Family History Of Breast Cancer Research Articles

Latent profile analysis of family adaptation in breast cancer patients-cross-sectional study

When individuals face life pressure or significant family changes, individuals with better family adaptation can better survive the crisis. Although the influencing factors of family adaptation have been investigated, the application of potential profile analysis has yet to be found. This analytical approach can reveal different potential categories of family adaptation, providing new perspectives for theoretical development and interventions. This study used latent profile analysis to explore family adaptation levels in breast cancer patients and identify different latent categories, examining their characteristic differences. A cross-sectional study was conducted in Jinzhou, China, from July 2023 to March 2024. The questionnaire included Sociodemographic and clinical characteristics, Benefit Finding Scale (BFS), Dyadic Coping Scale (DCI), Chinese Perceived Stress Scales (PSS), and Family adaptability and cohesion evaluation scales (FACES). Mplus8.3 and SPSS26.0 software were used for data analysis. The latent profile analysis (LPA) method was used to fit the family adaptations of breast cancer patients. Three latent categories of family adaptation were identified: low-level family adaptation (21.5%), medium level family adaptation (47.8%), and high-level family adaptation (30.6%). All 14 items with high levels of family adaptation scored higher than the other two groups. In particular, out of all the categories, item 9, "The idea of educating children is sound," scored highest. Compared with the low-level group, the influential factors of family adaptation in the high-level group were BFS, DCI, PSS, relapse and personal monthly income; The factors influencing family adaptation at the middle level are DCI, BFS, breast cancer type, family history of breast cancer, and personal monthly income. Compared with the medium level group, PSS and DCI were the influential factors of family adaptation in the high-level group. Family adaptation in breast cancer patients can be divided into three categories: low-level, medium-level, and high-level. There were significant differences among different categories of family adaptation levels in “personal monthly income”, “family history of breast cancer”, “type of breast cancer”, “recurrence”, “dyadic coping”, “benefit finding”, and “perception stress”.

Development of a Breast Cancer Risk Prediction Model Integrating Monogenic, Polygenic, and Epidemiologic Risk.

Breast cancer has been associated with monogenic, polygenic, and epidemiologic (clinical, reproductive, and lifestyle) risk factors, but studies evaluating the combined effects of these factors have been limited. We extended previous work in breast cancer risk modeling, incorporating pathogenic variants (PV) in six breast cancer predisposition genes and a 105-SNP polygenic risk score (PRS), to include an epidemiologic risk score (ERS) in a sample of non-Hispanic White women drawn from prospective cohorts and population-based case-control studies, with 23,518 cases and 22,832 controls, from the Cancer Risk Estimates Related to Susceptibility (CARRIERS) Consortium. The model predicts 4.4-fold higher risk of breast cancer for postmenopausal women with no predisposition PV and median PRS, but with the highest versus lowest ERS. Overall, women with CHEK2 PVs had >20% lifetime risk of breast cancer. However, 15.6% of women with CHEK2 PVs and a family history of breast cancer, and 45.1% of women with CHEK2 PVs but without a family history of breast cancer, had low (<20%) predicted lifetime risk and thus were below the threshold for MRI screening. CHEK2 PV carriers at the 10th percentile of the joint distribution of ERS and PRS, without a family history of breast cancer, had a predicted lifetime risk similar to the general population. These results illustrate that an ERS, alone and combined with the PRS, can contribute to clinically relevant risk stratification. Integrating monogenic, polygenic, and epidemiologic risk factors in breast cancer risk prediction models may inform personalized screening and prevention efforts.

Evaluation of a pre-post quasi-experimental educational intervention on breast cancer awareness among pharmacy professionals in Karachi, Pakistan.

