Breast Cancer Morbidity Research Articles

Mutation Spectra of BRCA Genes in Iranian Women with Early Onset Breast Cancer - 15 Years Experience

Breast cancer is the most common cancer in Iran. In the recent years an upward trend has been observed in the Iranian population. Early detection by molecular approaches may reduce breast cancer morbidity and mortality. We provided consultation to 3,782 women diagnosed with early onset breast cancer during the past 15 years (1999-2014). To establish a data set for BRCA gene alterations of the Iranian families at risk, two hundred and fifty four women who met our criteria were analyzed. A total number of 46 alterations including 18 variants with unknown clinical significance (39.1%), 18 missense mutations (39.1%), 7 Indels (15.2%) and 3 large rearrangement sequences (6%) were identified. Further scanning of affected families revealed that 49% of healthy relatives harbor identical causative mutations. This is the first report of comprehensive BRCA analysis in Iranian women with early onset breast cancer. Our findings provide valuable molecular data to support physicians as well as patients for the best decision making on disease management.

Exploring Molecular and Morphological Relationships between Obesity and CtBP in Breast Cancer

In the United States, 69% of adults are overweight or obese. This epidemic is associated with grave consequences, including increased breast cancer morbidity and mortality. One possible mechanism accounting for this elevated risk is adipocyte hypertrophy, which induces hormonal and immune dysregulations that may contribute to abnormal growth of surrounding epithelial cells. In addition, several metabolic intermediates associated with high carbohydrate food intake may influence cellular gene expression. One of these intermediates is NADH, which is elevated under conditions of obesity, diabetes, and metabolic syndrome. NADH stabilizes and activates C‐terminal binding protein (CtBP), a nuclear protein that plays a substantial epigenetic role in modifying gene expression. In particular, CtBP drives Epithelial‐Mesenchymal Transition, genome instability, and stem cell like pathways to induce tumor invasion and metastasis. In this study, we explore a link between obesity and CtBP by examining cohorts of breast cancer patient samples and in vitro assays. Using digital analysis of histological sections and immunohistochemistry, we correlate patient median adipocyte cross‐sectional area and BMI, along with gene and protein expressions of CtBP and its regulatory targets. These characteristics are then assessed in combination with patient parameters including age, race/ethnicity, and hormone receptor status. Furthermore, we perform functional in vitro assays by manipulating the levels of CtBP and glucose in human breast mammary cell lines. The goal of this study is to begin to understand how aspects of lifestyle and personal traits interact with the molecular pathways of CtBP to influence breast cancer incidence and mortality.

Abstract B29: Dissecting the effects of Brd4 short isoform on breast cancer progression

Abstract Breast cancer is one of the most common female malignancies in the United States with metastatic disease being the main contributor to breast cancer morbidity and mortality. Our lab previously identified BRD4, a member of the bromodomain family, as a regulator of breast cancer progression. Brd4 is a chromatin-modifying factor that regulates the expression of a large set of genes. Brd4 is normally expressed as two isoforms. The long isoform (Brd4-LF) contains two bromodomains in the N-terminus, an ET domain, a serine-rich SEED domain, and a proline-rich C-terminus. The short isoform (Brd4-SF) differs from the long isoform by a deletion of the proline-rich C-terminus and a three amino acid difference on the N-terminal domain. Previous studies in our laboratory indicate that these two isoforms have opposing effects on breast cancer progression. Highly metastatic mouse mammary tumor cells overexpressing Brd4-LF suppressed tumor growth and dissemination, whereas overexpression of Brd4-SF increased metastatic outgrowth in lungs. We have shown that these two isoforms are found in different compartments within the cell nucleus, leading to altered interaction with nuclear proteins. Brd4-LF is localized in the nuclear matrix while Brd4-SF is found in the nuclear envelope where it interacted with the LINC complex and known metastasis susceptibility proteins RRP1B and SIPA1. Given that these two isoforms reside in different subnuclear locations, we hypothesize that the isoforms bind to different sets of genes. To test this hypothesis we are utilizing the chromatin-immunoprecipitation sequencing (ChIP-seq) assay to characterize the genetic interactions associated with Brd4-SF. Identification of the Brd4-SF interacting genes will provide us with mechanistic insight into the underlying causes of the different metastatic outcomes promoted by the two isoforms, highlighting potential targets for future targeted therapies. Citation Format: Xinyi Zhu, Kent W. Hunter. Dissecting the effects of Brd4 short isoform on breast cancer progression. [abstract]. In: Proceedings of the AACR Special Conference on Tumor Metastasis; 2015 Nov 30-Dec 3; Austin, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(7 Suppl):Abstract nr B29.

