A Review of Breast Cancer Risk Factors in Adolescents and Young Adults

Traditional Clinicopathological Biomarkers Still Determine Disease-Free and Overall Survival in Invasive Breast Cancer Patients: A Pilot Study

Background: Molecular classification, tumor diameter, Ki67 expression, and brachytherapy administration still act as the most potent potential predictors of breast cancer recurrence and overall survival. Methods: Over the period of 23 months, we included in the study 92 invasive breast cancer (IBrC) patients initially diagnosed at the Clinical Ward of Breast Cancer and Reconstructive Surgery, Oncology Center in Bydgoszcz, Poland. The probability of disease-free survival (DFS) and overall survival (OS) in relation to potential prognostic factors for the patients were determined using a Kaplan-Meier analysis, and univariate and multivariate Cox regression analyses evaluated the predictive factors of IBrC patients. The investigation of the potential prognostic model's accuracy was analyzed using the ROC curve. Results: Patients with tumor size < 2 cm, Ki67 expression < 20%, luminal-A molecular subtype, and extra-dose brachytherapy boost administration displayed the most favorable prognosis according to breast cancer disease-free survival and overall survival. The estimated 5 year probability of DFS and OS rates in women with tumor diameter < 2 cm were 89% and 90%, respectively. In tumor diameter > 2 cm, the estimated 5 year probability of DFS was 73% and OS was 76%. Interestingly, the tumor diameter of 1.6 cm with a specificity of 60.5% and a sensitivity of 75% occurred as the best threshold point to differentiate patients with cancer recurrence from those without cancer progression. Conclusions: Our study provides essential information on the clinicopathological profile and future outcomes of early stage IBrC patients. Furthermore, the tumor diameter cut-off value of 1.6 cm discriminating between disease recurrence and those without disease progression patients represents an innovative direction for further research.

System biology mediated assessment of molecular mechanism for sinapic acid against breast cancer: via network pharmacology and molecular dynamic simulation

Sinapic acid is a hydroxycinnamic acid widespread in the plant kingdom, known to be a potent anti-oxidant used for the treatment of cancer, infections, oxidative stress, and inflammation. However, the mode of action for its chemotherapeutic properties has yet not been unleashed. Hence, we aimed to identify potential targets to propose a possible molecular mechanism for sinapic acid against breast cancer. We utilized multiple system biology tools and databases like DisGeNET, DIGEP-Pred, Cytoscape, STRING, AutoDock 4.2, AutoDock vina, Schrodinger, and gromacs to predict a probable molecular mechanism for sinapic acid against breast cancer. Targets for the disease breast cancer, were identified via DisGeNET database which were further matched with proteins predicted to be modulated by sinapic acid. In addition, KEGG pathway analysis was used to identify pathways; a protein-pathway network was constructed via Cytoscape. Molecular docking was performed using three different algorithms followed by molecular dynamic simulations and MMPBSA analysis. Moreover, cluster analysis and gene ontology (GO) analysis were performed. A total of 6776 targets were identified for breast cancer; 95.38% of genes predicted to be modulated by sinapic acid were common with genes of breast cancer. The 'Pathways in cancer' was predicted to be modulated by most umber of proteins. Further, PRKCA, CASP8, and CTNNB1 were predicted to be the top 3 hub genes. In addition, molecular docking studies revealed CYP3A4, CYP1A1, and SIRT1 to be the lead proteins identified from AutoDock 4.2, AutoDock Vina, and Schrodinger suite Glide respectively. Molecular dynamic simulation and MMPBSA were performed for the complex of sinapic acid with above mentioned proteins which revealed a stable complex throughout simulation. The predictions revealed that the mechanism of sinapic acid in breast cancer may be due to regulation of multiple proteins like CTNNB1, PRKCA, CASP8, SIRT1, and cytochrome enzymes (CYP1A1 & CYP3A4); the majorly regulated pathway was predicted to be 'Pathways in cancer'. This indicates the rationale for sinapic acid to be used in the treatment of breast cancer. However, these are predictions and need to be validated and looked upon in-depth to confirm the exact mechanism of sinapic acid in the treatment of breast cancer; this is future scope as well as a drawback of the current study.

