Sample records for breast feeding patients

  1. 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


    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.

  2. Breast-Feeding Twins: Making Feedings Manageable (United States)

    ... more than one baby? Here's help breast-feeding twins or other multiples, from getting positioned and ensuring ... babies who are born prematurely, as are many twins and higher order multiples. Breast milk is easier ...

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

    Directory of Open Access Journals (Sweden)

    Manjunatha Swamy R


    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

  4. Excessive milk production during breast-feeding prior to breast cancer diagnosis is associated with increased risk for early events


    Gustbée, Emma; Anesten, Charlotte; Markkula, Andrea; Simonsson, Maria; Rose, Carsten; Ingvar, Christian; Jernström, Helena


    Breast-feeding is a known protective factor against breast cancer. Breast-feeding duration is influenced by hormone levels, milk production, and lifestyle factors. The aims were to investigate how breast-feeding duration and milk production affected tumor characteristics and risk for early breast cancer events in primary breast cancer patients. Between 2002 and 2008, 634 breast cancer patients in Lund, Sweden, took part in an ongoing prospective cohort study. Data were extracted from question...

  5. [Current views on breast feeding]. (United States)

    Grüttner, R


    One of the greatest advantages of feeding exclusively breast-milk is the continuous provision of immunoglobulin A, especially during the first days of life, and of leucocytes with macrophage function as well as unspecific, antiinfectious agents like lactoferrin, lysozyme and neuraminic acid. It seems, that the organism is protected against allergic reactions at the mucosa level of the small intestine caused by the penetration of "foreign" protein by feeding exclusively breast-milk especially during the first weeks and months of life. During the first months of the infant's life an increased supply of iron results from the higher content of iron in breast-milk as compared to cow's milk, and the better absorption of the iron from breast-milk. Just because of this (the better provision with iron from natural food) solid foods should not be added to the infant's diet before 6 months of age. One of the disadvantages of breast-feeding is the passage of unwanted substances from breast-milk to the infant. First of all the chlorinated hydrocarbons have to be mentioned within this context. However, a decreasing tendency can be assumed according to recent investigations. An increasing tendency in breast-milk, though not confirmed, seems possible only for the polychlorinated biphenyls. Nevertheless, for the pediatrician no reason to advise against breast-feeding results from the unwanted admixtures of chlorinated hydrocarbons in breast-milk. One should rather vigorously propagate to feed as many children as possible exclusively with breast-milk over a period of 4 to 6 months.

  6. Breast feeding practice among medical women in Nigeria

    Directory of Open Access Journals (Sweden)

    A E Sadoh


    Full Text Available Background : Health care workers are important in the promotion, protection and support of breast feeding. Their ability to do this may be influenced by their knowledge, personal experiences and work. Patients and Method: The breast feeding experience of 36 female medical doctors who had babies within the preceding two years and had resumed work was evaluated using a semi-structured self administered questionnaire. Result: All respondents knew that babies should be exclusively breast fed for the first six months of life but only 60% knew that breast feeding should continue until two years. The exclusive breast feeding rate for the studied doctors was 11.1%. Before their babies were six months old, about 75% of respondents had resumed work whilst over 50% had started taking calls. Most could not breast feed during working or call hours. Alternative feeds during working or call hours included expressed breast milk in 34.4% and infant formula in 21.9%. Feeding bottle was the major method (77.4% for feeding these alternatives. Work schedule was rearranged to allow breast feeding in only 27.3% of respondents. Conclusion: Failure to carry out exclusive breast feeding, the use of infant formula and feeding bottles (rather than cup feeding are practices that may be inimical to the practice of breast feeding in society in general. The suboptimal breast feeding experience in these doctors and the identified knowledge deficits may limit their effectiveness in promoting and supporting breast feeding among their patients and communities. Female medical personnel should be empowered to carry out optimal feeding of their own infants.

  7. Breast feeding and infant nutrition. (United States)

    Smith, G V; Calvert, L J; Kanto, W P


    Breast feeding is a management problem requiring knowledge of the physiology of lactation, maternal and infant nutritional requirements, and specifics such as drugs which enter the milk. The job of the physician is to allay anxiety; this helps establish the let-down reflex and increases milk production. "Caking," mastitis and even abscesses are not indications for weaning. Rest, warm compresses and frequent nursing are indicated. Breast-fed infants have less tendency to obesity than those who are bottle-fed. Early solid foods in the diet are not needed.

  8. Successful breast feeding: the mother's dilemma. (United States)

    Harrison, M J; Morse, J M; Prowse, M


    A content analysis of 141 articles on breast feeding by discipline revealed differences in the factors considered necessary for breast feeding success and in the criteria used to determine success. Whereas medical articles focused on maternal factors prenatally and infant health post-natally, or the length of time breast feeding was maintained, lay articles focused on the relationship of the mother with her infant (the nursing couple) and the mother's ability to manage breast feeding within the family context. The implications of this discrepancy for nursing practice and research are discussed.

  9. Breast-feeding and alcoholism

    DEFF Research Database (Denmark)

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


    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...... deliveries in a Danish hospital, obtaining data about prepartum and postpartum variables. The present study concentrates on perinatal variables obtained from 200 of the original babies who participated in a 30-year high-risk follow-up study of the antecedents of alcoholism. RESULTS: Of the 27 men who were...... 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...

  10. Does breast feeding influence liver biochemistry?

    DEFF Research Database (Denmark)

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


    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....

  11. Isolated hydatid cyst of the breast that developed after breast feeding (United States)

    Moazeni-Bistgani, Mohammad


    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

  12. Food intakes in a group of breast-feeding and not breast-feeding mothers. (United States)

    Savino, F; Bonfante, G; Muratore, M C; Peltran, A; Cresi, F; Mostert, M; Oggero, R


    The relation between mother's diet and breast milk composition is still an open question. An important issue is whether mothers who are breast feeding modify, respect to before lactation, food intake to satisfy the increased requirements.

  13. Representing infant feeding: content analysis of British media portrayals of bottle feeding and breast feeding


    Henderson, L.; KITZINGER, Jenny; Green, J.


    Objective: To examine how breast feeding and bottle feeding are represented by the British media.\\ud Design: Content analysis.\\ud Subjects: Television programmes and newspaper articles that made reference to infant feeding during March 1999.\\ud Setting: UK mass media.\\ud Main outcome measures: Visual and verbal references to breast or bottle feeding in newspapers and television programmes.\\ud Results: Overall, 235 references to infant feeding were identified in the television sample and 38 in...

  14. Does breast feeding influence liver biochemistry?

    DEFF Research Database (Denmark)

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


    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....

  15. Breast Feeding Practices in Urban Community of Surat City

    Directory of Open Access Journals (Sweden)

    Nayak Sunil, Jay Padodara, Patel Sushil, Gharat Vaibhav, Patel Swati, Choksi Vivek, Desai Toral


    Full Text Available The breast feeding practices adopted in terms of duration, frequency and exclusiveness of breast feeding and weaning have great impact on complete physical, mental and psycho-social development of the child. The objective of conducting the study is to evaluate the breast feeding practices adopted by women in urban community, and s to study factors affecting time of initiation of breast feeding, age of weaning, and food given to the baby other than breast milk. The current cross sectional study conducted among 200 women reveal that 70% of mothers were able to start breast feeding within first hour of life after normal delivery. Out of 26 complicated deliveries, 6 mothers were able to start breast feeding within 4 hours of life. The major reasons for delay in starting of breast feeding were uneasiness to mother and not having adequate breast milk. Exclusive breast feeding was practiced by 50% of the mothers for first six month of life. The common reason given by mother for not giving exclusive breast feeding were no knowledge of exclusive breast feeding (40% and not having adequate breast milk(35%. This study emphasizes the need of breast feeding education programme regarding the duration of exclusive breast feeding and the age of weaning.

  16. Breast-feeding after breast cancer: if you wish, madam. (United States)

    Azim, Hatem A; Bellettini, Giulia; Gelber, Shari; Peccatori, Fedro A


    Breast cancer is the most common malignant tumor-affecting women during the child bearing period. With the rising trend in delaying pregnancy later in life, the issue of subsequent pregnancy and lactation following breast cancer diagnosis has been more frequently encountered. In this context, data is scarce particularly those addressing the issue of lactation. In this review, we discussed different endocrinal, clinical and biological aspects dealing with breast-feeding after breast cancer in an attempt to determine how safe and feasible this approach is.

  17. Breast-Feeding May Not Lead to Smarter Preschoolers (United States)

    ... Breast-Feeding May Not Lead to Smarter Preschoolers But study ... 2017 MONDAY, March 27, 2017 (HealthDay News) -- Breast-feeding may not make kids sharper or better behaved ...

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


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


    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...

  19. [Etanercept in pregnancy and breast-feeding]. (United States)

    Borrego, L


    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.

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

    LENUS (Irish Health Repository)

    Leahy-Warren, Patricia


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

    DEFF Research Database (Denmark)

    Stage, E; Nørgård, Hanne; Damm, Peter


    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....

  2. Breast-feeding: knowledge and attitudes of undergraduate nutrition majors

    Directory of Open Access Journals (Sweden)

    Erly Catarina Moura


    Full Text Available A sample of, forty-five undergraduate nutrition majors from San Jose State University (SJSU in the United States and forty-six from Pontifícia Universidade Católica de Campinas (PUC-Campinas in Brazil completed a 9uestionnaire elaborated to compare their' breast feeding experience, knowledge and attitudes. Results showed that 44.4% of SJSU and 80.4% of PUC-Campinas .students had been breast-fed (p=0.01. Although students intended to breast-feed, both groups had a negative attitude toward breast-feeding in public: SJSU students (56.8% felt social pressures to not breast=feed in public, and PUC-Campinas students (54.3% expressed personal constraint. SJSU students emphasized convenience, and PUC-Campinas students mentioned, immunological factors as advantages of breast-feeding. PUC-Campinas students considered protection as an advantage of formula, feeding. Concerning causal factors for breast feeding failure, SJSU students cited negative social pressure and biological problems, and PUC-Campinas students mentioned, lack of information. In conclusion, it is necessary to improve the curricula, if we expect future nutrition professionals to have adequate knowledge to promote and choose breast feeding successfully.

  3. Risk factors for early termination of breast feeding in Brazil. (United States)

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


    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.

  4. The Impact of a Self-Efficacy Intervention on Short-Term Breast-Feeding Outcomes (United States)

    Nichols, Jeni; Schutte, Nicola S.; Brown, Rhonda F.; Dennis, Cindy-Lee; Price, Ian


    Maternal self-efficacy for breast-feeding may contribute to success in breast-feeding. This study aimed to increase breast-feeding self-efficacy and actual breast-feeding through an intervention based on Bandura's self-efficacy theory. A total of 90 pregnant women participated in the study. The women who were assigned to a breast-feeding…

  5. Attitudes of medical and nursing personnel to breast feeding practices. (United States)

    Sharma, P; Dutta, A K; Narayanan, I; Mullick, D N


    Medical staff from the department of Pediatrics and Obstetrics and Gynecology (50 doctors and 50 nurses) were interviewed in an assessment of attitudes towards and knowledge of breast feeding. 98% of the doctors and nurses believed that breast feeding was better than artificial feeding. However, 32% of the nurses believed that commercial powder milk is preferable for use with a preterm baby. Most of the 100 believed that a newborn baby should receive boiled water for the 1st feed. All of the doctors and 94% of the nurses agreed that the newborn should be given the opportunity for a breast feed within the 1st 12 hours following birth. While most of the doctors and nurses generally supported breast feeding, they also did not believe that the 1st feed should be breast milk, and nearly 1/3 of the nurses advocated commercial milk for preterm babies. 86% of the nurses and 70% of the doctors believed that breast feeding ought to continue for 1 year. Even though a general awareness and understanding of breast feeding existed among the medical personnel interviewed, there are still areas in which staff could be re-educated and re-directed.

  6. Extended Breast-Feeding: What You Need to Know (United States)

    ... to reduce the risk of breast cancer, ovarian cancer, rheumatoid arthritis, high blood pressure, heart disease and diabetes. Improved health. Research suggests that the longer breast-feeding continues and the more breast milk a baby drinks, the better a mother's health ...

  7. The Behavioral Determinants of Breast-Feeding in the Netherlands: Predictors for the Initiation of Breast-Feeding (United States)

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


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

  8. [Main sociocultural aspects related to breast feeding in Malinalco, Mexico]. (United States)

    Pérez-Gil Romo, S E; Rueda Arroniz, F; Ysunza Ogazón, A; Andrade Contreras, M D


    The present paper discusses data related to some sociocultural aspects on breast-feeding behavior among a group of women from a rural community in Mexico called Malinalco. A sample of 225 mothers with children aged less than 60 months, was selected. Several home visits were done in order to fill up a questionnaire, as well as to follow direct interviews according to some selected variables to the deepened, such as: schooling, occupation, place of children deliveries, breast-feeding behavior beliefs on breast-feeding abandonment, weaning practices, etc. The results showed that there is no relation between breast-feeding practices, income and school years; nevertheless, there is a certain tendency on early abandonment of breast-feeding in women with higher level of schooling. Some local beliefs about breast-milk production were detected, as well as some remedies to stimulate milk production and to cure certain breast-feeding problems. Data on weaning age and the commonest weaning food products are presented. The importance that cultural dimension has on breast-feeding studies is discussed, as well as the relevance of recognizing "the changes of concepts" within the process of cultural development itself, in order to understand them better and to propose solutions to the generated problems.

  9. Neonate-Mother Interaction during Breast-Feeding. (United States)

    Thoman, Evelyn B.; And Others

    Using a modified time-sampling procedure, 20 primiparous and 20 multiparous mothers were observed while breast-feeding their 48-hour old infants. In comparison with multiparous mothers, primiparous mothers (1) spend more time in non-feeding activities, (2) spend more time feeding male infants, (3) change activity more frequently, (4) provide more…

  10. Duration of breast feeding and language ability in middle childhood. (United States)

    Whitehouse, Andrew J O; Robinson, Monique; Li, Jianghong; Oddy, Wendy H


    There is controversy over whether increased breast-feeding duration has long-term benefits for language development. The current study examined whether the positive associations of breast feeding on language ability at age 5 years in the Western Australian Pregnancy (Raine) Cohort, were still present at age 10 years. The Raine Study is a longitudinal study of 2868 liveborn children recruited at approximately 18 weeks gestation. Breast-feeding data were based upon information prospectively collected during infancy, and were summarised according to four categories of breast-feeding duration: (1) never breast-fed, (2) breast-fed predominantly for 6 months. Language ability was assessed in 1195 children at the 10 year follow-up (mean age = 10.58 years; standard deviation = 0.19) using the Peabody Picture Vocabulary Test - Revised (PPVT-R), which is based around a mean of 100 and a standard deviation of 15. Associations between breast-feeding duration and PPVT-R scores were assessed before and after adjustment for a range of sociodemographic, obstetric and psychosocial covariates. Analysis of variance revealed a strong positive association between the duration of predominant breast feeding and PPVT-R at age 10 years. A multivariable linear regression analysis adjusted for covariates and found that children who were predominantly breast-fed for >6 months had a mean PPVT-R score that was 4.04 points higher than children who were never breast-fed. This compared with an increase of 3.56 points at age 5 years. Breast feeding for longer periods in early life has a positive and statistically-independent effect on language development in middle childhood.

  11. Biomechanics of milk extraction during breast-feeding. (United States)

    Elad, David; Kozlovsky, Pavel; Blum, Omry; Laine, Andrew F; Po, Ming Jack; Botzer, Eyal; Dollberg, Shaul; Zelicovich, Mabel; Ben Sira, Liat


    How do infants extract milk during breast-feeding? We have resolved a century-long scientific controversy, whether it is sucking of the milk by subatmospheric pressure or mouthing of the nipple-areola complex to induce a peristaltic-like extraction mechanism. Breast-feeding is a dynamic process, which requires coupling between periodic motions of the infant's jaws, undulation of the tongue, and the breast milk ejection reflex. The physical mechanisms executed by the infant have been intriguing topics. We used an objective and dynamic analysis of ultrasound (US) movie clips acquired during breast-feeding to explore the tongue dynamic characteristics. Then, we developed a new 3D biophysical model of the breast and lactiferous tubes that enables the mimicking of dynamic characteristics observed in US imaging during breast-feeding, and thereby, exploration of the biomechanical aspects of breast-feeding. We have shown, for the first time to our knowledge, that latch-on to draw the nipple-areola complex into the infant mouth, as well as milk extraction during breast-feeding, require development of time-varying subatmospheric pressures within the infant's oral cavity. Analysis of the US movies clearly demonstrated that tongue motility during breast-feeding was fairly periodic. The anterior tongue, which is wedged between the nipple-areola complex and the lower lips, moves as a rigid body with the cycling motion of the mandible, while the posterior section of the tongue undulates in a pattern similar to a propagating peristaltic wave, which is essential for swallowing.

  12. Does frenotomy improve breast-feeding difficulties in infants with ankyloglossia? (United States)

    Ito, Yasuo


    The aim of this systematic review was to critically examine the existing literature regarding the effectiveness of tongue-tie division in infants with ankyloglossia, using the new grades of recommendations, assessment, development, and evaluation (GRADE) rating system. A clinical question was structured according to patient, intervention, comparison, and outcome, as follows: in infants with poor breast-feeding and ankyloglossia (patient), does frenotomy (intervention), compared to lactation support alone (comparison), improve feeding (outcome)? An electronic literature search was systematically conducted from databases including PubMed, Japana Centra Revuo Medicina (Igaku Chuo Zasshi), CINAHL, and Cochrane Library using the key words "ankyloglossia," "tongue-tie," "frenotomy," and/or "breast-feeding" in English and equivalent terms in Japanese. The literature search yielded four randomized clinical trials, and 12 observational studies for analysis. The quality of the literature was rated in regard to the two most important outcomes (sucking/latching, and nipple pain) and five less important outcomes (milk supply/milk production, continuation of breast-feeding, weight gain, adverse events, and dyad distress) in accordance with the GRADE system. Evidence levels of the most important outcomes were rated either A (strong evidence) or B (moderate evidence), and less important outcomes were rated C (weak evidence); every outcome consistently showed a favorable effect of frenotomy on breast-feeding. The literature review supported an overall moderate quality of evidence for the effectiveness of frenotomy for the treatment of breast-feeding difficulties in infants with ankyloglossia. No major complications from frenotomy were reported.

  13. 21 CFR 201.63 - Pregnancy/breast-feeding warning. (United States)


    ... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Pregnancy/breast-feeding warning. 201.63 Section...) DRUGS: GENERAL LABELING Labeling Requirements for Over-the-Counter Drugs § 201.63 Pregnancy/breast... during pregnancy or while nursing has been established for a particular drug product in a new...

  14. Breast-feeding success among infants with phenylketonuria. (United States)

    Banta-Wright, Sandra A; Shelton, Kathleen C; Lowe, Nancy D; Knafl, Kathleen A; Houck, Gail M


    Breast milk is the nutrition of choice for human infants (American Academy of Pediatrics, 2005; American Association of Family Physicians, 2008; Association of Women's Health Obstetric and Neonatal Nurses, 2005; Canadian Paediatric Society, 2005; U.S. Preventive Services Task Force, 2008; World Health Organization, 2009). In comparison to standard commercial formula, human breast milk has a lower concentration of protein and a lower content of the amino acid phenylalanine (Phe). For infants with phenylketonuria (PKU), these attributes of human breast milk make it ideal as a base source of nutrition. The purpose of this study was to compare the incidence and duration of breast-feeding and corresponding Phe levels of breast-fed and formula-fed infants with PKU in the caseload of a pediatric metabolic clinic at an urban tertiary-care medical center. Charts were reviewed for infants diagnosed with PKU beginning with 2005 and ending with 1980, the year no further breast-feeding cases were identified in the PKU population. During the first year of life, most of the infants, whether breast-fed or formula-fed, had similar mean Phe levels. However, the frequency distributions revealed that more breast-fed infants with PKU had Phe levels within the normal range (120-360 μmol/L) and were less likely to have low Phe levels (<120 μmol/L) than formula-fed infants with PKU. Further research is needed to understand how mothers manage breast-feeding in the context of PKU.

  15. Breast-feeding: knowledge and attitudes of undergraduate nutrition majors



    A sample of, forty-five undergraduate nutrition majors from San Jose State University (SJSU) in the United States and forty-six from Pontifícia Universidade Católica de Campinas (PUC-Campinas) in Brazil completed a 9uestionnaire elaborated to compare their' breast feeding experience, knowledge and attitudes. Results showed that 44.4% of SJSU and 80.4% of PUC-Campinas .students had been breast-fed (p=0.01). Although students intended to breast-feed, both groups had a negative attitude toward b...

  16. Developing a workplace breast feeding support model for employed lactating mothers. (United States)

    Yimyam, Susanha; Hanpa, Wasana


    Resuming work is often considered an obstacle for continued breast feeding. The objectives of this participatory action research study were to develop a breast feeding support model in the workplace and to compare breast feeding rates before and after implementation of the breast feeding support campaign. Twenty-four women participated before the implementation of the breast feeding support campaign, whereas 31 women participated after the campaign. Data were collected by interviewing employed women about their breast feeding practices within six months post partum. Additional data were collected through interviews with the workplace administrator and head of work sections as well as observation of the breast feeding support campaigns. Qualitative data were analysed using thematic analysis, whereas quantitative data were analysed using descriptive statistics and χ(2) test. The workplace breast feeding support model was developed based on the concept of Mother-Friendly Workplace Initiatives by the World Alliance for Breastfeeding Action (WABA) and the Thai government׳s promotion of a workplace breast feeding corner. Within this model, a committee for breast feeding support was created for working with the research team to develop breast feeding activities and media for breast feeding education and breast feeding support campaigns in the workplace. Breast feeding rates at six months after implementation of the breast feeding support campaign were significantly higher than rates before, both for exclusive breast feeding and any breast feeding at levels .004 and .033, respectively. These results suggest that breast feeding should be encouraged in every workplace depending on context. Individual advice and help for employed mothers should be provided from pregnancy through weaning in the postpartum period.

  17. Reflux Incidence among Exclusively Breast Milk Fed Infants: Differences of Feeding at Breast versus Pumped Milk. (United States)

    Yourkavitch, Jennifer; Zadrozny, Sabrina; Flax, Valerie L


    The practice of feeding infants expressed breast milk is increasing in the United States, but the impacts on infant and maternal health are still understudied. This study examines the monthly incidence of regurgitation (gastro-esophageal reflux) in exclusively breast milk fed infants from ages two to six months. Among infants whose mothers participated in the Infant Feeding Practices II Study (IFPS II; 2005-2007), data on reflux and feeding mode were collected by monthly questionnaires. A longitudinal, repeated measures analysis was used, with feeding mode lagged by one month in order to compare reflux incidence among infants fed directly at the breast to infants receiving pumped breast milk. Mothers in both feeding groups had similar characteristics, although a greater proportion feeding at least some pumped milk were primiparous. The number of exclusively breastfed infants decreased steadily between months 2 and 6, although the proportion fed at the breast remained similar over time. An association between feeding mode and reflux incidence was not found; however, the analyses were limited by a small number of reported reflux cases. More studies are needed to further explain the relationship between different feeding modes and infant reflux.


    Directory of Open Access Journals (Sweden)

    M.Alavi Naini


    Full Text Available Second to the cardiovascular disease, cancer is the main cause of death in Iran. In this study some of the risk factors of breast cancer; especially the ones related to breastfeeding have been assessed. The study was a retrospective study of 100 women with breast cancer. The most important risk factors in breast cancer were number of children, age of mother on the first pregnancy. The result showed that the increase of breast cancer was related to women who stopped breastfeeding before age 24 months. Breastfeeding for more than 12 months will reduce the incidence of breast cancer by 25%. In general there was a reverse relationship between duration of breastfeeding and risk of cancer in premonopausal, but not in postmenopausal women.

  19. Understanding adolescent mothers' feelings about breast-feeding. A study of perceived benefits and barriers. (United States)

    Radius, S M; Joffe, A


    This study was designed to assess the benefits and barriers accruing to breast-feeding as perceived by pregnant adolescents, and to establish whether these perceptions distinguished between adolescent mothers who chose to breast versus bottle feed. Surveys were completed by 254 young women attending prenatal clinics. Overall, 19.3% indicated their intent to breast-feed. When categorized by intended method of infant feeding (breast versus bottle), breast-feeding mothers cited more benefits and fewer barriers associated with that method of infant feeding. Overall, perceived benefits were more successful than perceived barriers in distinguishing between the groups of respondents. For those interested in promoting breast-feeding among adolescent mothers, our data support an emphasis on the diverse benefits of this method of infant feeding. Our results also suggest the usefulness of peer role models in correcting misinformation and encouraging breast-feeding among adolescent mothers.

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

    LENUS (Irish Health Repository)

    Tarrant, R C


    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.

  1. Breast feeding and the development of type 1 diabetes mellitus

    DEFF Research Database (Denmark)

    Kyvik, K O; Green, A; Svendsen, Anders Jørgen


    A case-control study was conducted to study the proposed inverse relationship between breast feeding and incidence of Type 1 diabetes mellitus. All Danish diabetic men born in Copenhagen during 1959-1964 and/or residing there for the first year of life (n = 119) were identified and a search made...

  2. Awareness regarding breast feeding and complementary feeding in mothers of children with severe acute malnutrition at stabilization centre Multan

    Directory of Open Access Journals (Sweden)

    Saadia Khan


    Full Text Available Breast feeding is the most natural way of feeding the infants and help to reduce child mortality and morbidity and millions of deaths could be prevented each year if mothers were aware of benefits of exclusive breast feeding for 4 -6 months and early initiation of breast feeding. In current study, awareness regarding breast feeding and complementary feeding in mothers of severely malnourished children was evaluated. The results showed that 99% mothers considered breast milk safe and effective but practically only 23% babies were breast fed while 77% were bottle fed. According to 58% mothers, there should be a early initiation of breast feeding, while 57% were un aware of the facts that clostrum should be given while 43% (43/100 of then considered it unhealthy and non effective. The current awareness reveals that most of the mothers prefer to give commercially available foods for their infants instead of breast feeding. This situation is alarming regarding child health and there is need to educate the mothers especially about the beneficial and health curing effects of breast feeding.

  3. Awareness regarding breast feeding and complementary feeding in mothers of children with severe acute malnutrition at stabilization centre Multan

    Directory of Open Access Journals (Sweden)

    Saadia Khan


    Full Text Available Breast feeding is the most natural way of feeding the infants and help to reduce child mortality and morbidity and millions of deaths could be prevented each year if mothers were aware of benefits of exclusive breast feeding for 4 -6 months and early initiation of breast feeding. In current study, awareness regarding breast feeding and complementary feeding in mothers of severely malnourished children was evaluated. The results showed that 99% mothers considered breast milk safe and effective but practically only 23% babies were breast fed while 77% were bottle fed. According to 58% mothers, there should be a early initiation of breast feeding, while 57% were un aware of the facts that clostrum should be given while 43% (43/100 of then considered it unhealthy and non effective. The current awareness reveals that most of the mothers prefer to give commercially available foods for their infants instead of breast feeding. This situation is alarming regarding child health and there is need to educate the mothers especially about the beneficial and health curing effects of breast feeding.

  4. Do early infant feeding patterns relate to breast-feeding continuation and weight gain ? data from a longitudinal cohort study.


    Casiday, R. E.; Wright, C. M.; Panter-Brick, C.; Parkinson, K.


    Objectives: To describe the first-week feeding patterns for breast- vs bottle-fed babies, and their association with sustained breast-feeding and infant weight gain at 6 weeks. Design: A longitudinal cohort study. Setting: Feeding diaries were completed by mothers in an urban UK community shortly after birth; follow-up weight and feeding data were collected at routine health checks. Subjects: Mothers of 923 full-term infants born during the recruiting period agreed to join the stud...

  5. Obstacles to and motivation for successful breast-feeding

    Directory of Open Access Journals (Sweden)

    A-M Bergh


    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.

  6. Nestle and breast vs. bottle feeding: mainstream and Marxist perspectives. (United States)

    Campbell, C E


    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.

  7. Breast-feeding among Mothers of Low Birth Weight Infants


    Lefebvre, Francine


    The physical and emotional condition of the mother delivering a premature or low birth weight infant may be quite different than that of the mother of a healthy term infant when initiating breast-feeding. Despite this difference, incidence and duration of lactation among mothers of pre-term or low birth weight infants was found to be quite good compared with that of mothers of term infants. Considerable problems, however, are encountered by premature or low birth weight infants when breast-fe...

  8. Association of breast-feeding and feeding on demand with child weight status up to 4 years

    NARCIS (Netherlands)

    Gubbels, J.S.; Thijs, C.; Stafleu, A.; Buuren, S. van; Kremers, S.P.J.


    Objectives. The mechanisms underlying the protective effect of breast-feeding on the development of childhood overweight are unclear. This study examines the association of breast-feeding with weight gain in the first year, and body mass index (BMI) and overweight up to 4 years. In addition, we exam

  9. [Breast feeding: importance of supportive counseling to the working mother]. (United States)

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


    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.

  10. Coordination of sucking, swallowing, and breathing and oxygen saturation during early infant breast-feeding and bottle-feeding. (United States)

    Goldfield, Eugene C; Richardson, Michael J; Lee, Kimberly G; Margetts, Stacey


    This prospective study compared the coordination of sucking, swallowing, and breathing and its relationship to oxygen saturation in infants during breast-feeding and bottle-feeding. After 4 to 6 wk of exclusive breast-feeding, infants began bottle-feedings of expressed human milk using one of two systems: a soft-walled bottle and nipple (system 1, Playtex) or a hard-walled bottle and nipple (system 2, Avent). Infants' sucking, swallowing, breathing, and oxygenation were measured during breast-feeding and bottle-feeding, and coordination of these activities during breast-feeding and bottle-feeding were compared. During breast-feeding, swallowing occurred nonrandomly between breaths and did not interfere with breathing. The same distribution of swallowing occurred in infants fed with system 1, while swallowing occurred randomly in infants fed with system 2. Swallowing significantly increased during bottle-feeding among infants using system 2, but decreased among infants using system 1. Infants using system 2 also had a greater instability in the coordination of sucking, swallowing, and breathing and more perturbation of breathing. Oxygen saturation was significantly higher in infants fed with system 1 compared with system 2. These results suggest that the overall feeding pattern and oxygenation of system 1 are closer to the physiologic norm than system 2.

  11. Breast versus bottle: correlates of adolescent mothers' infant-feeding practices. (United States)

    Joffe, A; Radius, S M


    Since the 1970s, breast-feeding as the preferred method of infant feeding has increased in overall popularity. However, certain populations, particularly poor, young, black, and less-educated women, have been slow to adopt this method. This prospective study was undertaken to identify factors relating to the choice of infant-feeding method among inner-city adolescents. Two hundred fifty-four pregnant adolescents completed a questionnaire supplying information regarding attitudes toward and knowledge about breast-feeding, social support, personal experience, and other variables hypothesized to correlate with their choice of infant-feeding method. Of the total sample, 17% said they were "probably" or "definitely" going to breast-feed their babies. Analyses revealed adolescents most likely to intend to breast-feed were those who perceived more benefits to breast-feeding, who desired more knowledge about it, who were themselves breast-fed, who reported supportive social environments, and who perceived relatively fewer barriers to breast-feeding their infants. Specific interventions based upon these findings are proposed. We conclude that adolescent mothers are interested in breast-feeding their babies and that interventions are feasible to increase breast-feeding within this population.

  12. The breast-feeding dilemma and its impact on HIV-infected women and their children. (United States)

    Heymann, S J; Vo, P


    The rate of HIV transmission via breast-feeding ranges from 14% to 26%, depending on the timing of maternal infection. In settings where infant mortality rates from infectious diseases and malnutrition are low and relatively safe alternatives to breast-feeding are available, HIV-infected mothers should be advised not to breast-feed. Where breast-feeding by HIV-infected mothers and bottle-feeding both present serious risks of mortality, changing the conditions in which families live so that safe feeding alternatives become available must be a top priority. At the same time, these mothers need information about the relative risks and benefits of breast-feeding, early weaning, wet-nursing, and formula feeding. This article reviews the available research data and discusses critical gaps in current knowledge.

  13. Experience and Personality Differences among Breast- and Bottle-Feeding Mothers. (United States)

    Berg-Cross, Linda; And Others


    Studies the relationship between different feeding modes and the mother's enjoyment of feeding and her attitude toward and style of weaning the child. Results indicate breast-feeding mothers are higher sensation seekers, more satisfied with the feeding experience, and more ambivalent about weaning than the artifically feeding mothers. (Author)

  14. Breast-Feeding Attitudes and Behavior among WIC Mothers in Texas (United States)

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


    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. Predictors of breast-feeding in a developing country: results of a prospective cohort study.


    Al-Sahab, B; Tamim, H; Mumtaz, G; Khawaja, M.; Khogali, M.; Afifi, R; Nassif, Y; Yunis, KA; National Collaborative Perinatal Neonatal Network (NCPNN)


    OBJECTIVE: Data on the prevalence and predictors of breast-feeding remain scarce in Lebanon. Moreover, no study has previously addressed the effect of the paediatrician's sex on breast-feeding. The present study aimed to assess the prevalence and predictors of breast-feeding at 1 and 4 months of infant age while exploring the potential role of the sex of the paediatrician. DESIGN: Prospective cohort study. Predictors of breast-feeding significant at the bivariate level were tested at 1 and 4 ...

  16. Maternal obesity and breast-feeding practices among white and black women. (United States)

    Liu, Jihong; Smith, Michael G; Dobre, Mirela A; Ferguson, James E


    Despite the increase in obesity among women of reproductive ages, few studies have considered maternal obesity as a risk factor for breast-feeding success. We tested the hypothesis that women who are obese (BMI = 30-34.9) and very obese (BMI >or=35) before pregnancy are less likely to initiate and maintain breast-feeding than are their normal-weight counterparts (BMI = 18.5-24.9) among white and black women. Data from 2000 to 2005 South Carolina Pregnancy Risk Assessment Monitoring System (PRAMS) were used. The overall response rate was 71.0%; there were 3,517 white and 2,846 black respondents. Black women were less likely to initiate breast-feeding and breast-fed their babies for a shorter duration than white women. Compared to normal-weight white women, very obese white women were less likely to initiate breast-feeding (odds ratio: 0.63; 95% confidence interval (CI) = 0.42, 0.94) and more likely to discontinue breast-feeding within the first 6 months (hazard ratio (HR) = 1.89; 95% CI: 1.39, 2.58). Among black women, prepregnancy BMI was neither associated with breast-feeding initiation nor with breast-feeding continuation within the first 6 months. Because very obese white women are less likely to initiate or continue breast-feeding than other white women, health professionals should be aware that very obese white women need additional breast-feeding support. Lower rates of breast-feeding among black women suggest that they should continue to be the focus of the programs and policies aimed at breast-feeding promotion in the United States.

  17. [Contraception and breast feeding. Spacing of pregnancies. Present concepts]. (United States)

    Buitrón-García-Figueroa, Rafael; Malanco-Hernández, Luz María; Lara-Ricalde, Roger; García-Hernández, Alejandra


    The risk of pregnancy in breastfeeding should be a concern of women. Family planning programs in the postnatal period contraceptive choices offer high efficiency. Breastfeeding is a natural contraception method (LAM) as a contraceptive shield has 98 % efficiency. Women should consider using an alternate contraceptive method when feeding requirements for this method to be effective are not met. Some of contraceptive alternatives in lactation include hormonal methods. According to the Medical Eligibility Criteria for Contraceptive Use WHO combined hormonal methods are contraindicated during breast feeding, hormonal progestogen only method are considered only in Group 3 and Group 1 immediate postpartum after 6 weeks postpartum. There are modifications to these criteria by the CDC and the UK for the use of these hormones in early in lactation.

  18. Education and Outreach for Breast Imaging and Breast Cancer Patients (United States)


    the project was the development of an educational intervention ( flip chart ) for physicians to use in the clinic setting when discussing breast...Procedure Scheduling on Breast Biopsy Patient Outcomes The first phase of this project is the development of an educational flip chart for...breast biopsy and breast cancer survivors to guide the content of the flip chart b) Develop outline and overall format c) Identify/develop

  19. Systematic review and meta-analysis investigating breast feeding and childhood wheezing illness. (United States)

    Brew, Bronwyn K; Allen, C Wendy; Toelle, Brett G; Marks, Guy B


    There is conflicting evidence concerning the relationship between breast feeding and wheezing illness. The objective of this study was to investigate whether there is any association between breast feeding and wheezing in children aged over 5 years and to discover possible sources of heterogeneity. An electronic search of MEDLINE and EMBASE databases was conducted from January 2000 to June 2010. In addition, reference lists from relevant publications were searched. Birth cohort, cross-sectional and case-control studies were included if they measured any breast feeding or exclusive breast feeding for 3 or 4 months. Wheezing illness, including asthma, was identified based on symptoms, reported diagnosis or objective criteria. Thirty-one publications were identified for meta-analysis. There was no association found between any or exclusive breast feeding and wheezing illness, although there was a high level of heterogeneity between the studies. Subgroup analysis revealed that any breast feeding slightly lowers the odds of wheeze (pooled odds ratio 0.92 [0.86, 0.98]) but slightly increases the odds of asthma defined by specific criteria (pooled odds ratio 1.10 [1.00, 1.22]). This meta-analysis does not provide evidence that breast feeding is protective against wheezing illness in children aged 5 years and over. The difference in the effects of breast feeding according to the nature of the wheezing illness highlights the importance of the heterogeneity of illness phenotypes.

  20. Does breast feeding provide protection against acute appendicitis? A case-control study. (United States)

    Alves, João Guilherme Bezerra; Figueiroa, José Natal; Barros, Isabela


    Breast feeding stimulates a more tolerant lymphoid tissue at the base of the appendix and this could provide protection against acute appendicitis. Two studies reported that children and adolescents with appendicitis were less likely to have been breast fed. In a case-control study of 200 children with histologically confirmed acute appendicitis matched by 200 siblings with the same sex and difference age - up to three-year-old - we found breast feeding in at least the first two months of life and for more than four months provides protection against acute appendicitis. These findings suggesting that breast feeding may possibly give protection against the development of appendicitis.

  1. Fewer Advanced Alzheimer's Patients on Feeding Tubes (United States)

    ... Fewer Advanced Alzheimer's Patients on Feeding Tubes Practice dropped by half ... organizations -- is declining, a new study finds. One Alzheimer's expert who reviewed the new findings was heartened ...

  2. Role of the World Health Organization in the Promotion of Breast-Feeding


    Sterken, Elisabeth


    In response to the global decline in breast-feeding initiation and duration rates, the World Health Organization has produced several documents to assist governments and health professionals to reverse the trend. The WHO International Code of Marketing of Breast-Milk Substitutes addresses the detrimental influence of promotional methods by the infant formula industry. The recent WHO/UNICEF statement Protecting, Promoting and Supporting Breast-feeding has been prepared to increase the awarenes...

  3. The lipid peroxidation in breast cancer patients. (United States)

    Kedzierska, Magdalena; Olas, Beata; Wachowicz, Barbara; Jeziorski, Arkadiusz; Piekarski, Janusz


    The aim of our study was to estimate oxidative stress (by using different biomarkers of lipid peroxidation--isoprostanes and thiobarbituric acid reactive substances (TBARS)) in patients with invasive breast cancer, patients with benign breast diseases and in a control group. We observed a statistically increased level of TBARS in plasma and isoprostanes in urine of patients with invasive breast cancer in comparison with a control group. The concentration of tested biomarkers in plasma or urine from patients with invasive breast cancer was also higher than in patients with benign breast diseases. Moreover, the levels of tested markers in patients with benign breast diseases and in a control group did not differ. Considering the data presented in this study, we suggest that free radicals induce peroxidation of unsaturated fatty acid in patients with breast cancer.

  4. Changes in sucking performance from nonnutritive sucking to nutritive sucking during breast- and bottle-feeding. (United States)

    Mizuno, Katsumi; Ueda, Aki


    Our aim was to obtain a better understanding of the differences between breast-feeding and bottle-feeding, particularly with regard to how sucking performance changes from nonnutritive sucking (NNS) to nutritive sucking (NS). Twenty-two normal term infants were studied while breast-feeding at 4 and 5 d postpartum. Five of the 22 infants were exclusively breast-fed, but we tested the other 17 infants while breast-feeding and while bottle-feeding. Before the milk ejection reflex (MER) occurs, little milk is available. As such, infants perform NNS before MER. For bottle-feeding, a one-way valve was affixed between the teat and the bottle so that the infants needed to perform NNS until milk flowed into the teat chamber. At the breast, the sucking pressure (-93.1 +/- 28.3 mm Hg) was higher during NNS compared with NS (-77.3 +/- 27.0 mm Hg). With a bottle, the sucking pressure was lower during NNS (-27.5 +/- 11.2 mm Hg) compared with NS (-87.5 +/- 28.5 mm Hg). Sucking frequency was higher and sucking duration was shorter during NNS compared with that during NS both at the breast and with a bottle. There were significant differences in the changes of sucking pressure and duration from NNS to NS between breast- and bottle-feeding. The change in sucking pressure and duration from NNS to NS differed between breast-feeding and bottle-feeding. Even with a modified bottle and teats, bottle-feeding differs from breast-feeding.

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

    LENUS (Irish Health Repository)

    Tarrant, R C


    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.

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

    DEFF Research Database (Denmark)

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


    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...... 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...... and carbamazepin are contraindicated. Olanzapine, risperidone, quetiapine and clozapine can be used for bipolar disorders and schizophrenia. CONCLUSION: It is important that health professionals treating fertile women with a psychiatric disease discuss whether psychotropic drugs are needed during pregnancy and how...

  7. [Health care personnel's opinion on the breast-feeding pattern in the Mexican rural area]. (United States)

    Potter, J E; Mojarro Dávila, O; Hernández, D


    This paper surveys the health care personnel's knowledge and opinion about the physiology of the mother milk production and the issues that occur when it is stopped at an earlier moment. From an inquire carried out in 1984 on 155 doctors and nurses and 48 midwives that render their services to the rural population of Mexico, it was found that the majority of the health care personnel recognized breast-feeding as the best nurture for the child. Nevertheless, this personnel is against having a long breast-feeding period. More than half of the doctors and nurses commented that the breast-feeding period must be stopped when the child has diarrhea, which is contrary to the international health agencies opinion. The majority of the health care personnel recommends the introduction of complementary food to children under three months old and suggests a quick stop of the breast-feeding period. From these data it is shown that the health care personnel has little knowledge about the breast-feeding role as an element that increases the period of amenorrhea and its value as a natural contraceptive. The relation between breast-feeding and amenorrhea and infertility is inaccurate, that is why it is concluded that it is necessary to have training for the health care personnel in some physiological aspects of breast-feeding that are of prime importance. If the health care personnel has a better knowledge about breast-feeding, these influencing agents to decrease the incidence and value of breast-feeding will turn into strong promoters of such a healthy practice.

  8. The influence of culture on breast-feeding decisions by African American and white women. (United States)

    Street, Darlene Joyner; Lewallen, Lynne Porter


    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.

  9. Antibiotics and breast-feeding: a critical review of the literature. (United States)

    Chung, Allison M; Reed, Michael D; Blumer, Jeffrey L


    Continuous breast-feeding, an integral component of the postpartum period, is often threatened upon maternal initiation of antibiotics. The real risk of antibiotic use while breast-feeding must be carefully analysed with regard to all the variables that influence the extent of antibiotic distribution into breast milk, including breast milk composition, physicochemical properties of the antibiotic (molecular weight, lipid solubility, pH, protein binding), length of feeding, and maternal disposition. In addition, infant disposition, including ability to absorb, metabolize, eliminate, and tolerate any amounts of antibiotic, must also be considered prior to maternal administration of antibiotic. The milk to plasma (M/P) ratio is a frequently quoted parameter used to predict drug distribution into breast milk. However, its utility is questionable and often fraught with misinterpretation. An alternative approach when the amount of antibiotic concentration in breast milk is known (through clinical trials) is to calculate an estimated or expected infant drug exposure factoring in known/expected milk consumption, drug concentration and bioavailability. In this review, the following antibiotic classes and current literature regarding their distribution into breast milk are critically reviewed: beta-lactam antibiotics, fluoroquinolones, sulfonamides, macrolides, aminoglycosides, tetracyclines, nitrofurantoin, metronidazole, vancomycin, clindamycin and chloramphenicol. In the majority of instances, these antibiotics do not distribute into breast milk in sufficient concentrations to be of any clinical consequence in the breast-feeding infant.

  10. Effect of prolonged breast-feeding on risk of atopic dermatitis in early childhood. (United States)

    Hong, Soyoung; Choi, Won-Jun; Kwon, Ho-Jang; Cho, Yoon Hee; Yum, Hye Yung; Son, Dong Koog


    The effect of breast-feeding on the risk of developing atopic disease remains controversial. This study is an investigation of the effect of breast-feeding on current atopic dermatitis (AD) among Korean children. This cross-sectional study of children's histories of current AD and environmental factors was completed by the subjects' parents. The subjects included 10,383 children aged 0-13 years in Seoul, Korea, in 2008. The diagnostic criteria of the International Study of Asthma and Allergies in Childhood were applied in this study. Adjustments were performed for age, gender, maternal education, smoking in the household, relocation to a new house within 1 year of birth, and parental history of atopic disease. After adjustment for confounders, age and duration of maternal education were found to be inversely associated with the prevalence of AD. Among subjects aged ≤5 years, the prevalence of AD was positively associated with the duration of breast-feeding (p feeding among children >5 years of age. Regardless of parental history of atopic diseases, breast-feeding >12 months was a significant risk factor for AD. The effect of breast-feeding differed by age group. Prolonged breast-feeding increased the risk of AD in children <5 years of age, regardless of parental history of atopic diseases.


    Institute of Scientific and Technical Information of China (English)


    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.

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

    DEFF Research Database (Denmark)

    Mølbak, K; Gottschau, A; Aaby, P


    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.......02). Children aged 12-35 months who were not breast fed had a 3.5 times higher mortality (1.4 to 8.3) than breast fed children. CONCLUSIONS: The beneficial effects of breast feeding are not restricted to infancy. Though children who are partially breast fed after infancy may have a lower state of nutrition than...... were recorded for three years. SETTING: 301 randomly selected houses in a semiurban area in the capital, Bissau. SUBJECTS: 849 children aged less than 3 years. MAIN OUTCOME MEASURES: Incidence and duration of diarrhoea, weight for age, and death of a child. RESULTS: The incidence of diarrhoea...

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

    DEFF Research Database (Denmark)

    Nielsen, René Ernst; Damkier, Per


    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.......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...

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

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    Alizadeh Taheri P


    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.

  15. Early cessation of breast milk feeding in very low birthweight infants. (United States)

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


    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.

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

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    Panina O.S.


    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

  17. Predicting breast-feeding intention among low-income pregnant women: a comparison of two theoretical models. (United States)

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


    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.

  18. [Treatment of elderly patients with breast cancer

    DEFF Research Database (Denmark)

    Paaschburg, B.; Pedersen, A.; Tuxen, M.K.;


    The latest investigations have been searched in order to present new guidelines for the treatment of elderly patients with primary breast cancer. It is concluded that breast-conserving surgery should be offered as well as the sentinel node technique. Axillary lymph node dissection is not necessary...

  19. Are Today's Mother Aware Enough About Breast Feeding?: A Knowledge, Attitude and Practice Study on Urban Mothers

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    Rajendra N Gadhavi


    Full Text Available Background: Breastfeeding is a widespread practice in though out India. However it has been changing over the years, particularly in the past few decades. We need to keep exploring Knowledge and practices of mother regarding breast feeding for timely intervention and maintenance of his valuable age old practice. Objective: This study was aimed to explore mother's knowledge, attitude and practice regarding breastfeeding. Methods: By using pre tested questioner, 200 mother delivered in last one year were interviewed to obtain information regarding knowledge, Attitude and practice of breast feeding. The study was conducted in area served by an Urban Health Clinic. Result: Knowledge on proper breast feeding technique was found inadequate in study participants. Only 10% women were aware about intitiation of breast feeding within half hour of delivery. Benefits of colostrums, importance of exclusive breast feeding and benefits of night feeding were known to 25%, 15% and 15% mothers respectively. Less than half (41.4% mother had started breast feeding within half hour of birth while 15% were practicing exclusive breast feeding. Attachment and positioning techniques of 60% mother were found improper. None of the mother interviewed in the study got counseling on breast feeding during ANC visits. Conclusion: Harmful socio-cultural practices like giving prelacteal feeds, delayed initiation of breastfeeding after birth, late introduction of weaning foods and avoidance of exclusive breastfeeding are still common among the mothers. [Natl J Med Res 2013; 3(4.000: 396-398

  20. Longitudinal study of prolonged breast- or bottle-feeding on dental caries in Japanese children. (United States)

    Yonezu, Takuro; Ushida, Nagako; Yakushiji, Masashi


    The aim of this investigation was to study the effects of prolonged breast- or bottle-feeding on dental caries in Japanese infants. This longitudinal study was conducted by means of a questionnaire and clinical examination of 592 children at 18 months, 2 years and 3 years of age. The children were divided into three groups: 1) children still being breast-fed at 18 months of age (n=42); 2) children still being bottle-fed at 18 months of age (n=45); and 3) children weaned off of breast- or bottle-feeding and with no nonnutritive-sucking habits at 18 months of age (n=205). Results showed that breast-feeding at 18 months of age produced many significant differences to the control children, including a higher prevalence of caries and higher number of dft. However, no significant differences were observed between bottle-fed and control children. In conclusion, our results suggest that prolonged breast-feeding at an early age before primary dentition has fully erupted is a risk factor for dental caries. Therefore, breast-fed children need to be monitored more closely, and aggressive methods of preventive care need to be instituted. It is also important to identify factors related to dental caries among breastfed children as soon as possible, and develop effective preventive programs.

  1. Two nursing mothers treated with zonisamide: Should breast-feeding be avoided? (United States)

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


    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.

  2. Measuring patient outcomes in breast augmentation: introducing the BREAST-Q Augmentation module. (United States)

    Pusic, Andrea L; Reavey, Patrick L; Klassen, Anne F; Scott, Amie; McCarthy, Colleen; Cano, Stefan J


    The Breast-Q Augmentation module is a new and unique questionnaire for measuring patient-reported outcomes following breast augmentation. It has undergone a rigorous development and validation process and is currently the only questionnaire for breast augmentation that meets international and federal standards for questionnaire development. The Breast-Q Augmentation module covers a comprehensive set of concerns of breast augmentation patients, including satisfaction with breasts and impact on quality of life. With its excellent psychometric properties, the Breast-Q Augmentation module can provide clinicians and researchers with a wealth of essential data to improve the field of breast augmentation from the perspectives of both surgeons and patients.


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


    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.


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    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%.

  5. Determinants of Breast Feeding Practices in Urban Slums of a Taluka Headquarter of District Anand, Gujarat

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    Varshney Amit M, Kumar Dinesh, Patel Mahendra, Singh Uday S


    Full Text Available Introduction: Medical and public health experts advocate breastfeeding as the best method of feeding young infants for a wide variety of reasons. Increasing urbanization and rising slum population is a ground reality even in the smaller towns of developing world. There are reports of improper child feeding practices in urban slums. The present study was undertaken to understand the determinants of breast feeding practices in urban slums of a small town (taluka head quarter, tire-IV in district Anand of Gujarat state. Methodology: A cross sectional study was conducted in the field practice area of Urban Health Training Centre of Pramukhswami Medical College. Out of six served areas two were selected by using simple random sampling. After taking consent, the mothers of all children between the ages of 0-2 years were interviewed using pretested questionnaire. Results: Of the 75 mothers interviewed 4(5% did not have any antenatal checkups (ANC and 73 (97.3% had institutional deliveries. Of the 71 mothers who had ANC only 28(39.4% were counselled about breastfeeding. Prevalence of pre-lacteal feeding, exclusive breast feeding (EBF and bottle feeding was 17(22.7%, 37(46.7% and 10(13.3% respectively. Maternal education beyond 7th grade and antenatal counselling about breastfeeding were associated with increased EBF and decreased pre-lacteal feeds. Conclusions: Breast feeding practices though better than national average was far from satisfactory. Female literacy continues to be an important factor in child rearing practices. The breast feeding counselling services need great deal of improvement in all healthcare settings.

  6. Cognitive Function in Adolescence: Testing for Interactions Between Breast-Feeding and "FADS2" Polymorphisms (United States)

    Martin, Nicolas W.; Benyamin, Beben; Hansell, Narelle K.; Montgomery, Grant W.; Martin, Nicholas G.; Wright, Margaret J.; Bates, Timothy C.


    Objectives: Breast-fed C-allele carriers of the rs single nucleotide polymorphism in the fatty acyl desaturase 2 ("FADS2") gene have been reported to show a 6.4 to 7 IQ point advantage over formula-fed C-allele carriers, with no effect of breast-feeding in GG carriers. An Australian sample was examined to determine if an interaction between…


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    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

  8. 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.


    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....

  9. Neonatal family care for 24 hours per day: effects on maternal confidence and breast-feeding. (United States)

    Wataker, Heidi; Meberg, Alf; Nestaas, Eirik


    In family care (FC) program for neonatal intensive care units (NICUs), parents are encouraged to reside together with their infant for 24 hours a day to actively be involved in the care. The aim of this study was to assess the impact of FC on maternal confidence and breast-feeding. Maternal confidence and rate of breast-feeding were assessed in 31 mothers offered FC that included special family rooms in the NICU, and in 30 mothers from a comparable NICU providing traditional care without such facilities. One week prior to hospital discharge, mothers in the FC group felt better informed regarding nursing issues and had more confidence in interpretation of the infants regarding feeding issues and in caregiving without staff attendance (P skill level for interpretation of the infant's signals and knowledge about breast-feeding (P < .05). Despite similar rate of breast-feeding at discharge, more infants in the FC group were breastfed 3 months after discharge (P < .05). An FC program in the NICU promoted better maternal confidence during the hospital stay and 3 months after discharge compared with traditional care.

  10. Socio-religious factors affecting the breast-feeding performance of women in the Yemen Arab Republic. (United States)

    Beckerleg, S


    Yemeni breast-feeding beliefs and practices are discussed in relation to the ritual status of Muslim women. It is argued that the existing socio-religious perspective of women in Yemen is expressed in, and reinforced by, their attitudes to breast-feeding. Yemeni women consider breastfeeding to be a powerful, but potentially destructive force. The Quran defines the worth of both women and breast-feeding, and this is upheld by the attitudes of contemporary Yemeni society. The practices and beliefs associated with the reproductive and menstrual cycles, indicate that these female functions are considered hedged with danger and ambiguity. Breast-feeding, which is connected to both cycles, is no exception. Traditional breast-feeding beliefs and practices are best understood within the wider context of the perceived place and ritual status of women in Yemeni society.

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


    De, G.; Batty, G.D.; Deary, I J


    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. \\ud \\ud 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 co...

  12. [Breast feeding and child care: a case study of 2 rural areas of Mexico]. (United States)

    Pérez-Gil-Romo, S E; Rueda-Arróniz, F; Díez-Urdanivia-Coria, S


    The present research is included in the fields of public health, social sciences and gender studies. Its objective is to provide insight into the nursing behaviour of two groups of mothers, their domestic and extra-domestic child care arrangements and their attitudes towards breast-feeding. Thirty-five mothers were selected in Malinalco, Mexico, and 35 in the Sierra de Juárez, Oaxaca. Each mother had at least two children and one of them under three years of age. The study was exploratory in its initial phase, subsequently cross-sectional, comparative and prospective. It constitutes a foundation for longitudinal case studies. A pre-coded questionnaire, including the following issues, was administered: family composition; maternal schooling; maternal employment; nursing behaviour with the last child; child care and attitudes towards breast-feeding. The main information regarding 33 mothers in Malinalco and 31 in Oaxaca revealed that in both areas mothers decided how to feed their children during the first days; during the first month, 55 per cent of mothers in Malinalco breast-fed their child, while approximately 90 per cent did so in Oaxaca. The majority of women worked outside home and resorted to extra-domestic arrangements for child care. No relation was found between the feeding method chosen with the last child and maternal employment. About 90 per cent of women in both areas were "happy" to have been born females and breast-feeding was considered a "must". Seventy five per cent of mothers would not allow other women to breast feed their child, even though they were aware that maternal milk is the best.(ABSTRACT TRUNCATED AT 250 WORDS)

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

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    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.

  14. An analysis of BMD changes with preopertive and postoperative premenopausal breast cancer patient

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    KIm, Su Jin; Son, Soon Yong; Choi, Kwan Woo [Dept. of Radiology, Asan Medical Center, Seoul (Korea, Republic of); Lee, Joo Ah [Dept. of Radiation Oncology, Catholic University, Incheon St.Mary' s Hospital, Incheon (Korea, Republic of); Min, Jung Whan; Kim, Hyun Soo [Dept. of Radiology, Shingu University, Sungnam (Korea, Republic of); Ma, Sang Chull [Dept. of Radiologic Science, Shin han University, Uijeongbu (Korea, Republic of); Lee, Jong Seok; Yoo, Beong Gyu [Dept. of Radiotechnology, Wonkwang Health Science University, Iksan (Korea, Republic of)


    The purpose of this study is to provide basic data of comparing BMD (bone mineral density) value of preoperative breast cancer patient and postoperative breast cancer patient due to bone loss with radiation/chemical therapy. The participants consisted of 254 breast cancer patients with BMD after having surgery and treatment from March 2007 to September 2013. Except for 84 patients with menopause or hysterectomy and we have analysed 171 patients. The BMD value (lumbar spine and femur) of before and after treatment from PACS by dure-energy X-ray absorptiometry was analyzed. First, we found variation of entire BMD and BMD according to treatment type, and analyzed detailed correlation by using marital status, number of children, presence of feeding, age of menarche, breast cancer therapy types as variable. Data was analyzed by using SPSS for Windows Program (version 18.0). BMD was decreased 7.1% in lumbar spine, 3.1% in femur respectively (p<.01). Also there is relatively high decrement (0.067 g/cm{sup 2}) in group who had just chemotherapy in femur (p<.05). There is decrement depend on marital status, number of children, presence of feeding, age of menarche, breast cancer therapy types but there was no statistical significance. The results show that BMD was decreased after treatment in premenopausal breast cancer patient, patient who had relatively high decrement need to be included high-risk group. As a result, aggressive prevention policy would be necessary.

