Late Menopause Research Articles

Age of Natural Menopause Among Jordanian Women and Factors Related to Premature and Early Menopause.

ObjectiveThe aim of this study was to assess factors related to the onset of premature/early natural menopause among Jordanian women.MethodsA cross-sectional study was conducted in early 2016. Subjects were enrolled based on random drop-off technique to the Obstetrics and Gynecology clinics at the Jordan University Hospital. Women 18 years of age and above were initially eligible to enroll, and women who had surgically induced menopause or specific disease were excluded from the analysis. Relevant data were collected using a questionnaire that included 30 questions. The following variables were collected: socio-demographic, body mass index, chronic conditions, diseases, reproductive characteristics, and health status. Hormone indicators of menopause were tested by measuring estrogen (E2) and follicle-stimulating hormone (FSH) levels. Age at natural menopause (ANM) was self-reported retrospectively and considered an independent variable against BMI, smoking, hormone therapy, and concomitant diseases. Association analysis and multinomial logistic regression were used to examine the associated factors of ANM with adjusted odds ratios (ORs), and their 95% confidence intervals (CIs) were reported.ResultsA total of 409 women were included in the analysis, aged between 20−75 years. The mean ANM in our sample was 48.5±5.0, with 2.7% of the women experienced premature menopause (ANM <40) and 7.8% early menopause (ANM 40–44). Within the menopause women (n=242), the percentage of women who had premature menopause was 4.5%, 13.6% with early menopause, and 21.1% with late menopause (ANM >52). Smoking was the major risk factor for premature/early menopausal age among Jordanian women with an OR of 2.46 (95% CI: 1.08–5.59, p<0.05). On the other hand, women with occasional arthritis symptoms and diseases such as hypertension, diabetes, dyslipidemia, and their combination were associated with average (45–52 years) or late menopause (>52 years).ConclusionSmoking is the main contributor of premature/early menopause in Jordanian women. Increased awareness and public health policy about the adverse effects of smoking on women’s reproductive health are needed.

Epidemiological profile of women with breast cancer in a public hospital in the Federal District of Brazil

Introduction: In Brazil, for the 2020–2022 triennium, the estimated incidence of breast cancer in women was 66,280/year. It is the most incident type of cancer in all Brazilian regions. Several risk factors are associated with the probable etiology of breast cancer, though the complexity of the disease makes it difficult to define its main cause. Objective: To investigate the prevalence of factors associated with breast cancer in an outpatient population at a public hospital in the Federal District, and to verify the epidemiological profile of this population to compare the data obtained with data published in the literature. Method: This is a descriptive cross-sectional study, with 115 participants diagnosed with breast cancer undergoing treatment in a highly complex unit of oncology care in the Federal District between July and October 2020. Data collection was done through a questionnaire. The electronic medical record was consulted to complement the data. Results: The majority of women were brown, married, with an average age of 52. Hormone therapy was reported by 73.9%, early menarche by only 33.9% and late menopause by 25.2%. Most had children before the age of 30 and more than 80% breastfed. A family history of breast cancer was present in 30.4% of the sample. The consumption of alcoholic beverages was reported by more than half of the women, but the use of cigarettes was denied by the majority. The practice of some physical activity before the diagnosis of cancer was reported by 69.6%. Most were overweight or had some degree of obesity. Non-special invasive carcinoma was the most common type. Conclusions: This study showed that the main factors present in the sample were: advanced age, alcohol consumption, use of hormone therapy and overweight.

Epidemiology and clinical features of patients with breast cancers hospitalized in the Department of Oncology in Fianarantsoa, Madagascar from 2011 to 2018

