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Alkan H, Akyıldız D. Effect of monthly reminders by telephone message on women's beliefs and practice behaviours regarding breast self-examination: A randomized controlled study. Int J Nurs Pract 2024; 30:e13241. [PMID: 38320959 DOI: 10.1111/ijn.13241] [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: 03/17/2023] [Revised: 11/20/2023] [Accepted: 01/20/2024] [Indexed: 02/08/2024]
Abstract
AIMS This study was conducted to examine the effect of monthly telephone message reminders after training on women's beliefs and practice behaviours regarding breast self-examination. METHODS This randomized controlled study was conducted with 83 women aged 20-69 years living in Turkey between September 2021 and July 2022. Women were randomly assigned (1:1) to the intervention (n = 41) or control group (n = 42), both groups received online breast self-examination training, and the intervention group received monthly reminders on their mobile phones for 3 months. Participants completed the Champion's Health Belief Model Scale and breast self-examination practice evaluation form at baseline and 3 months after intervention. RESULTS After the intervention, the mean scores of the benefits and self-efficacy subscales of Champion's Health Belief Model Scales were significantly higher in the intervention group compared to the control group, and the mean score of barriers was lower. The rate of performing breast self-exam regularly and at the appropriate time was higher in the intervention group. The rate of forgetting to perform breast self-examination was higher in control group. CONCLUSION A monthly reminder message may be recommended to increase women's belief in breast self-examination and increase regular practice.
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Affiliation(s)
- Hilal Alkan
- Gaziantep Şahinbey Kavaklık Rotary Family Health Center, Gaziantep, Turkey
| | - Deniz Akyıldız
- Faculty of Health Sciences, Division of Midwifery, Kahramanmaraş Sütçü İmam University, Kahramanmaras, Turkey
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Newton MV, Palanivelrajan VV. How "Breast Aware" are the Indian Women? A Study among the Women Visiting a Tertiary Care, Referral, and Teaching Hospital. Ann Afr Med 2024; 23:372-378. [PMID: 39034561 PMCID: PMC11364323 DOI: 10.4103/aam.aam_194_23] [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: 11/17/2023] [Accepted: 02/01/2024] [Indexed: 07/23/2024] Open
Abstract
INTRODUCTION "Who will educate us" lamented a School Principal after she took part in our study and education session. There is palpable low breast cancer (BC) literacy with rising incidence and disproportionate mortality rates. METHODOLOGY Breast Cancer Awareness Measure (BCAM) developed by Cancer Research UK was administered to 944 women. BCAM measures knowledge, age-related risk, and reported frequency of breast checking and other components. A woman is BC aware if she identified five or more nonlump symptoms, age-related risk, and reported breast checking once a week/month. At the end, each participant was given "Be Breast Aware" education; what/how to look for demonstrated on a model. RESULTS 2.8% health professionals. 3.1% BC survivors. 78.8% had lump knowledge and 55.3% had non-lump knowledge of BC, 10% had age-related risk knowledge. 24.3% check breasts once a week/month. 41.9% aware BC is common after 50 years. 14/944 (1.5%) had BC awareness. 59.9% had breast symptoms, but never consulted a doctor, 31.1% were embarrassed, and 29.4% were scared to consult. Nearly 43% heard of breast screening, 28.4% had mammography, 26.3% had ultrasound. About 44.1% knew family history risk. Those practicing breast checking looked for a size change (24.5%), nipple position (17.4%), discharge (22.1%), pain (32.5%), and lump (24.7%) in standing (17.8%), supine (8.5%) using finger pads (15.8%) fingertips (21.6%), using circular movements (16.4%), and pinching breast tissue (19.6%). CONCLUSION Health-care workers and BC survivors lack breast awareness which is alarming and indicates the need for BC awareness and post-BC treatment follow-up care education in these two groups and the general population. Some practice the wrong method (e.g., pinching tissue) of breast checking, which may lead to anxiety and unnecessary investigative costs. "Be Breast Aware" education based on the National Health Service 5-point plan given to 944 participants.
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Affiliation(s)
- Mario Victor Newton
- Department of General Surgery, St. John’s Medical College Hospital, Bengaluru, Karnataka, India
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Bosch X, Mota Gomes T, Montori-Palacin E, Moreno P, López-Soto A. Time to Diagnosis and Presenting Symptoms of Patients Diagnosed With Cancer Through Emergency and Nonemergency Routes: A Large Retrospective Study From a High-Volume Center. JCO Oncol Pract 2024; 20:932-942. [PMID: 38457754 DOI: 10.1200/op.23.00567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 01/14/2024] [Accepted: 02/02/2024] [Indexed: 03/10/2024] Open
Abstract
PURPOSE The symptoms with which a patient with cancer presents and the route taken to diagnosis (emergency v nonemergency) may affect the speed with which the diagnosis of cancer is made, thereby affecting outcomes. We examined time to diagnosis by symptom for cancers diagnosed through emergency and nonemergency routes (NERs). METHODS We performed a retrospective review of patients diagnosed with 10 solid cancers at Hospital Clínic of Barcelona between March 2013 and June 2023. Cancers were diagnosed through emergency presentation and admission (inpatient emergency route [IER]), emergency presentation and outpatient referral (outpatient emergency route [OER]), and primary care presentation and outpatient referral (NER). We assessed the effect of diagnostic routes on intervals to diagnosis for 19 cancer symptoms. RESULTS A total of 5,174 and 1,607 patients were diagnosed with cancer through emergency routes and NERs, respectively. Over 85% of patients presenting with alarm (localizing) symptoms such as hematuria through emergency routes were diagnosed with the expected cancer, whereas those with nonlocalizing symptoms such as abdominal pain had a more heterogeneous cancer-site composition. Median intervals were shorter for alarm than nonlocalizing symptoms and tended to be shorter in IERs than OERs. However, for most symptoms, intervals in both routes were invariably shorter than in the NER. For example, diagnostic intervals for hematuria and abdominal pain were 3 and 5 days shorter in IERs than OERs, but they were 5-8 and 17-22 days shorter than in the NER, respectively. CONCLUSION For patients with alarm symptoms, intervals were shorter than for those with nonlocalizing symptoms and, for most symptoms, intervals were shorter when patients were evaluated by emergency routes rather than NERs.
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Affiliation(s)
- Xavier Bosch
- Department of Internal Medicine, Hospital Clínic, University of Barcelona, August Pi i Sunyer Biomedical Research Institute (IDIBAPS) and Clínic Foundation for Biomedical Research (FCRB), Barcelona, Spain
| | - Tiago Mota Gomes
- Department of Internal Medicine, Hospital Clínic, University of Barcelona, August Pi i Sunyer Biomedical Research Institute (IDIBAPS) and Clínic Foundation for Biomedical Research (FCRB), Barcelona, Spain
| | - Elisabet Montori-Palacin
- Department of Internal Medicine, Hospital Clínic, University of Barcelona, August Pi i Sunyer Biomedical Research Institute (IDIBAPS) and Clínic Foundation for Biomedical Research (FCRB), Barcelona, Spain
| | - Pedro Moreno
- Department of Internal Medicine, Hospital Clínic, University of Barcelona, August Pi i Sunyer Biomedical Research Institute (IDIBAPS) and Clínic Foundation for Biomedical Research (FCRB), Barcelona, Spain
| | - Alfonso López-Soto
- Department of Internal Medicine, Hospital Clínic, University of Barcelona, August Pi i Sunyer Biomedical Research Institute (IDIBAPS) and Clínic Foundation for Biomedical Research (FCRB), Barcelona, Spain
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Iacob R, Iacob ER, Stoicescu ER, Ghenciu DM, Cocolea DM, Constantinescu A, Ghenciu LA, Manolescu DL. Evaluating the Role of Breast Ultrasound in Early Detection of Breast Cancer in Low- and Middle-Income Countries: A Comprehensive Narrative Review. Bioengineering (Basel) 2024; 11:262. [PMID: 38534536 DOI: 10.3390/bioengineering11030262] [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: 02/19/2024] [Revised: 03/04/2024] [Accepted: 03/06/2024] [Indexed: 03/28/2024] Open
Abstract
Breast cancer, affecting both genders, but mostly females, exhibits shifting demographic patterns, with an increasing incidence in younger age groups. Early identification through mammography, clinical examinations, and breast self-exams enhances treatment efficacy, but challenges persist in low- and medium-income countries due to limited imaging resources. This review assesses the feasibility of employing breast ultrasound as the primary breast cancer screening method, particularly in resource-constrained regions. Following the PRISMA guidelines, this study examines 52 publications from the last five years. Breast ultrasound, distinct from mammography, offers advantages like radiation-free imaging, suitability for repeated screenings, and preference for younger populations. Real-time imaging and dense breast tissue evaluation enhance sensitivity, accessibility, and cost-effectiveness. However, limitations include reduced specificity, operator dependence, and challenges in detecting microcalcifications. Automatic breast ultrasound (ABUS) addresses some issues but faces constraints like potential inaccuracies and limited microcalcification detection. The analysis underscores the need for a comprehensive approach to breast cancer screening, emphasizing international collaboration and addressing limitations, especially in resource-constrained settings. Despite advancements, notably with ABUS, the primary goal is to contribute insights for optimizing breast cancer screening globally, improving outcomes, and mitigating the impact of this debilitating disease.
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Affiliation(s)
- Roxana Iacob
- Department of Anatomy and Embriology, 'Victor Babeș' University of Medicine and Pharmacy, 300041 Timișoara, Romania
- Doctoral School, 'Victor Babeș' University of Medicine and Pharmacy, 300041 Timișoara, Romania
- Faculty of Mechanics, Field of Applied Engineering Sciences, Specialization Statistical Methods and Techniques in Health and Clinical Research, 'Politehnica' University Timișoara, Mihai Viteazul Boulevard No. 1, 300222 Timisoara, Romania
| | - Emil Radu Iacob
- Department of Pediatric Surgery, 'Victor Babeș' University of Medicine and Pharmacy, 300041 Timișoara, Romania
| | - Emil Robert Stoicescu
- Doctoral School, 'Victor Babeș' University of Medicine and Pharmacy, 300041 Timișoara, Romania
- Faculty of Mechanics, Field of Applied Engineering Sciences, Specialization Statistical Methods and Techniques in Health and Clinical Research, 'Politehnica' University Timișoara, Mihai Viteazul Boulevard No. 1, 300222 Timisoara, Romania
- Department of Radiology and Medical Imaging, 'Victor Babeș' University of Medicine and Pharmacy, 300041 Timișoara, Romania
- Research Center for Pharmaco-Toxicological Evaluations, 'Victor Babeș' University of Medicine and Pharmacy, 300041 Timișoara, Romania
| | - Delius Mario Ghenciu
- Doctoral School, 'Victor Babeș' University of Medicine and Pharmacy, 300041 Timișoara, Romania
| | - Daiana Marina Cocolea
- Doctoral School, 'Victor Babeș' University of Medicine and Pharmacy, 300041 Timișoara, Romania
| | - Amalia Constantinescu
- Department of Radiology and Medical Imaging, 'Victor Babeș' University of Medicine and Pharmacy, 300041 Timișoara, Romania
| | - Laura Andreea Ghenciu
- Discipline of Pathophysiology, 'Victor Babeș' University of Medicine and Pharmacy, 300041 Timișoara, Romania
| | - Diana Luminita Manolescu
- Department of Radiology and Medical Imaging, 'Victor Babeș' University of Medicine and Pharmacy, 300041 Timișoara, Romania
- Center for Research and Innovation in Precision Medicine of Respiratory Diseases (CRIPMRD), 'Victor Babeș' University of Medicine and Pharmacy, 300041 Timișoara, Romania
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Nilojan JS, Rajendra S, Naganathan G. Abducens nerve palsy due to clivus metastasis in a patient with breast carcinoma: A rare case. Int J Surg Case Rep 2024; 116:109437. [PMID: 38412597 PMCID: PMC10944127 DOI: 10.1016/j.ijscr.2024.109437] [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: 01/21/2024] [Revised: 02/19/2024] [Accepted: 02/21/2024] [Indexed: 02/29/2024] Open
Abstract
INTRODUCTION Breast cancer, comprising 25 % of all diagnosed cancers, predominantly affects women globally. While bone metastasis is common, occurrences at the clivus or skull base are rarely documented. Treatment varies from surgery in early stages to a multifaceted approach for advanced cases, incorporating chemotherapy, radiotherapy, and surgery based on staging and histology. CLINICAL PRESENTATION A 40-year-old female presented with a rapidly enlarging lump in her left breast and diplopia on right gaze. Histology was positive for invasive breast cancer (no special type) and Contrast-Enhanced Computed Tomography demonstrated metastatic deposits in multiple vertebrae and bilateral ilium. Further, magnetic resonance imaging of the brain and orbits revealed metastatic deposits in the clivus which extended up-to medial wall of the cavernous sinus, causing compression of the right abducens nerve. Multidisciplinary Tumor Board review recommended chemoradiotherapy. DISCUSSION Metastases from breast cancer can occur locally or to distant sites like lymph nodes, bones, lungs, liver, and brain. Unusual symptoms, such as new-onset diplopia, trigger further investigation. Although bone metastases occur in 50-65 % of cases, clivus metastasis is rare. Treatment aims at extending survival, symptom management, and enhancing quality of life through chemotherapy and radiotherapy. Outcomes hinge on metastatic burden and regional therapy responsiveness. Distant metastases substantially reduce the 5-year survival rate from 80 % to approximately 25 %, but cases often improve with regional interventions. CONCLUSION Although an extremely rare occurrence, clivus metastasis might be considered in patients with a history of malignancy, in particular, breast malignancy, presenting with new-onset sixth nerve palsy.
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Affiliation(s)
| | | | - Gayathri Naganathan
- Fellow of Breast Surgical Oncology, Department of Surgery, University of Toronto, Ontario, Canada.
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Fagbemi OO, Ojo C, Khan MA, Marla S, Narayanan S, Jafferbhoy S, Soumian S. Efficiency Assessment of Breast Clinics for Patients Under 35: A Comparative Analysis of Targeted Models in a University Hospital. Cureus 2024; 16:e54428. [PMID: 38510890 PMCID: PMC10951552 DOI: 10.7759/cureus.54428] [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] [Accepted: 02/18/2024] [Indexed: 03/22/2024] Open
Abstract
Despite the higher incidence of breast cancer in older age groups, it remains pertinent not to overlook breast cancer occurrence in those aged 35 years and below. Recent transitions toward targeted under-35 clinics in England aim to enhance efficiency and meet referral standards. Three models were planned, and we assessed the efficiency of each model. This study, conducted for five months within a single National Health Service (NHS) trust, analyzed data from the following clinics: the General One-Stop Clinic, the Under 35 One-Stop Clinic with ultrasound services (USS), and the Under 35 Clinic without USS services. Of the 300 patients recruited (100 consecutive patients from each clinic), 94.3% were female. The average age at presentation was 27.53 years. The most frequently encountered age group was between 26 and 30 years, and the majority of patients had palpable lumps (78, 51.6%). Out of 300 patients who attended the clinics, 151 had USS, and of these, 15 biopsies were performed. Fibroadenomas (32, 21.2%) and cysts (22, 14.6%) were the most common radiological findings. We found that more breast imaging was being undertaken for under-35 patients who attended the general one-stop clinics compared to the specific under-35 clinics. Targeted breast clinics for individuals 35 years and below offer an effective approach in terms of resource allocation and meeting cancer targets.
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Affiliation(s)
- Ona O Fagbemi
- Department of General Surgery, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, GBR
| | - Charles Ojo
- Department of Emergency Medicine, United Lincolnshire Hospitals NHS Trust, Boston, GBR
| | - Maryam A Khan
- Department of Breast Surgery, East Cheshire NHS Trust, Macclesfield, GBR
| | - Sekhar Marla
- Department of Breast Surgery, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, GBR
| | - Sankaran Narayanan
- Department of Breast Surgery, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, GBR
| | - Sadaf Jafferbhoy
- Department of Breast Surgery, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, GBR
| | - Soni Soumian
- Department of Breast Surgery, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, GBR
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Choudhari RC, Kaur K, Das A, Jaitak V. Synthesis, and In-silico Studies of Indole-chalcone Derivatives Targeting Estrogen Receptor Alpha (ER-α) for Breast Cancer. Curr Comput Aided Drug Des 2024; 20:640-652. [PMID: 37888813 DOI: 10.2174/0115734099263650230926053750] [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: 05/23/2023] [Revised: 08/08/2023] [Accepted: 08/10/2023] [Indexed: 10/28/2023]
Abstract
BACKGROUND Breast cancer is the prominent reason of death in women worldwide, and the cases are increasing day by day. There are many FDA-approved drugs for treating breast cancer. Due to drug resistance, and problems in selectivity, there is a need to develop more effective agents with few side effects. Indole derivatives have demonstrated significant pharmacological potential as anti-breast cancer agents. Further, chalcone derivatives incorporating heterocyclic scaffolds play a significant role in medicine. Indole-chalcone-based compounds offer the potential for improved biological activity and enhanced drug-like properties. It prompted us to explore the synthesis of Indole-Chalcone derivatives targeting estrogen receptor alpha (ER-α) to discover potent anti-breast cancer agents. OBJECTIVES To synthesize indole-chalcone derivatives and study their binding interactions for ER-α protein by molecular docking for breast cancer treatment. METHODS In this study, indole-chalcone derivatives have been synthesized using conventional heating. With the help of Schrodinger software, molecular interaction as well as ADME (Adsorption, Distribution, Metabolism, and Excretion) studies of the compounds were conducted. RESULTS Among all the synthesized compounds, four compounds (1, 2, 3, and 4) showed better docking scores (-10.24 kcal/mol, -10.15 kcal/mol, -9.40 kcal/mol, -9.29 kcal/mol, respectively) than the standard tamoxifen (-8.43 kcal/mol). CONCLUSION From In-silico studies, we can conclude that four compounds from the synthesized series fit into the active site of ER-α. ADME properties of synthesized derivatives were found in the acceptable range. In the future, these compounds can be further explored for biological activity.
