Delineation of Pathogenomic Insights of Breast Cancer in Young Women

Unveiling Collagen's Role in Breast Cancer: Insights into Expression Patterns, Functions and Clinical Implications

Collagen, the predominant protein constituent of the mammalian extracellular matrix (ECM), comprises a diverse family of 28 members (I-XXVIII). Beyond its structural significance, collagen is implicated in various diseases or cancers, notably breast cancer, where it influences crucial cellular processes including proliferation, metastasis, apoptosis, and drug resistance, intricately shaping cancer progression and prognosis. In breast cancer, distinct collagens exhibit differential expression profiles, with some showing heightened or diminished levels in cancerous tissues or cells compared to normal counterparts, suggesting specific and pivotal biological functions. In this review, we meticulously analyze the expression of individual collagen members in breast cancer, utilizing Transcripts Per Million (TPM) data sourced from the GEPIA2 database. Through this analysis, we identify collagens that deviate from normal expression patterns in breast cancer, providing a comprehensive overview of their expression dynamics, functional roles, and underlying mechanisms. Our findings shed light on recent advancements in understanding the intricate interplay between these aberrantly expressed collagens and breast cancer. This exploration aims to offer valuable insights for the identification of potential biomarkers and therapeutic targets, thereby advancing the prospects of more effective interventions in breast cancer treatment.

Understanding the Rising Breast Cancer Among Young Women: Biological Insights, Projections, and an Opportunity Window Leading up to 2040

Breast cancer is the most common cancer affecting women globally, with an increasing incidence of breast cancer in young women in India and worldwide. Despite medical advancements, the lifetime risk of developing breast cancer is still high. The emergence of breast cancer in young women is now acknowledged as a distinct entity characterized by unique clinical and biological features and an overall poor prognosis. This article discusses the changing landscape of breast cancer in young women in India and globally, potential examples of the underlying reasons, and possible strategies to start reversing the current upward trend.

Diagnostic delays in breast cancer among young women: An emphasis on healthcare providers

Despite advances in breast cancer care, breast cancer in young women (BCYW) faces unique challenges, diagnostic delays, and limited awareness in many countries. Here, we discuss the challenges and consequences associated with the delayed diagnosis of BCYW. The consequences of delayed diagnosis in young women - which generally varies among developed, developing, or underdeveloped countries - are severe due to a faster breast tumor growth rate than tumors in older women, also contributing to advanced cancer stages and poorer outcomes. Though there are many underlying reasons for diagnostic delays due to age, the article delves explicitly deep into the diagnostic delay of BCYW, focusing on healthcare providers, potential contributing factors, its consequences, and the urgent need to start minimizing such incidences. The article suggests several strategies to address these issues, including increasing awareness, developing educational programs for healthcare providers to identify signs and symptoms in young women, developing clear diagnostic guidelines, and improving screening strategies.

Identification of Potential Diagnostic and Prognostic Biomarkers for Gastric Cancer Based on Bioinformatic Analysis

Gastric cancer (GC) ranks third for cancer-related fatalities worldwide. It is still unclear what causes GC to progress. Using integrated bioinformatics analysis, COL5A2 has been proved to be related to GC development, which may identify the likely pathogenic mechanism. Data from GC patients were gathered using The Cancer Gene Atlas (TCGA) and the gene expression omnibus (GEO). The level of COL5A2 expression was compared between paired GC and normal tissues. The differentially expressed genes (DEGs) in GC patients with high and low COL5A2 expression were identified using functional enrichment analysis to identify the signature pathways linked to the DEGs. The clinical pathologic traits connected to overall survival (OS) of GC patients were examined utilizing Cox regression and the Kaplan-Meier method. To assess the prognostic significance of COL5A2, receiver operating characteristic (ROC) curves was drawn. How the immune system infiltrate both normal gastric and GC tumor tissues was investigated. Using the human protein atlas (HPA) database, regression, and the Kaplan-Meier method, immunohistochemical analysis of DEG COL5A2 expression in GC tissues was carried out. The correlation between COL5A2 expression and the GC grouping was found to be highly significant. Functional annotations revealed that COL5A2 participates in extracellular matrix structure, collagen metabolism, and other biological processes (BPs). High COL5A2 expression was associated with poor prognostic and clinical features, such as clinical T, N, and M stages. ROC curves exhibited that COL5A2 might predict the occurrence of gastric cancer. The infiltration degree of 21 immune cell subsets, including activated dendritic cells (aDCs), CD8+ T cells, and cytotoxic cells, was found to be dramatically relevant to COL5A2. Immunohistochemical analysis indicated that the expression of COL5A2 in tumor tissues is higher than that in normal tissues. The COL5A2 gene may offer fresh perspectives on the pathogenic mechanism underlying GC, as well as potential biomarkers for estimating GC patient prognosis. As a result, COL5A2 may be a useful biomarker for predicting patient survival.

Influence of age as a continuous variable on the prognosis of patients with pT1-2N1 breast cancer

PURPOSE

To assess the influence of age as a continuous variable on the prognosis of pT1-2N1 breast cancer and examine its decision-making value for postmastectomy radiotherapy (PMRT).

METHODS

We retrospectively evaluated 5438 patients with pT1-2N1 breast cancer after mastectomy in 11 hospitals. A multivariable Cox proportional hazards regression model with penalized splines was used to examine the relationship between age and oncologic outcomes.

RESULTS

The median follow-up was 67.0 months. After adjustments for confounding characteristics, nonsignificant downward trend in locoregional recurrence (LRR) risk was observed with increasing age (P-non-linear association = 0.640; P-linear association = 0.078). A significant non-linear association was found between age and disease-free survival (DFS) and overall survival (OS) (P-non-linear association <0.05; P-linear association >0.05, respectively). The DFS and OS exhibited U-shaped relationships, with the hazard ratios (HRs), reaching a nadir at 50 years old. A decreased risk of LRR with PMRT vs. no PMRT (HR = 0.304, 95% CI: 0.204-0.454) was maintained in all ages. The HR of PMRT vs. no PMRT for DFS and OS gradually increased with age. In patients ≤50 years old, PMRT was independently associated with favorable LRR, DFS, and OS, all P < 0.05). In patients >50 years old, PMRT was independently associated with reduced LRR (P = 0.004), but had no effect on DFS or OS.

CONCLUSIONS

Age was an independent prognostic factor for pT1-2N1 breast cancer; PMRT provided survival benefits for patients ≤50 years old, but not for patients >50 years old.