101
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Hu JY, Yi W, Zhang MY, Xu R, Zeng LS, Long XR, Zhou XM, Zheng XFS, Kang Y, Wang HY. MicroRNA-711 is a prognostic factor for poor overall survival and has an oncogenic role in breast cancer. Oncol Lett 2016; 11:2155-2163. [PMID: 26998141 DOI: 10.3892/ol.2016.4217] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2015] [Accepted: 12/21/2015] [Indexed: 12/16/2022] Open
Abstract
MicroRNAs are important in cancer development and progression. In the present study, the clinical significance and function of microRNA-711 (miR-711) expression in breast cancer were investigated. The expression level of miR-711 was analyzed in breast cancer tissue samples using reverse transcription-quantitative polymerase chain reaction. Cell proliferation, colony formation, apoptosis and Transwell assays were performed in breast cancer cell lines transfected with miR-711 mimics or inhibitors, or control sequence. miR-711 was found to be upregulated in 30 formalin-fixed paraffin-embedded breast cancer tissue samples compared with paired non-cancerous breast tissues (P<0.05). Furthermore, a higher miR-711 expression was demonstrated to be associated with poor overall and disease-free survival times in 161 breast cancer patients, and miR-711 was identified as an independent prognostic factor using multivariate Cox regression analysis. In vitro, overexpression of miR-711 resulted in a significant increase in proliferation, colony formation, migration and invasion of breast cancer cells. By contrast, downregulating miR-711 inhibited cell proliferation, colony formation, migration and invasion and enhanced the rate of apoptosis of breast cancer cells. To the best of our knowledge, the present study is the first to demonstrate that miR-711 is an independent prognostic factor and serves an important oncogenic function in breast cancer, suggesting that miR-711 is a potential biomarker of prognosis and a molecular therapeutic target in breast cancer.
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Affiliation(s)
- Jing-Ye Hu
- State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong 510060, P.R. China; Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong 510060, P.R. China; Guiyan College of Traditional Chinese Medicine, Guiyang, Guizhou 550001, P.R. China
| | - Wei Yi
- Department of Radiation Oncology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510120, P.R. China
| | - Mei-Yin Zhang
- State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong 510060, P.R. China; Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong 510060, P.R. China
| | - Rui Xu
- State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong 510060, P.R. China; Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong 510060, P.R. China
| | - Li-Si Zeng
- State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong 510060, P.R. China; Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong 510060, P.R. China
| | - Xiao-Ran Long
- State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong 510060, P.R. China; Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong 510060, P.R. China
| | - Xiao-Min Zhou
- State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong 510060, P.R. China; Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong 510060, P.R. China
| | - Xiao-Feng Steven Zheng
- Rutgers Cancer Institute of New Jersey, Rutgers University, New Brunswick, NJ 08903-2681, USA
| | - Yibin Kang
- Department of Molecular Biology, Princeton University, Princeton, NJ 08544-1014, USA
| | - Hui-Yun Wang
- State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong 510060, P.R. China; Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong 510060, P.R. China
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102
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Cyclin E amplification, over-expression, and relapse-free survival in HER-2-positive primary breast cancer. Tumour Biol 2016; 37:9813-23. [PMID: 26810187 DOI: 10.1007/s13277-016-4870-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Accepted: 01/14/2016] [Indexed: 12/25/2022] Open
Abstract
Cyclin E is a well-characterized cell cycle regulator and an amplified oncogene in breast cancer. Over-expression of cyclin E has generally been associated with poor survival. Recent studies have shown an interaction between HER-2 (ERBB2) and cyclin E, but the exact mechanism is unknown. Interestingly, cyclin E over-expression has been associated with trastuzumab resistance. We studied cyclin E over-expression, CCNE1 amplification, and relapse-free survival in HER-2-positive primary breast cancers treated with and without trastuzumab therapy. Formalin-fixed paraffin-embedded tissue samples from 202 HER-2-positive breast carcinomas were studied. Expression levels of cyclin E and proliferation marker Ki-67 were determined using immunohistochemistry. Chromogenic in situ hybridization (CISH) with a gene-specific bacterial artificial chromosome (BAC) probe was used to analyze presence of CCNE1 amplification. Majority of HER-2-positive breast carcinomas exhibited nuclear staining for cyclin E protein. Cyclin E was highly expressed (≥50 % cells) in 37 % of cases. Incidence of CCNE1 amplification (≥6 gene copies/cell or clusters) was 8 %. Cyclin E amplification and over-expression were strongly associated with each other, grade, hormone receptors, and Ki-67. Neither high cyclin E expression nor CCNE1 amplification was associated with relapse-free survival (RFS) irrespective of short-term (9-week regimen) adjuvant trastuzumab therapy. These results confirm cyclin E and HER-2 gene co-amplification in a fraction of HER-2-positive breast cancers. Cyclin E is frequently over-expressed but appears to have limited value as a prognostic or predictive factor in HER-2-positive breast cancer regardless of trastuzumab therapy.
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103
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Kempf E, Azria E, Kempf A. Computer-based risk prediction models: Ethical issues of Adjuvant! Online use in early-stage breast cancer. ACTA ACUST UNITED AC 2016; 44:79-81. [PMID: 26792034 DOI: 10.1016/j.gyobfe.2015.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 11/20/2015] [Indexed: 11/18/2022]
Affiliation(s)
- E Kempf
- Medical oncology department, Henri-Mondor Hospital, AP-HP, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil cedex, France.
| | - E Azria
- INSERM, U-1153, Epidemiology and Biostatistics Sorbonne Paris Cité Center, Obstetrical, Perinatal and Pediatric Epidemiology Team, DHU Risk in Pregnancy, Maternité de Port Royal, 53, avenue de l'Observatoire, 75014 Paris, France; Department of Obstetrics, Paris Descartes University, groupe hospitalier Paris-Saint-Joseph, 185, rue Raymond-Losserand, 75014 Paris, France
| | - A Kempf
- Robert-Debré Hospital management team, AP-HP, 48, boulevard Sérurier, 75019 Paris, France
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104
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Abstract
Background: Pharmaceuticals’ relative effectiveness has come to the fore in
the policy arena, reflecting the need to understand how relative efficacy (what can work)
translates into added benefit in routine clinical use (what does work). European payers
and licensing authorities assess value for money and post-launch benefit–risk profiles,
and efforts to standardize assessments of relative effectiveness across the European Union
(EU) are under way. However, the ways that relative effectiveness differs across EU
healthcare settings are poorly understood. Methods: To understand which factors influence differences in relative
effectiveness, we developed an analytical framework that treats the healthcare system as a
health production function. Using evidence on breast cancer from England, Spain, and
Sweden as a case study, we investigated the reasons why the relative effectiveness of a
new drug might vary across healthcare systems. Evidence was identified from a literature
review and national clinical guidance. Results: The review included thirteen international studies and thirty
country-specific studies. Cross-country differences in population age structure,
deprivation, and educational attainment were consistently associated with variation in
outcomes. Screening intensity appeared to drive differences in survival, although the
impact on mortality was unclear. Conclusions: The way efficacy translates into relative effectiveness across
health systems is likely to be influenced by a range of complex and interrelated factors.
These factors could inform government and payer policy decisions on ways to optimize
relative effectiveness, and help increase understanding of the potential transferability
of data on relative effectiveness from one health system to another.
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105
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Marshall DC, Webb TE, Hall RA, Salciccioli JD, Ali R, Maruthappu M. Trends in UK regional cancer mortality 1991-2007. Br J Cancer 2016; 114:340-7. [PMID: 26766741 PMCID: PMC4742578 DOI: 10.1038/bjc.2015.428] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2015] [Revised: 10/28/2015] [Accepted: 11/07/2015] [Indexed: 11/18/2022] Open
Abstract
Background: Until 1990, there was an upward trend in mortality from breast, lung, prostate, and colon cancers in the United Kingdom. With improvements in cancer treatment there has, in general, been a fall in mortality over the last 20 years. We evaluate regional cancer mortality trends in the United Kingdom between 1991 and 2007. Methods: We analysed mortality trends for breast, lung, prostate, and colon cancers using data obtained from the EUREG cancer database. We have described changes in age-standardised rates (using European standard population) per 100 000 for cancer mortality and generated trends in mortality for the 11 regions using Joinpoint regression. Results: Across all regions in the United Kingdom there was a downward trend in mortality for the four most common cancers in males and females. Overall, deaths from colon cancer decreased most rapidly and deaths from prostate cancer decreased at the slowest rate. Similar downward trends in mortality were observed across all regions of the United Kingdom with the data for lung cancer exhibiting the greatest variation. Conclusions: Mortality from the four most common cancers decreased across all regions of the United Kingdom; however, the rate of decline varied between cancer type and in some instances by region.
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Affiliation(s)
| | - Thomas E Webb
- Department of Medicine, Imperial College London, London SW7 2AZ, UK
| | - Richard A Hall
- Department of Medicine, Imperial College London, London SW7 2AZ, UK
| | | | - Raghib Ali
- Cancer Epidemiology Unit, University of Oxford, Oxford OX3 7LF, UK
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106
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Baird R, Banks I, Cameron D, Chester J, Earl H, Flannagan M, Januszewski A, Kennedy R, Payne S, Samuel E, Taylor H, Agarwal R, Ahmed S, Archer C, Board R, Carser J, Copson E, Cunningham D, Coleman R, Dangoor A, Dark G, Eccles D, Gallagher C, Glaser A, Griffiths R, Hall G, Hall M, Harari D, Hawkins M, Hill M, Johnson P, Jones A, Kalsi T, Karapanagiotou E, Kemp Z, Mansi J, Marshall E, Mitchell A, Moe M, Michie C, Neal R, Newsom-Davis T, Norton A, Osborne R, Patel G, Radford J, Ring A, Shaw E, Skinner R, Stark D, Turnbull S, Velikova G, White J, Young A, Joffe J, Selby P. An Association of Cancer Physicians' strategy for improving services and outcomes for cancer patients. Ecancermedicalscience 2016; 10:608. [PMID: 26913066 PMCID: PMC4762575 DOI: 10.3332/ecancer.2016.608] [Citation(s) in RCA: 2] [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: 11/10/2015] [Indexed: 12/02/2022] Open
Abstract
The Association of Cancer Physicians in the United Kingdom has developed a strategy to improve outcomes for cancer patients and identified the goals and commitments of the Association and its members.
