Cancer In Women Research Articles

Abstract 47: Survival of Breast Cancer in Women Treated Under Mexico's Seguro Popular

Abstract Purpose: To determine 5-year survival for breast cancer among uninsured women treated under Mexico's Seguro Popular landmark health reform according to clinical stage and identify factors associated to survival. Methods: We conducted a retrospective cohort study with data obtained from national reimbursement claims of patients treated under Seguro Popular from January 2007 to December 2016. Reimbursement data was cross-linked with a national mortality registry. We used the Kaplan-Meier method to estimate overall survival according to different variables and stratified them by clinical stage as early (I-IIA), locally advanced (IIB-IIIC), and metastatic (IV). We explored the relation between age, hospital patient volume, hospital infrastructure, and mortality. Hazard ratios and 95% confidence intervals (95%CI) were estimated, using the Cox proportional hazards model to adjust for clinical stage. Results: A total of 57,175 patients with breast cancer were analyzed. The mean age was 43.4 (SD 12.4). Most patients had locally advanced disease at diagnosis (55.1%, n=31,559) and 9.5% (n=5,435) had metastatic disease. The distribution of clinical stage did not appear to change over time (11% in 2007 vs. 13% in 2015 for metastatic disease). Five-year survival was 88.9% (CI95% 88.3-89.5) for early-stage disease, 69.6% (CI95% 69-70.2) for locally advanced cancer, and 36.9% (CI95% 35.4-38.5) for metastatic disease. These survival estimates did not change over time. After adjustment for clinical stage, age <40 years old (HR 1.17 [CI95% 1.12-1.23]), low hospital patient volume (≤248 patients/year, HR 1.21 [CI95% 1.17-1.25]), and treatment at a locally funded hospital (HR 1.15 [CI95% 1.11-1.2]) were associated with higher mortality. Conclusions: While Seguro Popular provided access to treatment for breast cancer, a high proportion of women were treated at advanced stages and clinical stage at diagnosis and survival did not appear to change over a decade. Future programs should prioritize early detection and strengthen quality of care. Citation Format: Antonio Bandala-Jacques, Rodrigo Huerta-Gutierrez, Salvador Zamora-Muñoz, Paula Cabrera, Alejandro Mohar, Martin Lajous. Survival of Breast Cancer in Women Treated Under Mexico's Seguro Popular [abstract]. In: Proceedings of the 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; 2021 Mar 10-11. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2021;30(7 Suppl):Abstract nr 47.

Abstract 790: A Utah Population Data Base Study of young women's breast cancer outcomes by parity status

Abstract Importance: A diagnosis of breast cancer after childbirth is reported to increase risk for metastasis and death in patients ≤45 years of age. Data to discern if a postpartum diagnosis is an independent risk factor for poor outcomes remain limited. Objective: Determine associations between time since last pregnancy and time to metastasis and breast cancer-specific death using cases available from the Utah Population Data Base (UPDB). Secondary objectives are time to metastasis and breast cancer specific-death delineated by tumor stage and ER status. Study Design: This is a population-based study of 2,977 women with stage I, II, or III breast cancer (BC) diagnosed at ≤ 45 years of age from 1996 to 2017. The study population was identified from the UPDB, a statewide dynamic database of linked data received from the Utah SEER Cancer Registry, birth certificates, death certificates, and medical records. Clinical prognostic factors include patient age at diagnosis, year of diagnosis, tumor size, stage, and estrogen receptor (ER) status. The primary exposures are no prior childbirth or time between the most recent childbirth and a breast cancer diagnosis, and primary outcomes are distant metastasis-free survival and breast cancer specific death. Results: Among the 2,977 predominantly white women from the state of Utah, USA, the reproductive histories of the breast cancer patients were grouped as nulliparous (n = 867), and parous: diagnosed 0-5 years (n = 614), >5-10 years (n = 615) and >10 years (n = 881) since last childbirth. We find a breast cancer diagnosis within 5 years of childbirth is associated with elevated risk for metastasis after controlling for diagnosis year, diagnosis age, tumor stage, and ER status [HR (95% CI) =1.64 (1.16, 2.32)], particularly in Stage I/II disease [HR (95% CI) =1.89 (1.24, 2.87)]. The 0-5 year group also had elevated risk of breast cancer-specific death [HR (95% CI) =1.57 (1.07, 2.32)]. While ER-negative tumors were enriched in women diagnosed 0-5 years postpartum, this enrichment could be attributed largely to the younger age of this reproductive group. Further, postpartum breast cancer patients diagnosed with ER-positive disease within 5 years of a completed pregnancy had significantly worse distant metastasis-free survival than nulliparous patients with ER-negative disease. Conclusions: In this population level study from the state of Utah, a diagnosis of breast cancer within 5 years postpartum is a risk factor for metastasis and breast cancer-specific death that is independent of known clinical parameters, including ER status. The increased risk for poor outcomes is highest in stage I/II diagnoses. Relevance: For women with breast cancers classically considered as having good prognostic tumor features, i.e. stage I or II and ER-positive, a postpartum diagnosis is a dominant demographic feature of increased risk for metastasis and death. Citation Format: Pepper Schedin, Sonali Jindal, Solange Bassale, Zhenzhen Zhang, Alison Fraser, Emily Guinto, Virginia F. Borges, Motomi Mori, Ken R. Smith. A Utah Population Data Base Study of young women's breast cancer outcomes by parity status [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 790.

