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Truncated WT1 Protein Isoform Expression Is Increased in MCF-7 Cells with Long-Term Estrogen Depletion. 在长期雌激素耗竭的MCF-7细胞中,截断的WT1蛋白亚型表达增加。
IF 1.9 Q3 Medicine Pub Date : 2021-11-20 eCollection Date: 2021-01-01 DOI: 10.1155/2021/6282514
Saavedra-Alonso Santiago, Zapata-Benavides Pablo, Mendoza-Gamboa Edgar, Chavez-Escamilla Ana Karina, Arellano-Rodríguez Mariela, Rodriguez-Padilla Cristina

Background: The wt1 gene codes for a transcription factor that presents several protein isoforms with diverse biological properties, capable of positively and negatively regulating genes involved in proliferation, differentiation, and apoptosis. WT1 protein is overexpressed in more than 90% of breast cancer; however, its role during tumor progression is still unknown. Methodology. In this work, we analyzed the expression of WT1 isoforms in several breast cancer cells with different tumor marker statuses and an in vitro assay using MCF-7 cells cultured with long-term estrogen depletion (MCF-7 LTED cells) with the finality to mimic the process of switching from hormone-dependent to hormone-independent. Moreover, growth kinetics, sensitivity to tamoxifen, and relative expression analysis of ER and Her2/neu were performed.

Results: Initially, the expression of 52-54 kDa protein isoform of WT1 in the breast cancer cell line ER (+) was detected by western blot and was absent in ER (-), and the 36-38 kDa protein isoform of WT1 was detected in all cell lines analyzed. The analysis of alternative splicing by RT-PCR shows that the 17AA (+)/KTS (-) isoform of WT1 was the most frequent in the four cell lines analyzed. In vitro, the MCF-7 cells in the estrogen depletion assay show an increase in the expression of the 52-54 kDa isoform of WT1 in the first 48 hours, and this was maintained until week 13, and later, this expression was decreased, and the 36-38 kDa isoform of WT1 did not show change during the first 48 hours but from week 1 showed an increase of expression, and this remained until week 27. Growth kinetic analysis showed that MCF-7 LTED cells presented a 1.4-fold decrease in cellular proliferation compared to MCF-7 cells cultured under normal conditions. In addition, MCF-7 LTED cells showed a decrease in sensitivity to the antiproliferative effect of tamoxifen (p ≤ 0.05). Samples collected until week 57 analyzed by qRT-PCR showed an increase in the relative expression of the Her2/neu and ER.

Conclusions: Modulation of protein isoforms showed differential expression of WT1 isoforms dependent on estrogen receptor. The absence of 52-54 kDa and the presence of the 36-38 kDa protein isoform of WT1 were detected in ER-negative breast cancer cell lines classified as advanced stage cells. Long-term estrogen depletion assay in MCF-7 cells increased the expression of the 36-38 kDa isoform and reduced the 52-54 kDa isoform, and these cells show an increase in the expression of tumor markers of ER and Her2/neu. MCF-7 LTED cells showed low proliferation and insensitivity to tamoxifen compared to MCF-7 cells in normal conditions. These results support the theory about the relationship of the 36-38 kDa isoform of WT1 and the absence of ER function in advanced breast cancer.

背景:wt1基因编码一种转录因子,该转录因子具有多种具有不同生物学特性的蛋白亚型,能够对参与增殖、分化和凋亡的基因进行正向和负向调节。WT1蛋白在90%以上的乳腺癌中过表达;然而,其在肿瘤进展过程中的作用尚不清楚。方法。在这项工作中,我们分析了WT1亚型在几种具有不同肿瘤标志物状态的乳腺癌细胞中的表达,并使用长期雌激素耗尽培养的MCF-7细胞(MCF-7 ltted细胞)进行了体外实验,最终模拟了从激素依赖性到激素非依赖性的转换过程。此外,还进行了生长动力学、对他莫昔芬的敏感性以及ER和Her2/neu的相对表达分析。结果:western blot初步检测到乳腺癌细胞系ER(+)中有52-54 kDa蛋白异构体的表达,ER(-)中没有WT1蛋白异构体的表达,分析的所有细胞系中均检测到WT1 36-38 kDa蛋白异构体。RT-PCR的选择性剪接分析表明,WT1的17AA (+)/KTS(-)亚型在4个细胞系中最常见。体外实验中,MCF-7细胞雌激素耗竭实验显示,WT1的52-54 kDa亚型在前48小时内表达增加,并持续到第13周,随后,这种表达减少,而WT1的36-38 kDa亚型在前48小时内没有变化,但从第1周开始表达增加,并一直持续到第27周。生长动力学分析显示,与正常条件下培养的MCF-7细胞相比,MCF-7 ltted细胞的增殖能力下降了1.4倍。MCF-7 ltted细胞对他莫昔芬抗增殖作用的敏感性降低(p≤0.05)。通过qRT-PCR分析,收集到第57周的样本显示Her2/neu和ER的相对表达增加。结论:WT1蛋白异构体的调节表现为依赖雌激素受体的WT1蛋白异构体的差异表达。在被归类为晚期细胞的er阴性乳腺癌细胞系中检测到WT1的52-54 kDa缺失和36-38 kDa蛋白亚型的存在。在MCF-7细胞中进行长期雌激素耗尽实验,发现36-38 kDa亚型的表达增加,52-54 kDa亚型的表达减少,这些细胞显示肿瘤标志物ER和Her2/neu的表达增加。与正常条件下的MCF-7细胞相比,MCF-7 ltted细胞增殖低,对他莫昔芬不敏感。这些结果支持了WT1 36-38 kDa亚型与晚期乳腺癌内质网功能缺失之间关系的理论。
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引用次数: 1
Signs of Central Hypersensitivity, Stress, and Anxiety following Treatment for Breast Cancer: A Case Control Study. 乳腺癌治疗后中枢性超敏反应、压力和焦虑的症状:一项病例对照研究。
IF 1.9 Q3 Medicine Pub Date : 2021-10-18 eCollection Date: 2021-01-01 DOI: 10.1155/2021/5691584
Ivana Leao Ribeiro, Ximena Gálvez González, Diego Lara Torres, Luz Alejandra Lorca, Snehil Dixit, Nicolás Yáñez Benavides, Francisco Ortega Gonzalez

Background: With treatment for breast cancer, women treated may present significant sensory abnormalities in the upper extremity. However, there are no conclusive studies that have evaluated pressure pain thresholds (PPT) in the shoulder of postoperated women for breast cancer. The aim of this study was to compare PPT in the shoulder, stress, anxiety, depression symptoms, and quality of sleep among postoperated women for breast cancer (PO group) and asymptomatic women of shoulder pain (control group).

