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Sefidbakht S, Beizavi Z, Kanaani Nejad F, Pishdad P, Sadighi N, Ghoddusi Johari M, Bijan B, Tahmasebi S. Association of imaging and pathological findings of breast cancer in very young women: Report of a twenty-year retrospective study. Clin Imaging 2024; 110:110094. [PMID: 38599926 DOI: 10.1016/j.clinimag.2024.110094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 01/14/2024] [Accepted: 01/20/2024] [Indexed: 04/12/2024]
Abstract
PURPOSE In this study, we aimed to assess the new trends in characteristics, molecular subtypes, and imaging findings of breast cancer in very young women. METHODS We retrospectively reviewed the database of a primary breast cancer referral center in southern Iran in 342 cases of 30-year-old or younger women from 2001 to 2020. Pathologic data, including nuclear subtype and grade, tumor stage, presence of in situ cancer, imaging data including lesion type in mammogram and ultrasound, and treatment data were recorded. Descriptive statistics were applied. Differences between categorical values between groups were compared using Pearson's Chi-square test. RESULTS The mean age was 27.89 years. The tumor type was invasive ductal carcinoma in 82 % of cases. Fourteen patients (4.4 %) had only in situ cancer, and 170 patients had in situ components (49.7 %). Molecular subtypes were available in 278 patients, including 117 (42.1 %) Luminal A, 64 (23.0 %) Luminal B, 58 (20.9 %) triple negative, and 39 (14 %) HER2 Enriched. In those with mammograms available, 63 (30.1 %) had no findings, 53 (25.3 %) had mass, 27 (12.9 %) had asymmetry, whether focal or global, 21 (10 %) had microcalcifications solely, and 45 (21.5 %) had more than one finding. Microcalcifications were significantly more common in Luminal cancers than HER2 and triple-negative cancers (p = 0.041). CONCLUSION Our study shows the most common subtype to be Luminal A cancer, with 74 % of the tumors being larger than 2 cm at the time of diagnosis. Irregular masses with non-circumscribed margins were the most common imaging findings.
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Affiliation(s)
- Sepideh Sefidbakht
- Medical Imaging Research Center, Department of Radiology, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Zahra Beizavi
- Department of Radiology, Mayo Clinic, Phoenix, AZ, USA
| | - Fatemeh Kanaani Nejad
- Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Parisa Pishdad
- Medical Imaging Research Center, Department of Radiology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nahid Sadighi
- Radiology Department, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Bijan Bijan
- Sutter Imaging (SMG) - Sacramento, Professor of Nuclear Medicine & Radiology (W.O.S.), University of California Davis Medical Center, Sacramento, CA, USA
| | - Sedigheh Tahmasebi
- Breast Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; Surgical Oncology Division, General Surgery Department, Shiraz University of Medical Sciences, Shiraz, Iran
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Igbokwe KK. Comparative examination of breast cancer burden in sub-Saharan Africa, 1990-2019: estimates from Global Burden of Disease 2019 study. BMJ Open 2024; 14:e082492. [PMID: 38553071 PMCID: PMC10982725 DOI: 10.1136/bmjopen-2023-082492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 03/19/2024] [Indexed: 04/02/2024] Open
Abstract
OBJECTIVES In view of the widening gap in survival data between high-income and low-income countries, this study aimed to evaluate the most up-to-date burden of female breast cancer and analyse the leading risk factors in countries and regions in sub-Saharan Africa. DESIGN An analysis of Global Burden of Disease (GBD) data. SETTING The data of incidences, deaths, disability-adjusted life years (DALYs) and age-standardised rates (ASR) were retrieved from GBD Results Tool (1 January 1990─31 December 2019) covering 4 sub-Saharan African regions and 44 countries. The burden estimable to the risk factors of breast cancer was also estimated. All estimates were presented as counts and ASR per 100 000 population. PARTICIPANTS Participants included patients with female breast cancer. MAIN OUTCOMES AND MEASURES Absolute numbers and ASR/estimates of incidence, deaths and DALY of female breast cancer by location in 1990 and 2019, with their percentage changes from 1990 to 2019. The leading risk factors (eg, alcohol consumption) of breast cancer in sub-Saharan Africa. RESULTS In sub-Saharan Africa, the incidences of breast cancer increased by 247% in 2019 from 1990, with the highest incidence recorded in Nigeria. The deaths and DALYs of breast cancer increased by 184% and 178%, respectively. From 1990 to 2019, the mortality ASR and DALY ASR increased throughout the region, mostly in Equatorial and Gabon. With varying trends between countries, alcohol consumption and high fasting plasma glucose were noted to be significant contributors to breast cancer deaths between 1990 and 2019. CONCLUSION The results show the increasing burden of breast cancer in sub-Saharan Africa and provide valuable information on the trends of breast cancer and the risk factors attributable to breast cancer across sociodemographic index, region and country. These findings may inform health policies and improve the rational allocation of health resources.
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Daniel O, Ashrafi A, Muthoni MA, Njoki N, Eric H, Marilynn O, Faith AB, Beth WG, Nyakio M, Odero-Marah V, Ragin C, Llanos AAM. Delayed breast cancer presentation, diagnosis, and treatment in Kenya. Breast Cancer Res Treat 2023; 202:515-527. [PMID: 37668821 DOI: 10.1007/s10549-023-07067-y] [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] [Received: 03/04/2023] [Accepted: 05/08/2023] [Indexed: 09/06/2023]
Abstract
PURPOSE In this mixed-methods study, we evaluated the factors that contribute to delayed breast cancer (BC) diagnosis and treatment at a Kenyan hospital. METHODS Individuals with a diagnosis of BC, either as a referral or index patient, were recruited to participate in this study through convenience sampling. Data were collected on sociodemographics, health history, and cancer history, diagnosis, and treatment of patients at Kenyatta National Hospital (KNH). For the quantitative analyses, the relationship between sociodemographic and health history factors with stage at diagnosis, number of visits before diagnosis, time to diagnosis, and time to initial intervention, stratified by time to onset of symptoms, were examined using regression analyses. For the qualitative analysis, in-depth interviews of every fifth patient were completed to assess reasons for delayed diagnosis and treatment. RESULTS The final analytic sample comprised of 378 female BC patients with an average age of 50. These females were generally of lower SES: 49.2% attained no or only primary-level education, 57.4% were unemployed, and the majority (74.6%) had a monthly household income of < 5000 Kenyan shillings (equivalent to ~ $41 USD). The median time from BC symptom onset to presentation at KNH was 13 (IQR = 3-36) weeks, from presentation to diagnosis was 17.5 (IQR = 7-36.5) weeks, and from diagnosis to receipt of the initial intervention was 6 (IQR = 3-13) weeks. Female BC patients who were never/unmarried, less educated, less affluent, users of hormonal contraception, and had ≥ 3 children were more likely to experience diagnosis and treatment delays. Qualitative data showed that financial constraints, lack of patient BC awareness, and healthcare practitioner misdiagnosis and/or strikes delayed patient diagnosis and treatment. CONCLUSIONS BC patients experience long healthcare system delays before diagnosis and treatment. Educating communities and providers about BC and expediting referrals may minimize such delays and subsequently BC mortality rates in Kenya.
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Affiliation(s)
- Ojuka Daniel
- Department of Surgery, University of Nairobi, P.O. Box, Nairobi, 19969-00202, Kenya.
- African Caribbean Cancer Consortium, Philadelphia, USA.
| | - Adiba Ashrafi
- Department of Epidemiology, Mailman School of Public Health, Columbia University Irving Medical Center, New York, NY, USA
| | - Musibi Alice Muthoni
- Cancer Treatment Centre, Kenyatta National Hospital, Nairobi, Kenya
- African Caribbean Cancer Consortium, Philadelphia, USA
| | - Njiraini Njoki
- Cancer Treatment Centre, Kenyatta National Hospital, Nairobi, Kenya
| | - Hungu Eric
- Cancer Treatment Centre, Kenyatta National Hospital, Nairobi, Kenya
- Department of Surgery, Kenyatta National Hospital, Nairobi, Kenya
| | - Omondi Marilynn
- Cancer Treatment Centre, Kenyatta National Hospital, Nairobi, Kenya
- Department of Surgery, Kenyatta National Hospital, Nairobi, Kenya
| | - Aseta Bonareri Faith
- Department of Surgery, University of Nairobi, P.O. Box, Nairobi, 19969-00202, Kenya
| | - Wambui Githambo Beth
- Department of Surgery, University of Nairobi, P.O. Box, Nairobi, 19969-00202, Kenya
| | - Mburu Nyakio
- Department of Surgery, University of Nairobi, P.O. Box, Nairobi, 19969-00202, Kenya
| | - Valerie Odero-Marah
- Biology Department, Center for Urban Health Disparities Research and Innovation, Morgan State University, Baltimore, MD, USA
- African Caribbean Cancer Consortium, Philadelphia, USA
| | - Camille Ragin
- Fox Chase Cancer Center, Cancer Prevention and Control Program, Philadelphia, PA, USA
- African Caribbean Cancer Consortium, Philadelphia, USA
| | - Adana A M Llanos
- Department of Epidemiology, Mailman School of Public Health, Columbia University Irving Medical Center, New York, NY, USA
- Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, NY, USA
- African Caribbean Cancer Consortium, Philadelphia, USA
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Srikanthan A, Awan AA, McGee S, Rushton M. Young Women with Breast Cancer: The Current Role of Precision Oncology. J Pers Med 2023; 13:1620. [PMID: 38003935 PMCID: PMC10672565 DOI: 10.3390/jpm13111620] [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: 10/08/2023] [Revised: 11/11/2023] [Accepted: 11/14/2023] [Indexed: 11/26/2023] Open
Abstract
Young adults aged 40 years and younger with breast cancer represent less than 5% of all breast cancer cases, yet it is the leading cause of death among young women with cancer worldwide. Breast cancer that develops at a young age is more aggressive and has biological features that carry an increased risk of relapse and death. Young adults are more likely to have a genetic predisposition and key biomarkers, including endocrine receptors, the HER2 receptor, and proliferation biomarkers, that appear different compared to older adults. Despite being more aggressive, management strategies are largely the same irrespective of age. Given the higher rates of genetic predisposition, fast access to genetic counselling and testing is a necessity. In this review, the biological differences in young adult breast cancer and the current role precision medicine holds in the treatment of young adults with breast cancer are explored. Given the relatively high risk of relapse, developing novel genomic tools to refine the treatment options beyond the current standard is critical. Existing predictive genomic tests require careful interpretation with consideration of the patient's clinical and pathological features in the young patient cohort. Careful evaluation is also required when considering extended endocrine therapy options. Improved characterization of mutations occurring in tumors using next-generation sequencing could identify important driver mutations that arise in young women. Applying the advances of precision medicine equitably to patients in resource-rich and low- and middle-income countries will be critical to impacting the survival of young adults with breast cancer worldwide.
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Affiliation(s)
- Amirrtha Srikanthan
- Division of Medical Oncology, The Ottawa Hospital, 501 Smyth Road, Ottawa, ON K1H 8L6, Canada; (A.A.A.); (S.M.); (M.R.)
- Department of Medicine, Faculty of Medicine, University of Ottawa, 451 Smyth Road, Ottawa, ON K1H 8M5, Canada
| | - Arif Ali Awan
- Division of Medical Oncology, The Ottawa Hospital, 501 Smyth Road, Ottawa, ON K1H 8L6, Canada; (A.A.A.); (S.M.); (M.R.)
- Department of Medicine, Faculty of Medicine, University of Ottawa, 451 Smyth Road, Ottawa, ON K1H 8M5, Canada
| | - Sharon McGee
- Division of Medical Oncology, The Ottawa Hospital, 501 Smyth Road, Ottawa, ON K1H 8L6, Canada; (A.A.A.); (S.M.); (M.R.)
- Department of Medicine, Faculty of Medicine, University of Ottawa, 451 Smyth Road, Ottawa, ON K1H 8M5, Canada
| | - Moira Rushton
- Division of Medical Oncology, The Ottawa Hospital, 501 Smyth Road, Ottawa, ON K1H 8L6, Canada; (A.A.A.); (S.M.); (M.R.)
- Department of Medicine, Faculty of Medicine, University of Ottawa, 451 Smyth Road, Ottawa, ON K1H 8M5, Canada
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Desalegn Z, Smith A, Yohannes M, Cao X, Anberber E, Bekuretsion Y, Assefa M, Bauer M, Vetter M, Kantelhardt EJ, Abebe T, Starlard-Davenport A. Human Breast Tissue Microbiota Reveals Unique Microbial Signatures that Correlate with Prognostic Features in Adult Ethiopian Women with Breast Cancer. Cancers (Basel) 2023; 15:4893. [PMID: 37835588 PMCID: PMC10571711 DOI: 10.3390/cancers15194893] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 10/02/2023] [Accepted: 10/05/2023] [Indexed: 10/15/2023] Open
Abstract
Breast cancer (BC) is the leading cause of cancer mortality among women in Ethiopia. Overall, women of African ancestry have the highest death toll due to BC compared to other racial/ethnic groups. The cause of the disparity in mortality is unclear. Recently, studies conducted in the United States and other high-income countries highlighted the role of microbial dysbiosis in BC initiation, tumor growth, and treatment outcome. However, the extent to which inter-individual differences in the makeup of microbiota are associated with clinical and histopathological outcomes in Ethiopian women has not been studied. The goal of our study was to profile the microbiome in breast tumor and normal adjacent to tumor (NAT) tissues of the same donor and to identify associations between microbial composition and abundance and clinicopathological factors in Ethiopian women with BC. We identified 14 microbiota genera in breast tumor tissues that were distinct from NAT tissues, of which Sphingobium, Anaerococcus, Corynebacterium, Delftia, and Enhydrobacter were most significantly decreased in breast tumors compared to NAT tissues. Several microbial genera significantly differed by clinicopathological factors in Ethiopian women with BC. Specifically, the genus Burkholderia more strongly correlated with aggressive triple negative (TNBC) and basal-like breast tumors. The genera Alkanindiges, Anoxybacillus, Leifsonia, and Exiguobacterium most strongly correlated with HER2-E tumors. Luminal A and luminal B tumors also correlated with Anoxybacillus but not as strongly as HER2-E tumors. A relatively higher abundance of the genus Citrobacter most significantly correlated with advanced-stage breast tumors compared to early-stage tumors. This is the first study to report an association between breast microbial dysbiosis and clinicopathological factors in Ethiopian women.
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Affiliation(s)
- Zelalem Desalegn
- Department of Microbiology, Immunology, and Parasitology, School of Medicine, College of Health Sciences Addis Ababa University, Addis Ababa 9086, Ethiopia; (Z.D.); (M.Y.); (T.A.)
- Global Health Working Group, Martin Luther University Halle-Wittenberg, 06097 Halle (Saale), Germany;
| | - Alana Smith
- Department of Genetics, Genomics and Informatics, College of Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA;
| | - Meron Yohannes
- Department of Microbiology, Immunology, and Parasitology, School of Medicine, College of Health Sciences Addis Ababa University, Addis Ababa 9086, Ethiopia; (Z.D.); (M.Y.); (T.A.)