Caregiver Characteristics Associated With Cognitive Complaints in Women With Breast Cancer.

To explore whether caregiver characteristics were associated with cognitive complaints reported by women with breast cancer undergoing chemotherapy. 61 dyads of women with breast cancer and their caregivers were recruited at Duke Women's Cancer Care Raleigh in North Carolina. An exploratory, cross-sectional design was used. Data were obtained on patients and caregivers. Patient cognitive complaints were represented by cognitive impairment (CI) and cognitive ability (CA). Two significant associations were found. Healthcare providers should consider caregivers when assessing and managing patients' cognitive symptoms. This study suggests the value of including caregivers when establishing interventions for patients who have cognitive complaints.

Abstract 99: A Tablet-Based Electronic Medical Record System to Improve Cancer Early Detection and Linkage to Care at Health Facilities In Rwanda

Abstract Purpose: For a cancer early detection program to improve cancer outcomes, patients with abnormal initial tests must be linked to timely diagnosis and care. We describe the development and early implementation of a tablet-based electronic medical record (EMR) at rural Rwandan health care facilities to facilitate clinical documentation and tracking of patients participating in a cervical cancer screening and breast cancer early detection program. Methods: To develop the EMR tool, a multi-institutional team was established consisting of software developers and health informatics implementers from Rwanda Biomedical Centre, Partners In Health, and the Clinton Health Access Initiative. We utilized the open-source software OpenMRS linked with an android mobile app, mUzima, used on tablets offline at rural health centers. Data are synchronized to a national OpenMRS server. In four workshops, clinicians and project leaders from Rwanda's Women's Cancer Early Detection initiative identified key clinical variables and workflows to track and link patients to care. Quality assessment of data from June-November 2020 is underway to identify gaps. Results: Twenty-two informatics trainers trained 269 clinicians at 81 health facilities from June- November 2020, enabling the tablet-based tool to be routinely utilized in the cancer early detection program in 4 districts. From June-November 2020, OpenMRS data show 13,783 patients were evaluated for cervical cancer screening and 3,608 had breast evaluation. Early implementation challenges included form completion burden for clinicians and insufficient validation rules limiting data quality. Additionally, clinical reports have not been finalized, requiring manual tracking of missed visits. Informatics, programmatic, and clinical partners discussed strategies to resolve challenges at a weeklong workshop in December 2020. Conclusion: Building an informatics system to facilitate cancer early detection in rural low-resource health facilities is feasible but requires continuous adaptation, training and multidisciplinary cross-institutional collaboration. Further evaluation will investigate the tool's impact on timely patient care. Citation Format: Eric Kagabo, Todd Anderson, Nadine Karema, Jean-Marie Vianney Dusengimana, Marc Hagenimana, Francois Uwinkindi, Jean Paul Balinda, Placide Habinshuti, Joshua Byiringiro, Nang'andu Chyizuka, Lydia Pace. A Tablet-Based Electronic Medical Record System to Improve Cancer Early Detection and Linkage to Care at Health Facilities In Rwanda [abstract]. In: Proceedings of the 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; 2021 Mar 10-11. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2021;30(7 Suppl):Abstract nr 99.

