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Badu-Peprah A, Otoo OK, Amamoo M, Quarshie F, Adomako B. Breast imaging reporting and data system for sonography: Positive and negative predictive values of sonographic features in Kumasi, Ghana. Transl Oncol 2024; 45:101976. [PMID: 38697004 PMCID: PMC11070917 DOI: 10.1016/j.tranon.2024.101976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 04/15/2024] [Accepted: 04/27/2024] [Indexed: 05/04/2024] Open
Abstract
BACKGROUND Breast cancer is the most common female cancer globally. The method of choice for screening and diagnosing breast cancer is mammography, which is not widely available in Ghana as compared to ultrasonography. This study aimed to evaluate the sonographic features of solid breast lesions using the new sonographic Breast Imaging- Reporting and Data System (BI-RADS-US) lexicon for malignancy with histopathology as the gold standard. METHODS This was a prospective quantitative study that sonographically scanned female patients with breast masses and consecutively selected cases recommended for core biopsy from May 2018 to May 2021. Sixty (60) solid breast masses were described using the sonographic BI-RADS lexicon features. Lesion description and biopsy results from histopathology were compared and analyzed using Pearson's Chi-square test. Odds ratios, sensitivity, specificity, and predictive values were also calculated. Statistical significance level was set at p ≤ 0.05. RESULTS Irregular shape (p < 0.0001), spiculated mass margins (p < 0.0001), and not parallel mass orientation (p= 0.0007) were more commonly associated with malignant masses. The sensitivity of breast ultrasound for malignancy was 93.9 % and the specificity was 55.6 % with an overall accuracy rate of 76.6 %. The negative predictive value was 88.7 % and the positive predictive value was 72.1 %. Descriptors like irregular shape, non-parallel orientation, angular and spiculated margins, echogenic halo, and markedly hypoechoic internal content, demonstrated higher odds ratios for malignancy. CONCLUSIONS This study adds valuable insights to the diagnosis of breast cancer using the sonographic BI-RADS lexicon features. The results demonstrate that specific sonographic descriptors can effectively differentiate between benign and malignant breast masses.
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Affiliation(s)
- Augustina Badu-Peprah
- Radiology Directorate, Komfo Anokye Teaching Hospital, Kumasi, Ghana; Radiology Department, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - Obed Kojo Otoo
- Radiology Directorate, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Mansa Amamoo
- Radiology Directorate, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Frank Quarshie
- Research Directorate, Klintaps College of Health and Allied Sciences, Klagon-Tema,Ghana
| | - Benjamin Adomako
- Research and Development Unit, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Record SM, Thomas SM, Ntowe K, Chiba A, Plichta JK. BRCA1/2 mutation carriers & risk reducing mastectomy: Who undergoes surgery and potential benefits. Am J Surg 2024; 227:146-152. [PMID: 37827871 PMCID: PMC10842097 DOI: 10.1016/j.amjsurg.2023.10.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/29/2023] [Accepted: 10/02/2023] [Indexed: 10/14/2023]
Abstract
BACKGROUND Risk-reducing mastectomy (RRM) is the most effective breast cancer risk-reduction strategy in BRCA1/2 mutation carriers. We examined factors associated with RRM and its relationship with overall survival (OS). METHODS Patients aged 18-80y at diagnosis of their BRCA1/2 mutation were selected from our institutional database and stratified by RRM receipt. Differences were tested; unadjusted OS was estimated. RESULTS Of the 306 patients, median age was 43y; median follow-up was 41.6mo. Patients undergoing RRM were more often married with a history of pregnancy (both p ≤ 0.05). Of female patients, 23.1% underwent RRM. Two patients had malignancy detected at RRM, and one developed breast cancer after RRM. Higher unadjusted OS was observed with RRM (p = 0.02). CONCLUSIONS Our analyses suggest that family-structure may play a role in a patient's decision to undergo RRM. We also demonstrated RRM is likely associated with improved survival, potentially underscoring the importance of this option for BRCA1/2 mutation carriers.
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Affiliation(s)
- Sydney M Record
- Department of Surgery, Duke University Medical Center, Durham, NC, USA
| | - Samantha M Thomas
- Duke Cancer Institute, Duke University, Durham, NC, USA; Biostatistics and Bioinformatics, Duke University, Durham, NC, USA
| | - Koumani Ntowe
- Department of Surgery, Duke University Medical Center, Durham, NC, USA
| | - Akiko Chiba
- Department of Surgery, Duke University Medical Center, Durham, NC, USA; Duke Cancer Institute, Duke University, Durham, NC, USA
| | - Jennifer K Plichta
- Department of Surgery, Duke University Medical Center, Durham, NC, USA; Duke Cancer Institute, Duke University, Durham, NC, USA; Department of Population Health Sciences, Duke University Medical Center, Durham, NC, USA.
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3
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Lee BJH, Yap QV, Low JK, Chan YH, Shelat VG. Cholecystectomy for asymptomatic gallstones: Markov decision tree analysis. World J Clin Cases 2022; 10:10399-10412. [PMID: 36312509 PMCID: PMC9602237 DOI: 10.12998/wjcc.v10.i29.10399] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 05/13/2022] [Accepted: 09/01/2022] [Indexed: 02/05/2023] Open
Abstract
Gallstones are a common public health problem, especially in developed countries. There are an increasing number of patients who are diagnosed with gallstones due to increasing awareness and liberal use of imaging, with 22.6%-80% of gallstone patients being asymptomatic at the time of diagnosis. Despite being asymptomatic, this group of patients are still at life-long risk of developing symptoms and complications such as acute cholangitis and acute biliary pancreatitis. Hence, while early prophylactic cholecystectomy may have some benefits in selected groups of patients, the current standard practice is to recommend cholecystectomy only after symptoms or complications occur. After reviewing the current evidence about the natural course of asymptomatic gallstones, complications of cholecystectomy, quality of life outcomes, and economic outcomes, we recommend that the option of cholecystectomy should be discussed with all asymptomatic gallstone patients. Disclosure of material information is essential for patients to make an informed choice for prophylactic cholecystectomy. It is for the patient to decide on watchful waiting or prophylactic cholecystectomy, and not for the medical community to make a blanket policy of watchful waiting for asymptomatic gallstone patients. For patients with high-risk profiles, it is clinically justifiable to advocate cholecystectomy to minimize the likelihood of morbidity due to complications.
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Affiliation(s)
- Brian Juin Hsien Lee
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore S308232, Singapore
| | - Qai Ven Yap
- Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore S117597, Singapore
| | - Jee Keem Low
- Department of General Surgery, Tan Tock Seng Hospital, Singapore S308433, Singapore
| | - Yiong Huak Chan
- Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore S117597, Singapore
| | - Vishal G Shelat
- Department of General Surgery, Tan Tock Seng Hospital, Singapore S308433, Singapore
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Al-Qahtani SD, Bin-Melaih HH, Atiya EM, Fahmy UA, Binmahfouz LS, Neamatallah T, Al-Abbasi FA, Abdel-Naim AB. Self-Nanoemulsifying Drug Delivery System of 2-Methoxyestradiol Exhibits Enhanced Anti-Proliferative and Pro-Apoptotic Activities in MCF-7 Breast Cancer Cells. Life (Basel) 2022; 12:life12091369. [PMID: 36143405 PMCID: PMC9503162 DOI: 10.3390/life12091369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 08/25/2022] [Accepted: 08/30/2022] [Indexed: 11/16/2022] Open
Abstract
(1) Background: 2-Methoxyestradiol (2ME) is a metabolite of estrogens and possesses promising anti-proliferative and cytotoxic activities. However, it suffers unfavorable pharmacokinetic characteristics such as absorption after oral administration. The aim of this study was to prepare an optimized 2ME self-nanoemulsifying drug delivery system (2ME-SNEDDS) and evaluate its cytotoxicity and pro-apoptotic activities in MCF-7 breast cancer cells. (2) Methods: For optimization of the 2ME-SNEDDS, a three-component system was used in the D-optimal mixture experimental study. MCF-7 cells were incubated with the 2ME-SNEDDS and subjected to an assessment of growth inhibition, cell cycle progression, annexin V staining, caspase-3 concentration, Bax, Bcl-2, and cyclin D1 mRNA expression, and reactive oxygen species (ROS) generation. (3) Results: The optimized formula had a globule size of 94.97 ± 4.35 nm. Zeta potential was found to be −3.4 ± 1.2 mV with a polydispersity index (PDI) of 0.34. In addition, 96.3 ± 4.3% of 2ME was released from the 2ME-SNEDDS within 24 h using the activated analysis bag technique. Moreover, the prepared 2ME-SNEDDS exhibited a significant enhancement of the anti-proliferative activity against MCF-7 cells in comparison to raw 2ME. This was associated with cyclin D1 expression down-regulation and the accumulation of cells in the G0/G1 and G2/M phases. The pro-apoptotic activities of the 2ME-SNEDDS were confirmed by annexin V staining, which indicated enhanced early and late cell death. This accompanied modulation of the mRNA expression of Bax and Bcl-2 in favor of apoptosis. The 2ME-SNEDDS significantly enhanced cleaved caspase-3 concentration in comparison to raw 2ME. In addition, the 2ME-SNEDDS significantly increased the generation of ROS in MCF-7 cells. (4) Conclusions: The 2ME-SNEDDS exhibits enhanced cytotoxicity and pro-apoptotic activity in MCF-7 cells. This is mediated by, at least partially, ROS generation.
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Affiliation(s)
- Salwa D. Al-Qahtani
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Science, Majmaah University, Majmaah 11952, Saudi Arabia
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Hawazen H. Bin-Melaih
- Department of Biological Sciences, Faculty of Sciences, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Eman M. Atiya
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Usama A. Fahmy
- Department of Pharmaceutics, Faculty of Pharmacy, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Lenah S. Binmahfouz
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Thikryat Neamatallah
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Fahad A. Al-Abbasi
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Ashraf B. Abdel-Naim
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, King Abdulaziz University, Jeddah 21589, Saudi Arabia
- Correspondence:
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Sinha A, Bavishi A, Hibler EA, Yang EH, Parashar S, Okwuosa T, DeCara JM, Brown SA, Guha A, Sadler D, Khan SS, Shah SJ, Yancy CW, Akhter N. Interconnected Clinical and Social Risk Factors in Breast Cancer and Heart Failure. Front Cardiovasc Med 2022; 9:847975. [PMID: 35669467 PMCID: PMC9163546 DOI: 10.3389/fcvm.2022.847975] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 04/13/2022] [Indexed: 11/29/2022] Open
Abstract
Breast cancer and heart failure share several known clinical cardiovascular risk factors, including age, obesity, glucose dysregulation, cholesterol dysregulation, hypertension, atrial fibrillation and inflammation. However, to fully comprehend the complex interplay between risk of breast cancer and heart failure, factors attributed to both biological and social determinants of health must be explored in risk-assessment. There are several social factors that impede implementation of prevention strategies and treatment for breast cancer and heart failure prevention, including socioeconomic status, neighborhood disadvantage, food insecurity, access to healthcare, and social isolation. A comprehensive approach to prevention of both breast cancer and heart failure must include assessment for both traditional clinical risk factors and social determinants of health in patients to address root causes of lifestyle and modifiable risk factors. In this review, we examine clinical and social determinants of health in breast cancer and heart failure that are necessary to consider in the design and implementation of effective prevention strategies that altogether reduce the risk of both chronic diseases
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Affiliation(s)
- Arjun Sinha
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Avni Bavishi
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Elizabeth A. Hibler
- Department of Preventive Medicine, Division of Cancer Epidemiology and Prevention, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Eric H. Yang
- UCLA Cardio-Oncology Program, Division of Cardiology, Department of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Susmita Parashar
- Division of Cardiology, Department of Medicine, Emory University, Atlanta, GA, United States
| | - Tochukwu Okwuosa
- Division of Cardiology, Department of Medicine, Rush University Medical Center, Chicago, IL, United States
| | - Jeanne M. DeCara
- Section of Cardiology, Department of Medicine, University of Chicago Medicine, Chicago, IL, United States
| | - Sherry-Ann Brown
- Division of Cardiology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Avirup Guha
- Cardio-Oncology Program, Division of Cardiology, Medical College of Georgia at Augusta University, Augusta, GA, United States
- Cardio-Oncology Program, Division of Cardiology, The Ohio State University Medical Center, Columbus, OH, United States
| | - Diego Sadler
- Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic Florida, Weston, FL, United States
| | - Sadiya S. Khan
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Sanjiv J. Shah
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Clyde W. Yancy
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Nausheen Akhter
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
- *Correspondence: Nausheen Akhter
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Life tables of annual life expectancy and mortality for companion dogs in the United Kingdom. Sci Rep 2022; 12:6415. [PMID: 35484374 PMCID: PMC9050668 DOI: 10.1038/s41598-022-10341-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 03/28/2022] [Indexed: 01/02/2023] Open
Abstract
A life table is a tabulated expression of life expectancy and mortality-related information at specified ages in a given population. This study utilised VetCompass data to develop life tables for the UK companion dog population and broken down by sex, Kennel Club breed group, and common breeds. Among 30,563 dogs that died between 1st January 2016 and 31st July 2020, life expectancy at age 0 was 11.23 [95% confidence interval (CI): 11.19–11.27] years. Female dogs (11.41 years; 95% CI: 11.35–11.47) had a greater life expectancy than males (11.07 years; 95% CI: 11.01–11.13) at age 0. Life tables varied widely between breeds. Jack Russell Terrier (12.72 years; 95% CI: 12.53–12.90) and French Bulldog (4.53 years; 95% CI: 4.14–5.01) had the longest and shortest life expectancy at age 0, respectively. Life tables generated by the current study allow a deeper understanding of the varied life trajectory across many types of dogs and offer novel insights and applications to improve canine health and welfare. The current study helps promote further understanding of life expectancy, which will benefit pet owners and the veterinary profession, along with many other sectors.
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Dry eye signs and symptoms in patients on aromatase inhibitor therapy. Eye (Lond) 2022; 36:766-772. [PMID: 33875824 PMCID: PMC8956617 DOI: 10.1038/s41433-021-01538-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 03/01/2021] [Accepted: 04/06/2021] [Indexed: 02/02/2023] Open
Abstract
PURPOSE The study aimed to test whether symptomatic dry eye in aromatase inhibitor (AI) patients is associated with the clinical features of evaporative dry eye. METHODS A cross-sectional, observational study of postmenopausal women treated with AI was conducted. Clinical information was gathered from their treating clinician. Ocular and treatment symptoms were assessed using validated questionnaires. Clinical assessments were performed to assess for dry eye. The primary outcome measure for this study was dry eye symptoms measured via questionnaire. The secondary outcome measures were clinical signs of dry eye and hormone levels. RESULTS A total of 25 women on AI were recruited. 64% of women reported symptoms of dry eye (ocular surface disease index ≥ 13). Higher tear osmolarity (323 vs 307 mOsm/L, p = 0.002) and increased meibomian gland dropout (4 vs 1, p = 0.002) were observed in patients with symptomatic dry eye when compared to asymptomatic patients. Multivariate logistic regression identified that longer duration of AI use and higher tear osmolarity increased the likelihood of a patient experiencing dry eye symptoms. CONCLUSION Our study found increased tear osmolarity and meibomian gland drop out in women on AI with symptomatic dry eye. Longer duration of AI therapy and higher tear osmolarity may increase the risk of developing dry eye.
