Iranian Journal of Breast Diseases
Year:2008 | Volume:2 | Issue:1 (2)|Papers Count:8

Introduction: Breast cancer is one of the main causes of cancer fatality in women. Among Iranian females, it is the most common cancer which tends to affect younger ones. Molecular biomarkers such as steroid receptors, HER2/neu and p53 are valuable in evaluation the clinical course, prognosis and treatment decisions. However their prognostic role in Iranian patients has not been explained completely. The correlation of mentioned factors with survival of breast cancer has been assessed in this study.Materials and Methods: IHC staining for steroid hormone receptors, HER2/neu and p53 in 339 breast cancer patients diagnosed between 2000- 2006 was done. All cases were followed up to March 2007 and the significance of biomarker status for prognosis was analyzed.Results: Of the 339 studied patients, 46.6%, 43.8%, 51.7% and 36.1% were positive for ER, PR, HER2/neu and p53 respectively. ER considerably correlated with PR (P=0.000). There was a similar relation between HER2/neu and p53 (P=0.041) as well HER2/neu and ER (P=0.001). Survival analysis detected no correlation between molecular biomarkers and recurrence free survival.Conclusion: The presented pattern of prognostic role of these biomarkers is explained partly by demographic factors. Since no similar study has been conducted in this region, larger studies in the basis of demographic variables are suggested.

Introduction: Survival of patients with breast cancer is affected by factors such as involved lymph nodes, tumor size, hormone receptors and kind of treatment, so recognizing and investigation of each one especially in patients in Iran is so important.Materials and Methods: In this study, we had 88 patients with breast cancer, T1, T2, T3, N0, N1, who had taken adjuvant therapies such as radiotherapy, chemotherapy, Tamoxifen, ovarian ablation, combination of 2 or more therapies or even one kind treatment after surgery. Then patients were followed up for 2-3 years and were investigated for prognostic recurrence factors. The results were analysed by X2 test and Fisher test.Results: Free Disease Survival (FDS) and total survival were 77.3% and 87.5% respectively and 23% of patients had recurrence (20 patients). 12.5% (11 patients) passed away. The most common site of metastases was bone. Patients with involved lymph nodes had 32% higher recurrence than the patients without involved lymph node. Patients with T2 tumor, had 17% higher recurrence than patients with T1 tumors. But patients at T3 stage had 9% lower recurrence in comparison with T2 stage and according to equal prognostic factors, they had 21% lower recurrence. Menopausal status did not any influence on tumor recurrence. Patients with positive estrogen receptor had lower recurrence (10% versus 25%). In few patients with ovarian ablation, there was no recurrence (P<0.001). Patients, who had taken breast conservative surgery, did not have any recurrence. Chemotherapy including 4 courses Adriamycine and then 4 courses CMF versus 6 courses CMF in patients with involved lymph nodes more than 3, and in T2 or T3 there was 13% lower recurrence rate in first group. Finally, patients with positive lymph node who had radiation therapy with other treatments, there was only 10% recurrence and we had 90% locally control.Conclusion: If treatment is accomplished at primary stages with no lymph node involvement, there will be higher survival in breast cancer.

Introduction: There are several benign breast diseases associated with the gravidity and lactating state. Gigantomastia is the worst acute and extreme end of the breast hypertrophy that occurs in two forms: Adolescent hypertrophy and gestational macromastia. Surgery is the mainstay of treatment for both of them.Case presentation: We present a case of 19-year-old patient, gravid one, with very huge breasts without any serious complication during pregnancy. The patient underwent reduction mammoplasty after vaginal delivery.Conclusions: Although gestational gigantomastia is very rare disorder, it can cause life threatening complications during pregnancy. Good management of the patient will decrease maternal morbidity and may allow continuing pregnancy with excellent outcome.

Introduction: Since Health Workers have a professional responsibility to teach others about breast cancer screening programs, it is important to plan interventions that can increase female health care professionals’ awareness of breast cancer beliefs and behaviors. This study was conducted to examine the state of knowledge, attitudes and practices towards breast cancer prevention programs among Iranian Health Workers in Southern Coastwise of the Caspian Sea in Mazandaran Province, Iran in 2006.Material and Methods: This was a descriptive, cross-sectional study. The samples were the Iranian Health workers, with 20 years of age and older, living in southern coastwise of the Caspian Sea in 2006. The sampling method was Multistage Random Sampling. A short structured self-administered questionnaire was used to collect data. Health workers randomly selected from urban or rural health-medical centers.Results: 715 (79.44%) of the 900 eligible participants completed the questionnaire. The mean age of the respondents was 34.46 years (SD=7.54) with a range of 19-59 years. 83.4% were married. 32.9% were Behvarzes, 63.8% were Health volunteer, and 3.4% were Health care. Knowledge about breast cancer prevention was acceptable in 41.3%, middle in 52%, and low in 6.7%. Almost, all participants have very positive or positive attitude related to breast cancer prevention programs. But 26.2% of the women performed breast self-examination monthly. 94.7% were interested in receiving some form of continuing education regarding cancer prevention programs especially breast cancer.Conclusions: Considering the role that health care workers may play in communicating health behaviors to the general public, planning education interventions for this group of females is essential.