  15. Resurgence of nutritional rickets associated with breast-feeding and special dietary practices. (United States)

    Edidin, D V; Levitsky, L L; Schey, W; Dumbovic, N; Campos, A


    Ten cases of nutritional rickets seen over a 10-month period are reviewed. The salient clinical features are summarized, and the striking association with unsupplemented breast-feeding, fad diets, and lack of immunizations is discussed. The importance of recognizing such associated practices for purposes of early diagnosis and intervention is stressed.

  16. [Skin to skin contact and breast-feeding after birth: not always without risk!

    NARCIS (Netherlands)

    Matthijsse, P.R.; Semmekrot, B.A.; Liem, K.D.


    Skin-to-skin contact after birth is propagated to facilitate breast-feeding and mother-child bonding. We describe two term infants with sudden unexpected postnatal collapse (SUPC) during skin-to-skin contact. The infants were found with abnormal colour, hypotonia and apnoea, in a prone position on t

  17. MRI evaluation of the contralateral breast in patients with recently diagnosed breast cancer


    Sangeeta Taneja; Amarnath Jena; Syed. Mohd. Shuaib Zaidi; Anuj Khurana


    Introduction: Contralateral breast cancer can be synchronous and/or metachronous in patients with cancer of one breast. Detection of a synchronous breast cancer may affect patient management. Dynamic contrast-enhanced MRI of the breast (DCE-MRI) is a sensitive technique for detecting contralateral lesions occult on the other imaging modalities in women already diagnosed with cancer of one breast. Aim: The aim was to assess the incidence of mammographically occult synchronous contralateral bre...

  18. Prenatal office practices regarding infant feeding choices. (United States)

    Dusdieker, Lois B; Dungy, Claibourne I; Losch, Mary E


    The objective of this study was to determine the obstetric care providers' roles in breast-feeding promotion during prenatal care. A questionnaire addressing breast-feeding issues was sent to family practitioners (FP), obstetric-gynecologists (OB/GYN), and nurse midwives (NM) in Iowa, USA. All NM, 97% of FP, and 85% of OB/GYN reported asking infant feeding preference-usually only at the first prenatal visit. NM (73%) were most likely to provide extensive breast-feeding counseling. OB/GYN (68%) and FP physicians (90%) reported doing their own breast-feeding counseling. Breast examinations targeting future breast-feeding problems were done in 82% to 84% of patients. NM practices shared more information supportive of breast-feeding. Nearly all providers offered prenatal classes, but only 41% of FP offered breast-feeding classes. Free formula samples were available in 73% of FP, 54% of OB/GYN, and 36% NM offices. Pamphlets on formula feeding and also breast-feeding were readily available. Overall NM (64%) reported being strong breast-feeding advocates compared to only 13% of FP and 7% of OB/GYN. In conclusion, little promotion of breast-feeding occurs in most prenatal practice settings.

  19. Ovarian stimulation in patients with breast cancer. (United States)

    Muñoz, Elkin; González, Naira; Muñoz, Luis; Aguilar, Jesús; Velasco, Juan A García


    Breast cancer is the most prevalent malignancy among women under 50. Improvements in diagnosis and treatment have yielded an important decrease in mortality in the last 20 years. In many cases, chemotherapy and radiotherapy develop side effects on the reproductive function. Therefore, before the anti-cancer treatment impairs fertility, clinicians should offer some techniques for fertility preservation for women planning motherhood in the future. In order to obtain more available oocytes for IVF, the ovary must be stimulated. New protocols which prevent exposure to increased estrogen during gonadotropin stimulation, measurements to avoid the delay in starting anti-cancer treatment or the outcome of ovarian stimulation have been addressed in this review. There is no evidence of association between ovarian stimulation and breast cancer. It seems that there are more relevant other confluent factors than ovarian stimulation. Factors that can modify the risk of breast cancer include: parity, age at full-term birth, age of menarche, and family history. There is an association between breast cancer and exogenous estrogen. Therefore, specific protocols to stimulate patients with breast cancer include anti-estrogen agents such as letrozole. By using letrozole plus recombinant follicular stimulating hormone, patients develop a multifollicular growth with only a mild increase in estradiol serum levels. Controlled ovarian stimulation (COS) takes around 10 days, and we discuss new strategies to start COS as soon as possible. Protocols starting during the luteal phase or after inducing the menses currently prevent a delay in starting ovarian stimulation. Patients with breast cancer have a poorer response to COS compared with patients without cancer who are stimulated with conventional protocols of gonadotropins. Although many centres offer fertility preservation and many patients undergo ovarian stimulation, there are not enough studies to evaluate the recurrence, breast cancer

  20. Antioxidant status of turkey breast meat and blood after feeding a diet enriched with histidine. (United States)

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


    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.

  1. Effects of breast-feeding duration, bottle-feeding duration and non-nutritive sucking habits on the occlusal characteristics of primary dentition


    Chen, Xiaoxian; Xia, Bin; Ge, Lihong


    Background Early transition from breastfeeding and non-nutritive sucking habits may be related to occlusofacial abnormalities as environmental factors. Previous studies have not taken into account the potential for interactions between feeding practice, non-nutritive sucking habits and occlusal traits. This study assessed the effects of breast-feeding duration, bottle-feeding duration and non-nutritive sucking habits on the occlusal characteristics of primary dentition in 3–6-year-old childre...

  2. Breast-feeding behavioral patterns among La Leche League mothers: a descriptive survey. (United States)

    Cable, T A; Rothenberger, L A


    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.

  3. Breast feeding a sick child; can social media influence practice? (United States)

    Mylod, Dominique


    Breast milk represents optimum infant nutrition. The World Health Organization's recommendation that babies should be exclusively breastfed for a minimum of 6 months (Kramer & Kakuma, 2001) remains unchanged in its second decade (Kramer & Kakuma, 2014), which is acknowledged in industrialized countries by successive policies and guidelines for the promotion and care of breastfeeding in children's wards and departments. The known protective influence of breast milk in preventing the onset of disease in later life is of particular import for any sick infant, but the user voice as represented by Helen Calvert's Twitter campaign @heartmummy#hospitalbreastfeeding has united service user and professional voices to call for improved breastfeeding support in pediatric care. Although breastfeeding rates in industrialized countries drop markedly in the first 6 weeks, breastfed babies with cardiac conditions benefit from better oxygen saturations, faster weight gain, and shorter hospital stays. Unwell babies are most in need of the benefits of breast milk. However, families and staff overcome physical barriers to the initiation and maintenance of breastfeeding, including lack of space, privacy, and separation of the maternal-infant dyad. Many women are motivated to breastfeed or express milk but are reluctant to approach health professionals for help and advice. Despite robust evidence and sound guidelines and policies, breastfeeding knowledge and experience amongst Child Health professionals is often inadequate and leaves them unable to support families. While @heartmummy#hospitalbreastfeeding highlights the issue, Child Health strategy needs investment in young people's long term health by increasing staff skills and focusing on breastfeeding as a core therapeutic intervention. Lactation Consultants could offer training, disseminate good practice, and address the needs of breastfeeding families.

  4. About The Breast-Feedıng Attitudes And Behavıour Of The Mothers That Gave Bırt In Hospitals In Trabzon




    Breast-feeding, impact on health baby and mother biologic and emotional as well as healthy growth and development of baby. This research was carried out as descriptive to determine the breast-feeding attitudes and behaviour of the mothers.The sample is composed of 405 mothers. Data were collected by using a questionnaire constructed by the researcher and The validity and reability of assessment scale breast feding was carried out by Arslan. The average breast feeding attitude points of the mo...

  5. Constructing compatibility: managing breast-feeding and weaning from the mother's perspective. (United States)

    Hauck, Yvonne L; Irurita, Vera F


    The purpose of this grounded theory study was to analyze the maternal process of managing the later stages of established breast-feeding and, ultimately, weaning the child from the breast within a Western Australian context. Data were analyzed from 33 participants' interview transcripts, field notes, 9 postal questionnaires from fathers, and individual and discussion group interviews with child health nurses. A common social problem of incompatible expectations was revealed. All participants faced a dilemma in the management of their experience when personal expectations were in opposition to others' expectations. A process of Constructing Compatibility by Adapting Focus was adopted to compensate for this incompatibility.


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    Renija Valiya


    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


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    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

  8. [Breast-feeding experience for women workers and students from a public university]. (United States)

    Silva, Isilia Aparecida


    This qualitative research aimed to know the main interfering elements in the breast-feeding process as experienced by professional women and by students, that was carried out with 65 professional women and students from a public university in São Paulo state. The data collection was proceeded by interviews which contents were analyzed according to Taylor and Bogdan and Symbolic Interactionism approaches. Results indicated that the breast-feeding process for these women demonstrated to be conditioned and highlighted by the conditions the women encounter in their domestic, professional, and study settings. The physical setting and the relations among their relatives, superiors and peers exerts a strong influence on their determination to keep on breastfeeding.

  9. Associations of breast-feeding patterns and introduction of solid foods with childhood bone mass: The Generation R Study. (United States)

    van den Hooven, Edith H; Gharsalli, Mounira; Heppe, Denise H M; Raat, Hein; Hofman, Albert; Franco, Oscar H; Rivadeneira, Fernando; Jaddoe, Vincent W V


    Breast-feeding has been associated with later bone health, but results from previous studies are inconsistent. We examined the associations of breast-feeding patterns and timing of introduction of solids with bone mass at the age of 6 years in a prospective cohort study among 4919 children. We collected information about duration and exclusiveness of breast-feeding and timing of introduction of any solids with postnatal questionnaires. A total body dual-energy X-ray absorptiometry scan was performed at 6 years of age, and bone mineral density (BMD), bone mineral content (BMC), area-adjusted BMC (aBMC) and bone area (BA) were analysed. Compared with children who were ever breast-fed, those never breast-fed had lower BMD (-4·62 mg/cm2; 95 % CI -8·28, -0·97), BMC (-8·08 g; 95 % CI -12·45, -3·71) and BA (-7·03 cm2; 95 % CI -12·55, -1·52) at 6 years of age. Among all breast-fed children, those who were breast-fed non-exclusively in the first 4 months had higher BMD (2·91 mg/cm2; 95 % CI 0·41, 5·41) and aBMC (3·97 g; 95 % CI 1·30, 6·64) and lower BA (-4·45 cm2; 95 % CI -8·28, -0·61) compared with children breast-fed exclusively for at least 4 months. Compared with introduction of solids between 4 and 5 months, introduction feeding compared with never breast-feeding is associated with higher bone mass in 6-year-old children, but exclusive breast-feeding for 4 months or longer was not positively associated with bone outcomes.

  10. Economic impact of breast-feeding-associated improvements of childhood cognitive development, based on data from the ALSPAC. (United States)

    Straub, Niels; Grunert, Philipp; Northstone, Kate; Emmett, Pauline


    The aim of this study was to assess the economic benefits of improved cognitive development related to being breast-fed. Breast-feeding rates were assessed in the Avon Longitudinal Study of Parents and Children. Educational attainment was assessed at age 16 years with higher attainment defined as gaining five General Certificate of Secondary Education (GCSE) passes at a high grade. The economic benefit of being breast-fed was calculated in a decision model using a child's educational attainment and the corresponding expected value of average income in later life. There was a positive association between being breast-fed and achieving higher educational attainment, which remained significant, after adjustment for possible confounders: being breast-fed £33·6 million over the working life of the cohort. Therefore, breast-feeding promotion is likely to be highly cost-effective and policymakers should take this into consideration.

  11. Demographic, breast-feeding, and nutritional trends among children with type 1 diabetes mellitus


    Baruah, Manash P.; Ammini, Ariachery C; Khurana, Madan L.


    Background: The pathogenesis of type 1 diabetes mellitus (T1DM) requires a genetic predisposition to particular environmental triggers that may activate mechanisms leading to progressive loss of pancreatic beta cells. Aims: We tried to compare the impact of some demographic and environmental factors and breast-feeding on children (aged < 18 years) with recent onset diabetes mellitus (≤1 year) with that on age, sex, and socioeconomic status-matched controls. Material and Methods: A total of 43...

  12. Effect of breast-feeding on the development of atopic dermatitis. (United States)

    Ghaderi, Reza; Makhmalbaf, Zahra


    Atopy can be defined as the genetically determined risk to develop allergic disease. Avoidance of one specific allergen may decrease the risk for sensitization against this allergen, but it will not affect atopy. Our aim was to investigate if exclusive breast-feeding is associated with atopic dermatitis during the first 5 years of life. Data on 200 children were taken from parental-administered questionnaires from a case control study in Birjand - Iran (recruited 2003) comprised of a case (100 children with atopic dermatitis) and a control (100 normal children) subgroup. Outcomes were physician-diagnosed atopic dermatitis (AD) and itchy rash. Data were analyzed by using SPSS package, Chi square and Exact Fisher tests.Thirty-four of the case and 50 of control group were exclusively breast-fed, whereas 6 of the case and 2 of control group were exclusively cow milk-fed. These differences were statistically significant. (P less than 0.05). Duration of breast-feeding in case and control group was different. These differences were statistically significant (P less than 0.001). Duration of cow's milk formula feeding in case and control group was different, but these differences were not statistically significant. (P=0.6) Positive family history of allergy in case and control group was 63% and 23% respectively and this difference was statistically significant (P less than 0.001). These findings support the hypothesis that exclusive breast-feeding is a protective factor for development of atopic dermatitis if compared with conventional cow's milk formula.

  13. Is breast feeding a risk factor for eczema during the first year of life? (United States)

    Sariachvili, Manana; Droste, Jos; Dom, Sandra; Wieringa, Marjan; Vellinga, Akke; Hagendorens, Margo; Bridts, Chris; Stevens, Wim; Sprundel, Marc Van; Desager, Kristine; Weyler, Joost


    Breast feeding (BF) provides many advantages to the offspring; however, at present there is an ongoing debate as to whether or not it prevents allergic diseases. The aim of the current study was to investigate the effect of duration of BF on eczema in the first year of life. A birth cohort of 1128 infants was followed prospectively from 5 months of pregnancy. Data were collected using questionnaires, a medical examination and blood tests for allergy at the age of 1 yr. Breast feeding was not statistically significant associated with eczema in the first year of life [adj ORs with 95% CIs: 0.8 (0.4-1.3), 0.8 (0.5-1.3) and 1.0 (0.6-1.5) for BF duration of 1-6 wk, 7-12 wk and > or = 13 wk, respectively]. Eczema was positively associated with atopy and educational level of the mother, use of antibiotics in pregnancy and passive smoking by the child during the first 12 months. Regular postnatal contact of the infants with dogs was inversely associated with eczema. Breast feeding was positively associated with eczema among children with non-atopic parents [adj ORs with 95% CIs: 2.1 (0.4-10.6), 2.2 (0.4-11.3) and 1.9 (0.4-8.5) for BF duration of 1-6 wk, 7-12 wk and > or = 13 wk, respectively], whereas an inverse association was found among children with atopic parents [adj ORs with 95% CIs: 0.6 (0.3-1.3), 0.7 (0.3-1.4) and 0.9 (0.5-1.7) for the same BF durations]. However, these associations were not statistically significant. Breast feeding has no significant effect on the prevalence of eczema in the first year of life. The effect of BF on eczema in children depends on parental atopy.

  14. The Breast vs. Bottle Battle: Infant Feeding Mis/Information

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    Melissa Rothfus


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    That “breast is best” is a truism even infant formula manufacturers do not openly dispute, and the choice to breastfeed has increasingly become part of the measure of a good mother in modern Canadian society.  Yet the information in support of breastfeeding’s purported benefits is problematic, even as public discourse vilifies the alternative.  This paper examines the issues surrounding infant feeding choices and the way in which information is utilized and manipulated by both sides of the emotionally charged breast vs. bottle debate.  While there are good reasons to support breastfeeding practices, the current state of our knowledge of its benefits does not justify the often strident

  15. Cadmium concentration in biological media of breast cancer patients. (United States)

    Strumylaite, Loreta; Bogusevicius, Algirdas; Abdrachmanovas, Olegas; Baranauskiene, Dale; Kregzdyte, Rima; Pranys, Darius; Poskiene, Lina


    The study aimed to determine and compare cadmium (Cd) concentration in different biological media of breast cancer and benign breast tumor patients. Concentration of Cd was determined in breast tissue, urine, and blood of 57 breast cancer and 51 benign tumor patients. Two samples of breast tissue from each patient, i.e., tumor and healthy tissue were taken for the analysis. Cd in biological media was determined by atomic absorption spectrometry (Perkin-Elmer, Zeeman 3030). The mean Cd concentration in breast cancer patients was 0.053 μg/g (95% confidence intervals, CI 0.042-0.065) for tumor sample and 0.02 μg/g (95% CI 0.014-0.026) for healthy breast tissue sample (P 0.05). Cd content in malignant tumor significantly differed from that in benign tumor (P Cancer patients with positive estrogen receptors (ERs) had significantly greater concentration of breast tissue Cd compared to patients with negative ERs (P = 0.035). Adjusted for creatinine, Cd in urine was significantly higher in cancer patients than in controls (P cancer patients, a positive Spearman's correlation was found between Cd in tumor and healthy breast tissue, blood (r = 0.44 and r = 0.39, respectively, P cancer patients and number of cigarettes smoked during lifetime was suggestive (r = 0.59, P = 0.075). The data obtained show higher concentration of cadmium in breast tumor and urine of cancer patients and support a possible relationship between cadmium and breast cancer.

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

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    M.S. Saba


    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.

  17. Circulating gangliosides of breast-cancer patients. (United States)

    Wiesner, D A; Sweeley, C C


    Gangliosides were isolated from the sera of recently diagnosed breast-cancer patients and from individuals who were apparently free of disease. Quantificative and qualitative analyses were carried out by 2-dimensional high-performance thin-layer chromatography and gas chromatography. The locations of isolated gangliosides on thin-layer chromatograms were determined by visualization with resorcinol, and each spot was quantified by digital image densitometry. The ganglioside profiles of cancer patients were compared to those of the control group, revealing a significant increase in total lipid-bound sialic acid and a specific increase in polysialogangliosides in the patients with breast cancer. Furthermore, an increase was noted in the ratio of gangliosides of the b-series biosynthetic pathway over those of the a-series in the cancer sera, as compared to the controls. Gas chromatographic analysis of the peracetylated methanolysis mixtures derived from the total ganglioside fraction of cancer patients supported the HPTLC data, with an increase in total sialic acid, galactose, and sphingosine residues. No unusual gangliosides were found in the mixture from breast-cancer patients.

  18. Associations of parity, breast-feeding, and birth control pills with lumbar spine and femoral neck bone densities. (United States)

    Hreshchyshyn, M M; Hopkins, A; Zylstra, S; Anbar, M


    The relationships between parity, breast-feeding, and the use of birth control pills and the bone densities of the lumbar spine and the femoral neck, measured by dual-photon densitometry, were studied in normal women. Femoral neck density was found to decrease by 1.1% per live-birth, whereas lumbar spine density showed no significant association with parity. Breast-feeding was found to increase lumbar spine density by 1.5% per breast-fed child, whereas femoral neck density was not significantly correlated. No significant relationships between the use of birth control pills and the bone densities were found.

  19. Nasogastric tube feeding: a safe option for patients? (United States)

    Williams, Trish


    This article will show that fine-bore nasogastric tube feeding can be facilitated for patients when long term percutaneous endoscopic gastrostomy (PEG) or radiologically inserted gastrostomy (RIG) options are not suitable. How the safe replacement of these tubes is facilitated, and what instructions the patient and the nursing home are given to support patient care and safety are also discussed. The decision to support this type of feeding must be completely individualised, considering home and external support agencies available to each patient. The risk assessment completed to facilitate this has been based on the patients' individual circumstances, and a nasogastric tube home passport developed to help in the assessment and decision-making process. For fine-bore nasogastric tube feeding to be safe, it does have to be supported once the patient is discharged from the hospital. A good knowledge of the home support and carer support agencies, and what is available, should be discussed. Multidisciplinary team support is essential in ensuring a safe discharge can be planned and managed. Good patient risk assessment and nursing considerations are discussed to show how the challenges that may prevent a patient discharge with this type of feed are managed. This article will show how two very different patients discharges were facilitated by safe fine-bore nasogastric tube feeding in the community. Patient assessment and nursing considerations are discussed, as well as the importance of a multidisciplinary approach to show how this was successfully achieved in a local district hospital.

  20. Misconceptions about breast lumps and delayed medical presentation in urban breast cancer patients (United States)

    Rauscher, Garth H; Ferrans, Carol Estwing; Kaiser, Karen; Campbell, Richard; Calhoun, Elizabeth; Warnecke, Richard B.


    BACKGROUND Despite current recommendations for women to be screened for breast cancer with mammography every one to two years, less than half of all newly diagnosed breast cancers are initially detected through screening mammography. Prompt medical attention to a new breast symptom can result in earlier stage at diagnosis, yet many patients delay seeking medical care after becoming aware of a breast symptom. METHODS In a population-based study of breast cancer we examined factors potentially associated with patient delay in seeking health care for a breast symptom among 436 symptomatic urban breast cancer patients (146 White, 197 Black and 95 Hispanic). Race/ethnicity, socioeconomic status, health care access and utilization, and misconceptions about the meaning of breast lumps were the key independent variables. RESULTS Sixteen percent of patients reported delaying more than 3 months before seeking medical advice about breast symptoms. Misconceptions about breast lumps, and lacking a regular provider, health insurance and recent preventive care were all associated with prolonged patient delay (p<0.005 for all). Misconceptions were much more common among ethnic minorities and women of lower socioeconomic status. CONCLUSION Reducing patient delay and disparities in delay will require both educating women about the importance of getting breast lumps evaluated in a timely manner, and providing greater access to regular health care. PMID:20200436

  1. Breast cancer patients with dense breasts do not have increased death risk (United States)

    High mammographic breast density, which is a marker of increased risk of developing breast cancer, does not seem to increase the risk of death among breast cancer patients, according to a study led by Gretchen L. Gierach, Ph.D., NCI. Image shows physician

  2. Breast Cancer Diagnosed During Pregnancy: Adapting Recent Advances in Breast Cancer Care for Pregnant Patients

    NARCIS (Netherlands)

    Loibl, S.; Schmidt, A.; Gentilini, O.; Kaufman, B.; Kuhl, C.; Denkert, C.; Minckwitz, G. von; Parokonnaya, A.; Stensheim, H.; Thomssen, C.; Calsteren, K. van; Poortmans, P.; Berveiller, P.; Markert, U.R.; Amant, F.


    Breast cancer during pregnancy (BCP), although rare, is becoming more common and treatment should be as similar as possible to that for nonpregnant young patients with breast cancer. A group of specialists convened to review current guidelines and provide guidance on how recent advances in breast ca

  3. Association between breast-feeding practices and sucking habits: a cross-sectional study of children in their first year of life. (United States)

    Moimaz, Suzely A S; Zina, Lívia G; Saliba, Nemre A; Saliba, Orlando


    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'S EXACT TEST 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.

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

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    Moimaz Suzely A


    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.

  5. Psychiatric Problems in Patients with Breast Cancer

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    Munevver Tunel


    Full Text Available Cancer is a physical disorder with concurrent mental and social components. During cancer, the feelings of fear, hopelessness, guilt, helplessness, abandonment perceived as a crisis leading to destruction in the suffering person. Breast cancer is the most common type of cancer among women. Prevalence of psychiatric disorders among cancer patients is approximately 50% and most of disorders are related with the occurrence of cancer and cancer treatment. Majority of patients present with major depression, adjustment disorder, anxiety disorders, sleep disorders, suicidial ideation, and delirium. Treatment of psychiatric disorders and cancer therapy should be conducted along with special consideration of drug interactions. This article reviews the adaptation process experienced by individuals during diagnosis and treatment of breast cancer, it psychological effects, resulting psychiatric comorbidites and their treatments. [Archives Medical Review Journal 2012; 21(3.000: 189-219

  6. Evaluation of factors influencing on non-exclusive breast feeding during the first six months of life in Bushehr Port using focus group discussion

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    Sherafat Akaberian


    Full Text Available Non-exclusive breast feeding in the early years of life is one of the most important factors in growth and development of infants. Therefore, exclusive breast feeding is recommended during the first six months of life. For determining the effective factors of non-exclusive breast feeding during the first six months of life, we used focus group discussion by participation of 60 mothers who had an infant under 6 months age and enjoyed non-exclusive breast feeding. Mothers divided into eight groups considering their occupation and number of child. All groups reported scanty of mother’s milk, mother’s occupation, mother’s illness, mother’s comfort, wrong beliefs, infant’s illness, doctors and health care providers recommendations, infant’s dependency to feeding bottle and pacifiers as the most frequent factors in using nonexclusive breast feeding. All mothers believed that health care centers, relatives and older members of family, books and pamphlets, mass media, physicians were their effective sources of awareness and promotion of exclusive breast feeding. Considering the presented ideas in all groups, it is realized that mothers during their pregnancy have sparse information about exclusive breast feeding and because of lack of enough essential training, some socio – cultural beliefs affects non-exclusive breast feeding. Mass media and especial training programs should be implemented to promote exclusive breast feeding in Bushehr Port.

  7. MRI evaluation of the contralateral breast in patients with recently diagnosed breast cancer

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    Sangeeta Taneja


    Full Text Available Introduction: Contralateral breast cancer can be synchronous and/or metachronous in patients with cancer of one breast. Detection of a synchronous breast cancer may affect patient management. Dynamic contrast-enhanced MRI of the breast (DCE-MRI is a sensitive technique for detecting contralateral lesions occult on the other imaging modalities in women already diagnosed with cancer of one breast. Aim: The aim was to assess the incidence of mammographically occult synchronous contralateral breast cancer in patients undergoing MRI mammography for the evaluation of a malignant breast lesion. Materials and Methods: A total of 294 patients with recently diagnosed breast cancer who underwent MRI of the breast were evaluated for lesions in the opposite breast. Results: The incidence of synchronous contralateral malignancy detected by preoperative MRI mammography done for evaluation of extent of disease was 4.1%. Conclusion: Preoperative breast MRI may detect clinically and mammographically occult synchronous contralateral cancer, and can help the patient avoid an additional second surgery or a second course of chemotherapy later; also, as theoretically these lesions are smaller, there may be a survival benefit as well.

  8. Malnutrition, dehydration, and ancillary feeding options in dysphagia patients. (United States)

    Via, Michael A; Mechanick, Jeffrey I


    Patients with dysphagia are at high risk for malnutrition. Several strategies may be used to address the nutritional needs of these patients. Dietary modification, the addition of oral supplements, or the use of nutritional support in the form of enteral tube feeds or parenteral nutrition infusions can greatly impact the overall health of the patient.

  9. [Breast-feeding during the process of transculturation]. (United States)

    Vega-Franco, L


    members of the mother's society. Breastfeeding must be considered a cultural trait. Although infant feeding practices have deep cultural roots, the interaction of technologically advanced societies in the western world with underdeveloped societies has produced a process of transculturation in the latter whereby breastfeeding is gradually being displaced. It is probable that only a process of education can combat the decline in breastfeeding.

  10. Enteral feeding pumps: efficacy, safety, and patient acceptability

    Directory of Open Access Journals (Sweden)

    White H


    Full Text Available Helen White, Linsey King Nutrition and Dietetic Group, School of Health and Wellbeing, Faculty Health and Social Science, Leeds Metropolitan University, Leeds, United Kingdom Abstract: Enteral feeding is a long established practice across pediatric and adult populations, to enhance nutritional intake and prevent malnutrition. Despite recognition of the importance of nutrition within the modern health agenda, evaluation of the efficacy of how such feeds are delivered is more limited. The accuracy, safety, and consistency with which enteral feed pump systems dispense nutritional formulae are important determinants of their use and acceptability. Enteral feed pump safety has received increased interest in recent years as enteral pumps are used across hospital and home settings. Four areas of enteral feed pump safety have emerged: the consistent and accurate delivery of formula; the minimization of errors associated with tube misconnection; the impact of continuous feed delivery itself (via an enteral feed pump; and the chemical composition of the casing used in enteral feed pump manufacture. The daily use of pumps in delivery of enteral feeds in a home setting predominantly falls to the hands of parents and caregivers. Their understanding of the use and function of their pump is necessary to ensure appropriate, safe, and accurate delivery of enteral nutrition; their experience with this is important in informing clinicians and manufacturers of the emerging needs and requirements of this diverse patient population. The review highlights current practice and areas of concern and establishes our current knowledge in this field. Keywords: nutrition, perceptions, experience

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

    Directory of Open Access Journals (Sweden)

    Herrick David


    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.

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


    Moimaz Suzely A; Zina Livia; Saliba Nemre; Saliba Orlando


    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 ...

  13. 产前互动式培训对母乳喂养率及喂养技巧的影响%Effect of prenatal interactive training on breast feeding rate and the skill of breast feeding

    Institute of Scientific and Technical Information of China (English)

    谢佐卿; 姚春花; 郑雪芳; 罗彦明


    Objective; To explore the relationship between prenatal interactive training and breast feeding rate and the skill of breast feeding. Methods: 100 healthy full -terra primiparous women who received prenatal interactive training were selected as observation group, and 100 healthy full -term primiparous women who did not received prenatal interactive training at the same time were selected as control group, the primiparous women in the two groups both received postpartum personalized education of breast feeding knowledge, the grasp situation of neonatal breast feeding skills and the success rate of breast feeding in the two groups were observed. Results; There was significant difference in correct grasp situation of neonatal breast feeding skills between observation group and control group ( P < 0. 05 ) , the rate of breast feeding in observation group and control group were 95% and 67% , respectively, there was significant difference between the two groups (P < 0. 05) . Conclusion: Prenatal interactive training in hospital and personalized publicity and education can improve the grasp situation of breast feeding skills and the success rate of breast feeding effectively.%目的:探讨产前互动式培训与母乳喂养率及喂养技巧的关系.方法:将参加产前互动式培训的100名健康足月妊娠初产妇设为观察组,未参加产前互动式培训的100名同期健康初产妇设为对照组,两组产妇均接受产后个性化哺乳知识教育,观察两组产妇产后新生儿喂养技巧掌握情况和母乳喂养成功率的差异.结果:观察组产妇与对照组产妇对母乳喂养技巧正确掌握情况差异有统计学意义(P<0.05),同时观察组与对照组母乳喂养率分别为95%和67%,差异有统计学意义(P<0.05).结论:产前互动式培训和住院个性化宣教能有效提高产妇母乳喂养技巧的掌握和母乳喂养成功率.

  14. [Pregnancy and breast feeding: antibiotics, irrigation and pastes]. (United States)

    Fatori Popovic, Sandra; Lübbers, Heinz-Theo; von Mandach von Mandach, Ursula


    The aim of this paper is to show aspects of dental treatment in pregnancy. The reader should gain security in the election of the proper drugs for antibiotic therapy and rinsing solutions. Antibiotics as penicillins are the first choice in case of dental infections in pregnancy. In allergic patients, macrolides may be an alternative. Wound and mouth rinsing solutions containing chlorhexidine should be preferred in pregnancy. Ledermix(®) in endodontic treatment should be avoided in the pregnant woman. Solcoseryl(®) can be used for wound healing. Elective dental procedures should be postponed after delivery and after lactation period.

  15. 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


    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...

  16. Breast, Formula and Combination Feeding in Relation to Childhood Obesity in Nova Scotia, Canada. (United States)

    Rossiter, Melissa D; Colapinto, Cynthia K; Khan, Mohammad K A; McIsaac, Jessie-Lee D; Williams, Patricia L; Kirk, Sara F L; Veugelers, Paul J


    Breastfeeding has been rigorously studied in relation to childhood obesity prevention. Few studies have examined whether combination feeding—breast milk and formula—may also be protective against obesity. This study aimed to investigate the relationship between breastfeeding duration, combination feeding and overweight and obesity among Canadian school children. We analyzed data from a 2011 cross-sectional, population based survey (n = 5,560), which included self-reported infant feeding behaviours, a food frequency questionnaire and measured height and weight. Multilevel regression methods were used to examine the association between breastfeeding duration and overweight and obesity adjusting for socioeconomic status, diet quality and physical activity. Thirty-four percent of children were breastfed for feeding, appears to have a protective effect on childhood obesity. While combination feeding confers less benefit than only breastfeeding, it is more desirable than formula feeding alone. Strategies and social policies are needed to promote exclusive and longer breastfeeding duration and should be integrated with comprehensive efforts to prevent childhood obesity and to reduce the burden of chronic diseases in the long term.

  17. Management of patients with metastatic breast cancer. (United States)

    Cruz Jurado, J; Richart Aznar, P; García Mata, J; Fernández Martínez, R; Peláez Fernández, I; Sampedro Gimeno, T; Galve Calvo, E; Murillo Jaso, L; Polo Marqués, E; García Palomo, A


    Hormone treatment is one of the key strategies in the management of metastatic breast cancer. Hormone treatment is one of the key strategies in the management of metastatic breast cancer. Aromatase inhibitors (AI) have been extensively studied in this setting. This section summarizes the key data regarding the use of AI in advanced breast cancer. In postmenopausal women, AI are the first line of treatment for untreated patients, or those who had prior AI treatment and progress after 12 months of adjuvant therapy. A longer disease-free interval and absence of visceral disease is associated with a better response. If tumors recur in less than 12 months, it is recommended that tamoxifen (TAM) or the estrogen-receptor antagonist fulvestrant (FUL) treatment be initiated. In the second-line setting, the best option after progression is the administration of either FUL or TAM. In the third-line setting, reintroduction of AI is considered an acceptable option. In premenopausal women who have not received prior treatment or who have progressed after 12 months following adjuvant treatment, it is recommended to initiate therapy with a combination of TAM and a luteinizing hormone-releasing hormone (LHRH) analog. If there is treatment failure with the use of this combination, megestrol acetate or an LHRH agonist plus an AI may be reasonable alternatives. Intensive research is ongoing to understand the mechanisms of resistance to hormone therapy. In human epidermal growth factor receptor 2 positive-patients, combinations with HER2 antagonists are associated with significant clinical activity.

  18. Metaplastic Breast Cancer in a Patient with Neurofibromatosis

    Directory of Open Access Journals (Sweden)

    Umar Shafique Chaudhry


    Full Text Available Metaplastic breast cancer is a rare malignancy in the breast. Neurofibromatosis Type 1 is an autosomal dominant multisystem disorder associated with multiple neoplasms such as optic gliomas and peripheral nerve sheath tumors. The association of breast cancer with neurofibromatosis is very rare. We present a case of a metaplastic breast cancer in a patient with Type 1 neurofibromatosis. The patient presented with a palpable mass in her left breast with suspicious findings on mammogram and ultrasound. Ultrasound-guided percutaneous biopsy showed metaplastic breast carcinoma with metastasis to an axillary lymph node. This is the third case report in the English literature to show metaplastic breast carcinoma in a patient with Type 1 neurofibromatosis. In this report we review recent literature and discuss the association between these two entities.

  19. Metaplastic breast cancer in a patient with neurofibromatosis. (United States)

    Chaudhry, Umar Shafique; Yang, Limin; Askeland, Ryan W; Fajardo, Laurie L


    Metaplastic breast cancer is a rare malignancy in the breast. Neurofibromatosis Type 1 is an autosomal dominant multisystem disorder associated with multiple neoplasms such as optic gliomas and peripheral nerve sheath tumors. The association of breast cancer with neurofibromatosis is very rare. We present a case of a metaplastic breast cancer in a patient with Type 1 neurofibromatosis. The patient presented with a palpable mass in her left breast with suspicious findings on mammogram and ultrasound. Ultrasound-guided percutaneous biopsy showed metaplastic breast carcinoma with metastasis to an axillary lymph node. This is the third case report in the English literature to show metaplastic breast carcinoma in a patient with Type 1 neurofibromatosis. In this report we review recent literature and discuss the association between these two entities.

  20. Iron sufficiency with prolonged exclusive breast-feeding in Peruvian infants. (United States)

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


    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.

  1. Effect of breast- and bottle-feeding duration on the age of pacifier use persistence


    Fernanda Barros de Arruda Telles; Rívea Inês Ferreira; Luiza do Nascimento Cezar Magalhães; Helio Scavone-Junior


    This study evaluated the effect of breast- and bottle-feeding duration on the age of pacifier use persistence. Questionnaires (n = 723) with information on nutritive and nonnutritive sucking habits of children aged 3-6 years were assessed. The sample was divided according to breastfeeding duration: G1 - non-breastfed, G2 - up to 3 months, G3 - discontinued between 4 and 6 months, G4 - discontinued between 7 and 12 months, and G5 - longer than 12 months. The children were also assigned to 4 gr...


    Institute of Scientific and Technical Information of China (English)

    FAN Jiang; LIU Bang-ling; SHEN Zhen-zhou; SHAO Zhi-ming; WU Jiong; LU Jin-song; WANG Lei; HOU Yi-feng; WANG Jie; DI Gen-hong; SHEN Kun-wei; HAN Qi-xia


    Objective: To investigate the effect of breast-conservation therapy in early stage breast cancer. Methods: A total of 234 early stage breast carcinoma patients received breast conserving treatment in our hospital. After the operation, they underwent adjuvant chemotherapy and radiotherapy. All of these patients desired to preserve their breasts. Results: After median follow-up of 29.46 months (range from 3 to 100 months), 3 cases had local relapse and 8 cases had distant metastasis. The overall survival rate of 5 year was 96.7%, and the disease free survival rate of 5 year was 87.85%. Conclusion: For early stage breast carcinoma patients, classic quadrantectomy, axillary dissection and post-operative adjuvant chemotherapy and radiotherapy lead to excellent local control and good survival.

  3. 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


    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 breast-feed are interrelated, and therefore, analyzing true causal effects presents a number of methodologic challenges....

  4. Mixed messages about the meanings of breast-feeding representations in the Australian press and popular magazines. (United States)

    Henderson, A M


    The popular press is an influential medium for the communication of messages and meanings about health and lifestyle issues (Lupton 1993). Through language and images, the print media present selected phenomena, events and issues to readers. The choice and connections between works used can impress upon the reader specific images of the world and the attitudes toward the presented issues and ideas (Nunan 1993). Discourse analysis is used in this study to examine representations of breast feeding in articles published in the Australian press and popular magazines over a six-month period. Discourse analysis is a method of inquiry that focuses on sociocultural and political contexts in which communication occurs (Lupton 1992). Discourses revealed mixed messages and meanings. Breast feeding was seen as natural and the best way of feeding but also as problematic in practice. Dominant ideologies of power and persuasion were also evident. The media portrayed predominantly negative views about breast feeding. Such discourses may influence decisions to breast feed and have wider implications for midwives in their roles as supporters and educators of women and their families.

  5. Why Breast Cancer Patients Seek Traditional Healers

    Directory of Open Access Journals (Sweden)

    Mazanah Muhamad


    Full Text Available Traditional healing is a common practice in low and middle income countries such as Malaysia. Eighty percent of Malaysians consult traditional healers or “bomoh” at some time in their life for health-related issues. The purpose of our study was to explore why breast cancer patients visit traditional healers. This is a qualitative study utilizing in-depth interviews with 11 cancer survivors who sought both traditional and Western medicine. The findings revealed the following reasons for which patients seek traditional healers: (1 recommendation from family and friends, (2 sanction from family, (3 perceived benefit and compatibility, (4 healer credibility, and (5 reservation with Western medicine and system delay. These factors work together and are strongly influenced by the Malaysian cultural context. The issue with the Western health system is common in a developing country with limited health facilities.

  6. Enteral Nutrition for Feeding Severely Underfed Patients with Anorexia Nervosa

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    Maria Gabriella Gentile


    Full Text Available Severe undernutrition nearly always leads to marked changes in body spaces (e.g., alterations of intra-extracellular water and in body masses and composition (e.g., overall and compartmental stores of phosphate, potassium, and magnesium. In patients with severe undernutrition it is almost always necessary to use oral nutrition support and/or artificial nutrition, besides ordinary food; enteral nutrition should be a preferred route of feeding if there is a functional accessible gastrointestinal tract. Refeeding of severely malnourished patients represents two very complex and conflicting tasks: (1 to avoid “refeeding syndrome” caused by a too fast correction of malnutrition; (2 to avoid “underfeeding” caused by a too cautious rate of refeeding. The aim of this paper is to discuss the modality of refeeding severely underfed patients and to present our experience with the use of enteral tube feeding for gradual correction of very severe undernutrition whilst avoiding refeeding syndrome, in 10 patients aged 22 ± 11.4 years and with mean initial body mass index (BMI of 11.2 ± 0.7 kg/m2. The mean BMI increased from 11.2 ± 0.7 kg/m2 to 17.3 ± 1.6 kg/m2 and the mean body weight from 27.9 ± 3.3 to 43.0 ± 5.7 kg after 90 days of intensive in-patient treatment (p < 0.0001. Caloric intake levels were established after measuring resting energy expenditure by indirect calorimetry, and nutritional support was performed with enteral feeding. Vitamins, phosphate, and potassium supplements were administered during refeeding. All patients achieved a significant modification of BMI; none developed refeeding syndrome. In conclusion, our findings show that, even in cases of extreme undernutrition, enteral feeding may be a well-tolerated way of feeding.

  7. Effect of breast- and bottle-feeding duration on the age of pacifier use persistence. (United States)

    Telles, Fernanda Barros de Arruda; Ferreira, Rívea Inês; Magalhães, Luiza do Nascimento Cezar; Scavone-Junior, Helio


    This study evaluated the effect of breast- and bottle-feeding duration on the age of pacifier use persistence. Questionnaires (n = 723) with information on nutritive and nonnutritive sucking habits of children aged 3-6 years were assessed. The sample was divided according to breastfeeding duration: G1 - non-breastfed, G2 - up to 3 months, G3 - discontinued between 4 and 6 months, G4 - discontinued between 7 and 12 months, and G5 - longer than 12 months. The children were also assigned to 4 groups by age of pacifier use persistence, as well as by age of bottle-feeding persistence: no habits, up to 2 years, 3-4 years and 5-6 years. Associations between nutritive sucking habits and pacifier use were analyzed using logistic regression. The larger breastfeeding groups were G2 (37.9%) and G4 (19.4%). Many children discontinued pacifier use and bottle-feeding at 3-4 years of age (24.9% and 40.1%, respectively). Chances of non-breastfed children (G1) with prolonged pacifier-sucking habits, in the three age ranges, were progressively higher in comparison with group G4 (OR: 4.0-7.5, p breastfeeding duration has an inversely proportional effect on the age of pacifier use persistence. Bottle-fed children who use pacifiers tend to discontinue these habits at the same period.

  8. Breast-, complementary and bottle-feeding practices in Kenya: stagnant trends were experienced from 1998 to 2009. (United States)

    Matanda, Dennis J; Mittelmark, Maurice B; Kigaru, Dorcus Mbithe D


    The pattern of infant and young child feeding that provides the most benefit includes being put to the breast within an hour of birth, exclusive breastfeeding for 6 months, continued breastfeeding along with complementary foods up to 2 years of age or beyond, and avoidance of any bottle-feeding. However, since there are no published data from Kenya regarding trends in these feeding practices, this research undertook time trend estimation of these feeding practices using the 1998, 2003, and 2008-2009 Kenya Demographic and Health Survey and also examined the multivariate relationships between sociodemographic factors and feeding practices with data from 2008 to 2009. Logistic regression was used to test the significance of trends and to analyze sociodemographic characteristics associated with feeding practices. There was a significant decline in early initiation of breastfeeding among children in Central and Western provinces and those residing in urban areas. Trends in exclusive breastfeeding showed significant improvement in most sociodemographic segments, whereas trends in complementary feeding and breastfeeding remained stable. Bottle-feeding significantly decreased among children aged 12 to 23 months, as well as those living in Coast, Eastern, and Rift Valley provinces. In the multivariate analysis, the province was significantly associated with feeding practices, after controlling for child's size, birth order, and parity. The stagnant (and in some cases worsening) trends in early initiation of breastfeeding and complementary feeding with breastfeeding paint a worrisome picture of breastfeeding practices in Kenya; therefore, efforts to promote the most beneficial feeding practices should be intensified.


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    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

  10. Rural-urban disparities of breast cancer patients in China. (United States)

    Zhang, Yan; Bu, Yulan; Gao, Hua


    The purpose of this study was to examine the rural-urban disparities in breast cancer patients in China. The retrospective study was performed with a total of 2,139 breast cancer patients hospitalized in Qilu Hospital of Shandong University between the years 1997 and 2011. We applied Chi-square analysis to identify significant disparities between rural and urban populations. Logistic regression model was used to estimate factors associated with the adjuvant chemotherapy treatment. Two-fifths of patients were considered rural dwellers. Significant disparities were found in marriage age (p rural-urban differences were also shown in the choice of neo-adjuvant chemotherapy (p = 0.0050) and surgical procedures (p rural-urban breast cancer patients exist in China. Interventions to increase early diagnosis of breast cancer among rural area are in need. Further research is needed to investigate potential attitude and perception differences between rural and urban populations with respect to breast cancer preventions and treatments.

  11. Knowledge and Practice of Exclusive Breast Feeding: Effects of Health Promotion Intervention in Nigeria.

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    Full Text Available AIM: Low level of knowledge and practice of exclusive breast feeding have been reported in Nigeria especially in rural communities. The purpose of this study is to identify factors contributing to low knowledge and practice of exclusive breast feeding (E B F in rural communities of Abia State, Nigeria and apply health promotion intervention (H P I to address these factors in order to increase knowledge and practice of E B F. METHOD: A quasi-experimental study design was used. Four communities formed the unit of allocation to experimental and control groups for the purpose of introducing health promotion intervention. A multi-stage sampling procedure was used in selecting the study sample. A sample size of 400 households out of 1978 enumerated from the four communities was used for the survey, two as experimental and two as control. Data were collected using a pretested structured questionnaire that was interviewer administered. Data were analyzed quantitatively and qualitatively. Chi-square statistic was used in determining statistical significance. Analysis of knowledge and practice of EBF was taken before and after H P I and compared in both experimental and control groups.\\ RESULT: The results indicated increase in knowledge of E B F from 28(14% to 200(98.5%. Correspondingly, practice of E B F increased from 21 (10% to 162(80% in the experimental group. No significant increase was made in the control group both in knowledge and practice of EBF. Factors contributing to low level of practice of EBF in the study area included low level of knowledge about ten steps to successful breast feeding, illusory fears about EBF, ignorance, resistance to change, cultural imperatives and medical reasons. Health promotion intervention directed at the rural women helped to scale up the practice of EBF to 70% within nine months. CONCLUSION: The study recommends health promotion intervention as a proven method for scaling up knowledge and practice of EBF in

  12. Breast feeding, parental allergy and asthma in children followed for 8 years. The PIAMA birth cohort study.

    NARCIS (Netherlands)

    Scholtens, S.; Wijga, A.H.; Brunekreef, B.; Kerkhof, M. van de; Hoekstra, M.O.; Gerritsen, J.; Aalberse, R.; Jongste, J.C. de; Smit, H.A.


    BACKGROUND: It is unclear how the association between breast feeding and asthma develops with age of the child and how this association over time is influenced by maternal or paternal allergy. These factors--the age of the child and maternal or paternal allergy--might partly explain the conflicting

  13. Breast feeding, parental allergy and asthma in children followed for 8 years. The PIAMA birth cohort study

    NARCIS (Netherlands)

    Scholtens, S.; Wijga, A. H.; Brunekreef, B.; Kerkhof, M.; Hoekstra, M. O.; Gerritsen, J.; Aalberse, R.; de Jongste, J. C.; Smit, H. A.


    Background: It is unclear how the association between breast feeding and asthma develops with age of the child and how this association over time is influenced by maternal or paternal allergy. These factors-the age of the child and maternal or paternal allergy-might partly explain the conflicting re

  14. Effect of breast- and bottle-feeding duration on the age of pacifier use persistence

    Directory of Open Access Journals (Sweden)

    Fernanda Barros de Arruda Telles


    Full Text Available This study evaluated the effect of breast- and bottle-feeding duration on the age of pacifier use persistence. Questionnaires (n = 723 with information on nutritive and nonnutritive sucking habits of children aged 3-6 years were assessed. The sample was divided according to breastfeeding duration: G1 - non-breastfed, G2 - up to 3 months, G3 - discontinued between 4 and 6 months, G4 - discontinued between 7 and 12 months, and G5 - longer than 12 months. The children were also assigned to 4 groups by age of pacifier use persistence, as well as by age of bottle-feeding persistence: no habits, up to 2 years, 3-4 years and 5-6 years. Associations between nutritive sucking habits and pacifier use were analyzed using logistic regression. The larger breastfeeding groups were G2 (37.9% and G4 (19.4%. Many children discontinued pacifier use and bottle-feeding at 3-4 years of age (24.9% and 40.1%, respectively. Chances of non-breastfed children (G1 with prolonged pacifier-sucking habits, in the three age ranges, were progressively higher in comparison with group G4 (OR: 4.0-7.5, p < 0.01. When comparing bottle-fed with non bottle-fed children, the age range at which bottle-feeding had been discontinued was significantly associated with that of pacifier use cessation: up to 2 years (OR = 6.2, 3-4 years (OR = 7.6 and 5-6 years (OR = 27.0, p < 0.01. It may be suggested that breastfeeding duration has an inversely proportional effect on the age of pacifier use persistence. Bottle-fed children who use pacifiers tend to discontinue these habits at the same period.

  15. Feeding Tips For Your Baby with CHD (United States)

    ... How To Feed Your Baby Either breast- or bottle-feeding works well for babies with heart problems, but ... do best with a combination of breast- and bottle-feeding. Breast-Feeding Your Baby If your baby is ...

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

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    M. Steyn


    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.

  17. Effects of exercise on breast cancer patients' quality of life


    Penttinen, Heidi


    The main goal of the thesis was to investigate the effects of a 12-month supervised exercise intervention on breast cancer patients' QoL shortly after adjuvant treatment. The secondary aims were to assess the physical and psychological well-being of patients immediately after adjuvant treatment of the largest breast cancer survivor population intervention study (BREX) to date and the patients' willingness to participate in such a long intervention. In addition, the work aimed to further clari...

  18. Plasma transforming growth factor beta levels in breast cancer patients

    NARCIS (Netherlands)

    Sminia, P; Barten, AD; Van Waarde, MAWH; Vujaskovic, Z; Van Tienhoven, G


    We investigated whether the concentration of circulating transforming growth factor beta (TGF beta) yields diagnostic value in breast cancer. Blood was collected from twenty stage I and II breast cancer patients both prior to treatment and after surgical excision of the tumour. Both latent and activ

  19. Survival in patients with breast cancer with bone metastasis

    DEFF Research Database (Denmark)

    Cetin, Karynsa; Christiansen, Christian Fynbo; Sværke, Claus;


    OBJECTIVES: Since population-based data on prognostic factors affecting survival in patients with breast cancer with bone metastasis (BM) are currently limited, we conducted this nationwide retrospective cohort study to examine the prognostic role of disease stage at breast cancer diagnosis...

  20. The central role of imaging for breast cancer patients

    NARCIS (Netherlands)

    Barentsz, M.W.


    This thesis describes the essential role of imaging in breast cancer diagnostics and treatment. Part I describes the impact of same-day diagnosis for breast cancer. Same-day diagnosis was introduced in the University Medical Center Utrecht in November 2011 with the aim to reduce patient anxiety by

  1. Counterview: Pre-operative breast MRI (magnetic resonance imaging) is not recommended for all patients with newly diagnosed breast cancer. (United States)

    Solin, Lawrence J


    For the woman with a newly diagnosed early stage breast cancer, the routine use of pre-operative breast MRI (magnetic resonance imaging) is not indicated beyond conventional breast imaging (i.e., mammography with correlation ultrasound as indicated). There is no consistent evidence that a pre-operative breast MRI confers a benefit to the patient by improving clinical outcomes or surgical procedures. In a meta-analysis of studies reporting on the use of pre-operative breast MRI for the patient with an established index cancer, multifocal or multicentric disease was found on breast MRI in 16% of the patients, a rate substantially higher than the rate of local recurrence after breast conserving surgery plus definitive radiation treatment. In the largest retrospective study of patients treated with breast conserving surgery plus radiation, no gain was found for adding a breast MRI to conventional breast imaging. No randomized clinical trial has been designed to evaluate long term clinical outcomes associated with adding a pre-operative breast MRI. Adding pre-operative breast MRI can alter clinical management in ways that are potentially harmful to patients, for example, increased ipsilateral mastectomies, increased contralateral prophylactic mastectomies, increased work-ups, and delay to definitive surgery. In summary, the routine use of pre-operative breast MRI is not warranted for the typical patient with a newly diagnosed early stage breast cancer.

  2. A Case Report of Breast Sparganosis in a Patient with Ipsilateral Breast Cancer: MRI and Ultrasonographic Findings

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Yoo Jin; Bae, Young Tae; Kim, Jee Yeon [Pusan National University Hospital, Pusan National University School of Medicine, Busan (Korea, Republic of); Choo, Ki Seok [Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan (Korea, Republic of)


    Sparganosis of the breast is a quite rare parasitic infection of humans and presents as soft tissue masses that mimic breast malignancy or benign tumor, such as fibroadenoma. We present here a case of histologically confirmed breast sparganosis in the upper inner quadrant of the right breast with coexisting breast cancer in the ipsilateral breast upper outer quadrant. Ultrasonography of breast sparganosis showed a well defined, tubular hypoechoic mass with discrete multilayered wall and tubule-in tubule appearance, surrounded by heterogenous hyperechoic areas in the subcutaneous fat layer of the breast. MRI revealed an elongated tubular structure with persistent and progressive enhancement. This is the second report concerned with the MRI and ultrasonographic findings of breast sparganosis and the first report of breast sparganosis in a patient with ipsilateral breast cancer

  3. 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)


    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.

  4. Survival Analysis of Breast Cancer Subtypes in Spinal Metastases Patients

    DEFF Research Database (Denmark)

    Wang, Miao; Jensen, Anders Bonde; Morgen, Soeren Smith


    growth factor receptor 2 subtypes had similar median survival duration and mortality risk. Patients with triple-negative breast cancer had a median survival duration of only 9.9 months. CONCLUSION: Patients with spinal metastases with ER/HR (-) status and triple-negative breast cancer could be downgraded...... from score "5" to "3" in Tokuhashi scoring system and from "slow growth" to "moderate growth" in Tomita scoring system. Spine surgeons should be critical before performing high-risk extensive surgery in patients with ER/HR (-) status, and especially, in those with triple-negative status. LEVEL...... hazards regression model unadjusted and adjusted by age were used. RESULTS: Patients with ER-negative (-) breast cancer had 11 months shorter median survival duration (10.6 vs. 21.5 mo) and 48% higher mortality risk (P=0.03) than those with ER-positive (+) breast cancer. Patients with PgR (-) status had...

  5. Enteral nutrition for feeding severely underfed patients with anorexia nervosa. (United States)

    Gentile, Maria Gabriella


    Severe undernutrition nearly always leads to marked changes in body spaces (e.g., alterations of intra-extracellular water) and in body masses and composition (e.g., overall and compartmental stores of phosphate, potassium, and magnesium). In patients with severe undernutrition it is almost always necessary to use oral nutrition support and/or artificial nutrition, besides ordinary food; enteral nutrition should be a preferred route of feeding if there is a functional accessible gastrointestinal tract. Refeeding of severely malnourished patients represents two very complex and conflicting tasks: (1) to avoid "refeeding syndrome" caused by a too fast correction of malnutrition; (2) to avoid "underfeeding" caused by a too cautious rate of refeeding. The aim of this paper is to discuss the modality of refeeding severely underfed patients and to present our experience with the use of enteral tube feeding for gradual correction of very severe undernutrition whilst avoiding refeeding syndrome, in 10 patients aged 22 ± 11.4 years and with mean initial body mass index (BMI) of 11.2 ± 0.7 kg/m(2). The mean BMI increased from 11.2 ± 0.7 kg/m(2) to 17.3 ± 1.6 kg/m(2) and the mean body weight from 27.9 ± 3.3 to 43.0 ± 5.7 kg after 90 days of intensive in-patient treatment (p refeeding syndrome. In conclusion, our findings show that, even in cases of extreme undernutrition, enteral feeding may be a well-tolerated way of feeding.

  6. The importance of preoperative breast MRI for patients newly diagnosed with breast cancer. (United States)

    Crowe, Joseph P; Patrick, Rebecca J; Rim, Alice


    The use of preoperative breast magnetic resonance imaging (bMRI) for patients newly diagnosed with breast cancer has been criticized for increasing the number of therapeutic mastectomies performed, as well as increasing the cost of treatment. The purpose of this report is to examine one surgeon's practice and to describe the MRI findings for patients with breast cancer to determine if those findings changed the therapeutic options for those patients in. Data were collected prospectively between August 2003 and January 2006 for patients newly diagnosed with breast cancer. Diagnoses were made by core biopsy or fine-needle aspiration; all lesions were intact at the time of MRI. Twenty-five percent of patients were found to have previously occult, but suspicious lesions on MRI that required additional diagnostic evaluation, including ultrasound, core biopsy, excisional biopsy, or any combination; for approximately half of these patients a separate cancer was confirmed. For most of these patients, the new lesion was ipsilateral and multicentric, and most required mastectomy. For the remaining 75% of patients, MRI confirmed the index lesion was the only area of concern, and appropriate surgical treatment was completed. Preoperative bMRI for patients newly diagnosed with breast cancer identified previously occult and separate tumors in 13% of patients, resulting in surgical treatment change for many.


