Non-specific Type Research Articles

Invasive Carcinoma of the Breast of the Nonspecific Type about 3 Cases

Breast cancer is the leading cancer in women worldwide, and the leading cause of cancer-related death in women. Invasive cancer accounts for over 90% of all histological types. The most common breast cancer (95%) is adenocarcinoma, which develops from the epithelial cells of the mammary gland. Infiltrating or invasive carcinoma includes the common infiltrating ductal carcinoma (IDC) (81%), IDC with a predominantly intraductal component (4%), infiltrating lobular carcinoma (10%), usually bilateral, and even rarer forms. Non-specific infiltrating carcinoma is the most common histological type of breast cancer, accounting for around 80% of all cancers, and its clinical and radiological presentation differs according to grade of differentiation. We report three cases of invasive breast carcinoma of the nonspecific type whose diagnosis was suspected by mammography and breast ultrasound and confirmed by anatomopathology of the three breast nodule biopsies and surgical specimens. All three patients were treated surgically by total mastectomy with homolateral axillary lymph node dissection and adjuvant chemotherapy and radiotherapy after a multidisciplinary coordination meeting.

Low-frequency stimulation of corpus callosum suppresses epileptiform activity in the cortex through γ-aminobutyric acid type B receptor and slow afterhyperpolarization-mediated reduction in tissue excitability.

Deep brain stimulation, particularly low-frequency stimulation (LFS) targeting fiber tracts, has emerged as a potential therapy for drug-resistant epilepsy (DRE) and for generalized epilepsy, both of which pose significant treatment challenges. LFS diffusely suppresses seizures in the cortex when applied to fiber tracts like the corpus callosum (CC). Nevertheless, the specific processes responsible for suppressing epileptic activity in the cortex induced by LFS remain unclear. This study investigates the mechanisms underlying the antiepileptic effect in the cortex of LFS of the CC in coronal rodent brain slices. An invitro 4-aminopyridine (4-AP) seizure model of cortical seizures was generated. LFS stimulation parameters were optimized to provide the largest antiepileptic effect in the cortex when applied to the CC. Changes to tissue excitability and percent time spent seizing were measured due to LFS in artificial cerebrospinal fluid, 4-AP, and in the presence of various specific and nonspecific γ-aminobutyric acid type B (GABAB) and slow afterhyperpolarization (sAHP) antagonists. LFS significantly suppressed seizure activity in the cortex, with an optimal frequency of 5 Hz (76.5%). Tissue excitability during LFS reduces across a wide range of interstimulus intervals, with a maximum reduction at 200 ms. Notably, the tissue excitability remains depressed at 1000 ms. LFS, in the presence of GABAB antagonists, had diminished seizure reduction (<15%) and failed to reduce tissue excitability in the 50-400-ms range. Tissue excitability measured with paired pulses in the 600-1000-ms range was depressed in the presence of GABAB antagonists, suggesting a different antiepileptic mechanism was active. Upon administering sAHP antagonists, seizure reduction was once again diminished (<15%). Upon administration of both sAHP and GABAB antagonists, LFS failed to provide any meaningful seizure reduction (<5%). LFS of the CC provides an antiepileptic effect in the cortex with well-understood mechanisms and could be an alternative to surgical intervention for patients suffering from DRE.

Invasive Micropapillary Carcinoma of the Breast: Comparison of Clinical, Epidemiological, Anatomopathological and Therapeutic Features with Infiltrating Carcinoma of Non-Specific Type

Invasive micropapillary carcinoma (IMCC) is a rare histological subtype of invasive breast cancer, its frequency ranges from 1.0 to 8.4% of all breast cancer cases. It is identified as a particularly aggressive tumor since frequent invasion of vessels, skin and lymph nodes is often reported. The aim of the work is to describe and compare the epidemiological, clinical, anatomopathological and molecular aspects of CMPI compared to CINS. Compare the overall survival of the two groups in order to identify the prognostic factors for CMPI. This is a retrospective, descriptive and analytical study spread over 6 years from January 2015 to December 2020, involving all cases of CMPI and CINS of the breast collected at the Obstetrics and Gynecology department of the Maternity and Neonatology Center of Monastir. The frequency found was 5.5% for CMPI and 72.69% for CINS. In our series we found the average age to be more advanced in CINS compared to CMPI without having a statistically significant difference (p=0.49). CMPI tends to be slightly larger than CINS with an average size of 3.7 compared to 3 for CINS. The right breast was the predominant tumor site for the 2 types of cancer p=0.71. CMPI presents a higher frequency of locoregional ADP and vascular emboli with p=0.001. Distant metastases were more frequent in CINS but without having a statistically significant difference. The overall survival of CMPI is 76% versus 86.4%. % of CINS. CMPI represents a particular variety of breast carcinomas; in this study we tried to dissect its different epidemiological, clinical, radiological and therapeutic characteristics which were largely in agreement with the literature.

