Levels In Breast Cancer Patients Research Articles

High lapatinib plasma levels in breast cancer patients: risk or benefit?

Lapatinib is a tyrosine kinase inhibitor targeting epidermal growth factor receptors 1 (EGFR/HER1) and 2 (HER2) used in the treatment of patients with HER2-positive breast cancer. The aim of the present study was to determine lapatinib plasma levels in breast cancer patients treated with lapatinib plus capecitabine. We assessed lapatinib plasma levels in blood samples from 21 breast cancer patients treated with lapatinib plus capecitabine using the standard regimen in an expanded access program. Liquid chromatography tandem mass spectrometry was used for measuring lapatinib plasma concentrations. The validated method was applied for measurement of 55 plasma samples. The median lapatinib plasma level was 5.09 μg/mL, with large interindividual differences. Patients of lower weight tended to have higher lapatinib plasma levels (Spearman correlation coefficient R = -0.435, P = 0.055). One patient's lapatinib plasma levels were markedly higher than those of the others, with a median level of 11.25 μg/mL and repeatedly exceeding 7.80 μg/mL. The treatment was terminated after 8 months when hyperbilirubinemia occurred. The lapatinib plasma levels reported here are twice as high as the clinically effective steady-state geometric mean maximum concentration. We conclude that increased lapatinib body levels occur when patients are in a nonfasting state at the time of drug intake and when lapatinib doses are not adjusted to low body weight or weight loss during treatment. In Europe, dose adjustments are not recommended in the case of hepatic function impairment. Thus, attention should be paid to changes in liver function test results in clinical practice, especially in patients of small stature and weight, given the risk of high plasma concentrations. Prospective lapatinib plasma level assessment in treated patients might be useful to confirm or refute the possible correlation of high lapatinib plasma levels with hepatic and/or other toxicities.

The clinical importance of serum galectin-3 levels in breast cancer patients with and without metastasis.

Studies have investigated expression status of galectin-3 (Gal-3), but very little is known about the importance of circulating Gal-3 in patients with breast cancer (BC). The purpose of the study was to investigate the clinical significance and potential diagnostic value of plasma Gal-3 levels in patients with BC. Fifty-two patients with BC and 35 age-matched healthy controls were enrolled. Levels of Gal-3 were investigated in BC patients and healthy controls. Gal-3 levels were determined using ELISA method. Serum Gal-3 levels were significantly higher in BC patients than in controls (P = 0.002). Gal-3 levels did not significantly differ according to patients' statuses of lymph node involvement, hormone receptor, lymphovascular invasion, e-cadherin, menopausal, stage, serum hemostatic markers (prothrombin time, partial thromboplastin time, and international normalized ratio), platelet counts, mean platelet volume, lactate dehydrogenase, carcinoembryonic antigen, and carbohydrate antigen 15-3 values (P > 0.05 for all). A cut-off value of Gal-3 to predict BC was determined at ≥3.17 ng/ml with a sensitivity of 75.0%, a specificity of 65.71%, a positive and negative predictive values of 76.5 and 63.9%, respectively (area under the curve: 0.705 [95% confidence interval, 0.598-0.798], P = 0.0002). Serum Gal-3 levels were significantly higher in BC patients and did not significantly differ according to clinical and tumoral characteristics of patients. Furthermore, there was no difference in Gal-3 levels between BC patients with and without metastatic disease. Serum Gal-3 levels can be used as an adjunct to other diagnostic or screening tests for BC regardless of clinical and tumoral characteristics of patients.

Differential expression of TGFβ isoforms in breast cancer highlights different roles during breast cancer progression.