Genital Powder Use and Risk of Epithelial Ovarian Cancer in the Ovarian Cancer in Women of African Ancestry Consortium.

Genital powder use is more common among African-American women; however, studies of genital powder use and ovarian cancer risk have been conducted predominantly in White populations, and histotype-specific analyses among African-American populations are limited. We used data from five studies in the Ovarian Cancer in Women of African Ancestry consortium. Participants included 620 African-American cases, 1,146 African-American controls, 2,800 White cases, and 6,735 White controls who answered questions on genital powder use prior to 2014. The association between genital powder use and ovarian cancer risk by race was estimated using logistic regression. The prevalence of ever genital powder use for cases was 35.8% among African-American women and 29.5% among White women. Ever use of genital powder was associated with higher odds of ovarian cancer among African-American women [OR = 1.22; 95% confidence interval (CI) = 0.97-1.53] and White women (OR = 1.36; 95% CI = 1.19-1.57). In African-American women, the positive association with risk was more pronounced among high-grade serous tumors (OR = 1.31; 95% CI = 1.01-1.71) than with all other histotypes (OR = 1.05; 95% CI = 0.75-1.47). In White women, a significant association was observed irrespective of histotype (OR = 1.33; 95% CI = 1.12-1.56 and OR = 1.38; 95% CI = 1.15-1.66, respectively). While genital powder use was more prevalent among African-American women, the associations between genital powder use and ovarian cancer risk were similar across race and did not materially vary by histotype. This is one of the largest studies to date to compare the associations between genital powder use and ovarian cancer risk, overall and by histotype, between African-American and White women.

Breast Cancer in Women Aged 75 Years and Older

Breast Cancer in Women Aged 75 Years and Older

Morphological and Prognostic Characteristics of Breast Cancer in Women Living in the Sakha Republic (Yakutia)

Background: This article presents the results of the analysis of the clinical and morphological examination of breast cancer (BC) in women of the Republic of Sakha (Yakutia) (RS(Y)). Methods and Results: The object of the study was fragments of breast tissue from 294 women who underwent surgical treatment and/or needle biopsy. By ethnicity, there were 118(40.1%) women of indigenous nationalities and 176(59.9%) women of non–indigenous nationalities. The greatest number of cases of BC was registered in the age group of 50-59 (32.6%). The age group of 40-49 was in second place (20.4%). Among the indigenous population, women in the age groups of 40-49 years (23.7%) and 50-59 years (26.3%) predominated. The age groups of 50-59 years (36.9%) and 60-69 years (22.2%) predominated among the non-indigenous women. Tumors with a size of 2 cm to 5 cm prevailed; they were detected in 185(62.9%) women. Tumors with a spread to the chest wall and skin develop more often in women of non-indigenous nationalities (15.9% of cases), than in women of indigenous nationality (6.8% of cases). Regardless of ethnicity, the most common histological form of BC in women of the RS(Y) was infiltrative ductal cancer (65.3%). Cancer staging according to the TNM staging system showed that n the age group of women under 39 years, Stage IIIB+IIIC (43.2%) was most often registered (p=0.01), while in other age groups, Stage IIA (32.4%) was more often noted. Conclusion: Our findings suggest that further investigation of the peculiarities of the course of BC in the female population of Yakutia would lead to much improved methods of diagnosis and treatment.

Predictors of falls after starting an exercise program: A secondary analysis in inactive, female cancer survivors participating in the GET FIT trial.

