201
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Zahra K, Farooqi HA. Cutting-edge innovations in breast cancer diagnosis- the potential of HDMI biomarkers. Clin Exp Metastasis 2024; 41:77-78. [PMID: 37847349 DOI: 10.1007/s10585-023-10238-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 10/06/2023] [Indexed: 10/18/2023]
Affiliation(s)
- Kainat Zahra
- Islamic International Medical College, Riphah International University, Rawalpindi, Pakistan.
| | - Hanzala Ahmed Farooqi
- Islamic International Medical College, Riphah International University, Rawalpindi, Pakistan
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202
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Shelton C, Ruiz A, Shelton L, Montgomery H, Freas K, Ellsworth RE, Poll S, Pineda-Alvarez D, Heald B, Esplin ED, Nielsen SM. ASO Visual Abstract: Universal Germline Genetic Testing for Breast Cancer: Implementation in a Rural Practice and Impact on Shared Decision Making. Ann Surg Oncol 2024; 31:1020. [PMID: 37978112 DOI: 10.1245/s10434-023-14596-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Affiliation(s)
| | | | | | | | - Karen Freas
- The Outer Banks Hospital, Nags Head, NC, USA
| | | | - Sarah Poll
- Invitae Corporation, San Francisco, CA, USA
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203
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Bhardwaj PV, Dulala R, Rajappa S, Loke C. Breast Cancer in India: Screening, Detection, and Management. Hematol Oncol Clin North Am 2024; 38:123-135. [PMID: 37330342 DOI: 10.1016/j.hoc.2023.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Breast cancer is the most common cancer in urban Indian women and the second most common cancer in all Indian women. The epidemiology as well as biology of this cancer seems to be different in the Indian subcontinent when compared with the West. The lack of population-based breast cancer screening programs and delay in seeking a medical consult due to financial and social reasons, including lack of awareness and fear related to a cancer diagnosis, results in delayed diagnosis.
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Affiliation(s)
- Prarthna V Bhardwaj
- Division of Hematology-Oncology, University of Massachusetts Chan Medical School - Baystate, 759 Chestnut Street, Springfield, MA 01199, USA
| | - Renuka Dulala
- Division of Hematology-Oncology, Holyoke Medical Center, 575 Beech Street, Holyoke, MA 01040, USA
| | - Senthil Rajappa
- Department of Medical Oncology, Basavatarakam Indo-American Cancer Hospital and Research Institute, Road no. 10, Banjara Hills, Hyderabad, Telangana 500034, India
| | - Chandravathi Loke
- Division of Hematology-Oncology, University of Massachusetts Chan Medical School - Baystate, 759 Chestnut Street, Springfield, MA 01199, USA.
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204
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Siegel SD, Rowland JP, Leonard DJ, Katurakes N, Bittner-Fagan H, Hoffman M, Hall-McBride R, Hicks LS, Petrelli NJ. A Population Health Proposal for Increasing Breast Cancer Screening to Reduce Racial Disparities in Breast Cancer: Getting the Village Back Together. Popul Health Manag 2024; 27:84-86. [PMID: 37909492 DOI: 10.1089/pop.2023.0178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2023] Open
Affiliation(s)
- Scott D Siegel
- Helen F. Graham Cancer Center and Research Institute, ChristianaCare, Newark, Delaware, USA
| | - Jennifer P Rowland
- Helen F. Graham Cancer Center and Research Institute, ChristianaCare, Newark, Delaware, USA
| | - Dawn J Leonard
- Helen F. Graham Cancer Center and Research Institute, ChristianaCare, Newark, Delaware, USA
| | - Nora Katurakes
- Helen F. Graham Cancer Center and Research Institute, ChristianaCare, Newark, Delaware, USA
| | | | - Matthew Hoffman
- Obstetrics and Gynecology, ChristianaCare, Newark, Delaware, USA
| | - Robert Hall-McBride
- Helen F. Graham Cancer Center and Research Institute, ChristianaCare, Newark, Delaware, USA
| | - LeRoi S Hicks
- Internal Medicine, ChristianaCare, Newark, Delaware, USA
- Institute for Research in Equity and Community Health, ChristianaCare, Newark, Delaware, USA
| | - Nicholas J Petrelli
- Helen F. Graham Cancer Center and Research Institute, ChristianaCare, Newark, Delaware, USA
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205
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Gutiérrez Urzúa RA, Hernández-Girón CA, Ángeles-Llerenas A, Torres-Mejía G. The marginalization index and its association with selected services within the comprehensive care offered to breast cancer patients. Eur J Oncol Nurs 2024; 68:102508. [PMID: 38219474 DOI: 10.1016/j.ejon.2024.102508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 12/15/2023] [Accepted: 01/05/2024] [Indexed: 01/16/2024]
Abstract
PURPOSE There is little information on the supportive care offered to breast cancer patients. We investigated the association between the marginalization index and selected services offered by health professionals. METHODS We used data from a cross-sectional parent study performed in Mexico from 2007 to 2009. We analyzed data from 832 women between 35 and 69 years of age with a histopathological diagnosis of breast cancer. This study was performed in hospitals in 5 states. We used frequencies, measures of central tendency, and logistic regression. We used the svy package of STATA statistical software v17. RESULTS Overall, 15.6% of the study population reported that health professionals offered them selected services. The offer of two or more selected services was greater among women living in states with a very high marginalization index (21.8%) than among those living in states with a very low marginalization index (13.8%). Among women living in states with high marginalization, the odds of receiving a selected service offer were 2.03 times higher than those living in states with low marginalization (Odds ratio (OR) = 2.03, 95% CI 1.08-3.83). For women in the highest tertile of the asset index, the odds of receiving a selected service offer were 2.7 times greater than the odds for women in the lowest tertile (OR = 2.66, 95% CI 1.03-6.88). CONCLUSION The prevalence of comprehensive care offered to breast cancer patients is low in Mexico and varies according to the marginalization index and the asset index.
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Affiliation(s)
- R Aleja Gutiérrez Urzúa
- School of Public Health, National Institute of Public Health, Avenida Universidad No. 655, Colonia Santa María Ahuacatitlán, Cuernavaca, Morelos, 62100, Mexico
| | - Carlos Alfonso Hernández-Girón
- Population Health Research Center, National Institute of Public Health, Avenida Universidad No. 655, Colonia Santa María Ahuacatitlán, Cuernavaca, Morelos, 62100, Mexico
| | - Angélica Ángeles-Llerenas
- Population Health Research Center, National Institute of Public Health, Avenida Universidad No. 655, Colonia Santa María Ahuacatitlán, Cuernavaca, Morelos, 62100, Mexico
| | - Gabriela Torres-Mejía
- Population Health Research Center, National Institute of Public Health, Avenida Universidad No. 655, Colonia Santa María Ahuacatitlán, Cuernavaca, Morelos, 62100, Mexico.
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206
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Costa L, Kumar R, Villarreal-Garza C, Sinha S, Saini S, Semwal J, Saxsena V, Zamre V, Chintamani C, Ray M, Shimizu C, Gusic LH, Toi M, Lipton A. Diagnostic delays in breast cancer among young women: An emphasis on healthcare providers. Breast 2024; 73:103623. [PMID: 38219460 PMCID: PMC10826418 DOI: 10.1016/j.breast.2023.103623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 12/07/2023] [Accepted: 12/10/2023] [Indexed: 01/16/2024] Open
Abstract
Despite advances in breast cancer care, breast cancer in young women (BCYW) faces unique challenges, diagnostic delays, and limited awareness in many countries. Here, we discuss the challenges and consequences associated with the delayed diagnosis of BCYW. The consequences of delayed diagnosis in young women - which generally varies among developed, developing, or underdeveloped countries - are severe due to a faster breast tumor growth rate than tumors in older women, also contributing to advanced cancer stages and poorer outcomes. Though there are many underlying reasons for diagnostic delays due to age, the article delves explicitly deep into the diagnostic delay of BCYW, focusing on healthcare providers, potential contributing factors, its consequences, and the urgent need to start minimizing such incidences. The article suggests several strategies to address these issues, including increasing awareness, developing educational programs for healthcare providers to identify signs and symptoms in young women, developing clear diagnostic guidelines, and improving screening strategies.
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Affiliation(s)
- Luis Costa
- Department of Medical Oncology, Hospital de Santa Maria- Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal; Instituto de Medicina Molecular-João Lobo Antunes, Faculdade de Medicina da Universidade de Lisboa, Lisboa, Portugal; Breast Cancer in Young Women Foundation, Denver, CO, USA.
| | - Rakesh Kumar
- Breast Cancer in Young Women Foundation, Denver, CO, USA; Cancer Research Institute, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, India; Department of Human and Molecular Genetics and VCU Institute of Molecular Medicine, Virginia Commonwealth University, School of Medicine, Richmond, VA, USA.
| | - Cynthia Villarreal-Garza
- Breast Cancer Center, Hospital Zambrano Hellion TecSalud, Tecnologico de Monterrey, San Pedro Garza Garcia, Mexico; Médicos e Investigadores en la Lucha contra el Cáncer de Mama, Mexico City, Mexico
| | | | - Sunil Saini
- Cancer Research Institute, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, India
| | - Jayanti Semwal
- Department of Community Medicine, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, India
| | - Vartika Saxsena
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Rishikesh, India
| | - Vaishali Zamre
- Breast Cancer Surgery Unit, Rajiv Gandhi Cancer Institute, Delhi, India
| | | | - Mukurdipi Ray
- Department of Surgical Oncology, All India Insititute of Medical Sciences, New Delhi, India
| | - Chikako Shimizu
- Department of Breast and Medical Oncology, Comprehensive Cancer Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Lejla Hadzikadic Gusic
- Division of Surgical Oncology, Department of Surgery, Levine Cancer Institute, Carolinas Medical Center, Atrium Health, Charlotte, NC, USA
| | - Masakazu Toi
- Tokyo Metropolitan Cancer and Infectious Disease Center, Komagome Hospital, Tokyo, Japan
| | - Allan Lipton
- Hematology-Oncology, Department of Medicine, Penn State University School of Medicine, Hershey, PA, USA
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207
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Ferenczi Á, Cserni G. Changes in breast cancer grade from biopsy to excision following surgery or primary chemotherapy. Pathologica 2024; 116:22-31. [PMID: 38482672 PMCID: PMC10938276 DOI: 10.32074/1591-951x-958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 12/11/2023] [Indexed: 03/17/2024] Open
Abstract
Objective To compare histological grade (G) of breast cancer and its components (scores for tubule formation - T, nuclear pleomorphism - P and mitotic counts - M) in core needle biopsies (CNBs) and surgical excision specimens (EXC) in patients treated with primary surgery (CHIR) or primary chemotherapy (PST). Methods Grade of matched pairs of carcinomas in CNB and EXC was assessed according to the Nottingham grading system. Results PST cases tended to have higher pretreatment G. Concordance rates in the CHIR (n = 760) and PST (n = 148) groups for T, P, M and G were 79%, 70%, 75%, 71% and 77%, 70%, 50%, 62%, respectively; differences in concordance rates were significant in M (p < 0.0001) and G (p = 0.024). For discordant cases in the CHIR group, CNBs tended to overestimate T and underestimate P, M and G, whereas in the PST group, the same trends were identified for T and P, but there was a significant tendency for M and G to be lower in EXC specimens. Conclusions The reversal of M and G underestimation in CNB to "overestimation" in the PST group can only be explained with the effect of mitosis reduction following chemotherapy. Whether the posttreatment decrease in G reflects any prognostic value remains to be elucidated.
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Affiliation(s)
- Ádám Ferenczi
- Department of Pathology, University of Szeged, Szeged, Hungary
| | - Gábor Cserni
- Department of Pathology, University of Szeged, Szeged, Hungary
- Department of Pathology, Bács-Kiskun County Teaching Hospital, Kecskemét, Hungary
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208
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Varga Z, Maccio U. Molecular pathology in breast disease: diagnostic, prognostic, and therapeutic tools. Virchows Arch 2024; 484:247-261. [PMID: 38015260 PMCID: PMC10948467 DOI: 10.1007/s00428-023-03709-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 11/08/2023] [Accepted: 11/14/2023] [Indexed: 11/29/2023]
Abstract
Molecular testing in breast cancer gained increasing attention and importance as specific molecular results can tailor not only oncological decisions on systemic adjuvant or neoadjuvant or in metastatic setting, but increasingly serve in diagnostic routine histopathological services to differentiate between morphologically overlapping or ambiguous histological pictures. Diagnostic tools involve in most cases a broad spectrum of immunohistochemical panels, followed by entity-specific in situ hybridization probes and in given cases NGS-based sequencing. Workflow of which methodology is applied and in which order depends on the specific entity resp. on the given differential diagnosis in question. Regarding prognostic/predictive molecular testing, the choice of assay and the workflow are based on clinical algorithms and on the evidence of targeted therapies following the molecular alterations. In this review paper, we aim to address the use of molecular technics in [1] the histological diagnostic setting (such as subtyping of invasive carcinomas/malignant spindle cell tumors and sarcomas and some B3 lesions) and [2] in the context of adjuvant or neoadjuvant or other clinical settings with special focus of targeted therapies.
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Affiliation(s)
- Zsuzsanna Varga
- Department of Pathology and Molecular Pathology, University Hospital Zurich, Schmelzbergstrasse 12, CH-8091, Zurich, Switzerland.
| | - Umberto Maccio
- Department of Pathology and Molecular Pathology, University Hospital Zurich, Schmelzbergstrasse 12, CH-8091, Zurich, Switzerland
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209
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Sultan G, Zubair S. An ensemble of bioinformatics and machine learning approaches to identify shared breast cancer biomarkers among diverse populations. Comput Biol Chem 2024; 108:107999. [PMID: 38070457 DOI: 10.1016/j.compbiolchem.2023.107999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 11/27/2023] [Accepted: 12/03/2023] [Indexed: 01/22/2024]
Abstract
Breast cancer continues to be a prominent cause for substantial loss of life among women globally. Despite established treatment approaches, the rising prevalence of breast cancer is a concerning trend regardless of geographical location. This highlights the need to identify common key genes and explore their biological significance across diverse populations. Our research centered on establishing a correlation between common key genes identified in breast cancer patients. While previous studies have reported many of the genes independently, our study delved into the unexplored realm of their mutual interactions, that may establish a foundational network contributing to breast cancer development. Machine learning algorithms were employed for sample classification and key gene selection. The best performance model further selected the candidate genes through expression pattern recognition. Subsequently, the genes common in all the breast cancer patients from India, China, Czech Republic, Germany, Malaysia and Saudi Arabia were selected for further study. We found that among ten classifiers, Catboost exhibited superior performance with an average accuracy of 92%. Functional enrichment analysis and pathway analysis revealed that calcium signaling pathway, regulation of actin cytoskeleton pathway and other cancer-associated pathways were highly enriched with our identified genes. Notably, we observed that these genes regulate each other, forming a complex network. Additionally, we identified PALMD gene as a novel potential biomarker for breast cancer progression. Our study revealed key gene modules forming a complex network that were consistently expressed in different populations, affirming their critical role and biological significance in breast cancer. The identified genes hold promise as prospective biomarkers of breast cancer prognosis irrespective of country of origin or ethnicity. Future investigations will expand upon these genes in a larger population and validate their biological functions through in vivo analysis.
