WorldWideScience

Sample records for breast cancer-related initiatives

  1. Blockade of Fas signaling in breast cancer cells suppresses tumor growth and metastasis via disruption of Fas signaling-initiated cancer-related inflammation.

    Science.gov (United States)

    Liu, Qiuyan; Tan, Qinchun; Zheng, Yuanyuan; Chen, Kun; Qian, Cheng; Li, Nan; Wang, Qingqing; Cao, Xuetao

    2014-04-18

    Mechanisms for cancer-related inflammation remain to be fully elucidated. Non-apoptotic functions of Fas signaling have been proposed to play an important role in promoting tumor progression. It has yet to be determined if targeting Fas signaling can control tumor progression through suppression of cancer-related inflammation. In the current study we found that breast cancer cells with constitutive Fas expression were resistant to apoptosis induction by agonistic anti-Fas antibody (Jo2) ligation or Fas ligand cross-linking. Higher expression of Fas in human breast cancer tissue has been significantly correlated with poorer prognosis in breast cancer patients. To determine whether blockade of Fas signaling in breast cancer could suppress tumor progression, we prepared an orthotopic xenograft mouse model with mammary cancer cells 4T1 and found that blockade of Fas signaling in 4T1 cancer cells markedly reduced tumor growth, inhibited tumor metastasis in vivo, and prolonged survival of tumor-bearing mice. Mechanistically, blockade of Fas signaling in cancer cells significantly decreased systemic or local recruitment of myeloid derived suppressor cells (MDSCs) in vivo. Furthermore, blockade of Fas signaling markedly reduced IL-6, prostaglandin E2 production from breast cancer cells by impairing p-p38, and activity of the NFκB pathway. In addition, administration of a COX-2 inhibitor and anti-IL-6 antibody significantly reduced MDSC accumulation in vivo. Therefore, blockade of Fas signaling can suppress breast cancer progression by inhibiting proinflammatory cytokine production and MDSC accumulation, indicating that Fas signaling-initiated cancer-related inflammation in breast cancer cells may be a potential target for treatment of breast cancer.

  2. Yes, breast cancer related lymphoedema can be managed | Maree ...

    African Journals Online (AJOL)

    The purpose of the study was to demonstrate that breast cancer related lymphoedema can be managed by means of Complete Decompression Therapy and consequently improve quality of life. An instrumental case study design was used. The target population was all women with breast cancer related lymphoedema ...

  3. Breast Cancer-Related Lymphedema: Implications for Family Leisure Participation

    Science.gov (United States)

    Radina, M. Elise

    2009-01-01

    An estimated 20% of breast cancer survivors face the chronic condition of breast cancer-related lymphedema. This study explored the ways in which women with this condition experienced changes in their participation in family leisure as one indicator of family functioning. Participants (N = 27) were interviewed regarding lifestyles before and after…

  4. Symptom report in detecting breast cancer-related lymphedema

    Directory of Open Access Journals (Sweden)

    Fu MR

    2015-10-01

    Full Text Available Mei R Fu,1 Deborah Axelrod,2,3 Charles M Cleland,1 Zeyuan Qiu,4 Amber A Guth,2,3 Robin Kleinman,2 Joan Scagliola,2 Judith Haber1 1College of Nursing, New York University, 2Department of Surgery, NYU School of Medicine, 3NYU Clinical Cancer Center, New York, NY, 4Department of Chemistry and Environmental Science, New Jersey Institute of Technology, Newark, NJ, USA Abstract: Breast cancer-related lymphedema is a syndrome of abnormal swelling coupled with multiple symptoms resulting from obstruction or disruption of the lymphatic system associated with cancer treatment. Research has demonstrated that with increased number of symptoms reported, breast cancer survivors' limb volume increased. Lymphedema symptoms in the affected limb may indicate a latent stage of lymphedema in which changes cannot be detected by objective measures. The latent stage of lymphedema may exist months or years before overt swelling occurs. Symptom report may play an important role in detecting lymphedema in clinical practice. The purposes of this study were to: 1 examine the validity, sensitivity, and specificity of symptoms for detecting breast cancer-related lymphedema and 2 determine the best clinical cutoff point for the count of symptoms that maximized the sum of sensitivity and specificity. Data were collected from 250 women, including healthy female adults, breast cancer survivors with lymphedema, and those at risk for lymphedema. Lymphedema symptoms were assessed using a reliable and valid instrument. Validity, sensitivity, and specificity were evaluated using logistic regression, analysis of variance, and areas under receiver operating characteristic curves. Count of lymphedema symptoms was able to differentiate healthy adults from breast cancer survivors with lymphedema and those at risk for lymphedema. A diagnostic cutoff of three symptoms discriminated breast cancer survivors with lymphedema from healthy women with a sensitivity of 94% and a specificity of 97

  5. Microsurgical techniques for the treatment of breast cancer-related lymphedema: a systematic review

    NARCIS (Netherlands)

    Penha, T.R.; Ijsbrandy, C.; Hendrix, N.A.; Heuts, E.M.; Voogd, A.C.; Meyenfeldt, M.F. von; Hulst, R.R. van der

    2013-01-01

    BACKGROUND: Upper limb lymphedema is one of the most underestimated and debilitating complications of breast cancer treatment. The aim of this review is to summarize the recent literature for evidence of the effectiveness of lymphatic microsurgery for the treatment of breast cancer-related

  6. Surveillance Recommendations in Reducing Risk of and Optimally Managing Breast Cancer-Related Lymphedema

    OpenAIRE

    Pamela L. Ostby; Armer, Jane M.; Dale, Paul S; Margaret J. Van Loo; Wilbanks, Cassie L.; Stewart, Bob R.

    2014-01-01

    Breast cancer survivors are at increased risk for the development of breast cancer-related lymphedema (BCRL), a chronic, debilitating, and disfiguring condition that is progressive and requires lifelong self-management of symptoms. It has been reported that over 40% of the 2.5 million breast cancer survivors in the United States may meet the criteria for BCRL during their lifetimes. Ongoing surveillance, beginning with pre-operative assessment, has been effective in identifying subclinical ly...

  7. Factors influencing response to lymphedema treatment in patients with breast cancer-related lymphedema.

    Science.gov (United States)

    Eyigör, Sibel; Cinar, Ece; Caramat, Ismail; Unlu, Burcu Koc

    2015-09-01

    In clinical practice, noticeable differences are seen in patient response to the treatment of breast cancer-related lymphedema. Although some factors influencing response to treatment are mentioned in the literature, there is no sufficient evidence and results are confusing. For this reason, our objective in this study is to identify predictive and response-related factors for response to treatment of breast cancer-related lymphedema. We analyzed data retrospectively from the files of patients with breast cancer-related lymphedema between 2006 and 2012. Patient demographics, clinical variables, and patient variables were recorded. Circumference measurements of lymphedema and healthy arms were recorded. We used a computer program (Limb Volumes Professional version 5.0) to transform these values to limb volumes in milliliters. The average age of 331 patients was 54.4 ± 10.9. The average length of lymphedema treatment was 2.92 ± 1.3 weeks. A statistically significant positive correlation was found between postoperative weight gain and postoperative duration, number of chemotherapy (CT) cycles, duration of tamoxifen use, and duration of hormonal therapy (p treatment methods used for treating breast cancer had no effect on the response to treatment of lymphedema. Weight gain during the treatment of breast cancer is important for both the development of lymphedema and the response to treatment. When treating breast cancer-related lymphedema, the relationship between activity level and postoperative weight gain may provide us guidance in clinical practice.

  8. [Cancer related fatigue in patients with breast cancer after chemotherapy and coping style].

    Science.gov (United States)

    Jiang, Pinglan; Wang, Shuhong; Jiang, Dongmei; Yu, Lingli

    2011-04-01

    To study the relevance between cancer related fatigue and coping styles in breast cancer patients after chemotherapy. A survey was conducted in 396 patients with breast cancer after chemotherapy on cancer related fatigue scale and Jalowiec coping scale, and the relation was analyzed. The rate of overall fatigue in breast cancer patients was 96.97%, mostly moderate fatigue. The rate of fatigue dimensions from high to low was physical fatigue, feeling fatigue and cognitive fatigue, respectively. The score of coping styles in patients with breast cancer after chemotherapy from high to low was optimistic coping, facing bravely, support seeking, self-reliance, emotional catharsis, avoidance, fatalism, and conservation. The most widely used coping style was optimistic coping style, and the least was emotional catharisis. There was a positive correlation between coping style of emotional catharsis and cancer related fatigue of all dimensions (Pcancer related fatigue in patients with breast cancer after chemotherapy. We should guide the patients to more active coping styles, to enhance the ability of psychological adaption in patients, reduce cancer related fatigue, and improve the quality of life.

  9. Factors Associated With the Development of Breast Cancer-Related Lymphedema After Whole-Breast Irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Shah, Chirag; Wilkinson, John Ben; Baschnagel, Andrew [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Ghilezan, Mihai [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); William Beaumont School of Medicine, Oakland University, Royal Oak, MI (United States); Riutta, Justin; Dekhne, Nayana; Balaraman, Savitha [Beaumont Cancer Institute, William Beaumont Hospital, Royal Oak, MI (United States); William Beaumont School of Medicine, Oakland University, Royal Oak, MI (United States); Mitchell, Christina; Wallace, Michelle [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Vicini, Frank, E-mail: fvicini@beaumont.edu [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Beaumont Cancer Institute, William Beaumont Hospital, Royal Oak, MI (United States); William Beaumont School of Medicine, Oakland University, Royal Oak, MI (United States)

    2012-07-15

    Purpose: To determine the rates of breast cancer-related lymphedema (BCRL) in patients undergoing whole-breast irradiation as part of breast-conserving therapy (BCT) and to identify clinical, pathologic, and treatment factors associated with its development. Methods and Materials: A total of 1,861 patients with breast cancer were treated at William Beaumont Hospital with whole-breast irradiation as part of their BCT from January 1980 to February 2006, with 1,497 patients available for analysis. Determination of BCRL was based on clinical assessment. Differences in clinical, pathologic, and treatment characteristics between patients with BCRL and those without BCRL were evaluated, and the actuarial rates of BCRL by regional irradiation technique were determined. Results: The actuarial rate of any BCRL was 7.4% for the entire cohort and 9.9%, 14.7%, and 8.3% for patients receiving a supraclavicular field, posterior axillary boost, and internal mammary irradiation, respectively. BCRL was more likely to develop in patients with advanced nodal status (11.4% vs. 6.3%, p = 0.001), those who had a greater number of lymph nodes removed (14 nodes) (9.5% vs. 6.0%, p = 0.01), those who had extracapsular extension (13.4% vs. 6.9%, p = 0.009), those with Grade II/III disease (10.8% vs. 2.9%, p < 0.001), and those who received adjuvant chemotherapy (10.5% vs. 6.7%, p = 0.02). Regional irradiation showed small increases in the rates of BCRL (p = not significant). Conclusions: These results suggest that clinically detectable BCRL will develop after traditional BCT in up to 10% of patients. High-risk subgroups include patients with advanced nodal status, those with more nodes removed, and those who receive chemotherapy, with patients receiving regional irradiation showing a trend toward increased rates.

  10. The impact of early detection and intervention of breast cancer?related lymphedema: a systematic review

    OpenAIRE

    Shah, Chirag; Arthur, Douglas W.; Wazer, David; Khan, Atif; Ridner, Sheila; Vicini, Frank

    2016-01-01

    Abstract Breast cancer?related lymphedema (BCRL) has become an increasingly important clinical issue as noted by the recent update of the 2015 NCCN breast cancer guidelines which recommends to ?educate, monitor, and refer for lymphedema management.? The purpose of this review was to examine the literature regarding early detection and management of BCRL in order to (1) better characterize the benefit of proactive surveillance and intervention, (2) clarify the optimal monitoring techniques, an...

  11. “Just live with it”: Having to live with breast cancer related lymphedema

    African Journals Online (AJOL)

    Living with breast cancer related lymphedema was not easy. Participants were not informed of the possibility of developing lymphedema and felt let down by the medical professionals they consulted. They had to face the physical, psychological and practical consequences without the continuous support of a knowledgeable ...

  12. Analysis of factors related to arm weakness in patients with breast cancer-related lymphedema.

    Science.gov (United States)

    Lee, Daegu; Hwang, Ji Hye; Chu, Inho; Chang, Hyun Ju; Shim, Young Hun; Kim, Jung Hyun

    2015-08-01

    The aim of this study was to evaluate the ratio of significant weakness in the affected arm of breast cancer-related lymphedema patients to their unaffected side. Another purpose was to identify factors related to arm weakness and physical function in patients with breast cancer-related lymphedema. Consecutive patients (n = 80) attended a single evaluation session following their outpatient lymphedema clinic visit. Possible independent factors (i.e., lymphedema, pain, psychological, educational, and behavioral) were evaluated. Handgrip strength was used to assess upper extremity muscle strength and the disabilities of arm, shoulder, and hand (DASH) questionnaire was used to assess upper extremity physical function. Multivariate logistic regression was performed using factors that had significant differences between the handgrip weakness and non-weakness groups. Out of the 80 patients with breast cancer-related lymphedema, 29 patients (36.3 %) had significant weakness in the affected arm. Weakness of the arm with lymphedema was not related to lymphedema itself, but was related to the fear of using the affected limb (odds ratio = 1.76, 95 % confidence interval = 1.30-2.37). Fears of using the affected limb and depression significantly contributed to the variance in DASH scores. Appropriate physical and psychological interventions, including providing accurate information and reassurance of physical activity safety, are necessary to prevent arm weakness and physical dysfunction in patients with breast cancer-related lymphedema.

  13. Breast cancer-related lymphedema: A literature review for clinical practice

    Directory of Open Access Journals (Sweden)

    Ausanee Wanchai

    2016-06-01

    Full Text Available Lymphedema is the swelling of soft tissues as a result of the accumulation of protein-rich fluid in extracellular spaces. Secondary lymphedema is precipitated by an event causing blockage or interruption of the lymphatic vessels. Secondary lymphedema is a potential complication that may affect the quality of life of patients treated for breast cancer. Life-long risk factors of post-breast cancer lymphedema are related to the extent of axillary node involvement, type of breast surgery, and radiation therapy. These factors decrease lymphatic drainage and increase stasis of fluids in the areas of skin and subcutaneous tissues that drain to regional lymph nodes. Breast cancer-related lymphedema can involve the arm and hand, as well as the breast and trunk on the operative side. Clinical symptom assessment and circumferential measures are widely used to evaluate lymphedema. Treatment of lymphedema associated with breast cancer can include combined modality approaches, compression therapy, therapeutic exercises, and pharmacotherapy.

  14. Aberrant DNA methylation of cancer-related genes in giant breast fibroadenoma: a case report

    Directory of Open Access Journals (Sweden)

    Orozco Javier I

    2011-10-01

    Full Text Available Abstract Introduction Giant fibroadenoma is an uncommon variant of benign breast lesions. Aberrant methylation of CpG islands in promoter regions is known to be involved in the silencing of genes (for example, tumor-suppressor genes and appears to be an early event in the etiology of breast carcinogenesis. Only hypermethylation of p16INK4a has been reported in non-giant breast fibroadenoma. In this particular case, there are no previously published data on epigenetic alterations in giant fibroadenomas. Our previous results, based on the analysis of 49 cancer-related CpG islands have confirmed that the aberrant methylation is specific to malignant breast tumors and that it is completely absent in normal breast tissue and breast fibroadenomas. Case presentation A 13-year-old Hispanic girl was referred after she had noted a progressive development of a mass in her left breast. On physical examination, a 10 × 10 cm lump was detected and axillary lymph nodes were not enlarged. After surgical removal the lump was diagnosed as a giant fibroadenoma. Because of the high growth rate of this benign tumor, we decided to analyze the methylation status of 49 CpG islands related to cell growth control. We have identified the methylation of five cancer-related CpG islands in the giant fibroadenoma tissue: ESR1, MGMT, WT-1, BRCA2 and CD44. Conclusion In this case report we show for the first time the methylation analysis of a giant fibroadenoma. The detection of methylation of these five cancer-related regions indicates substantial epigenomic differences with non-giant fibroadenomas. Epigenetic alterations could explain the higher growth rate of this tumor. Our data contribute to the growing knowledge of aberrant methylation in breast diseases. In this particular case, there exist no previous data regarding the role of methylation in giant fibroadenomas, considered by definition as a benign breast lesion.

  15. Establishing and Sustaining a Prospective Screening Program for Breast Cancer-Related Lymphedema at the Massachusetts General Hospital: Lessons Learned

    Directory of Open Access Journals (Sweden)

    Cheryl Brunelle

    2015-05-01

    Full Text Available There has been an increasing call to prospectively screen patients with breast cancer for the development of breast cancer-related lymphedema (BCRL following their breast cancer treatment. While the components of a prospective screening program have been published, some centers struggle with how to initiate, establish, and sustain a screening program of their own. The intent of this manuscript is to share our experience and struggles in establishing a prospective surveillance program within the infrastructure of our institution. It is our hope that by sharing our history other centers can learn from our mistakes and successes to better design their own prospective screening program to best serve their patient population.

  16. Segmental Bioimpedance Informs Diagnosis of Breast Cancer-Related Lymphedema.

    Science.gov (United States)

    Svensson, Brenda J; Dylke, Elizabeth S; Ward, Leigh C; Kilbreath, Sharon L

    2017-09-28

    Detection of lymphedema, particularly its mild stage, is clinically challenging. The aim of this study was to determine whether segmental bioimpedance spectroscopy (BIS) provided additional information to whole arm BIS in assessing women with or at risk of lymphedema following breast cancer. Participants (n = 66), aged 61.6 ± 10.5 years (mean ± standard deviation [SD]), were grouped according to lymphedema status: (1) at-risk (n = 24) had no indicators of lymphedema and (2) lymphedema (n = 42) were suspected to be developing lymphedema or had previously met lymphedema diagnostic criteria and undergone treatment. For each upper limb, impedance was measured for the whole arm, hand and four 10 cm segments of the arm, commencing at the ulnar styloid. Interlimb impedance ratios for corresponding locations were calculated and compared to previously determined, normatively based thresholds based on 2SD and 3SD above the mean. Segmental BIS classified 19% more women with lymphedema than 3SD whole arm thresholds and the same number as 2SD whole arm thresholds. Segmental BIS identified localized lymphedema and patterns in lymphedema distribution that were undetectable by whole arm BIS. Neither 3SD whole arm nor segmental BIS thresholds found lymphedema where it was not present; however, 2SD whole arm thresholds alone classified one woman in the at-risk group as having lymphedema. Segmental BIS classified as many or more cases of lymphedema than whole arm BIS thresholds without finding lymphedema where it was likely not present while also providing additional information regarding the distribution of lymphedema within the limb.

  17. Upper extremity function and quality of life in patients with breast cancer related lymphedema

    Directory of Open Access Journals (Sweden)

    Bojinović-Rodić Dragana

    2016-01-01

    Full Text Available Background/Aim. Upper limb lymphedema is one of the most frequent chronic complications after breast cancer treatment with a significant impact on the upper extremity function and quality of life (QoL. The aim of this study was to estimate health-related quality of life (HRQoL in patients with breast-cancer-related lymphedema and its correlation with upper limb function and the size of edema. Methods. The cross-sectional study included 54 breast-cancer-related lymphedema patients. The quality of life was evaluated by the Short Form 36-Item Health Survey (SF-36. Upper limb function was assessed by the Quick Disability of the Arm, Shoulder and Hand questionnaire (Quick DASH. The size of lymphedema was determined by the arm circumference. Results. The higher HRQoL score was assessed for mental health (47.0 ± 12.2 than for physical one (42.2 ± 7.5. The highest values of SF-36 were found in the domains of Mental Health (67.7 ± 22.9 and Social Function (70.1 ± 23.1. The lowest scores were registered in the domains of Role Physical (46.9 ± 39.1 and General Health (49.3 ± 20.1. Upper extremity function statistically significantly correlated with the domains Role Physical, Bodily Pain and Physical Composite Summary and also, with the domain Role Emotional (p 0.05. Conclusions. Physical disability in patients with breast cancer-related lymphedema influences quality of life more than mental health. Upper limb function has a significant impact on quality of life, not only on the physical, but also on the mental component. The presence of breast-cancer-related lymphedema certainly affects upper limb function and quality of life, but in this study no significant correlation between the size of edema and quality of life was found.

  18. The impact of early detection and intervention of breast cancer-related lymphedema: a systematic review.

    Science.gov (United States)

    Shah, Chirag; Arthur, Douglas W; Wazer, David; Khan, Atif; Ridner, Sheila; Vicini, Frank

    2016-06-01

    Breast cancer-related lymphedema (BCRL) has become an increasingly important clinical issue as noted by the recent update of the 2015 NCCN breast cancer guidelines which recommends to "educate, monitor, and refer for lymphedema management." The purpose of this review was to examine the literature regarding early detection and management of BCRL in order to (1) better characterize the benefit of proactive surveillance and intervention, (2) clarify the optimal monitoring techniques, and (3) help better define patient groups most likely to benefit from surveillance programs. A Medline search was conducted for the years 1992-2015 to identify articles addressing early detection and management of BCRL. After an initial search, 127 articles were identified, with 13 of these studies focused on early intervention (three randomized (level of evidence 1), four prospective (level of evidence 2-3), six retrospective trials (level of evidence 4)). Data from two, small (n = 185 cases), randomized trials with limited follow-up demonstrated a benefit to early intervention (physiotherapy, manual lymphatic drainage) with regard to reducing the rate of chronic BCRL (>50% reduction) with two additional studies underway (n = 1280). These findings were confirmed by larger prospective and retrospective series. Several studies were identified that demonstrate that newer diagnostic modalities (bioimpedance spectroscopy, perometry) have increased sensitivity allowing for the earlier detection of BCRL. Current data support the development of surveillance programs geared toward the early detection and management of BCRL in part due to newer, more sensitive diagnostic modalities. © 2016 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

  19. Effects of an expressive writing intervention on cancer-related distress in Danish breast cancer survivors

    DEFF Research Database (Denmark)

    Jensen-Johansen, Mikael Birkelund; Christensen, Søren; Valdimarsdottir, Heiddis

    2013-01-01

    Objective: To examine the effects of an expressive writing intervention (EWI) on cancer-related distress, depressive symptoms, and mood in women treated for early stage breast cancer. Methods: A nationwide sample of 507 Danish women who had recently completed treatment for primary breast cancer......), and negative (37-item Profile of Moods State) and positive mood (Passive Positive Mood Scale) were assessed at baseline and at 3 and 9 months post-intervention. Choice of writing topic (cancer versus other), alexithymia (20-item Toronto Alexithymia Scale), and social constraints (Social Constraints Scale) were...... included as possible moderators. Results: Significant (p psychological symptoms were seen in both groups (p 

  20. Cancer-related internet information communication between oncologists and patients with breast cancer: a qualitative study.

    Science.gov (United States)

    Shen, Megan Johnson; Dyson, Robert C; D'Agostino, Thomas A; Ostroff, Jamie S; Dickler, Maura N; Heerdt, Alexandra S; Bylund, Carma L

    2015-11-01

    Many patients with cancer search out information about their cancer on the internet, thus affecting their relationship with their oncologists. An in-depth analysis of patient-physician communication about information obtained from the internet is currently lacking. We audio-recorded visits of patients with breast cancer and their oncologists where internet information was expected to be discussed. Inductive thematic text analysis was used to identify qualitative themes from these conversations. Twenty-one patients self-reported discussing cancer-related internet information (CRII) with their oncologists; 16 audio recordings contained detectable discussions of CRII and were analyzed. Results indicated that oncologists and patients initiated CRII discussions implicitly and explicitly. Oncologists responded positively to patient-initiated CRII discussions by (1) acknowledging their limited expertise/knowledge, (2) encouraging/approving using the internet as an information resource, (3) providing information/guidance on the proper use of internet searches, (4) discussing the pros and cons of relevant treatment options, or (5) giving information. Finally, patients reacted to the CRII discussions by (1) indicating that they only used reputable sources/websites, (2) asking for further explanation of information, (3) expressing continued concern, or (4) asking for the oncologist's opinion or recommendation. These results indicate that the majority of patients introduce internet information implicitly, in order to guard against any threat to their self-esteem. Physicians, in turn, seem to respond in a supportive fashion to reduce any threat experienced. Future interventions may consider providing prescription-based guidance on how to navigate the internet as a health information resource and to encourage patients to bring these topics up with their oncologist. Copyright © 2015 John Wiley & Sons, Ltd.

  1. Surveillance recommendations in reducing risk of and optimally managing breast cancer-related lymphedema.

    Science.gov (United States)

    Ostby, Pamela L; Armer, Jane M; Dale, Paul S; Van Loo, Margaret J; Wilbanks, Cassie L; Stewart, Bob R

    2014-08-18

    Breast cancer survivors are at increased risk for the development of breast cancer-related lymphedema (BCRL), a chronic, debilitating, and disfiguring condition that is progressive and requires lifelong self-management of symptoms. It has been reported that over 40% of the 2.5 million breast cancer survivors in the United States may meet the criteria for BCRL during their lifetimes. Ongoing surveillance, beginning with pre-operative assessment, has been effective in identifying subclinical lymphedema (LE). A prospective model for surveillance is necessary in order to detect BCRL at an early stage when there is the best chance to reduce risk or slow progression. Physical methods for monitoring and assessment, such as circumferential arm measures, perometry, bioimpedance; exercise programs; prophylactic and early-intervention compression garments; and referral for complete decongestive therapy are all interventions to consider in the development of a BCRL surveillance program. In addition, supportive-educative programs and interactive engagement for symptom self-management should also be implemented. The importance of interdisciplinary collaboration is integral to the success of an effective personalized medicine program in breast cancer-related lymphedema surveillance.

  2. Surveillance Recommendations in Reducing Risk of and Optimally Managing Breast Cancer-Related Lymphedema

    Directory of Open Access Journals (Sweden)

    Pamela L. Ostby

    2014-08-01

    Full Text Available Breast cancer survivors are at increased risk for the development of breast cancer-related lymphedema (BCRL, a chronic, debilitating, and disfiguring condition that is progressive and requires lifelong self-management of symptoms. It has been reported that over 40% of the 2.5 million breast cancer survivors in the United States may meet the criteria for BCRL during their lifetimes. Ongoing surveillance, beginning with pre-operative assessment, has been effective in identifying subclinical lymphedema (LE. A prospective model for surveillance is necessary in order to detect BCRL at an early stage when there is the best chance to reduce risk or slow progression. Physical methods for monitoring and assessment, such as circumferential arm measures, perometry, bioimpedance; exercise programs; prophylactic and early-intervention compression garments; and referral for complete decongestive therapy are all interventions to consider in the development of a BCRL surveillance program. In addition, supportive-educative programs and interactive engagement for symptom self-management should also be implemented. The importance of interdisciplinary collaboration is integral to the success of an effective personalized medicine program in breast cancer-related lymphedema surveillance.

  3. Surveillance Recommendations in Reducing Risk of and Optimally Managing Breast Cancer-Related Lymphedema

    Science.gov (United States)

    Ostby, Pamela L.; Armer, Jane M.; Dale, Paul S.; Van Loo, Margaret J.; Wilbanks, Cassie L.; Stewart, Bob R.

    2014-01-01

    Breast cancer survivors are at increased risk for the development of breast cancer-related lymphedema (BCRL), a chronic, debilitating, and disfiguring condition that is progressive and requires lifelong self-management of symptoms. It has been reported that over 40% of the 2.5 million breast cancer survivors in the United States may meet the criteria for BCRL during their lifetimes. Ongoing surveillance, beginning with pre-operative assessment, has been effective in identifying subclinical lymphedema (LE). A prospective model for surveillance is necessary in order to detect BCRL at an early stage when there is the best chance to reduce risk or slow progression. Physical methods for monitoring and assessment, such as circumferential arm measures, perometry, bioimpedance; exercise programs; prophylactic and early-intervention compression garments; and referral for complete decongestive therapy are all interventions to consider in the development of a BCRL surveillance program. In addition, supportive-educative programs and interactive engagement for symptom self-management should also be implemented. The importance of interdisciplinary collaboration is integral to the success of an effective personalized medicine program in breast cancer-related lymphedema surveillance. PMID:25563360

  4. Symptom incidence, distress, cancer-related distress, and adherence to chemotherapy among African American women with breast cancer.

    Science.gov (United States)

    Yee, Melissa K; Sereika, Susan M; Bender, Catherine M; Brufsky, Adam M; Connolly, Mary C; Rosenzweig, Margaret Q

    2017-06-01

    There is a persistent racial survival disparity between African American (AA) and white women with breast cancer. There is evidence that symptom incidence, associated distress, and overall cancer-related distress may be unexplored, important contributing factors. The purpose of the current study was to: 1) describe and compare the number of chemotherapy-related symptoms and associated distress among AA women with breast cancer over the course of chemotherapy at 3 time points (at baseline before initiating chemotherapy, midpoint, and at the completion of chemotherapy); and 2) to describe the relationship between the number of chemotherapy-related symptoms and overall cancer distress compared with the ability to receive at least 85% of the prescribed chemotherapy within the prescribed timeframe. Descriptive, comparative, and correlational analyses of symptom incidence, symptom distress, cancer-related distress, and prescribed chemotherapy dose received among a cohort of AA women receiving chemotherapy for breast cancer were performed. AA women (121 women) experienced worsening symptoms from baseline to midpoint in chemotherapy and then stabilized for the duration of therapy. The inability to receive 85% of the prescribed chemotherapy within a prescribed time point was found to be significantly correlated with midpoint symptom distress. The main findings of the current study were that AA women experience a deterioration in symptom distress over the course of chemotherapy from baseline (before chemotherapy) to the midpoint, which was found to be associated with less adherence to chemotherapy overall. Thus, the incidence and management of physical and emotional symptoms, as measured through a multidimensional symptom measurement tool, may be contributing to breast cancer dose disparity and should be explored further. Cancer 2017;123:2061-2069. © 2017 American Cancer Society. © 2017 American Cancer Society.

  5. Multidisciplinary Approaches to the Management of Breast-Cancer-Related Lymphedema

    Directory of Open Access Journals (Sweden)

    Solmaz Fakhari

    2013-07-01

    Full Text Available Breast-cancer-related lymphedema is a significant morbidity mostly observed following primary treatments for breast cancer (surgery, radiation, and chemotherapy (1. Multiple complications might accompany lymphedema including cosmetic deformity, psychological disorders, consistent pain, and consequently decreased quality of life. Treatment  mostly focuses on reducing edema and its subsequent pain; however, no definite treatment has been hitherto introduced (2. Surgical approaches in the management of lymphedema are efficient including physiologic methods (e.g. flap interposition, lymph transfer, and lymphatic bypass and reductive techniques (e.g. liposuction (3. While the former mostly targets at reducing lymphedema through restoring lymphatic drainage, the latter aims at removing fibrofatty tissues which contribute to lymph stasis. Microsurgical variation of lymphatic bypass has gained popularity, in which the accumulated lymph in the lymphedematous limb is redirected. Non-surgical approaches are also practiced in most cases. Comprehensive decongestive therapy, consisting of skin care, exercise, special bandaging and massage, is the most frequently used non-surgical approach efficacy of which could be enhanced in combination with self-management strategies (4. Recently newer techniques have been introduced to tackle lymphedema and its associated pain. Manual lymph drainage, stellate ganglion block, acupuncture, deep oscillation, and pneumatic compression have been efficiently used in several studies. Moreover, significant short-term progress has been reported following other modalities such as low-level laser therapy (5. The complexity of breast-cancer-related lymphedema and its complications necessitates a multidisciplinary approach with the primary goal of easing the burden of the disease on the breast cancer patients. In addition, developing special guidelines encompassing these multidisciplinary approaches and providing educational and

  6. Exercise for breast cancer survival: the effect on cancer risk and cancer-related fatigue (CRF).

    Science.gov (United States)

    Hewitt, Jennifer A; Mokbel, Kefah; van Someren, Ken A; Jewell, Andrew P; Garrod, Rachel

    2005-01-01

    To date, all epidemiological research in this area has focused on the relationship between physical activity level and the risk of breast cancer in healthy women, or more recently, those who have recovered from the disease. Most of this research highlights the fact that those women who are physically active are at a reduced risk of the disease. Although physical activity is similar to exercise, it lacks the specificity of a prescribed exercise training program. Consequently, such research can only be viewed as a promising indicator of the beneficial effect that regular exercise may have for breast cancer survivors. Furthermore, due to the nature of such research, there has been a failure to provide specific evidence concerning the most suitable modality, duration, intensity, and frequency of training for risk reduction in breast cancer survivors. Thus, evidence aiding the correct prescription of exercise for this population has been lacking. More promising evidence is provided by randomized controlled trials, which examine the effect of exercise on specific risk factors and provide convincing scientific rationale for the use of exercise among breast cancer survivors. These studies not only provide understanding of the physiological mechanisms by which exercise can be effective at aiding a reduction in breast cancer risk, but also allow conclusions on the correct prescription to be drawn. Additionally, exercise has proven to be effective in combating cancer-related fatigue (CRF), significantly improving both quality of life outcomes (QOL) and physiological capacity in women who have survived breast cancer. In order to promote a wider understanding of the beneficial effect that exercise holds for this population regarding reduction of breast cancer risk and CRF, this review discusses this research, making conclusions regarding the necessary training prescription to elicit such benefits.

  7. Factors associated with psychological distress in women with breast cancer-related lymphoedema.

    Science.gov (United States)

    Alcorso, Jessica; Sherman, Kerry A

    2016-07-01

    Previous research has shown that lymphoedema impacts negatively on an individual, including psychological distress and body image disturbance, particularly for younger women. This study identified psychological factors associated with distress in women with breast cancer-related lymphoedema and determined whether age moderated the specific relationship between body image disturbance and distress. Australian women (n = 166) diagnosed with breast cancer-related lymphoedema were recruited through a community-based breast cancer organisation and lymphoedema treatment clinics. Participants completed an online survey assessing lymphoedema-related cognitions (personal control, perceived treatment effectiveness, and consequences of lymphoedema), perceived ability to self-regulate lymphoedema-related negative affect, body image disturbance, psychological distress (depression, anxiety and stress), and demographic/medical information. Beliefs about the consequences, perceived effectiveness of treatment and controllability of lymphoedema, perceived ability to self-regulate negative affect, body image disturbance, and number of lymphoedema symptoms were correlated with depression, anxiety, and stress scores. Multivariate regression analyses indicated that body image disturbance was significantly associated with depression, anxiety, and stress, and perceived treatment effectiveness was associated with stress. Age was a significant moderator of the relationship between body image disturbance and depression and anxiety, with older women with greater body image disturbance more distressed. Health professionals need to be aware that women diagnosed with lymphoedema are at risk of experiencing psychological distress, particularly arising from body image disturbance and beliefs that treatment cannot control lymphoedema. Furthermore, older women may be at an increased risk of anxiety and depression arising from body image disturbance. Copyright © 2015 John Wiley & Sons, Ltd

  8. Streptococcal toxic-shock syndrome due to Streptococcus dysgalactiae subspecies equisimilis in breast cancer-related lymphedema: a case report.

    Science.gov (United States)

    Sumazaki, Makoto; Saito, Fumi; Ogata, Hideaki; Yoshida, Miho; Kubota, Yorichika; Magoshi, Syunsuke; Kaneko, Hironori

    2017-07-14

    Breast cancer-related lymphedema often causes cellulitis and is one of the most common complications after breast cancer surgery. Streptococci are the major pathogens underlying such cellulitis. Among the streptococci, the importance of the Lancefield groups C and G is underappreciated; most cases involve Streptococcus dysgalactiae subspecies equisimilis. Despite having a relatively weak toxicity compared with group A streptococci, Streptococcus dysgalactiae subspecies equisimilis is associated with a mortality rate that is as high as that of group A streptococci in cases of invasive infection because Streptococcus dysgalactiae subspecies equisimilis mainly affects elderly individuals who already have various comorbidities. An 83-year-old Japanese woman with breast cancer-related lymphedema in her left upper limb was referred to our hospital with high fever and acute pain with erythema in her left arm. She showed septic shock with disseminated intravascular coagulation. Blood culture showed positive results for Streptococcus dysgalactiae subspecies equisimilis, confirming a diagnosis of streptococcal toxic-shock syndrome. She survived after successful intensive care. To the best of our knowledge, this case represents the first report of Streptococcus dysgalactiae subspecies equisimilis-induced streptococcal toxic-shock syndrome in a patient with breast cancer-related lymphedema. Breast cancer-related lymphedema is a common problem, and we must pay attention to invasive streptococcal soft tissue infections, particularly in elderly patients with chronic disease.

  9. Treatment of breast cancer-related lymphedema with adipose-derived regenerative cells and fat grafts

    DEFF Research Database (Denmark)

    Toyserkani, Navid Mohamadpour; Jensen, Charlotte Harken; Andersen, Ditte Caroline

    2017-01-01

    Breast cancer-related lymphedema (BCRL) is a debilitating late complication with a lack of treatment opportunities. Recent studies have suggested that mesenchymal stromal cells can alleviate lymphedema. Herein, we report the results from the first human pilot study with freshly isolated adipose......-derived regenerative cells (ADRC) for treating lymphedema with 6 months follow-up. Ten BCRL patients were included. ADRC was injected directly into the axillary region, which was combined with a scar-releasing fat graft procedure. Primary endpoints were change in arm volume. Secondary endpoints were change in patient...... tolerated and only minor transient adverse events related to liposuction were noted. In this pilot study, a single injection of ADRC improved lymphedema based on patient-reported outcome measures, and there were no serious adverse events in the 6 months follow-up period. In addition, half of the patients...

  10. Predictors of loco-regional recurrence and cancer-related death after breast cancer surgery.

    Science.gov (United States)

    Rausei, Stefano; Rovera, Francesca; Dionigi, Gianlorenzo; Tornese, Deborah; Fachinetti, Anna; Boni, Luigi; Dionigi, Renzo

    2010-01-01

    To determine which tumor-related factors might predispose the patient to loco-regional recurrence or death and the impact of these factors on the different types of events. We retrospectively analyzed the data of 1991 women between January 1998 and March 2010 for a first primary nonmetastatic breast cancer and treated with surgery and neo-adjuvant/adjuvant therapy. The overall survival distribution was estimated using the Kaplan-Meier method. The prognostic impact of several factors on cumulative overall and loco-regional recurrence free survival was evaluated by univariate (log-rank test) and multivariate analysis (Cox regression). At log-rank test, pT, nodal status, histotype, grading, lymphangioinvasive growth, tumor diameter, estrogen receptors (ER) status, progesterone receptors (PR) status, expression of Ki67, and expression of Her2/neu had a prognostic value on loco-regional recurrence or overall survival. In the multivariate analysis grading remained the only independent predictor of loco-regional recurrences. With regard to overall survival, the Cox model selected grading along with nodal status and PR status. Loco-regional recurrences after breast cancer surgery are not frequent events. They are markers of tumor aggressiveness and predictor of an increased likelihood of cancer-related death. However, loco-regional recurrence and systemic tumor progression are partially independent events, since some prognostic factors differ. © 2010 Wiley Periodicals, Inc.

  11. Effects of yoga on arm volume among women with breast cancer related lymphedema: A pilot study.

    Science.gov (United States)

    Fisher, Mary Insana; Donahoe-Fillmore, Betsy; Leach, Laura; O'Malley, Colleen; Paeplow, Cheryl; Prescott, Tess; Merriman, Harold

    2014-10-01

    Lymphedema affects 3-58% of survivors of breast cancer and can result in upper extremity impairments. Exercise can be beneficial in managing lymphedema. Yoga practice has been minimally studied for its effects on breast cancer related lymphedema (BCRL). The purpose of this study was to determine the effect of yoga on arm volume, quality of life (QOL), self-reported arm function, and hand grip strength in women with BCRL. Six women with BCRL participated in modified Hatha yoga 3×/week for 8 weeks. Compression sleeves were worn during yoga sessions. Arm volume, QOL, self-reported arm function, and hand grip strength were measured at baseline, half-way, and at the conclusion of yoga practice. Arm volume significantly decreased from baseline (2423.3 ml ± 597.2) to final measures (2370.8 ml ± 577.2) (p = .02). No significant changes in QOL (p = .12), self-reported arm function (p = .34), or hand grip strength (p = .26) were found. Yoga may be beneficial in the management of lymphedema. Copyright © 2014 Elsevier Ltd. All rights reserved.

  12. The need for preoperative baseline arm measurement to accurately quantify breast cancer-related lymphedema.

    Science.gov (United States)

    Sun, Fangdi; Skolny, Melissa N; Swaroop, Meyha N; Rawal, Bhupendra; Catalano, Paul J; Brunelle, Cheryl L; Miller, Cynthia L; Taghian, Alphonse G

    2016-06-01

    Breast cancer-related lymphedema (BCRL) is a feared outcome of breast cancer treatment, yet the push for early screening is hampered by a lack of standardized quantification. We sought to determine the necessity of preoperative baseline in accounting for temporal changes of upper extremity volume. 1028 women with unilateral breast cancer were prospectively screened for lymphedema by perometry. Thresholds were defined: relative volume change (RVC) ≥10 % for clinically significant lymphedema and ≥5 % including subclinical lymphedema. The first postoperative measurement (pseudo-baseline) simulated the case of no baseline. McNemar's test and binomial logistic regression models were used to analyze BCRL misdiagnoses. Preoperatively, 28.3 and 2.9 % of patients had arm asymmetry of ≥5 and 10 %, respectively. Without baseline, 41.6 % of patients were underdiagnosed and 40.1 % overdiagnosed at RVC ≥ 5 %, increasing to 50.0 and 54.8 % at RVC ≥ 10 %. Increased pseudo-baseline asymmetry, increased weight change between baselines, hormonal therapy, dominant use of contralateral arm, and not receiving axillary lymph node dissection (ALND) were associated with increased risk of underdiagnosis at RVC ≥ 5 %; not receiving regional lymph node radiation was significant at RVC ≥ 10 %. Increased pseudo-baseline asymmetry, not receiving ALND, and dominant use of ipsilateral arm were associated with overdiagnosis at RVC ≥ 5 %; increased pseudo-baseline asymmetry and not receiving ALND were significant at RVC ≥ 10 %. The use of a postoperative proxy even early after treatment results in poor sensitivity for identifying BCRL. Providers with access to patients before surgery should consider the consequent need for proper baseline, with specific strategy tailored by institution.

  13. Breast Cancer-Related Arm Lymphedema: Incidence Rates, Diagnostic Techniques, Optimal Management and Risk Reduction Strategies

    Energy Technology Data Exchange (ETDEWEB)

    Shah, Chirag [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Vicini, Frank A., E-mail: fvicini@beaumont.edu [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States)

    2011-11-15

    As more women survive breast cancer, long-term toxicities affecting their quality of life, such as lymphedema (LE) of the arm, gain importance. Although numerous studies have attempted to determine incidence rates, identify optimal diagnostic tests, enumerate efficacious treatment strategies and outline risk reduction guidelines for breast cancer-related lymphedema (BCRL), few groups have consistently agreed on any of these issues. As a result, standardized recommendations are still lacking. This review will summarize the latest data addressing all of these concerns in order to provide patients and health care providers with optimal, contemporary recommendations. Published incidence rates for BCRL vary substantially with a range of 2-65% based on surgical technique, axillary sampling method, radiation therapy fields treated, and the use of chemotherapy. Newer clinical assessment tools can potentially identify BCRL in patients with subclinical disease with prospective data suggesting that early diagnosis and management with noninvasive therapy can lead to excellent outcomes. Multiple therapies exist with treatments defined by the severity of BCRL present. Currently, the standard of care for BCRL in patients with significant LE is complex decongestive physiotherapy (CDP). Contemporary data also suggest that a multidisciplinary approach to the management of BCRL should begin prior to definitive treatment for breast cancer employing patient-specific surgical, radiation therapy, and chemotherapy paradigms that limit risks. Further, prospective clinical assessments before and after treatment should be employed to diagnose subclinical disease. In those patients who require aggressive locoregional management, prophylactic therapies and the use of CDP can help reduce the long-term sequelae of BCRL.

  14. [Search for breast cancer-related biomarker proteins for drug discovery].

    Science.gov (United States)

    Nagano, Kazuya

    2010-12-01

    The identification of biomarkers is a promising approach for the diagnosis and effective therapy of cancer. In particular, disease proteomics is a potentially useful method for identifying such biomarkers. However, very few biomarker proteins for drug development have been discovered using this approach. The main difficulty is to efficiently select potential biomarkers from the many candidate proteins identified by the proteomics approach. To circumvent this problem, we have developed "antibody proteomics technology" that can screen for biomarker proteins by isolating antibodies against each candidate in a rapid and comprehensive manner. Here, we applied "antibody proteomics technology" to breast cancer-related biomarker discovery and evaluated the utility of this novel technology. Cell extracts derived from breast tumor cells (SKBR3) and normal cells (184A1) were analyzed by two-dimensional differential gel electrophoresis (2D-DIGE) to identify proteins over-expressed in the tumor cells. Candidate proteins were extracted from the gel pieces, immobilized onto a nitrocellulose membrane using a dot blot apparatus and then used as target antigens in scFv-phage enrichment and selection. Following this in vitro phage selection procedure, scFvs binding to 21 different over-expressed proteins in tumor cells were successfully isolated within several weeks. The expression profiles of the identified proteins were then determined by tissue microarray analysis using the scFv-phages. Consequently, we identified three breast tumor-specific proteins. Our data demonstrates the utility of an antibody proteomics system for discovering and validating tumor-related proteins in pharmaceutical proteomics. Currently, we are analyzing the functions of these proteins to use them as diagnostic markers or therapeutic targets.

  15. Getting Beyond Impressions: An Evaluation of Engagement with Breast Cancer-related Facebook Content.

    Science.gov (United States)

    Theiss, Sunita Kapahi; Burke, Rachel M; Cory, Janine L; Fairley, Temeika L

    2016-11-01

    Reaching young adults with health messages has been a documented challenge in public health. Public health researchers have initiated studies to assess how social media are changing health communication. In 2014, the Centers for Disease Control and Prevention (CDC) launched social media-based health education initiatives on Facebook to increase knowledge of breast health and breast cancer among women under age 45 and those at higher risk for developing the disease. The current study used digital analytics and metrics to describe the impact of these social media efforts on health communication. Engagement rate was calculated by taking the average engagement rate for 574 posts published by the CDC Breast Cancer Facebook page in multiple categories, including CDC campaign specificity, content type, time of day, and year posted. Linear regression was used to model the effect of campaign content. Engagement rate (ER) was highest for content shared for the Know:BRCA campaign posts (ER=6.4), followed by the non-campaign related posts (ER=5.5), and the Bring Your Brave posts (ER=4.6). Overall engagement rate decreased from 2014-2016. Photos consistently produced the most significant engagement rate overall. We found that users were more likely to click, share, comment, or like the content of the post that had photos. These data suggest that that branded, visual content is more effective in facilitating engagement. These findings will be used to adjust both free and paid social media efforts for the CDC Breast Cancer Facebook page.

  16. Photobiomodulation therapy in breast cancer-related lymphedema: a randomized placebo-controlled trial.

    Science.gov (United States)

    Storz, Maximilian Andreas; Gronwald, Benjamin; Gottschling, Sven; Schöpe, Jakob; Mavrova, Russalina; Baum, Sascha

    2017-01-01

    The aim of our study was to examine the effects of photobiomodulation therapy (PBMT) in the treatment of breast cancer-related lymphedema using a compactly designed treatment regime consisting of eight therapy sessions in combination with a cluster laser device covering a total area size of 78.54 cm² over the axillary. Forty patients with unilateral lymphedema were enrolled in this double-blind, placebo-controlled trial in order to evaluate effects of PBMT on lymphedema-related pain, quality of life, grip strength and limb volume difference. Subjects received irradiation for ten minutes per session using a cluster laser covering a beam area of 78.54 cm². The applied energy was 384 Joules resulting in an energy density of 4.89 J/cm². Post-treatment, a 50% reduction in median pain scores and an increase in mean quality of life were observed. Mean grip strength was persistently higher after eight sessions of PBMT compared with pretreatment; however, no statistically significant intergroup differences (P > 0.05) were found over the time course. PBMT using a compactly designed treatment regime in combination with a cluster laser device did not significantly improve quality of life, pain scores, grip strength and limb volume over the time course. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. Prediction of treatment outcome with bioimpedance measurements in breast cancer related lymphedema patients.

    Science.gov (United States)

    Kim, Leesuk; Jeon, Jae Yong; Sung, In Young; Jeong, Soon Yong; Do, Jung Hwa; Kim, Hwa Jung

    2011-10-01

    To investigate the usefulness of bioimpedance measurement for predicting the treatment outcome in breast cancer related lymphedema (BCRL) patients. Unilateral BCRL patients who received complex decongestive therapy (CDT) for 2 weeks (5 days per week) were enrolled in this study. We measured the ratio of extracellular fluid (ECF) volume by using bioelectrical impedance spectroscopy (BIS), and single frequency bioimpedance analysis (SFBIA) at a 5 kHz frequency before treatment. Arm circumferences were measured at 10 cm above and below the elbow before and after treatment. We also investigated whether there is correlation between ECF ratio and SFBIA ratio with the change of arm circumference after CDT. A total of 73 patients were enrolled in this study. The higher ECF ratio was significantly correlated with higher reduction of arm circumference at both above and below the elbow after treatment, but the higher SFBIA ratio was correlated only with the higher reduction of arm circumference below the elbow. These results show that ECF volume measurements and SFBIA before treatment are useful tools for predicting the outcome of patients with lymphedema. We concluded that ECF volume measure can be used as a screening tool for predicting treatment outcome of BCRL patients.

  18. Depressed mood in breast cancer survivors: associations with physical activity, cancer-related fatigue, quality of life, and fitness level.

    Science.gov (United States)

    Galiano-Castillo, Noelia; Ariza-García, Angelica; Cantarero-Villanueva, Irene; Fernández-Lao, Carolina; Díaz-Rodríguez, Lourdes; Arroyo-Morales, Manuel

    2014-04-01

    One out of five cancer survivors suffer from depression after oncology treatment. The aim of this study was to examine the relationship between depression and quality of life (QoL), cancer-related symptoms, physical activity level, health-related fitness, and salivary flow rate in breast cancer survivors. 108 breast cancer survivors in the year after the conclusion of treatment were included in this cross-sectional study. Demographic and clinically relevant information, cancer-related fatigue (Piper Fatigue Scale), QoL (QLQ-Br23 module), pain intensity VAS scale, salivary flow rate, physical activity level (Minnesota Leisure Time Physical Activity Questionnaire), and health-related fitness were assessed in all participants. Depressed mood was measured with the Profile of Mood States (POMS) Depression subscale. Significant positive correlations between depressed mood and fatigue, systemic side effects, perceived shoulder pain, and breast-arms symptoms (r ranged between .57 and .28, P depressed mood and body image, future perspective, force handgrip, and physical activity level (r ranged between -.41 and -.19; p body image were significant predictors of depressed mood, and when combined, they explained 39.6% of the variance in depressed mood. Cancer-related fatigue, physical activity level, and QoL partially explain the variability of depressed mood in breast cancer survivors. This paper facilitates a better understanding of the relationship between depressed mood and possible factors associated with it. Copyright © 2013 Elsevier Ltd. All rights reserved.

  19. Better postdiagnosis diet quality is associated with less cancer-related fatigue in breast cancer survivors.

    Science.gov (United States)

    George, Stephanie M; Alfano, Catherine M; Neuhouser, Marian L; Smith, Ashley W; Baumgartner, Richard N; Baumgartner, Kathy B; Bernstein, Leslie; Ballard-Barbash, Rachel

    2014-12-01

    A comprehensive understanding of the role of modifiable health behaviors in effective management of cancer-related fatigue is needed. Among breast cancer survivors, we examined how postdiagnosis diet quality, independently and jointly with physical activity, is related to fatigue, and the potential mediating role of inflammation. Seven hundred seventy women diagnosed with stage 0-IIIA breast cancer in the Health, Eating, Activity, and Lifestyle study completed food frequency and physical activity questionnaires 30 months postdiagnosis. We scored diet quality using the Healthy Eating Index 2010 (HEI-2010). Serum concentrations of C-reactive protein (CRP) were measured in fasting 30-ml blood samples. Multidimensional fatigue was measured 41 months postdiagnosis using the 22-item revised Piper Fatigue Scale. In multivariate linear models, we determined whether fatigue was associated HEI-2010 quartiles (Q1-Q4), and a variable jointly reflecting HEI quartiles and physical activity levels. Survivors with better-quality diets (Q4 vs. Q1) had lower total fatigue (4.1 vs. 4.8, p-contrast = 0.003) and subscale scores (behavioral severity 3.4 vs. 4.2, p-contrast = 0.003; affective meaning 3.9 vs. 4.8, p-contrast = 0.007; sensory 4.4 vs. 5.2, p-contrast = 0.003; cognitive 4.6 vs. 5.0, p-contrast = 0.046). Least squares estimates of fatigue were similar in models including CRP. Compared to survivors with poor-quality diets and no physical activity, survivors with better-quality diets and meeting physical activity recommendations had significantly lower behavioral severity (3.2 vs. 4.7, p-contrast = 0.002) and sensory (3.8 vs. 4.8. p-contrast = 0.006) fatigue scores. In this large breast cancer survivor cohort, postdiagnosis diet quality was inversely and independently associated with fatigue. Future interventions designed to improve multiple energy balance behaviors can provide insight into their associations with fatigue.

  20. Genomic evolution from primary breast carcinoma to distant metastasis: Few copy number changes of breast cancer related genes

    NARCIS (Netherlands)

    Moelans, C.B.; Groep, P. van der; Hoefnagel, L.D.; Vijver, M.J. van de; Wesseling, P.; Wesseling, J.; Wall, E. van der; Diest, P.J. van

    2014-01-01

    Cancer initiation and progression is characterized by (epi)genetic aberrations. However, little is known about the changes that occur during breast cancer metastasis. In the present study, multiplex ligation-dependent probe amplification was used to compare copy numbers of 21 established oncogenes

  1. Assessment of breast cancer-related lymphedema: a comparison of moisture meter and spot bioimpedance measurement.

    Science.gov (United States)

    Czerniec, Sharon Anne; Ward, Leigh C; Kilbreath, Sharon L

    2015-03-01

    Tissue dielectric constant (TDC) and spot bioimpedance measurement (BIA) have a role in the assessment of tissue composition changes in breast cancer-related lymphedema (BCRL). Our aims were to determine whether TDC and spot BIA measures could detect inter-limb differences in BCRL, explore the relationship between methods, and establish the intra-rater reliability and technical error of measurement for TDC. Women with (n=20) and without (n=4) unilateral BCRL participated. Circumference, TDC, and spot BIA measures were completed on the most affected region of the arm for BCRL participants and at a standardized forearm point in women without lymphedema. All measures were compared to measurements from an identical location on the contralateral arm. The affected arm differed significantly to the unaffected arm of women with BCRL for TDC and spot BIA measures. The median (IQR) differences were: extra-small probe 5.75 (3.10-8.21), small probe 3.50 (1.16-6.89), medium probe 5.08 (0.88-10.91), and for spot BIA measurement (-35.20 Ω; -59.75 to -14.85 Ω). The small and medium TDC probe measures were moderately correlated to spot bioimpedance measurements (r=-0.54 and r=-0.43, respectively). Intra-rater reliability coefficients (ICC2,1) of TDC measures ranged from 0.50 (95% CI: 0.12-0.75) to 0.92 (0.82-0.96). TDC technical error of measurement for women with lymphedema varied from 10.5% to 13.3%. Both TDC and spot bioimpedance may have a role in clinical assessment of tissue compositional change in BCRL. Their relationship with tissue composition, assessed by imaging, is now required.

  2. Effects of physical exercise during adjuvant breast cancer treatment on physical and psychosocial dimensions of cancer-related fatigue : A meta-analysis

    NARCIS (Netherlands)

    Van Vulpen, Jonna K.|info:eu-repo/dai/nl/413986322; Peeters, Petra H M|info:eu-repo/dai/nl/074099655; Velthuis, Miranda J.; van der Wall, Elsken|info:eu-repo/dai/nl/142344532; May, Anne M.|info:eu-repo/dai/nl/304818658

    2016-01-01

    Cancer-related fatigue has a multidimensional nature and complaints typically increase during adjuvant treatment for breast cancer. Physical exercise might prevent or reduce cancer-related fatigue. So far, no meta-analysis has investigated the effects of physical exercise on different dimensions of

  3. Living with cancer-related uncertainty: associations with fatigue, insomnia, and affect in younger breast cancer survivors.

    Science.gov (United States)

    Hall, Daniel L; Mishel, Merle H; Germino, Barbara B

    2014-09-01

    Uncertainty in cancer patients and survivors about cancer-related symptoms, treatment, and disease course has been related to poorer mental and physical health. However, little is known about whether cancer-related uncertainty relates with specific disease and treatment-related outcomes such as fatigue, insomnia, and affect disruptions. In this paper, we report these associations in younger survivors aged 50 years or less, a population increasing in prevalence. Participants included 313 breast cancer survivors (117 African-Americans and 196 Caucasians) who were aged 24 to 50 years and were 2 to 4 years posttreatment. Self-reported cancer-related uncertainty (Mishel Uncertainty in Illness Scale-Survivor Version), fatigue (Piper Fatigue Scale-Revised), insomnia (Insomnia Severity Index), and negative and positive affect (Positive and Negative Affect Schedule (PANAS)) measures were collected upon study entry. Hierarchical regression analyses controlled for relevant sociodemographic variables include the following: race, age, years of education, number of children, employment status, marital status, monthly income, smoking status, family history of cancer, endorsement of treatment-induced menopause, and religiosity. Over and above these factors, higher cancer-related uncertainty was significantly associated with more self-reported fatigue (β = .43), insomnia (β = .34), negative affect (β = .43), as well as less positive affect (β = -.33), all ps affect.

  4. The effect of marital status on breast cancer-related outcomes in women under 65: A SEER database analysis.

    Science.gov (United States)

    Hinyard, Leslie; Wirth, Lorinette Saphire; Clancy, Jennifer M; Schwartz, Theresa

    2017-04-01

    Marital status is strongly associated with improved health and longevity. Being married has been shown to be positively associated with survival in patients with multiple different types of malignancy; however, little is known about the relationship between marital status and breast cancer in younger women. The purpose of this study is to investigate the effect of marital status on diagnosis, and survival of women under the age of 65 with breast cancer. The SEER 18 regions database was used to identify women between the ages of 25-64 diagnosed with invasive breast cancer in the years 2004-2009. Logistic regression was used to predict later stage diagnosis by marital status and Cox proportional hazards models were used to compare breast cancer-related and all-cause survival by marital status classification. Models were stratified by AJCC stage. After adjusting for age, race, and ER status, unmarried women were 1.18 times more likely to be diagnosed at a later stage than married women (95% CI 1.15, 1.20). In adjusted analysis unmarried women were more likely to die of breast cancer and more likely to die of all causes than married women across all AJCC stages. Younger unmarried women with breast cancer may benefit from additional counseling, psychosocial support and case management at the time of diagnosis to ensure their overall outcomes are optimized. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. Modification of the association between recreational physical activity and survival after breast cancer by promoter methylation in breast cancer-related genes.

    Science.gov (United States)

    McCullough, Lauren E; Chen, Jia; Cho, Yoon Hee; Khankari, Nikhil K; Bradshaw, Patrick T; White, Alexandra J; Teitelbaum, Susan L; Terry, Mary Beth; Neugut, Alfred I; Hibshoosh, Hanina; Santella, Regina M; Gammon, Marilie D

    2017-02-21

    Mechanisms underlying the inverse association between physical activity and survival after breast cancer are unresolved, but DNA methylation may play a role. We hypothesized that promoter methylation of breast cancer-related genes, as well as global methylation, may modify the association between prediagnostic recreational physical activity (RPA) and breast cancer mortality. Using a population-based sample of 1254 women diagnosed with first primary breast cancer, we examined modification of the RPA-mortality association by gene-specific promoter methylation and global methylation. Average lifetime RPA was assessed from menarche to diagnosis through structured in-home interviews. Promoter methylation of 13 breast cancer-related genes was evaluated in archived tumor by methylation-specific polymerase chain reaction and MethyLight assay. Global methylation in white blood cell DNA was determined at long interspersed nucleotide element 1 and by the luminometric methylation assay. After approximately 15 years of follow-up, 486 patients had died, and 186 of the deaths were breast cancer-related. We used Cox proportional hazards regression to estimate HRs and 95% CIs as well as likelihood ratio tests to assess multiplicative interactions. All-cause mortality was lower only among physically active women with methylated promoter of APC (HR 0.60, 95% CI 0.40-0.80), CCND2 (HR 0.56, 95% CI 0.32-0.99), HIN (HR 0.55, 95% CI 0.38-0.80), and TWIST1 (HR 0.28, 95% CI 0.14-0.56) in tumors, but not among those with unmethylated tumors (significant interaction p breast cancer that is associated with RPA may be more pronounced in women with promoter tumor methylation in biologically plausible genes.

  6. Effect of Kinesiology Taping on breast cancer-related lymphedema: a randomized single-blind controlled pilot study.

    Science.gov (United States)

    Smykla, A; Walewicz, K; Trybulski, R; Halski, T; Kucharzewski, M; Kucio, C; Mikusek, W; Klakla, K; Taradaj, J

    2013-01-01

    The aim of the study was to assess the efficacy of Kinesiology Taping (KT) for treating breast cancer-related lymphedema. Sixty-five women with unilateral stage II and III lymphedema were randomly grouped into the KT group (K-tapes, n = 20), the Quasi KT group (quasi K-tapes, n = 22), or the MCT group (multilayered compression therapy group, n = 23). Skin care, 45 min pneumatic compression therapy, 1 h manual lymphatic drainage, and application of K-tape/Quasi K-tapes/multilayered short-stretch bandages were given every treatment session, 3 times per week for 1 month. Patient evaluation items included limb size and percentage edema. Comparing the changes in K-tapes with quasi K-tapes changes, there were no significant differences (P > 0.05). The edema reduction of multilayered bandages was much better than in results observed in taping groups. The KT appeared to be ineffective at secondary lymphedema after breast cancer treatment. The single-blind, controlled pilot study results suggest that K-tape could not replace the bandage, and at this moment it must not be an alternative choice for the breast cancer-related lymphedema patient. The trial is registered with ACTRN12613001173785.

  7. Effect of Kinesiology Taping on Breast Cancer-Related Lymphedema: A Randomized Single-Blind Controlled Pilot Study

    Directory of Open Access Journals (Sweden)

    A. Smykla

    2013-01-01

    Full Text Available The aim of the study was to assess the efficacy of Kinesiology Taping (KT for treating breast cancer-related lymphedema. Sixty-five women with unilateral stage II and III lymphedema were randomly grouped into the KT group (K-tapes, n=20, the Quasi KT group (quasi K-tapes, n=22, or the MCT group (multilayered compression therapy group, n=23. Skin care, 45 min pneumatic compression therapy, 1 h manual lymphatic drainage, and application of K-tape/Quasi K-tapes/multilayered short-stretch bandages were given every treatment session, 3 times per week for 1 month. Patient evaluation items included limb size and percentage edema. Comparing the changes in K-tapes with quasi K-tapes changes, there were no significant differences (P>0.05. The edema reduction of multilayered bandages was much better than in results observed in taping groups. The KT appeared to be ineffective at secondary lymphedema after breast cancer treatment. The single-blind, controlled pilot study results suggest that K-tape could not replace the bandage, and at this moment it must not be an alternative choice for the breast cancer-related lymphedema patient. The trial is registered with ACTRN12613001173785.

  8. Assessment of Volume Measurement of Breast Cancer-Related Lymphedema by Three Methods: Circumference Measurement, Water Displacement, and Dual Energy X-Ray Absorptiometry

    DEFF Research Database (Denmark)

    Gjørup, Caroline; Zerahn, B.; Hendel, H.W.

    2010-01-01

    Background: Following treatment for breast cancer 12%-60% develop breast cancer-related lymphedema (BCRL). There are several ways of assessing BCRL. Circumference measurement (CM) and water displacement (WD) for volume measurements (VM) are frequently used methods in practice and research...

  9. Diagnostic Methods, Risk Factors, Prevention, and Management of Breast Cancer-Related Lymphedema: Past, Present, and Future Directions.

    Science.gov (United States)

    Sayegh, Hoda E; Asdourian, Maria S; Swaroop, Meyha N; Brunelle, Cheryl L; Skolny, Melissa N; Salama, Laura; Taghian, Alphonse G

    2017-06-01

    Breast cancer-related lymphedema (BCRL) is a chronic, adverse, and much feared complication of breast cancer treatment, which affects approximately 20% of patients following breast cancer treatment. BCRL has a tremendous impact on breast cancer survivors, including physical impairments and significant psychological consequences. The intent of this review is to discuss recent studies and analyses regarding the risk factors, diagnosis, prevention through early screening and intervention, and management of BCRL. Highly-evidenced risk factors for BCRL include axillary lymph node dissection, lack of reconstruction, radiation to the lymph nodes, high BMI at diagnosis, weight fluctuations during and after treatment, subclinical edema within and beyond 3 months after surgery, and cellulitis in the at-risk arm. Avoidance of potential risk factors can serve as a method of prevention. Through establishing a screening program by which breast cancer patients are measured pre-operatively and at follow-ups, are objectively assessed through a weight-adjusted analysis, and are clinically assessed for signs and symptoms, BCRL can be tracked accurately and treated effectively. Management of BCRL is done by a trained professional, with research mounting towards the use of compression bandaging as a first line intervention against BCRL. Finally, exercise is safe for breast cancer patients with and without BCRL and does not incite or exacerbate symptoms of BCRL. Recent research has shed light on BCRL risk factors, diagnosis, prevention, and management. We hope that education on these aspects of BCRL will promote an informed, consistent approach and encourage additional research in this field to improve patient outcomes and quality of life in breast cancer survivors.

  10. PAX5α and PAX5β mRNA expression in breast Cancer: Relation to ...

    African Journals Online (AJOL)

    Background: Many studies evaluated the role of paired box gene 5 (PAX5) in breast cancer. However, few investigated PAX5α and PAX5β isoforms individually. Objective: The aim of the present study is to evaluate mRNA expression of PAX5α and PAX5β in breast cancer and assessing their underlying pathological roles ...

  11. Far infrared ray (FIR) therapy: An effective and oncological safe treatment modality for breast cancer related lymphedema.

    Science.gov (United States)

    Li, Ke; Xia, Liang; Liu, Ning Fei; Nicoli, Fabio; Constantinides, Joannis; D'Ambrosia, Christopher; Lazzeri, Davide; Tremp, Mathias; Zhang, Ju Fang; Zhang, Yi Xin

    2017-07-01

    The incidence of breast cancer related lymphedema is approximately 5%. Far infrared ray (FIR) treatment can potentially reduce fluid volume and extremity circumference as well as the frequency of dermato-lymphangitis (DLA). However, there is no published data on the oncological safety of FIR and the potential for activation of any residual breast cancer cells. The aim of this study is to investigate the safety of far infrared ray (FIR) treatment of postmastectomy lymphedema, clinically and in vitro. Patients who underwent mastectomy more than 5years ago complicated by upper extremity lymphedema for more than 1year were included. The enrolled patients were divided into an FIR treatment group and a control group (conservative treatment using bandage compression). Outcome measures included tumor markers (CA153, CA125), ultrasonography of relevant structures and monitoring for adverse reactions 1year after treatment. For the in vitro part of the study, the effects of FIR on human breast adenocarcinoma cell lines (MCF7, MDA-MB231) compared to the effects of FIR on human dermal fibroblasts as a control were considered. The viability, proliferation, cell cycle and apoptotic statistics of the adenocarcinoma and human dermal fibroblast cell lines were analyzed and compared. Results demonstrated that after treatment with FIR, tumor marker (CA153, CA125) concentrations in both the FIR and control groups were not elevated. There was no statistically significant difference between FIR and control group marker expression (p>0.05). Furthermore, no patients were diagnosed with lymphadenectasis or newly enlarged lymph nodes in these two groups. Importantly, there were no adverse events in either group. The in vitro experiment indicated that FIR radiation does not affect viability, proliferation, cell cycle and apoptosis of fibroblasts, MCF-7 and MDA-MB-231 cells. FIR should be considered as feasible and safe for the treatment of breast cancer related lymphedema patients 5years

  12. Could Kinesio tape replace the bandage in decongestive lymphatic therapy for breast-cancer-related lymphedema? A pilot study.

    Science.gov (United States)

    Tsai, Han-Ju; Hung, Hsiu-Chuan; Yang, Jing-Lan; Huang, Chiun-Sheng; Tsauo, Jau-Yih

    2009-11-01

    The purpose of this study is to compare the treatment and retention effects between standard decongestive lymphatic therapy (DLT) combined with pneumatic compression (PC) and modified DLT, in which the use of a short-stretch bandage is replaced with the use of Kinesio tape (K-tape) combined with PC. Forty-one patients with unilateral breast-cancer-related lymphedema for at least 3 months were randomly grouped into the DLT group (bandage group, N = 21) or the modified DLT group (K-tape group, N = 20). Skin care, 30-min manual lymphatic drainage, 1-h pneumatic compression therapy, application of a short-stretch bandage or K-tape for each group, and a 20-min physical therapy exercise were given during every treatment session. Patient evaluation items included physical therapy assessment, limb size, water composition of the upper extremity, lymphedema-related symptoms, quality of life, and patients' acceptance to the bandage or tape. There was no significant difference between groups in all outcome variables (P > 0.05) through the whole study period. Excess limb size (circumference and water displacement) and excess water composition were reduced significantly in the bandage group; excess circumference and excess water composition were reduced significantly in the tape group. The acceptance of K-tape was better than the bandage, and benefits included longer wearing time, less difficulty in usage, and increased comfort and convenience (P tape could replace the bandage in DLT, and it could be an alternative choice for the breast-cancer-related lymphedema patient with poor short-stretch bandage compliance after 1-month intervention. If the intervention period was prolonged, we might get different conclusion. Moreover, these two treatment protocols are inefficient and cost time in application. More efficient treatment protocol is needed for clinical practice.

  13. Breast cancer related lymphedema in patients with different loco-regional treatments.

    Science.gov (United States)

    Ozcinar, Beyza; Guler, Sertac Ata; Kocaman, Nazmiye; Ozkan, Mine; Gulluoglu, Bahadir M; Ozmen, Vahit

    2012-06-01

    Lymphedema, a sequela of breast cancer and breast cancer therapy, changes functional abilities and may affect a patient's psychosocial adjustment and overall quality of life. Aim of this prospective observational study was to determine the rate of mid-term and late time period lymphedema in breast cancer patients with different loco-regional treatments, and factors associated with lymphedema. Patients surgically treated for early-stage breast cancer were prospectively enrolled in the study. Demographic, clinical, pathological, and loco-regional treatments data of patients and lymphedema rates were recorded. Patients were divided into six groups regarding different loco-regional treatments. Pre- and postoperative (12 months, and median 64 months after surgery) circumferences of arms were recorded. 218 patients, all female with a median age of 48 (19-82) years, were included in the study. The numbers of patients in breast conservation surgery group (BCS) (N=104), mastectomy group (N=114), sentinel lymph node biopsy group (SLNB) (N=80), axillary lymph node dissection group (ALND) (N=138), group with radiotherapy (RT) (N=88) and group without radiotherapy (N=130). Incidence of lymphedema after surgery in mid-term period was 24.8%. The rate of lymphedema at 64 months median follow-up time was 7.3%. (BCS: 11.1%, 4.2% and 0.5%; Mastectomy: 15.0%, 3.2% and 1.4%; SLNB: 8.0%, 1.9% and 0.5%; ALND: 18.0%, 5.3% and 1.4%; RT: 14.7%, 6.3% and 1.4%; without RT: 11.4%, 2.1% and 0.5%). When we excluded patients with both mid-term and late term lymphedema, only four patients developed lymphedema at late time, then re-calculated late term lypmhedema rate was 1.8%. The factors affecting the lymphedema was ALND and radiotherapy (RT) and no lymphedema was detected in patients underwent breast conserving surgery and SLNB. Age and body mass index were not related to lymphedema at any time. The incidence of lymphedema gradually increased in time and a quarter of patients experienced the

  14. Association Between Precautionary Behaviors and Breast Cancer-Related Lymphedema in Patients Undergoing Bilateral Surgery.

    Science.gov (United States)

    Asdourian, Maria S; Swaroop, Meyha N; Sayegh, Hoda E; Brunelle, Cheryl L; Mina, Amir I; Zheng, Hui; Skolny, Melissa N; Taghian, Alphonse G

    2017-10-04

    Purpose This study examined the lifestyle and clinical risk factors for lymphedema in a cohort of patients who underwent bilateral breast cancer surgery. Patients and Methods Between 2013 and 2016, 327 patients who underwent bilateral breast cancer surgery were prospectively screened for arm lymphedema as quantified by the weight-adjusted volume change (WAC) formula. Arm perometry and subjective data were collected preoperatively and at regular intervals postoperatively. At the time of each measurement, patients completed a risk assessment survey that reported the number of blood draws, injections, blood pressure readings, trauma to the at-risk arm, and number of flights since the previous measurement. Generalized estimating equations were applied to ascertain the association among arm volume changes, clinical factors, and risk exposures. Results The cohort comprised 327 patients and 654 at-risk arms, with a median postoperative follow-up that ranged from 6.1 to 68.2 months. Of the 654 arms, 83 developed lymphedema, defined as a WAC ≥ 10% relative to baseline. On multivariable analysis, none of the lifestyle risk factors examined through the risk assessment survey were significantly associated with increased WAC. Multivariable analysis demonstrated that having a body mass index ≥ 25 kg/m(2) at the time of breast cancer diagnosis ( P = .0404), having undergone axillary lymph node dissection ( P = .0464), and receipt of adjuvant chemotherapy ( P = .0161) were significantly associated with increased arm volume. Conclusion Blood pressure readings, blood draws, injections, and number or duration of flights were not significantly associated with increases in arm volume in this cohort. These findings may help to guide patient education about lymphedema risk reduction strategies for those who undergo bilateral breast cancer surgery.

  15. Breast and gynecologic cancer-related extremity lymphedema: a review of diagnostic modalities and management options

    Science.gov (United States)

    2013-01-01

    Lymphedema remains a poorly understood entity that can occur after lymphadenectomy. Herein, we will review the pathogenesis of lymphedema, diagnostic modalities and the natural history of extremity involvement. We will review the incidence of upper extremity lymphedema in patients treated for breast malignancies and lower extremity lymphedema in those treated for gynecologic malignancy. Finally, we will review traditional treatment modalities for lymphedema, as well as introduce new surgical treatment modalities that are under active investigation. PMID:24053624

  16. Breast and gynecologic cancer-related extremity lymphedema: a review of diagnostic modalities and management options

    OpenAIRE

    Tiwari, Pankaj; Coriddi, Michelle; Salani, Ritu; Povoski, Stephen P.

    2013-01-01

    Lymphedema remains a poorly understood entity that can occur after lymphadenectomy. Herein, we will review the pathogenesis of lymphedema, diagnostic modalities and the natural history of extremity involvement. We will review the incidence of upper extremity lymphedema in patients treated for breast malignancies and lower extremity lymphedema in those treated for gynecologic malignancy. Finally, we will review traditional treatment modalities for lymphedema, as well as introduce new surgical ...

  17. A Comparative Analysis of Genetic and Epigenetic Events of Breast and Ovarian Cancer Related to Tumorigenesis

    Directory of Open Access Journals (Sweden)

    Mckenna Longacre

    2016-05-01

    Full Text Available Breast cancer persists as the most common cause of cancer death in women worldwide. Ovarian cancer is also a significant source of morbidity and mortality, as the fifth leading cause of cancer death among women. This reflects the continued need for further understanding and innovation in cancer treatment. Though breast and ovarian cancer usually present as distinct clinical entities, the recent explosion of large-scale -omics research has uncovered many overlaps, particularly with respect to genetic and epigenetic alterations. We compared genetic, microenvironmental, stromal, and epigenetic changes common between breast and ovarian cancer cells, as well as the clinical relevance of these changes. Some of the most striking commonalities include genetic alterations of BRCA1 and 2, TP53, RB1, NF1, FAT3, MYC, PTEN, and PIK3CA; down regulation of miRNAs 9, 100, 125a, 125b, and 214; and epigenetic alterations such as H3K27me3, H3K9me2, H3K9me3, H4K20me3, and H3K4me. These parallels suggest shared features of pathogenesis. Furthermore, preliminary evidence suggests a shared epigenetic mechanism of oncogenesis. These similarities, warrant further investigation in order to ultimately inform development of more effective chemotherapeutics, as well as strategies to circumvent drug resistance.