Cancer, particularly breast cancer, is a major contributor to mortality and a significant impediment to life expectancy. In 2020, breast cancer accounted for 11.7% of all cancer cases and caused approximately 685,000 deaths worldwide, surpassing lung cancer in prevalence. The study aims to evaluate the impact of an educational intervention on breast cancer awareness among pharmacy students by comparing their understanding before and after the program. A pre-post quasi-experimental study was designed to assess knowledge and awareness of breast cancer, breast self-examination (BSE) practices, and attitudes toward breast cancer among female university students in Karachi, Pakistan. Participants completed a pre-session questionnaire, attended an awareness workshop and video tutorial, and then completed a post-session questionnaire 2 weeks later. Of 1,200 participants, 1,015 of them completed both the pre- and post-intervention questionnaires. Key demographic features included 83.9% of the participants being in the 18-24 age group, 26.8% being married, and only 14.2% having a family history of breast cancer. Before the intervention, 60.7% of the participants were not involved in regular breast self-exams due to a lack of awareness. Post-intervention results showed a significant increase in awareness, with 35.9% rising to 94.9%. The use of screening methods increased from 46.7 to 94.8%. Knowledge of breast cancer improved from 51.2 to 96.7%, and the general perception rose from 48.2 to 93.4%. Attitudes toward self-examination also shifted positively, indicating a significant change in perception. The study concludes the baseline knowledge of breast cancer among female students was inadequate but improved significantly from over 40% to over 90% following the educational intervention. The intervention positively influenced the general perception and attitudes toward breast cancer. These findings highlight the need for regular educational sessions to enhance awareness, improve healthcare outcomes, and reduce mortality rates, particularly in developing countries.

Breast Cancer Risk Assessment Tool (BCRAT) and long-term breast cancer mortality in the Women's Health Initiative.

While the Breast Cancer Risk Assessment Tool (BCRAT) predicts breast cancer incidence, the model's performance, re-purposed to predict breast cancer mortality, is uncertain. Therefore, we examined whether the BCRAT model predicts breast cancer mortality in postmenopausal women in the Women's Health Initiative (WHI). BCRAT 5-year breast cancer incidence risk estimates were calculated for 145,408 women (aged 50-79years) enrolled in the WHI at 40 US clinical centers to examine associations of BCRAT risk groups (< 1%, 1-< 3%, ≥ 3%) with breast cancer mortality using Cox proportional regression modeling in all participants and in those with incident breast cancer. Women with BCRAT ≥ 3% risk, compared to women with BCRAT < 1% risk, were older (age 70-79years: 38.3% versus 5.3%), less commonly Black (1.1% versus 40.2%), and had stronger breast cancer family history. With 20-years follow-up, considering all participants, with 8,849 breast cancers and 1,076 breast cancer deaths, breast cancer mortality in BCRAT group ≥ 3% was not higher versus BCRAT group < 1% (Hazard Ratio [HR] 1.06 95% Confidence Interval [CI] 0.80-1.40): percent without 20-year breast cancer mortality; 99.4% [group < 1%] and 98.8% [group ≥ 3%]. Considering women with incident breast cancer, breast cancer mortality was also not higher in BCRAT group ≥ 3% versus BCRAT group < 1% (HR 1.07 95% CI 0.79-1.45). The BCRAT model, at ≥ 3% 5-year incidence risk (US guideline threshold for chemoprevention), does not identify women with higher breast cancer mortality risk, with implications for breast cancer prevention strategies.

PFAS Levels, Early Life Factors, and Mammographic Breast Density in Premenopausal Women.

Mammographic breast density (MBD) is a strong risk factor and an intermediate phenotype for breast cancer, yet there are limited studies on how environmental pollutants are associated with MBD. We investigated associations of perfluorooctane sulfonate (PFOS), perfluorooctanoic acid (PFOA), and perfluorohexane sulfonate (PFHxS) levels with measures of MBD and evaluated if early life factors modified any associations. Metabolon performed metabolomics analysis using ultrahigh-performance liquid chromatography/tandem accurate mass spectrometry in fasting blood from 705 premenopausal women completing their annual screening mammogram in St. Louis, Missouri. We calculated least square means (LSM) of mammographic volumetric percent density (VPD), dense volume (DV), and nondense volume (NDV) by quartiles (Q) of PFOS, PFOA, and PFHxS from multivariable linear regression modeling overall and stratified by recruitment period, race, age at menarche, and body shape at age 10. Models were adjusted for age, age at menarche, body fat percentage, race, family history of breast cancer, oral contraceptive use, alcohol consumption, parity/age at first birth, and body shape at age 10. PFOS, PFOA, and PFHxS were not significantly associated with VPD or NDV. PFHxS was significantly positively associated with DV (, , , ; ). PFOS was positively associated with DV (, , , ; ) with DV being 8.1%, 12%, and 12.3% higher in Q2, Q3, and Q4 compared to Q1. Among women who were underweight/normal weight at age 10, PFOS was positively associated with VPD (, , , ; ) while there was an inverse association among women who were overweight/obese at age 10 (, , , ; ) (). We report novel associations of PFHxS and PFOS with DV in premenopausal women. PFOS, PFOA, and PFHxS were not associated with VPD and NDV. In addition, body shape at age 10 may modify the associations of PFOS with MBD. Further studies are needed to validate our findings and to evaluate the associations of other per- and polyfluoroalkyl substances (PFAS), as well as mixtures of PFAS, with MBD. https://doi.org/10.1289/EHP14065.

