Bano, Razia;Zafar, Waleed;Khan, Amina Iqbal;Fiaz, Sohaib Adil;Abid, Mahwish;Chaudhary, Mohammad Zulqarnain;Siddique, Neelam;Khan, Huma Majeed
Asian Pacific Journal of Cancer Prevention
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제17권7호
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pp.3631-3635
/
2016
Background: Breast lymphomas constitute a rare disease entity. To date, limited relevant data have been reported. We therefore here present a review of breast lymphoma patients treated at a single center over a 20 year period, focusing on histological types, treatment modalities and outcomes. Materials and Methods: We identified patients who were diagnosed and treated for breast lymphoma at a single center from January 1995 to January 2014 and extracted data regarding patients' demographics and clinical data. Results: Twenty-seven patients with breast lymphoma were identified, of which 3 were males. The median age at diagnosis was 37 years (range: 22-76 years). Chemotherapy was the main stay of treatment and 55.6% patients also received radiation to the affected breast. At our institute, only 3 patients, all with progressive disease, had surgery performed to achieve local palliation. Complete response after chemotherapy was seen in 63% patients and partial response in 7.4%, while 26% patients demonstrated disease progression. The mean follow up was 46.8 months. Seven patients (33.3%) who were alive at last follow up, as well as 1 patient who died, survived more than 5 years after diagnosis. Conclusions: Patients with breast lymphoma should receive aggressive treatment, with combination of chemotherapy and radiation therapy. Surgery should be limited for diagnosis and palliation of local symptoms in cases of progressive disease.
Objectives In this study, we identified the symptoms of insomnia, anxiety, and depressed mood in newly diagnosed women breast and thyroid cancer patients. Methods The subjects of this study were 1794 women patients who visited the Ewha Womans University Cancer Center for Women. They included 1119 newly diagnosed primary breast cancer patients and 675 newly diagnosed primary thyroid cancer patients. The patients completed the National Cancer Center Psychological Symptom Inventory (NCC-PSI) during their first follow-up visit after surgery, before starting chemotherapy or radiotherapy. The NCC-PSI is composed of the modified distress thermometer (MDT) and the modified impact thermometer (MIT) for insomnia, anxiety, and depressed mood. Results Anxiety severity was found to be greater in breast cancer patients than in thyroid cancer patients. Significant levels of anxiety, depressed mood and insomnia were present in 28, 24.5, and 20.7% in all the subjects, respectively. Moreover, anxiety symptoms, depressed mood and insomnia interfered with the daily lives of 20, 18.4, and 14.2% of all the subjects, respectively. Dealing with anxiety (18.8%) was found to need the most help, followed by dealing with insomnia (8.9%) and depressed mood (8.7%). Conclusions A significant level of distress was found in about 40% of the total subjects. Nearly 30% of newly diagnosed breast cancer patients reported significant anxiety symptoms and interferences with daily living caused by anxiety, which most commonly needed special care. Early assessment and management of psychological distress, especially anxiety, in breast and thyroid cancer treatment are very important to establish integrated cancer care.
The number of axillary lymph nodes involved and retrieved are important prognostic factors in breast cancer. The purpose of our study was to investigate whether the lymph node ratio (LNR) is a better prognostic factor in predicting disease-free survival (DFS) for breast cancer patients as compared with pN staging. The analysis was based on 804 breast cancer patients who had underwent axillary lymph node dissection between 1999 and 2008 in Sun Yat-Sen University Cancer Center. Optimal cutoff points of LNR were calculated using X-tile software and validated by bootstrapping. Patients were then divided into three groups (low-, intermediate-, and high-risk) according to the cutoff points. Predicting risk factors for relapse were performed according to Cox proportional hazards analysis. DFS was estimated using the Kaplan-Meier method and compared by the log-rank test. The 5-year DFS rate decreased significantly with increasing LNRs and pN. Univariate analysis found that the pT, pN, LNR, molecule type, HER2, pTNM stage and radiotherapy well classified patients with significantly different prognosis. By multivariate analysis, only LNR classification was retained as an independent prognostic factor. Furthermore, there was a significant prognostic difference among different LNR categories for pN2 category, but no apparent prognostic difference was seen between different pN categories in any LNR category. Therefore, LNR rather than pN staging is preferable in predicting DFS in node positive breast cancer patients, and routine clinical decision-making should take the LNR into consideration.
