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Han M, Chen H, Li J, Zheng X, Zhang X, Tao L, Zhang X, Feng X. Correlation between symptom experience and fear of cancer recurrence in postoperative breast cancer patients undergoing chemotherapy in China: A cross-sectional study. PLoS One 2024; 19:e0308907. [PMID: 39292722 PMCID: PMC11410183 DOI: 10.1371/journal.pone.0308907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 07/22/2024] [Indexed: 09/20/2024] Open
Abstract
OBJECTIVE To analyze the relationship between experience of symptoms (e.g., pain, fatigue) and fear of cancer recurrence (FCR) in Chinese postoperative patients with breast cancer undergoing chemotherapy. METHODS A total of 225 patients were recruited using convenience sampling. The Fear of Cancer Recurrence Inventory-Chinese Version and the Symptom Experience Index were used to collect data. The Mann-Whitney U test, Spearman's correlation, and multivariate analysis were employed to explore the relationships between symptom experience and FCR. RESULTS The total Fear of Cancer Recurrence Inventory score in postoperative patients with breast cancer undergoing chemotherapy was 43.19±22.83, and >64.0% of participants exhibited significant fear of cancer recurrence. The total score of symptom experience was 27.41±16.77, including scores of symptom severity (16.91±8.70) and symptom distress (10.50±8.89). Participants' symptom experience was positively correlated with fear of cancer recurrence (r = 0.353, P < 0.001). Patients with clinically relevant FCR had higher scores for total symptom experience (Z = -3.911, P<0.001), symptom severity (Z = -3.245, P = 0.001), and symptom distress (Z = -4.185, P<0.001), compared to patients without clinically relevant FCR. Symptom experience (b = 0.511, t = 6.474, P<0.001), age (b = -0.591, t = -4.201, P<0.001), and educational level (b = 4.147, t = 3.955, P<0.001) were statistically correlated with FCR, accounting for 27.0% of the variance. Among these variables, symptom experience demonstrated the strongest correlation, with a beta value of 0.371. CONCLUSION This study followed others in identifying a cross-sectional relationship between symptom experience and FCR. Further prospective research is required to better understand the nature of this relationship.
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Affiliation(s)
- Manxia Han
- Division of Head & Neck Tumor Multimodality Treatment, Cancer Center, West China Hospital, Sichuan University/ West China School of Nursing, Sichuan University, Chengdu, Sichuan Province, China
| | - Huaying Chen
- Cancer Day-care Unit, Division of Medical Oncology, Cancer Center, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan Province, China
| | - Jialing Li
- Division of Head & Neck Tumor Multimodality Treatment, Cancer Center, West China Hospital, Sichuan University/ West China School of Nursing, Sichuan University, Chengdu, Sichuan Province, China
| | - Xuemei Zheng
- Division of Head & Neck Tumor Multimodality Treatment, Cancer Center, West China Hospital, Sichuan University/ West China School of Nursing, Sichuan University, Chengdu, Sichuan Province, China
| | - Xue Zhang
- Department of Clinical Trial Center, West China Hospital, Sichuan University/ West China School of Nursing, Sichuan University, Chengdu, Sichuan Province, China
| | - Lin Tao
- Cancer Day-care Unit, Division of Medical Oncology, Cancer Center, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan Province, China
| | - Xiaoxia Zhang
- Division of Head & Neck Tumor Multimodality Treatment, Cancer Center, West China Hospital, Sichuan University/ West China School of Nursing, Sichuan University, Chengdu, Sichuan Province, China
| | - Xianqiong Feng
- Department of Nursing, West China Hospital, Sichuan University/ West China School of Nursing, Sichuan University, Nursing Key Laboratory of Sichuan Province, Chengdu, Sichuan Province, China
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Nasir KS, Badar F, Yusuf MA. Using Telemedicine to Care for Patients with Breast Cancer: A Natural Quasi-Experimental Study. JOURNAL OF CANCER & ALLIED SPECIALTIES 2024; 10:679. [PMID: 39156945 PMCID: PMC11326662 DOI: 10.37029/jcas.v10i2.679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Accepted: 05/30/2024] [Indexed: 08/20/2024]
Abstract
Introduction This investigation assessed the clinical characteristics of patients who received care through telemedicine and the clinical impact telemedicine service had on breast cancer patients in a low-income country. Materials and Methods This natural experimental study assessed the impact of telemedicine service on cancer outcomes among breast cancer patients at Shaukat Khanum Memorial Trust (SKMT), Pakistan, between January 1st, 2018, to December 31st, 2022. The study group (hybrid group) consisted of patients that had both face-to-face and telemedicine appointments, and the control group (physical group) included patients with only face-to-face encounters. Results A total of 3,205 patients were included in the analysis. Among those included in the analysis, 3,188 (99.5 %) were females, and the mean age of the cohort was 48.10 ± 11.94 years. Statistically significant differences were observed between the two groups in age, demographic distribution, disease stage, average number of emergency room visits, mean length of stay in the Intensive care unit, and the final patient status (alive at the end of observation period). However, the binary logistic regression model (forward-LR) suggested that the final patient outcome was related to disease relapse, COVID-19 infection, and age. Conclusion Telemedicine clinics, when conducted in parallel with physical clinics (hybrid setup), are safe and have a clinical impact similar to having just physical encounters among breast cancer patients in a low-income country.
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Affiliation(s)
- Khawaja Shehryar Nasir
- Department of Internal Medicine, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
| | - Farhana Badar
- Department of Cancer Registry and Clinical Data Management, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
| | - Muhammad Aasim Yusuf
- Department of Internal Medicine, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
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Bhattacharjee A, Rajbongshi BK, Vishwakarma GK. jmBIG: enhancing dynamic risk prediction and personalized medicine through joint modeling of longitudinal and survival data in big routinely collected data. BMC Med Res Methodol 2024; 24:172. [PMID: 39107693 PMCID: PMC11301890 DOI: 10.1186/s12874-024-02289-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 07/17/2024] [Indexed: 08/10/2024] Open
Abstract
We have introduced the R package jmBIG to facilitate the analysis of large healthcare datasets and the development of predictive models. This package provides a comprehensive set of tools and functions specifically designed for the joint modelling of longitudinal and survival data in the context of big data analytics. The jmBIG package offers efficient and scalable implementations of joint modelling algorithms, allowing for integrating large-scale healthcare datasets.By utilizing the capabilities of jmBIG, researchers and analysts can effectively handle the challenges associated with big healthcare data, such as high dimensionality and complex relationships between multiple outcomes.With the support of jmBIG, analysts can seamlessly fit Bayesian joint models, generate predictions, and evaluate the performance of the models. The package incorporates cutting-edge methodologies and harnesses the computational capabilities of parallel computing to accelerate the analysis of large-scale healthcare datasets significantly. In summary, jmBIG empowers researchers to gain deeper insights into disease progression and treatment response, fostering evidence-based decision-making and paving the way for personalized healthcare interventions that can positively impact patient outcomes on a larger scale.
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Affiliation(s)
| | - Bhrigu Kumar Rajbongshi
- Department of Mathematics and Computing, Indian Institute of Technology-Dhanbad, Dhanbad, India
| | - Gajendra K Vishwakarma
- Department of Mathematics and Computing, Indian Institute of Technology-Dhanbad, Dhanbad, India
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Savva KV, MacKenzie A, Coombes RC, Zhifang NM, Hanna BG, Peters CJ. An original study assessing biomarker success rate in breast cancer recurrence biomarker research. BMC Med 2024; 22:307. [PMID: 39075505 PMCID: PMC11288100 DOI: 10.1186/s12916-024-03460-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 05/30/2024] [Indexed: 07/31/2024] Open
Abstract
BACKGROUND Breast cancer is the second most common cause of cancer mortality worldwide. Biomarker discovery has led to advances in understanding molecular phenotyping and thus has a great potential for precision management of this diverse disease. Despite increased interest in the biomarker field, only a small number of breast cancer biomarkers are known to be clinically useful. Therefore, it is very important to characterise the success rate of biomarkers in this field and study potential reasons for the deficit. We therefore aim to achieve quantitative characterisation of the biomarker translation gap by tracking the progress of prognostic biomarkers associated with breast cancer recurrence. METHODS An electronic systematic search was conducted in Medline and Embase databases using keywords and mesh headings associated with breast cancer recurrence biomarkers (1940-2023). Abstracts were screened, and primary clinical studies involving breast cancer recurrence biomarkers were selected. Upon identification of relevant literature, we extracted the biomarker name, date of publication and journal name. All analyses were performed using IBM SPSS Statistics and GraphPad prism (La Jolla, California, USA). RESULTS A total of 19,195 articles were identified, from which 4597 articles reported breast cancer biomarkers associated with recurrence. Upon data extraction, 2437 individual biomarkers were identified. Out of these, 23 are currently recommended for clinical use, which corresponds to only 0.94% of all discovered biomarkers. CONCLUSIONS This study characterised for the first time the translational gap in the field of recurrence-related breast cancer biomarkers, indicating that only 0.94% of identified biomarkers were recommended for clinical use. This denotes an evident barrier in the biomarker research field and emphasises the need for a clearer route from biomarker discovery through to implementation.
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Affiliation(s)
- K-V Savva
- Department of Surgery and Cancer, Imperial College London, 10th Floor QEQM Wing, St Mary's Hospital, London, W2 1NY, UK.
| | - A MacKenzie
- Division of Surgery, Department of Surgery and Cancer, Imperial College London, London, UK
| | - R C Coombes
- Department of Surgery and Cancer, Imperial College London, 10th Floor QEQM Wing, St Mary's Hospital, London, W2 1NY, UK
| | - N M Zhifang
- Division of Surgery, Department of Surgery and Cancer, Imperial College London, London, UK
| | - B G Hanna
- Department of Surgery and Cancer, Imperial College London, 10th Floor QEQM Wing, St Mary's Hospital, London, W2 1NY, UK
| | - C J Peters
- Department of Surgery and Cancer, Imperial College London, 10th Floor QEQM Wing, St Mary's Hospital, London, W2 1NY, UK
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Lin D, Thompson CL, Demalis A, Derbes R, Al-Shaar L, Spielfogel ES, Sturgeon KM. Association between pre-diagnosis recreational physical activity and risk of breast cancer recurrence: the California Teachers Study. Cancer Causes Control 2024; 35:1089-1100. [PMID: 38613744 DOI: 10.1007/s10552-024-01870-8] [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: 01/09/2024] [Accepted: 03/10/2024] [Indexed: 04/15/2024]
Abstract
PURPOSE Studies have reported inverse associations of pre-diagnosis recreational physical activity (RPA) level with all-cause and breast cancer (BCa)-specific mortality among BCa patients. However, the association between pre-diagnosis RPA level and BCa recurrence is unclear. We investigated the association between pre-diagnosis RPA level and risk of BCa recurrence in the California Teachers Study (CTS). METHODS Stage I-IIIb BCa survivors (n = 6,479) were followed with median of 7.4 years, and 474 BCa recurrence cases were identified. Long-term (from high school to age at baseline questionnaire, or, age 55 years, whichever was younger) and baseline (past 3 years reported at baseline questionnaire) pre-diagnosis RPA levels were converted to metabolic equivalent of task-hours per week (MET-hrs/wk). Multivariable Cox proportional hazards models estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for risk of BCa recurrence overall and by estrogen receptor (ER)/progesterone receptor (PR) status. RESULTS Long-term RPA was not associated with BCa recurrence risk (ptrend = 0.99). The inverse association between baseline pre-diagnosis RPA level and BCa recurrence risk was marginally significant (≥26.0 vs. <3.4 MET-hrs/wk: HR = 0.79, 95% CI = 0.60-1.03; ptrend = 0.07). However, the association became non-significant after adjusting for post-diagnosis RPA (ptrend = 0.65). An inverse association between baseline pre-diagnosis RPA level and BCa recurrence risk was observed in ER-PR- cases (≥26.0 vs. <3.4 MET-hrs/wk: HR = 0.31, 95% CI = 0.13-0.72; ptrend = 0.04), but not in ER+ or PR+ cases (ptrend = 0.97). CONCLUSIONS Our data indicates that the benefit of baseline RPA on BCa recurrence may differ by tumor characteristics. This information may be particularly important for populations at higher risk of ER-PR- BCa.
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Affiliation(s)
- Dan Lin
- Department of Public Health Sciences, Pennsylvania State University College of Medicine, Penn State Cancer Institute, CH69, 500 University Drive, Hershey, PA, 17033, USA
| | - Cheryl L Thompson
- Department of Public Health Sciences, Pennsylvania State University College of Medicine, Penn State Cancer Institute, CH69, 500 University Drive, Hershey, PA, 17033, USA
| | - Alaina Demalis
- Pennsylvania State University College of Medicine, Hershey, PA, 17033, USA
| | - Rebecca Derbes
- Department of Public Health Sciences, Pennsylvania State University College of Medicine, Penn State Cancer Institute, CH69, 500 University Drive, Hershey, PA, 17033, USA
| | - Laila Al-Shaar
- Department of Public Health Sciences, Pennsylvania State University College of Medicine, Penn State Cancer Institute, CH69, 500 University Drive, Hershey, PA, 17033, USA
| | - Emma S Spielfogel
- Department of Computational and Quantitative Medicine, City of Hope, Duarte, CA, 91010, USA
| | - Kathleen M Sturgeon
- Department of Public Health Sciences, Pennsylvania State University College of Medicine, Penn State Cancer Institute, CH69, 500 University Drive, Hershey, PA, 17033, USA.
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Pfirmann P, Garrigue I, Chauveau B, Rondeau V, Tumiotto C, Weinmann L, Dubois V, Couzi L, Merville P, Kaminski H, Taton B. Trends in epidemiology and risk factors of opportunistic infections in kidney transplant recipients between 2004 and 2017. Nephrol Dial Transplant 2024; 39:627-636. [PMID: 37667539 DOI: 10.1093/ndt/gfad193] [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: 04/07/2023] [Indexed: 09/06/2023] Open
Abstract
BACKGROUND While opportunistic infections are a frequent and challenging problem in kidney transplant recipients, their long-term epidemiology remains hardly known. METHODS Opportunistic infections were recorded in 1144 recipients transplanted in our center between 2004 and 2015. Incidence rates and baseline risk factors were determined using joint frailty models. RESULTS After a median follow-up of 5.6 years, 544 opportunistic infections occurred in 373/1144 (33%) patients, dominated by viral infections (396/544, 72%), especially cytomegalovirus (CMV) syndromes and diseases (213/544, 39%). One-third of the infected patients experienced at least two opportunistic infections. The incidence of opportunistic infections was 10 times higher during the first year post-transplantation than after that (34.7 infections for 100 patient-years vs 3.64). Opportunistic infections associated with the age of the donor (P = .032), the age of the recipient (P = .049), the CMV serostatus (P < 10-6), a higher class II HLA mismatch (P = .032) and an induction treatment including rabbit anti-thymocyte globulins (P = .026). Repeated opportunistic infections associated with each other (P < 10-6) and with renal death (P < 10-6). CONCLUSION Opportunistic infections occur with a two-period incidence pattern and many susceptible patients suffer from repeated episodes. This knowledge may help tailor new prevention and follow-up strategies to reduce the burden of opportunistic infections and their impact on transplantation outcome.