Methods: 40 women participated (n = 20, PO group, age: average ± standard deviation, 49.2 ± 8.3 years; body mass index (BMI): 27.5 ± 3.0 kg/cm2; surgery time: 22.2 ± 34.4 months; n = 20, control group, 46.9 ± 8.1 years; BMI: 26.8 ± 3.5 kg/cm2). The PPT was evaluated with a digital algometer at 32 points in the shoulder region and one control point in the tibialis anterior. Stress, anxiety, and depression were evaluated with the Depression, Anxiety and Stress Scale 21 (DASS-21) and the quality of sleep by the Pittsburgh Sleep Quality Index.

Results: Significant differences were observed over 1.5 kgf/cm2 in 33 points evaluated (p < 0.01) with a small to high effect size (Cliff's delta range = 0.16; 0.92) and higher levels of anxiety and stress in the PO group (anxiety: median [first; third quartile], 5[3; 12.5]; stress: 9.7 ± 4.7 (7.8; 11.8)) in comparison with the control group (anxiety: 2.5[1; 4.8]; stress: 6.7 ± 3.31 (5.2; 8.3), (p < 0.05)). No significant differences were found between the groups in depression and sleep quality (p > 0.05).

Conclusion: Postoperated women for breast cancer present hyperalgesia in the shoulder anterior and posterior region, low PPT in the tibialis anterior, and higher levels of stress and anxiety compared to the control group.

背景:在乳腺癌治疗中,接受治疗的女性上肢可能出现明显的感觉异常。然而,尚无结论性研究评估乳腺癌术后妇女肩部压力疼痛阈值(PPT)。本研究的目的是比较乳腺癌术后妇女(PO组)和无症状肩关节疼痛妇女(对照组)肩关节疼痛、压力、焦虑、抑郁症状和睡眠质量。方法:40名女性参与研究(n = 20, PO组),年龄:平均±标准差,49.2±8.3岁;体重指数(BMI): 27.5±3.0 kg/cm2;手术时间:22.2±34.4个月;N = 20,对照组46.9±8.1岁;BMI: 26.8±3.5 kg/cm2)。在肩关节区域的32个点和胫骨前肌的一个控制点用数字测定仪评估PPT。采用抑郁、焦虑和压力量表21 (DASS-21)评估压力、焦虑和抑郁,采用匹兹堡睡眠质量指数评估睡眠质量。结果:在1.5 kgf/cm2以上的33个评估点上观察到显著差异(p < 0.01),效应大小从小到高(Cliff's delta范围= 0.16;0.92)和更高水平的焦虑和压力在PO组(焦虑:中位数[第一;第三四分位数],5[3;12.5);应力:9.7±4.7 (7.8;11.8))与对照组(焦虑:2.5[1;4.8);应力:6.7±3.31 (5.2;8.3), (p < 0.05)。两组患者抑郁程度、睡眠质量差异无统计学意义(p > 0.05)。结论:与对照组相比,乳腺癌术后女性肩背前后区存在痛觉过敏,胫骨前肌PPT较低,应激和焦虑水平较高。
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引用次数: 0
Detection of High- and Low-Risk HPV DNA in Archived Breast Carcinoma Tissues from Ethiopian Women. 埃塞俄比亚妇女乳腺癌存档组织中高危和低危 HPV DNA 的检测。
IF 1.9 Q3 Medicine Pub Date : 2021-10-11 eCollection Date: 2021-01-01 DOI: 10.1155/2021/2140151
Endale Gebregzabher, Daniel Seifu, Wondemagegnhu Tigneh, Yonas Bokretsion, Abebe Bekele, Markos Abebe, Gabriella Lillsunde-Larsson, Christina Karlsson, Mats G Karlsson

Background: Human papilloma virus (HPV) is involved in the development of cancer of the cervix, mouth and throat, anus, penis, vulva, or vagina, but it has not been much considered as a cause of breast cancer. Recently, a number of investigations have linked breast cancer to viral infections. High-risk HPV types, predominantly HPV types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, and 59, are established as carcinogens in humans. In this study we aimed to detect 19 high-risk and 9 low-risk HPVs from archived breast tumor tissue among Ethiopian women.

Methods: In this study, 75 breast cancer patients from Tikur Anbassa Specialized Hospital in Addis Ababa (Ethiopia) were included. HPV detection and genotyping were done using the novel Anyplex™ II HPV28 Detection Assay at the Orebro University Hospital, Sweden. The Anyplex™ II PCR System detects 19 high-risk HPV types (16, 18, 26, 31, 33, 35, 39, 45, 51, 52, 53, 56, 58, 59, 66, 68, 69, 73, and 82) and 9 low-risk HPV types (6, 11, 40, 42, 43, 44, 54, 61, and 70). IHC for p16 was done using an automated system, the Dako Autostainer Link.

Results: Out of the 75 valid tests, two were found to be positive (2.7%) for HPV. One of the cases was positive for the high-risk HPV16 genotype while the other was positive both for the high-risk HPV39 and the low-risk HPV6. The cell cycle protein p16 was highly expressed in the case positive for the high-risk HPV16, but it was not expressed in the case positive for HPV39.

Conclusion: The prevalence of HPV is low in Ethiopian breast cancer patients, but the role played by HPV in breast carcinogenesis among Ethiopian breast cancer patients cannot be commented based on these observations.

