Breast cancer in young women: challenges, progress, and barriers

Clinical features and prognostic factors of breast cancer in young women: a retrospective single-center study

PURPOSE

This research aims to characterize the differences in clinical features and prognostic factors between younger and older breast cancer (BC) patients in China.

METHODS

All patients who were recently diagnosed with BC between January 1, 2015 and December 31, 2016 at Shanxi Province Cancer Hospital were recruited. We collected the epidemiological and clinical data as well as the follow-up information.

RESULTS

Out of the 1968 BC patients who met the criteria for analysis, 227 (11.53%) were under 40 years of age with a median age of 34 years at diagnosis. All patients were classified into the age < 40, age 40-59, and age ≥ 60 groups. There were significant differences in the histology, tumor size, T stage, grade, and human epidermal growth factor receptor-2 (HER-2) levels among the three groups (all P < 0.05). The 5-year overall survival (OS) rates were 86.34%, 89.58%, and 84.84% for the age < 40, age 40-59, and age ≥ 60 groups, respectively. The TNM stage was the only predictor of clinical outcome in all BC patients. The prognostic value of intrinsic subtypes for OS was different among the three groups.

CONCLUSION

Our study helped identify an age-related prognostic indicator of adverse events in BC patients and showed that young women with BC exhibited more aggressive clinical and pathological features. Our findings may facilitate clinical management and therapeutic interventions in young BC patients, especially in young women with a history of exposure to risk factors and age < 40 years.

Knockdown of LINC00504 Inhibits the Proliferation and Invasion of Breast Cancer via the Downregulation of miR-140-5p

INTRODUCTION

Breast cancer is one of the most common cancers in the world. Long noncoding RNA 00504 (LINC00504) was reported to be a functional gene in some tumours but not breast. Accordingly, the purpose of this article is to study the function of LINC00504 in breast cancer.

METHODS

qPCR assay was used to detect the expression of LINC00504 in tissue and cell lines. The online database and chromatin immunoprecipitation assay (ChIP) were employed to confirm the transcription factor of LINC00504. Cell function assays including cell proliferation, migration and invasion were designed to detect the function of LINC00504 in vitro and in vivo. Luciferase reporter assay and RNA immunoprecipitation (RIP) assay were used to confirm the relationship between LINC00504 and miR-140-5p. And Western blot assay was employed for testing the key protein.

RESULTS

We found that LINC00504 is upregulated in breast cancer. In addition, we found that the transcription factor regulatory factor X5 (RFX5) can strongly bind to the LINC00504 promoter region and subsequently increase its transcriptional activity. We also found that the manipulation of RFX5 expression can significantly affect LINC00504 expression, which suggested that RFX5 can transcriptionally activate LINC00504 in breast cancer (BC). Knockdown of LINC00504 inhibits cell proliferation, migration and invasion in vitro and in vivo. We further found that LINCOO504 inhibits miR-140-5p, which decreases the levels of VEGFA. The further results showed that miR-140-5p was one of the target gene of LINC00504. The WB assay demonstrated that the E-cadherin was increased and Vimentin was decreased when knocking down of LINC00504 and they can be rescued while adding the inhibitors of miR-140-5p.

DISCUSSION

Our results demonstrated the mechanism by which the LINC00504-miR-140-5p-VEGFA axis participates in breast cancer cell proliferation and invasion and may lead to new lncRNA-based diagnostic or therapeutic strategies for breast cancer.

Distribution of breast lesions diagnosed by cytology examination in symptomatic patients at Eritrean National Health Laboratory, Asmara, Eritrea: a retrospective study

Background

Fine needle aspiration cytology is a simple, relatively accurate, non-invasive, and cost-effective method of diagnosing most breast pathologies. To date, there is no sufficient data depicting the distribution of breast lesions detected by fine needle aspiration cytology in our healthcare setting. The aim of this study was to elucidate the general distribution of breast lesions diagnosed by cytology test at Eritrean National Health Laboratory.

Methods

This retrospective study was carried out on 905 symptomatic patients between the years 2013 and 2017 at Eritrean National Health Laboratory. Diagnosis was made by fine needle aspiration cytology in patients with palpable breast lump and in some patients direct smear was prepared from a nipple discharge. Statistical analysis was carried out using Statistical Package for the Social Sciences version 23.

Results

A total of 905 patients were included in the study, of whom 871 (96.24%) were females. The age range of patients was from 13 to 93 years with mean and standard deviation of 33 ± 14.9 years. Breast lump, occurring in 892 (98.56%), was the most frequent presenting symptom. Fibroadenoma and fibrocystic breast lesions were the most prevalent lesions accounting for approximately 40% and 15%, respectively. Malignant breast lesions were seen predominantly in females above the age of 40 years with the highest frequency observed in the age range between 51 and 60 years. Pearson Chi-squared test showed significant association between patients’ age above 40 years and the risk of having a malignant breast lesion (p < 0.001). The highest number of benign and malignant breast lesions was documented in 2014 with little fluctuation elsewhere in the study period.

Conclusion

Fine needle aspiration cytology is a procedure of choice for preoperative diagnosis in breast lesions mainly in a resource-limited settings. Our study identified the occurrence of malignant breast lesions in young women, which is of a paramount public health concern. Of note, significant proportion of patients were late to seek medical attention. Therefore, enhancement of community awareness regarding breast disease and implementation of screening programs are necessary to ameliorate the morbidity and mortality associated with the disease.

Longitudinal effect of emotional processing on psychological symptoms in women under 50 with breast cancer

Breast cancer is a potential traumatic event associated with psychological symptoms, but few studies have analysed its impact in under-50 women. Emotional processing is a successful function in integrating traumatic experiences. This work analysed the relationship between emotional processing and psychological symptoms during three phases of treatment (before hospitalization, counselling after surgery and adjuvant therapy) in 50 women under the age of 50 with breast cancer. Mixed-effects models tested statistical differences among phases. There were significant differences in symptoms during the treatments: the levels of anxiety decrease from T1 to T3 (0.046), while those of hostility increase (<0.001). Emotional processing is a strong predictor of all symptoms. Clinical implications are discussed.