Dietary patterns and breast cancer risk in a prospective Japanese study.

The association between dietary patterns and breast cancer has been inconsistent. This study examined associations between dietary patterns and risk of developing breast cancer among 23,172 women from the Japan Collaborative Cohort Study, including 119 incidences of breast cancer diagnosed during a median 16.9-year follow-up period. Factor analysis was conducted to obtain dietary patterns, and Cox proportional models were used to estimate hazard ratios (HR) and 95% confidence intervals (95% CI) for breast cancer morbidity. Three dietary patterns were identified: ''vegetable pattern'' (vegetables, potatoes, seaweed, tofu, fruits, fresh fish, eggs, and miso soup); ''animal food pattern'' (meat, deep-fried foods, fried vegetables, fish paste and salt-preserved fish); and "dairy product pattern'' (milk, dairy products, fruits, coffee and tea). After adjusting for potential confounders, the vegetable and dairy product patterns were not significantly associated with risk of breast cancer. However, the animal food pattern was significantly associated with a decreased risk of breast cancer morbidity among premenopausal women by HR 0.47 for the 2nd tertile (95% CI 0.22-1.00) and HR 0.42 for the 3rd tertile (95% CI 0.18-0.93), compared with the bottom tertile (p for trend 0.04). We found no significant association between the vegetable and dairy product dietary patterns and breast cancer risk; however, an animal product diet may reduce risk of breast cancer among premenopausal Japanese women.

Network Analysis of MicroRNAs, Transcription Factors, Target Genes and Host Genes in Human Breast Cancer.

This study constructs three regulatory networks of microRNAs (miRNAs) and genes in breast cancer (BC), and the abnormally expressed network may be the fault graph of BC’s canceration, which helps us identify pathogenesis of BC. Scientists have identified genes and miRNAs as decisive biological factors in progression of BC. Insufficiently, research data of genes and miRNAs is unorganized and scattered, which made regulatory mechanism of BC still indeterminate. In the current study, we didn’t only investigate one or several elements (miRNAs, TFs, target genes and host genes) associated with morbidity of BC. Instead, we systematically studied regulatory interactions among the whole elements relevant to BC and important regulatory pathways during BC’s canceration. Then three regulatory networks (including the abnormally expressed network, related network and global network) are hierarchically constructed at three levels, aiming at analyzing significant miRNA-gene signaling pathways at the macroscopic level. Results shows the abnormally expressed network contains substantial faulty regulations between miRNAs and genes when BC occurs, and it may be underlying fault graph of BC’s canceration. Significantly, if medical measure can be taken to correct each faulty regualtion to normal regulation, thus each genes and miRNAs will return to its normal expression level, and canceration of BC may be prevented and not occur. Furthermore, regulatory networks contain massive self-adaption feedbacks, which helps to understand the regulatory mechanism of BC. In conslusion, these networks, especially the abnormally expressed network, offers a systematical explanation about BC’s pathogenesis, which may aid future research and therapy of BC.

Tumor-associated macrophages: unwitting accomplices in breast cancer malignancy.

Deleterious inflammation is a primary feature of breast cancer. Accumulating evidence demonstrates that macrophages, the most abundant leukocyte population in mammary tumors, have a critical role at each stage of cancer progression. Such tumor-associated macrophages facilitate neoplastic transformation, tumor immune evasion and the subsequent metastatic cascade. Herein, we discuss the dynamic process whereby molecular and cellular features of the tumor microenvironment act to license tissue-repair mechanisms of macrophages, fostering angiogenesis, metastasis and the support of cancer stem cells. We illustrate how tumors induce, then exploit trophic macrophages to subvert innate and adaptive immune responses capable of destroying malignant cells. Finally, we discuss compelling evidence from murine models of cancer and early clinical trials in support of macrophage-targeted intervention strategies with the potential to dramatically reduce breast cancer morbidity and mortality.