  18. Prolonged Response and Restoration of Functional Independence with Bevacizumab plus Vinorelbine as Third-Line Treatment for Breast Cancer-Related Leptomeningeal Metastases

    Directory of Open Access Journals (Sweden)

    Emilie Le Rhun

    2015-02-01

    Full Text Available Background: Survival of patients with leptomeningeal metastases (LM and impaired functional status is limited to several months, and rarely does neurological function improve with treatment. Case Report: A 34-year-old female with hormone-negative and HER2-positive metastatic breast cancer was diagnosed with bulky radiographic LM 45 months after initial diagnosis. She was treated with intra-CSF trastuzumab followed by intra-CSF liposomal cytarabine; however, the cancer progressed 8 months after the diagnosis of LM. At the time of the third LM progression, the patient presented with a cauda equina syndrome and cerebellar impairment resulting in an inability to walk. She was treated with CNS-directed radiotherapy (lumbosacral and cerebellar and bevacizumab plus vinorelbine. Rapid functional improvement occurred, and the patient regained the ability to walk and independently manage her daily activities. Twelve months later, she presented with rapid progression of the LM resulting in death within several weeks. Conclusion: In radiographically defined bulky LM, the combination of systemic therapy and CNS-directed radiotherapy likely is more active than intra-CSF therapy only. In lieu of the rapid and significant improvement in neurological function combined with the prolonged response, bevacizumab alone or in combination with chemotherapy and CNS-directed radiotherapy may be considered in select patients with radiographically bulky breast cancer-related LM.

  19. Return to work after early-stage breast cancer : A cohort study into the effects of treatment and cancer-related symptoms

    NARCIS (Netherlands)

    Balak, Fulya; Roelen, Corne A. M.; Koopmans, Petra C.; ten Berge, Elike E.; Groothoff, Johan W.

    Introduction Earlier diagnosis and better treatment have increased the survival rates of cancer patients. This warrants research on return to work of cancer survivors. What is the return to work rate following early-stage breast cancer? What is the effect of the type of treatment and cancer-related

  20. The Importance of Awareness and Education in Patients with Breast Cancer-Related Lymphedema.

    Science.gov (United States)

    Borman, Pınar; Yaman, Ayşegül; Yasrebi, Sina; Özdemir, Oya

    2017-09-01

    Upper extremity lymphedema occurs in one of five women after breast cancer treatment and causes significant morbidity. Women often report being uninformed regarding awareness of lymphedema and other side effects after the cancer surgery. The aim of the study was to assess the postoperative information and education about lymphedema in patients with lymphedema related to breast cancer surgery in the rehabilitation unit of a tertiary hospital. One hundred eighty patients who had admitted to lymphedema rehabilitation unit between September 2013 and February 2015 were recruited to the study. The demographic properties of women, duration, and grade of lymphedema were recorded. The patients were asked whether they had received any information about awareness of lymphedema or whether they have been educated for reducement of the risk of lymphedema after the breast cancer surgery. One hundred eighty women with a mean age of 52.9 ± 10.7 years (27-53) and with a mean lymphedema duration of 19.8 ± +39.4 months were included. Ninety-eight (54.4 %) patients had grade 1, 80 (44.4 %) patients had grade 2, and 2 (1.11 %) patients had grade 3 lymphedema. Among the participants, only 35 (19.5 %) had reported that they had received information or education about lymphedema. One hundred forty-five patients (80.5 %) were not informed or trained about the development of lymphedema. The degree and duration of lymphedema were lower in patients that had been informed or educated about lymphedema as compared to the patients who had not been informed or educated, but the difference was not statistically significant (p = 0.052). Only a minor group of patients (19 %) had received information and education about lymphedema and there is an unmet need for education or information about lymphedema after breast cancer treatment, especially in developing countries. The nonsignificant correlation between education and the degree and duration of lymphedema was thought to be

  1. Cancer-related fatigue and depression in breast cancer patients postchemotherapy: Different associations with optimism and stress appraisals.

    Science.gov (United States)

    Levkovich, Inbar; Cohen, Miri; Pollack, Shimon; Drumea, Karen; Fried, Georgeta

    2015-10-01

    Symptoms of depression and cancer-related fatigue (CRF) are common among breast cancer patients postchemotherapy and may seriously impair quality of life (QoL). This study aimed to assess the relationship between depression and CRF in breast cancer patients postchemotherapy and to examine their relationships to optimism and to threat and challenge appraisals. Participants included 95 breast cancer patients (stages 1-3) 1 to 6 months after completion of chemotherapy. Patients submitted personal and medical details and completed the following: physical symptom questionnaires (EORTC QLQ-C30, and QLQ-BR23), a symptoms of depression questionnaire (CES-D), the Fatigue Symptom Inventory (FSI), the Life Orientation Test (LOT-R), and a stress appraisals questionnaire. We found levels of depression, CRF, and appraisals of cancer as a threat to bemoderate and levels of optimism and appraisals of cancer as a challenge to be high. Depression and CRF were positively associated. A multivariate regression analysis revealed that 51% of the CRF variancewas explained; physical symptoms and threat appraisal were significantly associated with CRF. A 67% of the CRF variance of depression was explained; challenge and threat appraisals were significantly associated with depression [corrected]. Although CRF and depression were often experienced simultaneously and both were found to be higher among individuals who gave higher appraisals of cancer as a threat, only depression was related to optimism and challenge appraisals, while CRF was related mainly to intensity of physical symptoms. The different pattern of associations between optimism and appraisals warrants further clinical attention as well as future study.

  2. Transcription Factor EB Expression in Early Breast Cancer Relates to Lysosomal/Autophagosomal Markers and Prognosis.

    Science.gov (United States)

    Giatromanolaki, Alexandra; Sivridis, Efthimios; Kalamida, Dimitra; Koukourakis, Michael I

    2017-06-01

    Disrupting the autophagic balance to trigger autophagic death may open new strategies for cancer therapy. Transcription factor EB (TFEB) is a master regulator of lysosomal biogenesis and may play a role in cancer biology and clinical behavior. The expression of TFEB and the lysosomal cancer cell content (expression of lysosomal associated membrane protein 2a [LAMP2a] and cathepsin D) was studied in a series of 100 T1-stage breast carcinomas. Expression patterns were correlated with autophagy/hypoxia-related proteins, angiogenesis, and clinical outcome. The effect of hypoxic/acidic conditions on TFEB kinetics was studied in the MCF-7 cancer cell line. Overexpression of TFEB in cancer cell cytoplasm and the perinuclear/nuclear area was noted in 23 (23%) of 100 cases. High LAMP2a and cathepsin D expression was noted in 30 (30%) of 100 and 28 (28%) of 100 cases, respectively. TFEB expression was directly linked with LAMP2a (P breast carcinomas, define poor prognosis. Tumor acidity is among the microenvironmental conditions that trigger TFEB overactivity. TFEB is a sound target for the development of lysosomal targeting therapies. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Extracorporeal Shock Wave Therapy for Breast Cancer-Related Lymphedema: A Pilot Study.

    Science.gov (United States)

    Cebicci, Mehtap Aykac; Sutbeyaz, Serap Tomruk; Goksu, Sema Sezgin; Hocaoglu, Sehriban; Oguz, Arzu; Atilabey, Ayse

    2016-09-01

    To investigate the clinical effect of extracorporeal shock wave therapy (ESWT) in patients with secondary lymphedema after breast cancer treatment. Prospective clinical pilot study. Education and research hospital. Women with a diagnosis of lymphedema secondary to breast cancer (N=11). Patients were treated for 12 sessions of ESWT with 2500 impulses each. The treatment frequency was 4Hz in multiple shock mode. The energy flow density during treatment was equal to a working pressure of 2 bar. The primary outcome measure was volumetric measurements. The secondary outcome measures were the short version of the Disabilities of the Arm, Shoulder and Hand Questionnaire (QuickDASH) and the brief version of the World Health Organization Quality of Life (WHOQOL-BREF). Assessments were conducted by the same investigator at baseline, posttreatment, and at 1, 3, and 6 months after treatment for all patients. Significant reduction was found in the amount of lymphedema with ESWT treatment in all patients, and this reduction was maintained for 6 months. A statistically significant reduction was observed in volumetric measurements for the follow-up period (P=.001). The mean volume displacement of the affected upper extremity before treatment was 870.45±384.19mL at 6 months, and after the treatment it was 604.54±381.74mL. In addition, improvements were observed in the QuickDASH functional assessment tool and in the physical health domain of the WHOQOL-BREF questionnaire (P=.002 and P=.007, respectively). ESWT was shown to provide a reduction in the amount of lymphedema in patients with lymphedema secondary to breast cancer. Also, a marked improvement was observed in the functional status and quality of life of study patients. Treatment efficacy was maintained in the long term. As a noninvasive, novel, and effective method, ESWT is a promising treatment modality for the treatment of lymphedema, which is a chronic, progressive, and refractory condition. Copyright © 2016 American

  4. Using traditional acupuncture for breast cancer-related hot flashes and night sweats.

    Science.gov (United States)

    de Valois, Beverley A; Young, Teresa E; Robinson, Nicola; McCourt, Christine; Maher, Elizabeth J

    2010-10-01

    Women taking tamoxifen experience hot flashes and night sweats (HF&NS); acupuncture may offer a nonpharmaceutical method of management. This study explored whether traditional acupuncture (TA) could reduce HF&NS frequency, improve physical and emotional well-being, and improve perceptions of HF&NS. DESIGN/SETTINGS/LOCATION: This was a single-arm observational study using before and after measurements, located in a National Health Service cancer treatment center in southern England. Fifty (50) participants with early breast cancer completed eight TA treatments. Eligible women were ≥ 35 years old, ≥ 6 months post active cancer treatment, taking tamoxifen ≥ 6 months, and self-reporting ≥ 4 HF&NS incidents/24 hours for ≥ 3 months. Participants received weekly individualized TA treatment using a core standardized protocol for treating HF&NS in natural menopause. Hot Flash Diaries recorded HF&NS frequency over 14-day periods; the Women's Health Questionnaire (WHQ) assessed physical and emotional well-being; the Hot Flashes and Night Sweats Questionnaire (HFNSQ) assessed HF&NS as a problem. Measurements taken at five points over 30 weeks included baseline, midtreatment, end of treatment (EOT), and 4 and 18 weeks after EOT. Results for the primary outcome: Mean frequency reduced by 49.8% (95% confidence interval 40.5-56.5, p acupuncture to manage HF&NS, as well as research on nonhormonal pharmaceutical treatments. In addition to reduced HF&NS frequency, women enjoyed improved physical and emotional well-being, and few side-effects were reported. Further research is warranted into this approach, which offers breast cancer survivors choice in managing a chronic condition.

  5. L-dex ratio in detecting breast cancer-related lymphedema: reliability, sensitivity, and specificity.

    Science.gov (United States)

    Fu, M R; Cleland, C M; Guth, A A; Kayal, M; Haber, J; Cartwright, F; Kleinman, R; Kang, Y; Scagliola, J; Axelrod, D

    2013-06-01

    Advances in bioelectrical impedance analysis (BIA) permit the assessment of lymphedema by directly measuring lymph fluid changes. The objective of the study was to examine the reliability, sensitivity, and specificity of cross-sectional assessment of BIA in detecting lymphedema in a large metropolitan clinical setting. BIA was used to measure lymph fluid changes. Limb volume by sequential circumferential tape measurement was used to validate the presence of lymphedema. Data were collected from 250 women, including healthy female adults, breast cancer survivors with lymphedema, and those at risk for lymphedema. Reliability, sensitivity, specificity and area under the ROC curve were estimated. BIA ratio, as indicated by L-Dex ratio, was highly reliable among healthy women (ICC=0.99; 95% CI = 0.99 - 0.99), survivors at-risk for lymphedema (ICC=0.99; 95% CI = 0.99 - 0.99), and all women (ICC=0.85; 95% CI = 0.81 - 0.87); reliability was acceptable for survivors with lymphedema (ICC=0.69; 95% CI = 0.54 to 0.80). The L-Dex ratio with a diagnostic cutoff of >+7.1 discriminated between at-risk breast cancer survivors and those with lymphedema with 80% sensitivity and 90% specificity (AUC=0.86). BIA ratio was significantly correlated with limb volume by sequential circumferential tape measurement. Cross-sectional assessment of BIA may have a role in clinical practice by adding confidence in detecting lymphedema. It is important to note that using a cutoff of L-Dex ratio >+7.1 still misses 20% of true lymphedema cases, it is important for clinicians to integrate other assessment methods (such as self-report, clinical observation, or perometry) to ensure the accurate detection of lymphedema.

  6. Manual lymphatic drainage therapy in patients with breast cancer related lymphoedema.

    Science.gov (United States)

    Martín, Marta López; Hernández, Miguel A; Avendaño, Cristina; Rodríguez, Francisco; Martínez, Helena

    2011-03-09

    Lymphoedema is a common and troublesome condition that develops following breast cancer treatment. The aim of this study is to analyze the effectiveness of Manual Lymphatic Drainage in the treatment of postmastectomy lymphoedema in order to reduce the volume of lymphoedema and evaluate the improvement of the concomitant symptomatology. A randomized, controlled clinical trial in 58 women with post-mastectomy lymphoedema. The control group includes 29 patients with standard treatment (skin care, exercise and compression measures, bandages for one month and, subsequently, compression garments). The experimental group includes 29 patients with standard treatment plus Manual Lymphatic Drainage. The therapy will be administered daily for four weeks and the patient's condition will be assessed one, three and six months after treatment.The primary outcome parameter is volume reduction of the affected arm after treatment, expressed as a percentage. Secondary outcome parameters include: duration of lymphoedema reduction and improvement of the concomitant symptomatology (degree of pain, sensation of swelling and functional limitation in the affected extremity, subjective feeling of being physically less attractive and less feminine, difficulty looking at oneself naked and dissatisfaction with the corporal image). The results of this study will provide information on the effectiveness of Manual Lymphatic Drainage and its impact on the quality of life and physical limitations of these patients. ClinicalTrials (NCT): NCT01152099.

  7. Association of coping style, cognitive errors and cancer-related variables with depression in women treated for breast cancer.

    Science.gov (United States)

    Alcalar, Nilufer; Ozkan, Sedat; Kucucuk, Seden; Aslay, Isik; Ozkan, Mine

    2012-10-01

    The purpose of this study was to examine the correlation between depression levels with coping styles and cognitive errors in women treated for breast cancer. A total of 110 breast cancer outpatients who had had surgery at least 6 months previously, had completed adjuvant cancer treatment and had not experienced metastasis or recurrent lesions were evaluated. The Automatic Thoughts Questionnaire, Cognitive Errors Questionnaire, Mental Adjustment to Cancer Scale and Beck Depression Inventory were administered to all patients. Semi-structured interview forms were used to obtain medical and demographic data. All patients were categorized into depression and non-depression groups according to their Beck Depression Inventory scores. The study protocol was approved by the Medical Ethics Committee of Istanbul University Oncology Institute. Higher cognitive errors and automatic thought scores were found in the depression group. Fighting spirit was found to be the primary coping style used in the non-depression group, while helplessness/hopelessness, anxious/preoccupation and fatalism were the coping styles used the most in the depression group. No association between depression and socio-demographic (except for educational level) and cancer-related variables was detected. However, it was found that automatic thoughts, cognitive errors, education level, fighting spirit and anxious/preoccupation are important indicators of depression in our sample. A causal relationship exists between depression and a patient's cognitive patterns and accompanying anxiety. The degree of depression is inversely related to both fighting spirit coping type and educational level. If clinicians take this into consideration, diagnosing and treating depression will be more effective.

  8. Cancer-Related Fatigue in Women With Breast Cancer: Outcomes of a 5-Year Prospective Cohort Study.

    LENUS (Irish Health Repository)

    Goldstein, David

    2012-04-16

    PURPOSEProlonged and disabling fatigue is prevalent after cancer treatment, but the early natural history of cancer-related fatigue (CRF) has not been systematically examined to document consistent presence of symptoms. Hence, relationships to cancer, surgery, and adjuvant therapy are unclear. PATIENTS AND METHODSA prospective cohort study of women receiving adjuvant treatment for early-stage breast cancer was conducted. Women (n = 218) were enrolled after surgery and observed at end treatment and at 1, 3, 6, 9, and 12 months as well as 5 years. Structured interviews and self-report questionnaires were used to record physical and psychologic health as well as disability and health care utilization. Patients with CRF persisting for 6 months were assessed to exclude alternative medical and psychiatric causes of fatigue. Predictors of persistent fatigue, mood disturbance, and health care utilization were sought by logistic regression.ResultsThe case rate for CRF was 24% (n = 51) postsurgery and 31% (n = 69) at end of treatment; it became persistent in 11% (n = 24) at 6 months and 6% (n = 12) at 12 months. At each time point, approximately one third of the patients had comorbid mood disturbance. Persistent CRF was predicted by tumor size but not demographic, psychologic, surgical, or hematologic parameters. CRF was associated with significant disability and health care utilization. CONCLUSIONCRF is common but generally runs a self-limiting course. Much of the previously reported high rates of persistent CRF may be attributable to factors unrelated to the cancer or its treatment.

  9. Biomechanical Properties of the Skin in Patients with Breast Cancer-Related Lymphedema Compared to Healthy Individuals.

    Science.gov (United States)

    Killaars, R C; Penha, T R Lopez; Heuts, E M; van der Hulst, R R J W; Piatkowski, A A

    2015-09-01

    Biomechanical skin changes in breast cancer-related lymphedema (BRCL) have barely been described and objectively tested. This study aims to compare the skin of upper limb lymphedema with skin of the healthy contralateral arm, in order to demonstrate changes of elasticity, viscoelasticity, and level of hydration of the skin in BCRL. The secondary aim is to investigate the correlation between biomechanical skin changes and measurements that are currently used in clinical practice, such as volume measurement and lymph-ICF score. Eighteen patients with BCRL and 18 healthy individuals were included in the study. A Cutometer® was used for measurements for skin elasticity and viscoelasticity on both arms of each subject. A Corneometer® was used for measurements of skin hydration. Measurements of both test groups were compared. In BCRL patients, there was a significant difference (p = elasticity of the skin of the lymphedema arm compared to the healthy contralateral arm. There were no significant differences for level of skin hydration or viscoelasticity in lymphedema patients between the measurements on the skin of the lymphedematous and healthy arm. In healthy individuals, there were no significant differences for all measurements between skin of both arms. Spearman's correlation was significant (p = elasticity in BCRL patients. This study shows an impaired elasticity for the skin of the lower arm in patients with lymphedema compared to the contralateral healthy arm. Promising evidence is suggested for the use of the Cutometer device in the diagnostic evaluation of BCRL.

  10. Efficacy and safety of Wuling San for treatment of breast-cancer-related upper extremity lymphoedema: study protocol for a pilot trial

    OpenAIRE

    Zhu, Huiru; PENG, ZHENG; Dai, Meiyu; Zou, Yan; Qin, Fengxian; Chen, Jifei; Song, Liuying; He, Baoyu; Lv, Xiaolan; Dai, Shengming

    2016-01-01

    Introduction Breast-cancer-related upper extremity lymphoedema (BCUL), a common complication of mastectomy, can cause physical discomfort, psychological distress, cosmetic defects, functional disability and chronic recurrent erysipelas in the affected arm(s). It is a challenge to physicians involved in the management of these patients. Wuling San, a classic prescription in Traditional Chinese Medicine used in treating oedema for thousands of years, is reported by many Chinese journals to perf...

  11. Higher vascular endothelial growth factor-C concentration in plasma is associated with increased forearm capillary filtration capacity in breast cancer-related lymphedema

    DEFF Research Database (Denmark)

    Jensen, Mads Radmer; Simonsen, Lene; Karlsmark, Tonny

    2015-01-01

    shown that the forearm capillary filtration coefficient (CFC) is increased bilaterally in BCRL. In this study, we aimed to elucidate if increased CFC is associated with low-grade inflammation and/or vascular endothelial growth factor-c (VEGF-C) signaling. Fourteen patients with unilateral BCRL and nine......Breast cancer-related lymphedema (BCRL) is a frequent, chronic and debilitating swelling that mainly affects the ipsilateral arm and develops as a complication to breast cancer treatment. The pathophysiology is elusive opposing development of means for prediction and treatment. We have earlier...... increased forearm CFC in BCRL subjects. Interstitially increased MCP-1 levels may augment local microvascular protein permeability in BCRL....

  12. A comprehensive review of bioimpedance spectroscopy as a diagnostic tool for the detection and measurement of breast cancer-related lymphedema.

    Science.gov (United States)

    Seward, Cara; Skolny, Melissa; Brunelle, Cheryl; Asdourian, Maria; Salama, Laura; Taghian, Alphonse G

    2016-10-01

    As treatment for breast cancer improves and the threat of life-long chronic lymphedema becomes more prevalent, the need for effective screening tools emerges as crucial. This review was conducted using literature beginning in 1992 to analyze primary research testing the accuracy of bioimpedance spectroscopy as a diagnostic and early detection tool for breast cancer-related lymphedema. We concluded bioimpedance is an accurate diagnostic tool for pre-existent lymphedema, however, it has not been validated for early detection. J. Surg. Oncol. 2016;114:537-542. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  13. Changes in arm tissue composition with slowly progressive weight-lifting among women with breast cancer-related lymphedema.

    Science.gov (United States)

    Zhang, Xiaochen; Brown, Justin C; Paskett, Electra D; Zemel, Babette S; Cheville, Andrea L; Schmitz, Kathryn H

    2017-07-01

    Studies in breast cancer-related lymphedema (BRCL) have exclusively examined total arm volume, but not the specific tissue composition that contributes to total volume. We evaluated baseline differences in arm tissue composition [fat mass, lean mass, bone mineral content (BMC), and bone mineral density (BMD)] between the affected and unaffected arms in women with BRCL. We compared changes in arm tissue composition and self-reported lymphedema symptoms after 1 year of weight-lifting versus control. We utilized data from physical activity and lymphedema trial that included 141 women with BRCL. Arm tissue composition was quantified using dual-energy X-ray absorptiometry. The severity of lymphedema was quantified using self-report survey. Weight-lifting was performed at community fitness facilities. At baseline, the affected arm had more fat (∆ = 89.7 g; P composition of the affected arm was improved: lean mass (71.2 g; P = 0.01) and BMD (14.0 mg/cm 2 ; P = 0.02) increased, arm fat percentage decreased (-1.5%; P = 0.003). Composition of the unaffected arm was only improved in lean mass (65.2 g; P = 0·04). Increases in lean mass were associated with less severe BCRL symptoms. Among women with BRCL, slowly progressive weight-lifting could improve arm tissue composition. Changes in arm tissue composition predict changes in symptom burden. Investigating the combined effects of exercise and weight loss on arm tissue composition and BCRL symptoms may provide additional insight into the benefits of lifestyle modification on lymphedema biology.

  14. Can the Cancer-related Fatigue Case-definition Criteria Be Applied to Chronic Medical Illness? A Comparison between Breast Cancer and Systemic Sclerosis.

    Science.gov (United States)

    Kwakkenbos, Linda; Minton, Ollie; Stone, Patrick C; Alexander, Susanna; Baron, Murray; Hudson, Marie; Thombs, Brett D

    2015-07-01

    Fatigue is a crucial determinant of quality of life across rheumatic diseases, but the lack of agreed-upon standards for identifying clinically significant fatigue hinders research and clinical management. Case definition criteria for cancer-related fatigue were proposed for inclusion in the International Classification of Diseases. The objective was to evaluate whether the cancer-related fatigue case definition performed equivalently in women with breast cancer and systemic sclerosis (SSc) and could be used to identify patients with chronic illness-related fatigue. The cancer-related fatigue interview (case definition criteria met if ≥ 5 of 9 fatigue-related symptoms present with functional impairment) was completed by 291 women with SSc and 278 women successfully treated for breast cancer. Differential item functioning was assessed with the multiple indicator multiple cause model. Items 3 (concentration) and 10 (short-term memory) were endorsed significantly less often by women with SSc compared with cancer, controlling for responses on other items. Omitting these 2 items from the case definition and requiring 4 out of the 7 remaining symptoms resulted in a similar overall prevalence of cancer-related fatigue in the cancer sample compared with the original criteria (37.4% vs 37.8%, respectively), with 97.5% of patients diagnosed identically with both definitions. Prevalence of chronic illness-related fatigue was 36.1% in SSc using 4 of 7 symptoms. The cancer-related fatigue criteria can be used equivalently to identify patients with chronic illness-related fatigue when 2 cognitive fatigue symptoms are omitted. Harmonized definitions and measurement of clinically significant fatigue will advance research and clinical management of fatigue in rheumatic diseases and other conditions.

  15. Biased cognitive processing of cancer-related information among women with family histories of breast cancer: evidence from a cancer stroop task.

    Science.gov (United States)

    Erblich, Joel; Montgomery, Guy H; Valdimarsdottir, Heiddis B; Cloitre, Marylene; Bovbjerg, Dana H

    2003-05-01

    Stimuli associated with sources of stress have been shown to interfere with cognition. The authors hypothesized that women with the stress of having a family history of breast cancer (FH+) would exhibit greater interference on a task with cancer-related stimuli than women without cancer in the family (FH-). The authors developed a modified Stroop color-naming task to test this hypothesis in a sample of FH+ (n = 72) and FH- (n = 96) women. Consistent with the hypotheses, FH+ women had longer color-naming times and more errors (ps cancer word list relative to noncancer lists. This biased processing was not mediated by the significantly higher perceived risk, general distress, or cancer-specific distress in FH+ women. Maladaptive alterations in processing cancer stimuli may have important clinical implications, as these women must process complex cancer-related information critical to their health (e.g., options for chemoprevention, screening).

  16. Effects of an expressive writing intervention on cancer-related distress in Danish breast cancer survivors - results from a nationwide randomized clinical trial.

    Science.gov (United States)

    Jensen-Johansen, M B; Christensen, S; Valdimarsdottir, H; Zakowski, S; Jensen, A B; Bovbjerg, D H; Zachariae, R

    2013-07-01

    To examine the effects of an expressive writing intervention (EWI) on cancer-related distress, depressive symptoms, and mood in women treated for early stage breast cancer. A nationwide sample of 507 Danish women who had recently completed treatment for primary breast cancer were randomly assigned to three 20-min home-based writing exercises, one week apart, focusing on either emotional disclosure (EWI group) or a non-emotional topic (control group). Cancer-related distress [Impact of Event Scale (IES)], depressive symptoms (Beck Depression Inventory-Short Form), and negative (37-item Profile of Moods State) and positive mood (Passive Positive Mood Scale) were assessed at baseline and at 3 and 9 months post-intervention. Choice of writing topic (cancer versus other), alexithymia (20-item Toronto Alexithymia Scale), and social constraints (Social Constraints Scale) were included as possible moderators. Significant (pwriting topic moderated effects on IES, with women writing about other themes showing greater reductions in cancer-related avoidance than women writing about their cancer. Fewer depressive symptoms and higher levels of positive mood were seen 3 months post-intervention in women writing about their cancer when compared with the control group. Difficulties describing feelings and externally oriented thinking (20-item Toronto Alexithymia Scale) moderated effects on positive mood and IES-total, while no moderating effects were found of social constraints. In concordance with the majority of previous results with cancer patients, no main effects of EWI were found for cancer-related distress, depressive symptoms, and mood. Moderator analyses suggested that choice of writing topic and ability to process emotional experiences should be studied further. Copyright © 2012 John Wiley & Sons, Ltd.

  17. A Methodology for Cancer Therapeutics by Systems Pharmacology-Based Analysis: A Case Study on Breast Cancer-Related Traditional Chinese Medicines.

    Directory of Open Access Journals (Sweden)

    Yan Li

    Full Text Available Breast cancer is the most common carcinoma in women. Comprehensive therapy on breast cancer including surgical operation, chemotherapy, radiotherapy, endocrinotherapy, etc. could help, but still has serious side effect and resistance against anticancer drugs. Complementary and alternative medicine (CAM may avoid these problems, in which traditional Chinese medicine (TCM has been highlighted. In this section, to analyze the mechanism through which TCM act on breast cancer, we have built a virtual model consisting of the construction of database, oral bioavailability prediction, drug-likeness evaluation, target prediction, network construction. The 20 commonly employed herbs for the treatment of breast cancer were used as a database to carry out research. As a result, 150 ingredient compounds were screened out as active molecules for the herbs, with 33 target proteins predicted. Our analysis indicates that these herbs 1 takes a 'Jun-Chen-Zuo-Shi" as rule of prescription, 2 which function mainly through perturbing three pathways involving the epidermal growth factor receptor, estrogen receptor, and inflammatory pathways, to 3 display the breast cancer-related anti-estrogen, anti-inflammatory, regulation of cell metabolism and proliferation activities. To sum it up, by providing a novel in silico strategy for investigation of the botanical drugs, this work may be of some help for understanding the action mechanisms of herbal medicines and for discovery of new drugs from plants.

  18. Case report: Manual lymphatic drainage and kinesio taping in the secondary malignant breast cancer-related lymphedema in an arm with arteriovenous (A-V) fistula for hemodialysis.

    Science.gov (United States)

    Chou, Ya-Hui; Li, Shu-Hua; Liao, Su-Fen; Tang, Hao-Wei

    2013-08-01

    Lymphedema is a dreaded complication of breast cancer treatment. The standard care for lymphedema is complex decongestive physiotherapy, which includes manual lymphatic drainage (MLD), short stretch bandaging, exercise, and skin care. The Kinesio Taping could help to improve lymphatic uptake. We reported a patient with unilateral secondary malignant breast cancer-related lymphedema and arteriovenous (A-V) fistula for hemodialysis happened in the same arm, and used kinesio taping, MLD, and exercise to treat this patient because no pressure could be applied to the A-V fistula. The 12-session therapy created an excellent effect. We do not think the kinesio taping could replace short stretch bandaging, but it could be another choice for contraindicating pressure therapy patients, and we should pay attention to wounds induced by kinesio tape.

  19. Effects of physical exercise during adjuvant breast cancer treatment on physical and psychosocial dimensions of cancer-related fatigue: A meta-analysis.

    Science.gov (United States)

    van Vulpen, Jonna K; Peeters, Petra H M; Velthuis, Miranda J; van der Wall, Elsken; May, Anne M

    2016-03-01

    Cancer-related fatigue has a multidimensional nature and complaints typically increase during adjuvant treatment for breast cancer. Physical exercise might prevent or reduce cancer-related fatigue. So far, no meta-analysis has investigated the effects of physical exercise on different dimensions of fatigue. The aim of the present meta-analysis was to investigate the effects of physical exercise during adjuvant breast cancer treatment on physical and psychosocial dimensions of fatigue. We performed a systematic literature search in PubMed, Embase and the Cochrane Library in June 2015. Randomised controlled trials reporting the effects of physical exercise during adjuvant breast cancer treatment on different dimensions of fatigue were included. Pooled effects of 6 exercise programmes (including 784 patients) showed significant beneficial exercise effects on general fatigue (ES: -0.22, 95% CI -0.38; -0.05) and physical fatigue (ES: -0.35, 95% CI -0.49; -0.21). Effects on fatigue subscales 'reduced activity' (ES: -0.22, 95% CI -0.38; -0.05) and 'reduced motivation' (ES: -0.18, 95% CI -0.35; -0.01) were also in favour of physical exercise. No effects were found on cognitive and affective fatigue. Including only the supervised exercise programmes (n=4 studies), slightly larger pooled effect estimates were found on general fatigue (ES: -0.25, 95% CI -0.47; -0.04) and physical fatigue (-0.39, 95% CI -0.56; -0.23). In conclusion, physical exercise during adjuvant breast cancer treatment has beneficial effects on general fatigue, physical fatigue, 'reduced activity' and 'reduced motivation', but did not show effects on cognitive and affective fatigue. Largest effect sizes are found for physical fatigue, suggesting that this is the fatigue dimension most sensitive to physical exercise. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  20. Effects of manual lymphatic drainage on breast cancer-related lymphedema: a systematic review and meta-analysis of randomized controlled trials

    Science.gov (United States)

    2013-01-01

    Background Lymphedema is a common complication of axillary dissection for breast cancer. We investigated whether manual lymphatic drainage (MLD) could prevent or manage limb edema in women after breast-cancer surgery. Methods We performed a systematic review and meta-analysis of published randomized controlled trials (RCTs) to evaluate the effectiveness of MLD in the prevention and treatment of breast-cancer-related lymphedema. The PubMed, EMBASE, CINAHL, Physiotherapy Evidence Database (PEDro), SCOPUS, and Cochrane Central Register of Controlled Trials electronic databases were searched for articles on MLD published before December 2012, with no language restrictions. The primary outcome for prevention was the incidence of postoperative lymphedema. The outcome for management of lymphedema was a reduction in edema volume. Results In total, 10 RCTs with 566 patients were identified. Two studies evaluating the preventive outcome of MLD found no significant difference in the incidence of lymphedema between the MLD and standard treatment groups, with a risk ratio of 0.63 and a 95% confidence interval (CI) of 0.14 to 2.82. Seven studies assessed the reduction in arm volume, and found no significant difference between the MLD and standard treatment groups, with a weighted mean difference of 75.12 (95% CI, −9.34 to 159.58). Conclusions The current evidence from RCTs does not support the use of MLD in preventing or treating lymphedema. However, clinical and statistical inconsistencies between the various studies confounded our evaluation of the effect of MLD on breast-cancer-related lymphedema. PMID:23347817

  1. Development and pilot testing of a decision aid for men considering genetic testing for breast and/or ovarian cancer-related mutations (BRCA1/2).

    Science.gov (United States)

    Juan, Anne S; Wakefield, Claire E; Kasparian, Nadine A; Kirk, Judy; Tyler, Janet; Tucker, Kathy

    2008-12-01

    Despite the fact that both men and women can carry a breast/ovarian cancer-related mutation, the main emphasis in genetic counseling for breast/ovarian cancer-related risk remains on females. This study aimed to develop and pilot a decision aid specifically designed for men with a strong family history of breast and/or ovarian cancer who are considering genetic testing. The decision aid was developed by a multidisciplinary team of experts and a consumer representative. It was then reviewed by 27 men who had previously undergone genetic testing to identify a mutation in a BRCA1 or BRCA2 gene. All men who reviewed the decision aid indicated that they would recommend the booklet to other men in the same situation, and 96% of the sample (n = 26) reported being "very satisfied" or "satisfied" with the information contained in the decision aid. The decision aid was perceived by all participants as "very relevant" or "quite relevant" for men considering genetic testing. Ninety-three percent of men felt that it was easy to weigh the pros and cons of genetic testing with the help of the decision aid. The perceived impact on participants' emotions and understanding of the genetic testing process was also assessed. Several factors may hinder men from effectively weighing up the potential benefits and risks of genetic testing. A greater understanding of these issues may help health professionals to encourage men with a strong family history of breast and/or ovarian cancer to learn about cancer risk and the appropriate management strategies for themselves and their female relatives.

  2. PAX5О± and PAX5ОІ mRNA expression in breast Cancer: Relation ...

    African Journals Online (AJOL)

    Manal Basyouni Ahmed

    Background: Many studies evaluated the role of paired box gene 5 (PAX5) in breast cancer. However, few investigated PAX5a and PAX5b isoforms individually. Objective: The aim of the present study is to evaluate. mRNA expression of PAX5a and PAX5b in breast cancer and assessing their underlying pathological roles.

  3. Efficacy of low-frequency low-intensity electrotherapy in the treatment of breast cancer-related lymphoedema: a cross-over randomized trial.

    Science.gov (United States)

    Belmonte, Roser; Tejero, Marta; Ferrer, Montse; Muniesa, Josep Maria; Duarte, Esther; Cunillera, Oriol; Escalada, Ferran

    2012-07-01

    To compare the efficacy of low-frequency low-intensity electrotherapy and manual lymphatic drainage in the treatment of chronic upper limb breast cancer-related lymphoedema. Cross-over single-blind random clinical trial. Rehabilitation service. Thirty-six women with chronic upper limb breast cancer-related lymphoedema. Patients were randomized to undergo 10 sessions of manual lymphatic drainage followed by 10 sessions of low-frequency low-intensity electrotherapy or to undergo first low-frequency low-intensity electrotherapy followed by manual lymphatic drainage. There was a month of washout time between treatments. Each patient was examined just before and after each treatment. Researchers and outcome assessors were blinded for assigned treatment. Outcomes were lymphoedema volume, pain, heaviness and tightness, and health-related quality of life measured with the Functional Assessment of Cancer Therapy Questionnaire for Breast Cancer version 4 (FACT-B+4). Carry-over, period and treatment effects were analysed. Treatment effect was assessed using paired t-test. Thirty patients finalized treatment. Comparing the changes in low-frequency low-intensity electrotherapy with manual lymphatic drainage changes, there were no significant differences. Low-frequency low-intensity electrotherapy did not reduce lymphoedema volume (mean of change = 19.77 mL, P = 0.36), but significant reductions were observed in pain, heaviness and tightness (mean of change = 13.1, 16.2 and 6.4 mm, respectively), and FACT-B+4 summaries improved significantly (Trial Outcome Index mean of change = 5.4, P = 0.015). Manual lymphatic drainage showed no significant changes in any of the outcomes Although there are no significant differences between treatment changes, the observed trend towards a better health-related quality of life is remarkable in low-frequency low-intensity electrotherapy.

  4. The effectiveness of a deep water aquatic exercise program in cancer-related fatigue in breast cancer survivors: a randomized controlled trial.

    Science.gov (United States)

    Cantarero-Villanueva, Irene; Fernández-Lao, Carolina; Cuesta-Vargas, Antonio I; Del Moral-Avila, Rosario; Fernández-de-Las-Peñas, César; Arroyo-Morales, Manuel

    2013-02-01

    To investigate the effectiveness of an 8-week aquatic program on cancer-related fatigue, as well as physical and psychological outcomes in breast cancer survivors. A randomized controlled trial. Outpatient clinic, urban, academic medical center, and a sport university swimming pool. Breast cancer survivors (N=68) were randomly assigned to either an experimental (aquatic exercise group in deep water pool) group or a control (usual care) group. The intervention group attended aquatic exercise sessions 3 times per week for 8 weeks in a heated deep swimming pool. Sessions lasted 60 minutes in duration: 10 minutes of warm-up, 40 minutes of aerobic and endurance exercises, and 10 minutes of cool-down exercises. Patients allocated to the usual care group followed the oncologist's recommendations in relation to a healthy lifestyle. Values for fatigue (Piper Fatigue Scale), mood state (Profile of Mood States), and abdominal (trunk curl static endurance test) and leg (multiple sit-to-stand test) strength were collected at baseline, after the last treatment session, and at a 6-month follow-up. Immediately after discharge, the aquatic exercise group showed a large effect size in total fatigue score (d=.87; 95% confidence interval, .48-1.26), trunk curl endurance (d=.92; 95% confidence interval, 1.97-3.83), and leg strength (d=1.10; .55-2.76), but negligible effects in vigor, confusion, and disturbance of mood (daquatic exercise group maintained large to small effect sizes in fatigue scores, multiple sit-to-stand test, and trunk curl static endurance (.25>d>.90) and negligible effects for the fatigue-severity dimension and different scales of the Profile of Mood States (daquatic exercise program conducted in deep water was effective for improving cancer-related fatigue and strength in breast cancer survivors. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  5. Factors associated with cancer-related fatigue in breast cancer patients undergoing endocrine therapy in an urban setting: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Huang Xu

    2010-08-01

    Full Text Available Abstract Background Fatigue is prevalent in breast cancer survivors and has profound effects on daily life. The interference of fatigue with endocrine therapy may be difficult to separate. This study investigates the prevalence and severity of fatigue and identifies the demographic, clinical, and lifestyle factors associated with cancer-related fatigue (CRF in breast cancer patients undergoing endocrine therapy in an urban area. Methods Women with stage I-IIIA breast cancer were recruited and asked to participate (n = 371 in the study. The 315 women who responded to the questionnaire (84.9%, 54 (17.1% had completed endocrine therapy and 261 (82.9% were still undergoing endocrine therapy. The patients had been diagnosed at an average of 31 months prior to recruitment (range, 7 to 60 months; the average age was 48 (range, 33 to 72 years. The 11-point scale and Visual Analog Scale (VAS were employed to quantify the level of fatigue experienced by the patients. Logistic regression analyses and a trend test method were performed to evaluate factors associated with CRF. Results Among the 315 patients, 189 (60% had experienced or were experiencing CRF during endocrine therapy. Logistic regression analysis was performed to identify factors associated with CRF, including BMI (body mass index, clinical stage, menopausal status, duration of endocrine therapy, physical activity, and diet. Factors unrelated to CRF were age, marital status, treatment, endocrine therapy drugs, alcohol intake, and smoking. The trend test method revealed an association between physical activity and dietary level and the intensity of CRF. Conclusions The present findings suggest that fatigue is an important problem in the majority of breast cancer patients during endocrine therapy. We found that BMI, clinical stage, menopausal status, duration of endocrine therapy, physical activity, and diet are associated with fatigue. Future research should focus on the impact factors of CRF

  6. European Commission Initiative on Breast Cancer: Concept document

    OpenAIRE

    ULUTURK TEKIN ASLI; AMBROSIO MASSIMO; BOCCHI GIULIA; BRAMESFELD ANKE; DEANDREA SILVIA; DIMITROVA NADYA; LERDA DONATA; PYLKKANEN LIISA; SAZ PARKINSON ZULEIKA ESTHER; TORIGHELLI BEATRIZ

    2017-01-01

    The European Commission Initiative on Breast Cancer (ECIBC) is aimed at ensuring and harmonising breast cancer services quality across European countries. It is coordinated by Commission’s Joint Research Centre, under the supervision of the Directorate-General Health and Food Safety. This document describes the background of the initiative, its general goals and objectives, and its foreseen outcomes.

  7. Radiation therapy targets and the risk of breast cancer-related lymphedema: a systematic review and network meta-analysis.

    Science.gov (United States)

    Shaitelman, Simona F; Chiang, Yi-Ju; Griffin, Kate D; DeSnyder, Sarah M; Smith, Benjamin D; Schaverien, Mark V; Woodward, Wendy A; Cormier, Janice N

    2017-04-01

    New indications have been found for regional nodal irradiation (RNI) in breast cancer treatment, yet the relationship of RNI and lymphedema risk is uncertain. We sought to determine the association of RNI and lymphedema. We searched MEDLINE, EMBASE, and Scopus for articles in English on humans published from 1995 to 2015, using search terms breast neoplasm, treatment, and morbidity. Two investigators independently selected articles and extracted information, including manuscripts reporting incidence of lymphedema by radiation targets. Meta-analyses, review papers, case-control studies, matched-pair studies, repetitive datasets, and retrospective studies were excluded. A total of 2399 abstracts were identified and 323 corresponding articles reviewed. Twenty-one studies met inclusion criteria. Data were pooled using a random effects mixed model. Network meta-analyses were performed to determine the association of radiation targets alone and radiation targets plus extent of axillary surgery on incidence of lymphedema. The addition of RNI to breast/CW irradiation was associated with an increased incidence of lymphedema (OR 2.85; 95% CI 1.24-6.55). In patients treated with sentinel lymph node biopsy or axillary sampling, there was no association of lymphedema with the addition of RNI to breast/CW irradiation (OR 1.58; 95% CI 0.54-4.66; pooled incidence 5.7 and 4.1%, respectively). Among patients treated with axillary lymph node dissection (ALND), treatment with RNI in addition to breast/CW radiation was associated with a significantly higher risk of lymphedema (OR 2.74; 95% CI 1.38-5.44; pooled incidence 18.2 and 9.4%, respectively). RNI is associated with a significantly higher risk of lymphedema than irradiation of the breast/CW, particularly after ALND.

  8. Effects of Kinesio Taping on breast cancer-related lymphedema: A meta-analysis in clinical trials.

    Science.gov (United States)

    Kasawara, Karina Tamy; Mapa, Jéssica Monique Rossetti; Ferreira, Vilma; Added, Marco Aurélio Nemitalla; Shiwa, Silvia Regina; Carvas, Nelson; Batista, Patricia Andrade

    2018-05-01

    Lymphedema is known as a secondary complication of breast cancer treatment, caused by reduction on lymphatic flow and lymph accumulation on interstitial space. The Kinesio Taping (KT) has become an alternative treatment for lymphedema volume reduction. The objective of the study was to evaluate the literature through a systematic review on KT effects on lymphedema related to breast cancer. Search strategies were performed by the following keywords: "Kinesio Taping," "Athletic Tape," "Cancer," "Neoplasm," "Lymphedema," and "Mastectomy" with derivations and different combinations. The following databases were accessed: SCIELO, LILACS, MEDLINE via PubMed, and PEDro, between 2009 and 2016. Studies published in English, Portuguese, and Spanish were considered for inclusion. The studies' methodological quality was assessed by the PEDro scale. Seven studies were identified by the search strategy and eligibility. All of them showed positive effect in reducing lymphedema (perimeter or volume) before versus after treatment. However, with no effects comparing the KT versus control group or others treatments (standardized mean difference = 0.04, confidence interval 95%: -0.24; 0.33), the average score of the PEDro scale was 4.71 points. KT was effective on postmastectomy lymphedema related to breast cancer; however, it is not more efficient than other treatments.

  9. Lymphatic venous anastomosis (LVA) for treatment of secondary arm lymphedema. A prospective study of 11 LVA procedures in 10 patients with breast cancer related lymphedema and a critical review of the literature

    NARCIS (Netherlands)

    Damstra, R. J.; Voesten, H. G. J.; van Schelven, W. D.; van der Lei, B.

    Objective The incidence of breast cancer related lymphedema (BCRL) varies between 7-35% depending on the combination of treatment modalities. Early detection of BCRL is crucial in order to start an effective non-operative treatment program. Because of the lack of prospective research on this topic,

  10. Multi-analyte profiling and pathway analysis of plasma for proteins associated with cancer-related fatigue syndrome in disease-free breast cancer patients after primary treatment.

    Science.gov (United States)

    Minton, O; Coulton, G R; Stone, P

    2014-12-01

    A significant number of women treated for breast cancer develop long-term fatigue afterwards. Previous research has suggested that fatigue may be due to a prolonged inflammatory response. However, there are conflicting results and the exact nature of the disturbance remains unclear. To identify inflammatory markers associated with fatigue. We recruited women from a breast cancer follow-up clinic and categorised them on the basis of a diagnostic interview as to whether they met the criteria for cancer-related fatigue syndrome (cases) or not (controls). We took plasma samples from each participant to analyse subsequently using a panel of 88 biological markers. 90 samples were analysed in total (45 cases and 45 controls). A factorial analysis of variance (using age as a fixed factor) demonstrated a number of differences in inflammatory cytokines. There were 28 significantly different analytes in total. Granulocyte colony stimulating factor was the most significantly different analyte (pfatigue syndrome is associated with an increased pro-inflammatory immune response. Our findings indicate that these cytokine changes could underpin the subjective symptoms, such as perceived muscle weakness and concentration difficulties, experienced by women who feel fatigued after treatment. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  11. Factors influencing initiation and duration of breast feeding in Ireland.

    LENUS (Irish Health Repository)

    Leahy-Warren, Patricia

    2013-03-05

    The aim of this research was to identify factors associated with mothers breast feeding and to identify, for those who breast fed, factors associated with breast feeding for as long as planned. BACKGROUND: breast-feeding rates in Ireland are amongst the lowest in Europe. Research evidence indicates that in order for mothers to be successful at breast feeding, multiplicities of supports are necessary for both initiation and duration. The nature of these supports in tandem with other influencing factors requires analysis from an Irish perspective. DESIGN: cross-sectional study involving public health nurses and mothers in Ireland. This paper presents the results of the mothers\\' evaluation. METHOD: mothers (n=1715) with children less than three years were offered a choice of completing the self-report questionnaires online or by mail. Data were analysed and reported using descriptive and inferential statistics. FINDINGS: four in every five participants breast fed their infant and two thirds of them breast fed as long as planned. The multivariate logistic regression analysis identified that third level education, being a first time mother or previously having breast fed, participating online, having more than two public health nurse visits, and having a positive infant feeding attitude were independently and statistically significantly associated with breast feeding. Among mothers who breast fed, being aged at least 35 years, participating online, having a positive infant feeding attitude and high breast-feeding self-efficacy were independently and statistically significantly associated with breast feeding for as long as planned. CONCLUSIONS: findings from this study reinforce health inequalities therefore there needs to be a renewed commitment to reducing health inequalities in relation to breast feeding. RELEVANCE TO CLINICAL PRACTICE: this study has identified factors associated with initiation and duration of breast feeding that are potentially modifiable through

  12. Tc-99m-Human Serum Albumin Transit Time as a Measure of Arm Breast Cancer-Related Lymphedema

    DEFF Research Database (Denmark)

    Toyserkani, Navid M; Hvidsten, Svend; Tabatabaeifar, Siavosh

    2017-01-01

    BACKGROUND: Lymphoscintigraphy has often been used for evaluating arm lymphatic dysfunction, but no optimal approach for quantification has so far emerged. We propose a quantifiable measure of lymphatic function that we applied in patients treated for breast cancer. METHODS: Eleven patients, aged...... based on time activity curves generated from injection site and arm regions. Visual lymphedema scoring was performed based on dermal backflow and lymph node presence. Excess arm volume was calculated from circumference measurements. RESULTS: The MTT (mean ± SD) was significantly longer in the lymphedema......, 18.6-68.7 minutes; P Measurements of MTT were able to discriminate lymphedema from...

  13. Doxycycline attenuates breast cancer related inflammation by decreasing plasma lysophosphatidate concentrations and inhibiting NF-κB activation.

    Science.gov (United States)

    Tang, Xiaoyun; Wang, Xianyan; Zhao, Yuan Y; Curtis, Jonathan M; Brindley, David N

    2017-02-08

    We previously discovered that tetracyclines increase the expression of lipid phosphate phosphatases at the surface of cells. These enzymes degrade circulating lysophosphatidate and therefore doxycycline increases the turnover of plasma lysophosphatidate and decreases its concentration. Extracellular lysophosphatidate signals through six G protein-coupled receptors and it is a potent promoter of tumor growth, metastasis and chemo-resistance. These effects depend partly on the stimulation of inflammation that lysophosphatidate produces. In this work, we used a syngeneic orthotopic mouse model of breast cancer to determine the impact of doxycycline on circulating lysophosphatidate concentrations and tumor growth. Cytokine/chemokine concentrations in tumor tissue and plasma were measured by multiplexing laser bead technology. Leukocyte infiltration in tumors was analyzed by immunohistochemistry. The expression of IL-6 in breast cancer cell lines was determined by RT-PCR. Cell growth was measured in Matrigel™ 3D culture. The effects of doxycycline on NF-κB-dependent signaling were analyzed by Western blotting. Doxycycline decreased plasma lysophosphatidate concentrations, delayed tumor growth and decreased the concentrations of several cytokines/chemokines (IL-1β, IL-6, IL-9, CCL2, CCL11, CXCL1, CXCL2, CXCL9, G-CSF, LIF, VEGF) in the tumor. These results were compatible with the effects of doxycycline in decreasing the numbers of F4/80+ macrophages and CD31+ blood vessel endothelial cells in the tumor. Doxycycline also decreased the lysophosphatidate-induced growth of breast cancer cells in three-dimensional culture. Lysophosphatidate-induced Ki-67 expression was inhibited by doxycycline. NF-κB activity in HEK293 cells transiently expressing a NF-κB-luciferase reporter vectors was also inhibited by doxycycline. Treatment of breast cancer cells with doxycycline also decreased the translocation of NF-κB to the nucleus and the mRNA levels for IL-6 in the presence or

  14. Are compression corsets beneficial for the treatment of breast cancer-related lymphedema? New opportunities in physiotherapy treatment – a preliminary report

    Directory of Open Access Journals (Sweden)

    Hansdorfer-Korzon R

    2016-04-01

    Full Text Available Rita Hansdorfer-Korzon,1 Jacek Teodorczyk,2 Agnieszka Gruszecka,3 Piotr Lass2,4 1Department of Physiotherapy, 2Department of Nuclear Medicine, 3Department of Informatics and Statistics, 4Department of Molecular Spectroscopy, Institute of Experimental Physics, Gdansk, Poland Introduction: Treatment of secondary lymphedema still remains an important medical issue. Treatment response is characterized by periodic remission rather than complete recovery. Compression methods currently used as part of complete decongestive therapy vary considerably in efficacy. Manual drainage, bandaging, and compression pumps are ineffective in everyday practice. Positive results have increasingly been reported where compression garments have been used as part of the treatment. This pilot study demonstrates a beneficial effect following the use of compression corsets in the treatment of edema in breast cancer-related lymphedema (BCRL. Material: A total of 35 women with BCRL were enrolled. Of these, 29 patients completed the study. Methods: Ultrasound (B-mode was used to evaluate lymphedema in the side of the chest after mastectomy. This test was performed three times at a specific site on the operated side and symmetrically on the opposite side. Subsequently, patients were fit with an appropriate compression corset. The data were then statistically analyzed. Conclusion: After the surgical treatment of breast cancer, lymphatic fluid reservoirs may form at the side of the chest. The use of carefully selected compression corsets is an effective treatment for BCRL. Corsets are an important item, which we recommend should be included in compression clothing sets. We anticipate this finding will form the foundation for further work on the use of modern compression garments for the treatment of BCRL as well as contribute to the limited number of published reports that exist on the subject. Keywords: lymphedema, breast cancer, physical therapy

  15. Contrast-Enhancing Meningeal Lesions Are Associated with Longer Survival in Breast Cancer-Related Leptomeningeal Metastasis.

    Science.gov (United States)

    Regierer, Anne Constanze; Stroux, Andrea; Kühnhardt, Dagmar; Dieing, Annette; Lehenbauer-Dehm, Silvia; Flath, Bernd; Possinger, Kurt; Eucker, Jan

    2008-01-01

    BACKGROUND: Leptomeningeal metastasis (LM) is a devastating complication of advanced cancer. Despite aggressive therapy survival is very poor. METHODS: Data of all breast cancer patients with LM were retrospectively analyzed (n = 27). RESULTS: Median survival was 9 weeks. Patients with contrast-enhancing meningeal lesions (n = 11) detected by MRI had a median survival of 33 weeks versus 8 weeks for patients without contrast-enhancing lesions (n = 9; p = 0.0407). Patients who received systemic chemotherapy (n = 18) had a median survival of 15 weeks versus 7 weeks (n = 9; p = 0.0106). Patients undergoing radiotherapy (n = 8) had a median survival of 17 weeks as compared to 5 weeks for patients without radiotherapy (n = 18; p = 0.0188). In a multiple Cox regression analysis, lack of systemic therapy (hazard ratio, HR 89.5; p = 0.002) and negative hormone receptor status (HR 4.2; p = 0.027) emerged as significant main risk factors, together with contrast-enhancing lesion as effect modifier for systemic therapy (p = 0.03). CONCLUSION: Contrast-enhancing meningeal lesions, systemic therapy, and radiotherapy were significantly associated with longer survival. Patients with contrast-enhancing lesions who were treated systemically had the longest survival. Evidence is increasing that systemic therapy plays an important role and should be applied in breast cancer patients with LM.

  16. Randomized controlled pilot trial of mindfulness-based stress reduction for breast and colorectal cancer survivors: effects on cancer-related cognitive impairment.

    Science.gov (United States)

    Johns, Shelley A; Von Ah, Diane; Brown, Linda F; Beck-Coon, Kathleen; Talib, Tasneem L; Alyea, Jennifer M; Monahan, Patrick O; Tong, Yan; Wilhelm, Laura; Giesler, R Brian

    2016-06-01

    Cancer-related cognitive impairment (CRCI) is a common, fatigue-related symptom that disrupts cancer survivors' quality of life. Few interventions for CRCI exist. As part of a randomized pilot study targeting cancer-related fatigue, the effects of mindfulness-based stress reduction (MBSR) on survivors' cognitive outcomes were investigated. Breast and colorectal cancer survivors (n = 71) with moderate-to-severe fatigue were randomized to MBSR (n = 35) or a fatigue education and support (ES; n = 36) condition. The Attentional Function Index (AFI) and the Stroop test were used to assess survivors' cognitive function at baseline (T1), after the 8-week intervention period (T2), and 6 months later (T3) using intent-to-treat analysis. Mediation analyses were performed to explore mechanisms of intervention effects on cognitive functioning. MBSR participants reported significantly greater improvement on the AFI total score compared to ES participants at T2 (d = 0.83, p = 0.001) and T3 (d = 0.55, p = 0.021). MBSR also significantly outperformed ES on most AFI subscales, although both groups improved over time. MBSR produced greater Stroop accuracy rates relative to ES at T2 (r = 0.340, p = 0.005) and T3 (r = 0.280, p = 0.030), with improved accuracy over time only for the MBSR group. There were no significant differences in Stroop reaction time between groups. Improvements in mindfulness mediated the effect of group (e.g., MBSR vs. ES) on AFI total score at T2 and T3. Additional randomized trials with more comprehensive cognitive measures are warranted to definitively assess the efficacy of MBSR for CRCI. This pilot study has important implications for all cancer survivors as it is the first published trial to show that MBSR offers robust and durable improvements in CRCI.

  17. Factors associated with professional healthcare advice seeking in women at risk for developing breast cancer-related lymphedema.

    Science.gov (United States)

    Sherman, Kerry A; Kilby, Christopher J; Elder, Elisabeth; Ridner, Sheila H

    2017-10-18

    Approximately 6-20% of breast cancer patients undergoing lymph node surgery will develop lymphedema. At-risk individuals are encouraged to seek professional healthcare advice if symptoms arise. This study aimed to identify cognitive and affective factors associated with professional healthcare advice (PHCA) seeking behavior in women with heightened lymphedema risk. Women with increased lymphedema risk (N=462) completed an online survey measuring cognitive and affective responses to lymphedema risk, including the Illness Perception Questionnaire (Revised), and adherence to seeking PHCA. Overall, 62% of women reported seeking professional healthcare advice if symptoms arose. Logistic regression analysis indicated that adherence to seeking PHCA if lymphedema symptoms arise was associated with greater illness coherence, belief in the efficacy of seeking PHCA, and lymphedema risk-related emotional distress. Women were more likely to seek PHCA if symptoms arose if they held a coherent understanding of lymphedema and believed in the usefulness of seeking PHCA. For these women, psychological distress associated with lymphedema risk was associated with enhanced adherence to seeking PHCA. Health professionals should target lymphedema education to ensure at-risk women have a coherent understanding of lymphedema and that they believe in the effectiveness of seeking PHCA to help manage lymphedema symptoms. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. Correlation among bioimpedance analysis, sonographic and circumferential measurement in assessment of breast cancer-related arm lymphedema.

    Science.gov (United States)

    Choi, Y H; Seo, K S

    2014-09-01

    New approaches for assessment of lymphedema using ultrasonography (US) have been introduced recently and are reported to be reliable and simple. Ultrasonography provides detailed information about physical properties of the tissue in addition to volume and size. There have been only limited studies comparing bioimpedance analysis (BIA), US, and circumferential measurement (CM), which is considered a standard measurement. The aim of this study was to determine the relationship between US, BIA, and CM. Twenty-eight patients with lymphedema after breast cancer surgery underwent BIA, US, and CM. Impedance, which reflects the amount of extracellular fluid, was measured with 1 kHz frequency in affected and unaffected arms. Circumferences were measured at 10cm proximal and distal to the elbow and a truncated cone method used to calculate estimated volumes for upper arm and forearm. We found that interlimb forearm subcutis thickness differences measured by US were highly correlated with CM measurements and that interlimb upper arm subcutis thickness differences measured by US were moderately correlated with CM measurements and BIA ratios. However, the interlimb ratio of compressibility measured by US showed no or only weak correlation with impedance measurements and circumferential measurements. Our results also show that compressibility measured by US could not be predicted from BIA or CM measurements despite a high degree of concordance among subcutis thickness measured by US, CM, and BIA.

  19. Supermicrosurgical deep lymphatic vessel-to-venous anastomosis for a breast cancer-related arm lymphedema with severe sclerosis of superficial lymphatic vessels.

    Science.gov (United States)

    Yamamoto, Takumi; Yamamoto, Nana; Hayashi, Akitatsu; Koshima, Isao

    2017-02-01

    Lymphatic supermicrosurgery or supermicrosurgical lymphaticovenular anastomosis (LVA) is becoming popular for the treatment of compression-refractory upper extremity lymphedema (UEL) with its effectiveness and minimally invasiveness. In conventional LVA, superficial lymphatic vessels are used for anastomosis, but its treatment efficacy would be minimum when superficial lymphatic vessels are severely sclerotic. Theoretically, deep lymphatic vessels can be used for LVA, but no clinical case has been reported regarding deep lymphatic vessel-to-venous anastomosis (D-LVA). We report a breast cancer-related UEL case treated with D-LVA, in which a less-sclerotic deep lymphatic vessel was useful for anastomosis but superficial lymphatic vessels were not due to severe sclerosis. A 62-year-old female suffered from an 18-year history of compression-refractory right UEL after right breast cancer treatments, and underwent LVA under local infiltration anesthesia. Because superficial lymphatic vessels found in surgical fields were all severely sclerotic, a deep lymphatic vessel was dissected at the cubital fossa. A 0.50-mm deep lymphatic vessel running along the brachial artery was supermicrosurgically anastomosed to a nearby 0.40-mm vein. At postoperative 12 months, her right UEL index decreased from 134 to 118, and she could reduce compression frequency from every day to 1-2 days per week to maintain the reduced lymphedematous volume. D-LVA may be a useful option for the treatment of compression-refractory UEL, when superficial lymphatic vessels are severely sclerotic. © 2015 Wiley Periodicals, Inc. Microsurgery 37:156-159, 2017. © 2015 Wiley Periodicals, Inc.

  20. The Impact of L-Dex® Measurements in Assessing Breast Cancer Related Lymphedema (BCRL as Part of Routine Clinical Practice

    Directory of Open Access Journals (Sweden)

    Alison L. Laidley, MD

    2016-09-01

    Full Text Available Purpose: With improved survivorship, the prevalence of breast cancer related lymphedema (BCRL continues to increase, leading to impairment of a patients’ quality of life. While traditional diagnostic methods are limited by an inability to detect BCRL until clinically apparent, bioimpedance spectroscopy (BIS has been shown to detect subclinical BCRL. The purpose of this study is to evaluate the role of BIS in the early detection of BCRL as well as assessment of response to BCRL treatment. Methods: A retrospective review of 1,133 patients treated between November 2008 and July 2013 at two surgical practices was performed. Eligible patients (n=326 underwent pre-operative and post-operative L-Dex measurements. Patients were identified as having subclinical lymphedema if they were asymptomatic and the L-Dex score increased > 10 units above baseline and were monitored following treatment. Patients were stratified by lymph node dissection technique (SLNB vs. ALND and receipt of BCRL treatment.Results: The average age of the cohort was 56.2 years old and mean follow-up was 21.7 months. Of the 326 patients, 210 underwent SLNB and 116 underwent ALND. BCRL was identified by L-Dex in 40 patients (12.3%. The cumulative incidence rate of subclinical lymphedema was 4.3% for SLNB (n=9 and 26.7% for ALND (n=31. Of those diagnosed with BCRL, 50% resolved following treatment, 27.5% underwent treatment without resolution, and 22.5% had resolution without treatment. The prevalence of persistent, clinical BCRL was 0.5% for SLNB and 8.6% for ALND.Conclusions: This study demonstrates both the feasibility and clinical utility of implementing L-Dex measurements in routine breast cancer care. L-Dex identified patients with possible subclinical BCRL and allowed for assessment of response to therapy.

  1. A pilot randomized trial evaluating low-level laser therapy as an alternative treatment to manual lymphatic drainage for breast cancer-related lymphedema.

    Science.gov (United States)

    Ridner, Sheila H; Poage-Hooper, Ellen; Kanar, Collin; Doersam, Jennifer K; Bond, Stewart M; Dietrich, Mary S

    2013-07-01

    To examine the impact of advanced practice nurse (APN)-administered low-level laser therapy (LLLT) as both a stand-alone and complementary treatment for arm volume, symptoms, and quality of life (QOL) in women with breast cancer-related lymphedema. A three-group, pilot, randomized clinical trial. A private rehabilitation practice in the southeastern United States. 46 breast cancer survivors with treatment-related lymphedema. Patients were screened for eligibility and then randomized to either manual lymphatic drainage (MLD) for 40 minutes, LLLT for 20 minutes, or 20 minutes of MLD followed by 20 minutes of LLLT. Compression bandaging was applied after each treatment. Data were collected pretreatment, daily, weekly, and at the end of treatment. Independent variables consisted of three types of APN-administered lymphedema treatment. Outcome variables included limb volume, extracellular fluid, psychological and physical symptoms, and QOL. No statistically significant between-group differences were found in volume reduction; however, all groups had clinically and statistically significant reduction in volume. No group differences were noted in psychological and physical symptoms or QOL; however, treatment-related improvements were noted in symptom burden within all groups. Skin improvement was noted in each group that received LLLT. LLLT with bandaging may offer a time-saving therapeutic option to conventional MLD. Alternatively, compression bandaging alone could account for the demonstrated volume reduction. APNs can effectively treat lymphedema. APNs in private healthcare practices can serve as valuable research collaborators. Lasers may provide effective, less burdensome treatment for lymphedema. APNs with lymphedema certification can effectively treat this patient population with the use of LLLT. In addition, bioelectrical impedance and tape measurements can be used to assess lymphedema.

  2. Yoga for improving health-related quality of life, mental health and cancer-related symptoms in women diagnosed with breast cancer.

    Science.gov (United States)

    Cramer, Holger; Lauche, Romy; Klose, Petra; Lange, Silke; Langhorst, Jost; Dobos, Gustav J

    2017-01-03

    Breast cancer is the cancer most frequently diagnosed in women worldwide. Even though survival rates are continually increasing, breast cancer is often associated with long-term psychological distress, chronic pain, fatigue and impaired quality of life. Yoga comprises advice for an ethical lifestyle, spiritual practice, physical activity, breathing exercises and meditation. It is a complementary therapy that is commonly recommended for breast cancer-related impairments and has been shown to improve physical and mental health in people with different cancer types. To assess effects of yoga on health-related quality of life, mental health and cancer-related symptoms among women with a diagnosis of breast cancer who are receiving active treatment or have completed treatment. We searched the Cochrane Breast Cancer Specialised Register, MEDLINE (via PubMed), Embase, the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 1), Indexing of Indian Medical Journals (IndMED), the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) search portal and Clinicaltrials.gov on 29 January 2016. We also searched reference lists of identified relevant trials or reviews, as well as conference proceedings of the International Congress on Complementary Medicine Research (ICCMR), the European Congress for Integrative Medicine (ECIM) and the American Society of Clinical Oncology (ASCO). We applied no language restrictions. Randomised controlled trials were eligible when they (1) compared yoga interventions versus no therapy or versus any other active therapy in women with a diagnosis of non-metastatic or metastatic breast cancer, and (2) assessed at least one of the primary outcomes on patient-reported instruments, including health-related quality of life, depression, anxiety, fatigue or sleep disturbances. Two review authors independently collected data on methods and results. We expressed outcomes as standardised mean differences (SMDs

  3. Efficacy and safety of Wuling San for treatment of breast-cancer-related upper extremity lymphoedema: study protocol for a pilot trial.

    Science.gov (United States)

    Zhu, Huiru; Peng, Zheng; Dai, Meiyu; Zou, Yan; Qin, Fengxian; Chen, Jifei; Song, Liuying; He, Baoyu; Lv, Xiaolan; Dai, Shengming

    2016-12-16

    Breast-cancer-related upper extremity lymphoedema (BCUL), a common complication of mastectomy, can cause physical discomfort, psychological distress, cosmetic defects, functional disability and chronic recurrent erysipelas in the affected arm(s). It is a challenge to physicians involved in the management of these patients. Wuling San, a classic prescription in Traditional Chinese Medicine used in treating oedema for thousands of years, is reported by many Chinese journals to perform well in BCUL. Therefore, the aim of this study is to verify its efficacy and evaluate its safety using rigorous methodological designs in patients with BCUL. To verify the efficacy and assess the safety of Wuling San over a placebo, this double-blind, randomised, placebo-controlled, multicentre trial will be carried out in three hospitals. A total of 200 eligible patients with BCUL will be randomly allocated, in a ratio of 1:1, to either the experimental medicine group or the placebo group. The primary outcome measure will be the proportion of absolute reduced limb volume, as measured by perometry. The second outcome measure will be the number of participants with adverse events. The assessment will be carried out at the following time points: before enrolment (baseline) and 2, 4, 6 and 8 weeks after treatment. This trial will be conducted in accordance with the Declaration of Helsinki and supervised by the institutional review board of the Fourth Affiliated Hospital of Guangxi Medical University (approval number PJK2016088). All patients will receive information about the trial in verbal and written forms and will give informed consent before enrolment. This trial will help to demonstrate whether Wuling San is effective in the treatment of patients with BCUL. The results will be published in peer-reviewed journals or disseminated through conference presentations. NCT02726477; Pre-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted

  4. Assessment of segmental arm soft tissue composition in breast cancer-related lymphedema: a pilot study using dual energy X-ray absorptiometry and bioimpedance spectroscopy.

    Science.gov (United States)

    Czerniec, Sharon Anne; Ward, Leigh C; Meerkin, Jarrod D; Kilbreath, Sharon L

    2015-03-01

    Changes in arm soft tissue composition, especially increased adipose tissue, has been found in advanced, non-pitting breast cancer-related lymphedema (BCRL). The aim of this study was to examine whether these changes were localized to any particular region of the arm and whether they occurred in lymphedema which still pitted to pressure. Secondary aims were to explore relationships between arm segment volumes, bioimpedance spectroscopy (BIS) measurements of extracellular fluid (ECF), and dual-energy X-ray absorptiometry (DXA) measurements of tissue composition. Nine women with unilateral BCRL participated. The dominant arm was affected in 4 women, and all presented with lymphedema that pitted to pressure. Arm volume was calculated from circumferences by the truncated cone method, ECF was determined with BIS and fat and lean tissue content measured by DXA. BIS and DXA measurements for women with lymphedema were made of the whole arm and also of four 10 cm-segments measured from the ulnar styloid at the wrist. Whole arm DXA data were compared to those of 45 women of similar age and body mass index without lymphedema. All women with lymphedema had a significantly larger absolute fat mass in their affected arm compared to their unaffected arm, (median difference between arms 146.9 g). The forearm segment 10 - 20 cm proximal to the wrist had the highest median inter-limb fat difference of all four arm segments. The soft tissue composition changes associated with BCRL may occur in the presence of pitting and predominantly affect the proximal forearm.

  5. Transcriptome analysis of basal and luminal tumor-initiating cells in ErbB2-driven breast cancer

    Directory of Open Access Journals (Sweden)

    Nicholas Borcherding

    2015-06-01

    Full Text Available Breast cancer is the leading cause of cancer-related mortality for females worldwide [1]. Improving early screening strategies and understanding the events that lead to tumor initiation have led to demonstrable improvements in clinical outcome. Our previous work revealed a variance in the tumorigenic capacity between different mammary epithelial cell populations in an MMTV-ErbB2 mouse model. In order to greater understand how different mammary epithelial cells influence the tumorigenic capacity in ErbB2-induced breast cancer, we transplanted different cell populations from pre-neoplastic MMTV-ErbB2 female mice into recipient mice for tumorigenic study. We found that different mammary epithelial cells bear different tumorigenic potentials even when induced by the same ErbB2 proto-oncogene. To understand the difference in tumors formed from different epithelial cells, we performed gene expression profiling using these tumors (GSE64487. Several genes were further validated using real-time reverse transcription polymerase chain reaction (RT-PCR. Here we provide further details on the experimental methods and microarray analysis. This data provides a resource to further understanding how different mammary cell populations can initiate ErbB2-driven tumors and the role of these cell populations as putative tumor-initiating cells (TICs.

  6. Diffusion magnetic resonance imaging of breast lesions: Initial ...

    African Journals Online (AJOL)

    Hebatallah Hassan Mamdouh Hassan

    2013-03-31

    Mar 31, 2013 ... Conclusion: DWI shows potential for improving the PPV of breast MRI for detection of malig- nant breast lesions. Recommendation: ... Radiologists who practice breast imaging have long known that the field provides ... detection of breast cancer using digital mammography, with special reflection on the ...

  7. Breast-feeding intention, initiation and duration among Hong Kong Chinese women: a prospective longitudinal study.

    Science.gov (United States)

    Wang, Wenru; Lau, Ying; Chow, Aloysius; Chan, Kin Sin

    2014-06-01

    to (1) estimate the breast-feeding intention, initiation and duration rate; (2) identify the reasons to initiate and wean breast feeding and (3) explore predictors of breast-feeding duration. a prospective longitudinal study antenatal clinics of five regional hospitals from four clusters in Hong Kong a population-based sample of 2098 women in the second trimester of pregnancy was recruited with a systematic sampling method. three different sets of self-administered questionnaires were used to measure the breast-feeding intention, initiation and duration, demographic, socio-economic, obstetric, complications of pregnancy and intrapartum variables at three time points. Reasons for initiating and weaning breast feeding, the formal and informal supportive resources of participants during breast feeding were collated at the third time points. the rates of artificial feeding and breast feeding were 41.1% and 58.9%, whereas breast-feeding intention and initiation rates were 85.3% and 67.0%, respectively. The breast-feeding duration rates were 11.1%, 10.3%, 10.7% and 26.7%, for the 'within 3-6 weeks' and '>6 weeks' groups. The common reasons for initiating breast feeding were that breast feeding is beneficial for both the baby (89.8%) and mother (39.7%). Reasons for weaning breast feeding were insufficient breast milk (32.7%), tiredness and fatigue (39.7%) and return to work (29.6%). Partner, relatives and nurse midwives were important supportive resource during breast feeding. Ordinal logistic regression analysis identified five predictive factors of breast-feeding duration. Participants who were working part-time or were housewives (p=0.037), had monthly family income of breast-feeding intention (p=0.001) and early breast feeding within the first hour (pbreast feeding than their counterparts. mothers in Hong Kong do not meet the recommendation of the international standards for breast feeding. Understanding of reasons for initiation, weaning and predictors of breast

  8. The preventative power of "pink": Delineating the effects of social identification and protection motivation theory in breast cancer-related advertisements.

    Science.gov (United States)

    Devlin, Michael B; Dillard, Sydney

    2016-01-01

    An online experiment was conducted to assess the extent gender-salient breast cancer awareness advertisements had on influencing risk perception, encouraging preventative behaviors, and gathering health information. Social identification theory and protection motivation theory postulate gender-salient pink-branded advertisements trigger defense mechanisms, countering desired outcomes. This study concludes gender-salient ads focusing on women, and displaying the Susan G. Komen logo caused aversive behaviors, whereas gender-neutral ads, showing medical providers and logos such as American Medical Association, improve health-related reporting. Results also highlight a disconnect between women who socially identify as breast cancer survivors/supporters, and those with no prior experience with breast cancer.

  9. Breast Cancer-Initiating Cells: Insights into Novel Treatment Strategies

    Directory of Open Access Journals (Sweden)

    Maria Grazia Daidone

    2011-03-01

    Full Text Available There is accumulating evidence that breast cancer may arise from mutated mammary stem/progenitor cells which have been termed breast cancer-initiating cells (BCIC. BCIC identified in clinical specimens based on membrane phenotype (CD44+/CD24−/low and/or CD133+ expression or enzymatic activity of aldehyde dehydrogenase 1 (ALDH1+, have been demonstrated to have stem/progenitor cell properties, and are tumorigenic when injected in immunocompromized mice at very low concentrations. BCIC have also been isolated and in vitro propagated as non-adherent spheres of undifferentiated cells, and stem cell patterns have been recognized even in cancer cell lines. Recent findings indicate that aberrant regulation of self renewal is central to cancer stem cell biology. Alterations in genes involved in self-renewal pathways, such as Wnt, Notch, sonic hedgehog, PTEN and BMI, proved to play a role in breast cancer progression. Hence, targeting key elements mediating the self renewal of BCIC represents an attractive option, with a solid rationale, clearly identifiable molecular targets, and adequate knowledge of the involved pathways. Possible concerns are related to the poor knowledge of tolerance and efficacy of inhibiting self-renewal mechanisms, because the latter are key pathways for a variety of biological functions and it is unknown whether their interference would kill BCIC or simply temporarily stop them. Thus, efforts to develop BCIC-targeted therapies should not only be focused on interfering on self-renewal, but could seek to identify additional molecular targets, like those involved in regulating EMT-related pathways, in reversing the MDR phenotype, in inducing differentiation and controlling cell survival pathways.

  10. Effects of Recombinant Erythropoietin on Breast Cancer-Initiating Cells

    Directory of Open Access Journals (Sweden)

    Tiffany M. Phillips

    2007-12-01

    Full Text Available BACKGROUND: Cancer anemia causes fatigue and correlates with poor treatment outcome. Erythropoietin has been introduced in an attempt to correct these defects. However, five recent clinical trials reported a negative impact of erythropoietin on survival and/or tumor control, indicating that experimental evaluation of a possible direct effect of erythropoietin on cancer cells is required. Cancer recurrence is thought to rely on the proliferation of cancer initiating cells (CICs. In breast cancer, CICs can be identified by phenotypic markers and their fate is controlled by the Notch pathway. METHODS: In this study, we investigated the effect of erythropoietin on CICs in breast cancer cell lines. Levels of erythropoietin receptor (EpoR, CD24, CD44, Jagged-1 expression, activation of Notch-1 were assessed by flow cytometry. Self-renewing capacity of CICs was investigated in sphere formation assays. RESULTS: EpoR expression was found on the surface of CICs. Recombinant human Epo (rhEpo increased the numbers of CICs and self-renewing capacity in a Notch-dependent fashion by induction of Jagged-1. Inhibitors of the Notch pathway and P13-kinase blocked both effects. CONCLUSIONS: Erythropoietin functionally affects CICs directly. Our observation may explain the negative impact of recombinant Epo on local control and survival of cancer patients with EpoR-positive tumors.

