Breast Cancer In Israel Research Articles

Association between standard clinical and pathological breast cancer characteristics and the 21-gene recurrence score: A population-based study

11002 Background: The 21-gene recurrence score (RS) aims to quantify chemotherapy benefit in lymph node-negative, estrogen receptor (ER)-positive breast cancer (BC) patients. We aimed to elucidate the association between the RS and clinical-pathological features in a population-based Israeli cohort. Methods: Study population included all Israeli BC female patients referred to the RS assay from October 2004 until October 2006. Clinical and pathology data were collected upon referral, RS risk was categorized as previously defined (low < 18, intermediate 18–30, high = 31) and chemotherapy benefit was also assessed for each patient using NCCN guidelines, St. Gallen recommendations and Adjuvant! Online. Results: 300 patients were referred to the assay by 70 physicians from 16 institutions. Low, intermediate and high RS were noted in 109 (36 %), 134 (45 %) and 57 (19%) of the patients respectively, compared to 54%, 21% and 25% respectively, in the validation study (JCO;24:3726). Median age was 54 and median tumor size was 1.6 cm. Similar age distribution, tumor size and ER staining intensity were noted in all risk categories. Interestingly, no association has been identified between the RS and the presence of lymph nodes micrometastases. High tumor grade was noted in 15%, 20% and 56%; progesterone expression in 88% 72% 43%; non-infiltrative ductal carcinoma (IDC) 24%, 12% and 6%; and Her2 expression in 2%, 3% and 19% of the low, intermediate and high risk categories respectively (p<0.0001 for all variables). Risk assessment according to clinical guidelines or Adjuvant! Online correlated poorly with the RS. Conclusions: Risk stratification of referred Israeli patients differs from that of the validation study population. Moreover, the RS did not correlate with age, tumor size and ER intensity. The RS correlated with histology, grade, PR and Her2 expression and may be predicted, in specific subsets of patients, using these features. However, RS categorization cannot be predicted by commonly-used clinical predicting tools. No significant financial relationships to disclose.

Genetic analyses of male breast cancer in Israel.

Male breast cancer is a rare disorder, and little is known about the molecular mechanisms associated with the tumorigenic process. We genotyped 31 Jewish Israeli males with breast cancer for the predominant Jewish BRCA1 (185delAG, 5382InsC) and BRCA2 (6174delT) germline mutations: 11 individuals from high-risk families and 20 patients unselected for family history of cancer. Two patients of the high-risk group (18.2%) displayed germline mutations: one harbored the 185delAG BRCA1 mutation, and the other the 6174delT mutation in BRCA2. None of the unselected patients displayed any mutation. In 2 patients, complete mutation analysis of the BRCA2 gene did not reveal any disease-associated mutations. We conclude that the predominant Jewish germline mutations in BRCA1/BRCA2 contribute to male breast cancer in Israel, primarily in Ashkenazi individuals with a family history of cancer.

"You are a number, not a human being": Israeli breast cancer patients' experiences with the medical establishment.

In the course of interviews with Israeli women who had recently been treated for breast cancer, we found that our informants tended to offer us "treatment narratives" rather than, or sometimes in addition to, the "illness narratives" made famous by Arthur Kleinman. For the women we interviewed, treatment narratives constitute verbal platforms on which to explore what it means to be human during a period in which one's body, spirit, and social identity are undergoing intense transformations. A central theme in these narratives is the Hebrew word yachas, loosely translated as "attitude," "attention," or "relationship." The women consistently contrasted the good yachas of medical staff who treated them "like humans" or like "real friends" with the bad yachas of staff who treated them like numbers, machines, or strangers. We argue that the women used language (in various contexts) as a means of resisting the medical culture's pattern of treating patients as "nonhumans."

1292 The political aspects of breast cancer—the Israeli breast cancer coalition

Breast cancer presents political issues related to its gender and social aspects. In Israel, self-help groups of women with breast cancer, and health care professionals, together with women's organizations, have made an effort to unite to form the Breast Cancer Coalition. This coalition was established with the aim of representing a grass root feminist voice for bringing breast cancer care to the forefront of the national health care agenda. These developments, with further European implications, will be described in detail. Health promotion and education are at the heart of the work of the newly-established coalition. Nurses, as women, are in a uniquely powerful position to advertise, and participate in, such activities, both as health care consumers and as health care providers.

Early detection of breast cancer in Israel

Early detection of breast cancer in Israel

The Israeli Breast‐Cancer Anomalya

The Israeli Breast‐Cancer Anomaly^a

Breast cancer in Israel, 1960–1975. II. Effects of age and origin on survival

The effect of age and origin on survival, measured by the life table method, was examined for 10,702 breast cancer patients diagnosed in Israel between 1960 and 1975. In contrast to a major American study, we found no differences in survival between younger and older women with breast cancer. In stages II, III and IV, immigrants of Western origin survived significantly longer than native-born Israeli women and immigrants from other Asian or North African countries. This suggests that the different disease patterns (slow-growing, ‘insidious’ vs fast-growing, ‘fulminant’) may be distributed unequally among the several population groups, favoring women of Western origin. Factors accounting for this unequal distribution are undoubtedly genetic and environmental combined. The identification of groups of women with more aggresive disease may influence decisions about the use of more aggressive therapy.

Breast cancer in Israel, 1960–1975. I. Changing patterns at diagnosis

Ten thousand seven hundred and two new cases of breast cancer were diagnosed in Jewish women in Israel during the period 1960–1975. Throughout that period there was a steady rise in breast cancer incidence. This trend is explained by an increase in the incidence of stage I and II cancers in women aged 60 and older. No changes in stage III and IV incidence were seen in any age group. It is suggested that the increased incidence of less advanced cancers was caused by more self-examination by women which, in turn, resulted from increased public awareness of cancer, reinforced by specific screening and education programs. It remains to be shown whether the trend towards earlier diagnosis will be translated into improved outcomes.

Male breast cancer in Israel: Selected epidemiological and clinical aspects

All records of male patients with breast cancer diagnosed in Israel during the 7 yr period of 1960–1966 were reviewed. The mean annual incidence of the disease was 7.8 per million and the female/male ratio 67 : 1, both figures being compatible with incidence rates reported for the U.S. and Western Europe. There was a slight excess of cases among European born immigrants, as compared to those born in Africa and Asia; these differences were not statistically significant, possibly due to the small sample size. It is assumed that ethnic differences in the incidence of the disease are more marked among females than among males. Thirty per cent of the cases were diagnosed within one month after the onset of symptoms but only 50 per cent within 6 months. The estimated 3 yr survival rate was 70 per cent and the 5 yr rate 54.4 per cent.