- Global Health Working Group, Martin Luther University Halle-Wittenberg, 06097 Halle (Saale), Germany;
- School of Medical Laboratory Sciences, Addis Ababa University, Addis Ababa 9086, Ethiopia;
| | - Xueyuan Cao
- Department of Health Promotion and Disease Prevention, College of Nursing, University of Tennessee Health Science Center, Memphis, TN 38163, USA;
| | - Endale Anberber
- Department of Surgery, School of Medicine, Addis Ababa University, Addis Ababa 9086, Ethiopia;
| | - Yonas Bekuretsion
- Department of Pathology, School of Medicine, Addis Ababa University, Addis Ababa 9086, Ethiopia;
| | - Mathewos Assefa
- Department of Oncology, School of Medicine, Addis Ababa University, Addis Ababa 9086, Ethiopia;
| | - Marcus Bauer
- Institute of Pathology, Martin Luther University Halle-Wittenberg, 06097 Halle (Saale), Germany;
| | - Martina Vetter
- Department of Gynecology, Martin Luther University Halle-Wittenberg, 06097 Halle (Saale), Germany;
| | - Eva Johanna Kantelhardt
- Global Health Working Group, Martin Luther University Halle-Wittenberg, 06097 Halle (Saale), Germany;
- Department of Gynecology, Martin Luther University Halle-Wittenberg, 06097 Halle (Saale), Germany;
- Institute of Medical Epidemiology, Biostatistics, and Informatics, Martin Luther University Halle-Wittenberg, 06097 Halle (Saale), Germany
| | - Tamrat Abebe
- Department of Microbiology, Immunology, and Parasitology, School of Medicine, College of Health Sciences Addis Ababa University, Addis Ababa 9086, Ethiopia; (Z.D.); (M.Y.); (T.A.)
- Global Health Working Group, Martin Luther University Halle-Wittenberg, 06097 Halle (Saale), Germany;
| | - Athena Starlard-Davenport
- Department of Genetics, Genomics and Informatics, College of Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA;
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Borges PCC, Spencer HB, Barbosa C, Costa V, Furtado A, Leal MC, Lopes C, Ferreira D, Carvalho AL, Dos-Santos-Silva I, Santos LL. XPERT ® breast cancer STRAT4 as an alternative method of identifying breast cancer phenotype in Cape Verde (preliminary results). Ecancermedicalscience 2023; 17:1530. [PMID: 37138965 PMCID: PMC10151082 DOI: 10.3332/ecancer.2023.1530] [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: 11/06/2022] [Indexed: 05/05/2023] Open
Abstract
Introduction Breast cancer (BC) is a public health problem in developing countries, including Cape Verde. Immunohistochemistry (IHC) is the gold standard technique used for BC phenotypic characterisation to support efficient therapeutic decisions. However, IHC is a demanding technique that requires knowledge, trained technicians, expensive antibodies and reagents, controls, and results validation. The low number of cases in Cape Verde increases the risk of expiring the validity of the antibodies, and manual procedures often jeopardise the quality of the results. Thus, IHC is limited in Cape Verde, and an alternative technically easy solution is needed. A point-of-care messenger RNA (mRNA) STRAT4 BC assay to assess estrogen (ER), progesterone (PR), hormone growth factor 2 receptor (HER2), and Ki67, using the GeneXpert platform, has been recently validated on tissues from internationally accredited laboratories, showing excellent concordance with IHC results.To assess whether this technology can be implemented in Cape Verde to guide BC treatment we decided to study the level of agreement between the findings yielded by BC STRAT4 and the results are the same cases obtained by IHC. Methods Formalin-fixed and paraffin-embedded (FFPE) tissue samples from 29 Cabo Verdean BC patients diagnosed in Agostinho Neto University Hospital were analysed by applying IHC and BC STRAT4 assay. The time between sample collection and pre-analytic procedures is unknown. All the samples were pre-processed in Cabo Verde (fixed in formalin and embedded in paraffin). IHC studies were performed in referenced laboratories in Portugal. STRAT4 and IHC result concordance was assessed by calculating the percentage of results agreement and Cohen's Kappa (K) statistics. Results STRAT4 assay failed in 2 out of the 29 analysed samples. Of the 27 successfully analysed samples, STRAT4/IHC results for ER, PR, HER2, and Ki67 were concordant in 25, 24, 25, and 18 cases, respectively. Ki67 was indeterminate in three cases, and PR was indeterminate once.The percentage of agreement between STRAT4 and IHC results for ER, PR, HER2, and Ki67 was 92.59%, 92.31%, 92.59% and 81.82%, respectively. The Cohen's K statistic coefficients for each biomarker were 0.809, 0.845, 0.757 and 0.506, respectively. Conclusions According to our preliminary results, a point-of-care mRNA STRAT4 BC assay may be an alternative in laboratories unable to provide quality and/or cost-efficient IHC services. However, more data and improvement on sample pre-analytic processes are required to implement this BC STRAT4 Assay in Cape Verde.
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Affiliation(s)
- Pamela C C Borges
- Laboratório Biologia Molecular, Hospital Universitário Agostinho Neto, Praia, Plateau 112, Cabo Verde
| | | | - Carla Barbosa
- Hospital Universitário Agostinho Neto, Praia, Plateau 112, Cabo Verde
| | - Victor Costa
- Hospital Universitário Agostinho Neto, Praia, Plateau 112, Cabo Verde
| | - Antónia Furtado
- IMP Diagnostics, Molecular and Anatomic Pathology Lab, 4150-146, Porto, Portugal
| | - Maria Conceição Leal
- Anatomia Patológica, Instituto Português de Oncologia, 4200-072, Porto, Portugal
| | - Carlos Lopes
- Unilabs | Laboratório Anatomia Patológica, 4250-170, Porto, Portugal
| | - Dylan Ferreira
- Experimental Pathology and Therapeutics Group, Research Center of IPO Porto (CI-IPOP)/RISE@CI-IPOP (Health Research Network), Portuguese Oncology Institute of Porto (IPO Porto)/Porto Comprehensive Cancer Center (Porto.CCC), 4200-072, Porto, Portugal
| | | | | | - Lúcio Lara Santos
- Experimental Pathology and Therapeutics Group, Research Center of IPO Porto (CI-IPOP)/RISE@CI-IPOP (Health Research Network), Portuguese Oncology Institute of Porto (IPO Porto)/Porto Comprehensive Cancer Center (Porto.CCC), 4200-072, Porto, Portugal
- Surgical Oncology Department, Portuguese Institute of Oncology, 4200-072, Porto, Portugal
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Niang DGM, Gaba FM, Diouf A, Hendricks J, Diallo RN, Niang MDS, Mbengue B, Dieye A. Galectin-3 as a biomarker in breast neoplasms: Mechanisms and applications in patient care. J Leukoc Biol 2022; 112:1041-1052. [PMID: 36125083 DOI: 10.1002/jlb.5mr0822-673r] [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: 02/12/2022] [Revised: 08/26/2022] [Indexed: 12/24/2022] Open
Abstract
Galectin-3 is a member of the lectin family encoded by the LGALS3 gene on chromosome 14. It is secreted by a wide range of immune cells and mammary tumor cells. Through its activity on the tumor microenvironment, in particular on tumor-infiltrating leukocytes, galectin-3 improves the proliferation, survival, and colonizing ability of mammary neoplastic cells. Consequently, galectin-3 expression in the tumor microenvironment could worsen therapeutic outcomes of breast neoplasms and become a biomarker and a therapeutic target in combined immunotherapy in breast neoplasms. There is a limited amount of information that is available on galectin-3 in breast cancer in Africa. In this review, we analyze how galectin-3 influences the tumor microenvironment and its potential as a biomarker and therapeutic target in breast neoplasms. We aim to emphasize the significance of investigating galectin-3 in breast neoplasms in Africa based on the results of studies conducted elsewhere.
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Affiliation(s)
- Doudou Georges Massar Niang
- Division of Immunology, School of Medicine, Pharmacy and Dentistry, Cheikh Anta Diop University, Dakar, Senegal
| | - Folly Mawulolo Gaba
- Division of Immunology, School of Medicine, Pharmacy and Dentistry, Cheikh Anta Diop University, Dakar, Senegal
| | - Adame Diouf
- Division of Immunology, School of Medicine, Pharmacy and Dentistry, Cheikh Anta Diop University, Dakar, Senegal
| | - Jacobus Hendricks
- Department of Physiology and Environmental Health, University of Limpopo, Sovenga, Limpopo province, South Africa
| | - Rokhaya Ndiaye Diallo
- Division of Human Genetics, School of Medicine, Pharmacy and Dentistry, Cheikh Anta Diop University, Dakar, Senegal
| | - Maguette Deme Sylla Niang
- Division of Immunology, School of Medicine, Pharmacy and Dentistry, Cheikh Anta Diop University, Dakar, Senegal
| | - Babacar Mbengue
- Division of Immunology, School of Medicine, Pharmacy and Dentistry, Cheikh Anta Diop University, Dakar, Senegal
| | - Alioune Dieye
- Division of Immunology, School of Medicine, Pharmacy and Dentistry, Cheikh Anta Diop University, Dakar, Senegal
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Dyan B, Seele PP, Skepu A, Mdluli PS, Mosebi S, Sibuyi NRS. A Review of the Nucleic Acid-Based Lateral Flow Assay for Detection of Breast Cancer from Circulating Biomarkers at a Point-of-Care in Low Income Countries. Diagnostics (Basel) 2022; 12:diagnostics12081973. [PMID: 36010323 PMCID: PMC9406634 DOI: 10.3390/diagnostics12081973] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/08/2022] [Accepted: 08/09/2022] [Indexed: 12/24/2022] Open
Abstract
The current levels of breast cancer in African women have contributed to the high mortality rates among them. In South Africa, the incidence of breast cancer is also on the rise due to changes in behavioural and biological risk factors. Such low survival rates can be attributed to the late diagnosis of the disease due to a lack of access and the high costs of the current diagnostic tools. Breast cancer is asymptomatic at early stages, which is the best time to detect it and intervene to prevent high mortality rates. Proper risk assessment, campaigns, and access to adequate healthcare need to be prioritised among patients at an early stage. Early detection of breast cancer can significantly improve the survival rate of breast cancer patients, since therapeutic strategies are more effective at this stage. Early detection of breast cancer can be achieved by developing devices that are simple, sensitive, low-cost, and employed at point-of-care (POC), especially in low-income countries (LICs). Nucleic-acid-based lateral flow assays (NABLFAs) that combine molecular detection with the immunochemical visualisation principles, have recently emerged as tools for disease diagnosis, even for low biomarker concentrations. Detection of circulating genetic biomarkers in non-invasively collected biological fluids with NABLFAs presents an appealing and suitable method for POC testing in resource-limited regions and/or LICs. Diagnosis of breast cancer at an early stage will improve the survival rates of the patients. This review covers the analysis of the current state of NABLFA technologies used in developing countries to reduce the scourge of breast cancer.
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Affiliation(s)
- Busiswa Dyan
- Nanotechnology Innovation Centre, Health Platform, Mintek, 200 Malibongwe Drive, Randburg, Johannesburg 2194, South Africa
- Department of Life and Consumer Sciences, College of Agriculture and Environmental Sciences, University of South Africa, Private Bag X6, Florida, Johannesburg 1710, South Africa
- Correspondence: (B.D.); (N.R.S.S.)
| | - Palesa Pamela Seele
- Nanotechnology Innovation Centre, Health Platform, Mintek, 200 Malibongwe Drive, Randburg, Johannesburg 2194, South Africa
| | - Amanda Skepu
- Nanotechnology Innovation Centre, Health Platform, Mintek, 200 Malibongwe Drive, Randburg, Johannesburg 2194, South Africa
| | - Phumlane Selby Mdluli
- Nanotechnology Innovation Centre, Health Platform, Mintek, 200 Malibongwe Drive, Randburg, Johannesburg 2194, South Africa
| | - Salerwe Mosebi
- Department of Life and Consumer Sciences, College of Agriculture and Environmental Sciences, University of South Africa, Private Bag X6, Florida, Johannesburg 1710, South Africa
| | - Nicole Remaliah Samantha Sibuyi
- Nanotechnology Innovation Centre, Health Platform, Mintek, 200 Malibongwe Drive, Randburg, Johannesburg 2194, South Africa
- Correspondence: (B.D.); (N.R.S.S.)
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Immunohistochemical Features of Breast Cancer Seen in Women in Kinshasa, Democratic Republic of the Congo: A Six-Year Retrospective Study. Int J Breast Cancer 2022; 2022:8860947. [PMID: 35966938 PMCID: PMC9374542 DOI: 10.1155/2022/8860947] [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: 04/13/2022] [Accepted: 07/27/2022] [Indexed: 02/05/2023] Open
Abstract
Introduction The molecular classification of breast cancer (BC) based on gene expression and then protein profile has made it possible to distinguish different molecular subtypes. The objective of this study was to describe immunohistochemical features of BC infiltrating women at the Nganda Hospital Center in Kinshasa, Democratic Republic of the Congo (DRC). Methods A retrospective study from 2014 to 2019 involved 190 patients with invasive BC who were enrolled at the Nganda Hospital Center. The tumors were analyzed histologically and classified after an immunohistochemical study into subtypes: luminal A, luminal B, HER2-overexpressed, and triple-negative. A chi-square test was performed to assess the relationship between age, histological grade, and these subtypes. Results The luminal A subtype (44.74%) was the most common, followed by luminal B (40.53%), triple-negative (10.53%), and HER2-overexpressed (4.20%). The mean age of the patients at diagnosis was 48.27 years. Of all cases, 94.21% were ductal, 2.63% were mucinous, and 2.11% were lobular. They were classified as grade I in 68.82% of the cases, grade II in 28.42% of the cases, and grade III in 3.16% of the cases. There was a significant association between histological grade and breast cancer subtypes (p < 0.0001), but no correlation was found with age (p = 0.467). Conclusion In our BC patients, the luminal A was predominant, while HER2-overexpressed was the least found. A strong association was noted between histological grade and molecular subtypes. These results should allow for important clinical and policy implications for BC control in the DRC.
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Arzanova E, Mayrovitz HN. The Epidemiology of Breast Cancer. Breast Cancer 2022. [DOI: 10.36255/exon-publications-breast-cancer-epidemiology] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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11
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Sume BW, Assefa W, Merkeb Alamneh Y. Early onset, delayed diagnosis and laterality of breast carcinoma: Evidence from a tertiary care hospital. SAGE Open Med 2022; 10:20503121221114623. [PMID: 35910817 PMCID: PMC9326835 DOI: 10.1177/20503121221114623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 07/01/2022] [Indexed: 11/16/2022] Open
Abstract
Objectives: To assess age at onset, delayed diagnosis and laterality of breast carcinoma among women at Debre Markos Comprehensive Specialized Hospital, North West Ethiopia. Methods: Hospital-based descriptive study was conducted on 120 breast carcinoma cases at pathology department of Debre Markos Comprehensive Specialized Hospital, from October 2019 to December 2021. The women aware of symptoms until first medical consultation time was asked. The height and weight of the women were measured using the height and weight scale. The attending physician examined both breasts and regional lymph nodes. Pathological features of breast carcinomas were recorded when biopsy results arrived at the pathology department. Data were entered in Epi data version 3.1. Then, it was exported to SPSS version 25.0 statistical software for analysis. Results: Mean age of women was 39.9 ± 11.6 years, and median age was 38 years. Most women, 87 (72.5%) were aged less than 46 years. One hundred three (85.8%) women had complained breast lump pain for greater than 3 months before diagnosis. About 61 (50.8%) women had left breast carcinomas; 44 (36.7%) had right breast carcinomas and 15 (12.5%) had bilateral breast carcinomas. Of total, 53 (44.2%) cases were invasive ductal carcinomas; 41 (34.2%) had ductal carcinoma in situ; 14 (11.7%) were invasive lobular carcinomas; 8 (6.7%) were lobular carcinoma in situ and only 4 (3.3%) cases were mixed carcinomas. Conclusion: In this study, about two-third of the cases had early onset breast carcinoma. Most of the cases had delayed diagnosis of breast carcinoma. More than half of the cases had left breast carcinoma.