  11. Distinguishing Depressive Symptoms From Similar Cancer-Related Somatic Symptoms: Implications for Assessment and Management of Major Depression after Breast Cancer.

    Science.gov (United States)

    Thompson, Lora M A; Bobonis Babilonia, Margarita

    2017-10-01

    Prevalence rates of major depressive disorder (MDD) following breast cancer diagnosis are estimated to be ~5% to >20%, and these rates range from slightly below to somewhat above the expected prevalence rate for MDD in the general population of women in the United States. Women with a history of MDD are at increased risk for recurrence of MDD after breast cancer and need to be monitored closely. To properly diagnose and treat MDD, healthcare providers must be able to recognize depressive symptoms and distinguish them from similar somatic symptoms that are associated with breast cancer and breast cancer treatment. The National Comprehensive Cancer Network and the American Society of Clinical Oncology have published guidelines for the screening, assessment, and care of adult cancer patients with depressive symptoms. Use of a standardized and validated screening measure may help healthcare providers identify patients in need of further assessment or treatment. Evidence-based nonpharmacological interventions such as cognitive behavioral therapy and antidepressant medications are recommended treatment options.

  12. Factors associated with low screening for breast cancer in the Palestinian Authority: relations of availability, environmental barriers, and cancer-related fatalism.

    Science.gov (United States)

    Azaiza, Faisal; Cohen, Miri; Awad, Mariam; Daoud, Francoise

    2010-10-01

    The current study was conducted to assess screening behaviors in relation to cultural and environmental barriers among Palestinian women in the West Bank. The participants were 397 women, ages 30 to 65 years, residing in the Palestinian Authority, and a stratified sample method was used (98.3% participation rate). The participants completed questionnaires on breast examination behaviors and knowledge, on perceived cancer fatalism and health beliefs, and on environmental barriers scales. Greater than 70% of the women had never undergone mammography or clinical breast examination (CBE), whereas 62% performed self breast examination (SBE). Women were more likely to undergo mammography if they were less religious (odds ratio [OR], 0.59; 95% confidence interval [95% CI], 0.47-0.81) and if they expressed lower personal barriers (OR, 0.59; 95% CI, 0.29-0.76) and lower fatalism (OR, 0.39; 95% CI, 0.28-0.63). A higher likelihood for CBE was related to being Christian (OR, 2.91; 95% CI, 1.49-5.73) and being less religious (OR, 0.32; 95% CI, 0.13-0.78), to perceived higher effectiveness of CBE (OR, 1.46; 95% CI, 1.20-1.79), and to perceived lower cancer fatalism (OR, 0.35; 95% CI, 0.28-0.60). Women were more likely to perform SBE if they were more educated, resided in cities, were Christian, were less religious, had a first-degree relative with breast cancer, perceived higher effectiveness and benefits of SBE, and perceived lower barriers and fatalism. Participants reported a combination of personal, cultural, and environmental barriers, which should be addressed by educational programs and followed by the allocation of resources for early detection and treatment of breast cancer. Copyright © 2010 American Cancer Society.

  13. The inflammatory/cancer-related IL-6/STAT3/NF-κB positive feedback loop includes AUF1 and maintains the active state of breast myofibroblasts.

    Science.gov (United States)

    Hendrayani, Siti-Fauziah; Al-Harbi, Bothaina; Al-Ansari, Mysoon M; Silva, Gabriela; Aboussekhra, Abdelilah

    2016-07-05

    The IL-6/STAT3/NF-κB positive feedback loop links inflammation to cancer and maintains cells at a transformed state. Similarly, cancer-associated myofibroblats remains active even in absence of cancer cells. However, the molecular basis of this sustained active state remains elusive. We have shown here that breast cancer cells and IL-6 persistently activate breast stromal fibroblasts through the stimulation of the positive IL-6/STAT3/NF-κB feedback loop. Transient neutralization of IL-6 in culture inhibited this signaling circuit and reverted myofibrobalsts to a normalized state, suggesting the implication of the IL-6 autocrine feedback loop as well. Importantly, the IL-6/STAT3/NF-κB pro-inflammatory circuit was also active in cancer-associated fibroblasts isolated from breast cancer patients. Transient inhibition of STAT3 by specific siRNA in active fibroblasts persistently reduced the level of the RNA binding protein AUF1, blocked the loop and normalized these cells. Moreover, we present clear evidence that AUF1 is also part of this positive feedback loop. Interestingly, treatment of breast myofibroblasts with caffeine, which has been previously shown to persistently inhibit active breast stromal fibroblasts, blocked the positive feedback loop through potent and sustained inhibition of STAT3, AKT, lin28B and AUF1. These results indicate that the IL-6/STAT3/NF-κB positive feedback loop includes AUF1 and is responsible for the sustained active status of cancer-associated fibroblasts. We have also shown that normalizing myofibroblasts, which could be of great therapeutic value, is possible through the inhibition of this procarcinogenic circuit.

  14. The Behavioral Determinants of Breast-Feeding in the Netherlands: Predictors for the Initiation of Breast-Feeding

    Science.gov (United States)

    Kools, Els J.; Thijs, Carel; de Vries, Hein

    2005-01-01

    The aim of this study was to evaluate the behavioral determinants of the initiation of breast-feeding at birth. The prospective cohort study used the attitude, social influence, self-efficacy (ASE) model in 373 pregnant women in five child health care centers. Prenatally, 72% of the women had the intention to breast-feed, and 73% actually started…

  15. Contrast-enhanced Dedicated Breast CT: Initial Clinical Experience1

    Science.gov (United States)

    Prionas, Nicolas D.; Ray, Shonket; Huang, Shih-Ying; Beckett, Laurel A.; Monsky, Wayne L.; Boone, John M.

    2010-01-01

    Purpose: To quantify contrast material enhancement of breast lesions scanned with dedicated breast computed tomography (CT) and to compare their conspicuity with that at unenhanced breast CT and mammography. Materials and Methods: Approval of the institutional review board and the Radiation Use Committee and written informed consent were obtained for this HIPAA-compliant study. Between September 2006 and April 2009, 46 women (mean age, 53.2 years; age range, 35–72 years) with Breast Imaging Reporting and Data System category 4 or 5 lesions underwent unenhanced breast CT and contrast material–enhanced breast CT before biopsy. Two radiologists independently scored lesion conspicuity for contrast-enhanced breast CT versus mammography and for contrast-enhanced breast CT versus unenhanced breast CT. Mean lesion voxel intensity was measured in Hounsfield units and normalized to adipose tissue intensity on manually segmented images obtained before and after administration of contrast material. Regression models focused on conspicuity and quantified enhancement were used to estimate the effect of pathologic diagnosis (benign vs malignant), lesion type (mass vs calcifications), breast density, and interradiologist variability. Results: Fifty-four lesions (25 benign, 29 malignant) in 46 subjects were analyzed. Malignant lesions were seen significantly better at contrast-enhanced breast CT than at unenhanced breast CT (P mammography (P contrast-enhanced breast CT than at unenhanced breast CT (P contrast-enhanced breast CT and mammography. Malignant lesions enhanced 55.9 HU ± 4.0 (standard error), whereas benign lesions enhanced 17.6 HU ± 6.1 (P contrast-enhanced breast CT. Quantifying lesion enhancement may aid in the detection and diagnosis of breast cancer. © RSNA, 2010 PMID:20720067

  16. Long Island Breast Cancer Study Project (Past Initiative)

    Science.gov (United States)

    The Long Island Breast Cancer Study Project is a multistudy effort to investigate whether environmental factors are responsible for breast cancer in Suffolk and Nassau counties, NY, as well as in Schoharie County, NY, and Tolland County, CT.

  17. Comparison of Breast Cancer-Related Lymphedema (Upper Limb Swelling) Prevalence Estimated Using Objective and Subjective Criteria and Relationship with Quality of Life

    OpenAIRE

    Bulley, Catherine; van Gaal, S.; Coutts, Fiona; Blyth, Christine; Jack, W; Chetty, U.; M. Barber; Tan, Chee-Wee

    2013-01-01

    This study aimed to investigate lymphedema prevalence using three different measurement/diagnostic criterion combinations and explore the relationship between lymphedema and quality of life for each, to provide evaluation of rehabilitation. Cross-sectional data from 617 women attending review appointments after completing surgery, chemotherapy, and radiotherapy included the Morbidity Screening Tool (MST; criterion: yes to lymphedema); Lymphedema and Breast Cancer Questionnaire (LBCQ; criterio...

  18. Diffusion magnetic resonance imaging of breast lesions: Initial ...

    African Journals Online (AJOL)

    Hebatallah Hassan Mamdouh Hassan

    2013-03-31

    Mar 31, 2013 ... detection of breast cancer using digital mammography, with special reflection on the ... and characterization of breast cancer.2 Additional lesions seen by MRI that are not ..... A 42 years old female with family history of breast cancer and microcalcification on follow-up (high risk) developed right axillary lump ...

  19. Ocular metastasis as initial presentation in breast cancer ...

    African Journals Online (AJOL)

    Two patients presented to their ophthalmologists with vision disturbances. On ocular examination, retinopathic lesions were observed. On subsequent examination, these lesions were diagnosed as metastases of breast cancer. Neither patient had a history of breast cancer. In patients with breast cancer and multiple ...

  20. Iyengar-Yoga Compared to Exercise as a Therapeutic Intervention during (Neoadjuvant Therapy in Women with Stage I–III Breast Cancer: Health-Related Quality of Life, Mindfulness, Spirituality, Life Satisfaction, and Cancer-Related Fatigue

    Directory of Open Access Journals (Sweden)

    Désirée Lötzke

    2016-01-01

    Full Text Available This study aims to test the effects of yoga on health-related quality of life, life satisfaction, cancer-related fatigue, mindfulness, and spirituality compared to conventional therapeutic exercises during (neoadjuvant cytotoxic and endocrine therapy in women with breast cancer. In a randomized controlled trial 92 women with breast cancer undergoing oncological treatment were randomly enrolled for a yoga intervention (YI (n=45 or for a physical exercise intervention (PEI (n=47. Measurements were obtained before (t0 and after the intervention (t1 as well as 3 months after finishing intervention (t2 using standardized questionnaires. Life satisfaction and fatigue improved under PEI (p<0.05 but not under YI (t0 to t2. Regarding quality of life (EORTC QLQ-C30 a direct effect (t0 to t1; p<0.001 of YI was found on role and emotional functioning, while under PEI only emotional functioning improved. Significant improvements (p<0.001 were observed at both t1 and t2 also for symptom scales in both groups: dyspnea, appetite loss, constipation, and diarrhea. There was no significant difference between therapies for none of the analyzed variables neither for t1 nor for t2. During chemotherapy, yoga was not seen as more helpful than conventional therapeutic exercises. This does not argue against its use in the recovery phase.

  1. Cancer-related post-treatment pain and its impact on health-related quality of life in breast cancer patients: a cross sectional study in Palestine.

    Science.gov (United States)

    Abu Farha, Nader H; Khatib, Mohammed T; Salameh, Husam; Zyoud, Sa'ed H

    2017-01-01

    Post-treatment pain has been suggested as an important indicator for health-related quality of life (HRQOL) in patients with breast cancer. Therefore, this study was performed to examine the association between pain and its impact on HRQOL among breast cancer patients in Palestine. Also, this study aimed to determine the QOL profile for breast cancer patients and stated the factors associated with QOL. A correlational cross-sectional study was conducted from May 2016 to November 2016 at Al-Watani Hospital and An-Najah National University Hospital in the Nablus district in Palestine. The five-level EuroQol five-dimensional instrument (EQ-5D-5L) was used to examine HRQOL. Pain severity and interference were assessed using the Brief Pain Inventory (BPI). Multiple linear regression analysis was performed to determine the most important variables related with HRQOL. One hundred and seventy patients were involved in this study. Overall, all participants were female, with a mean ± SD for age of 51.71 ± 11.11 years. The reported HRQOL of this study was measured by using the median EQ-5D-5L index score, which was 0.67 (interquartile range: 0.51-0.84). There were moderate negative correlations between EQ-5D-5L index score and pain severity score (r = - 0.58, p value < 0.001), and pain interference score (r = - 0.604, p-value < 0.001). Furthermore, univariate analysis showed that age, marital status, employment status, income, current condition of cancer, and post-treatment pain were associated with quality of life (p-value < 0.05). Regression analysis revealed that patients with high income (p-value = 0.003), patients with lower pain severity score (p-value < 0.001), and lower pain interference score (p-value = 0.018) were independently associated with high QOL. This is the first study to present important data regarding QOL by using the EQ-5D-5L instruments that may help healthcare providers to identify patients at risk of low QOL. Healthcare

  2. Comparison of Breast Cancer-Related Lymphedema (Upper Limb Swelling Prevalence Estimated Using Objective and Subjective Criteria and Relationship with Quality of Life

    Directory of Open Access Journals (Sweden)

    Catherine Bulley

    2013-01-01

    Full Text Available This study aimed to investigate lymphedema prevalence using three different measurement/diagnostic criterion combinations and explore the relationship between lymphedema and quality of life for each, to provide evaluation of rehabilitation. Cross-sectional data from 617 women attending review appointments after completing surgery, chemotherapy, and radiotherapy included the Morbidity Screening Tool (MST; criterion: yes to lymphedema; Lymphedema and Breast Cancer Questionnaire (LBCQ; criterion: yes to heaviness and/or swelling; percentage limb volume difference (perometer: %LVD; criterion: 10%+ difference; and the Functional Assessment of Cancer Therapy breast cancer-specific quality of life tool (FACT B+4. Perometry measurements were conducted in a clinic room. Between 341 and 577 participants provided sufficient data for each analysis, with mean age varying from 60 to 62 (SD 9.95–10.03 and median months after treatment from 49 to 51. Lymphedema prevalence varied from 26.2% for perometry %LVD to 20.5% for the MST and 23.9% for the LBCQ; differences were not significant. Limits of agreement analysis between %LVD and the subjective measures showed little consistency, while moderate consistency resulted between the subjective measures. Quality of life differed significantly for women with and without lymphedema only when subjective measurements were used. Results suggest that subjective and objective tools investigate different aspects of lymphedema.

  3. Comparison of breast cancer-related lymphedema (upper limb swelling) prevalence estimated using objective and subjective criteria and relationship with quality of life.

    Science.gov (United States)

    Bulley, Catherine; Gaal, Susanne; Coutts, Fiona; Blyth, Christine; Jack, Wilma; Chetty, Udi; Barber, Matthew; Tan, Chee-Wee

    2013-01-01

    This study aimed to investigate lymphedema prevalence using three different measurement/diagnostic criterion combinations and explore the relationship between lymphedema and quality of life for each, to provide evaluation of rehabilitation. Cross-sectional data from 617 women attending review appointments after completing surgery, chemotherapy, and radiotherapy included the Morbidity Screening Tool (MST; criterion: yes to lymphedema); Lymphedema and Breast Cancer Questionnaire (LBCQ; criterion: yes to heaviness and/or swelling); percentage limb volume difference (perometer: %LVD; criterion: 10%+ difference); and the Functional Assessment of Cancer Therapy breast cancer-specific quality of life tool (FACT B+4). Perometry measurements were conducted in a clinic room. Between 341 and 577 participants provided sufficient data for each analysis, with mean age varying from 60 to 62 (SD 9.95-10.03) and median months after treatment from 49 to 51. Lymphedema prevalence varied from 26.2% for perometry %LVD to 20.5% for the MST and 23.9% for the LBCQ; differences were not significant. Limits of agreement analysis between %LVD and the subjective measures showed little consistency, while moderate consistency resulted between the subjective measures. Quality of life differed significantly for women with and without lymphedema only when subjective measurements were used. Results suggest that subjective and objective tools investigate different aspects of lymphedema.

  4. Metabolic Tumor Burden Assessed by Dual Time Point [(18)F]FDG PET/CT in Locally Advanced Breast Cancer: Relation with Tumor Biology.

    Science.gov (United States)

    Garcia-Vicente, Ana María; Pérez-Beteta, Julián; Pérez-García, Víctor Manuel; Molina, David; Jiménez-Londoño, German Andrés; Soriano-Castrejón, Angel; Martínez-González, Alicia

    2017-08-01

    The aim of the study was to investigate the influence of dual time point 2-deoxy-2-[(18)F]fluoro-D-glucose ([(18)F]FDG) positron emission tomography/x-ray computed tomography (PET/CT) on the standard uptake value (SUV) and volume-based metabolic variables of breast lesions and their relation with biological characteristics and molecular phenotypes. Retrospective analysis including 67 patients with locally advanced breast cancer (LABC). All patients underwent a dual time point [(18)F]FDG PET/CT, 1 h (PET-1) and 3 h (PET-2) after [(18)F]FDG administration. Tumors were segmented following a three-dimensional methodology. Semiquantitative metabolic variables (SUVmax, SUVmean, and SUVpeak) and volume-based variables (metabolic tumor volume, MTV, and total lesion glycolysis, TLG) were obtained. Biologic prognostic parameters, such as the hormone receptors status, p53, HER2 expression, proliferation rate (Ki-67), and grading were obtained. Molecular phenotypes and risk-classification [low: luminal A, intermediate: luminal B HER2 (-) or luminal B HER2 (+), and high: HER2 pure or triple negative] were established. Relations between clinical and biological variables with the metabolic parameters were studied. The relevance of each metabolic variable in the prediction of phenotype risk was assessed using a multivariate analysis. SUV-based variables and TLG obtained in the PET-1 and PET-2 showed high and significant correlations between them. MTV and SUV variables (SUVmax, SUVmean, and SUVpeak) where only marginally correlated. Significant differences were found between mean SUV variables and TLG obtained in PET-1 and PET-2. High and significant associations were found between metabolic variables obtained in PET-1 and their homonymous in PET-2. Based on that, only relations of PET-1 variables with biological tumor characteristics were explored. SUV variables showed associations with hormone receptors status (p metabolic variables and Ki-67, HER2, or p53 expression

  5. A constitutional predisposition to breast cancer-related lymphoedema and effect of axillary lymph node surgery on forearm muscle lymph flow.

    Science.gov (United States)

    Bains, S K; Stanton, A W B; Cintolesi, V; Ballinger, J; Allen, S; Zammit, C; Levick, J R; Mortimer, P S; Peters, A M; Purushotham, A D

    2015-02-01

    The aims of this prospective study were (a) to examine the relationship between pre-operative muscle lymph flow and the predisposition to BCRL in women treated by axillary nodal surgery for breast cancer; and (b) to test the 'stopcock' hypothesis that axillary lymph node surgery impairs forearm lymph flow in the short term. (99m)Tc-nanocoll was injected intramuscularly into both forearms of women undergoing surgery for breast cancer. Lymphatic clearance rate constant, k, representing lymph flow per unit interstitial fluid volume, was measured as the fractional disappearance rate of radioactivity from the depot site by gamma camera imaging. Axillary lymph node activity was calculated as percentage injected activity. BCRL was assessed by clinical examination and upper limb perometry. Of 38 pre-operative women, 33 attended at 8 ± 6 weeks post-operatively and 31 at 58 ± 9 weeks post-operatively. Seven patients (18%) developed BCRL. Prior to surgery the BCRL-destined patients had a higher mean k (0.0962 ± 0.034%/min) than non-BCRL patients (0.0830 ± 0.019%/min) (p = 0.10, unpaired t test). Post-operative k values were not significantly different from pre-operative, in either the ipsilateral (operated) or contralateral limb. Also, post-operative k values did not differ significantly between both upper limbs. Furthermore, there was no significant difference between pre- and post-operative axillary activity. Patients who develop BCRL have high lymph flow pre-surgery, which may predispose them to lymphatic overload and failure. Axillary lymph node surgery has no early, measurable effect on forearm muscle lymph flow despite surgical disruption of routes of lymph drainage. Copyright © 2014 Elsevier Ltd. All rights reserved.

  6. Factors affecting breast-feeding initiation in Greece: What is important?

    Science.gov (United States)

    Tavoulari, Evangelia-Filothei; Benetou, Vassiliki; Vlastarakos, Petros V; Andriopoulou, Eirini; Kreatsas, George; Linos, Athena

    2015-02-01

    to investigate the association between breast-feeding initiation and socio-demographic, lifestyle-related, clinical and lactation-related factors in a sample of mothers living in Greece. cross-sectional study. Tertiary University Hospital, maternity ward. 428 mothers were interviewed (43.2% response rate) from February until December 2009, using a structured face-to-face questionnaire after at least 24 hours from childbirth. 71.0% of mothers were Greeks and 29.0% immigrants; the mean age was 32.0 years. 44.4% initiated exclusive breast feeding, 7.9% artificial milk -feeding and 47.7% partial feeding. In the multivariate analysis, exclusive breast feeding was inversely related to maternal body mass index (BMI) at the beginning of gestation (odds ratio (OR)=0.93, 95% confidence intervals (95%CI)=0.89-0.98) and caesarean section (OR=0.54, 95% CI=0.35-0.84). Lactation-related factors which favourably affected exclusive breast-feeding initiation included previous breast-feeding experience (OR=2.29, 95% CI=1.39-3.78), information about breast feeding (OR=2.38, 95% CI=1.41-4.01) and rooming-in (OR=1.62 95% CI=1.03-2.54), whilst any breast feeding was favourably affected by encouraging women to breast feed (OR=5.42, 95% CI=1.90-15.50), providing information about breast feeding (OR=6.92, 95% CI=2.53-18.89), and rooming-in (OR=6.93 95% CI=2.01-23.88), and negatively associated with caesarean section (OR=0.11, 95% CI=0.03-0.39). Being an immigrant mother was also positively associated with any breast-feeding initiation (OR=7.97, 95% CI=1.02-62.19). Maternal age, education and income, as well as, smoking status, were not associated with any breast-feeding initiation. maternal BMI and immigrant status, information provided by midwives and encouragement, rooming-in and mode of childbirth (caesarean section), were found to be important for breast-feeding initiation in this study population. No other indicator of socio-demographic status was found to be associated with breast

  7. [Pulmonary Metastasis from a Phyllodes Tumor of the Breast Developing Sixteen Years after Initial Surgery].

    Science.gov (United States)

    Chang, Sung-Soo; Nakano, Takayuki; Okamoto, Taku; Takabatake, Daisuke

    2015-11-01

    We report a case of solitary pulmonary metastasis from a phyllodes tumor of the breast appearing 16 years after initial surgery. The patient was a 56-year-old woman who had undergone surgical extirpation of a left breast tumor diagnosed as phyllodes tumor (borderline malignancy) in 1998, and a right breast tumor diagnosed as fibromatosis in 2000. Sixteen years after the initial operation, she consulted our hospital because of a chest X-ray abnormality detected at a screening examination. Chest computed tomography revealed a well defined nodular shadow in the left upper lobe of the lung. Surgery was done since primary lung cancer was suspected. However, pathological diagnosis was a pulmonary metastasis from the phyllodes tumor of the left breast. Right breast tumor was also diagnosed as a metastasis from the left breast tumor by histopathological re-evaluation.

  8. Diffusion magnetic resonance imaging of breast lesions: Initial ...

    African Journals Online (AJOL)

    Objective: The purpose of our study was to investigate whether adding diffusion weighted imaging (DWI) to dynamic contrast-enhanced MRI (DCE-MRI) could improve specificity and the positive predictive value (PPV) of breast MRI in differentiating benign and malignant focal breast mass lesions. Materials and methods: ...

  9. Association Between Complementary and Alternative Medicine Use and Breast Cancer Chemotherapy Initiation: The Breast Cancer Quality of Care (BQUAL) Study.

    Science.gov (United States)

    Greenlee, Heather; Neugut, Alfred I; Falci, Laura; Hillyer, Grace Clarke; Buono, Donna; Mandelblatt, Jeanne S; Roh, Janise M; Ergas, Isaac J; Kwan, Marilyn L; Lee, Marion; Tsai, Wei Yann; Shi, Zaixing; Lamerato, Lois; Kushi, Lawrence H; Hershman, Dawn L

    2016-09-01

    Not all women initiate clinically indicated breast cancer adjuvant treatment. It is important for clinicians to identify women at risk for noninitiation. To determine whether complementary and alternative medicine (CAM) use is associated with decreased breast cancer chemotherapy initiation. In this multisite prospective cohort study (the Breast Cancer Quality of Care [BQUAL] study) designed to examine predictors of breast cancer treatment initiation and adherence, 685 women younger than 70 years with nonmetastatic invasive breast cancer were recruited from Columbia University Medical Center, Kaiser Permanente Northern California, and Henry Ford Health System and enrolled between May 2006 and July 31, 2010. Overall, 306 patients (45%) were clinically indicated to receive chemotherapy per National Comprehensive Cancer Network guidelines. Participants were followed for up to 12 months. Baseline interviews assessed current use of 5 CAM modalities (vitamins and/or minerals, herbs and/or botanicals, other natural products, mind-body self-practice, mind-body practitioner-based practice). CAM use definitions included any use, dietary supplement use, mind-body use, and a CAM index summing the 5 modalities. Chemotherapy initiation was assessed via self-report up to 12 months after baseline. Multivariable logistic regression models examined a priori hypotheses testing whether CAM use was associated with chemotherapy initiation, adjusting for demographic and clinical covariates, and delineating groups by age and chemotherapy indication. A cohort of 685 women younger than 70 years (mean age, 59 years; median age, 59 years) with nonmetastatic invasive breast cancer were recruited and followed for up to 12 months to examine predictors of breast cancer treatment initiation. Baseline CAM use was reported by 598 women (87%). Chemotherapy was initiated by 272 women (89%) for whom chemotherapy was indicated, compared with 135 women (36%) for whom chemotherapy was discretionary. Among

  10. Breast feeding initiation rate across Western countries: does religion matter? An ecological study.

    Science.gov (United States)

    Bernard, Jonathan Y; Cohen, Emmanuel; Kramer, Michael S

    2016-01-01

    Breast feeding initiation rates remain below 80% in some Western countries. Many individual-level determinants are known; however, less is known regarding cultural and societal determinants, such as religion, that could explain population-level variations. We examined the correlations of the proportions of Catholics and Protestants with the breast feeding initiation rates across and within Western countries. Using publicly available data, we carried out an ecological study comparing the proportions of Catholics and Protestants with the rates of breast feeding initiation. We correlated data at the country level, and additionally explored within-country data in five Western countries: France (Departments), Ireland (counties), the UK (countries), Canada (provinces) and the USA (states). Our analyses accounted for human development index, gross domestic product and population density. We observed a negative correlation (r=-0.30) between the proportion of Catholics and the rate of breast feeding initiation in Western countries. This correlation was consistent when using within-country data in France (r=-0.27), Ireland (r=-0.23), the UK (r=-0.79) and Canada (r=-0.62). In the USA, the positive correlation (r=0.26) between a state's proportion of Catholics and its breast feeding initiation rate was confounded by race, education and socioeconomic status (SES). After controlling for education and SES, the state proportion of non-Hispanic white Catholics was negatively correlated (r=-0.29) with the rate of breast feeding initiation. In this ecological study, we found consistent negative correlations between Catholicism and breast feeding initiation rates. Qualitative and quantitative studies at the individual level are needed to confirm and explain our findings. Our results suggest that women living in a country or region where Catholicism has historically dominated are less likely to initiate breast feeding, and that breast feeding promotion policies should be adapted to

  11. A Model to Estimate the Risk of Breast Cancer-Related Lymphedema: Combinations of Treatment-Related Factors of the Number of Dissected Axillary Nodes, Adjuvant Chemotherapy, and Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Myungsoo; Kim, Seok Won; Lee, Sung Uk; Lee, Nam Kwon; Jung, So-Youn; Kim, Tae Hyun; Lee, Eun Sook; Kang, Han-Sung [Research Institute and Hospital, National Cancer Center, Goyang (Korea, Republic of); Shin, Kyung Hwan, E-mail: shin.kyunghwan@gmail.com [Research Institute and Hospital, National Cancer Center, Goyang (Korea, Republic of)

    2013-07-01

    Purpose: The development of breast cancer-related lymphedema (LE) is closely related to the number of dissected axillary lymph nodes (N-ALNs), chemotherapy, and radiation therapy. In this study, we attempted to estimate the risk of LE based on combinations of these treatment-related factors. Methods and Materials: A total of 772 patients with breast cancer, who underwent primary surgery with axillary lymph node dissection from 2004 to 2009, were retrospectively analyzed. Adjuvant chemotherapy (ACT) was performed in 677 patients (88%). Among patients who received radiation therapy (n=675), 274 (35%) received supraclavicular radiation therapy (SCRT). Results: At a median follow-up of 5.1 years (range, 3.0-8.3 years), 127 patients had developed LE. The overall 5-year cumulative incidence of LE was 17%. Among the 127 affected patients, LE occurred within 2 years after surgery in 97 (76%) and within 3 years in 115 (91%) patients. Multivariate analysis showed that N-ALN (hazard ratio [HR], 2.81; P<.001), ACT (HR, 4.14; P=.048), and SCRT (HR, 3.24; P<.001) were independent risk factors for LE. The total number of risk factors correlated well with the incidence of LE. Patients with no risk or 1 risk factor showed a significantly lower 5-year probability of LE (3%) than patients with 2 (19%) or 3 risk factors (38%) (P<.001). Conclusions: The risk factors associated with LE were N-ALN, ACT, and SCRT. A simple model using combinations of these factors may help clinicians predict the risk of LE.

  12. X-ray scatter correction method for dedicated breast computed tomography: improvements and initial patient testing

    NARCIS (Netherlands)

    Ramamurthy, S.; D'Orsi, C.J.; Sechopoulos, I.

    2016-01-01

    A previously proposed x-ray scatter correction method for dedicated breast computed tomography was further developed and implemented so as to allow for initial patient testing. The method involves the acquisition of a complete second set of breast CT projections covering 360 degrees with a

  13. Familial breast cancer in Costa Rica: an initial approach.

    Science.gov (United States)

    Ramírez Monge, Adriana; Gutiérrez-Espeleta, Gustavo A; Loáiciga Vega, Kenneth

    2004-09-01

    Cancer is a worldwide problem because of its high rates of incidence and associated mortality. By 2000, more than 6.2 million people died from this illness worldwide. Among all types of cancer, breast cancer is one of the most studied. Each year, one million new cases are diagnosed around the world. We can classify breast cancer into two main kinds: sporadic cases and those which are a product of inherited genetic alterations. Approximately 5-10% of breast cancer cases are the result of inherited mutations, or alterations in breast cancer susceptibility genes, BRCA1 and BRCA2. Like other countries, Costa Rica possesses high rates of incidence and mortality for breast cancer. According to the "Registro Nacional de Tumores" (National Office of Tumor Records), in 2000 breast cancer had the highest rate of incidence and in 2002 it had the highest rate of mortality in comparison to other types of cancer. For this reason and the generalized lack of knowledge in the field we conducted an epidemiological research on breast cancer patients from Hospital San Juan de Dios, San José, Costa Rica, to find families with a history of breast cancer, and to determine the occurrence of familial cases within the population studied. So far, we have found 23 families, within which we discovered very informative cases that have rendered the identification of a pattern of inheritance. These findings allow us to announce that in Costa Rica there are several cases of inherited breast cancer and that we need more research is needed to improve the prevention, control, and treatment of this disease.

  14. Role of Human Breast Cancer Related Protein versus P-Glycoprotein as an Efflux Transporter for Benzylpenicillin: Potential Importance at the Blood-Brain Barrier.

    Science.gov (United States)

    Li, Yangfang; Wu, Qian; Li, Chen; Liu, Ling; Du, Kun; Shen, Jin; Wu, Yuqin; Zhao, Xiaofen; Zhao, Mei; Bao, Lingyun; Gao, Jin; Keep, Richard F; Xiang, Jianming

    2016-01-01

    While the blood-brain barrier (BBB) protects the brain by controlling the access of solutes and toxic substances to brain, it also limits drug entry to treat central nervous system disorders. Many drugs are substrates for ATP-binding cassette (ABC) transporters at the BBB that limit their entry into the brain. The role of those transporters in limiting the entry of the widely prescribed therapeutic, benzylpenicillin, has produced conflicting results. This study investigated the possible potential involvement of P-glycoprotein (P-gp) and breast cancer resistance protein (BCRP), two ABC transporters, in benzylpenicillin transport at BBB in human using MDCKII cells overexpressing those transporters as well as pharmacological inhibition. MDCKII cells overexpressing human BCRP (MDCKII-BCRP) but not those overexpressing human P-gp (MDCKII-MDR cells) had reduced [3H]benzylpenicillin uptake. Similarly, inhibiting BCRP increased [3H]benzylpenicillin uptake in MDCKII-BCRP cells, while inhibiting P-gp in MDCKII-MDR cells had no effect on uptake although there was evidence that benzylpenicillin is a substrate for canine P-gp. While inhibiting BCRP affected [3H]benzylpenicillin cell concentrations it did not affect transepithelial flux in MDCKII-BCRP cells. In summary, the results indicate that human BCRP and not human P-gp is involved in benzylpenicillin transport. However, targeting BCRP alone was not sufficient to alter transepithelial flux in MDCKII cells. Whether it would be sufficient to alter blood-to-brain flux at the human BBB remains to be investigated.

  15. Initial results from an online breast augmentation survey.

    Science.gov (United States)

    Young, V Leroy; Watson, Marla E; Boswell, C B; Centeno, Robert F

    2004-01-01

    Data have been lacking to answer many questions raised in the clinical literature and by the US Food and Drug Administration with regard to patient satisfaction with breast implants, informed consent, the impact of augmentation on quality of life, repeat operations, and other issues related to breast augmentation. The authors conducted an online survey of women with and without breast implants to collect data on key issues related to breast augmentation. A survey including 177 questions was posted on the Web site www.implantinfo.com for 6 months, from August 2001 to February 2002. The survey was aimed at women who had undergone augmentation and those who were considering augmentation but had not yet undergone surgery. The raw data were analyzed by Data Harbor (Chicago, IL), an independent data management and technology development company with experience in managing large, complex medical databases. The survey was completed by 4011 women, including 2273 who had received breast implants and 1738 who were considering augmentation. Among the key findings: More than half of the women who had undergone breast augmentation and those who were considering the procedure thought about the decision for at least 3 years before proceeding. Most women who underwent breast augmentation (88%) were satisfied with the results, and 93% said they would recommend the procedure to friends or family members. Nearly all women who received implants thought the surgery improved their overall appearance (92%) and self-confidence (82%) but said it did not result in significant changes in their marriage/dating activities, careers, or social lives. At least 92% said their surgeons had answered their questions and listened to their concerns, and more than 75% said they remembered being informed of the risks of surgery. The percentage of women with breast pain was greater among women with implants than among those without. However, other physical symptoms, such as those associated with

  16. Mouse Model of Human Breast Cancer Initiated by a Fusion Oncogene

    National Research Council Canada - National Science Library

    Orkin, Stuart H

    2006-01-01

    In this study, we generated a novel mouse model of human breast cancer based on a recurrent chromosomal translocation that produces the TEL-NTRK3 fusion oncogene, as the initiating mutation in human...

  17. California Breast Cancer Prevention Initiatives: Setting a research agenda for prevention.

    Science.gov (United States)

    Sutton, P; Kavanaugh-Lynch, M H E; Plumb, M; Yen, I H; Sarantis, H; Thomsen, C L; Campleman, S; Galpern, E; Dickenson, C; Woodruff, T J

    2015-07-01

    The environment is an underutilized pathway to breast cancer prevention. Current research approaches and funding streams related to breast cancer and the environment are unequal to the task at hand. We undertook the California Breast Cancer Prevention Initiatives, a four-year comprehensive effort to set a research agenda related to breast cancer, the environment, disparities and prevention. We identified 20 topics for Concept Proposals reflecting a life-course approach and the complex etiology of breast cancer; considering the environment as chemical, physical and socially constructed exposures that are experienced concurrently: at home, in the community and at work; and addressing how we should be modifying the world around us to promote a less carcinogenic environment. Redirecting breast cancer research toward prevention-oriented discovery could significantly reduce the incidence and associated disparities of the disease among future generations. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.

  18. The prevalence and determinants of breast-feeding initiation and duration in a sample of women in Ireland.

    LENUS (Irish Health Repository)

    Tarrant, R C

    2010-06-01

    To assess breast-feeding initiation and prevalence from birth to 6 months in a sample of mothers in Dublin, and to determine the factors associated with breast-feeding initiation and \\'any\\' breast-feeding at 6 weeks in a sample of Irish-national mothers.

  19. Breast cancer screening with tomosynthesis--initial experiences.

    Science.gov (United States)

    Tingberg, A; Förnvik, D; Mattsson, S; Svahn, T; Timberg, P; Zackrisson, S

    2011-09-01

    Experiences gained so far using tomosynthesis for breast cancer screening will be reported. A short summary of results from preparatory studies will also be presented. The sensitivity and specificity of breast tomosynthesis (BT) will be compared with conventional two-dimensional digital mammography (DM) for breast cancer screening in a population-based study. Over 2000 women have been examined so far with BT and DM. The BT reading is significantly more time-consuming than the DM reading. Preparatory studies have shown that BT has a higher diagnostic precision and higher accuracy of size measurements and stage determination than DM. There is potential to use lower compression force with BT compared with DM, without decreasing the diagnostic accuracy. BT might play an important role in clinical as well as screening mammography. A large-scale population-based study to investigate BT as a screening modality is underway.

  20. Impact of a combined multimodal-aerobic and multimodal intervention compared to standard aerobic treatment in breast cancer survivors with chronic cancer-related fatigue - results of a three-armed pragmatic trial in a comprehensive cohort design.

    Science.gov (United States)

    Kröz, Matthias; Reif, Marcus; Glinz, Augustina; Berger, Bettina; Nikolaou, Andreas; Zerm, Roland; Brinkhaus, Benno; Girke, Matthias; Büssing, Arndt; Gutenbrunner, Christoph

    2017-03-02

    Cancer-related fatigue (CRF) and insomnia are major complaints in breast cancer survivors (BC). Aerobic training (AT), the standard therapy for CRF in BC, shows only minor to moderate treatment effects. Other evidence-based treatments include cognitive behavioral therapy, e.g., sleep education/restriction (SE) and mindfulness-based therapies. We investigated the effectiveness of a 10-week multimodal program (MT) consisting of SE, psycho-education, eurythmy- and painting-therapy, administered separately or in combination with AT (CT) and compared both arms to AT alone. In a pragmatic comprehensive cohort study BC with chronic CRF were allocated randomly or by patient preference to (a) MT, (b) CT (MT + AT) or (c) AT alone. Primary endpoint was a composite score of the Pittsburgh Sleep Quality Index and the Cancer Fatigue Scale after 10 weeks of intervention (T1); a second endpoint was a follow-up assessment 6 months later (T2). The primary hypothesis stated superiority of CT and non-inferiority of MT vs. AT at T1. A closed testing procedure preserved the global α-level. The intention-to-treat analysis included propensity scores for the mode of allocation and for the preferred treatment, respectively. Altogether 126 BC were recruited: 65 were randomized and 61 allocated by preference; 105 started the intervention. Socio-demographic parameters were generally balanced at baseline. Non-inferiority of MT to AT at T1 was confirmed (p multimodal CRF-therapy was found to be confirmatively non-inferior to standard therapy and even yielded exploratively sustained superiority. A randomized controlled trial including a larger sample size and a longer follow-up to evaluate multimodal CRF-therapy is highly warranted. DRKS-ID: DRKS00003736 . Recruitment period June 2011 to March 2013. Date of registering 19 June 2012.

  1. Differences in breast-feeding initiation and continuation by maternal diabetes status.

    Science.gov (United States)

    Oza-Frank, Reena; Chertok, Ilana; Bartley, Adam

    2015-03-01

    To examine (i) the prevalence of and associations between breast-feeding initiation and continuation by maternal diabetes status and (ii) the reasons for not initiating and/or continuing breast-feeding by maternal diabetes status. Secondary data analyses of a population-based cross-sectional study were conducting using data from the US Centers for Disease Control and Prevention's Pregnancy Risk Assessment Monitoring System (PRAMS), 2009-2011. Multivariable logistic regression was used to investigate the associations between breast-feeding initiation and continuation by diabetes status. Thirty states and New York City, USA. Mothers of recently live-born infants, selected by birth certificate sampling. Among 72755 women, 8.8 % had gestational diabetes mellitus (GDM) and 1.7 % had pregestational diabetes mellitus (PDM). Breast-feeding initiation was similar among GDM and no diabetes mellitus (NDM) women (80.8 % v. 82.2 %, respectively, P=0.2), but continuation was lower among GDM (65.7 % v. 68.8 %, respectively, P=0.01). PDM women had lower initiation and continuation compared with NDM (78.2 %, P=0.03 and 60.4 %, Pdiabetes status may reflect differences in prenatal education, indicating the need for increased efforts among PDM women. Additionally, non-smoking women with PDM or GDM would benefit from additional breast-feeding education.

  2. Association Between Complementary and Alternative Medicine Use and Breast Cancer Chemotherapy Initiation The Breast Cancer Quality of Care (BQUAL) Study

    Science.gov (United States)

    Greenlee, Heather; Neugut, Alfred I.; Falci, Laura; Hillyer, Grace Clarke; Buono, Donna; Mandelblatt, Jeanne S.; Roh, Janise M.; Ergas, Isaac J.; Kwan, Marilyn L.; Lee, Marion; Tsai, Wei Yann; Shi, Zaixing; Lamerato, Lois; Kushi, Lawrence H.; Hershman, Dawn L.

    2017-01-01

    IMPORTANCE Not all women initiate clinically indicated breast cancer adjuvant treatment. It is important for clinicians to identify women at risk for noninitiation. OBJECTIVE To determine whether complementary and alternative medicine (CAM) use is associated with decreased breast cancer chemotherapy initiation. DESIGN, SETTING, AND PARTICIPANTS In this multisite prospective cohort study (the Breast Cancer Quality of Care [BQUAL] study) designed to examine predictors of breast cancer treatment initiation and adherence, 685 women younger than 70 years with nonmetastatic invasive breast cancer were recruited from Columbia University Medical Center, Kaiser Permanente Northern California, and Henry Ford Health System and enrolled between May 2006 and July 31, 2010. Overall, 306 patients (45%) were clinically indicated to receive chemotherapy per National Comprehensive Cancer Network guidelines. Participants were followed for up to 12 months. EXPOSURES Baseline interviews assessed current use of 5 CAM modalities (vitamins and/or minerals, herbs and/or botanicals, other natural products, mind-body self-practice, mind-body practitioner-based practice). CAM use definitions included any use, dietary supplement use, mind-body use, and a CAM index summing the 5 modalities. MAIN OUTCOMES AND MEASURES Chemotherapy initiation was assessed via self-report up to 12 months after baseline. Multivariable logistic regression models examined a priori hypotheses testing whether CAM use was associated with chemotherapy initiation, adjusting for demographic and clinical covariates, and delineating groups by age and chemotherapy indication. RESULTS A cohort of 685 women younger than 70 years (mean age, 59 years; median age, 59 years) with nonmetastatic invasive breast cancer were recruited and followed for up to 12 months to examine predictors of breast cancer treatment initiation. Baseline CAM use was reported by 598 women (87%). Chemotherapy was initiated by 272 women (89%) for whom

  3. Familial Breast Cancer in Costa Rica: An Initial Approach

    Directory of Open Access Journals (Sweden)

    Adriana Ramírez Monge

    2004-09-01

    Full Text Available Cancer is a worldwide problem because of its high rates of incidence and associated mortality. By 2000, more than 6.2 million people died from this illness worldwide. Among all types of cancer, breast cancer is one of the most studied. Each year, one million new cases are diagnosed around the world. We can classify breast cancer into two main kinds: sporadic cases and those which are a product of inherited genetic alterations. Approximately 5-10% of breast cancer cases are the result of inherited mutations, or alterations in breast cancer susceptibility genes, BRCA1 and BRCA2. Like other countries, Costa Rica possesses high rates of incidence and mortality for breast cancer. According to the "Registro Nacional de Tumores" (National Office of Tumor Records, in 2000 breast cancer had the highest rate of incidence and in 2002 it had the highest rate of mortality in comparison to other types of cancer. For this reason and the generalized lack of knowledge in the field we conducted an epidemiological research on breast cancer patients from Hospital San Juan de Dios, San José, Costa Rica, to find families with a history of breast cancer, and to determine the occurrence of familial cases within the population studied. So far, we have found 23 families, within which we discovered very informative cases that have rendered the identification of a pattern of inheritance. These findings allow us to announce that in Costa Rica there are several cases of inherited breast cancer and that we need more research is needed to improve the prevention, control, and treatment of this disease. Rev. Biol. Trop. 52(3: 531-536. Epub 2004 Dic 15.El cáncer es un problema a nivel mundial porque posee altas tasas de incidencia y mortalidad. Para el año 2000 más de 6.2 millones de personas murieron a causa de esta enfermedad. El cáncer de mama es uno de los tipos de cáncer más estudiados en el mundo por las mismas razones. Cada año, se diagnostican más de un mill

  4. Digital breast tomosynthesis (DBT): initial experience in a clinical setting

    Energy Technology Data Exchange (ETDEWEB)

    Skaane, Per; Gullien, Randi; Eben, Ellen B.; Haakenaasen, Unni; Naess Jebsen, Ingvild; Krager, Mona [Dept of Radiology, Oslo Univ. Hospital Ullevaal, Univ. of Oslo, Oslo (Norway)], e-mail: PERSKA@ous-hf.no; Bjoerndal, Hilde [Dept of Radiology, Oslo Univ. Hospital The Norwegian Radium Hospital, Oslo (Norway); Ekseth, Ulrika [Curato Roentgen Institute, Oslo (Norway); Jahr, Gunnar [Dept. of Radiology, Oslo Univ. Hospital Rikshospitalet, Oslo (Norway)

    2012-06-15

    Background: Digital breast tomosynthesis (DBT) is a promising new technology. Some experimental clinical studies have shown positive results, but the future role and indications of this new technique, whether in a screening or clinical setting, need to be evaluated. Purpose: To compare digital mammography and DBT in a side-by-side feature analysis for cancer conspicuity, and to assess whether there is a potential additional value of DBT to standard state-of-the-art conventional imaging work-up with respect to detection of additional malignancies. Material and Methods: The study had ethics committee approval. A total of 129 women underwent 2D digital mammography including supplementary cone-down and magnification views and breast ultrasonography if indicated, as well as digital breast tomosynthesis. The indication for conventional imaging in the clinical setting included a palpable lump in 30 (23%), abnormal mammographic screening findings in 54 (42%), and surveillance in 45 (35%) of the women. The women were examined according to present guidelines, including spot-magnification views, ultrasonography, and needle biopsies, if indicated. The DBT examinations were interpreted several weeks after the conventional imaging without knowledge of the conventional imaging findings. In a later session, three radiologists performed a side-by-side feature analysis for cancer conspicuity in a sample of 50 cases. Results: State-of-the-art conventional imaging resulted in needle biopsy of 45 breasts, of which 20 lesions were benign and a total of 25 cancers were diagnosed. The remaining 84 women were dismissed with a normal/definitely benign finding and without indication for needle biopsy. The subsequent DBT interpretation found suspicious findings in four of these 84 women, and these four women had to be called back for repeated work-up with knowledge of the tomosynthesis findings. These delayed work-ups resulted in two cancers (increasing the cancer detection by 8%) and two

  5. Tight junctions: a barrier to the initiation and progression of breast cancer?

    LENUS (Irish Health Repository)

    Brennan, Kieran

    2010-01-01

    Breast cancer is a complex and heterogeneous disease that arises from epithelial cells lining the breast ducts and lobules. Correct adhesion between adjacent epithelial cells is important in determining the normal structure and function of epithelial tissues, and there is accumulating evidence that dysregulated cell-cell adhesion is associated with many cancers. This review will focus on one cell-cell adhesion complex, the tight junction (TJ), and summarize recent evidence that TJs may participate in breast cancer development or progression. We will first outline the protein composition of TJs and discuss the functions of the TJ complex. Secondly we will examine how alterations in these functions might facilitate breast cancer initiation or progression; by focussing on the regulatory influence of TJs on cell polarity, cell fate and cell migration. Finally we will outline how pharmacological targeting of TJ proteins may be useful in limiting breast cancer progression. Overall we hope to illustrate that the relationship between TJ alterations and breast cancer is a complex one; but that this area offers promise in uncovering fundamental mechanisms linked to breast cancer progression.

  6. Effectiveness of CenteringPregnancy on Breast-Feeding Initiation Among African Americans: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Robinson, Karen; Garnier-Villarreal, Mauricio; Hanson, Lisa

    2018-01-17

    While breast-feeding initiation rates for African American mothers are low, an innovative model of group prenatal care, CenteringPregnancy, holds promise to increase breast-feeding rates. The aim of this systematic review and meta-analysis was to examine the effects of CenteringPregnancy versus individual prenatal care on breast-feeding initiation among African American mothers. Using a systematic approach and PRISMA guidelines, 4 electronic databases were used to search the literature. English-language studies, comparing CenteringPregnancy and individual prenatal care, including African American participants, and specifying breast-feeding initiation as an outcome were screened for inclusion. Study strength and quality were assessed and 7 studies were systematically reviewed and meta-analyzed. Participation in CenteringPregnancy increased the probability of breast-feeding initiation by 53% (95% confidence interval = 29%-81%) (n = 8047). A subgroup analysis of breast-feeding initiation among only African American participants was performed on 4 studies where data were available. Participation in CenteringPregnancy increased the probability of breast-feeding initiation by 71% (95% confidence interval = 27%-131%) (n = 1458) for African American participants. CenteringPregnancy is an effective intervention to increase breast-feeding initiation for participants, especially for African Americans. To close the racial gap in breast-feeding initiation, high-quality research providing specific outcomes for African American participants in CenteringPregnancy are needed.

  7. Cardiovascular disease and mortality after breast cancer in postmenopausal women: Results from the Women's Health Initiative.

    Directory of Open Access Journals (Sweden)

    Na-Jin Park

    Full Text Available Cardiovascular disease (CVD is the leading cause of morbidity and mortality among older postmenopausal women. The impact of postmenopausal breast cancer on CVD for older women is uncertain. We hypothesized that older postmenopausal women with breast cancer would be at a higher risk of CVD than similar aged women without breast cancer and that CVD would be a major contributor to the subsequent morbidity and mortality.In a prospective Women's Health Initiative study, incident CVD events and total and cause-specific death rates were compared between postmenopausal women with (n = 4,340 and without (n = 97,576 incident invasive breast cancer over 10 years post-diagnosis, stratified by 3 age groups (50-59, 60-69, and 70-79.Postmenopausal women, regardless of breast cancer diagnosis, had similar and high levels of CVD risk factors (e.g., smoking and hypertension at baseline prior to breast cancer, which were strong predictors of CVD and total mortality over time. CVD affected mostly women age 70-79 with localized breast cancer (79% of breast cancer cases in 70-79 age group: only 17% died from breast cancer and CVD was the leading cause of death (22% over the average 10 years follow up. Compared to age-matched women without breast cancer, women age 70-79 at diagnosis of localized breast cancer had a similar multivariate-adjusted hazard ratio (HR of 1.01 (95% confidence interval [CI]: 0.76-1.33 for coronary heart disease, a lower risk of composite CVD (HR = 0.84, 95% CI: 0.70-1.00, and a higher risk of total mortality (HR = 1.20, 95% CI: 1.04-1.39.CVD was a major contributor to mortality in women with localized breast cancer at age 70-79. Further studies are needed to evaluate both screening and treatment of localized breast cancer tailored to the specific health issues of older women.

  8. INITIAL BREASTFEEDING DIFFICULTIES AND ASSOCIATION WITH BREAST DISORDERS AMONG POSTPARTUM WOMEN.

    Science.gov (United States)

    Barbosa, Gessandro Elpídio Fernandes; Silva, Victor Bruno da; Pereira, Janeide Mendes; Soares, Marianne Silva; Medeiros, Rosemberg Dos Anjos; Pereira, Luciana Barbosa; Pinho, Lucinéia de; Caldeira, Antônio Prates

    2017-01-01

    To investigate the prevalence of difficulties in adopting initial breastfeeding techniques and their association with breast disorders in postpartum women. The cross-sectional study was carried out with 276 randomly selected mother-baby pairs in rooming-in in 3 hospitals in a city of Minas Gerais State (southeast Brazil). An assessment protocol was established to evaluate the breastfeeding technique used. The association between the variables studied and breast disorders was determined by the chi-square test followed by logistic regression, with significance level set at 0.05. The main factors indicating difficulties to initiate the breastfeeding techniques were inadequate attachment of the baby to the breast (25%), baby response to the contact with the breast (26.1%) and breast disorders (28.3%). Variables associated with postparturm breast disorders were: adolescent mothers (OR 3.35; 95%CI 1.51-7.44; p=0.003); maternal schooling ≤8 years (OR 2.07; 95%CI 1.01-4.23; p=0.048); and supplement provision to the newborn at the hospital (OR 2.36; 95%CI 1.40-4.92; p=0.003). Mothers working outside the household (OR 0.31; 95%CI 0.16-0.61; p=0.001) served as as protective factor on the multivariate model. The main difficulties in initial breastfeeding were associated with breast disorders, and the factors associated with this problem included demographic and social, variables, as well as others related to the care routine adopted by maternity hospitals.

  9. Association between sleep and breast cancer incidence among postmenopausal women in the Women's Health Initiative.

    Science.gov (United States)

    Vogtmann, Emily; Levitan, Emily B; Hale, Lauren; Shikany, James M; Shah, Neomi A; Endeshaw, Yohannes; Lewis, Cora E; Manson, Joann E; Chlebowski, Rowan T

    2013-10-01

    To determine whether the duration of sleep, sleep quality, insomnia, or sleep disturbance was associated with incident breast cancer in the Women's Health Initiative (WHI). Prospective cohort study. Women enrolled in one of the Clinical Trial (CT) arms or the Observational Study (OS) from the WHI conducted in the United States. This study included 110,011 women age 50 to 79 years with no history of cancer. Typical sleep duration, sleep quality, and other self-reported sleep measures over the past 4 weeks were assessed during the screening visits for both the CT and OS participants. The presence of insomnia and level of sleep disturbance was calculated from an index of the WHI Insomnia Rating Scale. The outcome for this study was primary, invasive breast cancer. A total of 5,149 incident cases of breast cancer were identified in this study. No statistically significant associations were found between sleep duration, sleep quality, insomnia, or level of sleep disturbance with the risk of breast cancer after multivariable adjustment. A positive trend was observed for increasing sleeping duration with the risk of estrogen receptor positive breast cancer, but the association estimates for each sleep duration category were weak and nonsignificant. This study does not provide strong support for an association between self-reported sleep duration, sleep quality, insomnia, or sleep disturbance with the risk of breast cancer.

  10. High education and increased parity are associated with breast-feeding initiation and duration among Australian women.

    Science.gov (United States)

    Holowko, Natalie; Jones, Mark; Koupil, Ilona; Tooth, Leigh; Mishra, Gita

    2016-10-01

    Breast-feeding is associated with positive maternal and infant health and development outcomes. To assist identifying women less likely to meet infant nutritional guidelines, we investigated the role of socio-economic position and parity on initiation of and sustaining breast-feeding for at least 6 months. Prospective cohort study. Australia. Parous women from the Australian Longitudinal Study on Women's Health (born 1973-78), with self-reported reproductive and breast-feeding history (N 4777). While 89 % of women (83 % of infants) had ever breast-fed, only 60 % of infants were breast-fed for at least 6 months. Multiparous women were more likely to breast-feed their first child (~90 % v. ~71 % of primiparous women), and women who breast-fed their first child were more likely to breast-feed subsequent children. Women with a low education (adjusted OR (95 % CI): 2·09 (1·67, 2·62)) or a very low-educated parent (1·47 (1·16, 1·88)) had increased odds of not initiating breast-feeding with their first or subsequent children. While fewer women initiated breast-feeding with their youngest child, this was most pronounced among high-educated women. While ~60 % of women breast-fed their first, second and third child for at least 6 months, low-educated women (first child, adjusted OR (95 % CI): 2·19 (1·79, 2·68)) and women with a very low (1·82 (1·49, 2·22)) or low-educated parent (1·69 (1·33, 2·14)) had increased odds of not breast-feeding for at least 6 months. A greater understanding of barriers to initiating and sustaining breast-feeding, some of which are socio-economic-specific, may assist in reducing inequalities in infant breast-feeding.

  11. The Haiti Breast Cancer Initiative: Initial Findings and Analysis of Barriers-to-Care Delaying Patient Presentation

    Directory of Open Access Journals (Sweden)

    Ketan Sharma

    2013-01-01

    Full Text Available Background. In Haiti, breast cancer patients present at such advanced stages that even modern therapies offer modest survival benefit. Identifying the personal, sociocultural, and economic barriers-to-care delaying patient presentation is crucial to controlling disease. Methods. Patients presenting to the Hôpital Bon Sauveur in Cange were prospectively accrued. Delay was defined as 12 weeks or longer from initial sign/symptom discovery to presentation, as durations greater than this cutoff correlate with reduced survival. A matched case-control analysis with multivariate logistic regression was used to identify factors predicting delay. Results. Of N=123 patients accrued, 90 (73% reported symptom-presentation duration and formed the basis of this study: 52 patients presented within 12 weeks of symptoms, while 38 patients waited longer than 12 weeks. On logistic regression, lower education status (OR = 5.6, P=0.03, failure to initially recognize mass as important (OR = 13.0, P<0.01, and fear of treatment cost (OR = 8.3, P=0.03 were shown to independently predict delayed patient presentation. Conclusion. To reduce stage at presentation, future interventions must educate patients on the recognition of initial breast cancer signs and symptoms and address cost concerns by providing care free of charge and/or advertising that existing care is already free.

  12. X-ray scatter correction method for dedicated breast computed tomography: improvements and initial patient testing.

    Science.gov (United States)

    Ramamurthy, Senthil; D'Orsi, Carl J; Sechopoulos, Ioannis

    2016-02-07

    A previously proposed x-ray scatter correction method for dedicated breast computed tomography was further developed and implemented so as to allow for initial patient testing. The method involves the acquisition of a complete second set of breast CT projections covering 360° with a perforated tungsten plate in the path of the x-ray beam. To make patient testing feasible, a wirelessly controlled electronic positioner for the tungsten plate was designed and added to a breast CT system. Other improvements to the algorithm were implemented, including automated exclusion of non-valid primary estimate points and the use of a different approximation method to estimate the full scatter signal. To evaluate the effectiveness of the algorithm, evaluation of the resulting image quality was performed with a breast phantom and with nine patient images. The improvements in the algorithm resulted in the avoidance of introduction of artifacts, especially at the object borders, which was an issue in the previous implementation in some cases. Both contrast, in terms of signal difference and signal difference-to-noise ratio were improved with the proposed method, as opposed to with the correction algorithm incorporated in the system, which does not recover contrast. Patient image evaluation also showed enhanced contrast, better cupping correction, and more consistent voxel values for the different tissues. The algorithm also reduces artifacts present in reconstructions of non-regularly shaped breasts. With the implemented hardware and software improvements, the proposed method can be reliably used during patient breast CT imaging, resulting in improvement of image quality, no introduction of artifacts, and in some cases reduction of artifacts already present. The impact of the algorithm on actual clinical performance for detection, diagnosis and other clinical tasks in breast imaging remains to be evaluated.

  13. A Targetable EGFR-Dependent Tumor-Initiating Program in Breast Cancer

    Directory of Open Access Journals (Sweden)

    Paul Savage

    2017-10-01

    Full Text Available Summary: Therapies targeting epidermal growth factor receptor (EGFR have variable and unpredictable responses in breast cancer. Screening triple-negative breast cancer (TNBC patient-derived xenografts (PDXs, we identify a subset responsive to EGFR inhibition by gefitinib, which displays heterogeneous expression of wild-type EGFR. Deep single-cell RNA sequencing of 3,500 cells from an exceptional responder identified subpopulations displaying distinct biological features, where elevated EGFR expression was significantly enriched in a mesenchymal/stem-like cellular cluster. Sorted EGFRhi subpopulations exhibited enhanced stem-like features, including ALDH activity, sphere-forming efficiency, and tumorigenic and metastatic potential. EGFRhi cells gave rise to EGFRhi and EGFRlo cells in primary and metastatic tumors, demonstrating an EGFR-dependent expansion and hierarchical state transition. Similar tumorigenic EGFRhi subpopulations were identified in independent PDXs, where heterogeneous EGFR expression correlated with gefitinib sensitivity. This provides new understanding for an EGFR-dependent hierarchy in TNBC and for patient stratification for therapeutic intervention. : Savage et al. demonstrate that sensitivity to EGFR inhibitor, gefitinib, in triple-negative breast cancer is paradoxically associated with EGFR heterogeneity. Using single-cell RNA sequencing in conjunction with functional assays, they identify TNBC tumors in which EGFR expression identifies cells with tumor-initiating capacity whose proliferative expansion is sensitive to EGFR inhibition. Keywords: breast cancer, tumor heterogeneity, patient-derived xenograft, single-cell RNA sequencing, EGFR inhibition, therapeutic response, tumor-initiating cell, cell hierarchy, BRCA1 mutation

  14. Selection of Brain Metastasis-Initiating Breast Cancer Cells Determined by Growth on Hard Agar

    Science.gov (United States)

    Guo, Lixia; Fan, Dominic; Zhang, Fahao; Price, Janet E.; Lee, Ju-Seog; Marchetti, Dario; Fidler, Isaiah J.; Langley, Robert R.

    2011-01-01

    An approach that facilitates rapid isolation and characterization of tumor cells with enhanced metastatic potential is highly desirable. Here, we demonstrate that plating GI-101A human breast cancer cells on hard (0.9%) agar selects for the subpopulation of metastasis-initiating cells. The agar-selected cells, designated GI-AGR, were homogeneous for CD44+ and CD133+ and five times more invasive than the parental GI-101A cells. Moreover, mice injected with GI-AGR cells had significantly more experimental brain metastases and shorter overall survival than did mice injected with GI-101A cells. Comparative gene expression analysis revealed that GI-AGR cells were markedly distinct from the parental cells but shared an overlapping pattern of gene expression with the GI-101A subline GI-BRN, which was generated by repeated in vivo recycling of GI-101A cells in an experimental brain metastasis model. Data mining on 216 genes shared between GI-AGR and GI-BRN breast cancer cells suggested that the molecular phenotype of these cells is consistent with that of cancer stem cells and the aggressive basal subtype of breast cancer. Collectively, these results demonstrate that analysis of cell growth in a hard agar assay is a powerful tool for selecting metastasis-initiating cells in a heterogeneous population of breast cancer cells, and that such selected cells have properties similar to those of tumor cells that are selected based on their potential to form metastases in mice. PMID:21514446

  15. Initiation of population-based mammography screening in Dutch municipalities and effect on breast-cancer mortality: a systematic review.

    NARCIS (Netherlands)

    Otto, S.J.; Fracheboud, J.; Looman, C.W.; Broeders, M.J.M.; Boer, R.; Hendriks, J.H.C.L.; Verbeek, A.L.M.; Koning, H.J. de

    2003-01-01

    BACKGROUND: More than a decade ago, a mammography screening programme for women aged 50-69 years was initiated in the Netherlands. Our aim was to assess the effect of this programme on breast-cancer mortality rates. METHODS: We examined data for 27948 women who died of breast-cancer aged 55-74 years

  16. Age of smoking initiation and risk of breast cancer in a sample of Ontario women

    Directory of Open Access Journals (Sweden)

    Sloan Margaret

    2009-02-01

    Full Text Available Abstract Objectives To examine the association between time of smoking initiation and both the independent and joint effects of active and passive tobacco smoke exposure and the risk of breast cancer in a sample of Ontario women. Methods Data from two large population-based case-control studies conducted among Ontario women aged 25–75 years were combined for analysis (n = 12,768. Results Women who had ever smoked and were exposed to passive smoke had a significant increased risk of breast cancer (OR 1.13, 95%CI 1.01–1.25. A significant increased risk was also observed among women who initiated smoking: at age 26 or older (OR 1.26, 95%CI 1.03–1.55; more than five years from menarche (OR 1.26, 95%CI 1.12–1.42; and, after their first live birth (OR 1.25, 95%CI 1.02–1.52. Conclusion The results suggest that women who initiate smoking at an older age are at an increased risk of breast cancer.

  17. Chemokines in cancer related inflammation

    Energy Technology Data Exchange (ETDEWEB)

    Allavena, Paola; Germano, Giovanni; Marchesi, Federica [Department of Immunology and Inflammation, IRCCS Humanitas Clinical Institute, Via Manzoni 56, 20089, Rozzano, Milan (Italy); Mantovani, Alberto, E-mail: alberto.mantovani@humanitasresearch.it [Department of Immunology and Inflammation, IRCCS Humanitas Clinical Institute, Via Manzoni 56, 20089, Rozzano, Milan (Italy); Department of Translational Medicine, University of Milan (Italy)

    2011-03-10

    Chemokines are key players of the cancer-related inflammation. Chemokine ligands and receptors are downstream of genetic events that cause neoplastic transformation and are abundantly expressed in chronic inflammatory conditions which predispose to cancer. Components of the chemokine system affect multiple pathways of tumor progression including: leukocyte recruitment, neo-angiogenesis, tumor cell proliferation and survival, invasion and metastasis. Evidence in pre-clinical and clinical settings suggests that the chemokine system represents a valuable target for the development of innovative therapeutic strategies.

  18. Metastatic breast cancer cells adhere strongly on varying stiffness substrates, initially without adjusting their morphology.

    Science.gov (United States)

    Massalha, Sonbula; Weihs, Daphne

    2017-06-01

    We show that metastatic breast cancer cells are quantitatively identifiable from benign cells during adherence onto soft, elastic gels. We identify differences in time-dependent morphology and strength of adherence of single breast cells that are likely related to their malignancy and metastatic potential (MP). Specifically, we compare high and low MP breast cancer cells with benign cells as a control on collagen-coated, polyacrylamide gels with Young's modulus in the physiological range of 2.4-10.6 kPa. We observe that the evaluated metastatic breast cancer cells remain rounded, with small contact area, up to 6.5 h following seeding. In contrast, the benign cells spread and become more elongated on stiffer gels. We identify measurable differences in the two-dimensional, lateral, traction forces exerted by the cells, where the rounded, metastatic cells apply significantly larger, traction forces, as compared to the benign cells, on gels stiffer than 2.4 kPa. The metastatic cell lines exhibited gel-stiffness-dependent differences in traction forces, strain energies, and morphologies during the initial stages of adhesion, which may relate to their MP or invasiveness.

  19. Breast MR imaging for the assessment of residual disease following initial surgery for breast cancer with positive margins

    Energy Technology Data Exchange (ETDEWEB)

    Krammer, Julia [University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Institute of Clinical Radiology and Nuclear Medicine, Mannheim (Germany); Memorial Sloan-Kettering Cancer Center, Breast Imaging Section, Department of Radiology, New York, NY (United States); Price, Elissa R. [University of California, San Francisco, Department of Radiology and Biomedical Imaging, Division of Women' s Imaging, San Francisco, CA (United States); Jochelson, Maxine S.; Watson, Elizabeth; Morris, Elizabeth A. [Memorial Sloan-Kettering Cancer Center, Breast Imaging Section, Department of Radiology, New York, NY (United States); Murray, Melissa P. [Memorial Sloan-Kettering Cancer Center, Department of Pathology, New York, NY (United States); Schoenberg, Stefan O. [University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Institute of Clinical Radiology and Nuclear Medicine, Mannheim (Germany)

    2017-11-15

    To determine the accuracy of post-operative MR in predicting residual disease in women with positive margins, emphasizing the size thresholds at which residual disease can be confidently identified. This IRB-approved HIPAA-compliant retrospective study included 175 patients with MR after positive margins following initial surgery for breast cancer. Two expert readers independently re-evaluated MR images for evidence of residual disease at the surgical cavity and multifocal/multicentric disease. All patients underwent definitive surgery and MR findings were correlated to histopathology. 139/175 (79.4%) patients had residual disease at surgery. Average overall sensitivity, specificity, PPV and NPV for residual disease at the surgical cavity were 73%, 72%, 91% and 45%, respectively. The readers identified 42/45 (93%, reader 1) and 43/45 (95%, reader 2) patients with residual invasive disease at the cavity of ≥5 mm and 22/22 (100%, both readers) patients with disease ≥10 mm. Average sensitivity, specificity, PPV and NPV for unknown multifocal/multicentric disease were 90%, 96%, 93% and 86%, respectively. Post-operative breast MR can accurately depict ≥5-mm residual disease at the surgical cavity and unsuspected multifocal/multicentric disease. These findings have the potential to lead to more appropriate selection of second surgical procedures in women with positive margins. (orig.)

  20. Real-time ultrasound elasticity of the breast: initial clinical results.

    Science.gov (United States)

    Barr, Richard G

    2010-06-01

    To determine the sensitivity and specificity of a real-time elasticity imaging (EI) ultrasound (US) system in the characterization of breast lesions as benign or malignant. A total of 208 patients with 251 lesions were scheduled to undergo a US-guided breast biopsy for a mass identified on B-mode US, and each received a real-time elasticity image of the lesion before the biopsy. The lesion size measurements were obtained, and the EI/B-mode size ratio was obtained. The pathology report was obtained and correlated with the EI/B-mode ratio. An EI/B-mode ratio equal to or greater than 1 was considered malignant lesion, whereas EI/B-mode ratios of less than 1 were considered benign. Sensitivity, specificity, positive predictive values, and negative predictive values were calculated. Of the 251 lesions biopsied, 197 were pathologically benign, and 54 were malignant. Of the 54 malignant lesions, all had an EI/B-mode ratio equal to or greater than 1. Of the 197 benign lesions, 187 had an EI/B-mode ratio of less than 1. Ten benign lesions had an EI/B-mode ratio of greater than 1. The benign lesions that had an EI/B-mode ratio of greater than 1 were lesions with dense fibrosis, and in addition, a characteristic artifact was identified, which was visualized in all simple and complex cysts. The results correspond with a sensitivity of 100%, specificity of 95%, a positive predictive value of 84%, and a negative predictive value of 100%. Initial results of a real-time EI system for characterization of breast lesions suggest this technique can provide significant new diagnostic information. As a result, this information may significantly improve the ability to select patients for breast biopsy, resulting in a reduction in the number of benign breast biopsies.

  1. Narrowing Racial Gaps in Breast Cancer Chemotherapy Initiation: The Role of the Patient-Provider Relationship

    Science.gov (United States)

    Sheppard, Vanessa B.; Isaacs, Claudine; Luta, George; Willey, Shawna C.; Boisvert, Marc; Harper, Felicity W. K.; Smith, Karen; Horton, Sara; Liu, Minetta C.; Jennings, Yvonne; Hirpa, Fikru; Snead, Felicia; Mandelblatt, Jeanne S.

    2013-01-01

    Purpose Chemotherapy improves breast cancer survival but is underused more often in black than in white women. We examined associations between patient-physician relationships and chemotherapy initiation and timeliness of initiation among black and white patients. Methods Women with primary invasive, non-metastatic breast cancer were recruited via hospitals (in Washington, DC and Detroit) and community outreach between July 2006 and April 2011. Data were collected via telephone interviews and medical records. Logistic regression models evaluated associations between chemotherapy initiation and independent variables. Since there were race interactions, analyses were race-stratified. Factors associated with time from surgery to chemotherapy initiation and delay of ≥ 90 days were evaluated with linear and logistic regressions, respectively. Results Among eligible women, 82.8% were interviewed and 359 (90.9%)of those had complete data. The odds of initiating chemotherapy were 3.26 times (95% CI: 1.51, 7.06) higher among black women reporting greater communication with physicians (vs. lesser), after considering covariates. In contrast, the odds of starting chemotherapy were lower for white women reporting greater communication (vs. lesser) (adjusted OR .22, 95% CI: .07, .73). The opposing direction of associations was also seen among the sub-set of black and white women with definitive clinical indications for chemotherapy. Among those initiating treatment, black women had longer mean time to the start of chemotherapy than whites (71.8 days vs. 55.0 days, p= .005), but race was not significant after considering trust in oncologists, where initiation time decreased as trust increased, controlling for covariates. Black women were also more likely to delay ≥ 90 days than whites (27% vs. 8.3%; p=.024), but this was not significant after considering religiosity. Conclusion The patient-physician dyad and sociocultural factors may represent leverage points to improve

  2. Elucidation of altered pathways in tumor-initiating cells of triple-negative breast cancer

    DEFF Research Database (Denmark)

    Christensen, Anne G; Ehmsen, Sidse; Terp, Mikkel G

    2017-01-01

    A limited number of cancer cells within a tumor are thought to have self-renewing and tumor-initiating capabilities that produce the remaining cancer cells in a heterogeneous tumor mass. Elucidation of central pathways preferentially used by tumor-initiating cells/cancer stem cells (CSCs) may allow...... reduction was also observed using patient-derived primary cancer cells. Further, blocking NF-κB signaling in mice transplanted with tumor-initiating cells significantly reduced tumor outgrowth. Our study demonstrates that suppressed apoptosis, activation of pathways associated with cell viability and CSCs...... their exploitation as potential cancer therapy targets. We used single cell cloning to isolate and characterize four isogenic cell clones from a triple-negative breast cancer cell line; two exhibited mesenchymal-like and two epithelial-like characteristics. Within these pairs, one, but not the other, resulted...

  3. Evaluating the impact of the Baby-Friendly Hospital Initiative on breast-feeding rates: a multi-state analysis.

    Science.gov (United States)

    Hawkins, Summer Sherburne; Stern, Ariel Dora; Baum, Christopher F; Gillman, Matthew W

    2015-02-01

    To evaluate the impact of the Baby-Friendly Hospital Initiative (BFHI) on breast-feeding initiation and duration overall and according to maternal education. Quasi-experimental study using data from five states (Alaska, Maine, Nebraska, Ohio, Washington) that participated in the Pregnancy Risk Assessment Monitoring System from 1999 to 2009. Using differences-in-differences models that included year and hospital fixed effects, we compared rates of breast-feeding initiation and duration (any and exclusive breast-feeding for ≥4 weeks) before and after BFHI accreditation between mothers who gave birth in hospitals that were accredited or became accredited and mothers from matched non-BFHI facilities. We stratified analyses into lower and higher education groups. Thirteen BFHI hospitals and nineteen matched non-BFHI facilities across five states in the USA. Mothers (n 11 723) who gave birth in BFHI hospitals and mothers (n 13 604) from nineteen matched non-BFHI facilities. Although we did not find overall differences in breast-feeding initiation between birth facilities that received BFHI accreditation compared with non-Baby-Friendly facilities (adjusted coefficient = 0·024; 95 % CI -0·00, 0·51), breast-feeding initiation increased by 3·8 percentage points among mothers with lower education who delivered in Baby-Friendly facilities (P = 0·05), but not among mothers with higher education (adjusted coefficient = 0·002; 95 % CI -0·04, 0·05). BFHI accreditation also increased exclusive breast-feeding for ≥4 weeks by 4·5 percentage points (P = 0·02) among mothers with lower education who delivered in BFHI facilities. By increasing breast-feeding initiation and duration among mothers with lower education, the BFHI may reduce socio-economic disparities in breast-feeding.

