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Austin JD, James E, Perez RL, Mazza GL, Kling JM, Fraker J, Mina L, Banerjee I, Sharpe R, Patel BK. Factors influencing U.S. women's interest and preferences for breast cancer risk communication: a cross-sectional study from a large tertiary care breast imaging center. BMC Womens Health 2024; 24:359. [PMID: 38907193 PMCID: PMC11191185 DOI: 10.1186/s12905-024-03197-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Accepted: 06/10/2024] [Indexed: 06/23/2024] Open
Abstract
BACKGROUND Breast imaging clinics in the United States (U.S.) are increasingly implementing breast cancer risk assessment (BCRA) to align with evolving guideline recommendations but with limited uptake of risk-reduction care. Effectively communicating risk information to women is central to implementation efforts, but remains understudied in the U.S. This study aims to characterize, and identify factors associated with women's interest in and preferences for breast cancer risk communication. METHODS This is a cross-sectional survey study of U.S. women presenting for a mammogram between January and March of 2021 at a large, tertiary breast imaging clinic. Survey items assessed women's interest in knowing their risk and preferences for risk communication if considered to be at high risk in hypothetical situations. Multivariable logistic regression modeling assessed factors associated with women's interest in knowing their personal risk and preferences for details around exact risk estimates. RESULTS Among 1119 women, 72.7% were interested in knowing their breast cancer risk. If at high risk, 77% preferred to receive their exact risk estimate and preferred verbal (52.9% phone/47% in-person) vs. written (26.5% online/19.5% letter) communications. Adjusted regression analyses found that those with a primary family history of breast cancer were significantly more interested in knowing their risk (OR 1.5, 95% CI 1.0, 2.1, p = 0.04), while those categorized as "more than one race or other" were significantly less interested in knowing their risk (OR 0.4, 95% CI 0.2, 0.9, p = 0.02). Women 60 + years of age were significantly less likely to prefer exact estimates of their risk (OR 0.6, 95% CI 0.5, 0.98, p < 0.01), while women with greater than a high school education were significantly more likely to prefer exact risk estimates (OR 2.5, 95% CI 1.5, 4.2, p < 0.001). CONCLUSION U.S. women in this study expressed strong interest in knowing their risk and preferred to receive exact risk estimates verbally if found to be at high risk. Sociodemographic and family history influenced women's interest and preferences for risk communication. Breast imaging centers implementing risk assessment should consider strategies tailored to women's preferences to increase interest in risk estimates and improve risk communication.
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Affiliation(s)
- Jessica D Austin
- Department of Quantitative Health Sciences, Division of Epidemiology, Mayo Clinic, 13400 E. Shea Blvd, Scottsdale, AZ, 85259, USA.
| | - Emily James
- Mayo Clinic College of Medicine of Medicine and Science, Mayo Clinic, 5777 E Mayo Blvd, Phoenix, AZ, 85054, USA
| | - Rachel L Perez
- Mayo Clinic College of Medicine of Medicine and Science, Mayo Clinic, 5777 E Mayo Blvd, Phoenix, AZ, 85054, USA
| | - Gina L Mazza
- Department of Quantitative Health Sciences, Division of Clinical Trials and Biostatistics, Mayo Clinic, 13400 E. Shea Blvd, Scottsdale, AZ, 85259, USA
| | - Juliana M Kling
- Women's Health Internal Medicine, Department of Internal Medicine, Mayo Clinic, 13400 E. Shea Blvd, Scottsdale, AZ, 85259, USA
| | - Jessica Fraker
- Women's Health Internal Medicine, Department of Internal Medicine, Mayo Clinic, 13400 E. Shea Blvd, Scottsdale, AZ, 85259, USA
| | - Lida Mina
- Department of Internal Medicine, Division of Medical Oncology, Mayo Clinic, 5777 E Mayo Blvd, Phoenix, AZ, 85054, USA
| | - Imon Banerjee
- Department of Diagnostic Radiology, Mayo Clinic, 5777 E Mayo Blvd, Phoenix, AZ, 85054, USA
| | - Richard Sharpe
- Department of Diagnostic Radiology, Mayo Clinic, 5777 E Mayo Blvd, Phoenix, AZ, 85054, USA
| | - Bhavika K Patel
- Department of Diagnostic Radiology, Mayo Clinic, 5777 E Mayo Blvd, Phoenix, AZ, 85054, USA
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Amornsiripanitch N, Ameri SM, Goldberg RJ. Impact of Age, Race, and Socioeconomic Status on Women's Perceptions and Preferences Regarding Communication of Estimated Breast Cancer Risk. Acad Radiol 2021; 28:655-663. [PMID: 32376184 DOI: 10.1016/j.acra.2020.03.041] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 03/07/2020] [Accepted: 03/22/2020] [Indexed: 11/30/2022]
