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Ajabnoor GMA. The Molecular and Genetic Interactions between Obesity and Breast Cancer Risk. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1338. [PMID: 37512149 PMCID: PMC10384495 DOI: 10.3390/medicina59071338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 07/14/2023] [Accepted: 07/19/2023] [Indexed: 07/30/2023]
Abstract
Breast cancer (BC) is considered the leading cause of death among females worldwide. Various risk factors contribute to BC development, such as age, genetics, reproductive factors, obesity, alcohol intake, and lifestyle. Obesity is considered to be a pandemic health problem globally, affecting millions of people worldwide. Obesity has been associated with a high risk of BC development. Determining the impact of obesity on BC development risk in women by demonstrating the molecular and genetic association in pre- and post-menopause females and risk to BC initiation is crucial in order to improve the diagnosis and prognosis of BC disease. In epidemiological studies, BC in premenopausal women was shown to be protective in a certain pattern. These altered effects between the two phases could be due to various physiological changes, such as estrogen/progesterone fluctuating levels. In addition, the relationship between BC risk and obesity is indicated by different molecular alterations as metabolic pathways and genetic mutation or epigenetic DNA changes supporting a strong connection between obesity and BC risk. However, these molecular and genetic alteration remain incompletely understood. The aim of this review is to highlight and elucidate the different molecular mechanisms and genetic changes occurring in obese women and their association with BC risk and development.
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Affiliation(s)
- Ghada M A Ajabnoor
- Department of Clinical Biochemistry, Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia
- Food, Nutrition and Lifestyle Unit, King Fahd Medical Research Centre, King Abdulaziz University, Jeddah 21551, Saudi Arabia
- Saudi Diabetes Research Group, Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia
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Richey WL, Heiselman JS, Ringel MJ, Meszoely IM, Miga MI. Computational Imaging to Compensate for Soft-Tissue Deformations in Image-Guided Breast Conserving Surgery. IEEE Trans Biomed Eng 2022; 69:3760-3771. [PMID: 35604993 PMCID: PMC9811993 DOI: 10.1109/tbme.2022.3177044] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE During breast conserving surgery (BCS), magnetic resonance (MR) images aligned to accurately display intraoperative lesion locations can offer improved understanding of tumor extent and position relative to breast anatomy. Unfortunately, even under consistent supine conditions, soft tissue deformation compromises image-to-physical alignment and results in positional errors. METHODS A finite element inverse modeling technique has been developed to nonrigidly register preoperative supine MR imaging data to the surgical scene for improved localization accuracy during surgery. Registration is driven using sparse data compatible with acquisition during BCS, including corresponding surface fiducials, sparse chest wall contours, and the intra-fiducial skin surface. Deformation predictions were evaluated at surface fiducial locations and subsurface tissue features that were expertly identified and tracked. Among n = 7 different human subjects, an average of 22 ± 3 distributed subsurface targets were analyzed in each breast volume. RESULTS The average target registration error (TRE) decreased significantly when comparing rigid registration to this nonrigid approach (10.4 ± 2.3 mm vs 6.3 ± 1.4 mm TRE, respectively). When including a single subsurface feature as additional input data, the TRE significantly improved further (4.2 ± 1.0 mm TRE), and in a region of interest within 15 mm of a mock biopsy clip TRE was 3.9 ± 0.9 mm. CONCLUSION These results demonstrate accurate breast deformation estimates based on sparse-data-driven model predictions. SIGNIFICANCE The data suggest that a computational imaging approach can account for image-to-surgery shape changes to enhance surgical guidance during BCS.
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Kirkham AA, Jerzak KJ. Prevalence of Breast Cancer Survivors Among Canadian Women. J Natl Compr Canc Netw 2022; 20:1005-1011. [PMID: 36075384 DOI: 10.6004/jnccn.2022.7028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 05/03/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND The 49% decrease in breast cancer mortality since 1986 has increased the number of breast cancer survivors requiring survivorship care. The purpose of this analysis was to estimate the 2022 prevalence of breast cancer survivors diagnosed within the past 15 years among Canadian women. METHODS We extracted the projected female breast cancer cases from 2007 to 2021 and rates of net survival (competing noncancer causes of death removed) from the Canadian Cancer Society's statistical reports. Overall survival was extracted from published Ontario data. Using known survival rates for 1, 5, 10, and 15 years, we interpolated remaining years and applied the corresponding net and overall survival rates to the projected cases for each year from 2007 to 2021 to determine survivors in 2022. Prevalence for predefined age groups was also calculated. As an example of excess healthcare costs attributable to breast cancer, we calculated the excess costs of heart failure hospitalizations. RESULTS From 2007 to 2021, there were 370,756 breast cancer cases. Using net survival, 318,429 (85.9%) of these patients were projected to survive breast cancer by 2022, a prevalence of 2.1% of Canadian women. Using overall survival, prevalence was 1.8%. Prevalence increased with age group, from 0.01% of those aged 20 to 24 years to 12.7% of those aged ≥90 years, and from 1.0% among the working and/or child-raising (age 20-64 years) to 5.4% among elderly populations (age ≥65 years). Among these survivors, 24.9% of projected heart failure hospitalizations would be in excess of those among matched control subjects, with projected excess costs of $16.5 million CAD. Given the excess healthcare costs, potential for reduced contributions to the workforce, and reduced quality of life associated with long-term impairments and risk of excess non-breast cancer death, enhanced breast cancer survivorship care is warranted. CONCLUSIONS With an overall prevalence of 2% among Canadian women, breast cancer survivors represent an increasing segment of the working-age and elderly populations.
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Affiliation(s)
- Amy A Kirkham
- University of Toronto, Knowledge, Innovation, Talent and Everywhere (KITE), Toronto Rehabilitation Institute, University Health Network; and
| | - Katarzyna J Jerzak
- Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
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Charati FG, Shojaee L, Haghighat S, Esmaeili R, Madani Z, Charati JY, Hosseini SH, Shafipour V. Motor exercises effect on improving shoulders functioning, functional ability, quality of life, depression and anxiety for women with breast cancer. Clin Breast Cancer 2022; 22:666-673. [DOI: 10.1016/j.clbc.2022.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 07/17/2022] [Accepted: 07/19/2022] [Indexed: 11/03/2022]
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Alshamsan B, Suleman K, Agha N, Abdelgawad MI, Alzahrani MJ, Elhassan T, Al-Tweigeri T, Ajarim D, Alsayed A. Association Between Obesity and Clinicopathological Profile of Patients with Newly Diagnosed Non-Metastatic Breast Cancer in Saudi Arabia. Int J Womens Health 2022; 14:373-384. [PMID: 35309953 PMCID: PMC8926012 DOI: 10.2147/ijwh.s343558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 03/03/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose Obesity is prevalent in Saudi Arabia and is associated with adverse clinical features and poor breast cancer (BC) outcomes. We determined the distribution of body mass index (BMI) and evaluated its association with disease characteristics and outcomes in women with non-metastatic BC. Patients and Methods We conducted a retrospective analysis of a prospectively collected database of consecutive patients treated for non-metastatic BC between 2002 and 2014. Patients were categorized into the following groups: underweight/normal weight (BMI <25 kg/m2), overweight (BMI 25–29.9 kg/m2), and obese (BMI ≥30 kg/m2). Regression analysis was used to evaluate clinicopathological factors associated with BMI and clinical stage. Results A total of 2212 patients were enrolled. The median age was 45 years (interquartile range [IQR], 39–52 years), and the median BMI was 30 kg/m2 (IQR, 26–34 kg/m2). Most patients were premenopausal (63.6%), nearly half of the patients had stage III disease, and 11.2% were screen-detected. The prevalence of obesity was 53.4%, with a significant difference between the peri/premenopausal (49.4%) and postmenopausal (61.7%) groups (p < 0.001). Obese patients were more likely to be aged >40 years, be postmenopausal, have a history of oral contraceptive pills, have advanced-stage disease, and have undergone radiation therapy, and were less likely to have human epithelial growth factor 2 (HER2)+ disease than non-obese patients. Premenopausal obese women had fewer hormone receptor-positive and more triple-negative cancers than postmenopausal obese women did. Obesity, non-screening-detected BC, and HER+ status were independent prognostic factors for advanced-stage presentation. Conclusion The prevalence of obesity and its significant association with advanced BC justify the upscaling of screening services and instituting weight-reduction strategies.
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Affiliation(s)
- Bader Alshamsan
- Medical Oncology, Oncology Center, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.,Department of Medicine, College of Medicine, Qassim University, Qassim, Saudi Arabia
| | - Kausar Suleman
- Medical Oncology, Oncology Center, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Naela Agha
- Medical Oncology, Oncology Center, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.,Northern Ireland Cancer Centre, Belfast City Hospital, Belfast, UK
| | - Marwa I Abdelgawad
- Medical Oncology, Oncology Center, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.,Clinical Oncology Department, Assiut University, Assiut, Egypt
| | - Mashari J Alzahrani
- Medical Oncology, Oncology Center, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.,Department of Medicine, Medical Oncology, University of Ottawa, Ottawa, ONT, Canada
| | - Tusneem Elhassan
- Medical Oncology, Oncology Center, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Taher Al-Tweigeri
- Medical Oncology, Oncology Center, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Dahish Ajarim
- Medical Oncology, Oncology Center, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Adher Alsayed
- Medical Oncology, Oncology Center, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
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Islam MA, Sathi NJ, Abdullah HM, Tabassum T. A Meta-Analysis of Induced Abortion, Alcohol Consumption, and Smoking Triggering Breast Cancer Risk among Women from Developed and Least Developed Countries. Int J Clin Pract 2022; 2022:6700688. [PMID: 36474551 PMCID: PMC9683974 DOI: 10.1155/2022/6700688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 10/29/2022] [Accepted: 10/31/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The most prominent form of cancer in women is breast cancer, and modifiable lifestyle risk factors, including smoking, alcohol consumption, and induced abortion, can all contribute significantly to this disease. OBJECTIVES This study's primary purpose was to assess the prevalence of breast cancer among women in developed and developing countries and the association between three modifiable hazard factors (induced abortion, smoking behavior, and alcohol use) and breast cancer. METHODS This study performed a systematic literature database review up to September 21, 2021. We employed meta-analytic tools such as the random effects model, forest plot, and subgroup analysis to conduct the research. Additionally, we conducted a sensitivity analysis to assess the influence of outliers. RESULTS According to the random effects model, smoker women have a higher risk of developing breast cancer from different countries (OR = 1.46; 95% CI: 1.08-1.97). In the case of induced abortion, the pooled estimate (OR = 1.25; 95% CI: 1.01-1.53) indicated a significant link between abortion and breast cancer. Subgroup analysis revealed that smoking substantially influences breast cancer in developing and developed countries. Breast cancer was more common among women who smoked in developed countries than in developing nations. CONCLUSION The observed findings give sufficient support for the hypothesis that smoking and abortion have a significant influence on breast cancer in different nations. Health organizations should individually design comprehensive scientific plans to raise awareness about the risks of abortion and smoking in developed and developing countries.
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Affiliation(s)
- Md. Akhtarul Islam
- Statistics Discipline, Science Engineering & Technology School, Khulna University, Khulna-9208, Bangladesh
| | - Nusrat Jahan Sathi
- Statistics Discipline, Science Engineering & Technology School, Khulna University, Khulna-9208, Bangladesh
| | - Hossain Mohammad Abdullah
- Statistics Discipline, Science Engineering & Technology School, Khulna University, Khulna-9208, Bangladesh
| | - Tarana Tabassum
- Statistics Discipline, Science Engineering & Technology School, Khulna University, Khulna-9208, Bangladesh
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Zhang M, Zhou J, Wang L. Breast cancer and pregnancy: Why special considerations prior to treatment are needed in multidisciplinary care. Biosci Trends 2021; 15:276-282. [PMID: 34556594 DOI: 10.5582/bst.2021.01187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Breast cancer diagnosed during pregnancy poses ethical and professional challenges. Clinical management of that condition should ensure the safety of both the mother and fetus. Clinical trials on breast cancer exclude pregnant women, so sufficient evidence with which to formulate guidelines for the management of these patients is lacking. Failing to undergo a breast examination during pregnancy, breast symptoms explained by physiological changes such as pregnancy, and unnecessary abortions after the diagnosis of breast cancer lead to worse outcomes for these patients. Multidisciplinary teams including breast surgeons, obstetricians, radiologists, pathologists, and anesthesiologists need to make an early diagnosis and comprehensively evaluate patients in different gestational weeks and with different stages of breast cancer in order to optimize outcomes.
