Tumors In Postmenopausal Women Research Articles

Complete Remission of Multiple Pulmonary Metastases of Endometrial Adenocarcinoma Treated with a Mixture of Low Molecular Weight Fucoidan and Canvaria gladiata Extract: A Case Report

Endometrial cancer (EC) is the most common malignant tumor in post-menopausal women, and the lung is one of the organs to which endometrial adenocarcinoma metastasizes. Chemotherapy is helpful for various malignancies, but not all are successful. A 71-year-old-Japanese-woman was diagnosed with metastatic lung cancer stage IV of primary endometrial adenocarcinoma. She received chemotherapy and hormone therapy after a total hysterectomy and pelvic lymphadenectomy. Subsequently, she visited this clinic for a second opinion as the metastatic lung cancer had repeated remissions and recurrences. Here, the authors report a case in which complete remission of metastatic lung cancer was achieved by using a product containing low molecular weight fucoidan extract (LMF) and Canavalia gladiata extract (CG) (LMF-CG) in combination with Medroxyprogesterone acetate (MPA) hormone therapy.

Mammary Myofibroblastoma: Report of an Uncommon Case

Mammary myofibroblastoma is an uncommon benign mesenchymatous tumor, representing less than 1% of mammary tumors. First individualized in 1987, it’s a benign tumor of unknown etiology, occurring in equal incidence in post-menopausal women and men. It has with a very large morphological spectrum but its management is surgical and the diagnosis is histological and immune histochemical. We hereby report a case of a myofibroblastoma in a 28-year-old woman that was successfully managed surgically. The particularity of our case is the very young age of our patient, since the cases described in the literature are tumors in post-menopausal women. This case raises the issue of pathology’s polymorphism.

Value of the Copenhagen index in the diagnosis of malignant adnexal tumors: A meta-analysis.

Ovarian cancer is a common gynecological malignant tumor. Early diagnosis is important for the prognosis of patients with ovarian cancer. To evaluate the accuracy of the Copenhagen Index (CPH-I) in detecting malignant adnexal tumors and to compare the diagnostic accuracy of CPH-I and the Risk of Ovarian Malignancy Algorithm (ROMA). PubMed, Web of Science, and Cochrane Library databases were used to retrieve eligible studies. The overall sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and area under the (summary receiver operating characteristic) curve (AUC) were 0.81, 0.88, 6.61, 0.22, 30.43, and 0.91, respectively, in diagnosing malignant adnexal tumors. In addition, using ROMA, the sensitivity, specificity, and AUC were 0.83, 0.85, and 0.90, respectively. CPH-I showed high accuracy in diagnosing malignant adnexal tumors, which could be an alternative method with similar efficacy to ROMA. CPH-I was more advantageous in diagnosing adnexal tumors in postmenopausal women.

The Pattern of Second Primary Tumours in Postmenopausal Women with Prior Breast Cancer in Western Romania: A Retrospective, Single-Institution Study.

With improved survival, more patients with prior breast cancer are at risk of having a second primary cancer diagnosed. The pattern and impact of second primary cancers following breast cancer is important for overall breast cancer therapeutic management. Our study is a first analysis of the trend of second primary tumours over time in terms of incidence, sites with significantly elevated risks and correlation with stage, molecular subtype and therapeutic strategies conducted in Eastern Europe in postmenopausal women with breast cancer. Patients and methods: Our study population included 28 patients with prior breast cancer (BC) and second primary tumours, which were diagnosed and treated in our Institution between 2004 and 2017. The criteria for selection were based on the completeness of the documentation of the first treatment for breast cancer, stage of disease, molecular subtype, the site of origin of the second tumours and the survival data. Results: An increased risk of second primary cancer was associated with the 51–60 years age group (53.6%), with the greater prevalence in patients living in urban environments (82.1%). The use of chemotherapy increased the risk of the occurrence of gynecological second malignancies (75%). Our study is a first analysis of the trend of second primary tumours over time in terms of identifying sites with significantly elevated risks and correlation with therapeutic strategies conducted in Eastern Europe in postmenopausal women with breast cancer. Conclusions: Our study is a first analysis of the trend of second primary tumours over time in terms of correlation with luminal subtype and stage at diagnosis of primary cancer sites with significantly elevated risks and correlation with therapeutic strategies in postmenopausal women with breast cancer conducted in Eastern Europe. The reported time from primary to second primary malignancy onset, with a significantly higher rate for postmenopausal breast cancer patients, was less than one year (50%). With the advances and wider availability of genetic testing (e.g., gene panels), patients diagnosed with multiple primaries should be increasingly investigated for an underlying cancer predisposition. Postmenopausal women with breast cancer may benefit from increased surveillance and advice to avoid second malignancies.