背景:人类乳头状瘤病毒(HPV)与宫颈癌、口腔癌、咽喉癌、肛门癌、阴茎癌、外阴癌或阴道癌的发病有关,但却很少被认为是乳腺癌的病因。最近,一些调查发现乳腺癌与病毒感染有关。高危 HPV 类型,主要是 HPV 类型 16、18、31、33、35、39、45、51、52、56、58 和 59,已被确定为人类致癌物。在这项研究中,我们旨在从埃塞俄比亚妇女的存档乳腺肿瘤组织中检测出 19 种高风险和 9 种低风险 HPV:在这项研究中,纳入了来自亚的斯亚贝巴 Tikur Anbassa 专科医院(埃塞俄比亚)的 75 名乳腺癌患者。瑞典奥雷布洛大学医院使用新型 Anyplex™ II HPV28 检测试剂盒进行了 HPV 检测和基因分型。Anyplex™ II PCR 系统可检测 19 种高风险 HPV 类型(16、18、26、31、33、35、39、45、51、52、53、56、58、59、66、68、69、73 和 82)和 9 种低风险 HPV 类型(6、11、40、42、43、44、54、61 和 70)。p16 的 IHC 检测使用自动系统 Dako Autostainer Link 进行:结果:在 75 项有效检测中,有两项检测发现 HPV 阳性(2.7%)。其中一个病例的高危型 HPV16 基因型呈阳性,另一个病例的高危型 HPV39 和低危型 HPV6 均呈阳性。细胞周期蛋白 p16 在高危型 HPV16 阳性病例中高表达,但在 HPV39 阳性病例中没有表达:结论:埃塞俄比亚乳腺癌患者的 HPV 感染率较低,但基于这些观察结果,还不能对 HPV 在埃塞俄比亚乳腺癌患者乳腺癌发生过程中所起的作用做出评论。
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引用次数: 0
Premenopausal Breast Cancer Risk Factors and Associations with Molecular Subtypes: A Case-Control Study. 绝经前乳腺癌危险因素及其与分子亚型的关联:一项病例对照研究
IF 1.9 Q3 Medicine Pub Date : 2021-10-08 eCollection Date: 2021-01-01 DOI: 10.1155/2021/5560559
Faustin Ntirenganya, Jean Damascene Twagirumukiza, Georges Bucyibaruta, Belson Rugwizangoga, Stephen Rulisa

Background: Breast cancer (BC) is the most prevalent cancer in women and the leading cause of women's cancer-related deaths and morbidity worldwide. In Rwanda, BC incidence is increasing with an unacceptably high mortality rate in premenopausal women.

Objectives: The purpose was to identify modifiable BC risk factors and assess associations between common breast cancer risks factors and molecular subtypes in premenopausal women in Rwanda.

Methods: This was a case-control study. Premenopausal women with histological confirmation of BC and frequency-matched for age controls were recruited. A preestablished questionnaire was administered to both cases and controls for sociodemographics, BC probable risk factors, and clinical and pathological characteristics. BC was classified into luminal A, luminal B, HER2-type, basal-like (triple negative), and unclassified molecular subtypes by immunohistochemistry (IHC). Odds ratio (OR) and 95% confidence interval (CI) were estimated using multivariate logistic regression analysis.

Results: 340 participants were recruited into the study (170 cases vs. 170 controls). The median age was 39 years. The majority of cases presented at advanced stages of the disease (51.2% in stages III and IV) and had invasive ductal carcinoma (98.2%). 60.6% had subtypes of poor prognosis (HER2 enriched 14.7%, triple negative 12.9%, and unclassified 32.9%). Alcohol intake (AOR = 3.73, 95%CI 2.19 - 6.32, p < 0.001), obesity/overweight in adolescence or early adulthood (AOR = 10.86, 95%CI 4.82 - 24.4, p < 0.001), history of primary infertility (AOR = 33.8, 95%CI 3.5 - 321.5, p = 0.002), nulliparity (AOR = 3.75, 95%CI 1.61 - 8.75, p = 0.002), and a history of benign breast disease (AOR = 6.06, 95%CI 1.19 - 30.73, p = 0.03) were associated with the occurrence of premenopausal breast cancer. There was no significant difference between risk factor stratification per molecular subtype.

Conclusion: Several reproductive, environmental, and lifestyle risk factors have been identified to be associated with premenopausal BC. Among them, alcohol intake and obesity/overweight during adolescence/early adulthood can be modified. Interventions targeting alcohol consumption and obesity/overweight in adolescents and young adults may decrease the incidence of premenopausal breast cancer.

