Breast cancer in South Asia: a Bangladeshi perspective

Systematic Review of Survival Outcomes of Pregnancy-Associated Breast Cancer in Asian Countries

Pregnancy-associated breast cancer (PABC) is a rare type of gestational cancer. It poses a significant challenge in diagnosis and management, especially in Asian countries with limited resources. We carried out a systematic literature review and narrative synthesis to identify survival outcomes for women with PABC in Asia. We searched MEDLINE, PubMed, Cochrane Library and the reference lists of the included English language articles for those conducted between January 2010 and August 2022. The search terms were pregnancy-associated breast cancer, breast cancer AND pregnancy, survival of PABC and prognosis of PABC patients. PABC is defined as breast cancer diagnosed either during pregnancy or 1 year-5 years postpartum. This review included observational studies conducted in Asian countries. The final 11 articles met the selection criteria and were analysed. Five of the studies had high quality methods as assessed using the Joanna Briggs Institute (JBI) checklist. We reported study design, year of diagnosis, country, definition of PABC, control group, age of participants, median follow-up time, survival outcomes and pregnancy as prognostic factors. Only five studies reported that PABC patients had a poor overall or disease-free survival rate compared to the control. Pregnancy was a significant independent prognostic factor of breast cancer in only two studies. This review highlights that pregnancy has an unconfirmed association with breast cancer survival in Asia. Most studies that found a non-significant association had small samples, thus there is a need for large-scale multinational epidemiological studies in Asia to establish the survival outcomes in PABC patients.

Quality of life and its predictors among patients with metastatic cancer in Bangladesh: the APPROACH survey

BACKGROUND

This study aimed to assess the health-related quality of life (HRQOL) (physical, functional, emotional, social, spiritual) and psychological (anxiety and depression) well-being and their associations with patient characteristics among patients with metastatic cancer in Bangladesh.

METHODS

A convenience sample of 386 Bangladeshi patients with stage IV solid cancers was recruited from a palliative care outpatient department and an inpatient palliative center. Dependent variables included the physical, functional, emotional, social, and overall scores of the Functional Assessment of Cancer Therapy-General (FACT-G) scale, the Functional Assessment of Chronic Illness Therapy-Spiritual Well-being (FACIT-SP) scale, the anxiety, depression, and overall scores of the Hospital Anxiety and Depression (HADS) scale. Linear regressions examined the association between dependent variables and patient characteristics.

RESULTS

A substantial proportion of Bangladeshi patients reported anxiety (59% of outpatients and 55% of inpatients) and depression (60% of outpatients and 73% of inpatients) symptoms. Generally, greater financial difficulty and symptom burden scores were associated with worse health outcomes. Older patients reported poorer functional and spiritual well-being but better anxiety scores. Females reported worse anxiety and depressive symptoms and physical well-being but better spiritual outcomes.

CONCLUSIONS

Additional efforts must be directed at improving the HRQOL of patients with metastatic cancer in Bangladesh. Furthermore, assistance should be made more accessible to vulnerable groups, including women, the elderly, and those with financial difficulty.

A Systematic Review on Childhood Non-Hodgkin Lymphoma: An Overlooked Phenomenon in the Health and Research Sector of Bangladesh

Globally, childhood cancer, particularly non-Hodgkin lymphomas (NHLs), is a prevalent concern. However, the difficulty becomes even more distressing in lower-middle-income nations such as Bangladesh. The insufficiency of research, resources, inadequate guidelines, expensive treatment costs, and specialized knowledge exacerbate the challenges associated with the treatment of certain types of cancers. Our investigation looked extensively into the circumstances prevailing in Bangladesh, with the objective of providing a comprehensive overview of the current status and approaches to managing NHL in the country. Through this work, our intention was to illuminate the domains that require immediate focus and assistance. To get insight into the present state of NHL in Bangladesh, our analysis focused on a selection of seven research articles and two case reports published between 2018 and 2023. In order to ensure the integrity and consistency of our review, we conducted a detailed selection procedure, employing the systematic PRISMA review methodology. From a pool of 294 papers, we selected the ones that met our predetermined criteria. These papers were sourced from reputable academic databases, such as Google Scholar and PubMed. The findings of our study indicate a higher prevalence of NHL among children in Bangladesh compared to Hodgkin lymphoma (HL). Additionally, this phenomenon exhibits a higher prevalence among male individuals. Our study revealed that in Bangladesh, there is a lack of a dedicated guideline or research center specifically focused on NHL. Additionally, the number of research centers and research dedicated to cancer treatment as a whole is limited. Our research aims to offer a complete analysis of NHL in the context of Bangladesh, with the intention of offering valuable guidance to healthcare professionals and policymakers. The utilization of our research outcomes has the potential to enhance patient care, facilitate the development of more effective clinical protocols, and promote greater accessibility and affordability of therapies. This has the potential to provide improved cancer care not only in Bangladesh but also in other comparable contexts worldwide.