Adult granulosa cell tumor with minor foci of juvenile granulosa cell tumor in postmenopausal woman: A rare case report.

IntroductionGranulosa cell tumor (GCT) is a rare neoplasm that is divided into adult GCT (AGCT) and juvenile GCT (JGCT). Generally, a patient will only have the AGCT or JGCT subtypes. Here, we presented the first case of AGTC accompanied by focal JGTC in a postmenopausal woman.Presentation of caseA 63-year-old postmenopausal woman came with distended abdomen accompanied by postmenopausal bleeding. CT scan shows a solid mass with cystic degeneration. Laparotomy found a solid mass from the right ovary measuring 18 × 15 × 14 cm. The pathological results showed a diffuse tumor representing AGCT, accompanied by Call-Exner bodies and nuclear groove. In addition, minor foci were also found, which consist of well-defined margins tumor and follicular-like structures that resemble JGCT. The patient underwent bilateral salpingo-oophorectomy with a total hysterectomy and no recurrence in three months follow-up.DiscussionAge and clinical symptoms cannot be used as specific differentiators between AGTC and JGTC. Radiological imaging also shows a similar appearance of solid masses tumors with hemorrhagic or fibrotic changes, multilocular cystic lesions, or completely cystic tumors. The concomitant findings of JGCT and AGCT could be distinguished very carefully by anatomical pathology examination. It is crucial to differentiate AGCT from JGCT, especially to see the prognosis.ConclusionThe role of pathologists is needed in differentiating AGCT and JGCT, primarily when found simultaneously.

Abstract 2827: Inactivating calcium-sensing receptor polymorphisms at rs1801725 are associated with increased risk of secondary malignancies

Abstract The dysregulation of systemic calcium homeostasis during malignancy is common in most patients with high-grade tumors. The associated comorbidity is known as cancer-induced hypercalcemia (CIH) which affects up to 30% of cases, in the absence of metastasis. In the course of breast cancer progression, the secretion of parathyroid hormone-related protein (PTHrP) by tumor cells and the associated destruction of bone tissues, leads to a progressive increase in systemic calcium or CIH. The increase in circulating Ca2+ is sensed by the calcium-sensing receptor (CaSR), which plays a significant role in maintaining Ca2+ homeostasis. More than 200 mutations and single nucleotide polymorphisms (SNPs) in the CaSR gene have been described, including the A986S CaSR at rs1801725 and Q1011E CaSR at rs1801726 SNPs with reduced sensitivity to Ca2+. Interestingly, high circulating Ca2+ is associated with aggressive breast tumors in premenopausal women and larger tumors in postmenopausal women; however, the contribution of the CaSR in breast cancer progression remains poorly understood. Unlike SNPs at rs1801726, up to 20% of breast cancer patients with SNPs at rs1801725 may be predisposed to higher circulating Ca2+ in the course of their disease. Since breast cancer frequently metastasizes to Ca2+ rich skeletal tissues, we hypothesize that the development of CIH and subsequent desensitization of the CaSR by sustained high Ca2+ is critical for both the adaptation of TNBC cells to CIH in Ca2+ rich microenvironments and TNBC progression. Our preliminary data reveal that the expression level and mutational status of the CaSR is cell type-specific, and that sustained high Ca2+ desensitizes the receptor, but promotes tumor cell growth and motility. In addition, our preliminary data show that the A986S SNP is associated with hypercalcemia, secondary malignancy of bone and respiratory organs, and deficiency of humoral immunity. This study provides novel insights into not only the adaptation of TNBC cells to high circulating Ca2+, but also suggests that mutations of the CaSR at rs1801725 are predictive of the likelihood for metastasis to lungs and bone. Citation Format: Heather K. Beasley, Ky'Era V. Actkins, Annika B. Faucon, Lea K. Davis, Amos M. Sakwe. Inactivating calcium-sensing receptor polymorphisms at rs1801725 are associated with increased risk of secondary malignancies [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 2827.