Prognostic Impact of HER2 Low Status in Male Breast Cancer: Prospective Cohort Analysis.

Male breast cancer (MBC) is a rare disease, and the potential influence of low expression of human epidermal growth factor receptor 2 (HER2 low) remains unexplored. In this prospective cohort study, we evaluated 870 patients treated for MBC between May 2009 and June 2023 to assess HER2 low status and its prognostic implications. With a median follow-up of 43 months (range 1-175 months), 659 eligible patients were categorized into three groups based on HER2 status: 501 (76%) HER2 low, 81 (12.3%) HER2 zero, and 77 (11.7%) HER2 positive. HER2 positivity correlated with younger age, higher proliferation index, non-specific type histology, lymphovascular invasion (LVSI), and low differentiation grade. Notably, all these parameters were equally distributed between the HER2 zero and HER2 low groups. Additionally, HER2 positivity was significantly associated with increased occurrences of regional and distant lymph nodes and pulmonary metastases. However, no statistically significant difference was observed between HER2 zero and HER2 low. Disease-free and overall survival showed no significant disparities between the groups. Our findings suggest that HER2 low status is frequently detected in MBC. Despite this, HER2 low did not correlate with clinical and pathological parameters, nor did it impact patients' survival.

Coupling of the expression of proliferation and epithelialmesenchymal transition markers with the histidine-rich glycoprotein HRG mRNA expression in breast diseases

Non-malignant breast diseases (NMBD) may increase the risk of developing a malignant neoplasm. Therefore, it seems relevant to search for criteria for cell malignancy in NMBD. Aim of the study was to investigate the relationship between expression of proliferation and epithelial-mesenchymal transition (EMT) markers and histidine-rich glycoprotein (HRG) mRNA in breast diseases. Material and methods. In breast biopsy specimens of 37 patients with invasive carcinoma of a non-specific type (ICNT) and 17 patients with NMBD expression of proliferation markers (Ki-67, cyclin D1 (CCND1)) and EMT markers (E-cadherin (CDH1), type II collagen (CII) and β1-integrin (CD29)) was determined immunohistochemically. HRG mRNA expression was estimated using real time PCR. Results. HRG mRNA expression was detected in 91.9 % cases (34 of 37) in ICNT, 82.4 % (14 of 17) in NMBD and in the latter case was inversely related to the expression of CDH1, CD29 and Ki-67. A direct relationship has been established between the presence of Ki-67 and CCND1, CII, between CCND1 and CD29 in NMBD. In patients with ICNT, a direct correlation was found between the HRG mRNA expression and the presence of CII, and an inverse correlation between the number of cells containing CII and CD29. It was found that in ICNT and NMBD with the presence of HRG mRNA expression, the CDH1 expression is less than in its absence. Conclusions. Indicators of HRG mRNA expression in NMBD, combined with the assessment of proliferation and EMT markers, can be useful in developing criteria for cell malignancy in benign breast diseases.

Relationship between the cytokine profle of supernatants of invasive breast carcinoma and its molecular and histopathological characteristics

