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Yaghjyan L, Heng YJ, Baker GM, Murthy D, Mahoney MB, Rosner B, Tamimi RM. Associations of stem cell markers CD44, CD24 and ALDH1A1 with mammographic breast density in women with benign breast biopsies. Br J Cancer 2024:10.1038/s41416-024-02743-2. [PMID: 38849477 DOI: 10.1038/s41416-024-02743-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 04/08/2024] [Accepted: 05/29/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND We examined associations of CD44, CD24 and ALDH1A1 breast stem cell markers with mammographic breast density (MBD), a well-established breast cancer (BCa) risk factor. METHODS We included 218 cancer-free women with biopsy-confirmed benign breast disease within the Nurses' Health Study (NHS) and NHSII. The data on BCa risk factors were obtained from biennial questionnaires. Immunohistochemistry (IHC) was done on tissue microarrays. For each core, the IHC expression was assessed using a semi-automated platform and expressed as percent of positively stained cells for each marker out of the total cell count. MBD was assessed with computer-assisted techniques. Generalised linear regression was used to examine the associations of each marker with square root-transformed percent density (PD), absolute dense and non-dense areas (NDA), adjusted for BCa risk factors. RESULTS Stromal CD44 and ALDH1A1 expression was positively associated with PD (≥ 10% vs. <10% β = 0.56, 95% confidence interval [CI] [0.06; 1.07] and β = 0.81 [0.27; 1.34], respectively) and inversely associated with NDA (β per 10% increase = -0.17 [-0.34; -0.01] and β for ≥10% vs. <10% = -1.17 [-2.07; -0.28], respectively). Epithelial CD24 expression was inversely associated with PD (β per 10% increase = -0.14 [-0.28; -0.01]. Stromal and epithelial CD24 expression was positively associated with NDA (β per 10% increase = 0.35 [0.2 × 10-2; 0.70] and β per 10% increase = 0.34 [0.11; 0.57], respectively). CONCLUSION Expression of stem cell markers is associated with MBD.
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Affiliation(s)
- Lusine Yaghjyan
- University of Florida, College of Public Health and Health Professions and College of Medicine, Department of Epidemiology, Gainesville, FL, USA.
| | - Yujing J Heng
- Department of Pathology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Gabrielle M Baker
- Department of Pathology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Divya Murthy
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Matt B Mahoney
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Bernard Rosner
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Rulla M Tamimi
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA
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Omoleye OJ, Freeman JQ, Oluwasanu M, Adeniji-Sofoluwe A, Woodard AE, Aribisala BS, Adejumo PO, Ntekim A, Makumbi T, Ndom P, Ajayi IO, Olopade OI, Huo D. Benign breast disease and breast cancer risk in African women: a case-control study. Cancer Causes Control 2024; 35:787-798. [PMID: 38177455 DOI: 10.1007/s10552-023-01837-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 11/27/2023] [Indexed: 01/06/2024]
Abstract
PURPOSE To examine the association between benign breast disease (BBD) and breast cancer (BC) in a heterogeneous population of African women. METHODS BC cases and controls were enrolled in three sub-Saharan African countries, Nigeria, Cameroon, and Uganda, between 1998 and 2018. Multivariable logistic regression was used to test the association between BBD and BC. Risk factors dually associated with BBD and BC were selected. Using a parametric mediation analysis model, we assessed if selected BC risk factors were mediated by BBD. RESULTS Of 6,274 participants, 55.6% (3,478) were breast cancer cases. 360 (5.7%) self-reported BBD. Fibroadenoma (46.8%) was the most commonly reported BBD. Women with a self-reported history of BBD had greater odds of developing BC than those without (adjusted odds ratio [aOR] 1.47, 95% CI 1.13-1.91). Biopsy-confirmed BBD was associated with BC (aOR 2.25, 95% CI 1.26-4.02). BBD did not significantly mediate the effects of any of the selected BC risk factors. CONCLUSIONS In this study, BBD was associated with BC and did not significantly mediate the effects of selected BC risk factors.
