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Barclay NL, Burn E, Delmestri A, Duarte-Salles T, Golozar A, Man WY, Tan EH, Tietzova I, Prieto-Alhambra D, Newby D. Trends in incidence, prevalence, and survival of breast cancer in the United Kingdom from 2000 to 2021. Sci Rep 2024; 14:19069. [PMID: 39153995 PMCID: PMC11330450 DOI: 10.1038/s41598-024-69006-1] [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: 01/17/2024] [Accepted: 07/30/2024] [Indexed: 08/19/2024] Open
Abstract
Breast cancer is the most frequently diagnosed cancer in females globally. However, we know relatively little about trends in males. This study describes United Kingdom (UK) secular trends in breast cancer from 2000 to 2021 for both sexes. We describe a population-based cohort study using UK primary care Clinical Practice Research Datalink (CPRD) GOLD and Aurum databases. There were 5,848,436 eligible females and 5,539,681 males aged 18+ years, with ≥ one year of prior data availability in the study period. We estimated crude breast cancer incidence rates (IR), prevalence and survival probability at one-, five- and 10-years after diagnosis using the Kaplan-Meier method. Analyses were further stratified by age. Crude IR of breast cancer from 2000 to 2021 was 194.4 per 100,000 person-years for females and 1.16 for males. Crude prevalence in 2021 was 2.1% for females and 0.009% for males. Both sexes have seen around a 2.5-fold increase in prevalence across time. Incidence increased with age for both sexes, peaking in females aged 60-69 years and males 90+ . There was a drop in incidence for females aged 70-79 years. From 2003-2019, incidence increased > twofold in younger females (aged 18-29: IR 2.12 in 2003 vs. 4.58 in 2018); decreased in females aged 50-69 years; and further declined from 2015 onwards in females aged 70-89 years. Survival probability for females after one-, five-, and ten-years after diagnosis was 95.1%, 80.2%, and 68.4%, and for males 92.9%, 69.0%, and 51.3%. Survival probability at one-year increased by 2.08% points, and survival at five years increased by 5.39% from 2000-2004 to 2015-2019 for females, particularly those aged 50-70 years. For males, there were no clear time-trends for short-term and long-term survival probability. Changes in incidence of breast cancer in females largely reflect the success of screening programmes, as rates rise and fall in synchronicity with ages of eligibility for such programmes. Overall survival from breast cancer for females has improved from 2000 to 2021, again reflecting the success of screening programmes, early diagnosis, and improvements in treatments. Male breast cancer patients have worse survival outcomes compared to females, highlighting the need to develop male-specific diagnosis and treatment strategies to improve long-term survival in line with females.
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Affiliation(s)
- Nicola L Barclay
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, OX3 7LD, UK
| | - Edward Burn
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, OX3 7LD, UK
| | - Antonella Delmestri
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, OX3 7LD, UK
| | - Talita Duarte-Salles
- Fundació Institut Universitari Per a La Recerca a L'Atenció Primària de Salut Jordi Gol I Gurina (IDIAPJGol), Barcelona, Spain
- Department of Medical Informatics, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Asieh Golozar
- Odysseus Data Service, Cambridge, MA, USA
- OHDSI Center at the Roux Institute, Northeastern University, Boston, MA, USA
| | - Wai Yi Man
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, OX3 7LD, UK
| | - Eng Hooi Tan
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, OX3 7LD, UK
| | - Ilona Tietzova
- First Department of Tuberculosis and Respiratory Diseases, First Faculty of Medicine, Charles University, Katerinska 1660/32, 121 08, Prague, Czech Republic
| | - Daniel Prieto-Alhambra
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, OX3 7LD, UK.
- Department of Medical Informatics, Erasmus University Medical Centre, Rotterdam, The Netherlands.
