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Breast (Edinburgh, Scotland) Apr 2014Neuroendocrine tumours (NET) of the breast are rare. Diagnosis depends on close scrutiny of core- or excisional-biopsy specimens for characteristic growth patterns... (Review)
Review
Neuroendocrine tumours (NET) of the breast are rare. Diagnosis depends on close scrutiny of core- or excisional-biopsy specimens for characteristic growth patterns (papillary, nesting or mixed), which should trigger immunohistochemical staining for neuroendocrine markers (in particular chromogranin and synaptophysin). The diagnosis is confirmed if a) >50% of the tissue specimen demonstrate neuroendocrine markers and b) in-situ ductal carcinoma is identified and/or imaging modalities exclude extra-mammary sites. Our literature search including the non-English literature identified 66 articles with data on 123 cases, including our own. Oestrogen receptors are not diagnostic for NET's of the breast as they are found in tumours of non-mammary origin, too. Half of reported cases of neuroendocrine tumours have axillary lymph node involvement. Breast-conserving surgery (wide local excision ± axillary clearance) is commonly performed for suitable tumours. Chemotherapy regimens utilised are commonly either platinum- (as for small-cell cancers) or anthracycline-based (as for primary breast cancers). Best management remains unknown.
Topics: Antineoplastic Agents; Biomarkers, Tumor; Breast Neoplasms; Carcinoma, Neuroendocrine; Female; Humans; Neuroendocrine Tumors
PubMed: 24342375
DOI: 10.1016/j.breast.2013.11.005 -
The Lancet. Oncology Aug 2008Oestrogen and family history are two of the most important risk factors for breast cancer. However, these risk factors cannot explain the differences in the incidence... (Review)
Review
Oestrogen and family history are two of the most important risk factors for breast cancer. However, these risk factors cannot explain the differences in the incidence and recurrence of breast cancer between premenopausal and postmenopausal women. In this paper I propose that, in premenopausal women, an iron deficiency caused by menstruation stabilises hypoxia inducible factor-1alpha, which increases the formation of vascular endothelial growth factor. This mechanism results in premenopausal women being more susceptible to angiogenesis and, consequently, leads to a high recurrence of breast cancer. Conversely, increased concentrations of iron in postmenopausal women, as a result of menstrual cessation, contribute to a high incidence of breast cancer via oxidative-stress pathways. Although the focus of this Personal View is on iron, this by no means negates the roles of other known risk factors in breast-cancer development. Characterisation of the role of iron in breast cancer could potentially benefit patients by decreasing recurrence and incidence and increasing overall survival.
Topics: Adult; Age Factors; Breast Neoplasms; Estrogens; Female; Humans; Incidence; Iron; Iron Deficiencies; Middle Aged; Neoplasm Recurrence, Local; Neovascularization, Pathologic; Postmenopause; Premenopause; Prognosis; Risk Factors; Sensitivity and Specificity
PubMed: 18672216
DOI: 10.1016/S1470-2045(08)70200-6 -
American Society of Clinical Oncology... 2016Personalized medicine is emerging as an important guiding principle in diagnosis and treatment. This means not just doing more for some, but safely doing less for... (Review)
Review
Personalized medicine is emerging as an important guiding principle in diagnosis and treatment. This means not just doing more for some, but safely doing less for others. The lessons learned about the biology of breast cancer over the last 2 decades have enabled us to understand the incredible heterogeneity of breast cancer and its associated behavior. Although much work remains, there is an emerging opportunity to identify and recognize more indolent forms of breast cancer, made more prevalent through the widespread adoption of screening. With our improving systemic therapies and improved molecular tools, we now have the opportunity to reduce the burden of treatment in women with lower-risk tumors. Our surgical treatments have evolved, with less morbid and more cosmetic procedures. In this article, we review the indications for further reducing local therapy, including adjuvant radiation.
