Fibroadenoma Group Research Articles

Expression of immune checkpoint markers in peripheral blood lymphocytes of women with fibroadenoma of the breast

Changes of the immune state in patients with fibroadenoma (FA) or other benign lesions of the breast, as well as the involvement of immune checkpoints in pathogenesis of these lesions, remain underexplored. The aim of this study was to compare the expression level of the key immune checkpoint markers CD279/PD-1, CD274/PD-L1, CD366/TIM3, and CD223/LAG3 in total circulating lymphocytes, T cell population as well as in its CD4 and CD8 subsets in peripheral blood from women with breast FA and healthy controls. Blood samples were taken from 12 women diagnosed with FA of the breast (aged 23-54 years, FA group) and 15 healthy women (aged 22-52 years, control group). Sample uptake was performed immediately before surgery, and samples were further analyzed by multicolor flow cytometry using monoclonal antibodies CD3-VioBlue, CD4/CD8-FITC, PD1-PE, PD-L1-PerCP-Cy.5.5, and TIM3/LAG3-APC. Each sample was incubated with 4 antibody combinations: CD3/CD4/PD1/PD-L1/TIM3, CD3/CD4/PD1/PD-L1/LAG3, CD3/CD8/PD1/PD-L1/TIM3, and CD3/CD8/PD1/PD-L1/LAG3. First, mono-expression of each of the 4 immune checkpoint markers was evaluated in the lymphocyte gate from both investigated groups. In FA samples, a significant increase in PD-L1 expression (assessed as percent of positive cells and fluorescence intensity change) was observed. Regarding expression of immune checkpoints in CD3+ T cells, along with significantly increased %PD-L1+, elevated numbers of PD1+T cells were detected. As for the differences in immune checkpoint expression changes between CD4+ and CD8+ T cell subsets, FA patient group demonstrated a more prominent increase in the amount of CD8+PD1+T cells relative to CD4 subset. The profiles of PD-L1 changes in CD4 and CD8 subpopulations were comparable showing, in both cases, a significant increase in FA sample group. We also analyzed changes in co-expression of any two immune checkpoint markers in CD4+ and CD8+ T cell subsets. The most noticeable was as increase in the prevalence of PD1+PD-L1+ phenotype in both T cell subpopulations from FA patients compared to the controls. With respect to co-expression of 3 checkpoint markers in CD4+ and CD8+ T cells, a significant increase in the percentage of PD1+PD-L1+TIM3+ cells among CD4 T helpers was found in FA. Thus, specific changes of T cell phenotype related to (co-)expression of immune checkpoint regulators may occur in systemic circulation of women with breast FA.

Association of Weight Indicators, Dietary Habits, and Physical Activity With Common Benign Breast Diseases

Benign breast diseases (BBDs) are 10 times more common than breast cancer, and fibroadenoma (FA) and fibrocystic disease (FCD) are the most frequent. The association of BBD with physical activity (PA), weight indicators, and diet was investigated. Eligible women were entered in the FA, non-FA, FCD, and non-FCD groups. A PA and a food questionnaire were completed and anthropometric measures were taken and 779 women were studied. There was no significant difference regarding weight indicators and PA between the groups. Contrary to the general assumption, chocolate, tea, and coffee do not increase BBD, while chicken may elevate the risk.

Investigation of the miR-637 and miR-523-5p as candidate biomarkers in breast cancer.

The distinction of benign lesions from malign tumors is crucial for the diagnosis and treatment of breast cancers. The aim of this study was to investigate the use of miRNAs as plasma biomarkers for the discrimination of malign and benign breast tumors. Whole blood samples obtained from 40 individuals in 3 groups designated as invasive ductal carcinoma group, fibroadenoma group and healthy controls were included in this study. The expression levels of 372 miRNAs were determined using RT-PCR. Results: The comparison of fibroadenoma group with healthy controls revealed an upregulation of thirty miRNAs and downregulation of twenty-nine miRNAs. The comparison of invasive ductal carcinoma (IDC) group with controls has shown that eight miRNAs were upregulated while eleven miRNAs were downregulated. When comparing IDC and fibroadenoma groups, 15 miRNAs were found to be upregulated, while 10 miRNAs were downregulated. Further analysis of these miRNAs aimed to determine their power in distinguishing IDCs from fibroadenomas. Among the miRNAs analyzed, seven miRNAs have shown sufficient discriminative power, of which three miRNAs, namely miR-637, miR-523-5p and miR-490-3p, have shown a significantly high discriminative power. Circulating miR-637 and miR-523-5p combination maybe used to discriminate between invasive ductal carcinomas and fibroadenomas. (Tab. 9, Fig. 4, Ref. 30).

