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Finkeldey L, Schmitz E, Ellinger S. Effect of the Intake of Isoflavones on Risk Factors of Breast Cancer-A Systematic Review of Randomized Controlled Intervention Studies. Nutrients 2021; 13:nu13072309. [PMID: 34371819 PMCID: PMC8308688 DOI: 10.3390/nu13072309] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 06/25/2021] [Accepted: 06/30/2021] [Indexed: 02/06/2023] Open
Abstract
Epidemiological studies suggest that high intake of soy isoflavones may protect against breast cancer, but causal relationships can only be established by experimental trials. Thus, we aimed to provide a systematic review of randomized controlled trials (RCTs) on the effect of an isoflavone intake on risk factors of breast cancer in healthy subjects. After a systematic literature search in PubMed, 18 different RCTs with pre- and/or postmenopausal women were included and investigated for details according to the PRISMA guideline. In these studies, isoflavones were provided by soy food or supplements in amounts between 36.5-235 mg/d for a period of 1-36 months. Breast density, estrogens including precursors, metabolites, estrogen response such as length of menstrual cycle, and markers of proliferation and inflammation were considered. However, in most studies, differences were not detectable between isoflavone and control/placebo treatment despite a good adherence to isoflavone treatment, irrespective of the kind of intervention, the dose of isoflavones used, and the duration of isoflavone treatment. However, the lack of significant changes in most studies does not prove the lack of effects as a sample size calculation was often missing. Taking into account the risk of bias and methodological limitations, there is little evidence that isoflavone treatment modulates risk factors of breast cancer in pre- and postmenopausal women. Future studies should calculate the sample size to detect possible effects and consider methodological details to improve the study quality.
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Affiliation(s)
- Luisa Finkeldey
- Faculty of Nutrition and Food Sciences, Niederrhein, University of Applied Sciences, Rheydter Street 277, 41065 Mönchengladbach, Germany; (L.F.); (E.S.)
| | - Elena Schmitz
- Faculty of Nutrition and Food Sciences, Niederrhein, University of Applied Sciences, Rheydter Street 277, 41065 Mönchengladbach, Germany; (L.F.); (E.S.)
| | - Sabine Ellinger
- Faculty of Nutrition and Food Sciences, Niederrhein, University of Applied Sciences, Rheydter Street 277, 41065 Mönchengladbach, Germany; (L.F.); (E.S.)
- Department of Nutrition and Food Sciences, Human Nutrition, University of Bonn, Meckenheimer Allee 166a, 53115 Bonn, Germany
- Correspondence:
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102
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Han Y, Lee CT, Xu S, Mi X, Phillip CR, Salazar AS, Rakhmankulova M, Toriola AT. Medication use and mammographic breast density. Breast Cancer Res Treat 2021; 189:585-592. [PMID: 34196899 DOI: 10.1007/s10549-021-06321-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 06/26/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE A dense breast on mammogram is a strong risk factor for breast cancer. Identifying factors that reduce mammographic breast density could thus provide insight into breast cancer prevention. Due to the limited number of studies and conflicting findings, we investigated the associations of medication use (specifically statins, aspirin, and ibuprofen) with mammographic breast density. METHODS We evaluated these associations in 775 women who were recruited during an annual screening mammogram at Washington University School of Medicine, St. Louis. We measured mammographic breast density using Volpara. We used multivariable-adjusted linear regressions to determine the associations of medication use (statins, aspirin, and ibuprofen) with mammographic breast density. Least squared means were generated and back-transformed for easier interpretation. RESULTS The mean age of study participants was 52.9 years. Statin use in the prior 12 months was not associated with volumetric percent density or dense volume, but was positively associated with non-dense volume. The mean volumetric percent density was 8.6% among statin non-users, 7.2% among women who used statins 1-3 days/week, and 7.3% among women who used statins ≥ 4 days/week (p trend = 0.07). The non-dense volume was 1297.1 cm3 among statin non-users, 1368.7 cm3 among women who used statins 1-3 days/week, and 1408.4 cm3 among those who used statins ≥ 4 days/week (p trend = 0.02). We did not observe statistically significant differences in mammographic breast density by aspirin or ibuprofen use. CONCLUSION Statin, aspirin, and ibuprofen use was not associated with volumetric percent density and dense volume, but statin use was positively associated with non-dense volume. Any potential associations of these medications with breast cancer risk are unlikely to be mediated through an effect on volumetric percent density.
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Affiliation(s)
- Yunan Han
- Department of Surgery, Division of Public Health Sciences, Washington University School of Medicine, 660 South Euclid Avenue, Campus, Box 8100, St. Louis, MO, 63110, USA.,Department of Breast Surgery, First Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Chee Teik Lee
- Department of Surgery, Division of Public Health Sciences, Washington University School of Medicine, 660 South Euclid Avenue, Campus, Box 8100, St. Louis, MO, 63110, USA.,School of Medicine, University College Dublin, Belfield, Dublin 4, D04 V1W8, Ireland
| | - Shuai Xu
- Department of Surgery, Division of Public Health Sciences, Washington University School of Medicine, 660 South Euclid Avenue, Campus, Box 8100, St. Louis, MO, 63110, USA
| | - Xiaoyue Mi
- Department of Surgery, Division of Public Health Sciences, Washington University School of Medicine, 660 South Euclid Avenue, Campus, Box 8100, St. Louis, MO, 63110, USA
| | - Courtnie R Phillip
- Department of Surgery, Division of Public Health Sciences, Washington University School of Medicine, 660 South Euclid Avenue, Campus, Box 8100, St. Louis, MO, 63110, USA
| | - Ana S Salazar
- Department of Surgery, Division of Public Health Sciences, Washington University School of Medicine, 660 South Euclid Avenue, Campus, Box 8100, St. Louis, MO, 63110, USA
| | - Malika Rakhmankulova
- Department of Surgery, Division of Public Health Sciences, Washington University School of Medicine, 660 South Euclid Avenue, Campus, Box 8100, St. Louis, MO, 63110, USA
| | - Adetunji T Toriola
- Department of Surgery, Division of Public Health Sciences, Washington University School of Medicine, 660 South Euclid Avenue, Campus, Box 8100, St. Louis, MO, 63110, USA. .,Alvin J. Siteman Cancer Center, Barnes-Jewish Hospital, Washington University School of Medicine, St. Louis, MO, USA.
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103
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Mode of detection matters: Differences in screen-detected versus symptomatic breast cancers. Clin Imaging 2021; 80:11-15. [PMID: 34218078 DOI: 10.1016/j.clinimag.2021.06.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 06/15/2021] [Accepted: 06/21/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Although extensive analyses evaluating screening mammography for breast cancer have been published, some utilized databases do not distinguish between modes of detection, which confounds the conclusions made about the impact of screening mammography. METHODS A retrospective cohort study of women at our institution with pathologically-proven breast cancer from January 2015 to April 2018 was conducted. Subjects were categorized by their mode of diagnosis: screening or non-screening. Patient demographics, tumor characteristics, and treatments were compared between detection methods using Wilcoxon rank-sum test for continuous variables and chi-squared or Fisher's exact test. RESULTS 1026 breast cancers were analyzed. 80.8% of screen-detected breast cancers were invasive. Compared to symptomatically detected cancers, screen-detected were smaller (median size 8 mm vs. 15 mm, p < 0.001), less invasive (80.8% vs. 94.3), had a lower pathologic grade (29% grade 3 vs. 45.7%, p < 0.001), a lower clinical stage, and less aggressive histology (51.9% low Ki67 vs. 30.5%, and 88.2% HER2 negative vs. 76.6%, p < 0.001). Screen-detected cancers were less likely to have extramammary disease (13.2% positive lymph nodes vs. 34.0% and 0.4% distant metastases vs. 6.9%, p < 0.001). Women with screen-detected cancers were more likely to undergo conservative treatment (74.8% underwent lumpectomy vs. 59.9%, and 80.0% received no chemotherapy vs. 51.3%, p < 0.001). CONCLUSION In this study, while the vast majority of screen-detected cancers were invasive, they were more likely to be smaller, less aggressive, and a lower pathologic grade and clinical stage. Furthermore, women with screen-detected cancers were less likely to have extramammary disease and more likely to undergo conservative treatment.
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104
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Fitzjohn JL, Zhou C, Chase JG, Ormsby Z, Haggers M. Modeling viscous damping in actuated breast tissue to provide diagnostic insight for breast cancer: A proof-of-concept analysis. Med Phys 2021; 48:4978-4992. [PMID: 34174093 DOI: 10.1002/mp.15054] [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: 02/04/2021] [Revised: 05/27/2021] [Accepted: 05/31/2021] [Indexed: 12/11/2022] Open
Abstract
PURPOSE This study develops a viscous damping model (VDM) based on Rayleigh Damping (RD) with potential use in low cost, non-invasive breast cancer diagnostics using Digital Image Elasto Tomography (DIET). METHODS A clinical trial involving 13 subjects, each with a tumor in one breast, resulted in 13 cancerous and 13 healthy breasts. Displacement data following actuator induced steady state vibration in the breast tissue were captured using the DIET system. Over 14 000 reference points on the breast surface were split into four segments and viscous damping constant calculated for each reference point. The VDM was fit to median-filtered data for each breast segment and VDM coefficients compared within each breast. One model coefficient, relating to stiffness, was hypothesized to differ in breast segments containing a tumor. Comparison of " b " coefficients in different breast segments using percentage tolerances provided an unbiased, generalizable diagnostic method. Bootstrapping with replacement was used to upsample the data and create smooth receiver operator characteristic (ROC) curves. A total of 12 breast segmentation configurations were used to demonstrate the robustness of the method. RESULTS Fitting the VDM to median-filtered data gave consistent results for one VDM coefficient (" a ") across all breasts. The second VDM coefficient (" b ") showed diagnostic potential with breast segments having consistent coefficients in healthy breasts. In cancerous breasts " b " coefficients were found to be statistically different in segments containing and adjacent to the tumor compared with the segment furthest from the tumor with p < 0.02 using the Student t-Test. Large discrepancies in " b " coefficients were found to be indicative of a tumor with a 14.5% tolerance resulting in sensitivity and specificity of 76.9%. The optimal breast configuration resulted in an area under the ROC curve (AUC) of 0.81 with sensitivity and specificity at 77% and 72%, respectively. CONCLUSION This VDM method enables a computationally simple diagnostic technique using DIET for comfortable breast screening for women of all ages. Regular screening potential allows for tolerance alteration based on age, prior subject-specific results, and other risk factors to manage false positives, reducing psychological harm while optimizing early detection for successful treatment and decreased mortality.
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Affiliation(s)
- Jessica L Fitzjohn
- Department of Mechanical Engineering, Centre for Bio-engineering, University of Canterbury, Christchurch, New Zealand
| | - Cong Zhou
- Department of Mechanical Engineering, Centre for Bio-engineering, University of Canterbury, Christchurch, New Zealand.,School of Civil Aviation, Northwestern Polytechnic University, Xian, China
| | - J Geoffrey Chase
- Department of Mechanical Engineering, Centre for Bio-engineering, University of Canterbury, Christchurch, New Zealand
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105
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Li H, Ye J, Liu H, Wang Y, Shi B, Chen J, Kong A, Xu Q, Cai J. Application of deep learning in the detection of breast lesions with four different breast densities. Cancer Med 2021; 10:4994-5000. [PMID: 34132495 PMCID: PMC8290249 DOI: 10.1002/cam4.4042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 03/04/2021] [Accepted: 03/20/2021] [Indexed: 01/05/2023] Open
Abstract
Objective This retrospective study evaluated the model from populations with different breast densities and showed the model's performance on malignancy prediction. Methods A total of 608 mammograms were collected from Northern Jiangsu People's Hospital in Yangzhou City. The data from this province have not been used in the training or evaluation data set. The model consists of three submodules, lesion detection (Mask‐rcnn), lesion registration between craniocaudal view and mediolateral oblique view, malignancy prediction network (ResNet). The data set used to train the model was obtained from nine institutions across six cities. For normal cases, there were no annotations. Here, we adopted the free‐response receiver operating characteristic (FROC) curve as the indicator to evaluate the detection performance of all cancers and triple‐negative breast cancer (TNBC). The FROC curves are also shown for mass/distortion/asymmetry and typical benign calcification in two kinds of populations with four types of breast density. Results The sensitivity to mass/distortion/asymmetry for the four types of breast (A, B, C, D) are 0.94, 0.92, 0.89, and 0.72, respectively, when false positive per image is 0.25, while these values are 1.00, 0.95, 0.92, and 0.90, respectively, for the amorphous calcification lesions. The sensitivity for the cancer is 0.85 at the same false‐positive rate. The TNBC accounts for about 10%–20% of all breast cancers and is more aggressive with poor prognosis than other breast cancers. Herein, we also evaluated performance on the TNBC cases. Our results show that Yizhun AI could detect 75% TNBC lesions at the same false‐positive level mentioned above. Conclusion The Yizhun AI model used in our work has good diagnostic efficiency for different types of breast, even for the extremely dense breast. It has a guiding role in the clinical diagnosis of breast cancer. The performance of Yizhun AI on mass/distortion/asymmetry is affected by breast density significantly compared to that on amorphous calcification.
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Affiliation(s)
- Hongmei Li
- Department of Radiology, Subei People's Hospital of Jiangsu Province, Yangzhou Jiangsu, China
| | - Jing Ye
- Department of Radiology, Subei People's Hospital of Jiangsu Province, Yangzhou Jiangsu, China
| | - Hao Liu
- Yizhun Medical AI, Beijing, China
| | - Yichuan Wang
- Yizhun Medical AI, Beijing, China.,School of Electronics Engineering and Computer Science, Peking University, Beijing, China
| | - Binbin Shi
- Department of Radiology, Subei People's Hospital of Jiangsu Province, Yangzhou Jiangsu, China
| | - Juan Chen
- Department of Radiology, Subei People's Hospital of Jiangsu Province, Yangzhou Jiangsu, China
| | - Aiping Kong
- Department of Radiology, Subei People's Hospital of Jiangsu Province, Yangzhou Jiangsu, China
| | - Qing Xu
- Department of Radiology, Subei People's Hospital of Jiangsu Province, Yangzhou Jiangsu, China
| | - Junhui Cai
- Department of Radiology, Subei People's Hospital of Jiangsu Province, Yangzhou Jiangsu, China
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106
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Li WM, Sun QW, Fan XF, Zhang JC, Xu T, Shen QQ, Jia L. Mammography breast density: an effective supplemental modality for the precise grading of ultrasound BI-RADS 4 categories. Gland Surg 2021; 10:2010-2018. [PMID: 34268085 DOI: 10.21037/gs-21-313] [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: 04/02/2021] [Accepted: 06/17/2021] [Indexed: 11/06/2022]
Abstract
Background High breast density is significantly associated with an increased risk of breast diseases. Presently, suspected breast masses assessed as Breast Imaging-Reporting and Data System (BI-RADS) grade 4 provide a wide range of positive predictive values. Moreover, subcategories (4a, 4b, and 4c) are still under consideration as the diagnostic criteria are neither comprehensive nor objective. However, whether mammography breast density (MBD) has any impact on the accurate grading of BI-RADS 4 assessed by ultrasound (US) remains unknown. Methods A total of 1,086 women with 1,293 breast masses were included and assessed as BI-RADS 3-5 by US. The subcategories of MBD (from the ACR-a to the ACR-d group) were assessed by mammography according to the criteria of the American College of Radiology (ACR). The clinicopathological characteristics of these patients were reviewed retrospectively. The malignancy rates of breast masses among different subgroups assessed by BI-RADS were re-estimated with MBD. Results Almost all BI-RADS 3 masses were classified as benign and nearly all BI-RADS 5 masses were identified as malignant. Significant inverse associations between MBD and malignancy rates were detected between the BI-RADS 4a and BI-RADS 4b groups. Moreover, malignancy rates decreased significantly from ACR-a to ACR-d for BI-RADS 4a and 4b breast lesions (P<0.001). However, this trend was not observed in BI-RADS 4c breast lesions. Conclusions MBD could serve as a crucial factor for the accurate grading of BI-RADS 4 lesions assessed by US. We strongly recommend the adoption of the MBD as a possible supplemental screening modality for US. Furthermore, it is equally beneficial for accurate risk assessment and screening recommendations based on MBD.
