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Sample records for breast feeding early

  1. Risk factors for early termination of breast feeding in Brazil.

    Science.gov (United States)

    Giugliani, E R; Issler, R M; Justo, E B; Seffrin, C F; Hartmann, R M; Carvalho, N M

    1992-01-01

    A prospective study was undertaken to identify possible factors related to the duration of breast feeding. Two hundred and thirty-eight mothers who had delivered normal single babies with birth weights greater than 2.5 kg and had initiated breast feeding were randomly selected at the maternity hospital, Hospital de Clinicas de Porto Alegre, Brazil, and followed by mail questionnaires until termination of breast feeding, or until the end of the first year. If no reply was received, telephone contact or home visits were made. The group of mothers who stopped breast feeding prior to the end of the third month was compared with those who extended breast feeding beyond three months with respect to socioeconomic, biological, environmental, medical and psychological factors. The variables with a significant coefficient of association with early termination of breast feeding were maternal education, past experience with breast feeding, help of a maid, help with housework provided by a relative, breast feeding orientation during prenatal care and encouragement from the husband. These factors act simultaneously, with interactions among them.

  2. RELATIONSHIPS BETWEEN BREAST-FEEDING, CO-SLEEPING, AND SOMATIC COMPLAINTS IN EARLY CHILDHOOD.

    Science.gov (United States)

    Peters, Elisabeth Maria; Lusher, Joanne Marie; Banbury, Samantha; Chandler, Chris

    2016-09-01

    The central aim of this study was to expand a limited body of knowledge on the complex relationship between breast-feeding, co-sleeping, and somatic complaints in early childhood. An opportunity sample of 98 parents from the general population with children aged 18 to 60 months consented to participate in the study. Each parent completed a series of questionnaires measuring somatic complaints, sleep problems, co-sleeping, breast-feeding, and demographic factors. Findings indicated that co-sleeping was associated with increased somatic complaints and that breast-feeding associated with decreased somatic complaints. Co-sleeping also was found to be associated with an increase in sleep problems. Boys demonstrated significantly higher levels of sleep problems than did girls. These findings highlight the relationship between co-sleeping during early childhood, which could have implications for prevention, treatment, and intervention regarding somatic complaints and sleep problems in early childhood. PMID:27552361

  3. Early cessation of breast milk feeding in very low birthweight infants.

    Science.gov (United States)

    Killersreiter, B; Grimmer, I; Bührer, C; Dudenhausen, J W; Obladen, M

    2001-01-01

    This investigation was carried out to comparatively assess the duration of breast milk feeding and to analyze risk factors for early cessation of breast milk feeding in term and very preterm infants. A cohort study was performed in 89 consecutive very low birthweight (VLBW) infants (2500 g born in the same hospital matched for gender and multiplicity. Median duration of breast milk feeding, as determined from charts and questionnaires mailed to the mothers at 6 and 12 months corrected age, was 36 days in VLBW infants, compared to 112 days in control infants (P35 years and spontaneous pregnancy (as opposed to pregnancy following infertility treatment) in term infants. Multivariate analysis revealed that VLBW, smoking and low parental school education were independent negative predictors of breast milk feeding. While these results emphasize the need for special support of VLBW infant mothers promoting lactation, the relationships between smoking, school education and breast milk feeding in both strata show that efforts to increase breast milk feeding require a public health perspective.

  4. Does breast feeding influence liver biochemistry?

    DEFF Research Database (Denmark)

    Jørgensen, Marianne Hørby; Ott, Peter; Juul, Anders;

    2003-01-01

    It is assumed that early feeding can affect liver biochemistry because breast-fed infants have a higher risk of hyperbilirubinemia than formula-fed infants. The authors sought to determine how feeding mode affected liver biochemistry in healthy term infants.......It is assumed that early feeding can affect liver biochemistry because breast-fed infants have a higher risk of hyperbilirubinemia than formula-fed infants. The authors sought to determine how feeding mode affected liver biochemistry in healthy term infants....

  5. Past and recent abuse is associated with early cessation of breast feeding: results from a large prospective cohort in Norway.

    OpenAIRE

    Sørbø, Marie Flem; Lukasse, Mirjam; Brantsæter, Anne Lise; Grimstad, Hilde

    2015-01-01

    Objective: Breast feeding provides a wide range of health benefits for both infants and mothers. Few studies have examined the impact of past and recent abuse of women on breastfeeding behaviour. The aims of our study were to examine whether exposure to past and recent emotional, sexual or physical abuse was associated with early breastfeeding cessation, and to assess whether a potential association differed for known and unknown perpetrators. Design: Prospective cohort study. Set...

  6. Cannabis and Breast feeding

    International Nuclear Information System (INIS)

    Cannabis is a drug derived from hemp plant, Cannabis sativa, used both as a recreational drug or as medicine. It is a widespread illegal substance, generally smoked for its hallucinogenic properties. Little is known about the adverse effects of postnatal cannabis exposure throw breast feeding because of a lack of studies in lactating women. The active substance of cannabis is the delta 9 Tetrahydrocannabinol (THC). Some studies conclude that it could decrease motor development of the child at one year of age. Therefore, cannabis use and abuse of other drugs like alcohol, tobacco, or cocaine must be contraindicated during breast feeding. Mothers who use cannabis must stop breast feeding, or ask for medical assistance to stop cannabis use in order to provide her baby with all the benefits of human milk.

  7. Breast-feeding and alcoholism

    DEFF Research Database (Denmark)

    Goodwin, D W; Gabrielli, W F; Penick, E C;

    1999-01-01

    OBJECTIVE: The authors' goal was to determine whether early termination of breast-feeding contributes to later alcohol dependence, as proposed more than 200 years ago by the British physician Thomas Trotter. METHOD: In 1959-1961, a multiple-specialty group of physicians studied 9, 182 consecutive...... diagnosed as alcohol dependent at age 30, 13 (48%) came from the group weaned from the breast before the age of 3 weeks; only 33 (19%) of the 173 non-alcohol-dependent subjects came from the early weaning group. When challenged by other perinatal variables in a multiple regression analysis, early weaning...... significantly contributed to the prediction of the severity of alcoholism at age 30. CONCLUSIONS: The data support the hypothesis that early weaning may be associated with a greater risk of alcohol dependence later in life....

  8. Does breast feeding influence liver biochemistry?

    DEFF Research Database (Denmark)

    Jørgensen, Marianne Hørby; Ott, Peter; Juul, Anders;

    2003-01-01

    It is assumed that early feeding can affect liver biochemistry because breast-fed infants have a higher risk of hyperbilirubinemia than formula-fed infants. The authors sought to determine how feeding mode affected liver biochemistry in healthy term infants....

  9. Yes to breast feeding, but...how?

    Science.gov (United States)

    Savane, M A

    1980-01-01

    Although the health and nutritional benefits of breastfeeding are recognized, social and economic constraints discourage the practice in developing countries. Outside employment of women, an image of breast feeding as representing a constraint on women's freedom, and the lack of facilities to aid working mothers are all factors. More affluent women are often pressured not to breast feed by stereotypes of feminine beauty, in order to maintain a certain lifestyle, and because of conflicts with their wifely duties. Many women holding good jobs are also practically unable to breast feed, but such women are usually able to provide adequate substitutes for their children. Women working in the service sector are often unable to breast feed because their place of work is too far away from their home, and they are often forced to leave their young children with inexpensive but unqualified caretakers. Women from the poorest sectors often most wean their children early because of employment, but are unable to afford a substitute formula in sufficient quantity. Undernourished women who breast feed are often pushed toward further depletion. Bottle feeding will remain a problem until societal structures are created which provide adequate support for women in their multiple roles. PMID:12233382

  10. When Breast-feeding is not Contraindicated: Do you know when to stop breast-feeding?

    OpenAIRE

    Newman, Jack

    1991-01-01

    As more mothers elect to breast-feed, more concomitant problems in mothers and babies are reported that are thought to contraindicate breast-feeding. Many frequently cited maternal and infant reasons for stopping breast-feeding are not valid. Breast-feeding can usually be maintained if the physician remembers that breast-feeding is important for the baby and mother and not simply another feeding method.

  11. Breast-feeding does not protect against allergic sensitization in early childhood and allergy-associated disease at age 7 years

    DEFF Research Database (Denmark)

    Jelding-Dannemand, Ea; Malby Schoos, Ann-Marie; Bisgaard, Hans

    2015-01-01

    clinic at 7 years of age, strictly adhering to predefined algorithms. Associations between duration of exclusive breast-feeding and outcomes were analyzed by logistic regression. RESULTS: We found no significant association between duration of exclusive breast-feeding and development of sensitization......% CI, 0.82-1.14]; and OR, 1.02 [95% CI, 0.84-1.23], respectively). Adjusting for reverse causation by excluding children with eczema, wheeze, or a positive skin prick test response before ending exclusive breast-feeding did not alter the results. CONCLUSION: Exclusive breast-feeding does not affect...

  12. Early breast cancer

    International Nuclear Information System (INIS)

    The therapy of early breast cancer has been changing during the last decennium. It requires a multi-disciplinary approach and in each of these disciplines improvements have been implemented. The result is that treatment schedules can now be adapted to specific subgroups. In this review early breast cancer is defined as operable disease, using the criteria set out by Haagensen. Emphasis is given to describing the new developments in prognostic criteria, since these form the basis for creating subgroups for specific treatment schedules. Distinction is made between the factors relating to growth rate and those relating to metastatic potential. Data on screening promises a beneficial effect of the implementation of screening in national health care programs. Important shifts are seen in treatment schedules; the place of postoperative radiotherapy after classic ablative treatment is being challenged, whereas it plays a major role in the new breast conserving therapy schedules. The data mentioned in the review suggest that a large proportion of 'operable' cases can be treated with breast conservation but details in the technique of breast conserving therapy are still under investigation. They form a major part of the coming prospective studies in breast cancer. Improvements in reconstruction techniques, creating better cosmetic results, make reconstruction more competitive with breast conserving therapy. The use of chemotherapy and endocrine manipulation in early breast cancer has now been clearly confirmed by the overview technique by the Peto-group, thanks to all efforts of individual trialists together. (orig.)

  13. 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

  14. Increased risk of eczema but reduced risk of early wheezy disorder from exclusive breast-feeding in high-risk infants

    DEFF Research Database (Denmark)

    Giwercman, Charlotte; Halkjaer, Liselotte B; Jensen, Signe Marie;

    2010-01-01

    Breast-feeding is recommended for the prevention of eczema, asthma, and allergy, particularly in high-risk families, but recent studies have raised concern that this may not protect children and may even increase the risk. However, disease risk, disease manifestation, lifestyle, and the choice to...

  15. Early feeding and neonatal hypoglycemia in infants of diabetic mothers

    Directory of Open Access Journals (Sweden)

    Leandro Cordero

    2013-12-01

    Full Text Available Objectives: To examine the effects of early formula feeding or breast-feeding on hypoglycemia in infants born to 303 A1-A2 and 88 Class B-RF diabetics. Methods: Infants with hypoglycemia (blood glucose < 40 mg/dL were breast-fed or formula-fed, and those with recurrences were given intravenous dextrose. Results: Of 293 infants admitted to the well-baby nursery, 87 (30% had hypoglycemia, corrected by early feeding in 75 (86%, while 12 (14% required intravenous dextrose. In all, 98 infants were admitted to the newborn intensive care unit for respiratory distress (40%, prematurity (33% or prevention of hypoglycemia (27%. Although all newborn intensive care unit patients received intravenous dextrose, 22 (22% had hypoglycemia. Of 109 hypoglycemia episodes, 89 (82% were single low occurrences. At discharge, 56% of well-baby nursery and 43% of newborn intensive care unit infants initiated breast-feeding. Conclusions: Hypoglycemia among infants of diabetic mothers can be corrected by early breast-feeding or formula feeding.

  16. The Prevalence of Breast Feeding Jaundice

    OpenAIRE

    A Gholozar; K Wares Isfahany; H Shajary; Sh Behjaty

    2004-01-01

    Background: Breast-milk jaundice occurs in 13% of neonates between 2nd and 4th day of life. Method: A prospective study was performed between December 2002 and December 2003 in Childrens Medical Center, Tehran. Enrollment criteria included term neonates with no underlying organic illness causing poor feeding, hypernatremia (serum sodium level more than 150 mEq/L), weight loss greater than 5% and urinary specific gravity above 1012. Results: Out of 217 cases of neonatal jaundice, 37 were recog...

  17. The Benefits of Breast Feeding.

    Science.gov (United States)

    Shamir, Raanan

    2016-01-01

    Human milk is considered as the gold standard for infant feeding. Breastfeeding advantages extend beyond the properties of human milk itself. A complex of nutritional, environmental, socioeconomic, psychological as well as genetic interactions establish a massive list of benefits of breastfeeding to the health outcomes of the breastfed infant and to the breastfeeding mother. For this reason, exclusive breastfeeding is recommended for about 6 months and should be continued as long as mutually desired by mother and child. The evidence in the literature on the effect of breastfeeding on health outcomes is based on observational studies due to the fact that it is unethical and practically impossible to randomize children to be breastfed or not. As such, multiple confounders cloud the evidence and one must base conclusions on the accumulating evidence when not contradictory and on the only intervention study, PROBIT (Promotion of Breastfeeding Intervention Trial). This review highlights some of the health outcomes related to breastfeeding such as the prevention of infections, the effect of breastfeeding on neurodevelopmental outcome, obesity, allergy and celiac disease. Available evidence as well as some of the contradictory results is discussed. PMID:27336781

  18. Factors Causing Exclusive Breast Feeding Failure in a Pakistani Urban Population

    International Nuclear Information System (INIS)

    Objective: To determine the factors responsible for termination of exclusive breast feeding in our population. Location and Duration: A cross sectional study was conducted at Combined Military Hospital Quetta, from February 2010 to June 2010. Study design: Cross-sectional study. Sample Size: A total of 620 mothers carrying healthy infants were interviewed.Inclusion Criteria: Mothers who failed to exclusively breast feed their infants within first six months of life and started supplemental feeds. Data Collection Procedure: A semi-structured, preformed questionnaire was filled containing information about mothers age, infant sex and reasons for discontinuation of exclusive breast feeding. Data Analysis: Data was analyzed using SPSS version 18. Results: Mean maternal age was 25.87 years. Early failure was seen in 41.9%$ and late failure in 58.1% infants. Difficulties in initiating and establishing breast feeding (84%), knowledge deficit about breast feeding benefits (78.8%) and milk insufficiency (69.2%) were the main reasons for early failure. Deficient knowledge about exclusive breast feeding which included its WHO definition of six months and its benefits (88.9%) was the most common reason of addition of weaning diets after 4 months of age. Other significant factors found for failure were working mothers (21.3%), premature delivery (13.5%), early second pregnancy (16.1%), and perception of poor weight gain by infant while exclusively breast fed (19.4%). Conclusion: Exclusive breast feeding ensures the best possible health of an infant. Dedicated efforts are required at national level for dissemination and promotion of knowledge about exclusive breast feeding. (author)

  19. PRESENT SITUATION OF BREAST-FEEDING AND COMPLEMENTARY FEEDING AND THEIR INFLUENCE ON GROWTH OF CHILDREN UNDER 36 MONTHS IN WESTERN CHINA

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective To find out the present situation of complementary feeding, breast-feeding and children nutrition, and further explore the relationship between them. Methods Random sampling was adopted and 7302pairs of mothers and their children under 36 months were investigated by means of questionnaires. Results Breastfeeding rate was 96.8% ,but exclusive breast-feeding rate was only 37.6% . Breast-feeding rate over 12 months was 34.7% ,breast-feeding rate over 24 months was only 15.8%. Timely sucking rate was 8.4% ,19.2% of children had too early complementary feeding, 26.8% had too late,and 43. 1% had appropriate feeding . To the children over 6months, the feeding rates of meat and eggs per week were 36. 3% and 49. 3 % , respectively. The stunting-rate was 24.0%, underweight-rate 22. 1 % ,and wasting-rate 8. 9 %. The incidence rate of iron deficiency anemia (IDA) was 23.3 %. Multivariable analysis showed that growth of children was associated with diet diversity,intake frequency of eggs and meat, too early complementary feeding,prolonged breast-feeding and diarrhea, etc. Conclusion In rural areas of western China ,breast-feeding has been fundamentally popularized ,however ,the unfit complementary feeding and malnutrition of children under 36 months are common and serious ,important complementary feeding recommendations and good hygiene condition are strongly needed.

  20. 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

  1. Eukaryotic Translation Initiation Factor 4E Is a Feed-Forward Translational Coactivator of Transforming Growth Factor β Early Protransforming Events in Breast Epithelial Cells.

    Science.gov (United States)

    Decarlo, Lindsey; Mestel, Celine; Barcellos-Hoff, Mary-Helen; Schneider, Robert J

    2015-08-01

    Eukaryotic translation initiation factor 4E (eIF4E) is overexpressed early in breast cancers in association with disease progression and reduced survival. Much remains to be understood regarding the role of eIF4E in human cancer. We determined, using immortalized human breast epithelial cells, that elevated expression of eIF4E translationally activates the transforming growth factor β (TGF-β) pathway, promoting cell invasion, a loss of cell polarity, increased cell survival, and other hallmarks of early neoplasia. Overexpression of eIF4E is shown to facilitate the selective translation of integrin β1 mRNA, which drives the translationally controlled assembly of a TGF-β receptor signaling complex containing α3β1 integrins, β-catenin, TGF-β receptor I, E-cadherin, and phosphorylated Smad2/3. This receptor complex acutely sensitizes nonmalignant breast epithelial cells to activation by typically substimulatory levels of activated TGF-β. TGF-β can promote cellular differentiation or invasion and transformation. As a translational coactivator of TGF-β, eIF4E confers selective mRNA translation, reprogramming nonmalignant cells to an invasive phenotype by reducing the set point for stimulation by activated TGF-β. Overexpression of eIF4E may be a proinvasive facilitator of TGF-β activity.

  2. Breast Cancer - Early Diagnosis

    Centers for Disease Control (CDC) Podcasts

    2011-04-28

    This podcast answers a listener's question about how to tell if she has breast cancer.  Created: 4/28/2011 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 4/28/2011.

  3. Breast feeding and cognitive development in childhood: a prospective birth cohort study.

    Science.gov (United States)

    Oddy, Wendy H; Kendall, Garth E; Blair, Eve; De Klerk, Nicholas H; Stanley, Fiona J; Landau, Louis I; Silburn, S; Zubrick, Stephen

    2003-01-01

    The aim of this study was to examine prospectively the relation between duration of breast feeding and cognitive outcomes. A cohort study of 2860 children enrolled before birth provided data from 2393 term infants of English-speaking mothers. Of these, complete infant feeding data in the first year of life and verbal cognitive IQ (Peabody Picture Vocabulary Test - PPVT-R) were available for 1450 children at 6 years, and a performance subtest (Perceptual organisation WISC - Block Design) for 1375 children at 8 years. Full breast feeding was categorised as none,> 0 to 6 months. Associations between breast-feeding duration and PPVT-R at 6 years and Block Design at 8 years were estimated before and after adjustment for gender, gestational age, maternal age, maternal education, parental smoking and the presence of older siblings. The early cessation of full breast feeding was associated with reduced verbal IQ and the performance subtest. In unadjusted analysis, mean standardised PPVT-R scores were 6.44 points greater (P 6 months compared with those never breast fed. After adjustment, mean PPVT-R scores were 3.56 points higher in children fully breast fed for> 6 months compared with those children never breast fed (P = 0.003). Similarly, Block Design scores were higher in those fully breast fed for> 6 months compared with those never breast fed in unadjusted (P = 0.001) but not adjusted analyses (P = 0.223). Interactions between maternal education (four levels) and breast feeding demonstrated a positive association of maternal education on verbal IQ (F = 2.64; P = 0.005) in children breast fed for longer but not on performance (F = 0.74; P = 0.67). The early introduction of milk other than breast milk was associated with reduced verbal IQ after adjustment for social and perinatal confounders. Although these effects were interacting with maternal education, they may act through undefined mechanisms in human milk. PMID:12562475

  4. Breast-feeding: nature's contraceptive.

    Science.gov (United States)

    Short, R V

    1985-01-01

    Our ancestors achieved the lowest rate of reproduction of any living mammal by the postponement of puberty until well into the 2nd decade of life, a maximal probability of conception of only about 24% per menstrual cycle even when ovulation had commenced, a 4-year birth interval as a result of the contraceptive effects of breastfeeding, and sharply declining fertility during the 4th decade of life, leading to complete sterility at the menopause. This pattern of reproduction was ideally suited to the prevailing lifestyle of the nomadic hunter-gatherer. The postponement of puberty resulted in a prolonged period of childhood dependency, thus enabling parents to transmit their acquired experience to their offspring. Long birth intervals were essential for a woman who had to wander 1000 or more miles each year in search of food, because she could not manage to carry more than 1 child with her at a time. The lifestyle of comparatively recent times of a settled agricultural economy made possible subsequent rural and urban development, but this transition from nomad to city dweller also stimulated fertility. The cultivation of crops and the domestication of animals led to the development of permanent housing, where the mother could leave her baby in a safe place while she worked in the field. The resultant reduction in mother-infant contact coupled with the availability of early weaning foods reduced the suckling frequency, thereby eroding the contraceptive effect of breastfeeding and decreasing the birth interval. The model conquest of disease eventually led to rapid rates of population growth. In the developed countries of Europe and North America, reproduction was subsequently held in check by the use of artificial forms of contraception, but this has yet to take place in the developing countries of Asia, Africa, and South America. For a developing country, contraceptives are expensive, may be culturally unacceptable, and carry health risks. Breastfeeding is 1 form of

  5. The development of a new breast feeding assessment tool and the relationship with breast feeding self-efficacy

    OpenAIRE

    Ingram, Jenny; Johnson, Debbie; Copeland, Marion; Churchill, Cathy; Taylor, Hazel

    2015-01-01

    Objective to develop a breast feeding assessment tool to facilitate improved targeting of optimum positioning and attachment advice and to describe the changes seen following the release of a tongue-tie. Design development and validation of the Bristol Breastfeeding Assessment Tool (BBAT) and correlation with breast feeding self-efficacy. Setting maternity hospital in South West England. Participants 218 breast feeds (160 mother–infant dyads); seven midwife assessors. Findings the tool has mo...

  6. Long-term breast-feeding in women with type 1 diabetes

    DEFF Research Database (Denmark)

    Stage, E; Nørgård, Hanne; Damm, Peter;

    2006-01-01

    Breast-feeding may be more difficult in women with diabetes because of neonatal morbidity and fluctuating maternal blood glucose values. The frequency of long-term breast-feeding and the possible predictors for successful breast-feeding were investigated.......Breast-feeding may be more difficult in women with diabetes because of neonatal morbidity and fluctuating maternal blood glucose values. The frequency of long-term breast-feeding and the possible predictors for successful breast-feeding were investigated....

  7. Breast Cancer Prevention and Early Detection

    Science.gov (United States)

    ... saved articles window. My Saved Articles » My ACS » Breast Cancer Prevention and Early Detection Download Printable Version [PDF] » ( ... the factors that may affect your risk for breast cancer, and find out what you can do to ...

  8. RECURRENCE PATTERN FOLLOWING BREAST - CONSERVING SURGERY FOR EARLY BREAST CANCER

    Directory of Open Access Journals (Sweden)

    Govindaraj

    2015-08-01

    Full Text Available OBJECTIVE: To study the Local Recurrence and metastasis pattern after Breast - Conserving Surgery for early breast cancer. MATERIALS AND METHODS: From 2010 to 2014 in department of surgery in VIMS Bellary, 70 patients with stage I or II invasive breast carcinoma were treated with breast - conserving surgery, radiation and chemotherapy. In this study we investigated the prognostic value of clinical and pathological factors in early breast cancer patients treated with BCS. All of the surgeries were performed by a single surgical team. Recurrence and its risk factors were evaluated.

  9. Maternal factors in newborns breast feeding jaundice: a case control study

    Directory of Open Access Journals (Sweden)

    Alizadeh Taheri P

    2013-03-01

    Full Text Available Background: Neonatal jaundice, especially breast feeding jaundice is one of the most common causes of neonatal readmission during the first month of life. Breast feeding jaundice may be due to decreased milk intake with dehydration and/or reduced caloric intake.  The aim of this Study was to determine maternal risk factors of breast feeding jaundice in order to prevent it than before.Methods: This case- control study was performed at Bahrami University Hospital, Tehran, Iran and involved 75 term exclusively breast fed newborns admitted for hyperbilirubinemia, with a weight loss greater than 7%, with one positive lab data as: serum Na≥ 150meq/lit, urine specific gravity> 1012, serum urea≥ 40mgr/dl, without assigned cause for hyperbilirubinemia. They were compared with 75 matched controls with weight loss less than 7%, without dehydration and a known cause of hyperbilirubinemia.Results: In comparison with control group, in neonates with breast feeding jaundice, inappropriate feeding practice (P<0.033, delayed onset of lactation (P<0.0001, inverted nipple (P<0.001 were significantly higher. In our study, there was no significant difference between two groups in education level of mother, learning breast feeding practice before and after delivery, method of delivery (cesarean or vaginal delivery, primiparity or multiparity and use of supplements (water or glucose water.Conclusion: This study shows need for special attention and follows up of mothers and neonates at risk for breast feeding jaundice, especially those with inverted nipples or undergraduate for successful breast feeding. On the other hand this study shows encouraging mothers for early lactation especially in the first hour of life decreases the risk for this kind of jaundice.

  10. Breast feeding's interruption following radiopharmaceutical administration to nursing mothers

    International Nuclear Information System (INIS)

    The radiopharmaceutical administration to lactating women for therapeutic or diagnostic purpose can achieve a radiological risk to the breast feeding child due to levels of radioactivity in the breast milk. International recommendations regarding safe assumption of nursing mother after radiopharmaceutical administration were analysed. We examined the formula proposed by Rommey et al. to establish objective guidelines in case of the administration of radiopharmaceutical to nursing mothers. The ICRP 54 metabolic model for iodine was modified in order to calculate the suppression breast feeding's period according to the radioactivity measured in the breast milk. (author). 6 refs., 1 fig., 1 tab

  11. [Etanercept in pregnancy and breast-feeding].

    Science.gov (United States)

    Borrego, L

    2010-05-01

    Etanercept is a biological drug, inhibitor of the Tumor Necrosis Factor indicated for the treatment of severe or moderate psoriasis resistant to other therapies. Because its use is becoming increasingly extended, we should know its possible teratogenic effects. The data provided by the literature and studies prior to the marketing of the product are very limited. Thus, it is necessary to study the presence of possible risks more through experiments in animal models and to conduct prolonged prospective studies in humans. With the current knowledge, it seems that suspension of the treatment from one month prior to becoming pregnant would provide an adequate safety margin, and that most of the patients who have become pregnant and have suspended etanercept as soon as they knew they were pregnant have not had any complications. However, the data needed to recommend etanercept for the control of psoriasis of a pregnant woman are very limited and controversial. Since the effects of a possible transfer of etanercept to maternal milk in a still-immature immune system are not known, in accordance with the risk/benefit principle, the use of etanercept should not be recommended in breast-feeding women. PMID:20492888

  12. Isolated hydatid cyst of the breast that developed after breast feeding

    Science.gov (United States)

    Moazeni-Bistgani, Mohammad

    2016-01-01

    A hydatid cyst of the breast is extremely rare, even in endemic areas. There are few reports of breast hydatid cysts. We report a case of an isolated hydatid cyst of the breast that was identified as a painless breast lump that had increased in size just after completion of breast feeding and was present with a painful breast mass after 25 years. This may indicate the possibility of retrograde passage of an Echinococcus granulosus egg through lactating ducts during breast feeding, liberation of an embryo that penetrates ductal mucus and enters the breast tissue and then develops into a hydatid cyst. When a patient comes from an area with little healthcare and where hydatid cysts are epidemic, and if this disease was indicated by radiologic or serologic examination, total mass excision without spillage is the best diagnostic and treatment. PMID:27194680

  13. Does breast-feeding affect severity of familial Mediterranean fever?

    Science.gov (United States)

    Makay, Balahan; Unsal, Erbil

    2009-12-01

    Familial Mediterranean fever (FMF) is the most common inherited autoinflammatory disease, which is caused by an inborn error in innate immune system. It was shown that disease severity of patients of the same ethnic origin differed according to different country of residence, suggesting an influence of environment on phenotype of FMF. Different microbial milieus of the countries were accused. Breast-feeding has an important role on innate immunity and protects the infant from infections. The aim of this study is to investigate whether being breast-fed and duration of breast-feeding has an impact on disease severity of FMF. The mothers of patients were asked to fill a questionnaire about the feeding type in infancy. Mode of delivery, gestational age, and age at onset of FMF symptoms were also asked. The disease severity score of each patient was calculated according to the scoring system suggested by Pras et al. (Am J Med Genet 75:216-219, 1998). MEFV mutations were noted. The mothers of 81 FMF patients completed the questionnaire. Fifteen patients (18.5%) had mild, 49 (60.5%) had moderate, and 17 (21%) had severe disease. All the patients except four were breast-fed for some period. The duration of breast-feeding was similar between three severity groups. Time to introduce cow's milk and complementary foods also did not differ between groups. Longer duration of breast-feeding did not delay the onset of FMF symptoms. Mode of delivery and gestational age had no effect on disease severity. Patients homozygous for M694V had higher severity scores. This preliminary study suggests that breast-feeding is not an exogenous factor having an influence on phenotype of FMF. M694V genotype seems to cause more severe disease. PMID:19688293

  14. Breast-feeding counselling in a diarrhoeal disease hospital.

    Science.gov (United States)

    Haider, R; Islam, A; Hamadani, J; Amin, N J; Kabir, I; Malek, M A; Mahalanabis, D; Habte, D

    1996-01-01

    Lactation counsellors were trained to advise mothers of partially breast-fed infants who were admitted to hospital because of diarrhoea, so that they could start exclusive breast-feeding during their hospital stay. Infants (n = 250) up to 12 weeks of age were randomized to intervention and control groups. Mothers in the intervention group were individually advised by the counsellors while mothers in the control group received only routine group health education. During follow-up at home by the counsellors a week later, only the mothers in the intervention group were counselled. All the mothers were evaluated for infant feeding practices at home two weeks after discharge. Among the 125 mother-infant pairs in each group, 60% of mothers in the intervention group were breast-feeding exclusively at discharge compared with only 6% in the control group (P < 0.001); two weeks later, these rates rose to 75% and 8% in the intervention and control groups, respectively (P < 0.001). However, 49% of mothers in the control group reverted back to bottle-feeding compared with 12% in the intervention group (P < 0.001). Thus, individual counselling had a positive impact on mothers to start exclusive breast-feeding during hospitalization and to continue the practice at home. Maternal and child health facilities should include lactation counselling as an integral part of their programme to improve infant feeding practices. PMID:8706233

  15. CLINICAL STUDY OF EARLY BREAST CARCINOMA

    Directory of Open Access Journals (Sweden)

    Kiran Kumar

    2016-01-01

    Full Text Available Carcinoma of the breast is one of the commonest cancers occurring in female and accounts for 1/3rd of all the malignant diseases occurring in them. It is mainly a disease of the developed countries and accounts for 1,00,000 deaths annually. Breast carcinoma is classified as Early breast cancer, Locally advanced breast cancer and Metastatic breast cancer. By definition early stage breast cancer constitutes breast tumors of clinical stages I, IIa and T2N1M0. Early breast cancer is the one diagnosed by mammography. Women when approaches at this stage, they can go for breast conservation surgery. Not all women are candidates for this approach, and some require mastectomy as part of their treatment. AIM To observe the incidence of early breast carcinoma with particular reference to the time taken by the patients to seek medical advice after the symptoms have developed i.e. the average time taken by the patients to seek medical advice, their appropriate management and prognosis. MATERIALS AND METHODS This prospective study was conducted over a period of 2 years from Oct-2012 to Oct-2014 in 30 female patients aged between 25-65 years who were presented with lump in breast of size ≤5cms with or without pain, with or without lymph nodes to the outpatient department. All the patients were thoroughly asked about history, examined clinically, investigated, staged and managed by surgery either Breast Conservation Surgery or Modified Radical Mastectomy. Postoperative complications were recorded and followed up regularly. RESULTS The incidence of early breast cancer in this study was 0.98% with peak age incidence between 40-60 years and duration of symptoms <6 months in 18 patients. Breast Conservation Surgery + axillary dissection + Radiotherapy was done in 23%. Prognosis was good in these patients with no local recurrence and death. CONCLUSION The prognosis of early stage breast carcinoma patients in this study was good. To have long term tumor free and

  16. Exemestane in early breast cancer: a review

    Directory of Open Access Journals (Sweden)

    Michael Untch

    2008-12-01

    Full Text Available Michael Untch1, Christian Jackisch21Interdisciplinary Breast Centre, Helios Klinikum Berlin-Buch, University Charité, Berlin, Germany; 2Department of Gynecology/Obstetrics, Klinikum Offenbach GmbH, Offenbach, GermanyAbstract: The adjuvant treatment of women with endocrine-sensitive early breast cancer has been dominated for the last 40 years by tamoxifen. However, the side-effects associated with this therapy have prompted a search for safer and biochemically more selective endocrine agents and led to the development of the third-generation aromatase inhibitors (AIs anastrozole, letrozole and exemestane. Promising results in advanced disease have paved the way for treating early breast cancer, and AIs are increasingly replacing tamoxifen in the adjuvant setting. Several large, randomized trials with AIs have been completed or are ongoing in women with early-stage breast cancer, documenting the significant impact that these drugs are making on the risk for recurrence of breast cancer. As a result, there is increasing and widespread use of AI therapy for the treatment of early-stage endocrine-responsive breast cancer. This review summarizes the data for exemestane in the adjuvant setting, showing that a switch to exemestane after 2 to 3 years of tamoxifen therapy is associated with a statistically significant survival benefit and is regarded as being sensitive by international and national experts.Keywords: early breast cancer, adjuvant setting, endocrine-sensitive, tamoxifen, aromatase inhibitor, exemestane, switch, IES 31, NSABP B-33, TEAM

  17. Effects of early discharge following breast surgery.

    Science.gov (United States)

    Murphy, A; Holcombe, C

    2001-02-01

    A small group of breast cancer surgery patients were discharged early with axillary drains in situ. The group was examined for wound infection, seroma formation and depression, and compared to a group who stayed in hospital. There was no indication that early discharge increased seroma formation or infection. Anxiety and depression appeared to be less in the early discharge group. PMID:12029907

  18. Breast-feeding and breast cancer in the offspring.

    OpenAIRE

    Ekbom, A.; C. C. Hsieh; Trichopoulos, D; Yen, Y. Y.; Petridou, E; Adami, H. O.

    1993-01-01

    The causation of breast cancer in certain strains of mice by a virus that can be transmitted vertically, through the milk produced during lactation, has led to the hypothesis that a similar phenomenon could exist in humans. There have been laboratory-based studies in humans suggesting that a virus may be involved in the etiology of female breast cancer although other investigations did not support this hypothesis. Descriptive data and epidemiologic evidence of ecologic nature do not indicate ...

  19. A STUDY ON BREAST FEEDING PRACTICES AMONG POST- NA TAL MOTHERS ATTENDING GOVT MATERNITY HOSPITAL AT HYDE RABAD, ANDHRA PRADESH

    Directory of Open Access Journals (Sweden)

    Bhavani

    2013-05-01

    Full Text Available ABSTRACT: BACKGROUND: Breast feeding plays an essential and sometimes underestimate role in the treatment and prevention of infant and chi ldhood illness. Improving breast feeding is a highly feasible and cost effective approach to redu cing the number of infant who die from infectious disease and malnutrition early in their lives. Cont inuing to breastfeed alone could save 1 to 1.5 million lives a year. Well over 40% of 10.9 million deaths annually occur due to inappropriate feeding practices , during the 1 st year of life. Lack of breast feeding and especia lly exclusive breast feeding during the 1 st year of life are important risk factors for infant and child hood morbidity and mortality that are only compounded by inappropriat e complementary feeding . Current evidence that Breast feeding is beneficial for infant and ch ild health is based on exclusive observational studies. The experimental intervention increased th e duration and degree of breast feeding. These results provide a solid scientific under planning f or future interventions to promote Breast feeding. Breast feeding practices appear to be ineffective e ven in institutions due to lack of knowledge of importance of breast milk , colostrums, and pre-lac teal feeds. In the present study an effort is made to assess the knowledge of breast feeding practices am ong post natal women and mothers attending immunization clinic . OBJECTIVES: To study the sociodemografic factors influence on breast feeding behavior of post natal mothers and to study the awa reness of benefits of colostrums, and effect of media on breast feeding practices. MATERIALS AND METHODS : The present study is a cross- sectional, Descriptive Hospital based ,conducted i n the post natal ward at Govt Maternity Hospital, sultan Bazar, Hyderabad, A.P., participants are the Mothers who have delivered within 3days of interview, and the Mothers attending immunization c linic , having children below 1 year of age . sample

  20. Pilot Implementation of Breast Cancer Early Detection Programs in Colombia

    OpenAIRE

    Murillo, Raúl; Díaz, Sandra; Sánchez, Oswaldo; Perry, Fernando; Piñeros, Marion; Poveda, César; Salguero, Edgar; Osorio, Dimelza

    2008-01-01

    Breast cancer is increasing in developing countries, and Colombia has a double burden from cervical and breast cancer. Suitable guidelines for breast cancer early detection are needed, and the Breast Health Global Initiative provides a favorable framework for breast cancer control in low resource nations. The Colombian National Cancer Institute developed evidence-based guidelines for breast cancer early detection in which coordinated early detection in symptomatic women and hospital-based scr...

  1. Study of Relationship between Hypernatremia in Neonates and Way of Maternal Breast Feeding

    Directory of Open Access Journals (Sweden)

    H Boskabadi

    2014-04-01

    Full Text Available Introduction: The extreme reduction in breast milk intake during the first days of life leads to weight loss, kidney failure and hypernatremia. The aim of this study was to examine the relationship between hypernatremia in neonates and way of maternal breastfeeding in hospitalized infants in Ghaem Hospital of Mashhad.   Materials and Methods: After obtaining parental consent, 687 infants referred to the neonatal ward and clinic of Ghaem hospital of Mashhad participated in this cross-sectional study. First, complete history of the mother and baby regarding pregnancy and delivery problems, way of breastfeeding, and the first time of lactation beginning were obtained. Then neonates were divided into two groups of normal and hypernatremia (sodium≥150 mg/dl according to the amount of blood sodium level. Data was analyzed using correlation tests, chi-square, t test and Mann-Whitney tests with SPSS software (version 11.5.   Results: According to the findings of this study, the average age (P=0.911, Apgar scores (P=0.192, time of the first lactation (P=0.081 and breast feeding duration (P=o.108 showed no statistically significant difference between normal and hypernatremia groups. But the admission weight (P=0.011, times of lactation (P=0.108, breast-feeding status (P=0.001, let down reflex in mother’s breast (0.001, kind of nutrition (P=o.oo1, breast filling after childbirth and lactation (P=0.000, and breast softening after breast-feeding (P=0.000, urination frequency (P=0.000, defecation frequency (P=0.000 and duration of maternal hospitalization (P=0.007 showed statistically significant difference between the groups.   Conclusion: Neonatal weight control, times of lactation, lactation status, breast changes during breast feeding and frequency of urination and defecation may be effective in the early detection of the reduced breast milk intake and the control of the related complications.   Key Words: Breast Feedinf, Breast Milk

  2. Session 1: Public health nutrition. Breast-feeding practices in Ireland.

    LENUS (Irish Health Repository)

    Tarrant, R C

    2008-11-01

    Breast-feeding is the superior infant feeding method from birth, with research consistently demonstrating its numerous short- and long-term health benefits for both mother and infant. As a global recommendation the WHO advises that mothers should exclusively breast-feed for the first 6-months of life, thus delaying the introduction of solids during this time. Historically, Irish breast-feeding initiation rates have remained strikingly low in comparison with international data and there has been little improvement in breast-feeding duration rates. There is wide geographical variation in terms of breast-feeding initiation both internationally and in Ireland. Some of these differences in breast-feeding rates may be associated with differing socio-economic characteristics. A recent cross-sectional prospective study of 561 pregnant women attending a Dublin hospital and followed from the antenatal period to 6 months post partum has found that 47% of the Irish-national mothers initiated breast-feeding, while only 24% were still offering \\'any\\' breast milk to their infants at 6 weeks. Mothers\\' positive antenatal feeding intention to breast-feed is indicated as one of the most important independent determinants of initiation and \\'any\\' breast-feeding at 6 weeks, suggesting that the antenatal period should be targeted as an effective time to influence and affect mothers\\' attitudes and beliefs pertaining to breast-feeding. These results suggest that the \\'cultural\\' barrier towards breast-feeding appears to still prevail in Ireland and consequently an environment that enables women to breast-feed is far from being achieved. Undoubtedly, a shift towards a more positive and accepting breast-feeding culture is required if national breast-feeding rates are to improve.

  3. Infant feeding practices in Kenya, Mexico and Malaysia. The rarity of the exclusively breast-fed infant.

    Science.gov (United States)

    Dimond, H J; Ashworth, A

    1987-02-01

    Infant feeding practices of 6149 mothers in Kenya, Mexico and Malaysia are reported. A high proportion of mothers initiated breast-feeding in each country regardless of social class. Most Kenyan mothers continued to breast-feed for at least 12 months. In Mexico and Malaysia, however, breast-feeding was discontinued relatively early, especially among urban mothers. Early supplementation of breast-fed infants with milk and/or other food was a common practice in each of the three countries. Among breast-fed infants below 4 months of age, the percentages who were exclusively breast-fed in the urban elite, urban poor and rural groups respectively were 6, 14 and 21 per cent in Kenya, 8, 19 and 31 per cent in Mexico, and 11, 9 and 11 per cent in Malaysia. Supplementation of breast-fed infants in the first two months of life was more likely to be with infant formula than with any other milk or food. At three months of age, however, nonmilk foods were the most common supplements in all population groups with the exception of those in urban Kenya. The policy implications are discussed.

  4. Breast Feeding And Its Significance In Infant Feeding Practices In India

    Directory of Open Access Journals (Sweden)

    Belavady Bhavani

    1987-01-01

    Full Text Available Surveys on breast-feeding practices have revealed a satisfactory situation in many parts of the country. However, adequacy in terms of quality and quantity of breast milk has not been studied much. Reports available indicate secretion of adequate amount of milk by the mother. This however should not be equated with adequacy of nutrients to this growing child. Concentrations of vitamins are low. The immunologica factors, proteins, minerals and calorie content are in the normal ranges observed in milk samples obtained from well-nourished mother. Breast-feeding should be recommended for as long as possible with adequate supplements. This will have a salubrious effect on the infant and help mothers in spacing births of children. Growth of infants fed soley on breast milk is satisfactory during the first 4 to 5 months. Proper time and type of supplements to be recommended for the community in general need to be studied. Effect of work outside the house on the mother and child, if any, has not received the attention it deserves. High priority has to be a corded to this study, in the present context of dynamic change occurring in the country in relation to the working status of women. Indian is considered a developing country and Indians are conservative by nature. Attitude of the community to infant feeding has not change much except in the educated urban elite and a small section of the poor who consider practice among the former as ideal. The concern and anxiety expressed with regard to breast-feeding by health personnel in foreign countries have not evoked the same response in our country. Reasons are many but if any single reason is to be assigned, it is the popularity of breast-feeding in a vast majority of our mothers. This article will highlight the findings of selected surveys on breast-feeding in the context of our present infant and pre-school feeding practices and refers to the quality and quantity of breast milk briefly.

  5. Can Breast Cancer in Men Be Found Early?

    Science.gov (United States)

    ... BRCA mutations, including prostate cancer , pancreatic cancer , and testicular cancer . Because breast cancer in men can be caused ... Breast Cancer In Men? Causes, Risk Factors, and Prevention Early Detection, Diagnosis, and Staging Treating Breast Cancer ...

  6. Re-evaluating early breast neoplasia

    OpenAIRE

    Moulis, Sharon; Sgroi, Dennis Charles

    2008-01-01

    Historically, histomorphological and epidemiological data suggested that atypical ductal hyperplasia and ductal carcinoma in situ are the earliest recognizable neoplastic stages of breast cancer progression. Over the past several years, detailed high-throughput molecular genetic, gene expression and epigenetic analyses have enhanced our understanding of these early neoplastic lesions and have re-shaped our view of human breast cancer progression to include multiple distinct pathways of evolut...

  7. Obstacles to and motivation for successful breast-feeding

    Directory of Open Access Journals (Sweden)

    A-M Bergh

    1993-05-01

    Full Text Available This study determined obstetric physiotherapists' perceptions about major obstacles to and methods of motivation for successful breast-feeding by means of the Friedman non-parametric procedure for the two-way analysis of variance. Three categories of obstacles were identified: maternal obstacles, health professionals and society. Maternal obstacles mentioned most were insufficient motivation (25% and knowledge (24%, anxiety (14%, fatigue (14%, and employment (14%. Obstacles related to health professionals included tack of support for mothers (20%, inappropriate lactation management (19%, lack of knowledge (15%, negative attitudes (5% and staff shortages (5%. With regard to society, lack of support (27% and life-styles (29% were identified as significant obstacles. The two most significantly important methods of motivation were information and education (53% and contact with other breast-feeders (27%. It is concluded that breast-feeding education efforts can be improved by identifying obstacles to breast-feeding and methods of motivation and that the Friedman test may be a statistical procedure to consider for determining priorities.

  8. Radiotherapy in the management of early breast cancer

    OpenAIRE

    Wang, Wei

    2013-01-01

    Radiotherapy is an indispensible part of the management of all stages of breast cancer. In this article, the common indications for radiotherapy in the management of early breast cancer (stages 0, I, and II) are reviewed, including whole-breast radiotherapy as part of breast-conserving treatment for early invasive breast cancer and pre-invasive disease of ductal carcinoma in situ, post-mastectomy radiotherapy, locoregional radiotherapy, and partial breast irradiation. Key clinical studies tha...

  9. Breast-conserving surgery and radiotherapy for early breast cancer

    International Nuclear Information System (INIS)

    From March 1987 through September 1989, a total of 31 patients with early breast cancer were treated with breat-conserving surgery and radiotherapy. As of February 1989, all patients are alive without recurrence. Cosmetic results were satisfactory (excellent; 25%, good; 75%) at 1 year after radiotherapy. Mild radiation pneumonitis requiring medication developed in 3 patients. (author)

  10. Early feeding: setting the stage for healthy eating habits.

    Science.gov (United States)

    Mennella, Julie A; Ventura, Alison K

    2011-01-01

    Food habits, an integral part of all cultures, have their beginnings during early life. This chapter reviews the development of the senses of taste and smell, which provide information on the flavor of foods, and discusses how children's innate predispositions interact with early-life feeding experiences to form dietary preferences and habits. Young children show heightened preferences for foods that taste sweet and salty and rejection of that which tastes bitter. These innate responses are salient during development since they likely evolved to encourage children to ingest that which is beneficial, containing needed calories or minerals, and to reject that which is harmful. Early childhood is also characterized by plasticity, partially evidenced by a sensitive period during early life when infants exhibit heightened acceptance of the flavors experienced in amniotic fluid and breast milk. While learning also occurs with flavors found in formulae, it is likely that this sensitive period formed to facilitate acceptance of and attraction to the flavors of foods eaten by the mother. A basic understanding of the development and functioning of the chemical senses during early childhood may assist in forming evidence-based strategies to improve children's diets. PMID:22044898

  11. Nestle and breast vs. bottle feeding: mainstream and Marxist perspectives.

    Science.gov (United States)

    Campbell, C E

    1984-01-01

    The breast vs. bottle feeding issue has sparked a controversial debate. Mainstream analysis of the problem shows that arguments made by the business community, as represented by the Nestle Corporation, do not withstand examination of the evidence. For example, it cannot be substantiated that women begin formula feeding because they have entered the labor force. Mainstream studies of cost effectiveness further indicate that bottle feeding is a drain on the incomes of impoverished Third World families and nations. Marxist analysis gives a very different perspective. Nestle represents 19th century capitalist development and the Industrial Revolution, and 20th century imperialism, neocolonialism and monopoly capitalism. Its motive has been capital accumulation and expansion. To increase surplus value appropriation, capitalism must devalue the household (subsistence) economy in which women enjoyed considerable status. Women also produce the most fundamental commodity for capitalism-laborers; therefore, the biological connection must be masked and controlled for the benefit of capital. Thus, as the capitalist mode of production has developed, women have been removed from important roles in production and reproduction. Coupled with the ascendancy of science, expertism and public health imperialism, breast feeding in any market economy becomes nearly impossible. As women internalize the values of capitalist ideology, they elevate "man-made" marketed commodities over subsistence goods such as breast milk. PMID:6500784

  12. [Effect of breast feeding and psychosocial variables upon psychomotor development of 12-month-old infants].

    Science.gov (United States)

    De Andraca, I; Salas, M I; López, C; Cayazzo, M S; Icaza, G

    1999-09-01

    This study evaluates the participation of psychosocial variables in the relation between breast feeding (BF) and psychomotor development (PMD) in dyads with different BF duration. We assessed 138 mother-infant dyads, divided in two groups: 86 received BF as unique source of milk feeding for at least 6 months (prolonged BF group) and 52 were weaned before 45 days of age (early weaning group). General information about pregnancy, delivery and feeding was collected in a non experimental prospective design. At 6-7 months of age a milk feeding situation was observed at home, and mother-infant interactional patterns were recorded through a specially designed scale. At 12 months of age the PMD was assessed (Bayley Scales of Infant Development). Infant temperament, home stimulation, mother depression and family stress were also measured. Similar family characteristics were observed in both study groups. Early bonding and first feeding experiences were different, both reported as better in the prolonged BF group. Moreover, dyads of this group showed a higher variety and quality of mother-infant interactional patterns during feeding, with a higher synchrony and reciprocity in the relationship. Mean Mental Development Index (MDI) and Psychomotor Developmental Index (PDI) were similar in both groups. Explicatory variables for MDI and PDI are different in both study groups. Dyads who attained prolonged BF conform from a psychosocial perspective--a different group than the early weaned. PMID:10667261

  13. [Breast feeding: importance of supportive counseling to the working mother].

    Science.gov (United States)

    Elgueta Noy, S; Paz Guzmán, P; Masalán, P

    1998-07-01

    This descriptive, exploratory, retrospective and transversal investigation tries to answer the following questionnaire: What is the impact that the Support Consultation to the working mother--Diagnosis Center of the Pontifical Catholic University of Chile--has on breast-feeding prolongation? The population that has been studied is formed by 82 mothers attended in the Support Consultation during March '95/September '95 period and from which a number of 30 people were taken as a sample. The impact of this consultation was evaluated with an instrument employed during an interview to each mother. Data were statistically analyzed with EPIINFO, the Kaplan-Meier survival method and the Mantel-Haenszel test to compare curves of survival. During data analysis authors found that mothers are mainly young adults, stable couples, first-time mothers, with technical and/or professional educational level, chiefly working as office clerks with full-time jobs and having a significant difference between existing minimum salary and the maximum one they earn. The results of this investigation lead us to the conclusion that mothers obtained an exclusive breast-feeding and ideal weaning age. The power of resolution of the Consultation--according to mothers--was satisfactory. The support given to the mother after her reincorporation to work is the most significant intensifier factor in relation with the increase in the probability of keeping on breast-feeding. In conclusion, the Consultation has good impact.

  14. Breast-Feeding Attitudes and Behavior among WIC Mothers in Texas

    Science.gov (United States)

    Vaaler, Margaret L.; Stagg, Julie; Parks, Sharyn E.; Erickson, Tracy; Castrucci, Brian C.

    2010-01-01

    Objective: This study explored the influence of demographic characteristics on attitudes toward the benefits of breast-feeding, approval of public breast-feeding, and the use of infant formula. Additionally, the study examined whether attitudes were related to infant feeding practices among mothers enrolled in the Special Supplemental Nutrition…

  15. Council tax valuation band predicts breast feeding and socio-economic status in the ALSPAC study population

    Directory of Open Access Journals (Sweden)

    Herrick David

    2006-01-01

    Full Text Available Abstract Background Breast-feeding rates in the UK are known to vary by maternal socio-economic status but the latter function is imperfectly defined. We test if CTVB (Council Tax Valuation Band – a categorical assessment of UK property values and amenities governing local tax levies of maternal address predicts, in a large UK regional sample of births, (a breast-feeding (b personal and socio-economic attributes of the mothers. Methods Retrospective study of a subset (n.1390 selected at random of the ALSPAC sample (Avon Longitudinal Study of Parents and Children, a large, geographically defined cohort of mothers followed from early pregnancy to 8 weeks post-delivery. Outcome measures are attitudes to breast-feeding prior to delivery, breast-feeding intention and uptake, demographic and socio-economic attributes of the mothers, CTVB of maternal home address at the time of each birth. Logistic regression analysis, categorical tests. Results Study sample: 1360 women divided across the CTVBs – at least 155 in any band or band aggregation. CTVB predicted only one belief or attitude – that bottle-feeding was more convenient for the mother. However only 31% of 'CTVB A infants' are fully breast fed at 4 weeks of life whereas for 'CTVB E+ infants' the rate is 57%. CTVB is also strongly associated with maternal social class, home conditions, parental educational attainment, family income and smoking habit. Conclusion CTVB predicts breast-feeding rates and links them with social circumstances. CTVB could be used as the basis for accurate resource allocation for community paediatric services: UK breast-feeding rates are low and merit targeted promotion.

  16. KNOWLEDGE, ATTITUDE AND PRACTICES OF NOURISHING MOTHERS ABOUT BREAST FEEDING, ATTENDING URBAN HEALTH CENTRE: A CROSS - SECTIONAL STUDY FROM KISHANGANJ, BIHAR

    Directory of Open Access Journals (Sweden)

    Laxman

    2014-02-01

    Full Text Available BACKGROUND : Breast feeding is almost universal , but there are many barriers for proper breast feeding practices. Despite the well - recognized importance of exclusive breast feeding (EBF , this practice is not widespread i n the developing countries like India. This is mainly due to lack of understanding and poor adherence of mothers to EBF practices for the first 6 months postpartum. Also , the knowledge and practices of early breast feeding are suboptimal among mothers. OBJ ECTIVE : To know knowledge , attitude and practices of nourishing rural mothers about breast feeding and their association with demographic variables. MATERIALS AND METHODS : The study was a cross - sectional study , performed in M.G.M.M.C. & L.S.K Hospital , Kishanganj , Bihar , between December - 2013 to January - 2014. A total of 129 nourishing mothers of children between 0 - 2 years of age were selected. Breast feeding knowledge of the mothers was evaluated by giving them a printed structured questionnaire containi ng different types of questions regarding breast feeding. RESULT : Among 129 nourishing mothers , 100% knew that mother’s milk is the best food for the baby. 71.3% of the mothers were having knowledge that breast feeding should be started within ½ hr. of bir th. 86.8% of the mothers were having knowledge that EBF should be given upto 6 months. CONCLUSION : This study showed a lack of understanding of the importance of breast feeding and poor adherence to EBF for the first 6 months of baby’s life. A lot of gap i s present between literate and illiterate mothers in breast feeding practices , which need to be changed

  17. Treatment of early breast cancer with conservation of the breast

    International Nuclear Information System (INIS)

    This paper reviews the current status of conservative treatment for early breast cancer. Radiotherapy to the breast after local tumour excision is important to prevent local breast relapse, but it is not clear whether it has any influence on the risk of distant metastases. Several questions remain to be answered. While most investigators agree that the breast should receive a radiation dose of about 50 Gy in 5 weeks, there is no general agreement about the need for a tumour bed booster dose. Considering patients with tumour infiltration at the surgical resection line for whom it is not possible for cosmetic reasons to perform re-resection, it is not clear whether an acceptable local control rate can be achieved through application of a high booster dose in the tumour bed. More trials are needed to show whether certain patients with small invasive carcinomas should be treated with wide local excision without radiotherapy. The need for radiotherapy after local excision for small intraductal (ductal carcinoma in situ) cancers is being addressed in ongoing trials. (orig.)

  18. Use of proteomics for the early diagnosis fo breast cancer

    NARCIS (Netherlands)

    van Winden, A.W.J.

    2010-01-01

    Breast cancer mortality rates in The Netherlands are among the highest in Europe. To improve breast cancer survival, early detection is of vital importance. The introduction of the national breast cancer screening program has led to an improvement in stage distribution at diagnosis of breast cancer.

  19. Maternal factors in newborns breast feeding jaundice: a case control study

    OpenAIRE

    Alizadeh Taheri P; Sepahran M; Shariat M

    2013-01-01

    Background: Neonatal jaundice, especially breast feeding jaundice is one of the most common causes of neonatal readmission during the first month of life. Breast feeding jaundice may be due to decreased milk intake with dehydration and/or reduced caloric intake.  The aim of this Study was to determine maternal risk factors of breast feeding jaundice in order to prevent it than before.Methods: This case- control study was performed at Bahrami University Hospital, Tehran, Iran and involved...

  20. Breast MRI, digital mammography and breast tomosynthesis: Comparison of three methods for early detection of breast cancer

    OpenAIRE

    Dragana Roganovic; Dragana Djilas; Sasa Vujnovic; Dag Pavic; Dragan Stojanov

    2015-01-01

    Breast cancer is the most common malignancy in women and early detection is important for its successful treatment. The aim of this study was to investigate the sensitivity and specificity of three methods for early detection of breast cancer: breast magnetic resonance imaging (MRI), digital mammography, and breast tomosynthesis in comparison to histopathology, as well as to investigate the intraindividual variability between these modalities.  We included 57 breast lesions, each detected by ...

  1. Breast-feeding and Vitamin D Supplementation Rates in the Ochsner Health System

    OpenAIRE

    Ponnapakkam, Tulasi; Ravichandran, Anisha; Bradford, Elease; Tobin, Gregory; Gensure, Robert

    2008-01-01

    Breast-feeding imparts many benefits to both mothers and infants. Because of these numerous recognized benefits, there has been an effort to increase breast-feeding rates nationwide; increasing breast-feeding rates was one of the goals of the U.S. Department of Health and Human Services' Healthy People 2010 initiative. This study examined the breast-feeding rate at the Ochsner Clinic Foundation by conducting a retrospective chart review of patients aged 0–12 months who visited any branch of t...

  2. Hypernatraemic dehydration and breast feeding: a population study.

    Science.gov (United States)

    Oddie, S; Richmond, S; Coulthard, M

    2001-10-01

    As part of a population based regional review of all neonatal readmissions, the incidence of dehydration with hypernatraemia in exclusively breast fed infants was estimated. All readmissions to hospital in the first month of life during 1998 from a population of 32 015 live births were reviewed. Eight of 907 readmissions met the case definition, giving an incidence of at least 2.5 per 10 000 live births. Serum sodium at readmission varied from 150 to 175 mmol/l. One infant had convulsions. The sole explanation for hypernatraemia was unsuccessful breast feeding in all cases. The eight cases are compared with the 65 cases published in the literature since 1979. Presentation, incidence, risk factors, pathophysiology, treatment, and prevention are discussed.

  3. Use of psychotropic drugs during pregnancy and breast-feeding

    DEFF Research Database (Denmark)

    Larsen, E R; Damkier, P; Pedersen, L H;

    2015-01-01

    with a psychiatric disease, we asked the Danish Psychiatric Society, the Danish Society of Obstetrics and Gynecology, the Danish Paediatric Society and the Danish Society of Clinical Pharmacology to appoint members for the working group. A comprehensive review of the literature was hereafter conducted. RESULTS......OBJECTIVE: To write clinical guidelines for the use of psychotropic drugs during pregnancy and breast-feeding for daily practice in psychiatry, obstetrics and paediatrics. METHOD: As we wanted a guideline with a high degree of consensus among health professionals treating pregnant women...

  4. A comparative analytic study of knowledge, attitude and practice of breast feeding in primi and multipara women at a tertiary care centre in Gujarat, India

    Directory of Open Access Journals (Sweden)

    Manthan Patel

    2016-10-01

    Conclusions: Efforts need to be made to help mother to initiate feeding early specially in caesarean section. Women need to be made aware of benefits of breast feeding and proper techniques. Health care providers and nursing staff should be encouraged to actively participate in proper counselling and training of mothers. [Int J Res Med Sci 2016; 4(10.000: 4403-4407

  5. Exclusive breast-feeding practice and associated factors in Enugu, Nigeria.

    Science.gov (United States)

    Aghaji, Margaret N

    2002-01-01

    A cross-sectional questionnaire survey was conducted among 235 infant-mother pairs in five Baby Friendly pairs in five Baby Friendly Hospitals in Enugu-Nigeria in 1998. The aims were to study their breast-feeding practices and associated factors. The exclusive breast-feeding rate was 33.3% while the predominant breast-feeding rate was 50.2%. Factors associated with exclusive breast-feeding included infants' birth order (P = 0.015), fathers' education (P =0.0244), mothers' education (P = 0.000001), occupation (P = 0.0069) and parity (P = 0.004). However, the infants' age (P = 0.054) and sex (P = 0.403), mothers' age (P = 0.2005), number of breast-feeding counseling attendances (P = 0.0883) and the breast-feeding initiator (P = 0.473) were comparable irrespective of breast-feeding practice. In the mothers' perspectives, the commonest reasons for not breastfeeding exclusively included; insufficient breast milk (58,37.0%) and the sociocultural practice of giving water to babies because of the hot climate (52,33.1%). For an improvement in the exclusive breast-feeding rate of this population, health workers should highlight to mothers the dangers of water supplementation and the dynamics of breastmilk supply through health education, home visits and the formation of community based lactation support groups. PMID:12081350

  6. Circulating GLP-1 in infants born small-for-gestational-age: breast-feeding versus formula-feeding.

    Science.gov (United States)

    Díaz, M; Bassols, J; Sebastiani, G; López-Bermejo, A; Ibáñez, L; de Zegher, F

    2015-10-01

    Prenatal growth restraint associates with the risk for later diabetes, particularly if such restraint is followed by postnatal formula-feeding (FOF) rather than breast-feeding (BRF). Circulating incretins can influence the neonatal programming of hypothalamic setpoints for appetite and energy expenditure, and are thus candidate mediators of the long-term effects exerted by early nutrition. We have tested this concept by measuring (at birth and at age 4 months) the circulating concentrations of glucagon-like peptide-1 (GLP-1) in BRF infants born appropriate-for-gestational-age (AGA; n=63) and in small-for-gestational-age (SGA) infants receiving either BRF (n=28) or FOF (n=26). At birth, concentrations of GLP-1 were similar in AGA and SGA infants. At 4 months, pre-feeding GLP-1 concentrations were higher than at birth; SGA-BRF infants had GLP-1 concentrations similar to those in AGA-BRF infants but SGA-FOF infants had higher concentrations. In conclusion, nutrition appears to influence the circulating GLP-1 concentrations in SGA infants and may thereby modulate long-term diabetes risk. PMID:26088812

  7. THYROID HORMONE PROFILE IN EARLY BREAST CANCER PATIENTS

    Directory of Open Access Journals (Sweden)

    Renija Valiya

    2016-06-01

    Full Text Available BACKGROUND Breast cancer is the most common malignant tumour in women worldwide. The relationship between breast cancer and thyroid disease is a controversy. Many of the studies showed hypothyroidism as the commonly found thyroid abnormality in breast cancer. [1] There is considerable evidence for an increased risk of thyroid and breast cancer in patients with iodine deficiency. This ability of iodine to reduce the risk of breast cancer is attributed to the ability of iodine and its compounds to induce apoptosis so that appropriate cell death occurs. Instead, in the absence of optimum level of iodine in the body the transformed cells continue to grow and divide resulting in cancer. AIMS 1. To find out the association of thyroid hormones and breast cancer in early breast cancer patients. 2. To find out the association of thyroid peroxidase antibodies in early breast cancer patients. Settings Cases: 82 breast cancer patients in early stage who attended the breast clinic. Controls: 82 age matched controls (Between 25-80 years. Design: Case control study. MATERIALS AND METHOD In this study, investigated for thyroid function test (T3, T4, TSH and thyroid peroxide antibody level in 82 early breast cancer patients. STATISTICAL ANALYSIS SPSS 16. RESULTS Statistically significant low T4 and high TSH in breast cancer patients, along with elevated thyroid peroxidase antibody. CONCLUSION Compared to hyperthyroidism, hypothyroidism was found to be clinically significant in breast cancer patients

  8. Does Breast Feeding Protect the Hypothyroid Infant Diagnosed by Newborn Screening?

    Science.gov (United States)

    Rovet, Joanne F.

    Because breast milk contains small quantities of thyroid hormones not found in commercial formula preparations, it was hypothesized that breast feeding may provide some protective benefit to the hypothyroid infant before medical treatment is begun. Of 108 children with congenital hypothyroidism, breast-fed children had higher thyroid hormone…

  9. Computerized Analysis of Breast Thermograms for Early Diagnosis of Breast Cancer

    OpenAIRE

    Asmita Wakankar; G. R. Suresh

    2012-01-01

    Breast cancer is one of the leading causes of death in women. Early detection of breast cancer is the key to improve survival rate. Malignant tumors causes localized temperature increase on breast surface which shows as hot spot and vascular patterns in breast infrared thermograms. Thermographic detection of breast cancer primarily depends on the visual analysis of these patterns by physicians, which is hard to provide objective and quantitative analysis. This paper proposes computerized anal...

  10. Breast MRI, digital mammography and breast tomosynthesis: comparison of three methods for early detection of breast cancer

    Directory of Open Access Journals (Sweden)

    Dragana Roganovic

    2015-11-01

    Full Text Available Breast cancer is the most common malignancy in women and early detection is important for its successful treatment. The aim of this study was to investigate the sensitivity and specificity of three methods for early detection of breast cancer: breast magnetic resonance imaging (MRI, digital mammography, and breast tomosynthesis in comparison to histopathology, as well as to investigate the intraindividual variability between these modalities.  We included 57 breast lesions, each detected by three diagnostic modalities: digital mammography, breast MRI, and breast tomosynthesis, and subsequently confirmed by histopathology. Breast Imaging-Reporting and Data System (BI-RADS was used for characterizing the lesions. One experienced radiologist interpreted all three diagnostic modalities. Twenty-nine of the breast lesions were malignant while 28 were benign. The sensitivity for digital mammography, breast MRI, and breast tomosynthesis, was 72.4%, 93.1%, and 100%, respectively; while the specificity was 46.4%, 60.7%, and 75%, respectively. Receiver operating characteristics (ROC curve analysis showed an overall diagnostic advantage of breast tomosynthesis over both breast MRI and digital mammography. The difference in performance between breast tomosynthesis and digital mammography was significant (p < 0.001, while the difference between breast tomosynthesis and breast MRI was not significant (p = 0.20. 

  11. 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.

  12. Comorbidity and survival after early breast cancer. A review

    DEFF Research Database (Denmark)

    Land, Lotte Holm; Dalton, Susanne Oksbjerg; Jørgensen, Trine Lembrecht;

    2011-01-01

    INTRODUCTION: Survival after breast cancer is determined by disease related factors such as stage at diagnosis, patient characteristics, e.g., age, and treatment. AIM: To review evidence published during the last ten years on the effect of comorbidity on survival after early breast cancer. METHODS......: A search in Pubmed with keywords, breast neoplasm, comorbidity, and survival, was performed. A total of 18 studies published between 2000 and August 2010 was included in this review. RESULTS: All 18 studies demonstrated that comorbidity had a significant impact on survival after breast cancer with poorer...... is an important prognostic factor in early breast cancer, irrespective of age and stage of disease....

  13. [India: breast feeding is obsolete, the bottle is modern].

    Science.gov (United States)

    Uniyal, M

    1992-09-01

    In July, 1992 Indian health groups met in New Delhi to demand that the government promote a child nutrition code based on the 1981 code of the WHO which stated that mother's milk is quite sufficient and is the best nourishment for infants. Every day approximately 40,000 children are born in India, but thousands of them die in infancy because of infection caused by the unsanitary mixing of milk powder in unsterile bottles. Indian health activists want the government to regulate the production, access, and distribution of mother's milk substitutes, bottles, and child nutriments. A new law based on internationally recognized codes for marketing mother's milk substitutes could put an end to the present irresponsible marketing. Activists are not opposed to the production of milk powder, but they think it should only be used when the mother has no milk. The turnover of India's child nutrition industry is about $280 million per year with an annual increase of 5%. The use of bottle feeding has infiltrated the whole urban scene, and it is spreading in rural areas. Women consider bottle feeding a modern way of child feeding. 60 million kg of milk powder is produced yearly and sold under 25 different product names. Amul and Nestle command 85% of the growing market. Experts have calculated that 1 billion liters of mother's milk is wasted and replaced by substitute milk every year. Many Indian children get their first substitute milk at health posts where free or subsidized milk is distributed despite notices calling on mothers to breast-feed. According to a national survey sponsored by UNICEF, almost 1/2 of India's mothers give their children milk substitutes at the instigation of doctors or health personnel. 63% of children in the state of West Bengal were undernourished because families did not buy enough milk powder. The activists want the government to launch an offensive against the advertisement of breast milk substitutes in state-owned TV and radio and to promote proper

  14. Maternal Infant Feeding Behaviors and Disparities in Early Child Obesity

    OpenAIRE

    Gross, Rachel S.; Mendelsohn, Alan L.; Fierman, Arthur H.; Hauser, Nicole R.; Messito, Mary Jo

    2014-01-01

    Background: Although disparities in child obesity exist during infancy, the underlying mechanisms are unclear. Assessing dissimilarities in feeding practices, styles, and beliefs may provide a better understanding of these mechanisms. This study sought to identify modifiable maternal-infant feeding behaviors that may contribute to disparities in early child obesity.

  15. Breast Cancer Metastasis to the Stomach Resembling Early Gastric Cancer

    OpenAIRE

    Eo, Wan Kyu

    2008-01-01

    Breast cancer metastases to the stomach are infrequent, with an estimated incidence rate of approximately 0.3%. Gastric metastases usually are derived from lobular rather than from ductal breast cancer. The most frequent type of a breast cancer metastasis as seen on endoscopy to the stomach is linitis plastica; features of a metastatic lesion that resemble early gastric cancer (EGC) are extremely rare. In this report, we present a case of a breast cancer metastasis to the stomach from an infi...

  16. The professionalising of breast feeding--where are we a decade on?

    Science.gov (United States)

    Barclay, Lesley; Longman, Jo; Schmied, Virginia; Sheehan, Athena; Rolfe, Margaret; Burns, Elaine; Fenwick, Jennifer

    2012-06-01

    This paper is an empirically informed opinion piece revisiting an argument published in Midwifery 10 years ago, that the increasing professionalisation of breast feeding was not supporting women in Australia in sustaining breast feeding. We present the last 10 years of primary research on the topic, explore major policy initiatives and the establishment and growth of lactation consultants in Australia to see if this has made a difference to sustained rates of breast feeding. We present an analysis of the only consistently collected national statistics on breast feeding and compare this with national and state level government data collections from the last decade. We have found that the considerable effort invested in trying to improve duration of breast feeding amongst women in Australia appears to have failed to improve sustained breast-feeding rates. We argue that this situation might be related to losing sight of the embodied nature of breast feeding and the relationships that must exist between the mother and baby, the knowledge and skills women quickly develop, and a loss of woman to woman support. We conclude that midwives have a major role in avoiding us reproducing similar, unintended, negative consequences to those resulting from increasing obstetrician managed normal birth. These include midwifery scrutiny and involvement in policy development and institutional practices and the design of services.

  17. Clinical Management of the Breast-Feeding Mother-Infant Dyad in Recovery From Opioid Dependence.

    Science.gov (United States)

    Busch, Deborah W

    2016-01-01

    Human milk is one of the most health-promoting and cost-effective nutritional substances known to humankind. Breastmilk provides substantial and remarkable physiological and psychological health benefits. Within the last decade, there has been a resurgence of breast-feeding in the United States and worldwide and an increased awareness of the immense health benefits for mothers, infants, and societies that support it. Each mother-baby dyad is a unique pair, with distinct relationships, biases, barriers, and obstacles. This article aims to address clinical management for the opioid-recovering breast-feeding dyad and to translate current evidenced-based practice findings, recommendations, and resources to best support this unique population. The recovering breast-feeding mother and newborn with opioid dependence deserve special consideration and expert care to foster their recovery and breast-feeding efforts. It is our moral and ethical responsibility as healthcare professionals to enable, foster, and promote breast-feeding among all families, especially those who stand to benefit the greatest. Substance recovery cannot be treated in isolation, nor can breast-feeding efforts; an interdisciplinary professional team effort promises the greatest chances for recovery success. With appropriate evidence-based practice support, training, and intervention by knowledgeable professionals, many women can overcome the biases and obstacles associated with opioid recovery to successfully breast-feed their babies. PMID:27272990

  18. Diagnosis and minimally invasive treatment of early stage breast carcinoma

    NARCIS (Netherlands)

    van Esser, S.

    1979-01-01

    In this thesis the diagnostic work up and minimally invasive surgical treatment of early stage breast carcinoma is studied. Although the surgical treatment of breast carcinoma has improved significantly over the past decades, there is still room for improvement. On the one hand the focus is on early

  19. Pap, gruel, and panada: early approaches to artificial infant feeding.

    Science.gov (United States)

    Obladen, Michael

    2014-01-01

    This paper collects information on artificial infant feeding published before 1860, the year when commercial formula became available. We have extensive artifactual evidence of thousands of feeding vessels since the Bronze Age. Special museum collections can be found in London, Paris, Cologne, Fécamp, Toronto, New Mexico, and elsewhere. The literature on the use of animal milk for infant feeding begins with Soranus in the 2nd century CE. Literature evidence from the very first printed books in the 15th century proves that physicians, surgeons, midwives, and the laity were aware of the opportunities and risks of artificial infant feeding. Most 17th to 19th century books on infant care contained detailed recipes for one or several of the following infant foods: pap, a semisolid food made of flour or bread crumbs cooked in water with or without milk; gruel, a thin porridge resulting from boiling cereal in water or milk, and panada, a preparation of various cereals or bread cooked in broth. During the 18th century, the published opinion on artificial feeding evolved from health concerns to a moral ideology. This view ignored the social and economic pressures which forced many mothers to forego or shorten breast-feeding. Bottle-feeding has been common practice throughout history.