The value of whole-tumor histogram and texture analysis based on apparent diffusion coefficient (ADC) maps for the discrimination of breast fibroepithelial lesions: corresponds to clinical management decisions.

This study aims to comprehensively evaluate the diagnostic value of quantitative parameters extracted from apparent diffusion coefficient (ADC) maps in distinguishing fibroepithelial tumors using whole-tumor histogram and texture analysis. This retrospective study included 66 female patients with single phyllodes tumor (PT) and 29 female patients with single fibroadenoma (FA) who underwent preoperative magnetic resonance imaging. By independently performing whole-tumor histogram and texture analysis based on ADC maps, two radiologists extracted seven histogram parameters and four texture parameters. The extracted parameters were compared using univariate analysis to determine their ability to distinguish FAs from PTs, benign PTs from FAs, as well as benign PTs from borderline and malignant PTs. When FAs and PTs were compared, ADC_skewness values of PTs were significantly lower than those of FAs (p < 0.05), whereas other significant extracted parameter values of PTs were significantly higher than those of FAs (p ≤ 0.001); the area under the curve of significant parameters combined was 0.936. Regarding the differences between FAs and benign PTs, ADC_SD, ADC_95th percentile and ADC_kurtosis of FAs were significantly lower than those of benign PT group, and ADC_skewness was higher than that of benign PT group (all p < 0.05). Furthermore, ADC_SD, ADC_95th percentile and all texture parameters are significantly higher in the borderline and malignant PT group than in FA and benign PT group (p < 0.05). In addition, ADC_kurtosis of malignant PT group was significantly lower than that of borderline PT group (p = 0.045). The extracted whole-tumor histogram and texture features of ADC maps can improve differential diagnosis of breast fibroepithelial tumors and contribute to optimal selection for clinical management of patients with fibroepithelial tumors.

Value of Histogram of Gray-Scale Ultrasound Image in Differential Diagnosis of Small Triple Negative Breast Invasive Ductal Carcinoma and Fibroadenoma.

ObjectiveTo investigate the value of gray-scale ultrasound (US) image histogram in the differential diagnosis between small (≤2.00 cm), oval, or round triple negative breast invasive ductal carcinoma (TN-IDC) and fibroadenoma (FA).MethodsFifty-five cases of triple negative breast invasive ductal carcinoma (TN-IDC group) and 57 cases of breast fibroadenoma (FA group) confirmed by pathology in Hubei cancer hospital from September 2017 to September 2021 were analyzed retrospectively. The gray-scale US images were analyzed by histogram analysis method, from which some parameters (including mean, variance, skewness, kurtosis and 1st, 10th, 50th, 90th and 99th percentile) can be obtained. Intraclass correlation coefficient (ICC) was used to evaluate the inter observer reliability of histogram parameters. Histogram parameters between the TN-IDC and FA groups were compared using independent Student’s t-test or Mann-Whitney U-test, respectively. In addition, the receiver operating characteristic (ROC) curve analysis was used for the significant parameters to calculate the differential diagnosis efficiency.ResultsAll the histogram parameters showed excellent inter-reader consistency, with the ICC values ranged from 0.883 to 0.999. The mean value, 1st, 10th, 50th, 90th and 99th percentiles of TN-IDC group were significantly lower than those of FA group (P < 0.05). The area under ROC curve (AUC) values of mean and n percentiles were from 0.807 to 0.848. However, there were no significant differences in variance, skewness and kurtosis between the two groups (P > 0.05).ConclusionHistogram analysis of gray-scale US images can well distinguish small, oval, or round TN-IDC from FA.

Is there a threshold for red cell distribution width to predict malignancy in breast masses?

