Câmara S, Pereira D, André S
… +6 more, Mira B, Vaz F, Oom R, Marques JC, Leal de Faria J, Rodrigues Dos Santos C
Int J Breast Cancer
· 2018 · PMID 29507815
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INTRODUCTION: Sentinel lymph node biopsy in prophylactic mastectomy is controversial. It avoids lymphadenectomy in occult carcinoma but is associated with increased morbidity. Women with BRCA mutations have a higher inci...INTRODUCTION: Sentinel lymph node biopsy in prophylactic mastectomy is controversial. It avoids lymphadenectomy in occult carcinoma but is associated with increased morbidity. Women with BRCA mutations have a higher incidence of occult carcinoma and our objective was to assess the clinical utility of sentinel lymph node biopsy when these women undergo prophylactic mastectomy. MATERIALS AND METHODS: Seven-year retrospective consecutive case-series study of women, with a BRCA deleterious mutation, admitted to prophylactic mastectomy, at our center. Breast MRI < 6 months before surgery was routine, unless contraindicated. RESULTS: Fifty-seven patients (43% BRCA1; 57% BRCA2) underwent 80 prophylactic mastectomies. 72% of patients had had breast cancer treated before prophylactic mastectomy or synchronously to it. The occult carcinoma incidence was 5%, and half of the cases were invasive. SLNB was performed in 19% of the prophylactic mastectomies; none of these had tumor invasion. Women with invasive carcinoma who had not undergone sentinel lymph node biopsy were followed closely with axillary ultrasound. The median follow-up was 37 months, with no local recurrence; 1 patient died of primary tumor systemic relapse. CONCLUSIONS: Our data do not support this procedure for routine (in agreement with previous literature), in this high risk for occult carcinoma population.
Int J Breast Cancer
· 2018 · PMID 29484211
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Stereotactic ablative body radiotherapy (SABR) has a role as definitive therapy in many tumor sites; however, its role in the treatment of breast cancer is less well explored. Currently, SABR has been investigated in the...Stereotactic ablative body radiotherapy (SABR) has a role as definitive therapy in many tumor sites; however, its role in the treatment of breast cancer is less well explored. Currently, SABR has been investigated in the neoadjuvant and adjuvant setting with a number of ongoing feasibility studies. However, its use comes with a number of radiobiological and technical challenges that require further evaluation. We have learned much from other extracranial disease sites such as lung, brain, and spine, where definitive treatment with SABR has shown encouraging outcomes. In women with breast cancer, SABR may eliminate the need for invasive surgery, reducing healthcare costs and hospital stays and providing an additional curative option for early-stage disease. This poses the following question: is there a role for SABR as a definitive therapy in breast cancer?
Int J Breast Cancer
· 2017 · PMID 29348942
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Recent advances in gene expression profiling have allowed for a more sophisticated understanding of the biology of breast cancers. These advances led to the development of molecular signatures that now allow clinicians t...Recent advances in gene expression profiling have allowed for a more sophisticated understanding of the biology of breast cancers. These advances led to the development of molecular signatures that now allow clinicians to more individually tailor recommendations regarding the utility and necessity of systemic therapies for women with breast cancer. Indeed, these molecularly based tests have been incorporated into national and international best practice guidelines and are now part of routine practice. Similar, though slower, progress is being made in the development of molecular signatures predictive of radiation response and necessity for women with breast cancer. This article will discuss the history of radiation response signature development, the current state of these signatures under ongoing clinical development, the barriers to their clinical adoption, and upcoming changes and opportunities that may allow for the personalized radiation treatment recommendations enabled by the development of these signatures.
