Diagnosed Breast Cancer Patients Research Articles

ACSS2 regulates ferroptosis in an E2F1-dependent manner in breast cancer brain metastatic cells.

Brain metastasis diagnosis in breast cancer patients is considered an end-stage event. The median survival after diagnosis is measured in months, thus there is an urgent need to develop novel treatment strategies. Breast cancers that metastasize to the brain must adapt to the unique brain environment and are highly dependent on acetate metabolism for growth and survival. However, the signaling pathways that regulate survival in breast cancer brain metastatic (BCBM) tumors are not known. Primary brain tumor cells can convert acetate to acetyl-CoA via phosphorylation of acetyl-CoA synthetase 2 (ACSS2) by the cyclin-dependent kinase-5 (CDK5) regulated by the nutrient sensor O-GlcNAc transferase (OGT). Here, we show that breast cancer cells selected to metastasize to the brain contain increased levels of O-GlcNAc, OGT and ACSS2-Ser267 phosphorylation compared to parental breast cancer cells. Moreover, OGT and CDK5 are required for breast cancer cell growth in the brain parenchyma in vivo. Importantly, ACSS2 and ACSS2-S267D phospho-mimetic mutant are critical for in vivo breast cancer growth in the brain but not in the mammary fat pad. Mechanistically, we show that ACSS2 regulates BCBM cell survival by suppressing ferroptosis via regulation of E2F1-mediated expression of anti-ferroptotic proteins SLC7A11 and GPX4. Lastly, we show treatment with a novel brain-permeable small molecule ACSS2 inhibitor induced ferroptosis and reduced BCBM growth ex vivo and in vivo. These results suggest a crucial role for ACSS2 in protecting from ferroptosis in breast cancer brain metastatic cells and suggests that breast cancer brain metastatic cells may be susceptible to ferroptotic inducers.

A study of a PERMA-based positive psychological intervention programme in subthreshold depressed patients with newly diagnosed breast cancer: formulation and application.

Depression seriously affects the quality of life of breast cancer patients and even hinders treatment and recovery after diagnosis. Subthreshold depression should be worthy of attention, and the risk of subthreshold depression developing into depression increases if timely intervention is not available. However, there is limited research on interventions for subthreshold depression, especially for newly diagnosed breast cancer patients. Exploring the efficacy of a PERMA-based positive psychological intervention programme in newly diagnosed breast cancer patients with subthreshold depression. Using PERMA as a framework, we constructed the intervention programme through a literature review and expert discussion approach, and revised the programme using the Delphi method. Then we selected 84 newly diagnosed breast cancer patients for a randomised controlled trial. The control group received conventional care (primary care, specialist care, psychological care, etc.), and the observation group received a PERMA-based positive psychological intervention programme. Patient data were collected before and after the intervention, and the dataset consisted of patient responses to general information, the Depression Screening Scale (CES-D), the Hamilton Depression Inventory (HAMD-17), and the Questionnaire on Psychosocial Adjustment in Breast Cancer Patients. A total of 79 patients completed the study (38 patients in the observation group and 41 patients in the control group), and before the intervention, there were no statistical differences in the comparison of general information, subthreshold depression scores, and psychosocial adaptation scores between the two groups (p > 0.05). After the intervention, the subthreshold depression (CES-D and HAMD-17 scores) scores of the observation group were lower than those of the control group (p < 0.01), and the psychosocial adaptation scores were significantly higher than those of the control group (p < 0.01). A positive psychological intervention programme using PERMA as a framework was more effective in reducing subthreshold depression levels and promoting levels of psychosocial adjustment in newly diagnosed breast cancer patients. Interventions for subthreshold depression are not limited to the traditional aftercare model, but rather from a positive psychology perspective. Especially for patients newly diagnosed with breast cancer, this is a new endeavour that has important implications for them. Because, instead of focusing on their negative emotions, we help them gradually adapt to their new identity and treatment process from a positive aspect during their most difficult period, thus reducing their subthreshold depression level and preventing it from developing into a more severe depression.