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Affiliation(s)
- Olasubomi J Omoleye
- Department of Medicine, University of Chicago, Chicago, IL, USA
- Center for Clinical Cancer Genetics and Global Health, University of Chicago, Chicago, IL, USA
| | - Jincong Q Freeman
- Department of Public Health Sciences, University of Chicago, Chicago, IL, USA
| | - Mojisola Oluwasanu
- Department of Health Promotion and Education, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
| | | | - Anna E Woodard
- Center for Clinical Cancer Genetics and Global Health, University of Chicago, Chicago, IL, USA
- Data Science Institute, University of Chicago, Chicago, IL, USA
| | | | - Prisca O Adejumo
- Department of Nursing, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Atara Ntekim
- Department of Radiation Oncology, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Timothy Makumbi
- Department of Surgery, Mulago Hospital, Mulago, Kampala, Uganda
| | - Paul Ndom
- Hôpital Général Yaoundé, Yaoundé, Cameroon
| | - IkeOluwapo O Ajayi
- Department of Epidemiology and Medical Statistics, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Olufunmilayo I Olopade
- Department of Medicine, University of Chicago, Chicago, IL, USA
- Center for Clinical Cancer Genetics and Global Health, University of Chicago, Chicago, IL, USA
| | - Dezheng Huo
- Center for Clinical Cancer Genetics and Global Health, University of Chicago, Chicago, IL, USA.
- Department of Public Health Sciences, University of Chicago, 5841 S. Maryland Avenue, MC 2000, Chicago, IL, 60637, USA.
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Omoleye OJ, Freeman JQ, Oluwasanu M, Adeniji-Sofoluwe A, Woodard AE, Aribisala BS, Adejumo PO, Ntekim A, Makumbi T, Ndom P, Ajayi IO, Olopade OI, Huo D. Benign breast disease and breast cancer risk in African women: A case-control study. RESEARCH SQUARE 2023:rs.3.rs-3301977. [PMID: 37693385 PMCID: PMC10491333 DOI: 10.21203/rs.3.rs-3301977/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
Purpose To examine the association between benign breast disease (BBD) and breast cancer (BC) in a heterogeneous population of African women. Methods BC cases and matched controls were enrolled in three sub-Saharan African countries, Nigeria Cameroon, and Uganda, between 1998-2018. Multivariable logistic regression was used to test the association between BBD and BC. Risk factors dually associated with BBD and BC were selected. Using a parametric mediation analysis model, we assessed if selected BC risk factors were mediated by BBD. Results Of 6418 participants, 55.7% (3572) were breast cancer cases. 360 (5.7%) self-reported BBD. Fibroadenoma (46.8%) was the most reported BBD. Women with a self-reported history of BBD had greater odds of developing BC than those without (adjusted odds ratio [aOR] = 1.47, 95% CI: 1.13-1.91). Biopsy-confirmed BBD was associated with BC (aOR = 3.11, 95% CI: 1.78-5.44). BBD did not significantly mediate the effects of any of the selected BC risk factors. Conclusions In this study, BBD was associated with BC and did not significantly mediate the effects of selected BC risk factors.
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Christopoulos P, Matsas A, Eleftheriades M, Kotsira G, Eleftheriades A, Vlahos NF. Investigating the Link between Early Life and Breast Anomalies. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10030601. [PMID: 36980159 PMCID: PMC10047184 DOI: 10.3390/children10030601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 02/07/2023] [Accepted: 03/15/2023] [Indexed: 03/30/2023]
Abstract
Several factors during childhood and adolescence are thought to be associated with the development of proliferative benign breast diseases and breast cancer in adulthood. In order to identify them, the authors conducted an extensive review of the literature up to October 2022, searching for clinical studies, reports, and guidelines in English. A thorough Medline/Pubmed and Google scholar database research was performed, investigating the link between diet, exercise, age of menarche, body mass index, ionizing radiation exposure during childhood and adolescence, and proliferative breast diseases and breast cancer in adulthood. A list of keywords, including breast disorders, adolescence, childhood, and breast cancer was included in our search algorithm. Numerous studies concede that the development of breast disease in adulthood is influenced by various risk factors, whose influence begins during early childhood and adolescence.
