Archives of Breast Cancer
Year:2021 | Volume:8 | Issue:3|Papers Count:12

Professor Peiman Haddad was born on December 6, 1960 in Kashan, a small town in Iran, where his father was serving as the attorney general and his mother was a high-school teacher. Peiman went to elementary school in Firoozkooh and attended the prestigious Kharazmi high-school in Tehran. After receiving his high-school diploma, he started medicine at Tehran University of Medical Sciences in 1984. He finished Radiation Oncology specialty at the same university by 1994. Soon, he joined Iranian Cancer Institute and start working there from 1996. . .

Background: Oxidative stress plays a key role in breast carcinogenesis. Cyclo (L-Leu-L-Pro) (CLP) is a homodetic cyclic dipeptide with 2, 5-diketopiperazine scaffold isolated from marine actinobacteria. This study aimed to evaluate the protective activity of CLP and linear-(L-Leu-L-Pro) (LP) from tert-butyl hydroperoxide (tBHP)-induced damage using normal breast epithelial cell line model (MCF-12A). Methods: The cytoprotective activity was evaluated by detecting the changes in intracellular ROS, mitochondrial superoxide, hydroxyl radical, hydrogen peroxide, and lipid peroxidation detection assays as well as cytotoxic assays of MTT, LDH assays and phase contrast microscopy. Genoprotective activity was evaluated by (Apurinic/Apyrimidinic) AP site, alkaline Comet, and 8-hydroxy-2deoxyguanosine assays. Results: The marine cyclic peptide, CLP, significantly protected MCF-12A cells by scavenging tBHP induced intracellular ROS such as super oxide, hydroxyl radicals and hydrogen peroxide, and by reducing the cytotoxicity and genotoxicity effect compared to LP. Moreover, the results showed that CD151 gene silencing by shRNA significantly reduced the overexpression of CD151, tBHP-induced ROS generation, cytotoxicity and genotoxicity in MCF-12A cells. The overexpression of CD151 caused increased levels of cytochrome P450, but was reduced following the application of CD151shRNA and CLP which led to elevated levels of intracellular ROS. Conclusion: In the present study we noticed that CD151 gene silencing by shRNA and treatment with CLP have similar effects on reducing the intracellular ROS. This study uncovers the protective activity of CLP against a CD151mediated oxidative stress-induced cellular damage. Our observations suggest that the anti-stress and anti-inflammation properties of CLP might have implications in cancer and are worth testing in cancer cell lines and tumor cells.

Background: Lifestyle modification like exercise is an essential rehabilitation measure that improves the quality of life (QoL) of women with breast cancer and helps in preventing cancer related complications. This study assessed the practice and outcome of exercise interventions on breast cancer-specific quality of life of survivors in Delta State, Nigeria. Methods: Experimental design was applied with intervention (47) and control (47) groups. This design involved a pre-test, an intervention, and a post-test. Exercise intervention (aerobic, resistance and flexibility exercises, including warm-up with Swiss ball and dance, climbing of stairs, treadmill, stationary exercise bicycle, shoulder, and arm exercises) was administered to the intervention group for twelve weeks. The assessment of breast cancer survivors' specific quality of life in the two groups was done with the English version of The European Organization for Research and Treatment of Cancer Breast Cancer-Specific Quality of Life Questionnaire (QLQ-EORTC-BR23) before and after the exercise intervention. Results: The overall pre and post-intervention breast cancer-specific functional quality of life was 65. 4± 22. 7 (intervention group); 71. 3± 23. 4 (control group) and 75. 05 ± 10. 4 (intervention group); 58. 65± 12. 9 (control group) while the pre and post breast cancer-specific symptoms QoL was 22. 2± 6. 2 (intervention group); 24. 1± 9. 6 (control group) and 11. 8± 13. 0 (intervention group); 30. 9± 21. 2 (control group), respectively. All the women in the intervention group practiced exercise only at mild/moderate intensity and no notable side effects were observed during the practice by many of them (n=39). Significant differences existed in the overall post-intervention breast cancer-specific functional and symptoms QoL between the two groups (p<0. 001) and no significant differences were observed among most of the specific QoL scales in relation to age, duration of diagnosis, and stage of the cancer diagnosis. Conclusion: Exercise remains beneficial to women with breast cancer and has proven to be one of the necessary means to improve their overall well-being. Therefore, healthcare providers that manage these patients in different hospitals should always counsel and support them to initiate the recommended exercises for cancer survivors to enhance their survival.

