International Journal of Breast Cancer最新文献

Background: Breast cancer screening and effective neoadjuvant treatments have increased surgeries for nonpalpable tumors, often requiring preoperative localization. The wire-guided method, performed on the same day as surgery, has limitations, prompting interest in wire-free alternatives like magnetic seed devices. Methods: A retrospective single-center study (November 2020-March 2024) compared magnetic seed and wire-guided localization in 558 patients. The primary aim was to assess localization and retrieval success, resection margins, and reoperation rates. Secondary endpoints included the interval between localization and surgery, operative time, incision site selection, and volume excised. Results: Among 558 patients, 188 underwent magnetic seed and 370 wire-guided localizations. Both groups were similar in BMI, breast size, and lesion characteristics. Complications in the wire-guided group included device migration (0.5%) and hematoma (1.3%). Success rates were comparable (98.9% vs. 99.7%), as were positive margins (5.3% vs. 6.7%) and reoperation rates (6.9% vs. 7.8%). Excised volume was significantly lower in the magnetic seed group (24.2 [range 6.5-48.0 cm³] vs. 41.5 cm³ [range 16.0-68.0 cm³], p < 0.001). The magnetic seed group had an average localization-to-surgery interval of 1 day (range 0-160 days). Conclusions: Magnetic seed localization is as safe and effective as wire-guided localization, with comparable success rates and resection margins adequacy. Its primary advantage is scheduling flexibility, offering a longer interval between localization and surgery.

Background: Chemotherapy-induced peripheral neuropathy (CIPN) is a common and debilitating complication of cancer treatment, particularly with agents like paclitaxel. Effective preventive measures for CIPN are limited. Metformin, an antihyperglycemic agent with neuroprotective properties, has shown promise in preclinical studies; however, its clinical utility in preventing CIPN remains underexplored. Objective: This study evaluates the preventive effects of metformin on paclitaxel-induced peripheral neuropathy in breast cancer patients. Methods: A randomized, controlled study was conducted involving 60 breast cancer patients receiving paclitaxel chemotherapy. Patients were assigned to an intervention group receiving metformin (500 mg twice daily) or a control group without metformin. Peripheral nerve function was assessed using nerve conduction studies (NCSs), measuring sensory nerve action potential (SNAP) amplitude, compound muscle action potential (CMAP) amplitude, and distal latency (DL). Clinical neurological symptoms and adverse effects of metformin were monitored throughout the study. Results: Of the 60 enrolled patients, 47 completed the study (26 control and 21 intervention). The incidence of CIPN was lower in the metformin group compared to the control group, although this difference did not reach statistical significance. Metformin was well-tolerated, with mild gastrointestinal side effects being the most common adverse events. No significant differences between the groups were observed in SNAP amplitude, CMAP amplitude, or DL. Conclusion: Metformin may modestly reduce the incidence of CIPN in patients receiving paclitaxel chemotherapy, although the observed effect was not statistically significant. Given its safety profile and potential neuroprotective benefits, metformin warrants further investigation in larger, multicenter trials to confirm its role in CIPN prevention.

Objectives: This study is aimed at evaluating androgen receptor (AR) and tumor-associated neutrophil (TAN) expressions in different breast cancer subtypes and their relationship with tumor differentiation, stage, and other clinicopathological markers. Methods: A cross-sectional study was conducted on 84 breast cancer patients at Stages I-IV. Tumor tissues were assessed using immunohistochemistry for ER, PR, HER2, AR, and Ki67, along with TAN evaluation using hematoxylin and eosin staining. Associations between AR, TAN, and other clinical variables were analyzed using chi-square, t-tests, and logistic regression. Results: AR was expressed in 70.2% of tumors and was significantly associated with ER positivity (OR = 74.31, p < 0.001), PR positivity (OR = 6.8, p = 0.01), and better differentiation (OR = 0.1 for poorly differentiated tumors, p = 0.035). AR positivity was highest in Luminal A/B subtypes (82%) and lowest in triple-negative breast cancer (TNBC) (20%; OR = 0.06, 95% CI: 0.01-0.3). In contrast, TAN positivity was observed in 45.6% of cases and was most frequent in TNBC (67%; OR = 3.7, 95% CI: 0.9-15.3) and poorly differentiated tumors (71.4%). TANs were inversely associated with PR positivity (OR = 0.21, p = 0.014) and showed a significant association with vascular invasion (p = 0.047). No significant associations were found between AR or TAN expression and metastatic status or neural invasion. Conclusion: AR is a defining marker for HR-positive breast cancers and may serve as an indicator of lower tumor grade and differentiation status. TANs, however, are linked to more aggressive phenotypes, especially in TNBC, suggesting a role in driving tumor progression. This highlights the potential for AR and TAN expression patterns to refine patient stratification across breast cancer subtypes.

