• 제목/요약/키워드: the poor breast

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Comparison between Early and Late Onset Breast Cancer in Pakistani Women Undergoing Breast Conservative Therapy: is There any Difference?

  • Bhatti, Abu Bakar Hafeez;Jamshed, Aarif;Khan, Amina;Siddiqui, Neelam;Muzaffar, Nargis;Shah, Mazhar Ali
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권13호
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    • pp.5331-5336
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    • 2014
  • Background: Early onset breast cancer is associated with poor outcomes but variable results have been reported. It is a significant problem in Pakistani women but remains under reported. Breast conservation plays an important role in surgical management of this younger patient group. The objective of this study was to determine the outcome of breast conservative therapy in patients with early onset breast cancer in our population and compare it with their older counterparts. Materials and Methods: A review of patients with invasive breast cancer who underwent breast conservation surgery at Shaukat Khanum Cancer Hospital from 1997 to 2009 was performed. Patients were divided into two groups i.e. Group I age ${\leq}40$ and Group II >40 years. A total of 401 patients with breast cancer were identified in Group I and 405 patients in Group II. Demographics, histopathological findings and receptor status of the two groups were compared. The Chi square test was used for categorical variables. Outcome was assessed on basis of 10 year locoregional recurrence free survival (LRRFS), disease free survival (DFS) and overall survival (OS). For survival analysis Kaplan Meier curves were used and significance was determined using the Log rank test. Cox regression was applied for multivariate analysis. Results: Median follow up was 4.31 (0.1-15.5) years. Median age at presentation was 34.6 years (17-40) and 51.9 years (41-82) for the two groups. Groups were significantly different from each other with respect to grade, receptor status, tumor stage and use of neoadjuvant therapy. No significant difference was present between the two groups for estimated 10 year LRRFS (86% vs 95%) (p=0.1), DFS (70% vs 70%) (p=0.5) and OS (75% vs 63%) (p=0.1). On multivariate analysis, tumor stage was an independent predictor of LRRFS, DFS and OS. Conclusions: Early onset breast cancer is associated with a distinct biology but does not lead to poorer outcomes in our population.

에스트로겐 수용체 ${\beta}$ 발현과 유방암 재발과의 관련성 (The Relationship Between the Expression of Estrogen Receptor ${\beta}$ and Recurrence in Breast Cancer)

  • 강수환;최정은;이수정
    • Journal of Yeungnam Medical Science
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    • 제28권2호
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    • pp.153-164
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    • 2011
  • Background: It has been reported that estrogen receptor beta ($ER{\beta}$) mRNA expression was down-regulated during carcinogenesis and was inversely related to estrogen receptor alpha ($ER{\alpha}$) expression in breast cancer. The association of $ER{\beta}$ mRNA expression to tamoxifen resistance has also been reported. In this study, the expression of $ER{\alpha}$ and $ER{\beta}$ via immunohistochemistry (IHC) and reverse transcription-polymerase chain reaction (RT-PCR) was prompted, and an attempt was made to find out the relationship between $ER{\beta}$ expression and recurrence in the hormonal therapy group, and between $ER{\beta}$ expression and known prognostic factors. Methods: Tumor specimens were obtained at surgery from 67 female breast cancer patients during the period of September 1995 to December 2000. All the specimens were frozen in liquid nitrogen and kept at $-70^{\circ}C$ until they were used. The medical records were analyzed retrospectively. The expressions of ER were analyzed using IHC and RT-PCR methods. Results: The median follow-up was at 93.0 months (range: 14-157 months). The percentage of $ER{\alpha}+/ER{\beta}+$, $ER{\alpha}+/ER{\beta}-$, $ER{\alpha}-/ER{\beta}+$, and $ER{\alpha}-/ER{\beta}$ group were 35.9% 9.4%, 47.2%, and 7.5%, respectively, in 53 patients with hormonal therapy. $ER{\beta}$ was positive in 42 (82.3%) of 51 ER-positive patients. In the hormonal therapy group, the recurrence rates of each group was 15.8%, 0%, 40.0%, and 0%, respectively. In this group, the $ER{\beta}$ expression tended to recur, but there was no clinical significance (p=0.084). Conclusion: The $ER{\beta}$ expression may be a predictive marker of a poor response to endocrine therapy in breast cancer patients, although this needs to be confirmed in additional studies.

