Medical Treatment Of Breast Cancer Research Articles

Hyaluronic acid-modified yeast β-glucan particles delivering doxorubicin for treatment of breast cancer

Breast cancer is one of the most threatening cancers that poses a great risk to women's health. The anti-tumor drug doxorubicin (DOX) is one of commonly used drugs in the treatment of breast cancer. However, the cytotoxicity of DOX has always been an urgent challenge to be solved. In this study, we report an alternative drug delivery system delivering DOX for reducing its physiological toxicity by using the yeast β-glucan particle (YGP) with a hollow and porous vesicle structure. Briefly, amino groups were grafted onto the surface of YGP with the silane coupling agent, then the oxidized hyaluronic acid (OHA) was attached by Schiff base reaction to get HA-modified YGP (YGP@N=C-HA), finally DOX was encapsulated into YGP@N=C-HA to get DOX-loaded YGP@N=C-HA (YGP@N=C-HA/DOX). In vitro release experiments exhibited the pH-responsive DOX release from YGP@N=C-HA/DOX. Cell experiments displayed that YGP@N=C-HA/DOX had good killing effect on both MCF-7 and 4T1 cells and could be internalized into these cells through CD44 receptors, showing targetability to cancer cells. Furthermore, YGP@N=C-HA/DOX could effectively inhibit tumor growth and reduce the physiological toxicity of DOX. Thus, the YGP-based vesicle provides an alternative strategy for lowering the physiological toxicity of DOX in the medical treatment of breast cancer.

Advances in medical treatment of breast cancer in 2022

AbstractBreast cancer has replaced lung cancer as the most common malignancy worldwide. The 5‐year survival rate of breast cancer has reached 90%. Systemic treatment of breast cancer has developed into a mature system including chemotherapy, targeted therapy, endocrine therapy and immunotherapy. This article summarizes the annual progress of breast cancer chemotherapy, targeted therapy, endocrine therapy and immunotherapy in 2022, providing valuable information for future research to better guide individualized treatment of breast cancer, thereby improving the prognosis and quality of life of breast cancer patients.

Posttraumatic Growth and Psychological Distress among Female Breast Cancer Survivors in India: A Cross-Sectional Study

Abstract Introduction Breast cancer survivors (BCS) may experience a cascade of negative reactions during the entire treatment process in the form of psychiatric morbidity. However, exposure to a traumatic event also has the fertile ground for the potential to catalyze a host of positive changes, including development in personal, interpersonal, and spiritual levels, commonly referred to as posttraumatic growth (PTG). PTG is defined as “positive psychological change experienced due to a struggle with highly challenging life circumstances.” Objective This study aims to measure the prevalence and correlates of PTG among BCS. Materials and Methods It was a cross-sectional study carried in a tertiary care center of North India from January 2021 to April 2021. Total 700 BCS were approached and screened using the purposive sampling technique. Data were analyzed using the Statistical Package for Social Sciences, version 20. Results The mean age (standard deviation [SD]) of the patients was 43.14 (8.53) years. The mean (SD) PTG score was 37 (13.66). Among the subdomain of PTG, most respondents showed growth in personal strength, relating to others, followed by an appreciation of life, spiritual change, and less growth in new possibilities. PTG was found to be significantly positively correlated with treatment completion time (r = 2.260, p = 0.02) and negatively correlated with depression, anxiety, and stress (r = –0.152, p = 0.04; r = –0.145, p = 0.05; r = –0.162, p = 0.02). Conclusion Psychological morbidities must be addressed along with medical treatment of breast cancer so that growth post trauma can be further facilitated.

Telerehabilitation for Managing Daily Participation among Breast Cancer Survivors during COVID-19: A Feasibility Study

We aimed to examine the feasibility and impact of a short-term occupation-based telerehabilitation intervention (Managing Participation with Breast Cancer (MaP-BC)) on daily participation, health-related quality-of-life, and breast-cancer-related symptoms and understand women’s perspectives regarding strategies to manage daily participation and symptoms during COVID-19 pandemic. A mixed-methods study (single-arm pre–post with a qualitative component) included 14 women after their primary medical treatment for breast cancer. Women received six weeks of occupation-based intervention using a video-communication. Sessions focused on identifying functional goals and training strategies to manage daily participation. The primary outcome was perceived performance and satisfaction with meaningful activities by the Canadian Occupational Performance Measure (COPM). Secondary outcomes were participation in the Activity Card Sort (ACS), upper-extremity functioning of Disability Arm Shoulder Hand, self-reported symptom severity, executive-functioning, health-related quality of life, and a question regarding strategies used to manage daily participation. Women significantly improved their daily participation in meaningful activities in the COPM, most ACS activity domains, self-reported executive functioning, and health-related-quality-of-life. Qualitative findings revealed three main themes: (1) daily life under the threats of breast cancer and COVID-19, (2) women’s own strategies to overcome challenges, and (3) contribution of the MaP-BC. Providing telerehabilitation during the COVID-19 pandemic is feasible and successful in improving women’s daily participation after breast cancer.