Temporal Pattern and Age-Period-Cohort Analysis of Breast Cancer Incidence in Iranian Women (2009-2017)

BACKGROUND

Breast cancer accounted for 28.1% of all female cancers in 2020 in Iran. This study was conducted to evaluate the time trend of breast cancer incidence and to identify the changes of breast cancer incidence in age, period, and birth cohorts in Iran, in the 2009-2017 timeframe.

METHODS

Annual cancer statistics for female breast cancer were obtained from the Iranian National Population-based Cancer Registry (INPCR) database from 2009 to 2017. The age-period-cohort (APC) analysis was used to evaluate the time trend of breast cancer incidence in age, period and birth cohorts between 2009 and 2017. R package (Epi) was used to analyze data. Results were considered statistically significant at P<0.05.

RESULTS

The age effect showed an increased incidence of breast cancer until the age of 45, and after this age the speed of increase was slower until 65 years. There was an increased diagnosis in 2015-2017 (period effect) for many age groups, especially in the 70- and over 80-year-old group.

CONCLUSION

Our findings indicated that breast cancer incidence peaks in the age of 45 in Iranian women, which is a decade earlier compared to the Western world. The period effect in 2015-2017 can be explained by the fact that in 2014, the former Iranian pathology-based cancer registry was upgraded to a population-based cancer registry, which resulted in improved coverage of cancer registry and case finding.

Pot Song as a Novel Cancer Communication Intervention: Lessons Learned from Developing, Implementing, and Evaluating a Culturally Grounded Intervention for Breast Cancer Education in Rural Bangladesh

Targeted public education may offer an approach to achieving more effective treatment in countries like Bangladesh, where breast cancer is a leading cause of cancer death in women. Effective cancer education interventions address the target population's cultural and contextual needs. However, there is little published literature to guide the development of educational cancer interventions in a region where lack of resources combined with cultural stigma about cancer contribute to poor breast health outcomes for women. The goal of the current study was to design, test, and evaluate a culturally grounded intervention to promote breast problem care among women in rural Bangladesh. The current manuscript first describes the process of formative evaluation that led to the development of the intervention, including decisions about the audience, message construction, and mode of intervention delivery. Second, we describe the testing process, including process and outcome evaluation. Finally, we describe the lessons learned from the process. We conclude with recommendations related to cultural grounding for message development, questionnaire design, data collection procedures, and analysis.

Health-related quality of life in breast cancer patients in Asia: A meta-analysis and systematic review

Objectives

The primary purposes of this meta-analysis and systematic review were to evaluate the health-related quality of life (HRQoL) of Asian breast cancer (BC) patients to understand their holistic HRQoL level and provide medical and nursing recommendations to improve and preserve their quality of life.

Methods

A comprehensive literature search was conducted to find cross-sectional studies published in Chinese and English concerning HRQoL in BC patients from the inceptions of databases to 14 March 2022. The databases consulted were PubMed, Web of Science, Embase, Cochrane, PsyclNFO, CINAHL, and CNKI. Literature screening, data extraction, risk bias assessment, and data synthesis were independently carried out by two researchers. The Endnote X9 and Stata 15.0 software programs were used during the meta-analysis process.

Results

Out of the 8,563 studies identified, 23 cross-sectional studies involving 3,839 Asian BC patients were included in this meta-analysis. Two tools, namely, European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC QLQ-C30) and Quality of Life Questionnaire Breast Cancer module 23 (EORTC QLQ-BR23)—were used to evaluate the HRQoL of BC patients in Asia. The pooled mean of the global health status of Asian BC patients was 58.34 (95% confidence interval [CI]: 53.66–63.02). According to functional subscales of EORTC QLQ-C30 and EORTC QLQ-BR23, Asian BC patients suffered from the worst emotional functioning (pooled mean=66.38; 95% CI: 59.66–73.11) and sexual enjoyment (pooled mean=49.31; 95% CI: 31.97–63.36). In addition, fatigue (pooled mean=42.17; 95% CI: 34.46–49.88) and being upset by hair loss (pooled mean=48.38; 95% CI: 36.64–60.12) were the most obvious symptoms that Asian BC patients experienced according to the meta-analysis results of the EORTC QLQ-C30 and EORTC QLQ-BR23 symptom subscales.

Conclusion

Asian BC patients experience a relatively low HRQoL due to the prominent decline in their body functions, as well as the unpleasant experiences caused by their symptoms. It is suggested that timely, appropriate, and targeted intervention should be provided in relation to the physical, psychological, and social aspects of Asian BC patients’ lives to enhance their ability to function, relieve them of adverse symptoms, and improve their overall HRQoL.

Systematic Review Registration

https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022321165.