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Riis M, Csanaky G, Lehne G, Tangerud A. Anaplastic large cell lymphoma, ALK-negative of the breast diagnosed a short time after removal of breast implant in a patient with breast carcinoma: diagnostic and therapeutic considerations. BMJ Case Rep 2022; 15:e248232. [PMID: 35236698 PMCID: PMC8896010 DOI: 10.1136/bcr-2021-248232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2022] [Indexed: 11/04/2022] Open
Abstract
A case of mass-forming breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) with onset a short time after explanation of the cosmetic prosthesis is reported. The cause of implant removal was carcinoma diagnosed in the ipsilateral breast. The rarity of an almost synchronous manifestation of BIA-ALCL and breast carcinoma and the diagnostic challenges of mass-forming BIA-ALCL in a previously operated breast substantiate this report. The clinical course, diagnostic workup and therapeutic considerations are presented and discussed in detail. This case shows that a diagnosis of BIA-ALCL must always be considered even without a prosthesis in place in patients with a long history of textured implants.
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Affiliation(s)
- Margit Riis
- Department of Breast and Endocrine Surgery, Oslo University Hospital, Oslo, Norway
| | - György Csanaky
- Department of Pathology, Oslo University Hospital, Oslo, Norway
| | - Gustav Lehne
- Department of Cancer Treatment, Oslo University Hospital, Oslo, Norway
| | - Aase Tangerud
- Department of Radiology, Oslo University Hospital, Oslo, Norway
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Bi J, Song L, Wang L, Wu M, Chen S, Wang Y, Wu S, Tian Y. Visit-to-visit fasting blood glucose variability and lifetime risk of cardiovascular disease: a prospective study. Cardiovasc Diabetol 2021; 20:207. [PMID: 34656122 PMCID: PMC8520235 DOI: 10.1186/s12933-021-01397-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 10/06/2021] [Indexed: 01/11/2023] Open
Abstract
Aims Previous studies suggested an adverse association between higher fasting blood glucose (FBG) variability and cardiovascular disease (CVD). Lifetime risk provides an absolute risk assessment during the remainder of an individual’s life. However, the association between FBG variability and the lifetime risk of CVD is uncertain. Objective We aimed to investigate the effect of the visit-to-visit FBG variability on the lifetime risk of CVD. Methods This study included participants from the Kailuan Study who did not have CVD at index ages 35, 45, and 55 years. The FBG variability was defined as the coefficient of variation (CV) of three FBG values that were measured during the examination periods of 2006–2007, 2008–2009, and 2010–2011. We used a modified Kaplan-Merrier method to estimate lifetime risk of CVD according to tertiles of FBG variability. Results At index age 35 years, the study sample comprised 46,018 participants. During a median follow-up of 7.0 years, 1889 participants developed CVD events. For index age 35 years, participants with high FBG variability had higher lifetime risk of CVD (32.5%; 95% confidence interval [CI]: 28.9–36.1%), compared with intermediate (28.3%; 95% CI: 25.5 –31.1%) and low (26.3%; 95% CI: 23.0–29.5%) FBG variability. We found that higher FBG variability was associated with increased lifetime risk of CVD in men but not women. Similar patterns were observed at index ages 45 and 55 years. Conclusions Higher FBG variability was associated with increased lifetime risk of CVD at each index age. Focusing on the FBG variability may provide an insight to the clinical utility for reducing the lifetime risk of CVD. Supplementary Information The online version contains supplementary material available at 10.1186/s12933-021-01397-1.
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Affiliation(s)
- Jianing Bi
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, Wuhan, 430030, China.,Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lulu Song
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, Wuhan, 430030, China.,Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lulin Wang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, Wuhan, 430030, China.,Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Mingyang Wu
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, Wuhan, 430030, China.,Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shouhua Chen
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan City, China
| | - Youjie Wang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, Wuhan, 430030, China.,Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shouling Wu
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan City, China.
| | - Yaohua Tian
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, Wuhan, 430030, China. .,Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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Upregulation of ADAR Promotes Breast Cancer Progression and Serves as a Potential Therapeutic Target. JOURNAL OF ONCOLOGY 2021; 2021:2012903. [PMID: 34616451 PMCID: PMC8490050 DOI: 10.1155/2021/2012903] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 08/03/2021] [Indexed: 12/16/2022]
Abstract
Background Breast cancer (BC) is the most common cause of cancer death worldwide, and its incidence is increasing every year. This study aims to investigate the expression characteristics of ADAR gene in breast cancer and to explore its role in the occurrence and development of BC and its possible mechanism. Methods TCGA portal was used to detect the expression of ADAR in cancer including BC, and its correlation with clinicopathological data as well as other genes was analyzed via UALCAN database. The TISCH database evaluated the expression of ADAR in different types of cell populations in BC at the single-cell level. The Kaplan-Meier plotter database was used to predict the correlation between ADAR expression and BC patient prognosis. The Human Protein Atlas was used to detect the expression of ADAR in tissues and location of ADAR mRNA in cells. Moreover, the relationships between immune response and ADAR expression in BC were assessed with the use of the TISIDB. Metascape and STRING were applied to predict ADAR with other protein interactions. Finally, the effect generated by ADAR expression on cell proliferating, invading, and migrating processes was assessed in vitro with knockdown and overexpression strategies. Results ADAR was significantly upregulated in BC tissues compared to paracancerous tissues. Single-cell RNA analysis showed that ADAR was specifically upregulated in cancer cell clusters and was also expressed in stromal and immune cell clusters. The upregulation of ADAR was positively correlated with clinicopathological stage and negatively correlated with BC prognosis. Experimental processes in vitro revealed ADAR knockdown hindered, proliferated, invaded, and migrated levels of BC cells, whereas over expression of ADAR played the opposite effect. ADAR protein, which may interact with OASL, STAT2, and IFIT3, was mainly located in the nucleoli in cells and primarily involved DNA modification and apoptotic signaling pathway. Immune factors may interact with ADAR in BC, and ADAR was found noticeably linked with immunosuppressor such as IL10, CD274, and IDO1. Conclusion ADAR is significantly upregulated in breast cancer tissues, which may promote the progression of BC through the interaction of cancer cells, stromal cells, and immune cells. Targeting ADAR may offer new hope in treating breast cancer.
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Pashayan N, Antoniou AC, Lee A, Wolfson M, Chiquette J, Eloy L, Eisen A, Stockley TL, Nabi H, Brooks JD, Dorval M, Easton DF, Knoppers BM, Chiarelli AM, Simard J. Should Age-Dependent Absolute Risk Thresholds Be Used for Risk Stratification in Risk-Stratified Breast Cancer Screening? J Pers Med 2021; 11:916. [PMID: 34575693 PMCID: PMC8469877 DOI: 10.3390/jpm11090916] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 09/03/2021] [Accepted: 09/13/2021] [Indexed: 12/16/2022] Open
Abstract
In risk-stratified cancer screening, multiple risk factors are incorporated into the risk assessment. An individual's estimated absolute cancer risk is linked to risk categories with tailored screening recommendations for each risk category. Absolute risk, expressed as either remaining lifetime risk or shorter-term (five- or ten-year) risk, is estimated from the age at assessment. These risk estimates vary by age; however, some clinical guidelines (e.g., enhanced breast cancer surveillance guidelines) and ongoing personalised breast screening trials, stratify women based on absolute risk thresholds that do not vary by age. We examine an alternative approach in which the risk thresholds used for risk stratification vary by age and consider the implications of using age-independent risk thresholds on risk stratification. We demonstrate that using an age-independent remaining lifetime risk threshold approach could identify high-risk younger women but would miss high-risk older women, whereas an age-independent 5-year or 10-year absolute risk threshold could miss high-risk younger women and classify lower-risk older women as high risk. With risk misclassification, women with an equivalent risk level would be offered a different screening plan. To mitigate these problems, age-dependent absolute risk thresholds should be used to inform risk stratification.
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Affiliation(s)
- Nora Pashayan
- Department of Applied Health Research, University College London, London WC1E 7HB, UK
| | - Antonis C. Antoniou
- Centre for Cancer Genetic Epidemiology, Department of Public Health & Primary Care, School of Clinical Medicine, University of Cambridge, Cambridge CB1 8RN, UK; (A.C.A.); (A.L.); (D.F.E.)
| | - Andrew Lee
- Centre for Cancer Genetic Epidemiology, Department of Public Health & Primary Care, School of Clinical Medicine, University of Cambridge, Cambridge CB1 8RN, UK; (A.C.A.); (A.L.); (D.F.E.)
| | - Michael Wolfson
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1G 5Z3, Canada;
| | - Jocelyne Chiquette
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université Laval, Quebec City, QC G1V 4G2, Canada;
- CHU de Québec-Université Laval Research Centre, Quebec City, QC G1S 4L8, Canada; (H.N.); (M.D.); (J.S.)
| | - Laurence Eloy
- Quebec Cancer Program, Ministère de la Santé et des Services Sociaux, Quebec City, QC G1S 2M1, Canada;
| | - Andrea Eisen
- Sunnybrook Health Science Centre, Toronto, ON M4N 3M5, Canada;
| | - Tracy L. Stockley
- Division Clinical Laboratory Genetics, Laboratory Medicine Program, University Health Network, Toronto, ON M5G 2C4, Canada;
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Hermann Nabi
- CHU de Québec-Université Laval Research Centre, Quebec City, QC G1S 4L8, Canada; (H.N.); (M.D.); (J.S.)
- Department of Social and Preventive Medicine, Faculty of Medicine, Université Laval, Quebec City, QC G1V 0A6, Canada
| | - Jennifer D. Brooks
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5S 1A1, Canada;
| | - Michel Dorval
- CHU de Québec-Université Laval Research Centre, Quebec City, QC G1S 4L8, Canada; (H.N.); (M.D.); (J.S.)
- Faculty of Pharmacy, Université Laval, Quebec City, QC G1V 0A6, Canada
- CISSS de Chaudière-Appalaches Research Center, Lévis, QC G6V 3Z1, Canada
| | - Douglas F. Easton
- Centre for Cancer Genetic Epidemiology, Department of Public Health & Primary Care, School of Clinical Medicine, University of Cambridge, Cambridge CB1 8RN, UK; (A.C.A.); (A.L.); (D.F.E.)
| | | | - Anna M. Chiarelli
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5S 1A1, Canada;
- Ontario Health, Cancer Care Ontario, Toronto, ON M5G 2L3, Canada;
| | - Jacques Simard
- CHU de Québec-Université Laval Research Centre, Quebec City, QC G1S 4L8, Canada; (H.N.); (M.D.); (J.S.)
- Department of Molecular Medicine, Faculty of Medicine, Université Laval, Québec City, QC G1V 0A6, Canada
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12
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Gao C, Polley EC, Hart SN, Huang H, Hu C, Gnanaolivu R, Lilyquist J, Boddicker NJ, Na J, Ambrosone CB, Auer PL, Bernstein L, Burnside ES, Eliassen AH, Gaudet MM, Haiman C, Hunter DJ, Jacobs EJ, John EM, Lindström S, Ma H, Neuhausen SL, Newcomb PA, O'Brien KM, Olson JE, Ong IM, Patel AV, Palmer JR, Sandler DP, Tamimi R, Taylor JA, Teras LR, Trentham-Dietz A, Vachon CM, Weinberg CR, Yao S, Weitzel JN, Goldgar DE, Domchek SM, Nathanson KL, Couch FJ, Kraft P. Risk of Breast Cancer Among Carriers of Pathogenic Variants in Breast Cancer Predisposition Genes Varies by Polygenic Risk Score. J Clin Oncol 2021; 39:2564-2573. [PMID: 34101481 PMCID: PMC8330969 DOI: 10.1200/jco.20.01992] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 02/19/2021] [Accepted: 04/20/2021] [Indexed: 12/11/2022] Open
Abstract
PURPOSE This study assessed the joint association of pathogenic variants (PVs) in breast cancer (BC) predisposition genes and polygenic risk scores (PRS) with BC in the general population. METHODS A total of 26,798 non-Hispanic white BC cases and 26,127 controls from predominately population-based studies in the Cancer Risk Estimates Related to Susceptibility consortium were evaluated for PVs in BRCA1, BRCA2, ATM, CHEK2, PALB2, BARD1, BRIP1, CDH1, and NF1. PRS based on 105 common variants were created using effect estimates from BC genome-wide association studies; the performance of an overall BC PRS and estrogen receptor-specific PRS were evaluated. The odds of BC based on the PVs and PRS were estimated using penalized logistic regression. The results were combined with age-specific incidence rates to estimate 5-year and lifetime absolute risks of BC across percentiles of PRS by PV status and first-degree family history of BC. RESULTS The estimated lifetime risks of BC among general-population noncarriers, based on 10th and 90th percentiles of PRS, were 9.1%-23.9% and 6.7%-18.2% for women with or without first-degree relatives with BC, respectively. Taking PRS into account, more than 95% of BRCA1, BRCA2, and PALB2 carriers had > 20% lifetime risks of BC, whereas, respectively, 52.5% and 69.7% of ATM and CHEK2 carriers without first-degree relatives with BC, and 78.8% and 89.9% of those with a first-degree relative with BC had > 20% risk. CONCLUSION PRS facilitates personalization of BC risk among carriers of PVs in predisposition genes. Incorporating PRS into BC risk estimation may help identify > 30% of CHEK2 and nearly half of ATM carriers below the 20% lifetime risk threshold, suggesting the addition of PRS may prevent overscreening and enable more personalized risk management approaches.