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Affiliation(s)
- Wei-Min Li
- Department of Ultrasonography, Affiliated Hospital of Jiangnan University, Wuxi, China
| | - Qiu-Wei Sun
- Department of Ultrasonography, Affiliated Hospital of Jiangnan University, Wuxi, China
| | - Xiao-Fang Fan
- Department of Ultrasonography, Affiliated Hospital of Jiangnan University, Wuxi, China
| | - Jun-Chao Zhang
- Department of Ultrasonography, Affiliated Hospital of Jiangnan University, Wuxi, China
| | - Ting Xu
- Department of Clinical and Research, Shenzhen Mindray Biomedical Electronics Co., Ltd, Shenzhen, China
| | - Qi-Qi Shen
- Department of Ultrasonography, Affiliated Hospital of Jiangnan University, Wuxi, China
| | - Lei Jia
- Department of Ultrasonography, Affiliated Hospital of Jiangnan University, Wuxi, China
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Chowdhury FA, Islam MF, Prova MT, Khatun M, Sharmin I, Islam KM, Hassan MK, Khan MAS, Rahman MM. Association of hyperlipidemia with breast cancer in Bangladeshi women. Lipids Health Dis 2021; 20:52. [PMID: 34022902 PMCID: PMC8141137 DOI: 10.1186/s12944-021-01480-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 05/13/2021] [Indexed: 02/25/2023] Open
Abstract
Background The association of circulating lipids with breast cancer is being debated. The objective of this study was to examine the relationship between abnormal plasma lipids and breast cancer risk in Bangladeshi women. Methods This was a case-control study designed using a population of 150 women (50 women in each group). The lipid levels of women with breast cancer were compared to the lipid levels of women with benign breast disease (control group 1) and healthy women (control group 2). Study samples were collected from the Department of Surgery, Bangabandhu Sheikh Mujib Medical University, for a period of 1 year. Ethical measures were in compliance with the current Declaration of Helsinki. Statistical analysis was performed with SPSS version 26. Results All of the comparison groups shared similar sociodemographic, anthropometric and obstetric characteristics. The incidence of dyslipidemia was significantly higher in breast cancer patients (96%) than in healthy women (84%) and patients with benign breast disease (82%) (P < 0.05 for both). The levels of total cholesterol, triglycerides, and low-density lipoprotein (LDL) cholesterol among the breast cancer patient group were significantly higher than those among both benign breast disease patients and healthy women (P < 0.05), except for high-density lipoprotein (HDL) cholesterol. Adjusting for other factors, body mass index (BMI) (kg/m2) (> 23) [OR 53.65; 95% CI: 5.70–504.73; P < 0.001] and total cholesterol (mg/dl) (≥ 200) [OR 16.05; 95% CI: 3.13–82.29; P < 0.001] were independently associated with breast cancer. Conclusions Total cholesterol and BMI are independent predictors of breast cancer risk among Bangladeshi women. Supplementary Information The online version contains supplementary material available at 10.1186/s12944-021-01480-2.
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Affiliation(s)
- Fatama Akter Chowdhury
- Department of Plastic Surgery and Burn, Dhaka Medical College Hospital, Dhaka, Bangladesh
| | - Md Faridul Islam
- Department of Vascular Surgery, National Institute of Cardiovascular Diseases, Dhaka, Bangladesh
| | | | - Mahbuba Khatun
- Narayanganj General (Victoria) Hospital, Narayanganj, Bangladesh
| | - Iffat Sharmin
- Abhaynagar Upazila Health Complex, Jashore, Bangladesh
| | | | - Md Kamrul Hassan
- Pi Research Consultancy Center, Dhaka, Bangladesh.,Shaheed Syed Nazrul Islam Medical College, Kishoreganj, Bangladesh
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108
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Bevinakoppamath S, Saleh Ahmed AM, Ramachandra SC, Vishwanath P, Prashant A. Chemopreventive and Anticancer Property of Selenoproteins in Obese Breast Cancer. Front Pharmacol 2021; 12:618172. [PMID: 33935708 PMCID: PMC8087246 DOI: 10.3389/fphar.2021.618172] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 03/05/2021] [Indexed: 12/24/2022] Open
Abstract
Obesity is a significant risk factor for various cancers including breast cancer resulting in an increased risk of recurrence as well as morbidity and mortality. Extensive studies on various pathways have been successful in establishing a biological relationship between obesity and breast cancer. The molecular classification of breast cancer includes five groups each having different responses to treatment. Increased levels of inflammatory cytokines seen in obese conditions drive the pro-proliferative pathways, such as the influx of macrophages, angiogenesis, and antiapoptotic pathways. Increased peripheral aromatization of androgens by aromatase increases the circulating estrogen levels which are also responsible for the association of obesity with breast cancer. Also, increased oxidative stress due to chronic low-grade inflammation in obese women plays an important role in carcinogenesis. Despite the availability of safe and effective treatment options for breast cancer, obese women are at increased risk of adverse outcomes including treatment-related toxicities. In the recent decade, selenium compounds have gained substantial interest as chemopreventive and anticancer agents. The chemical derivatives of selenium include inorganic and organic compounds that exhibit pro-oxidant properties and alter cellular redox homeostasis. They target more than one metabolic pathway by thiol modifications, induction of reactive oxygen species, and chromatin modifications to exert their chemopreventive and anticancer activities. The primary functional effectors of selenium that play a significant role in human homeostasis are selenoproteins like glutathione peroxidase, thioredoxin reductase, iodothyronine deiodinases, and selenoprotein P. Selenoproteins play a significant role in adipose tissue physiology by modulating preadipocyte proliferation and adipogenic differentiation. They correlate negatively with body mass index resulting in increased oxidative stress that may lead to carcinogenesis in obese individuals. Methylseleninic acid effectively suppresses aromatase activation thus reducing the estrogen levels and acting as a breast cancer chemopreventive agent. Adipose-derived inflammatory mediators influence the selenium metabolites and affect the proliferation and metastatic properties of cancer cells. Recently selenium nanoparticles have shown potent anticancer activity which may lead to a major breakthrough in the management of cancers caused due to multiple pathways. In this review, we discuss the possible role of selenoproteins as chemopreventive and an anticancer agent in obese breast cancer.
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Affiliation(s)
- Supriya Bevinakoppamath
- Center of Excellence in Molecular Biology and Regenerative Medicine, Department of Biochemistry, JSS Medical College, JSS Academy of Higher Education & Research, Mysore, India
| | - Adel Mohammed Saleh Ahmed
- Center of Excellence in Molecular Biology and Regenerative Medicine, Department of Biochemistry, JSS Medical College, JSS Academy of Higher Education & Research, Mysore, India
| | - Shobha Chikkavaddaraguddi Ramachandra
- Center of Excellence in Molecular Biology and Regenerative Medicine, Department of Biochemistry, JSS Medical College, JSS Academy of Higher Education & Research, Mysore, India
| | - Prashant Vishwanath
- Center of Excellence in Molecular Biology and Regenerative Medicine, Department of Biochemistry, JSS Medical College, JSS Academy of Higher Education & Research, Mysore, India
| | - Akila Prashant
- Center of Excellence in Molecular Biology and Regenerative Medicine, Department of Biochemistry, JSS Medical College, JSS Academy of Higher Education & Research, Mysore, India
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109
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Jiménez T, García-Pérez J, van der Haar R, Alba MÁ, Lucas P, Sierra MÁ, de Larrea-Baz NF, Salas-Trejo D, Llobet R, Martínez I, Pino MN, Alguacil J, González-Galarzo MC, Martínez-Cortés M, Pérez-Gómez B, Pollán M, Lope V. Occupation, occupational exposures and mammographic density in Spanish women. ENVIRONMENTAL RESEARCH 2021; 195:110816. [PMID: 33524328 DOI: 10.1016/j.envres.2021.110816] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 01/25/2021] [Accepted: 01/25/2021] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Mammographic density (MD), the proportion of radiologically dense breast tissue, is a strong risk factor for breast cancer. Our objective is to investigate the influence of occupations and occupational exposure to physical, chemical, and microbiological agents on MD in Spanish premenopausal women. METHODS This is a cross-sectional study based on 1362 premenopausal workers, aged 39-50, who attended a gynecological screening in a breast radiodiagnosis unit of Madrid City Council. The work history was compiled through a personal interview. Exposure to occupational agents was evaluated using the Spanish job-exposure matrix MatEmESp. MD percentage was assessed using the validated semi-automated computer tool DM-Scan. The association between occupation, occupational exposures, and MD was quantified using multiple linear regression models, adjusted for age, educational level, body mass index, parity, previous breast biopsies, family history of breast cancer, energy intake, use of oral contraceptives, smoking, and alcohol consumption. RESULTS Although no occupation was statistically significantly associated with MD, a borderline significant inverse association was mainly observed in orchard, greenhouse, nursery, and garden workers (β = -6.60; 95% confidence interval (95%CI) = -14.27; 1.07) and information and communication technology technicians (β = -7.27; 95%CI = -15.37; 0.84). On the contrary, a positive association was found among technicians in art galleries, museums, and libraries (β = 8.47; 95%CI = -0.65; 17.60). Women occupationally exposed to fungicides, herbicides, and insecticides tended to have lower MD. The percentage of density decreased by almost 2% for every 5 years spent in occupations exposed to the mentioned agents. CONCLUSIONS Although our findings point to a lack of association with the occupations and exposures analyzed, this study supports a deeper exploration of the role of certain occupational agents in MD, such as pesticides.
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Affiliation(s)
- Tamara Jiménez
- Department of Preventive Medicine, Public Health and Microbiology, Universidad Autónoma de Madrid (UAM), Madrid, Spain
| | - Javier García-Pérez
- Cancer and Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain.
| | | | - Miguel Ángel Alba
- Área de Higiene Industrial, Quirón Prevención, S.L.U., Barcelona, Spain
| | - Pilar Lucas
- Cancer and Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain
| | - María Ángeles Sierra
- Cancer and Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - Nerea Fernández de Larrea-Baz
- Cancer and Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain
| | - Dolores Salas-Trejo
- Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain; Valencian Breast Cancer Screening Program, General Directorate of Public Health, València, Spain; Centro Superior de Investigación en Salud Pública CSISP, FISABIO, València, Spain
| | - Rafael Llobet
- Institute of Computer Technology, Universitat Politècnica de València, València, Spain
| | - Inmaculada Martínez
- Valencian Breast Cancer Screening Program, General Directorate of Public Health, València, Spain; Centro Superior de Investigación en Salud Pública CSISP, FISABIO, València, Spain
| | - Marina Nieves Pino
- Servicio de Prevención y Promoción de la Salud, Madrid Salud, Ayuntamiento de Madrid, Madrid, Spain
| | - Juan Alguacil
- Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain; Centro de Investigación en Recursos Naturales, Salud y Medio Ambiente (RENSMA), Universidad de Huelva, Huelva, Spain
| | - Mª Carmen González-Galarzo
- Department of Developmental and Educational Psychology, University of Valencia, Valencia, Spain; Center for Research in Occupational Disease, Universitat Pompeu Fabra, Barcelona, Spain
| | - Mercedes Martínez-Cortés
- Servicio de Prevención y Promoción de la Salud, Madrid Salud, Ayuntamiento de Madrid, Madrid, Spain
| | - Beatriz Pérez-Gómez
- Cancer and Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain
| | - Marina Pollán
- Cancer and Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain
| | - Virginia Lope
- Cancer and Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain
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Santos Aragon LN, Soto-Trujillo D. Effectiveness of Tomosynthesis Versus Digital Mammography in the Diagnosis of Suspicious Lesions for Breast Cancer in an Asymptomatic Population. Cureus 2021; 13:e13838. [PMID: 33717771 PMCID: PMC7952495 DOI: 10.7759/cureus.13838] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Introduction The most frequent malignant tumor in women is breast cancer. A dense breast may mask lesions within the tissue. The constant improvement in diagnosis techniques has made the diagnosis more accurate. Digital mammography loses sensitivity in dense breasts as lesions may be masked by the over-position of tissue. Tomosynthesis increases sensitivity and specificity over diagnostic mammography. In this study, we examine the effectiveness of tomosynthesis versus digital mammography in asymptomatic patients. Materials and methods A cohort study of 1,499 Mexican patients that came for screening at a private health service from January to December 2015. A Breast Imaging Reporting and Database System (BI-RADS) classification was given by a breast radiologist with the digital mammography reading. Later, a second breast radiologist reviewed the same patients with tomosynthesis and assigned a second BI-RADS category. Results Patients were divided into three age groups. The one with the most had patients between 40-49 years (51.3%), where re-staging to a higher BI-RADS occurred in 40 patients. Re-staging to a lower category was most common in the group of age above 50, where 30 patients were assigned BI-RADS 2 after tomosynthesis. Dense breast (C and D) represented 38%. After tomosynthesis, 28 patients were classified as BI-RADS 4 or 5. The prevalence of diseases in groups BI-RADS 4 and BI-RADS 5 after re-staging and a breast cancer result was 0.024, with a sensitivity of 54% and a specificity of 88%. When re-staging 2D mammography with 3D tomosynthesis for suspicious lesions classified BI-RADS 3, 4, or 5, the prevalence was 0.23, with a sensitivity of 45% and a specificity of 98%. In this study, patients were asymptomatic, yet 20 breast cancers were detected, with a sensitivity of 54% and a specificity of 88%, exceeding the specificity of diagnostic mammography. Moreover, when re-staging to a BI-RADS of suspicious findings, the sensitivity was 45%, with a specificity of as high as 98%.
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Pedersen JE, Strandberg-Larsen K, Andersson M, Hansen J. Breast cancer among Danish women occupationally exposed to diesel exhaust and polycyclic aromatic hydrocarbons, 1964-2016. Scand J Work Environ Health 2021; 47:154-162. [PMID: 33025024 PMCID: PMC8114566 DOI: 10.5271/sjweh.3923] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective: The aim of this study was to explore the association between occupational exposure to diesel exhaust and polycyclic aromatic hydrocarbons (PAH), respectively, and breast cancer subtypes. Methods: The study included 38 375 women <70 years with incident breast cancer, identified in the Danish Cancer Registry, and 5 breast cancer-free controls per case who were randomly selected from the Danish Civil Registration System and matched on year of birth. Full employment history was obtained for all study subjects from a nationwide pension fund, and exposure to diesel exhaust and PAH was assessed using a job exposure matrix. Conditional logistic regression was used for estimation of odds ratios (OR) with adjustment for reproductive factors and socioeconomic status. Results: No noteworthy associations were observed for overall breast cancer in women exposed to diesel exhaust. However, diesel exhaust modestly elevated the risk of estrogen receptor negative breast tumors before age 50 [OR 1.26, 95% confidence interval (CI) 1.09–1.46]. Duration– and dose–response relationships were further observed for this subtype in this age group. No notable risk patterns were generally observed for PAH exposure. Conclusion: Occupational exposure to diesel exhaust may increase the risk of early-onset estrogen receptor negative breast tumors in women. Future studies exploring this association are warranted.
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Affiliation(s)
- Julie Elbæk Pedersen
- Danish Cancer Society Research Center, Strandboulevarden 49, 2100 Copenhagen Ø, Denmark.
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Valencia-Hernandez I, Peregrina-Barreto H, Reyes-Garcia CA, Lopez-Armas GC. Density map and fuzzy classification for breast density by using BI-RADS. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2021; 200:105825. [PMID: 33190944 DOI: 10.1016/j.cmpb.2020.105825] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 10/29/2020] [Indexed: 06/11/2023]
Abstract
Mammographic density (MD) is conformed by a different percentage of stromal, epithelial, and adipose tissue within the breast. One of the most critical findings in mammographic patterns for establishing a diagnosis of breast cancer is high breast tissue density. There is a wide variety of works focused on the study and automatic calculation of general breast density; however, they do not provide more detailed information about the changes that may occur within the breast tissue. This work proposes to generate a breast density map based on a texture analysis to identify the internal composition and distribution of the breast tissue through the diffuse division technique of the different densities inside the breast. Therefore, it is possible to obtain a density map associated with the breast that allows us to distinguish and quantify the different types of breast densities and their distribution according to the Breast Imaging Reporting and Data System (BI-RADS Breast Density Category). The proposed methodology was tested with mammograms from the BCDR and InBreast databases, demonstrating consistency in results and reaching an accuracy of 84.2% and 81.3%, respectively. Finally, the information obtained from the density map and its analysis could be a support tool for the specialist physician to monitor changes in breast density over time, since the fuzzy classification carried out allows quantifying the degree of membership in the BI-RADS breast density classes.