Knowledge and perception of breast cancer among women of reproductive age in Chattogram, Bangladesh: A cross-sectional survey

Background and Aims

Breast cancer is the second leading cause of cancer death in women worldwide. The significantly higher mortality rate has been considered due to poor knowledge of women, delay in diagnosis, and initiation of treatment. Therefore, this hospital-based cross-sectional study aimed to understand the knowledge and perception of women with breast cancer in Bangladesh.

Methods

Data was collected using a questionnaire-based interview from 357 women aged 15-49 years attending two tertiary care hospitals in Chattogram city of Bangladesh.

Results

Neighbors (18.6%) and relatives (18.1%) were the leading sources of information on breast cancer. Among the total, 69.5% knew about breast cancer however, only 14% of them knew about screening tests and 61.5% were unaware of risk factors for developing breast cancer. Pain in the breast, painless lump, and nipple discharge were the most recognized clinical symptoms by the participants. Exercise and weight control, the practice of breastfeeding, and taking medicine were the three most known prevention practices. Women perceived wrong conceptions that Breast cancer is only found in older age (42.3%) and women (15.7%) and that it causes losing one's breast (3.1%). A significant correlation was found between the education level of participants and their knowledge of risk factors related to breast cancer.

Conclusion

Although the majority of the participants have heard about breast cancer, they do not possess enough knowledge regarding the risk factor, symptoms, and preventive methods of breast cancer. We suggest interventions targeting a community-based awareness program.

A Scoping Review on the Status of Female Breast Cancer in Asia with a Special Focus on Nepal

This study aimed to provide updated evidence on the status of female breast cancer and cancer treatment facilities in Asia, with a special focus on Nepal. This review used search phrases that included, breast neoplasm or cancer, health status, epidemiology, breast cancer survivors, cancer care facilities, Asia, Nepal. Researchers examined databases from January 2011 to December 2020 (PubMed, PMC, Google Scholar, and the reference lists of included papers). Studies of any design and reviews, were included in the study, except for qualitative studies. The study findings are presented in a narrative synthesis format using Preferred Reporting Items for Systematic Reviews and Meta-analyses Extension for Scoping Reviews. An initial search resulted in 974 papers, and 896 were reviewed after being checked for duplication using the Zotero software. Accordingly, utilizing the inclusion and exclusion criteria, 188 publications were selected, and after review of titles and abstracts, an additional 98 papers were removed for different reasons. Finally, the study looked at 90 female breast cancer papers. Results showed that the number of cases of breast cancer is growing all around the world, including in Asia and Nepal. Age, early menarche, late menopause, nulliparity, positive family history, excessive fat consumption, alcohol, and smoking are all frequent risk factors for breast cancer found in Asian women. Breast self-examination, clinical breast examination, and mammography screening are common methods for detecting breast carcinoma. Chemotherapy, radiation, and modified mastectomy are commonly used options for treatment. The number of breast cancer survivors is growing throughout the world, indicating better clinical care. There is a paucity of survival data in many Asian countries, including Nepal. There is also a scarcity of health workforce specialized in cancer care and treatment, as well as a few health facilities that are available to treat cancer cases in many Asian countries, including Nepal.

Knowledge of breast cancer and breast self-examination practices and its barriers among university female students in Bangladesh: Findings from a cross-sectional study

Early diagnosis of breast cancer is the best approach towards its control that may result in alleviating related mortality and morbidity. This study aimed to evaluate knowledge about breast cancer and both practices and perceived barriers to breast self-examination among female university students in Bangladesh. A cross-sectional study was carried out with 400 female students of Jahangirnagar University, Bangladesh. Participants were sampled from female dormitories at the university from January to April 2020. Proportionate stratified random sampling was conducted to calculate the study sample from each dormitory. A validated semi-structured self-reported questionnaire was employed to collect data from participants during the survey periods. The questionnaire consisted of demographic variables, items about knowledge about breast cancer, breast self-examination practices and its barriers. We applied descriptive and inferential statistics and data were analyzed using the Statistical Package for the Social Sciences (SPSS). Participants were aged between 18–26 years and comprised university students of first year (20%), second year (24%), third year (22%), fourth year (21%) and Master’s (14%). 18% of them reported positive family history (mother, aunt, sister/cousin, grandmother) of breast cancer. The overall mean score of total knowledge items was 15 (SD = 3) out of 43, with an overall correct rate of 34%. The mean score of total knowledge items was significantly higher (p<0.001) among Master’s students and students with family members who have had breast cancer. Only one in five students (21%) ever practiced breast self-examination. The mean score of practice of breast self-examination was significantly higher (p<0.001) among participants who reported having family member of breast cancer. Total knowledge score about breast cancer and practice of breast self-examination were significantly correlated with each other (r = 0.54; p<0.001). About 33% participants reported ‘lack of knowledge’ as the main barrier to practicing breast self-examination followed by ‘I do not have the symptoms’ (22%), and ‘shyness/ uncomfortable feelings’ (17%). The study revealed low levels of knowledge about breast cancer and low breast self-examination practices. Our findings highlight the need to develop, implement and promote socially, culturally and demographically appropriate educational interventions programs aimed at breast cancer and breast self-examination awareness and practice in Bangladesh.