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Affiliation(s)
- Bickes Wube Sume
- Department of Biomedical Sciences, School of Medicine, Debre Markos University, Debre Markos, Ethiopia
| | - Wubshet Assefa
- Department of Pathology, School of Medicine, Debre Markos University, Debre Markos, Ethiopia
| | - Yoseph Merkeb Alamneh
- Department of Biomedical Sciences, School of Medicine, Debre Markos University, Debre Markos, Ethiopia
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Shet D, Gatty RC, Shetty A, Baliga MS. The Clinicopathological Profile of Breast Cancer in Young Women from a Tertiary Care Center. ASIAN JOURNAL OF ONCOLOGY 2022. [DOI: 10.1055/s-0042-1750352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Abstract
Background Increasing number of young breast cancer patients are seen in India and many of these young breast cancer patients are considered to have more aggressive disease biology.
Aim The aim of this article was to study the clinicopathological profile of breast cancer patients in the young and older patients to understand the difference between these two groups.
Methods This was a retrospective study conducted on 421 breast cancer patients.
Results Total of 421 breast cancer patients were studied, out of which 158 patients were less than or equal to 40 years age group and 263 patients were in more than or equal to 50 years age group. Commonest T stage on presentation was T2, which was seen 56.32% of young breast cancer patients and in 64.64% of older patients. Higher nodal spread was seen in younger patients when compared with older patients (p-value = 0.00001). Older group patients had significant decline from anatomical to pathological prognostic stage group compared with younger group (29 vs. 13.29%; p-value = 0.00001). Grade 3 tumors were seen in 58.23% of younger patients and 22.05% of older patients (p-value = 0.00001). Triple-negative breast cancer was seen more commonly in younger group compared with older group (p-value = 0.0088).
Conclusions Significant number of breast cancer patients present in younger age group in India. Younger breast cancer patients tend to have higher grade tumors and triple-negative breast cancer is common in younger age groups. Pathological prognostic stage grouping appears clinically more relevant than anatomical stage groups.
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Affiliation(s)
- Dinesh Shet
- Department of Medical Oncology, Father Muller Medical College Hospital, Kankanady, Mangalore, Karnataka, India
| | - Rohan Chandra Gatty
- Department of Surgical Oncology, Father Muller Medical College Hospital, Kankanady, Mangalore, Karnataka, India
| | - Arpitha Shetty
- Department of Medical Oncology, Father Muller Medical College Hospital, Kankanady, Mangalore, Karnataka, India
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Nthontho KC, Ndlovu AK, Sharma K, Kasvosve I, Hertz DL, Paganotti GM. Pharmacogenetics of Breast Cancer Treatments: A Sub-Saharan Africa Perspective. Pharmgenomics Pers Med 2022; 15:613-652. [PMID: 35761855 PMCID: PMC9233488 DOI: 10.2147/pgpm.s308531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 05/31/2022] [Indexed: 11/30/2022] Open
Abstract
Breast cancer is the most frequent cause of cancer death in low- and middle-income countries, in particular among sub-Saharan African women, where response to available anticancer treatment therapy is often limited by the recurrent breast tumours and metastasis, ultimately resulting in decreased overall survival rate. This can also be attributed to African genomes that contain more variation than those from other parts of the world. The purpose of this review is to summarize published evidence on pharmacogenetic and pharmacokinetic aspects related to specific available treatments and the known genetic variabilities associated with metabolism and/or transport of breast cancer drugs, and treatment outcomes when possible. The emphasis is on the African genetic variation and focuses on the genes with the highest strength of evidence, with a close look on CYP2A6, CYP2B6, CYP2C8, CYP2C9, CYP2C19, CYP2D6, CYP3A4/5, CYP19A1, UGT1A4, UGT2B7, UGT2B15, SLC22A16, SLC38A7, FcγR, DPYD, ABCB1, and SULT1A1, which are the genes known to play major roles in the metabolism and/or elimination of the respective anti-breast cancer drugs given to the patients. The genetic variability of their metabolism could be associated with different metabolic phenotypes that may cause reduced patients’ adherence because of toxicity or sub-therapeutic doses. Finally, this knowledge enhances possible personalized treatment approaches, with the possibility of improving survival outcomes in patients with breast cancer.
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Affiliation(s)
- Keneuoe Cecilia Nthontho
- School of Allied Health Professions, Faculty of Health Sciences, University of Botswana, Gaborone, Botswana
- Botswana-University of Pennsylvania Partnership, Gaborone, Botswana
| | - Andrew Khulekani Ndlovu
- School of Allied Health Professions, Faculty of Health Sciences, University of Botswana, Gaborone, Botswana
| | | | - Ishmael Kasvosve
- School of Allied Health Professions, Faculty of Health Sciences, University of Botswana, Gaborone, Botswana
| | - Daniel Louis Hertz
- Department of Clinical Pharmacy, University of Michigan College of Pharmacy, Ann Arbor, MI, USA
| | - Giacomo Maria Paganotti
- Botswana-University of Pennsylvania Partnership, Gaborone, Botswana
- Division of Infectious Diseases, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Biomedical Sciences, Faculty of Medicine, University of Botswana, Gaborone, Botswana
- Correspondence: Giacomo Maria Paganotti, Botswana-University of Pennsylvania Partnership, PO Box 45498, Riverwalk Gaborone, Botswana, Tel +267 3555375, Email
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Azubuike SO, Hayes L, Sharp L, Alabi A, Oyesegun RA, McNally R. Physical activity and the risk of breast cancer among Nigerian women. Cancer Epidemiol 2022; 78:102163. [DOI: 10.1016/j.canep.2022.102163] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 04/12/2022] [Accepted: 04/14/2022] [Indexed: 12/24/2022]
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Zemni I, Kacem M, Dhouib W, Bennasrallah C, Hadhri R, Abroug H, Ben Fredj M, Mokni M, Bouanene I, Belguith AS. Breast cancer incidence and predictions (Monastir, Tunisia: 2002–2030): A registry-based study. PLoS One 2022; 17:e0268035. [PMID: 35617209 PMCID: PMC9135193 DOI: 10.1371/journal.pone.0268035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 04/21/2022] [Indexed: 11/29/2022] Open
Abstract
Introduction Breast cancer is a major public health problem worldwide. It is the leading cause of cancer deaths in females. In developing countries like Tunisia, the frequency of this cancer is still growing. The aim of this study was to determine the crude and standardized incidence rates, trends and predictions until 2030 of breast cancer incidence rates in a Tunisian governorate. Methods This is a descriptive study including all female patients diagnosed with breast cancer in Monastir between 2002 and 2013. The data were collected from the cancer register of the center. Tumors were coded according to the 10th version of international classification of disease (ICD-10). Trends and predictions until 2030 were calculated using Poisson linear regression. Results A total of 1028 cases of female breast cancer were recorded. The median age of patients was 49 years (IQR: 41–59 years) with a minimum of 16 years and a maximum of 93 years. The age-standardized incidence rate (ASR) was of 39.12 per 100000 inhabitants. It increased significantly between 2002 and 2013 with APC of 8.4% (95% CI: 4.9; 11.9). Prediction until 2030 showed that ASR would reach 108.77 (95% CI: 57.13–209.10) per 100000 inhabitants. Conclusion The incidence and the chronological trends of breast cancer highlighted that this disease is of a serious concern in Tunisia. Strengthening preventive measures is a primary step to restrain its burden.
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Affiliation(s)
- Imen Zemni
- Department of Epidemiology and Preventive Medicine, Fattouma Bourguiba University Hospital, University of Monastir, Monastir, Tunisia
- Faculty of Medicine of Monastir, Department of Epidemiology, University of Monastir, Monastir, Tunisia
- Technology and Medical Imaging Research Laboratory—LTIM—LR12ES06, University of Monastir, Monastir, Tunisia
- * E-mail:
| | - Meriem Kacem
- Department of Epidemiology and Preventive Medicine, Fattouma Bourguiba University Hospital, University of Monastir, Monastir, Tunisia
- Faculty of Medicine of Monastir, Department of Epidemiology, University of Monastir, Monastir, Tunisia
- Technology and Medical Imaging Research Laboratory—LTIM—LR12ES06, University of Monastir, Monastir, Tunisia
| | - Wafa Dhouib
- Department of Epidemiology and Preventive Medicine, Fattouma Bourguiba University Hospital, University of Monastir, Monastir, Tunisia
- Faculty of Medicine of Monastir, Department of Epidemiology, University of Monastir, Monastir, Tunisia
- Technology and Medical Imaging Research Laboratory—LTIM—LR12ES06, University of Monastir, Monastir, Tunisia
| | - Cyrine Bennasrallah
- Department of Epidemiology and Preventive Medicine, Fattouma Bourguiba University Hospital, University of Monastir, Monastir, Tunisia
- Faculty of Medicine of Monastir, Department of Epidemiology, University of Monastir, Monastir, Tunisia
- Technology and Medical Imaging Research Laboratory—LTIM—LR12ES06, University of Monastir, Monastir, Tunisia
| | - Rim Hadhri
- Department of Pathology, Fattouma Bourguiba University Hospital, University of Monastir, Monastir, Tunisia
| | - Hela Abroug
- Department of Epidemiology and Preventive Medicine, Fattouma Bourguiba University Hospital, University of Monastir, Monastir, Tunisia
- Faculty of Medicine of Monastir, Department of Epidemiology, University of Monastir, Monastir, Tunisia
- Technology and Medical Imaging Research Laboratory—LTIM—LR12ES06, University of Monastir, Monastir, Tunisia
| | - Manel Ben Fredj
- Department of Epidemiology and Preventive Medicine, Fattouma Bourguiba University Hospital, University of Monastir, Monastir, Tunisia
- Faculty of Medicine of Monastir, Department of Epidemiology, University of Monastir, Monastir, Tunisia
- Technology and Medical Imaging Research Laboratory—LTIM—LR12ES06, University of Monastir, Monastir, Tunisia
| | - Moncef Mokni
- Faculty of Medicine of Sousse, Department of Pathology, Farhat Hached University Hospital, University of Sousse, Sousse, Tunisia
- Cancer Register of the Center, Sousse, Tunisia
| | - Ines Bouanene
- Department of Epidemiology and Preventive Medicine, Fattouma Bourguiba University Hospital, University of Monastir, Monastir, Tunisia
- Faculty of Medicine of Monastir, Department of Epidemiology, University of Monastir, Monastir, Tunisia
| | - Asma Sriha Belguith
- Department of Epidemiology and Preventive Medicine, Fattouma Bourguiba University Hospital, University of Monastir, Monastir, Tunisia
- Faculty of Medicine of Monastir, Department of Epidemiology, University of Monastir, Monastir, Tunisia
- Technology and Medical Imaging Research Laboratory—LTIM—LR12ES06, University of Monastir, Monastir, Tunisia
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Mukuku O, Mwang Sulu SM, Mashinda DK, Babaka Batalansi D, Wembonyama SO, Mboloko JE, Tshimpi Wola A. Epidemiology of cancers in women in Kinshasa, Democratic Republic of the Congo. JOURNAL OF CANCER PREVENTION & CURRENT RESEARCH 2022. [DOI: 10.15406/jcpcr.2022.13.00487] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Ajaz S, Zaidi SEZ, Ali S, Siddiqa A, Memon MA. Germline Mutation Analysis in Sporadic Breast Cancer Cases With Clinical Correlations. Front Genet 2022; 13:820610. [PMID: 35356428 PMCID: PMC8959921 DOI: 10.3389/fgene.2022.820610] [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: 11/23/2021] [Accepted: 02/08/2022] [Indexed: 11/15/2022] Open
Abstract
Demographics for breast cancers vary widely among nations. The frequency of germline mutations in breast cancers, which reflects the hereditary cases, has not been investigated adequately and accurately in highly-consanguineous Pakistani population. In the present discovery case series, germ-line mutations in twenty-seven breast cancer candidate genes were investigated in eighty-four sporadic breast cancer patients along with the clinical correlations. The germ-line variants were also assessed in two healthy gender-matched controls. The clinico-pathological features were evaluated by descriptive analysis and Pearson χ2 test (with significant p-value <0.05). The most frequent parameters associated with hereditary cancer cases are age and ethnicity. Therefore, the analyses were stratified on the basis of age (≤40 years vs. >40 years) and ethnicity. The breast cancer gene panel assay was carried out by BROCA, which is a genomic capture, massively parallel next generation sequencing assay on Illumina Hiseq2000 with 100bp read lengths. Copy number variations were determined by partially-mapped read algorithm. Once the mutation was identified, it was validated by Sanger sequencing. The ethnic analysis stratified on the basis of age showed that the frequency of breast cancer at young age (≤40 years) was higher in Sindhis (n = 12/19; 64%) in contrast to patients in other ethnic groups. Majority of the patients had stage III (38.1%), grade III (50%), tumor size 2–5 cm (54.8%), and invasive ductal carcinoma (81%). Overall, the analysis revealed germ-line mutations in 11.9% of the patients, which was not significantly associated with younger age or any particular ethnicity. The mutational spectrum was restricted to three genes: BRCA1, BRCA2, and TP53. The identified mutations consist of seven novel germ-line mutations, while three mutations have been reported previously. All the mutations are predicted to result in protein truncation. No mutations were identified in the remaining twenty-four candidate breast cancer genes. The present study provides the framework for the development of hereditary-based preventive and treatment strategies against breast cancers in Pakistani population.