Yoga Intervention and Inflammatory Homoeostasis in Breast Cancer Patients

Objectives: Yoga, renowned for its ability to maintain physical, mental and spiritual well-being, has recently gained prominence as a supportive therapy during conventional breast cancer (BC) treatment. This paradigm shift reflects a growing trend of people embracing yoga to enhance their overall health and aid in managing BC. The objective of this study was to determine the yoga intervention and inflammatory homoeostasis in newly diagnosed BC patients. Materials and Method: This study recruited 44 newly diagnosed BC patients at stages II, III and IV (without distant metastasis or other inflammatory diseases), all admitted for neoadjuvant chemotherapy followed by surgery. A prospective non-randomised control design was employed. Baseline assessments were conducted before the first chemotherapy cycle, with follow-ups before the 2nd and 3rd chemotherapy cycles, before surgery, and 2 months post-surgery. The outcome was compared with the control group. Results: The study showed significant within-subject effects in the yoga intervention group on serum tumour necrosis factor-alpha, interleukin (IL)-1-beta and IL-6 levels, while no significant changes were observed in the control group. Although between groups did not show statistically significant, the mean values indicated a consistent downregulation of proinflammatory markers over time in the yoga group. Conclusion: Incorporating yoga as a complementary therapy alongside conventional BC treatment significantly improved the health outcomes of BC patients by modulating proinflammatory markers.

Myocardial blood flow in newly diagnosed breast cancer patients at rest and during exercise

The heart depends critically on continuous blood supply, but it is unknown whether cancer itself affects myocardial blood flow (MBF). This study investigated MBF in cancer patients and cardiac morphology in a cancer mice model. MBF was quantified with [15O]H2O positron emission tomography at rest in recently diagnosed breast cancer patients and age-matched female controls, and additionally during 10-min exercise in the cancer patients. Cardiac morphological changes were analyzed with a breast cancer mouse model and control mice without tumors. Resting MBF was similar in cancer patients and controls. MBF increased significantly during exercise in cancer patients, and exercising MBF correlated positively with cancer grade. In the mouse model, cancer did not affect heart weight, cardiomyocyte size, myocardial capillary density, or capillary-to-myocyte size ratio. Thus, resting MBF in humans or myocardial capillarity in mice appears not to be affected by breast cancer. The exercise-induced MBF increase in cancer patients with higher histologic grade requires further investigations.

Associations Between Domain-specific Physical Activity Levels And Physical Characteristics Of Behavior In Newly Diagnosed Breast Cancer Patients

Associations Between Domain-specific Physical Activity Levels And Physical Characteristics Of Behavior In Newly Diagnosed Breast Cancer Patients

Impact of 18FDG PET/CT on Clinical Management, Cost Effectiveness, and Radiation Exposure in Newly Diagnosed Breast Cancer Patients.

