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Tran TXM, Chang Y, Ryu S, Park B. Mammographic breast features and risk of cardiovascular diseases in korean women. Heart Lung 2024; 67:176-182. [PMID: 38838416 DOI: 10.1016/j.hrtlng.2024.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Revised: 04/30/2024] [Accepted: 05/02/2024] [Indexed: 06/07/2024]
Abstract
BACKGROUND There is a growing amount of evidence on the association between cardiovascular diseases (CVDs) and breast calcification. Thus, mammographic breast features have recently gained attention as CVD predictors. OBJECTIVE This study assessed the association of mammographic features, including benign calcification, microcalcification, and breast density, with cardiovascular diseases. METHODS This study comprised 6,878,686 women aged ≥40 who underwent mammographic screening between 2009 and 2012 with follow-up until 2020. The mammographic features included benign calcification, microcalcification, and breast density. The cardiovascular diseases associated with the mammographic features were assessed using logistic regression. RESULTS The prevalence of benign calcification, microcalcification, and dense breasts were 9.6 %, 0.9 % and 47.3 % at baseline, respectively. Over a median follow-up of 10 years, benign calcification and microcalcification were positively associated with an increased risk of chronic ischaemic heart disease whereas breast density was inversely associated with it; the corresponding aOR (95 % CI) was 1.14 (1.10-1.17), 1.19 (1.03-1.15), and 0.88 (0.85-0.90), respectively. A significantly increased risk of chronic ischaemic heart disease (IHD) was observed among women with benign calcifications (aHR, 1.14; 95 % CI 1.10-1.17) and microcalcifications (aOR, 1.19; 95 % CI 1.06-1.33). Women with microcalcifications had a 1.16-fold (95 % CI 1.03-1.30) increased risk of heart failure. CONCLUSIONS Mammographic calcifications were associated with an increased risk of chronic ischaemic heart diseases, whereas dense breast was associated with a decreased risk of cardiovascular disease. Thus, the mammographic features identified on breast cancer screening may provide an opportunity for cardiovascular disease risk identification and prevention.
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Affiliation(s)
- Thi Xuan Mai Tran
- Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea; Institute for Health and Society, Hanyang University, Seoul, South Korea
| | - Yoosoo Chang
- Center for Cohort Studies, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Seoul, Republic of Korea
| | - Seungho Ryu
- Center for Cohort Studies, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Seoul, Republic of Korea
| | - Boyoung Park
- Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea; Hanyang Institute of Bioscience and Biotechnology, Hanyang University, Seoul, Republic of Korea.
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Pant A, Anjankar AP, Shende S, Dhok A, Jha RK, Manglaram AV. Early detection of breast cancer through the diagnosis of Nipple Aspirate Fluid (NAF). Clin Proteomics 2024; 21:45. [PMID: 38943056 PMCID: PMC11212179 DOI: 10.1186/s12014-024-09495-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 06/05/2024] [Indexed: 07/01/2024] Open
Abstract
The development of breast cancer has been mainly reported in women who have reached the post-menopausal stage; therefore, it is the primary factor responsible for death amongst postmenopausal women. However, if treated on time it has shown a survival rate of 20 years in about two-thirds of women. Cases of breast cancer have also been reported in younger women and the leading cause in them is their lifestyle pattern or they may be carriers of high penetrance mutated genes. Premenopausal women who have breast cancer have been diagnosed with aggressive build-up of tumors and are therefore at more risk of loss of life. Mammography is an effective way to test for breast cancer in women after menopause but is not so effective for premenopausal women or younger females. Imaging techniques like contrast-enhanced MRI can up to some extent indicate the presence of a tumor but it cannot adequately differentiate between benign and malignant tumors. Although the 'omics' strategies continuing for the last 20 years have been helpful at the molecular level in enabling the characteristics and proper understanding of such tumors over long-term longitudinal monitoring. Classification, diagnosis, and prediction of the outcomes have been made through tissue and serum biomarkers but these also fail to diagnose the disease at an early stage. Considerably there is no adequate detection technique present globally that can help early detection and provide adequate specificity, safety, sensitivity, and convenience for the younger and premenopausal women, thereby it becomes necessary to take early measures and build efficient tools and techniques for the same. Through biopsies of nipple aspirate fluid (NAF) biomarker profiling can be performed. It is a naturally secreted fluid from the cells of epithelium found in the breast. Nowadays, home-based liquid biopsy collection kits are also available through which a routine check on breast health can be performed with the help of NAF. Herein, we will review the biomarker screening liquid biopsy, and the new emerging technologies for the examination of cancer at an early stage, especially in premenopausal women.
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Affiliation(s)
- Abhishek Pant
- Department of Biochemistry, Datta Meghe Institute of Higher Education and Research, Wardha Sawangi Meghe, India.
| | - Ashish P Anjankar
- Department of Biochemistry, Datta Meghe Institute of Higher Education and Research, Wardha Sawangi Meghe, India
| | - Sandesh Shende
- Department of Biochemistry, Datta Meghe Institute of Higher Education and Research, Wardha Sawangi Meghe, India
| | - Archana Dhok
- Department of Biochemistry, Datta Meghe Institute of Higher Education and Research, Wardha Sawangi Meghe, India
| | - Roshan Kumar Jha
- Department of Biochemistry, Datta Meghe Institute of Higher Education and Research, Wardha Sawangi Meghe, India
| | - Anjali Vagga Manglaram
- Department of Biochemistry, Datta Meghe Institute of Higher Education and Research, Wardha Sawangi Meghe, India
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Wunderle M, Heindl F, Behrens AS, Häberle L, Hack CC, Heusinger K, Huebner H, Gass P, Ruebner M, Schulz-Wendtland R, Erber R, Hartmann A, Beckmann MW, Dougall WC, Press MF, Fasching PA, Emons J. Correlation of RANK and RANKL with mammographic density in primary breast cancer patients. Arch Gynecol Obstet 2024:10.1007/s00404-024-07495-1. [PMID: 38836929 DOI: 10.1007/s00404-024-07495-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 03/24/2024] [Indexed: 06/06/2024]
Abstract
PURPOSE The receptor activator of nuclear factor kappa B (RANK) and its ligand (RANKL) have been shown to promote proliferation of the breast and breast carcinogenesis. The objective of this analysis was to investigate whether tumor-specific RANK and RANKL expression in patients with primary breast cancer is associated with high percentage mammographic density (PMD), which is a known breast cancer risk factor. METHODS Immunohistochemical staining of RANK and RANKL was performed in tissue microarrays (TMAs) from primary breast cancer samples of the Bavarian Breast Cancer Cases and Controls (BBCC) study. For RANK and RANKL expression, histochemical scores (H scores) with a cut-off value of > 0 vs 0 were established. PMD was measured in the contralateral, non-diseased breast. Linear regression models with PMD as outcome were calculated using common predictors of PMD (age at breast cancer diagnosis, body mass index (BMI) and parity) and RANK and RANKL H scores. Additionally, Spearman rank correlations (ρ) between PMD and RANK and RANKL H score were performed. RESULTS In the final cohort of 412 patients, breast cancer-specific RANK and RANKL expression was not associated with PMD (P = 0.68). There was no correlation between PMD and RANK H score (Spearman's ρ = 0.01, P = 0.87) or RANKL H score (Spearman's ρ = 0.04, P = 0.41). RANK expression was highest in triple-negative tumors, followed by HER2-positive, luminal B-like and luminal A-like tumors, while no subtype-specific expression of RANKL was found. CONCLUSION Results do not provide evidence for an association of RANK and RANKL expression in primary breast cancer with PMD.
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Affiliation(s)
- Marius Wunderle
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen University Hospital, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054, Erlangen, Germany
- Bavarian Cancer Research Center (BZKF), Erlangen, Germany
| | - Felix Heindl
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen University Hospital, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054, Erlangen, Germany
- Bavarian Cancer Research Center (BZKF), Erlangen, Germany
| | - Annika S Behrens
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen University Hospital, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054, Erlangen, Germany
- Bavarian Cancer Research Center (BZKF), Erlangen, Germany
| | - Lothar Häberle
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen University Hospital, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054, Erlangen, Germany
- Bavarian Cancer Research Center (BZKF), Erlangen, Germany
- Biostatistics Unit, Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen University Hospital, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054, Erlangen, Germany
| | - Carolin C Hack
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen University Hospital, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054, Erlangen, Germany
- Bavarian Cancer Research Center (BZKF), Erlangen, Germany
| | - Katharina Heusinger
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen University Hospital, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054, Erlangen, Germany
- Bavarian Cancer Research Center (BZKF), Erlangen, Germany
| | - Hanna Huebner
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen University Hospital, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054, Erlangen, Germany
- Bavarian Cancer Research Center (BZKF), Erlangen, Germany
| | - Paul Gass
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen University Hospital, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054, Erlangen, Germany
- Bavarian Cancer Research Center (BZKF), Erlangen, Germany
| | - Matthias Ruebner
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen University Hospital, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054, Erlangen, Germany
- Bavarian Cancer Research Center (BZKF), Erlangen, Germany
| | - Rüdiger Schulz-Wendtland
- Bavarian Cancer Research Center (BZKF), Erlangen, Germany
- Institute of Diagnostic Radiology, Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen University Hospital, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054, Erlangen, Germany
| | - Ramona Erber
- Bavarian Cancer Research Center (BZKF), Erlangen, Germany
- Institute of Pathology, Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen University Hospital, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054, Erlangen, Germany
| | - Arndt Hartmann
- Bavarian Cancer Research Center (BZKF), Erlangen, Germany
- Institute of Pathology, Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen University Hospital, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054, Erlangen, Germany
| | - Matthias W Beckmann
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen University Hospital, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054, Erlangen, Germany
- Bavarian Cancer Research Center (BZKF), Erlangen, Germany
| | - William C Dougall
- Immunology in Cancer and Infection Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, QLD, 4702, Australia
- Hematology and Oncology Research, Amgen, Inc, Seattle, WA, 98119, USA
| | - Michael F Press
- Department of Pathology, Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, USA
| | - Peter A Fasching
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen University Hospital, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054, Erlangen, Germany.
- Bavarian Cancer Research Center (BZKF), Erlangen, Germany.
| | - Julius Emons
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen University Hospital, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054, Erlangen, Germany
- Bavarian Cancer Research Center (BZKF), Erlangen, Germany
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Jalil SMA, Henry JC, Cameron AJM. Targets in the Tumour Matrisome to Promote Cancer Therapy Response. Cancers (Basel) 2024; 16:1847. [PMID: 38791926 PMCID: PMC11119821 DOI: 10.3390/cancers16101847] [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: 03/13/2024] [Revised: 05/03/2024] [Accepted: 05/08/2024] [Indexed: 05/26/2024] Open
Abstract
The extracellular matrix (ECM) is composed of complex fibrillar proteins, proteoglycans, and macromolecules, generated by stromal, immune, and cancer cells. The components and organisation of the matrix evolves as tumours progress to invasive disease and metastasis. In many solid tumours, dense fibrotic ECM has been hypothesised to impede therapy response by limiting drug and immune cell access. Interventions to target individual components of the ECM, collectively termed the matrisome, have, however, revealed complex tumour-suppressor, tumour-promoter, and immune-modulatory functions, which have complicated clinical translation. The degree to which distinct components of the matrisome can dictate tumour phenotypes and response to therapy is the subject of intense study. A primary aim is to identify therapeutic opportunities within the matrisome, which might support a better response to existing therapies. Many matrix signatures have been developed which can predict prognosis, immune cell content, and immunotherapy responses. In this review, we will examine key components of the matrisome which have been associated with advanced tumours and therapy resistance. We have primarily focussed here on targeting matrisome components, rather than specific cell types, although several examples are described where cells of origin can dramatically affect tumour roles for matrix components. As we unravel the complex biochemical, biophysical, and intracellular transduction mechanisms associated with the ECM, numerous therapeutic opportunities will be identified to modify tumour progression and therapy response.
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Affiliation(s)
| | | | - Angus J. M. Cameron
- Barts Cancer Institute, Queen Mary University of London, John Vane Science Centre, Charterhouse Square, London EC1M 6BQ, UK; (S.M.A.J.); (J.C.H.)
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Buijs SM, Koolen SLW, Mathijssen RHJ, Jager A. Tamoxifen Dose De-Escalation: An Effective Strategy for Reducing Adverse Effects? Drugs 2024; 84:385-401. [PMID: 38480629 PMCID: PMC11101371 DOI: 10.1007/s40265-024-02010-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2024] [Indexed: 05/19/2024]
Abstract
Tamoxifen, a cornerstone in the adjuvant treatment of estrogen receptor-positive breast cancer, significantly reduces breast cancer recurrence and breast cancer mortality; however, its standard adjuvant dose of 20 mg daily presents challenges due to a broad spectrum of adverse effects, contributing to high discontinuation rates. Dose reductions of tamoxifen might be an option to reduce treatment-related toxicity, but large randomized controlled trials investigating the tolerability and, more importantly, efficacy of low-dose tamoxifen in the adjuvant setting are lacking. We conducted an extensive literature search to explore evidence on the tolerability and clinical efficacy of reduced doses of tamoxifen. In this review, we discuss two important topics regarding low-dose tamoxifen: (1) the incidence of adverse effects and quality of life among women using low-dose tamoxifen; and (2) the clinical efficacy of low-dose tamoxifen examined in the preventive setting and evaluated through the measurement of several efficacy derivatives. Moreover, practical tools for tamoxifen dose reductions in the adjuvant setting are provided and further research to establish optimal dosing strategies for individual patients are discussed.
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Affiliation(s)
- Sanne M Buijs
- Department of Medical Oncology, Erasmus MC Cancer Institute, Dr. Molewaterplein 40, PO Box 2040, 3015 CN, Rotterdam, The Netherlands.
| | - Stijn L W Koolen
- Department of Medical Oncology, Erasmus MC Cancer Institute, Dr. Molewaterplein 40, PO Box 2040, 3015 CN, Rotterdam, The Netherlands
- Department of Clinical Pharmacy, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Ron H J Mathijssen
- Department of Medical Oncology, Erasmus MC Cancer Institute, Dr. Molewaterplein 40, PO Box 2040, 3015 CN, Rotterdam, The Netherlands
| | - Agnes Jager
- Department of Medical Oncology, Erasmus MC Cancer Institute, Dr. Molewaterplein 40, PO Box 2040, 3015 CN, Rotterdam, The Netherlands
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Matthew KA, Getz KR, Jeon MS, Luo C, Luo J, Toriola AT. Associations of Vitamins and Related Cofactor Metabolites with Mammographic Breast Density in Premenopausal Women. J Nutr 2024; 154:424-434. [PMID: 38122846 PMCID: PMC10900193 DOI: 10.1016/j.tjnut.2023.12.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 12/12/2023] [Accepted: 12/14/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Identifying biological drivers of mammographic breast density (MBD), a strong risk factor for breast cancer, could provide insight into breast cancer etiology and prevention. Studies on dietary factors and MBD have yielded conflicting results. There are, however, very limited data on the associations of dietary biomarkers and MBD. OBJECTIVE We aimed to investigate the associations of vitamins and related cofactor metabolites with MBD in premenopausal women. METHODS We measured 37 vitamins and related cofactor metabolites in fasting plasma samples of 705 premenopausal women recruited during their annual screening mammogram at the Washington University School of Medicine, St. Louis, MO. Volpara was used to assess volumetric percent density (VPD), dense volume (DV), and nondense volume (NDV). We estimated the least square means of VPD, DV, and NDV across quartiles of each metabolite, as well as the regression coefficient of a metabolite in continuous scale from multiple covariate-adjusted linear regression. We corrected for multiple testing using the Benjamini-Hochberg procedure to control the false discover rate (FDR) at a 5% level. RESULTS Participants' mean VPD was 10.5%. Two vitamin A metabolites (β-cryptoxanthin and carotene diol 2) were positively associated, and one vitamin E metabolite (γ-tocopherol) was inversely associated with VPD. The mean VPD increased across quartiles of β-cryptoxanthin (Q1 = 7.2%, Q2 = 7.7%, Q3 = 8.4%%, Q4 = 9.2%; P-trend = 1.77E-05, FDR P value = 1.18E-03). There was a decrease in the mean VPD across quartiles of γ-tocopherol (Q1 = 9.4%, Q2 = 8.1%, Q3 = 8.0%, Q4 = 7.8%; P -trend = 4.01E-03, FDR P value = 0.04). Seven metabolites were associated with NDV: 3 vitamin E (γ-CEHC glucuronide, δ-CEHC, and γ-tocopherol) and 1 vitamin C (gulonate) were positively associated, whereas 2 vitamin A (carotene diol 2 and β-cryptoxanthin) and 1 vitamin C (threonate) were inversely associated with NDV. No metabolite was significantly associated with DV. CONCLUSION We report novel associations of vitamins and related cofactor metabolites with MBD in premenopausal women.
