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Roy P. Breast cancer in young Indian women: factors, challenges in screening, and upcoming diagnostics. J Cancer Res Clin Oncol 2023; 149:14409-14427. [PMID: 37552309 DOI: 10.1007/s00432-023-05215-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 07/26/2023] [Indexed: 08/09/2023]
Abstract
Breast cancer management for young Indian women are full of challenges. The National Cancer Registry Programme (NCRP) has predicted that nearly 2,30,000 cases of breast cancer will be reported annually by 2025; with a steady increase in cases of young women (< 45 years of age) with breast cancer. In this review, the available literature is evaluated to understand the various risk factors contributing to the rise in cases of breast cancer in young women in India. Further, the challenges that are faced by the technicians in early diagnosis (e.g., physiology of young breasts, limited trained professionals, and awareness among patients, and cost of the treatment) of breast cancer. This review also focuses on the upcoming diagnostics like serum biomarkers and nanosensors for the early identification of the disease. For better prognosis and to reduce the chances of disease reoccurrence and metastasis, it is important that the disease has to be identified at an early stage.
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Affiliation(s)
- Pragyan Roy
- College of Basic Sciences and Humanities, OUAT, Bhubaneswar, India.
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2
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Ng B, Puspitaningtyas H, Wiranata JA, Hutajulu SH, Widodo I, Anggorowati N, Sanjaya GY, Lazuardi L, Sripan P. Breast cancer incidence in Yogyakarta, Indonesia from 2008-2019: A cross-sectional study using trend analysis and geographical information system. PLoS One 2023; 18:e0288073. [PMID: 37406000 DOI: 10.1371/journal.pone.0288073] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 06/17/2023] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND Breast cancer is a significant public health concern worldwide, including in Indonesia. Little is known about the spatial and temporal patterns of breast cancer incidence in Indonesia. This study aimed to analyze temporal and spatial variations of breast cancer incidence in Yogyakarta Province, Indonesia. METHODS The study used breast cancer case data from the Yogyakarta Population-Based Cancer Registry (PBCR) from 2008 to 2019. The catchment areas of the PBCR included the 48 subdistricts of 3 districts (Sleman, Yogyakarta City, and Bantul). Age-standardized incidence rates (ASR) were calculated for each subdistrict. Joinpoint regression was used to detect any significant changes in trends over time. Global Moran's and Local Indicators of Spatial Association (LISA) analyses were performed to identify any spatial clusters or outliers. RESULTS The subdistricts had a median ASR of 41.9, with a range of 15.3-70.4. The majority of cases were diagnosed at a late stage, with Yogyakarta City having the highest proportion of diagnoses at stage 4. The study observed a significant increasing trend in breast cancer incidence over the study period the fastest of which is in Yogyakarta City with an average annual percentage change of 18.77%, with Sleman having an 18.21% and Bantul having 8.94% average changes each year (p <0.05). We also found a significant positive spatial autocorrelation of breast cancer incidence rates in the province (I = 0.581, p <0.001). LISA analysis identified 11 subdistricts which were high-high clusters in the central area of Yogyakarta City and six low-low clusters in the southeast region of the catchment area in the Bantul and Sleman Districts. No spatial outliers were identified. CONCLUSIONS We found significant spatial clustering of BC ASR in the Yogyakarta Province, and there was a trend of increasing ASR across the region. These findings can inform resource allocation for public health efforts to high-risk areas and develop targeted prevention and early detection strategies. Further res is needed to understand the factors driving the observed temporal and spatial patterns of breast cancer incidence in Yogyakarta Province, Indonesia.
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Affiliation(s)
- Bryant Ng
- Faculty of Medicine, Medicine Study Program, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Herindita Puspitaningtyas
- Faculty of Medicine, Doctorate Program of Health and Medical Science, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Juan Adrian Wiranata
- Academic Hospital, Universitas Gadjah Mada, Yogyakarta, Indonesia
- Faculty of Medicine, Master Program in Clinical Epidemiology, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Susanna Hilda Hutajulu
- Faculty of Medicine, Department of Internal Medicine, Division of Hematology and Medical Oncology, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Irianiwati Widodo
- Faculty of Medicine, Department of Anatomical Pathology, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Nungki Anggorowati
- Faculty of Medicine, Department of Anatomical Pathology, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Guardian Yoki Sanjaya
- Faculty of Medicine, Department of Health Policy and Management, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Lutfan Lazuardi
- Faculty of Medicine, Department of Health Policy and Management, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Patumrat Sripan
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
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Allen I, Hassan H, Sofianopoulou E, Eccles D, Turnbull C, Tischkowitz M, Pharoah P, Antoniou AC. Risks of second non-breast primaries following breast cancer in women: a systematic review and meta-analysis. Breast Cancer Res 2023; 25:18. [PMID: 36765408 PMCID: PMC9912682 DOI: 10.1186/s13058-023-01610-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 01/25/2023] [Indexed: 02/12/2023] Open
Abstract
BACKGROUND Second primary cancer incidence is rising among breast cancer survivors. We examined the risks of non-breast second primaries, in combination and at specific cancer sites, through a systematic review and meta-analysis. METHODS We conducted a systematic search of PubMed, Embase, and Web of Science, seeking studies published by March 2022. We included studies that reported standardized incidence ratios (SIRs), with associated standard errors, assessing the combined risk of second non-breast primaries following breast cancer. We performed meta-analyses of combined second primary risks, stratifying by age, follow-up duration, and geographic region. We also assessed second primary risks at several specific sites, stratifying by age. The inverse variance method with DerSimonian-Laird estimators was used in all meta-analyses, assuming a random-effects model. Associated biases and study quality were evaluated using the Newcastle-Ottawa scale. RESULTS One prospective and twenty-seven retrospective cohort studies were identified. SIRs for second non-breast primaries combined ranged from 0.84 to 1.84. The summary SIR estimate was 1.24 (95% CI 1.14-1.36, I2: 99%). This varied by age: the estimate was 1.59 (95% CI 1.36-1.85) when breast cancer was diagnosed before age 50, which was significantly higher than in women first diagnosed at 50 or over (SIR: 1.13, 95% CI 1.01-1.36, p for difference: < 0.001). SPC risks were also significantly higher when based on Asian, rather than European, registries (Asia-SIR: 1.47, 95% CI 1.29-1.67. Europe-SIR: 1.16, 95% CI 1.04-1.28). There were significantly increased risks of second thyroid (SIR: 1.89, 95% CI 1.49-2.38), corpus uteri (SIR: 1.84, 95% CI 1.53-2.23), ovary (SIR: 1.53, 95% CI 1.35-1.73), kidney (SIR: 1.43, 95% CI 1.17-1.73), oesophagus (SIR: 1.39, 95% CI 1.26-1.55), skin (melanoma) (SIR: 1.34, 95% CI 1.18-1.52), blood (leukaemia) (SIR: 1.30, 95% CI 1.17-1.45), lung (SIR: 1.25, 95% CI 1.03-1.51), stomach (SIR: 1.23, 95% CI 1.12-1.36) and bladder (SIR: 1.15, 95% CI 1.05-1.26) primaries. CONCLUSIONS Breast cancer survivors are at significantly increased risk of second primaries at many sites. Risks are higher for those diagnosed with breast cancer before age 50 and in Asian breast cancer survivors compared to European breast cancer survivors. This study is limited by a lack of data on potentially confounding variables. The conclusions may inform clinical management decisions following breast cancer, although specific clinical recommendations lie outside the scope of this review.