    Formenti, Silvia C.; Hsu, Howard; Fenton-Kerimian, Maria; Roses, Daniel; Guth, Amber; Jozsef, Gabor; Goldberg, Judith D.; DeWyngaert, J. Keith


    Purpose To report the 5-year results of a prospective trial of three-dimensional conformal external beam radiotherapy (3D-CRT) to deliver accelerated partial breast irradiation in the prone position (P-APBI). Methods Post-menopausal patients with Stage I breast cancer with non palpable <2 cm tumors, negative margins, and negative nodes, positive hormonal receptors, and no extensive intraductal component (EIC) were eligible. The trial was offered only once eligible patients had refused to undergo standard whole-breast radiotherapy. Patients were simulated and treated on a dedicated table for prone set-up. The 3D-CRT delivered was 30 Gy in five 6 Gy/daily fractions over 10 days with port film verification at each treatment. Ipsilateral breast, ipsilateral nodal, contralateral breast, and distant failure (IBF, INF, CBF, DF) were estimated using the cumulative incidence method. Disease-free, overall, and cancer-specific survival (DFS, OS, CSS) were recorded. Results One hundred patients accrued to this IRB- approved prospective trial, one with bilateral breast cancer. One patient withdrew consent after simulation and another elected to interrupt radiotherapy after receiving two treatments. Ninety-eight patients are evaluable for toxicity and, in one case, both breasts were treated with PBI. Median patient age was 68 years (range 53–88 years); in 55% the tumor size was <1 cm. All patients had hormonal receptor positive cancers: 87% underwent adjuvant anti-hormonal therapy. At a median follow-up of 64 months (range, 2–125 months), there was one local recurrence (1% IBF) and one contralateral breast cancer (1% CBF). There were no deaths due to breast cancer by 5 years. Grade 3 late toxicities occurred in 2 patients (1 breast edema, 1 transient breast pain). Cosmesis was rated good/excellent in 89% of patients with at least 36 months follow-up. Conclusions Five-year efficacy and toxicity of 3D-CRT to deliver prone-PBI are comparable to other experiences with similar

  8. The value of surveillance mammography of the contralateral breast in patients with a history of breast cancer

    NARCIS (Netherlands)

    Lu, W.L.; Schaapveld, M.; Jansen, L.; Bagherzadegan, E.; Sahinovic, M.M.; Baas, P.C.; Hanssen, L.M.H.C.; van der Mijle, H.C.J.; Brandenburg, J.D.; Wiggers, T.; de Bock, G.H.


    Purpose: To determine the contribution of surveillance mammography to the early detection of metachronous contralateral. breast cancer (MCBC) and to assess its impact on the survival of breast cancer patients with relation to compliance. Method: Breast cancer patients (5589) were identified using fi

  9. Fertility preservation options in breast cancer patients. (United States)

    Kasum, Miro; von Wolff, Michael; Franulić, Daniela; Čehić, Ermin; Klepac-Pulanić, Tajana; Orešković, Slavko; Juras, Josip


    The purpose of this review is to analyse current options for fertility preservation in young women with breast cancer (BC). Considering an increasing number of BC survivors, owing to improvements in cancer treatment and delaying of childbearing, fertility preservation appears to be an important issue. Current fertility preservation options in BC survivors range from well-established standard techniques to experimental or investigational interventions. Among the standard options, random-start ovarian stimulation protocol represents a new technique, which significantly decreases the total time of the in vitro fertilisation cycle. However, in patients with oestrogen-sensitive tumours, stimulation protocols using aromatase inhibitors are currently preferred over tamoxifen regimens. Cryopreservation of embryos and oocytes are nowadays deemed the most successful techniques for fertility preservation in BC patients. GnRH agonists during chemotherapy represent an experimental method for fertility preservation due to conflicting long-term outcome results regarding its safety and efficacy. Cryopreservation of ovarian tissue, in vitro maturation of immature oocytes and other strategies are considered experimental and should only be offered within the context of a clinical trial. An early pretreatment referral to reproductive endocrinologists and oncologists should be suggested to young BC women at risk of infertility, concerning the risks and benefits of fertility preservation options.

  10. MicroRNA analysis of breast ductal fluid in breast cancer patients. (United States)

    Do Canto, Luisa Matos; Marian, Catalin; Willey, Shawna; Sidawy, Mary; Da Cunha, Patricia A; Rone, Janice D; Li, Xin; Gusev, Yuriy; Haddad, Bassem R


    Recent studies suggest that microRNAs show promise as excellent biomarkers for breast cancer; however there is still a high degree of variability between studies making the findings difficult to interpret. In addition to blood, ductal lavage (DL) and nipple aspirate fluids represent an excellent opportunity for biomarker detection because they can be obtained in a less invasive manner than biopsies and circumvent the limitations of evaluating blood biomarkers with regards to tissue of origin specificity. In this study, we have investigated for the first time, through a real-time PCR array, the expression of 742 miRNAs in the ductal lavage fluid collected from 22 women with unilateral breast tumors. We identified 17 differentially expressed miRNAs between tumor and paired normal samples from patients with ductal breast carcinoma. Most of these miRNAs have various roles in breast cancer tumorigenesis, invasion and metastasis, therapeutic response, or are associated with several clinical and pathological characteristics of breast tumors. Moreover, some miRNAs were also detected in other biological fluids of breast cancer patients such as serum (miR-23b, -133b, -181a, 338-3p, -625), plasma (miR-200a), and breast milk (miR-181a). A systems biology analysis of these differentially expressed miRNAs points out possible pathways and cellular processes previously described as having an important role in breast cancer such as Wnt, ErbB, MAPK, TGF-β, mTOR, PI3K-Akt, p53 signaling pathways. We also observed a difference in the miRNA expression with respect to the histological type of the tumors. In conclusion, our findings suggest that miRNA analysis of breast ductal fluid is feasible and potentially very useful for the detection of breast cancer.

  11. Coagulation tests show significant differences in patients with breast cancer. (United States)

    Tas, Faruk; Kilic, Leyla; Duranyildiz, Derya


    Activated coagulation and fibrinolytic system in cancer patients is associated with tumor stroma formation and metastasis in different cancer types. The aim of this study is to explore the correlation of blood coagulation assays for various clinicopathologic factors in breast cancer patients. A total of 123 female breast cancer patients were enrolled into the study. All the patients were treatment naïve. Pretreatment blood coagulation tests including PT, APTT, PTA, INR, D-dimer, fibrinogen levels, and platelet counts were evaluated. Median age of diagnosis was 51 years old (range 26-82). Twenty-two percent of the group consisted of metastatic breast cancer patients. The plasma level of all coagulation tests revealed statistically significant difference between patient and control group except for PT (p50 years) was associated with higher D-dimer levels (p=0.003). Metastatic patients exhibited significantly higher D-dimer values when compared with early breast cancer patients (p=0.049). Advanced tumor stage (T3 and T4) was associated with higher INR (p=0.05) and lower PTA (p=0.025). In conclusion, coagulation tests show significant differences in patients with breast cancer.

  12. Breast MRI in high risk patients

    NARCIS (Netherlands)

    A.I.M. Obdeijn (Inge-Marie)


    markdownabstractAbstract In this thesis we address various indications of breast MRI, with the emphasis on the value of MRI in screening of women with high genetic risk for breast cancer, and especially in BRCA1 mutation carriers. We showed that in the era of up-to-date MRI expertise and digital

  13. Tamoxifen-associated vasculitis in a breast cancer patient

    Directory of Open Access Journals (Sweden)

    Vargas-Viveros Pablo


    Full Text Available Abstract Background Estrogen plays a critical role in breast cancer. Thereafter, endocrine therapy is a standard of care in patients with breast carcinoma, expressing ER or PR. Case presentation Herein we report the case of a 53-year old patient, who developed cholestasis and vasculitis during the treatment with tamoxifen. This toxicity was reversable after the removal of the drug. Thereafter she continued adjuvant treatment for breast carcinoma with anastrazole. Since tamoxifen has been widely indicated for patients with breast carcinoma, we did a literature review, looking for other cases with this type of toxicity. Conclusion This case is the third with vasculitis informed in the literature, but the first one that additionally developed cholestasis and arthritis. Although it is rare, we discuss the indication of this drug in the actual era, where aromatase inhibitors offer a better security profile.

  14. Profile of thyroid hormones in breast cancer patients

    Directory of Open Access Journals (Sweden)

    P.P. Saraiva


    Full Text Available Estrogen involvement in breast cancer has been established; however, the association between breast cancer and thyroid diseases is controversial. Estrogen-like effects of thyroid hormone on breast cancer cell growth in culture have been reported. The objective of the present study was to determine the profile of thyroid hormones in breast cancer patients. Serum aliquots from 26 patients with breast cancer ranging in age from 30 to 85 years and age-matched normal controls (N = 22 were analyzed for free triiodothyronine (T3F, free thyroxine (T4F, thyroid-stimulating hormone (TSH, antiperoxidase antibody (TPO, and estradiol (E2. Estrogen receptor ß (ERß was determined in tumor tissues by immunohistochemistry. Thyroid disease incidence was higher in patients than in controls (58 vs 18%, P < 0.05. Subclinical hyperthyroidism was the most frequent disorder in patients (31%; hypothyroidism (8% and positive anti-TPO antibodies (19% were also found. Subclinical hypothyroidism was the only dysfunction (18% found in controls. Hyperthyroidism was associated with postmenopausal patients, as shown by significantly higher mean T3 and T4 values and lower TSH levels in this group of breast cancer patients than in controls. The majority of positive ERß tumors were clustered in the postmenopausal patients and all cases presenting subclinical hyperthyroidism in this subgroup concomitantly exhibited Erß-positive tumors. Subclinical hyperthyroidism was present in only one of 6 premenopausal patients. We show here that postmenopausal breast cancer patients have a significantly increased thyroid hormone/E2 ratio (P < 0.05, suggesting a possible tumor growth-promoting effect caused by this misbalance.

  15. Multifocality as a prognostic factor in breast cancer patients registered in Danish Breast Cancer Cooperative Group (DBCG) 1996-2001

    DEFF Research Database (Denmark)

    Joergensen, L.E.; Gunnarsdottir, K.A.; Lanng, C.;


    The purpose of this study was to investigate the prognostic influence of multifocality in breast cancer patients. In a cohort of 7196 patients there were 945 patients with multifocality. We found no prognostic influence of multifocality on overall survival when controlling for known prognostic......, Gunnarsdottir KA, Rasmussen BB, Moeller S, Lanng C. The prognostic influence of multifocality in breast cancer patients. Breast 2004;13:188-193]....

  16. Feeding Your Newborn (United States)

    ... Old Feeding Your 1- to 2-Year-Old Feeding Your Newborn KidsHealth > For Parents > Feeding Your Newborn ... giving up the breast. previous continue About Formula Feeding Commercially prepared infant formula is a nutritious alternative ...

  17. Relationship between breast-feeding and bone mineral density among Korean women in the 2010 Korea National Health and Nutrition Examination Survey. (United States)

    Yeo, Ui Hyang; Choi, Chang Jin; Choi, Whan Seok; Kim, Kyung Soo


    Breast-feeding has the deleterious effect of hypoestrogenemia coupled with loss of calcium in the maternal bone mass. It is not clear whether changes in bone metabolism in lactating women lead to changes in maternal bone mineral density (BMD) over a longer period. The aim of the present study was to investigate the relationship between the duration of breast-feeding and BMD in healthy South Korean women. We analyzed data from the 2010 Korea National Health and Nutrition Examination Survey, a cross-sectional survey of Korean citizens. A total of 1342 women older than 19 years were selected for analysis. In postmenopausal women, the duration of breast-feeding per child was associated with low lumbar spine BMD after adjustment for age, body mass index, smoking, alcohol intake, physical activity, serum 25-hydroxyvitamin D level, and daily intake of calcium and calories (P < 0.05, P trend < 0.005). Prolonged breast-feeding for more than 1 year per child was associated with a deleterious effect on lumbar spine BMD compared with never breast-feeding or a shorter duration of breast-feeding (P < 0.05). These effects were not shown in premenopausal women or in femur BMD. In conclusion, the duration of breast-feeding per child is negatively correlated with lumbar spine BMD in postmenopausal women, but not in premenopausal women. Although the cause of the different results between postmenopausal and premenopausal women is not clear, our findings suggest that proper protective strategies should be recommended during prolonged breast-feeding to maintain bone health later in life.

  18. An investigation of plasma and salivary oxytocin responses in breast- and formula-feeding mothers of infants


    Grewen, Karen M.; DAVENPORT, RUSSELL E.; Light, Kathleen C.


    Oxytocin (OT) is a peptide increasingly studied in relation to human social interactions, affiliation, and clinical disorders. Studies are constrained by use of invasive blood draws and would benefit from a reliable salivary OT assay. Our goals were to examine feasibility of salivary OT measurement, compare salivary to plasma OT responses in 12 breast- and 8 formula-feeding mothers, and assess the degree of correlation between plasma and salivary OT. Using a commercial EIA kit, we measured OT...

  19. 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


    Full Text Available OBJETIVO: Identificar los factores maternos, laborales y de los servicios de salud que influyen en el abandono temprano de la lactancia materna en madres trabajadoras. MATERIAL Y MÉTODOS: Entre noviembre de 1998 y marzo de 1999 se efectuó un estudio transversal comparativo con madres derechohabientes del Instituto Mexicano del Seguro Social de Ensenada, Baja California, México. A 265 madres se les aplicó un cuestionario entre los tres y nueve meses posparto. Se distribuyeron en: grupo I: madres con abandono temprano de la lactancia materna; grupo II: madres que prolongaron la lactancia materna por más de tres meses. Para identificar los factores asociados con el abandono temprano de la lactancia materna, se utilizó regresión logística. RESULTADOS: El 42.3% (112 de las madres abandonaron temprano la lactancia materna. Los factores de riesgo fueron: tener conocimientos malos sobre lactancia materna, OR 5.97 (IC 95% 1.67-20.67, la ausencia del antecedente de haberla practicado en un hijo previo OR 2.98 (IC 95% 1.66-5.36, tener un plan de duración de la misma de 0 a 3 meses, OR 16.24 (IC 95% 5.37-49.12, y la falta de facilidades en el trabajo para efectuarla, OR 1.99 (IC 95% 1.12-3.56. CONCLUSIONES: Los principales factores asociados con el abandono temprano de la lactancia materna fueron maternos. El único factor laboral fue la ausencia de facilidades para amamantar. Es probable que la calidad de los conocimientos, la experiencia previa con ella y tener facilidades laborales influyan en la decisión de prolongarla.OBJECTIVE:To identify the maternal, work, and health services factors associated with a short duration of breast-feeding in working mothers. MATERIAL AND METHODS: A cross-sectional study was carried out between November 1998 and March 1999, among 265 mothers medically insured by (Instituto Mexicano del Seguro Social, IMSS Mexican Institute of Social Security, who completed a questionnaire when their babies were 3 to 9 months old

  20. The impact of oophorectomy on survival after breast cancer in BRCA1-positive breast cancer patients. (United States)

    Huzarski, T; Byrski, T; Gronwald, J; Cybulski, C; Oszurek, O; Szwiec, M; Gugała, K; Stawicka, M; Morawiec, Z; Mierzwa, T; Falco, M; Janiszewska, H; Kilar, E; Marczyk, E; Kozak-Klonowska, B; Siołek, M; Surdyka, D; Wiśniowski, R; Posmyk, M; Domagała, P; Sun, P; Lubiński, J; Narod, S A


    The aim of the study is to identify treatments which predict survival for women with a BRCA1 mutation, including oophorectomy and chemotherapy. 476 women with stage I to stage III breast cancer who carried a BRCA1 mutation were followed from diagnosis until April 2015. Information on treatment was obtained from chart review and patient questionnaires. Dates of death were obtained from the Poland vital statistics registry. Survival curves were compared for different subgroups according to treatment received. Predictors of overall survival were determined using the Cox proportional hazards model. The ten-year overall survival was 78.3 % (95 % CI 74.2-82.6 %) and the ten-year breast cancer-specific survival was 84.2 % (95 % CI 80.5-88.0 %). Sixty-two patients died of breast cancer, 14 patients died of ovarian cancer, and 2 patients died of peritoneal cancer. Oophorectomy was associated with a significant reduction in all-cause mortality in the entire cohort (adjusted HR = 0.41; 95 % CI 0.24-0.69; p = 0.0008) and in breast cancer-specific mortality among ER-negative breast cancer patients (HR = 0.44; 95 % CI 0.22-0.89; p = 0.02). Among women with breast cancer and a BRCA1 mutation, survival is greatly improved by oophorectomy due to the prevention of deaths from both breast and ovarian cancer.

  1. Estimated radiation dose to breast feeding infant following maternal administration of 57Co labelled to vitamin B12. (United States)

    Pomeroy, Kay M; Sawyer, Laura J; Evans, Martyn J


    Administration of a radiopharmaceutical may result in a radiation dose to an infant due to ingestion of the radiopharmaceutical secreted in the breast milk. Following a maternal administration of Co labelled to vitamin B12 (cyanocobalamin) as part of a Schilling test an estimate of the absorbed dose to a breast feeding infant was calculated. Milk samples were collected from every feed in the first 24 h, and at approximately 48 and 72 h post-administration. The absorbed dose to the infant's liver (the organ receiving the highest dose) was calculated to be 0.23 mGy. The effective dose to the infant was calculated to be 0.025 mSv, which is considerably lower than the current regulatory limit of 1 mSv. The Administration of Radioactive Substances Advisory Committee advise that the first feed, at approximately 4 h after administration, be discarded. The data show that this was unwarranted, and that the peak concentration of Co in the breast milk occurred at around 24 h.

  2. From folklore to scientific evidence: breast-feeding and wet-nursing in islam and the case of non-puerperal lactation. (United States)

    Moran, Lia; Gilad, Jacob


    Breast-feeding practice has an important medical and socio-cultural role. It has many anthropological aspects concerning the "power structures" that find their expression in breast-feeding and the practices that formed around it, both socially, scientifically, and legally-speaking. Breast-feeding has been given much attention by religions and taboos, folklore, and misconception abound around it making it a topic of genuine curiosity. This paper aims at expanding the spectrum of folklore associated with breast-feeding. The paper deals with historical, religious, and folkloristic aspects of breast-feeding, especially wet-nursing, in Islam and focuses on an intriguing Islamic tale on breast-feeding - lactation by non-pregnant women (or non-puerperal lactation). Apparently, accounts of non-puerperal lactation are not restricted to Islam but have been documented in various societies and religions throughout centuries. Two medical situations - hyperprolactinemia and induced lactation, appear as possible explanations for this phenomenon. This serves as an excellent example for the value of utilizing contemporary scientific knowledge in order to elucidate the origin, anthropology and evolvement of ancient myth and superstition.

  3. ["SOS SEIN 84" accelerated breast disease management: Patients satisfaction survey]. (United States)

    Arnaud, Antoine; Dumuids, Magali; Mège, Alice; de Rauglaudre, Gaëtan; Regis Arnaud, Anne; Martin, Nicole; Dupuy Meurat, Françoise; Dolle, Sabine; Gallon, Elise; Serin, Daniel


    In case of a new breast symptom or an abnormal result of breast imaging, some women have a problem finding a quick answer to allay their anxiety. The Institut Sainte-Catherine in Avignon has set up a new form of accelerated disease management through the opening of a new dedicated consultation called SOS SEIN 84. We present the result of a prospective quality study of our first new patients.

  4. [Genomic Tests as Predictors of Breast Cancer Patients Prognosis]. (United States)

    Bielčiková, Z; Petruželka, L


    Hormonal dependent breast cancer is a heterogeneous disease from a molecular and clinical perspective. The relapse risk of early breast cancer patients treated with adjuvant hormonal therapy varies. Validated predictive markers concerning adjuvant cytotoxic treatment are still lacking in ER+/ HER2-  breast cancer, which has a good prognosis in general. This can lead to the inefficient chemotherapy indication. Molecular classification of breast cancer reports evidence about the heterogeneity of hormonal dependent breast cancer and its stratification to different groups with different characteristics. Multigene assays work on the molecular level, and their aim is to provide patients risk stratification and therapy efficacy prediction. The position of multigene assays in clinical practice is not stabile yet. Non uniform level of evidence connected to patients prognosis interpretations and difficult comparison of tests are the key problems, which prevent their wide clinical use. The article is a summary of some of the most important multigene assays in breast cancer and their current position in oncology practice.

  5. Patterns of breast and bottle feeding and their association with dental caries in 1- to 4-year-old South African children. 1. Dental caries prevalence and experience. (United States)

    Roberts, G J; Cleaton-Jones, P E; Fatti, L P; Richardson, B D; Sinwel, R E; Hargreaves, J A; Williams, S


    In order to study associations between breast and bottle feeding and dental caries a questionnaire on feeding habits was completed by trained interviewers for 1,263 children aged 1 to 4 years from five South African communities. Of these, 73 to 94 per cent had been breast fed for mean periods of 9 to 16 months. The types of infant feeding practised (breast, bottle or mixed) varied little within the groups although each group differed significantly from the others for the preferred feeding practice. Using responses to a dietary interview the children were subdivided into those breast fed for 12 months or longer (n = 546), those who had mixed breast and bottle feeding (n = 527) and those who were bottle fed only (n = 190). Caries prevalence increased with the age of the child, more in bottle fed than other groups. Within all feeding groups caries prevalence was lowest among white children and in social class I. The dmfs and dmft scores showed irregular patterns and were significantly influenced by feeding group and the interaction between race and social class.

  6. BRCA2 Mutations in 154 Finnish Male Breast Cancer Patients

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    Kirsi Syrjäkoski


    Full Text Available The etiology and pathogenesis of male breast cancer (MBC are poorly known. This is due to the fact that the disease is rare, and large-scale genetic epidemiologic studies have been difficult to carry out. Here, we studied the frequency of eight recurrent Finnish BRCA2 founder mutations in a large cohort of 154 MBC patients (65% diagnosed in Finland from 1967 to 1996. Founder mutations were detected in 10 patients (6.5%, eight of whom carried the 9346(-2 A>G mutation. Two novel mutations (4075 delGT and 5808 del5 were discovered in a screening of the entire BRCA2 coding region in 34 samples. However, these mutations were not found in the rest of the 120 patients studied. Patients with positive family history of breast and/or ovarian cancer were often BRCA2 mutation carriers (44%, whereas those with no family history showed a low frequency of involvement (3.6%; P < .0001. Finally, we found only one Finnish MBC patient with 999 dell, the most common founder mutation in Finnish female breast cancer (FBC patients, and one that explains most of the hereditary FBC and MBC cases in Iceland. The variation in BRCA2 mutation spectrum between Finnish MBC patients and FBC patients in Finland and breast cancer patients in Iceland suggests that modifying genetic and environmental factors may significantly influence the penetrance of MBC and FBC in individuals carrying germline BRCA2 mutations in some populations.

  7. Pathologic Findings in MRI-Guided Needle Core Biopsies of the Breast in Patients with Newly Diagnosed Breast Cancer


    Siziopikou, K. P.; P. Jokich; Cobleigh, M.


    The role of MRI in the management of breast carcinoma is rapidly evolving from its initial use for specific indications only to a more widespread use on all women with newly diagnosed early stage breast cancer. However, there are many concerns that such widespread use is premature since detailed correlation of MRI findings with the underlying histopathology of the breast lesions is still evolving and clear evidence for improvements in management and overall prognosis of breast cancer patients...

  8. Resilience and Quality of Life in Breast Cancer Patients

    Directory of Open Access Journals (Sweden)

    Gordana Ristevska-Dimitrоvska


    Full Text Available BACKGROUND: Many studies have shown that a relationship exists between quality of life (QoL and resilience in breast cancer patients, but few studies present information on the nature of this relationship of resilience on QoL. Our aim was to examine the relationship between resilience and quality of life in breast cancer patients. METHODS: QoL was measured in 218 consequent breast cancer patients, with EORTC - QLQ Core 30 questionnaire, and EORTC QLQ-BR23. The resilience was measured with Connor Davidson Resilience Scale. RESULTS: The global quality of life was positively correlated with the levels of resilience (R = 0.39 p < 0.001. All functional scales (physical, role, emotional, cognitive and social functioning was in a positive correlation with resilience. The symptoms severity (fatigue, nausea and vomitus, pain, dyspnea, insomnia, appetite loss, constipation, diarrhea, financial difficulties was in negative correlation with resilience. Less resilient breast cancer patients reported worse body image and future perspective and suffered from more severe adverse effects of systemic therapy, and arm/breast symptoms. CONCLUSION: Our findings show that psychological resilience affects different aspects of health-related quality of life. More resilient patients have significantly better quality of life in almost all aspects of QoL.

  9. A prospective study of breast anthropomorphic measurements, volume and ptosis in 605 Asian patients with breast cancer or benign breast disease (United States)

    Mo, Miao; Chen, Jia-jian; Yang, Ben-long; Huang, Xiao-yan; Wu, Jiong


    Objectives The current study aims to summarize breast anthropomorphic measurement features in Chinese patients with breast diseases and to investigate their potential correlations with demographic factors. Materials and methods Fifteen breast anthropomorphic parameters of 605 Chinese female patients were collected prospectively. Breast ptosis status was scaled by two methods and breast volume was calculated according to a modified formula of BREAST-V. Results Among 1210 breasts, the average breast volume was 340.0±109.1 ml (91.8–919.2 ml). The distance from the nipple to the inframammary fold was 7.5±1.6 cm in the standing position. The width of the breast base was 14.3±1.4 cm (8.5–23.5 cm). The incidence of breast ptosis was 22.8% (274/1204), of which 37 (23.5%) and 79 (31.7%) women had severe ptosis assessed by different criteria. Increased height (OR[odds ratio] = 1.500, Pcosmetic and reconstructive breast surgery decisions. Post-menopausal status, increased BMI, and breastfeeding for more than six months were independent risk factors for both increased breast volume and breast ptosis. PMID:28192525


    Directory of Open Access Journals (Sweden)

    K. S. Titov


    Full Text Available Intrapleural immunotherapy for metastatic pleurisies demonstrates a high efficiency in the treatment of patients with breast cancer (BC. This immunotherapy modality is regarded as one of the stages of complex treatment in patients with disseminated BC and allows its capabilities to be extended for their further management.

  11. Advice given to women in Argentina about breast-feeding and the use of alcohol (United States)

    Pepino, M. Yanina; Mennella, Julie A.


    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

  12. 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


    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

  13. 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


    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

  14. Knowledge, attitude and practice of breast feeding at a tertiary care centre in the government medical college and hospital, Aurangabad, India

    Directory of Open Access Journals (Sweden)

    Varsha Deshmukh


    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 counseling and training of mothers. [Int J Reprod Contracept Obstet Gynecol 2016; 5(6.000: 1912-1915

  15. Computerized database management system for breast cancer patients. (United States)

    Sim, Kok Swee; Chong, Sze Siang; Tso, Chih Ping; Nia, Mohsen Esmaeili; Chong, Aun Kee; Abbas, Siti Fathimah


    Data analysis based on breast cancer risk factors such as age, race, breastfeeding, hormone replacement therapy, family history, and obesity was conducted on breast cancer patients using a new enhanced computerized database management system. My Structural Query Language (MySQL) is selected as the application for database management system to store the patient data collected from hospitals in Malaysia. An automatic calculation tool is embedded in this system to assist the data analysis. The results are plotted automatically and a user-friendly graphical user interface is developed that can control the MySQL database. Case studies show breast cancer incidence rate is highest among Malay women, followed by Chinese and Indian. The peak age for breast cancer incidence is from 50 to 59 years old. Results suggest that the chance of developing breast cancer is increased in older women, and reduced with breastfeeding practice. The weight status might affect the breast cancer risk differently. Additional studies are needed to confirm these findings.

  16. Breast feeding practices and associated factors in Bhaktapur District of Nepal: A community based cross-sectional study among lactating mothers

    Directory of Open Access Journals (Sweden)

    Dillee Prasad Paudel


    Full Text Available Background: Infant feeding is a major determinant of survival, future nutrition and health status of children. Breast-feeding is an unequalled way of providing ideal food for the healthy growth and development of infants. It is also an integral part of the reproductive process with important implications for the health of mothers. Exclusive breast feeding (EBF is superior to non-exclusive breast-feeding with a protective effect against both morbidity and mortality. This study was aimed to explore the breast feeding practice and affecting factors in Bhaktapur, Nepal. Materials and Methods: Community based cross-sectional study was carried out from February to May 2007 in a rural area of Bhaktapur, Nepal. Total 333 lactating mothers having a child less than 6 months were interviewed using pretested questionnaire with her written consent. Analysis was performed in Statistical Pakage of Social Science-13 version applying appropriate statistics. Results were presented in tabular and narrative forms. Results: Among 333 mothers (mean age ± standard deviation 24.68 ± 4.16 years, majority (76.6% were 20-30 years. Almost 83.0% were Hindus, 25.8% illiterate, 62.8% house-wives and 53.5% from joint family with low economic status. About 48.0% had a baby of 2-4 months, 86.0% avoided pre-lacteal feeding, 87.1% fed colostrums, 27.9% fed the first milk within half an hour and 55.0% practiced exclusive breast-feeding for 6 months. Child′s age, education, religion, occupation, family type and knowledge level were significant (P < 0.05 factors affecting to breast feeding. Conclusion: Despite the high proportion of women initiated breast-feeding early after birth, the prevalence of EBF for 6 months was very low and a large portion had poor practice of breast feeding. Education, relationship of mother with a family member and level of knowledge were found most significant factors. Appropriate measures such as public awareness and effective counseling will support

  17. Breast MRI in high risk patients


    Obdeijn, Inge-Marie


    markdownabstractAbstract In this thesis we address various indications of breast MRI, with the emphasis on the value of MRI in screening of women with high genetic risk for breast cancer, and especially in BRCA1 mutation carriers. We showed that in the era of up-to-date MRI expertise and digital mammography the screening efficacy is improved. However, the additional value of mammography over MRI is little while at the same time BRCA carriers are more sensitive the risks of low dose radiation ...

  18. Primary breast lymphoma in an immunocompromised male patient: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Yim, Bong Guk; Park, Jeong Seon; Koo, Hye Ryoung; Kim, Soo Yeon; Jang, Ki Seok [Hanyang University Medical Center, Hanyang University College of Medicine, Seoul (Korea, Republic of); Kim, Jin Young; Choi, Yun Young [Dept. of Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri (Korea, Republic of)


    Primary breast lymphoma in a male patient is extremely rare. We report a case of primary breast lymphoma in an immunocompromised male patient, after renal transplantation. The sonographic and histological features are described in depth.

  19. TRAM flap in reconstructive operations in patients with breast cancer

    Directory of Open Access Journals (Sweden)

    A. D. Zikiryakhodzhaev


    Full Text Available The treatment of breast cancer (BC is a relevant problem. Surgery is a key treatment method for BC. The volume of its operations varies from radical mastectomies to lumpectomies and, in the areas of regional metastases, from three-level lymphadenectomy to sentinel lymph node biopsy. Objective: to assess whether a displaced TRAM flap may be used for reconstructive operations for BC. The paper presents some experience in treating 11 BC patients in whom a displaced TRAMP flap was employed for reconstruction. At this time, the displaced TRAM flap was applied for delayed reconstruction in 3 patients. The mean age of the patients was 45.5 ± 15.7 years. In 8 BC patients undergoing one-stage reconstruction with a displaced TRAM flap, the treatment schedule was as follows: surgical treatment in 1 patient, combined treatment in 2 patients, and multimodality treatment in 5. The patients received targeted therapy in 3 cases or hormone therapy in 6. A lower abdominal skin-and-fat flap on one vascular pedicle was used in all the 11 patients.Indications for using a displaced TRAM flap were determined; complications were analyzed. The percentage of complications due to the use of a displaced TRAM flap was 9.1 % in our study.To reduce the rate of complications after breast reconstruction with a displaced TRAM flap, we carefully selected patients for this choiceof a plastic component. The displaced TRAM flap is one of the variants for delayed breast reconstruction despite its duration and complexity. Corrective surgery is further used to achieve breast symmetry. Corrective operations, namely, breast liposuction and submammary fold formation, were performed in 2 patients. For full breast recovery, the nipple-areolar complex is to be formed following skin-sparing mastectomies and delayed breast reconstructions. The cosmetic effect was evaluated in 11 patients as excellent in 4 (36.4 % cases, good in 7 (63.6 %. Neither local recurrences nor distant

  20. Imaging Surveillance of Patients with Breast Cancer after Primary Treatment: Current Recommendations

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Jung Hyun; Kim, Min Jung; Kim, Eun-Kyung; Moon, Hee Jung [Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul 120-752 (Korea, Republic of)


    Women who have been treated for breast cancer are at risk for second breast cancers, such as ipsilateral recurrence or contralateral metachronous breast cancer. As the number of breast cancer survivors increases, interest in patient management and surveillance after treatment has also increased. However, post-treatment surveillance programs for patients with breast cancer have not been firmly established. In this review, we focus on the imaging modalities that have been used in post-treatment surveillance for patients with breast cancer, such as mammography, ultrasonography, magnetic resonance imaging, and positron emission tomography, the effectiveness of each modality for detecting recurrence, and how they can be applied to manage patients.

  1. Comparison of Patient-reported Outcomes after Implant Versus Autologous Tissue Breast Reconstruction Using the BREAST-Q


    Pirro, Ortensia; Mestak, Ondrej; Vindigni, Vincenzo; Sukop, Andrej; Hromadkova, Veronika; Nguyenova, Alena; Vitova, Lenka; Bassetto, Franco


    Background: The demand for reconstructive breast procedures of various types has accelerated in recent years. Coupled with increased patient expectations, it has fostered the development of oncoplastic and reconstructive techniques in breast surgery. In the setting of postmastectomy reconstruction, patient satisfaction and quality of life are the most significant outcome variables when evaluating surgical success. The aim of this study was to evaluate the quality of life after implant breast ...

  2. Comparison of Patient-reported Outcomes after Implant Versus Autologous Tissue Breast Reconstruction Using the BREAST-Q (United States)

    Pirro, Ortensia; Vindigni, Vincenzo; Sukop, Andrej; Hromadkova, Veronika; Nguyenova, Alena; Vitova, Lenka; Bassetto, Franco


    Background: The demand for reconstructive breast procedures of various types has accelerated in recent years. Coupled with increased patient expectations, it has fostered the development of oncoplastic and reconstructive techniques in breast surgery. In the setting of postmastectomy reconstruction, patient satisfaction and quality of life are the most significant outcome variables when evaluating surgical success. The aim of this study was to evaluate the quality of life after implant breast reconstruction compared with autologous breast reconstruction. Materials and Methods: A cross-sectional study design was used. A total of 65 women who had completed postmastectomy implant-based or autologous reconstruction in the participating center were asked to complete the BREAST-Q (Reconstruction Module). Results: Data analysis demonstrated that women with autologous breast reconstruction were significantly more satisfied with their breasts (P = 0.0003) and with the overall outcome (P = 0.0001) compared with women with implant breast reconstruction. All other BREAST-Q parameters that were considered and observed were not significantly different between the 2 patient groups. Conclusions: Through statistical analysis, our results showed that patients who underwent autologous tissue reconstruction had better satisfaction with the reconstructed breast and the outcome, while both techniques appear to equally improve psychosocial well-being, sexual well-being, and chest satisfaction. PMID:28203513

  3. Background parenchymal enhancement in breast MRIs of breast cancer patients: Impact on tumor size estimation

    Energy Technology Data Exchange (ETDEWEB)

    Baek, Ji Eun [Department of Radiology, Seoul St. Mary' s Hospital, College of Medicine, The Catholic University of Korea (Korea, Republic of); Kim, Sung Hun, E-mail: [Department of Radiology, Seoul St. Mary' s Hospital, College of Medicine, The Catholic University of Korea (Korea, Republic of); Lee, Ah Won [Department of Hospital Pathology, Seoul St. Mary' s Hospital, College of Medicine, The Catholic University of Korea (Korea, Republic of)


    Objective: To evaluate whether the degree of background parenchymal enhancement affects the accuracy of tumor size estimation based on breast MRI. Methods: Three hundred and twenty-two patients who had known breast cancer and underwent breast MRIs were recruited in our study. The total number of breast cancer cases was 339. All images were assessed retrospectively for the level of background parenchymal enhancement based on the BI-RADS criteria. Maximal lesion diameters were measured on the MRIs, and tumor types (mass vs. non-mass) were assessed. Tumor size differences between the MRI-based estimates and estimates based on pathological examinations were analyzed. The relationship between accuracy and tumor types and clinicopathologic features were also evaluated. Results: The cases included minimal (47.5%), mild (28.9%), moderate (12.4%) and marked background parenchymal enhancement (11.2%). The tumors of patients with minimal or mild background parenchymal enhancement were more accurately estimated than those of patients with moderate or marked enhancement (72.1% vs. 56.8%; p = 0.003). The tumors of women with mass type lesions were significantly more accurately estimated than those of the women with non-mass type lesions (81.6% vs. 28.6%; p < 0.001). The tumor of women negative for HER2 was more accurately estimated than those of women positive for HER2 (72.2% vs. 51.6%; p = 0.047). Conclusion: Moderate and marked background parenchymal enhancement is related to the inaccurate estimation of tumor size based on MRI. Non-mass type breast cancer and HER2-positive breast cancer are other factors that may cause inaccurate assessment of tumor size.

  4. Prone Accelerated Partial Breast Irradiation After Breast-Conserving Surgery: Five-year Results of 100 Patients

    Energy Technology Data Exchange (ETDEWEB)

    Formenti, Silvia C., E-mail: [Department of Radiation Oncology, New York University School of Medicine and Langone Medical Center, New York, New York (United States); Hsu, Howard; Fenton-Kerimian, Maria [Department of Radiation Oncology, New York University School of Medicine and Langone Medical Center, New York, New York (United States); Roses, Daniel; Guth, Amber [Department of Surgery, New York University School of Medicine and Langone Medical Center, New York, New York (United States); Jozsef, Gabor [Department of Radiation Oncology, New York University School of Medicine and Langone Medical Center, New York, New York (United States); Goldberg, Judith D. [Division of Biostastistics, Department of Environmental Medicine, New York University School of Medicine and Langone Medical Center, New York, New York (United States); DeWyngaert, J. Keith [Department of Radiation Oncology, New York University School of Medicine and Langone Medical Center, New York, New York (United States)


    Purpose: To report the 5-year results of a prospective trial of three-dimensional conformal external beam radiotherapy (3D-CRT) to deliver accelerated partial breast irradiation in the prone position. Methods and Materials: Postmenopausal patients with Stage I breast cancer with nonpalpable tumors <2 cm, negative margins and negative nodes, positive hormone receptors, and no extensive intraductal component were eligible. The trial was offered only after eligible patients had refused to undergo standard whole-breast radiotherapy. Patients were simulated and treated on a dedicated table for prone setup. 3D-CRT was delivered at a dose of 30 Gy in five 6-Gy/day fractions over 10 days with port film verification at each treatment. Rates of ipsilateral breast failure, ipsilateral nodal failure, contralateral breast failure, and distant failure were estimated using the cumulative incidence method. Rates of disease-free, overall, and cancer-specific survival were recorded. Results: One hundred patients were enrolled in this institutional review board-approved prospective trial, one with bilateral breast cancer. One patient withdrew consent after simulation, and another patient elected to interrupt radiotherapy after receiving two treatments. Ninety-eight patients were evaluable for toxicity, and, in 1 case, both breasts were treated with partial breast irradiation. Median patient age was 68 years (range, 53-88 years); in 55% of patients the tumor size was <1 cm. All patients had hormone receptor-positive cancers: 87% of patients underwent adjuvant antihormone therapy. At a median follow-up of 64 months (range, 2-125 months), there was one local recurrence (1% ipsilateral breast failure) and one contralateral breast cancer (1% contralateral breast failure). There were no deaths due to breast cancer by 5 years. Grade 3 late toxicities occurred in 2 patients (one breast edema, one transient breast pain). Cosmesis was rated good/excellent in 89% of patients with at least 36

  5. Patient Preferences and Physician Practice Patterns Regarding Breast Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Hoopes, David J., E-mail: [Uniformed Services University of the Health Sciences, Department of Radiology and Radiological Sciences, WPAFB, OH (United States); Kaziska, David; Chapin, Patrick [Air Force Institute of Technology, WPAFB, OH (United States); Weed, Daniel [Clarian Healthcare, Methodist Hospital, Department of Radiation Oncology, Indianapolis, IN (United States); Smith, Benjamin D. [M.D. Anderson Cancer Center, Department of Radiation Oncology, Houston, TX (United States); Hale, E. Ronald [Wright-Patterson Medical Center, Department of Radiation Oncology, WPAFB, OH (United States); Johnstone, Peter A. [Indiana University School of Medicine, Department of Radiation Oncology, Indianapolis, IN (United States)


    Purpose: There are multiple current strategies for breast radiotherapy (RT). The alignment of physician practice patterns with best evidence and patient preferences will enhance patient autonomy and improve cancer care. However, there is little information describing patient preferences for breast RT and physician practice patterns. Methods and Materials: Using a reliable and valid instrument, we assessed the preferences of 5,000 randomly selected women (with or without cancer) undergoing mammography. To assess practice patterns, 2,150 randomly selected physician-members of American Society for Radiation Oncology were surveyed. Results: A total of 1,807 women (36%) and 363 physicians (17%) provided usable responses. The 95% confidence interval is < {+-}2.3% for patients and < {+-}5.3% for physicians. Patient preferences were hypofractionated whole breast irradiation (HF-WBI) 62%, partial breast irradiation (PBI) 28%, and conventionally fractionated whole breast irradiation (CF-WBI) 10%. By comparison, 82% of physicians use CF-WBI for more than 2/3 of women and 56% never use HF-WBI. With respect to PBI, 62% of women preferred three-dimensional (3D)-PBI and 38% favor brachytherapy-PBI, whereas 36% of physicians offer 3D-PBI and 66% offer brachytherapy-PBI. 70% of women prefer once-daily RT over 10 days vs. twice-daily RT over 5 days. 55% of physicians who use PBI do not offer PBI on clinical trial. Conclusions: HF-WBI, while preferred by patients and supported by evidence, falls behind the unproven and less preferred strategy of PBI in clinical practice. There is a discrepancy between women's preferences for PBI modality and type of PBI offered by physicians. Further alignment is needed between practice patterns, patient preferences, and clinical evidence.

  6. Manganese Superoxide Dismutase Polymorphism and Breast Cancer Recurrence: A Danish Population-Based Case-Control Study of Breast Cencer Patients Treated with Cyclophosphamide Epirubicin and 5-Fluororacil

    DEFF Research Database (Denmark)

    Ording, Anne Gulbech; Cronin Fenton, Deirdre; Christensen, Mariann


    Manganese Superoxide Dismutase Polymorphism and Breast Cancer Recurrence: A Danish Population-Based Case-Control Study of Breast Cencer Patients Treated with Cyclophosphamide Epirubicin and 5-Fluororacil......Manganese Superoxide Dismutase Polymorphism and Breast Cancer Recurrence: A Danish Population-Based Case-Control Study of Breast Cencer Patients Treated with Cyclophosphamide Epirubicin and 5-Fluororacil...

  7. Manganese Superoxide Dismtase Polymorphism and Breast Cancer Recurrence: A Danish Population-Based Case-Control Study of Breast Cancer Patients Treated with Cyclophosphamide Epirubicin and 5-fluorouracil

    DEFF Research Database (Denmark)

    Ording, Anne Gulbech; Cronin Fenton, Deirdre; Christensen, Mariann


    Manganese Superoxide Dismtase Polymorphism and Breast Cancer Recurrence: A Danish Population-Based Case-Control Study of Breast Cancer Patients Treated with Cyclophosphamide Epirubicin and 5-fluorouracil......Manganese Superoxide Dismtase Polymorphism and Breast Cancer Recurrence: A Danish Population-Based Case-Control Study of Breast Cancer Patients Treated with Cyclophosphamide Epirubicin and 5-fluorouracil...

  8. Sentinel lymph node biopsy in pregnant patients with breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Gentilini, Oreste; Toesca, Antonio; Sangalli, Claudia; Veronesi, Paolo; Galimberti, Viviana [European Institute of Oncology, Division of Senology, Milan (Italy); Cremonesi, Marta; Pedroli, Guido [European Institute of Oncology, Unit of Medical Physics, Milan (Italy); Colombo, Nicola [European Institute of Oncology, Unit of Cardiology, Milan (Italy); Peccatori, Fedro [European Institute of Oncology, Division of Haematology-Oncology, Milan (Italy); Sironi, Roberto [S. Pio X Hospital, Unit of Obstetrics and Gynecology, Milan (Italy); Rotmensz, Nicole [European Institute of Oncology, Division of Epidemiology and Biostatistics, Milan (Italy); Viale, Giuseppe [European Institute of Oncology, Division of Pathology, Milan (Italy); University of Milan School of Medicine, Milan (Italy); Goldhirsch, Aron [European Institute of Oncology, Department of Medicine, Milan (Italy); Veronesi, Umberto [European Institute of Oncology, Division of Senology, Milan (Italy); European Institute of Oncology, Milan (Italy); Paganelli, Giovanni [European Institute of Oncology, Division of Nuclear Medicine, Milano (Italy)


    Sentinel lymph node biopsy (SLNB) is currently not recommended in pregnant patients with breast cancer due to radiation concerns. Twelve pregnant patients with breast cancer received low-dose (10 MBq on average) lymphoscintigraphy using {sup 99m}Tc human serum albumin nanocolloids. The sentinel lymph node (SLN) was identified in all patients. Of the 12 patients, 10 had pathologically negative SLN. One patient had micrometastasis in one of four SLN. One patient had metastasis in the SLN and underwent axillary clearance. From the 12 pregnancies, 11 healthy babies were born with no malformations and normal weight. One baby, whose mother underwent lymphatic mapping during the 26th week of gestation, was operated on at the age of 3 months for a ventricular septal defect and at 43 months was in good health. This malformation was suspected at the morphological US examination during week 21, well before lymphoscintigraphy, and was confirmed a posteriori by a different observer based on videotaped material. No overt axillary recurrence appeared in the patients with negative SLNs after a median follow-up of 32 months. Our experience supports the safety of SLNB in pregnant patients with breast cancer, when performed with a low-dose lymphoscintigraphic technique. (orig.)

  9. Phyllodes Tumor of the Breast: Analysis of 48 Patients (United States)

    Kılıç, Murat Özgür; Terzioğlu, Serdar Gökay; Bozkurt, Betül; Dağlar, Gül


    Objective Phyllodes tumor (PT) is a rare biphasic breast neoplasm that accounts for less than 1% of all breast tumors. The aim of this study was to evaluate the clinicopathologic features, diagnostic difficulties, and therapeutic outcomes of patients with PT. Materials and Methods A total of 48 female patients who underwent surgery for PT were included in the study. Patient characteristics, clinicopathologic features of tumors, diagnostic findings, surgical outcomes, adjuvant therapies, and follow-up findings were retrospectively evaluated. Results The mean age of patients was 35 years. Painless breast mass was the most common (85.4%) presenting symptom. Total excision with at least 1 cm macroscopic clear margins was the most frequently performed (87.5%) surgery. Most patients (n=34, 70.8%) had benign PT; however, borderline and malignant tumors were found in 9 (18.8%) and 5 (10.4%) patients, respectively. During the mean follow-up period of approximately 30 months, local and distant recurrence was detected in three (6.3%) patients and one (2.1%) patient, respectively. Patients with malignant PT had larger tumors than those with benign and borderline PTs (p=0.010). No significant difference in other clinical, diagnostic, and pathologic characteristics was found between the groups. Conclusion PT can be easily confused with other breast masses such as fibroadenoma due to the non-specific clinical and radiologic findings. Surgical excision with at least 1 cm clear margins is of great importance to reduce the risk of local recurrence. However, recurrence can develop even after appropriate surgery, thus patients should be closely followed up after surgery. PMID:28331755

  10. Efficacy of interventions to improve sleep quality among patients with breast cancer : a systematic review


    Li, Xueqi; 李雪琪


    Introduction: Breast cancer is the most common cancer in women. While advances in therapeutic approaches have improved the survival of breast cancer patients, it is important to improve the quality of life among the cancer survivors. Sleep disturbance is one of the most important problems for breast cancer patients that substantially reduced their quality of life. Many interventions have been developed for improving sleep quality for breast cancer patients. The aim of this review is firstly t...

  11. A call for clarity in infant breast and bottle-feeding definitions for research. (United States)

    Thulier, Diane


    Unclear and inconsistent infant-feeding definitions have plagued much of breastfeeding research. To determine accurate health outcomes associated with infant feeding, it is imperative that different types of feedings be explicitly described. Definitions must be based on content, not mode of milk delivery. Five new definitions for infant feeding are provided. These definitions are operationally useful for breastfeeding researchers, allowing for the inclusion of almost every infant into an appropriate sample group.

  12. Endometrial polyp surveillance in premenopausal breast cancer patients using tamoxifen (United States)

    Jeon, Se Jeong; Lee, Jae Il; Kim, Hee Seung; Kim, Jae Weon; Park, Noh Hyun; Song, Yong Sang


    Objective To describe the endometrial pathologic lesions in premenopausal breast cancer patients with a history of tamoxifen (TMX) use. Methods We retrospectively reviewed the medical records of 120 premenopausal breast cancer patients with a history of TMX use that had undergone a gynecological examination. Results Among 120 patients, 44.2% (n=53) were asymptomatic with an endometrial thickness ≥5 mm, as assessed by transvaginal ultrasonography. Of the patients that reported abnormal uterine bleeding, 5% (n=6) had an endometrial thickness <5 mm and 20% (n=24) had an endometrial thickness ≥5 mm by transvaginal ultrasonography. The final group of patients were asymptomatic, but showed an abnormal endometrial lesion, such as an endometrial polyp, by transvaginal ultrasonography (30.8%, n=37). Of the 56 benign lesions that were histologically reviewed, 50 (41.7%) were endometrial polyps, 3 (2.5%) were submucosal myomas, 2 (1.7%) were endometrial hyperplasias, and 1 (0.8%) was chronic endometritis. There were 64 (53.3%) other non-pathologic conditions, including secreting, proliferative, and atrophic endometrium, or in some cases, there was insufficient material for diagnosis. In our data, only one case was reported as a complex hyperplasia without atypia arising from an endometrial polyp, and one patient was diagnosed with endometrioid adenocarcinoma. Conclusion For premenopausal breast cancer patients with a history of TMX use, the majority of the patients were asymptomatic, and endometrial polyps were the most common endometrial pathology observed. Therefore, we believe that endometrial assessment before starting TMX treatment, and regular endometrial screening throughout TMX treatment, are reasonable suggestions for premenopausal breast cancer patients. PMID:28217668

  13. Foot massage: effectiveness on postoperative pain in breast surgery patients. (United States)

    Ucuzal, Meral; Kanan, Nevin


    The aim of this study was to determine the effect of foot massage on pain after breast surgery, and provide guidance for nurses in nonpharmacologic interventions for pain relief. This was a quasiexperimental study with a total of 70 patients who had undergone breast surgery (35 in the experimental group and 35 in the control group). Patients in the control group received only analgesic treatment, whereas those in the experimental group received foot massage in addition to analgesic treatment. Patients received the first dose of analgesics during surgery. As soon as patients came from the operating room, they were evaluated for pain severity. Patients whose pain severity scored ≥4 according to the Short-Form McGill Pain Questionnaire were accepted into the study. In the experimental group, pain and vital signs (arterial blood pressure, pulse, and respiration) were evaluated before foot massage at the time patients complained about pain (time 0) and then 5, 30, 60, 90, and 120 minutes after foot massage. In the control group, pain and vital signs were also evaluated when the patients complained about pain (time 0) and again at 5, 30, 60, 90, and 120 minutes, in sync with the times when foot massage was completed in the experimental group. A patient information form was used to collect descriptive characteristics data of the patients, and the Short-Form McGill Pain Questionnaire was used to determine pain severity. Data were analyzed for frequencies, mean, standard deviation, chi-square, Student t, Pillai trace, and Bonferroni test. The results of the statistical analyses showed that patients in the experimental group experienced significantly less pain (p ≤ .001). Especially notable, patients in the experimental group showed a decrease in all vital signs 5 minutes after foot massage, but patients in the control group showed increases in vital signs except for heart rate at 5 minutes. The data obtained showed that foot massage in breast surgery patients was

  14. Anxiolytic Effect of Aromatherapy Massage in Patients with Breast Cancer


    Jiro Imanishi; Hiroko Kuriyama; Ichiro Shigemori; Satoko Watanabe; Yuka Aihara; Masakazu Kita; Kiyoshi Sawai; Hiroo Nakajima; Noriko Yoshida; Masahiro Kunisawa; Masanori Kawase; Kenji Fukui


    We examined how aromatherapy massage influenced psychologic and immunologic parameters in 12 breast cancer patients in an open semi-comparative trial. We compared the results 1 month before aromatherapy massage as a waiting control period with those during aromatherapy massage treatment and 1 month after the completion of aromatherapy sessions. The patients received a 30 min aromatherapy massage twice a week for 4 weeks (eight times in total). The results showed that anxiety was reduced in on...

  15. Smoking and survival in male breast cancer patients. (United States)

    Padron-Monedero, Alicia; Koru-Sengul, Tulay; Tannenbaum, Stacey L; Miao, Feng; Hansra, Damien; Lee, David J; Byrne, Margaret M


    The purpose of the article was to assess whether smoking affects survival in male breast cancer patients for the overall population and when stratified by race, ethnicity, and socioeconomic status. Data were obtained by linking the 1996-2007 Florida Cancer Data System, the Florida Agency for Health Care Administration, and the US Census. Inclusion criteria were males ≥18 years, diagnosed with breast cancer and residing in Florida (n = 1573). To analyze the association between smoking and survival, we performed sequential multivariate Cox proportional hazards regression models with progressive adjustment for main confounders. Compared to never smokers, worse survival was found in current (hazard ratio = 1.63; 95 % CI = 1.23-2.16) but not in former smokers (1.26; 0.99-1.59). Those who smoked ≥1 packs/day had worse survival (2.48; 1.59-3.87) than never smokers with a significant dose-response (P for linear trend survival, which was worse by intensity of smoking. Also, any smoking history is associated with worse survival in White and non-Hispanic male breast cancer patients compared to never smokers. Thus, male breast cancer patients should be advised to quit smoking.

  16. Breast-feeding, return of menses, sexual activity and contraceptive practices among mothers in the first six months of lactation in Onitsha, South Eastern Nigeria. (United States)

    Egbuonu, I; Ezechukwu, C C; Chukwuka, J O; Ikechebelu, J I


    The objective of this study was to determine the exclusive breast-feeding practices, return of menstruation, sexual activity and contraceptive practices among breast-feeding mothers in the first six months of lactation. The study was based in Onitsha, South Eastern Nigeria. A structured questionnaire was used to obtain data from breast-feeding mothers on their age, educational attainment, breast-feeding practices, return of menstruation, sexual activity and contraceptive practices within the first six months of lactation at intervals of 6 weeks, 10 weeks 14 weeks and 6 months post delivery. Analysis of the information obtained showed that out of the 178 mothers who participated in the study 81% of the mothers were within the ages of 20 - 34 years. While all the mothers had formal education, the majority (59%) had secondary education. Seventy-three percent initiated breast-feeding within one hour of delivery. On discharge from hospital, all of them had already established breast-feeding which continued up to six weeks and dropped to 97.8% at six months. Exclusive breast-feeding which was practised by 100% on discharge dropped to 3.9% at six months. The feeding regimen was on demand as practised by 98.9% of the mothers. Menstrual flow had returned in 33.8% of the mothers by 6 weeks of lactation, and had risen to 70.2% at six months. There was more prolonged lactational amenorrheoa in exclusively breast-feeding mothers than in those who were not. By 6 weeks post delivery 31.6% of the mothers had resumed sexual activity and this rose to 93.6% at six months. With the resumption of sexual activity only 5% of the mothers resorted to contraceptive practices other than lactational amenorrhea and this increased to 54% at six months. There was no pregnancy in any of these women during the six months period. While appreciating the role of lactational amenorrhea in child spacing and considering the early return of sexual activity among the mothers the practice of introducing

  17. Influence of preoperative MRI on the surgical management of patients with operable breast cancer.

    NARCIS (Netherlands)

    Braun, M.; Polcher, M.; Schrading, S.; Zivanovic, O.; Kowalski, T.; Flucke, U.; Leutner, C.; Park-Simon, T.W.; Rudlowski, C.; Kuhn, W.; Kuhl, C.K.


    PURPOSE: Evaluation of the impact of preoperative magnetic resonance imaging (MRI) of the breast on the clinical management of patients with operable breast cancer (BC). METHODS: Retrospective analysis of 160 patients with operable breast cancer (stages Tis through T4), treated from 2002 through 200

  18. Chromosomal instability in the lymphocytes of breast cancer patients

    Directory of Open Access Journals (Sweden)

    Harsimran Kaur


    Full Text Available Genomic instability in the tumor tissue has been correlated with tumor progression. In the present study, chromosomal aberrations (CAs in peripheral blood lymphocytes (PBLs of breast tumor patients were studied to assess whether chromosomal instability (CIN in PBLs correlates with aggressiveness of breast tumor (i.e., disease stage and has any prognostic utility. Cultured blood lymphocyte metaphases were scored for aberrations in 31 breast cancer patients and 20 healthy age and sex-matched controls. A variety of CAs, including aneuploidy, polyploidy, terminal deletions, acentric fragments, double minutes, chromatid separations, ring chromosome, marker chromosome, chromatid gaps, and breaks were seen in PBLs of the patients. The CAs in patients were higher than in controls. A comparison of the frequency of metaphases with aberrations by grouping the patients according to the stage of advancement of disease did not reveal any consistent pattern of variation in lymphocytic CIN. Neither was any specific chromosomal abnormality found to be associated with the stage of cancer. This might be indicative of the fact that cancer patients have constitutional CIN, which predisposes them to the disease, and this inherent difference in the level of genomic instability might play a role in disease progression and response to treatment.


