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Al-Janabi AAHS. The influence of age, menstrual state and body mass index on the relation between osteopenia and osteoporosis associated with breast cancer. J OBSTET GYNAECOL 2022; 42:3368-3373. [PMID: 36151899 DOI: 10.1080/01443615.2022.2125299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Osteoporosis and body mass index (BMI) have been reported to be associated with breast cancer. The correlation between other types of bone loss and breast cancer requires further illustrative evidence. Effect of age and menstrual state on the relationship of osteoporosis, osteopenia and BMI with breast cancer was evaluated in this study. Two hundred breast cancer patients and 200 breast cancer-free patients were included in a case-control study. Bone mineral density (BMD) and BMI were determined in all subjects. Postmenopause was the most frequent menstrual state. osteopenia was found to be significant in breast cancer patients and osteoporosis was significant in another group of women. There was no significant difference between breast cancer patients and control women in terms of age and menstrual status. Obesity was common in all subjects. In conclusion, bone loss rates are significantly low in breast cancer patients relative to healthy women. There was no significant impact of age, menstrual status or BMI on the development of osteopenia or osteoporosis in breast cancer patients. In addition, BMD analytical results may identify the appropriate treatment for bone loss. A routine check-up of osteopenia or osteoporosis is highly recommended for breast cancer patients.Impact StatementWhat is already known on this subject? Breast cancer may be associated with a wide variety of human body parameters. These parameters can include age, body mass index (BMI), obesity and menstrual status. There is also a correlation between osteoporosis and breast cancer.What do the results of this study add? Osteopenia is the most frequent form of bone loss among women with breast cancer. In contrast, osteoporosis as the worst stage of bone loss is unusual in these patients. Factors such as age, menstruation and BMI have no effect on the development of breast cancer.What are the implications of these findings for clinical practice and/or further research? Identification of the type of bone loss in women with breast cancer is essential to determine the appropriate type of therapy.
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Chen L, Qi Y, Kong X, Su Z, Wang Z, Wang X, Du Y, Fang Y, Li X, Wang J. Nutritional Risk Index Predicts Survival in Patients With Breast Cancer Treated With Neoadjuvant Chemotherapy. Front Nutr 2022; 8:786742. [PMID: 35096932 PMCID: PMC8793025 DOI: 10.3389/fnut.2021.786742] [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: 09/30/2021] [Accepted: 12/20/2021] [Indexed: 12/12/2022] Open
Abstract
Nutritional risk index (NRI) is an index based on ideal body weight that aims to present body weight and serum albumin levels. It has been utilized to discriminate patients at risk of postoperative complications and predict the postoperative outcome of major surgeries. However, this index remains limited for breast cancer patients treated with neoadjuvant chemotherapy (NACT). The research explores the clinical and prognostic significance of NRI in breast cancer patients. This study included 785 breast cancer patients (477 cases received NACT and 308 cases did not) were enrolled in this retrospective study. The optimal NRI cutoff value was evaluated by receiver operating characteristic (ROC) curve, then reclassified as low NRI group (<112) and high NRI group (≥112). The results demonstrated that NRI independently predicted survival on disease-free survival (DFS) and overall survival (OS) by univariate and multivariate Cox regression survival analyses [P = 0.019, hazard ratio (HR): 1.521, 95% CI: 1.071–2.161 and P = 0.004, HR: 1.415, 95% CI: 1.119–1.789; and P = 0.026, HR:1.500, 95% CI: 1.051–2.143 and P < 0.001, HR: 1.547, 95% CI: 1.221–1.959]. According to the optimal cutoff value of NRI, the high NRI value patients had longer mean DFS and OS time in contrast to those with low NRI value patients (63.47 vs. 40.50 months; 71.50 vs. 56.39 months). Furthermore, the results demonstrated that the high NRI score patients had significantly longer mean DFS and OS time than those with low NRI score patients in early-stage breast cancer (χ2 = 9.0510, P = 0.0026 and χ2 = 9.2140, P = 0.0024) and advanced breast cancer (χ2 = 6.2500, P = 0.0124 and χ2 = 5.8880, P = 0.0152). The mean DFS and OS values in patients with high NRI scores were significantly longer in contrast to those with low NRI scores in different molecular subtypes. The common toxicities after NACT were hematologic and gastrointestinal reactions, and the NRI had no statistically significant effects on toxicities, except in nausea (χ2 = 9.2413, P = 0.0024), mouth ulcers (χ2 = 4.8133, P = 0.0282), anemia (χ2 = 8.5441, P = 0.0140), and leukopenia (χ2 = 11.0951, P = 0.0039). NRI serves as a minimally invasive, easily accessible and convenient prognostic tool for evaluating breast cancer prognoses and treatment efficacy, and may help doctors in terms of selecting measures of greater efficiency or appropriateness to better treat breast cancer.