For the initial staging of breast cancer (BC), 18FDG PET/CT is recommended by professional guidelines in stage III (except T3N1) and inflammatory BC (T4d) and optional when conventional imaging is equivocal or suspicious. However, growing evidence also supports its role in the staging of intermediate-risk groups (IIA, IIB, T3N1 of IA). This study aimed to compare the impact of 18FDG PET/CT with conventional imaging (CT-chest+abdomen+pelvis and bone scan; CT-CAP+BS) in staging, cost-effectiveness, and radiation exposure in the initial staging of BC. A retrospective study (April 2020 2024) included 115 biopsy-proven BC patients who had CT-CAP+BS and 18FDG PET/CT for initial staging. Data were analyzed to see the impact of 18FDG PET/CT on change in staging, cost-effectiveness, and radiation exposure compared to CA-CAP+BS. Out of 115 patients (113 female and 02 male), 110 had unilateral and 5 had bilateral BC (Invasive Ductal Ca. 107; Non-IDC: 08) with non-significant laterality. The overall upstaging rate for regional nodal and/or distant metastases was 36% (24/66; excluded 49 with stage IV). The overall upstaging rate due to unsuspected higher nodal metastases was 20% (predominantly stage IIA, and IIB). Upstaging rate to stage IV was seen in 17% (11/66; predominantly in IIIA-C). The overall concordance (no change in staging) was seen in 64% (42/66) while no downstaging was found in any patient. In patients with stage-IV disease (n = 49), 18FDG PET/CT identified a higher number of hypermetabolic lesions in 18 (37%), lesser in 07 (14%), and similar in 24 (49%) cases. The estimated cost in Pak rupees for CT-CAP+BS and PET/CT was 139000 and 106000 respectively. The mean effective dose imparted by 18FDG PET/CT was 8.85 mSv compared to the reported 26.6 mSv by CT-CAP+BS. We conclude that in the initial staging of BC, 18FDG PET/CT compared with CT-CAP+BS has a significant impact on decision-making by upstaging the disease in stage II and III and detecting more metastatic lesions in stage-IV disease. Furthermore, 18FDG PET/CT is more cost-effective and imparts significantly lower radiation exposure as compared with CT+CAP+BS. These findings support the inclusion of 18FDG PET/CT in the initial staging of stage II-IV BC.

Model of Health-Related Quality of Life in Breast Cancer Patients Using Cross-Sectional Data: The Role of Resilience.

Resilience has been suggested as an important predictor of both physical and mental health-related quality of life in breast cancer patients. However, it is unclear why resilient women handle their diagnosis better, not only mentally, but also physically. The aim of this study was to investigate paths between resilience, physical activity, and mental, physical, and global health-related quality of life in breast cancer patients. Structural equation modeling was conducted to evaluate the proposed structural paths using a sample of 638 women with newly diagnosed breast cancer patients from Sweden. Resilience was directly associated with physical activity and mental health-related quality of life. It was indirectly associated with physical functioning, through mental health-related quality of life and physical activity. Resilience was also indirectly associated with global quality of life, through mental health-related quality of life. Mental health support and encouraging physical activity may be especially relevant to enhance all aspects of health-related quality of life early in the breast cancer process. Results should be replicated longitudinally.

Age, Onset, and Tumor Size Differences in Newly Diagnosed Breast Cancer Patients Before and During the SARS-CoV-2 Pandemic at Siloam Hospital Lippo Village (April 2019 – December 2020)

&lt;p&gt;&lt;strong&gt;Background:&lt;/strong&gt; The current pandemic condition has caused delays in cancer treatment therefore surveillance should be increased.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods:&lt;/strong&gt; By total sampling, this retrospective cross-sectional study enrolled 108 samples, who were newly diagnosed breast cancer patients at the outpatient department of Siloam Hospital Lippo Village (April 2019 - December 2020). Data obtained from medical records and interviews from December 2020 – February 2021.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Result:&lt;/strong&gt; From the total of 108 samples which consisted of 54 samples before the pandemic (April 2019 – February 2020) and 54 samples during the pandemic (March 2020 – December 2020), accompanied by an increasing trend. The age during pandemic was younger than before pandemic (51,167 years old ± 11,255 vs 47,537 years old ± 9,824, p value=0,038), the tumor size during pandemic was bigger than before pandemic (3,403 cm ± 3,024 vs 4,262cm ± 4,212, p value=0,046) but the onset of patient during pandemic was not longer than before pandemic (281,69 days ± 401,387 vs 178,09 days ± 292,563, p value=0,036).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Newly diagnosed patients have younger age and larger tumor size during pandemic when we compare to before pandemic period, but no difference in onset term. Surveillance to society is needed to ensure older people with smaller tumor size to seek medical attention.&lt;/p&gt;

