Number Of Breast Cancer Patients Research Articles

Artificial intelligence auxiliary diagnosis and treatment system for breast cancer in developing countries.

In many developing countries, a significant number of breast cancer patients are unable to receive timely treatment due to a large population base, high patient numbers, and limited medical resources. This paper proposes a breast cancer assisted diagnosis system based on electronic medical records. The goal of this system is to address the limitations of existing systems, which primarily rely on structured electronic records and may miss crucial information stored in unstructured records. The proposed approach is a breast cancer assisted diagnosis system based on electronic medical records. The system utilizes breast cancer enhanced convolutional neural networks with semantic initialization filters (BC-INIT-CNN). It extracts highly relevant tumor markers from unstructured medical records to aid in breast cancer staging diagnosis and effectively utilizes the important information present in unstructured records. The model's performance is assessed using various evaluation metrics. Such as accuracy, ROC curves, and Precision-Recall curves. Comparative analysis demonstrates that the BC-INIT-CNN model outperforms several existing methods in terms of accuracy and computational efficiency. The proposed breast cancer assisted diagnosis system based on BC-INIT-CNN showcases the potential to address the challenges faced by developing countries in providing timely treatment to breast cancer patients. By leveraging unstructured medical records and extracting relevant tumor markers, the system enables accurate staging diagnosis and enhances the utilization of valuable information.

Designing a virtual breast cancer prevention program for Iranian women: A study protocol

BACKGROUND: The growing number of breast cancer patients in Iran, following the lower referrals of women to screening centers after the outbreak of the COVID-19, suggests the need for designing virtual educational interventions to teach self-care methods to women. The aim of this study is to design a virtual training program for the prevention of breast cancer in women based on the steps of the ADDIE (Analysis, Design, Development, Implementation, and Evaluation) educational design model. MATERIALS AND METHODS: This developmental study will be conducted based on the steps of the ADDIE model. In the first step (analysis), a qualitative study, literature review, and a panel of experts will be conducted to analyze the situation (learners, content, platforms, and media for the electronic presentation of the program). In the design step, the learning objectives, educational strategies, and the way of program’s implementation and evaluation will be specified. In the third step, not only are the content, storyboard, and educational program developed, but the pilot study is also conducted and formative assessment is performed. In the fourth step, the program will be provided to the audience and will be implemented as a preliminary program. In the final step, the final virtual education program for the prevention of breast cancer in women will be presented based on the results of the evaluation. CONCLUSIONS: Using a comprehensive and systematic educational design model can be a step toward making changes and encouraging innovations in breast cancer prevention education programs in women based on virtual education. Given the existing needs and conditions, this program can promote cancer preventive behaviors as much as possible, reduce the costs imposed on the family and healthcare systems, and lower the complications and mortality rate caused by the delayed diagnosis of the disease.

Zinc finger protein 468 up-regulation of TFAM contributes to the malignant growth and cisplatin resistance of breast cancer cells

BackgroundBecause of the progress on the diagnosis and treatment for patients with breast cancer (BC), the overall survival of the patients has been improved. However, a number of BC patients cannot benefit from the existing therapeutic strategies as the essential molecular events triggering the development of BC are not well understood. Previous studies have shown that abnormal expression of zinc finger proteins is involved in the development of various malignancies, whereas it remains largely unclear on their significance during the progression of BC. In this study, we aimed to explore the clinical relevance, cellular function and underlying mechanisms of zinc finger protein 468 (ZNF468) in BC.MethodsThe clinical relevance of ZNF468 and TFAM was analyzed based on TCGA database. Overexpression or knockdown of ZNF468 and TFAM were performed by transfecting the cells with overexpression plasmids and siRNAs, respectively. Overexpression and knockdown efficacy was checked by immunoblotting. CCK-8, colony formation, transwell and apoptosis experiments were conducted to check the cellular function of ZNF468 and TFAM. The content of mtDNA was measured by the indicated assay kit. The effects of cisplatin on BC cells were detected by CCK-8 and colony formation assays. The regulation of ZNF468 on TFAM was analyzed by RT-qPCR, immunoblotting, dual luciferase activity and ChIP-qPCR assays.ResultsZNF468 was overexpressed in BC patients and inversely correlated with their prognosis. Based on overexpression and knockdown assays, we found that ectopic expression of ZNF468 was essential for the proliferation, growth and migration of BC cells. The expression of ZNF468 also negatively regulated the sensitivity of BC cells to the treatment of cisplatin. Mechanistically, ZNF468 potentiated the transcription activity of TFAM gene via direct binding on its promoter. Lastly, we demonstrated that ZNF468 up-regulation of TFAM was important for the growth, migration and cisplatin resistance in BC cells.ConclusionOur study indicates that ZNF468 promotes BC cell growth and migration via transcriptional activation of TFAM. ZNF468/TFAM axis can serve as the diagnostic and therapeutic target, as well as the predictor of cisplatin effectiveness in BC patients.