Screening for Breast Cancer: U.S. Preventive Services Task Force Recommendation Statement.

Update of the 2009 U.S. Preventive Services Task Force (USPSTF) recommendation on screening for breast cancer. The USPSTF reviewed the evidence on the following: effectiveness of breast cancer screening in reducing breast cancer-specific and all-cause mortality, as well as the incidence of advanced breast cancer and treatment-related morbidity; harms of breast cancer screening; test performance characteristics of digital breast tomosynthesis as a primary screening strategy; and adjunctive screening in women with increased breast density. In addition, the USPSTF reviewed comparative decision models on optimal starting and stopping ages and intervals for screening mammography; how breast density, breast cancer risk, and comorbidity level affect the balance of benefit and harms of screening mammography; and the number of radiation-induced breast cancer cases and deaths associated with different screening mammography strategies over the course of a woman's lifetime. This recommendation applies to asymptomatic women aged 40 years or older who do not have preexisting breast cancer or a previously diagnosed high-risk breast lesion and who are not at high risk for breast cancer because of a known underlying genetic mutation (such as a BRCA1 or BRCA2 gene mutation or other familial breast cancer syndrome) or a history of chest radiation at a young age. The USPSTF recommends biennial screening mammography for women aged 50 to 74 years. (B recommendation) The decision to start screening mammography in women prior to age 50 years should be an individual one. Women who place a higher value on the potential benefit than the potential harms may choose to begin biennial screening between the ages of 40 and 49 years. (C recommendation) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening mammography in women aged 75 years or older. (I statement) The USPSTF concludes that the current evidence is insufficient to assess the benefits and harms of digital breast tomosynthesis (DBT) as a primary screening method for breast cancer. (I statement) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of adjunctive screening for breast cancer using breast ultrasonography, magnetic resonance imaging (MRI), DBT, or other methods in women identified to have dense breasts on an otherwise negative screening mammogram. (I statement).

THE DYNAMICS OF MORBIDITY OF BREAST CANCER IN THE EASTERN-KAZAKHSTANSKAIA OBLAST AND ROLE OF RADIATION FACTOR

The analysis was carried out concerning morbidity of breast cancer in women of Eastern-Kazakhstanskaia oblast in 1971-2013 subject to indicators of radiation factor impact. The 6575 archive data was analyzed concerning radiation exposure of individuals radiated in the result of the Semipalatinsk nuclear testing area. The derived results testify availability of double dependence of breast cancer from unfavorable ecological conditions due to genetic predisposition related to mutations in genes of apoptosis regulation that can be one of leading causes of increasing of morbidity.

Breast Cancer Screening: An Assessment of Awareness, Attitude and Practice among Female Clients Utilizing Breast Imaging Services in South-Western Nigeria

Breast cancer is a leading cause of cancer deaths among women in many parts of the world and screening practices play a vital role in its prevention and early detection. This study sought to assess the level of awareness, determine the attitude and document breast cancer screening practices among respondents. A cross-sectional descriptive survey of 150 respondents was conducted at the Department of Radiology of a tertiary health facility in Ado-Ekiti, Nigeria. The study population consisted of female patients referred for breast imaging. A structured questionnaire was used for data collection. The data was analysed using SPSS version 16, Chicago USA Inc. Respondents presented for breast imaging due to breast related complaints (75.2%) as opposed to routine medical screening for breast cancer (24.8%). A total of 43 (28.7%) respondents had breast ultrasound scan done previously, 105 (70%) had practiced breast self examination (BSE) before, while 54 (36%) had clinical breast examination (CBE) done previously. Among those aged 40 years and above (n=67, 44.7%) only 18 (26.9%) had a previous mammographic screening. Overall attitude to BSE was good (56%) but attitude to CBE was negative (69.3%). Respondents’ occupation was found to have a significant association with attitude towards BSE (p=0.001). The logistic regression analysis of predictors of awareness of mammography showed that women aged 40 years and above are more likely to be aware of mammography as a screening tool for breast cancer (OR=3.05,P= 0.012; 95%CI 1.28-7.27). There is a need for increased awareness and adoption of breast cancer screening practices in our environment in order to engender a reduction in breast cancer morbidity and mortality.

