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Dehar N, Jabs D, Hopman W, Mates M. A Retrospective Analysis of Diagnostic Breast Imaging Outcomes in Young Women at a Tertiary Care Center. Curr Oncol 2024; 31:3939-3948. [PMID: 39057163 PMCID: PMC11276166 DOI: 10.3390/curroncol31070291] [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: 05/22/2024] [Revised: 06/29/2024] [Accepted: 07/03/2024] [Indexed: 07/28/2024] Open
Abstract
(1) Purpose: The purpose of this study was to describe the outcomes of diagnostic breast imaging and the incidence of delayed breast cancer diagnosis in the study population. (2) Methods: We collected the outcome data from diagnostic mammograms and/or breast ultrasounds (USs) performed on women between the ages of 30 and 50 with symptomatic breast clinical presentations between 2018 and 2019. (3) Results: Out of 171 eligible patients, 10 patients (5.8%) had BIRADS 0, 90 patients (52.6%) had benign findings (BIRADS 1 and 2), 41 (24.0%) patients had probable benign findings requiring short-term follow-up (BIRADS 3), while 30 (17.5%) patients had findings suspicious of malignancy (BIRADS 4 and 5). In the BIRADS 3 group, 92.7% had recommended follow-up, while in BIRADS 4 and 5, only 83.3% underwent recommended biopsy at a mean time of 1.7 weeks (range 0-22 wks) from their follow-up scan. Ten (6%) patients were diagnosed with breast cancer, all of whom had BIRADS 4 or 5, with a mean time of breast cancer diagnosis from initial diagnostic imaging of 2.2 weeks (range 1-22 wks). No patients had delayed breast cancer diagnosis in our cohort. (4) Conclusions: We conclude that diagnostic mammograms and breast US are appropriate investigations for clinical breast concerns in women aged 30-50 years.
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Affiliation(s)
- Navdeep Dehar
- Department of Oncology, Queen’s School of Medicine, Queen’s University, Kingston, ON K7L 5P9, Canada; (D.J.); (M.M.)
- Cancer Centre of Southeastern Ontario, Kingston Health Sciences Centre, Kingston, ON K7L 2V7, Canada
| | - Doris Jabs
- Department of Oncology, Queen’s School of Medicine, Queen’s University, Kingston, ON K7L 5P9, Canada; (D.J.); (M.M.)
- Cancer Centre of Southeastern Ontario, Kingston Health Sciences Centre, Kingston, ON K7L 2V7, Canada
| | - Wilma Hopman
- KGH Research Institute, Department of Public Health Sciences, Queen’s University, Kingston, ON K7L 3N6, Canada;
| | - Mihaela Mates
- Department of Oncology, Queen’s School of Medicine, Queen’s University, Kingston, ON K7L 5P9, Canada; (D.J.); (M.M.)
- Cancer Centre of Southeastern Ontario, Kingston Health Sciences Centre, Kingston, ON K7L 2V7, Canada
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Stubbendorff A, Stern D, Ericson U, Sonestedt E, Hallström E, Borné Y, Lajous M, Forouhi NG, Olsen A, Dahm CC, Ibsen DB. A systematic evaluation of seven different scores representing the EAT-Lancet reference diet and mortality, stroke, and greenhouse gas emissions in three cohorts. Lancet Planet Health 2024; 8:e391-e401. [PMID: 38849181 DOI: 10.1016/s2542-5196(24)00094-9] [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: 04/21/2023] [Revised: 02/23/2024] [Accepted: 04/18/2024] [Indexed: 06/09/2024]
Abstract
Different approaches have been used for translation of the EAT-Lancet reference diet into dietary scores that can be used to assess health and environmental impact. Our aim was to compare the different EAT-Lancet diet scores, and to estimate their associations with all-cause mortality, stroke incidence, and greenhouse gas emissions. We did a systematic review (PROSPERO, CRD42021286597) to identify different scores representing adherence to the EAT-Lancet reference diet. We then qualitatively compared the diet adherence scores, including their ability to group individuals according the EAT-Lancet reference diet recommendations, and quantitatively assessed the associations of the diet scores with health and environmental outcome data in three diverse cohorts: the Danish Diet, Cancer and Health Cohort (DCH; n=52 452), the Swedish Malmö Diet and Cancer Cohort (MDC; n=20 973), and the Mexican Teachers' Cohort (MTC; n=30 151). The DCH and MTC used food frequency questionnaires and the MDC used a modified diet history method to assess dietary intake, which we used to compute EAT-Lancet diet scores and evaluate the associations of scores with hazard of all-cause mortality and stroke. In the MDC, dietary greenhouse gas emission values were summarised for every participant, which we used to predict greenhouse gas emissions associated with varying diet adherence scores on each scoring system. In our review, seven diet scores were identified (Knuppel et al, 2019; Trijsburg et al, 2020; Cacau et al, 2021; Hanley-Cook et al, 2021; Kesse-Guyot et al, 2021; Stubbendorff et al, 2022; and Colizzi et al, 2023). Two of the seven scores (Stubbendorff and Colizzi) were among the most consistent in grouping participants according to the EAT-Lancet reference diet recommendations across cohorts, and higher scores (greater diet adherence) were associated with decreased risk of mortality (in the DCH and MDC), decreased risk of incident stroke (in the DCH and MDC for the Stubbendorff score; and in the DCH for the Colizzi score), and decreased predicted greenhouse gas emissions in the MDC. We conclude that the seven different scores representing the EAT-Lancet reference diet had differences in construction, interpretation, and relation to disease and climate-related outcomes. Two scores generally performed well in our evaluation. Future studies should carefully consider which diet score to use and preferably use multiple scores to assess the robustness of estimations, given that public health and environmental policy rely on these estimates.
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Affiliation(s)
- Anna Stubbendorff
- Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden.
| | - Dalia Stern
- CONAHCyT-Center for Population Health Research, National Institute of Public Health, Avenida Universidad 655, Cuernavaca, Mexico
| | - Ulrika Ericson
- Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
| | - Emily Sonestedt
- Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
| | - Elinor Hallström
- Department of Agriculture and Food, Research Institutes of Sweden, Lund, Sweden
| | - Yan Borné
- Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
| | - Martin Lajous
- CONAHCyT-Center for Population Health Research, National Institute of Public Health, Avenida Universidad 655, Cuernavaca, Mexico
| | - Nita G Forouhi
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge, UK
| | - Anja Olsen
- Department of Public Health, Aarhus University, Aarhus, Denmark; Danish Cancer Society, Copenhagen, Denmark
| | | | - Daniel B Ibsen
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge, UK; Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus Denmark; Department of Nutrition, Sports and Exercise, University of Copenhagen, Frederiksberg, Denmark
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Sefidbakht S, Beizavi Z, Kanaani Nejad F, Pishdad P, Sadighi N, Ghoddusi Johari M, Bijan B, Tahmasebi S. Association of imaging and pathological findings of breast cancer in very young women: Report of a twenty-year retrospective study. Clin Imaging 2024; 110:110094. [PMID: 38599926 DOI: 10.1016/j.clinimag.2024.110094] [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: 09/03/2023] [Revised: 01/14/2024] [Accepted: 01/20/2024] [Indexed: 04/12/2024]
Abstract
PURPOSE In this study, we aimed to assess the new trends in characteristics, molecular subtypes, and imaging findings of breast cancer in very young women. METHODS We retrospectively reviewed the database of a primary breast cancer referral center in southern Iran in 342 cases of 30-year-old or younger women from 2001 to 2020. Pathologic data, including nuclear subtype and grade, tumor stage, presence of in situ cancer, imaging data including lesion type in mammogram and ultrasound, and treatment data were recorded. Descriptive statistics were applied. Differences between categorical values between groups were compared using Pearson's Chi-square test. RESULTS The mean age was 27.89 years. The tumor type was invasive ductal carcinoma in 82 % of cases. Fourteen patients (4.4 %) had only in situ cancer, and 170 patients had in situ components (49.7 %). Molecular subtypes were available in 278 patients, including 117 (42.1 %) Luminal A, 64 (23.0 %) Luminal B, 58 (20.9 %) triple negative, and 39 (14 %) HER2 Enriched. In those with mammograms available, 63 (30.1 %) had no findings, 53 (25.3 %) had mass, 27 (12.9 %) had asymmetry, whether focal or global, 21 (10 %) had microcalcifications solely, and 45 (21.5 %) had more than one finding. Microcalcifications were significantly more common in Luminal cancers than HER2 and triple-negative cancers (p = 0.041). CONCLUSION Our study shows the most common subtype to be Luminal A cancer, with 74 % of the tumors being larger than 2 cm at the time of diagnosis. Irregular masses with non-circumscribed margins were the most common imaging findings.
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Affiliation(s)
- Sepideh Sefidbakht
- Medical Imaging Research Center, Department of Radiology, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Zahra Beizavi
- Department of Radiology, Mayo Clinic, Phoenix, AZ, USA
| | - Fatemeh Kanaani Nejad
- Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Parisa Pishdad
- Medical Imaging Research Center, Department of Radiology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nahid Sadighi
- Radiology Department, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Bijan Bijan
- Sutter Imaging (SMG) - Sacramento, Professor of Nuclear Medicine & Radiology (W.O.S.), University of California Davis Medical Center, Sacramento, CA, USA
| | - Sedigheh Tahmasebi
- Breast Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; Surgical Oncology Division, General Surgery Department, Shiraz University of Medical Sciences, Shiraz, Iran
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Boutrus RR, Abdelazim YA, Mohammed T, Bayomy M, Ibraheem MH, Hussein A, Sebaie ME. The impact of loco-regional treatment modality on the outcomes in breast cancer patients younger than forty years of age. BMC Cancer 2024; 24:599. [PMID: 38760780 PMCID: PMC11100067 DOI: 10.1186/s12885-024-12325-3] [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: 08/24/2023] [Accepted: 04/30/2024] [Indexed: 05/19/2024] Open
Abstract
PURPOSE To determine the impact of the loco-regional treatment modality, on the loco-regional recurrence (LRR) rates and overall survival (OS) in breast cancer patients younger than 40 years. METHODS Data of 623 breast cancer patients younger than 40 years of age were retrospectively reviewed. Patients were stratified according to the locoregional treatment approach into three groups: the mastectomy group (M), the mastectomy followed by radiation therapy group (MRX) and the breast conservative therapy group (BCT). RESULTS Median follow-up was 72 months (range, 6-180). Two hundred and nine patients were treated with BCT, 86 with MRM and 328 with MRX. The 10-year rate LRR rates according to treatment modality were: 13.4% for BCT, 15.1% for MRM and 8.5% for MRX (p 0.106). On univariate analysis, T stage (p 0.009), AJCC stage (p 0.047) and Her 2 status (p 0.001) were associated with LRR. Ten-year overall survival (OS) was 72.7% (78.5% in the BCT group, 69.8% in the MRM group and 69.8% in the MRX group, p 0.072). On Univariate analysis, age < 35 (p 0.032), grade III (p 0.001), N3 stage (p 0.001), AJCC stage III (p 0.005), ER negative status (0.04), Her 2-status positive (0.006) and lack of chemotherapy administration (p 0.02) were all predictors of increased mortality. CONCLUSION For patients younger than 40 years of age, similar LRR and overall survival outcomes were achieved using BCT, M or MRX. Young age at diagnosis should not be used alone in recommending one loco-regional treatment approach over the others.
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Affiliation(s)
- Rimoun R Boutrus
- Radiation Oncology Department, National Cancer Institute, Cairo University, 1 Kasr El Aini Street, Fom El Khalig, Cairo, 11796, Egypt
| | - Yasser A Abdelazim
- Radiation Oncology Department, National Cancer Institute, Cairo University, 1 Kasr El Aini Street, Fom El Khalig, Cairo, 11796, Egypt.
| | - Toka Mohammed
- Radiation Oncology Department, National Cancer Institute, Cairo University, 1 Kasr El Aini Street, Fom El Khalig, Cairo, 11796, Egypt
| | - Mohammed Bayomy
- Department of Clinical Oncology, Zagazig University, Zagazig, Egypt
| | - Maher H Ibraheem
- Surgical Oncology Department, Breast Division, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Alaadin Hussein
- Surgical Oncology Department, Breast Division, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Medhat El Sebaie
- Radiation Oncology Department, National Cancer Institute, Cairo University, 1 Kasr El Aini Street, Fom El Khalig, Cairo, 11796, Egypt
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Culha Y, Davarci SE, Ünlü B, Özaşkin D, Demir H, Baykara M. Comparison of clinicopathological and prognostic features of breast cancer patients younger than 40 years and older than 65 years. Discov Oncol 2024; 15:126. [PMID: 38649531 PMCID: PMC11035508 DOI: 10.1007/s12672-024-00952-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 03/28/2024] [Indexed: 04/25/2024] Open
Abstract
PURPOSE This study aims to compare the clinicopathological and prognostic features of women aged 40 years and younger and 65 years and older with breast cancer. METHODS Between January 2011 and December 2021, 136 female cases aged 40 years and younger and 223 female cases aged 65 and over were identified among all cases (1395 cases) registered as breast cancer in the file archives of Afyonkarahisar Health Sciences University Faculty of Medicine, Department of Medical Oncology for the study. A Chi-square (× 2) test was used for categorical variables, and an independent sample t-test for continuous variables. Log-rank test and Kaplan-Meier plots were used for survival analysis. For the statistical evaluation, p < 0.05 was considered significant. RESULTS Both overall survival (p < 0.01) and breast cancer-specific survival (BCSS) (p = 0.01) were significantly worse in the older group. BCSS were significantly worse in the older group in Luminal B (HER2-) (p = 0.013) and HR- HER2+ (p = 0.015) subtypes detected. In multivariate Cox regression analysis, only the presence of metastases at diagnosis or follow-up (p < 0.001) and ECOG PS 2-3 status (p = 0.001) were associated with an increased risk of breast cancer-specific death. CONCLUSION To our knowledge, no study directly compares these two groups. In our study, similar to many studies, more aggressive tumor features were found in young patients, but unlike many studies, mortality was found to be significantly higher in older patients. The presence of metastasis and poor ECOG PS were found to be the most influential factors in breast cancer-specific death risk.
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Affiliation(s)
- Yaşar Culha
- Department of Medical Oncology, Afyon Health Sciences University School of Medicine, Afyonkarahisar, Turkey.
| | - Sena Ece Davarci
- Department of Medical Oncology, Afyon Health Sciences University School of Medicine, Afyonkarahisar, Turkey
| | - Beyza Ünlü
- Department of Medical Oncology, Afyon Health Sciences University School of Medicine, Afyonkarahisar, Turkey
| | - Duygu Özaşkin
- Department of Medical Oncology, Afyon Health Sciences University School of Medicine, Afyonkarahisar, Turkey
| | - Hacer Demir
- Department of Medical Oncology, Afyon Health Sciences University School of Medicine, Afyonkarahisar, Turkey
| | - Meltem Baykara
- Department of Medical Oncology, Afyon Health Sciences University School of Medicine, Afyonkarahisar, Turkey
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Martínez-Nava GA, Urbina-Jara LK, Lira-Albarrán S, Gómez HL, Ruiz-García E, Nieto-Coronel MT, Ortiz-Lopez R, Martínez Villalba KN, Muñoz-Sánchez M, Aguilar D, Gómez-Flores-Ramos L, Cabrera-Nieto SA, Mohar A, Cruz-Ramos M. Somatic Mutations in Latin American Breast Cancer Patients: A Systematic Review and Meta-Analysis. Diagnostics (Basel) 2024; 14:287. [PMID: 38337803 PMCID: PMC10855727 DOI: 10.3390/diagnostics14030287] [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: 11/30/2023] [Revised: 01/16/2024] [Accepted: 01/18/2024] [Indexed: 02/12/2024] Open
Abstract
(1) Background: Somatic mutations may be connected to the exposome, potentially playing a role in breast cancer's development and clinical outcomes. There needs to be information regarding Latin American women specifically, as they are underrepresented in clinical trials and have limited access to somatic analysis in their countries. This study aims to systematically investigate somatic mutations in breast cancer patients from Latin America to gain a better understanding of tumor biology in the region. (2) Methods: We realize a systematic review of studies on breast cancer in 21 Latin American countries using various databases such as PubMed, Google Scholar, Web of Science, RedAlyc, Dianlet, and Biblioteca Virtual en Salud. Of 392 articles that fit the criteria, 10 studies have clinical data which can be used to create a database containing clinical and genetic information. We compared mutation frequencies across different breast cancer subtypes using statistical analyses and meta-analyses of proportions. Furthermore, we identified overexpressed biological processes and canonical pathways through functional enrichment analysis. (3) Results: 342 mutations were found in six Latin American countries, with the TP53 and PIK3CA genes being the most studied mutations. The most common PIK3CA mutation was H1047R. Functional analysis provided insights into tumor biology and potential therapies. (4) Conclusion: evaluating specific somatic mutations in the Latin American population is crucial for understanding tumor biology and determining appropriate treatment options. Combining targeted therapies may improve clinical outcomes in breast cancer. Moreover, implementing healthy lifestyle strategies in Latin America could enhance therapy effectiveness and clinical outcomes.
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Affiliation(s)
- Gabriela A. Martínez-Nava
- Laboratorio de Gerociencias, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Calz. México-Xochimilco 289, Tlalpan, Mexico City 14389, Mexico;
| | - Laura Keren Urbina-Jara
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey 64710, Mexico; (L.K.U.-J.); (R.O.-L.)
| | - Saúl Lira-Albarrán
- Departamento de Gestión Académica e Investigación, Hospital Escuela, Tegucigalpa 11101, Honduras;
| | - Henry L. Gómez
- Departmento de Medicina Oncológica, Instituto Nacional de Enfermedades Neoplásicas, Av. Angamos Este 2520, Lima 15023, Peru;
| | - Erika Ruiz-García
- Laboratorio de Medicina Traslacional, Instituto Nacional de Cancerologia, Mexico City 14080, Mexico;
| | - María Tereza Nieto-Coronel
- Departamento de Medicina Oncológica, Centro Oncopalia, Universidad Mayor de San Andrés, La Paz P.O. Box 8635, Bolivia;
| | - Rocio Ortiz-Lopez
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey 64710, Mexico; (L.K.U.-J.); (R.O.-L.)