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Affiliation(s)
- Kayode A Matthew
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, United States
| | - Kayla R Getz
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, United States
| | - Myung Sik Jeon
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, United States; Siteman Cancer Center Biostatistics and Qualitative Research Shared Resource, Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, United States
| | - Chongliang Luo
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, United States; Siteman Cancer Center Biostatistics and Qualitative Research Shared Resource, Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, United States
| | - Jingqin Luo
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, United States; Siteman Cancer Center Biostatistics and Qualitative Research Shared Resource, Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, United States
| | - Adetunji T Toriola
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, United States; Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, United States.
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Kanbayti IH, Alzahrani MA, Yeslam YO, Habib NH, Hadadi I, Almaimoni Y, Alahmadi A, Ekpo EU. Association between Family History of Breast Cancer and Breast Density in Saudi Premenopausal Women Participating in Mammography Screening. Clin Pract 2024; 14:164-172. [PMID: 38391399 PMCID: PMC10887693 DOI: 10.3390/clinpract14010013] [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: 12/03/2023] [Revised: 12/24/2023] [Accepted: 01/11/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND Mammographic density and family history of breast cancer (FHBC) are well-established independent factors affecting breast cancer risk; however, the association between these two risk factors in premenopausal-screened women remains unclear. The aim of this study is to investigate the relationship between mammographic density and FHBC among Saudi premenopausal-screened women. METHODS A total of 446 eligible participants were included in the study. Mammographic density was assessed qualitatively using the Breast Imaging Reporting and Data System (BIRADS 4th edition). Logistic regression models were built to investigate the relationship between mammographic density and FHBC. RESULTS Women with a family history of breast cancer demonstrated an 87% greater chance of having dense tissue than women without a family history of breast cancer (95% CI: 1.14-3.08; p = 0.01). Having a positive family history for breast cancer in mothers was significantly associated with dense tissue (adjusted odds ratio (OR): 5.6; 95% CI: 1.3-24.1; p = 0.02). CONCLUSION Dense breast tissue in Saudi premenopausal women undergoing screening may be linked to FHBC. If this conclusion is replicated in larger studies, then breast cancer risk prediction models must carefully consider these breast cancer risk factors.
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Affiliation(s)
- Ibrahem Hussain Kanbayti
- Radiologic Sciences Department, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mayada A Alzahrani
- Radiologic Sciences Department, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Yara O Yeslam
- Radiologic Sciences Department, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Noora H Habib
- Radiologic Sciences Department, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ibrahim Hadadi
- Department of Radiological Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia
| | - Yousef Almaimoni
- Radiologic Sciences Department, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Adnan Alahmadi
- Radiologic Sciences Department, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ernest U Ekpo
- Medical Image Optimization and Perception Group (MIOPeG), Faculty of Medicine and Health, The University of Sydney, Campus C4 75 East Street, Sydney, NSW 2141, Australia
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8
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Tran TXM, Kim S, Park B. Mammographic Breast Density and Risk of Ovarian Cancer in Korean Women. Cancer Epidemiol Biomarkers Prev 2023; 32:1690-1698. [PMID: 37816192 DOI: 10.1158/1055-9965.epi-23-0494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 08/04/2023] [Accepted: 10/05/2023] [Indexed: 10/12/2023] Open
Abstract
BACKGROUND This study aimed to investigate the potential association between mammographic breast density and ovarian cancer risk. METHODS This retrospective cohort study included women ≥40 years of age who underwent a mammography screening from 2009 to 2014. Breast density was assessed using the Breast Imaging-Reporting and Data System. The primary outcome was ovarian cancer development, and the cases were recorded until 2020. Cox proportional hazards regression was used to assess the association between breast density and ovarian cancer development. Subgroup analyses stratified by age, menopausal status, and body mass index (BMI) were conducted. RESULTS Of the 8,556,914 women included in this study, 9,246 ovarian cancer events were recorded during a median follow-up period of 10 years (interquartile range, 8.1-11.0 years). Compared with women with almost entirely fat density, those with scattered fibroglandular density, heterogeneous density, and extreme density had an increased risk of ovarian cancer with adjusted HRs of 1.08 [95% confidence interval (CI), 1.02-1.15], 1.16 (95% CI, 1.09-1.24), and 1.24 (95% CI, 1.15-1.34), respectively. The strongest association was observed in the ≥60 years age group; subgroup analysis indicated a significant increase in association between the higher-density category and ovarian cancer risk, regardless of BMI or menopausal status. CONCLUSIONS Higher levels of breast density are associated with an increased risk of ovarian cancer. IMPACT Breast density may have a relationship with ovarian cancer risk and could be used to assess future risk.
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Affiliation(s)
- Thi Xuan Mai Tran
- Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea
- Institute for Health and Society, Hanyang University, Seoul, South Korea
| | - Soyeoun Kim
- Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea
- Institute for Health and Society, Hanyang University, Seoul, South Korea
| | - Boyoung Park
- Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea
- Hanyang Institute of Bioscience and Biotechnology, Hanyang University, Seoul, Republic of Korea
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Vahala D, Amos SE, Sacchi M, Soliman BG, Hepburn MS, Mowla A, Li J, Jeong JH, Astell C, Hwang Y, Kennedy BF, Lim KS, Choi YS. 3D Volumetric Mechanosensation of MCF7 Breast Cancer Spheroids in a Linear Stiffness Gradient GelAGE. Adv Healthc Mater 2023; 12:e2301506. [PMID: 37670531 DOI: 10.1002/adhm.202301506] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 07/26/2023] [Indexed: 09/07/2023]
Abstract
The tumor microenvironment presents spatiotemporal shifts in biomechanical properties with cancer progression. Hydrogel biomaterials like GelAGE offer the stiffness tuneability to recapitulate dynamic changes in tumor tissues by altering photo-energy exposures. Here, a tuneable hydrogel with spatiotemporal control of stiffness and mesh-network is developed. The volume of MCF7 spheroids encapsulated in a linear stiffness gradient demonstrates an inverse relationship with stiffness (p < 0.0001). As spheroids are exposed to increased crosslinking (stiffer) and greater mechanical confinement, spheroid stiffness increases. Protein expression (TRPV4, β1 integrin, E-cadherin, and F-actin) decreases with increasing stiffness while showing strong correlations to spheroid volume (r2 > 0.9). To further investigate the role of volume, MCF7 spheroids are grown in a soft matrix for 5 days prior to a second polymerisation which presents a stiffness gradient to equally expanded spheroids. Despite being exposed to variable stiffness, these spheroids show even protein expression, confirming volume as a key regulator. Overall, this work showcases the versatility of GelAGE and demonstrates volume expansion as a key regulator of 3D mechanosensation in MCF7 breast cancer spheroids. This platform has the potential to further investigation into the role of stiffness and dimensionality in 3D spheroid culture for other types of cancers and diseases.
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Affiliation(s)
- Danielle Vahala
- School of Human Sciences, The University of Western Australia, Perth, WA, 6009, Australia
| | - Sebastian E Amos
- School of Human Sciences, The University of Western Australia, Perth, WA, 6009, Australia
| | - Marta Sacchi
- School of Human Sciences, The University of Western Australia, Perth, WA, 6009, Australia
| | - Bram G Soliman
- Department of Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago Christchurch, Christchurch, 8140, New Zealand
| | - Matt S Hepburn
- Department of Electrical, Electronic & Computer Engineering, School of Engineering, The University of Western Australia, Perth, WA, 6009, Australia
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, and Centre for Medical Research, The University of Western Australia, Perth, WA, 6009, Australia
| | - Alireza Mowla
- Department of Electrical, Electronic & Computer Engineering, School of Engineering, The University of Western Australia, Perth, WA, 6009, Australia
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, and Centre for Medical Research, The University of Western Australia, Perth, WA, 6009, Australia
| | - Jiayue Li
- Department of Electrical, Electronic & Computer Engineering, School of Engineering, The University of Western Australia, Perth, WA, 6009, Australia
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, and Centre for Medical Research, The University of Western Australia, Perth, WA, 6009, Australia
| | - Ji Hoon Jeong
- Soonchunhyang Institute of Medi-Bio Science, Soonchunhyang University, Cheonan-si, Chungcheongnam-do, 31151, South Korea
| | - Chrissie Astell
- School of Human Sciences, The University of Western Australia, Perth, WA, 6009, Australia
| | - Yongsung Hwang
- Soonchunhyang Institute of Medi-Bio Science, Soonchunhyang University, Cheonan-si, Chungcheongnam-do, 31151, South Korea
| | - Brendan F Kennedy
- Department of Electrical, Electronic & Computer Engineering, School of Engineering, The University of Western Australia, Perth, WA, 6009, Australia
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, and Centre for Medical Research, The University of Western Australia, Perth, WA, 6009, Australia
| | - Khoon S Lim
- Department of Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago Christchurch, Christchurch, 8140, New Zealand
- School of Medical Sciences, University of Sydney, Sydney, NSW, 2006, Australia
| | - Yu Suk Choi
- School of Human Sciences, The University of Western Australia, Perth, WA, 6009, Australia
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10
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Tran TXM, Chang Y, Kim S, Ryu S, Park B. Mammographic breast density and cardiovascular disease risk in women. Atherosclerosis 2023; 387:117392. [PMID: 38039604 DOI: 10.1016/j.atherosclerosis.2023.117392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 10/31/2023] [Accepted: 11/15/2023] [Indexed: 12/03/2023]
Abstract
AIMS We aimed to determine the predictive role of mammographic breast density in addition to the Framingham Risk Score (FRS) on subsequent CVD events in women. METHODS AND RESULTS This cohort study included 4,268,579 women aged ≥40 years who underwent mammography screening between 2009 and 2010 with follow-up until 2020. Breast density was reported following the Breast Imaging Reporting and Data System. Primary outcomes included coronary heart disease, cerebrovascular disease, peripheral arterial disease, and heart failure. The incremental predictive ability of breast density added to the FRS model was assessed using the ROC and net reclassification index (NRI) among all women and strata based on FRS risk categories (<5% as low-risk, 5%-10% as moderate-risk, and ≥10% as high-risk). In total, 135,475 CVD events were recorded after a median follow-up of 10.9 years. A lower category of breast density was associated with a higher risk of CVD. Compared to the extremely dense breast group, the hazard ratios (95% CI) for CVDs were 1.12 (1.09-1.14), 1.19 (1.17-1.22), and 1.29 (1.26-1.32) in women with heterogeneously dense, scattered fibroglandular densities, and almost entirely fat breast density, respectively. Adding breast density to the FRS showed a slight improvement in AUROC but a modest improvement in NRI; the C-statistic difference was 0.083% (95% CI 0.069-0.096) with a 7.15% (6.85-7.69) increase in NRI, with the strongest improvement observed in the low-risk group. CONCLUSIONS Mammographic breast density is an independent predictor of incident CVD among women. The addition of mammographic breast density to FRS improves the prediction of CVDs, especially in low-risk individuals.
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Affiliation(s)
- Thi Xuan Mai Tran
- Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Yoosoo Chang
- Center for Cohort Studies, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Seoul, Republic of Korea
| | - Soyeoun Kim
- Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Seungho Ryu
- Center for Cohort Studies, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Seoul, Republic of Korea.
| | - Boyoung Park
- Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea.
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11
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Pensotti A, Bertolaso M, Bizzarri M. Is Cancer Reversible? Rethinking Carcinogenesis Models-A New Epistemological Tool. Biomolecules 2023; 13:biom13050733. [PMID: 37238604 DOI: 10.3390/biom13050733] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 04/17/2023] [Accepted: 04/19/2023] [Indexed: 05/28/2023] Open
Abstract
A growing number of studies shows that it is possible to induce a phenotypic transformation of cancer cells from malignant to benign. This process is currently known as "tumor reversion". However, the concept of reversibility hardly fits the current cancer models, according to which gene mutations are considered the primary cause of cancer. Indeed, if gene mutations are causative carcinogenic factors, and if gene mutations are irreversible, how long should cancer be considered as an irreversible process? In fact, there is some evidence that intrinsic plasticity of cancerous cells may be therapeutically exploited to promote a phenotypic reprogramming, both in vitro and in vivo. Not only are studies on tumor reversion highlighting a new, exciting research approach, but they are also pushing science to look for new epistemological tools capable of better modeling cancer.
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Affiliation(s)
- Andrea Pensotti
- Research Unit of Philosophy of Science and Human Development, University Campus Bio-Medico of Rome, 00128 Rome, Italy
- Systems Biology Group Lab, Department of Experimental Medicine, Sapienza University, 00185 Rome, Italy
| | - Marta Bertolaso
- Research Unit of Philosophy of Science and Human Development, University Campus Bio-Medico of Rome, 00128 Rome, Italy
| | - Mariano Bizzarri
- Systems Biology Group Lab, Department of Experimental Medicine, Sapienza University, 00185 Rome, Italy
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12
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Karrobi K, Tank A, Fuzail MA, Kalidoss M, Tilbury K, Zaman M, Ferruzzi J, Roblyer D. Fluorescence Lifetime Imaging Microscopy (FLIM) reveals spatial-metabolic changes in 3D breast cancer spheroids. Sci Rep 2023; 13:3624. [PMID: 36869092 PMCID: PMC9984376 DOI: 10.1038/s41598-023-30403-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 02/22/2023] [Indexed: 03/05/2023] Open
Abstract
Cancer cells are mechanically sensitive to physical properties of the microenvironment, which can affect downstream signaling to promote malignancy, in part through the modulation of metabolic pathways. Fluorescence Lifetime Imaging Microscopy (FLIM) can be used to measure the fluorescence lifetime of endogenous fluorophores, such as the metabolic co-factors NAD(P)H and FAD, in live samples. We used multiphoton FLIM to investigate the changes in cellular metabolism of 3D breast spheroids derived from MCF-10A and MD-MB-231 cell lines embedded in collagen with varying densities (1 vs. 4 mg/ml) over time (Day 0 vs. Day 3). MCF-10A spheroids demonstrated spatial gradients, with the cells closest to the spheroid edge exhibiting FLIM changes consistent with a shift towards oxidative phosphorylation (OXPHOS) while the spheroid core had changes consistent with a shift towards glycolysis. The MDA-MB-231 spheroids had a large shift consistent with increased OXPHOS with a more pronounced change at the higher collagen concentration. The MDA-MB-231 spheroids invaded into the collagen gel over time and cells that traveled the farthest had the largest changes consistent with a shift towards OXPHOS. Overall, these results suggest that the cells in contact with the extracellular matrix (ECM) and those that migrated the farthest had changes consistent with a metabolic shift towards OXPHOS. More generally, these results demonstrate the ability of multiphoton FLIM to characterize how spheroids metabolism and spatial metabolic gradients are modified by physical properties of the 3D ECM.
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Affiliation(s)
- Kavon Karrobi
- Department of Biomedical Engineering, Boston University, Boston, MA, 02215, USA
| | - Anup Tank
- Department of Biomedical Engineering, Boston University, Boston, MA, 02215, USA
| | | | - Madhumathi Kalidoss
- Department of Biomedical Engineering, Boston University, Boston, MA, 02215, USA
| | - Karissa Tilbury
- Department of Chemical and Biomedical Engineering, University of Maine, Orono, ME, 04469, USA
| | - Muhammad Zaman
- Department of Biomedical Engineering, Boston University, Boston, MA, 02215, USA
| | - Jacopo Ferruzzi
- Department of Biomedical Engineering, Boston University, Boston, MA, 02215, USA
- Department of Biomedical Engineering, The University of Texas at Dallas, Richardson, TX, 75080, USA
| | - Darren Roblyer
- Department of Biomedical Engineering, Boston University, Boston, MA, 02215, USA.