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Affiliation(s)
- Chi Gao
- Harvard T.H. Chan School of Public Health, Boston, MA
| | | | | | - Hongyan Huang
- Harvard T.H. Chan School of Public Health, Boston, MA
| | | | | | | | | | - Jie Na
- Mayo Clinic, Rochester, MN
| | | | - Paul L. Auer
- UWM Joseph J. Zilber School of Public Health, Milwaukee, WI
| | | | | | - A. Heather Eliassen
- Harvard T.H. Chan School of Public Health, Boston, MA
- Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Mia M. Gaudet
- Department of Population Science, American Cancer Society, Atlanta, GA
| | - Christopher Haiman
- Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - David J. Hunter
- Harvard T.H. Chan School of Public Health, Boston, MA
- University of Oxford, Oxford, United Kingdom
| | - Eric J. Jacobs
- Department of Population Science, American Cancer Society, Atlanta, GA
| | | | - Sara Lindström
- Department of Epidemiology, University of Washington, Seattle, WA
- Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Huiyan Ma
- Beckman Research Institute of City of Hope, Duarte, CA
| | | | - Polly A. Newcomb
- Department of Epidemiology, University of Washington, Seattle, WA
- Fred Hutchinson Cancer Research Center, Seattle, WA
| | | | | | | | - Alpa V. Patel
- Department of Population Science, American Cancer Society, Atlanta, GA
| | - Julie R. Palmer
- Boston University School of Medicine and Slone Epidemiology Center, Boston, MA
| | - Dale P. Sandler
- National Institute of Environmental Health Sciences, Durham, NC
| | - Rulla Tamimi
- Population Health Sciences Department, Weill Cornell Medicine, New York, NY
| | - Jack A. Taylor
- National Institute of Environmental Health Sciences, Durham, NC
| | - Lauren R. Teras
- Department of Population Science, American Cancer Society, Atlanta, GA
| | | | | | | | - Song Yao
- Roswell Park Comprehensive Cancer Center, Buffalo, NY
| | | | | | - Susan M. Domchek
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | | | | | - Peter Kraft
- Harvard T.H. Chan School of Public Health, Boston, MA
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13
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Bracco PA, Gregg EW, Rolka DB, Schmidt MI, Barreto SM, Lotufo PA, Bensenor I, Duncan BB. Lifetime risk of developing diabetes and years of life lost among those with diabetes in Brazil. J Glob Health 2021; 11:04041. [PMID: 34326991 PMCID: PMC8284547 DOI: 10.7189/jogh.11.04041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023] Open
Abstract
BACKGROUND Given the paucity of studies for low- or middle-income countries, we aim to provide the first ever estimations of lifetime risk of diabetes, years of life spent and lost among those with diabetes for Brazilians. Estimates of Brazil´s diabetes burden consist essentially of reports of diabetes prevalence from national surveys and mortality data. However, these additional metrics are at times more meaningful ways to characterize this burden. METHODS We joined data on incidence of physician-diagnosed diabetes from the Brazilian risk factor surveillance system, all-cause mortality from national statistics, and diabetes mortality rate ratios from ELSA-Brasil, an ongoing cohort study. To calculate lifetime risk of developing diabetes, we applied an illness-death state model. To calculate years of life lost for those with diabetes and years lived with the disease, we additionally calculated the mortality rates for those with diabetes. RESULTS A 35-year-old white adult had a 23.4% (95% CI = 22.5%-25.5%) lifetime risk of developing diabetes by age 80 while a same-aged black/brown adult had a 30.8% risk (95% confidence interval (CI) = 29.6%-33.2%). Men diagnosed with diabetes at age 35 would live 32.9 (95% CI = 32.4-33.2) years with diabetes and lose 5.5 (95% CI = 5.1-6.1) years of life. Similarly-aged women would live 38.8 (95% CI = 38.3-38.9) years with diabetes and lose 2.1 (95% CI = 1.9-2.6) years of life. CONCLUSIONS Assuming maintenance of current rates, one-quarter of young Brazilians will develop diabetes over their lifetimes, with this number reaching almost one-third among young, black/brown women. Those developing diabetes will suffer a decrease in life expectancy and will generate a considerable cost in terms of medical care.
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Affiliation(s)
- Paula A Bracco
- Postgraduate Program in Epidemiology, School of Medicine and Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Edward W Gregg
- Department of Diabetes and Cardiovascular Disease Epidemiology, School of Public Health, Imperial College London, UK
| | - Deborah B Rolka
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Maria Inês Schmidt
- Postgraduate Program in Epidemiology, School of Medicine and Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Sandhi M Barreto
- Department of Preventive and Social Medicine, Medical School, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Paulo A Lotufo
- Department of Internal Medicine, School of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Isabela Bensenor
- Department of Internal Medicine, School of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Bruce B Duncan
- Postgraduate Program in Epidemiology, School of Medicine and Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
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14
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Bracco PA, Gregg EW, Rolka DB, Schmidt MI, Barreto SM, Lotufo PA, Bensenor I, Duncan BB. Lifetime risk of developing diabetes and years of life lost among those with diabetes in Brazil. J Glob Health 2021. [PMID: 34326991 PMCID: PMC8284547 DOI: 10.7189/jgh.11.04041] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Background Given the paucity of studies for low- or middle-income countries, we aim to provide the first ever estimations of lifetime risk of diabetes, years of life spent and lost among those with diabetes for Brazilians. Estimates of Brazil´s diabetes burden consist essentially of reports of diabetes prevalence from national surveys and mortality data. However, these additional metrics are at times more meaningful ways to characterize this burden. Methods We joined data on incidence of physician-diagnosed diabetes from the Brazilian risk factor surveillance system, all-cause mortality from national statistics, and diabetes mortality rate ratios from ELSA-Brasil, an ongoing cohort study. To calculate lifetime risk of developing diabetes, we applied an illness-death state model. To calculate years of life lost for those with diabetes and years lived with the disease, we additionally calculated the mortality rates for those with diabetes. Results A 35-year-old white adult had a 23.4% (95% CI = 22.5%-25.5%) lifetime risk of developing diabetes by age 80 while a same-aged black/brown adult had a 30.8% risk (95% confidence interval (CI) = 29.6%-33.2%). Men diagnosed with diabetes at age 35 would live 32.9 (95% CI = 32.4-33.2) years with diabetes and lose 5.5 (95% CI = 5.1-6.1) years of life. Similarly-aged women would live 38.8 (95% CI = 38.3-38.9) years with diabetes and lose 2.1 (95% CI = 1.9-2.6) years of life. Conclusions Assuming maintenance of current rates, one-quarter of young Brazilians will develop diabetes over their lifetimes, with this number reaching almost one-third among young, black/brown women. Those developing diabetes will suffer a decrease in life expectancy and will generate a considerable cost in terms of medical care.
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Affiliation(s)
- Paula A Bracco
- Postgraduate Program in Epidemiology, School of Medicine and Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Edward W Gregg
- Department of Diabetes and Cardiovascular Disease Epidemiology, School of Public Health, Imperial College London, UK
| | - Deborah B Rolka
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Maria Inês Schmidt
- Postgraduate Program in Epidemiology, School of Medicine and Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Sandhi M Barreto
- Department of Preventive and Social Medicine, Medical School, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Paulo A Lotufo
- Department of Internal Medicine, School of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Isabela Bensenor
- Department of Internal Medicine, School of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Bruce B Duncan
- Postgraduate Program in Epidemiology, School of Medicine and Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
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Turton P, El-Sharkawi D, Lyburn I, Sharma B, Mahalingam P, Turner SD, MacNeill F, Johnson L, Hamilton S, Burton C, Mercer N. UK Guidelines on the Diagnosis and Treatment of Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) on behalf of the Medicines and Healthcare products Regulatory Agency (MHRA) Plastic, Reconstructive and Aesthetic Surgery Expert Advisory Group (PRASEAG). Eur J Surg Oncol 2020; 47:199-210. [PMID: 33358076 DOI: 10.1016/j.ejso.2020.07.043] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 07/23/2020] [Indexed: 01/11/2023] Open
Abstract
Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is an uncommon T cell Non-Hodgkin Lymphoma (NHL) associated with breast implants. Raising awareness of the possibility of BIA-ALCL in anyone with breast implants and new breast symptoms is crucial to early diagnosis. The tumour begins on the inner aspect of the peri-implant capsule causing an effusion, or less commonly a tissue mass to form within the capsule, which may spread locally or to more distant sites in the body. Diagnosis is usually made by cytological, immunohistochemical and immunophenotypic evaluation of the aspirated peri-implant fluid: pleomorphic lymphocytes are characteristically anaplastic lymphoma kinase (ALK) negative and strongly positive for CD30. BIA-ALCL is indolent in most patients but can progress rapidly. Surgical removal of the implant with the intact surrounding capsule (total en-bloc capsulectomy) is usually curative. Late diagnosis may require more radical surgery and systemic therapies and although these are usually successful, poor outcomes and deaths have been reported. By adopting a structured approach, as suggested in these guidelines, early diagnosis and successful treatment will minimize the need for systemic treatments, reduce morbidity and the risk of poor outcomes.
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Affiliation(s)
- Philip Turton
- St James's Hospital, The Leeds Teaching Hospitals NHS Trust, Leeds, UK.
| | | | - Iain Lyburn
- Cobalt Medical Charity, Cheltenham, UK; Gloucestershire Hospitals NHS Foundation Trust, UK
| | | | | | - Suzanne D Turner
- Division of Cellular and Molecular Pathology, Department of Pathology, University of Cambridge, Cambridge, CB20QQ, UK; CEITEC, Masaryk University, Brno, Czech Republic
| | | | | | | | - Cathy Burton
- St James's Hospital, The Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Nigel Mercer
- Bristol Plastic Surgery, 58 Queen Square, Bristol, BS1 4LF, UK
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16
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Byun IH, Koo HK, Kim SJ, Kim HJ, Lee SW. Simultaneous Augmentation Mammoplasty and Vacuum-Assisted Breast Biopsy for Enhanced Cosmesis and Efficacy. Aesthetic Plast Surg 2020; 44:2041-2047. [PMID: 32671448 DOI: 10.1007/s00266-020-01858-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 06/27/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND In this era of expanding life expectancy and popularity of aesthetic breast surgeries, more women are likely to live more years with their augmented breasts. Thus, consistent attention to general breast health is crucial, and preoperative ultrasound is helpful to locate suspicious lesions. In this study, we present a combinative procedure of augmentation mammoplasty and vacuum-assisted breast biopsy (VABB). METHODS From January of 2018 to December of 2019, a total of 102 patients received simultaneous augmentation mammoplasty and VABB in our institute. Only patients of primary augmentation mammoplasty who received VABB on unilateral breasts were included. We sought to investigate the results of each breast and safety of adding VABB before performing augmentation within the same incision. RESULTS Among 204 breasts and implants, 28.43% were done via endoscopic transaxillary approach and 71.57% via inframammary approach. The mean implant volume was 329.34 ± 44.79 ml, and the mean follow-up period was 14.23 ± 4.64 months. All of the complication rates exhibited no statistically significant differences between the two groups. CONCLUSION Simultaneous augmentation mammoplasty and VABB prevented unnecessary scars and pain, and the complication rates did not statistically differ from those of augmentation only group. This co-operation is a safe and simple method potentially beneficial to many women interested in breast surgery. LEVEL OF EVIDENCE III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Il Hwan Byun
- Department of Plastic and Reconstructive Surgery, DA Plastic Surgery, 125 Teheran-ro, Gangnam-gu, Seoul, Korea
| | - Hyun Kook Koo
- Department of Plastic and Reconstructive Surgery, DA Plastic Surgery, 125 Teheran-ro, Gangnam-gu, Seoul, Korea
| | - Soo Jung Kim
- Department of Plastic and Reconstructive Surgery, DA Plastic Surgery, 125 Teheran-ro, Gangnam-gu, Seoul, Korea
| | - Hye-Jin Kim
- Department of General Surgery, DA Plastic Surgery, 125 Teheran-ro, Gangnam-gu, Seoul, Korea
| | - Sang Woo Lee
- Department of Plastic and Reconstructive Surgery, DA Plastic Surgery, 125 Teheran-ro, Gangnam-gu, Seoul, Korea.
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17
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Turton P, El-Sharkawi D, Lyburn I, Sharma B, Mahalingam P, Turner SD, MacNeill F, Johnson L, Hamilton S, Burton C, Mercer N. UK Guidelines on the Diagnosis and Treatment of Breast Implant-Associated Anaplastic Large Cell Lymphoma on behalf of the Medicines and Healthcare products Regulatory Agency Plastic, Reconstructive and Aesthetic Surgery Expert Advisory Group. Br J Haematol 2020; 192:444-458. [PMID: 33222158 PMCID: PMC7894347 DOI: 10.1111/bjh.17194] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 09/13/2020] [Accepted: 09/23/2020] [Indexed: 02/06/2023]
Abstract
Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is an uncommon T-cell non-Hodgkin Lymphoma (NHL) associated with breast implants. Raising awareness of the possibility of BIA-ALCL in anyone with breast implants and new breast symptoms is crucial to early diagnosis. The tumour begins on the inner aspect of the peri-implant capsule causing an effusion, or less commonly a tissue mass to form within the capsule, which may spread locally or to more distant sites in the body. Diagnosis is usually made by cytological, immunohistochemical and immunophenotypic evaluation of the aspirated peri-implant fluid: pleomorphic lymphocytes are characteristically anaplastic lymphoma kinase (ALK)-negative and strongly positive for CD30. BIA-ALCL is indolent in most patients but can progress rapidly. Surgical removal of the implant with the intact surrounding capsule (total en-bloc capsulectomy) is usually curative. Late diagnosis may require more radical surgery and systemic therapies and although these are usually successful, poor outcomes and deaths have been reported. By adopting a structured approach, as suggested in these guidelines, early diagnosis and successful treatment will minimise the need for systemic treatments, reduce morbidity and the risk of poor outcomes.
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Affiliation(s)
- Philip Turton
- St James's Hospital, The Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | | | - Iain Lyburn
- Cobalt Medical Charity, Cheltenham, UK.,Gloucestershire Hospitals NHS Foundation Trust, Gloucester, UK
| | | | | | - Suzanne D Turner
- Division of Cellular and Molecular Pathology, Department of Pathology, University of Cambridge, Cambridge, UK.,CEITEC, Masaryk University, Brno, Czech Republic
| | | | | | | | - Cathy Burton
- St James's Hospital, The Leeds Teaching Hospitals NHS Trust, Leeds, UK
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18
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Turton P, El-Sharkawi D, Lyburn I, Sharma B, Mahalingam P, Turner SD, MacNeill F, Johnson L, Hamilton S, Burton C, Mercer N. UK Guidelines on the Diagnosis and Treatment of Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) on behalf of the Medicines and Healthcare products Regulatory Agency (MHRA) Plastic, Reconstructive and Aesthetic Surgery Expert Advisory Group (PRASEAG). J Plast Reconstr Aesthet Surg 2020; 74:13-29. [PMID: 33483089 DOI: 10.1016/j.bjps.2020.10.064] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 10/20/2020] [Indexed: 12/30/2022]
Abstract
Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is an uncommon T cell Non-Hodgkin Lymphoma (NHL) associated with breast implants. Raising awareness of the possibility of BIA-ALCL in anyone with breast implants and new breast symptoms is crucial to early diagnosis. The tumour begins on the inner aspect of the peri-implant capsule causing an effusion, or less commonly a tissue mass to form within the capsule, which may spread locally or to more distant sites in the body. Diagnosis is usually made by cytological, immunohistochemical and immunophenotypic evaluation of the peri-implant fluid: pleomorphic lymphocytes are characteristically anaplastic lymphoma kinase (ALK) negative and strongly positive for CD30. BIA-ALCL is indolent in most patients but can progress rapidly. Surgical removal of the implant with the intact surrounding capsule (total en-bloc capsulectomy) is usually curative. Late diagnosis may require more radical surgery and systemic therapies and although these are usually successful, poor outcomes and deaths have been reported. By adopting a structured approach, as suggested in these guidelines, early diagnosis and successful treatment will minimize the need for systemic treatments, reduce morbidity and the risk of poor outcomes. These guidelines provide an evidence-based and systematic framework for the assessment and treatment of patients with suspected or proven BIA-ALCL and are aimed at all clinicians involved in the care of people with breast implants.