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Affiliation(s)
- I Valencia-Hernandez
- Instituto Nacional de Astrofísica, Óptica y Electrónica, Luis Enrique Erro 1, Santa Maria Tonantzintla, Puebla 72840, México
| | - H Peregrina-Barreto
- Instituto Nacional de Astrofísica, Óptica y Electrónica, Luis Enrique Erro 1, Santa Maria Tonantzintla, Puebla 72840, México.
| | - C A Reyes-Garcia
- Instituto Nacional de Astrofísica, Óptica y Electrónica, Luis Enrique Erro 1, Santa Maria Tonantzintla, Puebla 72840, México
| | - G C Lopez-Armas
- Centro de Enseñanza Técnica Industrial, Nueva Escocia 1885, Guadalajara, Jalisco, 44638, México
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Aglan SA, Elsammak M, Elsammak O, El-Bakoury EA, Elsheredy HG, Ahmed YS, Sultan MH, Awad AM. Evaluation of serum Nestin and HOTAIR rs12826786 C>T polymorphism as screening tools for breast cancer in Egyptian women. J Med Biochem 2021; 40:17-25. [PMID: 33584136 PMCID: PMC7857851 DOI: 10.5937/jomb0-25295] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Accepted: 05/27/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Nestin is a neural stem cell protein that plays an important role in cancer stem cells (CSC) development and proliferation. It has been identified as a marker for newly formed endothelial cells and was shown to be preferentially expressed in basal and myoepithelial cells of the mammary gland. HOTAIR is long intergenic non-coding (linRNA) associated with tumorigenesis through promotion of epithelial-mesenchymal transition (EMT) and stemness as well. HOTAIR gene contains a functioning single nucleotide polymorphic site rs12826786 C>T that has been associated with several cancer types. METHODS We evaluated serum Nestin and the HOTAIR rs12826786 C>T polymorphism in healthy Egyptian women and those with breast cancer as a possible screening tool to identify patients with breast cancer. Also, we tested the possible association of the two markers with each other and the aggressiveness of the disease. RESULTS Patients with breast cancer had a median (Min-Max) of serum Nestin 31.3 (6.7-167.3 pg/mL), while control subjects had a median (Min-Max) of serum Nestin 42.3 (25.7-315.95) pg/mL. The best cut-off value for serum Nestin to differentiate normal subjects and patients with breast cancer was 39.9 pg/mL. This cut-off value had a diagnostic sensitivity of 84.8% and specificity of 65.1%. There was a significant difference in the distribution of different alleles in patients with breast cancer than normal subjects (P=0.039 Exact Fisher test). The breast cancer patients group had 23.9% CC, 52.1% CT, and 23.9% TT genotypes, respectively, while the control group had 46.9% CC, 42.8% CT, and 10.2% TT, respectively. CONCLUSIONS A significantly low serum Nestin below 39.9 pg/mL and a higher percentage of the T/T homozygous variant allele of HOTAIR rs12826786 C>T were found in Egyptian patients with breast cancer. We suggest that the reported cut-off value of serum Nestin and the presence of C/T polymorphism can be used to assess the risk of females for developing breast cancer and might be of potential benefit in screening the disease. Larger studies in different ethnic groups are needed to confirm our findings.
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Affiliation(s)
- Sarah A. Aglan
- Alexandria University, Medical Research Institute, Department of Chemical Pathology, Egypt
| | - Mohamed Elsammak
- Alexandria University, Medical Research Institute, Department of Chemical Pathology, Egypt
| | | | - Eman A. El-Bakoury
- Alexandria University, Medical Research Institute, Department of Radio-diagnosis, Egypt
| | - Heba G. Elsheredy
- Alexandria University, Medical Research Institute, Department of Cancer Management and Research, Alexandria, Egypt
| | - Yasser S. Ahmed
- Alexandria University, Medical Research Institute, Department of Experimental and Clinical Surgery, Alexandria, Egypt
| | - Mohamed H. Sultan
- Alexandria University, Medical Research Institute, Department of Experimental and Clinical Surgery, Alexandria, Egypt
| | - Ahmed M. Awad
- Alexandria University, Medical Research Institute, Department of Chemical Pathology, Egypt
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Yamaguchi K, Hara Y, Kitano I, Hamamoto T, Kiyomatsu K, Yamasaki F, Yamaguchi R, Nakazono T, Egashira R, Imaizumi T, Irie H. Relationship between MRI findings and invasive breast cancer with podoplanin-positive cancer-associated fibroblasts. Breast Cancer 2021; 28:572-580. [PMID: 33389554 DOI: 10.1007/s12282-020-01198-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 11/19/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Purpose of our study is to assess the relationship between MRI findings and invasive breast cancer (IBC) with cancer-associated fibroblasts (CAFs) that are positive for podoplanin. METHODS We retrospectively analyzed the consecutive 109 IBCs. The IBCs were dichotomized as with (+) or without (-) podoplanin-positive CAFs. In MRI analyses, the dichotomized IBCs were compared the lesion to muscle ratio (L/M ratio) in STIR images, the ADC value, the distribution of kinetic parameters, and morphological findings. RESULTS Of the 109 IBCs, 28 (26%) IBCs had podoplanin(+) CAFs. Compared to the podoplanin(-) group, the podoplanin(+) group tended to have a more malignant pathological status. In the STIR images, the podoplanin(+) group had significantly higher L/M ratio (7.59 vs. 6.55, p = 0.040). In a dynamic study, the podoplanin(+) group had a significantly higher percentage of the washout pattern (42.21% vs. 29.43%, p = 0.045). There were 23 mass lesions and 5 non-mass enhancement (NME) lesions in the podoplanin(+) group, and 69 mass lesions and 12 NME lesions in the podoplanin(-) group. The mass lesions of the podoplanin(-) group had a significantly higher likelihood of showing an irregular shape (n = 47 vs. 8, p = 0.035). The podoplanin(+) group's lesions had a significantly higher likelihood of showing a circumscribed margin (n = 14 vs. 6, p < 0.001) and a rim enhancement (n = 10 vs. 13, p = 0.047). In multivariate analyses, only high nuclear grade was significant predictive value of podoplanin(+) CAFs. CONCLUSION Although not significant in multivariate analyses, MRI findings may be used to determine the podoplanin-positive CAF status of invasive breast cancer.
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Affiliation(s)
- Ken Yamaguchi
- Department of Radiology, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan.
| | - Yukiko Hara
- Department of Radiology, Saga Central Hospital, 3-8-1 Hyogominami, Saga, 849-8522, Japan
| | - Isao Kitano
- Department of Radiology, Saga Central Hospital, 3-8-1 Hyogominami, Saga, 849-8522, Japan
| | | | - Kazumitsu Kiyomatsu
- Department of Surgery, Saga Central Hospital, 3-8-1 Hyogominami, Saga, 849-8522, Japan
| | - Fumio Yamasaki
- Department of Pathology, Saga Central Hospital, 3-8-1 Hyogominami, Saga, 849-8522, Japan
| | - Rin Yamaguchi
- Department of Pathology and Laboratory Medicine, Kurume University Medical Center, 155-1 Kokubu, Kurume, 859-0863, Japan
| | - Takahiko Nakazono
- Department of Radiology, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan
| | - Ryoko Egashira
- Department of Radiology, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan
| | - Takeshi Imaizumi
- Department of Radiology, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan
| | - Hiroyuki Irie
- Department of Radiology, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan
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Miricescu D, Totan A, Stanescu-Spinu II, Badoiu SC, Stefani C, Greabu M. PI3K/AKT/mTOR Signaling Pathway in Breast Cancer: From Molecular Landscape to Clinical Aspects. Int J Mol Sci 2020; 22:E173. [PMID: 33375317 PMCID: PMC7796017 DOI: 10.3390/ijms22010173] [Citation(s) in RCA: 327] [Impact Index Per Article: 81.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 12/22/2020] [Accepted: 12/23/2020] [Indexed: 02/07/2023] Open
Abstract
Breast cancer is a serious health problem worldwide, representing the second cause of death through malignancies among women in developed countries. Population, endogenous and exogenous hormones, and physiological, genetic and breast-related factors are involved in breast cancer pathogenesis. The phosphatidylinositol 3-kinase (PI3K)/protein kinase B (AKT)/mammalian target of rapamycin (mTOR) is a signaling pathway involved in cell proliferation, survival, invasion, migration, apoptosis, glucose metabolism and DNA repair. In breast tumors, PIK3CA somatic mutations have been reported, located in exon 9 and exon 20. Up to 40% of PIK3CA mutations are estrogen receptor (ER) positive and human epidermal growth factor receptor 2 (HER2) -negative in primary and metastatic breast cancer. HER2 is overexpressed in 20-30% of breast cancers. HER1, HER2, HER3 and HER4 are membrane receptor tyrosine kinases involved in HER signaling to which various ligands can be attached, leading to PI3K/AKT activation. Currently, clinical studies evaluate inhibitors of the PI3K/AKT/mTOR axis. The main purpose of this review is to present general aspects of breast cancer, the components of the AKT signaling pathway, the factors that activate this protein kinase B, PI3K/AKT-breast cancer mutations, PI3K/AKT/mTOR-inhibitors, and the relationship between everolimus, temsirolimus and endocrine therapy.
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Affiliation(s)
- Daniela Miricescu
- Department of Biochemistry, Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd, 050474 Bucharest, Romania; (D.M.); (A.T.); (M.G.)
| | - Alexandra Totan
- Department of Biochemistry, Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd, 050474 Bucharest, Romania; (D.M.); (A.T.); (M.G.)
| | - Iulia-Ioana Stanescu-Spinu
- Department of Biochemistry, Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd, 050474 Bucharest, Romania; (D.M.); (A.T.); (M.G.)
| | - Silviu Constantin Badoiu
- Department of Anatomy and Embryology, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd, 050474 Bucharest, Romania
| | - Constantin Stefani
- Department of Family Medicine and Clinical Base, Dr. Carol Davila Central Military Emergency University Hospital, 134 Calea Plevnei, 010825 Bucharest, Romania;
| | - Maria Greabu
- Department of Biochemistry, Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd, 050474 Bucharest, Romania; (D.M.); (A.T.); (M.G.)
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Dzidzornu E, Angmorterh SK, Ofori-Manteaw BB, Aboagye S, Dzefi-Tettey K, Ofori EK. Mammography Diagnostic Reference Levels (DRLs) in Ghana. Radiography (Lond) 2020; 27:611-616. [PMID: 33342686 DOI: 10.1016/j.radi.2020.11.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 11/29/2020] [Accepted: 11/30/2020] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Diagnostic Reference Levels (DRLs) are essential for optimisation in mammography. A local DRL for screen-film mammography has been established in Ghana but none exists for the digital mammography systems. Furthermore, technological advancement is phasing out the use of screen-film mammography and replacing it with digital mammography systems. This study aims to establish the local DRLs used in digital mammography across three institutions in Ghana to guide mammography practice. METHODS Average glandular dose (AGD), compressed breast thickness (CBT), age of patients, entrance surface exposure (ESE), kVp, and mAs were retrospectively extracted from three digital mammography systems. The 75th and 95th percentile values were obtained for the AGD of each mammography projection and at CBT of 60 ± 5 mm. The correlation between the AGD and CBT, kVp, mAs, and ESE were investigated. RESULTS The 75th percentile for the AGD at CBT of 60 ± 5 mm for Centres 1, 2, 3, and all centres were 2.3, 1.8, 2.1, and 2.0 mGy respectively. The DRLs obtained were comparably higher than international studies except those of the United Kingdom. The AGD showed a strong positive correlation with the CBT, kVp, mAs, and ESE. There was variability in the AGD applied across the three centres for the craniocaudal (CC) and mediolateral oblique (MLO) projections. The mean AGD, mAs, and ESE for all the three centres and per centre recorded were higher than previous studies, but the mean kVp and CBT were lower than previous studies. CONCLUSION The higher DRLs estimated in this preliminary study indicates that there is a need for dose optimisation in digital mammography practice in Ghana to improve radiation protection. IMPLICATIONS FOR PRACTICE The findings will guide the process of optimisation and limit the variations in the radiation dose during mammography practice.
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Affiliation(s)
- E Dzidzornu
- Department of Medical Imaging, School of Allied Health Sciences, University of Health and Allied Sciences (UHAS), Ho, Ghana. https://twitter.com/BettyManteaw
| | - S K Angmorterh
- Department of Medical Imaging, School of Allied Health Sciences, University of Health and Allied Sciences (UHAS), Ho, Ghana.
| | - B B Ofori-Manteaw
- Department of Medical Imaging, School of Allied Health Sciences, University of Health and Allied Sciences (UHAS), Ho, Ghana. https://twitter.com/brytebarca
| | - S Aboagye
- Department of Speech, Language & Hearing Sciences, School of Allied Health Sciences, University of Health and Allied Sciences (UHAS), Ho, Ghana
| | - K Dzefi-Tettey
- Radiology Department, Korle-Bu Teaching Hospital, Accra, Ghana
| | - E K Ofori
- Department of Medical Imaging, School of Allied Health Sciences, University of Health and Allied Sciences (UHAS), Ho, Ghana
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Manley H, Mutasa S, Chang P, Desperito E, Crew K, Ha R. Dynamic Changes of Convolutional Neural Network-based Mammographic Breast Cancer Risk Score Among Women Undergoing Chemoprevention Treatment. Clin Breast Cancer 2020; 21:e312-e318. [PMID: 33277192 DOI: 10.1016/j.clbc.2020.11.007] [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: 07/28/2020] [Revised: 11/04/2020] [Accepted: 11/10/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION We investigated whether our convolutional neural network (CNN)-based breast cancer risk model is modifiable by testing it on women who had undergone risk-reducing chemoprevention treatment. MATERIALS AND METHODS We conducted a retrospective cohort study of patients diagnosed with atypical hyperplasia, lobular carcinoma in situ, or ductal carcinoma in situ at our institution from 2007 to 2015. The clinical characteristics, chemoprevention use, and mammography images were extracted from the electronic health records. We classified two groups according to chemoprevention use. Mammograms were performed at baseline and subsequent follow-up evaluations for input to our CNN risk model. The 2 chemoprevention groups were compared for the risk score change from baseline to follow-up. The change categories included stayed high risk, stayed low risk, increased from low to high risk, and decreased from high to low risk. Unordered polytomous regression models were used for statistical analysis, with P < .05 considered statistically significant. RESULTS Of 541 patients, 184 (34%) had undergone chemoprevention treatment (group 1) and 357 (66%) had not (group 2). Using our CNN breast cancer risk score, significantly more women in group 1 had shown a decrease in breast cancer risk compared with group 2 (33.7% vs. 22.9%; P < .01). Significantly fewer women in group 1 had an increase in breast cancer risk compared with group 2 (11.4% vs. 20.2%; P < .01). On multivariate analysis, an increase in breast cancer risk predicted by our model correlated negatively with the use of chemoprevention treatment (P = .02). CONCLUSIONS Our CNN-based breast cancer risk score is modifiable with potential utility in assessing the efficacy of known chemoprevention agents and testing new chemoprevention strategies.
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Affiliation(s)
- Haley Manley
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX
| | - Simukayi Mutasa
- Department of Radiology, New York-Presbyterian/Columbia University Medical Center, New York, NY
| | - Peter Chang
- Department of Radiological Sciences and Center for Artificial Intelligence in Diagnostic Medicine, University of California, Irvine, Irvine, CA
| | - Elise Desperito
- Department of Radiology, New York-Presbyterian/Columbia University Medical Center, New York, NY
| | - Katherine Crew
- Departments of Medicine and Epidemiology, New York-Presbyterian/Columbia University Medical Center, New York, NY
| | - Richard Ha
- Department of Radiology and Breast Imaging Section, New York-Presbyterian/Columbia University Medical Center, New York, NY.
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Bhatia S, Palomares MR, Hageman L, Chen Y, Landier W, Smith K, Umphrey H, Reich CA, Zamora KW, Armenian SH, Bevers TB, Blaes A, Henderson T, Hodgson D, Hudson MM, Korde LA, Melin SA, Merajver SD, Overholser L, Pruthi S, Wong FL, Garber JE. A Randomized Phase IIb Study of Low-dose Tamoxifen in Chest-irradiated Cancer Survivors at Risk for Breast Cancer. Clin Cancer Res 2020; 27:967-974. [PMID: 33272980 DOI: 10.1158/1078-0432.ccr-20-3609] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 11/11/2020] [Accepted: 11/30/2020] [Indexed: 11/16/2022]
Abstract
PURPOSE Low-dose tamoxifen reduces breast cancer risk, but remains untested in chest-irradiated cancer survivors-a population with breast cancer risk comparable with BRCA mutation carriers. We hypothesized that low-dose tamoxifen would be safe and efficacious in reducing radiation-related breast cancer risk. PATIENTS AND METHODS We conducted an investigator-initiated, randomized, phase IIb, double-blinded, placebo-controlled trial (FDA IND107367) between 2010 and 2016 at 15 U.S. sites. Eligibility included ≥12 Gy of chest radiation by age 40 years and age at enrollment ≥25 years. Patients were randomized 1:1 to low-dose tamoxifen (5 mg/day) or identical placebo tablets for 2 years. The primary endpoint was mammographic dense area at baseline, 1 and 2 years. IGF-1 plays a role in breast carcinogenesis; circulating IGF-1 and IGF-BP3 levels at baseline, 1 and 2 years served as secondary endpoints. RESULTS Seventy-two participants (low-dose tamoxifen: n = 34, placebo: n = 38) enrolled at a median age of 43.8 years (35-49) were evaluable. They had received chest radiation at a median dose of 30.3 Gy. Compared with the placebo arm, the low-dose tamoxifen arm participants had significantly lower mammographic dense area (P = 0.02) and IGF1 levels (P < 0.0001), and higher IGFBP-3 levels (P = 0.02). There was no difference in toxicity biomarkers (serum bone-specific alkaline phosphatase, lipids, and antithrombin III; urine N-telopeptide cross-links) between the treatment arms. We did not identify any grade 3-4 adverse events related to low-dose tamoxifen. CONCLUSIONS In this randomized trial in chest-irradiated cancer survivors, we find that low-dose tamoxifen is effective in reducing established biomarkers of breast cancer risk and could serve as a risk-reduction strategy.