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Affiliation(s)
- Pierre Pfirmann
- Service de Néphrologie, Transplantation, Dialyse et Aphérèses, CHU de Bordeaux, Bordeaux, France
| | - Isabelle Garrigue
- Laboratoire de Virologie, CHU de Bordeaux, Bordeaux, France
- CNRS-UMR 5234 Microbiologie Fondamentale et Pathogénicité, Université de Bordeaux, Bordeaux France
| | - Bertrand Chauveau
- Service de Pathologie, Groupe hospitalier Pellegrin, CHU de Bordeaux, Bordeaux, France
- CNRS-UMR 5164 ImmunoConcEpT, Université de Bordeaux, Bordeaux, France
| | - Virginie Rondeau
- Centre INSERM U1219, Institut de Santé Publique, d'Épidémiologie et de Développement, Bordeaux France
| | - Camille Tumiotto
- Laboratoire de Virologie, CHU de Bordeaux, Bordeaux, France
- CNRS-UMR 5234 Microbiologie Fondamentale et Pathogénicité, Université de Bordeaux, Bordeaux France
| | | | | | - Lionel Couzi
- Service de Néphrologie, Transplantation, Dialyse et Aphérèses, CHU de Bordeaux, Bordeaux, France
- CNRS-UMR 5164 ImmunoConcEpT, Université de Bordeaux, Bordeaux, France
| | - Pierre Merville
- Service de Néphrologie, Transplantation, Dialyse et Aphérèses, CHU de Bordeaux, Bordeaux, France
- CNRS-UMR 5164 ImmunoConcEpT, Université de Bordeaux, Bordeaux, France
| | - Hannah Kaminski
- Service de Néphrologie, Transplantation, Dialyse et Aphérèses, CHU de Bordeaux, Bordeaux, France
- CNRS-UMR 5164 ImmunoConcEpT, Université de Bordeaux, Bordeaux, France
| | - Benjamin Taton
- Service de Néphrologie, Transplantation, Dialyse et Aphérèses, CHU de Bordeaux, Bordeaux, France
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Loroña NC, Othus M, Malone KE, Linden HM, Tang MTC, Li CI. Alcohol, Smoking, and Risks of Breast Cancer Recurrence and Mortality among Women with Luminal, Triple-Negative, and HER2-Overexpressing Breast Cancer. Cancer Epidemiol Biomarkers Prev 2024; 33:288-297. [PMID: 38019269 PMCID: PMC10872526 DOI: 10.1158/1055-9965.epi-23-1081] [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: 09/07/2023] [Revised: 10/30/2023] [Accepted: 11/22/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND This study evaluates the relationship between smoking, alcohol, and breast cancer outcomes according to molecular subtype. METHODS This population-based prospective cohort consisted of 3,876 women ages 20 to 69 diagnosed with a first primary invasive breast cancer from 2004 to 2015 in the Seattle-Puget Sound region. Breast cancer was categorized into three subtypes based on estrogen receptor (ER), progesterone receptor (PR), and HER2 expressions: luminal (ER+), triple-negative (TN; ER-/PR-/HER2-), and HER2-overexpressing (H2E; ER-/HER2+). We fit Cox proportional hazards models to assess the association between alcohol consumption and smoking status at diagnosis and risks of recurrence, breast cancer-specific mortality, and all-cause mortality. RESULTS Histories of ever smoking [HR, 1.33; 95% confidence interval (CI), 1.01-1.74] and current smoking (HR, 1.59; 95% CI, 1.07-2.35) were associated with greater risk of breast cancer recurrence among TN cases. Smoking was also associated with greater risk of recurrence to bone among all cases and among luminal cases. Elevated risks of breast cancer-specific and all-cause mortality were observed among current smokers across all subtypes. Alcohol use was not positively associated with risk of recurrence or mortality overall; however, TN patients who drank four or more drinks per week had a decreased risk of recurrence (HR, 0.71; 95% CI, 0.51-0.98) and breast cancer-specific mortality (HR, 0.73; 95% CI, 0.55-0.97) compared with non-current drinkers. CONCLUSIONS Patients with breast cancer with a history of smoking at diagnosis have elevated risks of recurrence and mortality. IMPACT These findings underscore the need to prioritize smoking cessation among women diagnosed with breast cancer.
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Affiliation(s)
- Nicole C. Loroña
- Department of Epidemiology, University of Washington, Seattle, WA
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Megan Othus
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Kathleen E. Malone
- Department of Epidemiology, University of Washington, Seattle, WA
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA
| | | | - Mei-Tzu C. Tang
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Christopher I. Li
- Department of Epidemiology, University of Washington, Seattle, WA
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA
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Vagnini D, Natalucci V, Moi S, Vallorani L, Pietrelli A, Panico AR, Ferri Marini C, Lucertini F, Annibalini G, Sisti D, Rocchi MBL, Catalano V, Saita E, Emili R, Barbieri E. Home-based lifestyle intervention for breast cancer survivors: A surprising improvement in the quality of life during the first year of COVID-19 pandemic. PLoS One 2024; 19:e0296163. [PMID: 38165970 PMCID: PMC10760703 DOI: 10.1371/journal.pone.0296163] [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: 11/07/2022] [Accepted: 11/28/2023] [Indexed: 01/04/2024] Open
Abstract
INTRODUCTION The COVID-19 pandemic induced an extraordinary impact on public mental health to a degree not completely understood, especially in vulnerable populations such as breast cancer (BC) survivors. In this study, we described the short- (after 3-month) and long- (after 12-month) term effects of a multidisciplinary home-based lifestyle intervention in Italian women BC survivors during the first year of COVID-19 pandemic. MATERIALS AND METHODS In total, 30 Italian BC survivors with risk factors for recurrence took part in the ongoing MoviS trial (protocol: NCT04818359). Between January 2020 and January 2021, a 3-month lifestyle intervention based on psychological counseling, nutrition, and exercise was carried out. Participants were asked to fill out psychological questionnaires for the assessment of quality of life (QoL) indicators (European Organization for Research and Treatment of Cancer QoL, EORTC-QLQ-C30) and psychological health measures such as fatigue (Brief Fatigue Inventory, BFI), distress (Distress Thermometer, DT and Psychological Distress Inventory, PDI), cancer-related fatigue (Verbal Rating Scale, VRS), and mood states (Profile of Mood States Questionnaire, POMS). IBM SPSS Statistical Software version 27.0 and R Project for Statistical Computing version 4.2.1 were used to process data. All participants were assessed at four time points: T0 (baseline), T1 (3-month), and follow-up at T2 and T3 (6- and 12-month, respectively) to measure primary (quality of life indicators) and secondary (psychological health) outcomes. Friedman non parametric test and Wilcoxon signed rank test (with Bonferroni correction) were conducted to investigate the statistically significant differences in psychometric scores and between assessment times. RESULTS Compared to baseline (T0), at T1 most of the QoL indicators (i.e., symptoms of fatigue and general health) were improved (p < 0.017) with the exception of a worsening in participants' social functioning ability. Also, perception of severity of fatigue, distress, cancer-related fatigue, depression, and anger enhanced. Compared to baseline (T0), at T3 we mainly observed a stable condition with T0-T1 pairwise comparison, however other secondary outcomes (i.e., fatigue mood state, confusion, and anxiety) significantly improved. DISCUSSION Our preliminary findings support the proposal of this lifestyle intervention for BC survivors. Despite the home-confinement due to the COVID-19 pandemic, the intervention surprisingly improved QoL indicators and psychological health of the participants.
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Affiliation(s)
- Denise Vagnini
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Valentina Natalucci
- Department of Biomolecular Sciences, Division of Exercise and Health Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Sara Moi
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Luciana Vallorani
- Department of Biomolecular Sciences, Division of Exercise and Health Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Alice Pietrelli
- Medical Oncology Unit, AST Pesaro-Urbino, Santa Maria della Misericordia Hospital Urbino, Urbino, Italy
| | - Andrea Rocco Panico
- Department of Biomolecular Sciences, Division of Exercise and Health Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Carlo Ferri Marini
- Department of Biomolecular Sciences, Division of Exercise and Health Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Francesco Lucertini
- Department of Biomolecular Sciences, Division of Exercise and Health Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Giosuè Annibalini
- Department of Biomolecular Sciences, Division of Exercise and Health Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Davide Sisti
- Department of Biomolecular Sciences, Division of Exercise and Health Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Marco Bruno Luigi Rocchi
- Department of Biomolecular Sciences, Division of Exercise and Health Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Vincenzo Catalano
- Medical Oncology Unit, AST Pesaro-Urbino, Santa Maria della Misericordia Hospital Urbino, Urbino, Italy
| | - Emanuela Saita
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Rita Emili
- Medical Oncology Unit, AST Pesaro-Urbino, Santa Maria della Misericordia Hospital Urbino, Urbino, Italy
| | - Elena Barbieri
- Department of Biomolecular Sciences, Division of Exercise and Health Sciences, University of Urbino Carlo Bo, Urbino, Italy
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Basaad A, Basurra S, Vakaj E, Aleskandarany M, Abdelsamea MM. GraphX-Net: A Graph Neural Network-Based Shapley Values for Predicting Breast Cancer Occurrence. IEEE ACCESS 2024; 12:93993-94007. [DOI: 10.1109/access.2024.3424526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/26/2024]
Affiliation(s)
- Abdullah Basaad
- School of Computing and Digital Technology, Birmingham City University, Birmingham, U.K
| | - Shadi Basurra
- School of Computing and Digital Technology, Birmingham City University, Birmingham, U.K
| | - Edlira Vakaj
- School of Computing and Digital Technology, Birmingham City University, Birmingham, U.K
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Masud SF, Mark N, Goss T, Malinowski D, Schnitt SJ, Sparano JA, Donovan MJ. U.S. payer budget impact of using an AI-augmented cancer risk discrimination digital histopathology platform to identify high-risk of recurrence in women with early-stage invasive breast cancer. J Med Econ 2024; 27:972-981. [PMID: 39010830 DOI: 10.1080/13696998.2024.2379211] [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: 01/11/2024] [Revised: 07/03/2024] [Accepted: 07/09/2024] [Indexed: 07/17/2024]
Abstract
AIMS Use of gene expression signatures to predict adjuvant chemotherapy benefit in women with early-stage breast cancer is increasing. However, high cost, limited access, and eligibility for these tests results in the adoption of less precise assessment approaches. This study evaluates the cost impact of PreciseDx Breast (PDxBr), an AI-augmented histopathology platform that assesses the 6-year risk of recurrence in early-stage invasive breast cancer patients to help improve informed use of adjuvant chemotherapy. MATERIALS AND METHODS A decision-tree Markov model was developed to compare the costs of treatment guided by standard of care (SOC) risk assessment (i.e. clinical diagnostic workup with or without Oncotype DX) versus PDxBr with SOC in a hypothetical cohort of U.S. women with early-stage invasive breast cancer. A commercial payer perspective compares costs of testing, adjuvant therapy, recurrence, adverse events, surveillance, and end-of-life care. RESULTS PDxBr use in prognostic evaluation resulted in savings of $4 million (M) in year one compared to current SOC in 1 M females members. Over 6-years, savings increased to $12.5 M. The per-treated patient costs in year one amounted to $19.5 thousand (K) for SOC and $16.9K for PDxBr. LIMITATIONS For simplicity, recurrence was not specified. We performed scenario analyses to account for variations in rates for local, regional, and distant recurrence. Second, a recurrent patient incurs the total cost of treated recurrence in the first year and goes back to remission or death. Third, CDK4/6i treatment is only incorporated in the recurrence costs but not in the first line of treatment for early-stage breast cancer due to limited data. CONCLUSIONS Sensitivity analyses demonstrated robust overall savings to changes in all variables in the model. The use of PDxBr to assess breast cancer recurrence risk has the potential to fill gaps in care and reduce costs when gene expression signatures are not available.
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Affiliation(s)
| | | | | | | | - Stuart J Schnitt
- Brigham and Women's Hospital, Dana-Farber/Brigham and Women's Cancer Center, Boston, MA, USA
| | - Joseph A Sparano
- Division of Hematology and Medical Oncology, Ichan School of Medicine, Mount Sinai Health System, New York, NY, USA
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11
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Gu J, Wang J, Sun Y, Mao X, Qian C, Tang X, Wang J, Xie H, Ling L, Zhao Y, Liu X, Zhang K, Pan H, Wang S, Wang C, Zhou W. Immune cells within tertiary lymphoid structures are associated with progression-free survival in patients with locoregional recurrent breast cancer. Cancer Med 2024; 13:e6864. [PMID: 38133211 PMCID: PMC10807640 DOI: 10.1002/cam4.6864] [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: 05/02/2023] [Revised: 12/05/2023] [Accepted: 12/12/2023] [Indexed: 12/23/2023] Open
Abstract
INTRODUCTION Locoregional recurrent breast cancers have a poor prognosis. Little is known about the prognostic impact of immune microenvironment, and tertiary lymphoid structures (TLSs) in particular have not been reported. Thus, we aimed to characterize the immune microenvironment in locoregional recurrent breast tumors and to investigate its relationship with prognosis. METHODS We retrospectively included 112 patients with locoregional recurrent breast cancer, and hematoxylin-eosin staining and immunohistochemical staining (CD3, CD4, CD8, CD19, CD38, and CD68) were performed on locoregional recurrent tumor samples. The association of immune cells and TLSs with progression-free survival (PFS) were analyzed by survival analysis. RESULTS We found more immune cells in the peritumor than stroma. After grouping according to estrogen receptor (ER) status, a low level of peritumoral CD3+ cells in ER+ subgroup (p = 0.015) and a low level of stromal CD68+ cells in ER- subgroup (p = 0.047) were both associated with longer PFS. TLSs were present in 68% of recurrent tumors, and CD68+ cells within TLSs were significantly associated with PFS as an independent prognostic factor (p = 0.035). TLSs and immune cells (CD3, CD38, and CD68) within TLSs were associated with longer PFS in ER- recurrent tumors (p = 0.044, p = 0.012, p = 0.050, p < 0.001, respectively), whereas CD38+ cells within TLSs were associated with shorter PFS in ER+ recurrent tumors (p = 0.037). CONCLUSION Our study proposes potential predictors for the clinical prognosis of patients with locoregional recurrent breast cancer, emphasizing the prognostic value of immune cells within TLSs, especially CD68+ cells.
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Affiliation(s)
- Jinyuan Gu
- Department of Breast SurgeryThe First Affiliated Hospital with Nanjing Medical UniversityNanjingChina
- Jiangsu Key Lab of Cancer Biomarkers, Prevention and TreatmentJiangsu Collaborative Innovation Center For Cancer Personalized MedicineSchool of Public HealthNanjing Medical UniversityNanjingChina
| | - Jiaming Wang
- Department of Breast SurgeryThe First Affiliated Hospital with Nanjing Medical UniversityNanjingChina
| | - Yue Sun
- Department of OncologyThe First Affiliated Hospital with Nanjing Medical UniversityNanjingChina
| | - Xinrui Mao
- Department of Breast SurgeryThe First Affiliated Hospital with Nanjing Medical UniversityNanjingChina
- Jiangsu Key Lab of Cancer Biomarkers, Prevention and TreatmentJiangsu Collaborative Innovation Center For Cancer Personalized MedicineSchool of Public HealthNanjing Medical UniversityNanjingChina
| | - Chao Qian
- Department of General SurgerySir Run Run HospitalNanjing Medical UniversityNanjingChina
| | - Xinyu Tang
- Department of Breast SurgeryThe First Affiliated Hospital with Nanjing Medical UniversityNanjingChina
- Jiangsu Key Lab of Cancer Biomarkers, Prevention and TreatmentJiangsu Collaborative Innovation Center For Cancer Personalized MedicineSchool of Public HealthNanjing Medical UniversityNanjingChina
| | - Ji Wang
- Department of Breast SurgeryThe First Affiliated Hospital with Nanjing Medical UniversityNanjingChina
- Jiangsu Key Lab of Cancer Biomarkers, Prevention and TreatmentJiangsu Collaborative Innovation Center For Cancer Personalized MedicineSchool of Public HealthNanjing Medical UniversityNanjingChina
| | - Hui Xie
- Department of Breast SurgeryThe First Affiliated Hospital with Nanjing Medical UniversityNanjingChina
- Jiangsu Key Lab of Cancer Biomarkers, Prevention and TreatmentJiangsu Collaborative Innovation Center For Cancer Personalized MedicineSchool of Public HealthNanjing Medical UniversityNanjingChina
| | - Lijun Ling
- Department of Breast SurgeryThe First Affiliated Hospital with Nanjing Medical UniversityNanjingChina
- Jiangsu Key Lab of Cancer Biomarkers, Prevention and TreatmentJiangsu Collaborative Innovation Center For Cancer Personalized MedicineSchool of Public HealthNanjing Medical UniversityNanjingChina
| | - Yi Zhao
- Department of Breast SurgeryThe First Affiliated Hospital with Nanjing Medical UniversityNanjingChina
- Jiangsu Key Lab of Cancer Biomarkers, Prevention and TreatmentJiangsu Collaborative Innovation Center For Cancer Personalized MedicineSchool of Public HealthNanjing Medical UniversityNanjingChina
| | - Xiaoan Liu
- Department of Breast SurgeryThe First Affiliated Hospital with Nanjing Medical UniversityNanjingChina
- Jiangsu Key Lab of Cancer Biomarkers, Prevention and TreatmentJiangsu Collaborative Innovation Center For Cancer Personalized MedicineSchool of Public HealthNanjing Medical UniversityNanjingChina
| | - Kai Zhang
- Pancreas Center & Department of General SurgeryThe First Affiliated Hospital with Nanjing Medical UniversityNanjingJiangsuChina
- Pancreas Institute of Nanjing Medical UniversityNanjingJiangsuChina
| | - Hong Pan
- Department of Breast SurgeryThe First Affiliated Hospital with Nanjing Medical UniversityNanjingChina
- Jiangsu Key Lab of Cancer Biomarkers, Prevention and TreatmentJiangsu Collaborative Innovation Center For Cancer Personalized MedicineSchool of Public HealthNanjing Medical UniversityNanjingChina
| | - Shui Wang
- Department of Breast SurgeryThe First Affiliated Hospital with Nanjing Medical UniversityNanjingChina
- Jiangsu Key Lab of Cancer Biomarkers, Prevention and TreatmentJiangsu Collaborative Innovation Center For Cancer Personalized MedicineSchool of Public HealthNanjing Medical UniversityNanjingChina
| | - Cong Wang
- Department of PathologyThe First Affiliated Hospital with Nanjing Medical UniversityNanjingChina
| | - Wenbin Zhou
- Department of Breast SurgeryThe First Affiliated Hospital with Nanjing Medical UniversityNanjingChina
- Jiangsu Key Lab of Cancer Biomarkers, Prevention and TreatmentJiangsu Collaborative Innovation Center For Cancer Personalized MedicineSchool of Public HealthNanjing Medical UniversityNanjingChina
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12
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Olatunji G, Kokori E, Yusuf IA, Akinmoju O, Isarinade T, Komolafe R, Akinoso A, Akinboade A, Osaghae O, Abdulbasit M, Aderinto N. AE37 HER2-targeted vaccine in the prevention of breast cancer recurrence: A mini narrative review of current evidence. Medicine (Baltimore) 2023; 102:e36793. [PMID: 38206732 PMCID: PMC10754548 DOI: 10.1097/md.0000000000036793] [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: 11/13/2023] [Accepted: 12/05/2023] [Indexed: 01/13/2024] Open
Abstract
Breast cancer remains a significant global health challenge, necessitating innovative therapeutic strategies. This review synthesizes findings from multiple studies investigating the safety profile and efficacy of the AE37 human epidermal growth factor receptor 2 (HER2)-targeted vaccine, offering insights into its potential role in breast cancer immunotherapy. A systematic search of electronic databases, including PubMed, MEDLINE, Scopus, and Web of Science, was conducted to identify relevant articles published up to October 2023. The search strategy utilized a combination of keywords, including "AE37 HER2 vaccine," "breast cancer recurrence prevention," and related terms. Boolean operators (AND, OR) were employed to refine the search. The AE37 vaccine exhibited a favorable safety profile across all studies, with minimal adverse effects reported. Efficacy outcomes varied, with promising trends observed in specific breast cancer subgroups, such as advanced-stage, HER2 under-expressed, and triple-negative breast cancer patients. Subgroup analyses suggested potential benefits, emphasizing the need for precise patient stratification. While the AE37 HER2-targeted vaccine demonstrates a promising safety profile and potential efficacy in specific breast cancer subgroups, an understanding requires addressing identified limitations and advancing research in nuanced directions. This paper provides a foundation for navigating the complex landscape of breast cancer immunotherapy with the AE37 vaccine.
