International Journal of Cancer Management
Volume:14 Issue: 12, Dec 2021

 The aim of this study was to evaluate the dose distribution, as well as tumor control probability (TCP) and normal tissue complications probability (NTCP) models for females with left-sided breast cancer for 3D-CRT, 6, and 9 fields intensity modulated radiotherapy (IMRT) and hypofractionated tangential plans.

 Eighty females with left-sided breast cancer (N1T1 – N3T3) were included in this study. The patients were divided into breast conserving surgery (BCS) (n= 50) and mastectomy (n=30) patients. CT simulation images of the patients were imported on the treatment planning software (TiGRT, LinaTech, China) and the tangential treatment plans of the mentioned methods were done, using TPS. Dose assessments were performed, employing the TPS, and TCP-NTCP models of stated modalities were done, using Poisson linear-quadatric (PLQ) and Lyman-Kutcher-Burman (LKB) models on MATLAB and R software.

 For the BCS and post-mastectomy patients, 6FIMRT imposed lower doses to ipsilateral lung, heart, LAD, RCA, and contralateral breast compared to 9FIMRT, hypofractionated RT, and 3D-CRT (P < 0.005). Also, the NTCPs of the mentioned normal tissues for 6FIMRT were lower than other methods for both BCS and post-mastectomy groups. Moreover, it was found that the V20Gy for Ipsilateral lung and the V25Gy for heart, LAD, and RCA of 6FIMRT, 9FIMRT, and hypofractionated RT was significantly lower compared to 3D-CRT (P < 0.005) for both BCS and mastectomy groups, while there were no significant differences among them for the 6FIMRT and 9FIMRT with hypofractionated RT (P > 0.005). The TCP values of 9FIMRT, 6FIMRT, and hypofractionated RT were not considerably different; however, the TCP values of 3D-CRT were lower compared to other stated methods.

 6FIMRT is a suitable choice for RT of patients with left-sided breast cancer compared to other mentioned modalities, as a result of providing adequate PTV dose coverage and TCPs. Also, it may impose lower doses and NTCPs for OARs. Hypofractionated RT is a good alternative to reduce treatment time for patients with breast cancer.

 In oral lichen planus (OLP), which is a persistent inflammatory condition of the autoimmune system, cytotoxic T lymphocytes are triggered against epithelial cells. OLP resists treatment more than its cutaneous counterpart and potentially transforms into malignancy as oral squamous cell carcinoma (OSCC). Transforming growth factor β (TGF-β) is produced by various cells, such as leukocytes and epithelial cells, whereby epithelial-mesenchymal-epithelialn (EMT) forms the phenotype of invasive cancerous cells and promotes tumors.

 We investigated the role of TGF-β in the pathogenesis and biological behavior of dysplastic and non-dysplastic OLP.

 Thirty samples of erosive/atrophic OLP (15 dysplastic and 15 non-dysplastic) and 10 samples of normal mucosa of the oral cavity were immunohistochemically examined for the expression of TGF-β. Statistical analysis was performed using the Kruskal-Wallis and chi-squared tests.

 TGF-β expressed to varying degrees in the epithelium of the studied groups. The groups significantly differed in terms of the expression of TGF-β. In pairwise comparisons, the dysplastic OLP group showed significantly higher immunoreactivity than the normal and non-dysplastic groups, although there was no significant difference between the normal and non-dysplastic OLP groups. The expression of TGF-β in the sub-epithelial lymphocytes of the dysplastic and non-dysplastic OLP groups showed a statistically significant difference.

 According to the results, TGF-β, as a marker of the inflammatory process in chronic inflammatory conditions, was expressed in epithelial cells and sub-epithelial lymphocytes of all OLPs. This suggests a possible role of this marker in the pathogenesis of OLP. In addition, the increased expression of TGF-β, a marker also involved in carcinogenesis, in the epithelial keratinocytes indicates the role it might play in the development of carcinoma in OLP.

 Breast cancer is the biggest risk factor that endangers women's health. It is considered the highest stress-causing disease due to the unpleasant effects of disease on different aspects of patients’ life. Breast cancer is commonly associated with the symptoms of post-traumatic stress and its comorbidities such as anxiety and depression. It appears that time perspective therapy (TPT), as a new psychological treatment, can reduce the symptoms of post-traumatic stress, anxiety, and depression in females with breast cancer.

 This is a randomized controlled trial conducted from February to September 2019. A total of 30 patients with breast cancer were selected through a convenience sampling technique and were randomly divided into the control and treatment groups. The latter group attended 6-week sessions (each session lasted 90 minutes long) to receive TPT. To conduct pretest and posttest, all participants in the two groups were asked to fill out the following questionnaires: (1) Zimbardo Time Perspective Inventory (ZTPI); (2) The Post-traumatic Stress Disorder Checklist (PCL); (3) Beck Anxiety Inventory (BAI); and (4) the second version of Beck Depression Inventory (BDI-II). The analysis of covariance (ANCOVA) was used to evaluate the effects of treatment. A P-value smaller than 0.05 was considered significant.