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Affiliation(s)
- Li Chen
- Department of Thyroid and Breast Surgery, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yihang Qi
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiangyi Kong
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zhaohui Su
- Center on Smart and Connected Health Technologies, Mays Cancer Center, School of Nursing, University of Texas Health Science Center, San Antonio, TX, United States
| | - Zhongzhao Wang
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiangyu Wang
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yaying Du
- Department of Thyroid and Breast Surgery, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Yi Fang
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- *Correspondence: Yi Fang
| | - Xingrui Li
- Department of Thyroid and Breast Surgery, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
- Xingrui Li
| | - Jing Wang
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Jing Wang
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Santandrea G, Bellarosa C, Gibertoni D, Cucchi MC, Sanchez AM, Franceschini G, Masetti R, Foschini MP. Hormone Receptor Expression Variations in Normal Breast Tissue: Preliminary Results of a Prospective Observational Study. J Pers Med 2021; 11:jpm11050387. [PMID: 34066838 PMCID: PMC8150273 DOI: 10.3390/jpm11050387] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/27/2021] [Accepted: 05/04/2021] [Indexed: 01/13/2023] Open
Abstract
Normal breast tissue undergoes great variations during a woman’s life as a consequence of the different hormonal stimulation. The purpose of the present study was to examine the hormonal receptor expression variations according to age, menstrual cycle, menopausal state and body mass index. To this purpose, 49 tissue samples of normal breast tissue, obtained during surgery performed for benign and malignant conditions, were immunostained with Estrogen (ER), Progesterone (PR) and Androgen receptors (AR). In addition, Ki67 and Gross Cystic Disease Fluid Protein were studied. The data obtained revealed a great variability of hormone receptor expression. ER and AR generally increased in older and post-menopausal women, while young women presented a higher proliferative rate, evaluated with Ki67. PR increase was observed in women with BMI higher than 25. The different hormonal receptor expression could favor the development of breast cancer.
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Affiliation(s)
- Giacomo Santandrea
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, 41121 Modena, Italy;
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy
| | - Chiara Bellarosa
- Unit of Anatomic Pathology at Bellaria Hospital, Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy;
| | - Dino Gibertoni
- Unit of Hygiene and Biostatistics, Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy;
| | - Maria C. Cucchi
- Breast Surgery Unit, Bellaria Hospital, AUSL Bologna, 40126 Bologna, Italy;
| | - Alejandro M. Sanchez
- Multidisciplinary Breast Center–Dipartimento Scienze della Salute della donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (G.F.); (R.M.)
- Correspondence: (A.M.S.); (M.P.F.); Tel.: +39-051-622-5523 (M.P.F.); Fax: +39-051-622-5759 (M.P.F.)
| | - Gianluca Franceschini
- Multidisciplinary Breast Center–Dipartimento Scienze della Salute della donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (G.F.); (R.M.)
| | - Riccardo Masetti
- Multidisciplinary Breast Center–Dipartimento Scienze della Salute della donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (G.F.); (R.M.)
| | - Maria P. Foschini
- Unit of Anatomic Pathology at Bellaria Hospital, Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy;
- Correspondence: (A.M.S.); (M.P.F.); Tel.: +39-051-622-5523 (M.P.F.); Fax: +39-051-622-5759 (M.P.F.)