The Calcium-Sensing Receptor (CaSR) Variants at rs1801725 Increase the Risk of Developing Secondary Malignant Cancers

The dysregulation of systemic calcium homeostasis during malignancy is common in most patients with high-grade tumors. The associated comorbidity is known as cancer-induced hypercalcemia (CIH) which affects up to 30% of cases, in the absence of metastasis. In the course of breast cancer progression, the secretion of parathyroid hormone-related protein (PTHrP) by tumor cells and the associated destruction of bone tissues, leads to a progressive increase in systemic calcium or CIH. The increase in circulating Ca2+ is sensed by the calcium-sensing receptor (CaSR), which plays a significant role in maintaining Ca2+ homeostasis. More than 200 mutations and single nucleotide polymorphisms (SNPs) in the CaSR gene have been described, including the A986S CaSR at rs1801725 and Q1011E CaSR at rs1801726 SNPs with reduced sensitivity to Ca2+. Interestingly, high circulating Ca2+ is associated with aggressive breast tumors in premenopausal women and larger tumors in postmenopausal women; however, the contribution of the CaSR in breast cancer progression remains poorly understood. Unlike SNPs at rs1801726, up to 20% of breast cancer patients with SNPs at rs1801725 may be predisposed to higher circulating Ca2+ in the course of their disease. Since breast cancer frequently metastasizes to Ca2+ rich skeletal tissues, we hypothesize that the development of CIH and subsequent desensitization of the CaSR by sustained high Ca2+ is critical for both the adaptation of TNBC cells to CIH in Ca2+ rich microenvironments and TNBC progression. Our preliminary data reveal that the expression level and mutational status of the CaSR is cell type-specific, and that sustained high Ca2+ desensitizes the receptor, but promotes tumor cell growth and motility. Sustained high Ca2+ also triggers the expression of metastasis promoting genes, including the cancer/testis antigen, MAGEC2, and Plasminogen Activator Inhibitor, PAI-2, potentially via the early response genes FOS/FOSB. In addition, our preliminary data show that the A986S SNP is associated with hypercalcemia, secondary malignancy of bone and respiratory organs, and deficiency of humoral immunity. This study provides novel insights into not only the adaptation of TNBC cells to high circulating Ca2+, but also suggests that mutations of the CaSR at rs1801725 are predictive of the likelihood for metastasis to lungs and bone.

Abstract 1567: The role of the calcium-sensing receptor (CaSR) in the bone metastatic niche

Abstract Cancer-induced hypercalcemia (CIH) is common in cancer patients with metastatic disease and in up to 30% of breast cancer cases without evidence of metastasis. During malignancy, tumor cells-including triple negative breast cancer (TNBC) cells, secrete factors such as parathyroid hormone-related protein (PTHrP) that causes the osteolysis. As cancer progresses, it becomes inevitable that the increase in tumor cell derived PTHrP and the associated persistent osteolysis, leads to a progressive increase in systemic calcium (Ca2+) or CIH. The resulting increase in circulating Ca2+ is sensed by the calcium-sensing receptor (CaSR), which not only plays a significant role in maintaining Ca2+ homeostasis but also promotes tumor cell proliferation and motility. High circulating Ca2+ is associated with aggressive tumors in premenopausal women and larger tumors in postmenopausal women, but the contribution of the CaSR remains poorly understood. Since breast cancer frequently metastasizes to Ca2+-rich skeletal tissues, the goal of this study is to gain a better understanding of the role of CaSR in the adaptation of TNBC cells to high Ca2+ and subsequent survival in Ca2+ rich environments. More than 200 mutations, including single nucleotide polymorphisms (SNPs) in exon 7 of the CaSR gene, have been described. These include the inactivating A986S CaSR at rs1801725 and Q1011E CaSR at rs1801726 with reduced sensitivity to Ca2+. Unlike SNPs at rs1801726, up to 20% of breast cancer patients with SNPs at rs1801725 may be predisposed to higher circulating Ca2+ in the course of their disease. Our preliminary data reveal that the expression level and mutational status (in exon 7) of the CaSR is cell type specific, where sustained high Ca2+ desensitizes the receptor, but promotes tumor cell growth and motility. Sustained high Ca2+ triggers growth and the expression of metastasis promoting genes including the cancer/testis (melanoma) antigen, MAGEC2 and Plasminogen Activator Inhibitor, PAI-2, potentially via the early response genes FOS/FOSB. Moreover, our preliminary data showed that the A986S SNP is associated with hypercalcemia and secondary malignancy of bone, while the Q1011E SNP is associated with osteoporosis. We hypothesize that desensitization of the CaSR by sustained high Ca2+ is critical for both the adaptation of TNBC cells to CIH, and their survival in Ca2+ rich microenvironments. To test this hypothesis, we will determine whether high Ca2+ inducible genes/proteins underlie the adaptation of TNBC cells in high Ca2+ microenvironments. We anticipate that data from this proposed study will provide novel insights into the adaptation of TNBC cells in high Ca2+ prior to metastasis. This proposed research will study how the differences in the functional status of the CaSR (A986S in Caucasians and Q1011E in African Americans) may predispose breast cancer patients to rapid progression of advanced forms of breast cancer and becoming hypercalcemic. Citation Format: Heather K. Beasley, Ky'Era Actkins, Annika Faucon, Diva Whalen, Stephen Williams, Olga Korolkova, Amos Sakwe. The role of the calcium-sensing receptor (CaSR) in the bone metastatic niche [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 1567.