- Tecnologico de Monterrey, Institute for Obesity Research, Monterrey 64849, Mexico
| | - Kenia Nadiezhda Martínez Villalba
- Unidad de Epidemiología e Investigación Biomédica en Cáncer, Instituto de Investigaciones Biomédicas, UNAM-Instituto Nacional de Cancerología, Mexico City 14080, Mexico; (K.N.M.V.); (A.M.)
| | - Mariana Muñoz-Sánchez
- Facultad de Ciencias de la Salud, Universidad Anáhuac México, Mexico City 52786, Mexico; (M.M.-S.); (S.A.C.-N.)
| | - Dione Aguilar
- Tecnologico de Monterrey, Centro de Cáncer de Mama, Hospital Zambrano Hellion, San Pedro Garza García 66278, Mexico;
| | - Liliana Gómez-Flores-Ramos
- CONAHCYT/Center for Population Health Research, National Institute of Public Health, Universidad No. 655, Cuernavaca 62100, Mexico;
| | - Sara Aileen Cabrera-Nieto
- Facultad de Ciencias de la Salud, Universidad Anáhuac México, Mexico City 52786, Mexico; (M.M.-S.); (S.A.C.-N.)
| | - Alejandro Mohar
- Unidad de Epidemiología e Investigación Biomédica en Cáncer, Instituto de Investigaciones Biomédicas, UNAM-Instituto Nacional de Cancerología, Mexico City 14080, Mexico; (K.N.M.V.); (A.M.)
| | - Marlid Cruz-Ramos
- Programa Joven y Fuerte/CONAHCYT, Instituto Nacional de Cancerología, Av. San Fernando 22, Belisario Domínguez Sección 16, Tlalpan, Mexico City 14080, Mexico
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Kasgri KA, Abazari M, Badeleh SM, Badeleh KM, Peyman N. Comprehensive Review of Breast Cancer Consequences for the Patients and Their Coping Strategies: A Systematic Review. Cancer Control 2024; 31:10732748241249355. [PMID: 38767653 PMCID: PMC11107334 DOI: 10.1177/10732748241249355] [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: 09/22/2023] [Revised: 03/29/2024] [Accepted: 04/04/2024] [Indexed: 05/22/2024] Open
Abstract
BACKGROUND Women with breast cancer usually face multiple short-term and long-term problems in dealing with their acute and chronic symptoms during and after cancer treatment. However, serious gaps remain in addressing these issues in clinical and public health practice. METHODS According to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines, we conducted a systematic literature search from 2000-2021 in electronic databases, including Medline, PubMed, Embase, Scopus, Web of Knowledge, and Google Scholar databases using predefined keywords. RESULTS The review identified several significant and interconnected problems in breast cancer patient's treatment and supportive care. The results revealed that these issues are very common among breast cancer patients, and specific attention and serious measures are needed to address these problems. Despite implementing different protocols and programs for covering and addressing these problems, serious gaps still exist in supporting breast cancer patients during clinical and follow-up care. CONCLUSION Developing innovative and holistic approaches and programs based on the multifactorial assessment of symptoms are suggested for addressing and covering the multidimensional requirements of this population. Consequently, thorough evaluation, education, treatment, and referrals should be provided for the most common sequelae of these patients by including appropriate medication, exercise, counselling, occupational therapy, and complementary therapies. The present study provides a more comprehensive source of information about breast cancer patient's medical and supportive needs in comparison with individual studies on symptom experiences.
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Affiliation(s)
- Kobra A. Kasgri
- Department of Midwifery, Faculty of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran
| | - Morteza Abazari
- Department of Pharmaceutical Nanotechnology, School of Pharmacy, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Safa M. Badeleh
- Department of Food and Drug Control, School of Pharmacy, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Kosar M. Badeleh
- Department of Sciences, Islamic Azad University, Sari Branch, Sari, Iran
| | - Nooshin Peyman
- Department of Health Education and Health Promotion, Faculty of Health, Mashhad University of Medical Sciences, Mashhad, Iran
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Xu H, Xu B. Breast cancer: Epidemiology, risk factors and screening. Chin J Cancer Res 2023; 35:565-583. [PMID: 38204449 PMCID: PMC10774137 DOI: 10.21147/j.issn.1000-9604.2023.06.02] [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: 11/29/2023] [Accepted: 12/14/2023] [Indexed: 01/12/2024] Open
Abstract
Breast cancer is a global health concern with a significant impact on the well-being of women. Worldwide, the past several decades have witnessed changes in the incidence and mortality of breast cancer. Additionally, epidemiological data reveal distinct geographic and demographic disparities globally. A range of modifiable and non-modifiable risk factors are established as being associated with an increased risk of developing breast cancer. This review discusses genetic, hormonal, behavioral, environmental, and breast-related risk factors. Screening plays a critical role in the effective management of breast cancer. Various screening modalities, including mammography, ultrasound, magnetic resonance imaging (MRI), and physical examination, have different applications, and a combination of these modalities is applied in practice. Current screening recommendations are based on factors including age and risk, with a significant emphasis on minimizing potential harms to achieve an optimal benefits-to-harms ratio. This review provides a comprehensive insight into the epidemiology, risk factors, and screening of breast cancer. Understanding these elements is crucial for improving breast cancer management and reducing its burden on affected individuals and healthcare systems.
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Affiliation(s)
- Hangcheng Xu
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Binghe Xu
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
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9
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González Mariño MA. Mortality from Breast Cancer in Women under 50 Years of Age in Colombia. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRÍCIA 2023; 45:e775-e779. [PMID: 38141598 DOI: 10.1055/s-0043-1775881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2023] Open
Abstract
OBJECTIVE To calculate and analyze the mortality rates from breast cancer in women under 50 years of age in Colombia and to compare them with those of other countries in the region. METHODS Based on data from the registry of deaths in 2018 and the results of the National Population and Housing Census of Colombia for the same year, specific mortality rates in women with breast cancer, specific mortality according to age group, standardized by age, proportional mortality, potential years of life lost, and years of life expectancy lost in women under 50 years of age who died from breast cancer were calculated. The mortality rate of regional countries was consulted on the Global Cancer Observatory webpage. RESULTS In the group from 20 to 49 years, the specific mortality rate was higher in the age range from 45 to 49 years, with a rate of 23.42 × 100,000, a value that was above the specific mortality rate due to breast cancer in women in Colombia, 15.17 × 100.000. In the age range of 45 to 49 years, the potential years of life lost were 42.16. Of the 0.275 years of life expectancy lost by the population due to this neoplasia, women under 50 years of age represented 0.091 (33%). Colombia is the fifth in the rank of mortality in Latin American countries in this age group. CONCLUSION Breast cancer in patients from 30 to 59 years is the number one cause for the decrease in life expectancy of women in Colombia. Women under 50 years of age represent one third of this decrease. This neoplasm is also the leading cause of mortality in women younger than 50 years in South America.
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Affiliation(s)
- Mario Arturo González Mariño
- Department of Obstetrics and Gynecology, Faculty of Medicine, Universidad Nacional de Colombia, Bogotá, Colombia
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10
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Tiscoski KA, Giacomazzi J, Rocha MS, Gössling G, Werutsky G. Real-world data on triple-negative breast cancer in Latin America and the Caribbean. Ecancermedicalscience 2023; 17:1635. [PMID: 38414969 PMCID: PMC10898885 DOI: 10.3332/ecancer.2023.1635] [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: 04/28/2023] [Indexed: 02/29/2024] Open
Abstract
Breast cancer (BC) is the most prevalent cancer in women in Latin America and the Caribbean. We compiled real-world data (RWD) on the epidemiology, diagnosis, treatment, and patient outcomes of triple-negative breast cancer (TNBC), addressing the main barriers to optimal care in Latin America. The prevalence of TNBC varies between 11% and 38.5% of all BC cases diagnosed in the region, and TNBC primarily affects young patients. Delays in BC diagnosis, with consequent advanced disease stages and barriers to access efficient therapies, particularly due to high costs, negatively impact patient outcomes. Cancer clinical trials are an opportunity to access standard and novel therapies for patients with this aggressive BC subtype and thus must be prioritised. Finally, generating RWD and cost-effectiveness studies in a region with limited resources is critical for decision-makers to define the incorporation of new technologies for the treatment of BC.
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Affiliation(s)
- Katsuki Arima Tiscoski
- Santa Casa de Misericórdia de Porto Alegre, Rua Professor Annes Dias, Porto Alegre 90020-090, Brazil
- https://orcid.org/0000-0003-0074-4272
| | - Juliana Giacomazzi
- Latin American Cooperative Oncology Group (LACOG), Av Ipiranga, Porto Alegre 90619-900, Brazil
- https://orcid.org/0000-0001-5811-5140
| | - Matheus Soares Rocha
- Latin American Cooperative Oncology Group (LACOG), Av Ipiranga, Porto Alegre 90619-900, Brazil
- https://orcid.org/0000-0001-8972-7449
| | - Gustavo Gössling
- Latin American Cooperative Oncology Group (LACOG), Av Ipiranga, Porto Alegre 90619-900, Brazil
- https://orcid.org/0000-0002-4361-2889
| | - Gustavo Werutsky
- Latin American Cooperative Oncology Group (LACOG), Av Ipiranga, Porto Alegre 90619-900, Brazil
- https://orcid.org/0000-0001-6271-105X
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11
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Gao X, Zhang F, Zhou Q, Xu H, Bian J. Metastasis, characteristic, and treatment of breast cancer in young women and older women: A study from the Surveillance, Epidemiology, and End Results registration database. PLoS One 2023; 18:e0293830. [PMID: 37917616 PMCID: PMC10621871 DOI: 10.1371/journal.pone.0293830] [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: 08/29/2023] [Accepted: 10/19/2023] [Indexed: 11/04/2023] Open
Abstract
BACKGROUND Younger age is an independent risk factor for breast cancer (BC) prognosis, and BC in young women is often considered more aggressive. BC patients with different age and molecular subtypes have different metastasis patterns and survival. Herein, we aim to explore the metastasis patterns, characteristics and treatment methods of young patients with BC, and to compare them with older patients. METHODS Data of young patients (aged ≤40 years old) and older patients (aged >40 years old) with BC were extracted from the Surveillance, Epidemiology, and End Results (SEER) registration database in 2010-2019 in this retrospective cohort study. Univariate and multivariate competing risk models and proportional hazard models were used to explore the association between different metastasis patterns and treatments and BC prognoses in young and older patients. Kaplan-Meier (KM) curves were drawn to reflect the survival probability of patients with BC who have different metastasis patterns. Also, we performed subgroup analysis of different metastasis patterns to explore the association between different treatments and overall survival (OS)/cancer specific survival (CSS) in patients with BC. The evaluation index was hazard ratios (HRs) with 95% confidence intervals (CIs). RESULTS Totally, 5,984 patients died, and 92.56% of them died from BC. There were respectively 1,089 young patients and 9,105 older patients, and we found some differences of characteristics and metastasis patterns between them. After adjusting for covariates, young patients who had brain metastasis and multiple sites metastasis seemed to have high risk of both lower OS and CSS. Among older patients with BC, brain metastasis, liver metastasis, and multiple sites metastasis were all positively associated with both lower OS and CSS. In young and older patients, those who not receive radiotherapy or surgery, or received non-surgery combined with radiotherapy seemed to have high risk of both lower OS and CSS. Breast-conserving surgery (BCS) and surgery combined with radiotherapy were associated with higher OS and CSS in young patients, while only older patients received surgery combined with radiotherapy had higher OS and CSS. Results of subgroup analysis indicated that for patients with different metastasis patterns, developing a personalized treatment plan is necessary. CONCLUSIONS Characteristics of BC between young patients and older patients were different. Clinicians should focus on different metastasis sites and choose appropriate treatments in patients with different ages, which may improve the prognoses.
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Affiliation(s)
- Xiaokang Gao
- Department of Thyroid and Breast Surgery, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, Jiangsu Province, P. R. China
| | - Fengxia Zhang
- Department of Thyroid and Breast Surgery, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, Jiangsu Province, P. R. China
| | - Qiwang Zhou
- Department of Thyroid and Breast Surgery, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, Jiangsu Province, P. R. China
| | - Hui Xu
- Department of Thyroid and Breast Surgery, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, Jiangsu Province, P. R. China
| | - Jie Bian
- Department of Medical, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, Jiangsu Province, P. R. China
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12
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Tinterri C, Di Maria Grimaldi S, Sagona A, Barbieri E, Darwish S, Bottini A, Canavese G, Gentile D. Comparison of Long-Term Oncological Results in Young Women with Breast Cancer between BRCA-Mutation Carriers Versus Non-Carriers: How Tumor and Genetic Risk Factors Influence the Clinical Prognosis. Cancers (Basel) 2023; 15:4177. [PMID: 37627205 PMCID: PMC10452863 DOI: 10.3390/cancers15164177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 08/17/2023] [Accepted: 08/18/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND Breast cancer (BC) is very uncommon in young women (YW) and it is unclear whether a BRCA mutation has prognostic implications. Our aim was to evaluate the characteristics of YW with BC by comparing the long-term oncological results between BRCA-mutation carriers and non-carriers. METHODS We retrospectively reviewed all the consecutive YW (aged 18-40 years) diagnosed with BC. Endpoints were disease-free survival (DFS), distant disease-free survival (DDFS), and overall survival (OS). RESULTS 63 YW with a BRCA mutation were compared with 339 YW without BRCA mutation. BRCA-mutation carriers were younger (60.3% versus 34.8% if age ≤ 35 years, p = 0.001) and presented with more aggressive tumors (66.7% versus 40.7% if G3, p = 0.001; 57.2% versus 12.4% if biological subtype triple-negative, p = 0.001; 73.0% versus 39.2% if Ki67 ≥ 25%, p = 0.001). Non-carriers presented significantly better DFS, DDFS, and OS compared with BRCA-mutation carriers. Neoadjuvant chemotherapy was found to be an independent protective factor for OS in BRCA-mutation carriers. CONCLUSIONS BC is more likely to present at a younger age (≤ 35 years) and with more aggressive characteristics (G3, triple-negative, Ki67 ≥ 25%) in YW with BRCA mutation compared with their non-mutated counterparts. Young BRCA-mutation carriers showed a poorer prognosis in terms of recurrence and survival compared with non-carriers. The implementation of neoadjuvant chemotherapy may improve survival in YW with BC and BRCA mutation.
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Affiliation(s)
- Corrado Tinterri
- Breast Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan, Italy; (C.T.); (S.D.M.G.); (A.S.); (E.B.); (S.D.); (A.B.); (G.C.)
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan, Italy
| | - Simone Di Maria Grimaldi
- Breast Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan, Italy; (C.T.); (S.D.M.G.); (A.S.); (E.B.); (S.D.); (A.B.); (G.C.)
| | - Andrea Sagona
- Breast Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan, Italy; (C.T.); (S.D.M.G.); (A.S.); (E.B.); (S.D.); (A.B.); (G.C.)
| | - Erika Barbieri
- Breast Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan, Italy; (C.T.); (S.D.M.G.); (A.S.); (E.B.); (S.D.); (A.B.); (G.C.)
| | - Shadya Darwish
- Breast Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan, Italy; (C.T.); (S.D.M.G.); (A.S.); (E.B.); (S.D.); (A.B.); (G.C.)
| | - Alberto Bottini
- Breast Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan, Italy; (C.T.); (S.D.M.G.); (A.S.); (E.B.); (S.D.); (A.B.); (G.C.)
| | - Giuseppe Canavese
- Breast Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan, Italy; (C.T.); (S.D.M.G.); (A.S.); (E.B.); (S.D.); (A.B.); (G.C.)
| | - Damiano Gentile
- Breast Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan, Italy; (C.T.); (S.D.M.G.); (A.S.); (E.B.); (S.D.); (A.B.); (G.C.)
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan, Italy
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13
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Bustamante A, Chavarro PA, Hernández OM. [Exercise tolerance and fatigue in women survivors of non-metastatic breast cancer]. Rev Salud Publica (Bogota) 2023; 21:492-497. [PMID: 36753199 DOI: 10.15446/rsap.v21n5.81849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Accepted: 07/29/2019] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Breast cancer is the most common type of cancer worldwide, and the leading cause of disability and death in young women in Latin America. One of the most common symptoms in this population is fatigue, reported by 70 to 100% of survivors. OBJECTIVE To describe the relationship between exercise tolerance and fatigue in women survivors of non-metastatic breast cancer. MATERIALS AND METHODS Cross-sectional descriptive study in 40 women between 18 and 65 years of age, from a database pertaining to a highly complex healthcare institution in the city of Cali, Colombia. The relationship between fatigue and exercise tolerance was identified using the "Functional Assessment of Cancer Therapy FACT-F" questionnaire and the 6-minute walk test (TC6M). RESULTS 37.5% of the participants presented fatigue related to breast cancer; 33% of women presented dyspnea at the end of the TC6M, 37.5% reported having lower limb fatigue (modified Borg) and 42.5% did not reach 80% of the predicted distance in the TC6M. CONCLUSION A positive correlation (p 0.000) was found between fatigue and exercise tolerance in women survivors of non-metastatic breast cancer.
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Affiliation(s)
- Angelly Bustamante
- Universidad del Valle. Facultad de Salud. Escuela de Rehabilitación Humana. Integrante del Grupo de Investigación Ejercicio y Salud Cardiopulmonar GIESC. Cali, Colombia.
| | - Paola A Chavarro
- PC: Fisioterapeuta. Esp. Fisioterapia Cardiopulmonar. M. Sc. Educación. Universidad del Valle. Facultad de Salud. Escuela de Rehabilitación Humana. Integrante del Grupo de Investigación Ejercicio y Salud Cardiopulmonar GIESC. Cali, Colombia.
| | - Olga M Hernández
- OH: Fisioterapeuta. Esp. Docencia Universitaria. M. Sc. Epidemiología. Universidad del Valle, Escuela de Rehabilitación Humana. Integrante del Grupo de Investigación Ejercicio y Salud Cardiopulmonar GIESC. Cali, Colombia.