    Directory of Open Access Journals (Sweden)

    Manoharan Preeth


    Full Text Available Depression is a common symptom in cancer patients, which is difficult to be detected and consequently to be treated. It deteriorates over the course of cancer treatment, persists long after the end of therapy and influences negatively the quality of life. The aim of this study was to examine the prevalence rate and level anxiety and depression in breast cancer patient using HAD scale.The study was conducted on 94 female patients suffering from various stages of breast cancer. Patients included who were in the age group between 18-65yrs, estimated survival time more than six months, ability to speak and patients were excluded if they were affected by known mental disorder and metastasis in brain. Demographic data was collected from each patient’s medical record e.g. cancer type, date of cancer diagnosis, extension of the diseases, sites of metastasis, estimated life time. Levels of anxiety and depression were self rated by HADS (hospital anxiety and depression scaleOut of 94 patients twenty patients (21% were reported as mild depression (mean score 8.93 and 23 (24% patients as mild anxiety (mean score 9.42 likewise five Patients were reported as (positive cases chronic depression (mean score is 12.23 and six patients as chronic anxiety.(mean score is 12.23 The results of this present study clearly demonstrated that prevalence of anxiety and depression rates depended on the patients’ educational level, age, occupation, menopause and diagnosis period. Our study found that the depression and anxiety were common in most of the patients affected with breast cancer is also there was no relation between the anxiety and depression and stages of diseases. We think that this study needs to be extended in the future to involve more patient is may be further be tested to evaluate the same sample again, after psychiatric intervention is carried out.

  20. Breast Cancer Diagnosed During Pregnancy: Adapting Recent Advances in Breast Cancer Care for Pregnant Patients. (United States)

    Loibl, Sibylle; Schmidt, André; Gentilini, Oreste; Kaufman, Bella; Kuhl, Christine; Denkert, Carsten; von Minckwitz, Gunter; Parokonnaya, Anastasia; Stensheim, Hanne; Thomssen, Christoph; van Calsteren, Kristel; Poortmans, Philip; Berveiller, Paul; Markert, Udo R; Amant, Frederic


    Breast cancer during pregnancy (BCP), although rare, is becoming more common and treatment should be as similar as possible to that for nonpregnant young patients with breast cancer. A group of specialists convened to review current guidelines and provide guidance on how recent advances in breast cancer diagnosis and treatment can be adapted for pregnant patients. The majority of patients with BCP will be considered for treatment during the pregnancy. Premature delivery should be avoided whenever possible. Most treatments, including sentinel lymph node biopsy, systemic therapy with taxanes, platinum agents, or dose-dense treatment can be safely given during pregnancy, after careful risk/benefit assessment for mother and child. Chemotherapy is contraindicated during the first trimester because of a higher risk of fetal malformations but is feasible in the second and third trimesters. Other treatments such as radiation therapy or anti-human epidermal growth receptor 2 treatment are in general not indicated during pregnancy but might be considered in some instances. Patient data should be collected in a systematic way whenever possible.

  1. Types of Breast Pumps (United States)

    ... Devices Consumer Products Breast Pumps Types of Breast Pumps Share Tweet Linkedin Pin it More sharing options ... used for feeding a baby. Types of Breast Pumps There are three basic types of breast pumps: ...

  2. Letrozole Induced Hypercalcemia in a Patient with Breast Cancer

    Directory of Open Access Journals (Sweden)

    Suleyman Hilmi Ipekci


    Full Text Available Hypersecretion of PTHrP is a relatively common cause of malignancy-related hypercalcemia. However, there is only one case report of letrozole induced hypercalcemia. A 52-year-old female patient was referred to our clinic because of the recent discovery of hypercalcemia (11.0 mg/dL. The patient had a history of left breast carcinoma. She had started a course of letrozole (aromatase inhibitor; 2.5 mg dose/day ten months earlier. Patient’s parathyroid hormone-related protein levels were normal and a bone scintigram revealed no evidence of skeletal metastasis. Other potential causes of high calcium levels were ruled out. We recognized that, when letrozole was taken at one dose daily (2.5 mg, she had recurrent hypercalcemia. Our experience suggests that letrozole may precipitate hypercalcemia in a patient with breast cancer.

  3. Anxiolytic Effect of Aromatherapy Massage in Patients with Breast Cancer

    Directory of Open Access Journals (Sweden)

    Jiro Imanishi


    Full Text Available We examined how aromatherapy massage influenced psychologic and immunologic parameters in 12 breast cancer patients in an open semi-comparative trial. We compared the results 1 month before aromatherapy massage as a waiting control period with those during aromatherapy massage treatment and 1 month after the completion of aromatherapy sessions. The patients received a 30 min aromatherapy massage twice a week for 4 weeks (eight times in total. The results showed that anxiety was reduced in one 30 min aromatherapy massage in State-Trait Anxiety Inventory (STAI test and also reduced in eight sequential aromatherapy massage sessions in the Hospital Anxiety and Depression Scale (HADS test. Our results further suggested that aromatherapy massage ameliorated the immunologic state. Further investigations are required to confirm the anxiolytic effect of aromatherapy in breast cancer patients.

  4. Time trends in axilla management among early breast cancer patients

    DEFF Research Database (Denmark)

    Gondos, Adam; Jansen, Lina; Heil, Jörg;


    Background We examined time trends in axilla management among patients with early breast cancer in European clinical settings. Material and methods EUROCANPlatform partners, including population-based and cancer center-specific registries, provided routinely available clinical cancer registry data...... for a comparative study of axillary management trends among patients with first non-metastatic breast cancer who were not selected for neoadjuvant therapy during the last decade. We used an additional short questionnaire to compare clinical care patterns in 2014. Results Patients treated in cancer centers were...... younger than population-based registry populations. Tumor size and lymph node status distributions varied little between settings or over time. In 2003, sentinel lymph node biopsy (SLNB) use varied between 26% and 81% for pT1 tumors, and between 2% and 68% for pT2 tumors. By 2010, SLNB use increased to 79...

  5. An investigation of plasma and salivary oxytocin responses in breast- and formula-feeding mothers of infants. (United States)

    Grewen, Karen M; Davenport, Russell E; Light, Kathleen C


    Oxytocin (OT) is a peptide increasingly studied in relation to human social interactions, affiliation, and clinical disorders. Studies are constrained by use of invasive blood draws and would benefit from a reliable salivary OT assay. Our goals were to examine feasibility of salivary OT measurement, compare salivary to plasma OT responses in 12 breast- and 8 formula-feeding mothers, and assess the degree of correlation between plasma and salivary OT. Using a commercial EIA kit, we measured OT in 5 saliva and 7 plasma samples in a protocol designed to elicit changes in OT (Rest, Infant Interaction, Stress, Feeding). Breast-feeders had higher OT levels than formula-feeders across all conditions in plasma (+36%) and saliva (+23%). OT levels and ranges were similar in saliva and plasma, with slightly greater variance in saliva. Concurrently sampled plasma and salivary OT were correlated at end of Baseline Rest (r=+.59, p=.022) and Post-Stress Recovery (r=+.59, p=.025). These data suggest that salivary OT assay is feasible, and will be of value where plasma samples are not possible. Validation with larger samples is needed.

  6. Circulating Tumor Cells in Breast Cancer Patients: An Evolving Role in Patient Prognosis and Disease Progression

    Directory of Open Access Journals (Sweden)

    Holly Graves


    Full Text Available In this paper, we examine the role of circulating tumor cells (CTCs in breast cancer. CTCs are tumor cells present in the peripheral blood. They are found in many different carcinomas but are not present in patients with benign disease. Recent advances in theories regarding metastasis support the role of early release of tumor cells in the neoplastic process. Furthermore, it has been found that phenotypic variation exists between the primary tumor and CTCs. Of particular interest is the incongruency found between primary tumor and CTC HER2 status in both metastatic and early breast cancer. Overall, CTCs have been shown to be a poor prognostic marker in metastatic breast cancer. CTCs in early breast cancer are not as well studied, however, several studies suggest that the presence of CTCs in early breast cancer may also suggest a poorer prognosis. Studies are currently underway looking at the use of CTC level monitoring in order to guide changes in therapy.

  7. PAM50 breast cancer intrinsic subtypes and effect of gemcitabine in advanced breast cancer patients

    DEFF Research Database (Denmark)

    Jørgensen, Charlotte Levin Tykjær; Nielsen, Torsten O; Bjerre, Karsten D


    chemotherapy were analyzed by the Kaplan-Meier method, and Cox proportional hazards regression models. Data analysis was performed independently by the Danish Breast Cancer Cooperative Group (DBCG) statistical core and all statistical tests were two-sided. RESULTS: RNA from 270 patients was evaluable; 84...... by NanoString nCounter. Statistical analyses were prespecified as a formal prospective-retrospective clinical trial correlative study. Using time to progression (TTP) as primary endpoint, overall survival (OS) and response rate as secondary endpoints, relationships between subtypes and outcome after......: A significantly improved and clinically important prolongation of survival was seen from the addition of gemcitabine to docetaxel in advanced basal-like breast cancer patients....

  8. True Local Recurrences after Breast Conserving Surgery have Poor Prognosis in Patients with Early Breast Cancer (United States)

    Sarsenov, Dauren; Ilgun, Serkan; Ordu, Cetin; Alco, Gul; Bozdogan, Atilla; Elbuken, Filiz; Nur Pilanci, Kezban; Agacayak, Filiz; Erdogan, Zeynep; Eralp, Yesim; Dincer, Maktav


    Background: This study was aimed at investigating clinical and histopathologic features of ipsilateral breast tumor recurrences (IBTR) and their effects on survival after breast conservation therapy. Methods: 1,400 patients who were treated between 1998 and 2007 and had breast-conserving surgery (BCS) for early breast cancer (cT1-2/N0-1/M0) were evaluated. Demographic and pathologic parameters, radiologic data, treatment, and follow-up related features of the patients were recorded. Results: 53 patients (3.8%) had IBTR after BCS within a median follow-up of 70 months. The mean age was 45.7 years (range, 27-87 years), and 22 patients (41.5%) were younger than 40 years. 33 patients (62.3%) had true recurrence (TR) and 20 were classified as new primary (NP). The median time to recurrence was shorter in TR group than in NP group (37.0 (6-216) and 47.5 (11-192) months respectively; p = 0.338). Progesterone receptor positivity was significantly higher in the NP group (p = 0.005). The overall 5-year survival rate in the NP group (95.0%) was significantly higher than that of the TR group (74.7%, p 20 mm), high grade tumor and triple-negative molecular phenotype along with developing TR negatively affected overall survival (hazard ratios were 4.2 (CI 0.98-22.76), 4.6 (CI 1.07-13.03), 4.0 (CI 0.68-46.10), 6.5 (CI 0.03-0.68), and 6.5 (CI 0.02- 0.80) respectively, p 2 cm), high grade, triple negative phenotype, and having true recurrence were identified as independent prognostic factors with a negative impact on overall survival in this dataset of patients with recurrent breast cancer. In conjunction with a more intensive follow-up program, the role of adjuvant therapy strategies should be explored further in young patients with large and high-risk tumors to reduce the risk of TR. PMID:27158571

  9. Herpes zoster in breast cancer patients after radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Dunst, J.; Steil, B.; Furch, S.; Fach, A. [Halle-Wittenberg Univ., Halle (Germany). Dept. of Radiotherapy; Bormann, G.; Marsch, W. [Halle-Wittenberg Univ., Halle (Germany). Dept. of Dermatology


    Purpose: We have studied the incidence of herpes zoster in patients with adjuvant radiotherapy for breast cancer with special emphasis on possible correlations with other prognostic factors or survival. Patients and Methods: From 1/1985 through 12/1993, 1 155 breast cancer patients received postoperative radiotherapy with curative intent in our department. After mastectomy 961 patients were irradiated and after breast-preserving treatment 194 patients. The age ranged from 34 to 79 years, the median follow-up was 3.1 years (range: 0.3 to 12.4 years). There were 443 women (38%) pre- and 712 (62%) postmenopausal. 21% had T3- to T4-tumors, 55% had axillary lymph node involvement, and 65% received additional systemic hormonal and/or cytotoxic therapy. In case of postmastectomy radiotherapy, the lateral chest wall and lymphatics (axilla, parasternal and supraclavicular nodes) were irradiated with an anterior photon field to 50 Gy (axilla 44 Gy) and most of the chest wall with an electron field to 44 Gy in 2-Gy fractions. After breast-preservation, the breast was irradiated via tangential fields with 6- to 8-MV photons up to 50 Gy plus 8 Gy electron boost to the tumor bed. Most of the patients were followed routinely in the department for 2 to 5 years. The frequency of zoster was determined retrospectively by reviewing the patients' records. Results: A zoster after radiotherapy occurred in 41/1 155 patients (3.7%), mostly within the first 2 years after completion of radiotherapy. All infections remained localized and there was no evidence for systemic infections. Type of treatment (mastectomy vs breast-preservation) had no impact on the frequency of herpes zoster (36/961 patients after mastectomy and 5/194 patients after breast-preservation). There was also no correlation with other prognostic factors such as age, menopausal status, stage of disease or the use of adjuvant chemotherapy, nor was the occurrence of zoster linked to the degree of acute skin reaction in

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

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


    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.

  11. 乳旁加奶在母乳喂养中的应用%Application of the Breast Milk in the Breast Feeding

    Institute of Scientific and Technical Information of China (English)



    目的探讨使用乳旁加奶器混合喂养对母婴的影响。方法选择400组新生儿及其母亲随机分为观察组和对照组各200组。观察组以纯母乳喂养为基础,适时采用乳旁加奶器混合喂养方法,对照组实施纯母乳喂养。结果观察组的母亲睡眠状况、胎便排泄持续时间、每天排尿次数及新生儿睡眠质量,新生儿生理性黄疸消退时间均优于对照组,母乳达充足时间无差别。结论:母乳是新生儿最理想的天然食品,但在早期乳量不足的情况下,适时采用乳旁加奶的方法,可提高母亲及新生儿的睡眠质量、预防新生儿脱水、增加小便次数、促进大便排出,新生儿黄疸消退较快,更有利于新生儿的生长。%Objective Margin milk is mixed with milk feeding ef ects on maternal and infant.Methods Select 400 newborns and their mothers were randomly divided into observation group and control group 200 each set. Observation group based on pure breast-feeding, timely adopt next to the milk and milk mixed feeding method, the control implementation of exclusive breastfeeding.Results Observation group's mother sleep duration, meconium excretion, micturition number every day, and neonatal sleep quality,Neonatal physiological jaundice faded time were superior to control group, there was no dif erence in the breast milk of time.Conclusion Breast milk is a new student the most ideal natural food, but in the case of insuf icient early milk volume, timely adopt the method of near the milk white, to improve the quality of mothers and newborns sleep, prevent dehydration, to increase the number to urinate, and promote defecate eduction, neonatal jaundice subsided quickly, more conducive to the growth of newborns.

  12. Conditional disease-free survival among patients with breast cancer. (United States)

    Paik, Hyun-June; Lee, Se Kyung; Ryu, Jai Min; Park, Sungmin; Kim, Isaac; Bae, Soo Youn; Yu, Jonghan; Lee, Jeong Eon; Kim, Seok Won; Nam, Seok Jin


    Conditional disease-free survival (CDFS) reflects changes over time. Because traditional disease-free survival (DFS) is estimated from the date of diagnosis, it is limited in the ability to predict risk of recurrence in patients who have been disease free. In this study, we determined CDFS of breast cancer patients and estimated the prognostic factors for DFS.We retrospectively reviewed clinical data of 7587 consecutive patients who underwent curative surgery for breast cancer between January 2004 and December 2013 at Samsung Medical Center. Univariate and multivariate analyses were performed to identify risk factors for DFS, which was computed using the Kaplan-Meier method. CDFS rates were based on cumulative DFS estimates.Median follow-up duration was 20.59 months. Three-year DFS was 93.46% at baseline. Three-year CDFS survival estimates for patients who had been disease free for 1, 2, 3, 4, and 5 years after treatment were calculated as 92.84%, 92.37%, 93.03%, 89.41%, and 79.64%, respectively. Three-year CDFS increased continuously each year after 1 year of DFS in hormone receptor (HR)-negative patients but decreased each year in HR-positive patients.In HR-positive patients who are disease free after 3 years, continuous care including surveillance and metastases workup should be considered, although this is not recommended in the current guidelines. On the other hand, the social costs may be reduced in HR-negative patients by extending the surveillance interval. Further studies are needed to identify indicators of DFS prognosis in breast cancer patients.


    Institute of Scientific and Technical Information of China (English)

    王书文; 和新盈; 石景森; 赵东利; 李明众; 王诚; 薛文华


    Objective: To evaluate the safety and efficacy of external high-intensity focused ultrasound(HIFU) castration for breast cancerous patients after mastectomy if they are at a high risk of recurrence. Methods: We recruited 52 consecutive patients with primary operable breast cancer who were treated with mastectomy with excision of regional lymph nodes. Patients were positive for ER and PR immuno- cytochemical staining, node-positive, un-menopause, over 40 years old and were divided into two groups randomly. For castration, 26 patients received one or two times of HIFU treatment within five days, and the other patients received radiotherapy with DT 18Gy/9 f/11days. During and after the treatment, local changes and systemic response of the patients were observed. Results: After 1 month treatment, levels of serum E1 and E2 were significantly decreased compared to before treatment in HIFU groups (P<0.01 and P<0.001). The same changes were occurred in radiotherapy(RT) groups (P<0.05 and P<0.01). The levels of serum E1 or E2 in RT groups were higher than in HIFU groups (P<0.05). The symptom distribution of 'climacteric syndrome' of HIFU groups were significantly different from RT groups (P<0.01). The follow-up time was 4 months. The incidence of amenorrhea was 100% in all patients. No serious complications were seen. The temperature, pulse, blood pressure, and respiratory rate of the patients were almost normal. Conclusion: We have shown that the use of HIFU in the castrating of patients with breast cancer is feasible, safe and effective. This technology may provide a rapid noninvasive alterative to conventional bilateral oophorectomy or RT castration.

  14. SU-E-T-292: Dosimetric Advantage of Prone Breast Radiotherapy for Korean Left-Sided Breast Cancer Patients

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Y; Shin, J; Yu, J; Park, W; Choi, D; Huh, S; Han, Y; Kim, J [Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)


    Purpose: To evaluate the dosimetric benefit of prone breast radiotherapy for Korean left-sided early-stage breast cancer patients who have relatively small breast Methods: From April to June, 2014, 10 left-sided breast cancer patients received the whole breast irradiation in prone position after partial mastectomy with sentinel lymph node biopsy or axillary lymph node dissection. All patients were pTmi-2N0-1mi. Each patient underwent two computed tomoradiography (CT) simulations in supine and prone positions. The whole breast, ipsilateral lung, heart, and left anterior descending coronary artery (LAD) were contoured on each simulation CT images, and then tangential-fields treatment plan in each position was designed for the whole breast irradiation with the total dose of 50 Gy in 2 Gy fractions. Dose-volume histograms of two setups were compared for target coverage and radiation dose to normal organs with Wilcoxon signed rank tests. Results: The median age of patients was 47 years (range, 37 to 53). The median chest size was 82.5 cm (range, 75 to 90) and bra cup size was A in 4, B in 4, and C in 2 patients. The radiation dose to the whole breast was similar when comparing mean dose (Dmean) and dose covering 95% of the breast volume, but maximum dose (Dmax) of breast was higher in supine (median 52.3 vs. 52.7 Gy, p=0.013). Prone position reduced significantly the radiation dose in ipsilateral lung, heart, and LAD by median 5.7, 1.1, and 6.9 Gy of Dmean (p=0.005, 0.007, and 0.005) and 28.2, 18.8, and 35.0 Gy of Dmax (p=0.005, 0.005, and 0.007), respectively. Conclusion: Prone breast radiotherapy could be beneficial for Korean breast cancer patients since it substantially spared normal organs while achieving adequate coverage of the breast tissue. Further prospective study is required to validate the potential benefit of prone breast radiotherapy.

  15. Alimentação do recém-nascido pré-termo: aleitamento materno, copo e mamadeira Feeding preterm infants: breast, cup and bottle

    Directory of Open Access Journals (Sweden)

    Andréa Monteiro Correia Medeiros


    Full Text Available OBJETIVO: Verificar a oferta de seio materno em bebês nascidos pré-termos, internados na Unidade de Terapia Intensiva do Hospital e Maternidade Neomater, relacionando este dado com a forma de oferecer a dieta (copo ou mamadeira, na ausência da mãe, e a estimulação fonoaudiológica realizada. MÉTODOS: Participaram 48 recém-nascidos prematuros, com idade gestacional inferior ou igual a 36 6/7 semanas, com peso PURPOSE: To assess the offer of the maternal breast in preterm babies hospitalized at the Intensive Care Unit of the Hospital and Maternity Neomater, linking this datum with the manner to feed them (cup or bottle in the absence of the mother, and the speech-language stimulation carried out. METHODS: Forty-eight newborn preterm infants with gestational age less than or equal to 36 6/7 weeks, weighting <2500 grams and with stable respiratory pattern participated in this study. The newborns were divided into two groups: group A (35 newborns with bottle feeding, and group B (13 newborns with cup feeding. Speech-Language Pathology monitoring was organized in Stage 1 (non-nutritive sucking in "gloved finger" or "empty breast" concomitant with enteral feeding; Stage 2 (oral feeding offer - maternal breast, bottle or cup - with complement provided by enteral feeding; Stage 3 (exclusive oral feeding offer - maternal breast, bottle or cup; Stage 4 (effective breastfeeding offer. A comparison was carried out between the groups regarding the number of days in each phase. Data were statistically analyzed using the independent t-test, with significance level of 5%. RESULTS: There were no significant differences between the groups for any of the studied parameters. Breast feeding was equally accepted by newborns in the cup and the bottle groups. CONCLUSION: Breast feeding can be equally accepted, regardless the alternative feeding form used (cup or bottle, provided that there is adequate Speech-Language Pathology monitoring and encouragement to

  16. Acupuncture relieves menopausal discomfort in breast cancer patients

    DEFF Research Database (Denmark)

    Bokmand, Susanne; Flyger, Henrik


    BACKGROUND: This study evaluates the effect of acupuncture on hot flashes and disturbed night sleep in patients treated for breast cancer. The effect of acupuncture was tested against a sham-acupuncture group and a no-treatment control group. Plasma estradiol was measured to rule out this as cause...... of effect. Side effects of the treatment were registered. METHODS: We randomized 94 women into the study: 31 had acupuncture, 29 had sham acupuncture and 34 had no treatment. FINDINGS: In the acupuncture group, 16 patients (52%) experienced a significant effect on hot flashes compared with seven patients...

  17. Serum midkine expression in breast cancer patients and its clinical significance

    Institute of Scientific and Technical Information of China (English)

    Min Zhang


    Objective:To study serum midkine expression in breast cancer patients and its clinical significance.Methods: A total of 45 cases of patients with breast cancer and 45 cases of patients with benign breast tumor were selected for study, breast tumor specimens were collected to detect mRNA content of MK and serum was collected to detect protein content of MK; breast cancer MCF-7 cell lines were cultured and transfected with varying concentrations of MK expression plasmid, and then cell proliferation and apoptosis, VEGF expression in media as well as MMPs and TIMPs expression in cells was detected.Results:MK expression in breast tissue and serum MK content of breast cancer patients were higher than those of benign breast tumor patients, and MK expression in breast tissue and serum MK content of breast cancer patients with TNMⅢ/Ⅳ stage, low/un-differentiation and lymph node metastasis were higher than those of breast cancer patients with TNMⅠ/Ⅱ stage, medium/high differentiation and without lymph node metastasis; MK expression plasmid could dose-dependently increase mRNA content and protein content of MK in breast cancer cell lines, increase cell viability and decrease apoptosis percentage; VEGFA, VEGFB and VEGFC contents in media as well as MMP2 and MMP9 contents in cells of 100.0 μg/mL plasmid group were significantly higher than those of 0 μg/mL plasmid group, and contents of TIMP1 and TIMP2 in cells were significantly lower than those of 0 μg/mL plasmid group.Conclusion:Serum midkine content in breast cancer patients abnormally rises, and high expression of MK can induce breast cancer cell proliferation, inhibit breast cancer cell apoptosis and promote angiogenesis and cell invasion.

  18. Defining the Survival Benchmark for Breast Cancer Patients with Systemic Relapse


    Zeichner, Simon B.; Tadeu Ambros; John Zaravinos; Montero, Alberto J.; Mahtani, Reshma L; Ahn, Eugene R; Aruna Mani; Markward, Nathan J; Vogel, Charles L.


    BACKGROUND Our original paper, published in 1992, reported a median overall survival after first relapse in breast cancer of 26 months. The current retrospective review concentrates more specifically on patients with first systemic relapse, recognizing that subsets of patients with local recurrence are potentially curable. METHODS Records of 5,168 patients from a largely breast-cancer-specific oncology practice were reviewed to identify breast cancer patients with their first relapse between ...

  19. 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


    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.

  20. Breast magnetic resonance imaging in patients with occult breast carcinoma: evaluation on feasibility and correlation with histopathological findings

    Institute of Scientific and Technical Information of China (English)

    LU Hong; XU Yi-lin; ZHANG Shu-ping; LANG Rong-gang; Chi S.Zee; LIU Pei-fang; FU Li


    Background As an uncommon presentation, occult primary breast cancer remains a diagnostic and therapeutic challenge in clinical practice. This study aimed to retrospectively assess the feasibility of breast magnetic resonance imaging (MRI) in patients with malignant axillary lymphadenopathy and unknown primary malignancy, and correlation with histopathological characteristics.Methods A total of 35 women with occult breast carcinoma were evaluated with dynamic contrast-enhanced breast MRI. Whole seriate section was used in all cases. MRI performance was assessed and correlated with histopathological findings.Results Twenty-one of 35 patients were found to have primary breast carcinoma histologically. Twenty of the 21 patients had abnormal MR findings and 1 patient had a normal MRI study. Of the remaining 14 patients, 10 were negative on both MRI and surgery. Four had suspicious enhancement on MRI and no corresponding tumor was found. Lesions with mass enhancement were found in 55% (11/20) and ductual and segmental enhancement in 45%. The average diameter of the primary tumors was 15 mm. Invasive ductal carcinomas were found in 81% (17/21). One of 17 invasive ductual carcinomas was too small to be graded. Fourteen of the remaining 16 were classified as grade II and 2 as grade I. Thirty-two of the 35 patients had received estrogen receptor, progesterone receptor and human epidermal growth factor receptor 2 examinations and the 12 of 32 were triple-negative breast carcinoma.Conclusions Mass lesions with small size and lesions with ductal or segment enhancement are common MRI features in patients with occult breast cancer. The dominant types of primary tumors are invasive ductal carcinoma with moderate histopathological grade. The rate of triple-negative breast carcinoma may be higher in occult breast cancer.

  1. Avoiding preoperative breast MRI when conventional imaging is sufficient to stage patients eligible for breast conserving therapy

    Energy Technology Data Exchange (ETDEWEB)

    Pengel, Kenneth E., E-mail: [Department of Radiology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam (Netherlands); Loo, Claudette E. [Department of Radiology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam (Netherlands); Wesseling, Jelle [Department of Pathology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam (Netherlands); Pijnappel, Ruud M. [Department of Radiology/Image Sciences Institute, University Medical Center Utrecht Heidelberglaan 100, 3584 CX Utrecht (Netherlands); Rutgers, Emiel J.Th. [Department of Surgical Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam (Netherlands); Gilhuijs, Kenneth G.A. [Department of Radiology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam (Netherlands); Department of Radiology/Image Sciences Institute, University Medical Center Utrecht Heidelberglaan 100, 3584 CX Utrecht (Netherlands)


    Aim: To determine when preoperative breast MRI will not be more informative than available breast imaging and can be omitted in patients eligible for breast conserving therapy (BCT). Methods: We performed an MRI in 685 consecutive patients with 692 invasive breast tumors and eligible for BCT based on conventional imaging and clinical examination. We explored associations between patient, tumor, and conventional imaging characteristics and similarity with MRI findings. Receiver operating characteristic (ROC) analysis was employed to compute the area under the curve (AUC). Results: MRI and conventional breast imaging were similar in 585 of the 692 tumors (85%). At univariate analysis, age (p < 0.001), negative preoperative lymph node status (p = 0.011), comparable tumor diameter at mammography and at ultrasound (p = 0.001), negative HER2 status (p = 0.044), and absence of invasive lobular cancer (p = 0.005) were significantly associated with this similarity. At multivariate analysis, these factors, except HER2 status, retained significant associations. The AUC was 0.68. Conclusions: It is feasible to identify a subgroup of patients prior to preoperative breast MRI, who will most likely show similar results on conventional imaging as on MRI. These findings enable formulation of a practical consensus guideline to determine in which patients a preoperative breast MRI can be omitted.

  2. Predictive features of breast cancer on Mexican screening mammography patients (United States)

    Rodriguez-Rojas, Juan; Garza-Montemayor, Margarita; Trevino-Alvarado, Victor; Tamez-Pena, José Gerardo


    Breast cancer is the most common type of cancer worldwide. In response, breast cancer screening programs are becoming common around the world and public programs now serve millions of women worldwide. These programs are expensive, requiring many specialized radiologists to examine all images. Nevertheless, there is a lack of trained radiologists in many countries as in Mexico, which is a barrier towards decreasing breast cancer mortality, pointing at the need of a triaging system that prioritizes high risk cases for prompt interpretation. Therefore we explored in an image database of Mexican patients whether high risk cases can be distinguished using image features. We collected a set of 200 digital screening mammography cases from a hospital in Mexico, and assigned low or high risk labels according to its BIRADS score. Breast tissue segmentation was performed using an automatic procedure. Image features were obtained considering only the segmented region on each view and comparing the bilateral di erences of the obtained features. Predictive combinations of features were chosen using a genetic algorithms based feature selection procedure. The best model found was able to classify low-risk and high-risk cases with an area under the ROC curve of 0.88 on a 150-fold cross-validation test. The features selected were associated to the differences of signal distribution and tissue shape on bilateral views. The model found can be used to automatically identify high risk cases and trigger the necessary measures to provide prompt treatment.

  3. Breast cancer patients in Libya: Comparison with European and central African patients. (United States)

    Boder, Jamela Mostafa E; Elmabrouk Abdalla, Fathi B; Elfageih, Mohamed Ahmed; Abusaa, Abuagela; Buhmeida, Abdelbaset; Collan, Yrjö


    The present study evaluated the incidence of breast cancer in Libya and described the clinicopathological and demographic features. These features were then compared with corresponding data from patients from sub-Saharan Africa (Nigeria) and Europe (Finland). The study consisted of 234 patients with breast carcinoma, admitted to the African Oncology Institute in Sabratha, Libya, during the years 2002-2006. The pathological features were collected from pathology reports, patient histories from hospital files and the Sabratha Cancer Registry. The demographic differences between the Libyan, Nigerian and Finnish populations were prominent. The mean age of breast cancer patients in Libya was 46 years which was almost identical to that of Nigeria, but much lower than that of Finland. The Libyan breast cancer incidence was evaluated as 18.8 per 100,000 female individuals. This incidence was markedly higher in Finland, but was also high in Nigeria. Libyan and Nigerian breast cancer is predominantly of premenopausal type and exhibits unfavorable characteristics such as high histological grade and stage, large tumor size and frequent lymph node metastases. However, the histological types and histopathological risk features show similar importance regarding survival as European breast cancer cases. Survival in Libya ranks between the rates of survival in Nigeria (lowest) and Finland (highest). In conclusion, in Libya and other African countries, premenopausal breast cancer is more common than postmenopausal breast cancer. However, the opposite is true for Europe. Population differences may be involved, as suggested by the known variation, in the distribution of genetic markers in these populations. Different types of environmental impacts, however, cannot be excluded.

  4. Communication Needs of Patients with Breast Cancer: A Qualitative Study (United States)

    Khoshnazar, Tahereh Alsadat Khoubbin; Rassouli, Mrayam; Akbari, Mohammad Esmaeil; Lotfi-Kashani, Farah; Momenzadeh, Syrus; Rejeh, Nahid; Mohseny, Maryam


    Introduction: Since communication is considered to be one of the central concepts in caregiving practices, this study aims to examine the perception of women with breast cancer in terms of their communication needs. Methods: In this qualitative study, 20 participants (9 women with breast cancer, 10 of health-care professionals, and one family caregiver) were selected through purposive sampling, and a face-to-face semi-structured interview was conducted with each of them. After data collection, all interviews were transcribed and reviewed, and categories were extracted. The data were analyzed with Conventional Content Analysis of Landman and Graneheim using MAXQDA10 software. Results: The analysis resulted in two extracted categories: “therapeutic communication” and “facilitating empathy”, and five subcategories: “trust-building therapist”, “crying out to be heard,” “seeking a soothing presence,” “sharing knowledge,” and “supportive peers”. Conclusion: Identifying and promoting the communicative needs of patients could lead to a considerably better care of patients under treatment. Therefore, therapeutic communication, as an integral part, should be incorporated into the care plan for patients with breast cancer and their families in the Oncology and Palliative Care wards.

  5. Prevention of Bone Metastases in Breast Cancer Patients. Therapeutic Perspectives

    Directory of Open Access Journals (Sweden)

    Philippe Beuzeboc


    Full Text Available One in four breast cancer patients is at risk of developing bone metastases in her life time. The early prevention of bone metastases is a crucial challenge. It has been suggested that the use of zoledronic acid (ZOL in the adjuvant setting may reduce the persistence of disseminated tumor cells and thereby might improve outcome, specifically in a population of patients with a low estrogen microenvironment. More recently, the results of a large meta-analysis from 41 randomized trials comparing a bisphosphonate (BP to placebo or to an open control have been presented at the 2013 San Antonio Breast Cancer Meeting. Data on 17,016 patients confirm that adjuvant BPs, irrespective of the type of treatment or the treatment schedule and formulation (oral or intra-venously (IV, significantly reduced bone recurrences and improved breast cancer survival in postmenopausal women. No advantage was seen in premenopausal women. BPs are soon likely to become integrated into standard practice. Published data on the mechanisms involved in tumor cell seeding from the primary site, in homing to bone tissues and in the reactivation of dormant tumor cells will be reviewed; these might offer new ideas for innovative combination strategies.

  6. Lymphaticovenular bypass surgery for lymphedema management in breast cancer patients. (United States)

    Chang, D W


    Historically, the reported incidence of upper extremity lymphedema in breast cancer survivors who have undergone axillary lymph node dissection has ranged from 9% to 41%. In the past 2 decades, sentinel lymph node biopsy has become popular as a way to minimize the morbidity associated with axillary dissection without compromising the cure rate for breast cancer patients. However, even with sentinel node biopsy, the postoperative incidence of upper limb lymphedema in breast cancer patients remains at 4-10%. Lymphedema occasionally emerges immediately after surgery but most often appears after a latent period. Obesity, postoperative seroma, and radiation therapy have been reported as major risk factors for upper extremity lymphedema, but the etiology of lymphedema is still not fully understood. Common symptoms of upper limb lymphedema are increased volume and weight of the affected limb and increased skin tension. The increased volume of the affected limb not only causes physical impairments in wearing clothes and in dexterity but also affects patients' emotional and mental status. Surgical management of lymphedema can be broadly categorized into physiologic methods and reductive techniques. Physiologic methods such as flap interposition, lymph node transfers, and lymphatic bypass procedures aim to decrease lymphedema by restoring lymphatic drainage. In contrast, reductive techniques such as direct excision or liposuction aim to remove fibrofatty tissue generated as a consequence of sustained lymphatic fluid stasis. Currently, microsurgical variations of lymphatic bypass, in which excess lymph trapped within the lymphedematous limb is redirected into other lymphatic basins or into the venous circulation, have gained popularity.

  7. Clinical course of breast cancer patients with liver metastases. (United States)

    Zinser, J W; Hortobagyi, G N; Buzdar, A U; Smith, T L; Fraschini, G


    Between June 1973 and November 1980, 1,171 patients with metastatic breast cancer were treated with various doxorubicin-containing regimens at our institution (M.D. Anderson Hospital and Tumor Institute, Houston). Retrospective analysis of all 233 cases (20%) with liver metastases was done to correlate various clinical and biochemical characteristics with response to treatment, survival, and causes of death. A similar analysis was performed for 58 consecutive patients with liver metastases treated at this hospital between December 1955 and December 1957 with hormone therapy or single-agent chemotherapy. Objective responses were observed in 132 of 233 patients (57%) treated with combination chemotherapy. The median survival was 14 months in the 1970s and 5 months in the 1950s. Among patients who had liver metastases at the time of initial diagnosis of breast cancer, survival was longer for the group treated with combination chemotherapy. All cases were classified according to the number of organ sites involved by metastases. Patients with only liver metastases, or liver plus bone lesions had the longest survival. Other clinical and biochemical factors that correlated significantly with longer survival were: no prior chemotherapy, performance status of 1 to 2, absence of ascites, normal bilirubin and lactic dehydrogenase (LDH), SGOT less than or equal to 2 times normal and albumin greater than 4.5 g/dL. The main cause of death was multiorgan failure, with only 20% of patients dying of liver failure. The present study shows that the presence of liver metastases in breast cancer is not by itself an ominous factor. Most patients respond to therapy, and significant palliation with extended survival is possible for several prognostic subgroups. Further improvement in length and quality of survival is expected with earlier diagnosis.

  8. New development of breast cancer histological evaluation related to determination of therapeutic option for the patients

    Institute of Scientific and Technical Information of China (English)

    Kentaro Tamaki; Hironobu Sasano


    @@ Breast cancer is a heterogenous disease with molecular alterations, cellularcomposition, and clinical outcome.The more we know about the tumor characteristics underlying the heterogeneity of the disease, the greater the opportunity to refine treatment options.Great emphasis has been placed uponhistopathological characteristics of breast carcinoma cells in order to define bettertreatment options for breast cancer patients[1-2].

  9. A Modified Nottingham Prognostic Index for Breast Cancer Patients Diagnosed in Denmark 1978-1994

    DEFF Research Database (Denmark)

    Rostgaard, Klaus; Mouridsen, Henning T.; Væth, Michael;


    Stage of disease is a predictor of breast cancer survival. We used data from the Danish Cancer Register amd the Daniish Breast Cancer Cooperative Group to study stage distribution in 0-69-years-old Danish breast cancer patients diagnosed in 1978-1994. We constructed a modified Nottingham Prognostic...

  10. Gallium-67 breast uptake in a patient with hypothalamic granuloma (sarcoid)

    Energy Technology Data Exchange (ETDEWEB)

    Vazquez, R.; Oates, E.; Sarno, R.C.; Fay, J.; Gale, D.R.


    An unusual case is presented of bilateral breast uptake of (/sup 67/Ga)citrate in a patient with a hypothalamic granuloma in the absence of galactorrhea is presented. A possible mechanism for this incidental finding is elevated prolactin levels, as other causes of gallium breast uptake such as drug therapy, and intrinsic breast disease, were not present.

  11. 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


    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.

  12. Risk factors for postoperative seromas in Chinese breast cancer patients

    Institute of Scientific and Technical Information of China (English)

    LIN Yan-ping; YIN Wen-jin; YAN Ting-ting; ZHOU Li-heng; DI Geng-hong; WU Jiong; SHEN Zhen-zhou; SHAO Zhi-min; LU Jin-song


    S:Background Seroma formation is one of the most common complications after breast cancer surgery. Various risk factors have been evaluated for their associations with the development of seromas in Western populations. However,similar data are not available in Chinese series. Therefore, we sought to investigate the potential risk factors for Chinese breast cancer patients.Methods A prospective study of female breast cancer patients undergoing surgery was carried out in Cancer Hospital of Fudan Unversity, Shanghai, China. Univariate analyses were performed by chi-square test or Student's t test or Mann-Whitney test and multivariate analyses by stepwise Logistic regression. The logistic model included age (years),total serum protein concentration (g/L), drainage volume on postoperative day 3 (POD 3; ml) and time to daily drainage volume not more than 30 ml (TTV30; days).Results A total of 158 patients with breast cancer were studied. The mean age at diagnosis was (52.14±10.77) years (range 25-92). During the follow-up period, 24 (15.2%) patients developed seromas. Calculated as continuous variables in the stepwise Logistic regression, age (OR=1.090, 95% CI 1.028-1.155, P=0.004), total serum protein concentration (OR=0.886, 95% Cl 0.791-0.992, P=0.036), drainage volume on POD3 (OR=1.013, 95% CI 1.002-1.023, P=0.017) and TTV30 (OR=1.273, 95% CI 1.039-1.561, P=0.020) were independent risk factors for seroma formation. Additionally,significant difference in daily drainage volume was substantiated in the analysis by seroma formation (P=0.034) rather than by type of surgery (P=0.713).Conclusions Although the pathogenesis of seroma remains controversial, such risk factors as age, nutritional status,drainage volume on POD3 and TTV30 should be considered for prediction and prevention of seroma formation in Chinese breast cancer patients.

  13. Brain metastasis reirradiation in patients with advanced breast cancer (United States)

    Huang, Zhou; Sun, Bing; Shen, Ge; Cha, Lei; Meng, Xiangying; Wang, Junliang; Zhou, Zhenshan; Wu, Shikai


    The outcome of recurrent brain metastasis is dismal. This study aims to assess the clinical outcomes and toxicity of reirradiation as a salvage treatment for progressive brain metastasis in patients with advanced breast cancer. Between July 2005 and September 2014, the medical records of 56 patients with brain metastasis from breast cancer were retrospectively reviewed. Of these patients, 39 received whole-brain radiotherapy (WBRT) followed by stereotactic radiosurgery (SRS) reirradiation (Group 1), and 17 received SRS followed by WBRT reirradiation (Group 2). Overall survival (OS) and brain progression-free survival rates/times were calculated using the Kaplan–Meier method. Prognostic factors were evaluated using the Cox proportional hazards model. Change in neurologic function was also assessed. The median OS was 10.8 months (range, 1.3–56.8 months). In Group 1, the median PFS time (PFS-1) was 6.5 months and the OS time was 11.4 months. Multivariate analysis revealed that longer OS was significantly associated with a high Karnofsky performance score (KPS) (P = 0.004), controlled extracranial metastasis (P = 0.001) and a good response to reirradiation (P = 0.034). In Group 2, the median PFS time (PFS-2) after reirradiation was 8.5 months and the OS time was 10.8 months. Multivariate analysis revealed that longer OS was significantly associated with a high KPS (P = 0.018). The majority of the patients had improved or stable neurological function. Reirradiation is an effective and a safe treatment for patients with brain metastases from breast cancer. It might delay the progression of intracranial disease and improve neurological function. A suitable patient selection for reirradiation was suggested. PMID:27707842

  14. Increased Levels of Erythropoietin in Nipple Aspirate Fluid and in Ductal Cells from Breast Cancer Patients

    Directory of Open Access Journals (Sweden)

    Ferdinando Mannello


    Full Text Available Background: Erythropoietin (Epo is an important regulator of erythropoiesis, and controls proliferation and differentiation of both erythroid and non-erythroid tissues. Epo is actively synthesized by breast cells during lactation, and also plays a role in breast tissues promoting hypoxia-induced cancer initiation. Our aims are to perform an exploratory investigation on the Epo accumulation in breast secretions from healthy and cancer patients and its localization in breast cancer cells.

  15. 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


    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

  16. 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


    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

  17. [Evaluation of a diet and nutritional status of breast feeding women on the basis of a questionnaire study]. (United States)

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


    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.

  18. Breast feeding increases vasoconstriction induced by electrical field stimulation in rat mesenteric artery. Role of neuronal nitric oxide and ATP.

    Directory of Open Access Journals (Sweden)

    Javier Blanco-Rivero

    Full Text Available OBJECTIVES: The aim of this study was to investigate in rat mesenteric artery whether breast feeding (BF affects the vasomotor response induced by electrical field stimulation (EFS, participation by different innervations in the EFS-induced response and the mechanism/s underlying these possible modifications. METHODS: Experiments were performed in female Sprague-Dawley rats (3 months old, divided into three groups: Control (in oestrous phase, mothers after 21 days of BF, and mothers that had recovered their oestral cycle (After BF, in oestrous phase. Vasomotor response to EFS, noradrenaline (NA and nitric oxide (NO donor DEA-NO were studied. Neuronal NO synthase (nNOS and phosphorylated nNOS (P-nNOS protein expression were analysed and NO, superoxide anion (O(2(.-, NA and ATP releases were also determined. RESULTS: EFS-induced contraction was higher in the BF group, and was recovered after BF. 1 µmol/L phentolamine decreased the response to EFS similarly in control and BF rats. NA vasoconstriction and release were similar in both experimental groups. ATP release was higher in segments from BF rats. 0.1 mmol/L L-NAME increased the response to EFS in both control and BF rats, but more so in control animals. BF decreased NO release and did not modify O(2(.- production. Vasodilator response to DEA-NO was similar in both groups, while nNOS and P-nNOS expressions were decreased in segments from BF animals. CONCLUSION: Breast feeding increases EFS-induced contraction in mesenteric arteries, mainly through the decrease of neuronal NO release mediated by decreased nNOS and P-nNOS expression. Sympathetic function is increased through the increased ATP release in BF rats.

  19. [Abnormalities in behavior in the oral and cervical area: reassurance breast-feeding. Considerations on sudden infant death]. (United States)

    Gudin, R G; Khalef, M


    The oral zone reflects the relational modalities of the child: the sensorimotor physiological and psychological behaviour is established according to the development of the facial sphere and its aero-digestive crossroads. In the baby, the mandibular equilibrium and position and the dimensions of the lower part of the face essentially depend upon praxic activities, which drive the mandibular and hyoid displacements. During the period of immaturity, the lingual area is brought into movement with each "sucking-swallowing" action that characterises breast-feeding: the mandibulo-hyoid swing is subordinate to the pharyngo-lingual complex. The analysis of this psycho-motor behaviour reveals imperfect and upsetting "mimics" that modify the balance of the jaw and of the hyo-lingual area during swallowing, which is the second phase of the reassurance breast-feed. The lingual ptosis causes congestion of the airways. These lax children, with a receding chin, are deformed by their oral habits. The clinical picture evidences the constitutional hyperlaxity by examining the parental group -the same facial dystrophies, the same habits resulting in various disorders of general or cervical statics. At the level of the temporomandibular joint, the dysfunction is also accompanied by claudication by mandibulo-hyo-lingual tipping. The general and cervical statics of the baby are thus affected in the course of sleep. It is during paradoxical sleep that the baby's head tips on to the thorax, due to the resultant atonia of the neck muscles. The head, insufficiently supported on its cervical pillar accentuates the asphyxial mechanism provoked by the tipping of the lingual area on the epiglottis.(ABSTRACT TRUNCATED AT 250 WORDS)

  20. Mutations of the BRCA1 and BRCA2 genes in patients with bilateral breast cancer


    Steinmann, D; Bremer, M.; Rades, D; SKAWRAN, B.; Siebrands, C; Karstens, J.H.; Dörk, T.


    Mutations of the BRCA1 or BRCA2 genes have been shown to strongly predispose towards the development of contralateral breast cancer in patients from large multi-case families. In order to test the hypothesis that BRCA1 and BRCA2 mutations are more frequent in patients with bilateral breast cancer, we have investigated a hospital-based series of 75 consecutive patients with bilateral breast cancer and a comparison group of 75 patients with unilateral breast cancer, pairwise matched by age and ...

  1. Endoscopic gastrostomy, nasojejunal and oral feeding comparison in aspiration pneumonia patients

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    Ozge E Onur


    Full Text Available Background: Aspiration pneumonia is a potentially preventable illness requiring attention to small details of patient care. The type, management, and care of feeding should be carried out properly. Materials andMethods: This is a prospective clinical study of enteral feeding on patients admitted to hospital with aspiration pneumonia. The known enteral nutritional methods, advantages, and disadvantages were told to the patient or proxy. If they didn′t accept Percutaneous endoscopic gastrostomy (PEG, nasojejunal tube (NJT was advised. If they denied all of the procedures, oral feeding education was given. A total of 94 patients were enrolled to the study, 29 of them accepted PEG, 42 preferred NJT, and 23 preferred oral route. Results: A total of 94 patients with a mean age of 77.84, standard deviation 10.784; 95% confidence interval (CI 75.63-80.03 were enrolled to the study of which 27 (28.7% patients had a history of aspiration pneumonia. Oral feeding was prominently preferred for patients nursed by a relative (15; 65.2% of Oral feeding group and 16% of total or a caregiver (7; 30.4% of Oral feeding group and 7.4% of total while only 1 (4.3% of Oral feeding group and 1.1% of total with a health-care worker (P = 0.001. Overall re-aspiration rates at the 6 th month were 58%, 78%, 91% in EG, NJT, oral groups, respectively. Sixth months′ survival rates of the different feeding groups were not significantly divergent from each other. History of aspiration was also found to be a significant contributor of mortality. Conclusion: In aspiration pneumonia patients′ long-term survival rates of the different feeding groups were not significantly divergent from each other.

  2. Brief Behavioral Activation and Problem-Solving Therapy for Depressed Breast Cancer Patients: Randomized Trial (United States)

    Hopko, Derek R.; Armento, Maria E. A.; Robertson, Sarah M. C.; Ryba, Marlena M.; Carvalho, John P.; Colman, Lindsey K.; Mullane, Christen; Gawrysiak, Michael; Bell, John L.; McNulty, James K.; Lejuez, Carl W.


    Objective: Major depression is the most common psychiatric disorder among breast cancer patients and is associated with substantial impairment. Although some research has explored the utility of psychotherapy with breast cancer patients, only 2 small trials have investigated the potential benefits of behavior therapy among patients with…

  3. Screening of Breast Mass in Iraqi Females: Al-Kindy Hospital Breast Clinic

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    Wijdan Akram


    Full Text Available Problem statement: The aim of this study is to present the findings of a retrospective analysis in females with breast mass, the character of the women and the risk factors of breast cancer at Al-Kindy Breast Clinic Center. Approach: Data were collected during 2 months period using special form of questioner. The total number of studied sample was 60, which includes female patients living in Baghdad. Results: The highest prevalence of developing breast mass at age group 36-45 years, the majority of these women are housewives (81.7%, about (31.7% of the included sample were illiterate and only 10% graduated from college. (58.3% of the studied sample did not use contraception, while (30% of patients with breast mass had breast feeding on the other hand (70% did not had breast feeding, by self examination, (11.7% could not found the mass by themselves, (28.3% had a mass in the right breast, (50% had a mass in the left breast while (10% had the mass in both breasts. Conclusion: The study showed a high level of practice of breast-self examination among women in the sample under consideration, breast masses were more occurring at the third and fourth decades of life, the number of children may affect the development of breast mass and combined oral contraceptive has small increased risk of breast mass.

  4. "In flight catering": feeding critical care patients during aeromedical evacuation. (United States)

    Turner, S; Ruth, M J; Bruce, D L


    The benefits of early enteral nutrition are well recognised but may be incompatible with CCAST evacuation due to the risk of micro-aspiration predisposing to pneumonia. A study has been approved by the Surgeon Generals Research Strategy Group designed to quantify the risks of microaspiration during CCAST flights in order to inform DMA policy with regard to feeding critically ill casualties during flight.

  5. Endoscopically placed nasogastrojejunal feeding tubes: a safe route for enteral nutrition in patients with hepatic encephalopathy. (United States)

    Lee, Steven S; Mathiasen, Ronald A; Lipkin, Craig A; Colquhoun, Steven D; Margulies, Daniel R


    Patients with hepatic encephalopathy are at particular risk for aspiration when given oral or gastric feedings. An ideal strategy might combine distal enteral feeding with proximal gastric decompression, which is offered by a nasogastrojejunal (NGJ) feeding tube. One objective was to determine the efficacy and safety of endoscopically placed NGJ feeding tubes in patients with hepatic encephalopathy. Charts of patients who underwent NGJ tube placements between April 1997 and January 2000 were retrospectively reviewed. Two endoscopic techniques ("push" and "pull") were used. Eighteen patients (nine male and nine female) underwent 32 procedures. Twelve patients had undergone liver transplantation, four had decompensated cirrhosis, and two had fulminant hepatic failure. Twenty procedures used the push technique and 12 required the pull technique. The insertion time was shorter for the push technique compared with the pull technique (21.8 vs 39.6 min, P < 0.05). Enteral feedings were begun at an average of 5.2 hours after tube placement. The tubes remained in place for an average of 13.9 days. Complications related to the NGJ tubes included self-removal in eight, tube clogging in five, proximal migration in four, and intraduodenal migration of the gastric port in one. No aspiration episodes occurred. We conclude that NGJ feeding tubes may be placed endoscopically as a bedside procedure for patients with hepatic encephalopathy and provide a safe, efficacious, and rapid route for enteral nutrition in these patients.

  6. Arm and shoulder morbidity in breast cancer patients after breast-conserving therapy versus mastectomy

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    Nesvold, Inger-Lise (Dept. of Cancer Rehabilitation-Physiotherapy, Rikshospitalet, Univ. of Oslo, Div. The Norwegian Radium Hospital, Montebello, Oslo (Norway)); Dahl, Alv A.; Fossaa, Sophie D. (Dept. of Clinical Cancer Research, Rikshospitalet, Univ. of Oslo: Division The Norwegian Radiumhospital, Montebello, Oslo (Norway)); Loekkevik, Erik (Dept. of Oncology, Rikshospitalet, Montebello, Oslo (Norway)); Marit Mengshoel, Anne (Inst. of Nursing and Health Sciences, Univ. of Oslo: Medical Faculty, Oslo (Norway))


    Introduction. The objective of this study was to compare the prevalence of late effects in the arm and shoulder in patients with breast cancer stage II who had radical modified mastectomy (RM) or breast-conserving therapy (BCT) followed by loco-regional adjuvant radiotherapy with or without chemotherapy/anti-oestrogen. Material and methods. All patients had axillary lymph node dissection. At a median of 47 months (range 32-87) post-surgery, 263 women (RM: n=186, BCT: n=77) were seen during an outpatient visit and had their arm and shoulder function and the presence of lymphedema assessed by a clinical examination, interview and self-rating. Volume calculation was used to measure lymphedema. Results. In the RM group 20% had developed arm lymphedema versus 8% in the BCT group (p=0.02). In multivariate analysis lymphedema was associated with a higher number of metastatic axillary lymph nodes [OR1.14, p=0.02], RM [OR 2.75, p=0.04] and increasing body mass index (BMI) [OR 1.11, p<0.01]. In the RM group 24% had a restricted range of motion in shoulder flexion compared to 7% in the BCT group (p<0.01). Shoulder pain was reported by 32% in the RM group and by 12% in the BCT group (p=0.001). Increasing observation time, RM, and increasing BMI were significantly associated with impaired arm/shoulder function. Discussion. Arm/shoulder problems including lymphedema were significantly more common after RM compared to BCT in irradiated breast cancer patients who have undergone axillary lymph node dissection. The performance of BCT should be encouraged when appropriate, to ensure a low prevalence of arm/shoulder morbidity including lymphedema

  7. Response to influenza virus vaccination during chemotherapy in patients with breast cancer

    NARCIS (Netherlands)

    Meerveld-Eggink, A.; de Weerdt, O.; van der Velden, A. M. T.; Los, M.; van der Velden, A. W. G.; Stouthard, J. M. L.; Nijziel, M. R.; Westerman, M.; Beeker, A.; van Beek, R.; Rimmelzwaan, G. F.; Rijkers, G. T.; Biesma, D. H.


    Background: Patients receiving chemotherapy are at increased risk for influenza virus infection. Little is known about the preferred moment of vaccination during chemotherapy. Patients and methods: Breast cancer patients received influenza vaccination during FEC (5-fluorouracil, epirubicin and cyclo

  8. Breast-feeding, nutritional status, and other prognostic factors for dehydration among young children with diarrhoea in Brazil. (United States)

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


    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.

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

    Directory of Open Access Journals (Sweden)

    MS Maputle


    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.

  10. Intensity Modulated Accelerated Partial Breast Irradiation Before Surgery in Treating Older Patients With Hormone Responsive Stage 0-I Breast Cancer (United States)


    Ductal Breast Carcinoma in Situ; Estrogen Receptor-negative Breast Cancer; Estrogen Receptor-positive Breast Cancer; Invasive Ductal Breast Carcinoma; Invasive Ductal Breast Carcinoma With Predominant Intraductal Component; Lobular Breast Carcinoma in Situ; Medullary Ductal Breast Carcinoma With Lymphocytic Infiltrate; Mucinous Ductal Breast Carcinoma; Papillary Ductal Breast Carcinoma; Progesterone Receptor-positive Breast Cancer; Stage IA Breast Cancer; Stage IB Breast Cancer; Tubular Ductal Breast Carcinoma

  11. The Effect of Breast Hypertrophy on Patient Posture

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    Oren Lapid


    Full Text Available Background One of the reasons women with macromastia chose to undergo a breast reductionis to relieve their complaints of back, neck, and shoulder pain. We hypothesized thatchanges in posture after surgery may be the reason for the pain relief and that patient posturemay correlate with symptomatic macromastia and may serve as an objective measure forcomplaints. The purpose of our study was to evaluate the effect of reduction mammaplastyon the posture of women with macromastia.Methods A prospective controlled study at a university medical center. Forty-two patientsthat underwent breast reduction were studied before surgery and an average of 4.3 yearsfollowing surgery. Thirty-seven healthy women served as controls. Standardized lateral photoswere taken. The inclination angle of the back was measured. Regression analysis was performedfor the inclination angle.Results Preoperatively, the mean inclination angle was 1.61 degrees ventrally; this diminishedpostoperatively to 0.72 degrees ventrally. This change was not significant (P-value=0.104. Inthe control group that angle was 0.28 degrees dorsally. Univariate regression analysis revealedthat the inclination was dependent on body mass index (BMI and having symptomatic macromastia;on multiple regression it was only dependent on BMI.Conclusions The inclination angle of the back in breast reduction candidates is significantlydifferent from that of controls; however, this difference is small and probably does not accountfor the symptoms associated with macromastia. Back inclination should not be used as asurrogate “objective” measure for symptomatic macromastia.