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13
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Tran TXM, Chang Y, Kim S, Song H, Ryu S, Park B. Association of Breast Cancer Family History With Breast Density Over Time in Korean Women. JAMA Netw Open 2023; 6:e232420. [PMID: 36897591 DOI: 10.1001/jamanetworkopen.2023.2420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/11/2023] Open
Abstract
IMPORTANCE Evidence suggests that women with a family history of breast cancer (FHBC) in first-degree relatives have a higher level of breast density; however, studies of premenopausal women remain limited. OBJECTIVE To investigate the association between FHBC and mammographic breast density and breast density changes among premenopausal women. DESIGN, SETTING, AND PARTICIPANTS This retrospective cohort study used population-based data obtained from the National Health Insurance Service-National Health Information Database of Korea. We included premenopausal women aged 40 to 55 years who underwent mammography for breast cancer screening once between January 1, 2015, and December 31, 2016 (n = 1 174 214), and women who underwent mammography twice (first in 2015-2016 and again between January 1, 2017 and December 31, 2018) (n = 838 855). EXPOSURES Family history of breast cancer was assessed using a self-reported questionnaire, which included information on FHBC in the mother and/or sister. MAIN OUTCOMES AND MEASURES Breast density, based on the Breast Imaging Reporting and Data System, was categorized as dense (heterogeneously or extremely dense) and nondense (almost entirely fat or scattered fibroglandular areas). Multivariate logistic regression was used to assess the association among FHBC, breast density, and changes in breast density from the first to second screening. Data analysis was performed from June 1 to September 31, 2022. RESULTS Of the 1 174 214 premenopausal women, 34 003 (2.4%; mean [SD] age, 46.3 [3.2] years) reported having FHBC among their first-degree relatives, and 1 140 211 (97.1%; mean [SD] age, 46.3 [3.2] years) reported no FHBC. Odds of having dense breasts was 22% higher (adjusted odds ratio [aOR], 1.22; 95% CI, 1.19-1.26) in women with FHBC than in women without FHBC, and the association varied by affected relatives: mother alone (aOR, 1.15; 95% CI, 1.10-1.21), sister alone (aOR, 1.26; 95% CI, 1.22-1.31), and both mother and sister (aOR, 1.64; 95% CI, 1.20-2.25). Among women with fatty breasts at baseline, the odds of developing dense breasts was higher in women with FHBC than in those without FHBC (aOR, 1.19; 95% CI, 1.11-1.26), whereas among women with dense breasts, higher odds of having persistently dense breasts were observed in women with FHBC (aOR, 1.11; 95% CI, 1.05-1.16) than in those without FHBC. CONCLUSIONS AND RELEVANCE In this cohort study of premenopausal Korean women, FHBC was positively associated with an increased incidence of having increased or persistently dense breasts over time. These findings suggest the need for a tailored breast cancer risk assessment for women with FHBC.
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Affiliation(s)
- Thi Xuan Mai Tran
- Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Yoosoo Chang
- Center for Cohort Studies, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Republic of Korea
| | - Soyeoun Kim
- Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Huiyeon Song
- Department of Epidemiology and Biostatistics, Graduate School of Public Health, Hanyang University, Seoul, Republic of Korea
| | - Seungho Ryu
- Center for Cohort Studies, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Republic of Korea
| | - Boyoung Park
- Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea
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14
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Tran TXM, Kim S, Song H, Lee E, Park B. Association of Longitudinal Mammographic Breast Density Changes with Subsequent Breast Cancer Risk. Radiology 2023; 306:e220291. [PMID: 36125380 DOI: 10.1148/radiol.220291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Background Although Breast Imaging Reporting and Data System (BI-RADS) density classification has been used to assess future breast cancer risk, its reliability and validity are still debated in literature. Purpose To determine the association between overall longitudinal changes in mammographic breast density and breast cancer risk stratified by menopausal status. Materials and Methods In a retrospective cohort study using the Korean National Health Insurance Service database, women aged at least 40 years without a history of cancer who underwent three consecutive biennial mammographic screenings in 2009-2014 were followed up through December 2020. Participants were divided according to baseline breast density: fatty (BI-RADS categories a, b) versus dense (BI-RADS categories c, d) and then into subgroups on the basis of changes from the first to second and from second to third screenings. Women without change in breast density were used as the reference group. Main outcomes were incident breast cancer events, both invasive breast cancer and ductal carcinoma in situ. Cox proportion hazard regression was used to calculate the hazard ratio (HR) with adjustment for other covariables. Results Among 2 253 963 women (mean age, 59 years ± 9) there were 22 439 detected breast cancers. Premenopausal women with fatty breasts at the first screening had a higher risk of breast cancer as density increased in the second and third screenings (fatty-to-dense HR, 1.45 [95% CI: 1.27, 1.65]; dense-to-fatty HR, 1.53 [95% CI: 1.34, 1.74]; dense-to-dense HR, 1.93 [95% CI: 1.75, 2.13]). In premenopausal women with dense breasts at baseline, those in whom density continuously decreased had a 0.62-fold lower risk (95% CI: 0.56, 0.69). Similar results were observed in postmenopausal women, remaining significant after adjustment for baseline breast density or changes in body mass index (fatty-to-dense HR, 1.50 [95% CI: 1.39, 1.62]; dense-to-fatty HR, 1.42 [95% CI: 1.31, 1.53]; dense-to-dense HR, 1.62 [95% CI: 1.51, 1.75]). Conclusion In both premenopausal and postmenopausal women undergoing three consecutive biennial mammographic screenings, a consecutive increase in breast density augmented the future breast cancer risk whereas a continuous decrease was associated with a lower risk. © RSNA, 2022 Online supplemental material is available for this article. See also the editorial by Kataoka et al in this issue.
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Affiliation(s)
- Thi Xuan Mai Tran
- From the Departments of Preventive Medicine (T.X.M.T., B.P.) and Health Sciences (S.K.), Hanyang University College of Medicine, 222 Wangsimni-ro, Seongdong-gu, Seoul 04763, Republic of Korea; Department of Epidemiology and Biostatistics, Graduate School of Public Health, Hanyang University, Seoul, Republic of Korea (H.S.); Department of Radiology, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea (E.L.)
| | - Soyeoun Kim
- From the Departments of Preventive Medicine (T.X.M.T., B.P.) and Health Sciences (S.K.), Hanyang University College of Medicine, 222 Wangsimni-ro, Seongdong-gu, Seoul 04763, Republic of Korea; Department of Epidemiology and Biostatistics, Graduate School of Public Health, Hanyang University, Seoul, Republic of Korea (H.S.); Department of Radiology, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea (E.L.)
| | - Huiyeon Song
- From the Departments of Preventive Medicine (T.X.M.T., B.P.) and Health Sciences (S.K.), Hanyang University College of Medicine, 222 Wangsimni-ro, Seongdong-gu, Seoul 04763, Republic of Korea; Department of Epidemiology and Biostatistics, Graduate School of Public Health, Hanyang University, Seoul, Republic of Korea (H.S.); Department of Radiology, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea (E.L.)
| | - Eunhye Lee
- From the Departments of Preventive Medicine (T.X.M.T., B.P.) and Health Sciences (S.K.), Hanyang University College of Medicine, 222 Wangsimni-ro, Seongdong-gu, Seoul 04763, Republic of Korea; Department of Epidemiology and Biostatistics, Graduate School of Public Health, Hanyang University, Seoul, Republic of Korea (H.S.); Department of Radiology, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea (E.L.)
| | - Boyoung Park
- From the Departments of Preventive Medicine (T.X.M.T., B.P.) and Health Sciences (S.K.), Hanyang University College of Medicine, 222 Wangsimni-ro, Seongdong-gu, Seoul 04763, Republic of Korea; Department of Epidemiology and Biostatistics, Graduate School of Public Health, Hanyang University, Seoul, Republic of Korea (H.S.); Department of Radiology, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea (E.L.)
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15
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Singh N, Joshi P, Gupta A, Marak JR, Singh DK. Evaluation of volumetric breast density as a risk factor for breast carcinoma in pre- and postmenopausal women, its association with hormone receptor status and breast carcinoma subtypes defined by histology and tumor markers. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2022. [DOI: 10.1186/s43055-022-00759-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Mammographic breast density is acknowledged as an independent risk factor for breast cancer. Its association with different pathological types and tumors markers is still under evaluation. This study aims to assess the associations of volumetric density grades (VDG) with breast cancer risk in premenopausal and postmenopausal age groups separately. We also aim to assess the association of VDG with hormone receptor status and breast cancer subtypes defined by histology and tumor markers (ER, PR, Her 2-neu and Ki 67).
Results
This retrospective study was done with inclusion of two comparable groups of 185 breast cancer cases and 244 healthy controls. These groups were further divided into pre‑ and postmenopausal subgroups. Mammograms of the cases and controls were evaluated by fully automated volumetric breast density software-VOLPARA and classified into four VDG. The hormone receptor status and breast cancer subtypes defined by histological features and tumor markers in the various VDG were also evaluated. The risk of developing carcinoma was significantly higher in women with high-density breasts (VDG-c + VDG-d) as compared with low-density breasts (VDG-a + VDG-b) in both premenopausal and postmenopausal subgroups. No significant difference was seen in the histopathological characteristics of breast cancer among various VDG.
Conclusions
Our study suggests positive association between high VDG and risk of cancer in both premenopausal and postmenopausal group of Indian women. The hormone receptor status and breast cancer subtypes defined by histology and tumor markers did not reveal any relation to the grades of breast density.
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16
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Papanicolaou M, Parker AL, Yam M, Filipe EC, Wu SZ, Chitty JL, Wyllie K, Tran E, Mok E, Nadalini A, Skhinas JN, Lucas MC, Herrmann D, Nobis M, Pereira BA, Law AMK, Castillo L, Murphy KJ, Zaratzian A, Hastings JF, Croucher DR, Lim E, Oliver BG, Mora FV, Parker BL, Gallego-Ortega D, Swarbrick A, O'Toole S, Timpson P, Cox TR. Temporal profiling of the breast tumour microenvironment reveals collagen XII as a driver of metastasis. Nat Commun 2022; 13:4587. [PMID: 35933466 PMCID: PMC9357007 DOI: 10.1038/s41467-022-32255-7] [Citation(s) in RCA: 56] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 07/22/2022] [Indexed: 01/21/2023] Open
Abstract
The tumour stroma, and in particular the extracellular matrix (ECM), is a salient feature of solid tumours that plays a crucial role in shaping their progression. Many desmoplastic tumours including breast cancer involve the significant accumulation of type I collagen. However, recently it has become clear that the precise distribution and organisation of matrix molecules such as collagen I is equally as important in the tumour as their abundance. Cancer-associated fibroblasts (CAFs) coexist within breast cancer tissues and play both pro- and anti-tumourigenic roles through remodelling the ECM. Here, using temporal proteomic profiling of decellularized tumours, we interrogate the evolving matrisome during breast cancer progression. We identify 4 key matrisomal clusters, and pinpoint collagen type XII as a critical component that regulates collagen type I organisation. Through combining our proteomics with single-cell transcriptomics, and genetic manipulation models, we show how CAF-secreted collagen XII alters collagen I organisation to create a pro-invasive microenvironment supporting metastatic dissemination. Finally, we show in patient cohorts that collagen XII may represent an indicator of breast cancer patients at high risk of metastatic relapse. The distribution and organisation of matrix molecules in the tumour stroma help shape solid tumour progression. Here they perform temporal proteomic profiling of the matrisome during breast cancer progression and show that collagen XII secreted from CAFs provides a pro-invasive microenvironment.
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Affiliation(s)
- Michael Papanicolaou
- The Garvan Institute of Medical Research and The Kinghorn Cancer Centre, Sydney, NSW, Australia.,School of Life Sciences, Faculty of Science, University of Technology Sydney, Sydney, NSW, Australia.,Cancer Ecosystems Program, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia
| | - Amelia L Parker
- The Garvan Institute of Medical Research and The Kinghorn Cancer Centre, Sydney, NSW, Australia.,Cancer Ecosystems Program, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia.,School of Clinical Medicine, St Vincent's Healthcare Clinical Campus, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia
| | - Michelle Yam
- The Garvan Institute of Medical Research and The Kinghorn Cancer Centre, Sydney, NSW, Australia.,Cancer Ecosystems Program, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia
| | - Elysse C Filipe
- The Garvan Institute of Medical Research and The Kinghorn Cancer Centre, Sydney, NSW, Australia.,Cancer Ecosystems Program, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia.,School of Clinical Medicine, St Vincent's Healthcare Clinical Campus, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia
| | - Sunny Z Wu
- The Garvan Institute of Medical Research and The Kinghorn Cancer Centre, Sydney, NSW, Australia.,Cancer Ecosystems Program, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia.,School of Clinical Medicine, St Vincent's Healthcare Clinical Campus, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia
| | - Jessica L Chitty
- The Garvan Institute of Medical Research and The Kinghorn Cancer Centre, Sydney, NSW, Australia.,Cancer Ecosystems Program, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia.,School of Clinical Medicine, St Vincent's Healthcare Clinical Campus, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia
| | - Kaitlin Wyllie
- The Garvan Institute of Medical Research and The Kinghorn Cancer Centre, Sydney, NSW, Australia.,Cancer Ecosystems Program, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia
| | - Emmi Tran
- The Garvan Institute of Medical Research and The Kinghorn Cancer Centre, Sydney, NSW, Australia.,Cancer Ecosystems Program, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia
| | - Ellie Mok
- The Garvan Institute of Medical Research and The Kinghorn Cancer Centre, Sydney, NSW, Australia.,Cancer Ecosystems Program, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia
| | - Audrey Nadalini
- The Garvan Institute of Medical Research and The Kinghorn Cancer Centre, Sydney, NSW, Australia.,Cancer Ecosystems Program, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia
| | - Joanna N Skhinas
- The Garvan Institute of Medical Research and The Kinghorn Cancer Centre, Sydney, NSW, Australia.,Cancer Ecosystems Program, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia
| | - Morghan C Lucas
- The Garvan Institute of Medical Research and The Kinghorn Cancer Centre, Sydney, NSW, Australia
| | - David Herrmann
- The Garvan Institute of Medical Research and The Kinghorn Cancer Centre, Sydney, NSW, Australia.,Cancer Ecosystems Program, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia.,School of Clinical Medicine, St Vincent's Healthcare Clinical Campus, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia
| | - Max Nobis
- The Garvan Institute of Medical Research and The Kinghorn Cancer Centre, Sydney, NSW, Australia.,Cancer Ecosystems Program, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia.,School of Clinical Medicine, St Vincent's Healthcare Clinical Campus, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia
| | - Brooke A Pereira
- The Garvan Institute of Medical Research and The Kinghorn Cancer Centre, Sydney, NSW, Australia.,Cancer Ecosystems Program, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia.,School of Clinical Medicine, St Vincent's Healthcare Clinical Campus, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia
| | - Andrew M K Law
- The Garvan Institute of Medical Research and The Kinghorn Cancer Centre, Sydney, NSW, Australia
| | - Lesley Castillo
- The Garvan Institute of Medical Research and The Kinghorn Cancer Centre, Sydney, NSW, Australia
| | - Kendelle J Murphy
- The Garvan Institute of Medical Research and The Kinghorn Cancer Centre, Sydney, NSW, Australia.,Cancer Ecosystems Program, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia.,School of Clinical Medicine, St Vincent's Healthcare Clinical Campus, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia
| | - Anaiis Zaratzian
- The Garvan Institute of Medical Research and The Kinghorn Cancer Centre, Sydney, NSW, Australia
| | - Jordan F Hastings
- The Garvan Institute of Medical Research and The Kinghorn Cancer Centre, Sydney, NSW, Australia
| | - David R Croucher
- The Garvan Institute of Medical Research and The Kinghorn Cancer Centre, Sydney, NSW, Australia.,School of Clinical Medicine, St Vincent's Healthcare Clinical Campus, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia
| | - Elgene Lim
- The Garvan Institute of Medical Research and The Kinghorn Cancer Centre, Sydney, NSW, Australia.,School of Clinical Medicine, St Vincent's Healthcare Clinical Campus, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia
| | - Brian G Oliver
- School of Life Sciences, Faculty of Science, University of Technology Sydney, Sydney, NSW, Australia.,Woolcock Institute of Medical Research, Respiratory Cellular and Molecular Biology, The University of Sydney, Sydney, NSW, Australia
| | - Fatima Valdes Mora
- Cancer Epigenetic Biology and Therapeutics, Personalised Medicine, Children's Cancer Institute, Sydney, NSW, 2031, Australia.,School of Women's and Children's Health, Faculty of Medicine, UNSW Sydney, Sydney, NSW, Australia
| | - Benjamin L Parker
- Metabolic Systems Biology Laboratory, Charles Perkins Centre, School of Life and Environmental Sciences, University of Sydney, Sydney, NSW, Australia
| | - David Gallego-Ortega
- The Garvan Institute of Medical Research and The Kinghorn Cancer Centre, Sydney, NSW, Australia.,School of Clinical Medicine, St Vincent's Healthcare Clinical Campus, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia.,School of Biomedical Engineering, Faculty of Engineering and Information Technology, University of Technology Sydney, Sydney, NSW, Australia
| | - Alexander Swarbrick
- The Garvan Institute of Medical Research and The Kinghorn Cancer Centre, Sydney, NSW, Australia.,Cancer Ecosystems Program, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia.,School of Clinical Medicine, St Vincent's Healthcare Clinical Campus, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia
| | - Sandra O'Toole
- The Garvan Institute of Medical Research and The Kinghorn Cancer Centre, Sydney, NSW, Australia.,School of Clinical Medicine, St Vincent's Healthcare Clinical Campus, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia.,Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital and NSW Health Pathology, Sydney, NSW, Australia
| | - Paul Timpson
- The Garvan Institute of Medical Research and The Kinghorn Cancer Centre, Sydney, NSW, Australia. .,Cancer Ecosystems Program, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia. .,School of Clinical Medicine, St Vincent's Healthcare Clinical Campus, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia.