Alyusuf R, Wazir JF, Brahmi UP
… +2 more, Fakhro AR, Bakhiet M
Int J Breast Cancer
· 2017 · PMID 29348941
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The role of estrogen and progesterone receptors in breast cancer biology is well established. In contrast, other steroid hormones are less well studied. Glucocorticoids (GCs) are known to play a role in mammary developme...The role of estrogen and progesterone receptors in breast cancer biology is well established. In contrast, other steroid hormones are less well studied. Glucocorticoids (GCs) are known to play a role in mammary development and differentiation; thus, it is of interest to attempt to delineate their immunoexpression across a spectrum of mammary epithelia. . To delineate the distribution pattern of glucocorticoid receptors (GRs) in malignant versus nonmalignant epithelium with particular emphasis on lactational epithelium. . Immunohistochemistry (IHC) for GRs was performed on archival formalin-fixed paraffin-embedded tissue blocks of 96 cases comprising 52 invasive carcinomas, 21 cases with lactational change, and 23 cases showing normal mammary tissue histology. . Results reveal an overexpression of GRs in mammary malignant epithelium as compared to both normal and lactational groups individually and combined. GR overexpression is significantly more pronounced in HER-2-negative cancers. . This is the first study to compare GR expression in human lactating epithelium versus malignant and normal epithelium. The article discusses the literature related to the pathobiology of GCs in the breast with special emphasis on breast cancer. . The lactational epithelium did not show overexpression of GR, while GR was overexpressed in mammary NST (ductal) carcinoma, particularly HER-2-negative cancers.
Cazzaniga ME, Cortesi L, Ferzi A
… +14 more, Scaltriti L, Cicchiello F, Ciccarese M, Torre SD, Villa F, Giordano M, Verusio C, Nicolini M, Gambaro AR, Zanlorenzi L, Biraghi E, Casini E, Legramandi L, Rulli E
Int J Breast Cancer
· 2017 · PMID 29333297
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Triple-negative breast cancer (TNBC) shows a very bad prognosis, even in early stages of disease. Metronomic chemotherapy refers to the minimum biologically effective dose of a chemotherapy agent given as a continuous do...Triple-negative breast cancer (TNBC) shows a very bad prognosis, even in early stages of disease. Metronomic chemotherapy refers to the minimum biologically effective dose of a chemotherapy agent given as a continuous dosing regimen with no prolonged drug-free breaks that leads to antitumor activity. In the present article, we review preclinical and clinical data of metronomic administration of chemotherapy agents with or without biological agents in TNBC cell lines and patients, contextually reporting data from the VICTOR-2 study in the subgroup of patients with TNBC, in order to stimulate new ideas for the design of clinical trials in this subset of patients.
Akbari ME, Sayad S, Sayad S
… +4 more, Khayamzadeh M, Shojaee L, Shormeji Z, Amiri M
Int J Breast Cancer
· 2017 · PMID 29201466
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BACKGROUND: Breast cancer is the 5th leading cause of cancer death in Iranian women. This study analyzed 3010 women with breast cancer that had been referred to a cancer research center in Tehran between 1998 and 2014. M...BACKGROUND: Breast cancer is the 5th leading cause of cancer death in Iranian women. This study analyzed 3010 women with breast cancer that had been referred to a cancer research center in Tehran between 1998 and 2014. METHODS: In this retrospective study, we analyzed 3010 breast cancer cases with 32 clinical and paraclinical attributes. We checked the data quality rigorously and removed any invalid values or records. The method was data mining (problem definition, data preparation, data exploration, modeling, evaluation, and deployment). However, only the descriptive analyses' results of the variables are presented in this article. To our knowledge, this is the most comprehensive study on breast cancer status in Iran. RESULTS: A typical Iranian breast cancer patient has been a 40-50-year-old married woman with two children, who has a high school diploma and no history of abortion, smoking, or diabetes. Most patients were estrogen and progesterone receptor positive, human epidermal growth factor (HER) negative, and P53 negative. Most cases were detected in stage 2 with intermediate grade. CONCLUSION: This study revealed original findings which can be used in national policymaking to find the best early detection method and improve the care quality and breast cancer prevention in Iran.
