Precancerous Lesions of the Breast

Multi-targeting chemoprevention of Chinese herb formula Yanghe Huayan decoction on experimentally induced mammary tumorigenesis

BACKGROUND

Development of safe and effective chemopreventive agents is a winning strategy in reducing the morbidity and mortality of breast cancer. The current study was to investigate the mechanism-based chemopreventive potential of a Chinese herb formula Yanghe Huayan (YHHY) Decoction on the classical 7,12-dimethylbenz(a)anthracene (DMBA) induced rat mammary carcinogenesis model.

METHODS

Female Sprague-Dawley rats at 42 days of age were orally administered with a human equivalent dose of YHHY Decoction at 0.02 ml/g (10 mg/ml) once daily, starting 1 wk. before and 4 wks following DMBA treatment. Mammary tumor occurrence was monitored every day. The length of time before palpable tumor is examined is defined as tumor-free survival time. High performance liquid chromatography (HPLC) analyses were adopted to identify major chemical compositions of the decoction. Following bioinformatics data mining and experimental analyses were performed to demonstrate the underlying mechanism of action.

RESULTS

DMBA animals receiving YHHY Decoction exhibited a significant delay (P = 0.014) and in some animals prevention (P = 0.046) of tumor occurrence without obvious toxicity. Oncogenic myc activation was significantly suppressed in the DMBA-induced rats by the YHHY treatment. Eight major chemical compositions of the decoction were identified and were shown to interfere with multiple tumorigenic pathways simultaneously in the mammary tumors, including inducing tumor apoptosis and up-regulating pro-apoptotic protein Bax and down-regulating anti-apoptotic protein Bcl-2; suppressing abnormal cell proliferation and the MAPK/ERK, PI3K/AKT signalings; blocking neo-angiogenesis and the VEGF/KDR signaling, and inhibiting oxidative stress in the mammary tumors.

CONCLUSION

The multi-components and multi-targeting properties of the YHHY Decoction support its use as a potent chemopreventive drug in breast cancer.

Neoplasm of uncertain behaviour of the breast-a retrospective study in a breast unit

Introduction

Breast lesions include a heterogeneous group of entities with variable clinical behaviour and morphological presentation, mostly classified as benign or malignant, with predictable behaviour. However, there are lesions with clinical, breast imaging and/or biopsy characteristics that do not clarify their nature. These lesions have an uncertain behaviour regarding their malignant potential at diagnosis.We intend to relate the preoperative diagnosis of neoplasm of uncertain behaviour of the breast (NUnBB) regarding the core needle biopsy and the histological result after excisional biopsy.

Methods

This is a retrospective study of patients submitted to local excision of breast lesions with a perioperative diagnosis of NUnBB, classified as 2383 at 'International Statistical Classification of Diseases and Related Health Problems' (ICD 9), between January 2007 and October 2016 in a breast unit.

Results

Ninety-two cases with the diagnosis of NUnBB were analysed: 91 females with a mean age of 59 ± 14 years. All were submitted to local excision of breast lesion as ambulatory surgery with the following histology: 64% benign, 3% malignant potential and 33% malignant. Of those who presented malignant results, 69% underwent a surgical re-intervention for local control of the disease.

Discussion

Regarding the considerable number of malignant lesions at final histology and the high percentage of which are re-operated, NUnBB should be treated with the same priority as a confirmed malignant neoplasm and whenever possible, using the most appropriate surgical technique.