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Singh V, Reddy R, Sinha A, Marturi V, Panditharadyula SS, Bala A. A Review on Phytopharmaceuticals having Concomitant Experimental Anti-diabetic and Anti-cancer Effects as Potential Sources for Targeted Therapies Against Insulin-mediated Breast Cancer Cell Invasion and Migration. CURRENT CANCER THERAPY REVIEWS 2021. [DOI: 10.2174/1573394716999200831113335] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Diabetes and breast cancer are pathophysiologically similar and clinically established
diseases that co-exist with a wider complex similar molecular signalling and having a similar set of
risk factors. Insulin plays a pivotal role in the invasion and migration of breast cancer cells. Several
ethnopharmacological evidences shed light on the concomitant anti-diabetic and anti-cancer activity
of medicinal plant and phytochemicals against breast tumors of patients with diabetes. This present
article reviewed the findings on medicinal plants and phytochemicals with concomitant antidiabetic
and anti-cancer effects reported in scientific literature to facilitate the development of dual-
acting therapies against diabetes and breast cancer. The schematic tabular form of published literature
on medicinal plants (63 plants belongs to 45 families) concluded the dynamics of phytochemicals
against diabetes and breast tumors that could be explored further for the discovery of therapies
for controlling of breast cancer cell invasion and migration in patients with diabetes.
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Affiliation(s)
- Vibhavana Singh
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research, (NIPER) Hajipur, Export Promotion Industrial Park (EPIP) Hajipur, Bihar 844102, India
| | - Rakesh Reddy
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research, (NIPER) Hajipur, Export Promotion Industrial Park (EPIP) Hajipur, Bihar 844102, India
| | - Antarip Sinha
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research, (NIPER) Hajipur, Export Promotion Industrial Park (EPIP) Hajipur, Bihar 844102, India
| | - Venkatesh Marturi
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research, (NIPER) Hajipur, Export Promotion Industrial Park (EPIP) Hajipur, Bihar 844102, India
| | - Shravani S. Panditharadyula
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research, (NIPER) Hajipur, Export Promotion Industrial Park (EPIP) Hajipur, Bihar 844102, India
| | - Asis Bala
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research, (NIPER) Hajipur, Export Promotion Industrial Park (EPIP) Hajipur, Bihar 844102, India
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Coletta AM, Agha NH, Baker FL, Niemiro GM, Mylabathula PL, Brewster AM, Bevers TB, Fuentes-Mattei E, Basen-Engquist K, Gilchrist SC, Simpson RJ. The impact of high-intensity interval exercise training on NK-cell function and circulating myokines for breast cancer prevention among women at high risk for breast cancer. Breast Cancer Res Treat 2021; 187:407-416. [PMID: 33555464 PMCID: PMC8189992 DOI: 10.1007/s10549-021-06111-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 01/21/2021] [Indexed: 12/31/2022]
Abstract
Purpose Preclinical evidence suggests that natural killer cell (NK-cell) function and myokines facilitate the protective effects of exercise for breast cancer prevention. Since higher-intensity exercise acutely promotes greater mobilization and larger changes in NK-cell cytotoxicity than lower-intensity, high-intensity interval training (HIIT) might offer increased immune protection compared to moderate-intensity continuous-training (MICT). This study compared a 12-week HIIT program to a 12-week MICT program and usual care on changes in resting NK-cell function and circulating myokines among women at high risk for breast cancer. Methods Thirty-three women were randomized to HIIT, MICT, or usual care, for a supervised exercise intervention. Blood was collected at baseline and end-of-study. The cytotoxic activity of CD3−/CD56+ NK-cells against the K562 target cell line in vitro was determined by flow cytometry. Circulating myokines (IL-15, IL-6, irisin, OSM, osteonectin, IL-7) were assessed with luminex multiplex assays and ELISA. One-way ANOVA and paired sample t-tests assessed between- and within-group differences, respectively. Pearson correlation coefficients determined relationships between baseline fitness and change variables. Results Significant differences were not observed between groups for change in NK-cell function or circulating myokines (p > 0.05). Significant correlations were only observed for baseline peak aerobic capacity (ml/kg/min) and change in NK-cell-specific lysis (r = − 0.43, p = 0.02) and hemacytotoxicity for the total sample (r = − 0.46, p = 0.01). Conclusion Our findings suggest that exercise intensity may not significantly impact change in resting NK-cell function and circulating myokines among women at high risk for breast cancer. Structured exercise training may have a larger impact on NK-cell function in those with lower levels of cardiorespiratory fitness. Clinical trial registration: NCT02923401; Registered on October 4, 2016
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Affiliation(s)
- Adriana M Coletta
- Department of Health and Kinesiology, The University of Utah, Salt Lake City, UT, USA. .,Cancer Control and Population Sciences Program, Huntsman Cancer Institute, Salt Lake City, UT, USA. .,Huntsman Cancer Institute at the University of Utah, 2000 Circle of Hope Drive, Research South Building Room 4747, Salt Lake City, UT, 84112, USA.
| | - Nadia H Agha
- Department of Health and Human Performance, The University of Houston, Houston, TX, USA
| | - Forrest L Baker
- Department of Pediatrics, The University of Arizona, Tucson, AZ, USA.,Department of Nutritional Sciences, The University of Arizona, Tucson, AZ, USA
| | - Grace M Niemiro
- Department of Pediatrics, The University of Arizona, Tucson, AZ, USA
| | - Preteesh L Mylabathula
- Department of Pediatrics, The University of Arizona, Tucson, AZ, USA.,Department of Nutritional Sciences, The University of Arizona, Tucson, AZ, USA
| | - Abenaa M Brewster
- Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Therese B Bevers
- Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Enrique Fuentes-Mattei
- Department of Radiation Oncology Clinical Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Karen Basen-Engquist
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Susan C Gilchrist
- Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.,Department of Cardiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Richard J Simpson
- Department of Pediatrics, The University of Arizona, Tucson, AZ, USA.,Department of Nutritional Sciences, The University of Arizona, Tucson, AZ, USA.,Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.,Department of Immunobiology, The University of Arizona, Tucson, AZ, USA.,The University of Arizona Cancer Center, Tucson, AZ, USA
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Vellal AD, Sirinukunwattan K, Kensler KH, Baker GM, Stancu AL, Pyle ME, Collins LC, Schnitt SJ, Connolly JL, Veta M, Eliassen AH, Tamimi RM, Heng YJ. Deep Learning Image Analysis of Benign Breast Disease to Identify Subsequent Risk of Breast Cancer. JNCI Cancer Spectr 2021; 5:pkaa119. [PMID: 33644680 PMCID: PMC7898083 DOI: 10.1093/jncics/pkaa119] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 11/04/2020] [Accepted: 12/18/2020] [Indexed: 12/16/2022] Open
Abstract
Background New biomarkers of risk may improve breast cancer (BC) risk prediction. We developed a computational pathology method to segment benign breast disease (BBD) whole slide images into epithelium, fibrous stroma, and fat. We applied our method to the BBD BC nested case-control study within the Nurses' Health Studies to assess whether computer-derived tissue composition or a morphometric signature was associated with subsequent risk of BC. Methods Tissue segmentation and nuclei detection deep-learning networks were established and applied to 3795 whole slide images from 293 cases who developed BC and 1132 controls who did not. Percentages of each tissue region were calculated, and 615 morphometric features were extracted. Elastic net regression was used to create a BC morphometric signature. Associations between BC risk factors and age-adjusted tissue composition among controls were assessed using analysis of covariance. Unconditional logistic regression, adjusting for the matching factors, BBD histological subtypes, parity, menopausal status, and body mass index evaluated the relationship between tissue composition and BC risk. All statistical tests were 2-sided. Results Among controls, direction of associations between BBD subtypes, parity, and number of births with breast composition varied by tissue region; select regions were associated with childhood body size, body mass index, age of menarche, and menopausal status (all P < .05). A higher proportion of epithelial tissue was associated with increased BC risk (odds ratio = 1.39, 95% confidence interval = 0.91 to 2.14, for highest vs lowest quartiles, P trend = .047). No morphometric signature was associated with BC. Conclusions The amount of epithelial tissue may be incorporated into risk assessment models to improve BC risk prediction.
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Affiliation(s)
- Adithya D Vellal
- Department of Pathology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Korsuk Sirinukunwattan
- Department of Pathology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Department of Engineering Science, Institute of Biomedical Engineering (IBME), University of Oxford, Oxford, UK
- Big Data Institute, University of Oxford, Li Ka Shing Centre for Health Information and Discovery, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Oxford University NHS Foundation Trust, Oxford, UK
| | - Kevin H Kensler
- Division of Population Sciences, Dana Farber Cancer Institute, Boston, MA, USA
| | - Gabrielle M Baker
- Department of Pathology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Andreea L Stancu
- Department of Pathology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Michael E Pyle
- Department of Pathology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Laura C Collins
- Department of Pathology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Stuart J Schnitt
- Dana-Farber/Brigham and Women's Cancer Center, Harvard Medical School, Dana-Farber Cancer Institute-Brigham and Women's Hospital, Boston, MA, USA
| | - James L Connolly
- Department of Pathology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Mitko Veta
- Medical Image Analysis Group, Eindhoven University of Technology, Eindhoven, the Netherlands
| | - A Heather Eliassen
- Channing Division of Network Medicine, Department of Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Rulla M Tamimi
- Channing Division of Network Medicine, Department of Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA
| | - Yujing J Heng
- Department of Pathology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USA
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Allweis TM, Hermann N, Berenstein-Molho R, Guindy M. Personalized Screening for Breast Cancer: Rationale, Present Practices, and Future Directions. Ann Surg Oncol 2021; 28:4306-4317. [PMID: 33398646 DOI: 10.1245/s10434-020-09426-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 11/13/2020] [Indexed: 12/13/2022]
Abstract
Ever since screening for early breast cancer (BC) diagnosis was shown to decrease mortality from the disease, screening programs have been widely implemented throughout the world. Targeted age groups and schedules vary between countries but the majority use a population-based approach, regardless of personal BC risk. The purpose of this review was to describe current population-based screening practices, point out some of the shortcomings of these practices, describe BC risk factors and risk assessment models, and present ongoing clinical trials of personalized risk-adapted BC screening. Three ongoing, large-scale, randomized controlled clinical trials (WISDOM in the US, MyPEBS in Europe, and TBST in Italy) were identified through a search of the MEDLINE and US National Library of Medicine (ClinicalTrials.gov) databases. In these trials, women either undergo standard or personalized screening. The trials vary in methods of risk stratification and screening modalities, but all aim to examine whether personalized risk-adapted screening can safely replace the current population-based approach and lead to rates of advanced-stage BC at diagnosis comparable with those of current screening regimens. The results of these trials may change current population-based screening practices.
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Affiliation(s)
- Tanir M Allweis
- Department of Surgery and Breast Health Center, Kaplan Medical Center, Rehovot, Israel. .,Faculty of Medicine, Hebrew University, Jerusalem, Israel.
| | - Naama Hermann
- Department of General Surgery B and Meirav Comprehensive Breast Health Center, Sheba Medical Center, Ramat Gan, Israel
| | - Rinat Berenstein-Molho
- Breast Cancer Unit, Oncology Institute, Chaim Sheba Medical Center, Tel-Hashomer, Israel.,Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Michal Guindy
- Department of Imaging, Assuta Medical Center, Tel Aviv, Israel
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Berkey CS, Tamimi RM, Willett WC, Rosner B, Hickey M, Toriola AT, Frazier AL, Colditz GA. Adolescent alcohol, nuts, and fiber: combined effects on benign breast disease risk in young women. NPJ Breast Cancer 2020; 6:61. [PMID: 33298962 PMCID: PMC7683739 DOI: 10.1038/s41523-020-00206-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 10/21/2020] [Indexed: 12/29/2022] Open
Abstract
Adolescent drinking is associated with higher risks of proliferative benign breast disease (BBD) and invasive breast cancer (BC). Furthermore, adolescent nut and fiber consumptions are associated with lower risks of benign lesions and premenopausal BC. We hypothesize that diet (nuts, fiber) may mitigate the elevated BBD risk associated with alcohol. A prospective cohort of 9031 females, 9-15 years at baseline, completed questionnaires in 1996-2001, 2003, 2005, 2007, 2010, 2013, and 2014. Participants completed food frequency questionnaires in 1996-2001. In 2005, participants (>=18 years) began reporting biopsy-confirmed BBD (N = 173 cases). Multivariable logistic regression estimated associations between BBD and cross-classified intakes (14-17 years) of alcohol and peanut butter/nuts (separately, total dietary fiber). Only 19% of participants drank in high school; drinking was associated with elevated BBD risk (OR = 1.75, 95% CI: 1.20-2.56; p = 0.004) compared to nondrinkers. Participants consuming any nuts/butter had lower BBD risk (OR = 0.64, 95% CI: 0.45-0.90; p = 0.01) compared to those consuming none. Participants in top 75% fiber intake had lower risk (OR = 0.57, 95% CI: 0.40-0.81; p = 0.002) compared to bottom quartile. Testing our hypothesis that consuming nuts/butter mitigates the elevated alcohol risk, analyzing alcohol and nuts combined found that those who consumed both had lower risk (RR = 0.47, 95% CI: 0.24-0.89; p = 0.02) compared to drinkers eating no nuts. Our analysis of alcohol and fiber together did not demonstrate risk mitigation by fiber. For high school females who drink, their BBD risk may be attenuated by consuming nuts. Due to modest numbers, future studies need to replicate our findings in adolescent/adult females. However, high school students may be encouraged to eat nuts and fiber, and to avoid alcohol, to reduce risk of BBD and for general health benefits.
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Affiliation(s)
- Catherine S Berkey
- Channing Division of Network Medicine, Department of Medicine, Brigham & Women's Hospital and Harvard Medical School, Boston, MA, USA.
| | - Rulla M Tamimi
- Division of Epidemiology, Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA
| | - Walter C Willett
- Departments of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Bernard Rosner
- Channing Division of Network Medicine, Department of Medicine, Brigham & Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Martha Hickey
- Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, VIC, Australia
| | - Adetunji T Toriola
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine and Alvin J Siteman Cancer Center, St. Louis, MO, USA
| | - A Lindsay Frazier
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Graham A Colditz
- Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, USA
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Li X, Zhou C, Wu Y, Chen X. Relationship between formulaic breast volume and risk of breast cancer based on linear measurements. BMC Cancer 2020; 20:989. [PMID: 33046044 PMCID: PMC7552486 DOI: 10.1186/s12885-020-07499-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 10/06/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Whether breast volume is a risk factor for breast cancer is controversial. This study aimed to evaluate whether a significant association between breast volume and risk of breast cancer, based on linear measurements, was present by applying propensity score matching (PSM). METHODS The study was designed as a hospital-based case-control study. Between March 2018 and May 2019, 208 cases and 340 controls were retrospectively reviewed. Information on menarche, smoking, feeding mode, oral contraceptives, reproductive history and family history was obtained through a structured questionnaire. Breast volume was calculated using a formula based on linear measurements of breast parameters. Cox regression and PSM were used to estimate odds ratios and 95% confidence intervals for breast cancer using risk factors adjusted for potential confounders. RESULTS There was a significant difference in breast volume between the two groups before propensity score matching (P = 0.014). Binary logistic regression showed that the risk of breast cancer was slightly higher in the case group with larger breast volumes than in the control group(P = 0.009, OR = 1.002, 95%CI:1.000 ~ 1.003). However, there was no significant statistical difference between the two groups using an independent sample Mann-Whitney U test (P = 0.438) or conditional logistic regression (P = 0.446). CONCLUSIONS After PSM for potential confounding factors, there is no significant difference in breast volume estimated by BREAST-V formula between the case group and the control group. The risk of breast cancer may not be related to breast volume in Chinese women.