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Affiliation(s)
- Rahul Charudatta Choudhari
- Department of Pharmaceutical Sciences and Natural Products, Central University of Punjab, Ghudda, Bathinda (Pb), 151401, India
| | - Kamalpreet Kaur
- Department of Pharmaceutical Sciences and Natural Products, Central University of Punjab, Ghudda, Bathinda (Pb), 151401, India
| | - Agnidipta Das
- Department of Pharmaceutical Sciences and Natural Products, Central University of Punjab, Ghudda, Bathinda (Pb), 151401, India
| | - Vikas Jaitak
- Department of Pharmaceutical Sciences and Natural Products, Central University of Punjab, Ghudda, Bathinda (Pb), 151401, India
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Syed S, Akuma O, Emmanuel S, Mehmood F, Zahdeh T, Okonkwo CC, Kancherla N, Inban P, Tarimci B, Carredo CKC, Ejaz A, Rentiya ZS, Khan AM. A remarkable response to palliative treatment in metastatic breast cancer: A case report and comprehensive literature review. Radiol Case Rep 2023; 18:4489-4494. [PMID: 37868003 PMCID: PMC10589742 DOI: 10.1016/j.radcr.2023.09.022] [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: 04/07/2023] [Revised: 08/26/2023] [Accepted: 09/05/2023] [Indexed: 10/24/2023] Open
Abstract
The case report describes a patient with stage IV breast cancer which metastasized to the lungs. The patient's initial computed tomography (CT) scan revealed a malignant lesion in the upper outer quadrant of the left breast and multiple pulmonary nodules, suggesting pulmonary metastasis. After starting palliative chemotherapy with intravenous paclitaxel and subcutaneous injections of Herceptin, a follow-up CT scan 3 months after the initiation of treatment showed the disappearance of metastasis, and her cancer regressed to stage II breast cancer that could be surgically resected. This case report highlights the importance of timely and appropriate palliative treatment measures, which can lead to unexpected outcomes, such as the regression of metastatic lesions and the possibility of curative treatment in such advanced cancer.
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Affiliation(s)
| | | | - Sanni Emmanuel
- Danylo Halytsky Lviv National Medical University, Lviv, Ukraine
| | | | | | - Chinwe C. Okonkwo
- Caribbean Medical University School of Medicine, Willemstad, Curaçao
| | | | | | - Baris Tarimci
- Ege University Faculty of Medicine, Izmir, Turkey 9Cebu Institute of Medicine, Cebu, Philippines
| | | | | | - Zubir S. Rentiya
- Department of Radiation Oncology & Radiology, University of Virginia, Charlottesville, VA, USA
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Li X, Xu S, Hao LW, Zhou XN. Value of Molybdenum Target X-Ray and High-Frequency Color Doppler Flow Imaging in Early Diagnosis of Breast Carcinoma: A Comparative Analysis. Cancer Manag Res 2023; 15:1155-1163. [PMID: 37868685 PMCID: PMC10588806 DOI: 10.2147/cmar.s412924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 09/21/2023] [Indexed: 10/24/2023] Open
Abstract
Background Breast carcinoma (BC) threatens the physical and mental health of women worldwide, and early diagnosis is important for improving patient outcomes and ensuring successful treatment. Purpose This research mainly aims to compare and analyze the value of molybdenum target X-ray and high-frequency color Doppler flow imaging (CDFI) in the early diagnosis of BC. Methods First, 102 patients with suspected early-stage BC (ESBC) admitted to Henan Provincial People's Hospital were examined by molybdenum target X-ray and CDFI. Based on the pathological findings, the diagnostic efficiency data of the two diagnostic modalities such as positive detection rate (PDR), positive predictive value (PPV), negative predictive value (NPV), sensitivity (SEN), specificity (SPE), and accuracy (ACC), as well as imaging information like masses, microcalcifications (MCs), axillary lymph node (LN) metastases, and blood flow signal or vascular sign abnormalities were analyzed. Results CDFI contributed to higher PDR, PRV, NPV, SEN, and ACC than molybdenum target X-ray in ESBC diagnosis, but similar SPE. The combined diagnosis of molybdenum target X-ray plus CDFI contributed to even higher PDR, PRV, NPV, SEN, and ACC than molybdenum target X-ray alone and higher ACC than CDFI. Imaging inspection revealed that the number of cases of masses, axillary LN metastases, and abnormalities in blood flow signals or vascular signs detected by CDFI was significantly higher than that by molybdenum target X-ray, while the number of MCs was significantly lower. Conclusion Molybdenum target X-ray plus CDFI is more effective in the diagnosis of ESBC and plays a complementary role in imaging examination, which can synergistically improve the diagnostic ACC of ESBC and is worthy of clinical promotion.
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Affiliation(s)
- Xia Li
- Health Management Discipline of Henan Provincial People’s Hospital, Zhengzhou, Henan Province, 450000, People’s Republic of China
| | - Shuang Xu
- Health Management Discipline of Henan Provincial People’s Hospital, Zhengzhou, Henan Province, 450000, People’s Republic of China
| | - Liu-Wei Hao
- Health Management Discipline of Henan Provincial People’s Hospital, Zhengzhou, Henan Province, 450000, People’s Republic of China
| | - Xiao-Ning Zhou
- Health Management Discipline of Henan Provincial People’s Hospital, Zhengzhou, Henan Province, 450000, People’s Republic of China
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Setyawan IGB, Kurnia D, Setiaji K, Anwar SL, Purwanto DJ, Azhar Y, Budijitno S, Suprabawati DGA, Priyono SH, Siregar BA, Indriawan R, Tripriadi ES, Umar M, Pieter JSLA, Yarso KY, Hermansyah D, Wibisana IGNG, Harahap WA, Gautama W, Achmad D. Sociodemographic disparities associated with advanced stages and distant metastatic breast cancers at diagnosis in Indonesia: a cross-sectional study. Ann Med Surg (Lond) 2023; 85:4211-4217. [PMID: 37663742 PMCID: PMC10473298 DOI: 10.1097/ms9.0000000000001030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 06/20/2023] [Indexed: 09/05/2023] Open
Abstract
Background The global health burden of breast cancer is increasing with 5-year survival rates being much shorter in low-income and middle-income countries. Sociodemographic and clinical disparities in early cancer detection affect long-term outcome. Methods The authors compared social, demographic, and pathological characteristics associated with metastatic and late stages of breast cancer diagnosis using data collected from a special registry developed by Perhimpunan Bedah Onkologi Indonesia (PERABOI) in 2015. Results Of 4959 patients recruited in this study, 995 women (20.1%) were diagnosed with metastatic breast cancer. Lower education status and living in rural areas were significantly associated with Stage IV at diagnosis [odds ratio (OR)=1.256, 95% CI=1.093-1.445, P=0.001; and OR=1.197, 95% CI=1.042-1.377, P=0.012; respectively). Main complaints other than lump (ulceration, breast pain, and discharge) and occupation as a housewife were also associated with the presentation of metastatic diseases (OR=2.598, 95% CI=2.538-3.448, P<0.001 and OR=1.264, 95% CI=1.056-1.567, P=0.030, respectively). Having lower education and living outside Java and Bali islands were associated with the diagnosis of late-stage breast cancers (OR=1.908, 95% CI=1.629-2.232, P<0.001 and OR=3.039, 95% CI=2.238-4.126, P<0.001; respectively). A higher proportion of breast cancer patients were relatively younger with bigger tumour size, positive axillary nodal involvement, and more frequent Human epidermal growth factor receptor 2 overexpression. Conclusion The authors identified sociodemographic disparities in the metastatic and late-stage diagnosis of breast cancers among Indonesian women. The subsequent action is required to reduce disparities faced by women with lower social and educational levels for early diagnosis and better healthcare access.
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Affiliation(s)
- IG Budhi Setyawan
- Perhimpunan Bedah Onkologi Indonesia (PERABOI)/Indonesian Association of Surgical Oncology (ISSO)
- Division of Surgical Oncology, RSUP Dr IGNG Ngoerah/Udayana University, Denpasar, Bali
| | - Dian Kurnia
- Perhimpunan Bedah Onkologi Indonesia (PERABOI)/Indonesian Association of Surgical Oncology (ISSO)
- Division of Surgical Oncology, RSUD Dr M. Yunus Bengkulu, Kota Bengkulu, Bengkulu
| | - Kunta Setiaji
- Perhimpunan Bedah Onkologi Indonesia (PERABOI)/Indonesian Association of Surgical Oncology (ISSO)
- Division of Surgical Oncology, RSUP Dr Sardjito / Universitas Gadjah Mada, Yogyakarta
| | - Sumadi Lukman Anwar
- Perhimpunan Bedah Onkologi Indonesia (PERABOI)/Indonesian Association of Surgical Oncology (ISSO)
- Division of Surgical Oncology, RSUP Dr Sardjito / Universitas Gadjah Mada, Yogyakarta
| | - Deni J. Purwanto
- Perhimpunan Bedah Onkologi Indonesia (PERABOI)/Indonesian Association of Surgical Oncology (ISSO)
- Division of Surgical Oncology, RSK Dharmais, Jakarta 11420, DKI Jakarta
| | - Yohana Azhar
- Perhimpunan Bedah Onkologi Indonesia (PERABOI)/Indonesian Association of Surgical Oncology (ISSO)
- Division of Surgical Oncology, RSUP Dr Hasan Sadikin / Universitas Padjadjaran, Bandung, Jawa Barat
| | - Selamat Budijitno
- Perhimpunan Bedah Onkologi Indonesia (PERABOI)/Indonesian Association of Surgical Oncology (ISSO)
- Division of Surgical Oncology, RSUP Dr Kariadi / Universitas Diponegoro, Semarang, Jawa Tengah
| | - Desak Gede Agung Suprabawati
- Perhimpunan Bedah Onkologi Indonesia (PERABOI)/Indonesian Association of Surgical Oncology (ISSO)
- Division of Surgical Oncology, RSUD Dr Soetomo / Universitas Airlangga, Surabaya, Jawa Timur
| | - Sasongko Hadi Priyono
- Perhimpunan Bedah Onkologi Indonesia (PERABOI)/Indonesian Association of Surgical Oncology (ISSO)
- Division of Surgical Oncology, Universitas Lambung Mangkurat, Banjarmasin, Kalimantan Selatan
| | - Bintang Abadi Siregar
- Perhimpunan Bedah Onkologi Indonesia (PERABOI)/Indonesian Association of Surgical Oncology (ISSO)
- Division of Surgical Oncology, RSUD Dr H Abdul Moeloek / Universitas Lampung, Bandar Lampung, Lampung
| | - Ramses Indriawan
- Perhimpunan Bedah Onkologi Indonesia (PERABOI)/Indonesian Association of Surgical Oncology (ISSO)
- Division of Surgical Oncology, RSUD Propinsi NTB / Universitas Mataram, Kota Mataram, Nusa Tenggara Barat
| | - Effif Syofra Tripriadi
- Perhimpunan Bedah Onkologi Indonesia (PERABOI)/Indonesian Association of Surgical Oncology (ISSO)
- Division of Surgical Oncology, RSUD Dr Arifin Achmad / Universitas Riau, Pekanbaru, Riau
| | - Mulawan Umar
- Perhimpunan Bedah Onkologi Indonesia (PERABOI)/Indonesian Association of Surgical Oncology (ISSO)
- Division of Surgical Oncology, RSUP Dr Moh Hoesain / Universitas Sriwijaya, Palembang, Sumatra Selatan
| | - John SLA Pieter
- Perhimpunan Bedah Onkologi Indonesia (PERABOI)/Indonesian Association of Surgical Oncology (ISSO)
- Division of Surgical Oncology, RSUP Dr Wahidin Sudirohusodo / Universitas Hasanuddin, Makassar, Sulawesi Selatan
| | - Kristanto Yuli Yarso
- Perhimpunan Bedah Onkologi Indonesia (PERABOI)/Indonesian Association of Surgical Oncology (ISSO)
- Division of Surgical Oncology, RSUD Dr Moewardi / Universitas Sebelas Maret, Surakarta, Jawa Tengah
| | - Dedy Hermansyah
- Perhimpunan Bedah Onkologi Indonesia (PERABOI)/Indonesian Association of Surgical Oncology (ISSO)
- Division of Surgical Oncology, RSUP Dr H Adam Malik / Universitas Sumatra Utara, Medan, Sumatra Utara
| | - IGN Gunawan Wibisana
- Perhimpunan Bedah Onkologi Indonesia (PERABOI)/Indonesian Association of Surgical Oncology (ISSO)
- Division of Surgical Oncology, RSUP Dr Cipto Mangunkusumo / Universitas Indonesia, Padang, Sumatra Barat
| | - Wirsma Arif Harahap
- Perhimpunan Bedah Onkologi Indonesia (PERABOI)/Indonesian Association of Surgical Oncology (ISSO)
- Division of Surgical Oncology, RSUP Dr M Djamil / Universitas Andalas, Jakarta, DKI Jakarta, Indonesia
| | - Walta Gautama
- Perhimpunan Bedah Onkologi Indonesia (PERABOI)/Indonesian Association of Surgical Oncology (ISSO)
- Division of Surgical Oncology, RSK Dharmais, Jakarta 11420, DKI Jakarta
| | - Dimyati Achmad
- Perhimpunan Bedah Onkologi Indonesia (PERABOI)/Indonesian Association of Surgical Oncology (ISSO)
- Division of Surgical Oncology, RSUP Dr Hasan Sadikin / Universitas Padjadjaran, Bandung, Jawa Barat
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11
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Pereira EA, de Carvalho MVD, do Nascimento EA, de Queiroz RA, de Almeida AC, Antunes AA, Pettraki GGP, Soriano EP. Macromorphometric Analysis of Metastatic Lesions in Bones due to Breast Cancer: Contribution to Human Identification. Asian Pac J Cancer Prev 2023; 24:3087-3097. [PMID: 37774060 PMCID: PMC10762763 DOI: 10.31557/apjcp.2023.24.9.3087] [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: 03/15/2023] [Accepted: 09/13/2023] [Indexed: 10/01/2023] Open
Abstract
OBJECTIVE This study aimed to report the metastatic lesions observed in identified skeletons whose deaths were caused by breast cancer complications to provide information and evidence that can be used in cases of human identification forensics. METHODS The research was conducted at the Centre for Forensic Anthropology Studies of the Faculty of Odontology of the University of Pernambuco (CEAF/FOP/UPE), Recife, Brazil. The data bank of the CEAF/FOP/UPE was searched for skeletons with the cause of death reported as due to breast cancer, resulting in five cases. The skeletons were arranged in anatomical positions and macroscopically inspected to register, describe and measure the lesions present to establish the macroscopic patterns of bone destruction caused by breast cancer. RESULT Of the five skeletons, two presented metastatic lesions. In the first, lesions were observed in a disseminated form, affecting almost all bones. The lesions were predominantly osteolytic and ellipsoid-shaped; however, mixed and circular lesions were also found. The second skeleton presented four lesions of mixed characteristics. The finding of bone lesions in the macroscopic analysis of skeletons may reveal a more advanced stage of the neoplasm, as well as its dissemination in areas little rich in hematopoietic tissue, such as the diaphyses of long bones, a situation widely observed in the first reported case. CONCLUSION Besides providing more excellent knowledge of their macroscopic presentation, bone metastatic lesions may act as an individualizing factor in human identification cases, narrowing the sample of possible victims.
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Affiliation(s)
| | - Marcus Vitor Diniz de Carvalho
- Master’s Program in Forensic Sciences, Center for Forensic Anthropology Studies of the Faculty of Odontology of the University of Pernambuco (CEAF/FOP/UPE), Recife, Brazil.
| | | | | | - Adriana Conrado de Almeida
- Master’s Program in Forensic Sciences, Center for Forensic Anthropology Studies of the Faculty of Odontology of the University of Pernambuco (CEAF/FOP/UPE), Recife, Brazil.
| | - Antonio Azoubel Antunes
- Master’s Program in Forensic Sciences, Center for Forensic Anthropology Studies of the Faculty of Odontology of the University of Pernambuco (CEAF/FOP/UPE), Recife, Brazil.
| | - Gabriela Granja Porto Pettraki
- Master’s Program in Forensic Sciences, Center for Forensic Anthropology Studies of the Faculty of Odontology of the University of Pernambuco (CEAF/FOP/UPE), Recife, Brazil.
| | - Evelyne Pessoa Soriano
- Master’s Program in Forensic Sciences, Center for Forensic Anthropology Studies of the Faculty of Odontology of the University of Pernambuco (CEAF/FOP/UPE), Recife, Brazil.
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12
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AlSuwaydani SA, Alshamikh AS, Alotaibi RA, Almutairi KO, Alkhulifi BH. Breast Cancer Awareness and Screening Among Menopaused Females in Al-Qassim Region. Cureus 2023; 15:e41680. [PMID: 37575840 PMCID: PMC10413167 DOI: 10.7759/cureus.41680] [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] [Accepted: 07/10/2023] [Indexed: 08/15/2023] Open
Abstract
BACKGROUND Breast cancer (BC) is one of the most prevalent types of cancer among women worldwide including those in Saudi Arabia. The risk of developing BC can be lowered by reducing risk factors through early screening and by women having full knowledge of this condition. The aim of this study is thus to evaluate knowledge of the importance of early screening and detection of BC among post-menopausal women in Saudi Arabia's Qassim region and to compare it with pre-menopausal women. METHODOLOGY A cross-sectional study was conducted among post-menopausal women in the Qassim region. Data were collected by using a pre-tested, pre-coded, validated self-administered online questionnaire. Data were analyzed using SPSS (Social Package of Statistical Science) Statistics version 23.0. RESULTS Data were collected from 1386 women who agreed to participate in this study, of which 484 women reported that their menstruation had stopped (34.9%). In general, it was found that 73.7% of the participants had adequate knowledge with a significant difference between pre-menopausal and post-menopausal women. Concerning knowledge of BC (p = 0.042), pre-menopausal women had a higher level of knowledge (75.5% had adequate knowledge compared with 70.5% of post-menopausal women). Considering the source of knowledge of the participants regarding BC, websites or social media is considered the main source for 71.8% of the participants, followed by family and friends (52.2%). Concerning the knowledge about the risk factors of BC, 26.4% of the participants reported that they did not know them, and 11.8% of the participants did not know any of the symptoms of BC. CONCLUSION In this study, the knowledge of post-menopausal women was found to be adequate; however, it is significantly lower than that of the pre-menopausal women. Educational level is a significant factor that affects the level of knowledge regarding BC risk factors and different modalities for diagnosis and approaches for management, and this indicates the importance of increasing interest in education in our society.
