Global Trend of Breast Cancer Mortality Rate: A 25-Year Study

First mammogram-detected cancers portend worse survival in young women diagnosed with breast cancer

PURPOSE

Breast cancer (BC) screening guidelines for women ages 40-45 have differed across multiple organizations, resulting in variable ages of screening commencement among women in the US. We previously reported that delay in screening beyond age 40 increases risk for first mammogram cancer diagnoses. We hypothesize that first mammogram cancer detection may also diminish recurrence-free and overall survival (RFS, OS).

STUDY DESIGN

This retrospective cohort study included 738 women diagnosed with BC from ages 40-45 years and treated within a single hospital system from 2010 to 2019. First mammogram cancers were defined as those with tissue diagnoses established within 3 months of baseline mammogram. RFS after surgery and OS after BC diagnosis were analyzed in patients diagnosed on first versus subsequent mammograms via the Kaplan-Meier method, with p-values generated by log rank tests. Cumulative incidences of local and distant recurrence were also assessed.

RESULTS

Of 738 women, 218 had first mammogram cancers while 520 were diagnosed on subsequent mammograms. Median follow-up was 72.2 months (0.5-155.8 months). At 5 and 10 years after diagnosis, OS was significantly worse in patients diagnosed on their first mammogram (0.88 [0.83-0.93] and 0.80 [0.73-0.87]) versus subsequent mammograms (0.95 [0.93-0.97] and 0.90 [0.86-0.93]), p = 0.003. Patients with first mammogram cancers also had inferior 5- and 10-years RFS rates (0.81 [0.71-0.88] and 0.74 [0.65-0.83] vs. 0.88 [0.85-0.92] and 0.77 [0.72-0.83]), p = 0.04.

CONCLUSION

First mammogram cancers were associated with worse survival in our study cohort, reinforcing the importance of consistent guidelines for screening commencement at age 40.

A potential therapeutic molecule target: lncRNA AK023507 inhibits the metastasis of breast cancer by regulating the WNT/DOCK4/β-catenin axis

PURPOSE

Breast cancer (BC) has become the most common malignant tumor in women worldwide. This study was carried out to find and validate a novel molecular therapeutic target for BC.

METHODS

Long non-coding RNA (lncRNA) AK023507 was selected as the study objects through microarray analysis. The function of lncRNA AK023507 was verified by various cell function experiments in vitro, subcutaneous tumorigenesis experiments, and lung metastasis model experiments in vivo. The RNA pull-down experiment and Western blot experiment were used to confirm the mechanism regulation pathway and the recovery experiment was used to verify it. TCGA datasets were used for clinical and immune function prediction analysis.

RESULTS

In vitro cell function tests and in vivo experiments suggested that overexpression of lncRNA AK023507 inhibited the proliferation and metastasis of BC cells. The RNA pull-down experiment and Western blot analysis validated that lncRNA AK023507 interacted with the dedicator of cytokinesis 4 (DOCK4) protein. Analysis of public databases predicted that DOCK4 is a potential prognostic risk factor associated with epithelial-mesenchymal transition (EMT) and central memory T cell (TCM) cellular immune infiltration.

CONCLUSIONS

LncRNA AK023507 inhibits the proliferation and metastasis of BC by regulating the DOCK4/β-catenin axis. This discovery will provide new potential therapeutic targets for BC.

Tumor-infiltrating immune cells state-implications for various breast cancer subtypes

Breast cancer presents a variety of subtypes due to its cellular and molecular heterogeneity. The capacity of cancer cells to proliferate, invade, and metastasize depends not only on their intrinsic characters but also on their dynamic interaction with the host tumor microenvironment (TME), which includes immune cells. Meanwhile, the infiltration of immune cells in the TME severely affects the occurrence, development, treatment, and prognosis of breast cancer. Therefore, this review aims to explore the immune invasive tumor microenvironment in different intrinsic subtypes of breast cancer. Additionally, it highlights the mechanistic influence of the infiltrating immune cells on stage-wise dynamics of breast tumorigenesis. Moreover, the present review also attempts to discern the regulatory relationship between tumor infiltrating immune cells and immune microenvironment in different molecular subtypes of breast cancer, thus, spotlighting its clinical significance.

A Study on Breast Cancer Patient Care Using Chatbot and Video Education for Radiation Therapy: A Randomized Controlled Trial

PURPOSE

This study aimed to evaluate the use of chatbot and video education to reduce anxiety in patients with breast cancer undergoing radiation therapy (RT).

METHODS AND MATERIALS

This randomized controlled trial included patients with breast cancer scheduled for RT after surgery at an outpatient department of radiation oncology in a cancer center, randomly assigned to 4 groups: (1) video + chatbot, (2) video + paper, (3) paper + chatbot, and (4) paper + paper. In each group, patients received information regarding the treatment process and were frequently asked questions using the designated tool. Patient anxiety was evaluated using the Amsterdam preoperative anxiety and information scale (APAIS), state-trait anxiety inventory (STAI), and linear analog scale assessment (LASA) at 3 points: (1) initial outpatient visit (T0), (2) before the RT course (T1), and (3) after the RT course (T2). The primary endpoint was APAIS, and the secondaries were STAI and LASA. A mixed-model repeated-measures ANOVA was conducted with time as a within-group factor and treatment conditions as a between-group factor.

RESULTS

The final analysis included 145 patients. No significant interaction was observed between groups and time for the APAIS, STAI, or LASA. Although unplanned, analyses were conducted using the age of 50 years as the cutoff, based on a previous systematic review of digital literacy in the medical field. A trend toward reduced APAIS was found among patients aged ≤50 years who used the chatbot (per-protocol subgroup). In the video + chatbot group, the APAIS score decreased from 3.06 (T0) to 1.88 (T2); in contrast, in the paper + paper group, it decreased from 2.42 (T0) to 2.06 (T2). In contrast, no significant interaction was observed in the APAIS of per-protocol patients aged ≥50 years.

CONCLUSIONS

Overall, no significant differences were found in the effectiveness of different types of educational media in reducing patients' anxiety. However, for young patients who actively use video or chatbot resources, education through digital media may meaningfully reduce their anxiety during the RT process.

pH-responsive mesoporous silica nanoparticles functionalized with folic acid and chitosan for targeted epirubicin delivery: In vitro and in vivo efficacy in breast cancer

Mesoporous silica nanoparticles (MSNs) are emerging as a promising delivery system for various chemotherapy drugs due to their safety and compatibility with biological systems. In this study, MSNs functionalized with folic acid (FA) and chitosan (CS) loaded with epirubicin (EPI) were characterized to evaluate the efficacy of these nanoparticles in inhibiting MCF-7cell line and in mice bearing 4 T1 tumor. MSN-EPI@CS-FA showed a high drug loading efficiency of 79.49 %, likely due to the large pore volume and surface functional groups on the MSNs. In both in vitro and in vivo studies, the functionalized MSNs exhibited superior efficacy compared to unmodified MSNs. Notablygene expression results revealed enhanced expression levels of proapoptotic markers (Bax, caspase 3, and caspase 9) and down-regulation of the anti-apoptotic genes (Bcl-2, cyclin D, cyclin E, MMP-2, and MMP-9) in cells treated with MSN-EPI@CS-FA, indicating apoptosis through the mitochondrial pathway. In cells treated with MSN-EPI@CS-FA, there were significant changes in reactive oxygen species (ROS) levels, Malondialdehyde (MDA) content, and antioxidant enzyme activity compared to the MSN-EPI and EPI groups. In a murine 4 T1 breast tumor model, MSN-EPI@CS-FA more strongly than MSN-EPI inhibited tumor growth without drug accumulation in the liver or spleen and substantial targeting of the tumor, highlighting the efficacy of folate receptor-mediated active targeting in improving therapeutic outcomes. Therefore MSN-EPI@CS-FA exhibits significant promise as a potent anticancer therapy.

Exploring the revolutionary potential of MXene nanoparticles in breast Cancer therapy: A review of applications and future prospects

Breast cancer is a leading cause of cancer-related deaths in women worldwide. Early detection and accurate diagnosis are crucial for successful treatment and improving patient outcomes. Nanoparticles, such as MXenes, have emerged as a promising tool for various breast cancer applications due to their unique properties. MXenes possess a high surface area and excellent biocompatibility, and can be engineered to enhance targeting ability, as well as mechanical, electrochemical, and optical properties. This review article explores the potential of MXenes in breast cancer detection and treatment, including miRNA detection, MRI-guided photothermal therapy, combined therapy, and immunotherapy. MXenes can be used for miRNA detection, which has shown promise as a biomarker for breast cancer. MXenes can also be used for MRI-guided photothermal therapy, where they can absorb light and convert it into heat to destroy cancer cells. Additionally, MXenes can be used in combination therapy with other drugs to enhance their efficacy. MXenes can also be used for immunotherapy by enhancing the immune response against cancer cells. The article also discusses the future prospects of MXenes in breast cancer research and their cytotoxicity effects. The use of MXenes in breast cancer research is a novel approach with great potential for improving patient outcomes.

Effect of nursing application of emotion freedom technique on perceived stress, resilience and sexual satisfaction among women after mastectomy

BACKGROUND

A breast cancer diagnosis extends beyond physical health concerns, profoundly impacting a woman's psychological well-being, resilience and sexual satisfaction. Mastectomy intensifies these challenges, potentially affecting overall quality of life and long-term well-being. Understanding the interrelationships between perceived stress, resilience and sexual satisfaction is crucial for designing targeted interventions that effectively support mastectomized women. This study evaluates the effectiveness of the Emotional Freedom Technique in mitigating stress, enhancing resilience and improving sexual well-being post-mastectomy.

METHODS

A quasi-experimental pretest-posttest design was employed with a convenient sample of 112 Egyptian women who had undergone mastectomy. Participants were recruited from the Outpatient Oncology Clinic at Beni-Suef University Hospital. Data were collected over six months (January-June 2024) and analyzed using SPSS version 26.0. The intervention consisted of six structured EFT sessions delivered over six weeks. Paired t-tests assessed pre- and post-intervention differences, while Pearson and Spearman correlation analyses examined relationships between variables to accommodate different data distributions.