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Affiliation(s)
- Philip Turton
- St James's Hospital, The Leeds Teaching Hospitals NHS Trust, Leeds, UK.
| | | | - Iain Lyburn
- Cobalt Medical Charity, Cheltenham, UK; Gloucestershire Hospitals NHS Foundation Trust, UK
| | | | | | - Suzanne D Turner
- Division of Cellular and Molecular Pathology, Department of Pathology, University of Cambridge, Cambridge CB20QQ, UK; CEITEC, Masaryk University, Brno, Czech Republic
| | | | | | | | - Cathy Burton
- St James's Hospital, The Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Nigel Mercer
- Bristol Plastic Surgery, 58 Queen Square, Bristol BS1 4LF
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Sehgal AR. Lifetime Risk of Death From Firearm Injuries, Drug Overdoses, and Motor Vehicle Accidents in the United States. Am J Med 2020; 133:1162-1167.e1. [PMID: 32387317 PMCID: PMC7541401 DOI: 10.1016/j.amjmed.2020.03.047] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 03/17/2020] [Accepted: 03/18/2020] [Indexed: 01/11/2023]
Abstract
BACKGROUND News media and policy makers frequently discuss deaths from firearms, drug overdoses, and motor vehicle accidents. However, this information is generally presented as absolute numbers or annual rates. Cumulative lifetime risk may be an additional useful metric for understanding the impact of these causes of death. METHODS Data on all-cause firearm, drug overdose, and motor vehicle accident deaths were obtained from the US Centers for Disease Control and Prevention (CDC) for the year 2018. Age-specific death rates were used to estimate the cumulative risk of firearm, drug overdose, and motor vehicle accident deaths from birth to age 85 after accounting for other causes of death. RESULTS The lifetime risk of death from firearms, drug overdoses, and motor vehicle accidents was 0.93% (95% confidence interval [CI], 0.92%-0.94%), 1.52% (95% CI, 1.51%-1.53%), and 0.92% (95% CI, 0.91%-0.93%), respectively. Black males had a 2.61% (95% CI, 2.55%-2.66%) lifetime risk of firearm death, indicating that 1 out of 38 black males will die from firearms if current death rates persist. Residents of West Virginia had a 3.54% lifetime risk of drug overdose death, equivalent to 1 out of every 28 residents dying from overdoses. CONCLUSIONS The lifetime risk of death from firearms, drug overdoses, and motor vehicle accidents is substantial and varies greatly across demographic subgroups and states.
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Affiliation(s)
- Ashwini R Sehgal
- Center for Reducing Health Disparities, Case Western Reserve University, Cleveland, Ohio.
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20
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Older age and comorbidity in breast cancer: is RT alone the new therapeutic frontier? J Cancer Res Clin Oncol 2020; 146:1791-1800. [PMID: 32405744 DOI: 10.1007/s00432-020-03243-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Accepted: 05/01/2020] [Indexed: 10/24/2022]
Abstract
AIM To assess the impact of age, comorbidities and endocrine therapy (ET) in older breast cancer (BC) patients treated with hypofractionated radiotherapy (Hypo-RT). METHODS From June 2009 to December 2017, we enrolled in this study 735 ER-positive BC patients (stage pT1-T2, pNx-1, M0 and age ≥ 65 years) receiving hypo-RT and followed them until September 2019. Baseline comorbidities included in the hypertension-augmented Charlson Comorbidity Index were retrospectively retrieved. Logistic regression model estimated adjusted-odds ratios (ORs) of ET prescription in relation to baseline patient and tumor characteristics. Competing risk analysis estimated 5-year cumulative incidence function (CIF) of ET discontinuation due to side effects (with BC progression or death as competing events), and its effect on locoregional recurrence (LRR) and distant metastasis (DM) (with death as competing event). RESULTS ET has been prescribed in 89% patients. In multivariable analysis, the odds of ET prescription was significantly reduced in older patients (≥ 80 years, OR 0.08, 95% CI 0.03-0.20) and significantly increased in patients with moderate comorbidity. Patients ≥ 80 years discontinued the prescribed therapy earlier and more frequently than younger (65-69 years) patients (p = 0.060). Five-year CIF of LLR, DM and death from causes other that BC were 1.7%, 2.2% and 7.5%, respectively. Patients who discontinued ET had higher chance of LRR (p = 0.004). ET use did not impact on OS in any of the analyzed groups. CONCLUSIONS In older patients, ET did not show a benefit in terms of overall survival. Further studies focusing on tailored treatment approaches are warranted to offer the best care in terms of adjuvant treatment to these patients.
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Corris PA. The importance of deep phenotyping PH registries with a focus on the PVRI-GoDeep registry. Glob Cardiol Sci Pract 2020; 2020:e202012. [PMID: 33150156 PMCID: PMC7590938 DOI: 10.21542/gcsp.2020.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Paul A Corris
- Professor of Thoracic Medicine, Translational and Clinical Science, Faculty of Medical Sciences, Newcastle University, UK
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Corris PA, Seeger W. Call it by the correct name-pulmonary hypertension not pulmonary arterial hypertension: growing recognition of the global health impact for a well-recognized condition and the role of the Pulmonary Vascular Research Institute. Am J Physiol Lung Cell Mol Physiol 2020; 318:L992-L994. [PMID: 32233785 DOI: 10.1152/ajplung.00098.2020] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Affiliation(s)
- Paul A Corris
- Faculty of Medical Sciences, Newcastle University, Newcastle, United Kingdom and The Newcastle Upon Tyne Hospitals, NHS Foundation Trust, Newcastle, United Kingdom.,Chairman of the Board of the Pulmonary Vascular Research Institute, Canterbury, United Kingdom
| | - Werner Seeger
- University of Giessen and Marburg Lung Center (UGMLC), German Center for Lung Research (DZL), Cardio-Pulmonary Institute (CPI), Institute for Lung Health (ILH), Giessen, Germany; and the Max Planck Institute for Heart and Lung Research, Bad Nauheim, Germany.,President of the Pulmonary Vascular Research Institute, Canterbury, United Kingdom
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23
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Ramadan SZ. Methods Used in Computer-Aided Diagnosis for Breast Cancer Detection Using Mammograms: A Review. JOURNAL OF HEALTHCARE ENGINEERING 2020; 2020:9162464. [PMID: 32300474 PMCID: PMC7091549 DOI: 10.1155/2020/9162464] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 12/25/2019] [Accepted: 02/13/2020] [Indexed: 12/28/2022]
Abstract
According to the American Cancer Society's forecasts for 2019, there will be about 268,600 new cases in the United States with invasive breast cancer in women, about 62,930 new noninvasive cases, and about 41,760 death cases from breast cancer. As a result, there is a high demand for breast imaging specialists as indicated in a recent report for the Institute of Medicine and National Research Council. One way to meet this demand is through developing Computer-Aided Diagnosis (CAD) systems for breast cancer detection and diagnosis using mammograms. This study aims to review recent advancements and developments in CAD systems for breast cancer detection and diagnosis using mammograms and to give an overview of the methods used in its steps starting from preprocessing and enhancement step and ending in classification step. The current level of performance for the CAD systems is encouraging but not enough to make CAD systems standalone detection and diagnose clinical systems. Unless the performance of CAD systems enhanced dramatically from its current level by enhancing the existing methods, exploiting new promising methods in pattern recognition like data augmentation in deep learning and exploiting the advances in computational power of computers, CAD systems will continue to be a second opinion clinical procedure.
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Affiliation(s)
- Saleem Z. Ramadan
- Department of Industrial Engineering, German Jordanian University, Mushaqar 11180, Amman, Jordan
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24
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Breast Cancer Detection-A Synopsis of Conventional Modalities and the Potential Role of Microwave Imaging. Diagnostics (Basel) 2020; 10:diagnostics10020103. [PMID: 32075017 PMCID: PMC7168907 DOI: 10.3390/diagnostics10020103] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 02/04/2020] [Accepted: 02/11/2020] [Indexed: 01/11/2023] Open
Abstract
Global statistics have demonstrated that breast cancer is the most frequently diagnosed invasive cancer and the leading cause of cancer death among female patients. Survival following a diagnosis of breast cancer is grossly determined by the stage of the disease at the time of initial diagnosis, highlighting the importance of early detection. Improving early diagnosis will require a multi-faceted approach to optimizing the use of currently available imaging modalities and investigating new methods of detection. The application of microwave technologies in medical diagnostics is an emerging field of research, with breast cancer detection seeing the most significant progress in the last twenty years. In this review, the application of current conventional imaging modalities is discussed, and recurrent shortcomings highlighted. Microwave imaging is rapid and inexpensive. If the preliminary results of its diagnostic capacity are substantiated, microwave technology may offer a non-ionizing, non-invasive, and painless adjunct or stand-alone modality that could possibly be implemented in routine diagnostic breast care.
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25
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Virumbrales-Muñoz M, Livingston MK, Farooqui M, Skala MC, Beebe DJ, Ayuso JM. Development of a Microfluidic Array to Study Drug Response in Breast Cancer. Molecules 2019; 24:molecules24234385. [PMID: 31801265 PMCID: PMC6930663 DOI: 10.3390/molecules24234385] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 11/25/2019] [Accepted: 11/26/2019] [Indexed: 12/22/2022] Open
Abstract
Luminal geometries are common structures in biology, which are challenging to mimic using conventional in vitro techniques based on the use of Petri dishes. In this context, microfluidic systems can mimic the lumen geometry, enabling a large variety of studies. However, most microfluidic models still rely on polydimethylsiloxane (PDMS), a material that is not amenable for high-throughput fabrication and presents some limitations compared with other materials such as polystyrene. Thus, we have developed a microfluidic device array to generate multiple bio-relevant luminal structures utilizing polystyrene and micro-milling. This platform offers a scalable alternative to conventional microfluidic devices designed in PDMS. Additionally, the use of polystyrene has well described advantages, such as lower permeability to hydrophobic molecules compared with PDMS, while maintaining excellent viability and optical properties. Breast cancer cells cultured in the devices exhibited high cell viability similar to PDMS-based microdevices. Further, co-culture experiments with different breast cell types showed the potential of the model to study breast cancer invasion. Finally, we demonstrated the potential of the microfluidic array for drug screening, testing chemotherapy drugs and photodynamic therapy agents for breast cancer.
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Affiliation(s)
- María Virumbrales-Muñoz
- Department of Biomedical Engineering, University of Wisconsin-Madison, 1550 Engineering Drive, Madison, WI 53706, USA; (M.V.-M.); (M.F.)
- The University of Wisconsin Carbone Cancer Center, University of Wisconsin, Madison, WI 53705, USA
- School of Medicine and Public Health, University of Wisconsin-Madison, 750 Highland Avenue, Madison, WI 53726, USA
| | - Megan K. Livingston
- Department of Chemistry, University of Wisconsin-Madison, 1101 University Avenue, Madison, WI 53706, USA;
| | - Mehtab Farooqui
- Department of Biomedical Engineering, University of Wisconsin-Madison, 1550 Engineering Drive, Madison, WI 53706, USA; (M.V.-M.); (M.F.)
| | - Melissa C. Skala
- Department of Biomedical Engineering, University of Wisconsin-Madison, 1550 Engineering Drive, Madison, WI 53706, USA; (M.V.-M.); (M.F.)
- The University of Wisconsin Carbone Cancer Center, University of Wisconsin, Madison, WI 53705, USA
- Morgridge Institute for Research, 330 N Orchard street, Madison, WI 53715, USA
- Correspondence: (M.C.S.); (D.J.B.); (J.M.A.)
| | - David J. Beebe
- Department of Biomedical Engineering, University of Wisconsin-Madison, 1550 Engineering Drive, Madison, WI 53706, USA; (M.V.-M.); (M.F.)
- The University of Wisconsin Carbone Cancer Center, University of Wisconsin, Madison, WI 53705, USA
- School of Medicine and Public Health, University of Wisconsin-Madison, 750 Highland Avenue, Madison, WI 53726, USA
- Correspondence: (M.C.S.); (D.J.B.); (J.M.A.)
| | - Jose M. Ayuso
- Department of Biomedical Engineering, University of Wisconsin-Madison, 1550 Engineering Drive, Madison, WI 53706, USA; (M.V.-M.); (M.F.)
- The University of Wisconsin Carbone Cancer Center, University of Wisconsin, Madison, WI 53705, USA
- School of Medicine and Public Health, University of Wisconsin-Madison, 750 Highland Avenue, Madison, WI 53726, USA
- Morgridge Institute for Research, 330 N Orchard street, Madison, WI 53715, USA
- Correspondence: (M.C.S.); (D.J.B.); (J.M.A.)
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26
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Hu G, Liu H, Wang M, Peng W. IQ Motif Containing GTPase-Activating Protein 3 (IQGAP3) Inhibits Kaempferol-Induced Apoptosis in Breast Cancer Cells by Extracellular Signal-Regulated Kinases 1/2 (ERK1/2) Signaling Activation. Med Sci Monit 2019; 25:7666-7674. [PMID: 31605603 PMCID: PMC6807529 DOI: 10.12659/msm.915642] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 04/23/2019] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Breast cancer (BC), a prevalent and heterogeneous disease of glandular breast tissue, is the most common cancer in women. The interaction between Kaempferol and IQ motif containing GTPase-activating protein 3 (IQGAP3) in BC and its underlying mechanism are poorly defined. MATERIAL AND METHODS After natural phytochemicals treatment, the expression of IQGAP3 in BC cells (ZR-75-30 and BT474) was detected by real-time PCR. Then, the proliferation and apoptosis in BC cells with different gradient concentrations (10, 25, 50, and 100 µmol/l) of Kaempferol treatment were detected. After treatment with Kaempferol or epidermal growth factor (EGF), we assessed apoptosis and expression of related genes. RESULTS We found that natural phytochemicals, especially Kaempferol, decreased IQGAP3 expression in BC cells. Kaempferol significantly induced proliferation inhibition and apoptosis in BC cells, concurrent with decreased IQGAP3 expression. Upregulation of IQGAP3 inhibited apoptosis in BC cells, along with increased expression of phosphorylated extracellular signal-regulated kinases 1/2 (p-ERK1/2) and B cell lymphoma 2 (Bcl2) and decreased Bcl-2-associated X protein (Bax) expression, which was counteracted by Kaempferol treatment. EGF markedly inhibited Kaempferol-induced apoptosis in BC cells, and ERK1/2 inhibitor PD98059 had an effect similar to that of Kaempferol. CONCLUSIONS IQGAP3 may be a potential target gene for Kaempferol in the treatment of BC, and upregulation of IQGAP3 inhibits Kaempferol-induced apoptosis in BC cells by ERK1/2 signaling activation. Targeting IQGAP3 may contribute to the study of natural phytochemicals as anti-tumor drugs in BC.