Red cell distribution width (RDW) has been shown to have predictive properties in different diseases as well as solid cancers. We aimed to investigate the discriminative properties of RDW in benign and malignant breast lesions. In a retrospective cohort study the files of patients who underwent surgery for fibroadenomas (Group A) and breast cancer with axillary lymph node metastasis (Group B) were reviewed. The pathology reports and laboratory parameters and demographics of the patients were recorded for comparison. The patients were later excluded if they had an hemoglobin level below 12 mg/dl and the outliers were removed for a comparison. Seventy-six patients in the fibroadenoma group and 62 patients in the breast malignancy group were compared for the RDW levels to predict the presence of malignancy. Receiver operating characteristic curves were plotted for RDW and a threshold for prediction of malignancy was calculated. The difference in RDW levels between group A and group B was found to be significant, 13,10% (IQR 12.60 -13.70) versus 13,80% (IQR 13.10-14.40) respectively, P = 0,00. The area under the curve was 0.71 (95% confidence interval 0.62 to 0.79), P = 0,00. For the threshold of 13,75 the positive predictive value was 67.35 (95% CI 55.72 to 77.17) and negative predictive value was 67.42 (95% CI 60.76% to 73.44). The RDW levels, after adjusted for anemia, were found to have a positive prediction for malignancy in more than two thirds of the patients for the level of 13.75%.

Combination of Neutrophil-to-Lymphocyte Ratio and Red Cell Distribution Width With Serum Tumor Markers for the Differential Diagnosis of Breast Cancer and its Association With Pathological Features and Molecular Types

ObjectiveTo explore the neutrophil-to-lymphocyte ratio (NLR), red cell distribution width (RDW) and serum tumor markers as differential diagnostic markers of breast cancer (BC) and breast fibroadenoma (FA) and their associations with histopathological indicators and molecular typing in BC patients. MethodsWe collected pathological and routine clinical test data [NLR, RDW, serum tumor markers (CEA, CA15-3, CA125, CA19-9)] of 653 patients with BC and 100 patients with FA. After identifying indicators with significant inter-group differences, we used ROC curves to determine clinically significant cutoff values. Binary logistic regression analyses and ROC curves were used to analyze combined models for the differential diagnosis of BC and FA. Ordinal multinomial logistic regression analysis was used to explore correlations between routine clinical test indicators and pathological BC features. ResultsThe BC and FA groups had significantly different CEA, NLR, and CA19-9 levels (P < .05), with respective areas under the curve (AUC) of 0.799, 0.747, and 0.711 for differentiating BC from FA and respective optimal cutoff values of 1.35 ng/mL, 1.58, and 8.55 U/mL. Binary logistic regression and ROC curve analysis showed that CEA was superior to the other 2 factors for the differential diagnosis of BC and FA. whereas the combined use of all three indicators was diagnostically most effective (AUC = 0.886; 95% confidence interval: 0.838–0.933, P = .000; sensitivity and/or specificity: 76.5%/88.9%). Ordered multinomial logistic regression analysis showed that NLR, CEA, and CA15-3 correlated positively with BC TNM staging; RDW was negatively correlated with BC histological grade; RDW, CA15-3 and CA125 were obviously associated with BC molecular typing. ConclusionThe combination of CEA, NLR, and CA19-9 may be used to screen and diagnose BC. NLR, CEA and CA15-3 are related to the TNM staging of BC. RDW is related to BC histological grading. RDW, CA15-3 and CA125 are related to BC molecular typing.

Correlation analysis of breast fibroadenoma and the intestinal flora based on 16S rRNA sequencing*

