Background: Accurate axillary lymph node staging is crucial for breast cancer prognosis and treatment planning. This study compares the diagnostic efficacy of abbreviated MRI (AB-MRI) protocols with limited sequences and reduced time, against full-diagnostic MRI (FD-MRI) in staging axillary lymph node metastasis of breast cancer patients. Methods: This was a retrospective cross-sectional diagnostic-accuracy study of 88 women with breast cancer who underwent MRI for axillary lymph node staging. MRI protocols included FD-MRI, non-contrast T1 sequence, and contrast-enhanced T1 sequence. Imaging findings, interpreted by two radiologists blinded to histopathological results, were correlated with findings from sentinel lymph node biopsy or axillary lymph node dissection as the gold standard. Data analysis comprised diagnostic performance parameters (sensitivity and specificity) and inter-protocol agreement using the kappa statistic. Results: No statistically significant differences were detected among the three protocols (all McNemar's p-values > 0.05). The non-contrast abbreviated MRI protocol demonstrated a sensitivity of 84.9% (95% CI: 72.4%-93.3%) and a specificity of 85.7% (95% CI: 69.7%-95.2%). Unweighted Cohen’s Kappa demonstrated strong concordance between the non-contrast and contrast-enhanced AB-MRI protocols (κ = 0.931; 95% CI: 0.855–1.00), between the non-contrast AB-MRI protocol and the FD-MRI (κ = 0.930; 95% CI: 0.852–1.00), and between the contrast-enhanced AB-MRI protocol and the FD-MRI (κ = 0.907; 95% CI: 0.819–0.995), respectively. Conclusion: Non-contrast AB-MRI provides a less invasive, cost-effective alternative to FD-MRI for staging axillary lymph nodes in breast cancer, with shorter scan times and fewer procedural risks. Further studies are needed for validation in larger cohorts.

Background: Breast cancer is a leading cause of cancer-related mortality worldwide. Genetic factors, including polymorphisms in DNA repair genes such as BARD1, may influence susceptibility. Inflammatory and tumor markers also play a role in cancer progression. This study aimed to investigate the association between BARD1 exon mutations, immunological and hormonal markers, and breast cancer risk in Iraqi women. Methods: This case-control study comprised 100 patients with early-onset breast cancer and 100 healthy controls, frequency-matched for age and Body Mass Index (BMI). Serum levels of BARD1, MUC-1, CEA, CA15-3, estrogen, progesterone, prolactin, IL-1β, and TNF-α were measured using ELISA. Five BARD1 SNPs were genotyped using direct sequencing, and their association with breast cancer risk was assessed using logistic regression. The discriminative potential of the biomarkers was evaluated using Receiver Operating Characteristic (ROC) curve analysis. Results: Significantly elevated levels of IL-1β, TNF-α, CEA, BARD1, and MUC-1 were observed in the patients (p < 0.0001). ROC analysis showed discriminative potential for IL-1β (AUC = 0.88, 95% CI: 0.83–0.94), CEA (AUC = 0.78, 95% CI: 0.70–0.86), BARD1 (AUC = 0.77, 95% CI: 0.69–0.85), and MUC-1 (AUC = 0.73, 95% CI: 0.65–0.81). Three SNPs (rs2106145710, rs1695783243, and rs1574847014) were associated with increased breast cancer risk (rs1574847014 OR = 11.67, 95% CI: 3.5–38.8), whereas rs10498023 showed a protective effect (OR = 0.33, 95% CI: 0.22–0.51). Conclusion: Elevated levels of inflammatory and tumor markers, along with specific BARD1 polymorphisms, are associated with breast cancer risk in Iraqi women. These biomarkers may serve as noninvasive diagnostic tools, and genetic screening could aid in early risk stratification.