Factors Influencing Timely Follow-up After Inconclusive Screening Mammograms at a 3D Mobile Mammography Center.

Background The Linda Fenner 3D Mobile Mammography Center (LFMMC) was created to reduce disparities in screening for breast cancer and improve survival for women with limited access to such screening.However, for screened patients requiring follow-up testing, research has shown a wide variation of time taken to access diagnostic imaging, especially among uninsured women. Aim To explore factors associated with longer (>30 days) time intervals to complete diagnostic imaging after screening. Methods This was a retrospective cohort study using data from the LFMMC from 2014 to 2022. Women living in Miami-Dade County (MDC), over the age of 40, uninsured, and requiring follow-up diagnostic imaging after breast cancer screening were included. Factors assessed included women's age, area of residency, race, primary language spoken, marital status, body mass index (BMI), history of hormone use, previous mammogram, breast implants, breast cancer in immediate family, past breast surgery, and menopause status. The interval of time taken between receiving a screening mammogram result and completing further diagnostic imaging was the outcome, dichotomized into greater than 30 days (longer follow-up time) or up to 30 days.Multivariable binary logistic regression models were used to estimate independent associations (odds ratio [OR] and 95% confidence interval [CI]) of selected factors and longer time intervals to complete diagnostic imaging follow-up. Results We analyzed data from 926 eligible patients. Themean age was 50.1 years (SD = 8.81). A majority werewhite (n = 643; 69%), Hispanic (n = 698; 72%), had a history of previous mammograms (n = 589; 64%), and had no family history of breast cancer (n = 757; 82%).About 50% had a diagnostic follow-up exam performed after 30 days (median time to follow-up was 32, interquartile range 23-46 days). Single women had 30% lower odds of longer follow-up than married women (OR 0.70, 95% CI 0.52-0.93). Residents of Homestead (a city within Miami-Dade County) had 2.5 higher odds of having a longer time to follow-up, compared to non-Homestead residents (OR 2.50, 95% CI 1.60-3.90). Conclusions Being single was associated with a shorter time to follow up with diagnostic imaging while residing in Homestead was associated with a longer time to follow-up. Further research with a larger sample and further details on patient characteristics are warranted to better identify targets for interventions aimed at optimizing continuity of care and detecting breast cancer at earlier stages.

Barriers and facilitators to breast cancer screening among high-risk women: a qualitative study.

Women with greater than 20-25% lifetime breast cancer risk are recommended to have breast cancer screening with annual mammogram and supplemental breast MRI. However, few women follow these screening recommendations. The objective of this study was to identify barriers and facilitators of screening among women at high risk for breast cancer, guided by the Health Services Utilization Model (HSUM). Unaffected high-risk women (N=63) completed semi-structured qualitative interviews exploring their experiences with breast cancer screening. Interviews were audio recorded, transcribed verbatim, and analyzed using a combined deductive and inductive approach. Most participants (84%) had received a screening mammogram; fewer (33%) had received a screening breast MRI. Only 14% had received neither screening. In line with the HSUM, qualitative analysis identified predisposing factors, enabling factors, and need factors associated with receipt of breast cancer screening. Enabling factors - including financial burden, logistic barriers, social support, and care coordination - were most frequently discussed. Predisposing factors included knowledge, health beliefs, and self-advocacy. Need factors included healthcare provider recommendation, family history of breast cancer, and personal medical history. Although HSUM themes were consistent for both mammography and breast MRI, participants did highlight several important differences in barriers and facilitators between the two screening modalities. Barriers and enabling factors associated with supplemental screening for high-risk women represent possible intervention targets. Future research is needed to develop and test multilevel interventions targeting these factors, with the ultimate goal of increasing access to supplemental screening for high-risk women.

BRCA1/2 mutations and outcomes among Middle Eastern patients with early-onset breast cancer in Oman.