  20. The influence of culture on breast-feeding decisions by African American and white women.

    Science.gov (United States)

    Street, Darlene Joyner; Lewallen, Lynne Porter

    2013-01-01

    The purpose of this study was to examine how culture influenced breast-feeding decisions in African American and white women, using the Theory of Culture Care Diversity and Universality as a framework. One hundred eighty-six participants responded to the following: The word culture means beliefs and traditions passed down by your family and friends. How has culture affected how you plan to feed your baby? Qualitative content analysis was used to analyze the data. Four categories of responses were identified: influences of family, known benefits of breast-feeding, influences of friends, and personal choice. The findings suggest that race alone may not be as influential in infant feeding decisions as other factors. Although some women acknowledged the effect of their cultural background and experiences, most women reported that their culture did not affect their infant feeding decision. In this population, breast-feeding decisions were based on the influences of family, friends, self, and the perceived knowledge of breast-feeding benefits. Although breast-feeding statistics are commonly reported by race, cultural influences on infant feeding decisions may transcend race and include the influence of family and friends, learned information from impersonal sources, and information that is shared and observed from other people.

  1. Diagnosis and surgical treatment of suspicious nonpalpable breast lesions and early breast cancer

    OpenAIRE

    Saarela, A. (Arto)

    1999-01-01

    Abstract The purposes of the present research were to evaluate (1) the value of ultrasonographically guided fine-needle aspiration biopsy (US-FNAB) in nonpalpable suspicious breast lesions, (2) the preoperative use of methylene blue staining in nonpalpable galactographically suspicious breast lesions, (3) the determinants of positive histologic margins and residual cancer in wire-guided biopsy (WGB) of nonpalpable breast cancer and in lumpectomy for early breast ...

  2. Reasons for failure of breast-feeding counselling: mothers' perspectives in Bangladesh.

    Science.gov (United States)

    Haider, R; Kabir, I; Hamadani, J D; Habte, D

    1997-01-01

    During the hospitalization in the Dhaka hospital of the international Centre for Diarrhoeal Disease Research, Bangladesh, of a group of partially breast-fed infants aged 1-12 weeks who had been admitted with acute diarrhoea, their mothers were individually counselled by breast-feeding counsellors to start exclusive breast-feeding. The counselling was repeated 1 week later at home, and the women's infant-feeding practices were evaluated 2 weeks after their infants had been discharged from hospital. A total of 25% of the mothers failed to breast-feed exclusively despite having been counselled. The case studies of these mothers illustrate that although they generally complained about having "insufficient breast milk" various factors such as domineering grandmothers, lack of financial support by their husbands, too much housework, or disinterest contributed to their failure to breast-feed exclusively. While family support is essential for all lactating mothers, women with familial or financial problems require special attention and extra counselling sessions so that they can be helped to identify how to achieve and sustain exclusive breast-feeding. PMID:9277005

  3. Factores que influyen en el abandono temprano de la lactancia por mujeres trabajadoras Factors associated with short duration of breast-feeding in Mexican working women

    Directory of Open Access Journals (Sweden)

    Manuel Navarro-Estrella

    2003-08-01

    . Mothers were divided into two groups, based on breast-feeding duration: those who breast-fed for less than 3 months and those who did so for three months or more. Logistic regression was used to identify the factors associated with short duration of breast-feeding. RESULTS: One-hundred and twelve mothers (42.3% abandoned breast-feeding early. Risk factors were: poor maternal knowledge on breast-feeding, odds ratio (OR 5.97, 95% confidence interval (CI 1.67-20.67; mothers with no previous breast-feeding experience OR 2.98, 95% CI 1.66-5.36; mothers planning to breast-feed their babies for less than 3 months (OR 16.24, 95% CI 5.37-49.12; and mothers with no access to breast-feeding facilities at work (OR 1.99, 95% CI 1.12-3.56. CONCLUSIONS: The main factors associated with short duration of breast-feeding were the maternal ones. The only work-related factor associated with short duration of breast-feeding was the absence of breast-feeding facilities. It is probable that maternal knowledge on breast-feeding, previous breast-feeding experience, and the availability of facilities at work for breast-feeding affect the maternal decisions on breast-feeding duration.

  4. Three decades of breast-feeding trends in Singapore.

    Science.gov (United States)

    Chua, S; Viegas, O A; Ratnam, S S

    1990-03-01

    In 1985, about 60% of well-to-do mothers in Singapore initiated breastfeeding (BF). This value compares favorably with the 36% of poor mothers BF, but is still unacceptably low compared with the 85-95% of well-to-do mothers and 90% of poor mothers who were BF their babies during the 1950s. There has been a general decline in the incidence and duration of BF in Singapore over the last 36 years, however, in the last decade, a larger proportion of well-to-do mothers had initiated and continued BF. Whilst the overall decline probably reflects increasing affluence and "westernization" of the population, the variation between these 2 economic groups is probably a result of differences in education. Among the 3 major ethnic communities, the Chinese favor BF the least and the Malays favor it the most. The differences are also believed to be related to cultural variations and the ability of the ethnic groups to resist the trend towards BF in favor of traditional practices and beliefs. In 1951, over 80% of infants were BF for 4 or more weeks, but by 1978 only 37% were being breast fed. In 1985, 39% of the well-to-do mothers chose to breastfed their infants. Differences between well-to-do and poor groups were originally small. During the 1960-1970 period, the differences widened. In the 1980s, they seem to have narrowed, however. Among the poor population, the proportion seems to be leveling off, while it is going up for well-to-do mothers. These changes are not unique to Singapore. The ethnic community has, and continues to have, a strong influence on the choice of feeding method. Ethnic Chinese throughout Southeast Asia are poor breast feeders. The most important traditional practice for the Malay and Indian mothers is support from relatives. Their religion may play an important role, too. Islam tells them to breastfeed. Chinese mothers often have false ideas about BF. They feel that it will ruin their figures, or that artificial formulas are better because they are more

  5. Progress in promoting breast-feeding, combating malnutrition, and composition and use of infant formula, 1981-2006

    Science.gov (United States)

    More than 90% of women in developing countries and 50 to 90% of women in industrialized countries now initiate breast-feeding, a marked improvement from 25 y ago. The duration of breast-feeding has lengthened, but fewer than 35% of infants worldwide are still exclusively breast-fed at 4 mo of age. C...

  6. Lunge feeding in early marine reptiles and fast evolution of marine tetrapod feeding guilds

    OpenAIRE

    Motani, R; Chen, XH; Jiang, DY; Cheng, L.; Tintori, A; O. Rieppel

    2015-01-01

    Traditional wisdom holds that biotic recovery from the end-Permian extinction was slow and gradual, and was not complete until the Middle Triassic. Here, we report that the evolution of marine predator feeding guilds, and their trophic structure, proceeded faster. Marine reptile lineages with unique feeding adaptations emerged during the Early Triassic (about 248 million years ago), including the enigmatic Hupehsuchus that possessed an unusually slender mandible. A new specimen of this genus ...

  7. Adjuvant chemotherapy in early breast cancer.

    Science.gov (United States)

    Ejlertsen, Bent

    2016-05-01

    With long-term follow-up, the DBCG 77B trial demonstrates that oral single-agent cyclophosphamide significantly reduces the risk of recurrence and mortality as compared with no systemic therapy in pre-menopausal patients with high-risk early breast cancer. DBCG 77B is the only randomised trial assessing single-agent cyclophosphamide; and a second comparison suggests that its benefits are comparable to what may be achieved by classic CMF. The lack of benefits from adding methotrexate and fluorouracil to cyclophosphamide paved the way for combining cyclophosphamide with anthracyclines and later taxanes. DBCG 89D showed an incremental benefit in DFS and OS from substituting methotrexate with epirubicin. The advantage of anthracycline-containing three-drug combinations over CMF was confirmed by others and in the individual-patient EBCTCG meta-analysis, while standard AC or EC for four cycles not was superior to classic CMF. A further reduction in breast cancer mortality appeared in the EBCTCG meta-analysis from the addition of a taxane to a standard AC, while the substitution of cycles or drugs with a taxane was not associated with a reduction in mortality. No apparent benefit was observed in an early analysis of the DBCG 82C evaluating the addition of CMF to tamoxifen in post-menopausal high-risk breast cancer patients. Apart from menopausal status, the two trials had identical selection criteria, and the differences in outcome warranted a long-term follow-up of the 82C trial. After ten years of follow-up, CMF in the DBCG 82C was associated with a significant improvement in DFS; but even with 24 years of follow-up, mortality was not significantly improved. The diversity in outcome from the 77C and the 82B trials triggered further studies. The 77B trial used classic CMF with oral cyclophospamide, while a four-weekly intravenous CMF regimen was used in the 82B and C trials, and a three-weekly CMF regimen was used in the succeeding 89B and D trials. The outcome following

  8. Early myocardial deformation abnormalities in breast cancer survivors

    NARCIS (Netherlands)

    Bulten, B.F.; Mavinkurve-Groothuis, A.M.C.; Geus-Oei, L.F. de; Haan, A.F.J. de; Korte, C.L. de; Bellersen, L.; Laarhoven, H.W.M. van; Kapusta, L.

    2014-01-01

    To evaluate the role of 2D myocardial strain (rate) imaging in the detection of early subclinical cardiotoxicity in breast cancer survivors treated with an anthracycline-based chemotherapeutic regimen. 57 adult breast cancer survivors were analyzed 1 year after therapy. All patients underwent biomar

  9. Early retirement and non-employment after breast cancer

    DEFF Research Database (Denmark)

    Lindbohm, M-L; Kuosma, E; Taskila, T;

    2014-01-01

    This study examined whether workplace support, sociodemographic factors and co-morbidity are associated with early retirement or non-employment due to other reasons among breast cancer survivors. We also compared quality of life and chronic symptoms (pain, fatigue, anxiety and depression) among...... employed, retired and other non-employed breast cancer survivors....

  10. Prognostic value of breast cancer subtypes on breast cancer specific survival, distant metastases and local relapse rates in conservatively managed early stage breast cancer: a retrospective clinical study

    OpenAIRE

    Sanpaolo, Pietro; Barbieri, Viviana; Genovesi, Domenico

    2011-01-01

    International audience To ascertain if breast cancer subtypes had prognostic effect on breast cancer specific survival, distant metastases and local relapse rates in women affected by early stage breast cancer.

  11. A Breast Tissue Protein Expression Profile Contributing to Early Parity-Induced Protection Against Breast Cancer

    Directory of Open Access Journals (Sweden)

    Christina Marie Gutierrez

    2015-11-01

    Full Text Available Background/Aims: Early parity reduces breast cancer risk, whereas, late parity and nulliparity increase breast cancer risk. Despite substantial efforts to understand the protective effects of early parity, the precise molecular circuitry responsible for these changes is not yet fully defined. Methods: Here, we have conducted the first study assessing protein expression profiles in normal breast tissue of healthy early parous, late parous, and nulliparous women. Breast tissue biopsies were obtained from 132 healthy parous and nulliparous volunteers. These samples were subjected to global protein expression profiling and immunohistochemistry. GeneSpring and MetaCore bioinformatics analysis software were used to identify protein expression profiles associated with early parity (low risk versus late/nulliparity (high risk. Results: Early parity reduces expression of key proteins involved in mitogenic signaling pathways in breast tissue through down regulation of EGFR1/3, ESR1, AKT1, ATF, Fos, and SRC. Early parity is also characterized by greater genomic stability and reduced tissue inflammation based on differential expression of aurora kinases, p53, RAD52, BRCA1, MAPKAPK-2, ATF-1, ICAM1, and NF-kappaB compared to late and nulli parity. Conclusions: Early parity reduces basal cell proliferation in breast tissue, which translates to enhanced genomic stability, reduced cellular stress/inflammation, and thus reduced breast cancer risk.

  12. Breast feeding and growth in a group of selected 0 to 24 months infants

    International Nuclear Information System (INIS)

    WHO is undertaking a combined growth study in several countries, in order to establish adequate growth curves for breast-feeding infants. Present growth charts in use, were obtained in a sample of breast and artificial feeding infants, which have overestimated the growth needs. In our country during the last two decades the number of mothers who decide to breast-feed their infants has permanently grown, due to the implementation of health care programs that promote, mother-infant interaction tight after birth, in all Public Hospitals, and education programs for the mothers, during both antenatal and post natal control of mother and child. The last figures obtained in a country sample of 10000 mother-infant pair, shows that 45% of the mothers are exclusively breast-feeding their infants at 6 months of age. This figure could increase if our infants were evaluated by the adequate charts, because it is of common use that many health professionals suggest to stop breast-feeding because the infant is not growing according the charts in use. The anthropometric study proposed by WHO will benefit considerably by adding determination of breast-milk intake using isotopic dilution of deuterium, a standard procedure proposed by Coward et al and extensively used in our country. The proposed study will also include milk composition (fat, protein and lactose) and energy density of milk to correlate energy supply, milk volume and growth. (author)

  13. Early Feeding Is Feasible after Emergency Gastrointestinal Surgery

    OpenAIRE

    Lee, Hyung Soon; Shim, Hongjin; Jang, Ji Young; Lee, Hosun; Lee, Jae Gil

    2014-01-01

    Purpose This study was undertaken to assess the feasibility of early feeding in patients that have undergone emergency gastrointestinal (GI) surgery. Materials and Methods The authors retrospectively reviewed 84 patients that underwent emergency bowel resection and/or anastomosis from March 2008 to December 2011. Patients with severe shock, intestinal ischemia, sustained bowel perforation, or short bowel syndrome were excluded. Patients were divided into the early (group E; n=44) or late (gro...

  14. Experience in application of enriched breast milk in feeding children with very low birth weight

    Directory of Open Access Journals (Sweden)

    Panina O.S.

    2014-12-01

    Full Text Available Nursing of very low and extremely low birth weight infants is one of the most difficult problems of modern perinatol-ogy. It is impossible to carry out this task without organization of fee-ding of this group of children. The aim of our research was to study clinical efficiency of breast milk fortifiers administration (human milk fortifier when preterm infants feeding. Materials and methods. In consequence of this clinical research (with included 60 premature infants born at less than 33 weeks of gestational age with less than 1500g birth weight the following advantages before other types of feeding were revealed. Results. Mother and child solidarity in the course of breast feeding make deep favorable mutual emotional pressure. It was succeeded to keep all breast feeding advantages and to provide preterm infants special needs in feedstuffs. Human milk fortifiers administration provides higher body weight gain intensity; reduces length of stay in a hospital. It should not go unnoticed high tolerability and lack of complications at its medication usability was noted. Human milk fortifier divorce with small quantity of breast milk and that is especially important for very low and extremely low birth weight infants feeding. Conclusion. All above-mentioned allows recommending human milk fortifiers «PRE NAN FM 85» administration for breast milk in neonatal practice

  15. Preoperative PET/CT in early-stage breast cancer

    DEFF Research Database (Denmark)

    Bernsdorf, M; Berthelsen, A K; Wielenga, V T;

    2012-01-01

    The aim of this study was to assess the diagnostic and therapeutic impact of preoperative positron emission tomography and computed tomography (PET/CT) in the initial staging of patients with early-stage breast cancer.......The aim of this study was to assess the diagnostic and therapeutic impact of preoperative positron emission tomography and computed tomography (PET/CT) in the initial staging of patients with early-stage breast cancer....

  16. SCREENING FOR EARLY DETECTION OF BREAST CANCER

    Directory of Open Access Journals (Sweden)

    E. A. Rasskazova

    2014-01-01

    Full Text Available The article presents a brief overview of the main methods of breast cancer screening. Proven effectiveness of mammography as a screening method in reducing mortality from breast cancer, specified limits of the method. The main trend of increasing the effectiveness of screening is the transition to digital technologies. Properly organized screening with the active participation of the population reduces mortality from breast cancer by 30%.

  17. Nursing Experience of Neonatal Breast Feeding%新生儿母乳喂养护理体会

    Institute of Scientific and Technical Information of China (English)

    李金花

    2015-01-01

    Breast milk is the most ideal natural food for the newborn babies, which is the 20%~79% of al the food. Breast milk contains a wealth of immune active substances, can improve neonatal immunity. And breast feeding can provide the nutrition requirement of newborn at the same time, and deepen the af ection between mother and child. It is beneficial to the prevention of metabolic diseases in adult life. This paper takes a series of nursing for early breast feeding, and the ef ect is good.%母乳是婴儿最理想的天然食品,占所有食物中的1/2以上。母乳中含有丰富的免疫活性物质,能提高新生儿免疫力。母乳喂养能同时提供新生儿的营养需求,加深母亲与孩子之间的亲情。在成人生活中有利于预防代谢性疾病的发生。本文以一系列的护理为早期母乳喂养,效果良好。

  18. Predicting breast-feeding intention among low-income pregnant women: a comparison of two theoretical models.

    Science.gov (United States)

    Kloeblen, A S; Thompson, N J; Miner, K R

    1999-10-01

    This study examined the applicability of the transtheoretical model and a model derived from the theory of reasoned action for predicting breast-feeding intention among low-income pregnant women. Participants completed a 70-item self-report questionnaire assessing their breast-feeding attitudes, intentions, and support. A positive correlation existed between Stages of Change for breast-feeding and the number of Processes of Change used by respondents. A negative correlation existed between Stages of Change for breast-feeding and the number of negative breast-feeding beliefs held by respondents. Furthermore, women's normative beliefs and outcome beliefs were significantly correlated with breast-feeding intention in manners consistent with the model developed from the theory of reasoned action. After accounting for significant sociodemographic and lifestyle factors, the Processes of Change and outcome beliefs remained independently correlated with breast-feeding intention. These models are capable of predicting the intention to breast-feed and might offer an innovative approach for further breast-feeding research and intervention development.

  19. Predicting breast-feeding intention among low-income pregnant women: a comparison of two theoretical models.

    Science.gov (United States)

    Kloeblen, A S; Thompson, N J; Miner, K R

    1999-10-01

    This study examined the applicability of the transtheoretical model and a model derived from the theory of reasoned action for predicting breast-feeding intention among low-income pregnant women. Participants completed a 70-item self-report questionnaire assessing their breast-feeding attitudes, intentions, and support. A positive correlation existed between Stages of Change for breast-feeding and the number of Processes of Change used by respondents. A negative correlation existed between Stages of Change for breast-feeding and the number of negative breast-feeding beliefs held by respondents. Furthermore, women's normative beliefs and outcome beliefs were significantly correlated with breast-feeding intention in manners consistent with the model developed from the theory of reasoned action. After accounting for significant sociodemographic and lifestyle factors, the Processes of Change and outcome beliefs remained independently correlated with breast-feeding intention. These models are capable of predicting the intention to breast-feed and might offer an innovative approach for further breast-feeding research and intervention development. PMID:10533172

  20. Two nursing mothers treated with zonisamide: Should breast-feeding be avoided?

    Science.gov (United States)

    Ando, Hitoshi; Matsubara, Shigeki; Oi, Asako; Usui, Rie; Suzuki, Mitsuaki; Fujimura, Akio

    2014-01-01

    Zonisamide, an antiepileptic drug, is excreted into breast milk, but information regarding the safety of breast-feeding while using this drug is limited. We present the cases of two nursing mothers, taking 300 and 100 mg/day zonisamide. At 5 days after delivery, the milk concentrations and relative infant doses of the drug were 18.0 and 5.1 μg/mL, and 44 and 36%, respectively. In the first case, the mother fed colostrum and continued partial breast-feeding thus reducing the relative infant dose to 8%. The neonatal serum concentration of zonisamide declined to below the limit of detection at day 34 after birth. In the second case, the mother breast-fed partially until 2 weeks postpartum. No adverse effect was observed in the infants. These findings suggest that mothers taking zonisamide should not breast-feed exclusively, but may not have to avoid partial breast-feeding, with significant caution regarding adverse effects in infants.

  1. Lunge feeding in early marine reptiles and fast evolution of marine tetrapod feeding guilds.

    Science.gov (United States)

    Motani, Ryosuke; Chen, Xiao-hong; Jiang, Da-yong; Cheng, Long; Tintori, Andrea; Rieppel, Olivier

    2015-01-01

    Traditional wisdom holds that biotic recovery from the end-Permian extinction was slow and gradual, and was not complete until the Middle Triassic. Here, we report that the evolution of marine predator feeding guilds, and their trophic structure, proceeded faster. Marine reptile lineages with unique feeding adaptations emerged during the Early Triassic (about 248 million years ago), including the enigmatic Hupehsuchus that possessed an unusually slender mandible. A new specimen of this genus reveals a well-preserved palate and mandible, which suggest that it was a rare lunge feeder as also occurs in rorqual whales and pelicans. The diversity of feeding strategies among Triassic marine tetrapods reached their peak in the Early Triassic, soon after their first appearance in the fossil record. The diet of these early marine tetrapods most likely included soft-bodied animals that are not preserved as fossils. Early marine tetrapods most likely introduced a new trophic mechanism to redistribute nutrients to the top 10 m of the sea, where the primary productivity is highest. Therefore, a simple recovery to a Permian-like trophic structure does not explain the biotic changes seen after the Early Triassic. PMID:25754468

  2. Lunge feeding in early marine reptiles and fast evolution of marine tetrapod feeding guilds.

    Science.gov (United States)

    Motani, Ryosuke; Chen, Xiao-hong; Jiang, Da-yong; Cheng, Long; Tintori, Andrea; Rieppel, Olivier

    2015-01-01

    Traditional wisdom holds that biotic recovery from the end-Permian extinction was slow and gradual, and was not complete until the Middle Triassic. Here, we report that the evolution of marine predator feeding guilds, and their trophic structure, proceeded faster. Marine reptile lineages with unique feeding adaptations emerged during the Early Triassic (about 248 million years ago), including the enigmatic Hupehsuchus that possessed an unusually slender mandible. A new specimen of this genus reveals a well-preserved palate and mandible, which suggest that it was a rare lunge feeder as also occurs in rorqual whales and pelicans. The diversity of feeding strategies among Triassic marine tetrapods reached their peak in the Early Triassic, soon after their first appearance in the fossil record. The diet of these early marine tetrapods most likely included soft-bodied animals that are not preserved as fossils. Early marine tetrapods most likely introduced a new trophic mechanism to redistribute nutrients to the top 10 m of the sea, where the primary productivity is highest. Therefore, a simple recovery to a Permian-like trophic structure does not explain the biotic changes seen after the Early Triassic.

  3. 76 FR 30723 - Breast and Cervical Cancer Early Detection and Control Advisory Committee (BCCEDCAC)

    Science.gov (United States)

    2011-05-26

    ... HUMAN SERVICES Centers for Disease Control and Prevention Breast and Cervical Cancer Early Detection and... for breast and cervical cancer screening; updates on the National Breast and Cervical Cancer Early... Health and Human Services, and the Director, CDC, regarding the early detection and control of breast...

  4. Breast Contrast Enhanced MR Imaging: Semi-Automatic Detection of Vascular Map and Predominant Feeding Vessel

    Science.gov (United States)

    Petrillo, Antonella; Fusco, Roberta; Filice, Salvatore; Granata, Vincenza; Catalano, Orlando; Vallone, Paolo; Di Bonito, Maurizio; D’Aiuto, Massimiliano; Rinaldo, Massimo; Capasso, Immacolata; Sansone, Mario

    2016-01-01

    Purpose To obtain breast vascular map and to assess correlation between predominant feeding vessel and tumor location with a semi-automatic method compared to conventional radiologic reading. Methods 148 malignant and 75 benign breast lesions were included. All patients underwent bilateral MR imaging. Written informed consent was obtained from the patients before MRI. The local ethics committee granted approval for this study. Semi-automatic breast vascular map and predominant vessel detection was performed on MRI, for each patient. Semi-automatic detection (depending on grey levels threshold manually chosen by radiologist) was compared with results of two expert radiologists; inter-observer variability and reliability of semi-automatic approach were assessed. Results Anatomic analysis of breast lesions revealed that 20% of patients had masses in internal half, 50% in external half and the 30% in subareolar/central area. As regards the 44 tumors in internal half, based on radiologic consensus, 40 demonstrated a predominant feeding vessel (61% were supplied by internal thoracic vessels, 14% by lateral thoracic vessels, 16% by both thoracic vessels and 9% had no predominant feeding vessel—p<0.01), based on semi-automatic detection, 38 tumors demonstrated a predominant feeding vessel (66% were supplied by internal thoracic vessels, 11% by lateral thoracic vessels, 9% by both thoracic vessels and 14% had no predominant feeding vessel—p<0.01). As regards the 111 tumors in external half, based on radiologic consensus, 91 demonstrated a predominant feeding vessel (25% were supplied by internal thoracic vessels, 39% by lateral thoracic vessels, 18% by both thoracic vessels and 18% had no predominant feeding vessel—p<0.01), based on semi-automatic detection, 94 demonstrated a predominant feeding vessel (27% were supplied by internal thoracic vessels, 45% by lateral thoracic vessels, 4% by both thoracic vessels and 24% had no predominant feeding vessel—p<0.01). An

  5. Early breast cancer: diagnosis, treatment and survivorship.

    LENUS (Irish Health Repository)

    Meade, Elizabeth

    2013-01-11

    Breast cancer is the most common female cancer and globally remains a major public health concern. The diagnosis and treatment of breast cancer continues to develop. Diagnosis is now more precise, surgery is less mutilating and women now have the option of breast conserving therapy with better cosmesis, and without sacrificing survival. Radiotherapy is more targeted and the selection of patients for adjuvant chemotherapy is based not only on prognostic and predictive factors, but also on newer molecular profiling that will ensure that chemotherapy is given to the patients who need and respond to it. These developments all provide a more tailored approach to the treatment of breast cancer. Management now involves a multidisciplinary team approach in order to provide the highest standard of care for patients throughout their cancer journey from diagnosis through treatment and into follow-up care.

  6. IMPACT OF BREAST-FEEDING EDUCATION ON NUTRITIONAL AWARENESS OF MOTHERS IN SOUTH TERRAN, IRAN

    Directory of Open Access Journals (Sweden)

    A.Djazayery

    1995-06-01

    Full Text Available This semi-experimental study was conducted to investigate the impact of nutrition education on knowledge of mothers concerning breast-feeding in Giassi Charity Health Centre in the south of Tehran, Yaftabad. Breast-feeding and nutritional awareness of 104 randomly selected mothers was assessed before and after a one-month breast-feeding course (Three 90-minutes' sessions per week. The proportion of the mothers with high awareness before the course was 0.0% and increased to 83% after the course. In this study the effect of such independent variables as mothers’ age and age at the first pregnancy, their education, number of children and physiological status, as well as family income on their nutritional awareness was determined. Statistical analysis (of both total score and individual question score changes showed the nutrition education course to have had a positive impact on mothers’ nutritional knowledge and awareness (P<0.001, confidence limits 99.9%.

  7. Impact of sensory feed additives on feed intake, feed preferences, and growth of female piglets during the early postweaning period.

    Science.gov (United States)

    Clouard, C; Val-Laillet, D

    2014-05-01

    < 0.05) and 22-h (60% of total intake; P < 0.10) tests, respectively. In conclusion, feed supplementation with the FA1, FA2, and FA3 from weaning did not induce beneficial effects on feed intake and growth performance during the early postweaning period. The FA2 increased palatability and acceptance of the unfamiliar starter diet the day of feed transition, while the FA1 and FA3 increased palatability of the starter diet only after a few days of exposure, most likely through long-term familiarization processes. PMID:24668952

  8. Premenopausal endocrine-responsive early breast cancer: who receives chemotherapy?

    OpenAIRE

    Regan, M. M.; Pagani, O; Walley, B; et al, ...; Stahel, R. A.

    2008-01-01

    BACKGROUND: The role of chemotherapy in addition to combined endocrine therapy for premenopausal women with endocrine-responsive early breast cancer remains an open question, yet trials designed to answer it have repeatedly failed to adequately accrue. The International Breast Cancer Study Group initiated two concurrent trials in this population: in Premenopausal Endocrine Responsive Chemotherapy (PERCHE), chemotherapy use is determined by randomization and in Tamoxifen and Exemestane Trial (...

  9. Surgical treatment of early breast cancer in day surgery.

    Science.gov (United States)

    Marrazzo, Antonio; Taormina, Pietra; David, Massimo; Riili, Ignazio; Lo Gerfo, Domenico; Casà, Luigi; Noto, Antonio; Mercadante, Sebastiano

    2007-01-01

    Quadrantectomy and associated sentinel lymph node biopsy (SLNB) is currently employed in most breast surgery centres as the gold standard in the treatment of early breast cancer. This approach has a modest morbidity and can usually be performed in a day-surgery regimen, leading to best acceptance by the patients. This reports outlines the experience of our Breast Unit with quadrantectomy and SLNB in day surgery for early breast cancer. One hundred patients presenting to our institution with primary invasive breast cancer measuring less than 3 cm and clinically negative axillary nodes underwent quadrantectomy and SLNB in day surgery. For 60 women with breast cancer the sentinel node was negative, so the only definitive surgical treatment was performed in the day-surgery regimen; 40 patients with positive sentinel nodes were hospitalised a second time for axillary dissection. In these patients that needed clearance of the axilla, SLNB was performed on the only positive node in 22 cases (55%). None of the patients admitted for quadrantectomy and SLNB in day surgery required re-hospitalisation after discharge. All patients proved to be fully satisfied with early discharge from hospital when questioned on the occasion of subsequent monitoring. Short-stay surgical programs in early invasive breast cancer treatment are feasible today owing to the availability of less invasive approaches such as quadrantectomy and SLNB. There are two main pointers to a distinct advantage for this kind of approach, i.e. recovery and psychological adjustment. Recovery from surgery is faster and the patient tends to play down the seriousness of the operation and to have a better mental attitude to neoplastic disease. Moreover, when performing quadrantectomy with SLNB in day surgery fewer than 50% of breast cancer patients (40% in our experience) require another surgical treatment, concluding the surgery in a single session. PMID:18019641

  10. KNOWLEDGE, ATTITUDE AND PRACTICES REGARDING BREAST FEEDING, A PICTURE IN EAST KHASI HILLS DISTRICT OF MEGHALAYA

    Directory of Open Access Journals (Sweden)

    Star

    2013-02-01

    Full Text Available ABSTRACT: INTRODUCTION: Breast feeding is the normal way of providing young infants with the nutrients they need for healthy growth and deve lopment. A child who is breast fed has greater chances of survival than a child who is art ificially fed. The low prevalence and duration of exclusive and partial breastfeeding increase the risk of infant and childhood morbidity and mortality in both developed and developing countries. Worldwide, suboptimal breastfeeding still accounts for deaths of 1.4 million children a ged less than five years . AIM OF THE STUDY : 1. To assess the knowledge, attitude and practices reg arding breast feeding among women 2. To study the factors influencing breast feeding practic es among women residing in East Khasi Hills district of Meghalaya. METHODOLOGY: The present study is a cross sectional study conduct ed within the field practice area of NEIGRIHMS, two of which were urban- Nongmynsong and Pynthorbah and one rural area-Tynring. The study per iod was conducted from October 2012- December 2012 (three months duration. A total of 1 35 women were interviewed during the period. In the respective areas the households were s elected using simple random sampling after obtaining a list of all the households in the respective area from the ANM. In the selected household all the females available who have a chil d between 1-2 year of age were interviewed. Data analysis was done by descriptive analysis and a nalytical statistics by using Chi Square test using SPSS version 17.0. RESULTS & OBSERVATION: Out of 135 families visited, 70 (51.9% families were nuclear families. With respect to feed ing practices; 80 (59% mothers had given Exclusive Breast Feeding for a period of 6 months. 7 4 (55% of mothers had knowledge on colostrums and 109 (80.75% of mothers had given co lostrum to their babies . 42 (31.1% mothers had initiated BF within 1 hour . The variables which were found to be associated wit h breast feeding are the mother

  11. Skin toxicity during hypo fractionated breast irradiation in patient with early breast cancer

    International Nuclear Information System (INIS)

    Radiotherapy is an important component in the treatment of breast cancer. (1) Many women with an early stage of breast cancer are candidates for a breast conservation therapy, which combines both conservative surgery and radiotherapy. (2) According to the data from some series, an estimated 90% of the patients treated with radiotherapy for breast cancer will develop a degree of radiation-induced dermatitis. (3) The severity of the skin reactions during and following the breast irradiation is influenced by both treatment-related and patient-related factors. The treatment - related factors include the fraction size (the dose delivered with each treatment), the total dose delivered, the volume of tissue treated, the type of radiation (4) and the addition of chemotherapy. (5) The patient-related factors include breast size, smoking, axillary lymphocele drainage before treatment, age, and infection of the surgical wound. (6) A hypo fractionation radiotherapy is alternative for a standard fractionation radiotherapy for women with early stage of breast cancer after conservative surgery. The aim of the study was to analyse the acute skin reactions during a hypo fractionated radiotherapy in patients with early breast cancer at our institution. Materials and methods: Twenty patients with early stage of breast cancer (Stadium I and II) and conservative surgery (quadrantectomy of breast with ipsilateral axillary dissection) were analysed. The patients were treated with 6MV x rays on LINAC, using tangential fields with 2.65Gy per fraction and the total dose prescribed to target volume was 42,4 Gy. These patients were observed for acute skin toxicity during the second week and at the end of the treatment. We evaluated dryness, epilation, pigmentation, changes and eritema, dry desquamation (clinically characterized by scaling and pruritus) and moist desquamation (characterized by serious oozing and exposure of the dermis). By using the radiation therapy oncology group’s (RTOG

  12. Infant weight gain, duration of exclusive breast-feeding and childhood BMI - two similar follow-up cohorts

    DEFF Research Database (Denmark)

    Gunnarsdottir, Ingibjorg; Schack-Nielsen, Lene; Michaelsen, Kim F.;

    2010-01-01

    To describe the association between duration of exclusive breast-feeding (EBF), weight gain in infancy and childhood BMI in two populations with a long duration of EBF.......To describe the association between duration of exclusive breast-feeding (EBF), weight gain in infancy and childhood BMI in two populations with a long duration of EBF....

  13. Clinical Trial to Comparison the Effect of Family- centered Educational-supportive Program on Mothers’ Empowerment in Breast-feeding

    Directory of Open Access Journals (Sweden)

    Zeinab Heidari

    2016-03-01

    Results: Thirty-five mothers were in the intervention group and 35 were in the control group. The mean of the total score of breast-feeding empowerment and its seven areas in the intervention group was significantly higher than that of the control group. Moreover, exclusive breast-feeding was also significantly higher in the intervention group (P

  14. Feeding Disorders in Infancy: A Case for Early Intervention in Natural Environments

    Science.gov (United States)

    LeVota, Sheryl

    2010-01-01

    The focus of this article is to express the importance of early referral to early intervention in the natural environment of a child with feeding disorder. It is also to get the facts about treating feeding disorders early, in order to prevent long-term problems with feeding, to the people who are in any way involved in the life and care of an…

  15. Effect of breast feeding on intelligence in children: prospective study, sibling pairs analysis, and meta-analysis

    OpenAIRE

    Der, Geoff; Batty, G. David; Deary, Ian J

    2006-01-01

    Objective To assess the importance of maternal intelligence, and the effect of controlling for it and other important confounders, in the link between breast feeding and children's intelligence. Design Examination of the effect of breast feeding on cognitive ability and the impact of a range of potential confounders, in particular maternal IQ, within a national database. Additional analyses compared pairs of siblings from the sample who were and were not breast fed. The results are consi...

  16. 75 FR 7282 - Breast and Cervical Cancer Early Detection and Control Advisory Committee (BCCEDCAC)

    Science.gov (United States)

    2010-02-18

    ... HUMAN SERVICES Centers for Disease Control and Prevention Breast and Cervical Cancer Early Detection and... Force guidelines for breast and cervical cancer screening; Impact of the revised clinical screening recommendations for both breast and cervical cancer on the National Breast and Cervical Cancer Early...

  17. Autoantibodies to αS1-casein are induced by breast-feeding.

    Directory of Open Access Journals (Sweden)

    Klaudia Petermann

    Full Text Available BACKGROUND: The generation of antibodies is impaired in newborns due to an immature immune system and reduced exposure to pathogens due to maternally derived antibodies and placental functions. During nursing, the immune system of newborns is challenged with multiple milk-derived proteins. Amongst them, caseins are the main constituent. In particular, human αS1-casein (CSN1S1 was recently shown to possess immunomodulatory properties. We were thus interested to determine if auto-antibodies to CSN1S1 are induced by breast-feeding and may be sustained into adulthood. METHODS: 62 sera of healthy adult individuals who were (n = 37 or were not (n = 25 breast-fed against human CSN1S1 were investigated by a new SD (surface display-ELISA. For cross-checking, these sera were tested for anti Epstein-Barr virus (EBV antibodies by a commercial ELISA. RESULTS: IgG-antibodies were predominantly detected in individuals who had been nursed. At a cut-off value of 0.4, the SD-ELISA identified individuals with a history of having been breast-fed with a sensitivity of 80% and a specificity of 92%. Under these conditions, 35 out of 37 sera from healthy donors, who where breast-fed, reacted positively but only 5 sera of the 25 donors who were not breast-fed. The duration of breast-feeding was of no consequence to the antibody reaction as some healthy donors were only short term breast-fed (5 days minimum until 6 weeks maximum, but exhibited significant serum reaction against human CSN1S1 nonetheless. CONCLUSION: We postulate that human CSN1S1 is an autoantigen. The antigenicity is orally determined, caused by breast-feeding, and sustained into adulthood.

  18. A microengineered pathophysiological model of early-stage breast cancer.

    Science.gov (United States)

    Choi, Yoonseok; Hyun, Eunjeh; Seo, Jeongyun; Blundell, Cassidy; Kim, Hee Chan; Lee, Eunhee; Lee, Su Hyun; Moon, Aree; Moon, Woo Kyung; Huh, Dongeun

    2015-08-21

    A mounting body of evidence in cancer research suggests that the local microenvironment of tumor cells has a profound influence on cancer progression and metastasis. In vitro studies on the tumor microenvironment and its pharmacological modulation, however, are often hampered by the technical challenges associated with creating physiological cell culture environments that integrate cancer cells with the key components of their native niche such as neighboring cells and extracellular matrix (ECM) to mimic complex microarchitecture of cancerous tissue. Using early-stage breast cancer as a model disease, here we describe a biomimetic microengineering strategy to reconstitute three-dimensional (3D) structural organization and microenvironment of breast tumors in human cell-based in vitro models. Specifically, we developed a microsystem that enabled co-culture of breast tumor spheroids with human mammary ductal epithelial cells and mammary fibroblasts in a compartmentalized 3D microfluidic device to replicate microarchitecture of breast ductal carcinoma in situ (DCIS). We also explored the potential of this breast cancer-on-a-chip system as a drug screening platform by evaluating the efficacy and toxicity of an anticancer drug (paclitaxel). Our microengineered disease model represents the first critical step towards recapitulating pathophysiological complexity of breast cancer, and may serve as an enabling tool to systematically examine the contribution of the breast cancer microenvironment to the progression of DCIS to an invasive form of the disease. PMID:26158500

  19. OUTCOME OF EARLY ORAL FEEDING AFTER ELECTIVE COLONIC ANASTOMOSIS

    Directory of Open Access Journals (Sweden)

    Sushant

    2015-08-01

    Full Text Available OBJECTIVE: Outcome of early oral feeding after elective colonic anastomosis . STUDY DESI G N: Descriptive case series . PLACE & DURATION OF STUDY : Department of Surgery Mata Gujari Medical C ollege, Kishanganj, Bihar, India. From June 2012 - March 2014. METHODOLOGY: De tailed preoperative ev aluation of the selected patients was done. Patients with malignancies, heart disease, poor general conditions, distal loop obstructions were excluded from the series. In selected patient’s proper history, physical examination and base line investigations were done. Limited bowel preparation was done in all the patients. Postope ratively 15 - 50 ml of sips was allowed 2 hourly after recovery form anesthesia . Free oral fluid intake was allowed on postoperative day - 1 , semisolids on day - 2 and day - 3 as tolerated and full oral diet allowed on day - 4. In case of two episodes of vomiting and absence of bowel sounds , patients were kept nil by mouth and nasogastric tube was inserted . RESULTS : Total 68 pat ients were selected, out of which 46(67.64% were males and 22(32.36% females (M.F2.09 : 1 . The age range was from 28 year to 76 year wi th mean age of 47.5 +2.4 year . Passage of first flatus was observed between 2 to 6 days (mean 2.8 days , and the time of first passage of stool was 3 - 8 days (mean 4.6 days. Twelve (17.64% patients did not tolerate feeding . Intolerance to feed results into vomiting and abdominal distension. Postoperative complications included wound infection (10.29% , electrolyte imbalance (4.41%, respiratory tract infections (2.94%, anastigmatic leaks (1.47% and wound dehiscence (1.47% . The hospital stay was 3 - 8 day ( M ean 5.4 day . CONCLUSION : Early oral feeding after elective colonic surgery was safe and well tolerated by majority of the patients.

  20. Complementary feeding with cow's milk alters sleeping metabolic rate in breast-fed infants

    NARCIS (Netherlands)

    Haisma, H; Wells, JCK; Coward, WA; Duro, D; Victora, CG; Vonk, RJ; Wright, A; Visser, GH

    2005-01-01

    Although it is widely accepted that energy expenditure in infants is a function of feeding pattern, the mechanism behind this is not well understood. The objectives of this observational study were as follows: 1) to compare minimal observable energy expenditure (MOEE) between 2 subgroups of breast-f

  1. Blood hemoglobin level and treatment outcome of early breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Henke, M.; Sindlinger, F. [Dept. of Radiotherapy, Radiological Univ. Clinic, Freiburg (Germany); Ikenberg, H. [Dept. of Gynecology and Obstretics, Gynecological Univ. Clinic, Freiburg (Germany); Gerds, T.; Schumacher, M. [Inst. for Medical Biometry and Medical Informatics, Univ. Freiburg (Germany)

    2004-01-01

    Background and purpose: to determine whether the blood hemoglobin concentration correlates with the prognosis of patients with early breast cancer and, if so, whether this is restricted to treatment modality. Patients and methods: data were collected retrospectively from patients with early breast cancer (T1,2 NO-2 MO) who underwent either breast-conserving surgery followed by adjuvant radiotherapy (BCS-RT; n = 96) or a modified radical mastectomy (MRM; n = 194). The effect of preoperative blood hemoglobin level, nodal status, histological grading and hormone receptor status on disease-free survival was determined for both treatment modalities using a cox regression model and visualized by kaplan-meier plots. Results: the blood hemoglobin concentration significantly correlated with disease-free survival of patients receiving BCS-RT (relative risk [RR]: 0.67 per g/dl; p = 0.007). This was independent of other known risk factors for breast cancer patients, as determined by multivariate analysis. By contrast, the blood hemoglobin level had no prognostic significance when patients were treated with MRM. Conclusion: blood hemoglobin concentration seems to affect the prognosis of patients with early breast cancer when a treatment schedule that includes radiotherapy is applied. Reduced radiosensitivity due to diminished tumor oxygenation may be the underlying cause. Confirmative trials and studies intended to elucidate the underlying mechanism are warranted. (orig.)

  2. Proposal of a survey of radiation protection procedures during breast feeding

    International Nuclear Information System (INIS)

    Contamination can occur by breast milk ingestion involving mothers subjected to diagnostic procedures or treatment with radiopharmaceuticals, which can reach high concentrations in milk causing significant absorbed doses to the children organs. Besides internal dose, close contact between the baby and his mother give rise to external exposures. In Brazil, 7% of diagnostic procedures use 131I or 123I for thyroid imaging and 84% of these were hold by women. For 131I, 67Ga and 201Tl, is recommended breast feeding cessation. The present work proposes a survey of the state of the art of radiation protection to breast feeding infants. It was planned interviews with nuclear medicine staff applying a questionnaire in order to assess specific procedures to women in reproductive age. This is 'on progress work'. (author)

  3. Prolonged breast feeding, diarrhoeal disease, and survival of children in Guinea-Bissau

    DEFF Research Database (Denmark)

    Mølbak, K; Gottschau, A; Aaby, P;

    1994-01-01

    OBJECTIVE: To analyse the impact of breast feeding on diarrhoeal disease and survival in children above 1 year of age in Guinea-Bissau, west Africa. DESIGN: A community study of an open cohort followed up weekly by interviews over 15 months. Data on feeding practices, anthropometry, and survival...... was higher in weaned children than in partially breast fed children, both in 1 year olds (relative risk 1.41; 95% confidence interval 1.23 to 1.62) and in 2 year olds (1.67; 1.29 to 2.15). The mean duration of an episode of diarrhoea was 5.3 days in breast fed children compared with 6.3 days in weaned...... the weaned ones, the benefit in terms of lower morbidity may be more important for child survival in places with a high morbidity from diarrhoea and with high mortality....

  4. Antioxidant status of turkey breast meat and blood after feeding a diet enriched with histidine.

    Science.gov (United States)

    Kopec, W; Wiliczkiewicz, A; Jamroz, D; Biazik, E; Pudlo, A; Hikawczuk, T; Skiba, T; Korzeniowska, M

    2016-01-01

    The objective of this study was to investigate the effects of 1) spray dried blood cells rich in histidine and 2) pure histidine added to feed on the antioxidant status and concentration of carnosine related components in the blood and breast meat of female turkeys. The experiment was performed on 168 Big7 turkey females randomly assigned to 3 dietary treatments: control; control with the addition of 0.18% L-histidine (His); and control with the addition of spray dried blood cells (SDBC). Birds were raised for 103 d on a floor with sawdust litter, with drinking water and feed ad libitum. The antioxidant status of blood plasma and breast muscle was analyzed by ferric reducing ability (FRAP) and by 2,2-Azinobis-(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS) and 1,1-Diphenyl-2-picrylhydrazyl (DPPH) radicals scavenging ability. The activity of antioxidant enzymes superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx) was analyzed in the blood and breast meat, with the content of carnosine and anserine quantified by HPLC. Proximate analysis as well as amino acid profiling were carried out for the feed and breast muscles. Growth performance parameters also were calculated. Histidine supplementation of the turkey diet resulted in increased DPPH radical scavenging capacity in the breast muscles and blood, but did not result in higher histidine dipeptide concentrations. The enzymatic antioxidant system of turkey blood was affected by the diet with SDBC. In the plasma, the SDBC addition increased both SOD and GPx activity, and decreased GPx activity in the erythrocytes. Feeding turkeys with an SDBC containing diet increased BW and the content of isoleucine and valine in breast muscles. PMID:26574038

  5. Cognitive function after adjuvant treatment for early breast cancer

    DEFF Research Database (Denmark)

    Debess, Jeanne; Riis, Jens Østergaard; Engebjerg, Malene Cramer;

    2010-01-01

    start of adjuvant treatment and after 6 months by neuropsychological tests and questionnaires to evaluate cognitive function, quality of life and psychological distress. Neuropsychological tests did not reveal any differences in cognitive function between breast cancer patients after chemotherapy and......The purpose of this study was to examine cognitive function in patients with early breast cancer before and after adjuvant chemotherapy or 6 months of tamoxifen. We performed a population-based study in the county of North Jutland, Denmark, including 120 women aged <60 years who received adjuvant...... chemotherapy with seven cycles of cyclophosphamide, epirubicin and fluoruracil or adjuvant tamoxifen for 6 months for early breast cancer from 2004 to 2006. They were compared with an aged-matched group of 208 women without previous cancer selected randomly from the same population. Data were collected before...

  6. [A case of hypernatremic dehydration due to breast-feeding].

    Science.gov (United States)

    Marzouk, M; Neffati, F; Khelifa, H; Douki, W; Monastiri, K; Gueddiche, M N; Ben Amor, A; Najjar, M F

    2008-01-01

    The authors report an 11-day-old exclusively breast-fed female, with a birth weight of 3 300 g, who had suffered from dehydration stage I, with acute renal failure and metabolic acidosis, with 170 mmol/L of serum sodium. Renal ultrasounds were normal but the rate of sodium in mother's milk was three times higher than controls (87 versus 21 mmol/L). Intravenous rehydration allowed the correction of hydroelectrolytic disorders. PMID:18725352

  7. 77 FR 66469 - Breast and Cervical Cancer Early Detection and Control Advisory Committee (BCCEDCAC)

    Science.gov (United States)

    2012-11-05

    ... HUMAN SERVICES Centers for Disease Control and Prevention Breast and Cervical Cancer Early Detection and... meeting of the aforementioned committee: Name: Breast and Cervical Cancer Early Detection and Control..., regarding the early detection and control of breast and cervical cancer. The committee makes...

  8. Nipple Discharge: An Early Warning Sign of Breast Cancer

    Directory of Open Access Journals (Sweden)

    Veda Parthasarathy

    2012-01-01

    Full Text Available Nipple discharge (ND can be the earliest presenting symptom of breast cancer. We hereby present two cases of breast cancer with no palpable mass manifesting as isolated ND, which was whitish in color. In both cases, cytology of the discharge revealed highly pleomorphic cells indicating a high grade malignancy. Mammography showed diffuse, extensive microcalcifications. Simple mastectomy with axillary clearance was done. Histology in both cases revealed diffusely spreading intraductal carcinoma, with focus of microinvasion in one case. ND if scanty or not blood stained is often ignored by the patients and at times, the clinicians. This article highlights that ND can be an early warning sign of intraductal carcinomas that are non-invasive in early stage. Irrespective of the color or nature of the discharge, unilateral ND needs to be evaluated. Proper clinical assessment, cytological evaluation of the ND, and mammography ought to be performed in all such cases. Considering the low level of awareness in women regarding the warning signs of breast cancer, the current focus is to create "breast awareness." Women should be sensitized to recognize any unusual changes in their breasts and report to their health care providers at the earliest.

  9. Prevailing breast feeding practices of infants attending paediatric out-patient department

    Directory of Open Access Journals (Sweden)

    Manjunatha Swamy R

    2015-01-01

    Full Text Available Background: Objectives of current study were to know the prevailing infant feeding practices in infants and to identify the problems affecting infant and young child feeding practices and to analyze the environmental factors influence the mothers, families and caregivers in infant feeding. Methods: The present study is a hospital based observation study. A total of 501 mothers and their infants attending new born paediatric OPD, immunization clinic of department of paediatrics for various reasons of health care were recruited for the study after their informed consent and institutional ethical clearance. Information about the first feed after birth, time of initiation of breastfeeding, duration of exclusive breast feeding, time of introduction of complementary feeding, knowledge of feeding skills, mother's concept of adequacy of breast milk were collected in the structured, pre tested proforma by personal one to one interview with the mothers. All the mothers of infants from 0 to 1 year were included. Statistical analysis: The data obtained by the interview were analyzed with regarding to mothers education level, religion and other related parameters pertaining to feeding practices. Percentages of parameters were calculated and analyzed. Results: Majority of the mothers belong to the age group of 18 to 30 years (96.01%, prelacteal feeds were given by a good number of mothers (42.32%, 60.66% mothers were given the sugar water as the prelacteal feed and 71.56% mothers have used cup and spoon to give prelacteal feeds. 75.25% of the mothers have practiced giving colostrum, 72.26% of mothers were breastfeeding their baby for 5 to 10 minutes during each feed at an interval of 0.5 hours to 3.5 hours. Majority of mothers (34.73% had the knowledge of starting of weaning at six months and 46.88% of mothers were giving weaning food twice daily. Conclusion: Significant number of mothers had discarded colostrum and most of the mothers intended to give only

  10. Early formula feeding practices and their potential contribution to later obesity risk

    LENUS (Irish Health Repository)

    Tarrant, R C

    2013-01-02

    Background and Aims: Early feeding practices, including early introduction to solid foods and overfeeding, are known risk factors for childhood obesity. This study aimed to assess maternal formula feeding practices and infant formula feeding patterns, factors that are known to potentially contribute to later obesity risk. \\r\

  11. Influence of past breast feeding on pattern and severity of presentation of juvenile idiopathic arthritis.

    Science.gov (United States)

    Hyrich, Kimme L; Baildam, Eileen; Pickford, Hannah; Chieng, Alice; Davidson, Joyce E; Foster, Helen; Gardner-Medwin, Janet; Wedderburn, Lucy R; Thomson, Wendy

    2016-04-01

    This analysis aimed to study the influence of breast feeding on the pattern and severity of juvenile idiopathic arthritis (JIA) at presentation. The association between ever versus never breast feeding and disease severity at onset was compared in 923 children with JIA recruited to the UK Childhood Arthritis Prospective Study at first presentation to rheumatology. Fifty six per cent of children were ever breast fed (median 3.7 months). Breastfed children reported a lower median age at onset, a lower Childhood Health Assessment Questionnaire (CHAQ), a measure of disease severity, lower parent general evaluation scores and lower pain at presentation. There was a trend towards a higher proportion of breastfed children with rheumatoid factor-negative polyarthritis, but lesser enthesitis-related and psoriatic arthritis. There was a statistically significant inverse association between breast feeding and high CHAQ, even after adjusting for differences in socioeconomic status (adjusted OR 0.61 (95% CI 0.39 to 0.95)). Further work to understand the reasons behind these associations is required. PMID:26369575

  12. Long-term Results of Breast-conserving Surgery and Radiation Therapy in Early Breast Cancer

    International Nuclear Information System (INIS)

    To evaluate the long-term results after breast-conserving surgery and radiation therapy in early breast cancer in terms of failure, survival, and cosmesis. One hundred fifty-four patients with stage I and II breast cancer were treated with conservative surgery plus radiotherapy between January 1992 and December 2002 at the Keimyung University Dongsan Medical Center. According to TNM stage, 93 patients were stage I, 50 were IIa, and 11 were IIb. The affected breasts were irradiated with 6 MV photons to 50.4 Gy in 28 fractions over 5.5 weeks with a boost irradiation dose of 10∼16 Gy to the excision site. Chemotherapy was administered in 75 patients and hormonal therapy in 92 patients with tamoxifen. Follow-up periods were 13∼179 months, with a median of 92.5 months. The 5- and 10-year overall survival rates were 97.3% and 94.5%, respectively. The 5- and 10-year disease-free survival (5YDFS and 10YDFS, respectively) rates were 92.5% and 88.9%, respectively; the ultimate 5YDFS and 10YDFS rates after salvage treatment were 93.9% and 90.2%, respectively. Based on multivariate analysis, only the interval between surgery and radiation therapy (≤6 weeks vs. >6 weeks, p=0.017) was a statistically significant prognostic factor for DFS. The major type of treatment failure was distant failure (78.5%) and the most common distant metastatic site was the lungs. The cosmetic results were good-to-excellent in 96 patients (80.7%). Conservative surgery and radiation for early stage invasive breast cancer yielded excellent survival and cosmetic results. Radiation therapy should be started as soon as possible after breast-conserving surgery in patients with early breast cancer, ideally within 6 weeks

  13. Long-term Results of Breast-conserving Surgery and Radiation Therapy in Early Breast Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jin Hee; Byun, Sang Jun [Dongsan Medical Center, Daegu (Korea, Republic of)

    2009-09-15

    To evaluate the long-term results after breast-conserving surgery and radiation therapy in early breast cancer in terms of failure, survival, and cosmesis. One hundred fifty-four patients with stage I and II breast cancer were treated with conservative surgery plus radiotherapy between January 1992 and December 2002 at the Keimyung University Dongsan Medical Center. According to TNM stage, 93 patients were stage I, 50 were IIa, and 11 were IIb. The affected breasts were irradiated with 6 MV photons to 50.4 Gy in 28 fractions over 5.5 weeks with a boost irradiation dose of 10{approx}16 Gy to the excision site. Chemotherapy was administered in 75 patients and hormonal therapy in 92 patients with tamoxifen. Follow-up periods were 13{approx}179 months, with a median of 92.5 months. The 5- and 10-year overall survival rates were 97.3% and 94.5%, respectively. The 5- and 10-year disease-free survival (5YDFS and 10YDFS, respectively) rates were 92.5% and 88.9%, respectively; the ultimate 5YDFS and 10YDFS rates after salvage treatment were 93.9% and 90.2%, respectively. Based on multivariate analysis, only the interval between surgery and radiation therapy ({<=}6 weeks vs. >6 weeks, p=0.017) was a statistically significant prognostic factor for DFS. The major type of treatment failure was distant failure (78.5%) and the most common distant metastatic site was the lungs. The cosmetic results were good-to-excellent in 96 patients (80.7%). Conservative surgery and radiation for early stage invasive breast cancer yielded excellent survival and cosmetic results. Radiation therapy should be started as soon as possible after breast-conserving surgery in patients with early breast cancer, ideally within 6 weeks.

  14. Breast-feeding behavioral patterns among La Leche League mothers: a descriptive survey.

    Science.gov (United States)

    Cable, T A; Rothenberger, L A

    1984-06-01

    Many studies have documented the behavioral patterns of unrestricted breast-feeding among Third World mothers, but knowledge of this behavior among Western women is lacking. La Leche League International is a strong advocate of unrestricted breast-feeding, a feeding behavior more characteristic of women in developing countries than in Western society. To investigate the breast-feeding patterns of La Leche League mothers, a pilot study of 24 active members was undertaken. Utilizing a home diary, a 2-month record of suckling frequency, vaginal bleeding, sexual intercourse, solid food supplements, and six-hour intervals without a suckling episode was maintained. The results show the La Leche League mother in this sample to be an average of 29 years old, white, and well-educated. She fed an infant an average of 15 times per day and frequently slept with her child. Frequency of mother and child sleeping together was inversely related to the frequency of marital intercourse. Prolonged lactational amenorrhea was also found, as 92% of the mothers nursing infants 5 to 16 months old had not regained their normal menstrual flow. La Leche League mothers represent a subset of nursing mothers who have a life-style of which the primary care physician must be aware in order to provide optimal maternal-infant care.

  15. Radiation-induced breast cancer: the question of early breast cancer screening in Hodgkin's lymphoma survivors

    OpenAIRE

    Hilal, Talal; Rudy, David W.

    2016-01-01

    Chest irradiation is associated with numerous early and late complications that arise from ionizing radiation-induced damage to cellular structures within the field of therapy. In patients exposed to chest irradiation at an early age as part of the treatment of childhood cancer, specifically Hodgkin's lymphoma, the increased risk of breast cancer in the long run should be considered. A case of a 35-year-old woman who exposed to chest irradiation as part of the treatment of Hodgkin's lymphoma ...

  16. A suspension-feeding anomalocarid from the Early Cambrian.

    Science.gov (United States)

    Vinther, Jakob; Stein, Martin; Longrich, Nicholas R; Harper, David A T

    2014-03-27

    Large, actively swimming suspension feeders evolved several times in Earth's history, arising independently from groups as diverse as sharks, rays and stem teleost fishes, and in mysticete whales. However, animals occupying this niche have not been identified from the early Palaeozoic era. Anomalocarids, a group of stem arthropods that were the largest nektonic animals of the Cambrian and Ordovician periods, are generally thought to have been apex predators. Here we describe new material from Tamisiocaris borealis, an anomalocarid from the Early Cambrian (Series 2) Sirius Passet Fauna of North Greenland, and propose that its frontal appendage is specialized for suspension feeding. The appendage bears long, slender and equally spaced ventral spines furnished with dense rows of long and fine auxiliary spines. This suggests that T. borealis was a microphagous suspension feeder, using its appendages for sweep-net capture of food items down to 0.5 mm, within the size range of mesozooplankton such as copepods. Our observations demonstrate that large, nektonic suspension feeders first evolved during the Cambrian explosion, as part of an adaptive radiation of anomalocarids. The presence of nektonic suspension feeders in the Early Cambrian, together with evidence for a diverse pelagic community containing phytoplankton and mesozooplankton, indicate the existence of a complex pelagic ecosystem supported by high primary productivity and nutrient flux. Cambrian pelagic ecosystems seem to have been more modern than previously believed. PMID:24670770

  17. Two-year morbidity-mortality and alternatives to prolonged breast-feeding among children born to HIV-infected mothers in Cote d'Ivoire.

    Directory of Open Access Journals (Sweden)

    Renaud Becquet

    2007-01-01

    Full Text Available BACKGROUND: Little is known about the long-term safety of infant feeding interventions aimed at reducing breast milk HIV transmission in Africa. METHODS AND FINDINGS: In 2001-2005, HIV-infected pregnant women having received in Abidjan, Côte d'Ivoire, a peripartum antiretroviral prophylaxis were presented antenatally with infant feeding interventions: either artificial feeding, or exclusive breast-feeding and then early cessation from 4 mo of age. Nutritional counseling and clinical management were provided for 2 y. Breast-milk substitutes were provided for free. The primary outcome was the occurrence of adverse health outcomes in children, defined as validated morbid events (diarrhea, acute respiratory infections, or malnutrition or severe events (hospitalization or death. Hazards ratios to compare formula-fed versus short-term breast-fed (reference children were adjusted for confounders (baseline covariates and pediatric HIV status as a time-dependant covariate. The 18-mo mortality rates were also compared to those observed in the Ditrame historical trial, which was conducted at the same sites in 1995-1998, and in which long-term breast-feeding was practiced in the absence of any specific infant feeding intervention. Of the 557 live-born children, 262 (47% were breast-fed for a median of 4 mo, whereas 295 were formula-fed. Over the 2-y follow-up period, 37% of the formula-fed and 34% of the short-term breast-fed children remained free from any adverse health outcome (adjusted hazard ratio [HR]: 1.10; 95% confidence interval [CI], 0.87-1.38; p = 0.43. The 2-y probability of presenting with a severe event was the same among formula-fed (14% and short-term breast-fed children (15% (adjusted HR, 1.19; 95% CI, 0.75-1.91; p = 0.44. An overall 18-mo probability of survival of 96% was observed among both HIV-uninfected short-term and formula-fed children, which was similar to the 95% probability observed in the long-term breast-fed ones of the

  18. Feeding concentrate in early lactation based on rumination time

    DEFF Research Database (Denmark)

    Byskov, M.V.; Weisbjerg, Martin Riis; Markussen, B.;

    2015-01-01

    an experimental group (EXP) or a control group (CON) immediately after calving. In addition, all cows in the EXP and CON were assigned to either a high, medial or low rumination group according to their individual RT. Cows in the EXP assigned to the high (EH), medial (EM) or low (EL) rumination group were stepped......Precision feeding of dairy cows facilitates optimization of milk production. Accordingly, the objective was to study the effect on milk production when stepping up concentrate at 3 rates in early lactation according to individual daily rumination time (RT). Data was collected in 3 commercial dairy...... herds with Holstein cows, where daily RT was recorded by rumination sensors (Qwes HRTM). Cows were fed a partially mixed ration and concentrate at the milking robot. Concentrate was stepped up over the first 28 and 17 days in milk for primiparous and multiparous cows. Cows were assigned to either...

  19. Biochemical monitoring of pregnancy and breast feeding in five patients with classical galactosaemia - and review of the literature

    NARCIS (Netherlands)

    P. Schadewaldt; H.W. Hammen; L. Kamalanathan; U. Wendel; M. Schwarz; A.M. Bosch; N. Guion; M. Janssen; G.H.J. Boers

    2009-01-01

    Pregnancy, delivery, and postpartal metabolic control was monitored biochemically in five patients (22-38 years of age) with clinically, enzymatically, and genotypically established classical galactosaemia and good dietary compliance. Three of the patients performed breast feeding of their newborns.

  20. Effect of electronic education on the awareness of women about post partum breast feeding

    Directory of Open Access Journals (Sweden)

    Fariba Fahami

    2014-08-01

    Full Text Available Introduction: Electronic education is there to enhance knowledge of patients especially mothers during postpartum and can provide an efficient way to enhance personnel-patient interaction.  So, this study was conducted to define the effect of electronic education on the awareness of women about post partum breast feeding education. Materials and Methods: This is a quasi- experimental study conducted on  72 primiparous women during  postpartum period referring to Shahid Beheshti Hospital in  2013 .  In order to educate the subjects through electronic and paper based methods, the subjects were selected through random allocation.  A pre- test before and a post- test after education were conducted with a 15 item questionnaire to measure women’s awareness about breast feeding. The data were analyzed by descriptive statistical tests , and t-test and paired t- test through SPSS 11.5.  Significance level was considrred  (P

  1. Hard-object feeding in sooty mangabeys (Cercocebus atys and interpretation of early hominin feeding ecology.

    Directory of Open Access Journals (Sweden)

    David J Daegling

    Full Text Available Morphology of the dentofacial complex of early hominins has figured prominently in the inference of their dietary adaptations. Recent theoretical analysis of craniofacial morphology of Australopithecus africanus proposes that skull form in this taxon represents adaptation to feeding on large, hard objects. A modern analog for this specific dietary specialization is provided by the West African sooty mangabey, Cercocebus atys. This species habitually feeds on the large, exceptionally hard nuts of Sacoglottis gabonensis, stereotypically crushing the seed casings using their premolars and molars. This type of behavior has been inferred for A. africanus based on mathematical stress analysis and aspects of dental wear and morphology. While postcanine megadontia, premolar enlargement and thick molar enamel characterize both A. africanus and C. atys, these features are not universally associated with durophagy among living anthropoids. Occlusal microwear analysis reveals complex microwear textures in C. atys unlike those observed in A. africanus, but more closely resembling textures observed in Paranthropus robustus. Since sooty mangabeys process hard objects in a manner similar to that proposed for A. africanus, yet do so without the craniofacial buttressing characteristic of this hominin, it follows that derived features of the australopith skull are sufficient but not necessary for the consumption of large, hard objects. The adaptive significance of australopith craniofacial morphology may instead be related to the toughness, rather than the hardness, of ingested foods.

  2. Target Fortification of Breast Milk: Predicting the Final Osmolality of the Feeds.

    Directory of Open Access Journals (Sweden)

    Arum Choi

    Full Text Available For preterm infants, it is common practice to add human milk fortifiers to native breast milk to enhance protein and calorie supply because the growth rates and nutritional requirements of preterm infants are considerably higher than those of term infants. However, macronutrient intake may still be inadequate because the composition of native breast milk has individual inter- and intra-sample variation. Target fortification (TFO of breast milk is a new nutritional regime aiming to reduce such variations by individually measuring and adding deficient macronutrients. Added TFO components contribute to the final osmolality of milk feeds. It is important to predict the final osmolality of TFO breast milk to ensure current osmolality recommendations are followed to minimize feeding intolerance and necrotizing enterocolitis. This study aims to develop and validate equations to predict the osmolality of TFO milk batches. To establish prediction models, the osmolalities of either native or supplemented breast milk with known amounts of fat, protein, and carbohydrates were analyzed. To validate prediction models, the osmolalities of each macronutrient and combinations of macronutrients were measured in an independent sample set. Additionally, osmolality was measured in TFO milk samples obtained from a previous clinical study and compared with predicted osmolality using the prediction equations. Following the addition of 1 g of carbohydrates (glucose polymer, 1 g of hydrolyzed protein, or 1 g of whey protein per 100 mL breast milk, the average increase in osmolality was 20, 38, and 4 mOsm/kg respectively. Adding fat decreased osmolality only marginally due to dilution effect. Measured and predicted osmolality of combinations of macronutrients as well as single macronutrient (R2 = 0.93 were highly correlated. Using clinical data (n = 696, the average difference between the measured and predicted osmolality was 3 ± 11 mOsm/kg and was not statistically

  3. Target Fortification of Breast Milk: Predicting the Final Osmolality of the Feeds.

    Science.gov (United States)

    Choi, Arum; Fusch, Gerhard; Rochow, Niels; Fusch, Christoph

    2016-01-01

    For preterm infants, it is common practice to add human milk fortifiers to native breast milk to enhance protein and calorie supply because the growth rates and nutritional requirements of preterm infants are considerably higher than those of term infants. However, macronutrient intake may still be inadequate because the composition of native breast milk has individual inter- and intra-sample variation. Target fortification (TFO) of breast milk is a new nutritional regime aiming to reduce such variations by individually measuring and adding deficient macronutrients. Added TFO components contribute to the final osmolality of milk feeds. It is important to predict the final osmolality of TFO breast milk to ensure current osmolality recommendations are followed to minimize feeding intolerance and necrotizing enterocolitis. This study aims to develop and validate equations to predict the osmolality of TFO milk batches. To establish prediction models, the osmolalities of either native or supplemented breast milk with known amounts of fat, protein, and carbohydrates were analyzed. To validate prediction models, the osmolalities of each macronutrient and combinations of macronutrients were measured in an independent sample set. Additionally, osmolality was measured in TFO milk samples obtained from a previous clinical study and compared with predicted osmolality using the prediction equations. Following the addition of 1 g of carbohydrates (glucose polymer), 1 g of hydrolyzed protein, or 1 g of whey protein per 100 mL breast milk, the average increase in osmolality was 20, 38, and 4 mOsm/kg respectively. Adding fat decreased osmolality only marginally due to dilution effect. Measured and predicted osmolality of combinations of macronutrients as well as single macronutrient (R2 = 0.93) were highly correlated. Using clinical data (n = 696), the average difference between the measured and predicted osmolality was 3 ± 11 mOsm/kg and was not statistically significant. In

  4. Comparison of Face to Face Education with Other Methods to Pregnant Mothers in Increase Exclusive Breast Feeding

    Directory of Open Access Journals (Sweden)

    M.S. Saba

    2005-10-01

    Full Text Available Introduction & Objective: There is a direct relationship between the education and exclusive breast-feeding. Most of the educational programs have given after child birth, based on " Rooming in plan”, but because of difficult situation and busy thoughts of mothers, they were not desirable way of education, therefore in this study the role of verbal & nonverbal education was evaluated on the rate of breast-feeding by mothers before delivery.Materials & Methods: This is a randomized controlled-trial study on 108 pregnant women, 20-30 yrs old, paraone, without any systemic disease referring to Health Center of Hamadan. They were divided into two groups of 54 each , group Ι was given verbal education (lecture, movie, slide, question & answer and group ΙΙ nonverbal education (pamphlet of verbal abstracts. The two groups were followed up to 6 months after delivery in respect of restricted breast-feeding.Results: The rate of restricted breast-feeding was 82.7% for mothers on verbal education and 56.5% for nonverbal ones. This difference of percentile rise in two group was statistically meaningful, which showed verbal education was more efficient on outcome of restricted breast-feeding.Conclusion: We concluded that face to face education is more efficient compared to non-verbal education in increase exclusive breast feeding.

  5. Invited review: Carryover effects of early lactation feeding on total lactation performance in dairy cows

    DEFF Research Database (Denmark)

    Jørgensen, Carina; Spörndly, R; Bertilsson, J;

    2016-01-01

    In comparison with the intensive research on the direct effects of energy supply on dairy cow lactation performance, little attention has been paid to the effect of early lactation feeding on subsequent production. The present paper reviews 9 studies carried out with the aim of quantifying...... the immediate and subsequent responses in milk production and body weight to early lactation feeding. Most results showed that a more generous feeding in early lactation caused a positive carryover effect on subsequent production, whereas an inadequate level of feed in early lactation has been shown to reduce...

  6. Cosmetic results of conservative treatment for early breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Bo Kyoung; Shin, Seong Soo; Kim, Seong Deok; Ha, Sung Whan; Noh, Dong Young [College of Medicine, Seoul National Univ., Seoul (Korea, Republic of)

    2001-03-01

    This study was performed to evaluate the cosmetic outcome of conservative treatment for early breast cancer and to analyze the factors influencing cosmetic outcome. From February 1992 through January 1997, 120 patients with early breast cancer were treated with conservative surgery and postoperative radiotherapy. The types of conservative surgery were quadrantectomy and axillary node dissection for 108 patients (90%) and lumpectomy or excisional biopsy for 10 patients (8.3%). Forty six patients (38%) received adjuvant chemotherapy (CMF or CAF). Cosmetic result evaluation was carried out between 16 and 74 months (median, 33 months) after surgery. The cosmetic results were classified into four categories, i.e., excellent, good, fair, and poor. The appearances of the patients' breasts were also analyzed for symmetry using the differences in distances from the stemal notch to right and left nipples. A logistic regression analysis was performed to identify independent variables influencing the cosmetic outcome. Cosmetic score was excellent or good in 76% (91/120), fair in 19% (23/120) and poor in 5% (6/ 120) of the patients. Univariate analysis showed that tumor size (T1 versus T2) (p=0.04), axillary node status (NO versus N1) (p=0.0002), extent of surgery (quadrantectomy versus lumpectomy or excisional biopsy) (p=0.02), axillary node irradiation (p=0.0005) and chemotherapy (p=0,0001) affected cosmetic score. Multivariate analysis revealed that extent of surgery (p=0.04) and chemotherapy (p=0.0002) were significant factors. For breast symmetry, univariate analysis confirmed exactly the same factors as above. Multivariate analysis revealed that tumor size (p=0.003) and lymph node status (p=0.007) affected breast symmetry. Conservative surgery and postoperative radiotherapy resulted in excellent or good cosmetic outcome in a large portion of the patients. Better cosmetic results were achieved generally in the group of patients with smaller tumor size, without

  7. Cosmetic results of conservative treatment for early breast cancer

    International Nuclear Information System (INIS)

    This study was performed to evaluate the cosmetic outcome of conservative treatment for early breast cancer and to analyze the factors influencing cosmetic outcome. From February 1992 through January 1997, 120 patients with early breast cancer were treated with conservative surgery and postoperative radiotherapy. The types of conservative surgery were quadrantectomy and axillary node dissection for 108 patients (90%) and lumpectomy or excisional biopsy for 10 patients (8.3%). Forty six patients (38%) received adjuvant chemotherapy (CMF or CAF). Cosmetic result evaluation was carried out between 16 and 74 months (median, 33 months) after surgery. The cosmetic results were classified into four categories, i.e., excellent, good, fair, and poor. The appearances of the patients' breasts were also analyzed for symmetry using the differences in distances from the stemal notch to right and left nipples. A logistic regression analysis was performed to identify independent variables influencing the cosmetic outcome. Cosmetic score was excellent or good in 76% (91/120), fair in 19% (23/120) and poor in 5% (6/ 120) of the patients. Univariate analysis showed that tumor size (T1 versus T2) (p=0.04), axillary node status (NO versus N1) (p=0.0002), extent of surgery (quadrantectomy versus lumpectomy or excisional biopsy) (p=0.02), axillary node irradiation (p=0.0005) and chemotherapy (p=0,0001) affected cosmetic score. Multivariate analysis revealed that extent of surgery (p=0.04) and chemotherapy (p=0.0002) were significant factors. For breast symmetry, univariate analysis confirmed exactly the same factors as above. Multivariate analysis revealed that tumor size (p=0.003) and lymph node status (p=0.007) affected breast symmetry. Conservative surgery and postoperative radiotherapy resulted in excellent or good cosmetic outcome in a large portion of the patients. Better cosmetic results were achieved generally in the group of patients with smaller tumor size, without axillary

  8. Prognosis for Mammographically Occult, Early-Stage Breast Cancer Patients Treated With Breast-Conservation Therapy

    International Nuclear Information System (INIS)

    Purpose: To compare mammographically occult (MamOcc) and mammographically positive (MamPos) early-stage breast cancer patients treated with breast-conservation therapy (BCT), to analyze differences between the two cohorts. Methods and Materials: Our two cohorts consisted of 214 MamOcc and 2168 MamPos patients treated with BCT. Chart reviews were conducted to assess mammogram reports and method of detection. All clinical-pathologic and outcome parameters were analyzed to detect differences between the two cohorts. Results: Median follow-up was 7 years. There were no differences in final margins, T stage, nodal status, estrogen/progesterone receptor status, or 'triple-negative' status. Significant differences included younger age at diagnosis (p o histology (p < 0.0001). At 10 years, the differences in overall survival, cause-specific survival, and distant relapse between the two groups did not differ significantly. The MamOcc cohort had more breast relapses (15% vs. 8%; p = 0.0357), but on multivariate analysis this difference was not significant (hazard ratio 1.0, 95% confidence interval 0.993-1.007, p = 0.9296). Breast relapses were mammographically occult in 32% of the MamOcc and 12% of the MamPos cohorts (p = 0.0136). Conclusions: Although our study suggests that there are clinical-pathologic variations for the MamOcc cohort vs. MamPos patients that may ultimately affect management, breast relapse after BCT was not significantly different. Breast recurrences were more often mammographically occult in the MamOcc cohort; consideration should be given to closer follow-up and alternative imaging strategies (ultrasound, breast MRI) for routine posttreatment examination. To our knowledge, this represents the largest series addressing the prognostic significance of MamOcc cancers treated with BCT.