RESULTS

Post-intervention assessments revealed statistically significant improvements. Perceived stress scores decreased from 32.42 ± 1.70 to 17.27 ± 2.96 (t = 49.130, p < 0.001, Cohen's d = 3.2), resilience scores increased from 11.53 ± 1.67 to 31.46 ± 5.48 (t = 36.454, p < 0.001, Cohen's d = 2.8) and sexual satisfaction scores improved from 17.03 ± 1.55 to 31.00 ± 4.31 (t = 13.245, p < 0.001, Cohen's d = 2.5). Strong negative correlations were found between perceived stress and both resilience (r = -0.692, p < 0.001) and sexual satisfaction (r = -0.835, p < 0.001), while resilience and sexual satisfaction were strongly positively correlated (r = 0.890, p < 0.001).

CONCLUSION

EFT is a cost-effective, non-invasive intervention that significantly reduces stress, enhances resilience and improves sexual satisfaction in women post-mastectomy. To optimize clinical integration, healthcare institutions should develop structured EFT training programs for nurses, incorporating theoretical foundations, hands-on practice and competency assessments. Standardized protocols should be established to guide EFT implementation in post-mastectomy care. Further research should explore long-term effects and broader applicability across diverse healthcare settings.

CLINICAL TRIAL NUMBER

NCT06583629 on 4/9/2024.

Programable Prodrug Nanomodulator Targets Tumor Redox Homeostasis Imbalance to Amplify Disulfidptosis and Immunogenic Pyroptosis for Breast Tumor Immunotherapy

Despite the great potential of photodynamic therapy (PDT), its success remains compromised by the abnormal redox homeostasis of tumor cells, which supports survival, growth, and resistance to oxidative therapeutic interventions by neutralizing reactive oxygen species (ROS). To overcome this barrier, a multifunctional prodrug nanomodulator (Pro@FLNC) is designed to induce disulfidptosis and immunogenic pyroptosis to trigger an antitumor immune response. Pro@FLNC features a prodrug core-shell structure where ursolic acid (UA) and Chlorin e6 (Ce6) are conjugated via a GSH-responsive linker and encapsulated in a DSPE-PEG-FA lipid shell for enhanced stability, biocompatibility, and tumor-specific targeting. Within the tumor microenvironment (TME), Pro@FLNC depletes intracellular GSH, disrupts redox homeostasis, and releases Ce6 and UA, triggering oxidative stress and mitochondrial dysfunction. These mechanisms amplify ROS production, promote lipid peroxidation, and initiate disulfidptosis, evidenced by increased SLC7A11 expression and F-actin collapse. Elevated ROS levels and metabolic imbalance-triggered disulfidptosis further activate immunogenic pyroptosis, releasing damage-associated molecular patterns (DAMPs) that stimulate dendritic cell maturation and cytotoxic T-cell activation. Together, Pro@FLNC reshapes the TME, reduces immunosuppressive cells, and promotes CD8+ T-cell infiltration, effectively suppressing primary tumors and metastases. This programmed prodrug nanomodulator offers a promising strategy to enhance PDT and immunotherapy for advanced breast cancer.

Cancer screening in patients with acromegaly: a plea for a personalized approach and international registries

Acromegaly is a rare condition, and often diagnosis is delayed by several years, for most patients. Acromegaly is characterized by short and long-term respiratory, cardiovascular and metabolic comorbidities, with possible impact on mortality. In the last two decades, life expectancy has progressively increased in part due to a reduction in biochemically active disease, multidisciplinary treatment approaches and a reduction in complications, and the availability of new drugs. Of note, a leading cause of mortality, cardiovascular comorbidity, has been replaced by cancer(s). As such, neoplasms more frequently observed (colon, thyroid, breast, prostate, and stomach) in patients with acromegaly are receiving increased attention. Chronic exposure to increased growth hormone serum levels may contribute to an increase in the occurrence and progression of cancers. Various efforts have been made to determine the pathogenetic mechanisms involved. However, there are no clear medical-related societal agreement(s) in relation to screening methods or timing regarding neoplasm(s) diagnosis in patients with acromegaly. Additionally, independent and dependent risk factor data in patients with acromegaly is lacking. International/national registries could help lay the groundwork to better study the impact of cancer(s) in patients with acromegaly and subsequently lead to and validate the most appropriate diagnostic and therapeutic path forward.

Trends in breast cancer mortality in Peru and its geographical areas from 2013 to 2022 and prediction until 2027

BACKGROUND

In 2022, breast cancer was one of the most commonly diagnosed neoplasms and the leading cause of cancer death among women worldwide. In Peru, reports on mortality due to this neoplasm are scarce, especially after implementing strategies to reduce its impact. This study aimed to estimate mortality rates for breast cancer in Peru and its geographic regions from 2013 to 2022 and to project its evolution to 2027.

METHODS

An observational ecological study of multiple time series was conducted. Data were obtained from the Ministry of Health's death database via SINADEF. Mortality rates per 100,000 women were calculated using the direct method and Segi's world standard population. Mortality trends were analyzed using the Annual Percent Change (APC) calculated with Joinpoint regression software. Predictions for 2027 were also made using the Nordpred package in R Studio.

RESULTS

In 2013, the departments with the highest breast cancer mortality rates in Peru were Ica, Callao, Lambayeque and La Libertad. In 2022, Ancash and Tumbes were added, with Tumbes having the highest rates. For women under 50, Lambayeque and Madre de Dios led in 2013, while for women over 50, Tumbes had the highest mortality rate in 2022. Peru reported a significant increase of 3.97% on an annual basis for the entire period. According to regions, Rainforest region (APC = + 8.37) and the Rainforest region (APC = + 11.55) showed significant increases in mortality rates, while no significant changes were observed in the Coastal region. Moreover, an increase in breast cancer mortality in Peru is projected for the year 2027.

CONCLUSION

Breast cancer mortality in Peru has shown a constant increase, with significant regional disparities. The highest rates were recorded in the coastal region, although the Andean and jungle regions experienced the most pronounced increases. These disparities may be attributed to data underreporting during the COVID-19 pandemic and unequal access to diagnostic and treatment services. The findings highlight the urgent need for focused public health interventions to reduce these regional gaps and improve breast cancer management outcomes.

Understanding diagnostic delays among newly diagnosed breast cancer patients at a tertiary cancer care center in a low-middle-income country like Bangladesh

Breast cancer poses a significant health challenge for women globally, with survival rates varying widely between and within countries. The correlation between delayed diagnosis and lower survival rates is well-established, emphasizing the importance of addressing barriers to early presentation to improve survival rates in low-middle-income countries like Bangladesh. The objective of the study was to assess how often breast cancer patients present late, pinpoint the underlying reasons for the delay, and examine any potential links between delayed presentation and socio-demographic factors in our context. A prospective cross-sectional study was conducted at Ahsania Mission Cancer and General Hospital from July 2023 to December 2023. The study focused on newly diagnosed breast cancer patients attending the outpatient department. Following the provision of consent, the patient's information was obtained through face-to-face interviews and a review of their medical records. Diagnostic delay was defined as 90 days or more from the onset of symptoms to the initiation of medical treatment (by expert physicians). The collected data was stratified based on various socio-demographic variables, including age, marital status, education status, and socio-economic status. Data analysis and visualization were performed using Microsoft Excel and SPSS V 25. The study involved 242 participants; the majority (126, 52.06%) were aged 41 to 60 and came from a low-income, uneducated social background. Stage II breast cancer was the most common presentation (137, 56.6%). The average duration from diagnosis was 5.18 months, and nearly half of the patients (112, 46.28%) experienced more than 3 months of diagnostic delay. The delay in diagnosis was significantly associated with the patient's socio-economic status and the stage of cancer. The primary cause of delayed diagnosis was a lack of awareness about breast cancer symptoms, particularly the painless nature of breast lumps, which patients either did not notice or did not consider serious enough to seek medical attention, followed by the initial pursuit of alternative treatments. To facilitate earlier breast cancer diagnosis, policies should prioritize community-based education programs and adequate screening procedures, as well as expanded healthcare access.

Multilevel analysis of undergoing clinical breast examination and its associated factors among mothers of reproductive age in Kenya: Kenyan Demographic and Health Survey 2022

INTRODUCTION

Breast cancer is one of the most common public health concerns among women around the world. The incidence of breast cancer is increasing in all areas of the world. It is the first cause of death from malignant tumors. Breast cancer in Sub-Saharan African countries is the number one cancer and the leading cause of cancer mortality among women. In low-income countries like Kenya, early screening programs, including clinical breast examination by health professionals, can identify women's health status and risk of breast cancer. Therefore, this study was conducted to assess the uptake of clinical breast examination for cancer and to determine the associated factors among mothers of reproductive age.

METHODS

A total weighted sample of 10,267 mothers of reproductive age was included in this study. The data were taken from the recent Kenyan Demographic and Health Survey 2022. A multilevel multivariable logistic regression model was used to identify the associated factors associated with the uptake of clinical breast examination. In the multivariable multilevel analysis, the adjusted odds ratio (AOR) with a 95% CI was used to declare statistically significant associations with uptake among mothers of reproductive age in Kenya.

RESULTS

In Kenya, the overall prevalence of clinical breast examination uptake among mothers of reproductive age was 11.39%. In multilevel analysis, the significant factors associated with the uptake of clinical breast examination were the age of the mothers; age was significantly associated with the uptake of clinical breast examination; when compared with mothers aged 15-24 years, examination increased in those aged 25-34 years (AOR =  1.45; 95% CI (1.15-1.83)) and 34-49 years (AOR =  2.4; 95% CI (1.88-3.29)), when compared to no education, odds of examination increased in those with primary education (AOR =  2.0; 95% CI (1.19-3.37)) and secondary and higher (AOR =  2.67; 95% CI (1.56-4.57)), when compared to mothers who are unemployed, the odds of examination were higher among those who are employed (AOR =  1.42; 95% CI (1.16-1.74)), place of delivery; when compared to mothers who delivered at home, the odds of examination were higher among those who delivered at a health institution (AOR =  1.5; 95% CI (1.0-2.19)), when compared to those who are not exposed to television, odds of examination increased in those who were exposed to this form of media (AOR =  1.34; 95% CI (1.0-1.72)), when compared to those who travel on foot, odds of examination increased in those who used vehicles for transportation (AOR =  1.34; 95% CI (1.12-1.62)), and when compared to communities with a high level of literacy, the odds of examination increased in communities with a low level of literacy (AOR =  1.7; 95% CI (1.14-2.54)).