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Affiliation(s)
- Panagiotis Christopoulos
- Second Department of Obstetrics and Gynecology, "Aretaieion" Hospital, Faculty of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Alkis Matsas
- Second Department of Obstetrics and Gynecology, "Aretaieion" Hospital, Faculty of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Makarios Eleftheriades
- Second Department of Obstetrics and Gynecology, "Aretaieion" Hospital, Faculty of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Georgia Kotsira
- Second Department of Obstetrics and Gynecology, "Aretaieion" Hospital, Faculty of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Anna Eleftheriades
- Second Department of Obstetrics and Gynecology, "Aretaieion" Hospital, Faculty of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Nikolaos F Vlahos
- Second Department of Obstetrics and Gynecology, "Aretaieion" Hospital, Faculty of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece
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Abraham O, Szela L, Feng E, Egbujor M, Gay S. Exploring Youth Perceptions About Cancer Prevention and Preferences for Education: a Qualitative Study. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2023; 38:50-59. [PMID: 34387834 PMCID: PMC8360774 DOI: 10.1007/s13187-021-02077-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/04/2021] [Indexed: 05/04/2023]
Abstract
This study aimed to characterize adolescents' perspectives on cancer and cancer prevention and to explore their preferences for cancer education. A total of 188 middle and high school students participated in 25 focus groups. Focus groups were led by study team members and included five to ten participants each. Adolescents were asked to discuss their cancer and cancer prevention knowledge, sources of cancer education, and preferences for cancer prevention education. Focus groups were audio-recorded, and professionally transcribed. Transcripts were content and thematically analyzed by two study team members using NVivo qualitative data software. Six themes were identified in focus groups: knowledge about cancer, negative perceptions of cancer, awareness of cancer prevention, engagement in cancer prevention, facilitators and barriers for action, and preferences for cancer education. Adolescents described a wide range of cancer education sources, including friends, family, healthcare professionals, school, technology, and pamphlets. Participants associated cancer with negative emotions, such as sadness and fear. Participants expressed interest in learning about cancer and cancer prevention, but also identified barriers to engaging in preventative behaviors, such as discomfort, lack of knowledge, and lack of personal connection to cancer. Adolescents preferred learning through personal presentations, online videos, school, educational games, and social situations. Adolescence is a critical period for learning and developing healthy behaviors. Awareness of cancer and cancer prevention is crucial to lowering cancer risk in the future. To be effective, cancer education for adolescents should target specific areas of cancer prevention and address barriers to engagement in preventative behaviors.
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Affiliation(s)
- Olufunmilola Abraham
- Social and Administrative Sciences Division , University of Wisconsin-Madison School of Pharmacy, 777 Highland Avenue, Suite 2515, Madison, USA.
| | - Lisa Szela
- Social and Administrative Sciences Division, University of Wisconsin-Madison School of Pharmacy, Madison, WI, 53705, USA
| | - Emilie Feng
- Social and Administrative Sciences Division, University of Wisconsin-Madison School of Pharmacy, Madison, WI, 53705, USA
| | - Maryann Egbujor
- Social and Administrative Sciences Division, University of Wisconsin-Madison School of Pharmacy, Madison, WI, 53705, USA
| | - Sommer Gay
- Social and Administrative Sciences Division, University of Wisconsin-Madison School of Pharmacy, Madison, WI, 53705, USA
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Briscoe G, Villanueva C, Bepko J, Colucci J, Wendt E. Benign Breast Conditions and Disease. Fam Med 2022. [DOI: 10.1007/978-3-030-54441-6_113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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7
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Aghababayan S, Sheikhi Mobarakeh Z, Qorbani M, Tiznobeyk Z, Aminianfar A, Sotoudeh G. Higher Dietary Inflammatory Index Scores are Associated with Increased Odds of Benign Breast Diseases in a Case-Control Study. J Inflamm Res 2020; 13:61-69. [PMID: 32104043 PMCID: PMC7008174 DOI: 10.2147/jir.s232157] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 01/14/2020] [Indexed: 01/02/2023] Open
Abstract
Purpose Dietary inflammatory index (DII) is a new tool for assessing the inflammatory potential of diet. Since there is no study that has investigated the association of DII and benign breast diseases (BBD), the aim of our study was to compare DII scores in patients with and without BBD. Methods One hundred and eleven (111) subjects with BBD and 104 healthy women attending the Iranian Center for Breast Cancer affiliated with the Academic Center for Education, Culture and Research were enrolled in a case–control study. Dietary data collected using a 168‑item validated food frequency questionnaire (FFQ). Energy-adjusted DII was calculated based on FFQ. Socio demographic data were collected by interview. In addition, physical activity was measured by the International Physical Activity Questionnaire (IPAQ). Weight, height and waist circumference were also measured. Results After adjustment for multiple confounding variables, participants at the highest tertile of DII had increased OR for BBD (OR=1.7, 95% CI=0.75–3.95) (P-trend =0.04). Conclusion The increased chance of BBD was suggested with a higher consumption of diets with inflammatory potential. However, this result should be interpreted with caution as OR was not statistically significant. Interventional studies are warranted to elucidate the role of inflammatory diets in the development of BBD.