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Affiliation(s)
- Ghazala Sultan
- Department of Computer Science, Aligarh Muslim University, Aligarh 202002, India
| | - Swaleha Zubair
- Department of Computer Science, Aligarh Muslim University, Aligarh 202002, India.
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210
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Yur M, Özcan S, Yıldırım N, Özdede MR, Özcan M. Elevated Asprosin Levels in Breast Cancer: Insights from a Comparative Study. J Womens Health (Larchmt) 2024; 33:254-261. [PMID: 37856162 DOI: 10.1089/jwh.2023.0178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2023] Open
Abstract
Background: Breast cancer (BC) is the most common type of cancer in women. Diagnosis in the early stage is very important for cancer treatment. There is no good biomarker to diagnose BC in T1-T2 or N0 stage. This study aimed to evaluate asprosin (ASP) levels of BC compared with non-cancer. Materials and Methods: An enzyme-linked immunosorbent assay was used to evaluate serum ASP levels in 40 patients with BC and 40 healthy women. The cancer group included T1-T4, N1-N3, and M0-M1 patients. T stages were divided into groups as T1-T2 and T3-T4. N stages were divided into groups as N (0) and N (+). Results: ASP showed good discrimination (area under the curve = 0.767, 95% confidence interval: 0.657-0.878) between the BC group and the healthy group and acceptable discriminating ability (sensitivity = 0.825; specificity = 0.750) at the optimal cutoff value of 1.82 ng/mL. ASP indicated no difference for T, N, and M stages (p = 0.919, p = 0.859, and p = 0.225, respectively). There was a significant difference between grades within cancer patients in terms of ASP (p = 0.025). Conclusions: These findings provide evidence of a potential association between elevated ASP levels and the presence of BC. The observed higher levels of ASP in women with BC compared with healthy individuals suggest that ASP could potentially serve as a biomarker for distinguishing between the two groups. These results may contribute to our understanding of the potential role of ASP in BC detection and highlight its potential as a diagnostic marker. Further studies are required to establish whether ASP can be used to diagnose BC.
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Affiliation(s)
- Mesut Yur
- Department of Surgical Oncology and Faculty of Medicine, Firat University, Elazig, Turkey
| | - Sibel Özcan
- Department of Anaesthesiology and Reanimation, Faculty of Medicine, Firat University, Elazig, Turkey
| | - Nilgün Yıldırım
- Department of Medical Oncology, Firat University School of Medicine, Elazıg, Turkey
| | - Mehmet R Özdede
- Department of Physiology and Faculty of Medicine, Firat University, Elazig, Turkey
| | - Mete Özcan
- Department of Biophysics, Faculty of Medicine, Firat University, Elazig, Turkey
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211
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Haynes D, Hughes KD, Borrero M, Haas M, Roach L, Blaes A. Estimating uninsured and underinsured women eligible for Minnesota's Breast Cancer Screening Program. Cancer Causes Control 2024; 35:359-366. [PMID: 37775609 DOI: 10.1007/s10552-023-01792-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 09/06/2023] [Indexed: 10/01/2023]
Abstract
Since its inception in 1991, the mission of the National Breast and Cervical Cancer Early Detection Program's (NBCCEDP) mission is to improve access to mammography. This program has demonstrated evidence showing that it has improved breast cancer screening rates for women who are uninsured and underinsured. However, the literature has shown that NBCCEDP screenings are decreasing, and only reach a portion of eligible women. Reliable estimates at the sub-county level are needed to identify and reach eligible women. Our work builds upon previous estimates by integrating uninsured and insurance status into spatially adaptive filters. We use spatially adaptive filters to create small area estimates of standardized incidence ratios describing the utilization rate of NBCCEDP services in Minnesota. We integrate the American Community Survey (2010-2014) insurance status data to account for the percentage that an individual is uninsured. We test five models that integrate insurance status by age, sex, and race/ethnicity. Our composite model, which adjusts for age, sex, and race/ethnicity insurance statuses, reduces 95% of the estimation error. We estimate that there approximately 49,913.7 women eligible to receive services for Minnesota. We also create small geography (i.e., county and sub-county) estimates for Minnesota. The integration of the insurance data improved our utilization estimate. The development of these methods will allow state programs to more efficiently use their resources and understand their reach.
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Affiliation(s)
- David Haynes
- Institute for Health Informatics, Suite 8-100, 516 Delaware Street SE, Minneapolis, MN, 55455, USA.
| | - Kelly D Hughes
- Minnesota Department of Health, Sage Program, 85 7th Place E, St. Paul, MN, 55101, USA
| | - Maria Borrero
- School of Medicine, University of Minnesota, Minneapolis, MN, 55445, USA
| | - McKenna Haas
- School of Public Health, University of Minnesota, Minneapolis, MN, 55445, USA
| | - Lauren Roach
- School of Public Health, University of Minnesota, Minneapolis, MN, 55445, USA
| | - Anne Blaes
- School of Medicine, University of Minnesota, Minneapolis, MN, 55445, USA
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212
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Amir H, Subramanian V, Sornambikai S, Ponpandian N, Viswanathan C. Nitrogen-enhanced carbon quantum dots mediated immunosensor for electrochemical detection of HER2 breast cancer biomarker. Bioelectrochemistry 2024; 155:108589. [PMID: 37918312 DOI: 10.1016/j.bioelechem.2023.108589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 09/24/2023] [Accepted: 10/13/2023] [Indexed: 11/04/2023]
Abstract
Using nitrogen-enhanced carbon quantum dots (N-CQDs) on a coated graphite sheet (GS) substrate (N-CQDs/GS), a simple strategy for the electrochemical detection of human epidermal growth factor receptor 2 (HER2), a breast cancer biomarker, was investigated. The bovine serum albumin (BSA)-modified HER2 Antibody/N-CQDs/GS immunoelectrode enabled excellent activity preservation for the biosensor, while the GS electrode provided a highly stable and conducting substrate. With a linear response range of 0.1 ng/mL-1 ng/mL and a low detection limit of 4.8 pg/mL. Meanwhile, the methodology demonstrated optimal specificity, stability, and reproducibility for detecting HER-2 protein in breast cancer patients untreated blood samples.
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Affiliation(s)
- Humayun Amir
- Department of Nanoscience and Technology, Bharathiar University, Coimbatore 641046, Tamil Nadu, India
| | - Vasanth Subramanian
- Department of Nanoscience and Technology, Bharathiar University, Coimbatore 641046, Tamil Nadu, India
| | - Sundaram Sornambikai
- Department of Nanoscience and Technology, Bharathiar University, Coimbatore 641046, Tamil Nadu, India; Bharathiar Cancer Theranostics Research Centre (BCTRC), Bharathiar University, Coimbatore 641046, Tamil Nadu, India
| | - Nagamony Ponpandian
- Department of Nanoscience and Technology, Bharathiar University, Coimbatore 641046, Tamil Nadu, India
| | - Chinnusamy Viswanathan
- Department of Nanoscience and Technology, Bharathiar University, Coimbatore 641046, Tamil Nadu, India.
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213
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Abbasi-Dokht T, Malek F, Nafissi N, Mohammadlou M, Sheikh M, Akbari S, Zargaran MH, Baharlou R. Assessing angiogenesis factors as prognostic biomarkers in breast cancer patients and their association with clinicopathological factors. Biomarkers 2024; 29:36-43. [PMID: 38251636 DOI: 10.1080/1354750x.2024.2309541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 01/14/2024] [Indexed: 01/23/2024]
Abstract
INTRODUCTION Angiogenesis is fundamental for tumor growth and metastasis across many solid malignancies. Considerable interest has focused on the molecular regulation of tumor angiogenesis as a means to predict disease outcomes and guide therapeutic decisions. METHODS In the present study, we investigated the prognostic value of transforming growth factor beta (TGF-β), epidermal growth factor (EGF), fibroblast growth factor (FGF), delta-like ligand 4 (DLL4), and vascular endothelial growth factor (VEGF) in the serum of 120 women diagnosed with breast cancer using ELISA as well as examined their associations with clinical parameters and the outcome of the disease. RESULTS Our results demonstrated that the serum concentration of TGF-β and EGF were remarkably higher in patients with higher tumor size, end stages of the disease, and positive lymph node involvement compared to patients with lower tumor size, early stages of the disease, and negative lymph node involvement. In addition, we found a significant correlation between the serum concentration of VEGF and the level of EGF, FGF, and DLL4 in patients with breast cancer. Furthermore, both univariate and multivariate analyses showed that TGF-β and EGF can be used as end-stage predictors. DISCUSSION/CONCLUSION Based on our findings, increasing the level of angiogenesis factors is significantly associated with higher tumor size and late stages of the disease in patients with breast cancer. Moreover, measuring the level of angiogenesis factors could lead to better prediction of disease outcomes and choosing the best treatments for patients.
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Affiliation(s)
- Tannaz Abbasi-Dokht
- Cancer Research Center, Semnan University of Medical Sciences, Semnan, Iran
- Department of Immunology, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran
| | - Farhad Malek
- Department of Internal Medicine, Kosar Hospital, Semnan University of Medical Sciences, Semnan, Iran
| | - Nahid Nafissi
- Department of Breast, Rasoul Akram Hospital Clinical Research Development Center (RCRDC), Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Mohammadlou
- Cancer Research Center, Semnan University of Medical Sciences, Semnan, Iran
- Department of Immunology, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran
| | - Maryam Sheikh
- Cancer Research Center, Semnan University of Medical Sciences, Semnan, Iran
- Department of Immunology, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran
| | - Sedigheh Akbari
- Department of Internal Medicine, Kosar Hospital, Semnan University of Medical Sciences, Semnan, Iran
| | - Mohammad Hossein Zargaran
- Department of Internal Medicine, Kosar Hospital, Semnan University of Medical Sciences, Semnan, Iran
| | - Rasoul Baharlou
- Cancer Research Center, Semnan University of Medical Sciences, Semnan, Iran
- Department of Immunology, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran
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Gaba AG, Cao L, Renfrew RJ, Witte D, Wernisch JM, Sahmoun AE, Goel S, Egland KA, Crosby RD. The Impact of Medicaid Expansion Under the Affordable Care Act on the Gap Between American Indians and Whites in Breast Cancer Management and Prognosis. Clin Breast Cancer 2024; 24:142-155. [PMID: 38171945 PMCID: PMC10984638 DOI: 10.1016/j.clbc.2023.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 09/26/2023] [Accepted: 11/20/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND Breast cancer (BC) death rates in the USA have not significantly declined for American Indians (AIs) in comparison to Whites. Our objective was to determine whether Medicaid Expansion as part of the Affordable Care Act led to improved BC outcomes for AIs relative to Whites. PATIENTS AND METHODS Using the National Cancer Database, we conducted a retrospective cohort study. Included were BC patients who were AI and White; 40 to 64 years of age; diagnosed in 2009 to 2016; lived in states that expanded Medicaid in January 2014, and states that did not expand Medicaid. Our outcomes were stage at diagnosis, insurance status, timely treatment, and 3-year mortality. RESULTS There were 359,484 newly diagnosed BC patients, 99.49% White, 0.51% AI. Uninsured rates declined more in the expansion states than in the nonexpansion states (OR = 0.44, 95% CI: 0.15-0.97, P < 0.001). Lower rates of Stage I BC diagnosis was found in AIs compared to Whites (46.58% vs. 55.33%, P < .001); these differential rates did not change after Medicaid expansion. Rates of definitive treatment initiation within 30 days of diagnosis declined after Medicaid expansion (P < .001); there was a smaller decline in the expansion states (OR 1.118, 95% CI: 1.09, 1.15, P < .001). Three year mortality was not different between expansion and nonexpansion states post Medicaid expansion. CONCLUSIONS In newly diagnosed BCs, uninsured rates declined more in the states that expanded Medicaid in January 2014. Timely treatment post Medicaid expansion declined less in states that expanded Medicaid. There was no differential benefit of Medicaid expansion in the 2 races.
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Affiliation(s)
- Anu G Gaba
- Department of Medicine, Sanford Roger Maris Cancer Center, University of North Dakota, Fargo, ND.
| | - Li Cao
- Sanford Center for Biobehavioral Research, Fargo, ND
| | | | | | | | - Abe E Sahmoun
- Department of Internal Medicine, University of North Dakota School of Medicine, Fargo, ND
| | - Sanjay Goel
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | | | - Ross D Crosby
- Sanford Center for Biobehavioral Research, Fargo, ND
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215
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Lee I, Luo Y, Carretta H, LeBlanc G, Sinha D, Rust G. Latent pathway-based Bayesian models to identify intervenable factors of racial disparities in breast cancer stage at diagnosis. Cancer Causes Control 2024; 35:253-263. [PMID: 37702967 DOI: 10.1007/s10552-023-01785-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 08/21/2023] [Indexed: 09/14/2023]
Abstract
PURPOSE We built Bayesian Network (BN) models to explain roles of different patient-specific factors affecting racial differences in breast cancer stage at diagnosis, and to identify healthcare related factors that can be intervened to reduce racial health disparities. METHODS We studied women age 67-74 with initial diagnosis of breast cancer during 2006-2014 in the National Cancer Institute's SEER-Medicare dataset. Our models included four measured variables (tumor grade, hormone receptor status, screening utilization and biopsy delay) expressed through two latent pathways-a tumor biology path, and health-care access/utilization path. We used various Bayesian model assessment tools to evaluate these two latent pathways as well as each of the four measured variables in explaining racial disparities in stage-at-diagnosis. RESULTS Among 3,010 Black non-Hispanic (NH) and 30,310 White NH breast cancer patients, respectively 70.2% vs 76.9% were initially diagnosed at local stage, 25.3% vs 20.3% with regional stage, and 4.56% vs 2.80% with distant stage-at-diagnosis. Overall, BN performed approximately 4.7 times better than Classification And Regression Tree (CART) (Breiman L, Friedman JH, Stone CJ, Olshen RA. Classification and regression trees. CRC press; 1984) in predicting stage-at-diagnosis. The utilization of screening mammography is the most prominent contributor to the accuracy of the BN model. Hormone receptor (HR) status and tumor grade are useful for explaining racial disparity in stage-at diagnosis, while log-delay in biopsy impeded good prediction. CONCLUSIONS Mammography utilization had a significant effect on racial differences in breast cancer stage-at-diagnosis, while tumor biology factors had less impact. Biopsy delay also aided in predicting local and regional stages-at-diagnosis for Black NH women but not for white NH women.
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Affiliation(s)
- Inkoo Lee
- Department of Statistics, Rice University, Houston, USA
| | - Yi Luo
- Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine, Tallahassee, USA
| | - Henry Carretta
- Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine, Tallahassee, USA
| | - Gabrielle LeBlanc
- MD Class of 2023, Florida State University College of Medicine, Tallahassee, USA
| | - Debajyoti Sinha
- Department of Statistics, Florida State University, Tallahassee, USA
| | - George Rust
- Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine, Tallahassee, USA.