Introductionà notre connaissance, il s´agit d´une première étude épidémiologique des cancers du sein à Fianarantsoa. Notre objectif était de décrire les caractéristiques épidémio-cliniques de ces cancers au Service d´Oncologie de Fianarantsoa.Méthodesil s´agissait d´une étude rétrospective descriptive au Service d´Oncologie du Centre Hospitalier Universitaire de Tambohobe pendant 8 ans (2011 à 2018). Nous avons inclus toutes les patientes atteintes de cancer du sein avec une confirmation cytologique et/ou histologique. Les paramètres étudiés étaient l´âge, la profession, les antécédents familiaux de cancer du sein, la ménarche, la ménopause, la parité, la prise de contraception orale, le tabagisme, les circonstances de découverte, les symptômes mammaires, les signes d´extension, la localisation tumorale et le stade de la maladie.Résultatsnous avons inclus 62 patientes d´âge moyen de 52,83 ± 10,47 ans. Les femmes au foyer constituaient 39% (n = 24) des cas. Aucune patiente n´avait une ménarche précoce. La ménopause tardive était survenue chez 6,45% (n = 4) et des antécédents familiaux de cancer du sein étaient retrouvés chez 8,06% (n = 5). La prise de tabac à chiquer a été retrouvée chez 17,74% (n = 11) des cas. Les symptômes mammaires étaient observés dans 95,2% (n = 59) des cas. Le quadrant supéro-externe était touché dans 53,23% (n = 33) des cas. Le stade III s´observait dans 55% (n = 34) des cas et le stade IV dans 32% (n = 20).Conclusiondiagnostiqués à un stade avancé, les facteurs de risque de cancer du sein étaient peu observés.

RELATION OF ENDOMETRIAL PATHOLOGICAL CHANGES WITH ENDOCRINE DISORDERS AND METABOLIC SYNDROME

Endometrial hyperplasia (EH) is an abnormal proliferation of endometrial glands and stroma and is associated with an increased risk of endometrial cancer (EC). Risk factors such as obesity, chronic anovulation, late menopause, hypertension, and diabetes lead to an increased risk of EH and EC. Aim: to determine the association of pathological changes in the endometrium with endocrine disorders and metabolic syndrome in women in peri and postmenopause. This study including a total of 139 patients in peri and postmenopause. &nbsp;The examined group consisted of 104 women with fractional explorative curettage due to a medical indication and was divided into two subgroups: peri and postmenopausal. The control group included 35 healthy women. Anamnestic data, body weight, height, blood pressure measurement, were taken from all patients, and the following laboratory parameters were determined: glucose, TSH, thyroxine, glycosylated hemoglobin (HbA1c), and Vitamin D . The presence of metabolic syndrome (MetS) according to its diagnostic criteria was also determined. In our study, significance was found in the comparison of the examined and the control group (p = 0.0001) in addition to the significantly higher BMI in the examined group. The comparison also &nbsp;indicated the existence of a significant difference in the level of glycemia in addition to a significantly higher level in the examined group (p = 0.0001). The statistical analysis did not indicate a significant difference between the two subgroups of the examined group, nor between the examined and the control group in terms of TSH, thyroxine and HbA1c levels. The value of vit. D was significantly higher in the control than &nbsp;in the study group (p = 0.0001). The analysis showed that patients with fractional explorative curettage had 4.982 times [OR = 4.982 (2.06–12.02) 99% CI] significantly more often MetS compared to women in the control group. Patients in the examined group had a significantly higher BMI, glycemia, and more frequent presence of MetS than those in the control group. Keywords: endometrium, risk factors, fractional explorative curettage, metabolic syndrome

Microsatellite Instability in Endometrial Carcinoma.

Background: Endometrial carcinoma is the commonest gynaecological malignancy in the western countries with a standardised incidence of 8 per 100000 women. In India and Southeast Asia, the incidence of endometrial carcinoma is low but it is increasing due to increasing prevalence of obesity, diabetes, early menarche, late menopause, late marriage and declining birth rate. The study aimed to identify the role of microsatellite instability in endometrial carcinoma. Although MSI has been studied extensively in colorectal carcinoma there have been very few studies in southeast asian region regarding association of MSI and prognosis in endometrial carcinoma. To the best of our knowledge this is first study in India.&#x0D; Method: A Descriptive study in which 40 patients of endometrial carcinoma were studied. MSI was detected using immunohistochemistry (MSH-1, PMS-2, MSH-2, MSH-6). Statistical Analysis was done using SPSS software and fisher exact test was used to calculate p value. p value less than.05% was considered significant.&#x0D; Results: Overall prevalence of microsatellite instability was 40%. Microsatellite instability was associated with higher tumor grade, myometrial invasion&gt;50% and presented in initial stages compared to microsatellite stable tumors.&#x0D; Conclusion: Our study showed statistically significant association between microsatellite instability and Figo staging, tumor grade and myometrial invasion.