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거대 흉벽 결손에 대한 확장 외복사근 근피판을 이용한 흉벽재건 치험례 (Experience of Reconstruction of an Extensive Chest Wall Defect with Extended External Oblique Musculocutaneous Flap)

  • 김대희;김정헌;송승용
    • Archives of Plastic Surgery
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    • 제37권3호
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    • pp.277-280
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    • 2010
  • Purpose: The resection of locally advanced or recurred breast cancers frequently result in large chest wall defects and it leads to a great challenges to cover. Generally simple skin grafts are not a practical option for patients because of their poor cosmetic appearance and prognosis. The latissimus dorsi and rectus abdominis musculocutaneous flap have traditionally been recommended for closure of these large defects. Though the cosmetic result of reconstruction using these flaps is often excellent, but has significant drawbacks. Therefore, we thought that chest wall reconstruction using the external oblique musculocutaneous flap can be an alternative method for extensive chest wall defect related to large, locally advanced breast carcinoma. Methods & Results: We present a case of a 50-year-old Korean female, refered to our department with a left breast tumor for 10 months. CT demonstrate a large tumor on the left anterior chest wall and multiple nodules of varying size in the cervical areas and liver. FDG-PET showed areas of hot uptake throughout the left chest wall, mediastinum and liver. Biopsy was consistent with invasive ductal carcinoma (Grade III). The initial tumor was considered inoperable, so a series of chemotherapy was initiated. Though the size of the breast mass was slightly decreased, the patient continued to suffer from purulent discharge, unpleasant odor and contact bleeding of the mass, the salvage mastectomy was performed. Conclusion: We could reconstruct $23{\times}16\;cm$ sized large chest wall defect, resulting from the resection of a locally advanced breast carcinoma, using an external oblique musculocutaneous flap successfully. Immediate postoperatively checked flap was healthy. Overall result was good without any significant complications and discharged 3 weeks after operation.

Mammographic Screening of Women Attending a Reference Service Center in Southern Brazil

  • Lopes, Tiara Cristina Romeiro;Gravena, Angela Andreia Franca;de Oliveira Demitto, Marcela;Brischiliari, Sheila Cristina Rocha;Borghesan, Deise Helena Pelloso;Agnolo, Catia Millene Dell;de Barros Carvalho, Maria Dalva;Pelloso, Sandra Marisa
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권3호
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    • pp.1385-1391
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    • 2016
  • Background: To investigate the prevalence of and factors associated with performance of annual mammography by women above 40 years of age. Materials and Methods: This cross-sectional retrospective study was conducted at an oncology reference service in Southern Brazil from October 2013 to October 2014 with 525 women aged 40 years or older. Results: The prevalence of annual mammography was 54.1%; annual mammographic screening was performed for women without private medical insurance, who were under hormone replacement therapy and who had used contraception in the past. An association was found between non-performance of breast clinical and self-examination and non-performance of mammographic screening. Conclusions: Use of mammography for breast cancer screening in the public health care setting proved to be accessible; nevertheless, the proportion of screened women was low, and they exhibited poor adherence to the basic measures of care recommended for breast assessment. Thus, control of breast cancer requires implementing actions targeting the population most vulnerable to non-adherence to screening in addition to continuously monitoring and assessing that population to reduce the prevalence of this disease.

Prognostic Role of PTEN Gene Expression in Breast Cancer Patients from North-East Iran

  • Golmohammadi, Rahim;Rakhshani, Mohammad Hassan;Moslem, Ali Reza;Pejhan, Akbar
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권9호
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    • pp.4527-4531
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    • 2016
  • Background: PTEN protein is one of the most important tumour suppressor factors which is detectable by immunohistochemistry. The goal of the present study was to investigate the prognostic role of PTEN gene expression in breast cancer patients. Materials and Methods: This descriptive-analytical study was conducted on 100 breast cancer patients referred to Sabzevar hospitals in the north-east of Iran between 2010 and 2011, who were followed up to 2015. PTEN gene expression in tissue samples was determined using specific monoclonal antibodies and data were analyzed using Chi-square test and Fisher's exact test. Patient survival was analyzed after 4 years of follow-up using the Cox regression model. Results: PTEN gene expression was evident in 70 of 100 cnacer samples but was found at high levels in all non-cancer samples. There was an inverse significant relationship between PTEN gene expression and tumour stage or tumour grade (p<0.001). The expression of PTEN in invasive ductal tumours was lower than in non-invasive tumours. There was also an inverse significant relationship between the hazard of death and PTEN gene expression (p<0.001). In addition, there was an inverse significant relationship between tumour stage and hazard of death (p<0.001). Conclusion: These findings indicate that lack of PTEN gene expression can be a sign of a worse prognosis and poor survival in breast cancer cases.