Stakeholders' Experiences and Perspectives Regarding Care Quality for Women With Breast Cancer: A Systematic Review

BACKGROUND

The considerable growth in the number of patients with breast cancer leads to substantial pressure on healthcare services; however, the main measures that will evaluate what is important to the key stakeholders in improving the quality of breast cancer care are not well defined.

OBJECTIVE

This study aimed to synthesize providers' and patients' experiences and perspectives regarding barriers and quality breast cancer care in health services.

METHODS

PubMed, Scopus, MEDLINE, Web of Knowledge, and the Cochrane Library databases were searched, and articles published in English up to August 2020 were screened. Two reviewers independently screened all articles. Data were obtained directly from different stakeholder groups including patients, health providers, and professionals.

RESULTS

The search strategy identified 21 eligible articles that met inclusion criteria and reported perspectives of 847 health providers and 24 601 patients regarding healthcare quality. Health providers and patients with breast cancer noted information needs, psychosocial support, responsibility for care, and coordination of care as important quality improvement characteristics of the healthcare system.

CONCLUSION

Shifting to high-quality breast cancer care would likely be a complicated process, and there is a need for the cancer care services to consider important characteristics of quality cancer care as a care priority, that is, to be responsive.

IMPLICATION FOR PRACTICE

Breast cancer survivorship care programs and interventions may need to consider the barriers or common challenges to care noted in this review, especially regarding information sharing and the need for social support and care cooperation.

A Comprehensive Survey on Deep-Learning-Based Breast Cancer Diagnosis

Breast cancer is now the most frequently diagnosed cancer in women, and its percentage is gradually increasing. Optimistically, there is a good chance of recovery from breast cancer if identified and treated at an early stage. Therefore, several researchers have established deep-learning-based automated methods for their efficiency and accuracy in predicting the growth of cancer cells utilizing medical imaging modalities. As of yet, few review studies on breast cancer diagnosis are available that summarize some existing studies. However, these studies were unable to address emerging architectures and modalities in breast cancer diagnosis. This review focuses on the evolving architectures of deep learning for breast cancer detection. In what follows, this survey presents existing deep-learning-based architectures, analyzes the strengths and limitations of the existing studies, examines the used datasets, and reviews image pre-processing techniques. Furthermore, a concrete review of diverse imaging modalities, performance metrics and results, challenges, and research directions for future researchers is presented.

The relationship between the fear of breast cancer, risk factors, and early diagnosis behaviors of women by age groups

PURPOSE

This study investigates the relationship between fear of breast cancer, risk factors, and early diagnosis behavior of women aged 20 or above.

METHOD

It is a descriptive cross-sectional study.

FINDINGS

It was found that 17.3% of the women conducted breast self-examination, 14.0% underwent clinical breast examination, and that 9.3% of them underwent mammography. The predictors regularly affecting early diagnosis behaviors were identified through logistic regression. Different predictors for breast cancer diagnostic behaviors were found in each age group.

PRACTICE IMPLICATIONS

This study is important in terms of taking into account the age factor in the practices aiming to increase the diagnostic behavior of healthcare personnel, especially nurses.

CONCLUSION

It was concluded that there were different predictors of breast cancer diagnostic behaviors in both age groups of the women in the study.

Evaluation of knowledge, awareness and attitudes towards breast cancer risk factors and early detection among females in Bangladesh: A hospital based cross-sectional study

Background

Breast cancer (BCa) is a leading cause of mortality among women in Bangladesh. Many young women in Bangladesh have poor knowledge about breast cancer screening, including risk factors, warning signs/symptoms, diagnosis and early detection. We investigated awareness about breast cancer risk factors as a screening tool among women at the Sheikh Hasina Medical College (SHMC) of Tangail district in Bangladesh.

Methods

A cross sectional survey was conducted to collect data via a structured questionnaire from SHMC during the period of February to December 2019. A total of 1,007 participants (aged 33.47 (±12.37 years)) was considered for data analysis.

Results

Of the 1,007 women, about 50% were knowledgeable about the risk factors. Pain in the breast was identified as the most commonly warning sign/symptom of breast cancer. Only 32.2% of respondents knew at least one breast cancer screening method. The mean knowledge was scored 3.43 ± 2.25 out of a total possible score of 8. Awareness of BCa was associated with residence, family history of breast cancer, marital, literacy and socio-economic status (p <0.05). Only 14.7% of women who knew about BSE said they were conducting regular breast self-examination. Unmarried women (aOR: 2.971; 95% CI: 1.108–7.968) were more likely to have performed BSE compared to married women (p <0.05).