12075 Background: Women treated for cancer are more likely to fall than women without a cancer history. Exercise is a fall prevention strategy for older adults that we are testing in the GET FIT trial as a fall prevention approach in women cancer survivors. Increasing physical activity, though, could acutely increase the risk of falls in inactive survivors with known fall risk related to treatment. Knowing who might be at risk prior to beginning an exercise program would inform additional safety precautions during exercise. Methods: We conducted a secondary analysis of baseline data from the GET FIT trial that enrolled inactive, older women who had completed chemotherapy for cancer. Women completed objective (muscle strength, static postural control, range of motion, physical functioning) and self-report (fall history, comorbidities, presence of neuropathy symptoms, pain severity, depressive symptoms, cognitive functioning, perceptions of lower extremity functioning, disability, fear of falling, demographic, and clinical characteristics) measures at baseline. Falls were prospectively collected during the 6 month intervention using monthly self report. Potential predictors of falls were included if univariate tests revealed significant differences between fallers and non-fallers. To identify the strongest predictors of falls, we used an automated model selection and multimodel inference approach to perform an exhaustive model search. Results: Baseline data were available for 415 participants with known faller status at the end of the intervention, of whom 31.3% (n = 130) reported at least one fall. The average age of the sample was 62.1±6.4 years and consisted mostly of non-Hispanic white, married, highly educated, overweight or obese women treated for breast cancer. Fallers (1+ falls) and non-fallers significantly differed on measures of fall history, comorbidities, pain, neuropathy, fear of falling, disability, perceived lower extremity functioning, cognitive functioning, depression, and postural control. The best model of faller status (per BIC) included postural control (p = 0.004), perceived lower extremity functioning (p = 0.072), and fear of falling (p = 0.030). Odds of ≥1 fall during the intervention increased by 1.72 (95% CI: 1.05-2.83) times for a 0.1-point decrease in postural control, 1.11 (1.04-1.19) times for a 0.1-point increase in fear of falling, and 1.02 (1.00-1.03) times for a 1-point decrease in perceived lower extremity functioning. Conclusions: Women cancer survivors with poor balance, poor self-rated functioning, and a fear of falling may need to take additional fall precautions when starting an exercise program. Clinical trial information: NCT01635413.

Creation of Cervical Cancer Risk Factor Score Card in order to Know the Risk Score for Cervical Cancer in Women of Reproductive Age by Conducting Self-Assessment

Introduction: Cervical cancer is the second most common malignancy among various cancers in the genetalia of women, and often occurs at reproductive age. Purpose: The purpose of this study is to create a cervical cancer risk factor score card in order to know the risk score for cervical cancer in women of reproductive age by conducting self-assessment. Methods: The design of this research was cross-sectional, with 81 patients as respondents. Data were collected through filling out a questionnaire, then analyzed using Mc Nemar Test and ROC curve. Findings: Obtained a cut-off point 11 with a sensitivity value of 93.8%, a specificity of 90.9%. The results of testing the validity of the score card obtained results with an accuracy value of 92.6%, with a significant value of 0.000, which means there was a relationship between the scorecard and the diagnosis of cervical cancer. Conclusion: The score card can be used as a self-assessment in the hope that it can increase women to perform early detection of cervical cancer.

An Overview of Lung Cancer in Women and the Impact of Estrogen in Lung Carcinogenesis and Lung Cancer Treatment.

Lung cancer incidence and mortality have significantly increased in women worldwide. Lung adenocarcinoma is the most common form of lung cancer globally. This type of lung cancer shows differences by sex, including the mutational burden, behavior, clinical characteristics, and response to treatment. The effect of sex on lung cancer patients' survival is still controversial; however, lung adenocarcinoma is considered a different disease in women and men. Moreover, lung adenocarcinoma is strongly influenced by estrogen and is also different depending on the hormonal status of the patient. Young pre-menopausal women have been explored as an independent group. They presented in more advanced stages at diagnosis, exhibited more aggressive tumors, and showed poor survival compared to men and post-menopausal women, supporting the role of sex hormones in this pathology. Several reports indicate the estrogen's role in lung carcinogenesis and tumor progression. Thus, there are currently some clinical trials testing the efficacy of antihormonal therapy in lung cancer treatment. This mini review shows the updated data about lung cancer in women, its characteristics, the etiological factors that influence carcinogenesis, and the critical role of estrogen in lung cancer and treatment.