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Affiliation(s)
| | - Emmanuel Kokori
- Faculty of Clinical Sciences, University of Ilorin, Ilorin, Nigeria
| | - Ismaila Ajayi Yusuf
- Department of Medicine and Surgery, Obafemi Awolowo University Teaching Hospital, Ife, Nigeria
| | - Olumide Akinmoju
- Department of Medicine and Surgery, University of Ibadan, Ibadan, Nigeria
| | | | | | - Aminat Akinoso
- Faculty of Clinical Sciences, University of Ilorin, Ilorin, Nigeria
| | - Adeola Akinboade
- Faculty of Clinical Sciences, University of Ilorin, Ilorin, Nigeria
| | | | - Muili Abdulbasit
- Department of Medicine and Surgery, Ladoke Akintola University of Technology Teaching Hospital, Ogbomoso, Nigeria
| | - Nicholas Aderinto
- Department of Medicine and Surgery, Ladoke Akintola University of Technology Teaching Hospital, Ogbomoso, Nigeria
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13
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Pannu MK, Constantinou C. Inflammation, Nutrition, and Clinical Outcomes in Breast Cancer Survivors: A Narrative Review. Curr Nutr Rep 2023; 12:643-661. [PMID: 37751147 DOI: 10.1007/s13668-023-00495-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2023] [Indexed: 09/27/2023]
Abstract
PURPOSE OF REVIEW Breast cancer (BC) is the leading cause of death among women aged 44-55 years globally. Pro-inflammatory food can cause tissue-level inflammation, thereby creating a carcinogenic microenvironment and promoting breast cancer. The aim of this review is to provide an overview of the association between inflammation and nutrition and clinical outcomes in breast cancer survivors. RECENT FINDINGS Pro-inflammatory diets are associated with a higher mortality risk after diagnosis and worse prognosis after treatment. On the other hand, anti-inflammatory diets may improve tissue-level inflammation and improve the overall prognosis and quality of life of survivors. There is strong evidence that the Mediterranean diet in particular is associated with reduced recurrence risk of breast cancer and improved quality of life of survivors. This narrative review provides evidence that there is a strong association between inflammation, dietary habits, and adverse clinical outcomes in breast cancer survivors. It further discusses the current evidence for the role of dietary management in improving clinical outcomes in breast cancer survivors.
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Affiliation(s)
- Manjinder Kaur Pannu
- Department of Basic and Clinical Sciences, University of Nicosia Medical School, 21 Ilia Papakyriakou, 2414 Engomi, P.O. Box 24005, CY-1700, Nicosia, Cyprus
| | - Constantina Constantinou
- Department of Basic and Clinical Sciences, University of Nicosia Medical School, 21 Ilia Papakyriakou, 2414 Engomi, P.O. Box 24005, CY-1700, Nicosia, Cyprus.
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14
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Lin YS, Kuan CH, Lo C, Tsai LW, Wu CH, Huang CH, Yeong EK, Tai HC, Huang CS. Is Immediate Lymphatic Reconstruction on Breast Cancer Patients Oncologically Safe? A Preliminary Study. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2023; 11:e5385. [PMID: 37941816 PMCID: PMC10629743 DOI: 10.1097/gox.0000000000005385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 09/20/2023] [Indexed: 11/10/2023]
Abstract
Background In breast cancer patients receiving axillary lymph node dissection (ALND), immediate lymphatic reconstruction (ILR) with lymphovenous anastomosis is an emerging technique for reducing the risk of arm lymphedema. However, the oncologic safety of surgically diverting lymphatic ducts directly into venules in a node-positive axilla is still a concern of inadvertently inducing metastasis of remaining cancer cells. This study aimed to assess the oncologic safety of ILR. Methods From January 2020 to January 2022, 95 breast cancer patients received ALND, and 45 of them also received ILR. Patients with recurrent cancer, with follow-up less than 12 months, and with missed data were excluded. Variables were compared between ILR and non-ILR groups, and the outcome of interest was the rate of distant recurrence after follow-up for at least 1 year. Results Thirty-four patients in the ILR group and 32 patients in the non-ILR group fulfilled the inclusion criteria for analysis. No statistically significant difference was noted between groups in terms of age, body mass index, type of breast surgery, pathologic cancer staging, histologic type and grade of breast cancer, molecular subtypes, frequency of axillary lymph node metastasis, or adjuvant therapy. For the patients receiving follow-up for at least 1 year, no statistically significant difference was found in terms of distant recurrence rates between ILR and non-ILR groups (P = 0.44). Conclusion For breast cancer patients receiving ALND, ILR with lymphovenous anastomosis is oncologically safe, within an average follow-up period of 21 months.
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Affiliation(s)
- Ying-Sheng Lin
- From the Division of Plastic Surgery, Department of Surgery, National Taiwan University Hospital Yunlin Branch, Yunlin County, Taiwan
| | - Chen-Hsiang Kuan
- Division of Plastic Surgery, Department of Surgery, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | - Chiao Lo
- Division of General Surgery, Department of Surgery, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Li-Wei Tsai
- Division of General Surgery, Department of Surgery, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
- Department of Surgical Oncology, National Taiwan University Cancer Center, Taipei, Taiwan
| | - Chien-Hui Wu
- Division of General Surgery, Department of Surgery, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | - Chieh-Huei Huang
- Division of Plastic Surgery, Department of Surgery, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | - Eng-Kean Yeong
- Division of Plastic Surgery, Department of Surgery, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | - Hao-Chih Tai
- From the Division of Plastic Surgery, Department of Surgery, National Taiwan University Hospital Yunlin Branch, Yunlin County, Taiwan
- Division of Plastic Surgery, Department of Surgery, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | - Chiun-Sheng Huang
- From the Division of Plastic Surgery, Department of Surgery, National Taiwan University Hospital Yunlin Branch, Yunlin County, Taiwan
- Division of General Surgery, Department of Surgery, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
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15
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Natalucci V, Ferri Marini C, Lucertini F, Annibalini G, Sisti D, Vallorani L, Saltarelli R, Panico AR, Imperio M, Flori M, Busacca P, Villarini A, Donati Zeppa S, Agostini D, Monaldi S, Barocci S, Catalano V, Rocchi MBL, Benelli P, Stocchi V, Barbieri E, Emili R. Effect of a lifestyle intervention program's on breast cancer survivors' cardiometabolic health: Two-year follow-up. Heliyon 2023; 9:e21761. [PMID: 38027927 PMCID: PMC10651516 DOI: 10.1016/j.heliyon.2023.e21761] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 10/26/2023] [Accepted: 10/27/2023] [Indexed: 12/01/2023] Open
Abstract
The purpose of this study is to assess the cardiometabolic responses of a lifestyle intervention (LI) conducted at home among breast cancer (BC) survivors during the two years of COVID-19 pandemic. A 3-month LI focused on diet and exercise was performed on thirty BC survivors (women; stages 0-II; non-metastatic; aged 53.6 ± 7.6 years; non-physically active) with a risk factor related to metabolic/endocrine diseases. Anthropometrics, cardiorespiratory fitness (V ˙ O2max), physical activity level (PAL), adherence to the Mediterranean diet (MeDiet modified questionnaire), and several biomarkers (i.e., glycemia, insulin, insulin resistance [HOMA-IR] index, triglycerides, high- [HDL] and low- [LDL] density lipoproteins, total cholesterol, progesterone, testosterone, and hs-troponin) were evaluated before and 3-, 6-, 12-, and 24-month after the LI. Beneficial effects of the LI were observed on several variables (i.e., body mass index, waist circumference, MeDiet, PAL, V ˙ O2max, glycemia, insulin, HOMA-IR index, LDL, total cholesterol, triglycerides, testosterone) after 3-month. The significant effect on Mediterranean diet adherence and V ˙ O2max persisted up to the 24-month follow-up. Decreases in HOMA-IR index and triglycerides were observed up to 12-month, however did not persist afterward. This study provides evidence on the positive association between LI and cardiometabolic health in BC survivors.
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Affiliation(s)
- Valentina Natalucci
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Carlo Ferri Marini
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Francesco Lucertini
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Giosuè Annibalini
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Davide Sisti
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Luciana Vallorani
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Roberta Saltarelli
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Andrea Rocco Panico
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Marta Imperio
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Marco Flori
- U.O.C. Cardiologia/UTIC, AST, Ospedale Santa Maria della Misericordia, 61029, Urbino, Italy
| | - Paolo Busacca
- U.O.C. Cardiologia/UTIC, AST, Ospedale Santa Maria della Misericordia, 61029, Urbino, Italy
| | - Anna Villarini
- Department of Medicine and Surgery, University of Perugia, Piazzale Settimio Gambuli, 06132, Perugia, Italy
| | - Sabrina Donati Zeppa
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Deborah Agostini
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Silvia Monaldi
- U.O.C. Oncologia Medica, AST, Ospedale Santa Maria della Misericordia, 61029, Urbino, Italy
| | - Simone Barocci
- U.O.C. Patologia Clinica, AST, Ospedale Santa Maria della Misericordia, 61029, Urbino, Italy
| | - Vincenzo Catalano
- U.O.C. Oncologia Medica, AST, Ospedale Santa Maria della Misericordia, 61029, Urbino, Italy
| | | | - Piero Benelli
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Vilberto Stocchi
- Department of Human Sciences for the Promotion of Quality of Life, University San Raffaele, 20132, Roma, Italy
| | - Elena Barbieri
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Rita Emili
- U.O.C. Oncologia Medica, AST, Ospedale Santa Maria della Misericordia, 61029, Urbino, Italy
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16
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Chintapally N, Englander K, Gallagher J, Elleson K, Sun W, Whiting J, Laronga C, Lee MC. Tumor Characteristics Associated with Axillary Nodal Positivity in Triple Negative Breast Cancer. Diseases 2023; 11:118. [PMID: 37754314 PMCID: PMC10529347 DOI: 10.3390/diseases11030118] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 09/06/2023] [Accepted: 09/06/2023] [Indexed: 09/28/2023] Open
Abstract
Larger-size primary tumors are correlated with axillary metastases and worse outcomes. We evaluated the relationships among tumor size, location, and distance to nipple relative to axillary node metastases in triple-negative breast cancer (TNBC) patients, as well as the predictive capacity of imaging. We conducted a single-institution, retrospective chart review of stage I-III TNBC patients diagnosed from 1998 to 2019 who underwent upfront surgery. Seventy-three patients had a mean tumor size of 20 mm (range 1-53 mm). All patients were clinically node negative. Thirty-two patients were sentinel lymph node positive, of whom 25 underwent axillary lymph node dissection. Larger tumor size was associated with positive nodes (p < 0.001): the mean tumor size was 14.30 mm in node negative patients and 27.31 mm in node positive patients. Tumor to nipple distance was shorter in node positive patients (51.0 mm) vs. node negative patients (73.3 mm) (p = 0.005). The presence of LVI was associated with nodal positivity (p < 0.001). Tumor quadrant was not associated with nodal metastasis. Ultrasound yielded the largest number of suspicious findings (21/49), with sensitivity of 0.25 and specificity of 0.40. On univariate analysis, age younger than 60 at diagnosis was also associated with nodal positivity (p < 0.002). Comparative analyses with other subtypes may identify biologic determinants.
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Affiliation(s)
- Neha Chintapally
- University of South Florida Morsani College of Medicine, Tampa, FL 33602, USA; (N.C.); (K.E.); (J.G.)
| | - Katherine Englander
- University of South Florida Morsani College of Medicine, Tampa, FL 33602, USA; (N.C.); (K.E.); (J.G.)
| | - Julia Gallagher
- University of South Florida Morsani College of Medicine, Tampa, FL 33602, USA; (N.C.); (K.E.); (J.G.)
| | - Kelly Elleson
- Regional Breast Care, Genesis Care Network, 8931 Colonial Center Dr #301, Fort Myers, FL 33905, USA;
| | - Weihong Sun
- Comprehensive Breast Program, Moffitt Cancer Center, Tampa, FL 33612, USA; (W.S.); (C.L.)
| | - Junmin Whiting
- Department of Biostatistics & Bioinformatics, Moffitt Cancer Center, Tampa, FL 33612, USA;
| | - Christine Laronga
- Comprehensive Breast Program, Moffitt Cancer Center, Tampa, FL 33612, USA; (W.S.); (C.L.)
| | - Marie Catherine Lee
- Comprehensive Breast Program, Moffitt Cancer Center, Tampa, FL 33612, USA; (W.S.); (C.L.)
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17
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Lučić I, Kurtović M, Mlinarić M, Piteša N, Čipak Gašparović A, Sabol M, Milković L. Deciphering Common Traits of Breast and Ovarian Cancer Stem Cells and Possible Therapeutic Approaches. Int J Mol Sci 2023; 24:10683. [PMID: 37445860 DOI: 10.3390/ijms241310683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 06/21/2023] [Accepted: 06/23/2023] [Indexed: 07/15/2023] Open
Abstract
Breast cancer (BC) and ovarian cancer (OC) are among the most common and deadly cancers affecting women worldwide. Both are complex diseases with marked heterogeneity. Despite the induction of screening programs that increase the frequency of earlier diagnosis of BC, at a stage when the cancer is more likely to respond to therapy, which does not exist for OC, more than 50% of both cancers are diagnosed at an advanced stage. Initial therapy can put the cancer into remission. However, recurrences occur frequently in both BC and OC, which are highly cancer-subtype dependent. Therapy resistance is mainly attributed to a rare subpopulation of cells, named cancer stem cells (CSC) or tumor-initiating cells, as they are capable of self-renewal, tumor initiation, and regrowth of tumor bulk. In this review, we will discuss the distinctive markers and signaling pathways that characterize CSC, their interactions with the tumor microenvironment, and the strategies they employ to evade immune surveillance. Our focus will be on identifying the common features of breast cancer stem cells (BCSC) and ovarian cancer stem cells (OCSC) and suggesting potential therapeutic approaches.