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Affiliation(s)
- Saleh A AlSuwaydani
- Department of Surgery, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, SAU
| | - Abdulaziz S Alshamikh
- Department of Surgery, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, SAU
| | - Rayan A Alotaibi
- Department of Surgery, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaziah, SAU
| | - Khalid O Almutairi
- Department of Surgery, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaziah, SAU
| | - Buthaina H Alkhulifi
- Department of Surgery, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaziah, SAU
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13
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Cao X, Chen P, Agyekum EA, Zhang Q, Qian X, Wu T, Chambers KH, Yin L. Lung cancer with breast metastasis: a case report and review of the literature. J Int Med Res 2023; 51:3000605231188287. [PMID: 37523488 PMCID: PMC10392707 DOI: 10.1177/03000605231188287] [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: 08/02/2023] Open
Abstract
In this article, we present a rare case of breast metastasis of lung cancer. Chest computed tomography (CT) for a woman in her early 50s indicated right lung malignancy, multiple bone metastases, and an irregular mass in her right breast. Further inquiry into the case history revealed that the patient had been aware of the breast mass for 3 years, without respiratory symptoms. Biopsy of the breast mass suggested estrogen receptor (ER) (+), progesterone receptor (PR) (-), and human epidermal growth factor receptor 2 (HER2) (+ +) breast cancer. The patient was initially diagnosed with breast cancer with lung and bone metastasis. However, comprehensive breast cancer treatment was ineffective, and thyroid transcription factor-1 (TTF-1), napsin A, and cytokeratin 7 (CK7) were evaluated to better understand the origin of the cancer. To the best of our knowledge, this patient had the longest reported disease course from presentation with a breast lump as the first symptom to the final diagnosis of breast metastasis of lung cancer. To provide a better reference for differential diagnosis of ambiguous tumors, we also performed a systematic literature review.
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Affiliation(s)
- Xuan Cao
- Department of Breast Surgery, Jiangsu University Affiliated People's Hospital, Zhenjiang, China
| | - Peiqing Chen
- Department of Breast Surgery, Jiangsu University Affiliated People's Hospital, Zhenjiang, China
| | - Enock Adjei Agyekum
- Department of Ultrasound, Jiangsu University Affiliated People's Hospital, Zhenjiang, China
| | - Qing Zhang
- Department of Ultrasound, Jiangsu University Affiliated People's Hospital, Zhenjiang, China
| | - Xiaoqin Qian
- Department of Ultrasound, Jiangsu University Affiliated People's Hospital, Zhenjiang, China
| | - Ting Wu
- Department of Pathology, Jiangsu University Affiliated People's Hospital, Zhenjiang, China
| | | | - Liang Yin
- Department of Breast Surgery, Jiangsu University Affiliated People's Hospital, Zhenjiang, China
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Anifowose LO, Paimo OK, Adegboyega FN, Ogunyemi OM, Akano RO, Hammad SF, Ghazy MA. Molecular docking appraisal of Dysphania ambrosioides phytochemicals as potential inhibitor of a key triple-negative breast cancer driver gene. In Silico Pharmacol 2023; 11:15. [PMID: 37323538 PMCID: PMC10267046 DOI: 10.1007/s40203-023-00152-6] [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: 04/24/2023] [Accepted: 05/31/2023] [Indexed: 06/17/2023] Open
Abstract
Triple-negative breast cancer (TNBC) is a lethal and aggressive breast cancer subtype. It is characterized by the deficient expression of the three main receptors implicated in breast cancers, making it unresponsive to hormone therapy. Hence, an existing need to develop a targeted molecular therapy for TNBC. The PI3K/AKT/mTOR signaling pathway mediates critical cellular processes, including cell proliferation, survival, and angiogenesis. It is activated in approximately 10-21% of TNBCs, emphasizing the importance of this intracellular target in TNBC treatment. AKT is a prominent driver of the PI3K/AKT/mTOR pathway, validating it as a promising therapeutic target. Dysphania ambrosioides is an important ingredient of Nigeria's traditional herbal recipe for cancer treatment. Thus, our present study explores its anticancer properties through a structure-based virtual screening of 25 biologically active compounds domiciled in the plant. Interestingly, our molecular docking study identified several potent inhibitors of AKT 1 and 2 isoforms from D. ambrosioides. However, cynaroside and epicatechin gallate having a binding energy of - 9.9 and - 10.2 kcal/mol for AKT 1 and 2, respectively, demonstrate considerable drug-likeness than the reference drug (capivasertib), whose respective binding strengths for AKT 1 and 2 are - 9.5 and - 8.4 kcal/mol. Lastly, the molecular dynamics simulation experiment showed that the simulated complex systems of the best hits exhibit structural stability throughout the 50 ns run. Together, our computational modeling analysis suggests that these compounds could emerge as efficacious drug candidates in the treatment of TNBC. Nevertheless, further experimental, translational, and clinical research is required to establish an empirical clinical application. Graphical Abstract A structure-based virtual screening and simulation of Dysphania ambrosioides phytochemicals in the active pocket of AKT 1 and 2 isoforms.
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Affiliation(s)
- Lateef O. Anifowose
- Department of Biochemistry, Faculty of Basic Medical Sciences, College of Medicine, University of Ibadan, Ibadan, Oyo State Nigeria
- Department of Biochemistry, Faculty of Basic Medical Sciences, Ladoke Akintola University of Technology, Ogbomoso, Oyo State Nigeria
- Department of Biotechnology, Institute of Basic and Applied Sciences, Egypt-Japan University of Science and Technology, New Borg El-Arab, Alexandria, Egypt
| | - Oluwatomiwa K. Paimo
- Department of Biochemistry, Faculty of Basic Medical Sciences, College of Medicine, University of Ibadan, Ibadan, Oyo State Nigeria
- Department of Biochemistry, College of Biosciences, Federal University of Agriculture, Abeokuta, Ogun State Nigeria
| | - Fikayo N. Adegboyega
- Department of Biochemistry, Faculty of Basic Medical Sciences, Ladoke Akintola University of Technology, Ogbomoso, Oyo State Nigeria
- Department of Biotechnology, Institute of Basic and Applied Sciences, Egypt-Japan University of Science and Technology, New Borg El-Arab, Alexandria, Egypt
| | - Oludare M. Ogunyemi
- Department of Biochemistry, Faculty of Basic Medical Sciences, College of Medicine, University of Ibadan, Ibadan, Oyo State Nigeria
| | - Rukayat O. Akano
- Department of Biochemistry, Faculty of Basic Medical Sciences, Ladoke Akintola University of Technology, Ogbomoso, Oyo State Nigeria
| | - Sherif F. Hammad
- Department of Biotechnology, Institute of Basic and Applied Sciences, Egypt-Japan University of Science and Technology, New Borg El-Arab, Alexandria, Egypt
| | - Mohamed A. Ghazy
- Department of Biotechnology, Institute of Basic and Applied Sciences, Egypt-Japan University of Science and Technology, New Borg El-Arab, Alexandria, Egypt
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15
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Castelo M, Paszat L, Hansen BE, Scheer AS, Faught N, Nguyen L, Baxter NN. Comparing Time to Diagnosis and Treatment Between Younger and Older Adults With Colorectal Cancer: A Population-Based Study. Gastroenterology 2023; 164:1152-1164. [PMID: 36841489 DOI: 10.1053/j.gastro.2023.02.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 01/15/2023] [Accepted: 02/09/2023] [Indexed: 02/27/2023]
Abstract
BACKGROUND & AIMS Younger adults (aged <50 years) with colorectal cancer (CRC) may have prolonged delays to diagnosis and treatment that are associated with adverse outcomes. We compared delay intervals by age for patients with CRC in a large population. METHODS This was a population-based study of adults diagnosed with CRC in Ontario, Canada, from 2003 to 2018. We measured the time between presentation and diagnosis (diagnostic interval), diagnosis and treatment start (treatment interval), and the time from presentation to treatment (overall interval). We compared interval lengths between adults aged <50 years, 50 to 74 years, and 75 to 89 years using multivariable quantile regression. RESULTS Included were 90,225 patients with CRC. Of these, 6853 patients (7.6%) were aged <50 years. Younger patients were more likely to be women, present emergently, have stage IV disease, and have rectal cancer compared with middle-aged patients. Factors associated with significantly longer overall intervals included female sex (8.7 days; 95% confidence interval [CI], 6.6-10.9 days) and rectal cancer compared with proximal colon cancer (9.8 days; 95% CI, 7.4-2.2 days). After adjustment, adults aged <50 years had significantly longer diagnostic intervals (4.3 days; 95% CI. 1.3-7.3 days) and significantly shorter treatment intervals (-4.5 days; 95% CI, -5.3 to -3.7 days) compared with middle-aged patients. However, there was no significant difference in the overall interval (-0.6 days; 95% CI, -4.3 to 3.2 days). In stratified models, younger adults with stage IV disease who presented emergently and patients aged >75 years had longer overall intervals. CONCLUSIONS Younger adults present more often with stage IV CRC but have overall similar times from presentation to treatment as screening-eligible older adults.
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Affiliation(s)
- Matthew Castelo
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; ICES, Toronto, Ontario, Canada
| | - Lawrence Paszat
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; ICES, Toronto, Ontario, Canada
| | - Bettina E Hansen
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Adena S Scheer
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada
| | | | | | - Nancy N Baxter
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; ICES, Toronto, Ontario, Canada; Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada; School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.
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16
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Rommasi F. Identification, characterization, and prognosis investigation of pivotal genes shared in different stages of breast cancer. Sci Rep 2023; 13:8447. [PMID: 37231064 DOI: 10.1038/s41598-023-35318-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 05/16/2023] [Indexed: 05/27/2023] Open
Abstract
One of the leading causes of death (20.1 per 100,000 women per year), breast cancer is the most prevalent cancer in females. Statistically, 95% of breast cancer are categorized as adenocarcinomas, and 55% of all patients may go into invasive phases; however, it can be successfully treated in approximately 70-80% of cases if diagnosed in the nascent stages. The emergence of breast tumor cells which are intensely resistant to conventional therapies, along with the high rate of metastasis occurrence, has highlighted the importance of finding novel strategies and treatments. One of the most advantageous schemes to alleviate this complication is to identify the common differentially expressed genes (DEGs) among primary and metastatic cancerous cells to use resultants for designing new therapeutic agents which are able to target both primary and metastatic breast tumor cells. In this study, the gene expression dataset with accession number GSE55715 was analyzed containing two primary tumor samples, three bone-metastatic samples, and three normal samples to distinguish the up- and down regulated genes in each stage compared to normal cells as control. In the next step, the common upregulated genes between the two experimental groups were detected by Venny online tool. Moreover, gene ontology, functions and pathways, gene-targeting microRNA, and influential metabolites were determined using EnrichR 2021 GO, KEGG pathways miRTarbase 2017, and HMDB 2021, respectively. Furthermore, elicited from STRING protein-protein interaction networks were imported to Cytoscape software to identify the hub genes. Then, identified hub genes were checked to validate the study using oncological databases. The results of the present article disclosed 1263 critical common DEGs (573 upregulated + 690 downregulated), including 35 hub genes that can be broadly used as new targets for cancer treatment and as biomarkers for cancer detection by evaluation of expression level. Besides, this study opens a new horizon to reveal unknown aspects of cancer signaling pathways by providing raw data evoked from in silico experiments. This study's outcomes can also be widely utilized in further lab research since it contains diverse information on common DEGs of varied stages and metastases of breast cancer, their functions, structures, interactions, and associations.
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Affiliation(s)
- Foad Rommasi
- Department of Biochemistry, Faculty of Biological Sciences, Tarbiat Modares University, Tehran, Iran.
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17
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Brogowska KK, Zajkowska M, Mroczko B. Vascular Endothelial Growth Factor Ligands and Receptors in Breast Cancer. J Clin Med 2023; 12:jcm12062412. [PMID: 36983412 PMCID: PMC10056253 DOI: 10.3390/jcm12062412] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 03/14/2023] [Accepted: 03/20/2023] [Indexed: 03/30/2023] Open
Abstract
Breast cancer (BC) is the most common malignancy responsible for the largest number of deaths in women worldwide. The risk of developing BC is predisposed by many factors such as age, presence of genetic mutations or body weight. The diagnosis is mostly made relatively late, which is why patients are exposed to radical surgical treatments, long-term chemotherapy and lower survival rates. There are no sufficiently sensitive and specific screening tests; therefore, researchers are still looking for new diagnostic biomarkers that would indicate the appearance of neoplastic changes in the initial stage of neoplasm. The VEGF family of proteins (VEGF-A, VEGF-B, VEGF-C, VEGF-D, EG-VEGF, PlGF) and their receptors are significant factors in the pathogenesis of BC. They play a significant role in the process of angiogenesis and lymphangiogenesis in both physiological and pathological conditions. The usefulness of these proteins as potential diagnostic biomarkers has been initially proven. Moreover, the blockage of VEGF-related pathways seems to be a valid therapeutic target. Recent studies have tried to describe novel strategies, including targeting pericytes, use of miRNAs and extracellular tumor-associated vesicles, immunotherapeutic drugs and nanotechnology. This indicates their possible contribution to the formation of breast cancer and their usefulness as potential biomarkers and therapeutic targets.
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Affiliation(s)
| | - Monika Zajkowska
- Department of Neurodegeneration Diagnostics, Medical University of Bialystok, 15-269 Bialystok, Poland
| | - Barbara Mroczko
- Department of Neurodegeneration Diagnostics, Medical University of Bialystok, 15-269 Bialystok, Poland
- Department of Biochemical Diagnostics, Medical University of Bialystok, 15-269 Bialystok, Poland
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El Maouchi P, Fakhreddine O, Shmoury AH, El Zoghbi M, Chamseddine N, Abou Zeidane R, Amhaz G, Charafeddine M, Kazarian H, Assi HI. Breast cancer knowledge in Lebanese females with positive family history. Medicine (Baltimore) 2023; 102:e32973. [PMID: 36800620 PMCID: PMC9936015 DOI: 10.1097/md.0000000000032973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/19/2023] Open
Abstract
Breast cancer is the most commonly diagnosed cancer in women and the second leading cause of cancer-related death worldwide. Positive family history increases the likelihood of developing this disease. As late-stage presentation and poor survival rates are associated with a lack of knowledge about breast cancer and its screening methods, this study aimed to evaluate the knowledge of Lebanese women with first-degree relatives who were diagnosed with breast cancer. In this cross-sectional study, 200 women with a positive family history accompanying their relatives to oncology clinics or the infusion center at the American University of Beirut Medical Center, completed an online survey after institutional review board approval was granted. Demographic information and answers to questions related to breast cancer risk factors, warning signs, and screening techniques were collected and analyzed using descriptive statistics and chi-square tests. Eighty-one percent of the study participants agreed that a history of breast cancer is associated with a higher disease risk. The smaller portions were aware of other potential risk factors, such as hormone replacement therapy, alcohol consumption, late menopause, early menarche, and overweight and sedentary lifestyles. Also, 93% to 96.5% of the participants recognized breast self-examination and mammography as useful tools for early detection. Furthermore, younger participants who reached university level and were employed had more insights into breast cancer. Breast cancer knowledge and early diagnosis are key elements in preventing late presentations and reducing the associated morbidity and mortality. Further educational and awareness campaigns should be conducted in Lebanon to improve women knowledge of breast cancer.