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Affiliation(s)
- Sadia Ajaz
- Dr. Panjwani Center for Molecular Medicine and Drug Research (PCMD), International Center for Chemical and Biological Sciences (ICCBS), University of Karachi, Karachi, Pakistan
- Department of Human Genetics and Molecular Biology, University of Health Sciences, Lahore, Pakistan
- *Correspondence: Sadia Ajaz, ,
| | - Sani-e-Zehra Zaidi
- Dr. Panjwani Center for Molecular Medicine and Drug Research (PCMD), International Center for Chemical and Biological Sciences (ICCBS), University of Karachi, Karachi, Pakistan
| | - Saleema Ali
- Dr. Panjwani Center for Molecular Medicine and Drug Research (PCMD), International Center for Chemical and Biological Sciences (ICCBS), University of Karachi, Karachi, Pakistan
| | - Aisha Siddiqa
- Atomic Energy Medical Centre (AEMC), Jinnah Postgraduate Medical Centre (JPMC), Karachi, Pakistan
| | - Muhammad Ali Memon
- Atomic Energy Medical Centre (AEMC), Jinnah Postgraduate Medical Centre (JPMC), Karachi, Pakistan
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Djiwa T, Koui B, Simgban P, Mézéwè Sama B, Bombonne M, Doukouré B, Darré T. Histo-Molecular Profile of Breast Cancer in Young Women in Togo. CLINICAL PATHOLOGY (THOUSAND OAKS, VENTURA COUNTY, CALIF.) 2022; 15:2632010X221112452. [PMID: 35846252 PMCID: PMC9280847 DOI: 10.1177/2632010x221112452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 06/21/2022] [Indexed: 11/17/2022]
Abstract
Introduction: The frequency of breast cancer in young women, corresponding to women under 40 years of age; varies from 5% to 7% in developed countries. The objective of this study was to contribute to the improvement of the management of breast cancer in young women in Togo, by establishing the molecular classification of these cancers. Methodology: This was a retrospective descriptive and analytical study from January 2010 to December 2020. Results: About 35 cases of breast cancer were identified in women under 40 years of age. The average age was 35.4 ± 3.5 years. The right breast was affected in 18 cases (51.43%). Histologically, 30 cases (85.72%) were invasive carcinoma of no special type (NST), 2 cases (5.71%) were invasive lobular carcinoma and micro-papillary carcinoma respectively, and 1 case (2.86%) was tubular carcinoma. There were 6 cases (17.1%) of grade I, 25 cases (71.4%) of grade II, and 4 cases (11.4%) of grade III. Molecularly, there were 20 cases (57.1%) of triple-negative subtype, 6 cases (17.1%) of Luminal B subtype, 05 cases (14.3%) of HER2-enriched subtype and 4 cases (11.4%) of Luminal A subtype. Conclusion: Breast cancers of young Togolese women express very weakly hormone receptors, with a predominance of a triple negative subtype.
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Affiliation(s)
- Toukilnan Djiwa
- Department of Pathological Anatomy, Teaching Hospital of Lomé, Lome, Togo
| | - Baumaney Koui
- Department of Pathological Anatomy, Teaching Hospital of Abidjan, Abidjan, Ivory Coast
| | - Panakinao Simgban
- Department of Pathological Anatomy, Teaching Hospital of Lomé, Lome, Togo
| | | | - Mayi Bombonne
- Department of Pathological Anatomy, Teaching Hospital of Lomé, Lome, Togo
| | - Brahima Doukouré
- Department of Pathological Anatomy, Teaching Hospital of Abidjan, Abidjan, Ivory Coast
| | - Tchin Darré
- Department of Pathological Anatomy, Teaching Hospital of Lomé, Lome, Togo
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Mekonen S, Ibrahim M, Astatkie H, Abreha A. Exposure to organochlorine pesticides as a predictor to breast cancer: A case-control study among Ethiopian women. PLoS One 2021; 16:e0257704. [PMID: 34555072 PMCID: PMC8460037 DOI: 10.1371/journal.pone.0257704] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 09/07/2021] [Indexed: 11/26/2022] Open
Abstract
Breast cancer (BC) is becoming one of the most prevalent non-infectious disease in low and middle income countries. The steady rise of BC incidence may be related to the different risk factors. Among many, rampant presence of environmental pollutants might be one of the risk factors. Therefore, the aim of this study is to investigate exposure to organochlorine pesticides as a risk factor to breast cancer. A case-control study design was employed among breast cancer patients and non-breast cancer individuals (controls). Blood samples were collected from 100 study participants (50 cases and 50 controls) followed by serum separation, extraction and cleanup using standard analytical procdures. The findings revealed that ten organochlorine pesticides were detected in the serum of the study participants. From the detected organochlorine pesticides, heptachlor was observed at higher concentration for breast cancer patients (6.90±4.37 μg/L) and controls (9.15±3.84 μg/L). Mean serum level of p,p’-DDE, p,p’-DDT, heptachlor, gamma-chlordane, endosulfan, and dibutyl-chlorendate were significantly higher in the serum of breast cancer patients than the controls. From the studied pesticides, p,p’-DDT and gamma-chlordane are significant predictors for BC, while, others are equivocal. A unit increment of the concentration of p,p’-DDT (AOR; 2.03, 95% CI: 1.041–3.969) increased the odds of developing breast cancer by two, while for gamma-chlordane (AOR;3.12, 95% CI; 1.186–8.203) by three. Our study results suggesting that, organochlorines are a risk factors for breast cancer in Ethiopia. Decreasing exposure to such organochlorines might have a significant public health relevance in reducing non-communicable chronic illnesses. Besides, continues monitoring of persistent organic pollutants using body biomarkers is important for disease prevention and device mitigation measures.
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Affiliation(s)
- Seblework Mekonen
- Department of Environmental Health Science and Technology, Faculty of Public Health, Jimma University, Jimma, Ethiopia
- * E-mail:
| | - Mohammedgezali Ibrahim
- Department of Environmental Health Science and Technology, Faculty of Public Health, Jimma University, Jimma, Ethiopia
| | - Higemengist Astatkie
- Department of Environmental Health Science and Technology, Faculty of Public Health, Jimma University, Jimma, Ethiopia
| | - Aynalem Abreha
- Department of Oncology Addis Ababa, College of Health Sciences, University, Addis Ababa, Ethiopia
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The comparison of censored quantile regression methods in prognosis factors of breast cancer survival. Sci Rep 2021; 11:18268. [PMID: 34521936 PMCID: PMC8440570 DOI: 10.1038/s41598-021-97665-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 08/25/2021] [Indexed: 02/08/2023] Open
Abstract
The Cox proportional hazards model is a widely used statistical method for the censored data that model the hazard rate rather than survival time. To overcome complexity of interpreting hazard ratio, quantile regression was introduced for censored data with more straightforward interpretation. Different methods for analyzing censored data using quantile regression model, have been introduced. The quantile regression approach models the quantile function of failure time and investigates the covariate effects in different quantiles. In this model, the covariate effects can be changed for patients with different risk and is a flexible model for controlling the heterogeneity of covariate effects. We illustrated and compared five methods in quantile regression for right censored data included Portnoy, Wang and Wang, Bottai and Zhang, Yang and De Backer methods. The comparison was made through the use of these methods in modeling the survival time of breast cancer. According to the results of quantile regression models, tumor grade and stage of the disease were identified as significant factors affecting 20th percentile of survival time. In Bottai and Zhang method, 20th percentile of survival time for a case with higher unit of stage decreased about 14 months and 20th percentile of survival time for a case with higher grade decreased about 13 months. The quantile regression models acted the same to determine prognostic factors of breast cancer survival in most of the time. The estimated coefficients of five methods were close to each other for quantiles lower than 0.1 and they were different from quantiles upper than 0.1.
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Byrd DA, Vogtmann E, Wu Z, Han Y, Wan Y, Clegg-Lamptey JN, Yarney J, Wiafe-Addai B, Wiafe S, Awuah B, Ansong D, Nyarko K, Hullings AG, Hua X, Ahearn T, Goedert JJ, Shi J, Knight R, Figueroa JD, Brinton LA, Garcia-Closas M, Sinha R. Associations of fecal microbial profiles with breast cancer and nonmalignant breast disease in the Ghana Breast Health Study. Int J Cancer 2021; 148:2712-2723. [PMID: 33460452 PMCID: PMC8386185 DOI: 10.1002/ijc.33473] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 12/15/2020] [Accepted: 12/21/2020] [Indexed: 12/11/2022]
Abstract
The gut microbiota may play a role in breast cancer etiology by regulating hormonal, metabolic and immunologic pathways. We investigated associations of fecal bacteria with breast cancer and nonmalignant breast disease in a case-control study conducted in Ghana, a country with rising breast cancer incidence and mortality. To do this, we sequenced the V4 region of the 16S rRNA gene to characterize bacteria in fecal samples collected at the time of breast biopsy (N = 379 breast cancer cases, N = 102 nonmalignant breast disease cases, N = 414 population-based controls). We estimated associations of alpha diversity (observed amplicon sequence variants [ASVs], Shannon index, and Faith's phylogenetic diversity), beta diversity (Bray-Curtis and unweighted/weighted UniFrac distance), and the presence and relative abundance of select taxa with breast cancer and nonmalignant breast disease using multivariable unconditional polytomous logistic regression. All alpha diversity metrics were strongly, inversely associated with odds of breast cancer and for those in the highest relative to lowest tertile of observed ASVs, the odds ratio (95% confidence interval) was 0.21 (0.13-0.36; Ptrend < .001). Alpha diversity associations were similar for nonmalignant breast disease and breast cancer grade/molecular subtype. All beta diversity distance matrices and multiple taxa with possible estrogen-conjugating and immune-related functions were strongly associated with breast cancer (all Ps < .001). There were no statistically significant differences between breast cancer and nonmalignant breast disease cases in any microbiota metric. In conclusion, fecal bacterial characteristics were strongly and similarly associated with breast cancer and nonmalignant breast disease. Our findings provide novel insight into potential microbially-mediated mechanisms of breast disease.
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Affiliation(s)
- Doratha A. Byrd
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Emily Vogtmann
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Zeni Wu
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Yongli Han
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Yunhu Wan
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | | | | | | | - Seth Wiafe
- Loma Linda University, School of Public Health, Loma Linda, CA, USA
| | | | | | | | - Autumn G. Hullings
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Xing Hua
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Thomas Ahearn
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - James J. Goedert
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Jianxin Shi
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Rob Knight
- Department of Pediatrics, University of California San Diego, La Jolla, California
| | - Jonine D. Figueroa
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
- Usher Institute and CRUK Edinburgh Centre, University of Edinburgh, Edinburgh, UK
| | - Louise A. Brinton
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | | | - Rashmi Sinha
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
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Sanni DA, Popoola AO, Ibrahim NA, Omodele FO, Emiogun FE, Oludara MA, Obafunwa JO. Hormone Receptors and Her-2/neu Overexpression in Breast Carcinomas in Patients of West African Origin Seen at Lagos State University Teaching Hospital, Nigeria. ASIAN JOURNAL OF ONCOLOGY 2021. [DOI: 10.1055/s-0041-1729347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
AbstractBreast carcinoma is a disease of utmost concern to the individual, family, and society at large. The current trend in the management of breast carcinoma also involves hormonal therapy. Consequently, the hormone expression of the tumor in the individual involved must be known if he or she is to benefit from such therapy. This is a prospective study of estrogen and progesterone receptors as well as Her-2/neu overexpression in all breast carcinomas seen at the Lagos State University Teaching Hospital, Ikeja, Nigeria, between April, 1, 2016, and September, 30, 2018. The total number of cases analyzed during the period under study was 107, comprising 105 women and 2 men with an age range of 26 to 88 years and a mean age of 52 ± 13 years. The tumors fell into histologic grade II (71.0%) and grade III (29.0%). They expressed ER, PR, and Her-2/neu positivity in 42.1%, 33.6%, and 30.8% of the cases, respectively. Triple-negative breast cancer was 35.5%. Male breast cancers presented as invasive ductal carcinoma and exhibit similar staining pattern as the female breast cancer. In conclusion, this study shows that breast carcinomas occurred predominantly in females of younger age and present with tumors, most of which were of high grade and exhibit triple negativity. This observation is relevant to any therapeutic decisions and management of these patients. Improvement in breast carcinoma screening programs so that the disease can be detected early is also advocated.
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Affiliation(s)
- Daniel Ayodele Sanni
- Department of Pathology and Forensic Medicine, Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria
| | - Abiodun Olaniyi Popoola
- Department of Radiology, Oncology Unit, Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria
| | - Nasiru Akanmu Ibrahim
- Department of Surgery, General Surgery Unit, Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria
| | - Foluso Oyeropo Omodele
- Department of Surgery, General Surgery Unit, Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria
| | - Festus Edobor Emiogun
- Department of Pathology and Forensic Medicine, Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria
| | - Mobolaji Adewale Oludara
- Department of Surgery, General Surgery Unit, Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria
| | - John Oladapo Obafunwa
- Department of Pathology and Forensic Medicine, Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria
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Romieu I, Biessy C, Joffe M, Cubasch H, Norris S, Vorster HH, Taljaard-Krugell C, Gunter MJ, Rinaldi S. Reproductive factors and risk of breast cancer in black South African women. Cancer Causes Control 2021; 32:415-422. [PMID: 33471235 PMCID: PMC8075164 DOI: 10.1007/s10552-021-01390-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 01/02/2021] [Indexed: 01/22/2023]
Abstract
PURPOSE Breast cancer (BC) is increasing in black South African women, but few studies have investigated its risk factors. METHODS We conducted an analysis of reproductive factors and BC risk in the South African Breast Cancer (SABC) study-a population-based case-control study of black South African women from Soweto that included 399 cases and 399 matched controls. Information on lifestyle and reproductive history was obtained by interviews. Conditional logistic regression was used to determine the association of reproductive factors with BC, adjusting for potential confounding factors. RESULTS Seventy-five percent of all BC cases were ER+, 66% PR+, 30% HER2+, and 16% TN. None of the reproductive variables were associated with BC overall or by subtype in the overall population, nor in pre- (n = 135 cases) or in post-menopausal women separately. In HIV-negative pre-menopausal women (n = 97 cases), later age at first pregnancy and longer time between menarche and first full-time pregnancy were inversely related to BC risk (OR 0.89 (95% CI 0.82-0.97; and 0.93 95% CI 0.86-1.01, respectively). CONCLUSION In this population of black South African women, reproductive factors were not associated with BC risk.
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Affiliation(s)
- Isabelle Romieu
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
| | - Carine Biessy
- Section of Nutrition and Metabolism, International Agency for Research On Cancer, 150, Cours Albert Thomas, 69008, Lyon, France
| | - Maureen Joffe
- Non-Communicable Diseases Research Division, Wits Health Consortium (PTY) Ltd, Johannesburg, South Africa
- MRC Developmental Pathways To Health Research Unit, Department of Pediatrics, Faculty of Health, Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Herbert Cubasch
- Non-Communicable Diseases Research Division, Wits Health Consortium (PTY) Ltd, Johannesburg, South Africa
- Department of Surgery, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Shane Norris
- MRC Developmental Pathways To Health Research Unit, Department of Pediatrics, Faculty of Health, Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Hester H Vorster
- Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa
| | | | - Marc J Gunter
- Section of Nutrition and Metabolism, International Agency for Research On Cancer, 150, Cours Albert Thomas, 69008, Lyon, France
| | - Sabina Rinaldi
- Section of Nutrition and Metabolism, International Agency for Research On Cancer, 150, Cours Albert Thomas, 69008, Lyon, France.
