Breast Cancer In Women Research Articles

Relationship between Clinicopathological Factors of Breast Cancer and Lymph Node Metastasis in Young Women

Aim : To determine the incidence of lymph node metastasis in breast cancer of young women and its relationship with clinicopathologic factors. Methods : The study used an analytic observational design and a cross-sectional approach. Bivariate analysis was performed with Fisher's exact probability test to determine the association of clinicopathologic factors with lymph node metastasis. Results: N1 lymph node metastases could be found in most of the young women breast cancer patients at 42.9%, followed by N3 and N2 at 11.4% and 8.6%, respectively. On the other hand, 37.1% of patients showed no lymph node metastasis. Fisher's exact probability test showed that of the six clinicopathological factors, only tumour size was associated with lymph node metastasis with a p-value of 0.031. Conclusion : The incidence rate of lymph node metastasis in breast cancer of young women was 42.9% for N1, 11.4% for N3, and 8.6% for N2. There was a significant association between tumour size and lymph node metastasis.

Abstract B063: A community-based organization, health equity uplift and growth alliance for triple negative breast cancer and metastatic breast cancer in young women

Abstract Background: Triple Negative Breast Cancer (TNBC) and Metastatic Breast Cancer (MBC) disproportionately affect the Black, indigenous, and people of color (BIPOC) community as well as younger women. Breast cancer (BC) is the leading cause of cancer-related deaths in women less than 40 years old, and survival rates for young women with BC remain lower than for their older counterparts. While more effective treatments and progress in genomic and genetic testing have improved survival of those affected by BC, not everyone has benefited from these advances. Methods: In early 2023, Tigerlily Foundation issued a request for proposal for community-driven initiatives to educate and support young BIPOC women at risk or living with TNBC or MBC in under resourced communities. Fifteen applications were received by Tigerlily over a 6-week period, and 5 community-based organizations (CBOs) in under-resourced metropolitan areas were recommended for $20,000 each in funding by an independent review panel. Tigerlily met with CBO leaders 3 times between May 2023-April 2024 to share experiences, lessons learned and successes. Results: The community- based organization health equity uplift and growth (CBO HUG) alliance resulted in patients and caregivers with increased awareness regarding BC stage, type, and equitable care standards. Approximately, 620 CBO led programs were held over 12 months, where 15,419 BIPOC community members were reached, and 340 community members were referred for screening or health services in partnership with CBOs, Tigerlily’s ANGEL Advocates (Peer Navigators) and NCI Cancer Center Leadership. Programs generally fell into 19 program types, e.g., game nights, radio podcasts, and programs in connection with mobile mammogram units. Twelve Tigerlily ANGEL advocates participated by sharing Tigerlily resources and their stories, providing educational material, facilitating discussion groups, and co-designing content and evaluation instruments. Evaluation reports identified over 40 actionable and notable practices. These practices are categorized by those that worked well and those that need improvement, as noted by CBO leadership and/or ANGEL advocates. Conclusions: The CBO HUG Alliance education and capacity building initiative fostered solutions and bolstered community-based organizations in under-resourced communities. This program leveraged peer navigation and culturally sensitive programming to help young BIPOC persons optimize their health. CBO leaders provided local expertise and community-driven solutions which are at the core of Tigerlily’s commitment to uplift others by listening, learning, leveraging what we learned, and letting the community lead. Next steps include sustained co-curation of tailored content to support empowerment of priority populations. Citation Format: Jeanne M. Regnante, Mandi L. Pratt-Chapman, Belinda Paulicin, Amy Leader, Virginia Leach, LaToya A. Cooper, Sue Steele, Maimah Karmo. A community-based organization, health equity uplift and growth alliance for triple negative breast cancer and metastatic breast cancer in young women [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B063.

