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Calvo I, González-Rodríguez M, Neria F, Gallegos I, García-Sánchez L, Sánchez-Gómez R, Pérez S, Arenas MF, Estévez LG. An analysis of the association between breast density and body mass index with breast cancer molecular subtypes in early breast cancer: data from a Spanish population. Clin Transl Oncol 2024; 26:2541-2548. [PMID: 38734800 PMCID: PMC11410912 DOI: 10.1007/s12094-024-03469-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 03/18/2024] [Indexed: 05/13/2024]
Abstract
PURPOSE Breast cancer is an important health problem, like obesity and dyslipidemia, with a strong association between body mass index (BMI) and breast cancer incidence and mortality. The risk of breast cancer is also high in women with high mammographic breast density (MBD). The purpose of this study was to analyze the association between BMI and MBD according to breast cancer molecular subtypes. METHODS This transversal, descriptive, multicenter study was conducted at three Spanish breast cancer units from November 2019 to October 2020 in women with a recent diagnosis of early breast cancer. Data were collected at the time of diagnosis. RESULTS The study included 162 women with a recent diagnosis of early breast cancer. The median age was 52 years and 49.1% were postmenopausal; 52% had normal weight, 32% overweight, and 16% obesity. There was no association between BMI and molecular subtype but, according to menopausal status, BMI was significantly higher in postmenopausal patients with luminal A (p = 0.011) and HER2-positive (p = 0.027) subtypes. There was no association between MBD and molecular subtype, but there were significant differences between BMI and MBD (p < 0.001), with lower BMI in patients with higher MBD. Patients with higher BMI had lower HDL-cholesterol (p < 0.001) and higher insulin (p < 0.001) levels, but there were no significant differences in total cholesterol or vitamin D. CONCLUSIONS This study showed higher BMI in luminal A and HER2-positive postmenopausal patients, and higher BMI in patients with low MBD regardless of menopausal status.
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Affiliation(s)
- Isabel Calvo
- Breast Cancer Unit- Oncology, MD Anderson Cancer Center, Madrid, Spain.
- Fundación MD Anderson Internacional España, Madrid, Spain.
| | - Marta González-Rodríguez
- Breast Cancer Unit- Oncology, MD Anderson Cancer Center, Madrid, Spain
- Fundación MD Anderson Internacional España, Madrid, Spain
| | - Fernando Neria
- Facultad de Medicina, Universidad Francisco de Vitoria, Madrid, Spain
| | - Isabel Gallegos
- Breast Cancer Unit- Oncology, Hospital de Segovia, Segovia, Spain
| | | | | | - Silvia Pérez
- Breast Cancer Unit- Radiology, MD Anderson Cancer Center, Madrid, Spain
| | | | - Laura G Estévez
- Breast Cancer Unit- Oncology, MD Anderson Cancer Center, Madrid, Spain
- Fundación MD Anderson Internacional España, Madrid, Spain
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Dai Q, Zhang Y, Zhao X, Yang X, Sun H, Wu S, Chen S, Wang J, Cao Z, Ma X. Trajectories of peripheral white blood cells count around the menopause: a prospective cohort study. BMC Womens Health 2024; 24:504. [PMID: 39261797 PMCID: PMC11389272 DOI: 10.1186/s12905-024-03344-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2024] [Accepted: 08/29/2024] [Indexed: 09/13/2024] Open
Abstract
BACKGROUND Menopause significantly impacts the immune system. Postmenopausal women are more susceptible to infection. Nonetheless, the pattern of change in peripheral white blood cell counts around the menopause remains poorly understood. METHODS We conducted a prospective longitudinal cohort study with repeated measurements using Kailuan cohort study of 3632 Chinese women who participated in the first checkup (2006-2007) and reached their final menstrual period (FMP) by the end of the seventh checkup (2018-2020). Peripheral WBC count indicators included total white blood cells (TWBC), neutrophils (NEUT), lymphocytes (LYM), and monocytes (MON). Multivariable mixed effects regressions fitted piece-wise linear models to repeated measures of WBC count indicators as a function of time before or after the final menstrual period (FMP). Interaction and subgroup analysis were used to explore the effects of age and body mass index (BMI) on changes in WBC indicators around FMP. RESULTS WBC count indicators decreased before the FMP, and the reduction in TWBC, NEUT, and MON continued for 2 years following the FMP. LYM and NEUT declined during < -1 years and - 4 ∼ + 2 years relative to FMP, respectively. A reduction in MON was observed pre-FMP, extending continuously through the two-year period post-FMP. TWBC declined from - 3 to + 2 years relative to FMP, but both MON and TWBC increased during > + 2 years. The baseline age had an interaction effect on changes in WBC indicators during specific menopausal stages, except for TWBC. Individuals in different age subgroups showed distinct trajectories for NEUT, LYM and MON around the FMP. High baseline BMI had a synergistic effect on changes in specific menopause segments for TWBC, LYM, and MON. The impact of menopause on TWBC and LYM was postponed or counterbalanced in high BMI individuals. Individuals in three BMI subgroups experienced similar MON changes around FMP, and there were slight variations during < -4 years. CONCLUSIONS Menopause was associated with count changes of peripheral WBC. The trajectories of various WBC types differ around menopause. Age and BMI affected WBC trajectory around menopause. The menopause period may represent a window of opportunity to promote immune health in middle-aged women.
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Grants
- 2005DKA21300 National Human Genetic Resources Sharing Service Platform, China
- 2005DKA21300 National Human Genetic Resources Sharing Service Platform, China
- 2005DKA21300 National Human Genetic Resources Sharing Service Platform, China
- 2005DKA21300 National Human Genetic Resources Sharing Service Platform, China
- 2005DKA21300 National Human Genetic Resources Sharing Service Platform, China
- 2005DKA21300 National Human Genetic Resources Sharing Service Platform, China
- 2005DKA21300 National Human Genetic Resources Sharing Service Platform, China
- 2005DKA21300 National Human Genetic Resources Sharing Service Platform, China
- 2005DKA21300 National Human Genetic Resources Sharing Service Platform, China
- 2005DKA21300 National Human Genetic Resources Sharing Service Platform, China
- 2016YFC1000307 National Key Research and Development Program of China
- 2016YFC1000307 National Key Research and Development Program of China
- 2016YFC1000307 National Key Research and Development Program of China
- 2016YFC1000307 National Key Research and Development Program of China
- 2016YFC1000307 National Key Research and Development Program of China
- 2016YFC1000307 National Key Research and Development Program of China
- 2016YFC1000307 National Key Research and Development Program of China
- 2016YFC1000307 National Key Research and Development Program of China
- 2016YFC1000307 National Key Research and Development Program of China
- 2016YFC1000307 National Key Research and Development Program of China
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Affiliation(s)
- Qiaoyun Dai
- National Human Genetic Resources Center, National Research Institute for Family Planning, Beijing, China
| | - Yaya Zhang
- Graduate School of North, China University of Science and Technology, Tangshan, China
- Health Department of Kailuan (group), Kailuan General Hospital, Tangshan, China
| | - Xiujuan Zhao
- Graduate School of North, China University of Science and Technology, Tangshan, China
- Health Department of Kailuan (group), Kailuan General Hospital, Tangshan, China
| | - Xueying Yang
- National Human Genetic Resources Center, National Research Institute for Family Planning, Beijing, China
| | - Huayu Sun
- Graduate School of North, China University of Science and Technology, Tangshan, China
- Health Department of Kailuan (group), Kailuan General Hospital, Tangshan, China
| | - Shouling Wu
- Health Department of Kailuan (group), Kailuan General Hospital, Tangshan, China
| | - Shuohua Chen
- Health Department of Kailuan (group), Kailuan General Hospital, Tangshan, China
| | - Jianmei Wang
- Health Department of Kailuan (group), Kailuan General Hospital, Tangshan, China
| | - Zongfu Cao
- National Human Genetic Resources Center, National Research Institute for Family Planning, Beijing, China.
| | - Xu Ma
- National Human Genetic Resources Center, National Research Institute for Family Planning, Beijing, China.
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Hassan M, Tutar L, Sari-Ak D, Rasul A, Basheer E, Tutar Y. Non-genetic heterogeneity and immune subtyping in breast cancer: Implications for immunotherapy and targeted therapeutics. Transl Oncol 2024; 47:102055. [PMID: 39002207 PMCID: PMC11299575 DOI: 10.1016/j.tranon.2024.102055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 05/25/2024] [Accepted: 07/01/2024] [Indexed: 07/15/2024] Open
Abstract
Breast cancer (BC) is a complex and multifactorial disease, driven by genetic alterations that promote tumor growth and progression. However, recent research has highlighted the importance of non-genetic factors in shaping cancer evolution and influencing therapeutic outcomes. Non-genetic heterogeneity refers to diverse subpopulations of cancer cells within breast tumors, exhibiting distinct phenotypic and functional properties. These subpopulations can arise through various mechanisms, including clonal evolution, genetic changes, epigenetic changes, and reversible phenotypic transitions. Although genetic and epigenetic changes are important points of the pathology of breast cancer yet, the immune system also plays a crucial role in its progression. In clinical management, histologic and molecular classification of BC are used. Immunological subtyping of BC has gained attention in recent years as compared to traditional techniques. Intratumoral heterogeneity revealed by immunological microenvironment (IME) has opened novel opportunities for immunotherapy research. This systematic review is focused on non-genetic variability to identify and interlink immunological subgroups in breast cancer. This review provides a deep understanding of adaptive methods adopted by tumor cells to withstand changes in the tumor microenvironment and selective pressure imposed by medications. These adaptive methods include alterations in drug targets, immune system evasion, activation of survival pathways, and alterations in metabolism. Understanding non-genetic heterogeneity is essential for the development of targeted therapies.
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Affiliation(s)
- Mudassir Hassan
- Department of Zoology, Government College University Faisalabad, Faisalabad, Punjab 38000, Pakistan
| | - Lütfi Tutar
- Department of Molecular Biology and Genetics, Faculty of Arts and Sciences, Kırsehir Ahi Evran University, Kırsehir, Turkey
| | - Duygu Sari-Ak
- Department of Medical Biology, Hamidiye International School of Medicine, University of Health Sciences, Istanbul 34668, Turkey
| | - Azhar Rasul
- Department of Zoology, Government College University Faisalabad, Faisalabad, Punjab 38000, Pakistan
| | - Ejaz Basheer
- Department of Pharmacognosy, Faculty of Pharmaceutical, Sciences Government College University Faisalabad, Pakistan
| | - Yusuf Tutar
- Faculty of Medicine, Division of Biochemistry, Recep Tayyip Erdogan University, Rize, Turkey.
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Bermúdez M, Martínez-Barajas MG, Bueno-Urquiza LJ, López-Gutiérrez JA, Villegas-Mercado CE, López-Camarillo C. Role of MicroRNA-204 in Regulating the Hallmarks of Breast Cancer: An Update. Cancers (Basel) 2024; 16:2814. [PMID: 39199587 PMCID: PMC11352763 DOI: 10.3390/cancers16162814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2024] [Revised: 08/01/2024] [Accepted: 08/09/2024] [Indexed: 09/01/2024] Open
Abstract
microRNA-204-5p (miR-204) is a small noncoding RNA with diverse regulatory roles in breast cancer (BC) development and progression. miR-204 is implicated in the instauration of fundamental traits acquired during the multistep development of BC, known as the hallmarks of cancer. It may act as a potent tumor suppressor by inhibiting key cellular processes like angiogenesis, vasculogenic mimicry, invasion, migration, and metastasis. It achieves this by targeting multiple master genes involved in these processes, including HIF-1α, β-catenin, VEGFA, TGFBR2, FAK, FOXA1, among others. Additionally, miR-204 modulates signaling pathways like PI3K/AKT and interacts with HOTAIR and DSCAM-AS1 lncRNAs, further influencing tumor progression. Beyond its direct effects on tumor cells, miR-204 shapes the tumor microenvironment by regulating immune cell infiltration, suppressing pro-tumorigenic cytokine production, and potentially influencing immunotherapy response. Moreover, miR-204 plays a crucial role in metabolic reprogramming by directly suppressing metabolic genes within tumor cells, indirectly affecting metabolism through exosome signaling, and remodeling metabolic flux within the tumor microenvironment. This review aims to present an update on the current knowledge regarding the role of miR-204 in the hallmarks of BC. In conclusion, miR-204 is a potential therapeutic target and prognostic marker in BC, emphasizing the need for further research to fully elucidate its complex roles in orchestrating aggressive BC behavior.
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Affiliation(s)
- Mercedes Bermúdez
- Faculty of Dentistry, Autonomous University of Chihuahua, Chihuahua 31000, Mexico;
| | | | - Lesly Jazmín Bueno-Urquiza
- University Center for Health Sciences, University of Guadalajara, Guadalajara 44340, Mexico; (M.G.M.-B.); (L.J.B.-U.)
| | - Jorge Armando López-Gutiérrez
- Faculty of Dentistry, Autonomous University of Sinaloa, Josefa Ortiz de Domínguez s/n y Avenida de las Américas, Culiacan 80013, Mexico;
| | | | - César López-Camarillo
- Genomic Sciences Program, Autonomous University of Mexico City, San Lorenzo 290, Col del Valle, Mexico City 03100, Mexico
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Önder T, Ateş Ö, Öner İ, Karaçin C. Triglyceride-Glucose Index: A Candidate Prognostic Marker in HR-Positive/HER2-Negative Metastatic Breast Cancer Patients Treated With CDK4/6 Inhibitors. Clin Breast Cancer 2024; 24:519-526. [PMID: 38879437 DOI: 10.1016/j.clbc.2024.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Revised: 04/26/2024] [Accepted: 05/07/2024] [Indexed: 07/28/2024]
Abstract
AIMS AND OBJECTIVES Although cyclin-dependent kinase 4/6 inhibitors (CDK 4/6i) are a vital part of the treatment of hormone receptor (HR)-positive/HER-2-negative metastatic breast cancer (BC), individuals have different sensitivities to CDK4/6i, indicating the need for biomarkers. The fasting triglyceride glucose (TyG) index is an easily accessible surrogate marker of insulin resistance (IR). Herein, we investigated the prognostic significance of the fasting triglyceride glucose (TyG) index in HR+/HER2- metastatic BC patients treated with CDK4/6i plus endocrine therapy (ET). METHODS About 333 patients with HR+/HER2-metastatic BC treated with CDK4/6i plus ET were analyzed retrospectively. The TyG index was calculated within 3 months before the initiation of CDK4/6i plus ET. The median value of 8.43 was taken as the cutoff for the TyG index. RESULTS The median overall survival (OS) was 73.6 months (95% CI, 66.0-81.1) in the whole cohort. The progression-free survival (PFS) was significantly longer in the low-TyG subgroup than in the high-TyG subgroup (30.1 vs. 21.3 months, multivariate adjusted [HR] = 0.666, 95% CI, 0.450-0.987, P = .043). While the median OS was not reached in the low TyG subgroup, it was 69.0 months in the high TyG subgroup (multivariate-adjusted HR = 0.513, 95% CI, 0.281-0.936, P = .030). Although the ORR and DCR were numerically greater in the low-TyG subgroup, no significant differences were observed between the low-TyG subgroup and high-TyG subgroup (28.1% vs. 24.7%, P = .476; 83.2% vs. 80.1%, P = .463, respectively). CONCLUSIONS These data imply that the TyG index could be a predictive biomarker for the therapeutic efficacy of CDK4/6is. Extensive prospective studies are needed to confirm these findings.
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Affiliation(s)
- Tuğba Önder
- Health Sciences University, Dr Abdurrahman Yurtaslan Ankara Oncology Education and Research Hospital, Department of Medical Oncology, Yenimahalle Ankara, Turkey.
| | - Öztürk Ateş
- Health Sciences University, Dr Abdurrahman Yurtaslan Ankara Oncology Education and Research Hospital, Department of Medical Oncology, Yenimahalle Ankara, Turkey
| | - İrem Öner
- Health Sciences University, Dr Abdurrahman Yurtaslan Ankara Oncology Education and Research Hospital, Department of Medical Oncology, Yenimahalle Ankara, Turkey
| | - Cengiz Karaçin
- Health Sciences University, Dr Abdurrahman Yurtaslan Ankara Oncology Education and Research Hospital, Department of Medical Oncology, Yenimahalle Ankara, Turkey
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6
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Li Y, Liu M, Kong B, Zhang G, Zhang Q. The role of selenium intervention in gut microbiota homeostasis and gene function in mice with breast cancer on a high-fat diet. Front Microbiol 2024; 15:1439652. [PMID: 39144222 PMCID: PMC11322145 DOI: 10.3389/fmicb.2024.1439652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Accepted: 07/15/2024] [Indexed: 08/16/2024] Open
Abstract
Objective This study aimed to investigate the effect of selenium on gut microbiota in mice with breast cancer under a high-fat diet. Methods A total of 12 female BALB/c mice were randomly divided into two groups: 4 T1 + selenium+ high-fat diet group and 4 T1 + high-fat diet group. Mice were injected with 4 T1 cells on the right 4th mammary fat pad and kept on a high-fat diet. Fecal samples were collected, and DNA was extracted for metagenomic sequencing and bioinformatics analysis. Relevant target genes and pathways were annotated and metabolically analyzed to explore the intervention effect of selenium on breast cancer in the high-fat diet state. Results Selenium supplementation in the high-fat diet altered the composition and diversity of gut microbiota in mice with breast cancer. The gut microbial composition was significantly different in the selenium intervention group, with an increased abundance of Proteobacteria, Actinobacteria, and Verrucomicrobia phyla and species such as Helicobacter ganmani, Helicobacter japonicus, and Akkermansia muciniphila, while phyla, such as Bacteroidetes, Firmicutes, Deferribacteres, and Spirochaetes, and species, such as Prevotella sp. MGM2, Muribaculum intestinale, Lactobacillus murinus, and Prevotella sp. MGM1, were decreased. Functional analysis revealed differential expression of genes related to carbohydrate-active enzymes, pathogen-host interactions, cell communication, cell auto-induction, membrane transporters, and virulence factors. Furthermore, 37 COGs and 48 metabolites with rising metabolic potential in the selenium intervention group were predicted. Conclusion Selenium alters the homeostasis of gut microbiota in mice with breast cancer on a high-fat diet, affecting their composition, abundance, and associated metabolism. These findings suggest that the mechanism involves interfering with gut microbiota homeostasis, leading to altered synthesis of tumor-associated proteins and fatty acids and inducing tumor cell apoptosis and pyroptosis.