Abstract Objective To analyze the characteristics of the intestinal microflora in patients with breast fibroadenoma using 16S ribosomal RNA (rRNA) high-throughput sequencing. Methods Fecal samples from 20 patients with breast fibroadenoma and 36 healthy subjects were randomly collected and analyzed using high-throughput sequencing technology for 16S rRNA V4 region sequencing, and the alpha diversity (Chao index, Shannon index) was calculated using Mothur (v.1.39.5) software. Beta diversity was analyzed using QIIME (v1.80). SPSS software (version 23.0) and the t-test of two independent samples were used to analyze differences in the abundance of bacteria between the two groups. Results Compared with that in the healthy control group, the α diversity of the intestinal microflora in breast fibroadenoma patients increased, but the difference was not statistically significant (P &gt; 0.05). At the phylum level, significant differences were observed between the two groups. The abundance of Firmicutes was higher in the breast fibroadenoma group (P &lt; 0.05), whereas the abundance of Synergistetes was higher in the healthy control group (P &lt; 0.005). A total of five bacterial genera showed significant differences between the two groups: the breast fibroadenoma group showed higher levels of Bautia (P &lt; 0.005), Coprococcus (P &lt; 0.005), Roseburia (P &lt; 0.05), and Ruminococcus (P &lt; 0.005), whereas Sutterella was more abundant in the healthy control group than in the breast fibroadenoma group (P &lt; 0.05). Conclusion The diversity and abundance of the intestinal flora in patients with breast fibroadenoma are significantly different from those in healthy subjects, suggesting that an imbalance in the intestinal flora is correlated with the occurrence of breast fibroadenoma.

Pattern of breast fibroadenoma in females and its clinical approach: An observational study

Introduction: Comprehensive studies describing the histologic features of fibroadenomas are not available in literature. If hyperplasia behaves in a similar way as in the otherwise normal breast, it may contribute to the higher risk of subsequent invasive breast carcinoma. Hence the aim of this study was to make a thorough inventory of the histologic features of the epithelium and stroma within breast fibroadenomas in a large group of cases.Materials and Methods: The total period of study was 24 months. A total of hundered patients suspected of benign breast diseases were included in the study. After initial evaluation of the patient in the OPD of medical hospital, by senior residents of general surgery, patients with features suggestive of Benign Breast Diseases were subjected to a detailed history and clinical examination.Results: The youngest patients were of age 16 years diagnosed with fibroadenoma and the oldest patient was of age 40 years. The mean age of the patients with fibroadenoma was found to be 24 years. Majority of the lumps 76.19% had a size of 2 to 5 cms. The largest lump in the fibroadenoma group was seen in a 16 years old girl with 8x5 cms. Selected cases of fibroadenoma of 2-3 cms in size were reassured and asked for regular follow-up.Discussion and Conclusion: It has been known for many years that some benign breast lesions are more highly associated with breast cancer than others. In this study the types of benign breast lesions were recorded and the study has shown that benign breast lesions are common in our environment and the age incidence of benign breast lesions peaks in 2nd and third decade and with few exceptions our data was comparable to other studies on breast lesions.

Surgery for fibroadenoma arising from axillary accessory breast

BackgroundPatients with fibroadenomas in axillary accessory breasts (AABs) have a palpable mass, cyclic axillary pain, and aesthetic concerns that must be addressed. We compared the baseline patient characteristics, AAB characteristics, and surgical outcomes of patients with AABs with and without fibroadenomas undergoing surgical excision. We also monitored the patients for recurrence of axillary fibroadenomas.MethodsThis retrospective study involved 2310 women who underwent AAB excision from 2014 to 2019. Patients with and without a palpable fibroadenoma were divided into a fibroadenoma group and non-fibroadenoma group, respectively. All patients underwent complete excision of accessory mammary gland (AMG) tissue, including fibroadenomas in the AABs. We removed the fibroadenoma and the AMG tissue with a minimal axillary incision.ResultsThirty-nine patients had a palpable fibroadenoma in the AAB, and all patients in the fibroadenoma group had cyclic axillary pain and a palpable axillary mass. There were no significant differences in the patients’ age, weight of the AMG tissue, liposuction volume, or fibroadenoma laterality between the two groups. The body mass index in the fibroadenoma group was lower than that in the non-fibroadenoma group (19.9 vs. 22.3 kg/m2, respectively; P < 0.000). Concurrent fibroadenoma excision in a normal breast on the chest was performed more often in the fibroadenoma group than in the non-fibroadenoma group (35.9% (14/39) vs. 4.1% (92/2271), respectively; P < 0.000). The mean fibroadenoma size was 2.1 cm (range, 1.1–9.1 cm). All patients were satisfied with the degree of postoperative pain relief, disappearance of palpable lesions, and cosmetic improvement. No patients developed fibroadenoma recurrence.ConclusionsComplete excision of the AMG tissue and fibroadenoma is appropriate in patients with an AAB with a fibroadenoma. Surgeons should also consider the high incidence of concurrent fibroadenomas in the normal breasts on the chest.