Heterogeneity of Triple-Negative Breast Cancer: Differences in Clinicopathologic and Ultrasound Features Between Premenopausal and Postmenopausal Patients.

The aim of this study was to determine whether any salient differences exist in triple-negative breast cancer (TNBC) between premenopausal and postmenopausal patients by comprehensively comparing the ultrasound (US) and clinicopathologic features of these patients. A detailed evaluation of the US and clinicopathologic features of 60 tumors from 60 patients with a diagnosis of TNBC (36 premenopausal and 24 postmenopausal women) was conducted in this retrospective study. Triple-negative breast cancer in premenopausal patients was more likely to show a round or oval shape and microlobulated margins, more commonly exerted effects on surrounding tissue, and showed grade 3 blood flow according to the method of Adler et al (Ultrasound Med Biol 1990; 16:553-559) compared with tumors in postmenopausal women. Triple-negative breast cancer in postmenopausal patients showed some similar US features as those observed in estrogen receptor-positive tumors, including irregular shapes, angular or spiculated margins, and nonparallel growth to the skin (P < .05 for all). Although US cannot be used to unequivocally identify TNBC, it can distinguish some salient US features regarding TNBC between premenopausal and postmenopausal women. Such information can then provide some valuable predictive information on the diagnosis of TNBC for clinicians.

Stages of ovarian and endometrial cancer detection in women in the postmenapausal period in Baku city

Aim. To study the severity (according to the stages at the time of diagnosis) of female genital cancer detected in postmenopausal women in Baku in 20162018.&#x0D; Methods. 306 postmenopausal women with various tumors of the reproductive system were examined. The average age of the examined women was 59.30.4 (4883) years. 166 (54.2%) out of 306 patients had malignant tumors of the genitalia including ovarian cancer (n=97), endometrial cancer (n=50), cervical cancer (n=13), uterine sarcoma (n=6). Clinical, functional, laboratory, radiological, and morphological studies were performed. For the analysis of the obtained digital data, discriminant analysis methods were applied. The rate (Р%) and its 95% confidence intervals (mp%) of ovarian and endometrial cancer of the postmenopausal period among female citizens of Baku were calculated. Statistical significance of the difference between the indicators in the groups was determined by Pearson 2-criterion. All calculations were performed in Excel 2013 and SPSS-20.&#x0D; Results. According to the data of the study, ovarian cancer in the postmenopausal period was diagnosed in 15.53.7% of females at stage I, in 8.22.8% at stage II, in 66.04.8% at stage III, in 10.33.1% at stage IV of the development of the tumor process. In 68.06.6% of patients with endometrial cancer in the postmenopausal period, the tumor was determined at stage I, in 30.06.5% of patients at stage II, and in 2.02.0% of patients at stage III of the development of the tumor process. On comparison of the stages at detection of ovarian and endometrial cancer, a significant difference between these two forms of malignant neoplasms was found for both stages I and III.&#x0D; Conclusion. Detection of genital tumors in postmenopausal women is characterized by the diagnosis of ovarian cancer mainly in the later stages of the disease (compared to endometrial cancer), which indicates the need to develop effective screening methods for earlier detection of this tumor process.