Psychological experiences of family caregivers of patients with breast cancer: Protocol for a meta-synthesis.

The number of breast cancer patients is increasing, but there are insufficient sources of information for their family caregivers. The purpose of this systematic review was to elaborate the psychologically realistic experiences and corresponding needs of family members of patients with breast cancer in the course of their experience in the disease which may provide them with effective, targeted intervention strategies to improve their quality of life. Protocol for a meta-synthesis. We will search the Chinese databases (i.e., China National Knowledge Infrastructure, VIP Database and Wanfang Database) and the English databases (i.e., PubMed, Embase, Web of Science, the Cochrane Library, CINAHL and PsycINFO). Qualitative studies from the above databases, studying the psychological experiences of family members of patients with breast cancer, will be searched comprehensively. The quality of the study will be evaluated by two reviewers independently using the Joanna Briggs Institute (JBI) critical appraisal tools for qualitative study, and any disagreements will be discussed and judged by the third reviewer. Data will be extracted using JBI standardized data extraction tool. Then, the literature will be compared and analysed, and the raw results summarized using the JBI meta-aggregation tool. The reliability and credibility of the overall quality of the included studies will be assessed by using the JBI ConQual approach. N/A. No Patient or Public Contribution. REDACTED.

Potential of Dietary HDAC2i in Breast Cancer Patients Receiving PD-1/PD-L1 Inhibitors.

Breast cancer (BC) is a lethal malignancy with high morbidity and mortality but lacks effective treatments thus far. Despite the introduction of immune checkpoint inhibitors (ICIs) (including PD-1/PD-L1 inhibitors), durable and optimal clinical benefits still remain elusive for a considerable number of BC patients. To break through such a dilemma, novel ICI-based combination therapy has been explored for enhancing the therapeutic effect. Recent evidence has just pointed out that the HDAC2 inhibitor (HDAC2i), which has been proven to exhibit an anti-cancer effect, can act as a sensitizer for ICIs therapy. Simultaneously, dietary intervention, as a crucial supportive therapy, has been reported to provide ingredients containing HDAC2 inhibitory activity. Thus, the novel integration of dietary intervention with ICIs therapy may offer promising possibilities for improving treatment outcomes. In this study, we first conducted the differential expression and prognostic analyses of HDAC2 and BC patients using the GENT2 and Kaplan-Meier plotter platform. Then, we summarized the potential diet candidates for such an integrated therapeutic strategy. This article not only provides a whole new therapeutic strategy for an HDAC2i-containing diet combined with PD-1/PD-L1 inhibitors for BC treatment, but also aims to ignite enthusiasm for exploring this field.

The Impact of Symptom Burden, Social Support, Self-Efficacy, and eHealth Literacy on the Quality of Life of Patients Undergoing Breast Cancer Treatment: A Cross-Sectional Study

Purpose: The number of breast cancer patients in Korea has steadily increased. However, there are few studies addressing quality of life of patients undergoing breast cancer treatment in Korea. This study aimed to identify predictors of quality of life among patients undergoing breast cancer treatment.Methods: This descriptive, cross-sectional study included 142 patients with breast cancer undergoing treatment in a cancer hospital. Data were collected using the MD Anderson Symptom Inventory, Multidimensional Scale of Perceived Social Support, Breast Cancer Survivors Scale, eHealth Literacy Scale, and the Functional Assessment of Cancer Therapy-Breast Cancer through self-administered questionnaires from January 12 to December 6, 2022. Differences in the level of quality of life according to demographic and clinical variables and correlations among continuous variables were identified using univariate statistics, and hierarchical multiple regression was used to identify predictors of quality of life.Results: Employment status, comorbidities, disease duration, and cancer stage were demographic and clinical variables that showed significant associations with quality of life. Symptom burden, social support, self-efficacy, and eHealth literacy were also significantly associated with quality of life. The predictors of quality of life were employment status (β=.13, p=.009), cancer stage (β=.12, p=.033), symptom severity (β=-.14, p=.044), symptom interference (β=-.30, p<.001), social support (β=.13, p=.025), and self-efficacy (β=.46, p<.001). The explanatory power was approximately 69% (F=26.90, p<.001).Conclusion: Nursing interventions should be implemented for patients undergoing breast cancer treatment to improve their quality of life while reducing the symptom burden and enhancing self-efficacy and social support.