Perceived Barriers and Awareness of Mammography Screening Among Saudi Women Attending Primary Health Centers.

PurposeMammography screening (MS) is an underutilized screening tool; although it is provided free of charge to the Saudi community. The present study aimed at assessing knowledge and barriers of mammography screening among women attending primary health centers in Aljouf region, Saudi Arabia.Materials and MethodsA cross-sectional study was carried out among 423 women aged 41–75 years attending ten primary health centers in Aljouf region, Saudi Arabia. Structured interviewing questionnaires were used for data collection. SPSS program, version 24 was used for data analysis.ResultsThe least reported risk factors of BC in this study were early menarche (14.9%), first pregnancy after the age of 30 years (18%), and late menopause (18.7%). Concerning knowledge of MS, 50.8% of the women correctly identified that mammogram is the ideal method for detecting BC. The most encountered personal barriers towards MS were lack of information about mammogram (69.5%), fear of exposure to radiation (67.4%), fear of discovery of BC (62.9%), being busy all the time (62.2%), and fear of cancer treatment (61.9%). Regarding economic barriers, 40% of the participants reported that taking sick leave from work is difficult while 37.8% revealed that mammogram is costly. Concerning health system barriers, the most common barriers were fear of error in diagnosis (62.6%), long time to take medical appointment (57%), and preferring not to have a mammogram except after a doctor recommendation (52.7%). The present study showed that women’s education and residence significantly predicted their knowledge. Furthermore, women’s education and income significantly predicted their barriers towards MS.ConclusionMany barriers toward mammography screening were encountered in the present study. Addressing these barriers and raising awareness about MS may be of great value to increase its uptake by Saudi women.

Association of menopause with risk of carotid artery atherosclerosis

ObjectivesObservational studies suggest that the risk of cardiovascular disease increases during menopause; however, the menopause-related risk of subclinical atherosclerosis is unclear. The aim of the current study is to evaluate menopause and the risk of subclinical carotid atherosclerosis through a retrospective analysis of data from a population-based prospective cohort study. Study designThe study sample comprised 879 women in the Beijing community enrolled in the Chinese Multi-provincial Cohort Study at baseline study in 1992 and followed up to at least one carotid ultrasound examination at three on-site follow-up surveys. Age at menopause was categorized as <40 years (premature menopause), 40-44 years (early menopause), 45-49 years (relatively early menopause), 50-51 years (reference), and >51 years (relatively late menopause). Menopause staging at baseline was categorized as: reproductive, menopausal transition/perimenopause, early postmenopause, and late postmenopause. Menopause as a time-varying covariate was calculated using waiting time to menopause and menopause status at the last follow-up (2012). Main outcome measuresThe main outcome measures included carotid plaque and intima-media thickening. Gray's test was performed to assess the equality of cumulative incidence functions between age groups at menopause and between menopause stages. Multivariate Cox regression models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) associated with menopause. ResultsOf the 879 women included (mean [SD] age at baseline, 48.6 [8.1] years), 573 (65.2%) developed carotid plaques and 430 (48.9%) developed intima-media thickening during follow-up. Menopause was significantly associated with risk of developing carotid plaques (HR 1.93, 95% CI 1.05-3.54; P = 0.03) after adjustment for age at baseline, age at menopause, use of oral estrogen due to menopause, and traditional cardiovascular risk factors at baseline. No significant association was found between age at menopause and risk of carotid atherosclerosis. ConclusionMenopausal women, irrespective of age at menopause, had an increased risk of carotid plaque.

Association of Sjögren's Syndrome With Reduced Lifetime Sex Hormone Exposure: A Case-Control Study.