Topics: Breast Neoplasms; Early Detection of Cancer; Female; Humans; Mastectomy, Segmental; Neoplasm Staging; Precision Medicine; Radiotherapy, Adjuvant
PubMed: 27249759
DOI: 10.1200/EDBK_159060 -
Journal of Traditional Chinese Medicine... Aug 2021To investigate the effects of Aspongopus(A.)chinensis hemolymph on the proliferation and metastasis of breast cancer cells.
OBJECTIVE
To investigate the effects of Aspongopus(A.)chinensis hemolymph on the proliferation and metastasis of breast cancer cells.
METHODS
The in vitro effects of A. chinensis hemolymph were investigated in murine (4T1) and human (HCC1937) breast cancer cell lines. Cytotoxicity, cell apoptosis, and cell migration were evaluated by using the cell counting kit-8 assay, Hoechst staining, and wound healing experiments, respectively. A syngeneic mouse model was established to evaluate the in vivo effects of the hemolymph extract on tumor growth and metastasis. Mouse body weight, tumor size, blood levels of function-related enzymes, and pathological features of the liver and kidney tissues were evaluated.
RESULTS
The hemolymph of A. chinensis significantly inhibited in vitro tumor cell migration and viability while inducing apoptosis. Furthermore, it inhibited in vivo tumor growth and metastasis with a minimal effect on mouse body weight, and did not induce liver or kidney damage.
CONCLUSION
Our results suggested that the A.chinensis hemolymph has antitumorigenic properties, suggesting it has potential as a novel therapeutic option for the treatment of metastatic breast cancer.
Topics: Animals; Apoptosis; Breast Neoplasms; Cell Line, Tumor; Cell Movement; Cell Proliferation; Female; Hemolymph; Humans; Mice; Mice, Inbred BALB C; Neoplasm Metastasis
PubMed: 34392644
DOI: 10.19852/j.cnki.jtcm.2021.03.004 -
Asian Pacific Journal of Cancer... Nov 2022Breast cancer remains the most frequent and lethal cancer among women worldwide. This study aimed to investigate the characteristics, prognostic factors and outcome of...
INTRODUCTION
Breast cancer remains the most frequent and lethal cancer among women worldwide. This study aimed to investigate the characteristics, prognostic factors and outcome of breast cancer patient treated and followed-up in Shiraz, southern Iran from 2000 to 2005.
METHODS
In this retrospective study, 1,024 patients with breast cancer who were treated in Namazi hospital of Shiraz University of Medical Sciences between 2000 and 2005 were included. Survival analysis was performed to determine potential factors influencing disease free-and overall survival in these patients.
RESULTS
Median age of the patients at diagnosis was 47 (range 19-83) years. Median follow-up for surviving patients was 68 months. The majority of patients presented at stage II (42%) and stage III (41%). Additionally, most (61%) patients had positive axillary node. The 5-, 10- and 15-year overall survival rates were 83.8%, 61.5% and 56.6% respectively. On multivariate analysis for overall survival, histologic type, Tumor stage, node stage, disease stage, M stage, hormone receptor status, adjuvant radiotherapy, and chemotherapy regimen remained independent prognostic factor for overall survival.
CONCLUSION
in this study, the poor long-term oncologic outcome of the patients with breast cancer may be due to the higher rate of locally advanced disease; as well as the lack of modern systemic therapies in the study period.