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Affiliation(s)
- Isaac Allen
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
- Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, CB1 8RN, UK.
| | - Hend Hassan
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, CB1 8RN, UK
| | - Eleni Sofianopoulou
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, CB1 8RN, 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, Cambridge Biomedical Research Centre, National Institute for Health Research, University of Cambridge, Cambridge, UK
| | - Paul Pharoah
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, CB1 8RN, UK
| | - Antonis C Antoniou
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, CB1 8RN, UK
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Wong CB, Mustapa A, Matusin SNI, Abdullah MS, Usman AN, Haji Abdul Hamid MRW. Study of risk factors and marker status in women with breast cancer in Brunei Darussalam. Breast Dis 2023; 42:183-189. [PMID: 37355881 DOI: 10.3233/bd-239001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/26/2023]
Abstract
OBJECTIVE To investigate the associations between breast cancer staging and body mass index (BMI), menopausal status, and family history of breast cancer, as well as to assess the expression of tumor markers in women with breast cancer in Brunei Darussalam. METHODS A retrospective cross-sectional study was carried out at The Brunei Cancer Centre. Cases of women with breast cancer between 2000 and 2013 were retrieved from the medical records section and entered into a clinical proforma. These were reviewed and analyzed using appropriate statistical methods. RESULTS Overall, the mean age at diagnosis was 53.6 years ± 9.83. The postmenopausal women had a significantly higher risk of being diagnosed with late-onset breast cancer than premenopausal women (P = 0.022). The expressions of PR (P = 0.034), Her2 (P = 0.046), and CatD (P = 0.004) were significantly different in breast cancer staging. Other factors did not have a statistically-significant association with breast cancer staging. CONCLUSION While most of the factors studied were not significantly different in breast cancer staging, our findings showed that it is recommended that high-risk women perform regular breast screening after the age of 40 years old. A future study highly appreciates comparing breast cancer risk factors among the Bruneian and Western populations.
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Affiliation(s)
- Chieng Bing Wong
- Pengiran Anak Puteri Rashidah Sa'adatul Bolkiah (PAPRSB) Institute of Health Sciences, Universiti Brunei Darussalam, Jalan Tungku Link, Gadong, Brunei
| | - Aklimah Mustapa
- Pengiran Anak Puteri Rashidah Sa'adatul Bolkiah (PAPRSB) Institute of Health Sciences, Universiti Brunei Darussalam, Jalan Tungku Link, Gadong, Brunei
| | - Siti Nur Idayu Matusin
- Pengiran Anak Puteri Rashidah Sa'adatul Bolkiah (PAPRSB) Institute of Health Sciences, Universiti Brunei Darussalam, Jalan Tungku Link, Gadong, Brunei
- Halalan Thayyiban Research Centre, Universiti Islam Sultan Sharif Ali, Tutong, Brunei
| | - Muhammad Syafiq Abdullah
- Raja Isteri Pengiran Anak Saleha Hospital, Jalan Putera Al-Muhtadee Billah, Bandar Seri Begawan, Brunei
| | | | - Mas Rina Wati Haji Abdul Hamid
- Pengiran Anak Puteri Rashidah Sa'adatul Bolkiah (PAPRSB) Institute of Health Sciences, Universiti Brunei Darussalam, Jalan Tungku Link, Gadong, Brunei
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Esna-Ashari F, Saffari N, Parsapour H, Rezapur-Shahkolai F. Factors Associated with Breast Cancer Mammographic Screening Behavior among Iranian Women. Asian Pac J Cancer Prev 2022; 23:4073-4078. [PMID: 36579987 PMCID: PMC9971457 DOI: 10.31557/apjcp.2022.23.12.4073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Indexed: 12/30/2022] Open
Abstract
Breast cancer is one of the most common diseases of women, which can increase the survival of patients with its early diagnosis. Despite the existence of relatively sensitive methods of early detection of breast cancer, such as mammography, statistics show that a small number of women perform mammography according to the recommended clinical guidelines. Using the health belief model, this study aims to determine the factors affecting mammography among women teachers in Hamedan. METHODS This study was conducted on 458 female teachers aged 40 years and older of Hamadan city, in western part of Iran, during October to December of 2019. The participants were asked about the factors affecting mammography based on the health belief model. Questionnaires were completed by self-reported method and analyzed by SPSS software at 95% confidence interval. RESULTS The average age of the study participants was 46±4.1 years. Among the participants, about 41.5% had performed mammography at least once. In univariate analysis, the constructs of the health belief model generally predicts performing mammography between 35 and 49 percent. In multivariate analysis, age 46 to 50 years, having supplementary insurance, history of breast disease, perceived barriers with odds ratio of 3.4, 3.4, 10.6 and .89, respectively, were significantly related to mammography. CONCLUSIONS Female teachers over 45 years of age with a history of breast disease, if they do not have financial or other barriers to do mammography, perform breast cancer screening.
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Affiliation(s)
- Farzaneh Esna-Ashari
- Department of Community Medicine, School of Medicine and Research Center for Social Determinants of Health, Hamadan University of Medical Sciences, Hamadan, Iran.
| | - Narges Saffari
- General Physician, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.
| | - Hamideh Parsapour
- Department of Obstetrics and Gynecology, Fatemieh Hospital, Hamadan University of Medical Sciences, Hamadan, Iran.
| | - Forouzan Rezapur-Shahkolai
- Department of Public Health, School of Public Health and Research Center of Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran.,For Correspondence:
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Lim YX, Lim ZL, Ho PJ, Li J. Breast Cancer in Asia: Incidence, Mortality, Early Detection, Mammography Programs, and Risk-Based Screening Initiatives. Cancers (Basel) 2022; 14:4218. [PMID: 36077752 PMCID: PMC9454998 DOI: 10.3390/cancers14174218] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 08/24/2022] [Accepted: 08/26/2022] [Indexed: 12/09/2022] Open
Abstract
Close to half (45.4%) of the 2.3 million breast cancers (BC) diagnosed in 2020 were from Asia. While the burden of breast cancer has been examined at the level of broad geographic regions, literature on more in-depth coverage of the individual countries and subregions of the Asian continent is lacking. This narrative review examines the breast cancer burden in 47 Asian countries. Breast cancer screening guidelines and risk-based screening initiatives are discussed.