CONCLUSION

In Kenya, the uptake of clinical breast examinations among mothers of reproductive age remains low. To address this, policymakers and stakeholders need to prioritize breast cancer screening programs to reduce mortality rates. The factors identified in this study are crucial for developing strategies to enhance clinical breast examination services, facilitating early detection and treatment of breast cancer.

Cross-Attention Adaptive Feature Pyramid Network with Uncertainty Boundary Modeling for Mass Detection in Digital Breast Tomosynthesis

Computer-aided detection (CADe) of masses in digital breast tomosynthesis (DBT) is crucial for early breast cancer diagnosis. However, the variability in the size and morphology of breast masses and their resemblance to surrounding tissues present significant challenges. Current CNN-based CADe methods, particularly those that use Feature Pyramid Networks (FPN), often fail to integrate multi-scale information effectively and struggle to handle dense glandular tissue with high-density or iso-density mass lesions due to the unidirectional integration and progressive attenuation of features, leading to high false positive rates. Additionally, the commonly indistinct boundaries of breast masses introduce uncertainty in boundary localization, which makes traditional Dirac boundary modeling insufficient for precise boundary regression. To address these issues, we propose the CU-Net network, which efficiently fuses multi-scale features and accurately models blurred boundaries. Specifically, the CU-Net introduces the Cross-Attention Adaptive Feature Pyramid Network (CA-FPN), which enhances the effectiveness and accuracy of feature interactions through a cross-attention mechanism to capture global correlations across multi-scale feature maps. Simultaneously, the Breast Density Perceptual Module (BDPM) incorporates breast density information to weight intermediate features, thereby improving the network's focus on dense breast regions susceptible to false positives. For blurred mass boundaries, we introduce Uncertainty Boundary Modeling (UBM) to model the positional distribution function of predicted bounding boxes for masses with uncertain boundaries. In comparative experiments on an in-house clinical DBT dataset and the BCS-DBT dataset, the proposed method achieved sensitivities of 89.68% and 72.73% at 2 false positives per DBT volume (FPs/DBT), respectively, significantly outperforming existing state-of-the-art detection methods. This method offers clinicians rapid, accurate, and objective diagnostic assistance, demonstrating substantial potential for clinical application.

Causal effects of blood cells on breast cancer: Evidence from bidirectional Mendelian randomization combined with meta-analysis

Recent studies suggest blood cells influence breast cancer, but no Mendelian randomization (MR) studies have confirmed a causal relationship between specific blood cell phenotypes and breast cancer. MR analysis of blood cell phenotypes used breast cancer data from Finngen R11, UKB, and open genome-wide association study databases. Meta-analyzed inverse variance weighted results were adjusted for multiple comparisons. The reverse relationship was also explored. MR and meta-analysis identified significant associations between specific blood cell phenotypes and breast cancer: neutrophil perturbation response (side fluorescence standard deviation of neutrophil 4 in response to alhydrogel perturbation): odds ratio (OR) = 0.967, P = .0009; neutrophil perturbation response (forward scatter median of neutrophil 4 in response to Pam3CSK4 perturbation): OR = 0.972, P = .031; white blood cell perturbation response (side scatter coefficient of variation of WBC 2 in response to nigericin perturbation): OR = 0.972, P = .031; white blood cell perturbation response (forward scatter coefficient of variation of WBC in response to Pam3CSK4 perturbation): OR = 1.042, P = 8.15 × 10-5. And there was no reverse result. Neutrophil perturbation response (side fluorescence standard deviation of neutrophil 4 in response to alhydrogel perturbation) and white blood cell perturbation response (side scatter coefficient of variation of WBC 2 in response to nigericin perturbation) are protective factors for breast cancer. Conversely, neutrophil perturbation response (forward scatter median of neutrophil 4 in response to Pam3CSK4 perturbation) and white blood cell perturbation response (forward scatter coefficient of variation of WBC in response to Pam3CSK4 perturbation) are risk factors for breast cancer.

Deep Radiogenomics Sequencing for Breast Tumor Gene-Phenotype Decoding Using Dynamic Contrast Magnetic Resonance Imaging

PURPOSE

We aim to perform radiogenomic profiling of breast cancer tumors using dynamic contrast magnetic resonance imaging (MRI) for the estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) genes.

METHODS

The dataset used in the current study consists of imaging data of 922 biopsy-confirmed invasive breast cancer patients with ER, PR, and HER2 gene mutation status. Breast MR images, including a T1-weighted pre-contrast sequence and three post-contrast sequences, were enrolled for analysis. All images were corrected using N4 bias correction algorithms. Based on all images and tumor masks, a bounding box of 128 × 128 × 68 was chosen to include all tumor regions. All networks were implemented in 3D fashion with input sizes of 128 × 128 × 68, and four images were input to each network for multi-channel analysis. Data were randomly split into train/validation (80%) and test set (20%) with stratification in class (patient-wise), and all metrics were reported in 20% of the untouched test dataset.

RESULTS

For ER prediction, SEResNet50 achieved an AUC mean of 0.695 (CI95%: 0.610-0.775), a sensitivity of 0.564, and a specificity of 0.787. For PR prediction, ResNet34 achieved an AUC mean of 0.658 (95% CI: 0.573-0.741), a sensitivity of 0.593, and a specificity of 0.734. For HER2 prediction, SEResNext101 achieved an AUC mean of 0.698 (95% CI: 0.560-0.822), a sensitivity of 0.750, and a specificity of 0.625.

CONCLUSION

The current study demonstrated the feasibility of imaging gene-phenotype decoding in breast tumors using MR images and deep learning algorithms with moderate performance.

Effectiveness of mHealth-based psychosocial interventions for breast cancer patients and their caregivers: A systematic review and meta-analysis

BACKGROUND

Breast cancer causes significant distress in patient-caregiver dyads. While psychosocial and/or mHealth-based interventions have shown efficacy in improving their psychosocial well-being, no reviews have synthesised the effectiveness of such interventions delivered specifically to the breast cancer patient-caregiver dyad.

OBJECTIVE

To synthesise available evidence examining the effectiveness of mHealth-based psychosocial interventions among breast cancer patient-caregiver dyads in improving their psychosocial well-being (primary outcomes: dyadic adjustment, depression and anxiety; secondary outcomes: stress, symptom distress, social well-being and relationship quality), compared to active or non-active controls.

DESIGN

A systematic review and meta-analysis.

METHODS

Randomised controlled trials and quasi-experimental studies were comprehensively searched from seven electronic databases (PubMed, CENTRAL, CINAHL, Embase, PsycINFO, Scopus, Web of Science), ongoing trial registries (ClinicalTrials.gov, WHO ICTRP) and grey literature (ProQuest Dissertations and Theses Global) from inception of databases till 23 December 2022. Studies involving breast cancer patient-caregiver dyads participating in mHealth-based psychosocial interventions, compared to active or non-active controls, were included. Exclusion criteria were terminally ill patients and/or participants with psychiatric disorders or cognitive impairment and interventions collecting symptomatic data, promoting breast cancer screening or involving only physical activities. Screening, data extraction and quality appraisal of studies were conducted independently by two reviewers. Cochrane Risk of Bias Tool version 1 and JBI Critical Appraisal Checklist were used to appraise the randomised controlled trials and quasi-experimental studies, respectively. Meta-analyses using Review Manager 5.4.1 synthesised the effects of outcomes of interest. Sensitivity and subgroup analyses were conducted. The GRADE approach appraised the overall evidence quality.

RESULTS

Twelve trials involving 1204 breast cancer patient-caregiver dyads were included. Meta-analyses found statistically significant increase in caregiver anxiety (standardised mean difference (SMD) = 0.43, 95% confidence interval (CI) [0.09, 0.77], Z = 2.47, p = 0.01), involving 479 caregivers in 5 studies, and stress (SMD = 0.25, 95% CI [0.05, 0.45], Z = 2.44, p = 0.01), involving 387 caregivers in 4 studies post-intervention, favouring control groups. The intervention effects on the remaining outcomes were statistically insignificant. Beneficial effects of such interventions remain uncertain. The overall quality of evidence was very low for all primary outcomes.

CONCLUSIONS

Results of the effectiveness of mHealth-based psychosocial interventions on the psychosocial well-being of breast cancer patient-caregiver dyads are inconclusive. The high heterogeneity shown in the meta-analyses and very-low overall quality of evidence imply the need for cautious interpretation of findings. Higher-quality studies are needed to assess the effects of psychosocial interventions on dyadic outcomes and determine optimal intervention regimes.

The Five-Year Outcomes of Breast Cancer Surgical Management at the Colentina Surgical Clinic, Bucharest, Romania: A Descriptive Retrospective Analysis Between 2019 and 2023

Background: Breast cancer still represents the most commonly diagnosed cancer among women, accounting for 12.5% of all new annual cancer cases worldwide. In Romania in 2020, breast cancer was the most common, with a share of new cases of 26.9%, far behind the rates of colon cancer (11.8%) and cervix cancer (7.5%). The aim of this study is to reveal five years of experience in treating breast cancer at the Surgical Clinic of the Colentina Hospital in Bucharest, Romania. Methods: Retrospective analysis, including 68 patients admitted to our clinic between January 2019 and December 2023 undergoing modified radical mastectomy, sectorectomy, or subcutaneous mastectomy. Results: Madden-modified radical mastectomy with total excision of the axillary lymph nodes accounted for 77.94% of surgeries, with a complication rate of 13.2%, represented by lymphedema of the ipsilateral arm and prepectoral seroma. Conclusions: Continuous innovation regarding early diagnosis and treatment methods in our surgical clinic will, hopefully, contribute to improving the outcomes of our patients.