Background: Breast cancer (BRCA) remains a leading cause of cancer-related mortality among women. CCL18 and EGF are implicated in tumor biology; however, their roles in BRCA remain partly defined. This study investigates their expression profiles, immune associations, prognostic relevance, epigenetic regulation, and molecular networks. Methods: Expression data from TCGA, UALCAN, and GSCA were analyzed to compare CCL18 and EGF levels in BRCA and normal tissues. Immune infiltration was assessed using TIMER, while survival analyses were performed via Kaplan-Meier plotter and TCGA subcohorts, including menopausal status. Promoter DNA methylation was examined using UALCAN. Gene correlation networks and protein-protein interactions were assessed using UALCAN and STRING. Result: CCL18 was significantly upregulated in BRCA tissues, while EGF showed no consistent increase compared to normal tissue. Both genes were strongly correlated with immune cell infiltration. High CCL18 and EGF expression was associated with reduced relapse-free survival in BRCA. Promoter regions of both genes exhibited reduced DNA methylation, supporting their elevated expression in tumors. Interaction analyses revealed distinct immune- and signaling-related gene and protein networks. Conclusion: CCL18 shows strong prognostic and immunological relevance in BRCA, while EGF appears to play a broader oncogenic role. Hypomethylation of both genes may drive their aberrant expression and involvement in tumor progression.

Background: The study was aimed at measuring the factors contributing to the delayed presentation of breast cancer patients within the socio-ecological context by developing a scale. Methods: The study objectives were measured by developing the items on the basis of a 5-point scale named the Socio-Ecological Scale for Breast Cancer Patients (SES-BCP). The dimensionality of the measure and internal consistency were determined by collecting data from 350 breast cancer patients from five main hospitals in three main cities (Lahore, Multan, and Faisalabad) in the Punjab province of Pakistan. A multistage sampling technique was employed, and sociodemographic factors were kept in consideration. Confirmatory factor analysis was applied for the factor structure in the study by using a structural equation model. Results: With the distinctive five factors of the SES-BCP, a total of 51 items were confirmed in the final scale with sound psychometric properties, providing a multidimensional view of the study that helps in the early detection and cure of disease. Conclusions: It can be concluded that this scale is a valuable addition to assess the underlying factors of delayed presentation in patients with breast cancer in the context of the socio-ecological model in Pakistan.

Introduction: The practice of mammography has transitioned from analog to digital with improved accuracy and significant changes to findings. This study was aimed at investigating the current patterns of breast diseases among women presenting for mammography at a major hospital in the Volta region of Ghana. Methods: This descriptive retrospective study reviewed 508 mammography and complimentary breast ultrasound reports conducted between October 2019 and May 2023. Because they were incomplete and had essential patient data missing, 28 reports (n = 28) were excluded. Data extracted from the reports included patients' age, clinical indication, breast density, imaging impression, and BI-RADS classification for each breast. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) Version 26, and results are presented using descriptive and inferential statistics. Results: The study involved 480 women, aged 40-86 years (mean = 54.6 ± 10.1). The distribution of the breast densities of the women was as follows: almost entirely fatty (n = 79, 16.46%), scattered areas of fibroglandular density (n = 226, 47.08%), heterogeneously dense (n = 145, 30.21%), and extremely dense (n = 30, 6.25%). There was a statistically significant association between age and breast density (p < 0.01). While 30 (6.25%) of the women presented for screening, 450 (93.75%) presented for diagnostic mammography. Breast pain (n = 189, 39.38%), breast lump/mass (n = 155, 32.29%), and suspected breast cancer (n = 47, 9.79%) were the most common clinical indications. The study recorded a total of 960 BI-RADS classifications of which 261 (27.19%) were negative and 699 (72.81%) were positive. Most of the positive findings (n = 521, 74.54%) were BI-RADS 2 and 3. Both benign and suspicious for malignancy or highly suggestive of malignancy lesions were common across women aged 40-50 years. There was a statistically significant association between age and BI-RADS classification (p < 0.01). Conclusion: This study showed that most of the women presented for diagnostic mammography. Attendance for screening mammography was poor among women presenting for mammography at the hospital; hence, women should be encouraged through health education and other campaign strategies to undergo screening mammography more regularly to facilitate more timely detection and diagnosis of breast diseases. A third of the women in our study had dense breasts. The vast majority of the women had positive findings, but the majority of these findings were indicative of benign breast diseases.