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4
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Arthur RS, Xue X, Kamensky V, Chlebowski RT, Simon M, Luo J, Shadyab AH, Neuhouser ML, Banack H, Ho GYF, Lane DS, Pan K, Reding KW, Wassertheil-Smoller S, Dannenberg AJ, Rohan TE. The association between DXA-derived body fat measures and breast cancer risk among postmenopausal women in the Women's Health Initiative. Cancer Med 2019; 9:1581-1599. [PMID: 31875358 PMCID: PMC7013066 DOI: 10.1002/cam4.2690] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 10/06/2019] [Accepted: 10/24/2019] [Indexed: 12/22/2022] Open
Abstract
Background Most studies demonstrating an association between excess adiposity and postmenopausal breast cancer have used anthropometric measures, particularly body mass index (BMI). However, more direct body fat measures may more accurately determine the relationship between body fat distribution and breast cancer risk. Methods Cox proportional hazards regression models were created to examine the associations of dual‐energy x‐ray absorptiometry (DXA) body fat measures (at baseline and during follow‐up) with breast cancer risk among 10 931 postmenopausal women from the Women's Health Initiative cohort. A total of 639 incident invasive breast cancer cases (including 484 estrogen receptor positive (ER+) cases) were ascertained after a median follow‐up of 15.0 years. Results Excess whole body fat mass and trunk fat mass were positively associated with risk invasive breast cancer risk. These associations persisted even after additional adjustment for standard anthropometric measures. In time‐dependent analyses, we observed that both whole body fat mass and trunk fat mass, in the highest versus lowest category, were associated with a doubling of risk of invasive breast cancer overall (HR: 2.17; 95% CI: 1.54‐3.05 and 2.20; 1.55‐3.14, respectively) and of ER+ breast cancer (2.05; 1.37‐3.05 and 2.03; 1.34‐3.07, respectively). The remaining DXA measures were also positively associated with breast cancer risk in baseline and time‐dependent analyses. Conclusion These findings suggest that DXA‐derived body fat measures are positively associated with breast cancer risk after adjustment for BMI and other conventional breast cancer risk factors.
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Affiliation(s)
- Rhonda S Arthur
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Xiaonan Xue
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Victor Kamensky
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Rowan T Chlebowski
- Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Michael Simon
- Department of Oncology, Karmanos Cancer Institute, Detroit, MI, USA
| | - Juhua Luo
- Departments of Epidemiology and Biostatistics, School of Public Health, Indiana University Bloomington, Bloomington, IN, USA
| | - Aladdin H Shadyab
- Division of Epidemiology, Department of Family Medicine and Public Health, University of California San Diego School of Medicine, La Jolla, CA, USA
| | - Marian L Neuhouser
- Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Hailey Banack
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Gloria Y F Ho
- Feinstein Institute for Medical Research, Northwell Health, and Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Great Neck, NY, USA
| | - Dorothy S Lane
- Department of Preventive Medicine, Stony Brook University School of Medicine, Stony Brook, NY, USA
| | - Kathy Pan
- Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Kerryn W Reding
- University of Washington School of Nursing, Seattle, WA, USA
| | | | | | - Thomas E Rohan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
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5
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Nindrea RD, Aryandono T, Lazuardi L, Dwiprahasto I. Association of Overweight and Obesity with Breast Cancer During Premenopausal Period in Asia: A Meta-Analysis. Int J Prev Med 2019; 10:192. [PMID: 31772724 PMCID: PMC6868644 DOI: 10.4103/ijpvm.ijpvm_372_18] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 04/30/2019] [Indexed: 01/07/2023] Open
Abstract
Background: The association of overweight and obesity with breast cancer risk in premenopausal women and in different ethnicities remains in debate, especially among Asian women. The aim of this systematic review and meta-analysis was to determine the association of overweight and obesity with breast cancer during premenopausal period in Asian women. Methods: We performed a meta-analysis of research articles on the association of overweight and obesity with breast cancer during premenopausal period in Asian women published from January 2000 to July 2018 in article databases of EBSCO, PubMed, and ProQuest. Pooled odds ratios (ORs) were calculated by fixed and random-effect models. Publication bias was visually evaluated using funnel plots, and then statistically assessed using Egger's and Begg's tests. Review Manager 5.3 (RevMan 5.3) and Stata version 14.2 (Stata Corporation) were used to process the data. We reviewed 886 articles. Results: We found 15 studies conducted systematic review continued by meta-analysis of relevant data with 22,362 patients. There was significant association of obesity [OR = 1.36 (95% confidence interval (CI) 1.26–1.47, P < 0.00001)] and overweight [OR = 1.17 (95% CI 1.10–1.25, P < 0.00001)] with breast cancer during premenopausal period in Asian women. In this study, there was no significant publication bias for studies included in overweight and obesity with breast cancer during premenopausal in Asian women. Conclusions: This study suggested association of overweight and obesity with breast cancer during premenopausal period in Asian women.