Role of micronucleus assay as an indicator of chromosomal instability in aspirates of breast carcinoma

Background: A micronucleus (MN) is a small additional nucleus, morphologically identical to but smaller than the main nucleus. It is a sensitive indicator of chromosomal instability, and it can be detected in fine-needle aspiration (FNA) smears with the Giemsa stain by light microscopy and the acridine orange (AO) stain by fluorescent microscopy. The objective of this study was to analyze the MN score in FNA smears of patients with breast carcinoma and fibroadenoma (FA). Materials and Methods: This was a prospective observational study which included 78 cases of infiltrating duct carcinoma (IDC) and 82 of FA (as controls). Giemsa- and AO-stained FNA smears were analyzed and MN scores were compared between the IDC and FA cases. Results: The mean MN scores of the FA and IDC groups were 0.28 ± 0.45 and 11.28 ± 7.22 in the AO-stained smears and 0.13 ± 0.34 and 9.79 ± 6.5 in the Giemsa-stained smears (P = 0.0002 and 0.0001), respectively. The MN score increased in a stepwise manner from FA to Grade I, II, and III of IDC in Giemsa-stained smears. Comparisons of mean MN score between FA and the three different grades of IDC and between Grade I and II and Grade III were statistically significant (<0.001 in each category). Although the mean MN score with AO stain was higher than the mean MN score with Giemsa stain, this difference was not statistically significant (P = 0.17). Conclusion: The MN score in FNA smears in the IDC group was significantly higher than in the FA group, suggesting that it can be used as a potential additional surrogate marker for diagnosing and grading breast carcinoma. Both AO and Giemsa stains were equally good for MN scoring of the FNA smears.

Organochlorine Pesticide Tissue Levels in Benign and Malignant Breast Disease: A Comparative Exploratory Study.

Exposure to organochlorine pesticides (OCPs) may be a risk factor for breast cancer (BC). Their role may be more relevant in developing countries such as India, where an abundance of these products is used for agricultural purposes. The present study compares OCP tissue levels in patients who underwent BC surgery (group A) or patients who had surgery for excision of breast fibroadenoma (group B). We perform OCP level quantification using a PerkinElmer, Inc. (Waltham, MA) gas chromatograph (GC) that is equipped with a 63Ni selective electron-capture detector. Significantly higher breast tissue OCP levels are present in the study population, indicating significant exposure. We detect 18 different types of OPCs in study subjects, with six OPCs (γ-hexachlorocyclohexane [HCH], δ-HCH, endrin, endosulfan-II, p,p'-dichlorodiphenyldichloroenthane [DDD], and p,p'-dichlorodiphenyltrichloroenthane [DDT]) present in all subjects. Endosulfan-II, p,p'-DDT, and p,p'-DDD tissue levels are significantly higher in BC patients than in those with fibroadenoma. Higher tissue levels of OCPs (α-HCH) are significantly associated with the presence of extracapsular spread (1.42 vs. 0.91; p = 0.04) and higher disease stage (early BC vs. locally advanced BC; 18.90 vs. 11.90; p = 0.04). The present pilot study indicates higher OCP tissue levels in northern India BC patients compared to patients with fibroadenoma.

A Typical Features of Fibroadenoma, Correlation between Ultrasound and Pathology

Abstract Background Fibroadenomas (FAD) are benign tumors composed of stromal and epithelial elements. These tumors are commonly seen in young women. Multiple or complex fibroadenomas may indicate a slightly increased risk for breast cancer. Aim of the Work To assess the diagnostic accuracy of ultrasound in atypical fibroadenoma. Materials and Methods This retrospective study was approved by Ain Shams radiology department. On the basis of results of core needle or excisional surgical biopsy, we retrospectively identified 40 consecutive patients between October 2017 and October 2018 with the diagnosis of fibroadenoma. Results In our study, we found that The mean age in the simple fibroadenoma group was 29 years (range 18-49), and in the complex fibroadenoma group, it was 38 years (range 17-62) which represents statistically significant difference between the two groups (P =.021). Conclusion Complex fibroadenomas showed some characteristics that could help in differentiating them from their simple counterparts, namely, an irregular shape, noncircumscribed contours, a complex echo structure. The awareness of these distinguishing features could help radiologists decide which fibroadenomas should be sampled.