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Affiliation(s)
- Xiaoxia Li
- Department of Plastic and Cosmetic Surgery, Nanfang Hospital, Southern Medical University, 1838 Guangzhou North Road, Guangzhou, Guangdong 510515 P. R. China
| | - Chunlan Zhou
- Department of Nursing, Nanfang Hospital, Southern Medical University, 1838 Guangzhou North Road, Guangzhou, Guangdong 510515 P. R. China
| | - Yanni Wu
- Department of Nursing, Nanfang Hospital, Southern Medical University, 1838 Guangzhou North Road, Guangzhou, Guangdong 510515 P. R. China
| | - Xiaohong Chen
- Department of Thyroid Breast Surgery, the First Affiliated Hospital of Shantou University Medical College, 57 Changping Road, Shantou, Guangdong 515041 P. R. China
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Louro J, Román M, Posso M, Comerma L, Vidal C, Saladié F, Alcantara R, Sanchez M, Quintana MJ, Del Riego J, Ferrer J, Peñalva L, Bargalló X, Prieto M, Sala M, Castells X. Differences in breast cancer risk after benign breast disease by type of screening diagnosis. Breast 2020; 54:343-348. [PMID: 33023825 PMCID: PMC7770442 DOI: 10.1016/j.breast.2020.09.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 08/24/2020] [Accepted: 09/04/2020] [Indexed: 02/01/2023] Open
Abstract
Introduction We aimed to assess differences in breast cancer risk across benign breast disease diagnosed at prevalent or incident screens. Materials and methods We conducted a retrospective cohort study with data from 629,087 women participating in a long-standing population-based breast cancer screening program in Spain. Each benign breast disease was classified as non-proliferative, proliferative without atypia, or proliferative with atypia, and whether it was diagnosed in a prevalent or incident screen. We used partly conditional Cox hazard regression to estimate the adjusted hazard ratios of the risk of breast cancer. Results Compared with women without benign breast disease, the risk of breast cancer was significantly higher (p-value = 0.005) in women with benign breast disease diagnosed in an incident screen (aHR, 2.67; 95%CI: 2.24–3.19) than in those with benign breast disease diagnosed in a prevalent screen (aHR, 1.87; 95%CI: 1.57–2.24). The highest risk was found in women with a proliferative benign breast disease with atypia (aHR, 4.35; 95%CI: 2.09–9.08, and 3.35; 95%CI: 1.51–7.40 for those diagnosed at incident and prevalent screens, respectively), while the lowest was found in women with non-proliferative benign breast disease (aHR, 2.39; 95%CI: 1.95–2.93, and 1.63; 95%CI: 1.32–2.02 for those diagnosed at incident and prevalent screens, respectively). Conclusion Our study showed that the risk of breast cancer conferred by a benign breast disease differed according to type of screen (prevalent or incident). To our knowledge, this is the first study to analyse the impact of the screening type on benign breast disease prognosis. Breast cancer risk after a benign breast disease varied with the screening type. Incident benign breast disease had a higher breast cancer risk than prevalent. The risk remained increased regardless of benign breast disease subtype.
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Affiliation(s)
- Javier Louro
- IMIM (Hospital Del Mar Medical Research Institute), Barcelona, Spain; Research Network on Health Services in Chronic Diseases (REDISSEC), Barcelona, Spain; Servei D'Epidemiologia I Avaluació, Hospital Del Mar, Barcelona, Spain; European Higher Education Area (EHEA) Doctoral Programme in Methodology of Biomedical Research and Public Health in Department of Pediatrics, Obstetrics and Gynecology, Preventive Medicine and Public Health, Universitat Autónoma de Barcelona (UAB), Bellaterra, Barcelona, Spain
| | - Marta Román
- IMIM (Hospital Del Mar Medical Research Institute), Barcelona, Spain; Research Network on Health Services in Chronic Diseases (REDISSEC), Barcelona, Spain; Servei D'Epidemiologia I Avaluació, Hospital Del Mar, Barcelona, Spain
| | - Margarita Posso
- IMIM (Hospital Del Mar Medical Research Institute), Barcelona, Spain; Research Network on Health Services in Chronic Diseases (REDISSEC), Barcelona, Spain; Servei D'Epidemiologia I Avaluació, Hospital Del Mar, Barcelona, Spain
| | - Laura Comerma
- Servei de Patologia, Hospital Del Mar, Barcelona, Spain
| | - Carmen Vidal
- Catalan Institute of Oncology (ICO), Barcelona, Spain
| | - Francina Saladié
- Cancer Epidemiology and Prevention Service, Hospital Universitari Sant Joan de Reus, Institut D'Investigació Sanitària Pere Virgili, Universitat Rovira I Virgili, Reus, Spain
| | - Rodrigo Alcantara
- Servei de Diagnòstic per La Imatge, Hospital Del Mar, Barcelona, Spain
| | - Mar Sanchez
- Direction General of Public Health, Cantabria, Spain
| | - M Jesús Quintana
- Department of Clinical Epidemiology and Public Health, University Hospital de La Santa Creu I Sant Pau, IIB Sant Pau, Barcelona, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Spain
| | - Javier Del Riego
- Women's Imaging, Department of Radiology, UDIAT Centre Diagnòstic, Parc Taulí Hospital Universitari, Sabadell, Barcelona, Spain
| | - Joana Ferrer
- Radiology Department, Hospital de Santa Caterina, Salt, Girona, Spain
| | - Lupe Peñalva
- Vallés Oriental Breast Cancer Early Detection Program, Spain
| | | | - Miguel Prieto
- Breast Cancer Screening Program, Principality of Asturias, Spain
| | - María Sala
- IMIM (Hospital Del Mar Medical Research Institute), Barcelona, Spain; Research Network on Health Services in Chronic Diseases (REDISSEC), Barcelona, Spain; Servei D'Epidemiologia I Avaluació, Hospital Del Mar, Barcelona, Spain
| | - Xavier Castells
- IMIM (Hospital Del Mar Medical Research Institute), Barcelona, Spain; Research Network on Health Services in Chronic Diseases (REDISSEC), Barcelona, Spain; Servei D'Epidemiologia I Avaluació, Hospital Del Mar, Barcelona, Spain.
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Autenshlyus AI, Davletova KI, Mikhaylova ES, Proskura AV, Varaksin NA, Bogachuk AP, Sidorov SV, Lyakhovich VV, Lipkin VM. Influence of Internal and External Factors on the Production of Cytokines by Peripheral Blood Cells in Breast Cancer. DOKL BIOCHEM BIOPHYS 2020; 493:178-180. [PMID: 32894459 DOI: 10.1134/s1607672920040031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 12/26/2019] [Accepted: 01/20/2020] [Indexed: 11/22/2022]
Abstract
The article focuses on the influence of human leukemia differentiation factor (HLDF), carcinoembryonic antigen (CEA), and polyclonal activators (PA) on cytokine production by peripheral blood cells in breast cancer and benign breast diseases. It was found that the influence of internal factors on the production of cytokines by the peripheral blood cells is associated with lymphatic metastasis (CEA: IL-10; HLDF: IL-6, IL-1β, TNF-α, and G-CSF). One special circumstance was that there were no differences between the production of cytokines by peripheral blood cells in the patients with breast cancer compared to the patients with benign breast diseases with a high risk of malignant transformation. This is evidence of the functional similarity of peripheral blood cells in patients with these conditions. Cytokine production under the influence of PA was different only in case of TNF-α in all study groups.
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Affiliation(s)
- A I Autenshlyus
- Novosibirsk State Medical University, Novosibirsk, Russia. .,Institute of Molecular Biology and Biophysics, Subdivision of Federal Research Center of Fundamental and Translational Medicine, Novosibirsk, Russia.
| | - K I Davletova
- Novosibirsk State Medical University, Novosibirsk, Russia.,Institute of Molecular Biology and Biophysics, Subdivision of Federal Research Center of Fundamental and Translational Medicine, Novosibirsk, Russia
| | - E S Mikhaylova
- Novosibirsk State Medical University, Novosibirsk, Russia.,Institute of Molecular Biology and Biophysics, Subdivision of Federal Research Center of Fundamental and Translational Medicine, Novosibirsk, Russia
| | - A V Proskura
- Institute of Molecular Biology and Biophysics, Subdivision of Federal Research Center of Fundamental and Translational Medicine, Novosibirsk, Russia
| | | | - A P Bogachuk
- Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, Moscow, Russia
| | - S V Sidorov
- Novosibirsk State University, Novosibirsk, Russia
| | - V V Lyakhovich
- Institute of Molecular Biology and Biophysics, Subdivision of Federal Research Center of Fundamental and Translational Medicine, Novosibirsk, Russia
| | - V M Lipkin
- Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, Moscow, Russia
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Tsai MS, Chang SH, Kuo WH, Kuo CH, Li SY, Wang MY, Chang DY, Lu YS, Huang CS, Cheng AL, Lin CH, Chen PC. A case-control study of perfluoroalkyl substances and the risk of breast cancer in Taiwanese women. ENVIRONMENT INTERNATIONAL 2020; 142:105850. [PMID: 32580117 DOI: 10.1016/j.envint.2020.105850] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 05/18/2020] [Accepted: 05/19/2020] [Indexed: 05/09/2023]
Abstract
Breast cancer (BC) is a common cancer in women worldwide; however, the incidence of BC is increasing in younger women, possibly associated with the environment. Perfluoroalkyl substances (PFAS) are one of endocrine disruptors that accumulate in environment and impact human health. This study aimed to investigate whether the PFAS and BC are associated. We enrolled 120 BCE patients and 119 controls at National Taiwan University Hospital (NTUH) and also collected bio-specimen and questionnaire from 2013 to 2015. All subjects' plasma PFAS levels were analyzed by ultra-performance liquid chromatography tandem mass spectrometry method with electrospray ionization (UHPLC-ESI-MS/MS). A logistic regression model was used to estimate the association between PFAS and BC. In the ≤50 years age group, the adjusted odds ratio (OR) was 2.34 (95% CI = 1.02, 5.38) for perfluorooctane sulfonate (PFOS) exposure per natural log unit increase. After stratifying the estrogen receptor (ER) status and age group, we obtained a positive association for PFHxS and PFOS concentrations with respect to the risk of ER positive tumors for ≤50 years age group. In conclusion, we found that PFAS were associated with the BC risk of ER positive tumors in young Taiwanese women. Further studies are needed to follow and explore whether these associations are causal.
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Affiliation(s)
- Meng-Shan Tsai
- Institute of Environmental and Occupational Health Sciences, College of Public Health, National Taiwan University, Taipei 100, Taiwan
| | - Shu-Han Chang
- School of Pharmacy, College of Medicine, National Taiwan University, Taipei 100, Taiwan
| | - Wen-Hung Kuo
- Departments of Surgery, National Taiwan University Hospital, Taipei 100, Taiwan
| | - Ching-Hua Kuo
- School of Pharmacy, College of Medicine, National Taiwan University, Taipei 100, Taiwan; The Metabolomics Core Laboratory, Centers of Genomic Medicine and Precision Medicine, National Taiwan University, Taipei 100, Taiwan; Department of Pharmacy, National Taiwan University Hospital, Taipei 100, Taiwan
| | - Szu-Yi Li
- Department of Oncology, National Taiwan University Hospital, Taipei 100, Taiwan
| | - Ming-Yang Wang
- Departments of Surgery, National Taiwan University Hospital, Taipei 100, Taiwan
| | - Dwan-Ying Chang
- Department of Oncology, National Taiwan University Hospital, Taipei 100, Taiwan
| | - Yen-Shen Lu
- Department of Oncology, National Taiwan University Hospital, Taipei 100, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, Taipei 100, Taiwan
| | - Chiun-Sheng Huang
- Departments of Surgery, National Taiwan University Hospital, Taipei 100, Taiwan
| | - Ann-Lii Cheng
- Department of Oncology, National Taiwan University Hospital, Taipei 100, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, Taipei 100, Taiwan; Graduate Institute of Oncology and Cancer Research Centre, College of Medicine, National Taiwan University, Taipei 100, Taiwan
| | - Ching-Hung Lin
- Department of Oncology, National Taiwan University Hospital, Taipei 100, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, Taipei 100, Taiwan.
| | - Pau-Chung Chen
- Institute of Environmental and Occupational Health Sciences, College of Public Health, National Taiwan University, Taipei 100, Taiwan; Department of Public Health, National Taiwan University College of Public Health, Taipei 100, Taiwan; Department of Environmental and Occupational Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei 100, Taiwan; Office of Occupational Safety and Health, National Taiwan University College of Medicine and Hospital, Taipei 100, Taiwan; Innovation and Policy Center for Population Health and Sustainable Environment, National Taiwan University College of Public Health, Taipei 100, Taiwan.
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Costa RSSD, Silva IFD. P53 Expression in benign Breast Disease Development: A Systematic Review. Asian Pac J Cancer Prev 2020; 21:2485-2491. [PMID: 32986343 PMCID: PMC7779431 DOI: 10.31557/apjcp.2020.21.9.2485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Indexed: 12/03/2022] Open
Abstract
Background: Benign breast disease (BBD) is one of main breast cancer risk factors. Dysfunctions on p53 protein, which has a genome protective role, have been related to breast cancer developments. However, its role on BBD development is still unclear. Methods: A systematic review of literature was proceeded according to PRISMA-P guidelines. PubMed, BVS, MEDLINE and Scholar Google were used as databases, complemented by a manual search in articles references. Articles searches were conducted from May to July 2019 and publications in English, Spanish and Portuguese were selected. P53 expression was set as outcome among women with BBD and were included only articles with good quality according STROBE tools. Data concerning p53 expression frequencies were independently extracted by two review authors, and eligible articles were synthesized. Results: From 12 studies selected for this review, the majority analyzed p53 expression in non-proliferative lesions and general p53 expressions ranged from 0 to 100%. P53 expression was more frequently observed in cases series studies (91.7%) and in studies conducted in Occidental Europe (41.7%). P53 expression was more frequent among tissues with fibrocystic disease (22.5%) and fibroadenoma (22.5%). Conclusion: When compared with all breast tissues types, benign breast disease corresponds to 34.39% of p53 expression. Second outcomes were not evaluated because the heterogeneity observed in selected studies. In addition, more studies considering ethnicity and benign breast disease classification should also be considered for further analysis.
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Affiliation(s)
| | - Ilce Ferreira Da Silva
- National School of Public Health Sergio Arouca, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
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61
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Lyburn ID, Pinder SE. Screening detects a myriad of breast disease - refining practice will increase effectiveness and reduce harm. Br J Radiol 2020; 93:20200135. [PMID: 32816520 DOI: 10.1259/bjr.20200135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
For many individuals, the term 'cancer' equates to a disease that if untreated will progress, spread from the area initially affected and ultimately cause death. 'Breast cancer', however, is a diverse of range of pathological entities, incorporating indolent to fast-growing and aggressive lesions, with varying histological patterns, clinical presentations, treatment responses and outcomes. Screening for malignancy is based on the assumption that cancer has a gradual, orderly progression and that detecting lesions earlier in their natural history, and intervening, will reduce mortality. The natural history of epithelial atypia, ductal carcinoma in situ and even invasive breast cancer is poorly understood, but widely variable. We believe that population breast screening methodology needs to change to focus on diagnosis of lesions of greatest clinical relevance.
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Affiliation(s)
- Iain D Lyburn
- Cheltenham Imaging Centre, Cobalt Medical Charity, Cheltenham, United Kingdom
| | - Sarah E Pinder
- School of Cancer & Pharmaceutical Sciences, King's College, London, United Kingdom
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Stachs A, Stubert J, Reimer T, Hartmann S. Benign Breast Disease in Women. DEUTSCHES ARZTEBLATT INTERNATIONAL 2020; 116:565-574. [PMID: 31554551 DOI: 10.3238/arztebl.2019.0565] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 07/02/2019] [Accepted: 07/02/2019] [Indexed: 12/23/2022]
Abstract
BACKGROUND Most clinical breast changes in women are benign; in only 3% to 6% of cases are they due to breast cancer. How- ever, there is a lack of up-to-date, evidence-based treatment recommendations for the various benign differential diagnoses. METHODS Selective literature search of PubMed from 1985 to May 2019, including current national (AWMF, Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften [Association of Scientific Medical Societies in Germany]) and inter- national guidelines. RESULTS Mastalgia and fibrocystic changes are common (around 50% of all women over the age of 30). Fibroadenomas occur in 25% of women; they are the most common benign tumors of the breast and do not require treatment. With most benign breast changes the risk of dedifferentiation is very low. However, it is important in the differential diagnosis to distinguish between such benign changes and breast cancer or changes that carry a risk of malignancy. Complex cysts, for example, carry a risk of malig- nancy of 23% to 31%, papillary lesions 16% , and radial scars 7%. Where there is doubt, histological confirmation should be sought by means of percutaneous biopsy. CONCLUSION Benign breast changes can be definitively distinguished from malignant lesions through the selective use of avail- able diagnostic investigations and interdisciplinary collaboration. When lesions of uncertain malignant potential are found (B3 in the biopsy classification), complete excision is indicated. Prospective studies on the early diagnosis of breast cancer in lesions carrying a risk of malignancy are desirable.