Therapeutic potential of omega fatty acids in breast cancer. Review

ResumenFONDO : el cáncer de mamá es la segunda causa de la muerte en las mujeres en los países y en el desarrollo, la Colombia y el alto porcentaje de los estrógenos, la terapia y el tratamiento hormonal Actualmente, la primera línea de tratamiento para los tumores de mama en mujeres posmenopáusicas es el letrozol, un inhibidor de la enzima aromática que evita la transformación de andrógenos en estrógenos. Al igual que otras terapias, Letrozol tiene efectos adversos en los pacientes, por lo tanto, hay una búsqueda de nuevas alternativas que disminuyan estos efectos secundarios.Además, los ácidos grasos omega (FA), como el potencial nutricional debido a su actividad antiinflamatoria o proinflamatoria como inductores de carcinogénesis. Sin embargo, in vitro , in vivo ya sea epidemiológico con respecto a las actividades preventivas o inductoras de carcinogénesis en animales y humanos, la estructura de la estructura de la omega FA. OBJETIVOS : esta revisión estructurada pretende mostrar las principales evidencias in vitro , in vivoy epidemiológicas del potencial quimioterapéutico de ω-3 y ω-6 FA en diferentes tipos de neoplasias, particularmente en el cáncer de mamá, uso en tratamientos individuales o combinados con tratamientos adecuados. Antineoplásticos. Metodos : esta revisión estructurada presenta los estudios más representativos se publica las últimas dos con más de ω-3 y ω-6 FA, cáncer de mama y las principales estrategias terapéuticas para esta neoplasia. Los hallazgos se presentan en la forma de la lógica en los temas para la descripción general de la omega y su potencial en los tratamientos para el cáncer de mamá. RESULTADOSLos pacientes con estrógenos y derivados de progesterona han mostrado predisposición a desarrollar el cáncer de mama después de dos años de terapia continua. Además, las capacidades omega con potencial conocido como nutracéutico han demostrado su potencial como adyuvantes en el tratamiento contra diferentes neoplasias como el cáncer hepático y de color. CONCLUSIONES : las terapias actuales para el cáncer de mama y su baja eficacia a largo plazo, para explorar nuevas alternativas en la que omega FA podría mejorar los medicamentos; Sin embargo, el metabolismo de la omega.

SAT-343 Immunohistochemical Expression of Luteinizing Hormone/Human Chorionic Gonadotropin Receptor (LH/hCG Receptor) in Adrenal Adenomas of Postmenopausal Women

Background: Increasingly, patients are found to have incidentally found adrenal adenomas on imaging performed for other purposes. Further biochemical work-up results in a diagnosis of mild hypercortisolism in as many as 30% of these patients. The incidence of adrenal adenomas and Cushing’s is higher in women than men with peak incidence ages 50-70. Elevated expression of gonadal markers such as LH/hCG receptor and the gonadal transcription factor GATA-4 has been well described in post-gonadectomy induced adrenal cortical neoplasia in neutered ferrets and certain mouse strains. The majority of these neoplasms of the adrenal cortex, which share a common embryologic progenitor with the gonads in the urogenital ridge, produce sex steroids and appear to differentiate towards a “gonadal” molecular profile. Isolated case reports have demonstrated LH/hCG receptor expression in adrenal secretory tumors in postmenopausal women and pregnant females. Taken together, there is strong evidence that a subset of adrenal tumors is driven by LH in postmenopausal women. Hypothesis: We hypothesized that adrenal adenomas producing secretory syndromes in postmenopausal women express LH/hCG receptor. Methods: 24 archival adrenal tissues from women >50 years of age with hypersecretory syndromes (primary aldosteronism and Cushing’s) were obtained with IRB approval. The samples were immunostained for expression of the LH/hCG receptor (monoclonal unconjugated LHR Antibody (LHCGR/1417), Novus Biologicals, CO) utilizing the Streptavidin–Biotin staining method. The slides were reviewed in a blinded fashion, and cytoplasmic, membrane, and nuclear expression of the markers were graded as no immunoreactivity, or 1+, 2+, or 3+ staining. Results: All 24 adenomas had demonstrated expression of LH/hCG receptor in both normal and adenomatous tissue. The staining in adenomas was heterogeneous, with clusters of densely stained LH/hCG receptor positive cells found selectively in areas of the adenomas. In addition, these clusters were found in normal adjacent adrenal tissue primarily in the subcapsular, zona glomerulosa region, an area where the putative adrenal cortical stem cells are found. Conclusion: LH/hCG receptor was found to be expressed in normal adrenocortical and adenomatous tissue in postmenopausal women, a population that has elevated serum LH levels. These findings may have clinical implications and provide a rationale for the treatment of secretory adrenal adenomas with GnRH agonists or antagonists in postmenopausal women.