Long-Term Outcomes of Breast Cancer Patients with Local Recurrence After Mastectomy Undergoing Immediate Breast Reconstruction: A Retrospective Multi-institutional Study of 4153 Cases.

The number of breast cancer patients in Japan undergoing immediate breast reconstruction (IBR) has increased and the postoperative follow-up period has been extended. This study was conducted to clarify the clinical aspects of, and factors associated with, local recurrence (LR) after IBR. This was a multicenter study which included 4153 early breast cancer patients who underwent IBR. Clinicopathological characteristics were examined and factors potentially contributing to LR were analyzed. Risk factors for LR were examined separately for non-invasive and invasive breast cancers. The median follow-up period was 75 months. The 7-year LR rates were 2.1% and 4.3% for non-invasive and invasive cancers, respectively (p < 0.001). The proportions of LR detected by palpation, subjective symptoms, and ultrasonography were 40.0%, 27.3%, and 25.9%, respectively. Overall, 75.7% of LR were solitary, and 92.7% of these cases had no further recurrences during the observational period. Multivariate analysis of LR for invasive cancer showed that skin-sparing mastectomy (SSM) or nipple-sparing mastectomy (NSM), the presence of lymphovascular invasion, cancer at the surgical margin, and not receiving radiation therapy were factors related to LR. The 7-year overall survival rates of the patients with LR and non-LR of invasive cancers were 92.5% and 97.3%, respectively, (p = 0.002). The rate of LR after IBR was acceptably low and IBR can thus be performed safely for early breast cancer patients. Invasive cancer, SSM/NSM, lymphovascular invasion, and/or cancer at the surgical margin should prompt awareness of the possibility of LR.

Childbirth after perioperative systemic therapy in patients with breast cancer: a retrospective single institutional study in Japan.

The number of breast cancer patients of childbearing age has been increasing. Therefore, we investigated the characteristics and the childbearing status of the patients who received systemic therapy for breast cancer during their childbearing age to better understand the clinical impact of childbirth. Female patients with breast cancer younger than 40years old who underwent surgery and received perioperative systemic therapy from 2007 to 2014 were included in this study. We compared the characteristics of patients with and without childbirth after treatment. Of 590 patients, 26 delivered a child, and 355 did not bear a child during the median observation period of 8.1years, whilst 209 had unknown childbirth data. The childbirth group had a lower mean age at surgery (32.2 vs. 35.1, P<0.001). The proportion of patients who desired childbirth and used assisted reproductive technology was significantly higher in the childbirth group (65.4 vs. 23.9% and 45.2 vs. 5.1%, respectively, P<0.001). The patients in the childbirth group had significantly less advanced disease (P=0.002). In the childbirth group, the age at childbirth was significantly older in patients who received combined endocrine therapy and chemotherapy (40.8years) than in patients who received either alone (endocrine therapy: 36.9years, chemotherapy: 36.7years, P=0.04). However, survival was not different between those with and without childbirth. It is critical to recognize the desire for childbirth in patients with breast cancer who are receiving systemic therapy and to provide them with necessary fertility information before treatment to support their decision-making.

Preliminary Attainability Assessment of Real-World Data for Answering Major Clinical Research Questions in Breast Cancer Brain Metastasis: Framework Development and Validation Study.