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Affiliation(s)
- Angrit Stachs
- Department of Obstetrics and Gynecology, University of Rostock
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Re: Risk-reducing mastectomy: a case series of 124 procedures in Brazilian patients. Breast Cancer Res Treat 2020; 182:763-764. [PMID: 32535766 DOI: 10.1007/s10549-020-05742-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 06/10/2020] [Indexed: 10/24/2022]
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Chelmow D, Pearlman MD, Young A, Bozzuto L, Dayaratna S, Jeudy M, Kremer ME, Scott DM, O'Hara JS. Executive Summary of the Early-Onset Breast Cancer Evidence Review Conference. Obstet Gynecol 2020; 135:1457-1478. [PMID: 32459439 PMCID: PMC7253192 DOI: 10.1097/aog.0000000000003889] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 02/23/2020] [Accepted: 03/12/2020] [Indexed: 12/23/2022]
Abstract
The Centers for Disease Control and Prevention launched the Bring Your Brave campaign to increase knowledge about early-onset breast cancer, defined as breast cancer in women aged 18-45 years. The American College of Obstetricians and Gynecologists convened a panel of experts in breast disease from the Society for Academic Specialists in General Obstetrics and Gynecology to review relevant literature, validated tools, best practices, and practice guidelines as a first step toward developing educational materials for women's health care providers about early-onset breast cancer. Panel members conducted structured literature reviews, which were then reviewed by other panel members and discussed at an in-person meeting of stakeholder professional and patient advocacy organizations in April 2019. This article summarizes the relevant literature, existing guidance, and validated tools to guide health care providers in the prevention, early detection, and special considerations of early-onset breast cancer. Substantive knowledge gaps were noted and summarized to provide guidance for future research.
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Affiliation(s)
- David Chelmow
- Department of Obstetrics and Gynecology, Virginia Commonwealth University School of Medicine, Richmond, Virginia; the Department of Obstetrics and Gynecology, University of Michigan Medical School, Ann Arbor, Michigan; the Department of Women's Health, the University of Texas at Austin Dell Medical School, Austin, Texas; the Departments of Obstetrics and Gynecology and Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; the Department of Obstetrics and Gynecology, Thomas Jefferson University Hospital, Sidney Kimmel Medical College, Philadelphia, Pennsylvania; Southeast Kaiser Permanente Medical Group, Atlanta, Georgia; the Department of Obstetrics and Gynecology, University of Washington, Seattle, Washington; the Department of Obstetrics and Gynecology, University of Connecticut Medical School, Farmington, Connecticut; and the American College of Obstetricians and Gynecologists, Washington, DC
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Abstract
Advancements in cancer screening techniques have allowed for earlier detection of cancer at premalignant or early stages of disease. Several organizations have guidelines for screening strategies for breast, cervical, colon, and lung cancer. Ovarian cancer remains the deadliest cancer of the female reproductive tract; however, guidelines have yet to be shown effective in identifying ovarian cancer at earlier stages. It is important that providers familiarize themselves with up-to-date screening strategies in women at average risk and at increased risk of disease. The provider's role in guiding patients toward screening programs and counseling regarding risk reduction is one of the most important.
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Charlton BM, Farland LV, Boehmer U, Tamimi RM, Collins LC, VanKim NA, Bertone-Johnson ER, Potter J, Sarda V, Austin SB. Sexual orientation and benign breast disease in a cohort of U.S. women. Cancer Causes Control 2020; 31:173-179. [PMID: 31894493 DOI: 10.1007/s10552-019-01258-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 12/10/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE Several studies indicate that sexual minority (e.g., bisexual, lesbian) women may be at an increased risk for breast cancer. However, we know little about how risk factors, such as benign breast disease (BBD)-which can confer nearly a fourfold breast cancer risk increase-may vary across sexual orientation groups. METHODS Among Nurses' Health Study II participants followed from 1989 to 2013 (n = 99,656), we investigated whether bisexual and lesbian women were more likely than heterosexual women to have breast cancer risk factors including a BBD diagnosis (self-reported biopsy or aspiration confirmed, n = 11,021). Cox proportional hazard models were used to calculate hazard ratios (HR) and 95% confidence intervals (CI). RESULTS Compared to heterosexuals, sexual minority participants more commonly reported certain breast cancer risk factors including increased alcohol intake and nulliparity. However, sexual minority participants were more likely than heterosexuals to have certain protective factors including higher body mass index and less oral contraceptive use. When evaluating age- and family history-adjusted rates of BBD diagnoses across sexual orientation groups, bisexual (HR 1.04, 95% CI [0.78, 1.38]) and lesbian (0.99 [0.81, 1.21]) women were just as likely as heterosexuals to have a BBD diagnosis. Results were similar after adjusting for other known breast cancer risk factors. CONCLUSIONS In this cohort of women across the U.S., sexual minorities were more likely than heterosexuals to have some breast cancer risk factors-including modifiable risk factors such as alcohol intake. Heterosexual, bisexual, and lesbian women were equally as likely to have a BBD diagnosis.
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Affiliation(s)
- Brittany M Charlton
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA. .,Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA. .,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, 181 Longwood Avenue, Boston, MA, 02115, USA. .,Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA.
| | - Leslie V Farland
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 North Martin Avenue, Tucson, Az, 85724, USA
| | - Ulrike Boehmer
- Department of Community Health Sciences, Boston University School of Public Health, 715 Albany St, Boston, MA, 02118, USA
| | - Rulla M Tamimi
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, 181 Longwood Avenue, Boston, MA, 02115, USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA
| | - Laura C Collins
- Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA.,Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Avenue, Boston, MA, 02215, USA
| | - Nicole A VanKim
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, 715 North Pleasant Street, Amherst, MA, 01003, USA
| | - Elizabeth R Bertone-Johnson
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, 715 North Pleasant Street, Amherst, MA, 01003, USA
| | - Jennifer Potter
- Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA.,Division of General Internal Medicine, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA, 02215, USA.,The Fenway Institute, 1340 Boylston Street, Boston, MA, 02215, USA
| | - Vishnudas Sarda
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA
| | - S Bryn Austin
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA.,Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, 181 Longwood Avenue, Boston, MA, 02115, USA.,Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA
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Tavakolian S, Goudarzi H, Faghihloo E. Evaluating the expression level of HERV-K env, np9, rec and gag in breast tissue. Infect Agent Cancer 2019; 14:42. [PMID: 31798679 PMCID: PMC6884765 DOI: 10.1186/s13027-019-0260-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 11/18/2019] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE Breast cancer is one of the most common health problems. It has been suggested that several risk factors, either considered as external or internal, play a critical role in the pathogenesis of breast cancer, which among them, HERV-k, has the most fundamental role. In the present study, we aimed to evaluate the role of HERV-k env, gag, rec, np9 expressions in breast cancer progression. MATERIALS AND METHODS We collected 40 breast cancer tissues and their normal adjacent ones. After extracting the RNA of breast samples, we evaluated the expression of HERV-k env, gag, rec, np9 by using Quantitative real-time PCR (qRT-PCR). RESULTS The resulting data revealed that while there was a meaningful increase in the expression level of HERV-k env, gag and np9 in breast cancer tissues (P ≤ 0.01, 0.05, 0.05, respectively), we failed to find any significant elevation in the expression level of rec mRNA level. CONCLUSION The results of our study suggested that there is a plausible correlation between the mRNA expression level of HERV-K env, gag and np9 and the progression of breast cancer, proposing these markers as promising biomarkers to diagnose breast cancer.
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Affiliation(s)
- Shaian Tavakolian
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hossein Goudarzi
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ebrahim Faghihloo
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Baker GM, Pyle ME, Tobias AM, Bartlett RA, Phillips J, Fein-Zachary VJ, Wulf GM, Heng YJ. Establishing a Cohort of Transgender Men and Gender Nonconforming Individuals to Understand the Molecular Impact of Testosterone on Breast Physiology. Transgend Health 2019; 4:326-330. [PMID: 31750394 PMCID: PMC6863056 DOI: 10.1089/trgh.2019.0040] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Purpose: To characterize a cohort of transgender men and masculine-centered gender nonconforming individuals who underwent gender-affirming chest-contouring surgeries at our institution between 2013 and 2018. Methods: Demographics, medical history, and breast histopathological assessment for 340 patients were retrieved from medical records. Results: Most of our patients were white, non-Hispanic (75.0%), were taking testosterone (83.2%), and opted for chest-contouring surgery after 12–14 months of testosterone therapy. Ten patients were parous (2.9%). Seventy-nine (23.2%) and 27 (7.9%) patients had a family history of breast cancer or ovarian cancer, respectively. One transgender man was incidentally diagnosed with ductal carcinoma in situ at chest-contouring surgery. Conclusion: Future studies on this cohort will provide valuable insights about the impact of testosterone on breast physiology.
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Affiliation(s)
- Gabrielle M Baker
- Department of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Michael E Pyle
- Department of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Adam M Tobias
- Department of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Richard A Bartlett
- Department of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Jordana Phillips
- Division of Breast Imaging, Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Valerie J Fein-Zachary
- Division of Breast Imaging, Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Gerburg M Wulf
- Department of Hematology/Oncology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Yujing J Heng
- Department of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
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Abstract
BACKGROUND Reduction mammoplasty is indicated for symptomatic macromastia or breast asymmetry after contralateral cancer surgery. Previous studies compared the incidence of high-risk lesions in resection specimens between these 2 groups. However, no studies have compared incidental findings in breast reduction specimens based on relative risk of cancer. Our study stratifies lesions by relative risk of malignant progression and compares the frequency of these findings in bilateral versus unilateral reduction mammoplasties. METHODS Charts were reviewed from 422 patients undergoing breast reductions by a single surgeon over a 10-year period. Age, procedure, specimen weight, and histologic findings were recorded. Pathologic data were stratified by relative risk of malignant progression and compared between patients with and without cancer histories. RESULTS Three hundred five patients underwent bilateral reduction mammoplasty and 117 patients underwent unilateral reduction mammoplasty over the 10-year period. Bilateral patients had a higher incidence of benign lesions (P = 0.02). Both groups had similar incidences of proliferative lesions (P = 0.48). Unilateral patients had a higher incidence of atypia (P = 0.05) and carcinoma in situ (P < 0.01). One unilateral patient had an incidentally found invasive carcinoma. CONCLUSIONS Patients undergoing unilateral reduction after oncologic resection have a higher incidence of high-risk lesions compared with those undergoing bilateral reductions for macromastia. Although others have compared incidental findings between these cohorts, no group has compared these incidental findings stratified by risk. Our data underscore the importance of pathologic analysis of reduction specimens for early detection of high-risk lesions and will prove valuable for preoperative counseling before reduction mammoplasty for either of these indications.
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Saadallah F, Bouraoui I, Naija L, Sakhri S, Zemni I, Hassouna JB, Dhieb TB, Bouzaiene H, Rahal K. Coexistence of invasive ductal breast carcinoma and fibroadenoma. Pan Afr Med J 2019; 33:139. [PMID: 31558937 PMCID: PMC6754844 DOI: 10.11604/pamj.2019.33.139.17140] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 12/28/2018] [Indexed: 11/11/2022] Open
Abstract
Fibroadenomas are the most common breast disease that occurs usually in young. The coexistence of an invasive ductal carcinoma and a fibroadenoma in the ipsilateral breast is extremely rare. We present the case of a 52 years woman, presented to us for an upper-outer breast lump. Breast imaging concluded to tow contiguous lesions, one of them was suspicious. She had a conservative surgery. Histology concluded to a fibroadenoma and an invasive ductal carcinoma.
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Affiliation(s)
- Fatma Saadallah
- Department of Surgical Oncology, Salah Azaiz Anti-cancer Institute, Tunis, Tunisia
| | - Imen Bouraoui
- Department of Surgical Oncology, Salah Azaiz Anti-cancer Institute, Tunis, Tunisia
| | - Lamia Naija
- Department of Surgical Oncology, Salah Azaiz Anti-cancer Institute, Tunis, Tunisia
| | - Saida Sakhri
- Department of Surgical Oncology, Salah Azaiz Anti-cancer Institute, Tunis, Tunisia
| | - Ines Zemni
- Department of Surgical Oncology, Salah Azaiz Anti-cancer Institute, Tunis, Tunisia
| | - Jamel Ben Hassouna
- Department of Surgical Oncology, Salah Azaiz Anti-cancer Institute, Tunis, Tunisia
| | - Tarak Ben Dhieb
- Department of Surgical Oncology, Salah Azaiz Anti-cancer Institute, Tunis, Tunisia
| | - Hatem Bouzaiene
- Department of Surgical Oncology, Salah Azaiz Anti-cancer Institute, Tunis, Tunisia
| | - Khaled Rahal
- Department of Surgical Oncology, Salah Azaiz Anti-cancer Institute, Tunis, Tunisia
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Goldberg M, Cohn BA, Houghton LC, Flom JD, Wei Y, Cirillo P, Michels KB, Terry MB. Early-Life Growth and Benign Breast Disease. Am J Epidemiol 2019; 188:1646-1654. [PMID: 31107507 PMCID: PMC6736448 DOI: 10.1093/aje/kwz126] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 05/08/2019] [Accepted: 05/13/2019] [Indexed: 12/22/2022] Open
Abstract
Using prospective data from the Early Determinants of Mammographic Density study (United States, 1959-2008, n = 1121), we examined the associations between maternal body size, birth size, and infant and early childhood growth during 3 time periods (0-4 months, 4-12 months, and 1-4 years) and benign breast disease (BBD) using multivariable logistic regression with generalized estimating equations. A total of 197 women (17.6%) reported receiving a diagnosis of BBD by a physician. Higher body mass index at age 7 years was inversely associated with BBD risk. Rapid weight gain from age 1 year to 4 years, defined as an increase of least 2 major percentiles (e.g., 5th, 10th, 25th, 50th, 75th, and 95th) relative to stable growth, defined as remaining within 2 percentiles, was also inversely associated with BBD (odds ratio (OR) = 0.51, 95% confidence interval (CI): 0.23, 1.15). In contrast, rapid weight gain in infancy was positively associated with BBD relative to stable growth (from 0 to 4 months, OR = 1.65, 95% CI: 1.04, 2.62; from 4 to 12 months, 1.85, 95% CI: 0.89, 3.85), independent of birth weight, which was not associated with BBD. Our results suggest that patterns of early-life weight gain are important to BBD risk. Thus, susceptibility to BBD, like susceptibility to breast cancer, might start in early life.
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Affiliation(s)
- Mandy Goldberg
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Barbara A Cohn
- Child Health and Development Studies, Public Health Institute, Berkeley, California
| | - Lauren C Houghton
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Julie D Flom
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Ying Wei
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, New York
| | - Piera Cirillo
- Child Health and Development Studies, Public Health Institute, Berkeley, California
| | - Karin B Michels
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California
- Institute for Prevention and Cancer Epidemiology, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg im Breisgau, Germany
| | - Mary Beth Terry
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
- Herbert Irving Comprehensive Cancer Center, Irving Medical Center, Columbia University, New York, New York
- Imprints Center for Genetic and Environmental Lifecourse Studies, Mailman School of Public Health, Columbia University, New York, New York
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Berkey CS, Tamimi RM, Willett WC, Rosner B, Hickey M, Toriola AT, Lindsay Frazier A, Colditz GA. Dietary intake from birth through adolescence in relation to risk of benign breast disease in young women. Breast Cancer Res Treat 2019; 177:513-525. [PMID: 31222710 DOI: 10.1007/s10549-019-05323-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 06/13/2019] [Indexed: 11/28/2022]
Abstract
PURPOSE Nutritional factors during different periods in life impact breast cancer risk. Because benign breast disease (BBD) is a well-established risk factor for breast cancer, we investigated childhood nutrition from birth through age 14 year and subsequent BBD. METHODS A prospective cohort study of 9031 females, 9-15 year at baseline, completed questionnaires (including heights, weights) annually from 1996 to 2001, in 2003, 2005, 2007, 2010, 2013 and 2014. In 1996, mothers reported infant feeding practices during their daughters first year of life. Beginning in 1996, participants completed annual food frequency questionnaires. In 2005, participants (18 year +) began reporting whether they had ever been diagnosed with biopsy-confirmed BBD (N = 173 cases). Multivariable logistic regression models estimated associations between childhood nutrition and BBD, adjusted for maternal breast disease and childhood body size factors. RESULTS Although no infant nutrition factors were associated with biopsy-confirmed BBD, certain adolescent dietary factors were. A multivariable model simultaneously included the most important diet and body size factors from different age periods: higher BBD risk was associated with greater age 10 year consumption of animal (non-dairy, energy-adjusted) fat (OR 2.27, p < .02, top vs. bottom quartiles) and with lower 14 year consumption of nuts/peanut butter (OR 0.60, p = .033, top vs. bottom quartiles). CONCLUSION Greater intake of animal (non-dairy) fat at 10 year and lower intake of nuts/peanut butter at 14 year were independently associated with higher BBD risk. These dietary factors appeared to operate on BBD risk independent of childhood growth (gestational weight gain, childhood BMI and height, adolescent height growth velocity), young adult height and BMI, and family history.