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14
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Injectable Nano Drug Delivery Systems for the Treatment of Breast Cancer. Pharmaceutics 2022; 14:pharmaceutics14122783. [PMID: 36559276 PMCID: PMC9785637 DOI: 10.3390/pharmaceutics14122783] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 12/05/2022] [Accepted: 12/09/2022] [Indexed: 12/15/2022] Open
Abstract
Breast cancer is the most diagnosed type of cancer, with 2.26 million cases and 685,000 deaths recorded in 2020. If left untreated, this deadly disease can metastasize to distant organs, which is the reason behind its incurability and related deaths. Currently, conventional therapies are used to treat breast cancer, but they have numerous shortcomings such as low bioavailability, short circulation time, and off-target toxicity. To address these challenges, nanomedicines are preferred and are being extensively investigated for breast cancer treatment. Nanomedicines are novel drug delivery systems that can improve drug stability, aqueous solubility, blood circulation time, controlled release, and targeted delivery at the tumoral site and enhance therapeutic safety and effectiveness. Nanoparticles (NPs) can be administered through different routes. Although the injectable route is less preferred than the oral route for drug administration, it has its advantages: it helps tailor drugs with targeted moiety, boosts payload, avoids first-pass metabolism, and improves the pharmacokinetic parameters of the active pharmaceutical ingredients. Targeted delivery of nanomedicine, closer to organelles such as the mitochondria and nuclei in breast cancer, reduces the dosage requirements and the toxic effects of chemotherapeutics. This review aims to provide the current status of the recent advances in various injectable nanomedicines for targeted treatment of breast cancer.
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15
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Maliko N, Bijker N, Bos MEMM, Wouters MWJM, Vrancken Peeters MJTFD. Patterns of care over 10 years in young breast cancer patients in the Netherlands, a nationwide population-based study. Breast 2022; 66:285-292. [PMID: 36375390 PMCID: PMC9663518 DOI: 10.1016/j.breast.2022.11.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 11/06/2022] [Accepted: 11/07/2022] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION Each year, around 600 young (<40 years) breast cancer (BC) patients are registered in the national NABON Breast Cancer Audit (NBCA). The aim of this study is to compare patient and treatment characteristics of young and older age BC patients over time with a focus on outcome of quality indicators (QIs). Furthermore, we analysed whether de-escalation trends of treatment can be recognized to the same degree in both patient groups. MATERIAL AND METHODS From October 2011 to October 2020 all patients treated for stage I-III invasive BC were included. Tumour characteristics, treatment variables and outcome of QIs of two age categories young (<40 years) and older patient (≥40 years) were analysed. RESULTS In total 114,700 patients were included: 4.6% young patients and 95.4% older patients. Young patients more often presented with a palpable mass, higher stage, and triple-negative BC. Overall, young patients more often started with neoadjuvant systemic treatment (NST) (54.3% vs. 18.6%) and a greater proportion of the young patients retained their breast contour after surgery (73.5% vs. 69.3%). De-escalation trends such as decrease in axillary lymph node dissections and in the use of boost were observed. The omission of radiation treatment after breast conserving surgery was only observed in older patients. CONCLUSION Although this study shows that young women more often present with unfavourable tumours, therapeutic procedures are performed with a higher adherence to the QIs than for older patients and young women do benefit from some de-escalation trends to the same extend as older patients.
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Affiliation(s)
- Nansi Maliko
- Scientific Bureau, Dutch Institute for Clinical Auditing, Leiden, the Netherlands,Department of Surgical Oncology, Netherlands Cancer Institute/Antoni van Leeuwenhoek, Amsterdam, the Netherlands
| | - Nina Bijker
- Department of Radiation Oncology, AmsterdamUMC, Amsterdam, the Netherlands
| | - Monique EMM. Bos
- Department of Medical Oncology, Erasmus MC Cancer Institute, University Medical Centre Rotterdam, Rotterdam, the Netherlands
| | - Michel WJM. Wouters
- Scientific Bureau, Dutch Institute for Clinical Auditing, Leiden, the Netherlands,Department of Surgical Oncology, Netherlands Cancer Institute/Antoni van Leeuwenhoek, Amsterdam, the Netherlands,Department of Biomedical Data Sciences, Leiden University Medical Centre, Leiden, the Netherlands
| | - Marie-Jeanne TFD. Vrancken Peeters
- Department of Surgical Oncology, Netherlands Cancer Institute/Antoni van Leeuwenhoek, Amsterdam, the Netherlands,Department of Surgery, AmsterdamUMC, Amsterdam, the Netherlands,Corresponding author. Department of Surgical oncology, Netherlands CancerInstitute/Antoni van Leeuwenhoek Hospital Plesmanlaan 121, 1066CX, Amsterdam, the Netherlands.
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16
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TRIB3 Modulates PPARγ-Mediated Growth Inhibition by Interfering with the MLL Complex in Breast Cancer Cells. Int J Mol Sci 2022; 23:ijms231810535. [PMID: 36142452 PMCID: PMC9503934 DOI: 10.3390/ijms231810535] [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: 08/12/2022] [Revised: 09/02/2022] [Accepted: 09/06/2022] [Indexed: 12/03/2022] Open
Abstract
Aberrant expression or activity of proteins are amongst the best understood mechanisms that can drive cancer initiation and progression, as well as therapy resistance. TRIB3, a member of the Tribbles family of pseudokinases, is often dysregulated in cancer and has been associated with breast cancer initiation and metastasis formation. However, the underlying mechanisms by which TRIB3 contributes to these events are unclear. In this study, we demonstrate that TRIB3 regulates the expression of PPARγ, a transcription factor that has gained attention as a potential drug target in breast cancer for its antiproliferative actions. Proteomics and phosphoproteomics analyses together with classical biochemical assays indicate that TRIB3 interferes with the MLL complex and reduces MLL-mediated H3K4 trimethylation of the PPARG locus, thereby reducing PPARγ mRNA expression. Consequently, the overexpression of TRIB3 blunts the antiproliferative effect of PPARγ ligands in breast cancer cells, while reduced TRIB3 expression gives the opposite effect. In conclusion, our data implicate TRIB3 in epigenetic gene regulation and suggest that expression levels of this pseudokinase may serve as a predictor of successful experimental treatments with PPARγ ligands in breast cancer.
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17
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Karpisheh V, Ahmadi M, Abbaszadeh-Goudarzi K, Mohammadpour Saray M, Barshidi A, Mohammadi H, Yousefi M, Jadidi-Niaragh F. The role of Th17 cells in the pathogenesis and treatment of breast cancer. Cancer Cell Int 2022; 22:108. [PMID: 35248028 PMCID: PMC8897940 DOI: 10.1186/s12935-022-02528-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 02/21/2022] [Indexed: 12/11/2022] Open
Abstract
Breast cancer is a severe problem worldwide due to an increase in mortality and prevalence among women. Despite early diagnostic procedures as well as advanced therapies, more investigation is required to find new treatment targets. Various factors and mechanisms, such as inflammatory conditions, can play a crucial role in cancer progression. Among them, Th17 cells are identified as effective CD4+ T cells that play an essential role in autoimmune diseases and inflammation which may be associated with anti-tumor responses. In addition, Th17 cells are one of the main factors involved in cancer, especially breast cancer via the inflammatory process. In tumor immunity, the exact mechanism of Th17 cells is not entirely understood and seems to have a dual function in tumor development. Various studies have reported that cytokines secreted by Th17 cells are in close relation to cancer stem cells and tumor microenvironment. Therefore, they play a critical role in the growth, proliferation, and invasion of tumor cells. On the other hand, most studies have reported that T cells suppress the growth of tumor cells by the induction of immune responses. In patients with breast cancer compared to normal individuals, various studies have been reported that the Th17 population dramatically increases in peripheral blood which results in cancer progression. It seems that Th17 cells by creating inflammatory conditions through the secretion of cytokines, including IL-22, IL-17, TNF-α, IL-21, and IL-6, can significantly enhance breast cancer progression. Therefore, to identify the mechanisms and factors involved in the activation and development of Th17 cells, they can provide an essential role in preventing breast cancer progression. In the present review, the role of Th17 cells in breast cancer progression and its therapeutic potential was investigated.
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18
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Herzog JS, Chavarri-Guerra Y, Castillo D, Abugattas J, Villarreal-Garza C, Sand S, Clague-Dehart J, Alvarez-Gómez RM, Wegman-Ostrosky T, Mohar A, Mora P, Del Toro-Valero A, Daneri-Navarro A, Rodriguez Y, Cruz-Correa M, Ashton-Prolla P, Alemar B, Mejia R, Gallardo L, Shaw R, Yang K, Cervantes A, Tsang K, Nehoray B, Barrera Saldana H, Neuhausen S, Weitzel JN. Genetic epidemiology of BRCA1- and BRCA2-associated cancer across Latin America. NPJ Breast Cancer 2021; 7:107. [PMID: 34413315 PMCID: PMC8377150 DOI: 10.1038/s41523-021-00317-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 07/26/2021] [Indexed: 12/11/2022] Open
Abstract
The prevalence and contribution of BRCA1/2 (BRCA) pathogenic variants (PVs) to the cancer burden in Latin America are not well understood. This study aims to address this disparity. BRCA analyses were performed on prospectively enrolled Latin American Clinical Cancer Genomics Community Research Network participants via a combination of methods: a Hispanic Mutation Panel (HISPANEL) on MassARRAY; semiconductor sequencing; and copy number variant (CNV) detection. BRCA PV probability was calculated using BRCAPRO. Among 1,627 participants (95.2% with cancer), we detected 236 (14.5%) BRCA PVs; 160 BRCA1 (31% CNVs); 76 BRCA2 PV frequency varied by country: 26% Brazil, 9% Colombia, 13% Peru, and 17% Mexico. Recurrent PVs (seen ≥3 times), some region-specific, represented 42.8% (101/236) of PVs. There was no ClinVar entry for 14% (17/125) of unique PVs, and 57% (111/196) of unique VUS. The area under the ROC curve for BRCAPRO was 0.76. In summary, we implemented a low-cost BRCA testing strategy and documented a significant burden of non-ClinVar reported BRCA PVs among Latin Americans. There are recurrent, population-specific PVs and CNVs, and we note that the BRCAPRO mutation probability model performs adequately. This study helps address the gap in our understanding of BRCA-associated cancer in Latin America.
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Affiliation(s)
| | - Yanin Chavarri-Guerra
- Instituto Nacional de Ciencias Medicas y Nutrición, Salvador Zubiran, Mexico City, Mexico
| | | | | | - Cynthia Villarreal-Garza
- Hospital Zambrano Hellion TecSalud, Tecnologico de Monterrey, Monterrey, Mexico
- Instituto Nacional de Cancerología, México City, México
| | | | - Jessica Clague-Dehart
- City of Hope, Duarte, CA, USA
- School of Community & Global Health, Claremont Graduate University, Claremont, CA, USA
| | | | | | - Alejandro Mohar
- Instituto Nacional de Cancerología, México City, México
- Instituto de Investigaciones Biomédicas, Mexico City, Mexico
| | - Pamela Mora
- Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - Azucena Del Toro-Valero
- Instituto Jalisciense de Cancerología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, México City, México
| | - Adrian Daneri-Navarro
- Instituto Jalisciense de Cancerología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, México City, México
| | | | - Marcia Cruz-Correa
- University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico
| | - Patricia Ashton-Prolla
- Hospital de Clínicas de Porto Alegre and Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Bárbara Alemar
- Hospital de Clínicas de Porto Alegre and Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- Roche Pharmaceutical, Basel, Switzerland
| | | | | | - Robin Shaw
- Instituto Nacional de Cancerología, México City, México
| | | | | | | | | | | | | | - Jeffrey N Weitzel
- Latin American School of Oncology (Escuela Latinoamericana de Oncología), Tuxla Gutiérrez, Chiapas, Mexico.
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Liu X, Wang Q, Song S, Feng M, Wang X, Li L, Liu Y, Shi C. Epithelial Splicing Regulatory Protein 1 Is Overexpressed in Breast Cancer and Predicts Poor Prognosis for Breast Cancer Patients. Med Sci Monit 2021; 27:e931102. [PMID: 34262011 PMCID: PMC8290978 DOI: 10.12659/msm.931102] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background Epithelial splicing regulatory proteins (ESRPs), including ESRP1 and ESRP2, are important proteins for alternative splicing of mRNAs and are reported to promote or inhibit the progression of some tumors. However, the effects of ESRPs in breast cancer are still unknown. Material/Methods In this study, we detected the transcriptional level and alterations of ESRP1 in patients with breast cancer based on the Oncomine, Gene Expression Profiling Interactive Analysis, Gene Expression-Based Outcome for Breast Cancer Online, and cBioPortal databases. Using immunohistochemistry and quantitative polymerase chain reaction, the expression pattern of ESRP1 in breast cancer was analyzed. Analysis of the clinicopathological characteristics and function of ESRP1 in breast cancer were actualized through the University of Alabama Cancer database and Database for Annotation, Visualization and Integrated Discovery. Using the Kaplan-Meier plotter, the prognostic values of ESRP1 in patients with breast cancer were analyzed. The Encyclopedia of RNA Interactomes database was used to predict miRNAs that regulated ESRP1. Results We found that ESRP1 was significantly overexpressed in patients with breast cancer, compared with patients without breast cancer, and had statistically significant clinicopathological characteristics. Kaplan-Meier plotter analysis indicated that the elevated expression of ESRP1 was associated with poor prognosis in patients with breast cancer. Furthermore, hsa-miR-181c-5p was identified to be potentially involved in the regulation of ESRP1. Conclusions These results suggest that ESRP1 is a valuable target for the precise treatment of breast cancer and a potential biomarker for the prognosis of patients with breast cancer.
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Affiliation(s)
- Xinyu Liu
- School of Basic Medicine, College of Medicine, Qingdao University, Qingdao, China (mainland)
| | - Qiangshan Wang
- Jiaozhou Maternal and Child Health Hospital, Jiaozhou Maternal and Child Health Hospital, Qingdao, China (mainland)
| | - Siqi Song
- School of Basic Medicine, College of Medicine, Qingdao University, Qingdao, China (mainland)
| | - Manman Feng
- School of Basic Medicine, College of Medicine, Qingdao University, Qingdao, China (mainland)
| | - Xiaoya Wang
- School of Basic Medicine, College of Medicine, Qingdao University, Qingdao, China (mainland)
| | - Ling Li
- School of Basic Medicine, College of Medicine, Qingdao University, Qingdao, China (mainland)
| | - Ying Liu
- School of Basic Medicine, College of Medicine; Institute for Translational Medicine, The Affiliated Hospital of Qingdao University, College of Medicine, Qingdao University, Qingdao, China (mainland)
| | - Chunying Shi
- School of Basic Medicine, College of Medicine, Qingdao University, Qingdao, China (mainland)
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20
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Villarreal-Garza C, Mesa-Chavez F, Plata de la Mora A, Miaja-Avila M, Garcia-Garcia M, Fonseca A, de la Rosa-Pacheco S, Cruz-Ramos M, García Garza MR, Mohar A, Bargallo-Rocha E. Prospective Study of Fertility Preservation in Young Women With Breast Cancer in Mexico. J Natl Compr Canc Netw 2021; 19:1-8. [PMID: 34153944 DOI: 10.6004/jnccn.2020.7692] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 11/30/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Despite the risk of treatment-related infertility, implementation of fertility-preservation (FP) strategies among young patients with breast cancer is often suboptimal in resource-constrained settings such as Mexico. The "Joven & Fuerte: Program for Young Women With Breast Cancer" strives to enhance patient access to supportive care services, including FP measures through alliances with assisted-reproduction units and procurement of coverage of some of these strategies. This study describes patients from Joven & Fuerte who have preserved fertility, and assesses which characteristics were associated with the likelihood of undergoing FP. METHODS Women aged ≤40 years with recently diagnosed breast cancer were prospectively accrued. Sociodemographic and clinicopathologic data were collected from patient-reported and provider-recorded information at diagnosis and 1-year follow-up. Descriptive statistics, chi-square test, and simple logistic regression were used to compare patients who preserved fertility with those who did not. RESULTS In total, 447 patients were included, among which 53 (12%) preserved fertility, representing 38% of the 140 women who desired future biologic children. Oocyte/embryo cryopreservation was the most frequently used method for FP (59%), followed by temporary ovarian suppression with gonadotropin-releasing hormone agonists (GnRHa) during chemotherapy (26%), and use of both GnRHa and oocyte/embryo cryopreservation (15%). Younger age, higher educational level, being employed, having private healthcare insurance, and having one or no children were associated with a significantly higher likelihood of preserving fertility. CONCLUSIONS By facilitating referral and seeking funds and special discounts for underserved patients, supportive care programs for young women with breast cancer can play a crucial role on enhancing access to oncofertility services that would otherwise be prohibitive because of their high costs, particularly in resource-constrained settings. For these efforts to be successful and widely applied in the long term, sustained and extended governmental coverage of FP options for this young group is warranted.
