Archives of Breast Cancer
Volume:3 Issue: 1, Feb 2016

The technique most frequently employed for breast reconstruction, either immediate (IBR) or delayed (DBR), is the insertion of a prosthesis. The placement of a foreign body always carries the risk, albeit small, of peri-prosthetic infection and exposure of the implant that necessitates its removal, signaling the temporary or permanent failure of the reconstruction.
We retrospectively analyzed data of 738 consecutive patients immediate implant-only breast reconstructions between 1989 and 2005 in order to evaluate the contributing factors of failure.
Our statistical analysis identified 3 statistically significant risk factors of implant extrusion: irradiation (P = 0.01), post-operative chemotherapy (P = 0.03), and the use of non- Becker expanders (P = 0.02).
It is important, especially for the multidisciplinary breast cancer team members, to be aware of these factors in order to make the optimal decision for immediate reconstruction after mastectomy and the suggested techniques. The patients should also be aware, as part of a shared medical decision, of the risks and their frequency before accepting IBR.

Breast cancer is the most common malignancy among women. It is estimated that 1 in 10 women worldwide is affected by breast cancer during their lifetime. In 5 to 10% of breast cancer patients, the disease results from a hereditary predisposition, which can be attributable to mutations in either of two tumor suppressor genes, BRCA1 and BRCA2 to a large extent. BRCA2 6174delT mutation constitutes the common mutant alleles which predispose to hereditary breast cancer in the Ashkenazi population with a reported carrier frequency of 1.52%. In this study, we investigated the presence of the 6174delT mutation of the BRCA2 gene in Libyan woman affected with breast cancer and compared the results with those of other population groups.
Eighty- five Libyan women with breast cancer in additions to 5 relatives of the patients (healthy individuals) were recruited to this study. We obtained clinical information, family history, and peripheral blood for DNA extraction and analyzed the data using multiplex mutagenic polymerase chain reaction (MS-PCR) for detection of 6174delT mutation in the BRCA2 gene.
The 6174delT of the BRCA2 gene was not detected either in the 85 patients with breast cancer (18 with familial breast cancer and 67 with sporadic breast cancer) nor in the 5 healthy individuals.
The present study showed that the 6174delT of the BRCA2 gene was not detectable using mutagenic PCR in the Libyan patients with breast cancer and can be considered to be exceedingly rare

The axillary and supraclavicular nodal volume treatment results in improvement of local control and survival after breast conserving surgery (BCS) or modified radical mastectomy (MRM). Studies on the depth of these nodes have questioned the consistent use of standard fields for all patients. This study was done to assess the dose delivery to these lymph nodes with conventional treatment techniques according to body mass index (BMI).
Twenty six patients with breast cancer undergoing breast surgery were included and computed tomography (CT) simulation was done. Their axillary and supraclavicular nodal volumes were contoured for planning target volume (PTV). Supraclavicular and posterior axillary fields were generated for each patient with digital reconstruction radiography (DRR) technique. Then the dose distribution of the two conventional methods - anterior-posterior field (AP), and anterior field with posterior boost (AP boost) - for total dose of 5000 cGy, was examined with radiotherapy dose plan program. An AP planned field suitable for PTV, was designed and compared to AP boost. The diameter of axilla was measured at the center of AP field in CT scan. Data were analyzed in relationship to BMI.
PTV coverage and excessively irradiating normal tissues (hot points), proved to have significant differences in each method (p Current standard fields are not appropriate for all patients, because of poor coverage of PTV. To sum up, 3D CT planning is strongly recommended for patients with high BMI.

We aimed to create a shortened form of the Champion Health Belief Model instrument which is a widely used questionnaire about breast cancer screening behaviors with acceptable validity and reliability.
The Persian version of the Champion Health Belief Model (CHBM) instrument consists of 57 items in 8 concepts. The subjects of the study were 40 female faculty members and 34 nurses of Tehran University of Medical Sciences in 2014. Based on the results, the most influential questions in each concept were chosen and then analyzed for internal consistency and the mean scores of the concepts were compared to the original questionnaire. Next, the original form was delivered to a different population. The mean scores of each concept were compared between original and short forms. At last, the same second population was asked to fill in the shortened form in a two-week interval and a test re-test comparison was done.
In the first step, out of 57 items in the original questionnaire, 28 items were selected based on their influence on the mean score of each concept. In 40 female faculty members who were all above 40, all of the Cronbach’s alphas for all subscales were above 0.6 (ranging from 0.624 to 0.830) in the shortened form questionnaire; although they were lower than the original form. There were no significant differences between short and original questionnaires in terms of mean subscale scores. In the second step, in the second population including 34 female nurses aged over forty years in a university medical center, there was again no significant statistical difference between the 28-item and 57-item instruments. In the third step, two weeks later, the completed shortened questionnaire among 20 subjects of the same population of the nurses showed similar results, indicating the reliability of the newly design shortened form of the questionnaire.
The shortened 28-item form of the CHBM instrument seems to be both valid and reliable, and less time-consuming. Its results can be comparable to other studies that used the standard form.

This study aims to demonstrate the frequency of malignant breast cancer (BC) according to pathologic findings in Birjand during 2011-2013 years.
For this cross-sectional study, the sample consisted of pathologic records from 229 breast biopsies of two hospitals in Birjand.
Most of the biopsies in women were malignant cases which nearly 90% of them were detected after lymph node involvement. The mean age of women with malignant BC was 48.8 years.
A notable proportion of our cases were diagnosed in metastatic stages as advanced BC. It further highlights the importance of screening and diagnosis at earlier stages.

Gestational or pregnancy-associated breast cancer is defined as breast cancer diagnosed during pregnancy, within the first postpartum year, or during lactation. Breast cancer is one of the most common cancers in nonpregnant and pregnant women.
A 29-year-old pregnant woman presented at eight weeks gestational age with a palpable breast nodule. On breast ultrasound evaluation, only probably benign findings were detected. The pregnancy was uneventful until the third trimester when she started to have a severe back pain which became gradually resistant to medical therapy. Therefore, at 33 weeks, she was assisted at an emergency care facility and a highly suspicious breast mass was detected. A core biopsy was performed that revealed an invasive ductal carcinoma grade 3 with lymph node metastasis.
After several imaging studies, it was diagnosed as a stage 4 breast cancer with bone, liver, and pulmonary metastasis. At thirty four weeks gestation, the pregnancy was terminated by C-section and she started to receive palliative radiation therapy one week later. She also received several cycles of palliative chemotherapy. Nineteenth months after C-section, progression of the disease was observed and a cerebellar metastasis was found. Unfortunately, two months later, her clinical condition deteriorated and the patient died.
Gestational breast cancer represents a clinical situation of utmost important in which the health of both the mother and the fetus should be taken into account. Diagnosis is difficult due to the physiological changes of the mammary glands during pregnancy and lactation, and it usually occurs at an advanced stage.