  4. Capturing Changes in the Brain Microenvironment during Initial Steps of Breast Cancer Brain Metastasis

    Science.gov (United States)

    Lorger, Mihaela; Felding-Habermann, Brunhilde

    2010-01-01

    Brain metastases are difficult to treat and mostly develop late during progressive metastatic disease. Patients at risk would benefit from the development of prevention and improved treatments. This requires knowledge of the initial events that lead to brain metastasis. The present study reveals cellular events during the initiation of brain metastasis by breast cancer cells and documents the earliest host responses to incoming cancer cells after carotid artery injection in immunodeficient and immunocompetent mouse models. Our findings capture and characterize heterogeneous astrocytic and microglial reactions to the arrest and extravasation of cancer cells in the brain, showing immediate and drastic changes in the brain microenvironment on arrival of individual cancer cells. We identified reactive astrocytes as the most active host cell population that immediately localizes to individual invading tumor cells and continuously associates with growing metastatic lesions. Up-regulation of matrix metalloproteinase-9 associated with astrocyte activation in the immediate vicinity of extravasating cancer cells might support their progression. Early involvement of different host cell types indicates environmental clues that might codetermine whether a single cancer cell progresses to macrometastasis or remains dormant. Thus, information on the initial interplay between brain homing tumor cells and reactive host cells may help develop strategies for prevention and treatment of symptomatic breast cancer brain metastases. PMID:20382702

  5. ABCG2 is a potential marker of tumor-initiating cells in breast cancer.

    Science.gov (United States)

    Sicchieri, Renata Danielle; da Silveira, Willian Abraham; Mandarano, Larissa Raquel Mouro; de Oliveira, Tatiane Mendes Gonçalves; Carrara, Hélio Humberto Angotti; Muglia, Valdair Francisco; de Andrade, Jurandyr Moreira; Tiezzi, Daniel Guimarães

    2015-12-01

    The existence of tumor-initiating cells (TICs) within solid tumors has been hypothesized to explain tumor heterogeneity and resistance to cancer therapy. In breast cancer, the expression of CD44 and CD24 and the activity of aldehyde dehydrogenase 1 (ALDH1) can be used to selectively isolate a cell population enriched in TICs. However, the ideal marker to identify TICs has not been established. The aim of this study was to evaluate the expression of novel potential markers for TIC in breast carcinoma. We prospectively analyzed the expression of CD44, CD24, ABCG2, and CXCR4, and the activity of ALDH1 by using flow cytometry in 48 invasive ductal carcinomas from locally advanced and metastatic breast cancer patients who were administered primary chemotherapy. A mammosphere assay was employed in 30 samples. The relationship among flow cytometric analyses, ABCG2 gene expression, and clinical and pathological responses to therapy was analyzed. The GSE32646 database was analyzed in silico to identify genes associated with tumors with low and high ABCG2 expression. We observed that the presence of ABCG2(+) cells within the primary tumor was the only marker to predict the formation of mammospheres in vitro (R (2) = 0.15, p = 0.029). Quantitative polymerase chain reaction (qPCR) revealed a positive correlation between ABCG2 expression and the presence of ABCG2(+) cells within the primary tumor. The expression of ABCG2 was predictive of the response to neoadjuvant chemotherapy in our experiments and in the GSE32646 dataset (p = 0.04 and p = 0.002, respectively). The in silico analysis demonstrated that ABCG2(Up) breast cancer samples have a slower cell cycle and a higher expression of membrane proteins but a greater potential for chromosomal instability, metastasis, immune evasion, and resistance to hypoxia. Such genetic characteristics are compatible with highly aggressive and resistant tumors. Our results support the hypothesis that the presence of ABCG2

  6. Cancer-Related Fatigue: a multidimensional approach

    OpenAIRE

    Raaf, Pleun

    2013-01-01

    textabstractFatigue is experienced by cancer patients in all stages of the disease trajectory: from before diagnosis to years after completing treatment and also in advanced cancer. Fatigue has a greater negative influence on quality of life and daily activities than any other cancer-related symptom. Although both national and international guidelines have been developed to enhance the management of cancer-related fatigue, cancer-related fatigue is still poorly understood. This thesis describ...

  7. Initiators and promoters for the occurrence of screen-detected breast cancer and the progression to clinically-detected interval breast cancer.

    Science.gov (United States)

    Yen, Amy Ming-Fang; Wu, Wendy Yi-Ying; Tabar, Laszlo; Duffy, Stephen W; Smith, Robert A; Chen, Hsiu-Hsi

    2017-03-01

    The risk factors responsible for breast cancer have been well documented, but the roles of risk factors as initiators, causing the occurrence of screen-detected breast cancer, or promoters, responsible for the progression of the screen-detected to the clinically-detected breast cancer, have been scarcely evaluated. We used data from women in a cohort in Kopparberg (Dalarna), Sweden between 1977 and 2010. Conventional risk factors, breast density, and tumor-specific biomarkers are superimposed to the temporal course of the natural history of the disease. The results show that older age at first full-term pregnancy, dense breast, and a family history of breast cancer increased the risk of entering the preclinical screen-detectable phase of breast cancer by 23%, 41%, and 89%, respectively. Overweight/obesity (body mass index ≥25 kg/m 2 ) was a significant initiator (adjusted relative risk [aRR] 1.15; 95% confidence interval [CI], 0.99-1.33), but was inversely associated with the role of promoter (aRR 0.65; 95% CI, 0.51-0.82). Dense breast (aRR 1.46; 95% CI, 1.12-1.91), triple-negative (aRR 2.07; 95% CI, 1.37-3.15), and Ki-67 positivity (aRR 1.66; 95% CI, 1.19-2.30) were statistically significant promoters. When the molecular biomarkers were considered collectively as one classification, the basal-like subtype was the most influential subtype on promoters (aRR 4.24; 95% CI, 2.56-7.02) compared with the Luminal A subtype. We ascertained state-dependent covariates of initiators and promoters to classify the risk of the two-step progression of breast cancer. The results of the current study are useful for individually-tailored screening and personalized clinical surveillance of patients with breast cancer that was detected at an early stage. Copyright © 2016 The Authors. Production and hosting by Elsevier B.V. All rights reserved.

  8. Proteolysis-a characteristic of tumor-initiating cells in murine metastatic breast cancer

    Science.gov (United States)

    Hillebrand, Larissa E.; Bengsch, Fee; Hochrein, Jochen; Hülsdünker, Jan; Bender, Julia; Follo, Marie; Busch, Hauke; Boerries, Melanie; Reinheckel, Thomas

    2016-01-01

    Tumor initiating cells (TICs) have been identified and functionally characterized in hematological malignancies as well as in solid tumors such as breast cancer. In addition to their high tumor-initiating potential, TICs are founder cells for metastasis formation and are involved in chemotherapy resistance. In this study we explored molecular pathways which enable this tumor initiating potential for a cancer cell subset of the transgenic MMTV-PyMT mouse model for metastasizing breast cancer. The cell population, characterized by the marker profile CD24+CD90+CD45−, showed a high tumorigenicity compared to non-CD24+CD90+CD45− cancer cells in colony formation assays, as well as upon orthotopic transplantation into the mammary fat pad of mice. In addition, these orthotopically grown CD24+CD90+CD45− TICs metastasized to the lungs. The transcriptome of TICs freshly isolated from primary tumors by cell sorting was compared with that of sorted non-CD24+CD90+CD45− cancer cells by RNA-seq. In addition to more established TIC signatures, such as epithelial-to-mesenchymal transition or mitogen signaling, an upregulated gene set comprising several classes of proteolytic enzymes was uncovered in the TICs. Accordingly, TICs showed high intra- and extracellular proteolytic activity. Application of a broad range of protease inhibitors to TICs in a colony formation assay reduced anchorage independent growth and had an impact on colony morphology in 3D cell culture assays. We conclude that CD24+CD90+CD45− cells of the MMTV- PyMT mouse model possess an upregulated proteolytic signature which could very well represent a functional hallmark of metastatic TICs from mammary carcinomas. PMID:27542270

  9. Initial clinical experience with multilumen brachytherapy catheters for accelerated partial breast irradiation.

    Science.gov (United States)

    Shah, Chirag; Ghilezan, Mihai; Arthur, Douglas; Wilkinson, John B; Keisch, Martin; Chen, Peter; Vicini, Frank A

    2012-01-01

    To review the initial experience of three institutions using multilumen catheters to deliver accelerated partial breast irradiation (APBI) and evaluate dosimetric improvements. Patients were eligible for this analysis if they met criteria for accelerated partial breast irradiation at their respective institution and were not enrolled on the national Phase III trial. Minimum guidelines for treatment planning from the National Surgical Adjuvant Breast and Bowel Project B-39/Radiation Therapy Oncology Group 0413 protocol were followed. Toxicities were coded using common toxicity criteria version 3.0 criteria. Sixty-two patients were analyzed as part of this study. Median skin spacing was 11mm with a median skin dose of 86.9% (% of prescription dose [PD]). Median rib dose was 76.1% of the PD (range, 4.3-155.7%). The V(90), V(95), and V(100) of the PD for the planning target volume evaluation was 95.4%, 95.2%, and 80.3%, respectively. Seven patients had both skin and rib spacing skin dose and rib dose being 113.4% and 130.9% of the PD. For these cases, the median V(90), V(95), and V(100) of the PD was 99.2%, 94.3%, and 81.1%, respectively, whereas the median V(150) and V(200) were 22.5cc and 7.4cc. Overall, Grade I and II radiation dermatitis were noted in 41.9% and 6.5% of patients. The multilumen device led to improvements in target coverage and normal structure doses compared with traditionally accepted guidelines. Similar toxicities were seen compared with single-lumen devices, even in patients with skin and rib spacing Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  10. Dietary Glycemic Load, Glycemic Index, and Carbohydrate and Risk of Breast Cancer in the Women’s Health Initiative

    Science.gov (United States)

    Shikany, James M.; Redden, David T.; Neuhouser, Marian L.; Chlebowski, Rowan T.; Rohan, Thomas E.; Simon, Michael S.; Liu, Simin; Lane, Dorothy S.; Tinker, Lesley

    2013-01-01

    Dietary glycemic load (GL), glycemic index (GI), and carbohydrate could be associated with breast cancer risk by influencing long-term blood glucose and insulin concentrations. We examined associations between GL, GI, and carbohydrate and incident breast cancer in 148,767 Women’s Heath Initiative (WHI) participants. Dietary variables were estimated from food frequency questionnaires administered at baseline. Self-reported breast cancers during follow-up were confirmed by medical records review. Cox proportional hazards regression modeled time to breast cancer within quintiles of GL, GI, and carbohydrate. There were 6,115 total breast cancers after a median follow-up of 8.0 yr. We observed no associations between GL, GI, or carbohydrate and total incident breast cancer, with hazard ratios and 95% confidence intervals for the highest vs. lowest quintiles of 1.08, 0.92–1.29 (P for trend = 0.27); 1.01, 0.91–1.12 (P = 0.74); and 0.95, 0.80–1.14 (P = 0.98), respectively. There was a trend toward significance for the positive association between GL and in situ cancers (1.40, 0.94–2.13; P = 0.07). Although there was no evidence of associations between GL, GI, or carbohydrate and total breast cancer risk in WHI participants, the suggestion of an association between GL and risk of in situ cancers requires further investigation. PMID:21714685

  11. Associations between cancer-related financial stress and strain and psychological well-being among individuals living with cancer.

    Science.gov (United States)

    Sharp, Linda; Carsin, Anne-Elie; Timmons, Aileen

    2013-04-01

    Cancer places a financial and economic burden on individuals, but relatively little is known about the consequences. We investigated associations between cancer-related financial stress and strain and psychological well-being. Individuals >6 months post-diagnosis with breast, prostate and lung cancer, identified from the National Cancer Registry Ireland, completed a postal questionnaire. Financial stress was assessed by the impact of the cancer diagnosis on household ability to make ends meet, financial strain by feelings about household financial situation since the cancer diagnosis and psychological well-being (depression, anxiety and distress) by the Depression Anxiety Stress Scales-21. Logistic regression was used to identify associations between financial stress and strain and depression, anxiety and distress of (a) any severity and (b) severe or worse. The response rate was 54%. Of 654 respondents, 49% reported increased financial stress and 32% increased financial strain due to cancer. Depression, anxiety and distress were present in: 36%, 29% and 29%, respectively (any severity); and 14%, 13% and 13%, respectively (severe or worse). In adjusted analyses, depression risk was raised threefold in those reporting increased cancer-related financial stress (odds ratio (OR) = 2.79, 95%CI 1.87-4.17) and increased cancer-related financial strain (OR = 3.56, 95%CI 2.23-5.67). For severe or worse depression, the risk estimates were more pronounced (increased stress: OR = 4.36, 95%CI 2.35-8.10; increased strain: OR = 8.21, 95%CI 3.79-17.77). Similar associations were found for anxiety and distress. Cancer-related financial stress and strain were consistently associated with increased risk of adverse psychological outcomes. If confirmed, these findings provide further rationale for initiatives to alleviate the financial burden of cancer. Copyright © 2012 John Wiley & Sons, Ltd.

  12. Evidence based breast-feeding promotion: the Baby-Friendly Hospital Initiative.

    Science.gov (United States)

    Pérez-Escamilla, Rafael

    2007-02-01

    The Baby-Friendly Hospital Initiative (BFHI) is the translational tool developed by WHO and UNICEF to promote breast-feeding (BF) in maternity wards worldwide. BFHI was officially launched in the 1980s based on a "common sense" approach. Since then, research conducted in Latin America has shown that BFHI is highly cost-effective. BF trends over the past 2 decades strongly suggest that BFHI has had a global impact on BF outcomes. The 10th step of BFHI related to community-based BF promotion is one of the most challenging ones to address. Randomized controlled trials conducted in the Americas, Asia, and sub-Saharan Africa indicate that peer counseling is a very efficacious tool for increasing EBF rates. Low-cost rapid-response monitoring systems are needed to monitor the proper implementation and administration of BFHI steps following an evidence-based approach. This approach is essential for reenergizing the BFHI worldwide.

  13. Avaliação dos fatores de risco no linfedema pós-tratamento de câncer de mama Risk factors for breast cancer related lymphedema

    Directory of Open Access Journals (Sweden)

    Laura Ferreira de Rezende

    2010-12-01

    Full Text Available A principal complicação tardia no pós-operatório de câncer de mama é o desenvolvimento do linfedema, uma doença crônica, progressiva, geralmente incurável. O aumento do volume do membro pode desfigurar a imagem corporal, assim como aumentar a morbidade física e psicológica da paciente, além de promover significativo prejuízo para as funções. O presente estudo foi desenvolvido por meio de uma revisão sistemática a partir do cruzamento aleatório das palavras-chave: "linfedema", "compensações linfáticas", "sistema linfático", "dissecção axilar", "fatores de risco" e "câncer de mama". Foram selecionados 18 artigos entre os anos de 1979 e 2009, nos quais foram encontrados como principais fatores de risco para o desenvolvimento do linfedema a radioterapia, radioterapia axilar, infecção, dissecção axilar seguida de radioterapia, obesidade, número de linfonodos retirados e comprometidos e agressividade da cirurgia. As formas de compensação linfática após a dissecção axilar, como as anastomoses linfo-linfáticas, podem ser prejudicadas pela formação cicatricial, seroma pós-operatório, radioterapia e exercícios inadequados para reabilitação de ombro no câncer de mama.The main late complication after the surgery of breast cancer is the development of lymphedema, a chronic, progressive, usually incurable disease. The increase in the volume of the limb can disfigure the body image and develop the physical and psychological morbidity of the patient, promoting significant damage to the functions. This study was developed through a systematic review from the randomized crosschecking of the keywords "lymphedema", "lymphatic compensation", "lymphatic system", "axillary dissection", "risk factors" and "breast cancer". Eighteen articles were selected, between 1979 and 2009, in which radiotherapy, axillary radiation, infection, axillary dissection followed by radiotherapy, obesity, number of removed and impaired lymph

  14. The initiator and timing of referral to breast cancer genetic counselling: an exploration of everyday person-centered practice.

    NARCIS (Netherlands)

    Riel, E. van; Hubers, A.J.; Witkamp, A.J.; Dulmen, S. van; Ausems, M.G.E.M.

    2013-01-01

    Objective: The referral process for genetic counselling in breast cancer patients may be compromised by patient-related factors, like patient’s age, referral initiative or cancer history. This study aimed to characterize this referral process in daily clinical practice. Methods: During genetic

  15. Tetrandrine, a Compound Common in Chinese Traditional Medicine, Preferentially Kills Breast Cancer Tumor Initiating Cells (TICs) In Vitro

    Energy Technology Data Exchange (ETDEWEB)

    Xu, Wei; Debeb, Bisrat G.; Lacerda, Lara; Li, Jessica; Woodward, Wendy A., E-mail: wwoodward@mdanderson.org [Division of Radiation Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX 77030 (United States)

    2011-05-04

    Tetrandrine is a bisbenzylisoquinoline alkaloid found in Stephania tetrandra, a Chinese medicine commonly used as an anti-inflammatory. It has extensive pharmacological activity, including positive ion channel blockade and inhibition of multiple drug resistance proteins. These activities are very similar to that of salinomycin, a known drug targeting breast cancer initiation cells (TICs). Herein, we tested tetrandrine targeting of breast cancer TICs. SUM-149, an inflammatory breast cancer cell line and SUM-159, a non-inflammatory metaplastic breast cancer cell line were used in these studies. In proliferation assays using 3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl) -2H-tetrazolium (MTS), we found that the IC{sub 50} for inhibition of proliferation is 15.3 ± 4.1 μM for SUM-149 and 24.3 ± 2.1 μM for SUM-159 cells. Tetrandrine also inhibited mammosphere formation, a surrogate for breast cancer TICs growth in vitro with IC{sub 50} around 1 μM for SUM-149 and around 2 μM for SUM-159 cells. Tetrandrine has similar effects on the mammosphere formation from cells isolated from fresh patient sample. Moreover, tetrandrine decreases the aldehyde dehydrogenase (ALDH) positive population in SUM-159 by 45% ± 5.45% P = 0.005. In summary, tetrandrine demonstrates significant efficacy against in vitro surrogates for inflammatory and aggressive breast cancer TICs.

  16. Tetrandrine, a Compound Common in Chinese Traditional Medicine, Preferentially Kills Breast Cancer Tumor Initiating Cells (TICs In Vitro

    Directory of Open Access Journals (Sweden)

    Jessica Li

    2011-05-01

    Full Text Available Tetrandrine is a bisbenzylisoquinoline alkaloid found in Stephania tetrandra, a Chinese medicine commonly used as an anti-inflammatory. It has extensive pharmacological activity, including positive ion channel blockade and inhibition of multiple drug resistance proteins. These activities are very similar to that of salinomycin, a known drug targeting breast cancer initiation cells (TICs. Herein, we tested tetrandrine targeting of breast cancer TICs. SUM-149, an inflammatory breast cancer cell line and SUM-159, a non-inflammatory metaplastic breast cancer cell line were used in these studies. In proliferation assays using 3-(4,5-dimethylthiazol-2-yl-5-(3-carboxymethoxyphenyl-2-(4-sulfophenyl-2H-tetrazolium (MTS, we found that the IC50 for inhibition of proliferation is 15.3 ± 4.1 µM for SUM-149 and 24.3 ± 2.1 µM for SUM-159 cells. Tetrandrine also inhibited mammosphere formation, a surrogate for breast cancer TICs growth in vitro with IC50 around 1 µM for SUM-149 and around 2 µM for SUM-159 cells. Tetrandrine has similar effects on the mammosphere formation from cells isolated from fresh patient sample. Moreover, tetrandrine decreases the aldehyde dehydrogenase (ALDH positive population in SUM-159 by 45% ± 5.45% P = 0.005. In summary, tetrandrine demonstrates significant efficacy against in vitro surrogates for inflammatory and aggressive breast cancer TICs.

  17. Mitochondrially targeted vitamin E succinate efficiently kills breast tumour-initiating cells in a complex II-dependent manner

    OpenAIRE

    Yan, Bing; Stantic, Marina; Zobalova, Renata; Bezawork-Geleta, Ayenachew; Stapelberg, Michael; Stursa, Jan; Prokopova, Katerina; Dong, Lanfeng; Neuzil, Jiri

    2015-01-01

    Background Accumulating evidence suggests that breast cancer involves tumour-initiating cells (TICs), which play a role in initiation, metastasis, therapeutic resistance and relapse of the disease. Emerging drugs that target TICs are becoming a focus of contemporary research. Mitocans, a group of compounds that induce apoptosis of cancer cells by destabilising their mitochondria, are showing their potential in killing TICs. In this project, we investigated mitochondrially targeted vitamin E s...

  18. Ultrasound-guided Breast Biopsy in the Resource-limited Setting: An Initial Experience in Rural Uganda

    Directory of Open Access Journals (Sweden)

    Christopher R. Stark

    2017-06-01

    Full Text Available Purpose: To describe the methodology and initial experience behind creation of an ultrasoundguided percutaneous breast core biopsy program in rural Uganda. Methods and Materials: Imaging the World Africa (ITWA is the registered non-governmental organization division of Imaging the World (ITW, a not-for-profit organization whose primary aim is the integration of affordable high-quality ultrasound into rural health centers. In 2013, ITWA began the pilot phase of an IRB-approved breast care protocol at a rural health center in Uganda. As part of the protocol’s diagnostic arm, an ultrasound-guided percutaneous breast core biopsy training curriculum was implemented in tandem with creation of regionally supplied biopsy kits. Results: A surgeon at a rural regional referral hospital was successfully trained and certified to perform ultrasound-guided percutaneous breast core biopsies. Affordable and safe biopsy kits were created using locally available medical supplies with the cost of each kit totaling $10.62 USD. Conclusion: Successful implementation of an ultrasound-guided percutaneous breast core biopsy program in the resource-limited setting is possible and can be made sustainable through incorporation of local health care personnel and regionally supplied biopsy materials. Our hope is that ITWA’s initial experience in rural Uganda can serve as a model for similar programs in the future.

  19. Breast cancer management in middle-resource countries (MRCs): consensus statement from the Breast Health Global Initiative.

    Science.gov (United States)

    Yip, Cheng-Har; Cazap, Eduardo; Anderson, Benjamin O; Bright, Kristin L; Caleffi, Maira; Cardoso, Fatima; Elzawawy, Ahmed M; Harford, Joe B; Krygier, Gabriel D; Masood, Shahla; Murillo, Raul; Muse, Ignacio M; Otero, Isabel V; Passman, Leigh J; Santini, Luiz A; da Silva, Ronaldo Corrêa Ferreira; Thomas, David B; Torres, Soledad; Zheng, Ying; Khaled, Hussein M

    2011-04-01

    In middle resource countries (MRCs), cancer control programs are becoming a priority as the pattern of disease shifts from infectious diseases to non-communicable diseases such as breast cancer, the most common cancer among women in MRCs. The Middle Resource Scenarios Working Group of the BHGI 2010 Global Summit met to identify common issues and obstacles to breast cancer detection, diagnosis and treatment in MRCs. They concluded that breast cancer early detection programs continue to be important, should include clinical breast examination (CBE) with or without mammography, and should be coupled with active awareness programs. Mammographic screening is usually opportunistic and early detection programs are often hampered by logistical and financial problems, as well as socio-cultural barriers, despite improved public educational efforts. Although multidisciplinary services for treatment are available, geographical and economic limitations to these services can lead to an inequity in health care access. Without adequate health insurance coverage, limited personal finances can be a significant barrier to care for many patients. Despite the improved availability of services (surgery, pathology, radiology and radiotherapy), quality assurance programs remain a challenge. Better access to anticancer drugs is needed to improve outcomes, as are rehabilitation programs for survivors. Focused and sustained government health care financing in MRCs is needed to improve early detection and treatment of breast cancer. Copyright © 2011 Elsevier Ltd. All rights reserved.

  20. Initial results of the FUSION-X-US prototype combining 3D automated breast ultrasound and digital breast tomosynthesis.

    Science.gov (United States)

    Schaefgen, Benedikt; Heil, Joerg; Barr, Richard G; Radicke, Marcus; Harcos, Aba; Gomez, Christina; Stieber, Anne; Hennigs, André; von Au, Alexandra; Spratte, Julia; Rauch, Geraldine; Rom, Joachim; Schütz, Florian; Sohn, Christof; Golatta, Michael

    2018-01-04

    To determine the feasibility of a prototype device combining 3D-automated breast ultrasound (ABVS) and digital breast tomosynthesis in a single device to detect and characterize breast lesions. In this prospective feasibility study, the FUSION-X-US prototype was used to perform digital breast tomosynthesis and ABVS in 23 patients with an indication for tomosynthesis based on current guidelines after clinical examination and standard imaging. The ABVS and tomosynthesis images of the prototype were interpreted separately by two blinded experts. The study compares the detection and BI-RADS® scores of breast lesions using only the tomosynthesis and ABVS data from the FUSION-X-US prototype to the results of the complete diagnostic workup. Image acquisition and processing by the prototype was fast and accurate, with some limitations in ultrasound coverage and image quality. In the diagnostic workup, 29 solid lesions (23 benign, including three cases with microcalcifications, and six malignant lesions) were identified. Using the prototype, all malignant lesions were detected and classified as malignant or suspicious by both investigators. Solid breast lesions can be localized accurately and fast by the Fusion-X-US system. Technical improvements of the ultrasound image quality and ultrasound coverage are needed to further study this new device. The prototype combines tomosynthesis and automated 3D-ultrasound (ABVS) in one device. It allows accurate detection of malignant lesions, directly correlating tomosynthesis and ABVS data. The diagnostic evaluation of the prototype-acquired data was interpreter-independent. The prototype provides a time-efficient and technically reliable diagnostic procedure. The combination of tomosynthesis and ABVS is a promising diagnostic approach.

  1. Altered resting brain connectivity in persistent cancer related fatigue

    Science.gov (United States)

    Hampson, Johnson P.; Zick, Suzanna M.; Khabir, Tohfa; Wright, Benjamin D.; Harris, Richard E.

    2015-01-01

    There is an estimated 3 million women in the US living as breast cancer survivors and persistent cancer related fatigue (PCRF) disrupts the lives of an estimated 30% of these women. PCRF is associated with decreased quality of life, decreased sleep quality, impaired cognition and depression. The mechanisms of cancer related fatigue are not well understood; however, preliminary findings indicate dysfunctional activity in the brain as a potential factor. Here we investigate the relationship between PCRF on intrinsic resting state connectivity in this population. Twenty-three age matched breast cancer survivors (15 fatigued and 8 non-fatigued) who completed all cancer-related treatments at least 12 weeks prior to the study, were recruited to undergo functional connectivity magnetic resonance imaging (fcMRI). Intrinsic resting state networks were examined with both seed based and independent component analysis methods. Comparisons of brain connectivity patterns between groups as well as correlations with self-reported fatigue symptoms were performed. Fatigued patients displayed greater left inferior parietal lobule to superior frontal gyrus connectivity as compared to non-fatigued patients (P fatigue (P = 0.04, r = 0.52) and poor sleep quality (P = 0.04, r = 0.52) in the fatigued group. In contrast greater connectivity in the non-fatigued group was found between the right precuneus to the periaqueductal gray as well as the left IPL to subgenual cortex (P fatigue scores were associated with greater default mode network (DMN) connectivity to the superior frontal gyrus (P = 0.05 FDR corrected) among fatigued subjects (r = 0.82) and less connectivity in the non-fatigued group (r = −0.88). These findings indicate that there is enhanced intrinsic DMN connectivity to the frontal gyrus in breast cancer survivors with persistent fatigue. As the DMN is a network involved in self-referential thinking we speculate that enhanced connectivity between the DMN and

  2. Altered resting brain connectivity in persistent cancer related fatigue

    Directory of Open Access Journals (Sweden)

    Johnson P. Hampson

    2015-01-01

    Full Text Available There is an estimated 3 million women in the US living as breast cancer survivors and persistent cancer related fatigue (PCRF disrupts the lives of an estimated 30% of these women. PCRF is associated with decreased quality of life, decreased sleep quality, impaired cognition and depression. The mechanisms of cancer related fatigue are not well understood; however, preliminary findings indicate dysfunctional activity in the brain as a potential factor. Here we investigate the relationship between PCRF on intrinsic resting state connectivity in this population. Twenty-three age matched breast cancer survivors (15 fatigued and 8 non-fatigued who completed all cancer-related treatments at least 12 weeks prior to the study, were recruited to undergo functional connectivity magnetic resonance imaging (fcMRI. Intrinsic resting state networks were examined with both seed based and independent component analysis methods. Comparisons of brain connectivity patterns between groups as well as correlations with self-reported fatigue symptoms were performed. Fatigued patients displayed greater left inferior parietal lobule to superior frontal gyrus connectivity as compared to non-fatigued patients (P < 0.05 FDR corrected. This enhanced connectivity was associated with increased physical fatigue (P = 0.04, r = 0.52 and poor sleep quality (P = 0.04, r = 0.52 in the fatigued group. In contrast greater connectivity in the non-fatigued group was found between the right precuneus to the periaqueductal gray as well as the left IPL to subgenual cortex (P < 0.05 FDR corrected. Mental fatigue scores were associated with greater default mode network (DMN connectivity to the superior frontal gyrus (P = 0.05 FDR corrected among fatigued subjects (r = 0.82 and less connectivity in the non-fatigued group (r = −0.88. These findings indicate that there is enhanced intrinsic DMN connectivity to the frontal gyrus in breast cancer survivors with persistent

  3. Contrast-enhanced spectral mammography versus MRI: Initial results in the detection of breast cancer and assessment of tumour size.

    Science.gov (United States)

    Fallenberg, E M; Dromain, C; Diekmann, F; Engelken, F; Krohn, M; Singh, J M; Ingold-Heppner, B; Winzer, K J; Bick, U; Renz, D M

    2014-01-01

    To compare mammography (MG), contrast-enhanced spectral mammography (CESM), and magnetic resonance imaging (MRI) in the detection and size estimation of histologically proven breast cancers using postoperative histology as the gold standard. After ethical approval, 80 women with newly diagnosed breast cancer underwent MG, CESM, and MRI examinations. CESM was reviewed by an independent experienced radiologist, and the maximum dimension of suspicious lesions was measured. For MG and MRI, routine clinical reports of breast specialists, with judgment based on the BI-RADS lexicon, were used. Results of each imaging technique were correlated to define the index cancer. Fifty-nine cases could be compared to postoperative histology for size estimation. Breast cancer was visible in 66/80 MG, 80/80 CESM, and 77/79 MRI examinations. Average lesion largest dimension was 27.31 mm (SD 22.18) in MG, 31.62 mm (SD 24.41) in CESM, and 27.72 mm (SD 21.51) in MRI versus 32.51 mm (SD 29.03) in postoperative histology. No significant difference was found between lesion size measurement on MRI and CESM compared with histopathology. Our initial results show a better sensitivity of CESM and MRI in breast cancer detection than MG and a good correlation with postoperative histology in size assessment. • Contrast-enhanced spectral mammography (CESM) is slowly being introduced into clinical practice. • Access to breast MRI is limited by availability and lack of reimbursement. • Initial results show a better sensitivity of CESM and MRI than conventional mammography. • CESM showed a good correlation with postoperative histology in size assessment. • Contrast-enhanced spectral mammography offers promise, seemingly providing information comparable to MRI.

  4. Cancer related fatigue syndrome in neoplastic diseases

    Directory of Open Access Journals (Sweden)

    Magdalena Franc

    2014-12-01

    Full Text Available Fatigue is one of the most important factors which has a considerable influence on treatment and the life quality of oncological patients. The fatigue syndrome is often diagnosed during cancer treatment and this syndrome is not related to the physical effort. Cancer related fatigue is a patient’s subjective, psychologically, physically and emotionally based feeling. It is disproportionate to patient’s daily activity. The pathogenesis of this syndrome remains still unknown. However, on the basis of various questionnaires, it is possible to test the disease’s complex nature. Cancer related fatigue causes deterioration of patient’s life along with lower motivation to struggle with the disease. It is thought that the factor which increases the incidence of cancer related fatigue is a long-term use of drugs such as opioids, benzodiazepine, and medicines containing codeine, tranquilizers, anxiolytics and antidepressants. On the basis of the results, one can choose an appropriate treatment method for cancer related fatigue such as rehabilitation, psychotherapy or public assistance. A great number of patients consider excessive fatigue a typical concomitant symptom in neoplastic disease; therefore, they do not report it. It is of a paramount importance to make patients aware of the fact that cancer related fatigue is a serious disease which can be treated.

  5. Contrast-enhanced spectral mammography versus MRI: Initial results in the detection of breast cancer and assessment of tumour size

    Energy Technology Data Exchange (ETDEWEB)

    Fallenberg, E.M.; Renz, D.M. [Charite - Universitaetsmedizin Berlin, Clinic of Radiology, Berlin (Germany); Dromain, C. [Institut Gustave Roussy, Department of Radiology, Villejuif cedex (France); Diekmann, F. [St. Joseph-Stift Bremen, Department of Medical Imaging, Bremen (Germany); Engelken, F.; Krohn, M.; Singh, J.M.; Bick, U. [Charite - Universitaetsmedizin Berlin, Department of Radiology, Berlin (Germany); Ingold-Heppner, B. [Charite - Universitaetsmedizin Berlin, Institute of Pathology, Berlin (Germany); Winzer, K.J. [Charite - Universitaetsmedizin Berlin, Breast Center, Department of Gynecology, Berlin (Germany)

    2014-01-15

    To compare mammography (MG), contrast-enhanced spectral mammography (CESM), and magnetic resonance imaging (MRI) in the detection and size estimation of histologically proven breast cancers using postoperative histology as the gold standard. After ethical approval, 80 women with newly diagnosed breast cancer underwent MG, CESM, and MRI examinations. CESM was reviewed by an independent experienced radiologist, and the maximum dimension of suspicious lesions was measured. For MG and MRI, routine clinical reports of breast specialists, with judgment based on the BI-RADS lexicon, were used. Results of each imaging technique were correlated to define the index cancer. Fifty-nine cases could be compared to postoperative histology for size estimation. Breast cancer was visible in 66/80 MG, 80/80 CESM, and 77/79 MRI examinations. Average lesion largest dimension was 27.31 mm (SD 22.18) in MG, 31.62 mm (SD 24.41) in CESM, and 27.72 mm (SD 21.51) in MRI versus 32.51 mm (SD 29.03) in postoperative histology. No significant difference was found between lesion size measurement on MRI and CESM compared with histopathology. Our initial results show a better sensitivity of CESM and MRI in breast cancer detection than MG and a good correlation with postoperative histology in size assessment. (orig.)

  6. Laser immunotherapy: initial results from a human breast cancer pilot trial

    Science.gov (United States)

    Hode, Tomas; Guerra, Maria C.; Ferrel, Gabriela L.; Lunn, John A.; Adelsteinsson, Orn; Nordquist, Robert E.; Chen, Wei R.

    2010-02-01

    Laser Immunotherapy is an experimental treatment modality for late-stage, metastatic tumors, which targets solid primary and/or secondary tumors and utilizes an autologous vaccine-like approach to stimulate immune responses. Specifically, laser immunotherapy combines laser-induced in situ tumor devitalization with an immunoadjuvant for local immunostimulation. Here we report the initial results from a human breast cancer pilot trial with laser immunotherapy. Six stage III and IV cancer patients were treated, all of which were considered to be out of all other options, and preliminary data at the three-month examination are presented. The immediate goal of the trial was to determine the patient tolerance and the toxicity of the therapy, the optimal dose for the alteration of the course of the disease, and the reduction of the tumor burden. Each patient was individually evaluated for toxicity tolerance through physical exams and by appropriate supplemental and routine laboratory tests. Observable tumors in patients were followed with physical examination and radiological evaluations. Treatment efficacy was judged by the size and number of local and distant metastases before and after treatment.

  7. Intrathecal Therapy for Cancer-Related Pain

    Science.gov (United States)

    Burton, Allen W.

    2016-01-01

    Objective. The increasing incidence of cancer survivorship has shifted treatment of cancer-related pain from short-term analgesia to long-term chronic pain management. As a result, alternatives to oral analgesics, such as intrathecal therapy, may be beneficial for patients with cancer-related pain. The authors review the use of intrathecal therapy in the management of cancer-related pain. Methods. The Medline database was searched for English-language articles that included “ziconotide” or “morphine” AND (“cancer” OR “malignant”) AND “intrathecal” in title or abstract. Available abstracts from scientific congresses in the areas of neuromodulation and oncology were also reviewed. Results. Intrathecal therapy provides pain relief with reduced systemic concerns in patients with cancer-related pain. Patients should undergo multidisciplinary evaluation and, in most cases, drug trialing before intrathecal pump implantation. Morphine, an opioid (µ-opioid receptor antagonist), and ziconotide, a nonopioid (selective N-type calcium channel inhibitor), are both approved for intrathecal analgesia; however, tolerance and safety concerns may deter the use of intrathecal morphine. Ziconotide has also shown efficacy for reduction of cancer-related pain; however, proper dosing and titration must be used to prevent adverse events. There is little information available on use of intrathecal therapies specifically in cancer survivors. Conclusions. Treatment of cancer-related pain has shifted toward chronic pain management strategies, especially among cancer survivors. Intrathecal therapy provides an alternate route of administration of chronic pain medications (e.g., morphine and ziconotide) for cancer patients with and without active disease, although additional research is needed to support effectiveness in cancer survivors. PMID:28025375

  8. Breast lump as an initial manifestation in acute lymphoblastic leukemia: an unusual presentation. A case report.

    Science.gov (United States)

    Mandal, Shramana; Jain, Shyama; Khurana, Nita

    2007-02-01

    Breast lump as a presenting manifestation of acute lymphoblastic lymphoma (ALL) leukemia is extremely rare. We report a case of a young female who presented with a breast lump clinically suggestive of fibroadenoma. On fine needle aspiration cytology, it was diagnosed as lymphoid malignancy, later confirmed as ALL using hematological investigations.

  9. Establishing a family risk assessment clinic for breast cancer.

    LENUS (Irish Health Repository)

    Mulsow, Jurgen

    2012-02-01

    Breast cancer is the most common cancer affecting European women and the leading cause of cancer-related death. A total of 15-20% of women who develop breast cancer have a family history and 5-10% a true genetic predisposition. The identification and screening of women at increased risk may allow early detection of breast cancer and improve prognosis. We established a family risk assessment clinic in May 2005 to assess and counsel women with a family history of breast cancer, to initiate surveillance, and to offer risk-reducing strategies for selected high-risk patients. Patients at medium or high risk of developing breast cancer according to NICE guidelines were accepted. Family history was determined by structured questionnaire and interview. Lifetime risk of developing breast cancer was calculated using Claus and Tyrer-Cuzick scoring. Risk of carrying a breast cancer-related gene mutation was calculated using the Manchester system. One thousand two hundred and forty-three patients have been referred. Ninety-two percent were at medium or high risk of developing breast cancer. Formal assessment of risk has been performed in 368 patients, 73% have a high lifetime risk of developing breast cancer, and 72% a Manchester score >or=16. BRCA1\\/2 mutations have been identified in 14 patients and breast cancer diagnosed in two. Our initial experience of family risk assessment has shown there to be a significant demand for this service. Identification of patients at increased risk of developing breast cancer allows us to provide individuals with accurate risk profiles, and enables patients to make informed choices regarding their follow-up and management.

  10. 18F-FDG PET/CT in breast cancer: Evidence-based recommendations in initial staging.

    Science.gov (United States)

    Caresia Aroztegui, Ana Paula; García Vicente, Ana María; Alvarez Ruiz, Soledad; Delgado Bolton, Roberto Carlos; Orcajo Rincon, Javier; Garcia Garzon, Jose Ramon; de Arcocha Torres, Maria; Garcia-Velloso, Maria Jose

    2017-10-01

    Current guidelines do not systematically recommend 18F-FDG PET/CT for breast cancer staging; and the recommendations and level of evidence supporting its use in different groups of patients vary among guidelines. This review summarizes the evidence about the role of 18F-FDG PET/CT in breast cancer staging and the therapeutic and prognostic impact accumulated in the last decade. Other related aspects, such as the association of metabolic information with biology and prognosis are considered and evidence-based recommendations for the use of 18F-FDG PET/CT in breast cancer staging are offered. We systematically searched MEDLINE for articles reporting studies with at least 30 patients related to clinical questions following the Problem/Population, Intervention, Comparison, and Outcome framework. We critically reviewed the selected articles and elaborated evidence tables structuring the summarized information into methodology, results, and limitations. The level of evidence and the grades of recommendation for the use of 18F-FDG PET/CT in different contexts are summarized. Level III evidence supports the use of 18F-FDG PET/CT for initial staging in patients with recently diagnosed breast cancer; the diagnostic and therapeutic impact of the 18F-FDG PET/CT findings is sufficient for a weak recommendation in this population. In patients with locally advanced breast cancer, level II evidence supports the use of 18F-FDG PET/CT for initial staging; the diagnostic and therapeutic impact of the 18F-FDG PET/CT findings is sufficient for a strong recommendation in this population. In patients with recently diagnosed breast cancer, the metabolic information from baseline 18F-FDG PET/CT is associated with tumor biology and has prognostic implications, supported by level II evidence. In conclusion, 18F-FDG PET/CT is not recommended for staging all patients with early breast cancer, although evidence of improved regional and systemic staging supports its use in locally advanced

  11. Identification of a population of blood circulating tumor cells from breast cancer patients that initiates metastasis in a xenograft assay.

    Science.gov (United States)

    Baccelli, Irène; Schneeweiss, Andreas; Riethdorf, Sabine; Stenzinger, Albrecht; Schillert, Anja; Vogel, Vanessa; Klein, Corinna; Saini, Massimo; Bäuerle, Tobias; Wallwiener, Markus; Holland-Letz, Tim; Höfner, Thomas; Sprick, Martin; Scharpff, Martina; Marmé, Frederik; Sinn, Hans Peter; Pantel, Klaus; Weichert, Wilko; Trumpp, Andreas

    2013-06-01

    It has been hypothesized that carcinoma metastasis is initiated by a subpopulation of circulating tumor cells (CTCs) found in the blood of patients. However, although the presence of CTCs is an indicator of poor prognosis in several carcinoma entities, the existence and phenotype of metastasis-initiating cells (MICs) among CTCs has not been experimentally demonstrated. Here we developed a xenograft assay and used it to show that primary human luminal breast cancer CTCs contain MICs that give rise to bone, lung and liver metastases in mice. These MIC-containing CTC populations expressed EPCAM, CD44, CD47 and MET. In a small cohort of patients with metastases, the number of EPCAM(+)CD44(+)CD47(+)MET(+) CTCs, but not of bulk EPCAM(+) CTCs, correlated with lower overall survival and increased number of metastasic sites. These data describe functional circulating MICs and associated markers, which may aid the design of better tools to diagnose and treat metastatic breast cancer.

  12. Breast cancer prevention with Morinda citrifolia (noni at the initiation stage

    Directory of Open Access Journals (Sweden)

    Mian-Ying Wang

    2013-06-01

    significantly increased compared with positive controls at different time points. Histological examination showed that the malignancy of lesions in TNJ groups did not show a significant change when compared with that in positive and placebo groups.Conclusion: In conclusion, this is the first study which indicates that TNJ possesses a cancer preventive effect at the initiation stage of chemical carcinogenesis induced by DMBA in female SD rates.Key words: Morinda citrifolia, Tahitian noni® juice, breast cancer, cancer prevention

  13. Tumor-initiating cells of breast and prostate origin show alterations in the expression of genes related to iron metabolism

    Czech Academy of Sciences Publication Activity Database

    Rychtarčíková, Zuzana; Lettlová, Sandra; Tomkova, Veronika; Korenková, Vlasta; Langerová, Lucie; Simonova, Ekaterina; Zjablovskaja, Polina; Alberich-Jorda, Meritxell; Neužil, Jiří; Truksa, Jaroslav

    2017-01-01

    Roč. 8, č. 4 (2017), s. 6376-6398 ISSN 1949-2553 R&D Projects: GA ČR GA13-28830S; GA ČR GA15-03796S; GA MŠk(CZ) ED1.1.00/02.0109 Institutional support: RVO:86652036 ; RVO:68378050 Keywords : tumor-initiating cells * breast cancer * iron metabolism Subject RIV: FD - Oncology ; Hematology; EB - Genetics ; Molecular Biology (UMG-J) Impact factor: 5.168, year: 2016

  14. In real life, one-quarter of patients with hormone receptor-positive metastatic breast cancer receive chemotherapy as initial palliative therapy: a study of the Southeast Netherlands Breast Cancer Consortium

    NARCIS (Netherlands)

    Lobbezoo, D.J.; Kampen, R.J. van; Voogd, A.C.; Dercksen, M.W.; Berkmortel, F. van den; Smilde, T.J.; Wouw, A.J. van de; Peters, F.P.; Riel, J.M. van; Peters, N.A.; Boer, M. de; Peer, P.G.; Tjan-Heijnen, V.C.

    2016-01-01

    BACKGROUND: The objective of this study was to present initial systemic treatment choices and the outcome of hormone receptor-positive (HR+) metastatic breast cancer. PATIENTS AND METHODS: All the 815 consecutive patients diagnosed with metastatic breast cancer in 2007-2009 in eight participating

  15. The relative importance of social class and maternal education for breast-feeding initiation.

    Science.gov (United States)

    Skafida, Valeria

    2009-12-01

    To examine changes in breast-feeding take-up rates among young children in Scotland and to assess whether maternal education or occupation-based social class is a stronger and better predictor of breast-feeding take-up. Binary logistic regression models were developed from the first sweep of the Growing Up in Scotland longitudinal survey, for the two cohorts of children. A national representative survey for Scotland. A baby cohort of 5012 singletons born over a 12-month period between June 2004 and May 2005, and a toddler cohort of 2732 singletons born over a 12-month period between June 2002 and May 2003. Mothers from more privileged social classes and those with more educational qualifications resulted as more likely to breast-feed. However, maternal education was a better and more robust predictor of breast-feeding take-up compared with social class. There were no significant differences in breast-feeding take-up between the two cohorts and only minor differences between mothers aged 20-29 years and those who stated an intention to bottle-feed prior to birth. The study suggests that the importance of maternal education in influencing breast-feeding has been somewhat overlooked in research based in more developed countries. The results indicate that, compared with occupation-related social class, maternal education is a more informative, accurate and useful lens through which to understand and explain patterns of breast-feeding take-up.

  16. [Effectiveness of nursing instruction in reducing uncertainty, anxiety and self-care in breast cancer women undergoing initial chemotherapy].

    Science.gov (United States)

    Lien, Chin-Yen; Chen, Shu-Hui; Tsai, Pei-Pin; Chen, Kang-Min; Hsieh, Ya-I; Liang, Ying

    2010-12-01

    Level of uncertainty and anxiety may increase when breast cancer women experience unexpected side effects during chemotherapy. This longitudinal study explored the effectiveness of nursing instruction in reducing uncertainty, anxiety and self-care in breast cancer women undergoing initial chemotherapy. This study used a quasi-experimental design. Convenience sampling was used to recruit 75 women with breast cancer at a medical centre in northern Taiwan between January 2008 and September 2008. Participants were divided into either the control (n=37) or experimental (n=38) group. Control group patients received usual care. Experimental group patients were provided with nursing instructions that followed the evidence-based guidelines prescribed in the "Chemotherapy Self-Care for Breast Cancer" handbook and individualized education. Both groups received repeated questionnaires in the first, third and sixth chemotherapy cycles. Demographic data, Mishel's Uncertainty Illness Scale, Hospital Anxiety and Depression Scale and the Self-Care Scale were used for data collection and analysis. There were no significant differences in demographic data between the two groups. There were moderate to high levels of uncertainty and low levels of anxiety in both groups prior to the first chemotherapy cycle. There was a significant decrease in uncertainty and an elevation in self-care level (pcare in comparison with the control group. There was a significant decrease in complexity uncertainty in the experimental group (p=.02*) and no significant decrease in the control group. Study results indicate that nursing instruction can decrease uncertainty and elevate self-care levels. We suggest that nurses provide structured nursing instructions based on evidence-based guidelines to breast cancer women undergoing initial chemotherapy in order to promote self-care level and patient degree of control over their disease and treatment. This intervention may ameliorate patient and family

  17. Cancer-Related Fatigue: a multidimensional approach

    NARCIS (Netherlands)

    P.J. de Raaf (Pleun)

    2013-01-01

    textabstractFatigue is experienced by cancer patients in all stages of the disease trajectory: from before diagnosis to years after completing treatment and also in advanced cancer. Fatigue has a greater negative influence on quality of life and daily activities than any other cancer-related

  18. Breast health global initiative (BHGI outline for program development in Latin America Breast health global initiative (BHGI planeamiento para el desarrollo de programas en América latina

    Directory of Open Access Journals (Sweden)

    Benjamin O. Anderson

    2009-01-01

    Full Text Available The Breast Health Global Initiative (BHGI applied an evidence-based consensus review process to develop guidelines for breast cancer early detection, diagnosis, and treatment in low- and middle-income countries (LMCs including those in Latin America. Breast cancer outcomes correlate with the degree to which 1 cancers are detected early, 2 cancers can be diagnosed correctly, and 3 proper multimodality treatment can be provided in a timely fashion. Cancer prevention through health behavior modification may influence breast cancer incidence in LMCs. Diagnosing breast cancer at earlier stages will reduce breast cancer mortality. Programs to promote breast self-awareness and clinical breast examination and resource-adapted mammographic screening are important early detection steps. Screening mammography has been shown to reduce breast cancer mortality, but is cost prohibitive in some settings. Breast imaging, initially with ultrasound and, at higher resource levels with diagnostic mammography, improves preoperative diagnostic assessment and permits image-guided needle sampling. Multimodality therapy includes surgery, radiation, and systemic therapies.La Iniciativa Global para la Salud de la Mama (BGHI ha aplicado un proceso de revisión de consenso, basado en la evidencia, a fin de desarrollar guías para la detección precoz del cáncer de mama, diagnóstico y tratamiento, en países de bajos y medianos ingresos (PBMI incluyendo aquellos en América latina. La evolución del cáncer de mama se correlaciona con el grado al cual 1 los cánceres son detectados tempranamente 2los cánceres pueden ser diagnosticados correctamente, y 3el adecuado tratamiento multimodal suministrado a tiempo. La prevención del cáncer a través de modificaciones de las conductas de salud puede modificar la incidencia del cáncer de mama en PBMI. El diagnóstico del cáncer de mama en estadios iniciales reduce la mortalidad por cáncer de mama. Los programas que promueven

  19. Overweight, Obesity, and Postmenopausal Invasive Breast Cancer Risk: A Secondary Analysis of the Women's Health Initiative Randomized Clinical Trials.

    Science.gov (United States)

    Neuhouser, Marian L; Aragaki, Aaron K; Prentice, Ross L; Manson, JoAnn E; Chlebowski, Rowan; Carty, Cara L; Ochs-Balcom, Heather M; Thomson, Cynthia A; Caan, Bette J; Tinker, Lesley F; Urrutia, Rachel Peragallo; Knudtson, Jennifer; Anderson, Garnet L

    2015-08-01

    More than two-thirds of US women are overweight or obese, placing them at increased risk for postmenopausal breast cancer. To investigate in this secondary analysis the associations of overweight and obesity with risk of postmenopausal invasive breast cancer after extended follow-up in the Women's Health Initiative (WHI) clinical trials. The WHI clinical trial protocol incorporated measured height and weight, baseline and annual or biennial mammography, and adjudicated breast cancer end points in 67 142 postmenopausal women ages 50 to 79 years at 40 US clinical centers. The women were enrolled from 1993 to 1998 with a median of 13 years of follow-up through 2010; 3388 invasive breast cancers were observed. Height and weight were measured at baseline, and weight was measured annually thereafter. Data were collected on demographic characteristics, personal and family medical history, and personal habits (smoking, physical activity). Women underwent annual or biennial mammograms. Breast cancers were verified by medical records reviewed by physician adjudicators. Women who were overweight and obese had an increased invasive breast cancer risk vs women of normal weight. Risk was greatest for obesity grade 2 plus 3 (body mass index [BMI], calculated as weight in kilograms divided by height in meters squared, >35.0) (hazard ratio [HR] for invasive breast cancer, 1.58; 95% CI, 1.40-1.79). A BMI of 35.0 or higher was strongly associated with risk for estrogen receptor-positive and progesterone receptor-positive breast cancers (HR, 1.86; 95% CI, 1.60-2.17) but was not associated with estrogen receptor-negative cancers. Obesity grade 2 plus 3 was also associated with advanced disease, including larger tumor size (HR, 2.12; 95% CI, 1.67-2.69; P = .02), positive lymph nodes (HR, 1.89; 95% CI, 1.46-2.45; P = .06), regional and/or distant stage (HR, 1.94; 95% CI, 1.52-2.47; P = .05), and deaths after breast cancer (HR, 2.11; 95% CI, 1.57-2.84; P

  20. On the status and comparison of glucose intolerance in female breast cancer patients at initial diagnosis and during chemotherapy through an oral glucose tolerance test.

    Directory of Open Access Journals (Sweden)

    Lin-jie Lu

    Full Text Available AIMS: This study is to estimate the status and comparison of glucose intolerance in female breast cancer patients at initial diagnosis and during chemotherapy through an oral glucose tolerance test (OGTT, as well as to learn the effect of chemotherapy on the glucose metabolism of breast cancer patients. METHODS: All the 79 breast cancer patients at initial diagnosis, with the mean age of 53.2 years, and 96 breast cancer patients before the 5th or 6th cycle of chemotherapy, with the mean age of 51.5 years, participated in the study from December 2012 to October 2013. After an overnight fast, participants underwent OGTT test, and fasting and 2-hour glucose levels were measured to identify undiagnosed diabetes and prediabetes (i.e., impaired fasting glucose or impaired glucose tolerance in them. Previously diagnosed diabetes among the female breast cancer patients was determined on the self-report and the medical record. RESULTS: The overall incidences of total normal glucose tolerance, prediabetes, diabetes in female breast cancer patients at initial diagnosis and during chemotherapy were 24.1% and 38.5% (p0.05, respectively, and the differences of normal glucose tolerance and prediabetes instead of diabetes between the two groups were statistically significant. About 84% of the total diabetes and prediabetes in the female breast cancer patients at initial diagnosis and 79.7% of those during chemotherapy need to be diagnosed with OGTT. CONCLUSIONS: Breast cancer patients have high incidences of diabetes and prediabetes. After chemotherapy even with steroids, some breast cancer patients with abnormal glucose metabolism may even become normal. Isolated hyperglycemia 2 hours after glucose loading is common, and OGTT should be made for breast cancer patients at initial diagnosis and during chemotherapy.

  1. Comb-push ultrasound shear elastography of breast masses: initial results show promise.

    Directory of Open Access Journals (Sweden)

    Max Denis

    Full Text Available To evaluate the performance of Comb-push Ultrasound Shear Elastography (CUSE for classification of breast masses.CUSE is an ultrasound-based quantitative two-dimensional shear wave elasticity imaging technique, which utilizes multiple laterally distributed acoustic radiation force (ARF beams to simultaneously excite the tissue and induce shear waves. Female patients who were categorized as having suspicious breast masses underwent CUSE evaluations prior to biopsy. An elasticity estimate within the breast mass was obtained from the CUSE shear wave speed map. Elasticity estimates of various types of benign and malignant masses were compared with biopsy results.Fifty-four female patients with suspicious breast masses from our ongoing study are presented. Our cohort included 31 malignant and 23 benign breast masses. Our results indicate that the mean shear wave speed was significantly higher in malignant masses (6 ± 1.58 m/s in comparison to benign masses (3.65 ± 1.36 m/s. Therefore, the stiffness of the mass quantified by the Young's modulus is significantly higher in malignant masses. According to the receiver operating characteristic curve (ROC, the optimal cut-off value of 83 kPa yields 87.10% sensitivity, 82.61% specificity, and 0.88 for the area under the curve (AUC.CUSE has the potential for clinical utility as a quantitative diagnostic imaging tool adjunct to B-mode ultrasound for differentiation of malignant and benign breast masses.

  2. Comb-push ultrasound shear elastography of breast masses: initial results show promise.

    Science.gov (United States)

    Denis, Max; Mehrmohammadi, Mohammad; Song, Pengfei; Meixner, Duane D; Fazzio, Robert T; Pruthi, Sandhya; Whaley, Dana H; Chen, Shigao; Fatemi, Mostafa; Alizad, Azra

    2015-01-01

    To evaluate the performance of Comb-push Ultrasound Shear Elastography (CUSE) for classification of breast masses. CUSE is an ultrasound-based quantitative two-dimensional shear wave elasticity imaging technique, which utilizes multiple laterally distributed acoustic radiation force (ARF) beams to simultaneously excite the tissue and induce shear waves. Female patients who were categorized as having suspicious breast masses underwent CUSE evaluations prior to biopsy. An elasticity estimate within the breast mass was obtained from the CUSE shear wave speed map. Elasticity estimates of various types of benign and malignant masses were compared with biopsy results. Fifty-four female patients with suspicious breast masses from our ongoing study are presented. Our cohort included 31 malignant and 23 benign breast masses. Our results indicate that the mean shear wave speed was significantly higher in malignant masses (6 ± 1.58 m/s) in comparison to benign masses (3.65 ± 1.36 m/s). Therefore, the stiffness of the mass quantified by the Young's modulus is significantly higher in malignant masses. According to the receiver operating characteristic curve (ROC), the optimal cut-off value of 83 kPa yields 87.10% sensitivity, 82.61% specificity, and 0.88 for the area under the curve (AUC). CUSE has the potential for clinical utility as a quantitative diagnostic imaging tool adjunct to B-mode ultrasound for differentiation of malignant and benign breast masses.

  3. Patterns of statin initiation and continuation in patients with breast or colorectal cancer, towards end-of-life.

    Science.gov (United States)

    Smith, Amelia; Murphy, Laura; Bennett, Kathleen; Barron, Thomas I

    2017-05-01

    Cross-sectional studies show that statins, used in cardiovascular disease prevention, are often discontinued approaching death. Studies investigating associations between statin exposure and cancer outcomes, not accounting for these exposure changes, are prone to reverse causation bias. The aim of this study was to describe longitudinally the changes in statin initiation and continuation prior to death in patients with breast or colorectal cancer, thus establishing an appropriate exposure lag time. This study was carried out using linked cancer registry and prescribing data. We identified patients who died of their cancer (cases) and cancer survivors were used as controls. The probability of initiating or continuing statin use was estimated up to 5 years prior to death (or index date). Conditional binomial models were used to estimate relative risks and risk differences for associations between approaching cancer death and statin use. Compared to controls, the probability of continued statin use in breast cancer cases was significantly lower 3 months prior to death (RR 0.86 95% CI 0.79, 0.94). Similarly, in colorectal cancer cases, the probability of continued statin use was significantly lower 3 months prior to colorectal cancer death (RR 0.77 95% CI 0.68, 0.88). A significant proportion of patients will cease statin treatment in the months prior to a colorectal or breast cancer death.

  4. Delineating an Epigenetic Continuum for Initiation, Transformation and Progression to Breast Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Kang Mei; Stephen, Josena K. [Department of Otolaryngology/Head and Neck Surgery, Henry Ford Hospital, 1 Ford Place, 1D, Detroit, MI 48202 (United States); Raju, Usha [Department of Pathology, Henry Ford Hospital, Detroit, 1 Ford Place, 1D, Detroit, MI 48202 (United States); Worsham, Maria J., E-mail: mworsha1@hfhs.org [Department of Otolaryngology/Head and Neck Surgery, Henry Ford Hospital, 1 Ford Place, 1D, Detroit, MI 48202 (United States)

    2011-03-29

    Aberrant methylation of promoter CpG islands is a hallmark of human cancers and is an early event in carcinogenesis. We examined whether promoter hypermethylation contributes to the pathogenesis of benign breast lesions along a progression continuum to invasive breast cancer. The exploratory study cohort comprised 17 breast cancer patients with multiple benign and/or in situ lesions concurrently present with invasive carcinoma within a tumor biopsy. DNA from tumor tissue, normal breast epithelium when present, benign lesions (fibroadenoma, hyperplasia, papilloma, sclerosing adenosis, apocrine metaplasia, atypical lobular hyperplasia or atypical ductal hyperplasia), and in situ lesions of lobular carcinoma and ductal carcinoma were interrogated for promoter methylation status in 22 tumor suppressor genes using the multiplex ligation-dependent probe amplification assay (MS-MLPA). Methylation specific PCR was performed to confirm hypermethylation detected by MS-MLPA. Promoter methylation was detected in 11/22 tumor suppressor genes in 16/17 cases. Hypermethylation of RASSF1 was most frequent, present in 14/17 cases, followed by APC in 12/17, and GSTP1 in 9/17 cases with establishment of an epigenetic monocloncal progression continuum to invasive breast cancer. Hypermethylated promoter regions in normal breast epithelium, benign, and premalignant lesions within the same tumor biopsy implicate RASSF1, APC, GSTP1, TIMP3, CDKN2B, CDKN2A, ESR1, CDH13, RARB, CASP8, and TP73 as early events. DNA hypermethylation underlies the pathogenesis of step-wise transformation along a monoclonal continuum from normal to preneoplasia to invasive breast cancer.

  5. Effect of physical therapy on breast cancer related lymphedema

    DEFF Research Database (Denmark)

    Tambour, Mette; Tange, Berit; Christensen, Robin Daniel Kjersgaard

    2014-01-01

    BACKGROUND: Physical therapy treatment of patients with lymphedema includes treatment based on the principles of 'Complete Decongestive Therapy' (CDT). CDT consists of the following components; skin care, manual lymphatic drainage, bandaging and exercises. The scientific evidence regarding what...

  6. Yoga protocol for treatment of breast cancer-related lymphedema

    Directory of Open Access Journals (Sweden)

    S R Narahari

    2016-01-01

    Discussion: Yoga exercises were selected on the basis of their role in chest expansion, maximizing range of movements: flexion of large muscles, maximum stretch of skin, and thus part-by-part lymph drainage from center and periphery. This protocol addressed functional, volume, and movement issues of BCRL and was found to be superior to other BCRL yoga protocols. However, this protocol needs to be tested in centers routinely managing BCRL.

  7. Initial study on in vivo conductivity mapping of breast cancer using MRI.

    Science.gov (United States)

    Shin, Jaewook; Kim, Min Jung; Lee, Joonsung; Nam, Yoonho; Kim, Min-Oh; Choi, Narae; Kim, Sooyeon; Kim, Dong-Hyun

    2015-08-01

    To develop and apply a method to measure in vivo electrical conductivity values using magnetic resonance imaging (MRI) in subjects with breast cancer. A recently developed technique named MREPT (MR electrical properties tomography) together with a novel coil combination process was used to quantify the conductivity values. The overall technique was validated using a phantom study. In addition, 90 subjects were imaged (50 subjects with previously biopsy-confirmed breast tumor and 40 normal subjects), which was approved by our institutional review board (IRB). A routine clinical protocol, specifically a T2 -weighted FSE (fast spin echo) imaging data, was used for reconstruction of conductivity. By employing the coil combination, the relative error in the conductivity map was reduced from ~70% to 10%. The average conductivity values in breast cancers regions (0.89 ± 0.33S/m) was higher compared to parenchymal tissue (0.43 S/m, P conductivity compared to benign cases (0.56 S/m, n = 5) (P conductivity compared to in situ cancers (0.57 S/m) (P conductivity mapping of breast cancers is feasible using a noninvasive in vivo MREPT technique combined with a coil combination process. The method may provide a tool in the MR diagnosis of breast cancer. © 2014 Wiley Periodicals, Inc.

  8. The "Win-Win" initiative: a global, scientifically based approach to resource sparing treatment for systemic breast cancer therapy

    Directory of Open Access Journals (Sweden)

    Elzawawy Ahmed

    2009-05-01

    Full Text Available Abstract Background Worldwide, breast cancer is the most frequent malignancy among females. Its incidence shows a trend towards an increase in the next decade, particularly in developing countries where less than of 5% of resources for cancer management are available. In most breast cancer cases systemic cancer treatment remains a primary management strategy. With the increasing costs of novel drugs, amidst the growing breast cancer rate, it can be safely assumed that in the next decade, newly developed cancer drugs will become less affordable and therefore will be available to fewer patients in low and middle income countries. In light of this potentially tragic situation, a pressing need emerges for science-based innovative solutions. Methods In this article, we cite examples of recently published researches and case management approaches that have been shown to lower overall treatment costs without compromising patient outcomes. The cited approaches are not presented as wholly inclusive or definitive solutions but are offered as effective examples that we hope will inspire the development of additional evidence-based management approaches that provide both efficient and effective breast cancer treatment Results We propose a "win-win" initiative, borne in the year of 2008 of strategic information sharing through preparatory communications, publications and our conference presentations. In the year 2009, ideas developed through these mechanisms can be refined through focused small pilot meetings with interested stakeholders, including the clinical, patient advocate, and pharmaceutical communities, and as appropriate (as proposed plans emerge, governmental representatives. The objective is to draw a realistic road map for feasible and innovative scientific strategies and collaborative actions that could lead to resource sparing; i.e. cost effective and tailored breast cancer systemic treatment for low and middle income countries. Conclusion The

  9. Cancer-related fatigue treatment: An overview

    Directory of Open Access Journals (Sweden)

    Hemanth Mohandas

    2017-01-01

    Full Text Available Cancer-related fatigue is a symptom of cancer where most patients or the general practitioners tend to misinterpret due to the insufficient understanding or knowledge of cancer-related fatigue (CRF. This paper will provide a better perspective for the patients and the health professionals on how to manage and handle CRF for both mild and severe fatigue patients. Articles were selected from the searches of PubMed database that had the terms “randomized controlled trials,” “cancer,” “fatigue,” “pharmacologic treatment,” and “nonpharmacologic treatment” using both Mesh terms and keywords. The authors have reviewed the current hypothesis and evidence of the detailed etiology of the CRF present in the literature for healthier management, directives, and strategies to improve the treatment of cancer-related fatigue. An algorithm has been blueprinted on screening, and management, of the CRF, and various kinds of effective treatments and assessment tools have been briefly studied and explained. Although many strategies seemed promising, the quality of randomized controlled trials is generally quite low in studies, making it difficult to draw conclusions about the effectiveness of each self-care strategies. Therefore, future studies require better design and reporting of methodological issues to ensure evidence-based self-care recommendations for people receiving cancer treatment.

  10. Single Jejunum Metastasis from Breast Cancer Arising Twelve Years after the Initial Treatment

    Directory of Open Access Journals (Sweden)

    Cláudia Paiva

    2016-01-01

    Full Text Available Metastatic involvement of gastrointestinal tract from breast cancer is a rare event. We report the case of a 61-year-old woman presenting with bowel obstruction, related to metastasis of a primary breast cancer she had 12 years earlier (a triple-negative invasive ductal carcinoma treated with surgery and chemotherapy. Bowel obstruction was caused by a 20-centimeter tumor in the jejunum, involving also the transverse colon. The patient underwent en bloc resection of tumor with jejunum and transverse bowel segment and received adjuvant chemotherapy with carboplatin and paclitaxel. Twenty months later, she was alive without disease recurrence.

  11. Evaluation of breast lesions with contrast-enhanced ultrasound using the microvascular imaging technique: initial observations.

    Science.gov (United States)

    Liu, He; Jiang, Yu-Xin; Liu, Ji-Bin; Zhu, Qing-Li; Sun, Qiang

    2008-10-01

    The objective of this study was to evaluate the usefulness of contrast-enhanced ultrasound using the microvascular imaging technique in the diagnosis of breast lesions. In 104 patients with 104 breast lesions scheduled for surgery, conventional and contrast-enhanced ultrasound using the microvascular imaging technique were performed after administration of SonoVue. The enhancement patterns of breast lesions were classified as no enhancement, peripheral enhancement, homogeneous enhancement, regional enhancement, or heterogeneous enhancement based on the morphologic features of enhancement. The diagnostic value of contrast-enhanced ultrasound using the microvascular imaging technique was analyzed with the observers blinded to the clinical data and pathology (which served as the gold standard). None of the enhancement patterns was suggestive of benignity, with a sensitivity of 18.3%, specificity of 97.7%, positive predictive value (PPV) of 91.7%, negative predictive value (NPV) of 46.2%, and accuracy of 51.5%. The peripheral enhancement pattern was suggestive of malignancy, with a sensitivity of 39.5%, specificity of 98.3%, PPV of 94.4%, NPV of 69.4%, and accuracy of 73.8%. Homogeneous, regional, and heterogeneous enhancement patterns did not show meaningful diagnostic information. Contrast-enhanced ultrasound using the microvascular imaging technique provides diagnostic information on breast lesions.

  12. Integration of Nuclear- and Extranuclear-Initiated Estrogen Receptor Signaling in Breast Cancer Cells

    Science.gov (United States)

    Madak Erdogan, Zeynep

    2009-01-01

    Estrogenic hormones exert their effects through binding to Estrogen Receptors (ERs), which work in concert with coregulators and extranuclear signaling pathways to control gene expression in normal as well as cancerous states, including breast tumors. In this thesis, we have used multiple genome-wide analysis tools to elucidate various ways that…

  13. Promotion of Tumor-Initiating Cells in Primary and Recurrent Breast Tumors

    Science.gov (United States)

    2013-07-01

    Thioridazine (an FDA approved drug that is known to block dopamine receptor signaling and to block MALT1, a factor upstream of IKK) strongly reduces...KR et al. (2008). Breast tumor cells with PI3K mutation or HER2 amplification are selectively addicted to Akt signaling. PLoS ONE 3: e3065. Singh S

  14. [Evaluation through the EORTC questionnaires of long-term quality of life in patients with breast cancer in initial stages].

    Science.gov (United States)

    Arraras Urdaniz, J I; Illarramendi Mañas, J J; Manterola Burgaleta, A; Tejedor Gutiérrez, M; Vera García, R; Valerdi Alvarez, J J; Domínguez Domínguez, M A

    2003-12-01

    The objective of the present work is to evaluate the quality of life of a group of patients with breast cancer after a long follow-up time. 104 patients with breast cancer in initial stages, of a total of 125 to whom the questionnaire was sent, have completed the general questionnaire QLQ-C30 and the module of the breast QLQ-BR23 of the EORTC in 2001, five years after their diagnosis. A subgroup of 48 patients had completed these questionnaires in 1996. The scorings of quality of life and the differences among the measurements of 2001 and 1996 have been evaluated, and groups organized according to the stage, the type of treatment, and the surgery have been compared. The scorings of quality of life are appropriate and similar in both periods (1996 and 2001). There are alterations in the sexual function and concern over the future. The differences between the type of surgery focus on the corporal image. There are not significant differences in the analyses according to the stage or according to the type of treatment. The scorings of quality of life indicate that the situation of these patients is satisfactory. The differences in the type of surgery are similar to the ones observed in the literature.

  15. Predictors of initial levels and trajectories of anxiety in women before and for 6 months after breast cancer surgery.

    Science.gov (United States)

    Kyranou, Marianna; Puntillo, Kathleen; Dunn, Laura B; Aouizerat, Bradley E; Paul, Steven M; Cooper, Bruce A; Neuhaus, John; West, Claudia; Dodd, Marylin; Miaskowski, Christine

    2014-01-01

    The diagnosis of breast cancer, in combination with the anticipation of surgery, evokes fear, uncertainty, and anxiety in most women. Study purposes were to examine in patients who underwent breast cancer surgery how ratings of state anxiety changed from the time of the preoperative assessment to 6 months after surgery and to investigate whether specific demographic, clinical, symptom, and psychosocial adjustment characteristics predicted the preoperative levels of state anxiety and/or characteristics of the trajectories of state anxiety. Patients (n = 396) were enrolled preoperatively and completed the Spielberger State Anxiety inventory monthly for 6 months. Using hierarchical linear modeling, demographic, clinical, symptom, and psychosocial adjustment characteristics were evaluated as predictors of initial levels and trajectories of state anxiety. Patients experienced moderate levels of anxiety before surgery. Higher levels of depressive symptoms and uncertainty about the future, as well as lower levels of life satisfaction, less sense of control, and greater difficulty coping, predicted higher preoperative levels of state anxiety. Higher preoperative state anxiety, poorer physical health, decreased sense of control, and more feelings of isolation predicted higher state anxiety scores over time. Moderate levels of anxiety persist in women for 6 months after breast cancer surgery. Clinicians need to implement systematic assessments of anxiety to identify high-risk women who warrant more targeted interventions. In addition, ongoing follow-up is needed to prevent adverse postoperative outcomes and to support women to return to their preoperative levels of function.

  16. Organizational Twitter Use: Content Analysis of Tweets during Breast Cancer Awareness Month.

    Science.gov (United States)

    Diddi, Pratiti; Lundy, Lisa K

    2017-03-01

    On an average, at least one out of eight women are at risk of falling prey to breast cancer during their lifespan. Amongst varied initiatives to spread awareness about breast cancer, the most well-known campaign is Breast Cancer Awareness Month. This article explored, through content analysis, how four different health-related organizations-Susan G. Komen, U.S. News Health, Woman's Hospital, and Breast Cancer Social Media-used their Twitter accounts to talk about varied aspects of breast cancer during the month of October, which is observed as Breast Cancer Awareness Month. All the tweets by these organizations were analyzed for the presence or absence of the theoretical parameters of the Health Belief Model (HBM). A content analysis of 2916 tweets based on the HBM revealed that the content posted by these organizations reflected the use of varied theoretical constructs of the framework. Overall, the study demonstrated that while different organizations shared valuable breast cancer-related content on Twitter, each used the social media platform in a different fashion, evident through focus on different types of HBM constructs while publishing breast cancer-related tweets.

  17. Five-year results: the initial clinical trial of MammoSite balloon brachytherapy for partial breast irradiation in early-stage breast cancer.

    Science.gov (United States)

    Benitez, Pamela R; Keisch, Martin E; Vicini, Frank; Stolier, Alan; Scroggins, Troy; Walker, Alonzo; White, Julia; Hedberg, Peter; Hebert, Mary; Arthur, Doug; Zannis, Vic; Quiet, Coral; Streeter, Oscar; Silverstein, Mel

    2007-10-01

    Patients with early-stage invasive ductal breast cancer were prospectively evaluated using MammoSite RTS balloon brachytherapy (RTS Cytyc Corp, Marlborough, MA) as the sole modality for delivering accelerated partial breast irradiation to the lumpectomy bed with breast-conserving surgery. This report presents the 5-year results of the treated patients. From May 2000 to October 2001, 70 patients were enrolled in this prospective study. Forty-three patients completed accelerated partial breast irradiation with MammoSite brachytherapy following lumpectomy and axillary staging. Thirty-six patients have been followed for a median of 5.5 years (mean 65.2 months). Criteria for entry into the study were unifocal invasive ductal carcinoma, tumor size or = 45 years, absence of extensive intraductal component, cavity size > or = 3 cm in 1 dimension, node-negative, and final margins negative per National Surgical Adjuvant Breast and Bowel Project definition. A minimum balloon-to-skin surface distance of 5 mm was required. A dose of 34 Gy was delivered in 10 fractions over 5 days prescribed to 1 cm from the applicator surface using iridium-192 high-dose-rate brachytherapy. Data on infection, seromas, cosmetic outcome, and toxicities were collected at 3 and 6 months and at yearly intervals. Local recurrences, both true recurrences in the lumpectomy bed and failures outside the initially treated target volume (elsewhere failures), were recorded. Contralateral breast failure rates were noted. The catheter was not implanted in 16 of the 70 enrolled patients due to cavity size not amenable to balloon placement (n = 10), ineligible by criteria (n = 4), and skin spacing (n = 2). Fifty-four patients were implanted and 43 were successfully treated with MammoSite balloon brachytherapy. Reasons for catheter explantation in 11 patients were poor cavity conformance in 7, inadequate skin spacing in 2, positive node in 1 and age less than 45 years in 1. Of the 43 patients who completed

  18. Disparities in the Initial Local Treatment of Older Women with Early-Stage Breast Cancer: A Population-Based Study.

    Science.gov (United States)

    LeMasters, Traci J; Madhavan, Suresh S; Sambamoorthi, Usha; Vyas, Ami M

    2017-07-01

    Although breast cancer is most prevalent among older women, the majority are diagnosed at an early stage. When diagnosed at an early stage, women have the option of breast-conserving surgery (BCS) plus radiation therapy (RT) or mastectomy for the treatment of early-stage breast cancer (ESBC). Omission of RT when receiving BCS increases the risk for recurrence and poor survival. Yet, a small subset of older women may omit RT after BCS. This study examines the current patterns of local treatment for ESBC among older women. This study conducted a retrospective observational analysis using the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked dataset of women age ≥66 diagnosed with stage I-II breast cancer in 2003-2009. SEER-Medicare data was additionally linked with data from the Area Resource File (ARF) to examine the association between area-level healthcare resources and treatment. Two logistic regression models were used to estimate how study factors were associated with receiving (1) BCS versus BCS+RT and (2) Mastectomy versus BCS+RT. A stratified analysis was also conducted among women aged stage II disease, and nonwhite race were more likely to have mastectomy or BCS only, than BCS+RT. Women diagnosed in 2004-2006, treated by an oncology surgeon, residing in metro areas, areas of greater education and income, were less likely to receive mastectomy or BCS only, than BCS+RT. While women aged <70 years were more likely to receive BCS+RT, socioeconomic and physician specialties were associated with receiving BCS only. Over half of older women with ESBC initially receive BCS+RT. The likelihood for mastectomy and BCS only increases with age, comorbidity, and vulnerable socio-demographic characteristics. Findings demonstrate continued treatment disparities among certain vulnerable populations.

  19. Complementary therapies for cancer-related symptoms.

    Science.gov (United States)

    Deng, Gary; Cassileth, Barrie R; Yeung, K Simon

    2004-01-01

    Relief of cancer-related symptoms is essential in the supportive and palliative care of cancer patients. Complementary therapies such as acupuncture, mind-body techniques, and massage therapy can help when conventional treatment does not bring satisfactory relief or causes undesirable side effects. Controlled clinical trials show that acupuncture and hypnotherapy can reduce pain and nausea. Meditation, relaxation therapy, music therapy, and massage mitigate anxiety and distress. Pilot studies suggest that complementary therapies may treat xerostomia, hot flashes, and fatigue. Botanicals or dietary supplements are popular but often problematic. Concurrent use of herbal products with mainstream medical treatment should be discouraged.

  20. Breast cancer risk reduction--is it feasible to initiate a randomised controlled trial of a lifestyle intervention programme (ActWell) within a national breast screening programme?