To test whether cumulative estrogen exposure, as determined by age at menarche, age at menopause, female hormone use, hysterectomy, and parity, have an effect on the development of primary Sjögren's syndrome (SS). We performed a case-control study of 2,680 women from the Sjögren's International Collaborative Clinical Alliance registry, including 1,320 registrants with primary SS and 1,360 with sicca symptoms but no key features of primary SS (sicca controls). The composite estrogen score (CES) was calculated by point assignment for early menarche (age ≤10 years), high parity (>3 pregnancies), hysterectomy, female hormone use, and late menopause (age ≥53 years). Cumulative menstrual cycling (CMC) was calculated as years menstruating minus time pregnant. Using a regression model that adjusted for age, recruitment site, ethnicity, education, employment status, and smoking, we observed a progressive inverse trend between primary SS and CES. The odds ratio (OR) and 95% confidence interval (95% CI) were as follows for the sicca control group: CES 1, OR 0.81 (95% CI 0.67-0.99); CES 2, OR 0.74 (95% CI 0.57-0.97); CES 3, OR 0.50 (95% CI 0.30-0.86). This trend was corroborated by analysis of CMC. At the highest level of CMC within the postmenopausal group there was a 24% reduction in cumulative sex hormone exposure among primary SS participants relative to controls. Women with primary SS have lower estrogen exposure and CMC compared to sicca controls. Increasing estrogen exposure was negatively associated with development of primary SS. Further longitudinal studies of sex hormone exposure in primary SS are needed to confirm these findings.

Breast cancer epidemiology among surgically treated patients in Jordan: A retrospective study.

Background: Multiple risk factors contribute to the development of breast cancer, including age, positive family history, early menarche, late menopause and the strongest factor being female gender. In this study, we aimed to investigate the proportion of breast cancer patients with certain risk factors, the prevalence of each cancer type, in addition to the surgical procedures performed. Methods: The medical records of patients diagnosed with breast cancer from January 2010 to November 2015 were evaluated retrospectively regarding demographics, breast cancer risk factors, comorbidities, diagnostic methods, tumor location, cancer type and stage, pathological findings, tumor markers, harvested lymph nodes and the types of surgical procedures. The collected data were statistically analyzed as number, mean, and frequency as percentages. Cases with deficient medical records were excluded from the analysis of certain parameters. Results: The sample consisted of 120 patients, 118 (98.3%) of whom were women. The mean age was 56.5±12.0 years. The most common diagnostic method at presentation was self-exam in 93.3% of patients. Invasive ductal carcinoma was the most common type of tumor (80.0%). The pathological stages could be determined for only 106 patients, and 26 patients (24.5%) were at stage 1 disease, 45 patients (42.5%) were at stage 2 whereas 34 patients (32.1%) were at stage 3. According to the results of pathological examinations, 72.6% (85 patients) of the cases were estrogen receptor positive, 61.2% (71 patients) were progesterone receptor positive while 24.8% (27 patients) were HER positive. Modified radical mastectomy (MRM) was performed in 52 (43.3%) patients and wide local excision (WLE) was preferred in 46 (38.3%) cases. Conclusion: Advanced age, positive family history, and prolonged estrogen exposure were remarkable in the majority of patients. Moreover, the most common type of breast cancer was invasive ductal carcinoma, and around half of the patients presented at stage 2 disease. Modified radical mastectomy and WLE were the most commonly performed surgical procedures.

Comparison of various menopausal symptoms and risk factor analysis in Korean women according to stage of menopause

ObjectiveTo determine the prevalence and severity of menopausal symptoms and their related risk factors among middle-aged Korean women according to their reproductive stages. MethodsThis cross-sectional study included 3039 Korean women, aged 45–65 years, who attended their routine health checkup. Their scores from the Menopause Rating Scale (MRS) were compared and participants were categorized into four groups according to stage of menopause: premenopause, early menopause (≤2 years from their last menstruation), mid-menopause (2–8 years), and late menopause (>8 years). ResultsThe mean age of the participants was 52.81 ± 5.39 years, and 98.5 % of them reported one or more symptoms included in the MRS. The most common symptom was physical/mental exhaustion, experienced by 86.7 % of participants. The prevalence of moderate to severe symptoms, including vasomotor symptoms, heart discomfort, sleep problems, sexual problems, vaginal dryness, and joint/muscular discomfort, increased in the early menopausal period. This increased in the late menopausal period compared with its prevalence at premenopause. The prevalence of moderate to severe psychological symptoms, heart discomfort, and sleep problems followed a U-shaped trend after menopause: high at early menopause, low at mid-menopause, and high again at late menopause. A low level of physical exercise was an independent risk factor for a high total MRS score; however, the menopausal stages, age, and weight were also variously associated with menopausal symptoms. ConclusionsSeveral menopausal symptoms remain severe, or are aggravated, until the late menopausal period among Korean women. More attention is warranted to manage these symptoms in postmenopausal women.

