فصلنامه بیماری های پستان ایران
سال شانزدهم شماره 1 (پیاپی 60، بهار 1402)

The aim of this study was to evaluate the effectiveness of the adaptation improvement protocol based on the multimodal model on the level of mental health of women with breast cancer.

The current study is a randomized controlled clinical trial with pre-test and post-test with experimental and control groups. The present study was an applied study and the research method was quasi-experimental and its design was pre-test and post-test with experimental and control groups. The statistical population included patients with breast cancer referred to the specialized clinic of breast diseases in Mashhad. Among them, 30 were selected and randomly assigned to experimental and control groups. The experimental group was trained in adaptation improvement protocol based on the multimodal model and the control group did not receive any intervention. The research instrument was depression, anxiety and stress scale. Data were analyzed by analysis of covariance and SPSS-24 software.

The results of multivariate covariance analysis showed that there is a significant difference between the two groups in terms of the linear combination of depression, anxiety and stress subscales (Wickels lambda = 0.30, F =17.73, p <0.05). The results of univariate analysis of covariance showed that the adaptation improvement protocol based on the multimodal model has significantly reduced depression, anxiety and stress in women with breast cancer (P<0.001) and the effect size of the group on these variables was 65, 33 and 54, respectively.

The adaptation improvement protocol based on the multimodal model improved the level of mental health in women with breast cancer by creating spiritual, psychological, social, emotional and physical adaptation.

 In recent years, the role of psychological factors in physical diseases such as cancer has become more and more apparent and clarification of this role has been emphasized from various angles. The present study aimed to investigate the relationship between psychological capital with recurrence and sexual function in women with breast cancer.

 The design of the present study was descriptive-correlational implemented in 2021. The statistical population of the present study was all women with breast cancer in Iran who received a definitive diagnosis of cancer in 2015. Of those, 300 patients with this disease came to Tehran for treatment through sampling in the form of a plan Research entered. The tools used in this study included the Luthans Psychological Capital Questionnaire, Rosen's Sexual Function, and Simard's Fear of Recurrence. After collecting the questionnaire and extracting the primary data, the relationship between psychological components with fear of recurrence and sexual performance was analyzed.

 The majority of participants were bachelors (75 percent) and housekeeper ladies. The correlation between all the psychological capitals (hope, tolerance, self-efficacy, optimism) with sexual performance was positive and significant. There is a significant relationship between psychological capital and fear of recurrence. In addition, there is a relationship between psychological capital and the sexual function of women. Also, from the components of psychological capital, optimism can predict the fear of recurrence in the negative direction (R2 = 0.22) and sexual function in the positive direction (R2 = 0.06).

 Optimism as one of the psychological capitals can predict the fear of recurrence and sexual performance. Also, optimism can affect various dimensions of physical diseases such as cancer. Therefore, developing interventions to improve hope, optimism, resilience, and self-efficacy can help enhance sexual performance and fear of relapse in these patients.

 Breast cancer is the most common cancer in women and has the highest incidence rate among Iranian women. It can affect all aspects of mental health and subsequently affect a person's sexual performance. The present study was conducted with the aim of determining the relationship between sexual function with health anxiety and fear of recurrence in women with breast cancer history.

This cross-sectional study was conducted on 150 women aged 24-76 referring to the Breast Cancer Institute of Jihad University in Tehran, 2021. Three questionnaires, including the Health Anxiety Inventory (HAI-18), Female Sexual Function Index (FSFI-6), and Fear of Cancer Recurrence (FCR) were used to collect data and completed online. The data were analyzed by pearson's correlation coefficient, and One-Way ANOVA using SPSS 21.

There was a significant inverse correlation between sexual performance and health anxiety and sexual performance and fear of recurrence. Furthermore, the relationship between fear of relapse and health anxiety was significant. Also, there was a significant association between the level of education with the total score and all sexual function subscales except satisfaction and orgasm.

Based on this study, it is necessary to pay attention to the mental state and sexual function of women with breast cancer.

Breast cancer is a prevalent disease that has not been entirely treated by chemotherapy. This study attempted to investigate the effect of the cytotoxicity of Schiff bases derived from platinum (II) on the breast cancer cell line (SKBR3) and the expression of genes involving molecular pathways.

In this study, at first, the cytotoxicity of carboplatin (as the standard drug) and Schiff base derived from platinum (II) (12.5, 52, and 50 µM) on the SKBR3 cell line was investigated using MTT assay, and the half maximal inhibitory concentration (IC50) was determined. After cell treatment, RNA was extracted, and cDNA was synthesized. Then gene expression of various cellular pathways of apoptosis (BCL2 and BAX) and autophagy (ATG5, BECN1, TOP1, LC3, and HIF1A) was evaluated using the Real-time PCR method.