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Affiliation(s)
- Gaowu Hu
- Department of General Surgery, Shanghai Traditional Chinese Medicine-Integrated Hospital, Shanghai, P.R. China
| | - Huajiang Liu
- Department of Chinese Medicine, Jinshan Hospital of Fudan University, Shanghai, P.R. China
| | - Ming Wang
- Department of General Surgery, Shanghai Traditional Chinese Medicine-Integrated Hospital, Shanghai, P.R. China
| | - Wei Peng
- Department of General Surgery, Shanghai Traditional Chinese Medicine-Integrated Hospital, Shanghai, P.R. China
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27
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La Rocca E, Meneghini E, Dispinzieri M, Fiorentino A, Bonfantini F, Di Cosimo S, Gennaro M, Cosentino V, Sant M, Pignoli E, Valdagni R, Lozza L, De Santis MC. Hypofractionated irradiation in 794 elderly breast cancer patients: An observational study. Breast J 2019; 26:188-196. [DOI: 10.1111/tbj.13489] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 06/26/2019] [Accepted: 07/01/2019] [Indexed: 12/15/2022]
Affiliation(s)
- Eliana La Rocca
- Radiotherapy Unit 1 Fondazione IRCCS Istituto Nazionale dei Tumore Milan Italy
- Department of Oncology and Hemato‐oncology Università degli Studi di Milano Milan Italy
| | - Elisabetta Meneghini
- Analytical Epidemiology and Health Impact Unit Fondazione IRCCS Istituto Nazionale dei Tumori Milan Italy
| | - Michela Dispinzieri
- Radiotherapy Unit 1 Fondazione IRCCS Istituto Nazionale dei Tumore Milan Italy
| | - Alba Fiorentino
- Radiation Oncology General Regional Hospital “F. Miulli” Acqua viva delle Fonti Italy
| | | | - Serena Di Cosimo
- Department of Applied Research and Technological Development (DRAST) Fondazione IRCCS Istituto Nazionale dei Tumori Milan Italy
| | | | - Vito Cosentino
- Medical Physics Unit Fondazione IRCCS Istituto Nazionale dei Tumori Milan Italy
| | - Milena Sant
- Analytical Epidemiology and Health Impact Unit Fondazione IRCCS Istituto Nazionale dei Tumori Milan Italy
| | - Emanuele Pignoli
- Medical Physics Unit Fondazione IRCCS Istituto Nazionale dei Tumori Milan Italy
| | - Riccardo Valdagni
- Department of Oncology and Hemato‐oncology Università degli Studi di Milano Milan Italy
- Radiation Oncology 1 and Prostate Cancer Program Fondazione IRCCS Istituto Nazionale dei Tumori Milan Italy
| | - Laura Lozza
- Radiotherapy Unit 1 Fondazione IRCCS Istituto Nazionale dei Tumore Milan Italy
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28
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Bagheri S, Hashemi M, Alirahimi E, Habibi-Anbouhi M, Kazemi-Lomedasht F, Behdani M. Recombinant Expression of Zinc Transporter SLC39A6 and Its Functional Antibody Production. Monoclon Antib Immunodiagn Immunother 2019; 38:70-74. [PMID: 31009334 DOI: 10.1089/mab.2018.0045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Zinc transporter ZIP6 (SLC39A6) or LIV-1 is a protein that belongs to a subfamily of proteins group that displays structural specifications of zinc transporters in the cell membrane. Overexpression of this protein is observed in breast, prostate, and kidney tumor cells. Lately, LIV-1 is a dependable marker for detection of estrogen receptor positive breast cancer, which can be used to detect luminal breast cancer type A. In this study, the gene construct containing extracellular domain of human LIV-1 gene was subcloned into pET22b expression vector, expressed and confirmed by sodium dodecyl sulphate-polyacrylamide gel electrophoresis and western blotting. It was shown for the first time that the extracellular domain of LIV-1 could be expressed in bacterial systems and can be used for rabbit immunization. The reactivity of the resulted antibody was evaluated in flow cytometry and enzyme-linked immunosorbent assay. In conclusion, this protein can be used for animal immunization toward preparation of a new monoclonal antibody that can be introduced as a drug in the treatment of breast cancer.
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Affiliation(s)
- Sajedeh Bagheri
- 1 Biotechnology Research Center, Venom and Biotherapeutics Molecules Laboratory, Pasteur Institute of Iran, Tehran, Iran.,2 Department of New Sciences, Tehran Medical Branch, Islamic Azad University, Tehran, Iran
| | - Mehrdad Hashemi
- 2 Department of New Sciences, Tehran Medical Branch, Islamic Azad University, Tehran, Iran
| | - Ehsan Alirahimi
- 1 Biotechnology Research Center, Venom and Biotherapeutics Molecules Laboratory, Pasteur Institute of Iran, Tehran, Iran
| | | | - Fatemeh Kazemi-Lomedasht
- 1 Biotechnology Research Center, Venom and Biotherapeutics Molecules Laboratory, Pasteur Institute of Iran, Tehran, Iran
| | - Mahdi Behdani
- 1 Biotechnology Research Center, Venom and Biotherapeutics Molecules Laboratory, Pasteur Institute of Iran, Tehran, Iran
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29
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Musolino A, Michiara M, Bella MA, Naldi N, Zanelli P, Bortesi B, Capelletti M, Soldani L, Camisa R, Martella E, Franciosi V, Savi M, Neri TM, Ardizzoni A, Cascinu S. Molecular Profile and Clinical Variables in Brca1-Positive Breast Cancers. A Population-Based Study. TUMORI JOURNAL 2019; 91:505-12. [PMID: 16457150 DOI: 10.1177/030089160509100611] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Purpose To evaluate the clinical features of breast cancer patients with genetic susceptibility to this disease and to investigate the contribution of BRCA1 germline mutations to the phenotype of these tumors. Patients and Methods We reviewed the clinical and pathological records of 102 women with suspected inherited susceptibility to breast cancer consecutively seen at the Genetic Oncology Service of Parma, Italy. Sixty-two patients with a high probability of harboring a germline, cancer-predisposing mutation were tested for BRCA1 mutations. Exon 11 was screened using the protein truncation test and detected mutations were confirmed by direct sequencing (DS). All other exons were analyzed by DS. Results Among the 62 patients with a completed mutation analysis, 48 (77.4%) had wild-type BRCA1, six (9.6%) had variants of unclear significance, eight (13%) had deleterious mutations. BRCA1-associated breast cancers (BABC) were significantly less likely to be diagnosed at stage I than breast cancers in women without mutations (12.5% vs 51%; P = 0.045), more likely to have a high proliferation rate (100% vs 24%, P<0.001), and more likely to be histological grade 3 (100% vs 14%, P<0.001), estrogen and progesterone receptor negative (87.5% vs 13%, P<0.001; 75% vs 23%, P = 0.004), and p53 positive (87.5% vs 30%, P = 0.023). All tumors with BRCA1 mutations were HER-2/neu negative compared with 57% of the non-BRCA1 tumors ( P = 0.04). There were no significant differences between BABC and non-BABC in 20-year relapse-free survival, 20-year event-free survival, and 20-year overall survival. Conclusion In this population-based study, BABC seems to present with adverse molecular features when compared with non-BABC, although the prognosis appears to be similar.
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Affiliation(s)
- Antonino Musolino
- Medical Oncology Unit, University Hospital of Parma, Via Gramsci 14, 43100 Parma, Italy.
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30
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Liu T, Li B, Jiang Y, Zheng C, Zhang L, Wang Y. Screening and identification of novel specific markers of breast cancer stem cells. Oncol Lett 2019; 18:2262-2269. [PMID: 31452727 PMCID: PMC6676669 DOI: 10.3892/ol.2019.10535] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 05/08/2019] [Indexed: 01/11/2023] Open
Abstract
Breast cancer is the leading cause of death among women worldwide. Until recent years, triple negative breast cancer could be divided into 6 types according to different biomarkers with the development of sequence and microarray technology. However, these results rarely have therapeutic impact and still lack validation with the string criteria of clinical studies. Therefore, the present study aimed to screen novel markers of breast cancer stem cells and to verify the specificity in vitro and in vivo. In the present study, screening for phages specifically binding to breast cancer stem cells was performed, positive phage DNAs were extracted, and polypeptides were synthesized and labeled with FITC. The specificity of the polypeptides was identified in vitro and in vivo. Breast cancer stem cells were cultured and identified by flow cytometry. A phage random-peptide library was amplified and screened by culturing with breast cancer cells and breast cancer stem cells. The positive phage was identified by ELISA, and positive phage DNA was extracted. The DNA pellet was isolated and sent for external sequencing with the primer −96 gIII. Based on the sequencing results, a polypeptide was synthesized and labeled with FITC. The specificity to breast cancer stem cells was identified in vivo and vitro. Following three rounds of screening, the phage was enriched ~200-fold. Immunofluorescence demonstrated that two randomly selected phage clones, B8 and A3, had specific affinity to breast cancer stem cells. The results of the present study indicated that phage polypeptides that specifically bind to breast cancer stem cells were successfully screened through stem cell enrichment and phage display technology, which may be beneficial for targeted therapy and further study of breast cancer stem cells.
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Affiliation(s)
- Tingting Liu
- Breast Cancer Center, Shandong Cancer Hospital and Institute Affiliated to Shandong University, Jinan, Shandong 250117, P.R. China.,Department of Breast Surgery, Tai'an Central Hospital, Tai'an, Shandong 271000, P.R. China
| | - Baojiang Li
- Department of Breast Surgery, Tai'an Central Hospital, Tai'an, Shandong 271000, P.R. China
| | - Yunyun Jiang
- Department of Rehabilitation Medicine, Tai'an Central Hospital, Tai'an, Shandong 271000, P.R. China
| | - Chunhui Zheng
- Department of Oncology Surgery, Weifang People's Hospital, Weifang, Shandong 261000, P.R. China
| | - Li Zhang
- Department of Breast Oncology, Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital/Ministry of Education, Tianjin 300060, P.R. China
| | - Yongsheng Wang
- Breast Cancer Center, Shandong Cancer Hospital and Institute Affiliated to Shandong University, Jinan, Shandong 250117, P.R. China
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31
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Yadav S, Hartkop S, Cardenas PY, Ladkany R, Halalau A, Shoichet S, Maddens M, Zakalik D. Utilization of a breast cancer risk assessment tool by internal medicine residents in a primary care clinic: impact of an educational program. BMC Cancer 2019; 19:228. [PMID: 30871497 PMCID: PMC6416938 DOI: 10.1186/s12885-019-5418-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Accepted: 02/27/2019] [Indexed: 01/11/2023] Open
Abstract
Background Despite strong evidence of benefit, breast cancer risk assessment and chemoprevention are underutilized by primary care physicians. This study evaluates the impact of an educational program on knowledge and utilization of the NCI Breast Cancer Risk Assessment Tool (BCRAT) by internal medicine residents. Methods Internal medicine residents at the primary care clinic at William Beaumont Hospital participated in an educational program on breast cancer risk assessment and chemoprevention. A questionnaire was used to assess knowledge and practice before and after participation. Electronic health records of women between the ages of 35 and 65 who were seen by participating residents for annual health exams between Dec 15, 2015 and Dec 14, 2016 were reviewed. Utilization of BCRAT by the residents was compared pre- and post-educational program. Results A total of 43 residents participated in the study. 31 (72.1%) residents reported no prior knowledge about BCRAT. The remaining 12 (27.9%) reported limited knowledge of BCRAT, but the majority of these (n = 10, 83.3%) had not used it in the last six months. For each question on the pre-educational knowledge assessment, fewer than 10% of the residents responded correctly. After implementation of the educational program, there was a significant increase in the proportion of residents who answered correctly (Range: 67 to 100%, p < 0.001). Electronic health records of 301 clinic patients were reviewed, 118 (39.2%) in the pre-educational program group and 183 (60.8%) in the post-educational program group. There was a higher use of BCRAT in the post-educational program group compared to the pre-intervention group (3.8% vs. 0%, p < 0.05). However, a majority (n = 294, 98.7%) of eligible patients from both groups did not undergo breast cancer risk assessment. Conclusions Our study demonstrates that an educational intervention improved residents’ knowledge of BCRAT. Despite this improvement, a significant proportion of patients did not undergo breast cancer risk assessment. Expanding the scope and duration of this intervention and combining it with innovative use of technology to improve utilization should be the subject of future investigation. Electronic supplementary material The online version of this article (10.1186/s12885-019-5418-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Siddhartha Yadav
- Division of Medical Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Sarah Hartkop
- Department of Internal Medicine, Beaumont Health, 3601 W 13 Mile Rd, Royal Oak, MI, 48073, USA
| | - Paola Yumpo Cardenas
- Nancy and James Grosfeld Cancer Genetics Center, Beaumont Cancer Institute, Beaumont Health, 3577 W 13 Mile Rd, Suite 140, Royal Oak, MI, 48073, USA
| | - Rand Ladkany
- Department of Internal Medicine, Beaumont Health, 3601 W 13 Mile Rd, Royal Oak, MI, 48073, USA.,Nancy and James Grosfeld Cancer Genetics Center, Beaumont Cancer Institute, Beaumont Health, 3577 W 13 Mile Rd, Suite 140, Royal Oak, MI, 48073, USA
| | - Alexandra Halalau
- Department of Internal Medicine, Beaumont Health, 3601 W 13 Mile Rd, Royal Oak, MI, 48073, USA.,Oakland University William Beaumont School of Medicine, 2200 N Squirrel Rd, Rochester, MI, 48309, USA
| | - Sandor Shoichet
- Department of Internal Medicine, Beaumont Health, 3601 W 13 Mile Rd, Royal Oak, MI, 48073, USA.,Oakland University William Beaumont School of Medicine, 2200 N Squirrel Rd, Rochester, MI, 48309, USA
| | - Michael Maddens
- Department of Internal Medicine, Beaumont Health, 3601 W 13 Mile Rd, Royal Oak, MI, 48073, USA.,Oakland University William Beaumont School of Medicine, 2200 N Squirrel Rd, Rochester, MI, 48309, USA
| | - Dana Zakalik
- Nancy and James Grosfeld Cancer Genetics Center, Beaumont Cancer Institute, Beaumont Health, 3577 W 13 Mile Rd, Suite 140, Royal Oak, MI, 48073, USA. .,Oakland University William Beaumont School of Medicine, 2200 N Squirrel Rd, Rochester, MI, 48309, USA.