 Data analysis of 28 patients from the experimental and control groups showed that TPT significantly reduced the symptoms of post-traumatic stress, anxiety, and depression in the treatment group (P < 0.001 for symptoms of post-traumatic stress and anxiety, and P = 0.002 for depression). Such a difference was not seen in the control group.

 TPT may be an effective approach to reduce symptoms of post-traumatic stress, anxiety, and depression in Iranian women with breast cancer. Further investigations are required to confirm these findings, which may in turn help heath care professionals use TPT to promote the mental health of females with breast cancer.

 Cyclin-dependent kinase inhibitors (CKIs) are the negative regulator of cell cycle progression, which inhibits cyclin-cdk complexes, resulting in cell cycle arrest. Recently, we evaluated the effect of 5-Aza-CdR on DNMT1 gene expression in the WCH-17 hepatocellular carcinoma (HCC) cell line.

 The current study was designed to analyze the effects of 5-aza-2'–deoxycytidine (5-Aza-CdR, decitabine), 5-azacytidine (5-AzaC, vidaza), and 5'-fluoro-2'-deoxycytidine (FdCyd) on INK4a/ARF, CIP/KIP, and DNA methyltransferase 1 gene expression, apoptosis induction, and cell growth inhibition in colon cancer HCT-116 cell line.

 The colon cancer HCT-116 cell line was treated with 5-azaC, 5-Aza-CdR, and FdCyd at 24 and 48h. To determine colon cancer HCT-116 cell viability, cell apoptosis, and the relative expression level of the INK4a/ARF, CIP/KIP, and DNA methyltransferase 1 genes, MTT assay, flow cytometry, and qRT-PCR were done, respectively.

 5-azaC, 5-Aza-CdR, and FdCyd significantly inhibited colon cancer HCT-116 cell growth and induced apoptosis. Besides, they significantly increased CIP/KIP (p21CIP1, p27KIP1, and p57KIP2) and INK4 (p14ARF, p15INK4b, and p16INK4a) and decreased DNMT1 gene expression. Besides, minimal and maximal apoptosis were seen in the groups treated with FdCyd and 5-Aza-CdR, respectively. The IC50 for CAF for FdCyd was 1.72 ± 0.23 and 1.63 ± 0.21μM at 24 and 48h, respectively. The IC50 for CAF for 5-AzaC was 2.18 ± 0.33 and 1.98 ± 0.29 μM at 24 and 48h, respectively. The IC50 for CAF for 5-Aza-CdR was 4.08 ± 0.61 and 3.18 ± 0.50 μM at 24 and 48h, respectively.

 The 5-azac, 5-Aza-CdR, and FdCyd can reactivate the INK4a/ARF and CIP/KIP families through inhibition of DNMT1 activity.

 Colonic signet-ring cell carcinoma is a distinctive rare subtype of adenocarcinoma with a predilection for early metastasis. Among the rare extramammary metastatic adenocarcinomas to the breast, colonic signet-ring cell carcinomas constitute a small percentage. The distinction of a primary from a secondary breast signet-ring cell carcinoma is indispensable since it may result in different therapeutic approaches. Here we presented a rare case of metastatic breast signet-ring cell carcinoma from a rectal origin and review its distinctive histopathologic features.

 A 37-year-old woman presented with a breast mass 3 months after undergoing low anterior resection surgery to remove a rectal mass, diagnosed as signet-ring cell carcinoma. Histopathologic examination of the core needle breast mass biopsy revealed tumor cells with signet-ring cell cytomorphology. The performed immunohistochemistry confirmed carcinoma of colonic origin.

 Colorectal signet-ring cell carcinoma is a rare and aggressive tumor. Its metastatic spread is most seen in the intra-abdominal area, with seldom reported cases of breast metastasis. Histologically, it can mimic a primary breast carcinoma, especially if no prior history of colonic origin exists. Accurate diagnosis is important since these two entities carry different therapeutic management. Proper immunophenotyping, obtaining a thorough clinical history and imaging studies facilitate a correct diagnosis.
 

 Malignant melanomas of the parotid gland are relatively uncommon and usually seen as metastases from cutaneous or mucous sites of the head and neck region. Some malignant melanomas may metastasize before they regress. Therefore, identifying the primary origin of metastatic melanoma is sometimes difficult. Furthermore, metastasis to the breast from an extramammary site is uncommon and challenging. It may present as a well-defined rounded mass that histopathologically mimics the various architecture and cellular phenotypes. In addition, the immunohistochemical stains of some metastatic melanomas are equivocal and challenging.

 We presented a case of parotid gland malignant melanoma in a 42-year-old woman with metastasis to the breast in a short interval. Biopsy of parotid and breast lesions showed loss of immune-reactivity for several melanoma markers and was initially considered as malignant peripheral nerve sheath tumor and primary breast tumor, respectively.

 This case highlights the importance of obtaining past clinical history in surgical pathology cases to make a correct diagnosis. It also enhances our understanding regarding malignant melanoma as a mysterious tumor with various morphology and immunophenotype.