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Affiliation(s)
- Paul El Maouchi
- Department of Internal Medicine, MedStar Health, Baltimore, MD
| | - Omar Fakhreddine
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | | | | | - Nathalie Chamseddine
- Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Reine Abou Zeidane
- Department of Internal Medicine, Division of Hematology-Oncology, Naef K. Basile Cancer Institute, American University of Beirut Medical Center, Beirut, Lebanon
| | - Ghid Amhaz
- Department of Internal Medicine, Division of Hematology-Oncology, Naef K. Basile Cancer Institute, American University of Beirut Medical Center, Beirut, Lebanon
| | - Maya Charafeddine
- Department of Internal Medicine, Division of Hematology-Oncology, Naef K. Basile Cancer Institute, American University of Beirut Medical Center, Beirut, Lebanon
| | - Houry Kazarian
- Department of Internal Medicine, Division of Hematology-Oncology, Naef K. Basile Cancer Institute, American University of Beirut Medical Center, Beirut, Lebanon
| | - Hazem I. Assi
- Department of Internal Medicine, Division of Hematology-Oncology, Naef K. Basile Cancer Institute, American University of Beirut Medical Center, Beirut, Lebanon
- * Correspondence: Hazem I. Assi, Department of Internal Medicine, American University of Beirut Medical Center, P.O. Box: 11-0236, Riad El Solh 1107 2020, Beirut, Lebanon (e-mail: )
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Gozalishvilli-Boncheva A, Gonzalez-Espinoza IR, Castro-Ponce A, Bravo-Gutiérrez OA, Juárez-Salazar G, Montes-de-Oca-Moreda RI, Aguirre-Flores E, Coyotl-Huexotl M, Orozco-Luis J, Chiquillo-Domínguez M, Garibay-Díaz JC, Aranda-Claussen JE, Ponce-de-León EA, Sánchez-Sosa S, Sabaté-Fernández M, García-Reyna JC, Cordero-Vargas C, González-Blanco MJ, Aguilar-Priego JM, Sánchez-Fernández NJ, Cortés-García CA, González-Lozada LE, Miguel-Cruz E, Ceja-Utrera FJ, Hernández-Garcia MS, Piña-Vazquez M, Aguilar-Jiménez C. Observational analysis of clinical and pathological characteristics and their prognostic impact in Mexican patients with breast cancer: A multi-center study. Breast Dis 2023; 42:305-313. [PMID: 37807773 DOI: 10.3233/bd-230025] [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: 10/10/2023]
Abstract
Breast cancer is the most incidental and deadly neoplasm worldwide; in Mexico, very few epidemiologic reports have analyzed the pathological features and its impact on their clinical outcome. Here, we studied the relation between pathological features and the clinical presentation at diagnosis and their impact on the overall and progression-free survival of patients with breast cancer. For this purpose, we collected 199 clinical records of female patients, aged at least 18 years old (y/o), with breast cancer diagnosis confirmed by biopsy. We excluded patients with incomplete or conflicting clinical records. Afterward, we performed an analysis of overall and progression-free survival and associated risks. Our results showed an average age at diagnosis of 52 y/o (24-85), the most common features were: upper outer quadrant tumor (32%), invasive ductal carcinoma (76.8%), moderately differentiated (44.3%), early clinical stages (40.8%), asymptomatic patients (47.8%), luminal A subtype (47.8%). Median overall survival was not reached, but median progression-free survival was 32.2 months (29.75-34.64, CI 95%) associated risk were: clinical stage (p < 0.0001) symptomatic presentation (p = 0.009) and histologic grade (p = 0.02). Therefore, we concluded that symptom presence at diagnosis impacts progression-free survival, and palpable symptoms are related to an increased risk for mortality.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Juan Orozco-Luis
- Centro oncológico integral Hospital Ángeles Puebla, Puebla, México
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Vedsted P, Weller D, Zalounina Falborg A, Jensen H, Kalsi J, Brewster D, Lin Y, Gavin A, Barisic A, Grunfeld E, Lambe M, Malmberg M, Turner D, Harland E, Hawryluk B, Law RJ, Neal RD, White V, Bergin R, Harrison S, Menon U. Diagnostic pathways for breast cancer in 10 International Cancer Benchmarking Partnership (ICBP) jurisdictions: an international comparative cohort study based on questionnaire and registry data. BMJ Open 2022; 12:e059669. [PMID: 36521881 PMCID: PMC9756230 DOI: 10.1136/bmjopen-2021-059669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 11/18/2022] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES A growing body of evidence suggests longer time between symptom onset and start of treatment affects breast cancer prognosis. To explore this association, the International Cancer Benchmarking Partnership Module 4 examined differences in breast cancer diagnostic pathways in 10 jurisdictions across Australia, Canada, Denmark, Norway, Sweden and the UK. SETTING Primary care in 10 jurisdictions. PARTICIPANT Data were collated from 3471 women aged >40 diagnosed for the first time with breast cancer and surveyed between 2013 and 2015. Data were supplemented by feedback from their primary care physicians (PCPs), cancer treatment specialists and available registry data. PRIMARY AND SECONDARY OUTCOME MEASURES Patient, primary care, diagnostic and treatment intervals. RESULTS Overall, 56% of women reported symptoms to primary care, with 66% first noticing lumps or breast changes. PCPs reported 77% presented with symptoms, of whom 81% were urgently referred with suspicion of cancer (ranging from 62% to 92%; Norway and Victoria). Ranges for median patient, primary care and diagnostic intervals (days) for symptomatic patients were 3-29 (Denmark and Sweden), 0-20 (seven jurisdictions and Ontario) and 8-29 (Denmark and Wales). Ranges for median treatment and total intervals (days) for all patients were 15-39 (Norway, Victoria and Manitoba) and 4-78 days (Sweden, Victoria and Ontario). The 10% longest waits ranged between 101 and 209 days (Sweden and Ontario). CONCLUSIONS Large international differences in breast cancer diagnostic pathways exist, suggesting some jurisdictions develop more effective strategies to optimise pathways and reduce time intervals. Targeted awareness interventions could also facilitate more timely diagnosis of breast cancer.
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Affiliation(s)
- Peter Vedsted
- Department for Clinical Medicine, Aarhus Universitet, Aarhus, Denmark
- Department of Public Health, Research Unit for General Practice, Aarhus University, Aarhus C, Denmark
| | - David Weller
- General Practice, University of Edinburgh, Edinburgh, UK
| | - Alina Zalounina Falborg
- Department of Public Health, Research Unit for General Practice, Aarhus University, Aarhus C, Denmark
| | - Henry Jensen
- Department of Public Health, Research Unit for General Practice, Aarhus University, Aarhus C, Denmark
| | - Jatinderpal Kalsi
- Gynaecological Cancer Research Centre, University College London, London, UK
| | - David Brewster
- Scottish Registry, Information Services Division, NHS National Services Scotland, Edinburgh, UK
| | - Yulan Lin
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, Fujian, China
| | - Anna Gavin
- N Ireland Cancer Registry, Queen's University Belfast, Belfast, UK
| | | | - Eva Grunfeld
- Department of Family and Community Medicine, Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - Mats Lambe
- University Hospital, Regional Cancer Centre of Central Sweden, Uppsala, Sweden
| | - Martin Malmberg
- Department of Oncology, Lund University Hospital, Lund, Sweden
| | - Donna Turner
- Population Oncology, Cancer Care Manitoba, Winnipeg, Manitoba, Canada
| | - Elizabeth Harland
- Department of Epidemiology and Cancer Registry, CancerCare Manitoba, Winnipeg, Manitoba, Canada
| | - Breann Hawryluk
- Patient Navigation, CancerCare Manitoba, Winnipeg, Manitoba, Canada
| | - Rebecca-Jane Law
- North Wales Centre for Primary Care Research, Bangor University, Bangor, UK
| | | | - Victoria White
- CBRC, Cancer Council Victoria, Melbourne, Victoria, Australia
- Deakin University Faculty of Health, Burwood, Victoria, Australia
| | - Rebecca Bergin
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
| | | | - Usha Menon
- Women's Cancer, University College London, London, UK
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Lee J, Park NJY, Park HY, Kim WW, Kang B, Keum H, Kim HJ, Kim WH, Chae YS, Lee SJ, Lee IH, Park JY, Jung JH. Oncologic necessity for the complete removal of residual microcalcifications after neoadjuvant chemotherapy for breast cancer. Sci Rep 2022; 12:21535. [PMID: 36513704 PMCID: PMC9748126 DOI: 10.1038/s41598-022-24757-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 11/21/2022] [Indexed: 12/15/2022] Open
Abstract
The surgical range of breast cancer that shows pathologic complete response (pCR) without change in microcalcifications after neoadjuvant chemotherapy (NAC) is controversial. This study examined whole breast specimens to evaluate the necessity of mastectomy in those cases. The viability of cancer cells around the residual microcalcification was assessed using prospectively collected breast samples to confirm the presence or absence of cancer cells. A total of 144 patients with breast cancer and diffuse microcalcifications were classified into the reduced mass with no change in residual microcalcification (RESMIN, n = 49) and non-RESMIN (n = 95) groups. Five specimens were prospectively evaluated to assess the presence of viable cancer cells around the microcalcification. Tumor responses to NAC were significantly better with high pCR rates in the RESMIN group (p = 0.005 and p = 0.002). The incidence of human epidermal growth factor receptor 2-positive and triple-negative breast cancers was significantly high in the RESMIN group (p = 0.007). Although five (10.2%) patients had locoregional recurrence in the RESMIN group, no local recurrence in the breast was reported. Although pCR was highly estimated, residual cancers, including ductal carcinoma in situ, remained in 80% cases. Therefore, given the weak scientific evidence available currently, complete removal of residual microcalcifications should be considered for oncologic safety.
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Affiliation(s)
- Jeeyeon Lee
- grid.258803.40000 0001 0661 1556Department of Surgery, School of Medicine, Kyungpook National University, Daegu, Republic of Korea ,grid.258803.40000 0001 0661 1556Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea
| | - Nora Jee-Young Park
- grid.258803.40000 0001 0661 1556Department of Pathology, School of Medicine, Kyungpook National University, Daegu, Republic of Korea ,grid.258803.40000 0001 0661 1556Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea
| | - Ho Yong Park
- grid.258803.40000 0001 0661 1556Department of Surgery, School of Medicine, Kyungpook National University, Daegu, Republic of Korea ,grid.258803.40000 0001 0661 1556Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea
| | - Wan Wook Kim
- grid.258803.40000 0001 0661 1556Department of Surgery, School of Medicine, Kyungpook National University, Daegu, Republic of Korea ,grid.258803.40000 0001 0661 1556Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea
| | - Byeongju Kang
- grid.258803.40000 0001 0661 1556Department of Surgery, School of Medicine, Kyungpook National University, Daegu, Republic of Korea ,grid.258803.40000 0001 0661 1556Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea
| | - Heejung Keum
- grid.258803.40000 0001 0661 1556Department of Surgery, School of Medicine, Kyungpook National University, Daegu, Republic of Korea ,grid.258803.40000 0001 0661 1556Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea
| | - Hye Jung Kim
- grid.258803.40000 0001 0661 1556Department of Radiology, School of Medicine, Kyungpook National University, Daegu, Republic of Korea ,grid.258803.40000 0001 0661 1556Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea
| | - Won Hwa Kim
- grid.258803.40000 0001 0661 1556Department of Radiology, School of Medicine, Kyungpook National University, Daegu, Republic of Korea ,grid.258803.40000 0001 0661 1556Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea
| | - Yee Soo Chae
- grid.258803.40000 0001 0661 1556Department of Hematology/Oncology, School of Medicine, Kyungpook National University, Daegu, Republic of Korea ,grid.258803.40000 0001 0661 1556Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea
| | - Soo Jung Lee
- grid.258803.40000 0001 0661 1556Department of Hematology/Oncology, School of Medicine, Kyungpook National University, Daegu, Republic of Korea ,grid.258803.40000 0001 0661 1556Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea
| | - In Hee Lee
- grid.258803.40000 0001 0661 1556Department of Hematology/Oncology, School of Medicine, Kyungpook National University, Daegu, Republic of Korea ,grid.258803.40000 0001 0661 1556Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea
| | - Ji-Young Park
- grid.258803.40000 0001 0661 1556Department of Pathology, School of Medicine, Kyungpook National University, Daegu, Republic of Korea ,grid.258803.40000 0001 0661 1556Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea
| | - Jin Hyang Jung
- grid.258803.40000 0001 0661 1556Department of Surgery, School of Medicine, Kyungpook National University, Daegu, Republic of Korea ,grid.258803.40000 0001 0661 1556Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea
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22
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Pulappadi VP, Dhamija E, Baby A, Mathur S, Pandey S, Gogia A, Deo SVS. Imaging Features of Breast Cancer Subtypes on Mammography and Ultrasonography: an Analysis of 479 Patients. Indian J Surg Oncol 2022; 13:931-938. [PMID: 36687228 PMCID: PMC9845486 DOI: 10.1007/s13193-022-01606-7] [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: 05/17/2022] [Accepted: 07/19/2022] [Indexed: 01/25/2023] Open
Abstract
To compare features of clinically defined subtypes of breast cancer on mammography (MG) and ultrasonography (USG). After obtaining approval from the institute ethics committee, a retrospective observational study was performed on biopsy-proven breast cancer patients who underwent baseline MG from 2016 to 2020. MG and USG features were evaluated and the patients were classified based on immunohistochemistry profile into luminal like (LL)-oestrogen receptor (ER)/progesterone receptor (PR) + , Her2neu-; basal like (BL)-ER/PR-, Her2neu-; Her2 like (HL)-Her2neu + . A total of 479 patients (mean age, 51.4 ± 11.7 years; all females) were included: LL-198 (41.3%), BL-121 (25.2%) and HL-160 (33.3%). On MG, round shape (21/115, 18.3%, p < 0.001); circumscribed (16/115, 13.9%, p < 0.001) and microlobulated margins (28/115, 24.4%) were associated with BL tumours. Associated suspicious calcifications (96/160, 60%, p < 0.001) and skin thickening or retraction (75/149, 50.3%, p < 0.001) were more common in HL. On USG, round shape (12/95, 12.8%, p = 0.005); circumscribed (8/94, 8.5%) and microlobulated margins (44/94, 46.8%) and posterior acoustic enhancement (7/95, 7.5%, p = 0.012) were associated with BL. The logistic regression analysis revealed that spiculated margins on MG favoured LL (OR: 8.5, p = 0.001); round shape (OR: 6.8), circumscribed (OR: 10.8) or microlobulated margins (OR: 3.5) (p < 0.001 for each) favoured BL; whereas associated features of calcifications (OR: 3.3) (p = 0.019) and skin retraction or thickening (OR: 1.8) (p < 0.001) favoured HL. On USG, circumscribed (OR: 5.9, p = 0.005) or microlobulated margins (OR: 3, p < 0.001) and posterior acoustic enhancement (OR: 9.5, p = 0.006) favoured BL. Clinically defined subtypes of breast cancer show significant differences in the imaging appearances on mammography and USG. BL tumours may not show the typical imaging features of malignancy, necessitating clinicopathological correlation for accurate diagnosis.
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Affiliation(s)
- Vishnu Prasad Pulappadi
- Department of Radiodiagnosis and Interventional Radiology, Dr. BR Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, 110029 India
| | - Ekta Dhamija
- Department of Radiodiagnosis and Interventional Radiology, Dr. BR Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, 110029 India
| | - Akhil Baby
- Department of Radiodiagnosis and Interventional Radiology, Dr. BR Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, 110029 India
| | - Sandeep Mathur
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, 110029 India
| | - Shivam Pandey
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, 110029 India
| | - Ajay Gogia
- Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, 110029 India
| | - S. V. S. Deo
- Department of Surgical Oncology, All India Institute of Medical Sciences, New Delhi, 110029 India
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23
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Sullivan E, Safi N, Li Z, Remond M, Chen TYT, Javid N, Dickinson JE, Ives A, Hammarberg K, Anazodo A, Boyle F, Fisher J, Halliday L, Duncombe G, McLintock C, Wang AY, Saunders C. Perinatal outcomes of women with gestational breast cancer in Australia and New Zealand: A prospective population-based study. Birth 2022; 49:763-773. [PMID: 35470904 PMCID: PMC9790712 DOI: 10.1111/birt.12642] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 02/22/2022] [Accepted: 04/07/2022] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To determine the epidemiology, clinical management, and outcomes of women with gestational breast cancer (GBC). METHODS A population-based prospective cohort study was conducted in Australia and New Zealand between 2013 and 2014 using the Australasian Maternity Outcomes Surveillance System (AMOSS). Women who gave birth with a primary diagnosis of breast cancer during pregnancy were included. Data were collected on demographic and pregnancy factors, GBC diagnosis, obstetric and cancer management, and perinatal outcomes. The main outcome measures were preterm birth, maternal complications, breastfeeding, and death. RESULTS Forty women with GBC (incidence 7.5/100 000 women giving birth) gave birth to 40 live-born babies. Thirty-three (82.5%) women had breast symptoms at diagnosis. Of 27 women diagnosed before 30 weeks' gestation, 85% had breast surgery and 67% had systemic therapy during pregnancy. In contrast, all 13 women diagnosed from 30 weeks had their cancer management delayed until postdelivery. There were 17 preterm deliveries; 15 were planned. Postpartum complications included the following: hemorrhage (n = 4), laparotomy (n = 1), and thrombocytopenia (n = 1). There was one late maternal death. Eighteen (45.0%) women initiated breastfeeding, including 12 of 23 women who had antenatal breast surgery. There were no perinatal deaths or congenital malformations, but 42.5% of babies were preterm, and 32.5% were admitted for higher-level neonatal care. CONCLUSIONS Gestational breast cancer diagnosed before 30 weeks' gestation was associated with surgical and systemic cancer care during pregnancy and planned preterm birth. In contrast, cancer treatment was deferred to postdelivery for women diagnosed from 30 weeks, reflecting the complexity of managing expectant mothers with GBC in multidisciplinary care settings.
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Affiliation(s)
- Elizabeth Sullivan
- College of Health, Medicine and WellbeingUniversity of NewcastleNewcastleNew South WalesAustralia
| | - Nadom Safi
- College of Health, Medicine and WellbeingUniversity of NewcastleNewcastleNew South WalesAustralia
| | - Zhuoyang Li
- College of Health, Medicine and WellbeingUniversity of NewcastleNewcastleNew South WalesAustralia
| | - Marc Remond
- College of Health, Medicine and WellbeingUniversity of NewcastleNewcastleNew South WalesAustralia
| | - Tina Y. T. Chen
- Faculty of HealthUniversity of Technology SydneySydneyNew South WalesAustralia
| | - Nasrin Javid
- Faculty of HealthUniversity of Technology SydneySydneyNew South WalesAustralia
| | - Jan E. Dickinson
- Faculty of Health and Medical SciencesThe University of Western AustraliaPerthWestern AustraliaAustralia
| | - Angela Ives
- Faculty of Health and Medical Sciences, Medical SchoolThe University of Western AustraliaPerthWestern AustraliaAustralia
| | - Karin Hammarberg
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
| | - Antoinette Anazodo
- School of Women and ChildrenUniversity of New South WalesSydneyNew South WalesAustralia
| | - Frances Boyle
- Patricia Ritchie Centre for Cancer Care and ResearchMater Hospital Sydney, and University of SydneySydneyNew South WalesAustralia
| | - Jane Fisher
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
| | - Lesley Halliday
- School of Public Health and Community MedicineUniversity of New South WalesSydneyNew South WalesAustralia
| | - Greg Duncombe
- Faculty of Medicine, Centre for Clinical ResearchUniversity of QueenslandBrisbaneQueenslandAustralia
| | - Claire McLintock
- National Women's HealthAuckland City HospitalAucklandNew Zealand
| | - Alex Y. Wang
- Faculty of HealthUniversity of Technology SydneySydneyNew South WalesAustralia
| | - Christobel Saunders
- Faculty of Health and Medical SciencesThe University of Western AustraliaPerthWestern AustraliaAustralia
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24
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Castelo M, Paszat L, Hansen BE, Scheer AS, Faught N, Nguyen L, Baxter NN. Measurement of clinical delay intervals among younger adults with colorectal cancer using health administrative data: a population-based analysis. BMJ Open Gastroenterol 2022; 9:bmjgast-2022-001022. [PMID: 36410773 PMCID: PMC9680148 DOI: 10.1136/bmjgast-2022-001022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 11/07/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Clinical delays may be important contributors to outcomes among younger adults (<50 years) with colorectal cancer (CRC). We aimed to describe delay intervals for younger adults with CRC using health administrative data to understand drivers of delay in this population. METHODS This was a population-based study of adults <50 diagnosed with CRC in Ontario, Canada from 2003 to 2018. Using administrative code-based algorithms (including billing codes), we identified four time points along the pathway to treatment-first presentation with a CRC-related symptom, first investigation, diagnosis date and treatment start. Intervals between these time points were calculated. Multivariable quantile regression was performed to explore associations between patient and disease factors with the median length of each interval. RESULTS 6853 patients aged 15-49 were diagnosed with CRC and met the inclusion criteria. Males comprised 52% of the cohort, the median age was 45 years (IQR 40-47), and 25% had stage IV disease. The median time from presentation to treatment start (overall interval) was 109 days (IQR 55-218). Time between presentation and first investigation was short (median 5 days), as was time between diagnosis and treatment start (median 23 days). The greatest component of delay occurred between first investigation and diagnosis (median 78 days). Women, patients with distal tumours, and patients with earlier stage disease had significantly longer overall intervals. CONCLUSIONS Some younger CRC patients experience prolonged times from presentation to treatment, and time between first investigation to diagnosis was an important contributor. Access to endoscopy may be a target for intervention.