While TGFβ plays a critical role in tumor formation and progression, the role and contribution of its three different isoforms remain unclear. In this study, we aimed at elucidating the prognostic value of the TGFβ isoforms and assessed their expression levels in breast cancer patients at different stages of the disease. We found higher levels of TGFβ1 and TGFβ3 in cancer patients compared to normal tissues, with no significant changes in TGFβ2 expression. Similarly, TGFβ1 and TGFβ3, but not TGFβ2, showed higher expression levels in advanced lymph node-positive and metastatic tumors, suggesting different roles for the different isoforms in tumor progression and the metastatic process, while in the least aggressive molecular subtype (luminal A), expression of the three TGFβ isoforms significantly correlated with expression of both TGFβ receptors, such correlation only occurred between TGFβ1 and TGFβ3 and the TGFβ type II receptor (TβRII) in the highly aggressive basal-like subtype. Interestingly, a distinct and somehow opposite pattern was observed in HER-2 tumors, only showing significant association pattern between TGFβ2 and the TGFβ type I receptor (TβRI). Finally, the three TGFβ isoforms showed distinct association patterns with patient outcome depending on the different molecular subtype, highlighting context-dependent, differential prognostic values.

Alterations in serum levels of trace element in patients with breast cancer before and after chemotherapy.

Background:Breast cancer is the most common serious disease around the world. The trace elements have a vital role in the metabolism and chemotherapy may change the level of metal ions. Due to the ambiguity of the existence in this regard, the study examined the trace element serum levels in women with breast cancer before and after chemotherapy .Methods:Sixty patients were studied undergoing specialist. First sampling was taken before chemotherapy (after 4 weeks of surgery) and second sampling was taken after the completion of 3 courses of chemotherapy, approximately 9 weeks after the first chemotherapy. The patients took Adriamycin 60mg/m2 Cytoxan 600mg/m2. Serum zinc and iron levels were measured using standard spectrophotometric method. Measurement of serum copper was done by atomic absorption spectroscopy.Results:Serum zinc and iron levels in women after chemotherapy significantly decreased (p<0.001), however, the serum level of copper increased but was not significant (P=0.676).Conclusions:Our findings demonstrate significant decrease in zinc and iron levels in breast cancer patients after 3 courses of Adriamycin and Cytoxan chemotherapy. Prescribing zinc supplements can be useful after chemotherapy.

Melatonin and breast cancer: Evidences from preclinical and human studies.

The breast cancer affects women with high mortality and morbidity worldwide. The risk is highest in the most developed world but also is markedly rising in the developing countries. It is well documented that melatonin has a significant anti-tumor activities demonstrated on various cancer types in a plethora of preclinical studies. In breast cancer, melatonin is capable to disrupt estrogen-dependent cell signaling, resulting in a reduction of estrogen-stimulated cells, moreover, it's obvious neuro-immunomodulatory effect in organism was described. Several prospective studies have demonstrated the inverse correlation between melatonin metabolites and the risk of breast cancer. This correlation was confirmed by observational studies that found lower melatonin levels in breast cancer patients. Moreover, clinical studies have showed that circadian disruption of melatonin synthesis, specifically night shift work, is linked to increased breast cancer risk. In this regard, proper light/dark exposure with more selective use of light at night along with oral supplementation of melatonin may have benefits for high-risk women. The results of current preclinical studies, the mechanism of action, and clinical efficacy of melatonin in breast cancer are reviewed in this paper. Melatonin alone or in combined administration seems to be appropriate drug for the treatment of early stages of breast cancer with documented low toxicity over a wide range of doses. These and other issues are also discussed.

Resistin facilitates breast cancer progression via TLR4-mediated induction of mesenchymal phenotypes and stemness properties.

Growing evidence indicates that resistin-an obesity-related cytokine-is upregulated in breast cancer patients, yet its impact on breast cancer behavior remains to be ascertained. Similarly, Toll-like receptor 4 (TLR4) has been implicated in breast cancer progression, however, its clinically relevant endogenous ligand remains elusive. In this study, we observed that high serum resistin levels in breast cancer patients positively correlated with tumor stage, size and lymph node metastasis. These findings were replicated in animal models of breast cancer tumorigenesis and metastasis. Resistin was found to promote epithelial-mesenchymal transition and stemness in breast cancer cells-mechanisms critical to tumorigenesis and metastasis-through a TLR4/nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB)/signal transducer and activator of transcription 3 (STAT3) signaling pathway and negated by TLR4-specific antibody and antagonist. These findings provide clear evidence that resistin is a clinically relevant endogenous ligand for TLR4, which promotes tumor progression via TLR4/NF-κB/STAT3 signaling, providing insights into a novel therapeutic target in breast cancer.