Objective: This study is aimed at comparing the forward IMRT (F-IMRT) and VMAT techniques in the adjuvant treatment of left-sided breast cancer using hypofractionated radiation over 1 week with deep inspiration breath hold (DIBH) via the Elekta Active Breathing Coordinator (ABC) system. Materials and Methods: Treatment plans for 26 patients receiving 26 Gy in five fractions (5.2 Gy/fraction), followed by a 10-Gy electron boost in five fractions, were analyzed. The boost phase was excluded from the comparison. F-IMRT and VMAT plans were evaluated for dose to 95% of the volume, conformity index (CI), mean left lung dose (MLLD), left lung V8 Gy, mean heart dose (MHD), heart V1.5Gy and V7Gy, mean right breast dose (MRBD), and mean right lung dose (MRLD). Statistical analysis was conducted using the Wilcoxon signed-rank test. Results: PTV coverage was similar in F-IMRT and VMAT arms (95.83% vs. 95.38%), but CI was significantly improved with VMAT (1.31 vs. 1.04). F-IMRT significantly reduced MLLD (4.55 Gy vs. 5.95 Gy) and left lung V8Gy (18.78% vs. 25.87%) when compared to VMAT. MHD was lower with F-IMRT (1.79Gy vs. 2.47Gy), with significantly reduced heart V1.5Gy (21.6% vs. 54.4%) when compared to VMAT, with V7Gy not different (5.04% vs. 5.79%) between F-IMRT and VMAT. F-IMRT also resulted in lower MRBD (0.62 Gy vs. 2.4 Gy) and MRLD (0.38 Gy vs. 1.8 Gy) when compared to VMAT. Conclusion: F-IMRT provides comparable target coverage to VMAT while significantly reducing radiation exposure to the heart, lungs, and contralateral breast for left-sided breast cancer treatment with DIBH and hypofractionation over 1 week. Given its dosimetric advantages, F-IMRT should be the preferred technique to enhance patient safety and minimize long-term toxicities.

Molecular subtype is a crucial prognostic factor for bilateral breast cancer and plays a key role in guiding treatment decisions. Several studies have confirmed that the expression patterns of hormone receptor and human epidermal growth factor receptor 2 are generally consistent in synchronous bilateral primary breast cancer. Discordance in the receptor expression status is commonly associated with poorer prognosis in synchronous bilateral breast cancer. However, there is currently limited literature reporting such cases. This article presents a case of synchronous bilateral primary breast cancer with discordant molecular subtypes and reviews relevant literature.

Background: In Ghana, the incidence of breast cancer is increasing with disproportionately high mortality rates. Awareness about the disease process is critical for achieving early diagnosis of breast cancer in countries without a national screening program. Targeting adolescents in school will help to inculcate good health seeking behaviors with widespread reach. This study assessed the baseline knowledge in high school males and females as an important first step to inform the development of appropriate educational interventions to address identified gaps in student knowledge about breast cancer. Methodology: A multisite cross-sectional study was carried out in 14 high schools in two regions in southern Ghana to assess the baseline student knowledge of breast cancer. Self-administered questionnaires were used covering the following four domains: (1) general breast cancer knowledge, (2) breast cancer symptoms, (3) risk factors for breast cancer, and (4) breast self-examination/screening for breast cancer. For each domain of knowledge tested, the total score was categorized as adequate knowledge (≥ 50% of questions answered correctly) or inadequate knowledge (< 50% of questions answered correctly). Logistic regression was used to determine factors associated with each of the knowledge domains. Stata 14.0 was used for the statistical analysis, and a p < 0.05 was considered statistically significant. Results: Nine thousand seven hundred sixty-seven students from 10 coeducational and 4 girls-only schools participated with 68% of respondents being female. The mean student age was 16.9 ± 1.2 years. Eighty-four percent of the students demonstrated adequate general knowledge on breast cancer and 54% demonstrated adequate knowledge of breast cancer symptoms. However, only 34% and 21%, respectively, received a score of adequate knowledge in regard to breast cancer risk factors and BSE/breast cancer screening. After combining all domain scores to evaluate overall breast cancer knowledge, less than half (47%) of the students received an adequate breast cancer knowledge score. Females and the girls-only schools had statistically significant adequate levels of knowledge of breast cancer. Conclusion: The overall knowledge of breast cancer among senior high school students in southern Ghana is inadequate especially on knowledge of breast cancer risk factors, breast self-examination, and breast cancer screening. Breast cancer educational activities should be incorporated into the national school health curriculum in senior high schools across the country to ameliorate this knowledge gap, with special emphasis on risk factors and breast self-examination. Adolescent males should be included in breast cancer education.

Purpose: The purpose was to investigate the impact of breast density notification on anxiety using the State and Trait Anxiety Inventory (STAI) tool in South Australian women undergoing breast cancer screening. Methods: A survey-based cross-sectional mixed method study was conducted in women attending breast cancer screening at the Queen Elizabeth Hospital Breast/Endocrine outpatient department (n = 100). The women had participated in a previous study assessing their general knowledge of breast density and had indicated they wanted to know their own breast density. Breast density was assessed using Volpara software, and the participants were notified by letter. The STAI tool was administered with an additional question asking how participants felt after being told their breast density. State and trait anxiety levels were compared between those receiving notification of dense breasts and those notified of nondense breasts. Results: State anxiety scores were not different between women notified they had dense breasts (n = 34, mean state anxiety ± SD; 36.65 ± 13.03) and those who had nondense breasts (n = 66, 35.17 ± 13.60, p = 0.51). Severe trait anxiety was observed in 8 of 34 (23%) and 13 of 66 (20%) women in the dense and nondense groups, respectively, and there were no significant differences. Qualitative analysis of 122 coded responses revealed the majority of reactions to breast density notification were positive or neutral, with 17% being negative. Conclusion: Notification of dense breasts was not associated with elevated anxiety when compared to the notification of nondense breasts. Breast density notification approaches need to be considerate of the significant proportion of women with severe underlying anxiety.