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Affiliation(s)
- Ivan Lučić
- Laboratory for Oxidative Stress, Division of Molecular Medicine, Ruđer Bošković Institute, 10000 Zagreb, Croatia
| | - Matea Kurtović
- Laboratory for Hereditary Cancer, Division of Molecular Medicine, Ruđer Bošković Institute, 10000 Zagreb, Croatia
| | - Monika Mlinarić
- Laboratory for Oxidative Stress, Division of Molecular Medicine, Ruđer Bošković Institute, 10000 Zagreb, Croatia
| | - Nikolina Piteša
- Laboratory for Hereditary Cancer, Division of Molecular Medicine, Ruđer Bošković Institute, 10000 Zagreb, Croatia
| | - Ana Čipak Gašparović
- Laboratory for Oxidative Stress, Division of Molecular Medicine, Ruđer Bošković Institute, 10000 Zagreb, Croatia
| | - Maja Sabol
- Laboratory for Hereditary Cancer, Division of Molecular Medicine, Ruđer Bošković Institute, 10000 Zagreb, Croatia
| | - Lidija Milković
- Laboratory for Oxidative Stress, Division of Molecular Medicine, Ruđer Bošković Institute, 10000 Zagreb, Croatia
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18
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Stefanelli A, Farina E, Mastella E, Fabbri S, Turra A, Bonazza S, De Troia A, Radica MK, Carcoforo P. Full-Dose Intraoperative Electron Radiotherapy for Early Breast Cancer: Evidence from a Single Center's Experience. Cancers (Basel) 2023; 15:3239. [PMID: 37370849 DOI: 10.3390/cancers15123239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 06/12/2023] [Accepted: 06/16/2023] [Indexed: 06/29/2023] Open
Abstract
To evaluate the clinical response rate and cosmetic outcome after full-dose intraoperative electron radiotherapy (IOERT) in early breast cancer (BC) treated with conserving surgery. Inclusion criteria were: >60 years old, clinical tumor size ≤2 cm, luminal A carcinoma, patological negative lymph nodes, excluded lobular carcinoma histology. IOERT was delivered with a dose of 21 Gy at 90% isodose. Clinical, cosmetic and/or instrumental follow-up were performed 45 days after IOERT, 6 months after the first check, and every 12 months thereafter. Acute and late toxicities were assessed with the CTCAE v.4.03 and EORTC-RTOG scales, respectively. Cosmetic outcome was evaluated using the Harvard/NSABO/RTOG Breast Cosmesis Grading Scale. Overall, 162 consecutive patients were included in this analysis (median follow-up: 54 months, range: 1-98 months). The overall response rate was 97.5% (CI 95%: 0.93-0.99%). Locoragional relapse occurred in 2.5% of patients. No patient showed distant metastases. No patient showed radiation-related acute complications, with 3.7% showing late G2-3 toxicity. Only 3.7% of patients showed poor cosmetic results. Our data confirmed that IOERT is a feasible and valid therapeutic option in low-risk BC patients treated with lumpectomy. A low local recurrence rate combined with good cosmetic results validates the settings of our operative method in routinely clinical practice.
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Affiliation(s)
- Antonio Stefanelli
- Department of Radiation Oncology, University Hospital of Ferrara, 44121 Ferrara, Italy
| | - Eleonora Farina
- Department of Radiation Oncology, University Hospital of Ferrara, 44121 Ferrara, Italy
| | - Edoardo Mastella
- Department of Medical Physics, University Hospital of Ferrara, 44121 Ferrara, Italy
| | - Sara Fabbri
- Department of Medical Physics, University Hospital of Ferrara, 44121 Ferrara, Italy
| | - Alessandro Turra
- Department of Medical Physics, University Hospital of Ferrara, 44121 Ferrara, Italy
| | - Simona Bonazza
- Department of Surgery, University Hospital of Ferrara, 44121 Ferrara, Italy
| | | | | | - Paolo Carcoforo
- Department of Surgery, University Hospital of Ferrara, 44121 Ferrara, Italy
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19
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Zdanowski A, Sartor H, Feldt M, Skarping I. Mammographic density in relation to breast cancer recurrence and survival in women receiving neoadjuvant chemotherapy. Front Oncol 2023; 13:1177310. [PMID: 37388229 PMCID: PMC10304818 DOI: 10.3389/fonc.2023.1177310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 05/30/2023] [Indexed: 07/01/2023] Open
Abstract
Objective The association between mammographic density (MD) and breast cancer (BC) recurrence and survival remains unclear. Patients receiving neoadjuvant chemotherapy (NACT) are in a vulnerable situation with the tumor within the breast during treatment. This study evaluated the association between MD and recurrence/survival in BC patients treated with NACT. Methods Patients with BC treated with NACT in Sweden (2005-2016) were retrospectively included (N=302). Associations between MD (Breast Imaging-Reporting and Data System (BI-RADS) 5th Edition) and recurrence-free/BC-specific survival at follow-up (Q1 2022) were addressed. Hazard ratios (HRs) for recurrence/BC-specific survival (BI-RADS a/b/c vs. d) were estimated using Cox regression analysis and adjusted for age, estrogen receptor status, human epidermal growth factor receptor 2 status, axillary lymph node status, tumor size, and complete pathological response. Results A total of 86 recurrences and 64 deaths were recorded. The adjusted models showed that patients with BI-RADS d vs. BI-RADS a/b/c had an increased risk of recurrence (HR 1.96 (95% confidence interval (CI) 0.98-3.92)) and an increased risk of BC-specific death (HR 2.94 (95% CI 1.43-6.06)). Conclusion These findings raise questions regarding personalized follow-up for BC patients with extremely dense breasts (BI-RADS d) pre-NACT. More extensive studies are required to confirm our findings.
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Affiliation(s)
| | - Hanna Sartor
- Department of Translational Medicine, Diagnostic Radiology, Skåne University Hospital, Lund University, Lund/Malmö, Sweden
| | - Maria Feldt
- Division of Oncology, Department of Clinical Sciences, Lund University, Lund, Sweden
- Department of Oncology, Skåne University Hospital, Lund, Sweden
| | - Ida Skarping
- Division of Oncology, Department of Clinical Sciences, Lund University, Lund, Sweden
- Department of Clinical Physiology and Nuclear Medicine, Skåne University Hospital, Lund, Sweden
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20
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Das S, Kundu M, Hassan A, Parekh A, Jena BC, Mundre S, Banerjee I, Yetirajam R, Das CK, Pradhan AK, Das SK, Emdad L, Mitra P, Fisher PB, Mandal M. A novel computational predictive biological approach distinguishes Integrin β1 as a salient biomarker for breast cancer chemoresistance. Biochim Biophys Acta Mol Basis Dis 2023; 1869:166702. [PMID: 37044238 DOI: 10.1016/j.bbadis.2023.166702] [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: 11/09/2022] [Revised: 03/11/2023] [Accepted: 03/21/2023] [Indexed: 04/14/2023]
Abstract
Chemoresistance is a primary cause of breast cancer treatment failure, and protein-protein interactions significantly contribute to chemoresistance during different stages of breast cancer progression. In pursuit of novel biomarkers and relevant protein-protein interactions occurring during the emergence of breast cancer chemoresistance, we used a computational predictive biological (CPB) approach. CPB identified associations of adhesion molecules with proteins connected with different breast cancer proteins associated with chemoresistance. This approach identified an association of Integrin β1 (ITGB1) with chemoresistance and breast cancer stem cell markers. ITGB1 activated the Focal Adhesion Kinase (FAK) pathway promoting invasion, migration, and chemoresistance in breast cancer by upregulating Erk phosphorylation. FAK also activated Wnt/Sox2 signaling, which enhanced self-renewal in breast cancer. Activation of the FAK pathway by ITGB1 represents a novel mechanism linked to breast cancer chemoresistance, which may lead to novel therapies capable of blocking breast cancer progression by intervening in ITGB1-regulated signaling pathways.
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Affiliation(s)
- Subhayan Das
- School of Medical Science & Technology, Indian Institute of Technology Kharagpur, Kharagpur, India
| | - Moumita Kundu
- School of Medical Science & Technology, Indian Institute of Technology Kharagpur, Kharagpur, India
| | - Atif Hassan
- Department of Computer Science & Engineering, Indian Institute of Technology Kharagpur, Kharagpur, India
| | - Aditya Parekh
- Anant National University, Ahmedabad, Gujarat, India
| | - Bikash Ch Jena
- School of Medical Science & Technology, Indian Institute of Technology Kharagpur, Kharagpur, India
| | - Swati Mundre
- School of Medical Science & Technology, Indian Institute of Technology Kharagpur, Kharagpur, India
| | - Indranil Banerjee
- School of Medical Science & Technology, Indian Institute of Technology Kharagpur, Kharagpur, India; School of Pharmacy, Sister Nivedita University (Techno India Group), Kolkata, West Bengal, India
| | - Rajesh Yetirajam
- School of Medical Science & Technology, Indian Institute of Technology Kharagpur, Kharagpur, India
| | - Chandan K Das
- School of Medical Science & Technology, Indian Institute of Technology Kharagpur, Kharagpur, India
| | - Anjan K Pradhan
- Department of Human and Molecular Genetics, Virginia Commonwealth University, School of Medicine, Richmond, VA, USA; VCU Institute of Molecular Medicine, Virginia Commonwealth University, School of Medicine, Richmond, VA, USA
| | - Swadesh K Das
- Department of Human and Molecular Genetics, Virginia Commonwealth University, School of Medicine, Richmond, VA, USA; VCU Institute of Molecular Medicine, Virginia Commonwealth University, School of Medicine, Richmond, VA, USA; VCU Massey Cancer Center, Virginia Commonwealth University, School of Medicine, Richmond, VA, USA
| | - Luni Emdad
- Department of Human and Molecular Genetics, Virginia Commonwealth University, School of Medicine, Richmond, VA, USA; VCU Institute of Molecular Medicine, Virginia Commonwealth University, School of Medicine, Richmond, VA, USA; VCU Massey Cancer Center, Virginia Commonwealth University, School of Medicine, Richmond, VA, USA
| | - Pralay Mitra
- Department of Computer Science & Engineering, Indian Institute of Technology Kharagpur, Kharagpur, India
| | - Paul B Fisher
- Department of Human and Molecular Genetics, Virginia Commonwealth University, School of Medicine, Richmond, VA, USA; VCU Institute of Molecular Medicine, Virginia Commonwealth University, School of Medicine, Richmond, VA, USA; VCU Massey Cancer Center, Virginia Commonwealth University, School of Medicine, Richmond, VA, USA
| | - Mahitosh Mandal
- School of Medical Science & Technology, Indian Institute of Technology Kharagpur, Kharagpur, India.
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21
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Prieur A, Harper A, Khan M, Vire B, Joubert D, Payen L, Kopciuk K. Plasma hPG 80 (Circulating Progastrin) as a Novel Prognostic Biomarker for early-stage breast cancer in a breast cancer cohort. BMC Cancer 2023; 23:305. [PMID: 37016331 PMCID: PMC10071601 DOI: 10.1186/s12885-023-10729-1] [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: 12/14/2022] [Accepted: 03/10/2023] [Indexed: 04/06/2023] Open
Abstract
BACKGROUND Recurrence and metastases are still frequent outcomes after initial tumour control in women diagnosed with breast cancer. Although therapies are selected based on tumour characteristics measured at baseline, prognostic biomarkers can identify those at risk of poor outcomes. Circulating progastrin or hPG80 was found to be associated with survival outcomes in renal and hepatocellular carcinomas and was a plausible prognostic biomarker for breast cancer. METHODS Women with incident breast cancers from Calgary, Alberta, Canada enrolled in the Breast to Bone (B2B) study between 2010 to 2016 and provided blood samples prior to any treatment initiation. Plasma from these baseline samples were analysed for circulating progastrin or hPG80. Participant characteristics as well as tumour ones were evaluated for their association with hPG80 and survival outcomes (time to recurrence, recurrence - free survival, breast cancer specific survival and overall survival) in Cox proportional hazards regression models. RESULTS The 464 participants with measurable hPG80 in this study had an average age of 57.03 years (standard deviation of 11.17 years) and were predominantly diagnosed with Stage I (52.2%) and Stage II (40.1%) disease. A total of 50 recurrences and 50 deaths were recorded as of June 2022. In Cox PH regression models adjusted for chemotherapy, radiation therapy, cancer stage and age at diagnosis, log hPG80 (pmol/L) significantly increased the risks for recurrence (Hazard Ratio (HR) = 1.330, 95% Confidence Interval (CI) = (0.995 - 1.777, p = 0.054)), recurrence-free survival (HR = 1.399, 95% CI = (1.106 - 1.770), p = 0.005) and overall survival (HR = 1.385, 95% CI = (1.046 - 1.834), = 0.023) but not for breast cancer specific survival (HR = 1.015, 95% CI = (0.684 - 1.505), p = 0.942). CONCLUSIONS hPG80 levels measured at diagnosis were significantly associated with the risk of recurrence or death from any cause in women with breast cancer. Since the recurrence rates of breast cancer are still relatively high amongst women diagnosed at an early stage, identifying women at high risk of recurrence at their time of diagnosis is important. hPG80 is a promising new prognostic biomarker that could improve the identification of women at higher risk of poor outcomes.
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Affiliation(s)
- Alexandre Prieur
- Biodena Care, 2040 Avenue du Père Soulas, 34090, Montpellier, France
| | - Andrew Harper
- Cancer Epidemiology and Prevention Research, Alberta Health Services, 2210 - 2 Street SW, Calgary, AB, T2S 3C3, Canada
| | - Momtafin Khan
- Cancer Epidemiology and Prevention Research, Alberta Health Services, 2210 - 2 Street SW, Calgary, AB, T2S 3C3, Canada
| | - Bérengère Vire
- Biodena Care, 2040 Avenue du Père Soulas, 34090, Montpellier, France
| | - Dominique Joubert
- Biodena Care, 2040 Avenue du Père Soulas, 34090, Montpellier, France
| | - Léa Payen
- Lyon Sud Hospital, 69310, Pierre-Benite, France
| | - Karen Kopciuk
- Cancer Epidemiology and Prevention Research, Alberta Health Services, 2210 - 2 Street SW, Calgary, AB, T2S 3C3, Canada.
- Departments of Oncology, Mathematics and Statistics, Community Health Sciences, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada.
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22
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Dibble KE, Connor AE. Residential Locale Is Associated with Disparities in Genetic Testing-Related Outcomes Among BRCA1/2-Positive Women. J Racial Ethn Health Disparities 2023; 10:718-729. [PMID: 35178668 PMCID: PMC8853067 DOI: 10.1007/s40615-022-01259-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 02/04/2022] [Accepted: 02/07/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND While research on hereditary genetic testing for BRCA1/2 mutations continues to emerge, there remain unanswered questions regarding access to testing and cancer-related care. Our study determined the associations between race/ethnicity, residential locale, and genetic testing provider and related outcomes among US women with BRCA1/2 genetic mutations. METHODS One hundred ninety-three BRCA1/2-positive women from vulnerable health backgrounds were recruited via private national Facebook BRCA1/2-oriented support groups and completed an online survey. Adjusted odds ratios (aOR) and 95% confidence intervals (CIs) were estimated using multivariable logistic regression for the associations between race/ethnicity, residential locale, and genetic testing-related outcomes. RESULTS Women ranged in age (18-75, M = 39.5, SD = 10.7), and most were non-Hispanic white (66.3%) and lived in a suburban locale (54.9%). Women living in suburban areas were significantly less likely (aOR, .369, 95% CI, .177-.771) to receive behavioral referrals after genetic testing compared to those living in an urban locale. Women living in rural areas and suburban areas were 4.72 times more likely (95% CI, 1.48-15.1, p = .009) and 2.61 times more likely (95% CI, 1.05-6.48, p = .038), respectively, to receive genetic testing from a primary care provider versus private genetic testing office/hospital compared to women in urban locales. Associations between race/ethnicity and genetic testing outcomes were not statistically significant. Residential locale did not predict the odds of undergoing surgery for risk reduction or surveillance for early detection. CONCLUSION Our study identifies disparities in genetic testing resources among women living in suburban and rural areas. These findings can be used to inform future care, research, and community resources that may impact services relating to genetic testing within these locales.
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Affiliation(s)
- Kate E Dibble
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA.
| | - Avonne E Connor
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
- Department of Oncology, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD, 21205, USA
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23
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Miller K, Gannon MR, Medina J, Clements K, Dodwell D, Horgan K, Park MH, Cromwell DA. The Association Between Survival and Receipt of Post-mastectomy Radiotherapy According to Age at Diagnosis Among Women With Early Invasive Breast Cancer: A Population-Based Cohort Study. Clin Oncol (R Coll Radiol) 2023; 35:e265-e277. [PMID: 36764877 DOI: 10.1016/j.clon.2023.01.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 11/08/2022] [Accepted: 01/16/2023] [Indexed: 01/25/2023]
Abstract
AIMS Clinical trials of post-mastectomy radiotherapy (PMRT) for early invasive breast cancer (EIBC) have included few older women. This study examined whether the association between overall survival or breast cancer-specific survival (BCSS) and receipt of PMRT for EIBC altered with age. MATERIALS AND METHODS The study used patient-level linked cancer registration, routine hospital and radiotherapy data for England and Wales. It included 31 243 women aged ≥50 years diagnosed between 2014 and 2018 with low- (T1-2N0), intermediate- (T3N0/T1-2N1) or high-risk (T1-2N2/T3N1-2) EIBC who received a mastectomy within 12 months from diagnosis. Patterns of survival were analysed using a landmark approach. Associations between overall survival/BCSS and PMRT in each risk group were analysed with flexible parametric survival models, which included patient and tumour factors; whether the association between PMRT and overall survival/BCSS varied by age was assessed using interaction terms. RESULTS Among 4711 women with high-risk EIBC, 86% had PMRT. Five-year overall survival was 70.5% and BCSS was 79.3%. Receipt of PMRT was associated with improved overall survival [adjusted hazard ratio (aHR) 0.75, 95% confidence interval 0.64-0.87] and BCSS (aHR 0.78, 95% confidence interval 0.65-0.95) compared with women who did not have PMRT; associations did not vary by age (overall survival, P-value for interaction term = 0.141; BCSS, P = 0.077). Among 10 814 women with intermediate-risk EIBC, 59% had PMRT; 5-year overall survival was 78.4% and BCSS was 88.0%. No association was found between overall survival (aHR 1.01, 95% confidence interval 0.92-1.11) or BCSS (aHR 1.16, 95% confidence interval 1.01-1.32) and PMRT. There was statistical evidence of a small change in the association with age for overall survival (P = 0.007), although differences in relative survival were minimal, but not for BCSS (P = 0.362). CONCLUSIONS The association between PMRT and overall survival/BCSS does not appear to be modified by age among women with high- or intermediate-risk EIBC and, thus, treatment recommendations should not be modified on the basis of age alone.