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Affiliation(s)
- Matthew Castelo
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada,ICES, Toronto, Ontario, Canada
| | - Lawrence Paszat
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada,ICES, Toronto, Ontario, Canada
| | - Bettina E Hansen
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Adena S Scheer
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada,Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | | | | | - Nancy N Baxter
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada,ICES, Toronto, Ontario, Canada,Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada,School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
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25
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Ayipo YO, Ajiboye AT, Osunniran WA, Jimoh AA, Mordi MN. Epigenetic oncogenesis, biomarkers and emerging chemotherapeutics for breast cancer. BIOCHIMICA ET BIOPHYSICA ACTA. GENE REGULATORY MECHANISMS 2022; 1865:194873. [PMID: 36064110 DOI: 10.1016/j.bbagrm.2022.194873] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 08/20/2022] [Accepted: 08/28/2022] [Indexed: 06/15/2023]
Abstract
Breast cancer remains one of the leading causes of cancer-related deaths globally and the most prominent among females, yet with limited effective therapeutic options. Most of the current medications are challenged by various factors including low efficacy, incessant resistance, immune evasion and frequent recurrence of the disease. Further understanding of the prognosis and identification of plausible therapeutic channels thus requires multimodal approaches. In this review, epigenetics studies of several pathways to BC oncogenesis via the inducement of oncogenic changes on relevant markers have been overviewed. Similarly, the counter-epigenetic mechanisms to reverse such changes as effective therapeutic strategies were surveyed. The epigenetic oncogenesis occurs through several pathways, notably, DNMT-mediated hypermethylation of DNA, dysregulated expression for ERα, HER2/ERBB and PR, histone modification, overexpression of transcription factors including the CDK9-cyclin T1 complex and suppression of tumour suppressor genes. Scientifically, the regulatory reversal of the mechanisms constitutes effective epigenetic approaches for mitigating BC initiation, progression and metastasis. These were exhibited at various experimental levels by classical chemotherapeutic agents including some repurposable drugs, endocrine inhibitors, monoclonal antibodies and miRNAs, natural products, metal complexes and nanoparticles. Dozens of the potential candidates are currently in clinical trials while others are still at preclinical experimental stages showing promising anti-BC efficacy. The review presents a model for a wider understanding of epigenetic oncogenic pathways to BC and reveals plausible channels for reversing the unpleasant changes through epigenetic modifications. It advances the science of therapeutic designs for ameliorating the global burden of BC upon further translational studies.
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Affiliation(s)
- Yusuf Oloruntoyin Ayipo
- Centre for Drug Research, Universiti Sains Malaysia, USM, 11800 Pulau Pinang, Malaysia; Department of Chemistry and Industrial Chemistry, Kwara State University, P.M.B., Malete, 1530 Ilorin, Nigeria.
| | - Abdulfatai Temitope Ajiboye
- Department of Chemistry and Industrial Chemistry, Kwara State University, P.M.B., Malete, 1530 Ilorin, Nigeria
| | - Wahab Adesina Osunniran
- Department of Chemistry and Industrial Chemistry, Kwara State University, P.M.B., Malete, 1530 Ilorin, Nigeria
| | - Akeem Adebayo Jimoh
- Department of Chemistry and Industrial Chemistry, Kwara State University, P.M.B., Malete, 1530 Ilorin, Nigeria
| | - Mohd Nizam Mordi
- Centre for Drug Research, Universiti Sains Malaysia, USM, 11800 Pulau Pinang, Malaysia
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Zainul Azlan N, Azhar AA, Abd. Jalil MA. Knowledge Level on Breast Cancer and Breast Self-Examination (BSE) Practice Among Female University Students. INTERNATIONAL JOURNAL OF CARE SCHOLARS 2022; 5:46-57. [DOI: 10.31436/ijcs.v5i2.249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
Introduction: Breast cancer is the most common cancer affecting women in Malaysia and therefore, it is important to recognize the early signs and symptoms of breast cancer. In addition, breast self?examination (BSE) also has been suggested as a valuable technique for the early diagnosis of breast cancer. Therefore, this study aimed to assess the level of knowledge on breast cancer and breast self-examination (BSE); and determine the practice of BSE among female student in International Islamic University Malaysia (IIUM), Kuantan, Pahang. Methods: A quantitative cross-sectional study with stratified random sampling method was conducted among 245 female students in IIUM Kuantan Campus, from April to May 2021. Data were gathered by using Google Forms platform which was available in English Language and were distributed to female undergraduate students. The questionnaire was adapted from three sets of questionnaires, Nimir et al., (2014), Erdem and Toktas (2016) and Tewabe and Mekuria (2019). Data analysis was done by using SPSS version 23.0. Results: Majority of the participants (98.0%) have high knowledge regarding the knowledge on risk factors, signs and symptoms of breast cancer and breast self-examination (BSE). The result also showed that 31.0% participants never performed BSE. Most of them reported that the reasons that they do not perform BSE are due to lack of knowledge (35.1%), forgetfulness (33.9%) and negligence (21.6%). Around 36.3% participants reported that they do not know the technique that use to perform BSE.Conclusion: Participants having high knowledge on breast cancer and BSE; however, the practice of BSE is still lacking. Therefore, BSE need to be more educate and promote its practice among young women for early detection of breast cancer and its prevention.
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27
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Akanksha, Mishra SP, Kar AG, Karthik JS, Srivastava A, Khanna R, Meena RN. Expression of Poly(Adenosine Diphosphate-Ribose) Polymerase Protein in Breast Cancer. J Midlife Health 2022; 13:213-224. [PMID: 36950213 PMCID: PMC10025820 DOI: 10.4103/jmh.jmh_132_22] [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: 07/15/2022] [Revised: 09/09/2022] [Accepted: 09/19/2022] [Indexed: 01/28/2023] Open
Abstract
Background The use of poly(adenosine diphosphate-ribose) polymerase (PARP) inhibitors for breast cancer (BC) therapy is the subject of debate, and there is an urgent need to understand much the expression and prognostic role of the PARP1 protein. In this study, we have compared the expression of PARP between BC and benign breast disease (BBD) patients and also analyzed the association of PARP expression with clinicopathological parameters in BC. Methods The study consists of 30 patients with newly diagnosed operable BC who were planned for surgery without neoadjuvant chemotherapy and 15 patients of BBD as a control between 2019 and 2021. Immunohistochemical analyses were performed prospectively on tissue samples. Anti-human PARP1 rabbit polyclonal antibody gives strong nuclear positivity. Internal control was the adipose tissue and the BBD acted as the external control. PARP1 expression was evaluated using the multiplicative quickscore method. Results The mean age for BC patients was 51.30 ± 10.694 years (range: 25-75 years) while BBD was below 30 years. Overexpression of PARP was present in 25 (83.3%) and weak expression in 5 (16.7%) of BC patients compared to BBD, only 2 (13.3%) patients demonstrated an overexpression of PARP, and 13 (86.6%) patients showed weak expression which showed significant association (P < 0.001). In BC, nuclear PARP (nPARP) overexpression was seen in 22 (73.3%) patients and weak expression of nPARP in 8 (26.7%), whereas 5 (16.7%) patients showed cytoplasmic overexpression. On comparing expression of PARP with clinicopathological parameters, PARP overexpression was significantly associated with older population (age >50 years) (P = 0.002), postmenopausal women (P = 0.029), higher TNM stage (Stage II and III) (P = 0.014), higher histological grade (grade 2) (P = 0.043), and presence of lymphovascular invasion (P = 0.015). Enhanced PARP1 expression is closely correlated with positive estrogen receptor status (P = 0.001) and PR status (P = 0.001). Overall PARP and nPARP overexpression was significantly associated with ER- (P = 0.006 and P = 0.008) and PR-positive (P = 0.006 and P = 0.008) patients. The PARP and nPARP overexpression was significantly associated with nontriple-negative BC patients (P = 0.001 and P = 0.001). Conclusion We have not come across any study in the literature to compare PARP expression in BC and BBD patients. On the basis of our observations, we concluded that PARP overexpression is a poor prognostic marker in BC.
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Affiliation(s)
- Akanksha
- Department of General Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, UP, India
| | - Shashi Prakash Mishra
- Department of General Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, UP, India
| | - Amrita Ghosh Kar
- Department of Pathology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, UP, India
| | - J. S. Karthik
- Department of General Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, UP, India
| | - Aviral Srivastava
- Department of General Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, UP, India
| | - Rahul Khanna
- Department of General Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, UP, India
| | - Ram Niwas Meena
- Department of General Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, UP, India
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Silva D, Mesquita A. Evolving Evidence for the Optimization of Neoadjuvant Therapy in Triple-Negative Breast Cancer. BREAST CANCER: BASIC AND CLINICAL RESEARCH 2022; 16:11782234221107580. [PMID: 35783596 PMCID: PMC9243491 DOI: 10.1177/11782234221107580] [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: 07/24/2021] [Accepted: 05/27/2022] [Indexed: 11/15/2022] Open
Abstract
Representing 15% to 20% of all invasive breast cancers, adjuvant systemic
treatment for early-stage, high-risk triple-negative breast cancer (TNBC) is
preferentially done in the neoadjuvant setting based on a chemotherapy backbone
of anthracyclines and taxanes. Pathological complete response to neoadjuvant
treatment constitutes the main objective, regarding its correlation with
oncological outcomes. The optimal neoadjuvant regimen to achieve the highest
rates of pathological complete response is still under investigation, with the
increasing knowledge on the molecular pathways, genomic sequencing, and
immunological profile of TNBC allowing for the development of a wide array of
new therapeutic options. This review aims to summarize the current evidence and
ongoing clinical trials of new therapeutic options for the neoadjuvant treatment
of TNBC patients.
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Affiliation(s)
- Diogo Silva
- Department of Medical Oncology, Matosinhos Local Health Unity – Hospital Pedro Hispano, Porto, Portugal
| | - Alexandra Mesquita
- Department of Medical Oncology, Matosinhos Local Health Unity – Hospital Pedro Hispano, Porto, Portugal
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Impacto do tratamento oncológico na qualidade de vida de idosas com câncer de mama atendidas pelo Sistema Único de Saúde. PAJAR - PAN AMERICAN JOURNAL OF AGING RESEARCH 2022. [DOI: 10.15448/2357-9641.2022.1.43014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Objetivos: avaliar a qualidade de vida (QV), as interações medicamentosas e a adesão ao tratamento em pacientes idosas com câncer de mama que realizaram tratamento oncológico pelo Sistema Único de Saúde (SUS).Métodos: coorte prospectiva, com seis meses de seguimento, que incluiu pacientes idosas com câncer de mama atendidas em Hospital Universitário de Porto Alegre e atendidas pelo SUS. Foram selecionadas mulheres com idade ≥ 60 anos, divididas em dois grupos (60-69 anos e ≥ 70 anos).Resultados: 38 pacientes foram incluídas nas análises sobre QV e adesão ao tratamento. Dentro da classificação molecular, os subtipos mais diagnosticados foram, Luminal B/Her2- (34,2%), Luminal A (26,3%), Luminal B/HER2+ (21,1%). Os sintomas físicos mais relacionados à doença, no momento do diagnóstico, foram insônia, rigidez musculoesquelética, preocupação com os outros e com o futuro. Em contrapartida, seis meses depois os resultados menos favoráveis foram fadiga, náusea e vômito, dispneia, dor, inapetência, constipação, diarreia, problemas financeiros, efeitos adversos da terapia sistêmica, sintomas nas mamas e braços e alopecia. Baixos níveis de adesão ao tratamento foram identificados em 67,6% das pacientes. A polifarmácia foi evidenciada em 60,6%, e foi observada ao menos uma interação medicamentosa potencial em 78,8% da amostra. A média de medicamentos utilizados foi de 7,24 (DP= 3,77).Conclusões: este estudo demonstrou a importância do acompanhamento da população idosa com câncer de mama que faz uso de tratamento quimioterápico, a fim de compreender as implicações da senescência, bem como melhorar as taxas de adesão à terapia e a qualidade de vida desta população.
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Bennett C, Carroll C, Wright C, Awad B, Park JM, Farmer M, Brown E(B, Heatherly A, Woodard S. Breast Cancer Genomics: Primary and Most Common Metastases. Cancers (Basel) 2022; 14:3046. [PMID: 35804819 PMCID: PMC9265113 DOI: 10.3390/cancers14133046] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 06/17/2022] [Accepted: 06/20/2022] [Indexed: 11/16/2022] Open
Abstract
Specific genomic alterations have been found in primary breast cancer involving driver mutations that result in tumorigenesis. Metastatic breast cancer, which is uncommon at the time of disease onset, variably impacts patients throughout the course of their disease. Both the molecular profiles and diverse genomic pathways vary in the development and progression of metastatic breast cancer. From the most common metastatic site (bone), to the rare sites such as orbital, gynecologic, or pancreatic metastases, different levels of gene expression indicate the potential involvement of numerous genes in the development and spread of breast cancer. Knowledge of these alterations can, not only help predict future disease, but also lead to advancement in breast cancer treatments. This review discusses the somatic landscape of breast primary and metastatic tumors.
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Affiliation(s)
- Caroline Bennett
- Birmingham Marnix E. Heersink School of Medicine, The University of Alabama, 1670 University Blvd, Birmingham, AL 35233, USA; (C.B.); (C.C.); (C.W.)
| | - Caleb Carroll
- Birmingham Marnix E. Heersink School of Medicine, The University of Alabama, 1670 University Blvd, Birmingham, AL 35233, USA; (C.B.); (C.C.); (C.W.)
| | - Cooper Wright
- Birmingham Marnix E. Heersink School of Medicine, The University of Alabama, 1670 University Blvd, Birmingham, AL 35233, USA; (C.B.); (C.C.); (C.W.)
| | - Barbara Awad
- Debusk College of Osteopathic Medicine, Lincoln Memorial University, 6965 Cumberland Gap Pkwy, Harrogate, TN 37752, USA;
| | - Jeong Mi Park
- Department of Radiology, The University of Alabama at Birmingham, 619 19th Street South, Birmingham, AL 35249, USA;
| | - Meagan Farmer
- Department of Genetics, Marnix E. Heersink School of Medicine, The University of Alabama at Birmingham, 1670 University Blvd, Birmingham, AL 35233, USA; (M.F.); (A.H.)
| | - Elizabeth (Bryce) Brown
- Laboratory Genetics Counselor, UAB Medical Genomics Laboratory, Kaul Human Genetics Building, 720 20th Street South, Suite 332, Birmingham, AL 35294, USA;
| | - Alexis Heatherly
- Department of Genetics, Marnix E. Heersink School of Medicine, The University of Alabama at Birmingham, 1670 University Blvd, Birmingham, AL 35233, USA; (M.F.); (A.H.)
| | - Stefanie Woodard
- Department of Radiology, The University of Alabama at Birmingham, 619 19th Street South, Birmingham, AL 35249, USA;
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Ng YH, Ibrahim S, Chai YC. A case report of lymphedema as an unusual initial presentation of breast carcinoma. PROCEEDINGS OF SINGAPORE HEALTHCARE 2022. [DOI: 10.1177/20101058221111580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Breast carcinoma is one of the most common carcinomas among women around the world. Most of the women with breast carcinoma will present with signs and symptoms of breast problems to the health facility. Upper limb swelling is one of the rare initial presentations although it is rather common in patients as a sequelae of breast carcinoma treatment. We herein would like to report a case where a post-menopausal female presented with left upper limb swelling with initial history suggestive of traumatic injury of biceps muscle. Subsequent investigations of ultrasound, mammography, biopsy sample of the left breast found that the left upper limb swelling was due to a newly diagnosed invasive lobular carcinoma of the breast, staging of cT4cN2Mx which caused a rapidly progressing stage 2 lymphedema of the left upper limb. Lymphedema of the upper limb is a common complication of breast carcinoma treatment, especially those who require axillary lymph nodes clearance. Breast carcinoma with initial presentation of lymphedema of the upper limb is rare. Due to the rare presentation, diagnosis of breast carcinoma can be delayed. Clinicians should have high awareness to exclude breast cancer when a patient presents with unilateral upper limb swelling.