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Affiliation(s)
- Richard Baird
- ACP Executive Member
- ACP Strategy Drafting Group
- Supporting Chapter Author
- Addenbrooke’s Hospital, Cambridge, UK
| | - Ian Banks
- ACP Strategy Drafting Group
- Supporting Chapter Author
- University of Leeds, Leeds LS2 9JT, UK
| | - David Cameron
- ACP Executive Member
- ACP Strategy Drafting Group
- Edinburgh Cancer Research Centre, UK
| | - John Chester
- ACP Executive Member
- ACP Strategy Drafting Group
- Supporting Chapter Author
- Wales Cancer Research Centre, Cardiff, UK
| | - Helena Earl
- ACP Executive Member
- ACP Strategy Drafting Group
- Supporting Chapter Author
- Addenbrooke’s Hospital, Cambridge, UK
| | - Mark Flannagan
- ACP Strategy Drafting Group
- Supporting Chapter Author
- Beating Bowel Cancer, Harlequin House, 7 High St, Teddington, Middlesex TW11 8EE, UK
| | - Adam Januszewski
- ACP Executive Member
- ACP Strategy Drafting Group
- Supporting Chapter Author
- London Deanery, Stewart House, 32 Russell Square, London WC1B 5DN, UK
| | | | - Sarah Payne
- ACP Executive Member
- ACP Strategy Drafting Group
- Supporting Chapter Author
- Guy’s and St Thomas’s Hospital, London, UK and Medical Affairs Manager, Pfizer
| | - Emlyn Samuel
- ACP Strategy Drafting Group
- Cancer Research UK, Angel Building, 407 St John Street, London EC1V 4AD, UK
| | - Hannah Taylor
- ACP Executive Member
- ACP Strategy Drafting Group
- Supporting Chapter Author
- Severn Deanery, Vantage Office Park Old Gloucester Road, Hambrook, Avon, Bristol BS16 1GW, UK
| | - Roshan Agarwal
- ACP Executive Member
- Northampton General Hospital, Cliftonville, Northampton NN1 5BD, UK
| | - Samreen Ahmed
- ACP Executive Member
- University Hospitals of Leicester, Infirmary Square, Leicester LE1 5WW, UK
| | - Caroline Archer
- ACP Executive Member
- Queen Alexandra Hospital, Portsmouth, UK
| | - Ruth Board
- ACP Executive Member
- Lancashire Teaching Hospitals, UK
| | - Judith Carser
- ACP Executive Member
- Southern Health and Social Care Trust, Southern College of Nursing, Craigavon Area Hospital, 68 Lurgan Road, Portadown, BT63 5QQ, UK
| | - Ellen Copson
- Supporting Chapter Author
- University of Southampton, University Rd, Southampton SO17 1BJ, UK
| | - David Cunningham
- ACP Executive Member
- Supporting Chapter Author
- NIHR Biomedical Research Centre, Royal Marsden Hospital, London, UK
| | - Rob Coleman
- ACP Executive Member
- Weston Park Hospital, Sheffield, UK
| | - Adam Dangoor
- ACP Executive Member
- Supporting Chapter Author
- University Hospitals Bristol, Bristol, UK
| | - Graham Dark
- Supporting Chapter Author
- Freeman Hospital, Newcastle, UK
| | - Diana Eccles
- Supporting Chapter Author
- University of Southampton, University Rd, Southampton SO17 1BJ, UK
| | | | - Adam Glaser
- Supporting Chapter Author
- University of Leeds, Leeds LS2 9JT, UK
| | - Richard Griffiths
- ACP Executive Member
- Supporting Chapter Author
- Clatterbridge Cancer Centre, Clatterbridge Health Park, Clatterbridge Rd, Wirral, Merseyside CH63 4JY, UK
| | - Geoff Hall
- Supporting Chapter Author
- Leeds Cancer Centre, St James’s University Hospital, Leeds, UK
| | - Marcia Hall
- ACP Executive Member
- Mount Vernon Cancer Centre, Northwood, UK
| | - Danielle Harari
- Supporting Chapter Author
- Guy’s and St Thomas’ NHS Foundation Trust, London, UK
| | - Michael Hawkins
- Supporting Chapter Author
- University of Birmingham, Edgbaston, Birmingham, West Midlands B15 2TT, UK
| | - Mark Hill
- ACP Executive Member
- Kent Oncology Centre, Maidstone, Kent, UK
| | - Peter Johnson
- Supporting Chapter Author
- University of Southampton, University Rd, Southampton SO17 1BJ, UK
| | - Alison Jones
- ACP Executive Member
- Royal Free and University College Hospital, London, UK
| | - Tania Kalsi
- Supporting Chapter Author
- Guy’s and St Thomas’ NHS Foundation Trust, London, UK
| | | | - Zoe Kemp
- Supporting Chapter Author
- Royal Marsden Hospital, London, UK
| | - Janine Mansi
- ACP Executive Member
- Supporting Chapter Author
- Guy’s and St Thomas’ Hospitals, London, UK
| | - Ernie Marshall
- Supporting Chapter Author
- Clatterbridge Cancer Centre, Clatterbridge Health Park, Clatterbridge Rd, Wirral, Merseyside CH63 4JY, UK
| | - Alex Mitchell
- Supporting Chapter Author
- University of Leicester, University Rd, Leicester LE1 7RH, UK
| | - Maung Moe
- ACP Executive Member
- North Middlesex University Hospital, UK
| | | | - Richard Neal
- Supporting Chapter Author
- University of Bangor, Bangor, Gwynedd LL57 2DG , Wales, UK
| | - Tom Newsom-Davis
- Supporting Chapter Author
- Chelsea and Westminster Hospital, London, UK
| | | | - Richard Osborne
- Supporting Chapter Author
- Poole Hospital, Longfleet Rd, Poole, Dorset BH15 2JB, UK
| | - Gargi Patel
- ACP Executive Member
- Brighton and Sussex University Hospitals, UK
| | - John Radford
- Supporting Chapter Author
- University of Manchester, Oxford Rd, Manchester M13 9PL, UK
| | - Alistair Ring
- Supporting Chapter Author
- Royal Marsden Hospital, London, UK
| | - Emily Shaw
- Supporting Chapter Author
- Southampton General Hospital, Tremona Rd, Southampton, Hampshire SO16 6YD, UK
| | - Rod Skinner
- Supporting Chapter Author
- Royal Victoria Infirmary, Newcastle, UK
| | - Dan Stark
- Supporting Chapter Author
- Leeds Cancer Centre, St James’s University Hospital, Leeds, UK
| | - Sam Turnbull
- ACP Executive Member
- Leeds Cancer Centre, St James’s University Hospital, Leeds, UK
| | - Galina Velikova
- Supporting Chapter Author
- University of Leeds, Leeds LS2 9JT, UK
| | - Jeff White
- Supporting Chapter Author
- Beatson West of Scotland Cancer Centre, Glasgow, Scotland, UK
| | - Alison Young
- ACP Executive Member
- Supporting Chapter Author
- Leeds Cancer Centre, St James’s University Hospital, Leeds, UK
| | - Johnathan Joffe
- ACP Executive Member
- ACP Strategy Drafting Group
- Supporting Chapter Author
- Senior Author
- Huddersfield Royal Infirmary, Acre St, Huddersfield, West Yorkshire HD3 3EA, UK
| | - Peter Selby
- ACP Executive Member
- ACP Strategy Drafting Group
- Supporting Chapter Author
- Senior Author
- Leeds Cancer Centre, St James’s University Hospital, Leeds, UK
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107
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Lim D, Ha M, Song I. Trends in major cancer mortality in Korea, 1983–2012, with a joinpoint analysis. Cancer Epidemiol 2015; 39:939-46. [DOI: 10.1016/j.canep.2015.10.023] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Revised: 10/17/2015] [Accepted: 10/19/2015] [Indexed: 12/26/2022]
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108
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Smith A, Crouch S, Howell D, Burton C, Patmore R, Roman E. Impact of age and socioeconomic status on treatment and survival from aggressive lymphoma: a UK population-based study of diffuse large B-cell lymphoma. Cancer Epidemiol 2015; 39:1103-12. [PMID: 26341588 PMCID: PMC4676192 DOI: 10.1016/j.canep.2015.08.015] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Revised: 08/24/2015] [Accepted: 08/25/2015] [Indexed: 01/09/2023]
Abstract
AIM To examine the influence of patient's age and socio-economic status on treatment and outcome in diffuse large B-cell lymphoma (DLBCL); an aggressive curable cancer, with an incidence rate that increases markedly with age but varies little with socio-economic status. METHODS Set within a representative UK population of around 4 million, data are from an established patient cohort. This report includes all patients (≥ 18 years) newly diagnosed with DLBCL 2004-2012, with follow-up to February 2015. RESULTS Of the 2137 patients (median age 70.2 years) diagnosed with denovo DLBCL, 1709 (80%) were treated curatively/intensively and 1161(54.3%) died during follow-up. Five-year overall and relative survival (RS) estimates were 46.2% (95% CI 44.0-48.4%) and 54.6% (52.1%-57.0%) respectively for all patients, and 58.5% (56.1-60.9%) and 67.0% (64.3-69.6%) for intensively treated patients. 96.3% of patients <55 years (366/380) and 96.4% of those with the best performance status (543/563) were treated curatively: 5-year RSs being 77.9% (73.1-82%) and 87.1% (82.5-90.6%) respectively. At the other end of the age/fitness spectrum, 33.3% of those ≥ 85 years (66/198) and 41.1% with the worst performance (94/225) were treated curatively: the corresponding 5-year RSs being 50.5% (27.1-69.0%) and 22.9% (14.0-33.2%). The proportion of patients whose cancer was fully staged fell with increasing age and worsening performance status. No socio-economic variations with treatment, stage at presentation or outcome were detected. CONCLUSIONS Performance status is more discriminatory of survival than chronological age, with fitter patients benefiting from treatment across all ages. Socio-economic factors are not predictive of outcome in patients with DLBCL in the UK.
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Affiliation(s)
- Alexandra Smith
- Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, YO10 5DD, UK.
| | - Simon Crouch
- Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, YO10 5DD, UK
| | - Debra Howell
- Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, YO10 5DD, UK
| | - Cathy Burton
- St James's Institute of Oncology, Leeds Teaching Hospitals NHS Trust, LS9 7TF, UK
| | - Russell Patmore
- Queens Centre for Oncology, Castle Hill Hospital, HU16 5JQ, UK
| | - Eve Roman
- Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, YO10 5DD, UK
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109
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Voinescu DC, Ciobotaru OR, Sin A, Barna O, Coman M, Ciobotaru OC. Study of HER2, ER and PR markers and survival in invasive ductal carcinoma patients in south-east Romania. BIOTECHNOL BIOTEC EQ 2015. [DOI: 10.1080/13102818.2015.1058190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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110
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Keen JD, Jørgensen KJ. Four Principles to Consider Before Advising Women on Screening Mammography. J Womens Health (Larchmt) 2015; 24:867-74. [PMID: 26496048 PMCID: PMC4649764 DOI: 10.1089/jwh.2015.5220] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
This article reviews four important screening principles applicable to screening mammography in order to facilitate informed choice. The first principle is that screening may help, hurt, or have no effect. In order to reduce mortality and mastectomy rates, screening must reduce the rate of advanced disease, which likely has not happened. Through overdiagnosis, screening produces substantial harm by increasing both lumpectomy and mastectomy rates, which offsets the often-promised benefit of less invasive therapy. Next, all-cause mortality is the most reliable way to measure the efficacy of a screening intervention. Disease-specific mortality is biased due to difficulties in attribution of cause of death and to increased mortality due to overdiagnosis and the resulting overtreatment with radiotherapy and chemotherapy. To enhance participation, the benefit from screening is often presented in relative instead of absolute terms. Third, some screening statistics must be interpreted with caution. Increased survival time and the percentage of early-stage tumors at detection sound plausible, but are affected by lead-time and length biases. In addition, analyses that only include women who attend screening cannot reliably correct for selection bias. The final principle is that accounting for tumor biology is important for accurate estimates of lead time, and the potential benefit from screening. Since “early detection” is actually late in a tumor's lifetime, the time window when screen detection might extend a woman's life is narrow, as many tumors that can form metastases will already have done so. Instead of encouraging screening mammography, physicians should help women make an informed decision as with any medical intervention.