Analysis of the incidence and outcomes of breast cancer in women with schizophrenia

OBJECTIVE

Breast cancer (BC) is the leading cause of female cancer death in the world and the second leading cause of female cancer death in the U.S, Mortality from breast cancer is even higher in individuals with schizophrenia. The aim of our project was to evaluate the incidence of breast cancer in women with schizophrenia and to compare outcomes between breast cancer patients who were or were not on antipsychotics prior to diagnosis.

METHODS

This retrospective study used data from the TriNetX database. Women ≥18 years old diagnosed with schizophrenia were identified. The incidence of primary BC diagnosis between January 2011 and December 2023 was evaluated and stratified by ethnicity. We then conducted a retrospective cohort study to compare outcomes of women ≥18 years who did or did not use antipsychotics one year before BC diagnosis. Patients' propensity score was matched based on age, obesity, tobacco use, socioeconomic status, cancer stage, chemoradiation, axillary lymph node dissection (ALND), sentinel lymph node biopsy (SLNB), and hormone therapy use. Outcomes of interest were 5-year overall survival, recurrence, chemotherapy need, and lymphedema.

RESULTS

1,398,475 women ≥18 years old with schizophrenia were identified. Breast cancer incidence in these patients was 0.53 ​% in 2011 and 0.53 ​% in 2022, with a peak in 2017 (1.29 ​%). Non-Hispanic patients were diagnosed with BC approximately 1.3 times more than Hispanic patients. The outcomes study included 183,062 matched patients, with 91,531 per cohort. 5-year survival with the Kaplan-Meier analysis was significantly greater in women not on antipsychotics (72 ​%) compared to those on antipsychotics (60 ​%), log-rank test p-value <0.0001. The risk of local recurrence (13.4 ​% versus 22.6 ​%, p-value <0.0001), chemotherapy need (41.2 ​% versus 48.4 ​%, p-value <0.0001), and lymphedema (7.7 ​% versus 11.5 ​%, p-value <0.0001) were also significantly lower in women who did not take antipsychotics.

CONCLUSION

Breast cancer incidence in patients with schizophrenia identified through TriNetX has not experienced a significant uptrend or downtrend over the past decade. Non-Hispanic patients with schizophrenia have a higher incidence of BC than Hispanic patients. Matched breast cancer patients on antipsychotics at least one year prior to diagnosis had higher mortality, recurrence, chemotherapy need, and risk of lymphedema.

Bioactive Secondary Metabolites from Bauhinia variegata Linn. Roots: Isolation, Characterization, and Cytotoxic Evaluation

INTRODUCTION

This study aims to isolate and characterize potential cytotoxic compounds from the roots of Bauhinia variegata Linn. (Caesalpiniaceae) and evaluate their activity against human cancer cell lines. Five compounds, namely β-sitosterol (1), piperine (2), piperolein B (3), retrofractamide A (4), and dehydropipernonaline (5), were isolated from B. variegata roots using various chromatographic procedures.

METHODS

The root extracts were prepared using aqueous and organic solvents, including n-hexane, ethyl acetate, and methanol. The isolated compounds were subjected to a sulforhodamine B cytotoxicity assay against DU-145 and PC-3 (prostate), HT-29 (colon), and MCF-7 (breast) human cancer cell lines. Among the isolates, compound 5 exhibited significant bioactivity against all tested cell lines. Compound 4 demonstrated in vitro activity, specifically against MCF-7 cancer cell lines.

RESULTS

Importantly, these compounds were identified for the first time from B. variegata roots. In conclusion, this study highlights the enhanced spectrum of cytotoxic activity exhibited by the isolated compounds. These findings encourage further investigation to elucidate the mechanism of action of these compounds against the respective cell lines.

CONCLUSION

The identification and characterization of these bioactive compounds contribute to the understanding of the potential therapeutic applications of B. variegata in cancer treatment.

Development and validation of the surmising model for volumetric breast density using X-ray exposure conditions in digital mammography

The use of breast density as a biomarker for breast cancer treatment has not been well established owing to the difficulty in measuring time-series changes in breast density. In this study, we developed a surmising model for breast density using prior mammograms through a multiple regression analysis, enabling a time series analysis of breast density. We acquired 1320 mediolateral oblique view mammograms to construct the surmising model using multiple regression analysis. The dependent variable was the breast density of the mammary gland region segmented by certified radiological technologists, and independent variables included the compressed breast thickness (CBT), exposure current times exposure second (mAs), tube voltage (kV), and patients' age. The coefficient of determination of the surmising model was 0.868. After applying the model, the correlation coefficients of the three groups based on the CBT (thin group, 18-36 mm; standard group, 38-46 mm; and thick group, 48-78 mm) were 0.913, 0.945, and 0.867, respectively, suggesting that the thick breast group had a significantly low correlation coefficient (p = 0.00231). In conclusion, breast density can be accurately surmised using the CBT, mAs, tube voltage, and patients' age, even in the absence of a mammogram image.

Chitosan nanoparticles loaded with metformin and digoxin synergistically inhibit MCF-7 breast cancer cells through suppression of NOTCH-1 and HIF-1α gene expression

This study investigated the potential anticancer efficacy of co-treating the MCF-7 breast cancer cell line with chitosan nanoparticles (Cs NPs) loaded with metformin (Met) and digoxin (Dig). The Cs NPs had a size range of 90.6-148.7 nm and a zeta potential of +11.7 to +11.9 mV, indicating a positive surface charge. Notably, the Cs NPs demonstrated high encapsulation efficiencies, with values of 90.97 ± 5.14 % for Met and 92.12 ± 3.81 % for Dig, indicating effective loading of both drugs. The results revealed that the co-delivery of Met and Dig via Cs NPs significantly enhanced the anticancer efficacy, outperforming the treatment with individual free drugs or their combination, thereby demonstrating the potential benefits of nanoparticle-mediated co-administration. The drugs-loaded Cs NPs induced a marked increase in apoptosis in MCF-7 cells, with a cell death rate of 67.56 %, and significantly reduced mammosphere size by 48.08 %, thereby demonstrating a superior therapeutic efficacy compared to treatment with individual free drugs or their combination. Notably, the drug-loaded Cs NPs exhibited potent anti-migratory and anti-angiogenic effects, significantly inhibiting cell migration and new blood vessel formation, which may contribute to overcoming the inherent resistance of tumors to conventional therapies. Mechanistically, the co-treatment with drugs-loaded Cs NPs was found to downregulate the expression of NOTCH-1 and HIF-1α, two key transcription factors involved in tumor cell survival and adaptation, suggesting that their inhibition is a crucial component of the therapeutic efficacy of this treatment strategy. Collectively, the findings of this study suggest that the co-delivery of Met and Dig via chitosan Cs NPs represents a promising therapeutic strategy for breast cancer, as it effectively targets key pathways involved in tumor growth and progression, and underscores the potential of Cs NPs as a versatile platform for cancer therapy.

Experimental Induction of Mammary Carcinogenesis Using 7,12-Dimethylbenz(a)anthracene and Xenograft in Rats

BACKGROUND

Basic research using animal models is essential for investigating pathogenic molecular mechanisms and exploring new pharmaceutical treatments for tumors, including breast tumors.

METHODS AND RESULTS

Thirty-six female Wistar rats, four weeks old, were included in the study, but six were excluded early due to health complications, leaving 30 rats in the final cohort. Mammary gland tumors were induced using a single subcutaneous dose of 20 mg 7,12-dimethylbenz(a)anthracene (DMBA) on the right side and MCF7 cells (xenograft) on the left thoracic gland. The experiment spanned 28 weeks. Blood and white cell counts were monitored at the start, mid-point, and end of the study. Tumorigenesis was achieved via both DMBA and MCF7 xenograft. Ovariectomy was performed on all rats, and tumors became palpable after the fifth week following DMBA and MCF7 administration.

CONCLUSIONS

Oncogenesis using DMBA and MCF7 xenograft simultaneously had not been previously attempted. The results showed a 16.7% (6/36) animal mortality rate in the early stages of experimentation and a 100% induction of palpable tumors in the surviving animals.

Investigation of the causal relationship between breast cancer and thyroid cancer: a set of two-sample bidirectional Mendelian randomization study

PURPOSE

A potential association between breast (BC) and thyroid cancer (TC) has been observed. We investigated if the relationship between BC and TC is causal using bidirectional Mendelian randomization (MR) in Asian and European populations.

METHODS

BC-linked single nucleotide polymorphisms (SNPs) were acquired from a genome-wide association study (GWAS) conducted by the Breast Cancer Association Consortium and Biobank Japan. The most recent TC GWAS data were obtained from the FinnGen Project and National Biobank of Korea. We assessed the potential causal relationship between BC and TC using various MR methods, including inverse-variance-weighting (IVW). Sensitivity, heterogeneity, and pleiotropic tests were performed to assess reliability.

RESULTS

We found a bidirectional causal association between BC and TC within Europeans (IVW, TC on BC: odds ratio [OR] 1.090, 95% confidence interval [CI]: 1.012-1.173, P = 0.023; BC on TC: OR 1.265, 95% CI: 1.158-1.381, P < 0.001). A one-way causal relationship between BC susceptibility and TC risk was found in Asians (IVW BC on TC: OR 2.274, 95% CI: 2.089-2.475, P < 0.001). Subsequently, we identified a noteworthy bidirectional causal relationship between estrogen receptor (ER)-positive BC and TC (IVW, TC on ER-positive BC: OR 1.104, 95% CI: 1.001-1.212, P = 0.038; ER-positive BC on TC: OR 1.223, 95%CI: 1.072-1.395, P = 0.003), but not ER-negative BC and TC in Europeans.

CONCLUSION

We revealed a reciprocal causal association between ER-positive BC and TC. These findings establish a theoretical framework for the simultaneous surveillance and treatment of BC and TC.

A multi-phase structured cascade model for mass training of community healthcare workers in performing clinical breast exams in remote regions

Background

Clinical breast exam (CBE) by outreach healthcare workers (HCW) may help downstage breast cancer in resource-limited areas where mammography may not be feasible. We evaluated the effectiveness of a pilot cascade-model training programme for HCWs in remote areas of Pakistan.

