Increased Incidence Of Breast Cancer Research Articles

Abstract 798: Increasing breast cancer incidence across generation status in Mexican American women: The Multiethnic Cohort

Abstract Background: Breast cancer (BC) is the most commonly diagnosed cancer among Latino women in the US. Compared to foreign-born Latino women, US-born Latino women have a higher incidence of BC. While prior studies have suggested this difference in incidence may be explained by risk factors such as unhealthy lifestyle behaviors, reproductive history, and neighborhood socioeconomic status, it is unclear how the risk of BC has changed over generations among Latinos women. In this study, we investigated the association between generational status and BC incidence among Mexican American women within the Multiethnic Cohort (MEC). Methods: The study population included 15,303 self-reported Mexican Americans from the MEC. Generational status was categorized as: 1st generation (Mexico-born, n = 6,347), 2nd generation (US-born with one or two parents born in Mexico, n = 6,390), or 3rd generation (US-born with both parents born in the US, n = 2,566). Multivariable Cox models were used to calculate the hazard ratios (HR) and 95% confidence intervals (CI) of BC incidence by generational status. All models were adjusted for relevant risk factors including age, physical activity, smoking, alcohol intake, education, body mass index, diet, family history of BC, menopausal status, age at menarche, parity, mammography history, hormone use, neighborhood socioeconomic status, and Hispanic ethnic enclave. Results: During an average 21.5-year follow-up, 815 incident BC cases were identified. The age-adjusted incidence rate (per 100,000) of BC increased by generation (1st: 191.9; 2nd: 265.3; 3rd: 284.0). Third (70.4%) and 2nd (66.5%) generations had a larger proportion of localized disease at diagnosis compared to 1st generation women (59.7%). Compared to 1st generation Mexican Americans, 2nd (HR = 1.24; 95% CI: 1.03-1.49) and 3rd generation (HR = 1.28; 95% CI: 1.02-1.60) had elevated risks of BC (p-trend: 0.02) The positive association with generational status remained significant when restricting to women who reported mammogram use (HR 2nd vs. 1st = 1.27, 95% CI: 1.04-1.55; HR 3rd vs. 1st = 1.34, 95% CI: 1.06-1.70) (p-trend: 0.01). Conclusions: Our findings suggest that generational status among Mexican American women is associated with risk of BC, after adjusting for sociodemographic, lifestyle, neighborhood, and reproductive risk factors. Further studies are warranted to discover the potential factors that contribute to this increased risk and elucidate the underlying etiology. Citation Format: Xinman Zhang, Iona Cheng, Adelynn Paik, Brian Huang, Veronica Wendy Setiawan. Increasing breast cancer incidence across generation status in Mexican American women: The Multiethnic Cohort [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 798.

Impact of Alcohol Consumption on Breast Cancer Incidence and Mortality: The Women's Health Study.

Background: Alcohol intake is associated with breast cancer (BC) risk, but estimates of greatest public health relevance have not been quantified in large studies with long duration. Materials and Methods: In this prospective cohort study of 39,811 women (median 25 years follow-up), we examined the association between alcohol consumption and BC incidence and mortality with adjusted hazard ratios (HRs), cubic splines, absolute risks, number needed to harm (NNH), and population-attributable fractions. Results: We documented 2,830 cases of BC, including 237 BC deaths. Each additional alcoholic drink/day was associated with a 10% higher rate (HR = 1.10, 95% confidence intervals [CIs]: 1.04-1.16) of total BC in a linear manner (p = 0.0004). The higher rate was apparent for estrogen receptor (ER)+ (HR = 1.12, 95% CI: 1.06-1.18) but not ER- tumors (HR = 0.95, 95% CI: 0.82-1.10), with a statistically significant difference between these associations (p = 0.03). We constructed models comparing BC incidence among 100,000 women followed for 10 years. Compared to a scenario where all women rarely or never consumed alcohol, we expect 63.79 (95% CI: 58.35-69.24) more cases (NNH = 1,567) had all women consumed alcohol at least monthly and 278.66 (95% CI: 268.70-288.62) more cases (NNH = 358) had all women consumed >1 drink/day. Approximately 4.1% of BC cases were attributable to consumption exceeding one drink/month. Conclusion: Alcohol consumption is associated with a linear dose-response increase in BC incidence even within recommended limits of up to one alcoholic drink/day, at least for ER+ tumors. Our estimates of risk differences, attributable fraction, and NNH quantify the burden that alcohol consumption imposes on women in the general population. ClinicalTrials.gov Identifier: NCT00000479.

