فصلنامه بیماری های پستان ایران
سال هجدهم شماره 1 (پیاپی 68، بهار 1404)

In recent years, significant advancements have been made in the field of breast imaging. The present study provides an overview of keywords and the participation trends of various countries in the field through scientometric analysis. Moreover, research funding from institutions in the field of breast imaging, as an important factor contributing to scientific progress, is also examined.

Relevant articles were extracted from the Web of Science database, and their data were analyzed using Python scripts to evaluate keyword trends and research support.

The results indicated that research on breast imaging primarily focuses on the keywords “breast cancer” and “mammography,” while the use of “deep learning” has grown substantially since 2014. The National Institutes of Health (NIH) is at the forefront of funding these studies, and other organizations, such as the National Natural Science Foundation of China and the National Cancer Institute, also play significant roles. Other entities, including the World Health Organization and the Japan Cancer Research Institute, have also provided notable support.

Funding trends show that support from the NIH peaked in 2014, whereas the National Cancer Institute and the National Science Foundation exhibited varying patterns of funding. Internationally, the National Natural Science Foundation of China has significantly increased its support by 2022, and organizations such as the Korea National Research Foundation have taken a more active role. This reflects a growing global effort in breast imaging research. In recent years, the use of “deep learning” has risen significantly, underscoring an increasing interest in artificial intelligence and deep learning for breast imaging analysis.

Sexual problems in breast cancer patients with a history of mastectomy are an issue that impairs their quality of life and is associated with an increase in medical and health costs. The present study aimed to predict sexual function based on the dimensions of mindfulness (trait, relational, and sexual) and the mediating role of body image in women with breast cancer who have undergone mastectomy.

This correlational descriptive research was conducted in 2023-2024. The sample included 181 married patients with mastectomy surgery who were selected using convenience method. Sexual Mindfulness Measure (SMM), Five Facet Mindfulness Questionnaire (FFMQ), Relationship Mindfulness Measure (RMM), and Marital Sexual Function Scale (MSFS) were used to investigate the research objectives. Sampling was conducted both online and in person. The SPSS (version 25) and R software were used for data analysis. The data were analyzed in the descriptive section using mean, frequency, standard deviation, and Pearson correlation coefficient, and in the inferential statistics section using structural equation modeling.

The results showed that the proposed model has a good fit. Moreover, the two dimensions of sexual and relational mindfulness directly predicted marital sexual functioning (P<0.01). Additionally, the two dimensions of relational and sexual mindfulness with the mediating role of body image could significantly predict sexual function in married women with a history of mastectomy (P<0.01).

To enhance the sexual function of patients, therapists are recommended to focus on components such as sexual mindfulness, relational mindfulness, and body image.

Cancer is the world’s second leading cause of death, where 48,998 new breast cancer cases were found everyyear in Indonesia. Surgery procedure as primary treatment for breast cancer induced inflammation and immunosuppression, releasing inflammatory cytokines namely IL-6 and Platelet-To-Lymphocyte Ratio (PLR) as proinflammatory mediator. Pectoralis Nerve (PECS) II combination with general anesthesia (GA) is a common anesthetic technique in breast cancer surgery. Research about PECS Block and GA effect on proinflammatory biomarkers in early breast cancer surgery is still limited. This research aims to study the effects of the GA and PECS II combination compared to GA alone on IL-6 and PLR in breast cancer patients undergoing breast removal surgery.

This is an experimental study with pre-post test randomized control group design. 48 breast cancer patients who underwent breast removal surgery who meet the research criteria were included in this research. IL-6 and PLR were taken from blood sample 24 hour before and after surgery.

 Postoperative IL-6 levels were higher in GA group (11,18 ± 6,81) compared with PECS block (10,43 ± 9,40). Postoperative PLR levels were higher in GA group (268,79 ± 208,48) than PECS block (160,91 ± 62,58). The difference between IL-6 and PLR levels was found to be higher in GA group (2,35 ± 3,54 and 54,13 ± 110,61).

IL-6 and PLR as inflammation biomarkers were found to be lower in combination of PECS block II with GA than in GA alone.

Breast cancer is the most common cancer among Iranian women. As lack of education and early detection programs in developing countries is the main cause of increased morbidity and mortality. This study aimed to investigate self-examination among nomadic women who have received little attention.