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Affiliation(s)
- Yu Xian Lim
- Genome Institute of Singapore, Laboratory of Women’s Health & Genetics, Singapore 138672, Singapore
| | - Zi Lin Lim
- Genome Institute of Singapore, Laboratory of Women’s Health & Genetics, Singapore 138672, Singapore
| | - Peh Joo Ho
- Genome Institute of Singapore, Laboratory of Women’s Health & Genetics, Singapore 138672, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore 117549, Singapore
| | - Jingmei Li
- Genome Institute of Singapore, Laboratory of Women’s Health & Genetics, Singapore 138672, Singapore
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
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Potential Pro-Tumorigenic Effect of Bisphenol A in Breast Cancer via Altering the Tumor Microenvironment. Cancers (Basel) 2022; 14:cancers14123021. [PMID: 35740686 PMCID: PMC9221131 DOI: 10.3390/cancers14123021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 06/14/2022] [Accepted: 06/16/2022] [Indexed: 02/05/2023] Open
Abstract
Simple Summary Bisphenol A (BPA) is primarily used to produce polycarbonate plastics, such as water bottles. Exposure to BPA has been shown to increase the growth of breast cancer cells that depend on estrogen for growth due to its ability to mimic estrogen. More recent studies have suggested that BPA also affects the cellular and non-cellular components that compose tumor microenvironments (TMEs), namely the environment around a tumor, thereby potentially promoting breast cancer growth via altering the TME. The TME plays an essential role in cancer development and promotion. Therefore, it is crucial to understand the effect of BPA on breast TMEs to assess its role in the risk of breast cancer adequately. This review examines the potential effects of BPA on immune cells, fibroblasts, extracellular matrices, and adipocytes to highlight their roles in mediating the carcinogenic effect of BPA, and thereby proposes considerations for the risk assessment of BPA exposure. Abstract BPA, a chemical used in the preparation of polycarbonate plastics, is an endocrine disruptor. Exposure to BPA has been suggested to be a risk factor for breast cancer because of its potential to induce estrogen receptor signaling in breast cancer cells. More recently, it has been recognized that BPA also binds to the G protein-coupled estrogen receptor and other nuclear receptors, in addition to estrogen receptors, and acts on immune cells, adipocytes, and fibroblasts, potentially modulating the TME. The TME significantly impacts the behavior of cancer cells. Therefore, understanding how BPA affects stromal components in breast cancer is imperative to adequately assess the association between exposure to BPA and the risk of breast cancer. This review examines the effects of BPA on stromal components of tumors to highlight their potential role in the carcinogenic effect of BPA. As a result, I propose considerations for the risk assessment of BPA exposure and studies needed to improve understanding of the TME-mediated, breast cancer-promoting effect of BPA.
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Ho PJ, Wong FY, Chay WY, Lim EH, Lim ZL, Chia KS, Hartman M, Li J. Breast cancer risk stratification for mammographic screening: A nation-wide screening cohort of 24,431 women in Singapore. Cancer Med 2021; 10:8182-8191. [PMID: 34708579 PMCID: PMC8607242 DOI: 10.1002/cam4.4297] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 08/10/2021] [Accepted: 08/26/2021] [Indexed: 12/19/2022] Open
Abstract
Background Breast cancer incidence is increasing in Asia. However, few women in Singapore attend routine mammography screening. We aim to identify women at high risk of breast cancer who will benefit most from regular screening using the Gail model and information from their first screen (recall status and mammographic density). Methods In 24,431 Asian women (50–69 years) who attended screening between 1994 and 1997, 117 developed breast cancer within 5 years of screening. Cox proportional hazard models were used to study the associations between risk classifiers (Gail model 5‐year absolute risk, recall status, mammographic density), and breast cancer occurrence. The efficacy of risk stratification was evaluated by considering sensitivity, specificity, and the proportion of cancers identified. Results Adjusting for information from first screen attenuated the hazard ratios (HR) associated with 5‐year absolute risk (continuous, unadjusted HR [95% confidence interval]: 2.3 [1.8–3.1], adjusted HR: 1.9 [1.4–2.6]), but improved the discriminatory ability of the model (unadjusted AUC: 0.615 [0.559–0.670], adjusted AUC: 0.703 [0.653–0.753]). The sensitivity and specificity of the adjusted model were 0.709 and 0.622, respectively. Thirty‐eight percent of all breast cancers were detected in 12% of the study population considered high risk (top five percentile of the Gail model 5‐year absolute risk [absolute risk ≥1.43%], were recalled, and/or mammographic density ≥50%). Conclusion The Gail model is able to stratify women based on their individual breast cancer risk in this population. Including information from the first screen can improve prediction in the 5 years after screening. Risk stratification has the potential to pick up more cancers.
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Affiliation(s)
- Peh Joo Ho
- Genome Institute of Singapore, Singapore, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Fuh Yong Wong
- Division of Radiation Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Wen Yee Chay
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Elaine Hsuen Lim
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Zi Lin Lim
- Genome Institute of Singapore, Singapore, Singapore
| | - Kee Seng Chia
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Mikael Hartman
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore.,Department of Surgery, Yong Loo Lin School of Medicine National University of Singapore, Singapore, Singapore
| | - Jingmei Li
- Genome Institute of Singapore, Singapore, Singapore.,Department of Surgery, Yong Loo Lin School of Medicine National University of Singapore, Singapore, Singapore
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Rajarajan S, Korlimarla A, Alexander A, Anupama CE, Ramesh R, Srinath BS, Sridhar TS, Prabhu JS. Pre-Menopausal Women With Breast Cancers Having High AR/ER Ratios in the Context of Higher Circulating Testosterone Tend to Have Poorer Outcomes. Front Endocrinol (Lausanne) 2021; 12:679756. [PMID: 34234742 PMCID: PMC8256854 DOI: 10.3389/fendo.2021.679756] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 05/28/2021] [Indexed: 01/18/2023] Open
Abstract
Purpose Women with breast tumors with higher expression of AR are in general known to have better survival outcomes while a high AR/ER ratio is associated with poor outcomes in hormone receptor positive breast cancers mostly in post menopausal women. We have evaluated the AR/ER ratio in the context of circulating androgens specifically in patients younger than 50 years most of whom are pre-menopausal and hence have a high estrogenic hormonal milieu. Methods Tumor samples from patients 50 years or younger at first diagnosis were chosen from a larger cohort of 270 patients with median follow-up of 72 months. Expression levels of ER and AR proteins were detected by immunohistochemistry (IHC) and the transcript levels by quantitative PCR. Ciculating levels of total testosterone were estimated from serum samples. A ratio of AR/ER was derived using the transcript levels, and tumors were dichotomized into high and low ratio groups based on the third quartile value. Survival and the prognostic significance of the ratio was compared between the low and high ratio groups in all tumors and also within ER positive tumors. Results were further validated in external datasets (TCGA and METABRIC). Results Eighty-eight (32%) patients were ≤50 years, with 22 having high AR/ER ratio calculated using the transcript levels. Circulating levels of total testosterone were higher in women whose tumors had a high AR/ER ratio (p = 0.02). Tumors with high AR/ER ratio had significantly poorer disease-free survival than those with low AR/ER ratio [HR-2.6 (95% CI-1.02-6.59) p = 0.04]. Evaluation of tumors with high AR/ER ratio within ER positive tumors alone reconfirmed the prognostic relevance of the high AR/ER ratio with a significant hazard ratio of 4.6 (95% CI-1.35-15.37, p = 0.01). Similar trends were observed in the TCGA and METABRIC dataset. Conclusion Our data in pre-menopausal women with breast cancer suggest that it is not merely the presence or absence of AR expression but the relative activity of ER, as well as the hormonal milieu of the patient that determine clinical outcomes, indicating that both context and interactions ultimately influence tumor behavior.