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Twahir M, Oyesegun R, Yarney J, Gachii A, Edusa C, Nwogu C, Mangutha G, Anderson P, Benjamin E, Müller B, Ngoh C. Real-world challenges for patients with breast cancer in sub-Saharan Africa: a retrospective observational study of access to care in Ghana, Kenya and Nigeria. BMJ Open 2021; 11:e041900. [PMID: 33653746 PMCID: PMC7929861 DOI: 10.1136/bmjopen-2020-041900] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVE To evaluate medical resource utilisation and timeliness of access to specific aspects of a standard care pathway for breast cancer at tertiary centres in sub-Saharan Africa. DESIGN Data were retrospectively abstracted from records of patients with breast cancer treated within a prespecified 2-year period between 2014 and 2017. The study protocol was approved by local institutional review boards. SETTING Six tertiary care institutions in Ghana, Kenya and Nigeria were included. PARTICIPANTS Health records of 862 patients with breast cancer were analysed: 299 in Ghana; 314 in Kenya; and 249 in Nigeria. INTERVENTIONS As directed by the treating physician. OUTCOME MEASURES Parameters selected for evaluation included healthcare resource and use, medical procedure turnaround times and out-of-pocket (OOP) payment patterns. RESULTS Use of mammography or breast ultrasonography was <45% in all three countries. Across the three countries, 78%-88% of patients completed tests for hormone receptors and human epidermal growth factor receptor 2 (HER2). Most patients underwent mastectomy (64%-67%) or breast-conserving surgery (15%-26%). Turnaround times for key procedures, such as pathology, surgery and systemic therapy, ranged from 1 to 5 months. In Ghana and Nigeria, most patients (87%-93%) paid for diagnostic tests entirely OOP versus 30%-32% in Kenya. Similarly, proportions of patients paying OOP only for treatments were high: 45%-79% in Ghana, 8%-20% in Kenya and 72%-89% in Nigeria. Among patients receiving HER2-targeted therapy, the average number of cycles was five for those paying OOP only versus 14 for those with some insurance coverage. CONCLUSIONS Patients with breast cancer treated in tertiary facilities in sub-Saharan Africa lack access to timely diagnosis and modern systemic therapies. Most patients in Ghana and Nigeria bore the full cost of their healthcare and were more likely to be employed and have secondary or postsecondary education. Access to screening/diagnosis and appropriate care is likely to be substantively lower for the general population.
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Ali-Gombe M, Mustapha MI, Folasire A, Ntekim A, Campbell OB. Pattern of survival of breast cancer patients in a tertiary hospital in South West Nigeria. Ecancermedicalscience 2021; 15:1192. [PMID: 33889201 PMCID: PMC8043689 DOI: 10.3332/ecancer.2021.1192] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Indexed: 01/01/2023] Open
Abstract
Background of the study Breast cancer is the most common cancer among women in both developed and developing nations. The survival of breast cancer is increasing in developed countries with improved treatment modalities, while still very poor in developing countries. In Nigeria, few breast cancer survival data are available. Research design This is a retrospective cross-sectional study. Objectives To determine the survival of breast cancer patients and possible factors influencing it. Methodology Socio-demographic and clinical variables from treatment records and case notes of breast cancer patients treated from 1 January 2004 to 31 December 2008 at the Department of Radiation Oncology, University College Hospital, Ibadan. The status of patients was determined at 2 and 5 years after diagnosis. The survival of patients with breast cancer was compared using Log Rank test according to socio-demographic and clinical variables. The median survival times were obtained from the Kaplan–Meier survival curve. Cox’s proportional hazard model was fitted for those that were statistically significant in the Log Rank test. Missing data were reported as unknown, not documented or missing. Results A total of 378 patients were analysed. Age ranged between 22.0 and 87.0 years with mean of 47.6 (standard deviation (SD) = 11.2) years. Almost all patients were females (98.4%). More than half (55.3%) presented at stage III, 28.0% had metastasis and the stage was unknown in about 6.6% of the patients. Invasive ductal carcinoma was the most prevalent histology (89.2%). Only 124 (32.8%) patients had their histological grade stated and most of the patients had no immunohistochemistry done. All the patients had radiotherapy, chemotherapy and surgery. About 25.1% of the patients were lost to follow up. The 2- and 5-year survival rates were 56.4% and 37.6%, respectively. The 2- and 5-year survival rates according to stage were stage I (80.0% and 66.7%), stage II (67.7% and 57.6%), stage III (51.4% and 27.9%) and stage IV (37.9% and 13.8%). Median survival time was 41 months (95%CI = 35.0–44.0). The disease-free survival at 2 and 5 years was 66.6% and 60.3%, respectively. Median time for recurrence was 8.0 months. Level of education, height, tumour unilaterality, clinical tumour size, stage at presentation, presence of distant metastases, clinical axillary lymph node metastasis, supraclavicular node metastasis, mode of surgery and axillary clearance were found to have statistically significant association with survival. Conclusion A large number of the patients in our study presented at a young age, late with advanced stage disease which results in poor survival outcome.
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Affiliation(s)
- Musa Ali-Gombe
- Department of Radiology, College of Medical Sciences, Gombe State University, P.M.B 127, Gombe, Nigeria
| | | | - Ayorinde Folasire
- Department of Radiation Oncology, College of Medical Sciences, University of Ibadan, P.M.B 3017, Ibadan, Nigeria
| | - Atara Ntekim
- Department of Radiation Oncology, College of Medical Sciences, University of Ibadan, P.M.B 3017, Ibadan, Nigeria
| | - Oladapo Babatunde Campbell
- Department of Radiation Oncology, College of Medical Sciences, University of Ibadan, P.M.B 3017, Ibadan, Nigeria
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Ibitoye OF, Thupayegale-Tshwenegae G. The Impact of Education on Knowledge Attitude and Practice of Breast Self-Examination Among Adolescents Girls at the Fiwasaye Girls Grammar School Akure, Nigeria. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2021; 36:39-46. [PMID: 31377988 DOI: 10.1007/s13187-019-01595-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Breast cancer is the second most common cancer in women aged 15-45 after the non-melanoma of the skin. Lack of knowledge and practice of breast self-examination (BSE) have been blamed for the high morbidity and mortality associated with breast cancer among women and adolescents in particular. The study assessed the impact of education on knowledge, attitude and practice of breast self-examination among adolescent girls. A quasi-experimental study of only one group was conducted among school-going adolescents at Fiwasaye Girls Grammar School in Akure, Ondo State, Nigeria. Data were collected using a self-developed questionnaire adapted from previous studies. Statistical Package for the Social Science (SPSS) version 20 was used for data analysis, and data were presented using descriptive statistics. A total of 280 respondents took part in the study with the mean age of 13.21 ± 5.68. Over 60% knew about breast examination before education, and this percentage increased to 91.7% after training. The pre-assessment attitude towards and practice of breast self-examination were also poor but improved after training. There was a significant difference among the students pre- and post-knowledge at t (558) = 14.49, p = 0.01 and for pre- and post-practice of BSE at t (558) = 6.38, p = 0.01. The study affirms the importance of continuous education as an effective tool in increasing awareness, knowledge, attitude and practice of BSE.
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Affiliation(s)
- Olabisi Fatimo Ibitoye
- Department of Health Studies, University of South Africa, Pretoria, South Africa.
- Faculty of Nursing, University of Medical Science, Ondo, Ondo State, Nigeria.
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Lynch KA, Omisore AD, Famurewa O, Olasehinde O, Odujoko O, Vera J, Kingham TP, Alatise OI, Egberongbe AA, Morris EA, Atkinson TM, Sutton EJ. Designing Participatory Needs Assessments to Support Global Health Interventions in Time-Limited Settings: A Case Study From Nigeria. INTERNATIONAL JOURNAL OF QUALITATIVE METHODS 2021; 20:10.1177/16094069211002421. [PMID: 35185442 PMCID: PMC8855957 DOI: 10.1177/16094069211002421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Social scientists have advocated for the use of participatory research methods for Global Health project design and planning. However, community-engaged approaches can be time and resource-intensive. This article proposes a feasible framework for conducting a participatory needs assessment in time-limited settings using multiple, triangulated qualitative methods. This framework is outlined through a case study: a participatory needs assessment to inform the design of an ultrasound-guided biopsy training program in Nigeria. Breast cancer is the leading cause of death for Nigerian women and most cases in Nigeria are diagnosed at an advanced stage; timely diagnosis is impeded by fractious referral pathways, costly imaging equipment, and limited access outside urban centers. The project involved participant observation, surveys, and focus groups at the African Research Group for Oncology (ARGO) in Ile-Ife, Nigeria. Through this timely research and engagement, participants spoke about diagnostic challenges, institutional power dynamics, and infrastructure considerations for program implementation.
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Affiliation(s)
- Kathleen A. Lynch
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - Olusola Famurewa
- Department of Radiology, Obafemi Awolowo University, Ile-Ife, Nigeria
| | | | - Oluwole Odujoko
- Department of Pathology, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Jacqueline Vera
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - T. Peter Kingham
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | | | - Elizabeth A. Morris
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Thomas M. Atkinson
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Elizabeth J. Sutton
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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Agatha Ogunkorode RS, Holtslander L, Ferguson L, Maree JE, Anonson J, Ramsden VR. Factors influencing the health-seeking behaviors of women with advanced stages of breast cancer in Southwestern Nigeria: An interpretive description study. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2021. [DOI: 10.1016/j.ijans.2020.100273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Mlole AT, Yahaya JJ, Othieno E, Kalungi S, Okwi AL. Hormonal Receptors, Human Epidermal Growth Factor Receptor-2 and Triple Negative Immunohistochemical Typing in Women with Breast Cancer in Kampala, Uganda. Int J Womens Health 2020; 12:1109-1123. [PMID: 33343201 PMCID: PMC7745719 DOI: 10.2147/ijwh.s270082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 10/20/2020] [Indexed: 11/23/2022] Open
Abstract
Background The expression of estrogen and progesterone receptors (ER and PR) and human epidermal growth factor receptor-2 (HER2) has been reported to have an invaluable prognostic role. The aim of this study was to determine the expression of ER, PR and HER2 in women with breast cancer (BC) in Kampala, Uganda. Methods Expression of ER, PR and HER2 was determined immunohistochemically. Logistic regression was performed to determine the effect of the independent factors in predicting the risk of not expressing the breast markers. A two-tailed p<0.05 was regarded to be statistically significant. Results ER, PR and HER2 were expressed in 53.4%, 46.6% and 18.5%, respectively. ER and PR co-expression was present in 42.7% and 37.9% patients had triple negative breast cancer (TNBC). Age was an independent predictor of expression of ER (AOR = 0.18, 95% CI = 0.062–0.541, p = 0.002) and PR (AOR = 0.35, 95% CI = 0.129–0.968, p = 0.043). Conclusion The majority of patients in this study had less than 50 years with high tumour grade. Interestingly, most of them had high expression of HER2 with TNBC which are molecular subtypes of BC with poor prognosis. Age was an independent predictor of expression of both ER and PR.
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Affiliation(s)
- Angela T Mlole
- Department of Pathology, Makerere College of Health Sciences (MaKCHS), Makerere University, Kampala, Uganda
| | - James J Yahaya
- Department of Biomedical Science, College of Health Science (CHS), The University of Dodoma, Dodoma, Tanzania
| | - Emmanuel Othieno
- Department of Pathology, Mulago National Hospital, Kampala, Uganda
| | - Sam Kalungi
- Department of Pathology, Mulago National Hospital, Kampala, Uganda
| | - Andrew L Okwi
- Department of Pathology, Makerere College of Health Sciences (MaKCHS), Makerere University, Kampala, Uganda
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Salisu WJ, Mirlashari J, Varaei S, Seylani K. Limited access to care for persons with breast cancer in Africa: A systematic review. Eur J Oncol Nurs 2020; 50:101867. [PMID: 33276292 DOI: 10.1016/j.ejon.2020.101867] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 10/28/2020] [Accepted: 11/03/2020] [Indexed: 01/14/2023]
Abstract
PURPOSE To systematically review the available evidence and examine the factors that may limit patients' access to breast cancer care in Africa. METHODS We searched six databases (Google Scholar, Web of Science, PubMed, EMBASE, CINAHL, and Scopus) for studies conducted among breast cancer patients in Africa, highlighting patient challenges and barriers to care or treatment. The search was limited to studies published in the English language and from January 2000 until August 2019. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. There were no limitations to the methodological design of the included studies. RESULTS In total, 18,154 articles were retrieved through electronic search; twenty-five were eligible for inclusion after quality appraisal. We analyzed the data using the deductive content analysis approach. Three categories emerged as barriers to breast cancer care: Socio-economic challenges, Institutional shortfalls, and Distinctiveness. CONCLUSIONS The findings support that economic hardships, fear, and scarcity of cancer treatments/equipment are critical in limiting access to breast cancer care. Sustainable strategies aimed at scaling-up breast cancer care in the region are necessary. The results also highlight the need for reduced treatment cost and aggressive educational campaigns across healthcare facilities and the local communities.
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Affiliation(s)
- Waliu Jawula Salisu
- School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, 1419733171, Iran
| | - Jila Mirlashari
- School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, 1419733171, Iran; Women's Health Research Institute, Department of OBGYN, University of British Columbia, 4500 Oak Street, Vancouver, Canada
| | - Shokoh Varaei
- School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, 1419733171, Iran
| | - Khatereh Seylani
- School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, 1419733171, Iran.
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Wu D, Jia H, Zhang Z, Li S. Capsaicin suppresses breast cancer cell viability by regulating the CDK8/PI3K/Akt/Wnt/β‑catenin signaling pathway. Mol Med Rep 2020; 22:4868-4876. [PMID: 33173974 PMCID: PMC7646934 DOI: 10.3892/mmr.2020.11585] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 09/04/2020] [Indexed: 12/24/2022] Open
Abstract
Breast cancer displays high morbidity and mortality. Despite exerting certain effects, traditional treatments cannot eliminate every cancer cell and may kill normal cells due to inaccurate targeting. However, as a traditional Chinese medicine, capsaicin, an active compound extracted from chili peppers, has displayed potent anticarcinogenic activities in vitro and in vivo, but the underlying mechanism is not completely understood. The pharmacological effects of capsaicin on tumors was evaluated in MDA MB 231 breast cancer cells. The MTT, cell scratch assay, cell cycle analysis, cell transfection, reverse transcription‑quantitative PCR and western blotting were performed to investigate the potential antitumor mechanisms of capsaicin. In the present study, the potential anticancer mechanism underlying capsaicin in MDA‑MB‑231 cells in vitro was investigated. Capsaicin significantly inhibited MDA‑MB‑231 breast cancer cell viability and migration compared with the control group. The flow cytometry results indicated that capsaicin induced G2/M cell cycle arrest in MDA‑MB‑231 cells. In addition, capsaicin significantly reduced the expression of cyclin‑dependent kinase 8 (CDK8) in breast cancer cells compared with the control group. Moreover, LV‑CDK8 small interfering RNA‑transduced MDA‑MB‑231 cells displayed lower CDK8 mRNA and protein expression levels compared with LV‑negative control‑shRNA‑transduced cells. Furthermore, capsaicin significantly reduced the expression levels of phosphorylated (p)‑PI3K, p‑Akt, Wnt and β‑catenin in vitro compared with the control group. Collectively, the results of the present study suggested that capsaicin inhibited breast cancer cell viability, induced G2/M cell cycle arrest, reduced CDK8 expression levels, decreased the phosphorylation of PI3K and Akt and downregulated Wnt and β‑catenin expression levels in MDA‑MB‑231 cells.