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Affiliation(s)
- Mingdi Zhang
- Department of Breast Surgery, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Jing Zhou
- Laboratory for Reproductive Immunology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.,The Academy of Integrative Medicine of Fudan University, Shanghai, China.,Shanghai Key Laboratory of Female Reproductive Endocrine-related Diseases, Shanghai, China
| | - Ling Wang
- Laboratory for Reproductive Immunology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.,The Academy of Integrative Medicine of Fudan University, Shanghai, China.,Shanghai Key Laboratory of Female Reproductive Endocrine-related Diseases, Shanghai, China
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Lu YS, Wong A, Kim HJ. Ovarian Function Suppression With Luteinizing Hormone-Releasing Hormone Agonists for the Treatment of Hormone Receptor-Positive Early Breast Cancer in Premenopausal Women. Front Oncol 2021; 11:700722. [PMID: 34595110 PMCID: PMC8477635 DOI: 10.3389/fonc.2021.700722] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 08/04/2021] [Indexed: 01/08/2023] Open
Abstract
Chemotherapy and endocrine therapies are mainstays of treatment for early and advanced hormone receptor-positive (HR+) breast cancer. In premenopausal women with HR+ tumors, the benefits of adding ovarian function suppression (OFS) to endocrine therapy have been debated. Consequently, for many years, tamoxifen monotherapy has been the standard of care for endocrine treatment in the adjuvant setting. Recent studies have, however, provided new evidence that, in some premenopausal patients, OFS in combination with tamoxifen or aromatase inhibitors (AIs) can significantly increase survival versus tamoxifen alone. Luteinizing hormone-releasing hormone agonists (LHRHa), including goserelin, triptorelin, and leuprorelin, achieve OFS through sustained suppression of the release of follicle-stimulating hormone and luteinizing hormone from the pituitary. In turn, this suppresses production and secretion of estradiol, an ovarian hormone that supports cancer cell growth, survival, and proliferation. In this review, we discuss the clinical evidence supporting the addition of LHRHa to adjuvant endocrine therapies, including tamoxifen and AIs, for premenopausal women with breast cancer. We also discuss the role of LHRHa use in combination with adjuvant chemotherapy to preserve ovarian function and fertility in young patients with breast cancer. Finally, we discuss important practical aspects of the use of LHRHa in breast cancer treatment, including side-effects, patient adherence to treatment, and the use of slow-release, long-acting drug formulations.
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Affiliation(s)
- Yen-Shen Lu
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
| | - Andrea Wong
- Department of Haematology-Oncology, Cancer Science Institute, National University of Singapore, Singapore, Singapore
| | - Hee-Jeong Kim
- Department of Surgery, College of Medicine, Asan Medical Center, Seoul, South Korea
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9
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Mulvagh SL, Mullen KA, Nerenberg KA, Kirkham AA, Green CR, Dhukai AR, Grewal J, Hardy M, Harvey PJ, Ahmed SB, Hart D, Levinsson AL, Parry M, Foulds HJ, Pacheco C, Dumanski SM, Smith G, Norris CM. The Canadian Women’s Heart Health Alliance Atlas on the Epidemiology, Diagnosis, and Management of Cardiovascular Disease in Women — Chapter 4: Sex- and Gender-Unique Disparities: CVD Across the Lifespan of a Woman. CJC Open 2021; 4:115-132. [PMID: 35198930 PMCID: PMC8843896 DOI: 10.1016/j.cjco.2021.09.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 09/13/2021] [Indexed: 02/09/2023] Open
Abstract
Women have unique sex- and gender-related risk factors for cardiovascular disease (CVD) that can present or evolve over their lifespan. Pregnancy-associated conditions, polycystic ovarian syndrome, and menopause can increase a woman’s risk of CVD. Women are at greater risk for autoimmune rheumatic disorders, which play a role in the predisposition and pathogenesis of CVD. The influence of traditional CVD risk factors (eg, smoking, hypertension, diabetes, obesity, physical inactivity, depression, anxiety, and family history) is greater in women than men. Finally, there are sex differences in the response to treatments for CVD risk and comorbid disease processes. In this Atlas chapter we review sex- and gender-unique CVD risk factors that can occur across a woman’s lifespan, with the aim to reduce knowledge gaps and guide the development of optimal strategies for awareness and treatment.
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Toorang F, Sasanfar B, Esmaillzadeh A, Zendehdel K. Adherence to the DASH Diet and Risk of Breast Cancer. Clin Breast Cancer 2021; 22:244-251. [PMID: 34588148 DOI: 10.1016/j.clbc.2021.07.010] [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: 03/06/2021] [Revised: 06/15/2021] [Accepted: 07/20/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND The Dietary Approach to Stop Hypertension (DASH) eating pattern has been recommended as a healthy dietary plan by several international guidelines. However, data on the association between the DASH diet and breast cancer is limited. This study investigated the association between the DASH dietary pattern and risk of breast cancer. MATERIALS AND METHODS This is a hospital-based case-control study conducted between 2014 and 2016 in the Cancer Institute of Iran. Patients with histopathologically confirmed breast cancer were recruited. Controls were healthy subjects who were frequency matched to cases by residential place and age (±10 years). A validated 168-item Food Frequency Questionnaire was applied to assess the dietary intake of participants. Physical activity was assessed using the Global Physical Activity Questionnaire. The DASH dietary pattern scores were calculated using the method introduced by Fung. Unconditional logistic regression, in which potential confounders were taken into account, was applied to determine the association between adherence to the DASH dietary pattern and odds of breast cancer. RESULTS The study participants comprised 477 patients with breast cancer and 507 healthy controls. In the total population, patients with breast cancer were slightly older (45.9 vs. 43.9 years, P = .02), had slightly higher BMI (21.9 vs. 20.2, P = .01) and were less physically active (20 vs. 27 MET h/wk. P < .01) than controls. In Model A, which was adjusted for age and energy intake, adherence to the DASH dietary pattern substantially reduced breast cancer risk in the total population (OR for comparing extreme tertiles: 0.62; 95% CI 0.44-0.78; Ptrend = 0.004). Even after controlling for more cofounders, greatest adherence to DASH diet was associated with a 34% reduction in risk of breast cancer (OR 0.66; 95% CI 0.46, 0.94; Ptrend = 0.03). In premenopausal women, adherence to the DASH dietary pattern was insignificantly associated with a 32% reduction in breast cancer risk. This risk reduction was 38% in postmenopausal women, which was also not found to be significant CONCLUSION: Adherence to the DASH dietary pattern could be associated with an approximately 30% reduction in risk of breast cancer. However, further studies, in particular studies with prospective design, are required to confirm this claim.
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Affiliation(s)
- Fatemeh Toorang
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran; Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Bahareh Sasanfar
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran; Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran; Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Ahmad Esmaillzadeh
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran; Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Kazem Zendehdel
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran; Cancer Biology Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, I.R. Iran; Breast Diseases Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, I.R. Iran.
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Martelli V, Latocca MM, Ruelle T, Perachino M, Arecco L, Beshiri K, Razeti MG, Tagliamento M, Cosso M, Fregatti P, Lambertini M. Comparing the Gonadotoxicity of Multiple Breast Cancer Regimens: Important Understanding for Managing Breast Cancer in Pre-Menopausal Women. BREAST CANCER (DOVE MEDICAL PRESS) 2021; 13:341-351. [PMID: 34079366 PMCID: PMC8164347 DOI: 10.2147/bctt.s274283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 04/14/2021] [Indexed: 11/23/2022]
Abstract
Over the last several decades, improvements in breast cancer treatment have contributed to increased cure rates for women diagnosed with this malignancy. Consequently, great importance should be paid to the long-term side effects of systemic therapies. For young women (defined as per guideline ≤40 years at diagnosis) who undergo chemotherapy, one of the most impactful side effects on their quality of life is premature ovarian insufficiency (POI) leading to fertility-related problems and the side effects of early menopause. Regimens, type, and doses of chemotherapy, as well as the age of patients and their ovarian reserve at the time of treatment are major risk factors for treatment-induced POI. For these reasons, childbearing desire and preservation of ovarian function and/or fertility should be discussed with all premenopausal patients before planning the treatments. This manuscript summarizes the available fertility preservation techniques in breast cancer patients, the risk of treatment-induced POI with different anticancer treatments, and the possible procedures to prevent it. A special focus is paid to the role of oncofertility counseling, as a central part of the visit in this setting, during which the patient should receive all the information about the potential consequences of the disease and of the proposed treatment on her future life.
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Affiliation(s)
- Valentino Martelli
- Department of Medical Oncology, U.O.C Clinica Di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy
| | - Maria Maddalena Latocca
- Department of Medical Oncology, U.O.C Clinica Di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy
| | - Tommaso Ruelle
- Department of Medical Oncology, U.O.C Clinica Di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy
| | - Marta Perachino
- Department of Medical Oncology, U.O.C Clinica Di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy
| | - Luca Arecco
- Department of Medical Oncology, U.O.C Clinica Di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy
| | - Kristi Beshiri
- Department of Medical Oncology, U.O.C Clinica Di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy
| | - Maria Grazia Razeti
- Department of Medical Oncology, U.O.C Clinica Di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy
| | - Marco Tagliamento
- Department of Medical Oncology, U.O.C Clinica Di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy
| | - Maurizio Cosso
- Department of Radiology, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Piero Fregatti
- U.O.C. Clinica Di Chirurgia Senologica, Department of Surgery, IRCCS Ospedale Policlinico San Martino, Genova, Italy
- Department of Integrated Diagnostic Surgical Sciences, School of Medicine, University of Genova, Genova, Italy
| | - Matteo Lambertini
- Department of Medical Oncology, U.O.C Clinica Di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy
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12
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Xu L, Liu Y, Fan Z, Jiang Z, Liu Y, Ling R, Zhang J, Yu Z, Jin F, Wang C, Cui S, Wang S, Mao D, Han B, Wang T, Zhang G, Wang T, Guo B, Yu L, Xu Y, Fu F, Liu Z, Wang S, Luo K, Xiang Q, Zhang Z, Liu Q, Zhou B, Liu Z, Ma C, Tong W, Mao J, Duan X, Cui Y. Assessment of CPS + EG, Neo-Bioscore and Modified Neo-Bioscore in Breast Cancer Patients Treated With Preoperative Systemic Therapy: A Multicenter Cohort Study. Front Oncol 2021; 11:606477. [PMID: 33796452 PMCID: PMC8009183 DOI: 10.3389/fonc.2021.606477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 02/25/2021] [Indexed: 11/13/2022] Open
Abstract
This study was to assess the prognosis stratification of the clinical-pathologic staging system incorporating estrogen receptor (ER)-negative disease, the nuclear grade 3 tumor pathology (CPS + EG), Neo-Bioscore, and a modified Neo-Bioscore system in breast cancer patients after preoperative systemic therapy (PST). A retrospective multicenter cohort study was conducted from 12 participating hospitals' databases from 2006 to 2015. Five-year disease free survival (DFS), disease specific survival (DSS), and overall survival (OS) were calculated using Kaplan-Meier Method. Area under the curve (AUC) of the three staging systems was compared. Wald test and maximum likelihood estimates in Cox proportional hazards model were used for multivariate analysis. A total of 1,077 patients were enrolled. The CPS + EG, Neo-Bioscore, and modified Neo-Bioscore could all stratify the DFS, DSS, and OS (all P < 0.001). While in the same stratum of Neo-Bioscore scores 2 and 3, the HER2-positive patients without trastuzumab therapy had much poorer DSS (P = 0.013 and P values < 0.01, respectively) as compared to HER2-positive patients with trastuzumab therapy and HER2-negative patients. Only the modified Neo-Bioscore had a significantly higher stratification of 5-year DSS than PS (AUC 0.79 vs. 0.65, P = 0.03). So, the modified Neo-Bioscore could circumvent the limitation of CPS + EG or Neo-Bioscore. Clinical Trial Registration ClinicalTrials.gov, identifier NCT03437837.