  9. Analysis of radiation pneumonitis outside the radiation field in breast conserving therapy for early breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Ogo, Etsuyo; Fujimoto, Kiminori; Hayabuchi, Naofumi [Kurume Univ., Fukuoka (Japan). School of Medicine] (and others)

    2002-02-01

    In a retrospective study of radiation-induced pulmonary changes for patients with breast conserving therapy for early breast cancer, we sent questionnaires to the main hospitals in Japan. In this study, we analyzed pulmonary changes after tangential whole-breast irradiation. The purpose of this study was to determine the incidence and risk factors for radiation pneumonitis outside the radiation field. The questionnaires included patients data, therapy data, and lung injury information between August 1999 and May 2000. On the first questionnaires, answer letters were received from 107 institutions out of 158 (67.7%). On the second questionnaires, response rate (hospitals which had radiation pneumonitis outside the radiation field) was 21.7% (23/106). We could find no risk factors of this type of pneumonitis. We suggested that lung irradiation might trigger this type of pneumonitis which is clinically similar to BOOP (bronchiolitis obliterans organizing pneumonia). It developed in 1.5-2.1% among the patients with breast conserving surgery and tangential whole-breast irradiation. And it is likely appeared within 6 months after radiotherapy. (author)

  10. Analysis of radiation pneumonitis outside the radiation field in breast conserving therapy for early breast cancer

    International Nuclear Information System (INIS)

    In a retrospective study of radiation-induced pulmonary changes for patients with breast conserving therapy for early breast cancer, we sent questionnaires to the main hospitals in Japan. In this study, we analyzed pulmonary changes after tangential whole-breast irradiation. The purpose of this study was to determine the incidence and risk factors for radiation pneumonitis outside the radiation field. The questionnaires included patients data, therapy data, and lung injury information between August 1999 and May 2000. On the first questionnaires, answer letters were received from 107 institutions out of 158 (67.7%). On the second questionnaires, response rate (hospitals which had radiation pneumonitis outside the radiation field) was 21.7% (23/106). We could find no risk factors of this type of pneumonitis. We suggested that lung irradiation might trigger this type of pneumonitis which is clinically similar to BOOP (bronchiolitis obliterans organizing pneumonia). It developed in 1.5-2.1% among the patients with breast conserving surgery and tangential whole-breast irradiation. And it is likely appeared within 6 months after radiotherapy. (author)

  11. Breast-feeding, nutritional status, and other prognostic factors for dehydration among young children with diarrhoea in Brazil.

    Science.gov (United States)

    Victora, C G; Fuchs, S C; Kirkwood, B R; Lombardi, C; Barros, F C

    1992-01-01

    Early identification of children at high risk of diarrhoea-associated dehydration would be of great value to health care workers in developing countries. To identify prognostic factors for life-threatening dehydration, we carried out a case-control study among under-2-year-olds in Porto Alegre, Brazil. Cases were 192 children admitted to hospital with moderate or severe dehydration, while controls were children matched to controls by neighbourhood and age, who experienced nondehydrating diarrhoea in the week preceding the interview. The following variables were significantly associated with an increased risk of dehydration, after adjustment for age and other confounding variables: absence of the father from the home; low paternal education level; young age; maternal age 25-29 years or less than 20 years; mother of mixed race; high birth order; short birth interval; low birth weight; stunting, underweight and wasting; lack of breast-feeding; presence of other under-5-year-olds in the home; families with 4-5 members; lack of antenatal care; less than three doses of diphtheria-pertussis-tetanus or poliomyelitis vaccine; previous admission to hospital; use of medicines during the fortnight prior to the episode; and living in an unclean home. The associations were particularly strong (P less than 0.001) for the child's age, birth weight and other anthropometric indicators, birth interval, and feeding mode. In terms of their sensitivity and specificity, however, these prognostic factors were not as effective as early signs and symptoms for predicting the outcome of the episode.

  12. A randomized controlled trial evaluating early versus traditional oral feeding after colorectal surgery

    Directory of Open Access Journals (Sweden)

    Ahmet Dag

    2011-01-01

    Full Text Available OBJECTIVE: This prospective randomized clinical study was conducted to evaluate the safety and tolerability of early oral feeding after colorectal operations. METHODS: A total of 199 patients underwent colorectal surgery and were randomly assigned to early feeding (n = 99 or a regular diet (n = 100. Patients’ characteristics, diagnoses, surgical procedures, comorbidity, bowel movements, defecation, nasogastric tube reinsertion, time of tolerance of solid diet, complications, and length of hospitalization were assessed. RESULTS: The two groups were similar in terms of gender, age, diagnosis, surgical procedures, and comorbidity. In the early feeding group, 85.9% of patients tolerated the early feeding schedule. Bowel movements (1.7±0.89 vs. 3.27±1.3, defecation (3.4±0.77 vs. 4.38±1.18 and time of tolerance of solid diet (2.48±0.85 vs. 4.77±1.81 were significantly earlier in the early feeding group. There was no change between the groups in terms of nasogastric tube reinsertion, overall complication or anastomotic leakage. Hospitalization (5.55±2.35 vs. 9.0±6.5 was shorter in the early feeding group. CONCLUSIONS: The present study indicated that early oral feeding after elective colorectal surgery was not only well tolerated by patients but also affected the postoperative outcomes positively. Early postoperative feeding is safe and leads to the early recovery of gastrointestinal functions.

  13. Association between breast-feeding practices and sucking habits: A cross-sectional study of children in their first year of life

    Directory of Open Access Journals (Sweden)

    Moimaz Suzely A

    2008-09-01

    Full Text Available In addition to providing nutrition and immunological protection, breast-feeding has positive effects on the development of the infant′s oral cavity. The aim of the present study is to assess breast-feeding patterns and to analyze the influence of breast-feeding practices and maternal sociodemographic variables on the prevalence of non-nutritive sucking habits in a sample of Brazilian infants. This cross-sectional study was carried out in Southern Brazil. A random sample of 100 mothers of infants up to 12 months of age was interviewed during the National Vaccination Campaign Day. The prevalence and median duration of breast-feeding were assessed. Breast-feeding practice, the exposure factor, was categorized as exclusive breast-feeding, predominant breast-feeding, complementary breast-feeding, or weaning. Maternal sociodemographic variables included age, race, marital status, educational level, profession, and family income. The outcome investigated was the prevalence of sucking habits (pacifier use and thumb sucking. We used two-sample tests, the chi-square test and Fisher exact test0 for statistical analyses of the data. The study revealed that 75% of infants were being breast-fed. Pacifier use and thumb sucking were common in 55%. Bottle-feeding was prevalent in 74% of infants. Breast-feeding was negatively correlated with pacifier use and thumb sucking (OR = 0.11; 95% CI: 0.03 to 0.4. Bottle-feeding was strongly associated with weaning (p = 0.0003. Among the sociodemographic variables, only marital status showed a statistical association with sucking habits (p = 0.04. These findings suggest that breast-feeding can prevent the occurrence of sucking habits. Although we could not evaluate causality assessment, malocclusion prevention seems to be yet one more reason for promoting breast-feeding practices.

  14. Dosimetric comparison of 3DCRT versus IMRT in whole breast irradiation of early stage breast cancer

    Directory of Open Access Journals (Sweden)

    Mudasir Ashraf

    2014-08-01

    Full Text Available Purpose: The counseling regarding the treatment option is an important objective in the management of early stages breast cancer. In this study, we attempt to compare and analyze the dosimetric aspects of 3DRT over IMRT in the whole breast radiotherapy.Methods and Materials:  Both right and left sided computed tomography simulations of 14 women with early stage breast cancer were used for our retrospective study to compare the 3DCRT and IMRT. The dose prescribed was 50 Gy in 25 fractions to the whole breast PTV. The PTV was defined by adding unequal margins to the directional safety margin status of each lumpectomy cavity (i.e., medial, lateral, superior, inferior and deep margins measured from the tumor front after the examination of the surgical specimen: 2, 1.5, and 1 cm for resection margins < 1 cm, 1-2 cm, and > 2cm, respectively. And than modified so that it was no longer closer than 3mm to the skin surface and was no deep than the lung –chest interface. The prescribed dose delivered in 5 fractions per week schedule. Treatment plans were compared for target minimum dose, maximum dose, mean dose, conformity index, heterogeneity index and doses to organs at risk were compared and analysed.Results: The target coverage was achieved with 90% prescription to the 95% of the PTV. Conformity to the PTV was significantly higher with 3DCRT technique than IMRT. 3DCRT technique seems better in sparing critical organs parameters like lung V20 and Mean, heart, V25, Maximum, both lungs V20, Mean and Dose to the Normal Healthy tissue.Conclusion: We conclude from our study that treatment technique selection for whole Breast irradiation is an important factor in sparing the adjacent normal structures and in determining the associated risk. 3DCRT produces better conformity and heterogeneity indices of the target volume, also reduces dose to OARs the 3DCRT reduces the risk of radiation induced heart diseases

  15. Relationships between parenting style, feeding style and feeding practices and fruit and vegetable consumption in early childhood.

    Science.gov (United States)

    Blissett, Jackie

    2011-12-01

    Despite substantial evidence suggesting that a diet high in fruit and vegetables (FV) is associated with reduced risk of cancer, only 21% of children in the UK consume the recommended 5 portions of fruit or vegetables a day. This review examines the role of parenting style, feeding style and feeding practices in FV consumption in early childhood. Whilst inconsistencies in concepts and terminology cloud this literature, overall the evidence suggests that the context of an authoritative parenting and feeding style is associated with better FV consumption in the childhood years. This context is typified by emotional warmth but high expectations for children's dietary adequacy and behaviour, accompanied by specific feeding practices such as modeling consumption of FV, making FV available within the home, covertly restricting unhealthy alternative snack foods, and encouraging children to try FV. Further longitudinal and intervention studies are required to determine the efficacy of modification of parenting style and feeding practice on children's FV intake.

  16. Supraclavicular recurrence after early breast cancer: a curable condition?

    DEFF Research Database (Denmark)

    Pedersen, Anders N; Møller, Susanne; Steffensen, Karina D;

    2010-01-01

    treatment and primary patient characteristics, treatment response, and survival after supraclavicular recurrence (SR) in a large patient population. From the Danish Breast Cancer Cooperative Group treatment database 1977-2003, 305 patients were identified with SR without distant disease as site of first......The prognosis of ipsilateral supraclavicular lymph node recurrence after early breast cancer appears to be worse than for other loco-regional recurrences, but better than for distant metastases. The purpose of the present study was to investigate the relationship between different types of salvage...... recurrence. Salvage treatment types as well as other factors were related to response and survival. The median follow-up time for progression after SR was 25 months. Complete remission was 76% among patients receiving excision surgery, 67% with combined loco-regional and systemic therapy, and 48% with...

  17. Breast conserving operation and radiation therapy in early breast cancer: interim analysis

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jin Hee; Kim, Ok Bae; Kim, You Sah [College of Medicine, Keimyung Univ., Taegu (Korea, Republic of)

    2001-03-01

    To evaluate interim results in terms of failure, cosmetic results and survival after breast conserving operation and radiation therapy in early breast cancer. From January 1992 through December 1997, seventy two patients with early stage 0, I and II breast cancer were treated with conservative surgery plus radiotherapy at Keimyung University Dongsan Medical Center. Age distribution was 25 to 77 years old with median age of 43. Ac cording to TNM stage, five patients had stage 0, thirty three were stage I, twenty five were lIa, and nine were llb. Most patients underwent excision of all gross tumor and ipsilateral axillary dissection. Breast was irradiated through medial and lateral tangential fields of 6 MV photons to 50.4 Gy in 28 fractions over 5.5 weeks. We delivered a boost irradiation dose of 10 to 16 Gy in 1 to 2 weeks to excision site. Adjuvant chemotherapy was administered in forty one patients with CMF (cyclophosphamide, methotrexate, 5fluorouracil) regimens of 6 cycles concurrently or before radiation. Cosmetic results were assessed by questionnaire to patients grading of excellent, good, fair, poor. Follow-up periods were 22 to 91 months with median 40 months. Five year disease free survival rate (5YDFS) was 95.8%. According to stage, 5YDFS was 100%, 96.9%, 96% and 88.9% in stage 0, I, lIa and llb, respectively. Two patients had distant metastasis and one had local and distant failure. One patient with distant failure had bone and liver metastasis at 14 months after treatment and the other had lung and both supraclavicular metastasis at 21 months after treatment. Patient with local and distant failure had local recurrence on other quadrant in same breast and then salvaged with total mastectomy and chemotherapy but she died due to brain metastasis at 55 months. Complications were radiation pneumonitis in five patients (four patients of asymptomatic, one patient of symptomatic) and hand or arm edema(4 patients). Fifty nine patients answered our cosmetic

  18. Breast conserving operation and radiation therapy in early breast cancer: interim analysis

    International Nuclear Information System (INIS)

    To evaluate interim results in terms of failure, cosmetic results and survival after breast conserving operation and radiation therapy in early breast cancer. From January 1992 through December 1997, seventy two patients with early stage 0, I and II breast cancer were treated with conservative surgery plus radiotherapy at Keimyung University Dongsan Medical Center. Age distribution was 25 to 77 years old with median age of 43. Ac cording to TNM stage, five patients had stage 0, thirty three were stage I, twenty five were lIa, and nine were llb. Most patients underwent excision of all gross tumor and ipsilateral axillary dissection. Breast was irradiated through medial and lateral tangential fields of 6 MV photons to 50.4 Gy in 28 fractions over 5.5 weeks. We delivered a boost irradiation dose of 10 to 16 Gy in 1 to 2 weeks to excision site. Adjuvant chemotherapy was administered in forty one patients with CMF (cyclophosphamide, methotrexate, 5fluorouracil) regimens of 6 cycles concurrently or before radiation. Cosmetic results were assessed by questionnaire to patients grading of excellent, good, fair, poor. Follow-up periods were 22 to 91 months with median 40 months. Five year disease free survival rate (5YDFS) was 95.8%. According to stage, 5YDFS was 100%, 96.9%, 96% and 88.9% in stage 0, I, lIa and llb, respectively. Two patients had distant metastasis and one had local and distant failure. One patient with distant failure had bone and liver metastasis at 14 months after treatment and the other had lung and both supraclavicular metastasis at 21 months after treatment. Patient with local and distant failure had local recurrence on other quadrant in same breast and then salvaged with total mastectomy and chemotherapy but she died due to brain metastasis at 55 months. Complications were radiation pneumonitis in five patients (four patients of asymptomatic, one patient of symptomatic) and hand or arm edema(4 patients). Fifty nine patients answered our cosmetic

  19. Iron sufficiency with prolonged exclusive breast-feeding in Peruvian infants.

    Science.gov (United States)

    Pastel, R A; Howanitz, P J; Oski, F A

    1981-10-01

    Serum ferritin and erythrocyte porphyrin concentrations were measured in seven Peruvian infants, who ranged in age from 7.5-12.0 months (mean: 9.3 months), who had been exclusively breast-fed all their lives. No infant had evidence of iron deficiency as reflected by a reduced serum ferritin, or an increased erythrocyte porphyrin. Mean serum ferritin and erythrocyte porphyrin values in these seven infants were similar to those of 40 nonanemic, noniron-deficient U.S. infants who ranged in age from 9 to 12 months, on a mixed diet. These findings illustrate that exclusively breast-feeding an infant for at least 9 months of life meets the iron requirements of the full-term infant.

  20. The Impact of Diabetes Mellitus on Prognosis of Early Breast Cancer in Asia

    OpenAIRE

    Chen, Wei-Wu; Shao, Yu-Yun; Shau, Wen-Yi; Lin, Zhong-Zhe; Lu, Yen-Shen; Chen, Ho-Min; Kuo, Raymond N.C.; Cheng, Ann-Lii; Lai, Mei-Shu

    2012-01-01

    Using nationwide databases in Taiwan, the individual effect of diabetes mellitus on both the breast cancer–specific and overall survival rates in Asian patients with early-stage breast cancer was evaluated while taking into account other comorbidities. Diabetes mellitus was found to be an independent predictor of both the breast cancer–specific and overall survival rates.

  1. The Relationship Between Maternal Attachment, Perceived Social Support and Breast-Feeding Sufficiency

    International Nuclear Information System (INIS)

    Objective: To determine the relationship between maternal attachment, perceived social support and breast-feeding sufficiency. Study Design: Descriptive correlational design. Place and Duration of Study: A state hospital and two family health centers in Sakarya, Turkey, between June to December 2011. Methodology: The sample was 122 voluntary mothers who had healthy babies of 1 - 2 months old. The data were collected by a Personal Information Form, Maternal Attachment Inventory (MAI), Multidimensional Scale of Perceived Social Support (MSPSS) and Breast-feeding Self-Efficacy Scale-Short Form (BSES-SF). The data collected were analysed by percentage distribution, mean square, independent sample t-test, Mann-Whitney U, Kruskall-Wallis and Pearson correlation. Results: The mean age of the mothers was 25.01 ± 2.2 years, and 48.4% of them were primary school graduates. BSESSF was 61.02 ± 8.44 (16 - 70), MAI was 99.07 ± 7.19 (56 - 100) and MSPSS was 66.40 ± 13.58 (37 - 84). There was a positive, medium level, significant relationship between the total scores of BSES-SF and MAI (r=0.370, p < 0.001). There was a positive, medium level, significant relationship between the total score of BSES-SF and the score from family subdimension of MSPSS (r=0.255, p < 0.01).There was a positive, medium level, significant relationship between the total score of MAI and the total score of family subdimension of MSPSS (r=0.339, p < 0.001). Conclusion: Successful maternal attachment and familial support positively affected the breast-feeding sufficiency of the mother. (author)

  2. Stereotactic Accelerated Partial Breast Irradiation for Early-Stage Breast Cancer: Rationale, Feasibility, and Early Experience Using the CyberKnife Radiosurgery Delivery Platform

    OpenAIRE

    Obayomi-Davies, Olusola; Kole, Thomas P.; Oppong, Bridget; Rudra, Sonali; Makariou, Erini V.; Lloyd D Campbell; Hozaifa M Anjum; Sean P Collins; Unger, Keith; WILLEY, SHAWNA; Tousimis, Eleni; Collins, Brian T.

    2016-01-01

    Purpose The efficacy of accelerated partial breast irradiation (APBI) utilizing brachytherapy or conventional external beam radiation has been studied in early-stage breast cancer treated with breast-conserving surgery. Data regarding stereotactic treatment approaches are emerging. The CyberKnife linear accelerator enables excellent dose conformality to target structures while adjusting for target and patient motion. We report our institutional experience on the technical feasibility and rati...

  3. Stereotactic Accelerated Partial Breast Irradiation (SAPBI) for Early Stage Breast Cancer: Rationale, Feasibility and Early Experience using the CyberKnife Radiosurgery Delivery Platform

    OpenAIRE

    Olusola eOBAYOMI-DAVIES; Kole, Thomas P.; Bridget eOppong; Sonali eRudra; Erini eMakariou; Lloyd D Campbell; Hozaifa M Anjum; Sean P Collins; Keith eUnger; Willey, Shawna C.; Eleni A Tousimis; Brian Timothy Collins

    2016-01-01

    Purpose: The efficacy of accelerated partial breast irradiation (APBI) utilizing brachytherapy or conventional external beam radiation has been studied in early stage breast cancer treated with breast conserving surgery. Data regarding stereotactic treatment approaches are emerging. The CyberKnife linear accelerator enables excellent dose conformality to target structures while adjusting for target and patient motion. We report our institutional experience on the technical feasibility and rat...

  4. Survey on the effects of breast feeding on blood sugar in highbirth weight neonates

    OpenAIRE

    S. Behzadnia; V. Ghaffari; K. Vahidshahi

    2005-01-01

    Background and purpose : The low amount of blood sugar in neonates is an important and prevalent problem which needs serious attention because of its cerebral complications. High birth weight is one of the risk factors for hypoglycemia.There is no general agreement about how to approach the high birth weight neonates who do not have the symptoms of hypoglycemia but are at a high risk of it.In some centers the neonates blood sugar is checked before beginning the breast feeding and treatment bu...

  5. Pharmacological treatment of unipolar depression during pregnancy and breast-feeding-A clinical overview

    DEFF Research Database (Denmark)

    Nielsen, René Ernst; Damkier, Per

    2012-01-01

    This overview is aimed at clinicians working with patients in the fertile age who suffer from depressive disorders. The study of adverse effects of antidepressants on the foetus is hampered by difficulty in distinguishing between the behavioural changes that are related to the disorder itself and...... and changes that accompany its treatment with antidepressants. The current lack of solid scientific knowledge and the implications, mainly emotional, of treating pregnant or breast-feeding women often raise anxiety and cause concern among patients and clinicians....

  6. Early removing gastrointestinal decompression and early oral feeding improve patients' rehabilitation after colorectostomy

    Institute of Scientific and Technical Information of China (English)

    Tong Zhou; Xiao-Ting Wu; Ye-Jiang Zhou; Xiong Huang; Wei Fan; Yue-chun Li

    2006-01-01

    AIM: To evaluate the feasibility, safety, and tolerance of early removing gastrointestinal decompression and early oral feeding in the patients undergoing surgery for colorectal carcinoma.METHODS: Three hundred and sixteen patients submitted to operations associated with colorectostomy from January 2004 to September 2005 were randomized to two groups: In experimental group (n = 161), the nasogastric tube was removed after the operation from 12 to 24 hours and was promised immediately oral feeding; In control group (n = 155), the nasogastric tube was maintained until the passage of flatus per rectum.Variables assessed included the time to first passage of flatus, the time to first passage of stool, the time elapsedpostoperative stay, and postoperative complications such as anastomotic leakage, acute dilation of stomach,wound infection and dehiscense, fever, pulmonary infection and pharyngolaryngitis.RESULTS: The median and average days to the first passage of flatus (3.0±0.9 vs 3.6± 1.2, P<0.001), the first passage of stool (4.1± 1.1 vs 4.8± 1.4 P<0.001)and the length of postoperative stay (8.4± 3.4 vs 9.6±5.0, P<0.05) were shorter in the experimental group than in the control group. The postoperative complications such as anastomotic leakage (1.24% vs 2.58%), acute dilation of stomach (1.86% vs 0.06%)and wound complications (2.48% vs1.94%) were similar in the groups, but fever (3.73% vs 9.68%, P<0.05),pulmonary infection (0.62% vs 4.52%, P<0.05) and pharyngolaryngitis (3.11% vs 23.23%, P<0.001) were much more in the control group than in the experimental group.CONCLUSION: The present study shows that application of gastrointestinal decompression after colorectostomy can not effectively reduce postoperative complications.On the contrary, it may increase the incidence rate of fever, pharyngolaryngitis and pulmonary infection.These strategies of early removing gastrointestinal decompression and early oral feeding in the patients undergoing

  7. Early-stage bilateral breast cancer treated with breast-conserving surgery and definitive irradiation: the university of Pennsylvania experience

    International Nuclear Information System (INIS)

    Purpose: To determine whether patients with early-stage bilateral breast cancer can be treated with definitive irradiation following breast-conserving surgery with acceptable survival, local control, complications, and cosmesis. Methods and Materials: During the period 1977-1992, 55 women with Stage 0, I, or II concurrent (n = 12) or sequential (n = 43) bilateral breast cancer were treated with definitive irradiation following breast-conserving surgery. The records of these 55 patients with 110 treated breasts were reviewed for tumor size, histology, pathologic axillary lymph node status, first and overall site(s) of failure, and adjuvant chemotherapy or hormonal therapy. Curves for survival, local control, and regional control were determined. Cosmetic outcome, complication rates, and matching technique were analyzed. The median total radiation dose delivered was 64 Gy (range 42-72) using tangential whole-breast irradiation followed by an electron or iridium implant boost. The tangential fields were matched with no overlap in 40 patients (73%); there was overlap on skin of up to 4 cm in 14 patients (25%); and the matching technique was unknown in 1 patient (2%). The median follow-up for the 12 women with concurrent bilateral breast cancer was 4.0 years. The median follow-up for the other 43 women with sequential cancer was 9.3 and 4.9 years, respectively, after the first and second cancers. Results: For the overall group of 55 patients, the 5- and 10-year overall survival rates were 96% and 94%, respectively, after treatment of the first cancer, and 96% and 92%, respectively, after treatment of the second cancer. The 5- and 10-year actuarial relapse-free survival rates were 90% and 75%, respectively, after treatment of the first cancer, and 83% and 72%, respectively, after treatment of the second cancer. For the 110 treated breast cancers, the 5- and 10-year actuarial local failure rates were 5% and 15%, respectively. Complication rates were: 28% breast edema, 8

  8. Breast milk IL-1β level associates with development of eczema during early childhood

    DEFF Research Database (Denmark)

    Jepsen, A. A.; Chawes, B. L. K.; Carson, C. G.;

    2015-01-01

    We recently demonstrated adual effect of breastfeeding with increasedrisk of eczema and decreased risk ofwheezing in early childhood. We hypothesizethat maternal immune constitutioncharacterized by breast milk mediatorsmay explain such association.......We recently demonstrated adual effect of breastfeeding with increasedrisk of eczema and decreased risk ofwheezing in early childhood. We hypothesizethat maternal immune constitutioncharacterized by breast milk mediatorsmay explain such association....

  9. Clinical Outcome after Breast Conserving Surgery and Radiation Therapy for Early Breast Cancer

    International Nuclear Information System (INIS)

    This study was performed to evaluate the disease-free survival and risk factors of recurrence in early breast cancer patients who have undergone breast conserving surgery and radiation therapy. Materials and Methods: From March 1997 to December 2002, 77 breast cancer patients who underwent breast conserving surgery and radiation therapy were reviewed retrospectively. The median follow-up time was 58.4 months (range 43.8-129.4 months) and the mean subject age was 41 years. The frequency distribution of the different T stages, based on the tumor characteristics was 38 (49.3%) for T1, 28 (36.3%) for T2, 3 for T3, 7 for Tis and 1 for an unidentified sized tumor. In addition, 52 patients (67.5%) did not have axillary lymph metastasis, whereas 14 patients (18.1%) had 1-3 lymph node metastases and 3 (0.03%) had more than 4 lymph node metastases. The resection margin was negative in 59 patients, close (≤2 mm) in 15, and positive in 4. All patients received radiation therapy at the intact breast using tangential fields with a subsequent electron beam boost to the tumor bed at a total dose ranging from 59.4 Gy to 66.4 Gy. Patients with more than four positive axillary lymph nodes received radiation therapy (41.4-60.4 Gy) at the axillary and supraclavicular area. Chemotherapy was administered in 59 patients and tamoxifen or fareston was administered in 29 patients. Results: The 5 year overall survival and disease-free survival rates were 98.08% and 93.49%, respectively. Of the 77 patients, a total of 4 relapses (5.2%), including 1 isolated supraclavicular relapse, 1 supraclavicular relapse with synchronous multiple distant relapses, and 2 distant relapses were observed. No cases of local breast relapses were observed. Lymph node metastasis or number of metastatic lymph nodes was not found to be statistically related with a relapse (p=0.3289) nor disease-free survival (p=0.1430). Patients with positive margins had a significantly shorter disease-free survival period (p<0

  10. Clinical Outcome after Breast Conserving Surgery and Radiation Therapy for Early Breast Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Heung Lae; Kim, Cheo Ljin; Park, Sung Kwang; Oh, Min Kyung; Lee, Jin Yong; Ahn, Ki Jung [Inje University College of Medicine, Busan (Korea, Republic of)

    2008-12-15

    This study was performed to evaluate the disease-free survival and risk factors of recurrence in early breast cancer patients who have undergone breast conserving surgery and radiation therapy. Materials and Methods: From March 1997 to December 2002, 77 breast cancer patients who underwent breast conserving surgery and radiation therapy were reviewed retrospectively. The median follow-up time was 58.4 months (range 43.8-129.4 months) and the mean subject age was 41 years. The frequency distribution of the different T stages, based on the tumor characteristics was 38 (49.3%) for T1, 28 (36.3%) for T2, 3 for T3, 7 for Tis and 1 for an unidentified sized tumor. In addition, 52 patients (67.5%) did not have axillary lymph metastasis, whereas 14 patients (18.1%) had 1-3 lymph node metastases and 3 (0.03%) had more than 4 lymph node metastases. The resection margin was negative in 59 patients, close ({<=}2 mm) in 15, and positive in 4. All patients received radiation therapy at the intact breast using tangential fields with a subsequent electron beam boost to the tumor bed at a total dose ranging from 59.4 Gy to 66.4 Gy. Patients with more than four positive axillary lymph nodes received radiation therapy (41.4-60.4 Gy) at the axillary and supraclavicular area. Chemotherapy was administered in 59 patients and tamoxifen or fareston was administered in 29 patients. Results: The 5 year overall survival and disease-free survival rates were 98.08% and 93.49%, respectively. Of the 77 patients, a total of 4 relapses (5.2%), including 1 isolated supraclavicular relapse, 1 supraclavicular relapse with synchronous multiple distant relapses, and 2 distant relapses were observed. No cases of local breast relapses were observed. Lymph node metastasis or number of metastatic lymph nodes was not found to be statistically related with a relapse (p=0.3289) nor disease-free survival (p=0.1430). Patients with positive margins had a significantly shorter disease-free survival period (p<0

  11. 76 FR 55915 - Request for Nominations of Candidates to Serve on the Breast and Cervical Cancer Early Detection...

    Science.gov (United States)

    2011-09-09

    ... on the Breast and Cervical Cancer Early Detection and Control Advisory Committee (BCCEDCAC) The... the CDC on the early detection and control of breast and cervical cancer. The role of the BCCEDCAC...

  12. Safety of breast-feeding with HBV-DNA positive breast milk%HBV-DNA阳性乳汁喂养的安全性探讨

    Institute of Scientific and Technical Information of China (English)

    周冬生; 林秋香; 蒋就喜

    2013-01-01

    Objective To investigate the safety of breast-feeding by puerpera with HBV-DNA positive breast milk.Methods 117 puerpera with HBV-DNA positive breast milk (2 cases with twins) were studied.119 infants were given with HBV active and passive immunization.34 infants were provided with breast feeding and 85 infants were provided with artificial-feeding.Results 34 out of 119 infants (28.57%) were found to have chronic HBV infection.The rate of HBV infection in the breast-feeding group (32.35%,11/34) was similar to artificial-feeding froup (27.06%,23/85) (P>0.05).However,it has statistical significant difference that the amount of breast milk HBV-DNA loads between the group of chronic HBV infection in infants and the group of no infection(P<0.05).Conclusions Chronic HBV infection in infants is correlated with the amount of HBV-DNA in maternal milk.Breast-feeding with HBV-DNA positive breast milk may not increase the risk of chronic HBV infection in infants.%目的 探讨乳汁HBV-DNA阳性产妇母乳喂养的安全性.方法 乳汁HBV-DNA阳性产妇117例(双胞2例),119例幼儿出生时均接受HBV主动+被动免疫,自由选择喂养方式,其中母乳喂养34例(母乳喂养组),人工喂养85例(人工喂养组),观察两组幼儿慢性感染HBV情况.结果 119例幼儿慢性感染HBV 34例,慢性感染率为28.57%;其中母乳喂养组幼儿慢性感染率为32.35%(11/34),人工喂养组为27.06%(23/85),差异无统计学意义(P>0.05);但幼儿HBV慢性感染组与未感染组母亲乳汁HBV-DNA水平差异有统计学意义(P<0.05).结论 幼儿慢性感染HBV与产妇乳汁HBV-DNA载量有关,但母乳喂养并未增加感染HBV的风险.

  13. Pattern of Breast Cancer Distribution in Ghana: A Survey to Enhance Early Detection, Diagnosis, and Treatment

    Directory of Open Access Journals (Sweden)

    Frank Naku Ghartey Jnr

    2016-01-01

    Full Text Available Background. Nearly 70% of women diagnosed with breast cancer in Ghana are in advanced stages of the disease due especially to low awareness, resulting in limited treatment success and high death rate. With limited epidemiological studies on breast cancer in Ghana, the aim of this study is to assess and understand the pattern of breast cancer distribution for enhancing early detection and treatment. Methods. We randomly selected and screened 3000 women for clinical palpable breast lumps and used univariate and bivariate analysis for description and exploration of variables, respectively, in relation to incidence of breast cancer. Results. We diagnosed 23 (0.76% breast cancer cases out of 194 (6.46% participants with clinically palpable breast lumps. Seventeen out of these 23 (0.56% were premenopausal (<46.6 years with 7 (0.23% being below 35 years. With an overall breast cancer incidence of 0.76% in this study, our observation that about 30% of these cancer cases were below 35 years may indicate a relative possible shift of cancer burden to women in their early thirties in Ghana, compared to Western countries. Conclusion. These results suggest an age adjustment for breast cancer screening to early twenties for Ghanaian women and the need for a nationwide breast cancer screening to understand completely the pattern of breast cancer distribution in Ghana.

  14. The effect of level of feeding in early gestation on reproductive success in young rabbit does

    NARCIS (Netherlands)

    Rommers, J.M.; Meijerhof, R.; Noordhuizen, J.P.T.M.; Kemp, B.

    2004-01-01

    An experiment examined the effect of restricted feeding during early gestation on later feed intake and on kindling performance in young rabbit does. Nulliparous rabbit does (n = 94) were inseminated at 14.5 weeks of age. During the first 10 days of gestation, does were fed individually either to ap

  15. The Comparison of Salivary IgA and IgE Levels in Children with Breast- and Formula- Feeding During Infancy Period

    Directory of Open Access Journals (Sweden)

    A. Jafarzadeh

    2007-01-01

    Full Text Available Introduction: Oral local immune factors may play a protective role against oral diseases and defend against microbial agents. Salivary immunoglobulin A (IgA is a major factor for the local host defence against caries and periodontal disease. The aims of this study were to determine the concentrations of salivary IgA and IgE levels in breast-fed and formula-fed children in infancy period.Methods and Materials: Totally, 80 healthy 5 years old children were included in the study. According to type of feeding in infancy period, the children divided into two groups: 50 breast-fed and 30 formula-fed. One milliliter of saliva was collected from each participant, centrifuged, and stored at -70 C. The salivary IgA and IgE concentrations were measured, using ELISA technique.Results: In breast-fed children, the salivary IgA level (39.6 mg/l ± 17.3 was significantly higher than that in formula-fed children (26.9 mg/l ± 14 (P=0.0001. However, the salivary IgE level was significantly lower in breast-fed children, comparing with formula fed ones (5.01 IU/ml ± 19.70 vs. 11.74 IU/ml ± 39.40 (P=0.047.Discussion: These results suggest that breast feeding enhances salivary IgA level in the early period of life which may contribute in oral cavity immunity. Higher salivary IgE level observed in formula-fed subjects may have a potential role in development of allergic or inflammatory reactions.

  16. Breast implants following mastectomy in women with early-stage breast cancer: prevalence and impact on survival

    International Nuclear Information System (INIS)

    Few studies have examined the effect of breast implants after mastectomy on long-term survival in breast cancer patients, despite growing public health concern over potential long-term adverse health effects. We analyzed data from the Surveillance, Epidemiology and End Results Breast Implant Surveillance Study conducted in San Francisco–Oakland, in Seattle–Puget Sound, and in Iowa. This population-based, retrospective cohort included women younger than 65 years when diagnosed with early or unstaged first primary breast cancer between 1983 and 1989, treated with mastectomy. The women were followed for a median of 12.4 years (n = 4968). Breast implant usage was validated by medical record review. Cox proportional hazards models were used to estimate hazard rate ratios for survival time until death due to breast cancer or other causes for women with and without breast implants, adjusted for relevant patient and tumor characteristics. Twenty percent of cases received postmastectomy breast implants, with silicone gel-filled implants comprising the most common type. Patients with implants were younger and more likely to have in situ disease than patients not receiving implants. Risks of breast cancer mortality (hazard ratio, 0.54; 95% confidence interval, 0.43–0.67) and nonbreast cancer mortality (hazard ratio, 0.59; 95% confidence interval, 0.41–0.85) were lower in patients with implants than in those patients without implants, following adjustment for age and year of diagnosis, race/ethnicity, stage, tumor grade, histology, and radiation therapy. Implant type did not appear to influence long-term survival. In a large, population-representative sample, breast implants following mastectomy do not appear to confer any survival disadvantage following early-stage breast cancer in women younger than 65 years old

  17. Early breast cancer without axillary lymph node involvement; Cancer du sein sans atteinte ganglionnaire axillaire

    Energy Technology Data Exchange (ETDEWEB)

    Ghorbel, I.; Kanoun, S.; Kallel, A.; Belaid, A.; Azoury, F.; Heymann, S.; Marsiglia, H.; Bourgier, C. [Departement de Radiotherapie, Unite fonctionnelle de Senologie, institut Gustave-Roussy, 94 - Villejuif (France); Ghorbel, I.; Belaid, A. [Service de Radiotherapie Carcinologique, institut Salah-Azaiz. Tunis (Tunisia); Kanoun, S. [Service de Radiotherapie, hopital Farhat-Hached, Sousse (Tunisia); Kallel, A. [Service de Radiotherapie, clinique Ennasr, Tunis (Tunisia); Pichenot, E.; Verstraet, R. [Departement de Physique, institut Gustave-Roussy, 94 - Villejuif (France); Marsiglia, H. [Universite de Florence (Italy)

    2010-07-01

    Breast cancer is the most common cancer in women. In France, breast cancer incidence was 88.9 per 100, 000 women in 2000. Early detection of breast tumours by screening mammography allows a breast conserving treatment, i.e., breast irradiation preceded by a lumpectomy and a sentinel node biopsy. The standard irradiation of early breast cancers consists in delivering 50 Gy to the whole breast in 2 Gy fractions over a five-week period followed by an additional dose targeting the tumour bed of 16 Gy in eight fractions. The 3D-conformal treatment planning optimizes dose distribution to the whole breast and to the tumour bed and lessens the normal tissue irradiation (heart and ipsilateral lung). The aim of this article is to describe epidemiologic, radio anatomic and prognostic features of early stage breast cancer and to propose guidelines for 3D-conformal treatment planning in early breast cancers. This review is illustrated by a case report. (authors)

  18. Early oral feeding after elective abdominal surgery--what are the issues?

    DEFF Research Database (Denmark)

    Bisgaard, Thue; Kehlet, Henrik

    2002-01-01

    This review analyzes the literature and the historical concerns (restrictions, traditions, nasogastric tube) and pathophysiologic factors (postoperative ileus, risk of anastomotic dehiscence, nausea and vomiting, loss of appetite) invoked for not instituting early oral feeding after major abdominal...

  19. Early Closure of Gastroschisis After Silo Placement Correlates with Earlier Enteral Feeding

    Directory of Open Access Journals (Sweden)

    Jamie Harris

    2015-07-01

    Full Text Available Objectives: Gastroschisis is a congenital anomaly affecting 2.3-4.4/10,000 births. Previous studies show initiation of early enteral feeds predicts improved outcomes. We hypothesize that earlier definitive closure after silo placement; can lead to earlier enteral feed initiation.Design/ Setting/ Duration: Retrospective review of patients with gastroschisis from 2005 and 2014 at a single institution.Material and Methods: The data, including ethnicity, gestational age, birth weight, time to definitive closure, and time of first and full feeds, were analyzed using both Spearman’s rho and the Kruskal-Wallis rank sum test where appropriate; a p value <0.05 was considered significant.Results: Forty-three patients (24 males, 19 females born with gastroschisis were identified. Overall survival rate was 88% (38/43. Forty of the 43 patients had a silo placed prior to definitive closure. Median days to closure were 6 (0 to 85 days. First feeds on average began on day of life (DOL 17, and full feeds on DOL 25. Earlier closure of gastroschisis correlated with early initiation of feeds (p=0.0001 and shorter time to full feeds (p=0.018, closure by DOL4 showed a trend toward earlier feeding (p=0.13.Conclusion: Earlier closure of gastroschisis after silo placement was associated with earlier feed initiation and shorter time to full feeds.

  20. Factors Associated with the Early Introduction of Complementary Feeding in Saudi Arabia.

    Science.gov (United States)

    Alzaheb, Riyadh A

    2016-01-01

    Mothers' instigation of complementary feeding before their infant reaches 6 months old risks shortening their breastfeeding duration, and high morbidity and mortality for their child. Complementary feeding practices require further investigation in Saudi Arabia. The present study aims to evaluate complementary feeding practices, and to establish which factors are associated with the early introduction of complementary feeding in the Saudi Arabian context. Cross-sectional research was conducted with 632 mothers of infants aged between 4 and 24 months attending five primary health care centers (PHCCs) between July and December 2015 in Saudi Arabia. Data on participants' socio-demographic characteristics and complementary feeding practices were collected via structured questionnaires. A regression analysis identified the factors associated with the early introduction of solid foods, defined as before 17 weeks. 62.5% of the study's infants received solid foods before reaching 17 weeks old. The maternal factors at higher risk of early introduction of solids were: younger age; Saudi nationality; shorter education; employment within 6 months post-birth; caesareans; not breastfeeding fully for six weeks post-birth, and living in low-income households. Complementary feeding prior to 6 months postpartum was common in Saudi Arabia. Public health interventions are needed to reduce early complementary feeding, focusing on mothers at highest risk of giving solids too early. PMID:27420081

  1. Factors Associated with the Early Introduction of Complementary Feeding in Saudi Arabia

    Science.gov (United States)

    Alzaheb, Riyadh A.

    2016-01-01

    Mothers’ instigation of complementary feeding before their infant reaches 6 months old risks shortening their breastfeeding duration, and high morbidity and mortality for their child. Complementary feeding practices require further investigation in Saudi Arabia. The present study aims to evaluate complementary feeding practices, and to establish which factors are associated with the early introduction of complementary feeding in the Saudi Arabian context. Cross-sectional research was conducted with 632 mothers of infants aged between 4 and 24 months attending five primary health care centers (PHCCs) between July and December 2015 in Saudi Arabia. Data on participants’ socio-demographic characteristics and complementary feeding practices were collected via structured questionnaires. A regression analysis identified the factors associated with the early introduction of solid foods, defined as before 17 weeks. 62.5% of the study’s infants received solid foods before reaching 17 weeks old. The maternal factors at higher risk of early introduction of solids were: younger age; Saudi nationality; shorter education; employment within 6 months post-birth; caesareans; not breastfeeding fully for six weeks post-birth, and living in low-income households. Complementary feeding prior to 6 months postpartum was common in Saudi Arabia. Public health interventions are needed to reduce early complementary feeding, focusing on mothers at highest risk of giving solids too early. PMID:27420081

  2. Factors Associated with the Early Introduction of Complementary Feeding in Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Riyadh A. Alzaheb

    2016-07-01

    Full Text Available Mothers’ instigation of complementary feeding before their infant reaches 6 months old risks shortening their breastfeeding duration, and high morbidity and mortality for their child. Complementary feeding practices require further investigation in Saudi Arabia. The present study aims to evaluate complementary feeding practices, and to establish which factors are associated with the early introduction of complementary feeding in the Saudi Arabian context. Cross-sectional research was conducted with 632 mothers of infants aged between 4 and 24 months attending five primary health care centers (PHCCs between July and December 2015 in Saudi Arabia. Data on participants’ socio-demographic characteristics and complementary feeding practices were collected via structured questionnaires. A regression analysis identified the factors associated with the early introduction of solid foods, defined as before 17 weeks. 62.5% of the study’s infants received solid foods before reaching 17 weeks old. The maternal factors at higher risk of early introduction of solids were: younger age; Saudi nationality; shorter education; employment within 6 months post-birth; caesareans; not breastfeeding fully for six weeks post-birth, and living in low-income households. Complementary feeding prior to 6 months postpartum was common in Saudi Arabia. Public health interventions are needed to reduce early complementary feeding, focusing on mothers at highest risk of giving solids too early.

  3. Nectar feeding by the early-spring mosquito Aedes provocans.

    Science.gov (United States)

    Smith, S M; Gadawski, R M

    1994-07-01

    Nectar feeding by males and females of the mosquito Aedes provocans was studied at a site near Belleville, Ontario, Canada. Canada plum, Prunus nigra, and especially pin cherry, P. pensylvanica, bloomed contemporaneously with the emergence of Ae. provocans and were important nectar sources for adult mosquitoes during their first week of life. Blossoms of P. pensylvanica shielded for 24 h from foragers produced an average of 0.14 mg of sugar (approximately 2.3J). This nectar was avidly sought by both sexes of Ae. provocans; > 97% of the blossoms were visited by mosquitoes in the first few days of blooming. Young adult mosquitoes were found on blossoms at all hours of the day and night; feeding on P. nigra was strongly eocrepuscular, whereas on P. pensylvanica feeding was much less strongly periodic. Adults foraged for nectar in an energy-conserving, pedestrian strategy, devoting 56% (females) and 68% (males) of their time on blossoms to nectar feeding during foraging bouts that lasted a median of 5.3 min. Both sexes sought nectar soon after emergence--males before they had completed hypopygial rotation or swarmed, and females before mating or host seeking. Female Ae. provocans sought nectar in all stages of oogenesis, but primarily at the initiation of a gonotrophic cycle. Energy stores in the crop averaged 18J per female, with a distribution that depended on gonotrophic age and parity.

  4. CADe tools for early detection of breast cancer

    CERN Document Server

    Bottigli, U; Delogu, P; Fantacci, M E; Fauci, F; Forni, G; Golosio, B; Lauria, A; López, E; Magro, R; Masala, G L; Oliva, P; Palmiero, R; Raso, G; Retico, A; Stumbo, S; Tangaro, S

    2004-01-01

    A breast neoplasia is often marked by the presence of microcalcifications and massive lesions in the mammogram: hence the need for tools able to recognize such lesions at an early stage. Our collaboration, among italian physicists and radiologists, has built a large distributed database of digitized mammographic images and has developed a Computer Aided Detection (CADe) system for the automatic analysis of mammographic images and installed it in some Italian hospitals by a GRID connection. Regarding microcalcifications, in our CADe digital mammogram is divided into wide windows which are processed by a convolution filter; after a self-organizing map analyzes each window and produces 8 principal components which are used as input of a neural network (FFNN) able to classify the windows matched to a threshold. Regarding massive lesions we select all important maximum intensity position and define the ROI radius. From each ROI found we extract the parameters which are used as input in a FFNN to distinguish betwee...

  5. Patterns and predictors of early recurrence in postmenopausal women with estrogen receptor-positive early breast cancer

    OpenAIRE

    Mansell, James; Monypenny, Ian J.; Skene, Anthony I.; Abram, Paul; Carpenter, Robert; Gattuso, Jennifer M.; Wilson, Christopher R.; Angerson, Wilson J.; Doughty, Julie C.

    2008-01-01

    Abstract Previous studies suggest that disease recurrence peaks at around 2 years in patients with early stage breast cancer (EBC), but provide no data regarding recurrence type. This retrospective analysis aimed to identify early recurrence types and risk factors in estrogen receptor-positive (ER+) EBC patients treated with adjuvant tamoxifen following breast cancer surgery. Postmenopausal women diagnosed with ER+ EBC from 1995 to 2004 were evaluated. Annual hazard ratios (HR) for...

  6. Scintigraphic examinations during pregnancy and in breast-feeding women: a survey of Belgian nuclear medicine physician's attitudes

    International Nuclear Information System (INIS)

    Radiation protection is of major importance in pregnant and breast feeding women. This work was undertaken to assess the practices of Belgian nuclear medicine physicians towards performing diagnostic tests during pregnancy and in breast feeding women. A questionnaire was sent to 201 Belgian nuclear medicine physicians; 82 answers (41 %) were received. 51 % of the responding physicians agree to perform lung perfusion scan during pregnancy provided a reduced dose is administered, 33% refuse to perform it during first three months and 24% refuse to perform it for pregnancies older than three months. For the Tc-99m ventilation scan 79% and 66% refuse to perform it before and after first three months. Better agreement was observed for other Tc-99m scintigraphies or tests using other radionuclides. In breast feeding women 89% agree to perform Tc-99m tests provided a breast feeding break; however, the duration of this break appears variable. The need for obtaining a written informed consent appears controversial. Given the variability of the attitudes of nuclear medicine physicians, official guidelines for nuclear medicine diagnostic tests during pregnancy is needed. (authors)

  7. Effects of a mindfulness-based intervention on psychological distress, well-being, and maternal self-efficacy in breast-feeding mothers: results of a pilot study.

    Science.gov (United States)

    Perez-Blasco, Josefa; Viguer, Paz; Rodrigo, Maria F

    2013-06-01

    Several pilot studies have provided evidence that mindfulness-based intervention is beneficial during pregnancy, yet its effects in mothers during the early parenting period are unknown. The purpose of the present pilot study was to examine the effectiveness of a mindfulness-based intervention in breast-feeding mothers. We developed and tested an 8-week mindfulness-based intervention aimed at improving maternal self-efficacy, mindfulness, self-compassion, satisfaction with life, and subjective happiness, and at reducing psychological distress. A randomized controlled, between-groups design was used with treatment and control groups (n = 26) and pretest and posttest measures. ANCOVA results indicated that, compared to the control group, mothers in the treatment group scored significantly higher on maternal self-efficacy, some dimensions of mindfulness (observing, acting with awareness, non-judging, and non-reactivity), and self-compassion (self-kindness, mindfulness, over-identification, and total self-compassion). In addition, mothers who received the treatment exhibited significantly less anxiety, stress, and psychological distress. The results supported previous research findings about the benefits of mindfulness-based intervention in women from the perinatal and postpartum periods through the early parenting period. Additional research is needed to validate our findings in non-breast-feeding mothers and to examine the intervention's indirect benefits in terms of family relationships and child development. PMID:23512648

  8. Effects of early feeding and exogenous putrescine on growth and small intestinal development in posthatch ducks.

    Science.gov (United States)

    Peng, P; Xu, J; Chen, W; Tangara, M; Qi, Z L; Peng, J

    2010-02-01

    1. Effects of early feeding with a diet containing added putrescine on duck intestinal development and growth performance were examined by a 2 x 2 factorial arrangement with two different feeding times (6 and 48 h) and two levels of putrescine (0 and 025%). 2. A significant main effect of early feeding on increasing body weight (BW) was observed from hatch to 35 d, whereas dietary putrescine had no significant effect on BW. 3. In the first week posthatch, enhanced small intestinal weight and intestinal density (weight of intestinal tissue/unit length of intestine), increased villus length and reduced crypt depth were observed in the early feeding group, while no effect was observed when putrescine was added to the diet. 4. Maltase and sucrase activity and protein/DNA ratio in jejunum were increased by early feeding in the first week, while decreased by putrescine supplementation. 5. In conclusion, early feeding methods have great potential for small intestine development and thereafter enhanced the growth performance of ducks, but dietary putrescine used during this period should be used cautiously to avoid toxicity.

  9. An evaluation of two guidance programmes to promote breast-feeding

    Directory of Open Access Journals (Sweden)

    M. Steyn

    1989-09-01

    Full Text Available During the past ten years a comprehensive research project has been undertaken to develop a guidance programme in three adjacent communities in the South- Western Cape with the aim o f lowering the high incidence o f coronary heart disease. The purpose o f this substudy was to determine whether the guidance provided in the different communities had any influence on the knowledge o f and attitudes towards the nutrition o f pregnant women, babies and infants as well as breast-feeding practices o f the women who gave birth during the period 1980 to 1986. In the first community guidance was provided by means o f small mass media and interpersonal communication whereas only the small mass media were employed in the second. The third served as the control community. The findings suggest that the combined interpersonal and mass media programme was more successful than the mass media programme alone.

  10. Early feeding and early life housing conditions influence the response towards a noninfectious lung challenge in broilers.

    Science.gov (United States)

    Simon, K; de Vries Reilingh, G; Bolhuis, J E; Kemp, B; Lammers, A

    2015-09-01

    Early life conditions such as feed and water availability immediately post hatch (PH) and housing conditions may influence immune development and therefore immune reactivity later in life. The current study addressed the consequences of a combination of these 2 early life conditions for immune reactivity, i.e., the specific antibody response towards a non-infectious lung challenge. Broiler chicks received feed and water either immediately p.h. or with a 72 h delay and were either reared in a floor or a cage system. At 4 weeks of age, chicks received either an intra-tracheally administered Escherichia coli lipopolysaccharide (LPS)/Human Serum Albumin (HUSA) challenge or a placebo, and antibody titers were measured up to day 14 after administration of the challenge. Chicks housed on the floor and which had a delayed access to feed p.h. showed the highest antibody titers against HuSA. These chicks also showed the strongest sickness response and poorest performance in response to the challenge, indicating that chicks with delayed access to feed might be more sensitive to an environment with higher antigenic pressure. In conclusion, results from the present study show that early life feeding strategy and housing conditions influence a chick's response to an immune challenge later in life. These 2 early life factors should therefore be taken into account when striving for a balance between disease resistance and performance in poultry.

  11. DDT in fishes from four different Amazon sites: exposure assessment for breast feeding infants

    Energy Technology Data Exchange (ETDEWEB)

    D' Amato, C.; Torres, J.P.; Malm, O. [Lab. de Radioisotopos Eduardo Penna Franca, Inst. de Biofisica, UFRJ, RJ (Brazil); Bastos, W. [Lab. de Biogeoquimica, UNIR, Porto Velho (Brazil); Claudio, L.; Markowitz, S. [International Training Program on Environmental and Occupational Health, Mount Sinai School of Medicine, Queens Coll., NY (United States)

    2004-09-15

    Concerning DDT in food, based on clinical observations as well as experimental animals, the annual Joint FAO/WHO Meetings on Pesticide Residues held in 2000 estimated a Provisional Tolerable Daily Intake (PTDI) for DDT in 0.01 mg/kg/day. Marien and Laflamme have proposed a Tolerable Daily Intake (TDI) for breast feedings infants of 5 x 10{sup -3} mg/kg/day, and conducted an assessment to evaluate the public health significance of eating {sigma}ODDT contaminated fish, accomplished by establishing a daily intake level of DDT for the population of greatest concern, like breastfeeding infants. Their results indicated that mothers who frequently consume contaminated fish could have breast milk DDT concentrations highly enough to expose their infants to levels above the TDI. The aim of this study was to evaluate the ODDT (o,p'-DDT + p,p'-DDT + o,p'-DDE + p,p'-DDE + o,p'-DDD) levels in commercial fish samples from distinct Brazilian Amazon sites, which are consumed by the riverine populations, and to assess the potential health impacts from eating these fishes, especially for breastfeeding infants.

  12. Hypofractionated radiotherapy for early breast cancer: Review of phase III studies

    OpenAIRE

    Kacprowska, Agata; Jassem, Jacek

    2012-01-01

    Breast-conserving surgery including whole breast irradiation has long been a recommended procedure for early breast cancer. However, conventionally fractionated radiotherapy requires a lengthy hospitalisation or prolonged commuting to a hospital for radiotherapy. In recent years, hypofractionated radiotherapy has increasingly been used. This method involves higher fraction doses (above 2 Gy) as compared to conventional radiotherapy, so the total dose can be delivered in fewer fractions and in...

  13. Guideline implementation for breast healthcare in low- and middle-income countries: early detection resource allocation.

    Science.gov (United States)

    Yip, Cheng-Har; Smith, Robert A; Anderson, Benjamin O; Miller, Anthony B; Thomas, David B; Ang, Eng-Suan; Caffarella, Rosemary S; Corbex, Marilys; Kreps, Gary L; McTiernan, Anne

    2008-10-15

    A key determinant of breast cancer outcome in any population is the degree to which cancers are detected at early stages of disease. Populations in which cancers are detected at earlier stages have lower breast cancer mortality rates. The Breast Health Global Initiative (BHGI) held its third Global Summit in Budapest, Hungary in October 2007, bringing together internationally recognized experts to address the implementation of breast healthcare guidelines for early detection, diagnosis, and treatment in low- and middle-income countries (LMCs). A multidisciplinary panel of experts specifically addressed the implementation of BHGI guidelines for the early detection of disease as they related to resource allocation for public education and awareness, cancer detection methods, and evaluation goals. Public education and awareness are the key first steps, because early detection programs cannot be successful if the public is unaware of the value of early detection. The effectiveness and efficiency of screening modalities, including screening mammography, clinical breast examination (CBE), and breast self-examination, were reviewed in the context of resource availability and population-based need by the panel. Social and cultural barriers should be considered when early detection programs are being established, and the evaluation of early detection programs should include the use of well developed, methodologically sound process metrics to determine the effectiveness of program implementation. The approach and scope of any screening program will determine the success of any early detection program as measured by cancer stage at diagnosis and will drive the breadth of resource allocation needed for program implementation. PMID:18837017

  14. NIR fingerprint screening for early control of non-conformity at feed mills.

    Science.gov (United States)

    Fernández Pierna, Juan Antonio; Abbas, Ouissam; Lecler, Bernard; Hogrel, Patrick; Dardenne, Pierre; Baeten, Vincent

    2015-12-15

    The objective of this work was to devise a complete procedure based on chemometrics and the use NIR spectroscopy at the entrance of a feed mill to provide early evidence of non-conformity and unusual ingredients and thus help to achieve cost-savings. The procedure was validated at laboratory level and was adapted for application at the Cargill Animal Nutrition feed mill. The study focused on the characterisation of pure soybean meal with the aim of creating an early control system for detecting and quantifying any unusual ingredient that might be present in the soybean meal, such as melamine, cyanuric acid or whey powder (milk serum). The study results showed that the use of NIR, combined with some simple chemometric tools based on distances and residuals from regression equations, is appropriate for authenticating important feed products (in this case, soybean meal) and detecting the presence of abnormal samples or impurities in both the laboratory and at the feed mill.

  15. Skin Sparing Mastectomy and Immediate Breast Reconstruction (SSMIR for early breast cancer: Eight years single institution experience

    Directory of Open Access Journals (Sweden)

    Bobin Jean

    2008-04-01

    Full Text Available Abstract Background Skin Sparing Mastectomy (SSM and immediate breast reconstruction has become increasingly popular as an effective treatment for patients with breast carcinoma. The aim of this study was to evaluate the clinical outcome of skin sparing mastectomy in early breast cancer at a single population-based institution. Methods Records of ninety-five consecutive patients with operable breast cancer who had skin-sparing mastectomy and immediate breast reconstructions between 1995 and 2003 were reviewed. Patient and tumor characteristic, type of reconstruction, postoperative complications, aesthetic results and incidence of recurrence were analyzed. Results Mean age of the patients was 51.6(range 33–72 years. The AJCC pathologic stages were 0 (n = 51, 53.7%, I (n = 20, 21.1%, and II (n = 2, 2.1%. Twenty of the patients had recurrent disease (21.1%. The immediate breast reconstructions were performed with autologus tissue including latissimus dorsi musculocutaneous flap in 63 (66.3% patients and transverse rectus abdominis myocutaneous (TRAM flap in 4 (4.2% patients. Implants were used in 28 (29.4% patients. The average hospital stay was 7.7 days. Flap complication occurred in seven (10.4% patients resulting in four (6% re-operations and there were no delay in accomplishing postoperative adjuvant therapy. At a median follow-up of 69 months (range 48 to 144, local recurrence was seen in one patient (1.1% and systemic recurrence was seen in two patients (2.1%. Conclusion Skin sparing mastectomy and immediate breast reconstruction for early breast cancer is associated with low morbidity and low rate of local recurrence.

  16. Prevalence Of Exclusive Breast Feeding And Its Correlates In An Urban Slum In Western India

    Directory of Open Access Journals (Sweden)

    Patil Sapna S

    2009-12-01

    Full Text Available Background: The World Health Organizationrecommends the practice of exclusive breastfeeding ofinfants for the first 6 months after birth. The objectiveof present study was to estimate the prevalence andthe factors influencing exclusive breastfeeding.The perceptions of mothers about breastfeeding in anurban slum area of Western India were also enquired.Methods: This cross sectional study was conducted oversix months amongst 200 mothers of children in the agegroup of 6 – 12 months attending the growth anddevelopment clinic in one of the urban health centres.Data was collected using a pre-tested, structuredquestionnaire on breastfeeding practices. Factors relatedto exclusive breastfeeding were analysed using bivariateand multivariate analysis.Results: Prevalence of exclusive breastfeeding reportedby the participants was 61.5%. Having a male child,maternal age < 30 years, level of education of mother,parity, receiving infant feeding advice, initiation ofbreastfeeding within one hour of birth andadministration of colostrum to the baby were associatedwith exclusive breastfeeding (p<0.001. Multivariatelogistic regression analysis revealed that male sex(adjusted odd ratios: 20.03, primiparity (0.19, homedelivery (0.32, receiving infant feeding advice (5.90,initiation of breastfeeding within one hour of birth(0.26 and giving colostrum to the baby (2.56 wereindependently associated with exclusive breastfeeding.Prelacteal feeds were given by almost 35% of mothers.Conclusion: Prevalence of exclusive breastfeeding washigher than the national figures. However, practices likediscarding the colostrum, giving prelacteal feeds,early/late weaning and use of formula feeds are stillwidely prevalent and need to be addressed.

  17. Combining multifractal analyses of digital mammograms and infrared thermograms to assist in early breast cancer diagnosis

    Science.gov (United States)

    Gerasimova-Chechkina, E.; Toner, B.; Marin, Z.; Audit, B.; Roux, S. G.; Argoul, F.; Khalil, A.; Gileva, O.; Naimark, O.; Arneodo, A.

    2016-08-01

    We used a 1D wavelet transform modulus maxima (WTMM) method to analyze the temporal fluctuations of breast skin temperature recorded with an infrared (IR) camera from a panel of patients with breast cancer. This study shows that the multifractal complexity of temperature fluctuations observed in healthy breasts, is lost in the region of the malignant tumor in cancerous breasts. Then, we applied the 2D WTMM method to analyze the spatial fluctuations of breast density in the X-ray mammograms of the same patients. Compared to the correlated roughness fluctuations observed in the healthy areas, some clear loss of correlations is detected in malignant tumor foci. These physiological and architectural changes in the environment of malignant tumors detected in both thermograms and mammograms open new perspectives in computer-aided multifractal methods to assist in early breast cancer diagnosis.

  18. Breast

    International Nuclear Information System (INIS)

    Ultrasound is not an efficacious screening modality to detect early-stage breast malignancy in a clinically unremarkable population of women. Computed body tomography is similarly not practical for screening because of slice thickness and partial volume averaging, a higher radiation dose than modern mammography, and the lack of availability of such units for such a high throughput requirement. Nevertheless, these two imaging modalities can be very useful in management to guide the least invasive and efficacious treatment of the patient. X-ray mammography remains the principal imaging modality in the search for breast malignancy, but ultrasound is the single most important second study in the diagnostic evaluation of the breast. The combined use of these techniques and the ability to perform guided aspiration and localization procedures can result in a reduction in the surgical removal of benign cysts and reduction in the amount of tissue volume required if excision becomes necessary

  19. Adjuvant endocrine and chemotherapy for early breast cancer

    International Nuclear Information System (INIS)

    Objective: Present the results of the 1995 World Overview which will be held in Oxford England two weeks before ASTRO. Discuss the interpretation and application of these results. Review current research topics on the use of adjuvant endocrine and chemotherapy for early breast cancer. The survival benefits from adjuvant chemotherapy in premenopausal women and adjuvant tamoxifen in postmenopausal women are well established. Each will reduce the annual odds of death by about 25% resulting in a 10 year survival difference of 8-10%. By the time of this presentation, the results of the 1995 Adjuvant Therapy Overview should be with 10+ years of follow-up, and if possible these will be summarized. Current efforts to improve on previous results are focused on the following areas: Optimal chemotherapy dose. Decreasing dose will compromise patient survival. It is not as certain that increasing dose will have as much impact in improving survival. The NSABP was unable to demonstrate an improvement in survival by modestly increasing the dose of cyclophosphamide alone. However, recent results of a Canadian study of CEF (cyclophosphamide, epidoxorubicin, and 5-fluorouracil) and an Intergroup trial of an intense 16 week polychemotherapy program keep alive the possibility that dose escalation is still a very important question. An NSABP trial evaluating even greater cyclophosphamide dose escalation, an Intergroup evaluation of different doxorubicin doses, and two Intergroup trials evaluating very high dose chemotherapy and bone marrow transplantation should provide definitive evidence regarding the importance of dose. Drug sequence. A study from Milan suggests that initial treatment with single agent doxorubicin followed by CMF will be superior to alternating doxorubicin and CMF. This has not been confirmed yet, and the reason for increased benefit from such a sequence is not entirely clear. This concept is being explored further in an Intergroup trial comparing four cycles of

  20. Early feeding and risk of type 1 diabetes

    DEFF Research Database (Denmark)

    Knip, Mikael; Virtanen, Suvi M; Becker, Dorothy;

    2011-01-01

    Short-term breastfeeding and early exposure to complex dietary proteins, such as cow milk proteins and cereals, or to fruit, berries, and roots have been implicated as risk factors for ß cell autoimmunity, clinical type 1 diabetes, or both. The Trial to Reduce Insulin-dependent diabetes mellitus...... in the Genetically at Risk (TRIGR) is an international, randomized, double-blind, controlled intervention trial designed to answer the question of whether weaning to an extensively hydrolyzed formula in infancy will decrease the risk of type 1 diabetes later in childhood. In our pilot study, weaning to a highly...... recruited 5606 newborn infants with a family member affected by type 1 diabetes and enrolled 2159 eligible subjects who carried a risk-conferring HLA genotype. All recruited mothers were encouraged to breastfeed. The intervention lasted for 6-8 mo with a minimum study formula exposure time of 2 mo...

  1. Partial breast irradiation for early breast cancer: 3-year results of the German-Austrian phase II-trial

    International Nuclear Information System (INIS)

    Purpose: to evaluate perioperative morbidity, toxicity and cosmetic outcome in patients treated with interstitial brachytherapy to the tumor bed as the sole radiation modality after breast conserving surgery. Materials and methods: from 11/2000 to 11/2004, 240 women with early stage breast cancer participated in a protocol of tumor bed irradiation alone using pulsed dose rate (PDR) or high dose rate (HDR) interstitial multi-catheter implants (partial breast irradiation). Perioperative morbidity, acute and late toxicity as well as cosmetic outcome were assessed. Of the first 51 patients treated in this multicenter trial, we present interim findings after a median follow-up of 36 months. Results: perioperative Morbidity: Bacterial infection of the implant: 2% (1/51). Acute toxicity: radiodermatitis grade 1: 4% (2/51). Late toxicity: breast pain grade 1: 8% (4/51), grade 2: 2% (1/51); dyspigmentation grade 1: 8% (4/51); fibrosis grade 1: 4% (2/51), grade 2: 8% (4/51); telangiectasia grade 1: 10% (5/51), grade 2: 4% (2/51). Cosmetic results: Excellent and good in 94% (48/51) of the patients. Conclusion: this analysis indicates that accelerated partial breast irradiation with 192-iridium interstitial multicatheter PDR-/HDR-implants (partial breast irradiation) is feasible with low perioperative morbidity, low acute and mild late toxicity at a median follow-up of 36 months. The cosmetic result is not significantly affected. (orig.)

  2. A Study of Protein Energy Malnutrition with respect to Breast Feeding Practices in Less than Six Year Children

    Directory of Open Access Journals (Sweden)

    Balaji V Ukarande, Ajit S Nagaonkar

    2015-01-01

    Results: The Proportion of undernutrition was more in, who has not exclusively breast fed (72.92% and 44.07%, p<0.001, who did not received colostrum (91.74% and 27.64%, p<0.0001. Who received prelacteal feed (94.35% and 25.20%, p<0.05, Breast fed after 1hr of birth. (71.66% and 45.34% (p<0.0001. Who has un-hygienic feeding practices (63.33% and 50.57% p<0.05. Who weaned after 6 months of age (67.11% 43.60%. p<0.001. Conclusion: Adequate breastfeeding counseling and support are essential for mothers and families to initiate and maintain optimal breastfeeding practices. "

  3. Cosmetic Outcome and Seroma Formation After Breast-Conserving Surgery With Intraoperative Radiation Therapy Boost for Early Breast Cancer

    International Nuclear Information System (INIS)

    Purpose: To evaluate cosmetic outcome and its association with breast wound seroma after breast-conserving surgery (BCS) with targeted intraoperative radiation therapy (tIORT) boost for early breast cancer. Methods and Materials: An analysis of a single-arm prospective study of 55 patients with early breast cancer treated with BCS and tIORT boost followed by conventional whole breast radiation therapy (WBRT) between August 2003 and January 2006 was performed. A seroma was defined as a fluid collection at the primary tumor resection site identified clinically or radiologically. Cosmetic assessments using the European Organization for Research and Treatment of Cancer rating system were performed at baseline before BCS and 30 months after WBRT was completed. Results: Twenty-eight patients (51%) developed a seroma, with 18 patients (33%) requiring at least 1 aspiration. Tumor location was significantly associated with seroma formation (P=.001). Ten of 11 patients with an upper inner quadrant tumor developed a seroma. Excellent or good overall cosmetic outcome at 30 months was observed in 34 patients (62%, 95% confidence interval 53%-80%). Seroma formation was not associated with the overall cosmetic result (P=.54). Conclusion: BCS with tIORT boost followed by WBRT was associated with an acceptable cosmetic outcome. Seroma formation was not significantly associated with an adverse cosmetic outcome.

  4. Cosmetic Outcome and Seroma Formation After Breast-Conserving Surgery With Intraoperative Radiation Therapy Boost for Early Breast Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Senthi, Sashendra, E-mail: sashasenthi@msn.com [Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne (Australia); Link, Emma [Centre for Biostatistics and Clinical Trials, Peter MacCallum Cancer Centre, Melbourne (Australia); Chua, Boon H. [Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne (Australia); University of Melbourne, Melbourne (Australia)

    2012-10-01

    Purpose: To evaluate cosmetic outcome and its association with breast wound seroma after breast-conserving surgery (BCS) with targeted intraoperative radiation therapy (tIORT) boost for early breast cancer. Methods and Materials: An analysis of a single-arm prospective study of 55 patients with early breast cancer treated with BCS and tIORT boost followed by conventional whole breast radiation therapy (WBRT) between August 2003 and January 2006 was performed. A seroma was defined as a fluid collection at the primary tumor resection site identified clinically or radiologically. Cosmetic assessments using the European Organization for Research and Treatment of Cancer rating system were performed at baseline before BCS and 30 months after WBRT was completed. Results: Twenty-eight patients (51%) developed a seroma, with 18 patients (33%) requiring at least 1 aspiration. Tumor location was significantly associated with seroma formation (P=.001). Ten of 11 patients with an upper inner quadrant tumor developed a seroma. Excellent or good overall cosmetic outcome at 30 months was observed in 34 patients (62%, 95% confidence interval 53%-80%). Seroma formation was not associated with the overall cosmetic result (P=.54). Conclusion: BCS with tIORT boost followed by WBRT was associated with an acceptable cosmetic outcome. Seroma formation was not significantly associated with an adverse cosmetic outcome.

  5. Co-parenting and feeding in early childhood: Reflections of parent dyads on how they manage the developmental stages of feeding over the first three years.

    Science.gov (United States)

    Thullen, Matthew; Majee, Wilson; Davis, Alexandra N

    2016-10-01

    Family-level influences on the development of healthy eating behaviors start in infancy and toddlerhood with how families manage developmental stages of feeding. Little research on home feeding environments for young children has examined how mothers and fathers collaborate around feeding issues or contribute jointly to feeding. The purpose of this qualitative study is to examine co-parenting with regard to infant/toddler feeding practices. Twenty-four sets of co-resident, biological parents with a child between 6 months and 3 years were interviewed together about their feeding practices and how they discussed and collaborated on feeding during the main stages of feeding development in the first three years. Analyses illuminate themes related to how specific domains of co-parenting (satisfaction with labor, support, agreement, conflict) factor into infant and toddler feeding as well as how additional factors such as having older children and employment schedules shape how both food parenting practices and co-parenting are managed in relation to feeding. Mothers were the primary managers of feeding labor. Fathers participated in feeding in different ways and levels starting in infancy and increased involvement in feeding over the first few years requiring an ongoing negotiation around co-parenting related to feeding. Overall, this study develops insights into how multiple caregivers construct a family environment specifically related to early feeding - a perspective missing from current conceptualizations of home feeding environment. Attention to the concept of co-parenting within home feeding environments should help inform more effective approaches to intervene with families on issues around childhood obesity and family health. PMID:27288148

  6. The 10-Year Local Recurrence and Partial Breast Radiotherapy for Early Breast Cancer Treated by Conservative Surgery

    Institute of Scientific and Technical Information of China (English)

    Zhizhen Wang; Ruiying Li

    2006-01-01

    OBJECTIVE To study the local recurrence and the role of whole breast radiotherapy for early breast cancer treated by conservative surgery.METHODS From April 1990 to December 2000, 49 patients with early primary breast cancer were treated by conservative surgery in our hospital. The cases were comprised of Stage 0, 1; Stage Ⅰ, 31; and Stage Ⅱa,17. Forty cases underwent quadrantectomy plus axillary lymph node dissection, and the other 9 cases had lumpectomy alone. Irradiation, which was received by 39 patients, was administered by using low tangential half fields with 6 MV X-ray to decrease the pulmonary irradiative volume.The dose to the whole breast was 45 Gy/22~23f/4.5W, then a 15 Gy boost dose was delivered to the tumor bed by an electron beam. The other patients underwent an irradiated regional field according to postoperative pathology.RESULTS All patients were followed-up for 10 years or more. The 10year local recurrence rates, distant metastasis rates and survival rates were 6.1%, 4.1% and 98.0% respectively. All of the 3 patients who had a local recurrence had infiltrative carcinomas and negative lymph nodes.The 10-year local recurrence rate was higher (2.6% vs. 20.0%) with nonpostoperative whole breast radiotherapy, but the statistical difference was not marked because of the low number of cases. All of the recurrent lesions localized within 3 cm of the primary lesion.CONCLUSION Original recurrence of the tumor was the main type of local recurrence. Radiotherapy after conservative surgery is very essential.After conservative surgery it is feasible that irradiation can be delivered alone to the neighboring region of the tumor bed. Partial breast radiotherapy can substitute for whole breast radiotherapy.