| | - Danielle Newby
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, OX3 7LD, UK
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Allen I, Hassan H, Joko-Fru WY, Huntley C, Loong L, Rahman T, Torr B, Bacon A, Knott C, Jose S, Vernon S, Lüchtenborg M, Pethick J, Lavelle K, McRonald F, Eccles D, Morris EJ, Hardy S, Turnbull C, Tischkowitz M, Pharoah P, Antoniou AC. Risks of second primary cancers among 584,965 female and male breast cancer survivors in England: a 25-year retrospective cohort study. THE LANCET REGIONAL HEALTH. EUROPE 2024; 40:100903. [PMID: 38745989 PMCID: PMC11092881 DOI: 10.1016/j.lanepe.2024.100903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 03/27/2024] [Accepted: 03/28/2024] [Indexed: 05/16/2024]
Abstract
Background Second primary cancers (SPCs) after breast cancer (BC) present an increasing public health burden, with little existing research on socio-demographic, tumour, and treatment effects. We addressed this in the largest BC survivor cohort to date, using a novel linkage of National Disease Registration Service datasets. Methods The cohort included 581,403 female and 3562 male BC survivors diagnosed between 1995 and 2019. We estimated standardized incidence ratios (SIRs) for combined and site-specific SPCs using incidences for England, overall and by age at BC and socioeconomic status. We estimated incidences and Kaplan-Meier cumulative risks stratified by age at BC, and assessed risk variation by socio-demographic, tumour, and treatment characteristics using Cox regression. Findings Both genders were at elevated contralateral breast (SIR: 2.02 (95% CI: 1.99-2.06) females; 55.4 (35.5-82.4) males) and non-breast (1.10 (1.09-1.11) females, 1.10 (1.00-1.20) males) SPC risks. Non-breast SPC risks were higher for females younger at BC diagnosis (SIR: 1.34 (1.31-1.38) <50 y, 1.07 (1.06-1.09) ≥50 y) and more socioeconomically deprived (SIR: 1.00 (0.98-1.02) least deprived quintile, 1.34 (1.30-1.37) most). Interpretation Enhanced SPC surveillance may benefit BC survivors, although specific recommendations require more detailed multifactorial risk and cost-benefit analyses. The associations between deprivation and SPC risks could provide clinical management insights. Funding CRUK Catalyst Award CanGene-CanVar (C61296/A27223). Cancer Research UK grant: PPRPGM-Nov 20∖100,002. This work was supported by core funding from the NIHR Cambridge Biomedical Research Centre (NIHR203312)]. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.
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Affiliation(s)
- Isaac Allen
- National Disease Registration Service, National Health Service England, London, United Kingdom
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Hend Hassan
- National Disease Registration Service, National Health Service England, London, United Kingdom
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Walburga Yvonne Joko-Fru
- National Disease Registration Service, National Health Service England, London, United Kingdom
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Catherine Huntley
- National Disease Registration Service, National Health Service England, London, United Kingdom
- Division of Genetics and Epidemiology, Institute of Cancer Research, Sutton, United Kingdom
| | - Lucy Loong
- National Disease Registration Service, National Health Service England, London, United Kingdom
- Division of Genetics and Epidemiology, Institute of Cancer Research, Sutton, United Kingdom
| | - Tameera Rahman
- National Disease Registration Service, National Health Service England, London, United Kingdom
- Health Data Insight CIC, Cambridge, United Kingdom
| | - Bethany Torr
- National Disease Registration Service, National Health Service England, London, United Kingdom
- Division of Genetics and Epidemiology, Institute of Cancer Research, Sutton, United Kingdom
| | - Andrew Bacon
- National Disease Registration Service, National Health Service England, London, United Kingdom
| | - Craig Knott
- National Disease Registration Service, National Health Service England, London, United Kingdom
- Health Data Insight CIC, Cambridge, United Kingdom
| | - Sophie Jose
- National Disease Registration Service, National Health Service England, London, United Kingdom
- Health Data Insight CIC, Cambridge, United Kingdom
| | - Sally Vernon
- National Disease Registration Service, National Health Service England, London, United Kingdom
| | - Margreet Lüchtenborg
- National Disease Registration Service, National Health Service England, London, United Kingdom
- Centre for Cancer, Society and Public Health, Comprehensive Cancer Centre, School of Cancer and Pharmaceutical Sciences, King's College London, London, United Kingdom
| | - Joanna Pethick
- National Disease Registration Service, National Health Service England, London, United Kingdom
| | - Katrina Lavelle
- National Disease Registration Service, National Health Service England, London, United Kingdom
| | - Fiona McRonald
- National Disease Registration Service, National Health Service England, London, United Kingdom
| | - Diana Eccles
- Department of Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Eva J.A Morris
- Applied Health Research Unit, Big Data Institute, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Steven Hardy
- National Disease Registration Service, National Health Service England, London, United Kingdom
| | - Clare Turnbull