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216
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Delacôte C, Ariza JM, Delacour-Billon S, Ayrault-Piault S, Borghi G, Menanteau K, Bouron A, Métais M, Cowppli-Bony A, Molinié F. Socioeconomic and geographic disparities of breast cancer incidence according to stage at diagnosis in France. Cancer Causes Control 2024; 35:241-251. [PMID: 37697113 DOI: 10.1007/s10552-023-01779-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 08/17/2023] [Indexed: 09/13/2023]
Abstract
PURPOSE Low socioeconomic background (SB) has been associated with lower breast cancer (BC) incidence and higher BC mortality. One explanation of this paradox is the higher frequency of advanced BC observed in deprived women. However, it is still unclear if SB affects similarly BC incidence. This study investigated the link between SB and early/advanced BC incidence from Loire-Atlantique/Vendee Cancer registry data (France). MATERIALS AND METHODS Fourteen thousand three hundred fifty three women living in the geographic area covered by the registry and diagnosed with a primary BC in 2008-2015 were included. SB was approached by a combination of two ecological indexes (French European Deprivation Index and urban/rural residence place). Mixed effects logistic and Poisson regressions were used, respectively, to estimate the odds of advanced (stage ≥ II) BC and the ratio of incidence rates of early (stage 0-I) and advanced BC according to SB, overall and by age group (< 50, 50-74, ≥ 75). RESULTS Compared to women living in affluent-urban areas, women living in deprived-urban and deprived-rural areas had a higher proportion of advanced BC [respectively, OR = 1.11 (1.01-1.22), OR = 1.60 (1.25-2.06)] and lower overall (from - 6 to - 15%) and early (from - 9 to - 31%) BC incidences rates Advanced BC incidence rates were not influenced by SB. These patterns were similar in women under 75 years, especially in women living in deprived-rural areas. In the elderly, no association between SB and BC frequency/incidence rates by stage was found. CONCLUSION Although advanced BC was more frequent in women living in deprived and rural areas, SB did not influence advanced BC incidence. Therefore, differences observed in overall BC incidence according to SB were only due to higher incidence of early BC in affluent and urban areas. Future research should confirm these results in other French areas.
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Affiliation(s)
- Claire Delacôte
- Registre des Cancers de Loire-Atlantique et de Vendée, Nantes, France.
- SIRIC ILIAD INCa-DGOS-Inserm_12558, Nantes, France.
| | - Juan Manuel Ariza
- Registre des Cancers de Loire-Atlantique et de Vendée, Nantes, France
- SIRIC ILIAD INCa-DGOS-Inserm_12558, Nantes, France
| | - Solenne Delacour-Billon
- Registre des Cancers de Loire-Atlantique et de Vendée, Nantes, France
- French Network of Cancer Registries (FRANCIM), Toulouse, France
| | - Stéphanie Ayrault-Piault
- Registre des Cancers de Loire-Atlantique et de Vendée, Nantes, France
- French Network of Cancer Registries (FRANCIM), Toulouse, France
| | - Giulio Borghi
- Registre des Cancers de Loire-Atlantique et de Vendée, Nantes, France
| | - Katia Menanteau
- Registre des Cancers de Loire-Atlantique et de Vendée, Nantes, France
| | - Aurélie Bouron
- Registre des Cancers de Loire-Atlantique et de Vendée, Nantes, France
| | - Magali Métais
- Registre des Cancers de Loire-Atlantique et de Vendée, Nantes, France
| | - Anne Cowppli-Bony
- Registre des Cancers de Loire-Atlantique et de Vendée, Nantes, France
- SIRIC ILIAD INCa-DGOS-Inserm_12558, Nantes, France
- French Network of Cancer Registries (FRANCIM), Toulouse, France
- Equipe Constitutive du CERPOP, UMR 1295, Inserm, Equipe EQUITY, Université Toulouse III, Toulouse, France
| | - Florence Molinié
- Registre des Cancers de Loire-Atlantique et de Vendée, Nantes, France
- SIRIC ILIAD INCa-DGOS-Inserm_12558, Nantes, France
- French Network of Cancer Registries (FRANCIM), Toulouse, France
- Equipe Constitutive du CERPOP, UMR 1295, Inserm, Equipe EQUITY, Université Toulouse III, Toulouse, France
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217
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Lee SH, Brianna. Association of microRNA-21 expression with breast cancer subtypes and its potential as an early biomarker. Pathol Res Pract 2024; 254:155073. [PMID: 38218039 DOI: 10.1016/j.prp.2023.155073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 12/29/2023] [Indexed: 01/15/2024]
Abstract
Breast cancer has become the most diagnosed cancer worldwide in 2020 with high morbidity and mortality rates. The alarming increase in breast cancer incidence has sprung many researchers to focus on developing novel screening tests to identify early breast cancer which will allow clinicians to provide timely and effective treatments. With much evidence supporting the notion that the deregulation of miRNAs (a class of non-coding RNA) greatly contributes to cancer initiation and progression, the promising role of miRNAs as cancer biomarkers is gaining traction in the research world. Among the upregulated miRNAs identified in breast carcinogenesis, miR-21 was shown to be significantly expressed in breast cancer tissues and bodily fluids of breast cancer patients. Therein, this review paper aims to provide an overview of breast cancer, the role and significance of miR-21 in breast cancer pathogenesis, and its potential as a breast cancer biomarker. The paper also discusses the current types of tumor biomarkers and their limitations, the presence of miR-21 in extracellular vesicles and plasma, screening methods available for miRNA detection along with some challenges faced in developing diagnostic miR-21 testing for breast cancer to provide readers with a comprehensive outlook based on using miR-21 in clinical settings.
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Affiliation(s)
- Sau Har Lee
- School of Biosciences, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya 47500, Malaysia; Digital Health and Medical Advancements Impact Lab, Taylor's University, Subang Jaya 47500, Malaysia.
| | - Brianna
- Department of Medical Sciences, School of Medical and Life Sciences, Sunway University, Jalan Universiti, Bandar Sunway, Darul Ehsan, Selangor 47500, Malaysia
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218
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Tuncer SB, Celik B, Erciyas SK, Erdogan OS, Gültaslar BK, Odemis DA, Avsar M, Sen F, Saip PM, Yazici H. Germline mutational variants of Turkish ovarian cancer patients suspected of Hereditary Breast and Ovarian Cancer (HBOC) by next-generation sequencing. Pathol Res Pract 2024; 254:155075. [PMID: 38219492 DOI: 10.1016/j.prp.2023.155075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 12/11/2023] [Accepted: 12/29/2023] [Indexed: 01/16/2024]
Abstract
Hereditary Breast and Ovarian Cancer (HBOC) syndrome is characterized by an increased risk of developing breast cancer (BC) and ovarian cancer (OC) due to inherited genetic mutations. Understanding the genetic variants associated with HBOC is crucial for identifying individuals at high risk and implementing appropriate preventive measures. The study included 630 Turkish OC patients with confirmed diagnostic criteria of The National Comprehensive Cancer Network (NCCN) concerning HBOC. Genomic DNA was extracted from peripheral blood samples, and targeted Next-generation sequencing (NGS) was performed. Bioinformatics analysis and variant interpretation were conducted to identify pathogenic variants (PVs). Our analysis revealed a spectrum of germline pathogenic variants associated with HBOC in Turkish OC patients. Notably, several pathogenic variants in BRCA1, BRCA2, and other DNA repair genes were identified. Specifically, we observed germline PVs in 130 individuals, accounting for 20.63% of the total cohort. 76 distinct PVs in genes, BRCA1 (40 PVs), BRCA2 (29 PVs), ATM (1 PV), CHEK2 (2 PVs), ERCC2 (1 PV), MUTYH (1 PV), RAD51C (1 PV), and TP53 (1PV) and also, two different PVs (i.e., c.135-2 A>G p.? in BRCA1 and c.6466_6469delTCTC in BRCA2) were detected in a 34-year-old OC patient. In conclusion, our study contributes to a better understanding of the genetic variants underlying HBOC in Turkish OC patients. These findings provide valuable insights into the genetic architecture of HBOC in the Turkish population and shed light on the potential contribution of specific germline PVs to the increased risk of OC.
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Affiliation(s)
- Seref Bugra Tuncer
- Department of Cancer Genetics, Istanbul Faculty of Medicine, Oncology Institute, Istanbul University, Istanbul, Türkiye.
| | - Betul Celik
- Erzincan Binali Yıldırım University, Department of Molecular Biology, Erzincan, Türkiye
| | - Seda Kilic Erciyas
- Department of Cancer Genetics, Istanbul Faculty of Medicine, Oncology Institute, Istanbul University, Istanbul, Türkiye
| | - Ozge Sukruoglu Erdogan
- Department of Cancer Genetics, Istanbul Faculty of Medicine, Oncology Institute, Istanbul University, Istanbul, Türkiye
| | - Busra Kurt Gültaslar
- Department of Cancer Genetics, Istanbul Faculty of Medicine, Oncology Institute, Istanbul University, Istanbul, Türkiye
| | - Demet Akdeniz Odemis
- Department of Cancer Genetics, Istanbul Faculty of Medicine, Oncology Institute, Istanbul University, Istanbul, Türkiye
| | - Mukaddes Avsar
- Health Services Vocational of Higher Education, T.C. Istanbul Aydın University, Istanbul, Türkiye
| | - Fatma Sen
- Clinic of Medical Oncology, Avrasya Hospital, Istanbul, Türkiye
| | - Pınar Mualla Saip
- Department of Medical Oncology, Oncology Institute, Istanbul University, Istanbul, Türkiye
| | - Hulya Yazici
- Istanbul Arel University, Arel Medical Faculty, Department of Medical Biology and Genetics, Istanbul, Türkiye
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219
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Schreuder K, Bult TJ, Stroop B, Koppert LB, Bijlsma RM, Bantema-Joppe EJ, Hoornweg MJ, Siesling S. European quality indicators developed by the European Commission Initiative on Breast Cancer: a first nationwide assessment for the Dutch setting. Breast Cancer Res Treat 2024; 203:523-531. [PMID: 37882921 DOI: 10.1007/s10549-023-07158-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 10/05/2023] [Indexed: 10/27/2023]
Abstract
PURPOSE This observational study aims to assess the feasibility of calculating indicators developed by the European Commission Initiative on Breast Cancer (ECIBC) for the Dutch breast cancer population. METHODS Patients diagnosed with invasive or in situ breast cancer between 2012 and 2018 were selected from the Netherlands Cancer Registry (NCR). Outcomes of the quality indicators (QI) were presented as mean scores and were compared to a stated norm. Variation between hospitals was assessed by standard deviations and funnel plots and trends over time were evaluated. The quality indicator calculator (QIC) was validated by comparing these outcomes with the outcomes of constructed algorithms in Stata. RESULTS In total, 133,527 patients were included. Data for 24 out of 26 QIs were available in the NCR. For 67% and 67% of the QIs, a mean score above the norm and low or medium hospital variation was observed, respectively. The proportion of patients undergoing a breast reconstruction or neoadjuvant systemic therapy increased over time. The proportion treated within 4 weeks from diagnosis, having >10 lymph nodes removed or estrogen negative breast cancer who underwent adjuvant chemotherapy decreased. The outcomes of the constructed algorithms in this study and the QIC showed 100% similarity. CONCLUSION Data from the NCR could be used for the calculation of more than 92% of the ECIBC indicators. The quality of breast cancer care in the Netherlands is high, as more than half of the QIs already score above the norm and medium hospital variation was observed. The QIC can be easy and reliably applied.
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Affiliation(s)
- Kay Schreuder
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Enschede, The Netherlands.
- Department of Health Technology and Services Research (HTSR), Technical Medical Centre, University of Twente, Enschede, The Netherlands.
| | - Tim J Bult
- Department of Health Technology and Services Research (HTSR), Technical Medical Centre, University of Twente, Enschede, The Netherlands
| | - Babet Stroop
- Department of Health Technology and Services Research (HTSR), Technical Medical Centre, University of Twente, Enschede, The Netherlands
| | - Linetta B Koppert
- Department of Surgery, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Rhodé M Bijlsma
- Department of Medical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Enja J Bantema-Joppe
- Department of Radiation Oncology, Radiotherapy Institute Friesland, Leeuwarden, The Netherlands
| | - Marije J Hoornweg
- Department of Plastic and Reconstructive Surgery, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Sabine Siesling
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Enschede, The Netherlands
- Department of Health Technology and Services Research (HTSR), Technical Medical Centre, University of Twente, Enschede, The Netherlands
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220
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Al Masry Z, Pic R, Dombry C, Devalland C. A new methodology to predict the oncotype scores based on clinico-pathological data with similar tumor profiles. Breast Cancer Res Treat 2024; 203:587-598. [PMID: 37926760 DOI: 10.1007/s10549-023-07141-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 09/25/2023] [Indexed: 11/07/2023]
Abstract
PURPOSE The Oncotype DX (ODX) test is a commercially available molecular test for breast cancer assay that provides prognostic and predictive breast cancer recurrence information for hormone positive, HER2-negative patients. The aim of this study is to propose a novel methodology to assist physicians in their decision-making. METHODS A retrospective study between 2012 and 2020 with 333 cases that underwent an ODX assay from three hospitals in the Bourgogne Franche-Comté region (France) was conducted. Clinical and pathological reports were used to collect the data. A methodology based on distributional random forest was developed to predict the ODX score classes (ODX [Formula: see text] and ODX [Formula: see text]) using 9 clinico-pathological characteristics. This methodology can be used particularly to identify the patients of the training cohort that share similarities with the new patient and to predict an estimate of the distribution of the ODX score. RESULTS The mean age of participants is 56.9 years old. We have correctly classified [Formula: see text] of patients in low risk and [Formula: see text] of patients in high risk. The overall accuracy is [Formula: see text]. The proportion of low risk correct predicted value (PPV) is [Formula: see text]. The percentage of high risk correct predicted value (NPV) is approximately [Formula: see text]. The F1-score and the Area Under Curve (AUC) are of 0.87 and 0.759, respectively. CONCLUSION The proposed methodology makes it possible to predict the distribution of the ODX score for a patient. This prediction is reinforced by the determination of a family of known patients with follow-up of identical scores. The use of this methodology with the pathologist's expertise on the different histological and immunohistochemical characteristics has a clinical impact to help oncologist in decision-making regarding breast cancer therapy.
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Affiliation(s)
- Zeina Al Masry
- SUPMICROTECH, CNRS, institut FEMTO-ST, 24 rue Alain Savary, 25000, Besançon, France.
| | - Romain Pic
- Université de Franche-Comté, CNRS, LmB, 25000, Besançon, France
| | - Clément Dombry
- Université de Franche-Comté, CNRS, LmB, 25000, Besançon, France
| | - Chrisine Devalland
- Service d'anatomie et cytologie pathologiques, Hôpital Nord Franche-Comté, 100 Route de Moval, 90400, Trévenans, France
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221
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Pirikahu S, Darcey E, Lund H, Wylie E, Stone J. The impact of height and weight on rescreening rates within a population-based breast screening program. Cancer Med 2024; 13:e6883. [PMID: 38205936 PMCID: PMC10905218 DOI: 10.1002/cam4.6883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 12/04/2023] [Accepted: 12/16/2023] [Indexed: 01/12/2024] Open
Abstract
INTRODUCTION Women with obesity are at increased risk of post-menopausal breast cancer and less likely to participate in breast screening. This study investigates the impact of asking women their height and weight within a population-based screening program, and the association of BMI with rescreening status. METHODS Data regarding 666,130 screening events from 318,198 women aged 50-74 attending BreastScreen Western Australia between 2016 and 2021 were used to compare crude and age-standardised rescreening rates over time. Mixed effects logistic regression was used to investigate associations of BMI with rescreening status. RESULTS Rescreening rates for women screened since 2016 were within 1.8% points from the previous reporting period, stratified by screening round. Increasing BMI was associated with decreased likelihood of returning to breast screening (OR = 0.993, 95% CI: 0.988-0.998; OR = 0.989, 95% CI: 0.984-0.994; OR = 0.985, 95% CI: 0.982-0.987 for women screening for the first, second and third+ time, respectively). CONCLUSIONS This large, prospective study supports implementation of routine height and weight collection within breast screening programs. It shows that asking women their height and weight does not deter them from returning to screening and that women with increased BMI are less likely to rescreen, highlighting a need for targeted interventions to improve screening barriers for women living with obesity.