Kelly P, Ma Z, Baidas S
… +5 more, Moroose R, Shah N, Dagan R, Mamounas E, Rineer J
Int J Breast Cancer
· 2017 · PMID 29147583
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PURPOSE: Despite advances in endocrine therapy (ET), metastatic estrogen receptor positive breast cancer (BrCA) remains incurable. Though the mechanisms of resistance to ET have been studied extensively, the anatomic pat...PURPOSE: Despite advances in endocrine therapy (ET), metastatic estrogen receptor positive breast cancer (BrCA) remains incurable. Though the mechanisms of resistance to ET have been studied extensively, the anatomic pattern of disease progression remains poorly characterized. The purpose of this study was to characterize the pattern of progression for patients receiving ET for metastatic BrCA. METHODS: The records of 108 patients with metastatic BrCA who progressed on ET were reviewed. Progression was characterized as follows: diffuse progression, progression in greater than 3 sites; oligoprogression, progression in fewer than 3 sites with prior diffuse metastases; and oligometastatic disease with progression, progression in 3 or fewer sites with prior limited metastases. RESULTS: Seventy-four patients (69%) displayed only diffuse disease progression. Conversely, 23 patients (21%) displayed oligoprogression and 11 patients (10%) displayed oligometastases with progression at least once in their disease course. Further analysis of the patients with oligoprogression suggested that in 14 patients the sites of progression would have been amenable to local therapy. CONCLUSION: Oligoprogressive disease occurs in a significant subset of patients with metastatic BrCA treated with ET. These patients with oligoprogressive disease may be eligible for local therapy, potentially obviating the need to change of systemic therapy.
Larson KE, Valente SA, Shah C
… +6 more, Tendulkar RD, Cherian S, Yanda C, Tu C, Echle J, Grobmyer SR
Int J Breast Cancer
· 2017 · PMID 29130001
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PURPOSE: One benefit of intraoperative radiation therapy (IORT) is that it usually requires a single treatment, thus potentially eliminating distance as a barrier to receipt of whole breast irradiation. The aim of this s...PURPOSE: One benefit of intraoperative radiation therapy (IORT) is that it usually requires a single treatment, thus potentially eliminating distance as a barrier to receipt of whole breast irradiation. The aim of this study was to evaluate the distance traveled by IORT patients at our institution. METHODS: Our institutional prospective registry was used to identify IORT patients from 10/2011 to 2/2017. Patient's home zip code was compared to institution zip code to determine travel distance. Characteristics of local (<50 miles), regional (50-100 miles), and faraway (>100 miles) patients were compared. RESULTS: 150 were patients included with a median travel distance of 27 miles and mean travel distance of 121 miles. Most were local (68.7%), with the second largest group living faraway (20.0%). Subset analysis of local patients demonstrated 20.4% traveled <10 miles, 34.0% traveled 10-20 miles, and 45.6% traveled 20-50 miles. Six patients traveled >1000 miles. The local, regional, and faraway patients did not differ with respect to age, race, tumor characteristics, or whole breast irradiation. CONCLUSIONS: Breast cancer patients are traveling for IORT, with 63% traveling >20 miles for care. IORT is an excellent strategy to promote breast conservation in selected patients, particularly those who live remote from a radiation facility.
Yeh J, Chun J, Schwartz S
… +6 more, Wang A, Kern E, Guth AA, Axelrod D, Shapiro R, Schnabel F
Int J Breast Cancer
· 2017 · PMID 28912973
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PURPOSE: The purpose of this study was to compare and contrast the clinical characteristics of the triple negative breast cancer (TNBC) and non-TNBC patients, with a particular focus on genetic susceptibility and risk fa...PURPOSE: The purpose of this study was to compare and contrast the clinical characteristics of the triple negative breast cancer (TNBC) and non-TNBC patients, with a particular focus on genetic susceptibility and risk factors prior to diagnosis. METHODS: Our institutional database was queried for all patients diagnosed with invasive breast cancer between January 2010 and May 2016. RESULTS: Out of a total of 1964 patients, 190 (10%) patients had TNBC. The median age for both TNBC and non-TNBC was 59 years. There was a significantly higher proportion of African American and Asian patients with TNBC ( = 0.0003) compared to patients with non-TNBC. BRCA1 and BRCA2 were significantly associated with TNBC ( < 0.0001, = 0.0007). A prior history of breast cancer was significantly associated with TNBC ( = 0.0003). There was no relationship observed between TNBC and a history of chemoprevention or patients who had a history of AH or LCIS. CONCLUSIONS: We found that having Asian ancestry, a prior history of breast cancer, and a BRCA1 or BRCA2 mutation all appear to be positively associated with TNBC. In order to develop more effective treatments, better surveillance, and improved prevention strategies, it is necessary to improve our understanding of the population at risk for TNBC.