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Affiliation(s)
- Sama Aghababayan
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Sheikhi Mobarakeh
- Department of Cancer Quality of Life, Breast Cancer Research Center, Academic Center for Education, Culture and Research (ACECR), Tehran, Iran
| | - Mostafa Qorbani
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran.,Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zeinab Tiznobeyk
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Azadeh Aminianfar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Gity Sotoudeh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
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8
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Benign Breast Conditions and Disease. Fam Med 2020. [DOI: 10.1007/978-1-4939-0779-3_113-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Yaghjyan L, Esnakula AK, Scott CG, Wijayabahu AT, Jensen MR, Vachon CM. Associations of mammographic breast density with breast stem cell marker-defined breast cancer subtypes. Cancer Causes Control 2019; 30:1103-1111. [PMID: 31352658 DOI: 10.1007/s10552-019-01207-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 06/29/2019] [Indexed: 01/16/2023]
Abstract
PURPOSE High mammographic breast density is a strong, well-established breast cancer risk factor. Whether stem cells may explain high breast cancer risk in dense breasts is unknown. We investigated the association between breast density and breast cancer risk by the status of stem cell markers CD44, CD24, and ALDH1A1 in the tumor. METHODS We included 223 women with primary invasive or in situ breast cancer and 399 age-matched controls from Mayo Clinic Mammography Study. Percent breast density (PD), absolute dense area (DA), and non-dense area (NDA) were assessed using computer-assisted thresholding technique. Immunohistochemical analysis of the markers was performed on tumor tissue microarrays according to a standard protocol. We used polytomous logistic regression to quantify the associations of breast density measures with breast cancer risk across marker-defined tumor subtypes. RESULTS Of the 223 cancers in the study, 182 were positive for CD44, 83 for CD24 and 52 for ALDH1A1. Associations of PD were not significantly different across t marker-defined subtypes (51% + vs. 11-25%: OR 2.83, 95% CI 1.49-5.37 for CD44+ vs. OR 1.87, 95% CI 0.47-7.51 for CD44-, p-heterogeneity = 0.66; OR 2.80, 95% CI 1.27-6.18 for CD24+ vs. OR 2.44, 95% CI 1.14-5.22 for CD24-, p-heterogeneity = 0.61; OR 3.04, 95% CI 1.14-8.10 for ALDH1A1+ vs. OR 2.57. 95% CI 1.30-5.08 for ALDH1A1-, p-heterogeneity = 0.94). Positive associations of DA and inverse associations of NDA with breast cancer risk were similar across marker-defined subtypes. CONCLUSIONS We found no evidence of differential associations of breast density with breast cancer risk by the status of stem cell markers. Further studies in larger study populations are warranted to confirm these associations.
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Affiliation(s)
- Lusine Yaghjyan
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, 2004 Mowry Rd, Gainesville, FL, 32610, USA.
| | - Ashwini K Esnakula
- Department of Pathology, Immunology and Laboratory Medicine, College of Medicine, University of Florida, 1600 SW Archer Road, Gainesville, FL, 32610, USA
| | - Christopher G Scott
- Division of Biomedical Statistics and Informatics, Mayo Clinic College of Medicine, 200 First St. SW, Rochester, MN, 55905, USA
| | - Akemi T Wijayabahu
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, 2004 Mowry Rd, Gainesville, FL, 32610, USA
| | - Matthew R Jensen
- Division of Biomedical Statistics and Informatics, Mayo Clinic College of Medicine, 200 First St. SW, Rochester, MN, 55905, USA
| | - Celine M Vachon
- Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic College of Medicine, 200 First St. SW, Rochester, MN, 55905, USA
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Li J, Humphreys K, Ho PJ, Eriksson M, Darai-Ramqvist E, Lindström LS, Hall P, Czene K. Family History, Reproductive, and Lifestyle Risk Factors for Fibroadenoma and Breast Cancer. JNCI Cancer Spectr 2018; 2:pky051. [PMID: 31360866 PMCID: PMC6650060 DOI: 10.1093/jncics/pky051] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 07/31/2018] [Accepted: 08/10/2018] [Indexed: 12/21/2022] Open
Abstract
Background To understand which breast cancer (BC) risk factors also increase the risk of fibroadenoma and investigate whether these factors have the same effect in BC patients with previous fibroadenoma. Methods Using multistate survival analysis on a large dataset (n = 58 322), we examined the effects of BC risk factors on transitions between three states: event-free, biopsy-confirmed fibroadenoma, and BC. Hazard ratios and corresponding 95% confidence intervals associated with covariate effects were estimated. Median follow-up time was 25.3 years. Results The mean ages at diagnosis of fibroadenoma and BC were 42.6 and 48.3 years, respectively. Participant characteristics known to increase the risk of BC were found to increase the risk of fibroadenoma (family history of BC and higher education). Participant characteristics known to confer protective effects for BC (older age at menarche, more children, and larger childhood body size) were found to reduce fibroadenoma risk. The effect sizes associated with the direct transitions from event-free to fibroadenoma and BC were generally not different for the covariates tested. Age at fibroadenoma diagnosis was associated with the transition from fibroadenoma to BC (hazard ratioper year increase = 1.07 [95% confidence interval = 1.03 to 1.12]). Conclusion We showed that biopsy-confirmed fibroadenomas shared many risk factors with BC. More work is needed to understand the relationships between fibroadenoma and BC to identify women who are at high risk of developing BC after a fibroadenoma diagnosis.