CRP, IL-1α, IL-1β, and IL-6 levels and the risk of breast cancer: a two-sample Mendelian randomization study

Epidemiological studies have reported a positive association between chronic inflammation and cancer risk. However, the causal association between chronic inflammation and breast cancer (BC) risk remains unclear. Here, we performed a Mendelian randomization study to investigate the etiological role of chronic inflammation in BC risk. We acquired data regarding C-reactive protein (CRP), interleukin (IL)-1a, IL-1b, and IL-6 expression and BC related to single nucleotide polymorphisms (SNPs) from two larger consortia (the genome-wide association studies and the Breast Cancer Association Consortium). Next, we conducted the two-sample Mendelian randomization study to investigate the relationship of the abovementioned inflammatory factors with the incidence of BC. We found that genetically predicted CRP, IL-6, and IL-1a levels did not increase BC incidence (odds ratio (OR)CRP 1.06, 95% confidence interval (CI) 0.98–1.12, P = 0.2059, ORIL-6 1.05, 95% CI 0.95–1.16, P = 0.3297 and ORIL-1a 1.01, 95% CI 0.99–1.03, P = 0.2167). However, in subgroup analysis, genetically predicted IL-1b levels increased ER + BC incidence (OR 1.15, 95% CI 1.03–1.27, P = 0.0088). Our study suggested that genetically predicted IL-1b levels were found to increase ER + BC susceptibility. However, due to the support of only one SNP, heterogeneity and pleiotropy tests cannot be performed, which deserves further research.

Magnetic resonance imaging-guided radiofrequency ablation of breast cancer: a current state of the art review.

With a gradual increase in breast cancer incidence and mortality rates and an urgent need to improve patient prognosis and cosmetology, magnetic resonance imaging (MRI)-guided radiofrequency ablation (RFA) therapy has attracted wide attention as a new treatment method for breast cancer. MRI-RFA results in a higher complete ablation rate and extremely low recurrence and complication rates. Thus, it may be used as an independent treatment for breast cancer or adjuvant to breast-conserving surgery to reduce the extent of breast resection. Furthermore, with MRI guidance, accurate control of RFA can be achieved, and breast cancer treatment can enter a new stage of minimally invasive, safe, and comprehensive therapy. With progress in MR thermometry technology, the applications of MRI are expected to broaden.

Retracted: Global Increase in Breast Cancer Incidence: Risk Factors and Preventive Measures.

[This retracts the article DOI: 10.1155/2022/9605439.].

Abstract C072: Geographic disparities in age-specific breast cancer incidence trends in the United States, 2001-2018