Methods

The training programme comprised three phases. In phase one, fellowship-trained breast surgeons at a metropolitan academic centre trained six HCWs to perform CBEs. In phase two, these six HCWs (master trainers) trained 15 additional HCWs, implementing cascade training. In phase three, the consultant breast surgeon conducted a re-evaluation and refresher course for all 21 HCWs at least one year after the original training session. We assessed CBE ability and skills through pre- and post-changes through self-reported confidence and direct observation of procedural skills.

Results

Significant improvements in learners' self-reported confidence and CBE skills were observed in both phases one and two. The median scores in the learners' post-training self-reported confidence and CBE skills (inspection, palpation, and lymph node examination) improved by 20% and 46.2%, respectively, indicating excellent learning outcomes of the cascade training sessions. Phase three showed sustained high scores in self-reported confidence and CBE skills more than one year later.

Conclusions

Mass training of outreach HCWs in remote regions in performing CBE may be possible with a structured multiphase cascade-training model and may be an important step in downstaging symptomatic breast cancer in low-resource settings.

Mining and analysis of adverse event signals of trastuzumab deruxtecan via real-world data of FDA adverse event reporting system database from 2019 to 2023

BACKGROUND

Trastuzumab deruxtecan (T-DXd) is a novel generation antibody-drug conjugate. However, current evidence for the safety of T-DXd is mostly limited to clinical trials. Therefore, we mine and analyze adverse events (AEs) caused by T-DXd based on the FAERS database and to provide reference for the safe use of drug in clinical practice.

RESEARCH DESIGN AND METHODS

AEs associated with T-DXd were analyzed in the FAERS database from December 2019 to December 2023, and four disproportionality methods were combined to identify and evaluate reports.

RESULTS

A total of 4651 AE reports of T-DXd as the 'primary suspect' were collected. The median time to onset of T-DXd-related AEs was 25 days. The proportion of serious AEs was 69.40%. Death (24.19%) accounted for the highest occurrence frequency of clinical serious outcomes. The top three AEs in both frequency and signal intensity were interstitial lung disease. We also found 12 novel AEs not recorded in the drug label.

CONCLUSION

This study indicate the importance of timely mining and updating information of adverse drug reactions. Drug evaluation should be performed well before using T-DXd, and timely intervention measures should be taken to avoid related injury caused by AEs.

Antitumor activity of bimetallic silver/gold nanoparticles against MCF-7 breast cancer cells

Breast cancer poses a global threat with rising incidence and high mortality. Conventional treatments, including chemotherapy, radiation, surgery, and immunotherapy, have side effects, such as resistance issues and adverse effects due to genetic mutations. Meanwhile, noble metal nanoparticles (NPs) synthesized using environmentally friendly methods offer alternative treatments. Bimetallic gold (Au) and silver (Ag) NPs, using natural compounds like starch as stabilizers, enhance biomedical applications, including breast cancer therapies. In this work, the optical properties, stability, and particle size of colloidal bimetallic Ag/Au NPs were analyzed using UV-visible spectroscopy and ζ-potential measurements. The structural properties of the NPs were studied by powder X-ray diffraction (PXRD), while the morphology, chemical composition and particle size were determined using scanning transmission electron microscopy (STEM). The antitumor properties of the Ag/Au NPs were analyzed on human breast cancer cells (MCF-7) using the MTT viability method, reactive oxygen species (ROS) production, and genotoxicity assays. Peripheral blood mononuclear cells (PBMCs) were used as a reference of healthy cells. UV-vis spectroscopy and EDX mapping analysis confirmed the synthesis of bimetallic Ag/Au NPs. Localized surface plasmon resonance (LSPR) absorption bands shifted from 407 nm (Ag) to 524 nm (Au) based on the chemical composition of the NPs. The Ag/Au NPs showed cytocompatibility in PBMCs and a dose-dependent anticancer effect against MCF-7 cancer cells, as well as cell death dependent on ROS production was observed, particularly in NPs with atomic compositions of 50 and 75 at% Ag. This biological activity of the bimetallic NPs was associated with genotoxic damage of 20-24% greater than that observed in the monometallic counterparts. This study demonstrated the synthesis of mono- and bimetallic Ag/Au NPs using a rapid, reproducible and environmentally friendly method, with successful biomedical application against human breast cancer MCF-7 cells.

Correlation of CD44 Protein Expression with Larger Tumor Size and Advanced Stage of Breast Cancer Patients

OBJECTIVES

This study aimed to determine the expression of CD44 in breast cancer and its association with patients' clinicopathological data, particularly in Bali.

MATERIAL AND METHODS

This was a cross-sectional study in the Integrated Biomedical Laboratory and Biochemistry Laboratory of the Faculty of Medicine Udayana University, during January-December 2022, which lasted 12 months with 46 samples.

RESULTS

The study showed that the age range of our subjects was 38-86 years old, with the majority of the parity being less than three. The mean CD44 expression in all samples was 1177.83 ± 268.47 ng/mL. Based on the clinicopathological data, there was a significant difference in CD44 expression based on the patient's menstrual status (p=0.016), tumor size (p=0.003), and stage (p=0.002). Based on the analysis using the chi-square test with a cut-off CD44 expression of 85.81, significant results (p=0.001) were obtained on the association of CD44 expression with tumor size. The cut-off value with the stage of breast cancer was 99.66 and showed a significant association between CD44 expression advanced stage (p = 0.001) in breast cancer patients. Other variables showed insignificant results.

CONCLUSION

CD44 protein expression in breast cancer patients is between 35.47-1407.83 ng/mL. This study showed a significant association between CD44 expression with tumor size and the advanced stage of breast cancer patients.

Falls prevention in people with breast cancer: a survey of current physiotherapist practices

PURPOSE

To examine the current falls prevention knowledge, beliefs and practices of physiotherapists providing clinical care to people with breast cancer.

METHODS

A cross-sectional online survey of currently registered, practising Australian physiotherapists was conducted. The survey was developed and reported using the Checklist for Reporting Results of Internet E-Surveys (CHERRIES) checklist, with data analysed descriptively or using bivariate tests. Free-text responses to open-ended questions were classified into key themes for analysis.

RESULTS

Forty-two physiotherapists completed the survey, of which 55% (23/42) believed that people with breast cancer had a higher risk of falls compared to the general population. Whilst most respondents received prior training in assessing and managing falls risk factors (30/42; 71%), they reported only moderate confidence in assessing and delivering falls prevention care to people with breast cancer (median 6; IQR 4). Only half of respondents (20/38; 53%) routinely asked about falls history although 61% assessed standing balance (23/38) either through an overall functional assessment (16/38; 42%) or using specific balance measures (7/38; 18%).

CONCLUSIONS

Further resources and training for physiotherapists may be required to optimise their skills and confidence, and to embed best-practice falls prevention strategies into the physiotherapy care of people with breast cancer.

Label-Free Exosome Analysis by Surface-Enhanced Raman Scattering Spectroscopy with Laser-Ablated Silver Nanoparticle Substrate

Early diagnostics of breast cancer is crucial to reduce the risk of cancer metastasis and late relapse. Exosome, which contains distinct information of its origin, can be the target object as a liquid biopsy. However, its low sensitivity and inadequate diagnostic tools interfere with the point-of-care testing (POCT) of the exosome. Recently, Surface-enhanced Raman Scattering (SERS) spectroscopy, which amplifies the Raman scattering, has been proved as a promising tool for exosome detection. However, the fabrication process of SERS probe or substrate is still inefficient and far from large-scale production. This study proposes rapid and label-free detection of breast cancer-derived exosomes by statistical analysis of SERS spectra using silver-nanoparticle-based SERS substrate fabricated by selective laser ablation and melting (SLAM). Employing silver nanowires and optimizing laser process parameters enable rapid and low-energy fabrication of SERS substrate. The functionalities including sensitivity, reproducibility, stability, and renewability are evaluated using rhodamine 6G as a probe molecule. Then, the feasibility of POCT is examined by the statistical analysis of SERS spectra of exosomes from malignant breast cancer cells and non-tumorigenic breast epithelial cells. The presented framework is anticipated to be utilized in other biomedical applications, facilitating cost-effective and large-scale production performance.

Identification of molecular targets of Trigonelline for treating breast cancer through network pharmacology and bioinformatics-based prediction

Breast cancer, a highly prevalent and fatal cancer that affects the female population worldwide, stands as a significant health challenge. Despite the abundance of chemotherapy drugs, the adverse side effects associated with them have initiated an investigation into natural plant-based compounds. Trigonelline, an alkaloid found in Trigonella foenum-graecum, was previously reported for its anticancer properties by the researchers. In this present study, we have identified the molecular targets of Trigonelline in breast cancer and predicted its drug-like properties and toxicity. By analyzing breast cancer targets from databases including TTD, TCGA, Gene cards, and Trigonelline targets obtained from CTD, we identified 14 specific targets of Trigonelline in the context of breast cancer. The protein-protein interaction (PPI) network of the 14 Trigonelline targets provided insights into the complex relationships between different genes and targets. Heatmap analysis demonstrated the expression patterns of these 14 genes at the protein and RNA levels in breast cancer cells and breast tissues. Notably, four genes, namely EGF, BAX, EGFR, and MTOR, were enriched in the breast cancer pathway. At the same time, PARP1, DDIT3, BAX, and TNF were associated with the apoptosis pathway according to KEGG pathway enrichment analyses. Molecular docking studies between Trigonelline and target proteins from the Protein Data Bank (PDB) revealed favorable binding affinity. Furthermore, mutation analysis of target genes within a dataset of 1918 samples from cBioPortal revealed the absence of mutations. Remarkably, Trigonelline also exhibited binding affinity towards two mutant proteins, and based on these findings, we predicted that Trigonelline could be utilized to target breast cancer genes and their mutants through network pharmacology. Additionally, this was supported by molecular dynamic simulation studies. As our study is preliminary, further validation through in vitro and in vivo studies is essential to confirm the efficacy of Trigonelline in breast cancer treatment.

Access to prior screening mammograms affects the specificity but not sensitivity of radiologists' performance

AIMS

To establish the impact that access to prior mammograms has on radiologists' performance and the influence of radiologists' characteristics and breast density on their subsequent performance.