Abstract C151: Single and combined inhibition of AURKA and AURKB promotes a decrease in the expression of EMT biomarkers and transcription factors in triple-negative breast cancer in women of African ancestry

Abstract A major health disparity exists between Hispanic/Latino women (H/L) and women of African heritage (non-Hispanic black, NHB, Black H/L, and Caribbean H/L) compared to non-Hispanic White women (NHW) as they are more likely to die from breast cancer. Major contributors to these disparities are socioeconomic status, the detection of breast cancers at later stages, and higher rates of triple-negative breast cancer (TNBC). Molecularly, NHB women have increased expression of mRNAs coding for proteins that regulate the cell cycle, including the cyclins, centrosome, and mitotic kinases. TNBC lacks the estrogen receptor (ER), the progesterone receptor (PR), and the ERBB2 (HER2) receptor, which makes it even more challenging to treat with biological therapies. Mitotic kinases such as AURKA and AURKB are proteins essential for the cell cycle that promote normal cell division, the former involved in centrosome separation and the latter in regulating the spindle assembly checkpoint (SAC). However, when overexpressed, they can activate molecular pathways leading to the activation of centrosome amplification, chromosome instability, and early metastasis (epithelial-to-mesenchymal or EMT biomarkers, cell invasion, and migration) through transcription factors that could lead to a more aggressive breast cancer subtype, such as TNBC. This suggests that these mitotic kinases can drive cancer initiation and evolution. Hence, we hypothesize that co-inhibiting AURKA and AURKB will decrease the expression of EMT biomarkers and transcription factors and therefore, early metastasis. Using The Cancer Genome Atlas database, we identified higher expression of AURKA and AURKB in NHB women compared to NHW women and increased expression of AURKB in NHB women with TNBC. After siRNA-mediated knockdown, immunoblotting and Real-Time qPCR were performed using the MDA-MB-231 cells (NHW) and MDA-MB-157 (NHB) mesenchymal TNBC cells. Preliminary data from the immunoblotting indicates that the expression of AURKA and AURKB decreased in all cell lines compared to the control group, and the EMT biomarker Vimentin decreased in MDA-MB-157 after targeting both mitotic kinases singly and in combination. At a genetic level, EMT biomarkers such as Vimentin, N- Cadherin, and transcription factors such as Slug, Twist, Snail, and Zeb1 decreased in the MDA- MB-157 cell line after single and combined inhibition. These results suggest the role of AURKA and AURKB in TNBC and their potential as therapeutic targets in TNBC. Eventually, we are going to be evaluating cell migration, invasion, tumor growth, and metastasis rates after co- inhibiting AURKA and AURKB in TNBC. Because of their more prevalent expression in breast cancers from NHB women, these kinases may represent new treatment modalities for women of African heritage. Citation Format: Joel A. Orengo-Orengo, Melanie Cruz, Alexandra Aquino, Harold I. Saavedra. Single and combined inhibition of AURKA and AURKB promotes a decrease in the expression of EMT biomarkers and transcription factors in triple-negative breast cancer in women of African ancestry [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr C151.

Abstract C148: Triple negative breast cancer in Black women: The genomic rearrangement landscape and its relationship to obesity and neoadjuvant treatment outcomes