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Affiliation(s)
- Smita Bhatia
- University of Alabama at Birmingham, Birmingham, Alabama.
| | | | | | - Yanjun Chen
- University of Alabama at Birmingham, Birmingham, Alabama
| | - Wendy Landier
- University of Alabama at Birmingham, Birmingham, Alabama
| | - Kandice Smith
- University of Alabama at Birmingham, Birmingham, Alabama
| | | | | | | | | | - Therese B Bevers
- The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Anne Blaes
- University of Minnesota, Minneapolis, Minnesota
| | | | | | | | | | - Susan A Melin
- Wake Forest School of Medicine, Winston-Salem, North Carolina
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Azzam H, Kamal RM, Hanafy MM, Youssef A, Hashem LMB. Comparative study between contrast-enhanced mammography, tomosynthesis, and breast ultrasound as complementary techniques to mammography in dense breast parenchyma. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2020. [DOI: 10.1186/s43055-020-00268-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Abstract
Background
Mammography is accused of having low sensitivity and specificity in dense breast parenchyma. Also, women with dense breasts show an increased risk of developing breast cancer. Breast ultrasound has been used for several years for a better characterization of breast lesions. Contrast-enhanced mammography and tomosynthesis are relative novel imaging techniques that have been implicated in breast cancer detection and diagnosis. We aimed to compare breast tomosynthesis, contrast-enhanced mammography, and breast ultrasound as complementary techniques to mammography in dense breast parenchyma.
Results
The study included 37 patients with 63 inconclusive mammography breast lesions. They all performed contrast-enhanced mammography, single-view tomosynthesis, and breast ultrasound. Mammography had a sensitivity of 83%, a specificity of 48%, a positive predictive value of 68%, a negative predictive value of 68%, and a diagnostic accuracy of 68%. Contrast-enhanced mammography had a sensitivity of 89%, a specificity of 89%, a positive predictive value of 91%, a negative predictive value of 86%, and a diagnostic accuracy of 89%. Tomosynthesis had a sensitivity of 86%, a specificity of 81%, a positive predictive value of 86%, a negative predictive value of 81%, and a diagnostic accuracy of 84%. Breast ultrasound had a sensitivity of 97%, a specificity of 85%, a positive predictive value of 90%, a negative predictive value of 96%, and a diagnostic accuracy of 92%.
Conclusion
Breast ultrasound, tomosynthesis, and contrast-enhanced mammography showed better performance compared to mammography in dense breasts. However, ultrasound being safe with no radiation hazards should be the second step modality of choice after mammography in the assessment of mammography dense breasts. Adding tomosynthesis to mammography in screening increases its sensitivity. Contrast-enhanced mammography should be reserved for cases with inconclusive sonomammographic results.
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Mishra J, Kumar B, Targhotra M, Sahoo PK. Advanced and futuristic approaches for breast cancer diagnosis. FUTURE JOURNAL OF PHARMACEUTICAL SCIENCES 2020. [DOI: 10.1186/s43094-020-00113-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Breast cancer is the most frequent cancer and one of the most common causes of death in women, impacting almost 2 million women each year. Tenacity or perseverance of breast cancer in women is very high these days with an extensive increasing rate of 3 to 5% every year. Along with hurdles faced during treatment of breast tumor, one of the crucial causes of delay in treatment is invasive and poor diagnostic techniques for breast cancer hence the early diagnosis of breast tumors will help us to improve its management and treatment in the initial stage.
Main body
Present review aims to explore diagnostic techniques for breast cancer that are currently being used, recent advancements that aids in prior detection and evaluation and are extensively focused on techniques that are going to be future of breast cancer detection with better efficiency and lesser pain to patients so that it helps to a physician to prevent delay in treatment of cancer. Here, we have discussed mammography and its advanced forms that are the need of current era, techniques involving radiation such as radionuclide methods, the potential of nanotechnology by using nanoparticle in breast cancer, and how the new inventions such as breath biopsy, and X-ray diffraction of hair can simply use as a prominent method in breast cancer early and easy detection tool.
Conclusion
It is observed significantly that advancement in detection techniques is helping in early diagnosis of breast cancer; however, we have to also focus on techniques that will improve the future of cancer diagnosis in like optical imaging and HER2 testing.
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Moshina N, Aase HS, Danielsen AS, Haldorsen IS, Lee CI, Zackrisson S, Hofvind S. Comparing Screening Outcomes for Digital Breast Tomosynthesis and Digital Mammography by Automated Breast Density in a Randomized Controlled Trial: Results from the To-Be Trial. Radiology 2020; 297:522-531. [DOI: 10.1148/radiol.2020201150] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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The Physiological MicroRNA Landscape in Nipple Aspirate Fluid: Differences and Similarities with Breast Tissue, Breast Milk, Plasma and Serum. Int J Mol Sci 2020; 21:ijms21228466. [PMID: 33187146 PMCID: PMC7696615 DOI: 10.3390/ijms21228466] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 11/06/2020] [Accepted: 11/09/2020] [Indexed: 02/06/2023] Open
Abstract
Background: MicroRNAs (miRNAs) target 60% of human messenger RNAs and can be detected in tissues and biofluids without loss of stability during sample processing, making them highly appraised upcoming biomarkers for evaluation of disease. However, reporting of the abundantly expressed miRNAs in healthy samples is often surpassed. Here, we characterized for the first time the physiological miRNA landscape in a biofluid of the healthy breast: nipple aspirate fluid (NAF), and compared NAF miRNA expression patterns with publically available miRNA expression profiles of healthy breast tissue, breast milk, plasma and serum. Methods: MiRNA RT-qPCR profiling of NAF (n = 41) and serum (n = 23) samples from two healthy female cohorts was performed using the TaqMan OpenArray Human Advanced MicroRNA 754-Panel. MiRNA quantification data based on non-targeted or multi-targeted profiling techniques for breast tissue, breast milk, plasma and serum were retrieved from the literature by means of a systematic search. MiRNAs from each individual study were orderly ranked between 1 and 50, combined into an overall ranking per sample type and compared. Results: NAF expressed 11 unique miRNAs and shared 21/50 miRNAs with breast tissue. Seven miRNAs were shared between the five sample types. Overlap between sample types varied between 42% and 62%. Highly ranked NAF miRNAs have established roles in breast carcinogenesis. Conclusion: This is the first study to characterize and compare the unique physiological NAF-derived miRNA landscape with the physiological expression pattern in breast tissue, breast milk, plasma and serum. Breast-specific sources did not mutually overlap more than with systemic sources. Given their established role in carcinogenesis, NAF miRNA assessment could be a valuable tool in breast tumor diagnostics.
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Vernet-Tomás M, Louro J, Román M, Saladié F, Posso M, Prieto M, Vázquez I, Baré M, Peñalva L, Vidal C, Bargalló X, Sánchez M, Ferrer J, A Espinàs J, Quintana MJ, Rodríguez-Arana A, Castells X. Risk of breast cancer two years after a benign biopsy depends on the mammographic feature prompting recall. Maturitas 2020; 144:53-59. [PMID: 33358209 DOI: 10.1016/j.maturitas.2020.10.024] [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: 08/01/2019] [Revised: 08/04/2020] [Accepted: 10/30/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVE We aimed to explore whether the type of mammographic feature prompting a false-positive recall (FPR) during mammography screening influences the risk and timing of breast cancer diagnosis, particularly if assessed with invasive procedures. STUDY DESIGN We included information on women screened and recalled for further assessment in Spain between 1994 and 2015, with follow-up until 2017, categorizing FPRs by the assessment (noninvasive or invasive) and mammographic feature prompting the recall. MAIN OUTCOME MEASURES Breast cancer rates in the first two years after FPR (first period) and after two years (second period). RESULTS The study included 99,825 women with FPRs. In both periods, the breast cancer rate was higher in the invasive assessment group than in the noninvasive group (first period 12 ‰ vs 1.9 ‰, p < 0.001; second period 4.4‰ vs 3.1‰, p < 0.001). During the first period, the invasive assessment group showed diverse breast cancer rates for each type of mammographic feature, with a higher rate for asymmetric density (31.9‰). When the second period was compared with the first, the breast cancer rate decreased in the invasive assessment group (from 12‰ to 4.4‰, p < 0.001) and increased in the noninvasive assessment group (from 1.9‰ to 3.1‰, p < 0.001). CONCLUSION In the context of mammography screening, the risk of breast cancer diagnosis during the first two years after FPR was particularly high for women undergoing invasive assessment; importantly, the risk was modified by type of mammographic feature prompting the recall. This information could help to individualize follow-up after exclusion of malignancy.
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Affiliation(s)
- Maria Vernet-Tomás
- Institut Hospital del Mar d'Investigacions Mèdiques (IMIM). Dr. Aiguader 88, 08003, Barcelona, Spain.
| | - Javier Louro
- Institut Hospital del Mar d'Investigacions Mèdiques (IMIM). Dr. Aiguader 88, 08003, Barcelona, Spain; Research Network on Health Services in Chronic Diseases (REDISSEC), Barcelona, Spain
| | - Marta Román
- Institut Hospital del Mar d'Investigacions Mèdiques (IMIM). Dr. Aiguader 88, 08003, Barcelona, Spain; Research Network on Health Services in Chronic Diseases (REDISSEC), Barcelona, Spain
| | - Francina Saladié
- Fundació Lliga per a La Investigació i Prevenció del Càncer (FUNCA), Avinguda Josep Laporte, 2, 43204, Reus, Spain
| | - Margarita Posso
- Institut Hospital del Mar d'Investigacions Mèdiques (IMIM). Dr. Aiguader 88, 08003, Barcelona, Spain; Research Network on Health Services in Chronic Diseases (REDISSEC), Barcelona, Spain
| | - Miguel Prieto
- Consejería de Sanidad, Gobierno de Asturias. Calle Ciriaco Miguel Vigil, 9, 33005, Oviedo, Spain
| | - Ivonne Vázquez
- Institut Hospital del Mar d'Investigacions Mèdiques (IMIM). Dr. Aiguader 88, 08003, Barcelona, Spain
| | - Marisa Baré
- Consorci Corporació Sanitaria Parc Taulí, Parc Taulí, 1, 08208, Sabadell, Spain
| | - Lupe Peñalva
- Hospital General de Granollers, Av. Francesc Ribas, s/n, 08402, Granollers, Spain
| | - Carmen Vidal
- Programa de Prevenció i Control del Càncer de l'Institut Català d'Oncologia, Gran Via de l'Hospitalet, 199-203, 08908, L'Hospitalet de Llobregat, Spain
| | - Xavier Bargalló
- Centro de Diagnóstico por la Imagen Clínic (CDIC) del Hospital Clínic de Barcelona. Calle Villarroel 170, 08036, Barcelona, Spain
| | - Mar Sánchez
- Dirección General de Salud Pública del Gobierno de Cantabria, C/ Federico Vial 13, 39009, Santander, Spain
| | - Joana Ferrer
- Hospital de Santa Caterina, Carrer del Dr. Castany, s/n, 17190, Salt, Girona, Spain
| | - Josep A Espinàs
- Pla Director d'Oncologia del Departament de Salut de la Generalitat de Catalunya, Travessera de les Corts, 131-159, 08028, Barcelona, Spain
| | - M Jesús Quintana
- Departament d'Epidemiologia de l'Hospital de la Santa Creu i Sant Pau, c/ San Antoni M. Claret 167, 08025, Barcelona, Spain
| | - Ana Rodríguez-Arana
- Institut Hospital del Mar d'Investigacions Mèdiques (IMIM). Dr. Aiguader 88, 08003, Barcelona, Spain
| | - Xavier Castells
- Institut Hospital del Mar d'Investigacions Mèdiques (IMIM). Dr. Aiguader 88, 08003, Barcelona, Spain; Research Network on Health Services in Chronic Diseases (REDISSEC), Barcelona, Spain
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Individualized-thresholding Shear Wave Elastography combined with clinical factors improves specificity in discriminating breast masses. Breast 2020; 54:248-255. [PMID: 33188991 PMCID: PMC7670190 DOI: 10.1016/j.breast.2020.10.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 10/27/2020] [Accepted: 10/28/2020] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To investigate the diagnostic role of new metrics, defined as individualized-thresholding of Shear Wave Elastography (SWE) parameters, in association with clinical factors (such as age, mammographic density, lesion size and depth) and the BI-RADS features in differentiating benign from malignant breast lesions. METHODS Of 644 consecutive patients (median age, 55 years), prospectively referred for evaluation, 659 ultrasound detected breast lesions underwent SWE measurements. Multivariable logistic regression analysis was used to estimate the probability of malignancy. The area under the curve (AUC), optimal cutoff value, and the corresponding sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were determined. RESULTS 265 of 659 (40.2%) masses were malignant. Using two Emean cutoffs, 69.6 kPa for large superficial lesions (size >10 mm, depth ≤5 mm) and 39.2 kPa for the rest, the overall specificity, sensitivity, PPV and NPV were 92.6%, 86.8%, 88.8% and 91.3%, respectively. Combining multiple factors, including Emean with two cutoffs, age and BI-RADS, the new ROC curve based on the malignancy probability calculation showed the highest AUC (0.954, 95% CI: 0.938-0.969). Using the optimal probability threshold of 0.514, the corresponding specificity, sensitivity, PPV and NPV were 92.9%, 89.1%, 89.4% and 92.7%, respectively. CONCLUSIONS The false-positive rate can be significantly reduced when applying two Emean cutoffs based on lesion size and depth. Moreover, the combination of age, Emean with two cutoffs and BI-RADS can further reduce the false negatives and false positives. Overall, this multifactorial analysis improves the specificity of ultrasound while maintaining a high sensitivity.
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Khorshid Shamshiri A, Afzaljavan F, Alidoust M, Taherian V, Vakili F, Moezzi A, Homaei Shandiz F, Farrokh D, Pasdar A. ESR1 gene variants, haplotypes and diplotypes may influence the risk of breast cancer and mammographic density. Mol Biol Rep 2020; 47:8367-8375. [PMID: 33099762 DOI: 10.1007/s11033-020-05823-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 09/07/2020] [Indexed: 12/24/2022]
Abstract
Breast cancer as the most common cancer worldwide is influenced by genetic and physiological factors. Based on some evidence indicating the role of estrogen receptor 1 gene (ESR1) in breast cancer development, in this study, the association of three common variations in ESR1 gene with breast cancer and density in an Iranian population was evaluated. In a case-control study, 400 blood samples were collected for DNA extraction and genotyping. Breast density was assessed using mammography. ESR1 rs6915267 (G/A), rs2077647 (C/T) and rs1801132 (C/G) were genotyped using ARMS-PCR method. PHASE program was used to estimate the haplotypes frequencies. Our data analysis showed rs6915267 GA genotype in the heterozygous (GA) as well as co-dominant models was associated with lower mammographic density. None of the three variations were associated with the breast cancer risk. Haplotype analysis indicated G-T-C haplotype of rs6915267, rs2077647 and rs1801132 [OR = 0.54, 95% CI (0.31-0.92), p = 0.025] and G-T/G-T diplotype of rs6915267-rs2077647 [OR = 0.38, 95% CI (0.17-0.86), p = 0.019] were associated with a decreased risk of breast cancer. ESR1 may affect density of the breast and its haplotypes may modulate breast cancer risk.