Abstract
RATIONALE AND OBJECTIVES Performing breast cancer risk assessment at the time of screening mammography has potential to increase high-risk identification, appropriate supplemental screening, and risk management. The study's goal is to investigate women's interest in risk assessment and preferred method of risk communication in a diverse patient population. MATERIALS AND METHODS Surveys in English and five non-English languages were distributed to women presenting for screening mammography at eight screening mammography facilities between February and May 2019 to assess their interest in risk assessment, preferred method, and level of detail of estimated risk communication in hypothetical scenarios where estimated risks are average and elevated. RESULTS Among 683 survey respondents, 592 (87%) expressed interest in learning about their estimated lifetime risk of breast cancer. Controlling for age, race/ethnicity, and education, women with higher income were more interested in risk assessment than comparison group (p<0.05). The most preferred method of average risk communication was by a mailed letter accompanying mammographic results (57%), but more women exclusively preferred face-to-face communications of elevated risk than of average risk estimate (191, 28% vs. 128, 19%, p<0.0001). Phone communication was more preferred by younger women, electronic communication was less preferred by older women and those with lower income, and non-Hispanic blacks and older women preferred less detailed communication (p<0.05). CONCLUSION Sociodemographic factors influence women's interest in risk assessment and preference in risk communication about breast cancer. Screening Mammogram facilities implementing risk assessment should consider risk communication strategies that are most effective for their patient population.
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Affiliation(s)
- N Amornsiripanitch
- University of Massachusetts Medical School, 55 N Lake Ave, Worcester, MA 01655.
| | - S M Ameri
- University of Massachusetts Medical School, 55 N Lake Ave, Worcester, MA 01655. Phone: (617) 894-2712.
| | - R J Goldberg
- University of Massachusetts Medical School, 55 N Lake Ave, Worcester, MA 01655. Phone: (508) 856-8798. Fax (508) 856-8993.
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Wernli KJ, Bowles EA, Knerr S, Leppig KA, Ehrlich K, Gao H, Schwartz MD, O’Neill SC. Characteristics Associated with Participation in ENGAGED 2 - A Web-based Breast Cancer Risk Communication and Decision Support Trial. Perm J 2020; 24:1-4. [PMID: 33482952 PMCID: PMC7849258 DOI: 10.7812/tpp/19.205] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 10/14/2020] [Accepted: 03/01/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE We evaluated demographic and clinical characteristics associated with participation in a clinical trial testing the efficacy of an online tool to support breast cancer risk communication and decision support for risk mitigation to determine the generalizability of trial results. METHODS Eligible women were members of Kaiser Permanente Washington aged 40-69 years with a recent normal screening mammogram, heterogeneously or extremely dense breasts and a calculated risk of > 1.67% based on the Breast Cancer Surveillance Consortium 5-year breast cancer risk model. Trial outcomes were chemoprevention and breast magnetic resonance imaging by 12-months post-baseline. Women were recruited via mail with phone follow-up using plain language materials notifying them of their density status and higher than average breast cancer risk. Multivariable logistic regression calculated independent odds ratios (ORs) for associations between demographic and clinical characteristics with trial participation. RESULTS Of 2,569 eligible women contacted, 995 (38.7%) participated. Women with some college (OR = 1.99, 95% confidence interval [CI] 1.34-2.96) or college degree (OR = 3.35, 95% CI 2.29-4.90) were more likely to participate than high school-educated women. Race/ethnicity also was associated with participation (African-American OR = 0.50, 95% CI 0.29-0.87; Asian OR = 0.22, 95% CI 0.12-0.41). Multivariate adjusted ORs for family history of breast/ovarian cancer were not associated with trial participation. DISCUSSION Use of plain language and potential access to a website providing personal breast cancer risk information and education were insufficient in achieving representative participation in a breast cancer prevention trial. Additional methods of targeting and tailoring, potentially facilitated by clinical and community outreach, are needed to facilitate equitable engagement for all women.
