فصلنامه بیماری های پستان ایران
سال سیزدهم شماره 2 (پیاپی 49، تابستان 1399)

Therapies for many of diseases, especially cancer, have been improved significantly in the recent years, resulting in an increase in the number of patients who do not experience mortality. Therefore, the application of cure models is more suitable for survival analysis in this population than the usual survival models are. The aim of this study was to estimate the recurrence-free cure rate of breast cancer using the Poisson Beta Weibull (PBW) cure model and to determine the correlating factors.

The data for this study came from a cohort of 271 breast cancer patients who had visited Motamed Cancer Institute, Tehran, between 1997 and 2006 and were followed up from 2013 to 2017. In this study, the time interval between diagnosis and recurrence of the disease was calculated, and the effect of factors was estimated using a Cox survival model as the most common method of survival analysis. Then, by calculating the cure rate from recurrence, the effect of factors on patients’ survival and cure was analyzed using Weibull and PBWcure models. Data were analyzed using R, v 3.4.1, at a significance level of 5%.

The results showed that 17 (6.3%) of patients experienced relapse after treatment. One-, 3-, and 5-year survival rates for the patients were 0.97, 0.96, and 0.93, respectively. The results of this study showed that PBW Model has a better fit to data with the smallest AIC. Based on this model, estrogen receptor positivity was a significant factor affecting patients' cure (HR = 0.27) and the cure fraction was estimated to be 92%.

Estrogen receptor positivity is the most important factor affecting patients’ cure. The Poisson Beta Weibull cure model has a better fit to data. Since the model analyzes factors affecting both survival and cure, using this model is recommended in the analysis of the events with low incidence.

Breast cancer is the second most common cancer and one of the most common causes of death in women. Metastasis is also a challenge for breast cancer patients, affecting their survival. This study aimed to determine the survival rate and measure the factors affecting the progression of the disease from the time of diagnosis by considering metastasis as an intermediate condition using the disease-mortality model.

This retrospective study included 493 women with breast cancer referred to Imam Khomeini Clinic, Hamadan, between 2001 and 2017. First, the required information was extracted from patients’ files according to a checklist, and then the effect of background and clinical variables on the natural course of the disease was examined using a multistate model.

The risk of metastasis for people whose tumor size was 2-5 cm and >5 cm was higher than that for people whose tumor size was <2 cm (HR, 1.28; [95% CI, 1.10-1.79]; and HR, 2.48; [95% CI, 1.25-3.91], respectively). People with estrogen-, progesterone-, and epidermal growth factor–positive tumors were at higher risk for metastasis (HR, 2.58; [95% CI, 1.96-3.40]; HR, 1.69; [95% CI, 1.7-2.26]; and HR, 1.73; [95% CI, 1.29-2.31], respectively).

Public education on the importance of periodic examinations and early detection of breast cancer, as well as recognizing the symptoms of the disease, can help a person detect the disease early. Therefore, the patient can see a doctor before the tumor gets bigger and the disease progresses, which will help in timely treatment of the disease.

Breast self-examination is a simple, inexpensive, and technology-free tool for early detection of breast cancer, and in most countries, specifically in developing countries, it is the only genuine way to detect breast cancer rapidly. So, the current study was done to determine the factors affecting breast self-examination behavior in housewives.

This descriptive-analytical study was done with 450 housewives aged 20-40 years visiting health centers in Birjand, South Khorasan. The sample was randomly selected using a multistage cluster sampling method. Data were collected through a researcher-made questionnaire consisting of demographic information and transtheoretical model constructs and then were entered into the SPSS 19 software. Variables of normal distribution were analyzed using t tests and one-way analysis of variance, while non-normal data were analyzed using the Kruskal-Wallis, Mann-Whitney, and Fisher’s exact tests.

The mean age of women was 30.7 ± 5.2 years. Based on the structure of the change steps, 32.9% of the women were at the precontemplation stage, 19.6% at the contemplation stage, 23.3% at the preparation stage, 18.2% at the action stage, and 6% at the maintenance stage. The mean score was 2.33 ± 0.57 for the decision structure, 2.51 ± 0.82 for the change process, and 1.61 ± 0.81 for the self-efficacy. Among the variables studied, the level of education and awareness showed a significant relationship with the model constructs (p < 0.05).

According to the results of the study, most women studied did not perform breast self-examination. Consequently, it is necessary to perform educational interventions to improve the behavior of breast self-examination.