Background: Axillary lymph node dissection (ALND) has been the standard of care for node-positive breast cancer. However, recent advances have shown targeted axillary lymph node dissection (TALND) to be an oncologically safe and effective alternative in patients with adequate response to neoadjuvant therapy (NAT). The conventional dual-mapping technique employs a combination of a radioactive tracer and blue dye. Our study aimed to evaluate indocyanine green (ICG) as an adjunct to increase node detection in TALND. Methods: A descriptive cross-sectional study of 21 patients with biopsy-confirmed axillary lymph node metastases who underwent TALND was conducted. Prior to NAT, metastatic nodes were marked; preoperatively, localization was achieved via radiologic guidewire placement. During surgery, the marked node was excised, and sentinel node mapping was performed using a combination of ICG fluorescence, technetium-99 radiotracer, and palpation. The number and method of node detection were analyzed. Results: A total of 70 sentinel lymph nodes were identified across 21 patients, with a median of 3 nodes per patient (range, 1–7). Of these, 28 nodes (40.0%) were detected exclusively with ICG, 31 (44.3%) with both ICG and radiotracer, 4 (5.7%) solely with radiotracer, and 7 (10.0%) with palpation. Metastatic involvement was present in 7 of 21 patients (33.3%), including 2 cases in which metastatic nodes were detected only by ICG. Conclusion: ICG is a valuable adjunct for sentinel lymph node detection during TALND. Combined use of ICG and radiotracer enhances nodal identification and may reduce the need for extensive ALND in patients with clinically node-positive breast cancer.

Background: Male breast cancer, though rare, requires reliable diagnostic and prognostic markers. This study evaluated tumor markers, hormonal receptors, and inflammatory biomarkers in male breast cancer. Methods: A case–control study included 150 men with breast cancer and 50 matched controls (38–52 years). Diagnosis was confirmed by clinical evaluation, mammography, and histopathology. Serum was collected and stored at −80°C. Tumor markers—cancer antigen 15-3 (CA15-3), carcinoembryonic antigen (CEA), and alpha-fetoprotein (AFP) and inflammatory biomarkers, interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and C-reactive protein (CRP) were measured using enzyme-linked immunosorbent assay (ELISA). Hormonal receptors, estrogen receptor (ER), progesterone receptor (PR), and androgen receptor (AR) were measured by Cobas e411 immunoassay. Results: Age and education were similar between groups. Patients had higher smoking rates (45% vs. 20%, p = 0.01) and body mass index (28.6 ± 3.2 vs. 26.1 ± 2.8 kg/m², p = 0.02). Tumor markers, hormonal receptors, and inflammatory biomarkers were significantly elevated in patients (p < 0.001). Strong correlations were found between CA15-3 and IL-6 (r = 0.68), ER and CRP (r = 0.55), and PR and TNF-α (r = 0.61). Conclusions: Elevated tumor markers, hormonal receptors, and inflammatory biomarkers indicate a link between inflammation, hormonal regulation, and tumor progression, highlighting their diagnostic and prognostic value in male breast cancer.

Background: Breast cancer accounts for 25% of all cancer cases and 15% of all cancer related deaths among women. Hypoxia-inducible factor-1alpha (HIF1A) is a crucial regulator of cellular responses to hypoxia. The aim of the study is to analyze the gene expression of different types of miRNAs (miR-143-5p and miR-744-5p) as a molecular tumor marker in relation with HIF1A gene. Methods: The study included 100 newly diagnosed cases of BC who attended Oncology Center in Al-Anbar, Iraq from July 2024 to January 2025. After RNA extraction and cDNA creation, real-time PCR was used to quantitatively measure miRNAs expression levels for women with breast cancer (BC) and healthy control. . Results: The results showed that miR-143-5p exhibited significantly higher expression levels in high grade after treatment (HAT) and low grade before treatment (LBT) samples compared to Control, high grade before treatment (HBT), and low grade after treatment (LAT) samples. In contrast, miR-744-5p did not show significant differences in expression across the different sample types. HIF1A shows no statistically significant correlations with any of the other measured molecules in either the control group (miR-143-5p: r = -0.25, p = 0.32; miR-744-5p: r = -0.32, p = 0.23, for any of the experimental groups (all p-values > 0.05). MiR-744-5p showing moderate potential (AUC 0.629). HIF-1α exhibited high diagnostic potential in the HBT with AUC value 0.774 and moderate diagnostic in the HAT with AUC value 0.647 indicate that HIF1A gene good diagnostic marker of Bc. Conclusion: The findings suggest that miR-143-5p may serve as a potential biomarker for breast cancer.