Establishing women's cancer care services in a fragile, conflict and violence affected ecosystem in Africa.

BackgroundThe majority of the world’s poorest women (income < $1.90/day) reside in fragile, conflict and violence (FCV)-affected countries, like the Democratic Republic of the Congo. Health services in these settings have traditionally focused on immediate relief efforts, communicable diseases and malnutrition. Recent data suggests there is need to widen the focus to include cancer, as its incidence and mortality rates are rising.MethodsEmploying competency-based learning strategies, Congolese health professionals were trained to perform same-day cervical cancer screening and treatment of precancerous lesions of the cervix; same-day clinical breast examination and breast ultrasound diagnostics; surgical treatment of invasive cancers of the breast and cervix; and infusion of cytotoxic chemotherapy. Outpatient breast and cervical cancer care clinics, a chemotherapy suite and surgical theatres were outfitted with equipment and supplies.ResultsCombining local and regional hands-on training seminars with wise infrastructure investments, a team of US and Zambian oncology experts successfully implemented a clinical service platform for women’s cancers in a private sector health facility in the Democratic Republic of the Congo.ConclusionWe forged a novel partnership between oncology health professionals from Africa and its Diaspora, international philanthropic organisations, a cancer medicine access initiative and an established African cancer centre to build women’s cancer services in a FVC-affected African setting.

Leveraging a matrix of stakeholders to facilitate access to chemotherapy for women's cancers in the Democratic Republic of the Congo.

BackgroundCancer incidence is increasing worldwide. Over the next 20 years, the growing proportion of cases in low- and middle-income countries (LMICs) will account for an estimated 70% of all cancers diagnosed. The vast majority of cancer patients in LMICs will require chemotherapy, due to the advanced stage of their disease at the time of initial presentation. Unfortunately, the availability of cancer drugs in these environments is sparse, resulting in premature death and years of life lost. In an effort to lay a foundation for women’s cancer control in the Democratic Republic of the Congo (DRC), we implemented a programme which combined workforce development, infrastructure creation and cancer drug access. This manuscript reports on our experience with the latter.MethodsA private sector healthcare facility was selected as the programme implementation site. Workforce capacity was developed through a south–south partnership with an African national cancer centre. Cancer drugs were procured through a global cancer medicine access initiative.ResultsA new chemotherapy infusion unit was successfully established at the Biamba Marie Mutombo Hospital in Kinshasa, DRC. A team of Congolese healthcare providers was trained at the Cancer Disease Hospital in Zambia to safely and effectively administer chemotherapy for breast and cervical cancer. Over 100 breast and cervical cancer patients have been treated with 337 courses of chemotherapy, without any serious adverse events.ConclusionCommon barriers to cancer drug access and its administration can be eliminated using regional educational resources to build oncologic workforce capacity, private sector healthcare facilities for infrastructure support and pharmaceutical consortiums to procure low-cost cancer medicines. By leveraging a matrix of global, regional and local stakeholders, the prevailing status quo of very limited access to chemotherapy for women’s cancers was creatively disrupted in DRC, Africa’s largest fragile, conflict and violence-affected country.

No Association Between Statin Use and the Prognosis of Endometrial Cancer in Women With Type 2 Diabetes

Preclinical studies have suggested statins have antiproliferative and anti-metastatic effects on endometrial cancer cells. Similarly, most previous epidemiological studies have reported a better prognosis of endometrial cancer in patients who used statins. In this study, we explored the role of statins in the prognosis of endometrial cancer in women with type 2 diabetes in a hospital-based cohort. This retrospective cohort consisted of 119 women with type 2 diabetes who were diagnosed and treated for endometrial cancer at Oulu University Hospital, Finland, between 2007 and 2014. The patients were classified as statin users (n = 58) and nonusers (n = 61) based on the type of medication they were using at the time of endometrial cancer diagnosis. Statin use showed no association with progression-free survival or overall survival in the whole cohort nor the subgroups with type I or type II histology, in lower or higher body mass index groups, or at an early or advanced stage. The results remained similar in the multivariate analysis after adjusting for the patient’s age, cancer stage, and histology. Furthermore, statin use seemed not to have any association with most of the prognostic factors at the time of endometrial cancer diagnosis.