In recent decades, real-world evidence (RWE) in oncology has rapidly gained traction for its potential to answer clinical questions that cannot be directly addressed by randomized clinical trials. Integrating real-world data (RWD) into clinical research promises to contribute to more sustainable research designs, including extension, augmentation, enrichment, and pragmatic designs. Nevertheless, clinical research using RWD is still limited because of concerns regarding the shortage of best practices for extracting, harmonizing, and analyzing RWD. In particular, pragmatic screening methods to determine whether the content of a data source is sufficient to answer the research questions before conducting the research with RWD have not yet been established. We examined the PAR (Preliminary Attainability Assessment of Real-World Data) framework and assessed its utility in breast cancer brain metastasis (BCBM), which has an unmet medical need for data attainability screening at the preliminary step of observational studies that use RWD. The PAR framework was proposed to assess data attainability from a particular data source during the early research process. The PAR framework has four sequential stages, starting with clinical question clarification: (1) operational definition of variables, (2) data matching (structural/semantic), (3) data screening and extraction, and (4) data attainability diagramming. We identified 5 clinical questions to be used for PAR framework evaluation through interviews and validated them with a survey of breast cancer experts. We used the Samsung Medical Center Breast Cancer Registry, a hospital-based real-time registry implemented in March 2021, leveraging the institution's anonymized and deidentified clinical data warehouse platform. The number of breast cancer patients in the registry was 45,129; it covered the period from June 1995 to December 2021. The registry consists of 24 base data marts that represent disease-specific breast cancer characteristics and care pathways. The outcomes included screening results of the clinical questions via the PAR framework and a procedural diagram of data attainability for each research question. Data attainability was tested for study feasibility according to the PAR framework with 5 clinical questions for BCBM. We obtained data sets that were sufficient to conduct studies with 4 of 5 clinical questions. The research questions stratified into 3 types when we developed data fields for clearly defined research variables. In the first, only 1 question could be answered using direct data variables. In the second, the other 3 questions required surrogate definitions that combined data variables. In the third, the question turned out to be not feasible for conducting further analysis. The adoption of the PAR framework was associated with more efficient preliminary clinical research using RWD from BCBM. Furthermore, this framework helped accelerate RWE generation through clinical research by enhancing transparency and reproducibility and lowering the entry barrier for clinical researchers.

Retrospective analysis of treatment, including access to breast reconstructions, of breast cancer patients – war refugees from Ukraine in Poland – the experience of a single tertiary care institution

&lt;b&gt;Introduction:&lt;/b&gt; Following the Russian invasion, more than 3600000 refugees have fled Ukraine and settled down in Poland; this group includes a growing number of breast cancer patients whose treatment had been started in Ukraine and hence required urgent therapy in Poland.&lt;/br&gt;&lt;/br&gt; &lt;b&gt;Aim:&lt;/b&gt; The aim of the study was to analyze the treatment of breast cancer patients from Ukraine, who entered Poland as war refugees – the experience of a single tertiary care institution.&lt;/br&gt;&lt;/br&gt; &lt;b&gt;Material and methods:&lt;/b&gt; The treatment of 25 consecutive breast cancer patients, war refugees from Ukraine was reviewed retrospectively.&lt;/br&gt;&lt;/br&gt; &lt;b&gt;Results:&lt;/b&gt; Patients were treated according to subtype and staging, e.g. surgery, endocrine, anti-HER2 therapy, chemotherapy, radiotherapy. 7 patients received an immediate implant, mesh-based breast reconstruction. In 2 cases, the patients refused breast reconstruction.&lt;/br&gt;&lt;/br&gt; &lt;b&gt;Conclusions:&lt;/b&gt; Nearly 5.5 million refugees across Europe who have fled the combat zones in Ukraine; of these, the vast majority sought shelter in Poland, and many of whom are women. It is expected that breast cancer mortality rates may rise and progress in oncology may slow as the war in Ukraine disrupts routine patient care, clinical trials and research. Hence, support from neighboring countries is mandatory.

Abstract OT3-19-01: Phase II Study of Screening Brain MRIs in Stage IV Breast Cancer