Determinants of lymph node status in women with breast cancer: A hospital based study from eastern India

Background & objectives:Number of metastatic lymph nodes has a strong prognostic value in the course of breast cancer treatment, morbidity and mortality. This study was undertaken to determine the association between axillary lymph node metastasis and several variables such as age, tumour size, grade, lymphovascular invasion, oestrogen and progesterone receptor expression and HER2/neu status in patients with breast cancer.Methods:In this study 426 (with complete information on study variables) patients with breast cancer on treatment during March 2010 to December 2013, were analyzed. TNM (tumour node matastasis) staging was evaluated. The histological grading of tumours was done according to modified Bloom-Richardson Grading System. The immunophenotype of the tumour was determined as the expression of oestrogen (ER) and progesterone (PR) receptors and HER2/neu status. Univariate and multivariate analyses were carried out to determine the independent predictors of metastatic lymph node.Results:Among the studied patients, 44.36 per cent (189 of 426) of the patients had nodal metastases. Tumour histology, tumour grade, size and lympho-vascular invasion were related with node positivity. On univariate analysis, age, menopause, hormone receptor status did not relate with the node metastasis. Age, tumour grade, tumour size, lympho-vascular invasion and HER2/neu expression was likely to be associated with the number of lymph node metastasis.Interpretation & conclusions:The lymph node status was associated with clinical stage, tumour grade, tumour histology and HER2/neu status. These factors may be used for better management of such patients.

Quality of Life and Its Related Factors in Female Postoperative Breast Cancer Patients Younger than 50 Years.

Few reports on breast cancer patients have focused on the younger ages at which breast cancer morbidity increases. The purpose of this study was to clarify the quality of life (QOL) and its related factors in female postoperative breast cancer patients younger than 50 years. A total of 166 (valid rate 57.8%) female postoperative patients were administered a questionnaire anonymously answered at their outpatient clinics specializing in breast cancer. QOL was evaluated using the QOL Questionnaire for Cancer Patients Treated with Anticancer Drugs (QOL-ACD). Multiple regression analysis of 13 items that showed a significant difference in the total points of QOL-ACD was performed with categories as independent variables and the total points of QOL-ACD as a dependent variable. The mean age of the subjects was 43.6 years. The median total points of QOL-ACD was 88. The multiple regression analysis showed the following seven factors were related to the total points of QOL-ACD: ability to fulfill roles in the family, no symptoms, no financial difficuies, requiring no support at hospital visit, the use of many kinds of stress-coping methods, taking no medication for diseases other than cancer, and not unsatisfied with the scars and shape of breasts. The QOL of young, postoperative breast cancer patients was lower than that of the patient groups that included older subjects. To improve their QOL, it is important to provide social support for their family roles and economic situations, in addition to physical and psychological support based on the characteristics of the disease.

IMPACT OF KRAS VARIANT rs61764370 ON BREAST CANCER MORBIDITY

Low-penetrance gene variants and their combinations are topical study objects in breast cancer pathogenesis. Single nucleotide polymorphism rs61764370, localized in 3՛ UTR of KRAS gene, plays an important role in the development and progression of several cancers. The aim of our study was to determine the KRAS variant impact on breast cancer morbidity. 2214 patients diagnosed with breast cancer and 861 healthy controls were screened for KRAS variant by RFLP method. Available clinical data were collected and processed using statistical analysis methods. Results of present study suggest the KRAS variant impact on breast cancer development risk in premenopausal women, but it has no effect on breast cancer prognosis. We did not observe any KRAS variant effect on breast cancer patient 10-year disease-specific survival rates.