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Affiliation(s)
- John D Keen
- 1 Department of Radiology, John H. Stroger Jr. Hospital of Cook County , Chicago, Illinois
| | - Karsten J Jørgensen
- 2 The Nordic Cochrane Centre, Rigshospitalet Department, Copenhagen , Denmark
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111
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Petti S, Scully C. How many individuals must be screened to reduce oral cancer mortality rate in the Western context? A challenge. Oral Dis 2015; 21:949-54. [PMID: 26390304 DOI: 10.1111/odi.12372] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Revised: 09/07/2015] [Accepted: 09/13/2015] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Controlling oral cancer (OC) through screening is appealing. Advantages of this are as follows: OC is often preceded by visible premalignant lesions, early-stage survival is threefold greater than late-stage survival, and visual screening is inexpensive. Disadvantages of this are as follows: high frequency of false positives, undemonstrated cost-effectiveness, and irregular screening attendance by high-risk individuals. Screening effectiveness in Western countries has not been proven, because of low OC prevalence, which disproportionally increases the number of individuals needed to screen (NNS) to decrease mortality. This study estimated the NNS to obtain an evident decrease in OC mortality rate in the UK. METHODS Data gathered from reliable databanks were used. NNS to detect one case (NNScase ) was estimated using a Bayesian approach. NNS to prevent one death (NNSdeath ) was assessed multiplying NNScase by the number of cases that must be screen-detected to prevent one death. NNS to decrease mortality rate by 1% (NNSmortality ) was assessed multiplying NNSdeath by 1% of annual OC deaths. RESULTS NNSmortality was overall 1 125 000 (95% confidence interval - 95CI, 690 000-1 870 000), males 551 000 (95CI, 337 000-916 000), and females 571 000 (95CI, 347 000-942 000). CONCLUSIONS An OC visual screening campaign capable of producing an evident decrease in mortality rate in the UK requires a large number of adults to be annually and regularly screened.
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Affiliation(s)
- S Petti
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - C Scully
- WHO Collaborating Centre for oral health-general health, London, UK.,University College London, London, UK
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112
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Arponent O, Sudah M, Masarwah A, Taina M, Rautiainen S, Könönen M, Sironen R, Kosma VM, Sutela A, Hakumäki J, Vanninen R. Diffusion-Weighted Imaging in 3.0 Tesla Breast MRI: Diagnostic Performance and Tumor Characterization Using Small Subregions vs. Whole Tumor Regions of Interest. PLoS One 2015; 10:e0138702. [PMID: 26458106 PMCID: PMC4601774 DOI: 10.1371/journal.pone.0138702] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Accepted: 09/02/2015] [Indexed: 11/18/2022] Open
Abstract
Introduction Apparent diffusion coefficient (ADC) values are increasingly reported in breast MRI. As there is no standardized method for ADC measurements, we evaluated the effect of the size of region of interest (ROI) to diagnostic utility and correlation to prognostic markers of breast cancer. Methods This prospective study was approved by the Institutional Ethics Board; the need for written informed consent for the retrospective analyses of the breast MRIs was waived by the Chair of the Hospital District. We compared diagnostic accuracy of ADC measurements from whole-lesion ROIs (WL-ROIs) to small subregions (S-ROIs) showing the most restricted diffusion and evaluated correlations with prognostic factors in 112 consecutive patients (mean age 56.2±11.6 years, 137 lesions) who underwent 3.0-T breast MRI. Results Intra- and interobserver reproducibility were substantial (κ = 0.616–0.784; Intra-Class Correlation 0.589–0.831). In receiver operating characteristics analysis, differentiation between malignant and benign lesions was excellent (area under curve 0.957–0.962, cut-off ADC values for WL-ROIs: 0.87×10−3 mm2s-1; S-ROIs: 0.69×10−3 mm2s-1, P<0.001). WL-ROIs/S-ROIs achieved sensitivities of 95.7%/91.3%, specificities of 89.5%/94.7%, and overall accuracies of 89.8%/94.2%. In S-ROIs, lower ADC values correlated with presence of axillary metastases (P = 0.03), high histological grade (P = 0.006), and worsened Nottingham Prognostic Index Score (P<0.05). In both ROIs, ADC values correlated with progesterone receptors and advanced stage (P<0.01), but not with HER2, estrogen receptors, or Ki-67. Conclusions ADC values assist in breast tumor characterization. Small ROIs were more accurate than whole-lesion ROIs and more frequently associated with prognostic factors. Cut-off values differed significantly depending on measurement procedure, which should be recognized when comparing results from the literature. Instead of using a whole lesion covering ROI, a small ROI could be advocated in diffusion-weighted imaging.
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Affiliation(s)
- Otso Arponent
- Kuopio University Hospital, Diagnostic Imaging Centre, Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland
- University of Eastern Finland, Institute of Clinical Medicine, School of Medicine, Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland
- * E-mail:
| | - Mazen Sudah
- Kuopio University Hospital, Diagnostic Imaging Centre, Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland
| | - Amro Masarwah
- Kuopio University Hospital, Diagnostic Imaging Centre, Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland
- University of Eastern Finland, Institute of Clinical Medicine, School of Medicine, Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland
| | - Mikko Taina
- Kuopio University Hospital, Diagnostic Imaging Centre, Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland
- University of Eastern Finland, Institute of Clinical Medicine, School of Medicine, Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland
| | - Suvi Rautiainen
- Kuopio University Hospital, Diagnostic Imaging Centre, Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland
- University of Eastern Finland, Institute of Clinical Medicine, School of Medicine, Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland
| | - Mervi Könönen
- Kuopio University Hospital, Diagnostic Imaging Centre, Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland
| | - Reijo Sironen
- Kuopio University Hospital, Department of Pathology, Kuopio University Hospital, Kuopio, Finland
- University of Eastern Finland, Institute of Clinical Medicine, School of Medicine, Department of Clinical Pathology and Forensic Medicine, Kuopio University Hospital, Kuopio, Finland
- University of Eastern Finland, Cancer Center of Eastern Finland, Kuopio, Finland
| | - Veli-Matti Kosma
- Kuopio University Hospital, Department of Pathology, Kuopio University Hospital, Kuopio, Finland
- University of Eastern Finland, Institute of Clinical Medicine, School of Medicine, Department of Clinical Pathology and Forensic Medicine, Kuopio University Hospital, Kuopio, Finland
- University of Eastern Finland, Cancer Center of Eastern Finland, Kuopio, Finland
| | - Anna Sutela
- Kuopio University Hospital, Diagnostic Imaging Centre, Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland
| | - Juhana Hakumäki
- Kuopio University Hospital, Diagnostic Imaging Centre, Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland
| | - Ritva Vanninen
- Kuopio University Hospital, Diagnostic Imaging Centre, Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland
- University of Eastern Finland, Institute of Clinical Medicine, School of Medicine, Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland
- University of Eastern Finland, Cancer Center of Eastern Finland, Kuopio, Finland
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Siraj AK, Beg S, Jehan Z, Prabhakaran S, Ahmed M, R Hussain A, Al-Dayel F, Tulbah A, Ajarim D, Al-Kuraya KS. ALK alteration is a frequent event in aggressive breast cancers. Breast Cancer Res 2015; 17:127. [PMID: 26384210 PMCID: PMC4588266 DOI: 10.1186/s13058-015-0610-3] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Accepted: 07/07/2015] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION Breast cancer is the most common female malignancy worldwide and, despite improvements in treatment modalities, there are increased chances of recurrence and metastasis in a substantial number of cases and it remains one of the major causes of mortality among female cancer patients. Anaplastic lymphoma kinase (ALK) gene has been found to be altered in several solid and hematologic tumors. We aimed to comprehensively study the prevalence of ALK expression, and changes in copy number and translocation in a large cohort of breast cancer cases in a Middle Eastern population. METHODS ALK protein expression was investigated by immunohistochemistry and numerical and structural variations of the ALK gene were analyzed by fluorescence in situ hybridization (FISH) in a tissue microarray format in a cohort of more than 1000 Middle Eastern breast cancers. The data were correlated with clinicopathologic parameters and other important molecular biomarkers. RESULTS Immunohistochemical analysis showed ALK overexpression in 36.0 % of the breast cancer patients and gene amplification was present in 13.3 % of cases, seen by FISH analyses. ALK overexpression was significantly associated with ALK gene amplification (p = 0.0031). ALK-overexpressing tumors showed significant association with high-grade tumors (p = 0.0039), ductal histologic subtype (p = 0.0076), triple-negative phenotype (p = 0.0034), and high Ki-67 (p = 0.0001) and p-AKT (p <0.0001). CONCLUSIONS Immunohistochemical analysis showed ALK is overexpressed in a substantial proportion of breast cancers and possibly plays a significant role in the aggressive behavior of this cancer. Gene amplification is hypothesized to be a possible cause for a significant proportion of this overexpression. Based on these findings, a potential role for an ALK inhibitor, as a therapeutic agent targeting aggressive subtypes of breast cancer, merits further investigation.
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Affiliation(s)
- Abdul K Siraj
- Department of Human Cancer Genomic Research, King Faisal Specialist Hospital and Research Center, Makkah Al Mukarramah Branch Road, Riyadh, 12713, Saudi Arabia.
| | - Shaham Beg
- Department of Human Cancer Genomic Research, King Faisal Specialist Hospital and Research Center, Makkah Al Mukarramah Branch Road, Riyadh, 12713, Saudi Arabia.
| | - Zeenath Jehan
- Department of Human Cancer Genomic Research, King Faisal Specialist Hospital and Research Center, Makkah Al Mukarramah Branch Road, Riyadh, 12713, Saudi Arabia.
| | - Sarita Prabhakaran
- Department of Human Cancer Genomic Research, King Faisal Specialist Hospital and Research Center, Makkah Al Mukarramah Branch Road, Riyadh, 12713, Saudi Arabia.
| | - Maqbool Ahmed
- Department of Human Cancer Genomic Research, King Faisal Specialist Hospital and Research Center, Makkah Al Mukarramah Branch Road, Riyadh, 12713, Saudi Arabia.
| | - Azhar R Hussain
- Department of Human Cancer Genomic Research, King Faisal Specialist Hospital and Research Center, Makkah Al Mukarramah Branch Road, Riyadh, 12713, Saudi Arabia.
| | - Fouad Al-Dayel
- Department of Pathology, King Faisal Specialist Hospital and Research Center, Makkah Al Mukarramah Branch Road, Riyadh, 12713, Saudi Arabia.
| | - Asma Tulbah
- Department of Pathology, King Faisal Specialist Hospital and Research Center, Makkah Al Mukarramah Branch Road, Riyadh, 12713, Saudi Arabia.
| | - Dahish Ajarim
- Oncology Center, King Faisal Specialist Hospital and Research Center, Makkah Al Mukarramah Branch Road, Riyadh, 12713, Saudi Arabia.
| | - Khawla S Al-Kuraya
- Department of Human Cancer Genomic Research, King Faisal Specialist Hospital and Research Center, Makkah Al Mukarramah Branch Road, Riyadh, 12713, Saudi Arabia. .,Department of Pathology, Al-Faisal University, Al Zahrawi Street, Riyadh, 11533, Saudi Arabia.