Abstract Background: As systemic therapy improves, there has been an increasing number of breast cancer patients who develop brain metastasis. Screening of asymptomatic stage IV breast cancer patients with brain MRIs is not currently recommended by the National Comprehensive Cancer Network (NCCN) Guidelines. Retrospective reports suggest breast cancer patients are more likely to present with more advanced central nervous system disease at the time of brain metastasis diagnosis compared to melanoma and non-small cell lung cancer (NSCLC) patients. This may be in part due to routine screening recommendations in melanoma and NSCLC. Early detection and treatment of brain metastases may improve outcomes for breast cancer patients. Trial Design: The study is designed as a single arm, nonrandomized phase II study, with the goal of investigating the role of screening brain MRIs in neurologically asymptomatic patients with metastatic breast cancer. Breast cancer patients will be allocated based on receptor subtypes into triple negative (TN), HER2+, and hormone receptor (HR)+/HER2- breast cancer. Following study enrollment, patients will undergo a screening brain MRI. Patients will undergo a second brain MRI at first systemic progression or at 6 months whichever event occurs sooner. Eligibility: Asymptomatic, stage IV breast cancer patients that have progressed past first line therapy in the metastatic setting with an ECOG/= 6 months are eligible. Specific Aims: The primary objective is to determine the incidence of asymptomatic brain metastasis in metastatic breast cancer by subtype. Secondary objectives include determining the incidence of asymptomatic leptomeningeal disease, the number and size of brain metastases at diagnosis, the number of patients requiring whole brain radiation therapy vs. stereotactic radiation following diagnosis and overall survival and brain metastasis specific survival following brain metastasis diagnosis in metastatic breast cancer by subtype. Statistical Methods: A total of 30, 30, and 40 TN, HER2+, and HR+/HER2-, breast cancer patients will be enrolled, respectively. Using an incidence rate of 17%, the 95% CI by subtype will be (0.06,0.351), (0.06,0.351), and (0.07,0.322). Patient Accrual: This study is open with 30 patients enrolled at the time of submission. A total of 100 patients will be enrolled. Contact Information: Kamran A. Ahmed MD, Moffitt Cancer Center, email: kamran.ahmed@moffitt.org, Clinical trial information: NCT05115474. Funding: Florida Breast Cancer Foundation. Citation Format: Kamran A. Ahmed, Youngchul Kim, Avan Armaghani, John Arrington, Ricardo Costa, Brian J. Czerniecki, Roberto Diaz, Peter A. Forsyth, Hung Khong, Kimberley Lee, Loretta Loftus, Marilin Rosa, Hatem H. Soliman, Iman Washington, Aixa Soyano, Hyo S. Han. Phase II Study of Screening Brain MRIs in Stage IV Breast Cancer [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr OT3-19-01.

Isopimaric acid, an ion channel regulator, regulates calcium and oxidative phosphorylation pathways to inhibit breast cancer proliferation and metastasis

Breast cancer is the globally most common malignant tumor and the biggest threat to women. Even though the diagnosis and treatment of breast cancer are progressing continually, a large number of breast cancer patients eventually develop a metastatic tumor, especially triple-negative breast cancer (TNBC). Recently, metal ion homeostasis and ion signaling pathway have become important targets for cancer therapy. In this study, We analyzed the effects and mechanisms of isopimaric acid (IPA), an ion channel regulator, on the proliferation and metastasis of breast cancer cells (4 T1, MDA-MB-231and MCF-7) by cell functional assay, flow cytometry, western blot, proteomics and other techniques in vitro and in vivo. Results found that IPA significantly inhibited the proliferation and metastasis of breast cancer cells (especially 4 T1). Further studies on the anti-tumor mechanism of IPA suggested that IPA might affect EMT and Wnt signaling pathways by targeting mitochondria oxidative phosphorylation and Ca2+ signaling pathways, and then inducing breast cancer cell cycle arrest and apoptosis. Our research reveals the therapeutic value of IPA in breast cancer and provides a theoretical basis for the new treatment of breast cancer.

Reconstructive complications and early toxicity in breast cancer patients treated with proton-based postmastectomy radiation therapy.

Postmastectomy radiation therapy (PMRT) decreases the risk of locoregional recurrence and increases overall survival rates in patients with high-risk node positive breast cancer. While the number of breast cancer patients treated with proton-based PMRT has increased in recent years, there is limited data on the use of proton therapy in the postmastectomy with reconstruction setting. In this study, we compared acute toxicities and reconstructive complications in patients treated with proton-based and photon-based PMRT. A retrospective review of our institutional database was performed to identify breast cancer patients treated with mastectomy with implant or autologous reconstruction followed by PMRT from 2015 to 2020. Baseline clinical, disease, and treatment related factors were compared between the photon-based and proton-based PMRT groups. Early toxicity outcomes and reconstructive complications following PMRT were graded by the treating physician. A total of 11 patients treated with proton-based PMRT and 26 patients treated with photon-based PMRT were included with a median follow-up of 7.4 months (range, 0.7-33 months). Six patients (55%) in the proton group had a history of breast cancer (3 ipsilateral and 3 contralateral) and received previous RT 38 months ago (median, range 7-85). There was no significant difference in mean PMRT (p = 0.064) and boost dose (p = 0.608) between the two groups. Grade 2 skin toxicity was the most common acute toxicity in both groups (55% and 73% in the proton and photon group, respectively) (p = 0.077). Three patients (27%) in the proton group developed grade 3 skin toxicity. No Grade 4 acute toxicity was reported in either group. Reconstructive complications occurred in 4 patients (36%) in the proton group and 8 patients (31%) in photon group (p = 0.946). Acute skin toxicity remains the most frequent adverse event in both proton- and photon-based PMRT. In our study, reconstructive complications were not significantly higher in patients treated with proton- versus photon-based PMRT. Longer follow-up is warranted to assess late toxicities.