The aim of the study was to analyze the correlation between the cytokine profile of supernatants of invasive breast carcinoma of a nonspecific type (IBC-NST) samples, histopathological and molecular genetic parameters of IBC-NST, expression of the CD34 as a marker of angiogenesis and metastasis to regional lymph nodes (RLN).Material and Methods. The production of 14 cytokines in IBC-NST biopsy samples from 28 patients aged 37–60 years was studied. The concentration of cytokines in the supernatants of biopsies (CCSB) was determined (in pg/ml) using enzyme immunoassay (ELISA). The expression of CD34 and markers of IBC-NST molecular subtypes (HER2/neu, ER, PR, Ki67) in IBC-NST biopsy samples was evaluated by immunohistochemical method. The relative content of tumor cells of different differentiation grade in the IBC- NST samples was evaluated by histopathological analysis.Results. The assessment of CCSB showed statistically significant differences in IFN-γ, G-CSF, IL-2, IL-10 and MCP-1 between patients of group I (with metastases in RLNs) and group II (without metastases in RLNs). In group I, the correlations between histopathological parameters (Her2/neu, CD34 and Ki67 expressions, % of mitoses and poorly-differentiated cancer cells) and CCSB (MCP-1, IL-18) were revealed. In group II, the correlations between CCSB (IL-2, VEGF-A, G-CSF, IL-1Ra) and histopathological parameters, such as expression of Her2/neu, CD34, PR, % of mitoses and well-differentiated cancer cells, were revealed. The ROC analysis showed that the presence or absence of metastases in RLNs can be predicted on the basis of CD34 expression levels and concentrations of IL-10, G-CSF, and MCP-1 in supernatants of IBC-NST biopsy samples. The quality of the model for stratifying patients into groups with and without RLN metastases, based on the assessment of the concentration of MCP-1 in the supernatants of IBC-NST biopsies, reached maximum values (AUC=1.000) with relatively high CD34 expression.Conclusion. The analysis of the data obtained showed that the assessment of CD34 expression and production of cytokines in IBC-NST biopsies is important for predicting the presence or absence of metastases in RLNs.

The Determination of Heritability in palatal Rugae Pattern among Parents and their Off-Springs in Western India – A Cross-sectional Study

Abstract Background: Palatal rugae are asymmetrical elevations present on hard palate and are significant due to their uniqueness, stability and thus, aid in forensic identification. Objective: The objective is to determine palatal rugae morphology between parents and their offsprings and to determine their genetic inheritance. Materials and Methods: This randomized controlled cross-sectional single-blinded study was conducted on 50 families (randomly selected) who visited Vyas Dental College and Hospital. A total of 150 maxillary study models were examined and rugae were delineated and shape, size, and pattern of rugae were recorded. Results: Weak but significant correlation was seen in the nonspecific and angular type of palatal rugae between child and mother and child and father as P &lt; 0.05. Matching with either or both of their parent was seen for curved, wavy, divergent, straight, horseshoe, angular, and nonspecific type of rugae with the higher % of wavy pattern matching (52% with mother and 54% with father). A considerable number of samples showed high heritability of primary and secondary rugae from both parents, but more predominantly to their mothers (branched, nonspecific, and straight). Conclusion: Both environmental and genetic factors can influence the rugae pattern. Further, studies should be conducted on a larger sample size to get more significant results.

BREAST CARCINOMA WITH LOBULAR COMPONENT DISCOVERED BY THYROIDMETASTASIS: A CASE REPORT

Objective: Breast cancer is the most common cause of cancer-related deaths and is frequently diagnosed in women worldwide. The purpose of this study is to report a case of breast carcinoma with lobular component discovered through thyroid metastasis at the Mohammed VI University Hospital in Marrakech. Case presentation: The patient, a 59 year old multiparous postmenopausal woman with a history of diabetes and hypertension, was referred from the ENT department for a thyroid localization of a carcinomatous process of mammary origin, incidentally discovered during total thyroidectomy + lymph node dissection. A cervical mass had been evolving for approximately 2 years. Results: Physical examination revealed a cervical scar from thyroidectomy, along with an ulcerated lesion of the left breast measuring 2 x 2 cm in the sub-mammary groove, without palpable nodules or lymphadenopathy. Cervical CT scan showed a multinodular and heterogeneous cervical goiter, leading to the recommendation of total thyroidectomy + lymph node dissection. Histopathological examination with immunohistochemistry confirmed a thyroid localization of a mammary-origin carcinomatous process, specifically lobular type. Bilateral mammography revealed two lesions in the left upper outer quadrant and one near the left sub-mammary groove, associated with a left axillary lymph node classified as ACR 5. Biopsy of the sub-mammary lesion identified an infiltrating non-specific type of breast carcinoma with lobular differentiation, classified as luminal B. Following a multidisciplinary consultation, neoadjuvant chemotherapy AC60-Docetaxel + left patey post-chemotherapy was decided upon. Conclusion: Breast cancer metastases to the thyroid, as observed in this study, are rare. Only a few studies (39 cases) have reported this type of breast cancer metastasizing to the thyroid, highlighting the uniqueness of this studyin a southern country. Subject Areas: Gynecology &amp; Obstetrics.

