• Asian Pacific Journal of Cancer Prevention
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• v.15 no.18
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• pp.7839-7842
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• 2014

Background: Breast cancer is the most common malignancy in women worldwide and the second most common cancer in females in India. Receptor status may be important for survival. Objective: To analyse and correlate the clinical and morphological parameters with receptor status in breast carcinoma patients in a tertiary care institution in Southern India. Materials and Methods: This retrospective study involved 320 patients of breast cancer diagnosed in an oncology hospital over a period of $3^{1/2}$ years. Data was analysed using SPSS Version 21. Results: Some 60.6% patients with breast carcinomas belonged to the age group of 40 to 60 years. The most common histological type was infiltrating ductal carcinoma, not otherwise specified, accounting for 84.4% of patients. On immunohistochemistry, estrogen receptor (ER) and progesterone receptor (PR) were expressed in 56.3% and 53.1% of cases, respectively. Conclusions: Breast cancers in India, a developing country, occur in younger women and tend to be more aggressive with lower rates of ER and PR expression and higher histological tumor grades. Both ER and PR status of the tumors had significant associations with the patient age, pathological TNM stage and histological tumor grade.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.1
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• pp.181-184
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• 2015

Background: Breast cancer is the most common female cancer in Kerala, South India, with the incidence increasing in the past two decades, also in young women. However, there are limited data regarding the burden of disease, its epidemiology and histopathological characteristics in the state. Materials and Methods: This desciptive study covered 303 breast cancers evaluated during the period of December 2011 to August 2013 in the Department of Pathology, Government Medical College, Kottayam.The patients were also interviewed regarding selected risk factors. Results: The majority of the cases were 41-60 years of age with a mean at presentation of 53 years. Infiltrating ductal carcinoma was the most common subtype, followed by pure mucinous carcinoma and then lobular carcinoma. Of the cases, 6.6% were nullipara and 52.8% had fewer than or equal to 2 children. Median age at first child birth was 23 years (national value-19.8 years). A significant proportion (15%) had family history of breast cancer. Some 13.5%(41 cases) comprised the young breast cancer group (${\leq}40$years) with a mean age at first child birth in them was 27.4 years, 5 being nullipara and 6 having a positive family history. Conclusions: Breast cancer awareness, better availability of screening techniques and identification and targeting high risk groups all help to tackle the increasing load of breast carcinoma. A good proportion of cases comprised the young breast cancer group (under 40). Younger women should thus also be educated about breast carcinoma-risk factors, symptoms and diagnostic techniques to help in early detection and effective approach esto treatment.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.10
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• pp.4237-4245
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• 2015

Breast cancer is a menacing cancer, primarily affecting women. Continuous research is going on for detecting breast cancer in the early stage as the possibility of cure in early stages is bright. There are two main objectives of this current study, first establish statistics for breast cancer and second to find methodologies which can be helpful in the early stage detection of the breast cancer based on previous studies. The breast cancer statistics for incidence and mortality of the UK, US, India and Egypt were considered for this study. The finding of this study proved that the overall mortality rates of the UK and US have been improved because of awareness, improved medical technology and screening, but in case of India and Egypt the condition is less positive because of lack of awareness. The methodological findings of this study suggest a combined framework based on data mining and evolutionary algorithms. It provides a strong bridge in improving the classification and detection accuracy of breast cancer data.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.8
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• pp.3505-3508
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• 2015

Background: Ras genes are thought to play an important role in human cancer since they have been found to be activated frequently in several types of tumors including breast cancer, where the overall incidence of K-RAS oncogene activation is 0-10%. Evaluation of K-RAS gene not only for mutational frequency but also for mutation types in this downstream signaling gene pathway is necessary to determine the mechanisms of action. The present study was conducted to test the hypothesis that K-RAS activation is involved in breast cancer risk of south Indian population. Materials and Methods: A total of 70 paired pathologically confirmed tumor and non-tumor tissues from the same breast cancer patients were analysed for most common K-RAS mutations of codon 12,13 and 61 by polymerase chain reaction followed by restriction digestion and direct nucleotide sequencing method. Results: We found that a high rate of homozygous and heterozygous mutations of codon 12, but not codon 13 and 61, may influence the invasive ductal carcinoma of breast risk in this study. Conclusions: Our study indicated that only codon 12 may be involved in initiating breast carcinogenesis in India.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.1
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• pp.257-263
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• 2014