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Affiliation(s)
- Asma Khorshid Shamshiri
- Department of Medical Genetics and Molecular Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.,Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fahimeh Afzaljavan
- Department of Medical Genetics and Molecular Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.,Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maryam Alidoust
- Department of Medical Genetics and Molecular Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Vahideh Taherian
- Department of Medical Genetics and Molecular Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fatemeh Vakili
- Midwifery department, Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Atefeh Moezzi
- Department of Medical Genetics and Molecular Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.,Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Donya Farrokh
- Department of Radiology, Faculty of Medicine, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Alireza Pasdar
- Department of Medical Genetics and Molecular Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. .,Division of Applied Medicine, Medical School, University of Aberdeen, Foresterhill, AB25 2ZD, Aberdeen, UK. .,Bioinformatics Research Group, Mashhad University of Medical Sciences, Mashhad, Iran.
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Winkler J, Abisoye-Ogunniyan A, Metcalf KJ, Werb Z. Concepts of extracellular matrix remodelling in tumour progression and metastasis. Nat Commun 2020; 11:5120. [PMID: 33037194 PMCID: PMC7547708 DOI: 10.1038/s41467-020-18794-x] [Citation(s) in RCA: 953] [Impact Index Per Article: 238.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Accepted: 09/15/2020] [Indexed: 02/06/2023] Open
Abstract
Tissues are dynamically shaped by bidirectional communication between resident cells and the extracellular matrix (ECM) through cell-matrix interactions and ECM remodelling. Tumours leverage ECM remodelling to create a microenvironment that promotes tumourigenesis and metastasis. In this review, we focus on how tumour and tumour-associated stromal cells deposit, biochemically and biophysically modify, and degrade tumour-associated ECM. These tumour-driven changes support tumour growth, increase migration of tumour cells, and remodel the ECM in distant organs to allow for metastatic progression. A better understanding of the underlying mechanisms of tumourigenic ECM remodelling is crucial for developing therapeutic treatments for patients. Tumors are more than cancer cells — the extracellular matrix is a protein structure that organizes all tissues and is altered in cancer. Here, the authors review recent progress in understanding how the cancer cells and tumor-associated stroma cells remodel the extracellular matrix to drive tumor growth and metastasis.
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Affiliation(s)
- Juliane Winkler
- Department of Anatomy, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA, 94143, USA.
| | - Abisola Abisoye-Ogunniyan
- Department of Anatomy, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA, 94143, USA
| | - Kevin J Metcalf
- Department of Anatomy, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA, 94143, USA
| | - Zena Werb
- Department of Anatomy, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA, 94143, USA
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Liu C, Zhao Q, Yu X. Bone Marrow Adipocytes, Adipocytokines, and Breast Cancer Cells: Novel Implications in Bone Metastasis of Breast Cancer. Front Oncol 2020; 10:561595. [PMID: 33123472 PMCID: PMC7566900 DOI: 10.3389/fonc.2020.561595] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 08/27/2020] [Indexed: 02/05/2023] Open
Abstract
Accumulating discoveries highlight the importance of interaction between marrow stromal cells and cancer cells for bone metastasis. Bone is the most common metastatic site of breast cancer and bone marrow adipocytes (BMAs) are the most abundant component of the bone marrow microenvironment. BMAs are unique in their origin and location, and recently they are found to serve as an endocrine organ that secretes adipokines, cytokines, chemokines, and growth factors. It is reasonable to speculate that BMAs contribute to the modification of bone metastatic microenvironment and affecting metastatic breast cancer cells in the bone marrow. Indeed, BMAs may participate in bone metastasis of breast cancer through regulation of recruitment, invasion, survival, colonization, proliferation, angiogenesis, and immune modulation by their production of various adipocytokines. In this review, we provide an overview of research progress, focusing on adipocytokines secreted by BMAs and their potential roles for bone metastasis of breast cancer, and investigating the mechanisms mediating the interaction between BMAs and metastatic breast cancer cells. Based on current findings, BMAs may function as a pivotal modulator of bone metastasis of breast cancer, therefore targeting BMAs combined with conventional treatment programs might present a promising therapeutic option.
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Affiliation(s)
- Chang Liu
- Department of Endocrinology and Metabolism, Laboratory of Endocrinology and Metabolism, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Qian Zhao
- Department of Endocrinology and Metabolism, Laboratory of Endocrinology and Metabolism, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China.,Department of General Practice, West China Hospital, Sichuan University, Chengdu, China
| | - Xijie Yu
- Department of Endocrinology and Metabolism, Laboratory of Endocrinology and Metabolism, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
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Lee Argov EJ, Acheampong T, Terry MB, Rodriguez CB, Agovino M, Wei Y, Athilat S, Tehranifar P. Independent and joint cross-sectional associations of statin and metformin use with mammographic breast density. Breast Cancer Res 2020; 22:99. [PMID: 32933550 PMCID: PMC7493153 DOI: 10.1186/s13058-020-01336-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 09/02/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Well-tolerated and commonly used medications are increasingly assessed for reducing breast cancer risk. These include metformin and statins, both linked to reduced hormone availability and cell proliferation or growth and sometimes prescribed concurrently. We investigated independent and joint associations of these medications with mammographic breast density (MBD), a useful biomarker for the effect of chemopreventive agents on breast cancer risk. METHODS Using data from a cross-sectional study of 770 women (78% Hispanic, aged 40-61 years, in a mammography cohort with high cardiometabolic burden), we examined the association of self-reported "ever" use of statins and metformin with MBD measured via clinical Breast Imaging Reporting and Data System (BI-RADS) density classifications (relative risk regression) and continuous semi-automated percent and size of dense area (Cumulus) (linear regression), adjusted for age, body mass index, education, race, menopausal status, age at first birth, and insulin use. RESULTS We observed high statin (27%), metformin (13%), and combination (9%) use, and most participants were overweight/obese (83%) and parous (87%). Statin use was associated with a lower likelihood of high density BI-RADS (RR = 0.60, 95% CI = 0.45 to 0.80), percent dense area (PD) (β = - 6.56, 95% CI = - 9.05 to - 4.06), and dense area (DA) (β = - 9.05, 95% CI = - 14.89 to - 3.22). Metformin use was associated with lower PD and higher non-dense area (NDA), but associations were attenuated by co-medication with statins. Compared to non-use of either medication, statin use alone or with metformin were associated with lower PD and DA (e.g., β = - 6.86, 95% CI: - 9.67, - 4.05 and β = - 7.07, 95% CI: - 10.97, - 3.17, respectively, for PD) and higher NDA (β = 25.05, 95% CI: 14.06, 36.03; β = 29.76, 95% CI: 14.55, 44.96, respectively). CONCLUSIONS Statin use was consistently associated with lower MBD, measured both through clinical radiologist assessment and continuous relative and absolute measures, including dense area. Metformin use was associated with lower PD and higher NDA, but this may be driven by co-medication with statins. These results support that statins may lower MBD but need confirmation with prospective and clinical data to distinguish the results of medication use from that of disease.
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Affiliation(s)
- Erica J Lee Argov
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 W 168th St, New York, NY, USA
| | - Teofilia Acheampong
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 W 168th St, New York, NY, USA
| | - Mary Beth Terry
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 W 168th St, New York, NY, USA
| | - Carmen B Rodriguez
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 W 168th St, New York, NY, USA
| | - Mariangela Agovino
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 W 168th St, New York, NY, USA
| | - Ying Wei
- Department of Biostatistics, Columbia University Mailman School of Public Health, 722 W 168th St, New York, NY, USA
| | - Shweta Athilat
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 W 168th St, New York, NY, USA
| | - Parisa Tehranifar
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 W 168th St, New York, NY, USA.
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McGrowder DA, Miller FG, Nwokocha CR, Anderson MS, Wilson-Clarke C, Vaz K, Anderson-Jackson L, Brown J. Medicinal Herbs Used in Traditional Management of Breast Cancer: Mechanisms of Action. MEDICINES (BASEL, SWITZERLAND) 2020; 7:E47. [PMID: 32823812 PMCID: PMC7460502 DOI: 10.3390/medicines7080047] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 07/29/2020] [Accepted: 08/09/2020] [Indexed: 02/06/2023]
Abstract
Background: Breast cancer is one of the principal causes of death among women and there is a pressing need to develop novel and effective anti-cancer agents. Natural plant products have shown promising results as anti-cancer agents. Their effectiveness is reported as decreased toxicity in usage, along with safety and less recurrent resistances compared with hormonal targeting anti-cancer agents. Methods: A literature search was conducted for all English-language literature published prior to June 2020. The search was conducted using electronic databases, including PubMed, Embase, Web of Science, and Cochrane Library. The search strategy included keywords such as breast cancer, herbs, anti-cancer biologically active components, clinical research, chemotherapy drugs amongst others. Results: The literature provides documented evidence of the chemo-preventative and chemotherapeutic properties of Ginseng, garlic (Allium sativum), Black cohosh (Actaea racemose), Tumeric (Curcuma longa), Camellia sinenis (green tea), Echinacea, Arctium (burdock), Flaxseed (Linum usitatissimum) and Black Cumin (Nigella sativa). Conclusions: The nine herbs displayed anti-cancer properties and their outcomes and mechanisms of action include inhibition of cell proliferation, angiogenesis and apoptosis as well as modulation of key intracellular pathways. However, more clinical trials and cohort human studies should be conducted to provide key evidence of their medical benefits.
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Affiliation(s)
- Donovan A. McGrowder
- Department of Pathology, Faculty of Medical Sciences, The University of the West Indies, Kingston 7, Jamaica; (K.V.); (L.A.-J.); (J.B.)
| | - Fabian G. Miller
- Department of Physical Education, Faculty of Education, The Mico University College, 1A Marescaux Road, Kingston 5, Jamaica;
- Department of Biotechnology, Faculty of Science and Technology, The University of the West Indies, Kingston 7, Jamaica
| | - Chukwuemeka R. Nwokocha
- Department of Basic Medical Sciences, Faculty of Medical Sciences, The University of the West Indies, Kingston 7, Jamaica; (C.R.N.); (C.W.-C.)
| | - Melisa S. Anderson
- School of Allied Health and Wellness, College of Health Sciences, University of Technology, Kingston 7, Jamaica;
| | - Cameil Wilson-Clarke
- Department of Basic Medical Sciences, Faculty of Medical Sciences, The University of the West Indies, Kingston 7, Jamaica; (C.R.N.); (C.W.-C.)
| | - Kurt Vaz
- Department of Pathology, Faculty of Medical Sciences, The University of the West Indies, Kingston 7, Jamaica; (K.V.); (L.A.-J.); (J.B.)
| | - Lennox Anderson-Jackson
- Department of Pathology, Faculty of Medical Sciences, The University of the West Indies, Kingston 7, Jamaica; (K.V.); (L.A.-J.); (J.B.)
| | - Jabari Brown
- Department of Pathology, Faculty of Medical Sciences, The University of the West Indies, Kingston 7, Jamaica; (K.V.); (L.A.-J.); (J.B.)
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Kim EY, Chang Y, Ahn J, Yun JS, Park YL, Park CH, Shin H, Ryu S. Mammographic breast density, its changes, and breast cancer risk in premenopausal and postmenopausal women. Cancer 2020; 126:4687-4696. [PMID: 32767699 DOI: 10.1002/cncr.33138] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 07/05/2020] [Accepted: 07/06/2020] [Indexed: 01/06/2023]
Abstract
BACKGROUND The risk of breast cancer related to changes in breast density over time, including its regression and persistence, remains controversial. The authors investigated the relationship between breast density and its changes over time with the development of breast cancer in premenopausal and postmenopausal women. METHODS The current cohort study included 74,249 middle-aged Korean women (aged ≥35 years) who were free of breast cancer at baseline and who underwent repeated screening mammograms. Mammographic breast density was categorized according to the American College of Radiology Breast Imaging Reporting and Data System (BI-RADS). A dense breast was defined as heterogeneously dense or extremely dense, and changes in dense breasts between baseline and subsequent follow-up were classified as none, developed, regressed, or persistent dense breast. RESULTS During a median follow-up of 6.1 years (interquartile range, 4.1-8.8 years), a total of 803 incident breast cancers were identified. Baseline breast density was found to be positively associated with incident breast cancer in a dose-response manner, and this association did not significantly differ by menopausal status. The multivariable-adjusted hazard ratios (HRs) for breast cancer comparing "heterogeneously dense" and "extremely dense" categories with the nondense category were 1.96 (95% confidence interval [95% CI], 1.40-2.75) and 2.86 (95% CI, 2.04-4.01), respectively. With respect to changes in dense breasts over time, multivariable-adjusted HRs for breast cancer comparing persistent dense breast with none were 2.37 (95% CI, 1.34-4.21) in premenopausal women and 3.61 (95% CI, 1.78-7.30) in postmenopausal women. CONCLUSIONS Both baseline dense breasts and their persistence over time were found to be strongly associated with an increased risk of incident breast cancer in premenopausal and postmenopausal women. LAY SUMMARY Both baseline breast density and its changes over time were found to be independently associated with the risk of breast cancer in both premenopausal and postmenopausal women. The risk of incident breast cancer increased in women with persistent dense breasts, whereas the breast cancer risk decreased as dense breasts regressed. The findings of the current study support that both dense breasts at baseline and their persistence over time are independent risk factors for developing breast cancer.
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Affiliation(s)
- Eun Young Kim
- Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Yoosoo Chang
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.,Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.,Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Republic of Korea
| | - Jiin Ahn
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Ji-Sup Yun
- Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Yong Lai Park
- Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Chan Heun Park
- Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hocheol Shin
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.,Department of Family Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Seungho Ryu
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.,Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.,Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Republic of Korea
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Cheasley D, Devereux L, Hughes S, Nickson C, Procopio P, Lee G, Li N, Pridmore V, Elder K, Bruce Mann G, Kader T, Rowley SM, Fox SB, Byrne D, Saunders H, Fujihara KM, Lim B, Gorringe KL, Campbell IG. The TP53 mutation rate differs in breast cancers that arise in women with high or low mammographic density. NPJ Breast Cancer 2020; 6:34. [PMID: 32802943 PMCID: PMC7414106 DOI: 10.1038/s41523-020-00176-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Accepted: 07/13/2020] [Indexed: 01/01/2023] Open
Abstract
Mammographic density (MD) influences breast cancer risk, but how this is mediated is unknown. Molecular differences between breast cancers arising in the context of the lowest and highest quintiles of mammographic density may identify the mechanism through which MD drives breast cancer development. Women diagnosed with invasive or in situ breast cancer where MD measurement was also available (n = 842) were identified from the Lifepool cohort of >54,000 women participating in population-based mammographic screening. This group included 142 carcinomas in the lowest quintile of MD and 119 carcinomas in the highest quintile. Clinico-pathological and family history information were recorded. Tumor DNA was collected where available (n = 56) and sequenced for breast cancer predisposition and driver gene mutations, including copy number alterations. Compared to carcinomas from low-MD breasts, those from high-MD breasts were significantly associated with a younger age at diagnosis and features associated with poor prognosis. Low- and high-MD carcinomas matched for grade, histological subtype, and hormone receptor status were compared for somatic genetic features. Low-MD carcinomas had a significantly increased frequency of TP53 mutations, higher homologous recombination deficiency, higher fraction of the genome altered, and more copy number gains on chromosome 1q and losses on 17p. While high-MD carcinomas showed enrichment of tumor-infiltrating lymphocytes in the stroma. The data demonstrate that when tumors were matched for confounding clinico-pathological features, a proportion in the lowest quintile of MD appear biologically distinct, reflective of microenvironment differences between the lowest and highest quintiles of MD.