| | - Thomas R Cox
- The Garvan Institute of Medical Research and The Kinghorn Cancer Centre, Sydney, NSW, Australia. .,Cancer Ecosystems Program, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia. .,School of Clinical Medicine, St Vincent's Healthcare Clinical Campus, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia.
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17
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Barnard ME, Martheswaran T, Van Meter M, Buys SS, Curtin K, Doherty JA. Body Mass Index and Mammographic Density in a Multiracial and Multiethnic Population-Based Study. Cancer Epidemiol Biomarkers Prev 2022; 31:1313-1323. [PMID: 35511751 PMCID: PMC9250611 DOI: 10.1158/1055-9965.epi-21-1249] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 01/25/2022] [Accepted: 04/27/2022] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Mammographic density (MD) is strongly associated with breast cancer risk. We examined whether body mass index (BMI) partially explains racial and ethnic variation in MD. METHODS We used multivariable Poisson regression to estimate associations between BMI and binary MD [Breast Imaging Reporting and Database System (BI-RADS) A&B versus BI-RADS C&D] among 160,804 women in the Utah mammography cohort. We estimated associations overall and within racial and ethnic subgroups and calculated population attributable risk percents (PAR%). RESULTS We observed the lowest BMI and highest MD among Asian women, the highest BMI among Native Hawaiian and Pacific Islander women, and the lowest MD among American Indian and Alaska Native (AIAN) and Black women. BMI was inversely associated with MD [RRBMI≥30 vs. BMI<25 = 0.43; 95% confidence interval (CI), 0.42-0.44] in the full cohort, and estimates in all racial and ethnic subgroups were consistent with this strong inverse association. For women less than 45 years of age, although there was statistical evidence of heterogeneity in associations between BMI and MD by race and ethnicity (P = 0.009), magnitudes of association were similar across groups. PAR%s for BMI and MD among women less than 45 years were considerably higher in White women (PAR% = 29.2, 95% CI = 28.4-29.9) compared with all other groups with estimates ranging from PAR%Asain = 17.2%; 95% CI, 8.5 to 25.8 to PAR%Hispanic = 21.5%; 95% CI, 19.4 to 23.6. For women ≥55 years, PAR%s for BMI and MD were highest among AIAN women (PAR% = 37.5; 95% CI, 28.1-46.9). CONCLUSIONS While we observed substantial differences in the distributions of BMI and MD by race and ethnicity, associations between BMI and MD were generally similar across groups. IMPACT Distributions of BMI and MD may be important contributors to breast cancer disparities.
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Affiliation(s)
- Mollie E Barnard
- Department of Population Health Sciences, Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, Utah
| | - Tarun Martheswaran
- Department of Population Health Sciences, Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, Utah
| | | | - Saundra S Buys
- Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah
| | - Karen Curtin
- Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah
- Pedigree and Population Resource, Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, Utah
| | - Jennifer Anne Doherty
- Department of Population Health Sciences, Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, Utah
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18
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Fuller AM, Eisinger-Mathason TSK. Context Matters: Response Heterogeneity to Collagen-Targeting Approaches in Desmoplastic Cancers. Cancers (Basel) 2022; 14:cancers14133132. [PMID: 35804902 PMCID: PMC9264969 DOI: 10.3390/cancers14133132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 06/08/2022] [Accepted: 06/22/2022] [Indexed: 12/12/2022] Open
Abstract
Simple Summary A common feature of tumor types such as breast cancer, prostate cancer, pancreatic cancer, and soft-tissue sarcoma is the deposition of collagen-rich tissue called desmoplasia. However, efforts to control tumor growth by disrupting desmoplasia, collectively known as “collagen-targeting approaches”, have had mixed and contradictory results, sometimes even within the same cancer type. We believe that this phenomenon may be due—at least partially—to the fact that “collagen” is not a single molecule, but rather a diverse molecular family composed of 28 unique collagen types. Therefore, in this review, we discuss the diversity of collagen molecules in normal and cancer tissue, and explore how collagen heterogeneity relates to the mixed efficacy of collagen-targeting approaches for cancer therapy. Abstract The deposition of collagen-rich desmoplastic tissue is a well-documented feature of the solid tumor microenvironment (TME). However, efforts to target the desmoplastic extracellular matrix (ECM) en masse, or collagen molecules more specifically, have been met with mixed and sometimes paradoxical results. In this review, we posit that these discrepancies are due—at least in part—to the incredible diversity of the collagen superfamily. Specifically, whereas studies of “collagen-targeting” approaches frequently refer to “collagen” as a single molecule or relatively homogeneous molecular family, 28 individual collagens have been identified in mammalian tissues, each with a unique structure, supramolecular assembly pattern, tissue distribution, and/or function. Moreover, some collagen species have been shown to exert both pro- and anti-neoplastic effects in the desmoplastic TME, even within the same cancer type. Therefore, herein, we describe the diversity of the collagen family in normal tissues and highlight the context-specific roles of individual collagen molecules in desmoplastic tumors. We further discuss how this heterogeneity relates to the variable efficacy of “collagen-targeting” strategies in this setting and provide guidance for future directions in the field.
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19
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Coradini D, Ambrogi F. Differential expression of the genes coding for adipokines and epithelial cell polarity components in women with low and high mammographic density. Clin Breast Cancer 2022; 22:715-723. [DOI: 10.1016/j.clbc.2022.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 05/03/2022] [Accepted: 05/16/2022] [Indexed: 11/30/2022]
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20
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Xiao W, Pahlavanneshan M, Eun CY, Zhang X, DeKalb C, Mahgoub B, Knaneh-Monem H, Shah S, Sohrabi A, Seidlits SK, Hill R. Matrix stiffness mediates pancreatic cancer chemoresistance through induction of exosome hypersecretion in a cancer associated fibroblasts-tumor organoid biomimetic model. Matrix Biol Plus 2022; 14:100111. [PMID: 35619988 PMCID: PMC9126837 DOI: 10.1016/j.mbplus.2022.100111] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 05/05/2022] [Accepted: 05/11/2022] [Indexed: 12/26/2022] Open
Abstract
Pancreatic cancer organoid-stromal fibroblasts co-culture displayed significant chemoresistance in 3D culture system. Cancer associated fibroblasts in the physiologically relevant matrix system tended to be more phenotypically activated. Increased extracellular matrix stiffness induces hypersecretion of chemoresistance-promoting exosomes in a cancer associated fibroblasts-tumor organoid biomimetic model system.
In pancreatic ductal adenocarcinoma (PDAC), the abundant stromal cells which comprise the tumor microenvironment constitute more than 90% of the primary tumor bulk. Moreover, this desmoplastic environment has been found to be three times stiffer than normal pancreas tissue. Despite the importance of studying the desmoplastic environment of PDAC, there is still a lack of models designed to adequately recapitulate this complex stiff microenvironment, a critical hallmark of the disease that has been shown to induce chemoresistance. Here, we present a bio-mimetic, 3-dimensional co-culture system that integrates tumor organoids and host-matching stromal cancer associated-fibroblasts (CAFs) that recapitulates the complex, fibrotic matrix of PDAC using advanced biomaterials. With this model, we show that matrix-activated CAFs are able to “re-engineer” the fibrotic environment into a significantly stiffer environment through lysyl-oxidase dependent crosslinking. Moreover, we show that culture of CAFs in this model leads to an increase of exosomes; extracellular vesicles known to promote chemoresistance. Finally, using previously identified exosome inhibitors, climbazole and imipramine, we demonstrate how abrogation of exosome hypersecretion can reduce matrix stiffness-induced chemoresistance. These data highlight the importance of the development of new models that recapitulate not only the cellular composition found in PDAC tumors, but also the biophysical stresses, like stiffness, that the cells are exposed to in order to identify therapies that can overcome this critical feature which can contribute to the chemoresistance observed in patients. We believe that the 3D bio-mimetic model we have developed will be a valuable tool for the development, testing, and optimization of “mechano-medicines” designed to target the biophysical forces that lead to tumor growth and chemoresistance.
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Affiliation(s)
- Weikun Xiao
- Lawrence J. Ellison Institute for Transformative Medicine of USC, Los Angeles, CA 90064, United States
| | - Mahsa Pahlavanneshan
- Lawrence J. Ellison Institute for Transformative Medicine of USC, Los Angeles, CA 90064, United States
- Department of Biomedical Engineering, University of Southern California, Los Angeles, CA 90007, United States
| | - Chae-Young Eun
- Lawrence J. Ellison Institute for Transformative Medicine of USC, Los Angeles, CA 90064, United States
| | - Xinyu Zhang
- Lawrence J. Ellison Institute for Transformative Medicine of USC, Los Angeles, CA 90064, United States
| | - Charlene DeKalb
- Lawrence J. Ellison Institute for Transformative Medicine of USC, Los Angeles, CA 90064, United States
| | - Bayan Mahgoub
- Lawrence J. Ellison Institute for Transformative Medicine of USC, Los Angeles, CA 90064, United States
- Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, United States
| | - Hanaa Knaneh-Monem
- Lawrence J. Ellison Institute for Transformative Medicine of USC, Los Angeles, CA 90064, United States
| | - Sana Shah
- Lawrence J. Ellison Institute for Transformative Medicine of USC, Los Angeles, CA 90064, United States
- Health Promotion and Disease Prevention Studies, University of Southern California, Los Angeles, CA 90033, United States
| | - Alireza Sohrabi
- Department of Bioengineering, University of California, Los Angeles, CA 90095, United States
| | - Stephanie K. Seidlits
- Department of Bioengineering, University of California, Los Angeles, CA 90095, United States
| | - Reginald Hill
- Lawrence J. Ellison Institute for Transformative Medicine of USC, Los Angeles, CA 90064, United States
- Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, United States
- Corresponding author at: Lawrence J. Ellison Institute for Transformative Medicine of USC, Los Angeles, CA 90064, United States.
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21
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Mathur A, Taurin S. What influence does mammographic density have on breast cancer occurrence? Expert Rev Anticancer Ther 2022; 22:445-447. [PMID: 35416087 DOI: 10.1080/14737140.2022.2065985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Aanchal Mathur
- Department of Molecular Medicine, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Kingdom of Bahrain
| | - Sebastien Taurin
- Department of Molecular Medicine, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Kingdom of Bahrain
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22
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Gadaleta E, Thorn GJ, Ross-Adams H, Jones LJ, Chelala C. Field cancerization in breast cancer. J Pathol 2022; 257:561-574. [PMID: 35362092 PMCID: PMC9322418 DOI: 10.1002/path.5902] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 03/23/2022] [Accepted: 03/29/2022] [Indexed: 11/30/2022]
Abstract
Breast cancer affects one in seven women worldwide during their lifetime. Widespread mammographic screening programs and education campaigns allow for early detection of the disease, often during its asymptomatic phase. Current practice in treatment and recurrence monitoring is based primarily on pathological evaluations but can also encompass genomic evaluations, both of which focus on the primary tumor. Although breast cancer is one of the most studied cancers, patients still recur at a rate of up to 15% within the first 10 years post‐surgery. Local recurrence was originally attributed to tumor cells contaminating histologically normal (HN) tissues beyond the surgical margin, but advances in technology have allowed for the identification of distinct aberrations that exist in the peri‐tumoral tissues themselves. One leading theory to explain this phenomenon is the field cancerization theory. Under this hypothesis, tumors arise from a field of molecularly altered cells that create a permissive environment for malignant evolution, which can occur with or without morphological changes. The traditional histopathology paradigm dictates that molecular alterations are reflected in the tissue phenotype. However, the spectrum of inter‐patient variability of normal breast tissue may obfuscate recognition of a cancerized field during routine diagnostics. In this review, we explore the concept of field cancerization focusing on HN peri‐tumoral tissues: we present the pathological and molecular features of field cancerization within these tissues and discuss how the use of peri‐tumoral tissues can affect research. Our observations suggest that pathological and molecular evaluations could be used synergistically to assess risk and guide the therapeutic management of patients. © 2022 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland.
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Affiliation(s)
- Emanuela Gadaleta
- Centre for Cancer Biomarkers and Biotherapeutics, Barts Cancer Institute, Queen Mary University of London, London, UK
| | - Graeme J Thorn
- Centre for Cancer Biomarkers and Biotherapeutics, Barts Cancer Institute, Queen Mary University of London, London, UK
| | - Helen Ross-Adams
- Centre for Cancer Biomarkers and Biotherapeutics, Barts Cancer Institute, Queen Mary University of London, London, UK
| | - Louise J Jones
- Centre for Tumour Biology Barts Cancer Institute, Queen Mary University of London, London, UK
| | - Claude Chelala
- Centre for Cancer Biomarkers and Biotherapeutics, Barts Cancer Institute, Queen Mary University of London, London, UK
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23
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Factors Influencing Mammographic Density in Asian Women: A Retrospective Cohort Study in the Northeast Region of Peninsular Malaysia. Diagnostics (Basel) 2022; 12:diagnostics12040860. [PMID: 35453907 PMCID: PMC9032698 DOI: 10.3390/diagnostics12040860] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 03/28/2022] [Accepted: 03/28/2022] [Indexed: 02/05/2023] Open
Abstract
Mammographic density is a significant risk factor for breast cancer. In this study, we identified the risk factors of mammographic density in Asian women and quantified the impact of breast density on the severity of breast cancer. We collected data from Hospital Universiti Sains Malaysia, a research- and university-based hospital located in Kelantan, Malaysia. Multivariable logistic regression was performed to analyse the data. Five significant factors were found to be associated with mammographic density: age (OR: 0.94; 95% CI: 0.92, 0.96), number of children (OR: 0.88; 95% CI: 0.81, 0.96), body mass index (OR: 0.88; 95% CI: 0.85, 0.92), menopause status (yes vs. no, OR: 0.59; 95% CI: 0.42, 0.82), and BI-RADS classification (2 vs. 1, OR: 1.87; 95% CI: 1.22, 2.84; 3 vs. 1, OR: 3.25; 95% CI: 1.86, 5.66; 4 vs. 1, OR: 3.75; 95% CI: 1.88, 7.46; 5 vs. 1, OR: 2.46; 95% CI: 1.21, 5.02; 6 vs. 1, OR: 2.50; 95% CI: 0.65, 9.56). Similarly, the average predicted probabilities were higher among BI-RADS 3 and 4 classified women. Understanding mammographic density and its influencing factors aids in accurately assessing and screening dense breast women.