Enhancing an oncologist's recommendation to exercise to manage fatigue levels in breast cancer patients: a randomized controlled trial.

Fatigue is a troublesome symptom for breast cancer patients, which might be mitigated with exercise. Cancer patients often prefer their oncologist recommend an exercise program, yet a recommendation alone may not be enough to change behavior. Our study determined whether adding an exercise DVD to an oncologist's recommendation to exercise led to better outcomes than a recommendation alone. Ninety breast cancer patients, at varying phases of treatment and stages of disease, were randomized to receive the following: an oncologist verbal recommendation to exercise (REC; n=43) or REC plus a cancer-specific yoga DVD (REC + DVD; n=47). Fatigue, vigor, and depression subscales of the Profile of Mood States, and physical activity levels (MET-min/week), exercise readiness, and self-efficacy were assessed at baseline, 4, and 8weeks. Analyses controlled for age, time since diagnosis, and metastatic disease. Over 8weeks, women in REC + DVD used the DVD an average of twice per week. The REC + DVD group had greater reductions in fatigue (-1.9±5.0 vs. -1.0±3.5, p=0.02), maintained exercise readiness (-0.1±1.1 vs. -0.3±1.3; p=0.03), and reported less of a decrease in physical activity (-420±3075 vs. -427±5060 MET-min/week, p=0.06) compared to REC only. A low-cost, easily distributed, and scalable yoga-based DVD could be a simple booster to an oncologist's advice that motivates breast cancer patients, even those with advanced disease and/or in treatment, to engage in self-care, e.g., exercise, to manage fatigue. ClinicalTrials.gov Identifier: NCT03120819.

Self-Assembled DNA Generated Electric Current Biosensor for HER2 Analysis.

We have developed a new DNA self-assembly amplification technology that generates electric current for electrochemical biosensing. The new technology was used for detection of human epidermal growth factor receptor 2 (HER2). In our technology, an aptamer was utilized both as a ligand for recognition and as a signal generating reporter. The aptasensor is based on a sandwich formatand a DNA primer on a HER2 aptamer initiates auxiliary DNA self-assembled on the electrode to form a long one-dimensional DNA. The resulting DNA is then reacted with molybdate to generate electrochemical current. The sensitivity of the aptasensor with DNA self-assembly was greater than that of the aptasensor without DNA self-assembly due to the extended length of the DNA strand. Aptasensor analysis of HER2 in serum of breast cancer patients and healthy individuals is highly correlated (R2 = 0.9924) with ELISA measurements, with a p value of 1.37 × 10-7. The analysis of HER2 in serum (confirmed by ELISA) suggests that HER2 levels in breast cancer patients are much higher than healthy individuals. For HER2 positive patients, the levels are higher than those of HER2 negative patients. After surgery, there is a drop of HER2 levels in serum, suggesting potential clinical applications of the new self-assembled DNA electric current generating biosensor. Unlike proteins, DNA is easily amplifiable. The DNA signal amplification method presented here enables effective current generation, which can find wide range of biomedical applications for protein detection.

Down-regulation of traditional oncomiRs in plasma of breast cancer patients.

Deregulated expression of microRNAs has the oncogenic or tumor suppressor function in cancer. Since miRNAs in plasma are highly stable, their quantification could contribute to more precise cancer diagnosis, prognosis and therapy prediction. We have quantified expression of seven oncomiRs, namely miR-17/92 cluster (miR-17, miR-18a, miR-19a and miR-20a), miR-21, miR-27a and miR-155, in plasma of 137 breast cancer (BC) patients. We detected down-regulation of six miRNAs in patients with invasive BC compared to controls; however, only miR-20a and miR-27a down-regulations were statistically significant. Comparing miRNA expression between early and advanced stages of BC, we observed statistically significant decrease of miR-17 and miR-19a. We identified down-regulation of miR-17 and miR-20a in patients with clinical parameters of advanced BC (lymph node metastasis, tumor grade 3, circulating tumor cells, higher Ki-67-related proliferation, hormone receptor negativity and HER2 amplification), when compared to controls. Moreover, decreased level of miR-17 was found from low to high grade. Therefore, miR-17 could represent an indicator of advanced BC. Down-regulated miR-27a expression levels were observed in all clinical categories regardless of tumor progression. Hence, miR-27a could be used as a potential diagnostic marker for BC. Our data indicates that any changes in miRNA expression levels in BC patients in comparison to controls could be highly useful for cancer-associated pathology discrimination. Moreover, dynamics of miRNA expression changes could be used for BC progression monitoring.