Higher Incidence of Anemia and Clinical Utility of Indices of Iron Homeostasis in Newly Diagnosed Breast Cancer Patients: A Cross-Sectional Study from a Regional Oncology Centre of South India

Higher Incidence of Anemia and Clinical Utility of Indices of Iron Homeostasis in Newly Diagnosed Breast Cancer Patients: A Cross-Sectional Study from a Regional Oncology Centre of South India

Insomnia prehabilitation in newly diagnosed breast cancer patients: Protocol for a pilot, multicentre, randomised controlled trial comparing nurse delivered sleep restriction therapy to sleep hygiene education (INVEST trial).

Insomnia is a prevalent sleep disorder that negatively impacts daytime functioning and quality of life. Breast cancer patients report higher rates of insomnia and more circadian disruption than other cancer groups. Approximately 50% of patients experience acute insomnia following breast cancer diagnosis, which often persists during cancer treatment and rehabilitation. Sleep Restriction Therapy (SRT) is a clinically effective and tolerable treatment for persistent insomnia in breast cancer survivors. However, SRT has never been tested on patients with early signs of sleep disturbance who are undergoing cancer treatment. The aim of this pilot randomised controlled trial is to explore the feasibility and preliminary effectiveness of nurse delivered SRT for newly diagnosed breast cancer patients with acute insomnia. The trial has been registered on ClinicalTrials.gov (identifier: NCT06294041). The INVEST (INvestigating the Value of Early Sleep Therapy) trial will recruit 50 newly diagnosed breast cancer patients who meet criteria for acute insomnia. Patients will be recruited from breast cancer results clinics within two Scottish health boards (NHS Grampian and NHS Greater Glasgow and Clyde) and will be block randomised (1:1) to receive nurse delivered SRT or Sleep Hygiene Education (SHE). SRT will be delivered over 4 weekly sessions comprising two face-to-face meetings (either in person or online) and two telephone calls, whereas SHE will be administered in booklet form. Outcomes will be collected at baseline, 6 weeks, and 12 weeks post-randomisation. Primary outcomes in this trial relate to the feasibility of SRT for newly diagnosed breast cancer patients with acute insomnia. Specifically, we will explore (i) rates of patient recruitment and retention, (ii) intervention fidelity, (iii) data collection procedures and outcome measure completion, (iv) intervention acceptability. Secondary outcomes will focus on preliminary evaluation of patient responses to SRT, including insomnia severity, rest-activity rhythms, and mental health. Our dissemination plan comprises publishing trial outcomes in high-impact, peer-reviewed journals and on breast cancer charity websites and other patient resources. The outcomes from this pilot trial will also inform the development of a full-scale, multicentre RCT of SRT for acute insomnia in newly diagnosed breast cancer patients. University of Strathclyde is the sponsor (reference: UEC23/52). Protocol version v1.2 4 October 2023. This trial is the first to explore the value of sleep prehabilitation for newly diagnosed breast cancer patients.This will be the first trial to assess the feasibility of delivering SRT during breast cancer treatment, providing valuable insight into its tolerability and preliminary effectiveness.An embedded process evaluation will assess the acceptability of SRT, providing insight into potential optimisation of the intervention and recommendations for enhancing its future scalability and translation within cancer care.Due to the nature of the SRT intervention, nurse therapists and patients cannot be blinded to treatment allocation, increasing the risk of bias.

The Construction of Peer Support Among Recently Diagnosed Breast Cancer Patients.