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Affiliation(s)
- Yinan Li
- Beijing University of Chinese Medicine, Beijing, China
- Department of Oncology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Min Liu
- School of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Bingtan Kong
- Beijing University of Chinese Medicine, Beijing, China
- Department of Oncology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Ganlin Zhang
- Department of Oncology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Qing Zhang
- Department of Oncology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
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Amadou A, Freisling H, Sedlmeier AM, Bohmann P, Fontvieille E, Weber A, Konzok J, Stein MJ, Peruchet-Noray L, Jansana A, Noh H, His M, Gan Q, Baurecht H, Fervers B. Multi-Trait Body Shape Phenotypes and Breast Cancer Risk in Postmenopausal Women: A Causal Mediation Analysis in the UK Biobank Cohort. J Epidemiol Glob Health 2024; 14:420-432. [PMID: 38598163 PMCID: PMC11176278 DOI: 10.1007/s44197-024-00226-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 04/01/2024] [Indexed: 04/11/2024] Open
Abstract
Body shape phenotypes combining multiple anthropometric traits have been linked to postmenopausal breast cancer (BC). However, underlying biological pathways remain poorly understood. This study investigated to what extent the associations of body shapes with postmenopausal BC risk is mediated by biochemical markers. The study included 176,686 postmenopausal women from UK Biobank. Four body shape phenotypes were derived from principal component (PC) analysis of height, weight, body mass index, waist and hip circumferences, and waist-to-hip ratio (WHR). The four-way decomposition of the total effect was used to estimate mediation and interaction effects simultaneously as well as the mediated proportions. After 10.9 years median follow-up, 6,396 incident postmenopausal BC were diagnosed. There was strong evidence of positive associations between PC1 (general obesity) and PC2 (tall, low WHR), and BC risk. The association of PC1 with BC risk was positively mediated by testosterone and negatively by insulin-like growth factor-1 (IGF-1), with the overall proportion mediated (sum of the mediated interaction and pure indirect effect (PIE)) accounting for 11.4% (95% confidence intervals: 5.1 to 17.8%) and -12.2% (-20.5% to -4.0%) of the total effect, respectively. Small proportions of the association between PC2 and BC were mediated by IGF-1 (PIE: 2.8% (0.6 to 4.9%)), and sex hormone-binding globulin (SHBG) (PIE: -6.1% (-10.9% to -1.3%)). Our findings are consistent with differential pathways linking different body shapes with BC risk, with a suggestive mediation through testosterone and IGF-1 in the relationship of a generally obese body shape and BC risk, while IGF-1 and SHBG may mediate a tall/lean body shape-BC risk association.
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Affiliation(s)
- Amina Amadou
- Department of Prevention Cancer Environment, Centre Léon Bérard, 28 rue Laënnec, Lyon Cedex 08, 69373, France.
- Inserm U1296 Radiations : Défense, Santé, Environnement, Lyon, France.
| | - Heinz Freisling
- Nutrition and Metabolism Branch, International Agency for Research on Cancer (IARC), Lyon, France
| | - Anja M Sedlmeier
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Patricia Bohmann
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Emma Fontvieille
- Nutrition and Metabolism Branch, International Agency for Research on Cancer (IARC), Lyon, France
| | - Andrea Weber
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Julian Konzok
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Michael J Stein
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Laia Peruchet-Noray
- Nutrition and Metabolism Branch, International Agency for Research on Cancer (IARC), Lyon, France
| | - Anna Jansana
- Nutrition and Metabolism Branch, International Agency for Research on Cancer (IARC), Lyon, France
| | - Hwayoung Noh
- Department of Prevention Cancer Environment, Centre Léon Bérard, 28 rue Laënnec, Lyon Cedex 08, 69373, France
- Inserm U1296 Radiations : Défense, Santé, Environnement, Lyon, France
| | - Mathilde His
- Department of Prevention Cancer Environment, Centre Léon Bérard, 28 rue Laënnec, Lyon Cedex 08, 69373, France
- Inserm U1296 Radiations : Défense, Santé, Environnement, Lyon, France
| | - Quan Gan
- Nutrition and Metabolism Branch, International Agency for Research on Cancer (IARC), Lyon, France
| | - Hansjörg Baurecht
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Béatrice Fervers
- Department of Prevention Cancer Environment, Centre Léon Bérard, 28 rue Laënnec, Lyon Cedex 08, 69373, France
- Inserm U1296 Radiations : Défense, Santé, Environnement, Lyon, France
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8
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Ahmed ABM, Alrawa S, Yeddi AA, Alfadul ESA, Allah HMAA, Ahmed³ MBM. Breast cancer burden in eastern Sudan: seven-year retrospective study. Ecancermedicalscience 2024; 18:1704. [PMID: 39021556 PMCID: PMC11254413 DOI: 10.3332/ecancer.2024.1704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Indexed: 07/20/2024] Open
Abstract
Background Breast cancer (BC) is prevalent in Sudan, yet data on its epidemiology in Eastern Sudan is limited. This study aims to provide insights into the demographic and clinicopathologic features of BC patients treated at the East Oncology Centre (EOC) in Gadarif State, Eastern Sudan. Furthermore, we aim to identify the factors that contribute to a late-stage diagnosis. Methods This cross-sectional study included patients diagnosed with BC and treated in the EOC between 2016 and 2022. Data obtained from medical records were analysed using R software, with descriptive statistics and multiple logistic regressions applied to determine determinants of advanced-stage presentation. A p-value < 0.05 was considered statistically significant. Results Among the 394 patients studied, the majority were women (96%), married (66%) and from rural areas (43%). The peak years for BC diagnoses were 2018 and 2022, with a median age at diagnosis of 48 years. A family history of cancer was reported by 20% of patients. Clinical stages were distributed as follows: I (1.6%), II (17%), III (50%) and IV (32%). Twenty-five percent tested positive for human epidermal growth factor receptor 2, while 73% tested negative and 43% had triple-negative BC. Modified radical mastectomy was performed in 47% of patients, with 21% undergoing breast-conserving surgery. Treatment rates were 38% for radiotherapy, 84% for chemotherapy and 46% for hormonal therapy. Higher grade BC and lower education levels were associated with advanced-stage presentation, while a family history of cancer reduced the risk of advanced-stage disease (OR: 0.38, 95% CI: 0.18-0.78). Conclusion The study found that females in East Sudan often present at a young age and advanced stage, with a significant prevalence of triple-negative BC. Notably, family cancer history exhibited a protective effect against advanced-stage presentation, while grade 3 cancer was positively associated with advanced disease.
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Affiliation(s)
| | - Salma Alrawa
- Faculty of Medicine, University of Khartoum, Khartoum 11111, Sudan
| | - Ahmed A Yeddi
- Faculty of Medicine, University of Khartoum, Khartoum 11111, Sudan
| | | | | | - Muhannad Bushra Masaad Ahmed³
- Faculty of Medicine, University of Khartoum, Khartoum 11111, Sudan
- East Oncology Center, Ministry of Health, Gadarif 11111, Sudan
- Faculty of Medicine and Health Sciences, University of Gadarif, Gadarif 11111, Sudan
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Chen S, Yang Q, Zheng S, Chen C, Gao L, Liu J. Evaluation of the Efficacy and Safety of Pedicled Perforator Flap Technique for Salvage Nipple Reconstruction in Breast Cancer Patients: A Pilot Study. Surg Innov 2024:15533506241242906. [PMID: 38571331 DOI: 10.1177/15533506241242906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
Abstract
OBJECTIVE We propose a pedicled perforator flap technique for salvage nipple reconstruction after initial nipple reconstruction fails in breast cancer patients. METHODS This is a pilot study. A total of 21 female breast cancer patients who underwent nipple reconstruction following initial nipple reconstruction fails were enrolled, and salvage nipple reconstruction based pedicled perforator flap were performed between 2016 and 2020. Operative time, perforator design, postoperative complications, follow-up duration, projection of nipple, as well as patient-reported outcomes measured by the BREAST-Q and visual analogue scale (VAS) were assessed. RESULTS Sixteen patients underwent fifth lateral intercostal artery perforator reconstruction, while 5 patients underwent fifth anterior intercostal artery perforator flap reconstruction. The surgeries were successful without intraoperative complications, with a mean operative time of 67 minutes. Postoperative complications were absent. The mean follow-up duration was 18 months. The mean nipple projection was 8 mm (range, 6-10 mm) with a shrinkage of 20% at 6 months after surgery. The average scores for psychosocial well-being, satisfaction with breasts, and satisfaction with nipples domains of the BREAST-Q significantly increased (P < .01) at 6 months post-reconstruction. Sexual well-being subdomain showed no statistical difference (P = .9369). The VAS scores for cosmesis and patient satisfaction with surgery were 9 and 9.3, respectively. CONCLUSION The pedicled perforator flap technique for salvage nipple reconstruction is a safe and effective approach.
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Affiliation(s)
- Shuanglong Chen
- Department of Breast Surgery, The First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Qingmo Yang
- Department of Breast Surgery, The First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Shaoluan Zheng
- Department of Plastic and Reconstructive Surgery, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, China
- Xiamen Clinical Research Center for Cancer Therapy, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, China
| | - Chenxi Chen
- Department of Plastic and Reconstructive Surgery, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, China
- Xiamen Clinical Research Center for Cancer Therapy, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, China
| | - Lujuan Gao
- Department of Dermatology, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, China
- Department of Dermatology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Jiaqi Liu
- Department of Plastic and Reconstructive Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
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Navarro-Ibarra MJ, Saucedo-Tamayo MDS, Alemán-Mateo H, Parra-Sánchez H, Othón-Ontiveros P, Hernández J, Caire-Juvera G. Association Between Interleukin 6 and C-Reactive Protein Serum Levels and Body Composition Compartments and Components in Breast Cancer Survivors. Biol Res Nurs 2024; 26:231-239. [PMID: 37844913 DOI: 10.1177/10998004231207022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2023]
Abstract
Obesity is highly prevalent in breast cancer (BC) survivors. Adipose tissue promotes inflammation, affecting recurrence, morbidity, and quality of life. This study aimed to determine the relationship of body composition parameters with the levels of C-reactive protein (CRP) and interleukin 6 (IL-6) in female BC survivors. Additionally, we evaluated the association of log-transformed serum concentrations of CRP and IL-6 with the appendicular skeletal lean mass index (ASMI). The results showed that CRP was positively associated with body fat percentage (BFP; β adjusted = .08, 95% CI: .02-.14) in all participants, and with fat mass index (FMI; β = .24, 95% CI: .08-.40) only in premenopausal women. IL-6 was positively associated with FMI (β adjusted = .16, 95% CI: .03-.29), while ASMI decreased as CRP levels increased (β adjusted = -.30, 95% CI: -.53 to -.06). Interventions to improve body composition in BC survivors should also consider the role of inflammatory markers in changes in body composition to avoid sarcopenic obesity (SO) and the risk of BC recurrence.
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Affiliation(s)
- María Jossé Navarro-Ibarra
- Coordinación de Nutrición, Centro de Investigación en Alimentación y Desarrollo, Hermosillo, Mexico
- Departamento de Nutrición, Facultad de Medicina Mexicali, Universidad Autónoma de Baja California, Mexicali, Mexico
| | | | - Heliodoro Alemán-Mateo
- Coordinación de Nutrición, Centro de Investigación en Alimentación y Desarrollo, Hermosillo, Mexico
| | - Héctor Parra-Sánchez
- Coordinación de Nutrición, Centro de Investigación en Alimentación y Desarrollo, Hermosillo, Mexico
| | | | - Jesús Hernández
- Coordinación de Nutrición, Centro de Investigación en Alimentación y Desarrollo, Hermosillo, Mexico
| | - Graciela Caire-Juvera
- Coordinación de Nutrición, Centro de Investigación en Alimentación y Desarrollo, Hermosillo, Mexico
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11
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Riseberg E, Wu Y, Lam WC, Eliassen AH, Wang M, Zhang X, Willett WC, Smith-Warner SA. Lifetime dairy product consumption and breast cancer risk: a prospective cohort study by tumor subtypes. Am J Clin Nutr 2024; 119:302-313. [PMID: 38042408 PMCID: PMC10884601 DOI: 10.1016/j.ajcnut.2023.11.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 11/17/2023] [Accepted: 11/28/2023] [Indexed: 12/04/2023] Open
Abstract
BACKGROUND Previous literature on dairy products and risk of breast cancer is inconsistent, and the relationship may depend on the life-period of dietary assessment. OBJECTIVE We examined dairy consumption from adolescence through later adulthood and incidence of breast cancer by menopausal status and tumor molecular subtypes in the Nurses' Health Study (NHS), a prospective cohort study. METHODS We analyzed data from 63,847 females in the NHS collected from 1980 to 2018. Average intake of dairy products during adulthood was assessed by validated semiquantitative food frequency questionnaires throughout follow-up. Participants recalled adolescent dietary intake in 1986. Multivariable Cox proportional hazards models were used to estimate hazard ratios (HRs) relating dairy product consumption to breast cancer risk overall, by menopausal status, and by subtypes. RESULTS We documented 5733 incident cases of invasive breast cancer during 32 y of follow-up (n = 5298 postmenopausal). Lifetime, adolescent, adulthood, and postmenopausal total dairy and milk intakes were not associated with overall breast cancer risk (nonsignificant HRs comparing highest with lowest quintile range = 0.97-1.08), although there was a suggestive positive association between adolescent milk intake and breast cancer risk (HR: 1.09; 95% CI: 1.00, 1.18). Higher lifetime and premenopausal cheese intakes were associated with modestly lower risks of breast cancer (comparing highest with lowest quintile, HR for lifetime cheese intake: 0.90; 95% CI: 0.82, 0.98; HR for premenopausal cheese intake: 0.89; 95% CI: 0.79, 1.00). Results varied by tumor subtype and some evidence for heterogeneity was observed for an association between premenopausal milk intake and breast cancer (HR for estrogen receptor [ER]-positive: 0.84; 95% CI: 0.72, 0.99; ER-negative: 1.36; 95% CI: 1.00, 1.84; P heterogeneity = 0.04). CONCLUSIONS These findings suggest that overall dairy consumption was not associated with risk of breast cancer. However, heterogeneity was observed for type of dairy food, period of life, and tumor subtypes.
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Affiliation(s)
- Emily Riseberg
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - You Wu
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Institute for Hospital Management, School of Medicine, Tsinghua University, Beijing, China; Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States.
| | - Wai Ching Lam
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
| | - A Heather Eliassen
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
| | - Molin Wang
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
| | - Xuehong Zhang
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
| | - Walter C Willett
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Stephanie A Smith-Warner
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States
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12
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Sayed SF, Dailah HG, Nagarajan S, Abdelwahab SI, Abadi SSH, Akhtar N, Khuwaja G, Malham WADA. Knowledge of Non-Invasive Biomarkers of Breast Cancer, Risk Factors, and BSE Practices Among Nursing Undergraduates in Farasan Island, KSA. SAGE Open Nurs 2024; 10:23779608241248519. [PMID: 38681865 PMCID: PMC11055480 DOI: 10.1177/23779608241248519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 02/18/2024] [Accepted: 04/03/2024] [Indexed: 05/01/2024] Open
Abstract
Background of the Study Mammograms are sometimes met with issues of overdiagnosis and underdiagnosis; therefore, they are less reliable in identifying cancer in women with dense breasts. As a result, it is critical to be aware of other sensitive screening techniques for the early diagnosis of breast cancer. Aim The ultimate objective of this study was to assess the knowledge of nursing undergraduates regarding non-invasive biomarkers, such as volatile organic compounds in breath, nipple aspirate fluid, sweat, urine, and tears, for the early detection of breast cancer to help improve patient care, determine the risk factors, and encourage practice of breast self-examination. Methods Cross-sectional research was done in the Department of Nursing at Farasan campus using a self-structured questionnaire as the study tool. A total of 260 students willingly participated. The study tool had evaluation questions focused on the non-invasive biomarkers of breast cancer, risk factors, and breast self-examination practices to collect data. The data were subjected to descriptive and inferential statistics. The statistical significance was calculated at P < .05. Data analyses were done using Microsoft Excel (2013). Results A significant knowledge gap existed among the study participants about the non-invasive biomarkers of breast cancer. A lesser percentage of students (25%) stated that they do breast self-examination on a monthly basis. The most common reasons for not doing the breast self-examination were "not knowing how to do the breast self-examination" (77.3%), fear of a positive diagnosis (53.9%), thinking that they are not at risk as all were in their teens and hence not required (44.7%), and lack of time (48.7%). Age and frequency of breast self-examination were significantly associated (P < .05) as those few students (22.7%) who were doing breast self-examination practices every 2-4 months belonged to a higher study year. Furthermore, knowledge regarding incidence rates and health care expenditure by the government on breast cancer was also significantly low (P < .05). Conclusions Outcomes would help prioritize actions to help future nurses better understand breast cancer, allowing them to extend patient care in the best way possible.
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Affiliation(s)
| | - Hamad G. Dailah
- Department of Nursing, College of Nursing, Jazan University, Jazan, Saudi Arabia
| | - Sumathi Nagarajan
- Department of Nursing, Farasan University College, Jazan University, Jazan, KSA
| | | | | | - Nida Akhtar
- Department of Nursing, Al-Dayer College, Jazan University, Jazan, Saudi Arabia
| | - Gulrana Khuwaja
- Department of Pharmaceutical Chemistry, College of Pharmacy, Jazan University, Jazan, Saudi Arabia
| | - Wadeah Ali DA Malham
- Department of Nursing, Farasan University College, Jazan University, Jazan, Saudi Arabia
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Yin Y, Tong L, Wan Z, Sui Y, Li F, Huang Q, Zhao X. CYP4B1 polymorphisms and the risk of breast cancer in Chinese women: a case-control study. BMC Cancer 2023; 23:1177. [PMID: 38041008 PMCID: PMC10693087 DOI: 10.1186/s12885-023-11477-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 10/03/2023] [Indexed: 12/03/2023] Open
Abstract
BACKGROUND Breast cancer (BC) is one of the malignant diseases threatening the life and health of women worldwide. The CYP4B1 gene was abnormally expressed in BC and was associated with the prognosis of BC patients. This study aimed to explore the relationship between CYP4B1 single nucleotide polymorphisms (SNPs) and BC risk in Chinese women. METHODS A case-control study of 1,143 women (571 patients and 572 healthy individuals) was conducted. Rs2297813 G/T, rs12142787 G/A, and rs3766197 C/T in CYP4B1 were selected and genotyped by MassARRAY system. The relationships between these SNPs and the risk of BC were assessed by logistic regression analysis. In addition, multi-factor dimensionality reduction (MDR) was used to analyze SNP-SNP interactions. RESULTS CYP4B1 rs2297813 had a risk-increasing effect on BC in women with body mass index (BMI) ≤ 24 kg/m2 (OR = 1.72, p = 0.026). CYP4B1 rs12142787 was associated with an increased BC risk in smokers (AA: OR = 1.32, p = 0.045). Among non-drinkers, rs2297813 (OR = 1.69, p = 0.009) and rs12142787 (OR = 1.51, p = 0.020) were related to an increased incidence of BC. CYP4B1 rs3766197 (OR = 1.61p = 0.031) was associated with a higher risk of advanced stages (III/IV stage) of BC. Besides, the contributions of CYP4B1 rs2297813 (OR = 1.55, p = 0.021) and rs12142787 (OR = 1.53, p = 0.033) to BC risk might be associated with more than one birth in patients with BC. The three-locus model consisting of rs2297813, rs12142787, and rs3766197 was regarded as the best predictive model for BC risk. CONCLUSION CYP4B1 SNPs were associated with BC risk in Chinese women, especially in patients with BMI ≤ 24 kg/m2, smokers, non-drinkers, patients in advanced stages (III/IV stage), and patients who reproduced once. These findings shed light on the relationship between CYP4B1 SNPs and BC risk in Chinese women.