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Affiliation(s)
- Ricvan Dana Nindrea
- Doctoral Program, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta City, Indonesia.,Department of Public Health, Faculty of Medicine, Universitas Andalas, Padang City, Indonesia
| | - Teguh Aryandono
- Department of Surgery, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta City, Indonesia
| | - Lutfan Lazuardi
- Department of Health Policy and Management, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta City, Indonesia
| | - Iwan Dwiprahasto
- Department of Pharmacology and Therapy, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta City, Indonesia
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6
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Fazel A, Hasanpour-Heidari S, Salamat F, Rajaie S, Kazeminezhad V, Naeimi-Tabiei M, Jahangirrad A, Sedaghat S, Hosseinpoor R, Ghasemi-Kebria F, Roshandel G, Weiderpass E. Marked increase in breast cancer incidence in young women: A 10-year study from Northern Iran, 2004-2013. Cancer Epidemiol 2019; 62:101573. [PMID: 31330422 DOI: 10.1016/j.canep.2019.101573] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 06/23/2019] [Accepted: 07/15/2019] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Breast cancer is the most frequent cancer among women worldwide. Breast cancer incidence in young women is a health issue of concern, especially in middle-income countries such as Iran. The aim of this study is to report the breast cancer incidence variations in Golestan province, Iran, over a 10-year period (2004-2013). METHODS We analyzed data from the Golestan Population-based Cancer Registry (GPCR), which is a high-quality cancer registry collecting data on primary cancers based on standard protocols throughout the Golestan province. Age-standardized incidence rates (ASRs) and age-specific incidence rates per 100,000 person-years were calculated. Time trends in ASRs and age-specific rates were evaluated using Joinpoint regressions. The average annual percentage change (AAPC) with correspondence 95% confidence intervals (95%CIs) were calculated. RESULTS A total of 2106 new breast cancer cases were diagnosed during the study period. Most cases occurred in women living in urban areas: 1449 cases (68%) versus 657 cases (31%) in rural areas. Statistically significant increasing trends were observed over the 10-year study period amongst women of all ages (AAPC = 4.4; 95%CI: 1.2-7.8) as well as amongst women in the age groups 20-29 years (AAPC = 10.0; 95%CI: 1.7-19.0) and 30-39 years (AAPC = 5.1; 95%CI: 1.4-9.0). CONCLUSION The incidence of breast cancer increased between 2004 and 2013 in Golestan province amongst all age groups, and in particular amongst women aged 20-39 years. Breast cancer should be considered a high priority for health policy making in our community.
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Affiliation(s)
- Abdolreza Fazel
- Cancer Research Center, Golestan University of Medical Sciences, Gorgan, Iran; Omid Cancer Research Center, Omid Preventive and Health Promotion Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Susan Hasanpour-Heidari
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Fatemeh Salamat
- Cancer Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Siamak Rajaie
- Cancer Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | | | | | | | - SeyedMehdi Sedaghat
- Deputy of Public Health, Golestan University of Medical Sciences, Gorgan, Iran
| | - Reza Hosseinpoor
- Deputy of Public Health, Golestan University of Medical Sciences, Gorgan, Iran
| | - Fatemeh Ghasemi-Kebria
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Gholamreza Roshandel
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran.