BMI and Association with Histopathological Characteristics of the Tumor in Postmenopausal Women

The purpose of our study is to analyze the association between the increased bodyweight, by using the body mass index (BMI), and the histopath..ology of breast cancer (size of tumor, grade, hormone receptors, her2, lymph nodes) in postmenopausal women. In this retrospective study, 99 patients were examined, who were operated in our clinic who suffer from breast cancer from 12/2012 to 12/2014. ER and PR tumors were categorized as positive if 1% of the nuclei was stained. HER2 tumors were categorized as positive if › 10% of the nuclei was stained. The patients were categorized as being normal weight with BMI‹24, 9 Kg/m2, overweight with BMI 25-29,9 Kg/m2, or obese with BMI› 30Kg/m2. The average of BMI was 28, 28 kg/m2 (range 18, 64-44, 76) In the category of normal weight patients (BMI = 24,9Kg/m2), we diagnosed 10 patients of stage I (25%), 18 patients of stage II (45%), and 12 of stage III (30%). As far as tumor size concerns, 11 patients were in T1 ( 27,5% ), 9 were in T2 ( 22,5% ) and 5 in T3 ( 12,5% ) stage. Regarding the lymph nodes, 20 patients were diagnosed in N0 ( 50%), 14 in N1 ( 35% ), 5 in N2 ( 12,5% ) and 2 in N3 ( 5% ). Referring to the hormone receptors and the expression of Her2, the most common combination was ER+PR+Her2- in 26 patients ( 65%), followed by ER+PR+Her2+ in 4 ( 10% ) , ER-PR-Her2+ in 3( 7,5%) and ER-PR-Her2- in 2 (5% ). In the category of overweight patients (BMI 25-29,9kg/m2) we diagnosed 5 of stage I (18,5%), 10 ( 37% ) of stage II, and 12 (44,4% ) of stage III. Concerning the tumor size, we had 13 patients in T1 stage (48, 14%), 9 in T2 (33,33%) and 5 in T3 (18,5%). As far as lymph nodes concerns, 13 patients were diagnosed in N0 (48,14% ) , 5 in N1 (18,5% ) , 3 in N2 (11,11% ) and 5 in N3 ( 18,5%) . Referring to the hormone receptors and the expression of Her2 , the most common combination was ER+PR+Her2- in 15 patients (55,55% ), ER+PR+Her2+ in 4 (14,8% ), ER-PR-Her2+ in 3 (11,11% ) and ER-PR-Her2- in 1 ( 3,7% ).In the category of obese patients (BMI› 30Kg/m2) the grade was: 9 patients in stage I (34,6% ), 9 in stage II (34,6% ) and 8 in stage III ( 30,7%). Referring to the tumor size, we had 9 patients in T1 (34,6%), 15 in T2 (57,7% ) and 3 in T3 ( 11,11% ) . Respecting the lymph nodes 15 patients were in N0 (57,7% ) . In our study, we demonstrate that in postmenopausal women with BMI › 25 we diagnosed larger tumors, more positive lymph nodes and higher grade of breast cancer, which indicates more aggressive growth and characteristics of the cancer cells. These tumors have high expression of ER+PR+ and low expression of Her2 +.