Abstract Purpose: Obesity affects Black women disproportionately, for multifactorial reasons, 57.2% (Black) vs. 38.2% (White). A higher central body fat as measured by waist-to-hip ratio was associated with a higher risk of all-cause and breast cancer-specific death among Black women who had triple negative breast cancer (TNBC), an aggressive disease which affects Black women at a higher rate and contributes to the 41% worse survival outcomes compared to White women. Obesity is a chronic, inflammatory state which creates a mitogenic microenvironment, promotes tumorigenesis and may drive signaling pathways and genomic alterations associated with TNBC. The relevance of certain genomic alterations in breast cancer and the relationship with treatment has been less well described for TNBC and even less so in Black women. Majority of women with early stage TNBC are treated with neoadjuvant chemotherapy (NAC) given prior to surgery and have excellent survival outcomes if there is no residual breast cancer at the time of surgery, i.e. a pathologic complete response (pCR). The purpose of this pilot study was to investigate the genomic rearrangement and gene expression landscape changes in tumors from Black women with TNBC treated with NAC in a major large health system. Methods: A pilot cohort of 38 Black women with early stage I-III TNBC treated with NAC were identified from the tumor registry of Rutgers Cancer Institute and its affiliates within the RWJBarnabas-Health System, the largest in the state of New Jersey. pCR at time of surgery, pretreatment obesity (BMI ≥30 kg/m2) vs. non-obese (<30 kg/m2) was abstracted from pathology reports and the EMR. Whole genome sequencing and RNA sequencing on archived tissue of pre- and post-treatment tumor specimens and normal tumor-free tissue was performed. Results: Mean age at breast cancer diagnosis was 55, and 65% of women were obese. All patients received standard chemotherapy regimens. 20% achieved a pCR, while 80% had residual disease. Out of those with residual disease, 57% were obese. Preliminary data show differences in tumor genomic alterations between obese and non- obese Black patients treated with NAC and in selected obesity-related genes whose differential expression is known to contribute to aggressive breast cancer. Genes important in tumor promotion, tumor suppression, immunomodulation, drug delivery, and have an impact on survival depending on their expression levels, were differentially expressed. Conclusion: Our findings suggest that among Black women with TNBC, a higher BMI is inversely associated with achieving a pCR. Differences in tumor genomic alterations between obese and non-obese Black patients treated with NAC and in selected obesity-related genes were observed. Differentially expressed genes were also identified. Ongoing work will focus on Black patients with residual disease after NAC, and are thus chemoresistant, and determine whether there are associations with genomic alteration patterns and obesity. Extensive gene expression analysis and signaling pathway analysis will be performed. Citation Format: Coral Omene, Gregory Riedlinger, Anya Litvak, Anupama Nehra, Anita Kinney, Elisa Bandera, Adana AM Llanos, Hao Liu, Mridula George, Deborah Toppmeyer, Shridar Ganesan. Triple negative breast cancer in Black women: The genomic rearrangement landscape and its relationship to obesity and neoadjuvant treatment outcomes [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr C148.

Abstract B079: Impact of exercise interventions on mental and physical health outcomes among Black breast cancer survivors: A systematic review

Abstract This review aims to identify and characterize physical activity interventions developed to address mental and physical health outcomes among Black breast cancer (BC) survivors. Over 3.8 million BC survivors in the U.S. may experience physical, psychological, and functional symptoms that alter their ability to engage in physical activity. Physical activity for BC survivors is well recognized for managing these cancer-related symptoms and improving quality of life. However, physical inactivity is a public health problem among Black women with BC. Black women experience a 41% higher mortality rate and worse outcomes across all stages of BC than any other racial/ethnic group due to many factors, including psychosocial stressors and disproportionate socioeconomic disadvantages. More research is needed to understand barriers and facilitators among Black BC survivors to engage in physical activity, specifically posttreatment, and to decrease BC disparities. A systematic review was deemed appropriate, and the keywords “breast cancer AND black women AND exercise” were searched using the following databases: PubMed, Web of Science, CINAHL, and PsycINFO as of May 2024. Studies were selected based on inclusion/exclusion criteria using two reviewers. This review included 19 studies (n=8 descriptive and n=11 experimental) involving 9,691 breast cancer patients, focusing on the mental and physical health outcomes associated with physical activity among Black women. Findings indicate that Black women generally do not meet physical activity guidelines, exhibit lower physical functioning, higher body mass index (BMI), and often live with multimorbidity. Studies were categorized into physical health (BMI, lymphedema, fatigue, muscle strength, physical function, diet, and comorbidities) and mental health (quality of life, emotional well-being, social support, and negative mood). Exercise interventions demonstrated potential for improving physical activity, cardiorespiratory fitness, and muscle strength, with mixed results on quality of life (QOL) and fatigue. Significant associations were found between higher physical activity levels and QOL (n=7). Physical health-related findings included significant associations between physical activity and improved BMI (n=2), decreased lymphedema (n=2), and weight loss (n=1). However, four out of six studies focusing on BMI reported no significant associations with physical activity. An 8-week moderate-intensity exercise intervention led to marginal reductions in fatigue and slight improvements in QOL (P = 0.06) compared to baseline. A high prevalence of obesity, physical inactivity, and suboptimal adherence to physical activity among Black BC survivors from this systematic review highlight the need to develop culturally tailored physical activity interventions to address this public health issue. Specifically, more studies are needed to incorporate more goal setting, motivational techniques, and access to physical/psychosocial resources that address barriers and enhance facilitators to long-term exercise adherence. Citation Format: Sabrina M. Guillen, Lakeshia Cousin. Impact of exercise interventions on mental and physical health outcomes among Black breast cancer survivors: A systematic review [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B079.