What Has Changed During the COVID-19 Pandemic? - The Effect on an Academic Breast Department in Portugal.

One year ago, Portugal entered its first lockdown because of the coronavirus disease-2019 (COVID-19) pandemic. The impact of this on delays in cancer diagnosis and treatment is a major concern, which may negatively affect the outcomes of these patients. This retrospective, single-center analysis compared the clinical and pathological characteristics of breast cancer (BC) patients referred to a medical oncology first appointment between March 2020 and 2021, with the same period in the previous year. Strikingly, there was a 40% reduction in the number of BC patients during lockdown. However, there was a statistically significant increase in the proportion of metastatic BC patients admitted for the first time for systemic therapy (13.6% vs. 28.9%, p = 0.003). Additionally, a statistically significant increase in the number of patients with bilateral early BC at diagnosis after March 2020 was found (7.2% vs. 1.9%, p = 0.043). These findings support international recommendations for an accelerated restoration of BC screening, to reduce incidence of advanced breast cancer at diagnosis and mitigate the expected impact of the COVID-19 pandemic on patients with cancer. Further work is needed to examine in detail the impact of measures to manage the COVID-19 pandemic on breast cancer outcomes.

Sistem Pakar Mendiagnosa Penyakit Kanker Menggunakan Metode Forward Chaining

Cancer is a disease caused by abnormal growth of body tissue cells that turn into cancer cells. One of them is cervical cancer and breast cancer, this cancer often affects women. Some women tend not to know they have the disease. Data on the number of cervical cancer patients is 374 patients per year and the number of breast cancer patients is 281 per year. Knowledge and early monitoring of cervical cancer and breast cancer are needed to assist the community in carrying out early prevention and treatment. To provide a diagnosis, the help of an expert is needed, namely a specialist doctor who deals with the diagnosis and treatment of cancer. Given these conditions, it is necessary to develop a solution by designing a system that can help in overcoming the symptoms of cervical and breast cancer using an expert system for diagnosing cancer which aims to make it easier for doctors and patients to find out the symptoms of cervical cancer. and breast cancer in patients. The results showed that this expert system for diagnosing cervical cancer and breast cancer can be a medium of information, knowledge and a means of detection for cloud people in detecting the initial conditions of cervical cancer and breast cancer independently with the help of technology with this application which is expected to help in providing consultations providing information about the stage, symptoms and solutions

Exercise volume load in women with breast cancer: Study protocol for the ABRACE randomized clinical trial

BackgroundAn increased number of breast cancer patients are challenged by acute and persistent treatment side effects. Oncology guidelines have been establishing physical exercise to counteract several treatment-related toxicities throughout cancer care. However, evidence regarding the optimal dose-response, feasibility, and the minimal resistance exercise volume and/or intensity remains unclear. The ABRACE Study will assess the impact of different resistance training volumes (i.e., single or multiple sets) combined with aerobic exercise on physical and psychological outcomes of breast cancer patients undergoing primary treatment. MethodsThis study is a randomized, controlled, three-armed parallel trial. A total of 84 participants, aged ≥18 years, with breast cancer stages I-III, initiating adjuvant or neoadjuvant chemotherapy (≤50% of sessions completed) will be randomized to multiple sets resistance training plus aerobic training group, single set resistance training plus aerobic training group or control group. Neuromuscular and cancer-related fatigue (primary outcomes), muscle strength, muscle thickness, muscle quality by echo intensity, body composition, cardiorespiratory capacity, functional performance, upper-body endurance and quality of life will be measured before and after the 12-week intervention. Our analysis will follow the intention-to-treat approach and per-protocol criteria, with additional sub-group analysis. DiscussionFindings support prescribing exercise during chemotherapy for breast cancer and elucidate the potential role of different resistance training volumes as a management strategy for physical and psychological impairments in women with early-stage breast cancer. Our main hypothesis is for superiority in physical and psychological outcomes for both training groups compared to the control group, with no difference between single or multiple sets groups. Trial registrationClinical trials NCT03314168.