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Affiliation(s)
- Yanhai Yin
- Department of Internal Medicine Oncology, The First Affiliated Hospital of Xi'an Jiaotong University School of Medicine, No.76, Yanta West Road, Xi'an City, 710061, Shaanxi Province, China
- Department of Nuclear Medicine, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, Hainan, 570208, China
| | - Liangqian Tong
- Department of Nuclear Medicine, Central South University Xiangya School Affiliated Haikou Hospital, Haikou, Hainan, 570208, China
| | - Zhenling Wan
- Department of Pathology, Hainan Women and Children Medical Center, Haikou, Hainan, 570208, China
| | - Yanfang Sui
- Department of Rehabilitation Medicine, Central South University Xiangya School Affiliated Haikou Hospital, Haikou, Hainan, 570208, China
| | - Fen Li
- Department of Nuclear Medicine, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, Hainan, 570208, China
| | - Qian Huang
- Department of Nuclear Medicine, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, Hainan, 570208, China
| | - Xinhan Zhao
- Department of Internal Medicine Oncology, The First Affiliated Hospital of Xi'an Jiaotong University School of Medicine, No.76, Yanta West Road, Xi'an City, 710061, Shaanxi Province, China.
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Jee H, Won KS. Determining Optimal Cut-Off Value of Pancreatic-Cancer-Induced Total Cholesterol and Obesity-Related Factors for Developing Exercise Intervention: Big Data Analysis of National Health Insurance Sharing Service Data. Cancers (Basel) 2023; 15:5444. [PMID: 38001704 PMCID: PMC10670681 DOI: 10.3390/cancers15225444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 11/01/2023] [Accepted: 11/09/2023] [Indexed: 11/26/2023] Open
Abstract
This study aimed to examine the effects of multiple parameters on the incidence of pancreatic cancer. We analyzed data from 1,108,369 individuals in the National Health Insurance Sharing Service Database (NHISS DB; birth to death; 2002 to 2015) and identified 2912 patients with pancreatic cancer. Body mass index, systolic/diastolic blood pressure, and fasting blood glucose and total cholesterol concentrations were lower in women with than without pancreatic cancer (p < 0.01). Fasting blood glucose and total cholesterol concentrations were significantly different between men with and without pancreatic cancer (p < 0.05). In the logistic regression analysis, the total cholesterol concentration (odds ratio (OR), 1.007; 95% confidence interval (CI), 1.005-1.010) was significantly higher in men than women with pancreatic cancer (p < 0.05). Pancreatic cancer rates were highest in men who smoked for 5-9 years or more (OR, 5.332) and in women who smoked for 10-19 years (OR, 18.330). Daily intensive exercise reduced the risk of pancreatic cancer by 56% in men (95% CI, 0.230-0.896). Receiver operating characteristic curve analysis revealed a total cholesterol concentration cut-off point of 188.50 mg/dL (p < 0.05) in men with pancreatic cancer, with a sensitivity and specificity of 53.5% and 54.6%, respectively. For women, the cut-off values for weight and gamma glutamyl transpeptidase concentration were 58.5 kg and 20.50 U/L, respectively. The sex-specific differences in patients with pancreatic cancer identified herein will aid in the development of individualized evidence-based prognostic and preventive programs for the treatment of pancreatic cancer.
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Affiliation(s)
- Hyunseok Jee
- School of Kinesiology, Yeungnam University, 280, Daehak-ro, Gyeongsan 38541, Republic of Korea
| | - Kim Sang Won
- Medical Research Center, College of Medicine, Yeungnam University, Daegu 42415, Republic of Korea;
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Zhao J, Tian XC, Zhang JQ, Li TT, Qiao S, Jiang SL. Tribulus terrestris L. induces cell apoptosis of breast cancer by regulating sphingolipid metabolism signaling pathways. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2023; 120:155014. [PMID: 37639811 DOI: 10.1016/j.phymed.2023.155014] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 07/06/2023] [Accepted: 08/06/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND Tribulus terrestris L. (TT) was initially documented in Shen-Nong-Ben-Cao-Jing and has been used for thousands of years in China as a herb to calm liver, dispel melancholy and wind, promote blood circulation, improve eyesight, and relieve itching. Moreover, it was also used to treat breast cancer in ancient China. However, the pharmacological activities of TT extract on breast cancer have received little attention. PURPOSE In this study, we investigated the anti-breast cancer effects and possible mechanisms of action of this herbal drug. METHODS Network pharmacology analysis the study of network pharmacology was done to analyze the possibility of TT's anti-breast cancer effect. And then, molecular docking between TT7/TT8 and vascular endothelial growth factor receptor 2 (VEGFR2) were performed by Autodock software as well as the related protein expressions were analyzed by western blot to verify this effect. In vivo experiment: The mouse model of breast cancer was established by injection of 4T1 cells. Then drugs were intragastrically administered to the mice once daily for fourteen days. Body weight, tumor size, and tumor weight were recorded at the end of the experiment. Moreover, tumor inhibitory rate was calculated. Finally, pathological changes and apoptosis of breast cancer tissues were respectively evaluated by HE and Hoechst staining. Proteomics and metabonomics analyses: The tumor tissues were chosen to perform conjoint analysis. Firstly, differential proteins and metabolites were found. Furthermore, the functional analyses of them were analyzed by software. At the last, immunofluorescent staining of SGPP1, SPHK1 and p-SPHK1 in tumor tissue were done. RESULTS 12 active ingredients of TT, 127 targets of active ingredients, 15,253 targets of breast cancer, 1,225 targets of Ru yan, and 123 overlapping genes were obtained in the network pharmacology study. There was firm conjunction between TT7/TT8 and VEGFR2. Besides, tumor size and weight were markedly reduced in TT groups compared to the model group. The tumor inhibitory rate was more than 26% in TTM group. After drug treatment, many adipocytes and cracks between tumor and apoptosis were discovered. The western blot results showed that TT aqueous extract lowered the levels of VEGFR2, ERK1/2, p-ERK1/2 (Thr202, Tyr204) and Bcl2, while increasing the levels of Bax and the ratio of Bax/Bcl2. Furthermore, 495 differential proteins and 76 differential metabolites were found between TTM and model groups with the sphingolipid metabolism pathway being enriched. At last, TT treatment significantly reduced the levels of SGPP1, SPHK1 and p-SPHK1 in tumor tissue. CONCLUSIONS In conclusion, TT demonstrates therapeutic effects in a mouse model of breast cancer, and its mechanism of action involves the regulations of sphingolipid metabolism signaling pathways. This study lends credence to the pharmacological potential of TT extract as a breast cancer therapy.
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Affiliation(s)
- Jing Zhao
- Clinical Medical Laboratory Center, Jining No.1 People's Hospital, Shandong First Medical University, Jining, China
| | - Xin-Chen Tian
- Clinical Medical Laboratory Center, Jining No.1 People's Hospital, Shandong First Medical University, Jining, China
| | - Jia-Qi Zhang
- Clinical Medical Laboratory Center, Jining No.1 People's Hospital, Shandong First Medical University, Jining, China
| | - Tan-Tan Li
- Clinical Medical Laboratory Center, Jining No.1 People's Hospital, Shandong First Medical University, Jining, China
| | - Sen Qiao
- Hepatological Surgery Department, Jining No.1 People's Hospital, Shandong First Medical University, Jining, China
| | - Shu-Long Jiang
- Clinical Medical Laboratory Center, Jining No.1 People's Hospital, Shandong First Medical University, Jining, China.
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Nahmias-Blank D, Maimon O, Meirovitz A, Sheva K, Peretz-Yablonski T, Elkin M. Excess body weight and postmenopausal breast cancer: Emerging molecular mechanisms and perspectives. Semin Cancer Biol 2023; 96:26-35. [PMID: 37739109 DOI: 10.1016/j.semcancer.2023.09.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 09/14/2023] [Accepted: 09/15/2023] [Indexed: 09/24/2023]
Abstract
Postmenopausal, obese women have a significantly higher risk of developing estrogen receptor-positive (ER+) breast tumors, that are resistant to therapies and are associated with higher recurrence and death rates. The global prevalence of overweight/obese women has reached alarming proportions and with postmenopausal ER+ breast carcinoma (BC) having the highest incidence among the three obesity-related cancers in females (i.e., breast, endometrial and ovarian), this is of significant concern. Elucidation of the precise molecular mechanisms underlying the pro-cancerous action of obesity in ER+BC is therefore critical for disease prevention and novel treatment initiatives. Interestingly, accumulating data has shown opposing relationships between obesity and cancer in either pre- or post-menopausal women. Excess body weight is associated with an increased risk of breast cancer in postmenopausal women and a decreased risk in pre-menopausal women. Moreover, excess adiposity during early life appears to be protective against postmenopausal breast cancer, including both ER+ and ER negative BC subtypes. Overall, estrogen-dependent mechanisms have been implicated as the main driving force in obesity-related breast tumorigenesis. In the present review we discuss the epidemiologic and mechanistic aspects of association between obesity and breast tumors after menopause, mainly in the context of hormone dependency. Molecular and cellular events underlying this association present as potential avenues for both therapeutic intervention as well as the prevention of BC-promoting processes linked to excess adiposity, which is proving to be vital in an increasingly obese global population.
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Affiliation(s)
- Daniela Nahmias-Blank
- Sharett Institute of Oncology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Ofra Maimon
- Sharett Institute of Oncology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Amichay Meirovitz
- Legacy Heritage Oncology Center and Dr. Larry Norton Institute, Soroka University Medical Center, Be'er Sheva 84101, Israel
| | - Kim Sheva
- Legacy Heritage Oncology Center and Dr. Larry Norton Institute, Soroka University Medical Center, Be'er Sheva 84101, Israel
| | - Tamar Peretz-Yablonski
- Sharett Institute of Oncology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel; Hebrew University Medical School, Jerusalem 91120, Israel
| | - Michael Elkin
- Sharett Institute of Oncology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel; Hebrew University Medical School, Jerusalem 91120, Israel.
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Flore G, Deledda A, Lombardo M, Armani A, Velluzzi F. Effects of Functional and Nutraceutical Foods in the Context of the Mediterranean Diet in Patients Diagnosed with Breast Cancer. Antioxidants (Basel) 2023; 12:1845. [PMID: 37891924 PMCID: PMC10603973 DOI: 10.3390/antiox12101845] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 10/09/2023] [Indexed: 10/29/2023] Open
Abstract
Several studies report that breast cancer survivors (BCS) tend to have a poor diet, as fruit, vegetable, and legume consumption is often reduced, resulting in a decreased intake of nutraceuticals. Moreover, weight gain has been commonly described among BCS during treatment, increasing recurrence rate and mortality. Improving lifestyle and nutrition after the diagnosis of BC may have important benefits on patients' general health and on specific clinical outcomes. The Mediterranean diet (MD), known for its multiple beneficial effects on health, can be considered a nutritional pool comprising several nutraceuticals: bioactive compounds and foods with anti-inflammatory and antioxidant effects. Recent scientific advances have led to the identification of nutraceuticals that could amplify the benefits of the MD and favorably influence gene expression in these patients. Nutraceuticals could have beneficial effects in the postdiagnostic phase of BC, including helping to mitigate the adverse effects of chemotherapy and radiotherapy. Moreover, the MD could be a valid and easy-to-follow option for managing excess weight. The aim of this narrative review is to evaluate the recent scientific literature on the possible beneficial effects of consuming functional and nutraceutical foods in the framework of MD in BCS.
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Affiliation(s)
- Giovanna Flore
- Obesity Unit, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (G.F.); (A.D.); (F.V.)
| | - Andrea Deledda
- Obesity Unit, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (G.F.); (A.D.); (F.V.)
| | - Mauro Lombardo
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, 00166 Rome, Italy;
| | - Andrea Armani
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, 00166 Rome, Italy;
- Laboratory of Cardiovascular Endocrinology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele, 00166 Rome, Italy
| | - Fernanda Velluzzi
- Obesity Unit, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (G.F.); (A.D.); (F.V.)
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Roheel A, Khan A, Anwar F, Akbar Z, Akhtar MF, Imran Khan M, Sohail MF, Ahmad R. Global epidemiology of breast cancer based on risk factors: a systematic review. Front Oncol 2023; 13:1240098. [PMID: 37886170 PMCID: PMC10598331 DOI: 10.3389/fonc.2023.1240098] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 09/11/2023] [Indexed: 10/28/2023] Open
Abstract
Background Numerous reviews of the epidemiology and risk factors for breast cancer have been published previously which heighted different directions of breast cancer. Aim The present review examined the likelihood that incidence, prevalence, and particular risk factors might vary by geographic region and possibly by food and cultural practices as well. Methods A systematic review (2017-2022) was conducted following Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, reporting on epidemiological and risk factor reports from different world regions. Medical Subject Heading (MeSH) terms: "Breast neoplasm" "AND" country terms such as "Pakistan/epidemiology", "India/epidemiology", "North America/epidemiology", "South Africa/epidemiology" were used to retrieve 2068 articles from PubMed. After applying inclusion and exclusion terms, 49 papers were selected for systematic review. Results Results of selected articles were summarized based on risk factors, world regions and study type. Risk factors were classified into five categories: demographic, genetic and lifestyle risk factors varied among countries. This review article covers a variety of topics, including regions, main findings, and associated risk factors such as genetic factors, and lifestyle. Several studies revealed that lifestyle choices including diet and exercise could affect a person's chance of developing breast cancer. Breast cancer risk has also been linked to genetic variables, including DNA repair gene polymorphisms and mutations in the breast cancer gene (BRCA). It has been found that most of the genetic variability links to the population of Asia while the cause of breast cancer due to lifestyle modifications has been found in American and British people, indicating that demographic, genetic, and, lifestyle risk factors varied among countries. Conclusion There are many risk factors for breast cancer, which vary in their importance depending on the world region. However, further investigation is required to better comprehend the particular causes of breast cancer in these areas as well as to create efficient prevention and treatment plans that cater to the local population.
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Affiliation(s)
- Amna Roheel
- Riphah Institute of Pharmaceutical Sciences, Riphah International University, Lahore, Islamabad, Pakistan
| | - Aslam Khan
- Riphah Institute of Pharmaceutical Sciences, Riphah International University, Lahore, Islamabad, Pakistan
| | - Fareeha Anwar
- Riphah Institute of Pharmaceutical Sciences, Riphah International University, Lahore, Islamabad, Pakistan
| | - Zunaira Akbar
- Riphah Institute of Pharmaceutical Sciences, Riphah International University, Lahore, Islamabad, Pakistan
| | - Muhammad Furqan Akhtar
- Riphah Institute of Pharmaceutical Sciences, Riphah International University, Lahore, Islamabad, Pakistan
| | - Mohammad Imran Khan
- Riphah Institute of Pharmaceutical Sciences, Riphah International University, Lahore, Islamabad, Pakistan
| | - Mohammad Farhan Sohail
- Riphah Institute of Pharmaceutical Sciences, Riphah International University, Lahore, Islamabad, Pakistan
| | - Rizwan Ahmad
- Department of Natural Products, College of Clinical Pharmacy, Imam Andulrahman Bin Faisal University, Rakah, Dammam, Saudi Arabia
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Van Baelen K, Nguyen HL, Hamy-Petit AS, Richard F, Karsten MM, Nader Marta G, Vermeulen P, Toussaint A, Reyal F, Vincent-Salomon A, Dirix L, Dordevic AD, de Azambuja E, Larsimont D, Amato O, Maetens M, De Schepper M, Geukens T, Han SN, Baert T, Punie K, Wildiers H, Smeets A, Nevelsteen I, Floris G, Biganzoli E, Neven P, Desmedt C. Association of body mass index with clinicopathological features and survival in patients with primary invasive lobular breast cancer. Eur J Cancer 2023; 191:112988. [PMID: 37573673 DOI: 10.1016/j.ejca.2023.112988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 06/29/2023] [Accepted: 07/05/2023] [Indexed: 08/15/2023]
Abstract
PURPOSE Invasive lobular carcinoma (ILC) represents up to 15% of all breast carcinomas. While the proportion of women with overweight and obesity increases globally, the impact of body mass index (BMI) at primary diagnosis on clinicopathological features of ILC and the prognosis of the patients has not been investigated yet. PATIENTS AND METHODS We performed a multicentric retrospective study including patients diagnosed with non-metastatic pure ILC. The association of BMI at diagnosis with clinicopathological variables was assessed using linear or multinomial logistic regression. Univariable and multivariable survival analyses were performed to evaluate the association of BMI with disease-free survival (DFS), distant recurrence-free survival (DRFS), and overall survival (OS). RESULTS The data of 2856 patients with ILC and available BMI at diagnosis were collected, of which 2570/2856 (90.0%) had oestrogen receptor (ER)-positive and human epidermal growth factor receptor (HER2) not amplified/overexpressed (ER+/HER2-) ILC. Of these 2570 patients, 80 were underweight (3.1%), 1410 were lean (54.9%), 712 were overweight (27.7%), and 368 were obese (14.3%). Older age at diagnosis, a higher tumour grade, a larger tumour size, a nodal involvement, and multifocality were associated with a higher BMI. In univariable models, higher BMI was associated with worse outcomes for all end-points (DFS: hazard ratio (HR) 1.21, 95CI 1.12-1.31, p value<0.01; DRFS: HR 1.25, 95CI 1.12-1.40, p value<0.01; OS: HR 1.25, 95CI 1.13-1.37, p value<0.01). This association was not statistically significant in multivariable analyses (DFS: HR 1.09, 95CI 0.99-1.20, p value 0.08; DRFS: HR 1.03, 95CI 0.89-1.20, p value 0.67; OS: HR 1.11, 95CI 0.99-1.24, p value 0.08), whereas grade, tumour size, and nodal involvement were still prognostic for all end-points. CONCLUSION Worse prognostic factors such as higher grade, larger tumour size, and nodal involvement are associated with higher BMI in ER+/HER2- ILC, while there was no statistical evidence for an independent prognostic role for BMI. Therefore, we hypothesise that the effect of BMI on survival could be mediated through its association with these clinicopathological variables.