  12. Outcome of percutaneous endoscopic gastrostomy feeding in patients on peritoneal dialysis. (United States)

    Fein, P A; Madane, S J; Jorden, A; Babu, K; Mushnick, R; Avram, M M; Grosman, I


    Protein malnutrition is now well established as an important contributory factor to the high mortality in peritoneal dialysis (PD) patients. Low dietary protein calorie intake is one of the factors leading to protein malnutrition. If PD patients develop difficulty eating, percutaneous endoscopic gastrostomy (PEG) feeding may prove beneficial in providing adequate nutrition. Studies on the effectiveness of PEG feeding in PD patients are limited to pediatric patients. The objective of the present study was to assess the outcome of PEG feeding in adult patients with end-stage renal disease (ESRD) on PD. We retrospectively reviewed charts from May 1992 to February 2000 of 10 consecutive patients in our center who had had feeding tubes inserted. The patients' ages ranged from 37 to 81 years, with mean age of 65. Of the 10 patients, 7 were male, 5 were diabetic, and 1 was infected with the human immunodeficiency virus. Two patients had cerebrovascular accident (CVA) with dysphagia, 3 had multi-infarct dementia, 2 had anoxic encephalopathy, 2 had dementia, and 1 had calciphylaxis with anorexia. Of the 10 patients, 9 failed to eat because of neurologic disorders. Two patients who had functioning PEG feedings before starting PD had no complications. Only 2 of 8 patients already on PD continued with long-term PD after a PEG was inserted. Both patients whose PD was not interrupted at the time of PEG placement immediately developed peritonitis. Of the 6 patients who were maintained on hemodialysis (HD), 2 developed peritonitis within one week of starting PEG feedings. The other 4 had no complications from PEG feedings while being maintained on HD, but 1 developed peritonitis when PD was resumed. Of the 5 patients who developed peritonitis, 3 experienced fungal peritonitis. In PD patients, PEG feeding is associated with frequent complications. However, PEG placement prior to PD initiation appears to be safe. Maintaining patients on HD for at least 6 weeks appears to decrease

  13. Optimal management of bone metastases in breast cancer patients

    Directory of Open Access Journals (Sweden)

    Wong MH


    Full Text Available MH Wong, N PavlakisDepartment of Medical Oncology, Royal North Shore Hospital, Sydney, NSW, AustraliaAbstract: Bone metastasis in breast cancer is a significant clinical problem. It not only indicates incurable disease with a guarded prognosis, but is also associated with skeletal-related morbidities including bone pain, pathological fractures, spinal cord compression, and hypercalcemia. In recent years, the mechanism of bone metastasis has been further elucidated. Bone metastasis involves a vicious cycle of close interaction between the tumor and the bone microenvironment. In patients with bone metastases, the goal of management is to prevent further skeletal-related events, manage complications, reduce bone pain, and improve quality of life. Bisphosphonates are a proven therapy for the above indications. Recently, a drug of a different class, the RANK ligand antibody, denosumab, has been shown to reduce skeletal-related events more than the bisphosphonate, zoledronic acid. Other strategies of clinical value may include surgery, radiotherapy, radiopharmaceuticals, and, of course, effective systemic therapy. In early breast cancer, bisphosphonates may have an antitumor effect and prevent both bone and non-bone metastases. Whilst two important Phase III trials with conflicting results have led to controversy in this topic, final results from these and other key Phase III trials must still be awaited before a firm conclusion can be drawn about the use of bisphosphonates in this setting. Advances in bone markers, predictive biomarkers, multi-imaging modalities, and the introduction of novel agents have ushered in a new era of proactive management for bone metastases in breast cancer.Keywords: breast cancer, bone metastases, bisphosphonates, denosumab, biomarkers, optimal management

  14. Locoregional Recurrence by Tumor Biology in Breast Cancer Patients after Preoperative Chemotherapy and Breast Conservation Treatment (United States)

    Jwa, Eunjin; Shin, Kyung Hwan; Kim, Ja Young; Park, Young Hee; Jung, So-Youn; Lee, Eun Sook; Park, In Hae; Lee, Keun Seok; Ro, Jungsil; Kim, Yeon-Joo; Kim, Tae Hyun


    Purpose The purpose of this study is to determine whether breast cancer subtype can affect locoregional recurrence (LRR) and ipsilateral breast tumor recurrence (IBTR) after neoadjuvant chemotherapy (NAC) and breast-conserving therapy (BCT). Materials and Methods We evaluated 335 consecutive patients with clinical stage II-III breast cancer who received NAC plus BCT from 2002 to 2009. Patients were classified according to six molecular subtypes: luminal A (hormone receptor [HR]+/HER2–/Ki-67 < 15%, n=113), luminal B1 (HR+/HER2–/Ki-67 ≥ 15%, n=33), luminal B2 (HR+/HER2+, n=83), HER2 with trastuzumab (HER2[T+]) (HR–/HER2+/use of trastuzumab, n=14), HER2 without trastuzumab (HER2[T–]) (HR–/HER2+, n=31), and triple negative (TN) (HR–/HER2–, n=61). Results After a median follow-up period of 7.2 years, 26 IBTRs and 37 LRRs occurred. The 5-year LRR-free survival rates were luminal A, 96.4%; B1, 93.9%; B2, 90.3%; HER2(T+), 92.9%; HER2(T–), 78.3%; and TN, 79.6%. The 5-year IBTR-free survival rates were luminal A, 97.2%; B1, 93.9%; B2, 92.8%; HER2(T+), 92.9%; HER2(T–), 89.1%; and TN, 84.6%. In multivariate analysis, HER2(T–) (IBTR: hazard ratio, 4.2; p=0.04 and LRR: hazard ratio, 7.6; p < 0.01) and TN subtypes (IBTR: hazard ratio, 6.9; p=0.01 and LRR: hazard ratio, 8.1; p < 0.01) were associated with higher IBTR and LRR rates. A pathologic complete response (pCR) was found to show correlation with better LRR and a tendency toward improved IBTR controls in TN patients (IBTR, p=0.07; LRR, p=0.03). Conclusion The TN and HER2(T–) subtypes predict higher rates of IBTR and LRR after NAC and BCT. A pCR is predictive of improved IBTR or LRR in TN subtype. PMID:26910473

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

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    Patil Sapna S


    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.

  16. Glycoprotein components in the serum of patients with cancer breast


    Varkey, Miriam; Devi, R. Sundara; Rao, Shrinivas B.


    The levels of total sialic acid, lipid bound sialic acid and fucose were estimated in the sera of patients with benign and malignant tumours of breast. An increase was noted in all the three parameters, with a more marked increase in malignancy, when compared with benign and controls. Consequent to surgery, there was an elevation in the serum levels of the above parameters than the values prior to surgery and a decline was noted two months after surgery although none of the values reached the...

  17. Prognostic factors for patients with hepatic metastases from breast cancer. (United States)

    Wyld, L; Gutteridge, E; Pinder, S E; James, J J; Chan, S Y; Cheung, K L; Robertson, J F R; Evans, A J


    Median survival from liver metastases secondary to breast cancer is only a few months, with very rare 5-year survival. This study reviewed 145 patients with liver metastases from breast cancer to determine factors that may influence survival. Data were analysed using Kaplan-Meier survival curves, univariate and multivariate analysis. Median survival was 4.23 months (range 0.16-51), with a 27.6% 1-year survival. Factors that significantly predicted a poor prognosis on univariate analysis included symptomatic liver disease, deranged liver function tests, the presence of ascites, histological grade 3 disease at primary presentation, advanced age, oestrogen receptor (ER) negative tumours, carcinoembryonic antigen of over 1000 ng ml(-1) and multiple vs single liver metastases. Response to treatment was also a significant predictor of survival with patients responding to chemo- or endocrine therapy surviving for a median of 13 and 13.9 months, respectively. Multivariate analysis of pretreatment variables identified a low albumin, advanced age and ER negativity as independent predictors of poor survival. The time interval between primary and metastatic disease, metastases at extrahepatic sites, histological subtype and nodal stage at primary presentation did not predict prognosis. Awareness of the prognostic implications of the above factors may assist in selecting the most appropriate treatment for these patients.British Journal of Cancer (2003) 89, 284-290. doi:10.1038/sj.bjc.6601038

  18. Psychiatric Symptoms and Psychosocial Problems in Patients with Breast Cancer (United States)

    İzci, Filiz; İlgün, Ahmet Serkan; Fındıklı, Ebru; Özmen, Vahit


    Cancer is a physical disease and also one of the leading clinical manifestations where psychosocial problems are prevalent. Psychosocial problems that these patients may have in the long run include anxiety, uneasiness, mourning, helplessness, fatigue, impairment of concentration, sleep disorders, mental and cognitive reservation, sexual dysfunction, infertility, psychological distress, and psychiatric disorders. Psychosocial problems have a nature of underpinning the emergence of psychological troubles. The prevalence of psychological disorders in patients with cancer range from 29% to 47%. Psychiatric disorders that are likely to be seen are severe stress disorder, adjustment disorder, depressive disorder, and other neurotic disorders. It is considered by the present author that in the event of breast cancer, potential psychiatric disorders may affect prognosis of the disease, adherance to and success of therapy, social and societal functioning, and survival rate. This paper aims to review the psychiatric symptoms and diseases that may develop in patients with breast cancer, which is one of the most frequent types of a globally common disease; i.e., cancer, as well as the impact of psychiatric symptoms on the treatment of disease.

  19. Apoprotein E phenotype determines serum cholesterol in infants during both high-cholesterol breast feeding and low-cholesterol formula feeding. (United States)

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


    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.

  20. Breast cancer patients' narratives about positive and negative communication experiences

    DEFF Research Database (Denmark)

    Thomsen, Dorthe K; Pedersen, Anette F; Johansen, Mikael B


    Health staff-patient communication is increasingly considered an important issue in cancer research. However, questionnaires addressing satisfaction with communication limit the issues patients can raise, do not address the context of communication and often show a strong positive skew in responses....... Thus, qualitative studies of communication are also needed. Fifteen breast cancer patients were interviewed 3 months after finishing adjuvant treatment. They were asked to tell a 10 minute narrative and recall five experiences from treatment. Themes were extracted using categories derived from previous...... research while at the same time being sensitive to new elaborations and categories. The participants reported both positive and negative communication-related experiences from a wide range of treatment situations. Two major themes emerged: Information giving as professional care-giving and meeting...

  1. Infant feeding: formula, solids. (United States)

    Barness, L A


    This article discusses and evaluates current formulas, traces their continual improvement (based largely on new information on breast milk composition), and then discusses the question of supplemental feedings.

  2. Prevalence of TP53 germ line mutations in young Pakistani breast cancer patients. (United States)

    Rashid, Muhammad U; Gull, Sidra; Asghar, Kashif; Muhammad, Noor; Amin, Asim; Hamann, Ute


    Women from Pakistan and India are more often diagnosed with early-onset breast cancer than Caucasian women. Given that only 12% of Pakistani women diagnosed with breast cancer at or before 30 years of age have previously been shown to harbor germ line mutations in the breast cancer susceptibility genes BRCA1 and BRCA2, the genetic causes of the majority of early-onset cases are unexplained. Since germ line mutations in the tumor suppressor gene TP53 predispose women to early-onset breast cancer, we assessed the prevalence of TP53 mutations in 105 early-onset breast cancer patients from Pakistan, who had previously been found to be negative for BRCA1 and BRCA2 germ line mutations. The patient group included 67 women diagnosed with early-onset breast cancer at or before age 30 with no family history of breast or ovarian cancer (EO30NFH group) and 38 women diagnosed with breast cancer at or before age 40 with one or more first- or second-degree relatives with breast or ovarian cancer (EO40FH group). Mutation analysis of the complete TP53 coding region was performed using denaturing high-performance liquid chromatography analysis, followed by DNA sequencing of variant fragments. One deleterious mutation, c.499-500delCA in exon 5, was identified in the 105 breast cancer patients (1%). This mutation is novel in the germ line and has not been described in other populations. It was detected in a 28-year-old patient with no family history of breast or ovarian cancer. This mutation is rare as it was not detected in additional 157 recently recruited non-BRCA1 and non-BRCA2-associated early-onset breast cancer patients. Our findings show that TP53 mutations may account for a minimal portion of early-onset breast cancer in Pakistan.

  3. Factors associated with patient-reported cosmetic outcome in the Young Boost Breast Trial

    NARCIS (Netherlands)

    Brouwers, Patricia J. A. M.; van Werkhoven, Erik; Bartelink, Harry; Fourquet, Alain; Lemanski, Claire; van Loon, Judith; Maduro, John H.; Russell, Nicola S.; Scheijmans, Luc J. E. E.; Schinagl, Dominic A. X.; Westenberg, Antonia H.; Poortmans, Philip; Boersma, Liesbeth J.


    Purpose: To investigate which factors are related to patient reported cosmetic outcome (PRCO) after breast conserving therapy. Methods: From 2004 to 2011, 2421 cT1-2N0-2a breast cancer patients were randomised in the Young Boost Trial between a 16 and a 26 Gy boost to the tumour bed. Cosmesis was sc

  4. Dual-time FDG-PET/CT in patients with potential breast cancer recurrence

    DEFF Research Database (Denmark)

    Baun, Christina; Falch Braas, Kirsten; Gerke, Oke;

    Dual-time FDG-PET/CT in patients with potential breast cancer recurrence: head-to-head comparison with CT and bonescintigraphy......Dual-time FDG-PET/CT in patients with potential breast cancer recurrence: head-to-head comparison with CT and bonescintigraphy...

  5. Feeding Your Newborn (United States)

    ... for your child. These guidelines on breastfeeding and bottle feeding can help you make the decision that's right ... formula is a nutritious alternative to breast milk. Bottle feeding can offer more freedom and flexibility for moms, ...

  6. Preoperative breast MRI can reduce the rate of tumor-positive resection margins and reoperations in patients undergoing breast-conserving surgery

    NARCIS (Netherlands)

    A.I.M. Obdeijn (Inge-Marie); M.M.A. Tilanus-Linthorst (Madeleine); S. Spronk (Sandra); C.H.M. van Deurzen (Carolien); C. de Monyé (Cécile); M.G.M. Hunink (Myriam); M.B. Menke (Marian )


    textabstractOBJECTIVE. In breast cancer patients eligible for breast-conserving surgery, we evaluated whether the information provided by preoperative MRI of the breast would result in fewer tumor-positive resection margins and fewer reoperations. SUBJECTS AND METHODS. The study group consisted of 1

  7. Management issues in women with bipolar disorder during pregnancy and breast feeding period%妊娠及哺乳期妇女双相障碍的治疗

    Institute of Scientific and Technical Information of China (English)

    洪武; 方贻儒


    Bipolar disorder is a recurrent disease. Pregnancy is one of the risk factors of the recurrence. Management in women with bipolar disorder during pregnancy and breast-feeding is very difficult. The management issues are not only related to the health of patients, but also involved in the health of fetus and neonatus. This article reviewed the treatment progress of patients with bipolar disorder during pregnancy and breast-feeding, and also reviewed the management guidelines of China and other countries and regions.%双相障碍是一种容易复发的疾病,妊娠是双相障碍复发的危险因素之一。双相障碍患者的妊娠和哺乳期的处理一直是临床上的难题,这不仅关乎患者的健康,更涉及胎儿和新生儿的健康。本文将综述有关双相障碍妊娠及哺乳期治疗的进展以及中国和其他国家、地区相关治疗指南和建议。

  8. [Monitoring of patients with breast cancer after multimodal treatment]. (United States)

    Prieto, Marcela Martínez; de la Torre, Celia B Flores; Basurto, Carlos Sánchez; Forgach, Ernesto Sánchez


    Breast cancer is a frequent neoplasm in Latin America. Its control implies surveillance for about 10 years after diagnosis. The possibilities of metastatic disease depend on stage at diagnosis and the treatment administered to the patient. It is important that all medical centers implement their own follow-up that fits its needs. Surveillance must include physical therapy, attention to psychosocial aspects as well as treatment for toxicity, secondary effects, recurrence and second primaries. The American Society of Clinical Oncology (ASCO) includes monthly self-examination, annual mammography, office visits every three months for the first three years, and then biannual visits for the next two years and then annually. Randomized studies and the Cochrane database have proved that intensive follow-up is of no value compared with periodic appointments and annual mammography. Existing evidence suggests that postoperative surveillance of breast cancer patients is extremely expensive, time consuming and of no benefit in terms of survival. Most of recurrences present out of context from follow up visits. Thus, efficacy of routine doctor visits is questionable and a prospective study is needed to outline the adequate strategy.

  9. Alimentos complementares e fatores associados ao aleitamento materno e ao aleitamento materno exclusivo em lactentes até 12 meses de vida em Itapira, São Paulo, 1999 Complementary feeding and factors associated to breast-feeding and exclusive breast-feeding among infant up to 12 months of age, Itapira, São Paulo, 1999

    Directory of Open Access Journals (Sweden)

    Celene Aparecida Ferrari Audi


    Full Text Available OBJETIVOS: analisar as práticas alimentares no primeiro ano de vida e fatores associados ao aleitamento materno e ao aleitamento materno exclusivo, no município de Itapira, SP. MÉTODOS: inquérito realizado em 1999 com 679 lactentes menores de 12 meses no Dia Nacional de Vacinação como parte do projeto Amamentação & Municípios. A associação entre o aleitamento e as variáveis independentes condições de nascimento, uso de mamadeira, chupeta e característica maternas, foi verificada por meio de regressão logística múltipla. RESULTADOS: a idade média da mãe foi de 25,5 anos, sendo 41,8% primíparas e 51,7% dos partos cirúrgicos. O peso médio ao nascer foi de 3.223g. Observou-se que 98,1% dos lactentes foram amamentados nos primeiros 30 dias, porém houve introdução precoce de chá, água e outros leites. A prevalência do aleitamento materno exclusivo foi de 64,8% no primeiro mês, caindo para 45% e 30,1% aos quatro e seis meses, respectivamente. Aos 12 meses 61,6% dos lactentes eram amamentados. As variáveis associadas ao desmame foram: usar chupeta (OR 5,58; IC95%: 3,94 -7,89, baixo peso ao nascer (OR 2,74; IC95%: 1,46 - 5,13 e hospital de nascimento (OR 1,76; IC95%: 1,22 - 2,52. Para interrupção da amamentação exclusiva, nos primeiros seis meses, os resultados foram: usar chupeta (OR 4,41; IC95%: 2,57 - 7,59 e parto cesárea (OR 1,78; IC95%: 1,09-2,91. CONCLUSÕES: a prevalência observada, do aleitamento materno e aleitamento materno exclusivo, ainda está distante das atuais recomendações da OMS.OBJECTIVES: to analyze feeding practices in the first year of life and factors associated to breast-feeding and exclusive breast-feeding in the municipality of Itapira. METHODS: survey performed in 1999 with 679 infants under twelve months old in the National Vaccination Day as part of the Project Breast-Feeding & Municipalities. Association between breast-feeding and independent variables of birth conditions, bottle use

  10. Survival of breast cancer patients with synchronous or metachronous central nervous system metastases

    NARCIS (Netherlands)

    Ho, V.K.; Gijtenbeek, J.M.M.; Brandsma, D.; Beerepoot, L.V.; Sonke, G.S.; Loo, M. te


    BACKGROUND: Central nervous system (CNS) metastases represent a devastating complication for advanced breast cancer patients. This observational study examines the influence of patient, tumour and treatment characteristics on overall survival after synchronous or metachronous CNS metastases. METHODS

  11. Sentinel Lymph Node Occult Metastases Have Minimal Survival Effect in Some Breast Cancer Patients (United States)

    Detailed examination of sentinel lymph node tissue from breast cancer patients revealed previously unidentified metastases in about 16% of the samples, but the difference in 5-year survival between patients with and without these metastases was very small

  12. Efficacy of crushed lanthanum carbonate for hyperphosphatemia in hemodialysis patients undergoing tube feeding. (United States)

    Kitajima, Yukie; Takahashi, Taeko; Sato, Yuzuru; Nakaya, Yutaka


    Lanthanum carbonate (LaC) is a non-calcium-based phosphate binder used to treat hyperphosphatemia in patients with chronic kidney disease. Oral administration of LaC is difficult in patients undergoing tube feeding or those who are of advanced age because it is essential to chew the LaC tablet sufficiently before swallowing it. We report two cases in whom crushed LaC was used in hemodialysis patients undergoing tube feeding. In both cases, previously crushed LaC was mixed into enteral nutrients. We found that LaC administered this way was effective for decreasing serum phosphorus levels.

  13. Human papilloma virus identification in breast cancer patients with previous cervical neoplasia

    Directory of Open Access Journals (Sweden)

    James Sutherland Lawson


    Full Text Available Purpose: Women with human papilloma virus (HPV associated cervical neoplasia have a higher risk of developing breast cancer than the general female population. The purpose of this study was to (i identify high risk for cancer HPVs in cervical neoplasia and subsequent HPV positive breast cancers which developed in the same patients and (ii determine if these HPVs were biologically active.Methods: A range of polymerase chain reaction (PCR and immunohistochemical techniques were used to conduct a retrospective cohort study of cervical precancers and subsequent breast cancers in the same patients. Results: The same high risk HPV types were identified in both the cervical and breast specimens in 13 (46% of 28 patients. HPV type 18 was the most prevalent. HPVs appeared to be biologically active as demonstrated by the expression of HPV E7 proteins and the presence of HPV associated koilocytes. The average age of these patients diagnosed with breast cancer following prior cervical precancer was 51 years, as compared to 60 years for all women with breast cancer (p for difference = 0.001. Conclusions: These findings indicate that high risk HPVs can be associated with cervical neoplasia and subsequent young age breast cancer. However these associations are unusual and are a very small proportion of breast cancers. These outcomes confirm and extend the observations of 2 similar previous studies and offer one explanation for the increased prevalence of serious invasive breast cancer among young women.


    Institute of Scientific and Technical Information of China (English)

    Peng Yuan; Bing-he Xu; Da-tong Chu


    Objective To detect serum HER-2 oncoprotein levels in patients with operable and metastatic breast cancers, and to study the correlations between serum HER-2 level and lymph node status as well as other clinical parameters.Methods A total of 120 women were studied consisting of 10 healthy volunteers, 31 benign breast disease, 53 operable breast cancer, and 26 metastatic breast cancer patients. The levels of serum HER-2 were measured using an enzyme-liked immunosorbent assay (ELISA).Results The mean serum HER-2 levels were 9.6 + 1.5 ng/mL in healthy volunteers, 11.9 + 1.6 ng/mL in benign breast disease, 13.2 + 4.2 ng/mL in operable breast cancer, and 30.5 + 30.8 ng/mL in metastatic breast cancer patients. The former is much lower than the latter three (P=0.02, 0.001, 0.03, respectively). If using 15 ng/mL as a normal baseline, elevated serum HER-2 levels were observed in none of the healthy volunteers as well as patients with benign disease, but in 18.9% (10/53)operable breast cancer patients and 61.5% (16/26) metastatic patients. In patients with operable breast cancer, there was a positive correlation between serum concentrations of HER-2 and the size of primary rumor (P < 0.05), whereas there was no correlation between serum concentration and axillary lymph node or estrogen receptor status. In patients with metastatic disease, there was no correlation with site of metastases (P > 0.05).Conclusion Serum HER-2 level was strongly correlated with rumor loads and clinical stages, thus acting as a promising predictor of cancer recurrence in breast cancer patients.

  15. 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.

  16. 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


    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.

  17. Retrospective stuclies on lactation mastitis distribution in breast

    Institute of Scientific and Technical Information of China (English)

    LI Jian-yi; ZHANG Yang; ZHANG Wen-hai; JIA Shi; GU Xi


    Objective To find out the factors which would be likely to affect the occurrence of lactation mastitis.Methods 216 patients with lactation mastitis,who met our grouping criteria,were chosen for survey and clinical data collection.Their age,time of onset,mode of delivery,post-partum colostrum time,mastering of breast-feeding skills,feeding habits,occurring site of their mastitis and other data were input into SPSS 17.0 software,respectively,to perform retrospective analysis.Results Patients' average age and their age of first breast-feeding were all 30 years old ; the average age of their first pregnancy were 27 years old.Their initial post-natal breast-feeding was about 2 to 4 days.The onset of incidence of mastitis was about 28 days post-natal.First,second and third pregnancy patients represented 1/3 of the total patients respectively.63.4% patients had cesarean delivery and only 36.6% patients had vaginal delivery; 91.7% were outpatients and 8.3% patients were inpatients.10.6% patients had abscess and 89.4% patients hadn't.The distribution ratio of inflammation in the upper outer,lower outer,lower inner and upper inner quadrants of the breast was 30.6%,48.1%,19%,2.3% respectively.If the mode of delivery is considered as a factor to investigate incidence time of mastitis and postpartum colostrums time,no significant difference between the two groups was found (P > 0.05).Our survey indicated that 79.2% patients did not have any knowledge of breastfeeding,8.8% patients got the breast-feeding knowledge from their mothers,11.6% patients got the breastfeeding knowledge from books or web resources,only 0.5% of the patients participated in the training of breast-feeding.76.9% patients never had breast massage,19% of patients had a few times of massage,2.8% of patients had occasional massage,and only 1.4% of patients had regular breast massage with the help of their family.85.6% patients didn't have their breasts emptied from breast-feeding

  18. Detection of mammaglobin in the sera of patients with breast cancer. (United States)

    Fanger, G R; Houghton, R L; Retter, M W; Hendrickson, R C; Babcook, J; Dillon, D C; Durham, M D; Reynolds, L D; Johnson, J C; Carter, D; Fleming, T P; Roche, P C; Persing, D H; Reed, S G


    Current procedures for the diagnosis of breast cancer are cumbersome and invasive, making detection of this disease difficult. A rapid screening test for early detection of breast cancer would allow for better management of this deadly disease. In this report, we show that, with the exception of the skin, mammaglobin mRNA is specifically expressed in mammary tissue and commonly overexpressed in breast cancer. Mammaglobin is not expressed in other types of cancer including colon, lung, ovarian, and prostate cancer. Breast-specific expression of mammaglobin protein was shown using immunohistochemical methods. Mammaglobin is secreted from both established breast cancer cell lines and primary breast carcinoma cells cultured in vitro. Using a monoclonal antibody-based assay for monitoring the presence of mammaglobin in serum, elevated levels of mammaglobin were detected in sera of patients with breast cancer, but not in healthy women. Thus, mammaglobin, which is overexpressed and secreted from breast carcinoma cells, is detectable in sera of patients with breast cancer and may provide a rapid screening test for the diagnosis and management of breast cancer.

  19. Effect of Feeding Management on Aspiration Pneu-monia in Elderly Patients with Dysphagia

    Institute of Scientific and Technical Information of China (English)

    Min Li; Zheng Wang; Wei-Jia Han; Shi-Yin Lu; Ya-Zhen Fang


    Objective: To investigate the effects of feeding safety instructions and dietary intervention on as-piration pneumonia in elderly patients with dysphagia. Methods: The study included 40 long-term hospitalized elderly patients with dysphagia who nee-ded oral intake. According to the voluntary and matching principle, participants were divided into the intervention group ( n=20) and control group ( n=20) . We formed a multi-disciplinary team including clinical nurses, rehabilitation therapists and nutritionists. Clinical nurses collaborated with nutritionists and rehabilitation therapists to carry out feeding management. The patients in the control group were fed with semi-solid food, thick liquid, a partial mushy diet and so on accord-ing to their swallowing situations and tastes or preferences. The patients in the intervention group were fed with an all mushy diet. Patients in both groups were able to eat foods on their own or with assistance. Results: After a three-month intervention, the incidence of aspiration pneumonia in both groups was decreased, and the difference was statistically significant ( P<0. 05) . In the control group, seven patients had aspiration pneumonia, including two cases who died after nasogastric feeding due to aggravated dysphagia. In the control group, seven patients had aspiration pneumonia, in-cluding two cases was given nasogastric feeding due to aggravated dysphagia and then one case died. In the intervention group, four patients had aspiration pneumonia. There was no dropouts in either group. Conclusions: Elderly patients with dysphagia require a multidisciplinary team to work closely with them to carry out feeding management. Nurses should conduct safety guidance for care cate-ring and encouraging patients to actively eat a mushy diet. The diet can reduce the incidence of as-piration pneumonia, maintain oral intake and improve the quality of life.

  20. Synchronous bilateral breast cancer in a patient with Klinefelter’s syndrome


    Fentiman, Ian


    H M R Hoque, A Kothari, H Hamed, I S FentimanHedley Atkins Breast Unit, Guys’ Hospital, London, UKAbstract: Synchronous bilateral male breast cancer (MBC) is rare and only a few cases have been reported in the literature. The majority of MBC patients have no definable risk factors. We describe a case with Klinefelter’s syndrome, prior thymic irradiation, testicular surgery, and first degree family history in a 61-year-old male.Keywords: male breast cancer...

  1. Fortifier and Cream Improve Fat Delivery in Continuous Enteral Infant Feeding of Breast Milk

    Directory of Open Access Journals (Sweden)

    Mika Tabata


    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.

  2. [Breast feeding in Puerto Rico: traditional patterns, national trends and future strategies]. (United States)

    Parrilla Rodríguez, A M; Gorrín Peralta, J J


    The Puerto Rican society has gone through profound transformations during the past 50 years. Industrialization and the incorporation of women into the labor force have been accompanied by medicalization of the reproductive process and a progressive reduction in the prevalence of breastfeeding as the cultural norm for nutrition of infants. The data base for 1990 places Puerto Rico significantly below Latin America and the United States in the percentage of breastfed infants. The authors report their experience in the promotion of breastfeeding during the last 5 years. The principal negative factors which hinder the beginning and maintenance of successful breastfeeding are of a social nature. The orientation of physicians towards technology underrates the benefits of breastfeeding. The marketing strategies of the corporations which manufacture artificial milk continuously violate the International Code for Marketing of Breast Milk Substitutes and disfigure the community's perception on the benefits of breastfeeding. The lack of social and legal support for the breastfeeding working mother frequently prevents her from carrying out successful breastfeeding for the recommended period of time. Strategies are presented for the overturn of the existent barriers which have reduced breastfeeding in Puerto Rico to the present precarious levels.

  3. Radiation-induced brachial plexus neuropathy in breast cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Olsen, N.K.; Pfeiffer, P.; Mondrup, K.; Rose, C. (Odense Univ. Hospital (Denmark). Dept. of Neurology Odense Univ. Hospital (Denmark). Dept. of Clinical Neurophysiology Odense Univ. Hospital (Denmark). Dept. of Oncology R)


    The incidence and latency period of radiation-induced brachial plexopathy (RBP) were assessed in 79 breast cancer patients by a neurological follow-up examination at least 60 months (range 67-130 months) after the primary treatment. All patients were treated primarily with simple mastectomy, axillary nodal sampling and radiotherapy (RT). Postoperatively, pre- and postmenopausal patients were randomly allocated chemotherapy for antiestrogen treatment. All patients were recurrence-free at time of examination. Clinically, 35% (25-47%) of the patients had RBP; 19% (11-29%) had definite RBP, i.e. were physically disabled, and 16% (9-26%) had probable RBP. Fifty percent (31-69%) had affection of the entire plexus, 18% (7-35%) of the upper trunk only, and 4% (1-18%) of the lower trunk. In 28% (14-48%) of cases assessment of a definite level was not possible. RBP was more common after radiotherapy and chemotherapy (42%) than after radiotherapy alone (26%) but the difference was not statistically significant (p = 0.10). The incidence of definite RBP was significantly higher in the younger age group (p = 0.02). This could be due to more extensive axillary surgery but also to the fact that chemotherapy was given to most premenopausal patients. In most patients with RBP the symptoms began during or immediately after radiotherapy, and were thus without significant latency. Chemotherapy might enhance the radiation-induced effect on nerve tissue, thus diminishing the latency period. Lymphedema was present in 22% (14-32%), especially in the older patients, and not associated with the development of RBP. In conclusion, the damaging effect of RT on peripheral nerve tissue was documented. Since no successful treatment is available, restricted use of RT to the brachial plexus is warranted, especially when administered concomitantly with cytotoxic therapy. (orig.).

  4. Examining Patient Conceptions: A Case of Metastatic Breast Cancer in an African American Male to Female Transgender Patient


    Dhand, Amar; Dhaliwal, Gurpreet


    An African American male to female transgender patient treated with estrogen detected a breast lump that was confirmed by her primary care provider. The patient refused mammography and 14 months later she was diagnosed with metastatic breast cancer with spinal cord compression. We used ethnographic interviews and observations to elicit the patient’s conceptions of her illness and actions. The patient identified herself as biologically male and socially female; she thought that the former prot...

  5. Development and evaluation of a decision aid about fertility preservation for Dutch breast cancer patients : informing patients about fertility preservation

    NARCIS (Netherlands)

    Garvelink, Mirjam Marjolein


    In the Netherlands, information provision about fertility preservation (FP) for young women with breast cancer is not sufficient. Since an increasing number of Dutch breast cancer patients will face this preference-sensitive decision each year, there is a clear need for improvement of information pr

  6. Preoperative axillary lymph node evaluation in breast cancer patients by breast magnetic resonance imaging (MRI): Can breast MRI exclude advanced nodal disease?

    Energy Technology Data Exchange (ETDEWEB)

    Hyun, Su Jeong [Yonsei University College of Medicine, Department of Radiology, Breast Cancer Clinic, Severance Hospital, Research Institute of Radiological Science, Seoul (Korea, Republic of); Hallym University Medical Center, Department of Radiology, Kangnam Sacred Heart Hospital, Seoul (Korea, Republic of); Kim, Eun-Kyung; Moon, Hee Jung; Yoon, Jung Hyun; Kim, Min Jung [Yonsei University College of Medicine, Department of Radiology, Breast Cancer Clinic, Severance Hospital, Research Institute of Radiological Science, Seoul (Korea, Republic of)


    To evaluate the diagnostic performance of breast magnetic resonance imaging (MRI) in preoperative evaluation of axillary lymph node metastasis (ALNM) in breast cancer patients and to assess whether breast MRI can be used to exclude advanced nodal disease. A total of 425 patients were included in this study and breast MRI findings were retrospectively reviewed. The diagnostic performance of breast MRI for diagnosis of ALNM was evaluated in all patients, patients with neoadjuvant chemotherapy (NAC), and those without NAC (no-NAC). We evaluated whether negative MRI findings (cN0) can exclude advanced nodal disease (pN2-pN3) using the negative predictive value (NPV) in each group. The sensitivity and NPV of breast MRI in evaluation of ALNM was 51.3 % (60/117) and 83.3 % (284/341), respectively. For cN0 cases on MRI, pN2-pN3 manifested in 1.8 % (6/341) of the overall patients, 0.4 % (1/257) of the no-NAC group, and 6 % (5/84) of the NAC group. The NPV of negative MRI findings for exclusion of pN2-pN3 was higher for the no-NAC group than for the NAC group (99.6 % vs. 94.0 %, p = 0.039). Negative MRI findings (cN0) can exclude the presence of advanced nodal disease with an NPV of 99.6 % in the no-NAC group. (orig.)

  7. Prolactin and breast cancer: The need to avoid undertreatment of serious psychiatric illnesses in breast cancer patients: A review. (United States)

    Froes Brandao, Denise; Strasser-Weippl, Kathrin; Goss, Paul E


    Hyperprolactinemia, defined as a sustained elevation of prolactin (PRL) levels greater than 530 mIU/L in women and greater than 424 mIU/L in men, has been implicated for a long time in breast cancer etiology and prognosis. Elevated PRL values (approximately 2-3 times higher than the reference values) are a common adverse effect of antipsychotic medications, especially with first-generation drugs, and most antipsychotics carry a standard warning regarding PRL elevations on their US product labels. These associations foster undertreatment of serious psychiatric illnesses in both otherwise healthy patients and cancer patients. This review assesses both the preclinical and clinical evidence that has led to the hypothesis of PRL's role in breast cancer risk or breast cancer progression. It is concluded that taken together, the published data are unconvincing and insufficient to deprive cancer patients in general and breast cancer patients specifically of potentially effective antipsychotic or antidepressant medications for serious psychiatric indications. We thus call on revised medication guidelines to avoid the existing undertreatment of serious psychiatric illnesses among cancer patients based on an unproven contraindication to psychiatric medications. Cancer 2016;122:184-188. © 2015 American Cancer Society.

  8. Pregnancy after breast cancer: Are young patients willing to participate in clinical studies? (United States)

    Pagani, Olivia; Ruggeri, Monica; Manunta, Silvia; Saunders, Christobel; Peccatori, Fedro; Cardoso, Fatima; Kaufman, Bella; Paluch-Shimon, Shani; Gewefel, Hanan; Gallerani, Elisa; Abulkhair, O Malkahi; Pistilli, Barbara; Warner, Ellen; Saloustros, Emmanouil; Perey, Lucien; Zaman, Khalil; Rabaglio, Manuela; Gelber, Shari; Gelber, Richard D; Goldhirsch, Aron; Korde, Larissa; Azim, Hatem A; Partridge, Ann H


    Young patients with breast cancer (BC) are often concerned about treatment-induced infertility and express maternity desire. Conception after BC does not seem to affect outcome, but information in estrogen-receptor positive (ER+) disease is not definitive. From September 2012-March 2013, 212 evaluable patients with ER+ early BC, pregnancy. Overall, 37% of respondents were interested in the study; younger patients (≤30 years) reported higher interest (57%). Motivation in younger patients treated >30 months was higher (83%) than in older women (14%), interest was independent of age in patients treated for ≤30 months. A prospective study in this patient population seems relevant and feasible. The International-Breast-Cancer-Study-Group (IBCSG), within the Breast-International-Group (BIG) - North-American-Breast-Cancer-Groups (NABCG) collaboration, is launching a study (POSITIVE) addressing ET interruption to allow pregnancy.

  9. Differential Diagnosis of Parotid Lipoma in a Breast Ca Patient (United States)


    Lipomas are common benign tumors usually detected on the torso, neck, upper thighs, and upper arms. However, they are rarely found in the parotid gland region. Because of their rarity at this site, they are not often considered in the differential diagnosis of parotid tumors. This report describes a rare case of a lipoma in the superficial lobe of parotid gland. A 71-year-old female patient admitted to our department complaining about swelling and pain in the posterior area of the left mandibular region since one month. Her medical history included mastectomy after breast CA fifteen years ago. Clinical examination revealed a smooth-surfaced, soft, and painful mass, with well-defined margins in the left mandibular region. Differential diagnosis of metastasis, inflammatory neck swellings, and benign salivary gland tumors were considered for the patient. Advanced imaging methods such as ultrasonography and contrast tomography revealed that the lesion was a lipoma of parotid gland. A surgical intervention under general anesthesia was planned for the removal of the mass; however patient refused the surgical treatment. Patient was placed on six-month periodic recall. This article reviews the radiographic appearance and differential diagnoses of lipoma in this rare location.

  10. Patient-Reported Outcomes Following Breast Reconstruction Surgery and Therapeutic Mammoplasty: Prospective Evaluation 1 Year Post-Surgery with BREAST-Q Questionnaire. (United States)

    Shekhawat, Laxmi; Busheri, Laleh; Dixit, Santosh; Patel, Chaula; Dhar, Upendra; Koppiker, Chaitanyanand


    Breast Cancer (BC) treatment leads to mutilation and destruction of breast shape with negative effects on body image and self-esteem.One of the main goals of reconstructive and oncoplastic breast surgery is to satisfy patients and improve their quality of life (QoL).Therefore, it is important to assess the patient experience post-surgery by means of patient-reported outcome measures (PROMs) that focus on the patient's perception of the surgery and surgical care, as well as psychosocial well-being and physical functioning. The objective of the current study was to identify predictors of patient satisfaction such as breast appearance including implant type in a selective sample of women who underwent breast reconstruction surgery using implants. Participants in this prospective study were women, (age 26-75 years) that were newly diagnosed with breast carcinoma. All consecutive patients who underwent breast reconstruction between January 2013 and October 2014 were asked to complete the BREAST-Q questionnaire 1 year after surgery. 120 patients underwent unilateral breast reconstruction using implant. While 38 patients underwent reconstruction with opposite breast reduction symmertization, 27 patients underwent therapeutic mammoplasty. The response rate for BREAST-Q questionnaire completion was 98 % with 147 out of 150 study participants completed the questionnaire. From the data collected from 147 patients, the responses could be distributed into 4 distinct groups based on the reconstruction outcomes namely "very much satisfied" (93 %) or "definitely and mostly satisfied" (94 %) or "satisfied" with the outcome (88 %) or "definitely agree on having reconstruction rather than the alternative of having no breast "(91 %).The results showed significant improvement in all four areas that were evaluated after surgery namely satisfaction with the appearance of the breasts, psychosocial, sexual and physical well-being. While the reconstruction surgery had an overall

  11. Volatile organic metabolites identify patients with breast cancer, cyclomastopathy, and mammary gland fibroma. (United States)

    Wang, Changsong; Sun, Bo; Guo, Lei; Wang, Xiaoyang; Ke, Chaofu; Liu, Shanshan; Zhao, Wei; Luo, Suqi; Guo, Zhigang; Zhang, Yang; Xu, Guowang; Li, Enyou


    The association between cancer and volatile organic metabolites in exhaled breaths has attracted increasing attention from researchers. The present study reports on a systematic study of gas profiles of metabolites in human exhaled breath by pattern recognition methods. Exhaled breath was collected from 85 patients with histologically confirmed breast disease (including 39 individuals with infiltrating ductal carcinoma, 25 individuals with cyclomastopathy and from 21 individuals with mammary gland fibroma) and 45 healthy volunteers. Principal component analysis and partial least squares discriminant analysis were used to process the final data. The volatile organic metabolites exhibited significant differences between breast cancer and normal controls, breast cancer and cyclomastopathy, and breast cancer and mammary gland fibroma; 21, 6, and 8 characteristic metabolites played decisive roles in sample classification, respectively (P fibroma patients, and patients with cyclomastopathy (P < 0.05). The identified three volatile organic metabolites associated with breast cancer may serve as novel diagnostic biomarkers.

  12. Tube feeding in dementia: how incentives undermine health care quality and patient safety. (United States)

    Finucane, Thomas E; Christmas, Colleen; Leff, Bruce A


    For nursing home residents with advanced dementia, very little evidence is available to show clinical benefit from enteral tube feeding. Although no randomized clinical trials have been done, considerable evidence from studies of weaker design strongly suggest that tube feeding does not reduce the risks of death, aspiration pneumonia, pressure ulcers, other infections, or poor functional outcome. Nationally, however, utilization is high and highly variable. System-wide incentives favor use of tube feeding, and may influence substitute decision-makers, bedside clinicians, gastroenterologists, and administrators regardless of patient preferences or putative medical indications. Underlying the widespread use of this marginally effective therapy is a basic misunderstanding about malnutrition and about aspiration pneumonia. The face value of tube feeding is strong indeed. In addition to the general faith in intervention, the impulse to "do something" when things are going poorly, financial incentives favor tube feeding for gastroenterologists, hospitals, and nursing homes. The desire to avoid regulatory sanctions, bad publicity, and liability exposure creates a further incentive for nursing homes to provide tube feeding. Rational, evidence-based use of tube feeding in advanced dementia will depend fundamentally on improved education. Reimbursement schemes require significant modification to limit the irrational use of tube feeding. Nursing home regulations based more securely on scientific evidence would likely reduce nonbeneficial tube feeding, as would evidence-based tort reform. Quality improvement initiatives could create positive incentives. Realigning incentives in these ways could, we believe, improve the quality of care, quality of life, and safety of these vulnerable individuals, likely with reduced costs of care.

  13. Chemometric techniques on the analysis of Raman spectra of serum blood samples of breast cancer patients (United States)

    Rocha-Osornio, L. N.; Pichardo-Molina, J. L.; Barbosa-Garcia, O.; Frausto-Reyes, C.; Araujo-Andrade, C.; Huerta-Franco, R.; Gutiérrez-Juárez, G.


    Raman spectroscopy and Multivariate methods were used to study serum blood samples of control and breast cancer patients. Blood samples were obtained from 11 patients and 12 controls from the central region of Mexico. Our results show that principal component analysis is able to discriminate serum sample of breast cancer patients from those of control group, also the loading vectors of PCA plotted as a function of Raman shift shown which bands permitted to make the maximum discrimination between both groups of samples.

  14. LAPTM4B Gene Expression And Polymorphism As Diagnostic Markers Of Breast Cancer In Egyptian Patients

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    Shaker Olfat


    Full Text Available Background: The aim of this study was to investigate the association between LAPTM4B gene polymorphism and the risk of breast cancer among Egyptian female patients. Also, measurement was done of its serum level to evaluate its significance as a diagnostic marker for breast cancer.

  15. Prognostic value of serum tetranectin in patients with metastatic breast cancer

    DEFF Research Database (Denmark)

    Høgdall, C K; Sölétormos, G; Nielsen, D;


    To evaluate serum tetranectin as a prognostic marker before first-line chemotherapy, serum levels were studied in 67 patients with metastatic breast cancer. In the Cox analyses, the relative risk (RR) for death of cancer varied with the cut-off level of serum tetranectin. A maximal RR of 5...... prognostic factor in metastatic breast cancer....


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    Full Text Available BACKGROUND AND AIMS: The study was done to know the epidemiology, clinicopathological aspects of carcinoma breast patients in our population. MATERIALS AND METHODS: The epidemiological and clinicopathological data pertaining to demography and risk factors for carcinoma breast were analyzed in patients attending tertiary care hospital of North India from January 2012 to June 2013. Thorough Clinical and physical examination was done, FNAC was done for diagnosis of cancer Breast. RESULTS: In our study mean age of our female breast cancer patients was found to be lower compared to the western world, with an average difference of one decade. Majority of the patients were from urban background. Lump in the breast was a dominant symptom. Familial breast cancer was uncommon. Left sided breast cancer was slightly preponderant. CONCLUSION: Most common symptom was lump in breast among postmenopausal women from urban area. Lack of education was responsible for their delayed presentation. Left upper and outer quadrant being the commonest site, Infiltrating duct carcinoma was the most common type. Modified radical mastectomy was found to be a safe operative procedure. Adjuvant chemotherapy and hormonal therapy was found very effective in early stages. Overall survival for stage IV was 60% for 1 year follow up.

  17. Chronic Stress, Depression and Immunity in Spouses of Metastatic Breast Cancer Patients (United States)

    Mortimer, Jane S. Blake; Sephton, Sandra E.; Kimerling, Rachel; Butler, Lisa; Bernstein, Aaron S.; Spiegel, David


    Objective: The objective of this study was to examine how the chronicity of stress affects psychological stress-responses, depressive symptoms, and "in vivo" immunocompetence in spouses of women with metastatic breast cancer. Methods: Participants were 34 spouses of breast cancer patients. Their wives had been living with a diagnosis of…

  18. Conventional or adhesive external breast prosthesis? A prospective study of the patients' preference after mastectomy

    NARCIS (Netherlands)

    Thijs-Boer, FM; Thijs, JT; van de Wiel, HBM


    After having been subjected to radical mastectomy for breast cancer, women are usually Fitted with an external breast prosthesis. Different types of prostheses are available, but oncology nurses have few data enabling them to advise their patients adequately. in this prospective randomized crossover

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

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    Madhu K


    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. Breast schwannoma in a patient with diffuse large B-cell lymphoma: a case report

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    Salihoglu Ayse


    Full Text Available Abstract Introduction Schwannomas are mostly benign tumors arising from Schwann cells of the nerve sheaths. Breast schwannomas are very rare and account for only 2.6% of cases. As far as we know this is the first reported case of breast schwannoma discovered in a patient with diffuse large B-cell lymphoma. The breast schwannoma was evaluated with positron emission tomography and it exhibited moderate 18F-fluorodeoxyglucose uptake. Case presentation We present the case of a breast schwannoma in a 63-year-old Caucasian woman who was diagnosed with diffuse large B-cell lymphoma. Conclusion Imaging modalities including positron emission tomography-computed tomography failed to distinguish breast schwannoma from diffuse large B-cell lymphoma involvement of the breast.


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    Full Text Available The Breast Conservative Therapy is the standard treatment for early - stage breast cancer in the western world . On the other hand, in India BCT is not preferred by the surgeons and patients (11 - 23% vs. >60 - 70%. Patients suffer from cancer, its treatments and the side - effects of treatment. The majority of them encounter breast cancer multiplicity of physical and psychological difficultie s after finishing cancer treatment. Without rehabilitation these difficulties may lead to functional limitations, disabilities, and mental issues. The breast cancer survival rate has increased, due to improvements in early diagnostic procedures and more ag gressive therapies. Because of increased survival rate need of rehabilitation has been increased. The study was conducted with the aim of being able to determine the need of rehabilitation in patients of breast cancer after MRM in alleviating the disabilit y also, to assess post MRM complication and t o assess the psychological impairment and quality of life of breast cancer was observed that out of 90/122 (73.77% individuals were scoring below 40 which was suggestive of poor quality of life als o, o ut of 122 patients 18 patients developed lymphedema. Amongst the 122 patients 54.97% wanted breast reconstruction & most of them belong to younger age group

  2. GLUT 5 is not over-expressed in breast cancer cells and patient breast cancer tissues.

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    Gayatri Gowrishankar

    Full Text Available F18 2-Fluoro 2-deoxyglucose (FDG has been the gold standard in positron emission tomography (PET oncologic imaging since its introduction into the clinics several years ago. Seeking to complement FDG in the diagnosis of breast cancer using radio labeled fructose based analogs, we investigated the expression of the chief fructose transporter-GLUT 5 in breast cancer cells and human tissues. Our results indicate that GLUT 5 is not over-expressed in breast cancer tissues as assessed by an extensive immunohistochemistry study. RT-PCR studies showed that the GLUT 5 mRNA was present at minimal amounts in breast cancer cell lines. Further knocking down the expression of GLUT 5 in breast cancer cells using RNA interference did not affect the fructose uptake in these cell lines. Taken together these results are consistent with GLUT 5 not being essential for fructose uptake in breast cancer cells and tissues.

  3. A case of recurrence-mimicking charcoal granuloma in a breast cancer patient: Ultrasound,CT, PET/CT and breast-specific gamma imaging findings

    Energy Technology Data Exchange (ETDEWEB)

    Park, Dae Woong; Park, Ji Yeon; Park, Noh Hyuck; Kim, Seon Jeong; Shin, Hyuck Jai; Lee, Jeong Ju [Myongji Hospital, Seonam University College of Medicine, Goyang (Korea, Republic of); Yi, Seong Yoon [Div. of Hematology-Oncology, Dept. of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang (Korea, Republic of)


    Charcoal remains stable without causing a foreign body reaction and it may be used for preoperative localization of a non-palpable breast mass. However, cases of post-charcoal-marking granuloma have only rarely been reported in the breast, and a charcoal granuloma can be misdiagnosed as malignancy. Herein, we report the ultrasound, computed tomography (CT), 18F-fluorodeoxyglucose-positron emission tomography/CT, and breast-specific gamma imaging findings of recurrence-mimicking charcoal granuloma after breast conserving surgery, following localization with charcoal in a breast cancer patient.

  4. Development of a patient-specific two-compartment anthropomorphic breast phantom (United States)

    Prionas, Nicolas D.; Burkett, George W.; McKenney, Sarah E.; Chen, Lin; Stern, Robin L.; Boone, John M.


    The purpose of this paper is to develop a technique for the construction of a two-compartment anthropomorphic breast phantom specific to an individual patient's pendant breast anatomy. Three-dimensional breast images were acquired on a prototype dedicated breast computed tomography (bCT) scanner as part of an ongoing IRB-approved clinical trial of bCT. The images from the breast of a patient were segmented into adipose and glandular tissue regions and divided into 1.59 mm thick breast sections to correspond to the thickness of polyethylene stock. A computer-controlled water-jet cutting machine was used to cut the outer breast edge and the internal regions corresponding to glandular tissue from the polyethylene. The stack of polyethylene breast segments was encased in a thermoplastic ‘skin’ and filled with water. Water-filled spaces modeled glandular tissue structures and the surrounding polyethylene modeled the adipose tissue compartment. Utility of the phantom was demonstrated by inserting 200 µm microcalcifications as well as by measuring point dose deposition during bCT scanning. Affine registration of the original patient images with bCT images of the phantom showed similar tissue distribution. Linear profiles through the registered images demonstrated a mean coefficient of determination (r2) between grayscale profiles of 0.881. The exponent of the power law describing the anatomical noise power spectrum was identical in the coronal images of the patient's breast and the phantom. Microcalcifications were visualized in the phantom at bCT scanning. The real-time air kerma rate was measured during bCT scanning and fluctuated with breast anatomy. On average, point dose deposition was 7.1% greater than the mean glandular dose. A technique to generate a two-compartment anthropomorphic breast phantom from bCT images has been demonstrated. The phantom is the first, to our knowledge, to accurately model the uncompressed pendant breast and the glandular tissue

  5. Salivary total sialic acid levels increase in breast cancer patients: a preliminary study. (United States)

    Oztürk, Leyla Koç; Emekli-Alturfan, Ebru; Kaşikci, Emel; Demir, Gokhan; Yarat, Aysen


    Breast cancer is the most common cancer in women living in the Western world, even though it occurs worldwide. Cancer and cancer therapy induce multiple oral complications including dental and periodontal disease. Saliva is a complex and dynamic biologic fluid, which reflects both oral and systemic changes. While saliva is easily accessible body fluid, there has been little effort to study its value in cancer diagnosis. Sialic acids (SA), the end moieties of the carbohydrate chains, are biologically important and essential for functions of glycoconjugates that are reported to be altered in both blood and saliva of various cancer patients. Increased sialylation has been shown to be a characteristic feature in cancer tissue and blood in breast cancer patients. However, there is no data about salivary SA in breast cancer. The aim of this study was to evaluate salivary total sialic acid (TSA) levels in breast cancer patients who were under chemotheraphy. The study included 15 breast cancer patients in different stages and 10 healthy individuals as age-matched controls. Unstimulated whole saliva was collected. Salivary total protein and SA levels were determined. Flow rate was calculated from salivary volume by the time of secretion. Salivary SA was significantly higher and total protein was lower in breast cancer patients compared to controls. It is concluded that sialylation may be increased in saliva of patients with breast cancer as the same way for cancer tissue and for blood . Increased salivary SA may therefore be useful as a non-invasive predictive marker for breast cancer patients and for the prevention and management of oral complications of cancer and cancer therapy to improve oral function and quality-of-life. The effects of different types of chemotherapies and different stages of the disease on salivary SA levels and salivary sialo-glycomic are worthy of being further investigated in breast cancer patients.

  6. Oral mucosal lesions, microbial changes, and taste disturbances induced by adjuvant chemotherapy in breast cancer patients

    DEFF Research Database (Denmark)

    Jensen, Siri Beier; Mouridsen, Henning T.; Bergmann, Olav Jonas


    OBJECTIVE: The aim of the study was to examine oral mucosal lesions, microbial changes, and taste disturbances induced by adjuvant chemotherapy (CT) in breast cancer patients during and 1 year after treatment. STUDY DESIGN: Forty-five consecutive breast cancer patients, eligible for adjuvant CT...... with cyclophosphamide, epirubicin or methotrexate, and 5-fluorouracil were followed before, during, 6 months and 1 year after CT and were compared to a control group of 31 breast cancer patients not receiving adjuvant CT. RESULTS: During CT, oral mucosal lesions developed including erythema (n = 10, 22%) and ulceration...... in the CT group. CONCLUSION: In breast cancer patients, moderate-intensive adjuvant CT caused oral mucosal lesions, oral candidosis, taste disturbances and a more acidophilic oral microflora. These adverse effects were temporary and the majority of the patients were mildly affected....


    Institute of Scientific and Technical Information of China (English)


    Objective: To identify the feasibility of the lymphatic mapping and sentinel node biopsy (SNB) in patients with breast cancer and to examine whether the characteristics of the sentinel lymph node (SLN) accurately predict the status of axillary node. Methods: 33 patients with breast cancer intraoperatively and postoperatively underwent a lymphatic mapping and the SNB using Patent Blue. Results: The SLNs were found in 30 of 33 patients (90.9%), the SLN accurately predicted the status of the axillary in 29 (96.7%). In one case the SLN was negative, but other axillary nodes were tumor positive. Conclusion: This study confirmed that the procedure of lymphatic mapping and SNB in the patients with breast cancer is feasibility, and that the histological characteristics of the SLN accurately predict the status of the axillary node. We believe that this technique might replace axillary lymph node dissection for breast cancer patients with negative axillae in the future.

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

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    A. Jafarzadeh


    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.

  9. Effectiveness of psychological interventions on depression in patients after breast cancer surgery : a meta-analysis of randomized controlled trials



    INTRODUCTION: Breast cancer has become the most common cancer in women. With the improvement of medical treatment for breast cancer, extended survival and low recurrence rates in breast cancer have been achieved. However, as a threat to the survival and quality of life, long term depression in patients with breast cancer has attracted more and more concern. In clinical practice, individually delivered Cognitive Behavioral Therapy (CBT) is widely used to deal with the depression in patients. A...

  10. Blood Genome-Wide Transcriptional Profiles of HER2 Negative Breast Cancers Patients

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    Ovidiu Balacescu


    Full Text Available Tumors act systemically to sustain cancer progression, affecting the physiological processes in the host and triggering responses in the blood circulating cells. In this study, we explored blood transcriptional patterns of patients with two subtypes of HER2 negative breast cancers, with different prognosis and therapeutic outcome. Peripheral blood samples from seven healthy female donors and 29 women with breast cancer including 14 triple-negative breast cancers and 15 hormone-dependent breast cancers were evaluated by microarray. We also evaluated the stroma in primary tumors. Transcriptional analysis revealed distinct molecular signatures in the blood of HER2− breast cancer patients according to ER/PR status. Our data showed the implication of immune signaling in both breast cancer subtypes with an enrichment of these processes in the blood of TNBC patients. We observed a significant alteration of “chemokine signaling,” “IL-8 signaling,” and “communication between innate and adaptive immune cells” pathways in the blood of TNBC patients correlated with an increased inflammation and necrosis in their primary tumors. Overall, our data indicate that the presence of triple-negative breast cancer is associated with an enrichment of altered systemic immune-related pathways, suggesting that immunotherapy could possibly be synergistic to the chemotherapy, to improve the clinical outcome of these patients.