Conclusion

Although most participants were aware of breast cancer; knowledge about risk factors, warning signs/symptoms, early diagnosis and detection was relatively poor. Knowledge about performing BSE was particularly low. This highlights the importance of increasing awareness about breast cancer risk factors and early detection among young women in Bangladesh.

A meta-analysis and in silico analysis of polymorphic variants conferring breast cancer risk in the Indian subcontinent

Background: Genetic association studies on breast cancer on the Indian subcontinent have yielded conflicting results, and the precise effect of these variants on breast cancer pathogenesis is not known. Methods: Genomic variants, as obtained from selected studies from the Indian subcontinent, were subjected to random-effects and fixed-effect meta-analysis. Functional annotation of the relevant variants was done through a tried and tested in silico pipeline. Results: We found rs4646903/CYP1A1, rs1799814/CYP1A1, rs61886492/GCPII, del2/GSTM1, rs4680/COMT and rs1801394/MTRR to be associated with breast cancer. The del2/GSTM1 holds the association in premenopausal women. Conclusions: This is the first study of its kind from the Indian subcontinent analysing the extent of association of variants across populations followed by their functional annotation in the disease pathway.

Mutation in Exon2 of BRCA1 Gene in Adult Bengali Bangladeshi Female Patients with Breast Cancer: An Experience from Two Tertiary-Care Hospitals

Background:

The occurrence rate of BRCA1 mutations is found to be high in South Asian countries where early onset of breast cancer is common. In Bangladesh, noticeable percentage of patients experience breast cancer in their reproductive ages. The objective of this study was to identify any mutation in exon2 of the BRCA1 gene in adult Bengali Bangladeshi female patients with breast cancer.

Methods:

In this cross-sectional descriptive study, the genomic DNA was extracted from the blood of adult fifty Bengali Bangladeshi female breast cancer patients. The whole region of exon2 of the BRCA1 gene was amplified and the amplified DNA products were sequenced using Sanger sequencing. The raw chromatogram data were analyzed using Chromas software, and analyzed sequences were compared with the NCBI RefSeq database by BLAST search. The resultant amino acid change was detected by MEGA X software.

Results:

We found the mean age at diagnosis 44.66 years, whereas 96% of patients were married, 90% were multiparous and 86% breastfed their children. All patients had unilateral breast cancer and among them 94% had invasive ductal carcinoma. Only 24.5% of the patients had associated omorbidity. The family history of breast cancer or other BRCA-associated cancer was positive only for 4% of patients. A total of five mutations were identified all of which caused by substitutions. Among them three were nonsynonymous and two were synonymous. Only 2.5% of the patients, within the age group of 18-50 years, were found to have mutations in their blood, whereas 26.66% of the patients above 50 years found to have mutations in this study.

Conclusions:

Among this small sample size, we found five mutations in exon2 of the BRCA1 gene and this indicates the necessity to find out the mutation spectra of the BRCA1 gene in the Bangladeshi population.

A hospital based survey to evaluate knowledge, awareness and perceived barriers regarding breast cancer screening among females in Bangladesh

Background

Early diagnosis of breast cancer is essential for mitigating its related morbidity and mortality. Therefore, high awareness is required.

Objectives

We aimed to evaluate the knowledge, awareness and perceived barriers among females in Bangladesh regarding breast cancer.

Methods

A hospital-based survey was performed from April 2019 to June 2019. A total of 500 females aged >18 years were recruited to the study. The participants were selected by trained personnel and physicians via simple random sampling.

Results

The mean participant age was 37.13 ± 12.66 years. Among all the participants, 79% were married, 4% were single, 3% were divorced and 14% were widowed. We observed that 80.6% of respondents were housewives, 5% were students and 14.4% were working women. The participants had a severe lack of knowledge and awareness, and perceived barriers regarding breast cancer screening. Breast cancer was more linked to personal history, occupation and, marital status. Shyness, fear, lack of knowledge and deficient awareness programs were the major perceived barriers.

Conclusion

Educational interventions and proper, appropriate and socially acceptable awareness programs will help to ameliorate knowledge and awareness by addressing barriers regarding breast cancer among the females in Bangladesh.

Assessment of the risk of developing breast cancer using the Gail model in Asian females: A systematic review

Introduction

Currently, the Breast Cancer Risk Assessment Tool (BCRAT), also known as the Gail model (GM) has been widely recognized and adapted for to study disparity in racial and ethnic groups in America including Asian and Pacific Islander American females. However, its applicability outside America remains uncertain due to diversity in epidemiology and risk factors of breast cancer in populations especially in Asian females. We sought to evaluate the performance of the GM to predict breast cancer risk in Asian countries.

Material and methods

This study identified articles published from 2010 by searching PubMed, MEDLINE, Scopus, Web of Science, Google Scholar and gray literature. The initial search terms were breast cancer, mammary, carcinoma, tumor, neoplasm, risk assessment tool, BCRAT, breast cancer prediction, Gail model, Asia, and Asian.