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Affiliation(s)
- K Miller
- Clinical Effectiveness Unit, The Royal College of Surgeons of England, London, UK; Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK.
| | - M R Gannon
- Clinical Effectiveness Unit, The Royal College of Surgeons of England, London, UK; Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - J Medina
- Clinical Effectiveness Unit, The Royal College of Surgeons of England, London, UK
| | - K Clements
- National Cancer Registration and Analysis Service, NHS Digital, Birmingham, UK
| | - D Dodwell
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - K Horgan
- Department of Breast Surgery, St James's University Hospital, Leeds, UK
| | - M H Park
- Clinical Effectiveness Unit, The Royal College of Surgeons of England, London, UK; Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - D A Cromwell
- Clinical Effectiveness Unit, The Royal College of Surgeons of England, London, UK; Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
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24
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Factors Influencing Lymph Node Positivity in HER2/neu+ Breast Cancer Patients. Curr Oncol 2023; 30:2825-2833. [PMID: 36975428 PMCID: PMC10047436 DOI: 10.3390/curroncol30030215] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 02/14/2023] [Accepted: 02/24/2023] [Indexed: 03/02/2023] Open
Abstract
Axillary lymph node metastases are a key prognostic factor in breast cancer treatment. Our aim was to evaluate how tumor size, tumor location, and imaging results correlate to axillary lymph node diseases for patients with stage I-III HER2/neu+ breast cancer. This is a single-institution retrospective chart review of female breast cancer patients diagnosed with primary invasive Her2/neu+ breast cancer who were treated with upfront surgical resection from 2000–2021. Of 75 cases, 44/75 (58.7%) had nodal metastasis, and there was a significant association of larger tumor size to nodal metastases (p ≤ 0.001). Patients with negative nodes had a smaller mean tumor size (n = 30; 15.10 mm) than patients with positive nodes (n = 45; 23.9 mm) (p = 0.002). Preoperative imaging detected suspicious nodes in 36 patients, and ultrasound detected the most positive nodes (14/18; p = 0.027). Our data confirms that tumor size at diagnosis is correlated with a higher likelihood of axillary involvement in patients with Her2/neu+ breast cancer; notably, a large proportion of Her2/neu+ breast cancers have metastatic involvement of axillary lymph nodes even with small primary lesions.
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25
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Nikulin S, Razumovskaya A, Poloznikov A, Zakharova G, Alekseev B, Tonevitsky A. ELOVL5 and IGFBP6 genes modulate sensitivity of breast cancer cells to ferroptosis. Front Mol Biosci 2023; 10:1075704. [PMID: 36714261 PMCID: PMC9880435 DOI: 10.3389/fmolb.2023.1075704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 01/03/2023] [Indexed: 01/14/2023] Open
Abstract
Introduction: Relapse of breast cancer is one of the key obstacles to successful treatment. Previously we have shown that low expression of ELOVL5 and IGFBP6 genes in breast cancer tissue corresponded to poor prognosis. ELOVL5 participates directly in the elongation of polyunsaturated fatty acids (PUFAs) that are considered to play an important role in cancer cell metabolism. Thus, in this work we studied the changes in lipid metabolism in breast cancer cells with reduced expression of either ELOVL5 or IGFBP6 gene. Methods: MDA-MB-231 cells with a stable knockdown of either ELOVL5 or IGFBP6 gene were used in this study. Transcriptomic and proteomic analysis as well as RT-PCR were utilized to assess gene expression. Content of individual fatty acids in the cells was measured with HPLC-MS. HPLC was used for analysis of the kinetics of PUFAs uptake. Cell viability was measured with MTS assay. Flow cytometry was used to measure activation of apoptosis. Fluorescent microscopy was utilized to assess accumulation of ROS and formation of lipid droplets. Glutathione peroxidase activity was measured with a colorimetric assay. Results: We found that the knockdown of IGFBP6 gene led to significant changes in the profile of fatty acids in the cells and in the expression of many genes associated with lipid metabolism. As some PUFAs are known to inhibit proliferation and cause death of cancer cells, we also tested the response of the cells to single PUFAs and to combinations of docosahexaenoic acid (DHA, a n-3 PUFA) with standard chemotherapeutic drugs. Our data suggest that external PUFAs cause cell death by activation of ferroptosis, an iron-dependent mechanism of cell death with excessive lipid peroxidation. Moreover, both knockdowns increased cells' sensitivity to ferroptosis, probably due to a significant decrease in the activity of the antioxidant enzyme GPX4. Addition of DHA to commonly used chemotherapeutic drugs enhanced their effect significantly, especially for the cells with low expression of IGFBP6 gene. Discussion: The results of this study suggest that addition of PUFAs to the treatment regimen for the patients with low expression of IGFBP6 and ELOVL5 genes can be potentially beneficial and is worth testing in a clinically relevant setting.
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Affiliation(s)
- Sergey Nikulin
- Faculty of Biology and Biotechnologies, Higher School of Economics, Moscow, Russia,*Correspondence: Sergey Nikulin,
| | | | - Andrey Poloznikov
- P. A. Hertsen Moscow Oncology Research Center, Branch of the National Medical Research Radiological Center, Ministry of Health of the Russian Federation, Moscow, Russia
| | - Galina Zakharova
- World-Class Research Center “Digital Biodesign and Personalized Healthcare”, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Boris Alekseev
- P. A. Hertsen Moscow Oncology Research Center, Branch of the National Medical Research Radiological Center, Ministry of Health of the Russian Federation, Moscow, Russia
| | - Alexander Tonevitsky
- Faculty of Biology and Biotechnologies, Higher School of Economics, Moscow, Russia,Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, Moscow, Russia
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26
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Ramadan M, Alsiary R, Alsaadoun N, Alhusseini N, Raihan Sajid M, Mohamed Hamed N, Ziad Arabi T, Nedal Sabbah B. Risk of Breast Cancer Progression after Treatment in the Western Region of Saudi Arabia. BREAST CANCER: BASIC AND CLINICAL RESEARCH 2023; 17:11782234231158270. [PMID: 37009030 PMCID: PMC10061810 DOI: 10.1177/11782234231158270] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 02/01/2023] [Indexed: 03/31/2023] Open
Abstract
Background: The risk of breast cancer progression is one of the most difficult factors to predict as it is studied in different populations, patient groups, or time frames, resulting in conflicting estimates of incidence rates reported in the literature. The purpose of this study is to identify predictive factors for breast cancer recurrences in a sample of the Middle Eastern population. Methodology: A cohort retrospective study included all eligible breast cancer patients at the National Guard Health Affairs (NGHA) Hospital in Jeddah, Western region, from 2015 to 2021. Our primary outcome was the progression status of the patients; we adjusted for demographic, clinical, and molecule characteristics of the population. From 2015 to 2021, there were 319 patients diagnosed with breast cancer. Multiple logistic regression analysis was used to estimate predictors of breast cancer progression. Results: One of five breast cancer patients had breast cancer progression (20.83%), while 66.15% of the progression patients were between the ages of 41–65. In multivariate analysis, age, progesterone receptor (PR), family history, and tumor size were significant predictors of breast cancer progression. The age group of 20–40 years was a protective predictor of breast cancer progression, patients in the young age group were less likely to be diagnosed with progression (OR = 0.35; CI = 0.15, 0.81). While negative PRs and tumor size greater than 2 cm were significant predictor factors of breast cancer progression (OR = 2.07; CI = 1.09, 3.91, OR = 2.02; CI = 1.9, 3.78). Conclusion: Although the effect of young age as a protective factor for the progression of breast cancer remains controversial, our study revealed that patients between 41 and 60 years of age had a higher rate of progression. Future larger prospective studies are needed to delineate the role of age and PR hormone receptors in determining the best treatment options for women with breast cancer in the Saudi population.
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Affiliation(s)
- Majed Ramadan
- Population Health Research Section, Population Health Department, King Abdullah International Medical Research Center (KAIMRC), King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard—Health Affairs, Riyadh, Saudi Arabia
- Majed Ramadan, Population Health Research Section, Population Health Department, King Abdullah International Medical Research Center (KAIMRC), King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard—Health Affairs, C9F6+JRH, King Abdul Aziz Medical City, Jeddah 22384, Saudi Arabia.
| | - Rwiah Alsiary
- Department of Cellular Therapy and Cancer Research, King Abdullah International Medical Research Center (KAIMRC), King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard—Health Affairs, Riyadh, Saudi Arabia
| | - Noor Alsaadoun
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
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27
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Clèries R, Ameijide A, Buxó M, Vilardell M, Martínez JM, Font R, Marcos-Gragera R, Puigdemont M, Viñas G, Carulla M, Espinàs JA, Galceran J, Izquierdo Á, Borràs JM. Ten-Year Probabilities of Death Due to Cancer and Cardiovascular Disease among Breast Cancer Patients Diagnosed in North-Eastern Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:405. [PMID: 36612726 PMCID: PMC9819018 DOI: 10.3390/ijerph20010405] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 12/21/2022] [Accepted: 12/23/2022] [Indexed: 06/17/2023]
Abstract
Mortality from cardiovascular disease (CVD), second tumours, and other causes is of clinical interest in the long-term follow-up of breast cancer (BC) patients. Using a cohort of BC patients (N = 6758) from the cancer registries of Girona and Tarragona (north-eastern Spain), we studied the 10-year probabilities of death due to BC, other cancers, and CVD according to stage at diagnosis and hormone receptor (HR) status. Among the non-BC causes of death (N = 720), CVD (N = 218) surpassed other cancers (N = 196). The BC cohort presented a significantly higher risk of death due to endometrial and ovarian cancers than the general population. In Stage I, HR- patients showed a 1.72-fold higher probability of all-cause death and a 6.11-fold higher probability of breast cancer death than HR+ patients. In Stages II-III, the probability of CVD death (range 3.11% to 3.86%) surpassed that of other cancers (range 0.54% to 3.11%). In Stage IV patients, the probability of death from any cancer drove the mortality risk. Promoting screening and preventive measures in BC patients are warranted, since long-term control should encompass early detection of second neoplasms, ruling out the possibility of late recurrence. In patients diagnosed in Stages II-III at an older age, surveillance for preventing late cardiotoxicity is crucial.
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Affiliation(s)
- Ramon Clèries
- Pla Director d’Oncología, Av Gran Vía 199-203, 08908 L’Hospitalet de Llobregat, Barcelona, Spain
- Bellvitge Biomedical Research Institute, IDIBELL, Av. Gran Via de l’Hospitalet, 199-203-1a planta, 08908 L’Hospitalet de Llobregat, Barcelona, Spain
- Clinical Sciences Department, Universitat de Barcelona, 08907 Barcelona, Spain
| | - Alberto Ameijide
- Tarragona Cancer Registry, Epidemiology and Cancer Prevention Service, Hospital Universitari Sant Joan de Reus, IISPV, 43204 Reus, Spain
| | - Maria Buxó
- Girona Biomedical Research Institute, IDIBGI, C/Dr. Castany s/n, Edifici M2, Parc Hospitalari Martí i Julià, 17190 Salt, Spain
| | | | - José Miguel Martínez
- Statistics and Operational Research Department, Universitat Politècnica de Catalunya, EDIFICI H, Diagonal 647, 08028 Barcelona, Spain
- Public Health Research Group, University of Alicante, 03690 Alicante, Spain
| | - Rebeca Font
- Pla Director d’Oncología, Av Gran Vía 199-203, 08908 L’Hospitalet de Llobregat, Barcelona, Spain
- Bellvitge Biomedical Research Institute, IDIBELL, Av. Gran Via de l’Hospitalet, 199-203-1a planta, 08908 L’Hospitalet de Llobregat, Barcelona, Spain
| | - Rafael Marcos-Gragera
- Girona Biomedical Research Institute, IDIBGI, C/Dr. Castany s/n, Edifici M2, Parc Hospitalari Martí i Julià, 17190 Salt, Spain
- Girona Cancer Registry, Epidemiology Unit, Pla Director d’Oncologia, Institut Català d’Oncología, Group for Descriptive Epidemiology, Genetics and Cancer Prevention, Girona-IDIBGI, 17005 Girona, Spain
- Medical School, Universitat de Girona (UdG), 17071 Girona, Spain
- Epidemiology and Public Health Research Network Centre (CIBERESP), 28029 Madrid, Spain
| | - Montse Puigdemont
- Girona Cancer Registry, Epidemiology Unit, Pla Director d’Oncologia, Institut Català d’Oncología, Group for Descriptive Epidemiology, Genetics and Cancer Prevention, Girona-IDIBGI, 17005 Girona, Spain
| | - Gemma Viñas
- Medical Oncology Service, Catalan Institute of Oncology, Hospital Universitari de Girona “Doctor Josep Trueta”, 17005 Girona, Spain
| | - Marià Carulla
- Tarragona Cancer Registry, Epidemiology and Cancer Prevention Service, Hospital Universitari Sant Joan de Reus, IISPV, 43204 Reus, Spain
| | - Josep Alfons Espinàs
- Pla Director d’Oncología, Av Gran Vía 199-203, 08908 L’Hospitalet de Llobregat, Barcelona, Spain
- Bellvitge Biomedical Research Institute, IDIBELL, Av. Gran Via de l’Hospitalet, 199-203-1a planta, 08908 L’Hospitalet de Llobregat, Barcelona, Spain
| | - Jaume Galceran
- Tarragona Cancer Registry, Epidemiology and Cancer Prevention Service, Hospital Universitari Sant Joan de Reus, IISPV, 43204 Reus, Spain
| | - Ángel Izquierdo
- Girona Cancer Registry, Epidemiology Unit, Pla Director d’Oncologia, Institut Català d’Oncología, Group for Descriptive Epidemiology, Genetics and Cancer Prevention, Girona-IDIBGI, 17005 Girona, Spain
- Medical Oncology Service, Catalan Institute of Oncology, Hospital Universitari de Girona “Doctor Josep Trueta”, 17005 Girona, Spain
| | - Josep Maria Borràs
- Pla Director d’Oncología, Av Gran Vía 199-203, 08908 L’Hospitalet de Llobregat, Barcelona, Spain
- Bellvitge Biomedical Research Institute, IDIBELL, Av. Gran Via de l’Hospitalet, 199-203-1a planta, 08908 L’Hospitalet de Llobregat, Barcelona, Spain
- Clinical Sciences Department, Universitat de Barcelona, 08907 Barcelona, Spain
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Mauny A, Faure S, Derbré S. Phytoestrogens and Breast Cancer: Should French Recommendations Evolve? Cancers (Basel) 2022; 14:cancers14246163. [PMID: 36551648 PMCID: PMC9776930 DOI: 10.3390/cancers14246163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 12/07/2022] [Accepted: 12/12/2022] [Indexed: 12/15/2022] Open
Abstract
Breast cancer (BC) occurs less frequently in Asia, where there is high soy consumption. It has been hypothesized that soy isoflavones could be protective against BC recurrence and mortality. At the same time, health organizations in several countries have differing recommendations for soy consumption (soy foods or dietary supplements) in BC survivors. The objective of this review is to analyze the literature and to determine whether it is justified to advise avoiding soy in dietary supplements and/or food in women with a history of BC. We conducted a systematic literature search with the Medline/Pubmed and Web of Science databases. Only prospective cohort studies published since 2009 were retained. The endpoint of studies was BC recurrence and/or mortality, and the association with soy isoflavone intake was specifically targeted. Seven studies were included. None of these studies found statistically significant adverse effects of soy consumption on BC recurrence or mortality (specific or all-cause). Overall, only one study was not able to find beneficial effects of soy intake on BC patients. The other studies concluded that there were positive associations but in very variable ways. Two studies found a decrease in BC recurrence associated with a higher isoflavone intake only for post-menopausal women. The other four studies concluded that there were positive associations regardless of menopausal status. Four studies showed better results on women with hormonal-sensitive cancer and/or patients receiving hormonal treatment. Only one found a stronger association for patients with ER-negative BC. No adverse effects of soy isoflavones on BC mortality/recurrence were found. Soy isoflavones may exert beneficial effects. These results coincide with other recent works and suggest that soy isoflavone intake is safe for BC survivors. Thus, these data no longer seem to coincide with the French recommendations, which could then be brought to evolve. However, in order to confirm the current results, larger studies are needed.