| | - Elisabete Weiderpass
- Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Genetic Epidemiology Group, Folkhälsan Research Center, Faculty of Medicine, Helsinki University, Helsinki, Finland; Department of Community Medicine, University of Tromsø, The Arctic University of Norway, Tromsø, Norway
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7
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Gravena AAF, Romeiro Lopes TC, Demitto MDO, Borghesan DHP, Dell’ Agnolo CM, Brischiliari SCR, Carvalho MDDB, Pelloso SM. The Obesity and the Risk of Breast Cancer among Pre and Postmenopausal Women. Asian Pac J Cancer Prev 2018; 19:2429-2436. [PMID: 30255696 PMCID: PMC6249449 DOI: 10.22034/apjcp.2018.19.9.2429] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Background: Breast cancer is the most common cancer among women worldwide and the obesity is one of
the factors related to the risk of breast cancer mainly in postmenopausal women. This study investigated the association
between obesity in pre- and postmenopausal women with the development of breast cancer and the expression of
estrogen, progesterone, HeR-2 and triple-negative (TN) receptors. Methods: A case-control study was conducted
on 100 patients with recently diagnosed breast cancer and 400 age-matched controls. The women were divided into
pre- and post-menopausal groups. Results: The multivariate analysis showed that postmenopausal women with
a BMI ≥ 30 kg/m2 at pre-diagnosis and at the most recent measurement were 1.50 (95% CI 1.06-2.13) and 1.56
(95% CI 1.11-2.21) times more likely to develop breast cancer, respectively. These women had a prevalence of
obesity of 27.7% when considering pre-diagnosis BMI and 29.4% when analyzing the indicator of recent BMI. When
only the cases regarding the presence of obesity with clinicopathological variables were analyzed, a total of 95.2% of
the postmenopausal women with pre-diagnostic obesity according to BMI presented the positive estrogen receptor
(ER) subtype. Conclusions: In Brazilian women, there is an association between obesity and the risk of breast cancer
postmenopause; moreover, there is an association between the occurrence of the positive ER subtype in postmenopausal
women and pre-diagnostic obesity according to BMI.
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Raza U, Asif MR, Rehman AB, Sheikh A. Hyperlipidemia and hyper glycaemia in Breast Cancer Patients is related to disease stage. Pak J Med Sci 2018; 34:209-214. [PMID: 29643909 PMCID: PMC5857015 DOI: 10.12669/pjms.341.14841] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective: The study was designed to determine the hyperlipidemia in breast cancer of patients at disease presentation, without any treatment and to correlate these variations with disease stage. Methods: This cross sectional study was conducted at Liaquat National teaching hospital in Karachi from 2006 to 2011, Age and family history of 208 breast cancer patients with infiltrating Ductal Carcinoma were compared with 176 matched control subjects. Married females were selected, with children and short breast feeding period. Cancer stage I-III was considered for the study and patients were grouped on the basis of Tumor grade, Tumor size, lymph node metastasis and disease free survival. Disease staging was based on tumor size and lymph node metastasis. Biochemical estimations included variations in random blood glucose level and lipid profile. Results: Lipid profile and random blood glucose level were found significantly high (p<0.05) compared to control subjects. Hyperlipidemia was significantly high in breast cancer patients with lymph node metastasis. On increase in tumor grade I to II, increase in total cholesterol (4%), LDL-cholesterol 23% and 11% increase in triglycerides was observed. On Tumor size increase from ≤2 to 2.5cm, increase observed in blood random glucose level was (4%), total cholesterol (1.7%) triglycerides (2%) and LDL (3%) whereas HDL was (2%) low. These variations remain insignificant on further increase in tumor size and grade. Conclusion: Study suggests that variation in lipid profile and blood random glucose level is associated with disease stage. No independent correlation of hyperlipidemia and hyperglycemia was developed with disease free survival.