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Affiliation(s)
- Cynthia Villarreal-Garza
- 1Centro de Cancer de Mama, TecSalud, Tecnologico de Monterrey, San Pedro Garza Garcia, Nuevo Leon
- 2Joven & Fuerte, Programa para la Atencion e Investigacion para Pacientes Jovenes con Cancer de Mama en Mexico, Ciudad de Mexico
| | - Fernanda Mesa-Chavez
- 1Centro de Cancer de Mama, TecSalud, Tecnologico de Monterrey, San Pedro Garza Garcia, Nuevo Leon
- 2Joven & Fuerte, Programa para la Atencion e Investigacion para Pacientes Jovenes con Cancer de Mama en Mexico, Ciudad de Mexico
| | - Alejandra Plata de la Mora
- 2Joven & Fuerte, Programa para la Atencion e Investigacion para Pacientes Jovenes con Cancer de Mama en Mexico, Ciudad de Mexico
- 3Departamento de Tumores Mamarios e Investigacion, Instituto Nacional de Cancerologia, Ciudad de Mexico
| | - Melina Miaja-Avila
- 1Centro de Cancer de Mama, TecSalud, Tecnologico de Monterrey, San Pedro Garza Garcia, Nuevo Leon
- 2Joven & Fuerte, Programa para la Atencion e Investigacion para Pacientes Jovenes con Cancer de Mama en Mexico, Ciudad de Mexico
| | - Marisol Garcia-Garcia
- 1Centro de Cancer de Mama, TecSalud, Tecnologico de Monterrey, San Pedro Garza Garcia, Nuevo Leon
- 2Joven & Fuerte, Programa para la Atencion e Investigacion para Pacientes Jovenes con Cancer de Mama en Mexico, Ciudad de Mexico
| | - Alan Fonseca
- 2Joven & Fuerte, Programa para la Atencion e Investigacion para Pacientes Jovenes con Cancer de Mama en Mexico, Ciudad de Mexico
- 3Departamento de Tumores Mamarios e Investigacion, Instituto Nacional de Cancerologia, Ciudad de Mexico
| | | | - Marlid Cruz-Ramos
- 2Joven & Fuerte, Programa para la Atencion e Investigacion para Pacientes Jovenes con Cancer de Mama en Mexico, Ciudad de Mexico
- 3Departamento de Tumores Mamarios e Investigacion, Instituto Nacional de Cancerologia, Ciudad de Mexico
| | | | - Alejandro Mohar
- 2Joven & Fuerte, Programa para la Atencion e Investigacion para Pacientes Jovenes con Cancer de Mama en Mexico, Ciudad de Mexico
- 6Unidad de Epidemiologia e Investigacion Biomedica en Cancer, Instituto Nacional de Cancerologia, and
- 7Instituto de Biomedicas, Universidad Nacional Autonoma de Mexico, Ciudad de Mexico, México
| | - Enrique Bargallo-Rocha
- 2Joven & Fuerte, Programa para la Atencion e Investigacion para Pacientes Jovenes con Cancer de Mama en Mexico, Ciudad de Mexico
- 3Departamento de Tumores Mamarios e Investigacion, Instituto Nacional de Cancerologia, Ciudad de Mexico
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21
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Comprehensive omic characterization of breast cancer in Mexican-Hispanic women. Nat Commun 2021; 12:2245. [PMID: 33854067 PMCID: PMC8046804 DOI: 10.1038/s41467-021-22478-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 03/16/2021] [Indexed: 12/26/2022] Open
Abstract
Breast cancer is a heterogeneous pathology, but the genomic basis of its variability remains poorly understood in populations other than Caucasians. Here, through DNA and RNA portraits we explored the molecular features of breast cancers in a set of Hispanic-Mexican (HM) women and compared them to public multi-ancestry datasets. HM patients present an earlier onset of the disease, particularly in aggressive clinical subtypes, compared to non-Hispanic women. The age-related COSMIC signature 1 was more frequent in HM women than in those from other ancestries. We found the AKT1E17K hotspot mutation in 8% of the HM women and identify the AKT1/PIK3CA axis as a potentially druggable target. Also, HM luminal breast tumors present an enhanced immunogenic phenotype compared to Asiatic and Caucasian tumors. This study is an initial effort to include patients from Hispanic populations in the research of breast cancer etiology and biology to further understand breast cancer disparities. Cancers in different populations have been shown to be genetically distinct. Here, the authors sequence breast cancers from Mexican-Hispanic patients and find that these patients have a higher percentage of Akt1 mutations compared to Caucasian and Asian populations, suggesting these are clinically actionable.
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22
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Sun X, Liu J, Ji H, Yang M, Lu Y. Clinicopathological Characteristics and Prognosis of Breast Cancer in Young Women - A Single Center Study in a Developing Country. Cancer Manag Res 2021; 13:1601-1607. [PMID: 33628050 PMCID: PMC7898785 DOI: 10.2147/cmar.s299066] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 01/28/2021] [Indexed: 11/23/2022] Open
Abstract
Objective Breast cancer (BC) in young women tends to be more aggressive. This study highlights the clinicopathological features and outcomes of young breast cancer (YBC) patients in a developing country. Methods Consecutive patients aged 35 years or younger with a pathologically confirmed diagnosis of breast cancer treated and followed up at our department were included. Medical records and follow-up databases were reviewed and documented. Results The rate of breast conservation and reconstruction surgery is higher in YBC patients. YBC patients are more likely to have tumors over 5cm, high-grade, hormone receptor negative, triple negative and stage III than old patients. There was no statistically significant difference in the pathological type, lymph node metastasis, and HER2 status. The median follow-up time was 96 months. The disease-free survival (DFS) was significantly worse in the YBC group. However, the overall survival (OS) had no difference between the two groups. Conclusion YBC patients had more aggressive pathological features, such as hormone receptor negative, triple negative, high-grade and advanced stage, and poorer DFS than the old counterparts.
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Affiliation(s)
- Xiaoliang Sun
- Department of General Surgery, China-Japan Friendship Hospital, Beijing, People's Republic of China
| | - Jun Liu
- Department of General Surgery, China-Japan Friendship Hospital, Beijing, People's Republic of China
| | - Haoyang Ji
- Department of General Surgery, China-Japan Friendship Hospital, Beijing, People's Republic of China
| | - Meng Yang
- Department of General Surgery, China-Japan Friendship Hospital, Beijing, People's Republic of China
| | - Yao Lu
- Department of General Surgery, China-Japan Friendship Hospital, Beijing, People's Republic of China
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23
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Orlandini LF, Antonio MVDN, Espreafico CR, Bosquesi PL, Poli-Neto OB, de Andrade JM, Dos Reis FJC, Tiezzi DG. Epidemiological Analyses Reveal a High Incidence of Breast Cancer in Young Women in Brazil. JCO Glob Oncol 2021; 7:81-88. [PMID: 33434069 PMCID: PMC8081493 DOI: 10.1200/go.20.00440] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
PURPOSE Breast cancer screening is not recommended for young women (< 40 years old); therefore, those diagnosed are more likely to have advanced and metastatic disease, reducing treatment outcomes. This study aimed to investigate breast cancer epidemiology among young women in Brazil. METHODS Data from three publicly available databases and a cohort from a university hospital in Brazil were analyzed in a retrospective study. Descriptive statistics was performed on disease prevalence and stage distribution across age groups. Incidence was estimated using age-standardized incidence ratio. The impact of age in disease-specific survival was also analyzed. RESULTS Invasive breast cancer prevalence data by age group revealed that 4.4% and 20.6% of patients were < 35 and < 45 years old, respectively. In the United States, this prevalence was 1.85% and 11.5%, respectively (odds ratio [OR], 2.2; P < .0001). The percentage of regional and metastatic diseases were higher in São Paulo State (Fundação Oncocentro de São Paulo [FOSP]) compared with the United States (45% and 9.8% v 29% and 5.7%, respectively; P < .0001). In FOSP, regional and metastatic disease prevalence were higher among young patients (53.5% and 11.3%, respectively). The median tumor size in patients < 40 years old was higher (25.0 mm × 20.9 mm; P < .0001), and young patients have higher risk to be diagnosed with positive lymph nodes (OR, 1.5; P = .004) and higher proportion of luminal-B and triple-negative (TNBC) tumors. Young patients have a poor disease-specific survival because of late-stage diagnosis and more aggressive breast cancer subtypes (human epidermal growth factor receptor 2-enriched and TNBC) (P < .0001). CONCLUSION In Brazil, breast cancer prevalence among young patients and late-stage incidence during this age span is higher. Advanced disease and more aggressive subtypes lead to a significant impact on breast cancer-specific survival in young patients.
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Affiliation(s)
- Leonardo Fleury Orlandini
- Ribeirão Preto School of Medicine, Department of Gynecology and Obstetrics, Gynecologic Oncology and Breast Disease Division, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | | | - Claiver Renato Espreafico
- Advanced Research Center in Medicine, Union of the Colleges of the Great Lakes (UNILAGO), São José do Rio Preto, São Paulo, Brazil
| | - Priscila Longhin Bosquesi
- Advanced Research Center in Medicine, Union of the Colleges of the Great Lakes (UNILAGO), São José do Rio Preto, São Paulo, Brazil
| | - Omero Benedito Poli-Neto
- Ribeirão Preto School of Medicine, Department of Gynecology and Obstetrics, Gynecologic Oncology and Breast Disease Division, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Jurandyr Moreira de Andrade
- Ribeirão Preto School of Medicine, Department of Gynecology and Obstetrics, Gynecologic Oncology and Breast Disease Division, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Francisco José Cândido Dos Reis
- Ribeirão Preto School of Medicine, Department of Gynecology and Obstetrics, Gynecologic Oncology and Breast Disease Division, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Daniel Guimarães Tiezzi
- Ribeirão Preto School of Medicine, Department of Gynecology and Obstetrics, Gynecologic Oncology and Breast Disease Division, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.,Advanced Research Center in Medicine, Union of the Colleges of the Great Lakes (UNILAGO), São José do Rio Preto, São Paulo, Brazil
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Martinez-Cannon BA, Castro-Sanchez A, Barragan-Carrillo R, de la Rosa Pacheco S, Platas A, Fonseca A, Vega Y, Bojorquez-Velazquez K, Bargallo-Rocha JE, Mohar A, Villarreal-Garza C. Adherence to Adjuvant Tamoxifen in Mexican Young Women with Breast Cancer. Patient Prefer Adherence 2021; 15:1039-1049. [PMID: 34040357 PMCID: PMC8141391 DOI: 10.2147/ppa.s296747] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 03/30/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Breast cancer (BC) in young women is characterized by an unfavorable prognosis in hormone receptor-positive/HER2-negative tumors, which may be explained by low rates of tamoxifen adherence. In Mexico, up to 14% of all BC diagnoses occur in young women and no data on tamoxifen adherence has been reported. OBJECTIVE To estimate the rate of adherence to adjuvant tamoxifen in Mexican young women with BC (YWBC). METHODS A cross-sectional survey was conducted at the National Cancer Institute in Mexico City, among YWBC (≤40 years at diagnosis) receiving adjuvant tamoxifen. Adherence was measured subjectively, through self-reported surveys, and objectively, through medication possession ratio (MPR). Descriptive statistics were used to analyze sociodemographic characteristics. To compare associations between patients' characteristics and adherence, Chi-square test was used for categorical variables and Student's t-test or Mann-Whitney U-test for quantitative variables. RESULTS A total of 141 YWBC receiving adjuvant tamoxifen were included. Regarding subjective adherence, 95% expressed taking tamoxifen regularly, 70% reported missing 0 doses in the past 30 days, and 71.6% reported having adverse effects. Regarding objective adherence, 74.8% of patients had an MPR ≥80%. The association between subjective and objective adherence was statistically significant (p = 0.004). Subjective adherence was associated with not skipping tamoxifen doses when feeling worse. Objective adherence was associated with having a stable job, not skipping tamoxifen doses when feeling worse, taking additional medications, and time on tamoxifen treatment. Fifty-six percent considered the information on tamoxifen to be insufficient and 37% not understandable. CONCLUSION In our study, high subjective and objective adherence rates to adjuvant tamoxifen were reported, although an important proportion of women reported high rates of adverse effects and not fully understanding the benefits of tamoxifen. Strategies to increase tamoxifen adherence may be even more important now that longer durations of treatment or further ovarian function suppression have become the standard of care in YWBC.
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Affiliation(s)
- Bertha Alejandra Martinez-Cannon
- Breast Cancer Center, Hospital Zambrano Hellion TecSalud, Tecnologico de Monterrey, San Pedro Garza Garcia, Mexico
- Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Mexico City, Mexico
| | - Andrea Castro-Sanchez
- Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Mexico City, Mexico
| | - Regina Barragan-Carrillo
- Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Mexico City, Mexico
| | - Sylvia de la Rosa Pacheco
- Breast Cancer Center, Hospital Zambrano Hellion TecSalud, Tecnologico de Monterrey, San Pedro Garza Garcia, Mexico
| | - Alejandra Platas
- Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Mexico City, Mexico
- Departamento de Investigacion y de Tumores Mamarios, Instituto Nacional de Cancerologia, Mexico City, Mexico
| | - Alan Fonseca
- Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Mexico City, Mexico
- Departamento de Investigacion y de Tumores Mamarios, Instituto Nacional de Cancerologia, Mexico City, Mexico
| | - Yoatzin Vega
- Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Mexico City, Mexico
| | - Karen Bojorquez-Velazquez
- Departamento de Investigacion y de Tumores Mamarios, Instituto Nacional de Cancerologia, Mexico City, Mexico
| | - Juan Enrique Bargallo-Rocha
- Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Mexico City, Mexico
- Departamento de Investigacion y de Tumores Mamarios, Instituto Nacional de Cancerologia, Mexico City, Mexico
| | - Alejandro Mohar
- Departamento de Investigacion y de Tumores Mamarios, Instituto Nacional de Cancerologia, Mexico City, Mexico
- Instituto de Investigaciones Biomédicas de la Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Cynthia Villarreal-Garza
- Breast Cancer Center, Hospital Zambrano Hellion TecSalud, Tecnologico de Monterrey, San Pedro Garza Garcia, Mexico
- Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Mexico City, Mexico
- Correspondence: Cynthia Villarreal-Garza Breast Cancer Center, Hospital Zambrano Hellion TecSalud, Tecnologico de Monterrey, Av. Batallon de San Patricio 112, Real San Agustin, 66278, San Pedro Garza Garcia, Nuevo Leon, Mexico Email
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25
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Morante Z, Ruiz R, Araujo JM, Pinto JA, Cruz-Ku GDL, Urrunaga-Pastor D, Namuche F, Flores C, Mantilla R, Luján MG, Fuentes H, Schwarz L, Aguilar A, Neciosup S, Gómez HL. Impact of the Delayed Initiation of Adjuvant Chemotherapy in the Outcome of Triple Negative Breast Cancer. Clin Breast Cancer 2020; 21:239-246.e4. [PMID: 33221201 DOI: 10.1016/j.clbc.2020.09.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 09/15/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND Adjuvant chemotherapy decreases the recurrence risk and improves survival rates; however, it is unclear whether a delayed initiation is associated with adverse outcomes, especially in triple negative breast cancer (TNBC). In this study, we evaluated the influence of the time to start adjuvant chemotherapy (TTC) in the outcomes of TNBC. PATIENTS AND METHODS We retrospectively analyzed 15 years of data from patients with TNBC who received adjuvant chemotherapy at the Instituto Nacional de Enfermedades Neoplasicas (Lima, Peru). TTC was categorized into 4 groups: ≤ 30, 31 to 60, 61 to 90, and ≥ 91 days. We evaluated overall survival (OS) and distant recurrence-free survival (DRFS). Cox proportional hazard models were used to identify prognostic factors. RESULTS In total, 687 patients were included. The mean age at diagnosis was 49.1 years (SD, 11.8 years), and most (62.6%) patients had pathologic stage T2. The median TTC was 48.1 days (SD, 27.4 days); 189 (27.5%) received chemotherapy ≤ 30 days; 329 (47.9%), between 31 and 60 days; 115 (16.7%), between 61 and 90 days; and 54 (7.9%) in ≥ 90 days. In the multivariate analysis, a TTC between 31 and 60 days (hazard ratio [HR], 1.78; 95% confidence interval [CI], 1.17-2.72), 61 and 90 days (HR, 2.38; 95%CI, 1.43-3.97), and ≥ 91 days (HR, 2.45; 95% CI, 1.32-4.55) was associated with an increased mortality in contrast with a TTC < 30 days. Although a TTC between 31 and 60 days, 61 and 90 days, and ≥ 91 days was associated with an increased risk of DRFS (HR, 1.86; 95% CI, 1.24-2.79; HR, 2.34, 95% CI, 1.42-3.867; and HR, 3.16; 95% CI, 1.78-5.61, respectively). CONCLUSION A delaying in TTC ≥ 30 days was associated with poorer outcomes. Our data suggest that several efforts should be conducted to avoid a delayed TTC in patients with TNBC.
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Affiliation(s)
- Zaida Morante
- Departamento de Medicina Oncológica, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Lima, Peru; Grupo de Estudios Clínico Oncológicos Peruano (GECOPERU), Lima, Peru
| | - Rossana Ruiz
- Departamento de Medicina Oncológica, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Lima, Peru
| | - Jhajaira M Araujo
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Lima, Peru
| | - Joseph A Pinto
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Lima, Peru
| | | | - Diego Urrunaga-Pastor
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Lima, Peru; Universidad Científica del Sur, Lima, Peru
| | - Fernando Namuche
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Lima, Peru
| | - Claudio Flores
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Lima, Peru
| | - Raúl Mantilla
- Departamento de Medicina Oncológica, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - María G Luján
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Lima, Peru
| | - Hugo Fuentes
- Departamento de Medicina Oncológica, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - Luis Schwarz
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Lima, Peru
| | - Alfredo Aguilar
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Lima, Peru
| | - Silvia Neciosup
- Departamento de Medicina Oncológica, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - Henry L Gómez
- Departamento de Medicina Oncológica, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Grupo de Estudios Clínico Oncológicos Peruano (GECOPERU), Lima, Peru.
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26
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Zevallos A, Bravo L, Bretel D, Paez K, Infante U, Cárdenas N, Alvarado H, Posada AM, Pinto JA. The hispanic landscape of triple negative breast cancer. Crit Rev Oncol Hematol 2020; 155:103094. [PMID: 33027724 DOI: 10.1016/j.critrevonc.2020.103094] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 08/26/2020] [Accepted: 08/28/2020] [Indexed: 10/23/2022] Open
Abstract
Triple-negative breast cancer (TNBC) is a heterogeneous and complex disease characterized by the absence of immunohistochemical expression of estrogen receptor, progesterone receptor and HER2. These breast tumors present an aggressive biology and offer few opportunities to be treated with targeted therapy resulting in bad disease outcomes. The epidemiology of TNBC is intriguing where the understanding of its biology has progressed quickly. One of the peculiarities of this type of cancer is a high prevalence in Afrodescendants and Hispanic patients compared to Caucasian women. In this review we describe some features of TNBC, focusing in the Hispanic population, such as epidemiological, clinicopathological features and molecular features and the correlation between TNBC prevalence and the human development index.
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Affiliation(s)
- Alejandra Zevallos
- Escuela de Medicina Humana, Universidad Privada San Juan Bautista, Lima, Peru
| | - Leny Bravo
- Escuela de Medicina Humana, Universidad Privada San Juan Bautista, Lima, Peru
| | - Denisse Bretel
- Grupo de Estudios Clínicos Oncológicos Peruano, GECOPERU, Lima, Peru
| | - Kevin Paez
- Facultad de Ciencias Biológicas, Universidad Nacional San Luis Gonzaga de Ica, Ica, Peru
| | - Ulises Infante
- Facultad de Ciencias Biológicas, Universidad Nacional San Luis Gonzaga de Ica, Ica, Peru
| | - Nadezhda Cárdenas
- Escuela de Medicina Humana-Filial Ica, Universidad Privada San Juan Bautista, Ica, Peru
| | - Hober Alvarado
- Facultad de Ciencias Biológicas, Universidad Nacional San Luis Gonzaga de Ica, Ica, Peru
| | | | - Joseph A Pinto
- Unidad de Investigación Básica y Traslacional, Oncosalud - AUNA, Lima, Peru.