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Affiliation(s)
- Catherine S Berkey
- Channing Division of Network Medicine, Department of Medicine, Brigham & Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA.
| | - Rulla M Tamimi
- Channing Division of Network Medicine, Department of Medicine, Brigham & Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA
| | - Walter C Willett
- Departments of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, USA
| | - Bernard Rosner
- Channing Division of Network Medicine, Department of Medicine, Brigham & Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA
| | - Martha Hickey
- Department of Obstetrics and Gynaecology, The University of Melbourne and the Royal Women's Hospital, Melbourne, VIC, Australia
| | - Adetunji T Toriola
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine and Alvin J Siteman Cancer Center, St. Louis, MO, USA
| | - A Lindsay Frazier
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, USA
| | - Graham A Colditz
- Washington University School of Medicine, Alvin J. Siteman Cancer Center, St. Louis, MO, USA
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73
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Lilleborge M, Falk RS, Russnes H, Sauer T, Ursin G, Hofvind S. Risk of breast cancer by prior screening results among women participating in BreastScreen Norway. Cancer 2019; 125:3330-3337. [DOI: 10.1002/cncr.32330] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 05/05/2019] [Accepted: 05/13/2019] [Indexed: 11/11/2022]
Affiliation(s)
| | - Ragnhild S. Falk
- Oslo Centre for Biostatistics and Epidemiology Oslo University Hospital Oslo Norway
| | - Hege Russnes
- Institute for Cancer Research Oslo University Hospital Oslo Norway
| | - Torill Sauer
- Department of Pathology Akershus University Hospital Lorenskog Norway
- Institute of Clinical Medicine University of Oslo Lorenskog Norway
| | - Giske Ursin
- Cancer Registry of Norway, Oslo University Hospital Oslo Norway
- Institute for Basic Medical Sciences University of Oslo Oslo Norway
- Department of Preventive Medicine, Keck School of Medicine University of Southern California Los Angeles California
| | - Solveig Hofvind
- Cancer Registry of Norway, Oslo University Hospital Oslo Norway
- Department of Life Sciences and Health Oslo Metropolitan University Oslo Norway
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74
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Zeinomar N, Phillips KA, Daly MB, Milne RL, Dite GS, MacInnis RJ, Liao Y, Kehm RD, Knight JA, Southey MC, Chung WK, Giles GG, McLachlan SA, Friedlander ML, Weideman PC, Glendon G, Nesci S, Andrulis IL, Buys SS, John EM, Hopper JL, Terry MB. Benign breast disease increases breast cancer risk independent of underlying familial risk profile: Findings from a Prospective Family Study Cohort. Int J Cancer 2019; 145:370-379. [PMID: 30725480 DOI: 10.1002/ijc.32112] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 11/28/2018] [Accepted: 12/12/2018] [Indexed: 12/30/2022]
Abstract
Benign breast disease (BBD) is an established breast cancer (BC) risk factor, but it is unclear whether the magnitude of the association applies to women at familial or genetic risk. This information is needed to improve BC risk assessment in clinical settings. Using the Prospective Family Study Cohort, we used Cox proportional hazards models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association of BBD with BC risk. We also examined whether the association with BBD differed by underlying familial risk profile (FRP), calculated using absolute risk estimates from the Breast Ovarian Analysis of Disease Incidence and Carrier Estimation Algorithm (BOADICEA) model. During 176,756 person-years of follow-up (median: 10.9 years, maximum: 23.7) of 17,154 women unaffected with BC at baseline, we observed 968 incident cases of BC. A total of 4,704 (27%) women reported a history of BBD diagnosis at baseline. A history of BBD was associated with a greater risk of BC: HR = 1.31 (95% CI: 1.14-1.50), and did not differ by underlying FRP, with HRs of 1.35 (95% CI: 1.11-1.65), 1.26 (95% CI: 1.00-1.60), and 1.40 (95% CI: 1.01-1.93), for categories of full-lifetime BOADICEA score <20%, 20 to <35%, ≥35%, respectively. There was no difference in the association for women with BRCA1 mutations (HR: 1.64; 95% CI: 1.04-2.58), women with BRCA2 mutations (HR: 1.34; 95% CI: 0.78-2.3) or for women without a known BRCA1 or BRCA2 mutation (HR: 1.31; 95% CI: 1.13-1.53) (pinteraction = 0.95). Women with a history of BBD have an increased risk of BC that is independent of, and multiplies, their underlying familial and genetic risk.
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Affiliation(s)
- Nur Zeinomar
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
| | - Kelly-Anne Phillips
- Centre for Epidemiology and Biostatistics, The University of Melbourne, Parkville, VIC, Australia.,Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, Australia
| | - Mary B Daly
- Department of Clinical Genetics, Fox Chase Cancer Center, Philadelphia, PA
| | - Roger L Milne
- Centre for Epidemiology and Biostatistics, The University of Melbourne, Parkville, VIC, Australia.,Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, VIC, Australia
| | - Gillian S Dite
- Centre for Epidemiology and Biostatistics, The University of Melbourne, Parkville, VIC, Australia
| | - Robert J MacInnis
- Centre for Epidemiology and Biostatistics, The University of Melbourne, Parkville, VIC, Australia.,Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, VIC, Australia
| | - Yuyan Liao
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
| | - Rebecca D Kehm
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
| | - Julia A Knight
- Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Melissa C Southey
- Genetic Epidemiology Laboratory, Department of Pathology, The University of Melbourne, Parkville, VIC, Australia
| | - Wendy K Chung
- Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY.,Department of Pediatrics and Medicine, Columbia University, New York, NY
| | - Graham G Giles
- Centre for Epidemiology and Biostatistics, The University of Melbourne, Parkville, VIC, Australia.,Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, VIC, Australia
| | - Sue-Anne McLachlan
- Department of Medicine, St Vincent's Hospital, The University of Melbourne, Parkville, VIC, Australia.,Department of Medical Oncology, St Vincent's Hospital, Fitzroy, VIC, Australia
| | - Michael L Friedlander
- Prince of Wales Clinical School, University of New South Wales, Sydney, NSW, Australia.,Department of Medical Oncology, Prince of Wales Hospital, Randwick, NSW, Australia
| | - Prue C Weideman
- Centre for Epidemiology and Biostatistics, The University of Melbourne, Parkville, VIC, Australia
| | - Gord Glendon
- Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, Canada
| | - Stephanie Nesci
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
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- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, Australia.,The Research Department, The Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Irene L Andrulis
- Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, Canada.,Departments of Molecular Genetics and Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | - Saundra S Buys
- Department of Medicine and Huntsman Cancer Institute, University of Utah Health Sciences Center, Salt Lake City, UT
| | - Esther M John
- Department of Medicine and Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA
| | - John L Hopper
- Centre for Epidemiology and Biostatistics, The University of Melbourne, Parkville, VIC, Australia
| | - Mary Beth Terry
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY.,Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY
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75
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Park SK. Epidemiological characteristics of breast cancer in Koreans. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2019. [DOI: 10.5124/jkma.2019.62.8.424] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Affiliation(s)
- Sue K. Park
- Department of Preventive Medicine, College of Medicine, Seoul National University, Seoul, Korea
- Cancer Research Institute, Seoul National University, Seoul, Korea
- Department of Biomedical Science, Graduate School, Seoul National University, Seoul, Korea
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76
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Bernard S, Myers M, Fang WB, Zinda B, Smart C, Lambert D, Zou A, Fan F, Cheng N. CXCL1 Derived from Mammary Fibroblasts Promotes Progression of Mammary Lesions to Invasive Carcinoma through CXCR2 Dependent Mechanisms. J Mammary Gland Biol Neoplasia 2018; 23:249-267. [PMID: 30094610 PMCID: PMC6582941 DOI: 10.1007/s10911-018-9407-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Accepted: 07/24/2018] [Indexed: 12/21/2022] Open
Abstract
With improved screening methods, the numbers of abnormal breast lesions diagnosed in women have been increasing over time. However, it remains unclear whether these breast lesions will develop into invasive cancers. To more effectively predict the outcome of breast lesions and determine a more appropriate course of treatment, it is important to understand the underlying mechanisms that regulate progression of non-invasive lesions to invasive breast cancers. A hallmark of invasive breast cancers is the accumulation of fibroblasts. Fibroblast proliferation and activation in the mammary gland is in part regulated by the Transforming Growth Factor beta1 pathway (TGF-β). In animal models, TGF-β suppression of CCL2 and CXCL1 chemokine expression is associated with metastatic progression of mammary carcinomas. Here, we show that transgenic overexpression of the Polyoma middle T viral antigen in the mouse mammary gland of C57BL/6 mice results in slow growing non-invasive lesions that progress to invasive carcinomas in a stage dependent manner. Invasive carcinomas are associated with accumulation of fibroblasts that show decreased TGF-β expression and high levels of CXCL1, but not CCL2. Using co-transplant models, we show that decreased TGF-β signaling in fibroblasts contribute to mammary carcinoma progression through enhancement of CXCL1/CXCR2 dependent mechanisms. Using cell culture models, we show that CXCL1 mediated mammary carcinoma cell invasion through NF-κB, AKT, Stat3 and p42/44MAPK dependent mechanisms. These studies provide novel mechanistic insight into the progression of pre-invasive lesions and identify new stromal biomarkers, with important prognostic implications.
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Affiliation(s)
- Shira Bernard
- Department of Pathology and Laboratory Medicine, University of Kansas Medical Center, Kansas City, KS, 66160, USA
| | - Megan Myers
- Department of Pathology and Laboratory Medicine, University of Kansas Medical Center, Kansas City, KS, 66160, USA
| | - Wei Bin Fang
- Department of Pathology and Laboratory Medicine, University of Kansas Medical Center, Kansas City, KS, 66160, USA
| | - Brandon Zinda
- Department of Pathology and Laboratory Medicine, University of Kansas Medical Center, Kansas City, KS, 66160, USA
| | - Curtis Smart
- Department of Pathology and Laboratory Medicine, University of Kansas Medical Center, Kansas City, KS, 66160, USA
| | - Diana Lambert
- Department of Pathology and Laboratory Medicine, University of Kansas Medical Center, Kansas City, KS, 66160, USA
| | - An Zou
- Department of Pathology and Laboratory Medicine, University of Kansas Medical Center, Kansas City, KS, 66160, USA
| | - Fang Fan
- Department of Pathology and Laboratory Medicine, University of Kansas Medical Center, Kansas City, KS, 66160, USA
| | - Nikki Cheng
- Department of Pathology and Laboratory Medicine, University of Kansas Medical Center, Kansas City, KS, 66160, USA.
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77
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Mau K. Benign Breast Diseases: An Introduction for the Advanced Practice Nurse. Clin J Oncol Nurs 2018; 22:493-495. [PMID: 30239503 DOI: 10.1188/18.cjon.493-495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The discovery of an abnormality in the breast may provoke anxiety for patient and clinician alike. Fortunately, most lesions in the breast are benign. Physical examination and breast imaging, including mammography, ultrasound, and magnetic resonance imaging, assist in the diagnosis of benign breast diseases. Understanding benign breast diseases is important for advanced practice nurses because these diseases are commonly seen in daily clinical practice.
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78
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Barrow TM, Peng C, Wilson A, Wang H, Liu H, Shen L, Tang NJ, Sae-Lee C, Li PH, Guo L, Byun HM. Psychosocial stress is associated with benign breast disease in young Chinese women: results from Project ELEFANT. Breast Cancer Res Treat 2018; 173:217-224. [PMID: 30255453 DOI: 10.1007/s10549-018-4979-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 09/20/2018] [Indexed: 12/29/2022]
Abstract
PURPOSE Psychosocial stress, including bereavement and work-related stress, is associated with the risk of breast cancer. However, it is unknown whether it may also be linked with increased risk of benign breast disease (BBD). METHODS Our study leveraged 61,907 women aged 17-55 years old from the Project ELEFANT study. BBD was diagnosed by clinician. Self-reported data on psychosocial stress over a 10-year period was retrospectively collected from questionnaires and categorised by cause (work, social and economic) and severity (none, low and high). Odd ratios (ORs) for the development of BBD were estimated using logistic regression. The model was adjusted for age, BMI, TSH levels, smoking, alcohol consumption, family history, age of menarche, oral contraceptive usage, education and occupation. RESULTS Within our study, 8% (4,914) of participants were diagnosed with BBD. Work-related stress [OR 1.57, 95% confidence interval (CI) 1.46-1.69] and financial stress (OR 1.34, 95% CI 1.24-1.44) were significantly associated with BBD incidence, with a smaller but still significant association with social stress (OR 1.11, 95% CI 1.01-1.21). The associations remained significant after exclusion of participants with first- and second-degree family history of breast disease. The presence of multiple forms of stress did not synergistically increase risk. The neutrophil-lymphocyte ratio (NLR), a marker of systemic inflammation and prognostic marker for breast cancer, was not associated with BBD. CONCLUSIONS Psychosocial stress, particularly work-related and financial stress, is associated with increased risk of benign breast disease among young Chinese women.
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Affiliation(s)
- Timothy M Barrow
- Faculty of Health Sciences & Wellbeing, University of Sunderland, Sunderland, SR1 3SD, UK
| | - Cheng Peng
- Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Ander Wilson
- Department of Statistics, Colorado State University, Fort Collins, CO, USA
| | - Hao Wang
- Tianjin Research Institute for Family Planning, Tianjin, 300131, China
| | - Hongbin Liu
- Tianjin Research Institute for Family Planning, Tianjin, 300131, China
| | - Lilin Shen
- Tianjin Research Institute for Family Planning, Tianjin, 300131, China
| | - Nai-Jun Tang
- Department of Occupational & Environmental Health, School of Public Health, Tianjin Medical University, 22nd Qixiangtai Road, Heping District, Tianjin, 300070, China
| | - Chanachai Sae-Lee
- Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Campus for Ageing and Vitality, Newcastle Upon Tyne, NE4 5PL, UK.,Research Division, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Peng-Hui Li
- School of Environmental Science and Safety Engineering, Tianjin University of Technology, Tianjin, 300384, China
| | - Liqiong Guo
- Department of Occupational & Environmental Health, School of Public Health, Tianjin Medical University, 22nd Qixiangtai Road, Heping District, Tianjin, 300070, China.
| | - Hyang-Min Byun
- Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Campus for Ageing and Vitality, Newcastle Upon Tyne, NE4 5PL, UK
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79
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Shaik AN, Ruterbusch JJ, Abdulfatah E, Shrestha R, Daaboul MHDF, Pardeshi V, Visscher DW, Bandyopadhyay S, Ali-Fehmi R, Cote ML. Breast fibroadenomas are not associated with increased breast cancer risk in an African American contemporary cohort of women with benign breast disease. Breast Cancer Res 2018; 20:91. [PMID: 30092846 PMCID: PMC6085691 DOI: 10.1186/s13058-018-1027-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Accepted: 07/18/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Fibroadenomas are common benign breast lesions, and studies of European American women indicate a persistent, increased risk of breast cancer after diagnosing a fibroadenoma on biopsy. This association has not been independently assessed in African American women, despite reports that these women are more likely to present with fibroadenomas. METHODS The study cohort included 3853 African American women with a breast biopsy completed between 1997 and 2010 in metropolitan Detroit. Biopsies were microscopically reviewed for benign breast lesions, including fibroadenoma, proliferative disease, and atypia. Risk of breast cancer within the cohort was estimated using relative risk ratios and 95% CIs calculated using multivariable log-binomial regression. Relative risk of breast cancer in this cohort compared with African American women in the broader metropolitan Detroit population was estimated using standardized incidence ratios (SIRs). RESULTS Fibroadenomas occurred more frequently in biopsies of younger women, and other types of benign breast lesions were less likely to occur when a fibroadenoma was present (p = 0.008 for lobular hyperplasia; all other p values < 0.01). Unlike women with other benign lesions (SIR, 1.41; 95% CI, 1.20, 1.66), women with fibroadenomas did not have an increased risk of developing breast cancer compared with the general population (SIR, 0.94; 95% CI, 0.75, 1.18). Biopsies that indicated a fibroadenoma were associated with a reduced risk of breast cancer after adjusting for age at biopsy, proliferation, and atypia (relative risk, 0.67; 95% CI, 0.48, 0.93) compared with biopsies without a fibroadenoma. CONCLUSIONS These findings have important implications for breast cancer risk models and clinical assessment, particularly among African American women, in whom fibroadenomas are common.
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Affiliation(s)
- Asra N Shaik
- Department of Oncology, Wayne State University School of Medicine, 4100 John R Street, MM04EP, Detroit, MI, 48201, USA
| | - Julie J Ruterbusch
- Department of Oncology, Wayne State University School of Medicine, 4100 John R Street, MM04EP, Detroit, MI, 48201, USA
| | - Eman Abdulfatah
- Department of Pathology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Resha Shrestha
- Department of Pathology, Wayne State University School of Medicine, Detroit, MI, USA
| | - M H D Fayez Daaboul
- Department of Pathology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Visakha Pardeshi
- Department of Pathology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Daniel W Visscher
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | | | - Rouba Ali-Fehmi
- Department of Pathology, Wayne State University School of Medicine, Detroit, MI, USA
- Barbara Ann Karmanos Cancer Institute, Detroit, MI, USA
| | - Michele L Cote
- Department of Oncology, Wayne State University School of Medicine, 4100 John R Street, MM04EP, Detroit, MI, 48201, USA.