Evaluation of Relationships between Menopause Onset Age and Bone Mineral Density and Muscle Strength in Women from South-Western Poland.

Introduction The onset of the menopause entails numerous changes, both physical and mental, in the functioning of the bodies of women. Moreover, the early menopause increases the risk of occurrence of many civilization-related diseases. Major factors contributing to health deficits include lowered bone mineral density and sarcopenia, which can result in serious functional limitations and the acceleration of ageing processes in the body. The aim of this study was to determine how the menopause onset age is linked with bone mineral density and the strength of selected muscles of the limbs and the trunk. Material and Methods. 756 women aged 50-80 years were subjected to tests. The subjects were divided into three groups: (I) from 50 to 59 years, (II) from 60 to 69 years, and (III) from 70 to 79 years. Each of the women specified the age when her final menstrual period occurred. On this basis, groups of women with (1) the early menopause—before the 50th year of life—and (2) with the late menopause—after the 50th year of life—were distinguished. Bone mineral density (BMD), dominant hand grip strength, knee extensor and flexor strength, and functional upper and lower body muscle strength were determined in each of the women. Results The test results indicate differences in levels of muscle strength and BMD between the 50-year-old early- and late-menopausal women. The late-menopausal women score better motor ability test results and higher BMD values. The differences decrease in the groups of 60-year-old women, whereas the 70-year-old early- and late-menopausal women score similar results. Conclusions A higher percentage of women with a lowered bone mass and a lower strength level was found in the group of early-menopausal subjects. The rate of decline in hand grip strength, the functional efficiency of the upper and lower limbs, and BMD is faster in the late-menopausal women, whereby the two groups of 70-year-old women score similar test results.

Knowledge of symptoms and risk factors of breast cancer among women: a community based study in a low socio-economic area of Mumbai, India

BackgroundBreast cancer (BC) is leading cancer among women in India accounting for 27% of all cancers among women. Factors that make the policymakers and public health system worried are rising incidence of breast cancer in India and more importantly high death rates among breast cancer patients. One of the leading causes of high breast cancer deaths is lack of awareness and screening leading to the late presentation at an advanced stage. Therefore, the current research aimed to understand the knowledge of breast cancer symptoms and risk factors among women in a low socio-economic area of Mumbai.MethodsA cross-sectional study was conducted at Prabhadevi, Mumbai and primary data was collected from 480 women aged 18–55 years. Structured questionnaire was used to collect quantitative data pertaining to awareness, signs and symptoms of breast cancer. Bivariate and multivariate regression techniques were used for understanding of the socio-demographic differentials in breast cancer awareness among women.ResultsThe study found that around half (49%) of the women were aware of breast cancer. The women who were aware of breast cancer considered lump in breast (75%), change in shape and size of breast (57%), lump under armpit (56%), pain in one breast (56%) as the important and common symptoms. Less than one-fifth of the women who were aware of breast cancer reported early menstruation (5.6%), late menopause (10%), hormone therapy (13%), late pregnancy (15%) and obesity (19%) as the risk factors for breast cancer. The multivariate regression analysis showed women who had more than 10 years of schooling (Adjusted Odds Ratio: 3.93, CI: 2.57–6.02, P < 0.01) were about 4 times more likely to be aware of breast cancer than women who had less than 10 years of schooling.ConclusionIn conclusion, knowledge of danger signs and risk factors of breast cancer were low among women in the community. This may lead to late detection of breast cancer among women in the community. Therefore, the study calls for advocacy and larger intervention to enhance knowledge of breast cancer among women in the particular region with a special reference to women with low education.