Breast Cancer Screening for Women at Average Risk: 2015 Guideline Update From the American Cancer Society.

Breast cancer is a leading cause of premature mortality among US women. Early detection has been shown to be associated with reduced breast cancer morbidity and mortality. To update the American Cancer Society (ACS) 2003 breast cancer screening guideline for women at average risk for breast cancer. The ACS commissioned a systematic evidence review of the breast cancer screening literature to inform the update and a supplemental analysis of mammography registry data to address questions related to the screening interval. Formulation of recommendations was based on the quality of the evidence and judgment (incorporating values and preferences) about the balance of benefits and harms. Screening mammography in women aged 40 to 69 years is associated with a reduction in breast cancer deaths across a range of study designs, and inferential evidence supports breast cancer screening for women 70 years and older who are in good health. Estimates of the cumulative lifetime risk of false-positive examination results are greater if screening begins at younger ages because of the greater number of mammograms, as well as the higher recall rate in younger women. The quality of the evidence for overdiagnosis is not sufficient to estimate a lifetime risk with confidence. Analysis examining the screening interval demonstrates more favorable tumor characteristics when premenopausal women are screened annually vs biennially. Evidence does not support routine clinical breast examination as a screening method for women at average risk. The ACS recommends that women with an average risk of breast cancer should undergo regular screening mammography starting at age 45 years (strong recommendation). Women aged 45 to 54 years should be screened annually (qualified recommendation). Women 55 years and older should transition to biennial screening or have the opportunity to continue screening annually (qualified recommendation). Women should have the opportunity to begin annual screening between the ages of 40 and 44 years (qualified recommendation). Women should continue screening mammography as long as their overall health is good and they have a life expectancy of 10 years or longer (qualified recommendation). The ACS does not recommend clinical breast examination for breast cancer screening among average-risk women at any age (qualified recommendation). These updated ACS guidelines provide evidence-based recommendations for breast cancer screening for women at average risk of breast cancer. These recommendations should be considered by physicians and women in discussions about breast cancer screening.

Re-examining current breast cancer screening: An analysis of the 2009 U.S. Preventive Services Task Force guidelines for breast cancer screening

ABSTRACTThe U.S. Preventive Services Task Force (USPSTF) released new mammography screening guidelines in November 2009. The panel’s comprehensive review of evidence for this preventive service concluded that the net benefit of screening mammography was too small to justify universal screening for women younger than 50 years of age but advocated continuing universal screening, though biennially rather than annually, for women ages 50–74 years. Under these new recommendations, it is possible undetected early breast cancers may increase and result in increases in breast cancer morbidity. This policy analysis assessed the impact of the new guidelines regarding whether the policy changes have affected breast cancer detection and treatment in the ensuing 5 years, and whether these guidelines may affect morbidity and mortality from breast cancer in the future. Trade-offs are present in cost-effectiveness and earlier detection with better treatment for women ages 40–49 years. Follow-up studies will be crucial to monitor changes in outcome for mortality and surgical intervention and ascertain the full impact of the new guidelines for women younger than 50 years.

Abstract LB-300: Reintroduction of tumor-suppressor miR-34a shows therapeutic efficacy in triple-negative breast cancer

Abstract Triple-negative breast cancer (TNBC) accounts for a disproportionate share of the total breast cancer morbidity because of its aggressive behavior and lack of effective targeted therapies to treat the disease. MicroRNAs, global regulators of survival and proliferation pathways important in tumor development and maintenance, are highly dysregulated in cancer. We identified miR-34a to be aberrantly lost in TNBC lines when compared to both a luminal cancer subtype as well as normal breast cells. Re-introduction of miR-34a in TNBC lines results in inhibition of cell proliferation and invasion, reactivation of senescence, and enhanced sensitivity to apoptosis inducing agents. Furthermore, intratumoral delivery of miR-34a into subcutaneous tumors in nude mice, as well as systemic delivery of poly(amine-co-ester) PACE-loaded miR-34a in an orthotopic setting, delayed tumor growth. In conclusion, re-introduction of miR-34a in TNBC promotes potent anti-tumorigenic phenotypes in vitro and in vivo, and could be a promising targeted therapeutic agent to treat the disease. Citation Format: Brian D. Adams, Vikram Wali, Chris Cheng, Sachi Inukai, David Rimm, Lajos Pusztai, Mark Saltzman, Frank Slack. Reintroduction of tumor-suppressor miR-34a shows therapeutic efficacy in triple-negative breast cancer. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr LB-300. doi:10.1158/1538-7445.AM2015-LB-300