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32
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De Santis MC, Bonfantini F, Di Salvo F, Fiorentino A, Dispinzieri M, Caputo M, Di Cosimo S, Mariani G, Gennaro M, Cosentino V, Sant M, Pignoli E, Valdagni R, Lozza L. Hypofractionated Whole-Breast Irradiation With or Without Boost in Elderly Patients: Clinical Evaluation of an Italian Experience. Clin Breast Cancer 2018; 18:e1059-e1066. [PMID: 29773414 DOI: 10.1016/j.clbc.2018.04.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 03/07/2018] [Accepted: 04/02/2018] [Indexed: 01/11/2023]
Abstract
PURPOSE To examine local control, disease-free survival (DFS), and toxicity in elderly (≥ 65 years) breast cancer patients treated with hypofractionated radiotherapy (hypo-RT) with or without a boost to the tumor bed. PATIENTS AND METHODS The study was conducted on 752 patients treated from April 2009 to February 2017. Patients received 42.4 Gy in 16 daily fractions (2.65 Gy per fraction). A boost was only administered in cases of grade 3 primary tumor and close or positive margins. Acute and late toxicity was prospectively assessed during and after hypo-RT, based on the Radiation Therapy Oncology Group scale. DFS and local recurrence-free survival were estimated by the Kaplan-Meier method for cumulative probability. Log-rank tests were used to identify differences by subtype. Cox proportional hazard models were used to investigate the impact of various factors on the risk of disease progression. RESULTS Among the 752 patients treated, 41 (5.5%) experienced disease progression, including 7 (17.1%) exclusively local recurrences; 1 (2.4%) local and nodal recurrence; 1 (2.4%) local and nodal recurrence plus metastasis; 7 (17.1%) nodal recurrences plus metastases; and 25 (61%) exclusively distant metastases. The 5-year DFS, local recurrence-free survival, breast cancer-specific survival, and overall survival rates were 91.8% (95% confidence interval [CI], 88.6-94.2), 98.0% (95% CI, 96.1-99.1), 98.2% (95% CI, 96.5-99.1), and 87.5% (95% CI, 83.8-90.5), respectively. On univariate analysis, the administration of a boost, disease grade (grades 1 and 2 vs. 3), and molecular subtype (triple negative or human epidermal growth factor receptor 2 [HER2] positive, or luminal B vs. luminal A) significantly affected disease progression (P < .01). These findings were confirmed by multivariate analysis. CONCLUSION Hypo-RT is effective and well tolerated in the elderly population, and the routine use of a boost for patients over 65 years is not justified. Further studies on the boost issue are strongly advocated.
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Affiliation(s)
| | - Francesca Bonfantini
- Medical Physics Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Francesca Di Salvo
- Analytical Epidemiology and Health Impact Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Alba Fiorentino
- Radiation Oncology, Sacro Cuore Don Calabria Cancer Care Center, Negrar, Verona, Italy
| | - Michela Dispinzieri
- Radiotherapy Unit 1, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Mariangela Caputo
- Radiotherapy Unit 1, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Serena Di Cosimo
- Department of Applied Research and Technological Development (DRAST), Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Gabriella Mariani
- Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Massimiliano Gennaro
- Breast Surgery Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Vito Cosentino
- Medical Physics Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Milena Sant
- Analytical Epidemiology and Health Impact Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Emanuele Pignoli
- Medical Physics Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Riccardo Valdagni
- Radiation Oncology 1 and Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; Department of Oncology and Hemato-oncology, Università degli Studi di Milano, Milan, Italy
| | - Laura Lozza
- Radiotherapy Unit 1, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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The effects of increasing longevity and changing incidence on lifetime risk differentials: A decomposition approach. PLoS One 2018; 13:e0195307. [PMID: 29672532 PMCID: PMC5909551 DOI: 10.1371/journal.pone.0195307] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Accepted: 03/20/2018] [Indexed: 01/11/2023] Open
Abstract
Increasing longevity can distort time trends in summary measures of health and mortality, such as the lifetime risk of getting diseased. If not observing a cohort, this lifetime risk is calculated with cross-sectional data on age-specific incidence and survival. In those instances, incidence and survival may work in opposite directions resulting in lifetime risk estimates where, reductions in incidence might be offset by a simultaneous longevity increase. The proposed method decomposes the difference between two lifetime risks into contributions of changing incidence and changing survival. The approach can be extended to measure the contributions of changes in disease related mortality and even case fatality. We illustrate the method with hypothetical examples as well as remaining lifetime risk at age 60 of experiencing a myocardial infarction, colorectal cancer and hip fractures for Swedish males. The empirical examples show that the influence of increasing longevity on the development of lifetime risk depends on the respective age profile of occurrence. In the cases of myocardial infarction and hip fracture, longevity increases of the general population counterbalanced or even exceeded the substantial gains in disease incidence, while for colorectal cancer, the lifetime risk was almost unaffected by the longevity improvement. This was because colorectal cancer has an on average earlier onset than myocardial infarction and hip fracture.
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Bennett A, Sirkis T, Beiderman Y, Agdarov S, Beiderman Y, Zalevsky Z. Breast cancer early detection via tracking of skin back-scattered secondary speckle patterns. NANOSCALE IMAGING, SENSING, AND ACTUATION FOR BIOMEDICAL APPLICATIONS XV 2018. [DOI: 10.1117/12.2286791] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/04/2023]
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Lin YF, Tseng IJ, Kuo CJ, Lin HY, Chiu IJ, Chiu HW. High-level expression of ARID1A predicts a favourable outcome in triple-negative breast cancer patients receiving paclitaxel-based chemotherapy. J Cell Mol Med 2018; 22:2458-2468. [PMID: 29392887 PMCID: PMC5867090 DOI: 10.1111/jcmm.13551] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Accepted: 12/28/2017] [Indexed: 12/25/2022] Open
Abstract
Paclitaxel‐based chemotherapy is a common strategy to treat patients with triple‐negative breast cancer (TNBC). As paclitaxel resistance is still a clinical issue in treating TNBCs, identifying molecular markers for predicting pathologic responses to paclitaxel treatment is thus urgently needed. Here, we report that an AT‐rich interaction domain 1A (ARID1A) transcript is up‐regulated in paclitaxel‐sensitive TNBC cells but down‐regulated in paclitaxel‐resistant cells upon paclitaxel treatment. Moreover, ARID1A expression was negatively correlated with the IC50 concentration of paclitaxel in the tested TNBC cell lines. Kaplan‐Meier analyses revealed that ARID1A down‐regulation was related to a poorer response to paclitaxel‐based chemotherapy in patients with TNBCs as measured by the recurrence‐free survival probability. The pharmaceutical inhibition with p38MAPK‐specific inhibitor SCIO‐469 revealed that p38MAPK‐related signalling axis regulates ARID1A expression and thereby modulates paclitaxel sensitivity in TNBC cells. These findings suggest that ARID1A could be used as a prognostic factor to estimate the pathological complete response for TNBC patients who decide to receive paclitaxel‐based chemotherapy.
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Affiliation(s)
- Yuan-Feng Lin
- Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Ing-Jy Tseng
- School of Gerontology Healthy Management, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Chih-Jung Kuo
- Department of Veterinary Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Hui-Yu Lin
- Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Division of Breast Surgery and General Surgery, Department of Surgery, Cardinal Tien Hospital, Xindian District, New Taipei City, Taiwan
| | - I-Jen Chiu
- Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Division of Nephrology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Hui-Wen Chiu
- Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Division of Nephrology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
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36
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Calobrace MB, Schwartz MR, Zeidler KR, Pittman TA, Cohen R, Stevens WG. Long-Term Safety of Textured and Smooth Breast Implants. Aesthet Surg J 2017; 38:38-48. [PMID: 29040370 DOI: 10.1093/asj/sjx157] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
In this review, the authors provide a 20-year review and comparison of implant options and describe the evolution of breast implant surface textures; compare available implant surfaces; present long-term safety data from the 10-year US-based Core clinical studies; list the key benefits and risks associated with smooth and textured implants; and provide perspectives on breast implant-associated anaplastic large cell lymphoma (BIA-ALCL). The authors explore the key benefits and risks associated with all available devices so that optimal and safe patient outcomes can be achieved.
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Affiliation(s)
- M Bradley Calobrace
- Division of Plastic Surgery, University of Louisville, Louisville, KY
- Division of Plastic Surgery, University of Kentucky, Lexington, KY
| | | | | | | | | | - W Grant Stevens
- Division of Plastic Surgery, University of Southern California School of Medicine
- University of Southern California - Marina del Rey Aesthetic Surgery Fellowship Program, Los Angeles, CA
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Prevalence of incidental breast cancer and precursor lesions in autopsy studies: a systematic review and meta-analysis. BMC Cancer 2017; 17:808. [PMID: 29197354 PMCID: PMC5712106 DOI: 10.1186/s12885-017-3808-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Accepted: 11/21/2017] [Indexed: 01/11/2023] Open
Abstract
Background Autopsy studies demonstrate the prevalence pool of incidental breast cancer in the population, but estimates are uncertain due to small numbers in any primary study. We aimed to conduct a systematic review of autopsy studies to estimate the prevalence of incidental breast cancer and precursors. Methods Relevant articles were identified through searching PubMed and Embase from inception up to April 2016, and backward and forward citations. We included autopsy studies of women with no history of breast pathology, which included systematic histological examination of at least one breast, and which allowed calculation of the prevalence of incidental breast cancer or precursor lesions. Data were pooled using logistic regression models with random intercepts (non-linear mixed models). Results We included 13 studies from 1948 to 2010, contributing 2363 autopsies with 99 cases of incidental cancer or precursor lesions. More thorough histological examination (≥20 histological sections) was a strong predictor of incidental in-situ cancer and atypical hyperplasia (OR = 126·8 and 21·3 respectively, p < 0·001), but not invasive cancer (OR = 1·1, p = 0·75). The estimated mean prevalence of incidental cancer or precursor lesion was 19·5% (0·85% invasive cancer + 8·9% in-situ cancer + 9·8% atypical hyperplasia). Conclusion Our systematic review in ten countries over six decades found that incidental detection of cancer in situ and breast cancer precursors is common in women not known to have breast disease during life. The large prevalence pool of undetected cancer in-situ and atypical hyperplasia in these autopsy studies suggests screening programs should be cautious about introducing more sensitive tests that may increase detection of these lesions.
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38
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Bennett A, Sirkis T, Beiderman Y, Agdarov S, Beiderman Y, Zalevsky Z. Approach to breast cancer early detection via tracking of secondary speckle patterns reflected from the skin with artificial intradermal impurity. BIOMEDICAL OPTICS EXPRESS 2017; 8:5359-5367. [PMID: 29296472 PMCID: PMC5745087 DOI: 10.1364/boe.8.005359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 09/26/2017] [Accepted: 10/02/2017] [Indexed: 06/07/2023]
Abstract
Breast cancer has become a major cause of death among women. The lifetime risk of a woman developing this disease has been established as one in eight. The most useful way to reduce breast cancer death is to treat the disease as early as possible. The existing methods of early diagnostics of breast cancer are mainly based on screening mammography or Magnetic Resonance Imaging (MRI) periodically conducted at medical facilities. In this paper the authors proposing a new approach for simple breast cancer detection. It is based on skin stimulation by sound waves, illuminating it by laser beam and tracking the reflected secondary speckle patterns. As first approach, plastic balls of different sizes were placed under the skin of chicken breast and detected by the proposed method.
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Ben Mabrouk H, Nejia S, Maram M, Naziha M, Soufia CE. A New Protein Extract Inhibitor from Hypobranchial Purple Gland of Hexaplex trunculus, a Mediterranean Mollusk, Impairs the Motility of Human Glioblastoma U87 and the HeLa Cell Line of Cervical Carcinoma Cells. Nutr Cancer 2017; 69:1028-1035. [PMID: 29083237 DOI: 10.1080/01635581.2017.1359315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The aim of this study is to evaluate the effect of hypobranchial gland protein extracts (HGPEs) of Hexaplex trunculus on the viability, cell adhesion, and migration of human U87 glioblastoma cells and the HeLa cell line obtained from epithelial cervical carcinoma cells. Analysis of the HGPE on polyacrylamide gel (12%) shows a variety of proteins whose molecular weights vary between 12 and 1OO kDa. Chromatographic analysis shows 16 peaks obtained at various retention times. Cytotoxic effect was observed after 24 hours of incubation at the concentrations 20, 40, and 60 μg/ml in a dose-dependent manner. Concentrations giving 50% inhibition (IC50) are 22 μg/ml for U87 and 15 μg/ml for HeLa cells. Our results show inhibition of U87 and HeLa cancer cell adhesion at concentrations of 10 and 20 µg/ml, respectively. High-pressure liquid chromatography fractions did not show antiadhesive effect on both cancer cell lines. The presence of HGPEs completely blocked the migration of the two cancer cell lines at 10 µg/ml. This inhibition is dose-dependent. IC50 is about 2.5 μg/ml for both cancer cells. The HGPE of Hexaplex trunculus may have the potential to serve as a model for future anticancer drug development with probably a synergistic activity of the proteins of this extract.
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Affiliation(s)
- Hazem Ben Mabrouk
- a Tunis El Manar University, Pasteur Institute Tunis, Laboratory of Venoms and Therapeutic Biomolecule , Tunis , Tunisia
| | - Sayari Nejia
- a Tunis El Manar University, Pasteur Institute Tunis, Laboratory of Venoms and Therapeutic Biomolecule , Tunis , Tunisia
| | - Morjen Maram
- a Tunis El Manar University, Pasteur Institute Tunis, Laboratory of Venoms and Therapeutic Biomolecule , Tunis , Tunisia
| | - Marrakchi Naziha
- a Tunis El Manar University, Pasteur Institute Tunis, Laboratory of Venoms and Therapeutic Biomolecule , Tunis , Tunisia
| | - Chabchoub-Ellouze Soufia
- a Tunis El Manar University, Pasteur Institute Tunis, Laboratory of Venoms and Therapeutic Biomolecule , Tunis , Tunisia.,b Tunis El Manar University, Higher Institute of Medical Biotechnology Tunis, Laboratory of Biophysical and Medical Technology , Tunis , Tunisia
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40
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Li H, Giger ML, Huynh BQ, Antropova NO. Deep learning in breast cancer risk assessment: evaluation of convolutional neural networks on a clinical dataset of full-field digital mammograms. J Med Imaging (Bellingham) 2017; 4:041304. [PMID: 28924576 DOI: 10.1117/1.jmi.4.4.041304] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 08/18/2017] [Indexed: 01/11/2023] Open
Abstract
To evaluate deep learning in the assessment of breast cancer risk in which convolutional neural networks (CNNs) with transfer learning are used to extract parenchymal characteristics directly from full-field digital mammographic (FFDM) images instead of using computerized radiographic texture analysis (RTA), 456 clinical FFDM cases were included: a "high-risk" BRCA1/2 gene-mutation carriers dataset (53 cases), a "high-risk" unilateral cancer patients dataset (75 cases), and a "low-risk dataset" (328 cases). Deep learning was compared to the use of features from RTA, as well as to a combination of both in the task of distinguishing between high- and low-risk subjects. Similar classification performances were obtained using CNN [area under the curve [Formula: see text]; standard error [Formula: see text]] and RTA ([Formula: see text]; [Formula: see text]) in distinguishing BRCA1/2 carriers and low-risk women. However, in distinguishing unilateral cancer patients and low-risk women, performance was significantly greater with CNN ([Formula: see text]; [Formula: see text]) compared to RTA ([Formula: see text]; [Formula: see text]). Fusion classifiers performed significantly better than the RTA-alone classifiers with AUC values of 0.86 and 0.84 in differentiating BRCA1/2 carriers from low-risk women and unilateral cancer patients from low-risk women, respectively. In conclusion, deep learning extracted parenchymal characteristics from FFDMs performed as well as, or better than, conventional texture analysis in the task of distinguishing between cancer risk populations.