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Affiliation(s)
- Dane Cheasley
- Cancer Genetics Laboratory, Peter MacCallum Cancer Centre, Melbourne, VIC Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC Australia
| | - Lisa Devereux
- Cancer Genetics Laboratory, Peter MacCallum Cancer Centre, Melbourne, VIC Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC Australia
- Lifepool, Peter MacCallum Cancer Centre, Melbourne, VIC Australia
| | - Siobhan Hughes
- Cancer Genetics Laboratory, Peter MacCallum Cancer Centre, Melbourne, VIC Australia
| | - Carolyn Nickson
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC Australia
- Cancer Research Division, Cancer Council NSW, Sydney, NSW Australia
- Sydney School of Public Health, University of Sydney, Sydney, NSW Australia
| | - Pietro Procopio
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC Australia
- Cancer Research Division, Cancer Council NSW, Sydney, NSW Australia
- Sydney School of Public Health, University of Sydney, Sydney, NSW Australia
| | - Grant Lee
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC Australia
| | - Na Li
- Cancer Genetics Laboratory, Peter MacCallum Cancer Centre, Melbourne, VIC Australia
| | | | - Kenneth Elder
- Department of Surgery, University of Melbourne, Melbourne, VIC Australia
- The Royal Melbourne and Royal Women’s Hospitals, Parkville, VIC Australia
- The Edinburgh Breast Unit, Western General Hospital, Edinburgh, UK
| | - G. Bruce Mann
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC Australia
- Department of Surgery, University of Melbourne, Melbourne, VIC Australia
- The Royal Melbourne and Royal Women’s Hospitals, Parkville, VIC Australia
| | - Tanjina Kader
- Cancer Genetics Laboratory, Peter MacCallum Cancer Centre, Melbourne, VIC Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC Australia
| | - Simone M. Rowley
- Cancer Genetics Laboratory, Peter MacCallum Cancer Centre, Melbourne, VIC Australia
| | - Stephen B. Fox
- Department of Pathology, Peter MacCallum Cancer Centre, and University of Melbourne, Melbourne, VIC Australia
| | - David Byrne
- Department of Pathology, Peter MacCallum Cancer Centre, and University of Melbourne, Melbourne, VIC Australia
| | - Hugo Saunders
- Cancer Genetics Laboratory, Peter MacCallum Cancer Centre, Melbourne, VIC Australia
| | - Kenji M. Fujihara
- Cancer Genetics Laboratory, Peter MacCallum Cancer Centre, Melbourne, VIC Australia
| | - Belle Lim
- Cancer Genetics Laboratory, Peter MacCallum Cancer Centre, Melbourne, VIC Australia
- Drug Discovery Biology, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, VIC, Australia
| | - Kylie L. Gorringe
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC Australia
- Cancer Genetics and Genomics Program, Peter MacCallum Cancer Centre, Melbourne, VIC Australia
| | - Ian G. Campbell
- Cancer Genetics Laboratory, Peter MacCallum Cancer Centre, Melbourne, VIC Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC Australia
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Adedigba JA, Idowu BM, Hermans SP, Ibitoye BO, Pahwa S. Relationship between Mammographic Findings and Breast Abnormalities in a Nigerian Population. J Natl Med Assoc 2020; 113:77-87. [PMID: 32768243 DOI: 10.1016/j.jnma.2020.07.012] [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: 02/10/2020] [Revised: 07/05/2020] [Accepted: 07/11/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE This study aims to describe the mammographic findings in a population of Nigerian women and to explore the relationships between abnormal mammographic findings, breast malignancy, and breast composition. METHODOLOGY This was a retrospective study of consecutive mammograms carried out at Union Diagnostics and Clinical Services in Lagos, Nigeria from 2016 to 2018. Demographic information, indications for and findings on mammographic evaluation were obtained. A logistic regression fit model was used to establish the correlation between mammographic findings, breast density, and suspicion for breast malignancy (higher BIRADS scores). P ≤ 0.05 represented a statistically significant result. RESULTS A total of 304 patients were involved in this study (age range 20-80 years, mean age 49.0 ± 10.5 years). The patients between 40 and 49 years formed the largest age group with 128 patients (42.4%). Most patients were referred for a breast mass/lump (115/304-38.6%); 56 patients (18.8%) presenting for routine screening. The most common finding on the mammograms was BIRADS 4 in both breasts in 96 patients (31.6%). Most patients had heterogeneous breast density (195 patients - 64.1%). Multivariate logistic regression analysis showed a significant correlation between history of mass, poorly defined margins, and suspicion of malignancy. There was no statistically significant association between abnormal mammographic findings and higher breast density. CONCLUSION Poorly defined margins were positively correlated with BIRADS ratings suspicious for malignancy. The presence of a breast mass was positively correlated with a higher BIRADS score when other possible cofounding variables were not accounted for. Patient age did not correlate with breast density in this study.
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Affiliation(s)
| | - Bukunmi M Idowu
- Union Diagnostics and Clinical Services, Lagos 220005, Nigeria
| | - Sarah P Hermans
- Tulane University School of Medicine, New Orleans, LA 70112, USA
| | - Bolanle O Ibitoye
- Department of Radiology, Obafemi Awolowo University, Ile-Ife 220005, Nigeria
| | - Shivani Pahwa
- Department of Radiology, University Hospital Cleveland Medical Center, Cleveland, OH, USA
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133
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Wilson GJ, Fukuoka A, Love SR, Kim J, Pingen M, Hayes AJ, Graham GJ. Chemokine receptors coordinately regulate macrophage dynamics and mammary gland development. Development 2020; 147:dev187815. [PMID: 32467242 PMCID: PMC7328164 DOI: 10.1242/dev.187815] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 05/20/2020] [Indexed: 12/22/2022]
Abstract
Macrophages are key regulators of developmental processes, including those involved in mammary gland development. We have previously demonstrated that the atypical chemokine receptor ACKR2 contributes to the control of ductal epithelial branching in the developing mammary gland by regulating macrophage dynamics. ACKR2 is a chemokine-scavenging receptor that mediates its effects through collaboration with inflammatory chemokine receptors (iCCRs). Here, we reveal reciprocal regulation of branching morphogenesis in the mammary gland, whereby stromal ACKR2 modulates levels of the shared ligand CCL7 to control the movement of a key population of CCR1-expressing macrophages to the ductal epithelium. In addition, oestrogen, which is essential for ductal elongation during puberty, upregulates CCR1 expression on macrophages. The age at which girls develop breasts is decreasing, which raises the risk of diseases including breast cancer. This study presents a previously unknown mechanism controlling the rate of mammary gland development during puberty and highlights potential therapeutic targets.
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MESH Headings
- Animals
- Chemokine CCL3/deficiency
- Chemokine CCL3/genetics
- Chemokine CCL3/metabolism
- Chemokine CCL5/deficiency
- Chemokine CCL5/genetics
- Chemokine CCL5/metabolism
- Epithelium/metabolism
- Estradiol/pharmacology
- Female
- Lectins, C-Type/metabolism
- Macrophages/cytology
- Macrophages/metabolism
- Mammary Glands, Animal/growth & development
- Mammary Glands, Animal/metabolism
- Mannose Receptor
- Mannose-Binding Lectins/metabolism
- Mice
- Mice, Inbred C57BL
- Mice, Knockout
- Morphogenesis
- Receptors, CCR1/deficiency
- Receptors, CCR1/genetics
- Receptors, CCR1/metabolism
- Receptors, Cell Surface/metabolism
- Receptors, Chemokine/deficiency
- Receptors, Chemokine/genetics
- Receptors, Chemokine/metabolism
- Up-Regulation/drug effects
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Affiliation(s)
- Gillian J Wilson
- Chemokine Research Group, Institute of Infection, Immunity and Inflammation, University of Glasgow, 120 University Place, Glasgow G12 8TA, UK
| | - Ayumi Fukuoka
- Chemokine Research Group, Institute of Infection, Immunity and Inflammation, University of Glasgow, 120 University Place, Glasgow G12 8TA, UK
| | - Samantha R Love
- Chemokine Research Group, Institute of Infection, Immunity and Inflammation, University of Glasgow, 120 University Place, Glasgow G12 8TA, UK
| | - Jiwon Kim
- Chemokine Research Group, Institute of Infection, Immunity and Inflammation, University of Glasgow, 120 University Place, Glasgow G12 8TA, UK
- Department of Physiology, University of Toronto, Medical Sciences Building, 1 King's College Circle, Toronto, ON M5S 1A8, Canada
| | - Marieke Pingen
- Chemokine Research Group, Institute of Infection, Immunity and Inflammation, University of Glasgow, 120 University Place, Glasgow G12 8TA, UK
| | - Alan J Hayes
- Chemokine Research Group, Institute of Infection, Immunity and Inflammation, University of Glasgow, 120 University Place, Glasgow G12 8TA, UK
| | - Gerard J Graham
- Chemokine Research Group, Institute of Infection, Immunity and Inflammation, University of Glasgow, 120 University Place, Glasgow G12 8TA, UK
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134
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The Mechanical Microenvironment in Breast Cancer. Cancers (Basel) 2020; 12:cancers12061452. [PMID: 32503141 PMCID: PMC7352870 DOI: 10.3390/cancers12061452] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 05/27/2020] [Accepted: 06/01/2020] [Indexed: 01/22/2023] Open
Abstract
Mechanotransduction is the interpretation of physical cues by cells through mechanosensation mechanisms that elegantly translate mechanical stimuli into biochemical signaling pathways. While mechanical stress and their resulting cellular responses occur in normal physiologic contexts, there are a variety of cancer-associated physical cues present in the tumor microenvironment that are pathological in breast cancer. Mechanistic in vitro data and in vivo evidence currently support three mechanical stressors as mechanical modifiers in breast cancer that will be the focus of this review: stiffness, interstitial fluid pressure, and solid stress. Increases in stiffness, interstitial fluid pressure, and solid stress are thought to promote malignant phenotypes in normal breast epithelial cells, as well as exacerbate malignant phenotypes in breast cancer cells.
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135
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Conti A, Duggento A, Indovina I, Guerrisi M, Toschi N. Radiomics in breast cancer classification and prediction. Semin Cancer Biol 2020; 72:238-250. [PMID: 32371013 DOI: 10.1016/j.semcancer.2020.04.002] [Citation(s) in RCA: 153] [Impact Index Per Article: 38.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Revised: 03/30/2020] [Accepted: 04/01/2020] [Indexed: 12/15/2022]
Abstract
Breast Cancer (BC) is the common form of cancer in women. Its diagnosis and screening are usually performed through different imaging modalities such as mammography, magnetic resonance imaging and ultrasound. However, mammography and ultrasound-imaging techniques have limited sensitivity and specificity both in identifying lesions and in differentiating malign from benign lesions, especially in presence of dense breast parenchyma. Due to the higher resolution of magnetic resonance images, MRI represents the method with the higher specificity and sensitivity among all the available tools, in both lesions' identification and diagnosis. However, especially for diagnosis, even MRI has limitations that are only partially solved if combined with mammography. Unfortunately, due to the limits of all these imaging tools, in order to have a certain diagnosis, patients often receive painful and costly bioptics procedures. In this context, several computational approaches have been developed to increase sensitivity, while maintaining the same specificity, in BC diagnosis and screening. Amongst these, radiomics has been increasingly gaining ground in oncology to improve cancer diagnosis, prognosis and treatment. Radiomics derives multiple quantitative features from single or multiple medical imaging modalities, highlighting image traits which are not visible to the naked eye and hence significantly augmenting the discriminatory and predictive potential of medical imaging. This review article aims to summarize the state of the art in radiomics-based BC research. The dominating evidence extracted from the literature points towards a high potential of radiomics in disentangling malignant from benign breast lesions, classifying BC types and grades and also in predicting treatment response and recurrence risk. In the era of personalized medicine, radiomics has the potential to improve diagnosis, prognosis, prediction, monitoring, image-based intervention, and assessment of therapeutic response in BC.
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Affiliation(s)
- Allegra Conti
- Laboratory of Neuromotor Physiology, IRCCS Santa Lucia Foundation, Via Ardeatina, 306, 00179, Rome, Italy; Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.
| | - Andrea Duggento
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.
| | - Iole Indovina
- Laboratory of Neuromotor Physiology, IRCCS Santa Lucia Foundation, Via Ardeatina, 306, 00179, Rome, Italy; Department of Medicine and Surgery, Saint Camillus International University of Health and Medical Sciences, Rome, Italy
| | - Maria Guerrisi
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Nicola Toschi
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy; Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Boston, MA, United States.
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136
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McBride RB, Fei K, Rothstein JH, Alexeeff SE, Song X, Sakoda LC, McGuire V, Achacoso N, Acton L, Liang RY, Lipson JA, Yaffe MJ, Rubin DL, Whittemore AS, Habel LA, Sieh W. Alcohol and Tobacco Use in Relation to Mammographic Density in 23,456 Women. Cancer Epidemiol Biomarkers Prev 2020; 29:1039-1048. [PMID: 32066618 PMCID: PMC7196522 DOI: 10.1158/1055-9965.epi-19-0348] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Revised: 07/27/2019] [Accepted: 02/07/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Percent density (PD) is a strong risk factor for breast cancer that is potentially modifiable by lifestyle factors. PD is a composite of the dense (DA) and nondense (NDA) areas of a mammogram, representing predominantly fibroglandular or fatty tissues, respectively. Alcohol and tobacco use have been associated with increased breast cancer risk. However, their effects on mammographic density (MD) phenotypes are poorly understood. METHODS We examined associations of alcohol and tobacco use with PD, DA, and NDA in a population-based cohort of 23,456 women screened using full-field digital mammography machines manufactured by Hologic or General Electric. MD was measured using Cumulus. Machine-specific effects were estimated using linear regression, and combined using random effects meta-analysis. RESULTS Alcohol use was positively associated with PD (P trend = 0.01), unassociated with DA (P trend = 0.23), and inversely associated with NDA (P trend = 0.02) adjusting for age, body mass index, reproductive factors, physical activity, and family history of breast cancer. In contrast, tobacco use was inversely associated with PD (P trend = 0.0008), unassociated with DA (P trend = 0.93), and positively associated with NDA (P trend<0.0001). These trends were stronger in normal and overweight women than in obese women. CONCLUSIONS These findings suggest that associations of alcohol and tobacco use with PD result more from their associations with NDA than DA. IMPACT PD and NDA may mediate the association of alcohol drinking, but not tobacco smoking, with increased breast cancer risk. Further studies are needed to elucidate the modifiable lifestyle factors that influence breast tissue composition, and the important role of the fatty tissues on breast health.
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Affiliation(s)
- Russell B McBride
- Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, New York
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Kezhen Fei
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Joseph H Rothstein
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Stacey E Alexeeff
- Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - Xiaoyu Song
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Lori C Sakoda
- Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - Valerie McGuire
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, California
| | - Ninah Achacoso
- Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - Luana Acton
- Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - Rhea Y Liang
- Department of Radiology, Stanford University School of Medicine, Stanford, California
| | - Jafi A Lipson
- Department of Radiology, Stanford University School of Medicine, Stanford, California
| | - Martin J Yaffe
- Departments of Medical Biophysics and Medical Imaging, University of Toronto, Toronto, Ontario, Canada
| | - Daniel L Rubin
- Department of Radiology, Stanford University School of Medicine, Stanford, California
- Department of Biomedical Data Science, Stanford University School of Medicine, Stanford, California
| | - Alice S Whittemore
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, California
- Department of Biomedical Data Science, Stanford University School of Medicine, Stanford, California
| | - Laurel A Habel
- Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - Weiva Sieh
- Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, New York.
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York
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137
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Han Y, Berkey CS, Herman CR, Appleton CM, Alimujiang A, Colditz GA, Toriola AT. Adiposity Change Over the Life Course and Mammographic Breast Density in Postmenopausal Women. Cancer Prev Res (Phila) 2020; 13:475-482. [PMID: 32102947 PMCID: PMC8210631 DOI: 10.1158/1940-6207.capr-19-0549] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 01/21/2020] [Accepted: 02/19/2020] [Indexed: 11/16/2022]
Abstract
Mammographic breast density is a strong risk factor for breast cancer. We comprehensively investigated the associations of body mass index (BMI) change from ages 10, 18, and 30 to age at mammogram with mammographic breast density in postmenopausal women. We used multivariable linear regression models, adjusted for confounders, to investigate the associations of BMI change with volumetric percent density, dense volume, and nondense volume, assessed using Volpara in 367 women. At the time of mammogram, the mean age was 57.9 years. Compared with women who had a BMI gain of 0.1-5 kg/m2 from age 10, women who had a BMI gain of 5.1-10 kg/m2 had a 24.4% decrease [95% confidence interval (CI), 6.0%-39.2%] in volumetric percent density; women who had a BMI gain of 10.1-15 kg/m2 had a 46.1% decrease (95% CI, 33.0%-56.7%) in volumetric percent density; and women who had a BMI gain of >15 kg/m2 had a 56.5% decrease (95% CI, 46.0%-65.0%) in volumetric percent density. Similar, but slightly attenuated associations were observed for BMI gain from ages 18 and 30 to age at mammogram and volumetric percent density. BMI gain over the life course was positively associated with nondense volume, but not dense volume. We observed strong associations between BMI change over the life course and mammographic breast density. The inverse associations between early-life adiposity change and volumetric percent density suggest that childhood adiposity may confer long-term protection against postmenopausal breast cancer via its effect of mammographic breast density.
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Affiliation(s)
- Yunan Han
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
- Department of Breast Surgery, First Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Catherine S Berkey
- Channing Division of Network Medicine, Department of Medicine, Brigham & Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Cheryl R Herman
- Alvin J. Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri
| | | | - Aliya Alimujiang
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Graham A Colditz
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
- Alvin J. Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri
| | - Adetunji T Toriola
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri.