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Affiliation(s)
- Karen Van Baelen
- Laboratory for Translational Breast Cancer Research, Department of Oncology, KU Leuven, Leuven, Belgium; Department of Gynecological Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Ha-Linh Nguyen
- Laboratory for Translational Breast Cancer Research, Department of Oncology, KU Leuven, Leuven, Belgium
| | | | - François Richard
- Laboratory for Translational Breast Cancer Research, Department of Oncology, KU Leuven, Leuven, Belgium
| | - Maria Margarete Karsten
- Department of Gynecology and Breast Center, Charité Universitätsmedizin Berlin, Berlin, Germany
| | | | - Peter Vermeulen
- Translational Cancer Research Unit, Center for Oncological Research, Faculty of Medicine and Health Sciences, University of Antwerp & GZA Hospital Sint-Augustinus, Antwerp, Belgium
| | | | - Fabien Reyal
- Department of Surgery, Institut Curie, Paris, France
| | - Anne Vincent-Salomon
- Department of Pathology, Université Paris Sciences Lettres, Institut Curie, Paris, France
| | - Luc Dirix
- Translational Cancer Research Unit, Center for Oncological Research, Faculty of Medicine and Health Sciences, University of Antwerp & GZA Hospital Sint-Augustinus, Antwerp, Belgium
| | - Adam David Dordevic
- Department of Gynecology and Breast Center, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Evandro de Azambuja
- Institut Jules Bordet & l'Université Libre de Bruxelles (U.L.B), Brussels, Belgium
| | - Denis Larsimont
- Institut Jules Bordet & l'Université Libre de Bruxelles (U.L.B), Brussels, Belgium
| | - Ottavia Amato
- Institut Jules Bordet & l'Université Libre de Bruxelles (U.L.B), Brussels, Belgium; Department of Surgery, Oncology and Gastroenterology (DISCOG), University of Padova, Padova, Italy
| | - Marion Maetens
- Laboratory for Translational Breast Cancer Research, Department of Oncology, KU Leuven, Leuven, Belgium
| | - Maxim De Schepper
- Laboratory for Translational Breast Cancer Research, Department of Oncology, KU Leuven, Leuven, Belgium; Department of Pathology, University Hospitals Leuven, Leuven, Belgium
| | - Tatjana Geukens
- Laboratory for Translational Breast Cancer Research, Department of Oncology, KU Leuven, Leuven, Belgium; Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Sileny N Han
- Department of Gynecological Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Thaïs Baert
- Department of Gynecological Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Kevin Punie
- Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Hans Wildiers
- Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Ann Smeets
- Department of Surgical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Ines Nevelsteen
- Department of Surgical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Giuseppe Floris
- Department of Pathology, University Hospitals Leuven, Leuven, Belgium; Laboratory of Translational Cell & Tissue Research, Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
| | - Elia Biganzoli
- Unit of Medical Statistics, Biometry and Epidemiology "Giulio A. Maccacaro", Department of Clinical Sciences and Community Health & DSRC, University of Milan, Milan, Italy
| | - Patrick Neven
- Department of Gynecological Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Christine Desmedt
- Laboratory for Translational Breast Cancer Research, Department of Oncology, KU Leuven, Leuven, Belgium.
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Hu Y, Liu L, Chen Y, Zhang X, Zhou H, Hu S, Li X, Li M, Li J, Cheng S, Liu Y, Xu Y, Yan W. Cancer-cell-secreted miR-204-5p induces leptin signalling pathway in white adipose tissue to promote cancer-associated cachexia. Nat Commun 2023; 14:5179. [PMID: 37620316 PMCID: PMC10449837 DOI: 10.1038/s41467-023-40571-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 08/01/2023] [Indexed: 08/26/2023] Open
Abstract
Cancer-associated cachexia is a multi-organ weight loss syndrome, especially with a wasting disorder of adipose tissue and skeletal muscle. Small extracellular vesicles (sEVs) serve as emerging messengers to connect primary tumour and metabolic organs to exert systemic regulation. However, whether and how tumour-derived sEVs regulate white adipose tissue (WAT) browning and fat loss is poorly defined. Here, we report breast cancer cell-secreted exosomal miR-204-5p induces hypoxia-inducible factor 1A (HIF1A) in WAT by targeting von Hippel-Lindau (VHL) gene. Elevated HIF1A protein induces the leptin signalling pathway and thereby enhances lipolysis in WAT. Additionally, exogenous VHL expression blocks the effect of exosomal miR-204-5p on WAT browning. Reduced plasma phosphatidyl ethanolamine level is detected in mice lack of cancer-derived miR-204-5p secretion in vivo. Collectively, our study reveals circulating miR-204-5p induces hypoxia-mediated leptin signalling pathway to promote lipolysis and WAT browning, shedding light on both preventive screenings and early intervention for cancer-associated cachexia.
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Affiliation(s)
- Yong Hu
- Hubei Key Laboratory of Cell Homeostasis, College of Life Sciences, TaiKang Center for Life and Medical Sciences, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, Hubei, 430072, China
- Department of Endocrinology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430062, China
| | - Liu Liu
- Hubei Key Laboratory of Cell Homeostasis, College of Life Sciences, TaiKang Center for Life and Medical Sciences, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, Hubei, 430072, China
| | - Yong Chen
- Hubei Key Laboratory of Cell Homeostasis, College of Life Sciences, TaiKang Center for Life and Medical Sciences, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, Hubei, 430072, China
| | - Xiaohui Zhang
- Hubei Key Laboratory of Cell Homeostasis, College of Life Sciences, TaiKang Center for Life and Medical Sciences, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, Hubei, 430072, China
| | - Haifeng Zhou
- Hubei Key Laboratory of Cell Homeostasis, College of Life Sciences, TaiKang Center for Life and Medical Sciences, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, Hubei, 430072, China
| | - Sheng Hu
- Hubei Key Laboratory of Cell Homeostasis, College of Life Sciences, TaiKang Center for Life and Medical Sciences, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, Hubei, 430072, China
| | - Xu Li
- Hubei Key Laboratory of Cell Homeostasis, College of Life Sciences, TaiKang Center for Life and Medical Sciences, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, Hubei, 430072, China
| | - Meixin Li
- Hubei Key Laboratory of Cell Homeostasis, College of Life Sciences, TaiKang Center for Life and Medical Sciences, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, Hubei, 430072, China
| | - Juanjuan Li
- Department of Breast and Thyroid Surgery, Renmin Hospital of Wuhan University, Wuhan, Hubei, 430060, China
| | - Siyuan Cheng
- Department of Endocrinology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430062, China
| | - Yong Liu
- Hubei Key Laboratory of Cell Homeostasis, College of Life Sciences, TaiKang Center for Life and Medical Sciences, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, Hubei, 430072, China
- Hubei Key Laboratory of Cell Homeostasis, College of Life Sciences; TaiKang Center for Life and Medical Sciences; The Institute for Advanced Studies; Frontier Science Center for Immunology and Metabolism, Wuhan University, Wuhan, Hubei, 430072, China
| | - Yancheng Xu
- Department of Endocrinology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430062, China.
| | - Wei Yan
- Hubei Key Laboratory of Cell Homeostasis, College of Life Sciences, TaiKang Center for Life and Medical Sciences, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, Hubei, 430072, China.
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Davey MG, Ryan OK, Ryan ÉJ, Donlon NE, Reynolds IS, Fearon NM, Martin ST, Heneghan HM. The Impact of Bariatric Surgery on the Incidence of Colorectal Cancer in Patients with Obesity-a Systematic Review and Meta-analysis of Registry Data. Obes Surg 2023; 33:2293-2302. [PMID: 37341934 PMCID: PMC10345076 DOI: 10.1007/s11695-023-06674-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 05/23/2023] [Accepted: 06/07/2023] [Indexed: 06/22/2023]
Abstract
PURPOSE Cancer and obesity represent two of the most significant global health concerns. The risk of malignancy, including colorectal cancer (CRC), increases with obesity. The aim of this study was to perform a systematic review and meta-analysis to determine the value of bariatric surgery in reducing CRC risk in patients with obesity using registry data. MATERIALS AND METHODS A systematic review and meta-analysis were performed as per PRISMA guidelines. The risk of CRC was expressed as a dichotomous variable and reported as odds ratios (OR) with 95% confidence intervals (CIs) using the Mantel-Haenszel method. A multi-treatment comparison was performed, examining the risk reduction associated with existing bariatric surgery techniques. Analysis was performed using RevMan, R packages, and Shiny. RESULTS Data from 11 registries including 6,214,682 patients with obesity were analyzed. Of these, 14.0% underwent bariatric surgery (872,499/6,214,682), and 86.0% did not undergo surgery (5,432,183/6,214,682). The mean age was 49.8 years, and mean follow-up was 5.1 years. In total, 0.6% of patients who underwent bariatric surgery developed CRC (4,843/872,499), as did 1.0% of unoperated patients with obesity (54,721/5,432,183). Patients with obesity who underwent bariatric surgery were less likely to develop CRC (OR: 0.53, 95% CI: 0.36-0.77, P < 0.001, I2 = 99%). Patients with obesity undergoing gastric bypass surgery (GB) (OR: 0.513, 95% CI: 0.336-0.818) and sleeve gastrectomy (SG) (OR: 0.484, 95% CI: 0.307-0.763) were less likely to develop CRC than unoperated patients. CONCLUSION At a population level, bariatric surgery is associated with reduced CRC risk in patients with obesity. GB and SG are associated with the most significant reduction in CRC risk. PROSPERO REGISTRATION CRD42022313280.
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Affiliation(s)
- Matthew G Davey
- Discipline of Surgery, The Lambe Institute for Translational Research, University of Galway, Galway, H91YR71, Ireland.
| | - Odhrán K Ryan
- Surgical Professorial Unit, St. Vincent's University Hospital, Elm Park, Dublin 4, D04 T6F4, Ireland
| | - Éanna J Ryan
- Royal College of Surgeons in Ireland, 123 St. Stephens Green, Dublin 2, D02YN77, Ireland
| | - Noel E Donlon
- Royal College of Surgeons in Ireland, 123 St. Stephens Green, Dublin 2, D02YN77, Ireland
| | - Ian S Reynolds
- Royal College of Surgeons in Ireland, 123 St. Stephens Green, Dublin 2, D02YN77, Ireland
| | - Naomi M Fearon
- Surgical Professorial Unit, St. Vincent's University Hospital, Elm Park, Dublin 4, D04 T6F4, Ireland
| | - Sean T Martin
- Surgical Professorial Unit, St. Vincent's University Hospital, Elm Park, Dublin 4, D04 T6F4, Ireland
| | - Helen M Heneghan
- Surgical Professorial Unit, St. Vincent's University Hospital, Elm Park, Dublin 4, D04 T6F4, Ireland
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22
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Xu B, Lv L, Chen X, Li X, Zhao X, Yang H, Feng W, Jiang X, Li J. Temporal relationships between BMI and obesity-related predictors of cardiometabolic and breast cancer risk in a longitudinal cohort. Sci Rep 2023; 13:12361. [PMID: 37524743 PMCID: PMC10390576 DOI: 10.1038/s41598-023-39387-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 07/25/2023] [Indexed: 08/02/2023] Open
Abstract
Prospective inter-relationships among biomarkers were unexplored, which may provide mechanistic insights into diseases. We investigated the longitudinal associations of BMI change with trajectories of biomarkers related to cardiometabolic or breast cancer risk. A longitudinal study was conducted among 444 healthy women between 2019 to 2021. Cross‑lagged path analysis was used to examine the temporal relationships among BMI, cardiometabolic risk score (CRS), and obesity‑related proteins score (OPS) of breast cancer. Linear mixed-effect models were applied to investigate associations of time-varying BMI with biomarker-based risk score trajectories. Baseline BMI was associated with subsequent change of breast cancer predictors (P = 0.03), and baseline CRS were positively associated with OPS change (P < 0.001) but not vice versa. After fully adjustment of confounders, we found a 0.058 (95%CI = 0.009-0.107, P = 0.020) units increase of CRS and a 1.021 (95%CI = 0.041-1.995, P = 0.040) units increase of OPS as BMI increased 1 kg/m2 per year in postmenopausal women. OPS increased 0.784 (95%CI = 0.053-1.512, P = 0.035) units as CRS increased 1 unit per year. However, among premenopausal women, BMI only significantly affected CRS (β = 0.057, 95%CI = 0.007 to 0.107, P = 0.025). No significant change of OPS with time-varying CRS was found. Higher increase rates of BMI were associated with worse trajectories of biomarker-based risk of cardiometabolic and breast cancer. The longitudinal impact of CRS on OPS is unidirectional. Recommendations such as weight control for the reduction of cardiometabolic risk factors may benefit breast cancer prevention, especially in postmenopausal women.
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Affiliation(s)
- Bin Xu
- Department of Epidemiology and Biostatistics, Institute of Systems Epidemiology, and West China-PUMC C. C. Chen Institute of Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, 16#, Section 3, Renmin Nan Lu, Chengdu, 610041, Sichuan, People's Republic of China
| | - Liang Lv
- Department of Epidemiology and Biostatistics, Institute of Systems Epidemiology, and West China-PUMC C. C. Chen Institute of Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, 16#, Section 3, Renmin Nan Lu, Chengdu, 610041, Sichuan, People's Republic of China
| | - Xin Chen
- Department of Epidemiology and Biostatistics, Institute of Systems Epidemiology, and West China-PUMC C. C. Chen Institute of Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, 16#, Section 3, Renmin Nan Lu, Chengdu, 610041, Sichuan, People's Republic of China
| | - Xingyue Li
- Department of Epidemiology and Biostatistics, Institute of Systems Epidemiology, and West China-PUMC C. C. Chen Institute of Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, 16#, Section 3, Renmin Nan Lu, Chengdu, 610041, Sichuan, People's Republic of China
| | - Xunying Zhao
- Department of Epidemiology and Biostatistics, Institute of Systems Epidemiology, and West China-PUMC C. C. Chen Institute of Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, 16#, Section 3, Renmin Nan Lu, Chengdu, 610041, Sichuan, People's Republic of China
| | - Huifang Yang
- Department of Epidemiology and Biostatistics, Institute of Systems Epidemiology, and West China-PUMC C. C. Chen Institute of Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, 16#, Section 3, Renmin Nan Lu, Chengdu, 610041, Sichuan, People's Republic of China
| | - Wanting Feng
- Department of Epidemiology and Biostatistics, Institute of Systems Epidemiology, and West China-PUMC C. C. Chen Institute of Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, 16#, Section 3, Renmin Nan Lu, Chengdu, 610041, Sichuan, People's Republic of China
| | - Xia Jiang
- Department of Nutrition and Food Hygiene, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Jiayuan Li
- Department of Epidemiology and Biostatistics, Institute of Systems Epidemiology, and West China-PUMC C. C. Chen Institute of Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, 16#, Section 3, Renmin Nan Lu, Chengdu, 610041, Sichuan, People's Republic of China.
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Ajabnoor GMA. The Molecular and Genetic Interactions between Obesity and Breast Cancer Risk. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1338. [PMID: 37512149 PMCID: PMC10384495 DOI: 10.3390/medicina59071338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 07/14/2023] [Accepted: 07/19/2023] [Indexed: 07/30/2023]
Abstract
Breast cancer (BC) is considered the leading cause of death among females worldwide. Various risk factors contribute to BC development, such as age, genetics, reproductive factors, obesity, alcohol intake, and lifestyle. Obesity is considered to be a pandemic health problem globally, affecting millions of people worldwide. Obesity has been associated with a high risk of BC development. Determining the impact of obesity on BC development risk in women by demonstrating the molecular and genetic association in pre- and post-menopause females and risk to BC initiation is crucial in order to improve the diagnosis and prognosis of BC disease. In epidemiological studies, BC in premenopausal women was shown to be protective in a certain pattern. These altered effects between the two phases could be due to various physiological changes, such as estrogen/progesterone fluctuating levels. In addition, the relationship between BC risk and obesity is indicated by different molecular alterations as metabolic pathways and genetic mutation or epigenetic DNA changes supporting a strong connection between obesity and BC risk. However, these molecular and genetic alteration remain incompletely understood. The aim of this review is to highlight and elucidate the different molecular mechanisms and genetic changes occurring in obese women and their association with BC risk and development.
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Affiliation(s)
- Ghada M A Ajabnoor
- Department of Clinical Biochemistry, Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia
- Food, Nutrition and Lifestyle Unit, King Fahd Medical Research Centre, King Abdulaziz University, Jeddah 21551, Saudi Arabia
- Saudi Diabetes Research Group, Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia
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Sun J, Sun CK, Tang YX, Liu TC, Lu CJ. Application of SHAP for Explainable Machine Learning on Age-Based Subgrouping Mammography Questionnaire Data for Positive Mammography Prediction and Risk Factor Identification. Healthcare (Basel) 2023; 11:2000. [PMID: 37510441 PMCID: PMC10379972 DOI: 10.3390/healthcare11142000] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 07/06/2023] [Accepted: 07/08/2023] [Indexed: 07/30/2023] Open
Abstract
Mammography is considered the gold standard for breast cancer screening. Multiple risk factors that affect breast cancer development have been identified; however, there is an ongoing debate regarding the significance of these factors. Machine learning (ML) models and Shapley Additive Explanation (SHAP) methodology can rank risk factors and provide explanatory model results. This study used ML algorithms with SHAP to analyze the risk factors between two different age groups and evaluate the impact of each factor in predicting positive mammography. The ML model was built using data from the risk factor questionnaires of women participating in a breast cancer screening program from 2017 to 2021. Three ML models, least absolute shrinkage and selection operator (lasso) logistic regression, extreme gradient boosting (XGBoost), and random forest (RF), were applied. RF generated the best performance. The SHAP values were then applied to the RF model for further analysis. The model identified age at menarche, education level, parity, breast self-examination, and BMI as the top five significant risk factors affecting mammography outcomes. The differences between age groups ranked by reproductive lifespan and BMI were higher in the younger and older age groups, respectively. The use of SHAP frameworks allows us to understand the relationships between risk factors and generate individualized risk factor rankings. This study provides avenues for further research and individualized medicine.