    Science.gov (United States)

    Anderson, Annie S; Macleod, Maureen; Mutrie, Nanette; Sugden, Jacqueline; Dobson, Hilary; Treweek, Shaun; O'Carroll, Ronan E; Thompson, Alistair; Kirk, Alison; Brennan, Graham; Wyke, Sally

    2014-12-17

    Breast cancer is the most commonly diagnosed cancer and the second cause of cancer deaths amongst women in the UK. The incidence of the disease is increasing and is highest in women from least deprived areas. It is estimated that around 42% of the disease in post-menopausal women could be prevented by increased physical activity and reductions in alcohol intake and body fatness. Breast cancer control endeavours focus on national screening programmes but these do not include communications or interventions for risk reduction. This study aimed to assess the feasibility of delivery, indicative effects and acceptability of a lifestyle intervention programme initiated within the NHS Scottish Breast Screening Programme (NHSSBSP). A 1:1 randomised controlled trial (RCT) of the 3 month ActWell programme (focussing on body weight, physical activity and alcohol) versus usual care conducted in two NHSSBSP sites between June 2013 and January 2014. Feasibility assessments included recruitment, retention, and fidelity to protocol. Indicative outcomes were measured at baseline and 3 month follow-up (body weight, waist circumference, eating and alcohol habits and physical activity). At study end, a questionnaire assessed participant satisfaction and qualitative interviews elicited women's, coaches, and radiographers' experiences. Statistical analysis used Chi squared tests for comparisons in proportions and paired t tests for comparisons of means. Linear regression analyses were performed, adjusted for baseline values, with group allocation as a fixed effect. A pre-set recruitment target of 80 women was achieved within 12 weeks and 65 (81%) participants (29 intervention, 36 control) completed 3 month assessments. Mean age was 58 ± 5.6 years, mean BMI was 29.2 ± 7.0 kg/m(2) and many (44%) reported a family history of breast cancer. The primary analysis (baseline body weight adjusted) showed a significant between group difference favouring the intervention group of 2.04 kg

  1. Accelerated partial breast irradiation using 3D conformal radiotherapy: initial clinical experience

    Energy Technology Data Exchange (ETDEWEB)

    Gatti, M.; Madeddu, A.; Malinverni, G.; Delmastro, E.; Bona, C.; Gabriele, P. [IRCC-Radiotherapy, Candiolo, TO (Italy); Baiotto, B.; Stasi, M. [IRCC-Medical Physics, Candiolo, TO (Italy); Ponzone, R.; Siatis, D. [IRCC-Surgery, Candiolo, TO (Italy)

    2006-11-15

    Accelerated partial breast irradiation using 3D-C.R.T. is technically sophisticate but feasible and acute toxicity to date has been minimal. A C.T.V.-to-P.T.V. margin of 10 mm seems to provide coverage for analyzed patients. However, more patients and additional studies will be needed to validate the accuracy of this margin, and longer follow-up will be needed to assess acute and chronic toxicity, tumor control, and cosmetic results. (author)

  2. Promotion of Tumor-Initiating Cells in Primary and Recurrent Breast Tumors

    Science.gov (United States)

    2014-10-01

    Her2+ relative to responses to inhibitors and effects on TICs. Experimental approaches: C3Tag and Her2+ transgenic animal genotyping [animals are...Chodosh -- collaborator/W81XWH-12-10-0177 -Univ. Pennsylvania) --- Using conditional transgenic mouse models for Her2/neu-driven breast cancers...plated in 3ml of Mammocult media (Stem Cell Technologies, Vancouver, BC, Canada) on six-well low-adhesion plates ( Corning , Corning , NY, USA). Cells

  3. "Joven & Fuerte": Program for Young Women with Breast Cancer in Mexico - Initial Results.

    Science.gov (United States)

    Villarreal-Garza, Cynthia; Castro-Sánchez, Andrea; Platas, Alejandra; Miaja, Melina; Mohar-Betancourt, Alejandro; Barragan-Carrillo, Regina; Fonseca, Alan; Vega, Yoatzin; Martinez-Cannon, B Alejandra; Aguilar, Dione; Bargalló-Rocha, Enrique; Cardona-Huerta, Servando; Peña-Curiel, Omar; Matus-Santoso, Juan

    2017-01-01

    Despite the high rates of breast cancer among young Mexican women, their special needs and concerns have not been systematically addressed. To fulfill these unsatisfied demands, we have developed "Joven & Fuerte: Program for Young Women with Breast Cancer in Mexico," the first program dedicated to the care of young breast cancer patients in Latin America, which is taking place at the National Cancer Institute of Mexico and the two medical facilities of the Instituto Tecnológico y de Estudios Superiores de Monterrey. The program was created to optimize the complex clinical and psychosocial care of these patients, enhance education regarding their special needs, and promote targeted research, as well as to replicate this program model in other healthcare centers across Mexico and Latin America. From November 2013 to February 2017, the implementation of the "Joven & Fuerte" program has delivered specialized care to 265 patients, through the systematic identification of their particular needs and the provision of fertility, genetic, and psychological supportive services. Patients and families have engaged in pedagogic activities and workshops and have created a motivated and empowered community. The program developed and adapted the first educational resources in Spanish dedicated for young Mexican patients, as well as material for healthcare providers. As for research, a prospective cohort of young breast cancer patients was established to characterize clinicopathological features and psychosocial effects at baseline and during follow-up, as a guide for the development of specific cultural interventions addressing this vulnerable group. Eventually, it is intended that the program's organization and structure can reach national and international interactions and serve as a platform for other countries.

  4. Quantitative shear wave ultrasound elastography: initial experience in solid breast masses

    Science.gov (United States)

    2010-01-01

    Introduction Shear wave elastography is a new method of obtaining quantitative tissue elasticity data during breast ultrasound examinations. The aims of this study were (1) to determine the reproducibility of shear wave elastography (2) to correlate the elasticity values of a series of solid breast masses with histological findings and (3) to compare shear wave elastography with greyscale ultrasound for benign/malignant classification. Methods Using the Aixplorer® ultrasound system (SuperSonic Imagine, Aix en Provence, France), 53 solid breast lesions were identified in 52 consecutive patients. Two orthogonal elastography images were obtained of each lesion. Observers noted the mean elasticity values in regions of interest (ROI) placed over the stiffest areas on the two elastography images and a mean value was calculated for each lesion. A sub-set of 15 patients had two elastography images obtained by an additional operator. Reproducibility of observations was assessed between (1) two observers analysing the same pair of images and (2) findings from two pairs of images of the same lesion taken by two different operators. All lesions were subjected to percutaneous biopsy. Elastography measurements were correlated with histology results. After preliminary experience with 10 patients a mean elasticity cut off value of 50 kilopascals (kPa) was selected for benign/malignant differentiation. Greyscale images were classified according to the American College of Radiology (ACR) Breast Imaging Reporting and Data System (BI-RADS). BI-RADS categories 1-3 were taken as benign while BI-RADS categories 4 and 5 were classified as malignant. Results Twenty-three benign lesions and 30 cancers were diagnosed on histology. Measurement of mean elasticity yielded an intraclass correlation coefficient of 0.99 for two observers assessing the same pairs of elastography images. Analysis of images taken by two independent operators gave an intraclass correlation coefficient of 0.80. Shear

  5. Self-reported breast feeding practices and the Baby Friendly Hospital Initiative in Riyadh, Saudi Arabia: prospective cohort study.

    Science.gov (United States)

    Mosher, Cynthia; Sarkar, Abdullah; Hashem, Alaa AbouBakr; Hamadah, Reem E; Alhoulan, Asma; AlMakadma, Yosra A; Khan, Tehreem A; Al-Hamdani, Abdurahman K; Senok, Abiola

    2016-12-16

    The Baby Friendly Hospital Initiative (BFHI) is a practice guideline for healthcare providers to promote breastfeeding and increase breastfeeding rates. This study aimed to examine reported experiences and views on breastfeeding of women using prenatal and postnatal services, and opinions of staff, in the context of the BFHI programme in Riyadh, Saudi Arabia. Prospective cohort study. This prospective, longitudinal study was conducted from December 2013 to September 2015 at two healthcare facilities (BFHI and non-BFHI) in Riyadh Saudi Arabia. Women 36-40 weeks gestation receiving antenatal care at the hospitals were enrolled. Questionnaires were administered prenatally, at 1, 3 and 6 months postnatal and to the administrator and maternity staff. We recruited 277 women with an estimated 80% response rate. 156 (BFHI=78/139, non-BFHI=78/138, 56%) participants completed all questionnaires. Most BFHI-hospital participants (77.9%, n=8 for this question) acknowledged seeing the breast feeding policy compared to 23.5% (n=23) at the non-BFHI-hospital (pBreast feeding education and encouragement was higher at the BFHI-hospital (93.3%) compared to the non-BFHI-hospital (48.2%; pbreast feeding exclusively versus 29.6% (n=29) at the non-BFHI-hospital. Where formula feed was introduced, women in the BFHI-hospital more often practiced mixed feeding rather than exclusive formula feeding with some switching from mixed feeding to exclusive breast feeding between 3 and 6 months postpartum. Exclusive breast feeding rates declined in both hospitals at 3 and 6 months postpartum with lack of community services for lactation being a major reason. Although BFHI-hospital staff (n=9) were more conversant with BFHI principles, defects in adherence to the BFHI 10 Steps were identified. This is the first study assessing the effectiveness of BFHI implementation in Saudi Arabia. Although women reported increased breast feeding rates, we identified important weaknesses that could be

  6. Random start ovarian stimulation for fertility preservation appears unlikely to delay initiation of neoadjuvant chemotherapy for breast cancer.

    Science.gov (United States)

    Letourneau, Joseph M; Sinha, Nikita; Wald, Kaitlyn; Harris, Eve; Quinn, Molly; Imbar, Tal; Mok-Lin, Evelyn; Chien, A Jo; Rosen, Mitchell

    2017-10-01

    Is random start ovarian stimulation associated with delays in initiation of neoadjuvant chemotherapy for breast cancer? Among women who complete fertility preservation (FP) consultation, random start ovarian stimulation is unlikely to delay time to initiation of neoadjuvant chemotherapy start. Neoadjuvant chemotherapy is now a widely accepted treatment modality for operable breast cancer and random start ovarian stimulation is an increasingly-utilized modality for FP. While conventional ovarian stimulation does not appear to delay starting adjuvant chemotherapy, the relationship between random start ovarian stimulation and neoadjuvant chemotherapy start is not well-understood. Cross-sectional study of all women seen between from January 2011 to April 2017 for FP consultation prior to starting neoadjuvant chemotherapy for breast cancer. A chart-review was performed. Study inclusion criteria were female sex; age 18-45; non-metastatic breast cancer diagnosis; underwent FP consultation; underwent neoadjuvant chemotherapy. Referrals for FP evaluation came from a regional referral base of oncology clinics. Various time-points related to cancer diagnosis, FP or chemotherapy were obtained from medical record review. We compared time-points between those who underwent ovarian stimulation for FP versus those who did not using T-tests and linear modeling. A total of 89 women who had FP consultation prior to neoadjuvant chemotherapy were identified. Sixty-seven percent underwent ovarian stimulation prior to cancer treatment and 33% did not. Women who underwent ovarian stimulation were similar in parity and clinical cancer stage to those who did not. Overall, the average time from cancer diagnosis to chemotherapy start was similar between the group that did undergo ovarian stimulation and those who did not (38.1 ± 11.3 versus 39.4 ± 18.5 days, P = 0.672). Those that underwent ovarian stimulation were referred 9.4 ± 6.8 days after diagnosis versus 17.9 ± 15.3 days for those

  7. Magnetic resonance imaging - guided vacuum-assisted breast biopsy: an initial experience in a community hospital

    Energy Technology Data Exchange (ETDEWEB)

    Friedman, P.; Enis, S.; Pinyard, J., E-mail: jpinyard@gmail.com [Morristown Memorial Hospital, The Carol W. and Julius A. Rippel Breast Center, The Carol G. Simon Cancer Centre, Morristown, New Jersey (United States)

    2009-10-15

    To evaluate the effectiveness in diagnosing mammographically and sonographically occult breast lesions by using magnetic resonance imaging (MRI) guided vacuum-assisted breast biopsy in patients who presented to a community-based hospital with a newly established breast MRI program. The records of 142 consecutive patients, median age of 55 years, who had undergone MRI-guided biopsy at our institution between July 2006 and July 2007 were reviewed. From these patients, 197 mammographically and sonographically occult lesions were biopsied at the time of discovery. The pathology was then reviewed and correlated with the MRI findings. Cancer was present and subsequently discovered in 8% of the previously occult lesions (16/197) or 11% of the women studied (16/142). Of the cancerous lesions, 56% were invasive carcinomas (9/16) and 44% were ductal carcinomas in situ (7/16). Fourteen percent of the discovered lesions (28/197) were defined as high risk and included atypical ductal hyperplasia, atypical lobular hyperplasia, lobular carcinoma in situ, and radial scar. In total, occult cancerous and high-risk lesions were discovered in 22% of the found lesions (44/197) or 31% of the women who underwent MRI-guided biopsy (44/142). This study demonstrated that detection of cancerous and high-risk lesions can be significantly increased when an MRI-guided biopsy program is introduced at a community-based hospital. We believe that as radiologists gain confidence in imaging and histologic correlation, community-based hospitals can achieve similar rates of occult lesion diagnosis as those found in data emerging from academic institutions. (author)

  8. New metallic marker used after mammotome biopsy for the localization of breast lesions: Initial experience

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sun Mi; Park, Jeong Mi; Song, Ho Young [Asan Medical Center, Ulsan University College of Medicine, Ulsan (Korea, Republic of)] (and others)

    2003-12-15

    To determine the usefulness and complications of a newly made metallic tissue marker inserted after mammotome biopsy of breast lesions. We manufactured a new gold tissue marker and introducer for the insertion after ultrasound-guided mammotome biopsy for breast lesions. The new tissue marker was inserted to 7 dogs and 22 patients. Histopathologic findings were evaluated in all dogs and patients with malignant diseases who underwent surgery. Follow-up mammography and ultrasonography were performed in patients with benign diseases 6 months after the biopsy for the evaluation of complications including migration. In dogs, there was no foreign body reaction in 3 dogs, mild foreign body reactions in 3 dogs, and moderate foreign body reactions in one dog. Meanwhile, the marker was successfully inserted in 17 (77.3%) of 22 patients under ultrasonography-guidance. There were mild foreign body reactions in 4 patients with malignant diseases. On one month follow-up mammography and ultrasonography in 12 of 13 patients with benign diseases with the successful marker insertion showed hematoma with the size ranging from 8 to 23 mm in 8 patients (66.7%). Rotation of the marker without any change of location was seen in 4 patients while rotation with the changed location, about 1 cm in distance, was seen in 1 patient. On six month follow-up ultrasonography performed in 9 patients showed the disappearance of all hematomas. There was no change of the marker's location on mammography compared to the one-month follow-up mammography. Pain or inflammatory reaction was not noted in any patient. This new gold post-mammotome tissue marker showed mild foreign body reaction and no significant complication including migration. It will be very useful in routine practice of mammotome for breast lesions.

  9. Computer-assisted assessment of ultrasound real-time elastography: Initial experience in 145 breast lesions

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Xue; Xiao, Yang [Shenzhen Key Lab for Molecular Imaging, Paul C. Lauterbur Research Center for Biomedical Imaging, Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen (China); Zeng, Jie [Department of Medical Ultrasonics, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou (China); Qiu, Weibao; Qian, Ming; Wang, Congzhi [Shenzhen Key Lab for Molecular Imaging, Paul C. Lauterbur Research Center for Biomedical Imaging, Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen (China); Zheng, Rongqin, E-mail: zhengronggin@hotmail.com [Department of Medical Ultrasonics, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou (China); Zheng, Hairong, E-mail: hr.zheng@siat.ac.cn [Shenzhen Key Lab for Molecular Imaging, Paul C. Lauterbur Research Center for Biomedical Imaging, Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen (China)

    2014-01-15

    Purpose: To develop and evaluate a computer-assisted method of quantifying five-point elasticity scoring system based on ultrasound real-time elastography (RTE), for classifying benign and malignant breast lesions, with pathologic results as the reference standard. Materials and methods: Conventional ultrasonography (US) and RTE images of 145 breast lesions (67 malignant, 78 benign) were performed in this study. Each lesion was automatically contoured on the B-mode image by the level set method and mapped on the RTE image. The relative elasticity value of each pixel was reconstructed and classified into hard or soft by the fuzzy c-means clustering method. According to the hardness degree inside lesion and its surrounding tissue, the elasticity score of the RTE image was computed in an automatic way. Visual assessments of the radiologists were used for comparing the diagnostic performance. Histopathologic examination was used as the reference standard. The Student's t test and receiver operating characteristic (ROC) curve analysis were performed for statistical analysis. Results: Considering score 4 or higher as test positive for malignancy, the diagnostic accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were 93.8% (136/145), 92.5% (62/67), 94.9% (74/78), 93.9% (62/66), and 93.7% (74/79) for the computer-assisted scheme, and 89.7% (130/145), 85.1% (57/67), 93.6% (73/78), 92.0% (57/62), and 88.0% (73/83) for manual assessment. Area under ROC curve (A{sub z} value) for the proposed method was higher than the A{sub z} value for visual assessment (0.96 vs. 0.93). Conclusion: Computer-assisted quantification of classical five-point scoring system can significantly eliminate the interobserver variability and thereby improve the diagnostic confidence of classifying the breast lesions to avoid unnecessary biopsy.

  10. Dietary Regulation of PTEN Signaling and Mammary Tumor Initiating Cells: Implications for Breast Cancer Prevention

    Science.gov (United States)

    2012-07-01

    questions raised than answered. Nutr Rev 2007;65:459–66. [36] Lof M, Weiderpass E. Impact of diet on breast cancer risk. Curr Opin Obstet Gynecol 2009;21...Wnt and mammary stem cells: hormones cannot fly wingless. Curr Opin Pharmacol 2010; 10:643-649. 7. Tsukamoto AS, Grosschedl R, Guzman RC, Parslow T...Biol 2009;21:11–8. [16] Tlsty TD, Hein PW. Know thy neighbor: stromal cells can contribute oncogenic signals. Curr Opin Genet Dev 2001;11:54–9. [17

  11. Testosterone membrane-initiated action in breast cancer cells: Interaction with the androgen signaling pathway and EPOR.

    Science.gov (United States)

    Pelekanou, Vassiliki; Notas, George; Sanidas, Elias; Tsapis, Andreas; Castanas, Elias; Kampa, Marilena

    2010-04-01

    Membrane-initiated androgen actions have now been acknowledged, even though a specific binding site has not been biochemically characterized yet. Recent data indicate that testosterone-BSA, a non-permeable testosterone analog, can exert specific actions in breast cancer cell lines, including proper transcriptional effects, independent of the intracellular androgen sites. In the present work we explore the effects of testosterone-BSA in two specifically modified pathways, revealed by early trascriptome analysis, namely the non-genotropic androgen signaling and the HIF1alpha pathway. We provide evidence that p38 MAPK and PI3K/Akt/NFkappaB and/or Rho/Actin pathways are directly involved in testosterone-induced apoptosis, while the JNK/c-JUN pathway is involved in membrane site-initiated transcription. Furthermore we show that membrane-acting androgens modify the transcription of the erythropoietin receptor (EPOR), leading to erythropoietin-initiated actions. Interestingly, association of recombinant human erythropoietin (rHuEPO) together with testosterone-BSA protects cells from apoptosis, through discrete signaling events. The effect of testosterone-BSA is exerted through the classical erythropoietin promoter, while rHuEPO decreases the transcription of EPOR acting on a newly identified regulatory/promoter region, upstream of its known promoter. These results suggest a new interaction of membrane-acting androgen with EPOR and should be taken into account in the pharmaceutical manipulations of breast cancer patients. Copyright 2010 Federation of European Biochemical Societies. Published by Elsevier B.V. All rights reserved.

  12. Breast cancer, endometrial cancer, and cardiovascular events in participants who used vaginal estrogen in the Women's Health Initiative Observational Study.

    Science.gov (United States)

    Crandall, Carolyn J; Hovey, Kathleen M; Andrews, Christopher A; Chlebowski, Rowan T; Stefanick, Marcia L; Lane, Dorothy S; Shifren, Jan; Chen, Chu; Kaunitz, Andrew M; Cauley, Jane A; Manson, JoAnn E

    2018-01-01

    To determine the association between use of vaginal estrogen and risk of a global index event (GIE), defined as time to first occurrence of coronary heart disease (CHD), invasive breast cancer, stroke, pulmonary embolism, hip fracture, colorectal cancer, endometrial cancer, or death from any cause. For this prospective observational cohort study, we used data from participants of the Women's Health Initiative Observational Study, who were recruited at 40 US clinical centers, aged 50 to 79 years at baseline and did not use systemic estrogen therapy during follow-up (n = 45,663, median follow-up 7.2 years). We collected data regarding incident CHD, invasive breast cancer, stroke, pulmonary embolism, hip fracture, colorectal cancer, endometrial cancer, death, and self-reported use of vaginal estrogen (cream, tablet). We used Cox proportional-hazards regression models to adjust for covariates. Among women with an intact uterus, the risks of stroke, invasive breast cancer, colorectal cancer, endometrial cancer, and pulmonary embolism/deep vein thrombosis were not significantly different between vaginal estrogen users and nonusers, whereas the risks of CHD, fracture, all-cause mortality, and GIE were lower in users than in nonusers (GIE adjusted hazard ratio 0.68, 95% confidence interval 0.55-0.86). Among hysterectomized women, the risks of each of the individual GIE components and of the overall GIE were not significantly different in users versus nonusers of vaginal estrogen (GIE adjusted hazard ratio 0.94, 95% confidence interval 0.70-1.26). The risks of cardiovascular disease and cancer were not elevated among postmenopausal women using vaginal estrogens, providing reassurance about the safety of treatment.

  13. Incidence and mortality of female breast cancer in the Asia-Pacific region

    Science.gov (United States)

    Youlden, Danny R.; Cramb, Susanna M.; Yip, Cheng Har; Baade, Peter D.

    2014-01-01

    Objective To provide an overview of the incidence and mortality of female breast cancer for countries in the Asia-Pacific region. Methods Statistical information about breast cancer was obtained from publicly available cancer registry and mortality databases (such as GLOBOCAN), and supplemented with data requested from individual cancer registries. Rates were directly age-standardised to the Segi World Standard population and trends were analysed using joinpoint models. Results Breast cancer was the most common type of cancer among females in the region, accounting for 18% of all cases in 2012, and was the fourth most common cause of cancer-related deaths (9%). Although incidence rates remain much higher in New Zealand and Australia, rapid rises in recent years were observed in several Asian countries. Large increases in breast cancer mortality rates also occurred in many areas, particularly Malaysia and Thailand, in contrast to stabilising trends in Hong Kong and Singapore, while decreases have been recorded in Australia and New Zealand. Mortality trends tended to be more favourable for women aged under 50 compared to those who were 50 years or older. Conclusion It is anticipated that incidence rates of breast cancer in developing countries throughout the Asia-Pacific region will continue to increase. Early detection and access to optimal treatment are the keys to reducing breast cancer-related mortality, but cultural and economic obstacles persist. Consequently, the challenge is to customise breast cancer control initiatives to the particular needs of each country to ensure the best possible outcomes. PMID:25009752

  14. Entertainment education for informed breast cancer treatment decisions in low-literate women: development and initial evaluation of a patient decision aid.

    Science.gov (United States)

    Jibaja-Weiss, Maria L; Volk, Robert J; Granch, Thomas S; Nefe, Nancy E; Spann, Stephen J; Aoki, Noriaki; Robinson, Emily K; Freidman, Lois C; Beck, J Robert

    2006-01-01

    We report on the development and initial evaluation of a novel computerized decision support system (CDSS) that utilizes concepts from entertainment education (edutainment) to assist low-literate, multiethnic women in making initial surgical treatment decisions. We randomly assigned 51 patients diagnosed with early stage breast cancer to use the decision aid. Patients who viewed the CDSS improved their knowledge of breast cancer treatment; found the application easy to use and understand, informative, and enjoyable; and were less worried about treatment. The system clearly reached its intended objectives to create a usable decision aid for low-literate, novice computer users.

  15. Transfer of Methamphetamine (MA) into Breast Milk and Urine of Postpartum Women who Smoked MA Tablets during Pregnancy: Implications for Initiation of Breastfeeding.

    Science.gov (United States)

    Chomchai, Chulathida; Chomchai, Summon; Kitsommart, Ratchada

    2016-05-01

    Methamphetamine (MA) use by pregnant women remains a growing problem in South East Asia. After delivery, a negative maternal urine MA assay is assumed to reflect the absence of MA in breast milk and marks breastfeeding initiation. To date, no data exist that describe the relationship between the peripartum and postpartum transfer of MA into breast milk and its urinary excretion in women, following recreational use by smoking. This study aimed to determine the pharmacokinetic of smoked MA in breast milk and its relationship to urinary MA excretion in postpartum women who tested positive for MA before delivery. Timed urine and breast milk samples of 33 women who had positive urine drug screens for MA prior to delivery were analyzed for MA using Acquity Ultra Performance Liquid Chromatography (Waters, Milford, Massachusetts, USA) with the ACQUITY UPLC Photodiode Array Detector (Waters). Those participants with 4 or more timed breast milk samples were included for pharmacokinetic calculation using log-linear trapezoidal rule. Pharmacokinetic data from 2 women were analyzed. The half-life values for MA in the breast milk were 11.3 and 40.3 hours. The absolute infant doses were 21.3 and 51.7 µg/kg/day. Methamphetamine disappears from breast milk approximately 1 day before the maternal urine MA becomes negative. Smoked MA shows a similar breast milk pharmacokinetic pattern to previously reported intravenous MA. Breastfeeding can be safely initiated in mothers whose urine MA screen has turned negative for ≥ 24 hours. However, concurrent maternal substance use treatment and screening is necessary for continued promotion of lactation. © The Author(s) 2015.

  16. The oncogenic potential of human cytomegalovirus and breast cancer.

    Directory of Open Access Journals (Sweden)

    Georges eHerbein

    2014-08-01

    Full Text Available Breast cancer is among the leading causes of cancer-related death among women. The vast majority of breast cancers are carcinomas that originate from cells lining the milk-forming ducts of the mammary gland. Numerous articles indicate that breast tumors exhibit diverse phenotypes depending on their distinct physiopathological signatures, clinical courses and therapeutic possibilities. The human cytomegalovirus (HCMV is a multifaceted highly host specific betaherpesvirus that is regarded as asymptomatic or mildly pathogenic virus in immunocompetent host. HCMV may cause serious in utero infections as well as acute and chronic complications in immunocompromised individual. The involvement of HCMV in late inflammatory complications underscores its possible role in inflammatory diseases and cancer. HCMV targets a variety of cell types in vivo, including macrophages, epithelial cells, endothelial cells, fibroblasts, stromal cells, neuronal cells, smooth muscle cells, and hepatocytes. HCMV can be detected in the milk after delivery and thereby HCMV could spread to adjacent mammary epithelial cells. HCMV also infects macrophages and induces an atypical M1/M2 phenotype, close to the tumor associated macrophage phenotype, which is associated with the release of cytokines involved in cancer initiation or promotion and breast cancer of poor prognosis. HCMV antigens and DNA have been detected in tissue biopsies of breast cancers and elevation in serum HCMV IgG antibody levels has been reported to precede the development of breast cancer in some women. In this review, we will discuss the potential role of HCMV in the initiation and progression of breast cancer.

  17. Tumor initiating but differentiated luminal-like breast cancer cells are highly invasive in the absence of basal-like activity

    DEFF Research Database (Denmark)

    Kim, Jiyoung; Villadsen, René; Sørlie, Therese

    2012-01-01

    The majority of human breast cancers exhibit luminal epithelial differentiation. However, most aggressive behavior, including invasion and purported cancer stem cell activity, are considered characteristics of basal-like cells. We asked the following questions: Must luminal-like breast cancer cells...... become basal-like to initiate tumors or to invade? Could luminally differentiated cells within a basally initiated hierarchy also be tumorigenic? To answer these questions, we used rare and mutually exclusive lineage markers to isolate subsets of luminal-like and basal-like cells from human breast tumors....... We enriched for populations with or without prominent basal-like traits from individual tumors or single cell cloning from cell lines and recovered cells with a luminal-like phenotype. Tumor cells with basal-like traits mimicked phenotypic and functional behavior associated with stem cells assessed...

  18. Intracystic breast carcinoma: case study and review.

    Science.gov (United States)

    Alipour, Sadaf; Mood, Narges Izadi

    2010-12-01

    Breast carcinoma is the most common cancer in women, the second leading cause of cancer-related mortality in women, and the leading cause of death from cancer in women between the ages of 40 and 44. While cystic breast disease is the most frequent cause of benign breast masses, intracystic breast cancers are rare. We present a case of a postmenopausal woman with a large cystic breast carcinoma with its interesting radiologic and cytopathologic findings and review the literature.

  19. In real life, one-quarter of patients with hormone receptor-positive metastatic breast cancer receive chemotherapy as initial palliative therapy: a study of the Southeast Netherlands Breast Cancer Consortium.

    Science.gov (United States)

    Lobbezoo, D J A; van Kampen, R J W; Voogd, A C; Dercksen, M W; van den Berkmortel, F; Smilde, T J; van de Wouw, A J; Peters, F P J; van Riel, J M G H; Peters, N A J B; de Boer, M; Peer, P G M; Tjan-Heijnen, V C G

    2016-02-01

    The objective of this study was to present initial systemic treatment choices and the outcome of hormone receptor-positive (HR+) metastatic breast cancer. All the 815 consecutive patients diagnosed with metastatic breast cancer in 2007-2009 in eight participating hospitals were identified. From the 611 patients with HR+ disease, a total of 520 patients with HER2-negative (HER2-) breast cancer were included. Initial palliative systemic treatment was registered. Progression-free survival (PFS) and overall survival (OS) per initial palliative systemic therapy were obtained using the Kaplan-Meier method and compared using the log-rank test. From the total of 520 patients with HR+/HER2- metastatic breast cancer, 482 patients (93%) received any palliative systemic therapy. Patients that received initial chemotherapy (n = 116) were significantly younger, had less comorbidity, had received more prior adjuvant systemic therapy and were less likely to have bone metastasis only compared with patients that received initial endocrine therapy (n = 366). Median PFS of initial palliative chemotherapy was 5.3 months [95% confidence interval (CI) 4.2-6.2] and of initial endocrine therapy 13.3 months (95% CI 11.3-15.5), with a median OS of 16.1 and 36.9 months, respectively. Initial chemotherapy was also associated with worse outcome in terms of PFS and OS after adjustment for prognostic factors. A high percentage of patients with HR+ disease received initial palliative chemotherapy, which was associated with worse outcome, even after adjustment of relevant prognostic factors. © The Author 2015. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  20. Inflammatory Breast Cancer

    Science.gov (United States)

    ... breast cancer correctly. Their recommendations are summarized below. Minimum criteria for a diagnosis of inflammatory breast cancer ... Initial biopsy samples from the affected breast show invasive carcinoma. Further examination of tissue from the affected ...

  1. Using Collaborative Simulation Modeling to Develop a Web-Based Tool to Support Policy-Level Decision Making About Breast Cancer Screening Initiation Age

    Directory of Open Access Journals (Sweden)

    Elizabeth S. Burnside MD, MPH, MS

    2017-07-01

    Full Text Available Background: There are no publicly available tools designed specifically to assist policy makers to make informed decisions about the optimal ages of breast cancer screening initiation for different populations of US women. Objective: To use three established simulation models to develop a web-based tool called Mammo OUTPuT. Methods: The simulation models use the 1970 US birth cohort and common parameters for incidence, digital screening performance, and treatment effects. Outcomes include breast cancers diagnosed, breast cancer deaths averted, breast cancer mortality reduction, false-positive mammograms, benign biopsies, and overdiagnosis. The Mammo OUTPuT tool displays these outcomes for combinations of age at screening initiation (every year from 40 to 49, annual versus biennial interval, lifetime versus 10-year horizon, and breast density, compared to waiting to start biennial screening at age 50 and continuing to 74. The tool was piloted by decision makers (n = 16 who completed surveys. Results: The tool demonstrates that benefits in the 40s increase linearly with earlier initiation age, without a specific threshold age. Likewise, the harms of screening increase monotonically with earlier ages of initiation in the 40s. The tool also shows users how the balance of benefits and harms varies with breast density. Surveys revealed that 100% of users (16/16 liked the appearance of the site; 94% (15/16 found the tool helpful; and 94% (15/16 would recommend the tool to a colleague. Conclusions: This tool synthesizes a representative subset of the most current CISNET (Cancer Intervention and Surveillance Modeling Network simulation model outcomes to provide policy makers with quantitative data on the benefits and harms of screening women in the 40s. Ultimate decisions will depend on program goals, the population served, and informed judgments about the weight of benefits and harms.

  2. Urological cancer related to familial syndromes

    Directory of Open Access Journals (Sweden)

    Walter Henriques da Costa

    Full Text Available ABSTRACT Cancer related to hereditary syndromes corresponds to approximately 5-10% of all tumors. Among those from the genitourinary system, many tumors had been identified to be related to genetic syndromes in the last years with the advent of new molecular genetic tests. New entities were described or better characterized, especially in kidney cancer such as hereditary leiomyomatosis renal cell carcinoma (HLRCC, succinate dehydrogenase kidney cancer (SDH-RCC, and more recently BAP1 germline mutation related RCC. Among tumors from the bladder or renal pelvis, some studies had reinforced the role of germline mutations in mismatch repair (MMR genes, especially in young patients. In prostate adenocarcinoma, besides mutations in BRCA1 and BRCA2 genes that are known to increase the incidence of high-risk cancer in young patients, new studies have shown mutation in other gene such as HOXB13 and also polymorphisms in MYC, MSMB, KLK2 and KLK3 that can be related to hereditary prostate cancer. Finally, tumors from testis that showed an increased in 8 - 10-fold in siblings and 4 - 6-fold in sons of germ cell tumors (TGCT patients, have been related to alteration in X chromosome. Also genome wide association studies GWAS pointed new genes that can also be related to increase of this susceptibility.

  3. Adjustment of patients and husbands to the initial impact of breast cancer.

    Science.gov (United States)

    Northouse, L L; Swain, M A

    1987-01-01

    This study compared the psychosocial adjustment of 50 newly diagnosed breast cancer patients and their husbands at two points in time. Time 1 interviews were conducted approximately 3 days after surgery; Time 2 interviews were conducted 30 days later. Psychosocial adjustment was measured as a multidimensional construct using the Affects Balance Scale, the Brief Symptom Inventory, and the Psychosocial Adjustment to Illness Scale. Repeated measures analysis indicated that husbands' scores did not differ significantly from patients' scores on the adjustment measures that assessed level of mood and amount of symptom distress. Both patients and husbands reported levels of distress significantly above the level reported for the normal population. Patients and husbands differed only on the adjustment measure that assessed problems in carrying out various psychosocial roles, with patients reporting more role adjustment problems than husbands. Although both patients and husbands reported dramatic improvement in their levels of mood from Time 1 to Time 2, no significant change occurred in their levels of distress. Medical and demographic factors had little relationship to subjects' levels of adjustments at either time.

  4. Common genomic signaling among initial DNA damage and radiation-induced apoptosis in peripheral blood lymphocytes from locally advanced breast cancer patients

    DEFF Research Database (Denmark)

    Henríquez-Hernández, Luis Alberto; Pinar, Beatriz; Carmona-Vigo, Ruth

    2013-01-01

    suffering from locally advanced breast cancer and treated with high-dose hyperfractionated radiotherapy were recruited. Initial DNA damage was measured by pulsed-field gel electrophoresis and radiation-induced apoptosis was measured by flow cytometry. Gene expression was assessed by DNA microarray. RESULTS...

  5. Better postdiagnosis diet quality is associated with reduced risk of death among postmenopausal women with invasive breast cancer in the women's health initiative.

    Science.gov (United States)

    George, Stephanie M; Ballard-Barbash, Rachel; Shikany, James M; Caan, Bette J; Freudenheim, Jo L; Kroenke, Candyce H; Vitolins, Mara Z; Beresford, Shirley A; Neuhouser, Marian L

    2014-04-01

    Few studies have evaluated whether adherence to dietary recommendations is associated with mortality among cancer survivors. In breast cancer survivors, we examined how postdiagnosis Healthy Eating Index (HEI)-2005 scores were associated with all-cause and cause-specific mortality. Our prospective cohort study included 2,317 postmenopausal women, ages 50 to 79 years, in the Women's Health Initiative's Dietary Modification Trial (n = 1,205) and Observational Study (n = 1,112), who were diagnosed with invasive breast cancer and completed a food frequency questionnaire after being diagnosed. We followed women from this assessment forward. We used Cox proportional hazards models to estimate multivariate-adjusted HRs and 95% confidence intervals (CI) for death from any cause, breast cancer, and causes other than breast cancer, according to HEI-2005 quintiles. Over 9.6 years, 415 deaths occurred. After adjustment for key covariates, women consuming better quality diets had a 26% lower risk of death from any cause (HRQ4:Q1, 0.74; 95% CI, 0.55-0.99; Ptrend = 0.043) and a 42% lower risk of death from non-breast cancer causes (HRQ4:Q1, 0.58; 95% CI, 0.38-0.87; Ptrend = 0.011). HEI-2005 score was not associated with breast cancer death (HRQ4:Q1, 0.91; 95% CI, 0.60-1.40; Ptrend = 0.627). In analyses stratified by tumor estrogen receptor (ER) status, better diet quality was associated with a reduced risk of all-cause mortality among women with ER(+) tumors (n = 1,758; HRQ4:Q1, 0.55; 95% CI, 0.38-0.79; Ptrend = 0.0009). Better postdiagnosis diet quality was associated with reduced risk of death, particularly from non-breast cancer causes. Breast cancer survivors may experience improved survival by adhering to U.S. dietary guidelines.

  6. Projecting productivity losses for cancer-related mortality 2011 - 2030.

    Science.gov (United States)

    Pearce, Alison; Bradley, Cathy; Hanly, Paul; O'Neill, Ciaran; Thomas, Audrey Alforque; Molcho, Michal; Sharp, Linda

    2016-10-18

    When individuals stop working due to cancer this represents a loss to society - the loss of productivity. The aim of this analysis was to estimate productivity losses associated with premature mortality from all adult cancers and from the 20 highest mortality adult cancers in Ireland in 2011, and project these losses until 2030. An incidence-based method was used to estimate the cost of cancer deaths between 2011 and 2030 using the Human Capital Approach. National data were used for cancer, population and economic inputs. Both paid work and unpaid household activities were included. Sensitivity analyses estimated the impact of assumptions around future cancer mortality rates, retirement ages, value of unpaid work, wage growth and discounting. The 233,000 projected deaths from all invasive cancers in Ireland between 2011 and 2030 will result in lost productivity valued at €73 billion; €13 billion in paid work and €60 billion in household activities. These losses represent approximately 1.4 % of Ireland's GDP annually. The most costly cancers are lung (€14.4 billion), colorectal and breast cancer (€8.3 billion each). However, when viewed as productivity losses per cancer death, testis (€364,000 per death), cervix (€155,000 per death) and brain cancer (€136,000 per death) are most costly because they affect working age individuals. An annual 1 % reduction in mortality reduces productivity losses due to all invasive cancers by €8.5 billion over 20 years. Society incurs substantial losses in productivity as a result of cancer-related mortality, particularly when household production is included. These estimates provide valuable evidence to inform resource allocation decisions in cancer prevention and control.

  7. {sup 18}F-FDG PET/CT for initial staging in breast cancer patients. Is there a relevant impact on treatment planning compared to conventional staging modalities?

    Energy Technology Data Exchange (ETDEWEB)

    Krammer, J.; Schnitzer, A.; Kaiser, C.G.; Buesing, K.A.; Schoenberg, S.O.; Wasser, K. [University of Heidelberg, Institute of Clinical Radiology and Nuclear Medicine, University Medical Centre Mannheim, Medical Faculty Mannheim, Mannheim (Germany); Sperk, E. [University of Heidelberg, Department of Radiation Oncology, University Medical Centre Mannheim, Medical Faculty Mannheim, Mannheim (Germany); Brade, J. [University of Heidelberg, Institute of Medical Statistics, Biomathematics and Data Processing, Medical Faculty Mannheim, Mannheim (Germany); Wasgindt, S.; Suetterlin, M. [University of Heidelberg, Department of Gynaecology and Obstetrics, University Medical Centre Mannheim, Medical Faculty Mannheim, Mannheim (Germany); Sutton, E.J. [Memorial Sloan-Kettering Cancer Center, Evelyn H. Lauder Breast Center, Department of Radiology, New York, NY (United States)

    2015-08-15

    To evaluate the impact of whole-body {sup 18}F-FDG PET/CT on initial staging of breast cancer in comparison to conventional staging modalities. This study included 102 breast cancer patients, 101 patients were eligible for evaluation. Preoperative whole-body staging with PET/CT was performed in patients with clinical stage ≥ T2 tumours or positive local lymph nodes (n = 91). Postoperative PET/CT was performed in patients without these criteria but positive sentinel lymph node biopsy (n = 10). All patients underwent PET/CT and a conventional staging algorithm, which included bone scan, chest X-ray and abdominal ultrasound. PET/CT findings were compared to conventional staging and the impact on therapeutic management was evaluated. PET/CT led to an upgrade of the N or M stage in overall 19 patients (19 %) and newly identified manifestation of breast cancer in two patients (2 %). PET/CT findings caused a change in treatment of 11 patients (11 %). This is within the range of recent studies, all applying conventional inclusion criteria based on the initial T and N status. PET/CT has a relevant impact on initial staging and treatment of breast cancer when compared to conventional modalities. Further studies should assess inclusion criteria beyond the conventional T and N status, e.g. tumour grading and receptor status. (orig.)

  8. Evaluation of kinetic entropy of breast masses initially found on MRI using whole-lesion curve distribution data: Comparison with the standard kinetic analysis

    Energy Technology Data Exchange (ETDEWEB)

    Shimauchi, Akiko [University of Chicago, Department of Radiology, Chicago, IL (United States); Tohoku University, Department of Diagnostic Radiology, Graduate School of Medicine, Sendai, Miyagi (Japan); Abe, Hiroyuki; Schacht, David V.; Yulei, Jian; Pineda, Federico D.; Jansen, Sanaz A.; Ganesh, Rajiv; Newstead, Gillian M. [University of Chicago, Department of Radiology, Chicago, IL (United States)

    2015-08-15

    To quantify kinetic heterogeneity of breast masses that were initially detected with dynamic contrast-enhanced MRI, using whole-lesion kinetic distribution data obtained from computer-aided evaluation (CAE), and to compare that with standard kinetic curve analysis. Clinical MR images from 2006 to 2011 with breast masses initially detected with MRI were evaluated with CAE. The relative frequencies of six kinetic patterns (medium-persistent, medium-plateau, medium-washout, rapid-persistent, rapid-plateau, rapid-washout) within the entire lesion were used to calculate kinetic entropy (KE), a quantitative measure of enhancement pattern heterogeneity. Initial uptake (IU) and signal enhancement ratio (SER) were obtained from the most-suspicious kinetic curve. Mann-Whitney U test and ROC analysis were conducted for differentiation of malignant and benign masses. Forty benign and 37 malignant masses comprised the case set. IU and SER were not significantly different between malignant and benign masses, whereas KE was significantly greater for malignant than benign masses (p = 0.748, p = 0.083, and p < 0.0001, respectively). Areas under ROC curve for IU, SER, and KE were 0.479, 0.615, and 0.662, respectively. Quantification of kinetic heterogeneity of whole-lesion time-curve data with KE has the potential to improve differentiation of malignant from benign breast masses on breast MRI. (orig.)

  9. Initiating oncogenic event determines gene-expression patterns of human breast cancer models

    OpenAIRE

    Desai, Kartiki V; Xiao, Nianqing; Wang, Weili; Gangi, Lisa; Greene, John; Powell, John I.; Dickson, Robert; Furth, Priscilla; Hunter, Kent; Kucherlapati, Raju; Simon, Richard; Liu, Edison T; Green, Jeffrey E

    2002-01-01

    Molecular expression profiling of tumors initiated by transgenic overexpression of c-myc, c-neu, c-ha-ras, polyoma middle T antigen (PyMT) or simian virus 40 T/t antigen (T-ag) targeted to the mouse mammary gland have identified both common and oncogene-specific events associated with tumor formation and progression. The tumors shared great similarities in their gene-expression profiles as compared with the normal mammary gland with an induction of cell-cycle regulators, metabolic regulators,...

  10. Haploinsufficiency in the prometastasis Kiss1 Receptor Gpr54 delays breast tumor initiation, progression and lung metastasis

    Science.gov (United States)

    Cho, Sung-Gook; Wang, Ying; Rodriguez, Melissa; Tan, Kunrong; Zhang, Wenzheng; Luo, Jian; Li, Dali; Liu, Mingyao

    2016-01-01

    Activation of KISS1 receptor (KISS1R or GPR54) by its ligands (kisspeptins) regulates a diverse function both in normal physiology and pathophysiology. In cancer, KISS1-induced KISS1R signaling is known to inhibit tumor angiogenesis and metastasis. However, roles of KISS1 and KISS1R in earlier stages of tumor progression and metastasis in vivo are still unknown. In this study, we demonstrate a critical role for Kiss1r in early stages of tumor progression using mouse tumor models. PyMT/Kiss1r mice with different Kiss1r genotypes were obtained by crossing MMTV-PyMT transgenic mouse with Kiss1r heterozygous mouse (Kiss1r+/−). Kiss1r heterozygosity attenuated breast tumor initiation, growth, latency, multiplicity and metastasis in MMTV-PyMT/Kiss1r+/− mouse models. To confirm the effects of Kiss1r in tumor progression and limit any effect of endogenous hormones, we isolated primary tumor cells from PyMT/Kiss1r+/+ or PyMT/Kiss1r+/− mice and performed in vitro and in vivo tumorigenesis assays. Kiss1r heterozygosity inhibited PyMT-induced in vitro tumorigeneity and in vivo tumor growth in NOD.SCID/NCr mice. To understand the underlying mechanism, we showed that activation of KISS1R by kisspeptin-10 led to RhoA activation and RhoA-dependent gene expression through Gαq-p63RhoGEF signaling pathway. Furthermore, anchorage-independent growth was tightly linked to the dosage-dependent regulation of RhoA by KISS1R. When MCF10A cells overexpressing H-RasV12 were subjected to in vitro tumorigenesis assays, knockdown of KISS1R or inactivation of RhoA in MCF10A cells reduced Ras-induced anchorage-independent growth, similar to our data obtained from PyMT-Kiss1r+/− mouse models. Altogether, we conclude that Kiss1r haploinsufficiency delays breast tumor initiation, progression and metastasis through its downstream Gαq-p63RhoGEF-RhoA signaling pathway. PMID:21852382

  11. Psychosocial determinants of cancer-related information seeking among cancer patients.

    Science.gov (United States)

    Smith-McLallen, Aaron; Fishbein, Martin; Hornik, Robert C

    2011-02-01

    This study explores the utility of using the Integrative Model of Behavioral Prediction as a framework for predicting cancer patients' intentions to seek information about their cancer from sources other than a physician, and to examine the relation between patients' baseline intentions to seek information and their actual seeking behavior at follow-up. Within 1 year of their diagnosis with colon, breast, or prostate cancer, 1,641 patients responded to a mailed questionnaire assessing intentions to seek cancer-related information from a source other than their doctor, as well as their attitudes, perceived normative pressure, and perceived behavioral control with respect to this behavior. In addition, the survey assessed their cancer-related information seeking. One year later, 1,049 of these patients responded to a follow-up survey assessing cancer-related information seeking during the previous year. Attitudes, perceived normative pressure, and perceived behavioral control were predictive of information-seeking intentions, although attitudes emerged as the primary predictor. Intentions to seek information, perceived normative pressure regarding information seeking, baseline information-seeking behavior, and being diagnosed with stage 4 cancer were predictive of actual information-seeking behavior at follow-up. Practical implications are discussed.

  12. Aspirin blocks growth of breast tumor cells and tumor-initiating cells and induces reprogramming factors of mesenchymal to epithelial transition.

    Science.gov (United States)

    Maity, Gargi; De, Archana; Das, Amlan; Banerjee, Snigdha; Sarkar, Sandipto; Banerjee, Sushanta K

    2015-07-01

    Acetylsalicylic acid (ASA), also known as aspirin, a classic, nonsteroidal, anti-inflammatory drug (NSAID), is widely used to relieve minor aches and pains and to reduce fever. Epidemiological studies and other experimental studies suggest that ASA use reduces the risk of different cancers including breast cancer (BC) and may be used as a chemopreventive agent against BC and other cancers. These studies have raised the tempting possibility that ASA could serve as a preventive medicine for BC. However, lack of in-depth knowledge of the mechanism of action of ASA reshapes the debate of risk and benefit of using ASA in prevention of BC. Our studies, using in vitro and in vivo tumor xenograft models, show a strong beneficial effect of ASA in the prevention of breast carcinogenesis. We find that ASA not only prevents breast tumor cell growth in vitro and tumor growth in nude mice xenograft model through the induction of apoptosis, but also significantly reduces the self-renewal capacity and growth of breast tumor-initiating cells (BTICs)/breast cancer stem cells (BCSCs) and delays the formation of a palpable tumor. Moreover, ASA regulates other pathophysiological events in breast carcinogenesis, such as reprogramming the mesenchymal to epithelial transition (MET) and delaying in vitro migration in BC cells. The tumor growth-inhibitory and reprogramming roles of ASA could be mediated through inhibition of TGF-β/SMAD4 signaling pathway that is associated with growth, motility, invasion, and metastasis in advanced BCs. Collectively, ASA has a therapeutic or preventive potential by attacking possible target such as TGF-β in breast carcinogenesis.

  13. Murine model of hepatic breast cancer.

    Science.gov (United States)

    Rikhi, Rishi; Wilson, Elizabeth M; Deas, Olivier; Svalina, Matthew N; Bial, John; Mansoor, Atiya; Cairo, Stefano; Keller, Charles

    2016-12-01

    Breast cancer is the most common cancer in women and the second leading cause of cancer-related deaths in this population. Breast cancer related deaths have declined due to screening and adjuvant therapies, yet a driving clinical need exists to better understand the cause of the deadliest aspect of breast cancer, metastatic disease. Breast cancer metastasizes to several distant organs, the liver being the third most common site. To date, very few murine models of hepatic breast cancer exist. In this study, a novel murine model of liver breast cancer using the MDA-MB-231 cell line is introduced as an experimental (preclinical) model. Histological typing revealed consistent hepatic breast cancer tumor foci. Common features of the murine model were vascular invasion, lung metastasis and peritoneal seeding. The novel murine model of hepatic breast cancer established in this study provides a tool to be used to investigate mechanisms of hepatic metastasis and to test potential therapeutic interventions.

  14. Early Adoption of the SSO-ASTRO Consensus Guidelines on Margins for Breast-Conserving Surgery with Whole-Breast Irradiation in Stage I and II Invasive Breast Cancer: Initial Experience from Memorial Sloan Kettering Cancer Center.

    Science.gov (United States)

    Rosenberger, Laura H; Mamtani, Anita; Fuzesi, Sarah; Stempel, Michelle; Eaton, Anne; Morrow, Monica; Gemignani, Mary L

    2016-10-01

    Reexcision rates in patients undergoing breast-conserving surgery (BCS) for early-stage invasive breast cancer are highly variable. The Society of Surgical Oncology (SSO) and American Society for Radiation Oncology (ASTRO) published consensus guidelines to help standardize practice. We sought to determine reexcision rates before and after guideline adoption at our institution. We identified patients with stage I or II invasive breast cancer initially treated with BCS between June 1, 2013, and October 31, 2014. Margins were defined as positive (tumor on ink), close (≤1 mm), or negative (>1 mm), and were recorded for both invasive cancer and ductal carcinoma-in situ (DCIS) components. Reexcision rates were quantified, characteristics were compared between groups, and multivariable logistic regression was performed. A total of 1205 patients were identified, 504 before and 701 after the guideline adoption (January 1, 2014). Clinical and pathologic characteristics were similar between time periods. Reexcision rates significantly declined from 21.4 to 15.1 % (p = 0.006) after guideline adoption. A multivariable model identified extensive intraductal component (odds ratio [OR] 2.5, 95 % confidence interval [CI] 1.2-5.2), multifocality (OR 2.0, 95 % CI 1.2-3.6), positive (OR 844.4, 95 % CI 226.3-5562.5) and close (OR 38.3, 95 % CI 21.5-71.8) ductal carcinoma-in situ margin, positive (OR 174.2, 95 % CI 66.2-530.0) and close (OR 6.4, 95 % CI 3.0-13.6) invasive margin, and time period (OR 0.5, 95 % CI 0.3-0.9 for post vs. pre) as independently associated with reexcision. Overall reexcision rates declined significantly after guideline adoption. Close invasive margins were associated with higher rates of reexcision than negative invasive margins in both time periods; however, the effect diminished in the postguideline adoption period. Thus, we expect continued decline in reexcision rates as adherence to guidelines becomes more uniform.

  15. Statin use and reduced cancer-related mortality

    DEFF Research Database (Denmark)

    Nielsen, Sune F; Nordestgaard, Børge G; Bojesen, Stig E

    2012-01-01

    A reduction in the availability of cholesterol may limit the cellular proliferation required for cancer growth and metastasis. We tested the hypothesis that statin use begun before a cancer diagnosis is associated with reduced cancer-related mortality.......A reduction in the availability of cholesterol may limit the cellular proliferation required for cancer growth and metastasis. We tested the hypothesis that statin use begun before a cancer diagnosis is associated with reduced cancer-related mortality....

  16. Outcomes in Critically Ill Patients with Cancer-Related Complications.

    Directory of Open Access Journals (Sweden)

    Viviane B L Torres

    Full Text Available Cancer patients are at risk for severe complications related to the underlying malignancy or its treatment and, therefore, usually require admission to intensive care units (ICU. Here, we evaluated the clinical characteristics and outcomes in this subgroup of patients.Secondary analysis of two prospective cohorts of cancer patients admitted to ICUs. We used multivariable logistic regression to identify variables associated with hospital mortality.Out of 2,028 patients, 456 (23% had cancer-related complications. Compared to those without cancer-related complications, they more frequently had worse performance status (PS (57% vs 36% with PS≥2, active malignancy (95% vs 58%, need for vasopressors (45% vs 34%, mechanical ventilation (70% vs 51% and dialysis (12% vs 8% (P<0.001 for all analyses. ICU (47% vs. 27% and hospital (63% vs. 38% mortality rates were also higher in patients with cancer-related complications (P<0.001. Chemo/radiation therapy-induced toxicity (6%, venous thromboembolism (5%, respiratory failure (4%, gastrointestinal involvement (3% and vena cava syndrome (VCS (2% were the most frequent cancer-related complications. In multivariable analysis, the presence of cancer-related complications per se was not associated with mortality [odds ratio (OR = 1.25 (95% confidence interval, 0.94-1.66, P = 0.131]. However, among the individual cancer-related complications, VCS [OR = 3.79 (1.11-12.92, P = 0.033], gastrointestinal involvement [OR = 3.05 (1.57-5.91, P = <0.001] and respiratory failure [OR = 1.96(1.04-3.71, P = 0.038] were independently associated with in-hospital mortality.The prognostic impact of cancer-related complications was variable. Although some complications were associated with worse outcomes, the presence of an acute cancer-related complication per se should not guide decisions to admit a patient to ICU.

  17. Cancer-Related Psychological Distress: A Concept Analysis.

    Science.gov (United States)

    Gundelach, Amy; Henry, Barb

    2016-12-01

    Cancer-related psychological distress, as a concept, has limited research literature substantiation. Several studies report that patients with cancer suffer from significant psychological distress; however, the description of the concept of cancer-related psychological distress has not been clearly described. Theoretical work based on the concept is also unclear. This article is a report on the concept of cancer-related psychological distress to clarify the concept as separate from non-cancer-related psychological distress and promote the use of the term in nursing practice and research across the cancer trajectory. This article used a content analysis to examine the literature. The literature review for this article used CINAHL®, PsycINFO®, and PubMed to search publications from 1999-2016. Content analysis of the literature revealed that the term psychological distress was used often with regard to distress in patients with cancer, but the concept of cancer-related psychological distress was not clearly defined. Four attributes encompass the concept of cancer-related psychological distress.

  18. Prognostic factors and survival according to tumour subtype in women presenting with breast cancer brain metastases at initial diagnosis.

    Science.gov (United States)

    Leone, José Pablo; Leone, Julieta; Zwenger, Ariel Osvaldo; Iturbe, Julián; Leone, Bernardo Amadeo; Vallejo, Carlos Teodoro

    2017-03-01

    The presence of brain metastases at the time of initial breast cancer diagnosis (BMIBCD) is uncommon. Hence, the prognostic assessment and management of these patients is very challenging. The aim of this study was to analyse the influence of tumour subtype compared with other prognostic factors in the survival of patients with BMIBCD. We evaluated women with BMIBCD, reported to Surveillance, Epidemiology and End Results program from 2010 to 2013. Patients with other primary malignancy were excluded. Univariate and multivariate analyses were performed to determine the effects of each variable on overall survival (OS). We included 740 patients. Median OS for the whole population was 10 months, and 20.7% of patients were alive at 36 months. Tumour subtype distribution was: 46.6% hormone receptor (HR)+/HER2-, 17% HR+/HER2+, 14.1% HR-/HER2+ and 22.3% triple-negative. Univariate analysis showed that the presence of liver metastases, lung metastases and triple-negative patients (median OS 6 months) had worse prognosis. The HR+/HER2+ subtype had the longest OS with a median of 22 months. In multivariate analysis, older age (hazard ratio 1.8), lobular histology (hazard ratio 2.08), triple-negative subtype (hazard ratio 2.25), liver metastases (hazard ratio 1.6) and unmarried patients (hazard ratio 1.39) had significantly shorter OS. Although the prognosis of patients with BMIBCD is generally poor, 20.7% were still alive 3 years after the diagnosis. There were substantial differences in OS according to tumour subtype. In addition to tumour subtype, other independent predictors of OS are age at diagnosis, marital status, histology and liver metastases. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. Familial breast cancer: Genetic counseling over time, including patients´ expectations and initiators considering the Angelina Jolie effect.

    Science.gov (United States)

    Evers, Christina; Fischer, Christine; Dikow, Nicola; Schott, Sarah

    2017-01-01

    The German Consortium for hereditary breast/ovarian cancer (GC-HBOC) aims for nationwide access to professional, individualized yet structured care for families at high risk. The identification of such families remains key for optimal care. Our study evaluates counselees' characteristics, referral practices, expectations and motivations in respect to their first genetic consultation. The impact of the Angelina Jolie Effect (AJE) was prospectively assessed. All counselees could participate through a questionnaire. Groups were built in respect to neoadjuvant chemotherapy (FT) and before/after AJE. The 917 (88.5%) counselees (FT: 8.2%) were on average female (97.3%), with a mean age of 44.6, had children (71.9%), higher education (88%), personal (46.4%) or at least one first-degree relative (74.6%) with BC/OC or known BRCA1/2 mutation (11.8%), were in a relationship (76.1%), and living in a village (40.7%). The AJE is associated with significantly fewer cancelations (p = 0.005), more attendance among men (4.2% vs. 0.8%, p = 0.002), and people with familial BRCA1/2 (14.8% vs. 7.5%, p = 0.003). The majority seek information regarding their cancer risk (83%) or relatives' risk (74.8%), HBOC (69.1%), and surveillance programs for themselves (66.6%) or relatives (60.6%). Enhanced media awareness of genetic cancer motivates patients, including other patient groups. A higher number of participants, including more men, are attending GC due to the AJE. In terms of the rising complexity of genetic testing, the analysis of patients' expectations and initiators for GC suggests that there is an urgent need to develop to participate motivation analysis. The factors revealed as impediments to accessing GC-HBOC guide recommendations to optimize access to genetic counseling. Medical educational programs for primary gynecologists and families at risk might be options to reach more participants.

  20. Optimisation of the continuum of supportive and palliative care for patients with breast cancer in low-income and middle-income countries: executive summary of the Breast Health Global Initiative, 2014.

    Science.gov (United States)

    Distelhorst, Sandra R; Cleary, James F; Ganz, Patricia A; Bese, Nuran; Camacho-Rodriguez, Rolando; Cardoso, Fatima; Ddungu, Henry; Gralow, Julie R; Yip, Cheng-Har; Anderson, Benjamin O

    2015-03-01

    Supportive care and palliative care are now recognised as critical components of global cancer control programmes. Many aspects of supportive and palliative care services are already available in some low-income and middle-income countries. Full integration of supportive and palliative care into breast cancer programmes requires a systematic, resource-stratified approach. The Breast Health Global Initiative convened three expert panels to develop resource allocation recommendations for supportive and palliative care programmes in low-income and middle-income countries. Each panel focused on a specific phase of breast cancer care: during treatment, after treatment with curative intent (survivorship), and after diagnosis with metastatic disease. The panel consensus statements were published in October, 2013. This Executive Summary combines the three panels' recommendations into a single comprehensive document covering breast cancer care from diagnosis through curative treatment into survivorship, and metastatic disease and end-of-life care. The recommendations cover physical symptom management, pain management, monitoring and documentation, psychosocial and spiritual aspects of care, health professional education, and patient, family, and caregiver education. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. Characterizing biased cancer-related cognitive processing: relationships with BRCA1/2 genetic mutation status, personal cancer history, age, and prophylactic surgery.

    Science.gov (United States)

    Carpenter, Kristen M; Eisenberg, Stacy; Weltfreid, Sharone; Low, Carissa A; Beran, Tammy; Stanton, Annette L

    2014-09-01

    This study evaluated associations of cancer-related cognitive processing with BRCA1/2 mutation carrier status, personal cancer history, age, and election of prophylactic surgery in women at high risk for breast cancer. In a 2 (BRCA1/2 mutation carrier status) × 2 (personal cancer history) matched-control design, with age as an additional predictor, participants (N = 115) completed a computerized cancer Stroop task. Dependent variables were response latency to cancer-related stimuli (reaction time [RT]) and cancer-related cognitive interference (cancer RT minus neutral RT). RT and interference were tested as predictors of prophylactic surgery in the subsequent four years. RT for cancer-related words was significantly slower than other word groups, indicating biased processing specific to cancer-related stimuli. Participants with a cancer history evidenced longer RT to cancer-related words than those without a history; moreover, a significant Cancer History × Age interaction indicated that, among participants with a cancer history, the typical advantage associated with younger age on Stroop tasks was absent. BRCA mutation carriers demonstrated more cancer-related cognitive interference than noncarriers. Again, the typical Stroop age advantage was absent among carriers. Exploratory analyses indicated that BRCA+ status and greater cognitive interference predicted greater likelihood of undergoing prophylactic surgery. Post hoc tests suggest that cancer-related distress does not account for these relationships. In the genetic testing context, younger women with a personal cancer history or who are BRCA1/2 mutation carriers might be particularly vulnerable to biases in cancer-related cognitive processing. Biased processing was associated marginally with greater likelihood of prophylactic surgery. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

  2. Conservative interventions for preventing clinically detectable upper-limb lymphoedema in patients who are at risk of developing lymphoedema after breast cancer therapy

    NARCIS (Netherlands)

    Stuiver, Martijn M.; ten Tusscher, Marieke R.; Agasi-Idenburg, Carla S.; Lucas, Cees; Aaronson, Neil K.; Bossuyt, Patrick M. M.

    2015-01-01

    Background Breast cancer-related lymphoedema can be a debilitating long-term sequela of breast cancer treatment. Several studies have investigated the effectiveness of different treatment strategies to reduce the risk of breast cancer-related lymphoedema. Objectives To assess the effects of

  3. After initial treatment for primary breast cancer: information needs, health literacy, and the role of health care workers.

    Science.gov (United States)

    Schmidt, Anna; Ernstmann, Nicole; Wesselmann, Simone; Pfaff, Holger; Wirtz, Markus; Kowalski, Christoph

    2016-02-01

    After a short hospital stay of just some days follows long-term outpatient care for breast cancer patients. The aim of the study is to describe the information needs of breast cancer outpatients and to get in touch with aspects of health literacy, as well as contact various health care workers. In a multicenter study, patients were asked about their information needs 10 weeks after surgery. The analysis on hand includes data about 1248 female patients. In addition to descriptive analyses identifying the most prevalent information needs, logistic regression analyses were calculated to identify factors associated with these. The results show that information needs of breast cancer outpatients are mainly in "follow-up after acute treatment", "coping with long-term side effects", and "heredity of breast cancer". In addition to sociodemographic patient characteristics, perceived helpful contacts with various health care workers as well as a satisfactory patient's level of health literacy reduced the probability of unmet information needs. Breast cancer outpatients have numerous information needs. In addition to provide information at the right time regarding a specific disease phase, it is important that health professionals' support affected breast cancer patients in coping with the new situation.

  4. Breast cancer chemoprevention by dietary natural phenolic compounds: specific epigenetic related molecular targets.

    Science.gov (United States)

    Pan, Min-Hsiung; Chiou, Yi-Siou; Chen, Li-Hua; Ho, Chi-Tang

    2015-01-01

    Breast cancer is a systemic malignant disease that is a major cause of cancer-related death among women worldwide. Recently, multiple lines of evidence from epidemiologic studies have suggested that epigenetic and genetic changes are involved in breast cancer development. In breast cancer patients, hormone receptor status, breast cancer stem-like cell population, and tumor microenvironment are reflective of breast cancer progression, drug resistance, and tumor recurrence. Strong relationships between a phytochemical-rich diet and a reversal of epigenetic alterations and/or modulated signaling pathways of carcinogenesis (initiation, promotion, and progression) suggest a potential approach for preventing breast cancer. Additionally, dietary consumption of natural phenolic compounds containing phytoestrogen properties exerts beneficial effects in breast cancer chemoprevention. In this review, we summarize the specific chemopreventive targets of representative phenolic compounds with an emphasis on their efficacy at interfering with epigenetic event related hormonal and nonhormonal signaling cascades that are responsible for multistage breast carcinogenesis. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  5. Projections of cancer incidence and cancer-related deaths in Germany by 2020 and 2030.

    Science.gov (United States)

    Quante, Anne S; Ming, Chang; Rottmann, Miriam; Engel, Jutta; Boeck, Stefan; Heinemann, Volker; Westphalen, Christoph Benedikt; Strauch, Konstantin

    2016-09-01

    Past patterns of cancer disease and future changes in the demographic structure have a major influence on the projected incidences of human malignancies. In Germany, nearly a quarter of men and 20% of women die of cancer, and it is estimated that in Germany around 51% men and 43% women will develop cancer during lifetime. Here, we project the cancer incidence case number as well as the number of deaths for the most common cancers in the German population for the years 2020 and 2030. By 2030, prostate cancer will be the most common malignancy, surpassing breast cancer. Lung cancer will rank third most frequent cancer and will remain the most common cause of cancer-related mortality. Additionally, our projections show a marked increase in liver cancer cases with a continuous rise in liver cancer-related deaths. Finally, we project a constant increase in the incidence of pancreatic cancer. Based on our projections, pancreatic cancer will surpass colorectal and breast cancer to rank as the second most common cause of cancer-related deaths in Germany by 2030. © 2016 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

  6. Immunotherapy against cancer-related viruses.

    Science.gov (United States)

    Tashiro, Haruko; Brenner, Malcolm K

    2017-01-01

    Approximately 12% of all cancers worldwide are associated with viral infections. To date, eight viruses have been shown to contribute to the development of human cancers, including Epstein-Barr virus (EBV), Hepatitis B and C viruses, and Human papilloma virus, among others. These DNA and RNA viruses produce oncogenic effects through distinct mechanisms. First, viruses may induce sustained disorders of host cell growth and survival through the genes they express, or may induce DNA damage response in host cells, which in turn increases host genome instability. Second, they may induce chronic inflammation and secondary tissue damage favoring the development of oncogenic processes in host cells. Viruses like HIV can create a more permissive environment for cancer development through immune inhibition, but we will focus on the previous two mechanisms in this review. Unlike traditional cancer therapies that cannot distinguish infected cells from non-infected cells, immunotherapies are uniquely equipped to target virus-associated malignancies. The targeting and functioning mechanisms associated with the immune response can be exploited to prevent viral infections by vaccination, and can also be used to treat infection before cancer establishment. Successes in using the immune system to eradicate established malignancy by selective recognition of virus-associated tumor cells are currently being reported. For example, numerous clinical trials of adoptive transfer of ex vivo generated virus-specific T cells have shown benefit even for established tumors in patients with EBV-associated malignancies. Additional studies in other virus-associated tumors have also been initiated and in this review we describe the current status of immunotherapy for virus-associated malignancies and discuss future prospects.

  7. Familial breast cancer: Genetic counseling over time, including patients´ expectations and initiators considering the Angelina Jolie effect.

    Directory of Open Access Journals (Sweden)

    Christina Evers

    Full Text Available The German Consortium for hereditary breast/ovarian cancer (GC-HBOC aims for nationwide access to professional, individualized yet structured care for families at high risk. The identification of such families remains key for optimal care. Our study evaluates counselees' characteristics, referral practices, expectations and motivations in respect to their first genetic consultation. The impact of the Angelina Jolie Effect (AJE was prospectively assessed.All counselees could participate through a questionnaire. Groups were built in respect to neoadjuvant chemotherapy (FT and before/after AJE.The 917 (88.5% counselees (FT: 8.2% were on average female (97.3%, with a mean age of 44.6, had children (71.9%, higher education (88%, personal (46.4% or at least one first-degree relative (74.6% with BC/OC or known BRCA1/2 mutation (11.8%, were in a relationship (76.1%, and living in a village (40.7%. The AJE is associated with significantly fewer cancelations (p = 0.005, more attendance among men (4.2% vs. 0.8%, p = 0.002, and people with familial BRCA1/2 (14.8% vs. 7.5%, p = 0.003. The majority seek information regarding their cancer risk (83% or relatives' risk (74.8%, HBOC (69.1%, and surveillance programs for themselves (66.6% or relatives (60.6%.Enhanced media awareness of genetic cancer motivates patients, including other patient groups. A higher number of participants, including more men, are attending GC due to the AJE. In terms of the rising complexity of genetic testing, the analysis of patients' expectations and initiators for GC suggests that there is an urgent need to develop to participate motivation analysis. The factors revealed as impediments to accessing GC-HBOC guide recommendations to optimize access to genetic counseling. Medical educational programs for primary gynecologists and families at risk might be options to reach more participants.

  8. Psychological factors and psychosocial interventions for cancer related pain.

    Science.gov (United States)

    Ciucă, Andrada; Băban, Adriana

    2017-06-01

    The present paper is aimed at briefly presenting psychological factors involved in cancer related pain and what psychosocial interventions are efficient in reducing it. Cancer related pain is a complex experience and the most integrative and recommended approach is the biopsychosocial model. It has been proved that chronic pain is more strongly related to psychological factors than to treatment or illness related factors. Psychological factors influencing pain experience can be intuitively grouped starting with awareness of pain (i.e., attentional factor), then with evaluation of pain (i.e., cognitive factors) which is leading to feelings (i.e., emotional factors), and behaviours (i.e., coping strategies) regarding pain. Psychosocial interventions (i.e., skill based and education based interventions) have strong evidence that is effective in reducing cancer related pain.

  9. De Novo Post-Diagnosis Aspirin Use and Mortality in Women with Stage I-III Breast Cancer.

    Science.gov (United States)

    Barron, Thomas I; Murphy, Laura M; Brown, Chris; Bennett, Kathleen; Visvanathan, Kala; Sharp, Linda

    2015-06-01

    Aspirin use has been associated with significant reductions in breast cancer-related mortality in some observational studies. However, these studies included women who initiated aspirin use before breast cancer diagnosis. It is unclear whether initiating aspirin use after diagnosis is associated with similar reductions in mortality. This study investigates associations between de novo post-diagnostic aspirin use and all cause, breast cancer-specific mortality. Women, ages 50 to 80, with a diagnosis of stage I-III breast cancer were identified from Ireland's National Cancer Registry (N = 4,540). Initiation of de novo post-diagnostic aspirin use was identified from linked national prescription refill data (N = 764). Adjusted HRs were estimated for associations between de novo aspirin use and all-cause, breast cancer-specific mortality. The median time from diagnosis to aspirin initiation was 1.8 years. The mean number of days' supply of aspirin received was 631, and 95% of users were taking less than 150 mg/d. We found no association between de novo aspirin use and breast cancer-specific mortality [HR, 0.98; 95% confidence interval (CI), 0.74-1.30]. Similar null associations were found in women taking aspirin at high-intensity (HR, 1.03; 95% CI, 0.72-1.47) and women initiating use in the 1.5 years after diagnosis (HR, 1.04; 95% CI, 0.77-1.40). There was no effect modification by estrogen (Pinteraction = 0.81) or progesterone (Pinteraction = 0.41) receptor status. Initiating aspirin use after a breast cancer diagnosis was not associated with a reduction in breast cancer-specific mortality. On the basis of our findings, we suggest that a clearer understanding of aspirin's mechanism of action is needed to help inform the design of future studies in breast cancer. ©2015 American Association for Cancer Research.

  10. Recent Progress in Cancer-Related Lymphedema Treatment and Prevention

    Science.gov (United States)

    Shaitelman, Simona F.; Cromwell, Kate D.; Rasmussen, John C.; Stout, Nicole L.; Armer, Jane M.; Lasinski, Bonnie B.; Cormier, Janice N.

    2016-01-01

    This article provides an overview of the recent developments in the diagnosis, treatment, and prevention of cancer-related lymphedema. Lymphedema incidence by tumor site is evaluated. Measurement techniques and trends in patient education and treatment are also summarized to include current trends in therapeutic and surgical treatment options as well as longer-term management. Finally, an overview of the policies related to insurance coverage and reimbursement will give the clinician an overview of important trends in the diagnosis, treatment, and management of cancer-related lymphedema. PMID:25410402

  11. Cancer-related false knowledge in relatives of cancer patients and the general public.

    Science.gov (United States)

    Turhal, N S; Dane, F; Ulus, C; Sari, S; Senturk, N; Bingol, D

    2010-01-01

    Although there are many myths about cancer in Turkey, there is no study evaluating Turkish public's knowledge about cancer. The goals of our research were to: 1) measure the extent of knowledge of cancer among the Turkish public; 2) determine the differences in extent of cancer-related knowledge between participants who have relatives with cancer and those who do not; and 3) determine the sources of knowledge possessed. Data were obtained from a total of 415 participants (244 female, 171 male), all of them sitting at the Marmara University Faculty of Medicine Hospital (MUFMH) outpatient clinic waiting area for non-cancer-related reasons. Each participant completed a 3-part questionnaire. Appropriate statistical tests were used for comparison. The mean age was 41 years. Of 415 participants, 65.3% stated that they had one or more cancer patient in their immediate family; 70.1% of the participants had a high-school education or greater. The questionnaire showed that, depending on the question, anywhere from 1.7% to 88.5% of the general public possesses some false information; furthermore, the difference in accuracy between relatives of cancer patients and non-relatives was marginal. Only 3 specific questions, related to the following ideas, rendered answers that were statistically significantly different between these 2 groups: breast cancer is only seen in females (p knowledge about cancer was unacceptably high in our cohort. Broader efforts should be made to inform the Turkish public about cancer.

  12. Radiology as the Point of Cancer Patient and Care Team Engagement: Applying the 4R Model at a Patient's Breast Cancer Care Initiation.