Material and methods: This study performed to determine coping strategies in women with breast cancer refer to hospitals of Medical sciences universities of Tehran, 1386. This was a descriptive cross- sectional study in which data were obtained through of questionnaires. 175 breast cancer patients were selected by randomization. Findings were analyzed by descriptive statistical tests.Results: Findings showed that most of women used coping styles such as religious coping, positive idea (hopefulness and optimistic), Try for treatment, internal control, positive reappraisal, anxiety, social support and intentionally amnesia for adaptation.Conclusion: Fortunately, Findings suggest that the most samples with breast cancer used positively coping strategies for adaptation. Future studies with larger sample size are needed for clarifying coping strategies in breast cancer.

Introduction: Breast cancer is the most common malignancy in Iranian women. Nevertheless develops in breast cancer diagnosis and treatment, some patients die from metastasis. Matrix metalloproteinase enzymes have important role in mammary gland evaluation and production. These enzymes degrade different components of extra cellular matrix. Matrix metalloproteinase-3 (MMP-3) is one of the most important members of MMPs family. Also MMP3 affect on mammary gland evaluation. There is a single adenine insertion/ deletion polymorphism (5A/6A) at the position -1171 MMP3 gene promoter. This polymorphism affect on MMP3 expression, so the 5A allele express more than 6A allele. As a result of this SNP and MMP3 over expression, malignant tumors are created.Material and methods: MMP3 genotyping was done with PCR-RFLP technique on 120 cancer patients and 60 controls. The breast cancer patients were divided in to two groups: metastatic patients (M+) and non- metastatic patients (M-).Results: The results show that the 5A allele was more prevalent in the M+ group than controls and M- (OR= 2.91, P= 0.74, 0.94-8.98 CI 95%).Conclusion: So the probability of metastasis increase in 5A/5A genotypes.

Between 75% and 80% of breast cancer is estrogen receptor (ER)- positive and is treated with some form of endocrine therapy. It is clear that patients do not benefit from this therapy equally, and major efforts have been undertaken to identify biomarkers that predict the sensitivity to tamoxifen, and more recently, to aromatase inhibitors. Low levels of ER and human epidermal growth factor receptor 2 (HER2)- positive status seem to negatively affect response to tamoxifen; there is evidence for HER2 that this relative insensitivity may not extend to aromatase inhibitors in terms of early response, but data from adjuvant trials do not reveal differential benefit between tamoxifen and aromatase inhibitors on the basis of HER2 status. Progesterone receptor expression has strong prognostic significance in ER-positive disease but is not predictive of benefit from endocrine therapy.

Introduction: Despite advances in prevention, diagnosis, and treatment, breast cancer remains the most common malignancy and the second leading cause of cancer deaths in women. The Gail model is widely used to quantify an individual woman’s risk of developing breast cancer by utilizing important clinical parameters usually for clinical counseling purposes or to determine eligibility by radiographic and genetic trials.Objectives: The aim of this study was to estimate the 5-year and life time breast cancer risk in referring persons at Alzahra public women hospital.Material and methods: A cross-sectional study was performed in 1386 of 314 women referring to the different clinics at only public women hospital in Rasht. Participant’s ages were 35 and over years with no personal history of breast cancer. Risk estimation was performed utilizing the computerized Gail model provided by the National Cancer Institute with a questionnaire containing 8 questions. A calculated 5-year risk >1.66% was considered high-risk. This model has been validated with at least 5 studies. Data analyzing was done with SPSS.10.Results: The mean age was 45.8±9.4 years (range 35–81), and 17 (5.4%) patients had at least one first-degree relative with breast cancer. 20 person (6.4%) had biopsy history. Sixteen (5.1%) women had a 5-year risk >1.66%. The mean 5-year risk for all patients was 0.84±0.99 (range 1-12.5) and lifetime risk was 9±3.9 (range8-49.4).Conclusion: On the results this group of Rasht women’s breast cancer risk is lower comparing mean similar age but for avoiding an increase in the morbidity and mortality of the population, it is necessary that primary care clinics be able to determine risk factors and risk level and presenting high risk persons therefore it is recommended routine utilization of the Gail model for cancer prevention.