Results

The search yielded 20 articles, with 7 articles addressing the AUC and/or the expected (E) to observed (O) ratio of predicted breast cancer risk, representing the accuracy of the GM in the Asian population. One publication reported the sensitivity and specificity but no AUC. None of the studies were accepted as the standard for reporting prognostic models. Several studies reported good prognostic testing and likely developed a new model modifying the items in the instrument.

Conclusion

The results are not strong enough to develop breast cancer risk in the setting of Asian countries. Involving the breast cancer risk of the Asian population in developing a prognostic model with good statistical understanding is particularly important and can reduce flawed or biased models. Identifying the best methods to achieve well-suited prognostic models in the Asian population should be a priority.

Soluble resistance-related calcium-binding protein in cancers

Soluble resistance-related calcium binding protein (Sorcin) is an oncoprotein expressed at high levels in human cancers and confers multidrug resistance (MDR) in several tumors. Sorcin participates in a number of neoplastic processing including metastasis and apoptosis. In this review, we summarize and discuss the relationship of Sorcin with tumors as well as its regulatory mechanisms. Sorcin is increasingly considered as a potential molecular target for therapeutic intervention.

Knockdown of PAICS inhibits malignant proliferation of human breast cancer cell lines

BACKGROUND

Phosphoribosylaminoimidazole carboxylase, phosphoribosylaminoimidazole succinocarboxamide synthetase (PAICS), an enzyme required for de novo purine biosynthesis, is associated with and involved in tumorigenesis. This study aimed to evaluate the role of PAICS in human breast cancer, which remains the most frequently diagnosed cancer and the leading cause of cancer-related death among women in less developed countries.

RESULTS

Lentivirus-based short hairpin RNA targeting PAICS specifically depleted its endogenous expression in ZR-75-30 and MDA-MB-231 breast cancer cells. Depletion of PAICS led to a significant decrease in cell viability and proliferation. To ascertain the mechanisms through which PAICS modulates cell proliferation, flow cytometry was performed, and it was confirmed that G1-S transition was blocked in ZR-75-30 cells through PAICS knockdown. This might have occurred partly through the suppression of Cyclin E and the upregulation of Cyclin D1, P21, and CDK4. Moreover, PAICS knockdown obviously promoted cell apoptosis in ZR-75-30 cells through the activation of PARP and caspase 3 and downregulation of Bcl-2 and Bcl-xl expression in ZR-75-30 cells.

CONCLUSIONS

These findings demonstrate that PAICS plays an essential role in breast cancer proliferation in vitro, which provides a new opportunity for discovering and identifying novel effective treatment strategies.

Barriers to care for women with breast cancer symptoms in rural Bangladesh

Breast cancer survival rates in lower-income countries like Bangladesh are approximately 50%, versus over 80% in high income countries. Anecdotal reports suggest that, beyond economic and health system barriers, sociocultural factors may influence a woman's care-seeking behavior and resultant early stage diagnoses. To understand these barriers, we conducted 63 interviews (43 women with breast cancer symptoms and 20 men) in Khulna, Bangladesh. We identified socio-cultural barriers like neglect and indifference toward women, women's lack of power to use resources, and reduced support from family due to stigma. Interventions must address these barriers and improve the status of women in Bangladesh.

Triple negative breast cancer in Asia: An insider's view

While tremendous improvement has been made for the treatment of breast cancers, the treatment of triple negative breast cancer (TNBC) still remains a challenge due to its aggressive characteristics and limited treatment options. Most of the studies on TNBC were conducted in Western population and TNBC is reported to be more frequent in the African women. This review encapsulates the studies conducted on TNBC patients in Asian population and elucidates the similarities and differences between these two regions. The current treatment of TNBC includes surgery, radiotherapy and chemotherapy. In addition to the current chemotherapies, which mainly include cytotoxic agents, such as taxanes and anthracyclines, many clinical trials are investigating the potential use of other chemotherapy drugs, targeted therapeutics and combinational therapies to treat TNBC. Moreover, this review also integrates the studies involving novel markers, which will help us to dissect the pathologic process of TNBC and in turn facilitate the development of better treatment strategies to combat TNBC.

Pattern of hematological malignancies in adolescents and young adults in Bangladesh

INTRODUCTION

The adolescent and young adult (AYA) age group (15-39 years) bears distinct characteristics in terms of cancer biology, long-term health and treatment-related complications and psychosocial aspects. The overall scenario of cancer including hematological malignancies (HMs) is largely unknown in Bangladesh, where a significant proportion of people (44% of total population) belong to AYA age group. This study aims to describe the patterns of HM among AYA in the context of Bangladesh METHODS: Two previously published datasets (on hematological malignancies and childhood and adolescent cancer) were merged to construct a comprehensive dataset focusing exclusively on HMs in AYA age group. Univariate descriptive statistics were calculated and bivariate association were tested using Pearson's Chi-square test.