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Affiliation(s)
- Hui Li
- University of Chicago, Department of Radiology, Chicago, Illinois, United States
| | - Maryellen L Giger
- University of Chicago, Department of Radiology, Chicago, Illinois, United States
| | - Benjamin Q Huynh
- University of Chicago, Department of Radiology, Chicago, Illinois, United States
| | - Natalia O Antropova
- University of Chicago, Department of Radiology, Chicago, Illinois, United States
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Kubota Y, Heiss G, MacLehose RF, Roetker NS, Folsom AR. Association of Educational Attainment With Lifetime Risk of Cardiovascular Disease: The Atherosclerosis Risk in Communities Study. JAMA Intern Med 2017; 177:1165-1172. [PMID: 28604921 PMCID: PMC5710437 DOI: 10.1001/jamainternmed.2017.1877] [Citation(s) in RCA: 102] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
IMPORTANCE Estimates of lifetime risk may help raise awareness of the extent to which educational inequalities are associated with risk of cardiovascular disease (CVD). OBJECTIVE To estimate lifetime risks of CVD according to categories of educational attainment. DESIGN, SETTING, AND PARTICIPANTS Participants were followed from 1987 through December 31, 2013. All CVD events (coronary heart disease, heart failure, and stroke) were confirmed by physician review and International Classification of Diseases codes. A total of 13 948 whites and African Americans who were 45 to 64 years old and free of CVD at baseline were included from 4 US communities (Washington County, Maryland; Forsyth County, North Carolina; Jackson, Mississippi; and suburbs of Minneapolis, Minnesota). The data analysis was performed from June 7 to August 31, 2016. EXPOSURES Educational attainment. MAIN OUTCOMES AND MEASURES We used a life table approach to estimate lifetime risks of CVD from age 45 through 85 years according to educational attainment. We adjusted for competing risks of death from underlying causes other than CVD. RESULTS The sample of 13 948 participants was 56% female and 27% African American. During 269 210 person-years of follow-up, we documented 4512 CVD events and 2401 non-CVD deaths. Educational attainment displayed an inverse dose-response relation with cumulative risk of CVD, which became evident in middle age, with the most striking gap between those not completing vs completing high school. In men, lifetime risks of CVD were 59.0% (95% CI, 54.0%-64.1%) for grade school, 52.5% (95% CI, 47.7%-56.8%) for high school education without graduation, 50.9% (95% CI, 47.3%-53.9%) for high school graduation, 47.2% (95% CI, 41.5%-52.5%) for vocational school, 46.4% (95% CI, 42.8%-49.6%) for college with or without graduation, and 42.2% (95% CI, 36.6%-47.0%) for graduate/professional school; in women, 50.8% (95% CI, 45.7%-55.8%), 49.3% (95% CI, 45.1%-53.1%), 36.3% (95% CI, 33.4%-39.1%), 32.2% (95% CI, 26.0%-37.3%), 32.8% (95% CI, 29.1%-35.9%), and 28.0% (95% CI, 21.9%-33.3%), respectively. Educational attainment was inversely associated with CVD even within categories of family income, income change, occupation, or parental educational level. CONCLUSIONS AND RELEVANCE More than 1 in 2 individuals with less than high school education had a lifetime CVD event. Educational attainment was inversely associated with the lifetime risk of CVD, regardless of other important socioeconomic characteristics. Our findings emphasize the need for further efforts to reduce CVD inequalities related to educational disparities.
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Affiliation(s)
- Yasuhiko Kubota
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota.,Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Gerardo Heiss
- Department of Epidemiology, the University of North Carolina, Chapel Hill, North Carolina
| | - Richard F MacLehose
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Nicholas S Roetker
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Aaron R Folsom
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
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Fiorentino A, Mazzola R, Giaj Levra N, Fersino S, Ricchetti F, Di Paola G, Gori S, Massocco A, Alongi F. Comorbidities and intensity-modulated radiotherapy with simultaneous integrated boost in elderly breast cancer patients. Aging Clin Exp Res 2017; 30:533-538. [DOI: 10.1007/s40520-017-0802-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 07/14/2017] [Indexed: 12/11/2022]
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Reassessing risk models for atypical hyperplasia: age may not matter. Breast Cancer Res Treat 2017; 165:285-291. [PMID: 28589368 DOI: 10.1007/s10549-017-4320-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 05/27/2017] [Indexed: 01/11/2023]
Abstract
PURPOSE The aim of this study was to investigate the influence of age at diagnosis of atypical hyperplasia ("atypia", ductal [ADH], lobular [ALH], or severe ADH) on the risk of developing subsequent invasive breast cancer or ductal carcinoma in situ (DCIS). METHODS Using standard survival analysis methods, we retrospectively analyzed 1353 women not treated with chemoprevention among a cohort of 2370 women diagnosed with atypical hyperplasia to determine the risk relationship between age at diagnosis and subsequent breast cancer. RESULTS For all atypia diagnoses combined, our cohort showed a 5-, 10-, and 15-year risk of invasive breast cancer or DCIS of 0.56, 1.25, and 1.30, respectively, with no significant difference in the (65,75] year age group. For women aged (35,75] years, we observed no significant difference in the 15-year risk of invasive breast cancer or DCIS after atypical hyperplasia, although the baseline risk for a 40-year-old woman is approximately 1/8 the risk of a 70-year-old woman. The risks associated with invasive breast cancer or DCIS for women in our cohort diagnosed with ADH, severe ADH, or ALH, regardless of age, were 7.6% (95% CI 5.9-9.3%) at 5 years, 25.1% (20.7-29.2%) at 10 years, and 40.1% (32.8-46.6%) at 15 years. CONCLUSION In contrast to current risk prediction models (e.g., Gail, Tyrer-Cuzick) which assume that the risk of developing breast cancer increases in relation to age at diagnosis of atypia, we found the 15-year cancer risk in our cohort was not significantly different for women between the ages of 35 (excluded) and 75. This implies that the "hits" received by the breast tissue along the "high-risk pathway" to cancer might possibly supersede other factors such as age.
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44
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Qin J, Barbour KE, Murphy LB, Nelson AE, Schwartz TA, Helmick CG, Allen KD, Renner JB, Baker NA, Jordan JM. Lifetime Risk of Symptomatic Hand Osteoarthritis: The Johnston County Osteoarthritis Project. Arthritis Rheumatol 2017; 69:1204-1212. [PMID: 28470947 DOI: 10.1002/art.40097] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Accepted: 03/09/2017] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Symptomatic hand osteoarthritis (OA) is a common condition that affects hand strength and function, and causes disability in activities of daily living. Prior studies have estimated that the lifetime risk of symptomatic knee OA is 45% and that of hip OA is 25%. The objective of the present study was to estimate the overall lifetime risk of symptomatic hand OA, and the stratified lifetime risk according to potential risk factors. METHODS Data were obtained from 2,218 adult subjects (ages ≥45 years) in the Johnston County Osteoarthritis Project, a population-based prospective cohort study among residents of Johnston County, North Carolina. Data for the present study were collected from 2 of the follow-up cycles (1999-2004 and 2005-2010). Symptomatic hand OA was defined as the presence of both self-reported symptoms and radiographic OA in the same hand. Lifetime risk, defined as the proportion of the population who will develop symptomatic hand OA in at least 1 hand by age 85 years, was estimated from models using generalized estimating equations. RESULTS Overall, the lifetime risk of symptomatic hand OA was 39.8% (95% confidence interval [95% CI] 34.4-45.3%). In this population, nearly 1 in 2 women (47.2%, 95% CI 40.6-53.9%) had an estimated lifetime risk of developing symptomatic hand OA by age 85 years, compared with 1 in 4 men (24.6%, 95% CI 19.5-30.5%). Race-specific symptomatic hand OA risk estimates were 41.4% (95% CI 35.5-47.6%) among whites and 29.2% (95% CI 20.5-39.7%) among African Americans. The lifetime risk of symptomatic hand OA among individuals with obesity (47.1%, 95% CI 37.8-56.7%) was 11 percentage points higher than that in individuals without obesity (36.1%, 95% CI 29.7-42.9%). CONCLUSION These findings demonstrate the substantial burden of symptomatic hand OA overall and in sociodemographic and clinical subgroups. Increased use of public health and clinical interventions is needed to address its impact.
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Affiliation(s)
- Jin Qin
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kamil E Barbour
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Louise B Murphy
- Centers for Disease Control and Prevention, Atlanta, Georgia
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Park HJ, Kim SH, Moon DO. Growth inhibition of human breast carcinoma cells by overexpression of regulator of G-protein signaling 4. Oncol Lett 2017; 13:4357-4363. [PMID: 28588709 DOI: 10.3892/ol.2017.6009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Accepted: 07/15/2016] [Indexed: 01/05/2023] Open
Abstract
Breast cancer remains the second largest cause of mortality in women with cancer and does not respond well to conventional therapies. Regulator of G-protein signaling 4 (RGS4) is a GTPase-activating protein of the heterotrimeric Gq and Gi proteins. Altered levels of RGS4 are reportedly linked with several human diseases, including cancer. The present study investigated whether overexpression of RGS4 inhibited the growth of human breast cancer cells. Protein expression was investigated by western blot analysis. Cell viability and apoptosis were analyzed by MTT assay and flow cytometric analysis, respectively. Cell cycle analysis was performed using propidium iodide staining in order to examine the anti-proliferative function of increased RGS4 levels. Next, changes in the expression levels of G2/M cell cycle-related proteins were examined. Overexpression of RGS4 led to the upregulation of phosphorylayed (p)-Ser216 cell division cycle (Cdc)25C and p-Tyr15 Cdc2. Importantly, MG132-induced proteasome blockade prevented degradation of RGS4. Suppression of proliferation was associated with G2/M-phase cell cycle arrest. Furthermore, enhanced endogenous RGS4 protein levels significantly inhibited breast cancer cell growth, which was reversed by a pharmacological inhibitor of RGS4. Taken together, these results suggest that overexpression of RGS4 in human breast cancer cells by molecular means may offer a potential therapeutic approach.
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Affiliation(s)
- Hyun-Jung Park
- Department of Biology Education, Daegu University, Gyeongsan, Gyeongsangbuk-do 38453, Republic of Korea
| | - Seung-Hyun Kim
- Department of Biology Education, Daegu University, Gyeongsan, Gyeongsangbuk-do 38453, Republic of Korea
| | - Dong-Oh Moon
- Department of Biology Education, Daegu University, Gyeongsan, Gyeongsangbuk-do 38453, Republic of Korea
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Alinejad V, Dolati S, Motallebnezhad M, Yousefi M. The role of IL17B-IL17RB signaling pathway in breast cancer. Biomed Pharmacother 2017; 88:795-803. [DOI: 10.1016/j.biopha.2017.01.120] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2016] [Revised: 01/19/2017] [Accepted: 01/20/2017] [Indexed: 12/20/2022] Open
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Kim SH, Park HJ, Moon DO. Sulforaphane sensitizes human breast cancer cells to paclitaxel-induced apoptosis by downregulating the NF-κB signaling pathway. Oncol Lett 2017; 13:4427-4432. [PMID: 28599444 DOI: 10.3892/ol.2017.5950] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Accepted: 11/03/2016] [Indexed: 12/21/2022] Open
Abstract
Sulforaphane (SFN), an isothiocyanate present in cruciferous vegetables, has been demonstrated to inhibit the growth of various types of cancer cell. The aim of the present study was to investigate whether SFN sensitizes breast cancer cells to paclitaxel-induced apoptosis and to identify the signal pathway through which SFN mediates apoptosis. Combined treatment of breast cancer cells with SFN and paclitaxel resulted in increased activation of apoptotic signaling pathway members, including caspase-3, -8 and -9, and cytochrome c, compared with treatment with SFN or paclitaxel alone. In addition, treatment with SFN and paclitaxel resulted in downregulation of the nuclear factor kappa B signaling pathway, and reduced protein expression of apoptosis regulator Bcl-2 and phosphorylated AKT serine/threonine kinase. Furthermore, SFN-paclitaxel-induced apoptosis was inhibited by overexpression of Bcl-2. The results of the present study suggest that combined treatment with SFN and paclitaxel is a novel therapeutic strategy for the treatment of breast cancer.
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Affiliation(s)
- Seung-Hyun Kim
- Department of Biology Education, Daegu University, Gyeongsan, Gyeongsang 38453, Republic of Korea
| | - Hyun-Jung Park
- Department of Biology Education, Daegu University, Gyeongsan, Gyeongsang 38453, Republic of Korea
| | - Dong-Oh Moon
- Department of Biology Education, Daegu University, Gyeongsan, Gyeongsang 38453, Republic of Korea
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48
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Onisko A, Druzdzel MJ, Austin RM. How to interpret the results of medical time series data analysis: Classical statistical approaches versus dynamic Bayesian network modeling. J Pathol Inform 2016; 7:50. [PMID: 28163973 PMCID: PMC5248402 DOI: 10.4103/2153-3539.197191] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Accepted: 11/17/2016] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Classical statistics is a well-established approach in the analysis of medical data. While the medical community seems to be familiar with the concept of a statistical analysis and its interpretation, the Bayesian approach, argued by many of its proponents to be superior to the classical frequentist approach, is still not well-recognized in the analysis of medical data. AIM The goal of this study is to encourage data analysts to use the Bayesian approach, such as modeling with graphical probabilistic networks, as an insightful alternative to classical statistical analysis of medical data. MATERIALS AND METHODS This paper offers a comparison of two approaches to analysis of medical time series data: (1) classical statistical approach, such as the Kaplan-Meier estimator and the Cox proportional hazards regression model, and (2) dynamic Bayesian network modeling. Our comparison is based on time series cervical cancer screening data collected at Magee-Womens Hospital, University of Pittsburgh Medical Center over 10 years. RESULTS The main outcomes of our comparison are cervical cancer risk assessments produced by the three approaches. However, our analysis discusses also several aspects of the comparison, such as modeling assumptions, model building, dealing with incomplete data, individualized risk assessment, results interpretation, and model validation. CONCLUSION Our study shows that the Bayesian approach is (1) much more flexible in terms of modeling effort, and (2) it offers an individualized risk assessment, which is more cumbersome for classical statistical approaches.