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Affiliation(s)
- Savitha Rajarajan
- Division of Molecular Medicine, St. John’s Research Institute, Bangalore, India
- Centre for Doctoral Studies, Manipal Academy of Higher Education (MAHE), Manipal, India
| | - Aruna Korlimarla
- Division of Molecular Medicine, St. John’s Research Institute, Bangalore, India
- Department of Research, Sri Shankara Cancer Hospital and Research Centre, Bangalore, India
| | - Annie Alexander
- Division of Molecular Medicine, St. John’s Research Institute, Bangalore, India
| | - C. E. Anupama
- Division of Molecular Medicine, St. John’s Research Institute, Bangalore, India
| | - Rakesh Ramesh
- Department of Surgical Oncology, St. John’s Medical College and Hospital, Bangalore, India
| | - B. S. Srinath
- Department of Surgery, Sri Shankara Cancer Hospital and Research Centre, Bangalore, India
| | - T. S. Sridhar
- Division of Molecular Medicine, St. John’s Research Institute, Bangalore, India
| | - Jyothi S. Prabhu
- Division of Molecular Medicine, St. John’s Research Institute, Bangalore, India
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Chauhan R, Trivedi V, Rani R, Singh U. A Comparative Analysis of Body Mass Index with Estrogen Receptor, Progesterone Receptor and Human Epidermal Growth Factor Receptor 2 Status in Pre- and Postmenopausal Breast Cancer Patients. J Midlife Health 2021; 11:210-216. [PMID: 33767561 PMCID: PMC7978051 DOI: 10.4103/jmh.jmh_97_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 11/24/2020] [Accepted: 12/15/2020] [Indexed: 12/21/2022] Open
Abstract
Background Breast cancer is now the most common cancer among Indian women. Recent studies have suggested a possible link between risk factors like high BMI and molecular subtypes of breast cancer. Studies from Western and Asian population have shown varying relationship between post- menopausal obesity and expression of ER, PR, Her2-neu receptors in breast cancer patients. Aim This study was done with an aim to explore if overweight or obesity as defined by BMI and status of ER, PR and Her2-neu receptors differ in Indian pre-menopausal and post-menopausal breast cancer patients. Methods and Material This is a retrospective analysis of 446 breast cancer patients treated at Mahavir Cancer Sansthan, Patna from July to December 2019. Their case records were evaluated and data regarding age, menopausal status, height, weight and ER, PR & HER2-neu receptor status were extracted for analyses. Statistical Analysis Chi-square test was used to compare categorical variables between the pre-menopausal and post-menopausal group. Results The prevalence of obesity in the post-menopausal group was 2.3% more than the pre-menopausal group (P-value = 0.24). As compared to the pre-menopausal group, there was an increase in the ER/PR positivity in the postmenopausal group by 3.41% (P-value = 0.47) and in the Her2-neu positivity by 6.38% (P-value = 0.15). As compared to the pre-menopausal group, there was further increase in the ER/PR positivity in the post-menopausal group by 6.85% (P-value = 0.40) in sub-group of patients with BMI ≥ 25kg/m2. Conclusions Our study showed slightly increased incidence of obesity in post-menopausal breast cancer patients. Overweight post-menopausal patients also had a higher percentage of ER/PR receptor positivity and lower percentage of Triple negative breast cancer. The percentage of Her2-neu receptor positivity was more in post-menopausal patients. A high BMI was found to be associated with a lower Her2neu positivity.
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Affiliation(s)
- Richa Chauhan
- Department of Radiotherapy, Mahavir Cancer Sansthan, Patna, Bihar, India
| | - Vinita Trivedi
- Department of Radiotherapy, Mahavir Cancer Sansthan, Patna, Bihar, India
| | - Rita Rani
- Department of Radiotherapy, Mahavir Cancer Sansthan, Patna, Bihar, India
| | - Usha Singh
- Department of Radiotherapy, Mahavir Cancer Sansthan, Patna, Bihar, India
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Similar Repair Effects of Human Placenta, Bone Marrow Mesenchymal Stem Cells, and Their Exosomes for Damaged SVOG Ovarian Granulosa Cells. Stem Cells Int 2020; 2020:8861557. [PMID: 33376492 PMCID: PMC7738794 DOI: 10.1155/2020/8861557] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 11/07/2020] [Accepted: 11/18/2020] [Indexed: 12/30/2022] Open
Abstract
Background This study is aimed at investigating the repairing effect of mesenchymal stem cells and their exosomes from different sources on ovarian granulosa cells damaged by chemotherapy drugs—phosphoramide mustard (PM). Methods In this study, we choose bone marrow mesenchymal stem cells (BMSCs) and human placental mesenchymal stem cells (HPMSCs) for research. Then, they were cocultured with human ovarian granulosa cells (SVOG) injured by phosphoramide mustard (PM), respectively. β-Galactosidase staining, flow cytometry, and Western blot were used to detect the changes in the senescence and apoptosis of SVOG cells before and after their coculture with the above two types of MSCs. Subsequently, exosomes from these two types of MSCs were extracted and added to the culture medium of SVOG cells after PM injury to test whether these two types of exosomes played a role similar to that of MSCs in repairing damaged SVOG cells. Results PM treatment-induced apoptotic SVOG cells were significantly decreased after HPMSCs and BMSCs as compared with control group. After coculturing with these two types of MSCs, PM-treated SVOG cells showed significantly reduced senescence and apoptosis proportions as well as cleaved-Caspase 3 expression, and HPMSCs played a slightly stronger role than BMSCs in repairing SVOG cells in terms of the above three indicators. In addition, the ratios of senescent and apoptotic SVOG cells were also significantly reduced by the two types of exosomes, which played a role similar to that of MSCs in repairing cell damages. Conclusions The results indicated that BMSCs, HPMSCs, and their exosomes all exerted a certain repair effect on SVOG cells damaged by PM, and consistent repair effect was observed between exosomes and MSCs. The repair effect of exosomes secreted from BMSCs and HPMSCs on the SVOG cells was studied for the first time, and the results fully demonstrated that exosomes are the key carriers for MSCs to play their role.