背景:乳腺癌(BC)是女性中最常见的癌症,也是世界范围内女性癌症相关死亡和发病的主要原因。在卢旺达,不列颠哥伦比亚省的发病率正在增加,绝经前妇女的死亡率高得令人无法接受。目的:目的是确定可改变的乳腺癌危险因素,并评估卢旺达绝经前妇女常见乳腺癌危险因素与分子亚型之间的关系。方法:采用病例-对照研究。招募组织学证实BC且频率与年龄对照相匹配的绝经前妇女。对病例和对照组进行预先设置的问卷调查,以了解社会人口统计学、BC可能的危险因素以及临床和病理特征。免疫组化(IHC)将BC分为管腔A型、管腔B型、her2型、基底样(三阴性)和未分类的分子亚型。比值比(OR)和95%置信区间(CI)采用多变量logistic回归分析估计。结果:340名参与者被纳入研究(170例对照170例)。平均年龄为39岁。大多数病例出现在疾病晚期(51.2%为III期和IV期),并伴有浸润性导管癌(98.2%)。60.6%预后不良(HER2富集14.7%,三阴12.9%,未分类32.9%)。饮酒(AOR = 3.73, 95% ci 2.19 - 6.32, p < 0.001),肥胖/超重在青春期或成年早期(优势比= 10.86,95% ci 4.82 - 24.4, p < 0.001),与原发不孕症的历史(优势比= 33.8,95% ci 3.5 - 321.5, p = 0.002),未产妇(优势比= 3.75,95% ci 1.61 - 8.75, p = 0.002),和良性乳房疾病的历史(优势比= 6.06,95% ci 1.19 - 30.73, p = 0.03)与绝经前乳腺癌的发生有关。不同分子亚型的危险因素分层无显著差异。结论:一些生殖、环境和生活方式的危险因素已被确定与绝经前BC相关。其中,酒精摄入和青春期/成年早期的肥胖/超重是可以改变的。针对青少年和年轻人饮酒和肥胖/超重的干预措施可能会降低绝经前乳腺癌的发病率。
{"title":"Premenopausal Breast Cancer Risk Factors and Associations with Molecular Subtypes: A Case-Control Study.","authors":"Faustin Ntirenganya,&nbsp;Jean Damascene Twagirumukiza,&nbsp;Georges Bucyibaruta,&nbsp;Belson Rugwizangoga,&nbsp;Stephen Rulisa","doi":"10.1155/2021/5560559","DOIUrl":"https://doi.org/10.1155/2021/5560559","url":null,"abstract":"<p><strong>Background: </strong>Breast cancer (BC) is the most prevalent cancer in women and the leading cause of women's cancer-related deaths and morbidity worldwide. In Rwanda, BC incidence is increasing with an unacceptably high mortality rate in premenopausal women.</p><p><strong>Objectives: </strong>The purpose was to identify modifiable BC risk factors and assess associations between common breast cancer risks factors and molecular subtypes in premenopausal women in Rwanda.</p><p><strong>Methods: </strong>This was a case-control study. Premenopausal women with histological confirmation of BC and frequency-matched for age controls were recruited. A preestablished questionnaire was administered to both cases and controls for sociodemographics, BC probable risk factors, and clinical and pathological characteristics. BC was classified into luminal A, luminal B, HER2-type, basal-like (triple negative), and unclassified molecular subtypes by immunohistochemistry (IHC). Odds ratio (OR) and 95% confidence interval (CI) were estimated using multivariate logistic regression analysis.</p><p><strong>Results: </strong>340 participants were recruited into the study (170 cases <i>vs.</i> 170 controls). The median age was 39 years. The majority of cases presented at advanced stages of the disease (51.2% in stages III and IV) and had invasive ductal carcinoma (98.2%). 60.6% had subtypes of poor prognosis (HER2 enriched 14.7%, triple negative 12.9%, and unclassified 32.9%). Alcohol intake (AOR = 3.73, 95%<i>CI</i> 2.19 - 6.32, <i>p</i> < 0.001), obesity/overweight in adolescence or early adulthood (AOR = 10.86, 95%<i>CI</i> 4.82 - 24.4, <i>p</i> < 0.001), history of primary infertility (AOR = 33.8, 95%<i>CI</i> 3.5 - 321.5, <i>p</i> = 0.002), nulliparity (AOR = 3.75, 95%<i>CI</i> 1.61 - 8.75, <i>p</i> = 0.002), and a history of benign breast disease (AOR = 6.06, 95%<i>CI</i> 1.19 - 30.73, <i>p</i> = 0.03) were associated with the occurrence of premenopausal breast cancer. There was no significant difference between risk factor stratification per molecular subtype.</p><p><strong>Conclusion: </strong>Several reproductive, environmental, and lifestyle risk factors have been identified to be associated with premenopausal BC. Among them, alcohol intake and obesity/overweight during adolescence/early adulthood can be modified. Interventions targeting alcohol consumption and obesity/overweight in adolescents and young adults may decrease the incidence of premenopausal breast cancer.</p>","PeriodicalId":46159,"journal":{"name":"International Journal of Breast Cancer","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2021-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8519716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39527863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 10
Knowledge and Practice of Breast Cancer Screening Methods among Female Community Pharmacists in Jordan: A Cross-Sectional Study. 约旦女性社区药剂师乳腺癌筛查方法的知识和实践:一项横断面研究。
IF 1.9 Q3 Medicine Pub Date : 2021-09-30 eCollection Date: 2021-01-01 DOI: 10.1155/2021/9292768
Nehad M Ayoub, Ghaith M Al-Taani, Basima A Almomani, Linda Tahaineh, Khawla Nuseir, Areej Othman, Kofi Boamah Mensah

Objectives: Our study is aimed at exploring the knowledge and personal practice of breast cancer screening among female community pharmacists in Jordan.

Methods: A cross-sectional survey was carried out using a nonrandom sample selection method for pharmacists in community pharmacies.

Results: A total of 551 female pharmacists completed the questionnaire. The mean age of pharmacists was 29.1 ± 7.3 years (range 21-67), and most have bachelor degrees in pharmacy (89.1%). The mean score of knowledge of breast cancer signs and symptoms was 4.2 ± 1.5 out of 6 points (range 0-6). The mean score of knowledge of risk factors was 7.6 ± 1.9 out of 12 points (ranging from 2-12). The mean score for knowledge of screening guidelines was 2.8 ± 0.9 out of 4 points (range 0-4). Overall, 452 pharmacists (85.8%) had acceptable knowledge while 75 pharmacists (14.2%) had poor knowledge of breast cancer. Pharmacists surveyed were aware of the different screening methods of breast cancer. The percentage of pharmacists who has performed breast self-examination (BSE), clinical breast examination (CBE), and mammography was 46.6%, 16.5%, and 5.4%, respectively. The most common reason for the lack of BSE and CBE performance was the absence of breast symptoms. Not being at the age recommended for mammography was the most common reason for not undergoing this screening method. Knowledge and practice of screening methods were influenced by age, years of experience, geographic region, personal history of breast cancer, and educational level among community pharmacists.

Conclusions: This study revealed some gaps in the knowledge of breast cancer among female community pharmacists. The practice of the different screening methods was suboptimal, and variable reasons were indicated for the low uptake of these screening methods. Community pharmacists need to practice preventive behaviors to a satisfactory level to encourage women in the community to adopt similar behavior.