Topics: Adult; Aged; Aged, 80 and over; Female; Humans; Middle Aged; Young Adult; Breast; Breast Neoplasms; Iran; Medical Oncology; Retrospective Studies
PubMed: 36444601
DOI: 10.31557/APJCP.2022.23.11.3877 -
Medicine Jul 2015There has not been a clear answer about the efficacy of intraoperative radiotherapy (IORT) for women with early-stage breast cancer.The aim of this meta-analysis was to... (Meta-Analysis)
Meta-Analysis Review
There has not been a clear answer about the efficacy of intraoperative radiotherapy (IORT) for women with early-stage breast cancer.The aim of this meta-analysis was to summarize the available evidence comparing the efficacy and safety of IORT with those of whole-breast external beam radiotherapy (EBRT) for women with early-stage breast cancer.MEDLINE, EMBASE, the Web of Science, and the Cochrane Library were searched up to October 2014. Two authors independently conducted the literature selection and data extraction.Studies that compared IORT with whole-breast EBRT were included in the systematic review. IORT was defined as a single dose of irradiation to the tumor bed during breast-conserving surgery rather than whole-breast irradiation.Qualities of RCTs were evaluated according to the PEDro scale. Qualities of non-RCTs were evaluated according to the Methodological Index for Non-Randomized Studies (MINORS). The risk ratios (RRs) of ipsilateral breast tumor recurrence, overall mortality, breast cancer mortality, non-breast cancer mortality, and distant metastasis were pooled using a random-effects model.Four studies with 5415 patients were included in this meta-analysis, including 2 randomized controlled trials (RCTs) and 2 non-RCTs. Ipsilateral breast tumor recurrence was significantly higher in patients with IORT compared to those with whole-breast EBRT (RR 2.83, 95% CI 1.23-6.51), but with significant heterogeneity (I = 58.5%, P = 0.065). Comparing IORT with whole-breast EBRT, the pooled RRs for overall mortality, breast cancer mortality, non-breast cancer mortality, and distant metastasis were 0.88 (95% CI: 0.66-1.17), 1.20 (95% CI: 0.77-1.86), 0.76 (95% CI: 0.44-1.31), and 0.95 (95% CI: 0.61-1.49), respectively.IORT had a significantly higher risk of ipsilateral breast tumor recurrence than whole-breast EBRT. Overall mortality did not differ significantly. IORT should be used in conjunction with the prudent selection of suitable patients. It is imperative to identify women with a low risk of local recurrence.
Topics: Breast Neoplasms; Clinical Trials as Topic; Female; Humans; Mastectomy, Segmental; Neoplasm Metastasis; Neoplasm Recurrence, Local; Neoplasm Staging; Radiotherapy, Adjuvant
PubMed: 26166124
DOI: 10.1097/MD.0000000000001143 -
Oncotarget Jun 2014
Topics: Breast Neoplasms; Cell Movement; Female; Humans; Kruppel-Like Transcription Factors; Neoplasm Metastasis; Transcriptome
PubMed: 24907202
DOI: 10.18632/oncotarget.2057 -
Journal of Surgical Oncology Mar 2016Achieving negative margins with "no tumor on ink" is an appropriate goal in breast conserving therapy (BCT). Wider margins do not decrease recurrence rates, and... (Review)
Review
Achieving negative margins with "no tumor on ink" is an appropriate goal in breast conserving therapy (BCT). Wider margins do not decrease recurrence rates, and re-excision in patients with microscopic positive margins is warranted. Several strategies exist to increase rates of negative margins, including techniques to improve tumor localization, intraoperative assessment of margins and oncoplastic techniques. Negative margins should be the goal of BCT, as this will improve both local control and long-term survival.
Topics: Breast Neoplasms; Chemotherapy, Adjuvant; Female; Humans; Mastectomy, Segmental; Neoplasm Recurrence, Local; Neoplasm, Residual; Prognosis; Radiotherapy, Adjuvant; Treatment Outcome
PubMed: 26394558
DOI: 10.1002/jso.24047 -
Korean Journal of Radiology Jan 2019To compare digital breast tomosynthesis (DBT) and conventional full-field digital mammography (FFDM) in the detectability of breast cancers in patients with dense breast... (Comparative Study)
Comparative Study
OBJECTIVE
To compare digital breast tomosynthesis (DBT) and conventional full-field digital mammography (FFDM) in the detectability of breast cancers in patients with dense breast tissue, and to determine the influencing factors in the detection of breast cancers using the two techniques.
MATERIALS AND METHODS
Three blinded radiologists independently graded cancer detectability of 300 breast cancers (288 women with dense breasts) on DBT and conventional FFDM images, retrospectively. Hormone status, histologic grade, T stage, and breast cancer subtype were recorded to identify factors affecting cancer detectability. The Wilcoxon signed-rank test was used to compare cancer detectability by DBT and conventional FFDM. Fisher's exact tests were used to determine differences in cancer characteristics between detectability groups. Kruskal-Wallis tests were used to determine whether the detectability score differed according to cancer characteristics.