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Affiliation(s)
- Aurore Mauny
- Department Pharmacy, Faculty of Health Sciences, University of Angers, F-49000 Angers, France
| | - Sébastien Faure
- Department Pharmacy, Faculty of Health Sciences, University of Angers, F-49000 Angers, France
- Inserm, CNRS, MINT, SFR ICAT, University of Angers, F-49000 Angers, France
- Correspondence: (S.F.); (S.D.); Tel.: +33-(0)241-226-740 (S.F.); +33-(0)249-180-440 (S.D.)
| | - Séverine Derbré
- Department Pharmacy, Faculty of Health Sciences, University of Angers, F-49000 Angers, France
- SONAS, SFR QUASAV, University of Angers, F-49000 Angers, France
- Correspondence: (S.F.); (S.D.); Tel.: +33-(0)241-226-740 (S.F.); +33-(0)249-180-440 (S.D.)
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Bahl S, Carroll JS, Lupien M. Chromatin Variants Reveal the Genetic Determinants of Oncogenesis in Breast Cancer. Cold Spring Harb Perspect Med 2022; 12:a041322. [PMID: 36041880 PMCID: PMC9524388 DOI: 10.1101/cshperspect.a041322] [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] [Indexed: 11/24/2022]
Abstract
Breast cancer presents as multiple distinct disease entities. Each tumor harbors diverse cell populations defining a phenotypic heterogeneity that impinges on our ability to treat patients. To date, efforts mainly focused on genetic variants to find drivers of inter- and intratumor phenotypic heterogeneity. However, these efforts have failed to fully capture the genetic basis of breast cancer. Through recent technological and analytical approaches, the genetic basis of phenotypes can now be decoded by characterizing chromatin variants. These variants correspond to polymorphisms in chromatin states at DNA sequences that serve a distinct role across cell populations. Here, we review the function and causes of chromatin variants as they relate to breast cancer inter- and intratumor heterogeneity and how they can guide the development of treatment alternatives to fulfill the goal of precision cancer medicine.
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Affiliation(s)
- Shalini Bahl
- Princess Margaret Cancer Centre, Toronto, Ontario M5G 1L7, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, Ontario M5G 1L7, Canada
| | - Jason S Carroll
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge CB2 0RE, United Kingdom
| | - Mathieu Lupien
- Princess Margaret Cancer Centre, Toronto, Ontario M5G 1L7, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, Ontario M5G 1L7, Canada
- Ontario Institute for Cancer Research, Toronto, Ontario M5G 0A3, Canada
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30
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Yi X, Huang D, Li Z, Wang X, Yang T, Zhao M, Wu J, Zhong T. The role and application of small extracellular vesicles in breast cancer. Front Oncol 2022; 12:980404. [PMID: 36185265 PMCID: PMC9515427 DOI: 10.3389/fonc.2022.980404] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 08/23/2022] [Indexed: 11/13/2022] Open
Abstract
Breast cancer (BC) is the most common malignancy and the leading cause of cancer-related deaths in women worldwide. Currently, patients’ survival remains a challenge in BC due to the lack of effective targeted therapies and the difficult condition of patients with higher aggressiveness, metastasis and drug resistance. Small extracellular vesicles (sEVs), which are nanoscale vesicles with lipid bilayer envelopes released by various cell types in physiological and pathological conditions, play an important role in biological information transfer between cells. There is growing evidence that BC cell-derived sEVs may contribute to the establishment of a favorable microenvironment that supports cancer cells proliferation, invasion and metastasis. Moreover, sEVs provide a versatile platform not only for the diagnosis but also as a delivery vehicle for drugs. This review provides an overview of current new developments regarding the involvement of sEVs in BC pathogenesis, including tumor proliferation, invasion, metastasis, immune evasion, and drug resistance. In addition, sEVs act as messenger carriers carrying a variety of biomolecules such as proteins, nucleic acids, lipids and metabolites, making them as potential liquid biopsy biomarkers for BC diagnosis and prognosis. We also described the clinical applications of BC derived sEVs associated MiRs in the diagnosis and treatment of BC along with ongoing clinical trials which will assist future scientific endeavors in a more organized direction.
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Affiliation(s)
- Xiaomei Yi
- The First School of Clinical Medicine, Gannan Medical University, Ganzhou, China
- Laboratory Medicine, First Affiliated Hospital of Gannan Medical University, Ganzhou, China
| | - Defa Huang
- Laboratory Medicine, First Affiliated Hospital of Gannan Medical University, Ganzhou, China
| | - Zhengzhe Li
- The First School of Clinical Medicine, Gannan Medical University, Ganzhou, China
- Laboratory Medicine, First Affiliated Hospital of Gannan Medical University, Ganzhou, China
| | - Xiaoxing Wang
- The First School of Clinical Medicine, Gannan Medical University, Ganzhou, China
- Laboratory Medicine, First Affiliated Hospital of Gannan Medical University, Ganzhou, China
| | - Tong Yang
- The First School of Clinical Medicine, Gannan Medical University, Ganzhou, China
- Laboratory Medicine, First Affiliated Hospital of Gannan Medical University, Ganzhou, China
| | - Minghong Zhao
- The First School of Clinical Medicine, Gannan Medical University, Ganzhou, China
- Laboratory Medicine, First Affiliated Hospital of Gannan Medical University, Ganzhou, China
| | - Jiyang Wu
- The First School of Clinical Medicine, Gannan Medical University, Ganzhou, China
- Laboratory Medicine, First Affiliated Hospital of Gannan Medical University, Ganzhou, China
| | - Tianyu Zhong
- The First School of Clinical Medicine, Gannan Medical University, Ganzhou, China
- Laboratory Medicine, First Affiliated Hospital of Gannan Medical University, Ganzhou, China
- *Correspondence: Tianyu Zhong,
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Alkhaifi M, Clayton A, Kishibe T, Simpson JS. The Association Between Smoking Status and Breast Cancer Recurrence: A Systematic Review. J Breast Cancer 2022; 25:278-287. [PMID: 35657004 PMCID: PMC9411030 DOI: 10.4048/jbc.2022.25.e23] [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: 02/09/2022] [Revised: 04/21/2022] [Accepted: 05/08/2022] [Indexed: 01/28/2023] Open
Abstract
PURPOSE To determine whether smoking status (active/passive) affects recurrence events after breast cancer (BC) diagnosis among women. METHODS A comprehensive literature search of MEDLINE, Cochrane Central, EMBASE, and Web of Science databases on smoking status and BC outcomes retrieved 5,940 articles. After reviewing the inclusion and exclusion criteria, we selected 14 articles for a full review and synthesis. RESULTS Five studies were cohort retrospective, 6 were case-control, 2 were prospective cohort studies, and 1 was a secondary analysis of a randomized control trial. Among the 8 articles that focused on active smoking, 6 showed an increased risk of BC recurrence, and 2 showed no evidence of such an association. Studies that examined former smokers found little evidence of an increased risk of BC recurrence. This association may be dose-dependent. CONCLUSION Given the current evidence, although limited, active smokers should quit smoking after BC diagnosis as trends indicate a positive association between active and BC recurrence. More robust evidence is needed to assess such associations and examine the outcomes of quitting smoking in such patients.
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Affiliation(s)
- Muna Alkhaifi
- Department of Family and Community Medicine, St. Michael's Hospital, Unity Health Toronto, Faculty of Medicine, University of Toronto, Toronto, Canada.
| | - Adam Clayton
- Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Teruko Kishibe
- Library Services, St. Michael Hospital, Unity Health Toronto, Toronto, Canada
| | - Jory S Simpson
- Division of General Surgery, Department of Surgery, St. Michael's Hospital, Unity Health Toronto, Faculty of Medicine, University of Toronto, Toronto, Canada
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Stressful Life Events and Distress in Breast Cancer: A 5-Years Follow-Up. Int J Clin Health Psychol 2022; 22:100303. [PMID: 35572072 PMCID: PMC9055056 DOI: 10.1016/j.ijchp.2022.100303] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 03/14/2022] [Accepted: 03/14/2022] [Indexed: 11/24/2022] Open
Abstract
Background/Objective Method Results Conclusions
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Zhang Z, Tabung FK, Jin Q, Curran G, Irvin VL, Shannon J, Velie EM, Manson JE, Simon MS, Vitolins M, Valencia CI, Snetselaar L, Jindal S, Schedin P. Diet-Driven Inflammation and Insulinemia and Risk of Interval Breast Cancer. Nutr Cancer 2022; 74:3179-3193. [PMID: 35471124 PMCID: PMC9439260 DOI: 10.1080/01635581.2022.2063350] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 03/03/2022] [Accepted: 04/01/2022] [Indexed: 01/10/2023]
Abstract
Interval breast cancers (IBCs) emerge after a non-suspicious mammogram and before the patient's next scheduled screen. Risk factors associated with IBC have not been identified. This study evaluated if the empirical dietary inflammatory pattern (EDIP) or empirical dietary index for hyperinsulinemia (EDIH) scores are associated with IBC compared to screen-detected breast cancer. Data were from women 50-79 years-old in the Women's Health Initiative cohort who completed food frequency questionnaires at baseline (1993-98) and were followed through March 31, 2019 for breast cancer detection. Women were identified as having either IBC diagnosed within 1-year after their last negative screening mammogram (N = 317) or screen-detected breast cancer (N = 1,928). Multivariable-adjusted logistic regression analyses were used to estimate odds ratios for risk of IBC compared to screen-detected cancer in dietary index tertiles. No associations were observed between EDIP or EDIH and IBC. Odds ratios comparing the highest to the lowest dietary index tertile were 1.08; 95%CI, 0.78-1.48 for EDIP and 0.92; 95%CI, 0.67-1.27 for EDIH. The null associations persisted when stratified by BMI categories. Findings suggest that diet-driven inflammation or insulinemia may not be substantially associated with IBC risk among postmenopausal women. Future studies are warranted to identify modifiable factors for IBC prevention.
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Affiliation(s)
- Zhenzhen Zhang
- Division of Oncological Sciences, Oregon Health & Science University, Portland, Oregon, USA
| | - Fred K. Tabung
- College of Medicine and Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio, USA
| | - Qi Jin
- Interdisciplinary PhD Program in Nutrition, The Ohio State University, Columbus, Ohio, USA
| | - Grace Curran
- Cancer Early Detection Advanced Research Center, Oregon Health & Science University, Portland, Oregon, USA
| | - Veronica L Irvin
- College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon, USA
| | - Jackilen Shannon
- OHSU-PSU School of Public Health, Oregon Health & Science University, Portland, Oregon, USA
| | - Ellen M. Velie
- Zilber School of Public Health, University of Wisconsin at Milwaukee, Milwaukee, Wisconsin, USA
- Departments of Medicine and Pathology, Medical College of Wisconsin, Wauwatosa, Wisconsin, USA
| | - JoAnn E. Manson
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, and the Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Michael S. Simon
- Karmanos Cancer Institute, Department of Oncology, Wayne State University, Detroit, Michigan, USA
| | - Mara Vitolins
- Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Celina I. Valencia
- Department of Family and Community Medicine, College of Medicine-Tucson, The University of Arizona, Tucson, Arizona, USA
| | - Linda Snetselaar
- College of Public Health, Department of Epidemiology, University of Iowa, Iowa City, Iowa, USA
| | - Sonali Jindal
- Department of Cell, Developmental and Cancer Biology, Oregon Health & Science University, Portland, Oregon, USA
| | - Pepper Schedin
- Department of Cell, Developmental and Cancer Biology, Oregon Health & Science University, Portland, Oregon, USA
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Karzai S, Port E, Siderides C, Valente C, Ahn S, Moshier E, Ru M, Pisapati K, Couri R, Margolies L, Schmidt H, Cate S. Impact of Screening Mammography on Treatment in Young Women Diagnosed with Breast Cancer. Ann Surg Oncol 2022; 29:10.1245/s10434-022-11581-6. [PMID: 35364765 DOI: 10.1245/s10434-022-11581-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 02/21/2022] [Indexed: 01/01/2023]
Abstract
BACKGROUND There is little data exploring the impact of screening mammography on subsequent treatment in the 40-49-year age group with breast cancer. We sought to assess the association between frequency of mammography in young women and extent of surgery and chemotherapy required. METHODS An IRB-approved retrospective review was performed of patients diagnosed with breast cancer between ages 40 and 49 years from 1 January 2010 to 19 November 2018 within a single health system. Patients were grouped based on last screening 1-24 months prior to diagnosis (1-24 group), > 25 months prior to diagnosis (> 25 group), never screened, and > 25+ never screened (combination group). Multivariate logistic regression models were used to assess for associations between screening intervals and tumor and nodal stage, chemotherapy use, and extent of surgery. RESULTS Of 869 patients included for analysis, 20% were never screened, 60% screened 1-24 months, and 19% screened > 25 months prior to diagnosis. Compared with the 1-24 months group, the never-screened group, > 25 months group, and combined group were more likely to receive chemotherapy. The never-screened and combined groups were more likely to undergo mastectomy and/or axillary lymph node dissection. Of patients undergoing upfront surgery, the > 25 months and combined groups were more likely to receive adjuvant chemotherapy, while the never-screened and combined groups were more likely to have nodal disease. CONCLUSION Our findings support the initiation of screening mammography at age 40 years to reduce the risk of aggressive treatments for newly diagnosed breast cancers in this group.
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Affiliation(s)
- Shkala Karzai
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Elisa Port
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Cleo Siderides
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Christopher Valente
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Soojin Ahn
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Erin Moshier
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Meng Ru
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kereeti Pisapati
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ronald Couri
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Laurie Margolies
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Hank Schmidt
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sarah Cate
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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35
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Dibble KE, Connor AE. Anxiety and depression among racial/ethnic minorities and impoverished women testing positive for BRCA1/2 mutations in the United States. Support Care Cancer 2022; 30:5769-5778. [PMID: 35344102 PMCID: PMC10083824 DOI: 10.1007/s00520-022-07004-7] [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: 01/12/2022] [Accepted: 03/22/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE To outline the association between race/ethnicity and poverty status and perceived anxiety and depressive symptomologies among BRCA1/2-positive United States (US) women to identify high-risk groups of mutation carriers from medically underserved backgrounds. METHODS A total of 211 BRCA1/2-positive women from medically underserved backgrounds were recruited through national Facebook support groups and completed an online survey. Adjusted odds ratios (aOR) and 95% confidence intervals (CIs) were estimated using multivariable logistic regression for associations between race/ethnicity, poverty status, and self-reported moderate-to-severe anxiety and depressive symptoms. RESULTS Women ranged in age (18-75, M = 39.5, SD = 10.6). Most women were non-Hispanic white (NHW) (67.2%) and were not impoverished (76.7%). Hispanic women with BRCA1/2 mutations were 6.11 times more likely to report moderate-to-severe anxiety (95% CI, 2.16-17.2, p = 0.001) and 4.28 times more likely to report moderate-to-severe depressive symptoms (95% CI, 1.98-9.60, p < 0.001) than NHW women with these mutations. Associations were not statistically significant among other minority women. Women living in poverty were significantly less likely to report moderate-to-severe depressive symptoms than women not in poverty (aOR, 0.42, 95% CI, 0.18-0.95, p = 0.04). CONCLUSION Hispanic women with BRCA1/2 mutations from medically underserved backgrounds are an important population at increased risk for worse anxiety and depressive symptomology. Our findings among Hispanic women with BRCA1/2 mutations add to the growing body of literature focused on ethnic disparities experienced across the cancer control continuum.
