فهرست مطالب

Archives of Breast Cancer
Volume:3 Issue: 2, May 2016

  • تاریخ انتشار: 1395/04/21
  • تعداد عناوین: 7
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  • Elise Bo, Gallon Pages 32-33
  • Zahra Akbarzadeh, Farnaz Parvaresh, Reza Ghiasvand, Maryam Miraghajani Pages 34-40
    Background
    Breast cancer is the most common cancer in women worldwide. Recently, natural remedies such as Naringenin (Nar) - a kind of flavonoids which can be found in grapefruits, oranges, and tomatoes - seem to be interesting. They play a useful role in treatment and chemoprevention because of having pleiotropic molecular mechanisms of action on breast cancer cells.
    Methods
    We performed a PRISMA-directed systematic review to investigate the effects of Naringenin on some human breast cancer cells (MCF-7, T47D, and MDA-MB-231). Tumor size, apoptosis, estrogenic properties, and cytotoxicity were assessed as primary outcomes. The systematic search without restriction was conducted in electronic databases, including PubMed, Scopus, Google scholar, and Cochrane Library.
    Results
    Initially, 6445 articles were identified. After screening their titles and abstracts, 32 studies were selected for text appraisal. Finally, 6 articles which met the inclusion criteria were evaluated. Based on the evaluation, Nar could inhibit both cell proliferation and tumor growth at different concentration. Moreover, it could induce apoptosis.
    Conclusions
    Due to anticancer properties of Nar, some probable mechanisms of these effects are induction of alteration in aromatase and caspase enzymes, and suppression of oestrogen signal transduction pathways. However, more investigations are necessary in the future to decide whether Nar consumption is recommendable as part of breast cancer treatment and control. Also, some clinical trials should be designed to determine the optimal dose for the therapeutic use.
    Keywords: Naringenin, systematic review, breast cancer cells
  • Somaieh Borjalilu, Mojgan Karbakhsh, Rasool Mirsharifi, Kamelia Davoodzadeh, Mahdi Aghili, Ahmad Kaviani Pages 41-49
    Background
    Breaking bad news to cancer patients is one of the important responsibilities in the oncology setting. The purpose of this study is develop and validate a new theoretically based tool for measurement of attitude and practice of physicians toward breaking bad news.
    Methods
    The psychometric properties of the scale were established by following the guidelines of Clark and Watson. In the first phase, a literature review was performed to create items; then items were assessed for content validity through individual interview (n = 12) and construct validity was assessed by using factor analysis. Reliability was evaluated by Cronbach’s alpha. Research data was gathered from physicians working in breast cancer setting.
    Results
    A total of 12 expert reviews concluded that a large amount of items of attitude and practice questionnaires were important and essential (Content Validity Ratio > 0.73). The exploratory and confirmatory factor analyses for a sample of physicians (n = 200) indicated a 12-item of attitude scale with three factors: full disclosure, non-disclosure and individual disclosure. Cronbach’s Alpha for the factors returned 0.746, 0.834 and 0.795, respectively. The exploratory and confirmatory factor analyses for a sample of physicians (n = 200) indicated a 20-item of practice scale with six factors: preparation, setting of the interaction, communicate well, use of the “cancer” word, patient’s right to know and close the interview, and summarized. Cronbach’s Alpha for the factors returned 0.765, 0.63, 0.65, 0.793, 0.759 and 0.7, respectively.
    Conclusions
    A resultant 12 items of attitude and 20 items of practice questionnaire were developed to assess how physicians are giving bad news to breast cancer patients. The reliability of the new tools needs to be evaluated for further studies. This new questionnaire will provide researchers and clinicians with a thorough and suitable instrument to measure belief and practice regarding disclosing the truth to breast cancer patients.
    Keywords: Physician, bad news, telling truth, psychometric, questionnaire development
  • Afsaneh Alikhassi, Nasrin Ahmadinejad, Marzieh Lashkari, Hedieh Akbari Pages 50-55
    Background
    Postoperative breast abnormalities after breast conserving surgery or modified radical mastectomy are frequently overlooked and inaccurately assessed or reported using multidetector computed tomography (MDCT). These inaccurate results may have legal ramifications for the clinicians, cause patients avoidable anxiety, and lead to additional unnecessary diagnostic follow-up testing and costs.
    Methods
    The patients with a history of breast cancer who had undergone breast-conserving surgery or modified radical mastectomy up to 6 months prior to undergoing a thoracic MDCT scan consented and enrolled in this study. These patients underwent a thoracic MDCT scan either because of respiratory or cardiac clinical symptoms or as part of breast cancer staging.
    Results
    Forty women were included in this study. Different postoperative breast changes observed on thoracic MDCT scans including fibrous scar tissue, fat necrosis, seroma, abscess, hematoma, and recurrent and residual tumor were described.
    Conclusions
    MDCT scans offer sufficient evidence in many postoperative cases to allow a confident diagnosis. General radiologists who review thoracic MDCT scans should know how to characterize breast lesions incidentally found on MDCT scans after breast surgeries. This information would enhance the value of the radiologist’s report for appropriate case management.