Marotti JD, Muller KE, Tafe LJ
… +2 more, Demidenko E, Miller TW
Int J Breast Cancer
· 2017 · PMID 28698809
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BACKGROUND: Phosphatidylinositol-3,4,5-trisphosphate-dependent Rac exchange factor 1 (P-Rex1) has been implicated in cancer growth, metastasis, and response to phosphatidylinositol 3-kinase (PI3K) inhibitor therapy. The...BACKGROUND: Phosphatidylinositol-3,4,5-trisphosphate-dependent Rac exchange factor 1 (P-Rex1) has been implicated in cancer growth, metastasis, and response to phosphatidylinositol 3-kinase (PI3K) inhibitor therapy. The aim of this study was to determine whether P-Rex1 expression differs between primary and metastatic human breast tumors and between breast cancer subtypes. DESIGN: P-Rex1 expression was measured in 133 specimens by immunohistochemistry: 40 and 42 primary breast tumors from patients who did versus did not develop metastasis, respectively, and 51 breast-derived tumors from metastatic sites (36 of which had matching primary tumors available for analysis). RESULTS: Primary breast tumors showed significant differences in P-Rex1 expression based on receptor subtype. ER+ and HER2+ primary tumors showed higher P-Rex1 expression than primary triple-negative tumors. HER2+ metastases from all sites showed significantly higher P-Rex1 expression compared to other metastatic receptor subtypes. Solid organ (i.e., brain, lung, and liver) metastases showed higher P-Rex1 expression compared to bone metastases. CONCLUSIONS: P-Rex1 expression is increased in ER+ and HER2+ breast cancers compared to triple-negative tumors. P-Rex1 may be differentially expressed in metastatic tumors based on site and receptor status. The role of P-Rex1 in the development of breast cancer metastases and as a predictive biomarker of therapeutic response warrants further investigation.
Goussous G, Jafferbhoy S, Smyth N
… +4 more, Hammond L, Narayanan S, Kirby RM, Soumian S
Int J Breast Cancer
· 2017 · PMID 28695012
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One-step nucleic acid amplification (OSNA) is an intraoperative technique with a high sensitivity and specificity for sentinel node assessment. The aim of this study was to assess the impact of OSNA on micrometastases de...One-step nucleic acid amplification (OSNA) is an intraoperative technique with a high sensitivity and specificity for sentinel node assessment. The aim of this study was to assess the impact of OSNA on micrometastases detection rates and use of adjuvant chemotherapy. A retrospective review of patients with sentinel node micrometastases over a five-year period was carried out and a comparison of micrometastases detection using OSNA and H&E techniques was made. Out of 1285 patients who underwent sentinel node (SLN) biopsy, 76 patients had micrometastases. Using H&E staining, 36 patients were detected with SLN micrometastases (9/year) in contrast to 40 patients in the OSNA year (40/year) ( < 0.0001), demonstrating a fourfold increase with the use of OSNA. In the OSNA group, there was also a proportional increase in Grade III, triple-negative, ER-negative, and HER-2-positive tumours being diagnosed with micrometastases. Also on interactive PREDICT tool, the number of patients with a predicted 10-year survival benefit of more than 3% with adjuvant chemotherapy increased from 52 to 70 percent. OSNA has resulted in an increased detection rate of micrometastases especially in patients with aggressive tumour biology. This increased the number of patients who had a predicted survival benefit from adjuvant chemotherapy.