Breast cancer (BC) and its treatments decrease patients' psychological well-being. Peer support is one form of social support, but little is known about what gives rise to peer support. The purpose of this study was to examine how peer support is constructed among recently diagnosed BC patients. Eighteen women were randomly picked from 130 women who had received phone calls from a trained peer supporter and were invited to group interviews. In the interviews, patients discussed their cancer, peer support experiences, and social support. The transcribed data were analyzed using Braun and Clarke's thematic analysis approach. The construction of peer support among newly diagnosed BC patients was complex. It depended on the needs of the patient and the success of interactions. Once they had received a diagnosis, the lives of the patients changed suddenly, and patients dove into the I-we-others consideration and had a need to talk. Interaction with peer supporters gave them a chance to share their stories. At their best, interactions led to belonging, caring, and a sense of security. The need to be heard and seen is strong in a patient's changing health situation. Peer support plays an important role in high-standard care and in strengthening patients' self-determination. Hospitals should create chances for supportive communication, and the supportive communication should be easily accessible and successful. The training of peer supporters should ensure that they have reflected on their own BC process and know how to consider the needs of newly diagnosed patients.

Reliability of Kaiser Score in Assessing Additional Breast Lesions Identified on Staging MRI in Patients with Breast Cancer.

(1) Background: The Kaiser score is a user-friendly tool that evaluates lesions on breast MRI and has been studied in the general population and a few specific clinical scenarios. We aim to evaluate the performance of the Kaiser score in the characterization of additional lesions identified on staging breast MRI. (2) Methods: The Kaiser score of the biopsied additional lesions identified on staging MRI in recently diagnosed breast cancer patients was retrospectively determined. Statistical analysis was performed to evaluate the diagnostic capability of the Kaiser score and whether it is affected by different imaging and pathological parameters of the additional and the index lesion. (3) Results: Seventy-six patients with ninety-two MRI-detected lesions constitute the studied population. There was a statistically significant difference in the Kaiser score between benign and malignant lesions, irrespective of the pathology of the index cancer (p = 0.221) or the size and the imaging features of the additional lesion. Using a cutoff of 5 and above for suspicious lesions, biopsy could have been avoided in 34/92 lesions. (4) Conclusions: The Kaiser score can assist radiologists in the evaluation of additional MRI lesions identified in recently diagnosed breast cancer patients, thus decreasing the number of unneeded biopsies and delays in definitive surgical management.

Coconut Milk Consumption and Breast Cancer Risk in Thai Women: A Case-Control Study

Coconut milk contains plant-based saturated fat and phytochemicals with antioxidant activities. However, its role in breast cancer risk remains unclear. A case-control study was conducted on 244 participants to study the association. The Case group includes 61 newly diagnosed breast cancer patients receiving < 6 months of therapies. The Control group includes 183 healthy people with matched characteristics. A new questionnaire was developed, validated, and used in this study to estimate the frequency of coconut milk-containing food intake. Results show that the questionnaire has satisfactory content validity, test-retest reliability, and criterion-related validity. From the case-control study, either consuming 1–3 or 4–6 times/week of coconut-milk-containing curry or consuming 4–6 times/week of coconut milk-topped desserts are associated with increased risk of breast cancer (OR = 5.23, 5.6, and 2.6 respectively, p < 0.01). Consuming less than half of coconut milk liquid in desserts correlated with a reduced risk (OR = 0.43, p < 0.05). The findings suggest that moderate (less than half of a serving) and infrequent (less than once a week) consumption of coconut milk may be beneficial for breast cancer prevention. A larger scale study is warranted to confirm the findings and provide evidence for dietary recommendations.

Development and validation of an artificial intelligence model for predicting de novo distant bone metastasis in breast cancer: a dual-center study