Breast cancer is one of the most common cancers affecting women worldwide. Although the survival rate of breast cancer has increased, breast cancer still results in a high mortality rate. Breast cancer deaths are caused by metastasis that occurs in organ dysfunction. Recently, there have been many studies on circulating tumor cells (CTCs), which are related to breast cancer metastasis in the blood. Recent studies have demonstrated that some CTCs do not express epithelial markers. Therefore, in this study, total RNA was extracted from blood without separating out the CTCs, and the characteristics of the CTCs were analyzed by RT-qPCR. Cyclin D1 and twist-related protein 1 (TWIST1) are well-known markers for predicting the prognosis of patients with breast cancer. However, few studies have demonstrated the use of CCND1 and TWIST1 in blood as diagnostic and prognostic markers of breast cancer. In this study, patients with late-stage breast cancer had overexpressed CCND1 and TWIST1 than patients with different stages of breast cancer (P < 0.001 and P < 0.01, respectively). The relative expression level of CCND1 in survivors was higher than in patients who died (P = 0.06). The relative expression level of TWIST1 in survivors was lower than in patients who died (P = 0.08). Overall CCND1 and TWIST1 were not useful as markers for the diagnosis of breast cancer through blood. However, we showed the possibility of using CCND1 and TWIST1 as prognostic markers, and a large-scale study is needed to confirm the usefulness of these prognostic markers.
Background: Among the factors reported to determine the quality of life of breast cancer patients are socio-demographic background, clinical stage, type of treatment received, and the duration since diagnosis. Objective: The objective of this study was to determine the quality of life (QOL) scores among breast cancer patients at a Malaysian public hospital. Materials and Methods: This cross-sectional study of breast cancer patients was conducted between March to June 2013. QOL scores were determined using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and its breast cancer supplementary measure (QLQ-BR23). Both the QLQ-C30 and QLQ-BR23 assess items from functional and symptom scales. The QLQ-C30 in addition also measures the Global Health Status (GHS). Systematic random sampling was used to recruit patients. Results: 223 breast cancer patients were recruited with a response rate of 92.1%. The mean age of the patients was 52.4 years (95% CI = 51.0, 53.7, SD=10.3). Majority of respondents are Malays (60.5%), followed by Chinese (19.3%), Indians (18.4%), and others (1.8%). More than 50% of respondents are at stage III and stage IV of malignancy. The mean Global Health Status was 65.7 (SD = 21.4). From the QLQ-C30, the mean score in the functioning scale was highest for 'cognitive functioning' (84.1, SD=18.0), while the mean score in the symptom scale was highest for 'financial difficulties' (40.1, SD=31.6). From the QLQ-BR23, the mean score for functioning scale was highest for 'body image' (80.0, SD=24.6) while the mean score in the symptom scale was highest for 'upset by hair loss' (36.2, SD=29.4). Two significant predictors for Global Health Status were age and employment. The predictors explained 10.6% of the variation of global health status ($R^2=0.106$). Conclusions: Age and employment were found to be significant predictors for Global Health Status (GHS). The Quality of Life among breast cancer patients reflected by the GHS improves as age and employment increases.
Purpose: To establish a database for breast cancer patients to save and manage clinical data and to preliminarily investigate its clinical application. Materials and Methods: Information on breast cancer patients hospitalized in our department from 2008.01 to 2013.01 were input into our breast cancer management system. SPSS 16.0 software was used as a convenient reference to evaluate the accuracy of the newly built database. Results: A database of 2403 breast cancer patients was successfully established. Information in the database clearly displayed capabilities of storage, addition, retrieval, statistical analysis and other functions. As the continuously updated database showed, the distribution of age, sex, nationality, allergy history, pausimenia and marriage of patients was identical to that achieved by SPSS analysis, indicating reliable and accurate data analysis. Conclusions: The described database is easy and convenient to operate and manage, and should prove suitable for application in clinical research and treatment.