Cuello-López J, Fidalgo-Zapata A, Vásquez-Trespalacios E
Int J Breast Cancer
· 2017 · PMID 28607775
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INTRODUCTION: Obesity is an established risk factor for cancer and cancer-related deaths, including that of the breast. While the prevalence of female obesity has accelerated over the past decade in many developing count...INTRODUCTION: Obesity is an established risk factor for cancer and cancer-related deaths, including that of the breast. While the prevalence of female obesity has accelerated over the past decade in many developing countries, such as Colombia, the prevalence of overweight and obesity specifically in breast cancer populations has not been fully described. METHODS: A cross-sectional study including 849 women diagnosed with breast cancer between 2009 and 2014. Based on body mass index, prevalence of overweight (BMI ≥ 25 < 30) and obesity (BMI ≥ 30) and associations of BMI with clinical and tumor histopathological features were analyzed. RESULTS: Colombian breast cancer patients had a prevalence of overweight of 34.28% and obesity of 28.15%. Mean BMI was comparable between premenopausal and postmenopausal women (27.2 versus 27.7, resp.). Among premenopausal women, higher BMI was significantly positively associated with hormone receptor negative tumors, as well as with greater lymphovascular invasion. CONCLUSIONS: Colombian breast cancer patients exhibit a significant prevalence of overweight and obesity. Associations of high BMI and poor prognosis variables in the premenopausal population suggest risk of aggressive disease in this population. Future studies to further validate our observations are warranted in order to implement multidisciplinary clinical guidelines.
Birhane K, Alemayehu M, Anawte B
… +6 more, Gebremariyam G, Daniel R, Addis S, Worke T, Mohammed A, Negash W
Int J Breast Cancer
· 2017 · PMID 28596921
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BACKGROUND: Breast cancer is the most prevalent form of cancer in Ethiopia of all female cancers. It is considered to be a progressive disease with a poor prognosis if detected late. Breast self-examination is an importa...BACKGROUND: Breast cancer is the most prevalent form of cancer in Ethiopia of all female cancers. It is considered to be a progressive disease with a poor prognosis if detected late. Breast self-examination is an important prevention method of breast cancer. This study was aimed at assessing practice and associated factors of breast self-examination (BSE) among female Debre Berhan University students in Ethiopia. METHODS: A cross-sectional study was conducted in 2015 among 420 using self-administrated questionnaire. Multistage sampling technique was used to select the study participants. Bivariate and multivariate logistic regression analysis were done. RESULTS: Majority of the study participants, 338 (84.5%), were between 20 and 24 years old with the mean age of 21.1 ± 1.65. Only 14 (3.5%) had family history of breast cancer. Two hundred fifty-six (64%) of the participants had heard about BSE and 30.25% had good knowledge about BSE. Mass media were the most common source of information about breast cancer. Few of the participants (28.3%) had performed BSE. Lack of knowledge on how to perform BSE was cited as the main reason for not practicing BSE. Knowing how to perform, when to perform, and position to perform BSE and having a perception that BSE is important and useful to detect breast cancer were significant predictors of practices of BSE. CONCLUSIONS: This study revealed that most of the participants had low knowledge and practice of BSE. Therefore, it important to develop health educational programs in the university to raise awareness about BSE and breast cancer so as to practice self-breast examination.