Invasive Ductal Carcinoma in Breast Hamartoma: Case Report and Review if the Literature

Hamartoma of the breast is a rare benign lesion composed of a variable quantity of adipose, fibrous and glandular tissue. and rarely transform into malignant lesions. This tumor affects women at any age from puberty. The reported incidence of this anomaly in the literature varies between 0.1 and 0.7% of all benign breast tumors. The radiological and histological aspects are variable and depend on its adipose tissue content. The identification of these lesions makes it possible, on the one hand, to avoid systematic surgical excisions and, on the other hand, will prevent the appearance of breast cancer in these normally benign lesions. In this report, we review the literature and describe a case report of non-specific invasive ductal type infiltrating carcinoma within a Hamartoma in a 48-year-old woman. Mammography, ultrasound and magnetic resonance imaging showed the radiological semiology of a typical Hamartoma with suspicious microcalcifications on mammography. This case illustrates the importance of identifying unusual findings in a typical breast hamartoma during radiological examinations.

Clinicopathological features and prognostic analysis of HER2 low and fibrotic focus in HER2-negative breast cancer.

The aim of this study is to evaluate the clinicopathological features and prognostic significance of HER2 low, fibrotic focus (FF), and tumor-infiltrating lymphocytes (TILs) in patients with HER2-negative breast cancer. We retrospectively reviewed the data of 293 patients with HER2-negative, stage I-II, invasive breast cancer of non-specific types. The HER2-negative cases were classified into HER2 low and HER2 0. Digital analysis of hematoxylin-eosin stained whole slide images was used to evaluate the FF expression. TILs were also evaluated using the Whole Slide Image. Furthermore, the association between HER2 low, FF, and TILs as well as their prognostic significance were analyzed. The study cohort included 178 cases (60.8%) with HER2 low and 115 cases (39.2%) with HER2 0. Older age, lower Nottingham histological grade (NHG), estrogen receptor (ER) positivity, progesterone receptor (PR) positivity, and hormone receptor (HR) positivity were all associated with HER2 low. FF was correlated with older age, intermediate and low NHG, vascular invasion, HR positivity, HER2 low status, high Ki67 expression, and low TILs. Univariate survival analysis showed that FF was significantly associated with shorter progression-free survival (PFS). Stratified analysis indicated that in the HR-negative and HR-positive groups, HER2 status and TILs did not affect PFS. DFS was longer in patients without FF compared to those with FF in the HR-positive (hazard ratio [HR] = 0.313) and HER2 low (HR = 0.272) groups. DFS was also significantly longer in patients without FF compared to those with FF in the HR-negative (HR = 0.069) and HER2 0 groups (HR = 0.129). The results indicated that the HER2 low status and the TILs expression did not impact prognosis. However, patients with FF exhibited distinct biological characteristics and prognostic significance, particularly in the HR-negative and HER2 0 groups. This provides a rationale for accurate diagnosis and treatment of HER2-negative breast cancer.

A simple, rapid fluorescent reporter-based method for detection of ectopic cre recombinase expression in presumed retinal cell type-targeted mouse lines

Although cell type-specific Cre recombinase-expressing mouse lines are commonly used to generate conditional knockout of genes of interest, germline recombination and ectopic “leakiness” in Cre recombinase expression in non-specific cell types has been observed in several neuronal and glial-specific Cre lines. This often leads to inadvertent loss of conditional mouse lines, requiring rederivation. It is therefore imperative to be able to monitor and validate cell type-specific Cre recombinase-mediated gene editing. Herein, we describe a simple, inexpensive, rapid ZsGreen fluor-reporter-based strategy for genotype-free identification of ectopic leakiness using a custom-designed, 3-D blue LED light box. We assessed cell type-specific expression in several allegedly specific Cre recombinase mouse lines commonly used in vision research: retinal pigment epithelium (RPE)-specific (VMD2 (Best1) Cre, RPE65 Cre); astrocyte-specific (GFAP Cre); as well as photoreceptor-bipolar progenitor cell-specific (CRX Cre). Our standardized workflow allows facile, rapid identification of ectopic and non-specific Cre recombinase expression in any presume specific Cre mouse line, without the need for genotyping and without causing animal distress.