  7. Prone breast radiotherapy in early-stage breast cancer: a preliminary analysis

    International Nuclear Information System (INIS)

    Purpose: Women with large breasts have marked dose inhomogeneity and often an inferior cosmetic outcome when treated with breast conservation compared to smaller-sized patients. We designed a prone breast board, which both minimizes breast separation and irradiated lung or heart volume. We report feasibility, cosmesis, and preliminary local control and survival for selected women with Stage 0-II breast cancer. Materials and Methods: Fifty-six patients with clinical Stage 0-II breast cancer were treated with lumpectomy and breast irradiation utilizing a prototype prone breast board. A total of 59 breasts were treated. Indications for treatment in the prone position were large or pendulous breast size (n = 57), or a history of cardiopulmonary disease (n = 2). The median bra size was 41D (range, 34D-44EE). Cosmesis was evaluated on a 1-10 (worst-to-best) scale. Results: Acute toxicity included skin erythema (80% of patients experienced Grade I or Grade II erythema), breast edema (72% of patients experienced mild edema), pruritus (20% of patients), and fatigue (20% of patients reported mild fatigue). One patient required a treatment break. The only late toxicity was related to long-term cosmesis. The mean overall cosmesis score for 53 patients was 9.37 (range, 8-10). Actuarial 3- and 5-year local control rates are 98%. Actuarial overall survival at 3 and 5 years are 98% and 94%. Conclusion: Our data indicate that treating selected women with prone breast radiotherapy is feasible and tolerated. The approach results in excellent cosmesis, and short-term outcome is comparable to traditional treatment techniques. This technique offers an innovative alternative to women who might not otherwise be considered candidates for breast conservation

  8. Infant feeding practices in Malaysia.

    Science.gov (United States)

    Chen, S T

    1978-12-01

    Retrospective nutritional data on 100 children, aged 6 months to 2 1/2 years, who were admitted to the University Hospital in Kuala Lumpur, Malaysia, was obtained by interviewing the mothers of the children. Analysis of the data revealed that 1) only 49% of the children were breast-fed as infants; 2) 50% of the mothers who did breast-feed discontinued breast-feeding before the children were 3 months old; and 3) the weaning diet of at least 1/3 of the children was inadequate. 18% of the children were Malays, 49% were Chinese, and 33% were Indian. The proportion of breast-fed children was highest among the Malays and lowest among the Chinese. Mothers with higher incomes tended to stop breast-feeding earlier than mothers with lower incomes. 67% of the women said they stopped breast-feeding due to inadequate lactation. Most of the children received supplementary foods at relatively early ages. 50% of the infants received starchy foods by the time they were 3 1/2 months old, and 50% received fruit or fruit juice by the time they were 3 1/2 months old. Vegetable products, meat, fish, and eggs were not added to the diet until the children were considerably older. Recommendations, based on the study findings, were 1) hospitals should discontinue the practice of deferring breast-feeding initiation for 24 hours after delivery; 2) mothers should be encouraged to breast-feed fully; and 3) health personnel should discourage the widespread use of costly precooked cereals for supplementary feeding. Tables depicted 1) the frequency distribution of the 100 children by income and by milk feeding patterns according to ethnic affiliation and 2) the cost of serving precooked cereals as compared to the cost of serving home cooked meals. PMID:755160

  9. Concurrent chemo-radiotherapy in the treatment of early breast cancer: Current status

    Directory of Open Access Journals (Sweden)

    Nabil Ismaili

    2013-01-01

    Full Text Available Concurrent chemo-radiotherapy (CCRT in early breast cancer was investigated by few authors and remains controversial. This treatment is more commonly used for locally advanced breast cancer and showed high rate of complete pathological response. A search of articles published in English literature, between 1980 and November 2012, was conducted on Medline using the following terms: "breast cancer", "chemotherapy", "concurrent radiotherapy", and "Trastuzumab". We identified five phase I/II trials and three randomized phase three trials evaluating concurrent chemoradiotherapy in the adjuvant of breast cancer. In patients with early breast cancer having positive lymph nodes, phases III clinical trials showed that CCRT improved local control after conservative breast surgery. However, these randomized trials used non-standard regimen: Cyclophosphamide, methotrexate and fluorouracil (CMF or fluorouracil, mitoxantrone and cyclophosphamide (FNC. In addition, in phases II clinical trials, concurrent use of taxanes and anthracycline with standard whole-breast irradiation showed high rate of toxicity: Pulmonary toxicity with taxane; and cardiac and skin toxicity with anthracycline. Consequentely, CCRT is not be used in practice because of concerns of toxicity with the standard drugs (anthracyclines and taxanes and radiation. Anthracyclines with partial breast irradiation (PBI was feasible according to one phase I clinical trial, and should be investigated in randomized clinical trials. Concurrent Trastuzumab plus radiotherapy is safe and can be used in HER2-positive breast cancer; in this case, cardiac volume sparing and patient selections for internal mammary chain irradiation are highly recommended. The present paper aimed to review the current data evaluating the efficacy and safety of CCRT in early breast cancer.

  10. Feasibility, efficacy and cosmetic effect of three-dimensional conformal external bean partial breast irradiation for the selected early stage breast cancer patients after breast-conserving surgery

    International Nuclear Information System (INIS)

    Objective: To explore the feasibility, efficacy and cosmetic effect of three-dimensional conformal external beam partial breast irradiation (EB-PBI) after breast-conserving surgery for the selected Chinese early stage breast cancer patients. Methods: From June 2003 to December 2010, Forty-four early stage breast cancer patients underwent underwent EB-PBI after breast-conserving surgery. Twenty patients had CT simulation scan in moderate deep inspiration breathing hold, and twenty-four patients in free breathing. EB-PBI was planned and delivered by three-dimensional conformal radiotherapy (3DCRT) with four non-coplanar beams. The prescribed dose was 3.40 Gy per fraction in thirty-nine patients and 3.85 Gy per fraction in five patients, twice per day at an interval of at least six hours, in five consecutive days. Results: The number of patients with follow up time of 2, 3 and 5 years were 39, 31 and 16, Grade 1 acute radiation-induced dermatitis was observed in 17 patients (39%) at three months. Cosmesis was good or excellent in all cases at six months after radiotherapy and in 95% cases at two years after radiotherapy. The 2-, 3- and 5- year local control rates were 100%, 99% and 94%, respectively. The 2-, 3-, and 5-year survival rates were all 100% and no metastases occurred. Conclusions: EB-PBI delivered by 3DCRT is feasible for selected Chinese early stage breast cancer patients after breast-conserving surgery. The cosmetic effect, local control rate and long-term survival rate are satisfactory, and acute radiation toxicity is very low. (authors)

  11. Characterization of Lactobacillus spp. isolated from the feces of breast-feeding piglets.

    Science.gov (United States)

    Cho, Il Jae; Lee, Nam Keun; Hahm, Young Tae

    2009-09-01

    Lactobacillus spp., referred to as IJ-1 and IJ-2, were isolated from the feces of breast-feeding piglets and analyzed for probiotic properties. According to the analyses of 16S rDNA sequence, Lactobacillus sp. IJ-1 showed greater than 99% homology with Lactobacillus reuteri DSM 20016(T), and Lactobacillus sp. IJ-2 had greater than 99% homology with the L. gasseri ATCC 33323(T) and L. johnsonii ATCC 33200(T). The pH changes in the culture media of Lactobacillus sp. IJ-1 and Lactobacillus sp. IJ-2 were from 6.5 to 4.2 and 4.6, respectively. Their respective resistance against artificial gastric acid and artificial bile acid led to survival rates of nearly 186+/-44% and 13+/-5%. Neither strain produced the carcinogenic enzyme beta-glucuronidase. Both strains inhibited the growth of pathogenic microorganisms, such as Listeria monocytogenes ATCC 19111, Salmonella enterica KCTC 12401, Salmonella enteritidis ATCC 13076, Staphylococcus aureus KCTC 3881, and Bacillus cereus 3711, within 24 h of growth. PMID:19664551

  12. The Relationship between Complementary and Alternative Medicine Use and Breast Cancer Early Detection: A Critical Review

    Directory of Open Access Journals (Sweden)

    Laura C. Dale

    2012-01-01

    Full Text Available Objective. Complementary and alternative medicine (CAM use is prevalent. Concurrently, breast cancer is the most common cancer in women worldwide, with early detection techniques widely available. This paper examined the overlap between participation in allopathic breast cancer early detection activities and CAM use. Methods. A systematic review examined the association between breast screening behaviors and CAM use. Searches were conducted on the PubMed, Embase, CINAHL, and NCCAM databases and gray literature between 1990 and 2011. STROBE criteria were used to assess study quality. Results. Nine studies met the search criteria. Four focused on CAM use in women at high breast cancer risk and five on average risk women. CAM use in women ranged from 22% to 82% and was high regardless of breast cancer risk. Correlations between CAM use and breast cancer early detection were not strong or consistent but significant relationships that did emerge were positive. Conclusions. Populations surveyed, and measures used to assess CAM, breast cancer screening, and correlates, varied widely. Many women who obtained allopathic screening also sought out CAM. This provides a foundation for future interventions and research to build on women’s motivation to enhance health and develop ways to increase the connections between CAM and allopathic care.

  13. Multiple Biomarker Panels for Early Detection of Breast Cancer in Peripheral Blood

    Directory of Open Access Journals (Sweden)

    Fan Zhang

    2013-01-01

    Full Text Available Detecting breast cancer at early stages can be challenging. Traditional mammography and tissue microarray that have been studied for early breast cancer detection and prediction have many drawbacks. Therefore, there is a need for more reliable diagnostic tools for early detection of breast cancer due to a number of factors and challenges. In the paper, we presented a five-marker panel approach based on SVM for early detection of breast cancer in peripheral blood and show how to use SVM to model the classification and prediction problem of early detection of breast cancer in peripheral blood. We found that the five-marker panel can improve the prediction performance (area under curve in the testing data set from 0.5826 to 0.7879. Further pathway analysis showed that the top four five-marker panels are associated with signaling, steroid hormones, metabolism, immune system, and hemostasis, which are consistent with previous findings. Our prediction model can serve as a general model for multibiomarker panel discovery in early detection of other cancers.

  14. Early Post Operative Enteral Versus Parenteral Feeding after Esophageal Cancer Surgery

    Directory of Open Access Journals (Sweden)

    Mohammadtaghi Rajabi Mashhadi

    2015-09-01

    Full Text Available Introduction: The incidence of malnutrition in hospitalized patients is reported to be high. In particular, patients with esophageal cancer are prone to malnutrition, due to preoperative digestive system dysfunctions and short-term non-oral feeding postoperatively. Selection of an appropriate method for feeding in the postoperative period is important in these patients.   Materials and Methods: In this randomized clinical trial, 40 patients with esophageal cancer who had undergone esophagectomy between September 2008 and October 2009 were randomly assigned into either enteral feeding or parenteral feeding groups, with the same calorie intake in each group. The level of serum total protein, albumin, prealbumin, transferrin, C3, C4 and hs-C-reactive protein          (hs-CRP, as well as the rate of surgical complications, restoration of bowel movements and cost was assessed in each group.   Results: Our results showed that there was no significant difference between the groups in terms of serum albumin, prealbumin or transferrin. However, C3 and C4 levels were significantly higher in the enteral feeding group compared with the parenteral group, while hs-CRP level was significantly lower in the enteral feeding group. Bowel movements were restored sooner and costs of treatment were lower in the enteral group. Postoperative complications did not differ significantly between the groups. There was one death in the parenteral group 10 days after surgery due to myocardial infarction.   Conclusion:  The results of our study showed that enteral feeding can be used effectively in the first days after surgery, with few early complications and similar nutritional outcomes compared with the parenteral method. Enteral feeding was associated with reduced inflammation and was associated with an improvement in immunological responses, quicker return of bowel movements, and reduced costs in comparison with parenteral feeding.

  15. Stereotactic Accelerated Partial Breast Irradiation (SAPBI for Early Stage Breast Cancer: Rationale, Feasibility and Early Experience using the CyberKnife Radiosurgery Delivery Platform

    Directory of Open Access Journals (Sweden)

    Olusola eOBAYOMI-DAVIES

    2016-05-01

    Full Text Available Purpose: The efficacy of accelerated partial breast irradiation (APBI utilizing brachytherapy or conventional external beam radiation has been studied in early stage breast cancer treated with breast conserving surgery. Data regarding stereotactic treatment approaches are emerging. The CyberKnife linear accelerator enables excellent dose conformality to target structures while adjusting for target and patient motion. We report our institutional experience on the technical feasibility and rationale for SAPBI delivery using the CyberKnife radiosurgery system.Methods: Ten patients completed CyberKnife SAPBI in 2013 at Georgetown University Hospital. Four gold fiducials were implanted around the lumpectomy cavity prior to treatment under ultrasound guidance. The synchrony system tracked intrafraction motion of the fiducials. The clinical target volume (CTV was defined on contrast enhanced CT scans using surgical clips and post-operative changes. A 5 mm expansion was added to create the planning treatment volume (PTV. A total dose of 30 Gy was delivered to the PTV in 5 consecutive fractions. Target and critical structure doses were assessed as per the National Surgical Adjuvant Breast and Bowel Project B-39 study.Results: At least 3 fiducials were tracked in 100% of cases. The Mean treated PTV was 70 cm3 and the mean prescription isodose line was 80%. Mean dose to target volumes and constraints are as follows: 100% of the PTV received the prescription dose (PTV30. The volume of the ipsilateral breast receiving 30 Gy (V30 and above 15 Gy (V>15 was 14% and 31% respectively. The ipsilateral lung volume receiving 9 Gy (V9 was 3% and the contralateral lung volume receiving 1.5 Gy (V1.5 was 8%. For left sided breast cancers, the volume of heart receiving 1.5 Gy (V1.5 was 31%. Maximum skin dose was 36 Gy. At a median follow up of 1.3 years, all patients have experienced excellent/good breast cosmesis outcomes, and no breast events have been recorded

  16. Sector resection with and without radiotherapy in early breast cancer

    International Nuclear Information System (INIS)

    In 1982 a prospective, multicentre randomized trial of breast preserving surgery for invasive histopathological stage I breast cancer was started in the Uppsala-Oerebro health care region in Sweden. After identical preoperative investigation and surgical treatment, patients are randomly allocated to receive postoperative radiation with 54 Gy to the remaining breast for five weeks, or to serve as controls. The primary aim of the trial is to determine whether a standardized surgical technique aiming at local tumour radicality can reduce the rate of local recurrence to an acceptable level without postoperative radiotherapy. In December 1987 a second trial was initiated, with an almost identical design but including women with tumours mammographically 21-30 mm in diameter and with histopathologically negative nodes. The first trial is near the termination of patient accrual. Studies of the cosmetic result and of the psychosocial adjustment after breast conserving therapy as compared with mastectomy have been coupled to the trials. Among 263 patients who answered a questionnaire, 96.5% found the new appearance of the treated breast good or acceptable. The psychosocial adjustment was assessed in semi-structured interviews 4 and 13 months postoperatively in 99 women, 37 of whom underwent breast conserving surgery and the remainder modified radical mastectomy. There was a consistent but statistically non-significant tendency for the conservatively treated women to adjust better. Overall 5% of the women in the conservatively treated group and 22% of the mastectomized women are still suffering substantial psychosocial disturbance after 13 months. (orig.)

  17. Breastfeeding and allergic disease: a multidisciplinary review of the literature (1966-2001) on the mode of early feeding in infancy and its impact on later atopic manifestations

    DEFF Research Database (Denmark)

    Odijk, J.; Kull, I.; Borres, M.;

    2003-01-01

    feeding mode in relation to allergy has not been published previously. Here, the objective is to review the scientific literature regarding the impact of early feeding (breast milk and/or cow's milk and/or formula) on development of atopic disease. The work was performed by a multidisciplinary group......Background: Strategies to prevent children from developing allergy have been elaborated on the basis of state-of-the-art reviews of the scientific literature regarding pets and allergies, building dampness and health, and building ventilation and health. A similar multidisciplinary review of infant...... of Scandinavian researchers. Methods: The search in the literature identified 4323 articles that contained at least one of the exposure and health effect terms. A total of 4191 articles were excluded mainly because they did not contain information on both exposure and health effects. Consequently, 132 studies...

  18. Primary radiotherapy after tumour excision as an alternative to mastectomy for early breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Browde, S.; Nissenbaum, M.M. (University of the Witwatersrand, Johannesburg (South Africa))

    1983-09-28

    A conservative approach to the management of breast cancer is gaining acceptance. The evidence from many retrospective and prospective studies indicates that breast-preserving surgery and radiation therapy give results equal to those of mastectomy. Relapse affecting the breast alone has been shown not to be detrimental to survival, while the psychological benefits to the patients have been gratifying. A prospective study of early breast cancer treated by conservative surgery and radiation was commenced at the Johannesburg Hospital in 1980. The results in 57 patients are reported. So far there have been 2 cases of local recurrence. In the majority of cases satisfactory cosmetic results were achieved. It is considered that lumpectomy with axillary dissection to establish nodal status followed by irradiation is the treatment of choice for stage l and ll carcinoma of the breast.

  19. Analysis of dosimetry and clinical outcome using intensity modulated radiation therapy for early breast cancer patients after breast conservative surgery

    International Nuclear Information System (INIS)

    Objective: To analyze the dosimetric benefits, clinical effect and side-respond of whole breast using intensity modulated radiotherapy for early breast cancer after conservative surgery. Methods: From Oct. 2004 to Aug. 2005, 103 patients received the whole breast intensity modulated radiation therapy (IMRT). A dosimetric comparison of IMRT with conventional radiotherapy (CR) was performed on each patient. The cosmetic results, clinical effect and side-respond were observed. Results: The average volume proportion of 95% and 107% prescribed dose was 95.8% ± 4.90% and 84.0% ± 20.7% (t=9.60, P20 (lung volume of accepted > 20 Gy/all lung volume x 100%) of the ipsilateral lung were 15.70% ± 4.64% and 23.11% ± 7.88% (t=-13.3, P30 of the heart were 4.44% ± 3.93% and 15.55% ± 10.89% (t=-11.3, P<0.01) with IMRT and CR respectively for sixty-three left side breast cancer patients. The 1- and 2-year excellent rate of good cosmetic outcome was both 100%. The 1-, 2- and 3-year local control rate was 99%, 99% and 98 %, respectively. The 1-, 2- and 3-year disease-free survival rate was 99%, 99% and 96%, respectively. The Grade 1 and 2 acute radiation skin reaction rate was 95.1% and 4.9%, respectively. Conclusion: Compared with conventional radiotherapy, IMRT improves dose distribution of CTV and reduce the dose of normal tissue around CTV; but with better clinical effects and lower side-respond for early breast cancer patients after' breast conservative surgery. (authors)

  20. Advice given to women in Argentina about breast-feeding and the use of alcohol

    Science.gov (United States)

    Pepino, M. Yanina; Mennella, Julie A.

    2006-01-01

    Objective To explore the types of advice that women in Argentina received from health professionals, family members, and friends about drinking alcoholic beverages and about alcohol usage during pregnancy and lactation. Methods In December 2001 and December 2002, structured interviews were conducted with a total of 167 women who were then breast-feeding or who had recently breast-fed their infant. Mothers were asked about the type of advice, if any, that they had received about the use of alcohol from health professionals and from family members and friends. Also included were questions related to the usage of the traditional Argentine beverage “mate” (an infusion widely consumed in South America that is prepared from the leaves of the Ilex paraguayensis plant) and the types of advice the women had received about breast-feeding and neonatal care in general. Results Of the 167 women studied, 96.4% of them reported that their physician had advised them to breast-feed their infant. In addition, 93.4% of the women said they had treated their infant’s umbilical cord stump with alcohol. Fewer than half of the women (46.7%) reported that their physician had advised them about drinking alcoholic beverages during pregnancy, and even fewer (25.7%) received such advice during lactation. Family and friends were about equally likely to give advice about the consumption of alcoholic beverages during pregnancy (42.6%) and during lactation (47.9%). However, the type of advice changed, with the family and friends being significantly more likely to encourage drinking when the women were lactating than when they were pregnant (P lactancia. Métodos En diciembre de 2001 y diciembre de 2002 se llevaron a cabo entrevistas estructuradas con un total de 167 mujeres que estaban amamantando o que habían amamantado recientemente. A las madres se les preguntó qué tipo de consejos, en caso de haberlos, les dieron los profesionales de la salud y sus parientes y amistades acerca del

  1. Early complementary feeding is associated with low nutritional status of young infants recovering from diarrhoea.

    Science.gov (United States)

    Haider, R; Islam, A; Kabir, I; Habte, D

    1996-06-01

    Young infants admitted to hospital for diarrhoea were studied to identify and understand the reasons for early complementary feeding and to examine its effect on nutritional status. Of 132 infants, 71 percent were being breastfed, 24 percent had already stopped, and 5 percent had never been breastfed. Complementary feeds were started by the mothers when infants' median age (range) was 27 (1-180) days. Mothers' perceptions regarding breastmilk being insufficient (53 per cent) or causing diarrhoea (19 percent), were the major reasons for complementary feeding. The mean weight-for-age of the infants given complementary feeds before the age of 2 months was 72 percent of the National Centre for Health Statistics (NCHS) standards, compared to 82 percent in those starting after 2 months of age (P = 0.01). Similarly, the mean weight-for-length in these two groups were 86 and 91 percent, respectively (P = 0.04). Initiation of early complementary feeding is associated with infant malnutrition and this alarming trend should be strongly discouraged. PMID:8699586

  2. New and chronic use of hypnotics after diagnosis with early breast cancer

    DEFF Research Database (Denmark)

    Andersen, Lærke Toftegård; Suppli, Nis Frederik Palm; Dalton, Susanne Oksbjerg;

    2015-01-01

    BACKGROUND: To determine use and investigate factors associated with use of hypnotics the first year after a diagnosis with breast cancer. MATERIAL AND METHODS: A retrospective registry based cohort study linking clinical data from the Danish Breast Cancer Group with the National Prescription Drug...... Database and other health and administrative registries. We included 26 082 women diagnosed with early breast cancer as first time primary cancer during 1996-2006. Use of hypnotics was measured as redeemed prescriptions in the first year after diagnosis of early breast cancer. Prior use of hypnotics...... was defined as one or more prescriptions of hypnotics 13 months to 1 month before diagnosis, and chronic use was defined as four or more prescriptions. Hazard ratios (HRs) for clinical variables, treatment-related factors and sociodemographic factors were calculated. RESULTS: Among women with no prior history...

  3. Early diagnostic value of survivin and its alternative splice variants in breast cancer

    International Nuclear Information System (INIS)

    The inhibitor of apoptosis (IAP) protein Survivin and its splice variants are differentially expressed in breast cancer tissues. Our previous work showed Survivin is released from tumor cells via small membrane-bound vesicles called exosomes. We, therefore, hypothesize that analysis of serum exosomal Survivin and its splice variants may provide a novel biomarker for early diagnosis of breast cancer. We collected sera from forty breast cancer patients and ten control patients who were disease free for 5 years after treatment. In addition, twenty-three paired breast cancer tumor tissues from those same 40 patients were analyzed for splice variants. Serum levels of Survivin were analyzed using ELISA and exosomes were isolated from this serum using the commercially available ExoQuick kit, with subsequent Western blots and immunohistochemistry performed. Survivin levels were significantly higher in all the breast cancer samples compared to controls (p < 0.05) with exosome amounts significantly higher in cancer patient sera compared to controls (p < 0.01). While Survivin and Survivin-∆Ex3 splice variant expression and localization was identical in serum exosomes, differential expression of Survivin-2B protein existed in the exosomes. Similarly, Survivin and Survivin-∆Ex3 proteins were the predominant forms detected in all of the breast cancer tissues evaluated in this study, whereas a more variable expression of Survivin-2B level was found at different cancer stages. In this study we show for the first time that like Survivin, the Survivin splice variants are also exosomally packaged in the breast cancer patients’ sera, mimicking the survivin splice variant pattern that we also report in breast cancer tissues. Differential expression of exosomal-Survivin, particularly Survivin-2B, may serve as a diagnostic and/or prognostic marker, a “liquid biopsy” if you will, in early breast cancer patients. Furthermore, a more thorough understanding of the role of this

  4. The Investigation of Pregnant women' Cognition about Breast Feeding%孕妇对母乳喂养认知情况的调查

    Institute of Scientific and Technical Information of China (English)

    赵艳秋; 孙美农

    2012-01-01

    Objective This paper aims at knowing about the pregnant women's cognition about breast feeding , the feeding plan for infant and the requirements of breast feeding knowledge , in order to provide basis for clinical to have breast feeding health education . Methods We had an investigar~ tion on 190 pregnant women from obstetrical department outpatient service using a self-designed questionnaire . The main contents of the questionnaire include general materials , breast feeding plan postpartum , breast feeding cognition , knowledge source and the ways and timing of hoping to get breast feeding knowledge . Results There are 159 pregnant women planning to choose pure breast feeding; the average score of breast feeding knowledge of pregnant women is 8 .34+6 .42 , which is quite low; the score and the age and gestational age appears low positive correlation; the situation of taking the initiative for getting breast feeding knowledge of pregnant women from different gestational age and different culture degree has statistical difference ( P<0 .05 ); pregnant women's initiative of getting breast feeding knowledge are different , whose knowledge score has statistical difference ( P<0.05); 70% pregnant women hope to get propaganda and education from medical staffs; 66 .3% of them hope to learn certain knowledge about breast feeding during second trimester . Conclusions The cognition situation about breast feeding of pregnant women is not optimistic . The requirements of propaganda and education from medical staffs are amount . Medical staffs should develop effective breast feeding health education for pregnant women , for laying a foundation to improve the rate of pure breast feeding postpartum .%目的 了解孕妇母乳喂养知识的认知情况,对婴儿的喂养计划及对母乳喂养知识的需求情况,为临床进行母乳喂养方面的健康教育提供依据.方法 采用自行设计的问卷对产科门诊就诊的190名孕妇进行调查.问卷的主要内容

  5. Effects of Early Feeding Support on the Postoperative Weight Gain Status of Infants with Esophageal Atresia

    Directory of Open Access Journals (Sweden)

    Marzieh Ghorbani

    2016-07-01

    Full Text Available Background: Infants may lose their body resources after surgery due to inadequate nutrient intake and undergoing long periods of fasting after surgery for esophageal atresia, increases risk of several complications. Aim: This study aimed to evaluate the effects of early feeding support on the postoperative weight gain status of infants with esophageal atresia. Method: This randomized, controlled clinical trial was conducted on 36 infants with esophageal atresia (type C selected 48 hours after surgery during July 2015-March 2016 at Dr. Sheikh Hospital of Mashhad, Iran. In the intervention group, detecting no lack of leakage on chest X-ray, feeding was initiated and the control group received routine feeding. Neonatal weight changes were measured daily using a digital scale (TANITA model since the first day after the surgery and one month after discharge from the hospital. Data was analysed using SPSS version 16 by independent T-test and Chi-square. Results: Mean neonatal weight on admission was 2558.1±337.4 grams in the intervention group and 2547.6±856 grams in the control group (P=0.47. Results of independent T-test showed that daily weight gain before and after feeding was significantly higher in the intervention group compared to the control group (P=0.01. Moreover, weight gain one month after discharge had a significant difference between infants of the intervention and control groups (P=0.03. Implications for Practice: According to the results of this study, early feeding support could improve the weight index of neonates with esophageal atresia. Considering the possible complications and long-term consequences of surgery, early initiation of feeding could be an appropriate remedial measure in infants with esophageal atresia.

  6. Body composition and circulating high-molecular-weight adiponectin and IGF-I in infants born small for gestational age: breast- versus formula-feeding.

    Science.gov (United States)

    de Zegher, Francis; Sebastiani, Giorgia; Diaz, Marta; Sánchez-Infantes, David; Lopez-Bermejo, Abel; Ibáñez, Lourdes

    2012-08-01

    Prenatal growth restraint, if followed by postnatal overweight, confers risk for adult disease including diabetes. The mechanisms whereby neonatal nutrition may modulate such risk are poorly understood. We studied the effects of nutrition (breast-feeding [BRF] vs. formula-feeding [FOF]) on weight partitioning and endocrine state (as judged by high-molecular-weight [HMW] adiponectin and IGF-I) of infants born small for gestational age (SGA). Body composition (by absorptiometry), HMW adiponectin, and IGF-I were assessed at birth and 4 months in BRF infants born appropriate for gestational age (AGA; n = 72) and SGA infants receiving BRF (n = 46) or FOF (n = 56), the latter being randomized to receive a standard (FOF1) or protein-rich formula (FOF2). Compared with AGA-BRF infants, the catchup growth of SGA infants was confined to lean mass, independently of nutrition. Compared with AGA-BRF infants, SGA-BRF infants had normal HMW adiponectin and IGF-I levels at 4 months, whereas SGA-FOF infants had elevated levels of HMW adiponectin (particularly SGA-FOF1) and IGF-I (particularly SGA-FOF2). In conclusion, neonatal nutrition seems to influence endocrinology more readily than body composition of SGA infants. Follow-up will disclose whether the endocrine abnormalities in SGA-FOF infants can serve as early markers of an unfavorable metabolic course and whether they may contribute to design early interventions that prevent subsequent disease, including diabetes. PMID:22648385

  7. Serum/plasma DNA methylation pattern and early detection of breast cancer

    Directory of Open Access Journals (Sweden)

    Arootin Gharibiyan

    2015-01-01

    Full Text Available Breast cancer is the most common cancer among women. With its fatality rate reduced significantly if diagnosed early, developing cost-effective, noninvasive methods of early detection is highly investigated. Currently, mammography with magnetic resonance imaging is considered the optimal method of early detection in women who are at a significantly raised risk of developing breast cancer. Due to environmental effects and life-style changes in recent years, elevation of the risk of cancer incidents in lower risk populations is observed and therefore, the development of a relatively easy-performed and low-cost method for early detection of cancer in general and breast cancer in particular is needed. Serum-based analysis techniques have been quite popular subject of research recently as they can be performed with low technical knowledge, become automated and are cheap. In the present article, we have reviewed the literature related to the use of DNA methylation-detection based techniques for diagnosis of early-stage breast cancer using serum or plasma circulating tumor DNA and their power as a future biomarker. A reference to all genes that is reported to be differentially methylated in breast cancer accompanies the article.

  8. The value of mammography, color doppler ultrasound and biopsy in diagnosis of early breast cancer

    International Nuclear Information System (INIS)

    Objective: To study the diagnostic value of mammography, color Doppler ultrasound and biopsy in early breast cancer and to evaluate its diagnostic accuracy. Methods: 55 patients with breast cancer and 25 patients with benign breast masses, proved pathologically, were checked by mammography, color Doppler ultrasound and biopsy. Results: Mammography demonstrated breast cancer in 45 cases, the sensitivity and specificity were 82.0% and 88.0%, respectively, with the accuracy of 83.8%; Color Doppler ultrasound revealed breast cancer in 43 cases, the sensitivity, specificity and accuracy were 78.2%, 84.0% and 80.0%; Biopsy demonstrated breast cancer in 53 cases, the sensitivity, specificity and accuracy were 96.4%, 92.0% and 95.0%. When ultrasound, mammography and biopsy were combined together, the sensitivity, specificity and accuracy were 98.2%, 96.0% and 97.5%. Conclusion: Mammography, color Doppler ultrasound combined with biopsy can increase the diagnostic sensitivity and accuracy of early breast cancers

  9. Early Prediction and Evaluation of Breast Cancer Response to Neoadjuvant Chemotherapy Using Quantitative DCE-MRI

    OpenAIRE

    Alina Tudorica; Oh, Karen Y.; Stephen Y-C Chui; Nicole Roy; Troxell, Megan L.; Arpana Naik; Kathleen A Kemmer; Yiyi Chen; Megan L Holtorf; Aneela Afzal; Charles S Springer Jr.; Xin Li; Wei Huang

    2016-01-01

    The purpose is to compare quantitative dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) metrics with imaging tumor size for early prediction of breast cancer response to neoadjuvant chemotherapy (NACT) and evaluation of residual cancer burden (RCB). Twenty-eight patients with 29 primary breast tumors underwent DCE-MRI exams before, after one cycle of, at midpoint of, and after NACT. MRI tumor size in the longest diameter (LD) was measured according to the RECIST (Response Eval...

  10. Coping with early stage breast cancer: examining the influence of personality traits and interpersonal closeness

    OpenAIRE

    Saita, Emanuela; Acquati, Chiara; Kayser, Karen

    2015-01-01

    The study examines the influence of personality traits and close relationships on the coping style of women with breast cancer. A sample of 72 Italian patients receiving treatment for early stage breast cancer was recruited. Participants completed questionnaires measuring personality traits (Interpersonal Adaptation Questionnaire), interpersonal closeness (Inclusion of the Other in the Self Scale), and adjustment to cancer (Mini-Mental Adjustment to Cancer Scale). We hypothesized that diverse...

  11. Psychosocially Influenced Cancer: Diverse Early-Life Stress Experiences and Links to Breast Cancer

    OpenAIRE

    Schuler, Linda A.; Auger, Anthony P

    2010-01-01

    This perspective on Boyd et al. (beginning on page XXX in this issue of the journal) discusses recent published research examining the interplay between social stress and breast cancer. Cross-disciplinary studies using genetically defined mouse models and established neonatal and peripubertal paradigms of social stress are illuminating biological programming by diverse early-life experiences for the risk of breast cancer. Understanding the mechanisms underlying this programming can lead to id...

  12. Identifying gaps in the locoregional management of early breast cancer: highlights from the kyoto consensus conference.

    OpenAIRE

    Toi, Masakazu; Winer, Eric P.; INAMOTO, TAKASHI; BENSON, JOHN R.; Forbes, John F.; Mitsumori, Michihide; Robertson, John F. R.; Sasano, Hironobu; von Minckwitz, Gunter; Yamauchi, Akira; KLIMBERG, V. SUZANNE

    2011-01-01

    A consensus conference was held to investigate issues related to the local management of early breast cancer. Here, we highlight the major topics discussed at the conference and propose ideas for future studies. Regarding axillary management, we examined three major issues. First, we discussed whether the use of axillary reverse mapping could clarify the lymphatic system of breast and whether the ipsilateral arm might help avoid lymphedema. Second, the use of an indocyanine green fluorescent ...

  13. Advances in Medical Management of Early Stage and Advanced Breast Cancer: 2015.

    Science.gov (United States)

    Witherby, Sabrina; Rizack, Tina; Sakr, Bachir J; Legare, Robert D; Sikov, William M

    2016-01-01

    Standard management of early stage and advanced breast cancer has been improved over the past few years by knowledge gained about the biology of the disease, results from a number of eagerly anticipated clinical trials and the development of novel agents that offer our patients options for improved outcomes or reduced toxicity or both. This review highlights recent major developments affecting the systemic therapy of breast cancer, broken down by clinically relevant patient subgroups and disease stage, and briefly discusses some of the ongoing controversies in the treatment of breast cancer and promising therapies on the horizon.

  14. Conservative surgery and radiation therapy for early breast cancer

    International Nuclear Information System (INIS)

    A retrospective review of 402 patients with stage I or II invasive breast carcinoma treated with conservative surgery and radiotherapy between 1979 and 1992 w as done. Disease free and actuarial survival rates, local, regional and distant recurrence rates and treatment related acute and chronic complications were evaluated according to stage. The technique and dose of radiotherapy were assessed in relation to stage of the disease, status of margin of lumpectomy and cosmetic results. Treatment related morbidity was minimal and overall cosmetic results were excellent. In stage 0 (in situ), I and II survival at 12 years has been 100%, 90% and 80% respectively. It is concluded that breast conservation treatment is an appropriate method of primary therapy, along with radiation therapy, for women with Stage I and II breast cancer

  15. Effect of early grain feeding of beef steers on postabsorptive metabolism.

    Science.gov (United States)

    Nayananjalie, W A D; Pike, K L; Wiles, T R; McCann, M A; Scheffler, J M; Greiner, S P; Schramm, H H; Gerrard, D E; Jiang, H; Hanigan, M D

    2015-05-01

    The objective of this study was to determine the effect of early weaning followed by a period of high-grain feeding on plasma acetate kinetics and signaling protein phosphorylation in LM tissue of growing steers. We hypothesized that early grain feeding would result in altered cell signaling and acetate use to support observed improvements in carcass gain and marbling. Fall-born Angus × Simmental steers were weaned at 106 ± 4 d of age (early weaned [EW]; n = 6) and fed a high-grain diet for 148 d or remained with their dams (normal weaned [NW]; n = 6) on pasture until weaning at 251 ± 5 d of age. Both treatments were subsequently combined and grazed on mixed summer pasture to 394 ± 5 d of age followed by a feedlot ration until harvest at 513 ± 5 d of age. Longissimus muscle tissue biopsies were collected at 253 ± 5 and 394 ± 5 d of age and at harvest. Total and phosphorylated forms of 5' adenosine monophosphate-activated protein kinase (AMPK) and downstream proteins of the mammalian target of rapamycin signaling pathway were determined by western blotting. Eight steers were used to assess acetate clearance at different age points via a bolus infusion of acetate (4 mmol/kg of BW). Early weaned steers had greater (P carcass weights, but observed changes in acetate appearance and clearance rates do not appear to explain the observed differences in intramuscular fat deposition during the terminal feeding period. PMID:26020339

  16. Early intervention to promote oral feeding in patients with intracerebral hemorrhage: a retrospective cohort study

    Directory of Open Access Journals (Sweden)

    Nagata Izumi

    2011-01-01

    Full Text Available Abstract Background Stroke is a major cause of dysphagia, but little is known about when and how dysphagic patients should be fed and treated after an acute stroke. The purpose of this study is to establish the feasibility, risks and clinical outcomes of early intensive oral care and a new speech and language therapist/nurse led structured policy for oral feeding in patients with an acute intracerebral hemorrhage (ICH. Methods A total of 219 patients with spontaneous ICH who were admitted to our institution from 2004 to 2007 were retrospectively analyzed. An early intervention program for oral feeding, which consisted of intensive oral care and early behavioral interventions, was introduced from April 2005 and fully operational by January 2006. Outcomes were compared between an early intervention group of 129 patients recruited after January 2006 and a historical control group of 90 patients recruited between January 2004 and March 2005. A logistic regression technique was used to adjust for baseline differences between the groups. To analyze time to attain oral feeding, the Kaplan-Meier method and Cox proportional hazard model were used. Results The proportion of patients who could tolerate oral feeding was significantly higher in the early intervention group compared with the control group (112/129 (86.8% vs. 61/90 (67.8%; odds ratio 3.13, 95% CI, 1.59-6.15; P Conclusions Our data suggest that the techniques can be used safely and possibly with enough benefit to justify a randomized controlled trial. Further investigation is needed to solve the eating problems that are associated with patients recovering from a severe stroke.

  17. The influence of genetic variation in thirty selected genes on the clinical characteristics of early onset breast cancer

    OpenAIRE

    Tapper, William; Hammond, Victoria; Gerty, Sue; Ennis, Sarah; Simmonds, Peter; Collins, Andrew; Eccles, Diana

    2008-01-01

    Introduction: common variants that alter breast cancer risk are being discovered. Here, we determine how these variants influence breast cancer prognosis, risk and tumour characteristics. Methods: we selected 1,001 women with early onset nonfamilial invasive breast cancer from the Prospective study of Outcomes in Sporadic versus Hereditary breast cancer (POSH) cohort and genotyped 206 single nucleotide polymorphisms (SNPs) across 30 candidate genes. After quality control, 899 cases and 13...

  18. miRNAs as potential biomarkers in early breast cancer detection following mammography.

    Science.gov (United States)

    Fu, Sidney W; Lee, Woojin; Coffey, Caitrin; Lean, Alexa; Wu, Xiaoling; Tan, Xiaohui; Man, Yan-Gao; Brem, Rachel F

    2016-01-01

    Breast cancer is the most common cancer among American women, except for skin cancers. About 12 % women in the United States will develop invasive breast cancer during their lifetime. Currently one of the most accepted model/theories is that ductal breast cancer (most common type of breast cancer) follows a linear progression: from normal breast epithelial cells to ductal hyperplasia to atypical ductal hyperplasia (ADH) to ductal carcinoma in situ (DCIS), and finally to invasive ductal carcinoma (IDC). Distinguishing pure ADH diagnosis from DCIS and/or IDC on mammography, and even combined with follow-up core needle biopsy (CNB) is still a challenge. Therefore subsequent surgical excision cannot be avoided to make a definitive diagnosis. MicroRNAs (miRNAs) are a highly abundant class of endogenous non-coding RNAs, which contribute to cancer initiation and progression, and are differentially expressed between normal and cancer tissues. They can function as either tumor suppressors or oncogenes. With accumulating evidence of the role of miRNAs in breast cancer progression, including our own studies, we sought to summarize the nature of early breast lesions and the potential use of miRNA molecules as biomarkers in early breast cancer detection. In particular, miRNA biomarkers may potentially serve as a companion tool following mammography screening and CNB. In the long-term, a better understanding of the molecular mechanisms underlying the miRNA signatures associated with breast cancer development could potentially result in the development of novel strategies for disease prevention and therapy. PMID:26819702

  19. Treatment outcome in patients with triple negative early stage breast cancers compared with other molecular subtypes

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ja Young; Chang, Sei Kyung; Lee, Bo Mi; Shin, Hyun Soo [Dept. of Radiation Oncology, CHA Bundang Medical Center, CHA University, Seongnam (Korea, Republic of); Park, Heily [Dept. of Radiation Oncology, Presbyterian Hospital, Jeonju (Korea, Republic of)

    2012-09-15

    To determine whether triple negative (TN) early stage breast cancers have poorer survival rates compared with other molecular types. Between August 2000 and July 2006, patients diagnosed with stage I, II early stage breast cancers, in whom all three markers (estrogen receptor, progesterone receptor, and human epidermal growth factor receptor [HER]-2) were available and treated with modified radical mastectomy or breast conserving surgery followed by radiotherapy, were retrospectively reviewed. Of 446 patients, 94 (21.1%) were classified as TN, 57 (12.8%) as HER-2 type, and 295 (66.1%) as luminal. TN was more frequently associated with young patients younger than 35 years old (p = 0.002), higher histologic grade (p < 0.0001), and nuclear (p < 0.0001). The median follow-up period was 78 months (range, 4 to 130 months). There were 9 local relapses (2.0%), 15 nodal (3.4%), 40 distant metastases (9.0%), and 33 deaths (7.4%) for all patients. The rates of 5-year OS, DFS, LFS, and DMFS for all patients were 95.5%, 89.9%, 95.4%, and 91.7%, respectively. There were no significant differences in OS, DFS, LFS, and DMFS between triple negative and other subtypes (p > 0.05). We found that patients with TN early stage breast cancers had no difference in survival rates compared with other molecular subtypes. Prospective study in homogeneous treatment group will need for a prognosis of TN early stage breast cancer.

  20. Effect of breast feeding time on physiological, immunological and microbial parameters of weaned piglets in an intensive breeding farm.

    Science.gov (United States)

    García, G R; Dogi, C A; Ashworth, G E; Berardo, D; Godoy, G; Cavaglieri, L R; de Moreno de LeBlanc, A; Greco, C R

    2016-08-01

    The aim of this work was to study the long-lasting consequences of different weaning age on physiological, immunological and microbiological parameters of weaned piglets. Piglets were weaned at 14 days (14W) or 21 days (21W). Blood samples were taken for IgG and cortisol determination on preweaning day and at 4; 20 and 40 post-weaning days. Three animals of each group were sacrificed. Small intestines for morphometric studies and secretory-IgA determination in fluid were taken. The cecum was obtained for enterobacteria, lactobacilli and total anaerobes enumeration. A significant decrease in piglet's plasma IgG concentrations was observed immediately after weaning and no differences were found between 14W and 21W. An increase in intestinal S-IgA was observed according to piglet's age. This increase was significantly higher in piglets 14W compared to piglets 21W. Animals from 14W group showed a decrease in villus length and in the number of goblet cells and intraepithelial lymphocytes. Other parameters were not affected by the weaning age. A short-term increase in cortisol was observed after weaning in both experimental groups. Enterobacteria decreased significantly after weaning in both groups, reaching values of weaning after 40 days. Lactobacilli counts decreased in both groups after weaning; however their counts were always higher than those obtained for enterobacteria. No differences were observed between 14W and 21W with regards to counts of anaerobes. The shortening of breast feeding time would favor an early synthesis of intestinal S-IgA after weaning. The changes observed in the microbiota could decrease postweaning enteric infections. However, early weaning induced negative effects on the cells of gut innate immunity and villi atrophy. This work provides knowledge about advantages and disadvantages at different weaning and long-lasting consequences on pig health. It is critical that swine producers become aware of the biological impacts of weaning age, so

  1. The choice of multi-beam IMRT for whole breast radiotherapy in early-stage right breast cancer.

    Science.gov (United States)

    Haciislamoglu, Emel; Colak, Fatma; Canyilmaz, Emine; Zengin, Ahmet Yasar; Yilmaz, Ahmet Hakan; Yoney, Adnan; Bahat, Zumrut

    2016-01-01

    The aim of this study was to identify a rational strategy for the selection of multi-beam IMRT in patients with right breast cancer through the comparison of dosimetric parameters of the planning target volume (PTV) and organs at risk (OARs) using five different radiotherapy modalities. This was a retrospective study using computed tomography scans from ten patients with early-stage right breast cancer who had been treated previously. Three dimensional conformal radiotherapy (3DCRT), forward-planned IMRT (for-IMRT), inverse-planned IMRT (inv-IMRT), helical tomotherapy (HT), and volumetric-modulated arc therapy (VMAT) were planned for each patient. The plans were compared according to dose-volume histogram analysis. The most significant impact of inverse-planned multi-beam modalities for right breast cancer was the reduction of Dmax, Dmean, V53.5 and prescribed dose volume (cc) outside of the PTV (breast) (OB-V50) of the PTV. HT decreased the ipsilateral OAR volumes receiving higher doses. In exchange, HT also increased the volumes receiving low doses, which is known to lead to an increased rate of radiation-induced secondary malignancies. The heart, LAD, and contralateral doses for 3DCRT and for-IMRT were significantly lower than those for inv-IMRT, HT, and VMAT. In addition, inv-IMRT demonstrated an increase in exposed volume of heart, LAD, ipsilateral lung, and contralateral lung compared with those parameters for HT or VMAT. Although it is known to reduce cardiac toxicity with breath hold technique in left sided breast cancer, similarly it is possible for 3DCRT and for-IMRT techniques in right sided breast cancer even in free breathing. PMID:27350922

  2. Toxicity and cosmetic result of partial breast high-dose-rate interstitial brachytherapy for conservatively operated early breast cancer

    International Nuclear Information System (INIS)

    Objective: Objective To study the method, side effects and cosmetic outcome of high- dose-rate (HDR) accelerated partial breast interstitial irradiation (APBI) alone in early stage breast cancer' after conservative surgery. Methods: From February 2002 to June 2003,47 breast cancer lesions from 46 patients suffering from stage I/II breast cancer were treated with HDR 192Ir APBI after conservative surgery. All patients were over 40 year-old, with T1-2N0-1 (≤3 lymph nodes positive), surgical margin > 1-2 mm, but those having lobular or inflammatory breast cancer were excluded. HDR brachytherapy with 34 Gy, 10 fractions/5 days was used after surgery, toxic reaction and cosmetic outcome were observed in one month, 6 and 12 months respectively. Results: Follow up of 1846 months, 34 months was carried out for the whole group. During the treatment, acute reactions including: erythema, edema, tenderness and infection, all under I-II grade, none of III-IV grade were observed in 21 patients(46%); late toxicity reactions: skin fibrosis, breast tenderness, fat necrosis, and telangiectasia, totally 20 patients (43%) were observed: 2 patients in III grade but one patient received 6 cycle chemotherapy. The result of cosmetic outcome evaluation was excellent or good, at 6 months 95% and 12 months 98%, respectively, but there was no recurfence. Conclusions: Excellent and favorable cosmetic results are noted after APBI by interstitial alone. Acute and late reactions are few. Long term observation is necessary for the rate of' local control. (authors)

  3. Target Fortification of Breast Milk: Predicting the Final Osmolality of the Feeds

    OpenAIRE

    Arum Choi; Gerhard Fusch; Niels Rochow; Christoph Fusch

    2016-01-01

    For preterm infants, it is common practice to add human milk fortifiers to native breast milk to enhance protein and calorie supply because the growth rates and nutritional requirements of preterm infants are considerably higher than those of term infants. However, macronutrient intake may still be inadequate because the composition of native breast milk has individual inter- and intra-sample variation. Target fortification (TFO) of breast milk is a new nutritional regime aiming to reduce suc...

  4. Human milk and breast feeding: an update on the state of the art.

    Science.gov (United States)

    Ogra, P L; Greene, H L

    1982-04-01

    Current approaches to infant feeding have been based on the level of available knowledge of nutritional requirements of full term and low birth weight (LBW) infants and on established cultural traditions in many contemporary societies. This discussion summarizes existing information about infant nutrition and immunobiologic aspects of human milk, which may influence the choice of breast versus bottle feeding of infants in different parts of the world. The average caloric requirement for a normal full term infant from the 2nd day of age through the 1st year of life is estimated to be about 100-110 Kcal/kg/day. Caloric intake of less than 80 Kcal/kg/day is usually insufficient for physiologic needs and intakes over the average requirement may be associated with obesity. The minimum requirement for protien has been estimated to be about 1.8 gm/100 Kcal and protein intake of over 4.5 gm/100 Kcal may result in an increased urea nitrogen retention. The nutritional requirements of premature and LBW infants have not been clearly established, but the nutritional needs of a LBW infant appear to be significantly higher than the requirements of a normal full term infant. The chemical composition of human milk exhibits considerable variation between different individuals and in the same individual at different times of lactation, as well as between samples obtained from mothers of LBW infants and full term infants. Fresh milk contains a wealth of components that provide specific and nonspecific defenses against infectious agents or other macromolecules. The concentrations of protein, whey protein nitrogen, sodium and potassium in cow's milk are 2-3 times higher than in human milk. Only limited information is available about the spectrum of environmental chemical and toxins present in cow's milk. The composition of human milk meets the minimum requirements for protein and calories for a growing full term infant, despite the fact that protein content of pooled human milk is low

  5. A nested case-control study of adjuvant hormonal therapy persistence and compliance, and early breast cancer recurrence in women with stage I-III breast cancer

    OpenAIRE

    Bennett, Kathleen

    2013-01-01

    PUBLISHED Background: Non-persistence and non-compliance are common in women prescribed hormonal therapy for breast cancer, but little is known about their influence on recurrence. Methods: A nested case–control study of associations between hormonal therapy non-persistence and non-compliance and the risk of early recurrence in women with stage I–III breast cancer was undertaken. Cases, defined as women with a breast cancer recurrence within 4 years of hormonal therapy initiati...

  6. A nested case–control study of adjuvant hormonal therapy persistence and compliance, and early breast cancer recurrence in women with stage I–III breast cancer

    OpenAIRE

    Barron, T I; Cahir, C; Sharp, L.; Bennett, K.

    2013-01-01

    Background: Non-persistence and non-compliance are common in women prescribed hormonal therapy for breast cancer, but little is known about their influence on recurrence. Methods: A nested case–control study of associations between hormonal therapy non-persistence and non-compliance and the risk of early recurrence in women with stage I–III breast cancer was undertaken. Cases, defined as women with a breast cancer recurrence within 4 years of hormonal therapy initiation, were matched to contr...

  7. Adjuvant bisphosphonates in early breast cancer: consensus guidance for clinical practice from a European Panel.

    Science.gov (United States)

    Hadji, P; Coleman, R E; Wilson, C; Powles, T J; Clézardin, P; Aapro, M; Costa, L; Body, J-J; Markopoulos, C; Santini, D; Diel, I; Di Leo, A; Cameron, D; Dodwell, D; Smith, I; Gnant, M; Gray, R; Harbeck, N; Thurlimann, B; Untch, M; Cortes, J; Martin, M; Albert, U-S; Conte, P-F; Ejlertsen, B; Bergh, J; Kaufmann, M; Holen, I

    2016-03-01

    Bisphosphonates have been studied in randomised trials in early breast cancer to investigate their ability to prevent cancer treatment-induced bone loss (CTIBL) and reduce the risk of disease recurrence and metastasis. Treatment benefits have been reported but bisphosphonates do not currently have regulatory approval for either of these potential indications. This consensus paper provides a review of the evidence and offers guidance to breast cancer clinicians on the use of bisphosphonates in early breast cancer. Using the nominal group methodology for consensus, a systematic review of the literature was augmented by a workshop held in October 2014 for breast cancer and bone specialists to present and debate the available pre-clinical and clinical evidence for the use of adjuvant bisphosphonates. This was followed by a questionnaire to all members of the writing committee to identify areas of consensus. The panel recommended that bisphosphonates should be considered as part of routine clinical practice for the prevention of CTIBL in all patients with a T score of 18,000 patients supports clinically significant benefits of bisphosphonates on the development of bone metastases and breast cancer mortality in post-menopausal women or those receiving ovarian suppression therapy. Therefore, the panel recommends that bisphosphonates (either intravenous zoledronic acid or oral clodronate) are considered as part of the adjuvant breast cancer treatment in this population and the potential benefits and risks discussed with relevant patients. PMID:26681681

  8. Sensitivity of CA 15-3, CEA and serum HER2 in the early detection of recurrence of breast cancer

    DEFF Research Database (Denmark)

    Pedersen, Ann Christina; Sørensen, Patricia Diana; Jacobsen, Erik Hugger;

    2013-01-01

    The aim of this project was to investigate the sensitivity of CA 15-3, CEA and HER2 in the early diagnosis of metastatic breast cancer.......The aim of this project was to investigate the sensitivity of CA 15-3, CEA and HER2 in the early diagnosis of metastatic breast cancer....

  9. 77 FR 60703 - Breast and Cervical Cancer Early Detection and Control Advisory Committee: Notice of Charter Renewal

    Science.gov (United States)

    2012-10-04

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Breast and Cervical Cancer Early Detection and... Committee Act (Pub. L. 92-463) of October 6, 1972, that the Breast and Cervical Cancer Early Detection...

  10. Scintigraphic examinations during pregnancy and in breast-feeding women: a survey of nuclear medicine physician's attitudes in Belgium

    International Nuclear Information System (INIS)

    Aim: The present survey was undertaken to approach the practices of Belgian nuclear medicine physicians towards performing diagnostic tests during pregnancy and in breast-feeding women. Materials and Methods: Questionnaire (see infra) was sent to all (201) Belgian Nuclear Physicians. Results: 78 answers (39 %) were received. During pregnancy, do you accept to perform Tc-99m lung perfusion scan ? First 3 months pregnancy: Yes, using standard protocol: 16%; Yes, using a reduced dose: 51%; No: 33%. After 3 months pregnancy: Yes, using standard protocol: 24% ; Yes, using a reduced dose: 52% ; No: 24%. Tc-99m ventilation scan? First 3 months: Yes, using standard protocol: 10%; Yes, using a reduced dose: 11%; No: 79%. After 3 months : Yes, using standard protocol: 15%; Yes, using a reduced dose: 19%; No: 66%. Other diagnostic tests using Tc-99m? First 3 months: Yes, using standard protocol: 4%; Yes, using a reduced dose: 12%; No: 84%. After 3 months: Yes, using standard protocol: 4% ; Yes, using a reduced dose: 17%; No: 79%. Other diagnostic tests using other radioisotopes? First 3 months: Yes, using standard protocol: 3%; Yes, using a reduced dose: 0%; No: 97%. After 3 months: Yes, using standard protocol: 3% ; Yes, using a reduced dose: 0%; No: 97%. In breast-feeding women do you accept to perform Tc-99m diagnostic tests? No: 11%. Yes, using standard protocol: 0%. Yes, provided a breast-feeding break: 89%. In those situations is an informed consent necessary? Yes: 42% ; No: 58%. Conclusion: These results are quite similar to those obtained in other countries; given the diversity of the opinions expressed, practical guidelines defining a standardized attitude would be helpful

  11. Development of a novel approach for breast cancer prediction and early detection using minimally invasive procedures and molecular analysis: how cytomorphology became a breast cancer risk predictor.

    Science.gov (United States)

    Masood, Shahla

    2015-01-01

    With enhanced public awareness, advances in breast imaging, and emphasis on early breast cancer detection and prevention, more women are seeking consultation to assess the status of their breast health. Risk assessment has become an integral part of established multi-disciplinary breast care, and breast cancer risk reduction interventions have received a great deal of attention. Similarly, interest in identification of high-risk individuals has increased significantly. Atypical proliferative changes in breast epithelial cells are ranked high among various known breast cancer risk factors and, in recent years, have been the subject of several investigations. Breast tissue and fluid in the ductal system provide a rich source of cells and biomarkers that have the potential to aid in the assessment of short-term risk of breast cancer development, and assess responses to interventional prevention efforts. There are three minimally invasive procedures currently being utilized to sample breast tissue in asymptomatic high-risk individuals. These procedures are: fine-needle aspiration biopsy, nipple aspiration fluid, and ductal lavage. In this review article, the merits and limitations of each procedure are presented, and the contribution of cytomorphology and molecular analysis in breast cancer prediction is highlighted. In addition, the role of Masood Cytology Index as a surrogate endpoint biomarker in chemopreventative trials is discussed. PMID:25556774

  12. Time Interval From Breast-Conserving Surgery to Breast Irradiation in Early Stage Node-Negative Breast Cancer: 17-Year Follow-Up Results and Patterns of Recurrence

    Energy Technology Data Exchange (ETDEWEB)

    Vujovic, Olga, E-mail: olga.vujovic@lhsc.on.ca [Department of Radiation Oncology, London Regional Cancer Program, London, Ontario (Canada); Yu, Edward [Department of Radiation Oncology, London Regional Cancer Program, London, Ontario (Canada); Cherian, Anil [Station Health Centre, Royal Air Force Lossiemouth, Moray (United Kingdom); Dar, A. Rashid [Department of Radiation Oncology, London Regional Cancer Program, London, Ontario (Canada); Stitt, Larry [Department of Biometry, London Regional Cancer Program, London, Ontario (Canada); Perera, Francisco [Department of Radiation Oncology, London Regional Cancer Program, London, Ontario (Canada)

    2015-02-01

    Purpose: A retrospectivechart review was conducted to determine whether the time interval from breast-conserving surgery to breast irradiation (surgery-radiation therapy interval) in early stage node-negative breast cancer had any detrimental effects on recurrence rates. Methods and Materials: There were 566 patients with T1 to T3, N0 breast cancer treated with breast-conserving surgery and breast irradiation and without adjuvant systemic treatment between 1985 and 1992. The surgery-to-radiation therapy intervals used for analysis were 0 to 8 weeks (201 patients), >8 to 12 weeks (233 patients), >12 to 16 weeks (91 patients), and >16 weeks (41 patients). Kaplan-Meier estimates of time to local recurrence, disease-free survival, distant disease-free survival, cause-specific survival, and overall survival rates were calculated. Results: Median follow-up was 17.4 years. Patients in all 4 time intervals were similar in terms of characteristics and pathologic features. There were no statistically significant differences among the 4 time groups in local recurrence (P=.67) or disease-free survival (P=.82). The local recurrence rates at 5, 10, and 15 years were 4.9%, 11.5%, and 15.0%, respectively. The distant disease relapse rates at 5, 10, and 15 years were 10.6%, 15.4%, and 18.5%, respectively. The disease-free failure rates at 5, 10, and 15 years were 20%, 32.3%, and 39.8%, respectively. Cause-specific survival rates at 5, 10, and 15 years were 92%, 84.6%, and 79.8%, respectively. The overall survival rates at 5, 10, and 15 years were 89.3%, 79.2%, and 66.9%, respectively. Conclusions: Surgery-radiation therapy intervals up to 16 weeks from breast-conserving surgery are not associated with any increased risk of recurrence in early stage node-negative breast cancer. There is a steady local recurrence rate of 1% per year with adjuvant radiation alone.

  13. Adoption of Hypofractionated Whole-Breast Irradiation for Early-Stage Breast Cancer: A National Cancer Data Base Analysis

    International Nuclear Information System (INIS)

    Purpose: To evaluate the relationship of patient, hospital, and cancer characteristics with the adoption of hypofractionation in a national sample of patients diagnosed with early-stage breast cancer. Methods and Materials: We performed a retrospective study of breast cancer patients in the National Cancer Data Base from 2004-2011 who were treated with radiation therapy and met eligibility criteria for hypofractionation. We used logistic regression to identify factors associated with receipt of hypofractionation (vs conventional fractionation). Results: We identified 13,271 women (11.7%) and 99,996 women (88.3%) with early-stage breast cancer who were treated with hypofractionation and conventional fractionation, respectively. The use of hypofractionation increased significantly, with 5.4% of patients receiving it in 2004 compared with 22.8% in 2011 (P<.001 for trend). Patients living ≥50 miles from the cancer reporting facility had increased odds of receiving hypofractionation (odds ratio 1.57 [95% confidence interval 1.44-1.72], P<.001). Adoption of hypofractionation was associated with treatment at an academic center (P<.001) and living in an area with high median income (P<.001). Hypofractionation was less likely to be used in patients with high-risk disease, such as increased tumor size (P<.001) or poorly differentiated histologic grade (P<.001). Conclusions: The use of hypofractionation is rising and is associated with increased travel distance and treatment at an academic center. Further adoption of hypofractionation may be tempered by both clinical and nonclinical concerns

  14. Adoption of Hypofractionated Whole-Breast Irradiation for Early-Stage Breast Cancer: A National Cancer Data Base Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Elyn H. [Yale School of Medicine, Yale School of Medicine, New Haven, Connecticut (United States); Mougalian, Sarah S. [Yale School of Medicine, Yale School of Medicine, New Haven, Connecticut (United States); Department of Medical Oncology, Yale School of Medicine, New Haven, Connecticut (United States); Cancer Outcomes, Public Policy, and Effectiveness Research Center at Yale, New Haven, Connecticut (United States); Soulos, Pamela R. [Yale School of Medicine, Yale School of Medicine, New Haven, Connecticut (United States); Cancer Outcomes, Public Policy, and Effectiveness Research Center at Yale, New Haven, Connecticut (United States); Rutter, Charles E.; Evans, Suzanne B. [Yale School of Medicine, Yale School of Medicine, New Haven, Connecticut (United States); Cancer Outcomes, Public Policy, and Effectiveness Research Center at Yale, New Haven, Connecticut (United States); Department of Therapeutic Radiology, Yale School of Medicine, New Haven, Connecticut (United States); Haffty, Bruce G. [Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey and Robert Wood Johnson Medical School, New Brunswick, New Jersey (United States); Gross, Cary P. [Yale School of Medicine, Yale School of Medicine, New Haven, Connecticut (United States); Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey and Robert Wood Johnson Medical School, New Brunswick, New Jersey (United States); Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut (United States); Yu, James B., E-mail: james.b.yu@yale.edu [Yale School of Medicine, Yale School of Medicine, New Haven, Connecticut (United States); Cancer Outcomes, Public Policy, and Effectiveness Research Center at Yale, New Haven, Connecticut (United States); Department of Therapeutic Radiology, Yale School of Medicine, New Haven, Connecticut (United States)

    2014-12-01

    Purpose: To evaluate the relationship of patient, hospital, and cancer characteristics with the adoption of hypofractionation in a national sample of patients diagnosed with early-stage breast cancer. Methods and Materials: We performed a retrospective study of breast cancer patients in the National Cancer Data Base from 2004-2011 who were treated with radiation therapy and met eligibility criteria for hypofractionation. We used logistic regression to identify factors associated with receipt of hypofractionation (vs conventional fractionation). Results: We identified 13,271 women (11.7%) and 99,996 women (88.3%) with early-stage breast cancer who were treated with hypofractionation and conventional fractionation, respectively. The use of hypofractionation increased significantly, with 5.4% of patients receiving it in 2004 compared with 22.8% in 2011 (P<.001 for trend). Patients living ≥50 miles from the cancer reporting facility had increased odds of receiving hypofractionation (odds ratio 1.57 [95% confidence interval 1.44-1.72], P<.001). Adoption of hypofractionation was associated with treatment at an academic center (P<.001) and living in an area with high median income (P<.001). Hypofractionation was less likely to be used in patients with high-risk disease, such as increased tumor size (P<.001) or poorly differentiated histologic grade (P<.001). Conclusions: The use of hypofractionation is rising and is associated with increased travel distance and treatment at an academic center. Further adoption of hypofractionation may be tempered by both clinical and nonclinical concerns.

  15. Optimal approach in early breast cancer: Radiation therapy

    OpenAIRE

    Poortmans, Philip

    2013-01-01

    Radiation therapy significantly reduces by at least 70% the relative risk of local and regional recurrences for breast cancer after surgery. A positive influence on overall survival has been clearly demonstrated, especially for patients with a high absolute risk for locoregional recurrences. However, this is partially counterbalanced by late toxicity (dependent upon the radiation dose) especially to cardiac structures. Apart from this toxicity, a clear influence of radiation-therapy-related f...

  16. Surgical management for early-stage bilateral breast cancer patients in China.

    Directory of Open Access Journals (Sweden)

    Jia-jian Chen

    Full Text Available The aim of this study was to investigate the current surgical management strategy for bilateral breast cancer (BBC patients and to assess the changes in this strategy in China.This is a retrospective review of all patients with early-stage BBC who underwent surgical treatment at the Fudan University Shanghai Cancer Center between June 2007 and June 2014.A total of 15,337 patients with primary breast cancer were identified. Of these patients, 218 (1.5% suffered from synchronous bilateral breast cancer (sBBC, and 296 (2.0% suffered from metachronous bilateral breast cancer (mBBC. Patients with a lobular carcinoma component, those with estrogen receptor-positive cancer, and those with an accompanying sclerosing adenosis in the affected breast tended to develop BBC. The rates of bilateral mastectomy, breast conserving therapy, reconstruction, and combined surgeries were 86.2%, 6.4%, 3.7%, and 3.7%, respectively, for patients with sBBC and 81.1%, 4.4%, 3.0%, and 11.5%, respectively, for patients with mBBC. The interval between bilateral cancers, age at first diagnosis of breast cancer, histopathological type, and stage have significant impacts on the choice of surgery for patients with BBC.Bilateral mastectomy was the dominant surgical management for patients with BBC in China, despite the increased application of breast reconstruction surgery observed in recent years. Bilateral prosthetic breast reconstruction was the ideal choice for patients with sBBC. Chinese surgeons should take responsibility for patient education and inform their patients about their surgical options.

  17. An early history of human breast cancer:West meets East

    Institute of Scientific and Technical Information of China (English)

    Shou-He Yan

    2013-01-01

    Cancer has been increasingly recognized as a global issue. This is especially true in countries like China, where cancer incidence has increased likely because of changes in environment and lifestyle. However, cancer is not a modern disease; early cases have been recorded in ancient medical books in the West and in China. Here, we provide a brief history of cancer, focusing on cancer of the breast, and review the etymology of ai, the Chinese character for cancer. Notable findings from both Western and Chinese traditional medicine are presented to give an overview of the most important, early contributors to our evolving understanding of human breast cancer. We also discuss the earliest historical documents to record patients with breast cancer.

  18. The prognostic relevance of estimates of proliferative activity in early breast cancer

    DEFF Research Database (Denmark)

    Offersen, B V; Sørensen, Flemming Brandt; Knoop, A;

    2003-01-01

    clinicopathological parameters at diagnosis in early breast cancer patients. MATERIALS AND METHODS: Tumour specimens from 365 consecutively treated breast cancer patients were immunostained for MIB-1 and evaluated under the microscope using systematic random sampling accomplished by the CAST-grid system. RESULTS...... and number of mitoses included in the analysis, MIB-1 estimates showed no independent prognostic impact. CONCLUSIONS: High MIB-1 estimates did not add independent prognostic information at diagnosis when evaluated together with classical prognostic markers of early breast cancer.......AIMS: Immunohistochemical estimates of cell proliferation evaluated with MIB-1 antibody have been suggested as prognostic indicators in different types of carcinoma. This study investigates whether MIB-1 scores add additional prognostic impact when evaluated together with classical...

  19. Breast feeding practices and newborn care in rural areas: A descriptive cross-sectional study

    Directory of Open Access Journals (Sweden)

    Madhu K

    2009-01-01

    Full Text Available Context: Breastfeeding practices play an important role in reducing child mortality and morbidity. This study was aimed to describe the breastfeeding practices prevalent in rural areas. Objectives: The primary objective of this study was to describe the breastfeeding and newborn care practices in rural areas and the secondary objective was to describe the factors affecting the initiation and duration of breastfeeding. Settings and Design: The study was conducted in primary health care center (PHC that is attached to a medical college in Kengeri, rural Bangalore, Karnataka. Materials and Methods: Mothers with children who were 9 months old who came to the PHC for measles vaccination were included in the study and data was collected using the pre-tested questionnaire on breastfeeding and newborn practices. Results: Our study shows 97% of the mothers initiated breastfeeding, 19% used pre lacteal feeds, 90% had hospital deliveries and 10% had home deliveries, and 50% used a house knife to cut the umbilical cord among home deliveries. Conclusions: This study emphasizes the need for breastfeeding intervention programs especially for the mother during antenatal and postnatal check-ups and practices like discarding the colostrum and early/late weaning are still widely prevalent and need to be addressed.

  20. Conservative Surgery and Primary Radiotherapy for Early Breast Cancer; Yonsei Cancer Center Experience

    Energy Technology Data Exchange (ETDEWEB)

    Suh, Chang Ok; Lee, Hy De; Lee, Kyung Sik; Jung, Woo Hee; Oh, Ki Keun; Kim, Gwi Eon [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    1994-10-15

    Breast conserving surgery and irradiation is now accepted as preferable treatment method for the patients with stage I and II breast cancer. Our institution activated team approach for breast conservation 1991 and treated on hundred and forty patients during the next three years. Purpose: To present our early experience with eligibility criteria, treatment techniques, and the morbidities of primary radiotherapy. Materials and Methods: Sixty four patients with early stage breast cancer who received breast conserving treatment between January 1991 and December 1992 were evaluated. All patients received partial mastectomy(wide excision to quadrantectomy) and axillary node dissection followed by radiotherapy. Total dose of 4500-5040 cGy in 5-5 1/2 weeks was given to entire involved breast and boost dose of 1000-2000 cGy in 1-2 weeks was given to the primary tumor site. Linac 4 MV X-ray was used for breast irradiation and electron beam was used for boost. Thirty five patients received chemotherapy before or after radiotherapy. Patients characteristics, treatment techniques, and treatment related morbidities were analyzed. Results: Age distribution was ranged from 23 to 59 year old with median age of 40. Twenty-seven patients had T1 lesions and 34 patients had T2 lesions. In three patients, pathologic diagnosis was ductal carcinoma in situ. Thirty-seven patients were N0 and 27 patients were N1. There were three recurrences, one in the breast and two distant metastases during follow-up period(6-30 months, median 14 months). Only one breast recurrence occurred at undetected separate lesion with microcalcifications on initial mammogram. There was no serious side reaction which interrupted treatment courses or severe late complication. Only one symptomatic radiation pneumonitis and one asymptomatic radiation peumonitis were noted. Conclusions: Conservative surgery and primary radiotherapy for early breast cancer in proven to be safe and comfortable treatment method without

  1. PECULIARITIES OF THE TRANSITION OF EARLY STURGEON (ACIPENSERIDAE FRY TO ARTIFICIAL FORMULATED FEEDS IN RAS (A REVIEW

    Directory of Open Access Journals (Sweden)

    M. Simon

    2016-03-01

    Full Text Available Purpose. To review scientific sources on the morphological and ecophysiological peculiarities of the transition of early sturgeon fry (Acipenseridae to artificial formulated feeds. To summarize the biotechnological fundamentals of the use of artificial formulated feeds in the conditions of recirculating aquaculture systems (RAS. Findings. The transition of early sturgeon fry to artificial formulated feeds is one of the most difficult stages of their rearing, even under controlled conditions of RAS. The review contains the description of the peculiarities of sturgeon embryogenesis, their behavior and morpho-physiological changes at this stage of their development. It contains main requirements for the rearing of sturgeon larvae in RAS. We showed that the ultimate refuse from natural (live or frozen forage organisms is not advisable; the optimum is their combination with artificial feeds with gradual predominance of the latters. We provided the schemes of their feeding based on the combination of natural and artificial feeds. We reviewed the most common biologically active supplements, which contributed to better feed digestion during the periods of the transition to exogenous feeding. We highlighted the effect of feeding with brine shrimp nauplii enriched with polyunsaturated fatty acids on the growth and development of early sturgeon fry. Practical value. The array of the summarized information will be important for scientists who study the peculiarities of the transition of early sturgeon fry to artificial formulated feeds in RAS. The data on the biotechnologies of rational feeding of early sturgeon fry in RAS in this period are important in the conditions of continuous search for the most effective replacement of live forage organisms and reduction of fish fry mortality in postembryogenesis.