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Affiliation(s)
- Yam Hock Ng
- Department of orthopaedic, Hospital Sultan Ismail, Johor Bharu, Ministry of Health, Malaysia
| | - Saadon Ibrahim
- Department of orthopaedic, Hospital Sultan Ismail, Johor Bharu, Ministry of Health, Malaysia
| | - Yee Chin Chai
- Hospital Permai Johor Bahru, Johor Bahru, Ministry of Health, Malaysia
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Alam MS, Sultana A, Reza MS, Amanullah M, Kabir SR, Mollah MNH. Integrated bioinformatics and statistical approaches to explore molecular biomarkers for breast cancer diagnosis, prognosis and therapies. PLoS One 2022; 17:e0268967. [PMID: 35617355 PMCID: PMC9135200 DOI: 10.1371/journal.pone.0268967] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 05/11/2022] [Indexed: 02/06/2023] Open
Abstract
Integrated bioinformatics and statistical approaches are now playing the vital role in identifying potential molecular biomarkers more accurately in presence of huge number of alternatives for disease diagnosis, prognosis and therapies by reducing time and cost compared to the wet-lab based experimental procedures. Breast cancer (BC) is one of the leading causes of cancer related deaths for women worldwide. Several dry-lab and wet-lab based studies have identified different sets of molecular biomarkers for BC. But they did not compare their results to each other so much either computationally or experimentally. In this study, an attempt was made to propose a set of molecular biomarkers that might be more effective for BC diagnosis, prognosis and therapies, by using the integrated bioinformatics and statistical approaches. At first, we identified 190 differentially expressed genes (DEGs) between BC and control samples by using the statistical LIMMA approach. Then we identified 13 DEGs (AKR1C1, IRF9, OAS1, OAS3, SLCO2A1, NT5E, NQO1, ANGPT1, FN1, ATF6B, HPGD, BCL11A, and TP53INP1) as the key genes (KGs) by protein-protein interaction (PPI) network analysis. Then we investigated the pathogenetic processes of DEGs highlighting KGs by GO terms and KEGG pathway enrichment analysis. Moreover, we disclosed the transcriptional and post-transcriptional regulatory factors of KGs by their interaction network analysis with the transcription factors (TFs) and micro-RNAs. Both supervised and unsupervised learning's including multivariate survival analysis results confirmed the strong prognostic power of the proposed KGs. Finally, we suggested KGs-guided computationally more effective seven candidate drugs (NVP-BHG712, Nilotinib, GSK2126458, YM201636, TG-02, CX-5461, AP-24534) compared to other published drugs by cross-validation with the state-of-the-art alternatives top-ranked independent receptor proteins. Thus, our findings might be played a vital role in breast cancer diagnosis, prognosis and therapies.
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Affiliation(s)
- Md. Shahin Alam
- Bioinformatics Lab (Dry), Department of Statistics, University of Rajshahi, Rajshahi, Bangladesh
- * E-mail: (MNHM); (MSA)
| | - Adiba Sultana
- Bioinformatics Lab (Dry), Department of Statistics, University of Rajshahi, Rajshahi, Bangladesh
- Center for Systems Biology, Soochow University, Suzhou, China
| | - Md. Selim Reza
- Bioinformatics Lab (Dry), Department of Statistics, University of Rajshahi, Rajshahi, Bangladesh
| | - Md Amanullah
- Bioinformatics Lab (Dry), Department of Statistics, University of Rajshahi, Rajshahi, Bangladesh
- Department of Respiratory Medicine, Sir Run Run Shaw Hospital and Institute of Translational Medicine, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Syed Rashel Kabir
- Department of Biochemistry and Molecular Biology, Rajshahi University, Rajshahi, Bangladesh
| | - Md. Nurul Haque Mollah
- Bioinformatics Lab (Dry), Department of Statistics, University of Rajshahi, Rajshahi, Bangladesh
- * E-mail: (MNHM); (MSA)
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Leong YS, Hasikin K, Lai KW, Mohd Zain N, Azizan MM. Microcalcification Discrimination in Mammography Using Deep Convolutional Neural Network: Towards Rapid and Early Breast Cancer Diagnosis. Front Public Health 2022; 10:875305. [PMID: 35570962 PMCID: PMC9096221 DOI: 10.3389/fpubh.2022.875305] [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: 02/14/2022] [Accepted: 04/04/2022] [Indexed: 11/30/2022] Open
Abstract
Breast cancer is among the most common types of cancer in women and under the cases of misdiagnosed, or delayed in treatment, the mortality risk is high. The existence of breast microcalcifications is common in breast cancer patients and they are an effective indicator for early sign of breast cancer. However, microcalcifications are often missed and wrongly classified during screening due to their small sizes and indirect scattering in mammogram images. Motivated by this issue, this project proposes an adaptive transfer learning deep convolutional neural network in segmenting breast mammogram images with calcifications cases for early breast cancer diagnosis and intervention. Mammogram images of breast microcalcifications are utilized to train several deep neural network models and their performance is compared. Image filtering of the region of interest images was conducted to remove possible artifacts and noises to enhance the quality of the images before the training. Different hyperparameters such as epoch, batch size, etc were tuned to obtain the best possible result. In addition, the performance of the proposed fine-tuned hyperparameter of ResNet50 is compared with another state-of-the-art machine learning network such as ResNet34, VGG16, and AlexNet. Confusion matrices were utilized for comparison. The result from this study shows that the proposed ResNet50 achieves the highest accuracy with a value of 97.58%, followed by ResNet34 of 97.35%, VGG16 96.97%, and finally AlexNet of 83.06%.
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Affiliation(s)
- Yew Sum Leong
- Department of Biomedical Engineering, Faculty of Engineering, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Khairunnisa Hasikin
- Department of Biomedical Engineering, Faculty of Engineering, Universiti Malaya, Kuala Lumpur, Malaysia.,Department of Biomedical Engineering, Center for Image and Signal Processing (CISIP), Faculty of Engineering, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Khin Wee Lai
- Department of Biomedical Engineering, Faculty of Engineering, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Norita Mohd Zain
- Department of Biomedical Engineering, Faculty of Engineering, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Muhammad Mokhzaini Azizan
- Department of Electrical and Electronic Engineering, Faculty of Engineering and Built Environment, Universiti Sains Islam Malaysia, Nilai, Malaysia
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Elshami M, Al-Slaibi I, Ghithan RJ, Alser M, Shurrab NR, Ismail IO, Mahfouz II, Fannon AA, Qawasmi MA, Hawa MR, Giacaman N, Ahmaro M, Okshiya HM, Zaatreh RK, AbuKhalil WA, Usrof FD, Melhim NK, Madbouh RJ, Hziema HJA, Lahlooh RAA, Ubaiat SN, Jaffal NA, Alawna RK, Abed SN, Abuzahra BN, Kwaik AJA, Dodin MH, Taha RO, Alashqar DM, Mobarak RAA, Smerat T, Abu-El-Noor N, Bottcher B. Women's awareness of breast cancer symptoms: a national cross-sectional study from Palestine. BMC Public Health 2022; 22:801. [PMID: 35449048 PMCID: PMC9027340 DOI: 10.1186/s12889-022-13224-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 04/12/2022] [Indexed: 11/26/2022] Open
Abstract
Background Early diagnosis is crucial to reduce the morbidity and mortality associated with breast cancer (BC). Awareness of BC symptoms plays a key role in this. This study aimed to evaluate the Palestinian women’s awareness of BC symptoms and determine factors associated with good awareness. Methods This was a national cross-sectional study conducted from July 2019 to March 2020 in Palestine. Convenience sampling was used to recruit adult women from hospitals, primary healthcare centers, and public spaces located in 11 governorates. A translated-into-Arabic version of the validated BC awareness measure was utilized for data collection. The awareness level was categorized based on the number of symptoms recognized into: poor (0 to 4), fair (5 to 9), and good (10 to 13). Results Of 6269 approached, 5434 participants completed the questionnaire (response rate = 86.7%). A total of 5257 questionnaires were included in the analysis: 2551 from the Gaza Strip and 2706 from the West Bank and Jerusalem (WBJ). Participants living in the WBJ were more likely to be older, have higher monthly income, and suffer from more chronic diseases than participants living in the Gaza Strip. The most frequently identified BC symptom was ‘lump or thickening in the breast’ (n = 4887, 92.9%) followed by ‘lump or thickening under the armpit’ (n = 4394, 83.6%). The least frequently identified symptoms were ‘pulling in of the nipple’ (n = 2665, 50.7%) and ‘change in the position of the nipple’ (n = 2710, 51.6%). A total of 2191 participants (41.7%) demonstrated good awareness of BC symptoms. Participants from the Gaza Strip were more likely than participants from the WBJ to have good awareness (47.0.0% vs. 36.7%). On the multivariable analysis, being ≥ 40 years, completing a post-secondary education, knowing someone with cancer, and visiting hospitals and primary healthcare centers were all associated with an increase in the likelihood of having good awareness. However, living in the WBJ was associated with a decrease in the likelihood of having good awareness. Conclusion Less than half of women included in this study showed good awareness of BC symptoms. More targeted educational interventions are needed to promote Palestinian women’s awareness of BC symptoms to facilitate early diagnosis. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13224-7.
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Affiliation(s)
- Mohamedraed Elshami
- Division of Surgical Oncology, Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA. .,Ministry of Health, Gaza, Palestine.
| | | | | | | | | | | | | | | | - Malak Ayman Qawasmi
- Department of Medical Laboratory Sciences, Hebron University, Hebron, Palestine
| | | | | | - Manar Ahmaro
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | | | | | - Faten Darwish Usrof
- Department of Medical Laboratory Sciences, Faculty of Sciences, Islamic University of Gaza, Gaza, Palestine
| | | | | | | | | | | | - Nour Ali Jaffal
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | | | | | | | | | | | | | | | - Tasneem Smerat
- Faculty of Medicine and Health Sciences, Palestine Polytechnic University, Hebron, Palestine
| | | | - Bettina Bottcher
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
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Habbous S, Homenauth E, Barisic A, Kandasamy S, Majpruz V, Forster K, Yurcan M, Chiarelli AM, Groome P, Holloway CMB, Eisen A. Differences in breast cancer diagnosis by patient presentation in Ontario: a retrospective cohort study. CMAJ Open 2022; 10:E313-E330. [PMID: 35383035 PMCID: PMC9259434 DOI: 10.9778/cmajo.20210254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND In Ontario, patients with breast cancer typically receive their diagnoses through the Ontario Breast Screening Program (OBSP) after an abnormal screen, through screening initiated by a primary care provider or other referring physician, or through follow-up of symptoms by patients' primary care providers. We sought to explore the association of the route to diagnosis (screening within or outside the OBSP or via symptomatic presentation) with use of OBSP-affiliated breast assessment sites (O-BAS), wait times until diagnosis or treatment, health care use and overall survival for patients with breast cancer. METHODS In this retrospective cohort study, we used the Ontario Cancer Registry to identify adults (aged 18-105 yr) who received a diagnosis of breast cancer from 2013 to 2017. We excluded patients if they were not Ontario residents or had missing age or sex, or who died before diagnosis. We used logistic regression to evaluate factors associated with categorical variables (whether patients were or were not referred to an OBAS, whether patients were screened or symptomatic) and Cox proportional hazards regression to identify factors associated with all-cause mortality. RESULTS Of 51 460 patients with breast cancer, 42 598 (83%) received their diagnoses at an O-BAS. Patients whose cancer was first detected through the OBSP were more likely than symptomatic patients to be given a diagnosis at an O-BAS (adjusted odds ratio 1.68, 95% confidence interval [CI] 1.57 to 1.80). Patients screened by the OBSP were given their diagnoses 1 month earlier than symptomatic patients, but diagnosis at an O-BAS did not affect the time until either diagnosis or treatment. Patients referred to an O-BAS had significantly better overall survival than those who were not referred (adjusted hazard ratio 0.73, 95% CI 0.66 to 0.80). INTERPRETATION Patients screened through the OBSP were given their diagnoses earlier than symptomatic patients and were more likely to be referred to an O-BAS, which was associated with better survival. Our findings suggest that individuals with signs and symptoms of breast cancer would benefit from similar referral processes, oversight and standards to those used by the OBSP.
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Affiliation(s)
- Steven Habbous
- Ontario Health (Cancer Care Ontario) (Habbous, Homenauth, Barisic, Kandasamy, Majpruz, Forster, Yurcan, Chiarelli, Holloway, Eisen); Dalla Lana School of Public Health (Chiarelli), Toronto, Ont.; ICES Queen's (Groome), Kingston, Ont.; Department of Surgery (Holloway), University of Toronto; Department of Medical Oncology (Eisen), Sunnybrook Health Sciences Centre, Toronto, Ont.
| | - Esha Homenauth
- Ontario Health (Cancer Care Ontario) (Habbous, Homenauth, Barisic, Kandasamy, Majpruz, Forster, Yurcan, Chiarelli, Holloway, Eisen); Dalla Lana School of Public Health (Chiarelli), Toronto, Ont.; ICES Queen's (Groome), Kingston, Ont.; Department of Surgery (Holloway), University of Toronto; Department of Medical Oncology (Eisen), Sunnybrook Health Sciences Centre, Toronto, Ont
| | - Andriana Barisic
- Ontario Health (Cancer Care Ontario) (Habbous, Homenauth, Barisic, Kandasamy, Majpruz, Forster, Yurcan, Chiarelli, Holloway, Eisen); Dalla Lana School of Public Health (Chiarelli), Toronto, Ont.; ICES Queen's (Groome), Kingston, Ont.; Department of Surgery (Holloway), University of Toronto; Department of Medical Oncology (Eisen), Sunnybrook Health Sciences Centre, Toronto, Ont
| | - Sharmilaa Kandasamy
- Ontario Health (Cancer Care Ontario) (Habbous, Homenauth, Barisic, Kandasamy, Majpruz, Forster, Yurcan, Chiarelli, Holloway, Eisen); Dalla Lana School of Public Health (Chiarelli), Toronto, Ont.; ICES Queen's (Groome), Kingston, Ont.; Department of Surgery (Holloway), University of Toronto; Department of Medical Oncology (Eisen), Sunnybrook Health Sciences Centre, Toronto, Ont
| | - Vicky Majpruz
- Ontario Health (Cancer Care Ontario) (Habbous, Homenauth, Barisic, Kandasamy, Majpruz, Forster, Yurcan, Chiarelli, Holloway, Eisen); Dalla Lana School of Public Health (Chiarelli), Toronto, Ont.; ICES Queen's (Groome), Kingston, Ont.; Department of Surgery (Holloway), University of Toronto; Department of Medical Oncology (Eisen), Sunnybrook Health Sciences Centre, Toronto, Ont
| | - Katharina Forster
- Ontario Health (Cancer Care Ontario) (Habbous, Homenauth, Barisic, Kandasamy, Majpruz, Forster, Yurcan, Chiarelli, Holloway, Eisen); Dalla Lana School of Public Health (Chiarelli), Toronto, Ont.; ICES Queen's (Groome), Kingston, Ont.; Department of Surgery (Holloway), University of Toronto; Department of Medical Oncology (Eisen), Sunnybrook Health Sciences Centre, Toronto, Ont
| | - Marta Yurcan
- Ontario Health (Cancer Care Ontario) (Habbous, Homenauth, Barisic, Kandasamy, Majpruz, Forster, Yurcan, Chiarelli, Holloway, Eisen); Dalla Lana School of Public Health (Chiarelli), Toronto, Ont.; ICES Queen's (Groome), Kingston, Ont.; Department of Surgery (Holloway), University of Toronto; Department of Medical Oncology (Eisen), Sunnybrook Health Sciences Centre, Toronto, Ont
| | - Anna M Chiarelli
- Ontario Health (Cancer Care Ontario) (Habbous, Homenauth, Barisic, Kandasamy, Majpruz, Forster, Yurcan, Chiarelli, Holloway, Eisen); Dalla Lana School of Public Health (Chiarelli), Toronto, Ont.; ICES Queen's (Groome), Kingston, Ont.; Department of Surgery (Holloway), University of Toronto; Department of Medical Oncology (Eisen), Sunnybrook Health Sciences Centre, Toronto, Ont
| | - Patti Groome
- Ontario Health (Cancer Care Ontario) (Habbous, Homenauth, Barisic, Kandasamy, Majpruz, Forster, Yurcan, Chiarelli, Holloway, Eisen); Dalla Lana School of Public Health (Chiarelli), Toronto, Ont.; ICES Queen's (Groome), Kingston, Ont.; Department of Surgery (Holloway), University of Toronto; Department of Medical Oncology (Eisen), Sunnybrook Health Sciences Centre, Toronto, Ont
| | - Claire M B Holloway
- Ontario Health (Cancer Care Ontario) (Habbous, Homenauth, Barisic, Kandasamy, Majpruz, Forster, Yurcan, Chiarelli, Holloway, Eisen); Dalla Lana School of Public Health (Chiarelli), Toronto, Ont.; ICES Queen's (Groome), Kingston, Ont.; Department of Surgery (Holloway), University of Toronto; Department of Medical Oncology (Eisen), Sunnybrook Health Sciences Centre, Toronto, Ont
| | - Andrea Eisen
- Ontario Health (Cancer Care Ontario) (Habbous, Homenauth, Barisic, Kandasamy, Majpruz, Forster, Yurcan, Chiarelli, Holloway, Eisen); Dalla Lana School of Public Health (Chiarelli), Toronto, Ont.; ICES Queen's (Groome), Kingston, Ont.; Department of Surgery (Holloway), University of Toronto; Department of Medical Oncology (Eisen), Sunnybrook Health Sciences Centre, Toronto, Ont
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Ren S, Zhang Y, Qin P, Wang J. Factors Influencing Total Delay of Breast Cancer in Northeast of China. Front Oncol 2022; 12:841438. [PMID: 35311134 PMCID: PMC8924654 DOI: 10.3389/fonc.2022.841438] [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: 12/24/2021] [Accepted: 01/19/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives Delay in diagnosis and treatment, called total delay, could probably result in lower survival rates in breast cancer patients. This study aimed to investigate the factors associated with the comprehensive delay behaviors and to evaluate its effect on outcomes in patients with breast cancer in Dalian, a northeast city of China. Methods A retrospective chart review was conducted using a cancer registry dataset including 298 patients. The Kaplan–Meier survival analysis was used to identify the threshold of total delay, dividing the patients into a group with significant uncertainty and a group without substantial delay. The factors associated with the significant total delay were investigated from the potential candidates, like income level and marital status, by using the chi-squared test. The difference of the clinicopathologic characteristics between the patients grouped by the significant total delay, like tumor size and lymph node metastasis, was also investigated to find out the effect of the total delay. Results A total of 238 charts were used for analysis. The mean age was 57.3. The median of total delays was 3.75 months. Thirty days was identified as a threshold, more than which the total delay can lead to worse survival. Patients’ marital status (p = 0.010), income levels (p = 0.003), smoking status (p = 0.031), initial visiting hospital level (p = 0.005), self-health care (p = 0.001), and self-concern about initial symptom (p ≈ 0.000) were identified as the independent predictors of the total delay. Metastasis (p ≈ 0.000) was identified as the significant result relating to the significant total delay. Conclusions A total delay of more than 30 days predicts worse survival in breast cancer patients in Dalian. Several factors, like patients’ marital status and income levels, can be considered to be relevant to the significant total delay. We recommend that these factors be used to predict the potential patients with the significant total delay in the clinical practice.