High prevalence of early-onset breast cancer (EOBC) has been reported in Middle Eastern populations. For example, in Oman more than 50% of patients with breast cancer (BC) are under age 45 at diagnosis. Causes for this high incidence are unknown. Germline BRCA gene mutations have been associated with EOBC, however, prevalence of these mutations and how they relate to EOBC in Oman has not been assessed. Clinical data were collected for patients with BC treated at Royal Hospital, Oman between 2010 and 2022. Germline BRCA1/2 gene mutations were identified using sequencing and MLPA. Correlation and Kaplan-Meier survival analyses were performed to test relationships among clinico-pathological features, gene mutations, and outcomes. Total of 1336 Middle Eastern patients with BC were included; 611 were aged <45 at diagnosis (45.7%). No significant correlation was found between BRCA1/2 mutation status and EOBC (P = .229), and the majority of EOBC cases had no family history of BC. EOBC tumors did, however, differ in clinicopathological features; EOBCs were significantly larger (P < .0001), of higher grade (P < .0001), and included more HER2-enriched, and triple negative subtypes (P = .018) compared with later onset cases. Accordingly, survival analyses revealed that EOBC had significantly worse disease-free survival (P = .002). BRCA gene variants showed a distinct range of mutations including, in BRCA2, 3 previously unreported mutations and 4 potential founder recurrent mutations. Our findings showed that germline BRCA1/2 mutations were not over-represented in EOBC cases in Oman, and therefore are unlikely to be responsible for high EOBC rates.

Virtual reality: a game-changer in the diagnosis and surgical planning of astrocytoma grade III: a case report

BackgroundIn the dynamic realm of modern medicine, the advent of virtual reality technology heralds a transformative era, reshaping the contours of diagnosis and surgical planning with its immersive prowess. This study delves into the groundbreaking application of virtual reality in the intricate dance of neurosurgery, particularly spotlighting its role in the management of astrocytoma grade III—a cerebral challenge of significant complexity.Case presentationA 30-year-old Middle Eastern man from Syria grappled with the invisible tendrils of pain, manifesting as persistent headaches and a numbing sensation that crept into his neck and extremities. For two relentless months, the morning sun brought not hope but an intensification of his agony, rendering him unable to partake in the daily dance of life. The usual sentinels of relief, analgesic drugs, stood defeated, offering no respite. The neurological examination was normal, there were no pathological findings on sensory and motor examination, and he exhibited normal reflexes and neither meningeal nor cerebellar signs. He showed a family history of breast cancer. The initial foray into the enigmatic depths of his brain via computed tomography and magnetic resonance imaging imaging unveiled a finding in the right temporal lobe, a lesion that suggested something more sinister. Previous medical interventions included analgesic medications prescribed for persistent headaches, but they offered no relief. No other therapeutic interventions were administered prior to the current diagnosis. It was here that virtual reality technology emerged not as a mere tool but as a beacon of precision, casting a three-dimensional light on the shadowy intruder. This technological marvel allowed for meticulous measurement 21.8 × 14.5 mm and localization within the temporal theater, setting the stage for what was to come. With the path laid clear, the patient embarked on a surgical odyssey, a quest to excise the unwelcome guest. The operation was a triumph, a testament to human ingenuity and the symbiotic relationship between flesh and machine. The postoperative verdict was delivered through the lens of histopathology, confirming the presence of an astrocytoma grade III, a cerebral interloper known for its rapid proliferation. The battle, however, was far from over. Complementary radiotherapy and chemotherapy were enlisted as allies in this ongoing war, their potent forces working in concert to stave off the cellular insurgence. The patient’s journey through the healing arts was charted by periodic clinical and neurological examinations, with laboratory tests and the vigilant gaze of brain magnetic resonance imaging ensuring a watchful eye was kept on any potential resurgence.ConclusionsIn this narrative of resilience and technological prowess, we witness the harmonious fusion of human touch and digital precision, a partnership that redefines the boundaries of medicine and the art of healing, by use of virtual reality technology in the diagnosis of astrocytoma and enhancing the accuracy, effectiveness, and safety of neurosurgical procedures, which can ultimately benefit patients with brain tumors.

Uptake of Breast Cancer Screening Practices in Low and Middle-Income Countries: A Systematic Review and Meta-Analysis.