Lived Experiences of Women Receiving Medical Treatments for Breast Cancer in Ghana: A Qualitative Study

Breast cancer diagnosis and its treatment present women with significant challenges which require adjustment in several domains to ensure good health outcomes. Any psychosocial interventions to address the challenges need to be informed by empirical evidence. However, there is dearth of empirical literature in this regard in the Ghanaian context. To address some of these gaps, we explored the lived experiences of women living with breast in Ghana to inform healthcare practice and breast cancer research. In-depth individual interviews were conducted among 11 breast cancer patients receiving medical treatment for breast cancer. The interpretative phenomenological approach was used in the data analysis. Findings from the study showed that participants’ lived experiences cluster around three major themes; burdens of breast cancer treatments, alternative/herbal medicine use, and breast cancer stigma. These findings underscore the need for a multidisciplinary treatment approach to achieve optimum health outcomes among these groups of women.

Multi-stage feature selection (MSFS) algorithm for UWB-based early breast cancer size prediction.

Breast cancer is the most common cancer among women and it is one of the main causes of death for women worldwide. To attain an optimum medical treatment for breast cancer, an early breast cancer detection is crucial. This paper proposes a multi- stage feature selection method that extracts statistically significant features for breast cancer size detection using proposed data normalization techniques. Ultra-wideband (UWB) signals, controlled using microcontroller are transmitted via an antenna from one end of the breast phantom and are received on the other end. These ultra-wideband analogue signals are represented in both time and frequency domain. The preprocessed digital data is passed to the proposed multi- stage feature selection algorithm. This algorithm has four selection stages. It comprises of data normalization methods, feature extraction, data dimensional reduction and feature fusion. The output data is fused together to form the proposed datasets, namely, 8-HybridFeature, 9-HybridFeature and 10-HybridFeature datasets. The classification performance of these datasets is tested using the Support Vector Machine, Probabilistic Neural Network and Naïve Bayes classifiers for breast cancer size classification. The research findings indicate that the 8-HybridFeature dataset performs better in comparison to the other two datasets. For the 8-HybridFeature dataset, the Naïve Bayes classifier (91.98%) outperformed the Support Vector Machine (90.44%) and Probabilistic Neural Network (80.05%) classifiers in terms of classification accuracy. The finalized method is tested and visualized in the MATLAB based 2D and 3D environment.

Acceptability and preliminary test of efficacy of the Mind programme in women with breast cancer: An acceptance, mindfulness, and compassion-based intervention

Although there is some evidence on the efficacy of mindfulness-based interventions in improving health and psychological outcomes in women with breast cancer, further research is needed to understand these findings’ clinical significance. Furthermore, Acceptance and Commitment Therapy (ACT) intervention studies on breast cancer are scarce, and no compassion-based intervention has been tested for cancer patients. Given the complementarity and compatibility of mindfulness practice, ACT, and Compassion Focused Therapy, the current study combined these approaches to develop an integrative intervention specifically adapted to cancer patients, the Mind programme. Participants were recruited at the Radiotherapy Service of the Coimbra University Hospital (CHUC) and were assigned to one of two groups: the experimental group (Treatment As Usual + Mind Programme (8 weekly sessions and homework assignments) – n = 15) and the control group (Treatment As Usual – n = 17). There was a 100% retention on the experimental group, during the intervention. The effect size for psychological health (g = 0.79) was particularly noteworthy, suggesting that the intervention presented benefits that are comparable to mindfulness only-based interventions. The experimental group also improved on physical health (g = 0.16), quality of social relationships (g = 0.42), depression symptoms (g = −0.42), and stress (g = −0.32). Participants reported it was important for them to take part in the programme, and that it improved the way they deal with difficulties. Results indicate that the Mind programme may be a useful complement to the medical treatment of breast cancer and support the combination of acceptance, mindfulness, and compassion-based components in this context. Having an accessible and integrative psychological programme for people with cancer may significantly help improving quality of life and mental health in this population. Further implications are discussed.

Can posttraumatic growth after breast cancer promote positive coping?-A cross-lagged study.