- Division of Genetics and Epidemiology, Institute of Cancer Research, Sutton, United Kingdom
| | - Marc Tischkowitz
- Department of Medical Genetics, Cambridge Biomedical Research Centre, National Institute for Health Research, University of Cambridge, Cambridge, United Kingdom
| | - Paul Pharoah
- Department of Computational Biomedicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Antonis C. Antoniou
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
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Ilic L, Simon J, Hackl M, Haidinger G. Time Trends in Male Breast Cancer Incidence, Mortality, and Survival in Austria (1983-2017). Clin Epidemiol 2024; 16:57-69. [PMID: 38328515 PMCID: PMC10849143 DOI: 10.2147/clep.s428824] [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: 08/18/2023] [Accepted: 12/27/2023] [Indexed: 02/09/2024] Open
Abstract
Background Male breast cancer (MBC) comprises less than 1% of all breast cancer cases globally and remains understudied with persisting sex-specific survival disadvantages. We aim to contribute to better understanding of MBC with a comprehensive analysis of time-trends over several decades in Austria. Methods We used Austrian National Cancer Registry data on 1648 cases of MBC cases diagnosed between 1983 and 2017 in Austria. Overall incidence, mortality, and survival rates, as well as age-, stage-, and period-specific incidence and survival rates were calculated. Joinpoint regression was performed to assess trends. Results MBC incidence rates increased throughout the whole observation period (1983-2017) with an annual percent change (APC) of 1.44% (95% confidence interval, CI: 0.77 to 2.11). During the same period, morality rates were stable (APC: -0.25, 95% CI: -0.53 to 0.60). Ten-year survival rates showed three phases of decreasing increases with an average APC of 2.45%, 1983-2009 (95% CI: 2.1 to 2.74). Five-year survival rates improved until 2000 (APC: 2.31, 95% CI: 1.34 to 3.30) and remained stable thereafter (APC: 0.10, 95% CI: -0.61 to 0.80). Stage-specific analyses showed a single trend of stable incidence rates of distant disease MBC (APC: -0.03, 95% CI: -1.67 to 1.65). Further, we observed increases in localised, regional, and unknown stage cancer incidence and increases in incidence rates across all age groups over the whole observation period. However, the estimates on these subgroup-specific trends (according to age- and stage) show wider 95% CIs and lower bounds closer to zero or negative in comparison to our findings on overall incidence, mortality, and survival. Conclusion Despite improvements in survival rates, MBC mortality rates remained largely stable between 1983 and 2017 in Austria, possibly resulting from a balance between increasing overall incidence and stable incidence rates of distant disease MBC.
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Affiliation(s)
- Lazo Ilic
- Department of Health Economics, Center for Public Health, Medical University of Vienna, Vienna, Austria
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Judit Simon
- Department of Health Economics, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Monika Hackl
- Austrian National Cancer Registry, Statistics Austria, Vienna, Austria
| | - Gerald Haidinger
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
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Leone JP, Freedman RA, Leone J, Tolaney SM, Vallejo CT, Leone BA, Winer EP, Lin NU, Hassett MJ. Survival in male breast cancer over the past 3 decades. J Natl Cancer Inst 2023; 115:421-428. [PMID: 36583555 PMCID: PMC10086618 DOI: 10.1093/jnci/djac241] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 11/28/2022] [Accepted: 12/23/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Breast cancer mortality in women has declined statistically significantly over the past several years. In men, it is unclear whether survival has changed over time. We evaluated changes in breast cancer-specific survival (BCSS) and overall survival (OS) in male breast cancer over the past 3 decades. METHODS We evaluated men diagnosed with breast cancer between 1988 and 2017, reported in the Surveillance, Epidemiology, and End Results registry. Patients were categorized into 3 groups by year of diagnosis: 1988-1997, 1998-2007, and 2008-2017. BCSS and OS were estimated by Kaplan-Meier, and differences between groups were compared by log-rank test. Multivariable Cox regression evaluated the independent association of year of diagnosis with BCSS and OS. All tests were 2-sided. RESULTS We included 8481 men. Overall, BCSS at 5 years was 83.69%, 83.78%, and 84.41% in groups 1988-1997, 1998-2007, and 2008-2017, respectively (P = .86). There was no statistically significant difference in BCSS between the 3 groups within each stage of disease. Among all patients, OS at 5 years was 64.61%, 67.31%, and 69.05% in groups 1988-1997, 1998-2007, and 2008-2017, respectively (P = .01). In adjusted Cox models, each additional year of diagnosis had no statistically significant association with BCSS (hazard ratio = 1.00, 95% confidence interval = 0.99 to 1.01, P = .75), but there was statistically significant improvement in OS (hazard ratio = 0.99, 95% CI = 0.98 to 0.99, P = .009). CONCLUSIONS Over the past 3 decades, there has been no statistically significant improvement in BCSS in male breast cancer. Changes in OS over time are consistent with increasing life expectancy. Efforts to improve BCSS in male breast cancer are warranted.