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Affiliation(s)
- Ling Xu
- Breast Disease Center, Peking University First Hospital, Beijing, China
| | - Yinhua Liu
- Breast Disease Center, Peking University First Hospital, Beijing, China
| | - Zhimin Fan
- Department of Breast Surgery, First Hospital of Jilin University, Changchun, China
| | - Zefei Jiang
- Department of Breast Cancer, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, China
| | - Yunjiang Liu
- Hebei Breast Cancer Center, The 4th Hospital of Hebei Medical University, Shijiazhuang, China
| | - Rui Ling
- Department of Thyroid, Breast and Vascular Surgery, Xijing Hospital, Air Force (Military) Medical University, Xi'an, China
| | - Jianguo Zhang
- Breast Disease Department, Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Zhigang Yu
- Department of Breast Surgery, Second Hospital of Shandong University, Jinan, China
| | - Feng Jin
- Department of Breast Surgery, The First Hospital of China Medical University, Shenyang, China
| | - Chuan Wang
- Department of Breast Surgery, Affiliated Union Hospital of Fujian Medical University, Fuzhou, China
| | - Shude Cui
- Department of Breast Surgery, Affiliated Tumor Hospital of Zhengzhou University, Zhengzhou, China
| | - Shu Wang
- Breast Center, Peking University People's Hospital, Beijing, China
| | - Dahua Mao
- Department of Breast Surgery, The Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - Bing Han
- Department of Breast Surgery, First Hospital of Jilin University, Changchun, China
| | - Tao Wang
- Department of Breast Cancer, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, China
| | - Geng Zhang
- Hebei Breast Cancer Center, The 4th Hospital of Hebei Medical University, Shijiazhuang, China
| | - Ting Wang
- Department of Thyroid, Breast and Vascular Surgery, Xijing Hospital, Air Force (Military) Medical University, Xi'an, China
| | - Baoliang Guo
- Breast Disease Department, Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Lixiang Yu
- Department of Breast Surgery, Second Hospital of Shandong University, Jinan, China
| | - Yingying Xu
- Department of Breast Surgery, The First Hospital of China Medical University, Shenyang, China
| | - Fangmeng Fu
- Department of Breast Surgery, Affiliated Union Hospital of Fujian Medical University, Fuzhou, China
| | - Zhenzhen Liu
- Department of Breast Surgery, Affiliated Tumor Hospital of Zhengzhou University, Zhengzhou, China
| | - Siyuan Wang
- Breast Center, Peking University People's Hospital, Beijing, China
| | - Ke Luo
- Department of Breast Surgery, The Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - Qian Xiang
- Department of Pharmacy, Peking University First Hospital, Beijing, China
| | - Zhuo Zhang
- Department of Pharmacy, Peking University First Hospital, Beijing, China
| | - Qianxin Liu
- Department of Pharmacy, Peking University First Hospital, Beijing, China
| | - Bin Zhou
- Breast Disease Center, Peking University First Hospital, Beijing, China
| | - Zhaorui Liu
- Institute of Mental Health, Peking University, Beijing, China
| | - Chao Ma
- Institute of Mental Health, Peking University, Beijing, China
| | - Weiwei Tong
- Gennlife (Beijing) Technology Co., Ltd, Beijing, China
| | - Jie Mao
- Gennlife (Beijing) Technology Co., Ltd, Beijing, China
| | - Xuening Duan
- Breast Disease Center, Peking University First Hospital, Beijing, China
| | - Yimin Cui
- Department of Pharmacy, Peking University First Hospital, Beijing, China
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13
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Rostami S, Rafei A, Damghanian M, Khakbazan Z, Maleki F, Zendehdel K. Discriminatory Accuracy of the Gail Model for Breast Cancer Risk Assessment among Iranian Women. IRANIAN JOURNAL OF PUBLIC HEALTH 2021; 49:2205-2213. [PMID: 33708742 PMCID: PMC7917489 DOI: 10.18502/ijph.v49i11.4739] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background: The Gail model is the most well-known tool for breast cancer risk assessment worldwide. Although it was validated in various Western populations, inconsistent results were reported from Asian populations. We used data from a large case-control study and evaluated the discriminatory accuracy of the Gail model for breast cancer risk assessment among the Iranian female population. Methods: We used data from 942 breast cancer patients and 975 healthy controls at the Cancer Institute of Iran, Tehran, Iran, in 2016. We refitted the Gail model to our case-control data (the IR-Gail model). We compared the discriminatory power of the IR-Gail with the original Gail model, using ROC curve analyses and estimation of the area under the ROC curve (AUC). Results: Except for the history of biopsies that showed an extremely high relative risk (OR=9.1), the observed ORs were similar to the estimates observed in Gail’s study. Incidence rates of breast cancer were extremely lower in Iran than in the USA, leading to a lower average absolute risk among the Iranian population (2.78, ±SD 2.45). The AUC was significantly improved after refitting the model, but it remained modest (0.636 vs. 0.627, ΔAUC = 0.009, bootstrapped P=0.008). We reported that the cut-point of 1.67 suggested in the Gail study did not discriminate between breast cancer patients and controls among the Iranian female population. Conclusion: Although the coefficients from the local study improved the discriminatory accuracy of the model, it remained modest. Cohort studies are warranted to evaluate the validity of the model for Iranian women.
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Affiliation(s)
- Sahar Rostami
- Department of Reproductive Health and Midwifery, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.,Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Rafei
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Damghanian
- Nursing and Midwifery Care Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Zohreh Khakbazan
- Nursing and Midwifery Care Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzad Maleki
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran.,Social Determinants of Health Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Kazem Zendehdel
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran.,Cancer Biology Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran.,Breast Disease Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran
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14
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Fancellu A, Zhao XY, Cottu P, Sanna V, Li YP, Zhu Q, Tanda C, Zhang YY, Lai YM, Ginesu GC, Dai SQ, Porcu A. Comparing Clinicopathologic Features and Surgical Treatment of Premenopausal Breast Cancer across Italy and China: Report from a Medical Exchange Program. Breast Care (Basel) 2020; 15:511-518. [PMID: 33223995 DOI: 10.1159/000505448] [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: 05/25/2019] [Accepted: 12/16/2019] [Indexed: 02/05/2023] Open
Abstract
Background This study investigated the differences in clinicopathologic features and surgical treatment between an Italian and a Chinese cohort of premenopausal women with breast cancer, and highlighted the potential advantages of international medical exchange projects. Methods Premenopausal women who underwent surgical treatment between 2012 and 2016 at one Italian and one Chinese institution participating in a medical exchange program were compared. Factors associated with the probability to receive mastectomy were determined via logistic analysis. Changes in surgical management at the Chinese institution in the period 2018-2019, after the exchange program, were also evaluated. Results A total of 505 patients, 318 from Italy and 187 from China, were evaluated. The Chinese patients had more frequently advanced-stage tumours, large tumour size (30.9 vs. 18.1 mm, p < 0.01), invasive carcinoma (92.5 vs. 83.3%, p < 0.01), positive axillary lymph nodes (54.5 vs. 27.4%, p < 0.01), Her-2 positivity (36.4 vs. 22.0%, p < 0.01), and high proliferative index (55.1 vs. 30.2%, p < 0.01). Positive oestrogen receptor status and rates of triple-negative breast cancer did not differ (77.0 vs. 69.5%, p = 0.09 and 14.2 vs. 16%, p = 0.56, respectively). Mastectomy rates were higher among Chinese women (85 vs. 41%, p < 0.001), whereas use of sentinel node biopsy was more frequent among Italian women (77 vs. 33%, p < 0.001). Chinese women had more than 4-fold higher risk of receiving mastectomy. In the last 2 years, the rates of breast-conserving surgery and sentinel node biopsy at the Chinese institution increased from 15 to 23%, and from 33 to 42%, respectively. Conclusions Tumour features and surgical strategies for premenopausal breast cancer may differ significantly between Italy and China. Since the international exchange program, patients from the Chinese institution have been offered more frequently less invasive surgery. International exchange programs can help in designing epidemiological studies which may be useful for strategies to improve breast cancer management and control.
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Affiliation(s)
- Alessandro Fancellu
- Unit of General Surgery 2-Clinica Chirurgica, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Xue Yun Zhao
- Department of Thyroid and Breast Surgery, People's Hospital of Leshan, Leshan, China
| | - Pietrina Cottu
- Unit of General Surgery 2-Clinica Chirurgica, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Valeria Sanna
- Division of Medical Oncology, AOU Sassari, Sassari, Italy
| | - Yuan Ping Li
- Department of Thyroid and Breast Surgery, People's Hospital of Leshan, Leshan, China
| | - Qin Zhu
- Department of Thyroid and Breast Surgery, People's Hospital of Leshan, Leshan, China
| | - Cinzia Tanda
- Unit of General Surgery 2-Clinica Chirurgica, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Ying Yi Zhang
- Department of Thyroid and Breast Surgery, People's Hospital of Leshan, Leshan, China
| | - Yan Mei Lai
- Department of Thyroid and Breast Surgery, People's Hospital of Leshan, Leshan, China
| | - Giorgio Carlo Ginesu
- Unit of General Surgery 2-Clinica Chirurgica, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Shu Qin Dai
- Department of Thyroid and Breast Surgery, People's Hospital of Leshan, Leshan, China
| | - Alberto Porcu
- Unit of General Surgery 2-Clinica Chirurgica, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
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15
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Paris I, Di Giorgio D, Carbognin L, Corrado G, Garganese G, Franceschini G, Sanchez AM, De Vincenzo RP, Accetta C, Terribile DA, Magno S, Di Leone A, Bove S, Masetti R, Scambia G. Pregnancy-Associated Breast Cancer: A Multidisciplinary Approach. Clin Breast Cancer 2020; 21:e120-e127. [PMID: 32778512 DOI: 10.1016/j.clbc.2020.07.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 07/07/2020] [Accepted: 07/14/2020] [Indexed: 01/20/2023]
Abstract
The diagnosis of breast cancer (BC) during pregnancy is uncommon. It has varied among different studies from 1:10,000 to 1:3000 of all pregnancies, with a median age of 33 years. Pregnancy-associated BC represents a challenge in terms of clinical management to guarantee both maternal and fetal security in choosing the right treatment. This situation is complex and requires a multidisciplinary approach, including the surgeon, anesthesiologist, oncologist, radiotherapist, psychologist, and maternal-fetal medicine specialist. In the present review, we examined the management of pregnancy-associated BC, focusing on pathophysiologic background, risk factors, diagnosis, staging procedures, anesthesia, surgical management, and systemic treatment.
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Affiliation(s)
- Ida Paris
- Department of Woman and Child Health and Public Health, Woman Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
| | - Danilo Di Giorgio
- Gynaecology and Breast Care Center, Mater Olbia Hospital, Olbia, Italy
| | - Luisa Carbognin
- Department of Woman and Child Health and Public Health, Woman Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Giacomo Corrado
- Department of Woman and Child Health and Public Health, Woman Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Giorgia Garganese
- Department of Woman and Child Health and Public Health, Woman Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Gynaecology and Breast Care Center, Mater Olbia Hospital, Olbia, Italy; Università Cattolica del Sacro Cuore, Rome, Italy
| | - Gianluca Franceschini
- Department of Woman and Child Health and Public Health, Woman Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Università Cattolica del Sacro Cuore, Rome, Italy
| | - Alejandro Martin Sanchez
- Department of Woman and Child Health and Public Health, Woman Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Rosa Pasqualina De Vincenzo
- Department of Woman and Child Health and Public Health, Woman Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Università Cattolica del Sacro Cuore, Rome, Italy
| | - Cristina Accetta
- Department of Woman and Child Health and Public Health, Woman Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Daniela Andreina Terribile
- Department of Woman and Child Health and Public Health, Woman Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Università Cattolica del Sacro Cuore, Rome, Italy
| | - Stefano Magno
- Department of Woman and Child Health and Public Health, Woman Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Alba Di Leone
- Department of Woman and Child Health and Public Health, Woman Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Sonia Bove
- Gynaecology and Breast Care Center, Mater Olbia Hospital, Olbia, Italy
| | - Riccardo Masetti
- Department of Woman and Child Health and Public Health, Woman Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giovanni Scambia
- Department of Woman and Child Health and Public Health, Woman Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Università Cattolica del Sacro Cuore, Rome, Italy
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16
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Parisi F, Razeti MG, Blondeaux E, Arecco L, Perachino M, Tagliamento M, Levaggi A, Fregatti P, Poggio F, Lambertini M. Current State of the Art in the Adjuvant Systemic Treatment of Premenopausal Patients With Early Breast Cancer. CLINICAL MEDICINE INSIGHTS-ONCOLOGY 2020; 14:1179554920931816. [PMID: 32647477 PMCID: PMC7325453 DOI: 10.1177/1179554920931816] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 05/06/2020] [Indexed: 01/13/2023]
Abstract
Breast cancer is the most frequent malignancy diagnosed in premenopausal women. In this age group, breast tumors tend to be diagnosed at more advanced stages and to harbor more aggressive biological features. In addition, specific age-related issues including genetic counseling, fertility preservation, impact on social and couple relationships, working life, and management of long-term side effects should be considered highly relevant when managing early breast cancer in premenopausal women. Therefore, the care of these patients is particularly complex and a multidisciplinary approach is mandatory. The present review summarizes the current state of art in the adjuvant systemic treatment of premenopausal women with early breast cancer focusing on the optimal chemotherapy, endocrine therapy, and targeted therapy approaches in this specific patient population.