    Science.gov (United States)

    Weldon, Christine B; Friedewald, Sarah M; Kulkarni, Swati A; Simon, Melissa A; Carlos, Ruth C; Strauss, Jonathan B; Bunce, Mikele M; Small, Art; Trosman, Julia R

    2016-12-01

    Radiologists aspire to improve patient experience and engagement, as part of the Triple Aim of health reform. Patient engagement requires active partnerships among health providers and patients, and rigorous teamwork provides a mechanism for this. Patient and care team engagement are crucial at the time of cancer diagnosis and care initiation but are complicated by the necessity to orchestrate many interdependent consultations and care events in a short time. Radiology often serves as the patient entry point into the cancer care system, especially for breast cancer. It is uniquely positioned to play the value-adding role of facilitating patient and team engagement during cancer care initiation. The 4R approach (Right Information and Right Care to the Right Patient at the Right Time), previously proposed for optimizing teamwork and care delivery during cancer treatment, could be applied at the time of diagnosis. The 4R approach considers care for every patient with cancer as a project, using project management to plan and manage care interdependencies, assign clear responsibilities, and designate a quarterback function. The authors propose that radiology assume the quarterback function during breast cancer care initiation, developing the care initiation sequence, as a project care plan for newly diagnosed patients, and engaging patients and their care teams in timely, coordinated activities. After initial consultations and treatment plan development, the quarterback function is transitioned to surgery or medical oncology. This model provides radiologists with opportunities to offer value-added services and solidifies radiology's relevance in the evolving health care environment. To implement 4R at cancer care initiation, it will be necessary to change the radiology practice model to incorporate patient interaction and teamwork, develop 4R content and local adaption approaches, and enrich radiology training with relevant clinical knowledge, patient interaction

  13. Cancer-related lymphedema risk factors, diagnosis, treatment, and impact: a review.

    Science.gov (United States)

    Paskett, Electra D; Dean, Julie A; Oliveri, Jill M; Harrop, J Phil

    2012-10-20

    PURPOSE Cancer-related lymphedema (LE) is an incurable condition associated with lymph-involved cancer treatments and is an increasing health, quality of life (QOL), and cost burden on a growing cancer survivor population. This review examines the evidence for causes, risk, prevention, diagnosis, treatment, and impact of this largely unexamined survivorship concern. METHODS PubMed and Medline were searched for cancer-related LE literature published since 1990 in English. The resulting references (N = 726) were evaluated for strength of design, methods, sample size, and recent publication and sorted into categories (ie, causes/prevention, diagnosis, treatment, and QOL). Sixty studies were included. Results Exercise and physical activity and sentinel lymph node biopsy reduce risk, and overweight and obesity increase risk. Evidence that physiotherapy reduces risk and that lymph node status and number of malignant nodes increase risk is less strong. Perometry and bioimpedence emerged as attractive diagnostic technologies, replacing the use of water displacement in clinical practice. Swelling can also be assessed by measuring arm circumference and relying on self-report. Symptoms can be managed, not cured, with complex physical therapy, low-level laser therapy, pharmacotherapy, and surgery. Sequelae of LE negatively affect physical and mental QOL and range in severity. However, the majority of reviewed studies involved patients with breast cancer; therefore, results may not be applicable to all cancers. CONCLUSION Research into causes, prevention, and effect on QOL of LE and information on LE in cancers other than breast is needed. Consensus on definitions and measurement, increased patient and provider awareness of signs and symptoms, and proper and prompt treatment/access, including psychosocial support, are needed to better understand, prevent, and treat LE.

  14. Radio-photothermal therapy mediated by a single compartment nanoplatform depletes tumor initiating cells and reduces lung metastasis in the orthotopic 4T1 breast tumor model

    Science.gov (United States)

    Zhou, Min; Zhao, Jun; Tian, Mei; Song, Shaoli; Zhang, Rui; Gupta, Sanjay; Tan, Dongfeng; Shen, Haifa; Ferrari, Mauro; Li, Chun

    2015-11-01

    Tumor Initiating Cells (TICs) are resistant to radiotherapy and chemotherapy, and are believed to be responsible for tumor recurrence and metastasis. Combination therapies can overcome the limitation of conventional cancer treatments, and have demonstrated promising application in the clinic. Here, we show that dual modality radiotherapy (RT) and photothermal therapy (PTT) mediated by a single compartment nanosystem copper-64-labeled copper sulfide nanoparticles ([64Cu]CuS NPs) could suppress breast tumor metastasis through eradication of TICs. Positron electron tomography (PET) imaging and biodistribution studies showed that more than 90% of [64Cu]CuS NPs was retained in subcutaneously grown BT474 breast tumor 24 h after intratumoral (i.t.) injection, indicating the NPs are suitable for the combination therapy. Combined RT/PTT therapy resulted in significant tumor growth delay in the subcutaneous BT474 breast cancer model. Moreover, RT/PTT treatment significantly prolonged the survival of mice bearing orthotopic 4T1 breast tumors compared to no treatment, RT alone, or PTT alone. The RT/PTT combination therapy significantly reduced the number of tumor nodules in the lung and the formation of tumor mammospheres from treated 4T1 tumors. No obvious side effects of the CuS NPs were noted in the treated mice in a pilot toxicity study. Taken together, our data support the feasibility of a therapeutic approach for the suppression of tumor metastasis through localized RT/PTT therapy.Tumor Initiating Cells (TICs) are resistant to radiotherapy and chemotherapy, and are believed to be responsible for tumor recurrence and metastasis. Combination therapies can overcome the limitation of conventional cancer treatments, and have demonstrated promising application in the clinic. Here, we show that dual modality radiotherapy (RT) and photothermal therapy (PTT) mediated by a single compartment nanosystem copper-64-labeled copper sulfide nanoparticles ([64Cu]CuS NPs) could suppress

  15. Cancer-related fatigue : Predictors and effects of rehabilitation

    NARCIS (Netherlands)

    van Weert, Ellen; Hoekstra-Weebers, Josette; Otter, Renee; Postema, Klaas; Sanderman, Robbert; van der Schans, Cees

    Background. The aims of the study were to examine the effects of a multidimensional rehabilitation program on cancer-related fatigue, to examine concurrent predictors of fatigue, and to investigate whether change in fatigue over time was associated with change in predictors. Methods. Sample: 72

  16. Targeting cancer stem cells and signaling pathways by phytochemicals: Novel approach for breast cancer therapy.

    Science.gov (United States)

    Dandawate, Prasad R; Subramaniam, Dharmalingam; Jensen, Roy A; Anant, Shrikant

    2016-10-01

    Breast cancer is the most common form of cancer diagnosed in women worldwide and the second leading cause of cancer-related deaths in the USA. Despite the development of newer diagnostic methods, selective as well as targeted chemotherapies and their combinations, surgery, hormonal therapy, radiotherapy, breast cancer recurrence, metastasis and drug resistance are still the major problems for breast cancer. Emerging evidence suggest the existence of cancer stem cells (CSCs), a population of cells with the capacity to self-renew, differentiate and be capable of initiating and sustaining tumor growth. In addition, CSCs are believed to be responsible for cancer recurrence, anticancer drug resistance, and metastasis. Hence, compounds targeting breast CSCs may be better therapeutic agents for treating breast cancer and control recurrence and metastasis. Naturally occurring compounds, mainly phytochemicals have gained immense attention in recent times because of their wide safety profile, ability to target heterogeneous populations of cancer cells as well as CSCs, and their key signaling pathways. Therefore, in the present review article, we summarize our current understanding of breast CSCs and their signaling pathways, and the phytochemicals that affect these cells including curcumin, resveratrol, tea polyphenols (epigallocatechin-3-gallate, epigallocatechin), sulforaphane, genistein, indole-3-carbinol, 3, 3'-di-indolylmethane, vitamin E, retinoic acid, quercetin, parthenolide, triptolide, 6-shogaol, pterostilbene, isoliquiritigenin, celastrol, and koenimbin. These phytochemicals may serve as novel therapeutic agents for breast cancer treatment and future leads for drug development. Copyright © 2016. Published by Elsevier Ltd.

  17. Trends in Adult Cancer-Related Emergency Department Utilization: An Analysis of Data From the Nationwide Emergency Department Sample.

    Science.gov (United States)

    Rivera, Donna R; Gallicchio, Lisa; Brown, Jeremy; Liu, Benmei; Kyriacou, Demetrios N; Shelburne, Nonniekaye

    2017-10-12

    The emergency department (ED) is used to manage cancer-related complications among the 15.5 million people living with cancer in the United States. However, ED utilization patterns by the population of US adults with cancer have not been previously evaluated or described in published literature. To estimate the proportion of US ED visits made by adults with a cancer diagnosis, understand the clinical presentation of adult patients with cancer in the ED, and examine factors related to inpatient admission within this population. Nationally representative data comprised of 7 survey cycles (January 2006-December 2012) from the Nationwide Emergency Department Sample were analyzed. Identification of adult (age ≥18 years) cancer-related visits was based on Clinical Classifications Software diagnoses documented during the ED visit. Weighted frequencies and proportions of ED visits among adult patients with cancer by demographic, geographic, and clinical characteristics were calculated. Weighted multivariable logistic regression was used to examine the associations between inpatient admission and key demographic and clinical variables for adult cancer-related ED visits. Adult cancer-related ED utilization patterns; identification of primary reason for ED visit; patient-related factors associated with inpatient admission from the ED. Among an estimated 696 million weighted adult ED visits from January 2006 to December 2012, 29.5 million (4.2%) were made by a patient with a cancer diagnosis. The most common cancers associated with an ED visit were breast, prostate, and lung cancer, and most common primary reasons for visit were pneumonia (4.5%), nonspecific chest pain (3.7%), and urinary tract infection (3.2%). Adult cancer-related ED visits resulted in inpatient admissions more frequently (59.7%) than non-cancer-related visits (16.3%) (P cancer were the most common cancer diagnoses presenting to the ED. Pneumonia was the most common reason for adult cancer-related ED

  18. Predictors of invasive breast cancer and lymph node involvement in ductal carcinoma in situ initially diagnosed by vacuum-assisted breast biopsy: experience of 733 cases.

    Science.gov (United States)

    Trentin, Chiara; Dominelli, Valeria; Maisonneuve, Patrick; Menna, Simona; Bazolli, Barbara; Luini, Alberto; Cassano, Enrico

    2012-10-01

    To predict presence of invasive component and nodal involvement in women diagnosed preoperatively with ductal carcinoma in situ (DCIS) by vacuum-assisted breast biopsy (VABB). We retrospectively analyzed 733 patients with preoperatively diagnosed DCIS, investigating the association of clinical-radiological variables with invasive component and nodal involvement. Mammographic size >20 mm and residual lesion on post-VABB mammogram were related to invasive component (both p 20 mm with nodal involvement, both highly significant. Older age, lesion <20 mm, and no residual lesion predict absence of invasion and no nodal involvement in VABB-diagnosed DCIS. However it would be imprudent to routinely forego sentinel node biopsy in such patients as non-negligible proportions of them have invasive disease. Copyright © 2012 Elsevier Ltd. All rights reserved.

  19. Sentinel Lymph Node Detection in Contralateral Axilla at Initial Presentation of a Breast Cancer Patient: Case Report

    Directory of Open Access Journals (Sweden)

    Gülin Uçmak Vural

    2010-06-01

    Full Text Available The main basin for breast lymphatic drainage is ipsilateral axilla. However, extra-axillary drainage may be seen in some patients. The most common extra-axillary site is internal mammary chain, while contralateral axillary drainage is an extremely rare situation in previously untreated patients. We describe a case of untreated right breast retroareolar carcinoma with contralateral axillary drainage detected on preoperative lymphoscintigraphy. Contralateral axillary dissection was performed based on the result of frozen section examination of the sentinel lymph node (SLN which turned out to burden micrometastasis. Postoperative histopathological examination revealed invasive ductal carcinoma metastasis in 17 out of 22 lymph nodes from the ipsilateral axillary dissection, whereas 14 lymph nodes from contralateral axillary dissection other than the SLN were nonmetastatic. In our opinion, determination of contralateral axillary metastasis in primary staging process had a major contribution to the management of the patient

  20. Initial clinical experience with the Strut-Adjusted Volume Implant brachytherapy applicator for accelerated partial breast irradiation.

    Science.gov (United States)

    Yashar, Catheryn M; Blair, Sarah; Wallace, Anne; Scanderbeg, Dan

    2009-01-01

    Accelerated partial breast irradiation is becoming increasingly popular. The Cianna single-entry high-dose-rate applicator, Strut-Adjusted Volume Implant (SAVI, Cianna Medical, Aliso Viejo, CA), contains peripheral struts allowing greater planning flexibility for small-breasted women, technically easier insertion, and normal tissue exposure minimization. This study evaluates early clinical experience. Thirty patients treated with the SAVI with a median followup of 12 months were evaluated. The median age was 59.5. Tumor size averaged 0.9cm. Fifteen cancers were ductal carcinoma in situ (50%), 1 was invasive lobular (3.3%), 4 were tubular (6.7%), and the rest infiltrating ductal (40%). Most of them were estrogen receptor (ER) positive (90%). Nine women (30%) were premenopausal. Dosimetry was outstanding with median V90, V150, and V200 of 96.2%, 24.8, and 12.8cc. There were no symptomatic seromas, and one report of asymptomatic fat necrosis seen on mammogram at 1 year. In patients who had skin spacing of less than 1cm, the median skin dose was 245cGy/fraction. The median rib and lung dose per fraction for those patients with either structure less than 1cm was 340 and 255cGy (75% of prescribed dose), respectively. There have been no local recurrences to date. Early clinical experience with the SAVI demonstrates the ease of placement of a single-entry brachytherapy device combined with the increased dose modulation of interstitial brachytherapy. Dose to normal structures has remained exceedingly low. Almost half of evaluated patients were not candidates for other single-entry brachytherapy devices because of skin spacing or breast size, demonstrating an expansion of candidates for single-entry partial breast brachytherapy.

  1. Pathways between physical activity and quality of life in African-American breast cancer survivors.

    Science.gov (United States)

    Meadows, Rachel; Bonner, Timethia; Dobhal, Megha; Borra, Sujana; Killion, Jordan A; Paxton, Raheem

    2017-02-01

    Several studies have indicated that the relationship between physical activity and quality of life is not directed but mediated through various pathways. The purpose of this study was to assess the role of cancer-related fatigue, disability, and functional status as potential mediators in African-American breast cancer survivors. African-American breast cancer survivors (N = 135, mean age = 63) aged 55 years and older participated in a web-based survey consisting of measures assessing physical activity, functional status, cancer-related fatigue, disability, quality of life, and sociodemographic and medical characteristics. Structural equation modeling was used to assess the structural relationships among the constructs. The initial structural model fit the data and revealed a significant relationship between physical activity and quality of life (β = 0.34, P life (β = 0.11, P > 0.05) and mediated through pathways of functional status and fatigue (total β = 0.16, P life. Our data suggest that physical activity may be indirectly related to quality of life through pathways consisting of fatigue and functional status. Further longitudinal studies are needed to test the pathways through which varying levels of physical activity influence cancer-related and quality of life outcomes in minority cancer survivors.

  2. A mouse model for triple-negative breast cancer tumor-initiating cells (TNBC-TICs) exhibits similar aggressive phenotype to the human disease.

    Science.gov (United States)

    Kaur, Punit; Nagaraja, Ganachari M; Zheng, Hongying; Gizachew, Dawit; Galukande, Moses; Krishnan, Sunil; Asea, Alexzander

    2012-03-27

    Triple-negative breast cancer (TNBC) exhibit characteristics quite distinct from other kinds of breast cancer, presenting as an aggressive disease--recurring and metastasizing more often than other kinds of breast cancer, without tumor-specific treatment options and accounts for 15% of all types of breast cancer with higher percentages in premenopausal African-American and Hispanic women. The reason for this aggressive phenotype is currently the focus of intensive research. However, progress is hampered by the lack of suitable TNBC cell model systems. To understand the mechanistic basis for the aggressiveness of TNBC, we produced a stable TNBC cell line by sorting for 4T1 cells that do not express the estrogen receptor (ER), progesterone receptor (PgR) or the gene for human epidermal growth factor receptor 2 (HER2). As a control, we produced a stable triple-positive breast cancer (TPBC) cell line by transfecting 4T1 cells with rat HER2, ER and PgR genes and sorted for cells with high expression of ER and PgR by flow cytometry and high expression of the HER2 gene by Western blot analysis. We isolated tumor-initiating cells (TICs) by sorting for CD24+/CD44high/ALDH1+ cells from TNBC (TNBC-TICs) and TPBC (TPBC-TICs) stable cell lines. Limiting dilution transplantation experiments revealed that CD24+/CD44high/ALDH1+ cells derived from TNBC (TNBC-TICs) and TPBC (TPBC-TICs) were significantly more effective at repopulating the mammary glands of naïve female BALB/c mice than CD24-/CD44-/ALDH1- cells. Implantation of the TNBC-TICs resulted in significantly larger tumors, which metastasized to the lungs to a significantly greater extent than TNBC, TPBC-TICs, TPBC or parental 4T1 cells. We further demonstrated that the increased aggressiveness of TNBC-TICs correlates with the presence of high levels of mouse twenty-five kDa heat shock protein (Hsp25/mouse HspB1) and seventy-two kDa heat shock protein (Hsp72/HspA1A). Taken together, we have developed a TNBC-TICs model system

  3. Time-Varying Risk for Breast Cancer Following Initiation of Glucose-Lowering Therapy in Women with Type 2 Diabetes: Exploring Detection Bias.

    Science.gov (United States)

    Bowker, Samantha L; Lin, Mu; Eurich, Dean T; Johnson, Jeffrey A

    2017-04-01

    To explore detection bias in the association between glucose-lowering therapies and breast cancer in a cohort of women with type 2 diabetes. This was a retrospective, population-based cohort study. We identified new users of metformin, sulfonylureas, thiazolidinediones and insulin during the index period of January 1, 2003, to December 31, 2010. The main outcome was incident breast cancer, and patients were followed up from drug exposure index date until death, diagnosis of another type of cancer, termination of medical insurance or December 31, 2010. To explore detection bias, we split follow-up time into 2 discrete time periods of 0 to 3 months and 3 months to 6 years after drug index date. We performed time-varying Cox regression analyses, including duration of cumulative drug exposure and ever/never drug exposure for each glucose-lowering therapy into our model. The reference was no use of the same drug-exposure category. There were 22,169 women with type 2 diabetes, with a mean (SD) age of 53.0 (9.2) years and mean (SD) follow up of 2.2 (1.5) years. Hazard ratios for breast cancer in the first 3 months following initiation of metformin, sulfonylurea or thiazolidinedione were 0.66 (0.43 to 1.02), 0.74 (0.44 to 1.25) and 0.67 (0.38 to 1.18), respectively. In the later period of 3 months to 6 years following drug start, hazard ratios (95% CI) for breast cancer were 1.00 (0.98 to 1.02), 1.01 (0.98 to 1.03) and 0.98 (0.95 to 1.01) for metformin, sulfonylurea and thiazolidinedione cumulative exposure, respectively. Our findings suggest that no detection bias exists for glucose-lowering therapies and breast cancer in this population. Copyright © 2016 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

  4. A mouse model for triple-negative breast cancer tumor-initiating cells (TNBC-TICs exhibits similar aggressive phenotype to the human disease

    Directory of Open Access Journals (Sweden)

    Kau Punit

    2012-03-01

    Full Text Available Abstract Background Triple-negative breast cancer (TNBC exhibit characteristics quite distinct from other kinds of breast cancer, presenting as an aggressive disease--recurring and metastasizing more often than other kinds of breast cancer, without tumor-specific treatment options and accounts for 15% of all types of breast cancer with higher percentages in premenopausal African-American and Hispanic women. The reason for this aggressive phenotype is currently the focus of intensive research. However, progress is hampered by the lack of suitable TNBC cell model systems. Methods To understand the mechanistic basis for the aggressiveness of TNBC, we produced a stable TNBC cell line by sorting for 4T1 cells that do not express the estrogen receptor (ER, progesterone receptor (PgR or the gene for human epidermal growth factor receptor 2 (HER2. As a control, we produced a stable triple-positive breast cancer (TPBC cell line by transfecting 4T1 cells with rat HER2, ER and PgR genes and sorted for cells with high expression of ER and PgR by flow cytometry and high expression of the HER2 gene by Western blot analysis. Results We isolated tumor-initiating cells (TICs by sorting for CD24+/CD44high/ALDH1+ cells from TNBC (TNBC-TICs and TPBC (TPBC-TICs stable cell lines. Limiting dilution transplantation experiments revealed that CD24+/CD44high/ALDH1+ cells derived from TNBC (TNBC-TICs and TPBC (TPBC-TICs were significantly more effective at repopulating the mammary glands of naïve female BALB/c mice than CD24-/CD44-/ALDH1- cells. Implantation of the TNBC-TICs resulted in significantly larger tumors, which metastasized to the lungs to a significantly greater extent than TNBC, TPBC-TICs, TPBC or parental 4T1 cells. We further demonstrated that the increased aggressiveness of TNBC-TICs correlates with the presence of high levels of mouse twenty-five kDa heat shock protein (Hsp25/mouse HspB1 and seventy-two kDa heat shock protein (Hsp72/HspA1A. Conclusions

  5. Comparative study analyzing survival and safety of bevacizumab/carboplatin/paclitaxel versus carboplatin/docetaxel in initial treatment of metastatic Her-2-negative breast cancer

    Directory of Open Access Journals (Sweden)

    Abdel Kader Y

    2013-06-01

    Full Text Available Yasser Abdel Kader,1 Marc Spielmann,2 Tamer El-Nahas,1 Amr Sakr,1 Hassan Metwally31Department of Clinical Oncology, Cairo University, Cairo, Egypt; 2Department of Medical Oncology, Institute Gustave Rousssy, VuilleJuif, Paris, France; 3Department of Clinical Oncology, Monufia University, Monufia, EgyptPurpose: In view of the previous reports demonstrating the positive outcome of bevacizumab in metastatic breast cancer, we aimed at comparing the role of bevacizumab-based metronomic combination with taxane (paclitaxel versus a different taxane (docetaxel-based regimen in addition to carboplatin as initial treatment for metastatic Her-2-negative breast cancer.Patients and methods: This is a randomized Phase III study comparing the progression-free survival (PFS and safety in Her-2-negative female patients with initial diagnosis of metastatic breast cancer with World Health Organization performance status of 0–II. Forty-one patients were randomized from September 2008 to July 2009 to receive either; (1 bevacizumab 5 mg/kg day 1 and day 15, carboplatin area under the curve (AUC-2 day 1, day 8, and day 15, and paclitaxel 60 mg/m2 day 1, day 8, and day 15 (arm-I; or (2 carboplatin AUC-5 day 1, docetaxel 75 mg/m2 day 1 (arm-II. The Kaplan–Meier method was used for estimating survival; log-rank test for comparing survival curves. The primary end point was PFS, and secondary end points were overall survival (OS and safety.Results: PFS was 10 months in arm I versus 10.2 months in arm II (P = 0.9. The OS rate was similar in both arms: 37.6 months for arm I versus 37.4 months for arm II (P = 0.92. The toxicity revealed higher incidence of hypertension and proteinuria in arm I; however, with higher incidence of grade III–IV neutropenia and neutropenic fever in arm II. No treatment-related mortality was recorded.Conclusion: Bevacizumab/carboplatin/paclitaxel and carboplatin/docetaxel show comparable PFS and OS with different toxicity profiles

  6. Effect of dry-air chilling on sensory descriptive profiles of cooked broiler breast meat deboned four hours after the initiation of chilling.

    Science.gov (United States)

    Zhuang, H; Savage, E M; Smith, D P; Berrang, M E

    2009-06-01

    The objective of this study was to evaluate the effect of a dry air-chilling (AC) method on sensory texture and flavor descriptive profiles of broiler pectoralis major (fillet) and pectoralis minor (tender). The profiles of the muscles immersion-chilled and deboned at the same postmortem time and the profiles of the muscles hot-boned (or no chill) were used for the comparison. A total of 108 eviscerated carcasses (6-wk-old broilers) were obtained from a commercial processing line before the chillers. Carcasses were transported to a laboratory facility where they were either i) chilled by a dry AC method (0.7 degrees C, 150 min in a cold room), ii) chilled by immersion chilling (IC; 0.3 degrees C, 50 min in a chiller), or iii) not chilled (9 birds per treatment per replication). Both IC and AC fillets and tenders were removed from the bone at 4 h after the initiation of chilling (approximately 4.75 h postmortem) in a processing area (18 degrees C). The no-chill muscles were removed immediately upon arrival. The sensory properties (21 attributes) of cooked broiler breast meat were evaluated by trained panelists using 0- to 15-point universal intensity scales. The average intensity scores of the 9 flavor attributes analyzed ranged from 0.9 to 4.0. Regardless of breast muscle type, there were no significant differences in sensory flavor descriptive profiles between the 3 treatments. The average intensity scores of the 12 texture attributes ranged from 1.5 to 7.5 and there were no significant differences between the AC and IC samples. The average intensity scores of the texture attributes, cohesiveness, hardness, cohesiveness of mass, rate of breakdown, and chewiness of the no chill fillets and tenders were significantly higher than those of either of the chilled samples. These results demonstrate that chicken breast meat from AC retains sensory flavor profile characteristics but AC results in sensory texture profile differences when compared with no-chill meat. Sensory

  7. Doctor-patient communication about cancer-related internet information.

    Science.gov (United States)

    Bylund, Carma L; Gueguen, Jennifer A; D'Agostino, Thomas A; Li, Yuelin; Sonet, Ellen

    2010-01-01

    This article explores the effect of doctor-patient communication about cancer-related Internet information on self-reported outcomes. Two hundred and thirty cancer patients and caregivers completed an online survey regarding their experiences searching for and discussing with their doctors cancer-related Internet information. Participants who assertively introduced the Internet information in a consultation were more likely to have their doctor agree with the information. When doctors showed interest and involvement and took the information seriously, participants were less likely to report a desire to change the doctor's response. Taking the information seriously was also associated with greater satisfaction. This preliminary evidence that the doctor's response is associated with patient outcomes indicates the potential for improving patient-centered communication. In an effort to maximize patient-centered communication, doctors should be encouraged to take their patients and the information they present seriously, as well as show their patients that they are interested and involved.

  8. Effect of aerobic exercise on cancer-related fatigue

    Directory of Open Access Journals (Sweden)

    Jaivika Govindbhai Patel

    2017-01-01

    Full Text Available Background: Fatigue is the most common side effect of cancer treatment with chemotherapy and/or radiation therapy, selected biologic response modifiers. The main purpose of this study is to evaluate the effects of aerobic exercise on cancer-related fatigue in patients of the solid tumor after chemotherapy and radiotherapy. Methods: After screening for cancer-related fatigue, 34 patients fulfilled the inclusive criteria and were assigned into two groups (n = 17 recruited in the intervention group and n = 17 in control group. The intervention group received aerobic exercise program which included treadmill walking with low to moderate intensity (50%–70% of maximum heart rate, for 20–40 min/day for 5 days/week. Control group were taught stretching exercises of hamstrings, gastrocnemius, and soleus (to be done at home and were encouraged to remain active. Outcome measures such as brief fatigue inventory (BFI, 6-min walk test, and functional assessment of cancer therapy-general (FACT-G were taken at baseline and after 6-weeks. Results: The data were analyzed using the Wilcoxon matched-pairs signed rank test for within group and Mann–Whitney U-test for between group comparisons. The results of this study showed that there was a significant reduction in cancer-related fatigue BFI score (P < 0.0001,, also there was significant improvement in the physical performance as in 6-min walk distance (P < 0.0001 and quality of life, FACT-G score (P = 0.0001. Conclusion: Aerobic exercise for 6 weeks has beneficial effects on cancer-related fatigue in patients with solid tumor after chemotherapy and/or radiotherapy.

  9. Physician's initial impression of elderly breast cancer patients allows appropriate treatment stratification despite lack of quantitative assessment.

    LENUS (Irish Health Repository)

    Prichard, R S

    2012-02-01

    The management of older women with breast cancer is often suboptimal based on perceived patient comorbidities. The aim of this study was to evaluate the choice of treatment modality based on clinicians \\'gut-feeling\\' compared to comorbidity scoring indices. A retrospective review of women over 70 presenting with breast cancer was performed. Presenting comorbidities (Charlson Comorbidity Index and Cumulative Illness Rating Scale) and the treatment received was documented. Sixty-six patients were identified. Forty-six had surgery while twenty patients had primary endocrine manipulation. The mean age of patients having surgery was 76.4 in comparison to 84.4 for the endocrine group (p = 0.001). The CCI scores for the surgical group and endocrine group were 6.62 and 9.26 respectively (p = 0.001). The scores for the CIRS were 8.93 and 22.68 (p = 0.001). This study has demonstrated that physician\\'s "gut feelings\\' are often correct in identifying patients who may benefit from primary hormone therapy.

  10. Imaging Management of Breast Density, a Controversial Risk Factor for Breast Cancer.

    Science.gov (United States)

    Falcon, Shannon; Williams, Angela; Weinfurtner, Jared; Drukteinis, Jennifer S

    2017-04-01

    Breast density is well recognized as an independent risk factor for the development of breast cancer. However, the magnitude of risk is controversial. As the public becomes increasingly aware of breast density as a risk factor, legislation and notification laws in relation to breast density have become common throughout the United States. Awareness of breast density as a risk factor for breast cancer presents new challenges for the clinician in the approach to the management and screening of women with dense breasts. The evidence and controversy surrounding breast density as a risk factor for the development of breast cancer are discussed. Common supplemental screening modalities for breast cancer are also discussed, including tomosynthesis, ultrasonography, and magnetic resonance imaging. A management strategy for screening women with dense breasts is also presented. The American College of Radiology recognizes breast density as a controversial risk factor for breast cancer, whereas the American Congress of Obstetricians and Gynecologists recognizes breast density as a modest risk factor. Neither organization recommends the routine use of supplemental screening in women with dense breasts without considering additional patient-related risk factors. Breast density is a poorly understood and controversial risk factor for the development of breast cancer. Mammography is a screening modality proven to reduce breast cancer-related mortality rates and is the single most appropriate tool for population-based screening. Use of supplemental screening modalities should be tailored to individual risk assessment.

  11. Report of a case of primary breast lymphoma highlighting the importance of fine needle aspiration cytology as an initial diagnostic tool

    Directory of Open Access Journals (Sweden)

    Millu F Jain

    2015-01-01

    Full Text Available Primary non-Hodgkin lymphoma of breast is a rare pathology, representing 0.5% of malignant breast tumors. We report a case of 52 year old female presenting with a large painful mass in left breast with ipsilateral axillary lymph node diagnosed on fine needle aspiration cytology as non-Hodgkin′s lymphoma. Breast lymphoma should be differentiated from other breast malignancies because of the differences in their treatment modalities. When breast lymphoma presents as a lump with axillary node, it clinically mimics breast carcinoma. Ultrasonogram and mammogram shows no characteristic features that can distinguish it from other breast malignancy. In such cases, FNAC becomes an important diagnostic tool that can differentiate PBL from other breast malignancy and avoid unnecessary surgery.

  12. Measuring the societal burden of cancer: the cost of lost productivity due to premature cancer-related mortality in Europe.

    Science.gov (United States)

    Hanly, Paul; Soerjomataram, Isabelle; Sharp, Linda

    2015-02-15

    Every cancer-related death in someone of working age represents an economic loss to society. To inform priorities for cancer control, we estimated costs of lost productivity due to premature cancer-related mortality across Europe, for all cancers and by site, gender, region and country. Cancer deaths in 2008 were obtained from GLOBOCAN for 30 European countries across four regions. Costs were valued using the human capital approach. Years of productive life lost (YPLL) were computed by multiplying deaths between 15 and 64 years by working-life expectancy, then by country-, age- and gender-specific annual wages, corrected for workforce participation and unemployment. Lost productivity costs due to premature cancer-related mortality in Europe in 2008 were €75 billion. Male costs (€49 billion) were almost twice female costs (€26 billion). The most costly sites were lung (€17 billion; 23% of total costs), breast (€7 billion; 9%) and colorectum (€6 billion; 8%). Stomach cancer (in Southern and Central-Eastern Europe) and pancreatic cancer (in Northern and Western Europe) were also among the most costly sites. The average lost productivity cost per cancer death was €219,241. Melanoma had the highest cost per death (€312,798), followed by Hodgkin disease (€306,628) and brain and CNS cancer (€288,850). Premature mortality costs were 0.58% of 2008 European gross domestic product, highest in Central-Eastern Europe (0.81%) and lowest in Northern Europe (0.51%). Premature cancer-related mortality costs in Europe are significant. These results provide a novel perspective on the societal cancer burden and may be used to inform priority setting for cancer control. © 2014 UICC.

  13. [Fibrocystic breast disease--breast cancer sequence].

    Science.gov (United States)

    Habor, V; Habor, A; Copotoiu, C; Panţîru, A

    2010-01-01

    Fibrocystic breast disease has developed a major issue: the breast cancer sequence. Its involvement regarding the increse of breast cancer risk has 2 aspects: it may be either the marker of a prone tissue or a premalignant hystological deffect. Difficult differential diagnosis of benign proliferative breast lession and carcinoma led to the idea of sequency between the two: cancer does not initiate on normal mammary epithelia; it takes several proliferative stages for it to occur. In our series we analized a number of 677 breast surgical procedures where the pathologic examination reveals 115 cases (17%) of coexistence between cancer and fibrocystic breast disease. This aspect has proved to be related to earlier debut of breast cancer, suggesting that epithelial hyperplasia is a risk factor for breast cancer.

  14. Chronic Fatigue Syndrome (CFS) and Cancer Related Fatigue (CRF): two "fatigue" syndromes with overlapping symptoms and possibly related aetiologies.

    Science.gov (United States)

    Rovigatti, Ugo

    2012-12-01

    In July 2010, at the Muscle Fatigue Meeting, I presented an overview of Chronic Fatigue Syndrome and Cancer Related Fatigue, emphasizing a critical interpretation of the potential association between Chronic Fatigue Syndrome and Cancer Related Fatigue and a newly discovered retrovirus: Xenotropic Murine Related Virus. Since this association was hotly debated at that time, I suggested at the Meeting that it was wrong and most likely due to the identification of the wrong virus culprit. Today, 20 months after the Meeting, the first part of our prediction has turned out to be correct, as Xenotropic Murine Related Virus was shown to be a laboratory-created artefact. Still, the potential association of fatigue-syndromes with an infection (most likely viral) is sustained by a plethora of evidence and this overview will initially summarize data suggesting prior viral infection(s). The principal hypothesized mechanisms for both peripheral and central Chronic Fatigue Syndrome/Cancer Related Fatigue will be then summarized, also indicating plausible associations and triggering factors. All evidence accrued so far suggests that further research work should be performed in this interesting area and in order to identify an infectious agent for Chronic Fatigue Syndrome/Cancer Related Fatigue. One candidate RNA virus, Micro-Foci inducing Virus, will be described in this overview. Copyright © 2012 Elsevier B.V. All rights reserved.

  15. Elucidation of Altered Pathways in Tumor-Initiating Cells of Triple-Negative Breast Cancer: A Useful Cell Model System for Drug Screening.

    Science.gov (United States)

    Christensen, Anne G; Ehmsen, Sidse; Terp, Mikkel G; Batra, Richa; Alcaraz, Nicolas; Baumbach, Jan; Noer, Julie B; Moreira, José; Leth-Larsen, Rikke; Larsen, Martin R; Ditzel, Henrik J

    2017-08-01

    A limited number of cancer cells within a tumor are thought to have self-renewing and tumor-initiating capabilities that produce the remaining cancer cells in a heterogeneous tumor mass. Elucidation of central pathways preferentially used by tumor-initiating cells/cancer stem cells (CSCs) may allow their exploitation as potential cancer therapy targets. We used single cell cloning to isolate and characterize four isogenic cell clones from a triple-negative breast cancer cell line; two exhibited mesenchymal-like and two epithelial-like characteristics. Within these pairs, one, but not the other, resulted in tumors in immunodeficient NOD/Shi-scid/IL-2 Rγ null mice and efficiently formed mammospheres. Quantitative proteomics and phosphoproteomics were used to map signaling pathways associated with the tumor-initiating ability. Signaling associated with apoptosis was suppressed in tumor-initiating versus nontumorigenic counterparts with pro-apoptotic proteins, such as Bcl2-associated agonist of cell death (BAD), FAS-associated death domain protein (FADD), and myeloid differentiation primary response protein (MYD88), downregulated in tumor-initiating epithelial-like cells. Functional studies confirmed significantly lower apoptosis in tumor-initiating versus nontumorigenic cells. Moreover, central pathways, including β-catenin and nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB)-related signaling, exhibited increased activation in the tumor-initiating cells. To evaluate the CSC model as a tool for drug screening, we assessed the effect of separately blocking NF-κB and Wnt/β-catenin signaling and found markedly reduced mammosphere formation, particularly for tumor-initiating cells. Similar reduction was also observed using patient-derived primary cancer cells. Furthermore, blocking NF-κB signaling in mice transplanted with tumor-initiating cells significantly reduced tumor outgrowth. Our study demonstrates that suppressed apoptosis, activation

  16. Targeting RPL39 and MLF2 reduces tumor initiation and metastasis in breast cancer by inhibiting nitric oxide synthase signaling.

    Science.gov (United States)

    Dave, Bhuvanesh; Granados-Principal, Sergio; Zhu, Rui; Benz, Stephen; Rabizadeh, Shahrooz; Soon-Shiong, Patrick; Yu, Ke-Da; Shao, Zhimin; Li, Xiaoxian; Gilcrease, Michael; Lai, Zhao; Chen, Yidong; Huang, Tim H-M; Shen, Haifa; Liu, Xuewu; Ferrari, Mauro; Zhan, Ming; Wong, Stephen T C; Kumaraswami, Muthiah; Mittal, Vivek; Chen, Xi; Gross, Steven S; Chang, Jenny C

    2014-06-17

    We previously described a gene signature for breast cancer stem cells (BCSCs) derived from patient biopsies. Selective shRNA knockdown identified ribosomal protein L39 (RPL39) and myeloid leukemia factor 2 (MLF2) as the top candidates that affect BCSC self-renewal. Knockdown of RPL39 and MLF2 by specific siRNA nanoparticles in patient-derived and human cancer xenografts reduced tumor volume and lung metastases with a concomitant decrease in BCSCs. RNA deep sequencing identified damaging mutations in both genes. These mutations were confirmed in patient lung metastases (n = 53) and were statistically associated with shorter median time to pulmonary metastasis. Both genes affect the nitric oxide synthase pathway and are altered by hypoxia. These findings support that extensive tumor heterogeneity exists within primary cancers; distinct subpopulations associated with stem-like properties have increased metastatic potential.

  17. Decreasing Eukaryotic Initiation Factor 3C (EIF3C) Suppresses Proliferation and Stimulates Apoptosis in Breast Cancer Cell Lines Through Mammalian Target of Rapamycin (mTOR) Pathway.

    Science.gov (United States)

    Zhao, Weipeng; Li, Xichuan; Wang, Jun; Wang, Chen; Jia, Yongsheng; Yuan, Shunzong; Huang, Yong; Shi, Yehui; Tong, Zhongsheng

    2017-08-30

    BACKGROUND Translation initiation is the rate limiting step of protein synthesis and is highly regulated. Eukaryotic initiation factor 3C (EIF3C), an oncogene overexpressed in several human cancers, plays an important role in tumorigenesis and cell proliferation. MATERIAL AND METHODS Immunohistochemistry was used to determine the expression of EIF3C in breast cancer tissues from 42 patients. We investigated whether EIF3C silencing decreases breast cancer cell proliferation as assessed by colony formation assay, and whether EIF3C gene knockdown induces apoptosis as assessed by flow cytometry analysis. We utilized the stress and apoptosis signaling antibody array kit, while p-ERK1/2, p-Akt, p-Smad2, p-p38 MAPK, cleaved caspase-3, and cleaved caspase-7 were explored between EIF3C-siRNA and controls. Furthermore, the effects of EIF3C gene knockdown in mTOR pathway were analyzed by western blotting for different cell lines. RESULTS In EIF3C-positive tumors, 32 out of 42 showed significantly higher frequencies of high grade group by immunoreactivity (p=0.0016). BrdU incorporation after four days of cell plating was significantly suppressed in MDA-MB-231 cells by EIF3C knockdown compared with controls, with average changes of 7.8-fold (p<0.01). Clone number was significantly suppressed in MDA-MB-231 cells by EIF3C knockdown compared with controls (p<0.05). Cell apoptosis was significantly increased in the EIF3C-siRNA group when compared with the cells that were transfected with scrambled siRNA (3.51±0.0842 versus 13.24±0.2307, p<0.01). The mTOR signaling pathway was involved in decreasing EIF3C translational efficiency. CONCLUSIONS Unveiling the mechanisms of EIF3 action in tumorigenesis may help identify attractive targets for cancer therapy.

  18. Tools for assessing the quality and accessibility of online health information: initial testing among breast cancer websites.

    Science.gov (United States)

    Whitten, Pamela; Nazione, Samantha; Lauckner, Carolyn

    2013-12-01

    Health websites are used frequently, but there are many concerns about their value as information sources. Additionally, there are numerous personal barriers that prevent individuals from wholly benefitting from them. In order to assess the quality of health websites and their accessibility to users, we created tools based on previous research that examine design aspects, information validity, motivational health content and literacy content. To test these tools, we examined 155 breast cancer websites and created scores for each assessment tool to describe the percent of constructs on the average website. Results demonstrated that websites performed best on the design tool followed by the information validity, motivational health content and literacy assessment tools. The average website contained the majority of the design and information validity constructs, but only about a third of the motivational health or literacy constructs. Multiple items from the motivational health content and literacy assessment tools were not found on any of the websites, and many were only represented on a handful of sites. Overall, the assessment tools were useful in evaluating the quality of websites, and could serve as valuable resources for health website developers in the future.

  19. Microcalcifications versus artifacts: initial evaluation of a new ultrasound image processing technique to identify breast microcalcifications in a screening population.

    Science.gov (United States)

    Machado, Priscilla; Eisenbrey, John R; Cavanaugh, Barbara; Forsberg, Flemming

    2014-09-01

    A new commercial image processing technique (MicroPure, Toshiba America Medical Systems, Tustin, CA, USA) that identifies breast microcalcifications was evaluated at the time of patients' annual screening mammograms. Twenty women scheduled for annual screening mammography were enrolled in the study. Patients underwent bilateral outer-upper-quadrant real-time dual gray scale ultrasound and MicroPure imaging using an Aplio XG scanner (Toshiba). MicroPure combines non-linear imaging and speckle suppression to mark suspected calcifications as white spots in a blue overlay image. Four independent and blinded readers analyzed digital clips to determine the presence or absence of microcalcifications and artifacts. The presence of microcalcifications determined by readers was not significantly different from that of mammography (p = 0.57). However, the accuracy was low overall (52%) and also in younger women (<50 years, 54%). In conclusion, although microcalcifications can be identified using MicroPure imaging, this method is not currently appropriate for a screening population and should be used in more focused applications. Copyright © 2014 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  20. Role of Protein Synthesis Initiation Factors in Dietary Soy Isoflavone-Mediated Effects on Breast Cancer Progression

    Science.gov (United States)

    2012-03-01

    tumors were excised and stored snap frozen in liquid nitrogen. 7    2.4. Western blotting Cells and tumors were lysed and western blotted, as...et al. Eukaryotic initiation factor 4E binding protein family of proteins: sentinels at a translational control checkpoint in lung tumor defense

  1. Getting free of breast cancer

    DEFF Research Database (Denmark)

    Halttunen, Arja; Hietanen, P; Jallinoja, P

    1992-01-01

    Twenty-two breast cancer patients who were relapse-free and had no need for cancer-related treatment were interviewed 8 years after mastectomy in order to evaluate their feelings of getting free of breast cancer and the meaning of breast cancer in their lives. The study is a part of an intervention...... and follow-up study of 57 breast cancer patients. Half of the 22 patients still had frequent or occasional thoughts of recurrence and over two-thirds still thought they had not been 'cured' of cancer. More than half of the patients admitted that going through breast cancer had made them more mature. Women...... who had less thoughts of recurrence belonged to a group that had gone through an eight-week group psychotherapy intervention, were less depressed and had more other illnesses. Women who felt 'cured' had less limitations and restrictions due to cancer and belonged more often to higher social classes...

  2. Five years of letrozole compared with tamoxifen as initial adjuvant therapy for postmenopausal women with endocrine-responsive early breast cancer: update of study BIG 1-98.

    Science.gov (United States)

    Coates, Alan S; Keshaviah, Aparna; Thürlimann, Beat; Mouridsen, Henning; Mauriac, Louis; Forbes, John F; Paridaens, Robert; Castiglione-Gertsch, Monica; Gelber, Richard D; Colleoni, Marco; Láng, István; Del Mastro, Lucia; Smith, Ian; Chirgwin, Jacquie; Nogaret, Jean-Marie; Pienkowski, Tadeusz; Wardley, Andrew; Jakobsen, Erik H; Price, Karen N; Goldhirsch, Aron

    2007-02-10

    Previous analyses of the Breast International Group (BIG) 1-98 four-arm study compared initial therapy with letrozole or tamoxifen including patients randomly assigned to sequential treatment whose information was censored at the time of therapy change. Because this presentation may unduly reflect early events, the present analysis is limited to patients randomly assigned to the continuous therapy arms and includes protocol-defined updated results. Four thousand nine hundred twenty-two of the 8,028 postmenopausal women with receptor-positive early breast cancer randomly assigned (double-blind) to the BIG 1-98 trial were assigned to 5 years of continuous adjuvant therapy with either letrozole or tamoxifen; the remainder of women were assigned to receive the agents in sequence. Disease-free survival (DFS) was the primary end point. At a median follow-up time of 51 months, we observed 352 DFS events among 2,463 women receiving letrozole and 418 events among 2,459 women receiving tamoxifen. This reflected an 18% reduction in the risk of an event (hazard ratio, 0.82; 95% CI, 0.71 to 0.95; P = .007). No predefined subsets showed differential benefit. Adverse events were similar to previous reports. Patients on tamoxifen experienced more thromboembolic events, endometrial pathology, hot flashes, night sweats, and vaginal bleeding. Patients on letrozole experienced more bone fractures, arthralgia, low-grade hypercholesterolemia, and cardiovascular events other than ischemia and cardiac failure. The present updated analysis, which was limited to patients on monotherapy arms in BIG 1-98, yields results similar to those from the previous primary analysis but more directly comparable with results from other trials of continuous therapy using a single endocrine agent.

  3. Supervised exercise reduces cancer-related fatigue: a systematic review

    Directory of Open Access Journals (Sweden)

    José F Meneses-Echávez

    2015-01-01

    Full Text Available Question: Does supervised physical activity reduce cancer-related fatigue? Design: Systematic review with meta-analysis of randomised trials. Participants: People diagnosed with any type of cancer, without restriction to a particular stage of diagnosis or treatment. Intervention: Supervised physical activity interventions (eg, aerobic, resistance and stretching exercise, defined as any planned or structured body movement causing an increase in energy expenditure, designed to maintain or enhance health-related outcomes, and performed with systematic frequency, intensity and duration. Outcome measures: The primary outcome measure was fatigue. Secondary outcomes were physical and functional wellbeing assessed using the Functional Assessment of Cancer Therapy Fatigue Scale, European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire, Piper Fatigue Scale, Schwartz Cancer Fatigue Scale and the Multidimensional Fatigue Inventory. Methodological quality, including risk of bias of the studies, was evaluated using the PEDro Scale. Results: Eleven studies involving 1530 participants were included in the review. The assessment of quality showed a mean score of 6.5 (SD 1.1, indicating a low overall risk of bias. The pooled effect on fatigue, calculated as a standardised mean difference (SMD using a random-effects model, was –1.69 (95% CI –2.99 to –0.39. Beneficial reductions in fatigue were also found with combined aerobic and resistance training with supervision (SMD = –0.41, 95% CI –0.70 to –0.13 and with combined aerobic, resistance and stretching training with supervision (SMD = –0.67, 95% CI –1.17 to –0.17. Conclusion: Supervised physical activity interventions reduce cancer-related fatigue. These findings suggest that combined aerobic and resistance exercise regimens with or without stretching should be included as part of rehabilitation programs for people who have been diagnosed with cancer

  4. Acupuncture in the treatment of cancer-related psychological symptoms.

    Science.gov (United States)

    Haddad, Nadia Elisabeth; Palesh, Oxana

    2014-09-01

    Acupuncture is being adopted by cancer patients for a wide range of cancer-related symptoms including highly prevalent psychological symptoms like depression, anxiety, insomnia, and impairment in quality of life. Pharmacological treatment of prevalent symptoms like anxiety, depression, and sleep disturbance can contribute to the high chemical burden already carried by cancer patients, creating additional side effects. As a result, patients and providers alike are interested in evidence-based nonpharmacologic alternatives like acupuncture for these symptoms. This article reviews the current literature (January 2000 through April 2013) for acupuncture in cancer-related psychological symptoms with attention to both efficacy and acupuncture-specific methodology. All published studies that met our review criteria demonstrate a positive signal for acupuncture for the treatment of depression, anxiety, sleep disturbance, and for improving quality of life with most results showing statistical significance. However, there are only a handful of acupuncture studies that were specifically designed to evaluate depression, sleep disturbance, and quality of life as primary outcomes, and no studies were found that looked at anxiety as a primary outcome in this population. Published studies in cancer patients and survivors show that acupuncture treatment is not only safe but also more acceptable with fewer side effects than standard of care pharmacological treatments like antidepressants. Finally, there is wide variability in both the implementation and reporting of acupuncture methods in the literature, with only 2 of 12 studies reporting full details of acupuncture methods as outlined in the revised Standards for Reporting Interventions in Clinical Trials of Acupuncture guidelines, published in 2010 and providing an essential framework for the reporting of acupuncture methodology. This lack of methodological detail affects outcomes, generalizability, and validity of research

  5. Effects of Exercise Interventions and Physical Activity Behavior on Cancer Related Cognitive Impairments: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Philipp Zimmer

    2016-01-01

    Full Text Available This systematic review analyzes current data on effects of exercise interventions and physical activity behavior on objective and subjective cancer related cognitive impairments (CRCI. Out of the 19 studies which met all inclusion criteria, five RCTs investigated rodents, whereas the other 14 trials explored humans and these included six RCTs, one controlled trial, two prospective noncontrolled trials, one case series, one observational study, and three cross-sectional studies. The results from animal models revealed positive effects of exercise during and after chemotherapy or radiation on structural alterations of the central nervous system, physiological as well as neuropsychological outcomes. The overall study quality in patient studies was poor. The current data on intervention studies showed preliminary positive effects of Asian-influenced movement programs (e.g., Yoga with benefits on self-perceived cognitive functions as well as a reduction of chronic inflammation for breast cancer patients in the aftercare. Exercise potentially contributes to the prevention and rehabilitation of CRCI. Additional RCTs with standardized neuropsychological assessments and controlling for potential confounders are needed to confirm and expand preliminary findings.

  6. Breast Calcifications

    Science.gov (United States)

    ... and require no further testing or follow-up. Microcalcifications. These show up as fine, white specks, similar to grains of salt. They're usually noncancerous, but certain patterns can be an early sign of cancer. If breast calcifications appear suspicious on your initial mammogram, you ...

  7. Breast ultrasound: current concepts.

    Science.gov (United States)

    Candelaria, Rosalind P; Hwang, Lindsay; Bouchard, Richard R; Whitman, Gary J

    2013-06-01

    Breast ultrasound plays a major role in the identification, diagnosis, and staging of breast cancer. Gray-scale (brightness mode) is the most common form of ultrasound used in breast imaging (BI); newer techniques such as harmonic imaging, Doppler imaging, three-dimensional (3D) ultrasound, and elasticity imaging have also been employed. Breast lesions that are initially identified on mammography and magnetic resonance imaging can be further characterized with ultrasound. Breast ultrasound can differentiate solid from cystic masses, suspicious from benign lesions, and abnormal from normal lymph nodes. Ultrasound can guide needle biopsy of suspicious breast lesions and lymph nodes. Breast ultrasound can also be valuable when staging breast cancer and can help to determine if there is multifocal or multicentric disease, and also if there is associated regional lymphadenopathy. Copyright © 2013 Elsevier Inc. All rights reserved.

  8. Psychosocial impact of living with cancer-related lymphedema.

    Science.gov (United States)

    Fu, Mei R; Kang, Yang

    2013-02-01

    To summarize the evidence of and identify factors influencing the psychosocial impact of lymphedema, as well as to discuss nursing strategies. Peer-reviewed publications from 2004 to 2011 in 11 major medical indices. Poorer overall health-related quality of life was reported among cancer survivors with lymphedema. The consistent, detailed, and vivid descriptions from the qualitative studies suggest that cancer-related lymphedema exerts tremendous negative psychosocial impact, which quantitative studies failed to capture. Nursing strategies include helping patients to build a routine for daily care, setting goals, exercise, positive self-talk, providing helpful resources, and organizing support groups. Professional organizations should devote resources to public education through television advertisement, public meetings, and online education. Copyright © 2013 Elsevier Inc. All rights reserved.

  9. Charge transport in cancer-related genes and early carcinogenesis

    Science.gov (United States)

    Shih, Chi-Tin; Cheng, Yun-Yin; Wells, Stephen A.; Hsu, Ching-Ling; Römer, Rudolf A.

    2011-01-01

    The electronic transmission properties of DNA molecules are believed to play a significant role in many physical phenomena taking place in living organisms (Chakraborty, 2007) [1]. Here we study the charge transport (CT) properties of cancer-related genes, including some of the most important tumor suppressors. We find that the changes in averaged CT around the sites of pathogenic and cancerous mutations are statistically smaller than those on sites where pathogenic mutations have not been observed. The results suggest that CT might be an indicator to discriminate between pathogenic and non-pathogenic mutations at an early stage. Mutations which cause little change in CT may be more likely to occur, or more likely to be missed by damage-repair enzymes which probe CT, and are therefore more likely to persist and cause disease.

  10. Basic research on cancer related to radiation associated medical researches

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jong In; Hwang, Dae Yong; Bang, Ho Yoon [and others

    2000-12-01

    Basic Research on Cancer related to Radiation Associated Medical Researches including 1. Establishment of animal model of colorectal cancer liver metastasis and measurement of angiogenesis, 2. Tissue expression of Tie-1 and Tie-2 in human colorectal cancer, 3. Enhancement of G2/Mphase Cell Fraction by Adenovirus-mediated p53 Gene Transfer in Ovarian Cancer Cell Lines, 4. Clinical Characteristics of the patients with Non-B Non-C Hepatocellular Carcinoma and Frequency of HBV, HCV and TTV Viremia in these Patients, 5. Significance of serum iron and ferritin in patients with stomach cancer, 6. Telomerase assay for early detection of lung cancer, 7. Study on the Usefulness of Aldehyde dehydrogenase-2 Genotyping for Risk Group of Alcohol-related Cancer Screening, 8. Gene therapy using hepatoma specific promoter, 9. Study on the Influence of DNA repair gene, XRCC1 Genotypes on the Risk of Head and Neck Cancer were performed.

  11. Breast Cancer in Young Women

    Science.gov (United States)

    ... Campaign Initiatives Participation in Cancer Moonshot Stay Informed Breast Cancer in Young Women Recommend on Facebook Tweet Share Compartir Syndicate this page Marleah’s family history of breast cancer was her motivation for pursuing a career where ...

  12. Breast cancer screening in an era of personalized regimens: a conceptual model and National Cancer Institute initiative for risk-based and preference-based approaches at a population level.

    Science.gov (United States)

    Onega, Tracy; Beaber, Elisabeth F; Sprague, Brian L; Barlow, William E; Haas, Jennifer S; Tosteson, Anna N A; D Schnall, Mitchell; Armstrong, Katrina; Schapira, Marilyn M; Geller, Berta; Weaver, Donald L; Conant, Emily F

    2014-10-01

    Breast cancer screening holds a prominent place in public health, health care delivery, policy, and women's health care decisions. Several factors are driving shifts in how population-based breast cancer screening is approached, including advanced imaging technologies, health system performance measures, health care reform, concern for "overdiagnosis," and improved understanding of risk. Maximizing benefits while minimizing the harms of screening requires moving from a "1-size-fits-all" guideline paradigm to more personalized strategies. A refined conceptual model for breast cancer screening is needed to align women's risks and preferences with screening regimens. A conceptual model of personalized breast cancer screening is presented herein that emphasizes key domains and transitions throughout the screening process, as well as multilevel perspectives. The key domains of screening awareness, detection, diagnosis, and treatment and survivorship are conceptualized to function at the level of the patient, provider, facility, health care system, and population/policy arena. Personalized breast cancer screening can be assessed across these domains with both process and outcome measures. Identifying, evaluating, and monitoring process measures in screening is a focus of a National Cancer Institute initiative entitled PROSPR (Population-based Research Optimizing Screening through Personalized Regimens), which will provide generalizable evidence for a risk-based model of breast cancer screening, The model presented builds on prior breast cancer screening models and may serve to identify new measures to optimize benefits-to-harms tradeoffs in population-based screening, which is a timely goal in the era of health care reform. © 2014 American Cancer Society.

  13. Worse and worse off: the impact of lymphedema on work and career after breast cancer.

    Science.gov (United States)

    Boyages, John; Kalfa, Senia; Xu, Ying; Koelmeyer, Louise; Mackie, Helen; Viveros, Hector; Taksa, Lucy; Gollan, Paul

    2016-01-01

    Our study examines the impact of breast cancer-related lymphedema on women's work and career. Our research addresses a significant knowledge gap regarding the additional impact of lymphedema on breast cancer survivors. An online national survey was conducted with 361 women who either had breast cancer without lymphedema (Group 1, n = 209) or breast cancer with lymphedema (Group 2, n = 152). Participant recruitment was supported by the Breast Cancer Network Australia and the Australasian Lymphology Association. Both breast cancer and lymphedema had a significant negative influence on women's work and career. Respondents reported changes in employment resulting from stress and/or physical impairment, which affected attendance and work performance. The perceived negative impact of breast cancer on respondents' work and career was noticeably greater in Group 2 (63 %) than Group 1 (51 %) (p = 0.03). Of the participants who were in paid employment at some time (either at diagnosis of lymphedema or at the time of the survey (n = 103), 43 (42 %) indicated that lymphedema impacted their work performance. The impact of lymphedema on work was incremental with increased severity of lymphedema (range 22-75 %). The annual number of days off work for subclinical/mild lymphedema participants was 1.4 versus 8.1 days for moderate or severe participants (p = 0.003). This study identifies an additional detrimental effect of lymphedema on women's work and career over and above the initial impact of breast cancer and provides empirical evidence for future prospective studies and policy improvement.

  14. Racial/Ethnic Differences in Self-Reported Racism and Its Association With Cancer-Related Health Behaviors

    Science.gov (United States)

    Klassen, Ann C.; Bowie, Janice V.

    2010-01-01

    Objectives. We used population-based survey data to estimate the prevalence of self-reported racism across racial/ethnic groups and to evaluate the association between self-reported racism and cancer-related health behaviors. Methods. We used cross-sectional data from the 2003 California Health Interview Survey. Questions measured self-reported racism in general and in health care. The cancer risk behaviors we assessed were smoking, binge drinking, not walking, being overweight or obese, and not being up to date with screenings for breast, cervical, colorectal, and prostate cancers. Analyses included descriptive analyses and logistic regression. Results. Prevalences of self-reported racism varied between and within aggregate racial/ethnic groups. In adjusted analyses, general racism was associated with smoking, binge drinking, and being overweight or obese; health care racism was associated with not being up to date with screening for prostate cancer. Associations varied across racial/ethnic groups. Conclusions. Associations between general racism and lifestyle behaviors suggest that racism is a potential stressor that may shape cancer-related health behaviors, and its impact may vary by race/ethnicity. PMID:20019302

  15. Breast lump

    Science.gov (United States)

    ... removed with surgery. Breast infections are treated with antibiotics. If you are diagnosed with breast cancer , you will discuss your options carefully and thoroughly with your provider. Alternative Names Breast mass Images Female breast Breast lumps ...

  16. Breast lift

    Science.gov (United States)

    Mastopexy; Breast lift with reduction; Breast lift with augmentation ... enlargement with implants) when they have a breast lift. ... it for medical reasons. Women usually have breast lifts to lift sagging, loose breasts. Pregnancy, breastfeeding, and ...

  17. L-Dex Ratio in Detecting Breast Cancer-Related Lymphedema: Reliability, Sensitivity, and Specificity

    OpenAIRE

    Fu, Mei R.; Cleland, Charles M.; Guth, Amber A.; Kayal, Maia; Haber, Judith; Cartwright, Francis; Kleinman, Robin; Kang, Yang; Scagliola, Joan; Axelrod, Deborah

    2013-01-01

    Advances in bioelectrical impedance analysis (BIA) permit the assessment of lymphedema by directly measuring lymph fluid changes. The purpose of the study was to examine the reliability, sensitivity, and specificity of cross-sectional assessment of BIA in detecting lymphedema in a large metropolitan clinical setting. BIA was used to measure lymph fluid changes. Limb volume by sequential circumferential tape measurement was used to validate the presence of lymphedema. Data were collected from ...

  18. The efficacy of lymphaticovenular anastomosis in breast cancer-related lymphedema

    NARCIS (Netherlands)

    Winters, H.; Tielemans, H.J.P.; Hameeteman, M.; Paulus, V.A.A.; Beurskens, C.H.G.; Slater, N.J.; Ulrich, D.J.O.

    2017-01-01

    INTRODUCTION: Lymphedema can be a debilitating condition, causing a great decrease in a person's quality of life (QoL). Treatment with lymphaticovenular anastomosis (LVA), in which an anastomosis is created between the lymphatic and venous system, may attenuate lymphedema symptoms and reduce

  19. Segmental measurement of breast cancer-related arm lymphoedema using perometry and bioimpedance spectroscopy.

    Science.gov (United States)

    Czerniec, Sharon A; Ward, Leigh C; Lee, Mi-Joung; Refshauge, Kathryn M; Beith, Jane; Kilbreath, Sharon L

    2011-05-01

    To determine if bioimpedance spectroscopy (BIS) could detect localised lymphoedema of the arm and to compare BIS measurements with equivalent measures of limb volume by perometry. Women with mild to severe upper limb lymphoedema (n = 29) and women with no history of lymphoedema (n = 11) participated. Commencing at the ulnar styloid of the wrist, 4 × 10 cm segment measurements were made of each arm using both BIS and perometry. Average BIS inter-limb ratios for the total arm and each arm segment were higher than comparable perometry measures in women with lymphoedema, but similar to perometry measures for women without lymphoedema. Limits of agreement analysis showed that the mean difference between methods varied according to segment measured, ranging from 8.5% for the uppermost segment of the arm to 16.6% for the forearm segment just below the elbow. For all limb segments, there was a positive bias towards BIS measurements, which increased as lymphoedema severity increased. BIS can be used for localised measurement of lymphoedema. Because it is specific to extracellular fluid, BIS is more sensitive to localised lymphoedema than perometry.

  20. Microvascular filtration is increased in the forearms of patients with breast cancer-related lymphedema

    DEFF Research Database (Denmark)

    Jensen, Mads Radmer; Simonsen, Lene; Karlsmark, Tonny

    2013-01-01

    -enhanced ultrasound; venous occlusion strain-gauge plethysmography; lower-body negative pressure; noninvasive blood pressure measurements; and skin (99m)Tc-pertechnetate clearance technique. Measurements were performed bilaterally and simultaneously in the forearms, enabling use of the nonedematous forearm...

  1. Rural women’s knowledge of prevention and care related to breast cancer

    OpenAIRE

    N.H. Mugivhi; J.E. Maree,; S.C.D. Wright

    2009-01-01

    According to the experience of the researcher, an oncology nurse, women living in the rural areas of Thulamela municipality in the Limpopo Province, have many different perceptions of breast cancer. Perceptions are based on previous disease experiences. As with previous illnesses, changes in the breast caused by breast cancer are self-managed and treated. When these women seek medical advice for breast cancer related problems, they already have advanced cancer. The purpose of the study was to...

  2. Cognitive behavioral therapy for cancer-related cognitive dysfunction.

    Science.gov (United States)

    Kucherer, Shelly; Ferguson, Robert J

    2017-03-01

    To provide the reader with an overview of the cognitive-behavioral conceptualization of cancer-related cognitive dysfunction (CRCD) and how cognitive behavioral therapy (CBT) can play an important role in treatment. Recent findings show that Memory and Attention Adaptation Training (MAAT), a CBT developed to help cancer survivors develop adaptive skills to improve daily cognitive performance and emotional coping, may be an efficacious treatment of CRCD and can be delivered through videoconference technology to improve survivor access to care. The etiology of CRCD remains largely undetermined and likely is produced by multiple mechanisms. This can include neuronal death, microvascular damage, inflammatory processes, and psychological factors of perceptions of inadequate cognitive capacity to meet performance demands and related emotional distress. As a result, there are a variety of treatments currently being researched. More research with larger sample sizes, multiple clinicians and multiple sites are needed to confirm efficacy, but CBT approaches such as Memory and Attention Adaptation Training that address multiple psychological factors involved may offer a flexible nonpharmacological approach to CRCD that optimizes quality of life outcomes.

  3. Exercise, sleep and cancer-related fatigue: Are they related?

    Science.gov (United States)

    Medysky, Mary E; Temesi, John; Culos-Reed, Susan Nicole; Millet, Guillaume Y

    2017-04-01

    Cancer-related fatigue (CRF) is a commonly reported and debilitating side effect of cancer and/or cancer treatment. Sleep disorders are also highly reported in the cancer population; however it is unknown if sleep is associated with fatigue. In the general population, exercise has been shown to improve sleep, however in the cancer population this idea is under investigation. The primary purposes of this review were to: (i) review the prevalence and causes of sleep disorders in cancer patients and survivors, (ii) examine the relationship between sleep and CRF and (iii) review the impact of exercise interventions on sleep in cancer patients and survivors. A scoping review of the literature was conducted regarding exercise interventions in cancer patients and survivors with sleep as at least one outcome measure. A search of the literature revealed limited studies (n=21) assessing the effect of exercise on sleep disorders in the cancer population. Methodological issues are evident because assessing sleep is often not the main outcome of interest. The reviewed studies revealed that exercise positively impacts sleep quality and quantity. There seems to be possible relationship between sleep disorders, exercise and CRF. Further investigation of this relationship is necessary, specifically using objective measurement tools, in large, controlled studies, focusing on sleep as the primary outcome. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  4. The cost of lost productivity due to premature cancer-related mortality: an economic measure of the cancer burden.

    Science.gov (United States)

    Hanly, Paul A; Sharp, Linda

    2014-03-26

    Most measures of the cancer burden take a public health perspective. Cancer also has a significant economic impact on society. To assess this economic burden, we estimated years of potential productive life lost (YPPLL) and costs of lost productivity due to premature cancer-related mortality in Ireland. All cancers combined and the 10 sites accounting for most deaths in men and in women were considered. To compute YPPLL, deaths in 5-year age-bands between 15 and 64 years were multiplied by average working-life expectancy. Valuation of costs, using the human capital approach, involved multiplying YPPLL by age-and-gender specific gross wages, and adjusting for unemployment and workforce participation. Sensitivity analyses were conducted around retirement age and wage growth, labour force participation, employment and discount rates, and to explore the impact of including household production and caring costs. Costs were expressed in €2009. Total YPPLL was lower in men than women (men = 10,873; women = 12,119). Premature cancer-related mortality costs were higher in men (men: total cost = €332 million, cost/death = €290,172, cost/YPPLL = €30,558; women: total cost = €177 million, cost/death = €159,959, cost/YPPLL = €14,628). Lung cancer had the highest premature mortality cost (€84.0 million; 16.5% of total costs), followed by cancers of the colorectum (€49.6 million; 9.7%), breast (€49.4 million; 9.7%) and brain & CNS (€42.4 million: 8.3%). The total economic cost of premature cancer-related mortality in Ireland amounted to €509.5 million or 0.3% of gross domestic product. An increase of one year in the retirement age increased the total all-cancer premature mortality cost by 9.9% for men and 5.9% for women. The inclusion of household production and caring costs increased the total cost to €945.7 million. Lost productivity costs due to cancer-related premature mortality are significant. The higher premature mortality cost in males than

  5. Breast Pain

    Science.gov (United States)

    ... result in the development of breast cysts. Breast trauma, prior breast surgery or other factors localized to the breast can lead to breast pain. Breast pain may also start outside the breast — in the chest wall, muscles, joints or heart, for example — and ...

  6. Classification of cancer-related death certificates using machine learning.

    Science.gov (United States)

    Butt, Luke; Zuccon, Guido; Nguyen, Anthony; Bergheim, Anton; Grayson, Narelle

    2013-01-01

    Cancer monitoring and prevention relies on the critical aspect of timely notification of cancer cases. However, the abstraction and classification of cancer from the free-text of pathology reports and other relevant documents, such as death certificates, exist as complex and time-consuming activities. In this paper, approaches for the automatic detection of notifiable cancer cases as the cause of death from free-text death certificates supplied to Cancer Registries are investigated. A number of machine learning classifiers were studied. Features were extracted using natural language techniques and the Medtex toolkit. The numerous features encompassed stemmed words, bi-grams, and concepts from the SNOMED CT medical terminology. The baseline consisted of a keyword spotter using keywords extracted from the long description of ICD-10 cancer related codes. Death certificates with notifiable cancer listed as the cause of death can be effectively identified with the methods studied in this paper. A Support Vector Machine (SVM) classifier achieved best performance with an overall Fmeasure of 0.9866 when evaluated on a set of 5,000 freetext death certificates using the token stem feature set. The SNOMED CT concept plus token stem feature set reached the lowest variance (0.0032) and false negative rate (0.0297) while achieving an F-measure of 0.9864. The SVM classifier accounts for the first 18 of the top 40 evaluated runs, and entails the most robust classifier with a variance of 0.001141, half the variance of the other classifiers. The selection of features significantly produced the most influences on the performance of the classifiers, although the type of classifier employed also affects performance. In contrast, the feature weighting schema created a negligible effect on performance. Specifically, it is found that stemmed tokens with or without SNOMED CT concepts create the most effective feature when combined with an SVM classifier.

  7. Classification of Cancer-related Death Certificates using Machine Learning

    Directory of Open Access Journals (Sweden)

    Luke Butt

    2013-05-01

    Full Text Available BackgroundCancer monitoring and prevention relies on the critical aspect of timely notification of cancer cases. However, the abstraction and classification of cancer from the free-text of pathology reports and other relevant documents, such as death certificates, exist as complex and time-consuming activities.AimsIn this paper, approaches for the automatic detection of notifiable cancer cases as the cause of death from free-text death certificates supplied to Cancer Registries are investigated.Method A number of machine learning classifiers were studied. Features were extracted using natural language techniques and the Medtex toolkit. The numerous features encompassed stemmed words, bi-grams, and concepts from the SNOMED CT medical terminology. The baseline consisted of a keyword spotter using keywords extracted from the long description of ICD-10 cancer related codes.ResultsDeath certificates with notifiable cancer listed as the cause of death can be effectively identified with the methods studied in this paper. A Support Vector Machine (SVM classifier achieved best performance with an overall F-measure of 0.9866 when evaluated on a set of 5,000 free-text death certificates using the token stem feature set. The SNOMED CT concept plus token stem feature set reached the lowest variance (0.0032 and false negative rate (0.0297 while achieving an F-measure of 0.9864. The SVM classifier accounts for the first 18 of the top 40 evaluated runs, and entails the most robust classifier with a variance of 0.001141, half the variance of the other classifiers.ConclusionThe selection of features significantly produced the most influences on the performance of the classifiers, although the type of classifier employed also affects performance. In contrast, the feature weighting schema created a negligible effect on performance. Specifically, it is found that stemmed tokens with or without SNOMED CT concepts create the most effective feature when combined with

  8. Translation research: 'Back on Track', a multiprofessional rehabilitation service for cancer-related fatigue.

    Science.gov (United States)

    Gracey, J H; Watson, M; Payne, C; Rankin, J; Dunwoody, L

    2016-03-01

    To assess the effectiveness and acceptability of an individually tailored rehabilitation intervention for patients with cancer-related fatigue (CRF). Eighteen individuals, (16 female, two male, aged 40-83 years), who self-reported CRF (above four on a 10-point Likert scale) took part in an 8 week physical activity intervention weekly review and optional gym-based support. Fifteen participants had a primary diagnosis of breast cancer and along with the other participants had multiple myeloma, colorectal or prostate cancer. All participants took part in a goal-oriented walking and muscle strengthening programme with dietary advice and psychological support based on the Transtheoretical Model (TTM) of behaviour change. Effectiveness was assessed by physical and psychological outcomes. Focus groups with participants and individual interviews with the professionals delivering the intervention explored the feasibility and acceptability of the intervention. Statistically significant improvements were seen in the primary outcome of fatigue and on the secondary outcomes of physical function, depression and in triceps skin fold thickness reduction. Participants endorsed the intervention as being highly acceptable, holistic and as important as medical treatments for cancer. The importance of team working was highlighted as key to service delivery and success. A multidisciplinary home-based tailored intervention with optional weekly gym attendance is acceptable to people with CRF, improving physical and psychosocial outcomes. Study limitations and suggestions for further research are discussed. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  9. Fibroadenoma - breast

    Science.gov (United States)

    ... fibroadenoma; Breast lump - noncancerous; Breast lump - benign References Hacker NF, Friedlander ML. Breast disease: a gynecologic perspective. In: Hacker NF, Gambone JC, Hobel CJ, eds. Hacker and ...

  10. Cancer-Related Post-traumatic Stress (PDQ®)—Patient Version

    Science.gov (United States)

    Cancer-related post-traumatic stress can occur any time from diagnosis to after treatment ends. Shock, fear, helplessness, or horror can be felt by cancer patients and lead to cancer-related post-traumatic stress. Learn about the causes and ways doctors can help manage these symptoms of distress in this expert-reviewed summary.

  11. A coach in your pocket: on chronic cancer-related fatigue and physical behavior

    NARCIS (Netherlands)

    Wolvers, Marije D.J.

    2017-01-01

    Fatigue is a common and distressing long-term consequence of cancer. Chronic cancer-related fatigue affects work ability, hampers in maintaining social relations, and impacts patients’ well-being. Most treatments for chronic cancer-related fatigue focus to some extend on changing physical behavior,

  12. Development of video-assisted breast cancer surgery: Initial experience with a novel method for creating working space without prior liposuction

    OpenAIRE

    Wu, Qian-Fu; Yu, Ying-Hua; Zhu, Xiao; Cui, Ying; Mo, Qin-Guo; Wei, Chang-Yuan; Lin, Xue-Juan; Liu, Xue-Ying; Xie, Wei-Kang; Gan, Shui; Lei, Wei

    2017-01-01

    Endoscopic techniques are promising in breast surgery. In order to create working space, liposuction is widely used in video-assisted breast surgery (VABS). However, the use of liposuction is likely associated with side effects that may partly limit the application of VABS. Therefore, a new technique of endoscopic axillary lymphadenectomy without prior liposuction was developed by our group. A total of 106 female patients underwent VABS, with special adaptation of the video-assisted surgical ...

  13. Benign Breast Disease: Toward Molecular Prediction of Breast Cancer Risk

    Science.gov (United States)

    2006-06-01

    at the initial biopsy, the strength of the family history, meno- pausal status, and histologic findings of the biop- sy, as compared with expected...breast cancers for 646/758 (85%) of the cases. We assessed the significance of benign histology in predicting risk of future breast cancer, examining...TERMS Benign Breast Disease, Biomarkers, Histology , Breast Cancer 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT 18. NUMBER OF

  14. Physiotherapy treatments for breast cancer-related lymphedema: a literature review Tratamientos fisioterapéuticos para el linfedema después de la cirugía de cáncer de seno: una revisión de literatura Tratamentos fisioterapêuticos para o linfedema pós-câncer de mama: uma revisão de literatura

    OpenAIRE

    Nara Fernanda Braz da Silva Leal; Hélio Humberto Angotti Carrara; Karina Franco Vieira; Cristine Homsi Jorge Ferreira

    2009-01-01

    Breast cancer is the second most frequent cancer among women. Surgery is part of the therapeutic process to prevent metastases, but it can also cause some complications, including lymphedema. Physiotherapy contributes to its treatment, using different techniques that have been developed over the years. This systematic literature review aims to present physiotherapy modalities applied for lymphedema therapy. The literature review was conducted using textbooks and Lilacs, Pubmed and Scielo data...

  15. Objective-subjective disparity in cancer-related cognitive impairment: does the use of change measures help reconcile the difference?

    Science.gov (United States)

    O'Farrell, Erin; Smith, Andra; Collins, Barbara

    2017-10-01

    Studies to date have found little correlation between subjective and objective measures of cognitive function in cancer patients, making it difficult to interpret the significance of their cognitive complaints. The purpose of this study was to determine if a stronger correlation would be obtained using measures of cognitive change rather than static scores. Sixty women with early stage breast cancer underwent repeated cognitive assessment over the course of chemotherapy with a neuropsychological test battery (objective measure) and with the FACT-Cog (subjective measure). Their results were compared to 60 healthy women matched on age and education and assessed at similar intervals. We used multilevel modeling, with FACT-Cog as the dependent measure and ordinary least squares slopes of a neuropsychological summary score as the independent variable, to evaluate the co-variation between the subjective and objective measures over time RESULTS: Measures of both objective and subjective cognitive function declined over the course of chemotherapy in the breast cancer patients but there was no significant relationship between them, even when using change measures. Change in objective cognitive function was not related to change in anxiety or fatigue scores but the decline in perceived cognitive function was associated with greater anxiety and fatigue. The discrepancy in objective and subjective measures of cognition in breast cancer patients cannot be accounted for in terms of a failure to use change measures. Although the results are negative, we contend that this is the more appropriate methodology for analyzing cancer-related changes in cognition. Copyright © 2016 John Wiley & Sons, Ltd.