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Affiliation(s)
- Sarah Pirikahu
- Genetic Epidemiology Group, School of Population and Global HealthUniversity of Western AustraliaPerthWestern AustraliaAustralia
| | - Ellie Darcey
- Genetic Epidemiology Group, School of Population and Global HealthUniversity of Western AustraliaPerthWestern AustraliaAustralia
| | - Helen Lund
- BreastScreen Western AustraliaWomen and Newborn Health ServicePerthWestern AustraliaAustralia
| | - Elizabeth Wylie
- BreastScreen Western AustraliaWomen and Newborn Health ServicePerthWestern AustraliaAustralia
- Medical SchoolUniversity of Western AustraliaPerthWestern AustraliaAustralia
| | - Jennifer Stone
- Genetic Epidemiology Group, School of Population and Global HealthUniversity of Western AustraliaPerthWestern AustraliaAustralia
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Scott L, Truong LL, Houlden RL, Wijeratne DT. Screening and Management Recommendations for Type 2 Diabetes in Women With Breast Cancer. Can J Diabetes 2024; 48:66-72. [PMID: 37474100 DOI: 10.1016/j.jcjd.2023.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 05/26/2023] [Accepted: 07/12/2023] [Indexed: 07/22/2023]
Abstract
Breast cancer increases the risk of type 2 diabetes 1.07- to 4.27-fold, depending on patient and treatment characteristics, such as postmenopausal status, hormone therapy, and treatment with adjuvant chemotherapy. We evaluated the current evidence and considered the role of increased screening for type 2 diabetes in this at-risk population. This narrative review was conducted using Embase and MEDLINE databases. Keywords including diabetes and breast cancer were used. Articles were limited to those published in English between 2000 and 2022. It appears that the increased risk of diabetes begins at or just after breast cancer diagnosis, and remains elevated for at least 10 to 15 years, with greatest risk in the first 2 years after diagnosis. Subsets of patients with breast cancer appear to be at higher risk of developing type 2 diabetes, including those who were treated with adjuvant chemotherapy or hormone therapy. Further investigation is needed to develop specific screening recommendations for this population. If screening is performed with a glycated hemoglobin test during breast cancer treatment, then hemoglobin should be measured at the same time given the association of breast cancer therapy with anemia. Presence of breast cancer should not be a major factor when choosing among available antihyperglycemic agents. Overall, patients with breast cancer appear to be at an increased risk of developing type 2 diabetes. This increased risk suggests the need for further investigation to develop specific screening recommendations for this at-risk population.
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Affiliation(s)
- Laura Scott
- Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Lan-Linh Truong
- Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Robyn L Houlden
- Division of Endocrinology, Kingston General Hospital, Kingston, Ontario, Canada
| | - Don Thiwanka Wijeratne
- Department of Medicine, Queen's University, Kingston, Ontario, Canada; Department of Public Health, Queen's University, Kingston, Ontario, Canada; Division of Cancer Care and Epidemiology, Queen's University Cancer Research Institute, Kingston, Ontario, Canada.
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Valencia F, Gómez HL, Neciosup SP, Limón R, Torrico MDC, Morillas L, Torres R, Sánchez C, Araya I, Gómez R, Bruges R, Vargas C, Soria T, Muñoz R, Riofrío M, Gálvez M, Ruiz R, Benites P, Cardoso F. Advanced Breast Cancer Guidelines in Latin America: Assessment, Adaptation, and Implementation of Fifth Advanced Breast Cancer Consensus Guidelines. JCO Glob Oncol 2024; 10:e2200067. [PMID: 38301184 PMCID: PMC10846768 DOI: 10.1200/go.22.00067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 07/31/2023] [Accepted: 11/09/2023] [Indexed: 02/03/2024] Open
Abstract
PURPOSE As the fifth international consensus on advanced breast cancer (ABC5) established guidelines for the management of this disease, the aim of this article was to present the applicability of the consensus recommendations and to generate knowledge to improve access. METHODS Sixty-one recommendation statements were selected and discussed by 15 breast cancer experts from Latin America (LA). After the discussion, the level of consensus was determined through a vote. In addition to this, the level of access to each of the recommendations presented, according to the country and health system, was exposed. RESULTS Latin American experts had a high level of agreement with the ABC5 consensus recommendations (range, 83%-100%). Twelve of 61 statements are not available for all patients in LA. Among the limitations to access, the following ones are described: limited access to certain technologies (stereotactic body radiotherapy, positron emission tomography-computed tomography), the high costs of drugs that limits access to treatment with CDK4/6 inhibitors, pertuzumab, or poly(ADP-ribose) polymerase inhibitors, and the lack of molecular tests for access to therapeutic targets, as well as the difficult geography and cultural diversity of our continent. CONCLUSION Despite the great relevance of the recommendations of the ABC5 consensus guidelines, we highlight that we still need to improve access for all patients, regardless of the country or health system they are in, for which we call to action to policy makers and patient groups to improve clinical outcomes of patients with advanced breast cancer in our region.
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Affiliation(s)
| | | | | | - Ronald Limón
- OncoBolivia—Centro especializado de cáncer, Clínica de las Américas—Departamento de Oncología, Santa Cruz, Bolivia
| | | | - Lena Morillas
- Centro de Enfermedades Neoplásicas ONCOVIDA, La Paz, Bolivia
| | | | | | | | - Rodolfo Gómez
- Instituto de Cancerología de Las Américas de Medellín, Medellín, Colombia
| | | | - Carlos Vargas
- Unidad de Cáncer, Clínica de Country, Bogotá, Colombia
| | | | | | | | - Marco Gálvez
- Instituto Regional de Enfermedades Neoplasicas del Norte, Trujillo, Peru
| | | | - Pilar Benites
- Hospital Nacional Edgardo Rebagliati Martins, Lima, Perú
| | - Fatima Cardoso
- Breast Unit, Champalimaud Clinical Centre/Champalimaud Foundation, Lisbon, Portugal
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Hild S, Teigné D, Fairier D, Ruelle Y, Aubin-Auger I, Sidorkiewicz S, Citrini M, Gocko X, Cerisey C, Ferrat E, Rat C. Development and evaluation of a decision aid for women eligible for organized breast cancer screening according to international standards: A multi-method study. Breast 2024; 73:103613. [PMID: 38056169 PMCID: PMC10749284 DOI: 10.1016/j.breast.2023.103613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 11/09/2023] [Accepted: 11/20/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND and purpose: In France, women lack information to make a shared decision to start breast cancer screening. Decision aids are useful to facilitate this discussion, yet few meet international standards. The objective of this project was to build, validate and measure the quality of a decision aid for organized breast screening in France, in line with international standards, intended for both women and healthcare professionals. MATERIALS AND METHODS This mixed-methods study was conducted between January 2017 and June 2022. The prototype was developed from a qualitative study, systematic review and targeted literature review and alpha tested during two Delphi rounds. Readability was evaluated with the Flesch score and content with International Patient Decision Aid Standards Instrument (IPSASi). RESULTS An online decision aid, accessible at www.Discutons-mammo.fr, written in French was developed. The content included eligibility, information about breast screening the advantages and disadvantages of screening, patient preferences and a patient-based discussion guide using text, infographics, and videos. The Flesch readability test score was 65.4 and the IPDASi construct quality score was 176 out of 188. CONCLUSIONS This decision aid complies with IPDASi standards and could help women eligible for breast screening in France make a shared decision with a specialized healthcare professional about whether or not to participate in organized breast screening.
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Affiliation(s)
- Sandrine Hild
- Department of General Practice, Faculty of Medicine, Nantes University, 1, rue Gaston Veil, 44035, Nantes, France.
| | - Delphine Teigné
- Department of General Practice, Faculty of Medicine, Nantes University, 1, rue Gaston Veil, 44035, Nantes, France; University Research Department, Nantes University Hospital, Nantes, France.
| | - Damien Fairier
- Department of General Practice, Faculty of Medicine, Nantes University, 1, rue Gaston Veil, 44035, Nantes, France; University Research Department, Nantes University Hospital, Nantes, France.
| | - Yannick Ruelle
- Department of General Practice, Sorbonne University Paris Nord, UR 3412, DUMG, F-93430, Villetaneuse, France.
| | | | | | - Marie Citrini
- Patient Perspective, Sorbonne University, Paris, Nord, France.
| | - Xavier Gocko
- University Jean Monnet of Saint Etienne, Department of Medicine, Saint Etienne, France.
| | | | - Emilie Ferrat
- University Paris-Est Creteil, INSERM, IMRB, Equipe CEpiA, F-94010, Creteil, Paris, France.
| | - Cédric Rat
- Department of General Practice, Faculty of Medicine, Nantes University, 1, rue Gaston Veil, 44035, Nantes, France; National Institute for Health and Medical Research/INSERM U1302 Team 2, CRCINA, Nantes, France.
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225
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Alaeikhanehshir S, Schmitz RSJM, van den Belt-Dusebout AW, van Duijnhoven FH, Verschuur E, van Seijen M, Schaapveld M, Lips EH, Wesseling J. The effects of contemporary treatment of DCIS on the risk of developing an ipsilateral invasive Breast cancer (iIBC) in the Dutch population. Breast Cancer Res Treat 2024; 204:61-68. [PMID: 37964135 PMCID: PMC10806034 DOI: 10.1007/s10549-023-07168-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 10/25/2023] [Indexed: 11/16/2023]
Abstract
PURPOSE To assess the effects of contemporary treatment of ductal carcinoma in situ (DCIS) on the risk of developing an ipsilateral invasive breast cancer (iIBC) in the Dutch female population. METHODS Clinical data was obtained from the Netherlands Cancer Registry (NCR), a nationwide registry of all primary malignancies in the Netherlands integrated with the data from PALGA, the Dutch nationwide network and registry of histo- and cytopathology in the Netherlands, on all women in the Netherlands treated for primary DCIS from 2005 to 2015, resulting in a population-based cohort of 14.419 women. Cumulative iIBC incidence was assessed and associations of DCIS treatment type with subsequent iIBC risk were evaluated by multivariable Cox regression analyses. RESULTS Ten years after DCIS diagnosis, the cumulative incidence of iIBC was 3.1% (95% CI: 2.6-3.5%) in patients treated by breast conserving surgery (BCS) plus radiotherapy (RT), 7.1% (95% CI: 5.5-9.1) in patients treated by BCS alone, and 1.6% (95% CI: 1.3-2.1) in patients treated by mastectomy. BCS was associated with a significantly higher risk for iIBC compared to BCS + RT during the first 5 years after treatment (HR 2.80, 95% CI: 1.91-4.10%). After 5 years of follow-up, the iIBC risk declined in the BCS alone group but remained higher than the iIBC risk in the BCS + RT group (HR 1.73, 95% CI: 1.15-2.61). CONCLUSIONS Although absolute risks of iIBC were low in patients treated for DCIS with either BCS or BCS + RT, risks remained higher in the BCS alone group compared to patients treated with BCS + RT for at least 10 years after DCIS diagnosis.
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MESH Headings
- Female
- Humans
- Breast Neoplasms/epidemiology
- Breast Neoplasms/therapy
- Breast Neoplasms/diagnosis
- Carcinoma, Intraductal, Noninfiltrating/epidemiology
- Carcinoma, Intraductal, Noninfiltrating/therapy
- Carcinoma, Intraductal, Noninfiltrating/pathology
- Mastectomy/methods
- Mastectomy, Segmental/methods
- Incidence
- Neoplasm Recurrence, Local/surgery
- Carcinoma, Ductal, Breast/epidemiology
- Carcinoma, Ductal, Breast/therapy
- Carcinoma, Ductal, Breast/etiology
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Affiliation(s)
- Sena Alaeikhanehshir
- Division of Molecular Pathology, the Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, Amsterdam, 1066 CX, Netherlands
- Department of Surgical Oncology, the Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, Netherlands
| | - Renée S J M Schmitz
- Division of Molecular Pathology, the Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, Amsterdam, 1066 CX, Netherlands
| | - Alexandra W van den Belt-Dusebout
- Division of Molecular Pathology, the Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, Amsterdam, 1066 CX, Netherlands
| | - Frederieke H van Duijnhoven
- Department of Surgical Oncology, the Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, Netherlands
| | | | - Maartje van Seijen
- Division of Molecular Pathology, the Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, Amsterdam, 1066 CX, Netherlands
| | - Michael Schaapveld
- Department of Epidemiology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Esther H Lips
- Division of Molecular Pathology, the Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, Amsterdam, 1066 CX, Netherlands
| | - Jelle Wesseling
- Division of Molecular Pathology, the Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, Amsterdam, 1066 CX, Netherlands.
- Department of Pathology, the Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands.
- Department of Pathology, Leiden University Medical Center, Leiden, the Netherlands.
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226
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Nwakasi C, Esiaka D, Chinelo N, Ahmed S. How will I live this life that I'm trying to save? Being a female breast cancer survivor in Nigeria. Ethn Health 2024; 29:147-163. [PMID: 37936496 DOI: 10.1080/13557858.2023.2279478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 10/31/2023] [Indexed: 11/09/2023]
Abstract
OBJECTIVES Nigeria is experiencing an increasing rate of new cancer cases while marred by a weak health system. As cancer prevalence increases in Nigeria, especially among women, it is crucial to understand the experiences of female cancer survivors, given that their quality of life may be influenced by perceptions of cancer and what it means to be a cancer survivor. DESIGN This study employed a qualitative descriptive method. Semi-structured interviews were conducted with a purposive sample of 30 female breast cancer survivors in Abuja, Nigeria. RESULTS The three major themes were views about being a cancer survivor, cancer can be stigmatizing, and life after cancer diagnosis and therapy. CONCLUSION We argue that cancer-related identity and cancer-related stigma are key factors with help-seeking and quality-of-life implications. Tailored interventions such as cancer health education and social support for cancer survivors may help reduce the burden of cancer in Nigeria.