Role of Plasma D-Dimer Levels in Breast Cancer Patients and Its Correlation with Clinical and Histopathological Stage.

Breast cancer, the most common female malignancy, represents a heterogeneous group of tumors, which presen both varied behaviors and response to therapy. This study was done with an attempt to evaluate the role of D-dimer in patients of carcinoma breast, in predicting lymph node metastasis in carcinoma patients and to look for relationship of these markers with histopathologic parameters. Clinical data was obtained from clinical examination of patients admitted in the Department of Surgery with history of breast lump and confirmed with fine needle aspiration cytology (FNAC). Clinical staging was done using TNM staging. D-dimer level was measured prior to commencement of treatment, i.e., modified radical mastectomy (MRM) or neoadjuvant chemotherapy and finally 6months after surgery or completion of 6cycles of chemotherapy. The characteristics of the study population Out of 60 study cases minimum age of the patient being 30years and maximum being 74years. Of all histopathologic variables examined, D-dimer levels directly correlated with extent of lymph node involvement and lymphovascular invasion, D-dimer levels correlated strongest with the number of positive lymph nodes, but not with tumor size, estrogen receptor status, and progesterone receptor status. This study clearly shows that plasma D-Dimer levels are elevated in carcinoma breast patients. Increased D-Dimer levels are an important marker of clinical stage, lymphovascular invasion, lymph node involvement, and tumor metastasis.

The effect of rs5758550 on CYP2D6*2 phenotype and formation of endoxifen in breast cancer patients using tamoxifen.

CYP2D6*2 is considered fully active, but it has been suggested that it only happens in the presence of rs5758550. This study aims to elucidate the impact of this enhancer. DNA and blood samples from women enrolled in the CYPTAM study (NTR1509) were analyzed. Fourteen CYP2D6*2 carriers without the enhancer were reclassified. The relationship of CYP2D6 phenotypes and drug levels was studied. After correction for the absence of the enhancer, the correlation between CYP2D6 phenotypes and endoxifen did not improve (R2: 0.290 vs 0.279). No difference was observed in mean concentrations between CYP2D6*2 individuals with and without the enhancer. The rs5758550 enhancer does not lead to improved prediction of endoxifen levels in breast cancer patients.

Prevalence of Low Vitamin D in Patients with Breast Cancer in a Predominantly Hispanic Population at the American-Mexican Border

ABSTRACTIntroduction: Low level of vitamin D (VD) has been linked with a higher risk of cancers. The aim of this study was to assess the prevalence of low VD in patients with breast cancer in a predominantly Mexican Hispanic/Latino patient population, a fast growing and relatively understudied population. Materials/Methods: We sought to evaluate the serum VD levels in breast cancer patients diagnosed at the Texas Tech University Breast Cancer Center in El Paso, TX, between May 2013 and May2014 via a retrospective chart review of the Electronic Medical Records. Results: We identified a total of 83 consecutive breast cancer patients with available VD levels. Mean age 57 yr, 94% were Hispanics. VD was insufficient (<30 ng/ml) in 86% of patients (95% CI: 0.76–0.92) and it was deficient (<20 ng/ml) in 39% (95% CI: 0.28–0.50). Conclusion: VD deficiency is widely prevalent in Hispanic/Latino patients with breast cancer. This is quite alarming in view of possible increased risk of cancer with low VD and potentially worse cancer outcomes. This calls for increased efforts to screen for, diagnose, and treat VD deficiency in this patient population. Further pharmacogenomics studies are warranted to explore the underlying etiology of VD deficiency in this paradoxically sunny region.