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Yuen J, Fung SM, Sia CL, Venkatramani M, Shaw T, Courtney E, Li ST, Chiang J, Tan VKM, Tan BKT, Ngeow J. An in-depth exploration of the post-test informational needs of BRCA1 and BRCA2 pathogenic variant carriers in Asia. Hered Cancer Clin Pract 2020; 18:22. [PMID: 33110458 PMCID: PMC7585213 DOI: 10.1186/s13053-020-00154-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 10/19/2020] [Indexed: 12/17/2022] Open
Abstract
Introduction Identification of one's status as a BRCA1/2 pathogenic variant carrier often marks the start of navigating challenging decisions related to cancer risk management and result disclosure. Carriers report unmet informational needs, but studies have yet to explore the specific aspects of and how best to fulfill these needs. This study aims to explore the informational needs of BRCA1/2 pathogenic variant carriers in Asia to inform for the design of educational materials to support risk management decision-making. Methods Semi-structured in-depth interviews were conducted with two male and 22 female English-speaking BRCA1/2 pathogenic variant carriers, aged 29-66 years, identified through the Cancer Genetics Service at the National Cancer Centre Singapore. A grounded theory approach with thematic analysis was undertaken to extract dominant themes. Results Four themes were identified: (i) proactive online information seeking behaviors (ii) personalized informational needs; (iii) challenges in sharing the results; and (iv) lack of genetic awareness. Discussion Participants highlight challenges with sharing their result arising from significant post-result informational needs, which have manifested into proactive online information-seeking behaviors. They desire for an online source of information, where content is personalized, reliable and local. Participants foresee the potential of an online resource to raise genetic awareness. This suggests the use of a culturally tailored online-based genetics resource, to promote result disclosure, empower risk-management decisions and raise genetic literacy rates. Supplementary information Supplementary information accompanies this paper at 10.1186/s13053-020-00154-x.
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Affiliation(s)
- Jeanette Yuen
- Cancer Genetics Service, Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Si Ming Fung
- Cancer Genetics Service, Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Chin Leong Sia
- Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Drive, Singapore, Singapore
| | - Mallika Venkatramani
- Cancer Genetics Service, Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Tarryn Shaw
- Cancer Genetics Service, Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Eliza Courtney
- Cancer Genetics Service, Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Shao-Tzu Li
- Cancer Genetics Service, Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Jianbang Chiang
- Cancer Genetics Service, Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Veronique Kiak-Mien Tan
- Singhealth-Duke NUS Breast Centre, Singapore, Singapore.,Department of Breast Surgery, Singapore General Hospital, Singapore, Singapore.,Department of Breast Surgery, National Cancer Centre Singapore, Singapore, Singapore
| | - Benita Kiat-Tee Tan
- Singhealth-Duke NUS Breast Centre, Singapore, Singapore.,Department of Breast Surgery, Singapore General Hospital, Singapore, Singapore.,Department of Breast Surgery, National Cancer Centre Singapore, Singapore, Singapore.,Department of General Surgery, Sengkang General Hospital, Singapore, Singapore
| | - Joanne Ngeow
- Cancer Genetics Service, Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore.,Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Drive, Singapore, Singapore.,Oncology Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
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13
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Bone marrow mesenchymal stem cell-derived exosomal miR-144-5p improves rat ovarian function after chemotherapy-induced ovarian failure by targeting PTEN. J Transl Med 2020; 100:342-352. [PMID: 31537899 DOI: 10.1038/s41374-019-0321-y] [Citation(s) in RCA: 102] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 08/11/2019] [Accepted: 08/12/2019] [Indexed: 12/23/2022] Open
Abstract
Chemotherapy-induced premature ovarian failure (POF) in women is currently clinically irreversible. Bone marrow mesenchymal stem cells (BMSCs) are a promising cellular therapeutic strategy for POF. However, the underlying mechanism governing the efficacy of BMSCs in treating POF has not been determined. In this study, we show that BMSC and BMSC-derived exosome transplantation can significantly recover the estrus cycle, increase the number of basal and sinus follicles in POF rats, increase estradiol (E2) and anti-Mullerian hormone (AMH) levels, and reduce follicle stimulating hormone (FSH) and luteinizing hormone (LH) levels in the serum. Furthermore, we demonstrate that BMSC-derived exosomes prevent ovarian follicular atresia in cyclophosphamide (CTX)-treated rats via the delivery of miR-144-5p, which can be transferred to cocultured CTX-damaged granulosa cells (GCs) to decrease GC apoptosis. A functional assay revealed that overexpression of miR-144-5p in BMSCs showed efficacy against CTX-induced POF, and the improvement in the repair was related to the inhibition of GC apoptosis by targeting PTEN. The opposite effect was exhibited when miR-144-5p was inhibited. Taken together, our experimental results provide new information regarding the potential of using exosomal miR-144-5p to treat ovarian failure.
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Abstract
OBJECTIVE To summarise the evidence on determinants of health-related quality of life (HRQL) in Asian patients with breast cancer. DESIGN Systematic review conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations and registered with PROSPERO (CRD42015032468). METHODS According to the PRISMA guidelines, databases of MEDLINE (PubMed), Embase and PsycINFO were systematically searched using the following terms and synonyms: breast cancer, quality of life and Asia. Articles reporting on HRQL using EORTC-QLQ-C30, EORTC-QLQ-BR23, FACT-G and FACT-B questionnaires in Asian patients with breast cancer were eligible for inclusion. The methodological quality of each article was assessed using the quality assessment scale for cross-sectional studies or the Newcastle-Ottawa Quality Assessment Scale for cohort studies. RESULTS Fifty-seven articles were selected for this qualitative synthesis, of which 43 (75%) were cross-sectional and 14 (25%) were longitudinal studies. Over 75 different determinants of HRQL were studied with either the EORTC or FACT questionnaires. Patients with comorbidities, treated with chemotherapy, with less social support and with more unmet needs have poorer HRQL. HRQL improves over time. Discordant results in studies were found in the association of age, marital status, household income, type of surgery, radiotherapy and hormone therapy and unmet sexuality needs with poor global health status or overall well-being. CONCLUSIONS In Asia, patients with breast cancer, in particular those with other comorbidities and those treated with chemotherapy, with less social support and with more unmet needs, have poorer HRQL. Appropriate social support and meeting the needs of patients may improve patients' HRQL.