Role of ormeloxifene in regression of benign breast diseases

Background: Benign breast diseases are common pathological entities with which women in her early reproductive age present to OPD with fear of malignancy and significant morbidity. Except for surgery and use of non-selective estrogen receptor blockers, there are no other treatment options, and these have lot side effects. Ormeloxifene a newer drug has shown promising results with minimal side effects and used as the first line of treatment reducing the morbidity of surgery and subjecting the patient to less hormonal side effects.Methods: Diagnosis of benign breast diseases was made by baseline investigation which included measurement of size of fibroadenoma using Vernier caliper and USG, fibroadenosis,ie nodularity measured using Lucknow-Cardiff scale and VAS score was used for pain assessment of mastalgia after which patients will be given the drug and placebo and the response for the drug and its side effects are noted.Results: 61.9% (44) were diagnosed with fibroadenoma, 16.9% (12) with fibroadenosis and 21.1% (15) with mastalgia. Lucknow Cardiff score for fibroadenosis exhibited 50% had smooth breasts with no nodularity at the end of six months, in fibroadenoma group 52% showed decrease in size and 31% showed complete disappearance of the lump and in the mastalgia group 40% had no pain (VAS score of 0). 16(22.5%) of had menstrual abnormality as the major side effect.Conclusions: Ormeloxifene can be used as the first line of treatment in patients with fibroadenosis and mastalgia and used as an alternative to surgery for fibroadenoma.

Matrix Metalloproteinase-13 (MMP-13): A proposed Tumor Marker in Breast Carcinoma

Breast cancer is estimated to account for 31% new onset female cancers. Matrix metalloproteinases (MMPs) are extracellular zinc-dependent endopeptidases involved in the degradation and remodeling of extracellular matrix in physiological and pathological processes. In this study, we aimed to evaluate the use of matrix metalloproteinase-13 (MMP-13) as a potential tumor marker in breast cancer and we also aimed to investigate the role of infection as a cause of carcinogenesis by estimating the incidence of anti-cytomegalovirus IgG antibodies in breast cancer patients. Subjects and Methods: Serum CA15.3, anti-CMV IgG and MMP-13 were measured in 50 breast cancer female patients, 20 female patients with fibroadenoma of breast and 20 healthy age-matched female volunteers. Results: MMP-13 levels showed no significant difference between breast cancer patients and controls; on the other hand MMP-13 levels were significantly higher in fibroadenoma patients compared to controls. CA15.3 levels were significantly higher in breast cancer cases compared to both fibroadenoma and healthy controls. Conclusion: The results of this study show that MMP-13 level is highest among control group, while fibroadenoma group had the lowest MMP-13 level. CA15.3 is still the most useful serum tumor marker in patients with breast cancer.

Relationship Between ADAMTS8, ADAMTS18, and ADAMTS20 (A Disintegrin and Metalloproteinase with Thrombospondin Motifs) Expressions and Tumor Molecular Classification, Clinical Pathological Parameters, and Prognosis in Breast Invasive Ductal Carcinoma.

BackgroundThe aim of this study was to investigate the correlations between ADAMTSs expression and breast invasive ductal carcinoma (IDC), and to offer a theoretical basis for novel treatment methods for IDC patients.Material/MethodsNon-proliferative catheter of breast fibroadenoma (FA) and IDC were used as the normal control and experimental group, respectively. Immunohistochemical (IHC) staining and Western blot (WB) analysis was used to assess protein expression levels of ADAMTS8, ADAMTS18, and ADAMTS20 in both FA and IDC tissues. The results of IHC, the relationship between the protein expression and the tumor molecular classification, and clinical pathological parameters were all evaluated.ResultsIHC and WB results showed that the expression of ADAMTS8/18 in IDC samples was higher than in FA samples, while the expression of ADAMTS20 in IDC samples was lower than that in FA samples. According to the results of WB, the level of ADAMTS8 was higher in the HER2+ group than in the HER2− group and FA group. The expression of ADAMTS18 in the HR+ (including ER+ and PR+) group was significantly higher than in the HR− group and FA group. The expression of ADAMTS18 protein was also higher in the Ki67+ group than in the Ki67− group. ADAMTS20 was higher in HER2+ IDC compared with the basal subtype of IDC.ConclusionsADAMTS8/18/20 levels were not significantly correlated to the molecular subtype of IDC. ADAMTS18/20 was significantly associated with histological grade of IDC. ADAMTS8 may predict poor prognosis results of IDC patients.

