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Archives of Breast Cancer - Volume:5 Issue: 1, Feb 2018

Archives of Breast Cancer
Volume:5 Issue: 1, Feb 2018

  • تاریخ انتشار: 1397/01/20
  • تعداد عناوین: 8
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  • Ahmad Kalateh Sadati Pages 1-3
  • Maryam Mehrpooya, Jeyran Zebardast, Mahdi Aghili Pages 3-10
    Background
    Breast cancer is the most frequently occurring cause of cancer-related mortality in women all around the world. However, the risk of cardiovascular diseases increases in parallel with dramatic improvements in target-specific treatment for breast cancer. The aim of this review was to show the importance of cardiovascular involvement in patients with breast cancer.
    Methods
    Published literature, regarding breast cancer and cardiovascular involvements, as well as cardiovascular complications of current treatments for breast cancer, including chemotherapy and radiotherapy, was reviewed.
    Results
    Review of our data revealed that there are extensive direct and indirect impacts of breast cancer on the cardiovascular system. Cardiovascular complications of breast cancer are common and range from cardiomyopathy, pericardial involvement, venous thromboembolism, and arterial thrombosis to some uncommon problems.
    Conclusion
    Early detection of cardiovascular damages from breast cancer is strongly recommended. Considering the significant cardiovascular complications of both breast cancer and its treatment, early recognition, prevention, and management of these complications, even the minor ones, improve prognosis and survival of patients with breast cancer.
    Keywords: Breast cancer treatment, Cardiovascular, Cardiovascular complications
  • Soolmaz Sohrabi, Alireza Atashi, Ali Dadashi, Sina Marashi Pages 11-14
    Background
    Diagnosing breast cancer at an early stage can have a great impact on cancer mortality. One of the fundamental problems in cancer treatment is the lack of a proper method for early detection, which may lead to diagnostic errors. Using data analysis techniques can significantly help in early diagnosis of the disease. The purpose of this study was to evaluate and compare the efficacy of two data mining techniques, i.e., multilayer neural network and C4.5, in early diagnosis of breast cancer.
    Methods
    A data set from Motamed Cancer Institute's breast cancer research clinic, Tehran, containing 2860 records related to breast cancer risk factors were used. Of the records, 1141 (40%) were related to malignant changes and breast cancer and 1719 (60%) to benign tumors. The data set was analyzed using perceptron neural network and decision tree algorithms, and was split into two a training data set (70%) and a testing data set (30%) using Rapid Miner 5.2.
    Results
    For neural networks, accuracy was 80.52%, precision 88.91%, and sensitivity 90.88%; and for decision tree, accuracy was 80.98%, precision 80.97%, and sensitivity 89.32%. Results indicated that both algorithms have acceptable capabilities for analyzing breast cancer data.
    Conclusion
    Although both models provided good results, neural network showed more reliable diagnosis for positive cases. Data set type and analysis method affect results. On the other hand, information about more powerful risk factors of breast cancer, such as genetic mutations, can provide models with high coverage.
    Keywords: Decision tree, Multilayer neural network, Breast cancer, Data analysis
  • Somayyeh Borjalilu, Mojgan Karbakhsh, Mostafa Hosseini, Sanambar Sadighi, Ahmad Kaviani Pages 15-25
    Background
    Physicians’ beliefs about disclosure manner and their ethical attitude for telling the truth is an important issue in patient-physician interaction. The aim of this study was to examine clinicians’ practice and perception of disclosure models for giving bad news to breast cancer patients.
    Methods
    Participants (n = 207, age 21–61 years, mean work experience = 4.03 ± 6 years) working in different medical centers in Tehran, Iran, were recruited by purposive sampling method. They completed clinicians’ attitude and practice of Breaking Bad News (BBN) scales. Psychometric properties (reliability and validity) of these scales were approved.
    Results
    Clinicians’ practice differed significantly by their perception of disclosure model for giving bad news. Furthermore, difference in clinicians’ practice and perception of disclosure model for BBN was observed for age, gender, medical work experience in oncology setting, and receiving special training. Finally, clinicians’ perception of disclosure model for BBN (Adj. R2 = 0.32), age (Adj. R2 = 0.17), gender (Adj. R2 = 0.11), and receiving special training for giving bad news (Adj. R2 = 0.09) positively predicted their practice of BBN.
    Conclusion
    Findings of the study point to the importance of the clinicians’ perception of disclosure model for giving bad news and transcultural variables as factors affecting their practice. Therefore, it seems necessary to incorporate special BBN trainings and protocols culturally adapted to the Iranian society in educational curricula of medical specialties in breast cancer setting.
    Keywords: Breaking bad news, Clinician's practice, Perception of disclosure model, Breast cancer
  • Hengameh Mozaffarizadeh, Mohammadreza Hakimian, Mansoor Salehi, Elham Moazam, Mohaddeseh Behjati, Mahtab Keshvari, Faribourz Mokarian Pages 26-31
    Background
    Vitamin D serves several cancer protective roles within the human body.Vitamin D functions through binding with the VDR encoded by VDR gene. It has been demonstrated that polymorphism in VDR gene would influence expression and/or function of the VDR protein. The researchers found that the most important VDR gene polymorphisms that are associated with tumorigenesis include Fok1 (rs2228570), Bsm1 (rs1544410), Taq1 (rs771236), and Apa1 (rs7975232). The purpose of this study was to assess the association between Fok1, Bsm1, and Taq1 polymorphisms and breast cancer development.
