Study on mouse model of triple-negative breast cancer: association between higher parity and triple-negative breast cancer

Controlled ovarian hyperstimulation for fertility preservation in women with breast cancer: Practical issues

In Korean women, a westernized lifestyle is associated with an increased risk of breast cancer. Fertility preservation has become an increasingly important issue for women with breast cancer, in accordance with substantial improvements in survival rate after cancer treatment. The methods of controlled ovarian hyperstimulation (COH) for fertility preservation in breast cancer patients have been modified to include aromatase inhibitors to reduce the potential harm associated with increased estradiol levels. Random-start COH and dual ovarian stimulation are feasible options to reduce the total duration of fertility preservation treatment and to efficiently collect oocytes or embryos. Using a gonadotropin-releasing hormone agonist as a trigger may improve cycle outcomes in breast cancer patients undergoing COH for fertility preservation. In young breast cancer patients with BRCA mutations, especially BRCA1 mutations, the possibility of diminished ovarian reserve may be considered, although further studies are necessary. Herein, we review the current literature on the practical issues surrounding COH for fertility preservation in women with breast cancer.

Long-Term Safety of Letrozole and Gonadotropin Stimulation for Fertility Preservation in Women With Breast Cancer

CONTEXT AND OBJECTIVE

There has been increased attention to the issue of fertility preservation (FP). We aimed to investigate the long-term safety of FP via controlled ovarian stimulation with letrozole supplementation (COSTLES) prior to breast cancer treatment.

DESIGN, SETTING, AND PARTICIPANTS

This is a prospective, nonrandomized, controlled study conducted between the years 2002 and 2014. A total of 337 women diagnosed with stage 3 or less invasive breast cancer were enrolled during a FP consultation before chemotherapy. Of those, 120 elected to undergo COSTLES for FP prior to chemotherapy (FP group). The remaining 217 patients did not undergo any FP procedure and served as the controls.

MAIN OUTCOME MEASURE

The primary end point was cancer recurrence defined as the detection of locoregional tumor (chest wall, regional nodal disease), distant metastases, or contralateral invasive breast cancer.

RESULTS

The baseline characteristics at enrollment were similar between the FP and control groups except for the less frequent lymph node involvement (P = .02) in the former. The mean follow-up after diagnosis was 5.0 years in the FP group and 6.9 years in the control group. In the FP group, the hazard ratio for recurrence after ovarian stimulation was 0.77 (95% confidence interval 0.28–2.13), and the survival was not compromised compared with controls (P = .61). Neither BRCA gene mutation status (P = .57) nor undergoing FP before or after breast surgery (P = .44) affected survival outcomes in the FP group. Likewise, none of the tumor characteristics including the estrogen receptor status affected the survival rates after the COSTLES.

CONCLUSIONS

COSTLES is unlikely to cause a substantially increased recurrence risk in breast cancer during the 5 years after diagnosis.

Evaluation of apoptosis-associated protein (Bcl-2, Bax, cleaved caspase-3 and p53) expression in canine mammary tumors: An immunohistochemical and prognostic study

Apoptosis is an important process involved in pathogenesis and progression of neoplasia. However, it has been not so far extensively investigated in canine mammary tumors (CMTs). Therefore the aim of our study was to determine Bcl-2, Bax, cleaved caspase-3 (CC3) and p53 expression in CMTs and evaluate their correlation with host/tumor factors, and overall survival (OS). Bcl-2 expression was often found in benign lesions and in patients with low TNM stage. Expression of Bax, CC3 and p53 was observed in malignant CMTs. The expression of apoptosis-associated proteins was not significantly associated with OS. A positive-p53 status was significantly related with poorer tumor differentiation, higher mitotic index (MI), more invasive growth, necrosis, and occurred often in CMTs from large breed dogs. In the shorter-survival group of dogs (≤18 months), a positive correlation was found between CC3 and Bcl-2 expression; CC3 and MI, ERα and p53 expression, while in the longer-survival group (>18 months) CC3 expression was negatively correlated with ERα, whereas p53 expression was positively correlated with MI. We confirmed the usefulness of such parameters as: tumor size, MI, type of growth, tumor metastasis and TNM stage in predicting OS in a univariate analysis. In multivariate analysis we identified age as an independent prognostic factor for OS. Expression of single apoptosis-associated protein should not be used as a prognostic marker. However, we showed significant correlation patterns of expression of proteins involved in apoptotic-signaling pathways in shorter- and longer survival groups. So far, there have been only a few similar reports published.