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Affiliation(s)
- Candidus Nwakasi
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, USA
| | - Darlingtina Esiaka
- Department of Behavioral Science, Center for Health Equity Transformation, University of Kentucky, Lexington, KY, USA
| | - Nduka Chinelo
- Department of Community Medicine, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
| | - Sarah Ahmed
- Department of Health Sciences, Providence College, Providence, RI, USA
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227
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Baeker Bispo J, Lee H, Pal Choudhury P, Bailey Z, Jemal A, Islami F. Government Housing Assistance and Cancer Screening Among Adults With Low Income. Am J Prev Med 2024; 66:205-215. [PMID: 37943202 DOI: 10.1016/j.amepre.2023.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 10/05/2023] [Accepted: 10/05/2023] [Indexed: 11/10/2023]
Abstract
INTRODUCTION Access to affordable housing may support cancer control for adults with low income by alleviating financial barriers to preventive care. This study examines relationships between cancer screening and receipt of government housing assistance among adults with low income. METHODS Data are from the 2019 and 2021 National Health Interview Survey. Eligible respondents were classified as up-to-date or not with breast cancer (BC), cervical cancer (CVC) and colorectal cancer (CRC) screening guidelines. Multivariable logistic regression was used to model guideline-concordant screening by receipt of government housing assistance, overall and stratified by urban-rural status, race/ethnicity, and age. Analyses were performed in 2023. RESULTS Analyses for BC, CVC and CRC screening included 2,258, 3,132, and 3,233 respondents, respectively. There was no difference in CVC screening by housing assistance status, but screening for BC and CRC was higher among those who received assistance compared to those who did not (59.7% vs. 50.8%, p<0.01 for BC; 57.1% vs. 44.1%, p<0.01 for CRC). In models adjusted for sociodemographic characteristics, health status and insurance, these differences were not statistically significant for either BC or CRC screening. In stratified adjusted models, housing assistance was statistically significantly associated with increased BC screening in urban areas (aOR=1.35, 95% CI=1.00-1.82) and among Hispanic women (aOR=2.20, 95% CI=1.01-4.78) and women 45-54 years of age (aOR=2.10, 95% CI=1.17-3.75). CONCLUSIONS Policies that address housing affordability may enhance access to BC screening for some subgroups, including women in urban areas, Hispanic women, and younger women. More research on the mechanisms that link housing assistance to BC screening is needed.
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Affiliation(s)
- Jordan Baeker Bispo
- Department of Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia.
| | - Hyunjung Lee
- Department of Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia
| | - Parichoy Pal Choudhury
- Department of Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia
| | - Zinzi Bailey
- University of Minnesota School of Public Health, Minneapolis, Minnesota
| | - Ahmedin Jemal
- Department of Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia
| | - Farhad Islami
- Department of Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia
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228
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Addae JK, Sweeting RS, Meszoely IM, McCaffrey RL, Kauffmann RM, Kelley MC, Grau AM, Hewitt K. Superparamagnetic iron oxide (SPIO) for axillary mapping in patients with ductal carcinoma in situ undergoing mastectomy: single-institution experience. Breast Cancer Res Treat 2024; 204:117-121. [PMID: 38087058 DOI: 10.1007/s10549-023-07193-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 11/19/2023] [Indexed: 01/24/2024]
Abstract
PURPOSE Unnecessary axillary surgery can potentially be avoided in patients with DCIS undergoing mastectomy. Current guidelines recommend upfront sentinel lymph node biopsy during the index operation due to the potential of upstaging to invasive cancer. This study reviews a single institution's experience with de-escalating axillary surgery using superparamagnetic iron oxide dye for axillary mapping in patients undergoing mastectomy for DCIS. METHODS This is a retrospective single-institution cross-sectional study. All medical records of patients who underwent mastectomy for a diagnosis of DCIS from August 2021 to January 2023 were reviewed and patients who had SPIO injected at the time of the index mastectomy were included in the study. Descriptive statistics of demographics, clinical information, pathology results, and interval sentinel lymph node biopsy were performed. RESULTS A total of 41 participants underwent 45 mastectomies for DCIS. The median age of the participants was 58 years (IQR = 17; range 25 to 76 years), and the majority of participants were female (97.8%). The most common indication for mastectomy was diffuse extent of disease (31.7%). On final pathology, 75.6% (34/45) of mastectomy specimens had DCIS without any type of invasion and 15.6% (7/45) had invasive cancer. Of the 7 cases with upgrade to invasive disease, 2 (28.6%) of them underwent interval sentinel lymph node biopsy. All sentinel lymph nodes biopsied were negative for cancer. CONCLUSION The use of superparamagnetic iron oxide dye can prevent unnecessary axillary surgery in patients with DCIS undergoing mastectomy.
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Affiliation(s)
- Jamin Kweku Addae
- Department of Surgical Oncology and Endocrine Surgery, Vanderbilt University Medical Center, Preston Research Building, 2220 Pierce Ave., Nashville, TN, 37232, USA.
| | - Raeshell Sharawn Sweeting
- Department of Surgical Oncology and Endocrine Surgery, Vanderbilt University Medical Center, Preston Research Building, 2220 Pierce Ave., Nashville, TN, 37232, USA
| | - Ingrid Marie Meszoely
- Department of Surgical Oncology and Endocrine Surgery, Vanderbilt University Medical Center, Preston Research Building, 2220 Pierce Ave., Nashville, TN, 37232, USA
| | - Rachel Louise McCaffrey
- Department of Surgical Oncology and Endocrine Surgery, Vanderbilt University Medical Center, Preston Research Building, 2220 Pierce Ave., Nashville, TN, 37232, USA
| | - Rondi Marie Kauffmann
- Department of Surgical Oncology and Endocrine Surgery, Vanderbilt University Medical Center, Preston Research Building, 2220 Pierce Ave., Nashville, TN, 37232, USA
| | - Mark Carlton Kelley
- Department of Surgical Oncology and Endocrine Surgery, Vanderbilt University Medical Center, Preston Research Building, 2220 Pierce Ave., Nashville, TN, 37232, USA
| | - Ana Magdalena Grau
- Department of Surgical Oncology and Endocrine Surgery, Vanderbilt University Medical Center, Preston Research Building, 2220 Pierce Ave., Nashville, TN, 37232, USA
| | - Kelly Hewitt
- Department of Surgical Oncology and Endocrine Surgery, Vanderbilt University Medical Center, Preston Research Building, 2220 Pierce Ave., Nashville, TN, 37232, USA
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229
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Zhao YY, Ge HJ, Yang WT, Shao ZM, Hao S. Secretory breast carcinoma: clinicopathological features and prognosis of 52 patients. Breast Cancer Res Treat 2024; 203:543-551. [PMID: 37897648 DOI: 10.1007/s10549-023-07153-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 09/29/2023] [Indexed: 10/30/2023]
Abstract
PURPOSE Secretory breast carcinoma is a rare histological subtype of invasive breast cancer and considered with an indolent clinical behavior. This study was conducted to analyze the clinicopathological features of patients with secretory breast carcinoma (SBC), explore the outcome, and compare the prognostic difference with invasive ductal breast carcinoma (IDC). METHODS AND MATERIALS: Patients with SBC diagnosed between 2006 and 2017 from Fudan University Shanghai Cancer Center were included in the study, excluding patients with previous malignant tumor history and incomplete clinical data or follow-up records. Peculiar clinicopathological and immunohistochemical features of the cases were fully described. Clinical data of 4979 cases of IDC were also evaluated during this period. After propensity score matching, prognostic analysis of SBCs and IDCs was calculated by Kaplan-Meier method and landmark analysis method. RESULTS The data of 52 patients diagnosed with SBC were identified from the pathological files. Among them, 47 patients were women, and 5 were men. The median age of the 52 SBCs was 46 years (mean, 48.1 years; range, 10-80 years). The tumor sizes ranged from 0.3 to 6.8 cm, with a mean of 3.5 cm. Eight patients (15.4%) had positive axillary lymph node involvement. The molecular classification was mostly triple-negative breast cancer (65.4%). Fluorescence in situ hybridization confirmed the presence of ETV6::NTRK3 rearrangement in 16 of 18 cases (88.9%). Furthermore, Kaplan-Meier survival analysis and landmark analysis demonstrated that there were no statistically significant differences in DFS and OS between SBC and IDC patients. CONCLUSION Although SBCs are generally associated with a favorable prognosis, our work exhibited that the clinicopathological features of SBC were partly different from former understandings, indicating that therapeutic procedure should be prudent. Further studies are necessary to fully identify the clinical behavior and predictive markers to improve diagnosis and management in this unique subtype of breast cancer.
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Affiliation(s)
- Yuan-Yuan Zhao
- Department of Breast Surgery, Fudan University Shanghai Cancer Center, Fudan University, 270 Dong-An Road, Shanghai, 200032, People's Republic of China
- Department of General Surgery, Huashan Hospital, Fudan University, 12 Urumqi Road (M), Shanghai, 200040, People's Republic of China
| | - Hui-Juan Ge
- Department of Oncology, Shanghai Medical College, Fudan University, 270 Dong-An Road, Shanghai, 200032, People's Republic of China
- Department of Pathology, Fudan University Shanghai Cancer Center, Fudan University, 270 Dong-An Road, Shanghai, 200032, People's Republic of China
| | - Wen-Tao Yang
- Department of Oncology, Shanghai Medical College, Fudan University, 270 Dong-An Road, Shanghai, 200032, People's Republic of China
- Department of Pathology, Fudan University Shanghai Cancer Center, Fudan University, 270 Dong-An Road, Shanghai, 200032, People's Republic of China
| | - Zhi-Ming Shao
- Department of Breast Surgery, Fudan University Shanghai Cancer Center, Fudan University, 270 Dong-An Road, Shanghai, 200032, People's Republic of China.
- Department of Oncology, Shanghai Medical College, Fudan University, 270 Dong-An Road, Shanghai, 200032, People's Republic of China.
- Institutes of Biomedical Science, Fudan University, Shanghai, People's Republic of China.
| | - Shuang Hao
- Department of Breast Surgery, Fudan University Shanghai Cancer Center, Fudan University, 270 Dong-An Road, Shanghai, 200032, People's Republic of China.
- Department of Oncology, Shanghai Medical College, Fudan University, 270 Dong-An Road, Shanghai, 200032, People's Republic of China.
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230
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Kim SM, Jang M, Yun BL, Shin SU, Rim J, Kang E, Kim EK, Shin HC, Park SY, Kim B. Automated Versus Handheld Breast Ultrasound for Evaluating Axillary Lymph Nodes in Patients With Breast Cancer. Korean J Radiol 2024; 25:146-156. [PMID: 38238017 PMCID: PMC10831296 DOI: 10.3348/kjr.2023.0100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 11/06/2023] [Accepted: 11/07/2023] [Indexed: 01/31/2024] Open
Abstract
OBJECTIVE Automated breast ultrasound (ABUS) is a relevant imaging technique for early breast cancer diagnosis and is increasingly being used as a supplementary tool for mammography. This study compared the performance of ABUS and handheld ultrasound (HHUS) in detecting and characterizing the axillary lymph nodes (LNs) in patients with breast cancer. MATERIALS AND METHODS We retrospectively reviewed the medical records of women with recently diagnosed early breast cancer (≤ T2) who underwent both ABUS and HHUS examinations for axilla (September 2017-May 2018). ABUS and HHUS findings were compared using pathological outcomes as reference standards. Diagnostic performance in predicting any axillary LN metastasis and heavy nodal-burden metastases (i.e., ≥ 3 LNs) was evaluated. The ABUS-HHUS agreement for visibility and US findings was calculated. RESULTS The study included 377 women (53.1 ± 11.1 years). Among 385 breast cancers in 377 patients, 101 had axillary LN metastases and 30 had heavy nodal burden metastases. ABUS identified benign-looking or suspicious axillary LNs (average, 1.4 ± 0.8) in 246 axillae (63.9%, 246/385). According to the per-breast analysis, the sensitivity, specificity, positive and negative predictive values, and accuracy of ABUS in predicting axillary LN metastases were 43.6% (44/101), 95.1% (270/284), 75.9% (44/58), 82.6% (270/327), and 81.6% (314/385), respectively. The corresponding results for HHUS were 41.6% (42/101), 95.1% (270/284), 75.0% (42/56), 82.1% (270/329), and 81.0% (312/385), respectively, which were not significantly different from those of ABUS (P ≥ 0.53). The performance results for heavy nodal-burden metastases were 70.0% (21/30), 89.6% (318/355), 36.2% (21/58), 97.3% (318/327), and 88.1% (339/385), respectively, for ABUS and 66.7% (20/30), 89.9% (319/355), 35.7% (20/56), 97.0% (319/329), and 88.1% (339/385), respectively, for HHUS, also not showing significant difference (P ≥ 0.57). The ABUS-HHUS agreement was 95.9% (236/246; Cohen's kappa = 0.883). CONCLUSION Although ABUS showed limited sensitivity in diagnosing axillary LN metastasis in early breast cancer, it was still useful as the performance was comparable to that of HHUS.
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Affiliation(s)
- Sun Mi Kim
- Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Mijung Jang
- Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea.