Int J Breast Cancer
· 2017 · PMID 28487775
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. The objectives of this study were to identify the randomised controlled trials in breast cancer occurring in low and middle income countries (LMICs) generally and within Sub-Saharan Africa specifically, to describe the.... The objectives of this study were to identify the randomised controlled trials in breast cancer occurring in low and middle income countries (LMICs) generally and within Sub-Saharan Africa specifically, to describe the current status and identify opportunities for further research in these areas. . Data for this study were obtained from ClinicalTrials.gov. The search term "Breast Cancer Research" was used, and relevant information extracted and analysed. . 2414 trials were identified, of which 1099 were eligible for inclusion. 69 of these trials occurred in LMICs. Of the 52 LMICs globally, 30% were participating in breast cancer research. Of the 17 LMICs in Africa, 77% are situated in Sub-Saharan Africa; 23% were participating in breast cancer research, which accounted for 9% of total Sub-Saharan African studies. . This study provides current evidence for the need for breast cancer research in LMICs globally and within Sub-Saharan Africa. Within LMIC regions where research is active, the type and numbers of studies are unevenly distributed. High quality research within such areas should be encouraged as the results may have both local and global applications, particularly in the provision of affordable health care.
Zhou W, Sollie T, Tot T
… +4 more, Blomqvist C, Abdsaleh S, Liljegren G, Wärnberg F
Int J Breast Cancer
· 2017 · PMID 28286675
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Casting-type calcifications and a histopathological picture with cancer-filled duct-like structures have been presented as breast cancer with neoductgenesis. We correlated mammographic features and histopathological neod...Casting-type calcifications and a histopathological picture with cancer-filled duct-like structures have been presented as breast cancer with neoductgenesis. We correlated mammographic features and histopathological neoductgenesis with prognosis in a DCIS cohort with long follow-up. Mammographic features were classified into seven groups according to Tabár. Histopathological neoductgenesis was defined by concentration of ducts, lymphocyte infiltration, and periductal fibrosis. Endpoints were ipsilateral (IBE) in situ and invasive events. Casting-type calcifications and neoductgenesis were both related to high nuclear grade, ER- and PR-negativity, and HER2 overexpression but not to each other. Casting-type calcifications and neoductgenesis were both related to a nonsignificant lower risk of invasive IBE, HR 0.38 (0.13-1.08) and 0.82 (0.29-2.27), respectively, and the HR of an in situ IBE was 0.90 (0.41-1.95) and 1.60 (0.75-3.39), respectively. Casting-type calcifications could not be related to a worse prognosis in DCIS. We cannot explain why a more aggressive phenotype of DCIS did not correspond to a worse prognosis. Further studies on how the progression from in situ to invasive carcinoma is driven are needed.
Int J Breast Cancer
· 2017 · PMID 28182100
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Interactions between integrin-mediated adhesions and the extracellular matrix (ECM) are important regulators of cell migration and spreading. However, mechanisms by which extracellular ligands regulate cell migration and...Interactions between integrin-mediated adhesions and the extracellular matrix (ECM) are important regulators of cell migration and spreading. However, mechanisms by which extracellular ligands regulate cell migration and spreading in response to changes in substratum concentration are not well understood. Semaphorin 3A (Sema3A) has been shown to inhibit cell motility and alter integrin signaling in various cell types. We propose that Sema3A alters focal adhesions to modulate breast carcinoma cell migration and spreading on substrata coated with different concentrations of ECM. We demonstrate that Sema3A inhibits MDA-MB-231 cell migration and spreading on substrata coated with high concentrations of collagen and fibronectin but enhances migration and spreading at lower concentrations of collagen and fibronectin. Sema3A increases focal adhesion kinase phosphorylation at tyrosine 397 (pFAK) at focal adhesions on all substratum concentrations of collagen and fibronectin but decreased pFAK levels on laminin. Rho-associated protein kinase (ROCK) inhibition blocks the Sema3A-mediated effects on cell migration, spreading, and pFAK at focal adhesions when cultured on all concentrations of collagen. These results suggest that Sema3A shifts the optimal level of cell-matrix adhesions to a nonoptimal ECM coating concentration, in particular collagen, to yield maximal cell migration and spreading that may be mediated through a ROCK-dependent mechanism.