This was a cross-sectional study with a sample size of 432 nomadic women served by the Health Center of Shiraz University of Medical Sciences, selected using a multistage sampling method. Information was collected through a checklist divided to demographic, awareness, breast self-examination, self-care, and screening barriers’ parts by trained staff. All analysis was done at significance level of 0.05 using Stata software version 14.

The mean age of individuals was 53.09 ± 8.94 years, of which 223 (51.6%) were illiterate, and 380 (88%) married. Also, the mean score of awareness was higher in those who perform breast self-examination (BSE) 1-3 times a year (23.09 ± 8.87) and those who see a doctor for periodic examinations (25.42 ±7.29) (p<0.001). Finally, according to the Pearson test, there is an inverse and intermediate correlation between awareness and screening barriers (r=-0.309, p<0.001)

This study shows that awareness and barriers to screening are inversely correlated, and considering that more than half of the population is illiterate, this study may draw the attention of health authorities to increase awareness of BC and pay more attention to this population.

To analyze the long-chain non-binding nuclear factor κB interaction in breast cancer patients infected with human papillomavirus (HPV) type 16/18 and its correlation with the prognosis of breast cancer.

Select 400 breast cancer patients (observation group), and 50 benign breast disease patients (control group) admitted to Alkarama and Alyarmook Hospitals from Jan 2017 to January 2022. NKILA expression by using (ELISA and qPCR) and the serum index levels were detected.

The relative expression of NKILA in the tumor tissue of the patients in the observation group was significantly lower than that of the adjacent tissue (P<0.05), and the relative expression of NKILA in the adjoining tissue was considerably lower. Compared with the control group (P<0.05). The relative expression of NKILA and the high expression rate of NKILA in tumor tissues of the HPV 16/18 infection group were significantly lower than those of the non-HPV16/18 infection group. The relative expression of NKILA and the high expression rate of NKILA in tumor tissues in the recurrence and metastasis group were lower than those in the non-recurrence and metastasis group. (all P < 0.05)

The expression of NKILA is significantly reduced in breast cancer lesions compared to adjacent tissues and benign lesions. This decrease is more pronounced in patients with HPV 16/18 infection, triple-negative breast cancer, and those who have undergone surgical treatment. Furthermore, NKILA expression is markedly lower in patients with post-recurrence and metastatic breast cancer. These findings suggest that NKILA may serve as a potential biomarker for disease progression and recurrence in HPV-associated breast cancer.

With the rising incidence of breast cancer, the need for an effective diagnostic method, particularly in multifocal and multicenter breast cancers, becomes increasingly urgent. The present study aimed to evaluate the diagnostic accuracy of magnetic resonance imaging (MRI) in detecting multifocal and multicentric breast cancers.

This study was conducted cross-sectionally. The study population included patients with breast cancer who underwent MRI before surgery. The sample required for the study was collected through the census method. The Mc Nemar test was used to compare the results of the two methods of pathology and MRI. In addition, the Receiver Operating Characteristic (ROC) curve was used to determine the accuracy of MRI in diagnosing multifocal and multicentric breast cancers. All analyses were conducted using SPSS software (version 22).

In general, 94 patients were included in the study. The average age of the patients was 45.03 ± 11.37 years. Of the 21 cases reported based on the MRI results of the multifocal cancer, 9 (42.9%) had pathology consistent with the MRI results (P=0.238). The sensitivity, specificity, accuracy, and area under the curve (AUC) for the MRI diagnostic method were calculated as 60%, 86.1%, 80.8%, and 73% (CI 95%: 57.4 – 88.6), respectively.

Based on the research findings, this high specificity level contributes to the overall accuracy of MRI as a diagnostic tool, supporting its use in the diagnosis of multifocal and multicentric breast cancers.

Different methods of cancer treatment can lead to the destruction of fertility. Preserving fertility before starting treatment provides an opportunity for future fertility. This study aimed to explain how to provide fertility preservation services and the barriers to receiving them for breast cancer patients in Iran.

This qualitative study was conducted using the conventional qualitative content analysis method. Participants included service providers and breast cancer survivors who were purposively selected. Sampling continued until data saturation. Data were collected through the use of unstructured, in-depth interviews with participants. Data analysis was performed using the Granheim and Landman method (2004).

Data analysis led to the emerging theme entitled insufficient coverage of fertility preservation services in breast cancer patients. It means that despite access to different fertility preservation methods by the latest technology in the world, there are obstacles, such as lack of equal access to services, high costs, lack of insurance coverage, urgency in starting treatment, priority to save the patient's life, and lack of information to some patients, prevents some eligible people from receiving fertility preservation services.