RESULTS
Forty breast cancers (13.3%) were detectable only with DBT; 191 (63.7%) breast cancers were detected with both FFDM and DBT, and 69 (23%) were not detected with either. Cancer detectability scores were significantly higher for DBT than for conventional FFDM (median score, 6; range, 0-6; < 0.001). The DBT-only cancer group had more invasive lobular-type breast cancers (22.5%) than the other two groups (i.e., cancer detected on both types of image [both-detected group], 5.2%; cancer not detected on either type of image [both-non-detected group], 7.3%), and less detectability of ductal carcinoma (5% vs. 16.8% [both-detected group] vs. 27.5% [both-non-detected group]). Low-grade cancers were more often detected in the DBT-only group than in the both-detected group (22.5% vs. 10%, = 0.026). Human epidermal growth factor receptor-2 (HER-2)-negative cancers were more often detected in the DBT-only group than in the both-detected group (92.3% vs. 70.5%, = 0.004). Cancers surrounded by mostly glandular tissue were detected less often in the DBT only group than in the both-non-detected group (10% vs. 31.9%, = 0.016). DBT cancer detectability scores were significantly associated with cancer type ( = 0.012), histologic grade ( = 0.013), T and N stage ( = 0.001, = 0.024), proportion of glandular tissue surrounding lesions ( = 0.013), and lesion type ( < 0.001).
CONCLUSION
Invasive lobular, low-grade, or HER-2-negative cancer is more detectable with DBT than with conventional FFDM in patients with dense breasts, but cancers surrounded by mostly glandular tissue might be missed with both techniques.
Topics: Adult; Aged; Breast; Breast Neoplasms; Carcinoma, Intraductal, Noninfiltrating; Female; Humans; Mammography; Middle Aged; Neoplasm Staging; Radiographic Image Enhancement; Retrospective Studies
PubMed: 30627022
DOI: 10.3348/kjr.2018.0012 -
Medicine Jul 2019As the most popular beverage in East Asia, green tea (GT) has various biological activities effects such as anti-mutation, anti-oxidation, and anti-tumor. In this study,... (Meta-Analysis)
Meta-Analysis
BACKGROUND
As the most popular beverage in East Asia, green tea (GT) has various biological activities effects such as anti-mutation, anti-oxidation, and anti-tumor. In this study, we aimed to evaluate whether GT consumption could be an effective way to decrease the risk of breast cancer.
METHODS
We had performed a systematic review and updated meta-analysis of published case-control studies to evaluate the association between GT intake and the risk of breast cancer. Searching strategies were performed by the following keywords "Breast cancer," "breast neoplasm," and "green tea," with derivations and different combinations. The following databases were searched: PubMed, Cochrane Library, EMBASE, Web of science, China National Knowledge Infrastructure, WanFang, and China Biology Medicine disc. Studies published in both English and Chinese were considered for inclusion. Risk of bias was assessed through the Newcastle-Ottawa Scale (NOS). All data were analyzed through using Review Manager 5.1 software.
RESULTS
Fourteen studies fulfilled inclusion criteria for meta-analysis, yielding a total of 14,058 breast cancer patients and 15,043 control subjects. Individuals with the habit of drinking GT were found to have a negative association with the risk of future breast cancer (odds ratio 0.83; 95% confidence interval: 0.72-0.96) despite significant heterogeneity. In subgroup analyses, the negative correlation was still found in studies using registry-based controls, NOS grades ≥6 and the number of cases <500.
CONCLUSIONS
GT consumption may have a decreased incidence of breast cancer despite significant heterogeneity. However, owing to the quality of available studies, more properly designed trials are warranted to clarify the association between GT consumption and breast cancer.
Topics: Breast Neoplasms; Case-Control Studies; Female; Humans; Tea
PubMed: 31277115
DOI: 10.1097/MD.0000000000016147