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Affiliation(s)
- Uzma Raza
- Dr. Uzma Raza, M.Sc, MPhil, Ph.D. Professor and HOD of Biochemistry, Hamdard University, Karachi, Pakistan
| | - Mahay Rookh Asif
- Dr. Mahay Rookh Asif, MBBS, Ph.D. Professor of Pharmacology & Therapeutics, Dow International Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Asif Bin Rehman
- Dr. Asif Bin Rehman, MBBS, Ph.D. Professor of Pharmacology, Hamdard College of Medicine & Dentistry, Hamdard University, Karachi, Pakistan
| | - Aminuddin Sheikh
- Dr. Aminuddin Sheikh, MBBS, M.Phil. Professor of Pathology, Hamdard College of Medicine & Dentistry, Hamdard University, Karachi, Pakistan
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9
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Nindrea RD, Aryandono T, Lazuardi L. Breast Cancer Risk From Modifiable and Non-Modifiable Risk Factors among Women in Southeast Asia: A Meta-Analysis. Asian Pac J Cancer Prev 2017; 18:3201-3206. [PMID: 29281867 PMCID: PMC5980871 DOI: 10.22034/apjcp.2017.18.12.3201] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Objective: The aim of this study was to determine breast cancer risk from modifiable and non-modifiable factors among women in Southeast Asia. Methods: This meta-analysis was performed on research articles on breast cancer risk factors in PubMed, ProQuest and EBSCO databases published between 1997 and October 2017. Pooled odds ratios (OR) are calculated using fixed and random-effect models. Data were processed using Review Manager 5.3 (RevMan 5.3). Results: From a total of 1,211 articles, 15 studies (1 cohort and 14 case control studies) met the criteria for systematic review. Meta-analysis results showed that of the known modifiable risk factors for breast cancer, parity (nulipara) had the highest odd ratio (OR = 1.85 [95% CI 1.47-2.32]) followed by body mass index (overweight) (OR = 1.61 [95% CI 1.43-1.80]) and use of oral contraceptives (OR = 1.27 [95% CI 1.07-1.51]). Of non-modifiable risk factors, family history of breast cancer had the highest odd ratio (OR = 2.53 [95% CI 1.25-5.09]), followed by age (≥ 40 years) (OR = 1.53 [95% CI 1.34-1.76]) and menopausal status (OR = 1.44 [95% CI 1.26-1.65]). Conclusion: This analysis confirmed associations between both modifiable risk factors (parity, body mass index and use of oral contraceptives) and non-modifiable risk factors (family history of breast cancer, age and menopausal status) with breast cancer.
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10
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Shapira N. The potential contribution of dietary factors to breast cancer prevention. Eur J Cancer Prev 2017; 26:385-395. [PMID: 28746163 PMCID: PMC5553235 DOI: 10.1097/cej.0000000000000406] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 06/21/2017] [Indexed: 12/30/2022]
Abstract
Breast cancer (BC), the leading cancer in women, is increasing in prevalence worldwide, concurrent with western metabolic epidemics, that is, obesity, metabolic syndrome, and diabetes, and shares major risk factors with these diseases. The corresponding potential for nutritional contributions toward BC prevention is reviewed and related to critical stages in the life cycle and their implications for carcinogenic and pathometabolic trajectories. BC initiation potentially involves diet-related pro-oxidative, inflammatory, and procarcinogenic processes, that interact through combined lipid/fatty acid peroxidation, estrogen metabolism, and related DNA-adduct/depurination/mutation formation. The pathometabolic trajectory is affected by high estrogen, insulin, and growth factor cascades and resultant accelerated proliferation/progression. Anthropometric risk factors - high birth weight, adult tallness, adiposity/BMI, and weight gain - are often reflective of these trends. A sex-based nutritional approach targets women's specific risk in western obesogenic environments, associated with increasing fatness, estrogen metabolism, n-6 : n-3 polyunsaturated fatty acid ratio, and n-6 polyunsaturated fatty acid conversion to proinflammatory/carcinogenic eicosanoids, and effects of timing of life events, for example, ages at menarche, full-term pregnancy, and menopause. Recent large-scale studies have confirmed the effectiveness of the evidence-based recommendations against BC risk, emphasizing low-energy density diets, highly nutritious plant-based regimes, physical activity, and body/abdominal adiposity management. Better understanding of dietary inter-relationships with BC, as applied to food intake, selection, combination, and processing/preparation, and recommended patterns, for example, Mediterranean, DASH, plant-based, low energy density, and low glycemic load, with high nutrient/phytonutrient density, would increase public motivation and authoritative support for early/timely prevention, optimally merging with other dietary/health goals, for lifelong BC prevention.