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Kumar P, Aggarwal R. An overview of triple-negative breast cancer. Arch Gynecol Obstet 2015; 293:247-69. [PMID: 26341644 DOI: 10.1007/s00404-015-3859-y] [Citation(s) in RCA: 405] [Impact Index Per Article: 45.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Accepted: 08/18/2015] [Indexed: 12/22/2022]
Abstract
PURPOSE Triple-negative breast cancer (TNBC) is a heterogeneous group of tumors comprising various breast cancers simply defined by the absence of estrogen receptor, progesterone receptor and overexpression of human epidermal growth factor receptor 2 gene. In this review, we discuss the epidemiology, risk factors, clinical characteristics and prognostic variables of TNBC, and present the summary of recommended treatment strategies and all other available treatment options. METHODS We performed a systematic literature search using Medline and selected those articles which seemed relevant for this review. In addition, the ClinicalTrials.gov was also scanned for ongoing trials. RESULTS TNBC accounts for 10-20 % of all invasive breast cancers and has been found to be associated with African-American race, younger age, higher grade and mitotic index, and more advanced stage at diagnosis. Locoregional treatment is similar to other invasive breast cancer subtypes and involves surgery-mastectomy with or without adjuvant radiotherapy or breast conservation followed by adjuvant radiotherapy. Due to lack of drug-targetable receptors, chemotherapy is the only recommended systemic treatment to improve disease outcome. TNBC is sensitive to chemotherapy as demonstrated by high pathological complete response rates achieved after neoadjuvant chemotherapy, and this approach also allows for breast-conserving surgery. The peak risk of relapse is at 3 years after surgery, thereafter recurrence risk rapidly decreases. Survival after metastatic relapse is shorter as compared to other breast cancer subtypes, treatment options are few and response rates are poor and lack durability. Important molecular characteristics have now been identified that can subdivide this group of breast cancers further and can provide alternative systemic therapies. CONCLUSIONS To improve therapeutic outcome of TNBC, reliable predictive biomarkers and newer drugs against the known molecular pathways are required.
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Affiliation(s)
- Pankaj Kumar
- Department of Radiation Oncology, Max Super Speciality Hospital, Phase-6, Mohali, 160055, Punjab, India.
| | - Rupali Aggarwal
- Department of Radiation Oncology, Indus Super Speciality Hospital, Phase-1, Mohali, 160055, Punjab, India
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Senkus E, Kyriakides S, Ohno S, Penault-Llorca F, Poortmans P, Rutgers E, Zackrisson S, Cardoso F. Primary breast cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2015; 26 Suppl 5:v8-30. [PMID: 26314782 DOI: 10.1093/annonc/mdv298] [Citation(s) in RCA: 1056] [Impact Index Per Article: 117.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Affiliation(s)
- E Senkus
- Department of Oncology and Radiotherapy, Medical University of Gdańsk, Gdańsk, Poland
| | | | - S Ohno
- Breast Oncology Center, Cancer Institute Hospital, Tokyo, Japan
| | - F Penault-Llorca
- Department of Pathology, Centre Jean Perrin, Clermont-Ferrand EA 4677 Université d'Auvergne, Clermont-Ferrand, France
| | - P Poortmans
- Radboud University Medical Center, Nijmegen, The Netherlands
| | - E Rutgers
- Department of Surgery, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - S Zackrisson
- Department of Diagnostic Radiology, Lund University, Malmö, Sweden
| | - F Cardoso
- Breast Unit, Champalimaud Clinical Center, Lisbon, Portugal
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Liu N, Yu C, Shi Y, Jiang J, Liu Y. SMAD4 expression in breast ductal carcinoma correlates with prognosis. Oncol Lett 2015; 10:1709-1715. [PMID: 26622737 DOI: 10.3892/ol.2015.3442] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Accepted: 06/11/2015] [Indexed: 11/06/2022] Open
Abstract
The present study examined SMAD4 expression in fine-needle aspiration cell blocks from patients with breast ductal carcinoma, in order to assess its viability as a prognostic marker. Using immunohistochemistry, the SMAD4 protein status of 86 breast ductal carcinoma fine-needle biopsies, from patients who underwent tumor resection at Beihua University Affiliated Hospital (Jilin, China) between 2002 and 2008, was characterized. The association between SMAD4 expression and clinicopathological parameters, as well as prognosis was assessed using the Mantel-Haenszel method and Cox proportional hazards regression. SMAD4 staining was observed in the cytoplasm and nucleus, and its expression was found to be decreased in ductal breast carcinoma as compared with adjacent normal breast epithelia. Patients with reduced SMAD4 expression levels tended to exhibit more poorly differentiated tumors, a higher risk of recurrence and shorter overall survival. These results demonstrated that the evaluation of SMAD4 protein status in fine-needle biopsy specimens of breast ductal carcinoma may provide additional prognostic information.
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Affiliation(s)
- Nannan Liu
- Department of Pathology, College of Basic Medicine, Beihua University, Jilin City, Jilin 132013, P.R. China
| | - Chunyan Yu
- Department of Pathology, College of Basic Medicine, Beihua University, Jilin City, Jilin 132013, P.R. China
| | - Yanfen Shi
- Department of Pathology, China-Japan Friendship Hospital, Beijing 100029, P.R. China
| | - Jing Jiang
- Department of Pathology, Beihua University Affiliated Hospital, Jilin City, Jilin 132011, P.R. China
| | - Yuhe Liu
- Department of Pathology, College of Basic Medicine, Beihua University, Jilin City, Jilin 132013, P.R. China
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Viewpoint: It is time to reconsider policy for population-based mammography screening. J Public Health Policy 2015; 36:259-69. [PMID: 26108575 DOI: 10.1057/jphp.2015.19] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Breast cancer in women is an important cause of morbidity and mortality. Many countries in the Western world have widely promoted early detection through mammography screening and established population-based screening programs. Over the past 15 years, there has been growing debate about the benefits and harms of universal mammography screening. This article presents findings from the latest systematic review conducted by the Cochrane Collaboration and from the Canadian National Breast Screening Study 25-year follow up. The authors of both reports conclude there is no reliable evidence that population-based mammography screening reduces mortality, but there is good evidence of harm in the form of false positive findings, over-diagnosis and unnecessary treatment, and associated psychological distress. It is time for policymakers to discontinue universal population-based mammography screening and shift to a more selective approach to early detection.
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Cancer Mortality Trend Analysis in Italy, 1980-2010, and Predictions for 2015. TUMORI JOURNAL 2015; 101:664-75. [DOI: 10.5301/tj.5000352] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2015] [Indexed: 01/20/2023]
Abstract
Aims To update cancer mortality statistics in Italy, analyzing 1980-2010 trends, and to predict 2015 mortality rates. Methods World Health Organization cancer mortality and census data were extracted to calculate death rates for 30 cancer sites from 1980 to 2010. Trends were analyzed with joinpoint regression and predicted 2015 deaths rates were computed. Results In 2010 in Italy, there were 175,046 cancer deaths (98,847 men and 76,199 women), with total mortality rates, respectively, of 138.22 and 82.6/100,000. The leading cause of cancer death in men was lung cancer (25,457 deaths, 36.2/100,000), whereas in women it was breast cancer (12,115 deaths, 15.38/100,000). Total cancer mortality in men has been decreasing since the late 1980s, with an estimated annual percentage change (EAPC) of −1.8 in 1994-2010. In women, total cancer mortality rates decreased throughout the study period, with an EAPC of −1.1 in 1992-2010. Trends in mortality were decreasing for most cancers in both sexes. Only pancreatic and lung cancer trends in women were unfavorable. Total numbers of predicted cancer deaths in Italy for 2015 increased to 102,647 men and 82,047 women; however, the predicted rates decreased in men (129.1/100,000), while remaining stable in women (82.6/100,000). Conclusions Mortality rates for the most common cancers in Italy showed favorable trends that are likely to continue in the near future, with the exception of lung cancer mortality in women. Maintaining these trends requires continuous and improved control of tobacco, alcohol, and nutrition/overweight. Further improvements in diagnosis and treatment may also have a significant impact on cancer mortality.
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Cirak Y, Furuncuoglu Y, Yapicier O, Alici S, Argon A. Predictive and prognostic values of BubR1 and synuclein-gamma expression in breast cancer. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2015; 8:5345-5353. [PMID: 26191236 PMCID: PMC4503107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Accepted: 04/14/2015] [Indexed: 06/04/2023]
Abstract
The aim of this study is to determine the expression level of spindle assembly checkpoint (SAC) proteins-BubR1 and synuclein-gamma (SNCG) in human breast cancer tissues and to test whether there is a relationship between their expression levels and clinicopathologic parameters including respons to taxanes, tumor grade, estrogen receptor (ER) pozitivity, HER2 status, and overall survival (OS). We analyzed retrospectively paraffin-embedded tissue sections from 55 breast cancer patients whose clinical outcomes had been tracked after taxane treatment in neoadjuvan and metastatic setting. The expression status of BubR1 and SNCG was defined by immunohistochemistry (IHC) using the anti-BubR1 and anti-SNCG antibody. The BubR1 and SNCG was overexpressed in 38% and 62% of the study group, respectively. There was borderline significant correlation between low BubR1 expression and increased taxane sensitivity (P=0.05). In contrast, high SNCG expression was significantly associated with decreased taxane sensitivity (P=0.01). There was no association between the clinicopathologic parameters including histologic grade, ER positivity and HER2 status and the level of these proteins. However, triple negative tumors showed significantly more high BubR1 expression than those other molecular subtypes (P=0.04). Kaplan-Meier survival analysis failed to show a significant correlation between expression levels of BubR1 and SNCG and overall survival although patients with low levels of both proteins had a marginally longer survival time compared to those with high levels. In summary, our data suggest that both BubR1 and SNCG may be promising predictive marker rather than prognostic marker in patients with breast cancer.
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Affiliation(s)
- Yalcin Cirak
- Department of Medical Onkology, Bahcesehir University School of Medicine, Goztepe Medical Park HospitalIstanbul, Turkey
| | - Yavuz Furuncuoglu
- Department of Internal Medicine, Bahcesehir University School of Medicine, Goztepe Medical Park HospitalIstanbul, Turkey
| | - Ozlem Yapicier
- Department of Pathology, Bahcesehir University School of Medicine, Goztepe Medical Park HospitalIstanbul, Turkey
| | - Suleyman Alici
- Department of Medical Onkology, Bahcesehir University School of Medicine, Goztepe Medical Park HospitalIstanbul, Turkey
| | - Andac Argon
- Department of Medical Onkology, Bahcesehir University School of Medicine, Goztepe Medical Park HospitalIstanbul, Turkey
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Abstract
Mammography screening for breast cancer is widely available in many countries. Initially praised as a universal achievement to improve women's health and to reduce the burden of breast cancer, the benefits and harms of mammography screening have been debated heatedly in the past years. This review discusses the benefits and harms of mammography screening in light of findings from randomized trials and from more recent observational studies performed in the era of modern diagnostics and treatment. The main benefit of mammography screening is reduction of breast-cancer related death. Relative reductions vary from about 15 to 25% in randomized trials to more recent estimates of 13 to 17% in meta-analyses of observational studies. Using UK population data of 2007, for 1,000 women invited to biennial mammography screening for 20 years from age 50, 2 to 3 women are prevented from dying of breast cancer. All-cause mortality is unchanged. Overdiagnosis of breast cancer is the main harm of mammography screening. Based on recent estimates from the United States, the relative amount of overdiagnosis (including ductal carcinoma in situ and invasive cancer) is 31%. This results in 15 women overdiagnosed for every 1,000 women invited to biennial mammography screening for 20 years from age 50. Women should be unpassionately informed about the benefits and harms of mammography screening using absolute effect sizes in a comprehensible fashion. In an era of limited health care resources, screening services need to be scrutinized and compared with each other with regard to effectiveness, cost-effectiveness and harms.