Abstract Background: Temporal trends in breast cancer (BC) incidence rates are shown to vary by age and race/ethnicity in the United States (U.S.), but less is known about whether these trends also vary by geography. Methods: We used data from the U.S. Cancer Statistics (USCS) database, a population-based surveillance system of cancer registries covering 99% of the U.S. population, to evaluate trends in age-specific BC incidence rates from 2001-2018 by geography. Incidence rates were calculated for 15-year age groups, including 25-39, 40-54, 55-69, and 70-84 years. We calculated age-specific BC incidence rates stratified by state, region (Midwest, Northwest, South, West), and metropolitan or non-metropolitan designation based on Rural-Urban Continuum Codes. We also calculated rates further stratified by race/ethnicity. For each geographic subgroup, we calculated the average annual percent change (AAPC) in BC incidence using Joinpoint software; multiple permutation testing was used to identify inflection points in trends. Results: We found that BC incidence significantly increased from 2001-2018 in 18, 16, 3, and 15 states, respectively, for the age groups of 25-39, 40-54, 55-69, and 70-84 years. BC incidence significantly decreased in 3, 2, 15, and 1 state(s), respectively, for the age groups of 25-39, 40-54, 55-69, and 70-84 years. We identified regional differences in age-specific BC incidence trends from 2001-2018. In the 25-39 years age group, a significant increase in BC incidence was observed in the Northeast (AAPC=0.56), Midwest (AAPC=0.48), and West (AAPC=0.67), but not in the South. The Northeast and Midwest also experienced a significant increase in BC incidence in the 40-54 years age groups (AAPCs=0.52 and 0.38, respectively). The Midwest and West experienced a significant decrease in BC incidence in the 55-69 years age group (AAPCs = -0.35 and -0.89, respectively). The South was the only region to experience a significant increase in BC incidence in the 70-84 years age group (AAPC=0.28). Trends were mostly consistent between metropolitan and non-metropolitan areas within regions, except that BC incidence in the 55-69 years age group significantly increased in non-metropolitan areas of the South (AAPC = 0.27), but not metropolitan areas of the South. Regional differences were also observed when we further stratified BC incidence rates by race/ethnicity. Conclusions: These findings suggest that geography should be considered when measuring and addressing disparities in BC incidence rates. Additional studies are needed to identify the geographically patterned risk factors, such as certain environmental exposures, that may be contributing to these trends in BC incidence rates. Regional differences in screening practices may also be contributing to trends in older age groups. Citation Format: Rebecca D. Kehm, Josephine M. Daaboul, Mary Beth Terry. Geographic disparities in age-specific breast cancer incidence trends in the United States, 2001-2018 [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr C072.

Breast Cancer in the Arabian Gulf Countries.

Breast cancer stands as the prevailing malignancy across all six Gulf Cooperation Council (GCC) nations. In this literature review, we highlighted the incidence and trend of breast cancer in the GCC. Most of the studies reported a consistent increase in breast cancer incidence over the past decades, which was particularly attributed to the adoption of a Westernized lifestyle in the region and the implications of emerging risk factors and other environmental and societal factors, the increase in screening uptake, as well as the improvement in data collection and reporting in the GCC. The data on breast cancer risk factors in the GCC were limited. In this geographic region, breast cancer frequently manifests with distinctive characteristics, including an early onset, typically occurring before the age of 50; an advanced stage at presentation; and a higher pathological grade. Additionally, it often exhibits more aggressive features such as human epidermal growth factor receptor 2 (HER2) positivity or the presence of triple-negative (TN) attributes, particularly among younger patients. Despite the growing body of literature on breast cancer in the GCC, data pertaining to survival rates are, regrettably, meager. Reports on breast cancer survival rates emanating from the GCC region are largely confined to Saudi Arabia and the United Arab Emirates (UAE). In the UAE, predictive modeling reveals 2-year and 5-year survival rates of 97% and 89%, respectively, for the same period under scrutiny. These rates, when compared to Western counterparts such as Australia (89.5%) and Canada (88.2%), fall within the expected range. Conversely, Saudi Arabia reports a notably lower 5-year survival rate, standing at 72%. This disparity in survival rates underscores the need for further research directed toward elucidating risk factors and barriers that hinder early detection and screening. Additionally, there is a pressing need for expanded data reporting on survival outcomes within the GCC. In sum, a more comprehensive and nuanced understanding of breast cancer dynamics in this region is imperative to inform effective strategies for prevention, early detection, and improved patient outcomes.

Physical Activity and Breast Cancer Prevention Among Chinese American Women: A Qualitative Descriptive Study.