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Affiliation(s)
- Jingmei Li
- Department of Human Genetics, Genome Institute of Singapore, Singapore, Singapore.,Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Keith Humphreys
- Department of Human Genetics, Genome Institute of Singapore, Singapore, Singapore.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Peh Joo Ho
- Department of Human Genetics, Genome Institute of Singapore, Singapore, Singapore
| | - Mikael Eriksson
- Department of Human Genetics, Genome Institute of Singapore, Singapore, Singapore.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Eva Darai-Ramqvist
- Department of Human Genetics, Genome Institute of Singapore, Singapore, Singapore.,Department of Pathology and Cytology, Karolinska University Hospital, Stockholm, Sweden
| | - Linda Sofie Lindström
- Department of Human Genetics, Genome Institute of Singapore, Singapore, Singapore.,Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden
| | - Per Hall
- Department of Human Genetics, Genome Institute of Singapore, Singapore, Singapore.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Department of Oncology, Södersjukhuset, Stockholm, Sweden
| | - Kamila Czene
- Department of Human Genetics, Genome Institute of Singapore, Singapore, Singapore.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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Clarke MA, Joshu CE. Early Life Exposures and Adult Cancer Risk. Epidemiol Rev 2018; 39:11-27. [PMID: 28407101 DOI: 10.1093/epirev/mxx004] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Accepted: 01/19/2017] [Indexed: 12/14/2022] Open
Abstract
Very little is known about the influence of early life exposures on adult cancer risk. The purpose of this narrative review was to summarize the epidemiologic evidence relating early life tobacco use, obesity, diet, and physical activity to adult cancer risk; describe relevant theoretical frameworks and methodological strategies for studying early life exposures; and discuss policies and research initiatives focused on early life. Our findings suggest that in utero exposures may indirectly influence cancer risk by modifying biological pathways associated with carcinogenesis; however, more research is needed to firmly establish these associations. Initiation of exposures during childhood and adolescence may impact cancer risk by increasing duration and lifetime exposure to carcinogens and/or by acting during critical developmental periods. To expand the evidence base, we encourage the use of life course frameworks, causal inference methods such as Mendelian randomization, and statistical approaches such as group-based trajectory modeling in future studies. Further, we emphasize the need for objective exposure biomarkers and valid surrogate endpoints to reduce misclassification. With the exception of tobacco use, there is insufficient evidence to support the development of new cancer prevention policies; however, we highlight existing policies that may reduce the burden of these modifiable risk factors in early life.
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Smuczek B, Santos EDS, Siqueira AS, Pinheiro JJ, Freitas VM, Jaeger RG. The laminin-derived peptide C16 regulates GPNMB expression and function in breast cancer. Exp Cell Res 2017; 358:323-334. [DOI: 10.1016/j.yexcr.2017.07.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2017] [Revised: 07/02/2017] [Accepted: 07/04/2017] [Indexed: 11/27/2022]
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Yaghjyan L, Stoll E, Ghosh K, Scott CG, Jensen MR, Brandt KR, Visscher D, Vachon CM. Tissue-based associations of mammographic breast density with breast stem cell markers. Breast Cancer Res 2017; 19:100. [PMID: 28851411 PMCID: PMC5576318 DOI: 10.1186/s13058-017-0889-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 08/04/2017] [Indexed: 12/15/2022] Open
Abstract
Background Mammographic breast density is a well-established, strong breast cancer risk factor but the biology underlying this association remains unclear. Breast density may reflect underlying alterations in the size and activity of the breast stem cell pool. We examined, for the first time, associations of CD44, CD24, and aldehyde dehydrogenase family 1 member A1 (ALDH1A1) breast stem cell markers with breast density. Methods We included in this study 64 asymptomatic healthy women who previously volunteered for a unique biopsy study of normal breast tissue at the Mayo Clinic (2006-2008). Mammographically identified dense and non-dense areas were confirmed/localized by ultrasound and biopsied. Immunohistochemical analysis of the markers was performed according to a standard protocol and the staining was assessed by a single blinded pathologist. In core biopsy samples retrieved from areas of high vs. low density within the same woman, we compared staining extent and an expression score (the product of staining intensity and extent), using the signed rank test. All tests of statistical significance were two-sided. Results A total of 64, 28, and 10 women were available for CD44, CD24, and ALDH1A1 staining, respectively. For all three markers, we found higher levels of staining extent in dense as compared to non-dense tissue, though for CD24 and ALDH1A1 the difference did not reach statistical significance (CD44, 6.3% vs. 2.0%, p < 0.001; CD24, 8.0% vs. 5.6%, p = 0.10; and ALDH1A1, 0.5% vs. 0.3%, p = 0.12). The expression score for CD44 was significantly greater in dense as compared to non-dense tissue (9.8 vs.3.0, p < 0.001). Conclusions Our findings suggest an increased presence and/or activity of stem cells in dense as compared to non-dense breast tissue. Electronic supplementary material The online version of this article (doi:10.1186/s13058-017-0889-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Lusine Yaghjyan
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, 2004 Mowry Rd, Gainesville, FL, 32610, USA.