Management of Low Malignant Potential Ovarian Tumor in Postmenopausal Women via Minimal Invasive Surgery in Hospital Putrajaya

Management of Low Malignant Potential Ovarian Tumor in Postmenopausal Women via Minimal Invasive Surgery in Hospital Putrajaya

Abstract 1982: Obesity reversibly enhances mammary epithelial estrogen receptor alpha expression and progenitor activity

Abstract Obesity has been identified as an important risk factor for breast cancer in post-menopausal women and is significantly correlated with poor prognosis in breast cancer patients. Women with an increasing body mass index (BMI) are more likely to develop estrogen receptor alpha (ERα) positive tumors that are larger at the time of diagnosis and demonstrate an increased risk for metastasis. Given that obesity is becoming a global epidemic, understanding how obesity alters the biology of the normal breast is of significant clinical relevance. To examine the effects of obesity on mammary tissue, mice were fed a high fat diet to induce obesity and compared with mice fed a control diet. We also examined reduction mammoplasty tissue from women with a known BMI. In both obese female mice and women, mammary epithelial cell populations demonstrated significant decreases in basal/myoepithelial cells, when examined using either flow cytometry or cell type-specific markers (SMA and p63) in tissue. ERα expression was significantly increased in luminal cells in obese mammary tissue, compared with control mice or breast tissue from lean women. Functional assays demonstrated significantly enhanced mammary epithelial progenitor activity in obese mammary epithelial cells as well as elevated numbers of ERα positive epithelial cells that were co-labeled with markers of proliferation. Weight loss in a group of obese mice reversed increases in progenitor activity and ERα expression observed in obese mammary tissue. Obesity enhances the percentage of ERα positive epithelial cells and reduces the number of basal/myoepithelial cells within normal mammary tissue in both women and female mice. Both aspects of this phenotype have been linked to breast tumor susceptibility. These changes may contribute to lifetime risk for the development of ERα positive tumors in postmenopausal women. However, the changes in epithelial cell populations induced by obesity are reversible with weight loss, suggesting that weight loss interventions in obese women may effectively reduce breast cancer risk by decreasing the number of potential tumor progenitor cells in the breast epithelium. Citation Format: Tamara Chamberlin, Joseph V. D'Amato, Lisa M. Arendt. Obesity reversibly enhances mammary epithelial estrogen receptor alpha expression and progenitor activity [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 1982.

Urinary Polyamines as Biomarkers for Ovarian Cancer.

Elevated concentrations of polyamines have been found in urine of patients with malignant tumors, including ovarian cancer. Previous research has suffered from poorly standardized detection methods. Our liquid chromatography-tandem mass spectrometry (LC-MS/MS) method is capable of simultaneous standardized analysis of most known polyamines. Liquid chromatography-tandem mass spectrometry has not previously been used in the differential diagnostics of ovarian tumors in postmenopausal women. In this prospective study, postmenopausal women (n = 71) presenting with an adnexal mass and, as controls, women with genital prolapse or urinary incontinence scheduled for surgery (n = 22) were recruited in the study. For analysis of the polyamines, a morning urine sample was obtained before surgery. Preoperative serum CA125 concentrations were determined in the study group. Twenty-three women with benign and 37 with malignant ovarian tumors were eligible. Of all analyzed polyamines, only urinary N,N-diacetylspermine showed statistically significant differences between all groups except controls versus benign tumors. N,N-diacetylspermine was elevated in malignant versus benign tumors (P < 0.001), in high-grade versus low malignant potential tumors (P < 0.001), in stage III to IV versus stage I to II cancers (P < 0.001), and even in early-stage cancer (stage I-II) versus benign tumors (P = 0.017). N,N-diacetylspermine had better sensitivity (86.5%) but lower specificity (65.2%) for distinguishing benign and malignant ovarian tumors than CA125 with a cut-off value of 35 kU/L (sensitivity, 75.7%; specificity, 69.6%). Urinary N,N-diacetylspermine seems to be able to distinguish benign and malignant ovarian tumors as well as early and advanced stage, and low malignant potential and high-grade ovarian cancers from each other, respectively.

Molecular Biology In Young Women With Breast Cancer: From Tumor Gene Expression To DNA Mutations.

Young women with breast cancer (YWBC) represent roughly 15% of breast cancer (BC) cases in Latin America and other developing regions. Breast tumors occurring at an early age are more aggressive and have an overall worse prognosis compared to breast tumors in postmenopausal women. The expression of relevant proliferation biomarkers such as endocrine receptors and human epidermal growth factor receptor 2 appears to be unique in YWBC. Moreover, histopathological, molecular, genetic, and genomic studies have shown that YWBC exhibit a higher frequency of aggressive subtypes, differential tumor gene expression, increased genetic susceptibility, and specific genomic signatures, compared to older women with BC. This article reviews the current knowledge on tumor biology and genomic signatures in YWBC.