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Affiliation(s)
- Francesca Parisi
- Department of Medical Oncology, U.O.C Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy.,Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy
| | - Maria Grazia Razeti
- Department of Medical Oncology, U.O.C Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy.,Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy
| | - Eva Blondeaux
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy.,Department of Medical Oncology, U.O. Oncologia Medica 2, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Luca Arecco
- Department of Medical Oncology, U.O.C Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy.,Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy
| | - Marta Perachino
- Department of Medical Oncology, U.O.C Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy.,Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy
| | - Marco Tagliamento
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy.,Department of Medical Oncology, U.O. Oncologia Medica 2, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Alessia Levaggi
- Department of Medical Oncology, U.O.C Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Piero Fregatti
- U.O.C. Clinica di Chirurgia Senologica, IRCCS Ospedale Policlinico San Martino, Genova, Italy.,Department of Integrated Diagnostic Surgical Sciences, School of Medicine, University of Genova, Genova, Italy
| | - Francesca Poggio
- Department of Medical Oncology, U.O. Oncologia Medica 2, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Matteo Lambertini
- Department of Medical Oncology, U.O.C Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy.,Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy
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17
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Dano D, Hénon C, Sarr O, Ka K, Ba M, Badiane A, Thiam I, Diene P, Diop M, Dem A, Marino P, Mancini J, Annede P, Gonçalves A, Diouf D, Monneur A. Quality of Life During Chemotherapy for Breast Cancer in a West African Population in Dakar, Senegal: A Prospective Study. J Glob Oncol 2020; 5:1-9. [PMID: 31322991 PMCID: PMC6690633 DOI: 10.1200/jgo.19.00106] [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] [Indexed: 11/29/2022] Open
Abstract
PURPOSE The prevalence of breast cancer is increasing in low- to middle-income countries such as Senegal. Our prospective study assessed the quality of life (QoL) of patients with breast cancer undergoing chemotherapy in Senegal. PATIENTS AND METHODS Our study included women with breast cancer undergoing chemotherapy as initial treatment at the Center Aristide Le Dantec University Hospital in Dakar. Clinical, sociodemographic, and QoL data were collected and analyzed at three different times: baseline, 3 months, and 6 months after the start of systemic therapy. Health-related QoL was assessed using a Functional Assessment of Cancer Therapies-Breast (FACT-B) questionnaire after translation into the Wolof language. Linear mixed-effects models were performed to assess the changes in QoL scores. RESULTS Between July 2017 and February 2018, 120 patients were included in the study. Their median age was 45 years. Most patients (n = 105; 92%) had locally advanced disease (T3 to T4 stage) and lymph node involvement (n = 103; 88%), and half had metastatic disease. The FACT-B total scores significantly improved over time (β = 1.58; 95% CI, 0.50 to 2.67; P < .01). Nausea and vomiting were significantly associated with a decrease in FACT-B total scores (β = −16.89, 95% CI, −29.58 to −4.24, P = .012; and β = −13.44, 95% CI, −25.15 to −1.72, P = .028, respectively). CONCLUSION Our study confirmed the feasibility of standardized QoL assessment in Senegalese patients with breast cancer. Our results indicated a potential improvement of QoL over the course of chemotherapy. Optimizing nausea and vomiting prevention may improve QoL.
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Affiliation(s)
| | | | | | - Kanta Ka
- Aristide Le Dantec Hospital, Dakar, Senegal
| | | | | | | | - Papa Diene
- Aristide Le Dantec Hospital, Dakar, Senegal
| | | | | | - Patricia Marino
- Institut Paoli-Calmettes, Marseille, France.,Aix Marseille University, Marseille, France
| | - Julien Mancini
- Institut Paoli-Calmettes, Marseille, France.,Aix Marseille University, Marseille, France.,Timone University Hospital, Marseille, France
| | | | - Anthony Gonçalves
- Institut Paoli-Calmettes, Marseille, France.,Aix Marseille University, Marseille, France
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18
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Zahedi R, Molavi Vardanjani H, Baneshi MR, Haghdoost AA, Malekpour Afshar R, Ershad Sarabi R, Tavakoli F, Zolala F. Incidence trend of breast Cancer in women of eastern Mediterranean region countries from 1998 to 2019: A systematic review and meta-analysis. BMC Womens Health 2020; 20:53. [PMID: 32183824 PMCID: PMC7079343 DOI: 10.1186/s12905-020-00903-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 02/13/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND This study was conducted to provide evidence on the current status of breast cancer and its incidence trend in Eastern Mediterranean Region during 1998-2019. Also, this study aimed to investigate the association between the incidence of breast cancer and Human Development Index and some factors related to this index, including total fertility rate, and obesity, using a meta-analysis. METHOD Data on incidence of breast cancer were collected from various sources, including PubMed, Embase, Web of Science, and WHO, from 1998 to 2019 using systematic review and meta-analysis. Pooled age standardized rate was calculated based on study duration and quality of data using a subgroup analysis and random effect meta-analysis. RESULTS A total of 80 studies (545 data points) were analyzed. Pooled age standardized rate of breast cancer for Eastern Mediterranean Region was 37.1 per 100,000 person-year (95% confidence interval [CI], 34.5, 39.8) during 2011-2019. age standardized rate of breast cancer had an upward trend in Eastern Mediterranean Region from 2005 to 2019. However, the increasing trend was found to be slightly different in various regions based on quality of data. Moreover, pooled age standardized rate had a significant association with Human Development Index [- 89.2 (95% CI, - 119.8, - 58.7)] and obesity [1.2 (95% CI, 0.9, 1.5)]. CONCLUSION Pooled age standardized rate of breast cancer in Eastern Mediterranean Region was lower than the global average. Also, the age standardized rate value and its incremental trend have been higher in countries with high-quality data than in other countries of this region in recent years. Data quality or physiological factors, such as increase in obesity rates, could be the reasons for this incremental trend.
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Affiliation(s)
- Razieh Zahedi
- Modeling in Health Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | | | - Mohammad Reza Baneshi
- Modeling in Health Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Ali Akbar Haghdoost
- Modeling in Health Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Reza Malekpour Afshar
- Pathology and Stem Cell Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Roghayeh Ershad Sarabi
- Medical Informatics Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Fatemeh Tavakoli
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Farzaneh Zolala
- Social Determinants of Health Research Center, Institute for Futures Studies in Health, University of Medical Sciences, Kerman, Iran.
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19
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Lambertini M, Blondeaux E, Perrone F, Del Mastro L. Improving Adjuvant Endocrine Treatment Tailoring in Premenopausal Women With Hormone Receptor-Positive Breast Cancer. J Clin Oncol 2019; 38:1258-1267. [PMID: 31618128 DOI: 10.1200/jco.19.02242] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
The Oncology Grand Rounds series is designed to place original reports published in the Journal into clinical context. A case presentation is followed by a description of diagnostic and management challenges, a review of the relevant literature, and a summary of the authors' suggested management approaches. The goal of this series is to help readers better understand how to apply the results of key studies, including those published in Journal of Clinical Oncology, to patients seen in their own clinical practice.
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Affiliation(s)
- Matteo Lambertini
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,University of Genova, Genoa, Italy
| | - Eva Blondeaux
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Francesco Perrone
- Istituto Nazionale Tumori, IRCCS Fondazione G. Pascale, Naples, Italy
| | - Lucia Del Mastro
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,University of Genova, Genoa, Italy
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20
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Lambertini M, Richard F, Nguyen B, Viglietti G, Villarreal-Garza C. Ovarian Function and Fertility Preservation in Breast Cancer: Should Gonadotropin-Releasing Hormone Agonist be administered to All Premenopausal Patients Receiving Chemotherapy? CLINICAL MEDICINE INSIGHTS. REPRODUCTIVE HEALTH 2019; 13:1179558119828393. [PMID: 30886529 PMCID: PMC6410390 DOI: 10.1177/1179558119828393] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 01/10/2019] [Indexed: 11/15/2022]
Abstract
Chemotherapy-induced premature ovarian insufficiency (POI) is one of the potential drawbacks of chemotherapy use of particular concern for newly diagnosed premenopausal breast cancer patients. Temporary ovarian suppression obtained pharmacologically with the administration of a gonadotropin-releasing hormone agonist (GnRHa) during chemotherapy has been specifically developed as a method to counteract chemotherapy-induced gonadotoxicity with the main goal of diminishing the risk of POI. In recent years, important clinical evidence has become available on the efficacy and safety of this strategy that should now be considered a standard option for ovarian function preservation in premenopausal breast cancer patients, including women who are not interested in conceiving after treatment or that would not be candidates for fertility preservation strategies because of their age. Nevertheless, in women interested in fertility preservation, this is not an alternative to gamete cryopreservation, which remains as the first option to be offered. In this setting, temporary ovarian suppression with GnRHa during chemotherapy should be also proposed following gamete cryopreservation or to women who have no access, refuse, or have contraindications to surgical fertility preservation techniques. In this article, we present an overview about the role of temporary ovarian suppression with GnRHa during chemotherapy in breast cancer patients by addressing the available clinical evidence with the aim of identifying both the best candidates for the use of this strategy and the still existing gray zones requiring further investigation.
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Affiliation(s)
- Matteo Lambertini
- Department of Medical Oncology, U.O.C. Clinica di Oncologia Medica, Ospedale Policlinico San Martino, Genova, Italy.,Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy
| | - François Richard
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles (U.L.B), Brussels, Belgium
| | - Bastien Nguyen
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles (U.L.B), Brussels, Belgium
| | - Giulia Viglietti
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles (U.L.B), Brussels, Belgium
| | - Cynthia Villarreal-Garza
- Centro de Cancer de Mama del Hospital Zambrano Hellion, Tecnologico de Monterrey, Nuevo Leon, Mexico.,Departamento de Investigacion y de Tumores Mamarios del Instituto Nacional de Cancerologia, Mexico City, Mexico
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21
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Kirkham AA, Beaudry RI, Paterson DI, Mackey JR, Haykowsky MJ. Curing breast cancer and killing the heart: A novel model to explain elevated cardiovascular disease and mortality risk among women with early stage breast cancer. Prog Cardiovasc Dis 2019; 62:116-126. [PMID: 30797800 DOI: 10.1016/j.pcad.2019.02.002] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Accepted: 02/03/2019] [Indexed: 12/13/2022]
Abstract
Due to advances in prevention, early detection and treatment, early breast cancer mortality has decreased by nearly 40% during the last four decades. Yet, the risk of cardiovascular disease (CVD) mortality is significantly elevated following a breast cancer diagnosis, and it is a leading cause of death in this population. This review will discuss the most recent evidence for risks, pathology, mechanisms, and prevention of CVD morbidity and mortality in women with breast cancer. This evidence will be synthesized into a new model 'the compounding risk and protection model.' This model proposes that the balance between risk factors (i.e., older age, pre-existing traditional CVD risk factors and shared biologic pathways for CVD and cancer such as inflammation, as well as treatment-related and lifestyle toxicity) and potential protection factors (i.e., lifelong non-smoking, regular physical activity, a healthy diet rich in fruits and vegetables, and management of body weight and stress, heart failure therapy) determine the individual risk of CVD morbidity and mortality after diagnosis of early breast cancer.
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Affiliation(s)
- Amy A Kirkham
- Department of Biomedical Engineering, University of Alberta, Edmonton, Canada
| | - Rhys I Beaudry
- Integrated Cardiovascular Exercise Physiology and Rehabilitation Laboratory, College of Nursing and Health Innovation, The University of Texas at Arlington, Arlington, USA
| | - D Ian Paterson
- Division of Cardiology, Department of Medicine, University of Alberta, Edmonton, Canada
| | - John R Mackey
- Department of Oncology, University of Alberta, Edmonton, Canada; Medical Oncology, Cross Cancer Institute, Edmonton, Canada
| | - Mark J Haykowsky
- Integrated Cardiovascular Exercise Physiology and Rehabilitation Laboratory, College of Nursing and Health Innovation, The University of Texas at Arlington, Arlington, USA.
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22
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Xu L, Duan X, Zhou B, Liu Y, Ye J, Liu Z, Ma C, Zhang H, Zhang S, Zhang L, Zhao J, Cheng Y. Validation of the CPS+EG and Neo-Bioscore staging systems after preoperative systemic therapy for breast cancer in a single center in China. Breast 2018; 40:29-37. [PMID: 29677568 DOI: 10.1016/j.breast.2018.03.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2018] [Accepted: 03/24/2018] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Prognostic assessment after preoperative systemic therapy (PST) plays a vital role in determining treatment in breast cancer patients. Many researchers have sought to develop a system to quantitate residual tumor and its correlation with prognosis after PST. This retrospective study validated the CPS + EG staging system and Neo-Bioscore in a single center in China. METHODS Data from patients with non-metastatic primary breast cancer who were treated with PST and surgery from Jan. 2008 to Dec. 2014 at the Breast Disease Center of Peking University First Hospital, China, were reviewed. DFS, DSS and OS were calculated using the K-M curve and AUC. Multivariate analysis was used for a Cox proportional hazards model. All calculations were performed with SAS 9.4. RESULTS A total of 403 patients were enrolled in this study. The median follow-up period was 45 (range 11-107) months. The five-year DFS, DSS and OS rates were 86.4%, 91.2% and 90.5%, respectively. The CS, PS, CPS + EG staging system and Neo-Bioscore stratified patients according to DFS, DSS, and OS after PST, with all P values < 0.0001. The CPS + EG staging system and Neo-Bioscore stratified prognosis after PST better than CS. HER2-positive patients without trastuzumab treatment had obviously worse DFS and OS than other subgroups with different HER2 statuses that scored a 3 in the Neo-Bioscore system. CONCLUSIONS The CPS + EG staging system and Neo-Bioscore can improve prognostic prediction in non-pCR breast cancer patients after PST and, provided unfavorable prognostic factors such as insufficient treatment are incorporated, will have broader clinical applicability.