Breast cancer is the most prevalent cancer worldwide and the leading cause of cancer mortality in women. Uptake of breast cancer screening and early-detection practices in low- and middle-income countries (LMICs) has not been synthesized. We aimed to systematically quantify uptake of breast cancer screening in LMICs. We performed a systematic review and meta-analysis of observational population-based studies that reported the uptake of screening or early-detection practices. We searched PubMed, Scopus, Embase, and Web of Knowledge databases to January 2024. We pooled data using random-effects meta-analysis, and explored heterogeneity using subgroup analyses. 174 population-based studies encompassing >78 million women were included. Pooled prevalence of self-reported uptake of screening mammography, self-reported having had clinical breast examination for screening, and self-reported regular breast self-examination (relevant for breast awareness in LMICs) were 22.7% (95% CI: 18.6-27.2), 23.1% (95% CI: 19.5-27.0), and 14.6% (95% CI: 11.6-17.9) respectively. Uptake of breast cancer screening practices was lowest in Africa and low and lower-middle income countries. Uptake of breast cancer screening practices remained stable over time or slightly decreased. Women who lived in rural area, were single, had lower income level, had low educational attainment, were unemployed, were uninsured and had no family history of breast cancer were generally least likely to self-report uptake of breast cancer screening. This meta-analysis identified concerningly low uptake of breast cancer screening practices in LMICs. Governments should prioritize developing context-appropriate strategies to address this low uptake to support population-level stage-shifting of breast cancer in LMICs.

An initial investigation into the use of virtual reality (VR) glasses on self-reported pain perception during mammography

ObjectivePain is one of the causes of refraining from mammography. This study aimed to investigate the use of virtual reality (VR) glasses for management of pain during mammography. MethodsFifty subjects who were referred to the radiology unit for mammography screening were invited to participate in the study. The study was approved by the hospital's ethics committee and participants provided written and oral informed consent. Craniocaudal (CC) and mediolateral oblique (MLO) views of the right breast were first acquired, followed by left CC and MLO mammographic views with the VR glasses on. After the examination, participants completed a questionnaire including a validated visual analog scale (VAS) scoring system to analyze pain scores. Data were analyzed using Spearman's rho and the Kruskal-Wallis test, as well as the Bland–Altman analysis to examine discrepancy. ResultsThe association of the right breast pain score with the parameters of age, breast density, previous mammography, family history of breast cancer, educational attainment, and employment status was examined using a correlation test. All the parameters showed no significant correlation with the right breast pain score except age (p: 0.016, correlation coefficient: −.340). Apart from that this study demonstrated no significant correlation between the perceived pain experienced during mammography and the utilization of VR technology. ConclusionThe findings indicate an inverse correlation between participant's age and pain perception during mammography examinations. Moreover, the utilization of Virtual Reality (VR) did not demonstrate efficacy in reducing pain perception.

A newly Diagnosed Female Breast Cancer in Karbala: Demographic, Clinical, and Histopathological Characteristics

Abstract: Background: Breast cancer is considered as a significant public health issue due to its high incidence, prevalence, and mortality rate. It is a multi - faceted disease with both environmental and genetic causal factors. It is the first of the 10 most popular tumors triggering public concern in Iraq, compensating for 20% of all cancers and approximately 33 percent of total of female cancers. Materials and methods: This retrospective study was accomplished at the Breast Clinic, Al-Hussein Teaching Medical City, Karbala province, Iraq from September 2020 to March 2021. The study enrolled a randomly selected group of women (70 patients) newly diagnosed as breast cancer. The study included all women attending the breast clinic diagnosed a breast cancer based on clinical examination in combination with positive imaging findings and confirmed by pathological assessment. The data was collected for those patients including; demographical, clinical and histopathological findings and were statistically analyzed. Results: The mean age at time of diagnosis was (52.24±10.52) years and the mean body mass index was (26.80±4.23 kg/m2). A family history of breast cancer was recorded in (21.4%) of patients. most patient were presented with painless palpable mass (74.3%). Stage II breast cancer was the most frequent stage and invasive ductal carcinoma was the most common histological type (74.3%). Most cases were expressed positive for both estrogen and progesterone receptors while was negative in (84.3%) for human epidermal growth factor receptor 2. Conclusion: a significant proportion of breast cancer patients in Iraq have locally advanced disease with the most common complaint being a painless breast lump at time of diagnosis. Key words: breast cancer, invasive ductal carcinoma, immunohistochemistry.

Examining inequities associated with incarceration among breast cancer patients.