Background: Vascular endothelial growth factor (VEGF), an endothelial cell specific mitogen, has been implicated as a critical factor influencing tumor related angiogenesis. The aim of present study was to evaluate the relationship between VEGF +936C>T and +405C>G polymorphisms of VEGF with risk of breast cancer in Punjab, India. Materials and Methods: We screened DNA samples of 192 sporadic breast cancer patients and 192 unrelated healthy, gender and age matched control individuals for VEGF +936C>T and +405C>G polymorphisms using the PCR-RFLP method. Results: For the VEGF +405C>G polymorphism, we observed significantly increased frequency of GG genotype in cases as compared to controls and strong association of +405GG genotype was observed with three fold risk for breast cancer (OR=3.07; 95%CI 1.41-6.65; p=0.003). For the +936C>T polymorphism, significant associations of CT and combined CT+TT genotypes were observed with elevated risk of breast cancer (p=0.021; 0.023). The combined genotype combinations of GG-CC and GG-CT of +405C>G and +936C>T polymorphisms were found to be significantly associated with increased risk of breast cancer (p=0.04; 0.0064). Conclusions: The findings of the present study indicated significant associations of VEGF +936C>T and +405C>G polymorphisms with increased breast cancer risk in patients from Punjab, North India.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.12
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• pp.6333-6336
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• 2012

The burden of cancer is growing globally and is one of the top leading causes of death. Information on cancer patterns are essential for effective planning of cancer control interventions. There is limited published information available on pattern of cancer for the state of Odisha, India. The present study was an attempt to explore the pattern and trend of cancer in Odisha. To fulfill the objectives retrospective data available from 2001-2011 at Acharya Harihar Regional Cancer Center (AHRCC), Cuttack, Odisha, were analyzed. Medical records of cancer patients were reviewed and relevant information on diagnosis, primary site and demographic data were retrieved. Data were entered and analyzed using SPSS 16.0 (SPSS Inc.). A total of 74,861 cancer inpatients were registered at AHRCC for the years 2001-2011. The proportion of females outnumbered males with female:male ratio 1.1:1. The number of female cases increased four folds and that of males three fold over the period studied. Malignancies such as oral cancer (16.93%), acute lymphocytic leukemia/non Hodgkins lymphoma (14.09%) and cancer of gastrointestinal tract (21.07%) are leading cancers among males and carcinomas of breast (28.94%), cervix (23.66%) and ovary (16.11%) were leading among females. Findings from this study indicate an overall increase in cancer reporting which could be regarded as proxy measure for overall cancer situation in Odisha. There is scope and need for integrating other government hospitals, existing private health service providers and research institutions across the state for better planning of cancer control program.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.5
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• pp.1919-1924
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• 2014

Background: In India, breast cancer is the leading malignancy among women in a majority of the cancer registries. Therefore it is important to understand screening practices and its predictors, including in rural areas with high female literacy and good health indices. Materials and Methods: A cross-sectional study with multistage sampling was conducted in Vypin Block, Ernakulam district, Kerala, India. Four Panchayats (self administration units) were randomly chosen and a woman in every second household was invited to participate from the tenth ward of each. Thus a total of 809 women were interviewed. Results: The majority of the repondents (82.1%) were not aware of risk factors and about a third (37.9%) were not aware of symptoms of breast cancer. About half of the population studied (46.6%) had undergone screening. Age (35-50 years), being married, health professionals as source of information and working were significant predictors of screening. Logistic regression showed that older women (35-50 yrs) were more likely to practice screening. Out of the never screened, about a third (35%) were desirous of doing it, but had not for various reasons and 53.5% were not willing to screen. The reasons identified for not screening among those desirous of doing it were grouped into knowledge 66 (43.4%), resources 23 (15.1%) and psychosocial 32(21.1%) factors. Unmarried women were significantly more likely to express factors related to all the three domains. Conclusions: This study showed that in spite of the absence of a population-based screening program, about half of the study population had undergone some type of screening. The older women (35-50 years) in particular were significantly more likely to practice screening. At this critical juncture, a high quality breast cancer awareness and screening initiative can help to consolidate the gains and tackle knowledge, resource and psychosocial barriers.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.12
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• pp.6295-6298
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• 2012