Background: Breast cancer remains the most common cancer in women worldwide. Treatment has evolved into multimodal approaches, with pathologic complete response (pCR) after neoadjuvant chemotherapy (NAC) serving as a key prognostic marker. The aim of this study was to evaluate the value of inflammatory markers in predicting pCR to NAC in breast cancer. Methods: This cross-sectional study of 74 patients with breast cancer who underwent NAC followed by surgery included demographic, tumor, and immune-inflammatory marker data. Receiver operating characteristic curve analysis and the Youden index were used to determine optimal cutoff values. Univariate and multivariate logistic regression assessed associations between markers and pCR, adjusting for tumor stage, human epidermal growth factor receptor 2 (HER2), and estrogen receptor (ER) status. Results: Our multivariate analysis identified the pan-immune-inflammation value (PIV), HER2 status, and ER status as significant independent predictors of pCR. PIV (OR, 4.28; 95% CI, 1.59–16.88) remained significant among inflammatory markers, while the neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR) did not. HER2-positive (OR, 7.45; 95% CI, 2.30–24.15) and hormone receptor (HR)–negative (OR, 7.02; 95% CI, 2.63–18.70) statuses were also strongly associated with pCR. Conclusion: PIV is a robust predictor of pCR in patients with breast cancer receiving NAC, offering a comprehensive reflection of the immune-inflammatory state. Incorporating PIV with tumor-specific markers (e.g., receptor status, Ki-67, grade) may enhance treatment stratification. Further validation in diverse cohorts is warranted.

Background: Dual anti-HER2 blockade with trastuzumab plus pertuzumab combined with a taxane is the first-line treatment for metastatic HER2-positive breast cancer. However, little evidence is available on its efficacy and safety in sub-Saharan African populations. We aimed to report the effect of dual anti-HER2 blockade in Côte d’Ivoire on a cohort of patients followed up for HER2-positive metastatic breast cancer. Methods: We conducted a retrospective analytical cohort study of female patients with HER2-positive metastatic breast cancer who were followed up in the public cancer management hospitals in Côte d’Ivoire (Treichville University Hospital Center and the National Center for Radiation Oncology) over a 2-year period from January 1, 2021, to December 31, 2022. The outcome of interest was progression-free survival, estimated by the Kaplan-Meier method. A univariable Cox regression model was used to test factors associated with progression-free survival. Variables with P < 0.10 were included in the multivariable model. Results: We collected data on 30 patients. The median age was 47.2 years (interquartile range, 25 years). Common metastatic sites were the lung (63.3%), pleura (20.0%), liver (20.0%), bone (16.7%), and brain (6.7%). The most frequent adverse events were anemia (93.3%) and neutropenia (73.3%). The objective response rate was 60.0%. The median progression-free survival was 15.3 months. Median overall survival was not reached. Factors associated with better progression-free survival were the absence of brain metastasis (P = 0.003) and the administration of dual anti-HER2 blockade as first-line therapy (P = 0.005). Conclusion: Dual anti-HER2 blockade showed therapeutic activity in terms of objective response, progression-free survival, and tolerability.