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Affiliation(s)
- Karen J Wernli
- Kaiser Permanente Washington Health Research Institute, Seattle, WA
| | - Erin A Bowles
- Kaiser Permanente Washington Health Research Institute, Seattle, WA
| | | | | | - Kelly Ehrlich
- Kaiser Permanente Washington Health Research Institute, Seattle, WA
| | - Hongyuan Gao
- Kaiser Permanente Washington Health Research Institute, Seattle, WA
| | - Marc D Schwartz
- Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC
| | - Suzanne C O’Neill
- Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC
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Amornsiripanitch N, Ameri SM, Goldberg RJ. Primary Care Providers Underutilize Breast Screening MRI for High-Risk Women. Curr Probl Diagn Radiol 2020; 50:489-494. [PMID: 32546344 DOI: 10.1067/j.cpradiol.2020.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 03/23/2020] [Accepted: 04/14/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Supplemental MRI screening for women at high risk for breast cancer is underutilized. Our study assessed how primary care providers in our healthcare network identify high-risk women and recommend high-risk screening breast MRI. METHODS An electronic survey was distributed to providers in OB/GYN, family, and internal medicine departments between 1/14/19 and 3/22/19. The survey inquired about methods used to assess breast cancer risk, familiarity with the American Cancer Society's definition of high-risk, and whether screening breast MRI is recommended for high-risk women. RESULTS Response rate was 17% (89/524). After excluding providers who ordered ≤10 mammograms per year, the study included 75 respondents, who mostly ordered 10-1000 mammograms per year and supported annual/biennial screening mammogram starting at age 40-50 years. More providers reported estimating breast cancer risk qualitatively (with family, clinical history, and/or breast density) than quantitatively with risk calculators (73/75, 97% vs 22/75, 29%). A minority of providers (23/75, 31%) correctly defined high lifetime risk. Only 9/75 (12%) providers recommended screening MRI for high-risk women. Use of quantitative risk calculators or ability to correctly define high-risk were not associated with likelihood of recommending MRI screening. More providers had recommended MRI for screening in the setting of dense breasts than for high-risk screening (23/75, 31% vs 9/75, 12%). CONCLUSION Primary care providers at our institution did not routinely recommend screening MRI for high-risk women. Risk assessment and reporting at the time of mammography may improve MRI utilization and is an opportunity for radiologists to add value and directly participate in patient-centered care.
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Affiliation(s)
| | - S M Ameri
- University of Massachusetts Medical School, Worcester, MA
| | - R J Goldberg
- University of Massachusetts Medical School, Worcester, MA
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Paz MFCJ, Gomes Júnior AL, de Alencar MVOB, Tabrez S, Islam MT, Jabir NR, Oves M, Alam MZ, Asghar MN, Ali ES, da Conceição Machado K, da Conceição Machado K, da Silva FCC, Sobral ALP, de Castro E Sousa JM, de Moraes GP, Mishra SK, da Silva J, de Carvalho Melo-Cavalcante AA. Effect of Diets, Familial History, and Alternative Therapies on Genomic Instability of Breast Cancer Patients. Appl Biochem Biotechnol 2018; 188:282-296. [PMID: 30430345 DOI: 10.1007/s12010-018-2918-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Accepted: 11/05/2018] [Indexed: 12/30/2022]
Abstract
This study evaluates a correlation between family history, micronutrients intake, and alternative therapies with genetic instability, before and during breast cancer treatment. For this study, a total of 150 women were selected. Among those, 50 women were breast cancer patients on chemotherapy, while 50 breast cancer patients were on radiotherapy, and 50 were healthy females. All the participants signed the informed consent form and answered the public health questionnaire. Samples of buccal epithelial and peripheral blood cells were collected and analyzed through micronucleus and comet assays. The cells were evaluated for apoptosis and DNA damage. Results showed the association of patients' family history with an increase in toxicogenetic damage before and during cancer therapy. On the other hand, patients with late-onset cancer also presented genetic instability before and during therapy, along with those who did not take sufficient vegetables and alternative therapies. A positive correlation was observed between the genetic instability and alternative therapies, while inverse correlation was recorded with the vegetable consumption. Results clearly explain that the nutritional aspects and alternative therapies influence the genetic instability before and during cancer therapies especially in radiotherapy treated patients. Our data could be used for the monitoring therapies and management of breast cancer patients.