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Affiliation(s)
- Di Wu
- Department of Breast Surgery, The First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China
| | - Hongyao Jia
- Department of Breast Surgery, The First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China
| | - Zhiru Zhang
- Department of Breast Surgery, The First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China
| | - Sijie Li
- Department of Breast Surgery, The First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China
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Adeniji AA, Dawodu OO, Habeebu MY, Oyekan AO, Bashir MA, Martin MG, Keshinro SO, Fagbenro GT. Distribution of Breast Cancer Subtypes Among Nigerian Women and Correlation to the Risk Factors and Clinicopathological Characteristics. World J Oncol 2020; 11:165-172. [PMID: 32849957 PMCID: PMC7430856 DOI: 10.14740/wjon1303] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 07/16/2020] [Indexed: 12/31/2022] Open
Abstract
Background Breast cancer in African women differs from the Caucasian. Understanding the profile of Nigerian women with breast cancer will help with preventive measures and treatment. This study focused on the clinico-pathological characteristics, with risk factors of breast cancer patients in Nigeria. Methods Newly diagnosed female patients with breast cancer were assessed over 12 months. Patients were reviewed using a predesigned proforma which focused on socio-demographic information, clinical information, risk factors and tumor biology. Results A total of 251 women were identified; their mean age was 46 years. More than half (62.5%) are premenopausal at presentation, 37.8% with Eastern Cooperative Oncology Group (ECOG) score of 0 and right side (50.2%) as the most common primary site of disease. Less than half of them (43.0%) are estrogen receptor (ER) positive, 27.9% are progesterone receptor (PR) positive, 43.8% and 47.4% are hormone receptor positive and triple negative, respectively. Most patients presented at the latter stage of the disease, stage III (66.9%) and stage IV (18.3%). Only 15.9% are well differentiated and almost all (92.8%) had invasive ductal histological type. Obesity (66.2%) and physical inactivity (41.9%) are the most common risk factors for the disease. A significant relationship was found between immunohistochemistry status and family history of breast cancer, tumor site, previous breast surgery, previous lump and alcohol intake. Conclusion Findings from this study showed that Nigerian breast cancer patients differ from their counterparts in the high human development index (H-HDI) countries in terms of the patients and disease characteristics. In view of this, prevention and treatment options should consider this uniqueness to ensure better outcome.
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Affiliation(s)
- Adeoluwa Akeem Adeniji
- Oncology and Radiotherapy Department, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Olayemi Olubunmi Dawodu
- Molecular and Anatomical Pathology Department, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Muhammad Yaqub Habeebu
- Radiotherapy, Radiobiology, Radiodiagnosis and Radiography Department, College of Medicine, University of Lagos, Lagos, Nigeria
| | | | - Mariam Adebola Bashir
- Oncology and Radiotherapy Department, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Mike G Martin
- West Cancer Centre and Research Institute, Memphis, TN, USA
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Olasehinde O, Arije O, Wuraola FO, Samson M, Olajide O, Alabi T, Arowolo O, Boutin-Foster C, Alatise OI, Kingham TP. Life Without a Breast: Exploring the Experiences of Young Nigerian Women After Mastectomy for Breast Cancer. J Glob Oncol 2020; 5:1-6. [PMID: 31095453 PMCID: PMC6550027 DOI: 10.1200/jgo.18.00248] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE The majority of women managed for breast cancer in Nigeria are relatively young, many in their forties. Mastectomy, the most common surgical treatment, raises psychosocial concerns. Understanding these concerns may help address the fears of women who refuse treatment and aid in the care of those who have had mastectomy. METHODS Using qualitative methods, we purposively sampled women 45 years of age and younger who underwent mastectomy for breast cancer at a Nigerian teaching hospital. One-on-one in-depth interviews were conducted using an unstructured interview guide. Data were transcribed verbatim and analyzed to identify themes and subthemes. RESULTS The study identified six major themes on the impact of mastectomy on psychosocial lives of women, namely decision for mastectomy, postmastectomy transition, body image changes, relationship with husband and sexual life, coping with life postmastectomy, and social support. CONCLUSION Our findings highlight the importance of addressing individual patient's psychosocial needs and preferences when discussing breast cancer treatment with young women. The experiences of women described in this study reveal several useful themes for planning treatment protocols and postmastectomy care.
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Affiliation(s)
| | | | | | | | - Olawumi Olajide
- Obafemi Awolowo University, Ile-Ife, Osun, Nigeria.,Memorial Sloan Kettering Cancer Center, New York, NY
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Zeeshan S, Ali B, Ahmad K, Chagpar AB, Sattar AK. Clinicopathological Features of Young Versus Older Patients With Breast Cancer at a Single Pakistani Institution and a Comparison With a National US Database. J Glob Oncol 2020; 5:1-6. [PMID: 30860954 PMCID: PMC6449072 DOI: 10.1200/jgo.18.00208] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
PURPOSE The age at which women present with breast cancer varies widely among nations, and breast cancer may behave differently in younger women. Differences in clinicopathological characteristics based on age have not been well characterized in Pakistani patients with breast cancer. METHODS We conducted a retrospective review of patients with symptoms of breast cancer presenting to Aga Khan University Hospital (AKUH), a large tertiary care center in Pakistan, between 2001 and 2010; we compared young (≤ 40 years) versus older (> 40 years) patients in terms of their clinicopathological characteristics. We also compared this Pakistani cohort with the US population using data from the National Cancer Database (NCDB). RESULTS A total of 1,334 patients with breast cancer presented to our center over the 10-year review period. The median age at diagnosis was 50 years, compared with 60 years for patients in the NCDB. In the AKUH cohort, younger patients were significantly more likely than their older counterparts to present with metastatic disease (13.1% v 10.8%; P < .01). They also were more likely to present with higher-grade tumors (grade 3: 40.1% v 28.3%; P < .001), have triple hormone receptor–negative phenotype (25.4% v 14.1%, P < .001), and have positive axillary lymph node involvement (70.9% v 57.5%; P < .001) compared with older women. Younger and older patients in the AKUH cohort tended to present with higher-stage disease (P < .001) and were more likely to have triple hormone receptor–negative disease (P < .001), compared with all patients in the NCDB and with those of Indo-Pakistani origin. CONCLUSION Young Pakistani women, similar to their Western counterparts, present with more advanced disease and more aggressive tumor biology than their older counterparts.
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Affiliation(s)
| | - Basim Ali
- The Aga Khan University, Karachi, Pakistan
| | | | - Anees B Chagpar
- Yale University School of Medicine, New Haven, CT.,Yale Comprehensive Cancer Center, New Haven, CT
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Arko-Boham B, Owusu BA, Aryee NA, Blay RM, Owusu EDA, Tagoe EA, Adams AR, Gyasi RK, Adu-Aryee NA, Mahmood S. Prospecting for Breast Cancer Blood Biomarkers: Death-Associated Protein Kinase 1 (DAPK1) as a Potential Candidate. DISEASE MARKERS 2020; 2020:6848703. [PMID: 32566040 PMCID: PMC7267859 DOI: 10.1155/2020/6848703] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 05/01/2020] [Indexed: 01/03/2023]
Abstract
BACKGROUND Breast cancer is the commonest malignancy in women worldwide. It is estimated to affect approximately 1.5 million women annually and responsible for the greatest number of cancer-related mortalities among women. In 2018, breast cancer mortalities stood at 627,000 women representing approximately 15% of all cancer deaths among women. In Ghana, breast cancer is the second leading cause of cancer deaths, with an incidence of 2,900 cases annually; one of eight women with the disease die. This gives impetus to the fight for improved early detection, treatment, and/management. In this light, we investigated the potential of death-associated protein kinase 1 (DAPK1) as a biomarker for breast cancer. As a tumour suppressor, its expression is activated by several carcinogens to influence cellular pathways that result in apoptosis, autophagy, immune response, and proliferation. AIM To investigate DAPK1 as a blood biomarker for breast cancer. METHODS Blood samples of participants diagnosed with breast cancer and healthy controls were collected and processed to obtain serum. Information on age, treatment, diagnosis, and pathology numbers was retrieved from folders. Pathology numbers were used to retrieve breast tissue blocks of patients at the Department of Pathology of the KBTH. Tissue blocks were sectioned and immunohistochemically stained with anti-DAPK1 and counterstained with hematoxylin to determine the DAPK1 expression levels. DAKP1 levels in blood sera were quantified using a commercial anti-DAPK1 ELISA kit. Case and control group means were compared using one-way ANOVA and Chi-square test. Statistical significance was set at p ≤ 0.05. Results and Discussion. DAPK1 levels were higher in sera and breast tissues of breast cancer patients than controls. The augmented DAPK1 expression can be interpreted as a stress response survival mechanism to remediate ongoing deleterious events in the cells orchestrated by carcinogenesis. In the presence of abundant DAPK1, the proliferative power of cells (both cancerous and noncancerous) is increased. This may explain why high DAPK1 expression strongly associates with aggressive breast cancer phenotypes like the ER-negative breast cancers, especially the triple-negative breast cancers (TNBC) which are the most aggressive, fast-growing, and highly metastatic. CONCLUSION DAPK1 is highly expressed in sera and breast tissues of breast cancer patients than nonbreast cancer participants. The elevated expression of DAKP1 in circulation rather than in breast tissues makes it a candidate for use as a blood biomarker and potential use as therapeutic target in drug development.
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Affiliation(s)
- Benjamin Arko-Boham
- Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Ghana
- Department of Anatomy, School of Biomedical and Allied Health Sciences, University of Ghana, Ghana
| | - Bright Afriyie Owusu
- Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Ghana
| | - Nii Ayite Aryee
- Department of Medical Biochemistry, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Ghana
| | - Richard Michael Blay
- Department of Anatomy, School of Biomedical and Allied Health Sciences, University of Ghana, Ghana
| | - Ewurama Dedea Ampadu Owusu
- Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Ghana
- Centre of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Academic Medical Centre, University of Amsterdam, Netherlands
- Foundation for Innovative and New Diagnostics (FIND), Geneva, Switzerland
| | - Emmanuel Ayitey Tagoe
- Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Ghana
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Legon, Ghana
| | - Abdul Rashid Adams
- Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Ghana
| | - Richard Kwasi Gyasi
- Department of Pathology, School of Biomedical and Allied Health Sciences, University of Ghana, Ghana
| | - Nii Armah Adu-Aryee
- Department of Surgery, School of Medicine and Dentistry, College of Health Sciences, University of Ghana, Ghana
- Department of Surgery, Korle-Bu Teaching Hospital, Accra-, Ghana
| | - Seidu Mahmood
- Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Ghana
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Figueroa JD, Davis Lynn BC, Edusei L, Titiloye N, Adjei E, Clegg-Lamptey JN, Yarney J, Wiafe-Addai B, Awuah B, Duggan MA, Wiafe S, Nyarko K, Aitpillah F, Ansong D, Hewitt SM, Ahearn T, Garcia-Closas M, Brinton LA. Reproductive factors and risk of breast cancer by tumor subtypes among Ghanaian women: A population-based case-control study. Int J Cancer 2020; 147:1535-1547. [PMID: 32068253 DOI: 10.1002/ijc.32929] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 01/09/2020] [Accepted: 01/29/2020] [Indexed: 02/05/2023]
Abstract
Higher proportions of early-onset and estrogen receptor (ER) negative cancers are observed in women of African ancestry than in women of European ancestry. Differences in risk factor distributions and associations by age at diagnosis and ER status may explain this disparity. We analyzed data from 1,126 cases (aged 18-74 years) with invasive breast cancer and 2,106 controls recruited from a population-based case-control study in Ghana. Odds ratios (OR) and 95% confidence intervals (CI) were estimated for menstrual and reproductive factors using polytomous logistic regression models adjusted for potential confounders. Among controls, medians for age at menarche, parity, age at first birth, and breastfeeding/pregnancy were 15 years, 4 births, 20 years and 18 months, respectively. For women ≥50 years, parity and extended breastfeeding were associated with decreased risks: >5 births vs. nulliparous, OR 0.40 (95% CI 0.20-0.83) and 0.71 (95% CI 0.51-0.98) for ≥19 vs. <13 breastfeeding months/pregnancy, which did not differ by ER. In contrast, for earlier onset cases (<50 years) parity was associated with increased risk for ER-negative tumors (p-heterogeneity by ER = 0.02), which was offset by extended breastfeeding. Similar associations were observed by intrinsic-like subtypes. Less consistent relationships were observed with ages at menarche and first birth. Reproductive risk factor distributions are different from European populations but exhibited etiologic heterogeneity by age at diagnosis and ER status similar to other populations. Differences in reproductive patterns and subtype heterogeneity are consistent with racial disparities in subtype distributions.
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Affiliation(s)
- Jonine D Figueroa
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD.,Usher Institute and CRUK Edinburgh Centre, University of Edinburgh, Edinburgh, United Kingdom
| | - Brittny C Davis Lynn
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | | | | | | | | | | | | | | | - Maire A Duggan
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, AB, Canada
| | - Seth Wiafe
- Loma Linda University, School of Public Health, Loma Linda, CA
| | | | | | - Daniel Ansong
- Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Stephen M Hewitt
- Center for Cancer Research, National Cancer Institute, Bethesda, MD
| | - Thomas Ahearn
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | | | - Louise A Brinton
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
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Bayard S, Susick L, Kyei I, Chen Y, Davis MB, Gyan K, Newman LA. Brief report: Global health initiatives and breast oncology capacity-building in Africa. Am J Surg 2020; 219:563-565. [PMID: 32008719 DOI: 10.1016/j.amjsurg.2020.01.034] [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: 07/31/2019] [Accepted: 01/19/2020] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Global health initiatives provide exciting opportunities for capacity-building in low- and middle-income countries but data regarding how African clinicians characterize the most effective partnerships are lacking. METHODS We surveyed attendees at two "Breast Cancer in Africa" symposia sponsored through a surgeon-led global breast cancer research collaborative. Respondents ranked their preferences for needs from American global health partnerships. RESULTS 399 African attendees responded (170 at the 2017 Ghana conference; 229 at the 2018 Ethiopia conference). Physicians comprised 41.1% of respondents; nurses 20.1% and medical students 27.6%. Ancillary hospital staff comprised the remaining 11.2%. Among clinicians, 75.7% ranked educational/training programs or donation of medical supplies as the highest-priority needs compared to only 20.4% ranking direct monetary support as the highest-priority need (P < 0.0001). CONCLUSIONS Our survey study found that African clinicians prioritize training programs and donation of medical/hospital supplies above direct monetary support as their highest-value needs from global health initiatives.
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Affiliation(s)
- Solange Bayard
- Department of Surgery, Weill Cornell Medicine, New York, NY, USA
| | - Laura Susick
- Department of Public Health Sciences, Henry Ford Health System, Detroit, MI, USA
| | - Ishmael Kyei
- Department of Surgery, Komfo Anoyke Teaching Hospital, Kumasi, Ghana
| | - Yalei Chen
- Department of Public Health Sciences, Henry Ford Health System, Detroit, MI, USA
| | - Melissa B Davis
- Department of Surgery, Weill Cornell Medicine, New York, NY, USA
| | - Kofi Gyan
- Department of Surgery, Weill Cornell Medicine, New York, NY, USA
| | - Lisa A Newman
- Department of Surgery, Weill Cornell Medicine, New York, NY, USA.