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27
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Broggi G, Filetti V, Ieni A, Rapisarda V, Ledda C, Vitale E, Varricchio S, Russo D, Lombardo C, Tuccari G, Caltabiano R, Loreto C. MacroH2A1 Immunoexpression in Breast Cancer. Front Oncol 2020; 10:1519. [PMID: 32974186 PMCID: PMC7471871 DOI: 10.3389/fonc.2020.01519] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Accepted: 07/15/2020] [Indexed: 12/11/2022] Open
Abstract
MacroH2A1 has two splice isoforms, macroH2A1.1 and macroH2A1.2, that have been studied in several form of cancer. In the literature there are not many scientific papers dealing with the role of macroH2A1 in breast cancer. Breast cancer is the most frequent form of malignancy in females. It tend to metastasize to the bone in ~70% of patients. Despite treatment, new bone metastases will still occur in 30–50% of cases with advanced disease. Overall 5-year survival after the diagnosis of bone metastasis is ~20%. Osteoclasts and osteoblasts of the bone microenvironment are engaged by soluble factors released by neoplastic cells, resulting in bone matrix breakdown. This malfunction enhances the proliferation of the cancer cells, creating a vicious cycle. We investigated immunohistochemical expression of macroH2A1 in primitive breast cancer, focusing on the comparison of metastatic and non-metastatic cases. Furthermore, the immunohistochemical expression of macroH2A1 has been evaluated both in all cases of nodal metastases and in distant metastases. Our data demonstrated that macroH2A1 expression was higher expressed in metastatic breast cancer (77%) vs. non-metastatic breast cancer (32%). Also in analyzed metastases cases, a high macroH2A1 expression was detected: 85 and 80% in nodal and distant metastases cases, respectively. These results supported the fact that macroH2A1 is more highly expressed in breast cancer with worst prognosis.
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Affiliation(s)
- Giuseppe Broggi
- Section of Anatomic Pathology, Department Gian Filippo Ingrassia, University of Catania, Catania, Italy
| | - Veronica Filetti
- Human Anatomy and Histology, Department of Biomedical and Biotechnology Sciences, University of Catania, Catania, Italy
| | - Antonio Ieni
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Section of Pathology, University of Messina, Messina, Italy
| | - Venerando Rapisarda
- Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Caterina Ledda
- Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Ermanno Vitale
- Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Silvia Varricchio
- Department of Advanced Biomedical Sciences, Pathology Unit, University of Naples Federico II, Naples, Italy
| | - Daniela Russo
- Department of Advanced Biomedical Sciences, Pathology Unit, University of Naples Federico II, Naples, Italy
| | - Claudia Lombardo
- Human Anatomy and Histology, Department of Biomedical and Biotechnology Sciences, University of Catania, Catania, Italy
| | - Giovanni Tuccari
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Section of Pathology, University of Messina, Messina, Italy
| | - Rosario Caltabiano
- Section of Anatomic Pathology, Department Gian Filippo Ingrassia, University of Catania, Catania, Italy
| | - Carla Loreto
- Human Anatomy and Histology, Department of Biomedical and Biotechnology Sciences, University of Catania, Catania, Italy
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Montanha D, Martins LC, Braga ALF. Breast cancer in the Baixada Santista region and its relationship to contaminated areas. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:23181-23187. [PMID: 32335827 DOI: 10.1007/s11356-020-08062-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Accepted: 02/11/2020] [Indexed: 06/11/2023]
Abstract
The aim of this study was to analyze the temporal distribution of breast cancer and its relationship with contaminated areas in the Baixada Santista metropolitan region, São Paulo. It is an ecological study on the distribution of breast cancer in the municipalities of the region as well as in regions exposed to environmental contaminants. The population consisted of women aged 20 years and over, totaling 3233 cases in the 12 years of the study. First, we calculated the total annual breast cancer coefficients by municipality, then we standardized by age and the indicator of contamination density by municipality. We then performed cartographic sequencing that revealed the evolution of outcome and exposure. The results showed that the municipality of Santos presented a higher coefficient of the disease. Pearson's correlation was positive with r = 0.7 at a significance level of p = 0.036. Spatially, the most contaminated areas presented higher breast cancer coefficients, except for the municipality of Peruíbe, which despite its low environmental contamination index, presented a high disease coefficient. This study confirmed the hypothesis that environmental contamination affects breast cancer distribution, and the temporal trend shows an increase in the disease in eight of the nine municipalities in the region.
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Affiliation(s)
- Dionize Montanha
- Grupo de Avaliação de Exposição e Risco Ambiental, Programa de Pós-Graduação em Saúde Coletiva, Universidade Católica de Santos, Santos, São Paulo, Brazil.
- Centro Universitário Lusíada, Santos, Brazil.
| | - Lourdes Conceição Martins
- Grupo de Avaliação de Exposição e Risco Ambiental, Programa de Pós-Graduação em Saúde Coletiva, Universidade Católica de Santos, Santos, São Paulo, Brazil
- , Santos, Brazil
| | - Alfésio Luis Ferreira Braga
- Grupo de Avaliação de Exposição e Risco Ambiental, Programa de Pós-Graduação em Saúde Coletiva, Universidade Católica de Santos, Santos, São Paulo, Brazil
- , Santos, Brazil
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29
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Shah AN, Metzger O, Bartlett CH, Liu Y, Huang X, Cristofanilli M. Hormone Receptor-Positive/Human Epidermal Growth Receptor 2-Negative Metastatic Breast Cancer in Young Women: Emerging Data in the Era of Molecularly Targeted Agents. Oncologist 2020; 25:e900-e908. [PMID: 32176406 PMCID: PMC7288640 DOI: 10.1634/theoncologist.2019-0729] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Accepted: 01/29/2020] [Indexed: 12/16/2022] Open
Abstract
Breast cancer is the most common malignancy in young women worldwide, accounting for an estimated 30% of new cancer diagnoses and 25% of cancer deaths. Approximately two thirds of young women with breast cancer have hormone receptor-positive (HR+)/human epidermal growth receptor 2-negative (HER2-) tumors. Numerous studies, primarily in early-stage breast cancer, have demonstrated that young age is an independent risk factor for more aggressive disease and worse outcomes. Although more limited data are available regarding outcomes in young patients with advanced disease, these age-related disparities suggest that breast cancer in premenopausal women has distinct clinicopathologic and molecular features that can impact treatment outcomes. Until recently, limited data were available on the intrinsic molecular subtypes and genetics of young patients with HR+/HER2- metastatic breast cancer (mBC). In this review, we explore insights into the clinical and pathologic features of HR+/HER2- mBC in younger women derived from recent clinical trials of the cyclin-dependent kinase 4/6 inhibitors palbociclib (PALOMA-3), ribociclib (MONALEESA-7), and abemaciclib (MONARCH 2) and the implications of these findings for clinical practice, guideline development, and future research. IMPLICATIONS FOR PRACTICE: This review provides clinicians with an overview of emerging data on the unique clinicopathologic and molecular features of hormone receptor-positive/human epidermal growth receptor 2-negative metastatic breast cancer (mBC) in premenopausal women, summarizes findings from the most recent clinical trials of endocrine-based treatment in this patient population, and explores the implications of these findings for clinical practice, guideline development, and future research. Improved understanding of the key factors influencing disease course and treatment response in premenopausal patients with mBC may lead to more timely incorporation of evidence-based treatment approaches, thereby improving patient care and outcomes.
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Affiliation(s)
- Ami N. Shah
- Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Otto Metzger
- Dana‐Farber Cancer InstituteBostonMassachusettsUSA
| | | | - Yuan Liu
- Pfizer OncologySan DiegoCaliforniaUSA
| | - Xin Huang
- Pfizer OncologySan DiegoCaliforniaUSA
| | - Massimo Cristofanilli
- Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of MedicineChicagoIllinoisUSA
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30
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Franzoi MA, Rosa DD, Zaffaroni F, Werutsky G, Simon S, Bines J, Barrios C, Cronemberger E, Queiroz GS, Cordeiro de Lima V, Júnior RF, Couto J, Emerenciano K, Resende H, Crocamo S, Reinert T, Van Eyli B, Nerón Y, Dybal V, Lazaretti N, de Cassia Costamillan R, Pinto de Andrade DA, Mathias C, Vacaro GZ, Borges G, Morelle A, Filho CAS, Mano M, Liedke PER. Advanced Stage at Diagnosis and Worse Clinicopathologic Features in Young Women with Breast Cancer in Brazil: A Subanalysis of the AMAZONA III Study (GBECAM 0115). J Glob Oncol 2020; 5:1-10. [PMID: 31730380 PMCID: PMC6882517 DOI: 10.1200/jgo.19.00263] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
PURPOSE Breast cancer (BC) in young women is uncommon and tends to present with more aggressive characteristics. To better understand and characterize this scenario in Brazil through real-world data, we performed a subanalysis of AMAZONA III study (ClinicalTrials.gov identifier: NCT02663973). METHODS The AMAZONA III study (GBECAM 0115) is a prospective registry that included 2,950 women newly diagnosed with invasive BC in Brazil from January 2016 until March 2018 at 22 sites. Valid data were obtained from 2,888 patients regarding age at diagnosis and complete baseline information. To compare epidemiologic and clinicopathological features at the time of diagnosis, patients with BC were divided into two groups according to age: ≤ 40 years and > 40 years. Quantitative variables were described as means, and categorical variables were described as frequencies and percentages and compared using the Pearson’s χ2 test. RESULTS Of 2,888 women diagnosed with BC, 486 (17%) were ≤ 40 years old. Young women had higher educational level, most were employed and a significant number were married (P < .001 for all associations). Younger patients were more symptomatic at BC diagnosis (P < .001), and they also presented more frequently with stage III, T3/T4, grade 3 tumors, HER-2–positive, luminal B, and triple-negative subtypes. CONCLUSION Brazilian women younger than age 40 years have unfavorable clinicopathological features of BC at diagnosis, with more aggressive subtypes and advanced stage when compared with older women. These differences are not explained by socioeconomic or ethnic imbalances. The causes of a higher prevalence of BC among young women in Brazil deserve additional investigation.
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Affiliation(s)
- Maria Alice Franzoi
- Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.,Jules Bordet Institut, Brussels, Belgium.,Latin American Cooperative Oncology Group, Porto Alegre, Brazil
| | - Daniela D Rosa
- Latin American Cooperative Oncology Group, Porto Alegre, Brazil.,Grupo Brasileiro de Estudos em Câncer de Mama, Porto Alegre, Brazil.,Hospital Moinhos de Vento, Porto Alegre, Brazil
| | | | - Gustavo Werutsky
- Latin American Cooperative Oncology Group, Porto Alegre, Brazil.,Grupo Brasileiro de Estudos em Câncer de Mama, Porto Alegre, Brazil
| | - Sérgio Simon
- Latin American Cooperative Oncology Group, Porto Alegre, Brazil.,Grupo Brasileiro de Estudos em Câncer de Mama, Porto Alegre, Brazil
| | - José Bines
- Latin American Cooperative Oncology Group, Porto Alegre, Brazil.,Grupo Brasileiro de Estudos em Câncer de Mama, Porto Alegre, Brazil.,Instituto Nacional do Cancer, Rio de Janeiro, Brazil
| | - Carlos Barrios
- Latin American Cooperative Oncology Group, Porto Alegre, Brazil.,Grupo Brasileiro de Estudos em Câncer de Mama, Porto Alegre, Brazil
| | | | | | | | | | - José Couto
- Hospital do Câncer de Londrina, Londrina, Brazil
| | | | | | | | - Tomás Reinert
- Centro de Pesquisa e Educação da Serra Gaúcha- DeVita, Caxias do Sul, Brazil
| | | | - Yeni Nerón
- Centro de Pesquisas em Oncologia, Florianópolis, Brazil
| | - Vanessa Dybal
- Clínica Assistência Multidisciplinar em Oncologia, Salvador, Brazil
| | | | | | | | | | | | | | | | | | - Max Mano
- Instituto do Câncer do Estado de São Paulo, São Paulo, Brazil
| | - Pedro E R Liedke
- Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.,Latin American Cooperative Oncology Group, Porto Alegre, Brazil.,Grupo Brasileiro de Estudos em Câncer de Mama, Porto Alegre, Brazil
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31
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Villarreal-Garza C, Platas A, Miaja M, Fonseca A, Mesa-Chavez F, Garcia-Garcia M, Chapman JA, Lopez-Martinez EA, Pineda C, Mohar A, Galvez-Hernandez CL, Castro-Sanchez A, Martinez-Cannon BA, Barragan-Carrillo R, Muñoz-Lozano JF, Goss P, Bargallo-Rocha JE, Aguilar D, Cardona S, Canavati M. Young Women With Breast Cancer in Mexico: Results of the Pilot Phase of the Joven & Fuerte Prospective Cohort. JCO Glob Oncol 2020; 6:395-406. [PMID: 32142405 PMCID: PMC7113130 DOI: 10.1200/jgo.19.00264] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2020] [Indexed: 01/28/2023] Open
Abstract
PURPOSE The pilot-phase report of the Joven & Fuerte prospective cohort broadly characterizes and assesses the needs of Mexican young women with breast cancer (YWBC). PATIENTS AND METHODS Women age ≤ 40 years with nonmetastatic primary breast cancer were consecutively accrued from 2 hospitals. Data were collected at the first/baseline oncology visit and 2 years later using a sociodemographic survey, European Organisation for Research and Treatment of Cancer Quality-of-Life (QOL) Questionnaire Core 30 (QLQ-C30) and Breast Cancer-Specific QOL Questionnaire (QLQ-BR23), Hospital Anxiety and Depression Scale (HADS), Female Sexual Functioning Index (FSFI), Sexual Satisfaction Inventory, and patients' medical records. Pearson χ2 and 2-sided t tests were used for statistical analysis. An unadjusted P value < .05 was considered significant. RESULTS Ninety patients were included, all with government health care coverage. Most had low monthly household incomes (98%) and at least a high school education (59%). There was a considerable prevalence of unpartnered patients (36%) and unmet parity (25%). Patients' most common initial symptom was a palpable mass (84%), and they were most frequently diagnosed with stage III disease (48%), with 51% having had a physician visit ≤ 3 months since detection but 39% receiving diagnosis > 12 months later. At baseline, 66% of patients were overweight/obese, and this proportion had significantly increased by 2 years (P < .001). Compared with baseline, global QLQ-C30 had improved significantly by 2 years (P = .004), as had HADS-Anxiety (P < .001). However, both at baseline and at 2 years, nearly half of patients exhibited FSFI sexual dysfunction. CONCLUSION These preliminary findings demonstrate that YWBC in Mexico have particular sociodemographic and clinicopathologic characteristics, reinforcing the necessity to further describe and explore the needs of these young patients, because they may better represent the understudied and economically vulnerable population of YWBC in limited-resource settings.
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Affiliation(s)
- Cynthia Villarreal-Garza
- Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Ciudad de Mexico, Mexico
- Centro de Cancer de Mama, Tecnologico de Monterrey, Monterrey, Mexico
| | - Alejandra Platas
- Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Ciudad de Mexico, Mexico
- Departamento de Tumores Mamarios y Departamento de Investigacion, Instituto Nacional de Cancerologia, Ciudad de Mexico, Mexico
| | - Melina Miaja
- Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Ciudad de Mexico, Mexico
- Centro de Cancer de Mama, Tecnologico de Monterrey, Monterrey, Mexico
| | - Alan Fonseca
- Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Ciudad de Mexico, Mexico
| | - Fernanda Mesa-Chavez
- Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Ciudad de Mexico, Mexico
- Centro de Cancer de Mama, Tecnologico de Monterrey, Monterrey, Mexico
| | - Marisol Garcia-Garcia
- Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Ciudad de Mexico, Mexico
- Centro de Cancer de Mama, Tecnologico de Monterrey, Monterrey, Mexico
| | - Judy-Anne Chapman
- Canadian Cancer Trials Group, Queen’s University, Kingston, ON, Canada (retired)
| | - Edna A. Lopez-Martinez
- Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Ciudad de Mexico, Mexico
- Centro de Cancer de Mama, Tecnologico de Monterrey, Monterrey, Mexico
| | - Claudia Pineda
- Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Ciudad de Mexico, Mexico
| | - Alejandro Mohar
- Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Ciudad de Mexico, Mexico
- Departamento de Tumores Mamarios y Departamento de Investigacion, Instituto Nacional de Cancerologia, Ciudad de Mexico, Mexico
| | - Carmen L. Galvez-Hernandez
- Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Ciudad de Mexico, Mexico
- Departamento de Tumores Mamarios y Departamento de Investigacion, Instituto Nacional de Cancerologia, Ciudad de Mexico, Mexico
| | - Andrea Castro-Sanchez
- Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Ciudad de Mexico, Mexico
| | - Bertha-Alejandra Martinez-Cannon
- Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Ciudad de Mexico, Mexico
- Centro de Cancer de Mama, Tecnologico de Monterrey, Monterrey, Mexico
| | - Regina Barragan-Carrillo
- Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Ciudad de Mexico, Mexico
- Centro de Cancer de Mama, Tecnologico de Monterrey, Monterrey, Mexico
| | - Jose F. Muñoz-Lozano
- Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Ciudad de Mexico, Mexico
- Centro de Cancer de Mama, Tecnologico de Monterrey, Monterrey, Mexico
| | | | - Juan E. Bargallo-Rocha
- Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Ciudad de Mexico, Mexico
- Departamento de Tumores Mamarios y Departamento de Investigacion, Instituto Nacional de Cancerologia, Ciudad de Mexico, Mexico
| | - Dione Aguilar
- Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Ciudad de Mexico, Mexico
- Centro de Cancer de Mama, Tecnologico de Monterrey, Monterrey, Mexico
| | - Servando Cardona
- Centro de Cancer de Mama, Tecnologico de Monterrey, Monterrey, Mexico
| | - Mauricio Canavati
- Centro de Cancer de Mama, Tecnologico de Monterrey, Monterrey, Mexico
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32
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Flores-Balcázar CH, Flores-Luna ML, Villarreal-Garza CM, Bargalló-Rocha JE. Provider delay in treatment initiation and its influence on survival outcomes in women with operable breast cancer. Rep Pract Oncol Radiother 2020; 25:271-275. [PMID: 32140085 DOI: 10.1016/j.rpor.2020.02.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 12/18/2019] [Accepted: 02/19/2020] [Indexed: 01/03/2023] Open
Abstract
Aim The goal of this study was to determine whether a delay in starting treatment via surgery or neoadjuvant chemotherapy is related to a decrease in cancer-specific survival (CSS) in women with operable breast cancer (BrCr). Background Limited medical infrastructure and a lack of cancer prevention awareness in low- and middle-income countries have caused high BrCr incidence and mortality rates. Methods We analyzed a retrospective cohort of 720 women treated at a single center from 2005 to 2012. CSS estimates were obtained by the Kaplan-Meier method. A Cox model of proportional risks was performed to obtain the risk of dying from BrCr. We also obtained the risk according to the category of treatment initiation. Results Women with locally advanced stages and without hormone receptor expression were more likely to initiate treatment after 45 days. Patients in Stage IIIA had a 78.1% survival if treatment was initiated before 45 days (95% CI, 0.70-0.84) and 63.6% survival if treatment was started after 45 days (95% CI, 0.44-0.78; p < 0.001). Patients in Stage IIIB had a 62.9% survival if treatment was initiated before 45 days (95% CI, 0.53-0.72) and 57.4% survival if treatment started after 45 days (95% CI, 0.31-0.89; p < 0.001). Prognostic factors in which lower survival was recognized were Stage IIIA, Stage IIIB, treatment initiation after 45 days, and triple-negative tumors. Conclusions The initiation of treatment within the first 45 days of diagnosis of BrCr in women portends better survival compared with those who began treatment longer than 45 days from diagnosis.