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Affiliation(s)
- Ling Xu
- Breast Disease Center, Peking University First Hospital, No.8 Xi Shi Ku Street, Xi Cheng District, Beijing 100034, China.
| | - Xuening Duan
- Breast Disease Center, Peking University First Hospital, No.8 Xi Shi Ku Street, Xi Cheng District, Beijing 100034, China.
| | - Bin Zhou
- Breast Disease Center, Peking University First Hospital, No.8 Xi Shi Ku Street, Xi Cheng District, Beijing 100034, China.
| | - Yinhua Liu
- Breast Disease Center, Peking University First Hospital, No.8 Xi Shi Ku Street, Xi Cheng District, Beijing 100034, China.
| | - Jingming Ye
- Breast Disease Center, Peking University First Hospital, No.8 Xi Shi Ku Street, Xi Cheng District, Beijing 100034, China.
| | - Zhaorui Liu
- Institute of Mental Health, Peking University, No. 49 Hua Yuan North Street, Hai Dian District, Beijing 100191, China.
| | - Chao Ma
- Institute of Mental Health, Peking University, No. 49 Hua Yuan North Street, Hai Dian District, Beijing 100191, China.
| | - Hong Zhang
- Pathology Department, Peking University First Hospital, No.8 Xi Shi Ku Street, Xi Cheng District, Beijing 100034, China.
| | - Shuang Zhang
- Pathology Department, Peking University First Hospital, No.8 Xi Shi Ku Street, Xi Cheng District, Beijing 100034, China.
| | - Lanbo Zhang
- Breast Disease Center, Peking University First Hospital, No.8 Xi Shi Ku Street, Xi Cheng District, Beijing 100034, China.
| | - Jianxin Zhao
- Breast Disease Center, Peking University First Hospital, No.8 Xi Shi Ku Street, Xi Cheng District, Beijing 100034, China.
| | - Yuanjia Cheng
- Breast Disease Center, Peking University First Hospital, No.8 Xi Shi Ku Street, Xi Cheng District, Beijing 100034, China.
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23
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Peccatori FA, Lambertini M, Scarfone G, Del Pup L, Codacci-Pisanelli G. Biology, staging, and treatment of breast cancer during pregnancy: reassessing the evidences. Cancer Biol Med 2018; 15:6-13. [PMID: 29545964 PMCID: PMC5842335 DOI: 10.20892/j.issn.2095-3941.2017.0146] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Breast cancer is one of the most frequently diagnosed malignancies during pregnancy. Here, we review the management of women with breast cancer during pregnancy (BCP), focusing on biology, diagnosis and staging, local and systemic treatments, obstetric care and long-term follow-up of children with prenatal exposure to anticancer treatments.
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Affiliation(s)
| | - Matteo Lambertini
- Gynecologic Oncology Department, European Institute of Oncology, Milan 20141, Italy
| | - Giovanna Scarfone
- Gynecologic Oncology Department, European Institute of Oncology, Milan 20141, Italy
| | - Lino Del Pup
- Gynecologic Oncology Department, European Institute of Oncology, Milan 20141, Italy
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24
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Bakkach J, Mansouri M, Derkaoui T, Loudiyi A, Fihri M, Hassani S, Barakat A, Ghailani Nourouti N, Bennani Mechita M. Clinicopathologic and prognostic features of breast cancer in young women: a series from North of Morocco. BMC Womens Health 2017; 17:106. [PMID: 29121898 PMCID: PMC5680801 DOI: 10.1186/s12905-017-0456-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Accepted: 10/31/2017] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Literature data reported a higher frequency of breast cancer in young women (BCYW) in developing countries. BCYW is associated with delayed diagnosis, aggressive biology and poor prognosis. However, our knowledge of biological profile, treatment received and outcome of young patients is still limited in Morocco. We propose to analyze clinicopathologic, therapeutic and prognostic features of BCYW among a series of patients native and/or inhabitant of North of Morocco. METHODS We carried out a retro-prospective study of 331 infiltrating breast cancer cases registered between January 2010 and December 2015. Details of tumor pathology, treatment and outcome were collected. Disease-Free Survival (DFS) and Overall Survival (OS) were assessed by Kaplan-Meier analysis. RESULTS A total of 82 patients were diagnosed with breast cancer at the age of 40 or younger (24.8%). Median age was 36 years. More than one quarter (26%) of patients had family history of breast or ovarian cancer. Advanced stages accounted for 34.2% of cases. Median tumor diameter was 2.8 cm. Intermediate and high-grade tumors represented 47.6% and 40.2%, respectively. Nodal involvement was present in 58.5% and lymphovascular invasion was found in 47.7% of the patients. About two thirds (66.2%) of tumors were hormone receptor positive, 29.2% over-expressed HER2 receptor and 23% were triple negative. Patients underwent breast conserving surgery in 38.2% of cases, 61.7% were offered adjuvant chemotherapy and 84.6% received hormone therapy. Five-year DFS and OS were respectively 88.9% and 75.6%. Locoregional recurrence occurred in 2.8% of cases and 8.3% of patients developed distant metastases. CONCLUSION Our findings are in accordance with previous studies that have shown a higher frequency of breast cancer among Moroccan young women. In line with literature data, clinicopathologic profile seems to be aggressive and prognosis is pejorative in our series.
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Affiliation(s)
- Joaira Bakkach
- Human Genomic Research Laboratory, Faculty of Sciences and Techniques of Tangier, University Abdelmalek Essaâdi, Tangier, Morocco
| | - Mohamed Mansouri
- Human Genomic Research Laboratory, Faculty of Sciences and Techniques of Tangier, University Abdelmalek Essaâdi, Tangier, Morocco
- Oncology Clinic AL AMAL of Tangier, Tangier, Morocco
| | - Touria Derkaoui
- Human Genomic Research Laboratory, Faculty of Sciences and Techniques of Tangier, University Abdelmalek Essaâdi, Tangier, Morocco
| | - Ali Loudiyi
- Oncology Clinic AL AMAL of Tangier, Tangier, Morocco
| | - Mohamed Fihri
- Mathematics and Applications Laboratory, Faculty of Sciences and Techniques of Tangier, University Abdelmalek Essaâdi, Tangier, Morocco
| | - Samia Hassani
- Human Genomic Research Laboratory, Faculty of Sciences and Techniques of Tangier, University Abdelmalek Essaâdi, Tangier, Morocco
| | - Amina Barakat
- Human Genomic Research Laboratory, Faculty of Sciences and Techniques of Tangier, University Abdelmalek Essaâdi, Tangier, Morocco
| | - Naima Ghailani Nourouti
- Human Genomic Research Laboratory, Faculty of Sciences and Techniques of Tangier, University Abdelmalek Essaâdi, Tangier, Morocco
| | - Mohcine Bennani Mechita
- Human Genomic Research Laboratory, Faculty of Sciences and Techniques of Tangier, University Abdelmalek Essaâdi, Tangier, Morocco
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25
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García-Martínez A, Gamboa-Loira B, Tejero ME, Sierra-Santoyo A, Cebrián ME, López-Carrillo L. CYP1A1, CYP1B1, GSTM1 and GSTT1 genetic variants and breast cancer risk in Mexican women. ACTA ACUST UNITED AC 2017; 59:540-547. [DOI: 10.21149/8527] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2017] [Accepted: 07/17/2017] [Indexed: 01/14/2023]
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26
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Iwata H, Im SA, Masuda N, Im YH, Inoue K, Rai Y, Nakamura R, Kim JH, Hoffman JT, Zhang K, Giorgetti C, Iyer S, Schnell PT, Bartlett CH, Ro J. PALOMA-3: Phase III Trial of Fulvestrant With or Without Palbociclib in Premenopausal and Postmenopausal Women With Hormone Receptor-Positive, Human Epidermal Growth Factor Receptor 2-Negative Metastatic Breast Cancer That Progressed on Prior Endocrine Therapy-Safety and Efficacy in Asian Patients. J Glob Oncol 2017; 3:289-303. [PMID: 28831437 PMCID: PMC5560465 DOI: 10.1200/jgo.2016.008318] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
PURPOSE To assess efficacy and safety of palbociclib plus fulvestrant in Asians with endocrine therapy-resistant metastatic breast cancer. PATIENTS AND METHODS The Palbociclib Ongoing Trials in the Management of Breast Cancer 3 (PALOMA-3) trial, a double-blind phase III study, included 521 patients with hormone receptor-positive/human epidermal growth factor receptor 2-negative metastatic breast cancer with disease progression on endocrine therapy. Patient-reported outcomes (PROs) were assessed on study treatment and at the end of treatment. RESULTS This preplanned subgroup analysis of the PALOMA-3 study included premenopausal and postmenopausal Asians taking palbociclib plus fulvestrant (n = 71) or placebo plus fulvestrant (n = 31). Palbociclib plus fulvestrant improved progression-free survival (PFS) compared with fulvestrant alone. Median PFS was not reached with palbociclib plus fulvestrant (95% CI, 9.2 months to not reached) but was 5.8 months with placebo plus fulvestrant (95% CI, 3.5 to 9.2 months; hazard ratio, 0.485; 95% CI, 0.270 to 0.869; P = .0065). The most common all-cause grade 3 or 4 adverse events in the palbociclib arm were neutropenia (92%) and leukopenia (29%); febrile neutropenia occurred in 4.1% of patients. Within-patient mean trough concentration comparisons across subgroups indicated similar palbociclib exposure between Asians and non-Asians. Global quality of life was maintained; no statistically significant changes from baseline were observed for patient-reported outcome scores with palbociclib plus fulvestrant. CONCLUSION This is the first report, to our knowledge, showing that palbociclib plus fulvestrant improves PFS in asian patients. Palbociclib plus fulvestrant was well tolerated in this study.