  2. Clinical analysis of early breast cancer%早期乳腺癌临床分析*

    Institute of Scientific and Technical Information of China (English)

    盛陈毅; 倪启超

    2013-01-01

    Objective: To improve early det ection and diagnosis of breast cancer.Methods:Retrospective clinical analysis was done of the ages of onset of breast cancer, early diagnosis, histological types and surgical methods.Results:162 cases were clinically cured with early breast cancer, and the follow-up results showed that the 1-year and the 3-year sur-vival rates were 100% and 97.5%.Conclusion: Early detection and diagnosis of breast cancer depend primarily on clini-cians who can detect≤2cm milk block, with the combination of ultrasound and mammography.%目的:提高乳腺癌早期发现、早期诊断水平。方法:回顾性临床分析乳腺癌发病年龄、早期诊断方法、病理组织类型和手术方法。结果:162例早期乳腺癌均临床治愈出院,159例患者获随访,1年、3年生存率分别为100%、97.5%。结论:乳腺癌早期发现、早期诊断主要取决于临床医师检出≤2cm的乳块,辅以彩超和钼靶联合检查。

  3. 77 FR 71193 - Breast and Cervical Cancer Early Detection Federal Advisory Committee

    Science.gov (United States)

    2012-11-29

    ... From the Federal Register Online via the Government Publishing Office ] DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention (CDC) Breast and Cervical Cancer Early Detection Federal Advisory Committee Correction: This notice was published in the Federal Register...

  4. 75 FR 57472 - Breast and Cervical Cancer Early Detection and Control Advisory Committee (BCCEDCAC): Notice of...

    Science.gov (United States)

    2010-09-21

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Breast and Cervical Cancer Early Detection and Control Advisory Committee (BCCEDCAC): Notice of Charter Renewal This gives notice under the...

  5. Couple-Focused Group Intervention for Women With Early Stage Breast Cancer

    Science.gov (United States)

    Manne, Sharon L.; Ostroff, Jamie S.; Winkel, Gary; Fox, Kevin; Grana, Generosa; Miller, Eric; Ross, Stephanie; Frazier, Thomas

    2005-01-01

    This study examined the efficacy of a couple-focused group intervention on psychological adaptation of women with early stage breast cancer and evaluated whether perceived partner unsupportive behavior or patient functional impairment moderated intervention effects. Two hundred thirty-eight women were randomly assigned to receive either 6 sessions…

  6. The p53 codon 72 polymorphism is associated with risk and early onset of breast cancer among Saudi women

    OpenAIRE

    Al-Qasem, Abeer; Toulimat, Mohamed; Tulbah, Asma; Elkum, Naser; Al-Tweigeri, Taher; Aboussekhra, Abdelilah

    2012-01-01

    Breast cancer has a major impact on the health of women worldwide. In the Kingdom of Saudi Arabia (KSA), breast cancer incidence is on the increase and is characterized by early onset and aggressiveness. Owing to the importance of the TP53 gene in breast carcinogenesis, we analyzed the possible link between TP53 single nucleotide polymorphisms (SNPs) and the risk of breast cancer in Saudi women by direct sequencing of the TP53 gene exon 4 from 100 breast cancer tissues. The proportion of the ...

  7. A case of bronchiolitis obliterans organizing pneumonia (BOOP) after breast conserving therapy for early breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Hayashi, Shinya; Kiryuu, Takuji; Maeda, Sunao; Hoshi, Hiroaki; Shimokawa, Kuniyasu [Gifu Univ. (Japan). School of Medicine; Kawaguchi, Shimpei

    2001-03-01

    A case of BOOP occurring after radiotherapy for breast cancer was reported. TBLB and BAL were performed at the time of diagnosis. This case suggested that radiographic changes began in the irradiated area, then later spread to non-irradiated areas. In this article, we discussed the peculiary radiographic image, pathological manifestation, BAL characteristics and clinical course in this sequela. (author)

  8. Developing a discrete choice experiment in Malawi: eliciting preferences for breast cancer early detection services

    Directory of Open Access Journals (Sweden)

    Kohler RE

    2015-10-01

    Full Text Available Racquel E Kohler,1 Clara N Lee,2 Satish Gopal,3 Bryce B Reeve,1 Bryan J Weiner,1 Stephanie B Wheeler11Department of Health Policy and Management, Gillings School of Global Public Health, 2Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; 3UNC Project-Malawi, Tidziwe Center, Lilongwe, MalawiBackground: In Malawi, routine breast cancer screening is not available and little is known about women’s preferences regarding early detection services. Discrete choice experiments are increasingly used to reveal preferences about new health services; however, selecting appropriate attributes that describe a new health service is imperative to ensure validity of the choice experiment.Objective: To identify important factors that are relevant to Malawian women’s preferences for breast cancer detection services and to select attributes and levels for a discrete choice experiment in a setting where both breast cancer early detection and choice experiments are rare.Methods: We reviewed the literature to establish an initial list of potential attributes and levels for a discrete choice experiment and conducted qualitative interviews with health workers and community women to explore relevant local factors affecting decisions to use cancer detection services. We tested the design through cognitive interviews and refined the levels, descriptions, and designs.Results: Themes that emerged from interviews provided critical information about breast cancer detection services, specifically, that breast cancer interventions should be integrated into other health services because asymptomatic screening may not be practical as an individual service. Based on participants’ responses, the final attributes of the choice experiment included travel time, health encounter, health worker type and sex, and breast cancer early detection strategy. Cognitive testing confirmed the acceptability of the final attributes

  9. Exclusive breast-feeding duration is associated with attitudinal, socioeconomic and biocultural determinants in three Latin American countries.

    Science.gov (United States)

    Pérez-Escamilla, R; Lutter, C; Segall, A M; Rivera, A; Treviño-Siller, S; Sanghvi, T

    1995-12-01

    International health organizations have recommended exclusive breast-feeding (EBF) (i.e., breast milk as the only source of food) as the optimal infant feeding method during the first 4-6 mo of life. Therefore, it is important to document the determinants of EBF in different populations. Low-income urban women from Brazil (n = 446, 2 maternity wards), Honduras (n = 1582, 3 maternity wards) and Mexico (n = 765, 3 maternity wards) were interviewed at birth and in their homes at 1 mo and 2-4 mo after delivery. Multivariate survival analyses (Cox model) indicated that planned duration of EBF (all 3 countries), having a female infant, and not being employed (Brazil and Honduras), lower socioeconomic status (Honduras and Mexico) and higher birth weight (control hospital in Brazil and Honduras) were positively associated (P programs were more successful with EBF. The association between maternal education and EBF was modified by the maternity ward in Mexico and Honduras. Being > or = 18 y and having a partner living (Brazil) or not (Mexico) living at home were positively associated with EBF. These findings can contribute toward the design of EBF promotion efforts in Latin America. PMID:7500175

  10. Contribution of BRCA1 and BRCA2 Germline Mutations to Early Algerian Breast Cancer.

    Science.gov (United States)

    Henouda, Sarra; Bensalem, Assia; Reggad, Rym; Serrar, Nedda; Rouabah, Leila; Pujol, Pascal

    2016-01-01

    Breast cancer is the most common female malignancy and the leading cancer mortality cause among Algerian women. Germline mutations in the BRCA1 and BRCA2 genes in patients with early-onset breast cancer have not been clearly identified within the Algerian population. It is necessary to study the BRCA1/2 genes involvement in the Algerian breast cancer occurrence. We performed this study to define germline mutations in BRCA1/2 and their implication in breast cancer among young women from eastern Algeria diagnosed or treated with primary invasive breast cancer at the age of 40 or less who were referred to Anti-Cancer Center of Setif, Algeria. Case series were unselected for family history. Eight distinct pathogenic mutations were identified in eight unrelated families. Three deleterious mutations and one large genomic rearrangement involving deletion of exon 2 were found in BRCA1 gene. In addition, four mutations within the BRCA2 gene and one large genomic rearrangement were identified. Novel mutation was found among Algerian population. Moreover, five variants of uncertain clinical significance and favor polymorphisms were identified. Our data suggest that BRCA1/2 mutations are responsible for a significant proportion of breast cancer in Algerian young women. PMID:26997744

  11. Cosmetic outcome and curative effect of radiotherapy for early breast cancer after conservative surgery

    International Nuclear Information System (INIS)

    Objective: To study the cosmetic outcome and curative effect of 6 MV X-ray tangential field radiotherapy for early stage breast cancer after conservative surgery. Methods: The eligible criteria were single tumor ≤3 cm in diameter, surgical margin negative and lymph node negative. The exclusive criteria were inflammatory carcinoma or male breast cancer. After conservative surgery, 42 patients with stage 0, I or II breast cancer were treated with conventional radiotherapy with a total dose of 50 Gy to the whole breast and 10 Gy boost to the tumor bed. The efficacy and the cosmetic outcome of radiotherapy were evaluated every 3 months for the first 2 years and every 6 months after that and every 12 months after 5 years. Results: The follow up time was 19-90 months (median 56 months). Two patients died of metastasis after 16 months and 36 months, which was diagnosed by CT scan. Excellent or good cosmetic outcome was > 93% at 36 months. The local control rate was 100%. The 1- and 3-year survival rates was 100% and 98%, respectively. Conclusions: Tangential field radiotherapy for early breast cancer after conservative surgery has a satisfied result in both tumor control and cosmetic outcome, which can definitely improve the life quality of the patients. (authors)

  12. Energy needs of lactating mothers and breast-feeding children in Senegal

    International Nuclear Information System (INIS)

    This project aims to use isotopic techniques to measure energy expenditure and breast milk intake of children, and the energy expenditure and breast milk production of lactating mothers. Two separate methods are being used, both of which involve the use of doubly labelled water. The present report presents growth rate date on the children and data on how they spend their time; the isotopic analysis has not yet been performed. 5 refs, 5 tabs

  13. Patterns and predictors of early recurrence in postmenopausal women with estrogen receptor-positive early breast cancer.

    Science.gov (United States)

    Mansell, James; Monypenny, Ian J; Skene, Anthony I; Abram, Paul; Carpenter, Robert; Gattuso, Jennifer M; Wilson, Christopher R; Angerson, Wilson J; Doughty, Julie C

    2009-09-01

    Previous studies suggest that disease recurrence peaks at around 2 years in patients with early stage breast cancer (EBC), but provide no data regarding recurrence type. This retrospective analysis aimed to identify early recurrence types and risk factors in estrogen receptor-positive (ER+) EBC patients treated with adjuvant tamoxifen following breast cancer surgery. Postmenopausal women diagnosed with ER+ EBC from 1995 to 2004 were evaluated. Annual hazard ratios (HR) for recurrence at different sites were calculated. Time-dependent Cox regression analysis was used to identify predictors of recurrence within 2.5 years of diagnosis, including factors that were more strongly predictive of early than later recurrence. Of 3,614 patients evaluated, 476 developed recurrence during the 5-year median follow-up. Cumulative recurrence rates at 2.5 years (95% confidence interval) were: overall 6.3% (5.5-7.1), locoregional 1.1% (0.7-1.5), contralateral 0.5% (0.3-0.7), and distant 4.8% (4.0-5.6). The annual HR of overall recurrence peaked at 2 years (4.3% per annum). The majority of this peak represented distant recurrence (3.4% per annum). In Cox regression analysis, tumor size and grade, lymph node involvement, lymphovascular invasion, and symptomatic presentation were significant independent predictors of early recurrence. Age at diagnosis was independently predictive of recurrence within 2.5 years of diagnosis but not later recurrence. This study identified an early recurrence peak at 2 years, most of which were distant recurrences. Implementing an aromatase inhibitor after an initial 2-3 years of tamoxifen fails to address this early peak of distant recurrence and the potential breast cancer-associated mortality. PMID:19112615

  14. Preoperative Single Fraction Partial Breast Radiotherapy for Early-Stage Breast Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Palta, Manisha; Yoo, Sua; Adamson, Justus D.; Prosnitz, Leonard R. [Department of Radiation Oncology, Duke University Medical Center, Durham, NC (United States); Horton, Janet K., E-mail: janet.horton@duke.edu [Department of Radiation Oncology, Duke University Medical Center, Durham, NC (United States)

    2012-01-01

    Purpose: Several recent series evaluating external beam accelerated partial breast irradiation (PBI) have reported adverse cosmetic outcomes, possibly related to large volumes of normal tissue receiving near-prescription doses. We hypothesized that delivery of external beam PBI in a single fraction to the preoperative tumor volume would be feasible and result in a decreased dose to the uninvolved breast compared with institutional postoperative PBI historical controls. Methods and Materials: A total of 17 patients with unifocal Stage T1 breast cancer were identified. Contrast-enhanced subtraction magnetic resonance images were loaded into an Eclipse treatment planning system and used to define the target volumes. A 'virtual plan' was created using four photon beams in a noncoplanar beam arrangement and optimized to deliver 15 Gy to the planning target volume. Results: The median breast volume was 1,713 cm{sup 3} (range: 1,014-2,140), and the median clinical target volume was 44 cm{sup 3} (range: 26-73). In all cases, 100% of the prescription dose covered 95% of the clinical target volume. The median conformity index was 0.86 (range: 0.70-1.12). The median percentage of the ipsilateral breast volume receiving 100% and 50% of the prescribed dose was 3.8% (range: 2.2-6.9) and 13.3% (range: 7.5-20.8) compared with 18% (range: 3-42) and 53% (range: 24-65) in the institutional historical controls treated with postoperative external beam PBI (p = .002). The median maximum skin dose was 9 Gy. The median dose to 1 and 10 cm{sup 3} of skin was 6.7 and 4.9 Gy. The doses to the heart and ipsilateral lung were negligible. Conclusion: Preoperative PBI resulted in a substantial reduction in ipsilateral breast tissue dose compared with postoperative PBI. The skin dose appeared reasonable, given the small volumes. A prospective Phase I trial evaluating this technique is ongoing.

  15. Duration of breast-feeding and the incidence of type 2 diabetes mellitus in the Shanghai Women’s Health Study

    OpenAIRE

    Villegas, R.; Gao, Y.-T.; Yang, G.; Li, H. L.; Elasy, T; Zheng, W; Shu, X.-O.

    2007-01-01

    Aims/hypothesis The aim of this study was to examine the association between lifetime breast-feeding and the incidence of type 2 diabetes mellitus in a large population-based cohort study of middle-aged women. Methods This was a prospective study of 62,095 middle-aged parous women in Shanghai, China, who had no prior history of type 2 diabetes mellitus, cancer or cardiovascular disease at study recruitment. Breast-feeding history, dietary intake, physical activity and anthropometric measureme...

  16. Aedes aegypti midgut early trypsin is post-transcriptionally regulated by blood feeding.

    Science.gov (United States)

    Noriega, F G; Pennington, J E; Barillas-Mury, C; Wang, X Y; Wells, M A

    1996-02-01

    Early trypsin is a female-specific protease present in the Aedes aegypti midgut during the first hours after ingestion of a blood meal. Early trypsin gene expression was studied by Northern blot analysis. The early trypsin mRNA, absent in larvae, pupae and newly emerged females, reaches detectable levels at 24 h post-emergence and attains a maximum level at an adult age of 4-7 days. After the first week there is a decrease in the steady-state level of the transcript, but it remains readily detectable for up to a month after emergence. Despite the high levels of early trypsin mRNA present in the midgut of the unfed female, translation of the early trypsin mRNA occurs only after a blood or a protein meal. Early trypsin mRNA levels rapidly decrease during the first 24 h after feeding, but the steady-state level of the transcript rises again at the end of the blood digestion cycle (60 h), as the mosquito prepares for a second blood meal. PMID:8630532

  17. Development of a Compact Wide-Slot Antenna for Early Stage Breast Cancer Detection Featuring Circular Array Full-View Geometry

    Directory of Open Access Journals (Sweden)

    S. S. Tiang

    2014-01-01

    Full Text Available A novel planar type antenna printed on a high permittivity Rogers’ substrate is proposed for early stage microwave breast cancer detection. The design is based on a p-shaped wide-slot structure with 50 Ω microstrip feeding circuit to eliminate losses of transmission. The design parameters are optimized resulting in a good reflection coefficient at −10 dB from 4.5 to 10.9 GHz. Imaging result using inhomogeneous breast phantom indicates that the proposed antenna is capable of detecting a 5 mm size cancerous tumor embedded inside the fibroglandular region with dielectric contrast between the target and the surrounding materials ranging from 1.7 : 1 to 3.6 : 1.

  18. Early Detection of Breast Cancer using SVM Classifier Technique

    Directory of Open Access Journals (Sweden)

    Y.Ireaneus Anna Rejani

    2009-11-01

    Full Text Available This paper presents a tumor detection algorithm from mammogram. The proposed system focuses on the solution of two problems. One is how to detect tumors as suspicious regions with a very weak contrast to their background and another is how to extract features which categorize tumors. The tumor detection method follows the scheme of (a mammogram enhancement. (b The segmentation of the tumor area. (c The extraction of features from the segmented tumor area. (d The use of SVM classifier. The enhancement can be defined as conversion of the image quality to a better and more understandable level. The mammogram enhancement procedure includes filtering, top hat operation, DWT. Then the contrast stretching is used to increase the contrast of the image. The segmentation of mammogram images has been playing an important role to improve the detection and diagnosis of breast cancer. The most common segmentation method used is thresholding. The features are extracted from the segmented breast area. Next stage include, which classifies the regions using the SVM classifier. The method was tested on 75 mammographic images, from the mini-MIAS database. The methodology achieved a sensitivity of 88.75%.

  19. Breast feeding rate and its influencing factors in Haidian District of Beijing%北京市海淀区婴儿母乳喂养率及影响因素分析

    Institute of Scientific and Technical Information of China (English)

    曹洁

    2014-01-01

    Objective To understand the breast feeding status in Haidian District and explore its influencing factors , so as to provide basis for improvement of infant nutrition .Methods A self-designed questionnaire survey was carried out among 580 mothers or caregivers , who took their babies aged 0-4 months for health care in child early department center of Haidian Maternal and Children Health Hospital in the period of January to December in 2012.Results The pure breast feeding rate of mothers with senior middle school education or lower was significantly higher than that of the mothers with vocational high school education or higher (χ2 =4.192,P<0.05).The rate of breast feeding was different among mothers with different occupation , and that was highest among unemployed women (χ2 =9.631,P<0.05). The rate of pure breast feeding of eutocia was higher than that of dystocia (χ2 =5.631,P<0.05).The rate of pure breast feeding of women with normal breast development was higher than that of women with abnormal breast development (χ2 =48.275, P<0.05).Conclusion Education , occupation , obstetrical way as well as breast development are the major influencing factors of breast feeding .Intervention program should be implemented by maternal and child health care workers .%目的:了解北京市海淀区婴儿母乳喂养情况,探讨影响母乳喂养的相关因素,为改善婴儿营养提供依据。方法采用随机抽样的方法,抽取在北京市海淀妇幼保健医院儿童早期发展中心进行健康检查的0~4个月龄婴儿580例,用自行设计的母乳喂养状况调查表,了解2012年1月至12月产妇母乳喂养情况。结果母亲高中文化程度以下较中专文化程度以上纯母乳喂养率高,差异有统计学意义(χ2=4.192,P<0.05)。不同职业的母乳喂养率差异有统计学意义,其中全职妈妈的母乳喂养率最高(χ2=9.631,P<0.05)。顺产组的纯母乳喂养率高于剖宫产组

  20. Breast cancer - Early detection with mammography. Crushed stone-like calcifications - The most frequent malignant type

    Energy Technology Data Exchange (ETDEWEB)

    Tabar, Laszlo [Univ. of Uppsala (Sweden). School of Medicine]|[Central Hospital, Falun (Sweden). Dept. of Mammography; Tot, Tibor [Univ. of Uppsala (Sweden). School of Medicine]|[Central Hospital, Falun (Sweden). Dept. of Pathology and Clinical Cytology; Dean, Peter B. [Turku Univ. (Finland). Dept. of Diagnostic Radiology

    2008-07-01

    A comprehensive guide for analyzing the most common malignant type calcifications on the mammogram Internationally renowned breast cancer imagers Laszlo Tabar and Peter B. Dean and the eminent breast pathologist Tibor Tot distill decades of clinical expertise in this new volume covering the most frequently occurring malignant type calcifications: the pleomorphic, crushed stone-like calcifications. The book presents a systematic approach to using mammographic features to distinguish different subtypes of breast diseases originating within the terminal ductal lobular unit (TDLU). More than 800 images demonstrate abnormal findings with superb clarity, providing a state-of-the-art visual reference for interpreting mammograms in the clinical setting. Features: - Concise descriptions of mammographic and MRI findings correlated with high-quality histopathologic images to provide a reliable guide for accurate diagnosis and differential diagnosis, as well as prognostic classification - Extensive coverage of all aspects of the benign differential diagnostic counterparts of pleomorphic calcifications, including fibrocystic change, fibroadenoma, and papilloma - Straightforward discussion of terminology based on a thorough analysis of subgross anatomy, 3D histologic features, and long-term disease outcomes - 3D viewing glasses enclosed in the book for perceiving specially marked images in their true 3D form This book is ideal for all breast imagers and breast pathologists, as well as for surgeons and oncologists specializing in breast diseases. For the radiologist, this book is an indispensable reference for harnessing the power of mammography to detect breast cancer at the earliest stages possible. About the Breast Cancer: Early Detection with Mammography series: This series grew out of the bestselling book Breast Cancer: The Art and Science of Early Detection with Mammography. Written by the same authors, this series is based on 30 years of experience with more than one

  1. Breast cancer - Early detection with mammography. Crushed stone-like calcifications - The most frequent malignant type

    International Nuclear Information System (INIS)

    A comprehensive guide for analyzing the most common malignant type calcifications on the mammogram Internationally renowned breast cancer imagers Laszlo Tabar and Peter B. Dean and the eminent breast pathologist Tibor Tot distill decades of clinical expertise in this new volume covering the most frequently occurring malignant type calcifications: the pleomorphic, crushed stone-like calcifications. The book presents a systematic approach to using mammographic features to distinguish different subtypes of breast diseases originating within the terminal ductal lobular unit (TDLU). More than 800 images demonstrate abnormal findings with superb clarity, providing a state-of-the-art visual reference for interpreting mammograms in the clinical setting. Features: - Concise descriptions of mammographic and MRI findings correlated with high-quality histopathologic images to provide a reliable guide for accurate diagnosis and differential diagnosis, as well as prognostic classification - Extensive coverage of all aspects of the benign differential diagnostic counterparts of pleomorphic calcifications, including fibrocystic change, fibroadenoma, and papilloma - Straightforward discussion of terminology based on a thorough analysis of subgross anatomy, 3D histologic features, and long-term disease outcomes - 3D viewing glasses enclosed in the book for perceiving specially marked images in their true 3D form This book is ideal for all breast imagers and breast pathologists, as well as for surgeons and oncologists specializing in breast diseases. For the radiologist, this book is an indispensable reference for harnessing the power of mammography to detect breast cancer at the earliest stages possible. About the Breast Cancer: Early Detection with Mammography series: This series grew out of the bestselling book Breast Cancer: The Art and Science of Early Detection with Mammography. Written by the same authors, this series is based on 30 years of experience with more than one

  2. Exclusive breast-feeding of newborns among married women in the United States: the National Natality Surveys of 1969 and 1980.

    Science.gov (United States)

    Forman, M R; Fetterly, K; Graubard, B I; Wooton, K G

    1985-11-01

    Questions about infant feeding practices after birth were included in 1969 and 1980 National Natality Surveys (NNS). At 3-6 mo postpartum, NNS questionnaires were mailed to mothers of live infants born in wedlock, and responses were weighted to permit national estimates. Based on the NNS, the proportion of women who were exclusively breast-feeding newborns in the United States was significantly lower in 1969 (19% of white women, 9% of black women) compared with 1980 (51% of white women, 25% of black women). In 1969, the highest percentages of exclusive breast-feeding were observed among white women less than or equal to 34 yr, of parity less than or equal to 3 and greater than 7, and of higher than lower socioeconomic groups; and among black women greater than or equal to 30 yr, of parity greater than or equal to 4, and of lower than higher socioeconomic groups. Among women in both races in 1980, more primiparae than multiparae and the more highly educated were breast-feeding. More white than black women exclusively breast-fed within each birthweight and each sociodemographic characteristic in 1980; therefore, the racial differences remained across these factors. These findings are compared with results of the Ross Laboratories surveys of infant feeding.

  3. SAFETY OF EARLY ORAL FEEDING AFTER TRANSHIATAL ESOPHAGECTOMY : PRELIMINARY REPORT OF A PROSPECTIVE TRIAL

    Directory of Open Access Journals (Sweden)

    A. Jafarian

    2005-09-01

    Full Text Available Oral feeding is the best means of nutrition in surgical patients. There arc many reports on early oral feeding after lower gastrointestinal {(il operations but data regarding upper Gl procedures is rather scant. This limited study rocuses 011 early removal of nasogastric tube and start of oral diet after transhiatal csophagcctomy. We prospectively evaluated 13 consecutive patients (8 males. 5 females with esophageal cancer who had undergone rranshiatal csophngcctomy from March 100 I to September :lOrn. Nasogustric tube was removed on post-op day 1 and clear liquids started on day 3. Diet was advanced to son regular in tile next 5 days if the patients tolerated it. Mean age of patients was 63 years."nMenu body weight and serum albumin level were 57.9 kg and 3.73 gr/dl., respectively. Tumor pathology was squamous cell carcinoma in 11 cases and adenocarcinoma in I. Location oftumor was at the lower third of the esophagus in 11 cases and middle third in one. All patients ill the study group tolerated tile protocol well. Only one patient had nausea after oral intake, without vomiting. We had one neck wound infection and OIlC pulmonary infection. There was no anastomotic leakage or fistula. A group of I( esophageal cancer patients undergoing trnnshiuta! csophagcctomy in the same period ""'('I'C used as the control group. One anastomotic leakage occurred in control group. We had no significant complication. Early nasogastric tube removal and oral feeding seems to be safe in patients with esophageal cancer undergoing transhiatal csophagcctcmy.

  4. Gut Microbiome Developmental Patterns in Early Life of Preterm Infants: Impacts of Feeding and Gender.

    Science.gov (United States)

    Cong, Xiaomei; Xu, Wanli; Janton, Susan; Henderson, Wendy A; Matson, Adam; McGrath, Jacqueline M; Maas, Kendra; Graf, Joerg

    2016-01-01

    Gut microbiota plays a key role in multiple aspects of human health and disease, particularly in early life. Distortions of the gut microbiota have been found to correlate with fatal diseases in preterm infants, however, developmental patterns of gut microbiome and factors affecting the colonization progress in preterm infants remain unclear. The purpose of this prospective longitudinal study was to explore day-to-day gut microbiome patterns in preterm infants during their first 30 days of life in the neonatal intensive care unit (NICU) and investigate potential factors related to the development of the infant gut microbiome. A total of 378 stool samples were collected daily from 29 stable/healthy preterm infants. DNA extracted from stool was used to sequence the V4 region of the 16S rRNA gene region for community analysis. Operational taxonomic units (OTUs) and α-diversity of the community were determined using QIIME software. Proteobacteria was the most abundant phylum, accounting for 54.3% of the total reads. Result showed shift patterns of increasing Clostridium and Bacteroides, and decreasing Staphylococcus and Haemophilus over time during early life. Alpha-diversity significantly increased daily in preterm infants after birth and linear mixed-effects models showed that postnatal days, feeding types and gender were associated with the α-diversity, pdiversity, whereas females tended to have a higher diversity shortly after birth. Female infants were more likely to have higher abundance of Clostridiates, and lower abundance of Enterobacteriales than males during early life. Infants fed mother's own breastmilk (MBM) had a higher diversity of gut microbiome and significantly higher abundance in Clostridiales and Lactobacillales than infants fed non-MBM. Permanova also showed that bacterial compositions were different between males and females and between MBM and non-MBM feeding types. In conclusion, infant postnatal age, gender and feeding type significantly

  5. External beam irradiation plus 192Ir implant after breast-preserving surgery in women with early breast cancer

    International Nuclear Information System (INIS)

    Purpose: To provide more information for the clinician and to analyze the impact of the boost with brachytherapy on the local disease-free survival (LDFS), disease-free survival (DFS), specific overall survival (OS), and cosmesis, a retrospective study of external radiation therapy and 192Ir implantation in early breast cancer at Institut Catala d'Oncologia has been undertaken. Patients and Methods: From 1986 to 1996, 530 patients were selected for this study with a median follow-up period of 39.5 months (range, 10-115 months). External radiation therapy (combined with brachytherapy) was administered postoperatively to the breast in all patients. Mean given dose was 48.7 Gy (range, 42-52 Gy) with external radiation therapy to the breast, and 16.8 Gy (range, 10-27 Gy) was the mean dose with brachytherapy. Variables have been tested for cosmesis. Univariate and multivariate analysis have also been carried out. Results: Mean age of the patients was 54 years (range, 28-81 years). Stages were distributed as follows: 350 patients (66%) in Stage I, 173 in Stage II (32.8%), and 7 in Stage III (1.1%). Pathologic distribution was 445 patients with infiltrating ductal carcinoma (84%), 20 patients with infiltrating lobular carcinoma (4%), and 65 patients (12%) of a miscellaneous group. OS for the entire group was 89.4% and 85.9% at 5 and 7 years respectively. Probability of DFS was 81.7% and 70.1% at 5 and 7 years. The LDFS was 94.9% and 91.7% at 5 and 7 years. The MFS probability was 85.5% and 76.9% at 5 and 7 years, respectively. Univariate analysis demonstrated that age (older than 52 years), premenopausal status, moderate and high histologic grades (Grades II-III), and presence of intraductal comedocarcinoma were prognostic factors for local relapse. Multivariate analysis for local disease-free survival demonstrated that only perineural or muscular infiltration remain as prognostic factors. Tumor dose bed of 70 Gy or higher had a negative impact in breast subcutaneous

  6. Risk of pacemaker implantation subsequent to radiotherapy for early-stage breast cancer in Denmark, 1982-2005

    DEFF Research Database (Denmark)

    Rehammar, Jens Christian; Videbaek, L.; Brock Johansen, J.;

    2015-01-01

    . Objectives: The aim of this study was to examine the risk of severe conduction abnormalities evaluated by implantation of a pacemaker, subsequent to breast cancer radiotherapy. Methods: From the database of the Danish Breast Cancer Collaborative Group, we identified women treated with radiotherapy for early......-stage breast cancer in Denmark from 1982 to 2005. By record linkage to the Danish Pacemaker and ICD Registry information was retrieved on pacemaker implants subsequent to radiotherapy. Rate ratios (RR) of pacemaker implantation for left versus right sided breast cancer were calculated. Results: Among 18......,308 women treated with radiotherapy for early-stage breast cancer, 179 women had a pacemaker implanted subsequent to radiotherapy, 90 in 9,315 left sided and 89 in 8,993 right sided breast cancers. The unadjusted RR was 1.02 (0.76-1.36 95% CI, p=0.91) and the RR adjusted for year, age and time since...

  7. Convalescence and hospital stay after colonic surgery with balanced analgesia, early oral feeding, and enforced mobilisation

    DEFF Research Database (Denmark)

    Møiniche, S; Bülow, Steffen; Hesselfeldt, Peter;

    1995-01-01

    unselected patients (median age 69 years) undergoing colonic resection. INTERVENTIONS: Patients received combined epidural and general anaesthesia during operations and after operation were given continuous epidural bupivacaine 0.25%, 4 ml hour and morphine 0.2 mg hour, for 96 hours and oral paracetamol 4 g......OBJECTIVE: To evaluate the combined effects of pain relief by continuous epidural analgesia, early oral feeding and enforced mobilisation on convalescence and hospital stay after colonic resection. DESIGN: Uncontrolled pilot investigation. SETTING: University hospital, Denmark. SUBJECTS: 17...

  8. Health-related quality of life in early breast cancer

    DEFF Research Database (Denmark)

    Grønvold, Mogens

    2010-01-01

    of life (HRQL) research. HRQL research deals with subjective experiences and raises challenging, scientific questions. Therefore, much attention was directed towards methodological issues in this clinically motivated project. The study was a prospective, longitudinal, questionnaire-based investigation...... in cases where medical decision-making involves complex trade-offs between treatment efficiency and HRQL issues is needed. Contrary to expectations, the analyses showed that fatigue and emotional function predicted the risk of recurrence and death independently of biological and clinical prognostic...... variables. In multivariate Cox regression analyses patients who were more fatigued or had poorer emotional function had a worse prognosis. These results are consistent with one small study, but are inconsistent with five similar studies in patients with primary breast cancer, which found...

  9. Fatores associados ao aleitamento materno e desmame em Feira de Santana, Bahia Breast feeding and weaning associated factors, Feira de Santana, Bahia

    Directory of Open Access Journals (Sweden)

    Graciete Oliveira Vieira

    2004-06-01

    Full Text Available OBJETIVOS: conhecer a prevalência do aleitamento materno e os fatores associados ao desmame das crianças menores de um ano, em Feira de Santana, no ano 2001. MÉTODOS: estudo transversal com aplicação de questionários às 2319 mães presentes nas 44 (71,1% unidades de vacinação selecionadas, por estratificação simples. Foi calculada a razão de prevalência e considerado como significante p OBJECTIVES: to determine breast feeding prevalence and weaning associated factors in under one year old children in Feira de Santana in 2001. METHODS: cross sectional study with the use of questionnaires addressing 2319 mothers in 44 vaccination facilities; (71% selected by simple stratification. Prevalence ratio was calculated with the following parameters: p < 0.05 considered significant with interval at 95%. RESULTS: breast feeding prevalence was 692% for under one year old children. Exclusive breast feeding was higher for children not using pacifiers (49.4% who had been breast-fed in the first days of life (40.4%. Statistically significant variables with higher breast feeding chances were: babies who were breast-fed in the first day of life (p <0.001, mothers who were housewives (p <0.001, lower family income (p <0.001, multiparous mothers (p =0.03 and children not using pacifiers (p =0.000. CONCLUSIONS: assistance activities to prevent weaning should especially focus on mothers holding jobs away from home, those with higher family incomes and who are primaparous. As for the children the focus should be on the ones not breast-fed in the first day of life and/or using pacifiers.

  10. XeNA: Capecitabine Plus Docetaxel, With or Without Trastuzumab, as Preoperative Therapy for Early Breast Cancer

    OpenAIRE

    Stefan Glück, Edward F. McKenna Jr, Melanie Royce

    2008-01-01

    Combinations of capecitabine and a taxane are highly active in metastatic breast cancer, and synergy between capecitabine and docetaxel has also been demonstrated. Such combinations potentially would provide a promising non–anthracycline-based alternative for patients with early breast cancer. Non-anthracycline preoperative regimens are a particularly interesting proposition in human epidermal growth factor receptor 2 (HER2)-positive breast cancer, as they offer less cardiotoxicity and ...

  11. XeNA: Capecitabine Plus Docetaxel, With or Without Trastuzumab, as Preoperative Therapy for Early Breast Cancer

    OpenAIRE

    Glück, Stefan; McKenna Jr, Edward F.; Royce, Melanie

    2008-01-01

    Combinations of capecitabine and a taxane are highly active in metastatic breast cancer, and synergy between capecitabine and docetaxel has also been demonstrated. Such combinations potentially would provide a promising non–anthracycline-based alternative for patients with early breast cancer. Non-anthracycline preoperative regimens are a particularly interesting proposition in human epidermal growth factor receptor 2 (HER2)-positive breast cancer, as they offer less cardiotoxicity and thus c...

  12. Intraoperative radiation therapy delivered prior to lumpectomy for early-stage breast cancer: a single institution study

    OpenAIRE

    Yu, Wei; Lin, Zhi; Ju, Zhong-Jian; Li, Xi-Ru; ZHANG, YAN-JUN; Kong, Qing-Long; Gong, Han-Shun; Wang, Jian-Dong; Ma, Lin

    2015-01-01

    Objective: To evaluate the safety, cosmesis, and clinical outcome of intraoperative electron radiation therapy (IOERT) delivered prior to lumpectomy for early-stage breast cancer. Methods: From December 2008 to March 2012, 75 breast cancer patients (ages 34-66 years) were treated with IOERT during breast conservative surgery. IOERT was delivered using a mobile linear accelerator. Suitable energy and applicator size were chosen to ensure coverage of the tumor with anterior and posterior margin...

  13. Effect of obesity on prognosis after early-stage breast cancer

    DEFF Research Database (Denmark)

    Ewertz, Marianne; Jensen, Maj-Britt; Gunnarsdóttir, Katrín Á;

    2011-01-01

    PURPOSE This study was performed to characterize the impact of obesity on the risk of breast cancer recurrence and death as a result of breast cancer or other causes in relation to adjuvant treatment. PATIENTS AND METHODS Information on body mass index (BMI) at diagnosis was available for 18......,967 (35%) of 53,816 women treated for early-stage breast cancer in Denmark between 1977 and 2006 with complete follow-up for first events (locoregional recurrences and distant metastases) up to 10 years and for death up to 30 years. Information was available on prognostic factors and adjuvant treatment...... for all patients. Univariate analyses were used to compare the associations of known prognostic factors and risks of recurrence or death according to BMI categories. Cox proportional hazards regression models were used to assess the influence of BMI after adjusting for other factors. Results Patients...

  14. Review of Infant Feeding: Key Features of Breast Milk and Infant Formula

    Directory of Open Access Journals (Sweden)

    Camilia R. Martin

    2016-05-01

    Full Text Available Mothers’ own milk is the best source of nutrition for nearly all infants. Beyond somatic growth, breast milk as a biologic fluid has a variety of other benefits, including modulation of postnatal intestinal function, immune ontogeny, and brain development. Although breastfeeding is highly recommended, breastfeeding may not always be possible, suitable or solely adequate. Infant formula is an industrially produced substitute for infant consumption. Infant formula attempts to mimic the nutritional composition of breast milk as closely as possible, and is based on cow’s milk or soymilk. A number of alternatives to cow’s milk-based formula also exist. In this article, we review the nutritional information of breast milk and infant formulas for better understanding of the importance of breastfeeding and the uses of infant formula from birth to 12 months of age when a substitute form of nutrition is required.

  15. Lactancia materna, destete y ablactación: una encuesta en comunidades rurales de México A survey of breast-feeding and other infant feeding practices in rural Mexico

    Directory of Open Access Journals (Sweden)

    SUSAN VANDALE-TONEY

    1997-09-01

    xico.Objective. To determine the prevalence of lactation, the use of industrialized milk and weaning, and the factors related to lack of breast-feeding and early weaning in young infants of rural communities. Material and methods. Transversal study performed by last year medical students doing Social Service in 222 rural communities in Mexico who applied structured interviews to 5 409 families with children younger than 1 year of age. Results. The percentages of children who were never breast-fed were: in the north (N 21.4%, in the center (C 7.6% and in the south (S 5.3%. Children who were still being breast-fed, either exclusively or with mixed feeding by the third trimester were 35.6% (N, 67.6% (C and 77.5% (S; in the second trimester, 67.2% (N, 40.9% (C and 51.6% (S had been weaned. In the N region it was observed that lack of breast-feeding was associated to the health personnel who attended delivery, mothers with six or more years of education and less than four children, dwellings with permanent material floors, two or more household commodities and a head of the family different from the father. Early weaning was essentially associated to the same factors; additionally, to the child being taken care of by someone different from the mother, artificial lactation by parental decision or due to medical recommendation and the use of health services provided by social security or private physicians. Conclusions. Artificial lactation and early weaning are typical of small families, with high educational level of the mother, better living conditions and contact with medical personnel, especially in the N of the country. Children are weaned before the second semester of life and it is therefore deemed necessary to implement health programs which promote breast-feeding and gradual weaning after the sixth month of life among the infant population of Mexican rural communities.

  16. Influence of Early Quantitative Feed Restriction on Performance and Carcass Characteristics of Broiler Chickens

    Institute of Scientific and Technical Information of China (English)

    SHI Baoming; SHAN Anshan; CHAN Long

    2006-01-01

    An experiment was conducted to study the influence of early quantitative feed restriction on the performance and carcass characteristics of broiler chickens. Two hundred 8-day-old commercial Avian male broiler chicks were assigned to four groups randomly, with 50 broilers each. At the age of 8 days the broilers were restricted to 90%, 80% or 70% of the ad libitum intake for 7 days. When the restricion was finished, all birds received feed ad libitum again. The results showed that diet restriction resulted in a reduction in body weight and daily gain during the restriction period (P <0.05). The birds restricted to 90% of the ad libitum intake showed the occurring of growth compensation in the 3rd week. The birds restricted to 80% and 70% of the ad libitum intake had growth compensation in the 4th week. No significant differences between the effects of the restriction and the control on final body weight,growth rate, feed conversion efficiency and carcass characteristics (P >0.05).

  17. Clinical trial of a minimally invasive operation for early breast cancer. One of the methods of day surgery

    International Nuclear Information System (INIS)

    Surgical management for primary breast cancer has become less invasive. We performed breast-conserving therapy (wide excision: Bp) and sentinel lymph node biopsy (SLNB) with local anesthesia as a clinical trial. We hypothesized that it is possible to manage early breast cancer by day surgery employing this method. Twenty-three patients with early breast cancer (maximum diameter: 2.0 cm, and no evidence of metastases of lymph nodes on preoperative image examinations) underwent this method. The treatment was completed without any complications in all cases. There were no disadvantages in the local anesthesia group compared with the general anesthesia group regarding oncological findings. In conclusion, this method is one of the options to manage early breast cancer in day surgery. (author)

  18. The p53 codon 72 polymorphism is associated with risk and early onset of breast cancer among Saudi women

    Science.gov (United States)

    Al-Qasem, Abeer; Toulimat, Mohamed; Tulbah, Asma; Elkum, Naser; Al-Tweigeri, Taher; Aboussekhra, Abdelilah

    2012-01-01

    Breast cancer has a major impact on the health of women worldwide. In the Kingdom of Saudi Arabia (KSA), breast cancer incidence is on the increase and is characterized by early onset and aggressiveness. Owing to the importance of the TP53 gene in breast carcinogenesis, we analyzed the possible link between TP53 single nucleotide polymorphisms (SNPs) and the risk of breast cancer in Saudi women by direct sequencing of the TP53 gene exon 4 from 100 breast cancer tissues. The proportion of the polymorphic forms of SNP72 in the Saudi breast cancer patients were: Arg/Arg (RR), 39%; Pro/Pro (PP), 36%; and Arg/Pro (RP), 25%. The frequencies of these forms in disease-free Saudi women were 7.59, 22.22 and 60.19%, respectively. This indicates that the RR form of the codon 72 polymorphism is a potential risk factor, whereas the RP form is a protection factor against breast cancer among Saudi women (p=0.0001). Moreover, the results have shown that the p53 R72P SNP is significantly associated with the early onset of breast cancer in the Saudi population (p=0.0138). However, the codon 47 polymorphism appears to have no role in this disease among Saudi women. These results indicate that the TP53 gene could play a major role in breast carcinogenesis and the early onset of the disease among Saudi women. PMID:22741010

  19. The p53 codon 72 polymorphism is associated with risk and early onset of breast cancer among Saudi women.

    Science.gov (United States)

    Al-Qasem, Abeer; Toulimat, Mohamed; Tulbah, Asma; Elkum, Naser; Al-Tweigeri, Taher; Aboussekhra, Abdelilah

    2012-04-01

    Breast cancer has a major impact on the health of women worldwide. In the Kingdom of Saudi Arabia (KSA), breast cancer incidence is on the increase and is characterized by early onset and aggressiveness. Owing to the importance of the TP53 gene in breast carcinogenesis, we analyzed the possible link between TP53 single nucleotide polymorphisms (SNPs) and the risk of breast cancer in Saudi women by direct sequencing of the TP53 gene exon 4 from 100 breast cancer tissues. The proportion of the polymorphic forms of SNP72 in the Saudi breast cancer patients were: Arg/Arg (RR), 39%; Pro/Pro (PP), 36%; and Arg/Pro (RP), 25%. The frequencies of these forms in disease-free Saudi women were 7.59, 22.22 and 60.19%, respectively. This indicates that the RR form of the codon 72 polymorphism is a potential risk factor, whereas the RP form is a protection factor against breast cancer among Saudi women (p=0.0001). Moreover, the results have shown that the p53 R72P SNP is significantly associated with the early onset of breast cancer in the Saudi population (p=0.0138). However, the codon 47 polymorphism appears to have no role in this disease among Saudi women. These results indicate that the TP53 gene could play a major role in breast carcinogenesis and the early onset of the disease among Saudi women. PMID:22741010

  20. Toxicity and cosmesis outcomes after single fraction partial breast irradiation in early stage breast cancer

    Directory of Open Access Journals (Sweden)

    Pinnarò Paola

    2011-11-01

    Full Text Available Abstract Background To report the clinical outcome after a Single Shot 3D-CRT PBI (SSPBI in breast cancer patients after conservative surgery (ClinicalTrials.gov Identifier: NCT01316328. Methods A dose of 18Gy (in the first 4 patients and 21Gy (in the remaining 60 patients was prescribed in a single session and delivered to the index area (i.e. the area of breast including the primary tumor bed and the surrounding tissue using 3D-CRT with patients in prone position. Acute and late toxicity was assessed using the National Cancer Institute's CTC for Adverse Events. Cosmesis was defined based on modified Harvard criteria. Differences between dosimetric or clinical parameters of patients with/without G2 or more late toxicity or unsatisfactory (poor or fair cosmetic outcome were evaluated with the Mann-Whitney test. Odds ratios and 95% confidence interval were calculated for cosmesis and fibrosis. Univariate and multivariate analyses(UVA/MVA were used to determine covariates associated with an increase in fibrosis or fat necrosis rate. Results Sixty four patients were enrolled. With a median follow-up of 3 years, G2 and G3 subcutaneous fibrosis was detected in 20(31% and in 8(13% patients, and ≥G2 fat necrosis was observed in 2(3% patients. Good to excellent, fair and poor cosmesis was observed in 38(59%, 23(36% and 3(5% patients, respectively. Based on UVA, the breast volume receiving more than 21Gy (V21Gy was found to be a predictor of the ≥G1 or ≥G2 fibrosis/fat necrosis. Based on MVA, V21Gy was confirmed as a predictor for ≥G1 fibrosis/fat necrosis, the results correlated as a trend for ≥G2. Cosmesis was correlated with whole breast (WB mean dose (p = 0.030. Conclusion Our choice of a single dose of 21Gy significantly increased the treatment related toxicity. However, this should not discourage novel SSPBI approaches with lower equivalent doses.

  1. A STUDY ON FOLLOWUP OF LOW BIRTH WEIGHT BABIES ON EXCLUSIVE BREAST FEEDING UPTO FOUR MONTHS OF AGE

    Directory of Open Access Journals (Sweden)

    Srinivasa

    2016-03-01

    Full Text Available BACKGROUND Birth weight of a child is an important indicator of its vulnerability for childhood illness and chances of survival. A significant number of infant deaths can be averted by prevention of factors associated with LBW and adequate management of LBW babies. The incidence of low birth weight baby continues to be high in developing countries in contrast to developed countries. METHODOLOGY It was a prospective study conducted between October 2014 and September 2015. All babies delivered with a birth weight less than 2500 grams were included in the study. Detailed records were made regarding maternal history and new-born examination. Advantage of exclusive breast feeding explained to parents and advised to attend the Well Baby Clinic on Wednesdays at monthly intervals for first four months. During each visit growth parameters were measured, developmental milestones assessed. General physical examination and neurological examination done. Data analysed by Chi-square test and ANOVA test. RESULTS 21.4% of LBW babies were >2000 grams, 41.4% between 1500-2000 grams and the remaining <1500 grams were 37.2%. There was a significant association between head circumference, length and their gestational age. Among complication associated with neonates 74.4% cases were uncomplicated, 14.3% cases had hyperbilirubinaemia, 8.5% had respiratory problems and 2.8% had sepsis. From 0-4 months 70% of LBW babies gained double the weight, 73% of LBW babies had an average of 7cms increase in head circumference, 81% of LBW babies had an average of 7cms increase in chest circumference and 57% showed increase of 10cms in length. Of the babies that had not attained social smile by three months, 66.7% of babies less than 1500gms and 22.2% were above 2000gms which are IUGR babies that had not attained social smile either. Among the babies that had not attained complete neck control by 4 months, 76.9% of babies less than 1500gms. CONCLUSION Breast feed alone is

  2. Performance of Early Diagnosis of Breast and Cervical Cancer in the Municipality of Cienfuegos

    Directory of Open Access Journals (Sweden)

    Julio Padrón González

    2013-05-01

    Full Text Available Background: breast and cervical cancer are among the most frequent causes of death in women. Therefore, the early detection of these diseases is one of the prioritized programs of the Public Health System. Objective: to describe the performance of the Breast and Cervical Cancer Program in the municipality of Cienfuegos. Methods: a cross-sectional descriptive study was conducted over the period 2010-2011 in the context of the CARMEN project. A random sample was selected which was randomly stratified. The variables analyzed included age, marital status, skin color, health professional’s visits, knowledge of breast self-examination, clinical breast exam, mammography, cervical smear and time from the last medical examination of each test. The questionnaire of the CARMEN study was used. Results analysis was performed by SPSS package version 15, 0. Statistical significance level used was 95 %. Results: a total of 428 women (41,1 % had not been examined in over a year; 49 of them (4,6 % had not been checked for more than five years. 7,2 % of the study sample have never undergone a mammography, 28,6 % have had this test performed. 91,0 % of the women whose ages are included in the program has undergone a cervical smear. Conclusions: the objectives of the General Program for Cancer Control in Cuba are not being achieved. The inefficient areas of the Breast and Cervical Cancer Program are exposed.

  3. Quasi-multistatic MIST beamforming for the early detection of breast cancer.

    Science.gov (United States)

    O'Halloran, Martin; Jones, Edward; Glavin, Martin

    2010-04-01

    Microwave imaging via space-time (MIST) beamforming has been shown to be one of the most promising imaging modalities for detecting small malignant breast tumors. This paper outlines two modifications to the MIST system developed by Hagness for the early detection of breast cancer, resulting in a quasi-multistatic MIST beamformer (multi-MIST). Multistatic MIST beamforming involves illuminating the breast with an ultrawideband (UWB) signal from one antenna while collecting the reflections at an array of antennas, as opposed to traditional monostatic MIST beamforming where only the transmitting antenna records the reflections from the breast. In order to process the multistatic data, traditional data-adaptive artifact removal algorithms have to be modified to accommodate signals from all antennas. Also, the MIST beamforming algorithm, which spatially focuses the signal and compensates for frequency-dependent propagation effects, has to be modified. The algorithms are tested on a 2-D anatomically accurate finite-difference time-domain model of the breast. The multi-MIST beamformer described here is shown to offer an improved signal to clutter ratio when compared to the traditional monostatic MIST beamformer.

  4. The value of routine physical examination in the follow up of women with a history of early breast cancer

    NARCIS (Netherlands)

    Lu, W.; de Bock, G.H.; Schaapveld, M.; Baas, P.C.; Wiggers, T.; Jansen, L.

    2010-01-01

    PURPOSE: Routine physical examination is recommended in follow up guidelines for women with a history of breast cancer. The objective of this paper is to assess the contribution of routine physical examination in addition to mammography in the early diagnosis of breast cancer recurrences. PATIENTS A

  5. Long-term prognosis of patients with local recurrence after conservative surgery and radiotherapy for early breast cancer

    NARCIS (Netherlands)

    A.C. Voogd (Adri); F.J. van Oost (F.); E.J. Rutgers; S. Elkhuizen (Sylvia); A.N. van Geel (Albert); L.J.E.E. Scheijmans (L. J E E); M.J.C. van der Sangen (Maurice); G. Botke (G.); C.J.M. Hoekstra (C. J M); J.J. Jobsen (Jan); C.J.H. van de Velde (Cornelis); M.F. von Meyenfeldt (Maarten); J.M. Tabak (J.); J.L. Peterse (J.); M.J. Vijver (Marc ); J.W.W. Coebergh (Jan Willem); G. van Tienhoven (Geertjan)

    2005-01-01

    textabstractWe have studied the long-term prognosis of 266 patients considered to have isolated local recurrence in the breast following conservative surgery and radiotherapy for early breast cancer. The median follow-up of the patients still alive after diagnosis of local relapse was 11.2 years. At

  6. Adoption of Intensity Modulated Radiation Therapy For Early-Stage Breast Cancer From 2004 Through 2011

    International Nuclear Information System (INIS)

    Purpose: Intensity modulated radiation therapy (IMRT) is a newer method of radiation therapy (RT) that has been increasingly adopted as an adjuvant treatment after breast-conserving surgery (BCS). IMRT may result in improved cosmesis compared to standard RT, although at greater expense. To investigate the adoption of IMRT, we examined trends and factors associated with IMRT in women under the age of 65 with early stage breast cancer. Methods and Materials: We performed a retrospective study of early stage breast cancer patients treated with BCS followed by whole-breast irradiation (WBI) who were ≤65 years old in the National Cancer Data Base from 2004 to 2011. We used logistic regression to identify factors associated with receipt of IMRT (vs standard RT). Results: We identified 11,089 women with early breast cancer (9.6%) who were treated with IMRT and 104,448 (90.4%) who were treated with standard RT, after BCS. The proportion of WBI patients receiving IMRT increased yearly from 2004 to 2009, with 5.3% of WBI patients receiving IMRT in 2004 and 11.6% receiving IMRT in 2009. Further use of IMRT declined afterward, with the proportion remaining steady at 11.0% and 10.7% in 2010 and 2011, respectively. Patients treated in nonacademic community centers were more likely to receive IMRT (odds ratio [OR], 1.36; 95% confidence interval [CI], 1.30-1.43 for nonacademic vs academic center). Compared to privately insured patients, the uninsured patients (OR, 0.81; 95% CI, 0.70-0.95) and those with Medicaid insurance (OR, 0.87; 95% CI, 0.79-0.95) were less likely to receive IMRT. Conclusions: The use of IMRT rose from 2004 to 2009 and then stabilized. Important nonclinical factors associated with IMRT use included facility type and insurance status

  7. Adoption of Intensity Modulated Radiation Therapy For Early-Stage Breast Cancer From 2004 Through 2011

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Elyn H. [Yale School of Medicine, New Haven, Connecticut (United States); Mougalian, Sarah S. [Yale School of Medicine, New Haven, Connecticut (United States); Yale Cancer Center, New Haven, Connecticut (United States); Cancer Outcomes, Public Policy, and Effectiveness Research Center at Yale, New Haven, Connecticut (United States); Soulos, Pamela R. [Yale School of Medicine, New Haven, Connecticut (United States); Cancer Outcomes, Public Policy, and Effectiveness Research Center at Yale, New Haven, Connecticut (United States); Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut (United States); Smith, Benjamin D. [Department of Radiation Oncology, MD Anderson Cancer Center, Houston, Texas (United States); Haffty, Bruce G. [Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey (United States); Gross, Cary P. [Yale School of Medicine, New Haven, Connecticut (United States); Cancer Outcomes, Public Policy, and Effectiveness Research Center at Yale, New Haven, Connecticut (United States); Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut (United States); Yu, James B., E-mail: james.b.yu@yale.edu [Yale School of Medicine, New Haven, Connecticut (United States); Cancer Outcomes, Public Policy, and Effectiveness Research Center at Yale, New Haven, Connecticut (United States); Department of Therapeutic Radiology, Yale School of Medicine, New Haven, Connecticut (United States)

    2015-02-01

    Purpose: Intensity modulated radiation therapy (IMRT) is a newer method of radiation therapy (RT) that has been increasingly adopted as an adjuvant treatment after breast-conserving surgery (BCS). IMRT may result in improved cosmesis compared to standard RT, although at greater expense. To investigate the adoption of IMRT, we examined trends and factors associated with IMRT in women under the age of 65 with early stage breast cancer. Methods and Materials: We performed a retrospective study of early stage breast cancer patients treated with BCS followed by whole-breast irradiation (WBI) who were ≤65 years old in the National Cancer Data Base from 2004 to 2011. We used logistic regression to identify factors associated with receipt of IMRT (vs standard RT). Results: We identified 11,089 women with early breast cancer (9.6%) who were treated with IMRT and 104,448 (90.4%) who were treated with standard RT, after BCS. The proportion of WBI patients receiving IMRT increased yearly from 2004 to 2009, with 5.3% of WBI patients receiving IMRT in 2004 and 11.6% receiving IMRT in 2009. Further use of IMRT declined afterward, with the proportion remaining steady at 11.0% and 10.7% in 2010 and 2011, respectively. Patients treated in nonacademic community centers were more likely to receive IMRT (odds ratio [OR], 1.36; 95% confidence interval [CI], 1.30-1.43 for nonacademic vs academic center). Compared to privately insured patients, the uninsured patients (OR, 0.81; 95% CI, 0.70-0.95) and those with Medicaid insurance (OR, 0.87; 95% CI, 0.79-0.95) were less likely to receive IMRT. Conclusions: The use of IMRT rose from 2004 to 2009 and then stabilized. Important nonclinical factors associated with IMRT use included facility type and insurance status.

  8. Early detection of breast cancer: a molecular optical imaging approach using novel estrogen conjugate fluorescent dye

    Science.gov (United States)

    Bhattacharjee, Shubhadeep; Jose, Iven

    2011-02-01

    Estrogen induced proliferation of mutant cells is widely understood to be the one of major risk determining factor in the development of breast cancer. Hence determination of the Estrogen Receptor[ER] status is of paramount importance if cancer pathogenesis is to be detected and rectified at an early stage. Near Infrared Fluorescence [NIRf] Molecular Optical Imaging is emerging as a powerful tool to monitor bio-molecular changes in living subjects. We discuss pre-clinical results in our efforts to develop an optical imaging diagnostic modality for the early detection of breast cancer. We have successfully carried out the synthesis and characterization of a novel target-specific NIRf dye conjugate aimed at measuring Estrogen Receptor[ER] status. The conjugate was synthesized by ester formation between 17-β estradiol and a hydrophilic derivative of Indocyanine Green (ICG) cyanine dye, bis-1,1-(4-sulfobutyl) indotricarbocyanine-5-carboxylic acid, sodium salt. In-vitro studies regarding specific binding and endocytocis of the dye performed on ER+ve [MCF-7] and control [MDA-MB-231] adenocarcinoma breast cancer cell lines clearly indicated nuclear localization of the dye for MCF-7 as compared to plasma level staining for MDA-MB-231. Furthermore, MCF-7 cells showed ~4.5-fold increase in fluorescence signal intensity compared to MDA-MB-231. A 3-D mesh model mimicking the human breast placed in a parallel-plate DOT Scanner is created to examine the in-vivo efficacy of the dye before proceeding with clinical trials. Photon migration and florescence flux intensity is modeled using the finite-element method with the coefficients (quantum yield, molar extinction co-efficient etc.) pertaining to the dye as obtained from photo-physical and in-vitro studies. We conclude by stating that this lipophilic dye can be potentially used as a target specific exogenous contrast agent in molecular optical imaging for early detection of breast cancer.

  9. Association of breast feeding practice with worm infestation in children aged 0 -24 months in Calabar South Local Gov-ernment Area

    Institute of Scientific and Technical Information of China (English)

    John Ekabua; Kufre Ekabua; Martin Meremeku

    2009-01-01

    Objective:Reduction in child morbidity and mortality require improved knowledge about hygiene,baby feed-ing and childrearing practices,especially by mothers in low resource nations.The objectives of the study were to compare the prevalence of worm infestation between exclusively and non-exclusively breast -fed children and to determine the age at which exclusively breast -fed children child could be significantly infested with worms. Method:Systematic sampling of 196 mother-infants pairs was done.A pretested interviewer administered semi-structured questionnaire was used for data collection.Fresh stool samples collected from the children were examined using the cellophane thick faecal smear technique of Kato -Katz.Results:The difference in preva-lence of worm infestation within 6 months of age was not significant between the exclusively and non-exclusively breast feed children.Age of significant worm infestation for exclusively breast -fed infants was 13 months. Mother's educational level significantly influenced their de-worming practices.Conclusion:This study showed that breast milk does protect children in the first year of life against worm infestation;but the burden of infesta-tion becomes significant after 12 months of age.Mothers should be taught to de -worm their children from 13 months of age.

  10. Impact of early diagnosis of breast cancer on treatment and outcome

    International Nuclear Information System (INIS)

    The detection of non-palpable and small breast cancers by mammography in asymptomatic women is the really decisive contribution of medical imaging to the treatment and outcome of this by far most common malignant tumor in females. Early detection of the disease not only leads to a significant increase in overall cure rates, but also offers patients the enormous advantage of conservative therapy (conservation surgery and radiotherapy), which practically yields the same long-term results as mutilating radical operations. In the past decade a marked increase in early stages of breast cancer has occured. According to the established selection criteria for conservative treatment, over 70% of all newly diagnosed patients would therefore be candidates for this treatment modality. More than 80% are likely to have excellent cosmetic results. For precision radiotherapy of women with breast cancer, individual pretreatment tomographies (computerized tomograpy or transversal analog tomography) should be obtained for treatment planning in exactly the position to be used for subsequent radiotherapy. Useful images for this purpose can only be recorded in the planning unit of a radiotherapy center. Diagnostic procedures for staging of breast cancer will be discussed as well as the problems of locoregional recurrences and follow-up mammographies after conservative treatment. (Author)

  11. Effect of maternal Chlorella supplementation on carotenoid concentration in breast milk at early lactation.

    Science.gov (United States)

    Nagayama, Junya; Noda, Kiyoshi; Uchikawa, Takuya; Maruyama, Isao; Shimomura, Hiroshi; Miyahara, Michiyoshi

    2014-08-01

    Breast milk carotenoids provide neonates with a source of vitamin A and potentially, oxidative stress protection and other health benefits. Chlorella, which has high levels of carotenoids such as lutein, zeaxanthin and β-carotene, is an effective dietary source of carotenoids for humans. In this study, the effect of maternal supplementation with Chlorella on carotenoid levels in breast milk at early lactation was investigated. Ten healthy, pregnant women received 6 g of Chlorella daily from gestational week 16-20 until the day of delivery (Chlorella group); ten others did not (control group). Among the carotenoids detected in breast milk, lutein, zeaxanthin and β-carotene concentrations in the Chlorella group were 2.6-fold (p = 0.001), 2.7-fold (p = 0.001) and 1.7-fold (p = 0.049) higher, respectively, than those in the control group. Our study shows that Chlorella intake during pregnancy is effective in improving the carotenoid status of breast milk at early lactation.

  12. nab-Paclitaxel in combination with biologically targeted agents for early and metastatic breast cancer.

    Science.gov (United States)

    Megerdichian, Christine; Olimpiadi, Yuliya; Hurvitz, Sara A

    2014-06-01

    Taxanes are highly active chemotherapeutic agents used in the treatment of early-stage and metastatic breast cancer. Novel formulations have been developed to improve efficacy and decrease toxicity associated with these cytotoxic agents. nab-Paclitaxel is a biologically interactive, solvent-free, 130-nm-sized albumin-bound paclitaxel, developed to avoid the Cremophor vehicle used in solvent-based paclitaxel. Based on a pivotal phase 3 study, nab-paclitaxel was shown to be safely infused at a significantly higher dose of paclitaxel than the doses used with standard paclitaxel therapy, and had a shorter infusion time, no premedication, and higher response rates. It is now approved in the United States for treatment of breast cancer after failure of combination chemotherapy for metastatic disease or relapse within 6 months of adjuvant therapy, and has demonstrated promising efficacy and favorable tolerability. Recently, several phase 2 and 3 studies have suggested a role for nab-paclitaxel in combination with biologically targeted agents for the treatment of early- and late-stage breast cancer. This review will discuss the findings of clinical trials evaluating nab-paclitaxel in combination with biologically targeted therapeutic agents for breast cancer in the neoadjuvant, adjuvant, and metastatic settings. PMID:24560997

  13. "Who wants to eat in a toilet?" A social marketing approach to breast-feeding in public places and at work.

    Science.gov (United States)

    Blair-Stevens, Terry; Cork, Sarah

    2008-01-01

    A public health project is described which used social marketing philosophy and techniques to find out how to help facilitate breast-feeding in public places and for mothers returning to work. As part of a strategy to increase local breast-feeding rates, Brighton and Hove Healthy City Partnership, representing the local Primary Care Trust, City Council and the business, academic and voluntary sectors, worked with a social marketing consultancy. The consultancy carried out a literature review and qualitative research that used creative engagement methods to consult with local people. The consultations were with key stakeholders, mothers, and groups traditionally less interested in the subject of breast-feeding, such as employers, elderly people, teenage boys, and fathers. The qualitative research generated in-depth insight and soundly-based, practical recommendations for facilitating breast-feeding. The social marketing approach helped to establish that any ensuing policies and practices would be acceptable to a wide range of the local population. PMID:18973089

  14. 母乳喂养与儿童哮喘的关系%Correlation between breast-feeding and childhood asthma

    Institute of Scientific and Technical Information of China (English)

    田玉双; 金哲英; 王玉凤; 马印慧; 汪俊红

    2011-01-01

    目的 研究母乳喂养对儿童哮喘的影响.方法 对6个月到4岁的164例哮喘儿童和1763名非哮喘儿童进行问卷调查,收集母乳喂养情况,并分析母乳喂养与儿童哮喘的关系.结果 1927名儿童中母乳喂养<4月组的儿童有818例(42.4%),母乳喂养≥4月组的儿童有1109例(57.6%).母乳喂养≥4月组的儿童哮喘发生率显著低于母乳喂养<4月组(x2=6.456,P=0.011),同时母乳喂养可以降低儿童发生哮喘的危险(OR=1.512;95%CI:1.097-2.083).进一步分析发现:年龄<3岁组、女性儿童组、孕周≥37周组、体重<2500 g组、出生时母亲年龄≥30岁组以及父母亲没有过敏史组的儿童母乳喂养≥4月组的哮喘发生率均明显低于母乳喂养<4月组(P<0.05),其他各组的儿童哮喘发生率差异均没有显著性差异(P>0.05).结论 母乳喂养可能减少感染和特应性变态反应,因此可以明显降低儿童的哮喘发生率.%Objective To investigate the effects of breast-fecding on childhood asthma. Methods 164 children with asthma and 1763 children without asthma in 6 months to 4 years of age were investigated by questionnaire. The data of breast-feeding was collected,and analyzed the correlation between breast-feeding and childhood asthma. Results There were 818(42. 4% ) children in breast-feeding <4 months group and 1109 (57.6%) children in breast-feeding≥ 4 months group among 1927 children. The incidence of childhood asthina in breast-feeding ≥4 months group was lower than that in breast-feeding <4 months group (x2 =6.4.56, P=0.011), and breast-feeding could reduce the risk of childhood asthma ( 0R = 1.512; 95% CI: 1. 097~2. 083 ). Further analysis showed that children in age <3 years, female children, gestational age≥37 weeks, weight <2500 g, mother's age≥30 years or parents without allergic history group had lower incidence of asthma by breast-feeding ≥4months than that by breast-feeding < 4 months ( P

  15. Early onset of hypernatraemic dehydration and fever in exclusively breast-fed infants.

    Science.gov (United States)

    Ng, P C; Chan, H B; Fok, T F; Lee, C H; Chan, K M; Wong, W; Cheung, K L

    1999-12-01

    Five cases of moderately severe hypernatraemic dehydration were identified within a 5-month period between two regional hospitals in Hong Kong. Unlike previous reported cases, these exclusively breast-fed infants presented with the unusual triad of fever, absence of overt signs of dehydration and within the first week of life. Three of the cases also had high serum bilirubin concentrations at presentation. The fever subsided quickly and the serum bilirubin concentration fell rapidly within a few hours of rehydration. All infants made an uneventful recovery without permanent neurological sequelae. Fever, presumably secondary to dehydration, is an useful early warning sign. These cases emphasize the importance of early and regular measurement of bodyweight in exclusively breast-fed infants so that prompt identification of affected cases may prevent potentially detrimental complications.

  16. Proficient Feature Extraction Strategy for Performance Enhancement of NN Based Early Breast Tumor Detection

    Directory of Open Access Journals (Sweden)

    Khondker Jahid Reza

    2014-01-01

    Full Text Available Ultra Wideband is one of the promising microwave imaging techniques for breast tumor prognosis. The basic principle of tumor detection depends on the dielectric properties discrepancies between healthy and tumorous tissue. Usually, the tumor affected tissues scatter more signal than the healthy one and are used for early tumor detection through received pulses. Feedforward backpropagation neural network(NN was so far used for some research works by showing its detection efficiency up to 1mm (radius size with 95.8% accuracy. This paper introduces an efficient feature extraction method to further improve the performance by considering four main features of backpropagation NN. This performance is being increased to 99.99%. This strategy is well justified for classifying the normal and tumor affected breast with 100% accuracy in its early stage. It also enhances the training and testing performances by reducing the required duration. The overall performance is 99.99% verified by using thirteen different tumor sizes.

  17. Preference for subcutaneous or intravenous administration of trastuzumab in patients with HER2-positive early breast cancer (PrefHer)

    DEFF Research Database (Denmark)

    Pivot, Xavier; Gligorov, Joseph; Müller, Volkmar;

    2013-01-01

    Subcutaneous trastuzumab has shown non-inferior efficacy and a similar pharmacokinetic and safety profile when compared with intravenous trastuzumab in patients with HER2-positive early breast cancer. We assessed patient preference for either subcutaneous or intravenous trastuzumab...

  18. Onset and relapse of psychiatric disorders following early breast cancer: a case-control study. : Mental health of primary breast cancer survivors

    OpenAIRE

    Gandubert, Catherine; Carrière, Isabelle; Escot, Chantal; Soulier, Maryvonne; Hermès, Aziz; Boulet, Patrick; Ritchie, Karen; Chaudieu, Isabelle

    2009-01-01

    International audience OBJECTIVE: Our objective is to evaluate the mental status of primary early breast cancer survivors according to DSM-IV criteria, distinguishing new psychiatric diagnosis, which started after the cancer diagnosis from relapse. METHODS: A comparative study of 144 breast cancer survivors and 125 women without previous history of cancer was carried out. Neuropsychiatric symptomatology was assessed retrospectively using standardized psychiatric examinations (Mini Internat...

  19. De novo recurrent germline mutation of the BRCA2 gene in a patient with early onset breast cancer

    OpenAIRE

    van der Luijt, R. B.; van Zon, P. H A; Jansen, R.; van der Sijs-Bos, C. J M; Warlam-Rodenhuis, C.; Ausems, M.

    2001-01-01

    Germline mutations in either of the two major breast cancer predisposition genes, BRCA1 and BRCA2, account for a significant proportion of hereditary breast/ovarian cancer. Identification of breast cancer patients carrying mutations of these genes is primarily based on a positive family history of breast/ovarian cancer or early onset of the disease or both. In the course of mutation screening of the BRCA1 and BRCA2 genes in a hospital based series of patients with risk factors for hereditary ...

  20. [Evaluation of a diet and nutritional status of breast feeding women on the basis of a questionnaire study].

    Science.gov (United States)

    Weker, H; Rudzka-Kańtoch, Z; Dylag, H; Strucińska, M; Klemarczyk, W

    1999-01-01

    The subjects were 120 breast-feeding mothers whose children were admitted for outpatient or inpatient treatment at the Institute of Mother and Child in Warsaw, between March, 1998 and July, 1999. A special nutritional questionnaire was elaborated with the aim to evaluate subjects' nutritional status as well as their diet. All subjects completed the questionnaire and then selected parameters of their nutritional status and diet were evaluated. For 43 of the women under study it was the first month of lactation, for 33--the fourth month, for 23--the sixth and 21 women had been breast-feeding for more then six months. The subjects were of different age, coming from both urban and rural areas. In the studied group the nutritional status, i.e. body mass indices (BMI) before pregnancy, at the end of pregnancy and during lactation were within the normal range. 65 of the subjects had changed their diet due to pregnancy and 52 due to lactation. Women declared to be used to eating 3-4 meals per day. Having additional snacks was declared by 62.5%. Liquids' intake was on average about 2.5 l/24 hr, range 2-31. Average daily energy intake--2938 kcal/12,980 kJ, the lowest--in a diet of a mother with diabetes, the highest--in a diet of a vegetarian mother. The proportion of protein in energy intake was 15.1%, whereas fat--36.3%. Dietary practices of women under study in the period of lactation were well adjusted to nutritional recommendations for this group, as evidenced by indices of nutritional status (i.e. BMI). Among 120 women, 71 were taking supplementary preparations of vitamins and minerals. It turned out that a level of some vitamins in a daily food intake together with supplementation was definitely too high.

  1. Axillary treatment for patients with early breast cancer and lymph node metastasis: systematic review protocol

    OpenAIRE

    Goyal Amit; Duley Lelia; Fakis Apostolos

    2013-01-01

    Abstract Background For patients with early breast cancer and lymph node metastasis, axillary treatment is widely recommended. This is either surgical removal of the axillary lymph nodes, or axillary radiotherapy. The rationale for axillary treatment is that it will reduce the risk of recurrence in the axilla, and may improve survival. However, both treatments are associated with adverse effects, such as lymphedema, pain and sensory loss, and are costly to the health services and to patients....

  2. Diagnostic accuracy of mammography and ultrasonography in detection of early breast cancer

    International Nuclear Information System (INIS)

    To determine the value of mammography and ultrasonography in the detection of early breast cancer, and the usefulness of combining the two modalities for the diagnostic study of this condition. The mammographic and ultrasonographic features of 47 female patients aged 23-68 (average, 46) years with pathologically proven early breast cancer were analyzed retrospectively. Mammography was preformed in 46 patients and ultrasonography in 38, and 37 underwent both mammography and ultrasonography. Analysis of the mammographic and/or ultrasonographic features focused on mass, microcalcification, mass with microcalcification, multiple nodules, duct dilatation, and architectural distortion. Mammography revealed microcalcification in 29 (63%) patients, mass in 13 (28%) patients, mass with microcalcification in 8 (17%) patients, multiple nodules in 2 (4%) patients, architectural distortions in 1 (2%) patient, and negative finding in 9 (20%) patients. Ultrasonography revealed mass in 25 (66%) patients, microcalcification in 9 (24%) patients, mass with microcalcification in 8 (21%) patients, multiple nodules in 2 (5%) patients, duct dilatation in 3 (8%) patients, and negative finding in 7 (18%) patients. On combined study of mammography and ultrasonography of the 37 patients, mammography or ultrasonography revealed mass in 25 (68%) patients, microcalcification in 20 (54%) patients, multiple nodules in 2 (5%) patients, duct dilatation in 3 (8%) patients, and architectural distortion in 1 (3%) patient. In one (3%) patient among them, both mammography and ultrasonography revealed negative findings. The false negative rate of mammography, ultrasonography or both was 20%, 18%, and 3%, respectively, which was statistically significant difference (p<0.05). Combined study of mammography and ultrasonography is the most useful as a diagnostic study for early breast cancer. So, ultrasonography seems to be important additional method for detection of early breast cancer

  3. Effects of early weaning on finishing feed efficiency, marbling development and retail product quality of beef steers

    OpenAIRE

    Smith, Jason Kaleb

    2015-01-01

    Beef cattle producers continuously search for nutritional management options that provide flexibility to production scenarios. Due to its positive effects on maternal productivity, early weaning is one such alternative strategy that has received considerable interest. To better understand the effects of early weaning on calf productivity, an extensive literature review and three experiments were conducted to evaluate the effects of early weaning on finishing feed efficiency, marbling develo...