The diagnosis of breast cancer can be associated with significant emotional distress, yet, over time, cancer survivors also may experience positive psychological changes labeled posttraumatic growth (PTG). Two alternative paths between coping strategies and PTG were tested among breast cancer patients, employing longitudinal design: Would PTG after medical treatment of breast cancer lead to an increase in reporting positive coping strategies; alternatively, would positive coping strategies after medical treatment of breast cancer lead to increased PTG. A longitudinal study was conducted among 198 breast cancer patients who completed validated self-report scales, at five time points: at 3months after completing active medical treatment (T1); after 6months (T2); after 1year (T3); after 2years (T4); and after 7years (T5). The current study analyzes three time points: T1, T3, and T5 using structural equation modeling. Our results support the path that describes the first alternative, that higher report of PTG after medical treatment of breast cancer patients would lead to increased report of positive coping strategies. In addition, positive coping strategies were found to be positively linked to PTG after 6months, and the link was slightly stronger after 2years. Nevertheless, 7years after diagnosis, no association was found between positive coping strategies and PTG measurements. Finding positive meaning after coping with breast cancer, as reflected in PTG, may be a significant resource in coping with cancer, and it may lead to increase of positive coping strategies.

The association between complications and quality of life after mastectomy and breast reconstruction for breast cancer.

Medical treatment for breast cancer is associated with substantial toxicity and patient burden. There is less known about the impact of surgical complications. Understanding this impact could provide important information for patients when they are considering surgical options. Between 2008 and 2009, the UK National Mastectomy and Breast Reconstruction Audit recorded surgical complications for a prospective cohort of 17,844 women treated for breast cancer at 270 hospitals; 6405 of these women were surveyed about their quality of life 18 months after surgery. Breast appearance, emotional well-being, and physical well-being were quantified on 0- to 100-point scales. Linear multiple regression models, controlling for a range of baseline prognostic factors, were used to compare the scores of patients who had complications with the scores of those who did not. The overall complication rate was 10.2%. Complications were associated with little or no impairment in women undergoing mastectomy without reconstruction or with delayed reconstruction. The association was much larger for flap-related complications suffered during immediate reconstruction. The breast-appearance scores (adjusted mean difference, -23.8; 95% confidence interval [CI], -31.0 to -16.6) and emotional well-being scores (adjusted mean difference, -14.0; 95% CI, -22.0 to -6.0) of these patients were much lower than those of any other patient group. Implant-related complications were not associated with a lower quality of life in any surgical group. There is a strong case for prospectively collecting flap-complication rates at the surgeon and surgical unit level and for allowing patients to access these data when they make choices about their breast cancer surgery. Cancer 2017;123:3460-7. © 2017 American Cancer Society.

유방암 치료에 대한 한의 임상 가이드라인 개발을 위한 기초연구

Objectives : The purpose of this study was to present the clinical practice guidelines for breast cancer through the analysis of existing clinical practice guidelines in Western and Chinese medicine. Methods : The literature search was performed regarding conventional and integrative medical treatment of breast cancer using Google Scholar, KIOM OASIS, PUBMED and Jisan library of Daejeon university. Results : Breast cancer is the fifth most common cancer in Korea. Recent studies revealed that combining conventional and integrative medical treatment can reduce the sequela of surgical operation and improve survival rate. However there isn’t still a systemic clinical guideline for breast cancer in korean medicine. This study will be a preliminary study to establish clinical practice guidelines of Korean Medicine for breast cancer.Conclusions : Further objective and systemic clinical studies related to Korean Medicine are needed to develope more advanced clinical practice guidelines of breast cancer.

The potential for liquid biopsies in the precision medical treatment of breast cancer.

Currently the clinical management of breast cancer relies on relatively few prognostic/predictive clinical markers (estrogen receptor, progesterone receptor, HER2), based on primary tumor biology. Circulating biomarkers, such as circulating tumor DNA (ctDNA) or circulating tumor cells (CTCs) may enhance our treatment options by focusing on the very cells that are the direct precursors of distant metastatic disease, and probably inherently different than the primary tumor's biology. To shift the current clinical paradigm, assessing tumor biology in real time by molecularly profiling CTCs or ctDNA may serve to discover therapeutic targets, detect minimal residual disease and predict response to treatment. This review serves to elucidate the detection, characterization, and clinical application of CTCs and ctDNA with the goal of precision treatment of breast cancer.

The potential for liquid biopsies in the precision medical treatment of breast cancer

The potential for liquid biopsies in the precision medical treatment of breast cancer

Treating breast cancer in the 21st century: emerging biological therapies.