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Affiliation(s)
- Hiroji Iwata
- Hiroji Iwata, Aichi Cancer Center Hospital, Nagoya; Norikazu Masuda, National Hospital Organization, Osaka National Hospital, Osaka; Kenichi Inoue, Saitama Cancer Center, Saitama; Yoshiaki Rai, Sagara Hospital, Kagoshima City; Rikiya Nakamura, Chiba Cancer Center, Chiba, Japan; Seock-Ah Im, Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine; Young-Hyuck Im, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul; Jee Hyun Kim, Seoul National University Bundang Hospital, Seongnam; Jungsil Ro, National Cancer Center, Goyang, Republic of Korea; Justin T. Hoffman and Ke Zhang, Pfizer, La Jolla, CA; Carla Giorgetti, Shrividya Iyer, and Patrick T. Schnell, Pfizer, New York, NY; and Cynthia Huang Bartlett, Pfizer, Collegeville, PA
| | - Seock-Ah Im
- Hiroji Iwata, Aichi Cancer Center Hospital, Nagoya; Norikazu Masuda, National Hospital Organization, Osaka National Hospital, Osaka; Kenichi Inoue, Saitama Cancer Center, Saitama; Yoshiaki Rai, Sagara Hospital, Kagoshima City; Rikiya Nakamura, Chiba Cancer Center, Chiba, Japan; Seock-Ah Im, Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine; Young-Hyuck Im, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul; Jee Hyun Kim, Seoul National University Bundang Hospital, Seongnam; Jungsil Ro, National Cancer Center, Goyang, Republic of Korea; Justin T. Hoffman and Ke Zhang, Pfizer, La Jolla, CA; Carla Giorgetti, Shrividya Iyer, and Patrick T. Schnell, Pfizer, New York, NY; and Cynthia Huang Bartlett, Pfizer, Collegeville, PA
| | - Norikazu Masuda
- Hiroji Iwata, Aichi Cancer Center Hospital, Nagoya; Norikazu Masuda, National Hospital Organization, Osaka National Hospital, Osaka; Kenichi Inoue, Saitama Cancer Center, Saitama; Yoshiaki Rai, Sagara Hospital, Kagoshima City; Rikiya Nakamura, Chiba Cancer Center, Chiba, Japan; Seock-Ah Im, Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine; Young-Hyuck Im, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul; Jee Hyun Kim, Seoul National University Bundang Hospital, Seongnam; Jungsil Ro, National Cancer Center, Goyang, Republic of Korea; Justin T. Hoffman and Ke Zhang, Pfizer, La Jolla, CA; Carla Giorgetti, Shrividya Iyer, and Patrick T. Schnell, Pfizer, New York, NY; and Cynthia Huang Bartlett, Pfizer, Collegeville, PA
| | - Young-Hyuck Im
- Hiroji Iwata, Aichi Cancer Center Hospital, Nagoya; Norikazu Masuda, National Hospital Organization, Osaka National Hospital, Osaka; Kenichi Inoue, Saitama Cancer Center, Saitama; Yoshiaki Rai, Sagara Hospital, Kagoshima City; Rikiya Nakamura, Chiba Cancer Center, Chiba, Japan; Seock-Ah Im, Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine; Young-Hyuck Im, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul; Jee Hyun Kim, Seoul National University Bundang Hospital, Seongnam; Jungsil Ro, National Cancer Center, Goyang, Republic of Korea; Justin T. Hoffman and Ke Zhang, Pfizer, La Jolla, CA; Carla Giorgetti, Shrividya Iyer, and Patrick T. Schnell, Pfizer, New York, NY; and Cynthia Huang Bartlett, Pfizer, Collegeville, PA
| | - Kenichi Inoue
- Hiroji Iwata, Aichi Cancer Center Hospital, Nagoya; Norikazu Masuda, National Hospital Organization, Osaka National Hospital, Osaka; Kenichi Inoue, Saitama Cancer Center, Saitama; Yoshiaki Rai, Sagara Hospital, Kagoshima City; Rikiya Nakamura, Chiba Cancer Center, Chiba, Japan; Seock-Ah Im, Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine; Young-Hyuck Im, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul; Jee Hyun Kim, Seoul National University Bundang Hospital, Seongnam; Jungsil Ro, National Cancer Center, Goyang, Republic of Korea; Justin T. Hoffman and Ke Zhang, Pfizer, La Jolla, CA; Carla Giorgetti, Shrividya Iyer, and Patrick T. Schnell, Pfizer, New York, NY; and Cynthia Huang Bartlett, Pfizer, Collegeville, PA
| | - Yoshiaki Rai
- Hiroji Iwata, Aichi Cancer Center Hospital, Nagoya; Norikazu Masuda, National Hospital Organization, Osaka National Hospital, Osaka; Kenichi Inoue, Saitama Cancer Center, Saitama; Yoshiaki Rai, Sagara Hospital, Kagoshima City; Rikiya Nakamura, Chiba Cancer Center, Chiba, Japan; Seock-Ah Im, Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine; Young-Hyuck Im, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul; Jee Hyun Kim, Seoul National University Bundang Hospital, Seongnam; Jungsil Ro, National Cancer Center, Goyang, Republic of Korea; Justin T. Hoffman and Ke Zhang, Pfizer, La Jolla, CA; Carla Giorgetti, Shrividya Iyer, and Patrick T. Schnell, Pfizer, New York, NY; and Cynthia Huang Bartlett, Pfizer, Collegeville, PA
| | - Rikiya Nakamura
- Hiroji Iwata, Aichi Cancer Center Hospital, Nagoya; Norikazu Masuda, National Hospital Organization, Osaka National Hospital, Osaka; Kenichi Inoue, Saitama Cancer Center, Saitama; Yoshiaki Rai, Sagara Hospital, Kagoshima City; Rikiya Nakamura, Chiba Cancer Center, Chiba, Japan; Seock-Ah Im, Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine; Young-Hyuck Im, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul; Jee Hyun Kim, Seoul National University Bundang Hospital, Seongnam; Jungsil Ro, National Cancer Center, Goyang, Republic of Korea; Justin T. Hoffman and Ke Zhang, Pfizer, La Jolla, CA; Carla Giorgetti, Shrividya Iyer, and Patrick T. Schnell, Pfizer, New York, NY; and Cynthia Huang Bartlett, Pfizer, Collegeville, PA
| | - Jee Hyun Kim
- Hiroji Iwata, Aichi Cancer Center Hospital, Nagoya; Norikazu Masuda, National Hospital Organization, Osaka National Hospital, Osaka; Kenichi Inoue, Saitama Cancer Center, Saitama; Yoshiaki Rai, Sagara Hospital, Kagoshima City; Rikiya Nakamura, Chiba Cancer Center, Chiba, Japan; Seock-Ah Im, Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine; Young-Hyuck Im, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul; Jee Hyun Kim, Seoul National University Bundang Hospital, Seongnam; Jungsil Ro, National Cancer Center, Goyang, Republic of Korea; Justin T. Hoffman and Ke Zhang, Pfizer, La Jolla, CA; Carla Giorgetti, Shrividya Iyer, and Patrick T. Schnell, Pfizer, New York, NY; and Cynthia Huang Bartlett, Pfizer, Collegeville, PA
| | - Justin T. Hoffman
- Hiroji Iwata, Aichi Cancer Center Hospital, Nagoya; Norikazu Masuda, National Hospital Organization, Osaka National Hospital, Osaka; Kenichi Inoue, Saitama Cancer Center, Saitama; Yoshiaki Rai, Sagara Hospital, Kagoshima City; Rikiya Nakamura, Chiba Cancer Center, Chiba, Japan; Seock-Ah Im, Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine; Young-Hyuck Im, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul; Jee Hyun Kim, Seoul National University Bundang Hospital, Seongnam; Jungsil Ro, National Cancer Center, Goyang, Republic of Korea; Justin T. Hoffman and Ke Zhang, Pfizer, La Jolla, CA; Carla Giorgetti, Shrividya Iyer, and Patrick T. Schnell, Pfizer, New York, NY; and Cynthia Huang Bartlett, Pfizer, Collegeville, PA
| | - Ke Zhang
- Hiroji Iwata, Aichi Cancer Center Hospital, Nagoya; Norikazu Masuda, National Hospital Organization, Osaka National Hospital, Osaka; Kenichi Inoue, Saitama Cancer Center, Saitama; Yoshiaki Rai, Sagara Hospital, Kagoshima City; Rikiya Nakamura, Chiba Cancer Center, Chiba, Japan; Seock-Ah Im, Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine; Young-Hyuck Im, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul; Jee Hyun Kim, Seoul National University Bundang Hospital, Seongnam; Jungsil Ro, National Cancer Center, Goyang, Republic of Korea; Justin T. Hoffman and Ke Zhang, Pfizer, La Jolla, CA; Carla Giorgetti, Shrividya Iyer, and Patrick T. Schnell, Pfizer, New York, NY; and Cynthia Huang Bartlett, Pfizer, Collegeville, PA
| | - Carla Giorgetti
- Hiroji Iwata, Aichi Cancer Center Hospital, Nagoya; Norikazu Masuda, National Hospital Organization, Osaka National Hospital, Osaka; Kenichi Inoue, Saitama Cancer Center, Saitama; Yoshiaki Rai, Sagara Hospital, Kagoshima City; Rikiya Nakamura, Chiba Cancer Center, Chiba, Japan; Seock-Ah Im, Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine; Young-Hyuck Im, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul; Jee Hyun Kim, Seoul National University Bundang Hospital, Seongnam; Jungsil Ro, National Cancer Center, Goyang, Republic of Korea; Justin T. Hoffman and Ke Zhang, Pfizer, La Jolla, CA; Carla Giorgetti, Shrividya Iyer, and Patrick T. Schnell, Pfizer, New York, NY; and Cynthia Huang Bartlett, Pfizer, Collegeville, PA
| | - Shrividya Iyer
- Hiroji Iwata, Aichi Cancer Center Hospital, Nagoya; Norikazu Masuda, National Hospital Organization, Osaka National Hospital, Osaka; Kenichi Inoue, Saitama Cancer Center, Saitama; Yoshiaki Rai, Sagara Hospital, Kagoshima City; Rikiya Nakamura, Chiba Cancer Center, Chiba, Japan; Seock-Ah Im, Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine; Young-Hyuck Im, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul; Jee Hyun Kim, Seoul National University Bundang Hospital, Seongnam; Jungsil Ro, National Cancer Center, Goyang, Republic of Korea; Justin T. Hoffman and Ke Zhang, Pfizer, La Jolla, CA; Carla Giorgetti, Shrividya Iyer, and Patrick T. Schnell, Pfizer, New York, NY; and Cynthia Huang Bartlett, Pfizer, Collegeville, PA
| | - Patrick T. Schnell
- Hiroji Iwata, Aichi Cancer Center Hospital, Nagoya; Norikazu Masuda, National Hospital Organization, Osaka National Hospital, Osaka; Kenichi Inoue, Saitama Cancer Center, Saitama; Yoshiaki Rai, Sagara Hospital, Kagoshima City; Rikiya Nakamura, Chiba Cancer Center, Chiba, Japan; Seock-Ah Im, Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine; Young-Hyuck Im, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul; Jee Hyun Kim, Seoul National University Bundang Hospital, Seongnam; Jungsil Ro, National Cancer Center, Goyang, Republic of Korea; Justin T. Hoffman and Ke Zhang, Pfizer, La Jolla, CA; Carla Giorgetti, Shrividya Iyer, and Patrick T. Schnell, Pfizer, New York, NY; and Cynthia Huang Bartlett, Pfizer, Collegeville, PA
| | - Cynthia Huang Bartlett
- Hiroji Iwata, Aichi Cancer Center Hospital, Nagoya; Norikazu Masuda, National Hospital Organization, Osaka National Hospital, Osaka; Kenichi Inoue, Saitama Cancer Center, Saitama; Yoshiaki Rai, Sagara Hospital, Kagoshima City; Rikiya Nakamura, Chiba Cancer Center, Chiba, Japan; Seock-Ah Im, Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine; Young-Hyuck Im, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul; Jee Hyun Kim, Seoul National University Bundang Hospital, Seongnam; Jungsil Ro, National Cancer Center, Goyang, Republic of Korea; Justin T. Hoffman and Ke Zhang, Pfizer, La Jolla, CA; Carla Giorgetti, Shrividya Iyer, and Patrick T. Schnell, Pfizer, New York, NY; and Cynthia Huang Bartlett, Pfizer, Collegeville, PA
| | - Jungsil Ro
- Hiroji Iwata, Aichi Cancer Center Hospital, Nagoya; Norikazu Masuda, National Hospital Organization, Osaka National Hospital, Osaka; Kenichi Inoue, Saitama Cancer Center, Saitama; Yoshiaki Rai, Sagara Hospital, Kagoshima City; Rikiya Nakamura, Chiba Cancer Center, Chiba, Japan; Seock-Ah Im, Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine; Young-Hyuck Im, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul; Jee Hyun Kim, Seoul National University Bundang Hospital, Seongnam; Jungsil Ro, National Cancer Center, Goyang, Republic of Korea; Justin T. Hoffman and Ke Zhang, Pfizer, La Jolla, CA; Carla Giorgetti, Shrividya Iyer, and Patrick T. Schnell, Pfizer, New York, NY; and Cynthia Huang Bartlett, Pfizer, Collegeville, PA
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Hair Coloring, Stress, and Smoking Increase the Risk of Breast Cancer: A Case-Control Study. Clin Breast Cancer 2017; 17:650-659. [PMID: 28549689 DOI: 10.1016/j.clbc.2017.04.012] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 04/23/2017] [Accepted: 04/26/2017] [Indexed: 11/21/2022]
Abstract
PURPOSE Epidemiologic characteristics of breast cancer in Iran are significantly different from those in the West and even other regional countries, but little is known about the related factors. PATIENTS AND METHODS A hospital-based case-control study was conducted on 1052 women (526 new cases and 526 controls). Logistic regression was performed to investigate associations of study factors with breast cancer risk. RESULTS This study introduced occupation (odds ratio [OR]employed/household, 1.77; 95% confidence interval [CI], 1.15-2.69), marital age (OR24-30 y/< 18 y, 2.13; 95% CI, 1.03-4.40), age at first delivery (OR≥ 30 y/< 18 y, 3.53; 95% CI, 1.73-7.18), parity (OR1-2/Nulliparous or never married, 2.61; 95% CI, 1.13-6.02), birth interval (OR30-50 mos/< 18 mos, 2.38; 95% CI, 1.45-3.89), lifetime breastfeeding (OR≥ 42 mos/< 6 mos, 0.37; 95% CI, 0.18-0.77), and menarche age (year) (OR, 0.87; 95% CI, 0.79-0.96) as significant associates of breast cancer. In addition, body mass index (OR, 1.07; 95% CI, 1.02-1.11) and some health-related behaviors including hair coloring on a regular basis (ORyes/no, 1.93; 95% CI, 1.41-2.62), smoking (ORyes/no, 2.02; 95% CI, 1.22-3.34), oral contraceptive usage (ORever/never. 1.46; 95% CI, 1.05-2.04), physical inactivity (ORinactive/regular activity, 1.54; 95% CI, 1.39-1.75), past life stress (ORoften stressful/often calm, 2.40; 95% CI, 1.62-3.56), and regular bedtime (ORoften regular/no, 0.32; 95% CI, 0.19-0.54) were related to a higher risk of breast cancer. CONCLUSION This study revealed a significant number of factors that seem to contribute to the risk of breast cancer even more than the other previously introduced factors.