Breast cancer treatment patterns and quality of care among patients experiencing incarceration are underexplored. This study examined associations between incarceration and breast cancer disease and treatment characteristics. This retrospective analysis was conducted at a tertiary center in the Southeastern United States that serves as the state's safety-net hospital and primary referral site for the state's prisons. All patients ≥18 years diagnosed with breast cancer between 4/14/2014-12/30/2020 were included. Incarceration status was determined through electronic health record review. Linear regression was used to estimate the association of incarceration with time to treatment. Unadjusted overall survival (OS) was estimated using the Kaplan-Meier method with log-rank tests to compare groups. Of the 4329 patients included, 30 (0.7%) were incarcerated at the time of diagnosis or treatment (DI) and 4299 (99.3%) had no incarceration history (NI). Compared to patients who were NI, patients who were DI were younger (p < 0.001), more likely to be unmarried (p < 0.001), and more likely to have family history of breast cancer (p = 0.02). Patients who were DI had an increased time from diagnosis to neoadjuvant chemotherapy (+47.2 days on average, 95% CI 3.9-90.5, p = 0.03) and from diagnosis to surgery (+20 days on average, 95% CI 6.5-33.5, p = 0.02) compared to NI patients. No difference in OS was observed (log-rank p = 0.70). Patients who are incarcerated experienced significant delays in breast cancer care. While no differences in mortality were appreciated, these findings are concerning, as they indicate poorer care coordination for patients who are incarcerated. Further research is necessary to understand the full scope of these disparities and elucidate factors that contribute to them.

Pregnancy-Related Factors and Breast Cancer Risk for Women Across a Range of Familial Risk

Few studies have investigated whether the associations between pregnancy-related factors and breast cancer (BC) risk differ by underlying BC susceptibility. Evidence regarding variation in BC risk is critical to understanding BC causes and for developing effective risk-based screening guidelines. To examine the association between pregnancy-related factors and BC risk, including modification by a of BC where scores are based on age and BC family history. This cohort study included participants from the prospective Family Study Cohort (ProF-SC), which includes the 6 sites of the Breast Cancer Family Registry (US, Canada, and Australia) and the Kathleen Cuningham Foundation Consortium (Australia). Analyses were performed in a cohort of women enrolled from 1992 to 2011 without any personal history of BC who were followed up through 2017 with a median (range) follow-up of 10 (1-23) years. Data were analyzed from March 1992 to March 2017. Parity, number of full-term pregnancies (FTP), age at first FTP, years since last FTP, and breastfeeding. BC diagnoses were obtained through self-report or report by a first-degree relative and confirmed through pathology and data linkages. Cox proportional hazards regression models estimated hazard ratios (HR) and 95% CIs for each exposure, examining modification by PARS of BC. Differences were assessed by estrogen receptor (ER) subtype. The study included 17 274 women (mean [SD] age, 46.7 [15.1] years; 791 African American or Black participants [4.6%], 1399 Hispanic or Latinx participants [8.2%], and 13 790 White participants [80.7%]) with 943 prospectively ascertained BC cases. Compared with nulliparous women, BC risk was higher after a recent pregnancy for those women with higher PARS (last FTP 0-5 years HR for interaction, 1.53; 95% CI, 1.13-2.07; P for interaction < .001). Associations between other exposures were limited to ER-negative disease. ER-negative BC was positively associated with increasing PARS and increasing years since last FTP (P for interaction < .001) with higher risk for recent pregnancy vs nulliparous women (last FTP 0-5 years HR for interaction, 1.54; 95% CI, 1.03-2.31). ER-negative BC was positively associated with increasing PARS and being aged 20 years or older vs less than 20 years at first FTP (P for interaction = .002) and inversely associated with multiparity vs nulliparity (P for interaction = .01). In this cohort study of women with no prior BC diagnoses, associations between pregnancy-related factors and BC risk were modified by PARS, with greater associations observed for ER-negative BC.

Contribution of pre-diagnostic host factors to shaping the stromal microenvironment of breast cancer among sub-Saharan African women.

