فصلنامه بیماری های پستان ایران
سال دوم شماره 2 (پیاپی 5، تابستان 1388)

The objective of our study was so to show the impact of different chemotherapy regimens on induction of amenorrhea (CIA) in premenopausal women with breast cancer at different l ages. This is a follow-up study in 226 premenopausal women with breast cancer, who received one of the three groups of chemotherapy regimens: Conventional (CMF), antracyclinebased, and anthracycline-Taxanes based. They were evaluated for incidence of CIA in the follow-up clinic of ICBCIranain Center for Braest Cancer (ICBC). Statistical analysis using SPSS software was performed and logistic regression was used to determine the risk factors of CIA. From 226 patients with a median age of 40 yrs (26-56 yrs) who participated in this study, 154 patients (68.1%) were developed CIA, which in 101 patients (65.6%), CIA was established and never resumed. CIA was present in 52.5% of patients treated with conventional regimens (CMF), in 66.7% of patients treated with anthracyclines and in 78.7% of patients treated with anthracycline-taxan. So the frequency of CIA was significantly higher in Taxanes based chemotherapy group than the others (p=0.015). Although a slightly superior incidence of CIA in patients with hormone-insensitive tumors (ER-and PR-) versus hormone-sensitive tumors (ER+/or PR+) treated with combination regimens was observed, no statistically significant difference was found (p=0.629). From all the risk factors that were evaluated, anthracycline-taxan based regimen (OR: 4.14.059, CI95%:1.6-10.21.6-9.8) and age>40 yrs (OR: 3.23.5, CI95%: 1.7-6.11.9-6.6) were the most important factors in developing CIA in the study. The type of chemotherapy and age at the breast cancer diagnosis are the most important risk factors in CIA and Taxanes-based regimens induced more CIA than the other regimens.

Mutations in BRCA1 are present in approximately 50% of the early-onset breast cancer families and 80% of the early-onset breast and ovarian cancer families, whereas BRCA2 mutations are believed to account for a comparable percentage of inherited breast cancer cases. Therefore, the demand for BRCA1 and BRCA2 mutations screening is increasing as their identification will affect medical management of people at increased risk for breast and ovarian cancers. The aim of this study was to investigate mutations of BRCA1/2 in a number of breast cancer patients (at age ≤ 40 years) or with family history of breast or ovarian cancer. All study subjects (63 breast cancer patients (at age ≤ 40 years) or with family history of breast or ovarian cancer) and 50 controls were recruited from Feb.2009 to Mar. 2010 at kawsar Human Genetics Research Center, Iran. After collecting blood samples and extracting DNA, their BRCA1 and BRCA2 genes were fully sequenced. Many missense substitutions in BRCA1 and BRCA2 genes were identified. Here novel mutations are reported (Gly1140Ser, Ileu15Ieu, Ileu26Ieu, Glu23Gln, Leu3Opal (stop codon), Pro938Arg, Leu6Val, Arg7Cys, Ser177Val, IVS7+83(TT), IVS8 -70(CATT), IVS2+9(GC), IVS1-20(GA), IVS1-8(AG), IVS2+24(AG) in BRCA1 and Glu1391Gly in BRCA2) in BRCA1 and Glu1391Gly in BRCA2). The missense substitutions Glu1038Pro, Gly1140Ser were found in large series of breast cancer patients and 20% < of matched controls. The missense substitutions Gly1738Glu, Leu3stop codon, Ile21Val and IVS2-1 (GC), CD26SmallINSGTCCC^ATCTG E212catctgGTAAGTCAGC in BRCA1 and Leu1522Phe in BRCA2 are pathogenic. Based on our preliminary results some haplotypes may have a pathogenic role in breast cancer development, the haplotype at the BRCA1 locus defined by alleles Leu871Pro, GLu1038Gly, Ser1613Gly, Gly1140Ser was found in 10 affected families. More studies are required to confirm the hypothesis that genetic polymorphisms are associated with breast cancer.