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Ghaffari K, Hashemi M, Ebrahimi E, Shirkoohi R. BIRC5 Genomic Copy Number Variation in Early-Onset Breast Cancer. IRANIAN BIOMEDICAL JOURNAL 2017; 20:241-5. [PMID: 27372966 PMCID: PMC4983680 DOI: 10.7508/ibj.2016.04.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Background: Baculoviral inhibitor of apoptosis repeat-containing 5 (BIRC5) gene is an inhibitor of apoptosis that expresses in human embryonic tissues but it is absent in most healthy adult tissues. The copy number of BIRC5 has been indicated to be highly increased in tumor tissues; however, its association with the age of onset in breast cancer is not well understood. Methods: Forty tumor tissues of breast cancer were obtained from Tumor Bank of Cancer Institute, Imam Khomeini Hospital, Tehran, Iran. BIRC5 gene copy number variation (CNV) was evaluated using Multiplex Ligation-dependent Probe Amplification (MLPA) and then compared with the age of onset for each patient. Results: BIRC5 amplification was seen in 17.5% of cases. Also, a significant association was observed between BIRC5 gene amplification and individuals under 40 years of age (P=0.04). Conclusion: BIRC5 gene has the potential to be a marker for the detection and prognosis of cancer at an early age.
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Affiliation(s)
- Kimia Ghaffari
- Department of Genetics, Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran
| | - Mehrdad Hashemi
- Department of Genetics, Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran
| | - Elmira Ebrahimi
- Group of Genetics, Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Shirkoohi
- Group of Genetics, Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran
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Nogueira LP, Alessio R, Mantuano A, Sena G, de Almeida CE, Tromba G, Almeida AP, Salata C, Colaço MVG, Braz D, Barroso RC. Synchrotron microtomography to evaluate effects of different polychemotherapy drugs on cortical bone structure. Int J Radiat Biol 2017; 93:726-733. [DOI: 10.1080/09553002.2017.1304591] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Liebert P. Nogueira
- Physics Institute, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - Rita Alessio
- Nuclear Engineering Program, COPPE/Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Andrea Mantuano
- Physics Institute, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - Gabriela Sena
- Nuclear Engineering Program, COPPE/Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Carlos E. de Almeida
- Radiological Sciences Department, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | | | - Camila Salata
- CNEN, National Nuclear Energy Commission, Rio de Janeiro, Brazil
| | - Marcos V. G. Colaço
- Physics Institute, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - Delson Braz
- Nuclear Engineering Program, COPPE/Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Regina C. Barroso
- Physics Institute, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
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Nagrani R, Mhatre S, Rajaraman P, Chatterjee N, Akbari MR, Boffetta P, Brennan P, Badwe R, Gupta S, Dikshit R. Association of Genome-Wide Association Study (GWAS) Identified SNPs and Risk of Breast Cancer in an Indian Population. Sci Rep 2017; 7:40963. [PMID: 28098224 PMCID: PMC5241870 DOI: 10.1038/srep40963] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Accepted: 12/05/2016] [Indexed: 01/24/2023] Open
Abstract
To date, no studies have investigated the association of the GWAS-identified SNPs with BC risk in Indian population. We investigated the association of 30 previously reported and replicated BC susceptibility SNPs in 1,204 cases and 1,212 controls from a hospital based case-control study conducted at the Tata Memorial Hospital, Mumbai. As a measure of total susceptibility burden, the polygenic risk score (PRS) for each individual was defined by the weighted sum of genotypes from 21 independent SNPs with weights derived from previously published estimates of association odds-ratios. Logistic regression models were used to assess risk associated with individual SNPs and overall PRS, and stratified by menopausal and receptor status. A total of 11 SNPs from eight genomic regions (FGFR2, 9q31.2, MAP3K, CCND1, ZM1Z1, RAD51L11, ESR1 and UST) showed statistically significant (p-value ≤ 0.05) evidence of association, either overall or when stratified by menopausal status or hormone receptor status. BC SNPs previously identified in Caucasian population showed evidence of replication in the Indian population mainly with respect to risk of postmenopausal and hormone receptor positive BC.
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Affiliation(s)
- Rajini Nagrani
- Centre for Cancer Epidemiology, Tata Memorial Centre, Mumbai, India
| | - Sharayu Mhatre
- Centre for Cancer Epidemiology, Tata Memorial Centre, Mumbai, India
| | - Preetha Rajaraman
- Division of Cancer Epidemiology & Genetics, National Cancer Institute, Bethesda, USA
| | - Nilanjan Chatterjee
- Division of Cancer Epidemiology & Genetics, National Cancer Institute, Bethesda, USA
- Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, USA
- Department of Oncology, School of Medicine, Johns Hopkins University, USA
| | - Mohammad R. Akbari
- Women’s College Research Institute, Women’s College Hospital, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Paolo Boffetta
- Institute For Translational Epidemiology, Mount Sinai Hospital, One Gustave L.Levy Place New York, NY, USA
| | - Paul Brennan
- Genetic Epidemiology Group, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372 Lyon CEDEX, France
| | - Rajendra Badwe
- Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, India
| | - Sudeep Gupta
- Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, India
| | - Rajesh Dikshit
- Centre for Cancer Epidemiology, Tata Memorial Centre, Mumbai, India
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Lambertini M, Azim HA, Peccatori FA. Fertility Issues in Patients with Breast Cancer or Survivors. Breast Cancer 2017. [DOI: 10.1007/978-3-319-48848-6_61] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Villarreal-Garza C, Mohar A, Bargallo-Rocha JE, Lasa-Gonsebatt F, Reynoso-Noverón N, Matus-Santos J, Cabrera P, Arce-Salinas C, Lara-Medina F, Alvarado-Miranda A, Ramírez-Ugalde MT, Soto-Perez-de-Celis E. Molecular Subtypes and Prognosis in Young Mexican Women With Breast Cancer. Clin Breast Cancer 2016; 17:e95-e102. [PMID: 28065398 DOI: 10.1016/j.clbc.2016.11.007] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 10/18/2016] [Accepted: 11/13/2016] [Indexed: 01/02/2023]
Abstract
INTRODUCTION Young age represents an adverse prognostic factor in breast cancer (BC), and young women present with more advanced and aggressive disease. In Latin America, BC is increasing in young women, and there is a lack of information regarding the characteristics and outcomes of this patient population. PATIENTS AND METHODS We retrospectively analyzed a database of 4315 women treated for BC at a single institution. We compared clinical characteristics, treatment, and survival between women ≤ 40 and > 40 years of age. Survival analyses were performed for each molecular subtype. RESULTS A total of 662 women (15.3%) were ≤ 40 years old. Younger women had more advanced disease, higher grade, and a larger proportion of luminal B and triple-negative tumors (P < .001). At 5 years, both disease-free and overall survival (OS) were lower in younger women, although there were no differences after adjusting for stage. Five-year OS was worse for young women with hormone receptor-positive, human epidermal growth factor receptor 2-negative subtype (82% vs. 87.1%; P = .03), but not for those with human epidermal growth factor receptor 2-positive or triple-negative disease. This difference can be attributed to luminal B tumors, which showed a worse 5-year OS in younger women (79.1% vs. 85.2%; P = .03). CONCLUSION Although young Mexican patients with BC have more aggressive disease at presentation than older women, only those with luminal B tumors have a worse survival after adjusting for stage. Strategies aimed at downstaging the disease and at improving the treatment of luminal B tumors in this population are needed.
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Affiliation(s)
- Cynthia Villarreal-Garza
- Departamento de Investigacion y de Tumores Mamarios del Instituto Nacional de Cancerologia, Mexico City, Mexico; Centro de Cancer de Mama del Hospital Zambrano Hellion, Tecnologico de Monterrey, Nuevo Leon, Mexico
| | - Alejandro Mohar
- Departamento de Investigacion y de Tumores Mamarios del Instituto Nacional de Cancerologia, Mexico City, Mexico; Unidad de Investigación Biomédica en Cáncer, Instituto Nacional de Cancerología e Instituto de Biomédicas, UNAM, Mexico City, Mexico
| | - Juan Enrique Bargallo-Rocha
- Departamento de Investigacion y de Tumores Mamarios del Instituto Nacional de Cancerologia, Mexico City, Mexico
| | - Federico Lasa-Gonsebatt
- Departamento de Investigacion y de Tumores Mamarios del Instituto Nacional de Cancerologia, Mexico City, Mexico
| | - Nancy Reynoso-Noverón
- Departamento de Investigacion y de Tumores Mamarios del Instituto Nacional de Cancerologia, Mexico City, Mexico
| | - Juan Matus-Santos
- Departamento de Investigacion y de Tumores Mamarios del Instituto Nacional de Cancerologia, Mexico City, Mexico
| | - Paula Cabrera
- Departamento de Investigacion y de Tumores Mamarios del Instituto Nacional de Cancerologia, Mexico City, Mexico
| | - Claudia Arce-Salinas
- Departamento de Investigacion y de Tumores Mamarios del Instituto Nacional de Cancerologia, Mexico City, Mexico
| | - Fernando Lara-Medina
- Departamento de Investigacion y de Tumores Mamarios del Instituto Nacional de Cancerologia, Mexico City, Mexico
| | - Alberto Alvarado-Miranda
- Departamento de Investigacion y de Tumores Mamarios del Instituto Nacional de Cancerologia, Mexico City, Mexico
| | - María Teresa Ramírez-Ugalde
- Departamento de Investigacion y de Tumores Mamarios del Instituto Nacional de Cancerologia, Mexico City, Mexico
| | - Enrique Soto-Perez-de-Celis
- Departamento de Investigacion y de Tumores Mamarios del Instituto Nacional de Cancerologia, Mexico City, Mexico; Cancer Care in the Elderly Clinic, Department of Geriatrics, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
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Houghton LC, Ganmaa D, Rosenberg PS, Davaalkham D, Stanczyk FZ, Hoover RN, Troisi R. Associations of Breast Cancer Risk Factors with Premenopausal Sex Hormones in Women with Very Low Breast Cancer Risk. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13111066. [PMID: 27809264 PMCID: PMC5129276 DOI: 10.3390/ijerph13111066] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 10/20/2016] [Accepted: 10/26/2016] [Indexed: 12/26/2022]
Abstract
Breast cancer incidence rates are low but rising in urban Mongolia. We collected reproductive and lifestyle factor information and measured anthropometrics and serum sex steroid concentrations among 314 premenopausal women living in Ulaanbaatar, Mongolia. Mean differences in hormone concentrations by these factors were calculated using age-adjusted quadratic regression splines. Estrone and estradiol in college-educated women were, respectively, 18.2% (p = 0.03) and 23.6% (p = 0.03) lower than in high-school-educated women. Progesterone concentrations appeared 55.8% lower (p = 0.10) in women residing in modern housing compared with women living in traditional housing (gers), although this finding was not statistically significant. Testosterone concentrations were positively associated with adiposity and central fat distribution; 17.1% difference (p = 0.001) for highest vs. lowest quarter for body mass index and 15.1% difference (p = 0.005) for waist-to-height ratio. Estrogens were higher in the follicular phase of women who breastfed each child for shorter durations. A distinct hormonal profile was associated with an urban lifestyle in premenopausal, Mongol women. In particular, heavier, more-educated women living in urban dwellings had higher testosterone and lower estrogen and progesterone levels. Higher breast cancer incidence in urban compared with rural women suggest that the hormonal profile associated with a more traditional lifestyle may be protective among Mongol women.
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Affiliation(s)
- Lauren C Houghton
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA.
| | - Davaasambuu Ganmaa
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA.
| | - Philip S Rosenberg
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA.
| | | | - Frank Z Stanczyk
- Division of Reproductive Endocrinology and Infertility, Keck School of Medicine of the University of Southern California, Los Angeles, CA 90033, USA.
| | - Robert N Hoover
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA.
| | - Rebecca Troisi
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA.