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Affiliation(s)
- Sihang Ren
- Department of Breast Surgery, Institute of Breast Disease, The Second Hospital of Dalian Medical University, Dalian, China
| | - Yuting Zhang
- Dalian No.3 People's Hospital, Dalian Medical University, Dalian, China
| | - Pan Qin
- Faculty of Electronic Information and Electrical Engineering, Dalian University of Technology, Dalian, China
| | - Jia Wang
- Department of Breast Surgery, Institute of Breast Disease, The Second Hospital of Dalian Medical University, Dalian, China
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Latif S, Perveen S, Iqbal M, Ahmed T, Moula Bux K, Jafri SNA. Epidemiology of Carcinoma Breast in Young Adolescence Women. Cureus 2022; 14:e23683. [PMID: 35505755 PMCID: PMC9055974 DOI: 10.7759/cureus.23683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2022] [Indexed: 11/16/2022] Open
Abstract
Introduction The aim of this study was to compare epidemiological characteristics of breast cancer in young adolescent women (YAW) versus older women (OW). Methods This was a cross-sectional prospective observational study, conducted in Ward 3, Jinnah Postgraduate Medical Center, Karachi, Pakistan, from September 2021 to February 2022. A total of 120 female patients were recruited in this study from the Outpatient Department of Jinnah Postgraduate Medical Center, out of which 22 patients were below the age of 40 years and 98 were above 40 years. For breast cancer diagnosis, we used the triple assessment method involving clinical examination, radiology, and histopathology. Diagnosed patients were further evaluated for hormonal status and metastatic workup. Results were noted on a performa, and differences between both age groups were analyzed. Results Out of 120 patients, 22 were younger than 40 years and 98 were older than 40 years. YAW used to present late after the appearance of symptoms. Patients of both age groups mostly presented with breast lumps (68.18% in YAW and 81.6% in OW). YAW presented with larger sizes of lumps and with more nodal involvement as compared to OW. BI-RADS IV (Breast Imaging Reporting and Data System Category IV) was the most commonly observed (27.27% in YAW and 48.97% in OW) mammographic finding in both age groups. Invasive ductal carcinoma was the most common histological type in both age groups (72.73% in YAW and 76.53% in OW). The triple-negative disease was more commonly found in YAW than OW (40.91% in YAW vs 21.43% in OW). We found that usually YAW presented at advanced stages (stages III and IV, 54.55%) and higher grades (grade III, 63.63%). Conclusion Breast cancer in young patients is rare but more aggressive with higher grades, advanced stages, and poor prognostic features. Heredity is mainly the risk factor in young breast cancer patients. There should be proper screening programs for high-risk group for early diagnosis and prompt treatment. Other age-specific concerns such as psychological impact of disease should be addressed as well.
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Affiliation(s)
- Sidra Latif
- Surgery, Jinnah Postgraduate Medical Centre, Karachi, PAK
| | - Sughra Perveen
- General Surgery, Jinnah Postgraduate Medical Centre, Karachi, PAK
| | - Mazhar Iqbal
- Surgery, Jinnah Postgraduate Medical Centre, Karachi, PAK
| | - Tanweer Ahmed
- General Surgery, Jinnah Postgraduate Medical Centre, Karachi, PAK
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Majano SB, Lyratzopoulos G, Rachet B, de Wit NJ, Renzi C. Do presenting symptoms, use of pre-diagnostic endoscopy and risk of emergency cancer diagnosis vary by comorbidity burden and type in patients with colorectal cancer? Br J Cancer 2022; 126:652-663. [PMID: 34741134 PMCID: PMC8569047 DOI: 10.1038/s41416-021-01603-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 09/06/2021] [Accepted: 10/13/2021] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Cancer patients often have pre-existing comorbidities, which can influence timeliness of cancer diagnosis. We examined symptoms, investigations and emergency presentation (EP) risk among colorectal cancer (CRC) patients by comorbidity status. METHODS Using linked cancer registration, primary care and hospital records of 4836 CRC patients (2011-2015), and multivariate quantile and logistic regression, we examined variations in specialist investigations, diagnostic intervals and EP risk. RESULTS Among colon cancer patients, 46% had at least one pre-existing hospital-recorded comorbidity, most frequently cardiovascular disease (CVD, 18%). Comorbid versus non-comorbid cancer patients more frequently had records of anaemia (43% vs 38%), less frequently rectal bleeding/change in bowel habit (20% vs 27%), and longer intervals from symptom-to-first relevant test (median 136 vs 74 days). Comorbid patients were less likely investigated with colonoscopy/sigmoidoscopy, independently of symptoms (adjusted OR = 0.7[0.6, 0.9] for Charlson comorbidity score 1-2 and OR = 0.5 [0.4-0.7] for score 3+ versus 0. EP risk increased with comorbidity score 0, 1, 2, 3+: 23%, 35%, 33%, 47%; adjusted OR = 1.8 [1.4, 2.2]; 1.7 [1.3, 2.3]; 3.0 [2.3, 4.0]) and for patients with CVD (adjusted OR = 2.0 [1.5, 2.5]). CONCLUSIONS Comorbid individuals with as-yet-undiagnosed CRC often present with general rather than localising symptoms and are less likely promptly investigated with colonoscopy/sigmoidoscopy. Comorbidity is a risk factor for diagnostic delay and has potential, additionally to symptoms, as risk-stratifier for prioritising patients needing prompt assessment to reduce EP.
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Affiliation(s)
- Sara Benitez Majano
- Inequalities in Cancer Outcomes Network (ICON) Group, Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel St, Bloomsbury, London, WC1E 7HT, UK
| | - Georgios Lyratzopoulos
- Epidemiology of Cancer Healthcare & Outcomes (ECHO) Research Group, Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, University College London, London, WC1E 7HB, UK
| | - Bernard Rachet
- Inequalities in Cancer Outcomes Network (ICON) Group, Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel St, Bloomsbury, London, WC1E 7HT, UK
| | - Niek J de Wit
- University Medical Center, Utrecht University, Julius Center for Health Sciences and Primary Care, PO Box 85500, 3508 GA, Utrecht, The Netherlands
| | - Cristina Renzi
- Epidemiology of Cancer Healthcare & Outcomes (ECHO) Research Group, Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, University College London, London, WC1E 7HB, UK.
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Correia B, Fernandes J, Botica MJ, Ferreira C, Quintas A. Novel Psychoactive Substances: The Razor's Edge between Therapeutical Potential and Psychoactive Recreational Misuse. MEDICINES (BASEL, SWITZERLAND) 2022; 9:medicines9030019. [PMID: 35323718 PMCID: PMC8950629 DOI: 10.3390/medicines9030019] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 02/23/2022] [Accepted: 02/25/2022] [Indexed: 12/16/2022]
Abstract
BACKGROUND Novel psychoactive substances (NPS) are compounds of natural and synthetic origin, similar to traditional drugs of abuse. NPS are involved in a contemporary trend whose origin lies in a thinner balance between legitimate therapeutic drug research and legislative control. The contemporary NPS trend resulted from the replacement of MDMA by synthetic cathinones in 'ecstasy' during the 2000s. The most common NPS are synthetic cannabinoids and synthetic cathinones. Interestingly, during the last 50 years, these two classes of NPS have been the object of scientific research for a set of health conditions. METHODS Searches were conducted in the online database PubMed using boolean equations. RESULTS Synthetic cannabinoids displayed protective and therapeutic effects for inflammatory, neurodegenerative and oncologic pathologies, activating the immune system and reducing inflammation. Synthetic cathinones act similarly to amphetamine-type stimulants and can be used for depression and chronic fatigue. CONCLUSIONS Despite the scientific advances in this field of research, pharmacological application of NPS is being jeopardized by fatalities associated with their recreational use. This review addresses the scientific achievements of these two classes of NPS and the toxicological data, ending with a reflection on Illicit and NPS control frames.
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Affiliation(s)
- Beatriz Correia
- Laboratório de Ciências Forenses e Psicológicas Egas Moniz, Campus Universitário—Quinta da Granja, Monte de Caparica, 2825-084 Caparica, Portugal; (B.C.); (J.F.); (C.F.)
| | - Joana Fernandes
- Laboratório de Ciências Forenses e Psicológicas Egas Moniz, Campus Universitário—Quinta da Granja, Monte de Caparica, 2825-084 Caparica, Portugal; (B.C.); (J.F.); (C.F.)
| | - Maria João Botica
- Instituto Português de Oncologia de Lisboa Francisco Gentil (IPO), Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal;
| | - Carla Ferreira
- Laboratório de Ciências Forenses e Psicológicas Egas Moniz, Campus Universitário—Quinta da Granja, Monte de Caparica, 2825-084 Caparica, Portugal; (B.C.); (J.F.); (C.F.)
- Molecular Pathology and Forensic Biochemistry Laboratory, Centro de Investigação Interdisciplinar Egas Moniz, 2825-084 Caparica, Portugal
- Faculty of Medicine of Porto University, Rua Professor Lima Basto, 1099-023 Lisboa, Portugal
| | - Alexandre Quintas
- Laboratório de Ciências Forenses e Psicológicas Egas Moniz, Campus Universitário—Quinta da Granja, Monte de Caparica, 2825-084 Caparica, Portugal; (B.C.); (J.F.); (C.F.)
- Molecular Pathology and Forensic Biochemistry Laboratory, Centro de Investigação Interdisciplinar Egas Moniz, 2825-084 Caparica, Portugal
- Correspondence:
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Mamat WHW, Jarrett N, Lund S. Diagnostic Interval: Experiences among Women with Breast Cancer in Malaysia. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2021.7833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: The diagnostic pathway is critical for early breast cancer detection and prognosis improvement. Countries such as the United Kingdom, particularly England, have implemented faster diagnosis standards to ensure that patients receive a definitive diagnosis of cancer or are ruled out within 28 days of referral. However, there is a severe shortage of data on the experiences of breast cancer patients in Malaysia during the diagnostic interval.
AIM: This study aimed to explore what happened to the women during the diagnostic phase prior to confirmation of breast cancer.
METHODOLOGY: Purposive sampling was applied, and 14 participants were recruited from two government hospitals. The participants took part in in-depth, face-to-face, one-time, and audio-recorded interviews. All the interviews were subsequently transcribed verbatim and analyzed using narrative analysis.
RESULTS: The diagnostic interval for the women in this study was 1–3 months from first medical contact till diagnosis. Four themes were identified during the analysis for the diagnostic interval: 1) Women who are suspected of having breast cancer; 2) Women who experience false reassurance; 3) Woman who experience delayed referral; and 4) Women who experience inconclusive investigation results.
CONCLUSIONS: This study indicates that early warning signs of breast cancer may prompt doctors to take immediate action. However, unexpected delays may occur as a result of staffing and system issues in the healthcare system. Healthcare professionals should aggressively refer patients with typical symptoms and actively follow-up with patients who present with atypical symptoms in the community. Continuing education for healthcare professionals is necessary to improve diagnostic and referral procedures.
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Khan S, Pattanshetty R, Huddar V. Knowledge and awareness of breast cancer in Muslim population of Belagavi city: A population survey. JOURNAL OF DR. NTR UNIVERSITY OF HEALTH SCIENCES 2022. [DOI: 10.4103/jdrntruhs.jdrntruhs_60_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Razik MA, Alsubaie AM, Alsetri HM, Albassam KA, Alkhurayyif AO, Altamimi MM, Alanazi SM. Clinical and histopathological features of breast tumors in women: a cross-sectional study at three hospitals in the Kingdom of Saudi Arabia. Pan Afr Med J 2021; 39:267. [PMID: 34707768 PMCID: PMC8520403 DOI: 10.11604/pamj.2021.39.267.30341] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Accepted: 08/13/2021] [Indexed: 12/31/2022] Open
Abstract
Introduction there is a dearth of data on the epidemiology of breast tumors in the Kingdom of Saudi Arabia (KSA). This study aimed to determine the demographics, clinical patterns, and their association with histopathological types of breast tumors among females presently residing in KSA. Methods a multi-centric, cross-sectional study including female patients with symptoms suggestive of breast tumor was conducted at three hospitals in KSA from February 2019 to February 2020. The patient´s electronic health records were used to collect information related to their demographics, clinical findings including comordbities and symptoms and investigations. Binary logistic regression models were used to determine factors associated with the breast tumors. Results a total of 270 female patients were included in the study. The most frequently encountered symptom was a breast lump (95.9%, n = 259), followed by pain (18.9%, n = 51). More than half the population (53%, n = 143) had a histopathological diagnosis of fibroadenoma. Multivariate analysis revealed that patients > 46 years of age were less likely to present with fibroadenoma (AOR: 0.049 95% CI 0.02 - 0.15; p < 0.005). Those in the 31 - 45 years age group were less likely to present with ductal/lobular/papillary carcinomacompared to the less than 30 years group (AOR: 0.42, 95% CI 0.18 - 0.97; p = 0.04). Conclusion in this population of Saudi women with symptoms suggestive of breast tumor, those aged less than 40 years were more likely to have a fibroadenoma whereas those above 40 years were more likely to have breast cancer.
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Affiliation(s)
- Mohamed Abdel Razik
- General Surgery Department, College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
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Balema W, Liu D, Shen Y, El-Zein R, Debeb BG, Kai M, Overmoyer B, Miller KD, Le-Petross HT, Ueno NT, Woodward WA. Inflammatory breast cancer appearance at presentation is associated with overall survival. Cancer Med 2021; 10:6261-6272. [PMID: 34327874 PMCID: PMC8446552 DOI: 10.1002/cam4.4170] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 06/07/2021] [Accepted: 07/03/2021] [Indexed: 11/06/2022] Open
Abstract
Background Inflammatory breast cancer (IBC) is a clinical diagnosis. Here, we examined the association of a “classic” triad of clinical signs, swollen involved breast, nipple change, and diffuse skin change, with overall survival (OS). Method Breast medical photographs from patients enrolled on a prospective IBC registry were scored by two independent reviewers as classic (triad above), not classic, and difficult to assign. Chi‐squared test, Fisher's exact test, and Wilcoxon rank‐sum test were used to assess differences between patient groups. Kaplan–Meier estimates and the log‐rank test and Cox proportional hazard regression were used to assess the OS. Results We analyzed 245 IBC patients with median age 54 (range 26–81), M0 versus M1 status (157 and 88 patients, respectively). The classic triad was significantly associated with smoking, post‐menopausal status, and metastatic disease at presentation (p = 0.002, 0.013, and 0.035, respectively). Ten‐year actuarial OS for not classic and difficult to assign were not significantly different and were grouped for further analyses. Ten‐year OS was 29.7% among patients with the classic sign triad versus 57.2% for non‐classic (p < 0.0001). The multivariate Cox regression model adjusting for clinical staging (p < 0.0001) and TNBC status (<0.0001) demonstrated classic presentation score significantly associated with poorer OS time (HR 2.6, 95% CI 1.7–3.9, p < 0.0001). Conclusions A triad of classic IBC signs independently predicted OS in patients diagnosed with IBC. Further work is warranted to understand the biology related to clinical signs and further extend the understanding of physical examination findings in IBC.
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Affiliation(s)
- Wintana Balema
- Graduate School of Biomedical Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA.,Department of Radiation Oncology, Morgan Welch IBC Clinic and Research Program, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Diane Liu
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Yu Shen
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Randa El-Zein
- Department of Radiology, Houston Methodist Cancer Center, Houston, TX, USA
| | - Bisrat G Debeb
- Graduate School of Biomedical Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA.,Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Megumi Kai
- Department of Radiation Oncology, Morgan Welch IBC Clinic and Research Program, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Kathy D Miller
- Indiana University School of Medicine, Indianapolis, IN, USA
| | - Huong T Le-Petross
- Department of Radiation Oncology, Morgan Welch IBC Clinic and Research Program, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Naoto T Ueno
- Graduate School of Biomedical Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA.,Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Wendy A Woodward
- Graduate School of Biomedical Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA.,Department of Radiation Oncology, Morgan Welch IBC Clinic and Research Program, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Zannad F, Cotter G, Alonso Garcia A, George S, Davison B, Figtree G, Prasad K, Rockhold F, Schilsky RL, Stockbridge N, Pitt B, Butler J. What can heart failure trialists learn from oncology trialists? Eur Heart J 2021; 42:2373-2383. [PMID: 34076243 DOI: 10.1093/eurheartj/ehab236] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 02/24/2021] [Accepted: 04/30/2021] [Indexed: 12/27/2022] Open
Abstract
Globally, there has been little change in mortality rates from cardiovascular (CV) diseases or cancers over the past two decades (1997-2018). This is especially true for heart failure (HF) where 5-year mortality rates remain as high as 45-55%. In the same timeframe, the proportion of drug revenue, and regulatory drug approvals for cancer drugs, far out paces those for CV drugs. In 2018, while cancer drugs made 27% of Food and Drug Administration drug approvals, only 1% of drug approvals was for a CV drug, and over this entire 20 year span, only four drugs were approved for HF in the USA. Cardiovascular trialists need to reassess the design, execution, and purpose of CV clinical trials. In the area of oncology research, trials are much smaller, follow-up is shorter, and targeted therapies are common. Cardiovascular diseases and cancer are the two most common causes of death globally, and although they differ substantially, this review evaluates whether some elements of oncology research may be applicable in the CV arena. As one of the most underserved CV diseases, the review focuses on aspects of cancer research that may be applicable to HF research with the aim of streamlining the clinical trial process and decreasing the time and cost required to bring safe, effective, treatments to patients who need them. The paper is based on discussions among clinical trialists, industry representatives, regulatory authorities, and patients, which took place at the Cardiovascular Clinical Trialists Workshop in Washington, DC, on 8 December 2019 (https://www.globalcvctforum.com/2019 (14 September 2020)).