Immunohistochemical and biochemical analysis of mammary gland tumours of different age patients

Immunohistochemical and biochemical study of infiltrative ductal breast carcinoma and tissue adjacent to the tumour revealed a particular molecular profile and characteristics of the oxidant-antioxidant status neoplasms depending on the age of the patients and the presence of metastases in regional lymph nodes. Some causes of high aggressiveness and low hormone sensitivity of tumours in premenopausal women, as well as stability and high metastatic potential of tumours in postmenopausal women have been found.

Adult body size and physical activity in relation to risk of breast cancer according to tumor androgen receptor status.

Obesity and physical activity have been hypothesized to affect breast cancer risk partly via the androgen signaling pathway. We conducted the first study to evaluate these associations by tumor androgen receptor (AR) status. Height, weight, and physical activity were assessed using questionnaires in the Nurses' Health Study. AR, estrogen receptor (ER), and progesterone receptor (PR) status were determined using immunohistochemistry on tumor tissue and medical/pathology reports. A total of 1,701 AR(+) and 497 AR(-) cases were documented during 26 years of follow-up of 103,577 women. After adjusting for ER/PR status and other risk factors, the relative risks (RR) and 95% confidence intervals (95% CI) for every 5 kg/m(2) increase in body mass index (BMI) were 1.07 (1.01-1.13) for AR(+) and 1.16 (1.05-1.29) for AR(-) tumors (P-heterogeneity = 0.17). The RRs (95% CIs) per 5 hours of brisk walking/week were 0.87 (0.73-1.04) for AR(+) and 0.67 (0.45-0.99) for AR(-) tumors (P-heterogeneity = 0.22). Further, BMI, but not physical activity, associations differed significantly across ER/PR/AR subtypes (P-heterogeneity = 0.04 and 0.63, respectively). The RRs (95% CIs) for 5 kg/m(2) increase in BMI were 1.23 (1.04-1.45) for ER(+)PR(+)AR(-), 1.19 (1.01-1.39) for ER(-)PR(-)AR(-), 1.15 (1.08-1.23) for ER(+)PR(+)AR(+), and 0.88 (0.75-1.03) for ER(+)PR(-)AR(+) tumors. Higher BMI was associated with an increased risk of both AR(+) and AR(-) breast tumors in postmenopausal women, whereas physical activity, including brisk walking, was associated with a reduced risk of both subtypes. In addition, a significant positive association was observed between higher BMI and ER(-)PR(-)AR(-) tumors. The similar associations observed by AR status suggest that mechanisms other than androgen signaling underlie these two breast cancer risk factors.

Menopause is a determinant of breast adipose inflammation.

Chronic inflammation is recognized as a risk factor for the development of several malignancies. Local white adipose tissue (WAT) inflammation, defined by the presence of dead or dying adipocytes encircled by macrophages that form crown-like structures (CLS), occurs in the breasts (CLS-B) of most overweight and obese women. Previously, we showed that the presence of CLS-B is associated with elevated tissue levels of proinflammatory mediators and aromatase, the rate-limiting enzyme for estrogen biosynthesis. The associated increased levels of aromatase in the breast provide a plausible mechanistic link between WAT inflammation and estrogen-dependent breast cancers. Thus, breast WAT inflammation could be relevant for explaining the high incidence of estrogen-dependent tumors with aging despite diminished circulating estrogen levels after menopause. To explore this possibility, we determined whether menopause in addition to body mass index (BMI) is associated with breast WAT inflammation among 237 prospectively enrolled women. The presence of CLS-B and its severity (CLS-B/cm(2)) as indicators of WAT inflammation correlated with menopausal status (P = 0.008 and P < 0.001) and BMI (P < 0.001 for both). In multivariable analyses adjusted for BMI, the postmenopausal state was independently associated with the presence (P = 0.03) and severity of breast WAT inflammation (P = 0.01). Mean adipocyte size increased in association with CLS-B (P < 0.001). Our findings demonstrate that breast WAT inflammation, which is associated with elevated aromatase levels, is increased in association with the postmenopausal state independent of BMI. Breast WAT inflammation, a process that can potentially be targeted, may help to explain the high incidence of estrogen-dependent tumors in postmenopausal women.