The effects on anxiety and quality of life of breast cancer patients following completion of the first cycle of chemotherapy.

Objectives:Breast cancer patients as part of their treatment need to undergo various forms of chemotherapy. This is considered as a burdensome experience for many patients often leading to significant levels of anxiety. The aim of the study was to explore the anxiety levels and any correlations to the quality of life of women with breast cancer that were undergoing chemotherapy.Methods:This was a cross-sectional study utilizing an explanatory sequential design. Data were collected from 355 women with breast cancer with the Self Anxiety Scale, the EORTC QLQ-C30, the EORTC QLQ-BR23 and sociodemographic questionnaires. Further insight to patients’ experiences was given through 12 in-depth interviews.Results:Anxiety scores ranged between 24 and 75 (45.7 ± 10.11), with 44% reporting serious or/and intense anxiety. The results revealed statistically significant differences on patients’ anxiety levels depending on their source of support. Overall, patients’ global health-related quality of life was found to be low to average 55.91 ± 17.94. The results showed low emotional functioning (49.30 ± 29.12), low role functions (56.34 ± 27.50) and low sexual functioning (24.93 ± 20.75). Patients also reported experiencing problems with fatigue (49.04 ± 29.12), insomnia (44.32 ± 32.97), hair loss (48.25 ± 38.32) and arm symptoms (36.53 ± 23.71). Patients being solely supported by the family experienced higher anxiety levels (p < 0.001) and lower quality of life (p < 0.001). There was a statistically significant negative correlation between anxiety and quality of life (r = −0.623, p < 0.001). Statistically significant differences were also found in relation to demographics, anxiety and quality of life. The interviews provided further evidence on the impact of anxiety on patients’ lives.Conclusion:The time following the completion of the first cycle of chemotherapy is associated with anxiety and lower quality of life levels in breast cancer patients. Healthcare providers should consider the supportive healthcare needs from the beginning of chemotherapy in patients to optimize their conventional and supportive healthcare outcomes.

Circulating Vitamin D and Overall Survival in Breast Cancer Patients: A Dose-Response Meta-Analysis of Cohort Studies.

Studies have shown that vitamin D could have a role in breast cancer survival; however, the evidence of the relationship between patients’ vitamin D levels and their survival has been inconsistent. This meta-analysis explores possible dose-response relationships between vitamin D levels and overall survival by allowing for differences in vitamin D levels among populations of the various studies. Studies relating vitamin D (25-OH-D [25-hydroxyvitamin D]) levels in breast cancer patients with their survival were identified by searching PubMed and Embase. A pooled HR (hazard ratio) comparing the highest with the lowest category of circulating 25-OH-D levels were synthesized using the Mantel-Haenszel method under a fixed-effects model. A two-stage fixed-effects dose-response model including both linear (a log-linear dose-response regression) and nonlinear (a restricted cubic spline regression) models were used to further explore possible dose-response relationships. Six studies with a total number of 5984 patients were identified. A pooled HR comparing the highest with the lowest category of circulating 25-OH-D levels under a fixed-effects model was 0.67 (95% confidence interval = 0.56-0.79, P < .001). Utilizing a dose-response meta-analysis, the pooled HR for overall survival in breast cancer patients was 0.994 (per 1 nmol/L), Pfor linear trend < .001. At or above a 23.3 nmol/L threshold, for a 10 nmol/L, 20 nmol/L, or 25 nmol/L increment in circulating 25-OH-D levels, the risk of breast cancer overall mortality decreased by 6%, 12%, and 14%, respectively. There was no significant nonlinearity in the relationship between overall survival and circulating 25-OH-D levels. Our findings suggest that there is a highly significant linear dose-response relationship between circulating 25-OH-D levels and overall survival in patients with breast cancer. However, better designed prospective cohort studies and clinical trials are needed to further confirm these findings.