The stromal microenvironment (SME) is integral to breast cancer (BC) biology, impacting metastatic proclivity and treatment response. Emerging data indicate that host factors may impact the SME, but the relationship between pre-diagnostic host factors and SME phenotype remains poorly characterized, particularly among women of African ancestry. We conducted a case-only analysis involving 792 BC patients (17-84 years) from the Ghana Breast Health Study (GBHS). High-accuracy machine-learning algorithms were applied to standard H&E-stained images to characterize SME phenotypes (including percent tumor-associated connective tissue stroma, Ta-CTS (%), and tumor-associated stromal cellular density, Ta-SCD (%)). Associations between pre-diagnostic host factors and SME phenotypes were assessed in multivariable linear regression models. Decreasing Ta-CTS and increasing Ta-SCD were associated with aggressive, mostly high-grade tumors (p-value<0.001). Several pre-diagnostic host factors were associated with Ta-SCD independently of tumor characteristics. Compared with nulliparous women, parous women had higher levels of Ta-SCD [mean (standard deviation, SD) = 31.3% (7.6%) vs. 28.9% (7.1%); p-value=0.01]. Similarly, women with a positive family history of breast cancer had higher levels of Ta-SCD than those without family history [mean (SD) = 33.0% (7.5%)] vs. 30.9% (7.6%); p-value=0.03]. Conversely, increasing body size was associated with decreasing Ta-SCD [mean (SD) = 32.0% (7.4%), 31.3% (7.3%), and 29.0% (8.0%) for slight, average, and large body sizes, respectively, p-value=0.005]. Epidemiological risk factors were associated with varying degrees of stromal cellularity in tumors, independently of clinicopathological characteristics. The findings raise the possibility that epidemiological risk factors may partly influence tumor biology via the SME.

The Use of National Cancer Registry Data for Breast Cancer Family History Assessment in Premenopausal Women.

Background: Population-based cancer registries are the best source of information to measure cancer burden. However, little is done to use this information for individual cancer risk assessment. In this study, we aimed at identifying women at high risk of breast and ovarian cancer using data on family history of cancer from the Israel national cancer registry. Methods: We used the family history assessment tool (FHAT) to score all females, 26 to 45 years of age, in a 2.6-million-member health provider in Israel (Maccabi Healthcare Services). Data on breast, ovarian, prostate, and pancreatic cancer history among the participants and their parents (identified using the national census) were retrieved from the national cancer registry. These data were used to calculate individual FHAT scores. Results: A total of 377,931 eligible women were included in the analysis. A relevant family history of cancer was detected in 20,386 (5.4%), with FHAT scores ranging from 1 to 16. FHAT score was higher in older women and among those with a history of breast cancer. Among women aged 35-39, an FHAT score of 10 or above was associated with an OR of 15.23 (95%CI: 7.41-28.19) for breast cancer compared to women with an FHAT of 0. Conclusions: Using individual-level data from national cancer registries may assist in detecting women with a relevant family history of cancer.

Knowledge Regarding Breast Self-Examination Among Reproductive Age Women

Introduction: Breast cancer (BC) is the most common cancer and the fourth-leading cause of cancer mortality worldwide. Breast self-examination (BSE) plays an important role in the early detection of breast cancer. In developing countries like Nepal, breast cancer is diagnosed at late stages due to inadequate knowledge. Thus, this study assessed the knowledge regarding BSE among reproductive-age women. Method: Descriptive cross-sectional study among 100 reproductive-age women of Khairahani Municipality, Chitwan. A purposive sampling technique was used to select the sample and a face-to-face interview was conducted using a structured interview schedule to collect information related to the knowledge of BSE. Descriptive and inferential statistical analysis was done using SPSS version 22. Results: The mean age was 32.45 years and 82% were married. Likewise, 40% of women had completed primary and 35% secondary level education. Nearly half (47%) of women were homemakers and 13% had a family history of breast cancer. Out of 100 women, 72% knew the meaning and 96% knew the purpose of BSE. However, 21% of women knew the appropriate timing to perform BSE and only 20% technique of perming BSE. The majority of women had poor (48%) to moderate (36%) levels of knowledge and only (16%) had a good level of knowledge regarding BSE. Conclusion: The knowledge regarding BSE among reproductive-age women was found poor to moderate level. Whereas, they had good knowledge on purposes and observation during procedure but had poor level of knowledge on appropriate timing and technique of BSE.

A two-tool assessment of the quality of life of patients with breast cancer using generic and disease-specific tools in a Nigerian teaching hospital.