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Tewabe T, Mekuria Z. Knowledge and practice of breast self-examination among undergraduate students in Bahir Dar University, North-West Ethiopia, 2016: A cross-sectional study. J Public Health Afr 2019; 10:805. [PMID: 31244982 PMCID: PMC6562255 DOI: 10.4081/jphia.2019.805] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2017] [Accepted: 07/19/2018] [Indexed: 11/23/2022] Open
Abstract
Breast cancer is the most common cancer in women worldwide, with nearly 1.7 million new cases diagnosed each year which accounts 12% of all new cancer cases and 25% of all cancers in women. Breast self-examination offers women the best opportunity for reducing breast cancer deaths. From a total of 222 respondents about 190 (85.6%) heard about breast selfexamination. One hundred forty-three (75.3%) had good knowledge about sign and symptoms of breast cancer and 47 (24.7%) had poor knowledge about the sign and symptoms of breast cancer. From total respondents of the study 120 (54.1%) practiced breast self-examination. Breast selfexamination practice is relatively frequent problem in Bahir Dar University, health science students. Negligence, forgetfulness and lack of knowledge are the main factors for poor practice of breast self-examination. Public health education using the media, clubs and leaflet could significantly reduce poor practice of breast self-examination and increases early detection of breast lump.
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Affiliation(s)
- Tilahun Tewabe
- Bahir Dar University, College of Medicine and Health Science, Bahir Dar, Ethiopia
| | - Zelalem Mekuria
- Bahir Dar University, College of Medicine and Health Science, Bahir Dar, Ethiopia
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ROPO EBENEZER O, LOUGUE S. Bayesian Generalized Linear Mixed Modeling of Breast Cancer. IRANIAN JOURNAL OF PUBLIC HEALTH 2019; 48:1043-1051. [PMID: 31341845 PMCID: PMC6635339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Breast cancer is one of the most common cancers among women. Breast cancer treatment strategies in Nigeria need urgent strengthening to reduce mortality rate because of the disease. This study aimed to determine the relationship between the ages at diagnosis and established the prognostic factors of modality of treatment given to breast cancer patient in Nigeria. METHODS The data was collected for 247 women between years 2011-2015 who had breast cancer in two different hospitals in Ekiti State, Nigeria. Model estimation is based on Bayesian approach via Markov Chain Monte Carlo. A multilevel model based on generalized linear mixed model is used to estimate the random effect. RESULTS The mean age of the patients (at the time of diagnosis) was 42.2 yr with 52% of the women aged between 35-49 yr. The results of the two approaches are almost similar but preference is given to Bayesian because the approach is more robust than the frequentist. Significant factors of treatment modality are age, educational level and breast cancer type. CONCLUSION Differences in socio-demographic factors such as educational level and age at diagnosis significantly influence the modality of breast cancer treatment in western Nigeria. The study suggests the use of Bayesian multilevel approach in analyzing breast cancer data for the practicality, flexibility and strength of the method.
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Mfengwana PH, Mashele SS, Manduna IT. Cytotoxicity and cell cycle analysis of Asparagus laricinus Burch. and Senecio asperulus DC. on breast and prostate cancer cell lines. Heliyon 2019; 5:e01666. [PMID: 31193085 PMCID: PMC6517332 DOI: 10.1016/j.heliyon.2019.e01666] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 04/12/2019] [Accepted: 05/02/2019] [Indexed: 01/22/2023] Open
Abstract
Aims Medicinal plants play an important role in our African communities for treatment and prevention of various diseases including cancer. This study was aimed on evaluating the cytotoxicity activities of Asparagus laricinus Burch. and Senecio asperulus DC. Main methods In vitro cytotoxicity screening was carried out using fluorescent cellular stains on human prostate cancer (PC3), human breast cancer (MCF-7) and the non-cancerous African green monkey kidney (Vero) cell lines. The cells were imaged with the ImageXpress Micro XLS Widefield fluorescent Microscope, and the acquired images were analysed using the MetaXpress software and the Multi-Wavelength cell scoring application module. Melphalan was used as a positive control in all experiments. Key findings Asparagus laricinus methanol and Senecio asperulus DC. dichloromethane extracts exhibited cytotoxicity activity against breast cancer cells with IC50 values of 97.6 μg/mL and 69.15 μg/mL, respectively. Cell cycle analysis suggested that Asparagus laricinus methanol extract induced cell death selectively through apoptosis observed from Annexin V-FITC and PI stain. Cell cycle analysis also showed that Senecio asperulus DC. dichloromethane extracts induced breast cancer cells death through cell arrest at the synthesis phase and G2 phase. Senecio asperulus DC. dichloromethane extracts further showed cytotoxicity activity against prostate cancer cells with IC50 values of 69.25 μg/mL due to cell arrest at the G2 and early mitotic (G2/M) phase. Significance We, therefore, propose that the methanol extract of Asparagus laricinus is a suitable aspirant for future breast cancer chemotherapeutic drug, due to its selective cytotoxicity on cancer cells and not on non-cancerous cells.
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Affiliation(s)
- P H Mfengwana
- Department of Health Sciences, Central University of Technology, Free State, Private Bag X20539, Bloemfontein, 9300 South Africa
| | - S S Mashele
- Unit for Drug Discovery Research, Central University of Technology, Free State, Private Bag X20539, Bloemfontein, 9300 South Africa
| | - I T Manduna
- Centre for Applied Food Security and Biotechnology, Central University of Technology, Free State, Private Bag X20539, Bloemfontein, 9300 South Africa
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Deressa BT, Cihoric N, Badra EV, Tsikkinis A, Rauch D. Breast cancer care in northern Ethiopia - cross-sectional analysis. BMC Cancer 2019; 19:393. [PMID: 31023270 PMCID: PMC6485046 DOI: 10.1186/s12885-019-5612-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 04/12/2019] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND In Ethiopia, the incidence of new cases of breast cancer is currently increasing resulting to high rates of morbidity and mortality. Breast cancer is by far the most common cancer accounting for more than one out of three cancer cases in women and one out of every five in the general population. The study was conducted in University of Gondar Hospital cancer center, located in the North-West Ethiopia; to evaluate the clino-pathologic characteristics of breast cancer and care provided for patients. METHODS All biopsy proven breast cancer patients treated between 2016 and 2017, were identified and information regarding histology, stage, therapeutic procedure and follow up was retrospectively collected from their individual medical records and descriptive analysis was done. RESULTS Among 82 patients treated, 67 (82%) were women and 15 (18%) were men. The median age at the time of diagnosis was 45 years (25-82 years). Operation was performed for 56 (68%) patients. The predominant histology was ductal carcinoma in 61 patients (74%), followed by breast carcinoma of No Special Type (NST) in 17 (21%). The late presentation of the patients and the advanced stage at the time of presentation was observed in most of the patients. Chemotherapy was administered in 79 (96%) patients. Radiotherapy was not available in the hospital. CONCLUSION Breast cancer incidence is rising and becoming a major public health problem in Northern Ethiopia. Breast cancer care in northern-Ethiopia is limited in terms of both pathology, imaging and the offered treatment modalities, which need to be improved.
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Affiliation(s)
- Biniyam Tefera Deressa
- University of Gondar, Gondar, Ethiopia. .,Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
| | - Nikola Cihoric
- Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Eugenia Vlaskou Badra
- Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Alexandros Tsikkinis
- Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Daniel Rauch
- Regional Hospital Thun, Thun, Switzerland.,Department of Medical Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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Tian N, Zhou L, Yang D, Wu H, Ma Y, Lü L, Wu S. [Silencing RRM1 gene reverses paclitaxel resistance in human breast cancer cell line MCF- 7/R by inducing cell apoptosis]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2019; 39:304-312. [PMID: 31068300 DOI: 10.12122/j.issn.1673-4254.2019.03.08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To investigate the effects of ribonucleotide reductase catalytic subunit M1 (RRM1) gene silencing on drug resistance of human breast cancer cell line MCF-7/R. METHODS We established a paclitaxel-resistant breast cancer MCF-7 cell line (MCF-7/R) by exposing the cells to high-concentration paclitaxel in a short time. Small interfering RNAs (siRNAs) targeting RRM1 were designed to silence RRM1 expression in human breast cancer MCF-7/R cells. MTT assay was used to detect the IC50 values and the sensitivity to paclitaxel in the cells with or without siRNA transfection. The changes in the proliferative activity of MCF7 and MCF-7/R cells following RRM1 gene silencing were evaluated using EdU assay. Flow cytometry was used to analyze the cell apoptosis and cell cycle changes. We assessed the effect of RRM1 gene silencing and paclitaxel on the tumor growth in a nude mouse model bearing subcutaneous xenografts with or without siRNA transfection. RESULTS We detected significantly higher expressions of RRM1 at both the mRNA and protein levels in the drug-resistant MCF- 7/R cells than in the parental MCF-7 cells (P < 0.01). Transfection with the specific siRNAs significantly reduced the expression of RRM1 in MCF-7/R cells (P < 0.05), which showed a significantly lower IC50 value of paclitaxel than the cells transfected with the negative control siRNA (P < 0.05). RRM1 silencing significantly inhibited the proliferation (P < 0.01) and enhanced the apoptosis-inducing effect of paclitaxel in MCF-7/R cells (P < 0.001); RRM1 silencing also resulted in obviously reduced Akt phosphorylation, suppressed Bcl-2 expression and promoted the expression of p53 protein in MCF-7/R cells. In the tumor-bearing nude mice, the volume of subcutaneously transplanted tumors was significantly smaller in MCF-7/R/siRNA+ PTX group than in the other groups (P < 0.001). CONCLUSIONS RRM1 gene silencing can reverse paclitaxel resistance in human breast cancer cell line MCF-7/R by promoting cell apoptosis.
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Affiliation(s)
- Nannan Tian
- School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, China
| | - Lei Zhou
- School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, China
| | - Danni Yang
- School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, China
| | - Huanxian Wu
- School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, China
| | - Yunci Ma
- School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, China
| | - Lin Lü
- School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, China
| | - Shaoyu Wu
- School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, China
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Davies-Bolorunduro OF, Adeleye IA, Akinleye MO, Wang PG. Anticancer potential of metabolic compounds from marine actinomycetes isolated from Lagos Lagoon sediment. J Pharm Anal 2019; 9:201-208. [PMID: 31297298 PMCID: PMC6598170 DOI: 10.1016/j.jpha.2019.03.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2018] [Revised: 03/10/2019] [Accepted: 03/11/2019] [Indexed: 10/30/2022] Open
Abstract
Thirty-two actinomycetes strains were isolated from sediment samples from 12 different sites at Lagos Lagoon and identified using standard physiological and biochemical procedures as well as 16S rDNA gene sequence analysis. Secondary metabolites were extracted from the strains and their anticancer activity on the K562 (Human acute myelocytic leukemia), HeLa (cervical carcinoma), AGS (Human gastric), MCF-7 (breast adenocarcinoma) and HL-60 (Human acute promyelocytic leukemia) cell lines was determined. The metabolic extracts exhibited cytotoxicity with IC50 values ranging from 0.030 mg/mL to 4.4 mg/mL. The Streptomyces bingchenggensis ULS14 extract was cytotoxic against all the cell lines tested. The bioactivity-guided extraction and purification of the metabolic extracts from this strain yielded two purified anticancer compounds: ULDF4 and ULDF5. The structures of the extracted compounds were determined using spectroscopic analyses, including electrospray ionization mass spectrophotometer and nuclear magnetic resonance (1 Dimensional and 2 Dimensional), and were shown to be structurally similar to staurosporine and kigamicin. The IC50 of ULDF4 and ULDF5 against the HeLa cell line was 0.034 μg/mL and 0.075 μg/mL, respectively. This study is the first to reveal the anticancer potential of actinomycetes from Lagos Lagoon, which could be exploited for therapeutic purposes.
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Affiliation(s)
- Olabisi Flora Davies-Bolorunduro
- Department of Microbiology, University of Lagos, Akoka, Lagos, Nigeria.,Department of Chemistry, Georgia State University, Atlanta, GA, United States
| | | | | | - Peng George Wang
- Department of Chemistry, Georgia State University, Atlanta, GA, United States
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Sowunmi A, Olatunji T, Ketiku K, Campbell O. Sociodemographic correlates and management of breast cancer in Radiotherapy Department, Lagos University Teaching Hospital: A 10-year review. JOURNAL OF CLINICAL SCIENCES 2019. [DOI: 10.4103/jcls.jcls_82_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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McCormack VA, Febvey-Combes O, Ginsburg O, Dos-Santos-Silva I. Breast cancer in women living with HIV: A first global estimate. Int J Cancer 2018; 143:2732-2740. [PMID: 29992553 DOI: 10.1002/ijc.31722] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Revised: 06/08/2018] [Accepted: 06/12/2018] [Indexed: 12/11/2022]
Abstract
There is a growing population of older women living with HIV/AIDS (WLWHA). Breast cancer is a common cancer in women worldwide, but the global number of breast cancers in WLWHA is not known. We estimated, for each UN sub-region, the number and age distribution of WLWHA who were diagnosed with breast cancer in 2012, by combining IARC-GLOBOCAN estimates of age-country specific breast cancer incidence with corresponding UNAIDS HIV prevalence. Primary analyses assumed no HIV-breast cancer association, and a breast cancer risk reduction scenario was also considered. Among 16.0 million WLWHA aged 15+ years, an estimated 6,325 WLWHA were diagnosed with breast cancer in 2012, 74% of whom were in sub-Saharan Africa, equally distributed between Eastern, Southern and Western Africa. In most areas, 70% of HIV-positive breast cancers were diagnosed under age 50. Among all breast cancers (regardless of HIV status), HIV-positive women constituted less than 1% of the clinical burden, except in Eastern, Western and Middle Africa where they comprised 4-6% of under age 50 year old breast cancer patients, and in Southern Africa where this patient subgroup constituted 26 and 8% of breast cancers diagnosed under and over age 50 respectively. If a deficit of breast cancer occurs in WLWHA, the global estimate would reduce to 3,600. In conclusion, worldwide, the number of HIV-positive women diagnosed with breast cancer was already substantial in 2012 and with an expected increase within the next decade, early detection and treatment research targeted to this population are needed.