Awareness of Breast Cancer Risk Factors and Practice of Breast Self-Examination Among Nursing Students

Contents: Breast cancer is the most common cancer in women of both developed and less developed world. Breast cancer is a common malignancy among Saudi females, with a prevalence of 21.8%. Awareness of risk factors and practice of breast self-examination still has a significant role in the early detection effort of breast cancer, particularly in young women.&#x0D; Aim: of this study is to explore the awareness of breast cancer risk factors and the reported practice of breast self-examination among nursing students in the King Saud bin Abdulaziz University for Health Sciences -College of Nursing (CON-R), Kingdome of Saudi Arabia.&#x0D; Methods: A descriptive cross-sectional correlational design was utilized in this study on a convenience sample of 373 nursing students in King Saud bin Abdulaziz University for Health Sciences, College of Nursing (CON-R). The study used two tools. The first tool is a structured interview questionnaire designed by the researcher to collect data about the students' characteristics and to assess the student nurses' awareness of breast cancer risk factors. The second tool is a breast self-examination practice form that is designed to assess the student nurses' reported practice of breast self-examination.&#x0D; Results: The results of the present study show that 60.6% of the nursing students' age was between 20-24 years; 18.2 % of them had a positive family history of breast cancer. The nursing student higher awareness was revealed for risk factors of female gender (4.5±0.7), age more than 40 (4.3±0.8), positive family history (4.2±0.8), breast disease (4.1±0.8). Average awareness was revealed for risk factors of late menopause (2.8±1.8), and physical inactivity (3.0±1.1). 63.5% of students did not practice breast self-examination; among the remaining only 25.5% practicing monthly, only 5% was regularly practicing, while 31.1% of them did not practice regularly.&#x0D; Conclusion: The nursing students reveal a good awareness of most of the breast cancer risk factors. Despite a good awareness level, they reported that about two-thirds of students did not practice breast self-examination. The study recommended the conduction of awareness campaigns in all university campuses who are encompassing female students to enhance their awareness of breast cancer risk factors and promote their practice of breast self-examination.

Microbial Alterations and Risk Factors of Breast Cancer: Connections and Mechanistic Insights.

Breast cancer-related mortality remains high worldwide, despite tremendous advances in diagnostics and therapeutics; hence, the quest for better strategies for disease management, as well as the identification of modifiable risk factors, continues. With recent leaps in genomic technologies, microbiota have emerged as major players in most cancers, including breast cancer. Interestingly, microbial alterations have been observed with some of the established risk factors of breast cancer, such as obesity, aging and periodontal disease. Higher levels of estrogen, a risk factor for breast cancer that cross-talks with other risk factors such as alcohol intake, obesity, parity, breastfeeding, early menarche and late menopause, are also modulated by microbial dysbiosis. In this review, we discuss the association between known breast cancer risk factors and altered microbiota. An important question related to microbial dysbiosis and cancer is the underlying mechanisms by which alterations in microbiota can support cancer progression. To this end, we review the involvement of microbial metabolites as effector molecules, the modulation of the metabolism of xenobiotics, the induction of systemic immune modulation, and altered responses to therapy owing to microbial dysbiosis. Given the association of breast cancer risk factors with microbial dysbiosis and the multitude of mechanisms altered by dysbiotic microbiota, an impaired microbiome is, in itself, an important risk factor.

Potential Risk Factors of Breast Cancer among Women Attending Teaching Hospitals in Babylon Province

Background: Breast cancer is the most common cancer among women worldwide and the leading cause of cancer deaths among Iraqi women.Objective: To determine the potential risk factors associated with breast cancer.Methodology: This was a hospital based case control study which was conducted at Merjan and Al-Hilla teaching hospitals. A sample of three hundred women participants who were selected and divided into 100 patients with established breast cancer (cases) and 200 healthy women without breast cancer who were considered as healthy control group. Data were collected by interviewing both groups using a structured questionnaire which includes information about(tobacco smoking, economic status, age of menarche ,age of menopause , use of contraceptives level of education ,family history of breast cancer). medical records of patients and control group were reviewed to complete the data needed ,chi square statistical test and Odds Ratios were calculated.Results: Results of this study showed that the following factors like low economic status, ,late age of menopause ,positive family history, use of contraceptives were significantly associated with breast cancer(Unadjusted Odds Ratios more than one ,p values <0.05).Exposure to cigarette tobacco smoking, levels of education, and age of menarche did not show significant association with breast cancer in this study.Conclusion: Breast cancer was associated positively with the presence of positive family history, Low socioeconomic status, late menopause and using contraceptive pills regularly.