| | - Ethan Stoll
- Department of Pathology, Immunology and Laboratory Medicine, College of Medicine, University of Florida, 1600 SW Archer Road, Gainesville, FL, 32610, USA
| | - Karthik Ghosh
- Division of General Internal Medicine, Mayo Clinic College of Medicine, 200 First St SW, Rochester, MN, 55902, USA
| | - Christopher G Scott
- Division of Biomedical Statistics and Informatics, Mayo Clinic College of Medicine, 200 First St. SW, Rochester, MN, 55905, USA
| | - Matthew R Jensen
- Division of Biomedical Statistics and Informatics, Mayo Clinic College of Medicine, 200 First St. SW, Rochester, MN, 55905, USA
| | - Kathleen R Brandt
- Department of Radiology, Mayo Clinic College of Medicine, 200 First St. SW, Rochester, MN, 55905, USA
| | - Daniel Visscher
- Department of Anatomic Pathology, Mayo Clinic College of Medicine, 200 First St. SW, Rochester, MN, 55905, USA
| | - Celine M Vachon
- Department of Health Sciences Research, Division of Epidemiology, Mayo Clinic College of Medicine, 200 First St. SW, Rochester, MN, 55905, USA
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14
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Kerr J, Anderson C, Lippman SM. Physical activity, sedentary behaviour, diet, and cancer: an update and emerging new evidence. Lancet Oncol 2017; 18:e457-e471. [PMID: 28759385 PMCID: PMC10441558 DOI: 10.1016/s1470-2045(17)30411-4] [Citation(s) in RCA: 359] [Impact Index Per Article: 51.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 04/21/2017] [Accepted: 04/27/2017] [Indexed: 12/11/2022]
Abstract
The lifestyle factors of physical activity, sedentary behaviour, and diet are increasingly being studied for their associations with cancer. Physical activity is inversely associated with and sedentary behaviour is positively (and independently) associated with an increased risk of more than ten types of cancer, including colorectal cancer (and advanced adenomas), endometrial cancers, and breast cancer. The most consistent dietary risk factor for premalignant and invasive breast cancer is alcohol, whether consumed during early or late adult life, even at low levels. Epidemiological studies show that the inclusion of wholegrain, fibre, fruits, and vegetables within diets are associated with reduced cancer risk, with diet during early life (age <8 years) having the strongest apparent association with cancer incidence. However, randomised controlled trials of diet-related factors have not yet shown any conclusive associations between diet and cancer incidence. Obesity is a key contributory factor associated with cancer risk and mortality, including in dose-response associations in endometrial and post-menopausal breast cancer, and in degree and duration of fatty liver disease-related hepatocellular carcinoma. Obesity produces an inflammatory state, characterised by macrophages clustered around enlarged hypertrophied, dead, and dying adipocytes, forming crown-like structures. Increased concentrations of aromatase and interleukin 6 in inflamed breast tissue and an increased number of macrophages, compared with healthy tissue, are also observed in women with normal body mass index, suggesting a metabolic obesity state. Emerging randomised controlled trials of physical activity and dietary factors and mechanistic studies of immunity, inflammation, extracellular matrix mechanics, epigenetic or transcriptional regulation, protein translation, circadian disruption, and interactions of the multibiome with lifestyle factors will be crucial to advance this field.
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Affiliation(s)
- Jacqueline Kerr
- Moores Cancer Center, University of California, La Jolla, San Diego, CA, USA; Department of Family Medicine and Public Health, University of California, La Jolla, San Diego, CA, USA
| | - Cheryl Anderson
- Moores Cancer Center, University of California, La Jolla, San Diego, CA, USA; Department of Family Medicine and Public Health, University of California, La Jolla, San Diego, CA, USA
| | - Scott M Lippman
- Moores Cancer Center, University of California, La Jolla, San Diego, CA, USA; Department of Medicine, University of California, La Jolla, San Diego, CA, USA.