- Barbara Ann Karmanos Cancer Institute, Detroit, MI, USA.
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80
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Salamat F, Niakan B, Keshtkar A, Rafiei E, Zendehdel M. Subtypes of Benign Breast Disease as a Risk Factor of Breast Cancer: A Systematic Review and Meta Analyses. IRANIAN JOURNAL OF MEDICAL SCIENCES 2018; 43:355-364. [PMID: 30046203 PMCID: PMC6055208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND Researchers suggest that benign breast disease (BBD) is a key risk factor for breast cancer. The present study aimed to determinate the risk level of breast cancer in terms of various BBD subgroups. METHODS A meta-analysis was performed to determinate the risk of breast cancer associated with BBD. Observational studies (traditional case-control studies, nested case-control studies, and cohort studies) published from January 2000 to June 2015 were assessed to evaluate the risk of developing breast cancer related to BBD. Various databases such as Medline (PubMed), Web of Science (ISI), Scopus, and Google Scholar were searched. The additional search included the Journal of Breast Cancer Research and Treatment and the Journal of Cancer Research. RESULTS Twenty studies out of 21 were used to estimate the risk of developing breast cancer related to proliferative disease without atypia versus non-proliferative disease and the reported risk ranged from 1.04 to 1.83. The reported risk of developing breast cancer related to proliferative disease with atypia versus non-proliferative disease in 21 studies ranged from 1.59 to 4.74. Based on 20 studies, the pooled risk estimates for developing breast cancer related to proliferative disease without atypia versus non-proliferative disease was 1.58 (95% CI: 1.51-1.66). Based on 21 studies, the pooled risk estimates for developing breast cancer related to proliferative disease with atypia versus non-proliferative disease was 3.49 (95% CI: 3.23-3.77). CONCLUSION The overall result of this review showed an elevated risk for breast cancer related to BBD subtypes. We propose better strategies for screening recommendations for such women.
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Affiliation(s)
- Fatemeh Salamat
- Cancer Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Babak Niakan
- Cancer Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Abbasali Keshtkar
- Department of Health Sciences Education Development, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Elahe Rafiei
- Razi Clinical Research Development Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Manoosh Zendehdel
- Reproductive Health Research Center, Guilan University of Medical Sciences, Rasht, Iran
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81
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Riley T. Benign Breast Disease. PHYSICIAN ASSISTANT CLINICS 2018. [DOI: 10.1016/j.cpha.2018.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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82
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Papachristopoulou G, Tsapralis N, Michaelidou K, Ardavanis-Loukeris G, Griniatsos I, Scorilas A, Talieri M. Human kallikrein-related peptidase 12 (KLK12) splice variants discriminate benign from cancerous breast tumors. Clin Biochem 2018; 58:78-85. [PMID: 29807016 DOI: 10.1016/j.clinbiochem.2018.05.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 05/15/2018] [Accepted: 05/24/2018] [Indexed: 12/13/2022]
Abstract
OBJECTIVES As kallikrein-related peptidase 12 (KLK12) has been implicated in the cancer progression and alternative splicing plays significant role in this disease, the aim of this study was to examine the expression profile and the clinical impact of the KLK12 splice variants in breast cancer. DESIGN AND METHODS Total RNA was isolated and reverse transcripted from 141 tissues. Afterwards, quantitative real-time PCR were conducted, followed by the performance of the comparative CT (2-ΔΔCT) method for relative quantification, whilst their correlation with the clinicopathological features of breast malignancies were assessed by statistical analysis. RESULTS Both KLK12sv1/2 and KLK12sv3 showed higher expression in non-cancerous than in cancerous samples. KLKsv1/2 (P = 0.001) upregulated and KLK12sv3 (P < 0.001) downregulated in the malignant compared to the benign tumors and their discriminative ability was verified by ROC curve analysis. Moreover, KLK12sv3 was associated with grade (P = 0.012) and hormonal receptor status (P = 0.001). Furthermore, Kaplan-Meier and Cox regression analyses showed that patients with positive KLK12sv1/2 and KLK12sv3 levels presented a significantly longer disease-free survival (P = 0.014 and P = 0.013, respectively) and overall survival (P = 0.062 and P = 0.004, respectively). CONCLUSIONS Our results demonstrate the discriminative value of KLK12sv1/2 and KLK12sv3 between benign and malignant breast tumors as well as their potential favorable prognostic significance in breast adenocarcinoma.
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Affiliation(s)
- Georgia Papachristopoulou
- Department of Pathology, "Saint Savvas" Cancer Hospital of Athens, Athens GR-11522, Greece; Department of Biochemistry and Molecular Biology, National and Kapodistrian University of Athens, Athens GR-15701, Greece
| | - Nikolaos Tsapralis
- Department of Breast Cancer Surgery, "Saint Savvas" Cancer Hospital of Athens, Athens GR-11522, Greece
| | - Kleita Michaelidou
- Department of Biochemistry and Molecular Biology, National and Kapodistrian University of Athens, Athens GR-15701, Greece
| | - Gerasimos Ardavanis-Loukeris
- Department of Biochemistry and Molecular Biology, National and Kapodistrian University of Athens, Athens GR-15701, Greece
| | - Ioannis Griniatsos
- First Department of Surgery, National and Kapodistrian University of Athens, "Laiko" Hospital, Athens GR-11527, Greece
| | - Andreas Scorilas
- Department of Biochemistry and Molecular Biology, National and Kapodistrian University of Athens, Athens GR-15701, Greece
| | - Maroulio Talieri
- Department of Cellular Physiology, G. Papanicolaou Research Center of Oncology, "Saint Savvas" Cancer Hospital of Athens, Athens GR-11522, Greece.
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83
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Goff SL, Kleppel R, Makari-Judson G. 'No Pink Ribbons': How Women's Lived Experiences With Breast Atypia Inform Decisions Involving Risk-Reducing Medications. J Patient Cent Res Rev 2018; 5:158-166. [PMID: 31414000 DOI: 10.17294/2330-0698.1594] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Purpose Atypical hyperplasia (AH) is associated with a nearly 4-fold elevation of lifetime risk for breast cancer, and lobular carcinoma in situ (LCIS) is associated with a 7- to 8-fold risk. Women with AH/LCIS make numerous decisions in the course of treatment, including whether to take a risk-reducing medication, an option relatively few women pursue. We explored women's decision-making processes through patient narratives in an effort to inform decision supports for AH/LCIS. Methods We conducted in-depth interviews with 20 English-speaking women with AH/LCIS and no subsequent diagnosis of invasive breast cancer who had enrolled in the Rays of Hope Center for Breast Cancer Research patient registry between April 5, 2012, and March 31, 2016. Interviews were audiotaped, professionally transcribed, and qualitatively analyzed using thematic qualitative content analysis. Results We identified three major narrative themes: 1) experiences with medical care; 2) decision-making; and 3) making sense of AH/LCIS. Each major theme had several subthemes, many of which map onto existing decisional theories and heuristics. Subthemes included the impact of life context on diagnosis meaning, emotional responses, changes in self-concept and body image, and understanding of the risk-benefit of risk-reducing medications. Conclusions This narrative analysis offers important insights into how lived experience may influence decision-making for women with AH/LCIS. Decision supports that focus not only on analytic decisional processes, but also patients' subjectivities and decisional heuristics, could prove useful for women and their health care providers.
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Affiliation(s)
- Sarah L Goff
- Division of General Medicine, University of Massachusetts Medical School-Baystate, Springfield, MA.,Institute for Healthcare Delivery and Population Science, University of Massachusetts Medical School-Baystate, Springfield, MA
| | - Reva Kleppel
- Division of General Medicine, University of Massachusetts Medical School-Baystate, Springfield, MA
| | - Grace Makari-Judson
- Division of Hematology-Oncology, University of Massachusetts Medical School-Baystate, Springfield, MA
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84
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Román M, Caicoya M, Espinàs J, Sala M, Torá-Rocamora I, Quinta MJ, Vernet M, Saladié F, Romero A, Sánchez M, Baré M, Vidal C, Servitja S, Natal C, Corominas J, Ferrer J, Rodríguez-Arana A, Castells X. Clinical and histologic characteristics of breast cancers in women with previous pathologic diagnosis of benign breast disease in Spain. Breast J 2018. [PMID: 29517151 DOI: 10.1111/tbj.13003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Women with a benign breast disease (BBD) have an increased risk of subsequent breast carcinoma. Information is scarce regarding the characteristics of breast carcinomas diagnosed after a BBD. Our aim was to point out the differences in clinical and histologic characteristics of breast carcinomas diagnosed in women with and without a previous pathologic diagnosis of BBD in the context of population-based mammography screening. Retrospective cohort study of all women aged 50-69 years who were screened at least once in a population-based screening program in Spain, between 1994 and 2011 and followed up until December 2012. The mean follow-up was 6.1 years. We analyzed 6645 breast carcinomas, of whom 238 had a previous pathologic diagnosis of BBD. Information on clinical and histologic characteristics was collected from pathology reports. Logistic regression was used to estimate the odds ratio (OR) and 95% confidence intervals (95%CI) of occurrence of selected histologic characteristics of breast carcinomas in women with and without a previous BBD. Women with a previous BBD had a higher proportion of ductal carcinoma in situ (DCIS) compared with women without a BBD (22.1% and 13.6%, respectively). Among those diagnosed with an invasive breast carcinoma, women with previous BBD were more likely to be diagnosed with carcinomas sized >2 cm (OR = 1.46; 95%CI = 1.03-2.08), metastatic positive (OR = 2.66; 95%CI = 1.21-5.86), and with a high Ki-67 proliferation rate (OR = 1.93; 95%CI = 1.24-2.99). No differences were found across histologic subtypes of BBD. Screening participants with a previous pathologic diagnosis of BBD had a higher proportion of DCIS. However, invasive carcinomas detected in women with a BBD were associated with clinical and histologic characteristics conferring a worst prognosis.
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Affiliation(s)
- Marta Román
- Department of Epidemiology and Evaluation, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Research Network on Health Services in Chronic Diseases (REDISSEC), Barcelona, Spain
| | - Martin Caicoya
- Department of Epidemiology and Evaluation, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Research Network on Health Services in Chronic Diseases (REDISSEC), Barcelona, Spain
| | - Josep Espinàs
- Department of Health, Catalan Cancer Plan, Barcelona, Spain
| | - Maria Sala
- Department of Epidemiology and Evaluation, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Research Network on Health Services in Chronic Diseases (REDISSEC), Barcelona, Spain
| | - Isabel Torá-Rocamora
- Preventive Medicine and Epidemiology Department, Hospital Clinic, Barcelona, Spain
| | - Maria J Quinta
- Epidemiology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Mar Vernet
- Department of Obstetrics and Gynecology, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Francina Saladié
- Breast Cancer Screening Program of Tarragona, The Foundation League for the Research and Prevention of Cancer, Tarragona, Spain
| | - Anabel Romero
- Department of Epidemiology and Evaluation, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Research Network on Health Services in Chronic Diseases (REDISSEC), Barcelona, Spain
| | - Mar Sánchez
- General Directorate of Public Health, Government of Cantabria, Santander, Spain
| | - Marisa Baré
- Clinical Epidemiology and Cancer Screening, Parc Taulí University Hospital, Sabadell, Spain
| | - Carmen Vidal
- Cancer Prevention and Monitoring Program, Catalan Institute of Oncology, Barcelona, Spain
| | - S Servitja
- Department of Oncology, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Carmen Natal
- Breast Cancer Screening Program, Principality of Asturias, Oviedo, Spain
| | - Joosep Corominas
- Department of Pathological Anatomy, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Joana Ferrer
- Radiology Department, Hospital de Santa Caterina, Girona, Spain
| | - Ana Rodríguez-Arana
- Department of Image Diagnostics, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Xavier Castells
- Department of Epidemiology and Evaluation, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Research Network on Health Services in Chronic Diseases (REDISSEC), Barcelona, Spain
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85
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Zendehdel M, Niakan B, Keshtkar A, Rafiei E, Salamat F. Subtypes of Benign Breast Disease as a Risk Factor for Breast Cancer: A Systematic Review and Meta-Analysis Protocol. IRANIAN JOURNAL OF MEDICAL SCIENCES 2018; 43:1-8. [PMID: 29398746 PMCID: PMC5775989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Breast cancer is a multifactorial disease. Benign breast disease (BBD) is one of the most important risk factors for breast cancer. The etiology of BBD is unknown. It is divided into nonproliferative and proliferative diseases. The selection of studies will be based on titles, abstract screening, inclusion and exclusion criteria, and quality assessment. Previous studies have shown that all types of BBD increase the risk of breast cancer, but the risk degree is different for each one. Accurate risk estimation of breast cancer in each category can be very important for proper clinical management. This systematic review and meta-analysis will be conducted on observational studies (traditional case control, nested case control, case cohort, and cohort) published in the Web of Science (ISI), PubMed (MEDLINE), Scopus, Google Scholar, and the key journals of this field such as Breast Cancer Research and Treatment and Cancer Research from January 2000 to June 2015. Reference lists and gray literature will be reviewed too. All the initial retrievals will be performed by 2 researchers independently. The data extraction form will consist of general information concerning the studies, study eligibility, method, risk of bias assessment, and results-including odds ratios, risk ratios, rate ratios, and hazard ratios. The PRISMA and MOOSE guidelines will be used to report our findings. Registration Details: PROSPERO-42016035243.
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Affiliation(s)
- Manoosh Zendehdel
- Research Vice-Chancellorship, Guilan University of Medical Sciences, Rasht, Iran
| | - Babak Niakan
- Guilan University of Medical Sciences, Rasht, Iran
| | - Abbasali Keshtkar
- Department of Health Sciences Education Development, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Elahe Rafiei
- Research Vice-Chancellorship, Guilan University of Medical Sciences, Rasht, Iran
| | - Fatemeh Salamat
- Research Vice-Chancellorship, Guilan University of Medical Sciences, Rasht, Iran,Correspondence: Fatemeh Salamat, MS; Research Vice-Chancellorship, Guilan University of Medical Sciences, Postal Code: 41938-93345, Rasht, Iran Tel: +98 911 2372989 Fax: +98 13 33362842
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86
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Latronico A, Nicosia L, Faggian A, Abbate F, Penco S, Bozzini A, Cannataci C, Mazzarol G, Cassano E. Atypical ductal hyperplasia: Our experience in the management and long term clinical follow-up in 71 patients. Breast 2017; 37:1-5. [PMID: 29032282 DOI: 10.1016/j.breast.2017.10.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 10/06/2017] [Accepted: 10/06/2017] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION Atypical ductal hyperplasia (ADH) is a high-risk benign lesion found in approximately 1-10% of breast biopsies and associated with a variable incidence of carcinoma after surgical excision. The main goal of our study is to present our experience in the management and long-term follow-up of 71 patients with ADH diagnosed on breast biopsy. MATERIALS AND METHODS Results of 3808 breast biopsy specimens from 1 January 2000 to 31 December 2005 were analyzed to identify all biopsies which resulted in a diagnosis of ADH. The histopathological results of the 45 patients who underwent surgery were analyzed. Long-term follow-up for the remaining patients was carried out. RESULTS 45 of 71 (63.4%) patients with histological diagnosis of ADH on breast biopsy underwent surgery. Definitive histological results revealed invasive carcinoma in 7 cases (15.6%), high grade Ductal Carcinoma in situ (DCIS) in 10 (22.2%) patients, Lobular Carcinoma in situ (LCIS) in 4 cases (8.9%) and benign findings in 24 cases (53.3%). 12 of 71 (16.9%) patients underwent only long term follow-up; one (8,3%) of these developed invasive breast carcinoma after 6 years. CONCLUSION Atypical ductal hyperplasia diagnosed on breast biopsy is associated with a relatively high incidence of invasive carcinoma and high grade ductal carcinoma in situ at the time of surgical excision. Certain radiological and cytological criteria can be used to help determine which patients should forgo surgery and be followed up with good results. Long term follow-up is always crucial for patients who have not undergone surgery.