Abstract P4-14-11: National trend in African American women breast cancer research productivity from 1992-2012

Abstract INTRODUCTION: Despite extensive progress in breast cancer prevention, diagnosis and treatment over the past 20 years, African American women suffer disproportionate breast cancer morbidity and mortality. In 1998, breast cancer deaths among African American women were 28% higher than in white women and the five-year survival rate for African American women was 71% compared with 86% for white women. The purpose of this bibliometric study is to assess our national research efforts to combat this racial disparity by analyzing breast cancer research productivity in the United States focusing on African American women from 1992 to 2012. METHODS: This retrospective bibliometric analysis of public data was exempt from Institutional Review Board approval. Articles with "Breast Neoplasm" as a major medical subject heading (MeSH) term published between 1992 and 2012 were identified in the National Library of Medicine MEDLINE database. In addition, articles with "African Continental Ancestry Group" which included African American as a major MeSH term were identified. Country of origin, methodology, journal name, first author specialty and funding sources were recorded. Growth in number of publications was analyzed using linear and nonlinear regression statistical analysis. RESULTS: A total of 113,721 journal articles were identified with "Breast Neoplasm" as a major MeSH term worldwide, of which 34,155 (30.0%) were published from the United States. Among United States publications, 668 (2.0%) were specific to African ancestral populations. From 1992 to 2012, both African ancestral and non-African ancestral specific articles displayed linear growth patterns (p < 0.0001). National Institute of Health (NIH) funded studies displayed an exponential growth pattern (p < 0.0001) for African ancestral specific articles and displayed a linear growth pattern (p < 0.0001) for non-African ancestral articles. The largest specialty contributor of African ancestral specific articles was Epidemiology and Public Health (33.2%), followed by Medicine (internal medicine, family medicine, obstetrics & gynecology, nursing) (24.7%), Basic Sciences (17.4%), Surgery (15%), Medical and Radiation Oncology (4.7%), Pathology (2.9%) and Radiology (2.1%). African ancestral specific articles were most frequently published in Cancer (10.8%). CONCLUSION: Among breast cancer publications from the United States, only 2% of the articles were specific to African ancestral population, which is concerning given recent data indicating the persistent ethnic disparity in survival. However, the trend in research productivity in this population is encouraging, largely due to the exponential growth of NIH-funded studies specific for African American women in the past 20 years. NIH-funded research accounts for 52% of all published African American specific breast cancer studies as compared to 40.5% of studies that are non-specific to this population. Ultimately, improvements in breast cancer incidence, mortality, and survival rates in African American women will undoubtedly result from quality research and should continue to be a priority in our nation’s breast cancer research agenda. Citation Format: Ralph T Wynn, Daniel S Chow, Victoria L Mango, Lauren C Friedlander, Richard Ha. National trend in African American women breast cancer research productivity from 1992-2012 [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P4-14-11.

Abstract P4-07-12: Re-introduction of tumor suppressor miR-34a harbors therapeutic efficacy in triple negative breast cancer