  11. Primary tuberculous infection of breast: experiences of surgical resection for aged p.atients and review of literature

    Institute of Scientific and Technical Information of China (English)


    Primary mammary tuberculosis is a rare entity that usually occurs in female of reproductive age. Herein three such patients including two males with ages over 80 years, who underwent surgical resection, are reported. Fine needle biopsy failed to achieve specific diagnosis before surgical operation. All of their conditions got satisfactory improvement and anti-tuberculosis chemotherapy was administered postoperatively. Previous literature related to the epidemiology, diagnosis and treatment for mammary tuberculosis will be also reviewed. Mammary tuberculosis is usually related to breast feeding women and is extremely rare in aged man. The possible mechanisms resulting in this disease in our three patients, including direct extension, reactivation,or transmitted by staffs or peers of the nursing home, would also be discussed.

  12. Season of birth of breast cancer patients and its relation to patients' reproductive history in Tokyo, Japan.

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    Full Text Available Seasonal distribution of the birth dates of 405 pre-menopausal and 285 post-menopausal breast cancer patients was investigated in order to determine whether or not the season of their birth was related to various reproductive risk factors of breast cancer, including nulliparity, late age at first birth, early age at menarche, late age at menopause, and a history of benign breast diseases. The seasonal distributions of births were compared between groups of patients categorized according to whether they possessed each risk factor or not, separately for pre- and post-menopausal patients. Patients with the same menopausal status generally had the same seasonal distribution of births, irrespective of whether or not they possessed a risk factor. Moreover, low-risk patients exhibited more deviation in the seasonal distribution of birth from general births than the high-risk patients. These results suggest that the distinctive seasonal distribution of birth observed in breast cancer patients is basically a phenomenon independent from the effect of the reproductive history on the occurrence of breast cancer, and that specific seasonal factors are involved at the fetal or neonatal stage in the etiology of breast cancer.

  13. Prospective evaluation of skin surface electropotentials in Japanese patients with suspicious breast lesions. (United States)

    Fukuda, M; Shimizu, K; Okamoto, N; Arimura, T; Ohta, T; Yamaguchi, S; Faupel, M L


    The biofield breast examination (BBE) is a new, noninvasive and cost-effective method for diagnosing breast lesions currently undergoing multicenter evaluation in the USA and Europe. The test analyzes subtle differences in electrical potential caused by dysregulated epithelial proliferation. This report summarizes a prospective evaluation of BBE in a population of 101 patients with suspicious breast lesions scheduled either for open surgical biopsy or fine needle aspiration biopsy. Of the 101 patients included in the study, 49 were found to have a breast malignancy and 52 were found to have a benign breast lesion. BBE correctly identified 44 of 49 biopsy-proven cancers (sensitivity=90%) and correctly indicated no cancer in 31 of 52 biopsy-proven benign cases (specificity=60%). Sensitivity increased to 95% for cancers less than 2.5 cm in size. These results indicate that BBE may be an effective adjunctive test to help to resolve abnormalities discovered by physical examination or other screening methods.

  14. Follow-up of breast cancer patients: Preliminary findings from nurse-patient consultations and patient surveys

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    Moyez Jiwa


    Full Text Available BACKGROUND:Although clinicians in both primary and tertiary care settings are involved in the care of breast cancer patientsfollowing the active treatment phase, few studies report how patients interact with health care providers.METHODS:Participants in this breast cancer follow-up study were recruited from a hospital based nurse-led follow-upclinic in Western Australia. Methods included audio taped, transcribed consultations with Specialist BreastNurses (SBNs and patient self-completed surveys.RESULTS:Preliminary data suggest that SBNs play an important role in supporting women to deal with the impact ofbreast cancer in the years following active treatment. The data suggest that the process of adjustment to adiagnosis of cancer continues for many years after the treatment has ceased. In many cases the women requireon-going support to recalibrate their response to normal physical changes that may or may not be aconsequence of surgery, radiotherapy and chemotherapy.CONCLUSIONS:These preliminary data map the plethora of issues that influence cancer patients in the years followingtreatment. Women who were attending follow-up appointments for breast cancer experienced similar levels ofenablement following SBN consultations as would be expected from consultations with general practitioners.

  15. 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


    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

  16. [Efficiency of the capecitabine in patients with breast cancer with liver metastasis]. (United States)

    Gasanzade, D A; Zeĭnalov, R S; Musaev, I N


    The main purpose of the present research is to study the efficiency of capecitabine in treatment of patients with breast cancer with liver metastasis. The investigation was carried on 44 patients with breast cancer with liver metastasis. Patients were divided into 2 groups. The first group was composed of patients (n=21) cycles of chemotherapy ( DCapLv) was carried out. The second group (n=23) was composed of patients treated upon the schema of CapLv. Patients had their diagnosis morphologically verified Metastatic involvement of the liver was diagnosed on the base of data of MRI, CT and ultrasonographic research. The obtained results were compared with the results of treatment of patients (n=54), who received the "classical" schema of FAC treatment. The investigation proved high efficiency of chemotherapy treatment schema in patients with breast cancer with liver metastasis. Proposed schema of chemotherapy seems to have had few hepatotoxic effects.

  17. Feeding Your Baby in the NICU (United States)

    ... Use the combination of breast milk and formula, bottle-feeding and nursing that works best for you and ... the breast even if you supplement with a bottle-feeding afterwards, do so. Permit yourself room to experiment ...

  18. Serum Copper, Zinc levels and Copper/Zinz ratio as biochemical markers in diagnosis and prognosis of breast cancer patients

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    Sadr Sh


    Full Text Available Serum copper, zinc and the cu/zn ratio were measured in 55 patients with breast disease (20 with benign breast disease and 35 patients with breast cancer and 30 healthy subjects. The mean serum copper levels were higher in breast cancer than in benign breast diseases (127.5 µg/dl versus 92.4 µg/dl (P<0.0005 and controls (127.5 µg/dl versus 75.6 µg/dl (P<0.0005. Patients with advanced breast cancer had higher serum copper levels than did patients with early breast cancer (163 µg/dl versus 103.9 µg/dl (P<0.0005. Patients with advanced breast cancer had lower serum zinc levels than did patients with benign breast disease (68.9 µg/dl versus 135.9 µg/dl (P<0.0005 and controls (68.9 µg/dl versus 129.9 µg/dl (P<0.0005 but no significant difference have seen between serum zinc levels of early and advanced breast cancer patients (68.9 µg/dl versus 72.9 µg/dl (P<0.05. Serum zinc levels were not decreased in patients with benign breast disease

  19. Assessment of quality of life in breast cancer patients at a tertiary care hospital

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    G Damodar


    Conclusion: These findings have shown that there exists a strong correlation between the length of treatment and the QoL among breast cancer patients. Future interventions should target each specific aspect of QoL.

  20. Prognostic Impact of VEGFA Germline Polymorphisms in Patients with HER2-positive Primary Breast Cancer

    DEFF Research Database (Denmark)

    Maae, Else; Andersen, Rikke Fredslund; Dahl Steffensen, Karina;


    Background: Vascular endothelial growth factor A (VEGFA) is essential in tumour angiogenesis, and polymorphisms in the VEGFA gene have been associated with breast cancer prognosis. The human epidermal growth factor receptor 2 (HER2) is overexpressed in breast tumours and is also associated...... multivariate analysis, only the -634CC genotype remained an independent prognostic factor (p=0.008). Conclusion: The VEGFA -634CC genotype was found to be associated with an inferior prognosis for patients with HER2-positive breast cancer....... with angiogenesis. We investigated the possible prognostic impact of VEGFA single nucleotide polymorphisms (SNPs) in patients with HER2-positive primary breast cancer. Patients and Methods: DNA was isolated from venous blood samples from 116 HER2-positive patients and genotyped for VEGFA -2578C>A, -1498T>C, -1154G...

  1. The Study of DNA Methyltransferase-3B Promoter Variant Genotype among Iranian Sporadic Breast Cancer Patients

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    Ebrahim Eftekhar


    Full Text Available Background: DNA methyltransferase-3B (DNMT3B is an important enzyme responsible for maintaining the DNA methylation pattern in eukaryotic cells. In this study we have investigated the correlation between the 46359C→T polymorphism in the DNMT3B gene and the risk of breast cancer incidence among sporadic breast cancer patients in Fars Province, Southern Iran. Methods: In this case-control study, 100 breast cancer patients and 138 healthy control subjects were genotyped for the DNMT3B gene by the polymerase chain reaction-restriction fragment length polymorphism method. Results: The genotype frequency in the case (CC 27%, CT 47%, TT 26% group significantly (P=0.008 differed from the control (CC 19.56%, CT 67.3%, TT 13% group. We observed a decreased association between the CT genotype and lymph node involvement in breast cancer patients. Our results have shown that in comparison to the homozygous CC genotype carriers the DNMT3B-CT genotype has a significantly lower risk for breast cancer (OR=0.515, 95% CI=0.267-0.994, P=0.048. Conclusion: Our case-control study showed that the CT genotype was significantly associated with decreased breast cancer risk. Consistent with these results, a significant decrease of CT genotype among lymph node positive breast cancer patients was observed. However, a larger study population with more clinical data is needed to confirm these results.

  2. Bone Health in Patients with Breast Cancer: Recommendations from an Evidence-Based Canadian Guideline

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    Alexander H. G. Paterson


    Full Text Available Bone loss is common in patients with breast cancer. Bone modifying agents (BMAs, such as bisphosphonates and denosumab, have been shown to reverse or stabilize bone loss and may be useful in the primary and metastatic settings. The purpose of this review is to provide clear evidence-based strategies for the management of bone loss and its symptoms in breast cancer. A systematic review of clinical trials and meta-analyses published between 1996 and 2012 was conducted of MEDLINE and EMBASE. Reference lists were hand-searched for additional publications. Recommendations were developed based on the best available evidence. Zoledronate, pamidronate, clodronate, and denosumab are recommended for metastatic breast cancer patients; however, no one agent can be recommended over another. Zoledronate or any oral bisphosphonate and denosumab should be considered in primary breast cancer patients who are postmenopausal on aromatase inhibitor therapy and have a high risk of fracture and/or a low bone mineral density and in premenopausal primary breast cancer patients who become amenorrheic after therapy. No one agent can be recommended over another. BMAs are not currently recommended as adjuvant therapy in primary breast cancer for the purpose of improving survival, although a major Early Breast Cancer Cooperative Trialists’ Group meta-analysis is underway which may impact future practice. Adverse events can be managed with appropriate supportive care.

  3. Ultrasound guided intercostobrachial nerve blockade in patients with persistent pain after breast cancer surgery

    DEFF Research Database (Denmark)

    Wijayasinghe, Nelun; Duriaud, Helle M; Kehlet, Henrik;


    BACKGROUND: Persistent pain after breast cancer surgery (PPBCS) affects 25 - 60% of breast cancer survivors and damage to the intercostobrachial nerve (ICBN) has been implicated as the cause of this predominantly neuropathic pain. Local anesthetic blockade of the ICBN could provide clues...... determined the sonoanatomy of the ICBN and part 2 examined effects of the ultrasound-guided ICBN blockade in patients with PPBCS. SETTING: Section for Surgical Pathophysiology at Rigshospitalet, Copenhagen, Denmark. METHODS: Part 1: Sixteen unoperated, pain free breast cancer patients underwent systematic...

  4. Ultrasound Guided Intercostobrachial Nerve Blockade in Patients with Persistent Pain after Breast Cancer Surgery

    DEFF Research Database (Denmark)

    Wijayasinghe, Nelun; Duriaud, Helle M; Kehlet, Henrik


    BACKGROUND: Persistent pain after breast cancer surgery (PPBCS) affects 25 - 60% of breast cancer survivors and damage to the intercostobrachial nerve (ICBN) has been implicated as the cause of this predominantly neuropathic pain. Local anesthetic blockade of the ICBN could provide clues...... determined the sonoanatomy of the ICBN and part 2 examined effects of the ultrasound-guided ICBN blockade in patients with PPBCS. SETTING: Section for Surgical Pathophysiology at Rigshospitalet, Copenhagen, Denmark. METHODS: Part 1: Sixteen unoperated, pain free breast cancer patients underwent systematic...

  5. Cardiac and pulmonary complication probabilities for breast cancer patients after routine end-inspiration gated radiotherapy

    DEFF Research Database (Denmark)

    Korreman, Stine S; Pedersen, Anders N; Juhler-Nøttrup, Trine


    PURPOSE: Substantial reductions of radiation doses to heart and lung can be achieved using breathing adaptation of adjuvant radiotherapy following conservative surgery for breast cancer. The purpose of this study was to estimate the radiobiological implications after routine use of an end......-inspiration gated treatment, and to compare the results with predictions based on pre-clinical CT-studies. PATIENTS AND METHODS: Nineteen consecutive patients with axillary lymph node-positive left-sided breast cancer were referred for adjuvant radiotherapy after breast conserving surgery. Treatment was performed...... and pulmonary complication risks are of the order of 1% and smaller....

  6. Radio-induced malignancies after breast cancer postoperative radiotherapy in patients with Li-Fraumeni syndrome

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    Pachet Corinne


    Full Text Available Abstract Background There are no specific recommendations for the management of breast cancer patients with germ-line p53 mutations, an exceptional genetic condition, particularly regarding postoperative radiotherapy. Preclinical data suggested that p53 mutations conferred enhanced radiosensitivity in vitro and in vivo and the few clinical observations showed that Li-Fraumeni families were at a higher risk of secondary radio-induced malignancies. Methods We reviewed a cohort of patients with germ-line p53 mutations who had been treated for breast cancer as the first tumor event. We assessed their outcome and the incidence of secondary radio-induced malignancies. Results Among 47 documented Li-Fraumeni families treated from 1997 to 2007 at the Institut Gustave Roussy, 8 patients had been diagnosed with breast cancer as the first tumor event. Three patients had undergone conservative breast surgery followed by postoperative radiotherapy and five patients had undergone a mastectomy (3 with postoperative radiotherapy. Thus, 6/8 patients had received postoperative radiotherapy. Median follow-up was 6 years. Median age at the diagnosis of the primary breast cancer was 30 years. The histological characteristics were as follows: intraductal carcinoma in situ (n = 3, invasive ductal carcinoma (n = 4 and a phyllodes tumor (n = 1. Among the 6 patients who had received adjuvant radiotherapy, the following events had occurred: 3 ipsilateral breast recurrences, 3 contralateral breast cancers, 2 radio-induced cancers, and 3 new primaries (1 of which was an in-field thyroid cancer with atypical histology. In contrast, only one event had occurred (a contralateral breast cancer among patients who had not received radiation therapy. Conclusions These observations could argue in favor of bilateral mastectomy and the avoidance of radiotherapy.

  7. Detection of Slit2 promoter hypermethylation in tissue and serum samples from breast cancer patients. (United States)

    Kim, Ga-Eon; Lee, Kyung Hwa; Choi, Yoo Duk; Lee, Ji Shin; Lee, Jae Hyuk; Nam, Jong Hee; Choi, Chan; Park, Min Ho; Yoon, Jung Han


    Promoter hypermethylation has been shown to be a common mechanism for inactivation of tumor suppressor genes in breast cancer. The aim of this study was to investigate the prevalence of Slit2 promoter hypermethylation in both the tumor and serum samples of breast cancer patients with ductal carcinoma in situ (DCIS) or invasive breast carcinoma (IBC). The methylation status of Slit2 was investigated in 210 tissue samples (15 breast with no pathological findings, 26 DCIS, and 169 IBC samples) and 123 corresponding serum samples (15 breast with no pathological findings, 26 DCIS, and 82 IBC samples) using methylation-specific polymerase chain reaction. Immunohistochemical staining for Slit2 was also performed using tissue microarray blocks to determine whether Slit2 promoter hypermethylation correlated with loss of Slit2 expression. Slit2 promoter hypermethylation was not detected in breast tissue and serum samples from patients with no pathological findings. DCIS or IBC showed a statistically higher frequency of Slit2 promoter hypermethylation compared to breast with no pathological findings in both the tissue and serum samples; however, there were no statistically significant differences between DCIS and IBC samples. Similar Slit2 promoter hypermethylation patterns were seen in the tissue samples and corresponding serum specimens (p Slit2 promoter hypermethylation was associated with loss of Slit2 expression. These results suggest that Slit2 promoter hypermethylation appears to be responsible for functionally silencing Slit2 expression. Slit2 promoter hypermethylation may be considered as a possible serum marker for early detection of breast cancer.

  8. Biomarkers in Tissue Samples From Patients With Newly Diagnosed Breast Cancer Treated With Zoledronic Acid (United States)


    Estrogen Receptor-positive Breast Cancer; Invasive Ductal Breast Carcinoma; Progesterone Receptor-positive Breast Cancer; Stage IA Breast Cancer; Stage IB Breast Cancer; Stage IIA Breast Cancer; Stage IIB Breast Cancer


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    S. Yu. Sletina


    Full Text Available One of the components of pathogenetic treatment of patients with breast cancer is castration. The aim of research is to investigate the significance of video assisted laparoscopic surgery on female reproductive organs in the treatment of breast cancer patients. The study is based on analysis of treatment results of 320 breast cancer patients with noncompromised menstruation and presence of steroid hor- mone receptors in tumor tissue. In comparison to surgical techniques used earlier, video assisted endoscopic surgery allows to decrease the aggressiveness of operation, accelerate the rehabilitation of patients, and lower the length of hospital stay. Radiation castration is not always effective: menstruation recovered in some patients. Besides, radiotherapy can not be recommended for patients with patho- logically transformed ovaries. Chemical castration with Zoladex or other analogous drugs is inaccessible for most patients in Russia.

  10. Feasibility and Acute Toxicity of Hypofractionated Radiation in Large-breasted Patients

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    Dorn, Paige L., E-mail: [Department of Radiation and Cellular Oncology, University of Chicago Hospitals, Chicago, IL (United States); Corbin, Kimberly S.; Al-Hallaq, Hania; Hasan, Yasmin; Chmura, Steven J. [Department of Radiation and Cellular Oncology, University of Chicago Hospitals, Chicago, IL (United States)


    Purpose: To determine the feasibility of and acute toxicity associated with hypofractionated whole breast radiation (HypoRT) after breast-conserving surgery in patients excluded from or underrepresented in randomized trials comparing HypoRT with conventional fractionation schedules. Methods and Materials: A review was conducted of all patients consecutively treated with HypoRT at University of Chicago. All patients were treated to 42.56 Gy in 2.66 Gy daily fractions in either the prone or supine position. Planning was performed in most cases using wedges and large segments or a 'field-in-field' technique. Breast volume was estimated using volumetric measurements of the planning target volume (PTV). Dosimetric parameters of heterogeneity (V105, V107, V110, and maximum dose) were recorded for each treatment plan. Acute toxicity was scored for each treated breast. Results: Between 2006 and 2010, 78 patients were treated to 80 breasts using HypoRT. Most women were overweight or obese (78.7%), with a median body mass index of 29.2 kg/m{sup 2}. Median breast volume was 1,351 mL. Of the 80 treated breasts, the maximum acute skin toxicity was mild erythema or hyperpigmentation in 70.0% (56/80), dry desquamation in 21.25% (17/80), and focal moist desquamation in 8.75% (7/80). Maximum acute toxicity occurred after the completion of radiation in 31.9% of patients. Separation >25 cm was not associated with increased toxicity. Breast volume was the only patient factor significantly associated with moist desquamation on multivariable analysis (p = 0.01). Patients with breast volume >2,500 mL experienced focal moist desquamation in 27.2% of cases compared with 6.34% in patients with breast volume <2,500 mL (p = 0.03). Conclusions: HypoRT is feasible and safe in patients with separation >25 cm and in patients with large breast volume when employing modern planning and positioning techniques. We recommend counseling regarding expected increases in skin toxicity in women

  11. Breast imaging after dark: patient outcomes following evaluation for breast abscess in the emergency department after hours. (United States)

    Bosma, Melissa S; Morden, Kasey L; Klein, Katherine A; Neal, Colleen H; Knoepp, Ursula S; Patterson, Stephanie K


    In our study, we sought to report the management, clinical outcomes, and follow-up rates of patients who presented for evaluation of breast abscess in the Emergency Department (ED) after hours. A retrospective search of ultrasound reports at our institution identified all patients from January 1, 2009 to June 30, 2013 who were scanned in the ED after hours to evaluate for breast abscess. Patient demographics, clinical information, imaging findings, follow-up rates, and outcomes were reviewed. One hundred eighty-five patients were included in the study. Forty-four percent (86/185) of the patients were diagnosed with abscess based on ultrasound findings in the ED. Twenty-seven percent (23/86) were recently post-operative, and 12 % (10/86) were postpartum/breastfeeding. Mastitis was the diagnosis in the remaining 54 % (99/185). Only 1/86 cases were associated with breast cancer. Seventy-seven percent (66/86) of patients were treated with an invasive procedure; 39 % (26/66) had surgical evacuation, 30 % (20/66) image-guided drainage, 23 % (15/66) bedside or clinic incision and drainage, and 8 % (5/66) palpation-guided fine needle aspiration (FNA). Seventy-seven percent (143/185) of patients had clinical and/or imaging follow-up. Forty-four percent (63/143) had long-term follow-up (≥ 3 months). Almost 50 % of the patients who presented to the ED for evaluation of abscess were diagnosed with abscess while the remaining patients were diagnosed with mastitis. Appropriate clinical and/or imaging follow-up occurred in 77 %. Long-term follow-up (≥ 3 months) occurred more frequently in patients older than 30 years of age. Appropriate follow-up does not occur in approximately one fourth of cases, suggesting that additional clinician and patient education is warranted.


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    Anees eChagpar


    Full Text Available Introduction:Breast cancer is frequently diagnosed, yet variation remains in terms of practice patterns in presurgical workup. We sought to determine factors associated with this variation.Methods:An anonymous web-based survey was distributed to surgeons regarding their practices. Statistical analyses were conducted using SPSS.Results:253 surgeons responded to the survey. 17.0% were in academic practice, 37.5%% were hospital employed, and 41.5% were in private practice. 53.3% claimed that > 50% of their practice was breast-related. Surgeons were asked how often they would use various tests in the workup of an otherwise healthy asymptomatic patients, presenting with a non-palpable mammographic abnormality and a core needle biopsy showing invasive breast cancer. 23.5% stated they always would obtain a breast ultrasound, 17.2% stated they never would. 12.8% stated they never order a breast MRI; 4.1% always would. Workup of patients did not vary significantly based on number of years in practice nor practice setting. However, those whose practice was >50% breast were more likely to state that they would always order a breast ultrasound (32.5% vs. 12.9%, p<0.001, and less likely to state they would never order a breast MRI (3.4% vs. 25.8%, p<0.001. However, the proportions of surgeons who would always order a breast MRI was similar in the two groups (3.4% and 3.2%, respectively. Conclusions:These data highlight the lack of uniformity in the workup of asymptomatic patients presenting with non-palpable breast cancers, pointing to potential areas for improving value by minimizing variability.

  13. Mutations of the BRCA1 and BRCA2 genes in patients with bilateral breast cancer. (United States)

    Steinmann, D; Bremer, M; Rades, D; Skawran, B; Siebrands, C; Karstens, J H; Dörk, T


    Mutations of the BRCA1 or BRCA2 genes have been shown to strongly predispose towards the development of contralateral breast cancer in patients from large multi-case families. In order to test the hypothesis that BRCA1 and BRCA2 mutations are more frequent in patients with bilateral breast cancer, we have investigated a hospital-based series of 75 consecutive patients with bilateral breast cancer and a comparison group of 75 patients with unilateral breast cancer, pairwise matched by age and family history, for mutations in the BRCA1 and BRCA2 genes. Five frameshift deletions (517delGT in BRCA1; 4772delA, 5946delCT, 6174delT and 8138del5 in BRCA2) were identified in patients with bilateral disease. No further mutations, apart from polymorphisms and 3 rare unclassified variants, were found after scanning the whole BRCA1 and BRCA2 coding sequence. Three pathogenic BRCA1 mutations (Cys61Gly, 3814del5, 5382insC) were identified in the group of patients with unilateral breast cancer. The frequencies of common BRCA1 and BRCA2 missense variants were not different between the 2 groups. In summary, we did not find a significantly increased prevalence of BRCA1 and BRCA2 mutations in a hospital-based cohort of German patients with bilateral breast cancer. We conclude that bilaterality of breast cancer on its own is not strongly associated with BRCA1 and BRCA2 mutations when adjusted for age and family history. The high frequency of bilateral disease in multi-case breast cancer families may be due to a familial aggregation of additional susceptibility factors modifying the penetrance of BRCA1 and BRCA2 mutations.

  14. Psycho-oncological support for breast cancer patients: A brief overview of breast cancer services certification schemes and national health policies in Europe. (United States)

    Neamţiu, L; Deandrea, S; Pylkkänen, L; Freeman, C; López Alcalde, J; Bramesfeld, A; Saz-Parkinson, Z; Ulutürk, A; Lerda, D


    Psycho-oncology addresses the psychological, social, behavioural, and ethical aspects of cancer. Identification and proper management of the patients' psychosocial needs, as well as the needs of their caregivers and family are essential for a person-centred concept of breast cancer care. The aim of this overview is to describe how psychosocial support in breast cancer is incorporated in cancer-related policy documents, such as national cancer plans and breast cancer care certification schemes.

  15. Identification of prognostic genes for recurrent risk prediction in triple negative breast cancer patients in Taiwan.

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    Lee H Chen

    Full Text Available Discrepancies in the prognosis of triple negative breast cancer exist between Caucasian and Asian populations. Yet, the gene signature of triple negative breast cancer specifically for Asians has not become available. Therefore, the purpose of this study is to construct a prediction model for recurrence of triple negative breast cancer in Taiwanese patients. Whole genome expression profiling of breast cancers from 185 patients in Taiwan from 1995 to 2008 was performed, and the results were compared to the previously published literature to detect differences between Asian and Western patients. Pathway analysis and Cox proportional hazard models were applied to construct a prediction model for the recurrence of triple negative breast cancer. Hierarchical cluster analysis showed that triple negative breast cancers from different races were in separate sub-clusters but grouped in a bigger cluster. Two pathways, cAMP-mediated signaling and ephrin receptor signaling, were significantly associated with the recurrence of triple negative breast cancer. After using stepwise model selection from the combination of the initial filtered genes, we developed a prediction model based on the genes SLC22A23, PRKAG3, DPEP3, MORC2, GRB7, and FAM43A. The model had 91.7% accuracy, 81.8% sensitivity, and 94.6% specificity under leave-one-out support vector regression. In this study, we identified pathways related to triple negative breast cancer and developed a model to predict its recurrence. These results could be used for assisting with clinical prognosis and warrant further investigation into the possibility of targeted therapy of triple negative breast cancer in Taiwanese patients.

  16. Risk modeling and screening for BRCA1 mutations among Filipino breast cancer patients

    CERN Document Server

    Nato, A Q J


    Breast cancer susceptibility gene, type 1(BRCA1) has been thought to be responsible for approx 45% of families with multiple breast carcinomas and for approx 80% of breast and ovarian cancer families. In this study, we investigated 34 familial Filipino breast cancer (BC) patients to: (a) estimate breast cancer risks and BRCA1/2 mutation carrier probabilities using risk assessment and prior probability models, respectively; (b) screen for putative polymorphisms at selected smaller exons of BRCA1 by single-strand conformation polymorphism (SSCP) analysis; (c) screen for truncated mutations at BRCA1 exon 11 by radioactive protein truncation test (PTT); and (d) estimate posterior probabilities upon incorporation of screening results. SSCP analysis revealed 8 unique putative polymorphisms. Low prevalence of unique putative polymorphisms at exon 2, 5, 17, and 22 may indicate probable mutations. Contrastingly, high prevalence of unique putative polymorphisms at exons 13, 15, and 16 may suggest true polymorphisms whi...

  17. Life expectancy of screen-detected invasive breast cancer patients compared with women invited to the Nijmegen Screening Program

    NARCIS (Netherlands)

    J.D.M. Otten; M.J.M. Broeders (Mireille); G.J. den Heeten (Gerard); R. Holland (Roland); J. Fracheboud (Jacques); H.J. de Koning (Harry); A.L.M. Verbeek (Andre)


    textabstractBACKGROUND: Screening can lead to earlier detection of breast cancer and thus to an improvement in survival. The authors studied the life expectancy of women with screen-detected invasive breast cancer (patients) compared with women invited to the breast cancer screening program in Nijme

  18. Mass Spectrometry-Based Quantitative Metabolomics Revealed a Distinct Lipid Profile in Breast Cancer Patients

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    Yun Yen


    Full Text Available Breast cancer accounts for the largest number of newly diagnosed cases in female cancer patients. Although mammography is a powerful screening tool, about 20% of breast cancer cases cannot be detected by this method. New diagnostic biomarkers for breast cancer are necessary. Here, we used a mass spectrometry-based quantitative metabolomics method to analyze plasma samples from 55 breast cancer patients and 25 healthy controls. A number of 30 patients and 20 age-matched healthy controls were used as a training dataset to establish a diagnostic model and to identify potential biomarkers. The remaining samples were used as a validation dataset to evaluate the predictive accuracy for the established model. Distinct separation was obtained from an orthogonal partial least squares-discriminant analysis (OPLS-DA model with good prediction accuracy. Based on this analysis, 39 differentiating metabolites were identified, including significantly lower levels of lysophosphatidylcholines and higher levels of sphingomyelins in the plasma samples obtained from breast cancer patients compared with healthy controls. Using logical regression, a diagnostic equation based on three metabolites (lysoPC a C16:0, PC ae C42:5 and PC aa C34:2 successfully differentiated breast cancer patients from healthy controls, with a sensitivity of 98.1% and a specificity of 96.0%.

  19. Breast cancer size estimation with MRI in BRCA mutation carriers and other high risk patients

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    Mann, R.M., E-mail: [Radboud University Nijmegen Medical Centre, Department of Radiology, Nijmegen (Netherlands); Bult, P., E-mail: [Radboud University Nijmegen Medical Centre, Department of Pathology, Nijmegen (Netherlands); Laarhoven, H.W.M. van, E-mail: [Academic Medical Centre, University of Amsterdam, Department of Medical Oncology, Amsterdam (Netherlands); Radboud University Nijmegen Medical Centre, Department of Medical Oncology, Nijmegen (Netherlands); Span, P.N., E-mail: [Radboud University Nijmegen Medical Centre, Department of Radiation Oncology, Nijmegen (Netherlands); Schlooz, M., E-mail: [Radboud University Nijmegen Medical Centre, Department of Surgery, Nijmegen (Netherlands); Veltman, J., E-mail: [Hospital group Twente (ZGT), Department of Radiology, Almelo (Netherlands); Hoogerbrugge, N., E-mail: [Radboud University Nijmegen Medical Centre, Department of Human Genetics, Nijmegen (Netherlands)


    Objective: To assess the value of breast MRI in size assessment of breast cancers in high risk patients, including those with a BRCA 1 or 2 mutation. Guidelines recommend invariably breast MRI screening for these patients and therapy is thus based on these findings. However, the accuracy of breast MRI for staging purposes is only tested in sporadic cancers. Methods: We assessed concordance of radiologic staging using MRI with histopathology in 49 tumors in 46 high risk patients (23 BRCA1, 12 BRCA2 and 11 Non-BRCA patients). The size of the total tumor area (TTA) was compared to pathology. In invasive carcinomas (n = 45) the size of the largest focus (LF) was also addressed. Results: Correlation of MRI measurements with pathology was 0.862 for TTA and 0.793 for LF. TTA was underestimated in 8(16%), overestimated in 5(10%), and correctly measured in 36(73%) cases. LF was underestimated in 4(9%), overestimated in 5(11%), and correctly measured in 36(80%) cases. Impact of BRCA 1 or 2 mutations on the quality of size estimation was not observed. Conclusions: Tumor size estimation using breast MRI in high risk patients is comparable to its performance in sporadic cancers. Therefore, breast MRI can safely be used for treatment planning.

  20. The elevated homocysteine stimulates changes of haemostatic function of plasma isolated from breast cancer patients. (United States)

    Kedzierska, Magdalena; Malinowska, Joanna; Glowacki, Rafal; Olas, Beata; Bald, Edward; Jeziorski, Arkadiusz; Piekarski, Janusz


    The aim of our study was to explain the effect of elevated homocysteine (measured by HPLC) on haemostatic activity of plasma from breast cancer patients (fibrin polymerization and lysis; the thrombin and prothrombin time), because homocysteine (Hcys) induces changes in haemostasis, as well blood clotting as fibrinolysis. Patients were hospitalized in Department of Oncological Surgery, Medical University of Lodz, Poland. All patients have not had preadjuvant therapy, and samples from patients were taken before surgery. We observed that changes of selected parameters of haemostatic properties of plasma, e.g., the prothrombin time and thrombin time were prolonged in plasma from invasive breast cancer when compared with the control group (healthy subjects) and patients with benign breast diseases. Our results showed also that the correlation between the increased amount of Hcys and changes of selected parameters of haemostasis in invasive breast cancer patients exists. Considering the data presented in this study, we suggest that the elevated Hcys in invasive breast cancer patients may induce the changes of haemostatic properties of plasma isolated from these patients.

  1. Differences in the progesterone receptor contents between familial breast cancers and sporadic breast cancers stratified by patient age. (United States)

    Fukutomi, T; Akashi-Tanaka, S


    In the present study, we investigated the estrogen (ER) and progesterone receptor (PR) contents of familial breast cancers (FBCs) and compared the findings with those of sporadic breast cancers., stratified by the patients' age. To evaluate the hormone receptor contents of Japanese FBCs, we collected a consecutive series of 250 FBCs and 2,533 sporadic breast cancers (SBCs). These patients were divided into the three groups stratified by the patients' age at initial surgery (group I, under 40 years old; group II, 40-60 years old; group III, over 60 years old). The clinicopathological features of FBCs and SBCs, including ERs and PRs, were analyzed for each group. In all age groups, the PR contents of FBCs were significantly lower than those of SBCs, particularly for group III. In FBCs, the PR content was significantly lower in group III than in groups I or II. In addition, there was a nonsignificant trend towards a high frequency of ER-positive, PR-negative tumors in FBC patients aged 60 years and over. These data indicate that the loss of ER function and/or loss of binding capacity of PR to progesterone was associated with some late-onset FBCS.

  2. Neuroborreliosis Mimicking Leptomeningeal Carcinomatosis in a Patient With Breast Cancer

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    Stefanie Fischer MD


    Full Text Available Leptomeningeal carcinomatosis is a serious complication of advanced cancer. Various clinical manifestations may present, such as headache, nausea, seizures, cranial neuropathies. In this article, we report the case of a 65-year-old woman with metastatic breast cancer who was admitted to hospital suffering from facial palsy, which was suspected to be caused by leptomeningeal tumor infiltration. Magnetic resonance imaging (MRI scans of the head and spine showed meningeal enhancement of the facial nerve, conus medullaris, and fibers of the cauda equina, which were radiologically interpreted as leptomeningeal carcinomatosis. Assessment of cerebrospinal fluid found no malignant cells but investigation for infectious diseases established the diagnosis of neuroborreliosis. Antibiotic treatment with doxycycline was performed. After completion of treatment, follow-up MRI scans found complete regression of meningeal enhancement. Several months later, the patient is still in good condition and without neurological symptoms. Hence, initial diagnosis of leptomeningeal carcinomatosis was rejected. This case report should alert oncologists to carefully rule out infectious diseases before leptomeningeal carcinomatosis is diagnosed. Cerebrospinal fluid analysis is strongly recommended due to low specificity of MRI images in this regard.

  3. Cell cycle related proteins in hyperplasia of usual type in breast specimens of patients with and without breast cancer

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    Gobbi Helenice


    Full Text Available Abstract Background Hyperplasia of usual type (HUT is a common proliferative lesion associated with a slight elevated risk for subsequent development of breast cancer. Cell cycle-related proteins would be helpful to determine the putative role of these markers in the process of mammary carcinogenesis. The aim of this study was to analyze the expression of cell cycle related proteins in HUT of breast specimens of patients with and without breast cancer, and compare this expression with areas of invasive carcinomas. Results Immunohistochemical evaluation was performed using antibodies against cell cycle related proteins ER, PR, p53, p21, p63, and Ki-67 in hyperplasia of usual type (HUT in specimens of aesthetic reduction mammaplasty (ARM, in specimens of mammaplasty contralateral to breast cancer (MCC, and in specimens of invasive mammary carcinomas (IMC presenting HUT in the adjacent parenchyma. The results showed that the immunoexpression of ER, PR, p21, p53, p63, and KI-67 was similar in HUT from the three different groups. The p63 expression in myoepithelial cells showed discontinuous pattern in the majority of HUT, different from continuous expression in normal lobules. Nuclear expression of p53 and p21 was frequently higher expressed in IMC and very rare in HUT. We also found cytoplasmic expression of p21 in benign hyperplastic lesions and in neoplastic cells of IMC. Conclusion Our data failed to demonstrate different expression of cell cycle related proteins in HUT from patients with and without breast cancer. However, we found discontinuous expression of p63 in myoepithelial cells around HUT adjacent to carcinomas and cytoplasmic expression of p21 in epithelial cells of hyperplastic foci. Further studies are needed to determine how these subgroups relate to molecular abnormalities and cancer risk.

  4. Changes in brain activation in breast cancer patients depend on cognitive domain and treatment type (United States)

    Menning, Sanne; de Ruiter, Michiel B.; Veltman, Dick J.; Boogerd, Willem; Oldenburg, Hester S. A.; Reneman, Liesbeth


    Background Cognitive problems in breast cancer patients are common after systemic treatment, particularly chemotherapy. An increasing number of fMRI studies show altered brain activation in breast cancer patients after treatment, suggestive of neurotoxicity. Previous prospective fMRI studies administered a single cognitive task. The current study employed two task paradigms to evaluate whether treatment-induced changes depend on the probed cognitive domain. Methods Participants were breast cancer patients scheduled to receive systemic treatment (anthracycline-based chemotherapy +/- endocrine treatment, n = 28), or no systemic treatment (n = 24) and no-cancer controls (n = 31). Assessment took place before adjuvant treatment and six months after chemotherapy, or at similar intervals. Blood oxygen level dependent (BOLD) activation and performance were measured during an executive functioning task and an episodic memory task. Group-by-time interactions were analyzed using a flexible factorial design. Results Task performance did not differ between patient groups and did not change over time. Breast cancer patients who received systemic treatment, however, showed increased parietal activation compared to baseline with increasing executive functioning task load compared to breast cancer patients who did not receive systemic treatment. This hyperactivation was accompanied by worse physical functioning, higher levels of fatigue and more cognitive complaints. In contrast, in breast cancer patients who did not receive systemic treatment, parietal activation normalized over time compared to the other two groups. Conclusions Parietal hyperactivation after systemic treatment in the context of stable levels of executive task performance is compatible with a compensatory processing account of hyperactivation or maintain adequate performance levels. This over-recruitment of brain regions depends on the probed cognitive domain and may represent a response to decreased neural

  5. Bone health history in breast cancer patients on aromatase inhibitors.

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    Marilyn L Kwan

    Full Text Available A cross-sectional study was performed to assess bone health history among aromatase inhibitor (AI users before breast cancer (BC diagnosis, which may impact fracture risk after AI therapy and choice of initial hormonal therapy. A total of 2,157 invasive BC patients initially treated with an AI were identified from a prospective cohort study at Kaiser Permanente Northern California (KPNC. Data on demographic and lifestyle factors were obtained from in-person interviews, and bone health history and clinical data from KPNC clinical databases. The prevalence of osteoporosis and fractures in postmenopausal AI users was assessed, compared with 325 postmenopausal TAM users. The associations of bone health history with demographic and lifestyle factors in AI users were also examined. Among all initial AI users, 11.2% had a prior history of osteoporosis, 16.3% had a prior history of any fracture, and 4.6% had a prior history of major fracture. Postmenopausal women who were taking TAM as their initial hormonal therapy had significantly higher prevalence of prior osteoporosis than postmenopausal AI users (21.5% vs. 11.8%, p<0.0001. Among initial AI users, the associations of history of osteoporosis and fracture in BC patients with demographic and lifestyle factors were, in general, consistent with those known in healthy older women. This study is one of the first to characterize AI users and risk factors for bone morbidity before BC diagnosis. In the future, this study will examine lifestyle, molecular, and genetic risk factors for AI-induced fractures.

  6. Risk of regional recurrence in triple-negative breast cancer patients: a Dutch cohort study. (United States)

    van Roozendaal, Lori M; Smit, Leonie H M; Duijsens, Gaston H N M; de Vries, Bart; Siesling, Sabine; Lobbes, Marc B I; de Boer, Maaike; de Wilt, Johannes H W; Smidt, Marjolein L


    Triple-negative breast cancer is associated with early recurrence and low survival rates. Several trials investigate the safety of a more conservative approach of axillary treatment in clinically T1-2N0 breast cancer. Triple-negative breast cancer comprises only 15 % of newly diagnosed breast cancers, which might result in insufficient power for representative results for this subgroup. We aimed to provide a nationwide overview on the occurrence of (regional) recurrences in triple-negative breast cancer patients with a clinically T1-2N0 status. For this cohort study, 2548 women diagnosed between 2005 and 2008 with clinically T1-2N0 triple-negative breast cancer were selected from the Netherlands Cancer Registry. Follow-up data until 2014 were analyzed using Kaplan-Meier. Sentinel lymph node biopsy was performed in 2486 patients, and (completion) axillary lymph node dissection in 562 patients. Final pathologic nodal status was pN0 in 78.5 %, pN1mi in 4.5 %, pN1 in 12.3 %, pN2-3 in 3.6 %, and pNx in 1.1 %. During a follow-up of 5 years, regional recurrence occurred in 2.9 %, local recurrence in 4.2 % and distant recurrence in 12.2 %. Five-year disease-free survival was 78.7 %, distant disease-free survival 80.5 %, and 5-year overall survival 82.3 %. Triple-negative clinically T1-2N0 breast cancer patients rarely develop a regional recurrence. Their disease-free survival is more threatened by distant recurrence, affecting their overall survival. Consequently, it seems justified to include triple-negative breast cancer patients in randomized controlled trials investigating the safety of minimizing axillary staging and treatment.

  7. Potential role of pemetrexed in metastatic breast cancer patients pre-treated with anthracycline or taxane

    Institute of Scientific and Technical Information of China (English)

    Li-Yan Zhou; Ye-Hui Shi; Yong-Sheng Jia; Zhong-Sheng Tong


    Objectives: This article reviews pharmacology, pharmacokinetic properties, clinical efficacy, and safety in metastatic breast cancer patients, as well as the predictive biomarkers for outcome of treatment with pemetrexed-based regimens. Methods: PubMed, Embase, OVID, and the Cochrane Library databases were searched from the beginning of each database without any limitations to the date of publication. Search terms were‘‘pemetrexed’’ or‘‘LY231514’’ or“Alimta”,“metastatic breast cancer”, and“advanced breast cancer”. Results: There were 15 studies (n ¼ 1002) meeting our criteria for evaluation. Eight single-agent trials (n ¼ 551) and seven using combinations with other agents (n ¼ 451) were identified that evaluated pemetrexed for use in patients with metastatic breast cancer. Response rates to pemetrexed as a single agent varied from 8%to 31%, and with combination therapy have been reported to be between 15.8% and 55.7%. With routine supplementation of patients with folic acid, dexamethasone, and vitamin B12, the toxicity profile of these patients was mild, including dose-limiting neutropenia and thrombocytopenia, as well as lower grades of reversible hepatotoxicity and gastrointestinal toxicity. Expression of thymidylate synthase (TS) and other biomarkers are associated with the prognosis and sensitivity for pemetrexed in breast cancer. Conclusion: Pemetrexed has shown remarkable activity with acceptable toxicities for treatment of metastatic breast cancer patients. Translational research on pemetrexed in breast cancer identified biomarkers as well as additional genes important to its clinical activity and toxicity. Further research is needed to clarify the role of pemetrexed in breast cancer treatment in order to guide oncologists. Copyright © 2015, Chinese Medical Association Production. Production and hosting by Elsevier B.V. on behalf of KeAi Com-munications Co., Ltd. This is an open access article under the CC BY-NC-ND license

  8. Clinical features and prognosis of obese breast cancer patients:a retrospective study*

    Institute of Scientific and Technical Information of China (English)

    Zhendong Zheng; Heng Cao; Shuxian Qu; Yongye Liu; Ying Piao; Xiaodong Xie


    Objective:The aim of our study was to investigate the prognosis of obese breast cancer patients. Methods:This study was conducted on a total of 317 breast cancer patients who were histopathological y and clinical y diagnosed at the General Hospital of Shenyang Military Region (China) from 2004 to 2006. Clinical data including height, weight, age at diagnosis, tumor size, lymph node status, menopausal status, family history of cancer and hormone receptor status were col-lected. Log-rank test was performed to compare the disease free survival (DFS) and overal survival (OS). Cox proportional hazards regression analysis was conducted to make multivariate analysis. The Chi square test was used to compare the clinical features among normal weight group, overweight group, and obese group. Results:Obesity was an independent prognostic factor for DFS (P=0.022) and OS (P=0.032) in breast cancer patients. In the stratified analysis based on the hormone receptor status, obesity was independently associated with OS in patients with negative ER/PR (P=0.002), but such association was not observed in patients with positive hormone receptors. Obesity was also associated with lymph node status (P=0.001) and smoking (P=0.009). Conclusion:Obesity is associated with poor DFS and OS in patients with breast cancer. Therefore, maintaining normal weight may benefit breast cancer patients.

  9. Study of fruit and vegetable intake in breast cancer patients in the city of Sabzevar (United States)

    Kooshki, Akram; Moghaddam, Manidgeh Yousefi; Akbarzadeh, Roya


    Introduction Diet is one of the most important modifiable risk factors for prevention and control of chronic diseases, including breast cancer. This study aimed to determine the fruit and vegetable intake in women with cancer breast in Sabzevar. Methods This cross-sectional study was conducted on 125 women with breast cancer in Sabzevar in 2011. Census sampling was done on volunteers in a visiting home and suspected women referred to the mammography, ultrasound, and radiology clinic in the Sabzevar center for breast cancer. Demographic and semi quantitative food questionnaires of 160 foods were completed for each of the patients by trained interviewers. Data were analyzed using the software Nutritionist IV. Descriptive statistics, one-sample t-test, and Chi-square test were used, employing the SPSS version 16. Results In this study, 125 women were assessed with breast cancer. The highest risk with breast cancer was 35.5% in women 40 to 49 years old. The results of this study showed that patients with breast cancer had minimum daily recommended intake (3.06 ± 2.3 serving of fruits and 2.09 ± 1.81 serving of vegetables in days). One sample t-test showed that the mean intake of fruits and vegetables was not a significant deference with daily recommended intake (p>0.05). The chi-square test showed that patients with minimum daily recommended intake of fruits and vegetables were at high risk for breast cancer in comparison with those who received the highest amount (p=0.001). Conclusion This study supports evidence that high vegetable and fruit intake is associated with lower breast cancer risk.

  10. Comparison of bone mineral density in young patients with breast cancer and healthy women

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    Sousan Kolahi


    Full Text Available BACKGROUND: Almost 1 in 8 women will have breast cancer during their lifetime. Several risk factors were identified; however, 70% of females with breast cancer have no risk factors. Many risk factors are associated with sex steroid hormones. Some studies have been focused on identification of the indices of cumulative exposures to estrogen during the patients’ life. One of these indicators is bone mineral density (BMD. Our aim was the comparison of BMD in young patients with and without breast cancer, and finding a relationship between breast cancer and bone density. METHODS: In this case-control study, 120 people were enrolled; 40 patients with breast cancer and 80 normal healthy persons as control group. Measurement of BMD was performed in both groups and compared. RESULTS: Both groups were matched in age, weight, age at menarche, age at first marriage and first pregnancy, number of pregnancies over 32 weeks and lactation period, and taking supplemental calcium and vitamin D. However, there was a significant difference between the two groups in terms of estrogen intake, family history of breast cancer, and history of breast masses (P = 0.03, P = 0.03, P ≤ 0.01, respectively. A significant difference was found between BMD, bone mineral content (BMC, and t-scores of lumbar spine of the two groups; they were higher in the control group (P = 0.08, P ≤ 0.01, P = 0.06, respectively. CONCLUSIONS: This study shows that bone mineral density of young patients with breast cancer is not higher than normal similar age females; thus, BMD is not directly a risk factor for breast cancer.

  11. Benefit of Adjuvant Brachytherapy Versus External Beam Radiation for Early Breast Cancer: Impact of Patient Stratification on Breast Preservation

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    Smith, Grace L. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Jiang, Jing [Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Buchholz, Thomas A. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Xu, Ying [Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Hoffman, Karen E. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Giordano, Sharon H. [Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Hunt, Kelly K. [Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Smith, Benjamin D., E-mail: [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)


    Purpose: Brachytherapy after lumpectomy is an increasingly popular breast cancer treatment, but data concerning its effectiveness are conflicting. Recently proposed “suitability” criteria guiding patient selection for brachytherapy have never been empirically validated. Methods: Using the Surveillance, Epidemiology, and End Results–Medicare linked database, we compared women aged 66 years or older with invasive breast cancer (n=28,718) or ductal carcinoma in situ (n=7229) diagnosed from 2002 to 2007, treated with lumpectomy alone, brachytherapy, or external beam radiation therapy (EBRT). The likelihood of breast preservation, measured by subsequent mastectomy risk, was compared by use of multivariate proportional hazards, further stratified by American Society for Radiation Oncology (ASTRO) brachytherapy suitability groups. We compared 1-year postoperative complications using the χ{sup 2} test and 5-year local toxicities using the log-rank test. Results: For patients with invasive cancer, the 5-year subsequent mastectomy risk was 4.7% after lumpectomy alone (95% confidence interval [CI], 4.1%-5.4%), 2.8% after brachytherapy (95% CI, 1.8%-4.3%), and 1.3% after EBRT (95% CI, 1.1%-1.5%) (P<.001). Compared with lumpectomy alone, brachytherapy achieved a more modest reduction in adjusted risk (hazard ratio [HR], 0.61; 95% CI, 0.40-0.94) than achieved with EBRT (HR, 0.22; 95% CI, 0.18-0.28). Relative risks did not differ when stratified by ASTRO suitability group (P=.84 for interaction), although ASTRO “suitable” patients did show a low absolute subsequent mastectomy risk, with a minimal absolute difference in risk after brachytherapy (1.6%; 95% CI, 0.7%-3.5%) versus EBRT (0.8%; 95% CI, 0.6%-1.1%). For patients with ductal carcinoma in situ, EBRT maintained a reduced risk of subsequent mastectomy (HR, 0.40; 95% CI, 0.28-0.55; P<.001), whereas the small number of patients treated with brachytherapy (n=179) precluded definitive comparison with lumpectomy alone

  12. Quality of life and patient satisfaction after microsurgical abdominal flap versus staged expander/implant breast reconstruction: a critical study of unilateral immediate breast reconstruction using patient-reported outcomes instrument BREAST-Q. (United States)

    Liu, Chunjun; Zhuang, Yan; Momeni, Arash; Luan, Jie; Chung, Michael T; Wright, Eric; Lee, Gordon K


    Staged expander-implant breast reconstruction (EIBR) and microsurgical abdominal flap breast reconstruction (MAFBR) are the most common modes of breast reconstruction (BR) in the United States. Whether the mode of breast reconstruction has an impact on patient quality of life (QoL) and satisfaction remains a question. A retrospective study was conducted identifying a population of 119 patients who underwent unilateral immediate BR. Only patients who were eligible for either EIBR or MAFBR based on preoperative characteristics were included in the study. The following parameters were retrieved: demographics, mode of reconstruction, cancer, recovery, QoL, and patient satisfaction. The latter two parameters were determined using the BREAST-Q BR module questionnaire. Two-way analysis of variance with mode of reconstruction and occurrence of complication as independent variables was used to determine the effect on patient satisfaction and QoL. The association between mode of reconstruction and patient response with each item of the QoL and satisfaction survey domains was analyzed. The overall response rate was 62.2 %. Non-respondents and respondents did not significantly differ in demographics, surgery type, cancer staging, adjuvant therapy, and complication rate. Age and BMI were significantly higher in MAFBR, while level of education was higher in EIBR. MAFBR had higher scores in psychosocial and sexual wellbeing, satisfaction with outcome, breast, information, and plastic surgeon when compared with patients who underwent EIBR. For patients eligible for both MAFBR and EIBR, MAFBR is associated with higher levels of satisfaction and QoL. Comprehensive pre-operative information of pros and cons of both modes of BR is crucial for patients to make a well-informed decision, thus, resulting in higher levels of satisfaction.

  13. Association between illness severity and timing of initial enteral feeding in critically ill patients: a retrospective observational study

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    Huang Hsiu-Hua


    Full Text Available Abstract Background Early enteral nutrition is recommended in cases of critical illness. It is unclear whether this recommendation is of most benefit to extremely ill patients. We aim to determine the association between illness severity and commencement of enteral feeding. Methods One hundred and eight critically ill patients were grouped as “less severe” and “more severe” for this cross-sectional, retrospective observational study. The cut off value was based on Acute Physiology and Chronic Health Evaluation II score 20. Patients who received enteral feeding within 48 h of medical intensive care unit (ICU admission were considered early feeding cases otherwise they were assessed as late feeding cases. Feeding complications (gastric retention/vomiting/diarrhea/gastrointestinal bleeding, length of ICU stay, length of hospital stay, ventilator-associated pneumonia, hospital mortality, nutritional intake, serum albumin, serum prealbumin, nitrogen balance (NB, and 24-h urinary urea nitrogen data were collected over 21 days. Results There were no differences in measured outcomes between early and late feedings for less severely ill patients. Among more severely ill patients, however, the early feeding group showed improved serum albumin (p = 0.036 and prealbumin (p = 0.014 but worsened NB (p = 0.01, more feeding complications (p = 0.005, and prolonged ICU stays (p = 0.005 compared to their late feeding counterparts. Conclusions There is a significant association between severity of illness and timing of enteral feeding initiation. In more severe illness, early feeding was associated with improved nutritional outcomes, while late feeding was associated with reduced feeding complications and length of ICU stay. However, the feeding complications of more severely ill early feeders can be handled without significantly affecting nutritional intake and there is no eventual difference in length of hospital stay or mortality

  14. Basal like carcinoma of breast in patient with neurofibromatosis I: An association or co-existence?

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    Sree Rekha Jinkala


    Full Text Available Neurofibromatosis I (NF I, an autosomal dominant disorder is associated with increased risk of benign and malignant peripheral nerve sheath tumors and central nervous system tumors. There are only few case reports of breast carcinoma in known patients of NF I. We report a case of basal like carcinoma of the breast in a 69-year-old lady who had NF I. Considering the rare association of carcinomas with NF I and finding that both the NF I gene and a breast cancer pre-disposition gene, BRCA 1 are located in close proximity on chromosome 17q makes the association of these two conditions intriguing.

  15. Synchronous bilateral breast cancer in a patient with Klinefelter’s syndrome

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    H M R Hoque


    Full Text Available H M R Hoque, A Kothari, H Hamed, I S FentimanHedley Atkins Breast Unit, Guys’ Hospital, London, UKAbstract: Synchronous bilateral male breast cancer (MBC is rare and only a few cases have been reported in the literature. The majority of MBC patients have no definable risk factors. We describe a case with Klinefelter’s syndrome, prior thymic irradiation, testicular surgery, and first degree family history in a 61-year-old male.Keywords: male breast cancer, Klinefelter’s syndrome, bilateral, risk factors

  16. Integrative exercise and lifestyle intervention increases leisure-time activity in breast cancer patients

    DEFF Research Database (Denmark)

    Casla, Soraya; Hojman, Pernille; Cubedo, Ricardo


    BACKGROUND: Physical activity has been demonstrated to increase survival in breast cancer patients, but few breast cancer patients meet the general recommendations for physical activity. The aim of this pilot study was to investigate if a supervised integrated counseling and group-based exercise...... program could increase leisure-time activity in women with breast cancer. METHODS: This pilot project, designed as a single-arm study with pre-post testing, consisted of 24 classes of combined aerobic and strength exercise training as well as classes on dietary and health behavior. A total of 48 women...... with breast cancer who were undergoing or had recently completed anticancer treatment completed the study. Leisure-time physical activity, grip strength, functional capacity, quality of life (QoL), and depression were assessed at baseline, after intervention, and at the 12-week follow-up after intervention...

  17. Dynamic Breast Magnetic Resonance Imaging without Complications in a Patient with Dual-Chamber Demand Pacemaker

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    Sardanelli, F.; Lupo, P.; Esseridou, A.; Fausto, A.; Quarenghi, M. [Policlinico San Donato, San Donato Milanese, Milan (Italy). Depts. of Radiology, Arrhythmia and Electrophysiology Center


    Mammography and ultrasound indicated a cancer of the right breast in a 77-year-old woman with a dual-chamber demand pacemaker. The patient was not pacemaker-dependent. She underwent breast 1.5T magnetic resonance imaging (MRI) (dynamic gradient echo sequence with Gd-DOTA 0.1 mmol/kg). Before the patient entered the MR room, the configuration of the device was changed (the response to magnet was switched from asynchronous to off and the rate-responsive algorithm was disabled). No relevant modifications of heart rhythm or rate were observed during the MR examination. No symptom was reported. Immediately after the examination, the pacemaker interrogation showed neither program changes nor alert warnings. MRI detected a bifocal cancer in the right breast which allowed tailored breast-conserving treatment to be initiated. Histopathology confirmed a bifocal invasive ductal carcinoma.