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MESH Headings
- Adult
- Aged
- Biopsy
- Breast/pathology
- Breast Neoplasms/diagnosis
- Breast Neoplasms/pathology
- Breast Neoplasms/surgery
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Ductal, Breast/surgery
- Carcinoma, Intraductal, Noninfiltrating/diagnosis
- Carcinoma, Intraductal, Noninfiltrating/pathology
- Carcinoma, Intraductal, Noninfiltrating/surgery
- Carcinoma, Lobular/pathology
- Carcinoma, Lobular/surgery
- Female
- Follow-Up Studies
- Humans
- Middle Aged
- Neoplasm Grading
- Time Factors
- Watchful Waiting
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Affiliation(s)
- Antuono Latronico
- European Institute of Oncology, Breast Imaging Unit, Via G. Ripamonti, 435, 20141, Milano, Italy
| | - Luca Nicosia
- Postgraduate School of Radiology, Università degli Studi di Milano, Milan, Via Festa del Perdono 7, Milan, Italy.
| | - Angela Faggian
- Department of Radiology, Private Hospital "Villa dei Fiori", Acerra, Naples, Italy
| | - Francesca Abbate
- European Institute of Oncology, Breast Imaging Unit, Via G. Ripamonti, 435, 20141, Milano, Italy
| | - Silvia Penco
- European Institute of Oncology, Breast Imaging Unit, Via G. Ripamonti, 435, 20141, Milano, Italy
| | - Anna Bozzini
- European Institute of Oncology, Breast Imaging Unit, Via G. Ripamonti, 435, 20141, Milano, Italy
| | - Christine Cannataci
- Medical Imaging Department, Mater Dei Hospital, Triq Dun Karm, Msida, MSD 2090, Malta
| | - Giovanni Mazzarol
- European Institute of Oncology, Pathology Department, Via G. Ripamonti, 435, 20141, Milano, Italy
| | - Enrico Cassano
- European Institute of Oncology, Breast Imaging Unit, Via G. Ripamonti, 435, 20141, Milano, Italy
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87
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Merkkola-von Schantz PA, Jahkola TA, Krogerus LA, Kauhanen SM. Reduction mammaplasty in patients with history of breast cancer: The incidence of occult cancer and high-risk lesions. Breast 2017; 35:157-161. [DOI: 10.1016/j.breast.2017.07.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2017] [Accepted: 07/13/2017] [Indexed: 10/19/2022] Open
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88
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Abstract
Breast cancer is the most commonly diagnosed cancer in women in the United States and the second leading cause of cancer death in American women (1). Regular screening mammography starting at age 40 years reduces breast cancer mortality in average-risk women (2). Screening, however, also exposes women to harm through false-positive test results and overdiagnosis of biologically indolent lesions. Differences in balancing benefits and harms have led to differences among major guidelines about what age to start, what age to stop, and how frequently to recommend mammography screening in average-risk women (2-4).Breast cancer risk assessment is very important for identifying women who may benefit from more intensive breast cancer surveillance; however, there is no standardized approach to office-based breast cancer risk assessment in the United States. This can lead to missed opportunities to identify women at high risk of breast cancer and may result in applying average-risk screening recommendations to high-risk women. Risk assessment and identification of women at high risk allow for referral to health care providers with expertise in cancer genetics counseling and testing for breast cancer-related germline mutations (eg, BRCA), patient counseling about risk-reduction options, and cascade testing to identify family members who also may be at increased risk.The purpose of this Practice Bulletin is to discuss breast cancer risk assessment, review breast cancer screening guidelines in average-risk women, and outline some of the controversies surrounding breast cancer screening. It will present recommendations for using a framework of shared decision making to assist women in balancing their personal values regarding benefits and harms of screening at various ages and intervals to make personal screening choices from within a range of reasonable options. Recommendations for women at elevated risk and discussion of new technologies, such as tomosynthesis, are beyond the scope of this document and are addressed in other publications of the American College of Obstetricians and Gynecologists (ACOG) (5-7).
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89
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Benign breast disease and risk of thyroid cancer. Cancer Causes Control 2017; 28:913-920. [DOI: 10.1007/s10552-017-0918-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 06/21/2017] [Indexed: 10/19/2022]
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90
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Visscher DW, Frank RD, Carter JM, Vierkant RA, Winham SJ, Heinzen EP, Broderick BT, Denison LA, Allers TM, Johnson JL, Frost MH, Hartmann LC, Degnim AC, Radisky DC. Breast Cancer Risk and Progressive Histology in Serial Benign Biopsies. J Natl Cancer Inst 2017; 109:3074330. [PMID: 28376198 PMCID: PMC5412118 DOI: 10.1093/jnci/djx035] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Accepted: 02/15/2017] [Indexed: 01/11/2023] Open
Abstract
Background: More than 1 million women per year in the United States with benign breast biopsies are known to be at elevated risk for breast cancer (BC), with risk stratified on histologic categories of epithelial proliferation. Here we assessed women who had serial benign biopsies over time and how changes in the histologic classification affected BC risk. Methods: In the Mayo Clinic Benign Breast Disease Cohort of 13 466 women, 1414 women had multiple metachronous benign biopsies (10.5%). Both initial and subsequent biopsies were assessed histologically. BC risk for clinical and prognostic factors was assessed using subdistribution models to account for competing risks, and logistic regression/Wilcoxon/chi-square tests to assess covariates. All statistical tests were two-sided. Results: Breast cancer risk for women with serial biopsies, stratified by histologic category in the later biopsies, was similar to women with a single biopsy. We found that changes in histological category between initial and subsequent biopsy statistically significantly impacted BC risk. Women with nonproliferative initial findings and subsequent proliferative findings had an increased risk (hazard ratio [HR] = 1.77, 95% confidence interval [CI] = 1.06 to 2.94, P = .03) compared with no change. Among women with proliferative disease without atypia at initial biopsy, risk decreased if later biopsy regressed to nonproliferative (HR = 0.49, 95% CI = 0.25 to 0.98) and increased if later biopsy showed progression to atypical hyperplasia (HR = 1.49, 95% CI = 0.73 to 3.05) compared with no change (P = .04). Conclusions: We found that breast cancer risk increases in women with progressive epithelial proliferation over time and decreases in women whose biopsies show less proliferation. This finding has important implications for effective clinical management of the 100 000 women per year who have multiple benign breast biopsies.
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Affiliation(s)
- Daniel W. Visscher
- Affiliations of authors: Department of Laboratory Medicine and Pathology (DWV and JMC), Department of Health Sciences Research (RAV, SJW, EPH, BTB), Department of Oncology (TMA, JLJ, MHF, LCH), Department of Information Technology (LAD), and Department of Surgery (ACD), Mayo Clinic Rochester, MN; Departments of Health Science Research (RDF) and Cancer Biology (DCR), Mayo Clinic Jacksonville, FL
| | - Ryan D. Frank
- Affiliations of authors: Department of Laboratory Medicine and Pathology (DWV and JMC), Department of Health Sciences Research (RAV, SJW, EPH, BTB), Department of Oncology (TMA, JLJ, MHF, LCH), Department of Information Technology (LAD), and Department of Surgery (ACD), Mayo Clinic Rochester, MN; Departments of Health Science Research (RDF) and Cancer Biology (DCR), Mayo Clinic Jacksonville, FL
| | - Jodi M. Carter
- Affiliations of authors: Department of Laboratory Medicine and Pathology (DWV and JMC), Department of Health Sciences Research (RAV, SJW, EPH, BTB), Department of Oncology (TMA, JLJ, MHF, LCH), Department of Information Technology (LAD), and Department of Surgery (ACD), Mayo Clinic Rochester, MN; Departments of Health Science Research (RDF) and Cancer Biology (DCR), Mayo Clinic Jacksonville, FL
| | - Robert A. Vierkant
- Affiliations of authors: Department of Laboratory Medicine and Pathology (DWV and JMC), Department of Health Sciences Research (RAV, SJW, EPH, BTB), Department of Oncology (TMA, JLJ, MHF, LCH), Department of Information Technology (LAD), and Department of Surgery (ACD), Mayo Clinic Rochester, MN; Departments of Health Science Research (RDF) and Cancer Biology (DCR), Mayo Clinic Jacksonville, FL
| | - Stacey J. Winham
- Affiliations of authors: Department of Laboratory Medicine and Pathology (DWV and JMC), Department of Health Sciences Research (RAV, SJW, EPH, BTB), Department of Oncology (TMA, JLJ, MHF, LCH), Department of Information Technology (LAD), and Department of Surgery (ACD), Mayo Clinic Rochester, MN; Departments of Health Science Research (RDF) and Cancer Biology (DCR), Mayo Clinic Jacksonville, FL
| | - Ethan P. Heinzen
- Affiliations of authors: Department of Laboratory Medicine and Pathology (DWV and JMC), Department of Health Sciences Research (RAV, SJW, EPH, BTB), Department of Oncology (TMA, JLJ, MHF, LCH), Department of Information Technology (LAD), and Department of Surgery (ACD), Mayo Clinic Rochester, MN; Departments of Health Science Research (RDF) and Cancer Biology (DCR), Mayo Clinic Jacksonville, FL
| | - Brendan T. Broderick
- Affiliations of authors: Department of Laboratory Medicine and Pathology (DWV and JMC), Department of Health Sciences Research (RAV, SJW, EPH, BTB), Department of Oncology (TMA, JLJ, MHF, LCH), Department of Information Technology (LAD), and Department of Surgery (ACD), Mayo Clinic Rochester, MN; Departments of Health Science Research (RDF) and Cancer Biology (DCR), Mayo Clinic Jacksonville, FL
| | - Lori A. Denison
- Affiliations of authors: Department of Laboratory Medicine and Pathology (DWV and JMC), Department of Health Sciences Research (RAV, SJW, EPH, BTB), Department of Oncology (TMA, JLJ, MHF, LCH), Department of Information Technology (LAD), and Department of Surgery (ACD), Mayo Clinic Rochester, MN; Departments of Health Science Research (RDF) and Cancer Biology (DCR), Mayo Clinic Jacksonville, FL
| | - Teresa M. Allers
- Affiliations of authors: Department of Laboratory Medicine and Pathology (DWV and JMC), Department of Health Sciences Research (RAV, SJW, EPH, BTB), Department of Oncology (TMA, JLJ, MHF, LCH), Department of Information Technology (LAD), and Department of Surgery (ACD), Mayo Clinic Rochester, MN; Departments of Health Science Research (RDF) and Cancer Biology (DCR), Mayo Clinic Jacksonville, FL
| | - Joanne L. Johnson
- Affiliations of authors: Department of Laboratory Medicine and Pathology (DWV and JMC), Department of Health Sciences Research (RAV, SJW, EPH, BTB), Department of Oncology (TMA, JLJ, MHF, LCH), Department of Information Technology (LAD), and Department of Surgery (ACD), Mayo Clinic Rochester, MN; Departments of Health Science Research (RDF) and Cancer Biology (DCR), Mayo Clinic Jacksonville, FL
| | - Marlene H. Frost
- Affiliations of authors: Department of Laboratory Medicine and Pathology (DWV and JMC), Department of Health Sciences Research (RAV, SJW, EPH, BTB), Department of Oncology (TMA, JLJ, MHF, LCH), Department of Information Technology (LAD), and Department of Surgery (ACD), Mayo Clinic Rochester, MN; Departments of Health Science Research (RDF) and Cancer Biology (DCR), Mayo Clinic Jacksonville, FL
| | - Lynn C. Hartmann
- Affiliations of authors: Department of Laboratory Medicine and Pathology (DWV and JMC), Department of Health Sciences Research (RAV, SJW, EPH, BTB), Department of Oncology (TMA, JLJ, MHF, LCH), Department of Information Technology (LAD), and Department of Surgery (ACD), Mayo Clinic Rochester, MN; Departments of Health Science Research (RDF) and Cancer Biology (DCR), Mayo Clinic Jacksonville, FL
| | - Amy C. Degnim
- Affiliations of authors: Department of Laboratory Medicine and Pathology (DWV and JMC), Department of Health Sciences Research (RAV, SJW, EPH, BTB), Department of Oncology (TMA, JLJ, MHF, LCH), Department of Information Technology (LAD), and Department of Surgery (ACD), Mayo Clinic Rochester, MN; Departments of Health Science Research (RDF) and Cancer Biology (DCR), Mayo Clinic Jacksonville, FL
| | - Derek C. Radisky
- Affiliations of authors: Department of Laboratory Medicine and Pathology (DWV and JMC), Department of Health Sciences Research (RAV, SJW, EPH, BTB), Department of Oncology (TMA, JLJ, MHF, LCH), Department of Information Technology (LAD), and Department of Surgery (ACD), Mayo Clinic Rochester, MN; Departments of Health Science Research (RDF) and Cancer Biology (DCR), Mayo Clinic Jacksonville, FL
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91
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Association between lifestyle, menstrual/reproductive history, and histological factors and risk of breast cancer in women biopsied for benign breast disease. Breast Cancer Res Treat 2017. [PMID: 28643020 DOI: 10.1007/s10549-017-4347-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE Women with benign breast disease (BBD) have an increased risk of subsequent breast cancer. However, whether conventional breast cancer risk factors influence risk of breast cancer among women with BBD is unclear. In this study, we investigated the associations of lifestyle, menstrual/reproductive, and histological factors with risk of breast cancer among women biopsied for BBD. METHODS We conducted a case-control study, nested within a cohort of 15,395 women biopsied for BBD at Kaiser Permanente Northwest between 1971 and 2006. Cases were women who developed a subsequent invasive breast cancer during follow-up; controls were individually matched to cases on age at BBD diagnosis. A total of 526 case-control pairs were included in the study. We calculated crude and multivariable OR and 95% CI for the associations between lifestyle, menstrual/reproductive, and histological factors and breast cancer risk using conditional logistic regression. RESULTS Compared to premenopausal women, postmenopausal women had reduced risk of subsequent breast cancer (OR 0.60; 95% CI 0.39-0.94), whereas women who ever used hormone replacement therapy (HRT) had increased risk (OR 3.61; 95% CI 1.68-7.75), as did women whose BBD lesion showed atypical hyperplasia (OR 5.56; 95% CI 2.05-15.06). Smoking, BMI, early menarche, multiparity (≥4), history of oophorectomy, and extent of lobular involution were not associated with risk of breast cancer. CONCLUSION This study suggests that use of HRT and having atypical hyperplasia are associated with increased risk of breast cancer among women with BBD, while postmenopausal women with BBD have a reduced risk.
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92
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Posso M, Corominas JM, Serrano L, Román M, Torá‐Rocamora I, Domingo L, Romero A, Quintana MJ, Vernet‐Tomas M, Baré M, Vidal C, Sánchez M, Saladié F, Natal C, Ferrer J, Servitja S, Sala M, Castells X. Biomarkers expression in benign breast diseases and risk of subsequent breast cancer: a case-control study. Cancer Med 2017; 6:1482-1489. [PMID: 28470951 PMCID: PMC5463091 DOI: 10.1002/cam4.1080] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 03/28/2017] [Accepted: 03/29/2017] [Indexed: 11/16/2022] Open
Abstract
Women with benign breast diseases (BBD) have a high risk of breast cancer. However, no biomarkers have been clearly established to predict cancer in these women. Our aim was to explore whether estrogen receptor (ER), progesterone receptor (PR), and Ki67 expression stratify risk of breast cancer in screened women with BBD. We conducted a nested case-control study. Women with breast cancer and prior BBDs (86 cases) were matched to women with prior BBDs who were free from breast cancer (172 controls). The matching factors were age at BBD diagnosis, type of BBD, and follow-up time since BBD diagnosis. ER, PR, and Ki67 expression were obtained from BBDs' specimens. Conditional logistic regression was used to estimate odds ratios (ORs), and 95% confidence intervals (CIs) of breast cancer risk according to ER, PR, and Ki67 expression. Women with >90% of ER expression had a higher risk of breast cancer (OR = 2.63; 95% CI: 1.26-5.51) than women with ≤70% of ER expression. Similarly, women with >80% of PR expression had a higher risk of breast cancer (OR = 2.22; 95% CI: 1.15-4.27) than women with ≤40% of PR expression. Women with proliferative disease and ≥1% of Ki67 expression had a nonsignificantly increased risk of breast cancer (OR = 1.16; 95% CI: 0.46-2.90) than women with <1% of Ki67 expression. A high expression of ER and PR in BBD is associated with an increased risk of subsequent breast cancer. In proliferative disease, high Ki67 expression may also have an increased risk. This information is helpful to better characterize BBD and is one more step toward personalizing the clinical management of these women.