Assessing the quality of life (QoL) of breast cancer (BC) patients using a triangulation of tools is crucial for understanding their well-being and tailoring specific interventions to improve their overall experience. The study assessed the QoL of BC patients using a combination of generic and disease-specific validated questionnaires. The study utilized a self-administered questionnaire-based cross-sectional design among BC patients attending the Oncology clinic in a Nigerian teaching hospital. The 23-item EORTC-BR23 questionnaire and the 15-item HRQoL 15D questionnaire were provided to consenting eligible respondents for data collection. Descriptive (e.g., frequency, percentages, mean, median, etc.) and inferential (T-test and one-way ANOVA) statistical analyses were conducted on the cleaned data, with significant p values set at less than 0.05. A total of 60 female BC patients participated in the study. Respondents that were aged 41-50 years and 50-60 years were 20 (33.3%) and 19 (31.7%) respectively. Patients who were diagnosed with BC one year ago before the study were 22 (39.3%) with 51 (85%) reporting no positive family history of BC. Patients who had undergone surgery, radiotherapy, hormonal therapy, and chemotherapy were 52 (86.7%), 27 (45.0%), 14 (24.1%), and 54 (90%) respectively. The patients scored 30.00 ± 4.67% and 72.36 ± 2.93% for future perspective and body image, respectively, in the functional scales of the EORTC-BR23 with a maximum possible score of 100%. On the symptom scale, they scored 47.46 ± 2.52% and 63.40 ± 5.03% for side effects of therapy and being upset about hair loss, respectively. The patients' quality of life utility score in the 15-D tool was 0.79 ± 0.02. With p values less than 0.005, age, time since diagnosis, and cancer stage were influential determinants of patients' QoL. The QoL of the participants based on the HRQoL-15D was determined to be high. For the EORTC-BR23, respondents reported high quality of life for body image and sexual function but low quality of life for both sexual enjoyment and future perspective in terms of the functional scale. The symptom scale of EORTC-BR23 showed high symptoms for only the domain of upset by hair loss resulting in low QoL. Socio-demographic factor that affects the QoL of BC patients were age, number of years since diagnosis and stage of BC.

Barriers to Breast Cancer Screening in Saudi Arabia: A Systematic Review and Meta-Analysis.

Breast cancer is a significant public health concern globally, and early detection through screening programs can improve treatment outcomes and reduce mortality rates. However, the uptake of breast cancer screening among women in Saudi Arabia is hindered by various barriers. This systematic review and meta-analysis aimed to elucidate the barriers to breast cancer screening among women in Saudi Arabia, providing insights into the multifaceted challenges hindering screening uptake and informing tailored interventions and policy recommendations. A comprehensive literature search was conducted across electronic databases and grey literature sources to identify relevant studies on barriers to breast cancer screening in Saudi Arabia. Studies conducted between 2017 and 2023, employing diverse settings and methodologies, were included in the analysis. Data on the prevalence of barriers, family history of breast cancer, and self-reported breast examination practices were extracted and synthesized. A total of 14 studies met the inclusion criteria, encompassing diverse populations and methodologies. The included studies predominantly employed cross-sectional survey designs and targeted various populations across different regions of Saudi Arabia. The barriers to breast cancer screening were investigated, revealing concerns such as fear of discovering cancer, embarrassment due to breast-related tests, fear of pain related to clinical examination, and lack of awareness. Additionally, a substantial proportion of participants reported a family history of breast cancer, indicating a significant risk factor for the disease. Self-reported breast examination practices varied among participants, with disparities in screening behaviors observed. Our review identified fear of diagnosis, embarrassment, and lack of awareness as key barriers to breast cancer screening in Saudi Arabia. Targeted interventions, including education and improved access, are essential to address these challenges and enhance early detection efforts, reducing the burden of breast cancer.

Bilateral Male Breast Cancer : A Report Case

Breast cancer occurs in men, and its rate of incidence has increased recently. The main particularity of men's breast cancer is that its prognosis is usually worse than that of women, because it is diagnosed late and hence at advanced stage. Bilateral involvement has been reported only in rare cases. We report a case of a bilateral breast cancer, in a 47 year old patient , with no family history of breast cancer , who presented with a bilateral breast mass. Histopathological biopsy showed a bilateral invasive carcinoma, Luminal B, HER 2 negative . The extension PET scan showed no distant metastases. Bilateral mastectomy and bilateral sentinel lymph node were performed. The final histopathological exam confirmed the previous biopsy diagnostic, the tumors were mutually classified T2N0M0 of the TNM breast cancer classification. The surgical treatment was followed by tamoxifen hormonotherapy and an oncological semestriel follow-up. No recurrences or relapses were reported. The aim of our current work is to draw attention to this pathology in men, in order to contribute to its early diagnosis and therefore to improve its prognosis.