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Affiliation(s)
- Kate E Dibble
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA.
| | - Avonne E Connor
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
- Department of Oncology, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD, 21205, USA
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Luz FACD, Marinho EDC, Nascimento CP, Marques LDA, Duarte MBO, Delfino PFR, Antonioli RM, Araújo RAD, Silva MJB. The effectiveness of radiotherapy in preventing disease recurrence after breast cancer surgery. Surg Oncol 2022; 41:101709. [PMID: 35124329 DOI: 10.1016/j.suronc.2022.101709] [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: 09/25/2021] [Revised: 01/17/2022] [Accepted: 01/29/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND AND OBJECTIVES The locoregional management of breast cancer has a critical impact on prognosis. This study aimed to analyze the effectiveness of radiotherapy against the deleterious effect of positive surgical margins on disease outcomes. METHODS Retrospective, single-center study enrolled 721 breast cancer patients with a median follow-up of approximately 64.50 months (3.67-247.40). Analyses were performed considering the end of adjuvant therapy, except endocrine therapy. Kaplan-Meier and Cox regression were performed to obtain the predictive value of treatments. RESULTS The minimally adequate radiotherapy (≥45 cGy) was associated with improved outcomes in breast cancer patients compared to inadequate radiotherapy (<45 cGy/no) by controlling locoregional relapses and distant metastasis. In patients with positive surgical margins (n = 53), radiotherapy was associated with an approximate decrease of 90% in locoregional relapse risk [adjusted HR: 0.108 (0.012-0.932), p = 0.043]. Radiotherapy did not alter the adverse effect of positive surgical margins, especially in patients with a higher risk of poorly differentiated tumors (n = 146), presence of lymphovascular invasion (n = 163), and triple-negative subtype (n = 113). Notwithstanding, radiotherapy was associated with respective decreases of distant metastasis risk of 75.2% [adjusted HR: 0.248 (0.081-0.762), p = 0.015] and 67.8% [adjusted HR: 0.322 (0.101-1.029), p = 0.056] in patients with triple-negative tumors or with lymphovascular invasion. CONCLUSION Adequate radiotherapy is associated with better outcomes in breast cancer. Despite improving locoregional relapse-free survival, radiotherapy does not ablate positive surgical margins, a factor of poorer prognosis that prevails mainly in patients with factors of higher relapse risk.
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Affiliation(s)
- Felipe Andrés Cordero da Luz
- Center for Cancer Prevention and Research, Uberlandia Cancer Hospital, Minas Gerais, Brazil; Laboratory of Tumor Biomarkers and Osteoimmunology, Institute of Biomedical Sciences, Federal University of Uberlandia, Minas Gerais, Brazil.
| | | | | | | | - Mateus Bringel Oliveira Duarte
- Department of Radiotherapy, Oncology Sector, Clinical Hospital of the Federal University of Uberlandia, Minas Gerais, Brazil
| | | | | | - Rogério Agenor de Araújo
- Center for Cancer Prevention and Research, Uberlandia Cancer Hospital, Minas Gerais, Brazil; Medical Faculty, Federal University of Uberlandia, Minas Gerais, Brazil
| | - Marcelo José Barbosa Silva
- Laboratory of Tumor Biomarkers and Osteoimmunology, Institute of Biomedical Sciences, Federal University of Uberlandia, Minas Gerais, Brazil
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Xu C, Ganesan K, Liu X, Ye Q, Cheung Y, Liu D, Zhong S, Chen J. Prognostic Value of Negative Emotions on the Incidence of Breast Cancer: A Systematic Review and Meta-Analysis of 129,621 Patients with Breast Cancer. Cancers (Basel) 2022; 14:cancers14030475. [PMID: 35158744 PMCID: PMC8833353 DOI: 10.3390/cancers14030475] [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: 12/10/2021] [Revised: 01/07/2022] [Accepted: 01/11/2022] [Indexed: 02/06/2023] Open
Abstract
Breast cancer (BC) is one of the common malignant tumors in women and affects 1.6 million new cases globally each year. Investigators have recently found that negative emotions (NEs) and their impacts have greatly influenced the incidence and risk of BC. The present study aims to provide an association between NEs and the incidence of BC with possible risk factors. A total of 9343 studies were screened; nine studies met all inclusion criteria that were considered for the meta-analysis. The qualitative studies were measured by the Newcastle-Ottawa Scale; the observational studies were included with relative risks (RR) and corresponding 95% confidence intervals (CI). Besides the NEs and BC, the possible risk factors were evaluated. We analyzed data from 129,621 women diagnosed with NEs of which 2080 women were diagnosed with BC and their follow-up year ranges were from 4–24 years. NEs were significantly (p < 0.0001) associated with a higher incidence of BC with RR = 1.59, 95% CI:1.15–2.19, with other high-risk factors including, geographical distribution, emotion types, standard diagnosis of NEs, and follow-up duration. This study suggests that NEs significantly increase the risk for the incidence of BC, which can be supportive of the prognosis of the disease.
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Affiliation(s)
- Cong Xu
- School of Chinese Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong; (C.X.); (K.G.); (Y.C.)
| | - Kumar Ganesan
- School of Chinese Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong; (C.X.); (K.G.); (Y.C.)
| | - Xiaoyan Liu
- Department of Breast Surgery, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou 510405, China; (X.L.); (D.L.)
| | - Qiaobo Ye
- School of Basic Medical Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China;
| | - Yuenshan Cheung
- School of Chinese Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong; (C.X.); (K.G.); (Y.C.)
- Department of Breast Surgery, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou 510405, China; (X.L.); (D.L.)
| | - Dan Liu
- Department of Breast Surgery, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou 510405, China; (X.L.); (D.L.)
| | - Shaowen Zhong
- Department of Breast Surgery, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou 510405, China; (X.L.); (D.L.)
- Correspondence: (S.Z.); (J.C.); Tel.: +852-39-17-6479 (J.C.)
| | - Jianping Chen
- School of Chinese Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong; (C.X.); (K.G.); (Y.C.)
- Department of Breast Surgery, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou 510405, China; (X.L.); (D.L.)
- School of Basic Medical Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China;
- Shenzhen Institute of Research and Innovation, The University of Hong Kong, Shenzhen 518057, China
- Correspondence: (S.Z.); (J.C.); Tel.: +852-39-17-6479 (J.C.)
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Extracellular Vesicles as Mediators of Therapy Resistance in the Breast Cancer Microenvironment. Biomolecules 2022; 12:biom12010132. [PMID: 35053279 PMCID: PMC8773878 DOI: 10.3390/biom12010132] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/07/2022] [Accepted: 01/11/2022] [Indexed: 12/17/2022] Open
Abstract
Resistance to various therapies, including novel immunotherapies, poses a major challenge in the management of breast cancer and is the leading cause of treatment failure. Bidirectional communication between breast cancer cells and the tumour microenvironment is now known to be an important contributor to therapy resistance. Several studies have demonstrated that crosstalk with the tumour microenvironment through extracellular vesicles is an important mechanism employed by cancer cells that leads to drug resistance via changes in protein, lipid and nucleic acid cargoes. Moreover, the cargo content enables extracellular vesicles to be used as effective biomarkers for predicting response to treatments and as potential therapeutic targets. This review summarises the literature to date regarding the role of extracellular vesicles in promoting therapy resistance in breast cancer through communication with the tumour microenvironment.
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Harborg S, Ahern TP, Feldt M, Rosendahl AH, Cronin-Fenton D, Melander O, Borgquist S. Circulating lipids and breast cancer prognosis in the Malmö diet and cancer study. Breast Cancer Res Treat 2021; 191:611-621. [PMID: 34825306 PMCID: PMC8831289 DOI: 10.1007/s10549-021-06462-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 11/17/2021] [Indexed: 11/28/2022]
Abstract
Purpose Examine the association between circulating lipids and breast cancer outcomes in patients enrolled in the Malmö Diet and Cancer Study (MDCS). Patients and methods Circulating lipid levels were measured in blood sampled upon enrollment in the female MDCS cohort (N = 17,035). We identified all MDCS participants with incident invasive breast cancer diagnosed between 1991 and 2014. Follow-up time began at breast cancer diagnosis and continued until the first event of breast cancer recurrence, death, emigration, or 5 years of follow-up. We estimated the incidence rates of recurrence at 5 years and fit Cox regression models to compute crude and adjusted hazard ratios (HRs) with 95% confidence intervals (95% CI) of breast cancer recurrence as well as all-cause mortality according to cohort-specific tertiles of apolipoprotein A-1 (Apo A-1) and apolipoprotein B (Apo B). Results We enrolled 850 eligible patients. During the 5 years of follow-up, 90 invasive breast cancer recurrences were diagnosed over 3807 person-years. In multivariable analyses, high baseline levels of Apo B were associated with an increased rate of recurrence (tertile 3 vs. 1, HR = 2.30 [95% CI 1.13–4.68]). However, high baseline levels of Apo B were not associated with all-cause mortality (tertile 3 vs. 1, HR = 1.23 [95% CI 0.68–2.25]). We observed no associations between levels of Apo A-1 and recurrence (tertile 3 vs. 1, HR = 1.34 [95% CI 0.70–2.58]) or all-cause mortality (tertile 3 vs. 1, HR = 1.12 [95% CI 0.61–2.05]). Conclusion High pre-diagnostic levels of Apo B were associated with an increased risk of recurrence among breast cancer patients. Circulating Apo A-1 was not associated with breast cancer outcomes.
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Affiliation(s)
- Sixten Harborg
- Department of Oncology, Aarhus University Hospital/Aarhus University, Entrance C, Level 1, C118, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark. .,Department of Clinical Medicine and Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark.
| | - Thomas P Ahern
- Department of Surgery, Larner College of Medicine, University of Vermont, Burlington, USA
| | - Maria Feldt
- Department of Clinical Sciences Lund, Oncology, Skåne University Hospital, Lund University, Lund, Sweden
| | - Ann H Rosendahl
- Department of Clinical Sciences Lund, Oncology, Skåne University Hospital, Lund University, Lund, Sweden
| | - Deirdre Cronin-Fenton
- Department of Clinical Medicine and Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark
| | - Olle Melander
- Department of Clinical Sciences Malmö, Hypertension and Cardiovascular Disease, Lund University, Malmö, Sweden.,Department of Clinical Sciences Malmö, Lund University Diabetes Centre, Lund University Malmö, Malmö, Sweden.,Clinical Research Centre, Skåne University Hospital, Lund and Malmö, Malmö, Sweden.,Department of Emergency and Internal Medicine, Skåne University Hospital, Malmö, Sweden.,Department of Cardiology, Skåne University Hospital, Malmö, Sweden
| | - Signe Borgquist
- Department of Oncology, Aarhus University Hospital/Aarhus University, Entrance C, Level 1, C118, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark.,Department of Clinical Sciences Lund, Oncology, Skåne University Hospital, Lund University, Lund, Sweden
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Negoita S, Ramirez-Pena E. Prevention of Late Recurrence: An Increasingly Important Target for Breast Cancer Research and Control. J Natl Cancer Inst 2021; 114:340-341. [PMID: 34747495 DOI: 10.1093/jnci/djab203] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 10/13/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Serban Negoita
- Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Esmeralda Ramirez-Pena
- Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.,Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
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Nelson AT, Wang Y, Nelson ER. TLX, an Orphan Nuclear Receptor With Emerging Roles in Physiology and Disease. Endocrinology 2021; 162:6360449. [PMID: 34463725 PMCID: PMC8462384 DOI: 10.1210/endocr/bqab184] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Indexed: 12/14/2022]
Abstract
TLX (NR2E1), an orphan member of the nuclear receptor superfamily, is a transcription factor that has been described to be generally repressive in nature. It has been implicated in several aspects of physiology and disease. TLX is best known for its ability to regulate the proliferation of neural stem cells and retinal progenitor cells. Dysregulation, overexpression, or loss of TLX expression has been characterized in numerous studies focused on a diverse range of pathological conditions, including abnormal brain development, psychiatric disorders, retinopathies, metabolic disease, and malignant neoplasm. Despite the lack of an identified endogenous ligand, several studies have described putative synthetic and natural TLX ligands, suggesting that this receptor may serve as a therapeutic target. Therefore, this article aims to briefly review what is known about TLX structure and function in normal physiology, and provide an overview of TLX in regard to pathological conditions. Particular emphasis is placed on TLX and cancer, and the potential utility of this receptor as a therapeutic target.
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Affiliation(s)
- Adam T Nelson
- Department of Molecular and Integrative Physiology, University of Illinois Urbana-Champaign, Urbana, Illinois 61801, USA
| | - Yu Wang
- Department of Molecular and Integrative Physiology, University of Illinois Urbana-Champaign, Urbana, Illinois 61801, USA
| | - Erik R Nelson
- Department of Molecular and Integrative Physiology, University of Illinois Urbana-Champaign, Urbana, Illinois 61801, USA
- Cancer Center at Illinois, University of Illinois Urbana-Champaign, Urbana, Illinois 61801, USA
- Division of Nutritional Sciences, University of Illinois Urbana-Champaign, Urbana, Illinois 61801, USA
- University of Illinois Cancer Center, University of Illinois at Chicago, Chicago, Illinois 60612, USA
- Carl R. Woese Institute for Genomic Biology, Anticancer Discovery from Pets to People Theme, University of Illinois Urbana-Champaign, Urbana, Illinois 61801, USA
- Correspondence: Erik R. Nelson, PhD, Department of Molecular and Integrative Physiology, University of Illinois at Urbana-Champaign, 407 S Goodwin Ave (MC-114), Urbana, IL 61801, USA.
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Costeira B, da Silva FB, Oom R, Costa C, Moniz JV, Abecasis N, Santos CR. Locoregional recurrence in skin-sparing and nipple-sparing mastectomies. J Surg Oncol 2021; 125:352-360. [PMID: 34687468 DOI: 10.1002/jso.26725] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 09/06/2021] [Accepted: 10/10/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND Skin- and nipple-sparing mastectomies (SSMs/NSMs) present as an alternative for patients requiring mastectomy, with better aesthetic results. We aimed to evaluate the locoregional recurrence (LRR) rate and its predictive factors. METHODS Retrospective analysis of all consecutive cases of SSM and NSM for a primary diagnosis of in situ or invasive breast cancer, at a national cancer center, from January 1st, 2013 to May 31st, 2019. The primary outcome was LRR. Secondary outcomes included LRR predictive factors, overall survival (OS), and disease-free survival (DFS). RESULTS There were included 461 patients; 402 (87%) with invasive carcinoma. The median age was 46 (interquartile range [IQR]: 40-53) years. Ninety (20%) patients had locally advanced disease. LRR rate was 3.0%, with a median follow-up time of 39 (IQR: 21-59) months. The median time to recurrence was 22 (IQR: 10-45) months. Factors independently associated with LRR were high histological grade, negative estrogen receptor status, and high Ki67 (p < 0.05). OS was 94.8% and DFS was 92.8%. LRR was associated with decreased OS. DISCUSSION SSM and NSM present as a safe approach to breast cancer requiring mastectomy, including selected patients with a locally advanced tumor. The associated LRR rate is 3.0%, with risk factors being high grade, negative estrogen receptor status, and high Ki67.
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Affiliation(s)
- Beatriz Costeira
- Breast Surgery Unit, Department of General Surgery, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisbon, Portugal
| | - Francisca B da Silva
- Breast Surgery Unit, Department of General Surgery, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisbon, Portugal
| | - Rodrigo Oom
- Breast Surgery Unit, Department of General Surgery, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisbon, Portugal
| | - Cristina Costa
- Breast Surgery Unit, Department of General Surgery, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisbon, Portugal
| | - João V Moniz
- Breast Surgery Unit, Department of General Surgery, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisbon, Portugal
| | - Nuno Abecasis
- Breast Surgery Unit, Department of General Surgery, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisbon, Portugal
| | - Catarina R Santos
- Breast Surgery Unit, Department of General Surgery, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisbon, Portugal.,Deparment of Surgery, Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal
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Dasman H, Harahap WA, Khambri D. Analysis Predictors of the Outcome of Adjuvant of Hormone Therapy on Estrogen Receptor-positive Breast Cancer in Indonesia. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.6683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND: An existing study reported variation of the outcome of adjuvant hormone therapy on breast cancer.
AIM: This study aimed to examine predictors of the hormone therapy to the outcome of recurrence-free survival (RFS) of estrogen receptor-positive (ER+) breast cancer.
METHODS: In this cohort study, we followed up 219 eligible breast cancer patients with ER+ who had hormone therapy in 2017–2018. Age of patients, cancer stage, and various histopathology parameters were collected from the medical records, then we followed up with the patients within 2 years (2019–2020) to assess the RFS outcome. Bivariate analysis was conducted to assess the association between the clinicopathology parameters with RFS outcome. Multivariate analysis with logistic regression was also performed to see the dominant predictor. Mediation path analysis was also performed to determine the estimated effect of a predictor on the level of RFS and to see the visualization of the association of predictors with RFS.
RESULTS: Breast cancer RFS was 91.3% within 2 years of hormone therapy. The recurrent rate was only 8.7%, which most of them (68.4%) were local. There was no association of age, lymphovascular invasion (LVI), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) status with RFS. Based on the molecular subtype, the RFS was better in luminal A (p = 0.045), and also better gradually in the lower stage (p = 0.001). Multivariate analysis shows that the cancer stage was the dominant predictor of the RFS outcome (p = 0.001) with OR = 4.271 (Exp[B] = 1.937–9.417). Mediation analysis also found that there was a positively associated molecular subtype with RFS through cancer stage mediation (r = 16.7%, p = 0.006) but no statistically significant association of age, LVI, PR, and HER2 status (p > 0.005).