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Affiliation(s)
- Margarita Posso
- Department of Epidemiology and EvaluationIMIM (Hospital del Mar Medical Research Institute)BarcelonaSpain
- Department of Clinical Epidemiology and Public HealthHospital de la Santa Creu i Sant Pau (IIB Sant Pau)BarcelonaSpain
| | - Josep M. Corominas
- Pathology DepartmentIMIM (Hospital del Mar Medical Research Institute)BarcelonaSpain
| | - Laia Serrano
- Pathology DepartmentIMIM (Hospital del Mar Medical Research Institute)BarcelonaSpain
| | - Marta Román
- Department of Epidemiology and EvaluationIMIM (Hospital del Mar Medical Research Institute)BarcelonaSpain
- Research Network on Health Services in Chronic Diseases (REDISSEC)BarcelonaSpain
| | - Isabel Torá‐Rocamora
- Department of Epidemiology and EvaluationIMIM (Hospital del Mar Medical Research Institute)BarcelonaSpain
- Research Network on Health Services in Chronic Diseases (REDISSEC)BarcelonaSpain
| | - Laia Domingo
- Department of Epidemiology and EvaluationIMIM (Hospital del Mar Medical Research Institute)BarcelonaSpain
- Research Network on Health Services in Chronic Diseases (REDISSEC)BarcelonaSpain
- Agency for Health Quality and Assessment of Catalonia (AQuAS)BarcelonaSpain
| | - Anabel Romero
- Department of Epidemiology and EvaluationIMIM (Hospital del Mar Medical Research Institute)BarcelonaSpain
- Research Network on Health Services in Chronic Diseases (REDISSEC)BarcelonaSpain
| | - María Jesús Quintana
- Department of Clinical Epidemiology and Public HealthHospital de la Santa Creu i Sant Pau (IIB Sant Pau)BarcelonaSpain
- CIBER of Epidemiology and Public Health (CIBERESP)BarcelonaSpain
| | - María Vernet‐Tomas
- Obstetrics and Gynecology DepartmentIMIM (Hospital del Mar Medical Research Institute)BarcelonaSpain
| | - Marisa Baré
- Clinical Epidemiology and Cancer ScreeningParc Taulí University HospitalBarcelonaSpain
| | - Carmen Vidal
- Cancer Prevention and Control ProgramCatalan Institute of OncologyBarcelonaSpain
| | - Mar Sánchez
- Direction General of Public HealthDepartment of HealthGovernment of CantabriaSantanderSpain
| | - Francina Saladié
- Breast Cancer Screening Program of TarragonaThe Foundation League for the Research and Prevention of CancerTarragonaSpain
| | - Carmen Natal
- Principality of Asturias Breast Cancer Screening ProgramPrincipality of AsturiasOviedoSpain
| | - Joana Ferrer
- Radiology DepartmentHospital de Santa CaterinaGironaSpain
| | - Sònia Servitja
- Oncology DepartmentIMIM (Hospital del Mar Medical Research Institute)BarcelonaSpain
| | - María Sala
- Department of Epidemiology and EvaluationIMIM (Hospital del Mar Medical Research Institute)BarcelonaSpain
- Research Network on Health Services in Chronic Diseases (REDISSEC)BarcelonaSpain
| | - Xavier Castells
- Department of Epidemiology and EvaluationIMIM (Hospital del Mar Medical Research Institute)BarcelonaSpain
- Research Network on Health Services in Chronic Diseases (REDISSEC)BarcelonaSpain
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Abstract
Breast-related symptoms are among the most common reasons women present to obstetrician-gynecologists. Obstetrician-gynecologists are in a favorable position to diagnose benign breast disease in their patients. The purpose of a thorough understanding of benign breast disease is threefold: 1) to alleviate, when possible, symptoms attributable to benign breast disease, 2) to distinguish benign from malignant breast disease, and 3) to identify patients with an increased risk of breast cancer so that increased surveillance or preventive therapy can be initiated. Obstetrician-gynecologists may perform diagnostic procedures when indicated or may make referrals to physicians who specialize in the diagnosis and treatment of breast disease. The purpose of this Practice Bulletin is to outline common benign breast disease symptoms in women who are not pregnant or lactating and discuss appropriate evaluation and management. The obstetrician-gynecologist's role in the screening and management of breast cancer is beyond the scope of this document and is addressed in other publications of the American College of Obstetricians and Gynecologists ().
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Rosenberger LH, Weber R, Sjoberg D, Vickers AJ, Mangino DA, Morrow M, Pilewskie ML. Impact of self-reported data on the acquisition of multi-generational family history and lifestyle factors among women seen in a high-risk breast screening program: a focus on modifiable risk factors and genetic referral. Breast Cancer Res Treat 2017; 162:275-282. [PMID: 28132390 PMCID: PMC5332545 DOI: 10.1007/s10549-017-4115-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 01/11/2017] [Indexed: 01/04/2023]
Abstract
BACKGROUND The phrase "high-risk for breast cancer" is used to identify various groups at elevated cancer risk, and the appropriate surveillance and risk-reducing strategies differ based on the etiology of risk. Here, we review the utility of patient-reported data to capture women with modifiable lifestyle risk factors and those suitable for genetic counseling referral. METHODS Patient-reported data from a web-based survey were used to capture personal history, multi-generational family history, and lifestyle factors (body mass index, alcohol consumption, physical activity). Responses were tabulated, and percentage of patients who met criteria for possible intervention calculated. RESULTS 1277 women completed the survey from October 2014 to December 2015. Women were considered high risk for a combination of the following: family history of breast and/or ovarian cancer (77%), history of atypical hyperplasia or lobular carcinoma in situ (35%), known breast cancer-related gene mutation (11%). Based on self-reported data, 65% qualified for genetic evaluation but 40% reporting no prior testing. Only half of the population met national physical activity recommendations, nearly 40% were overweight/obese, and 18% reported consuming ≥1 alcoholic beverage per day. CONCLUSIONS Among women followed in a high-risk breast surveillance program, there is considerable opportunity for improved genetic referral and awareness of modifiable lifestyle factors based on self-reported data as 60% of respondents reported a possible area for intervention. While risk reduction associated with lifestyle changes is modest in comparison to chemoprevention or surgery, such changes are practically without risk, minimally expensive, and provide innumerable secondary health benefits.
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Affiliation(s)
- Laura H. Rosenberger
- Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, 10065,
| | - Ryan Weber
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, 10065,
| | - Daniel Sjoberg
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, 10065,
| | - Andrew J. Vickers
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, 10065,
| | - Debra A. Mangino
- Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, 10065,
| | - Monica Morrow
- Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, 10065,
| | - Melissa L. Pilewskie
- Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, 10065,
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95
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Berkey CS, Rosner B, Tamimi RM, Willett WC, Hickey M, Toriola A, Frazier AL, Colditz GA. Body size from birth through adolescence in relation to risk of benign breast disease in young women. Breast Cancer Res Treat 2017; 162:139-149. [PMID: 28062981 PMCID: PMC5290089 DOI: 10.1007/s10549-016-4084-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Accepted: 12/08/2016] [Indexed: 10/20/2022]
Abstract
PURPOSE Body size, from birth throughout adulthood, is associated with breast cancer risk, but few studies have investigated early-life body size and benign breast disease (BBD), a well-established breast cancer risk factor. We consider whether prenatal factors and size at birth, 10, 18 year, and intervening growth, are related to BBD risk. METHODS The Growing Up Today Study includes 9032 females who completed questionnaires annually from 1996 to 2001, then 2003, 2005, 2007, 2010, and 2013. In 1996, their mothers provided pregnancy-related data. From 2005 to 2013, participants (18 year+) reported whether they had ever been diagnosed with biopsy-confirmed BBD (N = 142 cases). RESULTS Girls had greater adiposity (BMI; kg/m2) at 10 year if they were larger at birth, if mother's pre-pregnancy BMI was higher, or if gestational weight gain was greater (all p < .01). Maternal height was (positively) associated (p < .05) with adolescent peak height growth velocity (PHV; in./year). Greater 10 year adiposity was associated with lower PHV and less height growth 10-18 year (both p < .01). Adiposity at 10 year was inversely associated with BBD (OR 0.83/(kg/m2), p < .01) as was increasing adiposity 10-18 year (OR 0.85/(kg/m2), p = .01). In a separate model, 10 year height (OR 1.13/in., p = .02) and height growth 10-18 year (OR 1.19/in.; p < .01) were positively associated. PHV was similarly positively associated (OR 2.58, p = .01, fastest versus slowest growth quartiles). In a multivariable model of BBD risk, gestational weight gain (daughters at highest risk if <20 lb gained), PHV (slowest growing girls at lowest risk), age 10 year height (positive), and BMI (inverse) were the most critical childhood risk factors (each p < .05). CONCLUSIONS Body size factors from pregnancy through adolescence were independently associated with BBD risk in young women.
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Affiliation(s)
- Catherine S Berkey
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA.
| | - Bernard Rosner
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA
| | - Rulla M Tamimi
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA
| | - Walter C Willett
- Departments of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Martha Hickey
- Department of Obstetrics and Gynaecology, University of Melbourne and The Royal Women's Hospital, Melbourne, Australia
| | - Adetunji Toriola
- Division of Public Health Sciences, Department of Surgery, Alvin J Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, USA
| | - A Lindsay Frazier
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Graham A Colditz
- Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, USA
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Kerlikowske K, Gard CC, Tice JA, Ziv E, Cummings SR, Miglioretti DL. Risk Factors That Increase Risk of Estrogen Receptor-Positive and -Negative Breast Cancer. J Natl Cancer Inst 2016; 109:2898140. [PMID: 28040694 DOI: 10.1093/jnci/djw276] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2016] [Revised: 09/17/2016] [Accepted: 10/19/2016] [Indexed: 12/15/2022] Open
Abstract
Background Risk factors may differentially influence development of estrogen receptor (ER)-positive vs -negative breast cancer. We examined associations with strong, prevalent risk factors by ER subtype. Methods Of 1 279 443 women age 35 to 74 years participating in the Breast Cancer Surveillance Consortium, 14 969 developed ER-positive and 3617 developed ER-negative invasive breast cancer. We calculated hazard ratios (HRs) using Cox regression and compared ER subtype hazard ratios at representative ages or by menopausal status using Wald tests. All statistical tests were two-sided. Results For women age 40 years, compared with no prior biopsy, ER-positive vs ER-negative HRs were 1.53 (95% CI = 1.30 to 1.81) vs 1.26 (95% CI = 0.90 to 1.76) for nonproliferative disease, 1.63 (95% CI = 1.23 to 2.17) vs 1.41 (95% CI = 0.78 to 2.57) for proliferative disease without atypia, and 4.47 (95% CI = 2.88 to 6.96) vs 0.20 (95% CI = 0.02 to 2.51) for proliferative disease with atypia. Benign disease proliferation risk was stronger for ER-positive than ER-negative cancer for women age 35 years (Wald P = .04), age 40 years (Wald P = .04), and age 50 years (Wald P = .06). Among pre/perimenopausal women, body mass index (BMI) had a stronger association with ER-negative than ER-positive cancer (obese II/III vs. normal weight: HR = 1.52, 95% CI = 1.19 to 1.94; vs 1.21, 95% CI = 1.08 to 1.36). Increasing BMI similarly increased ER-positive and ER-negative cancer risk among postmenopausal hormone users (Wald P = .15) and nonusers (Wald P = .08). Associations with ER subtype varied by race/ethnicity across all ages (P < .001) and by family history of breast cancer and breast density for specific ages. Conclusions Strength of risk factor associations differed by ER subtype. Separate risk models for ER subtypes may improve identification of women for targeted prevention strategies.
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Affiliation(s)
- Karla Kerlikowske
- Affiliations of authors: Departments of Medicine and Epidemiology and Biostatistics (KK, JAT, EZ) and General Internal Medicine Section, Department of Veterans Affairs (KK), University of California, San Francisco, San Francisco, CA; Department of Economics, Applied Statistics, and International Business, New Mexico State University, Las Cruces, NM (CCG); San Francisco Coordinating Center, California Pacific Medical Center Research Institute, San Francisco, CA (SRC); Department of Public Health Sciences, University of California, Davis, Davis, CA (DLM); Group Health Research Institute, Group Health Cooperative, Seattle, WA (DLM)
| | - Charlotte C Gard
- Affiliations of authors: Departments of Medicine and Epidemiology and Biostatistics (KK, JAT, EZ) and General Internal Medicine Section, Department of Veterans Affairs (KK), University of California, San Francisco, San Francisco, CA; Department of Economics, Applied Statistics, and International Business, New Mexico State University, Las Cruces, NM (CCG); San Francisco Coordinating Center, California Pacific Medical Center Research Institute, San Francisco, CA (SRC); Department of Public Health Sciences, University of California, Davis, Davis, CA (DLM); Group Health Research Institute, Group Health Cooperative, Seattle, WA (DLM)
| | - Jeffrey A Tice
- Affiliations of authors: Departments of Medicine and Epidemiology and Biostatistics (KK, JAT, EZ) and General Internal Medicine Section, Department of Veterans Affairs (KK), University of California, San Francisco, San Francisco, CA; Department of Economics, Applied Statistics, and International Business, New Mexico State University, Las Cruces, NM (CCG); San Francisco Coordinating Center, California Pacific Medical Center Research Institute, San Francisco, CA (SRC); Department of Public Health Sciences, University of California, Davis, Davis, CA (DLM); Group Health Research Institute, Group Health Cooperative, Seattle, WA (DLM)
| | - Elad Ziv
- Affiliations of authors: Departments of Medicine and Epidemiology and Biostatistics (KK, JAT, EZ) and General Internal Medicine Section, Department of Veterans Affairs (KK), University of California, San Francisco, San Francisco, CA; Department of Economics, Applied Statistics, and International Business, New Mexico State University, Las Cruces, NM (CCG); San Francisco Coordinating Center, California Pacific Medical Center Research Institute, San Francisco, CA (SRC); Department of Public Health Sciences, University of California, Davis, Davis, CA (DLM); Group Health Research Institute, Group Health Cooperative, Seattle, WA (DLM)
| | - Steven R Cummings
- Affiliations of authors: Departments of Medicine and Epidemiology and Biostatistics (KK, JAT, EZ) and General Internal Medicine Section, Department of Veterans Affairs (KK), University of California, San Francisco, San Francisco, CA; Department of Economics, Applied Statistics, and International Business, New Mexico State University, Las Cruces, NM (CCG); San Francisco Coordinating Center, California Pacific Medical Center Research Institute, San Francisco, CA (SRC); Department of Public Health Sciences, University of California, Davis, Davis, CA (DLM); Group Health Research Institute, Group Health Cooperative, Seattle, WA (DLM)
| | - Diana L Miglioretti
- Affiliations of authors: Departments of Medicine and Epidemiology and Biostatistics (KK, JAT, EZ) and General Internal Medicine Section, Department of Veterans Affairs (KK), University of California, San Francisco, San Francisco, CA; Department of Economics, Applied Statistics, and International Business, New Mexico State University, Las Cruces, NM (CCG); San Francisco Coordinating Center, California Pacific Medical Center Research Institute, San Francisco, CA (SRC); Department of Public Health Sciences, University of California, Davis, Davis, CA (DLM); Group Health Research Institute, Group Health Cooperative, Seattle, WA (DLM)
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97
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Trentham-Dietz A, Kerlikowske K, Stout NK, Miglioretti DL, Schechter CB, Ergun MA, van den Broek JJ, Alagoz O, Sprague BL, van Ravesteyn NT, Near AM, Gangnon RE, Hampton JM, Chandler Y, de Koning HJ, Mandelblatt JS, Tosteson ANA. Tailoring Breast Cancer Screening Intervals by Breast Density and Risk for Women Aged 50 Years or Older: Collaborative Modeling of Screening Outcomes. Ann Intern Med 2016; 165:700-712. [PMID: 27548583 PMCID: PMC5125086 DOI: 10.7326/m16-0476] [Citation(s) in RCA: 86] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Biennial screening is generally recommended for average-risk women aged 50 to 74 years, but tailored screening may provide greater benefits. OBJECTIVE To estimate outcomes for various screening intervals after age 50 years based on breast density and risk for breast cancer. DESIGN Collaborative simulation modeling using national incidence, breast density, and screening performance data. SETTING United States. PATIENTS Women aged 50 years or older with various combinations of breast density and relative risk (RR) of 1.0, 1.3, 2.0, or 4.0. INTERVENTION Annual, biennial, or triennial digital mammography screening from ages 50 to 74 years (vs. no screening) and ages 65 to 74 years (vs. biennial digital mammography from ages 50 to 64 years). MEASUREMENTS Lifetime breast cancer deaths, life expectancy and quality-adjusted life-years (QALYs), false-positive mammograms, benign biopsy results, overdiagnosis, cost-effectiveness, and ratio of false-positive results to breast cancer deaths averted. RESULTS Screening benefits and overdiagnosis increase with breast density and RR. False-positive mammograms and benign results on biopsy decrease with increasing risk. Among women with fatty breasts or scattered fibroglandular density and an RR of 1.0 or 1.3, breast cancer deaths averted were similar for triennial versus biennial screening for both age groups (50 to 74 years, median of 3.4 to 5.1 vs. 4.1 to 6.5 deaths averted; 65 to 74 years, median of 1.5 to 2.1 vs. 1.8 to 2.6 deaths averted). Breast cancer deaths averted increased with annual versus biennial screening for women aged 50 to 74 years at all levels of breast density and an RR of 4.0, and those aged 65 to 74 years with heterogeneously or extremely dense breasts and an RR of 4.0. However, harms were almost 2-fold higher. Triennial screening for the average-risk subgroup and annual screening for the highest-risk subgroup cost less than $100 000 per QALY gained. LIMITATION Models did not consider women younger than 50 years, those with an RR less than 1, or other imaging methods. CONCLUSION Average-risk women with low breast density undergoing triennial screening and higher-risk women with high breast density receiving annual screening will maintain a similar or better balance of benefits and harms than average-risk women receiving biennial screening. PRIMARY FUNDING SOURCE National Cancer Institute.