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15
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Zhao Y, Xiong P, McCullough LE, Miller EE, Li H, Huang Y, Zhao M, Wang MJ, Kang M, Wang Q, Li JY. Comparison of Breast Cancer Risk Predictive Models and Screening Strategies for Chinese Women. J Womens Health (Larchmt) 2017; 26:294-302. [PMID: 28263689 DOI: 10.1089/jwh.2015.5692] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Affiliation(s)
- Ying Zhao
- Department of Epidemiology and Biostatistics, West China School of Public Health, Sichuan University, Chengdu, People's Republic of China
- Department of Discipline Construction, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Ping Xiong
- Department of Epidemiology and Biostatistics, West China School of Public Health, Sichuan University, Chengdu, People's Republic of China
| | - Lauren E. McCullough
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Erline E. Miller
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina
| | - Hui Li
- Department of Epidemiology and Biostatistics, West China School of Public Health, Sichuan University, Chengdu, People's Republic of China
| | - Yuan Huang
- Department of Epidemiology and Biostatistics, West China School of Public Health, Sichuan University, Chengdu, People's Republic of China
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Min Zhao
- Department of Epidemiology and Biostatistics, West China School of Public Health, Sichuan University, Chengdu, People's Republic of China
| | - Meng-jie Wang
- Department of Epidemiology and Biostatistics, West China School of Public Health, Sichuan University, Chengdu, People's Republic of China
| | - Min Kang
- The Comprehensive Guidance Center of Women's Health, Women's and Children's Hospital of Sichuan Province, Chengdu, People's Republic of China
| | - Qiong Wang
- Department of Epidemiology and Biostatistics, West China School of Public Health, Sichuan University, Chengdu, People's Republic of China
- School of Public Health, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Jia-yuan Li
- Department of Epidemiology and Biostatistics, West China School of Public Health, Sichuan University, Chengdu, People's Republic of China
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16
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Benign Breast Conditions and Disease. Fam Med 2017. [DOI: 10.1007/978-3-319-04414-9_113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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17
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Abstract
Several studies have investigated the relation between benign breast diseases (BBD) and food intake. However, dietary patterns of these patients have not been taken into consideration up to now. The aim of this study is to determine the association between dietary patterns and BBD. In this case-control study, ninety-six patients with BBD and seventy controls were selected from women attending the Iranian Center for Breast Cancer affiliated with Academic Center for Education, Culture and Research. Demographic, physical activity and semi-quantitative FFQ were completed. The main dietary patterns were extracted by factor analysis. Two major dietary patterns emerged: Healthy dietary pattern including fish, poultry, eggs, low-fat dairy products, vegetables, legumes, nuts and seeds, whole grains, oil and mayonnaise, olives, fruits; and Unhealthy dietary pattern including red meats, organ and processed meats, high-fat dairy products, refined grains, sweets and desserts, animal and solid fats. After adjustment for age, BMI and energy intake, the participants in the highest tertile of Healthy dietary pattern (OR 0·44; 95 % CI 0·20, 0·99) were less likely to have BBD compared with those in the first tertile. After adjustment for other confounding variables, this relationship still remained close to significant level. However, higher consumption of Unhealthy dietary pattern was not associated with the risk of BBD. In conclusion, Healthy dietary pattern might be inversely associated with the risk of BBD; however, this result should be interpreted with caution. Future studies are needed to confirm our findings.
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18
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Knell J, Koning JL, Grabowski JE. Analysis of surgically excised breast masses in 119 pediatric patients. Pediatr Surg Int 2016; 32:93-6. [PMID: 26590129 DOI: 10.1007/s00383-015-3818-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/09/2015] [Indexed: 12/15/2022]
Abstract
PURPOSE Breast masses in children and adolescents are uncommon and the vast majority are benign. There are currently limited analyses of breast masses in this population and clinical management is highly variable between institutions and providers. The purpose of our study is to analyze the demographics, pathology and management of 119 pediatric patients with breast masses; one of the largest studies to date. METHODS We performed a retrospective review of patients who underwent excision of a breast mass at a single pediatric center from June 2009 to November 2013. Demographics, imaging, pathology and management were reviewed. RESULTS Average patient age was 15.3 years, average mass size was 3.15 cm and 20.3 % had a family history of breast cancer. 68 % of patients had pre-operative ultrasound, and 31.9 % underwent a period of observation. The most common indication for resection was patient and family anxiety. All masses were benign, with fibroadenoma being the most common histopathology (75.2 %). CONCLUSIONS In our cohort there were no cases of malignancy. Only 31.9 % of patients underwent some form of observation and patient or family anxiety was the most common indication for proceeding with surgery. This suggests that patient anxiety may result in unnecessary operation. Our data may help reassure patients, families and providers that the risk of malignancy is low and could help develop more optimal management strategies.