目的:本研究旨在探讨约旦女性社区药剂师对乳腺癌筛查的知识和个人实践。方法:采用非随机抽样方法对社区药房药师进行横断面调查。结果:共有551名女药师完成问卷调查。药师平均年龄29.1±7.3岁(21 ~ 67岁),药学专业本科学历占89.1%;乳腺癌体征和症状知识的平均得分为4.2±1.5分(满分为6分)。危险因素知识的平均得分为7.6±1.9分(满分为12分)。筛查指南知识的平均得分为2.8±0.9分(满分4分)。总体而言,452名药师(85.8%)对乳腺癌知识了解尚可,75名药师(14.2%)对乳腺癌知识了解不佳。受访的药剂师了解不同的乳腺癌筛查方法。受访药师进行乳腺自检(BSE)、临床乳腺检查(CBE)和乳腺x光检查的比例分别为46.6%、16.5%和5.4%。缺乏BSE和CBE表现的最常见原因是没有乳房症状。未达到推荐的乳房x光检查年龄是不进行这种筛查方法的最常见原因。社区药师对筛查方法的认识和实践受年龄、工作年限、地理区域、个人乳腺癌病史和文化程度的影响。结论:本研究揭示了社区女性药师对乳腺癌的认知存在一定差距。不同筛查方法的实践是次优的,并指出了各种原因,这些筛查方法的低吸收率。社区药剂师需要将预防行为实践到令人满意的水平,以鼓励社区妇女采取类似的行为。
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引用次数: 5
Dose-Dense Docetaxel versus Weekly Paclitaxel following Dose-Dense Epirubicin and Cyclophosphamide as Adjuvant Chemotherapy in Node-Positive Breast Cancer Patients: A Retrospective Cohort Analysis. 密集剂量多西他赛与每周紫杉醇在密集剂量表柔比星和环磷酰胺辅助化疗后的对比:一项回顾性队列分析。
IF 1.9 Q3 Medicine Pub Date : 2021-09-20 eCollection Date: 2021-01-01 DOI: 10.1155/2021/6653265
Sara Khoshroo, Saleh Sandoughdaran, Parisa Sabetrasekh, Parastoo Hajian, Pegah Bikdeli, Parto Sabetrasekh, Fatemeh Nasrollahi, Ladan Mohammadi Yeganeh, Sepideh Jafari Naeini, Hamid Reza Mirzaei

Methods: This study included patients from two prospective studies conducted in our institute from April 2007 to March 2009. Ninety-one women with axillary lymph node-positive breast cancer who had received four cycles of dose-dense epirubicin and cyclophosphamide were treated with either weekly paclitaxel (80 mg/m2) for 12 doses or biweekly docetaxel (75 mg/m2) for four cycles.

Results: After a median follow-up of 88 and 109 months, 11 (23.4%) and 10 (22.7%) patients had experienced disease recurrence (p = 0.16), while 10 (21.3%) and 5 (11.4%) patients had died in the paclitaxel and docetaxel arm, respectively (p = 0.56). No significant difference could be seen in 5-year DFS or OS among groups (HR: 0.58; 95% CI: 0.19-1.81, p = 0.35; HR: 0.58; 95% CI: 0.19-1.81, p = 0.35, respectively).

Conclusion: In conclusion, both evaluated adjuvant chemotherapy regimens have comparable effectiveness regarding DFS and OS.

方法:本研究纳入2007年4月至2009年3月在我院进行的两项前瞻性研究的患者。91名腋窝淋巴结阳性乳腺癌妇女接受了4个周期的剂量密集的表柔比星和环磷酰胺治疗,并接受每周紫杉醇(80 mg/m2)治疗12次或双周多西紫杉醇(75 mg/m2)治疗4次。结果:中位随访88个月和109个月后,紫杉醇组和多西紫杉醇组分别有11例(23.4%)和10例(22.7%)患者复发(p = 0.16),分别有10例(21.3%)和5例(11.4%)患者死亡(p = 0.56)。5年DFS和OS组间差异无统计学意义(HR: 0.58;95% CI: 0.19-1.81, p = 0.35;人力资源:0.58;95% CI: 0.19-1.81, p = 0.35)。结论:两种评估的辅助化疗方案在DFS和OS方面具有相当的有效性。
{"title":"Dose-Dense Docetaxel versus Weekly Paclitaxel following Dose-Dense Epirubicin and Cyclophosphamide as Adjuvant Chemotherapy in Node-Positive Breast Cancer Patients: A Retrospective Cohort Analysis.","authors":"Sara Khoshroo,&nbsp;Saleh Sandoughdaran,&nbsp;Parisa Sabetrasekh,&nbsp;Parastoo Hajian,&nbsp;Pegah Bikdeli,&nbsp;Parto Sabetrasekh,&nbsp;Fatemeh Nasrollahi,&nbsp;Ladan Mohammadi Yeganeh,&nbsp;Sepideh Jafari Naeini,&nbsp;Hamid Reza Mirzaei","doi":"10.1155/2021/6653265","DOIUrl":"https://doi.org/10.1155/2021/6653265","url":null,"abstract":"<p><strong>Methods: </strong>This study included patients from two prospective studies conducted in our institute from April 2007 to March 2009. Ninety-one women with axillary lymph node-positive breast cancer who had received four cycles of dose-dense epirubicin and cyclophosphamide were treated with either weekly paclitaxel (80 mg/m<sup>2</sup>) for 12 doses or biweekly docetaxel (75 mg/m<sup>2</sup>) for four cycles.</p><p><strong>Results: </strong>After a median follow-up of 88 and 109 months, 11 (23.4%) and 10 (22.7%) patients had experienced disease recurrence (<i>p</i> = 0.16), while 10 (21.3%) and 5 (11.4%) patients had died in the paclitaxel and docetaxel arm, respectively (<i>p</i> = 0.56). No significant difference could be seen in 5-year DFS or OS among groups (HR: 0.58; 95% CI: 0.19-1.81, <i>p</i> = 0.35; HR: 0.58; 95% CI: 0.19-1.81, <i>p</i> = 0.35, respectively).</p><p><strong>Conclusion: </strong>In conclusion, both evaluated adjuvant chemotherapy regimens have comparable effectiveness regarding DFS and OS.</p>","PeriodicalId":46159,"journal":{"name":"International Journal of Breast Cancer","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2021-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8478594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39474969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Importance of Clinical Data for the Diagnosis of Breast Tumours in North Afghanistan. 临床资料对阿富汗北部乳腺肿瘤诊断的重要性。
IF 1.9 Q3 Medicine Pub Date : 2021-07-30 eCollection Date: 2021-01-01 DOI: 10.1155/2021/6625239
Gerhard Stauch, Peter Fritz, Rauofi Rokai, Atiq Sediqi, Haroon Firooz, Hans Ullrich Voelker, Michael Weinhara, Joachim Mollin, Bishara Soudah, Peter Dalquen, Friedhelm Brinckmann, Jürgen Dippon

Background: This study was performed in knowledge of the increasing gap between breast disease treatment in countries with restricted resources and developed countries with increasingly sophisticated examination methods.