CONCLUSION: Cancer stage is the main predictor of RFS of hormone therapy outcome. Luminal A is most also likely to have a better outcome of RFS, especially mediated by the lower stage.
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Luz FAC, Araújo RA, Silva MJB. Decreased Survival of Invasive Ductal Breast Cancer Patients With Two Macrometastatic Lymph Nodes Among Few Resected Ones: Should Current Sentinel-Lymph-Node Guidelines Be Revised? Front Oncol 2021; 11:669890. [PMID: 34350113 PMCID: PMC8327777 DOI: 10.3389/fonc.2021.669890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 07/02/2021] [Indexed: 11/29/2022] Open
Abstract
Purpose Sentinel-lymph-node (SLN) biopsy (SLB) is an efficient and safe axillary surgical approach with decreased morbidity than total axillary lymph node dissection (ALND) in initial patients (T1–T2). Current guidelines strongly suggest avoiding completion of ALND in patients with one or two positive SLNs that will be submitted to whole-breast radiation therapy, but must be done when three SLNs are affected. Methods We performed a SEER-based study with breast invasive ductal carcinoma patients treated between 2010 and 2015. Optimal cutoffs of positive LNs predictive of survival were obtained with ROC curves and survival as a continuous variable. Bias was reduced through propensity score matching. Cox regression was employed to estimate prognosis. Nomograms were constructed to analyze the predictive value of clinicopathological factors for axillary burden. Results Of 43,239 initial patients that had one to three analyzed LNs, only 425 had two positive LNs and matched analysis demonstrated no survival difference versus pN2 patients [HR: 0.960 (0.635–1.452), p = 0.846]. The positive-to-analyzed LN proportion demonstrated a strong prognostic factor for a low rate (1 positive to ≤1.5 analyzed) [HR = 1.567 (1.156–2.126), p = 0.004], and analysis derived from the results demonstrated that a “negative LN margin” improves survival. Nomograms shows that tumor size is the main factor of axillary burden. Conclusion Macrometastasis of two LNs is a poor prognostic factor, similar to pN2, in SLNB (-like) patients; more extensive studies including preconized therapies must be done in order to corroborate or refute the resistance of this prognostic difference in patients with two macrometastatic lymph nodes within few resected.
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Affiliation(s)
- Felipe A C Luz
- Center for Projects, Prevention and Research in Cancer at the Hospital do Câncer in Uberlândia, Uberlândia, Brazil.,Laboratory of Tumors Osteoimmunology and Immunology, Institute of Biomedical Sciences, Federal University of Uberlândia, Uberlândia, Brazil
| | - Rogério A Araújo
- Laboratory of Tumors Osteoimmunology and Immunology, Institute of Biomedical Sciences, Federal University of Uberlândia, Uberlândia, Brazil.,Department of Clinical Medicine, Faculty of Medicine, Federal University of Uberlândia, Uberlândia, Brazil
| | - Marcelo J B Silva
- Laboratory of Tumors Osteoimmunology and Immunology, Institute of Biomedical Sciences, Federal University of Uberlândia, Uberlândia, Brazil
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Cannioto RA, Hutson A, Dighe S, McCann W, McCann SE, Zirpoli GR, Barlow W, Kelly KM, DeNysschen CA, Hershman DL, Unger JM, Moore HCF, Stewart JA, Isaacs C, Hobday TJ, Salim M, Hortobagyi GN, Gralow JR, Albain KS, Budd GT, Ambrosone CB. Physical Activity Before, During, and After Chemotherapy for High-Risk Breast Cancer: Relationships With Survival. J Natl Cancer Inst 2021; 113:54-63. [PMID: 32239145 DOI: 10.1093/jnci/djaa046] [Citation(s) in RCA: 93] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 03/09/2020] [Accepted: 03/25/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Although physical activity has been consistently associated with reduced breast cancer mortality, evidence is largely based on data collected at one occasion. We examined how pre- and postdiagnosis physical activity was associated with survival outcomes in high-risk breast cancer patients. METHODS Included were 1340 patients enrolled in the Diet, Exercise, Lifestyle and Cancer Prognosis (DELCaP) Study, a prospective study of lifestyle and prognosis ancillary to a SWOG clinical trial (S0221). Activity before diagnosis, during treatment, and at 1- and 2-year intervals after enrollment was collected. Patients were categorized according to the Physical Activity Guidelines for Americans as meeting the minimum guidelines (yes/no) and incrementally as inactive, low active, moderately active (meeting the guidelines), or high active. RESULTS In joint-exposure analyses, patients meeting the guidelines before and 1 year after diagnosis experienced statistically significant reductions in hazards of recurrence (hazard ratio [HR] = 0.59, 95% confidence interval [CI] = 0.42 to 0.82) and mortality (HR = 0.51, 95% CI = 0.34-0.77); associations were stronger at 2-year follow-up for recurrence (HR = 0.45, 95% CI = 0.31 to 0.65) and mortality (HR = 0.32, 95% CI = 0.19 to 0.52). In time-dependent analyses, factoring in activity from all time points, we observed striking associations with mortality for low- (HR = 0.41, 95% CI = 0.24 to 0.68), moderate- (HR = 0.42, 95% CI = 0.23 to 0.76), and high-active patients (HR = 0.31, 95% CI = 0.18 to 0.53). CONCLUSIONS Meeting the minimum guidelines for physical activity both before diagnosis and after treatment appears to be associated with statistically significantly reduced hazards of recurrence and mortality among breast cancer patients. When considering activity from all time points, including during treatment, lower volumes of regular activity were associated with similar overall survival advantages as meeting and exceeding the guidelines.
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Affiliation(s)
- Rikki A Cannioto
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Alan Hutson
- Department of Biostatistics and Bioinformatics, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Shruti Dighe
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - William McCann
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Susan E McCann
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Gary R Zirpoli
- Slone Epidemiology Center, Boston University, Boston, MA, USA
| | - William Barlow
- SWOG Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Kara M Kelly
- Department of Pediatric Oncology, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Carol A DeNysschen
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA.,Health, Nutrition, and Dietetics, State University of New York at Buffalo, Buffalo, NY, USA
| | - Dawn L Hershman
- Department of Medicine, Columbia University, New York, NY, USA
| | - Joseph M Unger
- SWOG Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Halle C F Moore
- Department of Hematology and Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | - James A Stewart
- Department of Hematology and Oncology, Baystate Medical Center, Springfield, MA, USA
| | - Claudine Isaacs
- Fisher Center for Hereditary Cancer and Clinical Genomics Research, Georgetown University, Washington, DC, USA
| | - Timothy J Hobday
- Department of Medical Oncology, Cancer Center, Mayo Clinic, Rochester, MN, USA
| | - Muhammad Salim
- Medical Oncology, Allan Blair Cancer Centre, Regina, SK, Canada
| | - Gabriel N Hortobagyi
- Department of Breast Medical Oncology, Division of Cancer Medicine - Clinical, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Julie R Gralow
- Breast Medical Oncology, Seattle Cancer Care Alliance, Seattle, WA, USA
| | - Kathy S Albain
- Department of Medicine, Loyola University Chicago Stritch School of Medicine, Chicago, IL, USA
| | - G Thomas Budd
- Department of Hematology and Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Christine B Ambrosone
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
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Nikulin S, Zakharova G, Poloznikov A, Raigorodskaya M, Wicklein D, Schumacher U, Nersisyan S, Bergquist J, Bakalkin G, Astakhova L, Tonevitsky A. Effect of the Expression of ELOVL5 and IGFBP6 Genes on the Metastatic Potential of Breast Cancer Cells. Front Genet 2021; 12:662843. [PMID: 34149804 PMCID: PMC8206645 DOI: 10.3389/fgene.2021.662843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 04/20/2021] [Indexed: 12/09/2022] Open
Abstract
Breast cancer (BC) is the leading cause of death from malignant neoplasms among women worldwide, and metastatic BC presents the biggest problems for treatment. Previously, it was shown that lower expression of ELOVL5 and IGFBP6 genes is associated with a higher risk of the formation of distant metastases in BC. In this work, we studied the change in phenotypical traits, as well as in the transcriptomic and proteomic profiles of BC cells as a result of the stable knockdown of ELOVL5 and IGFBP6 genes. The knockdown of ELOVL5 and IGFBP6 genes was found to lead to a strong increase in the expression of the matrix metalloproteinase (MMP) MMP1. These results were in good agreement with the correlation analysis of gene expression in tumor samples from patients and were additionally confirmed by zymography. The knockdown of ELOVL5 and IGFBP6 genes was also discovered to change the expression of a group of genes involved in the formation of intercellular contacts. In particular, the expression of the CDH11 gene was markedly reduced, which also complies with the correlation analysis. The spheroid formation assay showed that intercellular adhesion decreased as a result of the knockdown of the ELOVL5 and IGFBP6 genes. Thus, the obtained data indicate that malignant breast tumors with reduced expression of the ELOVL5 and IGFBP6 genes can metastasize with a higher probability due to a more efficient invasion of tumor cells.
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Affiliation(s)
- Sergey Nikulin
- Faculty of Biology and Biotechnologies, National Research University Higher School of Economics, Moscow, Russia
| | | | - Andrey Poloznikov
- Faculty of Biology and Biotechnologies, National Research University Higher School of Economics, Moscow, Russia
- School of Biomedicine, Far Eastern Federal University, Vladivostok, Russia
| | - Maria Raigorodskaya
- Faculty of Biology and Biotechnologies, National Research University Higher School of Economics, Moscow, Russia
- Scientific Research Centre Bioclinicum, Moscow, Russia
| | - Daniel Wicklein
- Institute of Anatomy and Experimental Morphology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Udo Schumacher
- Institute of Anatomy and Experimental Morphology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Stepan Nersisyan
- Faculty of Biology and Biotechnologies, National Research University Higher School of Economics, Moscow, Russia
| | - Jonas Bergquist
- Department of Chemistry – BMC, Uppsala University, Uppsala, Sweden
| | - Georgy Bakalkin
- Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden
| | - Lidiia Astakhova
- Scientific Research Centre Bioclinicum, Moscow, Russia
- School of Life Sciences, Immanuel Kant Baltic Federal University, Kaliningrad, Russia
| | - Alexander Tonevitsky
- Faculty of Biology and Biotechnologies, National Research University Higher School of Economics, Moscow, Russia
- Laboratory of Microfluidic Technologies for Biomedicine, Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry RAS, Moscow, Russia
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Operable breast cancer: How not to worsen the prognosis, especially in triple negative and stage II tumors. Surg Oncol 2021; 38:101596. [PMID: 34015750 DOI: 10.1016/j.suronc.2021.101596] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 04/13/2021] [Accepted: 04/26/2021] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Oncological surgery must follow some fundamental principles to be truly curative, one of which is the resection of the tumor with surgical margins free of neoplasia. In breast cancer, surgery with positive margins should be expanded immediately. There are probably different intensities, between the stages and molecular subtypes of operable breast cancer, of worsening prognosis due to the surgical margin compromised by the neoplasia in women not submitted to the necessary enlargement of the positive surgical margin. MATERIALS AND. METHODS Seven hundred and forty-seven women with invasive ductal carcinoma of the breast, analyzing anatomical-pathological information, types of surgery, molecular subtypes, and the presence or absence of the surgical margin compromised by neoplasia. RESULTS Sixty-one (8.2%) patients had positive surgical margin, causing 2.85 times more risk of locoregional relapse compared to negative surgical margin by multivariate analysis. In subgroup analysis, among stages I, II and III, stage II was the most negatively impacted, with those patients presenting 2.42 times more risk of distant metastasis and 4.94 times more risk of locoregional relapses compared to negative surgical margin by multivariate analysis. Among the molecular subtypes, Triple Negative tumors with a positive surgical margin had 3.56 times more risk of death, 4.98 times more risk of distant metastasis and 5.55 times more risk of locoregional relapse compared to negative surgical margin by multivariate analysis. CONCLUSIONS The positive surgical margin, especially in Stage II and Triple-Negative breast cancer patients negatively impact the patient's evolution, increasing risk of distant metastasis and death.
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Cortesi L, Rugo HS, Jackisch C. An Overview of PARP Inhibitors for the Treatment of Breast Cancer. Target Oncol 2021; 16:255-282. [PMID: 33710534 PMCID: PMC8105250 DOI: 10.1007/s11523-021-00796-4] [Citation(s) in RCA: 179] [Impact Index Per Article: 59.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2021] [Indexed: 12/13/2022]
Abstract
Loss-of-function mutations in BRCA1 and BRCA2 are detected in at least 5% of unselected patients with breast cancer (BC). These BC susceptibility genes encode proteins critical for DNA homologous recombination repair (HRR). This review provides an update on oral poly(ADP-ribose) polymerase (PARP) inhibitors for the treatment of BC. Olaparib and talazoparib are PARP inhibitors approved as monotherapies for deleterious/suspected deleterious germline BRCA-mutated, HER2-negative BC. Olaparib is approved in the USA for metastatic BC and in Europe for locally advanced/metastatic BC. Talazoparib is approved for locally advanced/metastatic BC in the USA and Europe. In phase 3 trials, olaparib and talazoparib monotherapies demonstrated significant progression-free survival benefits compared with chemotherapy. Common toxicities were effectively managed by supportive treatment and dose interruptions/reductions. Veliparib combined with platinum-based chemotherapy has also shown promise for locally advanced/metastatic BC in a phase 3 trial. Differences in efficacy and safety across PARP inhibitors (olaparib, talazoparib, veliparib, niraparib, rucaparib) may relate to differences in potency of PARP trapping on DNA and cytotoxic specificity. PARP inhibitors are being investigated in early BC, in novel combinations, and in patients without germline BRCA mutations, including those with somatic BRCA mutations and other HRR gene mutations. Ongoing phase 2/3 studies include PARP inhibitors combined with immune checkpoint inhibitors for the treatment of triple-negative BC. Wider access to testing for BRCA and other mutations, and to genetic counseling, are required to identify patients who could benefit from PARP inhibitor therapy. The advent of PARP inhibitors has potential benefits for BC treatment beyond the locally advanced/metastatic setting.
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Affiliation(s)
- Laura Cortesi
- Department of Oncology and Hematology, Azienda Ospedaliero, Universitaria di Modena Ospedale Civile di Baggiovara, Modena, Italy
| | - Hope S Rugo
- University of California San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
| | - Christian Jackisch
- Sana Klinikum Offenbach, Department of Obstetrics and Gynecology and Breast Cancer Center, Starkenburgring 66, 63069, Offenbach, Germany.
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Alzu’bi A, Najadat H, Doulat W, Al-Shari O, Zhou L. Predicting the recurrence of breast cancer using machine learning algorithms. MULTIMEDIA TOOLS AND APPLICATIONS 2021; 80:13787-13800. [DOI: 10.1007/s11042-020-10448-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Revised: 08/24/2020] [Accepted: 12/22/2020] [Indexed: 08/29/2023]
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Interrelationship of Seasons with Inflammation, Red Meat, Fruit, and Vegetable Intakes, Cardio-Metabolic Health, and Smoking Status among Breast Cancer Survivors. J Clin Med 2021; 10:jcm10040636. [PMID: 33562354 PMCID: PMC7915094 DOI: 10.3390/jcm10040636] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 01/18/2021] [Accepted: 02/01/2021] [Indexed: 12/13/2022] Open
Abstract
Seasons can affect human inflammatory status and the occurrence of diseases, and foods may also have differential impacts on inflammation across seasons; however, few studies have investigated whether there are independent and joint impacts of seasons and red meat, fruit and vegetable intakes on inflammation in breast cancer survivors. We conducted a cross-sectional study by leveraging a large cohort, the Women’s Healthy Eating and Living (WHEL) study. The WHEL study comprised primarily early stage breast cancer survivors and collected blood samples, dietary intake, demographic, and health status information at baseline. We selected 2919 participants who provided baseline dietary information and had measurement of C-reactive protein (CRP), a general marker of inflammation. In our multivariable-adjusted analyses, we found that red meat intakes were positively associated, while fruit and vegetable intakes were inversely associated with CRP; blood collected in the winter season was associated with lower CRP when compared to summer; and increased smoking intensity and body mass index (BMI) as well as having cardio-metabolic conditions (such as heart disease or diabetes) were positively associated with CRP. Furthermore, we examined the joint associations of food intakes and the season of blood draw with CRP in different subgroups. We found that moderate intakes of red meat were associated with a reduction of CRP in winter but not in other seasons; increased intakes of fruit and vegetables were associated with reduced inflammation in most seasons except winter. These associations were observed in most subgroups except past smokers with pack-years ≥ 15, in whom we observed no benefit of red meat intakes in winter. Our study provides valuable evidence for considering seasonal impacts on inflammation and seasonal food impacts in different subgroups among breast cancer survivors. The results of our study are in line with one of the emphases of the current NIH 2020–2030 nutrition strategy plan—namely, pay attention to what, when, and who should eat.
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