Background: In this work a new method for the Mean Glandular Dose evaluation in digital breast tomosynthesis (DBT) is presented. Methods: Starting from the experimental-based dosimetric index, 2ABD, which represents the average absorbed breast dose, the mean glandular dose MGD2ABD was calculated using a conversion function of glandularity f(G), obtained through the use of Monte Carlo simulations. Results: f(G) was computed for a 4. 5 cm thick breast: from its value MGD2ABD for different compressed breast thicknesses and glandularities was obtained. The comparison between MGD2ABD estimates and the dosimetric index provided in the current dosimetry protocols, following the Dance's approach, MGD Dance, showed a good agreement (<10%) for all the analyzed breast Dance thicknesses and glandularities. Conclusion: The strength of the proposed method can be considered an accurate mean glandular dose assessment starting from few and accessible parameters, reported in the header DICOM of each DBT exam.

Background: Nowadays, radiation therapy plays an important role in the treatment of breast cancer. The important point is the optimal control of the tumor along with the protection of organs at risk. This study aims to investigate and compare the radiobiological factors of the tumor and organs at risk in two different radiation therapy techniques of breast cancer. Methods: Ten left-sided breast cancer patients with breast-conservative surgery were selected for this study. Three-dimensional treatment planning was performed using CT scan images of the patients using PCRT 3D software. Two different tangential external beam techniques were compared: first, dual-isocentric technique (DIT) with two isocentre, one on the breast tissue, and the other one on the supraclavicular lymph nodes and second, a mono-isocentric technique (MIT) with one isocentre at the intersection of the tangential and the supraclavicular field. The total prescribed dose was 5000 cGy per 25 fractions. Dose-volume histograms (DVHs), Tumor control probability (TCP), and normal tissue complication probability (NTCP) curves were used to compare the dosimetric and radiobiological parameters of the tissues in the prementioned techniques. Results: The results showed that the maximum doses in planning target volume (PTV) with mean values of 109% and 110% in the SI and DIT were not significantly different in both techniques and that they were indeed at the optimum level based on the RTOG 1005 protocol. The dose homogeneity index in MMIT was more than that in DIT, while the conformity index and the mean TCP did not show a significant difference in the two techniques. Furthermore, minimum, mean, and maximum dose in the lung and the probability of pneumonitis decreased in MIT. On the other hand, the maximum dose, the dose of 33%, 66%, and 100% of the heart, and the probability of pericarditis in MIT were lower than the figure in DIT. Conclusion: Due to the absence of hot spots at the intersection of tangential and supraclavicular fields and the reduction of mechanical movements of the coach and collimator in MIT, the superiority of this method was confirmed.

Background: Although breast cancer is an important health problem in Myanmar, awareness of breast health has not been widely described. Methods: A cross-sectional descriptive study was carried out to explore awareness of early signs and risk factors of breast cancer among outpatient attendees at the Mandalay Central Women Hospital. Results: A total of 402 respondents with mean age of 31. 4± 9. 0 years participated in the study. More than half of the respondents (65. 9%) were aware of breast lumps as a breast cancer sign. Nearly half (42% to 48. 7%) of the respondents were aware of the various risk factors of breast cancer. Although 54. 1% had heard of breast self-examination, only 25. 3% had knowledge of mammograms. Older women (age 49 years or more) had significantly better awareness of two early breast cancer signs; change of breast shape (54. 1% vs 39. 9%) and discharge from nipple (49. 2% vs 33. 4%). Those with less than high school education had significantly lower awareness of the following signs of breast cancer; thickening of the breast skin (39. 3 % vs 20. 45%), dimpling of the breast skin (43. 2% vs 24. 6%), change of breast shape (52. 5% vs 35. 2%), and discharge from nipple (44. 9% vs 31. 9%). They also displayed significantly lower awareness of risk factors of breast cancer. Conclusion: Among the study respondents, only one third had heard of selfbreast examination and only a few (10%) examined both breasts regularly. Greater awareness of breast health and breast cancer screening should be imparted to promote breast health among women in Myanmar.