METHODS

Eight participants independently interpreted 72 digital screening mammograms in two reading sessions using the Royal Australian and New Zealand College of Radiologist's classification. In the first reading session, participants were given access to current and prior mammograms. In the second reading session six months later, participants only had access to the current mammograms. Radiologists' specificity, sensitivity, lesion sensitivity, Receiver Operating Characteristic (ROC) curve, and Jacknife Alternative Free-response ROC (JAFROC) were calculated. A Paired T-test was used to compare readings with and without prior mammograms, and to assess if breast density influenced participants performance. Independent Sample T-test was used to compare performance across radiologists' characteristics. A relative risk analysis was conducted to assess the probability of false positives and false negatives when prior mammograms were available.

RESULTS

Access to prior mammograms improved specificity in dense and non-dense breasts (p≤0.01) and reduced false positives (p = 0.01) but had no effect on sensitivity (p = 0.37), lesion sensitivity (p = 0.67), ROC (p = 0.16), and JAFROC (p = 0.24). Prior mammogram also reduced the probability of false positives (RR = 0.38; 95%CI:0.26-0.57, p<0.0001) without affecting the false negative rate (RR = 1.14; 95%CI:0.88-1.49, p = 0.30). The impact of prior mammograms on performance was not influenced by breast density or radiologists' characteristics.

CONCLUSIONS

Access to prior mammograms improves radiologists' specificity and reduces false positives without affecting sensitivity and the false negative rate regardless of radiologists' characteristics and breast density.

The Potential of Plant Polysaccharides and Chemotherapeutic Drug Combinations in the Suppression of Breast Cancer

Breast cancer is the most common cancer affecting women worldwide. The associated morbidity and mortality have been on the increase while available therapies for its treatment have not been totally effective. The most common treatment, chemotherapy, sometimes has dangerous side effects because of non-specific targeting, in addition to poor therapeutic indices, and high dose requirements. Consequently, agents with anticancer effects are being sought that can reduce the side effects induced by chemotherapy while increasing its cytotoxicity to cancer cells. This is possible using natural compounds that are safe and biologically active. There are many reports on plant polysaccharides due to their bioactive and anticancer properties. The use of plant polysaccharide together with a conventional cytotoxic drug may offer wide benefits in cancer therapy, producing synergistic effects, thereby reducing drug dose and, so, its associated side effects. In this review, we highlight an overview of the use of plant polysaccharides and chemotherapeutic drugs in breast cancer preclinical studies, including their mechanisms of anticancer activities. The findings emphasize the potential of plant polysaccharides to improve chemotherapeutic outcomes in breast cancer, paving the way for more effective and safer treatment strategies.

Transcriptomic era of cancers in females: new epigenetic perspectives and therapeutic prospects

In the era of transcriptomics, the role of epigenetics in the study of cancers in females has gained increasing recognition. This article explores the impact of epigenetic modifications, such as DNA methylation, histone modification, and non-coding RNA, on cancers in females, including breast, cervical, and ovarian cancers (1). Our findings suggest that these epigenetic markers not only influence tumor onset, progression, and metastasis but also present novel targets for therapeutic intervention. Detailed analyses of DNA methylation patterns have revealed aberrant events in cancer cells, particularly promoter region hypermethylation, which may lead to silencing of tumor suppressor genes. Furthermore, we examined the complex roles of histone modifications and long non-coding RNAs in regulating the expression of cancer-related genes, thereby providing a scientific basis for developing targeted epigenetic therapies. Our research emphasizes the importance of understanding the functions and mechanisms of epigenetics in cancers in females to develop effective treatment strategies. Future therapeutic approaches may include drugs targeting specific epigenetic markers, which could not only improve therapeutic outcomes but also enhance patient survival and quality of life. Through these efforts, we aim to offer new perspectives and hope for the prevention, diagnosis, and treatment of cancers in females.

Global, Regional, and National Burden of Brain and Central Nervous System Cancers for Males from 1990 to 2021 and Its Predicted Level in the Next 25 Years

BACKGROUND

A study of the global burden of cerebral and central nervous system (CNS) cancers from the Global Burden of Diseases (GBD) indicates that these cancers significantly contribute to morbidity and mortality internationally. To fully understand the global impact of CNS cancer, expanded research efforts are essential. We analyzed the temporal trend of the disease burden from 1990 to 2021 and made projections for the expected burden from 2020 through 2044.

METHODS

We tapped into GBD 2021 Study data to evaluate CNS cancer incidence and trends among males. Prevalence was assessed with DisMod-MR, trends via cluster analysis, and estimated annual percentage change (EAPC) calculated via linear regression. Forecasts for 2022-2044 used APC and BAPC models, with a p value <0.05 considered significant. Analyses relied on R software 4.0.2.

RESULTS

In 2021, males experienced between 148,118 and 232,469 new brain and CNS cancer cases, indicating increased global burden from 1990 to 2021. An observed link between the prevalence's EAPCs and Human Development Indices (HDIs) suggests higher incidence in more developed regions. Projections using the APC model suggest rising numbers of cases and losses in disability-adjusted life years (DALYs) from 2020 to 2044, while age-standardized rates are expected to decrease overall.

CONCLUSIONS

In summary, a higher Socio-Demographic Index (SDI) correlates with better outcomes for CNS cancer due to early medical interventions in regions with strong healthcare systems. This demonstrates the need for equitable healthcare policies that focus on improving diagnostic capabilities and professional training to enhance survival rates universally.

The relationship between tumor budding and survival of patients with breast cancer: A meta-analysis

Tumor budding has been proposed as a potential prognostic marker in various cancers, but its association with survival outcomes in breast cancer (BC) remains unclear. This meta-analysis aimed to clarify the relationship between tumor budding and survival outcomes in patients with BC. A comprehensive literature search was conducted in PubMed, EMBASE, and Web of Science. Cohort studies examining the association between tumor budding and overall survival (OS) and progression-free survival (PFS) in BC patients were included. Hazard ratios (HRs) and 95% confidence intervals (CIs) were pooled using a random-effects model to account for potential heterogeneity. Eleven cohort studies, including 2,828 patients, met the inclusion criteria. High tumor budding was significantly associated with poorer OS (HR = 1.89, 95% CI = 1.37-2.60, P < 0.001) and PFS (HR = 1.89, 95% CI = 1.32-2.71, P < 0.001). Subgroup analyses revealed a stronger association in studies where high tumor budding was defined as ≥ 10 buds / high-power field (HPF) compared to those with lower cutoffs. Sensitivity analyses confirmed the robustness of the findings. This meta-analysis demonstrates that high tumor budding is associated with significantly worse OS and PFS in BC patients, underscoring its prognostic significance. These findings suggest tumor budding could be a valuable marker in clinical assessments, and further research is needed to standardize its evaluation criteria in BC.

The role of helminths and their antigens in cancer therapy: insights from cell line models

BACKGROUND

Recent articles have explored the effect of worms on cancer cells. This review focused on various cell cultures employed to understand which cells are more commonly and less utilized.

METHODS

The present review analyzed studies published between 2013 and 2023 to obtain information about different cell cultures used in cancer studies involving helminths. Databases such as PubMed, Google Scholar, HINARI, and the Cochrane Library were searched.

RESULTS

This search yielded 130 records, but 97 papers were excluded because they were either irrelevant to the research topic (n = 72) or contradicted the research idea (n = 25).The remaining twenty-one articles focused on different types of worms, such as Echinococcus granulosus, Clonorchis sinensis, Opisthorchis felineus, Opisthorchis viverrini, Trichinella spiralis, Toxocara canis, and Heligmosomoides polygyrus.

CONCLUSION

Due to the presence of numerous antigens, parasites at different growth stages can impact various cells through unknown mechanisms. Given the high diversity of antigens and their effects, artificial intelligence can assist in predicting initial outcomes for future studies.

Cystathionine-γ-lyase contributes to tamoxifen resistance, and the compound I194496 alleviates this effect by inhibiting the PPARγ/ACSL1/STAT3 signalling pathway in oestrogen receptor-positive breast cancer

Tamoxifen (TAM) resistance is a major challenge in treating oestrogen receptor-positive (ER+) breast cancers. It is possible that the H2S synthase cystathionine-γ-lyase (CSE), which has been previously shown to promote tumour growth and metastasis in other cancer cells, is involved in this resistance. Therefore, we investigated CSE's role and potential mechanisms in TAM-resistant breast cancer cells. First, we examined the effect of CSE expression on TAM sensitivity and resistance in MCF7 (breast cancer) cells. The findings revealed that CSE was directly associated with TAM sensitivity and involved in TAM resistance in ER+ breast cancer cells, indicating that it may be useful as a biomarker. Next, we wanted to determine the molecular mechanism of CSE's role in TAM resistance. Using cell migration, co-immunoprecipitation, western blotting, and cell viability assays, we determined that the CSE/H2S system can affect the expression of PPARγ by promoting the sulfhydrylation of PPARγ, which regulates the transcriptional activity of ACSL1. ACSL1, in turn, influences STAT3 activation by affecting the phosphorylation, palmitoylation and dimerization of STAT3, ultimately leading to the development of TAM resistance in breast cancer. Finally, we examined the effect of CSE inhibitors on reducing drug resistance to determine whether CSE may be used as a biomarker of TAM resistance. We observed that the novel CSE inhibitor I194496 can reverse TAM resistance in TAM-resistant breast cancer via targeting the PPARγ/ACSL1/STAT3 signalling pathway. Overall, our data indicate that CSE may serve as a biomarker of TAM resistance and that the CSE inhibitor I194496 is a promising candidate for combating TAM resistance.