Cell treatment with platinum (II) Schiff bases complexes in various concentrations showed that complex A (IC50=34.76±2.16µM) had the most significant toxicity compared to other studied compounds. The synthesized complexes may affect the cytotoxicity of SKBR3 through suppression of HIF1A and TOP1 genes. Statistical analysis of samples was conducted using SPSS software program, two-way ANOVA analysis, and Kruskal-Wallis tests at the significance level of 0.05 and 0.001.

In this research, platinum-based Schiff bases showed a significant cytotoxic effect against the SKBR3 cell line. More information in this field can pave the way for discovering anticancer platinum drugs with more favorable properties.

 Sexual health is a significant concern for cancer survivors. This study aims to understand how breast cancer survivors and service providers in Iran perceive and experience sexual health services for breast cancer survivors.

The present study used a qualitative approach and conventional content analysis method. Data were collected through the use of unstructured in-depth interviews with participants. The main interview question was how the sexual health of patients is addressed and what services are provided in this regard.

Data analysis led to the emergence of two themes entitled passivity in providing sexual health services and physically oriented services  provided in the field of body image disorder.

The results showed that the sexual health services provided to breast cancer survivors are passive and limited to their expressed complaints. Moreover, while providing body image services is desirable and aligns with global standards in the physical aspect, there appears to be a deficiency in the psychosocial aspect. Providing services using a multidisciplinary approach, training employees about the late effects of cancer, and paying attention to the biopsychosocial aspects of sexual health can improve breast cancer survivors' quality of life.

Periodontitis is an inflammation of teeth-supporting tissues. Regarding the connection between breast cancer treatments and periodontal disease, the level of Interleukin-29 may be considered as a tool for prognostic prediction of disease to take adequate measures to prevent it. This study was conducted to assess the level of Interleukin-29 among women with breast cancer and periodontitis, and the quantity of HSV-1 antigen was also assessed.

This cross-sectional study was conducted on 90 women with breast cancer divided into three groups: periodontal patients after receiving chemotherapy (n=30), periodontal patients not receiving chemotherapy treatment (n=30), and patients without periodontitis as a control group (n=30). The levels of Interleukin-29 and HSV-1 antigen were measured using saliva samples of individuals and the ELISA method. The mean level of Interleukin-29 and HSV-1 antigen was analyzed among the three groups using the ANOVA test.

The mean of HSV-1 antigen in the group of patients with periodontitis after receiving chemotherapy was higher than the other two groups, but no statistically significant difference was observed among the three groups (P=0.071). The mean of Interleukin-29 level in the periodontitis group receiving chemotherapy (296.85) showed no significant differences as compared to the periodontitis group not receiving chemotherapy (314.99) and the control group (303.79) (P=0.572).

Compared to patients without periodontitis, the mean of Interleukin-29 level was greater in breast cancer patients with periodontitis. Moreover, a high level of HSV-1 antigen in periodontal patients receiving chemotherapy revealed an increased risk of periodontitis in breast cancer patients, emphasizing the importance of paying attention to oral and dental health in breast cancer patients.

The crucial and vital player in tumor recurrence is the tumor-initiating cells (TICs). OCT4 is a widely appreciated non-cell surface for TICs, dedicating detrimental properties to these cells, including self-renewal, epithelial-mesenchymal capacity, and drug resistance. OCT4 and its partners Sox2 and Nanog are up-regulated in stem cells; on the other hand, normal stem cells are more resistant to various herbal remedies like curcumin. Based on these facts, the main objective of the present study was to investigate the alteration of the mentioned genes expression after curcumin treatment in breast cancer cell, human bone marrow mesenchymal stem cells (hBM-MSCs), and non-tumor fibroblast cells (HSFPI3).

MTT assay and AnnexinV/PI were performed to calculate the effective concentration of curcumin. To assess the expression level of OCT4 and Nanog, real-time PCR was performed to quantify the alteration of the mRNA expression of the mentioned genes after treatment in MDA-MB231, hBM-MSCs, and HSFPI3.

Curcumin could not induce significant apoptosis in hBM-MSCs and HSFPI3 even after 24 and 36 hours after treatment in a toxic concentration for cancer cells. After 36-hour treatment with DNC, the mRNA expression of Oct4-B1 in both normal cells enhanced significantly compared to untreated samples. Furthermore, in HSFPI3 cells, the Nanog mRNA expression increased after this treatment.  The expression of both genes decreased in the MDA-MB231 after treatment with DNC.

Non-tumor cells are more resistant to the curcumin treatment compared to cancer cells. The reason is at least partially due to the different expression pattern results in these cells after treatment with this reagent. Pluripotent markers, including Oct4-B1 and Nanog are proposed to play a vital role in these non-tumor cells resistant to curcumin.