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Affiliation(s)
- Jeffrey Sun
- Department of Acute Medicine, West Middlesex University Hospital, London TW7 6AF, UK
- School of Medicine, Imperial College London, London SW7 2BX, UK
| | - Cheuk-Kay Sun
- Division of Hepatology and Gastroenterology, Department of Internal Medicine, Shin Kong Wu Ho-Su Memorial Hospital, Taipei 11101, Taiwan
- Graduate Institute of Business Administration, Fu Jen Catholic University, New Taipei City 24205, Taiwan
- School of Medicine, Fu Jen Catholic University, New Taipei City 24205, Taiwan
- School of Medicine, Taipei Medical University, Taipei 11031, Taiwan
| | - Yun-Xuan Tang
- Department of Radiology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei 11101, Taiwan
- Department of Medical Imaging and Radiological Technology, Yuanpei University of Medical Technology, Hsinchu 30015, Taiwan
| | - Tzu-Chi Liu
- Graduate Institute of Business Administration, Fu Jen Catholic University, New Taipei City 24205, Taiwan
| | - Chi-Jie Lu
- Graduate Institute of Business Administration, Fu Jen Catholic University, New Taipei City 24205, Taiwan
- Artificial Intelligence Development Center, Fu Jen Catholic University, New Taipei City 24205, Taiwan
- Department of Information Management, Fu Jen Catholic University, New Taipei City 24205, Taiwan
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25
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Zipinotti Dos Santos D, de Souza JC, Pimenta TM, da Silva Martins B, Junior RSR, Butzene SMS, Tessarolo NG, Cilas PML, Silva IV, Rangel LBA. The impact of lipid metabolism on breast cancer: a review about its role in tumorigenesis and immune escape. Cell Commun Signal 2023; 21:161. [PMID: 37370164 PMCID: PMC10304265 DOI: 10.1186/s12964-023-01178-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 05/26/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Breast cancer (BC) is the second most frequent type of cancer in the world and most common among women, configuring a major challenge to global health. BC is a complex and heterogeneous disease that can be subdivided into distinct tumor types based on the expression of molecular markers predicting patient outcomes and response to therapy. A growing number of studies have tried to expand the known markers by investigating the association of altered lipid metabolism with BC immune escape, progression, and metastasis. In this review, we describe the metabolic peculiarities of each BC subtype, understanding how this influences its aggressiveness and identifying whether these intrinsic vulnerabilities of each subtype can play a role in therapeutic management and may affect immune system cells in the tumor microenvironment. CONCLUSION The evidence suggests so far that when changes occur in lipid pathways, it can affect the availability of structural lipids for membrane synthesis, lipid synthesis, and degradation that contribute to energy homeostasis and cell signaling functions. These findings will guide the next steps on the path to understanding the mechanisms underlying how lipids alterations are related to disparities in chemotherapeutic response and immune escape in BC. Video Abstract.
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Affiliation(s)
- Diandra Zipinotti Dos Santos
- Biotechnology Program/RENORBIO, Health Sciences Center, Federal University of Espírito Santo, Vitoria (Espírito Santo), Brazil.
| | - Josiany Carlos de Souza
- Biotechnology Program/RENORBIO, Health Sciences Center, Federal University of Espírito Santo, Vitoria (Espírito Santo), Brazil
| | - Tatiana Massariol Pimenta
- Department of Pharmaceutical Sciences, Federal University of Espirito Santo, Marechal Campos Avenue, MaruípeEspírito Santo, Vitória, 1468, Brazil
| | - Bárbara da Silva Martins
- Department of Pharmaceutical Sciences, Federal University of Espirito Santo, Marechal Campos Avenue, MaruípeEspírito Santo, Vitória, 1468, Brazil
| | - Roberto Silva Ribeiro Junior
- Department of Pharmaceutical Sciences, Federal University of Espirito Santo, Marechal Campos Avenue, MaruípeEspírito Santo, Vitória, 1468, Brazil
| | - Solenny Maria Silva Butzene
- Department of Pharmaceutical Sciences, Federal University of Espirito Santo, Marechal Campos Avenue, MaruípeEspírito Santo, Vitória, 1468, Brazil
| | - Nayara Gusmão Tessarolo
- Viral Vector Laboratory, Center for Translational Investigation in Oncology, Cancer Institute of São Paulo/LIM24, University of São Paulo School of Medicine, São Paulo, (São Paulo), Brazil
| | | | - Ian Victor Silva
- Department of Morphology, Health Sciences Center, Federal University of Espirito Santo, Vitoria, Espirito Santo, Brazil
| | - Leticia B A Rangel
- Biotechnology Program/RENORBIO, Health Sciences Center, Federal University of Espírito Santo, Vitoria (Espírito Santo), Brazil.
- Department of Pharmaceutical Sciences, Federal University of Espirito Santo, Marechal Campos Avenue, MaruípeEspírito Santo, Vitória, 1468, Brazil.
- Biochemistry Program, Health Sciences Center, Federal University of Espirito Santo, Vitoria, Brazil.
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26
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Stella S, Massimino M, Manzella L, Parrinello NL, Vitale SR, Martorana F, Vigneri P. Glucose-dependent effect of insulin receptor isoforms on tamoxifen antitumor activity in estrogen receptor-positive breast cancer cells. Front Endocrinol (Lausanne) 2023; 14:1081831. [PMID: 37361518 PMCID: PMC10289407 DOI: 10.3389/fendo.2023.1081831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 05/23/2023] [Indexed: 06/28/2023] Open
Abstract
Introduction Breast cancer is the most common malignancy in women, and it is linked to several risk factors including genetic alterations, obesity, estrogen signaling, insulin levels, and glucose metabolism deregulation. Insulin and Insulin-like growth factor signaling exert a mitogenic and pro-survival effect. Indeed, epidemiological and pre-clinical studies have shown its involvement in the development, progression, and therapy resistance of several cancer types including breast cancer. Insulin/Insulin-like growth factor signaling is triggered by two insulin receptor isoforms identified as IRA and IRB and by Insulin-like growth factor receptor I. Both classes of receptors show high homology and can initiate the intracellular signaling cascade alone or by hybrids formation. While the role of Insulin-like growth factor receptor I in breast cancer progression and therapy resistance is well established, the effects of insulin receptors in this context are complex and not completely elucidated. Methods We used estrogen-dependent insulin-like growth factor receptor I deleted gene (MCF7IGFIRKO) breast cancer cell models, lentivirally transduced to over-express empty-vector (MCF7IGFIRKO/EV), IRA (MCF7IGFIRKO/IRA) or IRB (MCF7IGFIRKO/IRB), to investigate the role of insulin receptors on the antiproliferative activity of tamoxifen in presence of low and high glucose concentrations. The tamoxifen-dependent cytotoxic effects on cell proliferation were determined by MTT assay and clonogenic potential measurement. Cell cycle and apoptosis were assessed by FACS, while immunoblot was used for protein analysis. Gene expression profiling was investigated by a PCR array concerning genes involved in apoptotic process by RT-qPCR. Results We found that glucose levels played a crucial role in tamoxifen response mediated by IRA and IRB. High glucose increased the IC50 value of tamoxifen for both insulin receptors and IRA-promoted cell cycle progression more than IRB, independently of glucose levels and insulin stimulation. IRB, in turn, showed anti-apoptotic properties, preserving cells' survival after prolonged tamoxifen exposure, and negatively modulated pro-apoptotic genes when compared to IRA. Discussion Our findings suggest that glucose levels modify insulin receptors signaling and that this event can interfere with the tamoxifen therapeutic activity. The investigation of glucose metabolism and insulin receptor expression could have clinical implications in Estrogen Receptor positive breast cancer patients receiving endocrine treatments.
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Affiliation(s)
- Stefania Stella
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
- Center of Experimental Oncology and Hematology, Azienda Ospedaliera Universitaria (A.O.U.) Policlinico “G. Rodolico - San Marco”, Catania, Italy
| | - Michele Massimino
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
- Center of Experimental Oncology and Hematology, Azienda Ospedaliera Universitaria (A.O.U.) Policlinico “G. Rodolico - San Marco”, Catania, Italy
| | - Livia Manzella
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
- Center of Experimental Oncology and Hematology, Azienda Ospedaliera Universitaria (A.O.U.) Policlinico “G. Rodolico - San Marco”, Catania, Italy
| | - Nunziatina Laura Parrinello
- Division of Hematology, Azienda Ospedaliera Universitaria (A.O.U.) Policlinico “G. Rodolico-S. Marco”, Catania, Italy
| | - Silvia Rita Vitale
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
- Center of Experimental Oncology and Hematology, Azienda Ospedaliera Universitaria (A.O.U.) Policlinico “G. Rodolico - San Marco”, Catania, Italy
| | - Federica Martorana
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
- Center of Experimental Oncology and Hematology, Azienda Ospedaliera Universitaria (A.O.U.) Policlinico “G. Rodolico - San Marco”, Catania, Italy
| | - Paolo Vigneri
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
- Center of Experimental Oncology and Hematology, Azienda Ospedaliera Universitaria (A.O.U.) Policlinico “G. Rodolico - San Marco”, Catania, Italy
- University Oncology Department, Humanitas Istituto Clinico Catanese, Catania, Italy
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Mubarik S, Wang F, Nadeem AA, Fawad M, Yu C. Breast cancer epidemiology and sociodemographic differences in BRICS-plus countries from 1990 to 2019: An age period cohort analysis. SSM Popul Health 2023; 22:101418. [PMID: 37215157 PMCID: PMC10193025 DOI: 10.1016/j.ssmph.2023.101418] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 04/18/2023] [Accepted: 04/29/2023] [Indexed: 05/24/2023] Open
Abstract
Background Breast cancer (BC) is a major health concern in the BRICS-plus, a group of developing nations consisting of Brazil, Russia, India, China, South Africa, and 30 other Asian countries, with nearly half of the world's population. This study aims to identify potential risk factors contributing to the burden of BC by assessing its epidemiological and socio-demographic changes. Methods Data on BC outcomes were obtained from the 2019 Global Burden of Disease Survey. The age-period-cohort (APC) modeling technique was used to evaluate the nonlinear impacts of age, cohort, and period on BC outcomes and reported risk attributable mortality and disability adjusted life years (DALYs) rate changes between 1990 and 2019. Results In 2019, there were 0.90 million female BC cases and 0.35 million deaths in the BRICS-plus region, with China and India having the largest proportion of incident cases and deaths, followed by Pakistan. Lesotho experienced the highest annualized rates of change (AROC: 2.61%; 95%UI: 1.99-2.99) in the past three decades. Birth cohorts' impact on BC varies greatly between the BRICS-plus nations, with Pakistan suffering the largest risk increase in the most recent cohort. High body mass index (BMI), high fasting plasma glucose (FPG), and a diet high in red meat contributed to the highest death and DALYs rates in most BRICS-plus nations in 2019, and there was a strong negative link between SDI and death and DALYs rate. Conclusions The study found that the burden of BC varies significantly between BRICS-plus regions. Thus, BRICS-plus nations should prioritise BC prevention, raise public awareness, and implement screening efficiency measures to reduce the burden of BC in the future, as well as strengthen public health policies and initiatives for important populations based on their characteristics and adaptability.
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Affiliation(s)
- Sumaira Mubarik
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, Wuhan, 430071, China
| | - Fang Wang
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu, 221004, China
| | - Adeel Ahmad Nadeem
- State Key Laboratory of Water Resources and Hydropower Engineering Science, Wuhan University, Wuhan, 430072, China
| | - Muhammad Fawad
- School of Public Health and Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, Zhejiang, China
| | - Chuanhua Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, Wuhan, 430071, China
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Tang H, Wang R, Liu W, Xiao H, Jing H, Song F, Guo S, Li T, Yi L, Zhang Y, Bai X, Shang L. The influence of nutrition literacy, self-care self-efficacy and social support on the dietary practices of breast cancer patients undergoing chemotherapy: A multicentre study. Eur J Oncol Nurs 2023; 64:102344. [PMID: 37290159 DOI: 10.1016/j.ejon.2023.102344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 03/27/2023] [Accepted: 04/29/2023] [Indexed: 06/10/2023]
Abstract
PURPOSE Breast cancer patients undergoing chemotherapy experience adverse reactions, which lead to poor nutritional status. The objective of this study was to explore the dietary practice of Chinese breast cancer patients undergoing chemotherapy and to analyse the influence of nutrition literacy, self-care self-efficacy and perceived social support on dietary practice. METHOD A total of 295 participants from three hospitals in China were enrolled. The Dietary Nutritional Knowledge, Attitude and Practice Questionnaire; Nutrition Literacy Measurement Scale for Chinese Adults; Strategies Used by People to Promote Health and Perceived Social Support Scale were administered. Multiple linear regressions were used to identify influencing factors. RESULTS The dietary practice of patients were generally satisfactory. Nutrition literacy (r = 0.460, p < 0.001), self-care self-efficacy (r = 0.513, p < 0.001) and perceived social support (r = 0.703, p < 0.001) were positively correlated with dietary practice. The main factors influencing participants' dietary practice were nutrition literacy, self-care self-efficacy, perceived social support, living environment, cancer stage, body mass index, chemotherapy cycle and average monthly household income (all p < 0.05). The model explained 59.0% of the variance in dietary practice. CONCLUSIONS Health professionals should emphasize breast cancer patients' dietary practice throughout the entire chemotherapy course, and dietary interventions should be designed by oncology nurses based on patients' nutrition literacy, self-care self-efficacy and perceived social support. Female patients who have a higher body mass index and income, live in rural areas, have a lower education level, have stage I cancer and have undergone numerous chemotherapy cycles are the focus population of intervention.
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Affiliation(s)
- Han Tang
- Department of Health Statistics, School of Public Health, The Fourth Military Medical University, 710032, Xi'an, China; Department of Clinical Nursing, School of Nursing, The Fourth Military Medical University, 710032, Xi'an, China
| | - Ruibo Wang
- School of Nursing and Health, Zhengzhou University, 450001, Zhengzhou, China
| | - Wei Liu
- Department of Breast Surgery 2 (Area 1), The First Affiliated Hospital of Zhengzhou University, 450052, Zhengzhou, China
| | - Han Xiao
- Department of Breast Surgery 2 (Area 1), The First Affiliated Hospital of Zhengzhou University, 450052, Zhengzhou, China
| | - Haihong Jing
- Department of Breast Surgery 2 (Area 1), The First Affiliated Hospital of Zhengzhou University, 450052, Zhengzhou, China
| | - Fangxia Song
- Department of Breast Surgery 2 (Area 1), The First Affiliated Hospital of Zhengzhou University, 450052, Zhengzhou, China
| | - Shengjie Guo
- School of Nursing and Health, Zhengzhou University, 450001, Zhengzhou, China
| | - Ting Li
- School of Nursing and Health, Zhengzhou University, 450001, Zhengzhou, China
| | - Luanxing Yi
- School of Nursing, Fujian University of Traditional Chinese Medicine, 350025, Fuzhou, China
| | - Yuhai Zhang
- Department of Health Statistics, School of Public Health, The Fourth Military Medical University, 710032, Xi'an, China
| | - Xue Bai
- Puyang Oilfield General Hospital, 457001, Puyang, China
| | - Lei Shang
- Department of Health Statistics, School of Public Health, The Fourth Military Medical University, 710032, Xi'an, China.
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Arteaga DP, DeKraker C, Ennis M, Dewey N, Goebel EA, Welch S, Pimentel I, Ippolito JE, Lohmann AE. Body composition and endometrial cancer outcomes. J Natl Cancer Inst Monogr 2023; 2023:49-55. [PMID: 37139979 DOI: 10.1093/jncimonographs/lgad012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 02/24/2023] [Accepted: 03/06/2023] [Indexed: 05/05/2023] Open
Abstract
BACKGROUND Obesity is a known risk factor for developing endometrial cancer. However, the association of obesity with endometrial cancer (EC) outcomes has not been clearly established. This study examined how outcomes in women with early stage EC vary with body composition measured via computed tomography (CT). METHODS In this retrospective study, patients diagnosed with EC international Federation of Gynecology and Obstetrics stages I-III and available CT scans were included. Automatica software was used to assess the areas of visceral adipose tissue, subcutaneous adipose tissue (SAT), and intermuscular adipose tissue (IMAT) and skeletal muscle area. RESULTS Of 293 patient charts assessed, 199 met eligibility criteria. Median body mass index (BMI) was 32.8 kg/m2 (interquartile range [IQ] = 26.8-38.9); 61.8% had histologic subtype endometrioid carcinoma. Adjusted for age, international Federation of Gynecology and Obstetrics stage, and histologic subtype, a BMI of at least 30 vs less than 30 kg/m2 was associated with lower endometrial cancer-specific survival (ECSS) (hazard ratio [HR] = 2.32, 95% confidence interval [CI] = 1.27 to 4.25) and overall survival (OS) (HR = 2.7, 95% CI = 1.35 to 5.39). Higher IMAT 75th vs 25th percentile and SAT of at least 225.6 vs less than 225.6 cm2 were associated with lower ECSS (HR = 1.53, 95% CI = 1.1 to 2.13, and HR = 2.57, 95% CI = 1.13 to 5.88) and OS (HR = 1.50, 95% CI = 1.11 to 2.02, and HR = 2.46, 95% CI = 1.2 to 5.01), respectively. The association of visceral adipose tissue (75th vs 25th percentile) with ECSS and OS was not statistically significant (HR = 1.42, 95% CI = 0.91 to 2.22, and HR = 1.24, 95% CI = 0.81 to 1.89). CONCLUSION Higher BMI, IMAT, and SAT were associated with higher mortality from EC and lower OS. A better understanding of the mechanisms underlying these relationships could inform strategies to improve patient outcomes.
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Affiliation(s)
- Diana P Arteaga
- Department of Medicine, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
- Department of Oncology, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | - Corina DeKraker
- Department of Medicine, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | | | - Nicole Dewey
- Michener Institute of Education, University of Toronto, Toronto, ON, Canada
| | - Emily A Goebel
- Department of Medicine, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
- Department of Pathology and Laboratory Medicine, Schulich School of Medicine & Dentistry, Western University and London Health Science Centre, London, ON, Canada
| | - Stephen Welch
- Department of Medicine, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
- Department of Oncology, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | - Isabel Pimentel
- Department of Oncology, Vall d'Hebron Institute of Oncology (VHIO), Vall d'Hebron University Hospital, Barcelona, Catalonia, Spain
| | - Joseph E Ippolito
- Department of Radiology, Washington University School of Medicine, St Louis, MO, USA
| | - Ana Elisa Lohmann
- Department of Oncology, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
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Borg G, Dihge L, Johansson K. Risk factors for seroma formation after axillary lymph node dissection with special focus on the impact of early shoulder exercise. Acta Oncol 2023:1-7. [PMID: 37129993 DOI: 10.1080/0284186x.2023.2203831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
BACKGROUND Shoulder and arm dysfunction such as reduced range of motion (ROM) and seroma formation, are common complications following axillary lymph node dissection (ALND). There are conflicting results on the effect of early postoperative exercise on the risk of seroma. This study aims to present incidence of symptomatic seroma formation in a large, population-based cohort, and assesses whether early shoulder mobilization, and other common patient and treatment-related factors are predictors of seroma. METHODS This observational cohort study at the Surgical clinic at Lund University Hospital in Sweden, included 217 consecutive patients who underwent ALND due to breast cancer, cutaneous malignant melanoma (CMM), or carcinoma of unknown primary. A shoulder exercise program was introduced on the first postoperative day and data were collected at routine follow-up 4-6 weeks postsurgery. Main outcome was the strength of the associations between postsurgery exercise and seroma incidence based on logistic regression analyses, supported by data on seroma volume and number of aspirations. RESULTS Two hundred patients completed the study. The overall seroma incidence was 67.5% and the odds of seroma were lower for patients practicing ROM exercise two times/day versus 0-1 time/day (OR 0.42, 95% CI 0.18-0.96, p = .038). ROM exercise greater than two times/day did not increase the volume, neither did the arm cycling exercise. ALND combined with mastectomy and CMM surgery were associated with larger seroma volumes (1116 ± 1068ml, p = .006) and (1318 ± 920 ml, p < .001), respectively, compared to the breast conserving surgery (537 ± 478ml) while neoadjuvant chemotherapy showed no influence. The effect of age, patients ≥60 years compared to younger, or BMI ≥ 30.0 were weaker (p = .08). CONCLUSIONS Extensive surgical treatments for breast cancer and malignant melanoma produces more seroma, and higher age and obesity may also influence the risk. ROM exercises twice daily predict a lower incidence of seroma following ALND, and more frequent shoulder exercise do not increase the volumes.