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Affiliation(s)
- Christian H Flores-Balcázar
- Department of Radiation-Oncology, National Cancer Institute, 22 San Fernando Ave, Section XVI, Tlalpan, Mexico City 14080, Mexico
| | - Ma L Flores-Luna
- Department of Epidemiology, National Institute of Public Health, 50 Fray Pedro de Gante, Section XVI, Tlalpan, Mexico City 14080, Mexico
| | - Cynthia M Villarreal-Garza
- Department of Breast Tumors, National Cancer Institute, 22 San Fernando Ave, Section XVI, Tlalpan, Mexico City 14080, Mexico
| | - Juan E Bargalló-Rocha
- Department of Breast Tumors, National Cancer Institute, 22 San Fernando Ave, Section XVI, Tlalpan, Mexico City 14080, Mexico
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33
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Oliver J, Quezada Urban R, Franco Cortés CA, Díaz Velásquez CE, Montealegre Paez AL, Pacheco-Orozco RA, Castro Rojas C, García-Robles R, López Rivera JJ, Gaitán Chaparro S, Gómez AM, Suarez Obando F, Giraldo G, Maya MI, Hurtado-Villa P, Sanchez AI, Serrano N, Orduz Galvis AI, Aruachan S, Nuñez Castillo J, Frecha C, Riggi C, Jauk F, Gómez García EM, Carranza CL, Zamora V, Torres Mejía G, Romieu I, Castañeda CA, Castillo M, Gitler R, Antoniano A, Rojas Jiménez E, Romero Cruz LE, Vallejo Lecuona F, Delgado Enciso I, Martínez Rizo AB, Flores Carranza A, Benites Godinez V, Méndez Catalá CF, Herrera LA, Chirino YI, Terrazas LI, Perdomo S, Vaca Paniagua F. Latin American Study of Hereditary Breast and Ovarian Cancer LACAM: A Genomic Epidemiology Approach. Front Oncol 2019; 9:1429. [PMID: 31921681 PMCID: PMC6933010 DOI: 10.3389/fonc.2019.01429] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 12/02/2019] [Indexed: 12/29/2022] Open
Abstract
Purpose: Hereditary Breast and Ovarian Cancer (HBOC) syndrome is responsible for ~5-10% of all diagnosed breast and ovarian cancers. Breast cancer is the most common malignancy and the leading cause of cancer-related mortality among women in Latin America (LA). The main objective of this study was to develop a comprehensive understanding of the genomic epidemiology of HBOC throughout the establishment of The Latin American consortium for HBOC-LACAM, consisting of specialists from 5 countries in LA and the description of the genomic results from the first phase of the study. Methods: We have recruited 403 individuals that fulfilled the criteria for HBOC from 11 health institutions of Argentina, Colombia, Guatemala, Mexico and Peru. A pilot cohort of 222 individuals was analyzed by NGS gene panels. One hundred forty-three genes were selected on the basis of their putative role in susceptibility to different hereditary cancers. Libraries were sequenced in MiSeq (Illumina, Inc.) and PGM (Ion Torrent-Thermo Fisher Scientific) platforms. Results: The overall prevalence of pathogenic variants was 17% (38/222); the distribution spanned 14 genes and varied by country. The highest relative prevalence of pathogenic variants was found in patients from Argentina (25%, 14/57), followed by Mexico (18%, 12/68), Guatemala (16%, 3/19), and Colombia (13%, 10/78). Pathogenic variants were found in BRCA1 (20%) and BRCA2 (29%) genes. Pathogenic variants were found in other 12 genes, including high and moderate risk genes such as MSH2, MSH6, MUTYH, and PALB2. Additional pathogenic variants were found in HBOC unrelated genes such as DCLRE1C, WRN, PDE11A, and PDGFB. Conclusion: In this first phase of the project, we recruited 403 individuals and evaluated the germline genetic alterations in an initial cohort of 222 patients among 4 countries. Our data show for the first time in LA the distribution of pathogenic variants in a broad set of cancer susceptibility genes in HBOC. Even though we used extended gene panels, there was still a high proportion of patients without any detectable pathogenic variant, which emphasizes the larger, unexplored genetic nature of the disease in these populations.
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Affiliation(s)
- Javier Oliver
- Medical Oncology Service, Hospitales Universitarios Regional y Virgen de la Victoria, Institute of Biomedical Research in Malaga, CIMES, University of Málaga, Málaga, Spain
- Laboratorio de Secuenciación, Instituto de Medicina Traslacional e Ingeniería Biomédica, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
- Laboratorio Nacional en Salud, Diagnóstico Molecular y Efecto Ambiental en Enfermedades Crónico-Degenerativas, Facultad de Estudios Superiores Iztacala, Tlalnepantla de Baz, Mexico
| | - Rosalía Quezada Urban
- Laboratorio Nacional en Salud, Diagnóstico Molecular y Efecto Ambiental en Enfermedades Crónico-Degenerativas, Facultad de Estudios Superiores Iztacala, Tlalnepantla de Baz, Mexico
- Unidad de Biomedicina, Facultad de Estudios Superiores Iztacala, UNAM, Tlalnepantla de Baz, Mexico
| | - Claudia Alejandra Franco Cortés
- Laboratorio de Secuenciación, Instituto de Medicina Traslacional e Ingeniería Biomédica, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Clara Estela Díaz Velásquez
- Laboratorio Nacional en Salud, Diagnóstico Molecular y Efecto Ambiental en Enfermedades Crónico-Degenerativas, Facultad de Estudios Superiores Iztacala, Tlalnepantla de Baz, Mexico
| | - Ana Lorena Montealegre Paez
- Instituto de Nutrición, Genética y Metabolismo, Facultad de Medicina, Universidad El Bosque, Bogota, Colombia
| | | | - Carlos Castro Rojas
- Instituto de Nutrición, Genética y Metabolismo, Facultad de Medicina, Universidad El Bosque, Bogota, Colombia
| | - Reggie García-Robles
- Instituto de Nutrición, Genética y Metabolismo, Facultad de Medicina, Universidad El Bosque, Bogota, Colombia
| | - Juan Javier López Rivera
- Grupo INPAC, Organización Keralty, Departamento de Genética, Clínica Universitaria Colombia, Bogotá, Colombia
| | - Sandra Gaitán Chaparro
- Grupo INPAC, Organización Keralty, Facultad de Medicina, Fundación Universitaria Sanitas, Bogotá, Colombia
| | - Ana Milena Gómez
- Servicio de Genética, Hospital Universitario San Ignacio, Bogotá, Colombia
| | - Fernando Suarez Obando
- Servicio de Genética, Hospital Universitario San Ignacio, Bogotá, Colombia
- Instituto de Genética Humana, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Gustavo Giraldo
- Clínica Universitaria Bolivariana, Pontificia Universidad Bolivariana, Medellín, Colombia
| | - Maria Isabel Maya
- Clínica Universitaria Bolivariana, Pontificia Universidad Bolivariana, Medellín, Colombia
| | - Paula Hurtado-Villa
- Departamento Ciencias Básicas de Salud, Facultad de Ciencias de la Salud, Pontificia Universidad Javeriana Cali, Cali, Colombia
- Centro Médico Imbanaco, Cali, Colombia
| | - Ana Isabel Sanchez
- Centro Médico Imbanaco, Cali, Colombia
- Departamento Materno Infantil, Facultad de Ciencias de la Salud, Pontificia Universidad Javeriana Cali, Cali, Colombia
| | - Norma Serrano
- Fundación Cardiovascular de Colombia, Centro de Investigaciones, Floridablanca, Colombia
| | | | - Sandra Aruachan
- Departamento de Investigación y Estudios Clínicos, IMAT - Oncomédica S.A., Montería, Colombia
| | - Johanna Nuñez Castillo
- Departamento de Investigación y Estudios Clínicos, IMAT - Oncomédica S.A., Montería, Colombia
| | - Cecilia Frecha
- Instituto de Medicina Traslacional e Ingeniería Biomédica, CONICET-Instituto Universitario del Hospital Italiano-Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Cecilia Riggi
- Servicio de Ginecología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Federico Jauk
- Laboratorio de Secuenciación, Instituto de Medicina Traslacional e Ingeniería Biomédica, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | | | | | | | | | - Isabelle Romieu
- Instituto Nacional de Salud Pública, Cuernavaca, Mexico
- Hubert Department of Global Health, Emory University, Atlanta, GA, United States
| | - Carlos Arturo Castañeda
- Departamento de Oncología Médica, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - Miluska Castillo
- Departamento de Investigación, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | | | | | - Ernesto Rojas Jiménez
- Laboratorio Nacional en Salud, Diagnóstico Molecular y Efecto Ambiental en Enfermedades Crónico-Degenerativas, Facultad de Estudios Superiores Iztacala, Tlalnepantla de Baz, Mexico
- Unidad de Biomedicina, Facultad de Estudios Superiores Iztacala, UNAM, Tlalnepantla de Baz, Mexico
| | - Luis Enrique Romero Cruz
- Laboratorio Nacional en Salud, Diagnóstico Molecular y Efecto Ambiental en Enfermedades Crónico-Degenerativas, Facultad de Estudios Superiores Iztacala, Tlalnepantla de Baz, Mexico
- Unidad de Biomedicina, Facultad de Estudios Superiores Iztacala, UNAM, Tlalnepantla de Baz, Mexico
| | - Fernando Vallejo Lecuona
- Laboratorio Nacional en Salud, Diagnóstico Molecular y Efecto Ambiental en Enfermedades Crónico-Degenerativas, Facultad de Estudios Superiores Iztacala, Tlalnepantla de Baz, Mexico
- Unidad de Biomedicina, Facultad de Estudios Superiores Iztacala, UNAM, Tlalnepantla de Baz, Mexico
| | | | | | | | | | - Claudia Fabiola Méndez Catalá
- Laboratorio Nacional en Salud, Diagnóstico Molecular y Efecto Ambiental en Enfermedades Crónico-Degenerativas, Facultad de Estudios Superiores Iztacala, Tlalnepantla de Baz, Mexico
| | - Luis Alonso Herrera
- Unidad de Investigación Biomédica en Cáncer, Instituto de Investigaciones Biomédicas-Instituto Nacional de Cancerología, Ciudad de México, Mexico
| | - Yolanda Irasema Chirino
- Unidad de Biomedicina, Facultad de Estudios Superiores Iztacala, UNAM, Tlalnepantla de Baz, Mexico
| | - Luis Ignacio Terrazas
- Laboratorio Nacional en Salud, Diagnóstico Molecular y Efecto Ambiental en Enfermedades Crónico-Degenerativas, Facultad de Estudios Superiores Iztacala, Tlalnepantla de Baz, Mexico
- Unidad de Biomedicina, Facultad de Estudios Superiores Iztacala, UNAM, Tlalnepantla de Baz, Mexico
| | - Sandra Perdomo
- Instituto de Nutrición, Genética y Metabolismo, Facultad de Medicina, Universidad El Bosque, Bogota, Colombia
- Departamento de Patología, Hospital Universitario Fundación Santa Fe de Bogotá, Bogota, Colombia
| | - Felipe Vaca Paniagua
- Laboratorio Nacional en Salud, Diagnóstico Molecular y Efecto Ambiental en Enfermedades Crónico-Degenerativas, Facultad de Estudios Superiores Iztacala, Tlalnepantla de Baz, Mexico
- Unidad de Biomedicina, Facultad de Estudios Superiores Iztacala, UNAM, Tlalnepantla de Baz, Mexico
- Instituto Nacional de Cancerología, Ciudad de México, Mexico
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Abstract
OPINION STATEMENT Despite the increase of breast cancer incidence with age, approximately 7 to 10% ofwomen diagnosed with breast cancer are younger than the age 40. This subgroup ofpatients has different risk factors, tumour biology, clinical outcomes, and specific psy- chosocial issues, such as fertility preservation, family planning, and job reintegration. However, age alone should not be the main consideration when choosing the aggressive- ness of the treatment, as other factors must be considered, including the biologic aggressiveness of the tumour, potential long-term toxicities, and the preferences of the patient. Fertility preservation techniques should be discussed with the patient before starting any cancer treatment. Despite the significant percentage of breast cancer patients younger than age 40, fewclinical studies have specifically investigated disease characteristics and outcomes of this population, and most therapies routinely administered to these younger women were tested in older patients. Moreover, young women who have breast cancer are at a greater risk of sexual and psychological distress, and clinicians should address these issues in order to properly support patients during the long diagnostic and therapeutic journey. Consequently, it is essential to follow diagnostic and treatment guidelines specificallyaddressed to young women. Additional specific procedures should be followed to treat pregnant patients with breast cancer.
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35
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Carioli G, Bertuccio P, Malvezzi M, Rodriguez T, Levi F, Boffetta P, La Vecchia C, Negri E. Cancer mortality predictions for 2019 in Latin America. Int J Cancer 2019; 147:619-632. [PMID: 31637709 DOI: 10.1002/ijc.32749] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Revised: 10/03/2019] [Accepted: 10/09/2019] [Indexed: 12/11/2022]
Abstract
We estimated mortality figures for 2019 in seven Latin American countries, with focus on breast cancer. We retrieved cancer death certification and population data from the WHO and PAHO databases. We obtained mortality statistics for Argentina, Brazil, Chile, Colombia, Cuba, Mexico and Venezuela for 1970-2015. We predicted current death numbers and age-standardised (world population) mortality rates using joinpoint regression models. Total cancer mortality is predicted to decline in all countries and both sexes, except Argentinian women. Cuba had the highest all cancer rates for 2019, 136.9/100,000 men and 90.4 women, while Mexico showed the lowest ones, 63.8/100,000 men and 61.9 women. Stomach cancer showed favourable trends over the whole period, while colorectal cancer only recently. Lung cancer rates declined in men, while in women they decreased slightly over the most recent years, only. In Cuban women, lung cancer rates overtook breast cancer ones. Breast cancer showed overall favourable trends, but rates are rising in young women. Prostate and uterine cancer had favourable trends. Pancreas, ovary, bladder and leukaemias showed slightly decreasing trends. Between 1990 and 2019, mortality from all neoplasms is predicted to fall by about 18% in Argentina, 26% in Chile, 14% in Colombia, 17% in Mexico and 13% in Venezuela, corresponding to almost 0.5 million avoided cancer deaths. No decline was observed in Brazil and Cuba. Of concern, the persisting high rates of (cervix) uterus cancer, the high lung cancer rates in Cuba, the possible increases in breast cancer in young women, and the lack of overall declines in Brazil, Cuba and Venezuelan men.
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Affiliation(s)
- Greta Carioli
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Paola Bertuccio
- Department of Biomedical and Clinical Sciences, L. Sacco, Università degli Studi di Milano, Milan, Italy
| | - Matteo Malvezzi
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Teresa Rodriguez
- Navarra General Hospital, Navarra Health Service, Pamplona, Navarra, Spain
| | - Fabio Levi
- Institute of Social and Preventive Medicine (IUMSP), University of Lausanne, Lausanne, Switzerland
| | - Paolo Boffetta
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY.,Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Eva Negri
- Department of Biomedical and Clinical Sciences, L. Sacco, Università degli Studi di Milano, Milan, Italy
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36
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Millan Catalan O, Campos-Parra AD, Vázquez-Romo R, Cantú de León D, Jacobo-Herrera N, Morales-González F, López-Camarillo C, Rodríguez-Dorantes M, López-Urrutia E, Pérez-Plasencia C. A Multi-Center Study of BRCA1 and BRCA2 Germline Mutations in Mexican-Mestizo Breast Cancer Families Reveals Mutations Unreported in Latin American Population. Cancers (Basel) 2019; 11:E1246. [PMID: 31454914 PMCID: PMC6769960 DOI: 10.3390/cancers11091246] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 08/12/2019] [Accepted: 08/19/2019] [Indexed: 12/24/2022] Open
Abstract
The presence of germline and somatic deleterious mutations in the BRCA1 and BRCA2 genes has important clinical consequences for breast cancer (BC) patients. Analysis of the mutational status in BRCA genes is not yet common in public Latin American institutions; thus, our objective was to implement high-performance technology with highly reliable results with the possibility of analyzing several patients simultaneously, therefore reducing cost and work time. A prospective cohort of 252 unrelated sporadic breast cancer patients from the Mexican-mestizo population were analyzed using next generation sequencing (NGS) based on ion semiconductor sequencing. We found 28 pathogenic mutations (25 in BRCA1 and 13 in BRCA2), 11 of which had not been reported previously in Hispanic or Latin American populations. A total of 38 patients were positive for a pathogenic mutation representing 15% of our Mexican women cohort with breast cancer; 25 for BRCA1; and 13 for BRCA2. Our results revealed that there are mutations not analyzed by mutations panels, and our findings support the suitability of massive sequencing approaches in the public institutions of developing countries. Hence, BRCA screening should be offered to patients with breast cancer regardless of their family history of cancer in order to identify unaffected family carriers.