Chrysin Enhances Anti-Cancer Activity of Jurkat T Cell and NK-92 Cells Against Human Breast Cancer Cell Lines

Chrysin, a naturally occurring flavonoid in plant and bee products, demonstrates notable biological activities, including anti-cancer effects. These properties are partially attributed to its capability to activate immune cells. This study focused on exploring the immunomodulatory potential of chrysin on NK-92 and Jurkat-T cells targeting breast cancer cells (BCC). Chrysin leads to activation of NK-92 and T cells facilitated by the addition of human recombinant IL-2 and PHA-M. The anti-cancer efficacy of chrysin on these immune cells was evaluated in a co-culture setup with EGF-stimulated MCF-7 and MDA-MB-231 cells. Findings revealed that chrysin notably increased the cytotoxicity of NK-92 and T cells towards MCF-7 and MDA-MB-231 cells, with the most significant impact observed on MCF-7 cells (20 %). The activation of NK-92 cells, marked by increased IFN-γ production and CD56 expression, correlated with enhanced secretion of cytokines. Additionally, the activation of these cells against BCC was linked with elevated levels of granzyme-B, TNF-α, and nitric oxide (NO). Similarly, the cytotoxic activation of Jurkat-T cells against BCC was characterized by increased production of granzyme-B, IL-2, and IFN-γ. Consequently, these results support the hypothesis that chrysin significantly contributes to the activation and functional enhancement of NK-92 and T-cells against two distinct BCC lines.

Baseline [18F]FDG PET/CT and MRI first-order breast tumor features do not improve pathological complete response prediction to neoadjuvant chemotherapy

PURPOSE

To verify the ability of pretreatment [18F]FDG PET/CT and T1-weighed dynamic contrast-enhanced MRI to predict pathological complete response (pCR) after neoadjuvant chemotherapy (NAC) in breast cancer (BC) patients.

METHODS

This retrospective study includes patients with BC of no special type submitted to baseline [18F]FDG PET/CT, NAC and surgery. [18F]FDG PET-based features reflecting intensity and heterogeneity of tracer uptake were extracted from the primary BC and suspicious axillary lymph nodes (ALN), for comparative analysis related to NAC response (pCR vs. non-pCR). Multivariate logistic regression was performed for response prediction combining the breast tumor-extracted PET-based features and clinicopathological features. A subanalysis was performed in a patients' subsample by adding breast tumor-extracted first-order MRI-based features to the multivariate logistic regression.

RESULTS

A total of 170 tumors from 168 patients were included. pCR was observed in 60/170 tumors (20/107 luminal B-like, 25/45 triple-negative and 15/18 HER2-enriched surrogate molecular subtypes). Higher intensity and higher heterogeneity of [18F]FDG uptake in the primary BC were associated with NAC response in HER2-negative tumors (immunohistochemistry score 0, 1 + or 2 + non-amplified by in situ hybridization). Also, higher intensity of tracer uptake was observed in ALN in the pCR group among HER2-negative tumors. No [18F]FDG PET-based features were associated with pCR in the other subgroup analyses. A subsample of 103 tumors was also submitted to extraction of MRI-based features. When combined with clinicopathological features, neither [18F]FDG PET nor MRI-based features had additional value for pCR prediction. The only significant predictors were estrogen receptor status, HER2 expression and grade.

CONCLUSION

Pretreatment [18F]FDG PET-based features from primary BC and ALN are not associated with response to NAC, except in HER2-negative tumors. As compared with pathological features, no breast tumor-extracted PET or MRI-based feature improved response prediction.

Exploring SALL4 as a significant prognostic marker in breast cancer and its association with progression pathways involved in cancer genesis

Breast carcinoma is the leading factor in women's cancer-related fatalities. Due to its numerous inherent molecular subtypes, breast cancer is an extremely diverse illness. The human epidermal growth factor receptor 2 (HER2) positive subtypes stands out among these subtypes as being especially prone to cancer development and illness recurrence. The regulation of embryonic stem cells' pluripotency and self-renewal is carried out by the SALL4 (Spalt-like transcription factor 4) family member. Numerous molecular pathways operating at the transcriptional, post-transcriptional, and epigenomic levels regulate the expression of SALL4. Many transcription factors control the expression of SALL4, with STAT3 being the primary regulator in hepatocellular carcinoma (HCC) and breast carcinoma. Moreover, this oncogene has been connected to a number of cellular functions, including invasion, apoptosis, proliferation, and resistance to therapy. Reduced patient survival rates and a worse prognosis have been linked to higher levels of SALL4. In order to target the undruggable SALL4 that is overexpressed in breast carcinoma, we investigated the prognostic levels of SALL4 in breast carcinoma and its interaction with various related proteins. Using TIMER 2.0 analysis, the expression pattern of SALL4 was investigated across all TCGA datasets. The research revealed that SALL4 expression was elevated in various cancers. The UALCAN findings demonstrated that SALL4 was overexpressed in all tumor samples including breast cancer especially TNBC (Triple negative breast cancer). The web-based ENRICHR program was used for gene ontology analysis that revealed SALL4 was actively involved in the development of the nervous system, positive regulation of stem cell proliferation, regulation of stem cell proliferation, regulation of the activin receptor signaling pathway, regulation of transcription using DNA templates, miRNA metabolic processes, and regulation of transcription by RNA Polymerase I. Using the STRING database, we analyzed the interaction and involvement of SALL4 with other abruptly activated proteins and used Cytoscape 3.8.0 for visualization. Additionally, using bc-GenExMiner, we studied the impact of SALL4 on pathways abruptly activated in different breast cancer subtypes that revealed SALL4 was highly correlated with WNT2B, NOTCH4, AKT3, and PIK3CA. Furthermore, to target SALL4, we evaluated and analyzed the impact of CLP and its analogues, revealing promising outcomes.

A Novel Structure Fusion Attention Model to Detect Architectural Distortion on Mammography

Architectural distortion (AD) is one of the most common findings on mammograms, and it may represent not only cancer but also a lesion such as a radial scar that may have an associated cancer. AD accounts for 18-45% missed cancer, and the positive predictive value of AD is approximately 74.5%. Early detection of AD leads to early diagnosis and treatment of the cancer and improves the overall prognosis. However, detection of AD is a challenging task. In this work, we propose a new approach for detecting architectural distortion in mammography images by combining preprocessing methods and a novel structure fusion attention model. The proposed structure-focused weighted orientation preprocessing method is composed of the original image, the architecture enhancement map, and the weighted orientation map, highlighting suspicious AD locations. The proposed structure fusion attention model captures the information from different channels and outperforms other models in terms of false positives and top sensitivity, which refers to the maximum sensitivity that a model can achieve under the acceptance of the highest number of false positives, reaching 0.92 top sensitivity with only 0.6590 false positive per image. The findings suggest that the combination of preprocessing methods and a novel network architecture can lead to more accurate and reliable AD detection. Overall, the proposed approach offers a novel perspective on detecting ADs, and we believe that our method can be applied to clinical settings in the future, assisting radiologists in the early detection of ADs from mammography, ultimately leading to early treatment of breast cancer patients.

Prevalence of Breast Cancer Screening in Asia: Systematic Review and Meta-Analysis

BACKGROUND

Breast cancer is one of the leading causes of cancer-related mortality among women above 50 years of age. This systematic review and meta-analysis aimed at identifying the prevalence and trend of breast cancer screening among selected Asian countries.

METHODS

We searched three databases including, PubMed, Web of Science, and Scopus using our search terms. Two independent reviewers screened titles and abstracts applying the inclusion and exclusion criteria specified in the PROSPERO (registration ID: CRD42023401516) and any conflicts were resolved through discussion. Two independent reviewers and conflicts also completed the full-text screening, which was solved. Relevant information was extracted in an Excel sheet and random effects meta-analysis was performed to identify the pooled estimate of breast cancer screening in Asia using Stata 17.

RESULTS

We identified 41 studies from 14 selected Asian countries reporting breast cancer screening rates from 2012-2023. The pooled estimate of four countries (China, Iran, Japan, and Korea) with more than three data points on clinical breast examination and mammographic screening showed a screening rate of 24% (95% CI: 0.20 - 0.27) and 18% (95% CI: (0.14 - 0.21) in the last ten years respectively.

CONCLUSION

Most Asian countries do not have sufficient data on breast cancer screening due to a lack of nationally representative surveys or national-level cancer registries. Therefore, it is crucial to strengthen cancer control policies including breast cancer screening programs.

A new clinical prognosis model for breast cancer with ADSS as the hub gene

Background: Breast cancer (BRCA) is the most common malignant tumor and the leading cause of cancer death worldwide. Adenylosuccinate synthetase (ADSS) is highly expressed in BRCA and its subtypes malignant tumors and is associated with poor prognosis. Methods: By applying ROC curve, survival analysis, WGCNA, enrichment analysis, Cox regression model and other methods, this study explores the role of ADSS in BRCA and constructs a scoring model. Results: In this study, the ADSS demonstrated good diagnostic efficacy and high expression in breast cancer tissues. Further exploration of the role of ADSS in BRCA revealed that its significantly related coexpressed genes are clearly involved in biological functions and signaling pathways associated with cell proliferation and differentiation. Additionally, the ADSS-related scoring model showed a significant prognostic impact on clinical characteristics, such as metastasis to lymph nodes, and it was discovered that the ADSS score and related scoring genes may affect the immune microenvironment of BRCA patients, potentially participating in the occurrence of this disease. Conclusion: In summary, our gene expression analysis of ADSS in BRCA generated a clinical scoring model based on the ADSS that may be used to assess prognostic risk and provide potential clinical applications and rational therapeutic targets.

Platinum Group Metals Nanoparticles in Breast Cancer Therapy

Despite various methods currently used in cancer therapy, breast cancer remains the leading cause of morbidity and mortality worldwide. Current therapeutics face limitations such as multidrug resistance, drug toxicity and off-target effects, poor drug bioavailability and biocompatibility, and inefficient drug delivery. Nanotechnology has emerged as a promising approach to cancer diagnosis, imaging, and therapy. Several preclinical studies have demonstrated that compounds and nanoparticles formulated from platinum group metals (PGMs) effectively treat breast cancer. PGMs are chemically stable, easy to functionalise, versatile, and tunable. They can target hypoxic microenvironments, catalyse the production of reactive oxygen species, and offer the potential for combination therapy. PGM nanoparticles can be incorporated with anticancer drugs to improve efficacy and can be attached to targeting moieties to enhance tumour-targeting efficiency. This review focuses on the therapeutic outcomes of platinum group metal nanoparticles (PGMNs) against various breast cancer cells and briefly discusses clinical trials of these nanoparticles in breast cancer treatment. It further illustrates the potential applications of PGMNs in breast cancer and presents opportunities for future PGM-based nanomaterial applications in combatting breast cancer.