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24
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Akoko LO, Rutashobya AK, Lutainulwa EW, Mwanga AH, Kivuyo SL. The effect of reproductive, hormonal, nutritional and lifestyle on breast cancer risk among black Tanzanian women: A case control study. PLoS One 2022; 17:e0263374. [PMID: 35139096 PMCID: PMC8827470 DOI: 10.1371/journal.pone.0263374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 01/18/2022] [Indexed: 12/29/2022] Open
Abstract
Purpose This study aimed to determine the effect of reproductive, hormonal, lifestyle and nutritional factors on breast cancer development among Tanzanian black women. Methodology We undertook a case-control study age-matched to ±5years in 2018 at Muhimbili National Hospital. The study recruited 105 BC patients and 190 controls giving it 80% power to detect an odds ratio of ≥2 at the alpha error of <5% for exposure with a prevalence of 30% in the control group with 95% confidence. Controls were recruited from in patients being treated for non-cancer related conditions. Information regarding hormonal, reproductive, nutritional and lifestyle risk for breast cancer and demography was collected by interviews using a predefined data set. Conditional multinomial logistic regression used to determine the adjusted odds ratio for variables that had significant p-value in the binomial logistic regression model with 5% allowed error at 95% confidence interval. Results The study recruited 105 cases and 190 controls. Only old age at menopause had a significant risk, a 2.6 fold increase. Adolescent obesity, family history of breast cancer, cigarette smoking and alcohol intake had increased odds for breast cancer but failed to reach significant levels. The rural residency had 61% reduced odds for developing breast cancer though it failed to reach significant levels. Conclusion Older age at menopause is a significant risk factor for the development of breast cancer among Tanzanian women. This study has shed light on the potential role of modifiable risk factors for breast cancer which need to be studied further for appropriate preventive strategies in similar settings.
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Affiliation(s)
- Larry Onyango Akoko
- Department of Surgery, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
- * E-mail:
| | - Amonius K. Rutashobya
- Department of Surgery, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | | | - Ally H. Mwanga
- Department of Surgery, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Sokoine L. Kivuyo
- National Institute for Medical Research, Muhimbili Branch, Dar es Salaam, Tanzania
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25
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Mammographic density to predict response to neoadjuvant systemic breast cancer therapy. J Cancer Res Clin Oncol 2022; 148:775-781. [PMID: 35037102 DOI: 10.1007/s00432-021-03881-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 12/06/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND Mammographic density (MD) is a risk factor for breast cancer (BC) development, and recurrence. However, its predictive value has been less studied. Herein, we challenged MD as a biomarker associated with response in patients treated with neoadjuvant therapy (NAT). METHODS Data on all NAT treated BC patients prospectively collected in the registry of Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy (2009-2019) were identified. Diagnostic mammograms were used to evaluate and score MD as categorized by the Breast Imaging-Reporting and Data System (BI-RADS), which identifies 4 levels of MD in keeping with relative increase of fibro-glandular over fat tissue. Each case was classified according to the following categories a (MD < 25%), b (26-50%), c (51-75%), and d (> 75%). The association between MD and pathological complete response (pCR), i.e., absence of BC cells in surgical specimens, was analyzed in multivariable setting used logistic regression models with adjustment for clinical and pathological variables. RESULTS A total of 442 patients were analyzed, 120 of which (27.1%) attained a pCR. BI-RADS categories a, b, c, and d accounted for 10.0%, 37.8%, 37.1% and 15.2% of cases. Corresponding pCR were 20.5%, 26.9%, 30.5%, 23.9%, respectively. At multivariable analysis, when compared to cases classified as BI-RADS a, those with denser breast showed an increased likelihood of pCR with odds ratio (OR) of 1.70, 2.79, and 1.47 for b, c and d categories, respectively (p = 0.0996), independently of age, BMI [OR underweight versus (vs) normal = 3.76], clinical nodal and tumor status (OR T1/Tx vs T4 = 3.87), molecular subtype (HER2-positive vs luminal = 10.74; triple-negative vs luminal = 8.19). In subgroup analyses, the association of MD with pCR was remarkable in triple-negative (ORs of b, c and d versus a: 1.85, 2.49 and 1.55, respectively) and HER2-positive BC cases (ORs 2.70, 3.23, and 1.16). CONCLUSION Patients with dense breast are more likely to attain a pCR at net of other predictive factors. The potential of MD to assist decisions on BC management and as a stratification factor in neoadjuvant clinical trials should be considered.
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Yoon LS, Jacobs JP, Hoehner J, Pereira A, Gana JC, Corvalán C, Michels KB. The Association Between Breast Density and Gut Microbiota Composition at 2 Years Post-Menarche: A Cross-Sectional Study of Adolescents in Santiago, Chile. Front Cell Infect Microbiol 2022; 11:794610. [PMID: 34976871 PMCID: PMC8718921 DOI: 10.3389/fcimb.2021.794610] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 11/22/2021] [Indexed: 01/04/2023] Open
Abstract
The gut microbiome has been linked to breast cancer via immune, inflammatory, and hormonal mechanisms. We examined the relation between adolescent breast density and gut microbial composition and function in a cohort of Chilean girls. This cross-sectional study included 218 female participants in the Growth and Obesity Cohort Study who were 2 years post-menarche. We measured absolute breast fibroglandular volume (aFGV) and derived percent FGV (%FGV) using dual energy X-ray absorptiometry. All participants provided a fecal sample. The gut microbiome was characterized using 16S ribosomal RNA sequencing of the V3-V4 hypervariable region. We examined alpha diversity and beta diversity across terciles of %FGV and aFGV. We used MaAsLin2 for multivariable general linear modeling to assess differential taxa and predicted metabolic pathway abundance (MetaCyc) between %FGV and aFGV terciles. All models were adjusted for potential confounding variables and corrected for multiple comparisons. The mean %FGV and aFGV was 49.5% and 217.0 cm3, respectively, among study participants. Similar median alpha diversity levels were found across %FGV and aFGV terciles when measured by the Shannon diversity index (%FGV T1: 4.0, T2: 3.9, T3: 4.1; aFGV T1: 4.0, T2: 4.0, T3: 4.1). %FGV was associated with differences in beta diversity (R2 =0.012, p=0.02). No genera were differentially abundant when comparing %FGV nor aFGV terciles after adjusting for potential confounders (q > 0.56 for all genera). We found no associations between predicted MetaCyc pathway abundance and %FGV and aFGV. Overall, breast density measured at 2 years post-menarche was not associated with composition and predicted function of the gut microbiome among adolescent Chilean girls.
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Affiliation(s)
- Lara S Yoon
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, United States
| | - Jonathan P Jacobs
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, United States.,Vatche and Tamar Manoukian Division of Digestive Diseases, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, United States.,Division of Gastroenterology, Hepatology and Parenteral Nutrition, Veterans Administration Greater Los Angeles Healthcare System, Los Angeles, CA, United States
| | | | - Ana Pereira
- Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
| | - Juan Cristóbal Gana
- Department of Pediatric Gastroenterology and Nutrition, Division of Pediatrics, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Camila Corvalán
- Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
| | - Karin B Michels
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, United States.,Institute for Prevention and Cancer Epidemiology, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
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27
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Kuermanbayi S, Yang Y, Zhao Y, Li Y, Wang L, Yang J, Zhou Y, Xu F, Li F. In situ monitoring of functional activity of extracellular matrix stiffness-dependent multidrug resistance protein 1 using scanning electrochemical microscopy. Chem Sci 2022; 13:10349-10360. [PMID: 36277620 PMCID: PMC9473519 DOI: 10.1039/d2sc02708a] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 08/11/2022] [Indexed: 11/21/2022] Open
Abstract
Extracellular matrix (ECM) stiffness affects the drug resistance behavior of cancer cells, while multidrug resistance protein 1 (MRP1) on the cell membrane confers treatment resistance via actively transporting drugs out of cancer cells. However, the relationship between ECM stiffness and MRP1 functional activity in cancer cells remains elusive, mainly due to the technical challenge of in situ monitoring. Herein, we engineered in vitro cancer cell models using breast cancer cells (MCF-7 and MDA-MB-231 cells) as the reprehensive cells on polyacrylamide (PA) gels with three stiffness, mimicking different developmental stages of cancer. We in situ characterized the functional activity of MRP1 and investigated the effect of ECM stiffness on MRP1 of cancer cells before and after vincristine treatment using scanning electrochemical microscopy (SECM) with ferrocenecarboxylic acid (FcCOOH) as the redox mediator and endogenous glutathione (GSH) as the indicator. The SECM results show that the functional activity of MRP1 is enhanced with increasing ECM stiffness, and the MRP1-mediated vincristine efflux activity of MCF-7 cells is more affected by ECM stiffness than that of MDA-MB-231 cells. This work, for the first time, applied SECM to in situ and quantitatively monitor the functional activity of MRP1 in cancer cells in different tumor mechanical microenvironments, which could help to elucidate the mechanism of matrix stiffness-dependent drug resistance behavior in cancer cells. SECM using FcCOOH as the redox mediator and endogenous GSH as the indicator was employed to investigate the effect of extracellular matrix stiffness on the functional activity of MRP1 in cancer cells in situ.![]()
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Affiliation(s)
- Shuake Kuermanbayi
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology, Xi'an Jiaotong University, 710049, Xi'an, Shaanxi, China
- Bioinspired Engineering and Biomechanics Center (BEBC), Xi'an Jiaotong University, 710049, Xi'an, Shaanxi, China
| | - Yaowei Yang
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology, Xi'an Jiaotong University, 710049, Xi'an, Shaanxi, China
- Bioinspired Engineering and Biomechanics Center (BEBC), Xi'an Jiaotong University, 710049, Xi'an, Shaanxi, China
| | - Yuxiang Zhao
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology, Xi'an Jiaotong University, 710049, Xi'an, Shaanxi, China
- Bioinspired Engineering and Biomechanics Center (BEBC), Xi'an Jiaotong University, 710049, Xi'an, Shaanxi, China
| | - Yabei Li
- Bioinspired Engineering and Biomechanics Center (BEBC), Xi'an Jiaotong University, 710049, Xi'an, Shaanxi, China
- School of Chemistry, Xi'an Jiaotong University, 710049, Xi'an, Shaanxi, China
| | - Le Wang
- Department of Oncology, The First Affiliated Hospital of Medical College, Xi'an Jiaotong University, 710049, Xi'an, Shaanxi, China
| | - Jin Yang
- Department of Oncology, The First Affiliated Hospital of Medical College, Xi'an Jiaotong University, 710049, Xi'an, Shaanxi, China
| | - Yan Zhou
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology, Xi'an Jiaotong University, 710049, Xi'an, Shaanxi, China
- Bioinspired Engineering and Biomechanics Center (BEBC), Xi'an Jiaotong University, 710049, Xi'an, Shaanxi, China
| | - Feng Xu
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology, Xi'an Jiaotong University, 710049, Xi'an, Shaanxi, China
- Bioinspired Engineering and Biomechanics Center (BEBC), Xi'an Jiaotong University, 710049, Xi'an, Shaanxi, China
| | - Fei Li
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology, Xi'an Jiaotong University, 710049, Xi'an, Shaanxi, China
- Bioinspired Engineering and Biomechanics Center (BEBC), Xi'an Jiaotong University, 710049, Xi'an, Shaanxi, China
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Yu T, Ye DM. The epidemiologic factors associated with breast density: A review. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2022; 27:53. [PMID: 36092490 PMCID: PMC9450246 DOI: 10.4103/jrms.jrms_962_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 01/14/2022] [Accepted: 01/26/2022] [Indexed: 11/04/2022]
Abstract
In recent years, some studies have evaluated the epidemiologic factors associated with breast density. However, the variant and inconsistent results exist. In addition, breast density has been proved to be a significant risk factor associated with breast cancer. Our review summarized the published studies and emphasized the crucial factors including epidemiological factors associated with breast density. In addition, we also discussed the potential reasons for the discrepant results with risk factors. To decrease the incidence and mortality rates for breast cancer, in clinical practice, breast density should be included for clinical risk models in addition to epidemiological factors, and physicians should get more concentrate on those women with risk factors and provide risk-based breast cancer screening regimens.
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Onega T, Zhu W, Kerlikowske K, Miglioretti DL, Lee CI, Henderson LM, Tosteson ANA, Wernli KJ, diFlorio R, Weaver DL, Buist DSM. Preoperative MRI in breast cancer: effect of breast density on biopsy rate and yield. Breast Cancer Res Treat 2022; 191:177-190. [PMID: 34686934 PMCID: PMC9881728 DOI: 10.1007/s10549-021-06418-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 10/11/2021] [Indexed: 01/31/2023]
Abstract
PURPOSE Preoperative breast MRI is used to evaluate for additional cancer and extent of disease for newly diagnosed breast cancer, yet benefits and harms of preoperative MRI are not well-documented. We examined whether preoperative MRI yields additional biopsy and cancer detection by extent of breast density. METHODS We followed women in the Breast Cancer Surveillance Consortium with an incident breast cancer diagnosed from 2005 to 2017. We quantified breast biopsies and cancers detected within 6 months of diagnosis by preoperative breast MRI receipt, overall and by breast density, accounting for MRI selection bias using inverse probability weighted logistic regression. RESULTS Among 19,324 women with newly diagnosed breast cancer, 28% had preoperative MRI, 11% additional biopsy, and 5% additional cancer detected. Four times as many women with preoperative MRI underwent additional biopsy compared to women without MRI (22.6% v. 5.1%). Additional biopsy rates with preoperative MRI increased with increasing breast density (27.4% for extremely dense compared to 16.2% for almost entirely fatty breasts). Rates of additional cancer detection were almost four times higher for women with v. without MRI (9.9% v. 2.6%). Conditional on additional biopsy, age-adjusted rates of additional cancer detection were lowest among women with extremely dense breasts, regardless of imaging modality (with MRI: 35.0%; 95% CI 27.0-43.0%; without MRI: 45.1%; 95% CI 32.6-57.5%). CONCLUSION For women with dense breasts, preoperative MRI was associated with much higher biopsy rates, without concomitant higher cancer detection. Preoperative MRI may be considered for some women, but selecting women based on breast density is not supported by evidence. TRIAL REGISTRATION ClinicalTrials.gov: NCT02980848; registered 2017.
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Affiliation(s)
- Tracy Onega
- Department of Population Health Sciences, and the Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA.