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Affiliation(s)
- Jamie Knell
- Department of General Surgery, Brigham and Women's Hospital, Boston, MA, USA.
| | - Jeffery L Koning
- Department of Radiology, University of California San Diego, La Jolla, CA, USA
| | - Julia E Grabowski
- Department of Pediatric Surgery, Ann and Robert Lurie Children's Hospital of Chicago, Chicago, IL, USA
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19
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Villanueva CL, Briscoe G, Bepko J. Benign Breast Conditions and Disease. Fam Med 2015. [DOI: 10.1007/978-1-4939-0779-3_113-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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20
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Berkey CS, Tamimi RM, Willett WC, Rosner B, Lindsay Frazier A, Colditz GA. Adolescent physical activity and inactivity: a prospective study of risk of benign breast disease in young women. Breast Cancer Res Treat 2014; 146:611-8. [PMID: 25034340 DOI: 10.1007/s10549-014-3055-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Accepted: 07/04/2014] [Indexed: 10/25/2022]
Abstract
In previous investigations of adolescent activity recalled in adulthood, modest reductions in risk of benign breast disease (BBD) and premenopausal breast cancer were seen with moderate-strenuous activity during high school. We therefore investigated physical activity, walking, and recreational inactivity (watching TV-videos, playing computer-videogames) reported by adolescent girls in relation to their subsequent risk for BBD as young women. The Growing Up Today Study includes 9,039 females, 9-15 years at study initiation (1996), who completed questionnaires annually through 2001, then in 2003, 2005, 2007, 2010 and 2013. Annual surveys (1996-2001) obtained data on physical and sedentary activities during the past year. Beginning in 2005, women (≥18 years) reported whether they had ever been diagnosed with BBD confirmed by breast biopsy (n = 133 cases, to 11/01/2013). Logistic regression (adjusted for baseline adiposity and age; additional factors in multivariable-adjusted models) estimated associations between adolescent activities (moderate-vigorous, walking, METS, inactivity) and biopsy-confirmed BBD in young women. Girls who walked the most had significantly lower risk of BBD (multivariable-adjusted OR = 0.61, ≥30 vs ≤15 min/day; p = .049). We observed no evidence that inactivity (≥3 vs <2 h/day OR = 1.02, p = .92) or METS (top vs bottom tertile OR = 1.19, p = .42) were associated with BBD. Accounting for factors including family history, childhood adiposity, and other activities and inactivities, adolescent girls who walked the most were at lower risk for BBD. We found no evidence that high moderate-vigorous activity might reduce risk, nor did we observe any association with inactivity. Continued follow-up will re-evaluate these findings as more BBD cases, and ultimately breast cancer, are diagnosed.
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Affiliation(s)
- Catherine S Berkey
- Channing Division of Network Medicine, Department of Medicine, Brigham & Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA,
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White MC, Peipins LA, Watson M, Trivers KF, Holman DM, Rodriguez JL. Cancer prevention for the next generation. J Adolesc Health 2013; 52:S1-7. [PMID: 23601606 PMCID: PMC4402978 DOI: 10.1016/j.jadohealth.2013.02.016] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2012] [Revised: 02/27/2013] [Accepted: 02/28/2013] [Indexed: 12/15/2022]
Abstract
Given the continued growth in the number of persons with cancer in the United States, the primary prevention of cancer remains an urgent public health priority. As the field of cancer prevention continues to mature and scientific knowledge evolves, it is imperative to challenge the status quo and embrace new approaches to cancer prevention. In this commentary, we summarize recent trends and some of the scientific advances that have been made over the past few decades regarding the complex process of cancer development and the interaction of individual and social risk factors. We examine some of the assumptions and terminology that have characterized cancer prevention approaches for more than a quarter century and the impact of these assumptions and our use of terminology. We propose that it is possible for today's youth to experience lower cancer incidence rates as adults compared with previous generations. To accomplish this goal, a more transdisciplinary and multifaceted approach is needed, adapted as appropriate for different populations and stages of life. The greatest improvements in cancer prevention may occur as a result of innovative, multilevel interventions that build on the expanding scientific evidence base.
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Affiliation(s)
- Mary C White
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia 3034, USA.
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