Cancer, the uncontrolled division of cells, occurs because of environmental factors and genetic disorders. Breast cancer is the most common cancer and the second leading cause of cancer death in women. Four categories of key genes, including oncogenes, tumor suppressor genes, repairing genes, and programmed– cell death genes, contribute to cancer development. Bromoacetic acid is a chemical compound that is produced both artificially and by bacterial fermentation.

To investigate the effectiveness of bromoacetic acid in inhibiting the MCF7 cell line proliferation, the MTT assay was done and the expression of genes responsible for the regulation of apoptosis, including BAK, CASP3, CASP8, and BIM, was measured after 24, 48, and 72 hours of cell treatment with 2.5 µg/ml of bromoacetic acid using real–time PCR.

The results of the gene expression assays showed that bromoacetic acid treatment increased the expression of key genes BAK, CASP3, and, CASP8. However, the expression of BIM decreased at all three time points compared with controls.

bromoacetic acid can induce cell death via intrinsic and extrinsic apoptosis pathways.

Cachexia is a cancer complication that is associated with increased weight loss. Apoptosis has been known as one of the tissue-wasting pathways that cause weight loss and multiple organ failure in cancer-related cachexia. Various factors, including exercise training, can be effective in the reduction of cancer cachexia. In the present study, the effect of four weeks of high-intensity interval training (HIIT) on some biochemical indices of apoptosis in the liver tissue of breast tumor-bearing mice was investigated.

In the present experimental study, female BALB/c mice were randomly divided two cancerous groups (control and HIIT) following the induction of breast cancer by the injection of the 4T1 cell line and sham group (phosphate buffer saline injection). Each HIIT session included 6 intervals of 3 minutes and 20 seconds (80%-95% of VO2max) with 1-min active recovery (30%-35% of VO2max), performed for 4 weeks, 5 days per week.

The level of caspase-3 showed a reduction in the HIIT group compared with the control group (P < 0.01). The results also demonstrated an increase in the level of Bcl-2 and Bcl-2 to Bax ratio in the HIIT group compared with the control group (P = 0.01).

Based on the results, it seems that HIIT can reduce liver tissue wasting associated with breast cancer by decreasing caspase-3 and increasing Bcl-2 to Bax ratio.

Breast cancer is the most common cancer and leading cause of death among women worldwide. The aim of the present study was to determine synergistic effects of 5 weeks of endurance training along with curcumin on cancer progression, levels of VEGF-A, and gene expression of VEGFR in cancer tissue of female Mice with breast cancer.

The present study was an experimental study. Forty female BALB/c mice were transplanted with 4T1 tumors and randomly divided into four groups including an endurance training group (E) (5 weeks, five days a week), a curcumin group (CC), an endurance training along with curcumin (E-C), and a control group (C). All animals were killed 24 hours following the last training session, and tumors were immediately extracted. Levels of VEGF-A and gene expression of VEGFR were determined by a western blot and quantitative real-time PCR, respectively. Data were analyzed with a one-way analysis of variance. The level of significance was set at 0.05.

The results of the present study showed a significant decrease in cancer progression (p < 0.001), tumor levels of VEGFA (p < 0.001), and VEGFR expression (p < 0.001) in the E, CC, and—especially—E-C groups compared with the control group.

It seems that 5 weeks of endurance training in combination with curcumin supplementation may have greater inhibitory effect on angiogenesis mechanisms, including VEGF-A/VEFR axis, resulting in greater decrease in cancer progression in mice with breast cancer in comparison with E and CC groups.

Idiopathic granulomatous mastitis (IGM) is among the chronic diseases of the breast, which is more common in Middle Eastern countries than in Western countries. Since the etiology of the disease is not well known, there is no international consensus on the management of the disease. Antibiotic, Non-Steroidal anti-inflammatory drugs (NSAIDs), corticosteroids, cytotoxic and immunosuppressive medications, surgery, and conservative management are among the therapeutic options. Considering the fact that management of IGM needs long-term treatment and in the long-term, most of the medications may show the side effect, treatment with corticosteroids and other immunomodulators or cytotoxic drugs should be recommended cautiously in a patient whose disease is confined to the breast.According to the evidence and long-term experience, the authors recommend applying conservative management along with the training of the patient on how to drain the collections by physical maneuvers. Obviously, if granulomatous mastitis would be a part of the clinical syndrome of a systemic disease, appropriate treatment should be done according to the underlying disease.