Breast development and disorders in children and adolescents

Breast masses are infrequently encountered in pediatric and adolescent populations. Most breast masses in children are benign entities arising from embryological defects which can be managed once breast development is complete. Diagnostic and management dilemmas arise when fibroepithelial lesions of the breast are seen in clinical practice. Differentiation between a fibroadenoma and a phyllodes tumor is important to guide management. Breast cancer in children under 18 years of age is extremely rare and invasive diagnostic testing and aggressive management is only recommended when clinical suspicion of malignancy is very high. Patient and caregiver counseling plays an important role in the management of these diseases. While adult-onset breast diseases have been studied very closely, there is a dearth of literature on pediatric breast anomalies. This review aims to provide a scoping overview of the available literature on benign, fibroepithelial, and malignant lesions of the breast in pediatric and adolescent populations to help guide physicians and surgeons with decision-making regarding the diagnosis and management of pediatric breast diseases.

Racial, Lifestyle, and Healthcare Contributors to Perceived Cancer Risk among Physically Active Adolescent and Young Adult Women Aged 18-39 Years

The cancer incidence among adolescents and young adults (AYAs) has significantly increased in recent years, but there is limited information about the factors that influence the perceived cancer risk among AYAs. A cross-sectional, web-based survey of 281 physically active Black and White AYA women was administered to assess the influences of demographic characteristics, family history of cancer, cancer risk factor knowledge, and lifestyle-related risk and protective behaviors on perceived cancer risk. Linear regression analyses were performed in SAS version 9.4. Self-reported Black race (β = -0.62, 95% CI: -1.07, -0.17) and routine doctor visits (β = -0.62, 95% CI: -1.18, -0.07) were related to a lower perceived cancer risk. Family history of cancer (β = 0.56, 95% CI: 0.13, 0.99), cancer risk factor knowledge (β = 0.11, 95% CI: 0.03, 0.19), and current smoking status (β = 0.80, 95% CI: 0.20, 1.40) were related to a higher perceived cancer risk. Perceptions of cancer risk varied among this sample of physically active, AYA women. Lower perceptions of cancer risk among Black AYA women demonstrate a need for culturally tailored cancer educational information that presents objective data on lifetime cancer risk. Reportedly higher perceptions of cancer risk among AYA smokers presents an ideal opportunity to promote smoking cessation interventions. Future interventions to address cancer risk perception profiles among physically active, AYA women should tailor approaches that are inclusive of these unique characteristics.

Cancers Among Adolescents and Young Adults in Maine 2001-2017: A Descriptive Analysis and Model for Future Studies

Purpose: Maine has had a high age-adjusted incidence rate of cancer and a high incidence rate of childhood cancer. However, it is unknown if Maine adolescents and young adults (AYAs) have a higher-than-expected cancer incidence rate. Methods: Based on the International Classification of Diseases of Oncology, Third Edition (ICD-0-3) classification system, we obtained the incidence rates of AYA cancers by state, sex, race, and ethnicity from 2001 to 2017 using CDC WONDER. Overall, all cancer rates and age-adjusted incidence rates for specific cancers were compared and ranked by state. Results: Maine had a similar overall age-adjusted cancer incidence rate among non-Hispanic white AYAs compared with the national rate from 2001 to 2017. Among non-Hispanic white AYA cancers of the respiratory system, lung and bronchial cancers, uterine cancer, female breast cancer, thyroid cancer, lymphomas, and Hodgkin's lymphoma were significantly greater in Maine than the state with the lowest incidence rate for that cancer. Specifically, Maine was ranked as one of the top 10 states for the highest incidence rate of lung cancer, uterine cancer, Hodgkin's lymphoma, thyroid cancer (males only), and female breast cancer. Conclusion: Although the cancer incidence rate among AYAs in Maine was not significantly higher than the national average, Maine AYAs had a significantly higher incidence of lung cancer, uterine cancer, Hodgkin's lymphoma, thyroid cancer, and breast cancer. This information may direct future studies to identify regional cancer risk factors in Maine, which may account for this elevated rate. The described methodology is an innovative approach to identifying states with high cancer rates and directing future studies.