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Affiliation(s)
- Magnus Løberg
- Institute of Health and Society, University of Oslo, N-0317, Oslo, Norway. .,Department of Transplantation Medicine, Oslo University Hospital, 0424, Oslo, Norway. .,Department of Epidemiology, Harvard School of Public Health, Boston, MA, 02115, USA.
| | - Mette Lise Lousdal
- Department of Public Health, Aarhus University, 8000, Aarhus C, Denmark.
| | - Michael Bretthauer
- Institute of Health and Society, University of Oslo, N-0317, Oslo, Norway. .,Department of Transplantation Medicine, Oslo University Hospital, 0424, Oslo, Norway. .,Department of Epidemiology, Harvard School of Public Health, Boston, MA, 02115, USA. .,Department of Medicine, Sorlandet Hospital, 4604, Kristiansand, Norway.
| | - Mette Kalager
- Institute of Health and Society, University of Oslo, N-0317, Oslo, Norway. .,Department of Epidemiology, Harvard School of Public Health, Boston, MA, 02115, USA. .,Telemark Hospital, 3710, Skien, Norway.
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Andersen LT, Suppli NP, Dalton SO, Kroman N, Rosenberg J, Gögenur I. New and chronic use of hypnotics after diagnosis with early breast cancer. A retrospective cohort study. Acta Oncol 2015; 54:704-11. [PMID: 25752966 DOI: 10.3109/0284186x.2014.998276] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND To determine use and investigate factors associated with use of hypnotics the first year after a diagnosis with breast cancer. MATERIAL AND METHODS A retrospective registry based cohort study linking clinical data from the Danish Breast Cancer Group with the National Prescription Drug Database and other health and administrative registries. We included 26 082 women diagnosed with early breast cancer as first time primary cancer during 1996-2006. Use of hypnotics was measured as redeemed prescriptions in the first year after diagnosis of early breast cancer. Prior use of hypnotics was defined as one or more prescriptions of hypnotics 13 months to 1 month before diagnosis, and chronic use was defined as four or more prescriptions. Hazard ratios (HRs) for clinical variables, treatment-related factors and sociodemographic factors were calculated. RESULTS Among women with no prior history of hypnotic use, 17% became new users with 4% on a chronic level. Among prior users, 82% continued their use with one or more prescriptions of hypnotics and 15% increased their use to a chronic level. Significantly increased hazard ratios for use of hypnotics were seen with increasing age [age 50-59 years: HR 1.43 (95% CI 1.31-1.57), age 60-69: HR 1.57 (95% CI 1.44-1.71)], increasing number of tumor positive lymph nodes [1-3 lymph nodes: HR 1.12 (95% CI 1.05-1.09), 4-9 lymph nodes: HR 1.11 (95% CI 1.02-1.29)], chemotherapy [HR 1.25 (95% CI 1.12-1.39)], somatic comorbidity [HR 1.31 (95% CI 1.21-1.42)] and use of antidepressants the year before breast cancer diagnosis [HR 1.97 (95% CI 1.85-2.10)]. CONCLUSION This study detected a group of patients at great risk for initiating and increasing use of hypnotics and preventive and prophylactic mechanism should be investigated and initiated when this group of patients is seen in the clinical setting.
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de Almeida GS, Almeida LAL, Araujo GMR, Weller M. Reproductive Risk Factors Differ Among Breast Cancer Patients and Controls in a Public Hospital of Paraiba, Northeast Brazil. Asian Pac J Cancer Prev 2015; 16:2959-65. [DOI: 10.7314/apjcp.2015.16.7.2959] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Madsen MT, Huang C, Gögenur I. Actigraphy for measurements of sleep in relation to oncological treatment of patients with cancer: A systematic review. Sleep Med Rev 2015; 20:73-83. [DOI: 10.1016/j.smrv.2014.07.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Revised: 07/06/2014] [Accepted: 07/07/2014] [Indexed: 11/26/2022]
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Huang L, Chen S, Yao L, Liu G, Wu J, Shao Z. Phase II trial of weekly nab-paclitaxel and carboplatin treatment with or without trastuzumab as nonanthracycline neoadjuvant chemotherapy for locally advanced breast cancer. Int J Nanomedicine 2015; 10:1969-75. [PMID: 25792830 PMCID: PMC4362893 DOI: 10.2147/ijn.s77000] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Background Neoadjuvant chemotherapy has become standard treatment for women with locally advanced breast cancer. The aim of this study was to compare the efficacy and safety of nanoparticle albumin-bound paclitaxel (nab-paclitaxel) versus paclitaxel combined with carboplatin. Methods Thirty patients were treated with neoadjuvant nab-paclitaxel (125 mg/m2, days 1, 8, and 15) and carboplatin (area under the curve =2; days 1, 8, and 15) every 21 days for four cycles. Ninety matched patients received paclitaxel (80 mg/m2, days 1, 8, and 15) and carboplatin every 21 days for four cycles. Weekly trastuzumab is recommended for overexpression of human epidermal receptor-2. The primary endpoint was pathologic complete response (defined as ypT0/is ypN0). Matching was conducted according to six variables: body mass index, clinical tumor stage, clinical lymph node status, estrogen receptor status, HER2 status, and trastuzumab receiving rate. Results Ninety percent of patients in the nab-paclitaxel group and 80% of patients in the paclitaxel group experienced a clinical objective response (complete response or partial response; P=0.450). Eight patients in the nab-paclitaxel group and 23 patients in the paclitaxel group had a pathologic complete response in the breast and axillary nodes (26.7% versus 25.6%; P=0.904). Nab-paclitaxel showed a beneficial effective trend on clinical tumor stage II (36.8% versus 15.8%; P=0.051). When trastuzumab was added to nab-paclitaxel, the pathologic complete response rate was not significantly improved more than with trastuzumab and paclitaxel (43.6% versus 39.6%; P=0.769). Carboplatin plus nab-paclitaxel or paclitaxel had similarly low pathologic complete response rates (7.7% versus 10.5%) for the luminal molecular subtype. One (50%) triple-negative patient achieved a pathologic complete response. The nab-paclitaxel regimen caused more grade 4 neutropenia than the paclitaxel regimen (56.7% versus 21.1%; P<0.001). Conclusion Our study shows that weekly nab-paclitaxel and carboplatin with or without trastuzumab resulted in a pathologic complete response rate that was not superior to the matched cohorts. Future, larger trials are needed to validate that nab-paclitaxel is beneficial for clinical tumor stage II and the triple-negative subgroup.
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Affiliation(s)
- Liang Huang
- Department of Breast Surgery, Fudan University Shanghai Cancer Center/Cancer Institute, Shanghai, People's Republic of China ; Department of Oncology, Shanghai Medical College, Shanghai, People's Republic of China
| | - Sheng Chen
- Department of Breast Surgery, Fudan University Shanghai Cancer Center/Cancer Institute, Shanghai, People's Republic of China ; Department of Oncology, Shanghai Medical College, Shanghai, People's Republic of China
| | - Ling Yao
- Department of Breast Surgery, Fudan University Shanghai Cancer Center/Cancer Institute, Shanghai, People's Republic of China ; Department of Oncology, Shanghai Medical College, Shanghai, People's Republic of China
| | - Guangyu Liu
- Department of Breast Surgery, Fudan University Shanghai Cancer Center/Cancer Institute, Shanghai, People's Republic of China ; Department of Oncology, Shanghai Medical College, Shanghai, People's Republic of China
| | - Jiong Wu
- Department of Breast Surgery, Fudan University Shanghai Cancer Center/Cancer Institute, Shanghai, People's Republic of China ; Department of Oncology, Shanghai Medical College, Shanghai, People's Republic of China
| | - Zhiming Shao
- Department of Breast Surgery, Fudan University Shanghai Cancer Center/Cancer Institute, Shanghai, People's Republic of China ; Department of Oncology, Shanghai Medical College, Shanghai, People's Republic of China ; Institutes of Biomedical Science, Fudan University, Shanghai, People's Republic of China
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Huang C, Madsen MT, Gögenur I. Circadian rhythms measured by actigraphy during oncological treatments: a systematic review. BIOL RHYTHM RES 2015. [DOI: 10.1080/09291016.2015.1004840] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Parvinen I, Heinävaara S, Anttila A, Helenius H, Klemi P, Pylkkänen L. Mammography screening in three Finnish residential areas: comprehensive population-based study of breast cancer incidence and incidence-based mortality 1976-2009. Br J Cancer 2015; 112:918-24. [PMID: 25688742 PMCID: PMC4453946 DOI: 10.1038/bjc.2014.642] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Revised: 10/22/2014] [Accepted: 12/01/2014] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The aim of this study was to evaluate the effectiveness of a large-scale screening programme for breast cancer (BC) in Turku, Finland. Incidence and incidence-based mortality (IBM) figures were compared with the areas applying different screening policies. METHODS Deaths and person-time of women aged 40-84 were assessed for the period 1976-1986 (prescreening era) and the periods 1987-1997 and 1998-2009 (screening periods) using incidence and IBM by age at diagnosis and at death. There was a total of 40.7 million women-years, 83 497 invasive BCs obtained from the Finnish Cancer Registry; 17 508 BC deaths were linked with the data from Statistics Finland. RESULTS In Turku, a significant (> 20%) reduction in IBM occurred during 1987-2009 among women aged 60-74 years at diagnosis compared with Helsinki (IBMRR: 0.75, 95% CI: 0.57-1.00), and in women aged 75-84 years at death compared with the rest of Finland (IBMRR: 0.72, 95% CI: 0.53-0.96). CONCLUSIONS The wide mammography screening programme in Turku was effective in decreasing BC mortality in the elderly age groups. These results support the implementation of BC screening from age 50 up to 74 years.
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Affiliation(s)
- I Parvinen
- University of Turku, Medical Faculty, University of Turku, FI-20014 Turku, Finland
| | - S Heinävaara
- Finnish Cancer Registry, Unioninkatu 22, FI-00130 Helsinki, Finland
| | - A Anttila
- Finnish Cancer Registry, Unioninkatu 22, FI-00130 Helsinki, Finland
| | - H Helenius
- University of Turku, Medical Faculty, Department of Biostatistics, University of Turku, FI-20014 Turku, Finland
| | - P Klemi
- University of Turku, Medical Faculty, Department of Pathology, University of Turku, FI-20014 Turku, Finland
| | - L Pylkkänen
- University of Turku, Medical Faculty, Department of Clinical Oncology, University of Turku, FI-20014 Turku, Finland
- Cancer Society of Finland, Unioninkatu 22, FI-00130 Helsinki, Finland
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128
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Gonzaga CMR, Freitas-Junior R, Curado MP, Sousa ALL, Souza-Neto JA, Souza MR. Temporal trends in female breast cancer mortality in Brazil and correlations with social inequalities: ecological time-series study. BMC Public Health 2015; 15:96. [PMID: 25886146 PMCID: PMC4331144 DOI: 10.1186/s12889-015-1445-7] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2014] [Accepted: 01/20/2015] [Indexed: 11/17/2022] Open
Abstract
Background Breast cancer is the most common cause of death from cancer in women in less developed regions. Therefore, the objective of this study was to provide data on the temporal trends in female breast cancer mortality between 1990 and 2011 and to evaluate its association with the social inequalities present in Brazil. Methods Breast cancer mortality data and estimates for the resident population were obtained from the Brazilian National Health Service database for the 1990–2011 period. Age-standardized mortality rates were calculated (20–39, 40–49, 50–69 and ≥70 years) by direct standardization using the 1960 standard world population. Trends were modeled using joinpoint regression model and linear regression. The Social Exclusion Index and the Human Development Index were used to classify the 27 Brazilian states. Pearson’s correlation was used to describe the association between the Social Exclusion Index and the Human DeveIopment and the variations in mortality rates in each state. Results Age-standardized mortality rates in Brazil were found to be stable (annual percent change [APC] = 0.3; 95% CI: −0.1 – 0.7) between 1994 and 2011. Considering the Brazilian states, significant decreases in mortality rates were found in Rio Grande do Sul, Rio de Janeiro and São Paulo. Increases in mortality rates were most notable in the states of Maranhão (APC = 11.2; 95 %CI: 5.8 – 16.9), Piauí (APC = 9.8; 95% CI: 7.6 – 12.1) and Paraíba (APC = 9.3; 95% CI: 6.0 – 12.8). There was a statistically significant correlation between Social Exclusion Index and a change in female breast cancer mortality rates in the Brazilian states between 1990 and 2011 and between Human Development Index and mortality between 2001 and 2011. Conclusions Female breast cancer mortality rates are stable in Brazil. Reductions in these rates were found in the more developed states, possibly reflecting better healthcare.