Reproductive Factors and Risk of Thyroid Cancer in Women: An Analysis in the Nurses' Health Study II.

The incidence of thyroid cancer in women is increasing at an alarming rate, with greatest risk in the reproductive years. Establishing relationships of hormonally related reproductive factors with thyroid cancer has been difficult. We aimed to elucidate potential risk factors for thyroid cancer in a large cohort of women. Among 116,228 women in the Nurses' Health Study II followed from 1989 to 2013, 620 cases of thyroid cancer were identified. We examined reproductive and hormone-related factors, including age at menarche, age at menopause, parity, oral contraceptive use, and postmenopausal hormone therapy use. Pregnancy, reproductive years, and months of breastfeeding were used as surrogate markers for exposure to endogenous reproductive hormones. We used multivariable Cox models to calculate relative risks and 95% confidence intervals for the associations between these factors and risk of thyroid cancer. Number of reproductive years of 41years or more was associated with more than double the risk of thyroid cancer compared with 30years or fewer (relative risk, 2.20; 95% confidence interval, 1.19-4.06). The other variables analyzed (parity number, months of breastfeeding, age at menarche, menopausal status, and postmenopausal hormone therapy) were not associated with the risk of thyroid cancer. Women who entered menopause at age 45years or older had a higher risk of thyroid cancer compared with women who entered menopause at a younger age. This result did not reach statistical significance; however, there was a linear trend between later age at menopause and increased risk of thyroid cancer (ptrend=.009). This study used a unique large, longitudinal dataset to assess thyroid cancer risk factors and potential confounders over an extended time frame. Our key finding suggests increased risk of thyroid cancer may be associated with a variety of indicators of longer reproductive years. The Nurses' Health Study II has provided new insights into the hormonal risks associated with thyroid cancer.

Exploring Health Professionals’ Perceptions of Husbands’ Responsibilities in Muslim Women’s Health

Background: The husband has an important role in women's health. However, the information related to their roles is limited, including from the perspectives of health professionals. The health professionals' support and behavior have influenced men's and women's health behavior. Purpose: This study aimed to determine the health professionals’ perceptions of husbands’ roles and behavior in women's health, especially in the Muslim community.Methods: A qualitative descriptive approach applied in this study. Data were collected using the interview method. Ten clinicians from rural and urban areas of West Java, Indonesia, with a range of experience engaging with Muslim husbands involved in this study. Semi-structured interviews were recorded and then transcribed by the researchers. The transcribed data were analyzed using the comparative analysis for the interview technique.Results: Four main themes were identified: (1) Contextual factors impact husbands' roles in women's health; (2) Extensive roles of Muslim husbands in women's health; (3) Husbands and others involved in decisions about women's health; and (4) Level of health literacy affects husband's actions in women's health and cancer.Conclusion: Health professionals perceived that husbands' roles in Muslim women's health are pivotal, especially in supporting health treatments in health services. Little information was obtained about husbands' support in cancer prevention and early detection. Nurses can take the lead in improving Muslim husbands' understanding of women's health and cancer and raising their awareness of cancer screening for their wives.

Neoadjuvant radiotherapy for locally advanced and high-risk breast cancer.