- Huntsman Cancer Institute, RS 4725, 2000 Circle of Hope Dr., Salt Lake City, UT, 84018, USA.
| | - Weiwei Zhu
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Karla Kerlikowske
- Departments of Medicine and Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
- General Internal Medicine Section, Department of Veterans Affairs, University of California, San Francisco, CA, USA
| | - Diana L Miglioretti
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
- Department of Public Health Sciences, University of California, Davis, CA, USA
| | - Christoph I Lee
- Department of Radiology, University of Washington, and Seattle Cancer Care Alliance, Seattle, WA, USA
| | - Louise M Henderson
- Department of Radiology, University of North Carolina, Chapel Hill, NC, USA
| | - Anna N A Tosteson
- The Dartmouth Institute for Health Policy and Clinical Practice and Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - Karen J Wernli
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Roberta diFlorio
- Department of Radiology, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
| | - Donald L Weaver
- Department of Pathology, University of Vermont, Burlington, VT, USA
| | - Diana S M Buist
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
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The Other Side of the Coin: May Androgens Have a Role in Breast Cancer Risk? Int J Mol Sci 2021; 23:ijms23010424. [PMID: 35008851 PMCID: PMC8745651 DOI: 10.3390/ijms23010424] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 12/24/2021] [Accepted: 12/29/2021] [Indexed: 12/15/2022] Open
Abstract
Breast cancer prevention is a major challenge worldwide. During the last few years, efforts have been made to identify molecular breast tissue factors that could be linked to an increased risk of developing the disease in healthy women. In this concern, steroid hormones and their receptors are key players since they are deeply involved in the growth, development and lifetime changes of the mammary gland and play a crucial role in breast cancer development and progression. In particular, androgens, by binding their own receptor, seem to exert a dichotomous effect, as they reduce cell proliferation in estrogen receptor α positive (ERα+) breast cancers while promoting tumour growth in the ERα negative ones. Despite this intricate role in cancer, very little is known about the impact of androgen receptor (AR)-mediated signalling on normal breast tissue and its correlation to breast cancer risk factors. Through an accurate collection of experimental and epidemiological studies, this review aims to elucidate whether androgens might influence the susceptibility for breast cancer. Moreover, the possibility to exploit the AR as a useful marker to predict the disease will be also evaluated.
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31
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Yaghjyan L, Smotherman C, Heine J, Colditz GA, Rosner B, Tamimi RM. Associations of Oral Contraceptives with Mammographic Breast Density in Premenopausal Women. Cancer Epidemiol Biomarkers Prev 2021; 31:436-442. [PMID: 34862209 DOI: 10.1158/1055-9965.epi-21-0853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 09/15/2021] [Accepted: 11/30/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND We investigated the associations of oral contraceptives (OC) with percent breast density (PD), absolute dense area (DA), nondense area (NDA), and a novel image intensity variation (V) measure in premenopausal women. METHODS This study included 1,233 controls from a nested case-control study within Nurses' Health Study II cohort. Information on OCs was collected in 1989 and updated biennially. OC use was defined from the questionnaire closest to the mammogram date. PD, DA, and NDA were measured from digitized film mammograms using a computer-assisted thresholding technique; the V measure was obtained with a previously developed algorithm measuring the SD of pixel values in the eroded breast region. Generalized linear regression was used to assess associations between OCs and density measures (square root-transformed PD, DA, and NDA, and -untransformed V). RESULTS OC use was not associated with PD [current vs. never: β = -0.06; 95% confidence interval (CI), -0.37-0.24; past vs. never: β = 0.10; 95% CI, -0.09-0.29], DA (current vs. never: β = -0.20; 95% CI -0.59-0.18; past vs. never: β = 0.13; 95% CI, -0.12-0.39), and NDA (current vs. never: β = -0.19; 95% CI, -0.56-0.18; past vs. never: β = -0.01; 95% CI, -0.28-0.25). Women with younger age at initiation had significantly greater V-measure (<20 years vs. never: β = 26.88; 95% CI, 3.18-50.58; 20-24 years vs. never: β = 20.23; 95% CI, -4.24-44.71; 25-29 years vs. never: β = 2.61; 95% CI -29.00-34.23; ≥30 years vs. never: β = 0.28; 95% CI, -34.16-34.72, P trend = 0.03). CONCLUSIONS Our findings suggest that an earlier age at first OC use was associated with significantly greater V. IMPACT These findings could guide decisions about the age for OC initiation.
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Affiliation(s)
- Lusine Yaghjyan
- Department of Epidemiology, University of Florida, College of Public Health and Health Professions and College of Medicine, Gainesville, Florida.
| | - Carmen Smotherman
- Department of Epidemiology, University of Florida, College of Public Health and Health Professions and College of Medicine, Gainesville, Florida
| | - John Heine
- Cancer Epidemiology Department, Moffitt Cancer Center & Research Institute, Tampa, Florida
| | - Graham A Colditz
- Department of Surgery, Washington University in St. Louis School of Medicine, St. Louis, Missouri.,Institute for Public Health, Washington University in St. Louis, St. Louis, Missouri
| | - Bernard Rosner
- Channing Division of Network Medicine, Department of Medicine Research, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Rulla M Tamimi
- Department of Population Health Sciences, Weill Cornell Medicine, New York, New York
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32
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Bodelon C, Mullooly M, Pfeiffer RM, Fan S, Abubakar M, Lenz P, Vacek PM, Weaver DL, Herschorn SD, Johnson JM, Sprague BL, Hewitt S, Shepherd J, Malkov S, Keely PJ, Eliceiri KW, Sherman ME, Conklin MW, Gierach GL. Mammary collagen architecture and its association with mammographic density and lesion severity among women undergoing image-guided breast biopsy. Breast Cancer Res 2021; 23:105. [PMID: 34753492 PMCID: PMC8579610 DOI: 10.1186/s13058-021-01482-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 10/26/2021] [Indexed: 12/20/2022] Open
Abstract
Background Elevated mammographic breast density is a strong breast cancer risk factor with poorly understood etiology. Increased deposition of collagen, one of the main fibrous proteins present in breast stroma, has been associated with increased mammographic density. Collagen fiber architecture has been linked to poor outcomes in breast cancer. However, relationships of quantitative collagen fiber features assessed in diagnostic biopsies with mammographic density and lesion severity are not well-established. Methods Clinically indicated breast biopsies from 65 in situ or invasive breast cancer cases and 73 frequency matched-controls with a benign biopsy result were used to measure collagen fiber features (length, straightness, width, alignment, orientation and density (fibers/µm2)) using second harmonic generation microscopy in up to three regions of interest (ROIs) per biopsy: normal, benign breast disease, and cancer. Local and global mammographic density volumes were quantified in the ipsilateral breast in pre-biopsy full-field digital mammograms. Associations of fibrillar collagen features with mammographic density and severity of biopsy diagnosis were evaluated using generalized estimating equation models with an independent correlation structure to account for multiple ROIs within each biopsy section. Results Collagen fiber density was positively associated with the proportion of stroma on the biopsy slide (p < 0.001) and with local percent mammographic density volume at both the biopsy target (p = 0.035) and within a 2 mm perilesional ring (p = 0.02), but not with global mammographic density measures. As severity of the breast biopsy diagnosis increased at the ROI level, collagen fibers tended to be less dense, shorter, straighter, thinner, and more aligned with one another (p < 0.05). Conclusions Collagen fiber density was positively associated with local, but not global, mammographic density, suggesting that collagen microarchitecture may not translate into macroscopic mammographic features. However, collagen fiber features may be markers of cancer risk and/or progression among women referred for biopsy based on abnormal breast imaging. Supplementary Information The online version contains supplementary material available at 10.1186/s13058-021-01482-z.
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Affiliation(s)
- Clara Bodelon
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Dr., Rm 7-E238, Bethesda, MD, 20892, USA.
| | - Maeve Mullooly
- Division of Population Health Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Ruth M Pfeiffer
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Dr., Rm 7-E238, Bethesda, MD, 20892, USA
| | - Shaoqi Fan
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Dr., Rm 7-E238, Bethesda, MD, 20892, USA
| | - Mustapha Abubakar
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Dr., Rm 7-E238, Bethesda, MD, 20892, USA
| | - Petra Lenz
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Dr., Rm 7-E238, Bethesda, MD, 20892, USA
| | - Pamela M Vacek
- University of Vermont College of Medicine and Vermont Cancer Center, Burlington, VT, USA
| | - Donald L Weaver
- University of Vermont College of Medicine and Vermont Cancer Center, Burlington, VT, USA
| | - Sally D Herschorn
- University of Vermont College of Medicine and Vermont Cancer Center, Burlington, VT, USA
| | - Jason M Johnson
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Brian L Sprague
- University of Vermont College of Medicine and Vermont Cancer Center, Burlington, VT, USA
| | - Stephen Hewitt
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Dr., Rm 7-E238, Bethesda, MD, 20892, USA
| | - John Shepherd
- University of Hawaii Cancer Center, Honolulu, HI, USA
| | | | - Patricia J Keely
- Department of Cell and Regenerative Biology and Carbone Cancer Center, School of Medicine and Public Health, University of Wisconsin-Madison, 1111 Highland Ave., WIMR II Rm. 4528, Madison, WI, 53705, USA
| | - Kevin W Eliceiri
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, USA
| | | | - Matthew W Conklin
- Department of Cell and Regenerative Biology and Carbone Cancer Center, School of Medicine and Public Health, University of Wisconsin-Madison, 1111 Highland Ave., WIMR II Rm. 4528, Madison, WI, 53705, USA.
| | - Gretchen L Gierach
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Dr., Rm 7-E238, Bethesda, MD, 20892, USA
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Elwakeel E, Weigert A. Breast Cancer CAFs: Spectrum of Phenotypes and Promising Targeting Avenues. Int J Mol Sci 2021; 22:11636. [PMID: 34769066 PMCID: PMC8583860 DOI: 10.3390/ijms222111636] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 10/22/2021] [Accepted: 10/22/2021] [Indexed: 01/03/2023] Open
Abstract
Activationof the tumor-associated stroma to support tumor growth is a common feature observed in different cancer entities. This principle is exemplified by cancer-associated fibroblasts (CAFs), which are educated by the tumor to shape its development across all stages. CAFs can alter the extracellular matrix (ECM) and secrete a variety of different molecules. In that manner they have the capability to affect activation, survival, proliferation, and migration of other stromal cells and cancer cell themselves. Alteration of the ECM, desmoplasia, is a common feature of breast cancer, indicating a prominent role for CAFs in shaping tumor development in the mammary gland. In this review, we summarize the multiple roles CAFs play in mammary carcinoma. We discuss experimental and clinical strategies to interfere with CAFs function in breast cancer. Moreover, we highlight the issues arising from CAFs heterogeneity and the need for further research to identify CAFs subpopulation(s) that can be targeted to improve breast cancer therapy.
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Affiliation(s)
- Eiman Elwakeel
- Institute of Biochemistry I, Faculty of Medicine, Goethe-University Frankfurt, 60590 Frankfurt, Germany;
| | - Andreas Weigert
- Institute of Biochemistry I, Faculty of Medicine, Goethe-University Frankfurt, 60590 Frankfurt, Germany;
- Frankfurt Cancer Institute, Goethe-University Frankfurt, 60596 Frankfurt, Germany
- German Cancer Consortium (DKTK), Partner Site Frankfurt, 60590 Frankfurt, Germany
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34
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His M, Lajous M, Gómez-Flores-Ramos L, Monge A, Dossus L, Viallon V, Gicquiau A, Biessy C, Gunter MJ, Rinaldi S. Biomarkers of mammographic density in premenopausal women. Breast Cancer Res 2021; 23:75. [PMID: 34301304 PMCID: PMC8305592 DOI: 10.1186/s13058-021-01454-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 07/12/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND While mammographic density is one of the strongest risk factors for breast cancer, little is known about its determinants, especially in young women. We applied targeted metabolomics to identify circulating metabolites specifically associated with mammographic density in premenopausal women. Then, we aimed to identify potential correlates of these biomarkers to guide future research on potential modifiable determinants of mammographic density. METHODS A total of 132 metabolites (acylcarnitines, amino acids, biogenic amines, glycerophospholipids, sphingolipids, hexose) were measured by tandem liquid chromatography/mass spectrometry in plasma samples from 573 premenopausal participants in the Mexican Teachers' Cohort. Associations between metabolites and percent mammographic density were assessed using linear regression models, adjusting for breast cancer risk factors and accounting for multiple tests. Mean concentrations of metabolites associated with percent mammographic density were estimated across levels of several lifestyle and metabolic factors. RESULTS Sphingomyelin (SM) C16:1 and phosphatidylcholine (PC) ae C30:2 were inversely associated with percent mammographic density after correction for multiple tests. Linear trends with percent mammographic density were observed for SM C16:1 only in women with body mass index (BMI) below the median (27.4) and for PC ae C30:2 in women with a BMI over the median. SM C16:1 and PC ae C30:2 concentrations were positively associated with cholesterol (total and HDL) and inversely associated with number of metabolic syndrome components. CONCLUSIONS We identified new biomarkers associated with mammographic density in young women. The association of these biomarkers with mammographic density and metabolic parameters may provide new perspectives to support future preventive actions for breast cancer.
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Affiliation(s)
- Mathilde His
- International Agency for Research on Cancer (IARC/WHO), Nutrition and Metabolism Branch, CEDEX 08, 69372, Lyon, France
| | - Martin Lajous
- Center for Research on Population Health, National Institute of Public Health, 62100, Cuernavaca, México.
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA.
| | - Liliana Gómez-Flores-Ramos
- Center for Research on Population Health, National Institute of Public Health, 62100, Cuernavaca, México
- Cátedras-CONACYT, Mexico City, Mexico
| | - Adriana Monge
- Center for Research on Population Health, National Institute of Public Health, 62100, Cuernavaca, México
| | - Laure Dossus
- International Agency for Research on Cancer (IARC/WHO), Nutrition and Metabolism Branch, CEDEX 08, 69372, Lyon, France
| | - Vivian Viallon
- International Agency for Research on Cancer (IARC/WHO), Nutrition and Metabolism Branch, CEDEX 08, 69372, Lyon, France
| | - Audrey Gicquiau
- International Agency for Research on Cancer (IARC/WHO), Nutrition and Metabolism Branch, CEDEX 08, 69372, Lyon, France
| | - Carine Biessy
- International Agency for Research on Cancer (IARC/WHO), Nutrition and Metabolism Branch, CEDEX 08, 69372, Lyon, France
| | - Marc J Gunter
- International Agency for Research on Cancer (IARC/WHO), Nutrition and Metabolism Branch, CEDEX 08, 69372, Lyon, France
| | - Sabina Rinaldi
- International Agency for Research on Cancer (IARC/WHO), Nutrition and Metabolism Branch, CEDEX 08, 69372, Lyon, France
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Silver BB, Zhang SX, Rabie EM, Nelson CM. Substratum stiffness tunes membrane voltage in mammary epithelial cells. J Cell Sci 2021; 134:jcs256313. [PMID: 34313313 PMCID: PMC8310660 DOI: 10.1242/jcs.256313] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 06/02/2021] [Indexed: 11/20/2022] Open
Abstract
Membrane voltage (Vm) plays a critical role in the regulation of several cellular behaviors, including proliferation, apoptosis and phenotypic plasticity. Many of these behaviors are affected by the stiffness of the underlying extracellular matrix, but the connections between Vm and the mechanical properties of the microenvironment are unclear. Here, we investigated the relationship between matrix stiffness and Vm by culturing mammary epithelial cells on synthetic substrata, the stiffnesses of which mimicked those of the normal mammary gland and breast tumors. Although proliferation is associated with depolarization, we surprisingly observed that cells are hyperpolarized when cultured on stiff substrata, a microenvironmental condition that enhances proliferation. Accordingly, we found that Vm becomes depolarized as stiffness decreases, in a manner dependent on intracellular Ca2+. Furthermore, inhibiting Ca2+-gated Cl- currents attenuates the effects of substratum stiffness on Vm. Specifically, we uncovered a role for cystic fibrosis transmembrane conductance regulator (CFTR) in the regulation of Vm by substratum stiffness. Taken together, these results suggest a novel role for CFTR and membrane voltage in the response of mammary epithelial cells to their mechanical microenvironment.