Methods: The authors present the analysis of a breast disease register consisting of diagnostic cases from Mazar e Sharif and Herat in 2018 and 2019. The study comprises a total of 567 cases, which were presented to experts via telemedicine for final diagnosis. 62 cases (10.9%) were excluded due to inacceptable data or insufficient image quality. These data provided by daily diagnostic classification were used for the built-up of a profile for each frequent breast disease and a breast cancer register. All images and cases were seen by at least 3 independent experts. The diagnoses were made in 60% of cases by cytology of fine needle aspiration and in 40% by histological images.

Results: For each entity of breast diseases (e.g., fibroadenoma), a profile of context variables was constructed allowing to assist medical decisions, as "wait and see," elective surgery or immediate surgical intervention with R0 (complete) resection. These "profiles" could be described for fibroadenoma, mastitis, galactocele, fibrous-cystic disease, and invasive breast cancer.

Conclusions: The presented preliminary data set could serve as a cost-effective basis for a North Afghan breast cancer registry, with option to extent to a national model. These preliminary data are transformed in profiles of breast diseases, which are used by the local physicians in charge of breast disease patients. Each new case can be compared by the local treating physician with the profile of all preceded cases with the same diagnosis.

背景:本研究是在了解到资源有限的国家与检查方法日益成熟的发达国家在乳腺疾病治疗方面的差距越来越大的情况下进行的。方法:作者对2018年和2019年马扎里沙里夫和赫拉特的乳腺疾病诊断病例进行了分析。该研究共包括567例病例,这些病例通过远程医疗提交给专家进行最终诊断。62例(10.9%)因数据不可接受或图像质量不足而被排除。每日诊断分类提供的这些数据用于建立每一种常见乳房疾病的概况和乳腺癌登记册。所有图像和病例均由至少3名独立专家审阅。60%的病例通过细针穿刺细胞学检查确诊,40%的病例通过组织学检查确诊。结果:对于每一种乳腺疾病(如纤维腺瘤),构建了一个背景变量概况,以协助医疗决策,如“等待并观察”,选择性手术或立即手术干预R0(完全)切除。这些“特征”可用于纤维腺瘤、乳腺炎、半乳膨出、纤维囊性疾病和浸润性乳腺癌。结论:提出的初步数据集可以作为北阿富汗乳腺癌登记的成本效益基础,并可选择扩展到国家模型。这些初步数据被转化为乳腺疾病概况,供负责乳腺疾病患者的当地医生使用。每个新病例可以由当地治疗医生与所有相同诊断的既往病例的概况进行比较。
{"title":"The Importance of Clinical Data for the Diagnosis of Breast Tumours in North Afghanistan.","authors":"Gerhard Stauch,&nbsp;Peter Fritz,&nbsp;Rauofi Rokai,&nbsp;Atiq Sediqi,&nbsp;Haroon Firooz,&nbsp;Hans Ullrich Voelker,&nbsp;Michael Weinhara,&nbsp;Joachim Mollin,&nbsp;Bishara Soudah,&nbsp;Peter Dalquen,&nbsp;Friedhelm Brinckmann,&nbsp;Jürgen Dippon","doi":"10.1155/2021/6625239","DOIUrl":"https://doi.org/10.1155/2021/6625239","url":null,"abstract":"<p><strong>Background: </strong>This study was performed in knowledge of the increasing gap between breast disease treatment in countries with restricted resources and developed countries with increasingly sophisticated examination methods.</p><p><strong>Methods: </strong>The authors present the analysis of a breast disease register consisting of diagnostic cases from Mazar e Sharif and Herat in 2018 and 2019. The study comprises a total of 567 cases, which were presented to experts via telemedicine for final diagnosis. 62 cases (10.9%) were excluded due to inacceptable data or insufficient image quality. These data provided by daily diagnostic classification were used for the built-up of a profile for each frequent breast disease and a breast cancer register. All images and cases were seen by at least 3 independent experts. The diagnoses were made in 60% of cases by cytology of fine needle aspiration and in 40% by histological images.</p><p><strong>Results: </strong>For each entity of breast diseases (e.g., fibroadenoma), a profile of context variables was constructed allowing to assist medical decisions, as \"wait and see,\" elective surgery or immediate surgical intervention with R0 (complete) resection. These \"profiles\" could be described for fibroadenoma, mastitis, galactocele, fibrous-cystic disease, and invasive breast cancer.</p><p><strong>Conclusions: </strong>The presented preliminary data set could serve as a cost-effective basis for a North Afghan breast cancer registry, with option to extent to a national model. These preliminary data are transformed in profiles of breast diseases, which are used by the local physicians in charge of breast disease patients. Each new case can be compared by the local treating physician with the profile of all preceded cases with the same diagnosis.</p>","PeriodicalId":46159,"journal":{"name":"International Journal of Breast Cancer","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2021-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8349267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39296406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
Awareness of Breast Cancer Screening among the Medical and General Population of the North Region of Cameroon. 喀麦隆北部地区医务人员和普通民众对乳腺癌筛查的认识。
IF 1.9 Q3 Medicine Pub Date : 2021-07-27 eCollection Date: 2021-01-01 DOI: 10.1155/2021/6663195
Richard Tagne Simo, Erika Myriam Baiguerel, Armel Hervé Nwabo Kamdje, Paul Faustin Seke Etet, Mohamadou Ahmadou, Charlette Nangue, Phelix Bruno Telefo

Breast cancer has become a real public health problem in Cameroon, particularly in rural areas due to late diagnosis, resulting partly from the absence of national screening programs. This work is aimed at assessing breast cancer awareness in the North Region of Cameroon. Participants were selected in six health centers surrounding the rural area of Garoua, North Region, Cameroon, and administered a questionnaire aimed at assessing their awareness about breast cancer risk factors and screening. Out of the 475 women (including 37 medical personnel) interviewed, 45.5% attended at least secondary school; 91.3% were aware of the disease with the main sources of information from those around them (64.8%), media (46.5%), and health professionals in health facilities (42.7%). 23.3% had misconceptions and myth-based ideas on the origin of the disease. Ignorance was the main reason preventing the performance of breast self-examination, and the high cost prevents individuals from going for mammography. The highest awareness rate was observed in employed women with higher level of education. Our study highlights the need to raise awareness among the populations in North Region, Cameroon, about the risk factors and clinical signs of breast cancer and the importance of screening practice for early diagnosis of breast cancer.