RESULTS

A total of 2144 diagnosed HM related cases over a period of 2007-2014 were analyzed. Acute myeloid leukemia (AML) was the most frequent HM (35.1%) in AYAs, which was followed by acute lymphoblastic leukemia (ALL) and chronic myeloid leukemia (CML) constituting 22.7% and 20.8%, respectively. Among lymphomas, Non-Hodgkin lymphoma (NHL) constituted 13.9% of all HMs while 4.6% was for Hodgkin's lymphoma (HL).

CONCLUSION

This is the first attempt to provide a glimpse on the pattern and distribution of HMs among AYA in Bangladesh. Future studies are essential to get a better insight on the epidemiology, biology, potential risk factors and treatment outcomes for the AYA age group.

Awareness of Breast Cancer among Female Care Givers in Tertiary Cancer Hospital, China

Objective:

Breast cancer is a worldwide public health issue and most common cancer diagnosed among women including China, where advanced stages at diagnosis appears to be increasing and an ever-rising incidence twice as fast as global rates. The study was conducted to describe the awareness of breast cancer and associated factors among care giver women in tertiary Cancer Hospital, China.

Methods:

Institutional based cross-sectional study was conducted among 261 women selected by systematic random sampling. Information provided by the participants was converted into awareness scores for analysis using SPSS version 23. Awareness scores were dichotomized in to ‘good awareness and ‘poor awareness’ taking median score=11 as the cut-off point. Data analysis was performed using the binary logistic regression. A p-value of <0.05 was considered statistically significant.

Result:

The study showed that 46.7% of the respondents had good awareness. Breast lump was the most commonly known symptom of cancer by 61.7% of the respondents. Slightly more than half of the study participants acknowledged having a past history of breast cancer, drinking alcohol and having close relative with breast cancer as potential risk factors for breast cancer (63.6%, 58.6%, and 55.6% respectively). Nevertheless, a vast majority of the study participants were unable to appreciate modifiable risk factors of the disease. More than half of the participants had never/rarely checked their breasts and all of the participants wrongly answered breast cancer knowledge age related risk. Awareness level was significantly associated with entertainment preference (OR=3.57; 95%CI=1.71, 7.44) and residence setting areas (OR=2.4; 95%CI=1.04, 5.69).

Conclusion:

The study indicated suboptimal awareness while entertainment preference and residence setting were significantly associated with awareness level. Public awareness campaigns should be made by dissemination of information about breast cancer through health education and printed Medias with great emphases on women living in rural areas.

Breast cancer screening in developing countries

Developing countries have limited healthcare resources and use different strategies to diagnose breast cancer. Most of the population depends on the public healthcare system, which affects the diagnosis of the tumor. Thus, the indicators observed in developed countries cannot be directly compared with those observed in developing countries because the healthcare infrastructures in developing countries are deficient. The aim of this study was to evaluate breast cancer screening strategies and indicators in developing countries. A systematic review and the Population, Intervention, Comparison, Outcomes, Timing, and Setting methodology were performed to identify possible indicators of presentation at diagnosis and the methodologies used in developing countries. We searched PubMed for the terms "Breast Cancer" or "Breast Cancer Screening" and "Developing Country" or "Developing Countries". In all, 1,149 articles were identified. Of these articles, 45 full articles were selected, which allowed us to identify indicators related to epidemiology, diagnostic intervention (diagnostic strategy, diagnostic infrastructure, percentage of women undergoing mammography), quality of intervention (presentation of symptoms at diagnosis, time to diagnosis, early stage disease), comparisons (trend curves, subpopulations at risk) and survival among different countries. The identification of these indicators will improve the reporting of methodologies used in developing countries and will allow us to evaluate improvements in public health related to breast cancer.

Validation of an Indonesian Version of the Breast Cancer Awareness Scale (BCAS-I)

Background: Raising breast cancer awareness is a key strategy to reduce associated mortality. While a paucity of adequately validated instruments for breast cancer awareness is applicable across cultures, even outside the health care setting such instruments have been developed. Objective: This study investigated the validity and psychometric properties of a breast cancer awareness scale in Indonesia (BCAS-I). Methods: This cross-sectional study was carried out among Indonesian women conveniently selected within three provinces (Yogyakarta, South of Sumatera and East Nusa Tenggara) located in rural-urban areas using stratified random sampling. First, we translated all questionnaires from English to the local language and then back-translated. The third step was to perform psychometric testing of the adapted instrument by establishing internal consistency (Cronbach’s alpha score 0.79) and construct validity by confirmatory factor analysis (CFA). Results: In the 856 participants who responded (responded rate = 98.28%), the age ranged from 18 to 80 years old (mean = 30, SD = 11). The BCAS-I was shown to have good internal consistency, and CFA demonstrated the model fit data adequately (χ2 = 922.267, df = 515, p <0.001, comparative fit index = 0.965, Tucker-Lewis Index = 0.96, goodness-of-fit index = 0.97, adjusted goodness-of-fit index = 0.97, root-mean-square error of approximation = 0.03 95% confidence interval: 0.027, 0.034). The final version of BCAS-I consists of 33 items across 5 domains that cover most key aspects of breast cancer awareness for this population. Conclusion: The BCAS-I demonstrated good psychometric properties and was found to be valid to provide a measurement of breast cancer awareness in Asian women in general and Indonesian women in particular.