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Affiliation(s)
| | - Ruffo Freitas-Junior
- Department of Obstetrics and Gynecology, Federal University of Goiás (UFG), Goiânia, Brazil. .,, Alameda das Rosas, 533, Setor Oeste, 74110-060, Goiânia, GO, Brazil.
| | - Maria-Paula Curado
- Health Sciences, Federal University of Goiás (UFG), Goiânia, Brazil. .,Hospital Araújo Jorge, Goiás Anticancer Association (ACCG), Goiânia, Brazil. .,International Prevention Research Institute (IPRI), Lyon, France.
| | | | | | - Marta Rovery Souza
- Institute of Tropical Pathology and Public Health, Federal University of Goiás (UFG), Goiânia, Brazil.
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Sakiyama T, Tsurutani J, Iwasa T, Kawakami H, Nonagase Y, Yoshida T, Tanaka K, Fujisaka Y, Kurata T, Komoike Y, Nishio K, Nakagawa K. A phase I dose-escalation study of eribulin and S-1 for metastatic breast cancer. Br J Cancer 2015; 112:819-24. [PMID: 25654665 PMCID: PMC4453950 DOI: 10.1038/bjc.2015.10] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Revised: 12/12/2014] [Accepted: 12/21/2014] [Indexed: 02/07/2023] Open
Abstract
Background: We evaluated the safety, maximum-tolerated dose (MTD), pharmacokinetics, recommended dose for phase II (P2RD), and preliminary anticancer activity of a combination eribulin and S-1 therapeutic in metastatic breast cancer patients pretreated with anthracycline and taxane. Method: Patients aged 20–74 years were recruited. In level 1, patients received S-1 (65 mg m−2) from day 1 to 14, and eribulin (1.1 mg m−2) on day 1 and 8 in a 21-day cycle. In level 2, eribulin was increased to 1.4 mg m−2. In level 3, S-1 was increased to 80 mg m−2. Results: Twelve patients were enrolled into three cohorts. Planned dose escalation was completed, with one case exhibiting dose-limiting toxicity (grade 3 hypokalaemia) at level 3, without reaching the MTD. The P2RD was determined to be level 2 (eribulin 1.4 mg m−2 and S-1 65 mg m−2). The most common grade 3 or 4 toxicity was neutropenia (83.3%), followed by febrile neutropenia (25.0%). Five of eleven patients (41.7%) with measurable disease had a partial response. Pharmacokinetics were characterised by dose-dependent elimination and nonlinear exposure. Conclusion: Dose level 3 was not tolerated owing to febrile neutropenia development. Thus, intermediate dose level 2 was recommended for further evaluation. Preliminary antitumour activity warrants further investigation in this setting.
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Affiliation(s)
- T Sakiyama
- Department of Medical Oncology, Kindai University Faculty of Medicine, 377-2 Ohnohigashi, Osaka-sayama 589-8511, Japan
| | - J Tsurutani
- Department of Medical Oncology, Kindai University Faculty of Medicine, 377-2 Ohnohigashi, Osaka-sayama 589-8511, Japan
| | - T Iwasa
- Department of Medical Oncology, Kindai University Faculty of Medicine, 377-2 Ohnohigashi, Osaka-sayama 589-8511, Japan
| | - H Kawakami
- Department of Medical Oncology, Kindai University Faculty of Medicine, 377-2 Ohnohigashi, Osaka-sayama 589-8511, Japan
| | - Y Nonagase
- Department of Medical Oncology, Kindai University Faculty of Medicine, 377-2 Ohnohigashi, Osaka-sayama 589-8511, Japan
| | - T Yoshida
- Department of Medical Oncology, Kindai University Faculty of Medicine, 377-2 Ohnohigashi, Osaka-sayama 589-8511, Japan
| | - K Tanaka
- Department of Medical Oncology, Kindai University Faculty of Medicine, 377-2 Ohnohigashi, Osaka-sayama 589-8511, Japan
| | - Y Fujisaka
- Clinical Research Center, Osaka Medical Collage Hospital, 2-7 Daigaku-cho, Takatsuki 569-8686, Japan
| | - T Kurata
- Department of Thoracic Oncology, Kansai Medical University Hirakata Hospital, 2-3-1 Shinmachi, Hirakata 573-1191, Japan
| | - Y Komoike
- Department of Surgery, Kindai University Faculty of Medicine, 377-2 Ohnohigashi, Osaka-sayama 589-8511, Japan
| | - K Nishio
- Department of Genome Biology, Kindai University Faculty of Medicine, 377-2 Ohnohigashi, Osaka-sayama 589-8511, Japan
| | - K Nakagawa
- Department of Medical Oncology, Kindai University Faculty of Medicine, 377-2 Ohnohigashi, Osaka-sayama 589-8511, Japan
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Baum M. Saatchi is right to promote medical innovation but his bill is wrong way to do it. BMJ 2015; 350:h531. [PMID: 25652261 DOI: 10.1136/bmj.h531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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131
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Sipetic-Grujicic S, Murtezani Z, Ratkov I, Grgurevic A, Marinkovic J, Bjekic M, Miljus D. Comparison of male and female breast cancer incidence and mortality trends in Central Serbia. Asian Pac J Cancer Prev 2015; 14:5681-5. [PMID: 24289562 DOI: 10.7314/apjcp.2013.14.10.5681] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To compare breast cancer incidence and mortality trends in Central Serbia between males and females in the period 1999-2009. MATERIALS AND METHODS In this descriptive study, mortality data were obtained from the National Statistics Institute and morbidity data were derived from Institute of Public Health of Serbia for the period of interest. RESULTS Breast cancer is a leading cancer in the female population of Central Serbia, whereas in male population it is not on the list of 10 leading localizations, concerning both incidence as well as mortality. In the period 1999-2009 the average standardized incidence rates of breast cancer were 60.5/100,000 in women and 1.4/100,000 in men, while average standardized mortality rates were 20.4/100,000 and 0.4/100,000. The average standardized incidence and mortality rates were about 45 times higher in females than males. Male breast cancer comprises approximately 2.1% of all breast cancer cases. The average age-specific mortality and incidence rates increased with age in both sexes. In the observed period standardized mortality rates of breast cancer increased significantly only in men (y=0.320+0.021?, p=0.044). CONCLUSIONS The increase of breast cancer incidence in both sexes and mortality in men, indicate an urgent need for Serbian health professionals to apply existing cancer control and preventive measures. Male breast cancer is more present than in other world regions, with an outstanding increase of mortality, which demands a timely identification (screening) and adequate treatment. A national policy including mammography should be considered in the light of the newest findings.
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132
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Bartlett FR, Colgan RM, Donovan EM, McNair HA, Carr K, Evans PM, Griffin C, Locke I, Haviland JS, Yarnold JR, Kirby AM. The UK HeartSpare Study (Stage IB): randomised comparison of a voluntary breath-hold technique and prone radiotherapy after breast conserving surgery. Radiother Oncol 2015; 114:66-72. [PMID: 25739317 DOI: 10.1016/j.radonc.2014.11.018] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Accepted: 11/11/2014] [Indexed: 10/24/2022]
Abstract
PURPOSE To compare mean heart and left anterior descending coronary artery (LAD) doses (NTDmean) and positional reproducibility in larger-breasted women receiving left breast radiotherapy using supine voluntary deep-inspiratory breath-hold (VBH) and free-breathing prone techniques. MATERIALS AND METHODS Following surgery for early breast cancer, patients with estimated breast volumes >750 cm(3) underwent planning-CT scans in supine VBH and free-breathing prone positions. Radiotherapy treatment plans were prepared, and mean heart and LAD doses were calculated. Patients were randomised to receive one technique for fractions 1-7, before switching techniques for fractions 8-15 (40 Gy/15 fractions total). Daily electronic portal imaging and alternate-day cone-beam CT (CBCT) imaging were performed. The primary endpoint was the difference in mean LAD NTDmean between techniques. Population systematic (Σ) and random errors (σ) were estimated. Within-patient comparisons between techniques used Wilcoxon signed-rank tests. RESULTS 34 patients were recruited, with complete dosimetric data available for 28. Mean heart and LAD NTDmean doses for VBH and prone treatments respectively were 0.4 and 0.7 (p<0.001) and 2.9 and 7.8 (p<0.001). Clip-based CBCT errors for VBH and prone respectively were ⩽3.0 mm and ⩽6.5 mm (Σ) and ⩽3.5 mm and ⩽5.4 mm (σ). CONCLUSIONS In larger-breasted women, supine VBH provided superior cardiac sparing and reproducibility than a free-breathing prone position.
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Affiliation(s)
| | - Ruth M Colgan
- Joint Department of Physics, Royal Marsden NHS Foundation Trust and Institute of Cancer Research, Sutton, UK
| | - Ellen M Donovan
- Joint Department of Physics, Royal Marsden NHS Foundation Trust and Institute of Cancer Research, Sutton, UK
| | - Helen A McNair
- Department of Radiotherapy, Royal Marsden NHS Foundation Trust, Sutton, UK
| | - Karen Carr
- Department of Radiotherapy, Royal Marsden NHS Foundation Trust, Sutton, UK
| | - Philip M Evans
- Joint Department of Physics, Royal Marsden NHS Foundation Trust and Institute of Cancer Research, Sutton, UK; Centre for Vision, Speech and Signal Processing, University of Surrey, Guildford, UK
| | - Clare Griffin
- Clinical Trials and Statistics Unit (ICR-CTSU), Institute of Cancer Research, London, UK
| | - Imogen Locke
- Department of Radiotherapy, Royal Marsden NHS Foundation Trust, Sutton, UK
| | - Joanne S Haviland
- Clinical Trials and Statistics Unit (ICR-CTSU), Institute of Cancer Research, London, UK
| | - John R Yarnold
- Division of Radiotherapy and Imaging, Institute of Cancer Research, Sutton, UK
| | - Anna M Kirby
- Department of Radiotherapy, Royal Marsden NHS Foundation Trust, Sutton, UK
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Combined phosphoproteomics and bioinformatics strategy in deciphering drug resistant related pathways in triple negative breast cancer. INTERNATIONAL JOURNAL OF PROTEOMICS 2014; 2014:390781. [PMID: 25478227 PMCID: PMC4247952 DOI: 10.1155/2014/390781] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Revised: 10/21/2014] [Accepted: 10/22/2014] [Indexed: 11/17/2022]
Abstract
Because of the absence of a clear therapeutic target for triple negative breast cancer (TNBC), conventional chemotherapy is the only available systemic treatment option for these patients. Despite chemotherapy treatment, TNBC patients still have worse prognosis when compared with other breast cancer patients. The study is to investigate unique phosphorylated proteins expressed in chemoresistant TNBC cell lines. In the current study, twelve TNBC cell lines were subjected to drug sensitivity assays against chemotherapy drugs docetaxel, doxorubicin, gemcitabine, and cisplatin. Based on their half maximal inhibitory concentrations, four resistant and two sensitive cell lines were selected for further analysis. The phosphopeptides from these cells were enriched with TiO2 beads and fractionated using strong cation exchange. 1,645 phosphoprotein groups and 9,585 unique phosphopeptides were identified by a high throughput LC-MS/MS system LTQ-Orbitrap. The phosphopeptides were further filtered with Ascore system and 1,340 phosphoprotein groups, 2,760 unique phosphopeptides, and 4,549 unique phosphosites were identified. Our study suggested that differentially phosphorylated Cdk5, PML, AP-1, and HSF-1 might work together to promote vimentin induced epithelial to mesenchymal transition (EMT) in the drug resistant cells. EGFR and HGF were also shown to be involved in this process.