Oxidant/antioxidant balance has been suggested as an important factor for initiation and progression of cancer. The objective of this study was to determine changes in the levels of malondialdehyde (MDA), nitric oxide (NO), total cholesterol, triglycerides, LDL-cholesterol, HDL-cholesterol, total antioxidant capacity (TAC), glutathione peroxidase (GSH-Px), and superoxide dismutase (SOD) activities in serum samples of breast cancer patients (n=30) and healthy subjects (n=100). MDA and NO levels were found to be increased in breast cancer patients compared to the healthy subject group (p<0.05). Total cholesterol and triglycerides were elevated; and HDL-cholesterol level was found to be decreased in the cancer patients as compared to the healthy subjects (p<0.05). Compared to the healthy group, both serum TAC levels (p<0.001) and activity of SOD and GSH-Px (p=0.05) were found to be decreased in the breast cancer patients as compared to the healthy controls. Considering the data presented in this study, we suggest that free radicals induce lipid eroxidation and peroxidation of unsaturated fatty acid with decreased activity of enzymatic antioxidants in breast cancer.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.5
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• pp.1989-1992
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• 2014

Background: The aim of this study was to assess the response rates (clinical and pathological ) with docetaxel and epirubicin combination chemotherapy and its effect on outcome. Materials and Methods: We retrospectively analysed locally advanced breast cancer (LABC) patients who received NACT from January 2008 to December 2012 in our tertiary care centre. LABC constituted 37% of all breast cancer cases and 120 patients fulfilled the eligibility criteria. The regimens used for NACT were, six cycles of DEC (docetaxel $75mg/m^2$, epirubicin $75mg/m^2$, cyclophosphamide $50mg/m^2$ on Day 1, 3 weekly) and a sequential regimen (4 cycles of FEC, 5-flurouracil $600mg/m^2$, epirubicin $75mg/m^2$, cyclophosphamide $600mg/m^2$ followed by 4 cycles of docetaxel $85mg/m^2$). Results: The median age was 47 years (range 23-72). Ninety six ( 80 %) had T4 disease and 90% had clinically palpable lymph nodes at diagnosis. The median size of primary tumor at presentation was 5.9 cm. Hormone receptor positivity was seen in 55% and HER2/neu positivity, in 25%. Triple negative breast cancers constituted 25 % of the cases. The overall clinical response rate (complete or partial ) was 85% and pathological complete responses were obtained in 15%. Four cases defaulted, 5 patients died of treatment related toxicity and 15% developed febrile neutropenia on DEC. The median duration of follow up was 22 months. The median time to relapse was 20 months and the 3 year relapse free and overall survival rates were 50% and 70% respectively. Conclusions: LABC constituted 37% of all breast cancer cases at our institute. With NACT, pCR was seen in 15% of the cases. Sequential chemotherapy was better tolerated than concurrent anthracyline and taxane chemotherapy with a similar pCR.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.12
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• pp.5985-5987
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• 2012

A cross-sectional study was conducted among nursing staff of a missionary hospital of Delhi in June 2009. All the nurses were invited to participate in the training programme on breast cancer and techniques of breast self examination (BSE). A questionnaire was administered to all 259 participants seeking information on their level of awareness regarding breast cancer and relevant screening guidelines. With the help of 5 training workshops all the nurses were imparted training regarding the most appropriate technique of doing breast self exams. The mean age of the participants was 35.8 years. Out of a total of 259 nursing staff members 77.2% correctly answered all the 10 questions regarding high risk factors for breast cancer and after the training programme this increased to 100% (p<0.05). Only 65.2% of the participants gave correct responses to all the 8 questions regarding correct technique of performing a BSE, which after the training programme increased to 99.3% (p<0.05). At the baseline only 56.8% knew all the three screening methods correctly and after the intervention 98.7% could correctly mark the responses regarding screening (p<0.05). The actual practice of following the screening guidelines amongst the nursing staff was poor. Only 26 (10.03%) had ever done a BSE, none performed it monthly, 58 (22.4%) had ever gone themselves for a CBE and 18 (6. 94%) had ever undergone mammography.