Automated Breast Ultrasound

Due to the growing number of breast cancer patients, an early diagnosis is important in order to reduce the mortality rate of those affected. Methods such as mammography, DBT, MRI, HHUS or ABUS are used in the detection of breast cancer. The aim of this article is to review the literature showing the basic principle of ABUS and to point out its advantages and disadvantages in relation to conventional methods of breast imaging. ABUS is a relatively new ultrasound method that performs well on patients with dense breast tissue. It reduces operator dependence and provides valuable diagnostic information with multiplanar reconstructions. Using evidence from reliable researches, studies have demonstrated that ABUS has a higher diagnostic accuracy compared to mammography, which remains the primary modality for early diagnosis of breast cancer. Applying ABUS as an adjunct to mammography during the screening test has proven effective and further confirmed the importance of their application in clinical practice. The disadvantage of the combination of ABUS and mammography was that in a large number of studies the specificity was lower compared to mammography itself. Compared to DBT, ABUS has demonstrated to have a higher diagnostic performance, with the exception that it lacks the ability to effectively detect calcifications. Although MRI seem to outperform ABUS, ABUS devices offer a cost-effective and easy to use imaging system, making it the best alternative. The HHUS technique, on the other hand, was perceived by many studies as less painful, with a shorter operative time compared to ABUS. However, the sensitivity and specificity of this screening method continues to remain inferior to ABUS. The use of artificial intelligence is becoming widely used today. As a result, the CAD software has been developed to be applied in conjunction with ABUS in order to improve the detection rate of breast cancer as well as its accuracy. The use of CAD significantly reduced image reading time and improved the overall diagnostic accuracy of ABUS. According to all the presented data, the use of ABUS medical devices in clinical practice continues to grow in importance and with the further development of technology and medicine, its full integration into healthcare systems around the world is expected.

Re-purposing the pro-senescence properties of doxorubicin to introduce immunotherapy in breast cancer brain metastasis

An increasing number of breast cancer patients develop brain metastases (BM). Standard-of-care treatments are largely inefficient, and breast cancer brain metastasis (BCBM) patients are considered untreatable. Immunotherapies are not successfully employed in BCBM, in part because breast cancer is a "cold" tumor and also because the brain tissue has a unique immune landscape. Here, we generate and characterize immunocompetent models of BCBM derived from PyMT and Neu mammary tumors to test how harnessing the pro-senescence properties of doxorubicin can be used to prime the specific immune BCBM microenvironment. We reveal that BCBM senescent cells, induced by doxorubicin, trigger the recruitment of PD1-expressing Tcells to the brain. Importantly, we demonstrate that induction of senescence with doxorubicin improves the efficacy of immunotherapy with anti-PD1 in BCBM in a CD8 Tcell-dependent manner, thereby providing an optimized strategy to introduce immune-based treatments in this lethal disease. In addition, our BCBM models can be used for pre-clinical testing of other therapeutic strategies in the future.

The Effectiveness of Application of Lectures and Audiovisual Methods on Increasing Conscious Behavior in Cancer Early Detection Efforts Breasts of Housewives in Alue on District Kaway XVI

Breast cancer is the type of cancer that causes the biggest cause of death among women as well as the highest number of cases in the world. The number of breast cancer patients in West Aceh in 2017 was 22 people, then decreased to 10 people in 2018, and increased from 10 people to 17 people in 2019. Breast cancer cases increased due to lack of knowledge about BSE behavior, early symptoms caused by breast cancer and breast cancer risk factors. One way to prevent breast cancer is easy, inexpensive, and can be done yourself at home is to use the BSE (Breast Self-Examination) method. The purpose of this study was to determine the effectiveness of the application of the lecture and audiovisual methods before and after the intervention was given regarding the early detection of breast cancer in housewives in Alue on Village, Kaway XVI District. This type of research is a quasi-experimental with a two-group pre-test-post-test approach. The sample is 24 respondents with purposive sampling technique. The analysis used is univariate and bivariate. The results of the Wilcoxon test showed an increase in BSE behavior (p = 0.002) in housewives in Alue On village. The results of the t test show that the t-count value is 2.980 &gt; ttable 2.074, meaning that there is a difference in the average results of BSE behavior using the lecture and audiovisual methods where the group using the audiovisual method is more effective at increasing BSE behavior in early detection of breast cancer in housewives. Alue On village, Kaway XVI sub-district. It is recommended to mothers who have a good understanding of early detection of breast cancer to provide information to mothers whose understanding is still lacking.