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Affiliation(s)
- Oliver Millan Catalan
- Laboratorio de Genómica, Instituto Nacional de Cancerología (INCan). Av. San Fernando 22, Col. Sección XVI, C.P. Tlalpan, Ciudad de México 14080, Mexico
| | - Alma D Campos-Parra
- Laboratorio de Genómica, Instituto Nacional de Cancerología (INCan). Av. San Fernando 22, Col. Sección XVI, C.P. Tlalpan, Ciudad de México 14080, Mexico
| | - Rafael Vázquez-Romo
- Departamento de Cirugía de Tumores Mamarios, Instituto Nacional de Cancerología (INCan), Av. San Fernando 22, Col. Sección XVI, C.P. Tlalpan, Ciudad de México 14080, Mexico
| | - David Cantú de León
- Dirección de Investigación, Instituto Nacional de Cancerología (INCan), Av. San Fernando 22, Col. Sección XVI, C.P. Tlalpan, Ciudad de México14080, Mexico
| | - Nadia Jacobo-Herrera
- Unidad de Bioquímica, Instituto Nacional de Ciencias Médicas y Nutrición, Salvador Zubirán (INCMNSZ), Av. Vasco de Quiroga 15, Col Belisario Dominguez. C.P. Tlalpan, Ciudad de México 14080, Mexico
| | - Fermín Morales-González
- Instituto Jalisciense de Cancerología. Coronel Calderón 715, Guadalajara 44280, Jalisco, Mexico
| | - César López-Camarillo
- Posgrado en Ciencias Genómicas, Universidad Autónoma de la Ciudad de México, San Lorenzo 290, Del Valle Sur, Benito Juarez, Ciudad de México 03100, Mexico
| | | | - Eduardo López-Urrutia
- Laboratorio de Genómica, Unidad de Biomedicina, FES-IZTACALA, UNAM, Tlalnepantla 54090, Mexico.
| | - Carlos Pérez-Plasencia
- Laboratorio de Genómica, Instituto Nacional de Cancerología (INCan). Av. San Fernando 22, Col. Sección XVI, C.P. Tlalpan, Ciudad de México 14080, Mexico.
- Laboratorio de Genómica, Unidad de Biomedicina, FES-IZTACALA, UNAM, Tlalnepantla 54090, Mexico.
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37
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Gálvez-Hernández CL, Rivera-Fong L, Linares-Buitrón ÁV, Zapata-Barrera S, Mohar-Betancourt A, Calleja N, Villarreal-Garza C. [Validation of the Cognitive Emotional Regulation Questionnaire in Mexican patients with breast cancer]. SALUD PUBLICA DE MEXICO 2019; 60:488-489. [PMID: 30550102 DOI: 10.21149/9191] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
[No disponible]
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Affiliation(s)
- Carmen Lizette Gálvez-Hernández
- Cátedra-Conacyt, Instituto Nacional de Cancerología. Ciudad de México.,Joven y Fuerte: Programa para la Atención e Investigación de Mujeres Jóvenes con Cáncer de Mama, Instituto Nacional de Cancerología. Ciudad de México.,Instituto Nacional de Cancerología. Ciudad de México
| | - Liliana Rivera-Fong
- Facultad de Psicología, Universidad Nacional Autónoma de México. Ciudad de México
| | | | | | - Alejandro Mohar-Betancourt
- Joven y Fuerte: Programa para la Atención e Investigación de Mujeres Jóvenes con Cáncer de Mama, Instituto Nacional de Cancerología. Ciudad de México.,Instituto Nacional de Cancerología. Ciudad de México
| | - Nazira Calleja
- Facultad de Psicología, Universidad Nacional Autónoma de México. Ciudad de México
| | - Cynthia Villarreal-Garza
- Joven y Fuerte: Programa para la Atención e Investigación de Mujeres Jóvenes con Cáncer de Mama, Instituto Nacional de Cancerología. Ciudad de México.,Instituto Nacional de Cancerología. Ciudad de México.,Centro de Cáncer de Mama, Hospital Zambrano Hellion, Tecnológico de Monterrey. San Pedro Garza García, Nuevo León
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38
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Caglevic C, Anabalón J, Soza C, Milla E, Gaete F, Carrasco AM, Panay S, Gallardo C, Mahave M. Triple-negative breast cancer: the reality in Chile and in Latin America. Ecancermedicalscience 2019; 13:893. [PMID: 30792810 PMCID: PMC6372297 DOI: 10.3332/ecancer.2019.893] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Indexed: 12/21/2022] Open
Abstract
Breast cancer is the leading cause of cancer death among women worldwide. While triple-negative breast cancer is less common among various sub-types of breast cancer, it tends to affect younger women and is more aggressive, having a higher rate of early recurrence and mortality compared to other sub-types. We know about the association between triple-negative breast cancer and BRCA mutations, which are highly prevalent in founding populations of European origin, but the true prevalence of these mutations in Latin American populations is unknown. There is also very little information about the demographic and epidemiological aspects of triple-negative breast cancer in Latin America, which we will try to summarise in this article. In addition, we will try to provide a brief introduction to the most common recommendations for treating this histological class in Latin America.
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Affiliation(s)
- Christian Caglevic
- Medical Oncology Department, Clinica Alemana Santiago; Faculty of Medicine, Universidad del Desarrollo, Santiago 456, Chile
| | - Jaime Anabalón
- Oncology Institute Arturo López Pérez Foundation, Santiago 878, Chile
| | - Cristian Soza
- School of Biochemistry, Faculty of Science, San Sebastián University, Santiago 1457, Chile.,Oncoloop Foundation, Faculty of Medicine, Andrés Bello University, Santiago 890, Chile
| | - Elizabeth Milla
- Oncology Institute Arturo López Pérez Foundation, Santiago 878, Chile
| | - Fancy Gaete
- Hospital Santiago Oriente Dr Luis Tisné, Santiago 5150, Chile
| | | | - Sergio Panay
- Oncology Institute Arturo López Pérez Foundation, Santiago 878, Chile
| | - Carlos Gallardo
- Oncology Institute Arturo López Pérez Foundation, Santiago 878, Chile
| | - Mauricio Mahave
- Oncology Institute Arturo López Pérez Foundation, Santiago 878, Chile
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39
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Villarreal-Garza C, Lopez-Martinez EA, Muñoz-Lozano JF, Unger-Saldaña K. Locally advanced breast cancer in young women in Latin America. Ecancermedicalscience 2019; 13:894. [PMID: 30792811 PMCID: PMC6372300 DOI: 10.3332/ecancer.2019.894] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Indexed: 01/07/2023] Open
Abstract
The purpose of this review is to organise, summarise and critically assess existing knowledge on locally advanced breast cancer (LABC) among young women in Latin America. We discuss the most relevant findings in six sections: 1) epidemiology of breast cancer in young women in Latin America; 2) being young as a factor for worse prognosis; 3) LABC in young women in the region; 4) aggressive tumour behaviour among young women; 5) delays in diagnosis and treatment and 6) burden of advanced disease. We point out the need to dedicate resources to enhance earlier diagnosis and prompt referrals of young women with breast cancer; promote research regarding prevalence, biologic characteristics, outcomes and reasons for diagnosis and treatment delays for this age group; and finally, implement supportive care programmes as a means of improving patients and their families’ well-being. The recognition of the current standpoint of breast cancer in young patients across the continent should shed some light on the importance of this pressing matter.
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Affiliation(s)
- Cynthia Villarreal-Garza
- Breast Cancer Center, TecSalud, Tecnologico de Monterrey, Monterrey 66278, Mexico.,Research and Breast Cancer Department, Mexican National Cancer Institute, Mexico City 14080, Mexico.,Joven and Fuerte Program for Young Women with Breast Cancer, Mexico City 03720, Mexico
| | - Edna A Lopez-Martinez
- Breast Cancer Center, TecSalud, Tecnologico de Monterrey, Monterrey 66278, Mexico.,Joven and Fuerte Program for Young Women with Breast Cancer, Mexico City 03720, Mexico
| | - Jose Felipe Muñoz-Lozano
- Breast Cancer Center, TecSalud, Tecnologico de Monterrey, Monterrey 66278, Mexico.,Joven and Fuerte Program for Young Women with Breast Cancer, Mexico City 03720, Mexico
| | - Karla Unger-Saldaña
- CONACYT fellow-Epidemiology Unit, Mexican National Cancer Institute, Mexico City 14080, Mexico
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40
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Pinto JA, Pinillos L, Villarreal-Garza C, Morante Z, Villarán MV, Mejía G, Caglevic C, Aguilar A, Fajardo W, Usuga F, Carrasco M, Rebaza P, Posada AM, Tirado-Hurtado I, Flores C, Vallejos CS. Barriers in Latin America for the management of locally advanced breast cancer. Ecancermedicalscience 2019; 13:897. [PMID: 30792814 PMCID: PMC6372299 DOI: 10.3332/ecancer.2019.897] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Indexed: 01/21/2023] Open
Abstract
Breast cancer (BC) is a highly prevalent malignancy in Latin American women, most cases being diagnosed at locally advanced or metastatic stages when options for cancer care are limited. Despite its label as a public health problem in the region, Latin American BC patients face several barriers in accessing standard of care treatment when compared with patients from developed countries. In this review, we analyse the landscape of the four main identified barriers in the region: i) high burden of locally advanced/advanced BC; ii) inadequate access to medical resources; iii) deficient access to specialised cancer care and iv) insufficient BC research in Latin America. Unfortunately, these barriers represent the main factors associated with the BC poor outcomes seen in the region. Targeted actions should be conducted independently by each country and as a region to overcome these limitations and create an enhanced model of BC care.
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Affiliation(s)
- Joseph A Pinto
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Lima 15036, Peru
| | - Luis Pinillos
- Departamento de Radioterapia, Oncosalud-AUNA, Lima 15036, Peru
| | - Cynthia Villarreal-Garza
- Departamento de Investigación y de Tumores Mamarios, Instituto Nacional de Cancerología, Mexico City 14080, Mexico
| | - Zaida Morante
- Departamento de Medicina Oncológica, Oncosalud-AUNA, Lima 15036, Peru.,Departamento de Oncología Médica, Instituto Nacional de Enfermedades Neoplásicas, Lima 15038, Peru
| | - Manuel V Villarán
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Lima 15036, Peru
| | - Gerson Mejía
- Departamento de Oncología Médica, Hospital Clínico Viedma, Cochabamba 00725, Bolivia
| | - Christian Caglevic
- Medical Oncology Department, Clinica Alemana, Santiago 5951, Chile.,Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago 700, Chile
| | - Alfredo Aguilar
- Departamento de Medicina Oncológica, Oncosalud-AUNA, Lima 15036, Peru
| | - Williams Fajardo
- Departamento de Medicina Especializada, Hospital Nacional Dos de Mayo, Lima 15003, Peru
| | - Franz Usuga
- Grupo de Radioterapia Oncológica, Instituto Nacional de Cancerología, Bogotá 9-85, Colombia
| | - Marcia Carrasco
- Departamento de Oncología, Hospital Santa Rosa, Lima 95405, Peru.,Unidad de la Mama, Oncosalud-AUNA, Lima 15036, Peru
| | | | - Ana M Posada
- Unidad de la Mama, Oncosalud-AUNA, Lima 15036, Peru
| | | | - Claudio Flores
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Lima 15036, Peru
| | - Carlos S Vallejos
- Departamento de Medicina Oncológica, Oncosalud-AUNA, Lima 15036, Peru
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41
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Landeiro LCG, Gagliato DM, Fêde AB, Fraile NM, Lopez RM, da Fonseca LG, Petry V, Testa L, Hoff PM, Mano MS. Return to work after breast cancer diagnosis: An observational prospective study in Brazil. Cancer 2018; 124:4700-4710. [PMID: 30329152 DOI: 10.1002/cncr.31735] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Revised: 07/08/2018] [Accepted: 07/30/2018] [Indexed: 12/23/2022]
Abstract
BACKGROUND In North America and Europe, return-to-work (RTW) rates vary among breast cancer (BC) survivors, from 24% to 66% and from 53% to 82% at 6 and 36 months after diagnosis, respectively. To date, there is a lack of data on RTW rates after BC diagnosis in Latin America. Therefore, the primary objectives of this study were to define RTW rates at 12 and 24 months after BC diagnosis and to identify the factors associated with RTW in this population. METHODS In total, 125 employed women from a single institution with newly diagnosed BC were interviewed by telephone at 6, 12, and 24 months after diagnosis. Those who had inoperable or metastatic disease were excluded. RESULTS Overall, RTW rates were 30.3% and 60.4% at 12 and 24 months after BC diagnosis, respectively. Most women reported that they received support from their employer, but only 29.1% reported having been offered work adjustments. In multivariate analysis, the factors associated with positive RTW outcomes included higher household income (odds ratio [OR], 17.76; 95% confidence interval [CI], 3.33-94.75; P = .001), breast-conserving surgery (OR, 9.77; 95% CI, 2.03-47.05; P = .004), and work adjustments (OR, 37.62; 95% CI, 2.03-47.05; P = .004). The factors associated with negative RTW outcomes included adjuvant endocrine therapy (OR, 0.11; 95% CI, 0.02-0.74; P = .023), and depression diagnosed after BC (OR, 0.07; 95% CI, 0.01-0.63; P = .017). CONCLUSIONS RTW rates in the current study were lower than those observed in developed countries but similar to the rates among low-income Americans. Workplace adjustments, higher income, breast-conserving surgery, endocrine therapy, and depression after BC played an important role in the RTW decision.
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Affiliation(s)
- Luciana C G Landeiro
- Department of Breast Cancer, Sao Paulo State Cancer Institute, Sao Paulo, Brazil
| | - Debora M Gagliato
- Department of Breast Cancer, Sao Paulo State Cancer Institute, Sao Paulo, Brazil
| | - Angelo B Fêde
- Department of Breast Cancer, Sao Paulo State Cancer Institute, Sao Paulo, Brazil
| | - Natalia M Fraile
- Department of Breast Cancer, Sao Paulo State Cancer Institute, Sao Paulo, Brazil
| | - Rossana M Lopez
- Department of Epidemiology/ Biostatistics, Sao Paulo State Cancer Institute, Sao Paulo, Brazil
| | | | - Vanessa Petry
- Department of Breast Cancer, Sao Paulo State Cancer Institute, Sao Paulo, Brazil
| | - Laura Testa
- Department of Breast Cancer, Sao Paulo State Cancer Institute, Sao Paulo, Brazil
| | - Paulo M Hoff
- Department of Breast Cancer, Sao Paulo State Cancer Institute, Sao Paulo, Brazil
| | - Max S Mano
- Department of Breast Cancer, Sao Paulo State Cancer Institute, Sao Paulo, Brazil
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42
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Is the high proportion of young age at breast cancer onset a unique feature of Asian breast cancer? Breast Cancer Res Treat 2018; 173:189-199. [DOI: 10.1007/s10549-018-4947-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Accepted: 08/27/2018] [Indexed: 11/26/2022]
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43
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Gómez-Flores-Ramos L, Álvarez-Gómez RM, Villarreal-Garza C, Wegman-Ostrosky T, Mohar A. Breast cancer genetics in young women: What do we know? MUTATION RESEARCH-REVIEWS IN MUTATION RESEARCH 2017; 774:33-45. [PMID: 29173497 DOI: 10.1016/j.mrrev.2017.08.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 04/21/2017] [Accepted: 08/17/2017] [Indexed: 12/12/2022]
Abstract
Breast cancer (BC) in young women, generally defined in oncology as women who are 40 years of age or younger, represents 2 out of 10 BC cases in developing countries. Several research studies, including genetic cancer panel tests, genome-wide association studies, expression analyses and polymorphisms reports, have found that young women with BC exhibit a higher genetic susceptibility and specific genomic signature compared to postmenopausal women with BC. Thus, international guidelines recommend genetic counseling for this age population. This review presents the current state of the art of genetics and genomics with regards to young women with BC.
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Affiliation(s)
- Liliana Gómez-Flores-Ramos
- Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Circuito Mario de la Cueva, Coyoacán, Ciudad Universitaria, C.P. 04510, Mexico City, Mexico; Unidad de Investigación en Epidemiología, Subdivisión de Investigación Básica, Instituto Nacional de Cancerología, Av. San Fernando # 22, Col. Sección XVI, Delegación Tlalpan, C.P. 14080, Mexico City, Mexico
| | - Rosa María Álvarez-Gómez
- Clínica de Cáncer Hereditario, Subdivisión de Investigación Básica, Instituto Nacional de Cancerlogía, Av. San Fernando # 22, Col. Sección XVI, Delegación Tlalpan, C.P. 14080, Mexico City, Mexico
| | - Cynthia Villarreal-Garza
- Clínica de Cáncer Hereditario, Subdivisión de Investigación Básica, Instituto Nacional de Cancerlogía, Av. San Fernando # 22, Col. Sección XVI, Delegación Tlalpan, C.P. 14080, Mexico City, Mexico; Centro de Cáncer de Mama, Tecnológico de Monterrey, Centro Médico Zambrano Hellion, 6° Piso Av. Batallón de San Patricio #112 Col. Real San Agustín, San Pedro Garza García C.P. 66278, Nuevo León, Mexico
| | - Talia Wegman-Ostrosky
- Clínica de Cáncer Hereditario, Subdivisión de Investigación Básica, Instituto Nacional de Cancerlogía, Av. San Fernando # 22, Col. Sección XVI, Delegación Tlalpan, C.P. 14080, Mexico City, Mexico
| | - Alejandro Mohar
- Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Circuito Mario de la Cueva, Coyoacán, Ciudad Universitaria, C.P. 04510, Mexico City, Mexico; Unidad de Investigación en Epidemiología, Subdivisión de Investigación Básica, Instituto Nacional de Cancerología, Av. San Fernando # 22, Col. Sección XVI, Delegación Tlalpan, C.P. 14080, Mexico City, Mexico.