Abstract C023: Overcoming chemotherapy resistance in colombian breast cancer women: Studying gene expression, genetic ancestry, and survival impact on breast cancer response to neoadjuvant treatment response

Abstract C023: Overcoming chemotherapy resistance in colombian breast cancer women: Studying gene expression, genetic ancestry, and survival impact on breast cancer response to neoadjuvant treatment response

Dietary soluble, insoluble, and total fiber intake and their dietary sources in association with breast cancer

BackgroundA few studies have examined the association between different types of dietary fiber as well as their sources and the risk of breast cancer (BC) and the present study aimed to investigate these associations in a case-control study among Iranian women.MethodsA total of 464 women with pathologically confirmed breast cancer within the past year and 498 age-matched healthy controls were included. Dietary intakes were assessed using a 168-item food frequency questionnaire. The association between dietary soluble, insoluble, total dietary fiber, as well as, fiber from fruits, vegetables, legumes, cereals, and nuts intake with odds of breast cancer was assessed using multivariate logistic regression analysis.ResultsMean total dietary fiber intake of patients with and without cancer were 33.1 ± 15.3 g per day (g/d) and 34.2 ± 16.5 (g/d), respectively. Dietary total fiber (OR = 0.65; 95%CI: 0.47–0.90, Ptrend = 0.01), insoluble fiber (OR = 0.68; 95%CI: 0.49–0.93, Ptrend = 0.01), fruits’ fiber (OR = 0.68; 95%CI: 0.49–0.94, Ptrend = 0.02), and vegetables’ fiber (OR = 0.66; 95%CI: 0.48–0.91, Ptrend = 0.01) were significantly associated with reduced likelihood of developing breast cancer in all participants. Furthermore, dietary total and insoluble fiber, as well as, fiber from fruits were significantly associated with lower odds of breast cancer in premenopausal women (P < 0.05). In contrast, cereals’ fiber significantly increased the risk of breast cancer by 84% in premenopausal women (OR = 1.84; 95%CI: 1.18–2.86, Ptrend = 0.009). In postmenopausal women, cereals’ fiber had a significant inverse association with odds of breast cancer (OR = 0.56; 95%CI: 0.31–1.03, Ptrend = 0.04). Also, fiber from vegetables was significantly associated with a lower risk of breast cancer in postmenopausal women (OR = 0.53; 95%CI: 0.30–0.94, Ptrend = 0.03).ConclusionDietary fiber intake and more specifically insoluble, fruits’, and vegetables’ fiber intake might be associated with a reduced breast cancer risk, particularly in premenopausal women. Future prospective investigations are needed to confirm these findings.

Flamingo Search Sailfish Optimizer Based SqueezeNet for Detection of Breast Cancer Using MRI Images

Breast cancer with increased risk in women is identified with Breast Magnetic Resonance Imaging (Breast MRI) and this helps in evaluating treatment therapies. Breast MRI is time time-consuming process that involves the assessment of current imaging. This research work depends on the detection of breast cancer at the earlier stages. Among various cancers, breast cancer in women occurs in larger accounts for almost 30% of estimated cancer cases. In this research, many steps are followed for breast cancer detection like pre-processing, segmentation, augmentation, extraction of features, and cancer detection. Here, the median filter is utilized for pre-processing, as well as segmentation is followed after pre-processing, which is done by Psi-Net. Moreover, the process of augmentation like shearing, translation, and cropping are followed after segmentation. Also, the segmented image tends to process feature extraction, where features like shape features, Completed Local Binary Pattern (CLBP), Pyramid Histogram of Oriented Gradients (PHOG), and statistical features are extracted. Finally, breast cancer is detected using the DL model, SqueezeNet. Here, the newly devised Flamingo Search SailFish Optimizer (FSSFO) is used in training Psi-Net as well as SqueezeNet. Furthermore, FSSFO is the combination of both the Flamingo Search Algorithm (FSA) and SailFish Optimizer (SFO).

MiRNAs in Signal Transduction of SMAD Proteins in Breast Cancer.