Abstract Place Holder Abstract Date Expected for Obtaining Final Information for Abstract: 9/14 - 10/14 Triple negative breast cancer accounts for a disproportionate share of the total breast cancer morbidity because of its aggressive behavior, increased incidence in younger women, and lack of effective targeted therapies. MicroRNAs are global regulators of survival and proliferation pathways important in cancer development and tumor maintenance. MicroRNAs function as tumor suppressors and oncogenes, and are highly dysregulated in cancer. Here, we identified miR-34a to be aberrantly lost in triple negative cancer cell lines when compared to both a luminal cancer subtype as well as normal breast cells. Re-introduction of miR-34a in triple negative cancer lines results in inhibition of cell proliferation, reactivation of senescence, and enhances sensitivity to apoptotic-inducing agents. Furthermore, intratumoral delivery of miR-34a into subcutaneously implanted tumors in nude mice delays tumor growth as compared to a scrambled control. In conclusion re-introduction of miR-34a in triple negative breast cancer promotes anti-tumorigenic phenotypes both in vitro and in vivo, and could therefore be used as a therapeutic agent to treat the disease. Citation Format: Brian D Adams, Lajos Pusztai, David L Rimm, Frank J Slack. Re-introduction of tumor suppressor miR-34a harbors therapeutic efficacy in triple negative breast cancer [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P4-07-12.

Folic acid in pregnancy and mortality from cancer and cardiovascular disease: further follow-up of the Aberdeen folic acid supplementation trial

BackgroundSupplemental periconceptional folic acid is recommended to reduce the risk of fetal neural tube defects. A previous report indicated an elevated risk of breast cancer and all cancer deaths in...

Knowledge, attitude and practice of breast self-examination among female undergraduate students in the University of Buea.

BackgroundThe incidence of breast cancer is on the rise in many parts of Africa. In Cameroon, there were an estimated 2625 cases per 100,000 in 2012. The awareness of breast cancer preventive methods is therefore critical in the reduction of breast cancer morbidity and mortality. This study evaluated the knowledge, attitude and practice of breast self-examination (BSE), among female undergraduate students in the University of Buea.MethodsThe study comprised 166 female students of ages 17-30years (mean = 22.8 ± 3) sampled randomly. Data was collected by a pretested self-administered questionnaire.ResultsNearly three quarter (73.5%) of the respondents had previously heard of BSE. Only 9.0% knew how to perform BSE. Similarly, only 13.9% knew what to look for while performing BSE. Television (19.9%) was the main source of information on BSE. Although perceived by 88% of the respondents as important, only 3% had performed BSE regularly. Furthermore, only 19.9% of the respondents have been to any health facility to have breast examination. Overall, although a majority (63.3%) of the respondents had a moderate attitude towards BSE as an important method for early detection of breast cancer, just a modest 9.6% were substantially aware of it. Lack of knowledge on BSE was cited as the main reason for not performing BSE. A significant association was observed between knowledge and the practice of BSE (P = 0.029), and between attitude and the practice of BSE (P = 0.015).ConclusionsThese findings highlight the current knowledge gap that exists in the practice of BSE in the prevention of breast cancer in the study population. Sensitization campaigns and educational programmes ought to be intensified in order to address this issue.Electronic supplementary materialThe online version of this article (doi:10.1186/s13104-015-1004-4) contains supplementary material, which is available to authorized users.

Current management of lesions associated with an increased risk of breast cancer.

High-risk breast lesions, which comprise benign lesions and in situ carcinomas (lobular carcinoma in situ and ductal carcinoma in situ), are clinically, morphologically, and biologically heterogeneous and are associated with an increased risk of invasive breast cancer development, albeit to varying degrees. Recognition and proactive management of such lesions can help to prevent progression to invasive disease, and might, therefore, reduce breast cancer incidence, morbidity, and mortality. However, this opportunity comes with the possibility of overdiagnosis and overtreatment, necessitating risk-based intervention. Notably, despite the progress in defining the molecular changes associated with carcinogenesis, alterations identifying the individuals with high-risk lesions that will progress to invasive carcinoma remain to be identified. Thus, until reproducible clinicopathological or molecular features predicting an individual's risk of breast cancer are found, management strategies must be defined by population-level risks as determined by models such as the Gail or IBIS models, as well as patient attitudes toward the risks and benefits of interventions. Herein, we review the contemporary approaches to diagnosis and management of high-risk breast lesions. Progress in this area will ultimately be dependent on the ability to individualize risk prediction through better definition of the key drivers in the carcinogenic process.