  16. The performance of computer-aided detection when analyzing prior mammograms of newly detected breast cancers with special focus on the time interval from initial imaging to detection

    Energy Technology Data Exchange (ETDEWEB)

    Malich, Ansgar [Institute of Diagnostic Radiology, Suedharz-Hospital Nordhausen, Dr.-R.-Koch-Street 38, 99734 Nordhausen (Germany)], E-mail: ansgar.malich@gmx.de; Schmidt, Sabine [Institute of Diagnostic and Interventional Radiology, Friedrich-Schiller-University Jena, Bachstrasse 18, 07740 Jena (Germany); Fischer, Dorothee R. [Institute of diagnostic, interventional and pediatric Radiology, CH-3010 Bern (Switzerland); Facius, Mirjam; Kaiser, Werner A. [Institute of Diagnostic and Interventional Radiology, Friedrich-Schiller-University Jena, Bachstrasse 18, 07740 Jena (Germany)

    2009-03-15

    Purpose: The clinical role of CAD systems to detect breast cancer, which have not been on cancer containing mammograms not detected by the radiologist was proven retrospectively. Methods: All patients from 1992 to 2005 with a histologically verified malignant breast lesion and a mammogram at our department, were analyzed in retrospect focussing on the time of detection of the malignant lesion. All prior mammograms were analyzed by CAD (CADx, USA). The resulting CAD printout was matched with the cancer containing images yielding to the radiological diagnosis of breast cancer. CAD performance, sensitivity as well as the association of CAD and radiological features were analyzed. Results: 278 mammograms fulfilled the inclusion criteria. 111 cases showed a retrospectively visible lesion (71 masses, 23 single microcalcification clusters, 16 masses with microcalcifications, in one case two microcalcification clusters). 54/87 masses and 34/41 microcalcifications were detected by CAD. Detection rates varied from 9/20 (ACR 1) to 5/7 (ACR 4) (45% vs. 71%). The detection of microcalcifications was not influenced by breast tissue density. Conclusion: CAD might be useful in an earlier detection of subtle breast cancer cases, which might remain otherwise undetected.

  17. Selective Attention and Fear of Cancer Recurrence in Breast Cancer Survivors

    NARCIS (Netherlands)

    Custers, J. A. E.; Becker, E. S.; Gielissen, M. F. M.; van Laarhoven, H. W. M.; Rinck, M.; Prins, J. B.

    2015-01-01

    Anxious people show an attentional bias towards threatening information. It was investigated whether an attentional bias exists for cancer-related stimuli in breast cancer survivors and if different levels of fear of cancer recurrence would lead to different patterns of selective attention. Breast

  18. College Women and Breast Cancer: Knowledge, Behavior, and Beliefs regarding Risk Reduction

    Science.gov (United States)

    Burak, Lydia; Boone, Barbara

    2008-01-01

    Background: Although breast cancer prevention should begin in youth, many young women are not aware of the modifiable lifestyle risk factors for the disease. Purpose: The purposes of this study were to examine the breast cancer-related knowledge, behaviors, and beliefs of young women; to determine whether knowledge about lifestyle risks was…

  19. Mutation Detection in Patients With Advanced Cancer by Universal Sequencing of Cancer-Related Genes in Tumor and Normal DNA vs Guideline-Based Germline Testing.

    Science.gov (United States)

    Mandelker, Diana; Zhang, Liying; Kemel, Yelena; Stadler, Zsofia K; Joseph, Vijai; Zehir, Ahmet; Pradhan, Nisha; Arnold, Angela; Walsh, Michael F; Li, Yirong; Balakrishnan, Anoop R; Syed, Aijazuddin; Prasad, Meera; Nafa, Khedoudja; Carlo, Maria I; Cadoo, Karen A; Sheehan, Meg; Fleischut, Megan H; Salo-Mullen, Erin; Trottier, Magan; Lipkin, Steven M; Lincoln, Anne; Mukherjee, Semanti; Ravichandran, Vignesh; Cambria, Roy; Galle, Jesse; Abida, Wassim; Arcila, Marcia E; Benayed, Ryma; Shah, Ronak; Yu, Kenneth; Bajorin, Dean F; Coleman, Jonathan A; Leach, Steven D; Lowery, Maeve A; Garcia-Aguilar, Julio; Kantoff, Philip W; Sawyers, Charles L; Dickler, Maura N; Saltz, Leonard; Motzer, Robert J; O'Reilly, Eileen M; Scher, Howard I; Baselga, Jose; Klimstra, David S; Solit, David B; Hyman, David M; Berger, Michael F; Ladanyi, Marc; Robson, Mark E; Offit, Kenneth

    2017-09-05

    change to targeted therapy in 38 patients tested (3.7%) and predictive testing in the families of 13 individuals (1.3%), including 6 for whom genetic evaluation would not have been initiated by guideline-based testing. In this referral population with selected advanced cancers, universal sequencing of a broad panel of cancer-related genes in paired germline and tumor DNA samples was associated with increased detection of individuals with potentially clinically significant heritable mutations over the predicted yield of targeted germline testing based on current clinical guidelines. Knowledge of these additional mutations can help guide therapeutic and preventive interventions, but whether all of these interventions would improve outcomes for patients with cancer or their family members requires further study. clinicaltrials.gov Identifier: NCT01775072.

  20. Psycho-oncological support for breast cancer patients: A brief overview of breast cancer services certification schemes and national health policies in Europe

    OpenAIRE

    Neamţiu, L.; Deandrea, S.; Pylkkänen, L.; Freeman, C; López Alcalde, J.; Bramesfeld, A.; Saz-Parkinson, Z.; Ulutürk, A.; Lerda, D.

    2016-01-01

    Psycho-oncology addresses the psychological, social, behavioural, and ethical aspects of cancer. Identification and proper management of the patients' psychosocial needs, as well as the needs of their caregivers and family are essential for a person-centred concept of breast cancer care. The aim of this overview is to describe how psychosocial support in breast cancer is incorporated in cancer-related policy documents, such as national cancer plans and breast cancer care certifica...

  1. Selective attention and fear of cancer recurrence in breast cancer survivors.

    Science.gov (United States)

    Custers, J A E; Becker, E S; Gielissen, M F M; Van Laarhoven, H W M; Rinck, M; Prins, J B

    2015-02-01

    Anxious people show an attentional bias towards threatening information. It was investigated whether an attentional bias exists for cancer-related stimuli in breast cancer survivors and if different levels of fear of cancer recurrence would lead to different patterns of selective attention. Breast cancer survivors with high (n = 35) and low (n = 32) fear of cancer recurrence were compared to 40 healthy female hospital employees. Specificity of attentional biases was investigated using a modified Emotional Stroop Task. Self-report measures were used to assess depression and anxiety, feelings of fatigue, and experienced traumas. Compared to control participants, breast cancer survivors with both high and low levels of fear of cancer recurrence showed increased interference for cancer-related words, but not for other word types. The findings suggest a specific attentional bias for cancer-related words in breast cancer survivors that is independent of level of fear of cancer recurrence.

  2. Interpretation of NCCN Clinical Practice Guidelines in Oncology: Cancer-Related Fatigue

    National Research Council Canada - National Science Library

    Zhen-hua YE; Fu-rong DU; Yin-ping WU; Xue YANG; Zi YI

    2016-01-01

    Cancer-related fatigue (CRF) is a distressing, persistent, subjective sense of physical, emotional, and/or cognitive tiredness or exhaustion related to cancer or cancer treatment that is not proportional to recent activity...

  3. Body image mediates the effect of cancer-related stigmatization on depression

    DEFF Research Database (Denmark)

    Esser, Peter; Mehnert, Anja; Johansen, Christoffer

    2018-01-01

    OBJECTIVE: Because cancer-related stigmatization is prevalent but difficult to change, research on its impact on psychological burden and respective intervening variables is needed. Therefore, we investigated the effect of stigmatization on depressive symptomatology and whether body image mediate...

  4. Association between cancer literacy and cancer-related behaviour: evidence from Ticino, Switzerland

    OpenAIRE

    Nicola Diviani; Peter J. Schulz

    2014-01-01

    Background This paper details the role of different dimensions of health literacy in the relationship between health literacy and cancer-related health behaviours. In particular, Cancer Literacy is studied as an exemplar of a dimension of health literacy beyond basic reading and writing skills. The link between functional health literacy, Cancer Literacy and cancer-related health behaviours is investigated in a sample of Ticino (Switzerland) residents (n=639). Design and methods Detailed data...

  5. How to optimize breast ultrasound

    Energy Technology Data Exchange (ETDEWEB)

    Athanasiou, Alexandra [Department of Radiology, Curie Institute, 26 rue d' Ulm, 75005 Paris (France)], E-mail: alexandra.athanasiou@curie.net; Tardivon, Anne; Ollivier, Lilliane; Thibault, Fabienne; El Khoury, Carl; Neuenschwander, Sylvia [Department of Radiology, Curie Institute, 26 rue d' Ulm, 75005 Paris (France)

    2009-01-15

    Breast cancer is the most common female cancer, and the second cause of cancer-related mortality of women in our society. Mammography is the gold-standard method of breast imaging. However it is not an optimal screening tool, especially in cases of dense breast parenchyma. Even when optimally performed, its sensitivity ranges between 69 and 90%. Ultrasound represents an additional diagnostic tool that raises the detection rate of benign and malignant breast lesions. It is the method of choice for differentiating solid from cystic lesions, for further characterizing mammographic findings and better appreciating palpable breast lesions. B-mode ultrasonography is used in every day practice. Harmonic imaging and compound imaging can be used to ameliorate the image contrast and resolution. Colour Doppler is used for studying lesion vascularization however there is no consensus as to whether it really permits to differentiate malignancies from benign lesions. New technical developments such as breast elastography, 3D ultrasound and dedicated ultrasound computed aided diagnosis (CAD) are promising methods for the future.

  6. Oxalate induces breast cancer.

    Science.gov (United States)

    Castellaro, Andrés M; Tonda, Alfredo; Cejas, Hugo H; Ferreyra, Héctor; Caputto, Beatriz L; Pucci, Oscar A; Gil, German A

    2015-10-22

    Microcalcifications can be the early and only presenting sign of breast cancer. One shared characteristic of breast cancer is the appearance of mammographic mammary microcalcifications that can routinely be used to detect breast cancer in its initial stages, which is of key importance due to the possibility that early detection allows the application of more conservative therapies for a better patient outcome. The mechanism by which mammary microcalcifications are formed is still largely unknown but breast cancers presenting microcalcifications are more often associated with a poorer prognosis. We combined Capillary Electrochromatography, histology, and gene expression (qRT-PCR) to analyze patient-matched normal breast tissue vs. breast tumor. Potential carcinogenicity of oxalate was tested by its inoculation into mice. All data were subjected to statistical analysis. To study the biological significance of oxalates within the breast tumor microenvironment, we measured oxalate concentration in both human breast tumor tissues and adjoining non-pathological breast tissues. We found that all tested breast tumor tissues contain a higher concentration of oxalates than their counterpart non-pathological breast tissue. Moreover, it was established that oxalate induces proliferation of breast cells and stimulates the expression of a pro-tumorigenic gene c-fos. Furthermore, oxalate generates highly malignant and undifferentiated tumors when it was injected into the mammary fatpad in female mice, but not when injected into their back, indicating that oxalate does not induce cancer formation in all types of tissues. Moreover, neither human kidney-epithelial cells nor mouse fibroblast cells proliferate when are treated with oxalate. We found that the chronic exposure of breast epithelial cells to oxalate promotes the transformation of breast cells from normal to tumor cells, inducing the expression of a proto-oncogen as c-fos and proliferation in breast cancer cells

  7. Estrogen- and stress-induced DNA damage in breast cancer and chemoprevention with dietary flavonoid

    OpenAIRE

    Yasuda, Michiko T.; Sakakibara, Hiroyuki; Shimoi, Kayoko

    2017-01-01

    Breast cancer is one of the most commonly diagnosed female cancers and a leading cause of cancer-related death in women. Multiple factors are responsible for breast cancer and heritable factors have received much attention. DNA damage in breast cancer is induced by prolonged exposure to estrogens, such as 17?-estradiol, daily social/psychological stressors, and environmental chemicals such as polycyclic aromatic hydrocarbons (PAHs) and heterocyclic amines (HCAs). DNA damage induced by estroge...

  8. Femur fracture classification in women with a history of breast cancer

    OpenAIRE

    Chau, Stephanie; Chandra, Malini; Grimsrud, Christopher D.; Gonzalez, Joel R.; Hui, Rita L; Lo, Joan C.

    2014-01-01

    Purpose: Women with breast cancer are at increased risk for femur fracture. Contributing factors include estrogen deficiency, cancer-related therapies, or direct bone involvement. This study examines fracture subtypes in women with prior breast cancer experiencing a femur fracture. Methods: Women age ≥50 years old with a history of invasive breast cancer who experienced a femur fracture were identified during 2005–2012. Fracture site was classified by hospital diagnosis (for hip) and/or ra...

  9. Epidemiology, biology, and treatment of triple-negative breast cancer in women of African ancestry

    OpenAIRE

    Brewster, Abenaa M; Chavez-MacGregor, Mariana; Brown, Powel

    2014-01-01

    Breast cancer incidence is increasing worldwide, and breast cancer-related mortality is highest in women of African ancestry, who are more likely to have basal-like or triple-negative breast cancer (TNBC) than are women of European ancestry. Identification of cultural, epidemiological, and genetic risk factors that predispose women of African ancestry to TNBC is an active area of research. Despite the aggressive behaviour of TNBC, achievement of a pathological complete response with chemother...

  10. Association of pharmacokinetic and metabolic parameters derived using simultaneous PET/MRI: Initial findings and impact on response evaluation in breast cancer.

    Science.gov (United States)

    Jena, Amarnath; Taneja, Sangeeta; Singh, Aru; Negi, Pradeep; Mehta, Shashi Bhushan; Ahuja, Aashim; Singhal, Manish; Sarin, Ramesh

    2017-07-01

    To study relationships among pharmacokinetic and 18F-fluorodeoxyglucose (18F-FDG) PET parameters obtained through simultaneous PET/MRI in breast cancer patients and evaluate their combined potential for response evaluation. The study included 41 breast cancer patients for correlation study and 9 patients (pre and post therapy) for response evaluation. All patients underwent simultaneous PET/MRI with dedicated breast imaging. Pharmacokinetic parameters and PET parameters for tumor were derived using an in- house developed and vendor provided softwares respectively. Relationships between SUV and pharmacokinetic parameters and clinical as well as histopathologic parameters were evaluated using Spearman correlation analysis. Response to chemotherapy was derived as percentage reduction in size and in parameters post therapy. Significant correlations were observed between SUVmean, max, peak, TLG with Ktrans (ρ=0.446, 0.417, 0.491, 0.430; p≤0.01); with Kep(ρ=0.303, ρ=0.315, ρ=0.319; p≤0.05); and with iAUC(ρ=0.401, ρ=0.410, ρ=0.379; p≤0.05, p≤0.01). The ratio of ve/iAUC showed significant negative correlation to SUVmean, max, peak and TLG (ρ=0.420, 0.446, 0.443, 0.426; p≤0.01). Ability of SUV as well as pharmacokinetic parameters to predict response to therapy matched the RECIST criteria in 9 out of 11 lesions in 9 patients. Maximum post therapy quantitative reduction was observed in SUVpeak, TLG and Ktrans. Simultaneous PET/MRI enables illustration of close interactions between glucose metabolism and pharmacokinetic parameters in breast cancer patients and potential of their simultaneity in response assessment to therapy. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Lapatinib in patients with metastatic breast cancer following initial treatment with trastuzumab: an economic analysis from the Brazilian public health care perspective

    OpenAIRE

    Einarson, Thomas; Machado,

    2012-01-01

    Marcio Machado,1 Thomas R Einarson21GlaxoSmithKline Brasil Ltd, Rio de Janeiro, Brazil; 2Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, CanadaObjective: To evaluate, from the perspective of the Brazilian public health care system, the cost-effectiveness of lapatinib plus capecitabine (LAP/CAP) versus capecitabine alone (CAP) or trastuzumab plus capecitabine (TRAST/CAP) in the treatment of women with human epidermal growth factor receptor-2-positive metastatic breast cancer pr...

  12. Development and usability of a computer-tailored pedometer-based physical activity advice for breast cancer survivors.

    Science.gov (United States)

    De Cocker, K; Charlier, C; Van Hoof, E; Pauwels, E; Lechner, L; Bourgois, J; Spittaels, H; Vandelanotte, C; De Bourdeaudhuij, I

    2015-09-01

    This observational study aimed to adapt a computer-tailored step advice for the general population into a feasible advice for breast cancer survivors and to test its usability. First, several adaptations were made to the original design (adding cancer-related physical activity (PA) barriers and beliefs, and self-management strategies to improve survivors' personal control). Second, the adapted advice was evaluated in two phases: (1) a usability testing in healthy women (n = 3) and survivors (n = 6); and (2) a process evaluation during 3 weeks in breast cancer survivors (n = 8). Preliminary usability testing revealed no problems during logging-in; however, three survivors misinterpreted some questions. After refining the questionnaire and advice, survivors evaluated the advice as interesting, attractive to read, comprehensible and credible. Inactive survivors found the advice novel, but too long. The process evaluation indicated that the majority of the women (n = 5/8) reported increased steps. Monitoring step counts by using a pedometer was perceived as an important motivator to be more active. To conclude, this study provides initial support for the usability and acceptability of a computer-tailored pedometer-based PA advice for breast cancer survivors. After testing efficacy and effectiveness of this intervention, this tool can broaden the reach of PA promotion in breast cancer survivors. © 2014 John Wiley & Sons Ltd.

  13. [Mothers with breast cancer and their children: initial results regarding the effectiveness of the family oriented oncological rehabilitation program "gemeinsam gesund werden"].

    Science.gov (United States)

    John, Katja; Becker, Katja; Mattejat, Fritz

    2010-01-01

    When a parent has a serious somatic illness, children suffer grave distress, their risk to develop a mental disorder increases. Sick mothers, in comparison to patients without children, experience additional strain, e. g. because they worry about their children. Although many studies focus on the quality of life of breast cancer patients, little is known about the special situation of young mothers with breast cancer. Currently, a prospective study with four assessment points (pre, post, 3- and 12-months-follow-up) is conducted on a large sample of women taking part in the family-oriented inpatient rehabilitation program "gemeinsam gesund werden'. In this paper a longitudinal sample of 173 women and 153 children, their quality of life and psychological impairment prior to, after and in the course of one year after the rehabilitation is presented. Compared to the general population, the children as well as the mothers are considerably impaired, especially in regard to Psychological Health/Emotional Functioning. These impairments improve markedly within the survey period. One year after the rehabilitation, the children show no more impairment than the reference groups. The mothers improve significantly as well, however, after one year their quality of life scores are still lower than those of the general population. In conclusion, a considerable impairment of the analyzed group of mothers with breast cancer and their children, the necessity of special supportive measures as well as the effectiveness of the model rehabilitation program can be shown.

  14. Update on Management of Cancer-Related Cachexia.

    Science.gov (United States)

    Anderson, Lindsey J; Albrecht, Eliette D; Garcia, Jose M

    2017-01-01

    Cachexia is a metabolic syndrome driven by inflammation and characterized by loss of muscle with or without loss of fat mass. In cancer cachexia, the tumor burden and host response induce increased inflammation, decreased anabolic tone, and suppressed appetite leading to the clinical presentation of reduced body weight and quality of life (QOL). There is no approved treatment for cancer cachexia, and commonly used nutritional and anti-inflammatory strategies alone have proven ineffective for management of symptoms. Several other pharmacological agents are currently in development and have shown promise as a clinical strategy in early-phase trials. Recently, it has been proposed that multimodal strategies, with an anabolic focus, initiated early in the disease/treatment progression may provide the most therapeutic potential for symptom management. Here we review the data from recent clinical trials in cancer cachexia including pharmacological, exercise, and nutritional interventions.

  15. Cancer related knowledge and behavior among women across various socio-economic strata: A study from Delhi, India

    Directory of Open Access Journals (Sweden)

    Rahul Sharma

    2013-01-01

    Full Text Available Background: Cancer is predicted to be an increasingly important cause of morbidity and mortality in the next few decades worldwide. One important step in reducing the burden of morbidity and mortality from cancers is awareness among the population about the causes and prevention of cancers. Objective: To study the knowledge and preventive behavior regarding common cancers among the women from an area of Delhi, India. Study Design: Cross-sectional study. Setting: Four purposively selected residential areas representing various socio-economic strata, in North-East Delhi. Participants: One thousand two hundred and six women in the age group 18-60 years. Statistical Analysis: Proportions, Chi-square test. Results: Majority of the women (43.9% were graduates while 10.4% were illiterate. The awareness about breast cancer was maximum with 73.8% of the respondents being aware about it. The proportions of women aware about the other cancers were low. Only 52 (4.3% had ever been for a preventive check-up for cancer. The most common cancer checkup for which the respondents reported visiting a hospital was, breast cancer. Among the respondents, 46 (3.8% reported having a female member in their family who ever had cancer. Five hundred and seventy seven (47.8% had not seen any message regarding cancers common in females in any mass media. Women with a higher education level, having a female family member with cancer, and those who could recall mass media message regarding cancers, were significantly more likely to have had a preventive cancer checkup for self. Conclusion: The knowledge and actual preventive behavior about cancers was found to be low among the women. Increased mass media exposure and targeted strategies can possibly increase the awareness and the cancer-related health behavior among the women.

  16. Cancer related knowledge and behavior among women across various socio-economic strata: A study from Delhi, India

    Science.gov (United States)

    Sharma, Rahul; Bhasin, Sanjiv K.; Agrawal, Sandeep; Tewari, Reeti

    2013-01-01

    Background: Cancer is predicted to be an increasingly important cause of morbidity and mortality in the next few decades worldwide. One important step in reducing the burden of morbidity and mortality from cancers is awareness among the population about the causes and prevention of cancers. Objective: To study the knowledge and preventive behavior regarding common cancers among the women from an area of Delhi, India. Study Design: Cross-sectional study. Setting: Four purposively selected residential areas representing various socio-economic strata, in North-East Delhi. Participants: One thousand two hundred and six women in the age group 18-60 years. Statistical Analysis: Proportions, Chi-square test. Results: Majority of the women (43.9%) were graduates while 10.4% were illiterate. The awareness about breast cancer was maximum with 73.8% of the respondents being aware about it. The proportions of women aware about the other cancers were low. Only 52 (4.3%) had ever been for a preventive check-up for cancer. The most common cancer checkup for which the respondents reported visiting a hospital was, breast cancer. Among the respondents, 46 (3.8%) reported having a female member in their family who ever had cancer. Five hundred and seventy seven (47.8%) had not seen any message regarding cancers common in females in any mass media. Women with a higher education level, having a female family member with cancer, and those who could recall mass media message regarding cancers, were significantly more likely to have had a preventive cancer checkup for self. Conclusion: The knowledge and actual preventive behavior about cancers was found to be low among the women. Increased mass media exposure and targeted strategies can possibly increase the awareness and the cancer-related health behavior among the women. PMID:24455555

  17. Protocol for a feasibility trial for improving breast feeding initiation and continuation: assets-based infant feeding help before and after birth (ABA).

    Science.gov (United States)

    Jolly, Kate; Ingram, Jenny; Clarke, Joanne; Johnson, Debbie; Trickey, Heather; Thomson, Gill; Dombrowski, Stephan U; Sitch, Alice; Dykes, Fiona; Feltham, Max G; Darwent, Kirsty; MacArthur, Christine; Roberts, Tracy; Hoddinott, Pat

    2018-01-23

    Breast feeding improves the health of mothers and infants; the UK has low rates, with marked socioeconomic inequalities. While trials of peer support services have been effective in some settings, UK trials have not improved breast feeding rates. Qualitative research suggests that many women are alienated by the focus on breast feeding. We propose a change from breast feeding-focused interactions to respecting a woman's feeding choices, inclusion of behaviour change theory and an increased intensity of contacts in the 2 weeks after birth when many women cease to breast feed. This will take place alongside an assets-based approach that focuses on the positive capability of individuals, their social networks and communities.We propose a feasibility study for a multicentre randomised controlled trial of the Assets feeding help Before and After birth (ABA) infant feeding service versus usual care. A two-arm, non-blinded randomised feasibility study will be conducted in two UK localities. Women expecting their first baby will be eligible, regardless of feeding intention. The ABA infant feeding intervention will apply a proactive, assets-based, woman-centred, non-judgemental approach, delivered antenatally and postnatally tailored through face-to-face contacts, telephone and SMS texts. Outcomes will test the feasibility of delivering the intervention with recommended intensity and duration to disadvantaged women; acceptability to women, feeding helpers and professionals; and feasibility of a future randomised controlled trial (RCT), detailing recruitment rates, willingness to be randomised, follow-up rates at 3 days, 8 weeks and 6 months, and level of outcome completion. Outcomes of the proposed full trial will also be collected. Mixed methods will include qualitative interviews with women/partners, feeding helpers and health service staff; feeding helper logs; and review of audio-recorded helper-women interactions to assess intervention fidelity. Study results will

  18. Breast Diseases

    Science.gov (United States)

    Most women experience breast changes at some time. Your age, hormone levels, and medicines you take may cause lumps, bumps, and discharges (fluids that are not breast milk). If you have a breast lump, pain, ...

  19. Methodological considerations for disentangling a risk factor's influence on disease incidence versus postdiagnosis survival: The example of obesity and breast and colorectal cancer mortality in the Women's Health Initiative.

    Science.gov (United States)

    Cespedes Feliciano, Elizabeth M; Prentice, Ross L; Aragaki, Aaron K; Neuhouser, Marian L; Banack, Hailey R; Kroenke, Candyce H; Ho, Gloria Y F; Zaslavsky, Oleg; Strickler, Howard D; Cheng, Ting-Yuan David; Chlebowski, Rowan T; Saquib, Nazmus; Nassir, Rami; Anderson, Garnet; Caan, Bette J

    2017-12-01

    Often, studies modeling an exposure's influence on time to disease-specific death from study enrollment are incorrectly interpreted as if based on time to death from disease diagnosis. We studied 151,996 postmenopausal women without breast or colorectal cancer in the Women's Health Initiative with weight and height measured at enrollment (1993-1998). Using Cox regression models, we contrast hazard ratios (HR) from two time-scales and corresponding study subpopulations: time to cancer death after enrollment among all women and time to cancer death after diagnosis among only cancer survivors. Median follow-up from enrollment to diagnosis/censoring was 13 years for both breast (7,633 cases) and colorectal cancer (2,290 cases). Median follow-up from diagnosis to death/censoring was 7 years for breast and 5 years for colorectal cancer. In analyses of time from enrollment to death, body mass index (BMI) ≥ 35 kg/m2 versus 18.5-cancer mortality: HR = 1.99; 95% CI: 1.54, 2.56 for breast cancer (p trend colorectal cancer (p trend = 0.05). However, in analyses of time from diagnosis to cancer death, trends indicated no significant association (for BMI ≥ 35 kg/m2 , HR = 1.25; 95% CI: 0.94, 1.67 for breast [p trend = 0.33] and HR = 1.18; 95% CI: 0.84, 1.86 for colorectal cancer [p trend = 0.39]). We conclude that a risk factor that increases disease incidence will increase disease-specific mortality. Yet, its influence on postdiagnosis survival can vary, and requires consideration of additional design and analysis issues such as selection bias. Quantitative tools allow joint modeling to compare an exposure's influence on time from enrollment to disease incidence and time from diagnosis to death. © 2017 UICC.

  20. Development of a Taiwan cancer-related fatigue cognition questionnaire: reliability and validity.

    Science.gov (United States)

    Lai, Shih-Chiung; Lin, Wei-Chun; Chen, Chien-Hsin; Wu, Szu-Yuan

    2017-04-25

    We prospectively designed a Taiwan cancer-related fatigue cognition questionnaire, version 1.0 (TCRFCQ-V1.0), for Taiwanese patients with cancer and investigated the reliability and validity of this questionnaire. The completion rate of the TCRFCQ-V1.0 was high (97% of the patients completed all items), and the rate of missing data was low (0.2%-1.1% for each item). Moreover, the Cronbach alpha value was 0.889. We eliminated 5 items because their respective Cronbach alpha values were higher than the total mean value of Cronbach's alpha. Overall, the TCRFCQ-V1.0 had adequate Cronbach alpha coefficients (range, from 0.882 to 0.889). In addition, the results of Bartlett's test were significant (chi-squared, 2390.11; p 1, and the scree plot indicated no flattening factors. Overall, 28 items achieved a factor loading of ≥ 0.55. We enrolled patients with cancer who were aged > 18 years, had received a pathological diagnosis of cancer, and had undergone cancer treatments such as surgery, chemotherapy, radiotherapy, or concurrent chemoradiotherapy at a single institute in Taiwan. Of the identified 167 eligible patients, 161 (96.4%) were approached. Of these patients, 6 (7.2%) declined to participate and 155 (92.8%) were interviewed. The initial 43 items in the TCRFCQ-V1.0 were assessed for ceiling and floor effects. The TCRFCQ-V1.0 is a reliable and valid instrument for measuring CRF cognition in Taiwanese patients with cancer.

  1. Patients' and physiotherapists' belief in and use of acupuncture for cancer-related symptoms.

    Science.gov (United States)

    Enblom, Anna

    2017-08-01

    It is important to investigate attitudes to acupuncture, because therapists' and patients' expectations may affect the treatment outcome. To explore the use of and belief in acupuncture among oncological physiotherapists and to explore patients' interest in receiving acupuncture during cancer therapy and their belief in its effectiveness. 522 patients (80% female, mean age 67 years) reported on their interest in receiving acupuncture for nausea during radiotherapy treatment; a subgroup (n=198) additionally disclosed their belief in the effectiveness of acupuncture. 117 Swedish oncological physiotherapists (96% female, mean age 48 years) answered a questionnaire regarding their use of and belief in acupuncture. Of the patients initiating cancer therapy, 359 (69%) were interested in receiving acupuncture. The patients believed acupuncture to be effective for pain (79%), nausea (79%) and vasomotor symptoms (48%). Of the 117 physiotherapists, 66 (56%) practised acupuncture. Physiotherapists generally believed in the effectiveness of acupuncture. For pain, 89% believed that acupuncture was effective and 42% of them practised it. Similar responses were noted for chemotherapy-induced nausea (86% and 38%, respectively) and vasomotor symptoms (80% and 28%, respectively). Younger physiotherapists and patients were more likely to believe in the effectiveness of acupuncture compared with older ones. More than two thirds of patients with cancer were interested in receiving acupuncture during therapy. Patients and oncological physiotherapists believed that acupuncture was effective for cancer pain, nausea and vasomotor symptoms. Further studies of acupuncture for cancer-related symptoms and of the effect of patients' and clinicians' therapeutic relationships, including treatment expectations, would be welcome. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise

  2. Effects on image quality of a 2D antiscatter grid in x-ray digital breast tomosynthesis: Initial experience using the dual modality (x-ray and molecular) breast tomosynthesis scanner

    Energy Technology Data Exchange (ETDEWEB)

    Patel, Tushita, E-mail: tp3rn@virginia.edu [Department of Physics, University of Virginia, Charlottesville, Virginia 22904 (United States); Peppard, Heather [Department of Radiology and Medical Imaging, University of Virginia, Charlottesville, Virginia 22908 (United States); Williams, Mark B. [Department of Physics, University of Virginia, Charlottesville, Virginia 22904 (United States); Department of Radiology and Medical Imaging, University of Virginia, Charlottesville, Virginia 22908 (United States); Department of Biomedical Engineering, University of Virginia, Charlottesville, Virginia 22908 (United States)

    2016-04-15

    Purpose: Radiation scattered from the breast in digital breast tomosynthesis (DBT) causes image degradation, including loss of contrast between cancerous and background tissue. Unlike in 2-dimensional (2D) mammography, an antiscatter grid cannot readily be used in DBT because changing alignment between the tube and detector during the scan would result in unacceptable loss of primary radiation. However, in the dual modality breast tomosynthesis (DMT) scanner, which combines DBT and molecular breast tomosynthesis, the tube and detector rotate around a common axis, thereby maintaining a fixed tube-detector alignment. This C-arm geometry raises the possibility of using a 2D (cellular) focused antiscatter grid. The purpose of this study is to assess change in image quality when using an antiscatter grid in the DBT portion of a DMT scan under conditions of fixed radiation dose. Methods: Two 2D focused prototype grids with 80 cm focal length were tested, one stack-laminated from copper (Cu) and one cast from a tungsten-polymer (W-poly). They were reciprocated using a motion scheme designed to maximize transmission of primary x-ray photons. Grid-in and grid-out scatter-to-primary ratios (SPRs) were measured for rectangular blocks of material simulating 30%, 50%, and 70% glandular tissue compositions. For assessment of changes in image quality through the addition of a grid, the Computerized Imaging Reference Systems, Inc., phantom Model 011A containing a set of 1 cm thick blocks simulating a range of glandular/adipose ratios from 0/100 to 100/0 was used. To simulate 6.5 and 8.5 cm thick compressed breasts, 1 cm thick slices of PMMA were added to the Model 011A phantom. DBT images were obtained with and without the grid, with exposure parameters fixed for a given compressed thickness. Signal-difference-to-noise ratios (SDNRs), contrast, and voxel value-based attenuation coefficients (μ) were measured for all blocks from reconstructed phantom images. Results: For 4, 6, and

  3. Chinese herbal medicine for cancer-related fatigue: a systematic review of randomized clinical trials.

    Science.gov (United States)

    Su, Chun-Xiang; Wang, Li-Qiong; Grant, Suzanne J; Liu, Jian-Ping

    2014-06-01

    To assess the effectiveness and safety of Chinese herbal medicine for the treatment of cancer-related fatigue. We systematically searched seven electronic databases and two trial registries for randomized clinical trials of Chinese herbal medicine for cancer-related fatigue. Two authors independently extracted data and assessed the methodological quality of the included trials using the Cochrane risk of bias tool. Data were synthesized using RevMan 5.2 software. A total of 10 trials involving 751 participants with cancer-related fatigue were identified and the methodological quality of the included trials was generally poor. Chinese herbal medicine used alone or in combination with chemotherapy or supportive care showed significant relief in cancer-related fatigue compared to placebo, chemotherapy or supportive care based on single trials. Chinese herbal medicine plus chemotherapy or supportive care was superior to chemotherapy or supportive care in improving quality of life. Data from one trial demonstrated Chinese herbal medicine exerted a greater beneficial effect on relieving anxiety but no difference in alleviating depression. Seven trials reported adverse events and no severe adverse effects were found in Chinese herbal medicine groups. The findings from limited number of trials suggest that Chinese herbal medicine seems to be effective and safe in the treatment of cancer-related fatigue. However, the current evidence is insufficient to draw a confirmative conclusion due to the poor methodological quality of included trials. Thus, conducting rigorously designed trials on potential Chinese herbal medicine is warranted. Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. Relationship between cancer-related fatigue and physical activity in inpatient cancer rehabilitation.

    Science.gov (United States)

    Kummer, Franziska; Catuogno, Silvio; Perseus, Josef M; Bloch, Wilhelm; Baumann, Freerk T

    2013-08-01

    Fatigue is a serious problem for the majority of patients with cancer. In this context, several studies have shown benefits of physical activity during and following treatment. However, uncertainties remain regarding the optimal type and duration of physical activity. Therefore, this study examined the relationship between cancer-related fatigue and physical activity in the course of inpatient rehabilitation. Fatigue (Multidimensional Fatigue Inventory) and physical activity (Freiburg Questionnaire of Physical Activity) were assessed in a consecutive series of 35 patients with cancer attending oncological inpatient rehabilitation during a six-month study period. The three-week rehabilitation program included daily exercise therapy consisting of aerobic endurance training, moderate resistance training, coordination exercises, relaxation training and individual physiotherapy. At discharge, a significant improvement in each dimension of cancer-related fatigue (p=0.001-0.003) and a significant increase of physical activity levels (p=0.001) were observed. A small, but significant negative correlation was found between cancer-related fatigue and the level of physical activity (R=-0.438, p=0.004). The largest effects were associated with a weekly energy expenditure of 3000 kcal through physical activity. The results support a non-linear dose-response relationship between cancer-related fatigue and physical activity. Since this is the first study providing specific exercise recommendations for an effective treatment of cancer-related fatigue in the context of inpatient rehabilitation, further research is required to validate the observed trends.

  5. BMI-1 Promotes Self-Renewal of Radio- and Temozolomide (TMZ)-Resistant Breast Cancer Cells.

    Science.gov (United States)

    Yan, Yanfang; Wang, Ying; Zhao, Pengxin; Ma, Weiyuan; Hu, Zhigang; Zhang, Kaili

    2017-12-01

    Breast cancer is a hormone-dependent malignancy and is the most prevalent cause of cancer-related mortality among females. Radiation therapy and chemotherapy are common treatments of breast cancer. However, tumor relapse and metastasis following therapy are major clinical challenges. The importance of B-lymphoma Moloney murine leukemia virus insertion region-1 (BMI-1) was implicated in cell proliferation, stem cell maintenance, and tumor initiation. We established radio- and temozolomide (TMZ)-resistant (IRC-R) MCF-7 and MDA-MB-231 cell lines to investigate the mechanism involved in therapeutic resistance. Cell proliferation and sphere number were dramatically elevated, and BMI-1 was remarkably upregulated, in IRC-R cells compared to parental cells. Silencing BMI-1 by RNA interference only affected the cell proliferation of IRC-R but not parental cells, suggesting the critical role of BMI-1 in radio- and TMZ resistance. We used a xenograft mice model to elucidate that BMI-1 was necessary in tumor development by assessing tumor volume and Ki67 expression. We found that Hedgehog (Hhg) signaling exerted synergized functions together with BMI-1, implicating the importance of BMI-1 in Hhg signaling. Downregulation of BMI-1 could be an effective strategy to suppress tumor growth, which supports the potential clinical use of targeting BMI-1 in breast cancer treatment.

  6. Sexual problems, communication patterns, and depressive symptoms in couples coping with metastatic breast cancer.

    Science.gov (United States)

    Milbury, Kathrin; Badr, Hoda

    2013-04-01

    The treatment of breast cancer tends to result in physical side effects (e.g., vaginal dryness, stomatitis, and atrophy) that can cause sexual problems. Although studies of early-stage breast cancer have demonstrated that sexual problems are associated with increased depressive symptoms for both patients and their partners, comparatively little is known about these associations in metastatic breast cancer (MBC) and how patients and partners cope together with sexual problems. We examined the links between sexual problems, depressive symptoms, and two types of spousal communication patterns (mutual constructive and demand-withdraw) in 191 couples in which the patient was initiating treatment for MBC. Patients and partners separately completed paper-and-pencil surveys. Multilevel models indicated that high levels of sexual problems were significantly associated with more depressive symptoms only for patients who reported low levels of mutual constructive communication (p sexual problems were associated with more depressive symptoms regardless of the communication pattern reported. These associations remained significant when we controlled for patients' reports of average pain and functional and physical well-being and couples' dyadic adjustment. Sexual problems were associated with depressive symptoms for both MBC patients and their partners. The way in which patients and partners talk with one another about cancer-related problems seems to influence this association for patients. MBC patients may benefit from programs that teach couples how to minimize demand-withdraw communication and instead openly and constructively discuss sexual issues and concerns. Copyright © 2012 John Wiley & Sons, Ltd.

  7. Findings from the Community Health Intervention Program in South Carolina: Implications for Reducing Cancer-Related Health Disparities

    Science.gov (United States)

    McCracken, James Lyndon; Friedman, Daniela B.; Brandt, Heather M.; Adams, Swann Arp; Xirasagar, Sudha; Ureda, John R.; Mayo, Rachel M.; Comer, Kimberly; Evans, Miriam; Fedrick, Delores; Talley, Jacqueline; Broderick, Madeline; Hebert, James R.

    2013-01-01

    BACKGROUND The South Carolina Cancer Prevention and Control Research Network (SC-CPCRN) implemented the Community Health Intervention Program (CHIP) mini-grants initiative to address cancer-related health disparities and reduce the cancer burden among high-risk populations across the state. The mini-grants project implemented evidence-based health interventions tailored to the specific needs of each community. OBJECTIVE To support the SC-CPCRN’s goals of moving toward greater dissemination and implementation of evidence-based programs in the community to improve public health, prevent disease, and reduce the cancer burden. METHODS Three community-based organizations were awarded $10,000 each to implement one of the National Cancer Institute’s evidence-based interventions. Each group had 12 months to complete their project. SC-CPCRN investigators and staff provided guidance, oversight, and technical assistance for each project. Grantees provided regular updates and reports to their SC-CPCRN liaisons to capture vital evaluation information. RESULTS The intended CHIP mini-grant target population reach was projected to be up to 880 participants combined. Actual combined reach of the three projects reported upon completion totaled 1,072 individuals. The majority of CHIP participants were African-American females. Participants ranged in age from 19 to 81 years. Evaluation results showed an increase in physical activity, dietary improvements, and screening participation. CONCLUSIONS The success of the initiative was the result of a strong community-university partnership built on trust. Active two-way communication and an honest open dialogue created an atmosphere for collaboration. Communities were highly motivated. All team members shared a common goal of reducing cancer-related health disparities and building greater public health capacity across the state. PMID:23645547

  8. Intraoperative radiotherapy as a protocol for the treatment of initial breast cancer; Radioterapia intraoperatoria como protocolo de tratamento do cancer de mama inicial

    Energy Technology Data Exchange (ETDEWEB)

    Bromberg, Silvio Eduardo; Hanriot, Rodrigo de Morais, E-mail: sbromberg@terra.com.br [Hospital Israelita Albert Einstein, Sao Paulo, SP (Brazil); Nazario, Afonso Celso Pinto [Universidade Federal de Sao Paulo (UNIFESP), SP (Brazil). Escola Paulista de Medicina

    2013-07-01

    To report on preliminary outcomes of single-dose intraoperative radiotherapy for early-stage breast cancer based on local recurrence rates and complications. Methods: fifty postmenopausal women with ≤2.5cm breast tumors and clinically normal axillary lymph nodes were submitted to quadrantectomy, sentinel lymph node biopsy and intraoperative radiotherapy and studied. Mean follow-up time was 52.1 months. Results: mean patient age was 65.5 years; mean tumor diameter was 1.41cm 82% of nodules were hormonal receptor positive and HER-2negative. All patients received a 21 Gy radiation dose for a mean time of 8.97 minutes. Distant metastases were not observed. Local recurrence was documented in three cases, with identical histological diagnosis as the primary tumors. Thirty-five (70%) patients had local fibrosis, with gradual improvement and complete resolution over 18 months. Postoperative infection and seroma formation were not observed. Conclusion: partial radiotherapy is a potentially feasible and promising technique. Careful patient selection is recommended before a longer follow-up period has elapsed to confirm intraoperative radiotherapy safety and efficacy. (author)

  9. Preoperative Computed Tomography-Guided Percutaneous Hookwire Localization of Metallic Marker Clips in the Breast with a Radial Approach: Initial Experience

    Energy Technology Data Exchange (ETDEWEB)

    Uematsu, T.; Kasami, M.; Uchida, Y.; Sanuki, J.; Kimura, K.; Tanaka, K.; Takahashi, K. [Dept. of Diagnostic Radiology, Dept. of Pathology, and Dept. of Breast Surgery, Shizuoka Cancer Center Hospital, Naga-izumi, Shizuoka (Japan)

    2007-07-15

    Background: Hookwire localization is the current standard technique for radiological marking of nonpalpable breast lesions. Stereotactic directional vacuum-assisted breast biopsy (SVAB) is of sufficient sensitivity and specificity to replace surgical biopsy. Wire localization for metallic marker clips placed after SVAB is needed. Purpose: To describe a method for performing computed tomography (CT)-guided hookwire localization using a radial approach for metallic marker clips placed percutaneously after SVAB. Material and Methods: Nineteen women scheduled for SVAB with marker-clip placement, CT-guided wire localization of marker clips, and, eventually, surgical excision were prospectively entered into the study. CT-guided wire localization was performed with a radial approach, followed by placement of a localizing marker-clip surgical excision. Feasibility and reliability of the procedure and the incidence of complications were examined. Results: CT-guided wire localization surgical excision was successfully performed in all 19 women without any complications. The mean total procedure time was 15 min. The median distance on CT image from marker clip to hookwire was 2 mm (range 0-3 mm). Conclusion: CT-guided preoperative hookwire localization with a radial approach for marker clips after SVAB is technically feasible.

  10. Factors distinguishing regular readers of breast cancer information in magazines.

    Science.gov (United States)

    Johnson, J D

    1997-01-01

    This study examined the differences between women who were regular and occasional readers of breast cancer information in magazines. Based on uses and gratifications theory and the Health Belief Model, women respondents (n = 366) were predicted to differentially expose themselves to information. A discriminant analysis showed that women who were regular readers reported greater fear, perceived vulnerability, general health concern, personal experience, and surveillance need for breast cancer-related information. The results are discussed in terms of the potential positive and negative consequences of regular exposure to breast cancer information in magazines.

  11. Breast pain

    Science.gov (United States)

    ... the level of of hormones during menstruation or pregnancy often cause breast pain. Some swelling and tenderness just before your period is normal. Some women who have pain in one or both breasts may fear breast cancer . However, breast pain is not a common symptom ...

  12. Induction of erythropoiesis by hypoxia-inducible factor prolyl hydroxylase inhibitors without promotion of tumor initiation, progression, or metastasis in a VEGF-sensitive model of spontaneous breast cancer

    Directory of Open Access Journals (Sweden)

    Seeley TW

    2017-03-01

    Full Text Available Todd W Seeley, Mark D Sternlicht, Stephen J Klaus, Thomas B Neff, David Y Liu Therapeutics R&D, FibroGen, Inc., San Francisco, CA, USA Abstract: The effects of pharmacological hypoxia-inducible factor (HIF stabilization were investigated in the MMTV-Neundl-YD5 (NeuYD mouse model of breast cancer. This study first confirmed the sensitivity of this model to increased vascular endothelial growth factor (VEGF, using bigenic NeuYD;MMTV-VEGF-25 mice. Tumor initiation was dramatically accelerated in bigenic animals. Bigenic tumors were also more aggressive, with shortened doubling times and increased lung metastasis as compared to NeuYD controls. In separate studies, NeuYD mice were treated three times weekly from 7 weeks of age until study end with two different HIF prolyl hydroxylase inhibitors (HIF-PHIs, FG-4497 or roxadustat (FG-4592. In NeuYD mice, HIF-PHI treatments elevated erythropoiesis markers, but no differences were detected in tumor onset or the phenotypes of established tumors. Keywords: cancer progression, erythropoiesis, hypoxia-inducible factor, hypoxia-inducible factor prolyl hydroxylase inhibitors, vascular endothelial growth factor, MMTV-Neu breast cancer model

  13. Initial Report of a Prospective Dosimetric and Clinical Feasibility Trial Demonstrates the Potential of Protons to Increase the Therapeutic Ratio in Breast Cancer Compared With Photons

    Energy Technology Data Exchange (ETDEWEB)

    Bradley, Julie A., E-mail: jbradley@floridaproton.org; Dagan, Roi; Ho, Meng Wei; Rutenberg, Michael; Morris, Christopher G.; Li, Zuofeng; Mendenhall, Nancy P.

    2016-05-01

    Purpose: To compare dosimetric endpoints between proton therapy (PT) and conventional radiation and determine the feasibility of PT for regional nodal irradiation (RNI) in women with breast cancer. Methods and Materials: From 2012 to 2014, 18 women (stage IIA-IIIB) requiring RNI prospectively enrolled on a pilot study. Median age was 51.8 years (range, 42-73 years). The cohort included breast-conserving therapy (BCT) and mastectomy patients and right- and left-sided cancers. Treatment targets and organs at risk were delineated on computed tomography scans, and PT and conventional plans were developed. Toxicity was prospectively recorded using Common Terminology Criteria for Adverse Events version 4.0. A Wilcoxon signed-rank sum test compared the dose-volume parameters. The primary endpoint was a reduction in cardiac V5. Results: Median follow-up was 20 months (range, 2-31 months). For all patients, the PT plan better met the dosimetric goals and was used for treatment. Proton therapy alone was used for 10 patients (9 postmastectomy, 1 after BCT) and combined proton–photon in 8 (6 BCT, 2 postmastectomy with immediate expander reconstruction). Proton therapy improved coverage of level 2 axilla (P=.0005). Adequate coverage of internal mammary nodes was consistently achieved with PT (median D95, 50.3 Gy; range, 46.6-52.1 Gy) but not with conventional radiation therapy (median D95, 48.2 Gy; range, 40.8-55 Gy; P=.0005). Median cardiac V5 was 0.6% with PT and 16.3% with conventional radiation (P<.0001). Median ipsilateral lung V5 and V20 were improved with PT (median V5 35.3% vs 60.5% [P<.0001]; and median V20, 21.6% vs 35.5% [P<.0001]). Grade 3 dermatitis developed in 4 patients (22%), which was the only grade 3 toxicity. No grade 4+ toxicities developed. Conclusion: Proton therapy for RNI after mastectomy or BCT significantly improves cardiac dose, especially for left-sided patients, and lung V5 and V20 in all patients without excessive acute toxicity

  14. Lapatinib in patients with metastatic breast cancer following initial treatment with trastuzumab: an economic analysis from the Brazilian public health care perspective

    Directory of Open Access Journals (Sweden)

    Machado M

    2012-11-01

    Full Text Available Marcio Machado,1 Thomas R Einarson21GlaxoSmithKline Brasil Ltd, Rio de Janeiro, Brazil; 2Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, CanadaObjective: To evaluate, from the perspective of the Brazilian public health care system, the cost-effectiveness of lapatinib plus capecitabine (LAP/CAP versus capecitabine alone (CAP or trastuzumab plus capecitabine (TRAST/CAP in the treatment of women with human epidermal growth factor receptor-2-positive metastatic breast cancer previously treated with trastuzumab.Methods: An economic model was developed to compare costs and clinical outcomes over a 5-year time horizon. Both costs and outcomes were discounted at a 5% rate, in accordance with Brazilian pharmacoeconomic guidelines. Clinical inputs were determined using indirect treatment comparisons. Costs were derived from public reimbursement databases and reported in 2010 Brazilian real (R$1 = USD$0.52. Clinical outcomes included progression-free survival years (PFYs, life-years (LYs and quality-adjusted life-years (QALYs. The economic outcome was the incremental cost per LY, PFY, or QALY gained. The impact of variations in individual inputs (eg, drug cost, drug effectiveness was examined using one-way sensitivity analyses. Overall model robustness was tested using probabilistic sensitivity analyses, varying the ranges of all input parameters within their standard distributions.Results: Expected cost per patient was R$41,195 for CAP, R$95,256 for LAP/CAP, and R$113,686 for TRAST/CAP. Respective LYs were 1.406, 1.695, and 1.465; PFYs were 0.473, 0.711, and 0.612; and QALYS were 0.769, 0.958, and 0.827. LAP/CAP dominated TRAST/CAP for all outcomes. Incremental cost-effectiveness ratios of LAP/CAP over CAP were R$186,563 for LYs, R$226,403 for PFYs, and R$284,864 for QALYs. Results remained unchanged in one-way sensitivity analyses. In probabilistic analyses, LAP/CAP was dominant over TRAST/CAP in 93.5% of simulations.Conclusion: LAP

  15. The symptom burden of cancer: Evidence for a core set of cancer-related and treatment-related symptoms from the Eastern Cooperative Oncology Group Symptom Outcomes and Practice Patterns study.

    Science.gov (United States)

    Cleeland, Charles S; Zhao, Fengmin; Chang, Victor T; Sloan, Jeff A; O'Mara, Ann M; Gilman, Paul B; Weiss, Matthias; Mendoza, Tito R; Lee, Ju-Whei; Fisch, Michael J

    2013-12-15

    A set of common cancer-related and treatment-related symptoms has been proposed for quality of care assessment and clinical research. Using data from a large, multicenter, prospective study, the authors assessed the effects of disease site and stage on the percentages of patients rating these proposed symptoms as moderate to severe. The severity of 13 symptoms proposed to represent "core" oncology symptoms was rated by 3106 ambulatory patients with cancer of the breast, prostate, colon/rectum, or lung, regardless of disease stage or phase of care; 2801 patients (90%) repeated the assessment 4 to 5 weeks later. At the time of the initial assessment, approximately 33% of the patients reported ≥ 3 symptoms in the moderate-to-severe range; 11 of the 13 symptoms were rated as moderate to severe by at least 10% of all patients and 6 were rated as moderate to severe by at least 20% of those receiving active treatment. Fatigue/tiredness was the most severe symptom, followed by disturbed sleep, pain, dry mouth, and numbness/tingling. More patients with lung cancer and patients receiving active treatment reported moderate to severe symptoms. Percentages of symptomatic patients increased by disease stage, less adequate response to therapy, and declining Eastern Cooperative Oncology Group performance status. The percentages of patients reporting moderate to severe symptoms were stable across both assessments. The results of the current study support a core set of moderate to severe symptoms that are common across outpatients with solid tumors, that can guide consideration of progression-free survival as a trial outcome, and that should be considered in clinical care and in assessments of quality of care and treatment benefit. © 2013 American Cancer Society.

  16. Adenoid cystic breast cancer.

    Science.gov (United States)

    McClenathan, James H; de la Roza, Gustavo

    2002-06-01

    Adenoid cystic carcinoma is a rare type of breast cancer that is generally reported in individual case reports or as series from major referral centers. To characterize early diagnostic criteria for adenoid cystic carcinoma and to determine whether breast-preserving surgery with radiotherapy is as effective as mastectomy for eradicating the disease, we reviewed clinical records of a large series of patients treated for adenoid cystic carcinoma of the breast at a large health maintenance organization (HMO) that includes primary care facilities and referral centers. Using the data bank of the Northern California Cancer Registry of the Kaiser Permanente Northern California Region (KPNCR), we retrospectively reviewed medical records of patients treated for adenoid cystic carcinoma of the breast. Follow-up also was done for these patients. Adenoid cystic carcinoma of the breast was diagnosed in 22 of 27,970 patients treated for breast cancer at KPNCR from 1960 through 2000. All 22 patients were female and were available for follow-up. Mean age of patients at diagnosis was 61 years (range, 37 to 94 years). In 17 (77%) of the women, a lump in the breast led to initial suspicion of a tumor; in 4 (23%) of the 22 patients, mammography led to suspicion of a tumor. Median tumor size was 20 mm. Pain was a prominent symptom. Surgical management evolved from radical and modified radical mastectomy to simple mastectomy or lumpectomy during the study period, during which time 1 patient died of previous ordinary ductal carcinoma of the contralateral breast, and 7 died of unrelated disease. At follow-up, 12 of the 13 remaining patients were free of disease; 1 patient died of the disease; and 1 patient remained alive despite late occurrence of lymph node and pulmonary metastases. Whether breast-preserving surgery with radiotherapy is as effective as mastectomy for treating adenoid cystic carcinoma of the breast has not been determined.

  17. [The PAM program for the early detection of breast cancer: the initial results (1987-1990). Programa de Detección Precoz de Alteraciones Mamarias].

    Science.gov (United States)

    Rodríguez Sarmiento, C; Plasencia Taradach, A; Ferrer Masip, F; Gómez Gómez, A

    1991-02-16

    We report the results of the PAM program for the early detection of breast cancer, carried out in Barcelona in females aged 50-70 years who were invited to participate by two personal letters. Out of 5435 invited females in the three years of the program, 37.2% responded to the first cycle and 70.8% to the second. The rate of detection of cancer was 6.9/1000 participating women in the first cycle. The validity of mammography was high, comparable to that from other countries. Sensitivity was 87.5%, specificity 99.1%, positive predictive value 45.2% and negative predictive value 99.9%. Letter would be insufficient as the only means of invitation to achieve a high participation rate in the first circle.

  18. Predicting response before initiation of neoadjuvant chemotherapy in breast cancer using new methods for the analysis of dynamic contrast enhanced MRI (DCE MRI) data

    Science.gov (United States)

    DeGrandchamp, Joseph B.; Whisenant, Jennifer G.; Arlinghaus, Lori R.; Abramson, V. G.; Yankeelov, Thomas E.; Cárdenas-Rodríguez, Julio

    2016-03-01

    The pharmacokinetic parameters derived from dynamic contrast enhanced (DCE) MRI have shown promise as biomarkers for tumor response to therapy. However, standard methods of analyzing DCE MRI data (Tofts model) require high temporal resolution, high signal-to-noise ratio (SNR), and the Arterial Input Function (AIF). Such models produce reliable biomarkers of response only when a therapy has a large effect on the parameters. We recently reported a method that solves the limitations, the Linear Reference Region Model (LRRM). Similar to other reference region models, the LRRM needs no AIF. Additionally, the LRRM is more accurate and precise than standard methods at low SNR and slow temporal resolution, suggesting LRRM-derived biomarkers could be better predictors. Here, the LRRM, Non-linear Reference Region Model (NRRM), Linear Tofts model (LTM), and Non-linear Tofts Model (NLTM) were used to estimate the RKtrans between muscle and tumor (or the Ktrans for Tofts) and the tumor kep,TOI for 39 breast cancer patients who received neoadjuvant chemotherapy (NAC). These parameters and the receptor statuses of each patient were used to construct cross-validated predictive models to classify patients as complete pathological responders (pCR) or non-complete pathological responders (non-pCR) to NAC. Model performance was evaluated using area under the ROC curve (AUC). The AUC for receptor status alone was 0.62, while the best performance using predictors from the LRRM, NRRM, LTM, and NLTM were AUCs of 0.79, 0.55, 0.60, and 0.59 respectively. This suggests that the LRRM can be used to predict response to NAC in breast cancer.

  19. Membrane-initiated estradiol signaling of epithelial-mesenchymal transition-associated mechanisms through regulation of tight junctions in human breast cancer cells.

    Science.gov (United States)

    Jiménez-Salazar, Javier E; Posadas-Rodríguez, Pedro; Lazzarini-Lechuga, Roberto C; Luna-López, Armando; Zentella-Dehesa, Alejandro; Gómez-Quiroz, Luis E; Königsberg, Mina; Domínguez-Gómez, Guadalupe; Damián-Matsumura, Pablo

    2014-06-01

    Tumor cells utilize inappropriate epithelial-mesenchymal transition (EMT) mechanisms during the invasive process. It is becoming increasingly clear that estradiol (E2) induces breast cancer cell progression and enhances EMT; however, the mechanisms associated with this are unclear. We investigated the role of E2 on the expression and intracellular localization of the tight junction (TJ)-associated proteins, zonula occluden 1 (ZO-1), ZO-1-associated nucleic acid binding (ZONAB), and occludin, on the activation of c-Src and human epidermal growth factor receptor 2 (HER2) expression and cellular migration in the estrogen receptor (ER)-positive breast cancer cell lines, MCF-7 and T47D. We demonstrated that 1 nM E2 elicits c-Src activation after 15 min. The p-Src/ZO-1 complex led to ZO-1 and ZONAB disruption at the TJ and increased expression of HER2 mRNAs. These changes correlate with decreased expression of the epithelial markers occludin and CRB3 and increased synthesis of N-cadherin. This led to increased MCF-7 cell migration induced by E2, even in the presence of a cell proliferation inhibitor. Incubation with ICI 182,780 (Fulvestrant), an ER antagonist, precluded the effects of E2 on c-Src phosphorylation, p-Src/ZO-1 complex formation, ZO-1/ZONAB nuclear translocation, and migration of MCF-7 cells. Our findings suggest that E2 promotes TJ disruption during tumor progression and increases cell motility. We propose a novel pathway where estrogens promote EMT-associated mechanisms that possibly lead to metastasis.

  20. Physiotherapy treatments for breast cancer-related lymphedema: a literature review Tratamientos fisioterapéuticos para el linfedema después de la cirugía de cáncer de seno: una revisión de literatura Tratamentos fisioterapêuticos para o linfedema pós-câncer de mama: uma revisão de literatura

    Directory of Open Access Journals (Sweden)

    Nara Fernanda Braz da Silva Leal

    2009-10-01

    Full Text Available Breast cancer is the second most frequent cancer among women. Surgery is part of the therapeutic process to prevent metastases, but it can also cause some complications, including lymphedema. Physiotherapy contributes to its treatment, using different techniques that have been developed over the years. This systematic literature review aims to present physiotherapy modalities applied for lymphedema therapy. The literature review was conducted using textbooks and Lilacs, Pubmed and Scielo databases, from 1951 to 2009. Physiotherapy resources used for lymphedema treatment include complex decongestive therapy (CDT, pneumatic compression (PC, high voltage electrical stimulation (HVES and laser therapy. The analyzed literature shows that better results are obtained with combined techniques. CDT is the most used protocol, and its association with PC has demonstrated efficacy. The new techniques HVES and laser present satisfactory results.El cáncer de seno es el segundo tipo de cáncer más común entre las mujeres. La cirugía es parte del proceso terapéutico en la prevención de la diseminación de la enfermedad, sin embargo, puede ser causa de algunas complicaciones como el linfedema. La fisioterapia contribuye para su tratamiento con diferentes técnicas que vienen siendo desarrolladas a lo largo de los años. El objetivo de esta revisión sistemática de la literatura es presentar las modalidades fisioterapéuticas aplicadas en el tratamiento del linfedema. La revisión bibliográfica fue efectuada en libros textos y en las bases de datos LILACS, PubMed y SciELO, en el período de 1951 a 2009. Entre los recursos fisioterapéuticos utilizados en el tratamiento del linfedema están la terapia compleja descongestiva (TCD, compresión neumática (CN, estimulación eléctrica de alto voltaje (EVA y láserterapia. Los trabajos analizados muestran que los resultados son mejores con las técnicas combinadas. La TCD es el protocolo más utilizado, y su

  1. Induction of erythropoiesis by hypoxia-inducible factor prolyl hydroxylase inhibitors without promotion of tumor initiation, progression, or metastasis in a VEGF-sensitive model of spontaneous breast cancer.

    Science.gov (United States)

    Seeley, Todd W; Sternlicht, Mark D; Klaus, Stephen J; Neff, Thomas B; Liu, David Y

    2017-01-01

    The effects of pharmacological hypoxia-inducible factor (HIF) stabilization were investigated in the MMTV-Neu(ndl)-YD5 (NeuYD) mouse model of breast cancer. This study first confirmed the sensitivity of this model to increased vascular endothelial growth factor (VEGF), using bigenic NeuYD;MMTV-VEGF-25 mice. Tumor initiation was dramatically accelerated in bigenic animals. Bigenic tumors were also more aggressive, with shortened doubling times and increased lung metastasis as compared to NeuYD controls. In separate studies, NeuYD mice were treated three times weekly from 7 weeks of age until study end with two different HIF prolyl hydroxylase inhibitors (HIF-PHIs), FG-4497 or roxadustat (FG-4592). In NeuYD mice, HIF-PHI treatments elevated erythropoiesis markers, but no differences were detected in tumor onset or the phenotypes of established tumors.

  2. A Survey of the Status of Awareness of Lymphedema in Breast Cancer Patients in Busan-Gyeongnam, Korea

    OpenAIRE

    Choi, Jong Kyoung; Kim, Hui Dong; Sim, Young Joo; Kim, Ghi Chan; Kim, Dong Kyu; Yu, Byeng Chul; Park, Si-Sung; Jeong, Ho Joong

    2015-01-01

    Objective To support the establishment of lymphedema education plans and the actual practice of education by investigating the current lymphedema awareness status of Korean breast cancer patients. Methods cross-sectional population survey was conducted in 116 breast cancer patients in the Busan-Gyeongnam area. The survey included questions regarding demographic characteristics, breast cancer-related lymphedema (BCRL) risk factors, and characteristics and treatments of the disease. Some of the...

  3. Luminal breast cancer metastasis is dependent on estrogen signaling

    NARCIS (Netherlands)

    Ganapathy, Vidya; Banach-Petrosky, Whitney; Xie, Wen; Kareddula, Aparna; Nienhuis, Hilde; Miles, Gregory; Reiss, Michael

    Luminal breast cancer is the most frequently encountered type of human breast cancer and accounts for half of all breast cancer deaths due to metastatic disease. We have developed new in vivo models of disseminated human luminal breast cancer that closely mimic the human disease. From initial

  4. Normal breast physiology: the reasons hormonal contraceptives and induced abortion increase breast-cancer risk.

    Science.gov (United States)

    Lanfranchi, Angela

    2014-01-01

    A woman gains protection from breast cancer by completing a full-term pregnancy. In utero, her offspring produce hormones that mature 85 percent of the mother's breast tissue into cancer-resistant breast tissue. If the pregnancy ends through an induced abortion or a premature birth before thirty-two weeks, the mother's breasts will have only partially matured, retaining even more cancer-susceptible breast tissue than when the pregnancy began. This increased amount of immature breast tissue will leave the mother with more sites for cancer initiation, thereby increasing her risk of breast cancer. Hormonal contraceptives increase breast-cancer risk by their proliferative effect on breast tissue and their direct carcinogenic effects on DNA. Hormonal contraceptives include estrogen-progestin combination drugs prescribed in any manner of delivery: orally, transdermally, vaginally, or intrauterine. This article provides the detailed physiology and data that elucidate the mechanisms through which induced abortion and hormonal contraceptives increase breast-cancer risk.

  5. Toxigenic Helicobacter pylori Infection Precedes Gastric Hypochlorhydria in Cancer Relatives, and H. pylori Virulence Evolves in These Families

    National Research Council Canada - National Science Library

    Richard H. Argent; Rachael J. Thomas; Francisco Aviles-Jimenez; Darren P. Letley; Marie C. Limb; Emad M. El-Omar; John C. Atherton

    2008-01-01

    .... We aimed to determine whether infection with virulent H. pylori preceeded precancerous gastric hypochlorhydria and atrophy in gastric cancer relatives and quantify the extent of virulence factor evolution...

  6. Advancing breast cancer survivorship among African-American women.

    Science.gov (United States)

    Coughlin, Steven S; Yoo, Wonsuk; Whitehead, Mary S; Smith, Selina A

    2015-09-01

    Advances have occurred in breast cancer survivorship but, for many African-American women, challenges and gaps in relevant information remain. This article identifies opportunities to address disparities in breast cancer survival and quality of life, and thereby to increase breast cancer survivorship among African-American women. For breast cancer survivors, common side effects, lasting for long periods after cancer treatment, include fatigue, loss of strength, difficulty sleeping, and sexual dysfunction. For addressing physical and mental health concerns, a variety of interventions have been evaluated, including exercise and weight training, dietary interventions, yoga and mindfulness-based stress reduction, and support groups or group therapy. Obesity has been associated with breast cancer recurrence and poorer survival. Relative to white survivors, African-American breast cancer survivors are more likely to be obese and less likely to engage in physical activity, although exercise improves overall quality of life and cancer-related fatigue. Considerable information exists about the effectiveness of such interventions for alleviating distress and improving quality of life among breast cancer survivors, but few studies have focused specifically on African-American women with a breast cancer diagnosis. Studies have identified a number of personal factors that are associated with resilience, increased quality of life, and positive adaptation to a breast cancer diagnosis. There is a need for a better understanding of breast cancer survivorship among African-American women. Additional evaluations of interventions for improving the quality of life and survival of African-American breast cancer survivors are desirable.

  7. Transcription profiles of non-immortalized breast cancer cell lines

    Directory of Open Access Journals (Sweden)

    Holland James F

    2006-04-01

    Full Text Available Abstract Background Searches for differentially expressed genes in tumours have made extensive use of array technology. Most samples have been obtained from tumour biopsies or from established tumour-derived cell lines. Here we compare cultures of non-immortalized breast cancer cells, normal non-immortalized breast cells and immortalized normal and breast cancer cells to identify which elements of a defined set of well-known cancer-related genes are differentially expressed. Methods Cultures of cells from pleural effusions or ascitic fluids from breast cancer patients (MSSMs were used in addition to commercially-available normal breast epithelial cells (HMECs, established breast cancer cell lines (T-est and established normal breast cells (N-est. The Atlas Human Cancer 1.2 cDNA expression array was employed. The data obtained were analysed using widely-available statistical and clustering software and further validated through real-time PCR. Results According to Significance Analysis of Microarray (SAM and AtlasImage software, 48 genes differed at least 2-fold in adjusted intensities between HMECs and MSSMs (p Conclusion The expression profiles of 1176 genes were determined in finite life-span cultures of metastatic breast cancer cells and of normal breast cells. Significant differences were detected between the finite life-span breast cancer cell cultures and the established breast cancer cell lines. These data suggest caution in extrapolating information from established lines for application to clinical cancer research.

  8. Advancing Breast Cancer Survivorship among African American Women

    Science.gov (United States)

    Coughlin, Steven S.; Yoo, Wonsuk; Whitehead, Mary S.; Smith, Selina A.

    2015-01-01

    Purpose Advances have occurred in breast cancer survivorship but, for many African American women, challenges and gaps in relevant information remain. Methods This article identifies opportunities to address disparities in breast cancer survival and quality of life, and thereby to increase breast cancer survivorship among African American women. Results For breast cancer survivors, common side effects, lasting for long periods after cancer treatment, include fatigue, loss of strength, difficulty sleeping, and sexual dysfunction. For addressing physical and mental health concerns, a variety of interventions have been evaluated, including exercise and weight training, dietary interventions, yoga and mindfulness-based stress reduction, and support groups or group therapy. Obesity has been associated with breast cancer recurrence and poorer survival. Relative to white survivors, African American breast cancer survivors are more likely to be obese and less likely to engage in physical activity, although exercise improves overall quality of life and cancer-related fatigue. Considerable information exists about the effectiveness of such interventions for alleviating distress and improving quality of life among breast cancer survivors, but few studies have focused specifically on African American women with a breast cancer diagnosis. Studies have identified a number of personal factors that are associated with resilience, increased quality of life, and positive adaptation to a breast cancer diagnosis. Conclusions There is a need for a better understanding of breast cancer survivorship among African American women. Additional evaluations of interventions for improving the quality of life and survival of African American breast cancer survivors are desirable. PMID:26303657

  9. Use and taxonomy of social media in cancer-related research: a systematic review

    National Research Council Canada - National Science Library

    Koskan, Alexis; Klasko, Lynne; Davis, Stacy N; Gwede, Clement K; Wells, Kristen J; Kumar, Ambuj; Lopez, Natalia; Meade, Cathy D

    2014-01-01

    Little is known about how social media are used in cancer care. We conducted a systematic review of the use and taxonomy of social media in cancer-related studies, in PubMed, Web of Knowledge, CINAHL, and Google Scholar...

  10. Maternal and Paternal Influences on Children's Coping with Cancer-Related Stress.

    Science.gov (United States)

    Monti, Jennifer D; Winning, Adrien; Watson, Kelly H; Williams, Ellen K; Gerhardt, Cynthia A; Compas, Bruce E; Vannatta, Kathryn

    2017-07-01

    Childhood cancer is a significant source of stress for children and families, and children's coping with cancer-related stress is a key predictor of emotional adjustment. To extend understanding of the determinants of children's coping with cancer-related stress, this study examined whether mothers' and fathers' functioning after their child's diagnosis-including coping and depressive symptoms-is predictive of children's coping over time. Participants included 166 children (Mage = 13.47, SD = 2.47, 51.2% female), 161 mothers, and 83 fathers. Approximately two months post-diagnosis (T1), parents reported on their coping and depressive symptoms. At T1 and approximately 12 months later (T2), children reported on their coping. Results indicated that mothers' coping and depressive symptoms were correlated with children's coping at T1; fathers' coping and depressive symptoms were generally not associated with children's coping at T1. Hierarchical regression analyses revealed that fathers' secondary control coping (i.e., coping aimed at adapting to cancer-related stress) predicted higher levels of secondary control coping in children over time. Mothers' depressive symptoms predicted lower levels of secondary control coping over time in girls, and fathers' depressive symptoms predicted lower levels of secondary control coping over time across sex. Parents' functioning after their child's cancer diagnosis may shape how children cope with cancer-related stress. Parents' coping and depressive symptoms may be important targets for interventions aiming to promote positive adjustment in children with cancer.

  11. Developing Interventions for Cancer-Related Cognitive Dysfunction in Childhood Cancer Survivors

    Science.gov (United States)

    Ullrich, Nicole J.; Whelen, Megan J.; Lange, Beverly J.

    2014-01-01

    Survivors of childhood cancer frequently experience cancer-related cognitive dysfunction, commonly months to years after treatment for pediatric brain tumors, acute lymphoblastic leukemia (ALL), or tumors involving the head and neck. Risk factors for cancer-related cognitive dysfunction include young age at diagnosis, treatment with cranial irradiation, use of parenteral or intrathecal methotrexate, female sex, and pre-existing comorbidities. Limiting use and reducing doses and volume of cranial irradiation while intensifying chemotherapy have improved survival and reduced the severity of cognitive dysfunction, especially in leukemia. Nonetheless, problems in core functional domains of attention, processing speed, working memory and visual-motor integration continue to compromise quality of life and performance. We review the epidemiology, pathophysiology and assessment of cancer-related cognitive dysfunction, the impact of treatment changes for prevention, and the broad strategies for educational and pharmacological interventions to remediate established cognitive dysfunction following childhood cancer. The increased years of life saved after childhood cancer warrants continued study toward the prevention and remediation of cancer-related cognitive dysfunction, using uniform assessments anchored in functional outcomes. PMID:25080574

  12. Cancer-related loneliness mediates the relationships between social constraints and symptoms among cancer patients.

    Science.gov (United States)

    Adams, Rebecca N; Mosher, Catherine E; Winger, Joseph G; Abonour, Rafat; Kroenke, Kurt

    2017-10-05

    Cancer patients have high rates of persistent and disabling symptoms. Evidence suggests that social constraints (e.g., avoidance and criticism) negatively impact symptoms, but pathways linking these variables have yet to be identified. This study examined whether cancer-related loneliness (i.e., feeling socially disconnected related to having cancer) mediated the relationships between social constraints and symptoms (i.e., pain interference, fatigue, sleep disturbance, and cognitive complaints) in patients with various cancers (N = 182). Patients (51% female, mean age = 59) were recruited from the Indiana Cancer Registry and completed questionnaires assessing social constraints, cancer-related loneliness, and symptoms. Structural equation modeling was used to evaluate the hypothesized relationships among variables. The model demonstrated good fit. Consistent with our hypothesis, cancer-related loneliness mediated the relationships between social constraints and each symptom. Findings suggest that addressing cancer-related loneliness in symptom management interventions may mitigate the negative impact of social constraints on outcomes.

  13. Use of Geriatric Assessment Tools in Selecting Therapies in Women Aged ≥70 Years With Hormone Receptor-Positive Early-Stage Breast Cancer: Preliminary Experience With a Quality Improvement Initiative.

    Science.gov (United States)

    Wright, Jean L; Parekh, Arti; Pollock, Yao Yao; Schoenborn, Nancy; Smith, Karen L; Magnant, Colette; Stearns, Vered

    2017-07-15

    To develop a multidisciplinary algorithmic approach to management of women aged ≥70 years with clinically staged T1N0 hormone receptor-positive breast cancer, including geriatric assessments predicting life expectancy and the likelihood of functional decline in the near future, in the context of a program-wide quality improvement initiative, to better select patients for therapeutic interventions. Two geriatric assessment tools, the Combined Lee-Schonberg Index and the Vulnerable Elderly Scale, were introduced into our clinical workflow to predict long-term mortality and likelihood of functional decline. Scores from these tools, along with patient preferences and clinical features, were incorporated into a preoperative algorithm addressing the use of sentinel lymph node biopsy (SLNB), and a postoperative algorithm addressing the use of adjuvant radiation therapy (RT). The algorithms were approved for use in August 2015. Twenty-four patients were identified by in-clinic screening and have been managed using the algorithms as a guide. Mean patient age was 80 years (range, 71-89 years). Per the preoperative algorithm, consideration of omission of SLNB was an option in 11 of 24 patients (46%), and in total 18 of 24 (75%) opted against SLNB. Per the postsurgical algorithm, consideration of omission of adjuvant RT was an option for 19 of 24 patients (79%), and in total 17 of 24 (71%) opted to forego RT. Incorporation of simple geriatric assessments seems to have had a marked impact on decision making regarding both surgical and adjuvant therapies for women aged ≥70 years with early-stage hormone-positive breast cancer compared with historical patterns, with ≥71% omission of both SLNB and adjuvant RT in patients managed according to an institutional quality improvement initiative. Copyright © 2017. Published by Elsevier Inc.

  14. Estadiamento inicial dos casos de câncer de mama e colo do útero em mulheres brasileiras Initial staging of breast and cervical cancer in Brazilian women

    Directory of Open Access Journals (Sweden)

    Luiz Claudio Santos Thuler

    2005-11-01

    nas regiões onde estes hospitais estão localizados houve melhora na detecção precoce destes tipos de câncer.PURPOSE: to analyze time trends in the clinical staging at the moment of diagnosis in patients with breast and cervix cancer based on data produced by the Brazilian Public Health System (SUS. METHODS: in the first part of this study we identified the published documents describing clinical staging of patients at the moment of diagnosis. Considering their scarcity and poor representativity we conducted the second part of this study through an active search for information. A form was sent via regular mail to all cancer centers in the country (n=173 requesting information about the tumor site and stage at diagnosis by year, in the period of 1995-2002. The statistical analysis was performed using the "R" statistical package. The results are reported as percentage and boxplots. RESULTS: in the first part of the study (1990-1994 we described data from 18 hospitals concerning 7,458 patients with breast cancer and 7,216 patients with cervix cancer. The median of the percentage of cancers diagnosed at an advanced stage (stages III or IV was 52.6 and 56.8%, respectively. In the second part of the study (1995-2002 data were collected from 89 cancer hospitals and 7 chemotherapy or radiotherapy clinics. There was a total of 43,442 cases of breast cancer and 29,263 of cervix cancer. The response rate based on the potential contact list was 55%. The median percentage of patients in advanced stage was 45.3% for breast cancer and 42.5% for cervix cancer. CONCLUSIONS: few studies have examined the time trends in staging of cancer at diagnosis in Brazilian hospitals. Data obtained from Hospital Cancer Registries showed that in the last decade there was a reduction in the percentage of cervix and breast cancer at the advanced stage. This reduction can be due to an improvement in early detection of these cancers.

