Differences between the breeds were highly significant (P<0.01) also. Tahirova breed, which has a higher percentage of East Friesian had a daily milk yield of 566.66 g, while Sonmez breed with a lower percentage of East Friesian produced a higher daily milk yield of 827.05 g. Results of this study suggests that increasing milking frequency for a short time increases milk yield throughout lactation, especially for older animals, and sheep with too high East Friesian breeding may have lower milk yield than those with lower East Friesian breeding.

The influence of hepatitis B and C virus infections on patient and allograft outcomes in kidney transplantation

BACKGROUND

Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are the most important causes of chronic liver diseases among end-stage kidney disease patients. Our aim was to evaluate the influence of HBV and HCV infections on patient and allograft outcomes after successful kidney transplantation.

PATIENTS AND METHODS

We retrospectively analyzed 592 kidney transplantations performed between December 2008 and August 2010. We compared patient and graft survivals as well as age, gender, immunosuppression status, pretransplant dialysis duration, chronic allograft dysfunction, and causes of death.

RESULTS

Thirty-two patients (5.4%; group 1) were positive for HCV antibody, whereas 16 (2.7%) were positive for hepatitis B surface antigen (HBsAg) (group 2). Two patients (0.3%) were positive concurrently for both HCV antibody and HBsAg. Five hundred forty-two patients (91.6%; group 3) were negative for both. Patients were divided into groups with respect to viral infection. The groups were analyzed for age, gender, immunosuppression, pretransplant dialysis duration, chronic allograft dysfunction, and causes of death, as well as patient and graft outcomes. There were no differences in patient and graft survivals among the groups. None of the patients showed signs of hepatic failure. No patient or graft loss was observed among hepatitis groups when compared with disease-free patients.

CONCLUSION

Graft and patient survivals were not influenced by HBV and/or HCV infections. HBV and HCV infections are not contraindications for kidney transplantation.

Chylomediastinum following mitral valve replacement

Chylomediastinum is a rare but potentially serious complication. There is as yet no definitive treatment. We present an exceptional case of chylomediastinum due to mitral valve replacement. The patient was successfully treated using a conservative approach with total parenteral nutrition, nothing by mouth, and mediastinal tube drainage.