A Review of the Epidemiology of Breast Cancer in Asia: Focus on Risk Factors

Background and Aim:Breast cancer is the most prevalent cancer in women. To date, regional differences in breast cancer risk factors have not been identified. The aim of our review was to gain a better understanding of the role of risk factors in women with breast cancer in Asia. Methods:We conducted a PubMed search on 15 March 2016, for journal articles published in English between 2011 and 2016, which reported data for human subjects in Asia with a diagnosis of breast cancer. Search terms included breast neoplasm, epidemiology, Asia, prevalence, incidence, risk and cost of illness. Studies of any design were included, except for review articles and meta-analyses, which were excluded to avoid duplication of data. No exclusions were made based on breast cancer treatment. We reported the results using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Results:A total of 776 abstracts were retrieved. After screening against the eligibility criteria, 562 abstracts were excluded. The remaining 214 abstracts, which were published between 2013 and 2015, were included in this review. Results were summarized and reported under three categories: incidence, prevalence or outcomes for breast cancer in Asia; modifiable risk factors; and non-modifiable risk factors. We found that the increased risk of breast cancer among participants from Asia was associated with older age, family history of breast cancer, early menarche, late menopause, high body mass index, being obese or overweight, exposure to tobacco smoke, and high dietary intake of fats or fatty foods. In contrast, intake of dietary fruits, vegetables, and plant- and soy-based products was associated with a decreased breast cancer risk. While based on limited data, when compared to women from the United States, women from Asia had a decreased risk of breast cancer. Conclusions:This review of 214 abstracts of studies in Asia, published between 2013 and 2015, confirmed the relevance of known non-modifiable and modifiable risk factors for women with breast cancer.

EVALUATION OF RISK FACTORS FOR BREAST CANCER IN PAKISTANI WOMEN

Background: Breast cancer is one of the leading causes of morbidity and mortility in females of pakistan. We conducted this study to evaluate risk factors for developing breast cancer in Pakistani women. Methods: An observational/ cross sectional study was conducted at Dr. Ruth Pfau K. M Civil Hospital Karachi, Oncology Ward, from May 2017 to February 2018. A total of 80 patients of biopsy positive cases of breast cancer in Pakistani females were included who were admitted for chemotherapy. By taking the histories, their risk factors were evaluated, weight, height recorded and BMI calculated. Results: In this study 80 females were included to evaluate the risk factors for cancer of breast. Age was 40-59 years in 46.3% and 32.5% were of 24-39 year. Out of total, 98.8% were married, 1.3% was unmarried. Family history of breast cancer was 17.5%, early menarche 7.5%, late menopause 11.8%. Nulliparity was 10% and multiparity was 90%. Age at first full-term pregnancy above 35 years was 1.3%. Breast-feeding was in 77.5% and oral contraceptive pills use 18.8%. HRT was absent 100%. Dietary intake of high fat 40%, lack of exercise 95%, raised BMI 78.8% and use of hair dye in 58.8%. Synthetic dye use was reported in 4% and Henna was used in 96%. Frequency of hair dye use, ranged from occasional (4-5 times/year) 4.2%, to twice a month 4.2% and monthly 91.6%. Duration of hair dye use reported was for 2 years (4%), 5 years (7%), 7 years (11%), 10 years (14%), 15 years (20%) and 20 years (28%). Conclusion: The risk factors for cancer of breast have a different implication on Pakistani women than their western counterparts. Genetic and hormonal factors play a smaller role while life style factors play a major role including a recently associated risk factor of the use of hair dye.