For many years, the medical treatment of breast cancer was reliant solely on cytotoxic chemotherapy. However, over the past twenty years, treatment has evolved to a more target-directed approach. We now employ tailored therapy based on the presence or absence of receptors for estrogen, progesterone, and human epidermal growth factor 2 (HER2). We expect this trend to continue, as agents that use novel approaches to target HER2, as well as targeting different portions of the HER signaling pathway, are in various stages of development. Notably, pertuzumab, a humanized monoclonal antibody that binds to a different domain of the extracellular portion of the HER2 receptor than trastuzumab, was recently approved for use, as was lapatinib, a small-molecule tyrosine kinase inhibitor. Patients with triple negative breast cancer, particularly those with the BRCA mutation, have more limited treatment options and carry a worse prognosis than those who are hormone receptor positive. However, recent data has shown that PARP inhibitors may have significant anti-tumor effect in those with this subtype of breast cancer. Novel agents that inhibit mTOR, PI3K, the insulin-like growth factor, heat shock protein 90, and histone deacetylase have shown promise in phase I-III trials and offer exciting new possibilities for the treatment of this often fatal disease. As we are presented with an ever increasing number of treatment options, the timing and combinations of therapeutic agents used becomes ever more complex in the age of personalized care, but we are hopeful that ultimately this will lead to improved patient outcomes.

Demodex spp. Infestation in a breast-cancer patient: A case report

Demodex folliculorum and Demodex brevis are obligatory parasites that live in sebaceous glands and follicles. When immune system becomes suppressed by any reason, patients become vulnerable to obligatory parasites like D. folliculorum and D. brevis. Immune system becomes suppressed in cancer patients who undergo chemotherapy, and as a result these patients become vulnerable to infestations. In our case, a 45 year-old female has been admitted to oncology clinic for a medical treatment of breast cancer. Her systematic physical examination was normal, except redness on her cheeks and forehead. There was no abnormality in biochemical and haematological laboratory values. We have decided to apply chemotherapy of Adriamycin, cyclophosphamide and 5-fluorouracil. Due to the itchy redness on her cheeks and forehead, we had performed an examination for demodex before chemotherapy; and we have identified 20 mites/cm2 on her right and left cheeks, and 15 mites/cm2 on her forehead. When our patient had came our clinic with increasing complaint of itchy rash, after the first course of chemotherapy we have reexamined demodex. The result of microscopic examination revealed large amount of demodex of 50 mites/cm2 on her right and left cheeks and 30 mites/cm2 on her forehead, which were nearly 2.5-times higher than the previous examination. This increase probably was associated with immune suppression of chemotherapy.

Câncer e o sujeito em psicoterapia: horizontes de trabalho na perspectiva existencialista de Jean-Paul Sartre

Este artigo apresenta o relato de um processo psicoterápico realizado com Sofia, uma mulher de 36 anos em tratamento médico para um câncer de mama. Com base na teoria existencialista de Jean-Paul Sartre, compreendeu-se a doença como geradora de mudanças significativas em seu projeto de ser pelas alterações provocadas em suas relações e, consequentemente, em sua experiência de ser quem é. A partir disto, o objetivo principal do processo foi viabilizar Sofia a partir das diferentes condições e horizontes existenciais impostos pela doença, sem esquecer que experiências de sofrimento a atingiram em toda sua história e complexidade e não somente aquelas circunscritas à ocorrência do câncer. Finalizado o processo psicoterápico, considera-se que foi possível reorganizar seu projeto de ser, na medida em que se possibilitou a ela compreender aspectos importantes da trajetória que havia percorrido e ainda de suas possibilidades concretas no presente e para seu futuro.

Mortality reduction in the Swedish mammography screening program.

29 Background: The introduction of a nationwide mammography screening program in Sweden in 1986 was associated with a 50% persistent increase of breast cancer incidence (including carcinoma in situ). Whether screening has been instrumental in a recent decline in the breast cancer mortality remains an open question. Methods: We compared the 18 years breast cancer mortality for two groups of women; those diagnosed in the first 6 years of the screening program and those diagnosed during a 6 year period that included the last 4 years before screening started and the first 2 years of the screening program. The test group (n + 328,927) included women aged 40 to 69 at the first invitation to screening. On average the women in the age-matched control group (n + 317,404) were born 4 years earlier then the women in the test group. The numbers of incident invasive breast cancers in each county were obtained from the Swedish Cancer Registry (in-situ cancers were excluded) and the corresponding breast cancer deaths were obtained from the Swedish Causes of Death Registry. Results: After 18 years follow up, the mortality reduction was 14% in the test group. However, most of this difference (10%) occurred in the first five years after diagnosis reflecting improved medical treatment of breast cancer. Most of the 14% difference also disappeared if we adjusting for period effects. Conclusions: About 83% of women in the test group were also included in the control group making the two groups almost identical with respect to risk variables. By screening the control group at the end of a 6-year period, the results are adjusted for differences due to lead-time bias and by studying mortality instead of survival overdiagnosis (length time bias) is also adjusted for. We conclude that organized mammography screening is not an important cause for the reduction in the breast cancer mortality in Sweden.