    Methods
    In this study, 50 patients suffering from breast cancer with less than 6 months after the diagnosis of breast cancer and 50 healthy control individuals were included. Restriction fragment length polymorphism PCR (RFLP-PCR) was used to determine the genotype of polymorphisms.
    Results
    Statistical results showed that among the studied polymorphisms, Tt genotypes of Taq1 polymorphism have correlations with breast cancer development (P
    Conclusion
    The results of the present clearly demonstrated that there is a relationship between Taq1 polymorphism in VDR gene and development of breast cancer.
    Keywords: Breast cancer, VDR gene, Polymorphism
  • Alicia Van Der Laat, Allan Ramos-Esquivel, Denis Ulises Landaverde Pages 32-37
    Background
    Metformin shows anti-proliferative effect on tumor cells. We studied the effect of metformin on achieving complete pathological response (pCR) in breast cancer patients receiving neoadjuvant therapy in a Latin American population.
    Methods
    We conducted a cross-sectional study in Mexico Hospital, Costa Rica, from January 2007 to December 2015. Women with early-stage or locally advanced breast cancer receiving neoadjuvant systemic treatment were recruited for the study. Univariate and multivariate models were used to compare the pCR rate with metformin plus standard therapy versus standard treatment alone.
    Results
    Of 53 included women with early-stage or locally advanced breast cancer were included, 14 received metformin with systemic therapy, and 39 had systemic therapy alone. Only 15% of the patients had diabetes mellitus. The pCR rate was in the metformin group was 64.3% compared with 23.1% in the systemic therapy-alone group (OR: 6.0, 95% CI: 1.60–22.53, P= 0.008). This finding was confirmed after adjustment for potential confounders, suggesting that the use of metformin increased the pCR likelihood regardless of breast cancer subtype (adjusted OR: 5.56, 95% CI: 1.27–24.3, P = 0.02). There was a trend of achieving pCR in patients with Ki-67 > 55%. However, it did not reach statistical significance when metformin was added, suggesting that probably a high Ki-67 level in the presence of metformin is not a predictor factor of pCR.
    Conclusion
    This is the first study conducted in a Latin American population showing that metformin with systemic therapy increases pCR regardless of the intrinsic molecular subtype or Ki-67 levels. These findings encourage prospective studies to evaluate the role of neoadjuvant metformin in this population.
    Keywords: Breast cancer, Latin America, Metformin, Neoadjuvant therapy
  • Faramarz Karimian, Hesam Kondori, Seyed Mostafa Mosavi-Zadeh, Mohamadreza Neishaboury, Ali Abbaszadeh-Kasbi, Mohammad Reza Keramati Pages 38-43
    Background
    Seroma formation is a common complication after surgery for breast cancer. It may originate from dissected lymphatic ducts in axillary area. Two important predictive factors are the surgical technique, and instruments used during surgery. This study was conducted to determine the impact of three axillary dissection techniques, namely, blunt dissection with hemostat, sharp dissection with Metzenbaum scissors, and dissection with harmonic scissors, on seroma formation.
    Methods
    Patients with a tissue diagnosis of breast cancer who did not have metastasis, and were candidates for either breast conservation surgery (BCS) and sentinel lymph node biopsy (SLNB) with or without axillary lymph node dissection (ALND), or modified radical mastectomy (MRM) were included in a prospective study. Patients were randomly allocated to one of the above mentioned three groups. The incidence of seroma formation was compared among the groups.
    Results
    Sixty patients (age: 50.25 ± 10.33 years) were enrolled for the study. At the end of the study, after four weeks of postoperative follow up, 19 patients developed seroma (31.6%), of whom 5 (26.3%) had dissection with harmonic scissors, 6 (31.5%) with Metzenbaum scissors, and 8 (42.1%) were dissected bluntly. There was no significant difference among groups regarding seroma formation (P = 0.583).
    Conclusion
    Application of harmonic scissors for axillary dissection has no significant impact on seroma formation. However, MRM leads to significantly more seroma formation compared with BCS.
    Keywords: Harmonic scissors, Seroma, Breast cancer, Axillary lymph node dissection, Sentinel lymph node biopsy, modified radical mastectomy, Breast conservation surgery
  • Negar Mashoori, Sanaz Zand, Shahram Movafaghi, Farid Ardalan Azmoodeh, Ahmad Kaviani Pages 44-49
    Background
    Adenoid cystic carcinoma (AdCC) of the breast is a rare type of invasive breast cancer, accounting for less than 1% of all breast cancer cases. It is usually a low-grade tumor that rarely metastasizes to the axillary lymph nodes and distant organs. AdCC of the breast is mostly negative for estrogen receptor, progesterone receptor, and HER2-neu. However, despite being triple-negative, it has favorable outcome, and patients with AdCC of the breast generally have a good to excellent long-term survival.
    Case Presentation
    Here we report a case of a 51-year-old female presenting with left breast mastalgia who was finally diagnosed with AdCC of the left breast. The patient underwent breast‑conserving surgery and axillary staging followed by adjuvant chemoradiation.
    Conclusion
    Because of the rarity of AdCC of the breast, it has been difficult to conduct prospective trials to determine the best treatment option. Different types of therapy, including BCS and mastectomy with or without axillary staging with or without adjuvant chemoradiation have been reported, all with overall good to excellent long-term results. Prospective controlled trials will help in determining the best treatment.
    Keywords: Breast cancer, Breast adenoid cystic carcinoma (AdCC), Invasive breast cancer, Adjuvant therapy