Considering the importance of having children in improving the quality of life of breast cancer survivors, it seems necessary to remove the barriers to fertility preservation in breast cancer survivors.

Breast cancer is a prevalent global cancer, and surgery is vital for treatment. The debate between Breast-Conserving Surgery (BCS) and mastectomy has lasted for decades. This research aims to compare the quality of life, disease-free survival rates, and post-surgery outcomes of BCS and mastectomy in breast cancer patients.

This retrospective study involved 100 women aged 18-80 years with non-metastatic breast cancer who underwent mastectomy or BCS between January 2019 and June 2024. Patient data were collected from hospital records. Quality of life was assessed using the Arabic EORTC QLQ-BR23 questionnaire, and cosmetic outcomes were evaluated with the Harris scoring scale. Disease-free survival was determined through a medical record review. Data analyses were conducted using the Student’s t-test and the Chi-square test.

The BCS group demonstrated a significantly better body image than the mastectomy group (p< 0.01). The mastectomy group had a mean breast symptoms score of 48.5 compared to 62 for the BCS group. No significant differences were found between the groups concerning arm symptoms, hair loss upset, or systemic therapy's adverse effects. At 36 months post-surgery, disease-free survival rates were similar, with the mastectomy group at 87% and the BCS group at 82% (P=0.37).

The long-term disease-free survival rates for mastectomy and BCS are similar. However, BCS is associated with reduced breast-related discomfort and improved body image. This underscores the importance of tailoring care plans to the unique characteristics of each patient, tumor biology, and individual preferences, a responsibility that all healthcare providers should uphold.

Breast-conserving surgery (BCS) followed by radiotherapy is the standard treatment for early stages of breast cancer. Margin status may significantly impact local recurrence (LR) in patients treated with BCS. The present study aimed to evaluate the relationship between margin status and LR.

In a retrospective longitudinal study, we analyzed medical records of 1,716 breast cancer patients treated by BCS at Motamed Cancer Institute (MCI) from 2001 to 2020. The collected data included pathology report data, such as tumor size, axillary involvement, molecular subtype, margin status, histological grade, lymphovascular invasion, and LR, as well as demographic characteristics. Margins were defined as close if surgical margins were less than 2 mm, as free if surgical margins were higher than 2 mm, and as positive if malignant cells were present in one of the tissue edges.

It was found that 133 (7.7%) patients had LR. The mean follow-up time was 46.79 (±34.47) months. The multivariate logistic regression analysis showed that the presence of involved margins (OR=9.27; 95% CI: 2.08-41.36) and stage III of cancer (OR=6.69; 95% CI: 1.95-22.95) were correlated with LR.

The findings indicated a low LR rate for breast cancer. Margin involvement and stage III breast cancer were correlated with high LR risk and should be considered for these patients before surgery to reduce the LR rate. Prospective trials and long-term follow-up are required to confirm these results.

The present case-control study was conducted between September 2016 and August 2019 at Ayatollah Khansari Hospital in Arak (Iran) and aimed to comprehensively identify risk factors associated with breast cancer among local women. 

The research included 400 confirmed breast cancer cases and 400 age-matched healthy controls randomly selected from female hospital visitors. Sample size calculation was justified based on prior epidemiological studies assuming a breast cancer prevalence of approximately 50%, with calculations set at a 95% confidence interval and 80% statistical power. Data collection was performed using an interviewer-administered standardized questionnaire covering domains, such as socio-demographic characteristics, reproductive history, medical conditions, lifestyle behaviors, and family history. Data analysis utilized binary and multivariate logistic regression conducted through the SPSS (version 16) software, allowing for rigorous identification of independent risk factors. 

The results identified significant breast cancer risk factors, notably including family history of breast cancer (OR=12.02, 95% CI: 4.20–32.56, P<0.001), low education level (OR=6.38, 95% CI: 4.71–11.47, P<0.001), older age at first pregnancy (OR=3.21, 95% CI: 1.83–4.61, P<0.001), and early menarche (OR=2.43, 95% CI: 1.81–4.33, P<0.001). Urban lifestyle was found not to be significantly associated with breast cancer risk in multivariate analysis (OR=1.13, 95% CI: 0.98–1.40, P=0.068). 

These findings underscore the necessity for targeted genetic screening and tailored educational programs, particularly addressing women with lower educational status and family history of breast cancer, to improve early detection and prevention.