ObjectiveBreast cancer has become the most prevalent malignant tumor in women, and the occurrence of distant metastasis signifies a poor prognosis. Utilizing predictive models to forecast distant metastasis in breast cancer presents a novel approach. This study aims to utilize readily available clinical data and advanced machine learning algorithms to establish an accurate clinical prediction model. The overall objective is to provide effective decision support for clinicians.MethodsData from 239 patients from two centers were analyzed, focusing on clinical blood biomarkers (tumor markers, liver and kidney function, lipid profile, cardiovascular markers). Spearman correlation and the least absolute shrinkage and selection operator regression were employed for feature dimension reduction. A predictive model was built using LightGBM and validated in training, testing, and external validation cohorts. Feature importance correlation analysis was conducted on the clinical model and the comprehensive model, followed by univariate and multivariate regression analysis of these features.ResultsThrough internal and external validation, we constructed a LightGBM model to predict de novo bone metastasis in newly diagnosed breast cancer patients. The area under the receiver operating characteristic curve values of this model in the training, internal validation test, and external validation test1 cohorts were 0.945, 0.892, and 0.908, respectively. Our validation results indicate that the model exhibits high sensitivity, specificity, and accuracy, making it the most accurate model for predicting bone metastasis in breast cancer patients. Carcinoembryonic Antigen, creatine kinase, albumin-globulin ratio, Apolipoprotein B, and Cancer Antigen 153 (CA153) play crucial roles in the model’s predictions. Lipoprotein a, CA153, gamma-glutamyl transferase, α-Hydroxybutyrate dehydrogenase, alkaline phosphatase, and creatine kinase are positively correlated with breast cancer bone metastasis, while white blood cell ratio and total cholesterol are negatively correlated.ConclusionThis study successfully utilized clinical blood biomarkers to construct an artificial intelligence model for predicting distant metastasis in breast cancer, demonstrating high accuracy. This suggests potential clinical utility in predicting and identifying distant metastasis in breast cancer. These findings underscore the potential prospect of developing economically efficient and readily accessible predictive tools in clinical oncology.

Did the Coronavirus Disease 2019 (COVID-19) Pandemic Cause a Delay in the Diagnosis of Breast Cancer Patients?

Introduction The coronavirus disease 2019 (COVID-19) outbreak, first reported in Wuhan, China, in December 2019, quickly hit the world in just one month, causing a global public health emergency. We aimed to investigate whether the COVID-19 pandemic caused a delay in the hospital admissions of breast cancer patients and diagnosis of breast cancer, thus increasing the tumor size and the stage of the disease. Materials and methods Included in the study were patients who underwent breast cancer surgery between 01/03/2019 and 01/03/2020 (pre-COVID-19, first period) and between 01/03/2020 and 01/03/2021 (post-COVID-19, second period). Three hundred and seventy patients with enough details were included, and details were analyzed retrospectively. Tumor characteristics of pre-COVID-19 breast cancer patients were compared with the tumor characteristics of post-COVID-19 breast cancer patients. Demographics, preoperative diagnosis, tumor properties, surgical procedure (breast-conserving surgery, modified radical mastectomy, simple mastectomy, skin-sparing mastectomy), tumor size, total lymph node number, metastatic lymph node number, locally advanced disease, metastatic disease, and neoadjuvant therapy were evaluated. Results The mean tumor size increased significantly in the post-COVID-19 primary surgery group (p=0.005). There is no significant relationship between the pre-COVID-19 and post-COVID-19 period and pT in the neoadjuvant received group (p>0.05). The presence of pT2+pT3+pT4 was statistically significantly higher in the post-COVID-19 primary surgery group (p=0.001). The mean value of metastatic lymph nodes dissected between pre-COVID-19 and post-COVID-19 primary surgery groups increased significantly (p=0.010). Pericapsular extension was higher in the post-primary surgery group (p=0.002). Conclusion During the COVID-19 outbreak, breast cancer patients have difficulty accessing healthcare services and hesitate to apply to hospitals to fear contracting the COVID-19 disease. This situation has led to delays in diagnosing breast cancer patients, increased tumor size and pT grade, increased number of metastatic lymph nodes, pericapsular extension, and the resulting disease often appearing in advanced sizes and stages.