| | - Bo La Yun
- Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Sung Ui Shin
- Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Jiwon Rim
- Department of Radiology, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
| | - Eunyoung Kang
- Department of Surgery, Daerim St. Mary's Hospital, Seoul, Republic of Korea
| | - Eun-Kyu Kim
- Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Hee-Chul Shin
- Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - So Yeon Park
- Department of Pathology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Bohyoung Kim
- Division of Biomedical Engineering, Hankuk University of Foreign Studies, Yongin, Republic of Korea
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231
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Loibl S, André F, Bachelot T, Barrios CH, Bergh J, Burstein HJ, Cardoso MJ, Carey LA, Dawood S, Del Mastro L, Denkert C, Fallenberg EM, Francis PA, Gamal-Eldin H, Gelmon K, Geyer CE, Gnant M, Guarneri V, Gupta S, Kim SB, Krug D, Martin M, Meattini I, Morrow M, Janni W, Paluch-Shimon S, Partridge A, Poortmans P, Pusztai L, Regan MM, Sparano J, Spanic T, Swain S, Tjulandin S, Toi M, Trapani D, Tutt A, Xu B, Curigliano G, Harbeck N. Early breast cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up. Ann Oncol 2024; 35:159-182. [PMID: 38101773 DOI: 10.1016/j.annonc.2023.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 11/21/2023] [Accepted: 11/28/2023] [Indexed: 12/17/2023] Open
Affiliation(s)
- S Loibl
- GBG Forschungs GmbH, Neu-Isenburg; Centre for Haematology and Oncology, Bethanien, Frankfurt, Germany
| | - F André
- Breast Cancer Unit, Medical Oncology Department, Gustave Roussy, Cancer Campus, Villejuif
| | - T Bachelot
- Department of Medical Oncology, Centre Léon Bérard, Lyon, France
| | - C H Barrios
- Oncology Department, Latin American Cooperative Oncology Group and Oncoclínicas, Porto Alegre, Brazil
| | - J Bergh
- Department of Oncology-Pathology, Bioclinicum, Karolinska Institutet and Breast Cancer Centre, Karolinska Comprehensive Cancer Centre and University Hospital, Stockholm, Sweden
| | - H J Burstein
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, USA
| | - M J Cardoso
- Breast Unit, Champalimaud Foundation, Champalimaud Cancer Centre, Lisbon; Faculty of Medicine, Lisbon University, Lisbon, Portugal
| | - L A Carey
- Division of Medical Oncology, The University of North Carolina at Chapel Hill, Lineberger Comprehensive Cancer Center, Chapel Hill, USA
| | - S Dawood
- Department of Oncology, Mediclinic City Hospital, Dubai, UAE
| | - L Del Mastro
- Medical Oncology Clinic, IRCCS Ospedale Policlinico San Martino, Genoa; Department of Internal Medicine and Medical Specialities, School of Medicine, University of Genoa, Genoa, Italy
| | - C Denkert
- Institute of Pathology, Philipps-University Marburg and University Hospital Giessen and Marburg, Marburg
| | - E M Fallenberg
- Department of Diagnostic and Interventional Radiology, School of Medicine & Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - P A Francis
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - H Gamal-Eldin
- Department of Surgical Oncology, National Cancer Institute, Cairo University, Cairo, Egypt
| | - K Gelmon
- Department of Medical Oncology, British Columbia Cancer, Vancouver, Canada
| | - C E Geyer
- Department of Internal Medicine, Hillman Cancer Center, University of Pittsburgh, Pittsburgh, USA
| | - M Gnant
- Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria
| | - V Guarneri
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova; Oncology 2 Unit, Istituto Oncologico Veneto IOV IRCCS, Padova, Italy
| | - S Gupta
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
| | - S B Kim
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - D Krug
- Department of Radiation Oncology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - M Martin
- Hospital General Universitario Gregorio Maranon, Universidad Complutense, GEICAM, Madrid, Spain
| | - I Meattini
- Department of Radiation Oncology, Azienda Ospedaliero-Universitaria Careggi, Florence; Department of Experimental and Clinical Biomedical Sciences 'M. Serio', University of Florence, Florence, Italy
| | - M Morrow
- Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, USA
| | - W Janni
- Department of Obstetrics and Gynaecology, University of Ulm, Ulm, Germany
| | - S Paluch-Shimon
- Sharett Institute of Oncology Department, Hadassah University Hospital & Faculty of Medicine Hebrew University, Jerusalem, Israel
| | - A Partridge
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, USA
| | - P Poortmans
- Department of Radiation Oncology, Iridium Netwerk, Antwerp; Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - L Pusztai
- Yale Cancer Center, Yale School of Medicine, New Haven
| | - M M Regan
- Division of Biostatistics, Dana-Farber Cancer Institute, Harvard Medical School, Boston
| | - J Sparano
- Department of Medicine, Division of Hematology/Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, USA
| | - T Spanic
- Europa Donna Slovenia, Ljubljana, Slovenia
| | - S Swain
- Medicine Department, Georgetown University Medical Centre and MedStar Health, Washington, USA
| | - S Tjulandin
- N.N. Blokhin National Medical Research Centre of Oncology, Moscow, Russia
| | - M Toi
- Tokyo Metropolitan Cancer and Infectious Disease Center, Komagome Hospital, Bunkyo-ku, Japan
| | - D Trapani
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, USA
| | - A Tutt
- Breast Cancer Research Division, The Institute of Cancer Research, London; Comprehensive Cancer Centre, Division of Cancer Studies, Kings College London, London, UK
| | - B Xu
- Department of Medical Oncology, National Cancer Centre/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - G Curigliano
- Early Drug Development for Innovative Therapies Division, Istituto Europeo di Oncologia, IRCCS, Milan; Department of Oncology and Hemato-Oncology, University of Milano, Milan, Italy
| | - N Harbeck
- Breast Centre, Department of Obstetrics & Gynaecology and Comprehensive Cancer Centre Munich, LMU University Hospital, Munich, Germany
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Mendenhall MA, Guinigundo A, Davies D, Ward P, Drosick DR, Waterhouse DM. Integration of Genetic Testing and Counseling in Patients With Breast Cancer in a Large, Multisite Community-Based Practice. JCO Oncol Pract 2024; 20:262-267. [PMID: 37369093 DOI: 10.1200/op.22.00794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 03/03/2023] [Accepted: 05/22/2023] [Indexed: 06/29/2023] Open
Abstract
PURPOSE Despite data-driven consensus recommendations, there remains significant nonadherence to genetic screening and testing. More than 300,000 patients are diagnosed with breast cancer annually, with one third of these estimated to be eligible for homologous recombination deficiency (HRD)/BRCA testing following National Comprehensive Cancer Network (NCCN) guidelines. Only 35% of eligible patients are referred for genetic counseling. METHODS The goal of this project was to apply NCCN guidelines for germline genetic testing to all new patients with breast cancer within a large community oncology practice to improve HRD/BRCA testing. Plan-Do-Study-Act methodology was used, and cycles were built on a proven teaching infrastructure. In cycle 1, providers were educated and directed to use electronic health record (EHR) templates in the setting of an initial diagnosis visit and treatment planning. Discreet data fields were created in the EHR during cycle 2 to streamline and automate the process. Appropriate patients were referred to the genetics team for further evaluation, counseling, and testing. Adherence to the plan was maintained and measured using data analytic reports and chart audits. RESULTS Of the 1,203 patients with breast cancer eligible for inclusion, 1,200 (99%) were screened according to NCCN guidelines. Of the screened patients, 631 (52.5%) met the referral/testing criteria. In total, 585 (92.7%) of the 631 were referred to a genetic specialist. Seven percent had previous referrals. A total of 449 (71%) patients were acceptable to genetics referral while 136 (21.5%) patients refused. CONCLUSION The implemented methods of education, NCCN guidelines imbedded within provider notes, and discreet data fields in the EHR have proven to be highly effective in screening appropriate patients and ordering subsequent genetic referrals.
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Affiliation(s)
| | | | - Dan Davies
- Oncology Hematology Care (OHC), Cincinnati, OH
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Shelton C, Nielsen SM. ASO Author Reflections: Impact of Universal Germline Genetic Testing on Clinical Management in Rural Breast Cancer Patients. Ann Surg Oncol 2024; 31:1007. [PMID: 37996642 DOI: 10.1245/s10434-023-14510-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 10/11/2023] [Indexed: 11/25/2023]
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Elshami M, Qawasmi MA, Ghithan RJ, Al-Slaibi I, Alser M, Shurrab NR, Ismail IO, Mahfouz II, AbdulQader Fannon A, Hawa MR, Giacaman N, Ahmaro M, Okshiya HM, Zaatreh RK, AbuKhalil WA, Usrof FD, Melhim NK, Madbouh RJ, Abu Hziema HJ, Abed-Allateef Lahlooh R, Ubaiat SN, Jaffal NA, Alawna RK, Abed SN, Abuzahra BN, Abu Kwaik AJ, Dodin MH, Taha RO, Alashqar DM, Mobarak RAA, Smerat T, Albarqi SI, Abu-El-Noor N, Bottcher B. Barriers to Timely Seeking of Breast Cancer Care Among Palestinian Women: A Cross-Sectional Study. JCO Glob Oncol 2024; 10:e2300373. [PMID: 38386955 PMCID: PMC10898679 DOI: 10.1200/go.23.00373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 11/29/2023] [Indexed: 02/24/2024] Open
Abstract
PURPOSE Examining the association of breast cancer (BC) symptom awareness with time to help seeking and exploring barriers to timely presentation may enhance the effectiveness of BC awareness campaigns and early detection efforts. This study aimed to assess the anticipated time for seeking medical advice when experiencing a potential BC symptom among women in Palestine and to identify their barriers to early presentation. MATERIALS AND METHODS A convenience sampling method was used to recruit adult women from hospitals, primary health care facilities, and public areas across 11 governorates in Palestine. A translated-into-Arabic version of the validated BC Awareness Measure was used. The questionnaire consisted of three sections: sociodemographic information, recognition of 13 BC symptoms and reporting time for seeking medical advice, and barriers to early presentation. RESULTS A total of 5,257 questionnaires were included. The proportion of participants who would seek medical advice immediately varied on the basis of the nature of BC symptoms. For symptoms related to the breast, the proportion ranged from 25.7% for redness of the breast skin to 53.5% for a lump or thickening in the breast. For symptoms related to the nipple, the proportion ranged from 30.7% for nipple rash to 48.0% for discharge or bleeding from the nipple. Exhibiting good BC symptom awareness was associated with a higher likelihood of seeking medical advice within a week for all BC symptoms. Emotional barriers were the most frequently reported barriers. There was no association between increasing levels of BC awareness and reporting fewer or more barriers. CONCLUSION The nature of BC symptoms had an impact on help-seeking behaviors. Participants with good BC symptom awareness were more likely to seek medical advice earlier.
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Affiliation(s)
- Mohamedraed Elshami
- Division of Surgical Oncology, Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH
- Ministry of Health, Gaza, Palestine
| | - Malak Ayman Qawasmi
- Department of Medical Laboratory Sciences, Hebron University, Hebron, Palestine
| | | | | | - Mohammed Alser
- The United Nations Relief and Works Agency for Palestine Refugees in the Near East, Gaza, Palestine
| | | | | | | | | | | | | | - Manar Ahmaro
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | | | | | - Faten Darwish Usrof
- Faculty of Health Sciences Master of Medical Laboratory Sciences, Islamic University of Gaza, Gaza, Palestine
| | | | | | | | | | | | - Nour Ali Jaffal
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | | | | | | | | | | | | | | | - Tasneem Smerat
- Faculty of Medicine and Health Sciences, Palestine Polytechnic University, Hebron, Palestine
| | | | | | - Bettina Bottcher
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
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Tung WC, Chen Y. Breast Cancer Knowledge and Mammography Use Among Asian American Women Aged 40 and Older: Using the Transtheoretical Model Approach. J Immigr Minor Health 2024; 26:140-147. [PMID: 37556031 DOI: 10.1007/s10903-023-01529-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2023] [Indexed: 08/10/2023]
Abstract
Mammography screening rates remain low among Asian American women (AAW). The aims of our study were to: (a) assess breast cancer knowledge and mammography screening behaviors, and (b) identify the factors related to the transtheoretical model (TTM) stages of change in relation to mammography utilization among AAW aged 40 and older. Using a cross-sectional design, a convenience sample of 714 AAW completed a structured questionnaire in 2021. Participants demonstrated a moderate level of knowledge regarding breast cancer and mammography. Only 34.2% of the participants reported obtaining regular mammograms. The ordinal logistic regression indicated that age, birthplace, health perception, breast biopsy history, breast cancer knowledge, self-efficacy, and perceived barriers were correlated with TTM stages of change. Our results highlight the need for implementing effective interventions aimed at increasing knowledge and screening rates for breast cancer among AAW. Additional TTM studies with AAW are needed to determine the relationships among TTM constructs and develop theory-based programs to improve adherence to screening guidelines. Future research using a mixed-method design may provide opportunities to explore complex phenomena associated with breast cancer screening behaviors. Finally, further assessments of the Breast Cancer Knowledge Scale's psychometric properties are necessary to improve this instrument.
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Affiliation(s)
- Wei-Chen Tung
- The Valley Foundation School of Nursing, San Jose State University, One Washington Square, Health Building #403, San Jose, CA, 95192, USA.
| | - Yinghan Chen
- Department of Mathematics and Statistics, University of Nevada-Reno, Reno, NV, 89557, USA
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Fernandez G, Zeineh J, Prastawa M, Scott R, Madduri AS, Shtabsky A, Jaffer S, Feliz A, Veremis B, Mejias JC, Charytonowicz E, Gladoun N, Koll G, Cruz K, Malinowski D, Donovan MJ. Analytical Validation of the PreciseDx Digital Prognostic Breast Cancer Test in Early-Stage Breast Cancer. Clin Breast Cancer 2024; 24:93-102.e6. [PMID: 38114366 DOI: 10.1016/j.clbc.2023.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 10/19/2023] [Accepted: 10/29/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND PreciseDx Breast (PDxBr) is a digital test that predicts early-stage breast cancer recurrence within 6-years of diagnosis. MATERIALS AND METHODS Using hematoxylin and eosin-stained whole slide images of invasive breast cancer (IBC) and artificial intelligence-enabled morphology feature array, microanatomic features are generated. Morphometric attributes in combination with patient's age, tumor size, stage, and lymph node status predict disease free survival using a proprietary algorithm. Here, analytical validation of the automated annotation process and extracted histologic digital features of the PDxBr test, including impact of methodologic variability on the composite risk score is presented. Studies of precision, repeatability, reproducibility and interference were performed on morphology feature array-derived features. The final risk score was assessed over 20-days with 2-operators, 2-runs/day, and 2-replicates across 8-patients, allowing for calculation of within-run repeatability, between-run and within-laboratory reproducibility. RESULTS Analytical validation of features derived from whole slide images demonstrated a high degree of precision for tumor segmentation (0.98, 0.98), lymphocyte detection (0.91, 0.93), and mitotic figures (0.85, 0.84). Correlation of variation of the assay risk score for both reproducibility and repeatability were less than 2%, and interference from variation in hematoxylin and eosin staining or tumor thickness was not observed demonstrating assay robustness across standard histopathology preparations. CONCLUSION In summary, the analytical validation of the digital IBC risk assessment test demonstrated a strong performance across all features in the model and complimented the clinical validation of the assay previously shown to accurately predict recurrence within 6-years in early-stage invasive breast cancer patients.
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Affiliation(s)
- Gerardo Fernandez
- PreciseDx, New York, NY; Icahn School of Medicine at Mount Sinai, New York, NY
| | | | | | | | | | | | | | | | - Brandon Veremis
- PreciseDx, New York, NY; Icahn School of Medicine at Mount Sinai, New York, NY
| | | | | | - Nataliya Gladoun
- PreciseDx, New York, NY; Icahn School of Medicine at Mount Sinai, New York, NY
| | | | | | | | - Michael J Donovan
- PreciseDx, New York, NY; Icahn School of Medicine at Mount Sinai, New York, NY; University of Miami, Pathology, Miami, FL.
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Sakthivel R, Lin YC, Yu MC, Dhawan U, Liu X, Chen JC, Tung CW, Chung RJ. A sensitive sandwich-type electrochemical immunosensor using nitrogen-doped graphene/metal-organic framework-derived CuMnCoO x and Au/MXene for the detection of breast cancer biomarker. Colloids Surf B Biointerfaces 2024; 234:113755. [PMID: 38241894 DOI: 10.1016/j.colsurfb.2024.113755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 01/08/2024] [Accepted: 01/10/2024] [Indexed: 01/21/2024]
Abstract
In terms of cancer-related deaths among women, breast cancer (BC) is the most common. Clinically, human epidermal growth receptor 2 (HER2) is one of the most commonly used diagnostic biomarkers for facilitating BC cell proliferation and malignant growth. In this study, a disposable gold electrode (DGE) modified with gold nanoparticle-decorated Ti3C2Tx (Au/MXene) was utilized as a sensing platform to immobilize the capturing antibody (Ab1/Au/MXene). Subsequently, nitrogen-doped graphene (NG) with a metal-organic framework (MOF)-derived copper-manganese-cobalt oxide, tagged as NG/CuMnCoOx, was used as a probe to label the detection antibody (Ab2). A sandwich-type immunosensor (NG/CuMnCoOx/Ab2/HER2-ECD /Ab1/Au/MXene/DGE) was developed to quantify HER2-ECD. NG/CuMnCoOx enhances the conductivity, electrocatalytic active sites, and surface area to immobilize Ab2. In addition, Au/MXene facilitates electron transport and captures more Ab1 on its surface. Under optimal conditions, the resultant immunosensor displayed an excellent linear range of 0.0001 to 50.0 ng. mL-1. The detection limit was 0.757 pg·mL-1 with excellent selectivity, appreciable reproducibility, and high stability. Moreover, the applicability for determining HER2-ECD in human serum samples indicates its ability to monitor tumor markers clinically.