- Alvin J. Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri
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138
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Defining clinicopathological and radiological features of breast cancer in women under the age of 35: an epidemiological study. Ir J Med Sci 2020; 189:1195-1202. [PMID: 32285374 DOI: 10.1007/s11845-020-02229-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 04/02/2020] [Indexed: 12/26/2022]
Abstract
INTRODUCTION Breast cancer is the most commonly diagnosed female cancer. Diagnosis in younger women (under 35 years) is different to their older counterparts, and mammography is not considered as sensitive in this cohort. Consequentially, younger patients may present later with more advanced disease. METHODS This is a retrospective analysis of a prospectively updated database containing consecutive patients who presented to the symptomatic breast unit of Galway University Hospital between 2009 and 2015. Patient clinicopathologic factors, clinical examination features, diagnostic radiological modalities and Bi-RADS score were all assessed. Data was analysed using Statistical Package for the Social Sciences version 25. RESULTS One thousand eight hundred thirty-six patients were diagnosed with breast cancer, and of these, 51 (2.8%) patients were < 35 years. Invasive ductal carcinoma made up 90% of diagnosis, and 42% had an associated ductal carcinoma in situ. Fifty-four percent were high-grade tumours and 52% presented with stage III disease or greater. The main radiological tool used was ultrasound, which had a sensitivity of 87.50% (95% confidence interval [CI] 74.75 to 95.27%). Mammogram sensitivity was 86.84% (95% CI 71.91 to 95.59%). Magnetic resonance imaging was used in 29% of cases, with a sensitivity of 100.00% (95% CI 78.20 to 100.00%). CONCLUSION Females under 35 tend to be diagnosed with aggressive, advanced stage tumours. Ultrasound remains the radiological test of choice, although diagnosis using mammography demonstrated a relatively high sensitivity compared with previous reports. This study emphasises the varying epidemiology of breast cancer in younger patients and the potential role of mammography in making radiological diagnosis in those who are symptomatic.
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139
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Kılıç MÖ, Uçar AY. The Association Between Mammographic Density and Molecular Subtypes of Breast Cancer. Indian J Surg 2020. [DOI: 10.1007/s12262-019-01935-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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140
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Fernández-Nogueira P, Mancino M, Fuster G, Bragado P, Prats de Puig M, Gascón P, Casado FJ, Carbó N. Breast Mammographic Density: Stromal Implications on Breast Cancer Detection and Therapy. J Clin Med 2020; 9:jcm9030776. [PMID: 32178425 PMCID: PMC7141321 DOI: 10.3390/jcm9030776] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 03/06/2020] [Accepted: 03/09/2020] [Indexed: 12/21/2022] Open
Abstract
Current evidences state clear that both normal development of breast tissue as well as its malignant progression need many-sided local and systemic communications between epithelial cells and stromal components. During development, the stroma, through remarkably regulated contextual signals, affects the fate of the different mammary cells regarding their specification and differentiation. Likewise, the stroma can generate tumour environments that facilitate the neoplastic growth of the breast carcinoma. Mammographic density has been described as a risk factor in the development of breast cancer and is ascribed to modifications in the composition of breast tissue, including both stromal and glandular compartments. Thus, stroma composition can dramatically affect the progression of breast cancer but also its early detection since it is mainly responsible for the differences in mammographic density among individuals. This review highlights both the pathological and biological evidences for a pivotal role of the breast stroma in mammographic density, with particular emphasis on dense and malignant stromas, their clinical meaning and potential therapeutic implications for breast cancer patients.
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Affiliation(s)
- Patricia Fernández-Nogueira
- Institut d’Investigacions Biomèdiques Augustí Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain
- Correspondence: (P.F.-N.); (M.M.)
| | - Mario Mancino
- Department of Biochemistry and Molecular Biomedicine, University of Barcelona, Institute of Biomedicine, University of Barcelona (IBUB), 08028 Barcelona, Spain
- Department of Medicine, University of Barcelona, 08036 Barcelona, Spain
- Correspondence: (P.F.-N.); (M.M.)
| | - Gemma Fuster
- Department of Biochemistry and Molecular Biomedicine, University of Barcelona, Institute of Biomedicine, University of Barcelona (IBUB), 08028 Barcelona, Spain
- Department of Biochemistry & Physiology, School of Pharmacy and Food Sciences, University of Barcelona, 08028 Barcelona, Spain
- Department of Biosciences, Faculty of Sciences and Technology, University of Vic, 08500 Vic, Spain
| | - Paloma Bragado
- Department of Biochemistry and Molecular Biology, Faculty of Pharmacy, Complutense University of Madrid, Health Research Institute of the Hospital Clínico San Carlos, 28040 Madrid, Spain
| | - Miquel Prats de Puig
- Department of Medicine, University of Barcelona, 08036 Barcelona, Spain
- Breast Committee, Hospital El Pilar, Quirón salud Group, 08006 Barcelona, Spain
| | - Pere Gascón
- Department of Biochemistry and Molecular Biomedicine, University of Barcelona, Institute of Biomedicine, University of Barcelona (IBUB), 08028 Barcelona, Spain
- Oncology and Multidisciplinary Knowledge, 08036 Barcelona, Spain
| | - Francisco Javier Casado
- Department of Biochemistry and Molecular Biomedicine, University of Barcelona, Institute of Biomedicine, University of Barcelona (IBUB), 08028 Barcelona, Spain
| | - Neus Carbó
- Department of Biochemistry and Molecular Biomedicine, University of Barcelona, Institute of Biomedicine, University of Barcelona (IBUB), 08028 Barcelona, Spain
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Morgan MM, Schuler LA, Ciciliano JC, Johnson BP, Alarid ET, Beebe DJ. Modeling chemical effects on breast cancer: the importance of the microenvironment in vitro. Integr Biol (Camb) 2020; 12:21-33. [PMID: 32118264 PMCID: PMC7060306 DOI: 10.1093/intbio/zyaa002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 12/18/2019] [Accepted: 02/01/2020] [Indexed: 12/18/2022]
Abstract
Accumulating evidence suggests that our ability to predict chemical effects on breast cancer is limited by a lack of physiologically relevant in vitro models; the typical in vitro breast cancer model consists of the cancer cell and excludes the mammary microenvironment. As the effects of the microenvironment on cancer cell behavior becomes more understood, researchers have called for the integration of the microenvironment into in vitro chemical testing systems. However, given the complexity of the microenvironment and the variety of platforms to choose from, identifying the essential parameters to include in a chemical testing platform is challenging. This review discusses the need for more complex in vitro breast cancer models and outlines different approaches used to model breast cancer in vitro. We provide examples of the microenvironment modulating breast cancer cell responses to chemicals and discuss strategies to help pinpoint what components should be included in a model.
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Affiliation(s)
- Molly M Morgan
- Department of Pathology and Laboratory Medicine, University of Wisconsin-Madison, Madison, WI, USA
| | - Linda A Schuler
- Department of Comparative Biosciences, University of Wisconsin-Madison, Madison, WI, USA
- Carbone Comprehensive Cancer Center, University of Wisconsin-Madison, Madison, WI, USA
| | - Jordan C Ciciliano
- Department of Pathology and Laboratory Medicine, University of Wisconsin-Madison, Madison, WI, USA
| | - Brian P Johnson
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, USA
| | - Elaine T Alarid
- Carbone Comprehensive Cancer Center, University of Wisconsin-Madison, Madison, WI, USA
- Department of Oncology, University of Wisconsin-Madison, Madison, WI, USA
| | - David J Beebe
- Department of Pathology and Laboratory Medicine, University of Wisconsin-Madison, Madison, WI, USA
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, USA
- Carbone Comprehensive Cancer Center, University of Wisconsin-Madison, Madison, WI, USA
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142
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The impact of patient characteristics and lifestyle factors on the risk of an ipsilateral event after a primary DCIS: A systematic review. Breast 2020; 50:95-103. [PMID: 32120064 PMCID: PMC7073883 DOI: 10.1016/j.breast.2020.02.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 02/10/2020] [Indexed: 11/21/2022] Open
Abstract
Objective The majority of ‘low-risk’ (grade I/II) Ductal Carcinoma In Situ (DCIS) may not progress to invasive breast cancer during a women’s lifetime. Therefore, the safety of active surveillance versus standard surgical treatment for DCIS is prospectively being evaluated in clinical trials. If proven safe and selectively implemented in clinical practice, a significant group of women with low-risk DCIS may forego surgery and radiotherapy in the future. Identification of modifiable and non-modifiable risk factors associated with prognosis after a primary DCIS would also enhance our care of women with low-risk DCIS. Methods To identify modifiable and non-modifiable risk factors for subsequent breast events after DCIS, we performed a systematic literature search in PUBMED, EMBASE and Scopus. Results Six out of the 3870 articles retrieved were included for final data extraction. These six studies included a total of 4950 patients with primary DCIS and 640 recorded subsequent breast events. There was moderate evidence for an association of a family history of breast cancer, premenopausal status, high BMI, and high breast density with a subsequent breast cancer or further DCIS. Conclusion There is a limited number of recent studies published on the impact of modifiable and non-modifiable risk factors on subsequent events after DCIS. The available evidence is insufficient to identify potential targets for risk reduction strategies, reflecting the relatively small numbers and the lack of long-term follow-up in DCIS, a low-event condition. Need for risk management strategies for untreated DCIS patients. Limited evidence for association between lifestyle factors and prognosis after DCIS. Positive family history, premenopausal status, high breast density associated with prognosis.
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143
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Bin Y, Ding Y, Xiao W, Liao A. RASSF1A: A promising target for the diagnosis and treatment of cancer. Clin Chim Acta 2020; 504:98-108. [PMID: 31981586 DOI: 10.1016/j.cca.2020.01.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 01/16/2020] [Accepted: 01/16/2020] [Indexed: 02/07/2023]
Abstract
The Ras association domain family 1 isoform A (RASSF1A), a tumor suppressor, regulates several tumor-related signaling pathways and interferes with diverse cellular processes. RASSF1A is frequently demonstrated to be inactivated by hypermethylation in numerous types of solid cancers. It is also associated with lymph node metastasis, vascular invasion, and chemo-resistance. Therefore, reactivation of RASSF1A may be a viable strategy to block tumor progress and reverse drug resistance. In this review, we have summarized the clinical value of RASSF1A for screening, staging, and therapeutic management of human malignancies. We also highlighted the potential mechanism of RASSF1A in chemo-resistance, which may help identify novel drugs in the future.
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Affiliation(s)
- Yuling Bin
- Digestive System Department, the First Affiliated Hospital of University of South China, Hengyang, Hunan 421001, China
| | - Yong Ding
- Department of Vascular Surgery, Zhongshan Hospital, Institue of Vascular Surgery, Fudan University, Shanghai 200032, China
| | - Weisheng Xiao
- Digestive System Department, the First Affiliated Hospital of University of South China, Hengyang, Hunan 421001, China
| | - Aijun Liao
- Digestive System Department, the First Affiliated Hospital of University of South China, Hengyang, Hunan 421001, China.
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144
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Patel BK, Ridgeway JL, Ghosh K, Rhodes DJ, Borah B, Jenkins S, Suman VJ, Norman A, Jewett M, Singh D, Vachon CM, Radecki Breitkopf C. Behavioral and psychological impact of returning breast density results to Latinas: study protocol for a randomized clinical trial. Trials 2019; 20:744. [PMID: 31852492 PMCID: PMC6921571 DOI: 10.1186/s13063-019-3939-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 11/26/2019] [Indexed: 01/07/2023] Open
Abstract
Background Breast cancer is the most common cancer and the leading cause of cancer mortality among Latinas. As more is learned about the association between mammographic breast density (MBD) and breast cancer risk, a number of U.S. states adopted legislation and now a federal law mandates written notification of MBD along with mammogram results. These notifications vary in content and readability, though, which may limit their effectiveness and create confusion or concern, especially among women with low health literacy or barriers to screening. The purpose of this study is to determine whether educational enhancement of MBD notification results in increased knowledge, decreased anxiety, and adherence to continued mammography screening among Latina women in a limited-resources setting. Methods Latinas LEarning About Density (LLEAD) is a randomized clinical trial (RCT) comparing the impact of three notification approaches on behavioral and psychological outcomes in Latina women. Approximately 2000 Latinas undergoing screening mammography in a safety-net community clinic will be randomized 1:1:1 to mailed notification (usual care); mailed notification plus written educational materials (enhanced); or mailed notification, written educational materials, plus verbal explanation by a promotora (interpersonal). The educational materials and verbal explanations are available in Spanish or English. Mechanisms through which written or verbal information influences future screening motivation and behavior will be examined, as well as moderating factors such as depression and worry about breast cancer, which have been linked to diagnostic delays among Latinas. The study includes multiple psychological measures (anxiety, depression, knowledge about MBD, perceived risk of breast cancer, worry, self-efficacy) and behavioral outcomes (continued adherence to mammography). Measurement time points include enrollment, 2–4 weeks post-randomization, and 1 and 2 years post-randomization. Qualitative inquiry related to process and outcomes of the interpersonal arm and cost analysis related to its implementation will be undertaken to understand the intervention’s delivery and transferability. Discussion Legislation mandating written MBD notification may have unintended consequences on behavioral and psychological outcomes, particularly among Latinas with limited health literacy and resources. This study has implications for cancer risk communication and will offer evidence on the potential of generalizable educational strategies for delivering information on breast density to Latinas in limited-resource settings. Trial registration ClinicalTrials.gov, NCT02910986. Registered on 21 September 2016. Items from the WHO Trial Registration Data Set can be found in this protocol.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Matt Jewett
- Mountain Park Health Center, Phoenix, AZ, USA
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Breast-Associated Adipocytes Secretome Induce Fatty Acid Uptake and Invasiveness in Breast Cancer Cells via CD36 Independently of Body Mass Index, Menopausal Status and Mammary Density. Cancers (Basel) 2019; 11:cancers11122012. [PMID: 31847105 PMCID: PMC6966437 DOI: 10.3390/cancers11122012] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 11/29/2019] [Accepted: 12/10/2019] [Indexed: 12/26/2022] Open
Abstract
Breast adiposity is correlated with body mass index, menopausal status and mammary density. We here wish to establish how these factors influence the cross-talk between breast adipocytes and normal or malignant breast cells. Adipocyte-derived stem cells (ASCs) were obtained from healthy women and classified into six distinct groups based on body mass index, menopausal status and mammary density. The ASCs were induced to differentiate, and the influence of their conditioned media (ACM) was determined. Unexpectedly, there were no detectable differences in adipogenic differentiation and secretion between the six ASC groups, while their corresponding ACMs had no detectable influence on normal breast cells. In clear contrast, all ACMs profoundly influenced the proliferation, migration and invasiveness of malignant breast cells and increased the number of lipid droplets in their cytoplasm via increased expression of the fatty acid receptor CD36, thereby increasing fatty acid uptake. Importantly, inhibition of CD36 reduced lipid droplet accumulation and attenuated the migration and invasion of the breast cancer cells. These findings suggest that breast-associated adipocytes potentiate the invasiveness of breast cancer cells which, at least in part, is mediated by metabolic reprogramming via CD36-mediated fatty acid uptake.
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146
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Marie KL, Merlino G. Something Old, Something New: The Tumor Microenvironment Comes of Age. Cancer Discov 2019; 9:19-21. [PMID: 30626604 DOI: 10.1158/2159-8290.cd-18-1320] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
In this issue, Weeraratna and colleagues demonstrate that observed differences in melanoma aggressiveness in younger versus older patients can be explained not just by cell-intrinsic alterations over time, but by age-dependent changes in fibroblasts and the extracellular matrix they help create. Their findings identify novel cellular targets for melanoma therapy, as well as candidate prognostic biomarkers to better inform clinical decisions for patients with melanoma.See related article by Kaur et al., p. 64.See related article by Ecker et al., p. 82.
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Affiliation(s)
- Kerrie L Marie
- Laboratory of Cancer Biology and Genetics, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland.
| | - Glenn Merlino
- Laboratory of Cancer Biology and Genetics, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland.
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147
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Primac I, Maquoi E, Blacher S, Heljasvaara R, Van Deun J, Smeland HY, Canale A, Louis T, Stuhr L, Sounni NE, Cataldo D, Pihlajaniemi T, Pequeux C, De Wever O, Gullberg D, Noel A. Stromal integrin α11 regulates PDGFR-β signaling and promotes breast cancer progression. J Clin Invest 2019; 129:4609-4628. [PMID: 31287804 DOI: 10.1172/jci125890] [Citation(s) in RCA: 100] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Cancer-associated fibroblasts (CAFs) are key actors in modulating the progression of many solid tumors such as breast cancer (BC). Herein, we identify an integrin α11/PDGFRβ+ CAF subset displaying tumor-promoting features in BC. In the preclinical MMTV-PyMT mouse model, integrin α11-deficiency led to a drastic reduction of tumor progression and metastasis. A clear association between integrin α11 and PDGFRβ was found at both transcriptional and histological levels in BC specimens. High stromal integrin α11/PDGFRβ expression was associated with high grades and poorer clinical outcome in human BC patients. Functional assays using five CAF subpopulations (one murine, four human) revealed that integrin α11 promotes CAF invasion and CAF-induced tumor cell invasion upon PDGF-BB stimulation. Mechanistically, integrin α11 pro-invasive activity relies on its ability to interact with PDGFRβ in a ligand-dependent manner and to promote its downstream JNK activation, leading to the production of tenascin C, a pro-invasive matricellular protein. Pharmacological inhibition of PDGFRβ and JNK impaired tumor cell invasion induced by integrin α11-positive CAFs. Collectively, our study uncovers an integrin α11-positive subset of pro-tumoral CAFs that exploits PDGFRβ/JNK signalling axis to promote tumor invasiveness in BC.