The aim of this study was to identify miRNAs that could potentially influence the activity of SMAD proteins involved in TGFβ signal transduction in five types of breast cancer in Polish women. Patients with five breast cancer subtypes were included in the study: luminal A (n = 130), luminal B HER2- (n = 100), luminal B HER2+ (n = 96), non-luminal HER2+ (n = 36), and TNBC (n = 43). During surgery, tumor tissue was removed along with a margin of healthy tissue (control). Molecular analysis included determination of the expression of genes related to SMAD protein signal transduction using mRNA microarrays and reverse transcription quantitative polymerase chain reaction (RT-qPCR). Protein expression was determined using an enzyme-linked immunosorbent assay (ELISA). The miRNA profiling was performed using miRNA microarrays and the miRDB database. SMAD3 and SMAD5 were overexpressed in all types of breast cancer, which could be related to the reduced expression of miR-145, and the findings for SMAD4 and miR-155 were similar. Additionally, the level of SMAD7 was reduced, which may be due to the low activity of miR-15b and miR21b. This study determined the gene expression profiles involved in SMAD protein signal transduction across five different types of breast cancer and identified the miRNAs potentially regulating their activity. Overexpression of SMAD3, SMAD4, and SMAD5 suggests excessive activation of the TGFβ pathway, potentially promoting tumor growth and development. Concurrently, a significant reduction in SMAD7 expression removes inhibitory control in the TGFβ pathway, a phenomenon that is particularly evident in more aggressive breast cancer types.

Family history and genetic risk score combined to guide cancer risk stratification: A prospective cohort study.

Family history (FH) of cancer and polygenic risk scores (PRS) are pivotal for cancer risk assessment, yet their combined impact remains unclear. Participants in the UK Biobank (UKB) were recruited between 2006 and 2010, with complete follow-up data updated until February 2020 for Scotland and January 2021 for England and Wales. Using UKB data (N = 442,399), we constructed PRS and incidence-weighted overall cancer PRS (CPRS). FH was assessed through self-reported standardized questions. Among 202,801 men (34.6% with FH) and 239,598 women (42.0% with FH), Cox regression was used to examine the associations between FH, PRS, and cancer risk. We found a significant dose-response relationship between FH of cancer and corresponding cancer risk (Ptrend < .05), with over 10 significant pairs of cross-cancer effects of FH. FH and PRS are positively correlated and independent. Joint effects of FH of cancer (multiple cancers) and PRS (CPRS) on corresponding cancer risk were observed: for instance, compared with participants with no FH of cancer and low PRS, men with FH of cancer and high PRS had the highest risk of colorectal cancer (hazard ratio [HR]: 3.69, 95% confidence interval [CI]: 3.01-4.52). Additive interactions were observed in prostate and overall cancer risk for men and breast cancer for women, with the most significant result being a relative excess risk of interaction (RERI) of 2.98, accounting for ~34% of the prostate cancer risk. In conclusion, FH and PRS collectively contribute to cancer risk, supporting their combined application in personalized risk assessment and early intervention strategies.

Side Effect Profile of Arimidex vs. Femara: A Comparison Study

Background: Background: Aromatase inhibitors, Arimidex (anastrozole) and Femara (letrozole), are commonly used in the treatment of hormone receptor-positive (HR+) breast cancer in postmenopausal women. Despite similar efficacy, these drugs have different side effect profiles that impact patient compliance and quality of life.Objective: To compare the incidence and severity of side effects between Arimidex and Femara in postmenopausal women with HR+ breast cancer.Methods: A retrospective cohort study was conducted involving 1,000 postmenopausal women with HR+ breast cancer from multiple oncology centers. Participants were divided into two groups: Arimidex (n=500) and Femara (n=500). Side effects were assessed via patient self-reports, clinical evaluations, and standardized questionnaires. Data were analyzed using chi-square tests, t-tests, and logistic regression models, with p-values &lt;0.05 considered significant.Results: Arimidex was associated with higher rates of joint pain (45% vs. 30%, p&lt;0.001) and muscle pain (38% vs. 25%, p&lt;0.01). Femara showed increased rates of hypertension (28% vs. 20%, p&lt;0.05) and significant bone density loss (18% vs. 12%, p&lt;0.05).Conclusion: Arimidex and Femara exhibit distinct side effect profiles, suggesting the need for personalized treatment approaches based on patient risk factors.