Abstract 4218: Guggulsterone controls isomer-specifically TPA-induced MMP-9 expressions of MCF-7 cells: Identification of the cooperative combination of guggulsterone isomers in inhibition of breast cancer invasiveness

Abstract Guggulsterone [4,17(20)-pregnadiene-3,16-dione], a constituent of Commiphora mukul, is used to treat obesity, diabetes, arthritis, and atherosclerosis. Recently it has been known that guggulesterone isomers (trans or cis) show isomer-specificity in their antileukemic activities in leukemia cells. Here, we investigated whether guggulsterone isomers differently control 12-O-tetradecanoylpho-bol-13-acetate (TPA)-induced MMP-9 expression, and then the combination of these isomers cooperatively inhibits breast cancer invasiveness. Cis-guggulsterone inhibited TPA-induced MMP expression through blocking NF-κB signaling, whereas trans-guggulsterone through blocking MAPK/AP-1 signaling. Cis-guggulsterone was the more potent than trans-guggulsterone in inhibition of TPA-induced MMP-9 expression and cell invasion of MCF-7 cells. Furthermore, we found that the combination of these isomers showed addictive effects on inhibition of cell invasion of MCF-7 cells. These results suggest that guggulesterone controls isomer-specifically TPA-induced MMP-9 expressions and cell invasions of MCF-7 cells. This study is the first to show that combination of guggulsterone isomers might be known as a potential strategy for the medical treatment of breast cancer. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 4218. doi:10.1158/1538-7445.AM2011-4218

Individualisierte Therapie des Mammakarzinoms

Breast cancer is the most frequent tumor in women. Clinical research over the last few years has resulted in an increasing differentiation of treatment strategies in the adjuvant setting as well as in metastatic breast cancer. In recent years, the medical treatment of breast cancer was complemented by agents with new mechanisms of action that depend on biological properties of the tumor. As these agents target tumor specific characteristics they are called targeted agents or targeted therapy. Most frequently, different receptors, key proteins of intracellular pathways, thyrosinkinases, or cytokines serve as tumor targets. Even in endocrine treatment relevant changes of practical guidelines emerged. The most important targeted therapies are reviewed with special regard to metastatic breast cancer.

Biological Characteristics and Medical Treatment of Breast Cancer in Young Women—A Featured Population: Results from the NORA Study

Background. The present paper described the biological characteristics and clinical behavior of young women in the cohort NORA study Patients and Methods. From 2000–2002, patients (N > 3500) were enrolled at 77 Italian hospitals. Women aged ≤50 years (N = 1013) were stratified into age groups (≤35, 36–40, 41–45, and 46–50 years). The relationship between age and patient characteristics, cancer presentation, and treatment was analyzed. Results. Younger women more frequently had tumors with ER/PgR-negative(χ 2 = 7.07; P = .008), HER2 amplification (χ 2 = 5.76; P = .01), and high (≥10%) Ki67 labelling index (χ 2 = 9.53; P = .002). Positive nodal status, large tumors, and elevated Ki67 all associated with the choice for chemotherapy followed by endocrine therapy in hormone receptor-positive patients (P < .0001). At univariate analysis, ER-ve status, chemotherapy and age resulted as the only statistically significant variables (HR = 2.02, P = .004, and >40 versus ≤40, P < .0001, resp.). At multivariate analysis, after adjustment for significant clinical and pathological factors, age remains a significant prognostic variable (HR = 0.93, P = .0021). Conclusion. This cohort study suggests that age per sè is an important prognostic factor. The restricted role of early diagnosis and the aggressive behavior of cancer in this population make necessary the application of targeted medical strategies crucial.

E12. Cardiology for the oncologist – Cardiovascular side effects of medical breast cancer treatment

E12. Cardiology for the oncologist – Cardiovascular side effects of medical breast cancer treatment