Association of fatigue and insomnia with inflammatory cytokine and hematopoetic stem cell levels in breast cancer patients undergoing adjuvant radiation therapy.

e12048 Background: Fatigue and insomnia are frequent conditions experienced by breast cancer patients during adjuvant radiation therapy (RT). Our group reported that fatigue correlates with reduced CD34+ circulating hematopoetic stem cell (HSC) levels. Our current study examined the role of inflammatory cytokines in mediating fatigue and insomnia following adjuvant RT. Methods: Phlebotomies were conducted on 148 breast cancer patients undergoing adjuvant RT at five time points: prior to RT (D1), after two (D2) and five (D5) days of treatment, during the final week of RT (Df), and one month post-RT completion (M1). CD34+, CD45+, circulating blood cell (CBC), and 17 inflammatory cytokine levels were assessed. Patients also completed questionnaires at each time point, including the multidimensional fatigue inventory (MIF-21), insomnia severity index (ISI), and hospital anxiety and depression scale (HADS). Results: CD34+, CD45+ and CBC levels decreased during treatment with adjuvant RT, with the lowest levels observed at Df (p&lt;0.001). General fatigue significantly worsened throughout treatment from D1 to Df, returning to baseline at M1, (p&lt;0.001; adjusted for insomnia, depression and anxiety). General fatigue worsened as CD34+ counts, hemoglobin and CBCs increased (p&lt;0.001). Insomnia increased with reduced CD34+, CD45+ and CBCs (p&lt;0.05). TGF-β1, MCP-1, MMP-2, IL-1ra and IFN-α2a cytokine expression varied throughout RT (p&lt;0.01), most significantly at Df. Elevated MCP-1, TNF-RII and TNF-a levels correlated with worsening general fatigue, increased insomnia, and reduced activity and motivation (p&lt;0.001). MMP-2 increased as IL-1ra, CD34+, CD45+ and CBC counts decreased (p&lt;0.001). Further, the 52 patients who received prior adjuvant chemotherapy had elevated levels of fatigue, insomnia and anxiety, which correlated with high HSCs levels. Conclusions: Our findings demonstrate that fatigue and insomnia are associated with reduced HSCs and increased MCP-1, TNF-RII and TNF-a pro-inflammatory cytokines. This examination of the effect of RT on fatigue and insomnia is one of the most comprehensive longitudinal clinical evaluations of its kind.

Radiotherapy improves serum fatty acids and lipid profile in breast cancer

BackgroundBreast cancer is a disease with diverse clinical symptoms, molecular profiles, and its nature to response its therapeutic treatments. Radiotherapy (RT), along with surgery and chemotherapy is a part of treatment in breast cancer. The aim of present study was to investigate pre and post treatment effects of radiotherapy in serum fatty acids and its lipids profile in patients with breast cancer.MethodsIn this comparative as well as follow up study, Serum fatty acids were performed by gas chromatography to investigate fatty acids and Microlab for analysis of lipid profile.ResultsAmong serum free and total fatty acids the major saturated fatty acids (SFAs) in serum lipids of breast cancer patients (pre and post treated) were stearic acid (18:0) and palmitic acid (16:0). These fatty acids contributed about 35-50% of total fatty acids. The decreased concentrations of linoleic acid (C18:2) and arachidonic acid (C20:4) with a lower ratio of C18:2/C18:1 was found in pretreated breast cancer patients as compared to controls. The n-3/n-6 ratio of breast cancer patients was decreased before treatment but it was 35% increased after treatment. In addition, plasma activity of D6 desaturase was increased in the breast cancer patients, while the activity of D5 desaturase was decreased. Increased levels of SFAs, monounsaturated fatty acids (MUFAs) and decreased polyunsaturated fatty acids (PUFAs) levels in breast cancer patients (pre and post treated) as compared to controls. Serum total cholesterol (TC) (224.4 mg/dL) and low density lipoprotein cholesterol (LDL-C) (142.9 mg/dL) were significantly increased in pretreated breast cancer patients but after the radiotherapy treatment, the TC (150.2 mg/dL) and LDL-C (89.8 mg/dL) were decreased.ConclusionIt seems that RT would have played a potential role in the treatment of BC. After RT the serum levels of PUFAs, TC, and LDL-C are improved. Our study reinforces the important role of RT in the management of BC.The level of PUFAs, TC, and LDL-C can be used as the biomarkers for early diagnosis in individuals with risk of breast cancer.