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Affiliation(s)
- Peh Joo Ho
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Sofie A M Gernaat
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Mikael Hartman
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
- Department of Surgery, National University of Singapore, Singapore
| | - Helena M Verkooijen
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Imaging Division, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
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Masood A, Masood K, Hussain M, Ali W, Riaz M, Alauddin Z, Ahmad M, Masood M, Shahid A. Thirty Years Cancer Incidence Data for Lahore, Pakistan: Trends and Patterns 1984-2014. Asian Pac J Cancer Prev 2018; 19:709-717. [PMID: 29580045 PMCID: PMC5980846 DOI: 10.22034/apjcp.2018.19.3.709] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/17/2017] [Indexed: 12/02/2022] Open
Abstract
This research was conducted to generate trends and patterns of most common male and female cancers from 1984-2014 for the city population of Lahore Pakistan. Cancer incidence data gathered for different organs were processed through cleaning, integration, transformation, reduction and mining for ultimate representation. Risk of cancer appeared to be continuously increasing among both males and females. Overall, lymphomas and breast cancer are the most common neoplasm in males and females, respectively, in Lahore with almost the highest rates in the Asian Pacific region. The incidence of head and neck, brain, and lung cancers, as well as leukemia have rapidly increased among males, whereas, ovarian, cervix, head and neck and lymphomas have become more common among females. The present communication should be helpful for adequate strategic planning, identification of risk factors and taking appropriate prevention and control measures at the national level.
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Affiliation(s)
- Andleeb Masood
- Cancer Incidence Statistical Analysis Group, Department of Physics, Government College University, Lahore, Pakistan
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Qiang R, Cai N, Wang X, Wang L, Cui K, Wang X, Li X. MLL1 promotes cervical carcinoma cell tumorigenesis and metastasis through interaction with β-catenin. Onco Targets Ther 2016; 9:6631-6640. [PMID: 27843326 PMCID: PMC5098588 DOI: 10.2147/ott.s114370] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
MLL protein genes encode a family of crucial transcription factors that play a key role in multiple cancer development. The functions of different MLL proteins have not been definitively studied. MLL1 is a histone methyltransferase that mediates histone H3 lysine 4, and it has been found to have aberrant expression in several tumors. However, the function of MLL1 in cervical carcinoma is little known. We used tissue analysis, cell culture experiments, and molecular profiling to investigate the mechanism of MLL1 in cervical carcinoma development. We report here that MLL1 is overexpressed in cervical carcinoma tissues and cell lines, and its overexpression is correlated with the tumor grade. Through FACScan flow cytometry assay, we found that MLL1 promotes cell proliferation by promoting the G1/S transition through transcriptional activation of CCND1 in cervical carcinoma cells. Furthermore, we utilized co-immunoprecipitation and glutathione S-transferase pull-down assays to identify β-catenin as the transcription partner for MLL1 and demonstrated that MLL1 and β-catenin act in synergy in the transcriptional activation of CCND1 in cervical carcinoma cells. In addition, transwell assay and anchorage-independent cell growth assay also revealed that MLL1 promotes metastasis of cervical carcinoma cells through interaction with β-catenin. Our study not only demonstrated a role for MLL1 in the proliferation and metastasis of cervical carcinoma cells but also revealed the interaction of MLL1 with β-catenin to play a different role.
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Affiliation(s)
- Rong Qiang
- Center for Translational Medicine, The First Affiliated Hospital of Xi'an Jiaotong University; Medical Heredity Research Center, Northwest Women's and Children's Hospital, Shaanxi, People's Republic of China
| | - Na Cai
- Medical Heredity Research Center, Northwest Women's and Children's Hospital, Shaanxi, People's Republic of China
| | - Xiaobin Wang
- Medical Heredity Research Center, Northwest Women's and Children's Hospital, Shaanxi, People's Republic of China
| | - Lin Wang
- Medical Heredity Research Center, Northwest Women's and Children's Hospital, Shaanxi, People's Republic of China
| | - Ke Cui
- Medical Heredity Research Center, Northwest Women's and Children's Hospital, Shaanxi, People's Republic of China
| | - Xiang Wang
- Center for Translational Medicine, The First Affiliated Hospital of Xi'an Jiaotong University
| | - Xu Li
- Center for Translational Medicine, The First Affiliated Hospital of Xi'an Jiaotong University
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Zeinalian M, Eshaghi M, Sharbafchi MR, Naji H, Marandi SMM, Asgary S. A Comparative Study on Cancer Prevention Principles Between Iranian Traditional Medicine and Classic Medicine. Int J Prev Med 2016; 7:61. [PMID: 27141280 PMCID: PMC4837795 DOI: 10.4103/2008-7802.179508] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Accepted: 08/16/2015] [Indexed: 11/06/2022] Open
Abstract
Cancer is one of the three main causes of mortality in most human communities whose prevalence is being increased. A significant part of health budget in all countries has been allocated to treat the cancer, which is incurable in many cases. It has led the global health attitude to cancer prevention. Many cancer-related risk factors have been identified for which preventive recommendations have been offered by international organizations such as World Health Organization. Some of the most important of these risk factors are smoking and alcohol consumption, hypercaloric and low-fiber diet, obesity, inactivity, environmental and industrial pollution, some viral infections, and hereditary factors. Exact reviewing of Iranian-Islamic traditional medicine (IITM) resources determines that preventive rules, which named as six essential rules (Sitteh-e-Zarurieah) are abundantly found, including all identified cancer-related risk factors. These preventive rules are: Air (Hava), body movement and repose, sleep and wakefulness, food and drink, evacuation and retention, and mental movement and repose (A'raz-e-Nafsani). The associated risk factors in classic medicine are: Smoking and air pollution, sedentary life, sleep disturbance, improper nutrition and alcohol, chronic constipation, and psychoneurotic stresses. Moreover, these rules are comprehensive enough to include many of the other harmful health-related factors whose roles have been confirmed in the occurrence of different diseases, except cancer. Apparently, cancer prevention in Iran would be more successful if the sextet necessary rules of IITM are promoted among the populations and health policy makers.