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Affiliation(s)
- José P Leone
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Rachel A Freedman
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Julieta Leone
- Grupo Oncológico Cooperativo del Sur (GOCS), Neuquén, Argentina
| | - Sara M Tolaney
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | | | | | - Eric P Winer
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Yale Cancer Center, New Haven, CT, USA
| | - Nancy U Lin
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Michael J Hassett
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
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Management of men with high genetic risk of breast cancer. Is there a place for screening or risk-reducing surgery? Case report and review. CURRENT PROBLEMS IN CANCER: CASE REPORTS 2023. [DOI: 10.1016/j.cpccr.2023.100220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
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Allen I, Hassan H, Sofianopoulou E, Eccles D, Turnbull C, Tischkowitz M, Pharoah P, Antoniou AC. Risk of developing a second primary cancer in male breast cancer survivors: a systematic review and meta-analysis. Br J Cancer 2022; 127:1660-1669. [PMID: 36115878 PMCID: PMC9596702 DOI: 10.1038/s41416-022-01940-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 07/25/2022] [Accepted: 07/28/2022] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND With increasing survival after cancer diagnoses, second primary cancers (SPCs) are becoming more prevalent. We investigated the incidence and site of non-breast SPC risks following male breast cancer (BC). METHODS PubMed, Embase and Web of Science were systematically searched for studies reporting standardised incidence ratios (SIRs) for SPCs published by March 2022. Meta-analyses used the generic inverse-variance method, assuming a random-effects model. We evaluated SIRs for overall SPCs, site-specific risks, by age at BC onset, time since BC onset and geographic region. We assessed study quality using routine techniques. RESULTS Eight population-based retrospective cohort studies were identified. SIRs ranged from 1.05 to 2.17. The summary SIR estimate was 1.27 (95% CI: 1.03-1.56, I2: 86%), and there were increased colorectal (SIR: 1.29, 95% CI: 1.03-1.61), pancreatic (SIR: 1.64, 95% CI: 1.05-2.55) and thyroid (SIR: 5.58, 95% CI: 1.04-30.05) SPC risks. When an outlying study was excluded, the summary SIR for men diagnosed with BC before age 50 was 1.50 (95% CI: 1.21-1.85), significantly higher than men diagnosed at older ages (SIR: 1.14, 95% CI: 0.98-1.33). CONCLUSIONS Male BC survivors are at elevated risks of developing second primary colorectal, pancreatic and thyroid cancers. The estimates may assist their clinical management and guide decisions on genetic testing.
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Affiliation(s)
- Isaac Allen
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
| | - Hend Hassan
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Eleni Sofianopoulou
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Diana Eccles
- Department of Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Clare Turnbull
- Translational Genetics Team, Division of Genetics and Epidemiology, Institute of Cancer Research, London, UK
| | - Marc Tischkowitz
- Department of Medical Genetics, National Institute for Health Research, Cambridge Biomedical Research Centre, University of Cambridge, Cambridge, UK
| | - Paul Pharoah
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Antonis C Antoniou
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
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Ionescu S, Nicolescu AC, Marincas M, Madge OL, Simion L. An Update on the General Features of Breast Cancer in Male Patients-A Literature Review. Diagnostics (Basel) 2022; 12:1554. [PMID: 35885460 PMCID: PMC9323942 DOI: 10.3390/diagnostics12071554] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 06/19/2022] [Accepted: 06/24/2022] [Indexed: 11/28/2022] Open
Abstract
Male breast cancers are uncommon, as men account for less than 1 percent of all breast carcinomas. Among the predisposing risk factors for male breast cancer, the following appear to be significant: (a) breast/chest radiation exposure, (b) estrogen use, diseases associated with hyper-estrogenism, such as cirrhosis or Klinefelter syndrome, and (c) family health history. Furthermore, there are clear familial tendencies, with a higher incidence among men who have a large number of female relatives with breast cancer and (d) major inheritance susceptibility. Moreover, in families with BRCA mutations, there is an increased risk of male breast cancer, although the risk appears to be greater with inherited BRCA2 mutations than with inherited BRCA1 mutations. Due to diagnostic delays, male breast cancer is more likely to present at an advanced stage. A core biopsy or a fine needle aspiration must be performed to confirm suspicious findings. Infiltrating ductal cancer is the most prevalent form of male breast cancer, while invasive lobular carcinoma is extremely uncommon. Male breast cancer is almost always positive for hormone receptors. A worse prognosis is associated with a more advanced stage at diagnosis for men with breast cancer. Randomized controlled trials which recruit both female and male patients should be developed in order to gain more consistent data on the optimal clinical approach.
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Affiliation(s)
- Sinziana Ionescu
- 1st Clinic of General Surgery and Surgical Oncology, Bucharest Oncology Institute, 022328 Bucharest, Romania; (S.I.); (L.S.)
- Department of Surgery, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | | | - Marian Marincas
- 1st Clinic of General Surgery and Surgical Oncology, Bucharest Oncology Institute, 022328 Bucharest, Romania; (S.I.); (L.S.)
- Department of Surgery, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Octavia-Luciana Madge
- 1st Clinic of General Surgery and Surgical Oncology, Bucharest Oncology Institute, 022328 Bucharest, Romania; (S.I.); (L.S.)
- Faculty of Letters, University of Bucharest, 050663 Bucharest, Romania
| | - Laurentiu Simion
- 1st Clinic of General Surgery and Surgical Oncology, Bucharest Oncology Institute, 022328 Bucharest, Romania; (S.I.); (L.S.)
- Department of Surgery, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
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