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Affiliation(s)
- Gunilla Borg
- Department of Surgery, Skane University Hospital, Lund, Sweden
| | - Looket Dihge
- Department of Clinical Sciences, Division of Surgery, Lund University, Lund, Sweden
- Department of Plastic and Reconstructive Surgery, Skåne University Hospital, Malmö, Sweden
| | - Karin Johansson
- Department of Health Sciences, Lund University, Lund, Sweden
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Aryannejad A, Saeedi Moghaddam S, Mashinchi B, Tabary M, Rezaei N, Shahin S, Rezaei N, Naghavi M, Larijani B, Farzadfar F. National and subnational burden of female and male breast cancer and risk factors in Iran from 1990 to 2019: results from the Global Burden of Disease study 2019. Breast Cancer Res 2023; 25:47. [PMID: 37101247 PMCID: PMC10131337 DOI: 10.1186/s13058-023-01633-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 03/06/2023] [Indexed: 04/28/2023] Open
Abstract
BACKGROUND Breast cancer (BC) is one of the most burdensome cancers worldwide. Despite advancements in diagnostic and treatment modalities, developing countries are still dealing with increasing burdens and existing disparities. This study provides estimates of BC burden and associated risk factors in Iran at the national and subnational levels over 30 years (1990-2019). METHODS Data on BC burden for Iran were retrieved from the Global Burden of Disease (GBD) study from 1990 to 2019. GBD estimation methods were applied to explore BC incidence, prevalence, deaths, disability-adjusted life years (DALYs), and attributable burden to risk factors based on the GBD risk factors hierarchy. Moreover, decomposition analysis was performed to find the contribution of population growth, aging, and cause-specific incidence in the total incidence change. Age-standardized rates (per 100,000 population) and 95% uncertainty intervals (UI) were reported based on sex, age, and socio-demographic index (SDI). RESULTS Age-standardized incidence rate (ASIR) increased from 18.8 (95% UI 15.3-24.1)/100,000 in 2019 to 34.0 (30.7-37.9)/100,000 in 2019 among females and from 0.2/100,000 (0.2-0.3) to 0.3/100,000 (0.3-0.4) among males. Age-standardized deaths rate (ASDR) increased slightly among females from 10.3 (8.2-13.6)/100,000 in 1990 to 11.9 (10.8-13.1)/100,000 in 2019 and remained almost the same among males-0.2/100,000 (0.1-0.2). Age-standardized DALYs rate also increased from 320.2 (265.4-405.4) to 368.7 (336.7-404.3) among females but decreased slightly in males from 4.5 (3.5-5.8) to 4.0 (3.5-4.5). Of the 417.6% increase in total incident cases from 1990-2019, 240.7% was related to cause-specific incidence. In both genders, the BC burden increased by age, including age groups under 50 before routine screening programs, and by SDI levels; the high and high-middle SDI regions had the highest BC burden in Iran. Based on the GBD risk factors hierarchy, high fasting plasma glucose (FPG) and alcohol were estimated to have the most and the least attributed DALYs for BC among females, respectively. CONCLUSIONS BC burden increased from 1990 to 2019 in both genders, and considerable discrepancies were found among different provinces and SDI quintiles in Iran. These increasing trends appeared to be associated with social and economic developments and changes in demographic factors. Improvements in registry systems and diagnostic capacities were also probably responsible for these growing trends. Raising general awareness and improving screening programs, early detection measures, and equitable access to healthcare systems might be the initial steps to tackle the increasing trends.
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Affiliation(s)
- Armin Aryannejad
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Second Floor, No.10, Jalal Al-E-Ahmad Highway, Tehran, 1411713137, Iran
| | - Sahar Saeedi Moghaddam
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Second Floor, No.10, Jalal Al-E-Ahmad Highway, Tehran, 1411713137, Iran
| | - Baharnaz Mashinchi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Second Floor, No.10, Jalal Al-E-Ahmad Highway, Tehran, 1411713137, Iran
| | - Mohammadreza Tabary
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Second Floor, No.10, Jalal Al-E-Ahmad Highway, Tehran, 1411713137, Iran
- Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Negar Rezaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Second Floor, No.10, Jalal Al-E-Ahmad Highway, Tehran, 1411713137, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sarvenaz Shahin
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Second Floor, No.10, Jalal Al-E-Ahmad Highway, Tehran, 1411713137, Iran
| | - Nazila Rezaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Second Floor, No.10, Jalal Al-E-Ahmad Highway, Tehran, 1411713137, Iran
| | - Mohsen Naghavi
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshad Farzadfar
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Second Floor, No.10, Jalal Al-E-Ahmad Highway, Tehran, 1411713137, Iran.
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
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França-Lara ÉG, Weber SH, Pinho RA, Casali-da-Rocha JC, Elifio-Esposito S. A remote, fully oriented personalized program of physical exercise for women in follow-up after breast cancer treatment improves body composition and physical fitness. SPORTS MEDICINE AND HEALTH SCIENCE 2023. [DOI: 10.1016/j.smhs.2023.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023] Open
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Aghajanzadeh M, Torabi H, Najafi B, Talebi P, Shirini K. Intermammary breast cancer: A rare case of cancer with origin of breast cells in an unusual location. SAGE Open Med Case Rep 2023; 11:2050313X231154996. [PMID: 36798680 PMCID: PMC9926372 DOI: 10.1177/2050313x231154996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 01/18/2023] [Indexed: 02/15/2023] Open
Abstract
The most common type of cancer among the female population is breast cancer. The most common site for the occurrence of breast cancer is the upper outer quadrant; the upper inner quadrant is the second site, and both the lower outer and the lower inner quadrants are in the third place. This problem is rarely seen in the central portion. Intermammary metastasis due to breast cancer is an infrequent finding. This article presents a 62-year-old lady who presented to the surgical ward with intermammary swelling that appeared suddenly 3 months ago. Ultrasound examination showed a hypoechoic micro-lobulated mass with internal vascularity on the chest wall. Although core needle biopsy suspected invasive ductal carcinoma, both right and left axillary lymph nodes were normal and free. The patient was consulted by an oncologist who recommended radiotherapy before surgery and chemotherapy before and after surgery. This study aims to report and discuss a rare case of intermammary cancer with the origin of breast cells without breast and axillary lymph node involvement. Although the intermammary region is an extremely rare location where breast cancer could occur, its management strategy is the same as other breast cancers.
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Affiliation(s)
| | - Hossein Torabi
- Department of General Surgery, Poursina Medical and Educational Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Behrouz Najafi
- Department of Oncology, Guilan University of Medical Sciences, Rasht, Iran
| | - Pedram Talebi
- Department of Pathology, Guilan University of Medical Sciences, Rasht, Iran
| | - Kasra Shirini
- Department of General Surgery, Iran University of Medical Science, Tehran, Iran,Kasra Shirini, Department of General Surgery, Iran University of Medical Science, Tehran 1449614535, Iran.
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Sachdeva P, Ghosh S, Ghosh S, Han S, Banerjee J, Bhaskar R, Sinha JK. Childhood Obesity: A Potential Key Factor in the Development of Glioblastoma Multiforme. LIFE (BASEL, SWITZERLAND) 2022; 12:life12101673. [PMID: 36295107 PMCID: PMC9605119 DOI: 10.3390/life12101673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 10/15/2022] [Accepted: 10/18/2022] [Indexed: 12/04/2022]
Abstract
Glioblastoma multiforme (GBM) is a malignant primary tumor type of the central nervous system (CNS). This type of brain tumor is rare and is responsible for 12-15% of all brain tumors. The typical survival rate of GBM is only 12 to 14 months. GBM has a poor and unsatisfactory prognosis despite advances in research and therapeutic interventions via neurosurgery, radiation, and chemotherapy. The molecular heterogeneity, aggressive nature, and occurrence of drug-resistant cancer stem cells in GB restricts the therapeutic efficacy. Interestingly, the CNS tumors in children are the second most usual and persistent type of solid tumor. Since numerous research studies has shown the association between obesity and cancer, childhood obesity is one of the potential reasons behind the development of CNS tumors, including GBM. Obesity in children has almost reached epidemic rates in both developed and developing countries, harming children's physical and mental health. Obese children are more likely to face obesity as adults and develop non-communicable diseases such as diabetes and cardiovascular disease as compared to adults with normal weight. However, the actual origin and cause of obesity are difficult to be pointed out, as it is assumed to be a disorder with numerous causes such as environmental factors, lifestyle, and cultural background. In this narrative review article, we discuss the various molecular and genetic drivers of obesity that can be targeted as potential contributing factors to fight the development of GBM in children.
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Affiliation(s)
- Punya Sachdeva
- GloNeuro, Sector 107, Vishwakarma Road, Noida 201301, India
| | - Shampa Ghosh
- GloNeuro, Sector 107, Vishwakarma Road, Noida 201301, India
- ICMR—National Institute of Nutrition, Tarnaka, Hyderabad 500007, India
| | - Soumya Ghosh
- GloNeuro, Sector 107, Vishwakarma Road, Noida 201301, India
| | - Sungsoo Han
- School of Chemical Engineering, Yeungnam University, Gyeongsan 38541, Korea
| | - Juni Banerjee
- Department of Biotechnology and Bioengineering, Institute of Advanced Research, Gandhinagar 382426, India
- Correspondence: (J.B.); (R.B.); (J.K.S.)
| | - Rakesh Bhaskar
- School of Chemical Engineering, Yeungnam University, Gyeongsan 38541, Korea
- Correspondence: (J.B.); (R.B.); (J.K.S.)
| | - Jitendra Kumar Sinha
- GloNeuro, Sector 107, Vishwakarma Road, Noida 201301, India
- Correspondence: (J.B.); (R.B.); (J.K.S.)
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Mildly elevated diastolic blood pressure increases subsequent risk of breast cancer in postmenopausal women in the Health Examinees-Gem study. Sci Rep 2022; 12:15995. [PMID: 36163474 PMCID: PMC9512811 DOI: 10.1038/s41598-022-19705-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 09/02/2022] [Indexed: 12/24/2022] Open
Abstract
Epidemiological evidence suggests that hypertension is associated with breast cancer risk. However, previous studies disregard blood pressure components in the healthy population. We aimed to examine the relationship between systolic and diastolic blood pressure and breast cancer risk in a Korean population-based prospective cohort. A total of 73,031 women from the Health Examinees Gem Study were followed from baseline (2004 to 2013) through 2018. Systolic and diastolic blood pressure were measured by trainee physicians at baseline recruitment and then categorized based on the international guidelines for clinical hypertension. Associations between systolic and diastolic blood pressure with overall breast cancer and stratified by premenopausal and postmenopausal status were evaluated using adjusted multivariable Cox proportional hazard regression. A total of 858 breast cancer cases were recorded for a median follow-up period of 9 years. Compared with the normal DBP category (< 85 mmHg), the normal-high category was positively associated with breast cancer risk in postmenopausal women (85–89 mmHg, HR 1.73 95% CI 1.28–2.33), but not in premenopausal women (85–89 mmHg, HR 0.87 95% CI 0.56–1.35). Similar results were found when all cases of self-reported hypertension were excluded. Results for SBP did not show a significant association with breast cancer risk. The association between DBP and breast cancer suggests DBP could be an important factor in cancer prevention, especially for women after menopause. Our study provides a first detailed approach to understanding the importance of diastolic blood pressure for breast cancer prevention and warrants further investigation.
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Kim BK, Choi JE, Youn HJ, Park HS, Kim D, Oh SJ, Lee HJ, Lee J, Sun WY. Clinicopathological features and prognosis associated with breast cancer laterality: a nationwide study from the Korean Breast Cancer Society. Ann Surg Treat Res 2022; 103:119-128. [PMID: 36128032 PMCID: PMC9478426 DOI: 10.4174/astr.2022.103.3.119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 08/06/2022] [Accepted: 08/19/2022] [Indexed: 11/30/2022] Open
Abstract
Purpose Although breast cancer is known to show a left predominance, the clinical characteristics and causes underlying this finding remain unclear. In addition, no related studies on breast cancer laterality have been conducted in patients with breast cancer in Korea. Therefore, we aimed to analyze differences in breast cancer laterality and the associated clinicopathological characteristics and prognosis among Korean patients with breast cancer. Methods We conducted a retrospective analysis using large-scale data on clinicopathological factors and prognosis differences related to breast cancer laterality from the Korean Breast Cancer Society Registration system. The left-to-right ratio (LRR) of breast cancer was calculated through binomial distribution, and factors related to breast cancer laterality were identified through logistic regression analysis. In addition, the differences in the survival rates for left and right breast cancers were analyzed using the Kaplan-Meier method and Cox proportional hazards model. Results In 171,500 patients, the LRR was 1.031 (95% confidence interval, 1.022-1.041; P < 0.001). Multivariate analysis showed that the ratio of left breast cancer was related to age, body mass index (BMI), location, and human epidermal growth factor receptor 2 (HER2) status. The survival rate of patients with left and right breast cancers showed no significant difference. Conclusion A large-scale analysis revealed a left predominance in breast cancer laterality in Korean patients. Over time, this predominance gradually decreased. Age, BMI, location, and HER2 status affected breast cancer laterality. However, while left breast cancer showed relatively aggressive characteristics, it was not associated with a difference in the survival rate.
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Affiliation(s)
- Bong Kyun Kim
- Department of Surgery, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jung Eun Choi
- Department of Surgery, Yeungnam University Medical Center, Yeungnam University College of Medicine, Daegu, Korea
| | - Hyun Jo Youn
- Department of Surgery, Jeonbuk National University Medical School, Jeonju, Korea
| | - Hyung Seok Park
- Department of Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Dooreh Kim
- Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Se Jeong Oh
- Department of Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyouk Jin Lee
- Breast-Thyroid Center, Saegyaero Hospital, Busan, Korea
| | - Jina Lee
- Department of Surgery, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Woo Young Sun
- Department of Surgery, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Nakipoğlu C, Erdoğan İyigün Z, Kayan Tapan T, Özmen V, Soybir GR, İlgün AS. Evaluation of Abdominal Fat Ratio in Patients with Breast Cancer-Related Lymphedema: A Controlled Study. Lymphat Res Biol 2022; 21:130-134. [PMID: 36037063 DOI: 10.1089/lrb.2022.0008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: This study aimed to investigate the possible relationship between breast cancer-related lymphedema and central obesity, which is known to be effective in metabolic syndrome and chronic inflammation. Methods and Results: Thirty-six patients (18 lymphedemas, 18 control) enrolled in the study. There was no statistically significant difference in demographic data between the two groups except body mass index (BMI) distribution (p = 0.008). Although 50% of the patients in the study group were obese, this rate was 5.6% in the control group. Although there was a significant difference between the study and control groups in terms of abdominal circumference measurement, there was no significant difference between total and abdominal fat amount and ratios. When BMI and abdominal circumference measurements were evaluated together to predict lymphedema, the area under the curve in abdominal circumference measurement was higher than BMI (0.715 vs. 0.659). In receiver operating characteristic curve analysis, 107 cm of abdominal circumference measurement was determined as cutoff value for lymphedema, with 55% sensitivity and 89% specificity (Youden index: 0.44). Conclusion: Abdominal circumference measurement can be evaluated together with BMI in determining the risk of lymphedema.
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Affiliation(s)
- Cansu Nakipoğlu
- Department of Physical Therapy and Rehabilitation, Health Science Faculty, Demiroglu Bilim University, Istanbul, Turkey
| | - Zeynep Erdoğan İyigün
- Department of Physical Therapy and Rehabilitation, Health Science Faculty, Demiroglu Bilim University, Istanbul, Turkey
| | - Tuba Kayan Tapan
- Department of Physical Therapy and Rehabilitation, Health Science Faculty, Demiroglu Bilim University, Istanbul, Turkey
| | - Vahit Özmen
- Department of Physical Therapy and Rehabilitation, Health Science Faculty, Demiroglu Bilim University, Istanbul, Turkey
| | - Gürsel Remzi Soybir
- Department of Physical Therapy and Rehabilitation, Health Science Faculty, Demiroglu Bilim University, Istanbul, Turkey
| | - Ahmet Serkan İlgün
- Department of Physical Therapy and Rehabilitation, Health Science Faculty, Demiroglu Bilim University, Istanbul, Turkey
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Xue H, Du H, Xie Y, Zhai Y, Song S, Luo B, Qiu H, Wang K, Cui J, Song C, Xu H, Li W, Shi H, Li Z. Association Between Fat Mass to Lean Body Mass Ratio and All-Cause Mortality Among Middle-Aged and Elderly Cancer Patients Without Obesity: A Multi-Center Observational Study in China. Front Nutr 2022; 9:914020. [PMID: 35789967 PMCID: PMC9249599 DOI: 10.3389/fnut.2022.914020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 05/20/2022] [Indexed: 11/13/2022] Open
Abstract
Objective We aimed to investigate the association between fat mass to lean body mass ratio (RFL), percentage of body fat (PBF), and fat mass (FM) with mortality among middle-aged and elderly cancer patients without obesity. Methods This prospective hospital-based cohort study comprised 3,201 patients with stage I to IV cancer aged 40 years or above (mean age: 58 years for female patients and 61 years for male patients; mean length of follow-up was 1.67 years; the maximal follow-up length was 6.42 years). FM and PBF were measured by bioelectrical impedance analysis (BIA). Cox proportional hazard models were used, and adjusted hazard ratios (HRs) were estimated. Results We revealed a significant association between RFL and all-cause mortality among men aged ≥60 years after adjusting for confounders. Compared with those in the lowest tertile of RFL, elderly men in the medium and highest tertile had a 35 and 34% lower hazard of death from any cause, respectively. After additionally adjusted for C-reaction protein (CRP), HRs of medium and high tertile of RFL became short of statistical significance [medium tertile: adjusted HRs (95% CI) = 0.74 (0.46, 1.20); highest tertile: adjusted HRs (95% CI) = 0.84 (0.53, 1.33)]. Among elderly women, RFL was significantly related to all-cause mortality only when the additional adjustment for CRP [medium tertile: adjusted HRs (95% CI) = 2.08 (1.08, 4.01); highest tertile: adjusted HRs (95% CI) = 0.90 (0.45, 1.81)]. No significant association between RFL and all-cause mortality was observed among female participants or male participants aged less than 60 years. Conclusion Our findings showed a significant non-linear association between RFL and all-cause mortality, which was observed only in elderly men, and might be attenuated by their inflammation state.