Background: Mucinous breast cancer is a rare entity that accounts for 1%-4% of all breast cancers and is classified as pure mucinous breast carcinoma (PMBC) when extracellular mucin is >90%. This study aims to investigate the clinicopathological parameters in PMBC that may help understand tumor biology and clinical outcomes. Methods: 117 female patients diagnosed with PMBC are identified in this descriptive study. Corresponding clinicopathological parameters are investigated and compared with prognostic factors. Results: The mean age is 53.1 years, 54.7% are postmenopausal. 37.5% underwent SLND and 52.7% axillary dissection. 53.4% have pT2 disease, and 27.7% have metastatic lymph nodes. Lung (n=10) and bone (n=9) are the most common distant metastatic sites. MRM (44.3%) and BCS (41.5%) are common surgical procedures. Adjuvant therapy (88%), endocrine therapy (89.7%), chemotherapy (39.3%), and radiotherapy (60%) are common after surgery. KI-67 is higher in patients who received chemotherapy (p=0.005). Tumors are positive for ER (90.5%) and PR (79.3%) and less likely to stain with HER2 (11%). Of 38, 44.7% are luminal A, 55.3% are luminal B (unknown HER2 (n=7) and KI67 (n=72)). Conclusion: PMBC is a rare entity seen in older women. Tumors can be seen in various sizes and are usually ER/PR-positive and HER2-negative, with low nodal and distant metastasis rates. Even though it is infrequent, PMBC tends to metastasize to the lung and bone. Radiotherapy and endocrine therapy following BCS or MRM are preferred. Multigene assays guide systemic therapy in ER+/HER2- early-stage breast cancer; however, data on their application in PMBC and MBC remain limited.

Background: Self-compassion is an important concept for women facing breast cancer, yet there is limited research on changes in self-compassion during the postoperative phase. This concept analysis aims to explore the nuances of self-compassion in women recovering from breast cancer surgery, enhancing our understanding of their emotional journeys and informing future clinical practices to support their well-being. Methods: This concept analysis utilizes a concept analysis method to investigate the attributes, antecedents, and consequences of self-compassion in women following breast cancer surgery. The Google Scholar and Summon search engines were used to access relevant articles supporting this analysis, which were gathered from PubMed and MEDLINE databases, encompassing journals from both nursing and non-nursing fields. The analysis is based on Walker and Avant’s method, which entails identifying a concept, reviewing its prior applications, defining its attributes, cases, antecedents, and consequences, and establishing empirical referents. Results: This concept analysis highlights the importance of self-compassion among women who have undergone breast cancer surgery. It suggests that self-compassion positively impacts their physical and mental well-being post-surgery, reducing stress and promoting overall quality of life. This emphasizes the need to include self-compassion practices in the psychological support provided during post-operative care. Conclusion: This concept analysis identified its attributes, antecedents, consequences, and cases of the analyzed concept. This paper may guide healthcare providers and institutions to develop standards and strategies to assess and enhance self-compassion and promote well-being in the study population.

Background: Breast cancer (BC) is a leading cause of cancer-related mortality and morbidity among women worldwide. Recent evidence highlights the role of inflammatory cytokines in cancer biology. This study aimed to evaluate the biomarker potential of interleukin-40 (IL-40) in BC by assessing its serum levels and gene expression in female Iraqi patients. Methods: A case-control study included 100 patients with BC and 100 frequency-matched healthy controls (HCs) stratified by 5-year age intervals. Serum IL-40 levels were quantified using an enzyme-linked immunosorbent assay (ELISA), and C17orf99 (the gene encoding IL-40) expression was analyzed using quantitative polymerase chain reaction (qPCR). Statistical analyses were performed to compare age, body mass index (BMI), and clinical and molecular parameters. Results: Patients with BC exhibited a significantly higher BMI (31.60 vs 26.63 kg/m²) and elevated serum IL-40 levels (20.26 ± 6.90 vs 14.08 ± 6.12 ng/mL) compared with HCs. Gene expression analysis revealed a 3.7-fold upregulation of IL40 in patients with BC. Receiver operating characteristic (ROC) curve analysis demonstrated moderate diagnostic accuracy (area under the curve [AUC], 0.756). Conclusion: Elevated IL-40 levels and gene expression in patients with BC highlight their potential role in disease pathogenesis and utility as diagnostic biomarkers. The findings contribute to our understanding of BC pathogenesis. IL-40 can serve as a promising biomarker for risk assessment and early detection in women in Iraq.