Detection of Human Cytomegalovirus in Malignant and Benign Breast Tumors in Egyptian Women

IntroductionPrevious studies have reported a role for human cytomegalovirus (HCMV) in breast carcinogenesis. We sought to assess the role of HCMV infection in the development and/or progression of breast cancer (BC) among Egyptian patients. Patients and MethodsThe study included 61 patients with BC cases. Of these 61 patients, 40 had been assessed for HCMV in the blood, BC tissue samples, and adjacent non-neoplastic tissue samples, and 21 had been assessed for HCMV in the tissue only. Tissue samples from 20 patients with fibroadenoma (FA) were also included. As a control group, 41 blood samples obtained from healthy women with no history of cancer were used as a blood control group. HCMV was assessed using enzyme-linked immunosorbent assay, real-time polymerase chain reaction (PCR), and immunohistochemistry (IHC). ResultsA significant difference was found in the index value for the anti-CMV IgG antibodies between the BC patients and the control group (P = .001). Using real-time PCR, HCMV DNA was detected in 11 of 61 BC tissues (18%) compared with 1 of 20 FA tissues (5%). HCMV DNA was present in 8 of the 40 plasma samples (20%). Regarding the viral proteins, 21 of 61 samples (34.4%) were positive for early/immediate early (E/IE) and 49 (80.3%) were positive for PP65 expression by IHC. The concordance between the results obtained by the different assays was low. CMVPP65 expression was significantly associated with E/IE protein expression in the malignant and FA groups (P < .001). ConclusionThe presence of CMV proteins and DNA in BC tissues suggests a role for this virus. However, the basic criteria to support a causal association of HCMV with BC were not fulfilled.

Centchroman Regress Mastalgia and Fibroadenoma: An Institutional Study

Objectives: Centchroman (also known as Ormeloxifene) is one of the selective estrogen receptor modulators, or SERMs, a class of medication which acts selectively on the estrogen receptor. Because of its selective antiestrogen action, centchroman has been used for treatment of mastalgia and fibroadenoma. Materials And Methods: Benign breast disease patients up to 35 years of age attending surgery outpatient department from August 2012 to September 2014 and fulfilling inclusion criterion were included in the study. The patients were started on centchroman 30 mg on daily for a period of 12 weeks and were followed at weeks 4, 8, 12, and 24 to assess response to therapy. The Results were recorded as per clinical examination, ultrasonography for breast lump size and visual analog scale (VAS) for pain. Results: A total of 130 patients were included in the study, 88 (67.70%) of whom had mastalgia with or without nodularity, and 42 (32.30%) had fibroadenoma. Noncyclical pain was in 71 patients (80.70%), and cyclical pain was recorded in only 17 (19.30%) patients. A VAS score of 10 was recorded by 62 (70.50%) patients (severe pain), and the remaining 26 patients (29.50%) had VAS score from 7 to 10. Fibroadenoma size ranged from 1.5 to 5 cm, single or multiple in one or both breast. There was a good response in the mastalgia group, with a decrease in the VAS scoring from 10 to 3 in 69 (78.40%) of the patients in the first week. Almost all of the patients were painless at the end of first month, with complete disappearance of the nodularity. In the fibroadenoma group there was a mixed response, with complete disappearance in 21 (35%), partial regression (decrease in volume of fibroadenoma) in 29 (48.30%) and no response at all in the remaining 10 (16.70%) a period of 6 months. There were few side effects with scanty menses or amenorrhea as the only side effect. Conclusions: Centchroman is a safe drug for the treatment of mastalgia and fibroadenoma. It has shown good results in mastalgia and fibroadenoma, is an effective, safe and inexpensive.