乳腺癌在喀麦隆已成为一个真正的公共卫生问题,特别是在农村地区,原因是诊断较晚,部分原因是缺乏国家筛查方案。这项工作旨在评估喀麦隆北部地区对乳腺癌的认识。在喀麦隆北部地区Garoua农村地区周围的六个保健中心选择了参与者,并向他们发放了一份问卷,旨在评估他们对乳腺癌风险因素和筛查的认识。在接受采访的475名妇女(包括37名医务人员)中,45.5%至少上过中学;91.3%的人对该病有所了解,其主要信息来源是周围的人(64.8%)、媒体(46.5%)和卫生机构的卫生专业人员(42.7%)。23.3%的人对疾病的起源有误解和误解。无知是阻止人们进行乳房自我检查的主要原因,而高昂的费用也阻碍了人们去做乳房x光检查。觉悟率最高的是受教育程度较高的就业妇女。我们的研究强调了提高喀麦隆北部地区人群对乳腺癌危险因素和临床症状的认识的必要性,以及筛查实践对乳腺癌早期诊断的重要性。
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引用次数: 3
Evaluation of the Clinical and Imaging Findings of Breast Examinations in a Tertiary Facility in Ghana. 评价临床和影像学结果的乳房检查在加纳的三级设施。
IF 1.9 Q3 Medicine Pub Date : 2021-07-19 eCollection Date: 2021-01-01 DOI: 10.1155/2021/5541230
Emmanuel Kobina Mesi Edzie, Klenam Dzefi-Tettey, Philip Narteh Gorleku, Adu Tutu Amankwa, Eric Aidoo, Kwasi Agyen-Mensah, Ewurama Andam Idun, Frank Quarshie, Joshua Mensah Kpobi, Henry Kusodzi, Richard Ato Edzie, Abdul Raman Asemah

Breast diseases have been one of the major battles the world has been fighting. In winning this fight, the role of medical imaging cannot be overlooked. Breast imaging reveals hidden lesions which aid physicians to give the appropriate diagnosis and definitive treatment, hence this study, to determine the clinical and imaging findings of breast examinations to document the radiologic features in our setting. This cross-sectional retrospective study reviewed the sociodemographics, imaging reports (mammography and ultrasonography with BI-RADS scores and their features), and the clinical data of 425 patients from September 2017 to September 2020 in the Cape Coast Teaching Hospital. 72 solid lesions with their histology reports were also reviewed. Data obtained were organized, coded, and analyzed using Statistical Package for Social Sciences (SPSS Inc., Chicago, IL, USA) version 20.0. The results obtained were presented in appropriate tables and charts. A chi-squared test was employed for associations and statistical significance was specified at p ≤ 0.05. 63.29% of the patients were married, but only 18.59% had a positive family history of breast cancer. BI-RADS scores 1(57.46%) and 2(27.99%) were the most recurrent findings. The most common BI-RADS 2, 3, 4, and 5 imaging features were benign-looking axillary lymph nodes (66.33%), well-defined solid masses (61.54%), ill-defined solid masses (42.86%), and ill-defined solid masses with suspicious-looking axillary lymph nodes (100.00%), respectively. The most frequent indications were routine screening (49.18%), mastalgia (26.59%), and painless breast masses (19.77%). There was significant association between duration of symptoms and breast cancer (p value = 0.007). In conclusion, routine breast screening and mastalgia were the topmost indications for breast imaging. BI-RADS 1 and 2 were the commonest BI-RADS scores, and benign-looking axillary lymph nodes and simple cysts were the most frequent imaging features for BI-RADS 2 and ill-defined solid masses and suspicious-looking axillary lymph nodes for BI-RADS 4 and 5.

乳房疾病一直是全世界一直在进行的主要战斗之一。在赢得这场斗争中,医学成像的作用不容忽视。乳腺成像显示隐藏的病变,帮助医生给出适当的诊断和明确的治疗,因此本研究旨在确定乳腺检查的临床和影像学结果,以记录我们的放射学特征。本横断面回顾性研究回顾了2017年9月至2020年9月Cape Coast教学医院425例患者的社会人口统计学、影像学报告(乳房x光检查和超声检查BI-RADS评分及其特征)和临床数据,并对72例实性病变及其组织学报告进行了回顾。使用Statistical Package for Social Sciences (SPSS Inc., Chicago, IL, USA) 20.0版本对获得的数据进行组织、编码和分析。所得结果以适当的表格形式呈现。相关性采用卡方检验,p≤0.05为统计学显著性。63.29%的患者已婚,但仅有18.59%的患者有乳腺癌家族史。BI-RADS评分1分(57.46%)和2分(27.99%)是最常见的复发率。最常见的BI-RADS 2、3、4、5影像特征分别为:腋窝淋巴结良性(66.33%)、定义明确的实性肿块(61.54%)、不明确的实性肿块(42.86%)、不明确的实性肿块伴可疑腋窝淋巴结(100.00%)。最常见的指征是常规筛查(49.18%)、乳房疼痛(26.59%)和无痛性乳房肿块(19.77%)。症状持续时间与乳腺癌之间存在显著相关性(p值= 0.007)。总之,常规乳腺筛查和乳房疼痛是乳房影像学的首要指征。BI-RADS 1和2是最常见的BI-RADS评分,BI-RADS 2最常见的影像学特征是良性腋窝淋巴结和单发囊肿,BI-RADS 4和5最常见的影像学特征是模糊的实性肿块和可疑的腋窝淋巴结。
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引用次数: 3
HER2 Testing Characteristics Can Predict Residual Cancer Burden following Neoadjuvant Chemotherapy in HER2-Positive Breast Cancer. HER2检测特征可以预测HER2阳性乳腺癌新辅助化疗后残留的癌症负担。
IF 1.9 Q3 Medicine Pub Date : 2021-05-24 eCollection Date: 2021-01-01 DOI: 10.1155/2021/6684629
Tamera J Lillemoe, Mara Rendi, Michaela L Tsai, Monica Knaack, Rina Yarosh, Erin Grimm, Barbara Susnik, Janet Krueger, Susan Olet, Karen K Swenson