  4. Characteristics of breast milk and serology of women donating breast milk to a milk bank

    OpenAIRE

    Lindemann, P.; Foshaugen, I; Lindemann, R

    2004-01-01

    Objective: Breast milk is the most important nutrient to all newborn babies. If the mother's milk production is insufficient, it is important to provide donor breast milk without reduction of its immunologic and antimicrobial properties. Early use of breast milk to preterm infants has shown a reduced incidence of necrotising enterocolitis, a faster tolerance of enteral feeding, and a reduced need of parenteral nutrition. It is important to have milk from a CMV-IgG negative donor to VLBW infan...

  5. Filling the Gap for Early-Stage Breast Cancer Follow-Up: An Overview for Primary Care Providers.

    Science.gov (United States)

    Bond-Bero, Stacy

    2016-01-01

    Earlier detection and newer treatments now make breast cancer highly survivable, and breast cancer survivors are the largest female cancer survivor group in the United States. With earlier detection, more women are being diagnosed with early-stage breast cancer and need follow-up care. With the increasing number of breast cancer survivors, there is a projected shortage in the workforce of oncology specialists to care for these women. The American Society of Clinical Oncology recommends that breast cancer follow-up care can be provided by an oncologist or primary care provider, as long as the primary care provider has spoken to the oncologist about appropriate follow-up care. Several studies have shown that primary care providers and oncologists have comparable outcomes for follow-up care of women with early-stage breast cancer. The National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology (NCCN Guidelines) are considered the gold standard for breast cancer treatment and follow-up. These guidelines are clear and straightforward. Using knowledge of the NCCN Guidelines, primary care providers can fill the gap for follow-up care of women with early-stage breast cancer.

  6. Expression of the embryonic stem cell marker SOX2 in early-stage breast carcinoma

    Directory of Open Access Journals (Sweden)

    Wallwiener Diethelm

    2011-01-01

    Full Text Available Abstract Background The SRY-related HMG-box family of transcription factors member SOX2 has been mainly studied in embryonic stem cells as well as early foregut and neural development. More recently, SOX2 was shown to participate in reprogramming of adult somatic cells to a pluripotent stem cell state and implicated in tumorigenesis in various organs. In breast cancer, SOX2 expression was reported as a feature of basal-like tumors. In this study, we assessed SOX2 expression in 95 primary tumors of postmenopausal breast cancer patients. Methods Samples from 95 patients diagnosed and treated at the University of Tuebingen Institute of Pathology and Women's Hospital were analyzed by immunohistochemistry for SOX2 expression in the primary tumor samples and in corresponding lymph node metastasis, where present. Furthermore, SOX2 amplification status was assessed by FISH in representative samples. In addition, eighteen fresh frozen samples were analyzed for SOX2, NANOG and OCT4 gene expression by real-time PCR. Results SOX2 expression was detected in 28% of invasive breast carcinoma as well as in 44% of ductal carcinoma in situ (DCIS lesions. A score of SOX2 expression (score 0 to 3 was defined in order to distinguish SOX2 negative (score 0 from SOX2 positive samples (score 1-3 and among latter the subgroup of SOX2 high expressors (score 3 > 50% positive cells. Overall, the incidence of SOX2 expression (score 1-3 was higher than previously reported in a cohort of lymph node negative patients (28% versus 16.7%. SOX2 expression was detected across different breast cancer subtypes and did not correlate with tumor grading. However, high SOX2 expression (score 3 was associated with larger tumor size (p = 0.047 and positive lymph node status (0.018. Corresponding metastatic lymph nodes showed higher SOX2 expression and were significantly more often SOX2 positive than primary tumors (p = 0.0432. Conclusions In this report, we show that the embryonic stem

  7. Study of Relationship between Hypernatremia in Neonates and Way of Maternal Breast Feeding

    OpenAIRE

    H Boskabadi; Godarzi, M; M Zakerihamidi; F. Bagheri

    2014-01-01

    Introduction: The extreme reduction in breast milk intake during the first days of life leads to weight loss, kidney failure and hypernatremia. The aim of this study was to examine the relationship between hypernatremia in neonates and way of maternal breastfeeding in hospitalized infants in Ghaem Hospital of Mashhad.   Materials and Methods: After obtaining parental consent, 687 infants referred to the neonatal ward and clinic of Ghaem hospital of Mashhad participated in this cross-sectional...

  8. Gut Microbiome Developmental Patterns in Early Life of Preterm Infants: Impacts of Feeding and Gender.

    Directory of Open Access Journals (Sweden)

    Xiaomei Cong

    Full Text Available Gut microbiota plays a key role in multiple aspects of human health and disease, particularly in early life. Distortions of the gut microbiota have been found to correlate with fatal diseases in preterm infants, however, developmental patterns of gut microbiome and factors affecting the colonization progress in preterm infants remain unclear. The purpose of this prospective longitudinal study was to explore day-to-day gut microbiome patterns in preterm infants during their first 30 days of life in the neonatal intensive care unit (NICU and investigate potential factors related to the development of the infant gut microbiome. A total of 378 stool samples were collected daily from 29 stable/healthy preterm infants. DNA extracted from stool was used to sequence the V4 region of the 16S rRNA gene region for community analysis. Operational taxonomic units (OTUs and α-diversity of the community were determined using QIIME software. Proteobacteria was the most abundant phylum, accounting for 54.3% of the total reads. Result showed shift patterns of increasing Clostridium and Bacteroides, and decreasing Staphylococcus and Haemophilus over time during early life. Alpha-diversity significantly increased daily in preterm infants after birth and linear mixed-effects models showed that postnatal days, feeding types and gender were associated with the α-diversity, p< 0.05-0.01. Male infants were found to begin with a low α-diversity, whereas females tended to have a higher diversity shortly after birth. Female infants were more likely to have higher abundance of Clostridiates, and lower abundance of Enterobacteriales than males during early life. Infants fed mother's own breastmilk (MBM had a higher diversity of gut microbiome and significantly higher abundance in Clostridiales and Lactobacillales than infants fed non-MBM. Permanova also showed that bacterial compositions were different between males and females and between MBM and non-MBM feeding types

  9. Is early dynamic lymphoscintigraphy for detection of sentinel lymph nodes always achievable in breast tumor?

    International Nuclear Information System (INIS)

    In this article, we will discuss the achievement of early dynamic lymphoscintigraphic protocol and compare detection of sentinel node between benign and malignant breast tumors, and whether pathologic factor is related or not. During a six-month period, consecutive fifty-nine patients were enrolled into our study. The average age of patients was 47.6±9.8 years and all of them were clinically suspected of having breast cancer. The average tumor was 2.1±1.1 cm in size. First, Tc-99m sulfur colloid was injected around corners of palpable mass or biopsy cavity by the hybrid injection method. Immediately thereafter, dynamic protocol of lymphoscintigraphy, with 10 sec per frame for 60 frames was performed by established simultaneous dual-head vertical angle imaging technique. And delayed two-hour image was also acquired. All patients underwent surgery sixteen to twenty hours later and had a final pathological diagnosis. Among 59 patients, 14 of them were diagnosed with fibroadenoma and the other 45 cases with malignant conditions, infiltrating duct carcinoma mostly. The average age of the two groups was similar. From the summation image of dynamic study, identified axillary sentinel nodal activity was found as 80% in the group of benign breast tumor, but only 48% in the group of malignant breast tumor. In more than 88% of patients, sentinel lymph node was detectable on the delayed two-hour image between the two groups. Early dynamic protocol of pre-operative lymphoscintigraphy is helpful to clarify the relationship between the local lymphatic drainage basin and sentinel nodal uptake. However, this short period of protocol is not always achievable to detect sentinel node, especially in the group with breast malignant lesions. (author)

  10. Risk factors for recurrence after conservative treatment in early breast cancer; Preliminary report

    International Nuclear Information System (INIS)

    To evaluate our experience in the breast-conserving treatment for early breast cancer with special regard to recurrence pattern and related risk factors. Two hundred and sixteen patients with AJC stage I and II beast cancer who received breast conserving treatment between January 1991 and December 1994 were evaluated. Age distribution ranged from 23-80 year old with a median age of 44. One hundred and seventeen patients had T1 lesions and 99 patients had T2 lesions. Axillary lymph nodes were involved in 73 patients. All patients received a breast conserving surgery (wide excision to quadrantectomy) and axillary node dissection followed by radiotherapy. Ninety six patients received chemotherapy before or after radiotherapy. During the follow-up period (3-60 months, median 30 months), local recurrence were noted in six patients (true; 3, elsewhere; 1, skin; 2). Sixteen patients developed distant metastases as the first sign of recurrence at 8-38 months (median 20 months) after surgery. Among them, three patients simultaneously developed local recurrence with distant metastases. Contralateral breast cancer developed in one patient and non-mammary cancers developed in three patients. The actuarial 5 year survival rate was 88.4% (stage I: 96.7%, stage IIa: 95.2%, stage IIb 69.9%). Age, T stage, number of involved axillary lymph nodes, and AJC stage were risk factors for distant metastases in univariate analysis. In the multivariate analysis, the number of involved axillary lymph nodes was the most significant risk factor for metastases. Local recurrence was not common in the early years after radiotherapy. Distant metastases occurred at a steady rate during the first three years and was more common in the patients with larger tumors, higher number of involved axillary nodes, and younger age. (author)

  11. Risk factors for recurrence after conservative treatment in early breast cancer; Preliminary report

    Energy Technology Data Exchange (ETDEWEB)

    Suh, C. O.; Chung, E. J.; Lee, H. D.; Lee, K. S.; Oh, K. K.; Kim, G. E. [Yonsei Univ., Seoul (Korea, Republic of). Coll. of Medicine

    1997-12-01

    To evaluate our experience in the breast-conserving treatment for early breast cancer with special regard to recurrence pattern and related risk factors. Two hundred and sixteen patients with AJC stage I and II beast cancer who received breast conserving treatment between January 1991 and December 1994 were evaluated. Age distribution ranged from 23-80 year old with a median age of 44. One hundred and seventeen patients had T1 lesions and 99 patients had T2 lesions. Axillary lymph nodes were involved in 73 patients. All patients received a breast conserving surgery (wide excision to quadrantectomy) and axillary node dissection followed by radiotherapy. Ninety six patients received chemotherapy before or after radiotherapy. During the follow-up period (3-60 months, median 30 months), local recurrence were noted in six patients (true; 3, elsewhere; 1, skin; 2). Sixteen patients developed distant metastases as the first sign of recurrence at 8-38 months (median 20 months) after surgery. Among them, three patients simultaneously developed local recurrence with distant metastases. Contralateral breast cancer developed in one patient and non-mammary cancers developed in three patients. The actuarial 5 year survival rate was 88.4% (stage I: 96.7%, stage IIa: 95.2%, stage IIb 69.9%). Age, T stage, number of involved axillary lymph nodes, and AJC stage were risk factors for distant metastases in univariate analysis. In the multivariate analysis, the number of involved axillary lymph nodes was the most significant risk factor for metastases. Local recurrence was not common in the early years after radiotherapy. Distant metastases occurred at a steady rate during the first three years and was more common in the patients with larger tumors, higher number of involved axillary nodes, and younger age. (author).

  12. Risk of docetaxel-induced peripheral neuropathy among 1,725 Danish patients with early stage breast cancer

    DEFF Research Database (Denmark)

    Eckhoff, L; Knoop, A S; Jensen, M-B;

    2013-01-01

    Docetaxel-induced peripheral neuropathy (PN) can lead to sub-optimal treatment in women with early breast cancer. Here, we compare the frequency of dose reduction as a result of PN in two different adjuvant regimens. From the Danish Breast Cancer Cooperative Group READ trial we included 1......,725 patients with early stage breast cancer who randomly were assigned to three cycles of epirubicin and cyclophosphamide followed by three cycles docetaxel (D100) or six cycles of cyclophosphamide and docetaxel (D75). Eligible patients completed chemotherapy, received docetaxel, and provided information...

  13. AGR3 in Breast Cancer: Prognostic Impact and Suitable Serum-Based Biomarker for Early Cancer Detection

    Science.gov (United States)

    Garczyk, Stefan; von Stillfried, Saskia; Antonopoulos, Wiebke; Hartmann, Arndt; Schrauder, Michael G.; Fasching, Peter A.; Anzeneder, Tobias; Tannapfel, Andrea; Ergönenc, Yavuz; Knüchel, Ruth

    2015-01-01

    Blood-based early detection of breast cancer has recently gained novel momentum, as liquid biopsy diagnostics is a fast emerging field. In this study, we aimed to identify secreted proteins which are up-regulated both in tumour tissue and serum samples of breast cancer patients compared to normal tissue and sera. Based on two independent tissue cohorts (n = 75 and n = 229) and one serum cohort (n = 80) of human breast cancer and healthy serum samples, we characterised AGR3 as a novel potential biomarker both for breast cancer prognosis and early breast cancer detection from blood. AGR3 expression in breast tumours is significantly associated with oestrogen receptor α (P<0.001) and lower tumour grade (P<0.01). Interestingly, AGR3 protein expression correlates with unfavourable outcome in low (G1) and intermediate (G2) grade breast tumours (multivariate hazard ratio: 2.186, 95% CI: 1.008-4.740, P<0.05) indicating an independent prognostic impact. In sera analysed by ELISA technique, AGR3 protein concentration was significantly (P<0.001) elevated in samples from breast cancer patients (n = 40, mainly low stage tumours) compared to healthy controls (n = 40). To develop a suitable biomarker panel for early breast cancer detection, we measured AGR2 protein in human serum samples in parallel. The combined AGR3/AGR2 biomarker panel achieved a sensitivity of 64.5% and a specificity of 89.5% as shown by receiver operating characteristic (ROC) curve statistics. Thus our data clearly show the potential usability of AGR3 and AGR2 as biomarkers for blood-based early detection of human breast cancer. PMID:25875093

  14. 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. PMID:26993371

  15. Pregnant women’s knowledge about Mother-to-Child Transmission (MTCT of HIV infection through breast feeding

    Directory of Open Access Journals (Sweden)

    MS Maputle

    2008-09-01

    Full Text Available The HIV and AIDS epidemic in South Africa has reached serious proportions. Over 5, 5 million South Africans are infected with HIV (Department of Health, 2004:10. Mother to Child Transmission (MTCT is a well-established mode of HIV transmission and these infections may occur during pregnancy, labour, delivery and breastfeeding. According to the Department of Health (2000:2, breastfeeding constitutes a significant risk of MTCT HIV transmission. Studies in Africa have also shown that breast-feeding increases the risk of MTCT by 12%-43% (Department of Health, 2000:13; Department of Health, 2000:3. Since breastfeeding is a significant and preventable mode of HIV transmission to infants, there is an urgent need to educate, counsel and support women and families to make informed decisions about how best to feed their infants in the context of HTV. To achieve a reduction in MTCT, there is an urgent need to empower women with information on MTCT for informed decision-making. However, cultural factors and the stigma associated with HIV and AIDS might contribute to limited knowledge about MTCT through breastfeeding.

  16. Impact of comorbidity on mortality: a cohort study of 62,591 Danish women diagnosed with early breast cancer, 1990-2008

    DEFF Research Database (Denmark)

    Land, Lotte Holm; Dalton, Susanne Oksbjerg; Jensen, Maj-Britt;

    2011-01-01

    The incidence of breast cancer, as well as other chronic disease, increases with age, older breast cancer patients being more likely than younger to suffer from other diseases at time of diagnosis. Our objective was to assess the effect of comorbidity on mortality after early breast cancer. 62......,591 women diagnosed with early breast cancer 1990-2008 were identified using the Danish Breast Cancer Cooperative Group Registry. Data were linked to the Danish National Patient Register and the Danish Register of Causes of Death. Main outcome measures were mortality from all causes, breast cancer, and non...

  17. Association between Infant Feeding and Early Postpartum Infant Body Composition: A Pilot Prospective Study

    Directory of Open Access Journals (Sweden)

    Alex Kojo Anderson

    2009-01-01

    Full Text Available Research studies have produced conflicting results of the impact of breastfeeding on overweight/obesity. This study evaluated the impact of infant feeding on infant body composition. There were two groups of mother-infant pairs (exclusive breastfeeding [EBF; n=27] and mixed feeding [MF; n=13] in this study. At baseline, participants were similar in their demographic characteristics except prepregnancy weight, where MF mothers tended to be heavier than their EBF counterparts (67.3 kg versus 59.9 kg; P=.034. Infant birth weight was slightly higher among the MF group than their EBF counterparts (3.5 kg versus 3.4 kg, although the differences were not statistically significant. At 3 months postpartum, mean infant FMI (4.1 kg/m2 versus 3.8 kg/m2 and percent body fat (24.4% versus 23.1% were slightly higher among EBF infants than MF infants. In terms of growth velocity, EBF infants gained weight faster than their MF counterparts, although the differences were not statistically significant. The findings from this study suggest that EBF may promote faster weight gain and increase in both fat mass index (FMI and percent body fat in the early postpartum period in addition to the numerous health benefits enjoyed by the infant and the mother who exclusively breastfeeds her newborn.

  18. Axillary treatment for patients with early breast cancer and lymph node metastasis: systematic review protocol

    Directory of Open Access Journals (Sweden)

    Goyal Amit

    2013-01-01

    Full Text Available Abstract Background For patients with early breast cancer and lymph node metastasis, axillary treatment is widely recommended. This is either surgical removal of the axillary lymph nodes, or axillary radiotherapy. The rationale for axillary treatment is that it will reduce the risk of recurrence in the axilla, and may improve survival. However, both treatments are associated with adverse effects, such as lymphedema, pain and sensory loss, and are costly to the health services and to patients. With improvements in adjuvant therapy, routine axillary treatment may no longer offer any overall advantage. Objectives To assess the short and long term benefits and adverse effects of routine axillary treatment (axillary lymph node clearance or axillary radiotherapy for patients with lymph node positive early-stage breast cancer. Methods/Design Criteria for potentially eligibility for the study will be that the participants are men and women with early breast cancer and lymph nodes with metastasis. The study compares either axillary treatment with no axillary treatment, or axillary node clearance with axillary radiotherapy, and the study is a randomized trial. Primary outcomes are axillary recurrence, disease-free and overall survival. Secondary outcomes include breast or chest wall recurrence, distant metastasis, time to axillary recurrence, axillary recurrence-free survival, arm morbidity, quality of life and health economic costs. The search strategy will include the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE and WHO International Clinical Trials Registry Platform (ICTRP search portal. Two independent reviewers will assess studies for inclusion in the review, assess study quality and extract data. Characteristics of included studies will be described. Meta-analysis will be conducted using ReVman software. Comment This review addresses an important clinical question, and results will inform clinical practice and health care policy.

  19. Morbidity of ischemic heart disease in early breast cancer 15-20 years after adjuvant radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Gyenes, G.; Rutqvist, L.E. (Karolinksa Hospital, Stockholm (Sweden)); Fornander, T.; Carlens, P.

    1994-03-30

    The purpose of this study was to assess the cardiac side effects, primarily the occurrence of ischemic heart disease, in symptom-free patients with early breast cancer treated with radiotherapy. Thirty-seven survivors of a former randomized study of early breast cancer were examined. Twenty patients irradiated pre- or postoperatively for left sided disease (study group patients) were compared with 17 controls who were either treated for right sided disease, or were nonirradiated patients. Radiotherapy was randomized in the original study; either tangential field [sup 60]Co, or electron-therapy was delivered. Echocardiography and bicycle ergometry stress test with [sup 99m]Tc SestaMIBI myocardial perfusion scintigraphy were carried out and the patients' major risk factors for ischemic heart disease were also listed. Our results showed a significant difference between the scintigraphic findings of the two groups. Five of the 20 study group patients (25%), while none of the 17 controls exhibited some kind of significant defects on scintigraphy, indicating ischemic heart disease (p < 0.05). No deterioration in left ventricular systolic and/or diastolic function could be detected by echocardiography. Radiotherapy for left sided breast cancer with the mentioned treatment technique may present as an independent risk factor in the long-term development of ischemic heart disease, while left ventricular dysfunction could not be related to the previous irradiation. The authors emphasize the need to optimize adjuvant radiotherapy for early breast cancer by considering the dose both to the heart as well as the cancer. 39 refs., 4 tabs.

  20. Energy intake and requirements of infants in southern Brazil - the influence of breast feeding pattern and socio-economic status

    International Nuclear Information System (INIS)

    Energy requirements are a function of age, sex, and feeding mode. Work from others has demonstrated increased total energy expenditure (TEE) and sleeping metabolic rate (SMR) in formula-fed infants as compared to breast-fed infants. However, in practice many breast-fed infants also receive additional formula or cows' milk. At 4 months, we found that energy intake (kcal/d) in breast-fed infants also receiving cows' milk (BCFM) was 18% higher than that of infants who receive breast milk as the only source of milk (BM) (BCFM infants, 97.9 kcal/kg/d, BM infants, 83.1 kcal/kg/d, p=0.008). At 8 months increased minimal observable energy expenditure (MOEE) and SMR were found in BCFM infants (MOEE: BCFM infants, 51.6 kcal/kg/d, BM infants, 48.0 kcal/kg/d, p=0.041). TEE was also slightly higher, but not significantly so. Fat mass and fat mass index were higher in BCFM infants (p=0.016 and p=0.013). Reference data for growth or energy requirements have been based on infants from high SES to assure that they would be growing optimally with no constraints to health. In developed countries, obesity used to be a problem in the higher SES families. In countries in transition, there is a shift of the prevalence of obesity towards lower SES infants, but this depends on the stage of transition. On the other hand, poor living conditions may result in growth faltering, and an increase in TEE and ER. We observed higher TEE in low SES as compared to high SES infants (high SES, 62.9 kcal/kg/d, low SES, 75.9 kcal/kg/d, p=0.005), MOEE was not increased, and the higher TEE in low SES infants should be contributed to high activity energy expenditure. Analysis of covariance showed that this should be contributed increased crowding in the low SES families. In conclusion, the development of universally applicable values for energy requirements based on data from infants selected from particular social groups, without reference to feeding pattern, may not be acceptable. At both 4 and 8 months

  1. Cytokines, Fatigue, and Cutaneous Erythema in Early Stage Breast Cancer Patients Receiving Adjuvant Radiation Therapy

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    Vitaliana De Sanctis

    2014-01-01

    Full Text Available We investigated the hypothesis that patients developing high-grade erythema of the breast skin during radiation treatment could be more likely to present increased levels of proinflammatory cytokines which may lead, in turn, to associated fatigue. Forty women with early stage breast cancer who received adjuvant radiotherapy were enrolled from 2007 to 2010. Fatigue symptoms, erythema, and cytokine levels (IL-1β, IL-2, IL6, IL-8, TNF-α, and MCP-1 were registered at baseline, during treatment, and after radiotherapy completion. Seven (17.5% patients presented fatigue without associated depression/anxiety. Grade ≥2 erythema was observed in 5 of these 7 patients. IL-1β, IL-2, IL-6, and TNF-α were statistically increased 4 weeks after radiotherapy (P<0.05. After the Heckman two-step analysis, a statistically significant influence of skin erythema on proinflammatory markers increase (P = 0.00001 was recorded; in the second step, these blood markers showed a significant impact on fatigue (P = 0.026. A seeming increase of fatigue, erythema, and proinflammatory markers was observed between the fourth and the fifth week of treatment followed by a decrease after RT. There were no significant effects of hormone therapy, breast volume, and anemia on fatigue. Our study seems to suggest that fatigue is related to high-grade breast skin erythema during radiotherapy through the increase of cytokines levels.

  2. 早期乳腺癌部分乳腺加速放疗%Accelerated partial breast irradiation for early breast cancer

    Institute of Scientific and Technical Information of China (English)

    张秋宁; 王小虎

    2011-01-01

    随着乳腺癌术后复发模式的研究进展,部分乳腺照射方法 成为乳腺癌放疗的热点.组织间插植、球囊近距离治疗、术中放疗及三维适形放疗和调强放疗等部分乳腺加速放疗已进入临床研究.其局部控制率和安全性与全乳腺照射比较相当,同时具有治疗周期短、方便患者等优势.部分乳腺加速放疗在部分患者有望代替全乳腺放疗,成为早期乳腺癌保乳术后放疗的标准治疗之一.%With a view to patterns of local recurrence after breast conserving surgery, whole breast irradiation(WBI) after surgery is controversial and partial-breast irradiation(PBI) came up. Many clinical trials related with accelerated partial-breast irradiation using a variety of radiotherapeutic techniques such as interstitial brachytherapy (IBT), MammoSite Radiation Therapy System, intraoperative radiotherapy(IORT), threedimensional conformal radiotherapy(3-DCRT)and intensity modulated radiation therapy(IMRT) in selected patients have been carried out. Accelerated partial-breast irradiation that provides faster, more convenient treat-ment demonstrates local control rate and safety comparable to that of whole breast irradiation. Partial breast irradiation may be an alternative way to whole breast radiotherapy and will be one of the standard treatments in women with early breast cancer seeking breast conservation.

  3. Neoadjuvant therapy for early-stage breast cancer: the clinical utility of pertuzumab

    Directory of Open Access Journals (Sweden)

    Gollamudi J

    2016-02-01

    Full Text Available Jahnavi Gollamudi,1,* Jenny G Parvani,2,* William P Schiemann,3 Shaveta Vinayak3,4 1Department of Internal Medicine, 2Department of Biomedical Engineering, 3Case Comprehensive Cancer Center, Case Western Reserve University, 4Department of Hematology and Oncology, University Hospitals Case Medical Center, Cleveland, OH, USA *These authors contributed equally to this work Abstract: Approximately 20% of breast cancer patients harbor tumors that overexpress human epidermal growth factor receptor 2 (HER2; also known as ErbB2, a receptor tyrosine kinase that belongs to the epidermal growth factor receptor family of receptor tyrosine kinases. HER2 amplification and hyperactivation drive the growth and survival of breast cancers through the aberrant activation of proto-oncogenic signaling systems, particularly the Ras/MAP kinase and PI3K/AKT pathways. Although HER2-positive (HER2+ breast cancer was originally considered to be a highly aggressive form of the disease, the clinical landscape of HER2+ breast cancers has literally been transformed by the approval of anti-HER2 agents for adjuvant and neoadjuvant settings. Indeed, pertuzumab is a novel monoclonal antibody that functions as an anti-HER2 agent by targeting the extracellular dimerization domain of the HER2 receptor; it is also the first drug to receive an accelerated approval by the US Food and Drug Administration for use in neoadjuvant settings in early-stage HER2+ breast cancer. Here, we review the molecular and cellular factors that contribute to the pathophysiology of HER2 in breast cancer, as well as summarize the landmark preclinical and clinical findings underlying the approval and use of pertuzumab in the neoadjuvant setting. Finally, the molecular mechanisms operant in mediating resistance to anti-HER2 agents, and perhaps to pertuzumab as well, will be discussed, as will the anticipated clinical impact and future directions of pertuzumab in breast cancer patients. Keywords: breast cancer

  4. Treatment results and prognostic factors of early breast cancer treated with a breast conserving operation and radiotherapy

    International Nuclear Information System (INIS)

    The purpose of this study was to analyze the prognostic factors affecting local control and survival rates for patients with early breast cancer who received breast conserving treatment (BCT) and to find out the optimal treatment according to their risk factors. From October 1994 to December 2001, 605 patients with 611 stage I and II breast cancers received BCT, and the results were analyzed retrospectively. BCT consists of breast conserving surgery and whole breast irradiation. All the patients underwent lumpectomy or quad-rantectomy. Axillary lymph node dissection or sentinel lymph node biopsy was performed in 608 cases (99.5%). The radiation dose to the whole breast was 50.4 Gy over 5 weeks with a 1.8 Gy daily fraction and with boost doses of 9-14.4 Gy administered to the tumor bed. Adjuvant chemotherapy was performed in most of the patients with axillary lymph node metastasis or tumors larger than 1 cm. The median follow-up period was 47 months. Local relapse, regional relapse and distant metastasis occurred in 15 (2.5%), 16 (2.6%) and 43 patients (7.1%), respectively. The 5-year overall survival, local-relapse-free survival, distant-metastasis-free survival and disease-free survival rates were 95.3%, 97.2%, 91.3% and 88.5%, respectively. On multivariate analysis, age (P=0.02), number of involved axillary lymph nodes (P=0.01) and nuclear grade (P=0.01) affected the local-relapse-free survival. The factors associated with disease-free survival were the T stage (P=0.05), number of involved axillary lymph nodes (P=0.01) and nuclear grade (P=0.001). Overall survival was associated with the T stage (P=0.02), number of involved axillary lymph nodes (P=0.01) and c-erb B2 overexpression (P=0.05). Patients with more than two factors among age≤35 years, positive lymph node metastasis and high nuclear grade showed a poor 5-year local-relapse-free survival rate compared with others (P=0.001). Also, patients with more than two factors among tumor size >1 cm, positive

  5. THE CLINICAL SIGNIFICANCE OF 99mTc-MIBI BREAST IMAGING IN THE DIAGNOSIS OF EARLY BREAST CANCER

    Institute of Scientific and Technical Information of China (English)

    任长才; 金少津; 邹强; 朱汇庆; 王红鹰; 梁春立

    2001-01-01

    Objective: To find an effective, sensitive, specific and noninvasive diagnostic method of breast cancer. Methods: 109 masses of 102 patients with breast lesions smaller than 2 cm in diameter were divided into three groups to undergo 99mTc-MIBI imaging and compared with the results of pathology examination. 20 cases without breast lesions were selected as control. Abnormal condensation of 99mTc-MIBI in the breast reaching 10% higher than that in the counterpart of the healthy breast was regarded as positive. Results: Of 32 breast cancers, positive imaging appeared in 25. Negative imaging were found in 31 of 38 benign breast lesions. Of 39 occult breast lesions, positive imaging appeared in 6 and 3 of them were breast cancer, 2 of 3 patients with slightly increased 99mTc-MIBI imaging threshold were breast cancer also. No positive imaging was found in the control group. The diagnostic accuracy, sensitivity, specificity, positive predictive value, negative predictive value of 99mTc-MIBI was 88.4%, 89.2%, 88.0%, 75.0% and 95.3%, respectively. Conclusion: 99mTc-MIBI imaging had higher sensitivity and accuracy in the diagnosis of breast cancer and differentiation between benign and malignant breast lesions. It could provide useful information for the diagnosis of clinically suspected breast cancer.

  6. Treatment of early stage breast cancer by limited surgery and radical irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Chu, A.M.; Cope, O.; Russo, R.; Wang, C.C.; Schulz, M.D.; Wang, C.; Rodkey, G.

    1980-01-01

    Eighty-five female patients with early stage breast cancer, i.e., Stage I and II were treated by limited surgery followed by radical radiation therapy at Massachusetts General Hospital between January, 1956 and December, 1974. Patients included those who were medically inoperable or who refused mastectomy. The 5-year survival rate was 83% and 76% for Stage I and II, respectively. The corresponding disease free survival (absolute) was 67% and 42%. Although the number of patients so treated is small, there was no significant difference in survival from the results of the radical mastectomy series at the same institution. No major complications were encountered. Seventeen of eighty-five patients developed minor problems; mostly fibrosis and minimal arm lymphedema stemmming from older orthovoltage equipment and treatment techniques. With the current availability of megavoltage equipment, improvements in techniques and dosimetry, complications should decrease. Combined limited surgery and radical radiation therapy should be considered in those patients where a radical mastectomy is not feasible because of psychological or medical problems. Since this procedure results in a cosmetically acceptable breast, radical radiation in early stage breast cancer seems a reasonable alternative to radical mastectomy.

  7. Mesenchymal and stemness circulating tumor cells in early breast cancer diagnosis

    International Nuclear Information System (INIS)

    Epithelial mesenchymal transition (EMT) is a crucial event likely involved in dissemination of epithelial cancer cells. This process enables them to acquire migratory/invasive properties, contributing to tumor and metastatic spread. To know if this event is an early one in breast cancer, we developed a clinical trial. The aim of this protocol was to detect circulating tumor cells endowed with mesenchymal and/or stemness characteristics, at the time of initial diagnosis. Breast cancer patients (n = 61), without visceral or bone metastasis were enrolled and analysis of these dedifferentiated circulating tumor cells (ddCTC) was realized. AdnaGen method was used for enrichment cell selection. Then, ddCTC were characterized by RT-PCR study of the following genes: PI3Kα, Akt-2, Twist1 (EMT markers) and ALDH1, Bmi1 and CD44 (stemness indicators). Among the studied primary breast cancer cohort, presence of ddCTC was detected in 39% of cases. This positivity is independant from tumor clinicopathological factors apart from the lymph node status. Our data uniquely demonstrated that in vivo EMT occurs in the primary tumors and is associated with an enhanced ability of tumor cells to intravasate in the early phase of cancer disease. These results suggest that analysis of circulating tumor cells focused on cells showing mesenchymal or stemness characteristics might facilitate assessment of new drugs in clinical trials

  8. Cosmetic results in early stage breast cancer patients with high-dose brachytherapy after conservative surgery

    International Nuclear Information System (INIS)

    Purpose: to reveal cosmetic results in patients at early stages of low risk breast cancer treated with partial accelerated radiotherapy using high dose rate brachytherapy. Methods and materials: from March 2001 to July 2003,14 stages l and ll breast cancer patients were treated at the Colombian national cancer institute in Bogota with conservative surgery and radiotherapy upon the tumor bed (partial accelerated radiotherapy), using interstitial implants with iridium 192 (high dose rate brachytherapy) with a dose of 32 Gys, over 4 days, at 8 fractions twice a day. Results: with an average follow up of 17.7 months, good cosmetic results were found among 71.4 % of patients and excellent results among 14.3% of patients, furthermore none of the patients neither local nor regional or distant relapses. Conclusion: among patients who suffer from breast cancer at early stages, it showed is possible to apply partial accelerated radiotherapy upon the tumor bed with high doses over 4 days with good to excellent cosmetic results

  9. Targets for Neoadjuvant Therapy – The Preferences of Patients with Early Breast Cancer

    Science.gov (United States)

    Thill, M.; Pisa, G.; Isbary, G.

    2016-01-01

    Background: Therapists and administrative bodies consider a pathological complete remission as an independent and relevant endpoint in evaluations of the clinical utility of neoadjuvant therapy for early breast cancer. The present study aims to investigate which treatment outcomes of a neoadjuvant therapy are considered by the patients themselves to be relevant. Materials and Methods: With the help of analytic hierarchy process (AHP) methods patient preferences about the treatment targets of neoadjuvant therapy were assessed quantitatively. All participants had undergone a neoadjuvant therapy in the form of chemotherapy and, in HER2-positive cases, as a targeted antibody therapy against HER2 for the primary diagnosis of early breast cancer 12–36 months prior to the interview. The criteria for the hierarchy model were identified in an earlier qualitative survey. The patient interviews were conducted by 4 experienced female interviewers. Results: Forty-one patients participated in the quantitative survey, of these 15 (36.6 %) had suffered from HER2-positive disease. The achievement of pCR was the most important therapeutic target for the patients, even before disease-free survival, overall survival and the option for breast-preserving operation. Avoidance of side effects was considered to be the least important. In a comparison of the side effects the patients judged fatigue to be most important before nausea and loss of hair. Conclusion: For the patients the achievement of a pathological complete remission is considered to be an independent, relevant and highly desired target of neoadjuvant therapy. PMID:27239064

  10. Apoprotein E phenotype determines serum cholesterol in infants during both high-cholesterol breast feeding and low-cholesterol formula feeding.

    Science.gov (United States)

    Kallio, M J; Salmenperä, L; Siimes, M A; Perheentupa, J; Gylling, H; Miettinen, T A

    1997-04-01

    Our objective was to establish the role of the apoprotein (apo) E phenotype in determining serum cholesterol levels in infants fed exclusively on high-fat, high-cholesterol human milk and in those fed a low-cholesterol, high-unsaturated fat formula. The total and lipoprotein cholesterol, apoB, and triglyceride concentrations in serum were quantified and related to the apoE phenotype in 151 infants at birth and at 2, 6, 9, and 12 months of age. Forty-four had the E3/4 or 4/4 phenotype (E4 group), 94 had the E3/3 phenotype (E3 group), and 13 had the E2/3 or 2/4 phenotype (E2 group). In cord blood, cholesterol concentrations tended to be higher in the E4 than in the E2 group. With exclusive breast-feeding, the concentrations rose significantly faster and higher in the E4 group than in the E3 group or, especially, the E2 group. The values (mmol/L, mean +/- SEM) were 1.6 +/- 0.15, 1.5 +/- 0.05, 1.4 +/- 0.1 (P = n.s.) at birth; 4.2 +/- 0.1, 3.8 +/- 0.08, 3.4 +/- 0.2 (P HDL, HDL2, and HDL3 cholesterol concentrations did not depend on the apoE phenotype. Among infants fed high-fat, high-cholesterol human milk, the total and LDL-cholesterol concentrations and the LDL apoB concentration of those with the apoE phenotype 4/4 or 3/4 rose faster and to higher levels than in other infants. Among formula-fed infants, receiving a low-cholesterol, high-unsaturated fat diet, the differences between the apoE groups were smaller.

  11. Determining the Efficient Structure of Feed-Forward Neural Network to Classify Breast Cancer Dataset

    OpenAIRE

    Ahmed Khalid; Noureldien A. Noureldien

    2014-01-01

    Classification is one of the most frequently encountered problems in data mining. A classification problem occurs when an object needs to be assigned in predefined classes based on a number of observed attributes related to that object. Neural networks have emerged as one of the tools that can handle the classification problem. Feed-forward Neural Networks (FNN's) have been widely applied in many different fields as a classification tool. Designing an efficient FNN structure with optimum numb...

  12. Knowledge of breast cancer and its early detection measures among rural women in Akinyele Local Government Area, Ibadan, Nigeria

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    Oladepo Oladimeji

    2006-11-01

    Full Text Available Abstract Background Breast cancer is the commonest cancer among women in Nigeria and globally. In Nigeria, late presentations of breast cancer cases have also been consistent for three decades. In an environment where there is no established national screening program for breast cancer, it is pertinent to assess the knowledge of breast cancer and its early detection measures. The objective of this study therefore, was to assess rural women's level of knowledge of breast cancer and its early detection measures. Methods The knowledge of various aspects of breast cancer; etiology, early warning signs, treatment modes and early detection measures; was assessed among women in two randomly selected health districts in Akinyele Local Government in Ibadan. The assessment was performed with the use of a self-structured validated questionnaire administered by trained interviewers to 420 women randomly selected from the two health districts. The various aspects of facts about breast cancer were scored and added together to determine respondents' level of knowledge Results The mean score of knowledge of breast cancer was 55.4 SD 5.4 (range of scores obtainable was 26–78, while the mean score for knowledge of early detection of breast cancer was 24.8 SD 2.3 (range of scores obtainable was 12–36. The leading source of information about breast cancer was "elders, neighbors and friends" and 63(15.4% acknowledged this source, while only 18 (4.4% respondents acknowledged health workers as source. Only 54 (13.3% claimed to have heard about breast self- examination (BSE however, and the leading source of information about BSE were health workers. Nine (2.2% of respondents claimed this source. Conclusion This study revealed that respondents lacked knowledge of vital issues about breast cancer and early detection measures. It also revealed that health workers were not forthcoming with information to the public thereby constituting a challenge to community health

  13. Tailoring therapies--improving the management of early breast cancer: St Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2015.

    Science.gov (United States)

    Coates, A S; Winer, E P; Goldhirsch, A; Gelber, R D; Gnant, M; Piccart-Gebhart, M; Thürlimann, B; Senn, H-J

    2015-08-01

    The 14th St Gallen International Breast Cancer Conference (2015) reviewed substantial new evidence on locoregional and systemic therapies for early breast cancer. Further experience has supported the adequacy of tumor margins defined as 'no ink on invasive tumor or DCIS' and the safety of omitting axillary dissection in specific cohorts. Radiotherapy trials support irradiation of regional nodes in node-positive disease. Considering subdivisions within luminal disease, the Panel was more concerned with indications for the use of specific therapies, rather than surrogate identification of intrinsic subtypes as measured by multiparameter molecular tests. For the treatment of HER2-positive disease in patients with node-negative cancers up to 1 cm, the Panel endorsed a simplified regimen comprising paclitaxel and trastuzumab without anthracycline as adjuvant therapy. For premenopausal patients with endocrine responsive disease, the Panel endorsed the role of ovarian function suppression with either tamoxifen or exemestane for patients at higher risk. The Panel noted the value of an LHRH agonist given during chemotherapy for premenopausal women with ER-negative disease in protecting against premature ovarian failure and preserving fertility. The Panel noted increasing evidence for the prognostic value of commonly used multiparameter molecular markers, some of which also carried prognostic information for late relapse. The Panel noted that the results of such tests, where available, were frequently used to assist decisions about the inclusion of cytotoxic chemotherapy in the treatment of patients with luminal disease, but noted that threshold values had not been established for this purpose for any of these tests. Multiparameter molecular assays are expensive and therefore unavailable in much of the world. The majority of new breast cancer cases and breast cancer deaths now occur in less developed regions of the world. In these areas, less expensive pathology tests may

  14. Serum auto-antibody testing for early diagnosis of breast cancer

    International Nuclear Information System (INIS)

    The aim of this thesis is generate prototype-tests suitable for randomized prospective validation of auto-antibody based diagnostic testing using serum samples. Tumours can stimulate the production of auto-antibodies against autologous cellular proteins known as TAAs (tumour associated antigens). This discovery has lead to a possibility of using the auto-antibodies as serological tools for the early diagnosis and management of breast cancer. The recombinant proteins expressed by the SEREX clones, identified from screenings of brain and lung tumour, were used for the production of the protein microarrays and macroarrays. The protein microarrays showed better correlation between the replicates of the serum samples used. The optimized protocols were used for the subsequent experiments. A sizable panel of 642 clone-proteins was selected by marker-screening on protein macroarrays with 38000 clones. These 642 clone-proteins were used to generate protein microarrays that differentiated serum samples from breast cancer patients and controls. Antigenic peptide motifs were identified by in-silico analysis of 642 clone-proteins and peptide arrays were generated using synthetically generated peptides. Comparative studies between protein microarrays and peptide microarrays were done using breast cancer and healthy control samples. Simultaneously, SEREX strategy was used for the identification of the immunogenic TAAs. I identified 192 cDNA expression clones derived from breast cancer tissue samples and the selection was done using breast cancer sera. The genes corresponding to these clones were found over-represented for the pathways that are known to be associated with cancers. These genes showed typical features of TAAs, like over-expression, mutations and fusion genes. (author)

  15. Media representations of early human development: protecting, feeding and loving the developing brain.

    Science.gov (United States)

    O'Connor, Cliodhna; Joffe, Helene

    2013-11-01

    The public profile of neurodevelopmental research has expanded in recent years. This paper applies social representations theory to explore how early brain development was represented in the UK print media in the first decade of the 21st century. A thematic analysis was performed on 505 newspaper articles published between 2000 and 2010 that discussed early brain development. Media coverage centred around concern with 'protecting' the prenatal brain (identifying threats to foetal neurodevelopment), 'feeding' the infant brain (indicating the patterns of nutrition that enhance brain development) and 'loving' the young child's brain (elucidating the developmental significance of emotionally nurturing family environments). The media focused almost exclusively on the role of parental action in promoting optimal neurodevelopment, rarely acknowledging wider structural, cultural or political means of supporting child development. The significance of parental care was intensified by deterministic interpretations of critical periods, which implied that inappropriate parental input would produce profound and enduring neurobiological impairments. Neurodevelopmental research was also used to promulgate normative judgements concerning the acceptability of certain gender roles and family contexts. The paper argues that media representations of neurodevelopment stress parental responsibility for shaping a child's future while relegating the contributions of genetic or wider societal factors, and examines the consequences of these representations for society and family life. PMID:23273760

  16. Psychological aspects of breast conserving therapy (BCT) in early breast cancer

    International Nuclear Information System (INIS)

    Psychological and social status of 40 women who underwent BCT in early cancer was compared with 40 women after radical mastectomy. Women in BCT group showed significantly less anxiety about overall body image. The majority of them reported adjustment to work or ability to carry out household tasks. Almost all returned to normal social activities and interpersonal relationships. The majority of patients treated with BCT were fully satisfied in spite of unsatisfactory cosmetic results achieved in some of them and in spite of long duration of combined modality treatment. (author)

  17. High resolution computed tomography findings on the lung of early breast-cancer patients treated by postoperative breast irradiation with a hypofractionated radiotherapy schedule

    Directory of Open Access Journals (Sweden)

    Plataniotis G

    2005-01-01

    Full Text Available Context: Hypofractionated breast radiotherapy (RT, although convenient for patients and health care systems, could have a negative impact on normal tissues such as lung. Aims: To evaluate radiation-induced lung toxicity in early breast-cancer patients treated by hypofractionated RT. Settings and Design: We have been using the 42.5 Gy/16 fractions RT schedule since May 2003. As large fraction size is related to increased normal tissue toxicity we intended to investigate the possible radiation-induced lung toxicity to these patients, by performing high-resolution computed tomography (HRCT 6 months after the completion of the treatment. Methods and Material: A group of 30 consecutive early breast cancer patients (T1-2N0M0 have been treated by the above-mentioned RT schedule, using a pair of opposing tangential fields. The impact of chemotherapy and hormonotherapy and various breast size-related parameters on HRCT lung changes were investigated. Acute skin and breast tissue reactions were also recorded. Statistical analysis: used Correlation of numerical variables was investigated by Pearson correlation coefficient. Logistic regression analysis was used to investigate correlation between HRCT findings (present vs absent with other variables. Results: Minimal HRCT findings were evident in 15/30 patients. These included small septal lines, linear and subpleural opacities and to a lesser extend, focal-ground glass opacification. The HRCT findings were positively correlated only to field separation (distance between the entrance points of the tangential beams on the breast (H.R.=1.33, 95% CI: 1.013-1.75. Conclusions: The short 16-fraction RT schedule for early breast-cancer patients appears to have a minor effect on the underlying lung parenchyma.

  18. STUDY OF EARLY RADIATION PNEUMONITIS IN CARCINOMA BREAST AND LUNG TREATED WITH RADIOTHERAPY

    Directory of Open Access Journals (Sweden)

    Jaganath KP

    2013-06-01

    Full Text Available Background toxicity of the respiratory system is quite common after radiotherapy of thoracic tumors. Breast and lung cancer patients represent one of the groups for whom there is a long expected survival. The quantification of lung tissue response to irradiation is important in designing treatments associated with a minimum of complication and maximum tumor control. OBJECTIVE :- To study the impact of lung volume irradiated on early pneumonitis in patients undergoing RT for cancer breast. METHOD :- The Study was conducted as per ICH GCP guidelines and Ethics Committee approval.This is a prospective study of cancer of breast and lung treated with radiotherapy from February 2004 to January 2005. Computerized tomography (CT simulation was part of treatment planning. The volume of lung irradiated was calculated by using both CLD method and summation of area technique. Chest x-ray and spirometric tests were done first as a baseline procedure and later at one month and at 3 months after completion of radiotherapy. Patients of either sex and Karnofsky performance status (KPS>70 and all cases of carcinoma breast and lung receiving radiotherapy were included.Patients who have received previous chemotherapy with drugs like bleomycin and mitomycin were excluded from the study. RESULTS. The incidence of RP in carcinoma breast is 3.9%. With conventional technique of treatment planning for carcinoma breast, percentage of lung volume irradiated in majority of cases (16/26 was within 11% and Central Lung Distance (CLD proved to be best predictor of it. The spirometry evaluation showed reduction in the percentage values in different compartments patients. Changes were maximum in patients treated with anthracyclin-based chemotherapy also. INTERPRETATION AND CONCLUSION The incidence of RP of carcinoma breast is 3.9% treated with locoregional radiotherapy, which is accepted globally. The CLD (Central Lung Distance method of calculation of PIV (Percentage of

  19. Breast feeding-associated hypernatremic dehydration: A preventable tragedy in newborn infants

    Directory of Open Access Journals (Sweden)

    Sriram Krishnamurthy

    2011-12-01

    Full Text Available The innumerable and compelling benefits of exclusive breastfeeding to the infant, mother, family and society are well recognized. Hypernatremic dehydration is a rare, yet potentially preventable complication of exclusive breastfeeding; the etiology being inadequate lactation. We report 2 exclusively breastfed newborn infants with serum sodium levels of 166 and 159 mEq/L, respectively. Both babies presented with excessive weight loss, fever, dehydration, and irritability. Mothers had inadequate lactation. Corresponding breast milk sodium levels were elevated in both mothers (77 and 45 mEq/l; normal 7-21 mEq/L between 3-14 d postpartum. Appropriate parenteral fluids were administered to correct dehydration and hypernatremia. Serum sodium normalized within 72 hours. Following counseling, breastfeeding was resumed after 48 hours with both the mothers achieving good lactation. Infants were finally discharged on exclusive breastfeeding. Timely recognition and awareness of this potentially lethal, but preventable condition is essential to ensure a favorable outcome.

  20. Estimation of the cost of treatment by chemotherapy for early breast cancer in Morocco

    Directory of Open Access Journals (Sweden)

    Boutayeb Saber

    2010-09-01

    Full Text Available Abstract Background Breast cancer is the first cancer in women both in incidence and mortality. The treatment of breast cancer benefited from the progress of chemotherapy and targeted therapies, but there was a parallel increase in treatment costs. Despite a relatively high incidence of many sites of cancer, so far, there is no national register for this disease in Morocco. The main goal of this paper is to estimate the total cost of chemotherapy in the early stages of breast cancer due to its frequency and the chances of patients being cured. This study provides health decision-makers with a first estimate of costs and the opportunity to achieve the optimal use of available data to estimate the needs of antimitotics and trastuzumab in Morocco. Method We start by evaluating the individual cost according to the therapeutic sub-groups, namely: 1. Patients needing chemotherapy with only anthracycline-based therapy. 2. Patients needing chemotherapy with both anthracycline and taxane but without trastuzumab. 3. Patients needing trastuzumab in addition to chemotherapy. For each sub-group, the protocol of treatment is described, and the individual costs per unit, and for the whole cycle, are evaluated. Then we estimate the number of women suffering from breast cancer on the basis of two data bases available in Morocco. Finally, we calculate the total annual cost of treatment of breast cancer in Morocco. Results The total cost of breast cancer in Morocco is given in Moroccan dirhams (MAD, the US dollar at the current exchange rate (MAD 10 = USD 1.30 and in international dollars or purchasing power parity (MAD 10 = PPP 1.95. The cost of a therapy with trastuzumab is 8.4 times the cost of a sequential chemotherapy combining anthracycline and taxane, and nearly 60 times the cost of chemotherapy based on anthracycline alone. Globally, between USD 13.3 million and USD 28.6 million need to be devoted every year by the Moroccan health authorities to treat

  1. Irradiation with external beam and interstitial radioactive implant as primary treatment for early carcinoma of the breast

    International Nuclear Information System (INIS)

    The locoregional control of 60 to 61 patients supports the results published by other centers and compares favorably with results of any surgical series. The cosmetic results are excellent with only three of 61 patients having severe fibrosis of the breast develop. No rib fractures, skin ulcerations, symptomatic radiation pneumonitis, edema of the arm or limitation of arm movement have been observed as complications. Ten of the 28 patients who have had axillary dissection had transient edema of the breast develop. Results of numerous studies suggest that primary radiotherapy without mastectomy is appropriate treatment for early carcinoma of the breast. The accessibility of the breast makes it relatively easy to deliver curative doses of radiation with minimal damage to surrounding normal tissues. The cumulative radiotherapy experience has demonstrated the gratifying results of not only maintaining a rather normal breast but also avoiding the negative physical and psychologic repercussions of the mastectomy. Radiation therapy is an alternative to Halsted's radical mastectomy

  2. Transition from film to digital mammography: Impact for breast cancer screening through the national breast and cervical cancer early detection program

    NARCIS (Netherlands)

    N.T. van Ravesteyn (Nicolien); L. Van Lier (Lisanne); C.B. Schechter (Clyde); D.U. Ekwueme (Donatus U.); J. Royalty (Janet); J.W. Miller (Jacqueline W.); A.M. Near (Aimee); K.A. Cronin (Kathleen); E.A.M. Heijnsdijk (Eveline); J.S. Mandelblatt (Jeanne); H.J. de Koning (Harry)

    2015-01-01

    textabstractIntroduction The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) provides mammograms and diagnostic services for low-income, uninsured women aged 40-64 years. Mammography facilities within the NBCCEDP gradually shifted from plain-film to digital mammography. The pur

  3. Early gradual feeding with bovine colostrum improves gut function and NEC resistance relative to infant formula in preterm pigs

    Science.gov (United States)

    It is unclear when and how to start enteral feeding for preterm infants when mother's milk is not available. We hypothesized that early and slow advancement of either formula or bovine colostrum stimulates gut maturation and prevents necrotizing enterocolitis (NEC) in preterm pigs, used as models fo...

  4. Effect of Supplemental Feeding with Glycerol or Propylene Glycol in Early Lactation on the Fertility of Swedish Dairy Cows

    DEFF Research Database (Denmark)

    Lomander, H; Gustafsson, H; Frössling, J;

    2012-01-01

    The aim of this field study was to evaluate the effect of supplemental feeding with glycerol (GLY) or propylene glycol (PG) during early lactation on the fertility of Swedish dairy cows. Within 17 commercial dairy herds, 798 cows were randomized to three groups that were daily fed supplements...

  5. Early life soy exposure and age at menarche

    OpenAIRE

    Adgent, Margaret; Daniels, Julie; Rogan, Walter; Adair, Linda; Edwards, Lloyd; Westreich, Daniel; Maisonet, Mildred; Marcus, Michele

    2011-01-01

    This study examines the timing of menarche in relation to infant feeding methods, specifically addressing the potential effects of soy isoflavone exposure through soy-based infant feeding. Subjects were participants in the Avon Longitudinal Study of Parents and Children (ALSPAC). Mothers were enrolled during pregnancy and their children have been followed prospectively. Early life feeding regimes, categorized as primarily breast, early formula, early soy, and late soy were defined using infan...

  6. Factors influencing the surgery intentions and choices of women with early breast cancer: the predictive utility of an extended theory of planned behaviour

    NARCIS (Netherlands)

    Sivell, S.; Elwyn, G.; Edwards, A.; Manstead, A.S.; BresDex, g.

    2013-01-01

    BACKGROUND: Women diagnosed with early breast cancer (stage I or II) can be offered the choice between mastectomy or breast conservation surgery with radiotherapy due to equivalence in survival rates. A wide variation in the surgical management of breast cancer and a lack of theoretically guided res

  7. Awareness that early cancer lump is painless could decrease breast cancer mortality in developing countries

    OpenAIRE

    Garg, Pankaj

    2016-01-01

    There are several factors which contribute to patients’ reporting late to healthcare facility even after detecting the breast lump (patient delay). Amongst these, one of the important factors in low- and middle-income countries is lack of awareness that early cancer lump is painless (ECLIPs). Pain is often taken as a danger sign and absence of pain is often not taken seriously. The studies have shown that up to 98% of women in low-income countries are unaware that a painless lump could be a w...

  8. Early Detection of Breast Cancer Using Autoantibody Markers — EDRN Public Portal

    Science.gov (United States)

    To identify large numbers of antigens that can be used to recognize the presence of cancer by detecting antibodies to tumor proteins in the serum of the test subjects. Our technology will provide an early detection test for breast cancer in asymptomatic women. We will use bioinformatics techniques to analyze these protein microarray-immunoassays to discriminate between cancer patients and healthy subjects so as to detect disease prior to standard diagnoses as well as discriminate patients with benign conditions or other cancers that might be a false positive in less specific assays.

  9. Early Breast Cancer Precursor Lesions: Lessons Learned from Molecular and Clinical Studies

    OpenAIRE

    Sinn, Hans-Peter; Elsawaf, Zeinab; Helmchen, Birgit; Aulmann, Sebastian

    2010-01-01

    Atypical ductal hyperplasia (ADH), flat epithelial atypia (FEA), and lobular neoplasia (LN) form a group of early precursor lesions that are part of the low-grade pathway in breast cancer development. This concept implies that the neoplastic disease process begins at a stage much earlier than in situ carcinoma. We have performed a review of the published literature for the upgrade risk to ductal carcinoma in situ or invasive carcinoma in open biopsy after a diagnosis of ADH, FEA, or LN in cor...

  10. Health insurance mediation of the Mexican American non-Hispanic white disparity on early breast cancer diagnosis

    OpenAIRE

    Haji-Jama, Sundus; Gorey, Kevin M; Luginaah, Isaac N.; Balagurusamy, Madhan K; Hamm, Caroline

    2013-01-01

    We examined health insurance mediation of the Mexican American (MA) non-Hispanic white (NHW) disparity on early breast cancer diagnosis. Based on social capital and barrio advantage theories, we hypothesized a 3-way ethnicity by poverty by health insurance interaction, that is, that 2-way poverty by health insurance interaction effects would differ between ethnic groups. We secondarily analyzed registry data for 303 MA and 3,611 NHW women diagnosed with breast cancer between 1996 and 2000 who...

  11. Comparing the effects of conventional and hypofractionated radiotherapies on early skin toxicity and cosmetic outcomes after breast cancer conserving surgery

    OpenAIRE

    Haddad, P; AR Sebzari; B Kalaghchi; F Amouzegar Hashemi; Z Shahabi

    2012-01-01

    Background: The high number of breast cancer patients who receive radiation therapy after surgery has caused many to think about a shorter period of radiotherapy, which can significantly reduce the radiotherapy machine time, labor hours, and fewer patient visits. This study was designed to evaluate the acute skin effects and cosmetic outcomes of short course radiotherapy in early-stage breast cancer in comparison with the conventional treatment method.Methods: Fifty-two patients with operable...

  12. Aberrant reduction of telomere repetitive sequences in plasma cell-free DNA for early breast cancer detection

    OpenAIRE

    Wu, Xi; Tanaka, Hiromi

    2015-01-01

    Excessive telomere shortening is observed in breast cancer lesions when compared to adjacent non-cancerous tissues, suggesting that telomere length may represent a key biomarker for early cancer detection. Because tumor-derived, cell-free DNA (cfDNA) is often released from cancer cells and circulates in the bloodstream, we hypothesized that breast cancer development is associated with changes in the amount of telomeric cfDNA that can be detected in the plasma. To test this hypothesis, we devi...

  13. Amamentação natural como fonte de prevenção em saúde Breast-feeding as a source of prevention in healthcare

    Directory of Open Access Journals (Sweden)

    Leonardo dos Santos Antunes

    2008-02-01

    Full Text Available A importância da amamentação natural tem sido abordada sob âmbito multiprofissional. O cirurgião dentista como profissional da área de saúde está incluído neste contexto e deve ser capaz de orientar a gestante e as recém-mães visto a forte relação que existe entre amamentação natural e o desenvolvimento do sistema estomatognático. São inúmeros os benefícios gerados tanto para a mãe quanto para o bebê. Baseado nisso, o presente artigo propõe, por meio de uma revisão de literatura discutida, argumentar com informações atuais e esclarecedoras os benefícios da amamentação dando estímulo à conscientização da sua importância e à formulação de políticas e ações, através do SUS, que priorizem a prática da amamentação como meta.The importance of breast-feeding has been addressed through multi-professional approaches. As healthcare practitioners, dentists are included in this context and - due to the close links between breast-feeding and the development of the stomatognathic system - should be able to advise pregnant women and new mothers on this practice, with countless benefits for mothers and their babies. This paper thus presents up-to-date and enlightened information through a review of the literature that supports the benefits of breast-feeding, urging heightened awareness of its importance and the preparation of policies and actions implemented through Brazil's National Health System (SUS that rank breast-feeding as a high-priority goal.

  14. Knowledge, attitude and practice of breast feeding at a tertiary care centre in the government medical college and hospital, Aurangabad, India

    OpenAIRE

    Varsha Deshmukh; Ummehani Rasool; Bhakti Kalyankar; Rupali Gaikwad; Kanan Yelikar

    2016-01-01

    Background: Mother's milk undoubtedly represents the best nourishment for the child during first months of life. The benefits of breastfeeding (BF) specially, exclusive breastfeeding (EBF), are well established. No artificial feed can replace breast milk, its specific nutrients and protection against diseases. All women should be encouraged to exclusively breastfeed their infants up to 6 months of age and thereafter to continue along with appropriate and adequate complementary foods, for up t...

  15. Nosocomial colonization due to imipenem-resistant Pseudomonas aeruginosa epidemiologically linked to breast milk feeding in a neonatal intensive care unit

    Institute of Scientific and Technical Information of China (English)

    Caterina MAMMINA; Paola DI CARLO; Domenico CIPOLLA; Alessandra CASUCCIO; Matilde TANTILLO; Maria Rosa Anna PLANO; Angela MAZZOLA; Giovanni CORSELLO

    2008-01-01

    Aim: We describe a one-year investigation of colonization by imipenem-resistant, metallo-β-1actamase (MBL) producing Pseudomonas aeruginosa in a neonatal intensive care unit (NICU) of the University Hospital of Palermo, Italy. Methods: A prospective epidemiological investigation was conducted in the period 2003 January to 2004 January. Rectal swabs were collected twice a week from all neonates throughout their NICU stay. MBL production by imipenem-resistant strains of P aeruginosa was detected by phenotypic and molecular methods. Pulsed field gel electrophoresis (PFGE) was carried out on all isolates of P aeruginosa. The association between risk factors and colonization by imipenem-resistant, imipenem-susceptible P aeruginosa isolates and other multidrug-resistant Gram negative (MDRGN) organisms was analyzed for variables present at admission and during the NICU stay. Data analysis was carried out by the Cox proportional hazards regression model. Results: Twenty-two of 210 neonates were colonized with imipenem-resistant, MBL-producing P aeruginosa isolates and 14 by imipenem-susceptible P aeruginosa isolates. A single pulsotype, named A, was shared by all imipenem-resistant isolates. Colonization by P aeruginosa of pulsotype A was positively correlated with breast milk feeding and administration of ampicillin-sulbactam, and inversely correlated with exclusive feeding by formula. In the Cox proportional hazards regression model, birthweight of more than 2500 g and breast milk feeding were independently associated with an increased risk of colonization by MBL-producing P aeruginosa. Conclusion: The results strongly support an association between colonization by a well-defined imipenem-resistant, MBL producing P aeruginosa strain and breast milk feeding. Such a study may highlight the need for implementation of strategies to prevent expressed breast milk from becoming a vehicle of health care-associated infections.

  16. The Impact of Hypofractionated Whole Breast Radiotherapy on Local Relapse in Patients With Grade 3 Early Breast Cancer: A Population-Based Cohort Study

    International Nuclear Information System (INIS)

    Purpose: To determine whether patients with Grade 3 early breast cancer have an inferior rate of local disease control at 10 years with hypofractionated radiotherapy compared with more conventionally fractionated schedules. Methods and Materials: Local relapse rates were compared between patients receiving hypofractionated radiotherapy or conventionally fractionated radiotherapy to the whole breast in a population-based cohort of women with early-stage (T1-T2, N0, M0) Grade 3 breast cancers diagnosed between 1990 and 2000 and referred to the British Columbia Cancer Agency. Cumulative rates of local relapse were estimated using a competing risk method, and factors significant on univariate analysis were included with fractionation group in a multivariate model. The primary end point was local control at 10 years. Results: A total of 1,335 patients with Grade 3 tumors were treated with adjuvant radiotherapy, 252 with conventional fractionation, and 1,083 with a hypofractionated schedule. The 10-year cumulative incidence of local relapse was 6.9% in the hypofractionated group and 6.2% in the conventionally fractionated group (p = 0.99). Conclusions: There is no evidence that hypofractionation is inferior to conventional fractionation for breast conserving therapy in patients with Grade 3 breast cancer in this large population-based series after 10 years of follow-up.

  17. The Impact of Hypofractionated Whole Breast Radiotherapy on Local Relapse in Patients With Grade 3 Early Breast Cancer: A Population-Based Cohort Study

    Energy Technology Data Exchange (ETDEWEB)

    Herbert, Christopher, E-mail: cherbert@bccancer.bc.ca [Department of Radiation Oncology, BC Cancer Agency, Vancouver, British Columbia (Canada); Nichol, Alan [Department of Radiation Oncology, BC Cancer Agency, Vancouver, British Columbia (Canada); Olivotto, Ivo [Department of Radiation Oncology, BC Cancer Agency, Victoria, British Columbia (Canada); Weir, Lorna [Department of Radiation Oncology, BC Cancer Agency, Vancouver, British Columbia (Canada); Woods, Ryan; Speers, Caroline [Breast Cancer Outcomes Unit, BC Cancer Agency, Vancouver, British Columbia (Canada); Truong, Pauline [Department of Radiation Oncology, BC Cancer Agency, Victoria, British Columbia (Canada); Tyldesley, Scott [Department of Radiation Oncology, BC Cancer Agency, Vancouver, British Columbia (Canada)

    2012-04-01

    Purpose: To determine whether patients with Grade 3 early breast cancer have an inferior rate of local disease control at 10 years with hypofractionated radiotherapy compared with more conventionally fractionated schedules. Methods and Materials: Local relapse rates were compared between patients receiving hypofractionated radiotherapy or conventionally fractionated radiotherapy to the whole breast in a population-based cohort of women with early-stage (T1-T2, N0, M0) Grade 3 breast cancers diagnosed between 1990 and 2000 and referred to the British Columbia Cancer Agency. Cumulative rates of local relapse were estimated using a competing risk method, and factors significant on univariate analysis were included with fractionation group in a multivariate model. The primary end point was local control at 10 years. Results: A total of 1,335 patients with Grade 3 tumors were treated with adjuvant radiotherapy, 252 with conventional fractionation, and 1,083 with a hypofractionated schedule. The 10-year cumulative incidence of local relapse was 6.9% in the hypofractionated group and 6.2% in the conventionally fractionated group (p = 0.99). Conclusions: There is no evidence that hypofractionation is inferior to conventional fractionation for breast conserving therapy in patients with Grade 3 breast cancer in this large population-based series after 10 years of follow-up.

  18. A prospective cohort study on postoperative radiotherapy with TomoDirect using simultaneous integrated boost technique in early breast cancer

    International Nuclear Information System (INIS)

    To evaluate the technical feasibility and toxicity of TomoDirect in breast cancer patients who received radiotherapy after breast-conserving surgery. 155 consecutive patients with breast carcinoma in situ or T1-2 breast cancer with negative lymph node received breast irradiation with TomoDirect using simultaneous integrated boost technique in the prospective cohort study. A radiation dose of 50.4 Gy and 57.4 Gy in 28 fractions was prescribed to the ipsilateral breast and tumor bed, respectively. Dosimetric parameters of target and organ at risk and acute complication were assessed prospectively. The mean dose for the tumor bed is 58.90 Gy. The mean values of V54.53Gy (95% of the prescribed dose), V63.14Gy (110% of the prescribed dose), and V66.01Gy (115% of the prescribed dose) were 99.97%, 1.26%, and 0%, respectively. The mean value of radiation conformality index was 1.01. The mean value of radical dose homogeneity index was 0.89. The average dose irradiated to the ipsilateral lung, heart, and contralateral breast was 4.72 Gy, 1.09 Gy, and 0.19 Gy, respectively. The most common toxicity was dermatitis. During breast irradiation, grade 2 and 3 dermatitis occurred in 41 (26.5%) and 6 (3.9%) of the 155 patients, respectively. Two patients had arm lymphedema during breast irradiation. Two patients had grade 2 pneumonitis 1 month after breast irradiation. Radiotherapy using TomoDirect in early breast cancer patients showed acceptable toxicities and optimal results in terms of target coverage and organ at risk sparing

  19. Coping with Early Stage Breast Cancer:Examining the Influence of Personality Traits and Interpersonal Closeness

    Directory of Open Access Journals (Sweden)

    Emanuela eSaita

    2015-02-01

    Full Text Available The study examines the influence of personality traits and close relationships on the coping style of women with breast cancer. A sample of seventy-two Italian patients receiving treatment for early stage breast cancer was recruited. Participants completed questionnaires measuring personality traits (Interpersonal Adaptation Questionnaire, interpersonal closeness (Inclusion of the Other in the Self Scale, and adjustment to cancer (Mini-Mental Adjustment to Cancer Scale. We hypothesized that diverse personality traits and degrees of closeness contribute to determine the coping styles shown by participants. Multiple regression analyses were conducted for each of the five coping styles (Helplessness/Hopelessness, Anxious Preoccupation, Avoidance, Fatalism, and Fighting Spirit using personality traits and interpersonal closeness variables (Strength of Support Relations, and Number of Support Relations as predictors. Women who rated high on assertiveness and social anxiety were more likely to utilize active coping strategies (Fighting Spirit. Perceived strength of relationships was predictive of using an active coping style while the number of supportive relationships did not correlate with any of the coping styles. Implications for assessment of breast cancer patients at risk for negative adaptation to the illness and the development of psychosocial interventions are discussed.

  20. Early stage breast cancer detection by means of time-domain ultra-wide band sensing

    International Nuclear Information System (INIS)

    The interest in the use of ultra-wide band (UWB) impulses for medical imaging, particularly early stage breast cancer detection, is driven by safety advantage, super resolution capability, significant dielectric contrast between tumours and their surrounding tissues, patient convenience and low operating costs. However, inversion algorithms leading to recovery of the dielectric profile are complex in their nature, and vulnerable to noisy experimental conditions and environment. In this paper, we present a simplified yet robust gradient-based iterative image reconstruction technique to solve the nonlinear inverse scattering problem. The calculation is based on the Polak–Ribière's approach while the Broyden's formula is used to update the gradient in an iterative scheme. To validate this approach, both numerical and experimental results are presented. Animal derived biological targets in the form of chicken skin, beef and salted butter are used to construct an experimental breast phantom, while vegetable oil is used as a background media. UWB transceivers in the form of biconical antennas contour the breast forming a full view scanning geometry at a frequency range of 0–5 GHz. Results indicate the feasibility of experimental detection of millimetre scaled targets

  1. Identifying gaps in the locoregional management of early breast cancer: highlights from the Kyoto Consensus Conference.

    Science.gov (United States)

    Toi, Masakazu; Winer, Eric P; Inamoto, Takashi; Benson, John R; Forbes, John F; Mitsumori, Michihide; Robertson, John F R; Sasano, Hironobu; von Minckwitz, Gunter; Yamauchi, Akira; Klimberg, V Suzanne

    2011-10-01

    A consensus conference was held to investigate issues related to the local management of early breast cancer. Here, we highlight the major topics discussed at the conference and propose ideas for future studies. Regarding axillary management, we examined three major issues. First, we discussed whether the use of axillary reverse mapping could clarify the lymphatic system of breast and whether the ipsilateral arm might help avoid lymphedema. Second, the use of an indocyanine green fluorescent navigation system was discussed for intraoperative lymphatic mapping. These new issues should be examined further in practice. Finally, some agreement was reached on the importance of "four-node diagnosis" to aid in the diagnostic accuracy of sentinel nodes. Regarding breast treatment, there was general agreement that the clinical value of surgical margins in predicting local failure was dependent on the tumor's intrinsic biology and subtypes. For patients treated with preoperative chemotherapy, less extensive excision may be feasible in those who respond to systemic therapy in an acceptable manner. Most trials of preoperative chemotherapy lack outcome data on local recurrence. Therefore, there is a need for such data for overview analysis. We also agreed that radiation after mastectomy may be beneficial in node-positive cases where more than four nodes are involved. Throughout the discussions for both invasive and noninvasive disease, the investigation of nomograms was justified for major issues in the decision-making process, such as the presence or absence of microinvasion and the involvement of nonsentinel nodes in sentinel node-positive patients.

  2. Coping with early stage breast cancer: examining the influence of personality traits and interpersonal closeness.

    Science.gov (United States)

    Saita, Emanuela; Acquati, Chiara; Kayser, Karen

    2015-01-01

    The study examines the influence of personality traits and close relationships on the coping style of women with breast cancer. A sample of 72 Italian patients receiving treatment for early stage breast cancer was recruited. Participants completed questionnaires measuring personality traits (Interpersonal Adaptation Questionnaire), interpersonal closeness (Inclusion of the Other in the Self Scale), and adjustment to cancer (Mini-Mental Adjustment to Cancer Scale). We hypothesized that diverse personality traits and degrees of closeness contribute to determine the coping styles shown by participants. Multiple regression analyses were conducted for each of the five coping styles (Helplessness/Hopelessness, Anxious Preoccupation, Avoidance, Fatalism, and Fighting Spirit) using personality traits and interpersonal closeness variables (Strength of Support Relations, and Number of Support Relations) as predictors. Women who rated high on assertiveness and social anxiety were more likely to utilize active coping strategies (Fighting Spirit). Perceived strength of relationships was predictive of using an active coping style while the number of supportive relationships did not correlate with any of the coping styles. Implications for assessment of breast cancer patients at risk for negative adaptation to the illness and the development of psychosocial interventions are discussed. PMID:25699003

  3. Early stage breast cancer detection by means of time-domain ultra-wide band sensing

    Science.gov (United States)

    Zanoon, T. F.; Abdullah, M. Z.

    2011-11-01

    The interest in the use of ultra-wide band (UWB) impulses for medical imaging, particularly early stage breast cancer detection, is driven by safety advantage, super resolution capability, significant dielectric contrast between tumours and their surrounding tissues, patient convenience and low operating costs. However, inversion algorithms leading to recovery of the dielectric profile are complex in their nature, and vulnerable to noisy experimental conditions and environment. In this paper, we present a simplified yet robust gradient-based iterative image reconstruction technique to solve the nonlinear inverse scattering problem. The calculation is based on the Polak-Ribière's approach while the Broyden's formula is used to update the gradient in an iterative scheme. To validate this approach, both numerical and experimental results are presented. Animal derived biological targets in the form of chicken skin, beef and salted butter are used to construct an experimental breast phantom, while vegetable oil is used as a background media. UWB transceivers in the form of biconical antennas contour the breast forming a full view scanning geometry at a frequency range of 0-5 GHz. Results indicate the feasibility of experimental detection of millimetre scaled targets.