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Affiliation(s)
- Hongmei Xue
- Department of Clinical Nutrition, The First Hospital of Hebei Medical University, Shijiazhuang, China.,Hebei Province Key Laboratory of Nutrition and Health, Shijiazhuang, China
| | - Hongzhen Du
- Department of Clinical Nutrition, The First Hospital of Hebei Medical University, Shijiazhuang, China.,Hebei Province Key Laboratory of Nutrition and Health, Shijiazhuang, China
| | - Ying Xie
- Department of Clinical Nutrition, The First Hospital of Hebei Medical University, Shijiazhuang, China.,Hebei Province Key Laboratory of Nutrition and Health, Shijiazhuang, China
| | - Yijing Zhai
- Department of Clinical Nutrition, The First Hospital of Hebei Medical University, Shijiazhuang, China.,Hebei Province Key Laboratory of Nutrition and Health, Shijiazhuang, China
| | - Shiming Song
- Department of Clinical Nutrition, The First Hospital of Hebei Medical University, Shijiazhuang, China.,Hebei Province Key Laboratory of Nutrition and Health, Shijiazhuang, China
| | - Bin Luo
- Department of Clinical Nutrition, The First Hospital of Hebei Medical University, Shijiazhuang, China.,Hebei Province Key Laboratory of Nutrition and Health, Shijiazhuang, China
| | - Hong Qiu
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Kunhua Wang
- Department of Gastrointestinal Surgery, Institute of Gastroenterology, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Jiuwei Cui
- Cancer Center, The First Hospital of Jilin University, Changchun, China
| | - Chunhua Song
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Hongxia Xu
- Department of Nutrition, Daping Hospital and Research Institute of Surgery, Third Military Medical University, Chongqing, China
| | - Wei Li
- Cancer Center, The First Hospital of Jilin University, Changchun, China
| | - Hanping Shi
- Department of Gastrointestinal Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.,Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Chinese Society of Nutritional Oncology, Beijing, China
| | - Zengning Li
- Department of Clinical Nutrition, The First Hospital of Hebei Medical University, Shijiazhuang, China.,Hebei Province Key Laboratory of Nutrition and Health, Shijiazhuang, China
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Kosaka S, Miyashita M, McNamala K, Nomura M, Shima H, Kawai M, Sato I, Harada-Shoji N, Ishida T, Choi MH, Sasano H. Bird's eye view analysis of in situ cholesterol metabolic pathways in breast cancer patients and its clinicopathological significance in their subtypes. J Steroid Biochem Mol Biol 2022; 221:106103. [PMID: 35367370 DOI: 10.1016/j.jsbmb.2022.106103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/27/2022] [Accepted: 03/28/2022] [Indexed: 12/14/2022]
Abstract
Obesity has been known to increase the risks of breast cancer (BC) development and also to be associated with adverse clinical outcome of the patients. Abnormalities of cholesterol metabolism are not only related to obesity but also to biological or clinical behavior of BC patients. However, which metabolites or pathways of cholesterol metabolism could represent the characteristics of BC patients have remained virtually unknown. Therefore, in this study, we attempted to perform bird's eye view or comprehensive analysis of in situ or intra-tumoral cholesterol metabolic pathways using the multimodal approaches in order to elucidate the possible significance of cholesterol metabolites and its metabolic enzymes including CYP27A1, CYP7A1, and CYP46A1. GC-MS study using BC specimens was first performed in 60 BCE patients to evaluate cholesterol metabolism from cholesterol through oxysterols in both BC and normal tissues. Results of those analyses above lead to evaluating immunoreactivity and mRNA expression of CYP27A1, CYP7A1 and CYP46A1 in 213 and 153 BCE cases, respectively. Results of comprehensive GC-MS analysis did reveal that three oxysterols, 27-HC, 7α-HC and 24-HC were all related to malignant phenotypes in BC. 27-HC abundance was significantly associated with higher tumor stage (P = 0.0475) of BC patients. Luminal B type BC patients harboring high CYP27A1, the enzyme responsible for production of 27-HC were significantly associated with worse disease-free survival than those with low CYP27A1 (P = 0.0463). 7α-HC tended to be more abundant in HER2 positive and TNBC subtypes and higher levels of 7α-HC were also significantly associated with higher Ki-67 labeling index (P = 0.0022) and histological grade (P = 0.0286). CYP7A1, the enzyme involved in production of 7α-HC, was significantly more abundant in TNBC than other subtypes (vs Luminal A; P = 0.0321, vs Luminal B; P = 0.0048, vs HER2; P = 0.0103). The levels of 24-HC in BC were lower than normal breast tissues regardless of its subtypes. CYP46A1, the enzyme involved in the production of 24-HC, was detected only in 33 (15.5%) out of 213 BCE cases examined in this study. Results of our bird's eye view analysis of in situ or intra-tumoral cholesterol metabolism in BC patients did firstly reveal BC subtype dependent involvement of its different pathways. Results also indicated the therapeutic possibility of subtype dependent modification of cholesterol metabolizing pathways in BC patients.
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Affiliation(s)
- Shinkichi Kosaka
- Department of Pathology, Tohoku University Graduate School of Medicine, Miyagi, Japan; Division of Cancer Chemotherapy, Miyagi Cancer Center Research Institute, Natori, Japan
| | - Minoru Miyashita
- Department of Pathology, Tohoku University Graduate School of Medicine, Miyagi, Japan; Department of Breast and Endocrine Surgical Oncology, Tohoku University Graduate School of Medicine, Miyagi, Japan.
| | - Keely McNamala
- Department of Pathology, Tohoku University Graduate School of Medicine, Miyagi, Japan; Department of Pathology, Tohoku University Hospital, Miyagi, Japan
| | - Miyuki Nomura
- Division of Cancer Chemotherapy, Miyagi Cancer Center Research Institute, Natori, Japan
| | - Hiroshi Shima
- Division of Cancer Chemotherapy, Miyagi Cancer Center Research Institute, Natori, Japan
| | - Masaaki Kawai
- Department of Surgery I, Yamagata University Graduate School of Medical Science, Yamagata 990-9585, Japan
| | - Ikuro Sato
- Division of Cancer Chemotherapy, Miyagi Cancer Center Research Institute, Natori, Japan
| | - Narumi Harada-Shoji
- Department of Breast and Endocrine Surgical Oncology, Tohoku University Graduate School of Medicine, Miyagi, Japan
| | - Takanori Ishida
- Department of Breast and Endocrine Surgical Oncology, Tohoku University Graduate School of Medicine, Miyagi, Japan
| | - Man Ho Choi
- Molecular Recognition Research Center, Korea Institute of Science and Technology, Seoul, South Korea
| | - Hironobu Sasano
- Department of Pathology, Tohoku University Graduate School of Medicine, Miyagi, Japan; Department of Pathology, Tohoku University Hospital, Miyagi, Japan
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40
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Devericks EN, Carson MS, McCullough LE, Coleman MF, Hursting SD. The obesity-breast cancer link: a multidisciplinary perspective. Cancer Metastasis Rev 2022; 41:607-625. [PMID: 35752704 PMCID: PMC9470704 DOI: 10.1007/s10555-022-10043-5] [Citation(s) in RCA: 42] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 05/31/2022] [Indexed: 12/12/2022]
Abstract
Obesity, exceptionally prevalent in the USA, promotes the incidence and progression of numerous cancer types including breast cancer. Complex, interacting metabolic and immune dysregulation marks the development of both breast cancer and obesity. Obesity promotes chronic low-grade inflammation, particularly in white adipose tissue, which drives immune dysfunction marked by increased pro-inflammatory cytokine production, alternative macrophage activation, and reduced T cell function. Breast tissue is predominantly composed of white adipose, and developing breast cancer readily and directly interacts with cells and signals from adipose remodeled by obesity. This review discusses the biological mechanisms through which obesity promotes breast cancer, the role of obesity in breast cancer health disparities, and dietary interventions to mitigate the adverse effects of obesity on breast cancer. We detail the intersection of obesity and breast cancer, with an emphasis on the shared and unique patterns of immune dysregulation in these disease processes. We have highlighted key areas of breast cancer biology exacerbated by obesity, including incidence, progression, and therapeutic response. We posit that interception of obesity-driven breast cancer will require interventions that limit protumor signaling from obese adipose tissue and that consider genetic, structural, and social determinants of the obesity–breast cancer link. Finally, we detail the evidence for various dietary interventions to offset obesity effects in clinical and preclinical studies of breast cancer. In light of the strong associations between obesity and breast cancer and the rising rates of obesity in many parts of the world, the development of effective, safe, well-tolerated, and equitable interventions to limit the burden of obesity on breast cancer are urgently needed.
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Affiliation(s)
- Emily N Devericks
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Meredith S Carson
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Lauren E McCullough
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Michael F Coleman
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Stephen D Hursting
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. .,Nutrition Research Institute, University of North Carolina at Chapel Hill, Kannapolis, NC, USA. .,Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
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Lau TY, Kwan HY. Fucoxanthin Is a Potential Therapeutic Agent for the Treatment of Breast Cancer. Mar Drugs 2022; 20:md20060370. [PMID: 35736173 PMCID: PMC9229252 DOI: 10.3390/md20060370] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 05/18/2022] [Accepted: 05/24/2022] [Indexed: 12/04/2022] Open
Abstract
Breast cancer (BC) is one of the most common cancers diagnosed and the leading cause of cancer-related death in women. Although there are first-line treatments for BC, drug resistances and adverse events have been reported. Given the incidence of BC keeps increasing, seeking novel therapeutics is urgently needed. Fucoxanthin (Fx) is a dietary carotenoid commonly found in seaweeds and diatoms. Both in vitro and in vivo studies show that Fx and its deacetylated metabolite fucoxanthinol (Fxol) inhibit and prevent BC growth. The NF-κB signaling pathway is considered the major pathway contributing to the anti-proliferation, anti-angiogenesis and pro-apoptotic effects of Fx and Fxol. Other signaling molecules such as MAPK, MMP2/9, CYP and ROS are also involved in the anti-cancer effects by regulating the tumor microenvironment, cancer metastasis, carcinogen metabolism and oxidation. Besides, Fx also possesses anti-obesity effects by regulating UCP1 levels and lipid metabolism, which may help to reduce BC risk. More importantly, mounting evidence demonstrates that Fx overcomes drug resistance. This review aims to give an updated summary of the anti-cancer effects of Fx and summarize the underlying mechanisms of action, which will provide novel strategies for the development of Fx as an anti-cancer therapeutic agent.
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Gil-Herrero L, Pollán M, Martín M, López-Tarruella S, Castellanos M, Casla-Barrio S. The importance of physical exercise in cardiovascular fitness in breast cancer survivors. A cross-sectional study: women in Motion 2.0. Support Care Cancer 2022; 30:6745-6754. [PMID: 35524144 DOI: 10.1007/s00520-022-06993-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 03/15/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE To compare the cardiovascular fitness of breast cancer (BC) survivors with an active lifestyle to those with a sedentary lifestyle. METHODS A cross-sectional study was conducted. Participants were classified into four groups: two groups of active women who performed more than 150 min/week of physical exercise, active with BC (Act-BCW) and active without BC (Act-HW); and two groups of sedentary women who performed less than 90 min/week of physical exercise, sedentary with BC (Sed-BCW) and sedentary without BC (Sed-HW). VO2max was estimated by the 6-min walking test (6MWT); speed, isometric strength, lower body maximum strength, explosive strength, balance, and body composition were also measured. ANOVA was used to analyze group differences and post hoc comparisons were developed with the Bonferroni test. RESULTS A total of 92 women were recruited. Significant differences were found in VO2max between the Act-BCW and Sed-BCW groups (MeanDif = 5.86, p < 0.001). No differences in VO2max were observed between the active groups (MeanDif = 0.42, p = 0.753). Related body composition and fat mass levels were significantly lower in the Act-BCW group than in the sedentary groups (Sed-BCW MeanDif = - 6.78; p = 0.012; and Sed-HW MeanDif = - 12.07; p < 0.001). CONCLUSIONS Women who are Act-BCW can achieve similar values in physical condition as women who are Act-HW and have better values than women who are sedentary. Furthermore, our results suggest than physical activity level may have a greater impact in body composition than a previous history of BC.
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Affiliation(s)
| | | | - Miguel Martín
- Hospital General Universitario Gregorio Marañon, Madrid, Spain
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Zhang Z, Tabung FK, Jin Q, Curran G, Irvin VL, Shannon J, Velie EM, Manson JE, Simon MS, Vitolins M, Valencia CI, Snetselaar L, Jindal S, Schedin P. Diet-Driven Inflammation and Insulinemia and Risk of Interval Breast Cancer. Nutr Cancer 2022; 74:3179-3193. [PMID: 35471124 PMCID: PMC9439260 DOI: 10.1080/01635581.2022.2063350] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 03/03/2022] [Accepted: 04/01/2022] [Indexed: 01/10/2023]
Abstract
Interval breast cancers (IBCs) emerge after a non-suspicious mammogram and before the patient's next scheduled screen. Risk factors associated with IBC have not been identified. This study evaluated if the empirical dietary inflammatory pattern (EDIP) or empirical dietary index for hyperinsulinemia (EDIH) scores are associated with IBC compared to screen-detected breast cancer. Data were from women 50-79 years-old in the Women's Health Initiative cohort who completed food frequency questionnaires at baseline (1993-98) and were followed through March 31, 2019 for breast cancer detection. Women were identified as having either IBC diagnosed within 1-year after their last negative screening mammogram (N = 317) or screen-detected breast cancer (N = 1,928). Multivariable-adjusted logistic regression analyses were used to estimate odds ratios for risk of IBC compared to screen-detected cancer in dietary index tertiles. No associations were observed between EDIP or EDIH and IBC. Odds ratios comparing the highest to the lowest dietary index tertile were 1.08; 95%CI, 0.78-1.48 for EDIP and 0.92; 95%CI, 0.67-1.27 for EDIH. The null associations persisted when stratified by BMI categories. Findings suggest that diet-driven inflammation or insulinemia may not be substantially associated with IBC risk among postmenopausal women. Future studies are warranted to identify modifiable factors for IBC prevention.
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Affiliation(s)
- Zhenzhen Zhang
- Division of Oncological Sciences, Oregon Health & Science University, Portland, Oregon, USA
| | - Fred K. Tabung
- College of Medicine and Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio, USA
| | - Qi Jin
- Interdisciplinary PhD Program in Nutrition, The Ohio State University, Columbus, Ohio, USA
| | - Grace Curran
- Cancer Early Detection Advanced Research Center, Oregon Health & Science University, Portland, Oregon, USA
| | - Veronica L Irvin
- College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon, USA
| | - Jackilen Shannon
- OHSU-PSU School of Public Health, Oregon Health & Science University, Portland, Oregon, USA
| | - Ellen M. Velie
- Zilber School of Public Health, University of Wisconsin at Milwaukee, Milwaukee, Wisconsin, USA
- Departments of Medicine and Pathology, Medical College of Wisconsin, Wauwatosa, Wisconsin, USA
| | - JoAnn E. Manson
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, and the Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Michael S. Simon
- Karmanos Cancer Institute, Department of Oncology, Wayne State University, Detroit, Michigan, USA
| | - Mara Vitolins
- Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Celina I. Valencia
- Department of Family and Community Medicine, College of Medicine-Tucson, The University of Arizona, Tucson, Arizona, USA
| | - Linda Snetselaar
- College of Public Health, Department of Epidemiology, University of Iowa, Iowa City, Iowa, USA
| | - Sonali Jindal
- Department of Cell, Developmental and Cancer Biology, Oregon Health & Science University, Portland, Oregon, USA
| | - Pepper Schedin
- Department of Cell, Developmental and Cancer Biology, Oregon Health & Science University, Portland, Oregon, USA
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Núñez-Ruiz A, Sánchez-Brena F, López-Pacheco C, Acevedo-Domínguez NA, Soldevila G. Obesity modulates the immune macroenvironment associated with breast cancer development. PLoS One 2022; 17:e0266827. [PMID: 35472214 PMCID: PMC9041840 DOI: 10.1371/journal.pone.0266827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 03/28/2022] [Indexed: 11/19/2022] Open
Abstract
Growing evidence demonstrates a strong correlation between obesity and an increased risk of breast cancer, although the mechanisms involved have not been completely elucidated. Some reports have described a crosstalk between adipocytes, cancer cells, and immune cells within the tumor microenvironment, however, it is currently unknown whether obesity can promote tumor growth by inducing systemic alterations of the immune cell homeostasis in peripheral lymphoid organs and adipose tissue. Here, we used the E0771 breast cancer cell line in a mouse model of diet-induced obesity to analyze the immune subpopulations present in the tumors, visceral adipose tissue (VAT), and spleen of lean and obese mice. Our results showed a significant reduction in the frequency of infiltrating CD8+ T cells and a decreased M1/M2 macrophage ratio, indicative of the compromised anti-tumoral immune response reported in obesity. Despite not finding differences in the percentage or numbers of intratumoral Tregs, phenotypic analysis showed that they were enriched in CD39+, PD-1+ and CCR8+ cells, compared to the draining lymph nodes, confirming the highly immunosuppressive profile of infiltrating Tregs reported in established tumors. Analysis of peripheral T lymphocytes showed that tumor development in obese mice was associated to a significant increase in the percentage of peripheral Tregs, which supports the systemic immunosuppressive effect caused by the tumor. Interestingly, evaluation of immune subpopulations in the VAT showed that the characteristic increase in the M1/M2 macrophage ratio reported in obesity, was completely reversed in tumor-bearing mice, resembling the M2-polarized profile found in the microenvironment of the growing tumor. Importantly, VAT Tregs, which are commonly decreased in obese mice, were significantly increased in the presence of breast tumors and displayed significantly higher levels of Foxp3, indicating a regulatory feedback mechanism triggered by tumor growth. Altogether, our results identify a complex reciprocal relationship between adipocytes, immune cells, and the tumor, which may modulate the immune macroenvironment that promotes breast cancer development in obesity.