Prevalence and impact of metabolic associated fatty liver disease in non-metastatic breast cancer women at initial diagnosis: a cross-sectional study in China.

The epidemiologic data of metabolic associated fatty liver disease (MAFLD) in breast cancer (BC) patients remains limited. We aimed to investigate the prevalence and clinicopathological characteristics of hepatic steatosis (HS) and MAFLD in Chinese BC women at initial diagnosis. 3217 non-metastatic primary BC women with MAFLD evaluation indexes at initial diagnosis and 32,170 age-matched (in a 1:10 ratio) contemporaneous health check-up women were enrolled. The prevalence of HS (21.5% vs. 19.7%, p = 0.013) and MAFLD (20.8% vs. 18.6%, p = 0.002) were significantly higher in BC women than in health check-ups, respectively. Meanwhile, the prevalence of HS/MAFLD among elderly BC women (≥ 60years) was significantly higher than the health check-ups (38.7%/37.6% vs 31.9%/30.8%), respectively. In BC women with HS/MAFLD, the prevalence of overweight/obesity was up to 85.7%/88.6%, dyslipidemia and elevated blood pressure were 63.2%/63.7% and 59.7%/61.7%, respectively. No statistical significance of the expressions of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor 2 (HER-2) and Ki67 were found between BC women with HS/MAFLD and BC women without HS/MAFLD. After adjustment, BC women with HS showed significantly higher risk of lymph node metastasis than BC women without HS. Subjects with HS/MAFLD had higher risks of overweight/obesity, dyslipidemia, elevated blood pressure, hyperuricemia, and elevated enzymes than those without HS/MAFLD. Compared with health check-ups, BC patients have higher prevalence of HS/MAFLD. HS/MAFLD coexist with high prevalence of metabolic complications, and the risk of lymph node metastasis was significantly higher in BC women with HS than in BC women without HS.

Cáncer de mama en el varón: estudio multicéntrico en Aragón durante 27 años

IntroductionMale breast cancer accounts for 1% of all breast cancers. Its low frequency leads to a lack of awareness, resulting in significant diagnostic delays. Additionally, this limits the available evidence, which primarily uses diagnostic-therapeutic algorithms based on women. MethodsA multicenter, observational, descriptive, retrospective study was conducted in the autonomous community of Aragon, Spain, from 1995 to 2022 including men with a pathological diagnosis of breast cancer. The prevalence, clinical presentation, pathological characteristics and prognosis of this pathology in men were analyzed. ResultsA total of 148 patients were included, one of the largest series available, with a prevalence of 1%. The most common clinical presentation was a palpable retroareolar mass. Invasive ductal carcinoma was the most frequent type (88.89%), and luminal B was the predominant subtype (47.76%). Surgery was the most utilized treatment; mastectomy was performed in 90.34% and AL in 46.89%. At diagnosis, 52.46% had extramammary involvement. The recurrence rate was 24.1%, and the mortality attributed to the disease was 14.6%. ConclusionsThere is a high rate of metastatic involvement at diagnosis, a high percentage of mutilating surgeries, and a high number of recurrences compared to available studies on males. Additionally, a worse prognosis is observed compared to breast cancer in women, despite these tumors having a less aggressive molecular subtype. These findings highlight the importance of conducting studies focused on men to develop specific protocols.

Prevalence of Cardiotoxicity Secondary to Trastuzumab in Patients with HER-2-Positive Breast Cancer in Southeast Mexico