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134
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Ades F, Senterre C, Zardavas D, de Azambuja E, Popescu R, Parent F, Piccart M. An exploratory analysis of the factors leading to delays in cancer drug reimbursement in the European Union: The trastuzumab case. Eur J Cancer 2014; 50:3089-97. [DOI: 10.1016/j.ejca.2014.09.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Revised: 06/03/2014] [Accepted: 09/10/2014] [Indexed: 11/28/2022]
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135
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Investigation of circulating antibodies to ANXA1 in breast cancer. Tumour Biol 2014; 36:1233-6. [PMID: 25344217 DOI: 10.1007/s13277-014-2751-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Accepted: 10/15/2014] [Indexed: 10/24/2022] Open
Abstract
Our recent work demonstrated that circulating levels of IgG antibody to linear peptide antigens derived from annexin A1 (ANXA1) were significantly increased in lung cancer. The present study was then undertaken to test whether circulating anti-ANXA1 antibodies were also altered in breast cancer. An enzyme-linked immunosorbent assay was developed in-house to determine circulating IgG against ANXA1-derived peptide antigens in 152 female patients with breast cancer and 160 female control subjects. Student's t test revealed that patients with breast cancer had significantly higher levels of anti-ANXA1 IgG than control subjects (t = 4.75, P < 0.0001). Receiver operating characteristic (ROC) analysis showed that the area under the ROC curve was 0.73 with 95% confidence interval (CI) 0.67-0.78, and the sensitivity of anti-ANXA1 IgG assay was 23.2% against the specificity of 90%. The levels of anti-ANXA1 IgG did not appear to be stage-dependent, and Pearson correlation analysis showed no correlation between the anti-ANXA1 IgG levels and the stages of breast cancer (r = -0.02, df = 149, P = 0.796). This work suggests that circulating IgG for ANXA1-derived peptide antigens may have both diagnostic and prognostic values for breast cancer although further screening is needed to identify more such peptide antigens derived from tumor-associated antigens.
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136
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Ellis L, Woods LM, Estève J, Eloranta S, Coleman MP, Rachet B. Cancer incidence, survival and mortality: explaining the concepts. Int J Cancer 2014; 135:1774-82. [PMID: 24945976 DOI: 10.1002/ijc.28990] [Citation(s) in RCA: 102] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Accepted: 12/04/2013] [Indexed: 12/11/2022]
Abstract
Cancer incidence, survival and mortality are essential population-based indicators for public health and cancer control. Confusion and misunderstanding still surround the estimation and interpretation of these indicators. Recurring controversies over the use and misuse of population-based cancer statistics in health policy suggests the need for further clarification. In our article, we describe the concepts that underlie the measures of incidence, survival and mortality, and illustrate the synergy between these measures of the cancer burden. We demonstrate the relationships between trends in incidence, survival and mortality, using real data for cancers of the lung and breast from England and Sweden. Finally, we discuss the importance of using all three measures in combination when interpreting overall progress in cancer control, and we offer some recommendations for their use.
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Affiliation(s)
- Libby Ellis
- Cancer Research UK Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, United Kingdom
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137
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Wong IOL, Schooling CM, Cowling BJ, Leung GM. Breast cancer incidence and mortality in a transitioning Chinese population: current and future trends. Br J Cancer 2014; 112:167-70. [PMID: 25290086 PMCID: PMC4453599 DOI: 10.1038/bjc.2014.532] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Revised: 09/04/2014] [Accepted: 09/09/2014] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Projections of future trends in cancer incidence and mortality are important for public health planning. METHODS By using 1976-2010 data in Hong Kong, we fitted Poisson age-period-cohort models and made projections for future breast cancer incidence and mortality to 2025. RESULTS Age-standardised breast cancer incidence (/mortality) is projected to increase (/decline) from 56.7 (/9.3) in 2011-2015 to 62.5 (/8.6) per 100,000 women in 2021-2025. CONCLUSIONS The incidence pattern may relate to Hong Kong's socio-economic developmental history, while falling mortality trends are, most likely, due to improvements in survival from treatment advancement and improved health service delivery.
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Affiliation(s)
- I O L Wong
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - C M Schooling
- 1] School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China [2] City University of New York School of Public Health and Hunter College, New York, NY, USA
| | - B J Cowling
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - G M Leung
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
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Pinto AC, Canário R, Fidalgo P. Breast cancer control in China: challenges and opportunities of the use of population-based routine data studies. J Thorac Dis 2014; 6:1167-9. [PMID: 25276355 DOI: 10.3978/j.issn.2072-1439.2014.07.17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Accepted: 07/07/2014] [Indexed: 11/14/2022]
Affiliation(s)
- Ana Catarina Pinto
- 1 Medicine Department, Institut Jules Bordet, Université libre de Bruxelles, Brussels, Belgium ; 2 Br.E.A.S.T. Data Centre, Institut Jules Bordet, Brussels, Belgium ; 3 Department of Medical Oncology, Portuguese Institute of Oncology Francisco Gentil, EPE-Coimbra, Coimbra, Portugal
| | - Rita Canário
- 1 Medicine Department, Institut Jules Bordet, Université libre de Bruxelles, Brussels, Belgium ; 2 Br.E.A.S.T. Data Centre, Institut Jules Bordet, Brussels, Belgium ; 3 Department of Medical Oncology, Portuguese Institute of Oncology Francisco Gentil, EPE-Coimbra, Coimbra, Portugal
| | - Paula Fidalgo
- 1 Medicine Department, Institut Jules Bordet, Université libre de Bruxelles, Brussels, Belgium ; 2 Br.E.A.S.T. Data Centre, Institut Jules Bordet, Brussels, Belgium ; 3 Department of Medical Oncology, Portuguese Institute of Oncology Francisco Gentil, EPE-Coimbra, Coimbra, Portugal
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139
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Altobelli E, Lattanzi A. Breast cancer in European Union: an update of screening programmes as of March 2014 (review). Int J Oncol 2014; 45:1785-92. [PMID: 25174328 PMCID: PMC4203333 DOI: 10.3892/ijo.2014.2632] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Accepted: 06/26/2014] [Indexed: 12/11/2022] Open
Abstract
Breast cancer, a major cause of female morbidity and mortality, is a global health problem; 2008 data show an incidence of ~450,000 new cases and 140,000 deaths (mean incidence rate 70.7 and mortality rate 16.7, world age-standardized rate per 100,000 women) in European Union Member States. Incidence rates in Western Europe are among the highest in the world. We review the situation of BC screening programmes in European Union. Up to date information on active BC screening programmes was obtained by reviewing the literature and searching national health ministries and cancer service websites. Although BC screening programmes are in place in nearly all European Union countries there are still considerable differences in target population coverage and age and in the techniques deployed. Screening is a mainstay of early BC detection whose main weakness is the rate of participation of the target population. National policies and healthcare planning should aim at maximizing participation in controlled organized screening programmes by identifying and lowering any barriers to adhesion, also with a view to reducing healthcare costs.
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Affiliation(s)
- E Altobelli
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - A Lattanzi
- Epidemiologic and Social Marketing Unit, AUSL 4 Teramo, Italy
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140
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Adherence to cancer prevention guidelines in 18 African countries. PLoS One 2014; 9:e105209. [PMID: 25144291 PMCID: PMC4140739 DOI: 10.1371/journal.pone.0105209] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Accepted: 07/18/2014] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Cancer rates in Africa are projected to double by 2030 due to aging and increased exposure to cancer risk factors, including modifiable risk factors. We assessed adherence to 5 modifiable cancer risk factors across 18 African countries. METHODS Data on adults 18 years and older were obtained from the 2002-2004 World Health Survey. Adherence to current World Cancer Research Fund guidelines on smoking, alcohol, body weight, physical activity, and nutrition was assessed. Adherence scores ranged from 0 (no guideline met) to 5 (all guidelines met). Determinants of adherence were assessed using multivariable linear regression adjusted for individual and country level characteristics. RESULTS Across all countries, adherence to the guidelines among adults was high for smoking (72%-99%) and alcohol (85%-100%), but low for body weight (1.8%-78%), physical activity (3.4%-84%) and nutrition (1.4%-61%). Overall adherence score ranged from 2.32 in Mali to 3.72 in Comoros. In multivariable models, residing in low versus high SES households was associated with reduced adherence by 0.24 and 0.21 points for men and women respectively after adjusting for age, gender, education, and marital status (p<0.001). Every % increase in GDP spent on health was associated with increased adherence by 0.03 in men and 0.09 in women (p<0.001). CONCLUSIONS The wide variation in adherence to cancer prevention guidelines observed across countries and between population sub-groups suggests the need for targeted public health efforts to improve behaviors related to body weight, physical activity and nutrition.
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141
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Trends in breast cancer incidence and mortality in France 1990–2008. Breast Cancer Res Treat 2014; 147:167-75. [DOI: 10.1007/s10549-014-3073-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Accepted: 07/21/2014] [Indexed: 11/26/2022]
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Kluthcovsky ACGC, Faria TNP, Carneiro FH, Strona R. Female breast cancer mortality in Brazil and its regions. Rev Assoc Med Bras (1992) 2014; 60:387-93. [DOI: 10.1590/1806-9282.60.04.019] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2013] [Accepted: 01/13/2014] [Indexed: 11/22/2022] Open
Abstract
Objective: to analyze female breast cancer mortality trends in Brazil and its regions. Methods: female breast cancer mortality in Brazil and its regions was analyzed using mortality data from the Ministry of Health's Mortality Information System and the National Cancer Institute between 1991 and 2010. The variables analyzed were. proportional mortality from female breast cancer in relation to total deaths in women, mortality rates of the five primary locations of the neoplasms most common in women, and mortality rates for female breast cancer: Linear regression models were estimated to analyze mortality trends: Results: a growth in proportional mortality due to female breast cancer in Brazil and its regions was observed: In relation to the mortality rates for the five primary types of cancer, breast cancer persisted in first place in Brazil and its regions, except the North region, where cervical cancer was the most frequent: Rising female breast cancer mortality rates were observed for Brazil (p = 0.017), Northeastern (p < 0.001), North (p < 0.001) and the Mid-West (p = 0.001), regions, and declining rates for the Southeast region (p = 0.047), and stable rates for the South region. Conclusion: the results emphasize the importance of the disease in terms of public health in the country, reinforcing the need for early detection and appropriate treatment.