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Affiliation(s)
- Brian B. Silver
- Department of Molecular Biology, Princeton University, Princeton, NJ 08544, USA
| | - Sherry X. Zhang
- Department of Chemical & Biological Engineering, Princeton University, Princeton, NJ 08544, USA
| | - Emann M. Rabie
- Department of Molecular Biology, Princeton University, Princeton, NJ 08544, USA
- Graduate School of Biomedical Sciences, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ 08854, USA
| | - Celeste M. Nelson
- Department of Molecular Biology, Princeton University, Princeton, NJ 08544, USA
- Department of Chemical & Biological Engineering, Princeton University, Princeton, NJ 08544, USA
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36
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Norman MDA, Ferreira SA, Jowett GM, Bozec L, Gentleman E. Measuring the elastic modulus of soft culture surfaces and three-dimensional hydrogels using atomic force microscopy. Nat Protoc 2021; 16:2418-2449. [PMID: 33854255 PMCID: PMC7615740 DOI: 10.1038/s41596-021-00495-4] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 01/05/2021] [Indexed: 02/02/2023]
Abstract
Growing interest in exploring mechanically mediated biological phenomena has resulted in cell culture substrates and 3D matrices with variable stiffnesses becoming standard tools in biology labs. However, correlating stiffness with biological outcomes and comparing results between research groups is hampered by variability in the methods used to determine Young's (elastic) modulus, E, and by the inaccessibility of relevant mechanical engineering protocols to most biology labs. Here, we describe a protocol for measuring E of soft 2D surfaces and 3D hydrogels using atomic force microscopy (AFM) force spectroscopy. We provide instructions for preparing hydrogels with and without encapsulated live cells, and provide a method for mounting samples within the AFM. We also provide details on how to calibrate the instrument, and give step-by-step instructions for collecting force-displacement curves in both manual and automatic modes (stiffness mapping). We then provide details on how to apply either the Hertz or the Oliver-Pharr model to calculate E, and give additional instructions to aid the user in plotting data distributions and carrying out statistical analyses. We also provide instructions for inferring differential matrix remodeling activity in hydrogels containing encapsulated single cells or organoids. Our protocol is suitable for probing a range of synthetic and naturally derived polymeric hydrogels such as polyethylene glycol, polyacrylamide, hyaluronic acid, collagen, or Matrigel. Although sample preparation timings will vary, a user with introductory training to AFM will be able to use this protocol to characterize the mechanical properties of two to six soft surfaces or 3D hydrogels in a single day.
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Affiliation(s)
- Michael D. A. Norman
- Centre for Craniofacial and Regenerative Biology, King’s College London, London SE1 9RT, UK
| | - Silvia A. Ferreira
- Centre for Craniofacial and Regenerative Biology, King’s College London, London SE1 9RT, UK
| | - Geraldine M. Jowett
- Centre for Craniofacial and Regenerative Biology, King’s College London, London SE1 9RT, UK
| | - Laurent Bozec
- Faculty of Dentistry, University of Toronto, Toronto, ON M5G 1G6, Canada
| | - Eileen Gentleman
- Centre for Craniofacial and Regenerative Biology, King’s College London, London SE1 9RT, UK
- London Centre for Nanotechnology, London WC1H 0AH, UK
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Chen W, Park S, Patel C, Bai Y, Henary K, Raha A, Mohammadi S, You L, Geng F. The migration of metastatic breast cancer cells is regulated by matrix stiffness via YAP signalling. Heliyon 2021; 7:e06252. [PMID: 33659755 PMCID: PMC7895759 DOI: 10.1016/j.heliyon.2021.e06252] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 12/06/2020] [Accepted: 02/07/2021] [Indexed: 11/20/2022] Open
Abstract
Matrix stiffness is a driver of breast cancer progression and mechanosensitive transcriptional activator YAP plays an important role in this process. However, the interplay between breast cancer and matrix stiffness, and the significance of this interplay remained largely unknown. Here, we showed an increase in YAP nuclear localization and a higher proliferation rate in both highly metastatic MDA-MB-231 cells and the non-metastatic counterpart MCF-7 cells when they were exposed to the stiff matrix. However, in response to the stiff matrix highly metastatic MDA-MB-231 cells instead of MCF-7 cells exhibited upregulated mobility, which was shown to be YAP-dependent. Consistently, MDA-MB-231 cells exhibited different focal adhesion dynamics from MCF-7 cells in response to matrix stiffness. These results suggested a YAP-dependent mechanism through which matrix stiffness regulates the migratory potential of metastatic breast cancer cells.
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Affiliation(s)
- Wei Chen
- Department of Mechanical Engineering, McMaster University, Hamilton, ON L8S 0A3, Canada
| | - Shihyun Park
- Faculty of Health Sciences, McMaster University, Hamilton, ON L8S 4K1, Canada
| | - Chrishma Patel
- Faculty of Health Sciences, McMaster University, Hamilton, ON L8S 4K1, Canada
| | - Yuxin Bai
- Faculty of Health Sciences, McMaster University, Hamilton, ON L8S 4K1, Canada
| | - Karim Henary
- Department of Mechanical Engineering, McMaster University, Hamilton, ON L8S 0A3, Canada
| | - Arjun Raha
- Department of Mechanical Engineering, McMaster University, Hamilton, ON L8S 0A3, Canada
| | - Saeed Mohammadi
- W Booth School of Engineering Practice and Technology, McMaster University, Hamilton, ON L8S 0A3, Canada
| | - Lidan You
- Department of Mechanical & Industrial Engineering, University of Toronto, Toronto, ON M5S 3G8, Canada
| | - Fei Geng
- Department of Mechanical Engineering, McMaster University, Hamilton, ON L8S 0A3, Canada
- W Booth School of Engineering Practice and Technology, McMaster University, Hamilton, ON L8S 0A3, Canada
- Corresponding author.
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Mammographic density as an image-based biomarker of therapy response in neoadjuvant-treated breast cancer patients. Cancer Causes Control 2020; 32:251-260. [PMID: 33377172 PMCID: PMC7870759 DOI: 10.1007/s10552-020-01379-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 12/04/2020] [Indexed: 12/24/2022]
Abstract
Purpose Personalized cancer treatment requires predictive biomarkers, including image-based biomarkers. Breast cancer (BC) patients receiving neoadjuvant chemotherapy (NACT) are in a clinically vulnerable situation with the tumor present. This study investigated whether mammographic density (MD), assessed pre-NACT, is predictive of pathological complete response (pCR). Methods A total of 495 BC patients receiving NACT in Sweden 2005–2019 were included, merged from two different cohorts. Cohort 1 was retrospectively collected (n = 295) and cohort 2 was prospectively collected (n = 200). Mammograms were scored for MD pre-NACT according to the Breast Imaging-Reporting and Data System (BI-RADS), 5th Edition. The association between MD and accomplishing pCR post-NACT was analyzed using logistic regression models—for the whole cohort, stratified by menopausal status, and in different St. Gallen surrogate subtypes. Results In comparison to patients with low MD (BI-RADS a), the multivariable-adjusted odds ratio (OR) of accomplishing pCR following NACT was on a descending scale: 0.62 (95% confidence interval (CI) 0.24–1.57), 0.38 (95% CI 0.14–1.02), and 0.32 (95% CI 0.09–1.08) for BI-RADS b, c, and d, respectively. For premenopausal patients selectively, the corresponding point estimates were lower, although wider CIs: 0.31 (95% CI 0.06–1.62), 0.24 (95% CI 0.04–1.27), and 0.13 (95% CI 0.02–0.88). Subgroup analyses based on BC subtypes resulted in imprecise estimates, i.e., wide CIs. Conclusions It seemed as though patients with higher MD at baseline were less likely to reach pCR after NACT—a finding more pronounced in premenopausal women. Larger multicenter studies are needed to enable analyses and interpretation for different BC subtypes. Supplementary Information
The online version of this article (10.1007/s10552-020-01379-w) contains supplementary material, which is available to authorized users.
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Kim EY, Chang Y, Ahn J, Yun JS, Park YL, Park CH, Shin H, Ryu S. Mammographic breast density, its changes, and breast cancer risk in premenopausal and postmenopausal women. Cancer 2020; 126:4687-4696. [PMID: 32767699 DOI: 10.1002/cncr.33138] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 07/05/2020] [Accepted: 07/06/2020] [Indexed: 01/06/2023]
Abstract
BACKGROUND The risk of breast cancer related to changes in breast density over time, including its regression and persistence, remains controversial. The authors investigated the relationship between breast density and its changes over time with the development of breast cancer in premenopausal and postmenopausal women. METHODS The current cohort study included 74,249 middle-aged Korean women (aged ≥35 years) who were free of breast cancer at baseline and who underwent repeated screening mammograms. Mammographic breast density was categorized according to the American College of Radiology Breast Imaging Reporting and Data System (BI-RADS). A dense breast was defined as heterogeneously dense or extremely dense, and changes in dense breasts between baseline and subsequent follow-up were classified as none, developed, regressed, or persistent dense breast. RESULTS During a median follow-up of 6.1 years (interquartile range, 4.1-8.8 years), a total of 803 incident breast cancers were identified. Baseline breast density was found to be positively associated with incident breast cancer in a dose-response manner, and this association did not significantly differ by menopausal status. The multivariable-adjusted hazard ratios (HRs) for breast cancer comparing "heterogeneously dense" and "extremely dense" categories with the nondense category were 1.96 (95% confidence interval [95% CI], 1.40-2.75) and 2.86 (95% CI, 2.04-4.01), respectively. With respect to changes in dense breasts over time, multivariable-adjusted HRs for breast cancer comparing persistent dense breast with none were 2.37 (95% CI, 1.34-4.21) in premenopausal women and 3.61 (95% CI, 1.78-7.30) in postmenopausal women. CONCLUSIONS Both baseline dense breasts and their persistence over time were found to be strongly associated with an increased risk of incident breast cancer in premenopausal and postmenopausal women. LAY SUMMARY Both baseline breast density and its changes over time were found to be independently associated with the risk of breast cancer in both premenopausal and postmenopausal women. The risk of incident breast cancer increased in women with persistent dense breasts, whereas the breast cancer risk decreased as dense breasts regressed. The findings of the current study support that both dense breasts at baseline and their persistence over time are independent risk factors for developing breast cancer.
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Affiliation(s)
- Eun Young Kim
- Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Yoosoo Chang
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.,Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.,Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Republic of Korea
| | - Jiin Ahn
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Ji-Sup Yun
- Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Yong Lai Park
- Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Chan Heun Park
- Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hocheol Shin
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.,Department of Family Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Seungho Ryu
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.,Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.,Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Republic of Korea
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Menopausal Transition, Body Mass Index, and Prevalence of Mammographic Dense Breasts in Middle-Aged Women. J Clin Med 2020; 9:jcm9082434. [PMID: 32751482 PMCID: PMC7465213 DOI: 10.3390/jcm9082434] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 07/24/2020] [Accepted: 07/28/2020] [Indexed: 12/12/2022] Open
Abstract
The interrelationship between menopausal stage, excessive adiposity and dense breasts remains unclear. We aimed to investigate the relationship between menopausal stage and dense-breast prevalence in midlife women while considering a possible effect modification of being overweight. The present cross-sectional study comprised 82,677 Korean women, aged 35–65 years, who attended a screening exam. Menopausal stages were categorized based on the Stages of Reproductive Aging Workshop (STRAW + 10) criteria. Mammographic breast density was categorized according to Breast Imaging Reporting and Data System (BI-RADS). Dense breasts were defined as BI-RADS Breast Density category D (extremely dense). The prevalence of dense breasts decreased as menopausal stage increased (p-trend < 0.001), and this pattern was pronounced in overweight women than non-overweight women (p-interaction = 0.016). Compared with pre-menopause, the multivariable-adjusted prevalence ratios (and 95% confidence intervals) for dense breasts were 0.98 (0.96–1.00) in early transition, 0.89 (0.86–0.92) in late transition, and 0.55 (0.52–0.59) in post-menopause, among non-overweight women, while corresponding prevalence ratios were 0.92 (0.87–0.98), 0.83 (0.77–0.90) and 0.36 (0.31–0.41) among overweight women. The prevalence of dense breasts was inversely associated with increasing menopausal stages and significantly decreased from the late menopausal transition, with stronger declines among overweight women.
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Mammographic density changes during neoadjuvant breast cancer treatment: NeoDense, a prospective study in Sweden. Breast 2020; 53:33-41. [PMID: 32563178 PMCID: PMC7375568 DOI: 10.1016/j.breast.2020.05.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 05/26/2020] [Accepted: 05/30/2020] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES To assess if mammographic density (MD) changes during neoadjuvant breast cancer treatment and is predictive of a pathological complete response (pCR). METHODS We prospectively included 200 breast cancer patients assigned to neoadjuvant chemotherapy (NACT) in the NeoDense study (2014-2019). Raw data mammograms were used to assess MD with a fully automated volumetric method and radiologists categorized MD using the Breast Imaging-Reporting and Data System (BI-RADS), 5th Edition. Logistic regression was used to calculate odds ratios (OR) for pCR comparing BI-RADS categories c vs. a, b, and d as well as with a 0.5% change in percent dense volume adjusting for baseline characteristics. RESULTS The overall median age was 53.1 years, and 48% of study participants were premenopausal pre-NACT. A total of 23% (N = 45) of the patients accomplished pCR following NACT. Patients with very dense breasts (BI-RADS d) were more likely to have a positive axillary lymph node status at diagnosis: 89% of the patients with very dense breasts compared to 72% in the entire cohort. A total of 74% of patients decreased their absolute dense volume during NACT. The likelihood of accomplishing pCR following NACT was independent of volumetric MD at diagnosis and change in volumetric MD during treatment. No trend was observed between decreasing density according to BI-RADS and the likelihood of accomplishing pCR following NACT. CONCLUSIONS The majority of patients decreased their MD during NACT. We found no evidence of MD as a predictive marker of pCR in the neoadjuvant setting.
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Han Y, Berkey CS, Herman CR, Appleton CM, Alimujiang A, Colditz GA, Toriola AT. Adiposity Change Over the Life Course and Mammographic Breast Density in Postmenopausal Women. Cancer Prev Res (Phila) 2020; 13:475-482. [PMID: 32102947 PMCID: PMC8210631 DOI: 10.1158/1940-6207.capr-19-0549] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 01/21/2020] [Accepted: 02/19/2020] [Indexed: 11/16/2022]
Abstract
Mammographic breast density is a strong risk factor for breast cancer. We comprehensively investigated the associations of body mass index (BMI) change from ages 10, 18, and 30 to age at mammogram with mammographic breast density in postmenopausal women. We used multivariable linear regression models, adjusted for confounders, to investigate the associations of BMI change with volumetric percent density, dense volume, and nondense volume, assessed using Volpara in 367 women. At the time of mammogram, the mean age was 57.9 years. Compared with women who had a BMI gain of 0.1-5 kg/m2 from age 10, women who had a BMI gain of 5.1-10 kg/m2 had a 24.4% decrease [95% confidence interval (CI), 6.0%-39.2%] in volumetric percent density; women who had a BMI gain of 10.1-15 kg/m2 had a 46.1% decrease (95% CI, 33.0%-56.7%) in volumetric percent density; and women who had a BMI gain of >15 kg/m2 had a 56.5% decrease (95% CI, 46.0%-65.0%) in volumetric percent density. Similar, but slightly attenuated associations were observed for BMI gain from ages 18 and 30 to age at mammogram and volumetric percent density. BMI gain over the life course was positively associated with nondense volume, but not dense volume. We observed strong associations between BMI change over the life course and mammographic breast density. The inverse associations between early-life adiposity change and volumetric percent density suggest that childhood adiposity may confer long-term protection against postmenopausal breast cancer via its effect of mammographic breast density.
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Affiliation(s)
- Yunan Han
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
- Department of Breast Surgery, First Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Catherine S Berkey
- Channing Division of Network Medicine, Department of Medicine, Brigham & Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Cheryl R Herman
- Alvin J. Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri
| | | | - Aliya Alimujiang
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Graham A Colditz
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
- Alvin J. Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri
| | - Adetunji T Toriola
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri.