In Mexico, breast cancer (BC) is the principal cause of death in women over 30 years old, with an annual mortality rate of 14.61 deaths per a 100,000 population. Chemotherapy, in combination with trastuzumab (TTZ), improves the survival of cancer patients; however, cardiotoxicity (CT) is the principal consequence. CT prevalence occurs between 10% and 30% of patients; however, there are no data about the prevalence of CT in the Mexican population. This study aims to establish the prevalence of CT in patients treated with anti-HER-2 therapy among BC women in southeast Mexico. A retrospective cross-sectional study was carried out from January 2015 to July 2019. The records of 46 patients diagnosed with HER-2-positive BC who attended the Mexican Social Security Institute in the Ambulatory Care Medicine Unit were analyzed. The diagnostic criterion for CT was a decrease in LVEF &gt; 10% from baseline or a final LVEF &lt; 53%. CT prevalence was observed in 19 (41.3%) of women with cancer, with an average decrease in LVEF of 13%. In the population, we found an association between weight, surface area, and the loading dose of TTZ with CT. Nutritional follow-up and the administration of cardioprotective drugs are necessary to recover LVEF and avoid cardiovascular failure in women with BC and survivors.

Racial, Ethnic, and Socioeconomic Disparities in Meeting Physical Activity Guidelines among Female Breast Cancer Survivors in the United States.

Cancer survivors show low physical activity participation rates in the U.S. However, there are limited national-level data on disparities in the prevalence of meeting physical activity guidelines among women with and without breast cancer. We aimed to evaluate national-level trends in meeting physical activity guidelines across demographic and socioeconomic characteristics of breast cancer survivors and women without cancer. Data for women aged ≥35-years with and without breast cancer were obtained from the 2004-2018 National Health Interview Survey (NHIS). We used NHIS survey weights to generate national-level prevalence estimates and calculate absolute and relative indices of disparity for breast cancer survivors and women without cancer meeting aerobic (150-mins/week) and muscle strengthening guidelines (2-sessions/week) stratified by demographic (e.g., race/ethnicity) and socioeconomic (e.g., homeownership) characteristics. We included 5,845 breast cancer survivors and 160,162 women without cancer. The weighted percentage of breast cancer survivors meeting aerobic guidelines was 37.7% compared to 40.9% of women without cancer. Fewer women met muscle strengthening guidelines. There were lower proportions of women who were younger (<50-years), were non-Hispanic Black, were Hispanic, worked 35+ hours/week, or rented their home among breast cancer survivors meeting aerobic guidelines compared to women without cancer meeting aerobic guidelines. Breast cancer survivors were less likely to meet physical activity guidelines compared to women without cancer. Demographic and socioeconomic disparities may exist among breast cancer survivors and women without cancer meeting physical activity guidelines. Targeted interventions may be necessary to address low physical activity participation among breast cancer survivors.

Development of a Breast Cancer Risk Prediction Model Integrating Monogenic, Polygenic, and Epidemiologic Risk.

Breast cancer has been associated with monogenic, polygenic, and epidemiologic (clinical, reproductive, and lifestyle) risk factors, but studies evaluating the combined effects of these factors have been limited. We extended previous work in breast cancer risk modeling, incorporating pathogenic variants (PV) in six breast cancer predisposition genes and a 105-SNP polygenic risk score (PRS), to include an epidemiologic risk score (ERS) in a sample of non-Hispanic White women drawn from prospective cohorts and population-based case-control studies, with 23,518 cases and 22,832 controls, from the Cancer Risk Estimates Related to Susceptibility (CARRIERS) Consortium. The model predicts 4.4-fold higher risk of breast cancer for postmenopausal women with no predisposition PV and median PRS, but with the highest versus lowest ERS. Overall, women with CHEK2 PVs had >20% lifetime risk of breast cancer. However, 15.6% of women with CHEK2 PVs and a family history of breast cancer, and 45.1% of women with CHEK2 PVs but without a family history of breast cancer, had low (<20%) predicted lifetime risk and thus were below the threshold for MRI screening. CHEK2 PV carriers at the 10th percentile of the joint distribution of ERS and PRS, without a family history of breast cancer, had a predicted lifetime risk similar to the general population. These results illustrate that an ERS, alone and combined with the PRS, can contribute to clinically relevant risk stratification. Integrating monogenic, polygenic, and epidemiologic risk factors in breast cancer risk prediction models may inform personalized screening and prevention efforts.

Clinicopathological and Ultrasonographic Characteristics of Breast Cancer in Young Women.