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Yip CH. Challenges in the early detection of breast cancer in resource-poor settings. BREAST CANCER MANAGEMENT 2016. [DOI: 10.2217/bmt-2016-0026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Breast cancer is increasing in low- and middle-income countries (LMICs) compared with high-income countries, where presentation with later stages coupled with suboptimal treatment leads to a high mortality rate. An important strategy is to detect cancers at an early stage where cure is possible. Screening mammography requires resources that are not available in LMICs. Clinical breast examination and breast self-examination have not been shown to reduce mortality from breast cancer. Despite efforts to promote early detection, barriers to early detection in LMICs persist, and these barriers are not only due to poverty and illiteracy, but also due to psychosocial and cultural issues present in LMICs. Clearly, there are many challenges to early detection in LMICs that have to be addressed.
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Affiliation(s)
- Cheng-Har Yip
- Department of Surgery, Sime Darby Healthcare, Kuala Lumpur, Malaysia
- Department of Surgery, University Tunku Abdul Rahman, Kuala Lumpur, Malaysia
- Department of Surgery, University Malaya, Kuala Lumpur 50603, Malaysia
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Leung RC, Yau TC, Chan MC, Chan SW, Chan TW, Tsang YY, Wong TT, Chao C, Yoshizawa C, Soong IS, Kwan WH, Kwok CC, Suen JS, Ngan RK, Cheung PS. The Impact of the Oncotype DX Breast Cancer Assay on Treatment Decisions for Women With Estrogen Receptor-Positive, Node-Negative Breast Carcinoma in Hong Kong. Clin Breast Cancer 2016; 16:372-378. [DOI: 10.1016/j.clbc.2016.03.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Revised: 03/06/2016] [Accepted: 03/09/2016] [Indexed: 10/22/2022]
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36
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Lambertini M, Poggio F, Vaglica M, Blondeaux E, Del Mastro L. News on the medical treatment of young women with early-stage HER2-negative breast cancer. Expert Opin Pharmacother 2016; 17:1643-55. [DOI: 10.1080/14656566.2016.1199685] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
- Matteo Lambertini
- Department of Medical Oncology, U.O. Oncologia Medica 2, IRCCS AOU San Martino, IST, Genova, Italy
- BrEAST Data Centre, Department of Medicine, Institut Jules Bordet, and l’Université Libre de Bruxelles (U.L.B.), Brussels, Belgium
| | - Francesca Poggio
- Department of Medical Oncology, U.O. Oncologia Medica 2, IRCCS AOU San Martino, IST, Genova, Italy
| | - Marina Vaglica
- Department of Medical Oncology, U.O. Sviluppo Terapie Innovative, IRCCS AOU San Martino, IST, Genova, Italy
| | - Eva Blondeaux
- Department of Medical Oncology, U.O. Oncologia Medica 2, IRCCS AOU San Martino, IST, Genova, Italy
| | - Lucia Del Mastro
- Department of Medical Oncology, U.O. Sviluppo Terapie Innovative, IRCCS AOU San Martino, IST, Genova, Italy
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Sensorn I, Sukasem C, Sirachainan E, Chamnanphon M, Pasomsub E, Trachu N, Supavilai P, Pinthong D, Wongwaisayawan S. ABCB1 and ABCC2 and the risk of distant metastasis in Thai breast cancer patients treated with tamoxifen. Onco Targets Ther 2016; 9:2121-9. [PMID: 27110128 PMCID: PMC4835128 DOI: 10.2147/ott.s100905] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Genetic polymorphisms of drug-metabolizing enzymes and transporters have been extensively studied with regard to tamoxifen treatment outcomes. However, the results are inconclusive. Analysis of organ-specific metastasis may reveal the association of these pharmacogenetic factors. The aim of this study is to investigate the impact of CYP3A5, CYP2D6, ABCB1, and ABCC2 polymorphisms on the risk of all distant and organ-specific metastases in Thai patients who received tamoxifen adjuvant therapy. METHODS Genomic DNA was extracted from blood samples of 73 patients with breast cancer who received tamoxifen adjuvant therapy. CYP3A5 (6986A>G), CYP2D6 (100C>T), ABCB1 (3435C>T), and ABCC2 (-24C>T) were genotyped using allelic discrimination real-time polymerase chain reaction assays. The impacts of prognostic clinical factors and genetic variants on disease-free survival were analyzed using the Kaplan-Meier method and Cox regression analysis. RESULTS In the univariate analysis, primary tumor size >5 cm was significantly associated with increased risk of distant metastasis (P=0.004; hazard ratio [HR] =3.05; 95% confidence interval [CI], 1.44-6.47). In the multivariate analysis, tumor size >5 cm remained predictive of distant metastasis (P<0.001; HR=5.49; 95% CI, 2.30-13.10). ABCC2 -24CC were shown to be associated with increased risk of distant metastasis (P=0.040; adjusted HR=2.34; 95% CI, 1.04-5.27). The combined genotype of ABCC2 -24CC - ABCB1 3435 CT+TT was associated with increased risk of distant and bone metastasis (P=0.020; adjusted HR=2.46; 95% CI, 1.15-5.26 and P=0.040; adjusted HR=3.70; 95% CI, 1.06-12.89, respectively). CONCLUSION This study indicates that polymorphisms of ABCC2 and ABCB1 are independently associated with bone metastasis. Further prospective studies with larger sample sizes are needed to verify this finding.
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Affiliation(s)
- Insee Sensorn
- Department of Pharmacology, Faculty of Science, Mahidol University, Bangkok, Thailand
| | - Chonlaphat Sukasem
- Division of Pharmacogenomics and Personalized Medicine, Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Ekaphop Sirachainan
- Division of Medical Oncology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Montri Chamnanphon
- Division of Pharmacogenomics and Personalized Medicine, Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Ekawat Pasomsub
- Division of Virology, Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Narumol Trachu
- Research Center, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Porntip Supavilai
- Department of Pharmacology, Faculty of Science, Mahidol University, Bangkok, Thailand
| | - Darawan Pinthong
- Department of Pharmacology, Faculty of Science, Mahidol University, Bangkok, Thailand
| | - Sansanee Wongwaisayawan
- Division of Anatomical Pathology, Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Harvie M, Howell A, Evans DG. Can diet and lifestyle prevent breast cancer: what is the evidence? Am Soc Clin Oncol Educ Book 2016:e66-73. [PMID: 25993238 DOI: 10.14694/edbook_am.2015.35.e66] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Breast cancer is the most common cancer among women in both developed and less-developed countries. Rates of breast cancer are increasing worldwide, with a particular increase in postmenopausal and estrogen receptor-positive cases. The World Cancer Research Fund (WCRF) and American Cancer Society (ACS) cancer prevention guidelines recommend maintaining a healthy weight, undertaking at least 150 minutes of moderate intensity exercise per week, limiting alcohol consumption, and eating a plant-based diet. Observational data link adherence to physical activity and alcohol guidelines throughout life to a reduced risk of developing pre- and postmenopausal breast cancer. Weight control throughout life appears to prevent cases after menopause. Adherence to a healthy dietary pattern does not have specific effects on breast cancer risk but remains important as it reduces the risk for other common diseases, such as cardiovascular disease (CVD), diabetes, and dementia. Emerging data suggest that smoking during adolescence or early adulthood increases later risk of breast cancer. Lifestyle factors appear to modify risk among high-risk women with a family history and those with typical risk of the general population, although their effects among carriers of BRCA mutations are not well defined. Recent expert reports estimate that successful lifestyle changes could prevent 25% to 30% of cases of breast cancer. These reductions will only be achieved if we can implement targeted prevention programs for high-risk women and women in population-based breast screening programs during childhood, adolescence, and early adulthood when the rapidly developing breast is particularly susceptible to carcinogenesis.
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Affiliation(s)
- Michelle Harvie
- From the Genesis Breast Cancer Prevention Centre, University Hospital of South Manchester NHS Foundation Trust, Manchester, United Kingdom
| | - Anthony Howell
- From the Genesis Breast Cancer Prevention Centre, University Hospital of South Manchester NHS Foundation Trust, Manchester, United Kingdom
| | - D Gareth Evans
- From the Genesis Breast Cancer Prevention Centre, University Hospital of South Manchester NHS Foundation Trust, Manchester, United Kingdom
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Daroudi R, Akbari Sari A, Nahvijou A, Kalaghchi B, Najafi M, Zendehdel K. The Economic Burden of Breast Cancer in Iran. IRANIAN JOURNAL OF PUBLIC HEALTH 2015; 44:1225-33. [PMID: 26587497 DOI: pmid/26587497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Although breast cancer imposes a considerable economic burden on high-income countries, there is limited knowledge about its economic burden in low- and middle-income countries (LMCs), including Iran. In this study, we estimated the economic burden of breast cancer in Iran in 2010. METHODS We used the prevalence-based approach and estimated the direct and indirect costs of all breast cancer cases in 2010. We used several data sources, including national cancer registry reports, hospital records, occupational data, and interviews with experts. RESULT The economic burden of breast cancer was US$947,374,468. Most of the cost (77%) pertained to the productivity lost due to breast cancer deaths and the direct medical cost accounted for 18.56% of the estimated total cost. Out of the US$175,860,607 as the direct medical cost, the chemotherapy cost constituted the main part ($76,755,740), of which prescriptions of trastuzumab accounted for 41% ($31,529,280). CONCLUSION The economic burden of breast cancer in Iran is substantial and is expected to increase significantly due to the increasing incidence rate. Strategies for the prevention and early detection of breast cancer should be prioritized in the national cancer control program.
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Affiliation(s)
- Rajabali Daroudi
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran ; Dept. of Health Economics and Management, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Akbari Sari
- Dept. of Health Economics and Management, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Azin Nahvijou
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran
| | - Bita Kalaghchi
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran
| | - Massoomeh Najafi
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran
| | - Kazem Zendehdel
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran ; Cancer Research Models Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran
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Hossain MS, Ferdous S, Karim-Kos HE. Breast cancer in South Asia: a Bangladeshi perspective. Cancer Epidemiol 2014; 38:465-70. [PMID: 25182670 DOI: 10.1016/j.canep.2014.08.004] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Revised: 07/13/2014] [Accepted: 08/03/2014] [Indexed: 11/19/2022]
Abstract
South Asian countries are facing a hidden breast cancer epidemic. A significant proportion of the breast cancer cases occur in premenopausal women. Knowledge of the various aspects of breast cancer in different geographical regions is limited in South Asia. In this article, we review the Bangladeshi perspective of the epidemiology, risk factors, pathology, diagnosis and treatment of breast cancer. As in other developing countries, because of the lack of breast cancer awareness in Bangladeshi population and inadequate access to health care, most patients are diagnosed at an advanced stage of the disease. Early detection has a crucial impact on overall treatment outcomes. To battle against breast cancer in resource-limited countries like Bangladesh, it is not feasible to set up a parallel health service system solely dedicated to cancer. Therefore, a cost-effective public health strategy is needed which could reach a large number of women in the country. Considering all these issues, we propose an innovative female-based primary healthcare approach focused on awareness, screening and early detection of breast cancer in Bangladesh. This preventive strategy could be a model for other resource-limited developing countries.
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Affiliation(s)
- Mohammad Sorowar Hossain
- BRAC University, Department of Mathematical and Natural Sciences, Dhaka, Bangladesh; Biotechnology Division, Incepta Pharmaceutical Ltd, Dhaka, Bangladesh.
| | | | - Henrike E Karim-Kos
- Department of Public Health, Erasmus MC University Medical Centre, Rotterdam, The Netherlands
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Abstract
Breast cancer is one of the leading cancers world-wide. While the incidence in developing countries is lower than in developed countries, the mortality is much higher. Of the estimated 1 600 000 new cases of breast cancer globally in 2012, 794 000 were in the more developed world compared to 883 000 in the less developed world; however, there were 198 000 deaths in the more developed world compared to 324 000 in the less developed world (data from Globocan 2012, IARC). Survival from breast cancer depends on two main factors--early detection and optimal treatment. In developing countries, women present with late stages of disease. The barriers to early detection are physical, such as geographical isolation, financial as well as psychosocial, including lack of education, belief in traditional medicine and lack of autonomous decision-making in the male-dominated societies that prevail in the developing world. There are virtually no population-based breast cancer screening programs in developing countries. However, before any screening program can be implemented, there must be facilities to treat the cancers that are detected. Inadequate access to optimal treatment of breast cancer remains a problem. Lack of specialist manpower, facilities and anticancer drugs contribute to the suboptimal care that a woman with breast cancer in a low-income country receives. International groups such as the Breast Health Global Initiative were set up to develop economically feasible, clinical practice guidelines for breast cancer management to improve breast health outcomes in countries with limited resources.
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Affiliation(s)
- C H Yip
- Department of Surgery, University Malaya , Kuala Lumpur , Malaysia
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