  18. The tumor-to-breast volume ratio (TBR) predicts cancer-specific survival in breast cancer patients who underwent modified radical mastectomy. (United States)

    Wen, Jiahuai; Ye, Feng; Huang, Xiaojia; Li, Shuaijie; Yang, Lu; Xiao, Xiangsheng; Xie, Xiaoming


    Breast cancer is the most common cancer in women globally, and tumor size measured as the largest diameter of the tumor focus is currently used in tumor-lymph node-metastasis (TNM) staging for prognosis and treatment decisions. The present study utilized the tumor-to-breast volume ratio (TBR) to evaluate the relative tumor size and determined the prognostic impact of TBR on survival in patients with breast cancer. Two thousand twenty-five consecutive breast cancer patients who underwent modified radical mastectomy between January 2002 and December 2008 at Sun Yat-Sen University Cancer Center were enrolled in this retrospective study. Kaplan-Meier analysis was used to assess the prognostic effect of TBR on cancer-specific survival (CSS), and univariate log-rank test and multivariate Cox proportional hazards regression model were performed to identify independent prognostic factors. The optimal cutoff value of TBR was determined to be 1.70 %, and 1473 and 552 patients were categorized to low-TBR and high-TBR groups, respectively. In the whole patient cohort, CSS was significantly shorter in the high-TBR group (110.2 vs 128.5 months, P breast cancer patients (hazard ratio (HR) 1.489, 95 % CI 1.130-1.961, P = 0.005). High TBR was independently associated with poor prognosis in breast cancer patients. This variable may serve as a valuable parameter to predict the outcomes of breast cancer.

  19. Changes in Female Support Network Systems and Adaptation after Breast Cancer Diagnosis: Differences between Older and Younger Patients (United States)

    Ashida, Sato; Palmquist, Aunchalee E. L.; Basen-Engquist, Karen; Singletary, S. Eva; Koehly, Laura M.


    Purpose: This study evaluates the changes in social networks of older and younger breast cancer patients over a 6-month period following their first diagnosis and how such modifications are associated with changes in the patients' mood state. Design and Methods: Newly diagnosed breast cancer patients were interviewed shortly after their diagnosis…

  20. A target based approach identifies genomic predictors of breast cancer patient response to chemotherapy

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    Hallett Robin M


    Full Text Available Abstract Background The efficacy of chemotherapy regimens in breast cancer patients is variable and unpredictable. Whether individual patients either achieve long-term remission or suffer recurrence after therapy may be dictated by intrinsic properties of their breast tumors including genetic lesions and consequent aberrant transcriptional programs. Global gene expression profiling provides a powerful tool to identify such tumor-intrinsic transcriptional programs, whose analyses provide insight into the underlying biology of individual patient tumors. For example, multi-gene expression signatures have been identified that can predict the likelihood of disease reccurrence, and thus guide patient prognosis. Whereas such prognostic signatures are being introduced in the clinical setting, similar signatures that predict sensitivity or resistance to chemotherapy are not currently clinically available. Methods We used gene expression profiling to identify genes that were co-expressed with genes whose transcripts encode the protein targets of commonly used chemotherapeutic agents. Results Here, we present target based expression indices that predict breast tumor response to anthracycline and taxane based chemotherapy. Indeed, these signatures were independently predictive of chemotherapy response after adjusting for standard clinic-pathological variables such as age, grade, and estrogen receptor status in a cohort of 488 breast cancer patients treated with adriamycin and taxotere/taxol. Conclusions Importantly, our findings suggest the practicality of developing target based indices that predict response to therapeutics, as well as highlight the possibility of using gene signatures to guide the use of chemotherapy during treatment of breast cancer patients.

  1. Delay in Presentation, Diagnosis, and Treatment for Breast Cancer Patients in Jordan. (United States)

    Abu-Helalah, Ahmad Munir; Alshraideh, Ahmad Hussam; Al-Hanaqtah, Mo'tasem; Da'na, Moh'd; Al-Omari, Asim; Mubaidin, Rasmi


    Breast cancer is the most common cancer, and one of the leading causes of death for females in Jordan and many countries in the world. Studies have shown that delay in symptoms presentation, diagnosis or treatment would result in poor prognosis. There has been no published study from Jordan on delays in patient presentation, delays in diagnosis, or delays in treatment. Therefore, we conducted this study to assess these important quality indicators aiming to improve prognosis for breast cancer patients in Jordan. This project was a cross-sectional study on female breast cancer patients in Jordan. The total number of participants was 327. The proportion of patients with presentation delay, diagnosis delay, and treatment delay was 32.2%, 49.1%, or 32.4%, respectively. The main reported reasons for delay in presentation were ignorance of the nature of the problem (65.6%), limited/lack of knowledge that symptoms were suggestive of cancer diagnosis (16.7%), and misdiagnosis (16.7%). Predictors of delay and mean time for presentation, diagnosis, and treatment were identified. Our results reveal that breast cancer patients in Jordan are experiencing delays in presentation, diagnosis, and treatment. This could justify the advanced stages at diagnosis and poor outcomes for breast cancer patients in Jordan. We recommend revising the current early detection and down-staging programs in Jordan.

  2. Magnetic resonance imaging in patients with newly diagnosed breast cancer: a review of the literature. (United States)

    Pilewskie, Melissa; King, Tari A


    The use of magnetic resonance imaging (MRI) in patients with newly diagnosed breast cancer remains controversial. Here we review the current use of breast MRI and the impact of MRI on short-term surgical outcomes and rates of local recurrence. In addition, we address the use of MRI in specific patient populations, such as those with ductal carcinoma in situ, invasive lobular carcinoma, and occult primary breast cancer, and discuss the potential role of MRI for assessing response to neoadjuvant chemotherapy. Although MRI has improved sensitivity compared with conventional imaging, this has not translated into improved short-term surgical outcomes or long-term patient benefit, such as improved local control or survival, in any patient population. MRI is an important diagnostic test in the evaluation of patients presenting with occult primary breast cancer and has shown promise in monitoring response to neoadjuvant chemotherapy; however, the data do not support the routine use of perioperative MRI in patients with newly diagnosed breast cancer. Cancer 2014;120:120:2080-2089. © 2014 American Cancer Society.

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

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    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)


    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.

  4. Feeding in Oral Cancer Patients After Massive Ablative Surgery: Percutaneous Endoscopic Gastrostomy or Nasogastric Tube. (United States)

    Tabrizi, Reza; Hosseinpour, Sepanta; Taghizadeh, Fateme


    Feeding after ablative oral cancer surgery is a major concern in postoperative care phase. The aim of this study was to compare postoperative phase of healing in patients undergoing nasogastric tube insertion and percutaneous endoscopic gastrostomy. In this single randomized clinical trial, 40 patients were randomly allocated to 2 groups according to a randomized list: group one (20 patients) had nasogastric tube for 4 weeks and group two (20 patients) underwent percutaneous endoscopic gastrostomy for 4 weeks or more after the surgery. Occurrence of infection and wound dehiscence was assessed. Weight loss was defined as reduction in patients' weight at 4 weeks after the surgery compared with preoperation. Weight loss was 7.9 ± 1.91 kg in group one and 5.3 ± 1.38 kg in group two; the difference in this regard between the 2 groups was statistically significant (P = 0.001). In group one, 10 subjects had dehiscence versus 3 subjects in group two; this difference was significant (P = 0.04). Analysis of the data demonstrated a significant difference in postsurgical infection between the 2 groups (P = 0.044). It seems that gastrostomy may be an appropriate method for feeding in patients with extensive oral cancer.

  5. LOXL2 expression is associated with invasiveness and negatively influences survival in breast cancer patients. (United States)

    Ahn, Sung Gwe; Dong, Seung Myung; Oshima, Akira; Kim, Woo Ho; Lee, Hak Min; Lee, Seung Ah; Kwon, Seung-Hyun; Lee, Ji-Hae; Lee, Jae Myun; Jeong, Joon; Lee, Hy-De; Green, Jeffrey E


    Lysyl oxidase-like 2 (LOXL2) is associated with invasiveness and metastasis in breast cancer. We analyzed the prognostic impact of LOXL2 for breast cancer patients and investigated the role of LOXL2 in breast cancer cell lines. Immunohistochemical study of LOXL2 expression was done in samples from 309 patients. Survival analysis was performed using log-rank test and Cox regression hazard model. After identification of LOXL2 expression in breast cancer cell lines, we performed matrigel invasion and wound-healing assays with LOXL2-silenced cell lines. In the human study, LOXL2 was expressed in 16.2 % of patients. Comparing the LOXL2-positive versus negative groups, there was a significantly higher proportion of estrogen receptor-negative patients (54.0 vs. 37.0 %, respectively; p = 0.029) and triple-negative patients (34.0 vs. 18.0 %; p = 0.022) in the positive group. In multivariate analysis for overall survival and metastasis-free survival, positive LOXL2 was demonstrated as a poor prognostic factor (HR 2.27 and 2.10, respectively). In vitro study indicated that LOXL2 silencing induces a mesenchymal-epithelial transition-like process in basal cell lines (MDA-MB-231 and BT549) associated with decreased invasive and migratory properties. These clinical and preclinical data confirm that higher LOXL2 expression is associated with invasiveness of basal-like breast cancer cells and lower survival of breast cancer patients. Our results suggest the clinical value of LOXL2 as a therapeutic target in breast cancer.

  6. Immediate postmastectomy breast reconstruction showed limited advantage in patient survival after stratifying by family income.

    Directory of Open Access Journals (Sweden)

    Yi-Zhou Jiang

    Full Text Available BACKGROUND: Postmastectomy breast reconstruction is widely used in breast cancer patients for its aesthetic effect. Although several studies have casted suspicion upon the oncological safety of immediate breast reconstruction after mastectomy, the potential impact of different reconstruction methods on patient survival remains unclear. PATIENTS AND METHODS: We identified 35,126 female patients diagnosed with breast cancer from January 1, 1998 to December 31, 2002 in the Surveillance, Epidemiology, and End Results database. Breast cancer-specific survival (BCSS and overall survival (OS were compared among patients who underwent mastectomy with or without immediate breast reconstruction (autologous reconstruction or implant reconstruction using Cox proportional hazard regression models. RESULTS: In multivariate analysis unadjusted for family income, patients undergoing immediate postmastectomy reconstruction exhibited improved BCSS [POOLED reconstruction (any types of reconstruction: hazard ratio (HR  =  0.87, 95% confidence interval (CI 0.80-0.95, P = 0.001] and OS (pooled reconstruction: HR = 0.70, 95% CI 0.65-0.75, P<0.001 compared to patients who underwent mastectomy alone. However, after stratifying by family income, patients receiving reconstruction showed limited advantage in BCSS and OS compared with those undergoing mastectomy alone. When comparing between the two reconstruction methods, no significant differences were observed in either BCSS (implant versus autologous reconstruction: HR = 1.11, 95%CI 0.90-1.35, P = 0.330 or OS (implant versus autologous reconstruction: HR = 1.07, 95% 0.90-1.28, P = 0.424. CONCLUSIONS: Compared to mastectomy alone, immediate postmastectomy reconstruction had limited advantage in survival after adjusting for confounding factor of family income. Our findings, if validated in other large databases, may help to illustrate the actual effect of immediate postmastectomy reconstruction on patient survival.

  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. (United States)

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


    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.

  8. Overexpression of centromere protein H is significantly associated with breast cancer progression and overall patient survival

    Institute of Scientific and Technical Information of China (English)

    Wen-Ting Liao; Yan Feng; Men-Lin Li; Guang-Lin Liu; Man-Zhi Li; Mu-Sheng Zeng; Li-Bing Song


    Breast cancer is one of the leading causes of cancer death worldwide.This study aimed to analyze the expression of centromere protein H (CENP-H) in breast cancer and to correlate it with clinicopathologic data,including patient survival.Using reverse transcription-polymerase chain reaction and Westem blotting to detect the expression of CENP-H in normal mammary epithelial cells,immortalized mammary epithelial cell lines,and breast cancer cell lines,we observed that the mRNA and protein levels of CENP-H were higher in breast cancer cell lines and in immortalized mammary epithelial cells than in normal mammary epithelial cells.We next examined CENP-H expression in 307 paraffin-embedded archived samples of clinicopathologically characterized breast cancer using immunohistochemistry,and detected high CENP-H expression in 134 (43.6%) samples.Statistical analysis showed that CENP-H expression was related with clinical stage (P = 0.001),T classification (P = 0.032),N classification (P =0.018),and Ki-67 (P<0.001).Patients with high CENP-H expression had short overall survival.Multivariate analysis showed that CENP-H expression was an independent prognostic indicator for patient survival.Our results suggest that CENP-H protein is a valuable marker of breast cancer progression and prognosis.

  9. Adaptive HIV-specific B cell-derived humoral immune defenses of the intestinal mucosa in children exposed to HIV via breast-feeding.

    Directory of Open Access Journals (Sweden)

    Sandrine Moussa

    Full Text Available BACKGROUND: We evaluated whether B cell-derived immune defenses of the gastro-intestinal tract are activated to produce HIV-specific antibodies in children continuously exposed to HIV via breast-feeding. METHODS: Couples of HIV-1-infected mothers (n = 14 and their breastfed non HIV-infected (n = 8 and HIV-infected (n = 6 babies, and healthy HIV-negative mothers and breastfed babies (n = 10 as controls, were prospectively included at the Complexe Pédiatrique of Bangui, Central African Republic. Immunoglobulins (IgA, IgG and IgM and anti-gp160 antibodies from mother's milk and stools of breastfed children were quantified by ELISA. Immunoaffinity purified anti-gp160 antibodies were characterized functionally regarding their capacity to reduce attachment and/or infection of R5- and X4- tropic HIV-1 strains on human colorectal epithelial HT29 cells line or monocyte-derived-macrophages (MDM. RESULTS: The levels of total IgA and IgG were increased in milk of HIV-infected mothers and stools of HIV-exposed children, indicating the activation of B cell-derived mucosal immunity. Breast milk samples as well as stool samples from HIV-negative and HIV-infected babies exposed to HIV by breast-feeding, contained high levels of HIV-specific antibodies, mainly IgG antibodies, less frequently IgA antibodies, and rarely IgM antibodies. Relative ratios of excretion by reference to lactoferrin calculated for HIV-specific IgA, IgG and IgM in stools of HIV-exposed children were largely superior to 1, indicating active production of HIV-specific antibodies by the intestinal mucosa. Antibodies to gp160 purified from pooled stools of HIV-exposed breastfed children inhibited the attachment of HIV-1NDK on HT29 cells by 63% and on MDM by 77%, and the attachment of HIV-1JRCSF on MDM by 40%; and the infection of MDM by HIV-1JRCSF by 93%. CONCLUSIONS: The intestinal mucosa of children exposed to HIV by breast-feeding produces HIV-specific antibodies harbouring

  10. Overexpression of a novel cell cycle regulator ecdysoneless in breast cancer: a marker of poor prognosis in HER2/neu-overexpressing breast cancer patients. (United States)

    Zhao, Xiangshan; Mirza, Sameer; Alshareeda, Alaa; Zhang, Ying; Gurumurthy, Channabasavaiah Basavaraju; Bele, Aditya; Kim, Jun Hyun; Mohibi, Shakur; Goswami, Monica; Lele, Subodh M; West, William; Qiu, Fang; Ellis, Ian O; Rakha, Emad A; Green, Andrew R; Band, Hamid; Band, Vimla


    Uncontrolled proliferation is one of the hallmarks of breast cancer. We have previously identified the human Ecd protein (human ortholog of Drosophila Ecdysoneless, hereafter called Ecd) as a novel promoter of mammalian cell cycle progression, a function related to its ability to remove the repressive effects of Rb-family tumor suppressors on E2F transcription factors. Given the frequent dysregulation of cell cycle regulatory components in human cancer, we used immunohistochemistry of paraffin-embedded tissues to examine Ecd expression in normal breast tissue versus tissues representing increasing breast cancer progression. Initial studies of a smaller cohort without outcomes information showed that Ecd expression was barely detectable in normal breast tissue and in hyperplasia of breast, but high levels of Ecd were detected in benign breast hyperplasia, ductal carcinoma in situ (DCIS) and infiltrating ductal carcinoma (IDCs) of the breast. In this cohort of 104 IDC patients, Ecd expression levels showed a positive correlation with higher grade (P=0.04). Further analyses of Ecd expression using a larger, independent cohort (954) confirmed these results, with a strong positive correlation of elevated Ecd expression with higher histological grade (P=0.013), mitotic index (P=0.032), and Nottingham Prognostic Index score (P=0.014). Ecd expression was positively associated with HER2/neu (P=0.002) overexpression, a known marker of poor prognosis in breast cancer. Significantly, increased Ecd expression showed a strong positive association with shorter breast cancer specific survival (BCSS) (P=0.008) and disease-free survival (DFS) (P=0.003) in HER2/neu overexpressing patients. Taken together, our results reveal Ecd as a novel marker for breast cancer progression and show that levels of Ecd expression predict poorer survival in Her2/neu overexpressing breast cancer patients.

  11. Electrophysiological correlates of information processing in breast-cancer patients treated with adjuvant chemotherapy. (United States)

    Kreukels, Baudewijntje P C; Schagen, Sanne B; Ridderinkhof, K Richard; Boogerd, Willem; Hamburger, Hans L; van Dam, Frits S A M


    Cognitive deficits are found in a number of breast-cancer patients who have undergone adjuvant (Cyclophosphamide, Methotrexate, and 5-Fluorouracil (CMF)) chemotherapy, but the underlying mechanisms are still unclear. The objective of this study is to investigate information processing in these patients with concurrent registration of brain activity. Twenty-six breast-cancer patients treated with adjuvant CMF chemotherapy and a control group of 23 stage I breast-cancer patients not treated with chemotherapy were examined. Mean time since treatment for the CMF patients was 5.1 years after the last CMF course, and for the control patients 3.6 years after termination of radiotherapy. An information processing task was administered with concurrent EEG registration. Reaction times and the amplitudes and latencies of an Event Related Potential component (P3) in different task conditions related to input, central, and output processing of information were studied. Significant differences in latency and amplitude of the P3 component were found between the treatment groups with an earlier and reduced P3 in the chemotherapy group. Patients treated with chemotherapy had longer reaction times (although not significantly different) than the control group on all task conditions. Our data provide further evidence for long-term neurocognitive problems in breast-cancer patients treated with adjuvant (CMF) chemotherapy and offer new information regarding abnormalities in brain functioning in these patients.

  12. Intrathecal Trastuzumab Treatment in Patients with Breast Cancer and Leptomeningeal Carcinomatosis. (United States)

    Park, Won-Young; Kim, Han-Jo; Kim, Kyoungha; Bae, Sang-Byung; Lee, Namsu; Lee, Kyu-Taek; Won, Jong-Ho; Park, Hee-Sook; Lee, Sang-Cheol


    Leptomeningeal carcinomatosis is a fatal manifestation of metastatic breast cancer. Investigation of intrathecal (IT) trastuzumab for leptomeningeal carcinomatosis is currently underway; however, there has been no consensus. We report on two cases of human epidermal growth factor receptor 2 positive (HER2+) breast cancer following IT trastuzumab for leptomeningeal carcinomatosis. The first patient was treated with weekly IT 15 mg methotrexate plus IT 50 mg trastuzumab for 7 months, followed by IT trastuzumab (50 mg > 25 mg) for 18 months. The other patient received IT trastuzumab with systemic chemotherapy (trastuzumab and/or paclitaxel) for 13 months. Good control of leptomeningeal disease was achieved with IT trastuzumab in both patients, with survival durations of 20 and 29 months, respectively. We suggest that IT trastuzumab is a promising treatment for patients with HER2+ breast cancer and leptomeningeal carcinomatosis.

  13. Psychosocial group intervention for patients with primary breast cancer: A randomised trial

    DEFF Research Database (Denmark)

    Boesen, E. H.; Karlsen, R.; Christensen, J.


    Purpose: To test the effectiveness of a psycho-educational group intervention to improve psychological distress measured by POMS TMD, Quality of Life measured by European Organisation for Research and Treatment of Cancer (EORTC), the core and breast cancer module, Mental Adjustment measured by MAC...... and marital relationship measured by BLRI in women with primary breast cancer conducted 10 weeks after surgery. A secondary outcome was 4-year survival. Patients and methods: We randomly assigned 210 patients with primary breast cancer to a control or an intervention group. Patients in the intervention group......: No statistically significant effects of the intervention were found on any of the psychosocial questionnaire outcomes. There were not enough cases of death to analyse overall survival. The only statistically significant result was for patients who used anti depressive medication, for whom almost all measures...

  14. Psychological aspects of patients with breast cancer depending on the presence of visible postoperative defect

    Directory of Open Access Journals (Sweden)

    A. D. Zikiryakhodzhaev


    Full Text Available Objective. The study of coping behavior of patients with breast cancer (I, II stages in the postoperative period with «externally visible postoperative defect".Materials and methods. We studied the psychological characteristics of 35 patients with breast cancer (I, II stage, who underwent radical mastectomy, women were characterized in the postoperative period as "externally visible postoperative defect" ("e.v.p.d.", 35 patients with breast cancer (I, II stage who underwent ablative and reconstructive plastic surgery, women were characterized in the postoperative period as "without an externally visible postoperative defect" ("without an e.v.p.d.".The results and conclusions. The results of the study of women in both groups indicate that the patients are moderately using coping strategies for coping with the disease, preferring the strategy of "problem resolution" and "search of social support". Patients with breast cancer "with externally visible postoperative defect in comparing with patients with breast cancer "without an externally visible postoperative defect" often use positive religious coping in coping with the disease. The group of women with «externally visible postoperative defect" usually operate with negative religious coping. Both groups of women focused on the perception of social support. In a greater degree of social support they perceive from family and significant for them. Women with breast cancer and "externally visible postoperative defect” compared with women “without an externally visible postoperative defect" are not satisfied with your opportunities, have a feeling of weakness, doubt ability to evoke respect, sympathy, understanding and approval from others. They seek to change, doubt their self-worth, willing to put themselves in the guilt of their mistakes, failures, have low self-esteem. The group of patients with breast cancer "with externally visible postoperative defect" has an external locus of control

  15. Circulating tumor cells count and characterization in a male breast cancer patient. (United States)

    Gazzaniga, Paola; Naso, Giuseppe; Raimondi, Cristina; Gradilone, Angela; Palazzo, Antonella; Gandini, Orietta; Petracca, Arianna; Nicolazzo, Chiara; Cortesi, Enrico; Frati, Luigi


    A 64-y-old man presented to Medical Oncology Department a metastatic invasive ductal breast carcinoma, positive for estrogen (ER) and progesterone receptors (PR) and Her2/neu negative. The patient was treated with different lines of therapy, with rapid radiological progression of disease. After four courses of a third-line chemotherapy, a radiological stable disease was maintained. The patient was followed by serial blood drawings for the characterization and count of circulating tumor cells (CTC). This is the first report concerning the predictive and prognostic value of CTC in a male breast cancer patient.

  16. Self-reported psychological development in cosmetic breast surgery patients. (United States)

    Pérez-San-Gregorio, María Ángeles; Martín-Rodríguez, Agustín; Arias-Moreno, María Jesús; Rincón-Fernández, María Esther; Ortega-Martínez, José Ignacio


    Cosmetic breast surgery is the only therapeutic alternative for psychological and physical complications associated with micromasty, breast ptosis, and macromasty. We analyzed the effects of 2 variables, time, and type of cosmetic breast surgery, on anxiety symptomatology and quality of life.Following a mixed 3 × 4 design, 3 groups of women with breast augmentation (n = 63), mastopexy (n = 42), and breast reduction (n = 30) were selected and evaluated using the State-Trait Anxiety Inventory and the 12-Item Short-Form Health Survey at 4 different times, the preoperative stage, and at 1, 6, and 12 months postoperative. Pearson's chi square, Welch's U, Games-Howell tests, mixed analysis of variance, and Cohen's d and w for effect size were calculated.Results relating to anxiety (state and trait) showed that the time factor was significant (P surgery and time factors were found to have interactive effects on vitality (P = 0.044) and role-emotional (P = 0.023) dimensions. Compared to the other 2 groups, women who had undergone mastopexy felt worse (vitality) at 1 month since surgery than in the other stages, and better at 6 months since surgery (role-emotional). In the rest of the dimensions, and focusing on the most relevant effect sizes, the type of surgery made a difference in the physical functioning (P = 0.005) and role-physical (P = 0.020) dimensions, where women who had had breast reduction felt worse than those who had had augmentation. Time also resulted in differences in the physical functioning (P surgery than during the rest of the stages, as well as in the social functioning dimension (P cosmetic breast surgery recover their physical and psychological well-being.

  17. Accelerated partial breast irradiation with brachytherapy: patient selection and technique considerations

    Directory of Open Access Journals (Sweden)

    Trifiletti DM


    Full Text Available Daniel M Trifiletti,1 Kara D Romano,1 Shayna L Showalter,2 Kelli A Reardon,1 Bruce Libby,1 Timothy N Showalter11Department of Radiation Oncology, 2Division of Surgical Oncology, Department of Surgery, University of Virginia School of Medicine, Charlottesville, VA, USAAbstract: Accelerated partial breast irradiation (APBI through breast brachytherapy is a relatively recent development in breast radiotherapy that has gained international favor because of its reduction in treatment duration and normal tissue irradiation while maintaining favorable cancer-specific and cosmetic outcomes. Despite the fact that several large national trials have not reported final results yet, many providers are currently offering APBI to select patients and APBI is listed as a treatment option for selecting patients in the National Comprehensive Cancer Network guidelines. Multiple consensus guidelines exist in selecting patients for APBI, some with conflicting recommendations. In this review, the existing patient selection guidelines are reported, compared, and critiqued, grouping them in helpful subcategories. Unique patient and technical selection factors for APBI with brachytherapy are explored.Keywords: breast cancer, APBI, breast brachytherapy

  18. Pembrolizumab and Ruxolitinib Phosphate in Treating Patients With Metastatic Stage IV Triple Negative Breast Cancer (United States)


    Breast Carcinoma Metastatic in the Bone; Estrogen Receptor Negative; HER2/Neu Negative; Progesterone Receptor Negative; Recurrent Breast Carcinoma; Stage IV Breast Cancer; Triple-Negative Breast Carcinoma

  19. X-ray scatter correction method for dedicated breast computed tomography: improvements and initial patient testing (United States)

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


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

  20. Relationships among hope, coping style and social support for breast cancer patients

    Institute of Scientific and Technical Information of China (English)

    ZHANG Jing; GAO Wei; WANG Ping; WU Zhong-hui


    Background Breast cancer is one of the most common cancers in women, and its incidence seems to have gradually increased every year. During the treatment of breast cancer, patients suffer psychological morbidity, and hope is one important factor in maintaining psychological health. Therefore, in this study, we investigated the level of hope in Chinese women with breast cancer during chemotherapy and confirmed the relationships among hope, coping style, and social support.Methods One hundred and fifty-nine inpatients with breast cancer who were undergoing chemotherapy in two affiliated hospitals of Harbin Medical University were recruited and investigated. Each patient completed the Herth Hope Index (HHI), Jalowiec Coping Scale (JCS), and the social support scale made by XIAO Shui-yuan, and provided general demographic data.Results The mean hope level of the 159 patients with breast cancer was 38.62±4.56. There was a statistical difference between the hope level and monthly income. Analysis of results from the Pearson test showed no relationship between the hope level and coping style; however, there were positive relationships between hope and optimism, hope and self-reliance, and hope and palliative coping styles. In contrast, negative relationships were found between hope and the fatalistic and emotional coping styles. The total score of hope and social support had significantly positive relationship for the three scales.Conclusions Patients with breast cancer achieved high levels of hope, with the level of hope being proportional to increase in the income. During chemotherapy, patients with breast cancer had adopted many coping styles.

  1. Expression of IAP family proteins and its clinical importance in breast cancer patients. (United States)

    Pluta, P; Jeziorski, A; Cebula-Obrzut, A Pluta B; Wierzbowska, A; Piekarski, J; Smolewski, P


    Inhibitor of apoptosis (IAP) family proteins is involved in mechanisms of resistance to apoptosis in various cancer cells. The aim of this study was to assess the expression of selected IAP proteins such as XIAP, cIAP-1, cIAP-2 and survivin in breast cancer patients and evaluates their relationship with the prognostic and predictive factors and their impact to overall survival (OS) and progression free survival (PFS). The study was conducted with the use of tissue samples prospectively collected from 92 previously untreated female breast cancer patients. The control encompassed 10 fibroadenoma patients. The expression of XIAP, cIAP-1, cIAP-2 and survivin was assessed using flow multicolor cytometry. XIAP expression was present in 99 % of the breast cancer patients (91/92) with the median expression 13.65% (range 1-66.8%). Expression of XIAP in breast cancer was significantly higher compared to the control group (p=0.006). Median expression of cIAP-1, cIAP-2 and survivin in the study group was 25.95% (range 0.8-83.7%), 16.7% (range 1-53.2%) and 4.6% (range 0-43%) respectively. In the rank Spearman test, strong correlations (pproteins and survival. However, low expression of XIAP in breast cancer showed trend to longer PFS (p=0.08). XIAP, cIAP-1 cIAP-2 and survivin participate in antiapoptotic mechanisms in breast cancer and XIAP and survivin seem to have the most significant prognostic importance. Further studies are needed to establish more complete prognostic and predictive values of IAP family proteins in breast cancer patients.

  2. Impact of tumour epithelial subtype on circulating microRNAs in breast cancer patients.

    Directory of Open Access Journals (Sweden)

    Peadar S Waters

    Full Text Available While a range of miRNAs have been shown to be dysregulated in the circulation of patients with breast cancer, little is known about the relationship between circulating levels and tumour characteristics. The aim of this study was to analyse alterations in circulating miRNA expression during tumour progression in a murine model of breast cancer, and to detemine the clinical relevance of identified miRNAs at both tissue and circulating level in patient samples. Athymic nude mice received a subcutaneous or mammary fat pad injection of MDA-MB-231 cells. Blood sampling was performed at weeks 1, 3 and 6 following tumour induction, and microRNA extracted. MicroRNA microArray analysis was performed comparing samples harvested at week 1 to those collected at week 6 from the same animals. Significantly altered miRNAs were validated across all murine samples by RQ-PCR (n = 45. Three miRNAs of interest were then quantified in the circulation(n = 166 and tissue (n = 100 of breast cancer patients and healthy control individuals. MicroArray-based analysis of murine blood samples revealed levels of 77 circulating microRNAs to be changed during disease progression, with 44 demonstrating changes >2-fold. Validation across all samples revealed miR-138 to be significantly elevated in the circulation of animals during disease development, with miR-191 and miR-106a levels significantly decreased. Analysis of patient tissue and blood samples revealed miR-138 to be significantly up-regulated in the circulation of patients with breast cancer, with no change observed in the tissue setting. While not significantly changed overall in breast cancer patients compared to controls, circulating miR-106a and miR-191 were significantly decreased in patients with basal breast cancer. In tissue, both miRNAs were significantly elevated in breast cancer compared to normal breast tissue. The data demonstrates an impact of tumour epithelial subtype on circulating levels of

  3. Computerized Information and Support for Patients with Breast Cancer or HIV Infection. (United States)

    Rolnick, Sharon J.; Owens, Betta; Botta, Renee; Sathe, Laurie; Hawkins, Robert; Cooper, Leah; Kelley, Mary; Gustafson, David


    Use of the Comprehensive Health Enhancement Support System, a computerized information system, by patients with breast cancer or HIV was compared. Groups differed in the frequency of access and use of certain aspects (e.g., discussion groups). Identification of patient concerns provided useful information for system improvements. (SK)

  4. Characteristics of breast cancer patients who experience menopausal transition due to treatment

    NARCIS (Netherlands)

    S.F.A. Duijts; A.C. Stolk-Vos; H.S.A. Oldenburg; M. van Beurden; N.K. Aaronson


    Objective To identify patient-related and treatment-related factors associated significantly with climacteric symptoms in young patients who experience menopausal transition due to adjuvant treatment for breast cancer. Methods This cross-sectional study used questionnaire data collected to screen br

  5. Personalization of loco-regional care for primary breast cancer patients (part 2). (United States)

    Toi, Masakazu; Winer, Eric P; Benson, John R; Inamoto, Takashi; Forbes, John F; von Minckwitz, Gunter; Robertson, John F R; Grobmyer, Stephen R; Jatoi, Ismail; Sasano, Hironobu; Kunkler, Ian; Ho, Alice Y; Yamauchi, Chikako; Chow, Louis W C; Huang, Chiun-Sheng; Han, Wonshik; Noguchi, Shinzaburo; Pegram, Mark D; Yamauchi, Hideko; Lee, Eun-Sook; Larionov, Alexey A; Bevilacqua, Jose L B; Yoshimura, Michio; Sugie, Tomoharu; Yamauchi, Akira; Krop, Ian E; Noh, Dong Young; Klimberg, V Suzanne


    Kyoto Breast Cancer Consensus Conference, Kyoto, Japan, 18-20 February 2014 The loco-regional management of breast cancer is increasingly complex with application of primary systemic therapies, oncoplastic techniques and genetic testing for breast cancer susceptibility. Personalization of loco-regional treatment is integral to optimization of breast cancer care. Clinical and pathological tumor stage, biological features and host factors influence loco-regional treatment strategies and extent of surgical procedures. Key issues including axillary staging, axillary treatment, radiation therapy, primary systemic therapy (PST), preoperative hormonal therapy and genetic predisposition were identified and discussed at the Kyoto Breast Cancer Consensus Conference (KBCCC2014). In the second of a two part conference scene, consensus recommendations for radiation treatment, primary systemic therapies and management of genetic predisposition are reported and focus on the following topics: influence of both clinical response to PST and stage at presentation on recommendations for postmastectomy radiotherapy; use of regional nodal irradiation in selected node-positive patients and those with adverse pathological factors; extent of surgical resection following downstaging of tumors with PST; use of preoperative hormonal therapy in premenopausal women with larger, node-negative luminal A-like tumors and managing increasing demands for contralateral prophylactic mastectomy in patients with a unilateral sporadic breast cancer.

  6. Risk Profile in a Sample of Patients with Breast Cancer from the Public Health Perspective

    Directory of Open Access Journals (Sweden)

    Sorina IRIMIE


    Full Text Available Cancer represents a major public health and economical burden in developed countries and has emerged as a major public health problem in developing countries, matching its effect in industrialized nations. Although there have been recent declines in breast cancer mortality rates in some European Union countries, breast cancer remains of key importance to public health in Europe. Now days there is increasing recognition of the causative role of lifestyle factors, as smoking, diet, alcohol consumption, or lake of physical activity. The present study aimed to appreciate the presence and magnitude of modifiable risk factors for breast cancer in a sample of patients diagnosed with the disease, and to outline a risk profile liable to be changed in the intention of reducing the global risk. Risk factors have been investigated in 65 patients diagnosed with breast cancer using a questionnaire for breast cancer risk factors evaluation. The high risk profile was identified as taking shape for urban environment, modulated by the impact of overweight-obesity, smoking, reproductive factors and environmental exposure to different chemical substances. From the public health perspective, the control of overweight and obesity comes out in the foreground of preventive activities. Public health approaches emphasize on inexpensive, practical methods and in this perspective the approach of obesity should focus on the alteration of environmental context, promoting healthy eating and increased physical activity which could have a positive, independent impact on breast cancer risk

  7. Changes in intrinsic subtype of breast cancer during tumor progression in the same patient. (United States)

    Kim, Chungyeul; Lee, Jungjoo; Lee, Wonyoung; Kim, Aeree


    Hormone receptor (HR), human epidermal growth factor receptor 2 (HER2) and Ki67 are important prognostic factors and key variables in classification of the intrinsic subtype, which is essential for choice of adjuvant therapy in breast cancer management. There has been earlier reports that instability of hormonal and HER2 status during progression of tumor. However, breast cancer treatment guidelines recently recommended using the intrinsic subtype that is determined by four immunohistochemical (IHC) assays, estrogen receptor (ER), progesterone receptor (PR), HER2 and Ki67. The purpose of study was to investigate whether the intrinsic subtype changes during the tumor progression from ductal carcinoma in situ (DCIS) to lymph node metastasis. The study included 90 patients with breast cancer in Korea University Guro Hospital, between 1992 and 2008. All individuals had DCIS, invasive carcinoma and lymph node metastasis lesion. IHC staining for ER, PR, HER2 and Ki67 as well as SISH assay for HER2 gene amplification was done with following standard method. Overall 25% of breast cancer changed their intrinsic phenotype during progression. Study demonstrated that a subset of breast cancers can change their intrinsic subtype during cancer progression. These changes have an impact on patient prognosis and management, because each breast cancer subtype has their own differently optimized treatment options according to St. Gallen and NCCN guideline.

  8. Microwave radiothermometry in the diagnosis and evaluation of the neoadjuvant treatment of patients with breast cancer

    Directory of Open Access Journals (Sweden)

    O. A. Sinelnikova


    Full Text Available Microwave mammography permits thermal changes to be estimated both within the breast and onto its surface. It is obvious that ireplace X-ray mammography or ultrasonography (USG since it gives no information on breast structural changes, which is very nefor a physician.At the same time microwave mammography can yield additional information on the magnitude of proliferative processes and on the thermal activity of tissue. In many cases, this information may be decisive in elaborating treatment policy.Due to its simplicity , non-invasiveness, and safety , decimetric microw ave radiothermometry may be a promising method for diagno sing breast cancer and evaluating the efficiency of its treatment. When used in combination with X-ray study and USG, this technique provides incomparable assistance in defining the management of patients. The concurrent use of mammography , USG, and radiothermometric d iag- nosis of the breast assists in reducing the level of diagnostic errors to 1-3%.

  9. Qualitatively Understanding Patients' and Health Professionals' Experiences of the BRECONDA Breast Reconstruction Decision Aid

    DEFF Research Database (Denmark)

    Sherman, Kerry A; Shaw, Laura-Kate; Jørgensen, Lone


    OBJECTIVE: Women diagnosed with breast cancer or ductal carcinoma in situ (DCIS), and those with a genetic susceptibility to developing this disease, face the challenging decision of whether or not to undergo breast reconstruction following mastectomy. As part of a large randomized controlled trial......, this qualitative study examined women's experiences of using the Breast RECONstruction Decision Aid (BRECONDA), and health professionals' feedback regarding the impact of this resource on patients' knowledge and decision-making about breast reconstruction. METHOD: Semi-structured interviews were conducted...... with women who accessed the BRECONDA intervention (N = 36), and with their healthcare providers (N = 6). All interviews were transcribed verbatim and subjected to thematic analysis by three independent coders. RESULTS: Participants reported an overall positive impression, with all interviewees endorsing...

  10. Effect of melatonin on depressive symptoms and anxiety in patients undergoing breast cancer surgery

    DEFF Research Database (Denmark)

    Hansen, Melissa V; Andersen, Lærke T; Madsen, Michael T


    Depression, anxiety and sleep disturbances are known problems in patients with breast cancer. The effect of melatonin as an antidepressant in humans with cancer has not been investigated. We investigated whether melatonin could lower the risk of depressive symptoms in women with breast cancer...... in a three-month period after surgery and assessed the effect of melatonin on subjective parameters: anxiety, sleep, general well-being, fatigue, pain and sleepiness. Randomized, double-blind, placebo-controlled trial undertaken from July 2011 to December 2012 at a department of breast surgery in Copenhagen......, Denmark. Women, 30-75 years, undergoing surgery for breast cancer and without signs of depression on Major Depression Inventory (MDI) were included 1 week before surgery and received 6 mg oral melatonin or placebo for 3 months. The primary outcome was the incidence of depressive symptoms measured by MDI...

  11. Sentinel lymph node detection through radioguided surgery in patients with breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Abreu, Benedita Andrade Leal de; Santos, Adriana de Morais; Soares, Livia de Almeida; Santos, Antonio Ricardo dos; Barros, Idna de Carvalho; Abreu, Everardo Leal de; Cruz Filho, Alexandre Jorge Gomes da; Abreu, Joao Batista de; Vieira, Sabas Carlos [Universidade Estadual do Piaui, Teresina, PI (Brazil); Centro Federal de Educacao Tecnologica do Piaui (CEFET-PI), Teresina, PI (Brazil); Faculdade Sao Gabriel, PI (Brazil); Hospital Sao Marcos, PI (Brazil); Universidade Federal do Piaui (UFPI), Teresina, PI (Brazil)


    Biopsy of the sentinel lymphnode (SLNB), the first lymphnode to receive lymphatic drainage from the primary tumor, accurately predicts the axillary lymph node status and, when negative, obviates the need for axillary lymphadenectomy (AL). The aim of this study was, to verify the SLN localization in breast cancer through preoperative lymphoscintigraphy and intraoperative gamma-probe, as well as to demonstrate the benefits of such techniques in preventing complications of AL. Medical records of 228 patients with breast carcinoma, who were underwent SLN localization and, radioguided surgery, from March 2005 to December 2007 were analyzed retrospectively. Data regarding age, tumor characteristic, breast involved, type of surgery, radiopharmaceutical drainage pattern, axillary assessment (SLNB or AL) and number of lymph nodes dissected were collected. It was ascertained that radioguided surgery is a selective method of axillary assessment in breast cancer, which makes this technique a safe alternative to radical assessment of total dissection of axillary lymph nodes and its subsequent complications. (author)

  12. JAM-A expression positively correlates with poor prognosis in breast cancer patients. (United States)

    McSherry, Elaine A; McGee, Sharon F; Jirstrom, Karin; Doyle, Emma M; Brennan, Donal J; Landberg, Goran; Dervan, Peter A; Hopkins, Ann M; Gallagher, William M


    The cell-cell adhesion protein junctional adhesion molecule-A (JAM-A) influences epithelial cell morphology and migration. As migration is required for tumor cell invasion and metastasis, we sought to elucidate the role of JAM-A in invasive breast cancer. A breast cancer tissue microarray was analyzed for JAM-A protein expression, in parallel with analysis of JAM-A gene expression data from a breast cancer clinical dataset. Our data demonstrate a novel association between JAM-A gene and protein upregulation and poor prognosis in breast cancer. To mechanistically dissect this process, we used lentiviral technology to stably knock down JAM-A gene expression by shRNA in MCF7 breast cancer cells, which express high-endogenous levels of JAM-A. We also antagonized JAM-A function in wild-type MCF7 cells using an inhibitory antibody that blocks JAM-A dimerization. Knockdown or functional antagonism of JAM-A decreased breast cancer cell migration in scratch-wound assays. Reductions in beta1-integrin protein levels were observed after JAM-A-knockdown in MCF7 cells, suggesting a mechanism for reduced motility after loss of JAM-A. Consistent with this hypothesis, tissue microarray analysis of beta1-integrin protein expression in invasive breast cancer tissues revealed a trend toward high beta1-integrin protein levels being indicative of poor prognosis. Twenty-two percent of patients were observed to coexpress high levels of JAM-A and beta1-integrin protein, and MDA-MB-231 breast cells stably overexpressing JAM-A showed an increase in beta1-integrin protein expression. Our results are consistent with a previously unreported role for JAM-A overexpression as a possible mechanism contributing to progression in primary breast cancer; and a potential therapeutic target.

  13. BRCA1 and BRCA2 Gene Mutations Screening In Sporadic Breast Cancer Patients In Kazakhstan.

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    Ainur R. Akilzhanova


    Full Text Available Background: A large number of distinct mutations in the BRCA1 and BRCA2 genes have been reported worldwide, but little is known regarding the role of these inherited susceptibility genes in breast cancer risk among Kazakhstan women. Aim: To evaluate the role of BRCA1/2 mutations in Kazakhstan women presenting with sporadic breast cancer. Methods: We investigated the distribution and nature of polymorphisms in BRCA1 and BRCA2 entire coding regions in 156 Kazakhstan sporadic breast cancer cases and 112 age-matched controls using automatic direct sequencing. Results: We identified 22 distinct variants, including 16 missense mutations and 6 polymorphisms in BRCA1/2 genes. In BRCA1, 9 missense mutations and 3 synonymous polymorphisms were observed. In BRCA2, 7 missense mutations and 3 polymorphisms were detected. There was a higher prevalence of observed mutations in Caucasian breast cancer cases compared to Asian cases (p<0.05; higher frequencies of sequence variants were observed in Asian controls. No recurrent or founder mutations were observed in BRCA1/2 genes. There were no statistically significant differences in age at diagnosis, tumor histology, size of tumor, and lymph node involvement between women with breast cancer with or without the BRCA sequence alterations. Conclusions: Considering the majority of breast cancer cases are sporadic, the present study will be helpful in the evaluation of the need for the genetic screening of BRCA1/2 mutations and reliable genetic counseling for Kazakhstan sporadic breast cancer patients. Evaluation of common polymorphisms and mutations and breast cancer risk in families with genetic predisposition to breast cancer is ongoing in another current investigation. 

  14. Ionizing radiation-induced DNA injury and damage detection in patients with breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Borrego-Soto, Gissela; Ortiz-Lopez, Rocio; Rojas-Martinez, Augusto, E-mail:, E-mail: [Departamento de Bioquímica y Medicina Molecular, Facultad de Medicina, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León (Mexico)


    Breast cancer is the most common malignancy in women. Radiotherapy is frequently used in patients with breast cancer, but some patients may be more susceptible to ionizing radiation, and increased exposure to radiation sources may be associated to radiation adverse events. This susceptibility may be related to deficiencies in DNA repair mechanisms that are activated after cell-radiation, which causes DNA damage, particularly DNA double strand breaks. Some of these genetic susceptibilities in DNA-repair mechanisms are implicated in the etiology of hereditary breast/ovarian cancer (pathologic mutations in the BRCA 1 and 2 genes), but other less penetrant variants in genes involved in sporadic breast cancer have been described. These same genetic susceptibilities may be involved in negative radiotherapeutic outcomes. For these reasons, it is necessary to implement methods for detecting patients who are susceptible to radiotherapy-related adverse events. This review discusses mechanisms of DNA damage and repair, genes related to these functions, and the diagnosis methods designed and under research for detection of breast cancer patients with increased radiosensitivity. (author)

  15. High chondroitin sulfate proteoglycan 4 expression correlates with poor outcome in patients with breast cancer. (United States)

    Hsu, Nicholas C; Nien, Pei-Yung; Yokoyama, Kazunari K; Chu, Pei-Yi; Hou, Ming-Feng


    Chondroitin sulfate proteoglycan 4 (CSPG4), a transmembrane proteoglycan originally identified in melanoma cells, has been reported to be expressed in breast cancer cells. This study was performed to examine the expression and significance of CSPG4 in a cohort of breast cancer patients. Immunohistochemical analysis of CSPG4 was performed on tissue microarrays constructed from tissue specimens from 240 breast cancer patients. CSPG4 staining was correlated with clinical and pathological characteristics, overall survival (OS), and disease recurrence. Contradicting to a previous report, our results showed that high CSPG4 expression was not related to triple-negative status of breast cancer patients. The Kaplan-Meier method showed that high CSPG4 expression was significantly associated with shorter time to recurrence (TTR). Patients with high CSPG4 expression had poorer OS and shorter TTR in a multivariate survival analysis after adjustment for stage, tumor grade, expression of estrogen receptor and progesterone receptor, and HER2 overexpression. This study showed that high CSPG4 expression correlates with disease recurrence and OS in breast cancers.

  16. Choosing relevant endpoints for older breast cancer patients in clinical trials: an overview of all current clinical trials on breast cancer treatment. (United States)

    de Glas, N A; Hamaker, M E; Kiderlen, M; de Craen, A J M; Mooijaart, S P; van de Velde, C J H; van Munster, B C; Portielje, J E A; Liefers, G J; Bastiaannet, E


    With the ongoing ageing of western societies, the proportion of older breast cancer patients will increase. For several years, clinicians and researchers in geriatric oncology have urged for new clinical trials that address patient-related endpoints such as functional decline after treatment of older patients. The aim of this study was to present an overview of trial characteristics and endpoints of all currently running clinical trials in breast cancer, particularly in older patients. The clinical trial register of the United States National Institutes of Health Differences was searched for all current clinical trials on breast cancer treatment. Trial characteristics and endpoints were retrieved from the register and differences in characteristics between studies in older patients specifically (defined as a lower age-limit of 60 years or older) and trials in all patients were assessed using χ(2) tests. We included 463 clinical trials. Nine trials (2 %) specifically investigated breast cancer treatment in older patients. Ninety-one breast cancer trials included any patient-related endpoint (20 %), while five trials specifically addressing older patients included any patient-related endpoint (56 %, P = 0.02). Five of the trials in older patients incorporated a geriatric assessment (56 %). Clinical trials still rarely incorporate patient-related endpoints, even in trials that specifically address older patients. Trials that are specifically designed for older patients do not often incorporate a geriatric assessment in their design. This implicates that current clinical studies are not expected to fill the gap in knowledge concerning treatment of older breast cancer patients in the next decade.

  17. Human Papillomavirus (HPV in breast tumors: prevalence in a group of Mexican patients

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    Cetina Lucely


    Full Text Available Abstract Background Breast cancer is one of the main health problems in developed countries, occupying first place in mortality in women. It is well-known that there are risk factors associated with breast cancer development. Nonetheless, in 50–80% of cases known risk factors have not been identified, this has generated the attempt to identify new factors related with this neoplasia as viral infections. The aim of this work is investigate the prevalence of HPV DNA in patients with breast lesions at the Instituto Nacional de Cancerologia de Mexico. Methods Fifty-one cases of breast cancer were selected from the files of the institute and compared by age and tumor size with 43 cases of non malignant breast lesions (fibroadenoma, fibrocystic disease and phyllodes tumor. Paraffin embedded specimens were selected, HPV DNA was analyzed by polymerase chain reaction (PCR and sequenced for different types of HPV in case of positivity for HPV-DNA. Descriptive analysis of clinical and pathological variables was performed and comparisons between positive and negative cases was done. Results All patients were mexican, mean age was 53.3, median age of menarche was 13 and median tumor size 9 cms. Cervicovaginal cytology was performed to all patients, 1 patient (1.9% of cancer group had HPV and none in the other group, no cases were diagnosed with cervical dysplasia. In the group of carcinomas 36 (70.5% were negative and 15 (29.4% were positive to HPV-DNA, 10(66.6% were positive for HPV 16, 3(20% for HPV 18, two cases (13.4% were positive for both. In the group of benign conditions all were negative to HPV-DNA. Conclusion Presence of HPV in breast cancer in our group of cases is high in comparison to other authors; larger numbers of cases need to be analyzed in order to establish the exact role of this virus in the pathogenesis of breast cancer.

  18. Expression of sIL-2R before and after Chemotherapy in Patients with Breast Cancer

    Institute of Scientific and Technical Information of China (English)

    FAN Yuan-ming; SUN Zhi-jun


    Objective:To investigate the difference of peripheral blood sIL-2R before and after chemotherapy in breast cancer patients,and evaluate the clinical value of the sIL-2R in breast cancer's diagnosis and therapy.Methods:The peripheral blood sIL-2R levels of the breast cancer patients with or without chemotherapy were detected by ELISA.The healthy persons were made as the control group.Results:The slL-2R levels of the breast cancer patients were higher than that of the control group(P<0.05);the slL-2R's levels in Ⅰ~Ⅱ stage breast cancer were lower than that in Ⅲ~Ⅳ stag e breast cancer (P<0.05);the sIL-2R levels of the patients before chemotherapy were higher than that of the patients undergone chemotherapy(P<0.05);The level of the patient with chemotherapy was still higher than that of the control group(P<0.05);the sIL-2R levels of the patients whose chemotherapies were noneffective were higher than that of the patients received effective chemotherapies(P<0.05).There was no significant difference between the group with ER(+)or PR(+)and the group with ER(-)or PR(-)(P>0.05).Conclusion:The breast cancer patients have the high slL-2R levels.There is a close relationship between the cancer incidence and the patients,immune situation.The level of slL-2R could be a clinical index which Can be used for evaluating the cancer degree,because the higher levels of slL-2R can indicate that the immune ability of patient is worse.There is a significant difference between the slL-2R levels of the patients before chemotherapy and that of the patients undergone chemotherapy.

  19. Prática do aleitamento materno em comunidades rurais do semi-árido baiano The practice of maternal breast-feeding in rural communities of a semi-arid region of northeastern Brazil

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    Ana Marlúcia O. Assis


    Full Text Available Com o objetivo de conhecer p estabelecimento e duração do aleitamento materno total e exclusivo em comunidades rurais do Semi-Árido Baiano, Brasil, foram estudadas 226 crianças de O a 2 anos de idade, filhas de pequenos produtores rurais que vivem numa das regiões mais secas do nordeste brasileiro, de pobreza absoluta. Os dados referem-se a todas as crianças da família que à data do estudo tinham até 2 anos de idade. Os dados foram coletados por meio de formulários aplicados às mães ou responsáveis pelo menor, no período de 1988 a 1989. A tábua de vida foi o recurso estatístico utilizado para o cálculo da duração mediana do evento. Das 226 crianças que integraram o estudo, 91,6 iniciaram a amamentação ao peito. A duração mediana do aleitamento total foi de 90,28 dias e o aleitamento exclusivo apresentou duração mediana de 0,1 dia. Ainda que o estabelecimento da amamentação ao peito possa ser considerado alto, a duração mediana do aleitamento total foi extrememente curta, e o aleitamento exclusivo foi desprezível.A Research project in the establishment and duration of total and exclusive breast-feeding in rural communities of Cansação, BA, Brazil, is presented. It included 226 children, from zero to two years old, of families of peasants living on small-holdings in one of the driest and poorest regions of the Brazilian Northeast. The data were collected through questionnaires answered by mothers or any adult responsible for the child during 1988 and 1989. It relates to all children from these families who were two years of age at the time of the study. The survival time was the statistical method used to calculate the median duration of breast-feeding; 91.6% of the 226 children started to be breast-fed. This finding shows that the establishment of the breast-feeding was high. The median duration of total breast-feeding was of 90.28 days and exclusive breastfeeding presented a median duration of 0.1 day. Through

  20. Chemotherapy-induced prospective memory impairment in breast cancer patients with different hormone receptor expression (United States)

    Li, Wen; Gan, Chen; Lv, Yue; Wang, Shanghu; Cheng, Huaidong


    Abstract This study aimed to investigate prospective memory impairment in patients with breast cancer with different expression of hormone receptors, including the estrogen receptor (ER) and the progesterone receptor (PR). A total of 120 patients with breast cancer who underwent chemotherapy following surgery were divided into 2 groups. The A group included 60 patients with ER−/PR− status, and the B group included 60 patients with ER+/PR+ status. After 6 cycles of postoperative adjuvant chemotherapy, all patients were administered neuropsychological and prospective memory tests, such as the Mini-Mental State Examination (MMSE), verbal fluency test (VFT), and digit span test (DST), as well as examination of event-based prospective memory (EBPM) and time-based prospective memory (TBPM). As the neuropsychological background test results showed, there were no significant differences in MMSE, DST, and TBPM scores (∗:P > 0.05) between patients with breast cancer in the ER−/PR− and ER+/PR+ groups, while the VFT and EBPM scores were significantly greater in patients with breast cancer with ER+/PR+ status than in those with ER−/PR− status (∗∗: P memory impairment. PMID:28353608

  1. Optimization of indications for parasternal radiotherapy in patients with breast cancer

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    A. A. Zaytceva


    Full Text Available Detection of regional lymph nodes involvement is an extremely important step in the diagnosis and treatment of breast cancer. As with axillary lymph node metastases, parasternal lymph nodes metastases are an important prognostic factor. 1125 patients with breast cancer were under- went to thoracoscopicinternal mammary lymphadenectomy. Metastases were found in 204 of 1125 cases (18,3 %, representing 33,9 % of all cases of regional metastases (n = 601. Median overall survival in patients with internal mammary lymph nodes metastases who received radiation therapy and appropriate systemic treatment was 7,8 years, which is contrary to the earlier experience and is consistent with the results of the last years publications. We believe this excellent result is due to irradiation of the internal mammary nodes, and we believe that the thoracoscopic internal mammary lymphadenectomy should be a part of the diagnostic process in patients with breast cancer.

  2. Psychological impact of the diagnosis of breast cancer on the patient and her family. (United States)

    Northouse, L L


    The diagnosis of breast cancer creates emotional distress for patients as well as family members. This article reviews studies on the psychological adjustment of women and their family members during the diagnosis, hospitalization, and early convalescence from breast surgery. Studies indicate that the diagnostic phase is an extremely stressful time for women, marked by high anxiety, uncertainty, and difficulty making decisions. The hospital phase is especially difficult for spouses, who must juggle work responsibilities with added home responsibilities and also spend time at the hospital supporting their wives. In the convalescent phase, patients and family members need to adjust to changes in family roles, cope with fears about recurrence, and learn to balance the needs of all family members. In order to provide high quality health care to breast cancer patients and their family members, physicians and nurses need to address the emotional as well as the physical aspects of recovery.

  3. Rare Intensely Fluorine-18-fluorodeoxyglucose Avid Large Retropharyngeal Goiter in a Patient with Invasive Breast Carcinoma

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    Bina Kviatkovsky


    Full Text Available Diffuse increased fluorine-18-fluorodeoxyglucose ( 18 F-FDG avidity on positron emission tomography (PET scans has been demonstrated in patients with chronic thyroiditis, likely secondary to increased inflammatory cell glucose uptake. A complex association has been demonstrated between breast cancer and thyroid disease, although the mechanism remains elusive. Development of chronic thyroiditis and/or goiter in breast cancer patients has been suggested to convey a more favorable prognosis. Goiter extension is almost exclusively into retrosternal space, with only a handful of cases reported with superior extension into retropharyngeal space. We present a rare case of a diffusely enlarged goiter extending superior and posterior into the retropharyngeal space with an associated intense 18 F-FDG avidity standardized uptake value maximum (SUV max of 16.1 in a patient with invasive ductal breast cancer. To our knowledge, this represents the first published case of diffusely 18 F-FDG avid goiter with retropharyngeal extension.