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Affiliation(s)
- Aleida Núñez-Ruiz
- Departamento de Inmunología, Instituto de Investigaciones Biomédicas, UNAM, México City, México
| | - Flor Sánchez-Brena
- Departamento de Inmunología, Instituto de Investigaciones Biomédicas, UNAM, México City, México
| | - Cynthia López-Pacheco
- Departamento de Inmunología, Instituto de Investigaciones Biomédicas, UNAM, México City, México
- Laboratorio Nacional de Citometría de Flujo, Instituto de Investigaciones Biomédicas, UNAM, México City, México
| | | | - Gloria Soldevila
- Departamento de Inmunología, Instituto de Investigaciones Biomédicas, UNAM, México City, México
- * E-mail:
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Morlino D, Cioffi I, Marra M, Di Vincenzo O, Scalfi L, Pasanisi F. Bioelectrical Phase Angle in Patients with Breast Cancer: A Systematic Review. Cancers (Basel) 2022; 14:cancers14082002. [PMID: 35454908 PMCID: PMC9025027 DOI: 10.3390/cancers14082002] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 04/13/2022] [Accepted: 04/14/2022] [Indexed: 12/13/2022] Open
Abstract
Simple Summary Breast cancer (BC) patients suffer from loss of muscle tissue and fluid alterations during the whole trajectory of the disease. Such alterations might be reflected by phase angle (PhA) measures, but its use in the oncologic setting is still limited. Therefore, the aim of this systematic review was to assess PhA in BC patients, since it has been proven to be a reliable index for predicting nutritional status and survival. Findings reveal that PhA decreases after chemotherapy in BC patients, with high results in women with a better nutritional status, and these changes may persist even after five years. However, PhA remains stable, or can increase in some cases, when patients are supported by targeted lifestyle interventions. Thus, PhA can be useful to identify and monitor changes in body compartments and the nutritional status of BC patients over time. Abstract Breast cancer (BC) is the most common cancer diagnosed among women worldwide. Phase angle (PhA), a proxy measure of membrane integrity and function, has gained relevance in clinical practice and it has been suggested to be a prognostic and nutritional indicator. This systematic review aimed to explore PhA and its relationship with nutritional status and survival in BC patients. Four databases (PubMed, EMBASE, Web of Science, and CINAHL) were systematically searched until September 2021 for studies evaluating PhA in BC patients. A total of 16 studies met the inclusion criteria, where 11 were observational studies and 5 were interventional studies. Baseline PhA-value varied from 4.9 to 6.30 degrees, showing a great variability and heterogeneity across the selected studies. Available data suggested that PhA decreased by 5–15% after completing chemotherapy, and those effects might persist in the long term. However, the use of tailored nutritional and/or exercise programs during and after therapy could prevent PhA reduction and body derangement. High PhA values were found in women displaying a better nutritional status, while inconsistent data were found on survival. Therefore, further studies are needed to focus on the clinical relevance of PhA in BC patients, evaluating its association with disease outcomes and survival.
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Affiliation(s)
- Delia Morlino
- Department of Clinical Medicine and Surgery, Federico II University Hospital, Pansini 5, 80131 Naples, Italy; (D.M.); (M.M.); (F.P.)
| | - Iolanda Cioffi
- Department of Clinical Medicine and Surgery, Federico II University Hospital, Pansini 5, 80131 Naples, Italy; (D.M.); (M.M.); (F.P.)
- Correspondence: ; Tel.: +39-0817462333
| | - Maurizio Marra
- Department of Clinical Medicine and Surgery, Federico II University Hospital, Pansini 5, 80131 Naples, Italy; (D.M.); (M.M.); (F.P.)
| | - Olivia Di Vincenzo
- Department of Public Health, Federico II University Hospital, Pansini 5, 80131 Naples, Italy; (O.D.V.); (L.S.)
| | - Luca Scalfi
- Department of Public Health, Federico II University Hospital, Pansini 5, 80131 Naples, Italy; (O.D.V.); (L.S.)
| | - Fabrizio Pasanisi
- Department of Clinical Medicine and Surgery, Federico II University Hospital, Pansini 5, 80131 Naples, Italy; (D.M.); (M.M.); (F.P.)
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46
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Sutherland A, Huppe A, Wagner JL, Amin AL, Balanoff CR, Kilgore LJ, Larson KE. The clinical impact of MRI on surgical planning for patients with in-breast tumor recurrence. Breast Cancer Res Treat 2022; 193:515-522. [PMID: 35415789 DOI: 10.1007/s10549-022-06589-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 03/27/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The objective of this study was to evaluate the clinical utility of breast MRI for patients with known in-breast tumor recurrence (IBTR). The aim was to determine if the addition of breast MRI altered surgical approach or multidisciplinary management. Previous studies have focused on using breast MRI for surgical planning for index breast cancers (BC) or detecting IBTR. However, the clinical impact of obtaining MRI in the setting of known IBTR has not been evaluated. METHODS A single-institution retrospective chart review was performed to compare surgical approach and multidisciplinary management for patients diagnosed with isolated IBTR who did and did not undergo breast MRI following IBTR diagnosis. RESULTS IBTR was identified in 69 patients, 46% of whom underwent MRI. There was no difference in the operative approach (p = 0.14) for IBTR patients who did and did not undergo breast MRI Additionally, there was no difference in multidisciplinary care, treatment order, metastatic disease identification, or mortality between cohorts. A relatively small subgroup of patients (n = 3) required change in surgical plan based on MRI results. Patients proceeding with surgery first who also underwent breast MRI experienced a significantly longer time to surgical intervention (p = 0.03). CONCLUSION Breast MRI following IBTR diagnosis infrequently impacted clinical management, including surgical approach and multidisciplinary care. MRI for local disease assessment at the time of IBTR should be used selectively based on clinical concern.
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Affiliation(s)
- Amanda Sutherland
- Department of Surgery, Division of Breast Surgery, The University of Kansas Health System, 4000 Cambridge St, MS 2005, Kansas City, KS, 66160, USA
| | - Ashley Huppe
- Department of Radiology, The University of Kansas Health System, 4000 Cambridge St, MS 2005, Kansas City, KS, 66160, USA
| | - Jamie L Wagner
- Department of Surgery, Division of Breast Surgery, The University of Kansas Health System, 4000 Cambridge St, MS 2005, Kansas City, KS, 66160, USA
| | - Amanda L Amin
- Department of Surgery, Division of Breast Surgery, The University of Kansas Health System, 4000 Cambridge St, MS 2005, Kansas City, KS, 66160, USA
| | - Christa R Balanoff
- Department of Surgery, Division of Breast Surgery, The University of Kansas Health System, 4000 Cambridge St, MS 2005, Kansas City, KS, 66160, USA
| | - Lyndsey J Kilgore
- Department of Surgery, Division of Breast Surgery, The University of Kansas Health System, 4000 Cambridge St, MS 2005, Kansas City, KS, 66160, USA
| | - Kelsey E Larson
- Department of Surgery, Division of Breast Surgery, The University of Kansas Health System, 4000 Cambridge St, MS 2005, Kansas City, KS, 66160, USA.
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Leitner BP, Siebel S, Akingbesote ND, Zhang X, Perry RJ. Insulin and cancer: a tangled web. Biochem J 2022; 479:583-607. [PMID: 35244142 PMCID: PMC9022985 DOI: 10.1042/bcj20210134] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 02/13/2022] [Accepted: 02/15/2022] [Indexed: 12/13/2022]
Abstract
For a century, since the pioneering work of Otto Warburg, the interwoven relationship between metabolism and cancer has been appreciated. More recently, with obesity rates rising in the U.S. and worldwide, epidemiologic evidence has supported a link between obesity and cancer. A substantial body of work seeks to mechanistically unpack the association between obesity, altered metabolism, and cancer. Without question, these relationships are multifactorial and cannot be distilled to a single obesity- and metabolism-altering hormone, substrate, or factor. However, it is important to understand the hormone-specific associations between metabolism and cancer. Here, we review the links between obesity, metabolic dysregulation, insulin, and cancer, with an emphasis on current investigational metabolic adjuncts to standard-of-care cancer treatment.
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Affiliation(s)
- Brooks P. Leitner
- Departments of Cellular and Molecular Physiology, Yale School of Medicine, New Haven, CT, U.S.A
- Departments of Internal Medicine, Yale School of Medicine, New Haven, CT, U.S.A
| | - Stephan Siebel
- Departments of Cellular and Molecular Physiology, Yale School of Medicine, New Haven, CT, U.S.A
- Departments of Internal Medicine, Yale School of Medicine, New Haven, CT, U.S.A
- Departments of Pediatrics, Yale School of Medicine, New Haven, CT, U.S.A
| | - Ngozi D. Akingbesote
- Departments of Cellular and Molecular Physiology, Yale School of Medicine, New Haven, CT, U.S.A
- Departments of Internal Medicine, Yale School of Medicine, New Haven, CT, U.S.A
| | - Xinyi Zhang
- Departments of Cellular and Molecular Physiology, Yale School of Medicine, New Haven, CT, U.S.A
- Departments of Internal Medicine, Yale School of Medicine, New Haven, CT, U.S.A
| | - Rachel J. Perry
- Departments of Cellular and Molecular Physiology, Yale School of Medicine, New Haven, CT, U.S.A
- Departments of Internal Medicine, Yale School of Medicine, New Haven, CT, U.S.A
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Solikhah S, Perwitasari D, Permatasari TAE, Safitri RA. Diet, Obesity, and Sedentary Lifestyle as Risk Factor of Breast Cancer among Women at Yogyakarta Province in Indonesia. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.7228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND: Breast cancer prevalence remains high worldwide, including in Indonesia. Studies examining relationship between obesity, dietary habit, sedentary lifestyle, and breast cancer development are largely inconclusive.
AIM: This study aimed to determine relationship between obesity, dietary habit, sedentary lifestyle, and breast cancer risk among women at Yogyakarta Province in Indonesia.
METHODS: This was a cross-sectional study on 135 women selected purposively during March–May 2019. Binary logistic regression models were employed in the analysis with 0.05 considered significant.
RESULTS: Among study subjects, 54.07% and 40% were, respectively, ≥40 years old and smokers. About 53.33% consumed preserved food 3–6 times/week, and 49% and 50.37% consumed sweet food and beverage >1 time/ day, respectively. High body mass index (BMI) and physical inactivity were associated with 93% and 85% breast cancer risk reductions (adjusted odds ratio [AOR]: 0.07, 95% confidence interval [CI]: 0.01–0.45, p < 0.01 and AOR: 0.15, 95% CI: 0.05–0.47, p < 0.001). Smoking showed no significant relationship. A waist circumference (WC) of ≤80 was linked to 78% breast cancer risk reduction. Sweet food, sweet beverage, and energy drink consumption of >1 time/day led to 96%, 36%, and 84% reductions of invasive breast cancer risks. Meanwhile, consumption of preserved food 3–6 times/weeks and soft drinks >1 time/day correlated with an increased risk of breast cancer.
CONCLUSION: High BMI, physical inactivity, and lower WC were associated with the lower breast cancer risk, while preserved food and soft drink consumption significantly increase the risk. Although sedentary lifestyle seems to have a small protective effect, healthy lifestyle should be encouraged and effective strategies are required to encourage women to adopt healthy lifestyle.
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Smedsland SK, Vandraas KF, Bøhn SK, Dahl AA, Kiserud CE, Brekke M, Falk RS, Reinertsen KV. Sexual activity and functioning in long-term breast cancer survivors; exploring associated factors in a nationwide survey. Breast Cancer Res Treat 2022; 193:139-149. [PMID: 35226237 PMCID: PMC8993724 DOI: 10.1007/s10549-022-06544-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 02/13/2022] [Indexed: 12/15/2022]
Abstract
PURPOSE Sexual health is a key quality of life issue. Knowledge concerning sexual health in long-term breast cancer survivors (BCSs) is limited. Within a nationwide sample, we aimed to assess the prevalence of sexual inactivity and to explore factors associated with sexual inactivity and reduced sexual functioning among long-term BCSs. METHODS Long-term BCSs aged 20-65 years when diagnosed with early-stage breast cancer in 2011-2012 were identified by the Cancer Registry of Norway in 2019 (n = 2803) and invited to participate in a nationwide survey. Sexual health was measured using the multidimensional Sexual Activity Questionnaire. Factors associated with sexual inactivity and reduced sexual functioning were explored using multivariable logistic- and linear regression analyses with adjustments for relevant sociodemographic, health-, and cancer-related variables. RESULTS The final sample consisted of 1307 BCSs with a mean age of 52 years at diagnosis. Fifty-two percent of the BCSs were sexually inactive. Lack of interest was the most common reason for sexual inactivity. Treatment with aromatase inhibitor (OR 1.73, 95% CI 1.23, 2.43) and poor body image (OR 0.99, 95% CI 0.99, 0.995) were associated with sexual inactivity. Among sexually active BCSs, depression (B - 1.04, 95% CI - 2.10, - 0.02) and physical inactivity (B - 0.61, 95% CI - 1.21, - 0.02) were inversely related to sexual pleasure. Treatment with aromatase inhibitor (B 0.61, 95% CI 0.20, 1.01), sleep problems (B 0.37, 95% CI 0.04, 0.70), breast symptoms (B 0.01, 95% CI 0.003, 0.02), and chronic fatigue (B 0.43, 95% CI 0.05, 0.81) were associated with sexual discomfort. Chemotherapy (OR 1.91, 95% CI 1.23, 2.97), current endocrine treatment (OR 1.98, 95% CI 1.21, 3.25), and poor body image (OR 0.98, 95% CI 0.98, 0.99) were associated with less sexual activity at present compared to before breast cancer. CONCLUSION Treatment with aromatase inhibitor seems to affect sexual health even beyond discontinuation. Several common late effects were associated with sexual inactivity and reduced sexual functioning. To identify BCSs at risk of sexual dysfunction, special attention should be paid to patients treated with aromatase inhibitor or suffering from these late effects.
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Affiliation(s)
- Solveig K Smedsland
- National Advisory Unit of Late Effects after Cancer Treatment, Department of Oncology, Oslo University Hospital, Oslo, Norway.
| | - Kathrine F Vandraas
- National Advisory Unit of Late Effects after Cancer Treatment, Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - Synne K Bøhn
- National Advisory Unit of Late Effects after Cancer Treatment, Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - Alv A Dahl
- National Advisory Unit of Late Effects after Cancer Treatment, Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - Cecilie E Kiserud
- National Advisory Unit of Late Effects after Cancer Treatment, Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - Mette Brekke
- General Practice Research Unit, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Ragnhild S Falk
- Research Support Services, Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | - Kristin V Reinertsen
- National Advisory Unit of Late Effects after Cancer Treatment, Department of Oncology, Oslo University Hospital, Oslo, Norway
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50
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Chen ST, Lai HW, Wu WP, Chen ST, Liao CY, Wu HK, Chen DR, Mok CW. The impact of body mass index (BMI) on MRI diagnostic performance and surgical management for axillary lymph node in breast cancer. World J Surg Oncol 2022; 20:45. [PMID: 35193599 PMCID: PMC8864912 DOI: 10.1186/s12957-022-02520-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 02/11/2022] [Indexed: 11/22/2022] Open
Abstract
Background We hypothesized that different BMI might have different impact on pre-operative MRI axillary lymph node (ALN) prediction accuracy and thereby subsequent surgical lymph node management. The aim of this study is to evaluate the effect of BMI on presentation, surgical treatment, and MRI performance characteristics of breast cancer with the main focus on ALN metastasis evaluation. Methods The medical records of patients with primary invasive breast cancer who had pre-operative breast MRI and underwent surgical resection were retrospectively reviewed. They were categorized into 3 groups in this study: underweight (BMI < 18.5), normal (BMI of 18.5 to 24), and overweight (BMI > 24). Patients’ characteristics, surgical management, and MRI performance for axillary evaluation between the 3 groups were compared. Results A total of 2084 invasive breast cancer patients with a mean age of 53.4 ± 11.2 years were included. Overweight women had a higher rate of breast conserving surgery (56.7% vs. 54.5% and 52.1%) and initial axillary lymph node dissection (15.9% vs. 12.2% and 8.5%) if compared to normal and underweight women. Although the post-operative ALN positive rates were similar between the 3 groups, overweight women were significantly found to have more axillary metastasis on MRI compared with normal and underweight women (50.2% vs 37.7% and 18.3%). There was lower accuracy in terms of MRI prediction in overweight women (65.1%) than in normal and underweight women (67.8% and 76.1%). Conclusion Our findings suggest that BMI may influence the diagnostic performance on MRI on ALN involvement and the surgical management of the axilla in overweight to obese women with breast cancer.
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Affiliation(s)
- Shu-Tian Chen
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital-Chiayi Branch, Chiayi, Taiwan.,Chang Gung University College of Medicine, Taoyuan City, Taiwan.,Department of Biomedical Imaging and Radiological Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Hung-Wen Lai
- Chang Gung University College of Medicine, Taoyuan City, Taiwan. .,Endoscopy & Oncoplastic Breast Surgery Center, Changhua Christian Hospital, Changhua, Taiwan. .,Division of General Surgery, Changhua Christian Hospital, Changhua, Taiwan. .,Comprehensive Breast Cancer Center, Changhua Christian Hospital, Changhua, Taiwan. .,Minimal Invasive Surgery Research Center, Changhua Christian Hospital, Changhua, Taiwan. .,Kaohsiung Medical University, Kaohsiung, Taiwan. .,School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan. .,School of Medicine, Chung Shan Medical University, Taichung, Taiwan. .,Division of General Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
| | - Wen-Pei Wu
- Department of Biomedical Imaging and Radiological Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Radiology, Changhua Christian Hospital, Changhua, Taiwan
| | - Shou-Tung Chen
- Division of General Surgery, Changhua Christian Hospital, Changhua, Taiwan.,Comprehensive Breast Cancer Center, Changhua Christian Hospital, Changhua, Taiwan
| | - Chiung-Ying Liao
- Department of Radiology, Changhua Christian Hospital, Changhua, Taiwan
| | - Hwa-Koon Wu
- Department of Radiology, Changhua Christian Hospital, Changhua, Taiwan
| | - Dar-Ren Chen
- Division of General Surgery, Changhua Christian Hospital, Changhua, Taiwan.,Comprehensive Breast Cancer Center, Changhua Christian Hospital, Changhua, Taiwan
| | - Chi Wei Mok
- Division of Breast Surgery, Department of Surgery, Changi General Hospital, Singapore, Singapore.,Singhealth Duke-NUS Breast Centre, Singapore, Singapore
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