Elevated Serum Haptoglobin is Associated with Clinical Outcome in Triple-Negative Breast Cancer Patients

  • Tabassum, Umaira;Reddy, Obula;Mukherjee, Geetashree
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권9호
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    • pp.4541-4544
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    • 2012
  • Background: Breast cancer is the most common malignancy with the highest incidence rates among women worldwide. Triple-negative breast cancer (TNBC) disease is diagnosed more frequently in younger women, and is associated with a poor prognosis. Elevated levels of serum haptoglobin protein (Hp) are observed in many malignant diseases including breast cancer. We evaluated the expression and prognostic value of Hp among patients with TNBC. Materials and Methods: Serum Hp levels were determined by Elisa in 41 patients with TNBC and 10 normal individuals. Hp status was correlated with other clinico-pathological parameters including patient survival. Results: Of the 41 patients with TNBC, Hp over expression was detected in 24 (59%) by Elisa. Hp up-regulation was confirmed by Elisa based quantification in the serum of 41 TNBC patients against lower grades and 10 normal individuals. Survival analysis revealed that Hp ($p=2.016{\times}10^{-5}$), stage ($p=2.166{\times}10^{-5}$), distant metastasis ($p=2.217{\times}10^{-5}$), tumor size ($p=1.053{\times}10^{-5}$), and tumor grade (p=0.001), correlated with patient survival on univariate analysis. Multivariate analysis revealed that Hp (p=0.001), and grade of the disease (p=0.008) were independent predictors of survival. Conclusion: Our results indicate that serum levels of Hp may play a role as a potential serum biomarker and prognostic indicator among TNBC patients. Thus, Hp may present a new promising prognostic biomarker in TNBC patients, but independent validations are now necessary for confirmation.

Investigation of Phase Singularity Problem in Microwave Breast Tomography

  • Son, Seong-Ho;Simonov, Nikolai;Lee, Kwang-Jae;Jeon, Soon-Ik
    • Journal of electromagnetic engineering and science
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    • 제14권4호
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    • pp.332-335
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    • 2014
  • This paper investigates the phase singularity problem in microwave image reconstruction utilizing unwrapped phase data. The measured phases of the electric fields in most microwave measurement systems are wrapped. Thus, a certain phase unwrapping process is necessary for reconstruction of the image of a high contrast object. This unwrapping, however, is difficult in the presence of scattering nulls on/near the unwrapping path. At the null point, the phase value will be rendered, resulting in a poor image reconstruction. In this paper, we investigate the phase singularity arising from electromagnetic scattering nulls in microwave breast tomographic imaging. We then propose a transformation technique for the measured electric fields that avoids phase singularity.

Electromagnetic Field Exposure and Male Breast Cancer Risk: A Meta-analysis of 18 Studies

  • Sun, Jing-Wen;Li, Xiao-Rong;Gao, Hong-Yu;Yin, Jie-Yun;Qin, Qin;Nie, Shao-Fa;Wei, Sheng
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권1호
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    • pp.523-528
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    • 2013
  • Background: The possibility that electromagnetic fields (EMF) exposure may increase male breast cancer risk has been discussed for a long time. However, arguments have been presented that studies limited by poor quality could have led to statistically significant results by chance or bias. Moreover, data fo the last 10 years have not been systematically summarized. Methods and Results: To confirm any possible association, a meta-analysis was performed by a systematic search strategy. Totals of 7 case-control and 11 cohort studies was identified and pooled ORs with 95% CIs were used as the principal outcome measures. Data from these studies were extracted with a standard meta-analysis procedure and grouped in relation to study design, cut-off point, exposure assessment method, adjustment and exposure model. A statistical significant increased risk of male breast cancer with EMF exposure was defined (pooled ORs = 1.32, 95% CI = 1.14-1.52, P < 0.001), and subgroup analyses also showed similar results. Conclusions: This meta-analysis suggests that EMF exposure may be associated with the increase risk of male breast cancer despite the arguments raised.