Physical inactivity is a modifiable behavioral risk factor for breast cancer. Chinese American women have an increased breast cancer incidence and a low prevalence of meeting physical activity (PA) recommendations, yet little is known about their knowledge and experience regarding PA and breast cancer prevention. Given the significant cultural differences between Eastern and Western societies, effective interventions to promote PA among Chinese American women require understanding their knowledge levels regarding PA in breast cancer prevention and their PA experiences through a cultural lens. This qualitative descriptive study used virtual semi-structured individual interviews to explore Chinese American women's knowledge and perception of PA, their understanding of the role of PA in breast cancer prevention, and influence of culture and acculturation on PA experience. Twenty-one Chinese American women residing in eight states were interviewed. Using thematic analysis, four themes emerged: A limited appreciation of the preventability of breast cancer, variability in PA perception, Chinese culture norms and lifestyles influencing PA behavior, and the influence of the process of acculturation on PA behavior. Chinese American women had a limited understanding of PA in breast cancer prevention. Chinese culture, lifestyles, and traditional Chinese medicine positively and negatively influence Chinese American women's PA behaviors. When exposed to American culture, Chinese American women tended to adopt new PA behaviors, including increasing leisure-time PA while decreasing occupation- and transportation-related PA. Interventions to increase PA and reduce breast cancer risk among Chinese American women should address cultural factors and acculturation along with education and behavioral change strategies.

Severe mental illness and the risk of breast cancer: A two-sample, two-step multivariable Mendelian randomization study.

Based on epidemiological reports, severe mental illness (SMI) and breast cancer (BC) risk are linked positively. However, it is susceptible to clinical confounding factors, such as smoking, alcohol consumption, etc. Here, we performed a two-sample, two-step multivariable Mendelian randomization (MR) research to explore how the SMI etiologically influences BC risk and to quantify mediating effects of known modifiable risk factors. Data concerning the single nucleotide polymorphism (SNP)-associated with schizophrenia, bipolar disorder (BD), major depressive disorder (MDD), and BC were obtained from two large consortia: the Breast Cancer Association Consortium (BCAC) and the Psychiatric Genomics Consortium (PGC). Then, the correlations of the previous SMI with the BC prevalence and the potential impact of mediators were explored through the two-sample and two-step MR analyses. In two-sample MR, schizophrenia increased BC incidence (odds ratio (OR) 1.06, 95% confidence interval (CI) 1.02-1.10, P = 0.001). In subgroup analysis, schizophrenia increased ER+ BC (OR 1.06, 95% CI 1.03-1.10, P = 0.0009) and ER-BC (OR 1.06, 95% CI 1.01-1.11, P = 0.0123) incidences. Neither MDD nor BD elevated the BC risk. In two-step MR, smoking explained 11.29% of the schizophrenia-all BC risk association. Our study indicates that schizophrenia increases susceptibility to breast cancer, with smoking playing a certain mediating role. Therefore, BC screening and smoking should be incorporated into the health management of individuals with schizophrenia.

Effects of organized screening programs on breast cancer screening, incidence, and mortality in Europe

We link data on regional Organized Screening Programs (OSPs) throughout Europe with survey data and population-based cancer registries to estimate effects of OSPs on breast cancer screening (mammography), incidence, and mortality. Identification is from regional variation in the existence and timing of OSPs, and in their age-eligibility criteria. We estimate that OSPs, on average, increase mammography by 25 percentage points, increase breast cancer incidence by 16% five years after the OSPs implementation, and reduce breast cancer mortality by about 10% ten years after.

Сontemporary Medical Decision Support Systems Based on Artificial Intelligence for the Analysis of Digital Mammographic Images

The relevance of implementing artificial intelligence (AI) technologies in the diagnosis of breast cancer (BC) is associated with a continuing high increase in BC incidence among women and its leading position in the structure of cancer incidence. Theoretically, using AI technologies is possible both at the stage of screening and in clarifying BC diagnosis. The article provides a brief overview of AI systems used in clinical practice and discusses their prospects in BC diagnosis. Advances in machine learning can be effective to improve the accuracy of mammography screening by reducing missed cancer cases and false positives.

Evaluation of the Role of Oxidative Stress and Vitamin D in Blood of Breast Cancer Women

Breast cancer is one of the most common cancers in women, and it is the leading cause of cancer-related deaths around the world. It is the most common cancer diagnosed in Iraqi women. The obtained results show an increase in breast cancer incidence. The maximum rate of the disease occurred in women above 48 years. The incidence of cancers is closely related to the age group that was low in age 0-40 and increases rapidly with age increase due to obesity, the incidence of breast cancer increases with age that suggests may be due to DNA methylation which is one of the reasons behind increased BC with age, as it is a normal part of the aging process. The most essential reasons behind increased BC with age among Asians are poverty, poor dietary habits, and unhealthy lifestyle.