  4. 乳腺癌保乳手术38例临床分析%Analysis of breast conserving operation in 38 patients with early stage breast cancer

    Institute of Scientific and Technical Information of China (English)

    朱运新; 龚建军; 翟新发; 秦文祥

    2010-01-01

    Objective To study the effects of breast conserving surgery for early stage breast cancer. Methods The record of 38 patients with 0-IIa-stage breast cancer who received breast conserving surgery from Jan. 2005 to Feb.2010 was reviewed. The short-term effect was analyzed and the cosmetic effect was evaluated according to Rose standard. Results All patients recovered well and they were all satisfied with the shape of their breasts. No complication occurred. During the follow-up, no local recurrence and distant metastasis occurred. Conclusion Satisfactory clinical and cosmetic effect can be achieved by breast-conserving surgery in patients with early stage breast cancer.%目的 总结保乳手术治疗早期乳腺癌的临床经验及疗效观察.方法 回顾性分析2005年1月至2010年2月新疆石河子人民医院收治的38例临床0~IIa期、非乳晕区单发肿瘤的乳腺癌患者的临床资料.分析其近期疗效,并按Rose标准,对接受保乳手术的患者进行美容效果评价.结果 所有病例术后恢复良好,无1例出现并发症,随访未见局部复发及远处转移,患者对术后乳房外形及生活质量满意.结论 早期乳腺癌患者接受保乳手术治疗可取得满意的临床和美容效果.

  5. Cosmetic Analysis Following Breast-Conserving Surgery and Adjuvant High-Dose-Rate Interstitial Brachytherapy for Early-Stage Breast Cancer: A Prospective Clinical Study

    Energy Technology Data Exchange (ETDEWEB)

    Garsa, Adam A.; Ferraro, Daniel J.; DeWees, Todd [Department of Radiation Oncology, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri (United States); Margenthaler, Julie A. [Department of Surgery, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri (United States); Naughton, Michael [Department of Medicine, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri (United States); Aft, Rebecca [Department of Surgery, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri (United States); Department of Surgery, John Cochran Veterans Hospital, St. Louis, Missouri (United States); Gillanders, William E.; Eberlein, Timothy [Department of Surgery, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri (United States); Matesa, Melissa A. [Department of Radiation Oncology, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri (United States); Zoberi, Imran, E-mail: izoberi@radonc.wustl.edu [Department of Radiation Oncology, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri (United States)

    2013-03-15

    Purpose: To prospectively evaluate cosmetic outcomes in women treated with accelerated partial breast irradiation using high-dose-rate interstitial brachytherapy for early-stage breast cancer. Methods and Materials: Between 2004 and 2008, 151 patients with early-stage breast cancer were enrolled in a phase 2 prospective clinical trial. Eligible patients had stage Tis-T2 tumors of ≤3 cm that were excised with negative margins and with no nodal involvement. Patients received 3.4 Gy twice daily to a total dose of 34 Gy. Both the patients and the treating radiation oncologist qualitatively rated cosmesis as excellent, good, fair, or poor over time and ascribed a cause for changes in cosmesis. Cosmetic outcome was evaluated quantitatively by percentage of breast retraction assessment (pBRA). Patients also reported their satisfaction with treatment over time. Results: Median follow-up was 55 months. The rates of excellent-to-good cosmesis reported by patients and the treating radiation oncologist were 92% and 97% pretreatment, 91% and 97% at 3 to 4 months' follow-up, 87% and 94% at 2 years, and 92% and 94% at 3 years, respectively. Breast infection and adjuvant chemotherapy were independent predictors of a fair-to-poor cosmetic outcome at 3 years. Compared to pretreatment pBRA (7.35), there was no significant change in pBRA over time. The volume receiving more than 150 Gy (V150) was the only significant predictor of pBRA. The majority of patients (86.6%) were completely satisfied with their treatment. Conclusions: Patients and the treating physician reported a high rate of excellent-to-good cosmetic outcomes at all follow-up time points. Acute breast infection and chemotherapy were associated with worse cosmetic outcomes. Multicatheter interstitial brachytherapy does not significantly change breast size as measured by pBRA.

  6. Cosmetic Analysis Following Breast-Conserving Surgery and Adjuvant High-Dose-Rate Interstitial Brachytherapy for Early-Stage Breast Cancer: A Prospective Clinical Study

    International Nuclear Information System (INIS)

    Purpose: To prospectively evaluate cosmetic outcomes in women treated with accelerated partial breast irradiation using high-dose-rate interstitial brachytherapy for early-stage breast cancer. Methods and Materials: Between 2004 and 2008, 151 patients with early-stage breast cancer were enrolled in a phase 2 prospective clinical trial. Eligible patients had stage Tis-T2 tumors of ≤3 cm that were excised with negative margins and with no nodal involvement. Patients received 3.4 Gy twice daily to a total dose of 34 Gy. Both the patients and the treating radiation oncologist qualitatively rated cosmesis as excellent, good, fair, or poor over time and ascribed a cause for changes in cosmesis. Cosmetic outcome was evaluated quantitatively by percentage of breast retraction assessment (pBRA). Patients also reported their satisfaction with treatment over time. Results: Median follow-up was 55 months. The rates of excellent-to-good cosmesis reported by patients and the treating radiation oncologist were 92% and 97% pretreatment, 91% and 97% at 3 to 4 months' follow-up, 87% and 94% at 2 years, and 92% and 94% at 3 years, respectively. Breast infection and adjuvant chemotherapy were independent predictors of a fair-to-poor cosmetic outcome at 3 years. Compared to pretreatment pBRA (7.35), there was no significant change in pBRA over time. The volume receiving more than 150 Gy (V150) was the only significant predictor of pBRA. The majority of patients (86.6%) were completely satisfied with their treatment. Conclusions: Patients and the treating physician reported a high rate of excellent-to-good cosmetic outcomes at all follow-up time points. Acute breast infection and chemotherapy were associated with worse cosmetic outcomes. Multicatheter interstitial brachytherapy does not significantly change breast size as measured by pBRA

  7. Analysis of factors effecting maternal breast-feeding behavior%产妇哺乳行为的影响因素分析

    Institute of Scientific and Technical Information of China (English)

    郭琳; 周晓梅; 侯桂芝; 齐建林; 董燕; 吴程曦

    2013-01-01

    目的 探讨产妇哺乳行为的影响因素,以便有针对性地解决临床母乳喂养存在的问题.方法 2003-2008年来我院接受产后常规检查的妇女99名,接受检测时间为产后42 d,采用SCL-90评价孕妇的情绪.按中国常模划分,总分>160分或阳性项目数>43项,或任一因子分>2分为阳性,按SCL-90检测结果分成阳性组与阴性组,比较两组间哺乳行为的差异.同时填写产妇产后情况调查表.结果 受访的99例产妇中,共有26例(26.3%)采用母乳喂养;心理检测阳性组的母乳喂养率低于心理检测阴性组(x2=6.41,P<0.01);产妇哺乳行为与产妇的生产方式、婴儿排便和产妇对待婴儿哭闹的方式因素进入了回归方程,说明不同的生产方式、产妇对待哭闹婴儿的方式、婴儿排便情况与产妇的哺乳行为相互影响.结论 哺乳行为和产妇心理以及情绪状态存在联系.对长期有负性情绪体验的产妇给予必要的心理支持,建立良好的哺乳行为可降低心理应激、促进婴儿发育,增进亲子关系,有效的提高母乳喂养率.%Objective To analyze the factors effecting maternal breast-feeding behavior and to solve the problems existing in clinical maternal breast-feeding. Methods A total of 99 postpartum women were psychologically tested during routine examination on their postpartum 42nd day in 2003 through 2008. Symptom checklist 90 (SCL-90) was used to evaluate the mood of the women. According to Chinese norm, total score > 60, or positive item number > 43, or any item score > 2, was defined as positive and divided into positive group and negative group according to the SCL-90 results, the difference of breast-feeding behavior was compared between two groups. Results As for breast-feeding, 26 of the 99 ones (26. 3% ) experienced breast-feeding. The breastfeeding rate was lower in SCL-90 positive group than in SCL-90 negative group (χ2 =6.41, P < 0. 01 ) . Such factors as maternal

  8. Fortifier and Cream Improve Fat Delivery in Continuous Enteral Infant Feeding of Breast Milk

    Directory of Open Access Journals (Sweden)

    Mika Tabata

    2015-02-01

    Full Text Available Premature and high-risk infants require accurate delivery of nutrients to promote appropriate growth. Continuous enteral feeding methods may result in significant fat and micronutrient loss. This study evaluated fat loss in enteral nutrition using current strategies for providing high-risk infants fortified human milk (HM. The fat content of HM was measured by IR analyzer in a simulated feeding system using the Kangaroo epumpTM and the MedFusionTM 2010 pump. Comparisons in fat loss were made between HM, HM supplemented with donor HM-derived fortifier Prolacta + H2MFTM (H2MF, and HM supplemented with H2MF and donor HM-derived cream ProlactCRTM (cream. When using the Kangaroo epumpTM, the addition of H2MF and cream to HM increased fat delivery efficiency from 75.0% ± 1.2% to 83.7% ± 1.0% (p < 0.0001. When using the MedFusionTM 2010 pump, the addition of H2MF to HM increased fat delivery efficiency from 83.2% ± 2.8% to 88.8% ± 0.8% (p < 0.05, and the addition of H2MF and cream increased fat delivery efficiency to 92.0% ± 0.3% (p < 0.01. The addition of H2MF and cream to HM provides both the benefits of bioactive elements from mother’s milk and increased fat delivery, making the addition of H2MF and cream an appropriate method to improve infant weight gain.

  9. Optimal systemic therapy for early breast cancer in women: a clinical practice guideline.

    Science.gov (United States)

    Eisen, A; Fletcher, G G; Gandhi, S; Mates, M; Freedman, O C; Dent, S F; Trudeau, M E

    2015-03-01

    The Breast Cancer Disease Site Group of Cancer Care Ontario identified the need for new guidelines for the adjuvant systemic therapy of early-stage breast cancer. The specific question to be addressed was "What is the optimal adjuvant systemic therapy for female patients with early-stage operable breast cancer, when patient and disease factors are considered?" A systematic review was prepared based on literature searches conducted using the medline and embase databases for the period January 2008 to March 5, 2012, and updated to May 12, 2014. Guidelines were located from that search, from the Standards and Guidelines Evidence directory of cancer guidelines, and from the Web sites of major guideline organizations. The literature located was subdivided into the broad categories of chemotherapy, hormonal therapy, and therapy targeted to her2 (human epidermal growth factor receptor 2). Although several of the systemic therapies discussed in this guideline can be considered in the neoadjuvant setting, the review focused on trials with rates of disease-free and overall survival as endpoints and thus excluded several trials that used pathologic complete response as a primary endpoint. Based on the systematic review, the working group drafted recommendations on the use of chemotherapy, hormonal therapy, and targeted therapy; based on their professional experience, they also drafted recommendations on patient and disease characteristics and recurrence risk. The literature review and draft recommendations were circulated to a consensus panel of medical oncologists who had expertise in breast cancer and who represented the regions of Ontario. Items without initial consensus were discussed at an in-person consensus meeting held in Toronto, November 23, 2012. The final recommendations are those for which consensus was reached before or at the meeting. Some of the key evidence was revised after the updated literature search. Evidence reviews for systemic chemotherapy, endocrine

  10. Effects of feeding metabolite combinations from lactobacillus plantarum on plasma and breast meat lipids in Broiler Chickens

    Directory of Open Access Journals (Sweden)

    TC Loh

    2013-12-01

    Full Text Available The effects of feeding different doses of metabolite combination of L. plantarum RS5, RI11, RG14 and RG11 strains (Com3456 on cholesterol reduction in plasma and breast meat in broiler chickens and the possible mechanism was studied. A total of 504 male Ross broilers were grouped into 7 treatments and offered with different diets: (i standard corn-soybean based diet (-ve control; (ii standard cornsoybean based diet + neomycin and oxytetracycline (+ve control; (iii standard corn-soybean based diet + 0.1% metabolite combination of L. plantarum RS5, RI11, RG14 and RG11 strains (Com3456; (iv standard corn-soybean based diet + 0.2% of Com3456; (v standard cornsoybean based diet + 0.3% of Com3456 (vi standard corn-soybean based diet + 0.4% of Com3456 and (vii standard corn-soybean based diet + 0.5% of Com3456. The metabolite combinations supplemented in the diet of broilers reduced protein, cholesterol esters concentration in very low-density lipoprotein particles. The present of organic acids and proteinaceous compound in the metabolite combinations as found in previous study also increased lactic acid bacteria count in small intestine digesta and improved bile salts deconjugation ability of lactic acid bacteria.

  11. Five-year Results of Whole Breast Intensity Modulated Radiation Therapy for the Treatment of Early Stage Breast Cancer: The Fox Chase Cancer Center Experience

    Energy Technology Data Exchange (ETDEWEB)

    Keller, Lanea M.M., E-mail: Lanea.Keller@fccc.edu [Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA (United States); Sopka, Dennis M. [Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA (United States); Li Tianyu [Department of Biostatistics, Fox Chase Cancer Center, Philadelphia, PA (United States); Klayton, Tracy; Li Jinsheng; Anderson, Penny R. [Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA (United States); Bleicher, Richard J.; Sigurdson, Elin R. [Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, PA (United States); Freedman, Gary M. [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA (United States)

    2012-11-15

    Purpose: To report the 5-year outcomes using whole-breast intensity-modulated radiation therapy (IMRT) for the treatment of early-stage-breast cancer at the Fox Chase Cancer Center. Methods and Materials: A total of 946 women with early-stage breast cancer (stage 0, I, or II) were treated with IMRT after surgery with or without systemic therapy from 2003-2010. Whole-breast radiation was delivered via an IMRT technique with a median whole-breast radiation dose of 46 Gy and median tumor bed boost of 14 Gy. Endpoints included local-regional recurrence, cosmesis, and late complications. Results: With a median follow-up of 31 months (range, 1-97 months), there were 12 ipsilateral breast tumor recurrences (IBTR) and one locoregional recurrence. The 5-year actuarial IBTR and locoregional recurrence rates were 2.0% and 2.4%. Physician-reported cosmestic outcomes were available for 645 patients: 63% were considered 'excellent', 33% 'good', and <1.5% 'fair/poor'. For physician-reported cosmesis, boost doses {>=}16 Gy, breast size >900 cc, or boost volumes >34 cc were significantly associated with a 'fair/poor' cosmetic outcome. Fibrosis, edema, erythema, and telangectasia were also associated with 'fair/poor' physician-reported cosmesis; erythema and telangectasia remained significant on multivariate analysis. Patient-reported cosmesis was available for 548 patients, and 33%, 50%, and 17% of patients reported 'excellent', 'good', and 'fair/poor' cosmesis, respectively. The use of a boost and increased boost volume: breast volume ratio were significantly associated with 'fair/poor' outcomes. No parameter for patient-reported cosmesis was significant on multivariate analysis. The chances of experiencing a treatment related effect was significantly associated with a boost dose {>=}16 Gy, receipt of chemotherapy and endocrine therapy, large breast size, and electron boost energy

  12. Aromatase inhibitors, efficacy and metabolic risk in the treatment of postmenopausal women with early breast cancer

    Directory of Open Access Journals (Sweden)

    Stefano Gonnelli

    2008-11-01

    Full Text Available Stefano Gonnelli1, Roberto Petrioli21Department of Internal Medicine, Endocrine-Metabolic Science and Biochemistry, University of Siena, Italy (Dir. R. Nuti.; 2Department of Human Pathology and Oncology, Medical Oncology Section, University of Siena, Italy (Dir. G. FranciniAbstract: The third-generation aromatase inhibitors (AIs, letrozole, anastrozole and exemestane, are becoming the first choice endocrine drugs for post-menopausal women with breast cancer, since they present greater efficacy when compared with tamoxifen in both adjuvant and metastatic setting. In particular, several large and well designed trials have suggested an important role for AIs in the adjuvant treatment of postmenopausal women with estrogen-receptor positive breast cancer either in the upfront, sequential or extended adjuvant mode. Overall, AIs are associated with a small but significant improvement in disease free survival. The expanding use of AIs in the treatment of early breast cancer means that individual patients will be exposed to the agents for longer durations, making it increasingly important to establish their long-term safety. This review focused on the effects of AIs on bone metabolism, serum lipids and cardiovascular risk. AIs have adverse effects on bone turnover with a reduction of bone mineral density and an increase in the rate of fragility fractures. With respect to tamoxifen AIs present lower thrombotic risk and a less favorable impact on lipid profile, whereas the true effects on cardiovascular risk still remain to be clarified. An adequate monitoring of bone mineral density (BMD and lipid profile could be recommended for post-menopausal women candidate to AIs.Keywords: breast cancer, aromatase inhibitors, bone loss, lipids, cardiovascular risk

  13. Aromatase inhibitors, efficacy and metabolic risk in the treatment of postmenopausal women with early breast cancer

    Directory of Open Access Journals (Sweden)

    Stefano Gonnelli

    2008-12-01

    Full Text Available Stefano Gonnelli1, Roberto Petrioli21Department of Internal Medicine, Endocrine-Metabolic Science and Biochemistry, University of Siena, Italy (Dir. R. Nuti.; 2Department of Human Pathology and Oncology, Medical Oncology Section, University of Siena, Italy (Dir. G. FranciniAbstract: The third-generation aromatase inhibitors (AIs, letrozole, anastrozole and exemestane, are becoming the first choice endocrine drugs for post-menopausal women with breast cancer, since they present greater efficacy when compared with tamoxifen in both adjuvant and metastatic setting. In particular, several large and well designed trials have suggested an important role for AIs in the adjuvant treatment of postmenopausal women with estrogen-receptor positive breast cancer either in the upfront, sequential or extended adjuvant mode. Overall, AIs are associated with a small but significant improvement in disease free survival. The expanding use of AIs in the treatment of early breast cancer means that individual patients will be exposed to the agents for longer durations, making it increasingly important to establish their long-term safety. This review focused on the effects of AIs on bone metabolism, serum lipids and cardiovascular risk. AIs have adverse effects on bone turnover with a reduction of bone mineral density and an increase in the rate of fragility fractures. With respect to tamoxifen AIs present lower thrombotic risk and a less favorable impact on lipid profile, whereas the true effects on cardiovascular risk still remain to be clarified. An adequate monitoring of bone mineral density (BMD and lipid profile could be recommended for post-menopausal women candidate to AIs.Keywords: breast cancer, aromatase inhibitors, bone loss, lipids, cardiovascular risk

  14. Individual radiotherapy planning after organ-preserving surgery in early breast carcinoma patients

    International Nuclear Information System (INIS)

    It is the purpose of the paper to assess the beneficial effect of individual CT treatment planning in patients with early breast carcinoma after organ-preserving operations. The study covers 122 cases presenting breast carcinoma stage I-II, subjected to postoperative radiotherapy following quadrantectomy and radical axillary dissection. In 87.7 per cent CTV-I (clinical target volume)includes the preserved breast with the underlying thoracic wall. In patients with N1 and >3 positive axillary lymph nodes (12.3%) CTV-II is added for the supraclavicular lymph nodes. In all patients at least three transverse sections are prepared at irradiation position on CT Somatom AR.C (Siemens), and five with sagittal topogram for patients with left breast. The obtained CT data are plotted on the topographic section of the thoracic wall contour and verified by x-ray simulator. CT sections are used for high-precision outlining of PRV and organs at risk, using photographic magnifying lens. PTV-I is irradiated using two tangential fields (60Co) without boost for the tumor bed to the prescribed 50 Gy total focal dose, in 25 fractions over five weeks. Supraclavicular fossa irradiation is supplemented by a 'third' field at 44 Gy total dose. A 5-year local control is achieved in 96.0 per cent of patients, with excellent and good cosmetic results in 56.1 and 41.0 per cent of the cases, respectively. Post-irradiation pulmonary fibrosis is recorded in 1.6 per cent. The method described is readily accessible and practicable in all patients. It allows for homogeneous CTV irradiation at maximum sparing of the organs at risk. (author)

  15. The molecular subtype classification is a determinant of sentinel node positivity in early breast carcinoma.

    Directory of Open Access Journals (Sweden)

    Fabien Reyal

    Full Text Available INTRODUCTION: Several authors have underscored a strong relation between the molecular subtypes and the axillary status of breast cancer patients. The aim of our work was to decipher the interaction between this classification and the probability of a positive sentinel node biopsy. MATERIALS AND METHODS: Our dataset consisted of a total number of 2654 early-stage breast cancer patients. Patients treated at first by conservative breast surgery plus sentinel node biopsies were selected. A multivariate logistic regression model was trained and validated. Interaction covariate between ER and HER2 markers was a forced input of this model. The performance of the multivariate model in the training and the two validation sets was analyzed in terms of discrimination and calibration. Probability of axillary metastasis was detailed for each molecular subtype. RESULTS: The interaction covariate between ER and HER2 status was a stronger predictor (p = 0.0031 of positive sentinel node biopsy than the ER status by itself (p = 0.016. A multivariate model to determine the probability of sentinel node positivity was defined with the following variables; tumour size, lympho-vascular invasion, molecular subtypes and age at diagnosis. This model showed similar results in terms of discrimination (AUC = 0.72/0.73/0.72 and calibration (HL p = 0.28/0.05/0.11 in the training and validation sets. The interaction between molecular subtypes, tumour size and sentinel nodes status was approximated. DISCUSSION: We showed that biologically-driven analyses are able to build new models with higher performance in terms of breast cancer axillary status prediction. The molecular subtype classification strongly interacts with the axillary and distant metastasis process.

  16. The effects of early experience on subsequent feeding responses in the Tegu, Tupinambis teguixin (Squamata : Teiidae).

    Science.gov (United States)

    Punzo, F

    2003-01-01

    The purpose of this study was to assess the effects of early feeding experiences on subsequent responses to prey in the tegu, Tupinambis teguixin. Five-day old lizards were exposed to the odors of various prey and control substances on cotton-tipped applicators with the tongue-flick attack score (TFAS) chosen as the dependent variable. Each lizard was exposed to four stimuli: two controls (deionised water and cologne), and extracts from a mouse Mus musculus, and a lizard Ameiva ameiva, in a repeated measures, randomized block design, receiving one stimulus training session / day over a 40-day period. Tongue-flicks directed toward the applicator were counted over a 1 min period as well as the amount of time that elapsed from the first tongue flick to any bite that may have occurred. Live neonatal mice (but not A. ameiva), offered on a weekly basis, were used as a food source for tegus over a 10-month period. After 10 months, tegus were exposed to applicators containing control odors as well as those containing extracts from mice and lizards (A. ameiva). Mouse extracts elicited significantly higher TFAS as compared to those elicited by A. ameiva or control odors, suggesting that prey odors encountered in the environment shortly after hatching can influence prey preferences by these lizards later in life. These results also indicate that tegu lizards can learn to use specific odor cues associated with naturally occurring prey as releasers for subsequent hunting behaviors. PMID:12974408

  17. Delineation of target volumes and organs at risk in adjuvant radiotherapy of early breast cancer: national guidelines and contouring atlas by the Danish Breast Cancer Cooperative Group

    DEFF Research Database (Denmark)

    Nielsen, Mette H; Berg, Martin; Pedersen, Anders N;

    2013-01-01

    During the past decade planning of adjuvant radiotherapy (RT) of early breast cancer has changed from two-dimensional (2D) to 3D conformal techniques. In the planning computerised tomography (CT) scan both the targets for RT and the organs at risk (OARs) are visualised, enabling an increased focu...... on target dose coverage and homogeneity with only minimal dose to the OARs. To ensure uniform RT in the national prospective trials of the Danish Breast Cancer Cooperative Group (DBCG), a national consensus for the delineation of clinical target volumes (CTVs) and OARs was required....

  18. A high protein moderate carbohydrate diet fed at discrete meals reduces early progression of N-methyl-N-nitrosourea-induced breast tumorigenesis in rats

    Directory of Open Access Journals (Sweden)

    Singletary Keith W

    2010-01-01

    Full Text Available Abstract Breast cancer is the most prevalent cancer in American women. Dietary factors are thought to have a strong influence on breast cancer incidence. This study utilized a meal-feeding protocol with female Sprague-Dawley rats to evaluate effects of two ratios of carbohydrate:protein on promotion and early progression of breast tissue carcinomas. Mammary tumors were induced by N-methyl-N-nitrosourea (MNU at 52 d of age. Post-induction, animals were assigned to consume either a low protein high carbohydrate diet (LPHC; 15% and 60% of energy, respectively or a high protein moderate carbohydrate diet (HPMC; 35% and 40% of energy, respectively for 10 wk. Animals were fed 3 meals/day to mimic human absorption and metabolism patterns. The rate of palpable tumor incidence was reduced in HPMC relative to LPHC (12.9 ± 1.4%/wk vs. 18.2 ± 1.3%/wk. At 3 wk, post-prandial serum insulin was larger in the LPHC relative to HPMC (+136.4 ± 33.1 pmol/L vs. +38.1 ± 23.4 pmol/L, while at 10 wk there was a trend for post-prandial IGF-I to be increased in HPMC (P = 0.055. There were no differences in tumor latency, tumor surface area, or cumulative tumor mass between diet groups. The present study provides evidence that reducing the dietary carbohydrate:protein ratio attenuates the development of mammary tumors. These findings are consistent with reduced post-prandial insulin release potentially diminishing the proliferative environment required for breast cancer tumors to progress.

  19. Value of combined detection of serum miR-21,miR-195 and miR-222 in the diagnosis of early breast cancer

    Institute of Scientific and Technical Information of China (English)

    Wen-Zhao Zhang; Ying Li; De-Xiang Wu

    2016-01-01

    Objective:To study level of miRNA in the serum of early breast carcinoma patients and to evaluate the clinical diagnostic value of combined detection of early breast carcinoma. Methods:A total of 54 cases of early breast carcinoma, 58 cases of benign breast diseases and 70 cases of healthy physical examination women were selected as the research subjects, to analysis serum miR-21, miR-195 and miR-222 levels by fluorescence quantitative PCR method and to analyze the diagnostic value of single and combined detection in early breast cancer by receiver operating characteristic curve. Results:The relative expression levels of miR-21, miR-222 and miR-195 in early breast carcinoma patients were significantly higher than those in benign breast disease and healthy controls;there was no significant difference in the relative expression of miR-21, miR-222 and miR-195 in the benign breast disease group and healthy control group;receiver operating characteristic curve analysis showed that AUC of miR-21, miR-195 and miR-222 in the diagnosis of early breast carcinoma were 0.805, 0.86 and 0.848 respectively, the sensitivity were 63.3%, 70.0%and 70.0%, and the specificity were 86.7%, 93.3%and 90.0%;AUC, sensitivity and specificity of the combined detection were 0.974, 93.3%and 96.7%respectively. Conclusion:miR-21, miR-195 and miR-222 levels in serum of patients with early breast carcinoma rise, the combined detection of the 3 indicators have a high diagnostic value for early breast carcinoma, and contribute to early breast carcinoma screening and diagnosis.

  20. Clinical outcome of three dimensional conformal radiation therapy for early breast cancer after conservative surgery

    International Nuclear Information System (INIS)

    Objective: To compare the efficacy, complications, cosmetic results between conventional radiotherapy (CR) and three dimensional conformal radiation therapy (3DCRT) after conservative surgery for early breast cancer. Methods: Totally 106 patients underwent postoperative radiotherapy after breast-conserving surgery, including 62 patients who received CR and 46 received 3DCRT. The radiation dose was determined by the tumor size, tumor location and axillary node involvement. Tangential fields were used to deliver 6 MV X-ray beams to a total dose of 50 Gy in 5 weeks. An additional 10-15 Gy was given to the tumor bed with 6-9 MeV electron beams in 1.0-1.5 weeks. The median follow-up time was 32 months. Results: The local recurrence, metastasis or death were observed in 3, 5 and 2 patients in the CR group, while 1, 4 and 2 in the 3DCRT group. No statistical significant difference was found between these two groups (P>0.05). Radiation induced pneumonia was observed in 11 patients in CR group versus none in the 3DCRT group. Six months and one year after radiotherapy, 90% and 93% of these patients were assessed as excellent or in fine cosmetic state in the CR group, versus 91.5% and 93.8% in the 3DCRT group. There was no significant difference in the cosmetic results between these two groups (P > 0.05). Conclusions: Three dimensional conformal radiation therapy possesses similar treatment and cosmetic results to conventional radiotherapy after conservative surgery for early breast cancer. But the former, one can markedly reduce the likely hood of radiation complications. (authors)

  1. Hypothesis: primary antiangiogenic method proposed to treat early stage breast cancer

    International Nuclear Information System (INIS)

    Women with Down syndrome very rarely develop breast cancer even though they now live to an age when it normally occurs. This may be related to the fact that Down syndrome persons have an additional copy of chromosome 21 where the gene that codes for the antiangiogenic protein Endostatin is located. Can this information lead to a primary antiangiogenic therapy for early stage breast cancer that indefinitely prolongs remission? A key question that arises is when is the initial angiogenic switch thrown in micrometastases? We have conjectured that avascular micrometastases are dormant and relatively stable if undisturbed but that for some patients angiogenesis is precipitated by surgery. We also proposed that angiogenesis of micrometastases very rarely occurs before surgical removal of the primary tumor. If that is so, it seems possible that we could suggest a primary antiangiogenic therapy but the problem then arises that starting a therapy before surgery would interfere with wound healing. The therapy must be initiated at least one day prior to surgical removal of the primary tumor and kept at a Down syndrome level perhaps indefinitely. That means the drug must have virtually no toxicity and not interfere meaningfully with wound healing. This specifically excludes drugs that significantly inhibit the VEGF pathway since that is important for wound healing and because these agents have some toxicity. Endostatin is apparently non-toxic and does not significantly interfere with wound healing since Down syndrome patients have no abnormal wound healing problems. We propose a therapy for early stage breast cancer consisting of Endostatin at or above Down syndrome levels starting at least one day before surgery and continuing at that level. This should prevent micrometastatic angiogenesis resulting from surgery or at any time later. Adjuvant chemotherapy or hormone therapy should not be necessary. This can be continued indefinitely since there is no acquired resistance that

  2. Early-Stage Breast Cancer in the Octogenarian: Tumor Characteristics, Treatment Choices, and Clinical Outcomes

    Science.gov (United States)

    Mamtani, Anita; Gonzalez, Julie J.; Neo, Dayna; Slanetz, Priscilla J.; Houlihan, Mary Jane; Herold, Christina I.; Recht, Abram; Hacker, Michele R.; Sharma, Ranjna

    2016-01-01

    Background Nodal staging with sentinel node biopsy (SLNB), post-lumpectomy radiotherapy (RT), and endocrine therapy (ET) for estrogen receptor-positive (ER+) tumors is valuable in the treatment of early-stage (stages 1 or 2) breast cancer but used less often for elderly women. Methods This retrospective study investigated women referred for surgical evaluation of biopsy-proven primary early-stage invasive breast cancer from January 2001 to December 2010. Clinicopathologic features, treatment course, and outcomes for women ages 80–89 years and 50–59 years were compared. Results The study identified 178 eligible women ages 80–89 years and 169 women ages 50–59 years. The elderly women more often had grade 1 or 2 disease (p = 0.003) and ER+ tumors (p = 0.007) and less frequently had undergone adjuvant therapies (all p ≤ 0.001). Lumpectomy was performed more commonly for the elderly (92 vs. 83 %, p = 0.02), and axillary surgery was less commonly performed (46 vs. 96 %; p < 0.001). Fewer elderly women had undergone post-lumpectomy RT (42 vs. 89 %; p < 0.001) and ET for ER+ tumors (72 vs. 95 %; p < 0.001). During the median follow-up period of 56 months for the 80- to 89-year old group and 98 months for the 50- to 59-year-old group, death from breast cancer was similar (4 vs. 5 %; p = 0.5). The two groups respectively experienced 7 versus 6 locoregional recurrences and 11 versus 13 distant recurrences. Conclusions The octogenarians had disease survivorship similar to that of the younger women despite less frequent use of adjuvant therapies, likely reflecting lower-risk disease features. Whether increased use of axillary surgery, post-lumpectomy RT, and/or ET for ER+ tumors would further improve outcomes is an important area for further study, but treatment should not be deferred solely on the basis of age. PMID:27364507

  3. Training radiographers to deliver an intervention to promote early presentation of breast cancer

    International Nuclear Information System (INIS)

    Aim: To evaluate the feasibility of training sufficient radiographers to deliver an intervention to promote early presentation of breast cancer to all older women attending for their final routine mammogram within the NHS Breast Screening Programme. If the Promoting Early Presentation (PEP) intervention is demonstrated to be cost-effective, it may be implemented across the NHS requiring at least four radiographers per screening service to deliver the intervention. Methods: A pilot study in a single breast screening service was conducted to assess the feasibility of training sufficient radiographers to meet this objective. Quantitative and qualitative methods were used to evaluate the impact of training on participating radiographers and the screening service. Competency to deliver the intervention was assessed at key points during training according to quality criteria based on delivery of the key messages and style of delivery. Confidence to deliver the intervention was assessed using a self-report measure before and after training. Radiographers' experiences of training were elicited in face-to-face qualitative interviews. Results: Seven of eight radiographers who were released to undertake the training achieved the required level of competency to deliver the intervention within four months. All improved over time in their confidence to deliver the key messages of the intervention. The qualitative analysis revealed the benefits and challenges of training from the perspective of the radiographers. Conclusion: It was feasible and acceptable to train sufficient radiographers to deliver the PEP Intervention. The training package will be streamlined to improve efficiency for large implementation trials and clinical practice across the NHS.

  4. Detection of the smallest microcalcifications for early diagnostic of breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Martinazzi, Elizandra; Kleper, S.O., E-mail: elizandra.martinazzi@gmail.com [Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS (Brazil). Institute of Physics

    2011-07-01

    Even though breast cancer is a cancer with relatively easy early diagnostic and has an appropriate treatment, it has high mortality rates in Brazil. This is in part because the disease is diagnosed only in advanced stages, but also because the whole information contained in the mammograms is not used by physicians and radiologists. There are many parameters to be considered in assessing the quality of a mammogram image. Among these parameters are contrast, spatial resolution, the signal-to-noise ratio, and the efficiency of the applied dose. Even with the improvement of the quality of radiographs, many structures, such as small microcalcifications, are not always identified by radiologists in the images. To determine the lowest detectable structures in digital mammograms, we made a numerical analysis of a few digital mammography using simulators, determining the spatial and intensity resolutions, and studying the noise and its distribution. With this, we could determine the detection levels, quantifying the probability that any point is due to statistical noise or a real change in breast density. This is the first step towards early detection of microcalcifications. In our work, it was possible to detect even the smallest microcalcifications of the simulator, 0.18 mm in diameter, with false alarm probability smaller than 1/1000. (author)

  5. A prospective cohort study of early discontinuation of adjuvant chemotherapy in women with breast cancer: the breast cancer quality of care study (BQUAL).

    Science.gov (United States)

    Neugut, Alfred I; Hillyer, Grace Clarke; Kushi, Lawrence H; Lamerato, Lois; Buono, Donna L; Nathanson, S David; Bovbjerg, Dana H; Mandelblatt, Jeanne S; Tsai, Wei-Yann; Jacobson, Judith S; Hershman, Dawn L

    2016-07-01

    For many women with non-metastatic breast cancer, adjuvant chemotherapy prevents recurrence and extends survival. Women who discontinue chemotherapy early may reduce those benefits, but little is known about what predicts early discontinuation. We sought to determine prospectively the rate and reasons for early discontinuation of adjuvant chemotherapy in women with breast cancer. We conducted a prospective cohort study among three U.S. health care organizations. Of 1158 women with newly diagnosed non-metastatic breast cancer, 2006-2010, we analyzed 445 (38.4 %) patients who initiated standard adjuvant chemotherapy as defined by accepted guidelines. We interviewed patients at baseline and twice during treatment regarding sociodemographic/psychosocial factors and treatment decision-making and collected clinical data. They were categorized according to the number of cycles required by the chemotherapy regimen they had initiated. The outcome was early discontinuation (4 cycles of therapy (18.1 % for longer regimens, 7.4 % for 4 cycles) (odds ratio [OR] 2.59, 95 % CI 1.32-5.08), controlling for race, age, stage, hormone receptor status, social support, optimism, spirituality, stress, and physical symptoms. Higher levels of psychological symptoms on the Memorial symptom assessment scale also increased the odds of early discontinuation (OR 1.92, 95 % CI 0.998-3.68). The large majority of patients who initiated adjuvant chemotherapy for breast cancer completed their prescribed regimens, but early discontinuation was associated with lengthier regimens and, with borderline statistical significance, for those with psychological side effects. PMID:27287779

  6. Evaluation of Vascular Endothelial Growth Factor as a Prognostic Marker for Local Relapse in Early-Stage Breast Cancer Patients Treated With Breast-Conserving Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Moran, Meena S., E-mail: meena.moran@yale.edu [Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, CT (United States); Yang Qifeng [Department of Radiation Oncology, University of Medicine and Dentistry of New Jersey Robert Wood Johnson School of Medicine and the Cancer Institute of New Jersey, New Brunswick, NJ (United States); Department of Breast Surgery, Qilu Hospital, Shandong University, Jinan, People' s Republic of China (China); Goyal, Sharad [Department of Radiation Oncology, University of Medicine and Dentistry of New Jersey Robert Wood Johnson School of Medicine and the Cancer Institute of New Jersey, New Brunswick, NJ (United States); Harris, Lyndsay; Chung, Gina [Department of Medical Oncology, Yale University School of Medicine, New Haven, CT (United States); Haffty, Bruce G. [Department of Radiation Oncology, University of Medicine and Dentistry of New Jersey Robert Wood Johnson School of Medicine and the Cancer Institute of New Jersey, New Brunswick, NJ (United States)

    2011-12-01

    Purpose: Vascular endothelial growth factor (VEGF) is an important protein involved in the process of angiogenesis that has been found to correlate with relapse-free and overall survival in breast cancer, predominantly in locally advanced and metastatic disease. A paucity of data is available on the prognostic implications of VEGF in early-stage breast cancer; specifically, its prognostic value for local relapse after breast-conserving therapy (BCT) is largely unknown. The purpose of our study was to assess VEGF expression in a cohort of early-stage breast cancer patients treated with BCT and to correlate the clinical and pathologic features and outcomes with overexpression of VEGF. Methods and Materials: After obtaining institutional review board approval, the paraffin specimens of 368 patients with early-stage breast cancer treated with BCT between 1975 and 2005 were constructed into tissue microarrays with twofold redundancy. The tissue microarrays were stained for VEGF and read by a trained pathologist, who was unaware of the clinical details, as positive or negative according the standard guidelines. The clinical and pathologic data, long-term outcomes, and results of VEGF staining were analyzed. Results: The median follow-up for the entire cohort was 6.5 years. VEGF expression was positive in 56 (15%) of the 368 patients. Although VEGF expression did not correlate with age at diagnosis, tumor size, nodal status, histologic type, family history, estrogen receptor/progesterone receptor status, or HER-2 status, a trend was seen toward increased VEGF expression in the black cohort (26% black vs. 13% white, p = .068). Within the margin-negative cohort, VEGF did not predict for local relapse-free survival (RFS) (96% vs. 95%), nodal RFS (100% vs. 100%), distant metastasis-free survival (91% vs. 92%), overall survival (92% vs. 97%), respectively (all p >.05). Subset analysis revealed that VEGF was highly predictive of local RFS in node-positive, margin

  7. Early Prediction and Evaluation of Breast Cancer Response to Neoadjuvant Chemotherapy Using Quantitative DCE-MRI.

    Science.gov (United States)

    Tudorica, Alina; Oh, Karen Y; Chui, Stephen Y-C; Roy, Nicole; Troxell, Megan L; Naik, Arpana; Kemmer, Kathleen A; Chen, Yiyi; Holtorf, Megan L; Afzal, Aneela; Springer, Charles S; Li, Xin; Huang, Wei

    2016-02-01

    The purpose is to compare quantitative dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) metrics with imaging tumor size for early prediction of breast cancer response to neoadjuvant chemotherapy (NACT) and evaluation of residual cancer burden (RCB). Twenty-eight patients with 29 primary breast tumors underwent DCE-MRI exams before, after one cycle of, at midpoint of, and after NACT. MRI tumor size in the longest diameter (LD) was measured according to the RECIST (Response Evaluation Criteria In Solid Tumors) guidelines. Pharmacokinetic analyses of DCE-MRI data were performed with the standard Tofts and Shutter-Speed models (TM and SSM). After one NACT cycle the percent changes of DCE-MRI parameters K(trans) (contrast agent plasma/interstitium transfer rate constant), ve (extravascular and extracellular volume fraction), kep (intravasation rate constant), and SSM-unique τi (mean intracellular water lifetime) are good to excellent early predictors of pathologic complete response (pCR) vs. non-pCR, with univariate logistic regression C statistics value in the range of 0.804 to 0.967. ve values after one cycle and at NACT midpoint are also good predictors of response, with C ranging 0.845 to 0.897. However, RECIST LD changes are poor predictors with C = 0.609 and 0.673, respectively. Post-NACT K(trans), τi, and RECIST LD show statistically significant (P < .05) correlations with RCB. The performances of TM and SSM analyses for early prediction of response and RCB evaluation are comparable. In conclusion, quantitative DCE-MRI parameters are superior to imaging tumor size for early prediction of therapy response. Both TM and SSM analyses are effective for therapy response evaluation. However, the τi parameter derived only with SSM analysis allows the unique opportunity to potentially quantify therapy-induced changes in tumor energetic metabolism. PMID:26947876

  8. Early Prediction and Evaluation of Breast Cancer Response to Neoadjuvant Chemotherapy Using Quantitative DCE-MRI

    Directory of Open Access Journals (Sweden)

    Alina Tudorica

    2016-02-01

    Full Text Available The purpose is to compare quantitative dynamic contrast-enhanced (DCE magnetic resonance imaging (MRI metrics with imaging tumor size for early prediction of breast cancer response to neoadjuvant chemotherapy (NACT and evaluation of residual cancer burden (RCB. Twenty-eight patients with 29 primary breast tumors underwent DCE-MRI exams before, after one cycle of, at midpoint of, and after NACT. MRI tumor size in the longest diameter (LD was measured according to the RECIST (Response Evaluation Criteria In Solid Tumors guidelines. Pharmacokinetic analyses of DCE-MRI data were performed with the standard Tofts and Shutter-Speed models (TM and SSM. After one NACT cycle the percent changes of DCE-MRI parameters Ktrans (contrast agent plasma/interstitium transfer rate constant, ve (extravascular and extracellular volume fraction, kep (intravasation rate constant, and SSM-unique τi (mean intracellular water lifetime are good to excellent early predictors of pathologic complete response (pCR vs. non-pCR, with univariate logistic regression C statistics value in the range of 0.804 to 0.967. ve values after one cycle and at NACT midpoint are also good predictors of response, with C ranging 0.845 to 0.897. However, RECIST LD changes are poor predictors with C = 0.609 and 0.673, respectively. Post-NACT Ktrans, τi, and RECIST LD show statistically significant (P < .05 correlations with RCB. The performances of TM and SSM analyses for early prediction of response and RCB evaluation are comparable. In conclusion, quantitative DCE-MRI parameters are superior to imaging tumor size for early prediction of therapy response. Both TM and SSM analyses are effective for therapy response evaluation. However, the τi parameter derived only with SSM analysis allows the unique opportunity to potentially quantify therapy-induced changes in tumor energetic metabolism.

  9. Breast Cancer Awareness and Prevention Behavior Among Women of Delhi, India: Identifying Barriers to Early Detection

    Science.gov (United States)

    Dey, Subhojit; Sharma, Surabhi; Mishra, Arti; Krishnan, Suneeta; Govil, Jyotsna; Dhillon, Preet K.

    2016-01-01

    BACKGROUND Globally, breast cancer (BC) has become the leading cause of mortality in women. Awareness and early detection can curb the growing burden of BC and are the first step in the battle against BC. The aim of this qualitative study was to explore the awareness and perceived barriers concerning the early detection of BC. METHODS A total of 20 focus group discussions (FGDs) were conducted during May 2013–March 2014. Pre-existing themes were used to conduct FGDs; each FGD group consisted of an average of ~10 women (aged ≥18–70 years) who came to participate in a BC awareness workshop. All FGDs were audio taped and transcribed verbatim. The transcripts were inductively analyzed using ATLAS.ti. Based on emerged codes and categories, thematic analysis was done, and theory was developed using the grounded theory approach. RESULTS Data were analyzed in three major themes: i) knowledge and perception about BC; ii) barriers faced by women in the early presentation of BC; and iii) healthcare-seeking behavior. The findings revealed that shyness, fear, and posteriority were the major behavioral barriers in the early presentation of BC. Erroneously, pain was considered as an initial symptom of BC by most women. Financial constraint was also mentioned as a cause for delay in accessing treatment. Social stigma that breast problems reflect bad character of women also contributed in hiding BC symptoms. CONCLUSIONS Lack of BC awareness was prevalent, especially in low socioeconomic class. Women’s ambivalence in prioritizing their own health and social and behavioral hurdles should be addressed by BC awareness campaigns appropriately suited for various levels of social class.

  10. Pre-operative FDG PET/CT findings related to early tumor recurrence in breast cancer patients

    International Nuclear Information System (INIS)

    The purpose of this study was to identify any pre-operative FDG PET/CT findings related to early recurrence in the breast cancer patients. One hundred eighteen breast cancer patients who underwent 18F-FDG PET/CT scan for preoperative staging from September 2004 to September 2005 were included. All patients received operation and follow-up examination. From the FDG PET/CT images, (1) the peak standard uptake values (pSUV) of the primary tumor, (2) pSUV of axillary lymph node (LN) were recorded. 7 out of 118 patients had tumor recurrence within 26 months after the surgery. The mean pSUV of primary tumors with early recurrence (6.113.22) was significantly higher than the mean pSUV of the early recurrence negative follow-up group (3.432.43). The mean pSUVs of the axillary LN showed no significant difference between the early recurrence group and recurrence negative (2.122.17 vs 2.411.13). Of 111 patients with no evidence of recurrence, 71 patients showed no perceptible FDG uptake in the axillary LNs. On the other hand, all of the 7 recurrent breast cancer cases show increased FDG uptakes of axillary LN. In the recurrence negative group, no axillary LN demonstrated perceptibly increased FDG uptakes in 64% (71/111 cases); increased FDG uptake was noted in 36% (40/111 cases). In breast cancer patients who had early recurrence, the pSUV of the primary tumor was significantly higher than that of early recurrence negative patients. Though the pSUV of the axillary LN was not a predictor of recurrent breast cancer, all recurrent breast cancer patients had FDG uptake in axillary LN

  11. 初产妇中医体质类型对母乳喂养的影响%Effect of TCM Constitution Type on Breast Feeding in Primipara

    Institute of Scientific and Technical Information of China (English)

    周莉; 岑莉; 冯筠; 宁晔; 宁艳

    2013-01-01

    [Objective] To understand the effect of different traditional Chinese medicine(TCM) constitution types on breast feeding in primipara through TCM constitution identification applied in primipara.[Methods]TCM constitution questionnaire was used for the survey on the constitution of 253 primiparas delivered in our hospitals.Constitution types of primiparas were identified.Breast feeding of different types of primiparas within 4 months were followed up.[Results]There was significant difference in breast feeding among nine TCM constitution types.Breast feeding gradually decreased with the progression of childbed,and decreased more significantly at 4 months.Mild constitution in primiparas had the highest rate of breastfeeding and was suitable for the entire course of pregnancy,labor and childbed.[Conclusion]After the TCM constitution of primipara is classified,TCM intervention is of active significance in breast feeding of primipara.%[目的]将中医体质辨识应用于初产妇,了解不同的中医体质类型对母乳喂养的影响.[方法]通过对两医院分娩的253名初产妇应用《中医体质调查量表》进行体质调查,以明确初产妇体质类型.对各类型产妇4个月内的母乳喂养情况进行随访调查.[结果]九种不同的中医体质类型的母乳喂养有明显差异,随着产褥进程母乳喂养逐渐减少,4个月最为显著;平和质的产妇母乳喂养率最高,能适应怀孕、分娩、产褥的整个过程.[结论]对初产妇进行中医体质分类后可通过中医中药干预,对初产妇的母乳喂养具有积极的意义.

  12. Five-year Results of Whole Breast Intensity Modulated Radiation Therapy for the Treatment of Early Stage Breast Cancer: The Fox Chase Cancer Center Experience

    International Nuclear Information System (INIS)

    Purpose: To report the 5-year outcomes using whole-breast intensity-modulated radiation therapy (IMRT) for the treatment of early-stage-breast cancer at the Fox Chase Cancer Center. Methods and Materials: A total of 946 women with early-stage breast cancer (stage 0, I, or II) were treated with IMRT after surgery with or without systemic therapy from 2003-2010. Whole-breast radiation was delivered via an IMRT technique with a median whole-breast radiation dose of 46 Gy and median tumor bed boost of 14 Gy. Endpoints included local-regional recurrence, cosmesis, and late complications. Results: With a median follow-up of 31 months (range, 1-97 months), there were 12 ipsilateral breast tumor recurrences (IBTR) and one locoregional recurrence. The 5-year actuarial IBTR and locoregional recurrence rates were 2.0% and 2.4%. Physician-reported cosmestic outcomes were available for 645 patients: 63% were considered “excellent”, 33% “good”, and 900 cc, or boost volumes >34 cc were significantly associated with a “fair/poor” cosmetic outcome. Fibrosis, edema, erythema, and telangectasia were also associated with “fair/poor” physician-reported cosmesis; erythema and telangectasia remained significant on multivariate analysis. Patient-reported cosmesis was available for 548 patients, and 33%, 50%, and 17% of patients reported “excellent”, “good”, and “fair/poor” cosmesis, respectively. The use of a boost and increased boost volume: breast volume ratio were significantly associated with “fair/poor” outcomes. No parameter for patient-reported cosmesis was significant on multivariate analysis. The chances of experiencing a treatment related effect was significantly associated with a boost dose ≥16 Gy, receipt of chemotherapy and endocrine therapy, large breast size, and electron boost energy. Conclusions: Whole-breast IMRT is associated with very low rates of local recurrence at 5 years, 83%-98% “good/excellent” cosmetic outcomes, and minimal

  13. A Prospective Longitudinal Clinical Trial Evaluating Quality of Life After Breast-Conserving Surgery and High-Dose-Rate Interstitial Brachytherapy for Early-Stage Breast Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Garsa, Adam A.; Ferraro, Daniel J.; DeWees, Todd A. [Department of Radiation Oncology, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri (United States); Deshields, Teresa L. [Department of Medicine, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri (United States); Margenthaler, Julie A.; Cyr, Amy E. [Department of Surgery, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri (United States); Naughton, Michael [Department of Medicine, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri (United States); Aft, Rebecca [Department of Surgery, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri (United States); Department of Surgery, John Cochran Veterans Hospital, St. Louis, Missouri (United States); Gillanders, William E.; Eberlein, Timothy [Department of Surgery, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri (United States); Matesa, Melissa A.; Ochoa, Laura L. [Department of Radiation Oncology, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri (United States); Zoberi, Imran, E-mail: izoberi@radonc.wustl.edu [Department of Radiation Oncology, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri (United States)

    2013-12-01

    Purpose: To prospectively examine quality of life (QOL) of patients with early stage breast cancer treated with accelerated partial breast irradiation (APBI) using high-dose-rate (HDR) interstitial brachytherapy. Methods and Materials: Between March 2004 and December 2008, 151 patients with early stage breast cancer were enrolled in a phase 2 prospective clinical trial. Eligible patients included those with Tis-T2 tumors measuring ≤3 cm excised with negative surgical margins and with no nodal involvement. Patients received 3.4 Gy twice daily to a total dose of 34 Gy. QOL was measured using European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30, version 3.0, and QLQ-BR23 questionnaires. The QLQ-C30 and QLQ-BR23 questionnaires were evaluated during pretreatment and then at 6 to 8 weeks, 3 to 4 months, 6 to 8 months, and 1 and 2 years after treatment. Results: The median follow-up was 55 months. Breast symptom scores remained stable in the months after treatment, and they significantly improved 6 to 8 months after treatment. Scores for emotional functioning, social functioning, and future perspective showed significant improvement 2 years after treatment. Symptomatic fat necrosis was associated with several changes in QOL, including increased pain, breast symptoms, systemic treatment side effects, dyspnea, and fatigue, as well as decreased role functioning, emotional functioning, and social functioning. Conclusions: HDR multicatheter interstitial brachytherapy was well tolerated, with no significant detrimental effect on measured QOL scales/items through 2 years of follow-up. Compared to pretreatment scores, there was improvement in breast symptoms, emotional functioning, social functioning, and future perspective 2 years after treatment.

  14. Simple Prediction Model of Axillary Lymph Node Positivity After Analyzing Molecular and Clinical Factors in Early Breast Cancer.

    Science.gov (United States)

    Chung, Mi Joo; Lee, Jong Hoon; Kim, Sung Hwan; Suh, Young Jin; Choi, Hyun Joo

    2016-05-01

    The aim of this study was to evaluate the association between pretreatment molecular and clinical factors and axillary lymph node metastases in early breast cancer. A total of 367 consecutive breast cancer patients with cT1-2NxM0 who underwent breast conserving surgery and axillary lymph node dissection followed by whole breast irradiation were enrolled. We evaluated the pathologic tumor and node status, tumor differentiation, calcification, and lymphovascular invasion, the status of estrogen receptor (ER), progesterone receptor (PR), epidermal growth factor receptor 1 (EGFR1), and human epidermal growth factor receptor 2 (HER2), the expression of E-cadherin, P53, and Ki-67 index. Totally, 108 (29.4%) of the 367 patients had positive axillary lymph nodes. An increased tumor size (P = 0.024), the presence of lymphovascular invasion (P 20% (P = 0.038) were significantly associated with axillary lymph node metastases on the multivariate analysis. In our study, 86.2% of the patients with all the unfavorable factors had an involvement of axillary nodal metastases, and only 12.2% of the patients with all the favorable predictors had positive axillary nodes. The predictive power was significant on the receiver operating curve (P positive ALNM on multivariate analysis for the patients with cT1-2 breast cancer. Clinicians simply could predict the probability of ALNM after verifying the molecular and clinical factors in early breast cancer. PMID:27196477

  15. A randomised controlled trial of forward-planned radiotherapy (IMRT) for early breast cancer: Baseline characteristics and dosimetry results

    International Nuclear Information System (INIS)

    Background and purpose: This large trial was designed to investigate whether correction of dose inhomogeneities using intensity-modulated radiotherapy (IMRT) reduces late toxicity and improves quality of life in patients with early breast cancer. This paper reports baseline characteristics of trial participants and dosimetry results. Materials and methods: Standard tangential plans of 1145 trials were analysed. Patients with inhomogeneous plans, defined by ICRU recommendations, were randomised to forward-planned IMRT or standard radiotherapy. Results: Twenty-nine percentage of patients had adequate dosimetry with standard 2D radiotherapy. In the randomised patients, the decreases in mean volumes receiving greater than 107% (Vol > 107) and less than 95% (Vol 3 (95% CI 26.4-41.6; P 3 (95% CI 34.4-61.9; P 107 > 2 cm3 on standard radiotherapy plans. Conclusion: This large trial, in which patients with all breast sizes were eligible, confirmed that breast dosimetry can be significantly improved with a simple method of forward-planned IMRT and has little impact on radiotherapy resources. It is shown that patients with larger breasts are more likely to have dose inhomogeneities and breast separation gives some indication of this likelihood. Photographic assessment of patients at 2 years after radiotherapy, as the next part of this randomised controlled trial, will show whether these results for IMRT translate into improved cosmetic outcome in patients with early breast cancer. This would provide impetus for the widespread adoption of 3D planning and IMRT.

  16. Proteomics of Breast Muscle Tissue Associated with the Phenotypic Expression of Feed Efficiency within a Pedigree Male Broiler Line: I. Highlight on Mitochondria.

    Science.gov (United States)

    Kong, Byung-Whi; Lassiter, Kentu; Piekarski-Welsher, Alissa; Dridi, Sami; Reverter-Gomez, Antonio; Hudson, Nicholas James; Bottje, Walter Gay

    2016-01-01

    As feed represents 60 to 70% of the cost of raising an animal to market weight, feed efficiency (the amount of dry weight intake to amount of wet weight gain) remains an important genetic trait in animal agriculture. To gain greater understanding of cellular mechanisms of feed efficiency (FE), shotgun proteomics was conducted using in-gel trypsin digestion and tandem mass spectrometry on breast muscle samples obtained from pedigree male (PedM) broilers exhibiting high feed efficiency (FE) or low FE phenotypes (n = 4 per group). The high FE group had greater body weight gain (P = 0.004) but consumed the same amount of feed (P = 0.30) from 6 to 7 wk resulting in higher FE (P Analysis (IPA) program. In the entire data set, 228 mitochondrial proteins were identified whose collective expression indicates a higher mitochondrial expression in the high FE phenotype (binomial probability P analysis also identified mitochondrial dysfunction and oxidative phosphorylation as the number 1 and 5 differentially expressed canonical pathways (up-regulated in high FE) in the proteomic dataset. Upstream analysis (based on DE of downstream molecules) predicted that insulin receptor, insulin like growth receptor 1, nuclear factor, erythroid 2-like 2, AMP activated protein kinase (α subunit), progesterone and triiodothyronine would be activated in the high FE phenotype whereas rapamycin independent companion of target of rapamycin, mitogen activated protein kinase 4, and serum response factor would be inhibited in the high FE phenotype. The results provide additional insight into the fundamental molecular landscape of feed efficiency in breast muscle of broilers as well as further support for a role of mitochondria in the phenotypic expression of FE. Funding provided by USDA-NIFA (#2013-01953), Arkansas Biosciences Institute (Little Rock, AR), McMaster Fellowship (AUS to WB) and the Agricultural Experiment Station (Univ. of Arkansas, Fayetteville). PMID:27244447

  17. Long-term results of forward intensity-modulated radiation therapy for patients with early-stage breast cancer

    International Nuclear Information System (INIS)

    To observe long-term clinical outcomes for patients with early-stage breast cancer treated with forward intensity-modulated radiation therapy (IMRT), including local control and clinical toxicities. We retrospectively analyzed a total of 214 patients with stage I-II breast cancer who were treated with breast conserving surgery followed by adjuvant breast radiation therapy between 2001 and 2008. All patients were treated using forward IMRT. The whole breast was irradiated to a dose of 50 to 50.4 Gy followed by an 8 to 12 Gy electron boost to the surgical bed. The median age was 46 years (range, 21 to 82 years) and the medial follow-up time was 7.3 years (range, 2.4 to 11.7 years). Stage T1 was 139 (65%) and T2 was 75 (35%), respectively. Ipsilateral breast recurrence was observed in 3 patients. The 5- and 10-year local control rates were 99.1% and 97.8%, respectively. The cosmetic outcome was evaluated according to the Harvard scale and 89.4% of patients were scored as excellent or good. The whole breast radiation therapy as an adjuvant treatment using a forward IMRT technique showed excellent long-term local control as well as favorable outcomes of toxicity and cosmesis.

  18. Overexpression of Gli1 in cancer interstitial tissues predicts early relapse after radical operation of breast cancer

    Institute of Scientific and Technical Information of China (English)

    Ying-Hua Li; Hai-Feng Gao; Yan Wang; Fang Liu; Xiao-Feng Tian; Yang Zhang

    2012-01-01

    Objective:To investigate whether Gli1 expression is important in relapse after radical operation of breast cancer.Methods:Using immunohistochemistry,Glil expression was analyzed in human primary breast cancer (n=284) and paracancerous tissues (n=20),and also in local lymph nodes (n=28) and metastatic lymph nodes (n=28).Results:Initial analysis of Gli1 expression in a small cohort of 20 breast tumors and their paracancerous tissues showed a tendency towards Gli1 overexpression in breast cancer tissues (P<0.001).Further,Gli1 expression in 284 breast cancer tissue samples was analyzed and a significant correlation was found between increased expression of nuclear Gli1 and unfavorable recurrence-free survival (RFS) (P<0.05).The nuclear expression of Gli1 in metastatic lymph nodes following relapse after radical operation was much higher than that in the local lymph nodes of primary carcinoma (P<0.05).Most interestingly,the expression of Gli1 was much higher in the interstitial tissues of the relapsed group than of the non-relapsed group (P<0.001).Conclusions:Breast cancer shows a high prevalence of Gli1 expression,which is significantly correlated with aggressive features and unfavorable RFS.Nuclear Gli1 overexpression,especially in the interstitial tissues,signified early relapse after radical operation of breast cancer.

  19. Promoting Early Presentation of Breast Cancer in Older Women: Implementing an Evidence-Based Intervention in Routine Clinical Practice

    Directory of Open Access Journals (Sweden)

    Lindsay J. L. Forbes

    2012-01-01

    Full Text Available Background. Women over 70 with breast cancer have poorer one-year survival and present at a more advanced stage than younger women. Promoting early symptomatic presentation in older women may reduce stage cost effectively and is unlikely to lead to overdiagnosis. After examining efficacy in a randomised controlled trial, we piloted a brief health professional-delivered intervention to equip women to present promptly with breast symptoms, as an integral part of the final invited mammogram at age ~70, in the English National Health Service Breast Screening Programme. Methods. We trained mammographers, who then offered the intervention to older women in four breast screening services. We examined breast cancer awareness at baseline and one month in women receiving the intervention, and also in a service where the intervention was not offered. Results. We trained 27 mammographers to deliver the intervention confidently to a high standard. Breast cancer awareness increased 7-fold at one month in women receiving the intervention compared with 2-fold in the comparison service (odds ratio 15.2, 95% confidence interval 10.0 to 23.2. Conclusions. The PEP Intervention can be implemented in routine clinical practice with a potency similar to that achieved in a randomised controlled trial. It has the potential to reduce delay in diagnosis for breast cancer in older women.

  20. Long-term results of forward intensity-modulated radiation therapy for patients with early-stage breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Ha, Boram; Suh, Hyun Suk; Lee, Ji Hae; Lee, Kyung Ja; Lee, Rena; Moon, Byung In [Ewha Womans University College of Medicine, Seoul (Korea, Republic of)

    2013-12-15

    To observe long-term clinical outcomes for patients with early-stage breast cancer treated with forward intensity-modulated radiation therapy (IMRT), including local control and clinical toxicities. We retrospectively analyzed a total of 214 patients with stage I-II breast cancer who were treated with breast conserving surgery followed by adjuvant breast radiation therapy between 2001 and 2008. All patients were treated using forward IMRT. The whole breast was irradiated to a dose of 50 to 50.4 Gy followed by an 8 to 12 Gy electron boost to the surgical bed. The median age was 46 years (range, 21 to 82 years) and the medial follow-up time was 7.3 years (range, 2.4 to 11.7 years). Stage T1 was 139 (65%) and T2 was 75 (35%), respectively. Ipsilateral breast recurrence was observed in 3 patients. The 5- and 10-year local control rates were 99.1% and 97.8%, respectively. The cosmetic outcome was evaluated according to the Harvard scale and 89.4% of patients were scored as excellent or good. The whole breast radiation therapy as an adjuvant treatment using a forward IMRT technique showed excellent long-term local control as well as favorable outcomes of toxicity and cosmesis.

  1. Opportunistic breast cancer early detection in Tyrol, Austria 1996-2004

    Energy Technology Data Exchange (ETDEWEB)

    Frede, Thomas E. [BrustGesundheitZentrumTirol, Universitaetsklinik fuer Radiodiagnostik Radiologie II, University of Innsbruck, A-6020 Innsbruck (Austria)]. E-mail: thomas.frede@uibk.ac.at

    2005-07-01

    Purpose: Evaluate the need for a mammography-screening program for Tyrol, as recently proposed in an OeBIG feasibility study commissioned by the Austrian Ministry for Health and Women, in view of the already existing organized opportunistic screening. Materials and methods: This author has examined the state of breast cancer early detection and diagnosis in Tyrol. A comprehensive review of all available data and results based on 3340 primary biopsy recommendations between 1996 and 2004 at our breast centre was performed. Results: Early detection has been improved by organizing the existing opportunistic screening through a true team approach, incorporating not only the clinic's specialties, but also the private radiologists and referring physicians. In 2004, our centre made the definitive diagnosis in 230 (67.6%) of the about 340 primary breast cancer cases occurring yearly in Tyrol with 62.2% being discovered by routine examination and 74.3% stemming from second opinion examinations. About 92.4% of our primary biopsies are performed minimally invasive with an overall 42.9% (1375 of 3205 cases) malignancy rate. Pathological TNM-staging was obtained in over 95% of women under 70 years of age. On average 55.3% (62.0% in 2004) of all discovered cancers were TNM-stage 1 or better lesions (76.2% in our routine patients). With an overall participation of about 75% of our target group (women over 34 years), it is women under the age of 50 years, who most consistently follow our recommendations, resulting in an above average rate of 58.5% TNM-stage 1 and better lesions for all discovered breast cancers (routine and symptomatic) in this group. Conclusions: Opportunistic screening with a true team approach, combined with minimally invasive diagnosis and a strive for excellence have resulted in improved diagnosis, ever expanding patient and referring physician acceptance and an increase of positive prognostic factors, which eclipses the results of any published

  2. Cultural variation in early feeding pattern and maternal perceptions of infant growth

    NARCIS (Netherlands)

    van Eijsden, Manon; Meijers, Claire M. C.; Jansen, Jessica E.; De Kroon, Marlou L. A.; Vrijkotte, Tanja G. M.

    2015-01-01

    The perception of healthy growth and weight may differ between cultures, which could influence feeding practises and consequently affect the development of overweight. The present study examined ethnic variation in maternal perceptions of growth and their influence on feeding practises among Turkish

  3. The Dynamics of Parenting and Early Feeding--Constructs and Controversies: A Viewpoint

    Science.gov (United States)

    Jansen, Elena; Daniels, Lynne A.; Nicholson, Jan M.

    2012-01-01

    There is increasing evidence that parenting and feeding interact to influence children's eating behaviour and weight status. Interpretation of existing research is complicated by the lack of consensus in the conceptualisation and measurement of both "parenting" and "feeding", particularly the distinction between "styles", "dimensions" and…

  4. Local recurrences and distant metastases after breast-conserving surgery and radiation therapy for early breast cancer

    International Nuclear Information System (INIS)

    Purpose: To identify predicting factors for local failure and increased risk of distant metastases by statistical analysis of the data after breast-conserving treatment for early breast cancer. Methods and Materials: Between January 1976 and December 1993, 528 patients with nonmetastatic T1 (tumors ≤ 1 cm [n = 197], >1 cm [n = 220]) or T2 (tumors ≤ 3 cm [n 111]) carcinoma of the breast underwent wide excision (n = 435) or quadrantectomy (n = 93) with axillary dissection (negative nodal status [n-]: 396; 1-3 involved nodes: 100; >3 involved nodes: 32). Radiotherapy consisted of 45 Gy to the entire breast via tangential fields. Patients with positive axillary lymph nodes received 45 Gy to the axillary and supraclavicular area. Patients with positive axillary nodes and/or inner or central tumor locations received 50 Gy to the internal mammary lymph node area. A boost dose was delivered to the primary site by iridium 192 implant in 298 patients (mean total dose: 15.2 ± 0.07 Gy, range: 15-25 Gy) or by electrons in 225 patients (mean total dose: 14.8 ± 0.09 Gy, range: 5-20 Gy). The mean age was 52.5 ± 0.5 years (range: 26-86 years) and 267 patients were postmenopausal. Histologic types were as follows: 463 infiltrating ductal carcinomas, 39 infiltrating lobular carcinomas, and 26 other histotypes. Grade distribution according to the Scarff, Bloom, and Richardson (SBR) classification was as follows: 149 grade 1, 271 grade 2, 73 grade 3, and 35 nonclassified. The mean tumor size was 1.6 ± 0.3 cm (range: 0.3-3 cm). The intraductal component of the primary tumor was extensive (EIC = IC ≥ 25%) in 39 patients. Tumors were microscopically bifocal in 33 cases. Margins were assessed in the majority of cases by inking of the resection margins and were classified as positive in 13 cases, close (≤2 mm) in 21, negative (>2 mm tumor-free margin) in 417, and indeterminate in 77. Peritumoral vascular invasion was observed in 40 patients. Tamoxifen was administered for at

  5. A Bead-Based Multiplexed Immunoassay to Evaluate Breast Cancer Biomarkers for Early Detection in Pre-Diagnostic Serum

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    Carla H. van Gils

    2012-10-01

    Full Text Available This study investigates whether a set of ten potential breast cancer serum biomarkers and cancer antigens (osteopontin (OPN, haptoglobin, cancer antigen 15-3 (CA15-3, carcinoembryonic antigen (CEA, cancer antigen 125 (CA-125, prolactin, cancer antigen 19-9 (CA19-9, α-fetoprotein (AFP, leptin and migration inhibitory factor (MIF can predict early stage breast cancer in samples collected before clinical diagnosis (phase III samples. We performed a nested case-control study within the Prospect-EPIC (European Prospective Investigation into Cancer and nutrition cohort. We examined to what extent the biomarker panel could discriminate between 68 women diagnosed with breast cancer up to three years after enrollment and 68 matched healthy controls (all 56-64 years at baseline. Using a quantitative bead-based multiplexed assay, we determined protein concentrations in serum samples collected at enrollment. Principal Component Analysis (PCA and Random Forest (RF analysis revealed that on the basis of all ten proteins, early cases could not be separated from controls. When we combined serum protein concentrations and subject characteristics related to breast cancer risk in the RF analysis, this did not result in classification accuracy scores that could correctly classify the samples (sensitivity: 50%, specificity: 50%. Our findings indicate that this panel of selected tumor markers cannot be used for diagnosis of early breast cancer.

  6. iROLL: does 3-D radioguided occult lesion localization improve surgical management in early-stage breast cancer?

    Energy Technology Data Exchange (ETDEWEB)

    Bluemel, Christina; Kajdi, Georg W.; Schmid, Jan; Buck, Andreas K.; Herrmann, Ken [University Hospital of Wuerzburg, Department of Nuclear Medicine, Wuerzburg (Germany); Cramer, Andreas; Grossmann, Christoph; Grimminger, Hanns-Joerg [Missionsaerztliches Klinikum Wuerzburg, Department of Obstetrics and Gynecology, Wuerzburg (Germany); Malzahn, Uwe [University of Wuerzburg, Institute of Clinical Epidemiology and Biometry, Wuerzburg (Germany); Lamp, Nora [University of Wuerzburg, Institute of Pathology, Wuerzburg (Germany); Langen, Heinz-Jakob [Missionsaerztliches Klinikum Wuerzburg, Department of Radiology, Wuerzburg (Germany)

    2015-10-15

    To prospectively evaluate the feasibility of 3-D radioguided occult lesion localization (iROLL) and to compare iROLL with wire-guided localization (WGL) in patients with early-stage breast cancer undergoing breast-conserving surgery and sentinel lymph node biopsy (SLNB). WGL (standard procedure) and iROLL in combination with SLNB were performed in 31 women (mean age 65.1 ± 11.2 years) with early-stage breast cancer and clinically negative axillae. Patient comfort in respect of both methods was assessed using a ten point scale. SLNB and iROLL were guided by freehand SPECT (fhSPECT). The results of the novel 3-D image-based method were compared with those of WGL, ultrasound-based lesion localization, and histopathology. iROLL successfully detected the malignant primary and at least one sentinel lymph node in 97 % of patients. In a single patient (3 %), only iROLL, and not WGL, enabled lesion localization. The variability between fhSPECT and ultrasound-based depth localization of breast lesions was low (1.2 ± 1.4 mm). Clear margins were achieved in 81 % of the patients; however, precise prediction of clear histopathological surgical margins was not feasible using iROLL. Patients rated iROLL as less painful than WGL with a pain score 0.8 ± 1.2 points (p < 0.01) lower than the score for iROLL. iROLL is a well-tolerated and feasible technique for localizing early-stage breast cancer in the course of breast-conserving surgery, and is a suitable replacement for WGL. As a single image-based procedure for localization of breast lesions and sentinel nodes, iROLL may improve the entire surgical procedure. However, no advantages of the image-guided procedure were found with regard to prediction of complete tumour resection. (orig.)

  7. Prevalência do aleitamento materno em recém-nascidos de baixo peso Prevalence of breast feeding of low birthweight infants

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    César C. Xavier

    1991-10-01

    Full Text Available Estudou-se de forma longitudinal e prospectiva a duração do aleitamento materno no primeira ano de vida de 222 crianças nascidas com peso menor ou igual a 2.500 gramas no Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto (Brasil, no período de outubro de 1985 a setembro de 1986. A incidência do aleitamento materno foi de 86,5%. A prevalência encontrada para as crianças que foram amamentadas foi de 62,5% aos 3 meses, 38,5% aos 6 meses, 28,7% aos 9 meses e 25,0% aos 12 meses de vida. A mediana da duração do aleitamento materno foi de 4 meses. O peso ao nascer mostrou associação positiva com a incidência e duração do aleitamento materno, O nível de escolaridade materno associou-se positivamente com sua duração. A idade materna, situação conjugal e o número de consultas pré-natais não apresentaram associação com o aleitamento materno. Estes dados mostram índices menores em relação aos de populações de países desenvolvidos, em especial os pré-termos finlandeses nascidos com peso menor do que 1.500 gramas. Programas de ações envolvendo a comunidade e/ou instituições devem resultar em melhoria de nossos índices, se bem implementados.The present situation regarding the breast feeding of children born with a weight of 2,500 grammes or less (LWB at the Hospital das Clínicas of the Medical School of the Universidade de S. Paulo in Ribeirão Preto (Brazil was studied. The study was descriptive and the data were obtained through a longitudinal follow-up carried over the period from October 1985 to September 1986 inclusive. Of the 222 children included in the study, 30 (13.5% infants were not breastfed. Thus the incidence of breast feeding among this population was of 86.5%. At 3 months 62.5% of these infants were still being breastfed. At 6 months this figure fell to 38.5% and only 25.0% were still being breast-fed at the end of 12 months. The average duration of breast feeding for the 192 children that

  8. Evaluation of supporting role of early enteral feeding via tube jejunostomy following resection of upper gastrointestinal tract

    OpenAIRE

    Ghafouri, Ali; Salehi, Omran Abbas; Keshavarz, Seyed Ali; Hosseini, Saeed; Shojaifard, Abolfazl; Khorgami, Zhamak

    2012-01-01

    Background Today, early diagnosis of upper gastrointestinal (GI) tract malignancies and their surgical resection is becoming more feasible. One of the important side effects in upper GI tract malignancies is malnutrition which has direct relationship with postoperative complications. Nonetheless, there is no easy regimen of nutrition for these patients especially for the first week after operation. Accordingly we present a simple method for improving feeding such patients via tube jejunostomy...