- Alvin J. Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri
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Lee JS, Oh M. Breast Density of Mammography is Correlated with Reproductive Risk Factors Regardless of Menopausal Status: A Cross-Sectional Study of the Korean National Screening Program. Asian Pac J Cancer Prev 2020; 21:1011-1018. [PMID: 32334463 PMCID: PMC7445990 DOI: 10.31557/apjcp.2020.21.4.1011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE To clarify the limitations of mammography screening for women with dense breasts, we examined breast density and its effects on screening results. PATIENTS AND METHODS We performed a cross-sectional, observational study on women who underwent mammography. Data from the National Cancer Screening Program(NCSP) from 2009 to 2013 were used. The study population consisted of participants with high breast density. We used a logistic regression analysis to evaluate the relationships between breast density and reproductive factors and screening results according to menopause status. RESULTS High breast density was reported for 57.5% of all participants (3,417,319 participants). Screening results indicated breast density of <25%, 25-50%, 51-75%, and ≥76% for 16.4%, 26.3%, 37.8%, and 19.5%, respectively, of participants. According to the screening results, high breast density was correlated with high deferment and recall rates. Reproductive factors, especially parity, breastfeeding, and use of oral contraceptives, had consistent effects on screening results of premenopausal and postmenopausal women. Regardless of menopausal status, age, early onset of menarche (15 years or younger), fewer live births (≤1 birth), and previous benign breast disease were correlated with increased breast density. In postmenopausal women, early-onset menopause and longer-term hormone replacement therapy (≥2 years) also independently increased breast density. CONCLUSION Breast density influenced screening results, which could increase the rate of recall. Breast density was also influenced by reproductive factors, with patterns similar to those of breast cancer risk, regardless of menopausal status. We need to identify high-risk women with high density who would probably benefit from supplemental breast cancer screening.
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Affiliation(s)
- Jung Sun Lee
- Department of Surgery, Haeundae Paik Hospital, College of Medicine, Inje University, Busan, Korea
| | - Minkyung Oh
- Department of Pharmacology, Inje University College of Medicine, Clinical Trial Center, Inje University Busan Paik Hospital, Busan, Korea
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Fernández-Nogueira P, Mancino M, Fuster G, Bragado P, Prats de Puig M, Gascón P, Casado FJ, Carbó N. Breast Mammographic Density: Stromal Implications on Breast Cancer Detection and Therapy. J Clin Med 2020; 9:jcm9030776. [PMID: 32178425 PMCID: PMC7141321 DOI: 10.3390/jcm9030776] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 03/06/2020] [Accepted: 03/09/2020] [Indexed: 12/21/2022] Open
Abstract
Current evidences state clear that both normal development of breast tissue as well as its malignant progression need many-sided local and systemic communications between epithelial cells and stromal components. During development, the stroma, through remarkably regulated contextual signals, affects the fate of the different mammary cells regarding their specification and differentiation. Likewise, the stroma can generate tumour environments that facilitate the neoplastic growth of the breast carcinoma. Mammographic density has been described as a risk factor in the development of breast cancer and is ascribed to modifications in the composition of breast tissue, including both stromal and glandular compartments. Thus, stroma composition can dramatically affect the progression of breast cancer but also its early detection since it is mainly responsible for the differences in mammographic density among individuals. This review highlights both the pathological and biological evidences for a pivotal role of the breast stroma in mammographic density, with particular emphasis on dense and malignant stromas, their clinical meaning and potential therapeutic implications for breast cancer patients.
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Affiliation(s)
- Patricia Fernández-Nogueira
- Institut d’Investigacions Biomèdiques Augustí Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain
- Correspondence: (P.F.-N.); (M.M.)
| | - Mario Mancino
- Department of Biochemistry and Molecular Biomedicine, University of Barcelona, Institute of Biomedicine, University of Barcelona (IBUB), 08028 Barcelona, Spain
- Department of Medicine, University of Barcelona, 08036 Barcelona, Spain
- Correspondence: (P.F.-N.); (M.M.)
| | - Gemma Fuster
- Department of Biochemistry and Molecular Biomedicine, University of Barcelona, Institute of Biomedicine, University of Barcelona (IBUB), 08028 Barcelona, Spain
- Department of Biochemistry & Physiology, School of Pharmacy and Food Sciences, University of Barcelona, 08028 Barcelona, Spain
- Department of Biosciences, Faculty of Sciences and Technology, University of Vic, 08500 Vic, Spain
| | - Paloma Bragado
- Department of Biochemistry and Molecular Biology, Faculty of Pharmacy, Complutense University of Madrid, Health Research Institute of the Hospital Clínico San Carlos, 28040 Madrid, Spain
| | - Miquel Prats de Puig
- Department of Medicine, University of Barcelona, 08036 Barcelona, Spain
- Breast Committee, Hospital El Pilar, Quirón salud Group, 08006 Barcelona, Spain
| | - Pere Gascón
- Department of Biochemistry and Molecular Biomedicine, University of Barcelona, Institute of Biomedicine, University of Barcelona (IBUB), 08028 Barcelona, Spain
- Oncology and Multidisciplinary Knowledge, 08036 Barcelona, Spain
| | - Francisco Javier Casado
- Department of Biochemistry and Molecular Biomedicine, University of Barcelona, Institute of Biomedicine, University of Barcelona (IBUB), 08028 Barcelona, Spain
| | - Neus Carbó
- Department of Biochemistry and Molecular Biomedicine, University of Barcelona, Institute of Biomedicine, University of Barcelona (IBUB), 08028 Barcelona, Spain
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Piersma B, Hayward MK, Weaver VM. Fibrosis and cancer: A strained relationship. Biochim Biophys Acta Rev Cancer 2020; 1873:188356. [PMID: 32147542 DOI: 10.1016/j.bbcan.2020.188356] [Citation(s) in RCA: 292] [Impact Index Per Article: 73.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 03/03/2020] [Accepted: 03/03/2020] [Indexed: 12/18/2022]
Abstract
Tumors are characterized by extracellular matrix (ECM) deposition, remodeling, and cross-linking that drive fibrosis to stiffen the stroma and promote malignancy. The stiffened stroma enhances tumor cell growth, survival and migration and drives a mesenchymal transition. A stiff ECM also induces angiogenesis, hypoxia and compromises anti-tumor immunity. Not surprisingly, tumor aggression and poor patient prognosis correlate with degree of tissue fibrosis and level of stromal stiffness. In this review, we discuss the reciprocal interplay between tumor cells, cancer associated fibroblasts (CAF), immune cells and ECM stiffness in malignant transformation and cancer aggression. We discuss CAF heterogeneity and describe its impact on tumor development and aggression focusing on the role of CAFs in engineering the fibrotic tumor stroma and tuning tumor cell tension and modulating the immune response. To illustrate the role of mechanoreciprocity in tumor evolution we summarize data from breast cancer and pancreatic ductal carcinoma (PDAC) studies, and finish by discussing emerging anti-fibrotic strategies aimed at treating cancer.
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Affiliation(s)
- Bram Piersma
- Department of Surgery and Center for Bioengineering and Tissue Regeneration, University of California, San Francisco (UCSF), USA; Matrix research group, Department of Pathology and Medical Biology, University Medical Center Groningen, University of Groningen, the Netherlands
| | - M K Hayward
- Department of Surgery and Center for Bioengineering and Tissue Regeneration, University of California, San Francisco (UCSF), USA
| | - Valerie M Weaver
- Department of Surgery and Center for Bioengineering and Tissue Regeneration, University of California, San Francisco (UCSF), USA; Departments of Radiation Oncology, Bioengineering and Therapeutic Sciences, Eli and Edythe Broad Center of Regeneration Medicine and Stem Cell Research at UCSF, UCSF Helen Diller Comprehensive Cancer Center, 513 Parnassus Avenue, HSE565, San Francisco, CA 94143-0456, USA.
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The impact of patient characteristics and lifestyle factors on the risk of an ipsilateral event after a primary DCIS: A systematic review. Breast 2020; 50:95-103. [PMID: 32120064 PMCID: PMC7073883 DOI: 10.1016/j.breast.2020.02.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 02/10/2020] [Indexed: 11/21/2022] Open
Abstract
Objective The majority of ‘low-risk’ (grade I/II) Ductal Carcinoma In Situ (DCIS) may not progress to invasive breast cancer during a women’s lifetime. Therefore, the safety of active surveillance versus standard surgical treatment for DCIS is prospectively being evaluated in clinical trials. If proven safe and selectively implemented in clinical practice, a significant group of women with low-risk DCIS may forego surgery and radiotherapy in the future. Identification of modifiable and non-modifiable risk factors associated with prognosis after a primary DCIS would also enhance our care of women with low-risk DCIS. Methods To identify modifiable and non-modifiable risk factors for subsequent breast events after DCIS, we performed a systematic literature search in PUBMED, EMBASE and Scopus. Results Six out of the 3870 articles retrieved were included for final data extraction. These six studies included a total of 4950 patients with primary DCIS and 640 recorded subsequent breast events. There was moderate evidence for an association of a family history of breast cancer, premenopausal status, high BMI, and high breast density with a subsequent breast cancer or further DCIS. Conclusion There is a limited number of recent studies published on the impact of modifiable and non-modifiable risk factors on subsequent events after DCIS. The available evidence is insufficient to identify potential targets for risk reduction strategies, reflecting the relatively small numbers and the lack of long-term follow-up in DCIS, a low-event condition. Need for risk management strategies for untreated DCIS patients. Limited evidence for association between lifestyle factors and prognosis after DCIS. Positive family history, premenopausal status, high breast density associated with prognosis.
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Nakajima E, Iwase T, Miyagi Y, Fujita T, Ikeda N, Ishikawa T, Iwata H. Association of Parity and Infant Feeding Method with Breast Density on Mammography. Acad Radiol 2020; 27:e24-e26. [PMID: 31072765 DOI: 10.1016/j.acra.2019.03.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 03/25/2019] [Accepted: 03/25/2019] [Indexed: 11/17/2022]
Abstract
BACKGROUND Mammography (MMG) is widely used for the screening and diagnosis of breast cancer. High breast density on MMG prevents breast cancer detection. In the present study, we analyzed the effects of parity and infant feeding method on mammographic breast density. MATERIALS AND METHODS Ninety women diagnosed as having breast cancer were analyzed. Using the results of medical questionnaires, subjects were grouped according to their parity and infant feeding method, into either nulliparity or parity, and formula-feeding or breastfeeding. Each group consisted of 30 consecutive women from 45 to 49 years. Nulliparous group was unaffected by either parity or breastfeeding, formula-feeding group was affected by parity but not breastfeeding, and breastfeeding group was affected by both parity and breastfeeding. Mammographic breast density was evaluated on the contralateral and cancer-free breast, and was classified into ≥ 50% dense as high breast density and < 50% dense according to the Boyd quantitative scale. The association of parity and infant feeding method with breast density on MMG was analyzed using the Fisher's exact test. RESULTS Regarding parity, high breast densities were observed in 40% and 17% of nulliparous and parous breasts, respectively. Nulliparous breasts had significantly higher density than parous breasts (p = 0.010). Regarding infant feeding method, 17% of breasts in both the formula-feeding and breastfeeding groups had high densities. Infant feeding method was not associated with mammographic breast density (p = 1.0). CONCLUSION Nulliparity is associated with higher breast density, and parity, regardless of infant feeding method, induces atrophic changes of breast tissue.
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Affiliation(s)
- Eiji Nakajima
- Department of Thoracic Surgery, Tokyo Medical University Ibaraki Medical Center, 3-20-1 Chuo, Ami-machi, Inashiki-gun, Ibaraki 300-0395, Japan; Department of Breast Oncology, Aichi Cancer Center, Aichi, Japan.
| | - Takuji Iwase
- Department of Surgical Oncology, Breast Oncology Center, Cancer Institute Hospital of Japanese Foundation For Cancer Research, Tokyo, Japan
| | - Yumi Miyagi
- Department of Surgical Oncology, Breast Oncology Center, Cancer Institute Hospital of Japanese Foundation For Cancer Research, Tokyo, Japan
| | - Takashi Fujita
- Department of Breast Oncology, Jichi Medical University, Tochigi, Japan
| | - Norihiko Ikeda
- Department of Surgery, Tokyo Medical University, Tokyo, Japan
| | - Takashi Ishikawa
- Department of Breast Surgery, Tokyo Medical University, Tokyo, Japan
| | - Hiroji Iwata
- Department of Breast Oncology, Aichi Cancer Center, Aichi, Japan
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Relationship of Serum Progesterone and Progesterone Metabolites with Mammographic Breast Density and Terminal Ductal Lobular Unit Involution among Women Undergoing Diagnostic Breast Biopsy. J Clin Med 2020; 9:jcm9010245. [PMID: 31963437 PMCID: PMC7019918 DOI: 10.3390/jcm9010245] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 01/06/2020] [Accepted: 01/09/2020] [Indexed: 12/21/2022] Open
Abstract
The association of progesterone/progesterone metabolites with elevated mammographic breast density (MBD) and delayed age-related terminal duct lobular unit (TDLU) involution, strong breast cancer risk factors, has received limited attention. Using a reliable liquid chromatography-tandem mass-spectrometry assay, we quantified serum progesterone/progesterone metabolites and explored cross-sectional relationships with MBD and TDLU involution among women, ages 40–65, undergoing diagnostic breast biopsy. Quantitative MBD measures were estimated in pre-biopsy digital mammograms. TDLU involution was quantified in diagnostic biopsies. Adjusted partial correlations and trends across MBD/TDLU categories were calculated. Pregnenolone was positively associated with percent MBD-area (MBD-A, rho: 0.30; p-trend = 0.01) among premenopausal luteal phase women. Progesterone tended to be positively associated with percent MBD-A among luteal phase (rho: 0.26; p-trend = 0.07) and postmenopausal (rho: 0.17; p-trend = 0.04) women. Consistent with experimental data, implicating an elevated 5α-pregnanes/3α-dihydroprogesterone (5αP/3αHP) metabolite ratio in breast cancer, higher 5αP/3αHP was associated with elevated percent MBD-A among luteal phase (rho: 0.29; p-trend = 0.08), but not postmenopausal women. This exploratory analysis provided some evidence that endogenous progesterone and progesterone metabolites might be correlated with MBD, a strong breast cancer risk factor, in both pre- and postmenopausal women undergoing breast biopsy. Additional studies are needed to understand the role of progesterone/progesterone metabolites in breast tissue composition and breast cancer risk.
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Ferruzzi J, Zhang Y, Roblyer D, Zaman MH. Multi-scale Mechanics of Collagen Networks: Biomechanical Basis of Matrix Remodeling in Cancer. MULTI-SCALE EXTRACELLULAR MATRIX MECHANICS AND MECHANOBIOLOGY 2020. [DOI: 10.1007/978-3-030-20182-1_11] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Jin M, Kim JY, Kim TH, Kang DK, Han SH, Jung Y. Intraoperative Specimen Mammography for Margin Assessment in Breast-Conserving Surgery. J Breast Cancer 2019; 22:635-640. [PMID: 31897336 PMCID: PMC6933039 DOI: 10.4048/jbc.2019.22.e58] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 12/05/2019] [Indexed: 11/30/2022] Open
Abstract
The purpose of this study aimed to determine whether intraoperative specimen mammography is an effective margin assessment method in Asian women. Thus, 182 patients who underwent breast-conserving surgery (BCS) were evaluated. After wide excision, intraoperative specimen mammography was used to assess margin adequacy. The control group comprised 84 patients who underwent BCS and were evaluated for margin of frozen section during surgery. 61.6% patients had dense breasts and 85.7% of dense breasts could margin assess by intraoperative specimen mammography. There were no significant differences in the incidence of extremely close margins (p = 0.421) and second operation (p = 0.252) between both groups. Significant correlations were found between radiological and histological margins (R2 = 0.222, p < 0.05). The frozen section analysis group had longer operative time than the specimen mammography group. The study results show that intraoperative specimen mammography of breast lesions in BCS is useful in identifying margin clearance.
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Affiliation(s)
- Ming Jin
- Department of Surgery, Ajou University Hospital, Suwon, Korea
| | - Ji Young Kim
- Department of Surgery, Ajou University Hospital, Suwon, Korea
| | - Tae Hee Kim
- Department of Radiology, Ajou University Hospital, Suwon, Korea
| | - Doo Kyung Kang
- Department of Radiology, Ajou University Hospital, Suwon, Korea
| | - Se Hwan Han
- Department of Surgery, Ajou University Hospital, Suwon, Korea
| | - Yongsik Jung
- Department of Surgery, Ajou University Hospital, Suwon, Korea
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