Neoadjuvant radiotherapy (NART) as part of a multi-modality approach for locally advanced breast cancer (LABC) requires further investigation. Importantly, this approach may allow for a single-staged surgical procedure, with mastectomy and immediate autologous reconstruction. Multiple other potential benefits of NART include improved pathological downstaging of breast disease, reduced overall treatment time, elimination of time period with breast tissue deficit and improved patient satisfaction. This is a retrospective multi-institutional review of patients with LABC and high-risk breast disease undergoing NART. Eligible patients sequentially underwent neoadjuvant chemotherapy (NACT) with or without HER2-targeted therapy, NART, followed by mastectomy with immediate autologous breast reconstruction (BR) 4- to 6 weeks post-completion of radiotherapy. Patient and tumour characteristics were analysed using descriptive statistics. Surgical complications were assessed using the Clavien-Dindo Classification (Ann Surg 2004; 240: 205). From 3/2013 to 9/2019, 153 patients were treated with NART. The median age was 47 years (IQR 42-52), with median body mass index of 27. Eighteen patients experienced Grade 3 acute surgical complications. This included 13 Grade 3B breast-site events and 9 Grade 3B donor-site events, where further surgical intervention was required for management of wound infection, wound dehiscence, flap or mastectomy skin necrosis, haematoma and internal mammary venous anastomotic thrombosis. No autologous flap loss was observed. Neoadjuvant radiotherapy facilitates a single-stage surgical procedure with mastectomy and immediate autologous BR, eliminating the delay to reconstructive surgery and thus shortening a woman's breast cancer journey. The findings of this review support the use of NART, with comparable rates of surgical complications to standard sequencing.

Evaluating Polygenic Risk Scores for Breast Cancer in Women of African Ancestry.

Polygenic risk scores (PRSs) have been demonstrated to identify women of European, Asian, and Latino ancestry at elevated risk of developing breast cancer (BC). We evaluated the performance of existing PRSs trained in European ancestry populations among women of African ancestry. We assembled genotype data for women of African ancestry, including 9241 case subjects and 10 193 control subjects. We evaluated associations of 179- and 313-variant PRSs with overall and subtype-specific BC risk. PRS discriminatory accuracy was assessed using area under the receiver operating characteristic curve. We also evaluated a recalibrated PRS, replacing the index variant with variants in each region that better captured risk in women of African ancestry and estimated lifetime absolute risk of BC in African Americans by PRS category. For overall BC, the odds ratio per SD of the 313-variant PRS (PRS313) was 1.27 (95% confidence interval [CI] = 1.23 to 1.31), with an area under the receiver operating characteristic curve of 0.571 (95% CI = 0.562 to 0.579). Compared with women with average risk (40th-60th PRS percentile), women in the top decile of PRS313 had a 1.54-fold increased risk (95% CI = 1.38-fold to 1.72-fold). By age 85 years, the absolute risk of overall BC was 19.6% for African American women in the top 1% of PRS313 and 6.7% for those in the lowest 1%. The recalibrated PRS did not improve BC risk prediction. The PRSs stratify BC risk in women of African ancestry, with attenuated performance compared with that reported in European, Asian, and Latina populations. Future work is needed to improve BC risk stratification for women of African ancestry.

Impact of educational intervention on cervical cancer screening uptake among reproductive age women

The objective of this review is to examine the efficacy of educational approaches in increasing women's adoption of cervical screening. A search was conducted through PubMed, Medline and Google Scholar. Articles that met the eligibility criteria were reviewed. The preferred reporting items for systematic reviews and meta-analysis (PRISMA) guided the data synthesis and reporting. We conducted a qualitative synthesis of evidence and pooled individual research results in meta-analyses using RevMan 5.3 review manager, where applicable. Heterogeneity has been estimated for total summary results of studies pooled together. Quality analysis of the papers was done using JADAD scale. This meta-analysis included a total of nine articles (n=2316). Statistical research findings indicate that the use of cervical cancer educational approaches substantially improved cervical cancer screening rates and screening acceptability by double folds 2.88. The results of this study support the use of educational intervention for cervical cancer to increase the acceptance of cervical cancer screening by women. We also recommend more research to assess the efficacy of various teaching approaches and the effect of intervention length on the rise in women's cervical cancer screening services utilization.

Lung Cancer in Women: a Review

Lung Cancer in Women: a Review

Knowledge about Factors Associated with Cervical Cancer in Women: A Cross Sectional Study, Dhaka, Bangladesh

Knowledge about Factors Associated with Cervical Cancer in Women: A Cross Sectional Study, Dhaka, Bangladesh