Breast Carcinoma and Tuberculosis in Axillary Lymph Nodes: A Case Report

The coexistence of tuberculosis with axillary lymph node metastases in breast carcinoma is rare. Axillary lymph node metastasis is the most important factor in the staging of breast carcinoma, this can mimic or complicate the staging of a malignant disease. Dual organ pathology can lead to interpretation difficulties and inappropriate treatment of tuberculosis as well as breast carcinoma. We report an observation of infiltrating carcinoma of the non-specific type of the breast in woman aged 39, where tuberculosis was found in the axillary lymph nodes in addition to metastases. The possible and simultaneous occurrence of breast carcinoma and tuberculosis should be mentioned in order to avoid difficulties of interpretation and allow adequate management of axillary tuberculous lymphadenitis and breast carcinoma.

Comparative study of next generation sequencing and immunohistochemistry on molecular classification of endometrial carcinoma

Objective: To investigate the differences in molecular classification of endometrial carcinoma (EC) between various technical methods and to explore molecular classification schemes suitable for Chinese population. Methods: The study used a comprehensive scheme of next generation sequencing (NGS) and immunohistochemistry for molecular classification of 254 EC cases that were obtained at Department of Pathology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China from April 2021 to March 2022. According to the recommended threshold of Sanger sequencing which was approximate-20% variant allele fraction (VAF), NGS data were extracted to simulate the results of Sanger sequencing. Results: The 254 EC patients had a mean age of 51 years (range, 24 to 89 years). Combination of POLE (9-14 exons), TP53 total exons and microsatellite instability (MSI) detection was a better single scheme than NGS alone, while combination of MSI fragment analysis and conventional immunohistochemistry was the best solution and seemed best aligned with TCGA data and recent studies. POLE ultramuted type, mismatch repair defect type, TP53 mutant type and non-specific molecular characteristic type accounted for 11.4% (29/254), 31.5% (80/254), 22.4% (57/254) and 34.6% (88/254) of the cases, respectively. If Sanger sequencing was adopted for POLE and TP53 detection, the frequencies of these EC types were 9.1% (23/254), 31.5% (80/254), 12.9% (33/254) and 46.6% (118/254), respectively, with greatly increasing non-specific molecular characteristics cases. If POLE was detected by Sanger sequencing and others by immunohistochemistry, they were 9.1% (23/254), 42.2% (92/218), 13.8% (35/254) and 40.9% (105/254), respectively, with increasing the false positive rates of the mismatch repair defect group. Conclusions: Small and medium-sized NGS panels with MSI detection is a better solution than NGS alone. Sanger sequencing is currently available for POLE mutation detection, which is not sensitive enough for TP53 mutation detection, and seems equivalent to the efficiency of TP53 by immunohistochemistry. Further optimization of small and medium-sized NGS panels covering MSI detection and POLE and TP53 full exons may be the best choice for the future to meet national conditions.

Stroke-like presentation of acute toxic leukoencephalopathy due to capecitabine treatment with extensive intramyelinic edema.

Stroke-like presentation of acute toxic leukoencephalopathy due to capecitabine treatment with extensive intramyelinic edema.

An interdisciplinary student-led multifaceted intervention addressing overuse of broad-spectrum antibiotics for patients with penicillin allergies