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Affiliation(s)
- Rajalakshmi Sakthivel
- Department of Chemical Engineering and Biotechnology, National Taipei University of Technology (Taipei Tech), Taipei, Taiwan
| | - Yu-Chien Lin
- Department of Chemical Engineering and Biotechnology, National Taipei University of Technology (Taipei Tech), Taipei, Taiwan; Institute of Biomedical Engineering, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
| | - Min-Chin Yu
- Department of Chemical Engineering and Biotechnology, National Taipei University of Technology (Taipei Tech), Taipei, Taiwan
| | - Udesh Dhawan
- Centre for the Cellular Microenvironment, Division of Biomedical Engineering, James Watt School of Engineering, Mazumdar-Shaw Advanced Research Centre, University of Glasgow, Glasgow, UK
| | - Xinke Liu
- College of Materials Science and Engineering, Chinese Engineering and Research Institute of Microelectronics, Shenzhen University, Shenzhen, China; Department of Electrical and Computer Engineering, National University of Singapore, Singapore
| | - Jung-Chih Chen
- Institute of Biomedical Engineering, National Yang Ming Chiao Tung University, Hsinchu, Taiwan; Department of Electronics and Electrical Engineering, National Yang Ming Chiao Tung University, Hsinchu, Taiwan; Catholic Mercy Hospital, Catholic Mercy Medical Foundation, Hsinchu, Taiwan; Medical Device Innovation & Translation Centre, National Yang Ming Chiao Tung University, Taipei, Taiwan.
| | - Ching-Wei Tung
- Department of Materials Engineering, Ming Chi University of Technology, New Taipei City, Taiwan.
| | - Ren-Jei Chung
- Department of Chemical Engineering and Biotechnology, National Taipei University of Technology (Taipei Tech), Taipei, Taiwan; High-value Biomaterials Research and Commercialization Center, National Taipei University of Technology (Taipei Tech), Taipei, Taiwan.
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238
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Gao D, Cui C, Jiao Y, Zhang H, Li M, Wang J, Sheng X. Circular RNA and its potential diagnostic and therapeutic values in breast cancer. Mol Biol Rep 2024; 51:258. [PMID: 38302635 DOI: 10.1007/s11033-023-09172-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 12/15/2023] [Indexed: 02/03/2024]
Abstract
Breast cancer (BC) is one of the most common malignant tumors in women and still poses a significant threat to women worldwide. Recurrence of BC in situ, metastasis to distant organs, and resistance to chemotherapy are all attached to high mortality in patients with BC. Non-coding RNA (ncRNA) of the type known as "circRNA" links together from one end to another to create a covalently closed, single-stranded circular molecule. With characteristics including plurality, evolutionary conservation, stability, and particularity, they are extensively prevalent in various species and a range of human cells. CircRNAs are new and significant contributors to several kinds of disorders, including cardiovascular disease, multiple organ inflammatory responses and malignancies. Recent studies have shown that circRNAs play crucial roles in the occurrence of breast cancer by interacting with miRNAs to regulate gene expression at the transcriptional or post-transcriptional levels. CircRNAs offer the potential to be therapeutic targets for breast cancer treatment as well as prospective biomarkers for early diagnosis and prognosis of BC. Here, we are about to present an overview of the functions of circRNAs in the proliferation, invasion, migration, and resistance to medicines of breast cancer cells and serve as a promising resource for future investigations on the pathogenesis and therapeutic strategies.
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Affiliation(s)
- Di Gao
- Department of Biochemistry and Molecular Biology, Jiangsu University School of Medicine, 301 Xuefu Road, Zhenjiang, 212013, Jiangsu, China
- Institute of Digestive Diseases, Jiangsu University, Zhenjiang, Jiangsu, China
| | - Can Cui
- Department of Biochemistry and Molecular Biology, Jiangsu University School of Medicine, 301 Xuefu Road, Zhenjiang, 212013, Jiangsu, China
| | - Yaoxuan Jiao
- Department of Biochemistry and Molecular Biology, Jiangsu University School of Medicine, 301 Xuefu Road, Zhenjiang, 212013, Jiangsu, China
| | - Han Zhang
- Department of Biochemistry and Molecular Biology, Jiangsu University School of Medicine, 301 Xuefu Road, Zhenjiang, 212013, Jiangsu, China
| | - Min Li
- Department of Biochemistry and Molecular Biology, Jiangsu University School of Medicine, 301 Xuefu Road, Zhenjiang, 212013, Jiangsu, China
| | - Junjie Wang
- Department of Pathophysiology, Jiangsu University School of Medicine, Zhenjiang, 212013, Jiangsu, China
| | - Xiumei Sheng
- Department of Biochemistry and Molecular Biology, Jiangsu University School of Medicine, 301 Xuefu Road, Zhenjiang, 212013, Jiangsu, China.
- Institute of Digestive Diseases, Jiangsu University, Zhenjiang, Jiangsu, China.
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Bosompem K, Yorke J, Buckman TA, Brenu SG, Nyantakyi M, Aitpillah FSK, Kyei I, Adinku MO, Yorke DA, Obirikorang C, Acheampong E. Comparative analysis of breast cancer characteristics in young premenopausal and postmenopausal women in Ghana. Sci Rep 2024; 14:2704. [PMID: 38302488 PMCID: PMC10834954 DOI: 10.1038/s41598-024-52129-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 01/14/2024] [Indexed: 02/03/2024] Open
Abstract
Breast cancer is increasingly common among young women in Ghana. BCa is heterogeneous with unique traits that impact causes, prognostic, and predictive outcomes of patients before and after menopause. However, limited evidence exists on differences between young premenopausal (YPM) and postmenopausal cases in Ghana. This study compared breast tumour characteristics between YPM women (under 35 years) and postmenopausal women. We conducted a prospective cross-sectional study involving 140 BCa-diagnosed women at the Breast Care Clinic of Komfo Anokye Teaching Hospital (KATH), Kumasi from November 2019 to June 2021. Thirty-one (22.1%) of participants were YPM and 109 (77.9%) were postmenopausal. The median ages for YPM and postmenopausal were 32.0 (range: 25.0-35.0) and 57.0 (48.0-86.0) respectively. Invasive carcinoma was the most common histological type (97.1%). Left tumour location was the most frequent in both groups (51.6% for YPM and 51.8% for postmenopausal). Lumps detected were frequently in the outer upper quadrant in both groups (61.3% and 56.0%). The majority of the YPM women (80.7%) and postmenopausal women (87.0%) had stage III and IV diseases. Most YPM (64.5%) and postmenopausal women (64.4%) exhibited triple-negative breast cancer (TNBC). Both YPM 13 (56.6%) and postmenopausal participants 40 (56.3%) exhibited a predominantly partial response to neo-adjuvant chemotherapy but YPM women (21.7%) experienced disease progression than the postmenopausal women (12.7%). The study highlights consistent tumour characteristics and advanced clinical stages at diagnosis in both groups with a higher prevalence of TNBC. TNBC and HER2+ subtypes respond better to Anthracycline-based neoadjuvant chemotherapy. Establishing Breast Care Clinics in district and regional hospitals for early detection is crucial and further studies are warranted to understand the higher TNBC prevalence in black Africans and re-evaluate breast education programs to address the persistently late presentations.
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Affiliation(s)
- Kingsley Bosompem
- Directorate of Surgery, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Joseph Yorke
- Department of Surgery, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | | | - Michael Nyantakyi
- Department of Medical Diagnostics, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Francis Somiah-Kwaw Aitpillah
- Directorate of Surgery, Komfo Anokye Teaching Hospital, Kumasi, Ghana
- Department of Surgery, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Ishmael Kyei
- Department of Surgery, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | | | - Christian Obirikorang
- Department of Molecular Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Emmanuel Acheampong
- Department of Molecular Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
- Leicester Cancer Research Centre, Department of Genetic and Genome Biology, University of Leicester, Leicester, LE1 7RH, UK.
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240
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Retell JD, Cameron JK, Aitken JF, Youl P, Pyke C, Dunn J, Chambers S, Baade PD. Individual and area level factors associated with the breast cancer diagnostic-treatment interval in Queensland, Australia. Breast Cancer Res Treat 2024; 203:575-586. [PMID: 37930491 PMCID: PMC10805972 DOI: 10.1007/s10549-023-07134-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 09/22/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND Delays to breast cancer treatment can lead to more aggressive and extensive treatments, increased expenses, increased psychological distress, and poorer survival. We explored the individual and area level factors associated with the interval between diagnosis and first treatment in a population-based cohort in Queensland, Australia. METHODS Data from 3216 Queensland women aged 20 to 79, diagnosed with invasive breast cancer (ICD-O-3 C50) between March 2010 and June 2013 were analysed. Diagnostic dates were sourced from the Queensland Cancer Registry and treatment dates were collected via self-report. Diagnostics-treatment intervals were modelled using flexible parametric survival methods. RESULTS The median interval between breast cancer diagnosis and first treatment was 15 days, with an interquartile range of 9-26 days. Longer diagnostic-treatment intervals were associated with a lack of private health coverage, lower pre-diagnostic income, first treatments other than breast conserving surgery, and residence outside a major city. The model explained a modest 13.7% of the variance in the diagnostic-treatment interval [Formula: see text]. Sauerbrei's D was 0.82, demonstrating low to moderate discrimination performance. CONCLUSION Whilst this study identified several individual- and area-level factors associated with the time between breast cancer diagnosis and first treatment, much of the variation remained unexplained. Increased socioeconomic disadvantage appears to predict longer diagnostic-treatment intervals. Though some of the differences are small, many of the same factors have also been linked to screening and diagnostic delay. Given the potential for accumulation of delay at multiple stages along the diagnostic and treatment pathway, identifying and applying effective strategies address barriers to timely health care faced by socioeconomically disadvantaged women remains a priority.
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Affiliation(s)
- James D Retell
- Viertel Cancer Research Centre, Cancer Council Queensland, Brisbane, QLD, Australia
| | - Jessica K Cameron
- Viertel Cancer Research Centre, Cancer Council Queensland, Brisbane, QLD, Australia
- School of Mathematical Sciences, Queensland University of Technology, Brisbane, QLD, Australia
| | - Joanne F Aitken
- Viertel Cancer Research Centre, Cancer Council Queensland, Brisbane, QLD, Australia
- School of Public Health, University of Queensland, Brisbane, QLD, Australia
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia
- Institute for Resilient Regions, University of Southern Queensland, Brisbane, QLD, Australia
| | - Philippa Youl
- Cancer Alliance Queensland, Metro South Hospital and Health Service, Woolloongabba, QLD, Australia
| | - Chris Pyke
- Mater Hospital, Brisbane, QLD, Australia
| | - Jeff Dunn
- Prostate Cancer Foundation of Australia, Sydney, NSW, Australia
| | - Suzanne Chambers
- Faculty of Health Sciences, Australian Catholic University, Sydney, NSW, Australia
| | - Peter D Baade
- Viertel Cancer Research Centre, Cancer Council Queensland, Brisbane, QLD, Australia.
- Menzies Health Institute Queensland, Griffith University, Southport, QLD, Australia.
- School of Mathematical Sciences, Queensland University of Technology, Brisbane, QLD, Australia.
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241
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Krueger L. Employing a Risk Assessment Tool for Shared Decision-Making in Breast Cancer Screening. Creat Nurs 2024; 30:21-28. [PMID: 38321828 DOI: 10.1177/10784535241228582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
Background: The existing guidelines for breast cancer screening incorporate assessing individual risk but contain no universally recommended risk assessment tool in the primary care setting. Local Problem: A family planning program utilizing nurses and nurse practitioners for assessment, education, and referral lacked a risk assessment tool for assessing breast cancer risk. Methods: A breast cancer risk assessment tool was implemented in practice. Interventions: The interventions involved assessing the patient's risks, providing education on risk reduction strategies, and determining the need for clinical breast exams and referrals for mammography. Results: The study demonstrated a clear correlation between the number of breast cancer risks identified and the extent of education provided to patients based on their specific risk profiles (0 vs. 1.5 risks; 2 vs. 4.6 educational components). Among patients under age 35, 80% opted for a clinical breast exam, while 100% of patients age 40 and above agreed to both clinical breast exams and referrals for mammography after discussing individual risks. Conclusions: The use of a breast cancer risk assessment tool provided an evidence-based foundation for the shared decision-making conversation between patient and nurse/provider on risk reduction. The discussion included current evidence on the risk versus benefit of age-based screening options for breast cancer, allowing for an informed decision made jointly between the patient and provider.
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Xiao Y, Hu G, Xie N, Yin L, Pan Y, Liu C, Lou S, Zhu C. Development of a novel prognostic signature based on single-cell combined bulk RNA analysis in breast cancer. J Gene Med 2024; 26:e3673. [PMID: 38404059 DOI: 10.1002/jgm.3673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 12/16/2023] [Accepted: 01/26/2024] [Indexed: 02/27/2024] Open
Abstract
BACKGROUND Breast cancer (BC), a malignant tumor, is a significant cause of death and disability among women globally. Recent research indicates that copy number variation plays a crucial role in tumor development. In this study, we employed the Single-Cell Variational Aneuploidy Analysis (SCEVAN) algorithm to differentiate between malignant and non-malignant cells, aiming to identify genetic signatures with prognostic relevance for predicting patient survival. METHODS We analyzed gene expression profiles and associated clinical data from the Gene Expression Omnibus (GEO) and The Cancer Genome Atlas (TCGA) databases. Using the SCEVAN algorithm, we distinguished malignant from non-malignant cells and investigated cellular interactions within the tumor microenvironment (TME). We categorized TCGA samples based on differentially expressed genes (DEGs) between these cell types. Subsequent Kyoto Encyclopedia of Genes and Genomes pathway analysis was conducted. Additionally, we developed polygenic models for the DEGs using least absolute shrinkage and selection operator-penalized Cox regression analysis. To assess the prognostic accuracy of these characteristics, we generated Kaplan-Meier and receiver operating characteristic curves from training and validation datasets. We also monitored the expression variations of prognostic genes across the pseudotime of malignant cells. Patients were divided into high-risk and low-risk groups based on median risk scores to compare their TME and identify potential therapeutic agents. Lastly, polymerase chain reaction was used to validate seven pivotal genes. RESULTS The SCEVAN algorithm identified distinct malignant and non-malignant cells in GSE180286. Cellchat analysis revealed significantly increased cellular communication, particularly between fibroblasts, endothelial cells and malignant cells. The DEGs were predominantly involved in immune-related pathways. TCGA samples were classified into clusters A and B based on these genes. Cluster A, enriched in immune pathways, was associated with poorer prognosis, whereas cluster B, predominantly involved in circadian rhythm pathways, showed better outcomes. We constructed a 14-gene prognostic signature, validated in a 1:1 internal TCGA cohort and external GEO datasets (GSE42568 and GSE146558). Kaplan-Meier analysis confirmed the prognostic signature's accuracy (p < 0.001). Receiver operating characteristic curve analysis demonstrated the predictive reliability of these prognostic features. Single-cell pseudotime analysis with monocle2 highlighted the distinct expression trends of these genes in malignant cells, underscoring the intratumoral heterogeneity. Furthermore, we explored the differences in TME between high- and low-risk groups and identified 16 significantly correlated drugs. CONCLUSION Our findings suggest that the 14-gene prognostic signature could serve as a novel biomarker for forecasting the prognosis of BC patients. Additionally, the immune cells and pathways in different risk groups indicate that immunotherapy may be a crucial component of treatment strategies for BC patients.