Objectives: The response to HER2-targeted neoadjuvant chemotherapy (NAC) in HER2-positive (+) breast cancer can be quantified using residual cancer burden (RCB) pathologic evaluation to predict relapse free/overall survival. However, more information is needed to characterize the relationship between patterns of HER2 testing results and response to NAC. We evaluated clinicopathologic characteristics associated with RCB categories in HER2+ patients who underwent HER2-directed NAC.

Methods: A retrospective chart review was conducted with Stage I-III HER2+ breast cancer cases following NAC and surgical resection. HER2 immunohistochemistry (IHC) staining and fluorescence in situ hybridization (FISH), histologic/clinical characteristics, hormone receptor status, and RCB scores (RCB-0, RCB-I, RCB-II, and RCB-III) were evaluated.

Results: 64/151 (42.4%) patients with HER2+ disease had pathologic complete response (pCR). Tumors with suboptimal response (RCB-II and RCB-III) were more likely to demonstrate less than 100% HER2 IHC 3+ staining (p < 0.0001), lower HER2 FISH copies (p < 0.0001), and lower HER2/CEP17 ratios (p = 0.0015) compared to RCB-I and RCB-II responses. Estrogen receptor classification using ≥10% versus ≥1% staining showed greater association with higher RCB categories.

Conclusions: HER2+ characteristics show differing response to therapy despite all being categorized as positive; tumors with less than 100% IHC 3+ staining, lower HER2 FISH copies, and lower HER2/CEP17 ratios resulted in higher RCB scores.

目的:her2阳性(+)乳腺癌患者对her2靶向新辅助化疗(NAC)的反应可以通过残余癌症负担(RCB)病理评估来量化,以预测无复发生存期/总生存期。然而,需要更多的信息来描述HER2检测结果模式与NAC反应之间的关系。我们评估了接受HER2定向NAC的HER2+患者与RCB类型相关的临床病理特征。方法:回顾性分析I-III期HER2+乳腺癌NAC和手术切除后的病例。评估HER2免疫组织化学(IHC)染色和荧光原位杂交(FISH)、组织学/临床特征、激素受体状态和RCB评分(RCB-0、RCB- i、RCB- ii和RCB- iii)。结果:151例HER2+患者中有64例(42.4%)有病理完全缓解(pCR)。与RCB-I和RCB-II反应相比,次优反应(RCB-II和RCB-III)的肿瘤更可能表现出低于100%的HER2 IHC 3+染色(p < 0.0001), HER2 FISH拷贝数较低(p < 0.0001), HER2/CEP17比率较低(p = 0.0015)。雌激素受体分类≥10%和≥1%染色显示与较高RCB分类有更大的相关性。结论:HER2+特征对治疗的反应不同,尽管它们都被归类为阳性;IHC 3+染色低于100%、HER2 FISH拷贝数较低、HER2/CEP17比值较低的肿瘤可导致较高的RCB评分。
{"title":"HER2 Testing Characteristics Can Predict Residual Cancer Burden following Neoadjuvant Chemotherapy in HER2-Positive Breast Cancer.","authors":"Tamera J Lillemoe,&nbsp;Mara Rendi,&nbsp;Michaela L Tsai,&nbsp;Monica Knaack,&nbsp;Rina Yarosh,&nbsp;Erin Grimm,&nbsp;Barbara Susnik,&nbsp;Janet Krueger,&nbsp;Susan Olet,&nbsp;Karen K Swenson","doi":"10.1155/2021/6684629","DOIUrl":"https://doi.org/10.1155/2021/6684629","url":null,"abstract":"<p><strong>Objectives: </strong>The response to HER2-targeted neoadjuvant chemotherapy (NAC) in HER2-positive (+) breast cancer can be quantified using residual cancer burden (RCB) pathologic evaluation to predict relapse free/overall survival. However, more information is needed to characterize the relationship between patterns of HER2 testing results and response to NAC. We evaluated clinicopathologic characteristics associated with RCB categories in HER2+ patients who underwent HER2-directed NAC.</p><p><strong>Methods: </strong>A retrospective chart review was conducted with Stage I-III HER2+ breast cancer cases following NAC and surgical resection. HER2 immunohistochemistry (IHC) staining and fluorescence in situ hybridization (FISH), histologic/clinical characteristics, hormone receptor status, and RCB scores (RCB-0, RCB-I, RCB-II, and RCB-III) were evaluated.</p><p><strong>Results: </strong>64/151 (42.4%) patients with HER2+ disease had pathologic complete response (pCR). Tumors with suboptimal response (RCB-II and RCB-III) were more likely to demonstrate less than 100% HER2 IHC 3+ staining (<i>p</i> < 0.0001), lower HER2 FISH copies (<i>p</i> < 0.0001), and lower HER2/CEP17 ratios (<i>p</i> = 0.0015) compared to RCB-I and RCB-II responses. Estrogen receptor classification using ≥10% versus ≥1% staining showed greater association with higher RCB categories.</p><p><strong>Conclusions: </strong>HER2+ characteristics show differing response to therapy despite all being categorized as positive; tumors with less than 100% IHC 3+ staining, lower HER2 FISH copies, and lower HER2/CEP17 ratios resulted in higher RCB scores.</p>","PeriodicalId":46159,"journal":{"name":"International Journal of Breast Cancer","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2021-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8166502/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39023020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
期刊
International Journal of Breast Cancer
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