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Affiliation(s)
- Márcia Fernanda Correia Jardim Paz
- Laboratory of Genetic Toxicology, PPGBioSaúde and PPGGTA, Lutheran University of Brazil (ULBRA), Av. Farroupilha 8001, Prédio 22, Sala 22 (4° Andar), Canoas, RS, 92425-900, Brazil.,Northeast Biotechnology Network (RENORBIO), Post-Graduate Program in Pharmaceutical Science, Federal University of Piauí, Teresina, Piauí, 64.049-550, Brazil
| | - Antônio Luiz Gomes Júnior
- Northeast Biotechnology Network (RENORBIO), Post-Graduate Program in Pharmaceutical Science, Federal University of Piauí, Teresina, Piauí, 64.049-550, Brazil
| | | | - Shams Tabrez
- King Fahd Medical Research Center, King Abdulaziz University, Jeddah, 21589, Saudi Arabia.
| | - Muhammad Torequl Islam
- Department for Management of Science and Technology Development, Ton Duc Thang University, Ho Chi Minh City, 700000, Vietnam. .,Faculty of Pharmacy, Ton Duc Thang University, Ho Chi Minh City, 700000, Vietnam.
| | - Nasimudeen R Jabir
- King Fahd Medical Research Center, King Abdulaziz University, Jeddah, 21589, Saudi Arabia
| | - Mohammad Oves
- Center of Excellence in Environmental Research, King Abdulaziz University, Jeddah, 21589, Saudi Arabia
| | - Mohammad Zubair Alam
- King Fahd Medical Research Center, King Abdulaziz University, Jeddah, 21589, Saudi Arabia
| | | | - Eunüs S Ali
- Gaco Pharmaceuticals and Research Laboratory, Dhaka, 1000, Bangladesh.,College of Medicine and Public Health, Flinders University, Bedford Park, 5042, Australia
| | - Keylla da Conceição Machado
- Northeast Biotechnology Network (RENORBIO), Post-Graduate Program in Pharmaceutical Science, Federal University of Piauí, Teresina, Piauí, 64.049-550, Brazil
| | - Kátia da Conceição Machado
- Northeast Biotechnology Network (RENORBIO), Post-Graduate Program in Pharmaceutical Science, Federal University of Piauí, Teresina, Piauí, 64.049-550, Brazil
| | - Felipe Cavalcanti Carneiro da Silva
- Northeast Biotechnology Network (RENORBIO), Post-Graduate Program in Pharmaceutical Science, Federal University of Piauí, Teresina, Piauí, 64.049-550, Brazil
| | - André Luiz Pinho Sobral
- Northeast Biotechnology Network (RENORBIO), Post-Graduate Program in Pharmaceutical Science, Federal University of Piauí, Teresina, Piauí, 64.049-550, Brazil
| | - João Marcelo de Castro E Sousa
- Northeast Biotechnology Network (RENORBIO), Post-Graduate Program in Pharmaceutical Science, Federal University of Piauí, Teresina, Piauí, 64.049-550, Brazil
| | - Germano Pinho de Moraes
- Northeast Biotechnology Network (RENORBIO), Post-Graduate Program in Pharmaceutical Science, Federal University of Piauí, Teresina, Piauí, 64.049-550, Brazil
| | - Siddhartha Kumar Mishra
- Cancer Biology Laboratory, School of Biological Sciences (Zoology), Dr. Harisingh Gour Central University, Sagar, 470003, India
| | - Juliana da Silva
- Laboratory of Genetic Toxicology, PPGBioSaúde and PPGGTA, Lutheran University of Brazil (ULBRA), Av. Farroupilha 8001, Prédio 22, Sala 22 (4° Andar), Canoas, RS, 92425-900, Brazil
| | - Ana Amélia de Carvalho Melo-Cavalcante
- Northeast Biotechnology Network (RENORBIO), Post-Graduate Program in Pharmaceutical Science, Federal University of Piauí, Teresina, Piauí, 64.049-550, Brazil
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Paz MFCJ, Sobral ALP, Picada JN, Grivicich I, Júnior ALG, da Mata AMOF, de Alencar MVOB, de Carvalho RM, da Conceição Machado K, Islam MT, de Carvalho Melo Cavalcante AA, da Silva J. Persistent Increased Frequency of Genomic Instability in Women Diagnosed with Breast Cancer: Before, during, and after Treatments. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2018; 2018:2846819. [PMID: 30013718 PMCID: PMC6022262 DOI: 10.1155/2018/2846819] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 02/13/2018] [Indexed: 12/12/2022]