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Affiliation(s)
- Niva Shapira
- Department of Nutrition, School of Health Professions, Ashkelon Academic College, Ashkelon, Israel
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Li H, Sun X, Miller E, Wang Q, Tao P, Liu L, Zhao Y, Wang M, Qi Y, Li J. BMI, reproductive factors, and breast cancer molecular subtypes: A case-control study and meta-analysis. J Epidemiol 2016; 27:143-151. [PMID: 28142040 PMCID: PMC5376312 DOI: 10.1016/j.je.2016.05.002] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 05/08/2016] [Indexed: 02/07/2023] Open
Abstract
Background The effects of body mass index (BMI) and reproductive factors may vary among breast cancer molecular subtypes, evidence of which is lacking in East Asia. Methods From 2002 to 2010, 1256 breast cancer patients and 1416 healthy women were recruited. Anthropometric and reproductive factors were collected from medical charts. Breast cancer subtype was defined by ER, PR, and HER2 status. Polytomous logistic regression was used to evaluate associations between risk factors and breast cancer subtypes, with subgroup analysis by menopausal status. A meta-analysis of relevant published studies in East Asia was also performed. Results In our case-control study, late menarche was negatively associated with luminal tumor risk (Ptrend = 0.03). Higher BMI was associated with risk of both luminal and triple-negative tumors (Ptrend<0.001). Late age at first live birth was associated with a 1.41- to 2.08-fold increased risk of all subtypes, while late menopause increased risk by 2.62–5.56 times. Heterogeneity of these associations was not detected for different menopausal statuses. The meta-analysis revealed a positive dose-response relationship between BMI and risk of both luminal and ER-PR- subtypes (Ptrend<0.05). Early menarche and nulliparity increased luminal tumor risk by 1.39 and 1.26 times, respectively. Non-breastfeeding also increased the risk of all subtypes. Conclusions For East Asian women, overweight, late menopause, and lack of breastfeeding appear to increase risk of both luminal and ER−PR− tumors. Early menarche and nulliparity mainly impacted luminal tumor risk. These associations were not impacted by menopausal status. For East Asian women, overweight increases risk of both luminal and ER-PR- tumors. For East Asian women, early menarche increases luminal tumor risk. For East Asian women, nulliparity increases luminal tumor risk.
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Affiliation(s)
- Hui Li
- Department of Epidemiology and Biostatistics, West China School of Public Health, Sichuan University, Chengdu, China
| | - Xuezheng Sun
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Erline Miller
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Qiong Wang
- Department of Epidemiology and Biostatistics, West China School of Public Health, Sichuan University, Chengdu, China; Department of Health Service Management, Public Health School, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Ping Tao
- Department of Breast Surgery, Sichuan Cancer Hospital, Chengdu, China
| | - Li Liu
- The Comprehensive Guidance Center of Women's Health, Chengdu Women's and Children's Central Hospital, Chengdu, China
| | - Ying Zhao
- Department of Epidemiology and Biostatistics, West China School of Public Health, Sichuan University, Chengdu, China
| | - Mengjie Wang
- Department of Epidemiology and Biostatistics, West China School of Public Health, Sichuan University, Chengdu, China
| | - Yana Qi
- Department of Epidemiology and Biostatistics, West China School of Public Health, Sichuan University, Chengdu, China
| | - Jiayuan Li
- Department of Epidemiology and Biostatistics, West China School of Public Health, Sichuan University, Chengdu, China.
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12
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McNamara KM, Guestini F, Sakurai M, Kikuchi K, Sasano H. How far have we come in terms of estrogens in breast cancer? [Review]. Endocr J 2016; 63:413-24. [PMID: 27020038 DOI: 10.1507/endocrj.ej16-0022] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Major advances in breast cancer treatment have almost always been linked to the actions of estrogen. Therefore, this review focused on estrogen actions in the breast, particularly the developments of the past 20 years, the present understanding of disease biology and possible future developments. Within these areas have focused on what is known about the underlying molecular biology and in particular integration of the bioinformatics revolution of the last 15 years with other facets of research. In addition, there will be an emphasis on the understanding brought about by a greater appreciation for the intracrinology of the breast.