Associations between body mass index with cancer recurrence and all-cause mortality among survivors of breast cancer.

12074 Background: It is widely recognized that obesity is associated with increased breast cancer incidence. While body mass index (BMI) does not capture measures of body composition, it is routinely collected during clinical care. However, we do not know whether BMI at breast cancer diagnosis affects cancer recurrence or all-cause mortality. This study aims to investigate the associations between clinical categories of BMI, cancer recurrence, and all-cause mortality in this population. Methods: All breast cancer survivors treated at Northwestern Medicine on or after 1/1/2005 were included. We applied the WHO classification of BMI (kg/m2): underweight ( < 18.5), normal (18.5-24.9), overweight (25-29.9), class I obesity (30-34.9), class II obesity (35-39.9), and class III obesity (≥ 40). Cox proportional hazards models were used to determine the associations between BMI category at baseline and cancer recurrence plus all-cause mortality for breast cancer survivors. Models were adjusted for potential confounders including age, gender, race, ethnicity, histological grade, clinical stage, chemotherapy use, smoking, alcohol use, history of coronary artery disease, and history of Diabetes Mellitus. Results: Among all the 20,322 breast cancer survivors, 1,371 all-cause deaths and 1,183 cancer recurrences were observed. For patients aged 55 and above at diagnosis, there were 964 deaths and 632 cancer among 11,818 cases. When compared with a normal BMI (18.5-24.9), a BMI of 40 and above is associated with a higher risk of all-cause mortality among stage 1 breast cancer survivors (HR 1.90, 95 % CI 1.17-3.09), whereas a BMI of lower than 18.5 is associated with a higher risk of all-cause mortality among stage 4 breast cancer patients (HR 3.21, 95 % CI 1.24-8.30). For cancer recurrence, when compared with a normal BMI (18.5-24.9), a BMI of 40 and above is associated with a higher risk of cancer recurrence among stage 0 breast cancer survivors (HR 3.78, 95 % CI 1.21-11.81) and a BMI of 35 to 39.9 is associated with a higher risk of cancer recurrence among stage 3 breast cancer patients (HR 1.91, 95 % CI 1.01-3.61). We did not observe effect modification for either association by age at diagnosis using a cut-point of 55 years, which is considered as reaching postmenopausal status. Conclusions: Higher levels of obesity are associated with a higher mortality risk among early-stage breast cancer survivors whereas underweight is associated with a higher mortality risk for terminal-stage breast cancer. The associations between high-class obesity and increased risk of cancer recurrence were observed among stage 0 and stage 3 breast cancer survivors. These findings emphasize the importance of BMI as a tool for monitoring the health of breast cancer survivors. However, further study is needed to better understand the impact of BMI, and more importantly body composition, on the health and longevity of breast cancer survivors.

Associations of increasing breast cancer incidence with the current drinking habits and the past smoking habits among Japanese women

Background We have reported that age-specific incidence rates of breast cancer among Japanese women increased from 2005 to 2015 in a bimodal distribution pattern, with two peaks in the pre- and postmenopausal age groups. Objectives The present study aimed to assess the associations of the increasing age-specific breast cancer incidence or mortality with the prevalence of obesity and drinking and smoking habits, compared with those in uterine body, female and male colon and lung cancers. Methods Linear correlations of annual rates from 2005 to 2015 of the 10-year age-specific cancer incidence and mortality with the prevalence of obesity (body mass index, 25 and over) and drinking (alcohol, 20 g and over 3 times or more a week) and smoking habits were assessed by Pearson’s correlation coefficients during the same 10-year period (from 2005 to 2015) or the 10-year period 10 years before the cancer incidence and mortality were noted (from 1995 to 2005). Results Positive correlations (r>0.640) were found between the increasing breast cancer incidence and the drinking habit during the same period or the smoking habit during the period 10 years before. Similar but weaker correlations were found for the breast cancer mortality rate increasing with age. Positive correlations were found between the decreasing male lung cancer mortality rate and the smoking habit rate during the period 10 years before. Conclusions The present ecological study indicated that the breast cancer incidence was associated with the current drinking habits and the past smoking habits among Japanese women.