Abstract
This study aimed to evaluate DNA damage in patients with breast cancer before treatment (background) and after chemotherapy (QT) and radiotherapy (RT) treatment using the Comet assay in peripheral blood and the micronucleus test in buccal cells. We also evaluated repair of DNA damage after the end of RT, as well as the response of patient's cells before treatment with an oxidizing agent (H2O2; challenge assay). Fifty women with a mammographic diagnosis negative for cancer (control group) and 100 women with a diagnosis of breast cancer (followed up during the treatment) were involved in this study. The significant DNA damage was observed by increasing in the index and frequency of damage along with the increasing of the frequency of micronuclei in peripheral blood and cells of the buccal mucosa, respectively. Despite the variability of the responses of breast cancer patients, the individuals presented lesions on the DNA, detected by the Comet assay and micronucleus Test, from the diagnosis until the end of the oncological treatment and were more susceptible to oxidative stress. We can conclude that the damages were due to clastogenic and/or aneugenic effects related to the neoplasia itself and that they increased, especially after RT.
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Affiliation(s)
- Márcia Fernanda Correia Jardim Paz
- Laboratory of Genetic Toxicology, PPGBioSaúde and PPGGTA, Lutheran University of Brazil (ULBRA), Av. Farroupilha 8001, Prédio 22, Sala 22 (4° Andar), 92425-900 Canoas, RS, Brazil
- Laboratory of Genetic Toxicology, PPGCF, Federal University of Piauí, Av. Universitária S/N, Ininga, 64049-550 Teresina, PI, Brazil
- Post-Graduation Program in Biotechnology, RENORBIO, Federal University of Piauí, Av. Universitária, S/N, Ininga, 64049-550 Teresina, PI, Brazil
| | - André Luiz Pinho Sobral
- University Hospital of Piauí, Av. Universitária, S/N, Ininga, 64049-550 Teresina, PI, Brazil
| | - Jaqueline Nascimento Picada
- Laboratory of Genetic Toxicology, PPGBioSaúde and PPGGTA, Lutheran University of Brazil (ULBRA), Av. Farroupilha 8001, Prédio 22, Sala 22 (4° Andar), 92425-900 Canoas, RS, Brazil
| | - Ivana Grivicich
- Laboratory of Cancer Biology, PPGBioSaúde and PPGGTA, Lutheran University of Brazil (ULBRA), Av. Farroupilha 8001, Prédio 22, Sala 22 (4° Andar), 92425-900 Canoas, RS, Brazil
| | - Antonio Luiz Gomes Júnior
- Laboratory of Genetic Toxicology, PPGCF, Federal University of Piauí, Av. Universitária S/N, Ininga, 64049-550 Teresina, PI, Brazil
- Post-Graduation Program in Biotechnology, RENORBIO, Federal University of Piauí, Av. Universitária, S/N, Ininga, 64049-550 Teresina, PI, Brazil
- Biomedicine Department, UNINOVAFAPI University, Teresina, Brazil
| | - Ana Maria Oliveira Ferreira da Mata
- Laboratory of Genetic Toxicology, PPGCF, Federal University of Piauí, Av. Universitária S/N, Ininga, 64049-550 Teresina, PI, Brazil
- Post-Graduation Program in Biotechnology, RENORBIO, Federal University of Piauí, Av. Universitária, S/N, Ininga, 64049-550 Teresina, PI, Brazil
| | - Marcus Vinícius Oliveira Barros de Alencar
- Laboratory of Genetic Toxicology, PPGCF, Federal University of Piauí, Av. Universitária S/N, Ininga, 64049-550 Teresina, PI, Brazil
- Department of Biochemistry and Pharmacology, Federal University of Piauí, Av. Universitária, S/N, Ininga, 64049-550 Teresina, PI, Brazil