BackgroundThough 15% of hospitalized patients have a documented penicillin (PCN) allergy, fewer than 1% have an IgE-mediated reaction that necessitates avoidance of β-lactam antibiotics.ObjectiveOur interdisciplinary team of medical and nursing students led and executed a two-pronged quality improvement intervention to reduce prescribing of non-β-lactam antibiotics (NBLs) for patients with reported PCN allergies. To the best of our knowledge, this is the first multidisciplinary student-led intervention aimed at educating providers on low-risk penicillin allergy and encouraging best antibiotic prescribing practices.Design and participantsThe intervention took place from June 2021 to February 2022. We developed and provided clinician education modules, including peer-to-peer information sharing and in-person small group discussions, as well as clinical decision support (CDS) strategies through the electronic medical record (EMR). The target population was attendings, residents, nurse practitioners, and physician assistants on the hospital medicine service at a large urban academic tertiary care center. We followed the SQUIRE 2.0 guidelines for reporting on quality improvement.Main measuresPrimary outcome measures included number of NBL prescriptions and use of nonspecific descriptors (e.g., “other” or “unknown”) for PCN allergy reaction type, and were compared with a pre-intervention period.Key resultsThe percent of β-lactam prescriptions for patients with a PCN allergy after the intervention increased from 19 to 23% (p = 0.006). For patients with a low severity PCN allergy, the percent of β-lactam prescriptions increased from 20 to 28% (p = 0.001). There was a significant decrease in nonspecific PCN allergy reaction type from 23% in the pre-intervention period to 20% post-intervention (p = 0.012).ConclusionsAn intervention focused on educating prescribers and CDS strategies delivered through the EMR increased appropriate β-lactam prescribing for patients with a documented low-risk PCN allergy and reduced the use of nonspecific PCN allergy reaction type in EMR documentation.

Cytokine production by blood cells and tumor samples and its coupling to microRNA expression in breast cancer patients

Breast tumors show a complex structure and are highly heterogeneous. The study of cytokines, which exert great influence on tumor cells, and microRNAs, which, along with their influence on the proliferation and migration of neoplastic cells, may affect the work of cytokines, will contribute to a deeper understanding of pathological processes occurring in breast cancer. The aim of our work was to analyze the relationship of cytokine production with expression of miR-181a and miR-25in patients with invasive breast carcinoma of a non-specific type (IBC NST) with various molecular subtypes.Patients with IBC NST were divided into five subgroups according to the molecular genetics subtype of the tumor classified by immunohistochemical analysis of estrogen receptor (ER), progesterone (PR), epidermal growth factor 2 (HER2) and proliferation marker Ki-67. Using enzyme immunoassay, the concentration of 14 cytokines was determined in the supernatants of immunocompetent blood cells and tumors: IL-2, IL-6, IL-8, IL-10, IL-17, IL-18, IL-1β, IL-1ra, TNFα, IFNγ, G-CSF, GM-CSF, VEGF and MCP-1. The expression of miR-181a and miR-25 microRNAs isolated from the patients’ blood serum was evaluated using digital droplet polymerase chain reaction (ddPCR).In the luminal A subtype, cytokine concentrations and expression of miR-181a and miR-25 are significantly lower compared to other subtypes. Patients with the luminal B HER2-negative subtype were characterized by significantly increased expression of both studied microRNAs, especially when compared with the luminal A subtype. At the same time, patients with a triple negative molecular subtype, on the contrary, were characterized by high concentrations of cytokines in the supernatants of tumor samples and blood cells compared to other subtypes. In the general group of patients with IBC NST, direct correlations were found between the expression of both studied microRNAs and the concentration of vascular endothelial growth factor (VEGF) in the supernatant of tumor samples, which may presume mutual interactions existing between miR-181a and miR-25, and the process of angiogenesis in the tumor.The levels of cytokines in blood supernatants and tumors in invasive breast carcinoma may vary, depending on distinct molecular subtypes of the tumor. Moreover, they also have direct links with the levels of miR-181a and miR-25 in blood serum. Particularly noteworthy were the results of measuring the cytokines and microRNAs concentrations in luminal A, luminal B HER2-negative and triple negative molecular subtypes.