Risk factors for breast cancer among adult women residing in rural South Karnataka: a cross sectional study

Background: There’s a steady increase in breast cancer incidence among rural women since rural women are increasingly adopting urban lifestyles, reproductive habits and are also increasingly exposed to similar environmental factors as urban women due to economic development. Objectives was to assess the prevalence of risk factors of breast cancer among women aged 30 years and above residing in a rural South Karnataka Methods: This cross-sectional study was conducted from June 2016 to January 2017 in villages under Ittamadu primary health centre area, Ramanagara Taluk, Ramnagara district. A total of 600 women aged 30 years or above participated in the study. A semi structured questionnaire was administered by interview method after getting written consent. Descriptive statistics and Chi-square test was used. Results: This study revealed that the prevalence of risk factors (reproductive and non-reproductive) of breast cancer among adult women aged 30 years and above was between the least prevalence of 0.7% for family history of breast cancer to highest prevalence of 37.5% for age at menarche at less than 13 years of age. Conclusions: Indian breast cancer patients present with advanced disease stage and have numerous poor prognostic factors, hence knowledge regarding the prevalence of risk factors is necessary to identify how many women are at risk of developing breast cancer as per the established risk factors to promote early detection and timely treatment for improved survival and quality of life of breast cancer patients.

Trends in Socioeconomic Inequalities in Breast Cancer Incidence Among Women in Canada.

Breast cancer is the most common cancer among females in Canada. This study examines trends in socioeconomic inequalities in the incidence of breast cancer in Canada over time from 1992 to 2010. A census division level dataset was constructed using the Canadian Cancer Registry, Canadian Census of the Population and National Household Survey. A summary measure of the Concentration index (C), which captures inequality across socioeconomic groups, was used to measure income and education inequalities in breast cancer incidence over the 19-year period. The crude breast cancer incidence increased in Canada between 1992 and 2010. Age-standardized C values indicated no income or education inequalities in breast cancer incidence in the years from 1992 to 2004. However, the incidence was significantly concentrated among females in high income and highly educated neighbourhoods almost half the time in the 6 most recent years (2005-2010). The trend analysis indicated an increase in breast cancer incidence among females living in high income and highly educated neighbourhoods. Breast cancer incidence in Canada was associated with increased socioeconomic status in some more recent years. Our study findings provide previously unavailable empirical evidence to inform discussions on socioeconomic inequalities in breast incidence.

Facing inevitable PARPis resistance: Mechanisms and therapeutic strategies for breast cancer treatment

AbstractBRCA1/2 gene mutations, which result in a dysfunction of homologous recombination repair, have been discovered in at least 5% of breast cancer (BC) patients with the increase in BC incidence in recent years. PARP inhibitors (PARPis), the first drugs with clinical approval based on synthetic lethality, have been approved to treat BRCA1/2‐mutant BC. However, as with other targeted drugs, PARPis drug resistance has become a significant obstacle in the application of PARPis. In this paper, we discuss the mechanism of PARPis, the clinical application of PARPis as monotherapy and the possible induced resistance mechanism. By exploring the resistance mechanism, we aimed to identify appropriate effective therapeutic techniques to overcome PARPis resistance and improve the efficacy of PARPis as well as to provide theoretical and experimental evidence for the clinical use of PARPis in BRCA1/2‐mutant BC.

A review of research on the intersection between breast cancer and cardiovascular research in the Women's Health Initiative (WHI).