Impact of anti leukemia inhibitory factor antibody on immune related gene expression in breast cancer Balb/c mouse model

Leukemia inhibitory factor (LIF) is involved in the progression of different cancers. In this study, we investigated the effect of anti-LIF antibodies on immune-related gene expression in the Balb/c mouse model of breast cancer. To immunize mice against LIF, recombinant LIF with Freund adjuvant was injected into the test group, whereas the control group received phosphate-buffered saline with adjuvant. Tumor induction (4T1 cell line) was performed by increasing the antibody titer. The expression of immune-related genes was evaluated by real-time PCR. The anti-LIF titer was significantly increased in the immunized group. The expression of genes related to the differentiation of T helper (Th)-1, Th-2, and Th-17 cells was significantly higher in the immunized group than in the control group. In addition, anti-LIF did not have a significant effect on the expression of genes related to the differentiation of regulatory T cells, and immune checkpoint-associated genes. Additionally, the test group had higher survival and lower tumor development rates. The results demonstrated that the anti-LIF antibody may potentially play a role in the differentiation of immune cells or immune responses. However, further studies utilizing advanced techniques are necessary to validate its function.

Chemoprotective and immunomodulatory potential of Lactobacillus reuteri against cadmium chloride-induced breast cancer in mice

INTRODUCTION

The current study aimed to investigate the role of probiotic Lactobacillus reuteri for the treatment and prevention of breast cancer.

MATERIALS AND METHODS

Breast cancer was induced by using Cadmium Chloride (Cd) (2 mg/kg) in group II. Tamoxifen was administered to group III. Group IV was treated with Lactobacillus reuteri. Group V was treated with Cd for one month and divided into three subgroups including VA, VB, and VC which were treated with tamoxifen, Lactobacillus reuteri, and tamoxifen + Lactobacillus reuteri, respectively.

RESULTS

Significantly higher levels of TNF-α (40.9 ± 4.2 pg/mL), IL-6 (28.0 ± 1.5 pg/mL), IL-10 (60.2 ± 2.0 pg/mL), IFN-γ (60.2 ± 2.0 pg/mL), ALAT (167.2 ± 6.2 U/l), ASAT (451.6 ± 13.9 U/l), and MDA (553.8 ± 19.6 U/l) was observed in Cd group. In comparison, significantly lower levels of TNF-α (18.0 ± 1.1 pg/mL), IL-6 (9.4 ± 0.4 pg/mL), IL-10 (20.8 ± 1.1 pg/mL), IFN-γ (20.8 ± 1.1 pg/mL), ALAT (85.2 ± 3.6 U/l), ASAT (185 ± 6.9 U/l), and MDA (246.0 ± 7.5 U/l) were observed in group Cd + Tam + LR. Liver histopathology of the Cd group showed hemorrhage and ductal aberrations. However, mild inflammation and healthier branched ducts were observed in treatment groups. Furthermore, the renal control group showed normal glomerular tufts, chronic inflammation from the Cd group, and relatively healthier glomerulus with mild inflammation in treatment groups.

CONCLUSION

Hence, the preventive and anticancerous role of probiotic Lactobacillus reuteri is endorsed by the findings of the current study.

A comparative study of Mentha longifolia var. asiatica and Zygophyllum arabicum ZnO nanoparticles against breast cancer targeting Rab22A gene

Breast cancer is the most frequently diagnosed cancer worldwide, and the incidence rate has increased enormously over the last three decades. Rab proteins are members of the Rab GTPase superfamily. The aberrant function of these proteins leads to the development of tumors. Mentha longifolia var. asiatica and Zygophyllum arabicum have been known for their therapeutic potential for ages. The present study aimed to synthesize ZnO nanoparticles encapsulated with the extracts of M. longifolia var. asiatica and Z. arabicum and evaluating their therapeutic potential against breast cancer, targeting the Rab22A gene and its protein. UV-Vis spectrophotometer showed characteristic absorbance peaks at 295 nm and 345 nm for Z. arabicum and M. longifolia var. asiatica ZnONPs, respectively. The FTIR bands of Z. arabicum nanoparticles suggested the presence of aldehydes, alcohols, and polyols whereas bands of M. longifolia var. asiatica ZnONPs suggested the presence of carboxyl groups, hydroxyl groups, alkynes, and amines. SEM revealed the size of Z. arabicum ZnO NPs to be 25 ± 4 nm with a spherical shape as compared to nanoparticles of M. longifolia var. asiatica having a size of 35 ± 6 nm with a hexagonal shape. EDX determined the elemental composition of both particles. The cytotoxicity of both plant extracts and respective NPs was determined against the MCF-7 breast cancer cell line, which was found to be significant with an IC50 value of 51.68 μM for Z. arabicum and 88.02 μM for M. longifolia var. asiatica ZnO compared to plant extracts (64.01 μM and 107.9 μM for Z. arabicum and M. longifolia var. asiatica). The gene expression and protein levels of Rab22A were decreased in nanoparticle-treated cells as compared to the control group. The apoptotic role of synthesized nanoparticles against the MCF-7 cell line was also determined by the expression of apoptotic pathway genes and proteins (bax, caspase 3, caspase 8 and caspase 9). All samples showed significant apoptotic activity by activating intrinsic and extrinsic pathway genes. The activity of Z. arabicum was more eminent as compared to M. longifolia var. asiatica which was evident by the greater expression of studied genes and proteins as determined by Real-time qPCR and ELISA. This is the first-ever report describing the comparative analysis of the efficacy of Z. arabicum and M. longifolia var. asiatica ZnONPs against breast cancer.

Survival Outcomes of Breast Cancer Patients in South India Over 20 Years

OBJECTIVE

The study aimed to investigate the distribution and clinicopathologic features of breast cancer patients in South India, while also examining the overall survival (OS) and identifying predictive factors affecting it. Additionally, we aimed to assess the influence of risk factors on Disease Free Survival (DFS) and Distant Disease-Free Survival (DDFS).

METHODS

This retrospective cohort study on breast cancer trends used comprehensive follow-up including regular patient contact, medical record review and collaboration with healthcare providers. Patients without follow-up information for more than 12 months were contacted by telephone, while those with no follow-up after 2 years were labelled as lost to follow-up.

RESULTS

A total of 3256 patients were identified from a single cancer institute in India. The median follow-up time was 8.1 years. The 5-year survival rates were 89%, 84%, 85%, 88% and 10-year were 82%, 78%, 79%, 83% for luminal cancers, Triple Negative Breast Cancers, HER2 enriched and luminal with HER2 enriched respectively.

CONCLUSION

Poorer survival rates were seen among those with pT3/4 tumors, nodal involvement at diagnosis, Estrogen receptor negative status, high Ki67 proliferative index and higher TNM stage at diagnosis of the disease. Although our patients were younger and had more aggressive types of cancer, their DFS, DDFS and overall survival were comparable to other developed nations.

CDCA5 accelerates progression of breast cancer by promoting the binding of E2F1 and FOXM1

BACKGROUND

Breast cancer is one of the most common malignant tumors in women. Cell division cycle associated 5 (CDCA5), a master regulator of sister chromatid cohesion, was reported to be upregulated in several types of cancer. Here, the function and regulation mechanism of CDCA5 in breast cancer were explored.

METHODS

CDCA5 expression was identified through immunohistochemistry staining in breast cancer specimens. The correlation between CDCA5 expression with clinicopathological features and prognosis of breast cancer patients was analyzed using a tissue microarray. CDCA5 function in breast cancer was explored in CDCA5-overexpressed/knockdown cells and mice models. Co-IP, ChIP and dual-luciferase reporter assay assays were performed to clarify underlying molecular mechanisms.

RESULTS

We found that CDCA5 was expressed at a higher level in breast cancer tissues and cell lines, and overexpression of CDCA5 was significantly associated with poor prognosis of patients with breast cancer. Moreover, CDCA5 knockdown significantly suppressed the proliferation and migration, while promoted apoptosis in vitro. Mechanistically, we revealed that CDCA5 played an important role in promoting the binding of E2F transcription factor 1 (E2F1) to the forkhead box M1 (FOXM1) promoter. Furthermore, the data of in vitro and in vivo revealed that depletion of FOXM1 alleviated the effect of CDCA5 overexpression on breast cancer. Additionally, we revealed that the Wnt/β-catenin signaling pathway was required for CDCA5 induced progression of breast cancer.

CONCLUSIONS

We suggested that CDCA5 promoted progression of breast cancer via CDCA5/FOXM1/Wnt axis, CDCA5 might serve as a novel therapeutic target for breast cancer treatment.

Modifiable Risk Factors for Breast Cancer Mortality in Türkiye from 1990 to 2019: A Temporal Analysis of Global Burden of Disease Data

Background

Breast cancer is the leading cause of cancer-related mortality in women in Türkiye.

Aims

Explore the trends in female breast cancer mortality rates and the associated modifiable factors in Türkiye between 1990 and 2019.

Study Design

Epidemiological descriptive analysis.

Methods

The database of the Global Burden of Disease study was used to obtain data regarding breast cancer-related mortality and modifiable (behavioral and metabolic) risk factors among women in Türkiye from 1990 to 2019. The average annual percentage change (AAPC) for female breast cancer mortality rates was computed using the Joinpoint regression method.

Results

From 1990 to 2009, the breast cancer mortality rates in Türkiye tended to increase [from 12.26/105 in 1990 to 12.65/105 in 2019; AAPC=0.1 "95% confidence interval (CI): 0.1-0.1"]. In terms of breast cancer mortality attributed to modifiable factors, a 3% increase was observed from 1990 (20.4%) to 2019 (23.1%), the highest contributor being high body mass index (3.19% in 1990 to 5.87% in 2019; AAPC=1.5; 95% CI: 1.3-1.5), followed by high fasting plasma glucose (5.01% in 1990 to 7.72% in 2019; AAPC=1.4; 95% CI: 1.3-1.5).

Conclusion

The proportion of breast cancer-related deaths attributed to metabolic factors has been increasing in Türkiye from 1990 to 2019. Therefore, health policies aimed at managing metabolic factors in women are warranted to reduce breast cancer-related mortality in Türkiye.