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44
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Maishman T, Cutress RI, Hernandez A, Gerty S, Copson ER, Durcan L, Eccles DM. Local Recurrence and Breast Oncological Surgery in Young Women With Breast Cancer: The POSH Observational Cohort Study. Ann Surg 2017; 266:165-172. [PMID: 27455160 PMCID: PMC5639998 DOI: 10.1097/sla.0000000000001930] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To assess clinical and surgical factors affecting local recurrence and survival in young breast cancer patients in the Prospective study of Outcomes in Sporadic versus Hereditary breast cancer (POSH). BACKGROUND Emerging data suggest young age is a predictor of increased local recurrence. METHODS POSH is a prospective cohort of 3024 women of 18 to 40 years with breast cancer. Cohort characteristics were grouped by mastectomy or BCS. Endpoints were local-recurrence interval (LRI), distant disease-free interval (DDFI), and overall survival (OS); described using cumulative-hazard and Kaplan-Meier plots and multivariable analyses by Flexible Parametric and Cox regression models. RESULTS Mastectomy was performed in 1464 patients and breast-conserving surgery (BCS) in 1395. Patients undergoing mastectomy had larger tumors and higher proportions of positive family history, estrogen receptor+, progesterone receptor+, and/or human epidermal growth factor receptor 2+ tumors. Local events accounted for 15% of recurrences. LRI by surgical type varied over time with LRI similar at 18 months (1.0% vs 1.0%, P = 0.348) but higher for BCS at 5 and 10 years (5.3% vs 2.6%, P < 0.001; and 11.7% vs 4.9%, P < 0.001, respectively). Similar results were found in the adjusted model. Conversely, distant-metastases and deaths were lower for BCS but not after adjusting for prognostic factors. After mastectomy chest-wall radiotherapy was associated with improved LRI (hazard ratio, HR = 0.46, P = 0.015). Positive surgical margins, and development of local recurrence predicted for reduced DDFI (HR = 0.50, P < 0.001; and HR = 0.29, P = 0.001, respectively). CONCLUSIONS Surgical extent appears less important for DDFI than completeness of excision or, where appropriate, chest-wall radiotherapy. Despite higher local-recurrence rates for BCS, surgical type does not influence DDFI or OS after adjusting for known prognostic factors in young breast cancer patients.
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Affiliation(s)
- Tom Maishman
- Southampton Clinical Trials Unit, University of Southampton, Southampton, United Kingdom
| | - Ramsey I. Cutress
- Southampton Clinical Trials Unit, University of Southampton, Southampton, United Kingdom
- Cancer Sciences Academic Unit, Faculty of Medicine, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Aurea Hernandez
- Southampton Clinical Trials Unit, University of Southampton, Southampton, United Kingdom
| | - Sue Gerty
- Southampton Clinical Trials Unit, University of Southampton, Southampton, United Kingdom
| | - Ellen. R. Copson
- Cancer Sciences Academic Unit, Faculty of Medicine, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Lorraine Durcan
- Southampton Clinical Trials Unit, University of Southampton, Southampton, United Kingdom
| | - Diana M. Eccles
- Southampton Clinical Trials Unit, University of Southampton, Southampton, United Kingdom
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Yábar A, Meléndez R, Muñoz S, Deneo H, Freire J, Domínguez V, Carrasco-Navarro RM, Diaz ME, Velarde-López RE. Effect of Ki-67 assessment in the distribution of breast cancer subtypes: Evaluation in a cohort of Latin American patients. Mol Clin Oncol 2017; 6:503-509. [PMID: 28413656 PMCID: PMC5374902 DOI: 10.3892/mco.2017.1185] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Accepted: 02/03/2017] [Indexed: 11/17/2022] Open
Abstract
Breast cancer (BC) is a heterogeneous disease composed of four main subtypes with distinct clinical and epidemiological features. Although several reports have described the distribution of BC subtypes in Latin America, the majority of them have not included the cellular marker, Ki-67, in the immunohistochemical (IHC) panel. The aim of the present study was to describe the distribution of BC subtypes in a cohort of Latin American women using an IHC panel with Ki-67. A prospective cohort of 580 patients in three centers of Peru (the Hospital Nacional Edgardo Rebagliatti Martins, the Hospital Nacional Guillermo Almenara Irigoyen, the Hospital Nacional Alberto Sabogal, Lima) and one in Uruguay (Instituto Nacional del Cáncer, Montevideo) were evaluated. BC phenotypes were classified according to an IHC panel: Estrogen receptor (ER), progesterone receptor (PgR), HER2 and Ki-67. Silver in situ hybridization was used when the HER2 status, as determined by IHC, was equivocal. The associations between the BC phenotypes and their clinicopathological features were evaluated. ER was positive in 65% of the cases (n=377), and PgR in 50% (n=203). In total, 79.1% (n=459) were HER2-negative, 19.8% (n=115) were HER2-positive and 1% (n=6) had an equivocal status. With respect to Ki-67, 44.7% of the patients exhibited staining in >14% of the tumor cells (n=259). The distribution of subtypes was as follows: Luminal A, 31.9% (n=183); luminal B, 35% (n=201); HER2, 12.1% (n=70); and triple-negative, 20.9% (n=120). When Ki-67 was not included in the panel, the frequency of luminal A was 41.1% and luminal B, 25.8% (9.2% of the cases were misclassified). Ki-67 was most highly expressed in triple-negative and HER2 tumors. Inclusion of Ki-67 in the IHC panel to assign subtypes revealed a higher frequency of luminal B tumors than was reported previously for Latin American women with BC, whereas the distribution of triple-negative and HER2 tumors were similar to that previously reported. In conclusion, these results demonstrated that excluding Ki-67 from the panel of IHC markers may lead to an underestimation of the rates of luminal B tumors.
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Affiliation(s)
- Alejandro Yábar
- Department of Pathology, Edgardo Rebagliatti Martins National Hospital, Lima, Perú
| | - Rosa Meléndez
- Department of Pathology, Guillermo Almenara Irigoyen National Hospital, Lima, Perú
| | - Silvia Muñoz
- Department of Pathology, Alberto Sabogal National Hospital, Lima, Perú
| | - Hugo Deneo
- Laboratory of Pathological Anatomy, Nacional Cancer Institute, Montevideo, Uruguay
| | - Jimena Freire
- Laboratory of Pathological Anatomy, Nacional Cancer Institute, Montevideo, Uruguay
| | - Viviana Domínguez
- Laboratory of Pathological Anatomy, Nacional Cancer Institute, Montevideo, Uruguay
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Villarreal-Garza C, Martinez-Cannon BA, Platas A, Mohar A, Partridge AH, Gil-Moran A, Fonseca A, Vega Y, Bargallo-Rocha E, Cardona-Huerta S, Lopez-Aguirre YE, Barragan-Carrillo R, Castro-Sanchez A. Fertility concerns among breast cancer patients in Mexico. Breast 2017; 33:71-75. [PMID: 28284061 DOI: 10.1016/j.breast.2017.02.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Revised: 02/18/2017] [Accepted: 02/20/2017] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE Young women represent a high proportion of the total number of breast cancer (BC) patients in Mexico; however, no previous studies addressing their attitudes regarding the risk of chemotherapy-induced infertility and its contributing factors are available. The aim of this study was to evaluate the concerns of young women with BC towards the risk of infertility in two referral centers in Mexico with access to public health services. METHODS A cross-sectional study including women with newly or previously detected BC aged 40 years or younger at diagnosis was conducted. Variables regarding concerns about fertility were collected from an adapted version of the Fertility Issues Survey. RESULTS 134 consecutive eligible women responded to the in-person paper survey. 55% were partnered, 35.1% had no children, and 48% reported willingness to have children prior to BC diagnosis. Only 3% of patients considered to be able to afford extra expenses. At diagnosis, 44% of women expressed some level of concern about infertility risk. The only factor significantly associated with fertility concern was the desire of having children prior to diagnosis (OR 11.83, p = 0.006). Only 30.6% patients recalled having received information regarding infertility risk from their physicians. CONCLUSION A minority of young women with breast cancer in Mexico is informed about the risk of BC treatment-induced infertility, despite substantial interest. Informing all patients about infertility risk and available options for fertility preservation should be an essential aspect of the supportive care of young women with BC, even in low-middle income countries such as Mexico.
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Affiliation(s)
- Cynthia Villarreal-Garza
- Departamento de Investigacion y de Tumores Mamarios, Instituto Nacional de Cancerologia, Mexico City, Mexico; Centro de Cancer de Mama, Tecnologico de Monterrey, Monterrey, N.L., Mexico; Joven y Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Mexico City, Mexico
| | - Bertha Alejandra Martinez-Cannon
- Centro de Cancer de Mama, Tecnologico de Monterrey, Monterrey, N.L., Mexico; Joven y Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Mexico City, Mexico
| | - Alejandra Platas
- Joven y Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Mexico City, Mexico
| | - Alejandro Mohar
- Departamento de Investigacion y de Tumores Mamarios, Instituto Nacional de Cancerologia, Mexico City, Mexico; Joven y Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Mexico City, Mexico
| | - Ann H Partridge
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Arnoldo Gil-Moran
- Centro de Cancer de Mama, Tecnologico de Monterrey, Monterrey, N.L., Mexico
| | - Alan Fonseca
- Joven y Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Mexico City, Mexico
| | - Yoatzin Vega
- Joven y Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Mexico City, Mexico
| | - Enrique Bargallo-Rocha
- Departamento de Investigacion y de Tumores Mamarios, Instituto Nacional de Cancerologia, Mexico City, Mexico; Joven y Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Mexico City, Mexico
| | | | - Yadira Estefany Lopez-Aguirre
- Departamento de Investigacion y de Tumores Mamarios, Instituto Nacional de Cancerologia, Mexico City, Mexico; Joven y Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Mexico City, Mexico
| | - Regina Barragan-Carrillo
- Centro de Cancer de Mama, Tecnologico de Monterrey, Monterrey, N.L., Mexico; Joven y Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Mexico City, Mexico
| | - Andrea Castro-Sanchez
- Joven y Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Mexico City, Mexico; Catedras CONACYT, Instituto Nacional de Cancerologia, Mexico.
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Chavarri-Guerra Y, Blazer KR, Weitzel JN. Genetic Cancer Risk Assessment for Breast Cancer in Latin America. REVISTA DE INVESTIGACION CLINICA; ORGANO DEL HOSPITAL DE ENFERMEDADES DE LA NUTRICION 2017; 69:94-102. [PMID: 28453507 PMCID: PMC5658001 DOI: 10.24875/ric.17002195] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2017] [Accepted: 03/14/2017] [Indexed: 12/14/2022]
Abstract
In Latin America, breast cancer is the most common malignancy in women, and limited available data suggest that up to 15% of all breast cancer cases in the region are hereditary. Genetic cancer risk assessment and counseling is a critical component of the appropriate clinical care of patients with hereditary breast cancer and their families. Unfortunately, genetic services are underdeveloped across Latin America, and access to genetic testing and counseling is very scarce in the region. Barriers contributing to the access to genetic care are high cost and lack of insurance coverage for genetic tests, insufficient oncogenetics training or expertise, nonexistence of genetic counseling as a clinical discipline, and lack of supportive healthcare policies. In this review, we highlight relevant initiatives undertaken in several Latin American countries aimed at creating genetic cancer risk assessment programs. Additionally, we present a review of the scientific literature on the current status of breast cancer genomics in Latin America, with specific emphasis on demographic indicators, access to cancer genetic care, training and strategies to improve outcomes, and international collaborations.
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Affiliation(s)
- Yanin Chavarri-Guerra
- Department of Hemato-Oncology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubiran, Mexico City, Mexico
- Division of Clinical Cancer Genomics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Kathleen Reilly Blazer
- Division of Clinical Cancer Genomics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Jeffrey Nelson Weitzel
- Division of Clinical Cancer Genomics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
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The Rise in Mortality from Breast Cancer in Young Women: Trend Analysis in Brazil. PLoS One 2017; 12:e0168950. [PMID: 28046087 PMCID: PMC5207532 DOI: 10.1371/journal.pone.0168950] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 12/08/2016] [Indexed: 12/13/2022] Open
Abstract
Introduction Breast cancer is the most common cause of cancer death among women. Objective The objective of this study was to analyze time trends in overall mortality from breast cancer in Brazil, Brazilian regions and States. Methods This is an exploratory study, of the time series of deaths from breast cancer contained in the Mortality Information System (SIM), of women living in Brazil, Brazilian regions and States, from 1996 to 2013. For the trend analysis, the polynomial regression model was used, and a significant trend was considered when the estimated model obtained a p value <0.05. Results There was a tendency of increased mortality from breast cancer in Brazilian women (average increase of 0.18 per year; p <0.001), with regional differences, particularly in the age group 20–49 years (0.07 per year; p <0.001). The age group 50–69 years remained constant but had high average rates (37.14). Conclusion More effective planning is needed to focus on the different scenarios of the Brazilian regions. Screening strategies for the incidence and mortality from breast cancer must also be rethought according to age group in the country.
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Villarreal-Garza C, Mohar A, Bargallo-Rocha JE, Lasa-Gonsebatt F, Reynoso-Noverón N, Matus-Santos J, Cabrera P, Arce-Salinas C, Lara-Medina F, Alvarado-Miranda A, Ramírez-Ugalde MT, Soto-Perez-de-Celis E. Molecular Subtypes and Prognosis in Young Mexican Women With Breast Cancer. Clin Breast Cancer 2016; 17:e95-e102. [PMID: 28065398 DOI: 10.1016/j.clbc.2016.11.007] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 10/18/2016] [Accepted: 11/13/2016] [Indexed: 01/02/2023]
Abstract
INTRODUCTION Young age represents an adverse prognostic factor in breast cancer (BC), and young women present with more advanced and aggressive disease. In Latin America, BC is increasing in young women, and there is a lack of information regarding the characteristics and outcomes of this patient population. PATIENTS AND METHODS We retrospectively analyzed a database of 4315 women treated for BC at a single institution. We compared clinical characteristics, treatment, and survival between women ≤ 40 and > 40 years of age. Survival analyses were performed for each molecular subtype. RESULTS A total of 662 women (15.3%) were ≤ 40 years old. Younger women had more advanced disease, higher grade, and a larger proportion of luminal B and triple-negative tumors (P < .001). At 5 years, both disease-free and overall survival (OS) were lower in younger women, although there were no differences after adjusting for stage. Five-year OS was worse for young women with hormone receptor-positive, human epidermal growth factor receptor 2-negative subtype (82% vs. 87.1%; P = .03), but not for those with human epidermal growth factor receptor 2-positive or triple-negative disease. This difference can be attributed to luminal B tumors, which showed a worse 5-year OS in younger women (79.1% vs. 85.2%; P = .03). CONCLUSION Although young Mexican patients with BC have more aggressive disease at presentation than older women, only those with luminal B tumors have a worse survival after adjusting for stage. Strategies aimed at downstaging the disease and at improving the treatment of luminal B tumors in this population are needed.
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Affiliation(s)
- Cynthia Villarreal-Garza
- Departamento de Investigacion y de Tumores Mamarios del Instituto Nacional de Cancerologia, Mexico City, Mexico; Centro de Cancer de Mama del Hospital Zambrano Hellion, Tecnologico de Monterrey, Nuevo Leon, Mexico
| | - Alejandro Mohar
- Departamento de Investigacion y de Tumores Mamarios del Instituto Nacional de Cancerologia, Mexico City, Mexico; Unidad de Investigación Biomédica en Cáncer, Instituto Nacional de Cancerología e Instituto de Biomédicas, UNAM, Mexico City, Mexico
| | - Juan Enrique Bargallo-Rocha
- Departamento de Investigacion y de Tumores Mamarios del Instituto Nacional de Cancerologia, Mexico City, Mexico
| | - Federico Lasa-Gonsebatt
- Departamento de Investigacion y de Tumores Mamarios del Instituto Nacional de Cancerologia, Mexico City, Mexico
| | - Nancy Reynoso-Noverón
- Departamento de Investigacion y de Tumores Mamarios del Instituto Nacional de Cancerologia, Mexico City, Mexico
| | - Juan Matus-Santos
- Departamento de Investigacion y de Tumores Mamarios del Instituto Nacional de Cancerologia, Mexico City, Mexico
| | - Paula Cabrera
- Departamento de Investigacion y de Tumores Mamarios del Instituto Nacional de Cancerologia, Mexico City, Mexico
| | - Claudia Arce-Salinas
- Departamento de Investigacion y de Tumores Mamarios del Instituto Nacional de Cancerologia, Mexico City, Mexico
| | - Fernando Lara-Medina
- Departamento de Investigacion y de Tumores Mamarios del Instituto Nacional de Cancerologia, Mexico City, Mexico
| | - Alberto Alvarado-Miranda
- Departamento de Investigacion y de Tumores Mamarios del Instituto Nacional de Cancerologia, Mexico City, Mexico
| | - María Teresa Ramírez-Ugalde
- Departamento de Investigacion y de Tumores Mamarios del Instituto Nacional de Cancerologia, Mexico City, Mexico
| | - Enrique Soto-Perez-de-Celis
- Departamento de Investigacion y de Tumores Mamarios del Instituto Nacional de Cancerologia, Mexico City, Mexico; Cancer Care in the Elderly Clinic, Department of Geriatrics, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
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Eugênio DSG, Souza JA, Chojniak R, Bitencourt AGV, Graziano L, Souza EF. Breast cancer features in women under the age of 40 years. Rev Assoc Med Bras (1992) 2016; 62:755-761. [DOI: 10.1590/1806-9282.62.08.755] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Accepted: 03/16/2016] [Indexed: 01/24/2023] Open
Abstract
Summary Objective: To describe the clinical features, imaging findings and pathological aspects of breast cancer diagnosed in women under the age of 40 years. Method: A retrospective, descriptive study was performed through analysis of medical records between November 2008 and August 2012. One hundred and twenty (120) patients were included, of whom 112 underwent mammography, 113 underwent ultrasonography, and 105 underwent magnetic resonance imaging (MRI). The histopathological data was obtained in most cases from post-surgical analysis, which was available for 113 patients. Results: The mean age at diagnosis of primary breast cancer was 34 years. Only 11 patients (9.0%) had a family history of breast or ovarian cancer in first-degree relative. Ninety-two (92) patients sought medical attention after showing breast symptoms, and the presence of a palpable nodule was the main complaint. One hundred and twenty-two (122) primary tumors were diagnosed, of which 112 were invasive (95%). The most common histological type was invasive ductal carcinoma (73.8%). Luminal B was the predominant molecular subtype (42.6%). Ultrasonography was positive in 94.5% of the cases and the most common finding were nodules (94.8%). At mammography, the malignancy was observed in 92.8% and the presence of suggestive calcifications was the dominant feature. The MRI was positive in 98% of patients, and mass lesions were the most common. Conclusion: Most cases of breast cancer diagnosed in patients under the age of 40 years, in our population, had symptoms at diagnosis and tumor with more aggressive biological behavior. Despite the ultrasound has been the most widely used method, we found improved characterization of breast lesions when also used mammography and MRI.
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