Integration and Outcomes of Universal, Multigene Panel Testing for Newly Diagnosed Breast Cancer Patients at a Community Healthcare System

Integration and Outcomes of Universal, Multigene Panel Testing for Newly Diagnosed Breast Cancer Patients at a Community Healthcare System

Ki-67 expression and its correlation with clinicopathological parameters in Iraqi breast cancer patients

Breast cancer is the most common cancer worldwide and the major cause of cancer-related death among women in both developed and developing countries. In Iraq, breast cancer accounted for 37.9% of all malignant cases in 2020 and 15.3% of cancer-related fatalities. Relevant biomarkers play an important role in predicting prognosis and deciding the most effective therapy for each patient to delay metastases and reduce mortality. Objective: This study aimed to assess the significance of Ki-67 expression as a prognostic biomarker in breast cancer patients as well as investigate the correlations between Ki-67 and their clinicopathological features. Methods: The case-control study comprised sixty newly diagnosed breast cancer patients and ten women with benign breast tumors who served as controls. We assessed the tissue expression level of Ki-67 protein using the immunohistochemistry technique. Results: Our results showed that the median immunohistochemical expression scores of Ki-67 in the newly diagnosed breast cancer group were higher than those of the control group; the difference was significant (p &lt; 0.001). The Ki-67 expression score in breast cancer cells increases with tumor size and grade. Ki-67 expression showed a substantial negative correlation with estrogen receptor expression and a significant positive correlation with HER2 expression.

Lifestyle Behaviors and Needs After Breast Cancer Diagnosis: A Qualitative Assessment.

There is a need to gain a deeper understanding of facilitators and barriers involving lifestyle behaviors among newly diagnosed breast cancer patients. Design: Research team explored influences (e.g., social, cultural, environmental) for healthy lifestyle behaviors (nutrition, physical activity (PA), and self-care). One researcher conducted semi-structured interviews. Qualitative data were analyzed through content analysis. Demographic data were collected via survey, and descriptive statistics were generated. Patients were recruited, and interviews conducted via Zoom or phone. Twenty-eight newly diagnosed, treatment naïve breast cancer patients were interviewed, a majority were non-Hispanic White women (n=23; 82%) with invasive (n=14; 50%) breast cancer. Themes related to nutrition, PA, and self-care emerged, including influences (e.g., environmental, cultural, social), barriers, facilitators, and lived experiences. Most patients stressed the importance of maintaining healthy eating habits (n=23), and some were interested in understanding the relationship between nutrition and cancer (n=7). Sixteen reported sustaining their PA levels, while others (n=11) explained barriers, such as time, distance, and pain. All patients reported utilizing self-care strategies, and most reported increased engagement in self-care since being diagnosed (n=14). This study sheds light on factors influencing and hindering the adoption of healthy eating, PA, and self-care strategies among newly diagnosed breast cancer patients. The findings reflect the importance of healthy lifestyle behaviors as critical areas for upstream intervention.

P-367 Letrozole or Tamoxifen co-administration during fertility preservation of breast cancer patients: a retrospective cohort study