Background: Current trends in breast cancer treatment include the use of less aggressive surgeries to reduce morbidity, shorten hospital stays and improve cosmetic results. The aim of the study is to assess tumor cell viability after percutaneous ultrasound (US)-guided radiofrequency ablation (RFA) for small breast cancer by a combination of staining techniques. Methods: A prospective study was conducted at a single institution from 2013 to 2017. Twenty women with invasive ductal carcinoma of the breast measuring ≤ 20 mm were treated with US-guided RFA followed immediately by surgical resection. Tumor viability pre-and post-RFA was assessed with Hematoxylin and Eosin (H&E), Nicotinamide adenine dinucleotide (NADH), Succinate dehydrogenase (SDH), Cytochrome c oxidase (COX), Terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) and Cytokeratin 18 and 19 (CK18/CK19) staining techniques. Outcomes and correlation with the different techniques were evaluated with principal component analysis Cronbach’ s alpha. Results: Oxidative enzymes in frozen sections showed loss of SDH and NADH in 13 of the 16 tumors (81%) and COX in 11 of the 13 tumors (84%). In paraffinembedded tissues, CK18 was negative or markedly reduced in 98% and CK19 in 100% of the cases. Lack of evidence of cell death was seen in 3 cases where the maximum temperature achieved at the center of the tumor was ≤ 70º C. The reliability and internal consistency between the different staining techniques was high (Cronbach’ s alpha, 0. 8), with concordance between the staining results of the oxidative enzymes and of CK18/CK19. Conclusion: Loss of tumor viability in small breast tumors after US-guided percutaneous RFA could be assessed in our series with different staining methods. CK18 and CK19 could be used in paraffin-embedded tissues as surrogate markers of tumor cell viability after immediate RFA.

Background: Understanding disease symptoms is among the important psychological and behavioral variables in cancer treatment. The present study aimed to investigate the relationship between coping strategies and death anxiety through the mediation of disease perception in patients with breast cancer in Abadan in 2020. Methods: The study was a descriptive correlation performed by path analysis. The statistical population included all patients with breast cancer in Abadan in 2020 who referred to medical centers for six months. A total of 200 of them were selected as the sample of the study using convenience sampling. Research instruments included the Death Anxiety Scale (DAS), the Ways of Coping Questionnaire (WCQ), and the Brief Illness Perception Questionnaire (Brief IPQ). The proposed model was evaluated using path analysis with AMOS software. Results: The results showed that there was a significant association between emotion-focused strategy and disease perception (β = 0. 67, P= 0. 002), problemfocused strategy and disease perception (β =-0. 08, P= 0. 001), disease perception and death anxiety (β = 0. 39, P= 0. 001), and between emotion-focused strategy and death anxiety (β =-0. 26, P= 0. 001). There was no significant association between problem-focused strategy and death anxiety. The results of path analysis indicated that disease perception played a mediating role in the association between the emotion-and problem-focused strategies with death anxiety (P= 0. 01). Conclusion: According to the results of the study, the relationship between coping strategies and death anxiety through the mediation of disease perception had a good fit and can be an important step in identifying the factors affecting the death anxiety of patients with breast cancer.