  9. Lactation following conservation surgery and radiotherapy for breast cancer

    International Nuclear Information System (INIS)

    A 38-year-old woman with early stage invasive breast cancer was treated with wide excision of the tumor, axillary lymph node dissection, and breast irradiation. Three years later, she gave birth to a normal baby. She attempted breast feeding and had full lactation from the untreated breast. The irradiated breast underwent only minor changes during pregnancy and postpartum but produced small amounts of colostrum and milk for 2 weeks postpartum. There are only a few reports of lactation after breast irradiation. These cases are reviewed, and possible factors affecting breast function after radiotherapy are discussed. Because of scant information available regarding its safety for the infant, nursing from the irradiated breast is not recommended

  10. Early allergy symptoms in infants aged 0-6 months on breast milk substitutes

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    Mulya Safri

    2016-07-01

    Full Text Available Background Atopic diseases are common in children and a serious health problem worldwide. Atopic dermatitis, food allergies, asthma and allergic rhinitis, have been described as the natural progression of allergic diseases, also known as the “allergic march”. Cow’s milk protein is known to be a common trigger of food allergies and hypersensitivity reactions during infancy. Objective To give an overview of the breast milk substitutes (BMS and incidence of early allergy onset (allergic march in atopic infants aged 0-6 months. Methods This cross-sectional study included a total of 40 atopic infants collected by consecutive sampling. A questionnaire was used for interview that inquired information on the type of BMS used, initial allergy complaints, the age of the emergence of early allergic symptoms, and the breakdown for BMS type. Univariate analysis was carried out to describe their characteristics as frequency distributions and percentages of each variables. Results Atopic dermatitis and wheezing were more common in boys (62.5%. Atopic dermatitis was the most common initial symptom to occur in atopic infants (52.5%. Atopic dermatitis and wheezing occurred together in 27.5% subjects. Early allergy symptoms that first occurred at the age of 1 month were seen in 42.9% for atopic dermatitis category, 37.5% for wheezing category, and 63.6% for both symptoms category, respectively. Cow’s milk was the most common type of BMS given to atopic infants in the first 6 months of life (47.5%. Conclusion Early symptoms of allergies, such as atopic dermatitis and wheezing, are more common in boys than girls. Atopic dermatitis is the most common early symptom to arise, but both symptoms occur at an early age, often during the first month of life.

  11. Early allergy symptoms in infants aged 0-6 months on breast milk substitutes

    Directory of Open Access Journals (Sweden)

    Mulya Safri

    2015-01-01

    Full Text Available Background Atopic diseases are common in children and a serious health problem worldwide. Atopic dermatitis, food allergies, asthma and allergic rhinitis, have been described as the natural progression of allergic diseases, also known as the “allergic march”. Cow’s milk protein is known to be a common trigger of food allergies and hypersensitivity reactions during infancy. Objective To give an overview of the breast milk substitutes (BMS and incidence of early allergy onset (allergic march in atopic infants aged 0-6 months. Methods This cross-sectional study included a total of 40 atopic infants collected by consecutive sampling. A questionnaire was used for interview that inquired information on the type of BMS used, initial allergy complaints, the age of the emergence of early allergic symptoms, and the breakdown for BMS type. Univariate analysis was carried out to describe their characteristics as frequency distributions and percentages of each variables. Results Atopic dermatitis and wheezing were more common in boys (62.5%. Atopic dermatitis was the most common initial symptom to occur in atopic infants (52.5%. Atopic dermatitis and wheezing occurred together in 27.5% subjects. Early allergy symptoms that first occurred at the age of 1 month were seen in 42.9% for atopic dermatitis category, 37.5% for wheezing category, and 63.6% for both symptoms category, respectively. Cow’s milk was the most common type of BMS given to atopic infants in the first 6 months of life (47.5%. Conclusion Early symptoms of allergies, such as atopic dermatitis and wheezing, are more common in boys than girls. Atopic dermatitis is the most common early symptom to arise, but both symptoms occur at an early age, often during the first month of life. [Paediatr Indones. 2015;55:13-7.].

  12. Early allergy symptoms in infants aged 0-6 months on breast milk substitutes

    Directory of Open Access Journals (Sweden)

    Mulya Safri

    2016-07-01

    Full Text Available Background Atopic diseases are common in children and a serious health problem worldwide. Atopic dermatitis, food allergies, asthma and allergic rhinitis, have been described as the natural progression of allergic diseases, also known as the “allergic march”. Cow’s milk protein is known to be a common trigger of food allergies and hypersensitivity reactions during infancy. Objective To give an overview of the breast milk substitutes (BMS and incidence of early allergy onset (allergic march in atopic infants aged 0-6 months. Methods This cross-sectional study included a total of 40 atopic infants collected by consecutive sampling. A questionnaire was used for interview that inquired information on the type of BMS used, initial allergy complaints, the age of the emergence of early allergic symptoms, and the breakdown for BMS type. Univariate analysis was carried out to describe their characteristics as frequency distributions and percentages of each variables. Results Atopic dermatitis and wheezing were more common in boys (62.5%. Atopic dermatitis was the most common initial symptom to occur in atopic infants (52.5%. Atopic dermatitis and wheezing occurred together in 27.5% subjects. Early allergy symptoms that first occurred at the age of 1 month were seen in 42.9% for atopic dermatitis category, 37.5% for wheezing category, and 63.6% for both symptoms category, respectively. Cow’s milk was the most common type of BMS given to atopic infants in the first 6 months of life (47.5%. Conclusion Early symptoms of allergies, such as atopic dermatitis and wheezing, are more common in boys than girls. Atopic dermatitis is the most common early symptom to arise, but both symptoms occur at an early age, often during the first month of life. 

  13. Switching to Letrozole Versus Continued Tamoxifen Therapy in Treatment of Postmenopausal Women with Early Breast Cancer

    International Nuclear Information System (INIS)

    Tamoxifen has been the mainstay of breast cancer therapy. Over time, resistance to tamoxifen may develop. The aromatase inhibitors have proven to be a powerful drug for use in hormone-sensitive early breast cancer. The switching strategy was designed to combine the apparent superior efficacy of aromatase inhibitors with tamoxifen favourable effects. Methods: This study was performed on 120 postmenopausal women with histologically confirmed, hormone receptor-positive, operable invasive breast carcinoma who remained free of disease after 2 years of adjuvant tamoxifen therapy. They were randomized to receive either letrozole 2.5 mg/day (60 patients) or to continue 20 mg/day tamoxifen for 5 years (60 patients). Results: The treatment groups were well balanced in terms of age, tumor size, nodal status, oestrogen and progesterone receptor status, and previous surgery. The disease recurred in 10 patients in the group receiving tamoxifen and 3 patients in the same group switched to letrozole. There were 8 deaths in the group receiving tamoxifen and 3 deaths in the group of patients who switched to letrozole. Disease-free survival was higher in the group of patients who switched to letrozole compared to the group of patients who received tamoxifen (p=0.04), while the overall survival was not statistically significantly different in the two groups. Letrozole was associated with a significantly lower rate of vaginal bleeding and thromboembolic events. However, bone fractures and adverse cardiovascular events were more frequent in the arm receiving letrozole than in the arm receiving tamoxifen but these differences were not statistically significant. Conclusion: Switching to letrozole after 2 years of tamoxifen may be better than continuing five years of tamoxifen therapy as regard efficacy and tolerability. Further study is recommended on a larger group of patients to verify this finding

  14. Excellent outcomes with adjuvant toremifene or tamoxifen in early stage breast cancer

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    Jaime D. Lewis

    2014-01-01

    Full Text Available Fareston (toremifene and tamoxifen, both selective estrogen receptor modulators, are therapeutically equivalent treatments for metastatic breast cancer. We hypothesized that toremifene as compared with tamoxifen given as adjuvant therapy for early stage breast cancer would result in equivalent survival with an improved side effect profile, therefore, providing superior therapeutic efficacy.Subjects and methods. The North American Fareston versus Tamoxifen Adjuvant trial assigned 1813 perimenopausal or postmenopausal women with hormone receptor (HR – positive invasive breast cancer to adjuvant treatment with either tamoxifen or toremifene. The primary outcomes evaluated were disease-free survival (DFS and overall survival (OS.Results. Median follow-up was 59 months. The baseline characteristics of the 2 treatment groups were well-balanced. On the basis of intenttotreat, 5-year actuarial DFS was not significantly different between tamoxifen and toremifene (91.2 % (standard error of the mean (SE 1.2 % vs 91.2 % (SE 1.1 %, respectively. Similarly, 5-year actuarial OS was not significantly different between tamoxifen and toremifene (92.7 % (SE 1.1 % vs 93.7 % (SE 1.0 %, respectively. Controlling for patient age, tumor size, and tumor grade, a Cox multivariate survival analysis found no difference between patients randomized to toremifene versus tamoxifen in terms of OS (OR 0.951; 95 % confidence interval (CI, 0.623–1.451, p = 0.951 or DFS (OR 1.037; 95 % CI, 0.721–1.491, p = 0.846. Adverse events were similar in the 2 groups.Conclusions. Women treated with adjuvant hormonal therapy enjoyed excellent DFS and OS. No significant differences were found between treatment with either tamoxifen or toremifene. Treatment of HR-positive patients with either tamoxifen or toremifene is appropriate.

  15. Sentinel Lymph Node Biopsy Results in Early-Stage Breast Cancer

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    Ahmet Kocakuflak

    2011-06-01

    Full Text Available Aim: Sentinel lymph node biopsy (SLNB in breast cancer patients targets the evaluation of the initial lymph node (SLN which drains the primary tumor. The morbidity of unnecessary axillary dissection can be avoided by intensive preoperative assessment of SLN. Methods: Twenty-six consecutive patients who had been surgically treated for early-stage breast cancer between March 2005 and August 2007 were evaluated. Blue dye (methylene blue method was used to detect SLN. All patients underwent axillary lymph node dissection following SLNB. NCSS program was used for statistical analysis. Chi-square test was used in the comparison of binary groups. Results: Except for one, all patients were female. The mean age of the patients was 56 (29-76 years. While 13 patients underwent modified radical mastectomy (=mastectomy+axillary dissection, the remaining 13 patients underwent breast preserving surgery (lumpectomy+axillary dissection. SLN could not be found in 2 patients (7.6%.The male patient was one of these 2 patients and both of them were positive for axillary node metastases. The detection rate of SLN, specificity, negative predictive value, positive predictive value, sensitivity, false negativity, and reliability were 92.3%, 92.8%, 86%, 90.9%, 83.3%, 16.6%, and 88.4%, respectively. Conclusion: Our result support the hypothesis that SLNB with blue dye alone is a reliable technique and, surgery clinics should use it prior to axillary dissection to test their own success during the learning curve. (The Medical Bulletin of Haseki 2011; 49: 67-72

  16. miRNAs as potential biomarkers in early breast cancer detection following mammography

    OpenAIRE

    Fu, Sidney W.; Lee, Woojin; Coffey, Caitrin; Lean, Alexa; Wu, Xiaoling; Tan, Xiaohui; Man, Yan-Gao; Brem, Rachel F.

    2016-01-01

    Breast cancer is the most common cancer among American women, except for skin cancers. About 12 % women in the United States will develop invasive breast cancer during their lifetime. Currently one of the most accepted model/theories is that ductal breast cancer (most common type of breast cancer) follows a linear progression: from normal breast epithelial cells to ductal hyperplasia to atypical ductal hyperplasia (ADH) to ductal carcinoma in situ (DCIS), and finally to invasive ductal carcin...

  17. Prognostic factors of early breast cancer treated with radiation after radical mastectomy

    International Nuclear Information System (INIS)

    Objective: To study whether post-operative radiotherapy is necessary for patients with early breast cancer after radical mastectomy. Methods: In 1998, 270 early breast cancer patients with 0 -3 pathologically confirmed positive axillary lymph nodes after radical mastectomy were retrospectively analyzed. There were 156 patients with negative lymph node and 114 with 1 -3 positive lymph nodes. The prognostic index (PI) was defined as the sum of scores of the tumor size, number of positive axillary lymph nodes, receptor status, surgical margin status, lymphatic thrombi status, pathological grading and age. The PI≥ 4 was considered as high-risk, and PI 2 = 4.40, P =0.036), respectively. The corresponding disease-free survival rate, local recurrence rate, distant metastasis rate were 71.2% and 9.6% (χ2=3.90, P=0.048), 7.7% and 16.7% (χ2=5.22, P=0.022), 12.8% and 21.1%(χ2=3.27, P=0.070), respectively. The mean dis-ease-free survival time of the two groups was 97.03±2.53 months and 87.01±3.80 months, respectively. In the high-risk group, the 10-year survival rates of patients with and without radiotherapy were 72% and 56% (χ2=4.07, P=0.044), the local recurrence rates were 5% and 24% (χ2=11.16, P=0.001), and the distant metastasis rates were 16% and 26% (χ2=2.18, P=0.140). In the low-risk group, the survival rate of patients with and without radiotherapy were 81% and 71% (χ2 =1.57, P=0.210), the local recurrence rates were both 11% (χ2=0.01, P=0.975), and the distant metastasis rates were both 13% (χ2 =0.00, P=1.000). Conclusions: Early breast cancer patients with 1 -3 positive axillary lymph nodes should receive post-operative radiotherapy after radical mastectomy. The prognostic index may decrease the chance of unnecessary radiation by distinguishing the patients under low risk of recurrence from those under high risk. (authors)

  18. Mass spectrometry-based serum proteome pattern analysis in molecular diagnostics of early stage breast cancer

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    Stobiecki Maciej

    2009-07-01

    Full Text Available Abstract Background Mass spectrometric analysis of the blood proteome is an emerging method of clinical proteomics. The approach exploiting multi-protein/peptide sets (fingerprints detected by mass spectrometry that reflect overall features of a specimen's proteome, termed proteome pattern analysis, have been already shown in several studies to have applicability in cancer diagnostics. We aimed to identify serum proteome patterns specific for early stage breast cancer patients using MALDI-ToF mass spectrometry. Methods Blood samples were collected before the start of therapy in a group of 92 patients diagnosed at stages I and II of the disease, and in a group of age-matched healthy controls (104 women. Serum specimens were purified and the low-molecular-weight proteome fraction was examined using MALDI-ToF mass spectrometry after removal of albumin and other high-molecular-weight serum proteins. Protein ions registered in a mass range between 2,000 and 10,000 Da were analyzed using a new bioinformatic tool created in our group, which included modeling spectra as a sum of Gaussian bell-shaped curves. Results We have identified features of serum proteome patterns that were significantly different between blood samples of healthy individuals and early stage breast cancer patients. The classifier built of three spectral components that differentiated controls and cancer patients had 83% sensitivity and 85% specificity. Spectral components (i.e., protein ions that were the most frequent in such classifiers had approximate m/z values of 2303, 2866 and 3579 Da (a biomarker built from these three components showed 88% sensitivity and 78% specificity. Of note, we did not find a significant correlation between features of serum proteome patterns and established prognostic or predictive factors like tumor size, nodal involvement, histopathological grade, estrogen and progesterone receptor expression. In addition, we observed a significantly (p = 0

  19. Quadrantectomy and Nipple Saving Mastectomy in Treatment of Early Breast Cancer: Feasibility and Aesthetic Results of Adjunctive Latissmus Dorsi Breast Reconstruction

    International Nuclear Information System (INIS)

    Breast conserving surgery has been a recognised method of treatment of early breast cancer. The treatment methods include quadrantectomy or skin sparing mastectomy combined with ipsilateral axillary nodal dissection followed by radiotherapy. In the current study we evaluate the feasibility and oncologic safety of the quadrantectomy and SSM operations with preservation of the nipple and areola, and the cosmetic results of immediate reconstruction by using the latissmus dorsi flap. Materials and Methods: A breast conservative surgery (quadrantectomy or nipple sparing mastectomy) was carried out in a group of 55 patients with invasive breast cancer treated at the Department of Surgical Oncology, NCl, between January 2001 and April 2004. The selection criteria included those patients who presented with TI or T2 breast cancer and were located at least 2 cm from the nipple as the centre for the nipple areola complex. The age of the patients ranged from 32 years to 65 years. The follow up period ranged from 2 to 33 months with an average of 21 months. Pathological assessment of the specimens showed a negative safety margin in all cases. Most of our cases were invasive duct carcinoma grade 1-2 (42) (75%). The complications of the flap reconstruction included one major sloughing of the Iatissmus dorsi flap, 4 partial flap sloughing, 4 sloughing of the nipple and fat necrosis in 6 patients. The donor site healed normally in all of our cases except for one patient who suffered from a hypertrophic scar which settled down during the follow up period. The aesthetic assessment of the patients, showed an excellent to good results in the majority of cases (42) (75%) while in 6 (12%) results were fair and in 7 (13%) results were poor. Breast conservative surgery with quadrantectomy or skin sparing technique with preservation of the nipple and areola combined with immediate LD flap reconstruction is a valid procedure for treatment of early breast cancer. Immediate reconstruction by

  20. Feed Feeds: Managing Feeds Using Feeds

    OpenAIRE

    Wilde, Erik; Pesenson, Igor

    2008-01-01

    Feeds have become an important information channel on the Web, but the management of feed metadata so far has received little attention. It is hard for feed publishers to manage and publish their feed information in a unified format, and for feed consumers to manage and use their feed subscription data across various feed readers, and to share it with other users. We present a system for managing feed metadata using feeds, which we call "feed feeds". Because these feeds are Atom feeds, the wi...

  1. Healthy babies through infant-centered feeding protocol: an intervention targeting early childhood obesity in vulnerable populations

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    Horodynski Mildred A

    2011-11-01

    Full Text Available Abstract Background Poor feeding practices during infancy contribute to obesity risk. As infants transition from human milk and/or formula-based diets to solid foods, these practices interfere with infant feeding self-regulation and healthy growth patterns. Compared with other socioeconomic groups, lower-income mothers are more likely to experience difficulty feeding their infants. This may include misinterpreting feeding cues and using less-than-optimal feeding styles and practices, such as pressuring infants during mealtimes and prematurely introducing solid food and sweetened beverages. The Healthy Babies trial aims to determine the efficacy of a community-based randomized controlled trial of an in-home intervention with economically and educationally disadvantaged mother-infant dyads. The educational intervention is being conducted during the infant's first 6 months of life to promote healthy transition to solids during their first year and is based on the theory of planned behavior. Methods/Design We will describe our study protocol for a multisite randomized control trial being conducted in Colorado and Michigan with an anticipated sample of 372 economically and educationally disadvantaged African American, Hispanic, and Caucasian mothers with infants. Participants are being recruited by county community agency staff. Participants are randomly assigned to the intervention or the control group. The intervention consists of six in-home visits by a trained paraprofessional instructor followed by three reinforcement telephone contacts when the baby is 6, 8, and 10 months old. Main maternal outcomes include a maternal responsiveness, b feeding style, and c feeding practices. Main infant outcome is infant growth pattern. All measures occur at baseline and when the infant is 6 and 12 months old. Discussion If this project is successful, the expected outcomes will address whether the home-based early nutrition education intervention is effective

  2. BIRC5 Genomic Copy Number Variation in Early-Onset Breast Cancer

    Science.gov (United States)

    Ghaffari, Kimia; Hashemi, Mehrdad; Ebrahimi, Elmira; Shirkoohi, Reza

    2016-01-01

    Background: Baculoviral inhibitor of apoptosis repeat-containing 5 (BIRC5) gene is an inhibitor of apoptosis that expresses in human embryonic tissues but it is absent in most healthy adult tissues. The copy number of BIRC5 has been indicated to be highly increased in tumor tissues; however, its association with the age of onset in breast cancer is not well understood. Methods: Forty tumor tissues of breast cancer were obtained from Tumor Bank of Cancer Institute, Imam Khomeini Hospital, Tehran, Iran. BIRC5 gene copy number variation (CNV) was evaluated using Multiplex Ligation-dependent Probe Amplification (MLPA) and then compared with the age of onset for each patient. Results: BIRC5 amplification was seen in 17.5% of cases. Also, a significant association was observed between BIRC5 gene amplification and individuals under 40 years of age (P=0.04). Conclusion: BIRC5 gene has the potential to be a marker for the detection and prognosis of cancer at an early age. PMID:27372966

  3. Lymphoid infiltration as a prognostic variable for early-onset breast carcinomas.

    Science.gov (United States)

    Ménard, S; Tomasic, G; Casalini, P; Balsari, A; Pilotti, S; Cascinelli, N; Salvadori, B; Colnaghi, M I; Rilke, F

    1997-05-01

    Infiltration by lymphoid cells is a common feature of many human tumors, including breast carcinomas, and the degree of infiltration has been suggested to be a measure of the host immune response. Our analyses in a series of 1919 cases of primary ductal and lobular infiltrating breast carcinomas from women with a long-term follow-up revealed: (a) a 16-17% frequency of infiltrated tumors independent of the patient's age at diagnosis; and (b) a strong positive correlation between survival rates and the presence of lymphocytes at the tumor site in patients less than 40 years of age (P = 0.0002) but no association with prognosis in patients 40 years of age or older. Multivariate analysis indicated that lymphoid infiltration is independent of other conventional prognostic factors such as nodal status and tumor size in predicting survival. Thus, a possible immune response against the tumor seems to be relevant only in women with early-onset tumors. Because the immune system is functionally maximum in younger years, declining with age, this finding might reflect a difference in the efficiency of the immune system. Alternatively, the biology of these tumors might differ, leading to a difference in immuno-genicity.

  4. One life saved by four prevented recurrencies? Update of the early breast cancer trialists confirms. Postoperative radiotherapy improves survival after breast conserving surgery

    Energy Technology Data Exchange (ETDEWEB)

    Sautter-Bihl, M.L. [Staedtisches Klinikum Karlsruhe (Germany). Klinik fuer Radioonkologie und Strahlentherapie; Sedlmayer, F. [Landeskrankenhaus Salzburg (Austria); Budach, W. [University Hospital Duesseldorf (DE)] (and others)

    2012-06-15

    The debate about the impact of local control on survival in early breast cancer patients is still going on, in spite of the continuously growing evidence that avoidance of locoregional disease reduces the risk of tumor-specific death. Recently, B. Fisher, one of the pioneers of breast conserving therapy claimed that during the last two decades, as a result of the use of systemic therapy in conjunction with breast conserving surgery and radiation, the incidence of locoregional recurrence has been reduced to a level where further reduction is likely to have little impact on survival. The penultimate meta-analysis of the Early Breast Cancer Trialists' Collaborative Group (EBCTCG) reported the effect of radiotherapy in early breast cancer on recurrence and survival in 2005 and provided the essential message that four prevented local recurrences at 5 years would avoid one breast cancer death in 15 years. The scientific community has eagerly awaited the quinquennial update of the EBCTCG which has now been published. A total of 17 randomized studies comparing postoperative radiotherapy vs. none were analyzed and comprised 7 new studies in addition to follow-up data of from 9 previously reported trials. A total of 10,801 patients with pT1-2 tumors were included, the majority of whom (n=7,287) were node negative, while 1,050 were node positive (2,464 unknown). In contrast to the previous meta-analysis, all patients received breast conserving surgery, consisting of lumpectomy (n=8,422) or more extensive techniques like quadrantectomy or sectoral resection (n= 2,399). The effect of radiotherapy on 10-year recurrences of any type and their relation to the 15-year breast cancer death rate were studied in correlation to various prognostic parameters and treatment characteristics (e.g., surgery, tamoxifen use). Moreover, a subgroup analysis was performed according to low, intermediate, and high initial risk of recurrence, from which the expected absolute benefit was derived

  5. Clinical outcome analysis of 98 elderly women with early-stage breast cancer undergoing modified radical mastectomy or simple mastectomy

    Institute of Scientific and Technical Information of China (English)

    Zhilong Jia; Baoxia Su

    2012-01-01

    Objective: The aim of our study was to analyze the clinical results and prognosis for early elderly patients after surgery and to explore the rational treatment. Methods: Between January 1992 and December 2008, 98 early elderly breast cancer patients aged ≥ 65 years were treated with surgery, of which 52 patients received modified radical mastectomy and 46 patients received simple mastectomy. Results: Sixty-four (65.3%) patients had comorbidities including coronary heart disease, hypertension, diabetes, etc. After a median follow up of 56 months (21 to 280 months), the 5-year cumulative survival rate of breast modified radical mastectomy group and mastectomy group were 84.0% and 82.7%, separately (P = 0.653). The 5-year recurrence rate were 3.8% and 8.1%, separately (P = 0.504). Conclusion: The simple mastectomy is suitable for the treatment of early elderly breast cancer patients for its lower complication and recurrence rate. Early old women with breast cancer may be safely treated by simple mastectomy. Our findings suggest that modified radical mastectomy does not significantly increase the overall survival.

  6. Personality predicts perceived availability of social support and satisfaction with social support in women with early stage breast cancer

    NARCIS (Netherlands)

    B.L. den Oudsten; G.L. van Heck; A.F.W. van der Steeg; J.A. Roukema; J. de Vries

    2010-01-01

    This study examines the relationships between personality, on the one hand, and perceived availability of social support (PASS) and satisfaction with received social support (SRSS), on the other hand, in women with early stage breast cancer (BC). In addition, this study examined whether a stressful

  7. Time dependence of biomarkers: Non-proportional effects of immunohistochemical panels predicting relapse risk in early breast cancer

    NARCIS (Netherlands)

    J. Stephen; G. Murray; D.A. Cameron (David); J. Thomas; I. Kunkler (Ian); W. Jack (W.); G.R. Kerr; M.D. Piper; C.L. Brookes (Cassandra); D.W. Rea; C.J.H. van de Velde (Cornelis); A. Hasenburg (Annette); C. Markopoulos; L.Y. Dirix (Luc); C.M. Seynaeve (Caroline); J.M.S. Bartlett (John)

    2014-01-01

    textabstractBackground:We investigated the impact of follow-up duration to determine whether two immunohistochemical prognostic panels, IHC4 and Mammostrat, provide information on the risk of early or late distant recurrence using the Edinburgh Breast Conservation Series and the Tamoxifen vs Exemest

  8. Couples' Support-Related Communication, Psychological Distress, and Relationship Satisfaction among Women with Early Stage Breast Cancer

    Science.gov (United States)

    Manne, Sharon; Sherman, Marne; Ross, Stephanie; Ostroff, Jamie; Heyman, Richard E.; Fox, Kevin

    2004-01-01

    This study examined associations between couple communication about cancer and psychological distress and relationship satisfaction of women diagnosed with early stage breast cancer. One hundred forty-eight couples completed a videotaped discussion of a cancer-related issue and a general issue. Patients completed measures of psychological distress…

  9. Pretreatment anti-Müllerian hormone predicts for loss of ovarian function after chemotherapy for early breast cancer

    DEFF Research Database (Denmark)

    Anderson, Richard A; Rosendahl, Mikkel; Kelsey, Thomas W;

    2013-01-01

    Improving survival for women with early breast cancer (eBC) requires greater attention to the consequences of treatment, including risk to ovarian function. We have assessed whether biochemical markers of the ovarian reserve might improve prediction of chemotherapy related amenorrhoea....

  10. Risk of pacemaker or implantable cardioverter defibrillator after radiotherapy for early-stage breast cancer in Denmark, 1982-2005

    DEFF Research Database (Denmark)

    Rehammar, Jens Christian; Johansen, Jens Brock; Jensen, Maj-Britt;

    2016-01-01

    (RT). MATERIAL AND METHODS: All women treated for early-stage BC in Denmark from 1982 to 2005 were identified from the Danish Breast Cancer Cooperative Group. By record linkage to the Danish Pacemaker and ICD Registry information was retrieved on CIED implants subsequent to RT. Standardized incidence...

  11. Early detection of breast cancer: benefits and risks of supplemental breast ultrasound in asymptomatic women with mammographically dense breast tissue. A systematic review

    International Nuclear Information System (INIS)

    Mammographic screening alone will miss a certain fraction of malignancies, as evidenced by retrospective reviews of mammograms following a subsequent screening. Mammographic breast density is a marker for increased breast cancer risk and is associated with a higher risk of interval breast cancer, i.e. cancer detected between screening tests. The purpose of this review is to estimate risks and benefits of supplemental breast ultrasound in women with negative mammographic screening with dense breast tissue. A systematic search and review of studies involving mammography and breast ultrasound for screening of breast cancer was conducted. The search was performed for the period 1/2000-8/2008 within the data source of PubMed, DARE, and Cochrane databases. Inclusion and exclusion criteria were determined prospectively, and the Oxford evidence classification system for diagnostic studies was used for evidence level. The parameters biopsy rate, positive predictive value (PPV) for biopsy, cancer yield for breast ultrasound alone, and carcinoma detection rate by breast density were extracted or constructed. The systematic search identified no randomized controlled trials or systematic reviews, six cohort studies of intermediate level of evidence (3b) were found. Only two of the studies included adequate follow-up of subjects with negative or benign findings. Supplemental breast ultrasound after negative mammographic screening permitted diagnosis of primarily invasive carcinomas in 0.32% of women in breast density type categories 2-4 of the American College of Radiology (ACR); mean tumor size for those identified was 9.9 mm, 90% with negative lymph node status. Most detected cancers occurred in mammographically dense breast ACR types 3 and 4. Biopsy rates were in the range 2.3%-4.7%, with PPV of 8.4-13.7% for those biopsied due to positive ultrasound, or about one third of the PPV of biopsies due to mammography. Limitations: The study populations included wide age ranges, and

  12. Aleitamento materno ou artificial: práticas ao sabor do contexto. Brasil (1960-1988 The artificial milk feeding or breast feeding: context dependant practices. Brazil, 1960-1988

    Directory of Open Access Journals (Sweden)

    Suely Teresinha Schmidt Passos de Amorim

    2008-08-01

    Full Text Available Este estudo teve por objetivo a análise do discurso sobre o aleitamento, no período de 1960-1988, no Brasil, em reportagens veiculadas em revistas femininas de grande circulação no País. O estudo é centrado na área de História, especialmente na história da alimentação, com uma abordagem interdisciplinar. O período inicial - 1960 - está vinculado com o final do governo de Juscelino Kubitschek, em que a economia, liderada pelo setor industrial, cresceu em termos relativos e absolutos. O período final - 1988 - caracteriza a aprovação da Norma Brasileira de Comercialização de Alimentos para Lactentes (NBCAL, que restringiu a ação do marketing do leite em pó. A mudança nos enunciados dos discursos foi uma característica evidenciada. No período em que se apregoava o aleitamento artificial, o enunciado principal dos discursos foi a condição feminina, a valorização da mulher e o seu direito à liberdade. Com o retorno do incentivo ao aleitamento materno, os discursos foram radicais na defesa dessa prática, minimizando as dificuldades enfrentadas pela mulher em seu cotidiano.The aim of this study was the discourse analysis on breast feeding from 1960 through 1988 in Brazil, on articles published in famous women magazines. The focus of the study is the History area, mainly the Feeding History, with an interdisciplinary approach. The initial period - 1960 - is linked with the end of Juscelino Kubitschek's Government, when the economy, guided by the industrial sector, had grown in relative and absolute terms. The final period - 1988 - characterizes the Brazilian Norm of Suckling Feeding Business approval, which restricted the milk powder marketing. The change on discourses enunciates was very evident. During the period the artificial breast feeding was stimulated, the discourse main enunciate was the women's condition, women's valorization and their right of freedom. With the re-encouragement to the women breast feeding the

  13. Breast Density and Your Breast Mammogram Report

    Science.gov (United States)

    Breast Density and Your Mammogram Report Regular mammograms are the best way to find breast cancer early. But if ... But in some women, there’s little change. Breast density is very common, and is not abnormal. How ...

  14. Assessment of cosmetic outcome of oncoplastic breast conservation surgery in women with early breast cancer: A prospective cohort study

    OpenAIRE

    G Adimulam; Challa, V R; Dhar, A.; S Chumber; V Seenu; Srivastava, A.

    2014-01-01

    Background: The aim of this study was to assess the cosmetic outcome of patients undergoing oncoplastic breast conserving surgery in Indian population. Materials and Methods: A prospective cohort of 35 patients who were eligible for breast conservation surgery was included in the study from year 2007 to 2009. Patients with central quadrant tumors were excluded from the study. A double - blind cosmetic assessment was done by a plastic surgeon and a senior nurse not involved in the management o...

  15. Clinical analysis of intraoperative radiotherapy during breast-conserving surgery of early breast cancer in the Chinese Han population

    OpenAIRE

    Xin WANG; Liu, Jiaqi; Wang, Wenyan; Feng, Qinfu; Wang, Xiang

    2015-01-01

    Purpose While results of intraoperative radiotherapy (IORT) during breast-conserving surgery (BCS) have been reported when used either as a boost at the time of surgery or as the sole radiation treatment, the clinical safety and cosmetic outcome of IORT in the Chinese Han population has not. This report reviews oncologic and cosmetic outcomes for Chinese Han breast cancer patients who received IORT either as a boost or as their sole radiation treatment at our hospital. Method From July 2008 t...

  16. Influence of radiotherapy on the dose of adjuvant chemotherapy in early breast cancer

    International Nuclear Information System (INIS)

    399 patients with early breast cancer were randomly allocated to treatment by either modified radical mastectomy or lumpectomty and radiotherapy. 169 had histologically involved axillary nodes and were randomised to receive either adjuvant cytotoxic chemotherapy (76 patients) or no systemic adjuvant treatment (93 patients). Chemotherapy comprised a combination of oral cyclophosphamide and intravenous methotrexate and 5-fluorouracil (CMF) for 12 cycles over one year. Patients in the mastectomy group received a significantly higher percentage of the planned chemotherapy dose compared with those in the radiotherapy group (median 85% v. 71% p < 0.05). Patients treated with radiotherapy were more frequently nauseated and developed more severe alopecia, but these differences were not statistically significant. At median follow-up of 37 months the relapse-rate and pattern of relapse were similar in both groups of patients receiving CMF. (author). 11 refs.; 5 tabs

  17. Significance of Micrometastases: Circulating Tumor Cells and Disseminated Tumor Cells in Early Breast Cancer

    Directory of Open Access Journals (Sweden)

    Catherine Oakman

    2010-06-01

    Full Text Available Adjuvant systemic therapy targets minimal residual disease. Our current clinical approach in the adjuvant setting is to presume, rather than confirm, the presence of minimal residual disease. Based on assessment of the primary tumor, we estimate an individual’s recurrence risk. Subsequent treatment decisions are based on characteristics of the primary tumor, with the presumption of consistent biology and treatment sensitivity between micrometastases and the primary lesion. An alternative approach is to identify micrometastatic disease. Detection of disseminated tumor cells (DTC in the bone marrow and circulating tumor cells (CTC from peripheral blood collection may offer quantification and biocharacterization of residual disease. This paper will review the prognostic and predictive potential of micrometastatic disease in early breast cancer.

  18. Early Toxicity in Patients Treated With Postoperative Proton Therapy for Locally Advanced Breast Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Cuaron, John J. [Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Chon, Brian; Tsai, Henry; Goenka, Anuj; DeBlois, David [Procure Proton Therapy Center, Somerset, New Jersey (United States); Ho, Alice; Powell, Simon [Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Hug, Eugen [Procure Proton Therapy Center, Somerset, New Jersey (United States); Cahlon, Oren, E-mail: cahlono@mskcc.org [Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Procure Proton Therapy Center, Somerset, New Jersey (United States)

    2015-06-01

    Purpose: To report dosimetry and early toxicity data in breast cancer patients treated with postoperative proton radiation therapy. Methods and Materials: From March 2013 to April 2014, 30 patients with nonmetastatic breast cancer and no history of prior radiation were treated with proton therapy at a single proton center. Patient characteristics and dosimetry were obtained through chart review. Patients were seen weekly while on treatment, at 1 month after radiation therapy completion, and at 3- to 6-month intervals thereafter. Toxicity was scored using Common Terminology Criteria for Adverse Events version 4.0. Frequencies of toxicities were tabulated. Results: Median dose delivered was 50.4 Gy (relative biological equivalent [RBE]) in 5 weeks. Target volumes included the breast/chest wall and regional lymph nodes including the internal mammary lymph nodes (in 93%). No patients required a treatment break. Among patients with >3 months of follow-up (n=28), grade 2 dermatitis occurred in 20 patients (71.4%), with 8 (28.6%) experiencing moist desquamation. Grade 2 esophagitis occurred in 8 patients (28.6%). Grade 3 reconstructive complications occurred in 1 patient. The median planning target volume V95 was 96.43% (range, 79.39%-99.60%). The median mean heart dose was 0.88 Gy (RBE) [range, 0.01-3.20 Gy (RBE)] for all patients, and 1.00 Gy (RBE) among patients with left-sided tumors. The median V20 of the ipsilateral lung was 16.50% (range, 6.1%-30.3%). The median contralateral lung V5 was 0.34% (range, 0%-5.30%). The median maximal point dose to the esophagus was 45.65 Gy (RBE) [range, 0-65.4 Gy (RBE)]. The median contralateral breast mean dose was 0.29 Gy (RBE) [range, 0.03-3.50 Gy (RBE)]. Conclusions: Postoperative proton therapy is well tolerated, with acceptable rates of skin toxicity. Proton therapy favorably spares normal tissue without compromising target coverage. Further follow-up is necessary to assess for clinical outcomes and cardiopulmonary

  19. Early Post Operative Enteral Versus Parenteral Feeding after Esophageal Cancer Surgery

    OpenAIRE

    Rajabi Mashhadi, Mohammad Taghi; Bagheri, Reza; Ghayour-Mobarhan, Majid; ZILAEE, Marzie; Rezaei, Reza; Maddah, Ghodratollah; Majidi, Mohamad Reza; Bahadornia, Mojgan

    2015-01-01

    Introduction: The incidence of malnutrition in hospitalized patients is reported to be high. In particular, patients with esophageal cancer are prone to malnutrition, due to preoperative digestive system dysfunctions and short-term non-oral feeding postoperatively. Selection of an appropriate method for feeding in the postoperative period is important in these patients. Materials and Methods: In this randomized clinical trial, 40 patients with esophageal cancer who had undergone esophagectomy...

  20. Long-term radiation sequelae after breast-conserving therapy in women with early-stage breast cancer: an observational study using the LENT-SOMA scoring system

    International Nuclear Information System (INIS)

    Purpose: To evaluate the long-term toxicity after breast-conserving therapy in women with early-stage breast cancer. Methods and Materials: Late toxicity according to the late effects of normal tissue-subjective, objective, management, and analytic (LENT-SOMA) criteria and cosmetic outcome (graded by physicians) were evaluated in 590 of 2943 women with early-stage breast cancer who were irradiated between 1983 and 1995 using the following fractionation schedules: group A, 1983-1987, 2.5 Gy 4x/wk to 60 Gy; group B, 1988-1993, 2.5 Gy 4x/wk to 55 Gy, group C, 1994-1995, 2.0 Gy 5x/wk to 55 Gy. Results: LENT-SOMA Grade 3-4 toxicity was observed as follows: group A (median follow-up 171 months; range 154-222 months), fibrosis 16% (7 of 45), telangiectasia 18% (8 of 45), and atrophy 4% (2 of 45); group B (median follow-up 113 months; range 78-164 months), pain 2% (8 of 345), fibrosis 10% (34 of 345), telangiectasia 10% (33 of 345), arm edema 1% (2 of 345), and atrophy 8% (27 of 345); and group C (median follow-up 75 months, range 51-96 months, n = 200), occurrence of Grade 3-4 late morbidity ≤2%. The cosmetic outcome was very good to acceptable in 78% (35 of 45) of patients in group A, 83% (286 of 345) in group B, and 94% (187 of 200) in group C. Conclusion: In our population, the long-term side effects after breast-conserving therapy were not rare, but were mainly asymptomatic. The LENT-SOMA breast module is a practical tool to assess radiation-induced long-term toxicity

  1. Feasibility and acute toxicity of 3-dimensional conformal external-beam accelerated partial-breast irradiation for early-stage breast cancer after breast-conserving surgery in Chinese female patients

    Institute of Scientific and Technical Information of China (English)

    LI Feng-yan; HE Zhen-yu; XUE Ming; CHEN Li-xin; WU San-gang; GUAN Xun-xing

    2011-01-01

    Background A growing number of studies worldwide have advocated the replacement of whole-breast irradiation with accelerated partial breast irradiation using three-dimensional conformal external-beam radiation (APBI-3DCRr) for early-stage breast cancer. But APBI can be only used in selected population of patients with early-staged breast cancer. It is not replacing the whole breast radiotherapy. This study aimed to examine the feasibility and acute normal tissue toxicity of the APBI-3DCRT technique in Chinese female patients who generally have smaller breasts compared to their Western counterparts.Methods From May 2006 to December 2009, a total of 48 Chinese female patients (with early-stage breast cancer who met the inclusion criteria) received APBI-3DCRT after breast-conserving surgery at Sun Yat-sen University Cancer Center. The total dosage from APBI-3DCRT was 34 Gy, delivered in 3.4 Gy per fractions, twice per day at intervals of at least six hours. The radiation dose, volume of the target area and volume of irradiated normal tissues were calculated.Acute toxicity was evaluated according to the Common Toxicity Criteria (CTC) 3.0.Results Among the 48 patients, the planning target volume for evaluation (PTVE) was (90.42±9.26) cm3, the ipsilateral breast volume (IBV) was (421.74±28.53) cm3, and the ratio between the two was (20.74±5.86)%. Evaluation of the dosimetric characteristics of the PTVE revealed excellent dosimetric results in 14 patients and acceptable results in 34 patients. The dose delivered to the PTVE ranged from 93% to 110% of the prescribed dose. The average ratio of the volume of PTVE receiving 95% of the prescription dose (V95) was (99.26±0.37)%. The habituation index (HI) and the conformity index (CI) were 1.08±0.01 and 0.72±0.02, respectively, suggesting good homogeneity and conformity of the dose delivered to the target field. The radiation dose to normal tissues and organs was within the dose limitation.Subjects experienced mild acute

  2. Cerebrospinal fluid prohormone processing and neuropeptides stimulating feed intake of dairy cows during early lactation.

    Science.gov (United States)

    Kuhla, Björn; Laeger, Thomas; Husi, Holger; Mullen, William

    2015-02-01

    After parturition, feed intake of dairy cows increases within the first weeks of lactation, but the molecular mechanisms stimulating or delaying the slope of increase are poorly understood. Some of the molecules controlling feed intake are neuropeptides that are synthesized as propeptides and subsequently processed before they bind to specific receptors in feeding centers of the brain. Cerebrospinal fluid surrounds most of the feed intake regulatory centers and contains numerous neuropeptides. In the present study, we used a proteomic approach to analyze the neuropeptide concentrations in cerebrospinal fluid taken from dairy cows between day -18 and -10, and between day +10 and +20 relative to parturition. We found 13 proteins which were only present in samples taken before parturition, 13 proteins which were only present in samples taken after parturition, and 25 proteins which were commonly present, before and after parturition. Among them, differences in pro-neuropeptide Y, proenkephalin-A, neuroendocrine convertase-2, neurosecretory protein VGF, chromogranin-A, and secretogranin-1 and -3 concentrations relative to parturition highlight propeptides and prohormone processings involved in the control of feed intake and energy homeostasis. Scaffold analysis further emphasized an increased tone of endogenous opioids associated with the postparturient increase of feed intake.

  3. Low incidence of germline mutation in BRCA1 Exon 11 among early-onset and familial Filipino breast cancer patients

    International Nuclear Information System (INIS)

    Breast cancer susceptibility gene, type 1 (BRCA1) has been thought to be responsible for about 45% of families with multiple breast carcinoma cases and for more than 80% of hereditary breast and ovarian cancer (HBOC) families. About 61-75% of the reported distinct alterations that result in truncated protein products have been found in exon 11 which comprises 61% (3427bp) of the coding sequence of BRCA1(5592bp). Protein truncation test (PTT) has become a popular method as an efficient means of screening mutations in a coding sequence that lead to a truncated protein product. In this study, 34 early-onset and/or familial breast cancer (FBC) patients were investigated. Twenty-six patients are early-onset B(o)C cases (diagnosed≤40 years old), 14 of which have familiality of the disease. Among the 8 patients that have been diagnosed above 40 years old, 7 have familial clustering. Through radioactive PTT analysis of the 34 BC cases in a 5-20% denaturing gradient polyacrylamide gel, we found only one mutation in exon 11 having a 29.7 kDa truncated protein product. Our results corroborate the findings of a recently reported study of unselected incident breast cancer cases in the Philippines where the prevalence of BRCA1 mutation is also low. This would, however, be the second documented mutation in BRCA1 exon 11 in a Filipino BC patient since 1998. (author)

  4. Health beliefs related to breast cancer screening behaviours in women who applied to cancer early detection center

    Directory of Open Access Journals (Sweden)

    Melek Serpil Talas

    2015-06-01

    Full Text Available Background: Breast cancer is one of the most common malignancies affecting women in Turkey. The early detection methods for breast cancer have been associated with health belief variables. Objectives: The purpose of this study was to determine women's health beliefs related to breast cancer screening behaviours. Methods: This study was designed as descriptive and cross-sectional survey and was performed on 344 women who applied the Nigde Cancer Early Diagnosis, Screening and Education Center between May and October 2009. The data were collected using a questionnaire which consists of socio-demographic characteristics and breast cancer risk factors and Health Belief Model Scale. Data analysis was performed using frequency and Mann-Whitney U Test. All values of p0.05. According to study results, the rate of regular BSE performance rate for women was found low. Therefore, KETEM was planned to the training programs related to breast cancer screening methods. [TAF Prev Med Bull 2015; 14(3.000: 265-271

  5. Intraoperative radiotherapy for early breast cancer: do health professionals choose convenience or risk?

    International Nuclear Information System (INIS)

    The randomized TARGIT trial comparing experimental intra-operative radiotherapy (IORT) to up to 7 weeks of daily conventional external beam radiotherapy (EBRT) recruited participants in Western Australia between 2003 and 2012. We aimed to understand preferences for this evolving radiotherapy treatment for early breast cancer (EBC) in health professionals, and how they changed over time and in response to emerging data. Preferences for single dose IORT or EBRT for EBC were elicited in 2004 and 2011, together with factors that may be associated with these preferences. Western Australian health professionals working with breast cancer patients were invited to complete a validated, self-administered questionnaire. The questionnaire used hypothetical scenarios and trade-off methodology to determine the maximum increase in risk of local recurrence health professionals were willing to accept in order to have a single dose of IORT in the place of EBRT if they were faced with this decision themselves. Health professional characteristics were similar across the two time points although 2011 included a higher number of nurse (49% vs. 36%) and allied health (10% vs. 4%) participants and a lower number of radiation therapists (17% vs. 32%) compared to 2004. Health professional preferences varied, with 7.5% and 3% judging IORT unacceptable at any risk, 18% and 21% judging IORT acceptable only if offering an equivalent risk, 56% and 59% judging IORT acceptable with a low maximum increase in risk (1-3%) and 19% and 17% judging a high maximum increase in risk acceptable (4-5%), in 2004 and 2011 respectively. A significantly greater number of nurses accepted IORT as a treatment option in 2011. Most Western Australian health professionals working with breast cancer patients are willing to accept an increase in risk of local recurrence in order to replace EBRT with IORT in a hypothetical setting. This finding was consistent over two time points spanning 7 years despite the duration of

  6. A novel deleterious PTEN mutation in a patient with early-onset bilateral breast cancer

    International Nuclear Information System (INIS)

    An early age at Breast Cancer (BC) onset may be a hallmark of inherited predisposition, but BRCA1/2 mutations are only found in a minority of younger BC patients. Among the others, a fraction may carry mutations in rarer BC genes, such as TP53, STK11, CDH1 and PTEN. As the identification of women harboring such mutations allows for targeted risk-management, the knowledge of associated manifestations and an accurate clinical and family history evaluation are warranted. We describe the case of a woman who developed an infiltrating ductal carcinoma of the right breast at the age of 32, a contralateral BC at age 36 and another BC of the right breast at 40. When she was 39 years-old, during a dermatological examination, mucocutaneous features suggestive of Cowden Syndrome, a disorder associated to germ-line PTEN mutations, were noticed. PTEN genetic testing revealed the novel c.71A > T (p.Asp24Val) mutation, whose deleterious effect, suggested by conservation data and in silico tools, was definitely demonstrated by the incapacity of mutant PTEN to inhibit Akt phosphorylation when used to complement PTEN-null cells. In BC tissue, despite the absence of LOH or somatic mutations of PTEN, Akt phosphorylation was markedly increased in comparison to normal tissue, thus implying additional somatic events into the deregulation of the PI3K/Akt/mTOR pathway and, presumably, into carcinogenesis. Hence, known oncogenic mutations in PIK3CA (exons 10 and 21) and AKT1 (exon 2) were screened in tumor DNA with negative results, which suggests that the responsible somatic event(s) is a different, uncommon one. This case stresses the importance of clinical/genetic assessment of early-onset BC patients in order to identify mutation carriers, who are at high risk of new events, so requiring tailored management. Moreover, it revealed a novel PTEN mutation with pathogenic effect, pointing out, however, the need for further efforts to elucidate the molecular steps of PTEN

  7. [Influence of feeding patterns on the development of teeth, dentition and jaw in children].

    Science.gov (United States)

    Wang, Xiao-tong; Ge, Li-hong

    2015-02-18

    Breastfeeding has been recognized as the most natural and nutritious way of feeding babies. Besides the nutritional, immunological and emotional benefits, breastfeeding promotes a healthy stomatognathic system. First of all, the nutrients and minerals in maternal milk are easy to be absorbed by the infants, which contributes to the mineralization of the teeth, and suppress the propagation of bacteria on the teeth. Though the jury is still out on whether breastfeeding can prevent Early Childhood Caries (ECC), it is definite that we should pay attention to feeding at night and the oral hygiene of the babies. Secondly, the method of feeding is closely bound up with the development of dentition and jaw. Breast- and bottle-feeding involve different orofacial muscles, which possibly have different effects on the harmonic growth of maxilla and dental arches. Meanwhile, breathing, swallowing and mastication should be developing in harmony, and differences exist in the learning of the coordinated movement between breast feeding and bottle feeding children. Bottle feeding had been proved to be closely related with the non-nutritive sucking habits which can cause malocclusion. At last, it should be pointed out that breast feeding should be the only feeding source in the first 6 months of life, then supplementary foods should be added. And prolonged bottle feeding should be avoided. We can see that breast feeding is definitely good for the infants, but the reality is not optimistic in our country. PMID:25686355

  8. Impact of maternal BMI and sampling strategy on the concentration of leptin, insulin, ghrelin and resistin in breast milk across a single feed: a longitudinal cohort study

    Science.gov (United States)

    Andreas, Nicholas J; Hyde, Matthew J; Herbert, Bronwen R; Jeffries, Suzan; Santhakumaran, Shalini; Mandalia, Sundhiya; Holmes, Elaine; Modi, Neena

    2016-01-01

    Objectives We tested the hypothesis that there is a positive association between maternal body mass index (BMI) and the concentration of appetite-regulating hormones leptin, insulin, ghrelin and resistin in breast milk. We also aimed to describe the change in breast milk hormone concentration within each feed, and over time. Setting Mothers were recruited from the postpartum ward at a university hospital in London. Breast milk samples were collected at the participants’ homes. Participants We recruited 120 healthy, primiparous, breastfeeding mothers, aged over 18 years. Mothers who smoked, had multiple births or had diabetes were excluded. Foremilk and hindmilk samples were collected from 105 women at 1 week postpartum and 92 women at 3 months postpartum. Primary and secondary outcome measures We recorded maternal and infant anthropometric measurements at each sample collection and measured hormone concentrations using a multiplex assay. Results The concentration of leptin in foremilk correlated with maternal BMI at the time of sample collection, at 7 days (r=0.31, p=0.02) and 3 months postpartum (r=0.30, p=maternal BMI at 3 months postpartum (r=0.22, p=0.04). Breast milk ghrelin and resistin were not correlated with maternal BMI. Ghrelin concentrations at 3 months postpartum were increased in foremilk compared with hindmilk (p=0.01). Concentrations of ghrelin were increased in hindmilk collected at 1  week postpartum compared with samples collected at 3 months postpartum (p=0.03). A trend towards decreased insulin concentrations in hindmilk was noted. Concentrations of leptin and resistin were not seen to alter over a feed. Conclusions A positive correlation between maternal BMI and foremilk leptin concentration at both time points studied, and foremilk insulin at 3 months postpartum was observed. This may have implications for infant appetite regulation and obesity risk. PMID:27388351

  9. Current treatment of early breast cancer: adjuvant and neoadjuvant therapy [v1; ref status: indexed, http://f1000r.es/3l2

    Directory of Open Access Journals (Sweden)

    Elizabeth Miller

    2014-08-01

    Full Text Available Breast cancer is the most commonly diagnosed cancer in women. The latest world cancer statistics calculated by the International Agency for Research on Cancer (IARC revealed that 1,677,000 women were diagnosed with breast cancer in 2012 and 577,000 died. The TNM classification of malignant tumor (TNM is the most commonly used staging system for breast cancer. Breast cancer is a group of very heterogeneous diseases. The molecular subtype of breast cancer carries important predictive and prognostic values, and thus has been incorporated in the basic initial process of breast cancer assessment/diagnosis. Molecular subtypes of breast cancers are divided into human epidermal growth factor receptor 2 positive (HER2 +, hormone receptor positive (estrogen or progesterone +, both positive, and triple negative breast cancer. By virtue of early detection via mammogram, the majority of breast cancers in developed parts of world are diagnosed in the early stage of the disease. Early stage breast cancers can be completely resected by surgery. Over time however, the disease may come back even after complete resection, which has prompted the development of an adjuvant therapy. Surgery followed by adjuvant treatment has been the gold standard for breast cancer treatment for a long time. More recently, neoadjuvant treatment has been recognized as an important strategy in biomarker and target evaluation. It is clinically indicated for patients with large tumor size, high nodal involvement, an inflammatory component, or for those wish to preserve remnant breast tissue. Here we review the most up to date conventional and developing treatments for different subtypes of early stage breast cancer.

  10. Early experiences of breast-conservation treatment without axillary dissection for breast cancer patients with clinically-negative axillary nodes

    International Nuclear Information System (INIS)

    Nineteen patients with breast cancer who had clinically negative axillary nodes were treated with breast-conservation treatment, consisting of lumpectomy, irradiation, endocrine therapy (tamoxifen), and adjuvant chemotherapy. They were all women, whose ages ranged from 35 to 84 years with a mean of 53.8 years. Preoperative UICC staging was I in 10 patients, IIA in 8, and IIB in one; and postoperative staging was I in 7 and IIA in 12. Among evaluable 13 patients, 5 (38.5%) had microscopically positive margin. Radiation therapy was started within two to three weeks after breast-conserving surgery. Patients received irradiation to the ipsilateral breast and chest wall, including the ipsilateral axillary region, using opposed tangential fields to a dose of 4400 cGy at 275 cGy per fraction. Boost irradiation using an electron beam was delivered with a dose of 1000 cGy in 2 fractions in the last week of radiotherapy in all patients. In addition, adjuvant chemotherapy (cyclophosphamide, pirarubicin or epirubicin, 5-fluorouracil) and endocrine therapy (tamoxifen) were given. With a mean follow up of 20.7 months, one patient aged 80 died of cardiac failure and pneumonia without evidence of breast cancer progression. The other 18 patients are alive without either local failure or distant metastases. Cosmetic evaluation showed each 9 patients to be 'excellent' or 'good'. No patients have serious adverse effects as of this writing. Although the follow-up period is short and the number of patients is limited, the preliminary results of breast-conservation treatment for axillary negative breast cancer seem to be sufficiently good. (N.K.)

  11. Predictors of the risk of fibrosis at 10 years after breast conserving therapy for early breast cancer - A study based on the EORTC trial 22881-10882 'boost versus no boost'

    NARCIS (Netherlands)

    Collette, Sandra; Collette, Laurence; Budiharto, Tom; Horiot, Jean-Claude; Poortmans, Philip M.; Struikmans, Henk; Van den Bogaer, Walter; Fourquet, Alain; Jagerg, Jos J.; Hoogenraad, Willem; Mueller, Rolf-Peter; Kurtz, John; Morgan, David A. L.; Dubois, Jean-Bernard; Salamon, Emile; Mirimanoff, Rene; Bolla, Michel; Van der Hulst, Marleen; Warlam-Rodenhuis, Carla C.; Bartelink, Harry

    2008-01-01

    The EORTC 22881-10882 trial in 5178 conservatively treated early breast cancer patients showed that a 16 Gy boost dose significantly improved local control, but increased the risk of breast fibrosis. To investigate predictors for the long-term risk of fibrosis, Cox regression models of the time to m

  12. Predictors of the risk of fibrosis at 10 years after breast conserving therapy for early breast cancer: a study based on the EORTC Trial 22881-10882 'boost versus no boost'.

    NARCIS (Netherlands)

    Collette, S.; Collette, L.; Budiharto, T.; Horiot, J.C.; Poortmans, P.M.; Struikmans, H.; Bogaert, W. van den; Fourquet, A.; Jager, J.J.; Hoogenraad, W.; Mueller, R.P.; Kurtz, J.; Morgan, D.A.; Dubois, J.B.; Salamon, E.; Mirimanoff, R.; Bolla, M.; Hulst, M. van der; Warlam-Rodenhuis, C.C.; Bartelink, H.

    2008-01-01

    The EORTC 22881-10882 trial in 5178 conservatively treated early breast cancer patients showed that a 16 Gy boost dose significantly improved local control, but increased the risk of breast fibrosis. To investigate predictors for the long-term risk of fibrosis, Cox regression models of the time to m

  13. Sentinel Lymph Node Detection by 3D Freehand Single-Photon Emission Computed Tomography in Early Stage Breast Cancer

    Directory of Open Access Journals (Sweden)

    Salih Sinan Gültekin

    2016-06-01

    Full Text Available We herein present our first experience obtained by 3D freehand single-photon emission computed tomography (SPECT (F-SPECT guidance for sentinel lymph node detection (SLND in two patients with early stage breast cancer. F-SPECT guidance was carried out using one-day protocol in one case and by the two-day protocol in the other one. SLND was performed successfully in both patients. Histopathologic evaluation showed that the excised nodes were tumor negative. Thus, patients underwent breast-conserving surgery alone.

  14. Management of the Regional Lymph Nodes Following Breast-Conservation Therapy for Early-Stage Breast Cancer: An Evolving Paradigm

    Energy Technology Data Exchange (ETDEWEB)

    Warren, Laura E.G. [Harvard Radiation Oncology Program, Boston, Massachusetts (United States); Punglia, Rinaa S.; Wong, Julia S. [Department of Radiation Oncology, Brigham and Women' s Hospital and Dana-Farber Cancer Institute, Boston, Massachusetts (United States); Bellon, Jennifer R., E-mail: jbellon@lroc.harvard.edu [Department of Radiation Oncology, Brigham and Women' s Hospital and Dana-Farber Cancer Institute, Boston, Massachusetts (United States)

    2014-11-15

    Radiation therapy to the breast following breast conservation surgery has been the standard of care since randomized trials demonstrated equivalent survival compared to mastectomy and improved local control and survival compared to breast conservation surgery alone. Recent controversies regarding adjuvant radiation therapy have included the potential role of additional radiation to the regional lymph nodes. This review summarizes the evolution of regional nodal management focusing on 2 topics: first, the changing paradigm with regard to surgical evaluation of the axilla; second, the role for regional lymph node irradiation and optimal design of treatment fields. Contemporary data reaffirm prior studies showing that complete axillary dissection may not provide additional benefit relative to sentinel lymph node biopsy in select patient populations. Preliminary data also suggest that directed nodal radiation therapy to the supraclavicular and internal mammary lymph nodes may prove beneficial; publication of several studies are awaited to confirm these results and to help define subgroups with the greatest likelihood of benefit.

  15. Pattern of follow-up care and early relapse detection in breast cancer patients

    NARCIS (Netherlands)

    Geurts, S.M.E.; Vegt, de F.; Siesling, S.; Flobbe, K.; Aben, K.K.H.; Heiden-van der Loo, van der M.; Verbeek, A.L.M.; Dijck, van J.A.A.M.; Tjan-Heijnen, V.C.G.

    2012-01-01

    Routine breast cancer follow-up aims at detecting second primary breast cancers and loco regional recurrences preclinically. We studied breast cancer follow-up practice and mode of relapse detection during the first 5 years of follow-up to determine the efficiency of the follow-up schedule. The Neth

  16. Development of Conformation Independent Computational Models for the Early Recognition of Breast Cancer Resistance Protein Substrates

    Directory of Open Access Journals (Sweden)

    Melisa Edith Gantner

    2013-01-01

    Full Text Available ABC efflux transporters are polyspecific members of the ABC superfamily that, acting as drug and metabolite carriers, provide a biochemical barrier against drug penetration and contribute to detoxification. Their overexpression is linked to multidrug resistance issues in a diversity of diseases. Breast cancer resistance protein (BCRP is the most expressed ABC efflux transporter throughout the intestine and the blood-brain barrier, limiting oral absorption and brain bioavailability of its substrates. Early recognition of BCRP substrates is thus essential to optimize oral drug absorption, design of novel therapeutics for central nervous system conditions, and overcome BCRP-mediated cross-resistance issues. We present the development of an ensemble of ligand-based machine learning algorithms for the early recognition of BCRP substrates, from a database of 262 substrates and nonsubstrates compiled from the literature. Such dataset was rationally partitioned into training and test sets by application of a 2-step clustering procedure. The models were developed through application of linear discriminant analysis to random subsamples of Dragon molecular descriptors. Simple data fusion and statistical comparison of partial areas under the curve of ROC curves were applied to obtain the best 2-model combination, which presented 82% and 74.5% of overall accuracy in the training and test set, respectively.

  17. Dosimetric comparison of partial and whole breast external beam irradiation in the treatment of early stage breast cancer.

    Science.gov (United States)

    Kim, Yongbok; Parda, David S; Trombetta, Mark G; Colonias, Athanasios; Werts, E Day; Miller, Linda; Miften, Moyed

    2007-12-01

    A dosimetric comparison was performed on external-beam three-dimensional conformal partial breast irradiation (PBI) and whole breast irradiation (WBI) plans for patients enrolled in the National Surgical Adjuvant Breast and Bowel Project (NSABP) B-39/Radiation Therapy Oncology Group (RTOG) 0413 protocol at our institution. Twenty-four consecutive patients were treated with either PBI (12 patients) or WBI (12 patients). In the PBI arm, the lumpectomy cavity was treated to a total dose of 38.5 Gy at 3.85 Gy per fraction twice daily using a four-field noncoplanar beam setup. A minimum 6 h interval was required between fractions. In the WBI arm, the whole breast including the entirety of the lumpectomy cavity was treated to a total dose of 50.4 Gy at 1.8 Gy per fraction daily using opposed tangential beams. The lumpectomy cavity volume, planning target volume for evaluation (PTV_EVAL), and critical structure volumes were contoured for both the PBI and WBI patients. Dosimetric parameters, dose volume histograms (DVHs), and generalized equivalent uniform dose (gEUD) for target and critical structures were compared. Dosimetric results show the PBI plans, compared to the WBI plans, have smaller hot spots in the PTV_EVAL (maximum dose: 104.2% versus 110.9%) and reduced dose to the ipsilateral breast (V50: 48.6% versus 92.1% and V100: 10.2% versus 50.5%), contralateral breast (V3: 0.16% versus 2.04%), ipsilateral lung (V30: 5.8% versus 12.7%), and thyroid (maximum dose: 0.5% versus 2.0%) with p values < or = 0.01. However, similar dose coverage of the PTV_EVAL (98% for PBI and 99% for WBI, on average) was observed and the dose difference for other critical structures was clinically insignificant in both arms. The gEUD data analysis showed the reduction of dose to the ipsilateral breast and lung, contralateral breast and thyroid. In addition, preliminary dermatologic adverse event assessment data suggested reduced skin toxicity for patients treated with the PBI technique.

  18. Stink Bug (Hemiptera: Heteroptera: Pentatomidae) Feeding and Phenology on Early-Maturing Soybean in Minnesota.

    Science.gov (United States)

    Koch, Robert L; Rich, Walter A

    2015-10-01

    The invasion by Halyomorpha halys (Stål) and an increasing abundance of native Pentatomidae pose a threat to soybean, Glycine max (L.) Merrill, production in northern states. A risk assessment framework was used to provide an initial assessment of the risk of Pentatomidae affecting soybean production in northern states. A caged field study was performed over two years to assess the response of soybean to H. halys feeding. Cages placed over R4 soybean were infested with 0, 1, 2, 4, or 8 fourth-instar H. halys nymphs per 0.3 row-m, and the insects were allowed to feed for 15 to 16 days. Feeding by H. halys on soybean affected yield components, maturity, and quality (i.e., seed injury). Season-long monitoring of soybean fields was performed via sweep net sampling to assess the likelihood of herbivorous Pentatomidae occurring on soybean during plant growth stages susceptible to feeding injury. Adults of herbivorous species were collected at low densities in fields in mid- to late July before collection of herbivorous nymphs. Herbivorous nymphs were first collected in the R3 and R4 soybean growth stages and their abundance peaked during the R6 soybean growth stage. This preliminary assessment indicates that if populations of exotic and native herbivorous Pentatomidae continue to increase in abundance, they will pose a threat to northern soybean production. PMID:26453722

  19. Convalescence and hospital stay after colonic surgery with balanced analgesia, early oral feeding, and enforced mobilisation

    DEFF Research Database (Denmark)

    Møiniche, S; Bülow, Steffen; Hesselfeldt, Peter;

    1995-01-01

    /daily. No patient had a nasogastric tube, and oral feeding with normal food and protein enriched solutions (1000 Kcal (4180 KJ/day) was instituted 24 hours postoperatively together with intensive mobilisation. RESULTS: Median visual analogue pain scores were zero at rest and minimal during coughing and mobilisation...

  20. Early detection and prediction of cardiotoxicity after radiation therapy for breast cancer: the BACCARAT prospective cohort study

    International Nuclear Information System (INIS)

    Radiotherapy (RT) for breast cancer presents a benefit in terms of reducing local recurrence and deaths resulting from breast cancer but it can lead to secondary effects due to the presence of neighboring cardiac normal tissues within the irradiation field. Breast RT has been shown to be associated with long-term increased risk of heart failure, coronary artery disease, myocardial infarction and finally cardiovascular death more than 10 years after RT. However, there is still a lack of knowledge for early cardiotoxicity induced by breast RT that can appear long before the onset of clinically significant cardiac events. Based on a 2-year follow-up prospective cohort of patients treated with breast RT, the BACCARAT (BreAst Cancer and CArdiotoxicity Induced by RAdioTherapy) study aims to enhance knowledge on detection and prediction of early subclinical cardiac dysfunction and lesions induced by breast RT and on biological mechanisms potentially involved, based on functional and anatomical cardiac imaging combined with simultaneous assessment of multiple circulating biomarkers and accurate heart dosimetry. BACCARAT study consists in a monocentric prospective cohort study that will finally include 120 women treated with adjuvant 3D CRT for breast cancer, and followed for 2 years after RT. Women aged 50 to 70 years, treated for breast cancer and for whom adjuvant 3D CRT is indicated, without chemotherapy are eligible for the study. Baseline (before RT) and follow-up data include measurements of functional myocardial dysfunction including strain and strain rate based on 2D-speckle tracking echocardiography, anatomical coronary lesions including description of plaques in segments of coronary arteries based on Coronary computed tomography angiography, and a wide panel of circulating biomarkers. The absorbed dose is evaluated for the whole heart and its substructures, in particular the coronary arteries. Analysis on occurrence and evolution of subclinical cardiac lesions

  1. The impact of tamoxifen on breast recurrence, cosmesis, complications, and survival in estrogen receptor positive early stage breast cancer

    International Nuclear Information System (INIS)

    Purpose: In the NSABP B14 trial evaluating tamoxifen (tam) in axillary node negative, estrogen receptor positive tumors fewer breast recurrences were observed in patients treated with conservative surgery and radiation who received tam compared to the observation arm. An additional series, however, has suggested that tam adversely impacts on the cosmetic result. To further address these issues we compared the outcome of estrogen receptor positive tumors treated with conservative surgery and radiation with or without tam. Materials and Methods: From 1982 to 1991, 491 women with estrogen receptor positive stage I-II breast cancer underwent excisional biopsy, axillary dissection and radiation. The median age of the patient population was 60 years (range 39-85). The median followup was 5.3 years (range .1-12.8). 69% had T1 tumors and 83% had histologically negative axillary nodes. Reexcision was performed in 49%. The final margin of resection was negative in 64%, unknown in 18%, and close or positive in 19%. None of the patients received adjuvant chemotherapy. 154 patients received tam and 337 received no adjuvant therapy. Patients who received tam were more often axillary node positive (44% tam vs 5% no tam) and less often had unknown margins (9% tam vs 22% no tam). There were no significant differences for the 2 groups for median age, primary tumor size, histology, race, or use of reexcision. Results: The 5 yr act rate of breast recurrence was 4% for the tam patients compared to 7% for patients not receiving tam (p=.21). At 8 yrs, the breast recurrence rates were 4% for the tam patients compared to 11% for the no tam patients (p=.05). However, at 9 years the rates were 17% tam vs 14% no tam (p=.21). The benefit from tam in terms of a decreased 5 year actuarial breast recurrence rate was most evident for patients who did not have a reexcision (3% tam vs 10% no tam, p=.15), had unknown margins (7% tam vs 13% no tam, p=.37) or close margins (0% tam vs 11% no tam, p=.34

  2. Economic Impact of Gene Expression Profiling in Patients with Early-Stage Breast Cancer in France.

    Directory of Open Access Journals (Sweden)

    Gregory Katz

    Full Text Available The heterogeneous nature of breast cancer can make decisions on adjuvant chemotherapy following surgical resection challenging. Oncotype DX is a validated gene expression profiling test that predicts the likelihood of adjuvant chemotherapy benefit in early-stage breast cancer. The aim of this study is to determine the costs of chemotherapy in private hospitals in France, and evaluate the cost-effectiveness of Oncotype DX from national insurance and societal perspectives.A multicenter study was conducted in seven French private hospitals, capturing retrospective data from 106 patient files. Cost estimates were used in conjunction with a published Markov model to assess the cost-effectiveness of using Oncotype DX to inform chemotherapy decision making versus standard care. Sensitivity analyses were performed.The cost of adjuvant chemotherapy in private hospitals was estimated at EUR 8,218 per patient from a national insurance perspective and EUR 10,305 from a societal perspective. Cost-effectiveness analysis indicated that introducing Oncotype DX improved life expectancy (+0.18 years and quality-adjusted life expectancy (+0.17 QALYs versus standard care. Oncotype DX was found cost-effective from a national insurance perspective (EUR 2,134 per QALY gained and cost saving from a societal perspective versus standard care. Inclusion of lost productivity costs in the modeling analysis meant that costs for eligible patients undergoing Oncotype DX testing were on average EUR 602 lower than costs for those receiving standard care.As Oncotype DX was found both cost and life-saving from a societal perspective, the test was considered to be dominant to standard care. However, the delay in coverage has the potential to erode the quality of the French healthcare system, thus depriving patients of technologies that could improve clinical outcomes and allow healthcare professionals to better allocate hospital resources to improve the standard of care for all

  3. Androgen Receptor Expression in Early Triple-Negative Breast Cancer: Clinical Significance and Prognostic Associations

    Energy Technology Data Exchange (ETDEWEB)

    Pistelli, Mirco, E-mail: mirco.pistelli@alice.it; Caramanti, Miriam [Clinica di Oncologia Medica, AO Ospedali Riuniti-Ancona, Università Politecnica delle Marche, Ancona 60020 (Italy); Biscotti, Tommasina; Santinelli, Alfredo [Anatomia Patologica, AO Ospedali Riuniti-Ancona, Università Politecnica delle Marche, Ancona 60020 (Italy); Pagliacci, Alessandra; De Lisa, Mariagrazia; Ballatore, Zelmira; Ridolfi, Francesca; Maccaroni, Elena; Bracci, Raffaella; Berardi, Rossana; Battelli, Nicola; Cascinu, Stefano [Clinica di Oncologia Medica, AO Ospedali Riuniti-Ancona, Università Politecnica delle Marche, Ancona 60020 (Italy)

    2014-06-27

    Background: Triple-negative breast cancers (TNBC) are characterized by aggressive tumour biology resulting in a poor prognosis. Androgen receptor (AR) is one of newly emerging biomarker in TNBC. In recent years, ARs have been demonstrated to play an important role in the genesis and in the development of breast cancer, although their prognostic role is still debated. In the present study, we explored the correlation of AR expression with clinical, pathological and molecular features and its impact on prognosis in early TNBC. Patients and Methods: ARs were considered positive in case of tumors with >10% nuclear-stained. Survival distribution was estimated by the Kaplan Meier method. The univariate and multivariate analyses were performed. The difference among variables were calculated by chi-square test. Results: 81 TNBC patients diagnosed between January 2006 and December 2011 were included in the analysis. Slides were stained immunohistochemically for estrogen and progesterone receptors, HER-2, Ki-67, ALDH1, e-cadherin and AR. Of the 81 TNBC samples, 18.8% showed positive immunostaining for AR, 23.5% and 44.4% of patients were negative for e-cadherin and ALDH1, respectively. Positive AR immunostaining was inversely correlated with a higher Ki-67 (p < 0.0001) and a lympho-vascular invasion (p = 0.01), but no other variables. Univariate survival analysis revealed that AR expression was not associated with disease-free survival (p = 0.72) or overall survival (p = 0.93). Conclusions: The expression of AR is associated with some biological features of TNBC, such as Ki-67 and lympho-vascular invasion; nevertheless the prognostic significance of AR was not documented in our analysis. However, since ARs are expressed in a significant number of TNBC, prospective studies in order to determine the biological mechanisms and their potential role as novel treatment target.