Factors associated with late diagnosis of breast cancer in women in Togo, Sub-Saharan Africa

BackgroundBreast cancer is the most frequently diagnosed cancer in women worldwide. The objective of this study was to identify factors associated with late diagnosis of breast cancer in Togolese women.MethodsWe conducted a prospective cross-sectional study with descriptive and analytical purposes on cases of breast cancer in women in 2021, in Togo. The patients included in this study were women followed in the gynecology department for stages III and IV breast cancer.ResultsWe included 62 cases of breast cancer. The average age of the patients was 38.6 ± 12.5 years with extremes of 17 and 76 years. The breast nodule was the most common reason for consultation in 75.8% of cases. The histological types diagnosed were invasive carcinoma of non-specific type (58; 93.55%), mucinous carcinoma (3; 4.84%) and lobular carcinoma (1; 1.61%). For the stage of the cancer, 43 patients were stage III (69.4%) and 19 stage IV (30.6%).In multivariate analysis, the factors associated with late diagnosis of breast cancer were: fear of diagnosis (aOR = 1.29; p = 0.0014), long delay in diagnosis (aOR = 2.62; p = 0.0001) and failure to perform breast self-examination (aOR = 1.68; p = 0.0022).ConclusionThe fear of the diagnosis, the absence of self-examination of the breasts and the use of traditional treatment and self-medication in first intention constituted the essential factors of the late diagnosis of breast cancer. Strategies should be put in place at the national level to impact on these factors for an early diagnosis of breast cancer.

Patients’ and prescribers’ experiences of managing neuropathic pain with medication: a scoping review

Background: Neuropathic pain (NP) is a chronic condition that affects patients’ quality of life. Prescribing for NP within primary care is variable. There is a need to understand NP medicine management from both patient and prescribers’ perspectives. This scoping review aimed to identify, synthesise and identify gaps in the literature on the experiences of: i) prescribers in prescribing medicines to manage the symptoms of NP and ii) people with NP who use prescribed medicines to manage their symptoms. Methods: Four electronic bibliographic databases (Medline, CINAHL, Embase and PsycInfo) were searched from inception to the end of October 2022 using a structured search strategy. The findings were synthesised and presented using a modified framework for monitoring opioid prescribing called the 5 A’s framework. The 5 A’s are Analgesia, Activities of daily living, Adverse effects, Aberrant behaviour, and Activities and actions of healthcare professionals. Results: From the 10,995 records identified, 11 studies were included in the review. All the studies focused on patients' experiences, with no studies about the experiences of prescribers in managing NP. Patients reported that medicines seem to work at the outset but, over time, are less effective in relieving their pain. Patients took less than the prescribed dose of their medicine, depending on their pain level on the day. Taking medication allowed patients to participate in activities they would not otherwise have been able to do, often resulting in less isolation and loneliness. Conclusions: This scoping review has highlighted patients' experiences of using medicines to manage NP. Results provide insight into how patients cope with inadequate pain control and the impact this has on patients’ lives. More research is required to explore the experiences of people living with non-specific types of NP as well as the experiences of prescribers who prescribe medicines to manage NP.

Приме-нение метода мультисрезовой спиральной компьютерной томографии для оценки состояния лёгких у животных с моделированным антракозом

Occupational diseases and harmful production factors contribute to a significant disability of the working population. This article discusses some morphological aspects of changes in the lungs of experimental animals after the introduction of coal suspension into the respiratory tract. Specific and non-specific responses of lung tissue to the damage were determined. The object of the study was white outbred rats, formed according to the principle of pairs of analogues, with the separation of the experimental and control groups. On the 10th day of the experiment, the animals were withdrawn from the experiment, with a preliminary multislice computed tomography and subsequent microscopic assessment of the organization of the lung parenchyma. As a result, computed tomography revealed a pronounced reaction with the formation of emphysema in the subpleural parts of the lungs. Microscopic examination revealed non-specific types of responses to the introduction of coal dust with the formation of leukocyte infiltration in various parts of the lungs, accumulation of mucus and coal dust in the respiratory bronchioles.

Serum miR-181a and miR-25 in patients with malignant and benign breast diseases.

Breast tumor diseases include a wide range of pathologies that require different approaches to their treatment. MicroRNA (miR) levels, reflecting regulation of the gene expression involved in tumorigenesis, can be diagnostic and prognostic markers of breast diseases. The levels of circulating miR-181a and miR-25 were measured in patients with benign breast diseases (BBD), patients with invasive carcinoma of a nonspecific type (ICNT) and also in conditionally healthy women. Expression of both miRs was higher in patients of both groups as compared to controls; at the same time, the content of serum miR-181a and miR-25 was higher in BBD patients than in ICNT patients. The detected changes may be of interest in the context of precancerous changes in BBD. It seems possible to use them in the future as markers of the pathological process as a part of a large diagnostic panel.