Abstract B09: Serum vitamin D levels in breast cancer patients to assess its risk prediction to improve health

Abstract Introduction: In the field of cancer, vitamin D has emerged as the most creative research connecting it with risk reduction in various epithelial cancers. Aside from calcium homeostasis, vitamin D exerts a wide range of immunogenic and antiproliferative activities in the human body. Vitamin D exerts its antiproliferative outcome by binding to vitamin D receptor (VDR) found in various tissues and cells of the body. Several human genes contain vitamin D response elements (specific DNA sequences) that encode for proteins important in regulation of cell proliferation, differentiation, apoptosis, and angiogenesis. When the serum vitamin D levels are suboptimal these activities are impaired and as a result enhanced cellular growth, neo-angiogenesis, and cancer development takes place. The breast cells have VDRs in their nuclei and it is postulated that polymorphism of genes for these VDRs results in increased risk for breast cancer. Serum concentration of 25(OH) 2 D are more sensitive to exogenous sources like: dietary and supplemental intake and endogenous production through synthesis in the skin of vitamin D which is the best indicator of vitamin D status of the body. There are data showing that locally advanced breast cancer patients had more severe vitamin D deficiency than those with early stage disease. The aim of the study was to determine serum vitamin D levels in breast cancer patients related with grade and stage of the tumor and to assess its risk prediction to improve health. Materials and Methods: Study samples: The study was conducted on indoor and outdoor patients for a period of one year (January to December), and an equal number of age and sex matched controls were taken which included total of 500 adults. Clinical Aassessment: Body mass index (BMI) was categorized as normal weight (&amp;lt;24 kg/m2), overweight (24-28 kg/m2) and obese (&amp;gt;28 kg/m2), fasting blood glucose (60 to 100 mg/dl) and Glycosylated Hemoglobin (controlled&amp;lt;7% and &amp;gt;7% uncontrolled). Vitamin D nutritional status was based on 25(OH) D levels, which were assessed as mild/sufficient (30-50 nmol/L), moderate/insufficient (12.5-29.9 nmol/L), and severe/deficient (&amp;lt;12.5 nmol/L). Results: The mean age was 42±1.5 years. Age, marital status, menopausal, residential area and BMI were similar in distribution among cases and controls. The mean serum vitamin D level in the breast cancer patients was &amp;lt;12.5 nmol/L and in the control group was 36.9 nmol/L (P value &amp;lt;0.001). Vitamin D deficiency was seen in 97.6% breast cancer patients and in 69.3% of the control group (P value &amp;lt;0.001). Among the breast cancer patients the tumor characteristics (histology, grade, stage, and receptor status) did not show any significant associations with serum levels of vitamin D. Premenopausal breast cancer females had a mean serum vitamin D level of 11.1 nmol/L and postmenopausal females had a mean value of 15.65 nmol/L (P value 0.015). Low BMI did not correlate significantly with vitamin D deficiency (P value 0.787). Conclusion: Invariably almost all patients with breast cancer were vitamin D deficient. Tumor characteristics and BMI did not show any significant associations with serum levels of vitamin D. Note: This abstract was not presented at the conference. Citation Format: Vinit Mehrotra, Ashutosh Sharma. Serum vitamin D levels in breast cancer patients to assess its risk prediction to improve health. [abstract]. In: Proceedings of the AACR Special Conference: Improving Cancer Risk Prediction for Prevention and Early Detection; Nov 16-19, 2016; Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(5 Suppl):Abstract nr B09.

Perceived distress and its association with depression and anxiety in breast cancer patients.