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Affiliation(s)
- Keely May McNamara
- Department of Anatomic Pathology, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan
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13
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Gunaldi M, Afsar CU, Okuturlar Y, Gedikbasi A, Kocoglu H, Kural A, Akarsu C, Gunduz U, Tiken EE. Elevated serum levels of heat shock protein 70 are associated with breast cancer. TOHOKU J EXP MED 2016; 236:97-102. [PMID: 26018606 DOI: 10.1620/tjem.236.97] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Breast cancer (BC) is the most frequent cause of cancer death in women throughout the world. Thus, it is necessary to establish sensitive screening, diagnosis and treatment methods for BC. Heat shock protein 70 (HSP70) is an important cellular stress response protein that protects cells from apoptosis. Recent studies have shown that serum HSP70 levels may provide clinically important information in various types of cancer. HSP70 is also overexpressed in BC, which is known to be associated with cancer progression, apoptosis and cell proliferation. However, the serum level of HSP70 and its diagnostic and prognostic potential in BC have not been investigated yet. The aim of this study was to determine the usefulness of serum HSP70 level as a diagnostic test and its predictive value in patients with BC. This prospective study consisted of 45 female patients diagnosed with BC and 16 healthy women who were matched for age and body mass index (BMI). Enzyme-linked immunosorbent assay (ELISA) technique was used to measure the serum level of HSP70. The serum level of HSP70 was significantly higher in patients with BC than in the healthy control group (5.98 ± 2.05 vs. 1.49 ± 0.47 ng/ml, p = 0.001). HSP70 level > 2.41 ng/ml was the best cutoff value to predict BC (97.78% sensitivity and 93.75% specificity). This study shows that HSP70 can be used as an adjunct to other diagnostic tests for BC and may be helpful for identifying patients at increased risk of BC.
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Affiliation(s)
- Meral Gunaldi
- Department of Medical Oncology, Bakirkoy Dr. Sadi Konuk Education and Research Hospital
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14
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Tamaki K, Tamaki N, Kamada Y, Uehara K, Zaha H, Onomura M, Ueda M, Kurashita K, Miyazato K, Higa J, Miyara K, Shiraishi M, Murayama S, Ishida T. Can we improve breast cancer mortality in Okinawa? Consensus of the 7th Okinawa Breast Oncology Meeting. TOHOKU J EXP MED 2015; 235:111-5. [PMID: 25749491 DOI: 10.1620/tjem.235.111] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The rate of breast cancer mortality in Okinawa has gradually been increasing up to 2010. Now Okinawa has the second worst mortality rate in Japan, in part due to the enormous dietary changes resulting from the post-World War II US military occupation, high incidence of obesity, high non-optimal treatment rate, and low breast-cancer screening rate. To reduce breast cancer mortality in Okinawa, we established the Okinawa Breast Oncology Meeting (OBOM) in 2012. At the 7th OBOM held on January 10th, 2014, we discussed the breast cancer mortality in Okinawa focusing on lifestyle, breast cancer screening and optimal treatments. The Okinawan women who were overweight and/or obese during premenopausal and postmenopausal ages had a statistically significant higher risk of breast cancer development compared to those with non-overweight and/or obese women. The traditional diet of Okinawa consists of foods low in calories but rich in nutritional value. Therefore, we recommend Okinawan people not to forget the Okinawan traditional lifestyle, and to reduce their bodyweight to prevent breast cancer. One of the main goals of the OBOM is to raise breast cancer screening attendance rates to 50% (29.2% in 2010). We should standardize the quality control for breast cancer screening in Okinawa. It is important to continue enlightening the Okinawan population to receive optimal treatment. In addition, we are striving to establish systematic medical cooperation between the hospitals specializing in breast cancer treatment with rural hospitals. The OBOM group endeavors to contribute to the improvement of breast cancer mortality in Okinawa.
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Affiliation(s)
- Kentaro Tamaki
- Okinawa Breast Oncology Meeting Group; Department of Breast Surgery, Nahanishi Clinic, Naha, Japan.
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