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Affiliation(s)
- Amy Trentham-Dietz
- From the University of Wisconsin-Madison, Madison, Wisconsin; University of California, San Francisco, San Francisco, California; Harvard Medical School, Boston, Massachusetts; University of California Davis School of Medicine, Sacramento, California; Albert Einstein College of Medicine, Bronx, New York; Erasmus Medical Center, Rotterdam, the Netherlands; University of Vermont, Burlington, Vermont; Georgetown University Medical Center, Washington, DC; and Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
| | - Karla Kerlikowske
- From the University of Wisconsin-Madison, Madison, Wisconsin; University of California, San Francisco, San Francisco, California; Harvard Medical School, Boston, Massachusetts; University of California Davis School of Medicine, Sacramento, California; Albert Einstein College of Medicine, Bronx, New York; Erasmus Medical Center, Rotterdam, the Netherlands; University of Vermont, Burlington, Vermont; Georgetown University Medical Center, Washington, DC; and Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
| | - Natasha K Stout
- From the University of Wisconsin-Madison, Madison, Wisconsin; University of California, San Francisco, San Francisco, California; Harvard Medical School, Boston, Massachusetts; University of California Davis School of Medicine, Sacramento, California; Albert Einstein College of Medicine, Bronx, New York; Erasmus Medical Center, Rotterdam, the Netherlands; University of Vermont, Burlington, Vermont; Georgetown University Medical Center, Washington, DC; and Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
| | - Diana L Miglioretti
- From the University of Wisconsin-Madison, Madison, Wisconsin; University of California, San Francisco, San Francisco, California; Harvard Medical School, Boston, Massachusetts; University of California Davis School of Medicine, Sacramento, California; Albert Einstein College of Medicine, Bronx, New York; Erasmus Medical Center, Rotterdam, the Netherlands; University of Vermont, Burlington, Vermont; Georgetown University Medical Center, Washington, DC; and Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
| | - Clyde B Schechter
- From the University of Wisconsin-Madison, Madison, Wisconsin; University of California, San Francisco, San Francisco, California; Harvard Medical School, Boston, Massachusetts; University of California Davis School of Medicine, Sacramento, California; Albert Einstein College of Medicine, Bronx, New York; Erasmus Medical Center, Rotterdam, the Netherlands; University of Vermont, Burlington, Vermont; Georgetown University Medical Center, Washington, DC; and Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
| | - Mehmet Ali Ergun
- From the University of Wisconsin-Madison, Madison, Wisconsin; University of California, San Francisco, San Francisco, California; Harvard Medical School, Boston, Massachusetts; University of California Davis School of Medicine, Sacramento, California; Albert Einstein College of Medicine, Bronx, New York; Erasmus Medical Center, Rotterdam, the Netherlands; University of Vermont, Burlington, Vermont; Georgetown University Medical Center, Washington, DC; and Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
| | - Jeroen J van den Broek
- From the University of Wisconsin-Madison, Madison, Wisconsin; University of California, San Francisco, San Francisco, California; Harvard Medical School, Boston, Massachusetts; University of California Davis School of Medicine, Sacramento, California; Albert Einstein College of Medicine, Bronx, New York; Erasmus Medical Center, Rotterdam, the Netherlands; University of Vermont, Burlington, Vermont; Georgetown University Medical Center, Washington, DC; and Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
| | - Oguzhan Alagoz
- From the University of Wisconsin-Madison, Madison, Wisconsin; University of California, San Francisco, San Francisco, California; Harvard Medical School, Boston, Massachusetts; University of California Davis School of Medicine, Sacramento, California; Albert Einstein College of Medicine, Bronx, New York; Erasmus Medical Center, Rotterdam, the Netherlands; University of Vermont, Burlington, Vermont; Georgetown University Medical Center, Washington, DC; and Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
| | - Brian L Sprague
- From the University of Wisconsin-Madison, Madison, Wisconsin; University of California, San Francisco, San Francisco, California; Harvard Medical School, Boston, Massachusetts; University of California Davis School of Medicine, Sacramento, California; Albert Einstein College of Medicine, Bronx, New York; Erasmus Medical Center, Rotterdam, the Netherlands; University of Vermont, Burlington, Vermont; Georgetown University Medical Center, Washington, DC; and Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
| | - Nicolien T van Ravesteyn
- From the University of Wisconsin-Madison, Madison, Wisconsin; University of California, San Francisco, San Francisco, California; Harvard Medical School, Boston, Massachusetts; University of California Davis School of Medicine, Sacramento, California; Albert Einstein College of Medicine, Bronx, New York; Erasmus Medical Center, Rotterdam, the Netherlands; University of Vermont, Burlington, Vermont; Georgetown University Medical Center, Washington, DC; and Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
| | - Aimee M Near
- From the University of Wisconsin-Madison, Madison, Wisconsin; University of California, San Francisco, San Francisco, California; Harvard Medical School, Boston, Massachusetts; University of California Davis School of Medicine, Sacramento, California; Albert Einstein College of Medicine, Bronx, New York; Erasmus Medical Center, Rotterdam, the Netherlands; University of Vermont, Burlington, Vermont; Georgetown University Medical Center, Washington, DC; and Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
| | - Ronald E Gangnon
- From the University of Wisconsin-Madison, Madison, Wisconsin; University of California, San Francisco, San Francisco, California; Harvard Medical School, Boston, Massachusetts; University of California Davis School of Medicine, Sacramento, California; Albert Einstein College of Medicine, Bronx, New York; Erasmus Medical Center, Rotterdam, the Netherlands; University of Vermont, Burlington, Vermont; Georgetown University Medical Center, Washington, DC; and Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
| | - John M Hampton
- From the University of Wisconsin-Madison, Madison, Wisconsin; University of California, San Francisco, San Francisco, California; Harvard Medical School, Boston, Massachusetts; University of California Davis School of Medicine, Sacramento, California; Albert Einstein College of Medicine, Bronx, New York; Erasmus Medical Center, Rotterdam, the Netherlands; University of Vermont, Burlington, Vermont; Georgetown University Medical Center, Washington, DC; and Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
| | - Young Chandler
- From the University of Wisconsin-Madison, Madison, Wisconsin; University of California, San Francisco, San Francisco, California; Harvard Medical School, Boston, Massachusetts; University of California Davis School of Medicine, Sacramento, California; Albert Einstein College of Medicine, Bronx, New York; Erasmus Medical Center, Rotterdam, the Netherlands; University of Vermont, Burlington, Vermont; Georgetown University Medical Center, Washington, DC; and Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
| | - Harry J de Koning
- From the University of Wisconsin-Madison, Madison, Wisconsin; University of California, San Francisco, San Francisco, California; Harvard Medical School, Boston, Massachusetts; University of California Davis School of Medicine, Sacramento, California; Albert Einstein College of Medicine, Bronx, New York; Erasmus Medical Center, Rotterdam, the Netherlands; University of Vermont, Burlington, Vermont; Georgetown University Medical Center, Washington, DC; and Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
| | - Jeanne S Mandelblatt
- From the University of Wisconsin-Madison, Madison, Wisconsin; University of California, San Francisco, San Francisco, California; Harvard Medical School, Boston, Massachusetts; University of California Davis School of Medicine, Sacramento, California; Albert Einstein College of Medicine, Bronx, New York; Erasmus Medical Center, Rotterdam, the Netherlands; University of Vermont, Burlington, Vermont; Georgetown University Medical Center, Washington, DC; and Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
| | - Anna N A Tosteson
- From the University of Wisconsin-Madison, Madison, Wisconsin; University of California, San Francisco, San Francisco, California; Harvard Medical School, Boston, Massachusetts; University of California Davis School of Medicine, Sacramento, California; Albert Einstein College of Medicine, Bronx, New York; Erasmus Medical Center, Rotterdam, the Netherlands; University of Vermont, Burlington, Vermont; Georgetown University Medical Center, Washington, DC; and Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
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98
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Should we routinely analyze reduction mammaplasty specimens? J Plast Reconstr Aesthet Surg 2016; 70:196-202. [PMID: 27908767 DOI: 10.1016/j.bjps.2016.10.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Revised: 10/05/2016] [Accepted: 10/23/2016] [Indexed: 11/22/2022]
Abstract
BACKGROUND Reduction mammaplasty is one of the most common plastic surgery procedures. Preoperative imaging and histopathology protocols vary among countries and institutions. We aimed to analyze the incidence of occult breast cancer and high-risk lesions in reduction mammaplasty specimens. We also analyzed whether patients with abnormal histopathology differed from the study population in terms of demographics. PATIENTS AND METHODS In total, 918 women who underwent reduction mammaplasty from January 2007 to December 2011 were retrospectively reviewed for demographics, preoperative imaging, further preoperative examinations, pathology reports, and postoperative follow-up. RESULTS Abnormal histopathological findings were revealed in 88 (10%) patients with a mean age of 49.5 ± 10.2 years. The incidence of breast cancer was 1.2%, and the incidence of high-risk lesions (atypical ductal and lobular hyperplasia and lobular carcinoma in situ) was 5.5%. Age and specimen weights were significantly higher in patients with abnormal histopathology. Eighty-one percent of patients with abnormal histopathology had normal preoperative imaging revealing two high-risk and two cancer findings. Two patients developed breast cancer in the same breast in which the high-risk lesion was originally detected. CONCLUSION Women with abnormal histopathology cannot be sufficiently detected preoperatively. Therefore, histopathological analysis of reduction mammaplasty specimens seems mandatory. Reduction mammaplasty combined with subsequent histopathological examination offers a sufficient chance of detecting cancer and risk-increasing lesions that merits the cost of histopathology.
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99
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Figueroa JD, Pfeiffer RM, Brinton LA, Palakal MM, Degnim AC, Radisky D, Hartmann LC, Frost MH, Stallings Mann ML, Papathomas D, Gierach GL, Hewitt SM, Duggan MA, Visscher D, Sherman ME. Standardized measures of lobular involution and subsequent breast cancer risk among women with benign breast disease: a nested case-control study. Breast Cancer Res Treat 2016; 159:163-72. [PMID: 27488681 DOI: 10.1007/s10549-016-3908-7] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Accepted: 07/11/2016] [Indexed: 01/21/2023]
Abstract
Lesser degrees of terminal duct-lobular unit (TDLU) involution predict higher breast cancer risk; however, standardized measures to quantitate levels of TDLU involution have only recently been developed. We assessed whether three standardized measures of TDLU involution, with high intra/inter pathologist reproducibility in normal breast tissue, predict subsequent breast cancer risk among women in the Mayo benign breast disease (BBD) cohort. We performed a masked evaluation of biopsies from 99 women with BBD who subsequently developed breast cancer (cases) after a median of 16.9 years and 145 age-matched controls. We assessed three metrics inversely related to TDLU involution: TDLU count/mm(2), median TDLU span (microns, which approximates acini content), and median category of acini counts/TDLU (0-10; 11-20; 21-30; 31-50; >50). Associations with subsequent breast cancer risk for quartiles (or categories of acini counts) of each of these measures were assessed with multivariable conditional logistic regression to estimate odds ratios (ORs) and 95 % confidence intervals (CI). In multivariable models, women in the highest quartile compared to the lowest quartiles of TDLU counts and TDLU span measures were significantly associated with subsequent breast cancer diagnoses; TDLU counts quartile4 versus quartile1, OR = 2.44, 95 %CI 0.96-6.19, p-trend = 0.02; and TDLU spans, quartile4 versus quartile1, OR = 2.83, 95 %CI = 1.13-7.06, p-trend = 0.03. Significant associations with categorical measures of acini counts/TDLU were also observed: compared to women with median category of <10 acini/TDLU, women with >25 acini counts/TDLU were at significantly higher risk, OR = 3.40, 95 %CI 1.03-11.17, p-trend = 0.032. Women with TDLU spans and TDLU count measures above the median were at further increased risk, OR = 3.75 (95 %CI 1.40-10.00, p-trend = 0.008), compared with women below the median for both of these metrics. Similar results were observed for combinatorial metrics of TDLU acini counts/TDLU, and TDLU count. Standardized quantitative measures of TDLU counts and acini counts approximated by TDLU span measures or visually assessed in categories are independently associated with breast cancer risk. Visual assessment of TDLU numbers and acini content, which are highly reproducible between pathologists, could help identify women at high risk for subsequent breast cancer among the million women diagnosed annually with BBD in the US.
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Affiliation(s)
- Jonine D Figueroa
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA. .,Medical School, The Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Teviot Place, Edinburgh, EH8 9AG, UK.
| | - Ruth M Pfeiffer
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Louise A Brinton
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Maya M Palakal
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | | | | | | | | | | | - Daphne Papathomas
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Gretchen L Gierach
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Stephen M Hewitt
- Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
| | - Maire A Duggan
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, AB, Canada
| | | | - Mark E Sherman
- Division of Cancer Prevention, National Cancer Institute, Bethesda, MD, USA
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Lawson JS, Glenn WK, Salyakina D, Delprado W, Clay R, Antonsson A, Heng B, Miyauchi S, Tran DD, Ngan CC, Lutze-Mann L, Whitaker NJ. Human Papilloma Viruses and Breast Cancer. Front Oncol 2015; 5:277. [PMID: 26734565 PMCID: PMC4679879 DOI: 10.3389/fonc.2015.00277] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Accepted: 11/26/2015] [Indexed: 01/05/2023] Open
Abstract
PURPOSE Human papillomaviruses (HPV) may have a role in some breast cancers. The purpose of this study is to fill important gaps in the evidence. These gaps are: (i) confirmation of the presence of high risk for cancer HPVs in breast cancers, (ii) evidence of HPV infections in benign breast tissues prior to the development of HPV-positive breast cancer in the same patients, (iii) evidence that HPVs are biologically active and not harmless passengers in breast cancer. METHODS RNA-seq data from The Cancer Genome Atlas (TCGA) was used to identify HPV RNA sequences in breast cancers. We also conducted a retrospective cohort study based on polymerase chain reaction (PCR) analyses to identify HPVs in archival specimens from Australian women with benign breast biopsies who later developed breast cancer. To assess whether HPVs in breast cancer were biologically active, the expression of the oncogenic protein HPV E7 was assessed by immunohistochemistry (IHC). RESULTS Thirty (3.5%) low-risk and 20 (2.3%) high-risk HPV types were identified in 855 breast cancers from the TCGA database. The high risk types were HPV 18 (48%), HPV 113 (24%), HPV 16 (10%), HPV 52 (10%). Data from the PCR cohort study indicated that HPV type 18 was the most common type identified in breast cancer specimens (55% of 40 breast cancer specimens) followed by HPV 16 (13%). The same HPV type was identified in both the benign and subsequent breast cancer in 15 patients. HPV E7 proteins were identified in 72% of benign breast specimens and 59% of invasive breast cancer specimens. CONCLUSION There were four observations of particular interest: (i) confirmation by both NGS and PCR of the presence of high-risk HPV gene sequences in breast cancers, (ii) a correlation between high-risk HPV in benign breast specimens and subsequent HPV-positive breast cancer in the same patient, (iii) HPVs in breast cancer are likely to be biologically active (as shown by transcription of HPV DNA to RNA plus the expression of HPV E7 proteins), (iv) HPV oncogenic influences may occur early in the development of breast cancer.
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Affiliation(s)
- James S Lawson
- School of Biotechnology and Biomolecular Science, University of New South Wales , Sydney, NSW , Australia
| | - Wendy K Glenn
- School of Biotechnology and Biomolecular Science, University of New South Wales , Sydney, NSW , Australia
| | - Daria Salyakina
- Center for Computational Science, University of Miami , Miami, FL , USA
| | - Warick Delprado
- Douglass Hanly Moir Pathology , Macquarie Park, NSW , Australia
| | - Rosemary Clay
- Douglass Hanly Moir Pathology , Macquarie Park, NSW , Australia
| | - Annika Antonsson
- QIMR Berghofer Medical Research Institute , Brisbane, QLD , Australia
| | - Benjamin Heng
- School of Biotechnology and Biomolecular Science, University of New South Wales , Sydney, NSW , Australia
| | - Shingo Miyauchi
- School of Biotechnology and Biomolecular Science, University of New South Wales , Sydney, NSW , Australia
| | - Dinh D Tran
- School of Biotechnology and Biomolecular Science, University of New South Wales , Sydney, NSW , Australia
| | - Christopher C Ngan
- School of Biotechnology and Biomolecular Science, University of New South Wales , Sydney, NSW , Australia
| | - Louise Lutze-Mann
- School of Biotechnology and Biomolecular Science, University of New South Wales , Sydney, NSW , Australia
| | - Noel J Whitaker
- School of Biotechnology and Biomolecular Science, University of New South Wales , Sydney, NSW , Australia
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