Breast cancer is the most prevalent malignancies among women and is the 5th malignancy related cause of death in Iran. Annual incidence is 7770 cases and 1200 annual death. Widespread use of mammography and sonography increase survival of patients due to early diagnosis. Sensitivity and specificity of mammography and sonography in detecting breast cancer were different among various references and studies. So we decided to evaluate the concordance of mammography and sonography reports with tissue diagnosis in patients suffering from benign and malignant breast diseases. In this study 225 women referred to breast clinic in 2005-2009 with beast mass were evaluated. History & physical exam, mammography and\or sonography and Pathology reports were recorded. Mammography and\or sonography results was compared with tissue diagnosis (gold standard). In this evidence based study sensitivity and specificity of mammography were 73% and 44% and false negative rate of mammography was 17.27%.sensitivity and specificity of sonography were 69% and 49% and false negative rate was 17.68%. Sensitivity of sonography is significantly related to age, history of gravidity and breast feeding. Sensitivity of sonography is significantly related to age. Due to importance of mammography and sonography and high rate of false negative results of these imaging modalities any effort for standardizing and improvement of their quality is prudent and clinical judgment of surgeon obtained from history and thorough physical examination is the cornerstone of decision making in patients too.

Early detection of the breast cancer can significantly increase survival rate among women. Nowadays, researchers aim to automatize fine needle aspiration (FNA), as a simple, non-expensive and non-invasive test for breast cancer diagnosis. Intelligent diagnosis of breast cancer consists of 5 steps: fluid extraction from the breast lump, capturing digital microscopic images from the samples, extracting morphological real-valued features from the images, feature selection and designing a pattern recognition system to distinguish between benign and malignant tumors. Using WDBC database (including 569 FNA samples), a novel BPSO-based feature selection method and SVM classifiers an intelligent breast cancer diagnosis system is developed. Merit of the proposed system is successfully certified on WDBC dataset leading to recognition rate of %100 using only 28 features (in 5 SVM models). The system clearly outperforms previous works in both respects of accuracy and the number of required features. Developing a novel efficient feature selection algorithm can improve both accuracy and speed of intelligent breast cancer diagnosis systems. In addition to general diagnosis, using feature selection would help physicians discovering abnormalities caused by diseases.

many cases of breast cancer is diagnosed by women's themselves during self-examination. The goal of this study was to determine the Relationship between Breast self-examination and Self-esteem, Perceived Benefits/Barriers of Self-efficacy among Health Volunteers of Zarandieh city. This is a cross-sectional Breast Self Examination study and 106 health liaisons of Zarandieh city were involved. Data were collected using a multi-section questionnaire include demographic characteristics, Self-esteem, Perceived Benefits/Barriers of Self-efficacy and Breast self-examination behavior. The data analysis was performed by SPSS software. The rate of breast self-examination was 19 percent. Perceived benefits score among the patients was 46 per cent and perceived barriers score was 83 percent and fear of the test results were the main barriers of self-examination. Regression analysis showed that age, Education level, self-esteem and Perceived Benefits/Barriers, self-efficacy, all together explain 38.5% of breast self-examination variance and among them,pereceived barriers and self-esteem, was the most important predicting factor. The results of this study showed the relationship of Perceived Benefits/Barriers and self-esteem with breast self-examination.

The high prevalence of Breast Cancer especially in Iranian young women led our study to survey on Iranian scientists researching field related to Breast Cancer. The purpose of current study is to analyze and visualize the trend of scientific output in the field of Breast Cancer research in Iran.

Using the mixed-methods of Bibliometric analysis and systematic review we extracted all Iranian publications in the field of breast cancer from Medline through 1965-2008. All row data was extracted based on the MeSH thesaurus and In order to make more comprehensive the result of data retrieving, we made a new method of search strategy.

A total number of 114 articles published by Iranian authors were found. “Epidemiology and related issues” was the most popular subject area investigated by Iranian scientists. Molecular based researches were in second and clinical related issues were in third condition. The mean value of coauthor of papers was 4.67. About 70% of Iranian publications in this field were published in journals with Impact Factor between 0.396 and 5.684. Breast Cancer Research and Treatment was the high-impact journal that published Iranian publications. The United state and England were the most prolific countries that published Iranian publications in this field.

The study indicated the number of publications in the field of Breast Cancer in Medline emanated by Iranian scientists has been increased exponentially through the period of study especially after 2001.

The regional nodal involvement is considered a fundamental step to plan appropriate treatment of breast cancer patients, but is generally limited to axillary region, while many data show that the internal mammary nodes should be considered equally. The elective treatment of Internal mammary nodes is controversial because of the difficulty in predicting involvement, treatment-related morbidity and questionable efficacy. Although medial tumors have been reported to more commonly drain to IMNs, other predictive variables for IMN drainage may identify those patients who could benefit from further IMN assessment and treatment. The purpose of this study is to review historical and new data regarding internal mammary nodes in breast cancer.