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Affiliation(s)
- Ying Xiao
- Department of Emergency, Nanjing Jiangning Hospital, Nanjing, Jiangsu, China
| | - Ge Hu
- Hefei Cancer Hospital, Anhui Province Key Laboratory of Medical Physics and Technology, Institute of Health and Medical Technology, Institutes of Physical Science, Chinese Academy of Sciences, Hefei, China
| | - Ning Xie
- Department of Emergency, Nanjing Jiangning Hospital, Nanjing, Jiangsu, China
| | - Liang Yin
- Department of Breast Surgery, Affiliated People's Hospital of Jiangsu University, Zhenjiang, China
| | - Yaqiang Pan
- Department of Breast Surgery, Affiliated People's Hospital of Jiangsu University, Zhenjiang, China
| | - Cong Liu
- Department of Emergency, Nanjing Jiangning Hospital, Nanjing, Jiangsu, China
| | - Shihan Lou
- Department of Emergency, Nanjing Jiangning Hospital, Nanjing, Jiangsu, China
| | - Cunzhi Zhu
- Department of Emergency, Nanjing Tianyinshan Hospital & The First Affiliated Hospital of China Pharmaceutical University, Nanjing, Jiangsu, China
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243
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The 7(th) Symposium on Primary Breast Cancer in Older Women. Future Oncol 2024; 20:1-22. [PMID: 38421611 DOI: 10.2217/fon-2024-0144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024] Open
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244
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Li C, Wang Y, Liu M, Qu J, Zhang S. Time for detailed clinical management of Paget's disease of the breast. Int J Surg 2024; 110:1266-1267. [PMID: 37889547 PMCID: PMC10871616 DOI: 10.1097/js9.0000000000000855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 10/09/2023] [Indexed: 10/28/2023]
Affiliation(s)
| | - Yusheng Wang
- Department of Otolaryngology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
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Price MD, Rositch AF, Dedey F, Mali ME, Brownson KE, Nsaful J, Tounkara M, Price RR, Sutherland EK. Availability and Geographic Access to Hospital-Based Breast Cancer Diagnostic Services in Ghana. JCO Glob Oncol 2024; 10:e2300231. [PMID: 38330275 PMCID: PMC10860977 DOI: 10.1200/go.23.00231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 11/10/2023] [Accepted: 12/01/2023] [Indexed: 02/10/2024] Open
Abstract
PURPOSE Breast cancer is the most frequent cancer and second most common cause of cancer-related death in Ghana. Early detection and access to diagnostic services are vital for early treatment initiation and improved survival. This study characterizes the geographic access to hospital-based breast cancer diagnostic services in Ghana as a framework for expansion. METHODS A cross-sectional hospital-based survey was completed in Ghana from November 2020 to October 2021. Early diagnostic services, as defined by the National Comprehensive Cancer Network (NCCN) Framework for Resource Stratification, was assessed at each hospital. Services were characterized as available >80% of the time in the previous year, <80%, or not available. ArcGIS was used to identify the proportion of the population within 20 and 45 km of services. RESULTS Most hospitals in Ghana participated in this survey (95%; 328 of 346). Of these, 12 met full NCCN Basic criteria >80% of the time, with 43% of the population living within 45 km. Ten of the 12 met full NCCN Core criteria, and none met full NCCN Enhanced criteria. An additional 12 hospitals were identified that provide the majority of NCCN Basic services but lack select services necessary to meet this criterion. Expansion of services in these hospitals could result in an additional 20% of the population having access to NCCN Basic-level early diagnostic services within 45 km. CONCLUSION Hospital-based services for breast cancer early diagnosis in Ghana are available but sparse. Many hospitals offer fragmented aspects of care, but only a limited number of hospitals offer the full NCCN Basic or Core level of care. Understanding current availability and geographical distribution of services provides a framework for potential targeted expansion of services.
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Affiliation(s)
- Matthew D. Price
- Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD
- The University of Utah, Center for Global Surgery, Salt Lake City, UT
| | - Anne F. Rositch
- Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | | | - Meghan E. Mali
- The University of Utah, Center for Global Surgery, Salt Lake City, UT
- Department of Surgery, The University of Utah, Salt Lake City, UT
| | - Kirstyn E. Brownson
- The University of Utah, Center for Global Surgery, Salt Lake City, UT
- Department of Surgery, The University of Utah, Salt Lake City, UT
- Huntsman Cancer Institute, Salt Lake City, UT
| | | | - Mamadou Tounkara
- The University of Utah, Center for Global Surgery, Salt Lake City, UT
| | - Raymond R. Price
- The University of Utah, Center for Global Surgery, Salt Lake City, UT
- Department of Surgery, The University of Utah, Salt Lake City, UT
- Intermountain Healthcare, Salt Lake City, UT
| | - Edward Kofi Sutherland
- Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- The University of Utah, Center for Global Surgery, Salt Lake City, UT
- Ensign Global College Ghana, Kpong, Ghana
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246
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Sallout L, Tashkandi M, Moqnas A, AlMajed H, Al-Naeem A, Alwelaie Y. Fine-needle aspiration biopsy of axillary lymph nodes: A reliable diagnostic tool for breast cancer staging. Cancer Cytopathol 2024; 132:103-108. [PMID: 37843531 DOI: 10.1002/cncy.22770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 09/09/2023] [Accepted: 09/11/2023] [Indexed: 10/17/2023]
Abstract
BACKGROUND Pathologic evaluation of sentinel lymph node biopsy (SLNB) samples is crucial for axillary staging in patients newly diagnosed with breast cancer. Patients with pathologic evidence of nodal metastasis scheduled for upfront surgery typically also undergo axillary lymph node dissection (ALND). Although SLNB is the gold standard method for detecting nodal metastasis, axillary lymph node fine-needle aspiration biopsy (FNAB) utility has not been thoroughly explored. METHODS Ultrasound-guided axillary lymph node FNAB samples along with concurrent ipsilateral breast tissue samples were searched and reviewed. The control group included histologic findings of axillary dissection or intraoperative SLNB results. RESULTS A total of 354 axillary lymph node FNAB samples with matched histology were included. Of these, 187 (52.8%) were positive for metastatic carcinoma of breast origin; 143 (40.4%) were negative for metastasis; 12 (3.4%) showed atypical cells; six (1.7%) were suspicious for metastasis; and six (1.7%) were nondiagnostic because of a lack of lymphoid tissue and malignant cells. Of the 143 negative FNAB samples, 22 (15.4%) were positive on either intraoperative SLNB or ALND. When only the positive and negative FNAB samples were accounted for (n = 330; 93.2%), overall diagnostic sensitivity and specificity were 89.4% and 99.2%, respectively. CONCLUSIONS Although axillary SLNB is the standard procedure for detecting nodal metastasis of breast origin, axillary lymph node FNAB appears to be a suitable alternative in a significant proportion of patients. A standard SLNB should be performed in cases of negative axillary lymph node FNAB findings, particularly nodes with abnormal imaging findings.
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Affiliation(s)
- Luai Sallout
- Department of Pathology and Laboratory Medicine, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Mohamed Tashkandi
- Department of Pathology and Laboratory Medicine, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Amani Moqnas
- Department of Pathology and Laboratory Medicine, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Hebah AlMajed
- Department of Pathology and Laboratory Medicine, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Abdulrhman Al-Naeem
- Breast Imaging Department, Medical Imaging Administration, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Yazeed Alwelaie
- Department of Pathology and Laboratory Medicine, King Fahad Medical City, Riyadh, Saudi Arabia
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247
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Khan MMM, Waqar U, Munir MM, Woldesenbet S, Mavani P, Endo Y, Katayama E, Rawicz-Pruszyński K, Agnese DM, Obeng-Gyasi S, Pawlik TM. Disparities in Breast Cancer Screening Rates Among Adults With and Without Intellectual and Developmental Disabilities. Ann Surg Oncol 2024; 31:911-919. [PMID: 37857986 DOI: 10.1245/s10434-023-14425-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 09/26/2023] [Indexed: 10/21/2023]
Abstract
BACKGROUND Individuals with intellectual and developmental disabilities may face barriers in accessing healthcare, including cancer screening and detection services. We sought to assess the association of intellectual and developmental disabilities (IDD) with breast cancer screening rates. METHODS Data from 2018 to 2020 was used to identify screening-eligible individuals from Medicare Standard Analytic Files. Adults aged 65-79 years who did not have a previous diagnosis of breast cancer were included. Multivariable regression was used to analyze the differences in breast cancer screening rates among individuals with and without IDD. RESULTS Among 9,383,349 Medicare beneficiaries, 11,265 (0.1%) individuals met the criteria for IDD. Of note, individuals with IDD were more likely to be non-Hispanic White (90.5% vs. 87.3%), have a Charlson Comorbidity Index score ≤ 2 (66.2% vs. 85.5%), and reside in a low social vulnerability index neighborhood (35.7% vs. 34.4%). IDD was associated with reduced odds of undergoing breast cancer screening (odds ratio (OR) 0.77, 95% confidence interval (CI) 0.74-0.80; p < 0.001). Breast cancer screening rates in individuals with IDD were further influenced by social vulnerability and belonging to a racial/ethnic minority. CONCLUSIONS Individuals with IDD may face additional barriers to breast cancer screening. The combination of IDD and social vulnerability placed patients at particularly high risk of not being screened for breast cancer.
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Affiliation(s)
- Muhammad Muntazir Mehdi Khan
- Division of Surgical Oncology, Department of Surgery, The Urban Meyer III and Shelley Meyer Chair for Cancer Research, The Ohio State University, Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA
| | - Usama Waqar
- Division of Surgical Oncology, Department of Surgery, The Urban Meyer III and Shelley Meyer Chair for Cancer Research, The Ohio State University, Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA
- Medical College, Aga Khan University, Karachi, Pakistan
| | - Muhammad Musaab Munir
- Division of Surgical Oncology, Department of Surgery, The Urban Meyer III and Shelley Meyer Chair for Cancer Research, The Ohio State University, Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA
| | - Selamawit Woldesenbet
- Division of Surgical Oncology, Department of Surgery, The Urban Meyer III and Shelley Meyer Chair for Cancer Research, The Ohio State University, Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA
| | - Parit Mavani
- Division of Surgical Oncology, Department of Surgery, The Urban Meyer III and Shelley Meyer Chair for Cancer Research, The Ohio State University, Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA
| | - Yutaka Endo
- Division of Surgical Oncology, Department of Surgery, The Urban Meyer III and Shelley Meyer Chair for Cancer Research, The Ohio State University, Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA
| | - Erryk Katayama
- Division of Surgical Oncology, Department of Surgery, The Urban Meyer III and Shelley Meyer Chair for Cancer Research, The Ohio State University, Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA
| | - Karol Rawicz-Pruszyński
- Division of Surgical Oncology, Department of Surgery, The Urban Meyer III and Shelley Meyer Chair for Cancer Research, The Ohio State University, Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA
- Department of Surgical Oncology, Medical University of Lublin, Lublin, Poland
| | - Doreen M Agnese
- Division of Surgical Oncology, Department of Surgery, The Urban Meyer III and Shelley Meyer Chair for Cancer Research, The Ohio State University, Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA
| | - Samilia Obeng-Gyasi
- Division of Surgical Oncology, Department of Surgery, The Urban Meyer III and Shelley Meyer Chair for Cancer Research, The Ohio State University, Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA
| | - Timothy M Pawlik
- Division of Surgical Oncology, Department of Surgery, The Urban Meyer III and Shelley Meyer Chair for Cancer Research, The Ohio State University, Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA.
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248
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Carroll BR, Zheng Y, Ruddy KJ, Emmons KM, Partridge AH, Rosenberg SM. Satisfaction with Care and Attention to Age-Specific Concerns by Race and Ethnicity in a National Sample of Young Women with Breast Cancer. J Adolesc Young Adult Oncol 2024; 13:105-111. [PMID: 37594766 PMCID: PMC10877381 DOI: 10.1089/jayao.2023.0068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/19/2023] Open
Abstract
Purpose: In light of disparities in breast cancer care and outcomes, we explored whether attention to fertility, genetic, and emotional health concerns, as well as satisfaction with care, differs by race/ethnicity among young breast cancer patients. Methods: The Young and Strong Study was a cluster randomized trial of an intervention for patients and providers at 54 U.S. oncology practices enrolling women diagnosed with breast cancer at ≤45 years of age. Provider attention to fertility, genetics, and emotional health was evaluated by medical record review. The proportions of patients with attention to these concerns were compared by race/ethnicity (Hispanic, non-Hispanic Black [NHB], Asian, non-Hispanic White [NHW], or multiracial/other). Satisfaction with care was assessed with the Patient Satisfaction Questionnaire-18 (PSQ-18) at 3 months, with median scores for each of 7 PSQ-18 subscales (general satisfaction, interpersonal manner, communication, financial, time spent with doctor, accessibility, and technical quality) compared by race/ethnicity. Results: Among 465 patients, median age at diagnosis was 40; 6% were Hispanic, 11% NHB, 4% were Asian, 75% NHW, and 3% multiracial/other. Provider attention to genetics, emotional health, and fertility did not differ by race/ethnicity. Median PSQ-18 scores did not differ by race/ethnicity, with median subscale scores ranging from 3.0 to 4.5 across groups, indicating high levels of satisfaction. Conclusion: Satisfaction with care and provider attention to age-specific concerns were similar across racial/ethnic groups among young patients enrolled in an educational and supportive care intervention study. These data suggest that high-quality, equitable care is feasible. Further care delivery research is warranted in more diverse patient and practice settings. Clinical Trial Registration number: NCT01647607.
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Affiliation(s)
- Bridget Rose Carroll
- Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
- Breast Oncology Program, Dana-Farber Brigham Cancer Center, Boston, Massachusetts, USA
| | - Yue Zheng
- Data Science, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | | | - Karen M. Emmons
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Ann H. Partridge
- Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
- Breast Oncology Program, Dana-Farber Brigham Cancer Center, Boston, Massachusetts, USA
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Shoshana M. Rosenberg
- Department of Population Health Sciences, Weill Cornell Medicine, New York, New York, USA
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249
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Dalton JC, Chiba A, Plichta JK. The Evolving Era of Breast Cancer Risk Assessment in Benign Breast Disease. JAMA Surg 2024; 159:201-202. [PMID: 38091019 DOI: 10.1001/jamasurg.2023.6389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Affiliation(s)
- Juliet C Dalton
- Department of Surgery, Duke University Medical Center, Durham, North Carolina
| | - Akiko Chiba
- Department of Surgery, Duke University Medical Center, Durham, North Carolina
- Duke Cancer Institute, Duke University, Durham, North Carolina
| | - Jennifer K Plichta
- Department of Surgery, Duke University Medical Center, Durham, North Carolina
- Duke Cancer Institute, Duke University, Durham, North Carolina
- Department of Population Health Sciences, Duke University Medical Center, Durham, North Carolina
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250
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Shaughnessy AF. The Risk of Breast Cancer Overdiagnosis Is High in Older Women. Am Fam Physician 2024; 109:Online. [PMID: 38393810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2024]
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