BackgroundBreast cancer patients often experience a high level of distress. Psychological distress is a broad construct encompass both depression and anxiety. Previous studies in examining which of these psychological symptoms (either anxiety or depression) were more significantly associated with the distress level in breast cancer patients is lacking. This study aims to compare the level of depression and anxiety between patients with different level of distress. The correlation between the changes in distress level with depression or anxiety over 12 months was also examined.MethodsThis study is from the MyBCC cohort study. Two hundred and twenty one female breast cancer patients were included into the study. They were assessed at the time of diagnosis, 6 months and 12 month using Hospital Anxiety and Depression Scale (HADS) and distress thermometer. The information on age, ethnicity, treatment types and staging of cancer were collected.Results50.2%, 51.6% and 40.3% of patients had perceived high level of distress at baseline, 6 months and 1 year after diagnosis. Those with high perceived level of distress had significant higher anxiety scores even after adjusted for the underlying depressive scores (Adjusted OR at baseline = 1.28, 95% CI = 1.13–1.44; adjusted OR at 6 months = 1.27, 95% CI = 1.11–1.45; adjusted OR at 12 months = 1.51, 95% CI = 1.29–1.76). There were no significant differences in the depressive scores between the subjects with either low or high distress level. There was reduction in perceived level of distress, anxiety and depression scores at 12 months after the diagnosis. The decrease of distress was positively correlated with the reduction of anxiety scores but not the changes of depressive scores (r’ = 0.25).ConclusionAnxiety is a more significant psychological state that contributed to the feeling of distress in breast cancer as compared with depression. Levels of anxiety at diagnosis in this study would justify screening for anxiety, early identification and therapy for maintaining the psychological well-being of breast cancer patients. Further studies will be needed to measure the effectiveness of therapeutic interventions.

The Relationship between Physical Activity Intensity and Mental Health Status in Patients with Breast Cancer.

The aim of this study was to investigate the correlation between physical activity (PA) level and mental health status in a population-based sample of Korean female patients with breast cancer. Our analysis included 76 patients with breast cancer and 44 healthy controls. The Korean versions of the International Physical Activity Questionnaire (IPAQ), Beck Depressive Inventory (BDI), State-Trait Anxiety Inventory-KY (STAI-KY), and Somatosensory Amplification Scale (SSAS), and Quality of Life (QOL) scale were assessed. The frequency of moderate PA level in breast cancer patients was significantly lower than that of healthy control subjects (t = −2.6; P = 0.011). In turn, the incidence of low PA level in breast cancer patients was significantly higher than that observed in healthy controls (t = 2.85; P = 0.005). A moderate PA level was inversely correlated with BDI score (r = −0.35; P = 0.008) and was positively correlated with QOL score (r = 0.38; P = 0.011). A low level of PA was inversely correlated with SSAS score (r = −0.39; P < 0.001). In healthy controls, a high level of PA was positively correlated with QOL score (r = 0.50; P = 0.043). Moderate PA level was inversely correlated with SSAS score (r = −0.59; P < 0.001). A low level of PA was also positively correlated with BDI score (r = 0.35; P = 0.008). A moderate or low intensity of PA was inversely correlated with depression and somatosensory amplification and was positively correlated with QOL in breast cancer patients. Finally, we suggest that progressively low-to-moderate levels of PA can be well adapted to positively impact several measures of mental health.

Serum Albumin Levels in Breast Cancer: Correlation with Overall Survival

Introduction: Albumin in an important biomarker that indicates malnutrition as well as inflammation. The aim of the study was to evaluate the albumin levels in breast cancer patients and its association with overall survival among breast cancer patients of Malwa region of Punjab. Material and methods: The study was planned in Malwa region of Punjab. Sampling was done from Guru Gobind Singh Medical College and Hospital and Max Hospital. The estimation of albumin levels was done at Central University of Punjab. 250 patients with breast cancer and 250 age and sex matched controls were involved in the study. Albumin levels were estimated using fully automated bio analyzer Erba 200. Follow-up interviews were conducted at an interval of 3, 6, 12 and 15 months to determine the outcome among breast cancer patients. Results: Low levels of albumin was found among the diseased in comparison with controls (p 3.5 g/dl) are associated significantly with increased overall survival among breast cancer patients. Albumin estimation may be a simple and inexpensive tool for the risk assessment and outcome of the disease in Malwa region of Punjab where the incidence of breast cancer is reported to be very high.