A Prospective Study to study the Efficacy and Side Effects of Ormeloxifene in Regression of Mastalgia and Fibroadenoma: Is It the Ideal Drug?

ABSTRACT Ormeloxifene (Centchroman) is a novel nonsteroidal, selective estrogen receptor modulator birth control pill which has also been used recently for the treatment of mastalgia and fibroadenoma. Fibroadenomas are the most common benign breast tumors in women but worrisome for women fearing cancer. Mastalgia whether cyclic or noncyclic may be severely incapacitating for women. This study aims to analyze the effect of this new drug on the regression of mastalgia and fibroadenoma as an alternative to presently available steroid-based drugs with significant side effects. Materials and methods This was a prospective study involving 100 women of reproductive age group (up to 35 years of age) attending the outpatient department (OPD) in Malhotra Nursing Home, Agra and Rainbow Hospital Pvt Ltd., Agra, India, from August 2011 to August 2014, complaining of mastalgia and/ or fibroadenoma and fulfilling the inclusion criteria. After informed consent, these women were divided into a mastalgia group who had mastalgia with or without nodularity and a fibroadenoma group having sizes 1.5 to 2 cm, single or multiple in one or both breasts. Ormeloxifene 30 mg on alternate days was administered for 3 months in both the groups. Patients were followed at 1, 2, 4, 8, 12 and 24 weeks to assess response to therapy. Clinical examination, change in nodularity by palpation, breast lump size by ultrasonography, change in visual analog score (VAS) and breast tenderness were monitored. Results were analyzed using ‘t’ test. Results A total of 100 patients were included in this study. Eighty percent women belonged to the age group 25 to 35 years with a mean age of 28, 31.2 and 27.2 years in groups IA, IB and group B respectively. Mean interval between drug therapy and onset of response was 6 ± 2 days in mastalgia group and 15 ± 2 days in fibroadenoma group. 97.6 to 100% of women in the mastalgia group reported complete relief at 12 weeks of therapy with a decrease in VAS score from 10 to 3 in the first week of therapy itself while 28% of fibroadenoma group reported complete relief at 12 weeks of therapy, partial relief in 31% and equivocal response in 41%. Side effects observed were allergic rash development (2%) and a delay in menstruation of 7 to 10 days (14%) during therapy. Conclusion Ormeloxifene is a novel nonsteroidal drug found to be effective in treatment of mastalgia and partially in treatment of fibroadenoma in a short period of 3 months. As compared to the drugs presently in use namely danazol and bromocriptine, ormeloxifene is safer as suggested by its side-effect profile and is cost-effective too. There is need for prospective large randomized studies to compare this low-cost drug with the standard but costly drugs being prescribed at present. How to cite this article Gupta N. A Prospective Study to Study the Efficacy and Side Effects of Ormeloxifene in Regression of Mastalgia and Fibroadenoma: Is it the Ideal Drug? J South Asian Feder Obst Gynae 2016;8(1):48-56.

Quantitative detection of methylation of FHIT and BRCA1 promoters in the serum of ductal breast cancer patients.

The development of carcinoma has been found to be associated with epigenetic modifications. The aim of this study was to estimate the methylation levels of FHIT and BRCA1 promoters using the bisulphite sequencing method (BSP) and high-resolution melting curve analysis (HRM) in the serum of patients with ductal breast carcinoma as a biomarker for the possible application of early diagnosis of breast cancer. The results showed that the methylation levels of both BRCA1 and FHIT promoters were higher in the serum of the breast ductal carcinoma group (BDC group) than those of the breast fibroadenoma group (BFA group), and the healthy individuals group (HI group). However, the methylation levels of the BRCA1 promoters were very low in all three groups compared to the levels of FHIT. The advanced quantitative detection of the samples with HRM showed that the FHIT promoter methylation level of the cfDNA in each serum was also very high in the BDC group compared to the HI group. The methylation level of FHIT was found to be significantly associated with breast cancer (p < 0.05). In conclusion, the methylation quantitative detection of FHIT promoter in serum may be useful for the early diagnosis of ductal breast carcinoma.