  4. Early initiation of breast feeding but not bottle feeding increase exclusive breastfeeding practice among less than six months infant in Indonesia

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    Suparmi Suparmi


    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

  5. Breast Gangrene

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    Husasin Irfan


    Full Text Available Abstract Background Breast gangrene is rare in surgical practice. Gangrene of breast can be idiopathic or secondary to some causative factor. Antibiotics and debridement are used for management. Acute inflammatory infiltrate, severe necrosis of breast tissue, necrotizing arteritis, and venous thrombosis is observed on histopathology. The aim of was to study patients who had breast gangrene. Methods A prospective study of 10 patients who had breast gangrene over a period of 6 years were analyzed Results All the patients in the study group were female. Total of 10 patients were encountered who had breast gangrene. Six patients presented with breast gangrene on the right breast whereas four had on left breast. Out of 10 patients, three had breast abscess after teeth bite followed by gangrene, one had iatrogenic trauma by needle aspiration of erythematous area of breast under septic conditions. Four had history of application of belladonna on cutaneous breast abscess and had then gangrene. All were lactating female. Amongst the rest two were elderly, one of which was a diabetic who had gangrene of breast and had no application of belladonna. All except one had debridement under cover of broad spectrum antibiotics. Three patients had grafting to cover the raw area. Conclusion Breast gangrene occurs rarely. Etiology is variable and mutifactorial. Teeth bite while lactation and the iatrogenic trauma by needle aspiration of breast abscess under unsterlised conditions could be causative. Uncontrolled diabetes can be one more causative factor for the breast gangrene. Belladonna application as a topical agent could be inciting factor. Sometimes gangrene of breast can be idiopathic. Treatment is antibiotics and debridement.

  6. Long-term age-dependent failure pattern after breast-conserving therapy or mastectomy among Danish lymph-node-negative breast cancer patients

    DEFF Research Database (Denmark)

    Laurberg, Tinne; Lyngholm, Christina Daugaard; Christiansen, Peer


    PURPOSE: To describe long-term failure pattern after early-stage breast cancer in relation to local treatment (breast-conserving therapy (BCT) or mastectomy) and age. MATERIALS AND METHODS: Cohort study with balanced 5-year age groups and prospectively collected data; 813 Danish lymph......: BCT patients with no adjuvant systemic treatment developed LR throughout 20-year period and faced higher LR risk than mastectomy patients. LR was associated with DM among younger patients, and younger BCT patients had higher mortality than younger mastectomy patients....

  7. Study on the Correlation between Breast Hyperplasia and Breast Cancer%乳腺增生与乳腺癌相关性研究

    Institute of Scientific and Technical Information of China (English)

    王桂玲; 任连成; 刘春香


    To study analyzed the correlation between breast hyperplasia and breast cancer.Methods:Our hospital from April 2008 to April 2013 examination of 2000 women were analyzed,of which 150 cases were diagnosed as breast hyperplasia,clinical data were retrospectively analyzed,breast hyperplasia four years every 3~6 months once a month back for review.Results:150 cases of patients with breast hyperplasia,breast adenosis 56 cases (37.33%),sclerosing adenosis,35 cases (23.33%),55 cases of breast cystic hyperplasia (36.67%),4 cases (2.67%) patients developed breast cancer.Statistical analysis showed that the incidence of breast cancer and breast hyperplasia maximum ages were 51 and 31 to 40 years of age and older.Breast cancer and breast hyperplasia in patients with irregular menstruation correlation study found that breast cancer menstruation 1.71%,14.07%hyperplasia menstruation.Breast cancer and breast-feeding mode (P>0.05),and mammary gland hyperplasia associated with breast-feeding methods,not lactating mammary gland hyperplasia patients were significantly higher than lactating mammary gland hyperplasia patients (P0.05),而乳腺增生与哺乳方式相关,未哺乳患者乳腺增生发生率明显高于哺乳患者乳腺增生发生(P<0.05)。结论:乳腺增生患者有可能转变为乳腺癌,而主要诱因是导管和乳腺上皮增生及非典型性增生,临床需加强对乳腺疾病的预防指导,避免因诱因引导形成乳腺癌,从而充分保障广大女性生命安全与生活质量。

  8. Thyroid Function after Postoperative Radiation Therapy in Patients with Breast Cancer (United States)

    Wolny-Rokicka, Edyta; Tukiendorf, Andrzej; Wydmański, Jerzy; Roszkowska, Danuta; Staniul, Bogusław; Zembroń-Łacny, Agnieszka


    Objective: The aim of this study was to assess thyroid function in breast cancer patients exposed to therapeutic external beam radiation. The focus was on possible progressive changes and any relationships between the incidence of primary hypothyroidism, the time required to become hypothyroid, and factors such as chemotherapy, hormonotherapy and immunotherapy. Materials and Methods: Seventy females undergoing 3D conformal and IMRT radiation therapy for breast cancers were enrolled in a non-randomized prospective study. The patients was divided into two groups: those after mastectomy or breast conserving surgery (BCS) were irradiated to a scar of the chest wall/breast and the ipsilateral supraclavicular and the axillary areas (supraclavicular radiotherapy group - SC-RT group – 32 patients) and the control group receiving adjuvant chest wall/breast RT only (BCT group - 38 patients).The total doses were 50.0 to 70 Gy in 5 to 7 weeks. The median follow-up term was 24 months (range, 1–40 months). Thyroid function was evaluated by measuring thyroid stimulating hormone (TSH), free thyroxine (fT4), and free triiodothyronine (fT3) levels. The minimum, maximum and mean thyroid gland doses for 20 Gy (V20) were calculated for all patients. Results: Statistically significant results were obtained for the SC-RT group. Two yearsa fter the end of RT the chance of an event was increased in 6% of the population (p=0.009) in the SC-RT group. In the BCT group no significance was noted. No statistically significant differences were found for V20, chemio-, immunotherapy and hormonotherapy or Ki67 values (p=0.12). No significant results were obtained for development of hypothyroidism and clinical factors (age, thyroid volume, treatment modalities). Conclusion: Radiotherapy is associated with a higher incidence of thyroid toxicity in breast cancer patients. Routine thyroid function monitoring should be recommended in such cases.

  9. Building prognostic models for breast cancer patients using clinical variables and hundreds of gene expression signatures

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    Liu Yufeng


    Full Text Available Abstract Background Multiple breast cancer gene expression profiles have been developed that appear to provide similar abilities to predict outcome and may outperform clinical-pathologic criteria; however, the extent to which seemingly disparate profiles provide additive prognostic information is not known, nor do we know whether prognostic profiles perform equally across clinically defined breast cancer subtypes. We evaluated whether combining the prognostic powers of standard breast cancer clinical variables with a large set of gene expression signatures could improve on our ability to predict patient outcomes. Methods Using clinical-pathological variables and a collection of 323 gene expression "modules", including 115 previously published signatures, we build multivariate Cox proportional hazards models using a dataset of 550 node-negative systemically untreated breast cancer patients. Models predictive of pathological complete response (pCR to neoadjuvant chemotherapy were also built using this approach. Results We identified statistically significant prognostic models for relapse-free survival (RFS at 7 years for the entire population, and for the subgroups of patients with ER-positive, or Luminal tumors. Furthermore, we found that combined models that included both clinical and genomic parameters improved prognostication compared with models with either clinical or genomic variables alone. Finally, we were able to build statistically significant combined models for pathological complete response (pCR predictions for the entire population. Conclusions Integration of gene expression signatures and clinical-pathological factors is an improved method over either variable type alone. Highly prognostic models could be created when using all patients, and for the subset of patients with lymph node-negative and ER-positive breast cancers. Other variables beyond gene expression and clinical-pathological variables, like gene mutation status or DNA

  10. Breast-cancer patients' participation behavior and coping during presurgical consultations: a pilot study. (United States)

    Venetis, Maria K; Robinson, Jeffrey D; Kearney, Thomas


    In the context of breast-cancer care, there is extremely little research on the association between observed (i.e., taped and coded) communication behaviors and patients' health outcomes, especially those other than satisfaction. In the context of presurgical consultations between female breast cancer patients and a surgeon, the aim of this exploratory study was to test the association between communication-based participation behaviors and pre-post consultation changes in aspects of patients' mental adjustment to cancer (i.e., coping). Participants included 51 women newly diagnosed with breast cancer and a surgical oncologist from a National Cancer Institute (NCI)-designated cancer center in the northeastern United States. Outcomes were changes in patients' fighting spirit, helplessness/hopelessness, anxious preoccupation, cognitive avoidance, and fatalism (measured immediately before and after consultations via survey), and the main predictors were three communication-based participation behaviors coded from videotapes of consultations: patient question asking, patient assertion of treatment preferences, and surgeon solicitation of patient question/concern/opinion. Patients who more frequently asserted their treatment preferences experienced increases in their fighting spirit (p = .01) and decreases in their anxious preoccupation (p = .02). When companions (e.g., sister, spouse) asked more questions, patients experienced decreases in their anxious preoccupation (p = .05). These findings suggest that, in the present context, there may be specific, trainable communication behaviors, such as patients asserting their treatment preferences and companions asking questions, that may improve patients' psychosocial health outcomes.

  11. Do changes in lymph node status distribution explain trends in survival of breast cancer patients in Denmark?

    DEFF Research Database (Denmark)

    Rostgaard, Klaus; Vaeth, Michael; Rootzén, Helle;


    We studied the impact on survival of changes in breast cancer patients' distribution by lymph node status at the time of diagnosis. Our study included breast cancer patients diagnosed from 1978 to 1994 in Denmark, where the treatment schemes for breast cancer patients were fairly stable, and wher...... distribution explained half of the improvement in 5-year relative survival, and seem to be the single most important cause behind the improved survival of breast cancer patients in Denmark.......We studied the impact on survival of changes in breast cancer patients' distribution by lymph node status at the time of diagnosis. Our study included breast cancer patients diagnosed from 1978 to 1994 in Denmark, where the treatment schemes for breast cancer patients were fairly stable, and where...... mammography screening was limited. We measured lymph node status by the proportion of positive lymph nodes of all excised lymph nodes, as assessed by a pathologist. This measure was available for two-thirds of the breast cancer patients. The outcome was 5-year relative survival. Changes in lymph node status...

  12. 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.T. Rutgers (Emiel); 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)


    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

  13. Clinical outcome of percutaneous RF-ablation of non-operable patients with liver metastasis from breast cancer

    DEFF Research Database (Denmark)

    Kümler, Iben; Parner, Vibeke Kirk; Tuxen, Malgorzata K.


    PURPOSE: Despite improved anti-neoplastic treatment the prognosis for patients with liver metastases from metastatic breast cancer remains poor. MATERIALS AND METHODS: Thirty-two consecutive patients with metastatic breast cancer treated with radiofrequency ablation (RFA) at the Department of Onc...

  14. Depression, anxiety and quality of life through the use of complementary and alternative medicine among breast cancer patients in Turkey

    Directory of Open Access Journals (Sweden)

    Mehmet Emin Kalender


    Conclusions: Based on the previous studies, 20-83.3% of breast cancer patients among different countries and cultures used CAM. Our results suggested that the use of CAM among women is quite popular, but they showed no correlation between CAM usage and anxiety and depression. In addition, CAM usage was more common in breast cancer patients with a poor emotional and financial status.

  15. Phase II study of intensive chemotherapy with autologous bone marrow transplantation in patients in complete remission of disseminated breast cancer

    NARCIS (Netherlands)

    deVries, EGE; Rodenhuis, S; Hupperets, PSGJ; Dolsma, WV; Lebesque, JV; Blijham, GH; Bontenbal, M; Mulder, NH


    Background: This trial studied the disease-free survival after high-dose chemotherapy in patients in complete remission of metastatic breast cancer. Patients and methods: Thirty women, mean age 42.2 years (range 33-55) with metastatic breast cancer, received high-dose chemotherapy in a phase II stud

  16. Increasing in activity and plasma concentration of matrix metalloproteinase-9 in metastatic breast cancer patients

    Directory of Open Access Journals (Sweden)

    Morteza Sadeghi1


    Full Text Available (Received 30 March, 2009 ; Accepted 22 July, 2009AbstractBackground and purpose: Matrix metalloproteinase are a family of proteolytic enzymes that have specific functions in digestion of cells cohesive extra cellular matrix and also, increasing metastasis behavior of acute human tumors. It has been reported that MMPs in two forms, namely proenzyme and active enzyme in biological samples. It is distinguished that among this family, (MMP-9 Matrix Metalloproteinase-9 has function in both initiation and invasion steps of breast cancer. In our previous study, we reported a correlation between C/T polymorphism at promoter region of this gene and metastasis step of breast cancer.Considering few findings regarding the relationship between the active form of this enzyme and occurrence of cancer, and also the correlation between active form and allelic genotype of persons, in this study we decided to do a parallel study on measurement of active plasma MMP-9 and its relationship with allelic genotype of breast cancer patients.Materials and methods: After analysis of data, we found that concentration of active MMP-9 has a significant difference in breast cancer patients in comparison with control group, as the concentration of active form of this enzyme was less in control group than the breast cancer patients group (0.7 ng and 1.7 ng respectively. Thus, the level of active MMP-9 showed a significant increase in persons with CT and TT genotypes in comparison with CC genotype (1.5 folds.Results: The present data suggest the concentration of active MMP-9 in breast cancer patients has significantly increased in comparison with the control group and the increased in plasma level of this enzyme is related with the existence of T allele at this gene promoter and also in progression of breast cancer in these patients. We can use the active plasma level of this enzyme or the existence of T allele as a diagnostic tool for discriminating subgroups of breast cancer

  17. The anxious wait: assessing the impact of patient accessible EHRs for breast cancer patients

    Directory of Open Access Journals (Sweden)

    Wiljer David


    Full Text Available Abstract Background Personal health records (PHRs provide patients with access to personal health information (PHI and targeted education. The use of PHRs has the potential to improve a wide range of outcomes, including empowering patients to be more active participants in their care. There are a number of widespread barriers to adoption, including privacy and security considerations. In addition, there are clinical concerns that patients could become anxious or distressed when accessing complex medical information. This study assesses the implementation of a PHR, and its impact on anxiety levels and perceptions of self-efficacy in a sample of breast cancer patients. Methods A quasi-experimental pre-test/post-test design was used to collect data from participants to evaluate the use of the PHR. Study participants completed background and pre-assessment questionnaires and were then registered into the portal. By entering an activation key, participants were then able to review their lab results and diagnostic imaging reports. After six weeks, participants completed post-assessment questionnaires and usability heuristics. All data were collected using an online survey tool. Data were cleaned and analyzed using SAS v9.1. Results A total of 311 breast cancer patients completed demographic and pre-assessment questionnaires, 250 registered to use the online intervention, and 125 participants completed all required study elements. Matching the pre- and post-anxiety scores demonstrated a decrease in mean anxiety scores (-2.2, p = 0.03; the chemotherapy sub-group had a statistically insignificant mean increase (1.8, p = .14. There was no mean change in self-efficacy scores. Conclusions Participants generally found the portal easy to use; however, the perceived value of improved participation was not detected in the self-efficacy scores. Having access to personal health information did not increase anxiety levels. While these results suggest that the use

  18. Osteoporosis management in patients with breast cancer : EMAS position statement

    NARCIS (Netherlands)

    Trémollieres, Florence A; Ceausu, Iuliana; Depypere, Herman; Lambrinoudaki, Irene; Mueck, Alfred; Pérez-López, Faustino R; van der Schouw, Yvonne T; Senturk, Levent M; Simoncini, Tommaso; Stevenson, John C; Stute, Petra; Rees, Margaret


    Aromatase inhibitors (AIs) are the first-line recommended standard of care for postmenopausal estrogen receptor-positive breast cancer. Because they cause a profound suppression of estrogen levels, concerns regarding their potential to increase the risk of fracture were rapidly raised. There is curr

  19. The impact of p53 in predicting clinical outcome of breast cancer patients with visceral metastasis


    Yang, P.; Du, C.W.; Kwan, M; Liang, S. X.; Zhang, G.J.


    In the study, we analyzed role of p53 in predicting outcome in visceral metastasis breast cancer (VMBC) patients. 97 consecutive VMBC patients were studied. P53 positivity rate was 29.9%. In the p53-negative group, median disease free survival (DFS), and time from primary breast cancer diagnosis to death (OS1), time from metastases to death (OS2) were 25, 42.5, and 13.5 months, respectively. In the p53-positive group, they were 10, 22, and 8 months, respectively. Statistically significant dif...

  20. Cortical blindness and choroidal metastases secondary to metastatic breast carcinoma in a male patient. (United States)

    Palejwala, Neal; Yeh, Steven; Grossniklaus, Hans E; Bergstrom, Chris


    Male breast carcinoma is a rare entity that often goes undiagnosed until advanced stages. The authors describe the case of a patient with profound vision loss who was found to have bilateral choroidal metastases as well as advanced cerebral metastatic disease. Further medical work-up revealed widespread infiltrative ductal breast carcinoma. Given the presence of large occipital lobe lesions, the etiology of the patient's vision loss was thought to be cortical blindness. Prompt diagnosis and neurologic evaluation with this presentation is crucial because it can be associated with significant morbidity and mortality.

  1. Preferences for oral versus intravenous adjuvant chemotherapy among early breast cancer patients

    Directory of Open Access Journals (Sweden)

    Ishitobi M


    Full Text Available Makoto Ishitobi,1 Kazuyo Shibuya,2 Yoshifumi Komoike,1 Hiroki Koyama,1 Hideo Inaji1 1Department of Breast and Endocrine Surgery, 2Department of Nursing, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan Purpose: The purpose of this study was to evaluate preferences for oral versus intravenous adjuvant chemotherapy among early breast cancer patients (UMIN-CTR number UMIN000004696. Patients and methods: Eighty-two postmenopausal women with estrogen receptor-positive, human epidermal growth-factor receptor 2-negative breast cancer who had completed adjuvant chemotherapy were asked about their preferred route of administration of chemotherapy and the reason. Women also answered questions about their physical and psychological status and quality of life during chemotherapy. Results: Patients who had received oral chemotherapy preferred it more frequently than those who had received intravenous chemotherapy (100% versus 37%, respectively, chi-square =15.5; P<0.001. Patients who preferred the same route of administration of chemotherapy as they had previously received showed a significantly better psychological status during chemotherapy compared with those who preferred a different route. Conclusion: Our study showed that preferences for oral and intravenous chemotherapy strongly depended on the actual prior administration of chemotherapy and patients' own experiences during chemotherapy. Keywords: breast cancer, adjuvant, chemotherapy, patient preference, oral, intravenous

  2. Beyond barriers: fundamental 'disconnects' underlying the treatment of breast cancer patients' sexual health. (United States)

    Halley, Meghan C; May, Suepattra G; Rendle, Katharine A S; Frosch, Dominick L; Kurian, Allison W


    Sexual health concerns represent one of the most frequently experienced and longest-lasting effects of breast cancer treatment, but research suggests that service providers rarely discuss sexual health with their patients. Existing research examining barriers to addressing patients' sexual health concerns has focused on discrete characteristics of the provider-patient interaction without considering the broader context in which these interactions occur. Drawing on the experiences of 21 breast cancer survivors, this paper explores three ways in which fundamental cultural and structural characteristics of the cancer care system in the USA may prevent breast cancer survivors from addressing their sexual health concerns, including: (1) when patients discussed sexual health with their providers, their providers approached sexuality as primarily physical, while participants experienced complex, multidimensional sexual health concerns; (2) specialisation within cancer care services made it difficult for patients to identify the appropriate provider to address their concerns; and (3) the structure of cancer care literally disconnects patients from the healthcare system at the time when sexual side effects commonly emerged. These data suggest that addressing breast cancer survivors' sexual health concerns requires a multifaceted approach to health systems change.

  3. Fatty metamorphosis of the liver in patients with breast cancer:Possible associated factors

    Institute of Scientific and Technical Information of China (English)

    Cheng-Hsin Chu; Shee-Chan Lin; Shou-Chuan Shih; Chin-Roa Kao; Sun-Yen Chou


    AIM: To investigate the relationship between breast cancer and fatty liver in Chinese patients.METHODS: The study group consisted of 217 patients with newly diagnosed breast cancers and the control group of 182 subjects undergoing routine health examination in the same hospital. All subjects were female and the groups were matched for date of study. Ultrasound scanning was performed by the same operator using a 3.5 mHz transducer.Steatosis of the liver was diagnosed based on the criteria of Saverymuttu et al. Clinical variables were statistically analyzed.RESULTS: Fatty liver was diagnosed in 98 patients of the study group and 37 patients of the control group, a significant difference was found in incidence (98/217, 45.2 % and 37/182, 20.3 %; P<0.0001). On univariate analysis, fatty liver in breast cancer patients was associated with overweight,hyperlipidemia, and hepatitis. On multivariate analysis in the same patients, obesity and hyperlipidemia were significantly associated with fatty liver.CONCLUSION: The cause of fatty liver in women with breast cancer may be multifactorial. The present study confirms its link with overweight and hyperlipidemia.

  4. The Effect of Modes of Delivery on Infants' Feeding Practices

    Directory of Open Access Journals (Sweden)

    Gulshan Saeed


    Full Text Available Breast feeding has a great impact on the infant morbidity and mortality. According to Pakistan Demographic and Health survey (PDHS infant mortality rate is 78 deaths per 1,000 live births. World Health Organization recommends that exclusive breast feeding for six months can decrease infant mortality rate by one-third. The objective of the study was to find out how the mode of delivery had impact on the practice of breast feeding. Data were collected for 2500 consecutive patients during a period of two years, and it was seen that maternal initiative to breast feed was low and problems with lactation were much more in cases delivering their babies via cesarean sections than those delivering theirs by normal delivery. Vaginal and cesarean section deliveries took place in 54% and 46% of the case, respectively. Thirty percent of the women studied felt that they had no problems regarding breastfeeding, but 70% of them had some sort of problems with breastfeeding their babies. When the women were matched for the mode of delivery, 58% of women who had breastfeeding problems belonged to the cesarean delivery group and 42% of complaining mothers were from women with normal delivery. The relative risk of having problems with breastfeeding for women subjected to cesarean was 1.38 and the odds ratio was 0.61. The findings of the present study indicate that more in depth counseling sessions are required for women undergoing operative delivery to improve breast feeding among them

  5. Detection of Soluble B7-H4 Molecules in Serum of Patients with Breast Cancer and its Clinical Signiifcance

    Institute of Scientific and Technical Information of China (English)

    Chen Junjun; Shi Hongbing; Zheng Xiao; Cheng Gui; Xie Jun; Chen Lujun; Jiang Jingting; Wu Changping


    Objective:To investigate the expression of soluble B7-H4 molecules (soluble B7-H4, sB7-H4) in serum of patients with breast cancer and its clinical signiifcance. Methods:Seventy patients with breast cancer, 41 patients with benign breast disease and 28 healthy females were respectively selected as breast cancer group, benign control group and healthy control group. Enzyme-linked immunosorbent assay (ELISA) was applied to detect the content of serum sB7-H4 in three groups, and the clinical correlation with content of serum sB7-H4 in patients with breast cancer was analyzed. Besides, the expression of B7-H4 mRNA and proteins in breast cancer tissue and normal tissue adjacent to cancer was detected respectively with polymerase chain reaction (PCR) and immunohistochemical method. Results:The content of serum sB7-H4 in breast cancer group was obviously higher than in benign control group (U = 844.0, P Conclusion:In serum of patients with breast cancer, the content of sB7-H4 is increased notably and related to lymph node metastasis, hence it can be considered as a potential serum marker in the diagnosis and treatment of breast cancer.

  6. An ethical analysis of double bind conflicts as experienced by care workers feeding severely demented patients. (United States)

    Akerlund, B M; Norberg, A


    When patients with incurable dementia diseases no longer take food or fluid voluntarily, the care workers experience distress and anxiety. Thirty-nine care workers were interviewed about their thoughts, feelings and attitudes towards feeding severely demented patients. A phenomenological approach was used and the interviews were developed, attention paid to Bateson's double bind theory, Kohlberg's theory of moral development and ethical theories. Ethical theories, principles and rules, containing messages at different logical levels and the lack of empirical knowledge of the demented patients' inner world, led to the care worker's difficult double bind situations. To solve the conflicts the care workers need insight in all aspects of the problem. In order to understand all the components in a double bind situation it is important to redefine it from outside.

  7. Comparison of serum lipid profiles between normal controls and breast cancer patients

    Directory of Open Access Journals (Sweden)

    Pikul Laisupasin


    Full Text Available Background: Researchers have reported association of plasma/serum lipids and lipoproteins with different cancers. Increase levels of circulating lipids and lipoproteins have been associated with breast cancer risk. Aim: The aim of this study is to compare serum lipid profiles: total-cholesterol (T-CHOL, triglyceride (TG, high density lipoprotein-cholesterol (HDL-C, low density lipoprotein-cholesterol (LDL-C and very low density lipoprotein-cholesterol (VLDL-C between breast cancer patients and normal participants. Materials and Methods: A total of 403 women in this study were divided into two groups in the period during May 2006-April 2007. Blood samples were collected from 249 patients with early stage breast cancer and 154 normal controls for serum lipid profiles (T-CHOL, TG, HDL-C, LDL-C and VLDL-C analysis using Hitachi 717 Autoanalyzer (Roche Diagnostic GmbH, Germany. TG, LDL-C and VLDL-C levels in breast cancer group were significantly increased as compared with normal controls group (P < 0.001, whereas HDL-C and T-CHOL levels were not. Results: The results of this study suggest that increased serum lipid profiles may associate with breast cancer risk in Thai women. Further studies to group important factors including, cancer stages, types of cancer, parity, and menopausal status that may affect to lipid profiles in breast cancer patients along with an investigation of new lipid profiles to clarify most lipid factors that may involve in breast cancer development are needed.

  8. Interaction between smoking history and gene expression levels impacts survival of breast cancer patients. (United States)

    Andres, Sarah A; Bickett, Katie E; Alatoum, Mohammad A; Kalbfleisch, Theodore S; Brock, Guy N; Wittliff, James L


    In contrast to studies focused on cigarette smoking and risk of breast cancer occurrence, this study explored the influence of smoking on breast cancer recurrence and progression. The goal was to evaluate the interaction between smoking history and gene expression levels on recurrence and overall survival of breast cancer patients. Multivariable Cox proportional hazards models were fitted for 48 cigarette smokers, 50 non-smokers, and the total population separately to determine which gene expressions and gene expression/cigarette usage interaction terms were significant in predicting overall and disease-free survival in breast cancer patients. Using methods similar to Andres et al. (BMC Cancer 13:326, 2013a; Horm Cancer 4:208-221, 2013b), multivariable analyses revealed CENPN, CETN1, CYP1A1, IRF2, LECT2, and NCOA1 to be important predictors for both breast carcinoma recurrence and mortality among smokers. Additionally, COMT was important for recurrence, and NAT1 and RIPK1 were important for mortality. In contrast, only IRF2, CETN1, and CYP1A1 were significant for disease recurrence and mortality among non-smokers, with NAT2 additionally significant for survival. Analysis of interaction between smoking status and gene expression values using the combined samples revealed significant interactions between smoking status and CYP1A1, LECT2, and CETN1. Signatures consisting of 7-8 genes were highly predictive for breast cancer recurrence and overall survival among smokers, with median C-index values of 0.8 and 0.73 for overall survival and recurrence, respectively. In contrast, median C-index values for non-smokers was only 0.59. Hence, significant interactions between gene expression and smoking status can play a key role in predicting breast cancer patient outcomes.

  9. Evaluation of Contralateral Breast Surface Dose in FIF (Field In Field) Tangential Irradiation Technique for Patients Undergone Breast Conservative Surgery

    Energy Technology Data Exchange (ETDEWEB)

    Park, Byung Moon; Bang, Dong Wan; Bae, Yong Ki; Lee, Jeong Woo [Dept. of Radiation Oncology, Konkuk University Medical Center, Seoul (Korea, Republic of); Kim, You Hyun [Dept. of Radiological Science, College of Health Science, Korea University, Seoul (Korea, Republic of)


    The aim of this study is to evaluate contra-lateral breast (CLB) surface dose in Field-in-Field (FIF) technique for breast conserving surgery patients. For evaluation of surface dose in FIF technique, we have compared with other techniques, which were open fields (Open), metal wedge (MW), and enhanced dynamic wedge (EDW) techniques under same geometrical condition and prescribed dose. The three dimensional treatment planning system was used for dose optimization. For the verification of dose calculation, measurements using MOSFET detectors with Anderson Rando phantom were performed. The measured points for four different techniques were at the depth of 0 cm (epidermis) and 0.5 cm bolus (dermis), and spacing toward 2 cm, 4 cm, 6 cm, 8 cm, 10 cm apart from the edge of tangential medial beam. The dose calculations were done in 0.25 cm grid resolution by modified Batho method for inhomogeneity correction. In the planning results, the surface doses were differentiated in the range of 19.6-36.9, 33.2-138.2 for MW, 1.0-7.9, 1.6-37.4 for EDW, and for FIF at the depth of epidermis and dermis as compared to Open respectively. In the measurements, the surface doses were differentiated in the range of 11.1-71, 22.9-161 for MW, 4.1-15.5, 8.2-37.9 for EDW, and 4.9% for FIF at the depth of epidermis and dermis as compared to Open respectively. The surface doses were considered as underestimating in the planning calculation as compared to the measurement with MOSFET detectors. Was concluded as the lowest one among the techniques, even if it was compared with Open method. Our conclusion could be stated that the FIF technique could make the optimum dose distribution in Breast target, while effectively reduce the probability of secondary carcinogenesis due to undesirable scattered radiation to contra-lateral breast.

  10. Depression and Anxiety Symptoms Relate to Distinct Components of Pain Experience among Patients with Breast Cancer

    Directory of Open Access Journals (Sweden)

    Sarah K. Galloway


    Full Text Available Breast cancer is a leading cancer diagnosis among women worldwide, with more than 210,000 new cases and 40,000 deaths per year in the United States. Pain, anxiety, and depression can be significant factors during the course of breast cancer. Pain is a complex experience with sensory, affective, and cognitive dimensions. While depression and anxiety symptoms are relatively common among breast cancer patients, little is known about the relation between these psychiatric factors and distinct components of the pain experience. In the present study 60 females presenting to an NCI-designated Cancer Center with newly diagnosed breast cancer completed the Center for Epidemiological Studies 10-item Depression Scale, the State Instrument of the Spielberger State-Trait Anxiety Inventory, and the McGill Pain Questionnaire. Findings indicate that anxiety and depression are common among newly diagnosed breast cancer patients; furthermore, patients experience an appreciable amount of pain even before oncologic treatment starts. State anxiety serves as a predictor of the sensory dimension of the pain experience, whereas depression serves as a predictor of the affective dimension of the pain experience.

  11. MR mammography in the pre-operative staging of breast cancer in patients with dense breast tissue: comparison with mammography and ultrasound

    Energy Technology Data Exchange (ETDEWEB)

    Van Goethem, M.; Schelfout, K.; Verslegers, I.; Biltjes, I.; De Schepper, A. [Department of Radiology, University Hospital Antwerp, Antwerp (Belgium); Dijckmans, L. [Department of Gynecology, University Hospital Antwerp, Antwerp (Belgium); Van Der Auwera, J.C.; Weyler, J. [Department of Epidemiology and Social Medicine, University Hospital Antwerp, Antwerp (Belgium)


    The aim of this study was to determine whether pre-operative MR mammography could predict the extent of breast cancer in patients with dense breasts or whether dense parenchyma will lead to false-positive or inconclusive examinations. Sixty-seven patients with dense breasts with a malignant breast tumor planned for conservative surgery were reviewed. Detection rates of mammography, ultrasound, and MR mammography were studied, and the diameters of the lesions were measured and compared with pathological examination. Pathology revealed breast cancer in 65 patients. Sensitivity for detection of index lesions was 83% for mammography, 70.8% for ultrasound, and 98% for MR mammography. Mammography underestimated tumor extent in 37%, ultrasound in 40%, and MR in 12.5%. Of the 20 patients (31%) with multifocal or multicentric carcinoma, mammography detected the lesions in 35%, ultrasound in 30%, and MR in 100%, with a false-positive rate of 12.5, 14, and 23%. The MR mammography is more accurate in assessing tumor extent and multifocality in patients with dense breasts, but benign changes may lead to false-positive examinations. (orig.)

  12. MicroRNA analysis of breast ductal fluid in breast cancer patients


    Do Canto, Luisa Matos; Marian, Catalin; WILLEY, SHAWNA; Sidawy, Mary; DA CUNHA, PATRICIA A.; Rone, Janice D.; LI Xin; Gusev, Yuriy; Haddad, Bassem R.


    Recent studies suggest that microRNAs show promise as excellent biomarkers for breast cancer; however there is still a high degree of variability between studies making the findings difficult to interpret. In addition to blood, ductal lavage (DL) and nipple aspirate fluids represent an excellent opportunity for biomarker detection because they can be obtained in a less invasive manner than biopsies and circumvent the limitations of evaluating blood biomarkers with regards to tissue of origin ...

  13. Identification of Autoantibodies to Breast Cancer Antigens in Breast Cancer Patients (United States)


    contribute to malignant phenotype via enhancement of spreading, invasion, and migration •  Found in some adult tissues –  Hair follicles –  Basal...development of new targeted therapeutics to treat breast cancer. The major findings of this project are the methods developed for utilize a patient’s own immune system to make targeted therapeutics. Therefore, scFv libraries representing the immune repertoire from those

  14. Breast cancer surgery and diagnosis-related groups (DRGs): patient classification and hospital reimbursement in 11 European countries. (United States)

    Scheller-Kreinsen, David; Quentin, Wilm; Geissler, Alexander; Busse, Reinhard


    Researchers from eleven countries (i.e. Austria, England, Estonia, Finland, France, Germany, Ireland, Netherlands, Poland, Spain, and Sweden) compared how their DRG systems deal with breast cancer surgery patients. DRG algorithms and indicators of resource consumption were assessed for those DRGs that individually contain at least 1% of all breast cancer surgery patients. Six standardised case vignettes were defined and quasi prices according to national DRG-based hospital payment systems were ascertained. European DRG systems classify breast cancer surgery patients according to different sets of classification variables into three to seven DRGs. Quasi prices for an index case treated with partial mastectomy range from €577 in Poland to €5780 in the Netherlands. Countries award their highest payments for very different kinds of patients. Breast cancer specialists and national DRG authorities should consider how other countries' DRG systems classify breast cancer patients in order to identify potential scope for improvement and to ensure fair and appropriate reimbursement.

  15. Educational Counseling in Improving Communication and Quality of Life in Spouses and Breast Cancer Patients (United States)


    Anxiety Disorder; Depression; Ductal Breast Carcinoma in Situ; Lobular Breast Carcinoma in Situ; Psychosocial Effects of Cancer and Its Treatment; Stage IA Breast Cancer; Stage IB Breast Cancer; Stage II Breast Cancer; Stage IIIA Breast Cancer; Stage IIIB Breast Cancer; Stage IIIC Breast Cancer

  16. Breast cancer in patients with Li–Fraumeni syndrome – a case-series study and review of literature (United States)

    Nandikolla, Amara G; Venugopal, Sangeetha; Anampa, Jesus


    Background Li–Fraumeni Syndrome (LFS) is a rare disease with autosomal dominant inheritance linked to germline mutations of tumor suppressor gene TP53. These patients are predisposed to malignancies such as sarcoma, breast cancer, leukemia, and other malignancies. Breast cancer, the most common malignancy in adult patients with LFS, has an early-onset presentation and is usually treated as per the guidelines for the general population due to the limited literature about breast cancer in LFS. We aimed to describe our institutional experience treating patients with breast cancer and LFS to contribute to literature about this entity. Design Retrospective single-institution case-series study. We searched for cases with LFS and breast cancer from 01/01/2000 to 12/31/2015 with treatment received at our institution. Results We identified 4 cases (2 African Americans, 1 Indian, and 1 Hispanic) in 4 different families, who were diagnosed with LFS after presenting with breast cancer. Three cases were triple-negative disease and 1 case was ER+, HER2 positive disease. They were treated with mastectomy and a third-generation breast chemotherapy regimen and/or trastuzumab-containing regimen. Radiation therapy was used in 2 patients. Breast cancer recurrence was seen in 1 patient, while three other malignancies were identified after breast cancer treatment (1 breast sarcoma, 1 leiomyosarcoma, and 1 myelodysplastic syndrome). A patient, who underwent surveillance with a positron emission tomography-computed tomography scan, was found to have a stage I leiomyosarcoma and was treated with surgical resection, but then developed metastatic disease requiring cytotoxic chemotherapy. Conclusion Breast cancer among patients with LFS needs a multidisciplinary treatment approach. Surgical management follows the guidelines for the general population. Risk–benefit assessment of chemotherapy and radiotherapy needs to be performed carefully in a case-by-case approach. Patients should

  17. Identification of early breast cancer patient cohorts who may benefit from lapatinib therapy

    DEFF Research Database (Denmark)

    Strasser-Weippl, Kathrin; Horick, Nora; Smith, Ian E


    with HER2+ early breast cancer not treated with trastuzumab. We performed subgroup analyses and number-needed-to-treat (NNT) calculations using patient and tumour associated predictors. Hormone receptor negative (HR-) patients on lapatinib had a significantly prolonged disease-free survival (DFS) compared......In resource-constrained environments many patients with human epidermal growth factor receptor 2 (HER2)+ early breast cancer are currently not offered adjuvant anti-HER2 therapy. For patients who might be able to receive the tyrosine kinase inhibitor (TKI) lapatinib (e.g. after patent expiration...... 5 years) was between 5.9 (node positive patients patients (e.g. 15.6 for DFS at 4 years in HERA). In a subgroup analysis of the adjuvant TEACH trial, we show...

  18. Defining the Survival Benchmark for Breast Cancer Patients with Systemic Relapse (United States)

    Zeichner, Simon B; Ambros, Tadeu; Zaravinos, John; Montero, Alberto J; Mahtani, Reshma L; Ahn, Eugene R; Mani, Aruna; Markward, Nathan J; Vogel, Charles L


    BACKGROUND Our original paper, published in 1992, reported a median overall survival after first relapse in breast cancer of 26 months. The current retrospective review concentrates more specifically on patients with first systemic relapse, recognizing that subsets of patients with local recurrence are potentially curable. METHODS Records of 5,168 patients from a largely breast-cancer-specific oncology practice were reviewed to identify breast cancer patients with their first relapse between 1996 and 2006 after primary treatment. There were 189 patients diagnosed with metastatic disease within 2 months of being seen by our therapeutic team and 101 patients diagnosed with metastatic disease greater than 2 months. The patients were divided in order to account for lead-time bias than could potentially confound the analysis of the latter 101 patients. RESULTS Median survival for our primary study population of 189 patients was 33 months. As expected, the median survival from first systemic relapse (MSFSR) for the 101 patients excluded because of the potential for lead-time bias was better at 46 months. Factors influencing prognosis included estrogen receptor (ER) status, disease-free interval (DFI), and dominant site of metastasis. Compared with our original series, even with elimination of local-regional recurrences in our present series, the median survival from first relapse has improved by 7 months over the past two decades. CONCLUSION The new benchmark for MSFSR approaches 3 years. PMID:25922577

  19. 社区健康教育对哺乳期母乳喂养及乳腺炎的影响%Effect of community health education on lactation mastitis and breast feeding

    Institute of Scientific and Technical Information of China (English)

    张丽玲; 黄新桥; 曾绍芳; 幸晓燕


    目的:探讨社区健康教育对哺乳期母乳喂养和乳腺炎发生的影响。方法对90例产妇实施社区健康教育,时间6个月。了解其乳腺炎发生情况和母乳喂养情况。结果本组产妇乳腺炎发病率为3.3%,母乳喂养率为97.8%。结论对哺乳期产妇实施社区健康教育,可及时纠正产妇不良饮食习惯,使其能正确掌握哺乳期保健及新生儿护理方法,从而降低乳腺炎的发生,进而提高母乳喂养率。%Objective To study the effect of community health education on lactation mastitis and breast feeding.Method Ninety parturients were given community health education for 6 months and then the rates of mastitis and breast feeding were recorded.Results The mastitis morbidity was 3.3%and the rate of breast feeding was 97.8%.Conclusion The implementation of the community health education can reduce the morbidity of maternal mastitis and raise the rate of breast feeding.

  20. Delay in referring and related factors in patients with advanced breast cancer - Emam Hospital (2000

    Directory of Open Access Journals (Sweden)

    "Ghaem Maghami F


    Full Text Available Background: The aim of study was to determine the frequency of delay referring and related factors in patients with advanced breast cancer, in Imam Khomeini Hospital in the 2000. Materials and Methods: Successively 200 patients were entered the study if they were consentient. A questionnaire was constructed and information was obtained through interviewing. Results: From the cases, 64 patients (32 percent referred without delay and 136 patients (68 percent referred tardily. The patients who were late in comparison with patients who didn’t late, had significantly higher mean age (P=0.004, lower education level (P=0.002, and lower economic status (P=0.001. The frequency rate of single were lower among them (P=0.001, fewer percent were residual of big cities (P=0.01 and they had less rate of available physician (P=0.004. 24.3 percent of delay referring patients and 53.1 percent of patients without delay has a positive family history of breast cancer (P=0.001. 62.5 percent of delay referring patients and 85 percent of patients without delay were aware about importance of Self Breast Examination (S.B.E (P=0.002 and respectively 84.4 percent and 98.4 percent were award about symptoms of breast cancer (P=0.01. 23.5 percent and 33 percent of patients with and without delay Knew the method of B.S.E respectively. It wasn’t a significant difference. Conclusion: Lack of awareness about necessity of medical consultation, fear, carelessly, unavailable physician and poverty were the major causes of delay in patients who referred late.

  1. 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;


    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...

  2. Digital breast tomosynthesis (DBT) to characterize MRI-detected additional lesions unidentified at targeted ultrasound in newly diagnosed breast cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Mariscotti, Giovanna; Durando, Manuela; Regini, Elisa; Fornari, Alberto; Fonio, Paolo; Gandini, Giovanni [Breast Imaging Service, Radiology - University of Turin, Department of Diagnostic Imaging and Radiotherapy, A.O.U. Citta della Salute e della Scienza, Torino (Italy); Houssami, Nehmat [University of Sydney, Screening and Test Evaluation Program, School of Public Health, Sydney Medical School, Sydney, NSW (Australia); Campanino, Pier Paolo [Ospedale Koelliker, Breast Imaging Service, Torino (Italy); Bussone, Riccardo [A.O.U. Citta della Salute e della Scienza of Turin, SSCVD Breast Surgery. Department of Surgery, Torino (Italy); Castellano, Isabella; Sapino, Anna [University of Turin, Department of Biomedical Sciences and Human Oncology, A.O.U. Citta della Salute e della Scienza, Torino (Italy)


    Preoperative breast magnetic resonance (MR) often generates additional suspicious findings needing further investigations. Targeted breast ultrasound (US) is the standard tool to characterize MR additional lesions. The purpose of this study is to evaluate the potential role of digital breast tomosynthesis (DBT) to characterize MR detected additional findings, unidentified at targeted breast US. This prospective study included women who a) had biopsy-proven, newly diagnosed breast cancers detected at conventional 2D mammography and/or US, referred to breast MR for tumour staging; and b) had DBT if additional MR findings were not detected at targeted ('second look') US. In 520 patients, MR identified 164 (in 114 women, 22 %) additional enhancing lesions. Targeted US identified 114/164 (69.5 %) of these, whereas 50/164 (30.5 %) remained unidentified. DBT identified 32/50 of these cases, increasing the overall characterization of MR detected additional findings to 89.0 % (146/164). Using DBT the identified lesions were significantly more likely to be malignant than benign MR-detected additional lesions (p = 0.04). DBT improves the characterization of additional MR findings not identified at targeted breast US in preoperative breast cancer staging. (orig.)

  3. Aleitamento e hábitos orais deletérios em respiradores orais e nasais Breast-feeding and deleterious oral habits in mouth and nose breathers

    Directory of Open Access Journals (Sweden)

    Luciana Vitaliano Voi Trawitzki


    Full Text Available OBJETIVO: A amamentação promove vários benefícios na criança, entre eles o favorecimento da respiração nasal. Neste estudo verificou-se a relação do padrão respiratório com o histórico de aleitamento e hábitos orais deletérios. FORMA DE ESTUDO: clínico com coorte transversal. MATERIAL E MÉTODO: A população foi constituída por 62 crianças, de 3 anos e 3 meses a 6 anos e 11 meses, as quais foram submetidas à avaliação otorrinolaringológica, para definição dos grupos respiradores nasais e orais e entrevista fonoaudiológica. A avaliação otorrinolaringológica constituiu-se dos seguintes exames: rinoscopia anterior, oroscopia e exame radiológico. Os pais das crianças foram questionados em relação à forma (natural e/ou artificial, e ao período de aleitamento, além da presença de hábitos orais deletérios (sucção e mordida. O teste Exato de Fisher foi utilizado para comparar os grupos em relação à presença ou ausência de hábitos e diferentes períodos de aleitamento. RESULTADOS: O período de aleitamento materno foi maior nos respiradores nasais concentrando-se no período de 3 a 6 meses de idade. Quanto ao uso de mamadeira, os resultados mostraram que a maioria das crianças de ambos os grupos utilizou-se deste tipo de aleitamento nos primeiros anos de vida, não apresentando diferença estatística entre os grupos (p=0.58. A presença de hábitos orais deletérios ocorreu de maneira marcante nos respiradores orais, evidenciando diferença estatisticamente significativa, entre os grupos, para os hábitos de sucção (p=0.004 e hábitos de mordida (p=0.0002. CONCLUSÃO: As crianças respiradoras orais apresentaram um menor período de aleitamento materno e um histórico de hábitos orais presentes comparadas às crianças respiradoras nasais.AIM: Breast-feeding promotes several benefits in childhood, among them favoring the nasal breathing. In the present study, the relationship between breathing pattern

  4. Breast-feeding in Buddhist Art:Concerning the Raging Controversy about Breasting-feeding in Public Places%漫谈佛教艺术中的哺乳图--从当代社会关于公共场所哺乳问题的争论谈起

    Institute of Scientific and Technical Information of China (English)



    In recent years, many controversies have taken place on the internet about the legitimacy of breast-feeding in full view of the public.The heart of these controversies can be summarized as follows:what is beautiful and what is reprehensi-ble?In this age of diverse ideologies, why is there so much tolerance about ugly things and yet so little tolerance, or even zero tolerance, for truly beautiful things?Focusing on the raging controversy about breast-feeding in upblic places and mak-ing reference to breast-feeding scene s in the history of Buddhist art and their underlying aestheitc ideas, this paper attempts to reflect on this phenomenon.%近年来,关于妇女在公共场所无遮盖哺乳是否具有正当性的争议,在互联网上可谓此伏彼起。这一争论的实质在于:什么是美的?什么是不美的?在这个思想观念日益多元的时代,为什么人们有时候能够对丑陋的事物表现出极大的宽容,却对某些真正美好的事物如此苛责,甚至是“零容忍”?由此围绕当代社会关于公共场所哺乳问题的争论,结合宗教艺术史上的诸多艺术表现及其背后的审美观念进行反思。

  5. Proposal of a survey of radiation protection procedures during breast feeding;Proposta de um levantamento do estado da arte da radioprotecao para lactantes submetidas a procedimento com radiofarmacos e respectivos bebes

    Energy Technology Data Exchange (ETDEWEB)

    Santos, Liliane dos; Oliveira, Silvia M. Velasques de [Instituto de Radioprotecao e Dosimetria (IRD/CNEN-RJ), Rio de Janeiro, RJ (Brazil). Servico de Monitoracao Individual Interna


    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 {sup 131}I or {sup 123}I for thyroid imaging and 84% of these were hold by women. For {sup 131}I, {sup 67}Ga and {sup 201}Tl, 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)

  6. Levonorgestrel Intrauterine Device Placement in a Premenopausal Breast Cancer Patient with a Bicornuate Uterus. (United States)

    Eskew, Ashley M; Crane, Erin K


    Young women with breast cancer face contraceptive challenges. Data are limited and conflicting on the use of the levonorgestrel intrauterine device (LNG-IUD) in this patient population. A 32-year-old nulligravid woman with a history of breast cancer on tamoxifen presented with new-onset vaginal bleeding. Further workup revealed a previously undiagnosed bicornuate uterus. She underwent hysteroscopy, dilation and curettage, and LNG-IUD placement in each uterine horn. Postoperative follow-up confirmed retention and proper placement of both IUDs. Pathology from the dilation and curettage was benign, and the abnormal uterine bleeding abated. LNG-IUD placement in a young patient with a personal history of breast cancer on tamoxifen and a bicornuate uterus is a safe and feasible alternative for contraception.

  7. Diabetes insipidus and adrenal insufficiency in a patient with metastatic breast cancer. (United States)

    Netelenbos, T; Nooij, M A; Nortier, J W R


    A patient previously treated for bilateral breast cancer with mastectomy, radiation therapy and in remission on hormonal therapy for more than five years presented with abdominal symptoms from breast cancer relapse. She developed inappropriate polyuria and hypernatraemia, which responded to desmopressin. In combination with the absence of a high signal from the posterior lobe of the pituitary on MRI , these data indicated the presence of partial central diabetes insipidus. The anterior pituitary showed partial failure (low follicle-stimulating hormone, luteinising hormone and insulin-like growth factor-1 levels). Furthermore, primary adrenal insufficiency had developed, ascribed to bilateral tumour invasion of the adrenals. This rare combination of endocrinological failures in a patient with metastatic breast cancer is discussed.

  8. Colorectal carcinoma in a patient with prior breast cancer: Is there a causal link?

    Energy Technology Data Exchange (ETDEWEB)

    Scarles, Elaine [Blackpool Victoria Hospital, Blackpool, Lancashire FY3 8NR (United Kingdom); Nightingale, Julie [Department of Radiography, School of Health Care Professions, University of Salford, Salford, Greater Manchester, M6 6PU (United Kingdom)], E-mail:


    A 70-year-old female patient with prior breast cancer was diagnosed with colorectal carcinoma six years following the original breast referral. The cancers were both discovered at an early stage enabling potentially curative surgery to be performed, with an associated good long-term prognosis. This article explores a range of cancer risk factors associated with lifestyle, genetics and medication to ascertain whether the two primary cancers were independent oncological events, or whether they were related. Factors such as smoking, alcohol consumption, genetic predisposition and the use of contraceptives and Tamoxifen may increase the relative risk for both cancers. Various studies have offered conflicting data regarding the relative risk for developing the second cancer, but long-term cohort studies will continue to add to the evidence base. It is possible that the outcomes of these studies may have implications for the follow up of breast cancer patients within the colorectal cancer screening service.

  9. Hormone Replacement Therapy: An Increased Risk of Recurrence and Mortality for Breast Cancer Patients? (United States)

    Lupo, Molly; Dains, Joyce E.; Madsen, Lydia T.


    Historically, randomized controlled trials (RCTs) have shown an increased risk of recurrence and mortality among women who have used primarily oral HRT after breast cancer. However, many of these studies have had design flaws that may impact the findings. Numerous investigators have concluded that additional RCTs should be performed, but because of ethical issues and logistic challenges, large-scale RCTs are unlikely. Thus, the authors conducted an integrative review investigating recurrence and mortality data among breast cancer survivors who have used hormone replacement therapy (HRT). They recommend a stepwise algorithm for treating vaginal symptoms in breast cancer survivors: (1) start with nonhormonal treatments; (2) progress to a detailed discussion among patients and health-care professionals about the current known risks and benefits of vaginal estrogen; and (3) conclude with mutual decision-making between health-care providers and patients regarding the use of vaginal estrogen treatment. PMID:26705493

  10. Emotional aspects and pranayama in breast cancer patients undergoing radiation therapy: A randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Jyothi Chakrabarty


    Full Text Available Objective: Emotional disturbances are commonly experienced by cancer patients. The aim of this study was to determine the effectiveness of certain Pranayama techniques on the emotional aspects such as impatience, worry, anxiety, and frustration among breast cancer patients undergoing radiation therapy in India. Methods: The study was conducted as a randomized controlled trial. Patients were recruited when they were seeking radiation therapy for breast cancer. They were allocated into two groups using block randomization technique. The experimental group performed Pranayama along with radiation therapy, whereas the control group received only routine care. Results: Emotional aspects of the two groups were compared at the end of the treatment. Mann-Whitney U-test was used for comparison as the data were not following normality. It showed a significant difference between the two groups with the group who performed Pranayama showing a lesser mean score for these negative emotions. Conclusions: Pranayama might help in controlling the negative emotions likely to be faced by breast cancer patients, and it can be used as a supportive therapy for breast cancer patients receiving radiation therapy.

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

    Directory of Open Access Journals (Sweden)

    Leandro Cordero


    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.

  12. Validated biomarkers: The key to precision treatment in patients with breast cancer. (United States)

    Duffy, Michael J; O'Donovan, Norma; McDermott, Enda; Crown, John


    Recent DNA sequencing and gene expression studies have shown that at a molecular level, almost every case of breast cancer is unique and different from other breast cancers. For optimum management therefore, every patient should receive treatment that is guided by the molecular composition of their tumor, i.e., precision treatment. While such a scenario is still some distance into the future, biomarkers are beginning to play an important role in preparing the way for precision treatment. In particular, biomarkers are increasingly being used for predicting patient outcome and informing as to the most appropriate type of systemic therapy to be administered. Mandatory biomarkers for every newly diagnosed case of breast cancer are estrogen receptors and progesterone receptors in selecting patients for endocrine treatment and HER2 for identifying patients likely to benefit from anti-HER2 therapy. Amongst the best validated prognostic biomarker tests are uPA/PAI-1, MammaPrint and Oncotype DX. Although currently, there are no biomarkers available for predicting response to specific forms of chemotherapy, uPA/PAI-1 and Oncotype DX can aid the identification of lymph node-negative patients that are most likely to benefit from adjuvant chemotherapy, in general. In order to accelerate progress towards precision treatment for women with breast cancer, we need additional predictive biomarkers, especially for enhancing the positive predictive value for endocrine and anti-HER2 therapies, as well as biomarkers for predicting response to specific forms of chemotherapy. The ultimate biomarker test for achieving the goal of precision treatment for patients with breast cancer will likely require a combination of gene sequencing and transcriptomic analysis of every patient's tumor.

  13. Analysis of the individual radio sensitivity of breast cancer patients; Untersuchungen zur individuellen Strahlenempfindlichkeit von Brustkrebspatientinnen

    Energy Technology Data Exchange (ETDEWEB)

    Auer, Judith


    Individual radiosensitivity has a crucial impact on radiotherapy related side effects. A prediction of individual radiosensitivity could avoid these side effects. Our aim was to study a breast cancer collective for its variation of individual radiosensitivity. Peripheral blood samples were obtained from 129 individuals. 67 breast cancer patients and 62 healthy and age matched individuals were looked at and their individual radiosensitivity was estimated by a 3-color Fluorescence in situ hybridization approach. Blood samples were obtained (i) before starting adjuvant radiotherapy and were in vitro irradiated by 2 Gy; (ii) after 5 single doses of 1.8 Gy and after 72 h had elapsed. DNA of lymphocytes was probed with whole chromosome painting for chromosomes 1, 2 and 4. The rate of breaks per metaphase was analyzed and used as a predictor of individual radiosensitivity. Breast cancer patients were distinctly more radio-sensitive compared to healthy controls. Additionally the distribution of the cancer patients' radiosensitivity was broader. A subgroup of 9 rather radio-sensitive and 9 rather radio-resistant patients was identified. A subgroup of patients aged between 40 and 50 was distinctly more radio-sensitive than younger or older patients. The in vivo irradiation approach was not applicable to detect individual radiosensitivity. In the breast cancer collective a distinctly resistant and sensitive subgroup is identified, which could be subject for treatment adjustment. Especially in the range of age 40 to 50 patients have an increased radiosensitivity. An in vivo irradiation in a breast cancer collective is not suitable to estimate individual radiosensitivity due to a low deposed dose.

  14. High risk factors of brain metastases in 295 patients with advanced breast cancer

    Institute of Scientific and Technical Information of China (English)

    YAN Min; L(U) Hui-min; LIU Zhen-zhen; LIU Hui; ZHANG Meng-wei; SUN Xi-bin; CUI Shu-de


    Background The incidence of brain metastases in patients with breast cancer is approximately 10%-16%,and survival after diagnosis of brain metastases is usually short.This study was designed to evaluate the risk factors associated with brain metastases in advanced breast cancer patients,with a view to help predict patient groups with high risk of brain metastases.Methods In total,295 patients with advanced breast cancer were evaluated.All patients were pathologically confirmed and metastatic lesions were confirmed pathologically or by imaging.All patients were examined at least once every 6 months with head CT or MRI.Patients showing symptoms underwent immediate inspection,and brain metastatic lesions were confirmed by head CT and/or MRI.Results At a median follow-up of 12 months from the occurrence of metastases,brain metastases had occurred in 49 patients (16.6%).In our univariate analysis,variables significantly related to increased risk of brain metastases were hormone receptor-negative tumors,epidermal growth factor receptor 2 (HER2)-positive tumors,and multiple distant metastases.Patients with dominant tumor sites in soft tissue,or defined as Luminal A subtype,tended to have a lower risk of brain metastases than patients with visceral metastases,Luminal B subtype,triple-negative subtype or HER2-enriched subtype tumors.Conclusions Our results strongly suggest that factors such as Luminal B,triple-negative,and HER2-enriched subtypes are high risk factors for brain metastases.These data,therefore,provide pivotal clinical evidence towards a comprehensive understanding of the risk factors of brain metastases in advanced breast cancer patients.