Both obesity and metabolic syndrome are linked to increased incidence of type 2 diabetes, cardiovascular disease (CVD), and cancers of the breast (post-menopausal), and other obesity-related cancers. Over the past 50 years, the worldwide prevalence of obesity and metabolic syndrome has increased, with a concomitant higher incidence of associated co-morbidities and mortality. The precise mechanism linking metabolic syndrome to increased cancer incidence is incompletely understood, however, individual components of metabolic syndrome have been linked to increased breast cancer incidence and worse survival. There is a bidirectional relationship between the risk of CVD and cancer due to a high burden of shared risk factors and higher rates of CVD among cancer survivors, which may be impacted by the pro-inflammatory microenvironment associated with metabolic syndrome and cancer-directed therapies. The Women's Health Initiative (WHI) is an excellent resource to study a dual relationship between cancer and CVD (cardio-oncology) with extensive information on risk factors and long-term outcomes. The purpose of this review is to provide an overview of research on cardio-oncology conducted utilizing WHI data with focus on studies evaluating both breast cancer and CVD including shared risk factors and outcomes after cancer. The review also includes results on other obesity related cancers which were included in the analyses of breast cancer, articles looking at cancer after heart disease (reverse cardio-oncology) and the role of Clonal Hematopoiesis of Indeterminate Potential (CHIP) as a shared risk factor between CVD and cancer. A summary of pertinent WHI literature helps to delineate the direction of future research evaluating the relationship between CVD and other cancer sites, and provides information on the opportunity for other novel analyses within the WHI.

Molecular and Immunohistochemical Alterations in Breast Cancer Patients in Upper Egypt.

Breast cancer (BC) plays a major public health in Egyptian woman. In Upper Egypt, there is an increase in incidence of BC compared to other Egyptian areas. Triple-negative BC, estrogen receptor (ER)-negative, progesterone receptor (PR)-negative, and HER2-neu-negative, is a high-risk BC that lacks the benefit of specific therapy that targets these proteins. Accurate determination of Caveolin-1(Cav-1), Caveolin-2 (Cav-2) and HER-2/neu status have become of major clinical significance in BC by focusing about its role as a tumor marker for response to different therapies. The present study was performed on 73 female BC patients in the South Egypt Cancer Institute. Blood samples were used for Cav-1, Cav-2, and HER-2/neu genes amplification and expression. In addition, immunohistological analysis of mammaglobin, GATA3, ER, PR, and HER-2/neu was done. There was a statistically significant association between Cav-1, 2 and HER-2/neu genes expression and the age of patients (P< 0.001). There are increase in the level of Cav-1, 2 and increase in HER-2/neu mRNA expression in groups treated with chemotherapy and group treated with both chemotherapy and radiotherapy compared to each group baseline level of genes mRNA expression before treatment. On the contrary, the group treated with chemotherapy, radiotherapy and hormonal therapy revealed increase on the level of Cav-1, 2 and HER-2/neu mRNA expression when compared with their baseline for the same patients before treatment. Noninvasive molecular biomarkers such as Cav-1 and Cav-2 have been proposed for use in the diagnosis and prognosis for women with BC.

Life Habits, Frequency of Application and Long-Term Exposure to Cosmetic Products Containing Parabens Can Cause Higher Breast Cancer Risk among Women

Background: Modern lifestyle involves everyday use of cosmetic products containing various sources of Endocrine Disruptors (EDs), parabens being the most common ones. Growing cancer burden globally, namely the increased breast cancer incidence, suggests a lifestyle cause. Could the continuous and prolonged exposure to parabens be accountable for the higher breast cancer risk on a global scale? Methods: A Questionnaire was filled out on the subjects' anamnestic data, anthropometric measurements, sociodemographic characteristics, the presence of risk factors for the development of breast cancer, and the beginning and frequency of use of deodorants, body lotions and antiperspirants. Total of seventy-two (n = 72) patients were enrolled in the study. All obtained data was compared with risk factors for the development of breast cancer. Results: Women with breast cancer have longer been exposed to cosmetic products usage (an average of 36 years in total) in comparison to healthy women (an average of 24 years in total). Healthy women tend to start using cosmetic products earlier, at the average age of 16, and tend to use them more often as part of their everyday routine. In contrast, women with breast cancer start later on, at the average age of 19. Conclusion: Our study supports the fact that the most important risk factor for breast cancer is age, but also suggests that long term exposure to parabens could play a crucial role in breast cancer manifestation, even more so at an earlier age. Shift to healthier alternatives to parabens in cosmetic products would contribute to both disease prevention as well as greener environment.