Int J Breast Cancer
· 2017 · PMID 28168059
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. The aim of this study was to appraise the quality of information on BC available at websites run by organizations in Africa. . Three searches were conducted using Google search engine to generate a list of websites. Th.... The aim of this study was to appraise the quality of information on BC available at websites run by organizations in Africa. . Three searches were conducted using Google search engine to generate a list of websites. The identified websites were assessed using European Commission (EC) quality criteria for health-related websites, which comprises different assessment areas including, completeness, transparency and honesty, authority, privacy and data protection, updating of information, accountability, and accessibility. . Thirteen (13) websites were included in the evaluation. Majority of the websites evaluated had low scores on the completeness and transparency of their websites. Scores on accessibility were however moderate and high for most of the websites. Breast cancer-specific organizations provided the highest quality information, particularly in terms of completeness. The overall lowest and highest quality scores were 9 and 43 out of 63, respectively, and 77% of the included websites scored less than 50% of the total quality score. . This review has provided evidence of inadequate and inaccurate BC information provided by some cancer organizations in Africa. Considerable effort is required to make BC information on the Internet a valuable and up-to-date source for both professionals and patients.
Hanna MG, Bleiweiss IJ, Nayak A
… +1 more, Jaffer S
Int J Breast Cancer
· 2017 · PMID 28168058
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Oncotype Dx is used to determine the recurrence risk (RR) in patients with estrogen receptor positive (ER+) and lymph node negative (LN-) breast cancer. The RR is divided into low (0-17), intermediate (18-30), and high (...Oncotype Dx is used to determine the recurrence risk (RR) in patients with estrogen receptor positive (ER+) and lymph node negative (LN-) breast cancer. The RR is divided into low (0-17), intermediate (18-30), and high (31) to predict chemotherapy benefit. Our goal was to determine the association between histomorphology, immunohistochemistry, and RR. We retrospectively identified 536 patients with ER+ and LN- breast cancers that underwent Oncotype testing from 2006 to 2013. Tumor size ranged from 0.2 cm to 6.5 cm (mean = 1.3 cm) and was uniform in all 3 categories. The carcinomas were as follows: ductal = 63.2%, lobular = 11.1%, and mixed = 35.7%. The RR correlated with the Nottingham grade. Increasing RR was inversely related to PR positivity but directly to Her2 positivity. Of the morphologic parameters, a tubular(lobular) morphology correlated only with low-intermediate scores and anaplastic type with intermediate-high scores. Other morphologies like micropapillary and mucinous were uniformly distributed in each category. Carcinomas with comedo intraductal carcinoma were more likely associated with high RR. Forty-four patients with either isolated tumor cells or micrometastases were evenly distributed amongst the 3 RR. While there was only 1 ER discrepancy between our immunohistochemistry (3+ 80%) and Oncotype, up to 8% of PR+ cases (mean = 15%, median = 5%) and 2% of HER2+ cases were undervalued by Oncotype.
Int J Breast Cancer
· 2017 · PMID 28116166
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. This paper describes a UK survey of the choice of radiotherapy regime for the reconstructed chest wall in breast cancer patients. Questions focused on which fractionation regime consultants choose, their reasons for th.... This paper describes a UK survey of the choice of radiotherapy regime for the reconstructed chest wall in breast cancer patients. Questions focused on which fractionation regime consultants choose, their reasons for this, whether the type of reconstruction influences their choice, and whether bolus is used in patients who have undergone immediate reconstructive surgery. . Between July 2014 and July 2015 a survey was sent by email to UK consultant radiation oncologists treating breast cancer. . The response rate was 73%. 67% of respondents use 40 Gray (Gy) in 15 fractions, with 22% using 50 Gy in 25 fractions and 7% using other regimes. For 90% of consultants the type of reconstruction did not influence their decision regarding choice of fractionation. 83% of respondents do not usually use a bolus for chest wall radiotherapy in patients who have had immediate reconstructive surgery. . This survey illustrates there is variation in practice in the management of patients with breast cancer who have undergone immediate reconstructive surgery in the UK. There is a need for further research to determine which fractionation regime is optimal, whether the type of surgery is relevant, and whether bolus should be added.