P-53 expression in complex and/or atypical endometrial hyperplasia and endometrial adenocarcinoma

Endometrial cancer holds fourth position after breast, colon and lung cancers. In different parts of the world endometrial carcinoma accounts for 4-8% of all cancers. The Age Standardised Rate (ASR) is approximately 4.3 cases per 1,00,000 women. Endometrial cancers are majorly observed in post menopausal women. The age group for diagnosis of endometrial cancers is around 60 years. The most common symptom in patients of endometrial carcinoma is postmenopausal bleeding. The prominent risk factors for endometrial carcinoma include obesity, nulliparity, early menarche and late menopause, and estrogen therapy. There are two types of endometrial cancers: type I endometrial cancer is associated with unopposed estrogen expression and is more common (80% of cases) whereas type II endometrial malignancies are not related to estrogen and are more aggressive tumor.P53-driven model of carcinogenesis is responsible for the rapid development and progression of type II endometrial lesions. Early stage tumors (low grade) are primarily estrogen and progesterone receptor positive and P-53 negative. In contrast the advanced stage tumors (high grade) tumors show strong positive expression for P-53 and are negative for estrogen and progesterone receptors.

Night Shift Work-A Risk Factor for Breast Cancer.

Shift work is considered a risk factor for some health problems. This study aimed to determine whether night shift work is a significant factor for breast cancer risk. The case–control study was conducted from 2015–2019 in the Łódź region. The case group included 494 women diagnosed with malignant breast cancer; the control group included 515 healthy women. The research tool was an anonymous questionnaire. In the case group, the percentage of women working shift work was 51.9%, whereas in the control group, it was 34.1% (OR = 2.08 (95% CI: 1.61; 2.69)). A more insightful examination of shift work showed that only night work has a significant impact on breast cancer (OR = 2.61 (95% CI: 1.94; 3.53)). Even after considering the effect of other possible cancer factors (like high BMI, smoking, early menstruation, late menopause, pregnancy history, age, place of living, education), the odds of developing cancer were twice as high in the group of shift workers (OR = 2.20 (95% CI: 1.57; 3.08)). Considering a significantly higher risk of cancer among people working at night and a high percentage of such employees in Poland, the government should consider special action in the prophylactic treatment of cancers.

Autophagy Machinery as a Promising Therapeutic Target in Endometrial Cancer.

Endometrial cancer is the fourth most frequent neoplasia for women worldwide, and over the past two decades it incidence has increased. The most common histological type of endometrial cancer is endometrioid adenocarcinoma, also known as type 1 endometrial cancer. Endometrioid endometrial cancer is associated with diverse epidemiological risk factors including estrogen use, obesity, diabetes, cigarette smoking, null parity, early menarche, and late menopause. Clinical effectiveness of chemotherapy is variable, indicating that novel molecular therapies against specific cellular processes associated to cell survival and resistance to therapy, such as autophagy, urged to ameliorate the rates of success in endometrial cancer treatment. Autophagy (also known as macroautophagy) is a specialized mechanism that maintains cell homeostasis which is activated in response to cellular stressors including nutrients deprivation, amino acids starvation, hypoxia, and metabolic stress to prolong cell survival via lysosomal degradation of cytoplasmic macromolecules and organelles. However, in human cancer cells, autophagy has a controversial function due to its dual role as self-protective or apoptotic. Conventional antitumor therapies including hormones, chemotherapy and ionizing radiation, may activate autophagy as a pro-survival tumor response contributing to treatment resistance. Intriguingly, if autophagy continues above reversibility of cell viability, autophagy can result in apoptosis of tumor cells. Here, we have reviewed the mechanisms of autophagy described in endometrial cancers, including the role of PI3K/AKT/mTOR, AMPK-mTOR, and p53 signaling pathways that trigger or inhibit the process and thus representing potential molecular targets in therapeutic clinical approaches. In addition, we discussed the recent findings indicating that autophagy can be modulated using repurposing drugs which may leads to faster experimentation and validation, as well as more easy access of the medications to patients. Finally, the promising role of dietary compounds and microRNAs in autophagy modulation is also discussed. In conclusion, although the research about autophagy is scarce but ongoing in endometrial cancer, the actual findings highlight the promising usefulness of novel molecules for directing targeted therapies.