Background: There is a tendency to decrease the intensity of breast cancer treatments, e. g. omitting adjuvant chemotherapy in endocrine-sensitive and HER2 negative patients. The purpose of this study was to analyse changes in the frequency of the indication of adjuvant chemotherapy and the differences in survival over time for this subtype of breast cancer, with 1-3 positive nodes. Methods: The study was based on descriptive, observational, retrospective, single-institution research between 2004-10 and 2011-18, on endocrine-sensitive, HER-2 negative breast cancer, stage pN1 (1-3 nodes). The analytical tests carried out for a comparison of the frequency of chemotherapy use the chi-square test with Fisher's exact test. Survival data in both periods are presented. Results: A total of 236 patients were included, 66 for the period 2004-10, and 170 for 2011-18. More patients were treated with hormone therapy alone in 2011-18: hormone therapy alone 10/66 (15. 20%) for 2004-10, and 83/169 (49. 10%) for 2011-18; chemotherapy-hormone therapy 56/66 (84. 80%) for 2004-10, and 86/169 (50. 90%) for 2011-18 (P = 0. 0001). For 2004-10, the 5-year overall survival probability was 100%. For 2011-18 it was 98. 20% (95% CI 95. 65-100). For 2004-10, 5-year disease free survival (DFS) was 96. 9% (95% CI 92. 7-101). For 2011-18 it was 87. 7% (95% CI 81. 8-93. 5) (P=0, 040). For 2004-10 the 5 year distant relapse free interval was 96. 9% (95% CI 92. 5-101. 2). For 2011-18 it was 93% (95% CI 88. 1-97. 9) (P=0. 312). Conclusion: A decrease in the indication of adjuvant chemotherapy according to the clinical risk is confirmed in endocrine-sensitive, HER-2 negative breast cancer, with 1-3 positive nodes, over the period 2011-18 compared to 2004-10. Based on the results, 5-year DFS is slightly worse in the 2011-18 period.

Background: Almost all deaths from breast cancer are due to metastasis. People living with metastatic breast cancer (MBC) and their loved ones have been concerned about the lack of research progress. The purposes of this paper were to analyze breast cancer research spending in Canada, and to evaluate whether MBC research was aligned with patient priorities. The results from the MBC Priority Setting Partnership (MBC PSP) were used as an approximation of patient priorities. Methods: The data source was the Canadian Cancer Research Survey. MBC projects were identified and mapped to the patient priorities. Results: This analysis found that 18% of breast cancer research investment was directed to MBC, with a large proportion of this research investment focused on the biology of metastasis. Four of the top 10 MBC PSP priorities had not been addressed: optimal sequence of therapy, role of continuous versus intermittent treatment, benefits of early palliative care, and best methods for patient education. Conclusion: These figures provide a baseline from which any increases in MBC research and improved alignment to patient priorities can be measured. A cooperative effort by funders, researchers, patients, caregivers, and health care providers is needed to address research gaps.

Background: Metaplastic breast cancer (MBC) cancer is a rare subtype of breast carcinoma and carries a worse prognosis. Chondroid differentiation is the rarest among all its histologic subtypes. We report a case of MBC with chondroid differentiation and review its clinicopathological details, genetic basis, and management. Case presentation: A 56-year female presented with right-sided large breast lump. She noticed this lump 4 months before presenting. Trucut biopsy was suggestive of invasive ductal carcinoma. She underwent breast conservation surgery and histology was consistent with MBC with chondroid differentiation, pT2N3aM0. Tumour was triple-negative for ER, PR, and Her-2-neu receptors. Adjuvant treatment with chemotherapy followed by radiotherapy was given and she has been doing fine during 11 months of follow-up. Conclusion: The MBC is an uncommon subtype with heterogeneity in biological and morphological features and its knowledge is paramount while evaluating a breast lump. Understanding the pathologic and molecular basis is imperative in developing the targeted therapy to improve outcomes.

Background: Silicone lymphadenopathy is a recognized complication of silicone implant rupture. It occurs when silicone droplets migrate from breast implants to lymph nodes, resulting in the formation of granulomas (known as siliconoma) and lymph node enlargement. The ipsilateral axillary lymph nodes are most commonly involved but it can also affect contralateral axillary, supraclavicular, internal mammary and mediastinal lymph nodes. Case presentation: A 60-year-old woman with a history of left breast cancer who had undergone modified radical mastectomy (MRM) followed by left breast reconstruction with implant (30 years ago) presented with right axillary lymph nodes enlargement. An excisional biopsy of the two larger lymph nodes was performed to rule out malignancy. Pathologic examination showed features of silicone lymphadenopathy. Further examination with Ultrasound and MRI confirmed breast implant rupture. Conclusion: Silicone lymphadenopathy following breast augmentation and reconstruction primarily affects the ipsilateral axillary nodes. Contralateral lymph node involvement is rare and may occur several years after breast cancer diagnosis and can be the first sign of breast implant rupture. Although, the need to exclude malignancy in such cases is of outmost importance, silicone lymphadenopathy should also be considered in the differential diagnosis.