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143
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Peat G, Riley RD, Croft P, Morley KI, Kyzas PA, Moons KGM, Perel P, Steyerberg EW, Schroter S, Altman DG, Hemingway H. Improving the transparency of prognosis research: the role of reporting, data sharing, registration, and protocols. PLoS Med 2014; 11:e1001671. [PMID: 25003600 PMCID: PMC4086727 DOI: 10.1371/journal.pmed.1001671] [Citation(s) in RCA: 100] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
George Peat and colleagues review and discuss current approaches to transparency and published debates and concerns about efforts to standardize prognosis research practice, and make five recommendations. Please see later in the article for the Editors' Summary
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Affiliation(s)
- George Peat
- Arthritis Research UK Primary Care Research Centre, Research Institute for Primary Care & Health Sciences, Keele University, Keele, Staffordshire, United Kingdom
| | - Richard D. Riley
- School of Health and Population Sciences, University of Birmingham, United Kingdom
| | - Peter Croft
- Arthritis Research UK Primary Care Research Centre, Research Institute for Primary Care & Health Sciences, Keele University, Keele, Staffordshire, United Kingdom
| | - Katherine I. Morley
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
- Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, The University of Melbourne, Victoria, Australia
| | - Panayiotis A. Kyzas
- Department of Oral and Maxillofacial Surgery, North Manchester General Hospital, Pennine Acute NHS Trust, Manchester, United Kingdom
| | - Karel G. M. Moons
- Julius Center for Health Sciences and Primary Care, UMC Utrecht, Utrecht, Netherlands
| | - Pablo Perel
- London School of Hygiene & Tropical Medicine, London, United Kingdom
| | | | | | - Douglas G. Altman
- Centre for Statistics in Medicine, University of Oxford, Wolfson College Annexe, Oxford, United Kingdom
| | - Harry Hemingway
- Department of Epidemiology and Public Health and Director of the Farr Institute of Health Informatics Research at UCL Partners, London, United Kingdom
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144
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Loibl S, Reinisch M. Present status of adjuvant chemotherapy for elderly breast cancer patients. ACTA ACUST UNITED AC 2014; 7:439-44. [PMID: 24715824 DOI: 10.1159/000345867] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Elderly breast cancer patients are underrepresented in clinical trials, leading to a lack of knowledge regarding their tolerance of modern chemotherapy regimens. In addition, physicians are often reluctant to treat older patients with chemotherapy due to potential side effects. This article summarizes the up-to-date literature on chemotherapy in elderly patients with breast cancer, evaluates the impact of the patients' comorbidities and treatment alterations and aims to encourage treating patients adequately according to their disease in combination with the biological age rather than the chronological age alone. Finally, a short overview is given of the recruiting studies in Europe evaluating chemotherapy in elderly patients.
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Affiliation(s)
- Sibylle Loibl
- German Breast Group, Neu-Isenburg, Germany ; Städtische Kliniken Offenbach, Germany
| | - Mattea Reinisch
- German Breast Group, Neu-Isenburg, Germany ; Frauenklinik, Bürgerhospital Frankfurt/M., Germany
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145
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Pranjić N, Gledo I, Maleš-Bilić L. The Most Common New Cases of Breast Cancer among the Housewives: The Some Carcinogenic Determinants. Open Access Maced J Med Sci 2014. [DOI: 10.3889/oamjms.2014.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Numerous studies have observed risk factors for breast cancer. We aimed to investigate and assess the relationship between individual, social, occupational and environmental determinants of breast cancer using a questionnaire among 100 newly diagnosed female breast cancer patients and 100 control female subjects without cancer.METHODS: A case-control study using a family ambulatory based survey was conducted among 200 female patients from all municipalities of Zenica - Doboj Canton. New cases of breast cancer among subjects of experimental group (n = 100) were diagnosed between January 1, 2003 and December 31, 2007 using the institutional clinical procedure for breast cancer diagnosis. Data were obtained using a self - rated questionnaire specially designed for this research. The questionnaire contains a group of questions about individual and demographic data, occupational and environment characteristics, reproductive hystory, body mass index, life style and quality life factors.RESULTS: Fifty two percent of our examinees with breast cancer are housewives. There were no significant differences between the two groups and their subgroups except for prevalence of routine physical activity (P = 0.016), unemployment (P = 0.004), history arrival menopause (P = 0.012), and type of occupation/ workplace (P = 0.015) among subjects with breast cancer in relation to control subjects. We found significantly higher prevalence for failure to routine physical activity (P = 0.006), obesity (P = 0.009), unemployment (P = 0.001), unsecure existence (P = 0.015), and low level of education (P = 0.001) in housewives in relationship to others occupation.CONCLUSION: The most common new cases of breast cancer were among housewife. Inverse significantly link between breast cancer and poverty, arrival time of menopause and distant-cousin- degree family history were found. For most women, physical activity may reduce the risk of invasive breast cancer.
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146
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Ceugnart L, Taïeb S, Deghaye M. Controverses sur le dépistage du cancer du sein par mammographie : quelles informations donner aux femmes ? IMAGERIE DE LA FEMME 2014. [DOI: 10.1016/j.femme.2014.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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147
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Suzuki A, Ishida T, Ohuchi N. Controversies in breast cancer screening for women aged 40-49 years. Jpn J Clin Oncol 2014; 44:613-8. [PMID: 24821976 DOI: 10.1093/jjco/hyu054] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Mammography is the only method of breast cancer screening that has established evidence of a mortality reduction. However, mammography does not achieve sufficient accuracy in the high-density breasts of patients<50 years of age. In 2009, the US Preventive Services Task Force revised its recommendation for breast cancer screening in women aged 40-49 years from Grade B to C because the net benefit was relatively small for this age bracket. The net benefit of screening is the sum of benefits and harm and should always be monitored especially in population screening. A high recall rate, an inefficient number needed to invite for screening to prevent one breast cancer death, a high false-positive rate and unnecessary additional imaging for women aged 40-49 years are great concerns of mammography screening. Overdiagnosis is also a detriment of mammography screening; however, it may have a limited effect on women aged 40-49 years. Establishment of new evidence for breast cancer screening, such as ultrasonography screening, is needed in order to create a more effective screening system.
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Affiliation(s)
- Akihiko Suzuki
- Department of Advanced Breast Cancer Imaging, Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai
| | - Takanori Ishida
- Department of Surgical Oncology, Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Japan
| | - Noriaki Ohuchi
- Department of Surgical Oncology, Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Japan
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148
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Nelson M, Millican-Slater R, Forrest LC, Brackenbury WJ. The sodium channel β1 subunit mediates outgrowth of neurite-like processes on breast cancer cells and promotes tumour growth and metastasis. Int J Cancer 2014; 135:2338-51. [PMID: 24729314 PMCID: PMC4200311 DOI: 10.1002/ijc.28890] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2013] [Accepted: 04/03/2014] [Indexed: 02/03/2023]
Abstract
Voltage-gated Na+ channels (VGSCs) are heteromeric proteins composed of pore-forming α subunits and smaller β subunits. The β subunits are multifunctional channel modulators and are members of the immunoglobulin superfamily of cell adhesion molecules (CAMs). β1, encoded by SCN1B, is best characterized in the central nervous system (CNS), where it plays a critical role in regulating electrical excitability, neurite outgrowth and migration during development. β1 is also expressed in breast cancer (BCa) cell lines, where it regulates adhesion and migration in vitro. In the present study, we found that SCN1B mRNA/β1 protein were up-regulated in BCa specimens, compared with normal breast tissue. β1 upregulation substantially increased tumour growth and metastasis in a xenograft model of BCa. β1 over-expression also increased vascularization and reduced apoptosis in the primary tumours, and β1 over-expressing tumour cells had an elongate morphology. In vitro, β1 potentiated outgrowth of processes from BCa cells co-cultured with fibroblasts, via trans-homophilic adhesion. β1-mediated process outgrowth in BCa cells required the presence and activity of fyn kinase, and Na+ current, thus replicating the mechanism by which β1 regulates neurite outgrowth in CNS neurons. We conclude that when present in breast tumours, β1 enhances pathological growth and cellular dissemination. This study is the first demonstration of a functional role for β1 in tumour growth and metastasis in vivo. We propose that β1 warrants further study as a potential biomarker and targeting β1-mediated adhesion interactions may have value as a novel anti-cancer therapy.
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Affiliation(s)
- Michaela Nelson
- Department of Biology, University of York, Heslington, York, YO10 5DD, United Kingdom
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149
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Nolasco A, Quesada JA, Moncho J, Melchor I, Pereyra-Zamora P, Tamayo-Fonseca N, Martínez-Beneito MA, Zurriaga O. Trends in socioeconomic inequalities in amenable mortality in urban areas of Spanish cities, 1996-2007. BMC Public Health 2014; 14:299. [PMID: 24690471 PMCID: PMC3983886 DOI: 10.1186/1471-2458-14-299] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2014] [Accepted: 03/28/2014] [Indexed: 12/02/2022] Open
Abstract
Background While research continues into indicators such as preventable and amenable mortality in order to evaluate quality, access, and equity in the healthcare, it is also necessary to continue identifying the areas of greatest risk owing to these causes of death in urban areas of large cities, where a large part of the population is concentrated, in order to carry out specific actions and reduce inequalities in mortality. This study describes inequalities in amenable mortality in relation to socioeconomic status in small urban areas, and analyses their evolution over the course of the periods 1996–99, 2000–2003 and 2004–2007 in three major cities in the Spanish Mediterranean coast (Alicante, Castellón, and Valencia). Methods All deaths attributed to amenable causes were analysed among non-institutionalised residents in the three cities studied over the course of the study periods. Census tracts for the cities were grouped into 3 socioeconomic status levels, from higher to lower levels of deprivation, using 5 indicators obtained from the 2001 Spanish Population Census. For each city, the relative risks of death were estimated between socioeconomic status levels using Poisson’s Regression models, adjusted for age and study period, and distinguishing between genders. Results Amenable mortality contributes significantly to general mortality (around 10%, higher among men), having decreased over time in the three cities studied for men and women. In the three cities studied, with a high degree of consistency, it has been seen that the risks of mortality are greater in areas of higher deprivation, and that these excesses have not significantly modified over time. Conclusions Although amenable mortality decreases over the time period studied, the socioeconomic inequalities observed are maintained in the three cities. Areas have been identified that display excesses in amenable mortality, potentially attributable to differences in the healthcare system, associated with areas of greater deprivation. Action must be taken in these areas of greater inequality in order to reduce the health inequalities detected. The causes behind socioeconomic inequalities in amenable mortality must be studied in depth.
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Affiliation(s)
- Andreu Nolasco
- Unidad de Investigación de Análisis de la Mortalidad y Estadísticas Sanitarias, Departamento de Enfermería Comunitaria, Medicina Preventiva y Salud Pública e Historia de la Ciencia, Universidad de Alicante Campus de San Vicente del Raspeig s/n, Apartado 99, 03080 Alicante, España.
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150
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Abstract
Preventing breast cancer is an effective strategy for reducing breast cancer deaths. The purpose of chemoprevention (also termed preventive therapy) is to reduce cancer incidence by use of natural, synthetic, or biological agents. The efficacy of tamoxifen, raloxifene, and exemestane as preventive therapy against estrogen-receptor (ER)-positive breast cancer is well established for women at increased risk for breast cancer. However, because breast cancer is a heterogeneous disease, distinct preventive approaches may be required for effective prevention of each subtype. Current research is, therefore, focused on identifying alternative mechanisms by which biologically active compounds can reduce the risk of all breast cancer subtypes including ER-negative breast cancer. Promising agents are currently being developed for prevention of HER2-positive and triple-negative breast cancer (TNBC) and include inhibitors of the ErbB family receptors, COX-2 inhibitors, metformin, retinoids, statins, poly(ADP-ribose) polymerase inhibitors, and natural compounds. This review focuses on recent progress in research to develop more effective preventive agents, in particular for prevention of ER-negative breast cancer.
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