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Affiliation(s)
- Valerie A McCormack
- Section of Environment and Radiation, International Agency for Research on Cancer, Lyon, France
| | - Olivia Febvey-Combes
- Section of Environment and Radiation, International Agency for Research on Cancer, Lyon, France
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Ng’ang’a A, Nyangasi M, Nkonge NG, Gathitu E, Kibachio J, Gichangi P, Wamai RG, Kyobutungi C. Predictors of cervical cancer screening among Kenyan women: results of a nested case-control study in a nationally representative survey. BMC Public Health 2018; 18:1221. [PMID: 30400916 PMCID: PMC6219012 DOI: 10.1186/s12889-018-6054-9] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Cervical cancer is a major public health concern in Kenya. It is the leading cause of cancer morbidity and mortality among women. Although screening is an effective prevention method, uptake is low among eligible women. Little is known about predictors of cervical cancer screening uptake. This study explored relationship between uptake of cervical cancer screening, socio-demographic, behavioral and biological risk factors. METHODS Nested case-control study within STEPS survey, a population-based cross-sectional household survey conducted between April and June 2015.Cases were women who had undergone cervical cancer screening and controls were unscreened women. Study participants were women eligible for cervical cancer screening (30-49 years). Variables included socio-demographic; behavioral risk factors such as physical activity, tobacco and alcohol use diet and biological factors like diabetes and hypertension. Outcome of interest was cervical cancer screening. Data analysis was done using STATA version 14. Logistic regression model was used to assess relationship between cervical cancer screening and socio-demographic, behavioral and biological risk factors. RESULTS Of 1180 women interviewed, 16.4% (n = 194) had been screened for cervical cancer. Of unscreened women (n = 986), 67.9% were aware of cervical cancer screening. Higher screening rates were observed in more educated women (25.2%), highest income quintile (29.6%) and living in urban areas (23%) than in women with no formal education (3.2%), poorest (3.6%) and living in rural areas (13.8%). Younger women (35-39) and those with low High-density lipoprotein (HDL) were less likely to be screened [OR = 0.56; 95% CI = (0.34, 0.93); p-value = 0.025] and [OR = 0.51; 95% CI = (0.29, 0.91); p = value 0.023] respectively. Self-employed women, those in the fourth wealth quintile, binge drinkers, high sugar consumption and insufficient physical activity were more likely to be screened [OR 2.55 (1.12, 5.81) p value 0.026], [OR 3.56 (1.37, 9.28) p value 0.009], [OR 5.94 (1.52, 23.15) p value 0.010], [OR 2.99 (1.51, 5.89) p value 0.002] and [OR 2.79 (1.37, 5.68) p value 0.005] respectively. CONCLUSION Uptake of cervical cancer screening is low despite high awareness. Strategies to improve cervical cancer screening in Kenya should be implemented with messages targeting persons with both risky and non-risky lifestyles especially younger women with no formal education living in rural areas.
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Affiliation(s)
- Anne Ng’ang’a
- NCD Division National Cancer Control Program, Ministry of Health, Nairobi, Kenya
| | - Mary Nyangasi
- NCD Division National Cancer Control Program, Ministry of Health, Nairobi, Kenya
| | - Nancy G Nkonge
- Division of Pharmacy, Kenyatta National Hospital, Nairobi, Kenya
| | - Eunice Gathitu
- NCD Division National Cancer Control Program, Ministry of Health, Nairobi, Kenya
| | - Joseph Kibachio
- Division of Non Communicable Diseases, Ministry of Health, Nairobi, Kenya
- The Institute of Global Health, Faculty of Medicine, University of Geneva (UNIGE), Geneva, Switzerland
| | - Peter Gichangi
- Department of Human Anatomy, University of Nairobi, Nairobi, Kenya
| | - Richard G Wamai
- Department of Cultures, Societies and Global Studies, North Eastern University, Massachusetts, USA
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Gebresillassie BM, Gebreyohannes EA, Belachew SA, Emiru YK. Evaluation of Knowledge, Perception, and Risk Awareness About Breast Cancer and Its Treatment Outcome Among University of Gondar Students, Northwest Ethiopia. Front Oncol 2018; 8:501. [PMID: 30456205 PMCID: PMC6230991 DOI: 10.3389/fonc.2018.00501] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 10/15/2018] [Indexed: 11/13/2022] Open
Abstract
Background: Breast cancer is among the most common life-threatening public health problems of global concern including Ethiopia. Knowledge and awareness about the disease will help to reduce the number of cases who present at late stages of the disease. The objective of this survey was to assess the knowledge, perception and risk awareness about breast cancer among female medical and health science students of University of Gondar, Ethiopia. Methods: A cross sectional survey was conducted from May 03 to June 01, 2017 at University of Gondar, Ethiopia. Three hundred students were proportionally selected from nine departments using simple random sampling method. Using a structured questionnaire data on risk factors, symptoms and perception about breast cancer and its management approach was collected. Data were entered to and analyzed using SPSS version 21. Results: A total of 300 students had fully completed the survey making the response rate 95.24. The participants' mean age was 21.4 years with the standard deviation (SD) of 2.13 years. The overall level of knowledge on breast cancer was low. Majority of the participants were unaware for complex risk factors such as first child after the age of 30 years (51%), early onset of menses (55.3%), and menopause after the age of 55 years (47.7%) are liked with breast cancer even though they acknowledged old age, family history, and smoking as possible risk factors for breast cancer. Pain in the breast region, change in the shape of the breast, and nipple discharge were the most frequently correctly identified symptoms of breast cancer. Majority of the study participants had also correct beliefs about breast cancer management and its outcomes. however, they had negative perception of breast cancer treatment by considering it to be a long-term and painful process. In binary logistic regression analysis department (p = 0.000) and year of study (p = 0.008) were found to be an independent predicting factors for knowledge among the study participants. Conclusions: The overall level of knowledge on breast cancer and clinical breast examination guidelines was found to be low even though majority had positive perception toward the treatment and its outcomes. Hence, intensive breast health awareness campaign, which should also stress on the importance of early detection and reporting, is necessary to improve the knowledge about breast cancer.
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Affiliation(s)
| | | | - Sewunet Admasu Belachew
- School of Pharmacy, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Yohannes Kelifa Emiru
- School of Pharmacy, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
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Dusengimana JMV, Hategekimana V, Borg R, Hedt-Gauthier B, Gupta N, Troyan S, Shulman LN, Nzayisenga I, Fadelu T, Mpunga T, Pace LE. Pregnancy-associated breast cancer in rural Rwanda: the experience of the Butaro Cancer Center of Excellence. BMC Cancer 2018; 18:634. [PMID: 29866062 PMCID: PMC5987575 DOI: 10.1186/s12885-018-4535-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Accepted: 05/21/2018] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Breast cancer is the most common malignancy encountered during pregnancy. However, the burden of pregnancy-associated breast cancer (PABC) and subsequent care is understudied in sub-Saharan Africa (SSA). Here, we describe the characteristics, diagnostic delays and treatment of women with PABC seeking care at a rural cancer referral facility in Rwanda. METHODS Data from female patients aged 18-50 years with pathologically confirmed breast cancer who presented for treatment between July 1, 2012 and February 28, 2014 were retrospectively reviewed. PABC was defined as breast cancer diagnosed in a woman who was pregnant or breastfeeding. Numbers and frequencies are reported for demographic and diagnostic delay variables and Wilcoxon rank sum and Fisher's exact tests are used to compare characteristics of women with PABC to women with non-PABC at the alpha = 0.05 significance level. Treatment and outcomes are described for women with PABC only. RESULTS Of the 117 women with breast cancer, 12 (10.3%) had PABC based on medical record review. The only significant demographic differences were that women with PABC were younger (p = 0.006) and more likely to be married (p = 0.035) compared to women with non-PABC. There were no significant differences in diagnostic delays or stage at diagnosis between women with PABC and women with non-PABC women. Eleven of the women with PABC received treatment, three had documented treatment delays or modifications due to their pregnancy or breastfeeding, and four stopped breastfeeding to initiate treatment. At the end of the study period, six patients were alive, three were deceased and three patients were lost to follow-up. CONCLUSIONS PABC was relatively common in our cohort but may have been underreported. Although patients with PABC did not experience greater diagnostic delays, most had treatment modifications, emphasizing the potential value of PABC-specific treatment protocols in SSA. Larger prospective studies of PABC are needed to better understand particular challenges faced by these patients and inform policies and practices to optimize care for women with PABC in Rwanda and similar settings.
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Affiliation(s)
| | | | - Ryan Borg
- Partners In Health/Inshuti Mu Buzima, P.O.Box 3432, Kigali, Rwanda
| | - Bethany Hedt-Gauthier
- Partners In Health/Inshuti Mu Buzima, P.O.Box 3432, Kigali, Rwanda
- Harvard Medical School, Boston, MA USA
| | - Neil Gupta
- Partners In Health/Inshuti Mu Buzima, P.O.Box 3432, Kigali, Rwanda
- Harvard Medical School, Boston, MA USA
- Brigham and Women’s Hospital, Boston, MA USA
| | - Susan Troyan
- Harvard Medical School, Boston, MA USA
- Brigham and Women’s Hospital, Boston, MA USA
| | | | | | | | | | - Lydia E. Pace
- Harvard Medical School, Boston, MA USA
- Brigham and Women’s Hospital, Boston, MA USA
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Adeloye D, Sowunmi OY, Jacobs W, David RA, Adeosun AA, Amuta AO, Misra S, Gadanya M, Auta A, Harhay MO, Chan KY. Estimating the incidence of breast cancer in Africa: a systematic review and meta-analysis. J Glob Health 2018; 8:010419. [PMID: 29740502 PMCID: PMC5903682 DOI: 10.7189/jogh.08.010419] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Background Breast cancer is estimated to be the most common cancer worldwide. We sought to assemble publicly available data from Africa to provide estimates of the incidence of breast cancer on the continent. Methods A systematic search of Medline, EMBASE, Global Health and African Journals Online (AJOL) was conducted. We included population- or hospital-based registry studies on breast cancer conducted in Africa, and providing estimates of the crude incidence of breast cancer among women. A random effects meta-analysis was employed to determine the pooled incidence of breast cancer across studies. Results The literature search returned 4648 records, with 41 studies conducted across 54 study sites in 22 African countries selected. We observed important variations in reported cancer incidence between population- and hospital-based cancer registries. The overall pooled crude incidence of breast cancer from population-based registries was 24.5 per 100 000 person years (95% confidence interval (CI) 20.1-28.9). The incidence in North Africa was higher at 29.3 per 100 000 (95% CI 20.0-38.7) than Sub-Saharan Africa (SSA) at 22.4 per 100 000 (95% CI 17.2-28.0). In hospital-based registries, the overall pooled crude incidence rate was estimated at 23.6 per 100 000 (95% CI 18.5-28.7). SSA and Northern Africa had relatively comparable rates at 24.0 per 100 000 (95% CI 17.5-30.4) and 23.2 per 100 000 (95% CI 6.6-39.7), respectively. Across both registries, incidence rates increased considerably between 2000 and 2015. Conclusions The available evidence suggests a growing incidence of breast cancer in Africa. The representativeness of these estimates is uncertain due to the paucity of data in several countries and calendar years, as well as inconsistency in data collation and quality across existing cancer registries.
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Affiliation(s)
- Davies Adeloye
- Nigerian Urban Reproductive Health Initiative, Abuja, Nigeria.,Johns Hopkins Centre for Communication Programs, Baltimore, Maryland, USA.,Centre for Global Health Research and the World Health Organization Collaborating Centre for Population Health Research and Training, Usher Institute, University of Edinburgh, Scontland, UK
| | - Olaperi Y Sowunmi
- Computer and Information Sciences, Covenant University, Ota, Ogun State, Nigeria
| | - Wura Jacobs
- Department of Health Science, California State University, Fullerton, California, USA
| | - Rotimi A David
- Department of Urology, Morriston Hospital, Abertawe Bro Morgannwg University Health Board, Swansea, UK
| | - Adeyemi A Adeosun
- Health Initiative Department, National Jewish Hospital, Denver, Colorado, USA
| | - Ann O Amuta
- Department of Health Studies, Texas Woman's University, Denton, Texas, USA
| | - Sanjay Misra
- Department of Computer Engineering, Atilim University, Turkey
| | - Muktar Gadanya
- Department of Community Medicine, Aminu Kano Teaching Hospital, Bayero University, Kano, Nigeria
| | - Asa Auta
- School of Pharmacy and Biomedical Sciences, University of Central Lancashire, Fylde Road, Preston, UK
| | - Michael O Harhay
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Palliative and Advanced Illness Research (PAIR) Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Kit Yee Chan
- Centre for Global Health Research and the World Health Organization Collaborating Centre for Population Health Research and Training, Usher Institute, University of Edinburgh, Scontland, UK
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Li XY, Su L, Jiang YM, Gao WB, Xu CW, Zeng CQ, Song J, Xu Y, Weng WC, Liang WB. The Antitumor Effect of Xihuang Pill on Treg Cells Decreased in Tumor Microenvironment of 4T1 Breast Tumor-Bearing Mice by PI3K/AKT~AP-1 Signaling Pathway. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2018; 2018:6714829. [PMID: 29849718 PMCID: PMC5937580 DOI: 10.1155/2018/6714829] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 02/19/2018] [Accepted: 03/07/2018] [Indexed: 12/20/2022]
Abstract
To study the antitumor effect of Xihuang pill (XHP) on the number of Treg cells in the tumor microenvironment of 4T1 breast tumor-bearing mice by PI3K/AKT/AP-1 pathway, a mouse model was established. Flow cytometry (FCM) and immunohistochemistry (IHC) were used to detect the number of Treg cells in the tumor microenvironment; terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) was used to detect the apoptosis of Treg cells in tumor microenvironment. Quantitative real-time PCR (RT-qPCR) was used to detect the mRNA expression of PI3K, AKT, and AP-1 in Treg cells in tumor microenvironment; immunofluorescence (IF) and Western Blot (WB) were used to detect the protein expression of PI3K, AKT, and AP-1 in Treg cells in tumor microenvironment. Compared with the naive control group, the tumor weight in XHP groups decreased significantly (P < 0.05); FCM and IHC results showed that the number of Treg cells in the tumor microenvironment decreased with the dose of XHP groups (P < 0.05); TUNEL staining showed that the number of Treg cells in tumor microenvironment increased with the dose of XHP groups (P < 0.05); RT-qPCR results showed that the mRNA expression of PI3K and AKT in Treg cells decreased with the dose of XHP groups, while RNA expression of AP-1 increased with the dose of XHP groups (P < 0.05); IF and WB results showed that the protein expression of PI3K and AKT in Treg cells decreased with the dose of XHP groups and the protein expression of AP-1 increased with the dose of XHP groups (P < 0.05). The results suggested that XHP decreased the number of Treg cells via inhibiting PI3K and AKT expression and upregulating AP-1 expression in Treg cells and then promoting the apoptosis of Treg cells. Thus, XHP could improve the immunosuppressive state of tumor microenvironment and reverse the immune escape to inhibit tumor growth.
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Affiliation(s)
- Xin-ye Li
- Medical College of Dalian University, Dalian 116622, China
| | - Liang Su
- Xin Hua Affiliated Hospital of Dalian University, Dalian 116000, China
| | - Yi-ming Jiang
- Xin Hua Affiliated Hospital of Dalian University, Dalian 116000, China
| | - Wen-bin Gao
- Department of Medical Oncology, The 3rd Affiliated Hospital of Shenzhen University, Shenzhen 518001, China
| | - Chun-wei Xu
- Department of Pathology, Affiliated Hospital of Academy of Military Medical Sciences, Beijing 100071, China
| | | | - Jie Song
- Medical College of Dalian University, Dalian 116622, China
| | - Yu Xu
- Medical College of Dalian University, Dalian 116622, China
| | - Wen-cai Weng
- Xin Hua Affiliated Hospital of Dalian University, Dalian 116000, China
| | - Wen-bo Liang
- Medical College of Dalian University, Dalian 116622, China
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