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Affiliation(s)
- Mehrdad Zeinalian
- Entekhab Cancer Prevention and Control Research Center, ALA Charity Foundation, Isfahan, Iran
- Department of Genetics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mehdi Eshaghi
- Entekhab Cancer Prevention and Control Research Center, ALA Charity Foundation, Isfahan, Iran
- Department of Psychiatry, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Reza Sharbafchi
- Entekhab Cancer Prevention and Control Research Center, ALA Charity Foundation, Isfahan, Iran
- Department of Psychiatry, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Homayoun Naji
- Entekhab Cancer Prevention and Control Research Center, ALA Charity Foundation, Isfahan, Iran
| | | | - Sedigheh Asgary
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
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Song QK, Wang XL, Zhou XN, Yang HB, Li YC, Wu JP, Ren J, Lyerly HK. Breast Cancer Challenges and Screening in China: Lessons From Current Registry Data and Population Screening Studies. Oncologist 2015; 20:773-9. [PMID: 26001390 DOI: 10.1634/theoncologist.2014-0351] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Accepted: 03/02/2015] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND As one of its responses to the increasing global burden of breast cancer (BC), China has deployed a national registration and BC screening campaign. The present report describes these programs and the initial results of these national BC control strategies, highlighting the challenges to be considered. MATERIALS AND METHODS The primary BC incidence and prevalence data were obtained from the Chinese National Central Cancer Registry. MapInfo software was used to map the geographic distribution and variation. The time trends were estimated by the annual percentage of change from 2003 to 2009. The description of the screening plans and preliminary results were provided by the Ministry of Health. RESULTS Chinese cancer registries were primarily developed and activated in the East and Coastal regions of China, with only 12.5% of the registries located in West China. Geographic variation was noted, with the incidence of BC higher in North China than in South China and in urban areas compared with rural areas. Of great interest, these registries reported that the overall BC incidence has been increasing in China, with an earlier age of onset compared with Western countries and a peak incidence rate at age 50. In response to this increasing incidence and early age of onset, BC screening programs assessed 1.46 million women aged 35-59 years, using clinical breast examinations and ultrasound as primary screening tools between 2009 and 2011. The diagnostic rate for this screening program was only 48.0/10(5) with 440 cases of early stage BC. Early stage BC was detected in nearly 70% of screened patients. Subsequently, a second-generation screening program was conducted that included older women aged 35-64 years and an additional 6 million women were screened. CONCLUSION The cancer registration system in China has been uneven, with a greater focus on East rather than West China. The data from these registries demonstrate regional variation, an increasing BC incidence, and an early age of onset. The 2009 to 2011 BC screening program targeting women aged 35-59 years had a low detection rate that resulted in a second-generation screening program that extended the cohort size and ages screened to 35-64 years. IMPLICATIONS FOR PRACTICE Cancer registration has been active in China for decades; however, a national survey of registries has not been routinely reported. This study used MapInfo to describe the reported data and found asymmetric registration activities, geographic variations in breast cancer (BC) burdens, and an increasing incidence with a peak at age 50. The initial Chinese BC screening programs focused on a relatively young population of women aged 35-59 years and had a low detection rate, but 69.7% of patients had early stage BC. Older women were included in the second-generation screening programs, and an additional 6 million women were screened. Consideration of regional variations and age is necessary to optimize the efficiency and utility of BC screening in China, with the ultimate goal to reduce BC mortality.
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Affiliation(s)
- Qing-Kun Song
- Beijing Key Laboratory of Therapeutic Cancer Vaccine, Capital Medical University Cancer Center, Beijing Shijitan Hospital, Beijing, People's Republic of China; Duke University Medical Center, Durham, North Carolina, USA
| | - Xiao-Li Wang
- Beijing Key Laboratory of Therapeutic Cancer Vaccine, Capital Medical University Cancer Center, Beijing Shijitan Hospital, Beijing, People's Republic of China; Duke University Medical Center, Durham, North Carolina, USA
| | - Xin-Na Zhou
- Beijing Key Laboratory of Therapeutic Cancer Vaccine, Capital Medical University Cancer Center, Beijing Shijitan Hospital, Beijing, People's Republic of China; Duke University Medical Center, Durham, North Carolina, USA
| | - Hua-Bing Yang
- Beijing Key Laboratory of Therapeutic Cancer Vaccine, Capital Medical University Cancer Center, Beijing Shijitan Hospital, Beijing, People's Republic of China; Duke University Medical Center, Durham, North Carolina, USA
| | - Yu-Chen Li
- Beijing Key Laboratory of Therapeutic Cancer Vaccine, Capital Medical University Cancer Center, Beijing Shijitan Hospital, Beijing, People's Republic of China; Duke University Medical Center, Durham, North Carolina, USA
| | - Jiang-Ping Wu
- Beijing Key Laboratory of Therapeutic Cancer Vaccine, Capital Medical University Cancer Center, Beijing Shijitan Hospital, Beijing, People's Republic of China; Duke University Medical Center, Durham, North Carolina, USA
| | - Jun Ren
- Beijing Key Laboratory of Therapeutic Cancer Vaccine, Capital Medical University Cancer Center, Beijing Shijitan Hospital, Beijing, People's Republic of China; Duke University Medical Center, Durham, North Carolina, USA
| | - Herbert Kim Lyerly
- Beijing Key Laboratory of Therapeutic Cancer Vaccine, Capital Medical University Cancer Center, Beijing Shijitan Hospital, Beijing, People's Republic of China; Duke University Medical Center, Durham, North Carolina, USA
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Wang G, Li N, Chang S, Bassig BA, Guo L, Ren J, Su K, Li F, Chen S, Wu S, Zou Y, Dai M, Zheng T, He J. A prospective follow-up study of the relationship between C-reactive protein and human cancer risk in the Chinese Kailuan Female Cohort. Cancer Epidemiol Biomarkers Prev 2014; 24:459-65. [PMID: 25490990 DOI: 10.1158/1055-9965.epi-14-1112] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND C-reactive protein (CRP) has been associated with cancer risk in some prospective studies. However, the associations have not been entirely consistent and have not been evaluated in Chinese females. We conducted a large population-based cohort study to investigate whether elevated levels of CRP at baseline are associated with an increased risk of cancer among Chinese females. METHODS A total of 19,437 women from the Chinese Kailuan Female Cohort were enrolled in the study in July 2006. Levels of high-sensitivity CRP (hsCRP) were tested at baseline for all subjects. Multivariable Cox proportional hazards regression models were used to evaluate the association between levels of hsCRP and risk of all cancers, including breast cancer, lung cancer, colorectal cancer, and other cancers. RESULTS By December 31, 2011, a total of 322 incident cancer cases accrued. Compared with women with lower hsCRP levels (<1 mg/L), women with higher hsCRP (>3 mg/L) had a significantly increased risk of all incident cancers [HR, 1.62; 95% confidence intervals (CI), 1.23-2.14; P(trend) = 0.001] and breast cancer (HR, 1.74; 95% CI, 1.01-2.97; P(trend) = 0.047). The significant association between hsCRP levels and breast cancer risk was apparent among younger women (<50 years; HR, 2.76; 95% CI, 1.18-6.48). CONCLUSION Elevated levels of hsCRP at baseline may be associated with an increased risk of cancer, especially breast cancer, and particularly in younger Chinese women. IMPACT Our findings provide additional evidence for a role of inflammation in carcinogenesis and suggest that CRP may be a potentially useful biomarker of cancer risk in this population.
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Affiliation(s)
- Gang Wang
- Department of Oncology, Kailuan General Hospital, Tangshan, China
| | - Ni Li
- Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Sheng Chang
- Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Bryan A Bassig
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, Connecticut
| | - Lanwei Guo
- Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Jiansong Ren
- Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Kai Su
- Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Fang Li
- Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Shuohua Chen
- Health Department of Kailuan (group), Tangshan, China
| | - Shouling Wu
- Health Department of Kailuan (group), Tangshan, China
| | - Yuhuan Zou
- Department of Oncology, Kailuan General Hospital, Tangshan, China
| | - Min Dai
- Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Tongzhang Zheng
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, Connecticut.
| | - Jie He
- Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Beijing, China.