S396 Higher Rates of Dysphagia Incidence Among Patients With Malignant Primary Brain Tumors Compared to Brain Metastases: A National Study of Medicare Beneficiaries

Introduction: Dysphagia occurs frequently with central nervous system (CNS) diseases. Additionally, rates of dysphagia increase with age. However, there are no population-based estimates of dysphagia among older patients with malignant primary brain tumors (PBTs) or brain metastases. Therefore, we aimed to describe the incidence of new-onset dysphagia among Medicare beneficiaries with CNS malignancies and compare rates of dysphagia between those with malignant PBTs and solid tumor brain metastases. Methods: Using the 2013-2018 Medicare 5% Data sample and ICD-9/10 codes, we identified beneficiaries at least 65 years of age with malignant PBTs as well as the five most common solid tumors metastasizing to the brain (lung, breast, melanoma, renal, and colorectal). Those with coexisting disorders predisposing to symptomatic dysphagia such as head and neck cancer, achalasia, or relevant neurological conditions, were excluded. We estimated rates of new onset dysphagia, defined as occurring within one year from the time of cancer diagnosis, among those with continuous Medicare enrollment for at least six months of follow-up time. Comparisons were made between 1) beneficiaries with malignant PBTs and those with brain metastases and 2) beneficiaries with brain metastases and their counterparts without CNS metastases. A Chi-squared test was used to assess differences between groups. Results: Of the 80,187 beneficiaries identified, the median age of all patients was 72 and most patients (64.9%) were female, primarily due to the large number of breast cancer patients in the cohort. There were 3,018 (3.8%) beneficiaries with malignant PBTs and 805 (1.0%) had brain metastases (Table). Dysphagia occurred in 3,396 (4.2%) of the overall population. Patients with malignant PBTs were significantly more likely to have dysphagia than those with brain metastases (9.7% vs 6.5%, p< 0.01). Patients with brain metastases were more likely to have dysphagia than those without CNS involvement (6.5% vs 4.0%, p< 0.01) (Figure). Conclusion: The incidence of dysphagia is high among older patients with CNS malignancies, with significantly higher rates among those with PBTs compared to brain metastases. The presence of CNS metastases among commonly occurring solid tumors is also associated with the development of dysphagia. These results warrant further investigation to identify predictors of dysphagia among this population as well as to describe its impact on clinical outcomes and overall health care utilization.Figure 1.: Rates of new onset dysphagia within one year of cancer diagnosis among Medicare beneficiaries by disease subgroups: primary brain tumors, solid tumors (lung, breast, melanoma, renal, and colorectal cancer) with brain metastases, and solid tumors without brain metastases. Table 1. - Clinical and demographic data among Medicare beneficiaries studied. #Primary tumor type by brain metastases are not reported to meet CMS censoring reporting requirements. Primary Brain Tumors (N=3,018) Solid tumors with brain metastases (N=805) Solid tumors without brain metastases (N=76,364) Age, median (Q1, Q3) 73 (68, 78) 71 (67, 76) 72 (67, 79) Female 1,672 (55.4%) 478 (59.4%) 49,866 (65.3%) RaceWhiteBlackOther 2,520 (83.5%)248 (8.2%)250 (8.3%) 671 (83.4%)9 (8.6%)65 (8.1%) 66,284 (86.8%)5,727 (7.5%)4,353 (5.6%) Primary tumor typeBreastColorectalLungMelanomaRenal -- --# 29,739 (38.9%)14,378 (18.8%)13,464 (17.6%)12,225 (16.0%)6,558 (8.6%) New onset dysphagia(within 1 year of cancer diagnosis) 293 (9.7%) 52 (6.5%) 3,055 (4.0%)