Bordbar, Elahe;Malekzadeh, Mahyar;Ardekani, Mehdi Taghipour Fard;Doroudchi, Mehrnoosh;Ghaderi, Abbas
Asian Pacific Journal of Cancer Prevention
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제13권10호
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pp.5307-5312
/
2012
Introduction: Breast cancer cells and tumor stroma produce different cytokines and soluble factors. Cytokines, while playing crucial roles in immune responses to tumors, also favour tumor growth and progression. IL-7 and G-CSF are two cytokines that may exert influences on the pathophysiology of breast cancer. Materials and Methods: Sera were collected from 136 females with breast cancer before receiving chemotherapy or radiotherapy. The control group comprised of 60 healthy age-matched females without any acute or chronic diseases with no family history of breast cancer. Serum levels of IL-7 and G-CSF were measured by commercial enzyme linked immunosorbent assay. Results: While there was no significant difference in the level of G-CSF between patients ($92.81{\pm}594.54$ pg/ml) and controls (0.00 pg/ml), G-CSF level in sera of patients with advanced stages of breast cancer was elevated compared to early stages (p=0.0001). Moreover, the highest level of G-CSF was seen in patients with N3 phase tumors (p=0.0001). IL-7 was slightly but not significantly higher in the control group ($0.04{\pm}0.11$ pg/ml) in comparison with patients ($0.02{\pm}0.10$ pg/ml). Interestingly, a significant increase in the level of IL-7 in patients with skin involvement was observed (p=0.001). Conclusion: Our results showed an elevation of G-CSF in sera of patients with advanced stages of tumor, while IL-7 elevation correlated with skin involvement of breast cancer. IL-7 can be produced by keratinocytes in skin tissue and may be involved in the pathologic establishment of metastatic tumor cells in skin.
This study was aimed to obtain epidemiological information of cancer patients treated with Oriental medicine. 58 breast and gynecological cancer patients treated in Cancer Center of Daeguhanny Oriental Hospital from August 2012 to August 2013 were reviewed. Careful investigations were done by categorizing these patients by their origin, stage, treatment, conventional treatment type, chief complaint, etc. In tumor origin, breast cancer showed the largest proportion in total patients(74.1%) and inpatients(81.8%). 63.8% of the patients' tumors were stage III and IV. 48.3% of patients visited Oriental hospital for combination treatment with conventional medicine. 91.4% of the patients have under 5 years of cancer duration. Their cheif complaints are general weakness, postoperative pain and abdominal discomfort in general. This study presented the characteristics of breast and gynecological cancer patients treated by Oriental medical therapies, and thus would be valuable for futher studies of Oriental medical cancer treatments.
Purpose: The purpose of this study was to identify the stress and the coping strategies in breast cancer patients and their spouses. Methods: The stress level was measured by the Stress Questionnaire of Andersson & Albertsson (2000). The coping strategies were measured by the modified Lazarus & Folkman's Ways of Coping Questionnaire. The data were collected by a survey sampling 49 couples from one hospital in Seoul. The data were analyzed by t-test, ANOVA and paired t-test. Results: There was no significant differences between the stress level of breast cancer patients and their spouses. The problem-focused coping of breast cancer patients was significant higher than their spouses. The cancer patients and their spouses used problem-focused coping mode more than emotion-focused coping mode. In the problem-focused coping mode, breast cancer patients used two coping strategies - 'seeking information' and 'cognitive reconstruction' - significantly more than their spouses. In emotion-focused coping mode, the breast cancer patients used one coping strategy, 'emotional expression', significantly more than the their spouses. Conclusion: Further study needs to attempt to develop nursing interventions that could improve positive coping strategies.
Saeed, Shaista Afzal;Masroor, Imrana;Beg, Madiha;Idrees, Romana
Asian Pacific Journal of Cancer Prevention
/
제16권17호
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pp.7607-7612
/
2015
Aims: The purpose of our study was to evaluate the diagnostic performance of breast magnetic resonance imaging (MRI) in the evaluation of contralateral breast in patients with diagnosed breast cancer. A secondary objective was to determine accuracy of breast MRI in diagnosing multi-focal and multicentric lesions in the ipsilateral breast. Materials and Methods: Using a non-probability convenience sampling technique, patients with histopathologically diagnosed breast cancer with MRI of breast performed to exclude additional lesions were included. MRI findings were correlated with histopathology. In addition, follow-up imaging with mammography and ultrasound was also assessed for establishing stability of negative findings and for the detected of benign lesions. Results: Out of 157 MRI breast conducted during the period of 2008 to 2013, 49 were performed for patients with diagnosed breast cancer. The sample comprised of all females with mean age $50.7{\pm}11.0years$. The patient follow-up imaging was available for a period of 2-5 years. The sensitivity, specificity, and positive and negative predictive values of MRI in the detection of multifocal/multicenteric lesions was 85.7%, 88.8%, 60% and 96.6% respectively and for the detection of lesions in the contralateral breast were 100%, 97%, 83.3% and 100% respectively. Conclusions: Our study highlights the diagnostic performance and the added value of MRI in the detection of multifocal/multicenteric and contralateral malignant lesions. In patients with diagnosed breast cancer having dense breast parenchyma and with infiltrating lobular carcinoma as the index lesion MRI is particularly useful with excellent negative predictive value in the exclusion of additional malignant foci in the ipsilateral and contralateral breasts.
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