Epidemiology of childhood and adolescent cancer in Bangladesh, 2001-2014

BACKGROUND

Cancer burden among children and adolescents is largely unknown in Bangladesh. This study aims to provide a comprehensive overview on childhood and adolescent cancers and to contribute to the future strategies to deal with these diseases in Bangladesh.

METHODS

Data on malignant neoplasms in patients aged less than 20 years diagnosed between 2001 and 2014 (N = 3143) in Bangladesh was collected by the National Institute of Cancer Research and Hospital and ASHIC Foundation. The age pattern and distribution of cancer types were analysed and the incidence rates were calculated.

RESULTS

The age-standardised incidence rate was 7.8 per million person-years for children (0-14 years) in the last time period (2011-2014). Retinoblastoma (25%) and leukaemia (18%) were the most common childhood cancers. For adolescents (15-19 years), the age-specific incidence rate was 2.1 per million person-years in the same time period. Most common adolescent cancers were malignant bone tumours (38%), germ cell and gonadal tumours (17%), and epithelial tumours (16%). There were more boys affected (M: F ratio 2.0 in children and 1.4 in adolescents) than girls.

CONCLUSION

Cancer incidences were lower than expected most likely due to a low level of awareness about cancer among clinicians and the population, inadequate access to health care, lack of diagnostic equipment and incomplete recording of cases. Improvements on different levels should be made to get a better epidemiologic insight and to detect cancer earlier resulting in a better outcome for affected children and adolescents.

The prognostic value of intermedin in patients with breast cancer

This study aimed to evaluate the prognostic value of preoperative plasma intermedin levels in breast cancer patients. Plasma intermedin levels of 252 breast cancer women and 100 healthy women were determined using radioimmunoassay kit. Adverse event was defined as first local recurrence, distant metastasis, second primary cancer of another organ, or death from any cause during 5-year follow-up. Disease-free survival was defined as the time between surgery and the date of any adverse event whichever appeared first. Overall survival was defined from surgery to death for any cause. The relationships between plasma intermedin levels and clinical outcomes of breast cancer patients were evaluated using multivariate analysis. The results showed that preoperative plasma intermedin levels were substantially higher in patients than in healthy subjects using t-test. Intermedin was identified as an independent predictor for 5-year mortality, adverse event, disease-free survival, and overall survival using multivariate analysis. Based on receiver operating characteristic curve analysis, preoperative plasma intermedin levels had high predictive value for 5-year mortality and adverse event. In conclusion, preoperative plasma intermedin levels are highly associated with poor patient outcomes and intermedin may be a potential prognostic biomarker for patients with breast cancer.

The incidence, age at diagnosis of breast cancer in the Iraqi Kurdish population and comparison to some other countries of Middle-East and West

BACKGROUND

Studies on breast cancer among Iraqi Kurdish are limited. The incidence of breast cancer is lower, more common in younger age and a significant proportion of cases occur in premenopausal women. The aims of this study are to estimate the age-standardized incidence rate, age-specific rates and their comparison with some countries of Middle-East and West, and clarify the association of family history and premenopausal status with breast cancer.

MATERIALS AND METHODS

This retrospective case control study was conducted in Sulaimanyah governorate (North of Iraq). Data were collected regarding demographical profile of 536 patients who were registered in Hewa Hematology and Oncology Hospital during 2011-2013, and 496 age-matched controls.

RESULTS

There were 536 cases of breast cancer, 526 of them were female. The age range was 20-82 years. The mean age at diagnosis was 49.42±11.66 years compared to control 46.7±10.2 (p˂0.001, 95% CI: 1.7-3.7). The age-standardized rate was 17.9/100,000 Kurdish women population/year. Five year age-specific rates show the peak incidence for the age group 45-49 years (79.3/100,000). A significant percentage of patients were premenopausal at the time of diagnosis, which is account 55.52% of cases compared to control 59.67% (p=0.53). About 13.49% of cases have family history of breast cancer compared to control 3.2% (p=0.02).

CONCLUSION

Among Kurdish people in Iraq, the incidence of breast cancer is less than Middle-East and Western countries with higher incidence in younger age group than western society, but similar to Middle-East countries. More than half of Kurdish women with breast cancer are premenopausal.