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Survey of breast cancer mammography screening behaviors in Eastern Taiwan based on a health belief model. Kaohsiung J Med Sci 2014; 30:422-7. [DOI: 10.1016/j.kjms.2014.04.007] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2013] [Revised: 02/27/2014] [Accepted: 03/17/2014] [Indexed: 11/23/2022] Open
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Kim Z, Min SY, Yoon CS, Lee HJ, Lee JS, Youn HJ, Park HK, Noh DY, Hur MH. The basic facts of korean breast cancer in 2011: results of a nationwide survey and breast cancer registry database. J Breast Cancer 2014; 17:99-106. [PMID: 25013429 PMCID: PMC4090324 DOI: 10.4048/jbc.2014.17.2.99] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Accepted: 06/16/2014] [Indexed: 12/29/2022] Open
Abstract
Breast cancer is the second most frequent malignancy in Korean women, with a continuously increasing incidence. The Korean Breast Cancer Society has constructed a nationwide breast cancer database through an online registration program. The aim of the present study was to report the fundamental facts on Korean breast cancer in 2011, and to analyze the changing patterns in clinical characteristics and breast cancer management in Korea over the last 10 years. Data on newly diagnosed breast cancer patients, including the total number of cases, age, stage, and type of surgery, for the year 2011 were collected from 84 hospitals and clinics nationwide using a questionnaire survey. Additional data relating to the changing patterns of breast cancer in Korea were collected from the online breast cancer registry database and analyzed. According to nationwide survey data, a total of 16,967 patients were newly diagnosed with breast cancer in 2011. The crude incidence of female breast cancer, including invasive cancer and in situ cancer, was 67 cases per 100,000 women. Analysis of the survey and registry data gave equivalent results in terms of age distribution, stage, and type of surgery. The median age at diagnosis was 50 years, and the proportion of postmenopausal women (51.3%) was higher than that of premenopausal women (48.7%) with breast cancer. The incidence of stage 0 and stage I breast cancer increased continuously over the last 10 years (56.3% in 2011), and breast conserving surgery (65.7%) was performed more frequently than total mastectomy (33.8%). The total number of breast reconstruction surgeries increased approximately 8-fold. We conclude that the clinical characteristics of breast cancer have changed over the past 10 years in Korea, and surgical management has changed accordingly. Analysis of nationwide registry data will contribute to a better understanding of the characteristics of breast cancer in Korea.
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Affiliation(s)
- Zisun Kim
- Department of Surgery, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Sun Young Min
- Department of Surgery, Kyung Hee University Medical Center, Kyung Hee University School of Medicine, Seoul, Korea
| | - Chan Seok Yoon
- Department of Surgery, Cheil General Hospital and Women's Healthcare Center, Kwandong University College of Medicine, Seoul, Korea
| | - Hun Jae Lee
- Department of Social and Preventive Medicine, Inha University School of Medicine, Incheon, Korea
| | - Jung Sun Lee
- Department of Surgery, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Hyun Jo Youn
- Department of Surgery, Chonbuk National University Medical School, Jeonju, Korea
| | - Heung Kyu Park
- Department of Surgery, Gachon University Gil Medical Center, Incheon, Korea
| | - Dong-Young Noh
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Min Hee Hur
- Department of Surgery, Cheil General Hospital and Women's Healthcare Center, Kwandong University College of Medicine, Seoul, Korea
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Youlden DR, Cramb SM, Yip CH, Baade PD. Incidence and mortality of female breast cancer in the Asia-Pacific region. Cancer Biol Med 2014; 11:101-15. [PMID: 25009752 PMCID: PMC4069805 DOI: 10.7497/j.issn.2095-3941.2014.02.005] [Citation(s) in RCA: 174] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Accepted: 02/11/2014] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE To provide an overview of the incidence and mortality of female breast cancer for countries in the Asia-Pacific region. METHODS Statistical information about breast cancer was obtained from publicly available cancer registry and mortality databases (such as GLOBOCAN), and supplemented with data requested from individual cancer registries. Rates were directly age-standardised to the Segi World Standard population and trends were analysed using joinpoint models. RESULTS Breast cancer was the most common type of cancer among females in the region, accounting for 18% of all cases in 2012, and was the fourth most common cause of cancer-related deaths (9%). Although incidence rates remain much higher in New Zealand and Australia, rapid rises in recent years were observed in several Asian countries. Large increases in breast cancer mortality rates also occurred in many areas, particularly Malaysia and Thailand, in contrast to stabilising trends in Hong Kong and Singapore, while decreases have been recorded in Australia and New Zealand. Mortality trends tended to be more favourable for women aged under 50 compared to those who were 50 years or older. CONCLUSION It is anticipated that incidence rates of breast cancer in developing countries throughout the Asia-Pacific region will continue to increase. Early detection and access to optimal treatment are the keys to reducing breast cancer-related mortality, but cultural and economic obstacles persist. Consequently, the challenge is to customise breast cancer control initiatives to the particular needs of each country to ensure the best possible outcomes.
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Affiliation(s)
- Danny R Youlden
- 1 Cancer Council Queensland, Brisbane 4006, Australia ; 2 School of Mathematical Sciences, Queensland University of Technology, Brisbane 4000, Australia ; 3 Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia ; 4 Griffith Health Institute, Griffith University, Gold Coast 4222, Australia ; 5 School of Public Health and Social Work, Queensland University of Technology, Brisbane 4000, Australia
| | - Susanna M Cramb
- 1 Cancer Council Queensland, Brisbane 4006, Australia ; 2 School of Mathematical Sciences, Queensland University of Technology, Brisbane 4000, Australia ; 3 Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia ; 4 Griffith Health Institute, Griffith University, Gold Coast 4222, Australia ; 5 School of Public Health and Social Work, Queensland University of Technology, Brisbane 4000, Australia
| | - Cheng Har Yip
- 1 Cancer Council Queensland, Brisbane 4006, Australia ; 2 School of Mathematical Sciences, Queensland University of Technology, Brisbane 4000, Australia ; 3 Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia ; 4 Griffith Health Institute, Griffith University, Gold Coast 4222, Australia ; 5 School of Public Health and Social Work, Queensland University of Technology, Brisbane 4000, Australia
| | - Peter D Baade
- 1 Cancer Council Queensland, Brisbane 4006, Australia ; 2 School of Mathematical Sciences, Queensland University of Technology, Brisbane 4000, Australia ; 3 Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia ; 4 Griffith Health Institute, Griffith University, Gold Coast 4222, Australia ; 5 School of Public Health and Social Work, Queensland University of Technology, Brisbane 4000, Australia
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