    Keywords: Scar, seroma, computed tomography scan, breast conserving surgery, modified radical mastectomy
  • Asieh Sadat Fattahi, Alireza Tavassoli, Mahmood Reza Kalantari, Sajad Noorshafiee, Majid Rahmani Pages 56-61
    Background
    Core needle biopsy (CNB) with histological findings is regarded as one of the most important diagnostic measures that make preoperative assessment and planning for appropriate treatment possible. The aim of this study was to determine the sensitivity and specificity of core biopsy results in our patients with benign and malignant breast lumps, especially for borderline breast lesions, by using a classification method.
    Methods
    In this study, 116 patients who were referred to the Surgery Clinic of Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran with breast lump and underwent diagnostic procedures such as mammography and ultrasound were selected. Core needle biopsy (Tru-cut #14 or 16) was performed. After that, excisional biopsy was done. The benign, malignant and unspecified samples obtained by core needle biopsy were evaluated with the samples of the surgical and pathological findings.
    Then, false positive, false negative, sensitivity, specificity, and diagnostic accuracy of the core needle biopsy method were calculated. Also, the National Health Service Breast Screening Program (NHSBSP) classification was employed.
    Results
    The mean age of the participants in this study was 39±13.13 years and the mean tumor size was 2.7 cm. An average of 3.35 biopsies was taken from all patients. Most of the pathology samples taken from CNB and excisional biopsy were compatible with invasive ductal carcinoma. Of the B type classifications, B5 was the most frequent in both methods. Borderline lesions B3 and B4 had a change in their category after surgery. About 2.5% of the samples in core biopsy were inadequate. Skin bruising was the most common core biopsy complication reported. While, the most common complication of excisional biopsy was hematoma. Accuracy, sensitivity, specificity, positive and negative predictive values of the core needle biopsy procedure compared with excisional biopsy was 95.5%, 92.6%, 100%, 100%, and 91.8%, respectively.
    Conclusions
    Core needle biopsy has a high sensitivity and specificity with few side effects. Borderline classifications need more evaluation to rule out cancers.
    Keywords: Breast lumps, core needle biopsy, sensitivity, specificity, NHSBSP classification
  • Adil Al Jarrah, Huda S. Almoqbali, Ruqaya Al Shehi, Suad Al Aghbari, Syed Gauhar A. Rizvi, Badriya S. Al Qassabi, Ritu Lakhtakia Pages 62-65
    Background
    The role of the breast clinics is to diagnose breast cancer and reassure patients with benign disorders. One stop clinics - same day reporting - further reduce anxiety caused by the delay in the results. The first one stop clinic was introduced in SQUH–Oman in September 2011.
    Methods
    This retrospective analysis of 395 consecutive cases presented to Breast One Stop Clinic at SQUH was done between September 2011 and December 2013. All patients underwent triple assessment conducted by consultants. Mammography was performed for patients above 35 years with no contraindications. Ultrasound was done for all patients with palpable lesions. The reports were assigned a score (BIRADS 0-6). Fine Needle Aspiration Cytology (FNAC) was done for all patients with palpable abnormality or nipple discharge. An immediate report was given using the standard reporting categories: acellular/inadequate, benign, atypical, suspicious, and malignant (C1-C5).
    Results
    Out of 395 patients, 210 were found to have palpable lesions with a mean age of 36 years (12-84 years). All patients were female. The FNAC sensitivity and specificity was 95.7% and 92.2%, respectively. Out of 210 patients, 15.3% were diagnosed with breast cancer on FNAC who were subsequently staged and discussed in the Breast Multidisciplinary Team Meeting (MDT), and 84.7% were diagnosed to have benign breast disorders who were reassured and advised to be followed up after 6 months.
    Conclusions
    Immediate relief and reassurance to the majority of patients with benign disease obviate the need for review appointments. A reliable diagnosis can be obtained with triple assessment which can be used to avoid unnecessary core biopsy of benign lesions, if correctly done.
    Keywords: Fibroadenoma, FNAC sensitivity, breast carcinoma, breast one stop clinic
  • Mostafa Hosseini, Elham Vafaei, Alimohamad Asghari, Rahele Moein Ara, Nahid Nafissi Pages 66-69
    Background
    Otalgia and Bell’s palsy are rare manifestations of metastasis and the most common presentation of an inflammatory process in the temporal bone.
    Case Presentation
    This article explains a 34-year-old woman with breast cancer who presented with cranial nerve palsy symptoms. The 7th and 8th cranial nerves were involved in the metastatic phase and then hoarseness was added to her symptoms. Brain MRI showed a petrous lesion in the temporal bone due to metastasis, which was the first clue to cancer. Her metastatic workup showed multiple bone lesions. On chest CT scan, multiple lung lesions were noted. Also, a breast mass was discovered on her chest CT scan. On breast examination an irregular mass fixed to the pectoralis muscle was found. Pathologic evaluation of samples obtained through ultrasound-guided core needle biopsy confirmed the diagnosis of invasive ductal carcinoma.
    Conclusion
    Temporal bone metastases are rare and may be asymptomatic, or with mild symptoms mimicking mastoid infections. Physicians should consider metastatic cancer on the list of differential diagnoses in patients presenting with prolonged otologic symptoms or facial nerve disorders.
    Keywords: Metastasis, breast cancer, temporal bone, cranial nerve palsy