Purpose: The early detection of breast cancer in women under the age of 40 has posed significant challenges. This can be attributed in part to the limited research conducted on the breast cancer in this age group, particularly with regards to large sample sizes. We aimed to address this gap by analyzing and comparing the ultrasound imaging and pathological characteristics of breast cancer in women aged under 40 and those aged 40 and above. Methods: A retrospective assessment was conducted to examine the ultrasound imaging and clinicopathologic characteristics of 555 women with surgically confirmed breast cancers. The patient cohort consisted of 160 individuals below the age of 40 and 395 individuals aged 40 years and above. Results: Our study identified the breast cancer in patients under 40 years was more likely to show regular shape (p = 0.043) compared with tumors in patients who were 40 years and over. Furthermore, in young female patients (<40 years), irregular shape was correlated with the HER2-enriched type (p = 0.02), circumscribed margin (p = 0.001), and a lack of calcifications (p = 0.02) were associated with the triple-negative type. In another group (≥40 years), only a lack of calcifications (p = 0.003) were associated with the triple-negative type. Conclusion: Breast cancer in women under the age of 40 exhibits distinct ultrasonographic characteristics patterns that vary across different immunophenotypes, which may provide certain predictive information for physicians.

Surgical complications after immediate implant-based breast reconstruction for breast cancer in women over 65 years.

While immediate breast reconstruction rates in breast cancer are increasing, they remain low in women over 65 years old. The aim was to investigate surgical outcomes in women older than 65 years receiving implant-based immediate breast reconstruction. The population-based Stockholm Breast Reconstruction Database includes all adult women with breast cancer receiving an implant-based immediate breast reconstruction in Stockholm, Sweden, 2005-2015. Primary outcomes within 30 days from immediate breast reconstruction were: infection requiring antibiotics and reoperation on. Implant removal was a secondary outcome. Women more than 65 years were compared with younger age groups. Chi-square tests and multivariable logistic regression were applied for the primary outcomes, and Kaplan-Meier analysis for the secondary outcome. Among 1749 cases of immediate breast reconstruction, 140 (8.0%) were in women more than 65 years. Median follow-up was 74 months (1-198). Postoperative infection was not more common in women older than 65 years old (22 of 140, 15.7%) than in women under 65 years old (303 of 1609, 18.8%; P = 0.221). Reoperation on was more frequent in women older than 65 years than in other age groups (more than 65: 8.6%; 50-64: 6.5%; 40-49: 3.5%; less than 40: 1.6%; P < 0.001), however, age older than 65 years was not an independent risk factor in the multivariable analysis (OR 1.00, 95% c.i. 0.44 to 2.28). Overall, 6-year probability of implant removal was 11.4%, (8.1% due to complications and 3.3% due to patient preference). There was no statistically significant difference between age groups for either reason (P = 0.085 and P = 0.794 respectively). Older age alone was not associated with worse surgical outcomes after implant-based immediate breast reconstruction in highly selected patients older than 65 years when compared with their younger counterparts.

Does vaginal estrogen therapy increase risk of breast cancer in postmenopausal women?

Does vaginal estrogen therapy increase risk of breast cancer in postmenopausal women?

Analysing The Breast Cancer Awareness Of Public Health Care Management In India

One of the most prevalent types of cancer impacting women worldwide is breast cancer. Breast cancer in women is a significant global public health issue because of its high rate of morbidity and mortality as well as its substantial social and financial costs. The number of new cases and fatalities from breast cancer is rising year, contributing to the disease's growing global burden. In India, breast cancer ranks second in terms of cancer-related fatalities among women and is the most common cancer. However, the percentage is undoubtedly higher in America, where one in eight people get this potentially fatal cancer. According to the Population Based Cancer Registry of India, between 25% and 31% of all malignancies in women in urban areas (such as Mumbai, Delhi, Chennai, Ahmadabad, Bangalore, Bhopal, etc.) are breast cancers. Although the rise in breast cancer cases is mostly reported in large cities, it is very likely that many cases go unreported in rural areas. The average age at which breast cancer is diagnosed has dropped from 50–70 years to 30–50 years. Millions of people can be assisted in lowering the risk of breast cancer by receiving the right information and treatment under the direction of professionals. Therefore, this study aims to investigate practitioners' opinions regarding the implementation of the awareness model in the health sector as well as the public's perspective of the models for women suffering breast cancer.