  15. Do Cancer-Related Beliefs Influence the Severity, Incidence, and Persistence of Psychological Symptoms?

    Science.gov (United States)

    Desautels, Caroline; Trudel-Fitzgerald, Claudia; Ruel, Sophie; Ivers, Hans; Savard, Josée

    Previous studies have suggested that negative beliefs about cancer may impair patients' psychological well-being, but only a few of these studies focused on specific psychological symptoms, and many were cross-sectional. The aim of this study was to investigate longitudinally the relationship of cancer-related cognitions with the severity, incidence, and persistence of anxiety, fear of cancer recurrence, depression, and insomnia symptoms during an 18-month period. Patients scheduled to undergo surgery for cancer (N = 962) completed a questionnaire assessing cancer-related cognitions at baseline (T1), the Hospital Anxiety and Depression Scale, the severity subscale of the Fear of Cancer Recurrence Inventory, and the Insomnia Severity Index at baseline (T1) and 2 (T2), 6 (T3), 10 (T4), 14 (T5), and 18 (T6) months later. Group × time factorial analyses using mixed models revealed that participants endorsing more negative cancer-related cognitions consistently reported more severe symptoms throughout the 18-month period. Logistic regression analyses suggested that endorsing more negative cancer-related cognitions at T1 significantly increased incidence and persistence rates of clinical levels of psychological symptoms. These findings suggest that the endorsement of negative cancer-related beliefs at the perioperative period influences the longitudinal evolution of anxiety, fear of cancer recurrence, depression, and insomnia symptoms in the following months. These results highlight the relevance of using cognitive restructuring early during the cancer care trajectory to potentially revise erroneous beliefs about cancer and prevent the incidence and persistence of psychological disturbances over time.

  16. Breast feeding and risk of breast cancer in young women. United Kingdom National Case-Control Study Group.

    Science.gov (United States)

    1993-01-01

    OBJECTIVE--To investigate whether breast feeding is related to subsequent risk of breast cancer. DESIGN--Population based case-control study designed primarily to investigate the relation between oral contraceptives and risk of breast cancer; data obtained from questionnaires administered by interviewers, general practitioner notes, and family planning clinic records. SETTING--11 health regions in Britain. SUBJECTS--Women diagnosed with breast cancer before age 36 living in the defined study areas. One control per case, matched for age, was selected from the list of the case's general practitioner. 755 case-control pairs were interviewed. MAIN OUTCOME MEASURES--Duration of breast feeding each liveborn infant; timing of return of menses; hormone use; other risk factors for breast cancer. RESULTS--Risk of breast cancer fell with increasing duration of breast feeding (relative risk = 0.94 per three months' breast feeding; test for trend p = 0.026) and with number of babies breast fed (relative risk = 0.86; test for trend, p = 0.017). Breast feeding each baby for longer than three months conferred no additional benefit. Breast feeding was more strongly negatively associated with risk of breast cancer than duration of postpartum amenorrhoea (chi 2 test for trend, p = 0.69). Hormonal suppression of lactation was unrelated to risk of breast cancer (relative risk = 0.96 per episode of suppressed lactation; test for trend, p = 0.72). CONCLUSIONS--These results suggest that breast feeding protects against the development of breast cancer in young women. PMID:8343660

  17. DC-SCRIPT is a novel regulator of the tumor suppressor gene CDKN2B and induces cell cycle arrest in ERα-positive breast cancer cells

    NARCIS (Netherlands)

    M. Ansems (Marleen); J.N. Søndergaard (Jonas Nørskov); A.M. Sieuwerts (Anieta); M.W.G. Looman (Maaike W. G.); M. Smid (Marcel); A.M.A. de Graaf (Annemarie M. A.); V. de Weerd (Vanja); M. Zuidscherwoude (Malou); J.A. Foekens (John); J.W.M. Martens (John); G.J. Adema (Gosse J.)

    2015-01-01

    textabstractBreast cancer is one of the most common causes of cancer-related deaths in women. The estrogen receptor (ERα) is well known for having growth promoting effects in breast cancer. Recently, we have identified DC-SCRIPT (ZNF366) as a co-suppressor of ERα and as a strong and independent

  18. DC-SCRIPT is a novel regulator of the tumor suppressor gene CDKN2B and induces cell cycle arrest in ERalpha-positive breast cancer cells

    NARCIS (Netherlands)

    Ansems, M.; Sondergaard, J.N.; Sieuwerts, A.M.; Looman, M.W.G.; Smid, M.; Graaf, A.M.A. de; Weerd, V. de; Zuidscherwoude, M.; Foekens, J.A.; Martens, J.W.; Adema, G.J.

    2015-01-01

    Breast cancer is one of the most common causes of cancer-related deaths in women. The estrogen receptor (ERalpha) is well known for having growth promoting effects in breast cancer. Recently, we have identified DC-SCRIPT (ZNF366) as a co-suppressor of ERalpha and as a strong and independent

  19. A Standard Set of Value-Based Patient-Centered Outcomes for Breast Cancer: The International Consortium for Health Outcomes Measurement (ICHOM) Initiative.

    Science.gov (United States)

    Ong, Wee Loon; Schouwenburg, Maartje G; van Bommel, Annelotte C M; Stowell, Caleb; Allison, Kim H; Benn, Karen E; Browne, John P; Cooter, Rodney D; Delaney, Geoff P; Duhoux, Francois P; Ganz, Patricia A; Hancock, Patricia; Jagsi, Reshma; Knaul, Felicia M; Knip, Anne M; Koppert, Linetta B; Kuerer, Henry M; McLaughin, Sarah; Mureau, Marc A M; Partridge, Ann H; Reid, Dereesa Purtell; Sheeran, Lisa; Smith, Thomas J; Stoutjesdijk, Mark J; Vrancken Peeters, Marie Jeanne T F D; Wengström, Yvonne; Yip, Cheng-Har; Saunders, Christobel

    2017-05-01

    A major challenge in value-based health care is the lack of standardized health outcomes measurements, hindering optimal monitoring and comparison of the quality of health care across different settings globally. The International Consortium for Health Outcomes Measurement (ICHOM) assembled a multidisciplinary international working group, comprised of 26 health care providers and patient advocates, to develop a standard set of value-based patient-centered outcomes for breast cancer (BC). The working group convened via 8 teleconferences and completed a follow-up survey after each meeting. A modified 2-round Delphi method was used to achieve consensus on the outcomes and case-mix variables to be included. Patient focus group meetings (8 early or metastatic BC patients) and online anonymized surveys of 1225 multinational BC patients and survivors were also conducted to obtain patients' input. The standard set encompasses survival and cancer control, and disutility of care (eg, acute treatment complications) outcomes, to be collected through administrative data and/or clinical records. A combination of multiple patient-reported outcomes measurement (PROM) tools is recommended to capture long-term degree of health outcomes. Selected case-mix factors were recommended to be collected at baseline. The ICHOM will endeavor to achieve wide buy-in of this set and facilitate its implementation in routine clinical practice in various settings and institutions worldwide.

  20. Anti-MUC1 nano-aptamers for triple-negative breast cancer imaging by single-photon emission computed tomography in inducted animals: initial considerations.

    Science.gov (United States)

    Santos do Carmo, Fagner; Ricci-Junior, Eduardo; Cerqueira-Coutinho, Cristal; Albernaz, Marta de Souza; Bernardes, Emerson Soares; Missailidis, Sotiris; Santos-Oliveira, Ralph

    The early and specific detection of tumors remains a barrier in oncology, especially in cases such as the triple-negative breast cancer (TNBC). To address this gap, aptamers have found an important application in the recognition of tumor biomarkers such as mucin 1 (MUC1). However, there are still some difficulties in the use of aptamer, as their rapid biological clearance makes their use as drugs limited. In this study, the anti-MUC1 aptamer was used as a drug delivery system (DDS) for a radioactive polymeric nanoparticle (NP) in the imaging of TNBCs. Thus, poly(lactic-co-glycolic acid) NPs loaded with the anti-MUC1 aptamer and labeled with technetium-99m were used for a biodistribution study and imaging of TNBC. The results confirmed that the NP was successfully obtained, with a mean size of 262 nm, according to the dynamic light scattering data. The biodistribution assay in induced animal models with TNBC showed that although there was a high capture by intestine (>30%), the DDS developed had a high tumor uptake (5%) and with great in vivo imaging properties, corroborating the possibility of use of this DDS as an imaging drug for TNBC.

  1. Development and initial evaluation of a telephone-delivered, behavioral activation, and problem-solving treatment program to address functional goals of breast cancer survivors.

    Science.gov (United States)

    Lyons, Kathleen D; Hull, Jay G; Kaufman, Peter A; Li, Zhongze; Seville, Janette L; Ahles, Tim A; Kornblith, Alice B; Hegel, Mark T

    2015-01-01

    The purpose of this research was to develop and pilot test an intervention to optimize functional recovery for breast cancer survivors. Over two studies, 31 women enrolled in a goal-setting program via telephone. All eligible women enrolled (37% of those screened) and 66% completed all study activities. Completers were highly satisfied with the intervention, using it to address, on average, four different challenging activities. The longitudinal analysis showed a main effect of time for overall quality of life (F(5, 43.1) = 5.1, p = 0.001) and improvements in active coping (F (3, 31.7) = 4.9, p = 0.007), planning (F (3, 36.0) = 4.1, p = 0.01), reframing (F (3, 29.3) = 8.5, p < 0.001), and decreases in self-blame (F (3,31.6) = 4.3, p = 0.01). The intervention is feasible and warrants further study to determine its efficacy in fostering recovery and maximizing activity engagement after cancer treatment.

  2. Rates and determinants of early initiation of breastfeeding and exclusive breast feeding at 42 days postnatal in six low and middle-income countries: A prospective cohort study.

    Science.gov (United States)

    Patel, Archana; Bucher, Sherri; Pusdekar, Yamini; Esamai, Fabian; Krebs, Nancy F; Goudar, Shivaprasad S; Chomba, Elwyn; Garces, Ana; Pasha, Omrana; Saleem, Sarah; Kodkany, Bhalachandra S; Liechty, Edward A; Kodkany, Bhala; Derman, Richard J; Carlo, Waldemar A; Hambidge, K; Goldenberg, Robert L; Althabe, Fernando; Berrueta, Mabel; Moore, Janet L; McClure, Elizabeth M; Koso-Thomas, Marion; Hibberd, Patricia L

    2015-01-01

    Early initiation of breastfeeding after birth and exclusive breastfeeding through six months of age confers many health benefits for infants; both are crucial high impact, low-cost interventions. However, determining accurate global rates of these crucial activities has been challenging. We use population-based data to describe: (1) rates of early initiation of breastfeeding (defined as within 1 hour of birth) and of exclusive breastfeeding at 42 days post-partum; and (2) factors associated with failure to initiate early breastfeeding and exclusive breastfeeding at 42 days post-partum. Prospectively collected data from women and their live-born infants enrolled in the Global Network's Maternal and Newborn Health Registry between January 1, 2010-December 31, 2013 included women-infant dyads in 106 geographic areas (clusters) at 7 research sites in 6 countries (Kenya, Zambia, India [2 sites], Pakistan, Argentina and Guatemala). Rates and risk factors for failure to initiate early breastfeeding were investigated for the entire cohort and rates and risk factors for failure to maintain exclusive breastfeeding was assessed in a sub-sample studied at 42 days post-partum. A total of 255,495 live-born women-infant dyads were included in the study. Rates and determinants for the exclusive breastfeeding sub-study at 42 days post-partum were assessed from among a sub-sample of 105,563 subjects. Although there was heterogeneity by site, and early initiation of breastfeeding after delivery was high, the Pakistan site had the lowest rates of early initiation of breastfeeding. The Pakistan site also had the highest rate of lack of exclusive breastfeeding at 42 days post-partum. Across all regions, factors associated with failure to initiate early breastfeeding included nulliparity, caesarean section, low birth weight, resuscitation with bag and mask, and failure to place baby on the mother's chest after delivery. Factors associated with failure to achieve exclusive breastfeeding

  3. Women with inoperable or locally advanced breast cancer -- what characterizes them?

    DEFF Research Database (Denmark)

    El-Charnoubi, Waseem Asim Ghulam; Svendsen, Jesper Brink; Tange, Ulla Brix

    2012-01-01

    Breast cancer is the most common cancer among Danish women. Locally advanced breast cancer occurs in a relatively large proportion of all new primary breast cancer diagnoses and for unexplained reasons 20-30% of women with breast cancer wait more than eight weeks from the initial breast cancer...

  4. Body image mediates the effect of cancer-related stigmatization on depression: A new target for intervention.

    Science.gov (United States)

    Esser, Peter; Mehnert, Anja; Johansen, Christoffer; Hornemann, Beate; Dietz, Andreas; Ernst, Jochen

    2018-01-01

    Because cancer-related stigmatization is prevalent but difficult to change, research on its impact on psychological burden and respective intervening variables is needed. Therefore, we investigated the effect of stigmatization on depressive symptomatology and whether body image mediates this relationship. This bicentric study assessed patients of 4 major tumor entities. We measured stigmatization (SIS-D), depressive symptomatology (PHQ-9), and body image (FKB-20). Applying multiple mediator analyses, we calculated the total effect of stigmatization on depressive symptomatology and the indirect effects exerted via the 2 body image scales rejecting body evaluation and vital body dynamics. Among the 858 cancer patients recruited (breast: n = 297; prostate: n = 268; colorectal: n = 168; lung: n = 125), stigmatization showed total effects on depressive symptomatology across all stigma dimensions (all p total sample  < .001). Except for lung cancer patients, this result was replicated for each cancer group. Body image as a whole was shown to mediate the effect across all samples (γ total sample  = .04, 95%-CI: 0.03-0.06). Among the total sample and prostate cancer patients, the mediating effect of rejecting body evaluation was significantly larger than the effect of vital body dynamics (d total sample  = .02, 95%-CI: 0.01-0.04). Perceived stigmatization is an important and generalizable risk factor for depressive symptomatology among cancer patients. Apart from interventions addressing stigmatization, improving body image could additionally help to reduce the psychological burden in stigmatized patients. Copyright © 2017 John Wiley & Sons, Ltd.

  5. Breast Gangrene

    Directory of Open Access Journals (Sweden)

    Husasin Irfan

    2011-08-01

    Full Text Available Abstract Background Breast gangrene is rare in surgical practice. Gangrene of breast can be idiopathic or secondary to some causative factor. Antibiotics and debridement are used for management. Acute inflammatory infiltrate, severe necrosis of breast tissue, necrotizing arteritis, and venous thrombosis is observed on histopathology. The aim of was to study patients who had breast gangrene. Methods A prospective study of 10 patients who had breast gangrene over a period of 6 years were analyzed Results All the patients in the study group were female. Total of 10 patients were encountered who had breast gangrene. Six patients presented with breast gangrene on the right breast whereas four had on left breast. Out of 10 patients, three had breast abscess after teeth bite followed by gangrene, one had iatrogenic trauma by needle aspiration of erythematous area of breast under septic conditions. Four had history of application of belladonna on cutaneous breast abscess and had then gangrene. All were lactating female. Amongst the rest two were elderly, one of which was a diabetic who had gangrene of breast and had no application of belladonna. All except one had debridement under cover of broad spectrum antibiotics. Three patients had grafting to cover the raw area. Conclusion Breast gangrene occurs rarely. Etiology is variable and mutifactorial. Teeth bite while lactation and the iatrogenic trauma by needle aspiration of breast abscess under unsterlised conditions could be causative. Uncontrolled diabetes can be one more causative factor for the breast gangrene. Belladonna application as a topical agent could be inciting factor. Sometimes gangrene of breast can be idiopathic. Treatment is antibiotics and debridement.

  6. Targeting Breast Cancer Recurrence via Hedgehog-mediated Sensitization of Breast Cancer Stem Cells

    Science.gov (United States)

    2011-07-01

    defective quiescence is a predisposing factor for breast cancer . Under normal conditions, nulliparous MMTV-myc have a very low incidence of... parity in this model. Such a finding would implicate control of quiescence in breast cancer initiation and would further suggest that mammary stem...AD_________________ Award Number: W81XWH-10-1-0430 TITLE: Targeting Breast Cancer Recurrence via

  7. Modern surgical management of breast cancer therapy related upper limb and breast lymphoedema.

    Science.gov (United States)

    Leung, Nelson; Furniss, Dominic; Giele, Henk

    2015-04-01

    Breast cancer is the commonest cancer in the UK. Advances in breast cancer treatment means that the sequelae of treatment are affecting more women and for a longer duration. Lymphoedema is one such sequela, with wide-ranging implications, from serious functional and psychological effects at the individual level to wider economic burdens to society. Breast cancer-related lymphoedema is principally managed by conservative therapy comprising compression garments and manual decongestive massage. This approach is effective for early stages of lymphoedema, but it is not curative and the effectiveness depends on patient compliance. Early surgical approaches were ablative, gave significant morbidity and hence, reserved for the most severe cases of refractory lymphoedema. However, recent non-ablative reconstructive surgical approaches have seen a revival of interest in the prevention or surgical management of breast cancer-related lymphoedema. This review examines the modern surgical techniques for the treatment of breast cancer-related lymphoedema. Liposuction reduces the volume and symptoms of lymphedema, but requires continual compressive therapy to avoid recurrence. Lymphatic reconstruction or bypass techniques including lymph node transfer (inguinal nodes are transferred to the affected limb), lymphatico-lymphatic bypass (lymphatics bypass the axilla using a lymph vessel graft reconstructing lymphatic flow from arm to neck) and lymphaticovenous anastomoses (lymphatics in the arm are joined to the venous system aiding lymph drainage) show promise in reducing lymphedema significantly. Further research is required, including into the role of primary lymphaticovenous anastomoses in the prevention of lymphedema at the time of axillary dissection. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  8. Combined low initial DNA damage and high radiation-induced apoptosis confers clinical resistance to long-term toxicity in breast cancer patients treated with high-dose radiotherapy

    Directory of Open Access Journals (Sweden)

    Bordón Elisa

    2011-06-01

    Full Text Available Abstract Background Either higher levels of initial DNA damage or lower levels of radiation-induced apoptosis in peripheral blood lymphocytes have been associated to increased risk for develop late radiation-induced toxicity. It has been recently published that these two predictive tests are inversely related. The aim of the present study was to investigate the combined role of both tests in relation to clinical radiation-induced toxicity in a set of breast cancer patients treated with high dose hyperfractionated radical radiotherapy. Methods Peripheral blood lymphocytes were taken from 26 consecutive patients with locally advanced breast carcinoma treated with high-dose hyperfractioned radical radiotherapy. Acute and late cutaneous and subcutaneous toxicity was evaluated using the Radiation Therapy Oncology Group morbidity scoring schema. The mean follow-up of survivors (n = 13 was 197.23 months. Radiosensitivity of lymphocytes was quantified as the initial number of DNA double-strand breaks induced per Gy and per DNA unit (200 Mbp. Radiation-induced apoptosis (RIA at 1, 2 and 8 Gy was measured by flow cytometry using annexin V/propidium iodide. Results Mean DSB/Gy/DNA unit obtained was 1.70 ± 0.83 (range 0.63-4.08; median, 1.46. Radiation-induced apoptosis increased with radiation dose (median 12.36, 17.79 and 24.83 for 1, 2, and 8 Gy respectively. We observed that those "expected resistant patients" (DSB values lower than 1.78 DSB/Gy per 200 Mbp and RIA values over 9.58, 14.40 or 24.83 for 1, 2 and 8 Gy respectively were at low risk of suffer severe subcutaneous late toxicity (HR 0.223, 95%CI 0.073-0.678, P = 0.008; HR 0.206, 95%CI 0.063-0.677, P = 0.009; HR 0.239, 95%CI 0.062-0.929, P = 0.039, for RIA at 1, 2 and 8 Gy respectively in multivariate analysis. Conclusions A radiation-resistant profile is proposed, where those patients who presented lower levels of initial DNA damage and higher levels of radiation induced apoptosis were at low

  9. What do Omani Women know about Breast Cancer Symptoms?

    Science.gov (United States)

    Renganathan, Lakshmi; Ramasubramaniam, Shanthi; Al-Touby, Salem; Seshan, Vidya; Al-Balushi, Amal; Al-Amri, Warda; Al-Nasseri, Yusra; Al-Rawahi, Yuthar

    2014-11-01

    Breast cancer is one of the most common cancers and a leading cause of cancer-related mortality in women worldwide. Studies to detect the awareness of breast cancer among Arab women are few and point to a lack of breast cancer knowledge among females. Early detection of breast cancer plays a leading role in reducing mortality rates and improving prognosis. This study aims to assess the knowledge and awareness of breast cancer symptoms among Omani women. A descriptive, cross-sectional survey design was carried out in Muscat, Oman. The study was conducted at three health centers and three shopping malls using convenience sampling. A total of 369 women consented to be part of the study and completed a questionnaire. Responses to the questionnaire were summed to give an overall knowledge score. Descriptive statistics were used to summarize the data, which was also analyzed statistically. Among the total number of women 68 (19%) were calculated to have poor knowledge, 219 (59%) had average knowledge, 77 (21%) had good knowledge, and five (1%) had excellent knowledge on breast cancer. Among the variables, education status (p=0.002, p<0.050), and family history of breast cancer (p =0.000, p<0.010) was significantly related to a higher knowledge level. The study revealed that there was lack of awareness and knowledge on breast cancer symptoms among Omani women. Breast cancer awareness and early detection through regular breast screening is important to reduce the mortality and morbidity of the disease.

  10. Breast Tomosynthesis

    Science.gov (United States)

    ... cancers when they are most curable and breast-conservation therapies are available. See the Mammography page for ... special platform and gradually compressed with a clear plastic paddle. Breast compression is necessary during tomosynthesis imaging ...

  11. Breast Exam

    Science.gov (United States)

    ... 210:314. Mac Bride MB, et al. The evolution of the breast self-examination to breast awareness. ... of these materials may be reprinted for noncommercial personal use only. "Mayo," "Mayo Clinic," "MayoClinic.org," "Mayo ...

  12. Breast cancer

    Science.gov (United States)

    ... help you not feel alone. Outlook (Prognosis) New, improved treatments are helping people with breast cancer live ... carcinoma in situ Patient Instructions Breast radiation - discharge Chemotherapy - what to ask your doctor Lymphedema - self-care ...

  13. An exploratory study of host polymorphisms in genes that clinically characterize breast cancer tumors and pretreatment cognitive performance in breast cancer survivors

    Directory of Open Access Journals (Sweden)

    Koleck TA

    2017-03-01

    Full Text Available Theresa A Koleck,1,2 Catherine M Bender,1 Beth Z Clark,3,4 Christopher M Ryan,5,6 Puja Ghotkar,1 Adam Brufsky,4,7,8 Priscilla F McAuliffe,4,8,9 Priya Rastogi,4,7 Susan M Sereika,1,10,11 Yvette P Conley,1,12 1School of Nursing, University of Pittsburgh, Pittsburgh, PA, 2School of Nursing, Columbia University, New York, NY, 3Division of Gynecologic Pathology, Magee-Womens Hospital of University of Pittsburgh Medical Center (UPMC, 4School of Medicine, 5Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, 6Department of Psychiatry, University of California San Francisco, San Francisco, CA, 7Division of Hematology/Oncology, Magee-Womens Hospital of UPMC, 8University of Pittsburgh Cancer Institute, 9Division of Breast Surgical Oncology, Magee-Womens Hospital of UPMC, 10Department of Biostatistics, 11Department of Epidemiology, 12Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA Purpose: Inspired by the hypothesis that heterogeneity in the biology of breast cancers at the cellular level may account for cognitive dysfunction symptom variability in survivors, the current study explored relationships between host single-nucleotide polymorphisms (SNPs in 25 breast cancer-related candidate genes (AURKA, BAG1, BCL2, BIRC5, CCNB1, CD68, CENPA, CMC2, CTSL2, DIAPH3, ERBB2, ESR1, GRB7, GSTM1, MELK, MKI67, MMP11, MYBL2, NDC80, ORC6, PGR, RACGAP1, RFC4, RRM2, and SCUBE2, identified from clinically relevant prognostic multigene-expression profiles for breast cancer, and pretreatment cognitive performance.Patients and methods: The sample (n=220 was comprised of 138 postmenopausal women newly diagnosed with early stage breast cancer and 82 postmenopausal age- and education-matched healthy controls without breast cancer. Cognitive performance was assessed after primary surgery but prior to initiation of adjuvant chemotherapy and/or hormonal therapy using a comprehensive battery of

  14. Body image dissatisfaction in patients undergoing breast reconstruction: Examining the roles of breast symmetry and appearance investment.

    Science.gov (United States)

    Teo, Irene; Reece, Gregory P; Huang, Sheng-Cheng; Mahajan, Kanika; Andon, Johnny; Khanal, Pujjal; Sun, Clement; Nicklaus, Krista; Merchant, Fatima; Markey, Mia K; Fingeret, Michelle Cororve

    2017-11-19

    Reconstruction as part of treatment for breast cancer is aimed at mitigating body image concerns after mastectomy. Although algorithms have been developed to objectively assess breast reconstruction outcomes, associations between objectively quantified breast aesthetic appearance and patient-reported body image outcomes have not been examined. Further, the role of appearance investment in explaining a patient's body image is not well understood. We investigated the extent to which objectively quantified breast symmetry and patient-reported appearance investment were associated with body image dissatisfaction in patients undergoing cancer-related breast reconstruction. Breast cancer patients in different stages of reconstruction (n = 190) completed self-report measures of appearance investment and body image dissatisfaction. Vertical extent and horizontal extent symmetry values, which are indicators of breast symmetry, were calculated from clinical photographs. Associations among breast symmetry, appearance investment, body image dissatisfaction, and patient clinical factors were examined. Multi-variable regression was used to evaluate the extent to which symmetry and appearance investment were associated with body image dissatisfaction. Vertical extent symmetry, but not horizontal extent symmetry, was associated with body image dissatisfaction. Decreased vertical extent symmetry (β = -.19, P < .05) and increased appearance investment (β = .45, P < .001) were significantly associated with greater body image dissatisfaction while controlling for clinical factors. Breast symmetry and patient appearance investment both significantly contribute to an understanding of patient-reported body image satisfaction during breast reconstruction treatment. Copyright © 2017 John Wiley & Sons, Ltd.

  15. Cancer-related venous thromboembolic disease: current management and areas of uncertainty.

    Science.gov (United States)

    Radhakrishna, G; Berridge, D

    2012-01-01

    The relationship between cancer and venothromboembolic events is a complex, multifactorial process which is still not fully understood and therefore the use of current generic guidelines may be inadequate. Current management of cancer-related VTE may be suboptimal because of the lack of cancer-specific studies into the role of primary prophylaxis in both ambulant and non-ambulant cancer patients. Further research into developing cancer-specific risk assessment tools and the choice, dose and duration of prophylaxis is required. The management of confirmed symptomatic VTE in cancer patients is outlined but certain controversies remain. Areas for further research include the management of asymptomatic unsuspected VTE events, recurrent VTE events on treatment and the role of IVC filters and other treatment options are required. This paper attempts to cover some of the recent developments and areas of uncertainty surrounding the management of cancer-related VTE.

  16. Metastatic breast carcinoma uncovered in an otherwise unremarkable “random colon biopsy”

    Directory of Open Access Journals (Sweden)

    Mike Black

    2016-06-01

    Full Text Available Breast cancer is one of the most devastating cancers afflicting women, being a main cause of cancer related death. Approximately 50% of these patients have developed regional or distant metastases at the time of diagnosis; hence, an early diagnosis and surgery with indicated neoadjuvant therapy are crucial in eradicating this disease and improving patient survival. A significant percentage of patients, even after initial satisfactory tumor removal, still face the threat of metastatic diseases which could plague a wide spectrum of body sites such as bones, lungs, central nervous system, liver and gastrointestinal tract (mostly upper gastrointestinal locations. Colonic and anorectal involvement by metastatic breast cancer has been less frequently reported in disseminated diseases. Typically, metastatic disease presents as a mass, enteric stenosis, or obstruction. Rare cases, however, may not form an endoscopically or radiologically recognizable lesion, and thus could be overlooked. Here we report a unique case of random colon biopsies in a patient presenting with epigastric pain, whose stomach biopsy showed Helicobacter pylori-associated chronic active gastritis. No colonoscopic lesion was present; however, microscopic examination of the “random biopsy” revealed scattered single and small clusters of tumor cells involving the lamina propria of the colonic mucosa, morphologically and immunophenotypically consistent with metastatic disease from breast carcinoma. The clinical presentation and histopathology of the case were reviewed and compared with limited cases reported in the literature. We conclude that high levels of suspicion and alertness are essential to identify occult microscopic gastrointestinal metastatic breast cancer in the absence of a grossly appreciable lesion.

  17. A window-of-opportunity biomarker study of etodolac in resectable breast cancer

    Science.gov (United States)

    Schwab, Richard B; Kato, Shumei; Crain, Brian; Pu, Minya; Messer, Karen; Weidner, Noel; Blair, Sarah L; Wallace, Anne M; Carson, Dennis A; Parker, Barbara A

    2015-01-01

    Observational data show that nonsteroidal anti-inflammatory drug (NSAID) use is associated with a lower rate of breast cancer. We evaluated the effect of etodolac, an FDA-approved NSAID reported to inhibit cyclooxygenase (COX) enzymes and the retinoid X receptor alpha (RXR), on rationally identified potential biomarkers in breast cancer. Patients with resectable breast cancer planned for initial management with surgical resection were enrolled and took 400 mg of etodolac twice daily prior to surgery. Protein and gene expression levels for genes related to COX-2 and RXRα were evaluated in tumor samples from before and after etodolac exposure. Thirty subjects received etodolac and 17 subjects were assayed as contemporaneous or opportunistic controls. After etodolac exposure mean cyclin D1 protein levels, assayed by immunohistochemistry, decreased (P = 0.03). Notably, pre- versus post cyclin D1 gene expression change went from positive to negative with greater duration of etodolac exposure (r = −0.64, P = 0.01). Additionally, etodolac exposure was associated with a significant increase in COX-2 gene expression levels (fold change: 3.25 [95% CI: 1.9, 5.55]) and a trend toward increased β-catenin expression (fold change: 2.03 [95% CI: 0.93, 4.47]). In resectable breast cancer relatively brief exposure to the NSAID etodolac was associated with reduced cyclin D1 protein levels. Effect was also observed on cyclin D1 gene expression with decreasing levels with longer durations of drug exposure. Increased COX-2 gene expression was seen, possibly due to compensatory feedback. These data highlight the utility of even small clinical trials with access to biospecimens for pharmacodynamic studies. PMID:26275572

  18. Breast Cancer

    Science.gov (United States)

    Breast cancer affects one in eight women during their lives. No one knows why some women get breast cancer, but there are many risk factors. Risks that ... who have family members with breast or ovarian cancer may wish to be tested for the genes. ...

  19. Intolerance of uncertainty, cognitive complaints, and cancer-related distress in prostate cancer survivors.

    Science.gov (United States)

    Eisenberg, Stacy A; Kurita, Keiko; Taylor-Ford, Megan; Agus, David B; Gross, Mitchell E; Meyerowitz, Beth E

    2015-02-01

    Prostate cancer survivors have reported cognitive complaints following treatment, and these difficulties may be associated with survivors' ongoing cancer-related distress. Intolerance of uncertainty may exacerbate this hypothesized relationship by predisposing individuals to approach uncertain situations such as cancer survivorship in an inflexible and negative manner. We investigated whether greater cognitive complaints and higher intolerance of uncertainty would interact in their relation to more cancer-related distress symptoms. This cross-sectional, questionnaire-based study included 67 prostate cancer survivors who were 3 to 5 years post treatment. Hierarchical multiple regression analyses tested the extent to which intolerance of uncertainty, cognitive complaints, and their interaction were associated with cancer-related distress (measured with the Impact of Event Scale-Revised; IES-R) after adjusting for age, education, physical symptoms, and fear of cancer recurrence. Intolerance of uncertainty was positively associated with the IES-R avoidance and hyperarousal subscales. More cognitive complaints were associated with higher scores on the IES-R hyperarousal subscale. The interaction of intolerance of uncertainty and cognitive complaints was significantly associated with IES-R intrusion, such that greater cognitive complaints were associated with greater intrusive thoughts in survivors high in intolerance of uncertainty but not those low in it. Prostate cancer survivors who report cognitive difficulties or who find uncertainty uncomfortable and unacceptable may be at greater risk for cancer-related distress, even 3 to 5 years after completing treatment. It may be beneficial to address both cognitive complaints and intolerance of uncertainty in psychosocial interventions. Copyright © 2014 John Wiley & Sons, Ltd.

  20. Identification of Novel Thyroid Cancer-Related Genes and Chemicals Using Shortest Path Algorithm

    OpenAIRE

    Yang Jiang; Peiwei Zhang; Li-Peng Li; Yi-Chun He; Ru-jian Gao; Yu-Fei Gao

    2015-01-01

    Thyroid cancer is a typical endocrine malignancy. In the past three decades, the continued growth of its incidence has made it urgent to design effective treatments to treat this disease. To this end, it is necessary to uncover the mechanism underlying this disease. Identification of thyroid cancer-related genes and chemicals is helpful to understand the mechanism of thyroid cancer. In this study, we generalized some previous methods to discover both disease genes and chemicals. The method wa...

  1. Gender differences in associations between cancer-related problems and relationship dissolution among cancer survivors.

    Science.gov (United States)

    Stephens, Cristina; Westmaas, J Lee; Kim, Jihye; Cannady, Rachel; Stein, Kevin

    2016-10-01

    Research suggests that a cancer diagnosis predicts marital dissolution more strongly for women survivors than men, but there is a paucity of research on potential processes underlying this vulnerability. The present cross-sectional study examined whether specific cancer-related problems were associated with the odds of relationship breakup following diagnosis and whether these relationships differed between male and female cancer survivors. A national cross-sectional quality of life study assessed self-reported cancer-related problems and relationship change among survivors who were either 2, 6, or 10 years post-diagnosis (n = 6099). Bivariate analyses indicated that cancer-related problems (e.g., emotional distress) were greater for divorced/separated survivors compared to those with intact relationships and were greater for women versus men. Logistic regressions indicated that for both male and female survivors, lower income, younger age, and longer time since diagnosis were associated with greater odds of divorce or separation after diagnosis (ORs > 2.14, p emotional distress (OR = 1.14, p separation. For men only, fear of cancer recurrence was associated with greater odds of divorce or separation (OR = 1.32, p emotional or financial/employment problems attributed to the cancer diagnosis were associated with the likelihood of reporting relationship dissolution. Although directions of causality could not be ascertained, results suggest the possibility that helping male and female cancer survivors cope with specific cancer-related problems may benefit the quality and stability of their relationships with significant others following diagnosis.

  2. Monitoring Neutrophil-Expressed Cell Surface Esophageal Cancer Related Gene-4 after Severe Burn Injury.

    Science.gov (United States)

    Costantini, Todd W; Coimbra, Raul; Lopez, Nicole E; Lee, Jeanne G; Potenza, Bruce; Smith, Alan; Baird, Andrew; Eliceiri, Brian P

    2015-12-01

    We identified recently esophageal cancer related gene-4 (ECRG4) as a candidate cytokine that is expressed on the surface of quiescent polymorphonuclear leukocytes (PMNs) and shed in response to ex vivo treatment with lipopolysaccharide. To investigate the potential biologic relevance of changes in cell surface ECRG4 in human samples, we performed a pilot study to examine a population of burn patients in whom blood could be analyzed prospectively. We hypothesized that cutaneous burn injury would alter cell surface expression of ECRG4 on PMNs. Patients admitted with more than 20% total burn surface area (TBSA) (n = 10) had blood collected at the time of admission and weekly thereafter. For comparison, blood was obtained from a control group of healthy human volunteers (n = 4). We used flow cytometry to measure changes in ECRG4(+) PMNs from patients during recovery from injury. Esophageal cancer related gene-4 expression at each time point was compared with the patient's clinical status based on a Multiple Organ Dysfunction (MOD) score. Esophageal cancer related gene-4 was detected on the PMN surface of cells collected from healthy volunteers, however, within 48 h of admission after burn injury (n = 10 patients), the number of PMNs with cell surface ECRG4 was decreased. Esophageal cancer related gene-4 expression in PMNs was re-established over the course of patient recovery, unless complications occurred. In this case, the decrease in cell surface ECRG4(+) PMNs preceded the clinical diagnosis of infectious complications and was reflected by increased organ injury scores. From a small sample set, we were able to determine that PMN cell surface ECRG4 expression was decreased after burn injury and returned to baseline during recovery from injury. Although larger studies are needed to define the role of ECRG4 in human PMNs further, this report is the first assessment of cell surface ECRG4 protein in a patient population to support analogous findings in

  3. Lung cancer patients frequently visit the emergency room for cancer-related and -unrelated issues

    OpenAIRE

    KOTAJIMA, FUTOSHI; KOBAYASHI, KUNIHIKO; SAKAGUCHI, HIROZO; NEMOTO, MANABU

    2014-01-01

    Lung cancer patients visit the emergency room (ER) for cancer-related and -unrelated reasons more often compared to patients with other types of cancer. This results in increased admissions and deaths in the ER. In this study, we retrospectively reviewed the characteristics of lung cancer patients visiting the ER in order to optimize the utilization of emergency medical services and improve the patients’ quality of life. Lung cancer patients visiting the ER of a single institution over a 2-ye...

  4. Determinants of general practitioner's cancer-related gut feelings?a prospective cohort study

    OpenAIRE

    Donker, G? A; Wiersma, Eva; van der Hoek, Lucas; Heins, Marianne

    2016-01-01

    Background: General practitioners (GPs) use gut feelings to diagnose cancer in an early stage, but little is known about its impact. Method: Prospective cohort study of patients in 44 general practices throughout the Netherlands, from January 2010 until December 2013. GPs completed a questionnaire regarding gut feelings, patient and GP characteristics, if they noticed a cancer-related gut feeling during patient consultation. Follow-up questionnaires were sent 3 months later requesting informa...

  5. cGMP signaling as a target for the prevention and treatment of breast cancer.

    Science.gov (United States)

    Windham, Perrin F; Tinsley, Heather N

    2015-04-01

    One in eight women in the United States will be diagnosed with invasive breast cancer in her lifetime. Advances in therapeutic strategies, diagnosis, and improved awareness have resulted in a significant reduction in breast cancer related mortality. However, there is a continued need for more effective and less toxic drugs for both the prevention and the treatment of breast cancer in order to see a continued decline in the morbidity and mortality associated with this disease. Recent studies suggest that the cGMP signaling pathway may be aberrantly regulated in breast cancer. As such, this pathway may serve as a source of novel targets for future breast cancer drug discovery efforts. This review provides an overview of cGMP signaling in normal physiology and in breast cancer as well as current strategies being investigated for targeting this pathway in breast cancer. Copyright © 2014 Elsevier Ltd. All rights reserved.

  6. Single-cell analysis reveals a stem-cell program in human metastatic breast cancer cells

    Science.gov (United States)

    Lawson, Devon A.; Bhakta, Nirav R.; Kessenbrock, Kai; Prummel, Karin D.; Yu, Ying; Takai, Ken; Zhou, Alicia; Eyob, Henok; Balakrishnan, Sanjeev; Wang, Chih-Yang; Yaswen, Paul; Goga, Andrei; Werb, Zena

    2015-01-01

    Despite major advances in understanding the molecular and genetic basis of cancer, metastasis remains the cause of >90% of cancer-related mortality1. Understanding metastasis initiation and progression is critical to developing new therapeutic strategies to treat and prevent metastatic disease. Prevailing theories hypothesize that metastases are seeded by rare tumour cells with unique properties, which may function like stem cells in their ability to initiate and propagate metastatic tumours2–5. However, the identity of metastasis-initiating cells in human breast cancer remains elusive, and whether metastases are hierarchically organized is unknown2. Here we show at the single-cell level that early stage metastatic cells possess a distinct stem-like gene expression signature. To identify and isolate metastatic cells from patient-derived xenograft models of human breast cancer, we developed a highly sensitive fluorescence-activated cell sorting (FACS)-based assay, which allowed us to enumerate metastatic cells in mouse peripheral tissues. We compared gene signatures in metastatic cells from tissues with low versus high metastatic burden. Metastatic cells from low-burden tissues were distinct owing to their increased expression of stem cell, epithelial-to-mesenchymal transition, pro-survival, and dormancy-associated genes. By contrast, metastatic cells from high-burden tissues were similar to primary tumour cells, which were more heterogeneous and expressed higher levels of luminal differentiation genes. Transplantation of stem-like metastatic cells from low-burden tissues showed that they have considerable tumour-initiating capacity, and can differentiate to produce luminal-like cancer cells. Progression to high metastatic burden was associated with increased proliferation and MYC expression, which could be attenuated by treatment with cyclin-dependent kinase (CDK) inhibitors. These findings support a hierarchical model for metastasis, in which metastases are

  7. Cancer-related Traumatic Stress Reactions in Siblings of Children with Cancer

    Science.gov (United States)

    Kaplan, Lynne M.; Kaal, K. Julia; Bradley, Lauren; Alderfer, Melissa A.

    2013-01-01

    Objective To explore cancer-related posttraumatic stress (PTS) reactions in siblings of children with cancer including prevalence, common symptoms, comorbidity with anxiety and depression, and gender and age-related patterns. Method A total of 125 children (63 females) between the ages of 8 and 17 (M = 12.4; SD = 2.9 years) with a brother or sister with cancer, diagnosed 4 to 38 months prior to the study (M = 1.3 years; SD = 6.7 months), completed the Child PTSD Symptom Scale (CPSS), Revised Children's Manifest Anxiety Scale, and Child Depression Inventory-Short Form. Results Over half of the sample (60%) scored in the moderate to severe range for PTS and 22% fulfilled full criteria for PTSD based upon CPSS responses. Nearly 75% reported “Feeling upset when you think about or hear about the cancer,” and “Trying not to think about, talk about, or have feelings about the cancer.” Over 60% reported arousal symptoms. PTS symptoms reportedly interfered with functioning for 75% of the sample and co-occurred with anxiety and depressive symptoms. Gender and age-related patterns were not found. Conclusions Siblings of children with cancer experience cancer-related PTS reactions and greater attention should be paid to ameliorating their cancer-related distress with empirically-based treatments. PMID:23795631

  8. Cancer-Related Stress and Complementary and Alternative Medicine: A Review

    Directory of Open Access Journals (Sweden)

    Kavita D. Chandwani

    2012-01-01

    Full Text Available A cancer diagnosis elicits strong psychophysiological reactions that characterize stress. Stress is experienced by all patients but is usually not discussed during patient-healthcare professional interaction; thus underdiagnosed, very few are referred to support services. The prevalence of CAM use in patients with history of cancer is growing. The purpose of the paper is to review the aspects of cancer-related stress and interventions of commonly used complementary and alternative techniques/products for amelioration of cancer-related stress. Feasibility of intervention of several CAM techniques and products commonly used by cancer patients and survivors has been established in some cancer populations. Efficacy of some CAM techniques and products in reducing stress has been documented as well as stress-related symptoms in patients with cancer such as mindfulness-based stress reduction, yoga, Tai Chi Chuan, acupuncture, energy-based techniques, and physical activity. Much of the research limitations include small study samples and variety of intervention length and content. Efficacy and safety of many CAM techniques and some herbs and vitamin B and D supplements need to be confirmed in further studies using scientific methodology. Several complementary and alternative medicine therapies could be integrated into standard cancer care to ameliorate cancer-related stress.

  9. Cancer Communication on Social Media: Examining How Cancer Caregivers Use Facebook for Cancer-Related Communication.

    Science.gov (United States)

    Gage-Bouchard, Elizabeth A; LaValley, Susan; Mollica, Michelle; Beaupin, Lynda Kwon

    Americans are increasingly using social media (such as Facebook, YouTube, and Twitter) for health-related communication. Much of the previous research on social media and health communication has focused on Facebook groups related to a specific disease or Facebook pages related to an advocacy organization. Less is known about how people communicate about cancer on personal Facebook pages. In this study, we expand upon previous research by examining how cancer caregivers use personal Facebook pages for cancer-related communication. We examined themes in cancer-related exchanges through a content analysis of 12 months of data from 18 publically available Facebook pages hosted by parents of children with acute lymphoblastic leukemia (15 852 total posts). Six themes emerged: (1) documenting the cancer journey, (2) sharing emotional strain associated with caregiving, (3) promoting awareness and advocacy about pediatric cancer, (4) fundraising, (5) mobilizing support, and (6) expressing gratitude for support. Building upon previous research documenting the increasing use of social media for health-related communication and support, our findings show that personal Facebook pages offer a platform for cancer caregivers to share their cancer-related experiences, promote advocacy and awareness, and mobilize social support. Providers must recognize the importance of social media as a vehicle for support and communication for families of children with cancer. Nurses should educate parents on how to appraise information obtained through Facebook using evidence-based guidelines. Providers can encourage caregivers to use Facebook as a tool for communication, information, and support.

  10. High-Density and Very-Low-Density Lipoprotein Have Opposing Roles in Regulating Tumor-Initiating Cells and Sensitivity to Radiation in Inflammatory Breast Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Wolfe, Adam R. [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Atkinson, Rachel L. [Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Reddy, Jay P. [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Debeb, Bisrat G.; Larson, Richard; Li, Li [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Department of Clinical Cancer Prevention, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Masuda, Hiroko; Brewer, Takae [Department of Clinical Cancer Prevention, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Atkinson, Bradley J. [Department of Clinical Pharmacy Services, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Brewster, Abeena [Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Ueno, Naoto T. [Department of Clinical Cancer Prevention, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Woodward, Wendy A., E-mail: wwoodward@mdanderson.org [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Department of Clinical Cancer Prevention, University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

    2015-04-01

    Purpose: We previously demonstrated that cholesterol-lowering agents regulate radiation sensitivity of inflammatory breast cancer (IBC) cell lines in vitro and are associated with less radiation resistance among IBC patients who undergo postmastectomy radiation. We hypothesized that decreasing IBC cellular cholesterol induced by treatment with lipoproteins would increase radiation sensitivity. Here, we examined the impact of specific transporters of cholesterol (ie lipoproteins) on the responses of IBC cells to self-renewal and to radiation in vitro and on clinical outcomes in IBC patients. Methods and Materials: Two patient-derived IBC cell lines, SUM 149 and KPL4, were incubated with low-density lipoproteins (LDL), very-low-density lipoproteins (VLDL), or high-density lipoproteins (HDL) for 24 hours prior to irradiation (0-6 Gy) and mammosphere formation assay. Cholesterol panels were examined in a cohort of patients with primary IBC diagnosed between 1995 and 2011 at MD Anderson Cancer Center. Lipoprotein levels were then correlated to patient outcome, using the log rank statistical model, and examined in multivariate analysis using Cox regression. Results: VLDL increased and HDL decreased mammosphere formation compared to untreated SUM 149 and KPL4 cells. Survival curves showed enhancement of survival in both of the IBC cell lines when pretreated with VLDL and, conversely, radiation sensitization in all cell lines when pretreated with HDL. In IBC patients, higher VLDL values (>30 mg/dL) predicted a lower 5-year overall survival rate than normal values (hazard ratio [HR] = 1.9 [95% confidence interval [CI]: 1.05-3.45], P=.035). Lower-than-normal patient HDL values (<60 mg/dL) predicted a lower 5-year overall survival rate than values higher than 60 mg/dL (HR = 3.21 [95% CI: 1.25-8.27], P=.015). Conclusions: This study discovered a relationship among the plasma levels of lipoproteins, overall patient response, and radiation resistance in IBC patients

  11. Early initiation of breast feeding but not bottle feeding increase exclusive breastfeeding practice among less than six months infant in Indonesia

    Directory of Open Access Journals (Sweden)

    Suparmi Suparmi

    2016-07-01

    Full Text Available Abstrak Latar belakang: Pemberian asi eksklusif merupakan salah satu upaya dalam menurunkan kematian bayi dan neonatal. Namun, prevalensi asi eksklusif di Indonesia masih rendah. Penelitian ini bertujuan untuk menilai hubungan inisiasi menyusu dini dan penggunaan botol/dot dengan praktek asi eksklusif pada bayi di bawah usia 6 bulan di Indonesia. Metode: Penelitian ini menggunakan data Riset Kesehatan Dasar (Riskesdas tahun 2013. Sub-sampel adalah bayi dibawah usia 6 bulan. Dari 7226 bayi dibawah usia 6 bulan, 6397 memiliki data yang lengkap untuk dilakukan analisis. Analisis dilakukan dengan regresi Cox. Hasil: Dari 6397 responden, 44% mendapatkan asi eksklusif. Inisiasi menyusu dini, penggunaan botol, pelayanan kesehatan pasca persalinan, tempat tinggal dan status sosial ekonomi berhubungan dengan praktek pemberian asi eksklusif. Anak yang mendapat inisiasi menyusu dini 66% lebih besar kemungkinan untuk memperoleh asi eksklusif bila dibandingkan dengan anak yang tidak memperoleh inisiasi menyusu dini [risiko relatif suaian (RRa = 1,66; 95% interval kepercayaan (CI: 1,45 – 1,90]. Anak yang menggunakan dot/kempeng memiliki kemungkinan 71% lebih rendah untuk asi eksklusif bila dibandingkan dengan anak yang tidak menggunakan dot/kempeng (RRa = 0,29; 95% CI: 0,25 – 0,34. Kesimpulan: Inisiasi menyusu dini dapat meningkatkan pemberian asi eksklusif, sedangkan penggunaan dot dapat menurunkan praktek pemberian asi eksklusif. (Health Science Journal of Indonesia 2016;7:44-8 Kata kunci: asi eksklusif, inisiasi menyusu dini, dot  Abstract Background: Exclusive breastfeeding is a intervention to reduce neonatal and infant mortality. However,the prevalence of exclusive breastfeeding in Indonesia remains low. The aim of the study was identify the association of early initiation and bottle-feeding with exclusive breastfeeding practice among infant less than six month in Indonesia. Methods: This study was a part of Basic Health Research (RISKESDAS 2013

  12. Interrelationships of Prenatal and Postnatal Growth, Hormones, Diet, and Breast Cancer

    Science.gov (United States)

    2006-03-01

    infants to investigate the association between maternal age, diet, preeclampsia , and infant birth weight, and hormone levels using the infants’ cord...was restricted to parous women, which prevented us from assessing whether the induced abortion and breast cancer relation was stronger among...and 38 controls had a first-degree family history of breast cancer preventing us from assessing its’ role as an effect modifier. In summary, our study

  13. Carcinogenic Air Toxics Exposure and Their Cancer-Related Health Impacts in the United States.

    Science.gov (United States)

    Zhou, Ying; Li, Chaoyang; Huijbregts, Mark A J; Mumtaz, M Moiz

    2015-01-01

    Public health protection from air pollution can be achieved more effectively by shifting from a single-pollutant approach to a multi-pollutant approach. To develop such multi-pollutant approaches, identifying which air pollutants are present most frequently is essential. This study aims to determine the frequently found carcinogenic air toxics or hazardous air pollutants (HAPs) combinations across the United States as well as to analyze the health impacts of developing cancer due to exposure to these HAPs. To identify the most commonly found carcinogenic air toxics combinations, we first identified HAPs with cancer risk greater than one in a million in more than 5% of the census tracts across the United States, based on the National-Scale Air Toxics Assessment (NATA) by the U.S. EPA for year 2005. We then calculated the frequencies of their two-component (binary), and three-component (ternary) combinations. To quantify the cancer-related health impacts, we focused on the 10 most frequently found HAPs with national average cancer risk greater than one in a million. Their cancer-related health impacts were calculated by converting lifetime cancer risk reported in NATA 2005 to years of healthy life lost or Disability-Adjusted Life Years (DALYs). We found that the most frequently found air toxics with cancer risk greater than one in a million are formaldehyde, carbon tetrachloride, acetaldehyde, and benzene. The most frequently occurring binary pairs and ternary mixtures are the various combinations of these four air toxics. Analysis of urban and rural HAPs did not reveal significant differences in the top combinations of these chemicals. The cumulative annual cancer-related health impacts of inhaling the top 10 carcinogenic air toxics included was about 1,600 DALYs in the United States or 0.6 DALYs per 100,000 people. Formaldehyde and benzene together contribute nearly 60 percent of the total cancer-related health impacts. Our study shows that although there are many

  14. Carcinogenic Air Toxics Exposure and Their Cancer-Related Health Impacts in the United States.

    Directory of Open Access Journals (Sweden)

    Ying Zhou

    Full Text Available Public health protection from air pollution can be achieved more effectively by shifting from a single-pollutant approach to a multi-pollutant approach. To develop such multi-pollutant approaches, identifying which air pollutants are present most frequently is essential. This study aims to determine the frequently found carcinogenic air toxics or hazardous air pollutants (HAPs combinations across the United States as well as to analyze the health impacts of developing cancer due to exposure to these HAPs. To identify the most commonly found carcinogenic air toxics combinations, we first identified HAPs with cancer risk greater than one in a million in more than 5% of the census tracts across the United States, based on the National-Scale Air Toxics Assessment (NATA by the U.S. EPA for year 2005. We then calculated the frequencies of their two-component (binary, and three-component (ternary combinations. To quantify the cancer-related health impacts, we focused on the 10 most frequently found HAPs with national average cancer risk greater than one in a million. Their cancer-related health impacts were calculated by converting lifetime cancer risk reported in NATA 2005 to years of healthy life lost or Disability-Adjusted Life Years (DALYs. We found that the most frequently found air toxics with cancer risk greater than one in a million are formaldehyde, carbon tetrachloride, acetaldehyde, and benzene. The most frequently occurring binary pairs and ternary mixtures are the various combinations of these four air toxics. Analysis of urban and rural HAPs did not reveal significant differences in the top combinations of these chemicals. The cumulative annual cancer-related health impacts of inhaling the top 10 carcinogenic air toxics included was about 1,600 DALYs in the United States or 0.6 DALYs per 100,000 people. Formaldehyde and benzene together contribute nearly 60 percent of the total cancer-related health impacts. Our study shows that although

  15. Does preoperative breast MRI significantly impact on initial surgical procedure and re-operation rates in patients with screen-detected invasive lobular carcinoma?

    Science.gov (United States)

    Sinclair, K; Sakellariou, S; Dawson, N; Litherland, J

    2016-06-01

    To investigate whether magnetic resonance imaging (MRI) changes the management of patients with screen-detected invasive lobular carcinoma (ILC). A retrospective, controlled, single-centre analysis of 138 cases of screen-detected ILC was performed. All patients were assessed by a single multidisciplinary team as to whether preoperative MRI altered the initial management decision or reduced re-operation rates. Forty-three percent of patients had preoperative MRI. MRI guided surgical management in 40.7% patients. Primary mastectomy rates were not significantly different between the MRI and non-MRI groups (32% and 30% respectively, p=0.71). The MRI group had a lower secondary surgery rate (6.8% versus 15.2%); however, the results did not reach statistical significance, and there were no unnecessary mastectomies. MRI can be used appropriately to guide primary surgery in screen-detected ILC cases and affects the initial management decision in 40.7% of patients. It does not significantly affect the overall mastectomy rate or re-operation rates, but reduces the likelihood of the latter. As a result of this review, the authors' local policy for the use of MRI in screen-detected ILC patients has been modified. For patients undergoing mastectomy for ILC, MRI is no longer performed routinely to search for contralateral malignancy as this has no proven added benefit. Copyright © 2016 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  16. Genomic Disparities in Breast Cancer Among Latinas

    Science.gov (United States)

    Lynce, Filipa; Graves, Kristi D.; Jandorf, Lina; Ricker, Charité; Castro, Eida; Moreno, Laura; Augusto, Bianca; Fejerman, Laura; Vadaparampil, Susan T.

    2016-01-01

    Background Breast cancer is the most common cancer diagnosed among Latinas in the United States and the leading cause of cancer-related death among this population. Latinas tend to be diagnosed at a later stage and have worse prognostic features than their non-Hispanic white counterparts. Genetic and genomic factors may contribute to observed breast cancer health disparities in Latinas. Methods We provide a landscape of our current understanding and the existing gaps that need to be filled across the cancer prevention and control continuum. Results We summarize available data on mutations in high and moderate penetrance genes for inherited risk of breast cancer and the associated literature on disparities in awareness of and uptake of genetic counseling and testing in Latina populations. We also discuss common genetic polymorphisms and risk of breast cancer in Latinas. In the treatment setting, we examine tumor genomics and pharmacogenomics in Latina patients with breast cancer. Conclusions As the US population continues to diversify, extending genetic and genomic research into this underserved and understudied population is critical. By understanding the risk of breast cancer among ethnically diverse populations, we will be better positioned to make treatment advancements for earlier stages of cancer, identify more effective and ideally less toxic treatment regimens, and increase rates of survival. PMID:27842325

  17. Psychological Adjustment in Breast Cancer Survivors.

    Science.gov (United States)

    Stanton, Annette L; Bower, Julienne E

    2015-01-01

    Women living with a diagnosis of breast cancer constitute more than 20 % of the cancer survivor population in the United States. Research on trajectories of psychological adjustment in women recently diagnosed with breast suggests that the largest proportion of women evidences relatively low psychological distress either from the point of diagnosis or after a period of recovery. Substantial heterogeneity exists, however, and some women are at risk for lingering depression, anxiety, fear of cancer recurrence and other long-term psychological effects. Most women diagnosed with breast cancer also report a number of benefits that arise from their experience of cancer. Longitudinal studies have illuminated risk and protective factors for psychological adjustment in breast cancer survivors, which we describe in this chapter. Effective psychosocial interventions, as evidenced in randomized controlled trials, also are available for bolstering breast cancer-related adjustment. We offer directions for research to deepen the understanding of biological, psychological, and social contributors to positive adjustment in the context of breast cancer, as well as suggestions for the development of optimally efficient evidence-based psychosocial interventions for women living with the disease.

  18. Exploratory study of impact of cancer-related posttraumatic stress symptoms on diabetes self-management among cancer survivors.

    Science.gov (United States)

    James, Janey; Harris, Yael T; Kronish, Ian M; Wisnivesky, Juan P; Lin, Jenny J

    2017-10-21

    Posttraumatic stress symptoms (PTSS) can be triggered by a diagnosis of a potentially life-threatening illness such as cancer. Little is known about the impact of cancer-related PTSS symptoms on self-management behaviors for comorbid chronic medical conditions such as diabetes mellitus (DM). We recruited patients with DM and a recent diagnosis of early-stage cancer from 2 medical centers in New York City. Cancer-related PTSS were assessed using the Impact of Events Scale (score ≥ 26). DM self-management behaviors (medication adherence, exercise, healthy diet, and glucose testing) were measured 3 months later. Logistic regression was used to assess the association between cancer-related PTSS symptoms and DM self-management behaviors, adjusting for gender, marital status, and anxiety symptoms. Of 56 participants recruited, 33% reported cancer-related PTSS symptoms. Elevated cancer-related PTSS symptoms were associated with lack of healthy diet (odds ratio: 0.08, 95% confidence interval: 0.01-0.62). Early-stage cancer survivors with cancer-related PTSS symptoms were less likely to adhere to some DM self-management behaviors. Providers should recognize the impact of cancer-related PTSS symptoms to better support comorbid disease management in cancer survivors. Copyright © 2017 John Wiley & Sons, Ltd.

  19. Effects of breast cancer related lymphedema on hand muscle strength, hand functions and sensory loss of hand

    Directory of Open Access Journals (Sweden)

    Gul Mete Civelek

    2016-06-01

    Conclusion: In patients with BCRL, having axillary dissection, receiving chemotherapy and radiotherapy in post-operative period, obesity and shoulder pain are common. Evaluation of patients with BCRL should be made in details, should be versatile and should include questioning shoulder pain and hand evaluation. [Cukurova Med J 2016; 41(2.000: 208-216

  20. Cell-Assisted Lipotransfer Using Autologous Adipose-Derived Stromal Cells for Alleviation of Breast Cancer-Related Lymphedema.

    Science.gov (United States)

    Toyserkani, Navid Mohamadpour; Jensen, Charlotte Harken; Sheikh, Søren Paludan; Sørensen, Jens Ahm

    2016-07-01

    : Lymphedema is one of the most frequent side effects following cancer treatment, and treatment opportunities for it are currently lacking. Stem cell therapy has been proposed as a possible novel treatment modality. This study was the first case in which freshly isolated adipose-derived stromal cells were used to treat lymphedema. Treatment was given as a cell-assisted lipotransfer in which 4.07 × 10(7) cells were injected with 10 ml of lipoaspirate in the axillary region. Four months after treatment, the patient reported a great improvement in daily symptoms, reduction in need for compression therapy, and volume reduction of her affected arm. There were no adverse events. The outcome for this patient provides support for the potential use of cellular therapy for lymphedema treatment. We have begun a larger study to further test the feasibility and safety of this procedure (ClinicalTrials.gov Identifier NCT02592213). Lymphedema is a very debilitating side effect of cancer treatment and has very few treatment options. Stem cell therapy has the potential to change the treatment paradigm from a conservative to a more curative approach. Freshly isolated, autologous, adipose-derived stromal cells were combined with a fat-graft procedure to treat lymphedema. The treated patient had great improvement in daily symptoms, a reduced need for compression therapy, and a reduction in arm volume after 4 months. There were no adverse events. The use of cellular therapy for lymphedema treatment is supported by this patient's outcome. A phase II study has begun to further test its feasibility and safety. ©AlphaMed Press.

  1. Trends in breast cancer in the elderly in Denmark, 1980-2012

    DEFF Research Database (Denmark)

    Jensen, Jeanette D; Cold, Søren; Holck Nielsen, Mette

    2016-01-01

    Background Breast cancer is the most frequent malignancy among women worldwide and the second most common cause of cancer-related death in developed countries. The aim of the present analysis is to describe trends in incidence, mortality, prevalence, and relative survival in Denmark from 1980...

  2. Induction of apoptosis in human breast cancer cell line MCF-7 by ...

    African Journals Online (AJOL)

    Currently, breast cancer is the leading cause of cancer-related death in women. Therefore, there is an urgent need to develop alternative therapeutic measures against this deadly disease. Many components from dietary or medicinal plants have been identified that possess substantial chemopreventive properties. India has ...

  3. Selective attention and fear of cancer recurrence in breast cancer survivors

    NARCIS (Netherlands)

    Custers, J.A.E.; Becker, E.S.; Gielissen, M.F.M.; Laarhoven, H.W.M. van; Rinck, M.; Prins, J.B.

    2015-01-01

    BACKGROUND: Anxious people show an attentional bias towards threatening information. PURPOSE: It was investigated whether an attentional bias exists for cancer-related stimuli in breast cancer survivors and if different levels of fear of cancer recurrence would lead to different patterns of

  4. Breast Reconstruction After Mastectomy

    Science.gov (United States)

    ... Cancers Breast Cancer Screening Research Breast Reconstruction After Mastectomy On This Page What is breast reconstruction? How ... are some new developments in breast reconstruction after mastectomy? What is breast reconstruction? Many women who have ...

  5. Breast reconstruction - implants

    Science.gov (United States)

    Breast implants surgery; Mastectomy - breast reconstruction with implants; Breast cancer - breast reconstruction with implants ... to make reconstruction easier. If you will have breast reconstruction later, your surgeon will remove enough skin ...

  6. Breast Cancer Treatment

    Science.gov (United States)

    ... of Breast & Gynecologic Cancers Breast Cancer Screening Research Breast Cancer Treatment (PDQ®)–Patient Version General Information About Breast Cancer Go to Health Professional Version Key Points Breast ...

  7. Stages of Breast Cancer

    Science.gov (United States)

    ... of Breast & Gynecologic Cancers Breast Cancer Screening Research Breast Cancer Treatment (PDQ®)–Patient Version General Information About Breast Cancer Go to Health Professional Version Key Points Breast ...

  8. Breast Cancer Prevention

    Science.gov (United States)

    ... of Breast & Gynecologic Cancers Breast Cancer Screening Research Breast Cancer Prevention (PDQ®)–Patient Version What is prevention? Go ... from starting. Risk-reducing surgery . General Information About Breast Cancer Key Points Breast cancer is a disease in ...

  9. Breast cancer screening

    Science.gov (United States)

    Mammogram - breast cancer screening; Breast exam - breast cancer screening; MRI - breast cancer screening ... is performed to screen women to detect early breast cancer when it is more likely to be cured. ...

  10. Physical Exercise and Cancer-Related Fatigue in Hospitalized Patients: Role of the Clinical Nurse Leader in Implementation of Interventions.

    Science.gov (United States)

    McGowan, Katrina

    2016-02-01

    Guidelines suggest that aerobic endurance training and moderate resistance training lessen the effects of cancer-related fatigue (CRF). However, specifics regarding frequency, intensity, and type of physical activity required to alleviate fatigue are less specific. In addition, outcomes of these interventions during the initial stages of active treatment are not well documented. The purpose of this article is to review the current evidence-based literature regarding the effects of physical exercise on CRF and the role that the clinical nurse leader (CNL) can play in implementing interventions to address CRF and promote physical exercise to improve patient outcomes. A literature review of the effect of physical exercise on CRF was conducted using the CINAHL®, PubMed, and Google Scholar databases. As leaders in health care, CNLs have the knowledge and skill to take an active role in managing CRF and to develop evidence-based interventions to address fatigue in this patient population. Interventions may include creating and evaluating individualized exercise plans for inpatients with cancer and/or developing educational programs for the inpatient setting that may be continued after discharge and during outpatient treatment.

  11. Statins and breast cancer prognosis

    DEFF Research Database (Denmark)

    Ahern, Thomas P; Lash, Timothy L; Damkier, Per

    2014-01-01

    Much preclinical and epidemiological evidence supports the anticancer effects of statins. Epidemiological evidence does not suggest an association between statin use and reduced incidence of breast cancer, but does support a protective effect of statins-especially simvastatin-on breast cancer...... recurrence. Here, we argue that the existing evidence base is sufficient to justify a clinical trial of breast cancer adjuvant therapy with statins and we advocate for such a trial to be initiated without delay. If a protective effect of statins on breast cancer recurrence is supported by trial evidence......, then the indications for a safe, well tolerated, and inexpensive treatment can be expanded to improve outcomes for breast cancer survivors. We discuss several trial design opportunities-including candidate predictive biomarkers of statin safety and efficacy-and off er solutions to the key challenges involved...

  12. The Lived Experience of Iranian Women Confronting Breast Cancer Diagnosis

    OpenAIRE

    Esmat Mehrabi; Sepideh Hajian; Masoomeh Simbar; Mohammad Hoshyari; Farid Zayeri

    2016-01-01

    Introduction: The populations who survive from breast cancer are growing; nevertheless, they mostly encounter with many cancer related problems in their life, especially after early diagnosis and have to deal with these problems. Except for the disease entity, several socio-cultural factors may affect confronting this challenge among patients and the way they deal with. Present study was carried out to prepare clear understanding of Iranian women's...

  13. Psycho-oncological support for breast cancer patients: A brief overview of breast cancer services certification schemes and national health policies in Europe.

    Science.gov (United States)

    Neamţiu, L; Deandrea, S; Pylkkänen, L; Freeman, C; López Alcalde, J; Bramesfeld, A; Saz-Parkinson, Z; Ulutürk, A; Lerda, D

    2016-10-01

    Psycho-oncology addresses the psychological, social, behavioural, and ethical aspects of cancer. Identification and proper management of the patients' psychosocial needs, as well as the needs of their caregivers and family are essential for a person-centred concept of breast cancer care. The aim of this overview is to describe how psychosocial support in breast cancer is incorporated in cancer-related policy documents, such as national cancer plans and breast cancer care certification schemes. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  14. Cancer-related masculine threat, emotional approach coping, and physical functioning following treatment for prostate cancer.

    Science.gov (United States)

    Hoyt, Michael A; Stanton, Annette L; Irwin, Michael R; Thomas, KaMala S

    2013-01-01

    Aspects of masculinity and gender role, particularly those that are traditional and restrictive, are related to poorer physical and psychological outcomes in men with cancer. This longitudinal study uses a cancer-specific assessment to determine whether cancer-related masculine threat (CMT) predicts prostate-related (i.e., urinary, bowel, sexual) functioning over time, and whether cancer-related emotional approach coping (EAC) processes explain these relationships. Whether coping self-efficacy and emotional suppression explain effects of CMT on EAC also is tested. Sixty-six men (M age = 65.76; SD = 9.04) who underwent radical prostatectomy and/or radiation therapy for localized prostate cancer within two years were assessed on physical and psychological variables at study entry (T1), and two (T2) and four (T3) months later. Analyses controlling for baseline functioning and age revealed that CMT predicted declines in (T1 to T3) urinary (B = -.21, p emotional processing (T1 to T2), but not emotional expression. Decreased emotional processing predicted declining prostate-related functioning and helps explain the effect of CMT on bowel and sexual (but not urinary) functioning. Low coping self-efficacy (p emotional suppression, was a mechanism by which CMT predicted emotional processing. The extent to which men believe that cancer is inconsistent with their masculinity exacerbates declines in prostate-related functioning following cancer treatment. CMT likely shapes coping responses and negatively affects the efficacy of emotion-directed coping. Emotion-regulating coping processes, particularly the ability to process cancer-related emotions, appears to be one pathway through which gender role affects recovery from prostate cancer. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  15. Comparison of Genetic Variants in Cancer-Related Genes between Chinese Hui and Han Populations.

    Directory of Open Access Journals (Sweden)

    Chaoyong Tian

    Full Text Available The Chinese Hui population, as the second largest minority ethnic group in China, may have a different genetic background from Han people because of its unique demographic history. In this study, we aimed to identify genetic differences between Han and Hui Chinese from the Ningxia region of China by comparing eighteen single nucleotide polymorphisms in cancer-related genes.DNA samples were collected from 99 Hui and 145 Han people from the Ningxia Hui Autonomous Region in China, and SNPs were detected using an improved multiplex ligase detection reaction method. Genotyping data from six 1000 Genomes Project population samples (99 Utah residents with northern and western European ancestry (CEU, 107 Toscani in Italy (TSI, 108 Yoruba in Ibadan (YRI, 61 of African ancestry in the southwestern US (ASW, 103 Han Chinese in Beijing (CHB, and 104 Japanese in Tokyo (JPT were also included in this study. Differences in the distribution of alleles among the populations were assessed using χ2 tests, and FST was used to measure the degree of population differentiation.We found that the genetic diversity of many SNPs in cancer-related genes in the Hui Chinese in Ningxia was different from that in the Han Chinese in Ningxia. For example, the allele frequencies of four SNPs (rs13361707, rs2274223, rs465498, and rs753955 showed different genetic distributions (p0.000 between the Hui and Han populations.These results suggest that some SNPs associated with cancer-related genes vary among different Chinese ethnic groups. We suggest that population differences should be carefully considered in evaluating cancer risk and prognosis as well as the efficacy of cancer therapy.

  16. Quality Assurance of Ultrasonic Diagnosis in Breast

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Soo Young; Kim, Hong Dae [Hallym University, Kangnam Sacred Heart Hospital, Seoul (Korea, Republic of)

    2006-06-15

    Sonography is a subjective diagnostic method which is highly dependent on the experience of the operator and the equipment quality which requires real-time adjustments. Breast screening examination currently consists of clinical examination and mammography. Breast sonography, either supplementary to mammography or independently, is indicated for the dense breast, especially in younger women. Breast sonography is especially applicable for Korean women because of the denser breast parenchyma and the approximately 10-year younger incidence rate of breast cancer of Korean women compared to western women. To avoid unnecessary breast biopsy because of the high rate of false positive lesions in breast parenchyma, which is different from other body organs such as the liver or the kidney, a quality assurance program for breast sonography is essential. The quality assurance of breast ultrasound involves quality assurance of the equipment, imaging display and acquisition of clinical images, personnel qualifications and other aspects such as unification of lexicon, guideline of diagnostic examination and reporting system; US BI-RAD reporting system, assessment items and organization, education program, medical audit, certification issues, and medicolegal issues. A breast sonographic quality assurance system should be established before a scheme to initiate governmental medical insurance for breast sonography

  17. Methodology for the Model-based Small Area Estimates of Cancer-Related Knowledge - Small Area Estimates

    Science.gov (United States)

    The HINTS is designed to produce reliable estimates at the national and regional levels. GIS maps using HINTS data have been used to provide a visual representation of possible geographic relationships in HINTS cancer-related variables.

  18. Initial clinical experience with the Strut-Adjusted Volume Implant (SAVI) breast brachytherapy device for accelerated partial-breast irradiation (APBI): first 100 patients with more than 1 year of follow-up.

    Science.gov (United States)

    Yashar, Catheryn M; Scanderbeg, Daniel; Kuske, Robert; Wallace, Anne; Zannis, Victor; Blair, Sarah; Grade, Emily; Swenson, Virginia H; Quiet, Coral

    2011-07-01

    The Strut-Adjusted Volume Implant (SAVI; Cianna Medical, Aliso Viejo, CA) is a multichannel single-entry brachytherapy device designed to allow dose modulation to minimize normal tissue dose while simultaneously maximizing target coverage. This is the first report on the initial 102 patients with nearly 2 years of median follow-up. One hundred two patients were treated at two institutions. Data were collected on eligibility and dosimetry and followed for toxicity and recurrence. The median follow-up is 21 months. Overall dosimetry is outstanding (median percent of target volume receiving 90% of the prescription dose was 95.9%, volume of target receiving 150% of the prescription dose was 27.8 mL, and volume of target receiving 200% of the prescription dose was 14.0 cm(3)). No devices were pulled prior to treatment completion. For patients with a skin bridge of less than 7 mm, the maximum median skin dose was 280 cGy (median percent of target volume receiving 90% of the prescription dose was 95.2%, volume of target receiving 150% of the prescription dose was 25.8 cm(3) and volume of target receiving 200% of the prescription dose was 12.7 mL). For patients with both chest wall and skin of less than 7 mm, the maximum median lung dose was 205 cGy with simultaneous skin dose of 272 cGy. The rate of telangiectasia was 1.9%. Grade 1 hyperpigmentation developed in 10 patients (9.8%) and Grade 2 fibrosis in 2 patients (1.9%). There were 2 symptomatic seromas and 2 cases of asymptomatic fat necrosis (1.9%). Of the patients, 27% were not eligible for MammoSite balloon brachytherapy (Hologic, Inc., Marlborough, MA) and 5% were not eligible for any balloon brachytherapy. The recurrence rate was 1%. The SAVI appears to safely allow an increase in eligibility for APBI over balloon brachytherapy or three-dimensional conformal radiation, highlighting the outstanding device flexibility to maximize the target dose and minimize the normal tissue dose. The device was well tolerated by

  19. Breast cancer and pregnancy.

    Science.gov (United States)

    Knabben, Laura; Mueller, Michel D

    2017-08-29

    Background In the past decades the incidence of pregnancy-associated breast cancer (PABC) increased. Possible explanations are the trend to postpone childbearing and the general increase in the incidence of breast cancer. Materials and methods A sytematic review of the literature was performed with the aim to report on incidence, diagnosis, treatment and prognosis of breast cancer during pregnancy. We also cover the issue of pregnancy following a diagnosis of breast cancer including fertility preservation and prognosis. Results Ultrasound is the imaging method of choice in pregnancy, but mammography can also be performed as the fetal irradiation dose is low. To avoid a delay in diagnosis every sonographic mass in pregnant women which does not clearly correspond to a cyst needs further investigation by biopsy. Treatment should follow as close as possible the guidelines for non-pregnant patients. Administration of chemotherapy is possible after the first trimester. There is a large body of evidence for the use of anthracyclines. In contrast radiotherapy, trastuzumab and antihormonal treatment by tamoxifen are contraindicated during pregnancy. Pregnancy does not seem to influence prognosis. Most adverse obstetric outcomes are related to preterm delivery, which should therefore, whenever possible, be avoided. Young patients with breast cancer and incomplete family planning should be referred for counseling about fertility preservation options before the initiation of adjuvant treatment. A pregnancy following breast cancer does not have a negative impact on prognosis. Conclusion Multidisciplinary management of women with breast cancer in pregnancy is mandatory and data should be collected to allow further improvement in management.

  20. Posttraumatic stress and attentional bias towards cancer-related stimuli in parents of children recently diagnosed with cancer

    OpenAIRE

    Martin Cernvall; Emma Hovén; Lisa Ljungman; Gustaf Ljungman; Per Carlbring; Louise von Essen

    2016-01-01

    Objectives: To investigate whether posttraumatic stress symptoms (PTSS) are related to attentional bias towards cancer-related stimuli among parents of children recently diagnosed with cancer. Methods: Sixty-two parents completed questionnaires measuring PTSS, depression, and anxiety and the emotional Stroop task via the Internet. The emotional Stroop task included cancer-related words, cardiovascular disease-related words, and neutral words. Results: Participants were split in two groups bas...