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Affiliation(s)
- Irina Primac
- Laboratory of Tumor and Development Biology, GIGA-Cancer, University of Liège, Liège, Belgium
| | - Erik Maquoi
- Laboratory of Tumor and Development Biology, GIGA-Cancer, University of Liège, Liège, Belgium
| | - Silvia Blacher
- Laboratory of Tumor and Development Biology, GIGA-Cancer, University of Liège, Liège, Belgium
| | - Ritva Heljasvaara
- Oulu Centre for Cell-Extracellular Matrix Research and Biocenter Oulu, Faculty of Biochemistry and Molecular Medicine, University of Oulu, Oulu, Finland.,Department of Biomedicine and Centre for Cancer Biomarkers (CCBIO), Norwegian Centre of Excellence, University of Bergen, Bergen, Norway
| | - Jan Van Deun
- Laboratory of Experimental Cancer Research, Department of Human Structure and Repair, Ghent University, Ghent, Belgium
| | - Hilde Yh Smeland
- Department of Biomedicine and Centre for Cancer Biomarkers (CCBIO), Norwegian Centre of Excellence, University of Bergen, Bergen, Norway
| | - Annalisa Canale
- Laboratory of Tumor and Development Biology, GIGA-Cancer, University of Liège, Liège, Belgium
| | - Thomas Louis
- Laboratory of Tumor and Development Biology, GIGA-Cancer, University of Liège, Liège, Belgium
| | - Linda Stuhr
- Department of Biomedicine and Centre for Cancer Biomarkers (CCBIO), Norwegian Centre of Excellence, University of Bergen, Bergen, Norway
| | - Nor Eddine Sounni
- Laboratory of Tumor and Development Biology, GIGA-Cancer, University of Liège, Liège, Belgium
| | - Didier Cataldo
- Laboratory of Tumor and Development Biology, GIGA-Cancer, University of Liège, Liège, Belgium
| | - Taina Pihlajaniemi
- Oulu Centre for Cell-Extracellular Matrix Research and Biocenter Oulu, Faculty of Biochemistry and Molecular Medicine, University of Oulu, Oulu, Finland
| | - Christel Pequeux
- Laboratory of Tumor and Development Biology, GIGA-Cancer, University of Liège, Liège, Belgium
| | - Olivier De Wever
- Laboratory of Experimental Cancer Research, Department of Human Structure and Repair, Ghent University, Ghent, Belgium
| | - Donald Gullberg
- Department of Biomedicine and Centre for Cancer Biomarkers (CCBIO), Norwegian Centre of Excellence, University of Bergen, Bergen, Norway
| | - Agnès Noel
- Laboratory of Tumor and Development Biology, GIGA-Cancer, University of Liège, Liège, Belgium
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148
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Li E, Guida JL, Tian Y, Sung H, Koka H, Li M, Chan A, Zhang H, Tang E, Guo C, Deng J, Hu N, Lu N, Gierach GL, Li J, Yang XR. Associations between mammographic density and tumor characteristics in Chinese women with breast cancer. Breast Cancer Res Treat 2019; 177:527-536. [PMID: 31254158 DOI: 10.1007/s10549-019-05325-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 06/17/2019] [Indexed: 01/09/2023]
Abstract
PURPOSE Mammographic density (MD) is a strong risk factor for breast cancer, yet its relationship with tumor characteristics is not well established, particularly in Asian populations. METHODS MD was assessed from a total of 2001 Chinese breast cancer patients using Breast Imaging Reporting and Data System (BI-RADS) categories. Molecular subtypes were defined using immunohistochemical status on ER, PR, HER2, and Ki-67, as well as tumor grade. Multinomial logistic regression was used to test associations between MD and molecular subtype (luminal A = reference) adjusting for age, body mass index (BMI), menopausal status, parity, and nodal status. RESULTS The mean age at diagnosis was 51.7 years (SD = 10.7) and the average BMI was 24.7 kg/m2 (SD = 3.8). The distribution of BI-RADS categories was 7.4% A = almost entirely fat, 24.2% B = scattered fibroglandular dense, 49.4% C = heterogeneously dense, and 19.0% D = extremely dense. Compared to women with BI-RADS = A/B, women with BI-RADS = D were more likely to have HER2-enriched tumors (OR = 1.81, 95% CI 1.08-3.06, p = 0.03), regardless of menopausal status. The association was only observed in women with normal (< 25 kg/m2) BMI (OR = 2.43, 95% CI 1.24-4.76, p < 0.01), but not among overweight/obese women (OR: 0.98, 95% CI 0.38-2.52, p = 0.96). CONCLUSIONS Among Chinese women with normal BMI, higher breast density was associated with HER2-enriched tumors. The results may partially explain the higher proportion of HER2+ tumors previously reported in Asian women.
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Affiliation(s)
- Erni Li
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Jennifer L Guida
- Division of Cancer Epidemiology & Genetics, National Cancer Institute, NIH, DHHS, 9609 Medical Center Drive, Bethesda, MD, 20892-9761, USA.,Division of Cancer Control and Population Sciences, National Cancer Institute, NIH, DHHS, 9609 Medical Center Drive, Bethesda, MD, 20892-9761, USA
| | - Yuan Tian
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Hyuna Sung
- Division of Cancer Epidemiology & Genetics, National Cancer Institute, NIH, DHHS, 9609 Medical Center Drive, Bethesda, MD, 20892-9761, USA.,Cancer Surveillance and Health Services Program, American Cancer Society, Atlanta, GA, 30303, USA
| | - Hela Koka
- Division of Cancer Epidemiology & Genetics, National Cancer Institute, NIH, DHHS, 9609 Medical Center Drive, Bethesda, MD, 20892-9761, USA
| | - Mengjie Li
- Division of Cancer Epidemiology & Genetics, National Cancer Institute, NIH, DHHS, 9609 Medical Center Drive, Bethesda, MD, 20892-9761, USA.,Vanderbilt University, Nashville, TN, USA
| | - Ariane Chan
- Volpara Health Technologies Ltd, Wellington, New Zealand
| | - Han Zhang
- Division of Cancer Epidemiology & Genetics, National Cancer Institute, NIH, DHHS, 9609 Medical Center Drive, Bethesda, MD, 20892-9761, USA
| | - Eric Tang
- Division of Cancer Epidemiology & Genetics, National Cancer Institute, NIH, DHHS, 9609 Medical Center Drive, Bethesda, MD, 20892-9761, USA
| | - Changyuan Guo
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Joseph Deng
- Division of Cancer Epidemiology & Genetics, National Cancer Institute, NIH, DHHS, 9609 Medical Center Drive, Bethesda, MD, 20892-9761, USA
| | - Nan Hu
- Division of Cancer Epidemiology & Genetics, National Cancer Institute, NIH, DHHS, 9609 Medical Center Drive, Bethesda, MD, 20892-9761, USA
| | - Ning Lu
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Gretchen L Gierach
- Division of Cancer Epidemiology & Genetics, National Cancer Institute, NIH, DHHS, 9609 Medical Center Drive, Bethesda, MD, 20892-9761, USA
| | - Jing Li
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
| | - Xiaohong R Yang
- Division of Cancer Epidemiology & Genetics, National Cancer Institute, NIH, DHHS, 9609 Medical Center Drive, Bethesda, MD, 20892-9761, USA.
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149
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Roberts S, Strome A, Choi C, Andreou C, Kossatz S, Brand C, Williams T, Bradbury M, Kircher MF, Reshetnyak YK, Grimm J, Lewis JS, Reiner T. Acid specific dark quencher QC1 pHLIP for multi-spectral optoacoustic diagnoses of breast cancer. Sci Rep 2019; 9:8550. [PMID: 31189972 PMCID: PMC6561946 DOI: 10.1038/s41598-019-44873-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 05/20/2019] [Indexed: 12/29/2022] Open
Abstract
Breast cancer is the most common type of malignant growth in women. Early detection of breast cancer, as well as the identification of possible metastatic spread poses a significant challenge because of the structural and genetic heterogeneity that occurs during the progression of the disease. Currently, mammographies, biopsies and MRI scans are the standard of care techniques used for breast cancer diagnosis, all of which have their individual shortfalls, especially when it comes to discriminating tumors and benign growths. With this in mind, we have developed a non-invasive optoacoustic imaging strategy that targets the acidic environment of breast cancer. A pH low insertion peptide (pHLIP) was conjugated to the dark quencher QC1, yielding a non-fluorescent sonophore with high extinction coefficient in the near infrared that increases signal as a function of increasing amounts of membrane insertion. In an orthotopic murine breast cancer model, pHLIP-targeted optoacoustic imaging allowed us to differentiate between healthy and breast cancer tissues with high signal/noise ratios. In vivo, the sonophore QC1-pHLIP could detect malignancies at higher contrast than its fluorescent analog ICG-pHLIP, which was developed for fluorescence-guided surgical applications. PHLIP-type optoacoustic imaging agents in clinical settings are attractive due to their ability to target breast cancer and a wide variety of other malignant growths for diagnostic purposes. Intuitively, these agents could also be used for visualization during surgery.
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Affiliation(s)
- Sheryl Roberts
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, New York, 10065, USA
| | - Arianna Strome
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, New York, 10065, USA
| | - Crystal Choi
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, New York, 10065, USA
| | - Chrysafis Andreou
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, New York, 10065, USA
| | - Susanne Kossatz
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, New York, 10065, USA
| | - Christian Brand
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, New York, 10065, USA
| | - Travis Williams
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, New York, 10065, USA
| | - Michelle Bradbury
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, New York, 10065, USA.,Molecular Pharmacology Program, Sloan Kettering Institute for Cancer Research, New York, New York, 10065, USA
| | - Moritz F Kircher
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, New York, 10065, USA.,Molecular Pharmacology Program, Sloan Kettering Institute for Cancer Research, New York, New York, 10065, USA.,Center for Molecular Imaging and Nanotechnology (CMINT), Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA.,Department of Radiology, Weill Cornell Medical College, 1300 York Avenue, New York, New York, 10065, USA.,Department of Imaging, Dana-Farber Cancer Institute/Harvard Medical School, Boston, MA 02215, USA
| | - Yana K Reshetnyak
- Department of Physics, University of Rhode Island, 2 Lippitt Rd, Kingston, RI, 02881, USA
| | - Jan Grimm
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, New York, 10065, USA.,Department of Radiology, Weill Cornell Medical College, 1300 York Avenue, New York, New York, 10065, USA.,Department of Molecular Pharmacology, Memorial Sloan Kettering Cancer Center, New York, New York, USA.,Department of Pharmacology, Weill Cornell Medical College, New York, NY, USA
| | - Jason S Lewis
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, New York, 10065, USA.,Department of Radiology, Weill Cornell Medical College, 1300 York Avenue, New York, New York, 10065, USA.,Department of Pharmacology, Weill Cornell Medical College, New York, NY, USA.,Molecular Pharmacology Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Radiochemistry and Molecular Imaging Probes Core, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Thomas Reiner
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, New York, 10065, USA. .,Department of Radiology, Weill Cornell Medical College, 1300 York Avenue, New York, New York, 10065, USA. .,Chemical Biology Program, Memorial Sloan Kettering Cancer Center, New York City, NY, 10065, United States.
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150
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Catalá-López F, Forés-Martos J, Driver JA, Page MJ, Hutton B, Ridao M, Alonso-Arroyo A, Macías Saint-Gerons D, Gènova-Maleras R, Valderas JM, Vieta E, Valencia A, Tabarés-Seisdedos R. Association of Anorexia Nervosa With Risk of Cancer: A Systematic Review and Meta-analysis. JAMA Netw Open 2019; 2:e195313. [PMID: 31173122 PMCID: PMC6563572 DOI: 10.1001/jamanetworkopen.2019.5313] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
IMPORTANCE Anorexia nervosa is recognized as an important cause of morbidity in young people. However, the risk of cancer in people with anorexia nervosa remains uncertain. OBJECTIVE To evaluate the association of anorexia nervosa with the risk of developing or dying of cancer. DATA SOURCES MEDLINE, Scopus, Embase, and Web of Science from database inception to January 9, 2019. STUDY SELECTION Published observational studies in humans examining the risk of cancer in people with anorexia nervosa compared with the general population or those without anorexia nervosa. Studies needed to report incidence or mortality rate ratios (RRs). DATA EXTRACTION AND SYNTHESIS Screening, data extraction, and methodological quality assessment were performed by at least 2 researchers independently. A random-effects model was used to synthesize individual studies. Heterogeneity (I2) was assessed and 95% prediction intervals (PIs) were calculated. MAIN OUTCOMES AND MEASURES All cancer incidence and cancer mortality associated with anorexia nervosa. Secondary outcomes were site-specific cancer incidence and mortality. RESULTS Seven cohort studies published in 10 articles (42 602 participants with anorexia nervosa) were included. Anorexia nervosa was not associated with risk of developing any cancer (4 studies in women; RR, 0.97; 95% CI, 0.89-1.06; P = .53; I2, 0%; 95% PI, 0.80-1.18; moderate confidence). Anorexia nervosa was associated with decreased breast cancer incidence (5 studies in women; RR, 0.60; 95% CI, 0.50-0.80; P < .001; I2, 0%; 95% PI, 0.44-0.83; high confidence). Conversely, anorexia nervosa was associated with increased risk of developing lung cancer (3 studies in women; RR, 1.50; 95% CI, 1.06-2.12; P = .001; I2, 0%; 95% PI, 0.19-16.46; low confidence) and esophageal cancer (2 studies in women; RR, 6.10; 95% CI, 2.30-16.18; P < .001; I2, 0%; low confidence). CONCLUSIONS AND RELEVANCE Among people with anorexia nervosa, risk of developing cancer did not differ compared with the general population, but a significantly reduced risk of breast cancer was observed. Understanding the mechanisms underlying these associations could have important preventive potential.
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Affiliation(s)
- Ferrán Catalá-López
- Department of Health Planning and Economics, National School of Public Health, Institute of Health Carlos III, Madrid, Spain
- Department of Medicine, University of Valencia, INCLIVA Health Research Institute, Centro de Investigación en Red de Salud Mental (CIBERSAM), Valencia, Spain
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Jaume Forés-Martos
- Department of Medicine, University of Valencia, INCLIVA Health Research Institute, Centro de Investigación en Red de Salud Mental (CIBERSAM), Valencia, Spain
| | - Jane A. Driver
- Geriatric Research Education and Clinical Center, Veterans Affairs Boston Healthcare System, Boston, Massachusetts
- Division of Aging, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Matthew J. Page
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Brian Hutton
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Manuel Ridao
- Instituto Aragonés de Ciencias de la Salud, Red de Investigación en Servicios de Salud en Enfermedades Crónicas, Zaragoza, Spain
| | - Adolfo Alonso-Arroyo
- Department of History of Science and Documentation, University of Valencia, Valencia, Spain
- Unidad de Información e Investigación Social y Sanitaria, University of Valencia, Spanish National Research Council, Valencia, Spain
| | - Diego Macías Saint-Gerons
- Department of Medicine, University of Valencia, INCLIVA Health Research Institute, Centro de Investigación en Red de Salud Mental (CIBERSAM), Valencia, Spain
| | | | - José M. Valderas
- Health Services and Policy Research Group, Exeter Collaboration for Academic Primary Care, University of Exeter Medical School, University of Exeter, Exeter, United Kingdom
| | - Eduard Vieta
- Hospital Clínic, Universitat de Barcelona, Institut d’Investigacions Biomèdiques August Pi i Sunyer, Centro de Investigación en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Alfonso Valencia
- Life Sciences Department, Barcelona Supercomputing Center, Barcelona, Spain
| | - Rafael Tabarés-Seisdedos
- Department of Medicine, University of Valencia, INCLIVA Health Research Institute, Centro de Investigación en Red de Salud Mental (CIBERSAM), Valencia, Spain
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