| | - Rodrigo Mendes de Carvalho
- Central Laboratory of Public Health of Piauí, Rua Dezenove de Novembro 1945, Bairro Primavera, 64002-570 Teresina, PI, Brazil
| | - Kátia da Conceição Machado
- Laboratory of Genetic Toxicology, PPGCF, Federal University of Piauí, Av. Universitária S/N, Ininga, 64049-550 Teresina, PI, Brazil
- Post-Graduation Program in Biotechnology, RENORBIO, Federal University of Piauí, Av. Universitária, S/N, Ininga, 64049-550 Teresina, PI, Brazil
| | - Muhammad Torequl Islam
- Department for Management of Science and Technology Development, Ton Duc Thang University, Ho Chi Minh City 700000, Vietnam
- Faculty of Pharmacy, Ton Duc Thang University, Ho Chi Minh City 700000, Vietnam
| | - Ana Amélia de Carvalho Melo Cavalcante
- Laboratory of Genetic Toxicology, PPGCF, Federal University of Piauí, Av. Universitária S/N, Ininga, 64049-550 Teresina, PI, Brazil
- Post-Graduation Program in Biotechnology, RENORBIO, Federal University of Piauí, Av. Universitária, S/N, Ininga, 64049-550 Teresina, PI, Brazil
| | - Juliana da Silva
- Laboratory of Genetic Toxicology, PPGBioSaúde and PPGGTA, Lutheran University of Brazil (ULBRA), Av. Farroupilha 8001, Prédio 22, Sala 22 (4° Andar), 92425-900 Canoas, RS, Brazil
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Paz MFCJ, de Alencar MVOB, Gomes Junior AL, da Conceição Machado K, Islam MT, Ali ES, Shill MC, Ahmed MI, Uddin SJ, da Mata AMOF, de Carvalho RM, da Conceição Machado K, Sobral ALP, da Silva FCC, de Castro e Souza JM, Arcanjo DDR, Ferreira PMP, Mishra SK, da Silva J, de Carvalho Melo-Cavalcante AA. Correlations between Risk Factors for Breast Cancer and Genetic Instability in Cancer Patients-A Clinical Perspective Study. Front Genet 2018; 8:236. [PMID: 29503660 PMCID: PMC5821102 DOI: 10.3389/fgene.2017.00236] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 12/27/2017] [Indexed: 11/18/2022] Open
Abstract
Molecular epidemiological studies have identified several risk factors linking to the genes and external factors in the pathogenesis of breast cancer. In this sense, genetic instability caused by DNA damage and DNA repair inefficiencies are important molecular events for the diagnosis and prognosis of therapies. Therefore, the objective of this study was to analyze correlation between sociocultural, occupational, and lifestyle risk factors with levels of genetic instability in non-neoplastic cells of breast cancer patients. Total 150 individuals were included in the study that included 50 breast cancer patients submitted to chemotherapy (QT), 50 breast cancer patients submitted to radiotherapy (RT), and 50 healthy women without any cancer. Cytogenetic biomarkers for apoptosis and DNA damage were evaluated in samples of buccal epithelial and peripheral blood cells through micronuclei and comet assay tests. Elder age patients (61-80 years) had higher levels of apoptosis (catriolysis by karyolysis) and DNA damage at the diagnosis (baseline damage) with increased cell damage during QT and especially during RT. We also reported the increased frequencies of cytogenetic biomarkers in patients who were exposed to ionizing radiation as well as for alcoholism and smoking. QT and RT induced high levels of fragmentation (karyorrhexis) and nuclear dissolution (karyolysis) and DNA damage. Correlations were observed between age and karyorrhexis at diagnosis; smoking and karyolysis during RT; and radiation and karyolysis during QT. These correlations indicate that risk factors may also influence the genetic instability in non-neoplastic cells caused to the patients during cancer therapies.