전남 신안군 한반도해송숲의 곰솔 수세약화 원인 분석 (Causes of Weakening Tree Vigor of Pinus thunbergii in Hanbando Coastal Forest in Shinangun, Jeollanamdo Province)

  • 김선화;박석곤
    • 한국환경생태학회지
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    • 제35권4호
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    • pp.398-407
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    • 2021
  • 한반도해송숲의 지형환경, 기상조건, 토양 이화학적 성질과 곰솔의 생육상태를 조사해, 이곳 곰솔의 수세약화 원인을 찾아내고자 했다. 곰솔의 수세가 불량하거나 고사한 지역(수세불량지)과 대조구로서 곰솔의 생육상황이 양호한 지역(수세양호지)으로 나눠 조사했다. 그 결과, 수세불량지의 입목밀도는 수세양호지보다 유의적으로 높았지만, 수관폭은 반대로 수세양호지에서 더 넓었다. 고사목 개체수와 입목밀도는 서로 부(-)의 상관관계를 보였고, 또 입목밀도와 흉고직경·수고·수관고(crown height)·수관폭 사이에서는 부(-)의 상관관계를 보였다. 즉, 입목밀도가 높으면 개체의 수관이 겹쳐 하부 가지가 죽어 수관고와 수관폭이 작아졌다. 이에 엽량 감소에 따른 광합성량이 줄어들어 수고와 직경의 생장량이 적어졌다고 본다. 이로 인해 수세가 약해지면서 해안사구라서 수분·양분의 부족과 강한 조풍 등의 환경압이 가중되어 해안가 근처의 곰솔이 대규모로 죽은 것으로 판단된다. 한반도해송숲의 고사목 발생과 수세약화 원인은 복합적이지만, 곰솔 생장에 따른 적정한 입목밀도 관리 부족이라는 내부요인을 제1 요인으로 꼽을 수 있다. 또 곰솔 생육에 불리한 토양조건과 조풍, 강풍 등의 환경압을 제2 요인이라고 볼 수 있다.

Relation between Ki-67, ER, PR, Her2/neu, p21, EGFR, and TOP II-α Expression in Invasive Ductal Breast Cancer Patients and Correlations with Prognosis

  • Yan, Jian;Liu, Xiao-Long;Han, Lu-Zhe;Xiao, Gang;Li, Ning-Lei;Deng, Yi-Nan;Yin, Liang-Chun;Ling, Li-Juan;Yu, Xiao-Yuan;Tan, Can-Liang;Huang, Xiao-Ping;Liu, Li-Xin
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권2호
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    • pp.823-829
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    • 2015
  • The aim of the present study was to investigate the expression of the transcription factor Ki-67, ER, PR, Her2/neu, p21, EGFR, and TOP II-${\alpha}$ in the tumor tissue of patients with invasive ductal carcinoma(IDC); in addition, we examined correlations between these markers. Two hundred and sixteen IDC patients, who were not previously been treated with chemo- or radiotherapy, were included in the study. All tumors were grade I-III. Expression of molecular markers was determined by immunohistochemical analysis on paraffin-embedded tissue sections. Follow-up data were collected for 3 months to 10 years and analyzed for tumor recurrence, survival time, and prognostic risk factors. We determined Ki-67 expression correlates with the expression of ER, PR, HER-2, EGFR, and TOP-${\alpha}$, as well as lymph node involvement, high tumor grade, lymphovascular invasion, high tumor stage, and high TNM stage in IDC. Positive Ki-67 expression was a risk factor for rapid tumor recurrence and may help tumor progression, leading to poor prognosis in IDC. Ki-67 was directly correlated with EGFR, TOP II-${\alpha}$, lymph node involvement, high tumor grade, lymphovascular invasion, high tumor stage, and high TNM stage in the hormone receptor subtypes of breast cancer. In triple negative breast cancer, Ki-67 correlated with TOP II-${\alpha}$. Expression of Ki-67 correlated with that of ER, PR, HER-2, EGFR, TOP II-${\alpha}$, and p21. In addition, the biomarker Ki-67 has a role as a prognostic factor and indicates a poor prognosis in IDC.