Abstract Study question How do fertility preservation (FP) outcomes differ between breast cancer patients stimulated with FSH and Tamoxifen versus FSH and Letrozole? Summary answer Letrozole and Tamoxifen co-administration yielded similar number of retrieved and cryopreserved oocytes/embryos, as well as similar oocyte maturation and fertilization and rates. What is known already Oocyte/embryo cryopreservation is recommended before initiation of chemotherapy in cancer patients. The co-administration of Tamoxifen, a selective estrogen receptor modulator, or Letrozole, an aromatase inhibitor, during ovarian stimulation with gonadotropins, are used to limit the potentially harmful effects of a supra-physiological rise in estrogen levels on hormone-sensitive cancers. However, the optimal choice between the two is still unclear and with no sound evidence. Study design, size, duration Retrospective cohort study of all FP treatments of newly diagnosed breast cancer patients in two tertiary centers between 2000-2022. Collected data included 354 FP cycles of 290 patients and compared treatment parameters and outcomes of Tamoxifen or Letrozole co-administration. Participants/materials, setting, methods Breast cancer patients who underwent FP before chemotherapy were included. Patients with a history of radiation or gonadotoxic treatment, as well as those undergoing other fertility preservation treatments, such as ovarian tissue cryopreservation were excluded. Main results and the role of chance Overall, 215 Letrozole and 139 Tamoxifen treatment cycles were compared, with no significant demographic differences. Treatments with Letrozole had higher FSH dosages (3970IU vs. 2839IU, p &amp;lt; 0.001) but shorter duration (9.7 vs. 10.5 days, p &amp;lt; 0.001). The Letrozole group achieved lower peak E2 levels and endometrial thickness (1508pmol/L, 8.1mm vs. 8760pmol/L, 9.5mm, p &amp;lt; 0.001). The mean number of retrieved oocytes was comparable between the groups (13.6 with Letrozole vs 14.7 with Tamoxifen, p = 0.06). In 122 Letrozole and 46 Tamoxifen patients that underwent strictly oocytes cryopreservation the mean number of cryopreserved oocytes was comparable (11 vs. 12.1, p = 0.21). Moreover, in embryo cryopreservation cycles of 71 patients treated with Letrozole compared to 76 patients with Tamoxifen, no difference was observed in the number of cryopreserved embryos (6.2 vs. 7.0, p = 0.12). Oocyte maturation rate among strictly oocyte preservation cycles was comparable (86% with Letrozole vs. 83% with Tamoxifen, p = 0.80), as were fertilization rates in embryo cryopreservation cycles (62% vs. 63%, p = 0.8 and 71% vs. 76%, p = 0.3 in IVF and ICSI with Letrozole and Tamoxifen, respectively). Multivariate analysis, controlling for potential confounders showed no significant correlations between Tamoxifen or Letrozole co-administration and the number of retrieved oocytes or oocyte maturation rate. Limitations, reasons for caution The primary limitation of our study is its retrospective design and the variation in treatment duration and gonadotrophin dosages among groups. Wider implications of the findings This study provides reassurance that both Tamoxifen and Letrozole are equally effective options when co-administered in FP treatments of breast cancer patients. Trial registration number not applicable

The effect of exercise and disease status on mobilization of anti-tumorigenic and pro-tumorigenic immune cells in women with breast cancer.

Mobilization of certain immune cells may improve the ability of the immune system to combat tumor cells, but the effect of acute exercise on mobilizing immune cells has been sparsely investigated in cancer patients. Therefore, we examined how acute exercise influences circulating immune cells in breast cancer patients. Nineteen newly diagnosed breast cancer patients aged 36-68 performed 30 minutes of moderate-intensity exercise with a cycle ergometer. Blood samples were collected at various time points: at rest, at 15 (E15) and 30 minutes (E30) after onset of the exercise, and at 30 and 60 minutes post-exercise. We analyzed several immune cell subsets using flow cytometry. Acute exercise increased the number of total leukocytes, neutrophils, lymphocytes, monocytes, basophils, total T-cells, CD4+ T-cells, T helper (Th) 2-cells, Th 17-cells, CD8+ T-cells, CD4-CD8- T-cells, CD56+ natural killer (NK) cells, and CD14-CD16+ monocytes. Many of the changes were transient. Proportions of NK-cells and CD8+ T-cells increased, while the proportion of myeloid derived suppressor cells (MDSCs) reduced, and proportion of regulatory T-cells remained unchanged by exercise. Several associations were detected between cell mobilizations and disease state. For instance, tumor size correlated negatively with NK cell mobilization at E15, and progesterone receptor positivity correlated negatively with CD8+ T-cell mobilization. The findings show that the proportions of CD8+ T-cells and NK cells increased and the proportion of MDSCs proportion decreased in breast cancer patients after 30-minute exercise, suggesting a change in the profile of circulating immune cells towards more cytotoxic/anti-tumorigenic. The mobilization of some immune cells also appears to be related to the disease state.