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Affiliation(s)
- Faiez Zannad
- Université de Lorraine, Inserm Clinical Investigation Center 1439 at Institut Lorrain du Coeur et des Vaisseaux, CHU 54500, University Hospital of Nancy, Nancy, France
| | - Gad Cotter
- 2Momentum Research, Inc., 3100 Tower Blvd, Durham, NC, 27707, USA, Inserm, Paris, 942 Mascot, France
| | - Angeles Alonso Garcia
- Medicines and Healthcare products Regulatory Agency (MHRA), 10 South Colonnade, London, E14 4PU, UK
| | - Suzanne George
- Sarcoma Center, Dana-Farber Cancer Center, 450 Brookline Ave, Boston, MA, 02215, USA
| | - Beth Davison
- 2Momentum Research, Inc., 3100 Tower Blvd, Durham, NC, 27707, USA, Inserm, Paris, 942 Mascot, France
| | - Gemma Figtree
- Northern Clinical School, Kolling Institute of Medical Research, University of Sydney, Sydney, Australia, Reserve Road, St Leonards, NSW 2065
| | - Krishna Prasad
- Medicines and Healthcare products Regulatory Agency (MHRA), 10 South Colonnade, London, E14 4PU, UK
| | - Frank Rockhold
- Department of Biostatistics & Bioinformatics, Duke University Medical Center, 2424 Erwin Rd, Durham, NC, 27710, USA
| | | | - Norman Stockbridge
- Division of Cardiovascular and Renal Products, FDA Center for Drug Evaluation and Research (CDER), 10903 New Hampshire Ave, Silver Spring, MD, 20993, USA
| | - Bertram Pitt
- Division of Cardiology, University of Michigan, 1500 E. Medical Center Dr, Ann Arbor, MI, 48109, USA
| | - Javed Butler
- Department of Medicine, University of Mississippi Medical Center, 2500 North State St, Jackson, MS, 39216, USA
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Virgilsen LF, Pedersen AF, Vedsted P, Petersen GS, Jensen H. Alignment between the patient's cancer worry and the GP's cancer suspicion and the association with the interval between first symptom presentation and referral: a cross-sectional study in Denmark. BMC FAMILY PRACTICE 2021; 22:129. [PMID: 34167486 PMCID: PMC8228922 DOI: 10.1186/s12875-021-01480-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 06/04/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND General practitioners (GPs) have a key role in the diagnosis of cancer. It is crucial to identify factors influencing the decision to refer for suspected cancer. The aim of this study was to investigate the alignment between the patient's cancer worry and the GP's suspicion of cancer in the first clinical encounter and the association with the time interval from the first symptom presentation until the first referral to specialist care, i.e. the primary care interval (PCI). METHOD The study was performed as a cross-sectional study using survey data on patients diagnosed with incident cancer in 2010 or 2016 and their GPs in Denmark. We defined four alignment groups: 1) patient worry and GP suspicion, 2) GP suspicion only, 3) patient worry only, and 4) none of the two. A long PCI was defined as an interval longer than the 75th percentile. RESULTS Among the 3333 included patients, both patient worry and GP suspicion was seen in 39.5%, only GP suspicion was seen in 28.2%, only patient worry was seen in 13.6%, and neither patient worry nor GP suspicion was seen in 18.2%. The highest likelihood of long PCI was observed in group 4 (group 4 vs. group 1: PPR 3.99 (95% CI 3.34-4.75)), mostly pronounced for easy-to-diagnose cancer types. CONCLUSION Misalignment between the patient's worry and the GP's suspicion was common at the first cancer-related encounter. Importance should be given to the patient interview, due to a potential delayed GP referral among patients diagnosed with "easy-to-diagnose" cancer types presenting with unspecific symptoms.
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Affiliation(s)
- Line Flytkjær Virgilsen
- Research Centre for Cancer Diagnosis in Primary Care, Research Unit for General Practice, Bartholins Allé 2, 8000, Aarhus C, Denmark.
| | - Anette Fischer Pedersen
- Research Centre for Cancer Diagnosis in Primary Care, Research Unit for General Practice, Bartholins Allé 2, 8000, Aarhus C, Denmark.,Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 82, 8200, Aarhus C, Denmark
| | - Peter Vedsted
- Research Centre for Cancer Diagnosis in Primary Care, Research Unit for General Practice, Bartholins Allé 2, 8000, Aarhus C, Denmark.,Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 82, 8200, Aarhus C, Denmark
| | | | - Henry Jensen
- Research Centre for Cancer Diagnosis in Primary Care, Research Unit for General Practice, Bartholins Allé 2, 8000, Aarhus C, Denmark
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Hong K, Majercak KR, Villalonga-Olives E, Perfetto EM. Patient-reported outcomes in breast cancer FDA drug labels and review documents. J Patient Rep Outcomes 2021; 5:36. [PMID: 33881661 PMCID: PMC8060367 DOI: 10.1186/s41687-021-00308-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 04/01/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Patient-reported outcomes (PROs) can provide valuable information about drug benefit-risk tradeoffs from the patient perspective and are particularly important to patients with breast cancer due to its symptoms and adverse events from breast cancer treatments. The United States Food and Drug Administration (U.S. FDA) has acknowledged PROs as important approval endpoints used in clinical trials of cancer drugs. However, previous studies found that PROs are rarely mentioned in cancer drug labels, a widely used and trusted source of information about drugs. Our objectives were to compare PRO data reported in FDA labeling versus FDA medical review documents for breast cancer drugs approved in the U.S. between 2000 and 2019 to identify possible causes for PRO-data labeling exclusions. METHODS We included new molecular entities (NMEs) and biologic license applications (BLAs) initially approved for breast cancer treatment by the FDA between 1/1/2000 and 12/31/2019. Product labeling and FDA medical review documents were collected from the FDA-Approved Drugs database (Drugs@FDA). From these resources, details on PRO measures used in trials, design of trials using PRO measures, PRO-endpoint status, analytical methods, and FDA reviewer comments regarding PRO measurement were extracted. RESULTS Of 633 FDA-approved drugs, 13 were indicated for breast cancer treatment; none of their prescribing information contained information about PROs. However, 11 of 13 (85%) included PRO measures and endpoint information in FDA medical review documents. PRO measures were used in 14 different clinical trials, and FDA reviewers' comments regarding PRO measurement were related to lack of meaningfulness and clinical significance, lack of content validity, and inadequate analytical methods. CONCLUSIONS Despite the importance of PROs to patients with breast cancer, PRO measures were only described in FDA medical review documents of breast cancer drugs, but not in drug product labeling. Therefore, it appears that PRO data are often collected in breast cancer trials, but have not been methodologically acceptable to FDA reviewers. Collaborative efforts between the FDA and industry are warranted to increase the number of breast cancer drug applications with appropriate use of PRO measures and endpoints.
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Affiliation(s)
- Kyungwan Hong
- Department of Pharmaceutical Health Services Research, University of Maryland, School of Pharmacy, 220 Arch Street, 12th Floor, Room: 01-328, Baltimore, MD, 21201, USA.
| | - Kayleigh R Majercak
- Department of Pharmaceutical Health Services Research, University of Maryland, School of Pharmacy, 220 Arch Street, 12th Floor, Room: 01-328, Baltimore, MD, 21201, USA
| | - Ester Villalonga-Olives
- Department of Pharmaceutical Health Services Research, University of Maryland, School of Pharmacy, 220 Arch Street, 12th Floor, Room: 01-328, Baltimore, MD, 21201, USA
| | - Eleanor M Perfetto
- Department of Pharmaceutical Health Services Research, University of Maryland, School of Pharmacy, 220 Arch Street, 12th Floor, Room: 01-328, Baltimore, MD, 21201, USA
- National Health Council, Washington DC, USA
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Roldán-Jiménez C, Pajares B, Iglesias Campos M, Trinidad-Fernández M, Gutiérrez-Sánchez D, Ribelles N, Alba E, Cuesta-Vargas AI. Structural validity and reliability of the Spanish Central Sensitization Inventory in breast cancer survivors. Pain Pract 2021; 21:740-746. [PMID: 33768652 DOI: 10.1111/papr.13009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 03/07/2021] [Accepted: 03/17/2021] [Indexed: 12/14/2022]
Abstract
INTRODUCTION One of the most widely used instruments to identify symptoms that may be related to central sensitization is the Central Sensitization Inventory (CSI). Although this instrument has been translated and validated in Spanish patients with chronic musculoskeletal pain, no psychometric analysis has been carried out in breast cancer survivors. The aim of this study was to perform a psychometric analysis of the Spanish version of the Central Sensitization Inventory (CSI-Sp) in Spanish breast cancer survivors. MATERIALS AND METHODS A validation study was carried out in 183 breast cancer survivors. A psychometric analysis of internal consistency, factor structure, and test-retest reliability of the CSI-Sp was performed. Internal consistency was determined using Cronbach's alpha. Test-retest reliability was evaluated using the Intraclass Correlation Coefficient (ICC) Type 2.1. Exploratory factor analysis was used to determine the internal structure of the questionnaire. RESULTS The internal consistency was high (α = 0.91). The test-retest reliability was satisfactory with excellent values (ICC 2.1 = 0.95). The exploratory factor analysis yielded a one factor structure explaining the 33.88% of total variance. CONCLUSIONS The CSI-Sp has demonstrated to be a psychometrically strong measure for assessing central sensitization symptoms in breast cancer survivors based on internal consistency, test-retest reliability, and structural validity. Further studies that analyze other measurement properties in different Spanish clinical populations are needed.
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Affiliation(s)
- Cristina Roldán-Jiménez
- Departamento de Fisioterapia, Facultad de Ciencias de la Salud, Andalucia Tech, Universidad de Málaga, Málaga, Spain.,Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Bella Pajares
- Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Marcos Iglesias Campos
- Unidad de Gestión Clínica Intercentros de Oncología Médica, IBIMA, Hospitales Universitarios Regional y Virgen de la Victoria, Málaga, Spain
| | - Manuel Trinidad-Fernández
- Departamento de Fisioterapia, Facultad de Ciencias de la Salud, Andalucia Tech, Universidad de Málaga, Málaga, Spain
| | - Daniel Gutiérrez-Sánchez
- Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain.,Departamento de Enfermería y Podología, Facultad de Ciencias de la Salud, Universidad de Málaga, Málaga, Spain
| | - Nuria Ribelles
- Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Emilio Alba
- Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | - Antonio Ignacio Cuesta-Vargas
- Departamento de Fisioterapia, Facultad de Ciencias de la Salud, Andalucia Tech, Universidad de Málaga, Málaga, Spain.,Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain.,School of Clinical Science, Faculty of Health Science, Queensland University Technology, Brisbane City, Qld, Australia
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48
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AlShamlan NA, AlOmar RS, Almukhadhib OY, Algarni SA, Alshaibani AK, Elmaki SA, Al Shammari MA, Sebiany AM. Characteristics of Breast Masses of Female Patients Referred for Diagnostic Breast Ultrasound from a Saudi Primary Health Care Setting. Int J Gen Med 2021; 14:755-763. [PMID: 33688246 PMCID: PMC7937368 DOI: 10.2147/ijgm.s298389] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 02/19/2021] [Indexed: 01/30/2023] Open
Abstract
Background Breast masses are common among females presenting to primary health care (PHC) facilities. The family physician’s role is crucial in detecting breast disease. Utilization of breast ultrasonography has been increasing recently as a diagnostic tool. Objective This study aims to determine the characteristics of masses detected on breast ultrasound, their associations with characteristics of females attending the PHC setting and explore the management of these cases by family physicians. Methods This registered based, cross-sectional study included 321 females who were referred for diagnostic breast ultrasound in the PHC center of the University hospital, Eastern province, Saudi Arabia (2017–2019). t-test, Chi-squared and Fisher’s Exact tests were performed to assess associations between the presence of breast masses in the ultrasound and patients’ characteristics. Moreover, to compare the breast masses in two groups of patients (< 40 years and ≥ 40 years) regarding their characteristics, ultrasound findings, and further management performed. P < 0.05 was considered statistically significant. Results Approximately 24% patients had a breast mass and 70.92% of cases were detected among females ≥ 40 years old. The odds of having a breast mass were highest among overweight, females complaining from a breast lump, and who had early menarche. Grand multiparous had lower odds of a breast mass. Females < 40 years old had higher rates of breastfeeding, increasing parity, and obesity than older females. Sonographic examined masses were larger in young females, and posterior enhancement of the mass was more reported in older. BI-RADs of the masses were not associated with the patient’s age. Conclusion Breast masses were prevalent among females who underwent breast ultrasound. The results support referral for investigation when a female complains of a breast lump. Family physicians have a vital role in encouraging protective behaviors from developing breast masses such as maintaining normal weight and breastfeeding.
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Affiliation(s)
- Nouf A AlShamlan
- Department of Family and Community Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Reem S AlOmar
- Department of Family and Community Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Omar Y Almukhadhib
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Saad A Algarni
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Askar K Alshaibani
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Sara A Elmaki
- Department of Radiology at Family and Community Medicine Center, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Malak A Al Shammari
- Department of Family and Community Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Abdulaziz M Sebiany
- Department of Family and Community Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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49
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Lai J, Mak V, Bright CJ, Lyratzopoulos G, Elliss-Brookes L, Gildea C. Reviewing the impact of 11 national Be Clear on Cancer public awareness campaigns, England, 2012 to 2016: A synthesis of published evaluation results. Int J Cancer 2021; 148:1172-1182. [PMID: 32875560 DOI: 10.1002/ijc.33277] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 08/07/2020] [Accepted: 08/17/2020] [Indexed: 12/23/2022]
Abstract
The Be Clear on Cancer (BCoC) campaigns have run in England since 2010. They aim to raise awareness of possible cancer symptoms, encouraging people to consult a general practice with these symptoms. Our study provides an overview of the impact of 11 national campaigns, for bowel, lung, bladder and kidney, breast and oesophago-gastric cancers. We synthesised existing results for each campaign covering seven clinical metrics across the patient pathway from primary care attendances to one-year net survival. For each metric, "before" and "after" periods were compared to assess change potentially related to the campaign. Results show that primary care attendances for campaign-related symptoms increased for 9 of 10 campaigns and relevant urgent referrals for suspected cancer increased above general trends for 9 of 11 campaigns. Diagnostic tests increased for 6 of 11 campaigns. For 7 of 11 campaigns, there were increases in cancer diagnoses resulting from an urgent referral for suspected cancer. There were sustained periods where more cancers were diagnosed than expected for 8 of 10 campaigns, with higher than expected proportions diagnosed at an early stage for sustained periods for 4 of 10 campaigns. There was no impact on survival. In summary, there is evidence that the BCoC campaigns impact help-seeking by patients and referral patterns by general practitioners, with some impact on diagnosis (incidence and stage). There was no clear evidence of impact on survival.
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Affiliation(s)
- Jennifer Lai
- National Cancer Registration and Analysis Service (NCRAS), Public Health England, London, UK
| | - Vivian Mak
- National Cancer Registration and Analysis Service (NCRAS), Public Health England, London, UK
| | - Chloe J Bright
- National Cancer Registration and Analysis Service (NCRAS), Public Health England, London, UK
| | - Georgios Lyratzopoulos
- National Cancer Registration and Analysis Service (NCRAS), Public Health England, London, UK
- Department of Epidemiology and Public Health, Health Behaviour Research Centre, University College London, London, UK
| | - Lucy Elliss-Brookes
- National Cancer Registration and Analysis Service (NCRAS), Public Health England, London, UK
| | - Carolynn Gildea
- National Cancer Registration and Analysis Service (NCRAS), Public Health England, London, UK
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50
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Guruprasad P, Lee YG, Kim KH, Ruella M. The current landscape of single-cell transcriptomics for cancer immunotherapy. J Exp Med 2021; 218:e20201574. [PMID: 33601414 PMCID: PMC7754680 DOI: 10.1084/jem.20201574] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 11/28/2020] [Accepted: 12/02/2020] [Indexed: 12/28/2022] Open
Abstract
Immunotherapies such as immune checkpoint blockade and adoptive cell transfer have revolutionized cancer treatment, but further progress is hindered by our limited understanding of tumor resistance mechanisms. Emerging technologies now enable the study of tumors at the single-cell level, providing unprecedented high-resolution insights into the genetic makeup of the tumor microenvironment and immune system that bulk genomics cannot fully capture. Here, we highlight the recent key findings of the use of single-cell RNA sequencing to deconvolute heterogeneous tumors and immune populations during immunotherapy. Single-cell RNA sequencing has identified new crucial factors and cellular subpopulations that either promote tumor progression or leave tumors vulnerable to immunotherapy. We anticipate that the strategic use of single-cell analytics will promote the development of the next generation of successful, rationally designed immunotherapeutics.
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Affiliation(s)
- Puneeth Guruprasad
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA
- Center for Cellular Immunotherapies, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
- Department of Medicine, Division of Hematology and Oncology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Yong Gu Lee
- Center for Cellular Immunotherapies, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
- Department of Medicine, Division of Hematology and Oncology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Ki Hyun Kim
- Center for Cellular Immunotherapies, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
- Department of Medicine, Division of Hematology and Oncology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Marco Ruella
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA
- Center for Cellular Immunotherapies, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
- Department of Medicine, Division of Hematology and Oncology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA
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