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Affiliation(s)
- Agnieszka Onisko
- Department of Pathology, University of Pittsburgh Medical Center, Magee-Womens Hospital, Pittsburgh, PA 15213, USA
- Faculty of Computer Science, Bialystok University of Technology, 15-351 Bialystok, Poland
| | - Marek J. Druzdzel
- Faculty of Computer Science, Bialystok University of Technology, 15-351 Bialystok, Poland
- Decision Systems Laboratory, School of Information Sciences and Intelligent Systems Program, University of Pittsburgh, Pittsburgh, PA 15260, USA
| | - R. Marshall Austin
- Department of Pathology, University of Pittsburgh Medical Center, Magee-Womens Hospital, Pittsburgh, PA 15213, USA
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Tang W, Yao L, Roetker NS, Alonso A, Lutsey PL, Steenson CC, Lederle FA, Hunter DW, Bengtson LGS, Guan W, Missov E, Folsom AR. Lifetime Risk and Risk Factors for Abdominal Aortic Aneurysm in a 24-Year Prospective Study: The ARIC Study (Atherosclerosis Risk in Communities). Arterioscler Thromb Vasc Biol 2016; 36:2468-2477. [PMID: 27834688 DOI: 10.1161/atvbaha.116.308147] [Citation(s) in RCA: 95] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Accepted: 10/03/2016] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Abdominal aortic aneurysm (AAA) is an important vascular disease in older adults, but data on lifetime risk of AAA are sparse. We examined lifetime risk of AAA in a community-based cohort and prospectively assessed the association between midlife cardiovascular risk factors and AAAs. APPROACH AND RESULTS In ARIC study (Atherosclerosis Risk in Communities), 15 792 participants were recruited at visit 1 in 1987 to 1989 and followed up through 2013. Longitudinal smoking status was defined using smoking behavior ascertained from visit 1 (1987-1989) to visit 4 (1996-1998). We followed up participants for incident, clinical AAAs using hospital discharge diagnoses, Medicare outpatient diagnoses, or death certificates through 2011 and identified 590 incident AAAs. An abdominal ultrasound was conducted in 2011 to 2013 in 5911 surviving participants, and 75 asymptomatic AAAs were identified. We estimated the lifetime risk of AAA from the index age 45 years through 85 years of age. At age 45, the lifetime risk for AAA was 5.6% (95% confidence interval, 4.8-6.1) and was higher in men (8.2%) and current smokers (10.5%). Smokers who quit smoking between visit 1 and visit 4 had a 29% lower AAA lifetime risk compared with continuous smokers but had a higher risk than pre-visit 1 quitters. The lifetime risk of rupture or medical intervention was 1.6% (95% confidence interval, 1.2-1.8). Smoking, white race, male sex, greater height, and greater low-density lipoprotein or total cholesterol were associated with an increased risk of clinical AAA and asymptomatic AAA. CONCLUSIONS At least 1 in 9 middle-aged current smokers developed AAA in their lifetime. Smoking cessation reduced the lifetime risk of AAA.
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Affiliation(s)
- Weihong Tang
- From the Division of Epidemiology and Community Health (W.T., L.Y., N.S.R., P.L.L., A.R.F.) and Division of Biostatistics (W.G.), School of Public Health, Division of Cardiology (E.M.), Department of Medicine, School of Medicine (F.A.L., D.W.H., E.M.), University of Minnesota, Minneapolis; Department of Imaging (C.C.S.), Minneapolis VA Health Care System (C.C.S., F.A.L.), MN; Health Economics and Outcomes Research, Life Sciences, Optum, Eden Prairie, MN (L.G.S.B.); and Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA (A.A.).
| | - Lu Yao
- From the Division of Epidemiology and Community Health (W.T., L.Y., N.S.R., P.L.L., A.R.F.) and Division of Biostatistics (W.G.), School of Public Health, Division of Cardiology (E.M.), Department of Medicine, School of Medicine (F.A.L., D.W.H., E.M.), University of Minnesota, Minneapolis; Department of Imaging (C.C.S.), Minneapolis VA Health Care System (C.C.S., F.A.L.), MN; Health Economics and Outcomes Research, Life Sciences, Optum, Eden Prairie, MN (L.G.S.B.); and Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA (A.A.)
| | - Nicholas S Roetker
- From the Division of Epidemiology and Community Health (W.T., L.Y., N.S.R., P.L.L., A.R.F.) and Division of Biostatistics (W.G.), School of Public Health, Division of Cardiology (E.M.), Department of Medicine, School of Medicine (F.A.L., D.W.H., E.M.), University of Minnesota, Minneapolis; Department of Imaging (C.C.S.), Minneapolis VA Health Care System (C.C.S., F.A.L.), MN; Health Economics and Outcomes Research, Life Sciences, Optum, Eden Prairie, MN (L.G.S.B.); and Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA (A.A.)
| | - Alvaro Alonso
- From the Division of Epidemiology and Community Health (W.T., L.Y., N.S.R., P.L.L., A.R.F.) and Division of Biostatistics (W.G.), School of Public Health, Division of Cardiology (E.M.), Department of Medicine, School of Medicine (F.A.L., D.W.H., E.M.), University of Minnesota, Minneapolis; Department of Imaging (C.C.S.), Minneapolis VA Health Care System (C.C.S., F.A.L.), MN; Health Economics and Outcomes Research, Life Sciences, Optum, Eden Prairie, MN (L.G.S.B.); and Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA (A.A.)
| | - Pamela L Lutsey
- From the Division of Epidemiology and Community Health (W.T., L.Y., N.S.R., P.L.L., A.R.F.) and Division of Biostatistics (W.G.), School of Public Health, Division of Cardiology (E.M.), Department of Medicine, School of Medicine (F.A.L., D.W.H., E.M.), University of Minnesota, Minneapolis; Department of Imaging (C.C.S.), Minneapolis VA Health Care System (C.C.S., F.A.L.), MN; Health Economics and Outcomes Research, Life Sciences, Optum, Eden Prairie, MN (L.G.S.B.); and Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA (A.A.)
| | - Carol C Steenson
- From the Division of Epidemiology and Community Health (W.T., L.Y., N.S.R., P.L.L., A.R.F.) and Division of Biostatistics (W.G.), School of Public Health, Division of Cardiology (E.M.), Department of Medicine, School of Medicine (F.A.L., D.W.H., E.M.), University of Minnesota, Minneapolis; Department of Imaging (C.C.S.), Minneapolis VA Health Care System (C.C.S., F.A.L.), MN; Health Economics and Outcomes Research, Life Sciences, Optum, Eden Prairie, MN (L.G.S.B.); and Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA (A.A.)
| | - Frank A Lederle
- From the Division of Epidemiology and Community Health (W.T., L.Y., N.S.R., P.L.L., A.R.F.) and Division of Biostatistics (W.G.), School of Public Health, Division of Cardiology (E.M.), Department of Medicine, School of Medicine (F.A.L., D.W.H., E.M.), University of Minnesota, Minneapolis; Department of Imaging (C.C.S.), Minneapolis VA Health Care System (C.C.S., F.A.L.), MN; Health Economics and Outcomes Research, Life Sciences, Optum, Eden Prairie, MN (L.G.S.B.); and Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA (A.A.)
| | - David W Hunter
- From the Division of Epidemiology and Community Health (W.T., L.Y., N.S.R., P.L.L., A.R.F.) and Division of Biostatistics (W.G.), School of Public Health, Division of Cardiology (E.M.), Department of Medicine, School of Medicine (F.A.L., D.W.H., E.M.), University of Minnesota, Minneapolis; Department of Imaging (C.C.S.), Minneapolis VA Health Care System (C.C.S., F.A.L.), MN; Health Economics and Outcomes Research, Life Sciences, Optum, Eden Prairie, MN (L.G.S.B.); and Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA (A.A.)
| | - Lindsay G S Bengtson
- From the Division of Epidemiology and Community Health (W.T., L.Y., N.S.R., P.L.L., A.R.F.) and Division of Biostatistics (W.G.), School of Public Health, Division of Cardiology (E.M.), Department of Medicine, School of Medicine (F.A.L., D.W.H., E.M.), University of Minnesota, Minneapolis; Department of Imaging (C.C.S.), Minneapolis VA Health Care System (C.C.S., F.A.L.), MN; Health Economics and Outcomes Research, Life Sciences, Optum, Eden Prairie, MN (L.G.S.B.); and Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA (A.A.)
| | - Weihua Guan
- From the Division of Epidemiology and Community Health (W.T., L.Y., N.S.R., P.L.L., A.R.F.) and Division of Biostatistics (W.G.), School of Public Health, Division of Cardiology (E.M.), Department of Medicine, School of Medicine (F.A.L., D.W.H., E.M.), University of Minnesota, Minneapolis; Department of Imaging (C.C.S.), Minneapolis VA Health Care System (C.C.S., F.A.L.), MN; Health Economics and Outcomes Research, Life Sciences, Optum, Eden Prairie, MN (L.G.S.B.); and Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA (A.A.)
| | - Emil Missov
- From the Division of Epidemiology and Community Health (W.T., L.Y., N.S.R., P.L.L., A.R.F.) and Division of Biostatistics (W.G.), School of Public Health, Division of Cardiology (E.M.), Department of Medicine, School of Medicine (F.A.L., D.W.H., E.M.), University of Minnesota, Minneapolis; Department of Imaging (C.C.S.), Minneapolis VA Health Care System (C.C.S., F.A.L.), MN; Health Economics and Outcomes Research, Life Sciences, Optum, Eden Prairie, MN (L.G.S.B.); and Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA (A.A.)
| | - Aaron R Folsom
- From the Division of Epidemiology and Community Health (W.T., L.Y., N.S.R., P.L.L., A.R.F.) and Division of Biostatistics (W.G.), School of Public Health, Division of Cardiology (E.M.), Department of Medicine, School of Medicine (F.A.L., D.W.H., E.M.), University of Minnesota, Minneapolis; Department of Imaging (C.C.S.), Minneapolis VA Health Care System (C.C.S., F.A.L.), MN; Health Economics and Outcomes Research, Life Sciences, Optum, Eden Prairie, MN (L.G.S.B.); and Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA (A.A.)
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Turin TC, Saad N, Jun M, Tonelli M, Ma Z, Barnabe CCM, Manns B, Hemmelgarn B. Lifetime risk of diabetes among First Nations and non-First Nations people. CMAJ 2016; 188:1147-1153. [PMID: 27647609 DOI: 10.1503/cmaj.150787] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2016] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Lifetime risk is a relatively straightforward measure used to communicate disease burden, representing the cumulative risk of an outcome during the remainder of an individual's life starting from a disease-free index age. We estimated the lifetime risk of diabetes among men and women in both First Nations and non-First Nations populations using a cohort of adults in a single Canadian province. METHODS We used a population-based cohort consisting of Alberta residents from 1997 to 2008 who were free of diabetes at cohort entry to estimate the lifetime risk of diabetes among First Nations and non-First Nations people. We calculated age-specific incidence rates with the person-year method in 5-year bands. We estimated the sex- and index-age-specific lifetime risk of incident diabetes, after adjusting for the competing risk of death. RESULTS The cohort included 70 631 First Nations and 2 732 214 non-First Nations people aged 18 years or older. The lifetime risk of diabetes at 20 years of age was 75.6% among men and 87.3% among women in the First Nations group, as compared with 55.6% among men and 46.5% among women in the non-First Nations group. The risk was higher among First Nations people than among non-First Nations people for all index ages and for both sexes. Among non-First Nations people, men had a higher lifetime risk of diabetes than women across all index ages. In contrast, among First Nations people, women had a higher lifetime risk than men across all index ages. INTERPRETATION About 8 in 10 First Nations people and about 5 in 10 non-First Nations people of young age will develop diabetes in their remaining lifetime. These population-based estimates may help health care planners and decision-makers set priorities and increase public awareness and interest in the prevention of diabetes.
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Affiliation(s)
- Tanvir Chowdhury Turin
- Department of Family Medicine (Turin), Department of Community Health Sciences (Turin, Manns, Hemmelgarn), Institute of Public Health (Turin, Manns, Hemmelgarn) and Department of Medicine (Saad, Jun, Tonelli, Ma, Barnabe, Manns, Hemmelgarn), University of Calgary, Calgary, Alta.
| | - Nathalie Saad
- Department of Family Medicine (Turin), Department of Community Health Sciences (Turin, Manns, Hemmelgarn), Institute of Public Health (Turin, Manns, Hemmelgarn) and Department of Medicine (Saad, Jun, Tonelli, Ma, Barnabe, Manns, Hemmelgarn), University of Calgary, Calgary, Alta
| | - Min Jun
- Department of Family Medicine (Turin), Department of Community Health Sciences (Turin, Manns, Hemmelgarn), Institute of Public Health (Turin, Manns, Hemmelgarn) and Department of Medicine (Saad, Jun, Tonelli, Ma, Barnabe, Manns, Hemmelgarn), University of Calgary, Calgary, Alta
| | - Marcello Tonelli
- Department of Family Medicine (Turin), Department of Community Health Sciences (Turin, Manns, Hemmelgarn), Institute of Public Health (Turin, Manns, Hemmelgarn) and Department of Medicine (Saad, Jun, Tonelli, Ma, Barnabe, Manns, Hemmelgarn), University of Calgary, Calgary, Alta
| | - Zhihai Ma
- Department of Family Medicine (Turin), Department of Community Health Sciences (Turin, Manns, Hemmelgarn), Institute of Public Health (Turin, Manns, Hemmelgarn) and Department of Medicine (Saad, Jun, Tonelli, Ma, Barnabe, Manns, Hemmelgarn), University of Calgary, Calgary, Alta
| | - Cheryl Carmelle Marie Barnabe
- Department of Family Medicine (Turin), Department of Community Health Sciences (Turin, Manns, Hemmelgarn), Institute of Public Health (Turin, Manns, Hemmelgarn) and Department of Medicine (Saad, Jun, Tonelli, Ma, Barnabe, Manns, Hemmelgarn), University of Calgary, Calgary, Alta
| | - Braden Manns
- Department of Family Medicine (Turin), Department of Community Health Sciences (Turin, Manns, Hemmelgarn), Institute of Public Health (Turin, Manns, Hemmelgarn) and Department of Medicine (Saad, Jun, Tonelli, Ma, Barnabe, Manns, Hemmelgarn), University of Calgary, Calgary, Alta
| | - Brenda Hemmelgarn
- Department of Family Medicine (Turin), Department of Community Health Sciences (Turin, Manns, Hemmelgarn), Institute of Public Health (Turin, Manns, Hemmelgarn) and Department of Medicine (Saad, Jun, Tonelli, Ma, Barnabe, Manns, Hemmelgarn), University of Calgary, Calgary, Alta
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