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Affiliation(s)
| | | | - Antonio Luiz Gomes Junior
- Postgraduate Program in Pharmaceutical Sciences, Federal University of Piauí, Teresina, Brazil
- Biomedicine Department, UNINOVAFAPI University, Teresina, Brazil
| | | | - Muhammad Torequl Islam
- Postgraduate Program in Pharmaceutical Sciences, Federal University of Piauí, Teresina, Brazil
- Department of Pharmacy, Southern University Bangladesh, Chittagong, Bangladesh
| | - Eunus S. Ali
- School of Medicine, Flinders University, Adelaide, SA, Australia
| | - Manik Chandra Shill
- Department of Pharmaceutical Sciences, North South University, Dhaka, Bangladesh
| | - Md. Iqbal Ahmed
- Pharmacy Discipline, Life Science School, Khulna University, Khulna, Bangladesh
| | - Shaikh Jamal Uddin
- Pharmacy Discipline, Life Science School, Khulna University, Khulna, Bangladesh
| | | | | | | | | | | | | | | | - Paulo Michel Pinheiro Ferreira
- Postgraduate Program in Pharmaceutical Sciences, Federal University of Piauí, Teresina, Brazil
- Department of Biophysics and Physiology, Universidade Federal do Piauí, Teresina, Brazil
| | - Siddhartha Kumar Mishra
- Cancer Biology Laboratory, School of Biological Sciences (Zoology), Dr. Harisingh Gour Central University, Sagar, India
| | - Juliana da Silva
- Program in Cellular and Molecular Biology Applied to Health Sciences, Universidade Luterana do Brasil, Canoas, Brazil
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Rapport F, Khanom A, Doel MA, Hutchings HA, Bierbaum M, Hogden A, Shih P, Braithwaite J, Clement C. Women's Perceptions of Journeying Toward an Unknown Future With Breast Cancer: The "Lives at Risk Study". QUALITATIVE HEALTH RESEARCH 2018; 28:30-46. [PMID: 28938853 DOI: 10.1177/1049732317730569] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Breast cancer risk classifications are useful for prognosis, yet little is known of their effect on patients. This study clarified women's understandings of risk as they "journeyed" through the health care system. Breast cancer patients and women undergoing genetic investigation were recruited ( N = 25) from a large UK Health Board, 2014-2015, completing a "Book of Experience," and Bio-photographic elicitation interviews. Stakeholder and Participant Feedback Forums were undertaken with key stakeholders, including patients, oncologists, funders, and policy developers, to inform team understanding. Thematic and visual frameworks from multidisciplinary analysis workshops uncovered two themes: "Subjective Understandings of Risk" and "Journeying Toward an Unknown Future." Breast cancer patients and women undergoing investigation experienced risk intuitively. Statistical formulations were often perplexing, diverting attention away from concrete life-and-death facts. Following risk classification, care must be co-defined to reduce patients' foreboding about an unknown future, taking into consideration personal risk management strategies and aspirations for a cancer-free future.
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Affiliation(s)
| | | | | | | | - Mia Bierbaum
- 1 Macquarie University, Sydney, New South Wales, Australia
| | - Anne Hogden
- 1 Macquarie University, Sydney, New South Wales, Australia
| | - Patti Shih
- 1 Macquarie University, Sydney, New South Wales, Australia
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9
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Screening Mammography: Patient Perceptions and Preferences Regarding Communication of Estimated Breast Cancer Risk. AJR Am J Roentgenol 2017; 208:1163-1170. [DOI: 10.2214/ajr.16.16779] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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